The Link Between Nephrolithiasis and Vascular Calcification
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Cardiac Imaging Guidelines Effective October 1, 2021
Cigna Medical Coverage Policies – Radiology Cardiac Imaging Guidelines Effective October 1, 2021 ____________________________________________________________________________________ Instructions for use The following coverage policy applies to health benefit plans administered by Cigna. Coverage policies are intended to provide guidance in interpreting certain standard Cigna benefit plans and are used by medical directors and other health care professionals in making medical necessity and other coverage determinations. Please note the terms of a customer’s particular benefit plan document may differ significantly from the standard benefit plans upon which these coverage policies are based. For example, a customer’s benefit plan document may contain a specific exclusion related to a topic addressed in a coverage policy. In the event of a conflict, a customer’s benefit plan document always supersedes the information in the coverage policy. In the absence of federal or state coverage mandates, benefits are ultimately determined by the terms of the applicable benefit plan document. Coverage determinations in each specific instance require consideration of: 1. The terms of the applicable benefit plan document in effect on the date of service 2. Any applicable laws and regulations 3. Any relevant collateral source materials including coverage policies 4. The specific facts of the particular situation Coverage policies relate exclusively to the administration of health benefit plans. Coverage policies are not recommendations for treatment and should never be used as treatment guidelines. This evidence-based medical coverage policy has been developed by eviCore, Inc. Some information in this coverage policyy m na ot apply to all benefit plans administered by Cigna. These guidelines include procedures eviCore does not review for Cigna. -
National Taiwan University Hospital Hsinchu Branch Research Protocol 2018
National Taiwan University Hospital Hsinchu Branch Research Protocol 2018 1. Project name Prevalence and Outcomes of Peripheral Artery Disease in Sepsis Patients in the Medical Title Intensive Care Unit Principal Department of Internal Medicine, Cardiovascular Division investigator Mu-Yang Hsieh, Attending Physician Table of Contents 1. Project name.........................................................................................................................................................1 2. Abstract................................................................................................................................................................3 Background...............................................................................................................................................................3 Methods....................................................................................................................................................................3 3. Background..........................................................................................................................................................4 Prior research in this field.........................................................................................................................................4 Sepsis and peripheral artery disease..............................................................................................................4 Peripheral artery disease- its impact on the outcomes..................................................................................4 -
Disentangling the Multiple Links Between Renal Dysfunction and Cerebrovascular Disease Dearbhla Kelly, Peter Malcolm Rothwell
