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1

Bernolian, Nuswil, Radiyati Umi Partan, Siti Nurmaini, Cindy Kesty, and Benedictus Wicaksono Widodo. "Congenital Heart Diseases in Pregnancy." Bioscientia Medicina : Journal of Biomedicine and Translational Research 5, no. 4 (July 8, 2021): 988–1004. http://dx.doi.org/10.32539/bsm.v5i4.376.

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This research aims to shed light into congenital heart diseases, the pathophysiology, and the ultrasonographic findings of congenital heart diseases. Congenital heart diseases are a major health concern, affecting 1.35 million children born every year. Ventricular septal defect, atrial septal defect, and atrioventricular septal defect are found in 57.9% cases of congenital heart diseases. The risk factors include consanguineous marriage, family history of congenital heart diseases, old maternal and paternal age, and exposure to teratogens, and genetic factors. Missteps in cardiac development are the main pathophysiology of congenital heart diseases. Ultrasonography screening in 18–22 weeks gestational age is utilized to screen. Follow-up screening can increase detection rate to 80%. This study has limitation of only discussing most common congenital heart diseases and did not delve into rarer types of congenital heart diseases and did not discuss impacts or burden of congenital heart diseases in adulthood and health comorbidities associated. This literature review is beneficial for general practitioners and obstetricians focusing in maternal fetal medicine.
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2

DOĞANAY, Zahide, Ayşe YILMAZ, and Veysel Garani SOYLU. "Lung and cardiac ultrasonography in intensive care." Kastamonu Medical Journal 2, no. 3 (September 22, 2022): 57–62. http://dx.doi.org/10.51271/kmj-0073.

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Ultrasonography is an imaging tool that is increasingly used in the diagnosis and follow-up of many lung and heart diseases. Full lung ultrasonography is the examination of both hemithorax and protocols and image definitions have been created to make the examination more systematic and accurate. Cardiac ultrasonography is used to evaluate a moving organ. It requires users to be able to detect and interpret dynamic and variable values. Another feature of ultrasonography is its ability to guide interventional procedures. Ultrasonography will develop in the future and will be used more as a modern diagnostic tool in lung and heart evaluation by specialists.
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3

Poplata, Indira, Elvedina Hodžić, Nedim Begić, and Ljiljana Stijepović. "THE IMPORTANCE OF ULTRASONOGRAPHY IN THE DETECTION OF CONGENITAL HEART DISEASES IN CHILDREN." MEDIS – International Journal of Medical Sciences and Research 3, no. 2 (May 19, 2024): 13–17. http://dx.doi.org/10.35120/medisij030213p.

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Over the last few years, remarkable progress has been made in the field of congenital heart diseases. Improvements considering diagnostic modalities, especially imaging, in surgical and interventional techniques, as well as in postoperative therapy and care, have contributed to a significant reduction in mortality and morbidity. One of the most important applications of medical imaging techniques in children is the detection and treatment of congenital heart anomalies. Objective of this article is to show the importance of ultrasonography in the detection of congenital heart diseases in children. The study was conducted on children with simple and complex congenital heart diseases and was conducted on the Pediatric Clinic, UKCS. The research is descriptive on a representative sample. In our study, 166 children were observed, of which 148 children (77 boys, 71 girls) with simple congenital heart diseases, and 18 children (8 boys, 10 girls) with complex congenital heart diseases. Out of the total number of observed children, 115 had a surgical correction, 97 children with simple congenital heart diseases (45 boys, 52 girls) and 18 children with complex congenital heart diseases (8 boys, 10 girls). The number of children monitored through the Cardiac Counseling Center who didn’t undergo surgical correction was 51, all with simple congenital heart diseases. Out of the total number of observed children who were frequently coming for follow-ups, 28 children had changes on the ECG, and 138 of them had no changes on the ECG, 93 were surgically treated, and 73 of them were on conservative therapy. Based on the results of the research, we conclude that ultrasonography is an important method in the detection and treatment of congenital heart diseases.
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4

Katende, Andrew, Johanna Oehri, Victor Z. Urio, Evance Mahundi, Lulu Wilson, Victor Myovela, Chipegwa Mlula, et al. "Use of a Handheld Ultrasonographic Device to Identify Heart Failure and Pulmonary Disease in Rural Africa." JAMA Network Open 7, no. 2 (February 28, 2024): e240577. http://dx.doi.org/10.1001/jamanetworkopen.2024.0577.

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ImportanceAgreement in lung ultrasonography findings between clinicians using a handheld ultrasonographic device and expert sonographers using a high-end ultrasonographic machine has not been studied in sub-Saharan Africa.ObjectiveTo determine the agreement in ultrasonographic findings and diagnoses between primary care clinicians trained in lung ultrasonography, board-certified expert sonographers, and senior physicians.Design, Setting, and ParticipantsThis cross-sectional single-center study was conducted from February 1, 2022, to April 30, 2023 at a referral center in rural Tanzania. Individuals 5 years or older with respiratory symptoms and at least 2 distinct respiratory signs or symptoms were eligible. A total of 459 individuals were screened.ExposuresParticipants provided their medical history and underwent a clinical examination and lung ultrasonography performed by a clinician, followed by a lung ultrasonography performed by an expert sonographer, and finally chest radiography and a final evaluation performed by a senior physician. Other tests, such as echocardiography and Mycobacterium tuberculosis testing, were conducted on the decision of the physician. Clinicians received 2 hours of instruction and three 2-hour sessions of clinical training in the use of a handheld lung ultrasonographic device; expert sonographers were board-certified.Main Outcomes and MeasuresPercentage agreement and Cohen κ coefficient for sonographic findings and diagnoses compared between clinicians and expert sonographers, and between clinicians and senior physicians.ResultsThe median (IQR) age of 438 included participants was 54 (38-66) years, and 225 (51%) were male. The median (range) percentage agreement of ultrasonographic findings between clinicians and expert sonographers was 93% (71%-99%), with κ ranging from −0.003 to 0.83. Median (range) agreement of diagnoses between clinicians and expert sonographers was 90% (50%-99%), with κ ranging from −0.002 to 0.76. Between clinicians and senior physicians, median (range) agreement of diagnoses was 89% (55%-90%), with κ ranging from −0.008 to 0.76. Between clinicians and senior physicians, diagnosis agreements were 85% (κ, 0.69) for heart failure, 78% (κ, 0.57) for definite or probable tuberculosis, 50% (κ, 0.002) for viral pneumonia, and 56% (κ, 0.06) for bacterial pneumonia.Conclusions and RelevanceIn this cross-sectional study, the agreement of ultrasonographic findings between clinicians and sonographers was mostly substantial. Between clinicians and senior physicians, agreement was substantial in the diagnosis of heart failure, moderate in the diagnosis of tuberculosis, but slight in the diagnosis of pneumonia. These findings suggest that handheld ultrasonographic devices used in addition to clinical examination may support clinicians in diagnosing cardiac and pulmonary diseases in rural sub-Saharan Africa.
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Abd El Raouf, Mustafa, Magdy Elgioushy, and Shimaa A. Ezzeldein. "Congestive heart failure in cattle; etiology, clinical, and ultrasonographic findings in 67 cases." June-2020 13, no. 6 (2020): 1145–52. http://dx.doi.org/10.14202/vetworld.2020.1145-1152.

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Background and Aim: Congestive heart failure (CHF) is a clinical disorder that results from cardiac dysfunction with subsequent fatal outcomes in most cases. Several diseases are incriminated in occurrence of CHF. Therefore, the aims of this study were to identify CHF etiology and associated clinical findings in 67 cows and to investigate the relationship between CHF and the other body organs using ultrasonographic examination. Materials and Methods: Sixty-seven cows affected by CHF admitted to the clinic with a history of loss of appetite, decrease in milk production, constipation, and brisket edema were thoroughly investigated clinically and ultrasonographically. In addition, ten apparently healthy cows were used as a control group. Results: Clinically, cows with CHF manifested jugular engorgement and pulsation (88.1%), brisket and/or intermandibular edema (77.6%), and muffled heart sounds (76.1%). Based on the ultrasonographic examination, traumatic pericarditis (82.1%) was the most prevalent etiology of CHF. Extracardiac etiology of CHF identified were exudative pleurisy (10.4%) and mediastinal abscesses (7.5%). Hepatomegaly (88.1%) and pleural effusion (61.2%) were the most documented consequences. Conclusion: Both cardiac and extracardiac diseases could be associated with CHF in cattle. Ultrasonographic changes in liver and pleura secondary to CHF were the most common findings. Ultrasonography is a good tool for the diagnosis of cardiac and extracardiac etiologies of CHF in cattle.
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6

Hamadah, M. H., M. Kabbani, and M. A. Faraji. "77. Ultrasonography assessment of congenital renal anomalies in children with congenital heart diseases." Journal of the Saudi Heart Association 28, no. 3 (July 2016): 219. http://dx.doi.org/10.1016/j.jsha.2016.04.078.

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7

Bolvardi, Ehsan, Seyyed Mohsen Pouryaghobi, Koorosh Ahmadi, Roohye Farzane, Niaz Mohamad Jafari Chokan, and Hamidreza Reihani. "The Prognostic Value of Using Ultrasonography in Cardiac Resuscitation of Patients with Cardiac Arrest." International Journal of Biomedical Science 12, no. 3 (September 15, 2016): 110–14. http://dx.doi.org/10.59566/ijbs.2016.12110.

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Cardiopulmonary arrest is the final result of many diseases and therefore, need for a careful implementation of cardiopulmonary resuscitation (CPR) protocols in these cases is undeniably important. The introduction of ultrasound into the emergency department has potentially allowed the addition of an extra data point in the decision about when to cease cardiopulmonary resuscitation (CPR). The aim of this study is to evaluate the ability of cardiac ultrasonography performed by emergency physicians to predict resuscitation outcome in adult cardiac arrest patients. Ultrasonographic examination of the subxiphoid cardiac area was made immediately after admission to the emergency department with pulseless cardiac arrest. Sonographic cardiac activity was defined as any detectable motion within the heart including the atria, ventricles or valves. Successful resuscitation was defined as: return of spontaneous circulation for ≥ 20 min; return of breathing; palpable pulse; measurable blood pressure. The present study includes 159 patients. The presence of sonographic cardiac activity at the beginning of resuscitation was significantly associated with a successful outcome (41/49 [83.7%] versus 15/110 [13.6%] patients without cardiac activity at the beginning of resuscitation). Ultrasonographic detection of cardiac activity may be useful in determining prognosis during cardiac arrest. Further studies are needed to elucidate the predictive value of ultrasonography in cardiac arrest patients.
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8

Bao, Zheng. "Application of ultrasound diagnosis in cardiac and liver diseases." Applied and Computational Engineering 31, no. 1 (January 22, 2024): 201–6. http://dx.doi.org/10.54254/2755-2721/31/20230151.

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Ultrasonography is a non-invasive imaging modality widely used to evaluate and diagnose many diseases. The purpose of this article is to provide a more detailed overview of the use of ultrasound in the diagnosis of heart and liver disease. In addition to a basic introduction to heart and liver disease, this article will explore specific applications of ultrasound in specific heart and liver diseases. In terms of heart disease, ultrasound plays an important role in the diagnosis of coronary atherosclerotic heart disease, valvular heart disease and congenital heart disease. Ultrasound can assess the degree of narrowing and blood flow in coronary arteries to help determine a patient's cardiovascular risk. For valvular heart disease, ultrasound can detect and evaluate the function and abnormality of the heart valves, providing information about valve stenosis or regurgitation. For congenital heart disease, ultrasound can reveal structural abnormalities and hemodynamic changes in the heart, helping to determine the type and severity of the lesion. In liver disease, ultrasound plays an important role in the evaluation of pathologies such as cirrhosis and hepatocellular carcinoma. Ultrasound can assess the shape, size, and texture of the liver, help detect and diagnose cirrhosis, and assess liver function and disease progression. In addition, ultrasound is also of great significance for the early diagnosis and monitoring of hepatocellular carcinoma, which can reveal the location, size and blood flow of the tumor. The role of ultrasound in diagnosing and monitoring disease will expand further with advances in technologies such as artificial intelligence and elastography. In conclusion, ultrasound plays a key role in the assessment, diagnosis and monitoring of heart and liver diseases and has many advantages. With the further development of technology and the expansion of application, the position of ultrasound in clinical practice will be further strengthened.
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9

Shao, Xuebo, Weidong Tang, Lianglong Yu, Qi Chen, Lijun Zhu, and Yanyan He. "Adoption of Ultrasonography in Hemodynamic Diagnosis and Monitoring of Severe Respiratory Diseases." Journal of Medical Imaging and Health Informatics 10, no. 9 (August 1, 2020): 2073–78. http://dx.doi.org/10.1166/jmihi.2020.3141.

