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Biomedical subjects

William E Torres

Publications and source records attributed to William E Torres.

8 recordsLinked to original sources
PubMed2006

Adverse reactions to intravenous iodinated contrast media: a primer for radiologists.

Adverse reactions to intravenous iodinated contrast media may be classified as general and organ-specific, such as contrast-induced nephrotoxicity. General adverse reactions may be subclassified into acute and delayed types. Acute general adverse reactions can range from transient minor reactions to life-threatening severe reactions. Non-ionic contrast media have lower risk of mild and moderate adverse reactions. However, the risk of fatal reactions is similar for ionic and non-ionic contrast media. Adequate preprocedure evaluation should be performed to identify predisposing risk factors. Prompt recognition and treatment of acute adverse reactions is crucial. Risk of contrast induced nephrotoxicity can be reduced by use of non-ionic contrast media, less volume of contrast, and adequate hydration. The radiologist can play a pivotal role by being aware of predisposing factors, clinical presentation, and management of adverse reactions to contrast media.

Acidosis, Lactic↗
PubMed2005

Changes in C-reactive protein predict insulin sensitivity in severely obese individuals after weight loss surgery.

The production of inflammatory mediators by abdominal adipose tissue may link obesity and insulin resistance. We determined the influence of systemic levels of interleukin-6 and C-reactive protein on insulin sensitivity after weight loss via Roux-en-Y gastric bypass surgery. Severely obese individuals (n = 15) were evaluated at baseline and at 6 months after surgery. Insulin sensitivity was determined by frequently sampled intravenous glucose tolerance testing at the same time points. Visceral and subcutaneous adipose tissue volumes were quantified by computed tomography. Interleukin-6 and C-reactive protein were measured by enzyme-linked immunoassay in plasma and in adipose tissue biopsies. Correlation analysis was used to determine associations between insulin sensitivity and other outcome variables. Significance was set at P < 0.05. Plasma interleukin-6 concentrations were significantly correlated to the IL-6 content of subcutaneous adipose tissue (r = 0.71). At 6 months postsurgery, subcutaneous and visceral adipose tissue volumes were significantly reduced (34.7% and 44.1%, respectively) and insulin sensitivity had improved by 160.9%. Significant longitudinal correlations were found between insulin sensitivity and plasma C-reactive protein (r = -0.61), but not plasma interleukin-6 at 6 months. These findings offer insights that link obesity and insulin resistance via the activity of inflammatory mediators.

Adipose Tissue↗
PubMedDate not supplied

Multidetector-row CT angiography for preoperative evaluation of potential laparoscopic renal donors: how accurate are we?

The purpose of this study was to evaluate multidetector-row computed tomography (MDCT) angiography in preoperative evaluation of renal donors for renal vascular abnormalities. Eighty-one patients underwent renal MDCT angiography and laparoscopic donor nephrectomy. MDCT angiographic findings were compared with surgical findings. The sensitivity and specificity of MDCT angiography for detection of accessory arteries, prehilar renal artery branching, and renal venous anomalies were 88% and 98%, 100% and 97%, and 100% and 97%, respectively. CT findings agreed with surgical findings for accessory renal arteries, prehilar renal artery branching, and renal venous anomalies in 94%, 93%, and 98% of patients, respectively.

Adult↗
PubMedDate not supplied

Multidetector row computed tomography evaluation of potential living laparoscopic renal donors: the story so far.

Renal transplantation is the treatment of choice for end-stage renal disease. Living related kidney donation is the major source of renal grafts due to limited availability of cadaveric kidneys. Open nephrectomy was used to harvest donor kidneys. However, the laparoscopic approach is associated with less postoperative pain and quick recovery. So, most centers now prefer a laparoscopic approach to explant donor kidneys. Laparoscopic approach is technically challenging due to limited operative visibility. Hence, accurate preoperative detection of renal arterial and venous anomalies is imperative to avoid inadvertent vascular injury and bleeding. The preoperative workup of renal donors includes clinical evaluation, laboratory tests, and imaging. Traditionally, the renal donors were evaluated with conventional imaging techniques, which included renal catheter angiography and intravenous urography. However, conventional imaging is invasive, expensive, and less accurate for evaluation of complex renal venous anomalies, small calculi, and diffuse or focal renal parenchymal lesions. The introduction of multidetector row computed tomography (MDCT) revolutionized the CT technology by enabling isotropic resolution with faster scan coverage in a single, short breath-hold. Consequently, MDCT has now replaced conventional imaging for comprehensive imaging of potential living renal donors. MDCT is a minimally invasive technique that can accurately detect urolithiasis, renal arterial and venous anomalies, renal parenchymal lesions, and urinary tract anomalies. Renal vascular anomalies detected by MDCT can help the surgeon in planning donor nephrectomy. MDCT with three-dimensional CT angiography enables accurate preoperative renal vascular mapping. This article reviews the role of MDCT in preoperative evaluation of potential laparoscopic renal donors.

Clinical Protocols↗
PubMedDate not supplied

Adverse reactions to intravenous iodinated contrast media: an update.

Assessment of patients before intravenous contrast injection can help in detecting predisposing risk factors for adverse reactions to contrast media. Early recognition and treatment of acute adverse reactions can prevent morbidity and mortality (rare).

Contrast Media↗
PubMedDate not supplied

Development of a teaching file by using a DICOM database.

A teaching file of Digital Imaging and Communications in Medicine (DICOM) images was developed. Selected computed tomographic, magnetic resonance, angiographic, nuclear medicine, and ultrasonographic images were transferred to a personal computer (PC) with a 75-GB hard drive. The database created from the DICOM header information was modified to include American College of Radiology (ACR) Learning File categories. Database modification allowed cases to be searched by diagnosis, by findings, and by patient age, sex, and demographics. Technologists inputted ACR codes into the DICOM headers before the images were acquired, thereby reducing database maintenance time. Images were manipulated and reviewed and were used for case presentations, board review, and conferences. Selected images were transferred via a hospital network to workstations for consultation, saving time for referring clinicians. The teaching file is reliable, cost-effective, and easy to install and takes advantage of recent technologic advances in computer hardware and software. Rapid cost reductions and increases in PC storage capacity allow maintenance of the teaching file in DICOM format without intermediate steps involving automation or manual conversion. This setup rivals any of the proprietary software currently available from other vendors.

Computer Communication Networks↗
PubMedDate not supplied

Paleoradiology: advanced CT in the evaluation of nine Egyptian mummies.

Axial thin-collimation state-of-the-art spiral computed tomography (CT) was combined with sagittal and coronal reformatting, three-dimensional (3D) reconstruction, and virtual "fly-through" techniques to nondestructively study nine Egyptian mummies. These techniques provided important paleopathologic and historical information about mummification techniques, depicted anatomy in the most informative imaging plane, illustrated the soft-tissue preservation and physical appearance of mummies in superb detail, and generated an intriguing virtual tour through hollow mummified remains without harming the specimens themselves. Images generated with these methods can help archaeologists and Egyptologists understand these fascinating members of mankind and can serve as adjunct visual aids for laypersons who are interested in mummies. CT has emerged as the imaging modality of choice for the examination of Egyptian mummies due to its noninvasive cross-sectional nature and inherently superior contrast and spatial resolution. As multi-detector row CT and postprocessing tools evolve, the capabilities and applications of CT will continue to proliferate, attesting to the expanded versatility and utility of CT as a noninvasive research tool in the multidisciplinary study of Egyptian mummies.

History, Ancient↗