Resistance Index Values Research Articles

Assessment of the Microbial Quality of Braised Products from Bangangte City and Antibiotic Susceptibility of Selected Pathogens Isolated Therein

The present study had as objective to assess the microbiological quality and profile of some braised products and their accompanying soups sold in the city of Bangangte (Cameroon) and evaluate the antibiotic susceptibility of selected pathogens isolated in these products. An investigation was conducted in three locations in city of Bangangte in order to assess the environment and working conditions as well as the respect of good hygiene practices. Then, samples of braised fish (05) and its soups (05), and braised chicken (05) and its soups (05) were collected from six vendors in each location. The samples (360) were submitted to microbiological analyses and the isolates were identified at species level using API gallery. The susceptibility of the isolates to 14 antibiotics were tested. The 72 participants involved in this study declared having knowledge on hygiene despite the fact that, most of them had no formal education and do not apply good hygiene practices. Microbiological analyses revealed the poor quality of all the samples of braised products. Fecal coliforms and staphylococci counts higher than the values recommended by norms demonstrated the non-respect of good hygiene and manufacturing practices during the braising activity. The 169 strains isolated from these products belonged to 12 different species: Enterobacter gergoviae, Enterobacter spp., Morganella morganiae, Yersinia enterolitica, Yersinia frederiksenii, Staphylococcus aureus, Staphylococcus epidermitidis, Staphylococcus spp., Clostridium spp., Klebsiella pneumoniae, Enterobacter aerogene, and Proteus mirabilis. Strains which could be considered as marker of braised fish sold in the city of Bangangte were Yersinia enterolitica, Staphylococcus aureus and Klebsiella pneumonia while for braised chicken, they were Yersinia enterolitica, Staphylococcus aureus and Proteus mirabilis. The antibiotic susceptibility test performed on these pathogens revealed that they were resistant with 93.75% having multiple antibiotic resistance index values greater than 0.2. We conclude that the microbiological quality of braised products is poor and we suggest to producers to applicate the good hygiene practices. For breeders, we suggest respecting withdrawal periods and the better use of antibiotics.

The penile duplex ultrasound: How and when to perform it?

Because it is a superficial structure, the penis is ideally suited to ultrasound imaging. A number of disease processes, including Peyronie's disease, penile fractures and tumors, are clearly visualized with ultrasound. Baseline and dynamic assessment of cavernosal arterial changes after pharmaco-stimulation with alprostadil allows standardized diagnosis of arterial and venogenic causes of erectile dysfunction (ED). To illustrate how to correctly perform flaccid and dynamic penile duplex ultrasound (D-PDU) and in which patients to recommend it. An extensive search of the literature was carried out on Pubmed with the insertion of the following Medical Subjects Headings (MeSH) terms and keywords "penile color Doppler ultrasound" "peak systolic velocity" "end-diastolic velocity", "acceleration time", "resistance index". In our experience, arterial erectile dysfunction is identified after standardized intracavernous injection (ICI) of alprostadil (10mcg) when values of peak systolic velocity (PSV) are <35cm/s and, in the most severe forms, for values <25cm/s. Arterial insufficiency can also be identified by increased acceleration time (AT) values (>110ms) and/or by a lack of visualization of helicine arteries at power Doppler mode along with incomplete achievement of penile rigidity. The veno-occlusive incompetence is determined when end-diastolic velocity (EDV) values are >4.5-5cm/s or in the case of resistance index (RI) values <0.75. The assessment of additional surrogate markers of endothelial dysfunction, that is, intima-media thickness, mean platelet volume (MPV), endothelial progenitor cells (EPC), endothelial cell specific molecule-1(endocan) are also useful in assessing the patient's cardiovascular risk but are still considered investigational in the interpretation of D-PDU results. D-PDU scan after ICI with vasoactive drugs is a safe procedure and represents the gold standard for the diagnostics of penile pathologies and should be performed in men with ED not responding to oral conventional therapies and/or in those requiring accurate stratification of cardiovascular risk.

