Strict Indications Research Articles

Computed Tomography in Limb Salvage and Deformity Correction-3D Assessment, Indications, Radiation Exposure, and Safety Considerations.

Computed tomography (CT) is an essential tool in orthopedic surgery but is known to be a method with that entails radiation exposure. CT increases the risk of developing fatal cancer, which should not be underestimated. However, patients with bone defects and/or deformities must frequently undergo numerous investigations during their treatment. CT is used for surgical planning, evaluating callus maturation, alignment measurement, length measurement, torsion measurement, and angiography. This study explores the indications in CT scans for limb lengthening and deformity correction and estimates the effective radiation dose. These results should help avoid unnecessary radiation exposure by narrowing the examination field and by providing explicit scanning indications. For this study, 19 posttraumatic patients were included after the bone reconstruction of 21 lower limbs. All patients underwent CT examinations during or after treatment with an external ring fixator. The mean effective dose was 3.27 mSv, with a mean cancer risk of 1:117,014. The effective dose depended on the location and indication of measurement, with a mean dose of 0.04 mSv at the ankle up to 6.8 mSv (or higher) for vascular depictions. CT evaluation, with or without 3D reconstruction, is a crucial tool in complex bone reconstruction and deformity treatments. Therefore, strict indications are necessary to reduce radiation exposure—especially in young patients—without compromising the management of their patients.

Analysis of the Thermal Decomposition Products of Pathological and Healthy Tissues in Paranasal Sinuses: A High-Resolution Terahertz Gas Spectroscopy Study

We present the novel results of studying tissue metabolites of the ear-nose-throat organs (pathological and relatively healthy mucosal tissues) during heating and thermal exposure using gas spectrometers of the terahertz (THz) frequency range based on non-stationary effects. Tissue metabolites of the ear-nose-throat organs obtained during surgery according to strict medical indications have been studied for the first time in the world. All the tissues used in the samples were histological verified for confirming the morphological diagnosis. For obtaining a unified picture, chemical compounds appearing during thermal decomposition of pathological and relatively healthy tissues were identified using the spectroscopic approach, with mandatory histological verification of the samples. The obtained results demonstrate that a powerful research tool has been proposed for evaluation of metabolites in otorhinolaryngology with detection of diseases markers.

Safety and survival of docetaxel and cabazitaxel in metastatic castration-resistant prostate cancer.

To investigate real-world haematological toxicity, overall survival (OS) and the treatment characteristics of docetaxel and cabazitaxel chemotherapy in metastatic castration-resistant prostate cancer (mCRPC). This retrospective claims data study followed patients with mCRPC receiving cabazitaxel or docetaxel from their first chemotherapy infusion. Haematological toxicities were measured using treatment codes and inpatient diagnoses. OS was estimated using the Kaplan-Meier method. A multivariable Cox regression analysis was used to identify OS predictors. Data from 539 patients administered docetaxel and 240 administered cabazitaxel were analysed. Regarding adverse events, within 8 months of treatment initiation, some kind of treatment for haematological toxicity was documented in 31% of patients given docetaxel and in 61% of patients given cabazitaxel. In the same period, hospitalization associated with haematological toxicity was documented in 11% of the patients in the docetaxel cohort and in 15% of the patients in the cabazitaxel cohort. In the docetaxel cohort, 9.9% of patients required reverse isolation and 13% were diagnosed with sepsis during hospitalization. In the cabazitaxel cohort, the cumulative incidence was 7.9% and 15%, respectively. The median OS was reached at 21.9 months in the docetaxel cohort and, because of a later line of therapy, at 11.3 months in the cabazitaxel cohort. A multivariate Cox regression revealed that indicators of locally advanced and metastatic disease, severe comorbidities, and prior hormonal/cytotoxic therapies were independent predictors of early death. Cabazitaxel patients face an increased risk of haematological toxicities during treatment. Together with their short survival time, this calls for a strict indication when using cabazitaxel in patients with mCRPC.