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To enhance the clinical diagnosis rate of acute respiratory distress syndrome (ARDS) and provide a reliable basis for follow-up treatment, in this research, the hemodynamic indexes of patients with severe respiratory diseases are monitored by ultrasonic imaging. A total of 64 patients with ARDS in the department of respiratory medicine of XXX hospital from June 2018 to December 2018 are listed as study subjects (including 45 males and 19 females), and are divided into control group (CG) and experimental group (EG) in random. In the CG, central venous pressure is used to detect the patients, while in the EP, ultrasonic imaging is used to detect the patients, and the ultrasonic image is denoised by wavelet transform. Respiratory parameters (respiratory rate, oxygenation index, and positive end-expiratory pressure ventilation) and hemodynamic parameters (heart rate, mean arterial pressure, pulmonary static compliance, and airway plateau pressure) are compared on the first and 10th day of admission. The fluid volume of the two groups of patients was managed according to the hemodynamic parameters. After three months, the prognosis (duration of ICU treatment, duration of mechanical ventilation, incidence of heart failure and mortality) of the patients in both groups were calculated. The results show that wavelet transform can effectively reduce the noise of ultrasonic images, so as to obtain real and reliable data. Compared with the first day of admission, respiratory parameters and hemodynamics of the patient change significantly after 10 days (P < 0.05). The average daily fluid intake in the EP is significantly lower than that in the CG (P < 0.05). The duration of treatment in ICU and mechanical ventilation in the EG is significantly lower than that in the CG (P < 0.05), which indicates that ultrasonic imaging can detect and diagnose the hemodynamics of patients, thus providing reliable guidance for patients’ fluid management and avoiding patients’ cardiac failure induced by fluid overload. This provides an experimental scheme for hemodynamic monitoring of patients with severe respiratory system.
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10

Rat, Nora, Iolanda Muntean, Diana Opincariu, Liliana Gozar, Rodica Togănel, and Monica Chițu. "Cardiovascular Imaging for Guiding Interventional Therapy in Structural Heart Diseases." Current Medical Imaging Formerly Current Medical Imaging Reviews 16, no. 2 (January 24, 2020): 111–22. http://dx.doi.org/10.2174/1573405614666180612081736.

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Development of interventional methods has revolutionized the treatment of structural cardiac diseases. Given the complexity of structural interventions and the anatomical variability of various structural defects, novel imaging techniques have been implemented in the current clinical practice for guiding the interventional procedure and for selection of the device to be used. Three– dimensional echocardiography is the most used imaging method that has improved the threedimensional assessment of cardiac structures, and it has considerably reduced the cost of complications derived from malalignment of interventional devices. Assessment of cardiac structures with the use of angiography holds the advantage of providing images in real time, but it does not allow an anatomical description. Transesophageal Echocardiography (TEE) and intracardiac ultrasonography play major roles in guiding Atrial Septal Defect (ASD) or Patent Foramen Ovale (PFO) closure and device follow-up, while TEE is the procedure of choice to assess the flow in the Left Atrial Appendage (LAA) and the embolic risk associated with a decreased flow. On the other hand, contrast CT and MRI have high specificity for providing a detailed description of structure, but cannot assess the flow through the shunt or the valvular mobility. This review aims to present the role of modern imaging techniques in pre-procedural assessment and intraprocedural guiding of structural percutaneous interventions performed to close an ASD, a PFO, an LAA or a patent ductus arteriosus.
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11

Bai, Xue-Peng, Jia-Xing Li, Jin-Lan Ma, Xin-Bao Tian, Chao Han, and Yun Wang. "A comparative study examining the impact of coronary artery bypass grafting surgery with non-extracorporeal circulation on heart function and structure in patients with various forms of coronary heart diseases." Medicine 103, no. 29 (July 19, 2024): e38844. http://dx.doi.org/10.1097/md.0000000000038844.

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The aim of this study is to assess alterations in heart function and structure in patients diagnosed with non-ST segment elevation acute myocardial infarction (NSTEAMI), unstable angina (UA), and stable angina (SA) 1 year after undergoing off-pump coronary artery bypass grafting (OPCABG) performed without extracorporeal circulation. A total of 182 patients who underwent OPCABG were included and classified into 3 groups based on their preoperative diagnosis: the NSTEAMI group (n = 68), the UA group (n = 64), and the SA group (n = 50). Cardiac ultrasonography data were collected for all groups both preoperatively and 1 year postoperatively. Clinical data were subjected to statistical analysis. In the NSTEAMI group, postoperative observations revealed increases in left ventricular stroke volume and left ventricular end-systolic diameter, along with reductions in left ventricular end-diastolic volume (LVEDV) and left ventricular end-diastolic diameter (LVEDD) 1-year post-surgery. The UA group demonstrated decreases in LVEDV and LVEDD 1-year post-surgery. Similarly, the SA group exhibited an increase in left ventricular ejection fraction (LVEF) and reductions in LVEDV and LVEDD 1-year post-surgery. Comparative analysis of cardiac ultrasonography data revealed that the NSTEAMI group displayed significantly lower left ventricular stroke volume and notably higher left ventricular end-systolic diameter and volume compared to the UA and SA groups 1-year post-surgery. Furthermore, the SA group exhibited significantly elevated LVEF compared to the UA and NSTEAMI groups 1-year post-surgery. Cardiac ultrasonography findings indicate that all 3 groups exhibited improvements in cardiac function and left ventricular structure 1-year post-surgery. However, the NSTEAMI group demonstrated more substantial improvements in comparison to the UA and SA groups.
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Khalphallah, Arafat, Enas Elmeligy, Khaled Khesruf, Haitham Mohammed, Abdulrahman Abdulkarim, Ashraf Seida, and Al lethie. "Echocardiographic characterization of cardiac chambers and vasculatures in buffaloes (Bubalus bubalis) during diastolic and systolic phases." Open Veterinary Journal 13, no. 10 (2023): 1239. http://dx.doi.org/10.5455/ovj.2023.v13.i10.2.

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Background: Ultrasonography had diagnostic importance in the evaluation of different diseases in buffaloes, including cardiovascular diseases. Aim: The current work describes the normal echocardiographic findings in healthy buffaloes, along with establishing reference values for echocardiographic dimensions for both sides of the heart i.e. left and right ones. Methods: About 30 healthy adult buffaloes that belonged to private farms in Assiut, Egypt, were included in this study. Each animal underwent a complete clinical evaluation as well as haematological analyses, lipid profile indices, liver functions, cardio-thoracic radiography and echocardiography to confirm no diseased conditions were detected. The study was conducted on healthy buffaloes (n = 30) in Assiut Governorate, Egypt. Results: The obtained results reported healthy buffaloes with normal clinical findings as well as indices of blood pictures and serum biochemicals that were within the reference intervals. Radiography revealed free reticulum and a well-defined diaphragm. The heart was seen as a typical radio-opaque organ. Ultrasonographically, using gray scale B-mode and M-mode, the heart was commonly imaged from the left 4th intercostal space. Different echocardiographic views were described, including the 4 chamber view, i.e., right atrium (RA), right ventricle (RV), tricuspid valve (TCV), left atrium (LA), left ventricle (LV), mitral valve (MV), and interventricular septum (IVS), and the right ventricular outflow tract (RVOT), i.e., Right atrium (RA), tricuspid valve (TCV), right ventricle (RV), pulmonary artery (PA), and pulmonary valve (PV). Cross sections in each of the apex and base of the heart were described. Echocardiographic dimensions during cardiac diastole and systole included diameters and wall thickness of each of atria and ventricles were demonstrated. Interventricular septal thickness wall thickness as well as diameters of aorta and pulmonary artery were stated. Conclusion: The work tried to put reference values on the normal echocardiographic dimensions using two-dimensional B mode gray scale ultrasonography in healthy adult buffaloes. These echocardiographic reference dimensions with normal echocardiographic imaging will be very helpful in enhancing the diagnostic efficacy of ultrasounds for recognizing the abnormal findings related to cardiac disorders.
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Di Maria, Alessio, Rossella Siligato, Marta Bondanelli, and Fabio Fabbian. "Venous Doppler flow patterns, venous congestion, heart disease and renal dysfunction: A complex liaison." World Journal of Cardiology 16, no. 1 (January 26, 2024): 5–9. http://dx.doi.org/10.4330/wjc.v16.i1.5.

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The World Journal of Cardiology published an article written by Kuwahara et al that we take the pleasure to comment on. We focused our attention on venous congestion. In intensive care settings, it is now widely accepted that venous congestion is an important clinical feature worthy of investigation. Evaluating venous Doppler profile abnormalities at multiple sites could suggest adequate treatment and monitor its efficacy. Renal dysfunction could trigger or worsen fluid overload in heart disease, and cardio-renal syndrome is a well-characterized spectrum of disorders describing the complex interactions between heart and kidney diseases. Fluid overload and venous congestion, including renal venous hypertension, are major determinants of acute and chronic renal dysfunction arising in heart disease. Organ congestion from venous hypertension could be involved in the development of organ injury in several clinical situations, such as critical diseases, congestive heart failure, and chronic kidney disease. Ultrasonography and abnormal Doppler flow patterns diagnose clinically significant systemic venous congestion. Cardiologists and nephrologists might use this valuable, non-invasive, bedside diagnostic tool to establish fluid status and guide clinical choices.
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Hamadah, Hussam K., Omar Hijazi, Mohammad A. Faraji, and Mohamed S. Kabbani. "Bedside ultrasonography screening for congenital renal anomalies in children with congenital heart diseases undergoing cardiac repair." Journal of the Saudi Heart Association 30, no. 2 (April 2018): 95–101. http://dx.doi.org/10.1016/j.jsha.2017.09.002.

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15

Kokhanenko, Nikolay Yurevich, Yuriy Nikolaevich Shiryajev, Andrey Lvovich Lugovoy, Sergey Alexandrovich Danilov, and Lekso Zurabovich Gurtskaya. "Features of pathogenesis, clinical course and diagnosis of acute cholecystitis of patients with decompensated cardiovascular diseases." Pediatrician (St. Petersburg) 6, no. 4 (December 15, 2015): 62–68. http://dx.doi.org/10.17816/ped6462-68.

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The work presents the features of pathogenesis, clinical course and diagnosis of acute cholecystitis of patients with decompensated cardiovascular diseases have been submitted in this report. The main diseases of cardiovascular system that affects the prognosis of acute cholecystitis have been set off. The sufficient detailed is written about the criteria for patients at risk. Listed severe somatic diseases, which are frequent in older patients being treated in surgical hospitals. The pathogenetic link between inflammatory disease of the gallbladder and cardiovascular system has been explained. The problem of mutual deterioration between acute cholecystitis and different manifestations of coronary artery disease has been reviewed. The noting widespread introduction of new non-invasive methods (ultrasonography, computer tomography and magnetic resonance tomography) and invasive (endovideosurgery) diagnostics. Detailed characteristics of such instrumental techniques as ultrasonography, magnetic resonance cholangiopancreatography, magnetic tomography, endoscopic retrograde cholangiopancreatography, diagnostic laparoscopy has been given. The role of specific biochemical markers of necrosis has been showed: creatinephosphokinase, its heart fraction, troponin test. Possible changes on the electrocardiogram of patients with acute cholecystitis and reasons for their appearance have been described. Detailed recommendations for the identification of acute myocardial infarction of patients with acute cholecystitis using markers of myocardial damage have been given.
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Oral, Orcun, Muhammet Hamza Halil Toprak, Fahrettin Uysal, Ozlem Mehtap Bostan, and Ergun Cil. "The frequency of asymptomatic urinary system abnormalities in children detected with cineurography imaging during angiocardiography." Cardiology in the Young 29, no. 2 (February 2019): 119–22. http://dx.doi.org/10.1017/s1047951118001828.