Renal Resistive Index as A Potential Indicator of Acute Kidney Injury in Horses

Reliable and simple tests are constantly being sought to enable the quick detection of acute kidney injury in humans and animals. Diagnosis of subclinical AKI in horses, mainly in field practice, is difficult. An ultrasound scan is a routine test performed when kidney disease is suspected. The aim of the study was to establish the value of the renal resistive index (RRI) in intrarenal arteries in horses with clinical AKI and compare it to that of healthy horses. The second goal was to determine whether potentially nephrotoxic agents can influence RRI. The kidney ultrasonography examination was performed in 30 healthy horses, 11 horses with AKI and 30 horses at risk for AKI (10 colic horses, 10 horses receiving gentamicin and 10 horses receiving NSAIDs). RRI values were measured using pulsed-wave Doppler. Differences in RRI between groups were observed only in the right kidney. Horses with AKI had significantly higher RRI values compared to healthy horses. In the risk group, there was no effect of potentially nephrotoxic agents on the RRI value. RRI value in horses seem to be lower than in other species. The increase in this parameter in horses with AKI affected only one kidney and these values did not reach values obtained in other species. The clinical application of this method in non-cooperating animals remains questionable, and therefore RRI Doppler ultrasonography of blood flow in the intrarenal arteries may have poor clinical utility as a diagnostic tool in the diagnosis of AKI in horses.

Importance of Increased Arterial Resistance in Risk Prediction in Patients with Cardiovascular Risk Factors and Degenerative Aortic Stenosis.

Background: Cardiovascular disease is a leading cause of heart failure (HF) and major adverse cardiac and cerebral events (MACCE). Objective: To evaluate impact of vascular resistance on HF and MACCE incidence in subjects with cardiovascular risk factors (CRF) and degenerative aortic valve stenosis (DAS). Methods: From January 2016 to December 2018, in 404 patients with cardiovascular disease, including 267 patients with moderate-to-severe DAS and 137 patients with CRF, mean values of resistive index (RI) and pulsatile index (PI) were obtained from carotid and vertebral arteries. Patients were followed-up for 2.5 years, for primary outcome of HF and MACCE episodes. Results: RI and PI values in patients with DAS compared to CRF were significantly higher, with optimal cut-offs discriminating arterial resistance of ≥0.7 for RI (sensitivity: 80.5%, specificity: 78.8%) and ≥1.3 for PI (sensitivity: 81.3%, specificity: 79.6%). Age, female gender, diabetes, and DAS were all independently associated with increased resistance. During the follow-up period, 68 (16.8%) episodes of HF-MACCE occurred. High RI (odds ratio 1.25, 95% CI 1.13–1.37) and PI (odds ratio 1.21, 95% CI 1.10–1.34) were associated with risk of HF-MACCE. Conclusions: An accurate assessment of vascular resistance may be used for HF-MACCE risk stratification in patients with DAS.

Impact of a Magnesium Sulfate Loading Dose on Fetal Umbilical Artery Doppler Parameters in Women with Severe Preeclampsia

Background:Preeclampsia isthe most significant reason of maternal mortality throughout the world, as well asgolden way to perinatal mortality and morbidity, affecting 2–8% of pregnancies.Objective:To see how magnesium sulfate affects fetal umbilical artery Doppler changesin women suffering from extreme preeclampsia.Methods: It is interventional (experimental) non-randomized study wascarried out in the department of gynecology of the al-hussein university hospital according to sample size.50 women in this study weredrawn from the emergency department and the Obstetrics outpatient clinic. Between April 2020 and January 2021, they were all diagnosed with extreme preeclampsia.Results:The treatment of magnesium sulfate to pregnant women having serious preeclampsia and eclampsiaminimize umbilical artery Doppler velocimetry indices by a statistically significant amount. In terms of different Doppler parameters, there was a considerable difference in the study group's umbilical artery Doppler parameters before and after magnesium sulfate treatment (mean values of Resistance Index, PulsatilityIndex, and Systolic/Diastolic ratio in the study group). The conclusion:to diagnose complications and evaluate fetal well-being in pregnant women suffering preeclampsia, clinical examinations should be backed up and verified by laboratory tests and ultrasonography. Doppler flow tests should be included in the sonographic review since they can help predict preeclampsia and determine fetal condition.

