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Mozetic de Barros V, Pacheco RL, Cabrera Martimbianco AL, Mozetic V, Junior SC, Riera R. Definition and reporting of composite outcomes are often inadequate in randomized clinical trials on pharmacological interventions for coronary artery disease. J Clin Epidemiol 2024; 165:111212. [PMID: 37939745 DOI: 10.1016/j.jclinepi.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/25/2023] [Accepted: 11/01/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES To estimate the frequency and critically appraise the use and reporting of composite outcomes in randomized clinical trials on pharmacological interventions for coronary artery disease. STUDY DESIGN AND SETTING A metaresearch study. A search strategy was developed to retrieve references from MEDLINE. We considered articles, published from 1st January 2020, to December 31, 2021, reporting results of clinical primary outcomes from randomized clinical trials which assessed pharmacological interventions, used alone or in combination, for the treatment or secondary prevention (previous coronary event) of coronary artery disease. RESULTS From the 34 included studies, 28 (82.35%) had a primary composite outcome. Thirteen unique composite primary outcomes were used with the most frequent being "cardiovascular death, myocardial infarction, stroke" (12/28, 42.86%). The term major adverse cardiac events was used for five distinct composite primary outcomes. A combination of 12 different components resulted in the 28 primary composite outcomes, with stroke being the most frequent component present in 96.43% (27/28) of the primary composite outcomes. From the included studies, 60.71% (17/28) reported the estimates for each individual component and the direction of the effect was consistent between all components and the composite outcomes in 58.82% (10/17) of them. Additionally, no included study discussed potential limitations and/or related advantages of the composite outcomes. CONCLUSION In randomized clinical trials on pharmacological interventions for coronary artery disease, composite outcomes are frequently used, but the definition of their components is very heterogeneous. The estimate for individual components within the composite outcome is often not fully reported, which prevents a complete analysis of their adequacy for clinical practice. The term major adverse cardiac events was used inconsistently and to refer to different set of components, which can also be misleading and confusing.
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Affiliation(s)
- Valéria Mozetic de Barros
- Cardiologist at Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, São Paulo, Brazil
| | - Rafael Leite Pacheco
- Researcher at Núcleo de Avaliação de Tecnologias em Saúde, Hospital Sírio-Libanês (HSL), São Paulo, São Paulo, Brazil; Professor at Department of Medicine, Centro Universitário São Camilo (CUSC), São Paulo, São Paulo, Brazil; Pesquisador, Disciplina de Economia e Gestão em Saúde, Universidade Federal de São Paulo (Unifesp), São Paulo, São Paulo, Brazil.
| | - Ana Luiza Cabrera Martimbianco
- Researcher at Núcleo de Avaliação de Tecnologias em Saúde, Hospital Sírio-Libanês (HSL), São Paulo, São Paulo, Brazil; Professor at Postgraduate Program in Health and Environment, Universidade Metropolitana de Santos (Unimes), São Paulo, São Paulo, Brazil
| | - Vânia Mozetic
- Ophthalmologist, Instituto Dante Pazzanese de Cardiologia, São Paulo, São Paulo, Brazil
| | - Sebastião Castilho Junior
- Medical student at Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
| | - Rachel Riera
- Research coordinator at Núcleo de Avaliação de Tecnologias em Saúde, Hospital Sírio-Libanês (HSL), São Paulo, São Paulo, Brazil; Professor at Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, São Paulo, Brazil
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Mozetic V, Santos NFDC, Itikawa ACY, Morais NSBD. Overview of Cochrane systematic review about retinal detachment. RBOF 2021. [DOI: 10.5935/0034-7280.20210029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Mozetic V, Cruz MFSD, Cruz NFSD, Polizelli MU, Moraes NSBD. Analysis of Cochrane Systematic Reviews about retinopathy of prematurity. Revista Brasileira de Oftalmologia 2021. [DOI: 10.5935/0034-7280.20210008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Mozetic V, Leonel L, Leite Pacheco R, de Oliveira Cruz Latorraca C, Guimarães T, Logullo P, Riera R. Reporting quality and adherence of randomized controlled trials about statins and/or fibrates for diabetic retinopathy to the CONSORT checklist. Trials 2019; 20:729. [PMID: 31842982 PMCID: PMC6916100 DOI: 10.1186/s13063-019-3868-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 10/31/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND A considerable amount of randomized controlled trials (RCTs) have been published on statins and/or fibrates for diabetic retinopathy, a clinical condition associated with high social and economic burden. Adherence to the CONSORT statement items is imperative to ensure transparency and reproducibility in clinical research. The aim of this study is to assess the reporting quality and the adherence to CONSORT of RCTs assessing statins and/or fibrates for diabetic retinopathy. METHODS We conducted a critical appraisal study at Discipline of Evidence-based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp). A sensitive literature search was performed to identify all relevant RCTs, with no time or language limits. Two authors independently evaluated the reporting quality of the selected RCTs using the CONSORT statement as a standard. RESULTS Thirteen reports of RCTs were included in this study. The adherence of the reports to CONSORT items ranged from 24% to 68%. The median score was 11 (interquartile range (IQR) 8 to 13). When analyzed separately, the methods sections of the reports had a median of three items (IQR 2 to 4) judged adherent to the methods items of CONSORT (items 3 to 12). The most underreported items were those related to trial design, title and abstract, allocation concealment, implementation of the randomization sequence, and blinding. Other important items, such as the one related to the description of the inclusion criteria, also had low adherence. CONCLUSIONS The overall adherence to the CONSORT checklist items was poor, especially in the items related to the methods section. RCT reports on statins and/or fibrates for diabetic retinopathy must be optimized to avoid reporting biases and to improve transparency and reproducibility.