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AbstractIntroductionDiagnostic and interventional catheter angiography of the heart is frequently used in paediatric cardiology. It is also possible to detect urinary system anomalies with cineurography images that may be obtained during angiocardiography. In this study, the aim was to determine the frequency, distribution, and properties of urinary system anomalies accompanying heart diseases, and to find out the effectiveness of cineurographic images in detecting the urinary system anomalies.MethodsThe cineurographic images of 2022 children who had undergone angiocardiography between 1995 and 2015 were retrospectively examined.ResultsUrinary system anomalies were detected in 261 of the 2022 cases (12.9%). Of these 261 cases, 148 were males (56.7%), whereas 113 were females (43.3%). Among the heart diseases, the group most accompanied by urinary system anomalies was the non-cyanotic left-to-right shunted heart diseases, which was detected in 120 (39.1%) patients. Pelvicalyceal ectasia was the most common urinary system anomaly encountered and was detected in 89 patients (34.1%). Of the urinary system anomalies cases, 94 detected by cineurography were determined to be clinically severe. When the effectiveness of the cineurography was evaluated using the ultrasonography records of the patients, it was found to have 63.8% accuracy.ConclusionMany of the patients with CHDs concomitantly have urinary system anomalies. It is possible to determine asymptomatic urinary system anomalies using cineurographic imaging during angiocardiography. This may lead to earlier treatments and improved prognosis for the patients, thus making it possible to prevent potential future problems.
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Gönülal, Melis, Aylin Öztürk, and Fatma Yıldız. "RELATİONSHİP BETWEEN ANDROGENETİC ALOPECİA AND CARDİOVASCULAR COMORBİDİTY MARKERS İN WOMEN." Ambiance in Life International Scientific Journal in Medicine of Southern Caucasus 05, no. 03 (December 10, 2020): 19–23. http://dx.doi.org/10.36962/0503202019.

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Background Although androgenetic alopecia is a cosmetic problem for lots of men and women, it’s also investigated about relations with systemic diseases. Severity of androgenetic alopecia was found related to coronary artery diseases in some groups. Methods Twenty seven female volunteers with androgenetic alopecia older 18 years old were enrolled to the study. Androgenetic alopecia were scored by Ludwig classification. Blood biochemical markers which are related to cardiac diseases were studied. These were serum total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, dehydroepiandrosterone sulphate,total testosterone, C reactive protein levels. As imaging carotid ultrasonography was used. Right and left common carotid arteries’ intima media thickness were measured. Results No corelation with other serum low-density lipoprotein, total chlolesterol , triglyserides , C reactive protein and androgenetic alopecia severity could be found. A negative corelation between serum high-density lipoprotein level and Ludwig severity was investigated. Conclusions Patients of androgenetic alopecia must be also concerned about cardiac diseases. Measurement of carotid arteries’ intima media thickness in people with androgenetic alopecia measurement can be helpful in determining risk of premature cardiovascular heart diseases. There is a need for more clinical studies of relationship between serum lipids especially high-density lipoprotein and androgenetic alopecia severity in women. Keywords: female type androgenetic alopecia, DHEA-S, carotid intima media thickness, cardiovascular heart diseases,HDL
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Rauniyar, RK, U. Sharma, and S. Baboo. "Isolated Extra hepatic Hydatid Cyst of Para spinal Muscle - Unusual Presentation - a Case Report." Nepalese Journal of Radiology 2, no. 1 (October 23, 2012): 31–34. http://dx.doi.org/10.3126/njr.v2i1.6977.

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Hydatid disease (echinococcosis) commonly involves liver while other known extrahepatic sites of involvement are lung, heart, brain, kidney, bones, spleen, pancreas, adrenal and muscles.1-3 Ultrasonography (US) and computed tomography (CT) features are characteristic especially in hepatic disease and hence diagnosed easily, while isolated extrahepatic diseases are sometimes difficult to diagnose. Here, we present an interesting case of hydatid cyst in paraspinal muscle with unusual clinical and imaging features, but treated successfully inspite, initial diagnostic dilemma. Imaging features and follow up result are discussed. NJR I VOL 2 I ISSUE 1 31-34 Jan-June, 2012 DOI: http://dx.doi.org/10.3126/njr.v2i1.6977
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D, Damodharan, and Amit Kumar Goel. "An Implementation of Cardiovascular Disease Prediction in Ultrasonography Images using AWMYOLOv4 Deep Learning Mode." International Journal on Recent and Innovation Trends in Computing and Communication 10, no. 9 (September 30, 2022): 40–52. http://dx.doi.org/10.17762/ijritcc.v10i9.5669.

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Cardiovascular diseases are one of the most important issues facing the people and their origins also death is contained all over the world the facing issues in past 25 years. Every country’s inversing large amount in health care researches and it’s related to enhanced predict the diseases. Cardio issues are not even physicians can easily be predicted and it is a very challenging task that requires high knowledge and expertise. To identify to create machine language models used to efficiently predict the earliest stage of cardiovascular disease. In this work, we recommend AWMF filter for the pre-process the Input Image after the input move to YOLOv4 neural network method for classification and segmentation to the heart affected areas by using ultrasonic Images with the help of a machine learning algorithm. The proposed algorithm uses ultrasonic picture classification and segmentation to detect cardiovascular disease earlier. This model shows the more accurate result on 96% of training and 98% testing data. And this method shows better results and providing while compared to the existing method.
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Bakos, Zoltán, and Károly Vörös. "Intraoperative echocardiography and surgical treatment of traumatic pericarditis in a pregnant cow." Acta Veterinaria Hungarica 59, no. 2 (June 1, 2011): 175–79. http://dx.doi.org/10.1556/avet.2011.001.

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Traumatic pericarditis is one of the most significant bovine cardiac diseases. The authors describe the use of intraoperative echocardiography and successful surgical treatment of a case of traumatic pericarditis. A seven-year-old Hungarian Simmental dairy cow in late pregnancy showed severe oedema of the throat region and brisket, as well as jugular distension. Cardiac auscultation demonstrated tachycardia with a normal cardiac rhythm. The heart sounds were muffled, but no cardiac murmur or splashing sounds were heard. A large amount of echogenic fluid with some strands of fibrin was seen in the pericardial and right pleural cavities by ultrasonography. Ultrasound-guided pericardiocentesis demonstrated the presence of a thick, fetid and purulent exudate. Pericardiotomy was performed in standing position with sedation and local anaesthesia. After costal resection, intraoperative echocardiography was performed. It showed an echogenic tract between the caudal pericardium and diaphragm, but no foreign body was seen. Two weeks after the surgery, the cow delivered a healthy bull-calf. Intraoperative echocardiography — not reported earlier — can be applied to evaluate the entire bovine pericardial sac and heart. The report also demonstrates that surgical treatment of traumatic pericarditis can be successful in carefully selected cases.
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Li, Fenghe, Xuehu Wang, Wen Huang, Wei Ren, Jun Cheng, Mao Zhang, and Yu Zhao. "Risk factors associated with the occurrence of silent pulmonary embolism in patients with deep venous thrombosis of the lower limb." Phlebology: The Journal of Venous Disease 29, no. 7 (May 9, 2013): 442–46. http://dx.doi.org/10.1177/0268355513487331.

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Objective The aim of our study is to investigate the prevalence of silent pulmonary embolism in patients with deep venous thrombosis in the lower limbs and to evaluate the associated risk factors. Methods A total of 322 patients with acute deep venous thrombosis confirmed by CT venography or Doppler ultrasonography were studied. The diagnosis of silent pulmonary embolism was established by computed tomography pulmonary arteriography (CTPA). The association between covariates and the prevalence of silent pulmonary embolism in patients with deep venous thrombosis in lower limbs were assessed using chi-square test and multivariable regression. Results The incidence of silent pulmonary embolism was 33.5% (108 in 322 patients) in all patients with deep venous thrombosis in lower limbs. Chi-square test showed male gender, the right lower limb, proximal location of the thrombus, unprovoked venous thrombosis and coexisting heart diseases were related to a higher incidence of silent pulmonary embolism in patients with deep venous thrombosis in lower limbs. The multivariate regression analysis confirmed that the risk factors associated with silent pulmonary embolism in deep venous thrombosis patients included the right side and proximal location of the thrombus (odds ratio: 2.023, 95% CI: 1.215–3.368; odds ratio: 3.610, 95% CI: 1.772–7.354), unprovoked venous thrombosis (odds ratio: 2.037, 95% CI: 1.188–3.493), coexisting heart diseases (odds ratio: 4.507, 95% CI: 2.667–7.618). Conclusion Silent pulmonary embolism occurred frequently in patients with deep venous thrombosis in lower limbs. The right side, the proximal location of the thrombus, unprovoked venous thrombosis and coexisting heart diseases increased the risk for the occurrence of silent pulmonary embolism.
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Vandi, Giacomo, Leonardo Calza, Nicolò Girometti, Roberto Manfredi, Giuseppina Musumeci, Isabella Bon, and Maria Carla Re. "Acute onset myopericarditis as unusual presentation of primary HIV infection." International Journal of STD & AIDS 28, no. 2 (July 10, 2016): 199–201. http://dx.doi.org/10.1177/0956462416654852.

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A 30-year-old man was admitted to hospital after complaining of a retrosternal burning pain, radiating to the jugular region, and to both upper limbs. An electrocardiography examination showed a ST segment elevation involving the lower-lateral leads. A trans-thoracic ultrasonography showed findings compatible with an acute myopericarditis. All performed serological testings excluded other recent infections with cardiac tropism. Among screening tests, a peripheral lymphocyte subset analysis was performed and an inversion of the CD4/CD8 ratio was found. Therefore, HIV testing was performed and proved positive for HIV-1 antibodies. The discovery of a primary HIV infection with involvement of a vital organ led us to start HAART. On day 20, our patient underwent a right heart catheterization and endomyocardial biopsy. During the following days, the clinical conditions of our patient improved, and a further heart ultrasonography documented a mild pericardial thickening as a result of the recent myopericarditis. Also the evolving changes of ECG were compatible with a benign evolution of myopericarditis. The histopathologic studies revealed a mild fibrosis of the myocardial right ventricular tissue, and inflammatory findings compatible with a recent myocarditis. At the real-time PCR analysis on bioptic sample, only HHV6 DNA and HIV-DNA were reactive. An immunofluorescence staining was performed to highlight the HIV p24 protein and a positive signal was detected in myocardial tissue. Considering the low avidity level of the anti-HIV IgG antibodies and the positivity of HIV-DNA in the endomyocardial tissue, we believe that the clinical manifestation presented can be referred to the recent primary HIV-infection.
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Karpyshyn, Nataliya. "Effect of Combination Therapy with Atorvastatin and Ursodeoxycholic Acid on the Course of Ischemic Heart Disease with Co-Existent Non-Alcoholic Fatty Liver Disease and Obesity." Galician Medical Journal 23, no. 4 (December 12, 2016): 2016420. http://dx.doi.org/10.21802/gmj.2016.4.20.