Evaluation of the relationship between shear wave elastography measurements with laboratory and Doppler US parameters in patients with adult Hashimoto’s thyroiditis

Background/aimHashimoto thyroiditis (HT) is an autoimmune disease that leads to tissue stiffening secondary to lymphocyte infiltration of the thyroid gland. Gray-scale ultrasound (US) is widely used in its diagnosis. Numerous studies have been conducted comparing elastography findings of HT with tissue stiffness and immunoreactivity levels. This study aims to reveal the relationship between shear wave elastography (SWE) and Doppler parameters in patients with HT.Materials and methodsThe study group consisted of 45 patients diagnosed with HT, and 20 control patients without thyroid pathology. Thyroid-stimulating hormone (TSH) and antithyroid peroxidase (TPO) values were examined in patients with HT. Thyroid gland volume and echo patterns were evaluated in the gray-scale US. Doppler measurements –peak systolic velocity (Vmax), end-diastolic velocity (Vmin), pulsatility index (PI), resistivity index (RI)– from the superior thyroidal artery and SWE measurements were taken from both thyroid lobes. ResultsThe mean age of men and women in the HT group was 44.8 and 43.4 years. The mean TSH value (normal value: 0.3–4.2 uIU/mL) was 3.90 ± 6.6 uIU/mL, and the anti-TPO value (normal value: < 35 IU/mL) was 235.47 ± 271.12 IU/mL. The average thyroid gland volume was 10.12 ± 2.71 mL in the HT group and 6.62 ± 2.11 mL in the control group (P = 0.034). HT group mean Vmax, mean Vmin, mean PI and RI values were significantly lower compared to normal subjects (P = 0.022, P = 0.026, P = 0.042, P = 0.046, respectively). The average SWE value of the thyroid gland was 24.56 ± 18.04 kPa in the experimental group and 7.34 ± 3.54 (P < 0.05) in the control group.ConclusionA positive correlation was found between PI and RI values and elastography values. An increase in SWE and decreases in Vmax and Vmin were found as high diagnostic value for HT.

Renal Doppler indices and their correlation with laboratory indices of human immunodeficiency virus sero-positive adult individuals

IntroductionRenal Doppler resistive index (RI) and pulsatility index (PI) values are potentially more sensitive at detecting renal abnormalities when compared to standard laboratory indices in patients with HIV/AIDS. To the best of our knowledge, there are no published research articles on renal Doppler indices and their correlation with laboratory indices of HIV sero-positive adult individuals. This study aimed to assess the renal function of HIV-sero-positive adults using RI and PI, and correlating these indices against laboratory values. MethodsA prospective cross-sectional study was conducted from July 2019 to April 2020. A purposive sampling method was employed and included 396 HIV sero-positive adult individuals. Sampling for the renal RI and PI was performed at the level of the inter-lober arteries, in between the medullary pyramids. An RI value above 0.70 and a PI value above 1.56 were consider abnormal. Serum creatine and urea together with evidence of proteinuria were recorded at the time of scanning. ResultsForty-three (10.9%) men had an abnormal RI, 32 (8.1%) had abnormal PI, five (2.5%) had abnormal creatinine, two (1%) abnormal urea and eight (4.1%) with proteinuria. In women, 29 (7.3%) had abnormal RI, 22 (5.6%) abnormal PI, four (2%) abnormal creatinine and urea and six (3%) had proteinuria. There was a statistically significant weak positive correlation between RI and PI and serum creatinine and urea (r > 0.2, P < 0.05). ConclusionThe proportion of patients with abnormal RI and PI was higher than the proportion of participants with abnormal serum urea, creatinine and proteinuria. Renal Doppler indices could be used be used in the early assessment of renal function in HIV sero-positive adults individuals. Implications for practiceSerum creatinine and urea are routinely used to evaluate renal function in patients with HIV/AIDS. Findings from this initial study show that RI and PI could be used detecting early renal abnormalities when compared to standard laboratory values.

