RESUMO
PURPOSE: To describe and illustrate the spectrum of magnetic resonance imaging (MRI) findings of tibial stress injuries (TSI) and propose a simplified classification system. MATERIAL AND METHODS: Retrospective analysis of MRI exams of 44 patients with clinical suspicion of unilateral or bilateral TSI, using a modified classification system to evaluate the intensity and location of soft-tissue changes and bone changes. RESULTS: Most of the patients were young athletic men diagnosed in late stage of TSI. Changes were predominantly found in the middle and distal parts of tibias along medial and posterior borders. CONCLUSIONS: TSI may be suspected in young, healthy patients with exertional lower leg pain. MRI is the only diagnostic method to visualise early oedematic signs of TSI. Knowledge of typical locations of TSI can be helpful in proper diagnosis before its evolution to stress fracture.
RESUMO
PURPOSE: Intravesical BCG instillations improve recurrence free survival in patients with non-muscle-invasive bladder cancer (NMIBC). METHODS: This is a national survey study, covering 223 urological centres, aimed at reliable identification of BCG availability and implemented treatment patterns. RESULTS: Response rate was 93.7%. BCG was used in 56.5% of urological departments. Another 22.7% referred patients to other hospitals for instillations, while 20.8% did not recommend BCG at all. The most common indications for BCG instillations were as follows: T1 tumours (88.5%), carcinoma in situ (83.6%) and high grade tumours (73.8%). Maintenance therapy was routinely abandoned in 16.4% of centres or was scheduled for <1 year, 1 year, 3 years and 1-3 years in 6.6%, 19.7%, 21.3% and 31.2% of centres, respectively. Continuation of BCGdespite treatment failure in carcinoma in situ cases was considered in 21.3% of departments. CONCLUSION: Our findings indicate that BCG is underused, while patterns of maintenance and follow-up are suboptimal.