Articles de revues : « Cardiovascular system – ultrasonography »

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LAZARIDIS, LJ, et EA KIOSSIS. « Applications of ultrasonography in ruminants (I) : A Review. » Journal of the Hellenic Veterinary Medical Society 61, n^o 4 (22 mars 2018) : 339. http://dx.doi.org/10.12681/jhvms.14907.

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In the middle of 1960s ultrasonography entered the veterinary clinical practice of large animals, almost one decade after the introduction in medicine. First ultrasonography was used to approach problems of the ovine genital system. Overtime, new applications were developed and the use of ultrasonography in large animal medicine was intensified. In the everyday veterinary clinical practice B-mode ultrasonographic devices are mainly used, with simple or convex linear array probes, with a frequency of 3.0 MHz to 7.5 MHz, while sector probes are also used. The adequate knowledge of the anatomy of the region, the appropriate restraint of the animal and a previous good clinical examination are the main prerequisites to conduct an ultrasonographic examination. In ruminants ultrasonographic examination can be applied in mainy systems. In respiratory system ultrasonography is used to evaluate the general condition of the thoracic cavity, with main diagnosticai applications in pulmonary emphysema, bronchopneumonia and aspiration pneumonia. In cardiovascular system ultrasonography contributes efficiently to the examination of the heart and the vessels. Doppler devices offer the opportunity of better estimation of some blood parameters. In the last two decades the use of ultrasonography has been propagated widely to approach problems associated to the digestive system of the ruminants and to evaluate the general condition of their peritoneal cavity. Ultrasonography is a very useful diagnostic tool to evaluate traumatic reticuloperitonitis and distension of the cecum. In cattle ultrasonographic examination of some organs, such as liver, spleen and pancreas, offers an opportunity to estimate changes in their size, contour and their position in the abdomen comparatively to their adjacent organs. Changes in the normal echotexture image are in most cases a sign of pathological conditions. Ultrasonography is useful in calves for the estimation of the condition of their umbilicus. At their first week of life, contributes to confront better some conditions such as omphalophlebitis, omphaloarteritis and omphalolourachitis. In the ruminants' urinarysystem ultrasonography is used to approach cases of urolithiasis along to the deferent section, cases with rupture of the urinary tract or cases with the presence of a mass. Application of ultrasonography in the bovine's musculoskeletal system, which has been researched thoroughly at the last two decades, offers an opportunity to image in a better way the joints which are covered by huge muscles. The anatomical and tissue function can be estimated in real time and the general condition of the animal can be evaluated. New advantages of ultrasonography are being researched, with main purpose the use of this technology as much as possible. Ultrasonography is a very effective imaging means in the service of the clinical veterinarian, which offers him the opportunity to examine in real time the area he desires in ruminants, but it doesn't replace the clinical examination.

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Dincer, Emre, Hamza Özer, Sevilay Topçuoğlu et Güner Karatekin. « Ultrasonography Causes Agitation and Pain Leading to Hemodynamic Disturbance in Neonates : A Prospective Observational Study ». Children 10, n^o 2 (10 février 2023) : 347. http://dx.doi.org/10.3390/children10020347.

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Background: Ultrasonography is widely used in neonatological practice and studies investigating the hemodynamic effects of various treatment protocols or clinical situations. On the other hand, pain causes changes in the cardiovascular system; so, in the case of ultrasonography leading to pain in neonates, it may cause hemodynamic alterations. In this prospective study, we evaluate whether ultrasonographic application causes pain and changes in the hemodynamic system. Methods: Newborns undergoing ultrasonographic examination were enrolled in the study. Vital signs, cerebral and mesenteric tissue oxygenation (StO2) levels, and middle cerebral artery (MCA) Doppler measurements were recorded, and NPASS scores were calculated before and after ultrasonography. Results: We enrolled 39 patients in the study. After ultrasonography, Neonatal Pain, Agitation, and Sedation Scale (NPASS) scores were significantly higher (p < 0.01), and all vital signs (heart rate, respiratory rate, SpO2, diastolic and systolic blood pressure; p = 0.03; p < 0.01, p < 0.01, p < 0.01, p = 0.02, p = 0.03, respectively) were altered. Cerebral (p = 0.008) and mesenteric (p = 0.039) StO2 levels were significantly lower in the whole study group, MCA end-diastolic velocity decreased (p = 0.02), and the resistive index (p = 0.03) increased in patients whose NPASS score was >7 after ultrasonography. Conclusions: This study is the first to show that ultrasonography may cause pain in newborn patients, and alters vital signs and hemodynamic parameters. Therefore, precautions should be taken to protect newborn babies from pain during ultrasound applications, as they are already exposed to many noxious stimuli. Furthermore, pain scores should be considered in studies using ultrasonography and evaluating hemodynamic parameters to increase the reliability of the studies.

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Demková, Katarína, Tibor Varga et Ján Tokarčík. « Association of non-alcoholic fatty liver disease with cardiac structural impairment ». Gastroenterologie a hepatologie 76, n^o 4 (31 août 2022) : 341–46. http://dx.doi.org/10.48095/ccgh2022341.

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Summary: Non-alcoholic fatty liver disease encompasses a spectrum of pathologic entities ranging from liver steatosis through non-alcoholic steatohepatitis and fibrosis to cirrhosis of the liver. Patients with non-alcoholic fatty liver disease have a higher incidence of coronary artery disease, cardiovascular events due to atherosclerosis, both ischemic and haemorrhagic strokes, thromboembolic events, conduction system disorders, left ventricular dysfunction, and also cardiovascular mortality. Non-alcoholic fatty liver disease is also associated with structural abnormalities of the myocardium and valves. Non-alcoholic steatohepatitis develops in about 8–20% of obese patients with simple hepatic steatosis. The disease tends to progress and may be poorly controlled therapeutically. Non-alcoholic steatohepatitis increases the risk of mortality from cardiovascular disease by 2.1-fold and the risk of mortality from any cause by 2.3-fold. The inflammatory process in the liver may represent a major determinant of systemic complications in people with non-alcoholic fatty liver disease, so its assessment could be useful for cardiovascular risk assessment. Due to the documented association between the severity of hepatic steatosis assessed by ultrasonography and coronary or carotid atherosclerosis, ultrasonographic examination of the liver may be helpful in identifying people at high cardiovascular risk. The present case report confirms the importance of echocardiographic screening for structural and functional cardiac abnormalities in patients with chronic non-alcoholic steatohepatitis in order to initiate early treatment and improve their prognosis. Key words: non-alcoholic fatty liver disease – ultrasonography – echocardiography – screening

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BENEDETTO, FRANCESCO ANTONIO, FRANCESCA MALLAMACI, GIOVANNI TRIPEPI et CARMINE ZOCCALI. « Prognostic Value of Ultrasonographic Measurement of Carotid Intima Media Thickness in Dialysis Patients ». Journal of the American Society of Nephrology 12, n^o 11 (novembre 2001) : 2458–64. http://dx.doi.org/10.1681/asn.v12112458.

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Abstract. High-resolution carotid ultrasonography is considered a fundamental technique for the investigation of the vascular system. However, it is still very unclear whether ultrasonographic studies of carotid arteries are useful for the prediction of cardiovascular events in patients with end-stage renal disease. The prediction power of carotid ultrasonography for all-cause and cardiovascular mortality was tested in a cohort of 138 patients receiving chronic dialysis treatment (91 receiving hemodialysis treatment and 47 receiving continuous ambulatory peritoneal dialysis treatment; follow-up, 29.8 ± 15.0 mo), and the relationship between this parameter and alterations in left ventricular mass (LVM) and geometry was examined. On univariate analysis, intima media thickness (IMT) was directly related to LVM as well as to the absolute and relative thicknesses of LV walls but independent of LV end-diastolic volume. Data analysis based on LV geometry patterns revealed that patients with concentric hypertrophy were those with the highest IMT. The internal diameter of the common carotid artery (DCCA) was also related to concentric hypertrophy, but the strength of this relationship was of borderline significance (P= 0.06). During the follow-up period, 63 patients died: 32 (51%) of them of cardiovascular causes. IMT was significantly higher (P= 0.006) in patients who died of cardiovascular causes (1.10 ± 0.21 mm) than in patients who survived (0.99 ± 0.24 mm), In a Cox regression model, this parameter turned out to be an independent predictor of cardiovascular death, and it retained an independent effect in a model that included LVM. Treatment modality failed to independently predict this outcome. The risk of cardiovascular death was progressively higher from the first IMT tertile onward. DCCA failed to predict cardiovascular outcomes. IMT in dialysis patients is associated with LV concentric hypertrophy and is an independent predictor of cardiovascular death. IMT may be usefully applied for risk stratification in the dialysis population.

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He, Wei, Songnong Li, Hanguang Xiao, Chuanxiang Yu et Haitao Lin. « AN EMBEDDED MICROPROCESSOR UNIT-BASED PORTABLE NONINVASIVE ARTERIOSCLEROSIS DETECTING SYSTEM AND ITS EXPERIMENTAL STUDY ». Biomedical Engineering : Applications, Basis and Communications 25, n^o 06 (décembre 2013) : 1350051. http://dx.doi.org/10.4015/s1016237213500518.

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Pulse wave velocity (PWV) and arterial stiffness index (ASI) are considered as the independent predictors of cardiovascular morbidity and mortality — the effective methods to assess arterial stiffness. A portable noninvasive arterial elasticity detecting system (PNAEDS) was developed based on embedded microprocessor unit. This system can simultaneously measure PWV, ASI and other arteriosclerosis critical risk factors. Algorithm of main critical risk factors and design of the system were described in detail. To verify the performance of the PNAEDS, laboratory prospective validation and clinical trial were launched. Reliability of the system and superiority of improved PWV algorithm were validated in laboratory prospective validation. Subsequently, the authors implemented a comparative clinical trial (60 subjects) between measured values obtained by the PNAEDS and carotid intima-media thickness (IMT) value that Doppler ultrasonography measured. Clinical testing results revealed that the measurement with the PNAEDS was consistent with the measurement with the Doppler ultrasonography. In summary, the system may be used to reliably determine the arteriosclerosis critical risk factors and to the early diagnosis and prevention of cardiovascular disease.

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Kokhanenko, Nikolay Yurevich, Yuriy Nikolaevich Shiryajev, Andrey Lvovich Lugovoy, Sergey Alexandrovich Danilov et Lekso Zurabovich Gurtskaya. « Features of pathogenesis, clinical course and diagnosis of acute cholecystitis of patients with decompensated cardiovascular diseases ». Pediatrician (St. Petersburg) 6, n^o 4 (15 décembre 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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Bastrikov, O. Yu, E. A. Grigoricheva, V. V. Belov et V. V. Milegov. « Association of arterial stiffness and cardiovascular system remodeling in patients with hypertension ». Kazan medical journal 95, n^o 4 (15 août 2014) : 485–90. http://dx.doi.org/10.17816/kmj1827.

