Clinical Research Directory

Renal Structural and Functional Alterations Following Repeated Ureteroscopic Procedures: An Exploratory Multimodal Imaging Study

Introduction and objectives Saline irrigation and instrumentation during Retrograde Intrarenal Surgery (RIRS) causes elevation of intrarenal pressure (IRP) inducing intrarenal backflow (IRB). In an experimental study from 2025 Hinojosa-Gonzalez et al. demonstrated an association between elevated IRP and increased risk of bacteremia. The potential of elevated IRP and IRB to breach physiological barriers and facilitate systemic translocation of renal pelvic contents warrants investigation into their effects on parenchymal integrity and function. Using contrast-enhanced MRI in a porcine model, Lildal et al. (2023) demonstrated segmental IRB with sharply demarcated areas of contrast distribution, predominantly at the renal poles. The preferential involvement of renal poles resembles the distribution of renal scarring observed in reflux nephropathy, raising the hypothesis that repeated pressure-related exposure may contribute to localized parenchymal alterations. However, whether repeated ureteroscopic procedures are associated with similar persistent regional changes in renal structure and function remains unclear. We therefore initiated an exploratory clinical study assessing renal structure and function following multiple ureteroscopic procedures using multiparametric MRI, DMSA scintigraphy and ultrasound elastography. Materials and methods This exploratory cross-sectional case-control study aims to enroll 10 patients with repeated unilateral ureteroscopic procedures and 10 healthy controls. Eligible patients must have undergone ≥3 ipsilateral procedures (RIRS/URS/URSL) and ≤1 contralateral procedure. Major exclusions include solitary kidney, metabolic or structural renal disorders compromising MRI analysis, chronic UTI, previous multiple PCNL procedures, and MRI contraindications. All participants undergo serum creatinine measurement and multiparametric renal MRI (1.5T Philips Ingenia), including T1 mapping, heavily T2-weighted 3D imaging, diffusion-weighted imaging, T2\* imaging, and renal arterial flow assessment. Renal scintigraphy is performed using ⁹⁹ᵐTc-DMSA, with planar imaging for quantification of split renal function and SPECT for evaluation of cortical scarring. Bilateral renal shear-wave elastography (Mindray Resona I9 ultrasound system) is conducted to quantify regional parenchymal stiffness in five predefined regions per kidney. Planned analyses will compare regional imaging parameters between patients and controls and between ipsilateral and contralateral kidneys, accounting for within-subject correlation. Segmental imaging parameters will be compared between groups and kidneys using linear mixed-effects models accounting for repeated measurements within subjects.

Investigation of the Effects of Exercise in Individuals With Juvenile Hallux Valgus

This study aims to evaluate the short- and long-term effects of toe spread-out exercises, performed under supervision for 3 months, on the angular severity of deformity and the electromechanical activity, stiffness, and thickness of the abductor hallucis muscle, as well as its contribution to functional status, in individuals with juvenile hallux valgus.

HIBOC = Hepatic Imaging Biomarkers in Obese Children

The goal of this prospective, diagnostic observational study is to learn about how imaging based markers for components of liver disease appear in children with obesity. It aims to determine whether the imaging markers (ultrasound and MRI) for liver disease can be tools to improve diagnostics for liver affection in children with obesity and to ascertain how the markers are related to multiple clinical measures, for example BMI and serology measure, and treatment effects over time.

Knee Medial Collateral Ligament Recovery After Pie-Crusting Release Technique

Medial meniscus tears requiring surgical interventions are mostly being done by arthroscopic procedures. During the arthroscopy, accessing the medial joint space is challenging. Because of this situation, pie-crusting of the medial collateral ligament (MCL) of the knee is described. This procedure is to release the MCL 1 cm distal to its origin with a needle-tip. This release provides enough space for both identifying the tear and also provides enough space to introduce necessary equipment in the joint space for repair. But there are some doubts about MCL release. Some authors suspected ongoing valgus instability after this procedure. Our aim is to identify the tension of MCL with USG shear wave elastography before the procedure, and 3 weeks, 6 weeks and 3 months postoperatively.

SWE to Detect Enthesitis in PsA: Relationship With SIRT2 Expression and Disease Activity

1. To assess the diagnostic utility of shear-wave elastography (SWE), gray-scale (GS) ultrasound, and Power Doppler (PD) in detecting Patellar and Achilles tendinopathy in psoriatic patients with and without arthritis. 2. Investigate the relation between SWE, GS ultrasound, and PD finding and SIRT2 expression levels. 3. Evaluate the association of the imaging findings and SIRT2 levels with psoriatic arthritis disease activity score.

Effect of Malnutrition on Liver and Spleen Stiffness in Children

This prospective observational study aims to evaluate the effect of malnutrition on liver and spleen stiffness in children using shear wave elastography. Two groups of participants will be enrolled: children diagnosed with malnutrition and age-matched healthy controls. Organ stiffness measurements will be compared between the two groups to assess the impact of malnutrition on liver and spleen tissue properties.