Can ureteral wall thickness (UWT) be used as a potential parameter for decision-making in uncomplicated distal ureteral stones 5-10 mm in size? A prospective study.

OBJECTIVE: To evaluate the correlation between ureteral wall thickness (UWT) and stone passage (SP) and its cut-off value in distal uncomplicated ureteral stones. PATIENTS AND METHODS: In the prospective study from January 2019 to January 2020 at a tertiary care hospital, we reviewed 212 patients aged above 18 years with single, symptomatic, radiopaque, and distal ureteric stone sized 5-10 mm, who were treated with MET (Silodosin 8 mg once daily) until SP or a maximum of 4 weeks. There were 2 groups: responders and non-responders. Demographic data of the patients and all stone radiological parameters including stone size, laterality, density, UWT, the diameter of the ureter proximal to the stone (PUD), and the degree of hydronephrosis were recorded and compared between the 2 groups. RESULTS: There were 126 (59.4%) in the responder group and 86 (40.6%) in the non-responder group. On univariate analysis, gender, stone density, stone size, PUD, UWT, and the degree of hydronephrosis were significant factors for stone passage. However, using multivariate analysis, only UWT and the degree of hydronephrosis were significant. ROC analysis showed that 3.75 mm is the cut-off value for UWT, with 86% and 87.3% sensitivity and specificity, respectively. CONCLUSIONS: UWT and hydronephrosis can be used as potential predictors for SP and can help with decision-making in patients with uncomplicated 5-10 mm lower ureteric stones.

Role of ultrasonography in assessment of anatomic upper airway changes in patients with obstructive sleep apnea.

Instroduction: Obstructive sleep apnea is a common disorder, characterized by recurrent narrowing and closure of the upper airway accompanied by intermittent oxyhemoglobin desaturation and sympathetic activation. Ultrasound imaging of the airways has advantages of being safe, quick, repeatable, portable and widely available. Airway ultrasound can visualize and assess the mouth and tongue, oropharynx, hypopharynx, epiglottis, larynx, vocal cords, cricothyroid membrane, cricoid cartilage, trachea, and cervical esophagus. MATERIAL AND METHODS: This study assessed the role of ultrasonography in detecting the level and degree of obstruction of airway passages in patients with obstructive sleep apnea (OSA) and its relation to OSA severity. It included thirty-three patients diagnosed as OSA, and ten healthy subjects as a control group. All participants were ≥ 18 years and were subjected to full medical history, Epworth sleepiness score (ESS), thorough clinical examination, complete overnight polysomnography and neck ultrasonography. RESULTS: Ultrasonography findings showed a statistically significant increase in lateral parapharyngeal wall thickness (LPWT) (P < 0.001) and a significant increase in distance between lingual arteries (DLA) (P < 0.01) among OSA patients. Moreover, there was a significant statistical decrease in the retropalatal pharynx transverse diameter (RPD) (P < 0.05) in the OSA group compared to those without OSA. LPWT and DLA are parameters that can be used to predict the severity of OSA. Combination of LPWT and RPD can achieve a 100% sensitivity and specificity. CONCLUSIONS: Ultrasound is more objective and convenient than the questionnaire because it doesn't require overnight time consumption. It is also more relevant than pulse oximetry for examining pharyngeal airspace. Also, this study demonstrated that submental ultrasonography is sufficiently sensitive for differentiating OSA severity.

Neurotensin receptor binding abnormalities in the entorhinal cortex in schizophrenia and affective disorders.

BACKGROUND: Convergent evidence from in vivo and in vitro studies of schizophrenia have implicated the mesial temporal lobe as a primary site of pathological change in this disorder. We have previously reported decreased neurotensin receptor density in layer II of the intermediate entorhinal cortex (ERC) in schizophrenia, a finding seen elsewhere but not seen in more caudal ERC. METHODS: To study neuroanatomic and diagnostic specificity, we measured the density of neurotensin receptors in the intermediate and caudal ERC and hippocampal formation of schizophrenic, affective disorder control subjects, and normal control subjects. Slide-based radioligand binding was used to perform these studies. RESULTS: Not only schizophrenic but also affective disorder subjects had decreased neurotensin receptor density in layer II of the intermediate ERC. Affective disorder subjects had significantly decreased neurotensin receptor density in layers V/VI of the intermediate ERC, and schizophrenic subjects trended in the same direction. CONCLUSIONS: These findings demonstrate region-specific changes in neurotensin receptor binding levels in the mesial temporal lobe; however, there is no clear diagnostic specificity for these changes, because they were seen to varying degrees in both schizophrenia and affective disorders.