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Aim. To study the indices of arterial wall local stiffness and it association with structural and functional parameters of cardiovascular system remodeling in hypertensive patients. Methods. Cross-sectional population study included 213 industrial workers, among them 106 patients with stage I-II hypertension and 107 healthy individuals. The stage of arterial hypertension and additional cardiovascular risk category was performed in accordance with national guidelines. All patients underwent echocardiography, carotid arteries ultrasonography, including arterial stiffness evaluation. Results. In patients with hypertension, significant association of arterial wall stiffness indices and «intima-media» complex thickness (total impact of 91%) and echocardiographic parameters describing the left heart chambers volume were revealed. The fact of identifying the relatively high rate of altered arterial wall stiffness parameters, as well as its association with «intima-media» complex thickness in healthy individuals with normal blood pressure (total impact of 81%) may suggest that vascular wall rigidity change may premise vascular remodeling. Conclusion. Arterial wall stiffness indices may be a marker of effective control of risk factors in individuals with normal blood pressure and effect of drug therapy in patients with hypertension.

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Kovaitė, Milda, Žaneta Petrulionienė, Ligita Ryliškytė, Jolita Badarienė, Alma Čypienė, Vilma Dženkevičiūtė et Aleksandras Laucevičius. « Relationship of arterial wall parameters to cardiovascular risk factors and cardiovascular risk assessed by SCORE system ». Medicina 43, n^o 7 (17 juin 2007) : 529. http://dx.doi.org/10.3390/medicina43070067.

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Objective. To investigate the relationship of arterial wall parameters (flow-mediated dilatation of the brachial artery, augmentation index, pulse wave velocity, stiffness index, carotid intima-media thickness) to conventional cardiovascular risk factors and cardiovascular risk assessed by SCORE system. Material and methods. A total of 209 subjects aged 40–65 years without clinically overt cardiovascular disease were examined. Parameters of arterial stiffness were obtained by two methods: augmentation index and carotid-radial pulse wave velocity by applanation tonometry and stiffness index by the means of finger photoplethysmography. Flow-mediated dilatation of the brachial artery, reflecting endothelial function, and carotid intima-media thickness was determined using a high-resolution B-mode ultrasonography. Results. Age and the presence of diabetes strongly influenced all parameters of the arterial wall (diabetes was not independent predictor when evaluating augmentation index). Mean arterial pressure and gender were independent predictors for arterial stiffness parameters – carotid-radial pulse wave velocity and augmentation index. Flow-mediated dilatation was strongly dependent on the diameter of the brachial artery, age, and body mass index. Using logistic regression, it was found that pulse wave velocity (P=0.014), intima-media thickness (P=0.004), and flow-mediated dilatation (P=0.020) were important parameters dividing subjects to the groups of increased (³5%) and low (<5%) cardiovascular risk assessed by SCORE system. The cutoff values for intima-media thickness and pulse wave velocity were 0.078 cm and 8.95 m/s, respectively. Conclusions. Arterial wall parameters are closely associated with conventional risk factors; they are influenced by age and the presence of diabetes. Arterial stiffness parameters are also influenced by mean arterial pressure; high-density lipoprotein cholesterol has influence on carotid intima-media thickness. Cutoff values for carotid intima-media thickness and carotid-radial pulse wave velocity could help to discriminate patients with increased cardiovascular risk.

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Oltean-Péter, Balázs, István Kovács, Monica Chițu et Imre Benedek. « The Role of Carotid Ultrasonography in Patients with High Risk of Atherosclerosis ». Journal of Interdisciplinary Medicine 3, n^o 4 (1 décembre 2018) : 229–33. http://dx.doi.org/10.2478/jim-2018-0029.

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Abstract Atherosclerosis is a systemic disease that most often affects the carotid arteries. Being usually asymptomatic in its early stages, it is diagnosed only in advanced stages, when treatment is more difficult and prognosis is poor. Carotid ultrasound (US) is the most commonly used method for diagnosing carotid artery disease and represents a proper method for screening in patients with cardiovascular (CV) risk factors. This paper shows the methodology and necessity of carotid imaging methods in patients at high risk of developing atherosclerotic lesions. We also review the findings that underline the need of carotid screening in patients with ischemic heart disease or with ischemic arteriopathy, showing that the carotid arteries are like ‘mirrors’ of the arterial system, which need to be assessed in every patient with CV risk factors, regardless of the presence or absence of symptoms.

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Kweon, Ye-Na, Hae-Jin Ko, A.-Sol Kim, Hye-In Choi, Ji-Eun Song, Ji-Yeon Park, Sung-Min Kim, Hee-Eun Hong et Kyung-Jin Min. « Prediction of Cardiovascular Risk Using Nonalcoholic Fatty Liver Disease Scoring Systems ». Healthcare 9, n^o 7 (15 juillet 2021) : 899. http://dx.doi.org/10.3390/healthcare9070899.

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This study aimed to determine whether nonalcoholic fatty liver disease (NAFLD) is an independent risk factor for CVD and to identify the most useful NAFLD diagnostic tool for predicting CVD. Data from a total of 23,376 Korean adults without established CVD were analyzed. Cardiovascular risk was calculated using the Framingham Risk Score (FRS) 2008. The presence of NAFLD was defined as moderate-to-severe fatty liver disease diagnosed by ultrasonography. Scores for fatty liver were calculated using four NAFLD scoring systems (Fatty Liver Index, FLI; Hepatic Steatosis Index, HSI; Simple NAFLD Score, SNS; Comprehensive NAFLD Score, CNS), and were compared and analyzed according to cardiovascular risk group. Using the FRS, 67.4% of participants were considered to be at low risk of CVD, 21.5% at intermediate risk, and 11.1% at high risk. As the risk of CVD increased, both the prevalence of NAFLD and the score from each NAFLD scoring system increased significantly (p < 0.001). In the unadjusted analysis, the CNS had the strongest association with high CVD risk; in the adjusted analysis, the FLI score was most strongly associated with high CVD risk. Fatty liver is an important independent risk factor for CVD. Therefore, the available NAFLD scoring systems could be utilized to predict CVD.

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SIRLIER EMİR, Burcu, Sevler YILDIZ, Aslı KAZĞAN KILIÇASLAN, Kerim UĞUR et Osman KURT. « Yaygın anksiyete bozukluğu olan hastalarda arteriyel sertliğin değerlendirilmesi ». Cukurova Medical Journal 48, n^o 2 (30 juin 2023) : 385–93. http://dx.doi.org/10.17826/cumj.1219982.

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Purpose: Generalized anxiety disorder (GAD) is a psychiatric condition where both physical and mental symptoms are observed due to the activation of the sympathetic system. It is known that the disorder affects the cardiovascular system. The present study aimed to analyze arterial stiffness in GAD patients and compare the findings with healthy controls. Materials and Methods: 40 patients diagnosed with GAD and 40 healthy individuals were included in the study. Carotid and femoral artery intima-medial thickness (IMT) and arterial thickness parameters were measured with Doppler ultrasonography. Results: The femoral IMT of the patients was significantly low. Although the carotid IMT was higher in patients when compared to the controls, the difference was not statistically significant. A significant negative correlation was determined between fluoxetine equivalent dose and femoral IMT. There was a correlation between femoral IMT and fluoxetine equivalent dose. Conclusion: Arterial stiffness should be investigated for its potential to indicate cardiovascular risk in GAD. Further comprehensive studies should be conducted to clarify whether atherosclerosis symptoms were associated with the nature of the GAD or prescription medicine.

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Lee, B. B., R. Mattassi, Y. H. Choe, M. Vaghi, J. M. Ahn, D. I. Kim, S. H. Huh, C. H. Lee et D. Y. Kim. « Critical role of duplex ultrasonography for the advanced management of a venous malformation ». Phlebology : The Journal of Venous Disease 20, n^o 1 (1 mars 2005) : 28–37. http://dx.doi.org/10.1258/0268355053300875.

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Objectives: Duplex ultrasonography was assessed for its advanced role as a contemporary guide for the safer management of venous malformation (VM) at the lower extremities through a comparison study with matching magnetic resonance imaging (MRI) and/or ascending phlebography findings. Methods: A retrospective review of 50 patients with a VM in the lower extremities was performed using the duplex scan findings on the initial diagnosis and the subsequent follow-up assessment of the treatment response. The screening findings of deep vein thrombosis (DVT) development following ethanol sclerotherapy on 40 patients were also included. A marginal vein (lateral embryonal) compression test was also performed on 10 patients, who were candidates for a resection preoperatively, in order to assess its value in predicting the response to the subsequent resection. The duplex scan findings were compared with the available ascending phlebography results in 38 patients, and also with the MRI findings available for all 50 patients. Results: The duplex scan on the 50 patients confirmed the existence of a normal deep vein system in the lower extremities in 43 patients as the true-positive test findings. One false-negative test finding was subsequently confirmed by an angiographic evaluation. The duplex scan also confirmed the absence of a normal deep vein system in four patients as a true-negative test. MRI subsequently confirmed two false-positive findings in one patient, and angiography confirmed two false-positive findings in another (sensitivity − 97.8%, specificity − 66.7%, positive predictive value − 95.6%, and negative predictive value − 80%). Among a total of 40 patients who received ethanol sclerotherapy, the duplex scan identified DVT in three patients, and also screened out properly in 37 patients through a total of 185 ethanol sclerotherapy sessions. The compression test predicted the surgical outcome successfully in the majority (7/8). The duplex scan appears to have comparable reliability to MRI and/or angiography for diagnosing and managing VM. Conclusions: The duplex scan can provide the critical haemodynamic information of both the deep venous system and VM lesions quite effectively with the cost-effectiveness of a non-invasive test. In particular, the duplex scan is an excellent test for the safe management of VM of the lower extremity, including the early detection of DVT through multi-session ethanol sclerotherapy.

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Xiao, Hanguang, Wei He, Songnong Li, Chuanxiang Yu et Haitao Lin. « A LABVIEW-BASED MULTI-PARAMETER MEASURING SYSTEM OF ARTERY STIFFNESS AND CLINICAL STUDY ». Biomedical Engineering : Applications, Basis and Communications 23, n^o 05 (octobre 2011) : 419–26. http://dx.doi.org/10.4015/s1016237211002773.

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An artery stiffness measuring system was developed based on LabVIEW for the multiparameter measurement of cardiovascular hemodynamics. The overall hardware and software design of the system were introduced. The basic theory and methods were described for the calculation of pulse wave velocity (PWV), artery stiffness index (ASI), aorta compliance (C1) and arteriole compliance (C2). In order to illustrate the effectiveness of the system, the comparative clinical trial was performed on 218 participators by measuring carotid intima-media thickness (CIMT) using ultrasonography instrument and measuring the multiparameters by the developed system. In addition, age and blood pressure were divided respectively into five and three groups to analyze their correlation with the multi-parameters of the system. The results showed that the age and blood pressure groups are positively correlated with PWV and ASI, and negatively with C1 and C2; PP, ASI and PWV are positively correlated with CIMT; C2 is negatively correlated with CIMT. The results demonstrated that the system could be used to detect and diagnose artery stiffness from different aspects by measuring the multi-parameters.

