Sonography Research Articles

Human-AI collaboration for ultrasound diagnosis of thyroid nodules: a clinical trial.

This clinical trial examined how the articifial intelligence (AI)-based diagnostics system S-Detect for Thyroid influences the ultrasound diagnostic work-up of thyroid ultrasound (US) performed by different US users in clinical practice and how different US users influences the diagnostic accuracy of S-Detect. We conducted a clinical trial with 20 participants, including medical students, US novice physicians, and US experienced physicians. Five patients with thyroid nodules (one malignant and four benign) volunteered to undergo a thyroid US scan performed by all 20 participants using the same US systems with S-Detect installed. Participants performed a focused thyroid US on each patient case and made a nodule classification according to the European Thyroid Imaging Reporting And Data System (EU-TIRADS). They then performed a S-Detect analysis of the same nodule and were asked to re-evaluate their EU-TIRADS reporting. From the EU-TIRADS assessments by participants, we derived a biopsy recommendation outcome of whether fine needle aspiration biopsy (FNAB) was recommended. The mean diagnostic accuracy for S-Detect was 71.3% (range 40-100%) among all participants, with no significant difference between the groups (p = 0.31). The accuracy of our biopsy recommendation outcome was 69.8% before and 69.2% after AI for all participants (p = 0.75). In this trial, we did not find S-Detect to improve the thyroid diagnostic work-up in clinical practice among novice and intermediate ultrasound operators. However, the operator had a substantial impact on the AI-generated ultrasound diagnosis, with a variation in diagnostic accuracy from 40 to 100%, despite the same patients and ultrasound machines being used in the trial.

Radiological and Histopathological Insights into Primary Breast Endocrine Carcinoma: A Case Study

A 75-year-old woman with a medical history of hypothyroidism presented to the triple assessment breast clinic with a 2 weeks history of right sided breast lump, no history of pain or nipple discharge with no significant family history of breast cancer. Her clinical examination revealed 4 x 4 cm hard, nonmobile right upper outer quadrant (10 O’clock) breast mass with multiple enlarged right axillary lymph nodes. No evidence of skin or underlying muscle involvement. No nipple discharge was noted. Her radiological assessment with mammogram and ultrasound showed two supicious masses; occupying the right upper outer and central outer breast, one at 9 O’clock and the second at 11-12 O’clock (the largest), with suspicious pleomorphic microcalcification in mammogram. Multiple significant axillary lymphadenopathies are also detected. Ultrasound-guided core biopsy was performed and the histopathology was in favor of a triple negative neuroendocrine carcinoma in keeping with small cell carcinoma with axillary metastasis. An extensive work-up was done for the patient to detect distant metastasis (PET/CT scan) versus other primary tumor. Her PET scan demonstrated multicenteric breast tumor with uptake in the splenic flexure, therefore gastrocolposcopy were performed and showed adenoma with low grade dysplasia on final histopathology.The tumor was staged as cT2N2M0. The patient started on neoadjuvant chemotherapy and on further follow up the tumor size had regressed completely, and the patient will be scheduled for surgery upon finishing her chemotherapy.

Prevention of infectious complications after transrectal ultrasound-guided prostate biopsy: comparison of povidone-iodine, chlorhexidine, and formalin disinfection

