scholarly journals Bilateral Renal Mass-Renal Disorder: Tuberculosis

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Ozlem Tiryaki ◽  
Celalettin Usalan ◽  
Samet Alkan
Keyword(s):  
Primary Care ◽  
Renal Failure ◽  
Renal Mass ◽  
Young Female ◽  
Care Physician ◽  
Renal Masses ◽  
Renal Disorder ◽  
Surgical History ◽  
Bilateral Renal Mass ◽  
New Onset

A 30-year-old woman has presented complaining of weakness and fatigue to her primary care physician. The renal sonography is a routine step in the evaluation of new onset renal failure. When the renal masses have been discovered by sonography in this setting, the functional imaging may be critical. We reported a case about bilateral renal masses in a young female patient with tuberculosis and renal insufficiency. Magnetic resonance (MR) has revealed the bilateral renal masses in patient, and this patient has been referred to our hospital for further management. The patient’s past medical and surgical history was unremarkable.

Case 6.9

2014 ◽  
pp. 299-300
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Renal Failure ◽  
Back Pain ◽  
Signal Intensity ◽  
Medical Facility ◽  
Renal Masses ◽  
Leg Weakness ◽  
Adrenal Masses ◽  
New Onset

68-year-old woman with back pain, leg weakness, and new-onset renal failure; renal US at another medical facility showed bilateral renal masses Coronal fat-suppressed SSFSE images (Figure 6.9.1) demonstrate large bilateral hypointense adrenal masses. The lesions show uniform, moderate signal intensity on axial fat-suppressed FRFSE images (...

Unrestricted Direct Access to Physical Therapist Services Is Associated With Lower Health Care Utilization and Costs in Patients With New-Onset Low Back Pain

2019 ◽  
Author(s):  
Brigid Garrity ◽  
Christine McDonough ◽  
Omid Ameli ◽  
James Rothendler ◽  
Kathleen Carey ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Utilization ◽  
Physical Therapist ◽  
Care Physician ◽  
Direct Access ◽  
Care Utilization ◽  
Low Back ◽  
Unrestricted Access ◽  
New Onset

Abstract Background Low back pain (LBP) is one of the most prevalent conditions for which patients seek physical therapy in the United States. The American Physical Therapy Association categorizes direct access to physical therapist services into 3 levels: limited, provisional, and unrestricted. Objective The objective of this study was to evaluate the association of level of access to physical therapist services with LBP-related health care utilization and costs. Design This was a retrospective cohort study of patients with new-onset LBP between 2008 and 2013; data were from OptumLabs Data Warehouse. Methods We identified 59,670 individuals who were 18 years old or older, who had new-onset LBP, and who had commercial or Medicare Advantage insurance through a private health plan. We examined 2 samples. The first was health care utilization among individuals who saw a physical therapist first in states with either unrestricted access or provisional access. The second was LBP-related costs among individuals who saw either a physical therapist or a primary care physician first. Results Individuals who saw a physical therapist first in states with provisional access had significantly higher measures of health care utilization within 30 days, including plain imaging and frequency of physician visits, than individuals who saw a physical therapist first in states with unrestricted access. Compared with individuals who saw a primary care physician first, pooled across provisional-access and unrestricted-access states, those who saw a physical therapist first in provisional-access states had 25% higher relative costs at 30 days and 32% higher relative costs at 90 days, whereas those who saw a physical therapist first in unrestricted-access states had 13% lower costs at 30 days and 32% lower costs at 90 days. Limitations This was a claims-based study with limited information on patient characteristics, including severity and duration of pain. Conclusions Short-term LBP-related health care utilization and costs were lower for individuals in unrestricted-access states than in provisional-access states.

Review of The fifteen minute hour: Applied psychotherapy for the primary care physician.

1988 ◽  
Vol 6 (4) ◽  
pp. 483-487
Author(s):  
Richard P. McQuellon ◽  
Guyton J. Winker
Keyword(s):  
Primary Care ◽  
Primary Care Physician ◽  
Care Physician

Histologic Heterogeneity of Extirpated Renal Cell Carcinoma Specimens: Implications for Renal Mass Biopsy

2020 ◽  
Vol 7 (3) ◽  
pp. 20-25
Author(s):  
Lauren Nahouraii ◽  
Jordan Allen ◽  
Suzanne Merrill ◽  
Erik Lehman ◽  
Matthew Kaag ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Mass ◽  
Tumor Stage ◽  
High Grade ◽  
Renal Masses ◽  
Histologic Heterogeneity ◽  
Adequate Sampling ◽  
Renal Mass Biopsy

Pathologic characteristics of extirpated renal cell carcinoma (RCC) specimens <7  cm were reviewed to get better information on technical nuances of renal mass biopsy (RMB). Specimens were stratified according to tumor stage, nuclear grade, size, histology, presence of lymphovas-cular invasion (LVI), necrosis, and sarcomatoid features. When considering pT1 (0–7 cm) tumors pT1b (4–7 cm), RCC masses were more likely to have necrosis (43% vs 16%, P < 0.001), LVI (6% vs 2%, P = 0.024), high-grade nuclear elements (29% vs 17%, P < 0.001), and sarcomatoid features (2% vs 0%, P = 0.006) compared with pT1a (0–4 cm) tumors. Additionally, pT3a tumors were more highly associated with necrosis (P = 0.005), LVI, sarcomatoid features, and high-grade disease (P for all < 0.001) when compared to pT1 masses. For masses <4 cm, pT3a cancers were more likely to demonstrate necrosis (38% vs 16%, P < 0.001), LVI (10% vs 2%, P = 0.037), high-grade nuclear elements (31% vs 17%, P = 0.05), and sarcomatoid features (3% vs 0%, P = 0.065) compared to pT1a tumors. Similarly, for masses 4–7 cm, pathologic T3a tumors were significantly more likely to have sarcomatoid features (16% vs 2%, P < 0.001) and LVI (28% vs 6%, P < 0.001) compared to pT1b tumors. In summary, pT3a tumors and those RCC masses >4 cm exhibit considerable histologic heterogeneity and may harbor elements that are not easily appreciated with limited renal sampling. Therefore, if RMB is considered for renal masses greater than 4 cm or those that abut sinus fat, a multi-quadrant biopsy approach is necessary to ensure adequate sampling and characterization of the mass.

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