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Hougaku, Hidetaka, Jerome L. Fleg, Samer S. Najjar, Edward G. Lakatta, S. Mitchell Harman, Marc R. Blackman et E. Jeffrey Metter. « Relationship between androgenic hormones and arterial stiffness, based on longitudinal hormone measurements ». American Journal of Physiology-Endocrinology and Metabolism 290, n^o 2 (février 2006) : E234—E242. http://dx.doi.org/10.1152/ajpendo.00059.2005.

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Circulating testosterone levels (T) decrease with age in men. Low T has been associated with coronary disease and with risk factors for atherosclerosis. This study examines the relationship in men between androgenic hormones and arterial stiffness, a major risk factor for cardiovascular events. T, sex hormone-binding globulin (SHBG), and dehydroepiandrosterone sulfate (DHEAS) were measured longitudinally over 33 yr (follow-up 11.8 ± 8.3 yr) in 901 men from the Baltimore Longitudinal Study of Aging, of whom 206 (68.1 ± 13.7 yr) underwent carotid duplex ultrasonography. The 901 men were used to characterize age-associated hormone levels by means of mixed-effects models. Hormone values were estimated for the 206 men at the time of ultrasonography. Free T index (FTI) was calculated by dividing T by SHBG. The arterial stiffness index was calculated from peak systolic and end diastolic diameters of the common carotid artery and simultaneous brachial artery blood pressure. T, FTI, and DHEAS were correlated negatively with age, pulse pressure (PP), and stiffness index (each P < 0.01), whereas SHBG was correlated positively with age and stiffness index ( P < 0.01). However, T was the only hormone that predicted the stiffness index after adjustment for age, PP, fasting plasma glucose, body mass index, and total cholesterol. T values 5–10 yr before the carotid study also predicted the stiffness index ( P < 0.05). Thus the adverse influence of low T on the cardiovascular system in men may be mediated in part via the effects of T on vascular structure and function.

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Mitrokhina, T. V., S. V. Yureneva, E. Yu Maychuk, S. Yu Kuznetsov, I. V. Voevodina et S. V. Moiseenko. « BONE MINERAL DENSITY AND VASCULAR WALL CHARACTERISTICS IN WOMEN AFTER OVARIECTOMY AND PROLONGED HORMONE THERAPY ». Osteoporosis and Bone Diseases 15, n^o 2 (15 août 2012) : 13–17. http://dx.doi.org/10.14341/osteo2012213-17.

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Osteoporosis and atherosclerosis are the most socially significant chronic non-infectious diseases. This is due to their high prevalence and medical, social and economic consequences from osteoporotic bone fractures and myocardial infarction and stroke as a result of cardiovascular diseases (CVD). The level of estrogen is essential for the formation and maintenance of bone mass in women. The sharp decline in estrogen levels after bilateral ovariectomy plays the role of trigger factor in the development of complex disorders of the bone and the cardiovascular system. Pathogenetically justified approach to the correction of the estrogen-deficient states is the use of hormone replacement therapy (HRT). To study the effect of HRT on the cardiovascular system and bone mineral density (BMD) we examined 50 women with surgical menopause which received HRT for more than a 10-year period. We studied the anthropometric and biochemical parameters (blood cholesterol and its fractions, fasting blood glucose), performed Doppler ultrasonography of head and neck vessels with measurement of pulse velocity, dual-energy x-ray absorptiometry (DEXA) for BMD estimation. Examination was carried out twice - in the early period after the operation (the first year) and after 10 years. Analysis of the cardio-vascular system and the BMD has demonstrated more severe atherosclerotic vascular changes and a greater decrease in BMD in patients who discontinued use of HRT. The severity of atherosclerosis and the level of the BMD were dependent on HRT use.

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Josowitz, Rebecca, Rebecca Linn et Jack Rychik. « The Placenta in Congenital Heart Disease : Form, Function and Outcomes ». NeoReviews 24, n^o 9 (1 septembre 2023) : e569-e582. http://dx.doi.org/10.1542/neo.24-9-e569.

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The maternal-fetal environment, controlled and modulated by the placenta, plays a critical role in the development and well-being of the fetus, with long-term impact through programming of lifelong health. The fetal cardiovascular system and placenta emerge at the same time embryologically, and thus placental form and function are altered in the presence of congenital heart disease (CHD). In this review, we report on what is known about the placenta from a structural and functional perspective when there is CHD. We describe the various unique pathologic findings as well as the diagnostic imaging tools used to characterize placental function in utero. With growing interest in the placenta, a standardized approach to characterizing placental pathology has emerged. Furthermore, application of ultrasonography techniques and magnetic resonance imaging now allow for insights into placental blood flow and functionality in vivo. An improved understanding of the intriguing relationship between the placenta and the fetal cardiovascular system will provide opportunities to develop novel ways to optimize outcomes. Once better understood, therapeutic modulation of placental function offered during the vulnerable period of fetal plasticity may be one of the most impactful ways to alter the course of CHD and its complications.

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Shakya, Shristi, Kalpana Upadhaya Subedi et Megha Mishra. « Incidence of Birth Defects among Live Born Neonates at Tertiary Level Maternity Hospital in Nepal ». Journal of Nepal Paediatric Society 42, n^o 2 (31 décembre 2022) : 36–39. http://dx.doi.org/10.3126/jnps.v42i2.41093.

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Introduction: Birth defects are structural and functional anomalies that present before, at birth, or later in life. This study aimed to find out total incidence, type of structural birth defects in live born babies in Nepal. Methods: The study was conducted at a tertiary level maternity hospital in Nepal from 14 April 2018 to 13 April 2019. Data was collected on online Newborn Birth Defect data base developed by WHO South- East-Asia Regional Office. All live born babies with external and internal birth defects confirmed by radiographic, ultrasonography and echocardiography until seven days of life were included. Ethical approval was obtained from Institutional Review Committee of hospital. Results: Total of 21,564 live babies were delivered during one-year study period. Out of these, 220 (1.02%) had one or more birth defects. Number of male babies {130 (59%)} were more than female {89 (40.9%)}. 176 (80%) babies with the malformation were born to mother within age group 20 to 35 years. Of the total 220 babies with birth defects, 197 (89.5%) had isolated malformations and remaining 23 (10.4%) had sequence malformations. The most frequent malformations involved cardiovascular system 125 (56.8%) followed by gastrointestinal system 37 (16.8%), musculoskeletal system 34 (15.4%) and central nervous system 18 (8.1%). Conclusions: Incidence of overall birth defects in this study was found to be 1.02% in which cardiovascular system anomalies was the most common followed by gastrointestinal, musculoskeletal and central nervous system anomalies.

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Jansen, Cees, Frans L. Moll, Freddie E. E. Vermeulen, Johanna M. P. I. van Haelst et Rob G. A. Ackerstaff. « Continuous Transcranial Doppler Ultrasonography and Electroencephalography During Carotid Endarterectomy : A Multimodal Monitoring System to Detect Intraoperative Ischemia ». Annals of Vascular Surgery 7, n^o 1 (janvier 1993) : 95–101. http://dx.doi.org/10.1007/bf02042666.

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Mickelsson, Malin, Kim Ekblom, Kristina Stefansson, Per Liv, Emma Nyman, Anders Själander, Ulf Näslund et Johan Hultdin. « ABO Blood Groups, RhD Factor and Their Association with Subclinical Atherosclerosis Assessed by Carotid Ultrasonography ». Journal of Clinical Medicine 13, n^o 5 (27 février 2024) : 1333. http://dx.doi.org/10.3390/jcm13051333.

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Background: The ABO blood group system has previously been associated with cardiovascular disease (CVD), where non-O blood group individuals have shown an increased risk. Studies assessing early atherosclerotic disease while also including RhD are few. We aimed to determine whether the ABO and RhD blood groups are associated with subclinical atherosclerosis in a healthy population. Methods: We included 3532 participants from the VIPVIZA trial with available carotid ultrasonography results to assess subclinical disease. Information about blood groups was obtained from the SCANDAT-3 database, where 85% of VIPVIZA participants were registered. Results: RhD− individuals aged 40 years showed increased carotid intima–media thickness (B 1.09 CI 95% 1.03; 1.14) compared to RhD+ individuals. For ABO, there were no differences in ultrasonography results when assessing the whole study population. However, 60-year-old individuals with heredity for CVD and a non-O blood group had decreased odds for carotid plaques (OR 0.54 CI 95% 0.33; 0.88). Conclusions: RhD blood group is associated with subclinical atherosclerosis in younger individuals, indicating a role as a mediator in the atherosclerotic process. In addition, a non-O blood group was associated with decreased subclinical atherosclerosis in individuals aged 60 and with heredity (corresponding to the group with the highest atherosclerotic burden).

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Rajendran, Rohini, et Sushma D. Ladi. « Comparative Evaluation of Supraclavicular and Infraclavicular Approaches to Brachial Plexus Block for Upper Limb Surgeries Using Ultrasonography ». Indian Journal of Anesthesia and Analgesia 8, n^o 6 (15 décembre 2021) : 597–602. http://dx.doi.org/10.21088/ijaa.2349.8471.8621.87.

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Background and Aim: Brachial plexus blocks when administered adroitly offer numerous benefits over general anaesthesia for upper limb surgeries. It is especially beneficial in patients with substantial comorbid conditions such as diseases involving the respiratory and cardiovascular system, life-threatening obesity, and those with an anticipated difficult airway. Out of its many approaches, we aim to compare and assess the Supraclavicular and Infraclavicular techniques utilising ultrasonography. Methods: Sixty consenting ASA I–II patients, aged 18–65 years, scheduled for elective upper limb surgery were randomly divided into two groups of 30 each: Supraclavicular (S) and Infraclavicular block Groups (I). Blocks were performed under ultrasound-guidance. The quality of the block intra-operatively, patient satisfaction post-operatively, duration of the sensory & motor block, and complications were observed. Results: Demographics, number of attempts, mean pain score felt during the administration of the block, mean duration of motor and sensory blockade and incidence of complications were all comparable between the two groups & statistically not significant. However, at 5 and 10 minutes after the execution of the block, the Infraclavicular group showed a higher level of blockade, indicating that the onset of action of the block was significantly quicker. Conclusion: Time taken to perform & rapidity of onset were more in the Infraclavicular block with no difference in adequacy of both blocks at 30 minutes.

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Gancheva, R., A. Kundurdjiev, T. Kundurdjiev et Zl Kolarov. « Cardiovascular Risk in Type 2 Diabetic Patients With Asymptomatic Hyperuricemia and Gout ». Acta Medica Bulgarica 46, n^o 2 (1 mai 2019) : 13–20. http://dx.doi.org/10.2478/amb-2019-0012.

