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Taiwanese Journal of Obstetrics &... Mar 2023We aimed to investigate whether there is a relationship between diaphragm thickness and disease severity in Covid-19 pregnant subgroups.
OBJECTIVE
We aimed to investigate whether there is a relationship between diaphragm thickness and disease severity in Covid-19 pregnant subgroups.
MATERIAL AND METHODS
In this prospective study 100 pregnant patients were enrolled. Thickness of the diaphragm muscle at end-expiration was measured using B-Mode US. Hemoglobin,WBC, NLR, procalcitonin and LDH levels were measured.
RESULTS
There was a statistically significant difference between the groups in terms of diaphragm thickness, and the diaphragm thickness was thinner in the severe disease group (p < 0.001). There was no statistically significant difference between the groups with mild to moderate disease severity (p = 0.708).
CONCLUSION
Covid-19 patients who developed serious infection has thinner diaphragms than those who did not. Low diaphragm muscle thickness at the outset of Covid-19 disease, may predispose to poor clinical outcomes. Diaphragmatic ultrasound may be a promising tool to evaluate the risk of Covid-19 disease severity.
Topics: Humans; Pregnancy; Female; Diaphragm; Prospective Studies; COVID-19; Ultrasonography
PubMed: 36965895
DOI: 10.1016/j.tjog.2022.10.008 -
Journal of Healthcare Engineering 2022When the human body is anesthetized, the human nerve tissue will be greatly affected, which also affects the breathing of the human body. The respiration during...
When the human body is anesthetized, the human nerve tissue will be greatly affected, which also affects the breathing of the human body. The respiration during anesthesia is a lack of initiative, and the energy efficiency of the diaphragm in the lungs is very important to the safety of anesthesia. In this paper, the application of the ultrasound evaluation of the diaphragm in clinical anesthesia was studied. In this paper, 24 patients who underwent lung examination under medical anesthesia at our hospital were evaluated by the ultrasound vertical mixed echo method. Through patient voluntary selection and consent, 16 patients were examined with B-mode ultrasound and the other 8 patients with M-mode ultrasound to compare the effects of different ultrasounds on diaphragm image quality. In addition, this paper also analyzes the differences between different ultrasounds and the strengths and weaknesses of diaphragmatic ultrasound evaluation in clinical anesthesia. The suggestions of using different ultrasounds in ultrasonic evaluation are given. The study showed that 16 cases of B-mode ultrasound evaluation of the diaphragm obtained ultrasound images which showed a large field of vision, acoustic frequency between 7 and 18 MHz, and thickness difference between 0.35 and 0.52 cm. In 8 patients with the diaphragm evaluated by M-mode ultrasound, the local features of M-mode ultrasound images were clearer than those of B-mode ultrasound images, but the visual field area was smaller, the acoustic frequency was between 10 and 15 MHz, and the thickness difference was between 0.12 and 0.18 cm. Based on the above data, this paper suggests that, in the ultrasonic evaluation of the diaphragm, B-mode ultrasound should be used to check the patients first, and then M-mode ultrasound should be used to check the parts with poor quality so that the accurate diaphragm quality of patients can be obtained in the vast majority of patients.
Topics: Anesthesia; Diaphragm; Humans; Respiration; Thorax; Ultrasonography
PubMed: 35281531
DOI: 10.1155/2022/2163225 -
Relationships between diaphragm ultrasound, spirometry, and respiratory mouth pressures in children.Respiratory Physiology & Neurobiology Nov 2022Diaphragm ultrasound (DUS) is a noninvasive method of evaluating the diaphragm's structure and function. This study explored the relationships between DUS, spirometry,...
Diaphragm ultrasound (DUS) is a noninvasive method of evaluating the diaphragm's structure and function. This study explored the relationships between DUS, spirometry, and respiratory mouth pressures in 10 healthy children (median age: 11 [range: 7-14 years]; 5 females, 5 males). Thickening fraction correlated with maximal inspiratory pressure (MIP) (Spearman's rho [r] = 0.64, p = 0.05). During quiet breaths, excursion time correlated with MIP (r = 0.78, p = 0.01) while velocity correlated with maximal expiratory pressure (r = -0.82, p = 0.01). During deep breaths, MIP correlated with excursion (r = 0.64, p = 0.05) and time (r = 0.87, p = 0.01). Excursion time during deep breaths also correlated with forced vital capacity (r = 0.65, p = 0.04). Our findings suggest that DUS parameters are closely related to spirometry and respiratory mouth pressures in healthy children and further support the use of DUS as a noninvasive method of respiratory assessment.
Topics: Child; Diaphragm; Female; Humans; Male; Maximal Respiratory Pressures; Mouth; Spirometry; Vital Capacity
PubMed: 35905862
DOI: 10.1016/j.resp.2022.103950 -
BMC Medical Imaging Feb 2022To clarify the differences in diaphragm thickness between male and female participants in healthy young adults with ultrasonography using the mean intima media thickness...