Emergency STA-MCA bypass surgery for symptomatic progressive ischemic stroke

BackgroundIntravascular acute thrombectomy is recommended for acute cerebral infarction within 8 h of onset, based on several randomized controlled trials. However, standard treatment for cases outside these indications has not been established. ObjectiveEmergent superficial temporal artery (STA)-middle cerebral artery (MCA) bypass was performed within 72 h of onset for non-cardiogenic cerebral artery occlusive disease and the surgical outcomes are discussed. MethodsRetrospective review of 18 consecutive patients with non-cardiac cerebrovascular occlusive stroke who underwent emergent bypass surgery from September 2010 to August 2018. Surgical indications were determined as symptomatic ICA or MCA occlusive disease within 8–72 h after onset, and crescendo and/or progressive frequent transient ischemic attack, or impending stroke despite aggressive medical treatment with National Institutes of Health Stroke Scale (NIHSS) at 4 points or more, small cortical infarction (1/3 or less), and observed perfusion-diffusion mismatch. ResultsSurgical outcome was good recovery in 2 patients, moderate disability in 8, severe disability in 6, and death in 2 patients. Favorable outcome was achieved in 55.6%, and poor outcome in 44.4%. No patient showed enlargement of the area of cerebral infarction. The value of the BRS significantly improved after surgery in favourable outcome group. No patient suffered any complication related to surgical intervention including hemorrhagic complications. ConclusionsEmergent STA-MCA bypass surgery can improve clinical outcome and reduce the risk of morbidity under strict surgical indications, so could be an option for acute stage revascularization after ineffective thrombolytic therapy for non-cardiac acute cerebrovascular stroke.

Salvage carbon dioxide transoral laser microsurgery for laryngeal cancer after (chemo)radiotherapy: a European Laryngological Society consensus statement

PurposeTo provide expert opinion and consensus on salvage carbon dioxide transoral laser microsurgery (CO2 TOLMS) for recurrent laryngeal squamous cell carcinoma (LSCC) after (chemo)radiotherapy [(C)RT].MethodsExpert members of the European Laryngological Society (ELS) Cancer and Dysplasia Committee were selected to create a dedicated panel on salvage CO2 TOLMS for LSCC. A series of statements regarding the critical aspects of decision-making were drafted, circulated, and modified or excluded in accordance with the Delphi process.ResultsThe expert panel reached full consensus on 19 statements through a total of three sequential evaluation rounds. These statements were focused on different aspects of salvage CO2 TOLMS, with particular attention on preoperative diagnostic work-up, treatment indications, postoperative management, complications, functional outcomes, and follow-up.ConclusionManagement of recurrent LSCC after (C)RT is challenging and is based on the need to find a balance between oncologic and functional outcomes. Salvage CO2 TOLMS is a minimally invasive approach that can be applied to selected patients with strict and careful indications. Herein, a series of statements based on an ELS expert consensus aimed at guiding the main aspects of CO2 TOLMS for LSCC in the salvage setting is presented.

ROSS SURGERY: OUR EXPERIENCE.

At Santa Marta Hospital, Ross Surgery was performed for the first time in 1999. Twenty years later, we feel it is desirable to evaluate the mid and long-term results of our experience, as well as estimate the future of this procedure. Between March 1999 and June 2016, 23 Ross procedures were performed at our institution. We did a retrospective analysis of the patients´ data, results of the surgery, complications, freedom from reoperation and mortality. The majority (36,4%) of the patients had aortic stenosis, 22,7% had aortic regurgitation and 27,3% had aortic stenosis and regurgitation. Sub-valvular stenosis was present in 13,6% of patients. The mean follow-up is 15 years. The overall mortality was 9%, without early mortality. In our series, 83% of the patients are free from reoperation. Eighty percent (n=16) of the survivors are in NYHA class I, with the remaining 20% (n=4) in class II. Ross surgery has strict indications and in this group of patients the advantages are undeniable and the outcomes, according to our results (with 83% of patients free from reoperation, at a mean follow-up of 15 years), are positive and encouraging.

