End-diastolic Velocity Research Articles

Idebenone Attenuates Diabetic Retinopathy by Modulating Autophagy Via Targeting Akt Signaling.

Diabetic Retinopathy (DR) is a common microvascular issue caused by diabetes. Idebenone (IDE) is a coenzyme Q10 analog and antioxidant that has been utilized in the treatment of neurodegenerative diseases. Our goal was to investigate how IDE might treat diabetic retinopathy. An in vivo DR model was established by injecting a single dose of streptozotocin (STZ). Rats were treated with IDE, and their vascular function was measured by ultrasound. The retina structure was checked by haematoxylin and eosin (HE) staining. The expression of biomarkers of autophagy and apoptosis was measured by western blotting assay. The retina endothelial cell line RF/6A was stimulated with high glucose (HG) and treated with IDE. Cell proliferation and apoptosis were assessed using the Edu assay, TUNEL assay, and flow cytometry, respectively. Reduced peak systolic velocity (PSV), mean velocity (MV), end-diastolic velocity (EDV), and increased pulsatility index (PI) and resistance index (RI) were observed in diabetic rats; however, these traits were reversed by IDE therapy. IDE alleviated the STZ-induced disordered retina structure. The IDE administration suppressed DR-induced apoptosis and autophagy both in vivo and in vitro. IDE suppressed the activation of Phosphatidylinositol 3 kinase (PI3K) signaling. Activation of PI3K abolished the IDE-alleviated retina damage and cell death. IDE regulated the autophagy of retina cells to alleviate diabetic retinopathy via regulating the PI3K signaling pathway.

Expanded Fetal Growth Restriction Definition Identifies High Proportion of Umbilical Artery Doppler Anomalies.

Fetal growth restriction (FGR) increases the risk for perinatal morbidity and mortality. The Society for Maternal-Fetal Medicine expanded the definition of FGR to independently include abdominal circumference (AC) < 10th percentile for gestational age (GA), regardless of estimated fetal weight (EFW). While studies have shown increased detection of small for GA neonates with expanded definition, no studies have evaluated the likelihood of abnormal umbilical artery Dopplers (UAD) detection with expanded definition. The objective of this study was to compare the likelihood of identifying UAD abnormalities in fetuses with normal EFW and restricted AC versus those by EFW alone. Single-institution retrospective cohort study of fetal growth ultrasounds meeting criteria for FGR either by EFW < 10th percentile or AC < 10th percentile with normal EFW. Those with FGR by AC alone were compared with those with FGR by EFW. Primary outcome was prevalence of UAD abnormalities, including elevated systolic/diastolic ratio, and absent and/or reversed end diastolic velocity. Receiver operator characteristic curves were generated to compare predictive value of UAD abnormalities by FGR definition. A total of 619 scans met criteria for FGR between November 2020 and June 2021, with 441 (71%) meeting definition by EFW and 178 (29%) by AC criteria alone. Baseline characteristics were similar between groups. FGR by AC alone was identified earlier (30.4 ± 3.3 vs. 35.4 ± 3.0 weeks' gestation, p < 0.001) with higher proportion identified before 32 weeks (70 vs. 11%, p < 0.001). Proportion of abnormal UAD were similar between groups (15 vs. 15%, adjusted odds ratio: 1.12, 95% confidence interval: 0.61-2.23). Use of EFW alone would have failed to identify 29% of abnormal UAD. A combined definition of FGR had the highest detection of abnormal UAD (area under curve: 0.78 vs. AC alone 0.73 vs. EFW alone 0.69). A definition of FGR that considers both EFW and AC improves detection of abnormal UAD. · Fetuses with restricted AC are equally likely to exhibit abnormal UAD indices compared with those that meet criteria by EFW.. · Earlier GA of FGR detection and improved detection of abnormal UAD with expanded growth definition.. · Expanded definition of FGR significantly improves detection of abnormal UAD as compared with those diagnosed with EFW criteria alone.. · Expanded growth restriction definition improves Doppler identification..