PurposeWe aimed to compare the efficacy of three different antiseptic methods to determine the most effective prophylactic approach to prevent infectious complications after transrectal ultrasound-guided prostate biopsy (TRUS-PB). The methods evaluated were transrectal povidone-iodine injection (TRPI), biopsy needle disinfection with chlorhexidine, and biopsy needle disinfection with formalin.MethodsBetween January 2018 and January 2023, 904 patients who underwent TRUS-PB were retrospectively analyzed. All patients had prophylactic antibiotic use and negative urine/rectal culture results. Patients were divided into three groups according to the antiseptic protocol: Group 1 (n = 245) received only TRPI injection into the rectum before biopsy, Group 2 (n = 295) received only chlorhexidine needle disinfection before biopsy, and Group 3 (n = 364) received only formalin needle disinfection before biopsy. The biopsy needles used in our clinic are not single-use and are used on other patients after sterilization. The primary endpoint was the incidence of infectious complications within 30 days post-procedure. Continuous variables were analyzed using the Mann-Whitney U test, while categorical variables were analyzed using the Chi-square test, and post-hoc analysis was applied for pairwise comparisons between groups. Univariate and multivariate logistic regression analysis was performed to evaluate factors associated with postoperative infection.ResultsThe overall infection rate was 20.4%. Infection rates were 4.5% in the TRPI group, 16.6% in the chlorhexidine group, and 34.1% in the formalin group (p < 0.001). The TRPI group showed significantly lower rates of all infectious complications compared to other groups. Disinfection of biopsy needles with chlorhexidine was found to be significantly more effective in preventing infectious complications compared to disinfection with formalin (p < 0.001).ConclusionTRPI injection before TRUS-PB appears to be more effective in preventing post-biopsy infectious complications compared to needle disinfection with chlorhexidine or formalin. This method may be considered as a preferred antiseptic approach for TRUS-PB procedures.

Pediatric endoscopic ultrasound-guided liver biopsy: 3-year experience.

Liver biopsy is the gold standard for diagnosing and staging liver diseases. Endoscopic ultrasound-guided liver biopsy (EUS-LB) has been reported in adults with equivalent or better safety profiles than percutaneous liver biopsies. The aim of this study was to retrospectively assess the safety and efficacy of EUS-LB in pediatric patients. This was a retrospective chart review of consecutive pediatric patients undergoing EUS-LB at Cincinnati Children's Hospital Medical Center from March 2020 to April 2023. Patients ≤21 years old were included. EUS-LB was performed via fine-needle biopsy technique with transduodenal and/or transgastric approach. Histology was independently reviewed by one of two expert pathologists, including length (cm) and complete portal tract (CPT) number per the American Association for the Study of Liver Diseases (AASLD) adequacy criteria. Demographics, clinical data, technical information, diagnostic success, and adverse events were recorded. Eighty-three patients were included in the analysis, with various indications that required liver biopsy. All biopsies achieved diagnostic and technical success, with 77 (93%) meeting both AASLD criteria for adequacy. Most patients (57, 69%) underwent biopsy of both hepatic lobes, with an overall median of two needle passes. Total specimen length was a median of 7.9 cm (interquartile range [IQR] 5.2-10.3), and the median maximum intact specimen was 4.2 cm (IQR 3.1-5.4). The median CPT number was 24 (IQR 17-32) per patient. Four mild adverse events (5%) occurred; none involved bleeding. EUS-LB was well tolerated and yielded samples that were technically and diagnostically successful in a pediatric population, with comparable safety to percutaneous liver biopsy.

Diagnostic and safety value of ultrasound-guided transthoracic core needle biopsy for mediastinal masses: a single-center experience.

US-guided (Ultrasound-guided) percutaneous transthoracic core needle biopsy (CNB) is a favorable method for establishing the correct diagnosis of mediastinal masses. However, studies in this area are scant and often include small samples, thus making it difficult to provide robust evidence regarding the safety and efficacy of this procedure. Thus, we aimed to report on the 20 years of experience at our center with regard to US-guided CNB.We included all consecutive patients referred to our center to undergo US-guided percutaneous transthoracic CNB for a mediastinal mass between 1999 and 2022. Descriptive statistics were used to display data. A multivariate logistic regression analysis was used to inquire about predictors of diagnostic sampling.The final cohort included 140 patients with a median age of 37 years. In 20.7% of the cases, the mediastinal mass was an incidental finding. The parasternal approach was used most often. US-guided CNB was diagnostic in 84.3% of the patients and most of the diagnoses included hematological neoplasms. The reasons for non-diagnostic sampling included firm lesion consistency, low quantity of samples, and lesion necrosis. The parasternal approach resulted in an independent predictor of diagnostic sampling (AOR 4.16, 95% CI 1.14-15.23, p=0.031), while a bulky feature revealed only a trend for diagnostic sampling. One non-severe adverse event occurred, with spontaneous resolution.US-guided percutaneous transthoracic CNB is an effective and safe procedure that allows the diagnosis of mediastinal masses. The identification of patients that could benefit from this technique should be the next step in researching this topic.

