The combination of ultrasonic propulsion and burst wave lithotripsy can be used in awake patients to reposition and break up ureteral stones to facilitate passage, according to a study published in The Journal of Urology. M. Kennedy Hall, MD, and colleagues tested transcutaneous focused ultrasound in the form of ultrasonic propulsion and burst wave lithotripsy to reposition ureteral stones and facilitate passage in awake patients. The analysis included 29 individuals receiving either ultrasonic propulsion alone (N=16) or with burst wave lithotripsy (N=13). The investigators found stone motion in 66% of patients, and the stone passed in 18 of the 21 distal ureteral stone cases with at least 2 weeks of follow-up. In seven of 13 burst wave lithotripsy cases, fragmentation was seen. The procedure was tolerated by all. Hematuria on initial urination post-procedure and mild pain were anticipated. Seven participants had associated discomfort with only 18 of 820 propulsion bursts (2.2%). “This technology has the potential to provide an advantageous and patient-centered solution for the gap between expectant management and
urological intervention for symptomatic ureteral stones,” Dr. Hall and colleagues wrote.

Black Women Have Less Access to Newer Mammogram Technology

During 2005-2020, Black women had less access to new mammographic imaging technology compared with White women in the Medicare population, according to a study published in Radiology. Eric W. Christensen, PhD, and colleagues examined the relationship between use of newer mammographic technology and race in women aged 40-89 with Medicare fee-for-service insurance who were receiving mammography services in a retrospective study. More than 4 million institutional mammography claims were included. The OR for Black versus White women receiving digital mammography rather than screen-film mammography in 2005 was 0.80 within an institution; these differences persisted until 2009. The use of digital breast tomosynthesis within an institution was less likely for Black versus White women during 2015-2020 (OR, 0.84). Racial differences were seen in digital mammography use across institutions, which followed a U-shaped pattern; the differences peaked at 3.8 percentage points less for Black versus White women in 2011 and decreased to a difference of 1.2 percentage points less in 2016. “Advocacy for favorable reimbursement and incentive policies may diminish these differences if kept apace of evolving technologies,” Dr. Christensen and colleagues wrote.