Longitudinal assessment of transcranial Doppler imaging in children with sickle cell disease without neurological symptoms

IntroductionStroke is one of the most devastating complications of sickle cell disease (SCD). Transcranial Doppler Imaging (TCDI) is the least invasive screening method to predict patients at risk for developing stroke in the disease. After a 10-year follow-up, we longitudinally assessed the TCDI in children with SCD without neurological symptoms.Methods25 out of 43 pediatric patients with SCD studied 10-year previously were recruited. The remaining 18 patient were not available for follow-up, but their initial data are presented for comparison. TCDI scanning was carried out using a phased-array transducer of 1–3 MHz through the trans-temporal window. Peak systolic velocity (PSV), end-diastolic velocity (EDV), time-averaged mean of the maximum velocity (TAMMV), resistive index (RI), and pulsatility index (PI) were obtained in the anterior and posterior Circle of Willis vessels.ResultsThe highest initial and follow-up TAMMV (mean ± SD) were: 77.3 ± 20.9 and 71.6 ± 9.9 in the t-ICA, 94.3 ± 25.8 and 82 ± 18.2 in the MCA, 76.6 ± 25.6 and 70.6 ± 10.7 in the ACA, and 59.1 ± 15.8 and 63.9 ± 8.5 in the PCA, respectively. There was no statistically significant difference between initial and follow-up SCD data for all vascular parameters in all vessels on each side (P > 0.05) except for RI and PI (P < 0.05). There was significant correlation between TAMMV, PSV, and EDV (P = 0.001).ConclusionThere are no absolute Doppler velocity changes between the initial and follow-up period over the years. There is a possibility that PSV and EDV could be used in parallel with TAMMV Subclinical vascular degeneration is not suggested by these vascular measures.

Ultrasonographic and functional evaluation of forearm circulation with occluded radial artery

Abstract Introduction The transradial approach (TRA) has gained popularity in cardiology procedures. This study aims to evaluate forearm and hand arterial circulation in radial artery (RA) occlusion (RAO) patients after coronary angiography (CAG) and percutaneous coronary interventions (PCI). The ulnar (UA) and anterior interosseous artery (AIA) can compensate for RAO. Methods A prospective, observational study was conducted on 40 RAO patients after CAG/PCI. Ultrasonographic and functional evaluation (Barbeau test) of collateral circulation through AIA or UA were performed. Statistical analyses were applied to evaluate various Doppler ultrasound parameters and the anatomical characteristics of the RAO. Results The RAO group mean age was 71.22 ± 9.99 years, and 45% were male. RA, UA, and AIA showed significant differences in peak systolic velocity, end-diastolic velocity, arterial diameter, total flow volume, and stroke volume (p &amp;lt; 0.01). Pulse quality over RA and UA also differed significantly (p &amp;lt; 0.0001). Blood flow direction in the distal RA segment divided patients into an antegrade flow group (50%) from AIA and a retrograde flow group (50%) from UA. The Barbeau test results varied among RAO patients, with type D being the most common. Anatomical locations of RAO included the anatomical snuffbox (10%), wrist (60%), and forearm (30%). The logistic regression model revealed that the Barbeau test results on Finger 2 (p=0.0006, OR=0.1398) and Finger 4 (p=0.004, OR 0.2843) were significant predictors for the occurrence of antegrade or retrograde blood flow in the distal RA when RAO occurred. Furthermore, when the RA was occluded, the study revealed that a palpable pulse over the RA was still possible in 15% of cases. Conclusion Ultrasonographic evaluation and the Barbeau test can assess collateral circulation and predict blood flow patterns in RAO patients. Further research is needed to validate these findings, explore additional factors influencing collateral circulation and access route selection, and investigate the clinical implications of different RAO anatomical locations in cardiology procedures.Radial Artery OcclusionThe pulse quality over RA/UA with RAO

High-frequency ultrasound for assessing the renal characteristics of spontaneous type 2 diabetes mellitus db/db mice.

There are few ultrasonographic studies on the spontaneous T2DM db/db mouse. Our objective was to dynamically investigate and assess renal morphological and hemodynamic changes in spontaneous type 2 diabetes mellitus db/db mice through high-frequency ultrasound. Eighteen male db/db mice (the model group) and twelve male db/+ mice (the control group) were included. Body weight and fasting blood glucose were measured at the ages of 8, 16 and 32 weeks. High-frequency ultrasound examinations were conducted at the same ages. Compared with those in the control group, H&E and Masson staining revealed pathological changes in the renal tissue of the db/db mice at 16 weeks of age, and the lesions were significantly aggravated at 32 weeks of age. The body mass of the mice in the model group increased significantly at 8, 16 and 32 weeks of age, and the kidney volume measured by ultrasound also increased with age. Compared with those of the control group, the blood flow scores determined via power Doppler were significantly different. The peak systolic velocity (PSV), end diastolic velocity (EDV), and resistive index (RI) of the renal artery and the PSV, EDV, and RI of the segmental artery were significantly different at the 16th week compared with those that at the eighth week. The results of high-frequency ultrasound revealed that the renal hemodynamics of db/db mice changed at the sixteen weeks.