Virulotyping and genetic diversity of Aeromonas hydrophila isolated from Nile tilapia (Oreochromis niloticus) in aquaculture farms in Egypt

This study focused on the genotyping of Aeromonas hydrophila isolated from diseased Nile tilapia, virulence genes, and their relation with motile aeromonad septicemia (MAS) clinical signs, and the resistance profiles of the recovered isolates to the frequently used antimicrobials in aquaculture. We determined the prevalence of A. hydrophila and the associated mortality in fish in various farms. We also investigated the extent of homogeneity of isolates sampled from various aquaculture farms and fish organs and how these variables would drive A. hydrophila heterogeneity to help developing control strategies against this infection. Of the 41 (41%) A. hydrophila isolates recovered by culture from diseased fish in four aquaculture fish farms (faced 35–50% mortality rates) located at different geographical regions in Egypt, 39 (39%) were confirmed by 16S rDNA-PCR amplification. Five distinct patterns were found for the distribution of virulence genes among 41% of A. hydrophila isolates. Thirteen isolates (33.33%) were positive for aer gene; 9 (23.1%) harbored lip gene, 2 (5.13%) carried hlyA gene, and one isolate (2.56%) was positive for ast gene. A positive correlation was found between hlyA and ast, and between lip and aer genes (r = 0.6 and 0.5, respectively). All isolates were resistant to ampicillin and amoxicillin. The least resistance was noted for doxycycline and gentamicin (7.7%) followed by streptomycin (10.3%), trimethoprim/sulfamethoxazole (17.9%), chloramphenicol (25.6%), colistin (43.6%), and erythromycin (47.7%). Most isolates were susceptible to ciprofloxacin. Multiple antimicrobial resistance index values ranged from 0·2–0·6 among multidrug-resistant (MDR) isolates (87·2%). Enterobacterial repetitive intergenic consensus (ERIC)-PCR allowed differentiating A. hydrophila isolates into 3 ERIC clusters, each contained isolates belonging to different farms and organs. The fingerprinting profiles of isolates were diverse without any obvious regional or organ-specific isolates. Our results indicated that sampling localities and sampled organs differ, albeit none substantially, in terms of the respective isolates heterogeneity. In conclusion, the high prevalence of A. hydrophila in Nile tilapia and its diverse antimicrobial resistance and virulence profile suggest the increased risk of this infection and raise concerns about its public health importance. The prudent use of antibiotics in the fish industry is now becoming mandatory to avoid the great losses in aquaculture due to MDR A. hydrophila. Our study also indicated the importance of ERIC genotyping for the analysis of A. hydrophila diversity during future molecular epidemiology investigations.

Adiponectin and 8-epi-PGF2α as intermediate influencing factors in weight reduction after legume consumption: a 12-week randomised controlled trial.

Legumes are rich sources of essential nutrients, and their potential health benefits were reported in many studies. Several studies showed a positive effect of legumes on obesity, but randomised clinical trials are limited in the Korean population. The present intervention study investigated the impact of legumes on body weight in obese Korean subjects. A total of 400 participants (BMI ≥ 25 kg/m2) were randomised into two groups. The legume-enriched diet (LD) group replaced one-third of their refined rice consumption with legumes three times per day as a carbohydrate source. In contrast, the usual diet (UD) group consumed their UD. The mean weight loss at 12 weeks was 2·87 (sem 0·21) kg and 0·17 (sem 0·11) kg in the LD and UD, respectively, which was significantly different between the groups (P < 0·001). HDL-cholesterol and adiponectin levels were increased, and levels of glucose, insulin, TAG, and 8-epi-PGF2α and the homoeostasis model assessment of insulin resistance (IR) index value decreased at 12 weeks compared with baseline in the LD. The consumption of legumes may accelerate weight loss accompanied by regulation of adiponectin and 8-epi-PGF2α in obese subjects. In particular, legumes seemed to induce significant changes in BMI by increasing adiponectin in females. Additionally, increases in plasma adiponectin due to greater substantial weight loss may be related to the improvement in IR.

