Nouvelles techniques radiologiques pour les patients insuffisants rénaux

Radiological investigations using gadolinium or intravenous iodinated contrast products are used cautiously in patients suffering from chronic kidney disease because of their risk of acute kidney injury and systemic nephrogenic fibrosis. In this article, we review several radiological alternatives that can be useful to obtain renal anatomical and/or functional information in this patient population. The basic principles, indications, and advantages and limitations of Doppler ultrasound with measurement of the resistance index, contrast-enhanced ultrasound, and a technique called BOLD-MRI (blood-oxygenation level dependent-MRI) are discussed.

Interictal arterial spin-labeling MRI perfusion in intractable epilepsy

INTRODUCTION: Magnetic resonance imaging (MRI) is required for the investigation of surgically intractable epilepsy. In addition to the standard MRI techniques, perfusion sequences can be added to improve visualization of underlying pathological changes. Arterial spin-labeling (ASL) MRI perfusion does not require contrast administration and, for this reason, may have advantages in these patients. METHODS: We report here on 16 patients with epilepsy who underwent MRI of the brain with ASL and positron emission tomography (PET). RESULTS: Despite a slightly reduced resolution with ASL, we found a correlation between ASL, PET and electrophysiological data, with hypoperfusion on ASL that corresponded with hypoperfusion on interictal PET. CONCLUSION: Given the correlation between ASL and PET and electrophysiology, perfusion with ASL could become part of the standard work-up in patients with epilepsy.

Temporary zinc oxide-eugenol cement: eugenol quantity in dentin and bond strength of resin composite

Uptake of eugenol from eugenol-containing temporary materials may reduce the adhesion of subsequent resin-based restorations. This study investigated the effect of duration of exposure to zinc oxide–eugenol (ZOE) cement on the quantity of eugenol retained in dentin and on the microtensile bond strength (μTBS) of the resin composite. The ZOE cement (IRM Caps) was applied onto the dentin of human molars (21 per group) for 1, 7, or 28 d. One half of each molar was used to determine the quantity of eugenol (by spectrofluorimetry) and the other half was used for μTBS testing. The ZOE-exposed dentin was treated with either OptiBond FL using phosphoric acid (H3PO4) or with Gluma Classic using ethylenediaminetetraacetic acid (EDTA) conditioning. One group without conditioning (for eugenol quantity) and two groups not exposed to ZOE (for eugenol quantity and μTBS testing) served as controls. The quantity of eugenol ranged between 0.33 and 2.9 nmol mg−1 of dentin (median values). No effect of the duration of exposure to ZOE was found. Conditioning with H3PO4 or EDTA significantly reduced the quantity of eugenol in dentin. Nevertheless, for OptiBond FL, exposure to ZOE significantly decreased the μTBS, regardless of the duration of exposure. For Gluma Classic, the μTBS decreased after exposure to ZOE for 7 and 28 d. OptiBond FL yielded a significantly higher μTBS than did Gluma Classic. Thus, ZOE should be avoided in cavities later to be restored with resin-based materials.

Ärztliche Fahreignungsuntersuchungen – rechtliche Grundlagen und Neuerungen im Fokus

Mit rund 50’000 Arztzeugnissen im Rahmen der obligatorischen Kontrolluntersuchungen leisten die behandelnden Ärzte im Kanton Bern jedes Jahr einen wichtigen Beitrag zur Verkehrssicherheit. Rund um die Verkehrssicherheit und die individuellen Mobilitätsbedürfnisse stellen sich oft anspruchsvolle medizinische Fragen. Unklarheiten bestehen manchmal zum Arztgeheimnis und seiner Wirkung für den Informationsaustausch mit dem Strassenverkehrs- und Schifffahrtsamt (SVSA). Solche Rechtsfragen und Hinweise auf Neuerungen mit Bezug zu Fahreignungsabklärungen beleuchten im nachfolgenden Beitrag die Verantwortlichen des SVSA und des Instituts für Rechtsmedizin der Universität Bern (IRM).

Mineral-magnetic record of Late Quaternary climatic changes in a high Alpine lake

The magnetic properties of a sediment core from a high altitude lake in the Swiss Alps were compared with palynological and geochemical data to link climatic and mineral magnetic variations. According to pollen data, the sediments extend from the present to the Younger Dryas, i.e., they cover more than 10,000 years of environmental change in the Alps. The major change in magnetic properties corresponds to the climatic warming of the early Holocene. High-coercivity magnetic minerals that characterize the Late Glacial period almost disappeared during the Holocene and the concentration of ferrimagnetic minerals increased sharply. The contribution of superparamagnetic grains also decreased in the Holocene sediments. Similar variations in {SP} content and coercivity, of smaller magnitude, are found in the Holocene and are interpreted to represent minor climatic variations. Comparison with the historical record of the last 1000 years confirms this interpretation. The magnetic mineralogy, the superparamagnetic contents, and the {IRM} intensity in the coarse-grained, Late Glacial sediments are similar to those measured in the catchment bedrock. This indicates a detrital origin. The different properties and the higher concentration of magnetic minerals in the Holocene sediments are due to authigenic phases. Magnetic properties provide a high resolution record of climatic change. They are sensitive even to small variations that are not recorded in the pollen or {LOI} data. Magnetic parameters show fine-scale variation and constitute a valuable supplement to conventional climatic indicators.