Cerebrovascular disease J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp-2019-320526 on 11 September 2019. Downloaded from REVIEW Disentangling the multiple links between renal dysfunction and cerebrovascular disease Dearbhla Kelly, Peter Malcolm Rothwell ► Additional material is ABSTRact consequences of renal dysfunction,and diseases that published online only. To view, Chronic kidney disease (CKD) has a rapidly rising can cause both CKD and stroke. please visit the journal online (http:// dx. doi. org/ 10. 1136/ global prevalence, affecting as many as one-third jnnp- 2019- 320526). of the population over the age of 75 years. CKD is ASSOciatiONS BETWEEN CKD AND a well-known risk factor for cardiovascular disease CEREBROVASCULAR DISEASE Centre for the Prevention and, in particular, there is a strong association with Stroke risk of Stroke and Dementia, stroke. Cohort studies and trials indicate that reduced Nuffield Department of Clinical There is conflicting evidence about whether CKD, Neurosciences, University of glomerular filtration rate increases the risk of stroke by specifically low estimated glomerular filtration Oxford, Oxford, UK about 40% and that proteinuria increases the risk by rate (eGFR), is a risk factor for stroke indepen- about 70%. In addition, CKD is also strongly associated dent of traditional cardiovascular risk factors. In Correspondence to with subclinical cerebrovascular abnormalities, vascular a meta-analysis of 22 634 people from four popu- Dr Dearbhla Kelly, Centre for cognitive impairment and -
Peripheral Vascular Disease (PVD) Fact Sheet
FACT SHEET FOR PATIENTS AND FAMILIES Peripheral Vascular Disease (PVD) What is peripheral vascular disease? Vascular disease is disease of the blood vessels (arteries and veins). Peripheral vascular disease (PVD) affects The heart receives blood, the areas that are “peripheral,” or outside your heart. sends it to The most common types of PVD are: the lungs to get oxygen, • Carotid artery disease affects the arteries and pumps that carry blood to your brain. It occurs when it back out. one or more arteries are narrowed or blocked by plaque, a fatty substance that builds up inside artery walls. Carotid artery disease can increase Veins carry Arteries carry your risk of stroke. It can also cause transient blood to your oxygen-rich [TRANZ-ee-ent] ischemic [iss-KEE-mik] attacks (TIAs). heart to pick blood from up oxygen. your heart TIAs are temporary changes in brain function to the rest of that are sometimes called “mini-strokes.” your body. • Peripheral arterial disease (PAD) often affects the arteries to your legs and feet. It is also caused by Healthy blood vessels provide oxygen plaque buildup, and can for every part of your body. cause pain that feels like a dull cramp or heavy tiredness in your hips or legs when • Venous insufficiency affects the veins, usually you exercise or climb stairs. in your legs or feet. Your veins have valves that This pain is sometimes Damaged Healthy keepvalve blood fromvalve flowing backward as it moves called claudication. If PAD toward your heart. If the valves stop working, blood worsens, it can cause cold Plaque can build backs up in your body, usually in your legs. -
An Unusually Dry Story
555050 Case Report An unusually dry story Srinivas Rajagopala, Gurukiran Danigeti, Dharanipragada Subrahmanyan We present a middle-aged woman with a prior history of central nervous system (CNS) Access this article online demyelinating disorder who presented with an acute onset quadriparesis and respiratory Website: www.ijccm.org failure. The evaluation revealed distal renal tubular acidosis with hypokalemia and DOI: 10.4103/0972-5229.164808 medullary nephrocalcinosis. Weakness persisted despite potassium correction, and ongoing Quick Response Code: Abstract evaluation confi rmed recurrent CNS and long-segment spinal cord demyelination with anti-aquaporin-4 antibodies. There was no history of dry eyes or dry mouth. Anti-Sjogren’s syndrome A antigen antibodies were elevated, and there was reduced salivary fl ow on scintigraphy. Coexistent antiphospholipid antibody syndrome with inferior vena cava thrombosis was also found on evaluation. The index patient highlights several rare manifestations of primary Sjogren’s syndrome (pSS) as the presenting features and highlights the differential diagnosis of the clinical syndromes in which pSS should be considered in the Intensive Care Unit. Keywords: Acute demyelinating encephalomyelitis, distal renal tubular acidosis, hypokalemic paralysis, nephrocalcinosis, neuromyelitis optica, Sjogren’s syndrome Introduction was diagnosed with postviral encephalomyelitis 3 years ago and treated with steroids with complete resolution of Primary Sjogren’s syndrome (pSS) is a relatively symptoms and signs. She had normal menstrual cycles common autoimmune disease affecting 2–3% of the adult and had one spontaneous second trimester abortion population. It is characterized by lymphocyte infi ltration 8 years ago. She had one living child and had undergone and destruction of exocrine glands. -