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Non-alcoholic fatty liver disease is considered as an independent predictor of cardiovascular diseases which plays an important role in the development of ischemic heart disease. The drug most frequently used for treating this comorbidity is atorvastatin which favours better survival outcomes and is essential in the primary and secondary prevention of cardiovascular diseases. Ursodeoxycholic acid is prescribed as an alternative therapy for ischemic heart disease with co-existent non-alcoholic fatty liver disease and obesity to eliminate statin side effects. The use of ursodeoxycholic acid as a hepatoprotector in comprehensive basic treatment contributes to the improvement of the cardiovascular system in patients with ischemic heart disease as well as the increase in treatment efficacy; it improves the functional status of the liver affecting the major pathogenic mechanisms of the disease.The objective of the research was to study the effect of combined hypolipidemic therapy with atorvastatin and ursodeoxycholic acid on the indices of blood lipids, liver transaminase levels, functional status of the liver and the course of non-alcoholic fatty liver disease in patients with ischemic heart disease and obesity.Materials and methods. 20 patients with ischemic heart disease, co-existent non-alcoholic fatty liver disease and obesity were examined. They received ursodeoxycholic acid in addition to atorvastatin for four weeks. All the patients underwent clinical tests, visceral ultrasonography, blood lipid test, liver transaminase test and 13C-methacetin breath test.Results. The study revealed a significant decrease in the level of the pro-atherogenic fractions of blood lipids (р<0.01) as well as an improved functional status of the liver due to a significant increase in metabolic capacity of the liver and cumulative dose on the 40th and 120th minutes after ursodeoxycholic acid administration (р<0.01).Conclusions. The use of ursodeoxycholic acid in addition to atorvastatin in patients with ischemic heart disease, co-existent non-alcoholic fatty liver disease and obesity makes it possible to avoid the adverse effect of hypolipidemic therapy on the functional status of the liver.
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Sigitova, O. N., A. R. Bogdanova, and T. Yu Kim. "The structure and features of the course of chronic kidney disease in patients with coronary heart disease and comorbid diseases." Kazan medical journal 102, no. 5 (October 13, 2021): 606–13. http://dx.doi.org/10.17816/kmj2021-606.

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Aim. To investigate the prevalence, structure, and features of the course of chronic kidney disease (CKD) in patients with coronary heart disease (CHD) associated with comorbid diseases. Methods. The observation group consisted of 257 patients of the Interregional Clinical Diagnostic Center (Kazan) with coronary heart disease (20142018): 183 males and 74 females, aged from 38 to 95 years (mean age 61.80.6). Observation program: clinical examination; serum creatinine and lipid profiles, the albumin/creatinine ratio in a single portion of urine, morning urine osmolality, glomerular filtration rate estimated by the CKD-EPI; renal scintigraphy, ultrasonography of the kidneys, renal Doppler ultrasound and angiography. Chronic kidney disease was diagnosed if one of the criteria was met: the glomerular filtration rate 60 ml/min/1.73 m2 or the ratio of albumin to creatinine in urine (ACR) 30 mg/g. Statistical analysis was performed by using the methods of variational statistics: determination of the arithmetic mean (M), standard error of the mean (m) and difference significance according to the Student's test (t). Results. Examination of patients revealed the following comorbid diseases and syndromes: hypertension (90.7%), hyper- and dyslipidemia (96.5%), overweight/obesity (74.3%), diabetes mellitus (17.9%), chronic heart failure stages IIIa according to StrazheskoVasilenko classification (100%). 164 (63.8%) patients were first time diagnosed with chronic kidney disease: hypertensive nephropathy in 66.4%, ischemic renal disease in 21.9%, diabetic nephropathy in 2.4%, a combination of diabetic and hypertensive nephropathy in 9.3%. 51.2% of patients had stage 2 of chronic kidney disease, 42.1% stage 3, 6.7% stage 4 or 5. A feature of chronic kidney disease is its latent course (absence of complaints and clinical manifestations) and, as a consequence, unidentified diagnosis at the prehospital stage, which is generally characteristic of secondary nephropathies in cardiovascular diseases and these comorbid conditions. Conclusion. Chronic kidney disease was first diagnosed in 63.8% of patients with coronary heart disease with 1 to 5 comorbid diseases; a feature of chronic kidney disease is its secondary nature, the course of the disease is hidden by underlying and/or comorbid disease and, as a result, its late diagnosis.
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P., Aswathy, Lillykutty Pothen, Renu Thambi, and Sankar S. "Pathological features in perinatal autopsy and its relation with clinical and antenatal sonography findings." International Journal of Research in Medical Sciences 10, no. 6 (May 27, 2022): 1302. http://dx.doi.org/10.18203/2320-6012.ijrms20221486.

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Background: Perinatal mortality is considered as a yardstick of obstetric and maternal care before and around the time of death. Perinatal autopsy is an inevitable procedure which helps to ascertain the cause of death, identify rare diseases, supplements clinical diagnosis and provide risk estimates for future pregnancies. The aim of the study was to describe the pathological features in perinatal autopsy specimens and to compare the pathological features with clinical and antenatal sonography findings.Methods: A descriptive study was conducted among 43 perinatal autopsy cases. A thorough perinatal autopsy was done. Detailed maternal medical and obstetric history including the laboratory and USG findings were collected. Collected data analysed using Statistical package for social sciences (SPSS) software. Results: The results were grouped into fetal, maternal and placental findings. Congenital anomalies were detected in 20% cases. That included gastrochisis, ebstein anomaly, isolated dextrocardia, hypoplastic left heart syndrome, cleft lip and palate, prune belly syndrome, club foot. Placenta findings observed were chorioamnionitis, placental thrombotic vasculopathy and placental findings in COVID-19 positive cases. The most common maternal comorbidity was hypertension (20.9%). Perinatal mortality was high in those cases with past history of abortions and history of infertility treatment. Full agreement between perinatal autopsy and antenatal USG findings was detected in 36.36% cases. Additional anomalies detected on autopsy was 54.54%.Conclusions: A thorough clinical history, prenatal ultrasonography and perinatal autopsy features could be described in detail in all the cases. Comparison of finding at autopsy with antenatal ultrasonography finding indicate that ultrasonography finding have only a reasonable value in assessing fetal status. Advanced radiology techniques could be maximum helpful.
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Pires, Sâmara Turbay, Maria Cristina Ferrarini Nunes Soares Hage, Ana Carolina Brandão de Campos Fonseca Pinto, and Stefano Carlo Filippo Hagen. "Comparative study between radiology and ultrasound in the evaluation of extracardiac thoracic diseases in dogs and cats." Ciência Rural 45, no. 12 (December 2015): 2207–13. http://dx.doi.org/10.1590/0103-8478cr20140192.

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ABSTRACT: This study compared radiographic and B-mode and Doppler ultrasound exams of the thoracic cavity, excluding the heart, in canine and feline species, in which the radiographs revealed the formation of a potential acoustic window. The objectives were to demonstrate the advantages and limitations of each technique and to determine whether the additional information influenced the differential diagnosis as well as the outcome of each case. The advantages of B-mode ultrasonography included: better qualitative and quantitative evaluation of pleural effusions, an improved ability to determine whether a nodule was solid or cystic and easier determination of the location in the pulmonary parenchyma. The Power Doppler ultrasound evaluated the blood supply pattern of the nodules and masses and differentiated between vessels and fluid bronchogram. A limitation of the ultrasound examination was the need to be guided by the previous radiography. The advantages of the radiographic examination included the possibility of localizing pulmonary lesions at any depth in the absence of a pleural effusion and providing a panoramic view of the extent of the thoracic disease. The ultrasound examination influenced the differential diagnosis in 18 (62.06%) cases and influenced the outcome of 8 (27.58%) cases.
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Leménager, Paul, Yves-Kenol Franck, Florine Corlin, Nicolas Bouscaren, Mathieu Nacher, and Antoine Adenis. "Aetiological and morphological spectrum of cardiomyopathies in French Guiana: a retrospective study." Open Heart 7, no. 1 (May 2020): e001206. http://dx.doi.org/10.1136/openhrt-2019-001206.

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IntroductionCardiomyopathies are a heterogeneous heart diseases group in terms of morphology and aetiology. Hypothesising a tropical specificity and given an absence of data in French Guiana, the primary objective of our study was to describe morphologies and aetiologies of cardiomyopathies observed at Cayenne General Hospital.MethodsA cross-sectional study was conducted in Cayenne Hospital from 1 January 2009 to 1 June 2014 in the hospital database. Only patients with the definition of the European Society of Cardiology (ESC) were included, based on the first transthoracic ultrasonography found during the study period. Medical files were consulted.ResultsWith 182 patients included, the prevalence of cardiomyopathies among heart diseases was estimated at 4.3% (95% CI 3.7% to 4.9%). Twelve patients had a familial or genetic aetiology (6.6%) and 170 a non-familial or non-genetic aetiology (93.4%). The morphological spectrum was: dilated for 114 patients (62.6%), hypertrophic for 27 (14.8%), unclassified for 1 (0.5%) and non-classifiable for 13 (7.1%). This group was constituted of patients with a systolic and/or diastolic functional impairment without morphological abnormality. The aetiological spectrum found 184 aetiologies including: 70.9% undetermined, 8.7% infectious (with 6.5% chagasic and 0.5% related with human immunodeficiency virus) and 6.0% with toxins.ConclusionsCardiomyopthies are a common and severe clinical problem. The frequency of infectious aetiologies and dilated impairment are arguments for cardiomyopathies with tropical particularities. However, the preponderance of undetermined aetiologies justifies the development of further research programmes.
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Janecka, Aleksandra, Joanna Stefanowicz, Anna Owczarzak, Marek Tomaszewski, Tomasz Batko, and Ninela Irga-Jaworska. "Assessment of Metabolic Syndrome and Kidney and Heart Function in Childhood Cancer Survivors." Children 10, no. 6 (June 18, 2023): 1073. http://dx.doi.org/10.3390/children10061073.

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Background: The survivors of childhood cancer suffer from a number of long-term side effects. These include atherosclerosis and cardiovascular diseases (CVDs) that develop earlier in adulthood than in the rest of the population. The aim of this study was to identify prognostic factors of developing atherosclerosis before the development of symptomatic CVD. Methods: A total of 141 children that were 7–18 years old were examined; there were 116 survivors of childhood malignancies (hematopoietic and lymphoproliferative malignancies—52; neuroblastoma—22; Wilms tumor—24; other solid tumors—18) and 25 healthy controls. Anthropometric measurements, blood pressure measurements, ultrasonography of the abdomen, echocardiography, and laboratory tests were performed. Results: There were no significant differences in gender distribution, time from the end of the treatment, weight, BMI, prevalence of central obesity, blood pressure and resistive index of the renal arteries, lipid profile, or glucose and fibrinogen levels. Patients with solid tumors had a significantly lower height and worse renal function. Patients with hematological malignancies significantly presented the lowest shortening fraction of the left ventricle. The salusin β levels were significantly higher in the control group than among the patients. Conclusions: The type and severity of side effects are closely related to the type of neoplasm and the treatment that has been undergone. Careful observation and regular follow-up are necessary.
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Rodríguez, Maria M., Fernando Chaves, Rita L. Romaguera, Peter L. Ferrer, Claudia de la Guardia, and Jocelyn H. Bruce. "Value of Autopsy in Nonimmune Hydrops Fetalis: Series of 51 Stillborn Fetuses." Pediatric and Developmental Pathology 5, no. 4 (July 2002): 365–74. http://dx.doi.org/10.1007/s10024-001-0260-6.

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Nonimmune hydrops fetalis (NIHF) is used to describe fetuses and newborns with generalized edema and cavity effusions. It is helpful to alert physicians about the presence of anemia, heart failure, and/or hypoproteinemia, but this diagnosis is frequently overlooked. We reviewed the autopsy files from 1990 to 2000, selected all cases with NIHF including clinical information (with maternal laboratory tests and ultrasound), and classified patients by etiology. Among 840 stillborn autopsies during the 11-year period, we found 51 with NIHF (6.07%). The clinical summary had mentioned hydrops in 14 patients and the etiology in another 7 by fetal ultrasonography, but without addressing the possibility of hydrops. In the remaining 30 cases neither hydrops nor an etiology was mentioned. Other pertinent diagnoses were maternal diabetes mellitus (4), congenital heart disease (3), and cystic hygroma (2). The following diagnoses were made in one instance each: cardiac tumor, twin transfusion syndrome, congenital adenomatoid malformation, syphilis, Turner syndrome, and cerebral arteriovenous malformation. Postmortem and placental examination confirmed the following etiologies: congenital infections (17); placental pathology significant enough to explain NIHF (10); cardiovascular diseases (8) (further classified as congenital heart disease [3], rhabdomyoma [1], and vascular malformations [4]); chromosomal abnormalities (6); uncontrolled maternal diabetes (4); intrathoracic lesions (2); prune-belly syndrome (2); and idiopathic NIHF (2). Only 3.9% of the cases studied had no identifiable etiology. The cause of hydrops was confirmed by autopsy in 47 fetuses (92%), which further supports the importance of performing an autopsy. Thirty-two cases (62.74%) had placental abnormalities helpful to the etiology (parvovirus, syphilis, Turner's syndrome, etc.). In 20 instances, the clinical summary had no mention of either hydrops or any of the diseases leading to it. The autopsy in conjunction with placental examination and fetal ultrasound represent the best combination to determine the etiology of NIHF among stillborn fetuses.
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Nayak, Gayathri, Vallidevi Bolla, Santosh K. Balivada, and Prabhudev P. "Technological Evolution of Ultrasound Devices: A Review." International Journal of Health Technology and Innovation 1, no. 03 (December 10, 2022): 24–32. http://dx.doi.org/10.60142/ijhti.v1i03.55.