Research on Intelligent Evaluation Model of Global Food System Using Analytic Hierarchy Process with Statistics and Calculations

In order to cope with the instability of the current global food system, this paper established a global food system evaluation model and a global food system optimization model. We reimagine and determine the priority of the food system, conduct a comprehensive and reasonable assessment of the current food system, optimize it according to the current situation and predict the time required for the implementation of the system and the changes it will bring. We have established a global food system evaluation model. We begin with constructing a strict agreement-based global food system indicator system, consisting of 4 measurement dimensions and 21 indicators and their characteristics. (The four dimensions of the metrics are environment, society, food security and nutrition, and economy. The 21 indicators include 7 environmental indicators, 3 economic indicators, 3 social indicators, and 14 food and nutrition indicators) Next, depend on a large number of statistics and calculations, the Spearman correlation coefficient between the indicators is obtained. The Spearman correlation matrix is made to measure the correlation and correlation between the indicators. Then, we use the correlation as a reference to determine the weight of each indicator through the analytic hierarchy process and sort them.

Programing of Deep Brain Stimulation and Features of Devices

Deep brain stimulation(DBS)is an effective therapy for conditions involving drug-resistant involuntary movements, such as Parkinson's disease, tremor, and dystonia. Programming of DBS, as well as strict surgical indications, appropriate target selection, and accurate electrode placement, is one of the most important factors in the success of DBS. To obtain effective stimulation for a long period, it is important to expand the therapeutic window and reduce side effects. Recent advances in DBS devices have dramatically expanded the variety of stimulus settings. While the indication criteria of DBS and surgical techniques have been established, the details of the programming algorithm are not yet unified. In this paper, we describe the features of each device, basic programming methods, management of DBS-related side effects, and advanced stimulus methods.

Innovations in liver transplantation in 2020, position of the Belgian Liver Intestine Advisory Committee (BeLIAC).

Liver transplantation (LT) remains the only curative option for patients suffering from end-stage liver disease, acute liver failure and selected hepatocellular carcinomas and access to the LT-waiting list is limited to certain strict indications. However, LT has shown survival advantages for patients in certain indications such as acute alcoholic hepatitis, hepatocellular carcinoma outside Milan criteria and colorectal cancer metastases. These newer indications increase the pressure in an already difficult context of organ shortage. Strategies to increase the transplantable organ pool are therefore needed. We will discuss here the use of HCV positive grafts as the use of normothermic isolated liver perfusion. Belgian Liver Intestine Advisory Committee (BeLIAC) from the Belgian Transplant Society (BTS) aims to guarantee the balance between the new indications and the available resources.

MO732HD-PATIENTS WITH ATRIAL FIBRILLATION TREATED ADEQUATELY AND SAFE WITH DOAC BY INDIVIDUAL DOSING USING ROUTINE ANTI-XA DRUG-EFFECT MONITORING: LONG-TERM CLINICAL PRACTICE DATA

