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Biomedical subjects

A C Winfield

Publications and source records attributed to A C Winfield.

At least 37 records · Page 2Linked to original sources
PubMed1986

Response of patients to informed consent for excretory urography.

The desirability of obtaining written informed consent for low-risk radiologic procedures has been the subject of controversy. A group of 80 patients was studied to evaluate the effect of informed consent for excretory urograms on: (1) incidence of contrast reactions; (2) discomfort during the procedure; (3) level of patients' anxiety before and after the procedure; (4) patients' perception of the procedure; and (5) desirability of informed consent from the patients' viewpoint. Results revealed no statistically significant difference between the 2 groups in the incidence of reactions, discomfort, perception of the examination, or anxiety level prior to the procedure. The informed consent group had a statistically greater factual knowledge of the procedure evaluated objectively (P less than 0.01). Of the patients who received the written consent form, 83% regarded it as helpful and none viewed it as harmful or refused the examination. In the control group, 32% desired more information.

Adult↗
PubMed1986

Ureteral abnormalities in women with endometriosis.

High-volume intravenous urography was performed in 63 women with surgically proven endometriosis. Subtle abnormalities were found in 15.9% of these women. No patient had urologic symptoms, and there was no evidence of hydroureter or ureteral obstruction on the IVP. Long-term follow-up study will be required to determine whether or not these lesions will progress and cause ureteral obstruction.

Adult↗
PubMed1986

Observer variation in quantitative assessment of rheumatoid arthritis. Part I. Scoring erosions and joint space narrowing.

Six observers, including two bone and joint radiologists, two general radiologists, and two senior radiology residents, compared scores to quantitate radiographic findings in the hands and wrists of patients with rheumatoid arthritis. In the scoring system used, erosions and joint-space narrowing are graded separately. This scoring system differs from other methods in that equivocal findings are not scored, while ankylosis, subluxation, and dislocation are scored, and data from postoperative joints are included. Total radiographic scores were highly significantly correlated for all observers (R = .908-.958, P less than .001), as were subtotal scores for erosions (R = .723-.931, P less than .001) and joint-space narrowing (R = 0.843-0.966, P less than .001). Analysis of proximal interphalangeal, metacarpophalangeal, and wrist-joint scores showed highly significant correlations for all observers in each location. Highly significant correlations were found among three separate readings of two bone and joint radiologists (R = .950-.961, P less than .001). This scoring system provides highly consistent and reproducible results, even in the hands of less experienced observers.

Analysis of Variance↗
PubMed1986

Angiomyolipomas in tuberous sclerosis: subselective embolotherapy with alcohol, with long-term follow-up study.

The use of subselective renal artery embolotherapy with absolute alcohol, using balloon occlusion to prevent backflow, is described in treating three hemorrhaging angiomyolipomas in two patients with tuberous sclerosis. Embolotherapy was chosen to treat the extensive hemorrhage and to spare the normal renal parenchyma. Literature reports of this treatment are reviewed, indicating it is one of the best methods for achieving a safe, permanent, and complete ablation.

Adolescent↗
PubMed1985

Vicarious excretion of contrast medium in patients without azotemia.

Although excretion of urographic iodinated contrast agents via the biliary and gastrointestinal tract is not uncommon in patients with renal insufficiency, such vicarious excretion is unusual in the presence of normal renal function. The observation of such vicarious excretion in 2 patients with acute unilateral ureteral obstruction and no azotemia is reported in conjunction with review of the appropriate literature and suggestion of possible etiologies.

Adult↗
PubMed1985

Breast sonotomography and high-frequency, hand-held, real-time sonography: a clinical comparison.

The diagnostic quality of breast sonography as performed with a dedicated tomographic unit (ST) and a hand-held, high-frequency, real-time transducer (RT) was evaluated in 76 patients. In 38 per cent of cases, ST was found to be of equal diagnostic quality to RT. The number of instances in which ST was judged to be better than RT was slightly greater than those in which RT was considered better than ST (34 vs. 24 per cent) (P less than or equal to 0.10). In 3 per cent of cases, the diagnostic quality of both ST or RT was considered to be poor. The majority of instances when the diagnostic quality of ST was judged to be better than RT occurred in establishing a negative diagnosis, whereas RT seemed to have greater diagnostic quality than ST in the evaluation of a palpable mass.

Adult↗
PubMed1984

Advantages of nonionic contrast agents in adult urography.