Shear-Wave Elastography Improves Diagnostic Accuracy in Chronic Kidney Disease Compared to Conventional Ultrasound.

Non-invasive tests are increasingly demanded for diagnosing and prognostication of chronic kidney disease (CKD). Shear-wave elastography (SWE), an emerging technique for measuring tissue stiffness, shows promise for distinguishing between individuals with different stages of renal fibrosis. This study aimed to compare the diagnostic accuracy of two-dimensional SWE (2D-SWE) and conventional ultrasound for detecting CKD, employing renal biopsy as the gold standard. From May 2020 to October 2023, this prospective study included 30 healthy volunteers and 169 patients with CKD who had undergone 2D-SWE and conventional ultrasound of both kidneys. Cortical and medullary stiffness, cortical pixel intensity, renal length, parenchymal and cortical thickness, interlobar artery peak systolic velocity, end-diastolic velocity (EDV), and resistive index were measured. The diagnostic accuracy of 2D-SWE and conventional ultrasound was compared using the receiver operating characteristic curve (ROC) and Delong test. For diagnosing CKD, the area under the ROC (AUC) of cortical stiffness (0.96 [95% CI, 0.93, 0.99]) was significantly higher than that of all conventional ultrasound parameters, including EDV (0.78 [95% CI, 0.71, 0.86]) and cortical thickness (0.74 [95% CI, 0.67, 0.80]). The sensitivity of cortical stiffness (91%) was significantly higher than that of EDV (68%) and cortical thickness (53%). No significant difference was found in the specificity of cortical stiffness (96%) compared to that of EDV (79%) and cortical thickness (100%). Two-dimensional SWE showed higher diagnostic accuracy than that of conventional ultrasound for detecting CKD.

Transcranial Doppler ultrasound in evaluating cerebral blood flow abnormalities in major depressive disorder.

Previous research has shown that blood flow abnormalities affect major depressive disorder (MDD) from multiple perspectives. Therefore, this study aims to investigate the relationship between middle cerebral artery (MCA) blood flow velocity parameters and clinical symptom scores (Hamilton Depression Rating Scale [HAMD] and Montgomery-Åsberg Depression Rating Scale [MADRS]) in patients with MDD. We compared the MCA blood flow velocity parameters, including peak systolic velocity (MCA-PSV), end-diastolic velocity (MCA-EDV), and mean velocity (MCA-MV), between 50 MDD patients and 50 control subjects. Additionally, we analyzed the correlation between these parameters and HAMD and MADRS scores. Hemodynamic parameters such as pulsatility index and resistance index were also compared between the 2 groups. MCA-PSV, MCA-EDV, and MCA-MV were significantly lower in MDD patients compared to the control group, while pulsatility index and resistance index were significantly higher. Correlation analysis revealed that MCA-PSV, MCA-EDV, and MCA-MV were significantly negatively correlated with HAMD and MADRS scores in MDD patients, indicating that cerebral blood flow velocity decreases as depressive symptoms worsen. Furthermore, regression analysis confirmed the negative relationship between blood flow velocity parameters and clinical symptom scores. The results of this study suggest that the reduction in cerebral blood flow velocity in MDD patients may be associated with the severity of depressive symptoms. This finding provides new insights into the pathophysiological mechanisms of MDD and offers a potential theoretical basis for developing depression treatment strategies based on cerebral blood flow velocity parameters.

Morphological and Hemodynamic Features of the Carotid Artery on Color Doppler Ultrasound in Hypertensive Patients

Objective: 1. Described the characteristics and morphology of the carotid artery on color Doppler ultrasonography in patients with hypertensive. 2. Determine the relationship between carotid intima-media thickness (cIMT) on color Doppler ultrasound images and some clinical and laboratory parameters and some risk factors in hypertensive patients. Subjects and methods: This was a cross-sectional descriptive study on 64 hospitalized hypertensive patients. Results: 62.5% are female. Mean age 66.41±11.91. The right common cIMT 0.74 (0.7-0.81) mm; the left was 0.8 (0.7-0.8) mm; the average cIMT on both sides was 0.75 (0.75-0.79) mm. Mean peak systolic velocity of the right common carotid artery 58.03±14.74 cm/s; left side 60.71±15.73 cm/s. Right common carotid end-diastolic velocity 14.68±4.88 cm/s; left side 16.09±6.04 cm/s. Right common carotid resistance index 0.75±0.063; left side 0.74±0.067. There were 25 (39.1%) cases of right common carotid atherosclerotic plaque with the thickest 2.500.71mm and 33 (51.6%) cases of left common carotid plaque with the thickest 2.3 (1.99-2)mm. There were an independent correlation between age and sex with the cIMT on both sides with correlation coefficients of R=0.514, p=0.013; R=0.514, p &lt; 0.0001, respectively. Conclusion: There were a correlation between the common cIMT with age and sex, every 1 year increase will increase the thickness of the common cIMT by 0.005 mm. cIMT was higher than in men.