Current Status of Prostate Biopsy in Africa: Are We Ready for a Targeted Biopsy?

Prostate cancer remains a significant public health issue globally, with considerable disparities in diagnostic and management practices, especially in Africa. Traditional diagnostic methods such as transrectal ultrasound-guided biopsies have limitations in accuracy and are associated with potential complications. Emerging targeted biopsy techniques promise improved cancer detection rates and reduced morbidity but face adoption challenges across the African continent due to variable access to advanced imaging technologies and professional expertise. This study aims to evaluate the current practices of prostate biopsy techniques in Africa, focusing particularly on the readiness for and integration of targeted biopsy methods. It assesses the accessibility, quality, volume of procedures, and availability of advanced diagnostic tools across different regions. The survey included 58 centers across five African regions, representing a 70% response rate from an initial 83 invitations sent. Finger-guided biopsy was the most common method, used by 41 centers, while only one center reported using MRI fusion biopsy. Thirty-five centers routinely administered a rectal enema, and nearly all (n = 50) centers employed antibiotic prophylaxis, predominantly fluoroquinolones. For anesthesia, 12 centers used injectable lidocaine, and 38 centers used intrarectal lidocaine gel. The number of biopsy cores taken varied, with most centers taking 12, while others used fewer. The findings indicate a critical need for concerted efforts to bridge the gap in prostate cancer diagnostics and treatment in Africa. Enhancing the quality of prostate cancer care on the continent requires investments in training, infrastructure, and standardization of practices. Collaborative efforts towards adopting advanced diagnostic tools and methods are essential for aligning African practices with global standards, ultimately improving outcomes for prostate cancer patients.

Association of Quadratus Lumborum Muscle Stiffness with Chronic Low Back Pain Features: An Observational Study

Background and Objectives: Low back pain (LBP) is highly prevalent and often associated with altered muscle function, including in the quadratus lumborum (QL) muscle. While some studies have highlighted the clinical relevance of QL muscle stiffness in LBP, the findings remain inconsistent, and the role of this parameter in relation to clinical severity indicators is not well understood. Considering the high prevalence of myofascial trigger points among patients, objectively and reliably quantifying QL stiffness and its association with other clinical parameters could improve the identification of early stages of the condition before other alterations become apparent. Therefore, this study aimed to explore the association between QL stiffness and multiple indicators of LBP severity. Materials and Methods: A cross-sectional observational study was conducted involving the participation of seventy-six patients suffering from chronic LBP. An ultrasound scanner with shear-wave elastography (SWE) was used to determine the participants’ QL stiffness. Additional information was collected on LBP-associated pain intensity, disability, central sensitization, and quality of life. Results: QL muscle stiffness was negatively correlated with pain intensity (p &lt; 0.01) and central sensitization (p &lt; 0.01), and it was positively correlated with physical quality of life (p &lt; 0.01). Muscle stiffness influenced the variance in pain intensity along with physical quality of life, central sensitization, and chronicity (together explaining 49% of the variance) but did not explain the variance in central sensitization. Conclusions: Assessing QL muscle stiffness in patients with LBP is recommended, as greater muscle softness is linked to higher pain intensity, central sensitization, and poorer physical quality of life. Regression analyses further highlighted that QL stiffness helps explain the variance in pain intensity, physical quality of life, central sensitization, and chronicity, but it did not directly affect the central sensitization variance.

Automatic Identification of Fetal Abdominal Planes from Ultrasound Images Based on Deep Learning.