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Numerous imaging technologies have been researched upon and applied in the field of medicine to enhance clinicians’ faculty for diagnosis of indispositions or diseases and the modalities include magnetic resonance imaging (MRI), X-ray imaging, computed tomography (CT) and ultrasound (US). One imaging technique that is used to identify abnormalities in various body areas is the ultrasound. It is a non-invasive method that provides real-time imaging without radiation exposure. This article mainly focuses on ultrasonography and the various technological and equipment advancements over the years. It is more difficult to operate conventional ultrasound equipment due to its complex structure, which is large in size and takes up more space. For scanning different parts of the body, there are a variety of probes to choose from. The probes are selected based on the size and shape of the beam. Imaging can be performed in several modes, such as A mode, B mode, M mode, D mode, etc. Capacitive micro-machined ultrasound transducers (CMUTs) replace the traditional piezoelectric crystals in a transducer that produces ultrasonic waves. Ultrasonography has many applications in the diagnosis of various parts of the body, i.e., lungs, abdominal parts, heart, bladder, and so on. From the earliest ultrasound machines in the 1950s with patient immersion tanks to the hand held ultrasound devices in the late 2000s where images can be obtained on mobile screens, the evolution of this device over centuries has been phenomenal.
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De Bernardo, Giuseppe, Angela Lucariello, Antonio Saggese, Maurizio Giordano, Desiree Sordino, Carmela Buonomo, Stefano Gisone, Antonio De Luca, Germano Guerra, and Angelica Perna. "Bilateral Wilms tumor with neonatal onset and the importance of prenatal diagnosis." Journal of Renal Injury Prevention 8, no. 4 (September 13, 2019): 257–62. http://dx.doi.org/10.15171/jrip.2019.49.

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Wilms tumor (WT) occurs in 1:10.000 live births and affects mainly the unilateral kidney. The National Wilms Tumor Study Group registered 6832 patients with WT from 1969 to January 1993, out of whom only 11 patients (0.16%) were newborns. Since 1969, 14 cases of prenatal diagnosis of WT have been reported in literature, two of which were bilateral WT. Currently, the patients’ survival rate is greater than 90%, owing to a combination of surgery, chemotherapy, and radiotherapy for high-risk patients. We report a case of bilateral WT, undiagnosed during the prenatal period due to the incomplete evaluation of the abdomen with ultrasonography. The newborn was vaginally delivered at 40 weeks’ gestational age with a good perinatal adaptation. Suddenly, during the night the newborn showed respiratory distress, bradycardia and then respiratory arrest. For this reason, he was ventilated, intubated and subjected to conventional mechanical ventilation. Despite the normal cardiac ultrasonography, the health care providers suspected a cyanotic congenital heart disease with duct dependency. After a gradual resumption of the oximetry and blood pressure, the infant was transported by the neonatal emergency transport system to the Cardiac Pediatric Surgery Department of a level III hospital. There, the clinical condition became extremely serious and the infant died of asystole. During autopsy, two large tumoral masses were found in both kidneys, also the characterization of the tumors was done through histological exam, which confirmed the diagnosis of WT. A prenatal diagnosis of WT is very important because the families can take advantage of prenatal counseling to understand the risks of continuing the pregnancy and to evaluate the need for abortion, while health care providers can prepare to face a difficult delivery. The review of the literature suggests that prenatal diagnosis of bilateral WT is possible. During prenatal age, the complete assessment of the abdomen with ultrasonography and Eco-Color-Doppler can reveal kidney anomalies and raise suspicion of diseases with urinary malformations.
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Aftab, Kausar, Asim Khurshid, Ayesha Fayyaz, and Irum Jabeen. "Causes of portal hypertension in children." Professional Medical Journal 28, no. 10 (September 30, 2021): 1489–94. http://dx.doi.org/10.29309/tpmj/2021.28.05.5376.

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Objective: To determine different causes of portal hypertension in children. Study Design: Cross Sectional study. Setting: Department of Pediatric Medicine, Department of Pediatric Gastroenterology and Department of Medical Emergency, The Children’s Hospital and Institute of Child Health, Multan. Period: 3rd April 2019 to 2nd October 2019. Material & Methods: A total of 71 children presenting with portal hypertension aged 1 month to 15 years of either gender were included. Newborns or children with congenital heart diseases were excluded. Patient samples were collected for complete blood counts and liver function tests, Ultrasound Abdomen and color Doppler ultrasonography were done for portal vein pressure to determine various causes of portal hypertension. Results: Overall, mean age was 9.00 ± 3.64 years. Out of the 71 patients, 51 (71.83%) were male and 20 (28.17%) were females. Different causes of portal hypertension were portal vein thrombosis in 48 (67.61%), liver cirrhosis in 14 (19.72%) and biliary atresia in 9 (12.68%) children. Conclusion: Among children having portal hypertension, portal vein thrombosis was noted to be the commonest cause followed by liver cirrhosis and biliary atresia.
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Fozilov, H. G., H. H. Ataniyazov, G. A. Khamidullaeva, S. Ya Abdullaeva, and R. B. Alieva. "Early Detection and Control of Risk Factors for Cardiovascular Diseases in the Aral Region: Experience of Uzbekistan." Kardiologiia 64, no. 1 (January 31, 2024): 37–43. http://dx.doi.org/10.18087/cardio.2024.1.n2614.

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Aim. To analyze the results of screening of the population older than 40 years for early detection of risk factors for cardiovascular diseases in real clinical practice of family clinics in the Aral Sea region.Material and methods. The results of screening of the population older than 40 years were analyzed for a total of 2,430 respondents from family clinics of the district (Republic of Uzbekistan, Republic of Karakalpakstan, Ellikkala district) according to the modified WHO PEN protocol. 1,020 of the respondents with blood pressure ≥140/90 mm Hg were included in the study (mean age, 57.68±8.06 years; women, 61.4%; men, 38.6%). Additionally, the following parameters were determined: salt-taste threshold using the R. Henkin method, echocardiography, ultrasonography of the brachiocephalic arteries, blood lipid spectrum, microalbuminuria, serum creatinine and uric acid. Statistical data are presented as mean±SD. The prevalence of signs in the study group was assessed using the Pearson’s chi-square test, and the Pearson correlation coefficient was used.Results. Among the patients with elevated blood pressure included in the study, 24 (2.4%) were younger than 40 years, 847 (81%) were 40-65 years old, and 169 (16.6%) were older than 65 years. Low cardiovascular risk was twice more common among women compared to men: 11.3% vs. 5.6% (χ²=8.990; p=0.003); almost 75% fewer patients with ischemic heart disease, 7.4% vs. 28.9% (χ²=14.939; p=0.0001); however, the incidence of type 2 diabetes mellitus was twice higher, 13.7% vs. 7.4% (χ²=9.205; p=0.002); the female group had significantly fewer cases of postinfarction cardiosclerosis (PICS) (χ²=5.313; p=0.021). Among women, there were no tobacco users or regular alcohol drinkers whereas among men these risk factors were identified in 59.4% (χ²=178.848; p=0.0001) and 35% (χ²=82.238; p=0.0001), respectively. 85.6% of the respondents had a high salt-taste threshold, 96% had left ventricular hypertrophy, 76% had microalbuminuria, 21% had proteinuria, and 92% of both men and women had a common carotid artery intima-media thickening >0.9 mm.Conclusion. The study showed a broad prevalence of cardiovascular risk factors in the population of hypertensive patients in the Aral region, a high salt-taste threshold, and significant damages to target organs, which differed from other regions of Uzbekistan. Among hypertensive men, there was a significant prevalence of tobacco and alcohol use, and a significantly more frequent detection of ischemic heart disease, PICS and hyperuricemia compared to women; in the female population, the prevalence of type 2 diabetes mellitus was significantly greater.
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Shulpekova, Yu O., V. M. Nechaev, and V. T. Ivashkin. "Biliary pain in the structure of episodes of right upper abdominal pain." Voprosy detskoj dietologii 18, no. 6 (2020): 42–52. http://dx.doi.org/10.20953/1727-5784-2020-6-42-52.

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Acute or recurrent pain in the right upper part of the abdomen is a common cause for visits to physicians. Not less than two thirds of episodes of pain in this area are conditioned by biliary colic and acute cholecystitis. Other most common causes include diseases of the liver, pancreas, prepyloric and pyloric parts of the stomach and the beginning portion of the small intestine, the right kidney, and also subhepatic appendicitis. Some cases of developing pain are associated with the right lung affection and involvement of the diaphragmatic pleura, with heart diseases, involvement of the locomotor system and nerves. Taking into account a high prevalence of cholelithiasis in Russia – around 10–12% – we can conclude that episodes of biliary colic develop every year in 1 of 500–1000 individuals. In Russia, approximately half a million cholecystectomies are performed annually. The prevalence of gall stones among the paediatric population amounts to 2%. As distinct from adults, who in 80% of cases have an asymptomatic course of disease, pain episodes in children manifest themselves in 60–67% of cases. The diiagnosis of acute cholecystitis might meet with considerable difficulties; a scale for assessment of the likelihood of acute cholecystitis has been developed. Unlike in adults, in children a significantly large proportion of cases occur due to acalculous cholecystitis. Differentiating the causes of pain might be difficult, therefore, its character and concomitant symptoms should be thoroughly analysed, and the findings of additional examinations should also be taken into consideration (at the first step – assessment of haematological and biochemical parameters, urinalysis, electrocardiogram and abdominal ultrasonography). Key words: right upper abdominal pain, biliary colic, biliary dyskinesia, cholelithiasis
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Mamun, Abdullah Al, Nazmul Hosain, and Farzana Amin. "Ultrasound Based Flow Measurements of the Left and Right Carotid System of Arteries in Bangladeshi Patients." Bangladesh Heart Journal 38, no. 2 (December 12, 2023): 110–14. http://dx.doi.org/10.3329/bhj.v38i2.70281.

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Carotid arteries are the major supply to the head, neck and brain. The right common carotid artery usually originates from the brachiocephalic artery while the left common carotid artery arises as a direct branch of the arch of the aorta. Common carotid arteries bifurcate at the level of the carotid sinus into the internal carotid artery, which supplies the brain, and the external carotid artery. Approximately 15–20% of the cardiac output is distributed to the brain in healthy adults under resting conditions. Cardiovascular diseases are the leading cause of death globally, taking an estimated 17.9 million lives each year. US 2017 statistics shows that cerebrovascular disease or Stroke alone ranked fifth for males but fourth for females. Ultrasonography can measure the velocity of blood flow in the Carotid system of arteries. A total 139 patients, who underwent Carotid Duplex study between July 2021 and June 2022 were included in this cross-sectional study. The criteria for exclusion included age less than 13 years, presence of associated peripheral vascular diseases, hemodynamically unstable patients, incomplete data collection and patient’s reluctance to join the study. Data analysis was performed using MS Office Excel. The Peak systolic velocity and the End diastolic velocity were measured at four levels, namely the Common carotid arteries and the Internal carotid arteries on the right and the left sides. No significant difference was observed in the Peak systolic velocity and the End diastolic velocity in either Common carotid or the internal carotid arteries between the right and left sides. Moreover, these findings were similar both in age groups above and below 50 years of age. Bangladesh Heart Journal 2023; 38(2): 110-114
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El-Maraghy, Abbas S., Ahmed A. Abu Naglah, Ayman Amin, Kamal A. Merghany, and Mohamed M. Khalil. "Frequency of hepatopulmonary syndrome and portopulmonary hypertension in cirrhotic liver patients." Egyptian Journal of Bronchology 12, no. 1 (January 12, 2018): 119–28. http://dx.doi.org/10.4103/ejb.ejb_26_17.