Doppler ultrasound imaging and shear wave elastography for evaluation of interstitial fibrosis/tubular atrophy in IgA nephropathy.

The purpose of this study was to explore the value of Doppler ultrasound imaging and shear wave elastography (SWE) in evaluating renal interstitial fibrosis/tubular atrophy (IFTA). During April 2019 and November 2023, biopsy-proven IgA nephropathy (IgAN) patients were enrolled in our study. Conventional ultrasound, Doppler ultrasound imaging and SWE measurements were performed, and related parameters were collected. According to the Oxford classification of IgAN, interstitial fibrosis/tubular atrophy (T) lesions were grouped into T0, T1 and T2 group. Receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic accuracy of SWE in identifying IFTA. A total of 100 IgAN patients were enrolled in the final cohort. 67 patients were in the T0 group, and 33 patients were in the T1/T2 group. The average SWE values were 42.17 ± 9.11kPa in the T0 group and 36.83 ± 10.32kPa in the T1/T2 group (p = 0.01). Multivariate logistic regression revealed that the SWE value and end diastolic velocity (EDV) of the interlobar artery were found to be independent risk factors for IFTA. For the diagnosis of IFTA, the area under the ROC curve (AUC) of SWE alone was 0.652, whereas the AUC of SWE in combination with the EDV was 0.807 (p = 0.008). The combination of Doppler ultrasound imaging and SWE measurements could improve the diagnostic performance of quantitative assessment of IFTA in IgAN patients.

Association between Breast Arterial Calcification on Mammography and Impaired Ocular Perfusion: A Novel Study Using Color Doppler Ultrasonography.

To investigate the relationship between the mammography-detected breast arterial calcification (BAC) and orbital color Doppler ultrasonography (CDUS) results. Our single-center study, included female patients who applied to our hospital between January and May 2022 and underwent mammography and orbital CDUS examinations. Two radiologists evaluated the mammograms, grouped the patients as BAC (+) and BAC (-), and performed orbital CDUS. Continuous variables obtained from CDUS were compared according to the presence of BAC. Also, receiver operating characteristics (ROC) analysis was used to determine the orbital CDUS threshold values for the presence of BAC. A total of 119 women were included with a median age of 62 years, 57 (47.90%) had BAC. Orbital CDUS examination was performed on both eyes of 119 patients (238 eyes in total). Peak systolic velocity (PSV) and end-diastolic velocity (EDV) values of the ophthalmic artery (OA) (P < .001) and EDV of the central retinal artery (CRA) (P < .001) were significantly lower in patients with BAC. Pulsatile index (PI) and resistive index (RI) values of OA (P < .001) and CRA (P < .001) were higher in patients with BAC. In ROC analysis, the cut-off values for the presence of BAC were calculated as OA PI ≥1.415 and OA RI ≥0.755 (P < .001); CRA PI ≥1.135 and CRA RI ≥0.655 (P < .001). Orbital perfusion disorders may be observed in patients with vascular calcification detected on routine mammography. Therefore, a more detailed evaluation of patients with BAC detected on mammography with orbital CDUS may enable early detection and treatment of ocular vascular problems.

Regional Blood Flow Spectral Parameters as Predictors of Epidural-Related Maternal Fever: A Prospective Observational Study