Uterine artery Doppler indices: pulsatility index and resistance index as predictive tools for the incidence of heavy menstrual bleeding related to copper intrauterine contraceptive device.

ObjectivesTo assess the predictive value of the initial uterine artery Doppler indices, the pulsatility index (PI), and resistance index (RI) in the prediction of heavy menstrual bleeding before and after copper intrauterine contraceptive device (IUCD) insertion.MethodsThe current prospective clinical study included 100 women who intended to use a copper IUCD (Cu T-380A) and met the inclusion criteria. Uterine artery Doppler PI and RI indices were calculated before IUCD insertion and at three and six months after insertion. Based on the presence or absence of menorrhagia, all women were classified into two groups: non-bleeding (n=52) and extreme menstrual bleeding (n=48). Receiver operating curve analysis was used to determine the predictive value of uterine artery PI and RI in patients with menorrhagia relevant to IUCD.ResultsThe PI and RI indices displayed a highly significant difference between the IUCD groups at three and six months after insertion (P<0.001). Uterine artery PI ≤2.02 (sensitivity of 95.8%, specificity of 100%, and area below the curve [AUC] of 0.97 at P-value<0.001) and RI ≤0.83 (sensitivity of 93.8%, specificity of 100%, and AUC of 0.949 at P-value<0.001) were correlated with significant menstrual bleeding following insertion of IUCD.ConclusionThe presented results confirmed our assumption that the initial studies of uterine artery Doppler can predict heavy-menstrual bleeding associated with IUCD and therefore, should be conducted in women pursuing reversible long-acting contraception.

Value of renal resistive index in covid-19 ARDS patients: an early inflammation alert for the lung-kidney cross-talk?

We analysed RRI and other hemodynamic, re-spiratory and inflammation parameters in critically ill pa-tients affected by severe covid-19 with acute distress respi-ratory syndrome (ARDS) aiming at verifying their modifica-tions during supine and prone positioning and any mutual correlation or interplay with RRI.

Variations in the Profiles of Vascular-Related Factors Among Different Sub-Types of Polycystic Ovarian Syndrome in Northern China.

Recently, a growing body of evidence has suggested that abnormal ovarian angiogenesis, secondary to the imbalance between various angiogenic markers, is involved in the pathogenesis of PCOS, and this has led to the use of various interventions (such as Diane-35) to restore the normal ovarian angiogenesis. Therefore, we conducted the current investigation to determine the role of such markers (endothelial growth factor (VEGF), endostatin (ES), and thrombospondin-1 (TSP-1)) in the pathogenesis of PCOS along with the associated changes in ovarian blood flow in patients with PCOS compared to healthy controls, both before and after a course of oral contraception. A total of 381 patients with PCOS and 98 healthy females of childbearing age were recruited from July 2014 to June 2017 at the Reproductive Center of the Second Affiliated Hospital of Harbin Medical University. The serum levels of VEGF, ES, and TSP-1 were determined by enzyme-linked immunosorbent assay, while ovarian perfusion was measured by the pulsatility index (PI) and resistance index (RI) by using transvaginal color Doppler ultrasound. Repeated analyses were carried out after 3 months of Diane-35 treatment. Post-treatment serum levels of luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratio of patients with PCOS decreased significantly (P <0.05). The RI values of most PCOS patients increased after treatment (P<0.05), while PI was significantly increased in all patients (P<0.05). However, variable changes in the serum levels of TSP-1, VEGF, and ES after treatment were observed. Serum VEGF levels showed a negative correlation with serum LH/FSH ratio, T concentration, and ES (P <0.05), while ES levels were negatively correlated with serum T concentrations only (P<0.05). The markers of angiogenesis (VEGF, ES, and TSP-1) were expressed differently among PCOS patients, who also responded differently to the same course of Diane-35 treatment. This field still warrants further investigation to reach a more definitive conclusion.