Fetal biometric assessments through ultrasound diagnostics are integral in obstetrics and gynecology, requiring considerable time investment. This study aimed to explore the potential of artificial intelligence (AI) architectures in automatically identifying fetal abdominal standard scanning planes and structures, particularly focusing on the abdominal circumference. Ultrasound images from a prospective cohort study were preprocessed using CV2 and Keras-OCR to eliminate textual elements and artifacts. Optical character recognition detected and removed textual components, followed by inpainting using adjacent pixels. Six deep learning neural networks, Xception and MobileNetV3Large, were employed to categorize fetal abdominal view planes. The dataset included nine classes, and the models were evaluated through a tenfold cross-validation cycle. The MobileNet3Large and EfficientV2S achieved accuracy rates of 79.89% and 79.19%, respectively. Data screening confirmed non-normal distribution, but the central limit theorem was applied for statistical analysis. ANOVA test revealed statistically significant differences between the models, while Tukey's post hoc tests showed no difference between MobileNet3Large and EfficientV2S, while outperforming the other networks. AI, specifically MobileNet3Large and EfficientV2S, demonstrated promise in identifying fetal abdominal view planes, showcasing potential benefits for prenatal ultrasound diagnostics. Further studies should compare these AI models with established methods for automatic abdominal circumference measurement to assess overall performance.

Case report: Primary cardiac synovial sarcoma with suspected connective tissue disease diagnosed by EBUS-TBMB

Primary cardiac synovial sarcoma (PCSS) most commonly originates in the right atrium of the heart and is exceptionally rare. Although biomarkers of autoimmune diseases, such as antinuclear antibodies (ANAs), have been reported as potential indicators of certain tumors, the association between PCSS and ANAs remains unclear. Herein, we describe a case of pleural effusion that was initially considered to be due to connective tissue disease (CTD) but was finally diagnosed as PCSS through endobronchial ultrasound-guided transbronchial mediastinum biopsy (EBUS-TBMB). Clinicians need to update their knowledge regarding the potential association between PCSS and ANAs. This case report also emphasizes the importance of EBUS-TBMB, under the guidance of positron emission tomography/computed tomography (PET/CT), in the diagnosis of this rare tumor in an unusual location.

Preliminary ultrasonography study of the pancreas in the dromedary camel (Camelus dromedarius)

IntroductionPancreatic lesions in camels can lead to significant economic losses. They are practically undetectable, as clinical signs alone are insufficient for specific diagnosis. Ultrasonography is a valuable diagnostic tool for evaluating the pancreas. However, ultrasonographic reference patterns of the pancreas in the camel are yet to be established. This study aimed to define the ultrasonographic appearance, reference values, location, and acoustic window for evaluating the pancreas in healthy camels.MethodsEight adult and 14 young Moroccan camels were investigated by ultrasonography using a micro-convex probe with SIUI CTS-900 V and Samsung MH70A Doppler ultrasound scanners at 3.5 MHz.ResultsThe body of the pancreas was scanned just below the right kidney, behind the 12th rib; an ultrasonographic pattern of pancreatic parenchyma appeared as a hyperechoic elongated band, including the portal vein, with a Doppler flow response. The average thickness of the body was 3.60 ± 0.24 cm (n = 14) in young camels significantly lower than in adult camels 4.61 ± 0.26 cm (n = 8). The right lobe was scanned on the right side, adjacent to the duodenal ampulla and abomasum, beneath the liver along the 11th, 10th, and 9th intercostal spaces. The ultrasonographic pattern of parenchyma appeared as a hyperechoic triangle compared to the liver, including portal and duodenal-pancreatic veins, showing a Doppler flow response. The corresponding parenchyma thickness within the three intercostal spaces was 3.93 ± 0.33 cm, 4.40 ± 0.20 cm, and 3.46 ± 0.39 cm in the young camels (n = 14), and 4.99 ± 0.46 cm, 5.90 ± 0.27 cm, and 4.11 ± 0.68 cm in the adults (n = 8), respectively. The pancreatic major duct was seen as an anechoic circle with a hyperechoic wall, with a maximum diameter of 1 cm, and the left lobe scanned beneath the cranial extremity of the spleen; its ultrasonographic pattern showed an irregular hypoechoic band with a mean thickness of 2.32 ± 0.32 cm (n = 14) in young camels and 3.08 ± 0.52 cm (n = 8) in the adults, including a small splenic vein.ConclusionUltrasonography combined with Doppler techniques provides valuable information on pancreatic health, blood flow, and tissue perfusion, aiding early detection of pancreatic diseases and, consequently, minimizing economic losses in camel husbandry.