Background: Epidural-related maternal fever (ERMF) is a common phenomenon that appears to be unique to laboring women and presents diagnostic and therapeutic dilemmas for anesthesiologists. It is crucial to identify and predict the occurrence of ERMF at an early stage to improve the outcomes for mothers and infants. This study evaluated the degree of sympathetic blockade induced by epidural labor analgesia (ELA) by quantifying blood flow spectral parameters using Pulsed-wave Doppler (PWD). The aim was to determine the predictive value of these parameters for the onset of ERMF. Methods: A total of 103 women who had vaginal deliveries with ELA were recruited into the study. PWD ultrasound was used to measure peak systolic velocity (PSV, cm/s) and end-diastolic velocity (EDV, cm/s) in the anterior and posterior tibial arteries. Measurements were taken 1 minute before induction of analgesia and at 5-minute intervals for the subsequent 30 minutes. The change of PSV (ΔPSV) and EDV (ΔEDV) at 30 minutes relative to baseline after induction of analgesia was calculated. Participants were categorized into two groups based on their body temperature during labor and delivery: febrile and afebrile. Generalized estimating equations were used to assess differences both between and within groups across multiple time points. The correlation between two variables was analyzed using Spearman's rank correlation coefficient. Receiver operating characteristic (ROC) curves were plotted to ascertain the cut-off values of lower extremity arterial ultrasound flow spectral parameters for predicting ERMF. Results: Of the 103 study participants, 73 were ultimately included for analysis. Thirteen participants (17.8%) in the study developed ERMF. PSV was significantly higher in the febrile group than the non-febrile group at 10 min after ELA (p &lt; 0.05). In contrast, EDV showed a significant difference between the two groups at 15 min after ELA (p &lt; 0.01). Based on linear correlation analysis, there was a positive correlation between PSV and EDV at 30 minutes after analgesia induction and the peak labor temperature (p &lt; 0.05). ROC curve analysis identified a cut-off value of 43.35 and an area under the curve (AUC) of 0.701 for ΔPSV in the anterior tibial artery region (95% confidence interval (CI) 0.525 to 0.878, p = 0.025) and a cut-off value of 29.94 and an AUC of 0.733 for ΔEDV (95% CI 0.590 to 0.877, p = 0.001). The cut-off value for ΔPSV in the region of the posterior tibial artery was 39.96 with an AUC of 0.687 (95% CI 0.514 to 0.860, p = 0.034), and the cut-off value for ΔEDV was 33.10 with an AUC of 0.713 (95% CI 0.558 to 0.869, p = 0.007). Conclusions: Regional blood flow spectral parameters after epidural analgesia induction can predict the occurrence of ERMF by indirectly reflecting the degree of sympathetic activity inhibition. Specifically, the amount of change in peak systolic velocity and end-diastolic velocity relative to baseline parameters 30 min after ELA induction was the most predictive. Clinical Trial Registration: The study has been registered in the Chinese Clinical Trial Registry https://www.chictr.org.cn/ (reference number: ChiCTR2400080507, 31/01/2024).

Blood Flow of the Infraspinatus Muscle in Individuals With and Without Shoulder Pain and Myofascial Trigger Points: A Color Doppler Ultrasound and Reliability Study.

Myofascial trigger points (MTrPs) are potential contributors to shoulder pain and can lead to local ischemia and hypoxia, thus causing pain. Color Doppler ultrasound (US) has been used to examine the vascular environment around MTrPs, but has not been used to examine blood flow impairments in patients with shoulder pain and MTrPs. The reliability of color Doppler US for measuring infraspinatus muscle blood flow also has not been established. This study aimed to investigate differences in blood flow between individuals with and without shoulder pain and the reliability of Doppler US for measuring infraspinatus muscle blood flow. Forty participants were enrolled, 20 with shoulder pain and MTrPs and 20 without. Color Doppler US examination was performed twice on each participant to measure peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index (RI), and pulsatile index (PI) of the infraspinatus muscle. The symptomatic participants had significantly higher PSV (ie, impaired blood flow) than the asymptomatic participants. There were no significant between-group differences in EDV, RI, and PI. The results also demonstrated good-to-excellent intra-rater reliability for color Doppler US measurements of PSV, EDV, RI, and PI for both groups. This study demonstrated differences in blood flow near MTrPs in the infraspinatus muscle between individuals with and without shoulder pain. It also established good-to-excellent reliability of color Doppler US in measuring infraspinatus muscle blood flow. These findings suggest color Doppler US is a useful tool to identify vascular impairments for shoulder pain associated with MTrPs.

Randomized trial of low intensity shockwave therapy for erectile dysfunction utilizing grayscale ultrasound for analysis of erectile tissue homogeneity/inhomogeneity.