Early changes in renal resistive index and mortality in diabetic and nondiabetic kidney transplant recipients: a cohort study

BackgroundRenal resistive index (RI) predicts mortality in renal transplant recipients (RTR). However, its predictive value may be different according to the time of measurement. We analysed RI changes between 1 month and 3 months after transplantation and its predictive value for death with a functioning graft (DWFG).MethodsWe conducted a retrospective study in 1685 RTR between 1985 and 2017. The long-term predictive value of changes in RI value from 1 month to 3 months was assessed in diabetic and non-diabetic RTR.ResultsBest survival was observed in RTR with RI < 0.70 both at 1 and 3 months, and the worst survival was found in RTR with RI ≥ 0.70 both at 1 and 3 months (HR = 3.77, [2.71–5.24], p < 0.001). The risk of DWFG was intermediate when RI was < 0.70 at 1 month and ≥ 0.70 at 3 months (HR = 2.15 [1.29–3.60], p = 0.003) and when RI was ≥0.70 at 1 month and < 0.70 at 3 months (HR = 1.90 [1.20–3.03], p = 0.006).In diabetic RTR, RI was significantly associated with an increased risk of death only in those with RI < 0.70 at 1 month and ≥ 0.70 at 3 months (HR = 4.69 [1.07–20.52], p = 0.040). RI considered as a continuous variable at 1 and 3 months was significantly associated with the risk of DWFG in nondiabetic but not in diabetic RTR.ConclusionRI changes overtime and this impacts differently diabetic and nondiabetic RTR. RI short-term changes have a strong prognosis value and refines the risk of DWFG associated with RI.

Role of uterine artery Doppler in assessment of unexplained infertility

BackgroundThe study aimed to compare the values of uterine artery Doppler indices including resistance index (RI), pulsatility index (PI), and systolic/diastolic (S/D) ratios in fertile female and female with unexplained infertility and investigate their association with unexplained infertility. This study included 70 women divided into two groups. Study group included 40 women with unexplained infertility and control group included 30 fertile women.ResultsThe mean ages of study and control groups were 26.9 and 28.5 years respectively. In infertile group, the mean values of uterine arteries resistance index (RI), pulsatility index (PI), and systolic/diastolic (S/D) ratios were 0.9, 2.9, and 8.0 respectively. In the fertile control group, mean RI and PI values and S/D ratio were 0.6, 1.5, and 2.7 respectively. There was statistically significant difference as regards RI, PI, and S/D ratios between study and control groups. The best cut off values of RI, PI, and S/D ratios for predicting increased uterine blood flow impedance were more than 0.67, 1.95, and 3 respectively with sensitivity of 100%, 95%, and 100% respectively, specificity of 96.7%, 86.7%, and 96.7% respectively, and diagnostic accuracy of 98.6%, 91.42%, and 98.57% respectively.ConclusionUterine artery Doppler indices mean values were higher in unexplained infertility women than fertile women. Uterine artery Doppler indices have high sensitivity and specificity for diagnosis of high uterine blood flow impedance. High uterine blood flow impedance diagnosed by uterine artery Doppler may contribute in the etiology of unexplained infertility. Uterine artery Doppler should be included in investigation of unexplained infertility.

Valorization of briquettes fuel using Pinus spp. sawdust from five regions of Mexico

This research characterized briquettes made with Pinus spp. sawdust without the use of additives. For this purpose, 19 samples of sawdust from different wood industries located in five states of the Mexican Republic were used. The densification process was carried out in a vertical hydraulic piston laboratory briquette machine. The briquettes were made with 40 g of sawdust, at 50 °C, 20 kPa and pressing for 5 min. The results obtained varied as follows: moisture content (4.1% to 7.2%), density (813.9 to 1,014.4 kg/m3), volumetric expansion (7.4% to 37.3%), compressive strength (4.9 to 40.8 N/mm), impact resistance index (46.7% to 200%), ash (0.1% to 1.1%), volatile matter (82.9% to 90.7%), fixed carbon (8.9% to 16.4%), and calorific value (20.5 to 22.8 MJ/kg). The density of the briquettes was within the “acceptable” classification (800 to 1,200 kg/m3). It was observed that, the higher the density, the lower the volumetric expansion, the higher the compressive strength, and the higher the impact resistance index. According to the ash content, the briquettes could achieve international quality. Due to high volatile matter values, rapid combustion of the briquettes with little generation of toxic smoke would be expected. Fixed carbon and calorific value results were acceptable.

