Assessment of referral patterns for CT KUB in a tertiary setting

The purpose of this study was to assess the referral patterns and the use of unenhanced renal tract CT (CT KUB) for investigating patients presenting with clinically suspected renal colic. We retrospectively reviewed 500 consecutive CT KUB studies requested for suspected renal colic carried out at a single institution between December 2006 and July 2007. Follow‐up radiology reports and discharge summaries on the hospital clinical Intranet were also reviewed. Studies were analysed for characteristics including patient demographics, referring clinical team, time of referral, final diagnosis and requirement for further imaging. The majority of requests were from Emergency (ED) or Urology Departments (49%, 245 out of 500, and 37%, 186 out of 500, respectively). The positive rate for urolithiasis was 67% (337 out of 500), the negative rate was 25% (123 out of 500), and 8% (40 out of 500) of patients had alternative significant findings. Female patients were more likely to have a negative study than male patients (35 versus 20%, P < 0.0001) and more likely to have alternative significant pathology (12 versus 6%, P < 0.0001). Patients referred by specialities other than Urology and ED were more likely to be female and have a negative or alternative finding (P < 0.0001). CT KUB is a widely used first method of investigation for patients with suspected renal colic with a high positive predictive value allowing rapid diagnosis and intervention. However, given the high rate of negative or alternative findings on CT KUB in young women, especially those referred by specialities other than ED or Urology, ultrasound should be considered as an alternative imaging method to minimise unnecessary radiation exposure.     

Ureaplasma Urealyticum or Mycoplasma Hominis Infections and Semen Quality of Infertile Men in Abidjan

Objective To determine the prevalence of U. urealyticum and M. hominis in semen samples collected from men admitted in clinic for infertility, and to compare the quality of these semen samples.
Methods A total of 1 058 semen samples collected were investigated. Sperm semiological assays were performed according to the guidelines of the World Health Organisation （WHO）. Semen were examined by Mycoplasma IST for the detection of mycoplasma. Semen culture on agar media was used to detect other microorganisms. Chlamydia was detected using direct fluorescent assay （DFA） of Clamydia Trachomatis.
Results Among 1 058 semen samples, microorganisms were detected in 638 （60.3%）. The infected sperms consisted of mycoplasma alone in 507 cases （47.9%）, mycoplasma and other microorganisms in 98 （9.3%）, giving in all 605 （57.2%） samples infected with mycoplasma. The last 33 （3.1%） consisted of other microorganisms alone. The frequency of U. urealyticum, M. hominis and mixed genital infections detected in semen samples of infertile men were 39%, 23.8% and 5.6%, respectively. The rates of abnormal semen parameters recorded among patients infected with mycoplasma were for volume （22.2%-25%）, viscosity （29.6%-43.5%）, pH （64.7%-72.9%）, motility （80.8%-93.8%）, morphology （36.3%-47.9%）, sperm concentration （53.3%-58.3%） and leukocyte count （51.4%-58.3%）.
Conclusion Frequency of U. urealyticum infection was higher than that of M. hominis. Mycoplasma infections were associated with disorders of pH, motility and sperm concentration. In addition M. hominis infection affected spermatozoa morphology. Therefore, screening of U. urealyticum clinically relevant in Abidjan. and M. hominis for routine semen analysis is     

Bag and supply transport tips

Wearily glancing at the front entrance of the apartment building, about 100 yards away and up two flights of stairs, Chris thinks, "One more trip and I should have everything." Two boxes of supplies and a bag of assessment equipment are needed for this visit and Chris must transport everything alone. For the next visit, Chris will again be required to transport various boxes and bags. Because of increasing shoulder and neck pain, Chris resolves to stop using shoulder straps and start using bags with wheels and portable hand carts for the boxes and other bulky supplies these visits require.