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Affiliation(s)
- Vânia Mozetic
- Ophthalmologist of Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
| | - Letícia Leonel
- Discipline of Evidence-Based Medicine, Universidade Federal de São Paulo (Unifesp), São Paulo, Brasil
| | - Rafael Leite Pacheco
- Discipline of Evidence-Based Medicine, Universidade Federal de São Paulo (Unifesp), São Paulo, Brasil
- Centro Universitário São Camilo, São Paulo, Brazil
| | | | - Taís Guimarães
- Discipline of Evidence-Based Medicine, Universidade Federal de São Paulo (Unifesp), São Paulo, Brasil
| | | | - Rachel Riera
- Discipline of Evidence-Based Medicine, Universidade Federal de São Paulo (Unifesp), São Paulo, Brasil
- Centre of Health Technology Assessment, Hospital Sírio-Libanês, São Paulo, Brazil
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Mozetic V, Pacheco RL, Latorraca CDOC, Riera R. Statins and/or fibrates for diabetic retinopathy: a systematic review and meta-analysis. Diabetol Metab Syndr 2019; 11:92. [PMID: 31719846 PMCID: PMC6839185 DOI: 10.1186/s13098-019-0488-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/28/2019] [Indexed: 02/06/2023] Open
Abstract
Evidence from observational studies have found a relationship between serum cholesterol and diabetic retinopathy (DR). Apart of the assumption that cholesterolemic control has benefits for patients with diabetes with or without retinopathy, the effects of lipid-lowering drugs have not been properly mapped and critically assessed so far. The objective of this study was to evaluate the effects of statins and/or fibrates on prevention and progression of DR. We conducted a Systematic review of randomized controlled trials (RCTs) following the Cochrane Handbook for Systematic Reviews of Interventions and reported in accordance to PRISMA Statement. GRADE approach was used to summarize the certainty of the evidence. Eight RCTs that fulfilled our eligibility criteria were included, assessing the effects of fibrates (n = 4), statins (n = 3) and fibrate plus statins (n = 1) for therapy (n = 8) or prevention (n = 4) of DR. Overall, the main concern regarding risk of bias assessment was due to incomplete outcome data because high rate of losses in five RCTs. Furthermore, the risk of reporting bias was rated unclear due the lack of previously published protocol in seven RCTs. Fibrates seemed to be associated with a 45% risk reduction of macular edema incidence (Relative Risk 0.55, 95% confidence interval of 0.38 to 0.81, 1309 participants, 2 RCTs, I2 = 0%, low certainty of the evidence). The certainty of evidence for other outcomes was also very low or low, and we are uncertain regarding the effects of fibrates for DR. Overall, adverse events seemed to be similar between fibrate and placebo, but again based on the width of the confidence intervals, an important increase of adverse events cannot be rule out. The combination statin/fibrate did not seem to have benefit for visual acuity but is likely that further studies can modify this estimate since the current evidence is limited. Adverse events and quality of life were not measured or reported. Concluding, this study found eight RCTs, with limited methodological quality, that assessed the effects of fibrates and/or statins for DR. Based on these findings, we are uncertain about the effects of statins for DR. Fibrates seemed to reduce the incidence of macular edema (low certainty evidence) without increase adverse events (low to very low certainty evidence). Number of Protocol registration PROSPERO CRD42016029746.