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Abstract Aim: To study the differences in cardiovascular risk between type 2 diabetic and non-diabetic patients with asymptomatic hyperuricemia and gout using the Framingham Risk Score (FRS) and complex multimodal ultrasonography. Patients and methods: A total of 201 patients participated, divided into two groups: 1/ patients with asymptomatic hyperuricemia (n = 52), and 2/ patients with gout (n = 149). FRS was determined as well as ultrasound parameters, independent predictors of cardiovascular risk: left atrial size (LA), intima-media thickness (IMT) and common carotid artery resistive index (CCARI). Results: The patients in the two groups were age-matched and conventional cardiovascular risk factors were equally distributed. In the asymptomatic hyperuricemia group, 12 patients (23.1%) had diabetes. In this group, there was no difference in FRS between diabetic and non-diabetic individuals. However, diabetic patients had larger LA, thicker intima-media and higher CCARI. In the gout group 18 subjects (12%) had diabetes, but the FRS, LA, IMT and CCARI values were similar among diabetic and non-diabetic patients. Furthermore, when gout subjects were subdivided according to the presence of tophi, we found that the subgroup having gouty tophi and diabetes had larger LA (p = 0.014) compared to those with gouty tophi without diabetes. Conclusion: In diabetic patients with asymptomatic hyperuricemia and gouty tophi, a more complex approach for estimation of cardiovascular risk is needed. Our work suggests that diabetes and tophi might potentiate their action on the cardiovascular system.

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TOMSIN, KATHLEEN, et WILFRIED GYSELAERS. « ASSESSMENT OF THE MATERNAL VENOUS CIRCULATION : WHY IS IT RELEVANT ? » Fetal and Maternal Medicine Review 24, n^o 3 (août 2013) : 194–99. http://dx.doi.org/10.1017/s0965539513000168.

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The venous system is considered the main capacitor of the human body. Approximately 70% of the total blood volume resides in the venous bed, half of which circulates as venous return whereas the other half functions as reserve volume in the splanchnic veins. These veins are richly innervated and highly compliant, and communicate with the systemic circulation via capillaries (entrance) and portal vein and liver (exit). This constitution allows the venous compartment to balance circulating and stored blood volumes, and thus control cardiac output. Clinical conditions with reduced cardiac output are often associated with hampered venous return, resulting in visceral oedema, ascites or organ dysfunction. Organ dysfunction or failure may also result from (sub)obstructed venous outflow, as is illustrated in renal vein thrombosis or in the Nutcracker syndrome. Recently, the application of Doppler ultrasonography in the study of the maternal venous system illustrated that preeclampsia is another cardiovascular disorder with dysfunctional venous haemodynamics. In this opinion paper, we summarise results from Doppler studies of the maternal venous compartment, illustrating that performing venous haemodynamics function tests is to become a fundamental part of an integrated cardiovascular assessment of women with hypertension in pregnancy, facilitating an individualised diagnostic and therapeutic approach for every woman at risk for gestational hypertensive disease.

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ZHANG, Yong-li, Jun-tao LIU, Jin-song GAO, Jian-qiu YANG et Xu-ming BIAN. « Influential and prognostic factors of small for gestational age infants ». Chinese Medical Journal 122, n^o 4 (février 2009) : 386–89. http://dx.doi.org/10.3760/cma.j.issn.0366-6999.2009.04.006.

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Background Small for gestational age (SGA) infants are associated with a high rate of oligohydramnios, stillbirth and cesarean delivery. Among SGA patients there is a higher risk of neonatal complications, such as polycythemia, hyperbilirubinemia, and hypothermia. Additionally, the SGA infant is prone to suffer from major neurologic sequelae, as well as cardiovascular system disease, in later life. Proper monitoring and therapy during pregnancy are, therefore, of utmost importance. The present study aimed to investigate the influential and prognostic factors of SGA infants. Methods From January 2001 to June 2007, a total of 55 SGA neonatal infants were included in a study group. All were born at Peking Union Medical College Hospital, with regular formal antenatal examinations. In addition, a total of 122 cases of appropriate for gestational age (AGA) infants were born at the same time and were registered into a control group. All cases were singleton pregnancies with detailed information of the maternal age, gravidity, parity, maternal height and weight, complications, uterine height and abdominal circumference, results from transabdominal ultrasonography between 32–38 gestational weeks, pregnancy duration, delivery manner, placenta, umbilical cord, and neonatal complications. Results Significant differences were observed in placenta weight and neonatal malformations between the study and control groups. Multivariate analysis revealed increased parity, maternal hyperthyroidism and hyperthyroidism history as risk factors. Fetal abdominal circumferences less than 30 and 32 cm at 32–38 gestational weeks respectively, as determined by ultrasonography, resulted in a Youden index of 0.62. Conclusions SGA infants were associated with a greater risk of smaller placentas and infant malformations. Increased parity, maternal hyperthyroidism, and a hyperthyroid history were risk factors for SGA infants. Fetal abdominal circumference less than 30 cm at 32 gestational weeks and less than 32 cm at 38 weeks, as determined by ultrasonography, was considered an effective index for SGA. Chin Med J 2009;122(4):386–389

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Phoon, Colin Kit Lun. « Where's the spleen ? Looking for the spleen and assessing its function in the syndromes of isomerism ». Cardiology in the Young 7, n^o 3 (juillet 1997) : 347–57. http://dx.doi.org/10.1017/s1047951100004297.

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AbstractDespite the close association of certain constellations of cardiac malformations with splenic status (right isomerism / asplenia, left isomerism / polysplenia), the association is not perfect. Given the risk of infection in the patient lacking splenic tissue, it seems prudent to assess the state of the spleen separately from the cardiovascular system, in order to decide on antimicrobial prophylaxis. A wide variety of tests is available to assess splenic function and/or anatomy. Counting pitted erythrocytes or Howell-Jolly bodies in the peripheral blood smear can be a good indicator of the lack of splenic function, although the former appears more sensitive and quantitative than the latter. Radionuclide spleen scans can provide both anatomic and functional information about the spleen, and may be a useful adjunctive test. Relatively poor spatial resolution, and interfering hepatic activity (even with spleen-specific scans), mitigate its usefulness in the young infant. The reliability of computed tomography and magnetic resonance imaging in detecting splenic tissue in the heterotaxy syndromes is unproven and perhaps only fair at best. They are probably most helpful as adjunctive tests. Ultrasonography offers excellent spatial resolution, portability, and lack of ionizing radiation, but is operator- and patient-dependent. Nonetheless, ultrasonography, coupled with an examination of the peripheral blood for Howell-Jolly bodies or pitted erythrocytes, is probably the set of tests with highest sensitivity and greatest convenience. Management strategies for the asplenic patient are also discussed.

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Matic, Predrag, Goran Vucurevic, Vuk Djulejic, Nenad Ilijevski et Djordje Radak. « Congenital interruption of the inferior vena cava : A case report ». Srpski arhiv za celokupno lekarstvo 140, n^o 5-6 (2012) : 359–61. http://dx.doi.org/10.2298/sarh1206359m.

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Introduction. Congenital interruption of the inferior vena cava is a rare entity. It can be associated with other organ and system malformations, especially the cardiovascular system. Usually, patients are asymptomatic and the anomaly is therefore diagnosed incidentally. In some cases it can be of clinical importance. Case Outline. A 22-year-old female was diagnosed during evaluation of cardiac symptoms. Clinical examination showed normal findings. CT angiography and cavography were used to establish the diagnosis of inferior vena cava interruption. Since there was no need for surgical intervention the patient was discharged in good condition. During a five year follow-up no significant health problems were noted with patient leading normal life. Conclusion. Diagnostic tools used to establish the diagnosis of inferior vena cava interruption are ultrasonography, as well as CT and MR angiography and phlebography. Mediastinal masses found on chest roentgenogram must raise suspicion of inferior vena cava interruption. Although the anomaly is rare, physicians should be aware of the infrahepatic interruption of the IVC, especially because it can present at any age.

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Turgut, H., R. Ozdemir, IK Gokce, C. Karakurt et A. Karadag. « Sirenomelia associated with hypoplastic left heart in a newborn ». Balkan Journal of Medical Genetics 20, n^o 1 (30 juin 2017) : 91–94. http://dx.doi.org/10.1515/bjmg-2017-0001.

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Abstract Sirenomelia, also known as “mermaid malformation/syndrome,” is a rare, serious congenital anomaly characterized by variable degrees of fusion of the lower limbs and associated with severe malformations of vertebral, genitourinary, cardiovascular system and single umbilical artery. The first pregnancy of a 25-year-old woman resulted in one twin born by Cesarian section at 32 weeks’ gestation, who was referred to our hospital with cyanosis, a congenital anomaly and respiratory distress. On physical examination, there was no urogenital region and anal fissure and gender was indeterminate. The arms were in adduction and wrist in flexion position with four fingers on the right hand and two fingers on the left hand. There was a single lower extremity with a webbed single foot and two toes consistent with sirenomelia type IV radiologically. Abdominal ultrasonography showed urogenital system agenesis and echocardiography detected hypoplastic left heart. However, the patient died 4 hours after birth. The other twin was followed for 1 week for nutrition and respiratory support and was then discharged without any problems.

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Nekrasova, T. A., O. V. Ledentsova, L. G. Strongin, L. V. Kazakova et A. Iu Lukushkina. « Specific features of hemodynamics in the patients of different age groups presenting with autoimmune thyroiditis and subclinical hypothyroidism ». Problems of Endocrinology 57, n^o 3 (15 juin 2011) : 21–24. http://dx.doi.org/10.14341/probl201157321-24.

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This study was designed to elucidate the relationship between the age of the patients presenting with autoimmune thyroiditis and subclinical hypothyroidism and the changes in their cardiovascular system. The following characteristics were estimated: the structure of the left ventricle, its overall and segmental diastolic function (by tissue Doppler echocadiography), and rigidity of the arterial walls (from the Young's modulus of elasticity, by ultrasonography). The patients were 95 women at the age of 20 to 50 years of whom 47 presented with autoimmune thyroiditis and subclinical hypothyroidism and 48 with euthyroidism (controls). They were divided into 3 age groups to be compared in the «subclinical hypothyroidism vs control» mode. Group 1 comprised 12 ad 13 women respectively aged 20-30 years, Group 2 contained 12 and 10 patients (31-40 years), group 3 included 23 and 25 patients (41-50 years). Young women with subclinical hypothyroidism were characterized by high values of Young's modulus and a large number of dysfunctional left ventricular segments (p<0.05). In the patients of the intermediate age, subclinical hypothyroidism also tended to have high values of Young's modulus in the absence of diastolic dysfunction. The oldest patients showed no signs of left ventricular dysfunction or arterial wall rigidity compared with controls (p<0.05). The results of the study indicate that the patient's age influences manifestations of changes in the cardiovascular system characteristic of subclinical hypothyroidism. In young women, this condition is associated with more pronounced disturbances of both overall and segmental diastolic functions and arterial elasticity than in control subjects. The women of older age groups show less apparent cardiovascular and metabolic abnormalities while the role of subclinical hypothyroidism as a cardiovascular risk factor is relatively insignificant.

