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The Veterinary Clinics of North... Mar 2016Modern portable ultrasound scan machines provide the veterinary clinician with an inexpensive and noninvasive method to further examine sheep on farms, which should take... (Review)
Review
Modern portable ultrasound scan machines provide the veterinary clinician with an inexpensive and noninvasive method to further examine sheep on farms, which should take no more than 5 minutes with the results available immediately. Repeat examinations allow monitoring of the disease process and assessment of therapy. 5 MHz linear array scanners can be used for most organs except the heart and right kidney. Transthoracic ultrasonography is particularly useful for critical evaluation of lung and pleural pathologies. Transabdominal ultrasonographic examination can readily identify distended urinary bladder and advanced hydronephrosis.
Topics: Animals; Hydronephrosis; Lung Diseases; Sheep; Sheep Diseases; Ultrasonography; Urinary Bladder Diseases
PubMed: 26922119
DOI: 10.1016/j.cvfa.2015.09.008 -
The Korean Journal of Gastroenterology... Feb 2020CT enterography and magnetic resonance (MR) enterography are widely used imaging modalities used to examine the small bowel. These radiologic tests are distinguished... (Review)
Review
CT enterography and magnetic resonance (MR) enterography are widely used imaging modalities used to examine the small bowel. These radiologic tests are distinguished from routine abdominopelvic CT and MRI by the oral ingestion of a large amount of neutral contrast to distend the small bowel before scanning. For achievement of high quality, diagnostic images and proper technique are required. Conducted protocols still vary in patient preparation, enteric contrast, and CT and MRI acquisition sequences, resulting in heterogeneous diagnostic accuracy. The purpose of this article is to review the processes and techniques that optimize CT/MR enterography for patients with suspected Crohn's disease or other small bowel diseases.
Topics: Contrast Media; Crohn Disease; Humans; Intestine, Small; Magnetic Resonance Imaging; Patient Positioning; Tomography, X-Ray Computed
PubMed: 32098462
DOI: 10.4166/kjg.2020.75.2.86 -
Acta Ophthalmologica Mar 2019Corneal nerves are key components of the physiological system that controls ocular surface homeostasis. The cornea is primarily innervated by the ophthalmic branch of... (Review)
Review
Corneal nerves are key components of the physiological system that controls ocular surface homeostasis. The cornea is primarily innervated by the ophthalmic branch of the trigeminal nerves (cranial nerve V), which distend bilaterally from the pons. The nasociliary branch (afferent) of the ophthalmic nerve is sensory for cornea, eyelid and conjunctiva. These nerve fibres play a role in sensing temperature, chemical and mechanical stimuli, and pain, whereas, branches of the facial nerve (cranial nerve VII) contain motor nerves that control blinking and autonomic (sympathetic and a paucity of parasympathetic) fibres that stimulate tear production and secretion via feedback loops between the ocular surface, lacrimal glands and brain. Disruption of these nerves with interruption of neural feedback loops between the ocular surface and lacrimal glands can lead to corneal diseases such as dry eye disease (DED) and neurotrophic keratopathy (NK). Inversely, hypersensitivity of the nerve fibres and/or dysregulation of pain-controlling nervous centres may lead to neuropathic pain. Recently, medications that specifically target regeneration of corneal nerves have started to become available - and considering the high prevalence of diseases associated with corneal nerve dysfunction, these agents promise to fulfil a hitherto important unmet need. In this review, we explore the physiology of corneal nerves, the pathology of corneal nerve diseases and how these relate to neuropathic pain, NK and DED. We also discuss what novel treatments may be useful against diseases involving corneal nerves.
Topics: Cornea; Corneal Diseases; Homeostasis; Humans; Microscopy, Confocal; Ophthalmic Nerve
PubMed: 30225941
DOI: 10.1111/aos.13844 -
Paediatric Respiratory Reviews Aug 2019Obstructive sleep apnea (OSA) is characterized by snoring, recurrent obstruction (apneas) of the upper airway which disrupts normal ventilation during sleep. In the last... (Review)
Review
Obstructive sleep apnea (OSA) is characterized by snoring, recurrent obstruction (apneas) of the upper airway which disrupts normal ventilation during sleep. In the last decade, there has been a increase in children diagnosed with persistent, severe OSA attributed to (1) the obesity epidemic as 25-60% of obese children will have obesity related OSA (2) advances in medical technology that have increased life expectancy of medically complex children (3) improved diagnostics and (4) increased awareness. Positive airway pressure (PAP) is commonly used to treat persistent, severe OSA. PAP devices deliver pressurized air via nasal or oronasal interfaces to distend the upper airway and ameliorate OSA. Although effective in treating OSA, PAP adherence is suboptimal. This review article provides an overview of (1) PAP use in pediatric OSA (2) PAP devices (3) PAP adherence, (4) strategies and interventions to improve adherence and (5) Optimizing PAP delivery during pediatric to adult transition.