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Affiliation(s)
- Vânia Mozetic
- Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
- Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil
| | - Rafael Leite Pacheco
- Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
- Centro de Pesquisa Médica, Centro Universitário São Camilo, São Paulo, Brazil
| | - Carolina de Oliveira Cruz Latorraca
- Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
- Centro de Pesquisa Médica, Centro Universitário São Camilo, São Paulo, Brazil
| | - Rachel Riera
- Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
- Center of Health Technology Assessment, Hospital Sirio-Libanês, São Paulo, Brazil
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Ahel J, Dordevic G, Markic D, Mozetic V, Spanjol J, Grahovac B, Stifter S. Nuclear EGFR characterize still controlled proliferation retained in better differentiated clear cell RCC. Med Hypotheses 2015; 85:183-5. [PMID: 25959864 DOI: 10.1016/j.mehy.2015.04.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 04/25/2015] [Indexed: 11/30/2022]
Abstract
Renal cell carcinoma (RCC) is the most common solid kidney tumor representing 2-3% of all cancers, with the highest frequency occurring in Western countries. There was a worldwide and European annual increase in incidence of approximately 2% although incidence has been stabilized in last few years. One third of the patients already have metastases in the time of the diagnosis with poor prognosis because RCC are radio and chemoresistant. The prognostic value of EGFR over-expression in RCC is a controversial issue that could be explained by different histological types of study tumors and non-standardized criteria for evaluation of expression. Recent evidences points to a new mode of EGFR signaling pathway in which activated EGFR undergoes nuclear translocalization and then, as transcription factor, mediates gene expression and other cellular events required for highly proliferating activities. According to our observations, the membranous expression of EGFR associates with high nuclear grade and poor differentiated tumors. On the other hand, nuclear EGFR expression was high in low nuclear graded and well differentiated tumors with good prognosis. We hypothesize that this mode of EGFR signaling characterizes still controlled proliferation retained in well differentiated RCC with Furhman nuclear grade I or II.
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Affiliation(s)
- J Ahel
- Department of Urology, Clinical Hospital Centre Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
| | - G Dordevic
- Department of Pathology, School of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia.
| | - D Markic
- Department of Urology, Clinical Hospital Centre Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
| | - V Mozetic
- Medico Polyclinic, Agatićeva 8, 51000 Rijeka, Croatia
| | - J Spanjol
- Department of Urology, Clinical Hospital Centre Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
| | - B Grahovac
- Department of Pathology, School of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia
| | - S Stifter
- Department of Pathology, School of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia
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Maricić A, Dordević G, Petranović D, Pavlović-Ruzić I, Orlić P, Mozetic V, Valencić M. [Carcinoma of the Bellini duct with an unusual clinical picture]. Aktuelle Urol 2004; 35:134-6. [PMID: 15146378 DOI: 10.1055/s-2004-818366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
A 37-year-old male patient presented with a Bellini duct carcinoma, at first as a metastatic illness of the paraaortal lymph nodes, without significant radiologic signs of a kidney tumor. Cytological diagnostics did not recognize this tumor. Macroscopically and microscopically the tumor fulfilled the major and minor criteria of Sringly et al., but immunohistochemical findings did not show cell affinity for UEA-1, which, according to the literature, typically confirms its origin from Bellini ducts. This rare neoplasm, primarily found in a younger population, still represents a diagnostic and therapeutical challenge as a result of its aggressive clinical course. In our patient, as in the majority of cases presented in the literature, tumor prognosis was very poor, in spite of aggressive surgical, radium and immune therapy.
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Affiliation(s)
- A Maricić
- Klinik für Chirurgie, Abteilung für Urologie, Klinisches Krankenhaus-Zentrum, Rijeka, Kroatien
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Orlic P, Vukas D, Drescik I, Ivancic A, Blecic G, Budiselic B, Velcic G, Maricic A, Oguic R, Mozetic V, Valencic M, Sotosek S, Vukas D. Vascular complications after 725 kidney transplantations during 3 decades. Transplant Proc 2003; 35:1381-4. [PMID: 12826165 DOI: 10.1016/s0041-1345(03)00506-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Among 725 renal transplantations, the most common vascular complication was arterial stenosis, which was observed in 23 patients (3.17%). The majority of 20 (6.49%) arterial stenoses appeared in our initial experiences when we routinely used end-to-end renal graft to internal iliac artery anastomoses. A significant reduction in this incidence (0.72%) was achieved by introducing end-to-side anastomoses of the renal graft artery to the external or common iliac arteries. Intractable hypertension or impaired renal function in 14 patients (60.87%) with arterial stenosis demanded treatment. Patch angioplasty was more successful than other methods. The limited possibilities of conservative treatment of arterial hypertension at that time were the main reason for this frequent surgical repair. Among other vascular complications, the most serious were 12 episodes of arterial bleeding in 10 patients. Five kidneys were lost because of ruptured arterial anastomoses. In 6 patients, the common or external iliac artery was ligated as to achieve hemostasis with acute arterial insufficiency of the lower extremity in 4 patients. One patient required leg amputation, whereas 2 underwent extra-anatomic bypass procedures and 1 died because of hepatic failure. The majority of vascular complications occurred in the initial period of our transplantation practice. However, in spite of progress in diagnostic and treatment options, vascular complications may cause considerable clinical problems.