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Ghincea, Christian V., T. Brett Reece, Muhammad Aftab, Joseph C. Cleveland et Jay D. Pal. « Noteworthy Cardiac Literature 2019 : Cerebral Protection, Zone 2 Arch, Intravascular Ultrasonography in Dissection, Heart Allocation, and Mitral Durability ». Seminars in Cardiothoracic and Vascular Anesthesia 24, n^o 2 (28 avril 2020) : 187–91. http://dx.doi.org/10.1177/1089253220920146.

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The year of 2019 continues to have notable literature advancing the practice of cardiac surgery. In this article, topics of discussion will include the evolution of cerebral protection, the advancement of arch surgical techniques, the heart transplant allocation system, and mitral repair approach and durability.

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Alkatiri, Abdul H., Doni Firman, Amir A. Alkatiri, Paskalis I. Suryajaya et Albert Sudharsono. « The Role of Angiotensin Antagonism in Coronary Plaque Regression : Insights from the Glagovian Model ». International Journal of Vascular Medicine 2021 (7 avril 2021) : 1–10. http://dx.doi.org/10.1155/2021/8887248.

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The benefit of antagonizing the effect of the renin angiotensin aldosterone system (RAAS), notably by the use of angiotensin-converting enzyme inhibitor (ACEi) and angiotensin II type 1 receptor blocker (ARB) for coronary artery disease (CAD), has been demonstrated in multiple studies, which may be attributed to their ability to inhibit the deleterious effect of RAAS to the cardiovascular system. It is well known that angiotensin II (Ang II) plays a vital role in atheromatous plaque formation and progression through multiple pathways, including inflammatory and arterial remodeling aspects. Significant coronary atheromatous plaque regression has been previously demonstrated in various studies using statin agents. Similar results have been reported in different studies using angiotensin inhibitor agents, notably ARB agents. Analysis from various trials utilizing ARB showed a significant plaque regression using olmesartan and telmisartan as evaluated by IVUS studies. In contrary, the use of ACEi did not demonstrated significant plaque regression, which may be attributed to the heavy plaque calcification in respective studies. On this review, we aim to present the basic mechanism on the role of RAAS in plaque modulation and its arterial remodeling aspect, which is then integrated with the clinical evidence based on the available intravascular ultrasonography (IVUS) studies on coronary arteries.

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Khanal, Gopal Prasad, Prakash Sharma, Prakash Kayastha et Anju Poudel. « Prevalence and Spectrum of Fetal Congenital Anomalies : A Hospital Based Study from Mid-Western Part of Nepal ». Nepalese Journal of Radiology 9, n^o 2 (31 décembre 2019) : 2–9. http://dx.doi.org/10.3126/njr.v9i2.27413.

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Introduction: To estimate the prevalence and pattern of congenital anomalies through obstetric ultrasound on pregnant women visiting Rapti sub-regional hospital, Ghorahi, Dang, Nepal. Methods: A descriptive cross sectional study was conducted among 10,380 pregnant women visiting Radiology department of Rapti sub-regional hospital from January 2016 to July 2017. The findings of transabdominal ultrasonography (USG) performed by Radiologist and information regarding women’sage and gestational age were recorded. The images of any significant cases were also saved. Data wereanalyzed based on study objectives using descriptive statistics such as frequency, percentage, mean, rangeand standard deviation. The classification of the malformation was done based on the anatomical system. Results: Out of 10,380 ultrasound performed during the study period, 106 (1.02%) pregnant women presented with different congenital anomalies. The antenatal prevalence of congenital anomalies was 10.21 per 1000 pregnant women. The mean maternal age was 25.9 ± 4.80 years. Regarding gestation age, 87 (82.1%) anomalies were detected at second trimester of pregnancy. Most commonly involved body system was central nervous system 51 (48.1%), followed by cardiovascular system 12 (11.3%), musculoskeletal system 10 (9.4%), gastrointestinal system 5 (4.7%), respiratory system 5 (4.7%), genitourinary system 4 (3.8%). Other anomalies were cystic hygroma 9 (8.4%), hydrops fetalis 4 (3.8%), cleft lip 3 (2.8%), pelvic cystic lesion 2 (1.8%) and conjoined twins 1 (0.9%). Conclusion: The prevalence of congenital anomalies is high in mid-western part of Nepal. Central nervous system anomalies were more common than other anomalies.

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Patel, Kinjal G., et Chintu Chaudhary. « Study of congenital malformations in newborns : a hospital based prospective study ». International Journal of Contemporary Pediatrics 4, n^o 4 (21 juin 2017) : 1409. http://dx.doi.org/10.18203/2349-3291.ijcp20172676.

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Background: Congenital malformations represent a defect in the morphogenesis during fetal life. Since the introduction of primary health care and immunization programme, congenital malformations have emerged as one of the commonest cause of perinatal mortality. The objective was to study the incidence, systemic distribution, various maternal risk factors and immediate outcome of congenital malformations in hospital delivered neonates.Methods: This study was conducted at a tertiary care hospital for a period of 2 years. All the hospital delivered live neonates and stillbirth babies with congenital malformations are included in this study. Detailed history, examinations and investigations are carried out to identify etiological factors. Their outcome in form of morbidity and mortality are taken up to their hospital stay.Results: Out of 9600 babies with malformations 171(1.88%) having single malformation and 23(0.25%) having multiple malformations. Incidence of malformations was higher in stillbirths (24.25/1000 livebirths) against than in live births (19.96/1000 livebirths). The cardiovascular system was involved in 23.4% of babies, followed by musculoskeletal system (22.3%) then gastrointestinal (15.9%) and genitourinary system (15.4%). Multiple malformations were seen in 11.8% cases. Maternal risk factors associated with malformations were oligohydramnios in 4.12%, previous abortion in 2.5%, eclampsia in 2.5%, polyhydramnios in 1.54%, maternal diabetes in 1.54% and consanguinity in 1.03%. Maximum mortality occurred in babies with gastrointestinal system malformations (56.5%) followed by cardiovascular system malformations (21.7%). Majority of babies with malformations discharged (78.9%) only 11.8% of babies expired and 2.6% of babies left against medical advice (LAMA).Conclusions: Congenital malformations represent one of the causes of neonatal mortality. Stillborn babies have higher incidence of malformations. Antenatal ultrasonography and maternal risk factors has important role to identify malformations. Early detection and timely management required to decrease the mortality.

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Uhl, Jean Francois, Miguel Lo Vuolo et Nicos Labropoulos. « Anatomy of the lymph node venous networks of the groin and their investigation by ultrasonography ». Phlebology : The Journal of Venous Disease 31, n^o 5 (9 juin 2015) : 334–43. http://dx.doi.org/10.1177/0268355515585039.

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Objective To describe the anatomy of the lymph node venous networks of the groin and their assessment by ultrasonography. Material and methods Anatomical dissection of 400 limbs in 200 fresh cadavers following latex injection as well as analysis of 100 CT venograms. Routine ultrasound examinations were done in patients with chronic venous disease. Results Lymph node venous networks were found in either normal subjects or chronic venous disease patients with no history of operation. These networks have three main characteristics: they cross the nodes, are connected to the femoral vein by direct perforators, and join the great saphenous vein and/or anterior accessory great saphenous vein. After groin surgery, lymph node venous networks are commonly seen as a dilated and refluxing network with a dystrophic aspect. We found dilated lymph node venous networks in about 15% of the dissected cadavers. Conclusion It is likely that lymph node venous networks represent remodeling and dystrophic changes of a normal pre-existing network rather than neovessels related to angiogenic factors that occur as a result of an inflammatory response to surgery. The so-called neovascularization after surgery could, in a number of cases, actually be the onset of dystrophic lymph node venous networks. Lymph node venous networks are an ever-present anatomical finding in the groin area. Their dilatation as well as the presence of reflux should be ruled out by US examination of the venous system as they represent a contraindication to a groin approach, particularly in recurrent varicose veins after surgery patients. A refluxing lymph node venous network should be treated by echo-guided foam injection.

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Saloni Moon, Kavita Gomase, Shalini Moon, Pradnya Sakale et Roshan Umate. « Case Report on CAKUT Syndrome with Known Case of Chronic Kidney Disease ». Journal of Pharmaceutical Negative Results 13, n^o 3 (7 octobre 2022) : 1035–37. http://dx.doi.org/10.47750/pnr.2022.13.03.163.

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Background: Congenital abnormalities of the kidneys and urinary tracts (CAKUT) are conditions brought on by errors in the growth of the kidneys and the outflow tubes that drain the kidneys. Although the issue may not become apparent until later in life, CAKUT is a congenital abnormality brought on by improper urinary system development. Case presentation: We are presenting the case of a 23-year-old man who has chronic kidney disease and is undergoing maintenance hemodialysis. The patient was apparently alright 2 weeks back when he had complained of breathlessness. fever 2 episodes, lower which was insidious in onset and gradually progressive. On arrival, the patient was provided oxygen therapy via a face mask for breathlessness and to make him feel comfortable with the head elevation. On laboratory investigation, the patient’s blood values are altered. The patient underwent computed tomography of the kidney-ureter-bladder (CT-KUB), and Ultrasonography of the kidneys (USG). A permanent tunnel hemodialysis catheter under local anesthesia was placed and he received 2 cycles of hemodialysis. During the course in the hospital, the patient’s condition was improving and was stable clinically and vitally hence, the patient was discharged. Conclusion: CAKUT can occur alone or in conjunction with heart and cardiovascular malformations, gastrointestinal tract malformations, central nervous system malformations, skeletal system malformations, lung, face, genito-reproductive system malformations, abdominal wall malformations, chromosomal abnormalities, MCA, and other organ system malformations.

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Nebieridze, D. V., T. V. Kamyshova, A. A. Sarycheva et A. S. Safaryan. « Cardiovascular risk profile in patients with arterial hypertension who first seek medical attention ». Cardiovascular Therapy and Prevention 17, n^o 5 (15 novembre 2018) : 5–10. http://dx.doi.org/10.15829/1728-8800-2018-5-5-10.

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Aim.Objective assessment of cardiovascular risk (CVR) in patients with arterial hypertension (AH), who first contact with primary care setting.Material and methods. 300 patients (age 40-65 years) with sustained increase in arterial pressure and first seek medical attention were included in the study. All patients underwent medical examination, history taking to identify risk factors, blood pressure measurement and anthropometric research, biochemical blood assay to estimate levels of total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, glucose. Based on the specified parameters, the risk was determined by SCORE (Systematic Coronary Risk Evaluation). After the risk assessment, all patients underwent an echo-cardiography, duplex ultrasonography screening of the brachiocephalic arteries and determination of microalbuminuria to detect target organ damage. According to results of a complex survey, the risk was reclassified based on the presence of target organ damage.Results.The study showed that patients with sustained AH who first seek medical attention have a large number of risk factors and their combinations, among which the most common are dyslipidemia (89,3%), smoking (37,7%) and obesity (28,3%). Patients with AH who first seek medical attention without clinical signs of atherosclerosis often have various disorders of target organs, such as left ventricular hypertrophy — 67,3%, thickening of carotid intima-media complex — 46,3%, atherosclerotic plaques in carotid arteries — 34,7%, microalbuminuria — 25,3%, as well as different combinations thereof. After a complex examination, the CVR profile of patients changes increases. According to SCORE 60% of patients with low and mean risk is reclassified to high risk.Conclusion.One of the most important tasks of health care system in Russia is to increase the efficiency of the CVR stratification systems, as well as to develop a new standards of examination of patients with AH on an outpatient stage, in order to reduce cardiovascular morbidity and mortality.