Diagnostic Imaging and Risk Factors Downloaded from by EERP/BIBLIOTECA CENTRAL User on 26 August 2019
ISSN 2472-1972 Nephrocalcinosis and Nephrolithiasis in X-Linked Hypophosphatemic Rickets: Diagnostic Imaging and Risk Factors Downloaded from https://academic.oup.com/jes/article-abstract/3/5/1053/5418933 by EERP/BIBLIOTECA CENTRAL user on 26 August 2019 Guido de Paula Colares Neto,1,2 Fernando Ide Yamauchi,3 Ronaldo Hueb Baroni,3 Marco de Andrade Bianchi,4 Andrea Cavalanti Gomes,4 Maria Cristina Chammas,4 and Regina Matsunaga Martin1,2 1Department of Internal Medicine, Division of Endocrinology, Osteometabolic Disorders Unit, Hospital das Cl´ınicas da Faculdade de Medicina da Universidade de S~ao Paulo, 05403-900 S~ao Paulo, SP, Brazil; 2Department of Internal Medicine, Division of Endocrinology, Laborat´orio de Hormoniosˆ e Gen´etica Molecular (LIM/42), Hospital das Cl´ınicas da Faculdade de Medicina da Universidade de S~ao Paulo, 05403-900 S~ao Paulo, SP, Brazil; 3Department of Radiology and Oncology, Division of Radiology, Computed Tomography Unit, Hospital das Cl´ınicas da Faculdade de Medicina da Universidade de S~ao Paulo, 05403-001 S~ao Paulo, SP, Brazil; and 4Department of Radiology and Oncology, Division of Radiology, Ultrasound Unit, Hospital das Cl´ınicas da Faculdade de Medicina da Universidade de S~ao Paulo, 05403-001 S~ao Paulo, SP, Brazil ORCiD numbers: 0000-0003-3355-0386 (G. P. Colares Neto); 0000-0002-4633-3711 (F. I. Yamauchi); 0000-0001-7041-3079 (M. C. Chammas). Context: Nephrocalcinosis (NC) and nephrolithiasis (NL) are described in hypophosphatemic rickets, but data regarding their prevalence rates and the presence of metabolic risk factors in X-linked hypophosphatemic rickets (XLH) are scarce. -
Radiological Imaging of the Kidney
Medical Radiology / Diagnostic Imaging Radiological Imaging of the Kidney von Emilio Quaia 1st Edition. Springer 2010 Verlag C.H. Beck im Internet: www.beck.de ISBN 978 3 540 87596 3 schnell und portofrei erhältlich bei beck-shop.de DIE FACHBUCHHANDLUNG Contents Part I Embryology and Anatomy 1 Embryology of the Kidney .................................... 3 Marina Zweyer 2 Normal Radiological Anatomy and Anatomical Variants of the Kidney . 17 Emilio Quaia, Paola Martingano, Marco Cavallaro, and Roberta Zappetti 3 Normal Radiological Anatomy of the Retroperitoneum ............ 79 Emilio Quaia Part II Imaging and Interventional Modalities 4 Ultrasound of the Kidney . 87 Emilio Quaia 5 Computed Tomography. 129 5.1 General Concepts........................................ 129 Emilio Quaia, Paola Martingano, and Marco Cavallaro 5.2 Multidetector CT Urography and CT Angiography . 160 Roberto Pozzi Mucelli, Giulia Zamboni, Livia Bernardin, and Alberto Contro 6 Magnetic Resonance Imaging of the Kidney . 179 Maria Assunta Cova, Marco Cavallaro, Paola Martingano, and Maja Ukmar 7 Renal Angiography and Vascular Interventional Radiology . 197 Fabio Pozzi-Mucelli and Andrea Pellegrin 8 Nuclear Medicine . 229 Egesta Lopci and Stefano Fanti xi xii Contents 9 The Role of Kidney Biopsy in the Diagnosis of Renal Disease and Renal Masses............................. 257 Michele Carraro and Fulvio Stacul 10 Nonvascular Interventional Radiology Procedures ................ 271 Raul N. Uppot Part III Non-Tumoral Pathology 11 Congenital and Development Disorders of the Kidney ............. 291 Veronica Donoghue 12 Renal Cystic Disease ......................................... 311 Kyongtae T. Bae, Alessandro Furlan, and Fadi M. El-Merhi 13 Renal Parenchymal and Inflammatory Diseases . 339 Emilio Quaia 14 Obstructive Uropathy, Pyonephrosis, and Reflux Nephropathy in Adults . 357 Emilio Quaia, Paola Martingano, and Marco Cavallaro 15 Nephrocalcinosis and Nephrolithiasis .......................... -