64 Longitudinal study of spiral artery and intravillous blood flow and adverse pregnancy outcomes

Superb Micovascular Imaging (SMI) improves visualization of small vessels by suppressing global motions while preserving low-flow components such as the micro-vessels in the placenta. We sought to determine if SMI aided visualization of flow velocities in spiral artery (SA) and the intravillous space (IV) can predict development of late onset fetal growth restriction (FGR), gestational hypertension (GHT) and/or preeclampsia (PE). Prospective longitudinal study measuring SA and IV flow velocity using SMI Color Doppler between 11 to 13 + 6, 18 to 21 + 6 and 28 to 34 weeks of gestation. SA and IV flow velocities were reported as resistance indices (RI). Late FGR was defined as EFW < 10th percentile after 34 weeks, and GHT and PE by ACOG standards. RI values were analyzed with multilevel modeling: individual regression curves were estimated and combined to obtain the reference intervals for SA and IV flow velocities in normal pregnancies. Student t-tests compared deviation from expected flow velocity between normal and complicated pregnancies. Of 540 pregnancies included; 19 (3.5%) had FGR, 31 (5.7%) PE and 61 (11.3%) GHT. In uncomplicated pregnancies, SA RI decreased progressively with advancing gestational age, while IV RI decreased with gestational age (Fig). Mean RI values for both SA and IV were significantly higher in the FGR group compared with uncomplicated pregnancies in the third trimester (Table). There was no significant difference in mean RI between uncomplicated pregnancies and those with PE and GHT at any gestational age. When all adverse outcomes were combined, increased SA RI was significantly associated with these outcomes only in the third trimester when compared with the control group [mean RI (SD)= 0.27(0.11) versus 0.33(0.11), respectively; p=0.042]. SMI improved the visualization of SA and IV. Significant differences were seen in pregnancies at risk mostly for late-onset FGR, but only in the early third-trimester.The potential role of SA and IV for predicting adverse outcomes appear limited. Supported by U01HD087213.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Normal values of flow velocity and resistance index of the ophthalmic, the central retinal, and the short posterior ciliary arteries by color Doppler ultrasound in Mexican population

Normal values of flow velocity and resistance index of the ophthalmic, the central retinal, and the short posterior ciliary arteries by color Doppler ultrasound in Mexican population

Multiparametric ultrasound findings in acute kidney failure due to rare renal cortical necrosis

Renal cortical necrosis (RCN) is a rare cause of acute kidney failure and is usually diagnosed on the basis of characteristic enhancement patterns on cross-sectional imaging. Contrast-enhanced ultrasound (CEUS) offers benefits in patients with kidney failure in the clinical setting including the use of a nonnephrotoxic intravascular contrast agent and the fact that it can be performed at the bedside in critical cases. Therefore, the aim of this study is to investigate whether CEUS can reliably identify typical imaging features of RCN. We retrospectively analyzed 12 patients with RCN examined in our department and confirmation of the diagnosis by either histopathology, other contrast-enhanced cross-sectional imaging tests, and/or CEUS follow-up. Assessed parameters in conventional US were reduced echogenicity, loss of corticomedullary differentiation, length and width of kidney, hypoechoic rim, resistance index and in CEUS delayed wash-in of contrast agent (> 20 s), reverse rim sign, maximum nonenhancing rim and additional renal infarction. Furthermore, imaging features in RCN were compared with the findings in renal vein thrombosis (RVT), among them echogenicity, corticomedullar differentiation, hypoechoic rim, RI value, delayed cortical enhancement, total loss of cortical perfusion and enhancement of renal medulla. All 12 patients showed the reverse rim sign, while a hypoechogenic subcapsular rim was only visible in four patients on B-mode ultrasound. A resistance index (RI) was available in 10 cases and was always less than 1. RI was a strong differentiator in separating RVT from RCN (RI > 1 or not measurable due to hypoperfusion as differentiator, p = 0.001). CEUS showed total loss of medullary enhancement in all cases of RVT. With its higher temporal resolution, CEUS allows dynamic assessment of renal macro- and microcirculation and identification of the typical imaging findings of RCN with use of a nonnephrotoxic contrast agent.