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Soares, Frederico Aécio Carvalho, Elisa Barp Neuwald, Verônica Santos Mombach, Ana Elize Ribeiro D'Avila, Francisco de Oliveira Conrado et Félix Hilario Diaz González. « Systolic blood pressure of dogs at hospital and domestic environment ». Ciência Rural 42, n^o 7 (14 juin 2012) : 1242–48. http://dx.doi.org/10.1590/s0103-84782012005000036.

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The measurement of blood pressure (BP) is an important assessment of the cardiovascular system, being influenced by physical and pathological conditions. Certain situations of stress and anxiety during BP measurement can lead to elevated values in small animals, known in medicine as "white coat effect". The aim of this research was to compare systolic blood pressure (SBP) measurement using Doppler ultrasonography in 45 adult healthy dogs in two environments, at a veterinary hospital and at home. Comparison of heart rate, serum concentrations of cortisol and glucose intended to help the evaluation of the stress level of the animals. The mean of SBP at the veterinary hospital was 154.7mmHg and it was significantly (P<0.01) higher than at home (136.3mmHg). It was also observed that HR (mean=122.7bpm), and serum cortisol (median=4.5µg dL-1) and glucose (mean=95.9mg dL-1) concentrations were significantly higher (P<0.01) at the hospital, when compared with values obtained at home (109.6bpm; 1.5µg dL-1 and 85.5mg dL-1, respectively). In conclusion, the environment can influence SBP in dogs, due to factors related to stress.

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Boutari, Chrysoula, Eleni Georgianou, Alexandros Sachinidis, Alexandra Katsimardou, Konstantinos Christou, Alexia Piperidou et Asterios Karagiannis. « Renovascular Hypertension : Novel Insights ». Current Hypertension Reviews 16, n^o 1 (13 février 2020) : 24–29. http://dx.doi.org/10.2174/1573402115666190416153321.

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Renovascular hypertension (RVH) remains among the most prevalent and important, but also potentially reversible, causes of secondary hypertension. The predominant causes of renal artery stenosis (RAS) are atherosclerotic renovascular arterial stenosis (ARAS) and renal fibromuscular dysplasia. This condition can lead to progressive renal injury, cardiovascular complications and ‘flash pulmonary edema’. Duplex Doppler ultrasonography, computed tomographic angiography and magnetic resonance angiography are the most commonly used diagnostic methods. There are three therapeutic options available: medical therapy including renin-angiotensin-aldosterone system antagonists, lipid-lowering agents, and antiplatelet therapy, percutaneous angioplasty with or without stent placement and surgical revascularization. Three large trials failed to demonstrate the superiority of renal artery revascularization over pharmaceutical therapy in controlling blood pressure and preserving renal function. For this reason, today revascularization is only recommended for patients with progressive worsening of renal function, recurrent ‘flash pulmonary edema’ and rapid increase in antihypertensive requirement in patients with previously well-controlled hypertension. However, more properly designed trials are needed in order to identify which patient populations would probably benefit from renal revascularization.

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Bourron, Olivier, Carole Elodie Aubert, Sophie Liabeuf, Philippe Cluzel, Frédérique Lajat-Kiss, Michel Dadon, Michel Komajda et al. « Below-Knee Arterial Calcification in Type 2 Diabetes : Association With Receptor Activator of Nuclear Factor κB Ligand, Osteoprotegerin, and Neuropathy ». Journal of Clinical Endocrinology & ; Metabolism 99, n^o 11 (1 novembre 2014) : 4250–58. http://dx.doi.org/10.1210/jc.2014-1047.

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Context: Calcification of the arterial wall in diabetes contributes to the arterial occlusive process occurring below the knee. The osteoprotegerin (OPG)/receptor activator of nuclear factor κB ligand (RANKL) system is suspected to be involved in the calcification process. Objective: The aim of the study was to investigate whether there is a link between arterial calcification in type 2 diabetes and 1) conventional cardiovascular risk factors, 2) serum RANKL and OPG levels, and 3) neuropathy. Patients and Methods: We objectively scored, in a cross-sectional study, infrapopliteal vascular calcification using computed tomography scanning in 198 patients with type 2 diabetes, a high cardiovascular risk, and a glomerular filtration rate >30 mL/min. Color duplex ultrasonography was performed to assess peripheral arterial occlusive disease, and mediacalcosis. Peripheral neuropathy was defined by a neuropathy disability score >6. RANKL and OPG were measured in the serum by routine chemistry. Results: Below-knee arterial calcification was associated with arterial occlusive disease. In multivariate logistic regression analysis, the variables significantly and independently associated with the calcification score were age (odds ratio [OR] = 1.08; 95% confidence interval [CI] = 1.04–1.13; P < .0001), male gender (OR = 3.53; 95% CI = 1.54–8.08; P = .003), previous cardiovascular disease (OR = 2.78; 95% CI = 1.39–5.59; P = .005), and neuropathy disability score (per 1 point, OR = 1.21; 95% CI = 1.05–1.38; P = .006). The association with ln OPG, significantly associated with calcification score in univariate analysis (OR = 3.14; 95% CI = 1.05–9.40; P = .045), was no longer significant in multivariate analysis. RANKL and OPG/RANKL were not significantly associated with the calcification score. Conclusions: Below-knee arterial calcification severity is clearly correlated with peripheral neuropathy severity and with several usual cardiovascular risk factors, but not with serum RANKL level.

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Fassiadis, N., J. M. Holdstock et M. S. Whiteley. « The Saphenofemoral Valve : Gate Keeper Turned into Rear Guard ». Phlebology : The Journal of Venous Disease 17, n^o 1 (mars 2002) : 29–31. http://dx.doi.org/10.1177/026835550201700107.

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Objective: Trendelenburg's theory was based on the concept of a descending valvular incompetence com mencing at the saphenofemoral junction (SFJ) with subsequent distal progression of reflux. The aim of this study was to evaluate the distribution of reflux in patients with superficial venous incompetence in order to assess validity of the above hypothesis. Procedures: The superficial and deep venous system of a consecutive series of 443 patients presenting with primary varicose veins was examined by one vascular technologist using colour flow ultrasonography. Results: Six hundred and eleven lower limbs in 443 patients were examined. The distribution of long saphenous vein (LSV) reflux was the following: Of the 611 limbs 454 showed LSV reflux, with 240 legs exhibiting total reflux (SFJ and LSV) and 214 legs exhibiting reflux in evolution (LSV reflux with competent saphenofemoral valve, isolated posterior arch reflux and lateral anterior thigh vein reflux with SFJ reflux). Conclusion: These results suggest that reflux starts distally and progresses proximally, thus throwing the Trendelenburg theory into dispute.

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Naibzai, Zabit Khan ,., Abeera Afzal Buzdar, Maham Khalid, Najma Fatima, Nimra Khalid et Zarmast Khan. « Prevalence and Pattern of Congenital Malformations among Neonates in the Neonatal Unit of a Tertiary Care Hospital ». Pakistan Journal of Medical & ; Health Sciences 16, n^o 10 (30 octobre 2022) : 372–75. http://dx.doi.org/10.53350/pjmhs221610372.

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Background and Aim: Globally, congenital anomalies (CA) are a major contributing factor for neonate’s admission in NICU causing neonatal morbidity and mortality particularly in developing countries. Congenital anomalies generally indicate the morphogenesis defect in an early neonate’s life. The leading cause for perinatal mortality is congenital anomalies that arise with advancement of delivery and care for newborn babies. The present study aimed to evaluate the prevalence and pattern of congenital anomalies among neonates admitted to neonatal unit. Methodology: This retrospective study was carried out on 1620 neonates (newborns to age 28 days) admitted to the neonatal unit of Services Hospital, Lahore from April 2020 to March 2022. The incidence, risk factors, and pattern of congenital anomalies were measured. Detailed examinations such as radiological, laboratory, ultrasonography, and echocardiography were recorded. Different outcomes such as hospital stay, morbidity, and mortality were determined with 95% confidence intervals. SPSS version 25 was used for data analysis. Results: Of the total 1620 admitted neonates, the prevalence of neonates with congenital anomalies were 112 (6.9%). Out of 112 neonates diagnosed with congenital anomalies, 64 (57.1%) were male and 48 (42.9%) were females. The incidence of cesarean and other modes of delivery were 74 (66%) and 38 (34%) respectively. Cardiovascular system malformation was the most prevalent affected system in 36 (31.9%) neonates followed by central nerve system 28 (25%), genitourinary system 19 (17%), musculoskeletal system 16 (14.3%), gastrointestinal tract 6 (5.4%), digestive system 4 (3.6%), and syndromes and skin 3 (2.7%). Congenital anomalies were significantly increasing over time. The incidence of discharged, referred to higher centers for intervention, and expired babies were 77 (68.8%), 19 (16.7%), and 16 (14.3%) respectively. Conclusion: The present study found that the prevalence of congenital anomalies was 6.9%. Cardiovascular system malformation was the most prevalent congenital anomaly followed by the central nerve system. The overall mortality rate was 14.3% caused by congenital anomalies. A better health care strategies and management must be developed in terms of early detection, supplementation facilitation, decreasing drug usage, and better antenatal care to prevent the impacts of congenital anomalies on neonates. Keywords: Prevalence, Pattern, Congenital anomalies, neonates

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Manko, Yu A., O. I. Smiian, A. M. Loboda, S. V. Popov, P. I. Sichnenko, O. G. Vasylieva, K. O. Smiian, I. Yu Vysotsky et T. O. Aleksakhina. « Chronic tonsillitis in adolescents : clinical features and the role of ultrasound diagnosis in the northern region of Ukraine ». CHILD`S HEALTH 18, n^o 3 (6 juillet 2023) : 162–65. http://dx.doi.org/10.22141/2224-0551.18.3.2023.1579.