Management of Ureteral Stones
Management of Ureteral Stones Ureteral stone disease is among the most painful and prevalent of urologic disorders. As many as 5 percent of Americans will be affected by urinary stones at some point in their lives. Fortunately, most stones pass out of the body without any intervention. If you are not so lucky, the following information should help you and your doctor address the causes, symptoms and possible complications created by your ureteral stone disease. How does the urinary tract work under normal conditions? The urinary tract is similar to a plumbing system, with special pipes that allow water and salts to flow through them. The urinary tract includes two kidneys, two ureters and the urethra. The kidneys act as a filter system for the blood, cleansing it of poisonous materials and retaining valuable glucose, salts and minerals. Urine, the waste product of the filtration, is produced in the kidney and trickles down hours a day through two 10- to 12-inch long tubes called ureters, which connect the kidneys to the bladder. The ureters are about one-fourth inch in diameter and their muscular walls contract to make waves of movement to force the urine into the bladder. The bladder is expandable and stores the urine until it can be conveniently disposed of. It also closes passageways into the ureters so that urine cannot flow back into the kidneys. The tube through which the urine flows out of the body is called the urethra. What is a ureteral stone? A ureteral stone is a kidney stone that has moved down into the ureter. -
Magnesium: the Forgotten Electrolyte—A Review on Hypomagnesemia
medical sciences Review Magnesium: The Forgotten Electrolyte—A Review on Hypomagnesemia Faheemuddin Ahmed 1,* and Abdul Mohammed 2 1 OSF Saint Anthony Medical Center, 5666 E State St, Rockford, IL 61108, USA 2 Advocate Illinois Masonic Medical Center, 833 W Wellington Ave, Chicago, IL 60657, USA; [email protected] * Correspondence: [email protected] Received: 20 February 2019; Accepted: 2 April 2019; Published: 4 April 2019 Abstract: Magnesium is the fourth most abundant cation in the body and the second most abundant intracellular cation. It plays an important role in different organ systems at the cellular and enzymatic levels. Despite its importance, it still has not received the needed attention either in the medical literature or in clinical practice in comparison to other electrolytes like sodium, potassium, and calcium. Hypomagnesemia can lead to many clinical manifestations with some being life-threatening. The reported incidence is less likely than expected in the general population. We present a comprehensive review of different aspects of magnesium physiology and hypomagnesemia which can help clinicians in understanding, identifying, and treating this disorder. Keywords: magnesium; proton pump inhibitors; diuretics; hypomagnesemia 1. Introduction Magnesium is one of the most abundant cation in the body as well as an abundant intracellular cation. It plays an important role in molecular, biochemical, physiological, and pharmacological functions in the body. The importance of magnesium is well known, but still it is the forgotten electrolyte. The reason for it not getting the needed attention is because of rare symptomatology until levels are really low and also because of a lack of proper understanding of magnesium physiology. -
Urogenital Radiology ESUR 2012 Gratefully Acknowledges the Support of the Following Sponsors