BACKGROUND
To clarify the differences in diaphragm thickness between male and female participants in healthy young adults with ultrasonography using the mean intima media thickness (IMT) method and to investigate the relationship between diaphragm thickness and respiratory pressure.
METHODS
Twenty-nine healthy individuals (16 females and 13 males) participated in the study. Diaphragm thickness was measured at total lung capacity (TLC) and at functional residual capacity (FRC) in each participant. We measured the diaphragm thickness using a method for mean intima media thickness. Moreover, change ratio of diaphragm thickness was calculated with the diaphragm thickness at TLC and FRC.
RESULTS
Mean diaphragm thicknesses at FRC in males were significantly narrower than those in females (p < 0.001). The change ratio of diaphragm thickness was significantly augmented in males compared with that in females (p < 0.001). There was a positive correlation between the change ratio of diaphragm thickness and pulmonary function data and respiratory muscle strength in healthy young adults.
CONCLUSIONS
The change ratio of diaphragm thickness using the IMT method can be accurately performed with a high degree of reproducibility by clinical laboratory technicians and may be a useful indicator for evaluating diaphragm muscle strength.
Topics: Adult; Carotid Intima-Media Thickness; Diaphragm; Female; Functional Residual Capacity; Healthy Volunteers; Humans; Male; Sex Factors; Total Lung Capacity; Ultrasonography; Young Adult
PubMed: 35148697
DOI: 10.1186/s12880-022-00748-y -
Cleveland Clinic Journal of Medicine Dec 2021Long-acting reversible contraceptives (ie, intrauterine devices and the etonogestrel subdermal implant) have become increasingly popular methods of contraception because...
Long-acting reversible contraceptives (ie, intrauterine devices and the etonogestrel subdermal implant) have become increasingly popular methods of contraception because of their convenience and safety profile. At the same time, the use of depot medroxyprogesterone acetate, one of the most prescribed contraceptives in the United States since its approval in 1992, is on the wane. The history and pros and cons of these contraceptive methods are reviewed.
Topics: Contraception; Contraceptive Agents, Female; Female; Humans; Intrauterine Devices; Medroxyprogesterone Acetate; United States
PubMed: 34857607
DOI: 10.3949/ccjm.88a.20110 -
Medical Science Monitor : International... Mar 2017BACKGROUND The aims of this study are to investigate the difference between the diaphragm thickness at end expiration and the thickness at total lung capacity (TLC), and...
BACKGROUND The aims of this study are to investigate the difference between the diaphragm thickness at end expiration and the thickness at total lung capacity (TLC), and to examine differences in inspiratory muscle function between stroke patients and healthy individuals. MATERIAL AND METHODS Forty-five stroke patients and 49 healthy volunteers were included in this study. Diaphragm thickness was measured at end expiration and at TLC by ultrasonography. The maximal inspiratory pressure (MIP), peak inspiratory flow (PIF), vital capacity (VC), and inspiratory muscle endurance (IME) were assess to evaluate inspiratory muscle function. RESULTS In stroke patients, the diaphragm was significantly thinner on the affected side than the less affected side at end expiration and at TLC. The change between the thickness at end expiration and at TLC were also significant on both sides. Between groups, the difference in diaphragm thickness at end expiration was not significant, but at TLC, the diaphragms were significantly thicker in healthy individuals than on either side in stroke patients, and the change in diaphragm thickness was significantly greater for healthy individuals. Inspiratory muscle functions were also significantly greater in healthy individuals. MIP, PIF, and VC were positively correlated with the change in thickness in healthy individuals, and MIP was positively correlated with the change in thickness and IME in stroke patients. CONCLUSIONS Stroke patients showed decreases in the thickening ability of the diaphragm at TLC and in inspiratory muscle function. The change between the diaphragm thickness at end expiration and at TLC was positively correlated with MIP, PIF, and VC.
Topics: Adult; Case-Control Studies; Chronic Disease; Diaphragm; Female; Humans; Male; Middle Aged; Respiratory Mechanics; Respiratory Muscles; Stroke; Tidal Volume; Total Lung Capacity
PubMed: 28284044
DOI: 10.12659/msm.900529 -
Ultrasound in Medicine & Biology Sep 2022Ultrasonography of the diaphragm in the zone of apposition has become increasingly popular to evaluate muscle thickness and thickening fraction. However, measurements in...
Ultrasonography of the diaphragm in the zone of apposition has become increasingly popular to evaluate muscle thickness and thickening fraction. However, measurements in this anatomical location are frequently hindered by factors that constrain physical accessibility or that alter diaphragm position. Therefore, other anatomical positions at the chest wall for transducer placement are used, but the variability in diaphragm thickness across the dome has not been systematically studied. The aim of this study was to evaluate anatomical variation of diaphragm thickness in 46 healthy volunteers on three ventrodorsal lines and two craniocaudal positions on these three lines. The intraclass correlation coefficient (ICC) for diaphragm thickness in the craniocaudal direction on the mid-axillary line was significantly higher than those on the posterior axillary and midclavicular lines, suggesting it had the lowest variability (ICC = .89, 95% confidence interval [CI]: 0.83-0.93, ICC = 0.74, 95% CI: 0.62-0.85, ICC = 0.62, 95% CI: 0.43-0.47, p < 0.05). Average diaphragm thickness was comparable on the posterior axillary and midaxillary lines and substantially larger on the midclavicular line (1.24 mm [1.06-1.47], 1.27 mm [1.10-1.42] and 2.32 [1.97-2.70], p < 0.01). We conclude that the normal diaphragm has a large variability in thickness, especially in the ventrodorsal direction. Variability in craniocaudal position is the lowest at the midaxillary line, which therefore appears to be the preferred site for diaphragm thickness measurement.