Topics: Child; Continuous Positive Airway Pressure; Humans; Patient Compliance; Sleep Apnea, Obstructive
PubMed: 31130426
DOI: 10.1016/j.prrv.2019.04.006 -
Medical Physics Jan 2024The distension properties of the vagina are critical to its function including support of surrounding organs, childbirth, and intercourse. It could be altered by many...
BACKGROUND
The distension properties of the vagina are critical to its function including support of surrounding organs, childbirth, and intercourse. It could be altered by many pathophysiological processes like pregnancy, radiotherapy, and reconstruction surgery. However, there are no clinically available diagnostic tools capable of quantifying the distension properties of the vagina.
PURPOSE
A proof-of-concept study was designed to assess the feasibility of a novel three-dimensional (3D) ultrasound imaging technique that allows quantitative evaluation of the vagina under distension.
METHODS
Patients with symptomatic pelvic organ prolapse (POP) were recruited for the study. An ultrathin, oversized bag was inserted into the vagina and filled with water using a modified urodynamics system. The instilled water volume and intravaginal pressure were continuously recorded. At maximum vaginal capacity, 3D transintroital ultrasound of the distended vagina and surrounding pelvic structures was performed. Exams were performed in duplicate for each patient, two hours apart (round A and round B). Following the development of a 3D surface model of the distended vagina from each scan, several measurements were obtained, including cross-sectional area, anteroposterior (AP) length and lateral width in the plane of minimum hiatal dimensions (PMHD), AP and lateral diameter at the pubic symphysis (PS) level, maximum and minimum diameter, and maximum vertical length. To assess repeatability between measurements in two rounds, the coefficient of variation (CV) and the intraclass correlation coefficient (ICC) were calculated for each measurement. Correlations between physical measurements including the pelvic organ prolapse quantification (POP-Q) system and vaginal diameter measurements, and obtained metrics were also assessed.
RESULTS
Sixteen patients with POP (average age 69 years) completed both rounds of imaging. There was sufficient echogenicity on 3D transintroital ultrasound of the distended vaginal wall to establish boundaries for 3D surface models of the vagina. Overall, all metrics had good or excellent reliability (ICC = 0.77-0.93, p < 0.05; CV = 3%-18%) except maximum diameter, which demonstrated only moderate reliability (ICC = 0.67, p = 0.092). Strong correlations were found between physical exam measurements including D point of POP-Q, introitus diameter and lateral diameter at apex, and maximum vaginal capacity, maximum vertical length, lateral diameter at PS, minimum diameter, and distended PMHD measurements. The results demonstrated that this system could generate 3D models of the shape of the distended vagina and provide multiple metrics that could be reliably calculated from automated analyses of the models.
CONCLUSIONS
A novel system for evaluation of the distension properties of the vagina was developed and preliminary evaluation was performed. This system may represent a technique for evaluation of the biomechanical and structural properties of the vagina.
Topics: Pregnancy; Female; Humans; Aged; Feasibility Studies; Reproducibility of Results; Ultrasonography; Vagina; Pelvic Organ Prolapse; Water; Imaging, Three-Dimensional
PubMed: 37905819
DOI: 10.1002/mp.16810 -
Journal of the American College of... Dec 2021Posterior urethral valves are a congenital malformation in males that results in the obstruction of urinary outflow from the proximal urethra. Presentation depends on...
Posterior urethral valves are a congenital malformation in males that results in the obstruction of urinary outflow from the proximal urethra. Presentation depends on severity of disease, with patients presenting antenatally with oligohydramnios and hydronephrosis, to postnatally with delayed or poor voiding, urinary tract infections, or renal anomalies on ultrasound. Our case illustrates an 11-day-old male who presented to the emergency department with poor feeding, vomiting, significant abdominal distension, and pitting edema of the lower extremities. The patient was found to have hypoglycemia, hyponatremia, hyperkalemia, and acute renal failure. Point of care ultrasound showed severe bilateral hydronephrosis with a significantly distended bladder that was compressing the inferior vena cava. Early recognition of the obstruction via ultrasound led to rapid decompression of the bladder using catheterization and immediate involvement of urology, nephrology, and neonatology consults in the pediatric emergency department.