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Background. Chronic tonsillitis is the most common disease among children and adolescents in the structure of pathology of the ENT organs. Untimely diagnosis and irrational treatment lead to decompensation of chronic tonsillitis and the development of lesions of many organs and systems of the child’s body of tonsillogenic origin. The aim of the work was to study the clinical features and ultrasound changes of the palatine tonsils in adolescents with chronic tonsillitis. Materials and methods. We have examined 47 children aged 13 to 17 years suffering from chronic tonsillitis: group I — 27 patients with compensated chronic tonsillitis, group II — 20 patients suffering from decompensated chronic tonsillitis. The control group consisted of 16 practically healthy children, representative in terms of age and gender. We used clinical methods, ultrasonography of the palatine tonsils, and statistical methods. The study was approved by the Institutional Bioethics Committee and it conforms to the principles outlined in the Declaration of Helsinki. Results. According to the results of an ultrasound examination of the palatine tonsils in children with chronic tonsillitis, the main changes were an increase in their transverse dimensions by more than 15 mm, deepening of lacunae, thickening of the capsule, fibrous changes. In addition, in patients with tonsillogenic lesions of the cardiovascular system and a decompensated form of chronic tonsillitis, the pathological signs of the disease according to ultrasound were more significant and were manifested by unclear contours, increased echogenicity, heterogeneous hyperechoic structure, diffuse fibrous and cystic changes of the palatine tonsils. Conclusions. Ultrasonography of the palatine tonsils is a non-invasive, painless, accessible and informative method for studying the structure of the tonsils in normal and pathological conditions. It allows for a more thorough assessment of their changes in compensated and decompensated forms of chronic tonsillitis.

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Oral, Orcun, Muhammet Hamza Halil Toprak, Fahrettin Uysal, Ozlem Mehtap Bostan et Ergun Cil. « The frequency of asymptomatic urinary system abnormalities in children detected with cineurography imaging during angiocardiography ». Cardiology in the Young 29, n^o 2 (février 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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Погорелова, О. А., О. А. Фомичева, М. И. Трипотень, Л. Б. Круглый, Е. В. Герасимова, Ф. Ф. Шингареева, Г. И. Хеймец, Ю. А. Карпов, Т. В. Попкова et Т. В. Балахонова. « Feasibility of contrast-enhanced ultrasonography for atherosclerotic plaques in carotid arteries in patients with rheumatoid arthritis ». Kardiologicheskii vestnik, n^o 4 (11 décembre 2020) : 57–65. http://dx.doi.org/10.36396/ms.2020.15.4.008.

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Введение. Ревматоидный артрит (РА) ассоциируется с повышенным риском сердечно-сосудистых заболеваний по сравнению с общей популя- цией. Для понимания роли системного воспаления в развитии сердечно-сосудистых катастроф у больных РА принципиальное значение имеет концепция о сходстве патогенетических механизмов аутоиммунного воспаления и атеросклероза. Ультразвуковое исследование с контраст- ным усилением (КУУЗИ) позволяет выявить неоваскуляризацию (НВ) атеросклеротической бляшки (АСБ), что отражает воспаление в бляшке и свидетельствует о ее нестабильности. Материал и методы. Был обследован 21 пациент с РА (7 мужчин и 14 женщин) в возрасте 61 (58; 65) год, длительность заболевания 7 (3; 16) лет. КУУЗИ сонных артерий (СА) проводили на ультразвуковой системе Philips IU22 c линейным датчиком 3–9 МГц, с внутривенным введением контрастного препарата «Соновью». Степень НВ бляшки оценивали как 0 — отсутствие НВ, 1 — слабая НВ, 2 — выраженная НВ, 3 — НВ при наличии пульсирующего сосуда. Результаты. У всех больных РА была выявлена НВ бляшки сонной артерии, при этом слабая степень НВ была выявлена в 7 случаях (33,3%), выраженная степень НВ — в 14 (66,7%). При проведении корреляционного анализа по Спирмену выявлена прямая уме- ренная корреляция между степенью НВ и холестерином липопротеидами низкой плотности (ХС ЛПНП) (R = 0,46, р = 0,04), прямая заметная корреляция между степенью НВ и триглицеридами (R = 0,56, р = 0,01), обратная заметная корреляция между степенью НВ и холестерином липопротеидами высокой плотности (R = -0,52, р = 0,02), умеренная корреляция между НВ бляшки и длительностью РА (R = 0,43, р = 0,052), заметная корреляция между НВ и наличием специфических антител к циклическому цитруллинированному пептиду (R = 0,57, р = 0,0068). Не было выявлено взаимосвязи между степенью НВ и уровнем высокочувствительного С-реактив- ного белка, скоростью оседания эритроцитов, холестерина, индексом активности РА DAS28 и наличием специфических антител ревматоидного фактора IgM. Заключение. КУУЗИ продемонстрировало наличие преимущественно высокой степени неоваскуляризации АСБ СА у пациентов с РА. КУУЗИ СА является доступным методом выявления нестабильности атеросклеротической бляшки СА у пациентов с РА с целью ранней профилактики и предотвращения сердечно-сосудистых осложнений Introduction. Rheumatoid arthritis (RA) is associated with an increased risk of cardiovascular disease compared to the general population. Similarity of the pathogenetic mechanisms of autoimmune inflammation and atherosclerosis is fundamentally important for understanding the role of systemic inflammation in the development of cardiovascular complications in RA. Contrast-enhanced ultrasound (CEUS) reveals neovascularization of an atherosclerotic plaque, which reflects inflammation in the plaque and indicates its vulnerability. Material and methods. We examined 21 patients with RA (7 males) with the median age of 61 [58; 65] years old and the median RA duration of 7[3; 16] years. CEUS of the carotid arteries was performed with the PHILIPS IU22 ultrasound system and 3-9 MHz linear array transducer. Ultrasound contrast agent SonoVue was administered intravenously. The degree of carotid intraplaque neovascularization was visually assessed on a scale from 0 to 3. Grade 0 represented no visible neovascularization, grade 1 — limited to moderate neovascularization, grade 2 extensive appearance of neovascularization, grade 3 — presence of a pulsating arterial vessel within the plaque (Shah et al. 2007). The association between the degree of neovascularization, biochemical parameters and RA duration was assessed with the Spearman’s correlation coefficient. Results. All patients with RA were found to have carotid intraplaque neovascularization. Grade 1 of neovascularization was detected in 33.3 % of patients and grade 2 was detected in 66.7%. The degree of neovascularization was positively associated with the LDL-C level (R = 0,46, p = 0,04), and the TG level (R = 0,56, p = 0,01) and negatively associated with the HDL-C level (R = -0,52, p = 0,02). The degree of neovascularization was also associated with RA duration (R = 0,43, p = 0,052) and the presence of antibodies against cyclic citrullinated peptides (aCCP) (R = 0,57, p = 0,0068). No association was found between the degree of neovascularization and the levels of hs-CRP, ESR, cholesterol, the RA activity index DAS28 and the presence of rheumatoid factor (RF). Conclusion. CEUS of carotid arteries demonstrated the presence of a predominantly extensive degree of carotid intraplaque neovascularization in patients with RA. CEUS of the carotid arteries is a readily accessible method for detecting plaque vulnerability and can be used for early detection and prevention of cardiovascular complications in patients with RA

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Погорелова, О. А., О. А. Фомичева, М. И. Трипотень, Л. Б. Круглый, Е. В. Герасимова, Ф. Ф. Шингареева, Г. И. Хеймец, Ю. А. Карпов, Т. В. Попкова et Т. В. Балахонова. « Feasibility of contrast-enhanced ultrasonography for atherosclerotic plaques in carotid arteries in patients with rheumatoid arthritis ». Kardiologicheskii vestnik, n^o 4 (11 décembre 2020) : 57–65. http://dx.doi.org/10.36396/ms.2020.15.4.008.

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Введение. Ревматоидный артрит (РА) ассоциируется с повышенным риском сердечно-сосудистых заболеваний по сравнению с общей популя- цией. Для понимания роли системного воспаления в развитии сердечно-сосудистых катастроф у больных РА принципиальное значение имеет концепция о сходстве патогенетических механизмов аутоиммунного воспаления и атеросклероза. Ультразвуковое исследование с контраст- ным усилением (КУУЗИ) позволяет выявить неоваскуляризацию (НВ) атеросклеротической бляшки (АСБ), что отражает воспаление в бляшке и свидетельствует о ее нестабильности. Материал и методы. Был обследован 21 пациент с РА (7 мужчин и 14 женщин) в возрасте 61 (58; 65) год, длительность заболевания 7 (3; 16) лет. КУУЗИ сонных артерий (СА) проводили на ультразвуковой системе Philips IU22 c линейным датчиком 3–9 МГц, с внутривенным введением контрастного препарата «Соновью». Степень НВ бляшки оценивали как 0 — отсутствие НВ, 1 — слабая НВ, 2 — выраженная НВ, 3 — НВ при наличии пульсирующего сосуда. Результаты. У всех больных РА была выявлена НВ бляшки сонной артерии, при этом слабая степень НВ была выявлена в 7 случаях (33,3%), выраженная степень НВ — в 14 (66,7%). При проведении корреляционного анализа по Спирмену выявлена прямая уме- ренная корреляция между степенью НВ и холестерином липопротеидами низкой плотности (ХС ЛПНП) (R = 0,46, р = 0,04), прямая заметная корреляция между степенью НВ и триглицеридами (R = 0,56, р = 0,01), обратная заметная корреляция между степенью НВ и холестерином липопротеидами высокой плотности (R = -0,52, р = 0,02), умеренная корреляция между НВ бляшки и длительностью РА (R = 0,43, р = 0,052), заметная корреляция между НВ и наличием специфических антител к циклическому цитруллинированному пептиду (R = 0,57, р = 0,0068). Не было выявлено взаимосвязи между степенью НВ и уровнем высокочувствительного С-реактив- ного белка, скоростью оседания эритроцитов, холестерина, индексом активности РА DAS28 и наличием специфических антител ревматоидного фактора IgM. Заключение. КУУЗИ продемонстрировало наличие преимущественно высокой степени неоваскуляризации АСБ СА у пациентов с РА. КУУЗИ СА является доступным методом выявления нестабильности атеросклеротической бляшки СА у пациентов с РА с целью ранней профилактики и предотвращения сердечно-сосудистых осложнений Introduction. Rheumatoid arthritis (RA) is associated with an increased risk of cardiovascular disease compared to the general population. Similarity of the pathogenetic mechanisms of autoimmune inflammation and atherosclerosis is fundamentally important for understanding the role of systemic inflammation in the development of cardiovascular complications in RA. Contrast-enhanced ultrasound (CEUS) reveals neovascularization of an atherosclerotic plaque, which reflects inflammation in the plaque and indicates its vulnerability. Material and methods. We examined 21 patients with RA (7 males) with the median age of 61 [58; 65] years old and the median RA duration of 7[3; 16] years. CEUS of the carotid arteries was performed with the PHILIPS IU22 ultrasound system and 3-9 MHz linear array transducer. Ultrasound contrast agent SonoVue was administered intravenously. The degree of carotid intraplaque neovascularization was visually assessed on a scale from 0 to 3. Grade 0 represented no visible neovascularization, grade 1 — limited to moderate neovascularization, grade 2 extensive appearance of neovascularization, grade 3 — presence of a pulsating arterial vessel within the plaque (Shah et al. 2007). The association between the degree of neovascularization, biochemical parameters and RA duration was assessed with the Spearman’s correlation coefficient. Results. All patients with RA were found to have carotid intraplaque neovascularization. Grade 1 of neovascularization was detected in 33.3 % of patients and grade 2 was detected in 66.7%. The degree of neovascularization was positively associated with the LDL-C level (R = 0,46, p = 0,04), and the TG level (R = 0,56, p = 0,01) and negatively associated with the HDL-C level (R = -0,52, p = 0,02). The degree of neovascularization was also associated with RA duration (R = 0,43, p = 0,052) and the presence of antibodies against cyclic citrullinated peptides (aCCP) (R = 0,57, p = 0,0068). No association was found between the degree of neovascularization and the levels of hs-CRP, ESR, cholesterol, the RA activity index DAS28 and the presence of rheumatoid factor (RF). Conclusion. CEUS of carotid arteries demonstrated the presence of a predominantly extensive degree of carotid intraplaque neovascularization in patients with RA. CEUS of the carotid arteries is a readily accessible method for detecting plaque vulnerability and can be used for early detection and prevention of cardiovascular complications in patients with RA

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Mamun, Abdullah Al, Nazmul Hosain et Farzana Amin. « Ultrasound Based Flow Measurements of the Left and Right Carotid System of Arteries in Bangladeshi Patients ». Bangladesh Heart Journal 38, n^o 2 (12 décembre 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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Farrah, J., et S. K. Shami. « Patterns of Incompetence in Patients with Recurrent Varicose Veins : A Duplex Ultrasound Study ». Phlebology : The Journal of Venous Disease 16, n^o 1 (mars 2001) : 34–37. http://dx.doi.org/10.1177/026835550101600109.