Topics: Diaphragm; Healthy Volunteers; Humans; Thorax; Ultrasonography
PubMed: 35691733
DOI: 10.1016/j.ultrasmedbio.2022.05.008 -
Biosensors & Bioelectronics May 2022Due to their immature morphology and functional immaturity, cardiomyocytes have limited use as an in vitro disease model of the native heart. Mechanical stimulation...
Due to their immature morphology and functional immaturity, cardiomyocytes have limited use as an in vitro disease model of the native heart. Mechanical stimulation induces structural growth in cardiomyocytes in vitro by addressing the electrical-mechanical interactions between the tissues. However, current in vitro models are restricted in their capacity to replicate the milieu observed in natural myocardium. Herein, we proposed a Galinstan strain sensor integrated nanogrooved circular PDMS diaphragm to mimic the native cardiac tissues. The impact of combined topographical and mechanical stimulation on cultured cardiomyocytes at various strain areas on a circular PDMS diaphragm is studied in detail. An inverted microscope is used to image live cells and video acquisition to study the contractility of cultured cardiomyocytes. The structural changes of the cultured cardiomyocytes are investigated by its sarcomere length and connexin-43 (Cx43) expression using immunocytochemistry analysis. Cyclic strain is found to promote structural development in cultured cardiomyocytes, and diaphragms with nano-groove patterns displayed increased contractile activity and gene expression (sarcomere length ∼1.97 ± 0.03 μm and normalized Cx43-1.57) as compared to flat diaphragms (sarcomere length ∼1.82 ± 0.02 μm and normalized Cx43-1.32). The nanogrooved circular diaphragm exhibited distinct stretching mechanisms at various places, with the equibi-axial stretching regions providing the optimal structural growth and formation of natural myocardium at the diaphragm's center. Cardiomyocytes that are more mature have the potential to produce a more realistic in vitro cardiac model for disease modeling and medication development.
Topics: Anisotropy; Biosensing Techniques; Cells, Cultured; Diaphragm; Myocardium; Myocytes, Cardiac
PubMed: 35158156
DOI: 10.1016/j.bios.2022.114017 -
Journal of Thoracic Imaging Nov 2019Diaphragmatic dysfunction is a potential cause of dyspnea that can lead to significant morbidity. The purpose of this review article is to provide readers with the... (Review)
Review
Diaphragmatic dysfunction is a potential cause of dyspnea that can lead to significant morbidity. The purpose of this review article is to provide readers with the essentials for performing diaphragm ultrasonography, image interpretation, and the technical limitations one needs to be aware of. Diaphragm ultrasonography is simple to perform and has proven to be an accurate and safe bedside modality, overcoming many of the traditional limitations of fluoroscopy.
Topics: Diaphragm; Dyspnea; Humans; Image Interpretation, Computer-Assisted; Ultrasonography
PubMed: 31385877
DOI: 10.1097/RTI.0000000000000436 -
The European Journal of Contraception &... Aug 2019Our aim was to provide a consensus of best practice in intrauterine contraception (IUC) for French practitioners. A meeting of 38 gynaecologists was held to establish... (Review)
Review
Our aim was to provide a consensus of best practice in intrauterine contraception (IUC) for French practitioners. A meeting of 38 gynaecologists was held to establish a consensus of best practice in IUC, using the validated nominal group (NG) method to reach consensus. Seventy questions were posed covering insertion, monitoring and removal of IUC devices. Two working groups were formed and all proposals were voted on, discussed and approved by the NG. Of the 70 questions asked, answers to only four failed to reach NG consensus. While, in general, the IUC practices of French gynaecologists are in line with international guidelines, some notable differences were identified: for example, when to use the levonorgestrel-releasing intrauterine system versus the copper intrauterine device; practice recommendations in the event of upper genital tract infections; and immediate postpartum insertion. Clinicians are encouraged to inform women about IUC, irrespective of their age or parity. In general, the wishes and characteristics of the woman must be the main criteria informing the choice of IUC, once all potential contraindications have been excluded and information about IUC shared. This consensus paper is intended to update and standardise knowledge about IUC for health care professionals, to address any reticence about use of this contraceptive method.
Topics: Consensus; Female; France; Health Knowledge, Attitudes, Practice; Humans; Intrauterine Devices; Midwifery; Physicians; Practice Guidelines as Topic
PubMed: 31204843
DOI: 10.1080/13625187.2019.1625325