Abstract Background and Aims Hemodialysis (HD) patients (Pts) with nonvalvular atrial fibrillation (AF) on anti-vitamin-K oral anticoagulation (VK-OAC) are at high risk for cardio-vascular events, major bleeding and rapid vascular/valvular calcification. Thus, current VK-OAC is debated since prospective studies are missing, but all direct oral anticoagulation drugs (DOACs) are not labeled for ESRD. We studied the clinical feasibility of long-term DOAC treatment in HD-pts using individual dosing by regular anticoagulant drug-effect monitoring. Method We analysed 9 HD-patients with AF (median age 77 yrs; range=R: 59-86; 7 Male) on DOAC therapy for at least 6 months (n=1 rivaroxaban=Riva, n=8 apixaban=Apix) initiated by cardiologist with patients informed consent with lower dose as in CKD-4 under regular (weekly) anti-Xa drug-effect monitoring (prior HD) using available routine laboratory test validated for low-molecular heparin: Target trough range (12-24h after drug) was 0.1-1.0 U/ml (=prophylactic to therapeutic anti-Xa levels; test range <0.1, >1.6 U/ml). Bleeding caused drug stop/reduction until anti-Xa control. Results Median study time was 14 months (R: 6-24). We analysed 310 anti-Xa levels on Apix and 83 levels on Riva. After dose adjustment finally 2 Apix-Pts (22%) received full CKD-4 dose (35 mg/week=wk) and 7 patients (78%) had median dose of 10 mg/wk (10-27 mg; 6x Apix) or 40 mg/wk Riva, i.e. 29% and 38% of usual CKD-4 dose. Two Pts with higher dose had clinical reasons: short-bowl-syndrome (less resorption) or high grade (3-4) left atrial sludge (therapeutic goal). Overall, median anti-Xa level was 0.47 U/ml (R: <0.1->1.6) and 80% were in center-accepted targets: 0.1-1.2 U/ml. Lower dose Pts had higher in-target-rate (83%) than the 2 high dose Pts (70%) by more exceeding the upper limit. During our study we saw no cerebral/systemic thrombo-embolic event or major bleeding, but 2 pts had epistaxis (need out-patient intervention), 1x persistent macrohematuria (need catheterization) and 3 pts. had multiple subcutaneous hematoma, none needed event-related transfusion. We saw two non-cardiovascular deaths (22%; 2/9): 1x pneumonic sepsis, 1x advanced cancer. Conclusion We provide new clinical feasibility data on long-term DOACs therapy in HD-patients. Since DOACs are not labelled for ESRD we recommend strict indication plus regular anti-Xa drug-effect monitoring for adequate individual dosing. Our data support initial doses as for CKD-4 but applied only on HD-free days (4x/wk; =57% of usual) and adjustment in steady-state (1-2 wks): final individual doses were increased up to 100% in some patients, but mostly were reduced to 30-40% of usual CKD-4 doses. Overall, this individual dosing approach for DOACs provided adequate anti-Xa levels to prevent thrombo-embolic as well as major bleeding events. This initial data need to be confirmed in larger studies to improve evidence-based management of HD-patients with nonvalvular AF.

Dental Care of Patients With Dementia: A Survey on Practice Equipment, Training, and Dental Treatment.

For patients with dementia, dental care can pose a considerable challenge due to cognitive impairment, behavioral, and psychological symptoms, and (often subsequently) limited autonomous oral care. In this study, we aimed to assess the proficiency of dentists in general practice in the outpatient dental care of these patients. A total of 119 dentists from private practices in Lower Saxony, Germany, participated in this study. Concerning treatment of patients with dementia, they provided details about (1) practice equipment/consultation, (2) training/expertise, and (3) special circumstances of dental treatment. Participating dentists predominantly reported to use medical aids (e.g., positioning cushions) to improve the treatment situation for patients with dementia. Over two thirds (68.6%) offered consultations in nursing homes, and at the patients' homes (47.0%). The training rate was remarkably low in the field of gerodontology for dentists and their practice staff (<10%), however, 54.5% expressed interest in such training. The majority of dentists reportedly adapted their treatment strategy to the needs of patients with dementia (e.g., communication, inclusion of caregivers, time management). Furthermore, most participants adapted dental treatment adequately (e.g., strict indication for tooth extraction, simple design of dental prostheses). In summary, even though training in the field of gerodontology must be considered insufficient, most dentists in this study showed an adequate adaptation of their treatment strategy as well as consideration of dental characteristics in patients with dementia, along with interest in trainings. We conclude that dementia-specific training should be expanded in the field of dentistry, preferably already at university level.