Nonionic radiographic contrast agents have a reported advantage of decreased contrast osmolality. Before clinical significance can be attributed to this lower osmolality, an observed difference must be documented. In a randomized double-blind study with 55 patients, Iohexol, a new nonionic contrast agent, is compared with Renografin 60 for use in adult urography. Hemodynamic parameters, serum and urine chemistries, including osmolality, were recorded before and after contrast injection. Radiographic quality and adverse reactions were recorded. This study focused on the change in urine osmolality (delta Osm) from pre- and post-injection urine specimens. The group receiving nonionic contrast agents had an average delta Osm of 65 mOsm/L while those receiving the ionic agent had an average delta Osm of 120 mOsm/L. This significant difference in urine osmolality is discussed with respect to the observed advantage in radiographic quality and the lower incidence of adverse reactions noted in the group receiving nonionic contrast material.

Adolescent↗
PubMed1984

Evaluation of renal masses by MR imaging.

Magnetic resonance (MR) imaging was performed in 20 subjects, 10 of whom had benign or malignant renal masses, and 10 were normal volunteers. The purpose of the study was to evaluate the ability of MR to provide significant diagnostic information in the management of renal mass lesions. Ten normal patients were included to supply baseline data. Different pulse sequences were used and their contribution to the diagnosis was evaluated. The emphasis has been placed on evaluating MR against the pathological diagnosis rather than other imaging modalities.

Adenocarcinoma↗
PubMed1984

Percutaneous nephrostomy in neonates, infants, and children.

In a 20-month period, 13 percutaneous nephrostomies were placed in 10 pediatric patients ranging in age from one day to six and one-half years. The procedure was successful in all cases with no significant complications. Final diagnoses included ureteropelvic junction obstruction, ureterovesical junction obstruction, posterior urethral valves, and pyonephrosis. Localization of the obstruction as detected on initial antegrade nephrostography was found to be incomplete or incorrect in three patients. In one patient, both ureteropelvic and ureterovesical junction obstruction were present. In the other two patients, the misdiagnosis probably related to the difficulty of filling a distended, obstructed ureter prior to drainage.

Age Factors↗
PubMed1984

Hexabrix as a contrast agent for hysterosalpingography.

Hexabrix, a monoacidic dimeric iodinated contrast material, was compared with Renografin 60 (diatrizoate meglumine) for safety, tolerance, and efficacy in hysterosalpingography, in a double blind study of 52 patients. No serious adverse reactions were noted in either group of patients. Discomfort during and after the procedure was not statistically different in the two groups. No difference in radiographic quality was seen. It was concluded that Hexabrix, despite reduced osmolality and increased viscosity, offers no significant benefit over Renografin 60, but it is a safe and acceptable contrast agent for hysterosalpingography.

Contrast Media↗
PubMed1984

Current perspectives on medical imaging.

Advances in biomedical technology have expanded the potential of medical imaging. Selected aspects of developments in sonography, nuclear medicine, nuclear magnetic resonance and digital imaging are addressed, stressing the wide scope permitted by these newer modalities.

Angiography↗
PubMed1983

Prevention of acute pelvic inflammatory disease after hysterosalpingography: efficacy of doxycycline prophylaxis.

In an attempt to minimize the infectious morbidity of hysterosalpingography, the efficacy of oral doxycycline prophylaxis was examined. The records and hysterosalpingograms of 278 consecutive women (group 1) were reviewed to correlate the radiologic findings and the development of acute pelvic inflammatory disease (PID) after hysterosalpingography. Four women (1.4%) developed PID and all four had tubal dilatation. The overall frequency of PID in women with dilated tubes was 4/35 (11%). Subsequently, 56 of 326 women (group 2) with tubal dilatation received oral doxycycline prophylaxis. No cases of PID were observed in the 56 women who had antibiotic prophylaxis (p less than 0.02) or in group 2 as a whole. The study suggests that the risk of infection after hysterosalpingography is very low when nondilated tubes are present (0/398 women of groups 1 and 2). The relative risk of PID in women with peritubal disease or proximal tubal occlusion, although apparently low, remains to be determined. Furthermore, in the highest-risk group of women with dilated tubes, doxycycline prophylaxis was effective in reducing infection after hysterosalpingography.

Doxycycline↗
PubMed1983

Practical experience with percutaneous nephrostomy: avoidance of common technical pitfalls.

In our 18-month experience with percutaneous nephrostomy (PCN) at Vanderbilt University Hospital and Veterans Administration Hospital (Nashville), a total of 47 PCNs were attempted with a success rate of 96%. The procedure is rapid, offers low morbidity, and has been readily accepted. Some variations of the standard procedure to avoid common technical difficulties include (1) using a combination of real-time ultrasonography and fluoroscopy as a guidance system, (2) maintaining the position of the Chiba needle during the entire procedure, (3) choosing the optimal puncture site, and (4) exercising care in tract dilatation.

Adolescent↗