Recurrent Borderline Ovarian Tumors in the Adolescent Population: Case Report

Background and Clinical Significance: Borderline ovarian tumors (BOTs) are a rare diagnosis, especially in the adolescent population. This can make initial management and surveillance strategies difficult, given the limited guidelines and experience in this young age group. Case Presentation: We present two cases of recurrent serous BOTs diagnosed in adolescent patients. Both patients were initially treated with fertility-sparing surgery and followed with transabdominal pelvic ultrasounds. Secondary surgical debulking of recurrent disease with uterine preservation was successful in both patients with a long-term disease-free status. Conclusions: Although rare, BOTs can occur in adolescent patients and should be on the differential for ovarian masses in this age group. Fertility-sparing surgical techniques, reproductive endocrinology consultation, surveillance strategies, and hormone replacement therapy should all be taken into consideration when treating adolescent patients with BOTs.

Development of a Pediatric Age-Based and Weight-Adjusted Nomogram for Bladder Volumes Associated With Successful Completion of Transabdominal Pelvic Ultrasound (TPU).

To develop a nomogram for pediatric bladder volumes associated with the successful completion of transabdominal pelvic ultrasound (TPU) in female pediatric patients presenting with lower abdominal and/or pelvic pain in the emergency department. This study hypothesizes that the target bladder volumes for successful TPU vary by age and weight. We retrospectively calculated bladder volumes on all successful transabdominal pelvic ultrasound studies during a 2-year period for patients 8 to 18 years old by ellipsoid bladder volume formula using the largest cross-sectional areas captured on transverse and longitudinal cine clips. Measurements were collected by 2 study personnel with initial measurements validated by a pediatric radiologist. Bladder volume by age and weight percentile groups were descriptively analyzed, and a quantile regression model was used to regress bladder volume on age adjusting for patient weight. We analyzed bladder volumes from 1030 successful transabdominal pelvic ultrasound studies. The greatest drop in median volume was seen amongst non-overweight children in younger age groups. Nomogram bladder volumes for transabdominal pelvic ultrasound increase consistently with age and weight until approximately 13 years old and 60kg, respectively, with minimal change thereafter in patients 13 to 18 years old. We provide a pediatric age-based and weight-adjusted nomogram for bladder volumes associated with successful transabdominal pelvic ultrasound imaging. Further evaluation of its use is warranted to decrease inefficiency in bladder filling prior to TPU completion and improve timeliness in diagnosing pelvic emergencies.

Point-of-Care Ultrasound Diagnosis of Restrictive Cardiomyopathy in a 3-Year-Old Patient.

Restrictive cardiomyopathy is a rare form of cardiomyopathy in children, representing only 2.5%-3% of all pediatric cardiomyopathies, and is typically diagnosed between the ages of 6 and 10. The underlying etiology varies depending on age and region; however, idiopathic, genetic, and endomyocardial fibrosis are among the most common. Cohort studies have demonstrated mortality as high as 50% within 2 years of diagnosis, as well as high rates of adverse events including thromboembolism, pulmonary hypertension, and sudden cardiac death. There is a paucity of literature on point-of-care ultrasound (POCUS) for the diagnosis of pediatric restrictive cardiomyopathy. We present a case of a 3-year-old female whose diagnosis of heart failure was rapidly identified via POCUS which subsequently expedited life-saving treatment.

Ultrasound diagnosis and surgical treatment of rare lumbar renal hernia in a domestic cat (Felis catus)

AbstractLumbar hernias are infrequent occurrences in human surgical practices, with sparse reports in veterinary literature. This paper presents a rare case of lumbar renal hernia. A 4‐month‐old mixed‐breed domestic cat was evaluated, showing increased volume just behind the 13th rib, which was reducible, rounded and painless. A targeted ultrasound examination revealed the protrusion of the left kidney into the subcutaneous tissue and an abdominal wall defect measuring approximately 2.7 cm. The patient underwent surgical intervention to correct the abdominal musculature defect by suturing the defect's edges. After 130 days of operation, the patient was discharged with no signs of recurrence. This report contributes to the limited number of cases of lumbar renal hernia described in the literature and seeks to assist the scientific community in managing similar cases of lumbar renal hernias.