PubMed: 34849508
DOI: 10.1002/emp2.12599 -
Singapore Medical Journal Jan 2019Infantile colic is a common self-limiting condition that causes significant distress to parents and caregivers. There is no clear cause, gold standard remedy or...
Infantile colic is a common self-limiting condition that causes significant distress to parents and caregivers. There is no clear cause, gold standard remedy or preventative action. The role of the family physician is to rule out sinister causes while providing counselling and reassurance for parents. The mainstay of management is parental support and reassurance while looking out for red flags in the baby such as fever, lethargy, distended abdomen and failure to thrive. This article provides a framework to approaching infantile colic and practical pointers to share with parents.
Topics: Caregivers; Colic; Crying; Evidence-Based Medicine; Humans; Infant; Infant Formula; Infant, Newborn; Muscle Hypertonia; Parenting; Parents; Pediatrics; Physicians, Family; Primary Health Care; Professional-Patient Relations
PubMed: 30840991
DOI: 10.11622/smedj.2019004 -
Tierarztliche Praxis. Ausgabe G,... Jun 2016Venous diseases due to venous catheters have variable symptoms and clinical progress. They comprise perivenous hematoma, periphlebitis, endophlebitis, phlebothrombosis... (Review)
Review
Venous diseases due to venous catheters have variable symptoms and clinical progress. They comprise perivenous hematoma, periphlebitis, endophlebitis, phlebothrombosis or septic thrombophlebitis. To diagnose venous disease, a clinical examination (possibillity to distend the vein, swelling, pain, increased skin temperature, and any exudation around the injection site) and an ultrasonographic examination (perivenous tissue, venous wall, venous content) of the vein are performed. Treatment of venous diseases depends on the etiology and pathogenesis and combines the use of anticoagulants (heparin, phenprocoumon), anti-inflammatory and analgesic substances (non-steroidal inflammatory drugs) as well as the application of antibiotics depending on the case. For prevention of venous diseases a careful catheter management is important. This includes in particular the adequate selection of the catheter system (long-term catheter made of polyurethane), catheter care and intensive monitoring. This article reviews the different venous diseases, diagnosis and therapeutic measures in a practical manner.
Topics: Animals; Anti-Bacterial Agents; Catheter-Related Infections; Horse Diseases; Horses
PubMed: 27224936
DOI: 10.15653/TPG-140417 -
Nihon Shokakibyo Gakkai Zasshi = the... 2016An 83-year-old male presented with distended abdomen. A computed tomography scan demonstrated pleural effusion, ascites, peritoneal thickness, and panniculitis. Multiple... (Review)
Review
An 83-year-old male presented with distended abdomen. A computed tomography scan demonstrated pleural effusion, ascites, peritoneal thickness, and panniculitis. Multiple small white nodules of peritoneum were observed during a laparoscopy examination, and biopsy specimens revealed noncaseating granulomas. Gallium scintigram demonstrated an accumulation in the peritoneum and revealed a panda sign that has been described as an indication of sarcoidosis. Although sarcoidosis rarely induces peritonitis with ascites, peritoneal sarcoidosis was diagnosed and he began receiving steroid therapy. After primary steroid therapy, his ascites completely disappeared, and he has maintained a complete response with continuous low dose steroid therapy.
Topics: Aged, 80 and over; Ascites; Humans; Male; Peritonitis; Sarcoidosis; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 27725463
DOI: 10.11405/nisshoshi.113.1743 -
ACG Case Reports Journal Mar 2021Pancreatic ganglioneuromas occur mostly in children and rarely in young adults, with no cases reported in adults older than 60 years. An 86-year-old-woman, with active...
Pancreatic ganglioneuromas occur mostly in children and rarely in young adults, with no cases reported in adults older than 60 years. An 86-year-old-woman, with active advanced multiple myeloma, presented with epigastric pain for 2 days. Abdominal and pelvic computed tomography demonstrated a distended gallbladder, mildly dilated biliary tree, and a 13 × 8-mm hypodense mass in pancreatic body, without extrapancreatic invasion at endoscopic ultrasound. Fine-needle endoscopic ultrasound-guided core biopsy revealed characteristic histopathology of ganglioneuroma, as confirmed by immunohistochemical positivity for S100, SOX-10, and synaptophysin. This demonstrates novel finding of pancreatic ganglioneuroma occurring in the elderly. Lesion inclusion in the differential diagnosis may mandate tissue for pathologic diagnosis and complete lesion resection.
PubMed: 33763500
DOI: 10.14309/crj.0000000000000546