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Abstract Background Chronic liver diseases may cause abnormal changes in the pulmonary vascular bed. There are two important and pathophysiologically different pulmonary vascular abnormalities – hepatopulmonary syndrome (HPS) and portopulmonary hypertension (PPHTN). Pathophysiologically, HPS results from vasodilatation, whereas PPHTN results from vasoconstriction. Objective The objective of this study was to determine the frequency of HPS and PPHTN in dyspneic cirrhotic hepatic patients. Patients and methods This study included 87 patients with cirrhotic liver disease admitted to Al-Azhar University Hospitals from September 2013 to September 2015. The diagnosis of cirrhosis was based on clinical, biochemical, serological, and metabolic workup, abdominal ultrasound, or liver biopsy. All patients in this study were subjected to complete medical history taking and clinical examination, liver function tests, plain chest radiography, and thoracic high-resolution computed tomography, abdominal ultrasonography, arterial blood gas analysis in the supine and standing positions, calculation of alveolar–arterial oxygen gradient, saline two-dimensional contrast-enhanced echocardiography, and right-heart catheterization only for all cases with PPHTN. Results The present study showed that the prevalence of HPS was 25.28% (22 out of 87 cases) and was higher than the prevalence of PPHTN, which was 5.7% (5 out of 87 cases). Conclusion HPS and PPHTN are not uncommon in patients with hypoxemia and chronic hepatic disease. Diagnoses of such disorders are essential, especially in patients who are listed for liver transplantation.
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Davidson, Bruce, Joanna Wisniewska, Grzegorz Malek, Jaroslaw Kober, Pawel Kuca, Barbara Burakowska, Karina Oniszh, Alexander Gallus, Anthonie Lensing, and Witold Tomkowski. "Accuracy of compression ultrasound in screening for deep venous thrombosis in acutely ill medical patients." Thrombosis and Haemostasis 97, no. 02 (2007): 191–94. http://dx.doi.org/10.1160/th06-10-0601.

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SummaryThe value of vein ultrasonography for diagnosis of symptomatic deep vein thrombosis (DVT) is widely accepted. We are unaware of published data comparing ultrasonography with the “gold standard” of venography for DVT diagnosis in asymptomatic persons in the patient group of acutely ill medical patients. It was the objective of this study to evaluate sensitivity and specificity of compression ultrasound (CUS) examinations in the diagnosis of proximal and distal DVT in acutely ill medical patients [with congestive heart failure (NYHA class III and IV), exacerbations of respiratory disease, infectious disease, and inflammatory diseases] considered to be at moderate risk of venous thromboembolism (VTE). CUS examination was performed prior to ascending venography on day 6–15 of the hospital stay. Both investigations were done on the same day, each interpreted without knowledge of the other’s result. Proximal and calf veins were separately evaluated. Technically satisfactory venography was obtained in 160 patients. In 12 of 160 patients (7.5%, 95% CI = [4.0%-12.7%]), venography confirmed the presence of DVT, all of which was asymptomatic. Proximal DVT was detected in five patients (3.1%, 95% CI = [1.0%- 7.1%]) and distal DVT in seven patients (4.4%, 95% CI = [1.8% – 8.8%]). CUS of proximal veins was technically satisfactory in all 160 patients and CUS of distal veins in 150 patients. In three of five patients with veongraphically proven proximal DVT, the diagnosis was confirmed by CUS (sensitivity 60%, 95%CI = [23%-88%]). In one patient, the CUS was false positive (specificity 99.4%, 95%CI = [96%-99%]). Positive and negative predictive values (PPV and NPV) of CUS in the diagnosis of proximal DVT were 75% (95%CI = [30%-95%]) and 98% (95% CI = [95%-99%]), respectively. In two of seven patients with venographically proven calf DVT, the diagnosis was confirmed by CUS (sensitivity 28.6%, 95%CI = [8%-64%]) and in two patients, CUS was false positive (specificity 98.6, 95%CI = [95%-99%]). PPV and NPV of CUS in diagnosis of distal DVT were 50% (95%CI = [15–85%]) and 96% (95% CI = [92%-98%]), respectively. In conclusion, CUS underestimates the incidence of proximal and distal DVT compared to contrast venography in acutely ill medical patients without thrombosis symptoms.
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Cohen, Alexander Thomas, Theodore Erich Spiro, Harry Roger Büller, Lloyd Haskell, Da-Yi Hu, Russell Hull, Alexandre Mebazaa, et al. "Rivaroxaban Compared with Enoxaparin for the Prevention of Venous Thromboembolism In Acutely Ill Medical Patients: MAGELLAN Study Methodology." Blood 116, no. 21 (November 19, 2010): 3331. http://dx.doi.org/10.1182/blood.v116.21.3331.3331.

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Abstract Abstract 3331 Background: The results of clinical trials comparing low molecular weight heparins or a pentasaccharide with placebo controls have provided compelling evidence for the benefits of pharmacologic thromboprophylaxis for 10–14 days in acutely ill medical patients (Samama et al. N Engl J Med 1999;341:793–800; Leizorovicz et al. Circulation 2004;110:874–879; Cohen et al. BMJ 2006;332:325–329). Oral rivaroxaban 10 mg once daily (od) has been shown to be effective and well tolerated for the prevention of venous thromboembolism (VTE) for 31–39 days after elective hip replacement (Eriksson et al. N Engl J Med 2008;358:2765–2775; Kakkar et al. Lancet 2008;372:31–39) and for 10–14 days after knee replacement surgery in adult patients (Lassen et al. N Engl J Med 2008;358:2776–2786; Turpie et al. Lancet 2009;373:1673–1680). Aims: To compare the efficacy and safety of thromboprophylaxis with oral rivaroxaban 10 mg od for (1) up to 14 days and (2) up to 39 days with subcutaneous enoxaparin 40 mg od for up to 14 days in patients with acute medical illness requiring hospitalization. Methods: MAGELLAN (Multicenter, rAndomized, parallel Group Efficacy and safety study for the prevention of venous thromboembolism in hospitalized acutely iLL medical patients comparing rivaroxabAN with enoxaparin) was a multinational, multicenter, randomized, double-blind, double-dummy, active comparator controlled study in patients with current reduced mobility that was likely to persist. All enrolled patients received study medication on day 1 (defined as the day of randomization), underwent mandatory bilateral lower limb venous ultrasonography on day 10±4 and on day 35±4, and were followed until day 90±7. Suspected symptomatic VTE was investigated promptly using appropriate vascular and pulmonary imaging procedures. The inclusion criteria were: age ≥40 years; immobilization; heart failure, active cancer, acute ischemic stroke, acute infection, acute inflammatory or rheumatic disorders, or acute respiratory insufficiency. Patients with acute ischemic stroke without leg paresis or paralysis, acute infection, acute inflammatory or rheumatic disorders, or acute respiratory insufficiency required at least 1 additional risk factor for VTE, e.g. age ≥75 years, previous VTE, previous cancer or heart failure, severe venous disease, thrombophilia, recent major surgery or serious trauma, hormone replacement therapy or morbid obesity (body mass index ≥35 kg/m2). The exclusion criteria included an increased risk of bleeding; prohibited drugs or procedures, e.g. anticoagulant therapy; and concomitant conditions or diseases, e.g. allergies, severe renal or liver disease. The primary efficacy outcome was the composite of asymptomatic proximal deep vein thrombosis (DVT) detected by mandatory venous ultrasonography, symptomatic proximal and distal DVT, symptomatic pulmonary embolism, and fatal VTE reported during the treatment phase of the study. There were 2 efficacy analysis populations, pertaining to the 2 primary efficacy endpoints. The study was powered at the 90% level to show non-inferiority at day 10±4 and superiority at day 35±4. The primary safety outcome was the composite of major bleeding events and clinically relevant non-major bleeding events. Sparse pharmacokinetic/pharmacodynamic sampling was performed by measuring rivaroxaban levels at peak and trough time points in all patients. In selected centers, a full pharmacokinetic/pharmacodynamic profile was performed. Pharmacogenetic and health economic outcomes were also assessed. Results: The first patient was enrolled in December 2007. As of July 2010, 8,101 subjects have been enrolled in the study from 556 centers in 52 countries. The mean age of patients is approximately 69 years, and around 46% are female. Approximate distributions of the acute medical conditions are as follows: 34% have heart failure, 32% have acute infectious diseases, 24% have acute respiratory insufficiency, 17% have acute ischemic stroke, 8% have active cancer, and 5% have acute inflammatory and rheumatic diseases. Conclusions: MAGELLAN will determine the efficacy and safety of oral rivaroxaban (short- and extended-duration regimens) compared with the current standard of care in a diverse population of acutely ill medical patients with reduced mobility and other risk factors for venous thromboembolic disease. Disclosures: Cohen: Bayer Schering Pharma: Consultancy, Research Funding; Johnson and Johnson: Consultancy, Research Funding. Spiro:Bayer Healthcare Pharmaceuticals Inc.: Employment. Büller:Bayer Schering Pharma: Consultancy, Research Funding. Haskell:Johnson & Johnson Pharmaceutical Research & Development L.L.C.: Employment. Hu:Bayer Schering Pharma: Research Funding. Hull:Bayer Schering Pharma: Research Funding. Mebazaa:Bayer Schering Pharma: Research Funding. Merli:Bayer Schering Pharma: Research Funding. Schellong:Bayer Schering Pharma: Research Funding. Spyropoulos:Bayer Schering Pharma: Research Funding. Tapson:Bayer Schering Pharma: Research Funding.
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Karmacharya, Robin Man, Satish Vaidya, Amit Kumar Singh, Prasesh Dhakal, Sushil Dahal, Prabha Shrestha, Sohail Bade, and Niroj Bhandari. "Analysis/Spectrum of admitted cases of lower extremity arterial disease (LEAD) in University Hospital of Nepal." Annapurna Journal of Health Sciences 1, no. 1 (February 10, 2021): 17–22. http://dx.doi.org/10.52910/ajhs.8.

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Introduction: Peripheral arterial disease is a condition due to partial or complete occlusion of arteries excluding that of heart and brain. Lower extremity arterial disease is specific to lower limbs. Some of the patients are asymptomatic while a majority present with claudication, rest pain, ulceration or even gangrene. Methods: We took all admitted cases of lower extremity arterial disease from January, 2015 to December 2018. ABI was used as the first clinical tool for the diagnosis of PAD in patients with history or physical examination findings suggestive of PAD as per AHA guidelines. Outpatient arterial Doppler ultrasonography complemented by lower limb CT angiogram was used as a confirmatory tool for the diagnosis and also to assess anatomical location and severity of stenosis. Results: Total of 54 cases of lower extremity arterial diseases were identified with a mean age of 59.2 years (S.D. 11.4). Right lower limb was involved in 35(50%). Mean age was 58 years(SD 13.1). Mean duration of symptom was 3.4 years (SD 3.3). Claudication was present in all the patients. 32(45.7%) had ulcers. Toe(44.3%) was most commonly involved. Decreased local temperature(91.4%) and color change(87.1%) were major symptoms. 35(50%) of the patients had gangrene. Mean peak systolic velocity was lowest in the peroneal artery. 16.6% patients got additional peripheral bypass surgery. Conclusion: Claudication, decreased local temperature and color change were very common findings of lower extremity arterial disease. Gangrene was present in half of the patients.
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Basaula, Yuba Nidhi, Radha Kumari Paudel, and Ram Hari Chapagain. "A Five Years Study of Occurrence and Associated Risk Factors for Birth Defects in a Tertiary Care Hospital in Central Nepal." Journal of Nepal Paediatric Society 39, no. 3 (December 31, 2019): 135–41. http://dx.doi.org/10.3126/jnps.v39i3.28447.