Ultrasound Super-Resolution Imaging of Neonatal Cerebral Vascular Reorganization.

During the first days of neonatal growth, the central nervous system (CNS) develops self-regulatory mechanisms to ensure constant cerebral perfusion. However, this vascular neogenesis takes place at a microscopic scale that cannot be observed with current clinical imaging techniques. Ultrasound localization microscopy (ULM) allows us to observe micro-vessels of the order of a few microns at depths of several centimeters. This can be done using conventional clinical ultrasound scanners and contrast sequences (CEUS). In this study, ULM is used to observe the human microvasculature in neonatal patients undergoing treatment for life-threatening malformations forming direct connections between the cerebral arterial and venous systems. It is observed that neuroendovascular treatment of neonatal arteriovenous malformations causes remodeling and reorganization of the cerebral vasculature by also activating corticomedullary vascular connections. ULM enables us to follow microvascular changes in human neonates with high spatio-temporal resolution. ULM may provide a novel clinical translatable tool, particularly including cerebral imaging in very young patients.

Feasibility of remote robot empowered teleultrasound scanning for radioactive patients

To investigate the feasibility of robot-assisted teleultrasound diagnosis for radioactive patients compared with conventional ultrasound diagnosis. In this prospective study (ChineseClinicalTrials.gov identifier, ChiCTR2200057253), 32 radioactive patients were examined by conventional ultrasound and MGIUS-R3 robot-assisted ultrasound from March 2022 to June 2022. After two scans, patients completed a satisfaction survey, including comfort score, fear score, tension score and pain score. The durations of both scans were recorded, and sonographers wore lead apron to prevent the radiation during the conventional examination. Subsequently, the ultrasonic images saved by sonographers were diagnosed and scored. Finally, we evaluated the feasibility of the robot-assisted teleultrasound diagnosis system regarding patients’ satisfaction, examination duration, image quality and diagnostic consistency via χ2 test, Kappa consistency test and Wilcoxon signed-rank test. Among 32 patients (mean age, 54.9 ± 9.8 [SD]; 16 women), 29 had consistent diagnoses and 3 had inconsistent diagnoses between two scans, but the diagnostic consistency was good (Kappa = 0.818, P < 0.001). In addition, there was no statistical difference between two scans with regard to image quality score (29.28 ± 0.47vs29.31 ± 0.44, P = 0.97), comfort score (10vs10, P > 0.99), tension score (0vs0, P > 0.99) and fear score (0.09vs0, P = 0.32). Although 7 patients felt slightly painful during teleultrasound scan, the pain intensity was acceptable (0.31vs0, P = 0.02). The mean duration of teleultrasound examinations was 11.1 min (6–24 min), which was longer than 5.9 min (2–17 min) of conventional examinations (P < 0.001). Comparing robot-assisted teleultrasound and conventional ultrasound, there was no evidence of differences regarding patients’ satisfaction and image quality, and the diagnostic consistency was remarkable.

Predictive Value of Lung Ultrasound Combined With ACEF Score for the Prognosis of Acute Myocardial Infarction.

Lung ultrasound (LUS) and the ACEF score (age, creatinine, and ejection fraction) have been shown to be pivotal in predicting an unfavorable prognosis in acute myocardial infarction (AMI). The aim of this study is to investigate the prognostic value of LUS combined with ACEF score in AMI. The ACEF score and the total number of B-lines in eight thoracic regions of LUS were calculated. Adverse events were recorded during hospitalization and follow-up, defined as all-cause death and other cardiovascular events. Multivariate logistic regression identified predictors of adverse events during hospitalization. Multivariate Cox regression identified predictors of adverse events during follow-up. We enrolled 204 patients. The B-lines (adjusted OR 1.08, [95% CI: 1.03-1.13], p < 0.01) and the ACEF score (adjusted OR 2.71 [95% CI: 1.07-6.81], p < 0.05) independently predicted adverse events during hospitalization. The C-index values were 0.81 (p < 0.01) for the ACEF score, 0.81 (p < 0.01) for LUS, and 0.86 (p < 0.01) for their combination. One hundred seventy-one patients were followed up for 12 months (IQR, 8.13-15.93). Both the B-lines (adjusted HR 1.06 [95% CI: 1.03-1.09], p < 0.05) and the ACEF score (adjusted HR 1.95 [95% CI: 1.10-3.43], p < 0.05) remained associated with an increased risk of adverse events during follow-up. The C-index values were 0.74 (p < 0.01) for the ACEF score, 0.73 (p < 0.01) for LUS, and 0.80 (p < 0.01) for their combined predictive ability. The B-lines and ACEF score are associated with adverse events in AMI patients. When combined, they provide increasing value in assessing the risk of adverse events, which has significant implications for risk stratification.

