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Biomedical subjects

Vikram Dogra

Publications and source records attributed to Vikram Dogra.

14 recordsLinked to original sources
PubMed2006

Transrectal sonography in prostate evaluation.

Prostate cancer is the most prevalent newly diagnosed noncutaneous malignancy in men. With the continued use of prostate-specific antigen screening, there has been a dramatic rise in the number of prostate biopsied performed. Transrectal ultrasonography (TRUS) is an essential tool used for detecting prostate pathology and performing prostate biopsies. This article review the indications and principles of TRUS of the prostate, the technique of TRUS, and controversies pertaining to prostate core biopsy.

Biopsy↗
PubMed2006

What's new in urologic ultrasound?

Ultrasonography allows providers to noninvasively image an area of interest in real time without the risks of ionizing radiation or nephrotoxic contrast agents. This article present basic concepts of ultrasound along with new advances in ultrasound technology and their applications in small parts evaluation.

Humans↗
PubMed2006

Controversies in transrectal ultrasonography and prostate biopsy.

Transrectal ultrasound-guided biopsy of the prostate is the gold standard for the detection of prostate cancer. In its current form, transrectal gray-scale ultrasound is unable to differentiate malignant prostate tissue from benign tissue. The general indications for performing a sonographic guided biopsy of the prostate are an abnormal digital rectal examination or an abnormal prostate-specific antigen (PSA). Several controversial areas remain: the ideal number of biopsy cores, the use of PSA velocity, free PSA, PSA density, age- and race-adjusted PSA, the use of local anesthetics, and the overall best patient preparation methods, including such topics as routine antibiotic prophylaxis or bowel enemas, remain unsettled. There are also unanswered questions regarding repeat biopsy and protocols for managing patients with a diagnosis of high-grade intraepithelial neoplasia. This article will explore some of the current controversies and review the pertinent literature.

Biomarkers, Tumor↗
PubMed2005

First trimester bleeding evaluation.

First trimester bleeding is a common presentation in the emergency room. Ultrasound evaluation of patients with first trimester bleeding is the mainstay of the examination. The important causes of first trimester bleeding include spontaneous abortion, ectopic pregnancy, and gestational trophoblastic disease; 50% to 70% of spontaneous abortions are due to genetic abnormalities. In normal pregnancy, the serum beta hCG doubles or increases by at least 66% in 48 hours. The intrauterine GS should be visualized by TVUS with beta hCG levels between 1000 to 2000 mIU/mL IRP. Visualization of the yolk sac within the gestational sac is definitive evidence of intrauterine pregnancy. Embryonic cardiac activity can be identified with CRL of >5 mm. A GS with a mean sac diameter (MSD) of 8 mm or more without a yolk sac and a GS with an MSD of 16 mm or more without an embryo, are important predictors of a nonviable gestation. A GS with a mean sac diameter of 16 mm or more (TVUS) without an embryo is a sonographic sign of anembryonic gestation. A difference of <5 mm between the mean sac diameter and the CRL carries an 80% risk of spontaneous abortion. Approximately 20% of women with first trimester bleeding have a subchorionic hematoma. The presence of an extra ovarian adnexal mass is the most common sonographic finding in ectopic pregnancy. Other findings include the tubal ring sign and hemorrhage. About 26% of ectopic pregnancies have normal pelvic sonograms on TVUS. Complete hydatidiform mole presents with a complex intrauterine mass with multiple anechoic areas of varying sizes (Snowstorm appearance). Twenty-five percent to 65% of molar pregnancies have associated theca-leutin cysts. Arteriovenous malformation of the uterus is a rare but life-threatening cause of vaginal bleeding in the first trimester. The sonographic findings in a patient with first trimester bleeding should be correlated with serum beta hCG levels to arrive at an appropriate clinical diagnosis.

Female↗
PubMed2004

Acute painful scrotum.

The ability of US to diagnose the pathogenesis of the acute scrotum is unsurpassed by any other imaging modality. It is the first imaging performed in patients with acute scrotum. Knowledge of the normal and pathologic sonographic appearance of the scrotum and proper sonographic technique is essential for accurate diagnosis of acute scrotum. High-frequency transducer sonography combined with color flow Doppler sonography provides the information essential to reach a specific diagnosis in patients with testicular torsion, epididymo-orchitis, and testicular trauma.

Acute Disease↗
PubMed2004

Priapism.

Priapism is a relatively uncommon condition that may present as a medical emergency associated with significant pain and anxiety in the veno-occlusive or low-flow variant. Pharmacologic advances and, specifically, the availability of intracavemosal alpha-agonist therapy have dramatically improved the prospects of resolution for patients with low-flow priapism presenting within the first few hours of the acute episode. High-flow priapism is not considered an emergency and treatment measures are typically conservative aimed at preservation of potency. Urologists, radiologists, and other health care personnel caring for the patient with priapism must be familiar with various etiologic factors implicated in low-flow and high-flow priapism to formulate a logical step-care approach. Differentiation of the low-flow from the high-flow state is perhaps the most critical initial diagnostic challenge that determines the sequence of further interventions including surgical shunts in low-flow priapism refractory to medical therapy.

Adult↗
PubMed2004

A feasibility study of high intensity focused ultrasound for liver biopsy hemostasis.

This study was conducted to demonstrate the feasibility of high intensity focused ultrasound (HIFU) application to control post-liver-biopsy hemorrhage. Anesthetized Yorkshire pigs (n = 3; mean weight = 23.0 kg) were used and the liver organ was exposed surgically by an open laparotomy. Core biopsies were performed on the hepatic parenchyma with 14-gauge (n = 41) and 18-gauge (n = 33) core biopsy needles. The focus of HIFU (4.23 MHz) field was applied for 15 to 45 s to the needle entry site in the liver immediately after needle retraction. Blood loss from a biopsy site was determined using surgical sponges as absorbent applied at the site. Mean blood loss for control sites was 6.16 g (14-gauge, n = 20) and 1.22 g (18-gauge, n = 10). Virtually no blood loss was measured for biopsies after HIFU application (n = 44) for using needles of both sizes. Our results indicate that intraoperative HIFU application could successfully induce hemostasis after liver biopsy in a porcine model.

Animals↗