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Objectives: To identify the patterns of venous incompetence in patients with recurrent varicose veins using duplex ultrasound scanning. Setting: Oldchurch District General Hospital, Southeast England. Patients and methods: 836 patients (581 women, median age 51 years (range 22–86 years) and 255 men, median age 53 years (range 23–28 years) referred to the vascular laboratory for the assessment of recurrent varicose veins. Duplex ultrasonography was undertaken by an experienced operator to evaluate the venous system in the lower limbs. A total of 1254 limbs with recurrent varicose veins were studied. Results: Recurrent reflux was found at the sapheno-femoral (SFJ) or saphenopopliteal junction (SPJ) in 43% of cases. The source of recurrent varices was an unoperated SFJ or SPJ in 386 (31%) limbs. Thigh perforators accounted for varices in 16% of limbs. Conclusion: Nearly half of recurrences were attributable to inadequate surgical treatment at the initial operation or possible angiogenesis. Nearly a third of recurrences originated at previously unoperated sites, confirming a need for objective venous assessment before recurrent varicose vein surgery.

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More, Vibha Subhash, Annal Abhay Vaidya, S. V. Parelkar et Madhva Prasad. « Study of congenital fetal malformations among antenatal women in a tertiary care centre ». International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, n^o 4 (27 mars 2018) : 1505. http://dx.doi.org/10.18203/2320-1770.ijrcog20181344.

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Background: Congenital malformations are morphological or functional anomalies that occur in the prenatal period as a result of genetic mutation, chromosomal abnormalities and adverse intrauterine environment. Early recognition is important. If congenital malformations are detected beyond the period of legal limit for medical termination of pregnancy, it carries immense burden on the pregnant woman.Methods: A descriptive observational study was conducted as a retrospective analysis of patient-records, over a span of 9 consecutive months in the Department of Obstetrics and Paediatric Surgery, at a tertiary care centre, Mumbai. The project was carried out to study demographic profiles, risk factors and system-wise distribution of pregnant women carrying malformed fetus.Results: The average annual incidence rate was 29 per 1000 deliveries. Of 151 patients, renal malformations were the commonest accounted for 40% of all congenital malformations. This was followed by central nervous system 32%, cardiovascular 14%, gastrointestinal 8% and musculoskeletal 3%. Congenital malformations were more common in multigravida than primigravida. 92% of congenital malformations were detected beyond 20 weeks of gestation. Previous abortions, hypothyroidism and raised sugars were associated high risk factors.Conclusions: The diagnosis of congenital malformation using ultrasonography occurs at a later gestational age than 20 weeks. For these patients a combined approach of the obstetrician/neonatologist/paediatric surgeon allows better counselling of parents and to permit preparation of the team to optimize neonatal outcomes.

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Wang, You, Hang Zhou, Fang Fu, Ken Cheng, Qiuxia Yu, Ruibin Huang, Tingying Lei, Xin Yang, Dongzhi Li et Can Liao. « Prenatal Diagnosis of Chromosome 16p11.2 Microdeletion ». Genes 13, n^o 12 (8 décembre 2022) : 2315. http://dx.doi.org/10.3390/genes13122315.

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(1) Objective: To investigate the prenatal diagnosis and genetic counseling for 16p11.2 microdeletion syndrome and to evaluate its pregnancy outcome. (2) Methods: This study included 4968 pregnant women who selected invasive prenatal diagnoses from 1 January 2017 to 1 August 2022. These 4698 pregnancies underwent chromosomal microarray analysis (CMA), data on 81 fetuses diagnosed with 16p11.2 microdeletion syndrome based on prenatal ultrasound features and genetic test results were recorded, and their pregnancy outcome was evaluated. (3) Results: 1.63% of fetuses (81/4968) were diagnosed with 16p11.2 microdeletion syndrome. Among these, there were skeletal malformations in 48.15% of the 81 fetuses, cardiovascular malformations in 30.86%, central nervous system malformations (CNS) in 11.11%, digestive system structural abnormalities in 6.17%, and isolated ultrasonography markers in 3.70%. (4) Conclusions: 16p11.2 microdeletion syndrome can display various systemic ultrasound abnormalities in the perinatal period but vertebral malformations are the most common. Our study is the first to report that TBX1 and CJA5 are associated with 16p11.2 microdeletion syndrome, expanding the disease spectrum of 16p11.2 microdeletion syndrome. In our study, the ventricular septal defect is the main feature of cardiac structural abnormalities caused by 16p11.2 microdeletion syndrome. In addition, our study highlights the use of CMA in 16p11.2 microdeletion syndrome, analyzed their genetic results, and evaluated the follow-up prognosis, which can be useful for prenatal diagnosis and genetic counseling.

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Kadiyani, Lamk, Sivasubramanian Ramakrishnan, Sanjeev Kumar et Pradeep Ramakrishnan. « Tubercular pseudoaneurysm of the axillary artery ». Annals of Pediatric Cardiology 16, n^o 5 (septembre 2023) : 363–66. http://dx.doi.org/10.4103/apc.apc_156_23.

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ABSTRACT Tuberculous (TB) involvement of the vascular system has been reported in the preantibiotic era. We, hereby, report a case involving a teenage boy who presented to us with left upper limb pain followed by gradually progressive motor and sensory deficit over 1 month with preceding history of tuberculosis. Examination revealed a palpable, noncompressible, nonpulsatile swelling superior to the lateral third of the clavicle. Imaging through ultrasonography, computed tomography, and magnetic resonance imaging confirmed the presence of a pseudoaneurysm with compression of the underlying nerves. The child underwent surgical thrombectomy with pseudoaneurysm repair and arteriorrhaphy along with antitubercular medications with complete recovery at 6 months. The tissue staining, nucleic acid amplification tests, and histopathology confirmed TB etiology. Tuberculosis continues to remain a major health concern, especially in the developing world. High index of suspicion is necessary to diagnose such manifestations to avoid catastrophic sequelae.

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Ienghong, Kamonwon, Somsak Tiamkao, Vajarabhongsa Bhudhisawasdi, Dhanu Gaysonsiri et Korakot Apiratwarakul. « Point of Care Ultrasound in Geriatric Patients at the Emergency Department ». Open Access Macedonian Journal of Medical Sciences 9, E (19 mai 2021) : 386–89. http://dx.doi.org/10.3889/oamjms.2021.6105.

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BACKGROUND: Point of care ultrasound (POCUS) plays an important role as a crucial tool for the diagnosis of various conditions in emergency and critical ill patients. However, POCUS examination in elderly populations has not been well studied. AIM: This was a retrospective observational study of elderly patients at the Department of Emergency Medicine who had received POCUS examination at a tertiary university hospital, Thailand. METHODS: The study was conducted throughout January 2020–December 2020. Patients’ characteristics and ultrasonography findings were recorded. RESULTS: A total of 191 elderly patients were evaluated. Median patient age was 75.65 years; 56.02% of patients were female. Chief complaints where POCUS scans were applied were respiratory (36.65%) and cardiovascular system-related (21.99%). The most frequent procedures performed were cardiac, lung, and inferior vena cava examinations. Abnormal ultrasound findings were discovered in 133 patients (68.91%). The 66.17% of abnormal ultrasound findings were associated with final diagnosis. The admission rate of elderly patients (56.82%) was highest among patients with positive ultrasound findings associated with final diagnosis. CONCLUSIONS: POCUS utilization in elderly patients was useful in aiding emergency physicians amid diagnosis of various diseases, especially life-threatening ones.

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Ulusoy, Serap, et Hakki Zafer Iscan. « The management of venous leg ulcers : Effects of four-layer bandage system ». Turkish Journal of Vascular Surgery 32, n^o 3 (5 novembre 2023) : 147–52. http://dx.doi.org/10.9739/tjvs.2023.09.026.

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Aim: Chronic Venous Ulcer (CVU) accounts for nearly 70% of all chronic leg ulcers (CLU), seriously impacting the quality of life and creating a heavy economic burden. Here, we present CVU therapy with a four-layer bandage system in 113 patients retrospectively treated by the General Surgery Chronic Wound Unit and Cardiovascular Surgery Department. Material and Methods: From January 2022 to January 2023, 113 patients with CVU were evaluated retrospectively. All patients were documented by color Doppler ultrasonography (CDUS), ulcer size, and demographics. If there were multiple ulcers, the largest one was assessed. Immobile patients and patients with an Ankle Brachial Index (ABI) of <0.7 were excluded. Debridement, exercise, venoactive drugs, and a four-layer bandage system were performed for all patients. The primary outcome was to assess the ulcer healing, and the secondary outcome was to obtain the recurrence rate and the treatment compatibility of patients. Results: The mean age of the patients was 60.73±11.3 (28-91) years and 77.9% were male. Body Mass Index (BMI) was 30.4±7.7 kg/m2 (min:18-max:51 kg/m2). The mean follow-up period was 18.82±13.4 weeks. Pseudomonas aeruginosa (38%) and Staphylococcus aureus (31.8%) were the most identified microorganisms. Four patients experienced recurrence of the CVU (3.5%). The older patients had larger ulcers than the younger patients. Female patients had larger-sized ulcers (p=0.001). Completely healed ulcers were 26.5% of the total. The four-layer compression bandage was applied 12 times for per patient. The mean healing period was 23.2±13.8 weeks. The mean healing rate was 4.17±3.78% for a week. The multivariant analysis revealed that age and pain had negatively affected the ulcer healing. Conclusion: The management of CVU is challenging and needs a multidisciplinary approach. Compression is the main goal of the treatment. Surgical or endovenous therapies may be beneficial for decreasing ulcer recurrence. For patients with slow ulcer healing, adjuvant treatment modalities such as patient education, smoking cessation, diet and lifestyle modification, and exercise should be recommended.

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