Electrohydraulic shockwave devices have been Food and Drug Administration-cleared for improved blood flow and connective tissue activation and have been used to treat erectile dysfunction (ED). In this study, the main focus was to evaluate improvement in erectile tissue quality after low intensity shockwave therapy (LiSWT). A single-blind, sham-controlled, randomized, prospective study, was performed in men with ED naïve to shockwave or radial ballistic pressure wave therapy. Participants were randomized 1:2 to simulated (sham) or active LiSWT treatment. After simulated treatments, participants in the Sham Arm were converted to active LiSWT, while participants initially in the Active Treatment Arm received no further treatment. Assessments were performed at baseline and two follow-up visits. Subjective parameters of erectile function (EF) were assessed by total and EF domain scores of the International Index of Erectile Function (IIEF) and sexual encounter profile (SEP). Objective parameters of penile erection were measurements of hypoechoic areas in images obtained by grayscale ultrasound (GUS) with high resolution 15.4 MHz probe and cavernosal artery peak systolic velocity (PSV) and end diastolic velocity (EDV) by color duplex Doppler ultrasound (DUS). Outcome measures for erectile and urinary function were also obtained. Simulated LiSWT did not significantly change any assessment parameter. Sham Arm participants who converted to active LiSWT had significantly increased mean IIEF total (P=0.02) and IIEF-EF scores that approached statistical significance (P=0.06), relative to baseline. Similarly, at the end of the study, Active Treatment Arm participants had significantly increased mean IIEF total (P=0.02) and IIEF-EF scores that approached statistical significance (P=0.07), relative to baseline. Additionally, at the end of the study, SEP3 success rates (erection lasting long enough for successful intercourse) approached statistical significance when Sham Arm participants were converted to active LiSWT (P=0.08) and reached statistical significance in the Active Treatment Arm (P=0.049). GUS assessments by visual grading were significantly correlated to IIEF-EF score (P=0.002) and were significantly increased relative to baseline in the Active Treatment Arm at follow-up Assessment 1 (P=0.03) and Assessment 2 (P=0.04). The greatest reduction in hypoechoic area after LiSWT occurred in the proximal penile shaft. EDV was also significantly reduced in the Active Treatment Arm at follow-up Assessment 1 (P=0.04) and Assessment 2 (P=0.04). LiSWT also resulted in improved prostate symptom scores, approaching significance in the Active Treatment Arm (P=0.055) with no changes in prostate-specific antigen. Treatment-related adverse events were limited and transient. In this prospective trial, LiSWT was safe and efficacious for erectile symptoms using GUS imaging as a novel, non-invasive method to assess improvements in corporal veno-occlusive function. Improved veno-occlusion and reduced hypoechoic area demonstrated by GUS imaging suggest that LiSWT decreases connective tissue content in penile erectile tissue. Lower urinary tract symptoms also improved with LiSWT. NCT06600893 on clinicaltrials.gov.

Ultrasonographic Assessment of Testicular Biometry and Arterial Blood Flow in Pre- and Postpubertal Miranda Donkeys: Correlations With Semen Quality Parameters.

The main goals of this study were to document and compare the normal ranges of testicular haemodynamic parameters in pre- (aged 8-12 months; n = 4) and postpubertal (aged 24-259 months; n = 16) Miranda donkeys in the breeding season, and to correlate animal biometric data and testicular Doppler indices with basic semen quality parameters of sexually mature jacks. Colour and pulsed-Doppler ultrasonography were employed to assess blood flow in the left and right distal supratesticular artery (DsTA) and their marginal branches (marginal arteries-MA). Peak systolic velocity (PSV), end diastolic velocity (EDV), pulsatility index (PI) and resistive index (RI) were evaluated in both blood vessels, and TAMV (time-averaged mean velocity), TABF (total arterial blood flow) and TABF rate (TABF-R) were calculated for MA. The mean diameter of MA was greater (p < 0.05; 0.24 ± 0.05 vs. 0.19 ± 0.05 cm; mean ± SD) but TABF-R was less (p < 0.05; 0.004 ± 0.004 vs. 0.02 ± 0.01 mL/s/cm3) in sexually mature donkeys compared with prepubertal animals. Apart from RI values for the right testicle of prepubertal donkeys, PI and RI were consistently greater (p < 0.05) in DsTA compared with MA. Significant correlations were found among select biometric and haemodynamic attributes of the testes (height, width and length, TV, TTV and PSV-ST) and ejaculate characteristics (volume, sperm defects-total, head and midpiece) in sexually mature donkeys (n = 8). The present results highlight the importance of scrotal ultrasonography for the reproductive assessment of jacks and provide reference values, based on the available subpopulation of Miranda donkeys that can be used in their clinical and reproductive management and research, or conservation programmes.