British Society of Urogenital Radiology ESUR 2012 gratefully acknowledges the support of the following sponsors Main Sponsors Other Sponsors Our thanks also to www.esur2012.org __________________________________________________________________________________ ESUR – BSUR 2012 19th European Symposium on Urogenital Radiology and 7th BSUR Annual Scientific Meeting Congress Chairman: Sami Moussa (UK) Scientific Programme Committee President ESUR: Gertraud Heinz‐Peer (AT) Chairman: Sami Moussa (UK) Chairman BSUR: Phil Cook (UK) Boris Brkljacic (HR) SAR Honorary Lecture: Stuart Silverman (US) Michel Claudon (FR) Phil Cook (UK) MAIN TOPICS: Imaging and Management of Stone Nigel Cowan (UK) Disease Lorenzo Derchi (IT) Vikram Dogra (US) ACCREDITATION Nicolas Grenier (FR) CPD accreditation has been awarded by the Royal Gertraud Heinz‐Peer (AT) College of Radiologists as follows: Vibeke Løgager (DK Thursday 13 September (Members’ Day): 3 Sameh Morcos (UK) Friday 14 September: 7 Parvi Ramchandani (US) Saturday 15 September: 7 Michael Riccabona (AT) Sunday 16 September: 4 John Spencer (UK) Harriet Thoeny (CH) A total of 15 European CME credits (ECMEC) have Ahmet Turgut (TR) been awarded by the European Accreditation Council for Continuing Medical Education Local Committee (EACCME). Sami Moussa Julian Keanie VENUE: John Brush Surgeons’ Hall, Royal College of Surgeons of Sameh Morcos Edinburgh, Nicolson Street, Edinburgh EH8 9DW Edinburgh, UK LOCAL CONGRESS ORGANISER Intelligent Events Limited www.intel‐events.co.uk Page | 1 www.esur2012.org __________________________________________________________________________________ -
Cardiovascular Disease Session Guidelines
Cardiovascular Disease Session Guidelines This is a 15 minute webinar session for CNC physicians and staff CNC holds webinars on the 3rd Wednesday of each month to address topics related to risk adjustment documentation and coding Next scheduled webinar: • Wednesday, February 28th • Topic: Respiratory Disease CNC does not accept responsibility or liability for any adverse outcome from this training for any reason including undetected inaccuracy, opinion, and analysis that might prove erroneous or amended, or the coder/physician’s misunderstanding or misapplication of topics. Application of the information in this training does not imply or guarantee claims payment. Agenda • Statistics • Amputation Status & Atherosclerosis • Angina Pectoris • Acute Myocardial Infarction • Specified Heart Arrhythmias • Congestive Heart Failure • Pulmonary Hypertension • Cardiomyopathy • Hypertensive Heart disease Statistics • Nearly 35 percent of Tarrant County and Dallas area deaths each year are attributed to cardiovascular disease. • About 610,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths • Heart disease is the leading cause of death for both men and women • Every year about 735,000 Americans have a heart attack. Of these, (approximately 70%) 525,000 are a first heart attack and (approximately 30%)210,000 happen in people who have already had a heart attack Amputations There are nearly 2 million people living with limb loss in the United States Approximately 185,000 amputations occur in the United States each -
RENAL IMPAIRMENT in SARCOIDOSIS with SPECIAL REFERENCE to NEPHROCALCINOSIS by K
Postgrad Med J: first published as 10.1136/pgmj.31.360.516 on 1 October 1955. Downloaded from 5I6 ARENAL IMPAIRMENT IN SARCOIDOSIS WITH SPECIAL REFERENCE TO NEPHROCALCINOSIS By K. M. CITRON, M.D.(Lond.), M.R.C.P. Senior Medical Registrar, Brompton Hospital Introduction Case Record* Although impaired renal function is uncommon Miss I.E., aged 23, had in 1948 commenced in sarcoidosis the recognition of this complication work in a factory where she was engaged in coating is of importance since it may cause death and be- the inside of fluorescent tubes with a mixture con- cause prompt treatment may result in recovery of taining beryllium phosphor. This exposure to renal function. beryllium lasted one year. A chest radiograph at The kidney is a common site for sarcoid lesions. the end of this time was stated to be normal. Thus, in a combined series of 45 autopsies the However, ten months later, in April 1953, she kidneys showed macroscopic or microscopic in- attended the Brompton Hospital complaining of volvement in 20 per cent. (Ricker and Clark, I949; dry cough and dyspnoea on exertion. Physical Longcope and Freiman, I952). In view of the examination at this time showed no abnormalityby copyright. known tendency of sarcoid lesions to infiltrate but the chest radiograph showed miliary mottling organs extensively and impair function, it was in both lungs and enlarged hilar shadows (Fig. i). assumed by earlier authors that renal impairment The Mantoux reaction was negative i :ioo O.T. was due to massive invasion of the kidneys (Kline- and the E.S.R.