The features of antibacterial therapy in children

At present, the use of antibacterial drugs is one of the most frequently recommended methods of treating a large number of infectious diseases. However, in clinical practice, excessive use of antibiotics, unreasonable antibiotic therapy, and inappropriate combinations are quite common, which creates the risk of unwanted side effects, increases the cost of treatment and leads to an increase in microorganism resistance. That is why, in modern medicine, the problem of rational antibiotic therapy, i.e. the adequate use of antibacterial drugs, compliance with strict indications for their use, certain schemes and principles of use, and the creation of protocols for antibiotic therapy in pediatric practice, remains relevant. Antibacterial drugs should be prescribed for inflammatory diseases of bacterial etiology and for perioperative prophylaxis. Antibiotics should not be used in the treatment of uncomplicated acute viral respiratory diseases, since they do not have an antiviral effect, do not reduce fever, and do not prevent the development of bacterial complications. The purpose of this work is to form a methodological approach to the use of antibacterial drugs in pediatrics based on existing Russian recommendations.

The Use of VEPTR in Congenital Scoliosis

Background: Congenital scoliosis is nowadays addressed by many surgical solutions. There are rare cases presenting with mixed vertebral defects associated with Thoracic Insufficiency Syndrome (TIS). The presence of mixed vertebral defects may present with a very high progressive potential, inducing a severe scoliotic curve which impairs the development of the thoracic cage. Additionally, these cases may associate rib fusions which will further impair the development of the lung in these patients. The unique surgical solution in these cases is represented by VEPTR (Vertical Expandable Prosthesis Titanium Rib) devices able to expand the thorax and to control the scoliotic curve. Material and methods: The surgical technique of the VEPTR device in a rib-to-spine construct consists in a distraction based device able to expand the thorax on the concave side of the scoliosis by consecutive distractions and, secondary, to control de scoliotic curve. The upper module of the device is placed on the first, second and/or third rib and the lower module is fixed to the upper lumbar spine. The construct is completed with the expansion module which allows distractions (1/2 or 1 cm for each distraction). The patients undergo every 4-6 months consecutive distractions until skeletal maturity when definitive spinal fusion is performed. Results: The VEPTR device in standard constructs with placement as recommended by the developer proved to be efficient in controlling congenital scoliotic curves and thoracic expansion. Unusual placements of the device complicated the evolution of patients with congenital scoliosis and required additional surgical procedures to correct the deformities and to try to ensure remnant spinal growth. Conclusions: The VEPTR device has strict indications, congenital scoliosis with TIS being one of them. Proper indication and surgical procedure will aid the patients all along spinal and thoracic growth, in order to obtain a lung and spinal development as close to normal as possible in order to avoid premature death due to TIS.

A minimum 8-year follow-up comparative study of decompression and coflex stabilization with decompression and fusion

The current study aimed to compare the outcomes of decompression and interlaminar stabilisation with those of decompression and fusion for the treatment of lumbar degenerative disease (LDD) at a minimum 8-year follow-up. The current study also aimed to analyse the risk factors of radiographic adjacent segment degeneration (ASD). A total of 82 consecutive patients with LDD who underwent surgery between June 2007 and February 2011 were retrospectively reviewed. Of these patients, 39 underwent decompression and Coflex interspinous stabilisation (Coflex group) and 43 underwent decompression and posterior lumbar interbody fusion (PLIF) (PLIF group). All patients had a minimum of 8-years of follow-up data. Radiographic and clinical outcomes were compared between the groups, and the risk factors of developing radiographic ASD were also evaluated. The Oswestry disability index and visual analogue scale leg and back pain scores of both groups significantly improved compared with the baseline (all P<0.05), and no difference were indicated between the two groups at each follow-up time point (P>0.05). The Coflex group exhibited preserved mobility (P<0.001), which was associated with a decreased amount of blood loss (P<0.001), shorter duration of surgery (P=0.001), shorter duration of hospital stay and a lower incidence of ASD (12.8 vs. 32.56%; P=0.040) compared with the fusion group. The current study indicated that coflex and fusion technologies are safe and effective for the treatment of LDD, based on long-term follow-up data. However, Coflex interspinous stabilisation was revealed to reduce ASD incidence. Under strict indications, Coflex interspinous stabilisation is an effective and safe treatment method.