DISCREPANCY BETWEEN PATIENT VERSUS PROVIDER ASSESSMENT OF ERECTION QUALITY

ObjectiveTo characterize the discrepancy between patients’ and providers’ assessments of erection rigidity and its association with patient characteristics and penile ultrasound parameters. MethodsPatients presenting for penile doppler ultrasound between July 2022 and October 2023 were reviewed retrospectively. After intracavernosal injection, patients and providers independently rated erection rigidity from 1 to 10 prior to ultrasound. We defined discrepancy as a difference of 2 out of 10 or greater between the two assessments. Chi-squared and Mann Whitney U tests were used for hypothesis testing. Results65/297 (22%) of patients demonstrated a discrepancy in perceived erection quality. 58/65 (89%) of these patients rated their erections lower than their providers. There was a higher incidence of ED as the primary diagnosis in the discrepant group as compared to the concordant group (p=0.01). The discrepant group also showed a higher resistive index on penile ultrasound (p=0.04), with no difference in peak systolic velocity, end diastolic velocity, or other clinical variables between the two groups. ConclusionDiscrepancy in perceived erection rigidity was mainly driven by lower patient perception, although these patients had noninferior penile hemodynamics to their peers. These findings underscore the influence of subjective perception of virility on sexual function. It is critical for clinicians to identify patients with poor perception of erectile function out of proportion to physiologic abnormalities. Thoughtful counseling about treatment goals and expectations, emphasizing functional outcomes, and adjunctive treatments such as sex therapy or psychotherapy are critical to therapeutic success in this population.

Does the resistive index of the radial artery change after arterial cannulation in patients undergoing abdominal surgery? A prospective observational study.

To evaluate the flow at the cannulation site in the radial artery, the resistive indices (RIs) before cannula insertion and 6 h after decannulation were measured (primary outcome). The secondary outcomes were measurement of the artery size by anteroposterior (AP) diameter at the insertion site, RI and AP diameter at a point 4 cm proximal and in the ipsilateral ulnar artery before insertion and 6 h after cannula removal. In 96 patients requiring an arterial line during surgery, peak systolic velocity (PSV) and end-diastolic velocity (EDV) were measured to derive RI using a linear ultrasound transducer. The RI was measured at R1 (insertion point), R2, 4 cm proximal to R1, and U1 on the ipsilateral ulnar artery. The AP diameter of the arteries at baseline R10, R20 and U10 was measured and repeated 6 h after removal of the cannula, R16, R26 and U16. RI or AP diameter in R1 or R2 did not differ pre- and post-cannulation. Mean R10 1.143 [standard deviation (SD: 0.239)] versus R16 1.181 (SD: 0.260) m/sec [mean difference (MD): -0.0372 (95% confidence interval (CI): -0.098, 0.023), P = 0.230]. Mean AP diameter at baseline versus 6 h decannulation 0.177 (SD: 0.042) versus 0.172 (SD: 0.045) cm [MD: 0.005 (95% CI: 0.003, 0.013), P = 0.222] was also similar. The mean PSV in U10 versus U16 was higher: 0.480 (SD: 0.178) versus 0.528 (SD: 0.316) m/sec [MD: 0.120 (95% CI: -0.185, -0.054), P = 0.002] and AP diameter was also higher than baseline (P = 0.001). The flow in the radial artery did not change following cannulation. The PSV and AP diameter in the ulnar artery increased after decannulation, suggesting a compensatory increase in flow.

Utility of doppler ultrasound in early-onset neonatal sepsis: A case-control study.

Early-onset sepsis is one of the leading causes of neonatal morbidity and mortality worldwide and timely diagnosis is, therefore, of paramount importance. As there is a lack of literature regarding early alteration of the cerebral blood flow (CBF) in neonatal sepsis, our study aimed to appraise changes in the CBF velocities and Doppler indices in neonates with early-onset neonatal sepsis (EONS) and to assess its diagnostic accuracy. A total of 99 neonates were recruited in the study; 56 neonates with EONS, and the age-matched 43 neonates without any manifestations of sepsis. A Transcranial Doppler examination and cerebral hemodynamics were assessed in neonates during the first seventy-two hours of life. Doppler indices and CBFV were measured in the anterior cerebral artery (ACA), and middle cerebral artery (MCA), of either side. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated. A significantly lower resistance in Resistivity (RI) and Pulsatility (PI) indices, a significant high end-diastolic velocity (EDV), and relatively higher peak systolic velocity (PSV) in both ACA and MCA have been documented within 72 hours of birth in neonates with EONS compared to the control group of neonates without sepsis. Our Study revealed that assessment of CBF at early hours of birth by Transcranial Doppler examination showed alteration in cerebral hemodynamics in neonates with EONS with an increase in the CBF and a decrease in the resistance. It can be adopted as a bedside, noninvasive tool with immediate diagnostic value.