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Introduction: Congenital anomalies account for 7.0% of neonatal deaths in Nepal. The present study was carried out to determine the overall rate of congenital malformations, incidence and prevalence in live births, still birth and incidence affecting various organ systems, at Bharatpur Hospital, Nepal. Methods: All the intramural deliveries between Jan 2015 to Dec 2019 were included in the study. All the newborns were looked for congenital malformations after birth within seven days. Antenatal ultrasonography findings were noted. 2D echocardiography was also used for all congenital heart diseases, along with routine X-ray chest. A total of 131 babies with congenital problem were studied and the information was recorded in WHO NBBD Proforma. Data were recorded in MS Excel and SPSS 16 version was used for analysis. Results: Out of the total 60160 deliveries, 131 (0.21% of total birth) were with congenital malformations, sex wise distribution was 65 (49.5%) females and 63 (48.7%) males and three (1.8%) were ambiguous. Oro-facial malformation (49, 37.4%) was the commonest form of malformation followed by the musculoskeletal system (31, 23.6 %), centre nervous system (31, 23.6%) and congenital malformations of genital organs (8, 6.0%). Conclusions: The incidence of congenital malformation in this study was 0.21%. Females were more common than males and oro-facial malformation was the commonest type of malformation. Lack of antenatal visit, lack of folic acid during pre-conception period and low socioeconomic status were the commonest risk factors.
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Picchianti Diamanti, Andrea, Milica Markovic, Giuseppe Argento, Simonetta Giovagnoli, Alberto Ricci, Bruno Laganà, and Raffaele D’Amelio. "Therapeutic management of patients with rheumatoid arthritis and associated interstitial lung disease: case report and literature review." Therapeutic Advances in Respiratory Disease 11, no. 1 (October 12, 2016): 64–72. http://dx.doi.org/10.1177/1753465816668780.

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Rheumatoid arthritis (RA) is an inflammatory autoimmune disease that can present different extrarticular manifestations involving heart, lungs and kidneys. In recent years there has been a growing awareness of the central role played by the lungs in the onset and progression of RA. In particular interstitial lung disease (ILD) is a common pulmonary manifestation that may be related to the inflammatory process itself, infectious complications and to the treatments used. Management of patients with ILD/RA is still a challenge for clinicians, both synthetic [mainly methotrexate (MTX), leflunomide] and biologic immunosuppressors [mainly anti-tumor necrosis factor (TNF)α] have in fact been related to the onset or worsening of lung diseases with conflicting data. Here we report the case of a 61-year-old male patient with severely active early RA, previously treated with MTX, who developed subacute ILD, along with a review of ILD/RA topic. Tocilizumab (humanized monoclonal antibody against the interleukin-6 receptor) was introduced on the basis of its effectiveness in RA without concomitant MTX and the ability to overcome the profibrotic effects of interleukin (IL)-6. After 3 months of treatment the clinical condition of the patient strongly improved until it reached low disease activity. He no longer complained of cough and dyspnea and bilateral basal crackles were no more present. Considering its distinctive features, tocilizumab, in such a challenging clinical condition, appears to be a safe and effective therapy, thus it enables RA remission without deteriorating ILD, at 1-year follow up, as confirmed by ultrasonography of the affected joints and chest high-resolution computed tomography (HRCT).
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42

Shevchuk, S. V., Y. S. Seheda, O. Y. Galyutina, N. P. Masik, and O. V. Shevchuk. "Serum paraoxonase activity in patients with rheumatoid arthritis, its relationship with the clinical course and cardiovascular compications." Regulatory Mechanisms in Biosystems 9, no. 1 (February 17, 2018): 90–94. http://dx.doi.org/10.15421/021813.

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Nowadays low paraoxonase activity is generally recognized as an independent risk factor of cardiovascular diseases involved in pathologic remodeling of the heart and vessels as well as thrombosis in the general population. But the role of paraoxonase activity in RA patients is unknown. Based on the above, the aim of the work was to study serum paraoxonase activity in patients with rheumatoid arthritis, to evaluate its association with clinical course and structural and functional status of the cardiovascular system. 67 patients with RA, 18 males and 49 females were studied. The control group consisted of 25 apparently healthy individuals. Rheumatoid arthritis was diagnosed according to international classification criteria ACR 2012. The indices of total cholesterol (TC), high density lipoprotein cholesterol (HDLC) and triglycerides (TG) in blood serum were determined by standard conventional methods. Low density lipoprotein cholesterol (LDLC) values were calculated by Friedwald formula. Serum paraoxonase activity was measured by spectrophotometric method. High resolution ultrasound and Doppler ultrasonography of the brachial artery were performed to study endothelium function. Sonographic B-mode scanning and pulsed Doppler ultrasound of heart and blood flow spectra were done on ultrasound scanner. Serum paraoxonase activity was found to be about 18.8% lower in the patients with RA than in the control group. Serum paraoxonase activity was shown to decrease proportionally to the increase of the age in RA patients. In the group of patients over 45, the level of the enzyme was 13.0% lower than in the patients over 30. The study established that the increase of systolic and diastolic arterial pressure is associated with decrease of serum paraoxonase activity in RA patients. The patients with RA combined with arterial hypertension had significantly (by 10.9%) lower activity of the studied enzyme than those with no arterial hypertension. However, no significant relationship between paraoxonase activity and duration of the disease, obesity and smoking was revealed. Paraoxonase activity in RA patients was demonstrated to be dependent on lipid levels. The lowest paraoxonase activity was recorded in individuals with the highest levels of TC, LDLC and the lowest HDLC indices. Paraoxonase activity in RA patients is associated not only with atherosclerotic vascular damage (IMT, decreased FMDBA) but also with structural and functional heart status (systolic and diastolic functions, left ventricular myocardial hypertrophy). Decreased serum paraoxonase level is suggested to be the predictor of early development of cardiovascular complications in RA patients.
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43

Napoli, C., G. Bruzzese, L. J. Ignarro, E. Crimi, F. De Nigris, S. Williams-Ignarro, S. Libardi, et al. "Long-term treatment with sulfhydryl angiotensin-converting enzyme inhibition reduces carotid intima-media thickening and improves the nitric oxide/oxidative stress pathways in newly diagnosed patients with mild to moderate primary hypertension." Cardiovascular Therapy and Prevention 11, no. 3 (June 20, 2012): 93–101. http://dx.doi.org/10.15829/1728-8800-2012-3-93-101.

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Aim. Sulfhydryl angiotensin-converting enzyme (ACE) inhibitors exert antiatherosclerotic effects in preclinical models and antioxidant effects in patients. However, whether ACE inhibitors have any clinically significant antiatherogenic effects remains still debated. Objectives. In mildly hypertensive patients, we evaluated the effect of the sulfhydryl ACE inhibitor zofenopril in comparison with the carboxylic ACE inhibitor enalapril on carotid atherosclerosis (intima-media thickness [IMT] and vascular lumen diameter) and systemic oxidative stress (nitrite/nitrate, asymmetrical dimethyl-L-arginine, and isoprostanes). Material and methods. In 2001, we started a small prospective randomized clinical trial on 48 newly diagnosed mildly hypertensive patients with no additional risk factors for atherosclerosis (eg, hyperlipidemia, smoke habit, familiar history of atherosclerosisrelated diseases or diabetes). Patients were randomly assigned either to the enalapril (20 mg/d, n = 24) or the zofenopril group (30 mg/d, n = 24); the planned duration of the trial was 5 years. Carotid IMT and vascular lumen diameter were determined by ultrasonography for all patients at baseline and at 1, 3, and 5 years. Furthermore, nitrite/nitrate, asymmetrical dimethyl-L-arginine, and isoprostane levels were measured. Results. In our conditions, IMT of the right and left common carotid arteries was similar at baseline in both groups (P = NS). Intima-media thickness measurements until 5 years revealed a significant reduction in the zofenopril group but not in the enalapril group (P b .05 vs enalapril-treated group). This effect was coupled with a favorable nitric oxide/oxidative stress profile in the zofenopril group. Conclusion. Long-term treatment with the sulfhydryl ACE inhibitor zofenopril besides its blood pressure–lowering effects may slow the progression of IMT of the carotid artery in newly diagnosed mildly hypertensive patients. (Am Heart J 2008;156:1154.e1-1154.e8.)
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Laudhittirut, Tanarut, Natrada Rujivipat, Kornnicha Saringkarisate, Peeraya Soponpattana, Teerawat Tunwichai, and Sirilak Disatian Surachetpong. "Accuracy of methods for diagnosing heart diseases in cats." May-2020 13, no. 5 (2020): 872–78. http://dx.doi.org/10.14202/vetworld.2020.872-878.

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Aim: This study aimed to determine the accuracy of the current methods for diagnosing heart diseases in cats. Materials and Methods: The data of 58 cats were retrospectively retrieved. Cats were classified into two groups: Thirty-eight cats with heart diseases and 20 healthy cats. Echocardiography was the gold standard method for diagnosing heart disease. The results of seven methods were retrieved: (1) Vertebral heart score (VHS) with a cutoff value >8, (2) VHS with a cutoff value >8.5, (3) multiplication of cardiac length (L) and width (W), (4) multiplication of cardiac L and W divided by the L of the fourth sternal thoracic bone, (5) N-terminal Pro-B-type natriuretic peptide (NT-proBNP) point-of-care test, (6) subjective ultrasonographic assessment of the left atrial size, and (7) subjective radiographic assessment of the left atrial size. Cross-tabulation was used to calculate the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for each test. This study found that using the NT-proBNP point-of-care test was optimal in the diagnosis of cats with heart disease. Results: The subjective ultrasonographic assessment of the left atrial size was good for diagnosing hypertrophic cardiomyopathy and congestive heart failure. Conclusion: This study showed that the more tests used, the higher the reliability of the diagnosis.
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Michaeli, David, and Z. Harry Rappaport. "Tissue resonance analysis: a novel method for noninvasive monitoring of intracranial pressure." Journal of Neurosurgery 96, no. 6 (June 2002): 1132–37. http://dx.doi.org/10.3171/jns.2002.96.6.1132.

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✓ A number of noninvasive methods used to measure intracranial pressure (ICP) have been proposed in the literature. For a variety of reasons, however, none of these have displayed significant practical applicability. The authors describe their development of a new, computerized, portable device based on tissue resonance analysis (TRA) technology for the noninvasive monitoring and measurement of ICP. In response to the heart beat, the soft tissue and fluid compartments of the brain each exhibit characteristic vibration and mechanical resonant responses that radiate through the organs and tissues of the body. Patterns of vibration and mechanical resonance of various body organs and tissues are different and provide the possibility of extracting new and specific information in a noninvasive fashion. According to the TRA approach, ICP is dependent on the value of the dominant secondary (mechanical) resonance level of brain tissue. By digitally processing a reflected ultrasound signal (by using a concave ultrasonography probe with a carrier frequency of 1 MHz) from the third ventricle, the authors obtained a digital high-resolution echopulsogram, which visually is equivalent to ICP waves that are obtained invasively. The fast Fourier relationship of electrocardiogram and echopulsogram waves allowed the derivation of the secondary mechanical resonance levels. The authors developed a formula for a quantitative, noninvasive measurement of ICP, which uses information regarding multiple components of the intracranial space—both mechanical (secondary resonance) and physiological (time required for transfer of arterial blood to venous blood through brain tissue)—and the relationship between these components. A comparison of invasive and noninvasive ICP measurements was made during blinded trials in 40 patients with various diseases of the central nervous system, and ranges of ICP were measured from 1 to 66 mm Hg. The ICP values obtained using the two methods were highly correlated (r = 0.99), without a statistically significant difference between simultaneously obtained readings (p = 1). By using an integrative approach that reflects all components of the intracranial compartment, TRA allows for accurate noninvasive recordings of ICP. This method has significant advantages over other noninvasive technologies reported to date.
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Kryukov, Evgeniy V., Alexander Ya Fisun, Yuri S. Halimov, Sergey V. Gaiduk, and Pavel V. Agafonov. "Risk factors and circulatory system pathologies in military personnel in the Arctic region." Bulletin of the Russian Military Medical Academy 23, no. 4 (December 15, 2021): 85–92. http://dx.doi.org/10.17816/brmma64998.