Features of cerebral blood flow in patients with chronic obstructive pulmonary disease associated with hypertension

Objective. The aim of the work was to study the features of cerebral blood flow in patients with chronic obstructive pulmonary disease (COPD) associated with hypertension (HTN). Design and methods. A crosssectional study was conducted, which included 90 males 40–60 years old. Of these, 30 patients with chronic COPD associated with HTN (COPD + HTN) were included in the study group, 30 individuals with isolated COPD were in the comparison group, 30 healthy volunteers were included in the control group. All participants underwent physical examination, spirography, 24-hour blood pressure monitoring and ultrasound examination of cerebral vessels. Results. Patients with COPD + HTN in comparison with the control showed an increase in the diameter (p = 0,018) and complex of the intima-media of the common carotid artery (p = 0,003) while the velocities, resistance index (RI) and pulsation index (PI) did not change. In the basin of the internal carotid artery an increase in RI values was noted (p = 0,018). At the intracranial level there was a decrease in the end-diastolic velocity (p = 0,03) and the time-averaged average blood flow velocity (TAV) (p = 0,033) without due changes RI and PI. At the same time no changes in speed indicators and indices were noted in the vertebral artery basin. Among the indicators of cerebral perfusion in patients with COPD + HTN, hydrodynamic resistance (p = 0,0015), intracranial pressure (ICP) (p = 0,0048) significantly increased, and the cerebral blood flow index was comparable with the control. Assessment of venous cerebral blood flow showed an increase in the diameter of the internal jugular vein (p = 0,021) with unchanged TAV together with an increase in ICP indicating the formation of venous dysfunction. It was shown that the body mass index, forced expiratory volume at the first second, systolic and diastolic blood pressure together determine the peak systolic blood flow velocity from the midbrain artery. Conclusions. The cerebral blood flow in patients with COPD + HTN is characterized by a change in arterial blood flow at the level of both intra- and extracranial vessels, while maintaining a normal cerebral blood flow index, as well as the formation of arteriovenous dyshemia against the background of remodeling of the cerebral vascular bed.

Assessment of cervical volume and spectral Doppler parameters in tumour dominant vessel of patients with locally advanced squamous cell cervical carcinoma

We evaluated cervical volume and spectral Doppler parameters: peak systolic velocity (PSV), resistance index (RI) and pulsatility index (PI) in the tumour dominant vessel of 50 patients with cervical squamous cell carcinoma (SCC) staged IIB and IIIB and their changes during treatment. The patients underwent transvaginal Doppler ultrasonography prior to treatment, after external beam radiation therapy (EBRT) and 6 weeks after brachytherapy. Radiotherapy decreased cervical volume and PSV values of the tumour dominant vessel. The PSV values before EBRT in G1 + G2 tumours were higher than in G3 tumours. No correlations between cervical volume, PSV, RI and PI values with disease-free survival (DFS) and overall survival (OS) were found. We concluded, that sonographic assessment of changes in cervical volume of patients with locally advanced cervical SCC during treatment did not allow to predict treatment results. Spectral Doppler parameters PSV, RI and PI of tumour dominant vessel did not predict prognosis for these patients. Impact Statement What is already known on this subject? Transvaginal Doppler sonography is considered as a useful diagnostic method in patients with cervical carcinoma. However, despite numerous studies, the value of spectral Doppler parameters in tumour dominant vessel and cervical volume of patients with locally advanced cervical SCC is still not well defined. What the results of this study add? In our prospective study, we found that sonographic assessment of changes in cervical volume of patients with locally advanced cervical SCC during treatment did not allow to predict treatment results and spectral Doppler parameters of tumour dominant vessel did not predict prognosis for these patients. What the implications are of these findings for clinical practice and/or further research? Our study underlines the limited value of spectral Doppler technique in patients with cervical carcinoma. Further research should be focussed on identifying and validating novel prognostic and predictive factors.