Hemodynamic profiles in idiopathic intracranial hypertension: Doppler ultrasonography as a diagnostic tool for pulsatile tinnitus

Purpose: This study aims to evaluate the role of ophthalmic Doppler ultrasonography (USG) in differentiating IIH patients with and without bilateral PT by analyzing hemodynamic changes in the orbital vessels. Materials and Methods: A prospective, single-center, case-control study was conducted at Harran University from November 2023 to June 2024. The study included 20 IIH patients. Participants underwent clinical assessments, ophthalmic evaluations, brain imaging, lumbar puncture, and transorbital sonography. IIH patients were categorized into PT (n=8) and non-PT (n=12) groups. Doppler USG measured end-diastolic velocity (EDV), peak systolic velocity (PSV), time-averaged velocity (TAV), resistive index (RI), pulsatility index (PI), and systolic to the diastolic ratio (S/D) of the central retinal artery. Results: Significant differences were observed in left eye EDV and TAV, with lower values in the PT group. Although not statistically significant, right-eye EDV and TAV also trended lower in the PT group. Additionally, both eyes' PSV values showed a trend toward statistical significance, being lower in the PT group. ROC curve analysis identified optimal thresholds for left eye EDV (5.35; sensitivity 75%, specificity 83.33%) and TAV (9; sensitivity 50%, specificity 91.67%). Conclusion: Orbital Doppler USG reveals distinct hemodynamic profiles in IIH patients with PT, suggesting EDV and TAV as potential biomarkers. Larger cohort studies are needed to validate and clarify IIH-PT mechanisms.

Comparing Carotid Artery Velocities with Current ASCVD Risk Stratification: A Novel Approach to Simpler Risk Assessment.

To explore the potential of a novel approach to simplify risk assessment by comparing carotid artery velocities with current atherosclerotic cardiovascular disease (ASCVD) risk stratification method using nonlinear measurements. In this prospective study conducted at a medical center in southern Taiwan from January 1, 2020, to December 31, 2021, 1636 participants aged 40-75 years without prior ASCVD events were enrolled. Carotid flow velocity was obtained through duplex ultrasonography. ASCVD risk was categorized into two groups according to the 2022 USPSTF guidelines for primary prevention. We analyzed associations between flow indices and ASCVD risk using logistic regression and generalized additive models (GAMs). The end diastolic velocity (EDV) of common carotid artery (CCA) and the peak systolic velocity (PSV) of internal carotid artery (ICA) were inversely and nonlinearly associated with cardiovascular event risk. Multivariate logistic regression analysis with ROC curves revealed that the optimal speed for the EDV of CCA was approximately 23.75cm/s, and the optimal PSV and EDV of ICA were approximately 81.75cm/s and 26.75cm/s, respectively. The GAMs showed U-shaped relationships between elevated ASCVD risk and blood flow velocity in the carotid arteries, with inflection points of approximately 82cm/s in the PSV of ICA and near 25cm/s in the EDV of CCA. Both methods revealed similar results. The EDVs and PSVs of the CCA and ICA are associated with the development of cardiovascular events. Optimal velocity ranges were identified; however, further hemodynamic investigations are warranted.

Ultrasound assessment of biometric parameters of the head and brain and Doppler indices in cerebral arteries in sheep in the prenatal period

The aim of this study was to perform a biometric analysis of the head in sheep embryos/fetuses and to determine Doppler parameters in the middle cerebral artery and umbilical artery in 12 prenatal sheep. Using B-Mode ultrasound, the biparietal distance (BPD), occipital-nasal length (ONL), eye length and width, choroid plexus width, and turbinate complex width were determined. Peak systolic velocity (PSV), end diastolic velocity (EDV), PSV/EDV ratio, resistance index (RI) and pulsatility index (PI) were also determined. From the 26th to the 110th day of pregnancy, a progressive increase in BPD and ONL was observed (p<0.01 and p<0.05). The width of the choroid plexus increased until the 96th day of pregnancy (p<0.01 and p<0.05). The PSV in the MCA during the last period of pregnancy was higher than in the first period of pregnancy (p<0.05). A similar trend was noted for EDV (p<0.01). PSV/EDV, RI and PI at the end of pregnancy were the lowest. In the first period of pregnancy, EDV was higher in the MCA than in the UA (p<0.01), but in subsequent periods these differences were reversed (p<0.05, p<0.01). In the first stage of pregnancy, RI and PI in the MCA were lower than in the UA (p<0.01) but in subsequent periods of pregnancy these differences were reversed. The results indicate that several parameters that indicate changes in the heads of prenatal sheep can be detected ultrasonographically.