Cardiac arrhythmias in pregnancy : Epidemiology, clinical characteristics, and treatment options

Symptomatic arrhythmias rarely occur during pregnancy and are predominantly benign. However, the increasing average age of women who are pregnant, especially in Western European countries, has contributed to a significant increase in arrhythmias in pregnant women in recent years. Previous or existing heart diseases can increase the occurrence of arrhythmias. In most cases pregnancy is safe and without consequences for the child and/or mother. Further cardiological work-up (including ECG and echocardiography, and possibly cardiac MRI) should always be performed. The indication for treatment should be made in close cooperation between obstetricians and cardiologists considering symptoms, hemodynamics and prognosis. In the absence of larger studies on efficacy and side effects of antiarrhythmic drugs, these should be administered very cautiously, under strict indication and whenever possible by avoiding the first trimester. Cardiologists with special expertise in arrhythmias should always be consulted, especially in the case of complex and relevant rhythm disturbances.

The current status and future directions of robotic pancreatectomy.

Robotic surgery has emerged as an alternative to laparoscopic surgery and it has also been applied to pancreatectomy. With the increase in the number of robotic pancreatectomies, several studies comparing robotic pancreatectomy and conventional open or laparoscopic pancreatectomy have been published. However, the use of robotic pancreatectomy remains controversial. In this review, we aimed to provide a comprehensive overview of the current status of robotic pancreatectomy. Various aspects of robotic pancreatectomy and conventional open or laparoscopic pancreatectomy are compared, including the benefits, limitations, oncological efficacy, learning curves, and costs. Both robotic pancreatoduodenectomy and distal pancreatectomy have favorable or comparable outcomes to conventional procedures, and robotic pancreatectomy has the potential to be an alternative to open or laparoscopic procedures. However, there are still several disadvantages to robotic platforms, such as prolonged operative duration and the high cost of the procedure. These disadvantages will be improved by developing instruments, overcoming the learning curve, and increasing the number of robotic pancreatectomies. In addition, robotic pancreatectomy is still in the introductory period in most centers and should only be used in accordance with strict indications.

СИМУЛЬТАННЫЕ ОПЕРАЦИИ ПРИ ЭХИНОКОККОЗЕ ПЕЧЕНИ

Objective. To evaluate the results and effectiveness of simultaneous operations for echinococcosis of the liver. Methods. Surgical diseases requiring surgical treatment (cholelithiasis: calculus cholecystitis, choledocholithiasis, nodular goiter, ventral postoperative hernia) were detected in 38 patients with echinococcosis of the liver. 23 patients underwent organ-preserving operations for echinococcosis, and 15 patients underwent radical operations, all operations were perfomed in combined with cholecystectomy, choledocholitotomy, thyroidectomy, and herniotomy (coating of a polypropylenemesh for hernia gate).Immediate and remote results were studied. Patients were reexamined 6 months after surgery within a 3-year period. The examination included the checkup, general blood test, liver and kidney tests, an ultrasound examination of the abdominal organs, and a chest x-ray once a year. Results. During theimmediate postoperative period 4 patients out of 38 (10.5%) had complications. After simultaneous operations using organ-preserving methods of echinococcectomy, 2 patients out of 23 (8.7%) had complications (pleuritis, wound suppuration), and 2 - out of 15 had radical operations (bile leakage, pleuritis). All complications had been cured by the time of discharge. The remote results were studied over a period of 6 months to 3 years. 34 patients were examined up to 1 year, 31 - from 1 to 2 years, 26 - from 2 to 3 years. Within the examination and follow-up periods no recurrence of echinoccosis was observed. Conclusion. During simultaneous operations and the echinococcectomy of the liver it is necessary to observe accurately the rules of aparasiticity and antiparasiticity.Simultaneous operations for the liver echinococcosis should be performed according to strict indications and by a highlyexperiencedandqualified surgeon. Patients who have undergone simultaneous operations was asked toundergoa medicalcontrol examination at least once a year. What this paper adds The possibility of performing simultaneous operations for echinococcosis of the liver has been defined. The sequence of operations for echinococcosis in combination with other pathologies requiring surgical treatment has been justified.