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Affiliation(s)
- P Orlic
- Department of Surgery, Clinical Hospital Center, Medical University School, Rijeka, Croatia
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Orlic P, Zelic M, Petrosic N, Maricic A, Zambelli M, Bacic I, Mozetic V, Fucak M, Marjanovic J, Matanic-Manestar M, Padovan M, Zagar D, Fucak M, Romcevic M. Use of non-heart-beating donors: preliminary experience with perfusion in situ. Transplant Proc 1999; 31:2097-8. [PMID: 10455981 DOI: 10.1016/s0041-1345(99)00274-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- P Orlic
- Clinical Hospital Center Rijeka, Croatia
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Miletić D, Fuckar Z, Mraović B, Dimec D, Mozetic V. Ultrasonography in the evaluation of hemoperitoneum in war casualties. Mil Med 1999; 164:600-2. [PMID: 10459274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
Abstract
The aim of this study was to evaluate the sensitivity, specificity, accuracy, and positive and negative predictive values of emergent ultrasound examination in the detection of hemoperitoneum among war casualties, and to compare the results of this method in a specific war situation and civil conditions. Ninety-four wounded individuals with suspected blunt or penetrating abdominal trauma were treated at a level I war hospital (group W), and 242 civilians with multiple injuries with suspected blunt abdominal trauma were evaluated at the emergency center of a university hospital (group C). All examinations were performed in less than 5 minutes with a portable ultrasonographic scanner, and typical points were scanned (Morison's pouch, Douglas and perisplenic spaces, paracolic gutter). In group W, hemoperitoneum was identified correctly in 19 patients, with three false-negative and no false-positive findings, whereas group C presented 98 true-positive results, 13 false-negative results, and again no false-positive results. We observed that ultrasonography in specific war conditions showed sensitivity of 86%, specificity of 100%, accuracy as high as 97%, positive predictive value of 100%, and negative predictive value of 96%, whereas in civil conditions the corresponding values were 88%, 100%, 95%, 100%, and 91%, respectively. The sensitivity, specificity, accuracy, and positive and negative predictive values of emergent ultrasound examination in the diagnosis of hemoperitoneum are approximately equal in war and civil conditions.
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Affiliation(s)
- D Miletić
- Department of Anesthesiology, University Hospital Rijeka, Croatia
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Abstract
PURPOSE The aim of this study was to evaluate kidney length in patients with postoperative acute renal failure (PARF). METHODS The effect of PARF on renal size was prospectively studied in 76 patients with PARF and 40 healthy volunteers. Sonographic measurements of kidney length and the level of serum creatinine were obtained each day patients stayed in our surgical intensive care unit. These measurements were done once in volunteers. All study subjects were divided into groups on the basis of age, those younger than 65 years and those 65 years or older. Statistical analyses on the relation of renal size, age, and degree of PARF used the kidney length:body height ratio (KBR) and the peak serum creatinine level. Follow-up kidney length and creatinine measurements were done in 24 patients 1-5 years after they recovered from PARF. RESULTS Regardless of age, mean KBRs were significantly greater in patients than in healthy volunteers (< 65 years, p < 0.001; > or = 65 years, p = 0.008), with a negative correlation between KBR and patient age (r = -0.664; p < 0.001). A positive correlation was found between the KBR and the peak serum creatinine level in patients younger than 65 years (r = 0.543; p < 0.001); an insignificant negative correlation was found between these factors in patients 65 years or older (r = -0.264; p = 0.1). Follow-up on recovered patients showed that their KBRs were significantly lower than the values when patients had PARF (< 65 years, p < 0.001; > or = 65 years, p = 0.027). CONCLUSIONS PARF produces a sonographically measurable increase in renal size.