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Considering the remoteness of the Arctic region, its harsh climatic and geographical characteristics, complex sanitary and epidemiological situation, and peculiarities of a military labor, circulatory system pathologies are expected to significantly contribute to the morbidity structure of the personnel of the Armed Forces of the Russian Federation in the Arctic region. A comparative analysis of the occurrence of cardiovascular risk predictors such as: dyslipidemia, tobacco smoking, high blood pressure, abdominal obesity, negative psychosocial factors, poor diet, alcohol consumption, physical inactivity, individual signs of atherosclerosis, and circulatory system diseases in the servicemen of the Arctic region, and temperate climate was performed. The results of the analysis revealed that military service in the climatic and geographic conditions of the Arctic zone is associated with a higher prevalence of the negative psychosocial factors, diet disorders, bad habits, and an arterial hypertension. Negative psychosocial factors included: stress, increased anxiety, and the depression, which are explained by the remoteness and limited communication in the Arctic region and the mainland, poor prospects for the professional career growth and high-quality training of the family members, monotony, and low availability of the leisure activities. The higher prevalence of an arterial hypertension among the arctic servicemen was caused by the newly diagnosed arterial hypertension and a history of arterial hypertension. In a significant proportion of arctic servicemen, low-density lipoprotein values exceed the target values, which ensure the prevention of the atherosclerosis and its complications. This may contribute to the development of the hypertension and coronary heart disease, and requires a more careful selection of servicemen in the Arctic region with mandatory in-depth examinations of the circulatory systems and metabolism, including the electrocardiography, echocardiography, treadmill test, ultrasonography of the brachiocephalic arteries with the determination of the thickness of the intimamedia complex, sphygmomanometer, and determination of the rigidity and biological age of the blood vessels, lipid profiling, and fasting glycemia.
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Maeno, Yasuki, and Akiko Hirose. "Screening of Fetal Heart for the Congenital Heart Diseases." Donald School Journal of Ultrasound in Obstetrics and Gynecology 5, no. 1 (2011): 33–38. http://dx.doi.org/10.5005/jp-journals-10009-1174.

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ABSTRACT Screening of the congenital heart disease (CHD) is one of the most important techniques in prenatal ultrasonographic examination. Step by step screening methods for taking account for the level of screener, especially in the area with poor detection rate, is needed for starting effective fetal CHD screening. In this review, the fetal cardiac screening is divided into two methods accounting for steps for learning screening technique; the basic screening and the advanced screening. Basic screening is a simple method even for the one who is not familiar to the cardiac anatomy. The goal of this basic screening is to detect most of the ductal dependent lesions including transposition of the great arteries. For the basic screening, ‘location’ and ‘size’ of the heart and vessels are checked in standard fourchamber view and three-vessel view. Advanced screening is a screening for detecting all fetal CHDs, including total anomalous pulmonary venous return. For the advanced screening, the side of the heart is defined, and then the ‘detail anatomy’ and the ‘function and blood flow’ are assessed in all standard screening views, including one fetal abdominal transverse view and three fetal chest transverse views, such as four-chamber, three-vessel and three-vessel and trachea view.
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Goloeva, R., Z. Alekberova, T. Popkova, and S. Glukhova. "POS0115 RISK FACTORS FOR CORONARY HEART DISEASE AND ATHEROSCLEROSIS IN PATIENTS WITH BECHET’S DISEASE." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 268.2–269. http://dx.doi.org/10.1136/annrheumdis-2021-eular.3431.

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Background:Objectives:To evaluate traditional risk factors for clinically manifest and asymptomatic atherosclerosis in pts with BD.Methods:Traditional risk factors for atherosclerosis were evaluated in 95 pts with Bechet’s disease (BD) and 40 healthy age and gender matched controls. The male-to-female ratio was 3,7:1, pts’ mean age was 29.7 (23-35) y, the mean age at the disease onset - 19,9 (14-25) y, and mean disease duration - 9,6 (4-15) y. The common carotid artery intima-media thickness (IMT) was evaluated by high resolution B-mode ultrasonography. A plaque was defined as a local intima-media thickening ≥1,2 mm, with reference IMT thickness <0,9 mm. Serum concentration of high-sensitivity C-reactive protein (hs CRP) was measured by immunonephelometric assay (BN-100 Analyzer; Dade Behring). Lipid profile evaluation included total cholesterol, TGs, HDL, LDL and atherogenic index.Results:Traditional risk factors for atherosclerosis (one or more) were found in 85,3% of BD pts, dyslipidemia was the most common risk factor and was present in 76,84% of pts, mostly due to increased total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels. 22,1% had arterial hypertension (AH), 29,5% were current smokers, 27,4% had excess body weight, 3,1% had family history of cardiovascular diseases (CVD). Traditional risk factors for atherosclerosis were found in 80% out of 40 gender and age matching subjects from the control group, i.e., showing practically the same prevalence as in BD pts.Table 1.The incidence-rate of traditional risk factors in BD patients and controlsVariablesBD pts (n=95)Controls (n=40)рAge, years29,0 [23,0;35,0]29,0 [25,0;32,0]NSBMI, kg/m223,1 [21,1;25,5]23,8 [22,0;26,0]NSBMI ≥ 25 kg/m2, n (%)26 (27,4)15 (37,5)NSArterial hypertension, n (%)21 (22,1)4 (10)NSFamily history of CVD3 (3,1)5 (12,5)0,05Cigarette smoking, n (%)28 (29,5)12 (30,0)NSDyslipidemia, n (%)73 (76,8)27 (67,5)NSTotal cholesterol, mml/l5,0 [4,3;6,1]5,1 [4,5;5,7]NSCholesterol > 5,0 mml/l, n (%)47 (49,5)25 (62,5)NSTGs, mml/l0,92 [0,7;1,3]0,89 [0,60;1,08]NSTGs > 1,7 mml/l, n (%)8 (8,4)3 (7,5)NSLDL, mml/l3,36 (2,8;4,0)3,3 [2,7;3,7]NSLDL > 3 mml/l, n (%)63 (66,3)25 (62,5)NSHDL, mml/l1,19 [1,0;1,5]1,35 [1,2;1,6]0,06HDL ≤1 mml/l (male), ≤ 1,2 mml/l (female) n (%)30 (31,6)5 (12,5)0,03Reduced HDL levels were more common in BD pts vs the controls - 30 (31,6%) vs 5 (12,5), р=0,03 as shown in table 1. Other traditional risk factors were similarly present in both groups with no significant difference between BD pts and the controls.Analysis showed similar incidence of CV events (nonfatal myocardial infarction, angina pectoris and stroke) in both groups. There were no differences between BD pts and healthy people in terms of lifetime risk for CVD. High lifetime risk ≥ 20% was found in 4 BD pts vs 0 in the control group; moderate lifetime risk >10% < 20% - in 6,3% of BD pts vs 2,5% in the control group, and low lifetime risk < 10% -was found in 89,5% of BD pts vs 97,5% of the controls.Average IMT values were significantly higher in BD pts - 0.68 [0.60;0.73] vs 0.63 [0.56;0.65], p=0.008, but at the same time, IMT thinning (up to < 0.5 mm) was significantly more common in BD pts - 32.6% vs 12.5% in the control group (p=0.01). HsCRP serum levels were significantly higher in BD pts (2.42 [0.5;8.8] mg / l) than in the control group (0.37 [0.15;0.75]), p=0.001. There was a correlation between hs-CRP and BMI in BD pts (r=0.2, p<0.05), but no correlation was found between hsCRP and BD activity/BD clinical manifestations.Conclusion:Decreased HDL cholesterol levels were more common in BD patients than in the control group, just as thinning of IMT, most likely because of vasculitis.Disclosure of Interests:None declared
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49

Dos Santos, Ivan Felismino Charas, Letícia Rocha Inamassu, Sheila Canevese Rahal, Maria Jaqueline Mamprim, David José De Castro Martins, Bárbara Sardela Ferro, Bruna Martins Da Silva, Gustavo Manea Ferreira, Marina Paivo Branco, and José Ivaldo de Siqueira Silva Júnior. "Dopplerfluxometria da artéria femoral de cães adultos hígidos (Canis lupus familiaris)." Acta Scientiae Veterinariae 46, no. 1 (October 11, 2018): 5. http://dx.doi.org/10.22456/1679-9216.87308.

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Background: In Veterinary Medicine, there are several methods for early and accurate assessment of blood flow dynamics. The Dopplerfluxometry can access the peak systolic velocity, mean velocity and end diastolic velocity, including Resistive Index and Pulsatility Index. Normal values of Dopplerfluxometry in healthy dogs allow the identification of vascular abnormalities and authors’ knowledge there are no reference regarding the values of Dopplerfluxometry of the femoral artery in healthy dogs. The aim of the study was to assess the femoral Dopplerfluxometry of adult healthy dogs by Resistive Index, Pulsatility Index, systolic and diastolic velocities, and femoral artery diameter.Materials, Methods & Results: Eighteen healthy intact beagle dogs, male and female, aging from 2 to 4 years old (mean ± SD: mean 3 ± 0.8 years), weighing from 10.1-17.9 kg [22.3-39.5 lb] [mean ± SD: 14.3 ± 2.7 kg (31.5 ± 5.96 lb)] were used. The dogs underwent to physical examination, complete blood cell count, serum biochemistry examination urinalysis, and radiographs examination, muscular and cardiac evaluation. Females had to be in anestrous. All dogs were submitted to right femoral artery Dopplerfluxometry. The dogs were positioned in dorsal recumbency by one person without any chemical restraint. A high definition ultrasound device equipped with a 3 - 13 MHz multi-frequency linear transducer was used. The right femoral artery was identified with the transducer positioned transversely on the right triangle femoral area. Peak systolic velocity, end-diastolic velocity was measured. The Resistivity Index and Pulsatility Index were calculated automatically by the ultrasound machine software. Three measurements were obtained with the Doppler spectrum. The values of peak systolic velocity, end-diastolic velocity, Resistivity Index, Pulsatility Index and femoral artery diameter were expressed as Mean ± Standard Deviation (SD).Discussion: No studies regarding to femoral artery Dopplerfluxometry in healthy dogs were found in the literature. These results can be used as normal reference values of Dopplerfluxometric parameters for adult dogs. The literature cited only Dopplerfluxometric values of renal arteries, abdominal aorta and of the internal thoracic artery. The normal values of arterial Dopplerfluxometry is necessary to identify the spectral quantitative characteristics of the blood flow for diagnosis and prognosis of vascular diseases. Authors referred to changes in blood perfusion by Dopplerfluxometry examination, but no changes in B-mode ultrasonography. The femoral Resistivity Index values can be used to correlate the postoperative evolution in dogs submitted to femoral bone, hip and knee surgeries, since Dopplerfluxometry allows blood flow assessment in the femoral region muscles. Changes in the heart rate, blood pressure, stress, exercise, and diseases as hypotension, renal lesion, hepatic diseases, diabetes, hyperadrenocorticism can change the Dopplerfluxometric parameters. All dogs which used in this study were clinically healthy, and were used beagle dogs due to lowest variations within breed. Sedation was avoid due to possible changes in Dopplerfluxometric parameters since the use of sedation or tranquilization in animals is strongly discussed due to possible hemodynamic changes that may occur during the examination. In conclusion, the mean values of the right femoral artery Dopplerfluxometry in male and female adult healthy dogs is Resistivity Index (0.887); Pulsatility Index (1.599); peak systolic velocity (124.41 cm/s), end-diastolic velocity (14.12 cm/s), femoral artery diameter (3.9 mm).
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50

Stoll, C., E. Garne, and M. Clementi. "Evaluation of prenatal diagnosis of associated congenital heart diseases by fetal ultrasonographic examination in Europe." Prenatal Diagnosis 21, no. 4 (2001): 243–52. http://dx.doi.org/10.1002/pd.34.

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