Системная красная волчанка или волчаночноподобный синдром при ВИЧ-инфекции: обзор клинических случаев

Background. Due to multi-organ lesions and a wide range of clinical manifestations, human immunodeficiency virus (HIV infection) resembles systemic connective tissue diseases, particularly systemic lupus erythematosus (SLE). Similarity of immune disorders in patients with HIV infection and SLE may lead to misdiagnosis resulting in wrong tactics of treatment (prescribing immunosuppressive therapy instead of high-dose antiretroviral therapy). Aim. To report the HIV infection and SLE differential diagnosis challenges. Results. By January 2021, the analysis of national literature revealed two cases of HIV infection in young women, initially misdiagnosed with suspected SLE. In addition to two patients described in literature, one more female patient with SLE manifestations combined with advanced stage of HIV infection was examined. Conclusion. HIV and SLE differential diagnosis is the ultimate challenge for clinicians. Physicians should be especially apprehensive about HIV infection when making the diagnosis of SLE. SLE therapy in patients with HIV infection should be appointed according to strict indications.

Relative versus absolute RNA quantification: a comparative analysis based on the example of endothelial expression of vasoactive receptors

BackgroundIn the present study, two distinct PCR methods were used for the quantification of genetic material and their results were compared: real-time-PCR (qPCR; relative quantification) and droplet digital PCR (ddPCR; absolute quantification). The comparison of the qPCR and the ddPCR was based on a stimulation approach of microvascular endothelial cells in which the effect of a pro-inflammatory milieu on the expression of vasoactive receptors was investigated.ResultsThere was consistency in directions of effects for the majority of genes tested. With regard to the indicated dimension of the effects, the overall picture was more differentiated. It was striking that deviations were more pronounced if the measured values were on the extreme edges of the dynamic range of the test procedures.ConclusionsTo obtain valid and reliable results, dilution series are recommended, which should be carried out initially. In case of ddPCR the number of copies per µl should be adjusted to the low three-digit range. With regard to qPCR it is essential that the stability and reliability of the reference genes used is guaranteed. Here, ddPCR offers the advantage that housekeeping genes are not required. Furthermore, an absolute quantification of the sample can be easily performed by means of ddPCR. Before using ddPCR, however, care should be taken to optimize the experimental conditions. Strict indications for this methodology should also be made with regard to economic and timing factors.

Radiološka metoda pregleda u dijagnostici bolesnog bubrega

Radiological examination methods in the diagnosis of kidney disease, thanks to their objectivity and their capabilities, have taken their place in the diagnosis of urosystems and kidney disease. Radiological methods of examination in the diagnosis of the kidney are numerous and diverse. They are sovereign, dominant and unrivaled. However, the dangers that lurk and threaten in their application, especially ionization and complications from iodine contrast agents, indicate and say that they should be used in strict indications, with well-educated staff and with full protection measures. The aim of this paper is to show and point out the number, variety, advantages and disadvantages of radiological methods of examination in kidney diagnostics. The material and method of work is the experience gained in the profession based on urographic examinations and other radiological methods of examination of the urogenital system, primarily in 18,000 IVUs performed in the period 1994-2021. at the Center for Radiology of the University Medical Center Nis and numerous literal announcements of authors and co-authors written in domestic and foreign journals. The results of the work are shown illustratively, with pictures - nephrocalcinosis, renal cyst, pheochromocytoma, VUR V 0 , kidney tumor, color doppler of the renal artery, a series of native and contrast spiral CT tomograms of the kidney. The development of radiological techniques in recent decades has enriched radiological diagnostics with new diagnostic possibilities. Therefore, we received new radiological images, in which our results are compatible with numerous literal world releases. In conclusion, the authors point out that radiological methods in the diagnosis of kidneys are indispensable and, among other methods of examination, indispensable.