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Affiliation(s)
- A Sustić
- Department of Anesthesiology, Clinical Hospital Rijeka, Kresimirova, Croatia
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Abstract
PURPOSE The aim of this study was to evaluate sonographically measured absolute and relative lengths of normal kidneys according to subject height, sex, and age. METHODS Real-time sonography was performed on 202 subjects. Measurements of longitudinal renal diameter represented absolute renal length. Relative renal length was calculated using the kidney length: body height ratio (KBR). RESULTS Statistical analyses were done on findings in 175 subjects without renal impairment (104 men and 71 women) whose ages ranged from 17 to 85 years (mean +/- SD, 46.3 +/- 17.1). The mean heights of the subjects were 176 +/- 7 cm for men and 167 +/- 6 cm for women. The left kidney was absolutely (mean +/-SD, 112 +/- 9 mm) and relatively (mean KBR +/- SD, 0.655 +/- 0.042) longer than the right kidney (absolute length, 110 +/- 8 mm; KBR, 0.641 +/- 0.038), regardless of sex (p < 0.01). The absolute renal length was significantly greater in men than in women for both kidneys (p < 0.01), but there was no significant difference between KBRs (p > 0.05). Renal length decreased with age, and the rate of decrease seemed to accelerate at 60 years and older. When height and age were included in the multivariate regression analysis, sex was not a significant predictor of kidney length. CONCLUSIONS Relative renal length better represents kidney size than absolute renal length because it eliminates sex and height differences.
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Affiliation(s)
- D Miletić
- Department of Radiology, Clinical Hospital Rijeka, Croatia
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Abstract
PURPOSE The aim of this study was to evaluate the reliability of Doppler waveform alterations in diagnosing acute unilateral renal obstruction. METHODS From December 1993 to January 1996, 54 patients with unilateral renal obstruction were prospectively examined by conventional and duplex Doppler sonography. Seventy-eight patients with nonrenal abdominal problems comprised the control group. Doppler signals were obtained from interlobar arteries and arcuate arteries at the corticomedullary junction. From the waveform analysis, we calculated resistance (RI) and pulsatility (PI) indices. We also used the differences in RI and PI between the 2 kidneys in the same examinee (delta RI and delta PI) for further statistical analysis. RESULTS The mean RI and PI (+/- standard deviation) in the patients without renal impairment were 0.64 +/- 0.04 and 1.14 +/- 0.14, respectively. The mean delta RI and delta PI were 0.02 +/- 0.01 and 0.07 +/- 0.05, respectively. Both the RI and PI were significantly correlated with age (r = 0.74 and 0.69, respectively; p < 0.01). Acute renal obstruction significantly (p < 0.01) elevated the mean RI (0.72 +/- 0.04), delta RI (0.09 +/- 0.04), PI (1.42 +/- 0.17), and delta PI (0.33 +/- 0.18). Significant decreases in RI and delta RI were noted after relief of the obstruction. The best accuracy in diagnosing acute unilateral renal obstruction was achieved with the combination of delta RI > or = 0.06 and/or delta PI > or = 0.20, which had a sensitivity of 94% and specificity of 99%. CONCLUSIONS Renal Doppler indices are reliable parameters in the sonographic diagnosis of acute unilateral obstructive uropathy.
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Affiliation(s)
- D Miletić
- Department of Radiology, Clinical Hospital Rijeka, Croatia
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Orlić P, Dimec D, Mozetic V, Vukas D, Racki S, Madzar Z, Orlić L, Matić-Glazar D, Grzetić M, Razmilić D. Living kidney donor with splenic artery aneurysm. Transplant Proc 1996; 28:368. [PMID: 8644267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- P Orlić
- Kidney Transplant Center, Clinical Hospital Center, Rijeka, Croatia
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Abstract
We report the case of a 41 year-old male who came to the emergency room with a complaint of abdominal pain, and was diagnosed to have an acute obstructive abdomen due to a right inguinal hernia incarceration. During surgery, an intestinal granulomatous inflammation was observed adhered to the hernial sac. The histopathologic study confirmed the diagnosis of tuberculosis. We present a review of the different clinical forms of intestinal tuberculosis and the difficulties encountered in the differential diagnosis of such, emphasizing the uncommon presentation described in our patient.
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Affiliation(s)
- M Faccin
- College of Medicine of the University Foundation of ABC (UFABC), São Paulo, Brazil
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