No evidence for the need of a routine renal transplant ultrasound after elective transplant ureteric stent removal—A retrospective cohort study

Transplant ureteric stent insertion reduces the incidence of MUCs, but it is not known whether routine PSRGU is needed to detect unmasked MUCs. This study evaluated whether routine PSRGU in the pRTR is a useful tool to identify MUCs before they become clinically apparent. A retrospective analysis was undertaken of the clinical outcomes following elective stent removal from pediatric kidney‐only transplant recipients at two London centers between 2012 and 2016. Our policy was to perform PSRGU either routinely or urgently if there were concerning symptoms or biochemical evidence of renal allograft dysfunction. Elective stent removal was performed in 86% (97 of 113 pRTR), and 75 (77%) of whom had routine PSRGU at a median (IQR) of 6 (2‐8) days after stent removal. There were changes to management in 3 (4%) of pRTR with PSRGU identifying no MUC. Nineteen patients (25%) had urgent PSRGU, most commonly due to renal allograft dysfunction, at a median (IQR) of 5.5 (2.7‐12.3) days after stent removal. Of these, two pRTR required ureteric intervention. For our current practice of removing transplant stents at 4‐6 weeks post‐transplantation, our study has found no evidence to support routine PSRGU after elective stent removal.     

Psychosis

This article is intended to expand the clinician's understanding of psychosis. The concept of psychosis and the differential diagnosis of this condition are discussed. The treatment of psychotic illness also is briefly addressed.     

Separation of phagocytic leukocytes from the peripheral blood of chickens

Phagocytic leukocytes were separated from the peripheral blood of chickens using a one-step Percoll density gradient technique. Heterophils recovered from two fractions of the gradient were of 96.9 to 99.8% purity and were fully viable and functional, as demonstrated by their capacity to phagocytose latex beads and staphylococci. Adherent mononuclear cells were cultured from specific gradient fractions and shown to phagocytose staphylococci.     

Practice guidelines: the radiology perspective

Clinical practice guidelines have emerged as a reality for medical practitioners over the past 20 years. Although virtually all groups interested in the development of practice guidelines hope for improvements in patient care, secondary expectations vary widely among those using them. Their use in daily practice by physicians has met with resistance from barriers including concerns of “cookbook” medicine, a loss of autonomy, and increased professional liability. The recent experience of the ACR in addressing these challenges illustrates that physicians are receptive to steps perceived to mitigate the risks accompanying the use of guidelines as well as to efforts to increase their understanding of implementing guidelines in clinical practice. The experiences of other medical societies and an inventory of future trends reveal additional challenges associated with the use of practice guidelines, as third parties look to guidelines as points of reference for gauging the performance of health care providers.     

Localization of proopiomelanocortin mRNA in functional subsets of neurons defined by their axonal projections

In situ cDNA:mRNA hybridization is a technique that has been developed for the visualization of cDNA:mRNA hybrids in individual cells. To use this technique to answer questions of regulation in heterogeneous populations of cells in the brain, it must be combined with other procedures allowing for the identification of functional subgroups of neurons. We report here a procedure by which in situ cDNA:mRNA hybridization may be combined with retrograde axonal tracing using the fluorescent tracer fast blue. Using this technique, it now becomes possible to measure mRNA regulation in functional subsets of cells defined by their axonal projections.     

Group B streptococcus: the effectiveness of screening and chemoprophylaxis

Although antepartum screening for Group B Streptococcus is not ideal, it may be the most practical approach until rapid tests are proven to be useful in this clinical setting. The efficacy has been established for intrapartum chemoprophylaxis with a penicillin antibiotic of patients with a positive antepartum culture. There is evidence that supports the concept for selective intrapartum chemoprophylaxis in some populations. Intrapartum chemoprophylaxis prevents maternal morbidity. Rapid tests for intrapartum diagnosis of Group B streptococcus colonization appear promising, providing results are available in time for therapy to be administered before delivery.