Criteria for choosing a method for treating trichobezoar in the stomach of decorative rabbits

Trichobezoars are hairballs that form in the stomach. Trichobezoar is a common pathology in decorative rabbits, without proper treatment, leading to the death of the animal. There are a number of opinions on the choice of treatment for this disease. Our research was to study and analyze clinical cases with a diagnosis of trichobezoar of decorative rabbits (n-15) to determine the criteria that help to choose a treatment method or conservative or surgical. This article reflects the importance of obtaining a complete anamnesis, the main clinical symptoms observed during a general examination, dental diseases that could also cause trichobezoar formation are identified, the need for hematological and biochemical analysis to assess the general condition of animals and exclude the causes of other non-specific clinical symptoms is considered. Additional research methods of ultrasound and X-ray diagnostics are used. Significant changes were noted towards an increase in ALT 96-144 U/L, urea 6.9-23.5 mmol/L, leukocytes 14-98 10*9 μl/L and a decrease in these indicators after infusion therapy - ALT 73.1-102.93 U/L, urea 5.2-11.3 mmol/L, leukocytes 9.2-89 10*9 μl/L, the need for infusion therapy was confirmed. Conservative drug treatment was performed in rabbits (n-7), surgical treatment in the volume of gastrotomy in rabbits (n-8). In each group, 2 deaths were observed due to the severe condition of the animals at the time of treatment. In the course of the work, the significance of the results of hematological studies, the use of ultrasound and X-ray diagnostics, their priority, the need to monitor the condition of rabbits for two weeks after the treatment were determined. Criteria were identified that can be used to select a method of treating this disease - conservative or surgical. The prognosis of the outcome of any selected treatment method is the general condition of the rabbit at the time of its initiation. The importance of aspects constituting the prevention of trichobezoar was noted.

Isepamicin alone as antimicrobial prophylaxis for transrectal prostate needle biopsy: " Do we still need levofloxacin? ".

The purpose of this study was to investigate whether conventional levofloxacin (LVFX) administration is unnecessary for transrectal ultrasound-guided prostate needle biopsy (TRP-Bx) in view of the increase in LVFX-resistant Escherichia coli and appropriate use of antibiotics. The study included 636 cases undergoing TRP-Bx, divided into two groups based on the prophylactic antibiotic regimen. Group 1 (n = 308) received both oral levofloxacin (LVFX) 500 mg and intravenous isepamicin (ISP) 400 mg. Group 2 (n = 328) received only intravenous ISP 400 mg. Biopsies involved sampling 12 cores using an 18G needle. A high-risk subgroup included patients with a large prostate (> 75 ml), severe dysuria, diabetes mellitus, or steroid use. Significantly more high-risk cases were in Group 2 than in Group 1 (35.7% vs. 24.4%, p = 0.003). Febrile genitourinary tract infections (fGUTIs) occurred in three patients (0.5%), with no significant difference between the groups (0.3% in Group 1 vs. 0.6% in Group 2). No fGUTI complications were noted among high-risk cases in either group. Of the fGUTI cases, one involved LVFX-resistant E. coli; another involved E. coli susceptible to both LVFX and amikacin, isolated from blood. The single- and short-duration intravenous dose of ISP 400 mg would appear to be one of possible options in preventing TRP-Bx-related fGUTIs in both low-risk and high-risk patients.

Combining pelvic floor ultrasonography with deep learning to diagnose anterior compartment organ prolapse

Combining pelvic floor ultrasonography with deep learning to diagnose anterior compartment organ prolapse