Resistance Index Values Research Articles

The effect of endoscopic renal and ureteral stone surgeries on renal blood flow in children: a prospective trial

Aim: To assess the impact of endoscopic stone surgeries on renal perfusion and blood flow in children. Materials and methods: Children who underwent percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS), ureterorenoscopy (URS), endoscopic combined intrarenal surgery (ECIRS) were included to the study. Renal Doppler ultrasonography (RDUS) was performed one day before the operation, and on the postoperative 1st day and 1st month. Peak systolic velocity (PSV) and end-diastolic velocity (EDV) were measured, and resistive index (RI) was calculated with the (PSV-EDV)/PSV formula. RDUS parameters were compared before and after surgery and between ipsilateral and contralateral kidneys. Results: A total of 45 children with a median age was 8 (2–17) years were included (15 (33.3%) girls, 30 (66.7%) boys). PCNL was performed in 13 children (28.9%), RIRS 11 (24.4%), URS 12 (26.7%), and ECIRS 9 (20%). There was no significant difference in renal and segmental PSV, EDV and RI values of operated kidney in the preoperative, postoperative periods. There was no significant difference between RDUS parameters of the ipsilateral and contralateral kidneys in preoperative or postoperative periods. PSV and EDV values were significantly higher in the 1st postoperative month in the group without preoperative DJ stent than in the group with DJ stent (p = 0,031, p = 0,041, respectively). However, RI values were similar. The mean RI were below the threshold value of 0.7 in each period. Conclusion: RDUS parameters didn’t show a significant difference in children. Endoscopic surgeries can be safely performed in pediatric stone disease.

Early Morbidities of Hypoxia-Ischemic Encephalopathy in Term Neonates With a Resistive Index as a Prognostic Indicator.

Background Acidosis, hypoxemia, and hypercarbia are symptoms of a syndrome known as perinatal asphyxia that occurs during the first and second stages of labor and shortly after delivery due to poor gas exchange. The Doppler technique is a non-invasive way to assess the risk of neurodevelopment damage in hypoxic-ischemic encephalopathy (HIE) that may be done at the patient's bedside without disturbing them. The study aims to evaluate cranial ultrasound findings in HIEand investigate the role of resistive index (RI) values assessed by color Doppler transcranial ultrasonography in predicting early morbidities in neonates with HIE within 72 hours of life. Methodology Prospective observational research was carried out at the north Karnataka region's tertiary newborn critical care unit. The study included 54 infants with HIE in total. The male-to-female ratio was 1.7:1, with 34 (63%) male and 20 (37%) female newborns. Results About 32 instances had grade I HIE, 8 had grade II HIE, and 14 had grade III HIE. In 35 instances (64.81%), the RI was normal; in 19 cases (35.19%), it was abnormal. Increased periventricular density and cerebral parenchyma echo density were common Doppler ultrasonography findings. Roughly 93% of people survived, and 7% of people died from HIE. Seizures (12.96%) and acute renal damage (33.33%) were the most frequent consequences. Conclusion In instances of HIE, the RI was revealed to be a favorable predictive indicator for newborn prognosis. Counselingand educating parents about early morbidities, anticipated long-term consequences, and the need for follow-up will all benefit from it. Additionally, color Doppler is a practical and secure diagnostic method for determining a newborn's level of HIE.

Bridging Stent-Graft Implantation in the Renal Artery During Complex Endovascular Aortic Procedures does not alter the Renal Sonographic Resistance Index

Abstract Background Ultrasound examination of the resistance index (RI) of both kidneys can provide evidence of renal artery stenosis. The extent to which the RI is changed after bridging stent-graft implantation due to altered flow characteristics is not known. Aims The aim of the study was to investigate the influence of renal bridging stent-grafts on the RI of the kidneys after fenestrated endovascular aortic repair (FEVAR). Methods Ultrasound examinations of the kidneys were conducted using a GE LOGIQ S7 XDclear ultrasound system (GE Medical Systems AG, Glattburg, Switzerland). The evaluation was performed according to SGUM 2D standard criteria. The RI was determined in all consecutive patients on the day before and after renal bridging stent-graft implantation. For this purpose, the kidneys were divided into 3 areas according to the standard protocol and 2 RI values were recorded per area by evaluating intrarenal arterial Doppler signals. Mean values were calculated and compared for each kidney. Results For 64 kidneys in 32 consecutive patients (73.9±7.8 years, 4 female, 28 male) treated with FEVAR and renal bridging stent–graft implantation pre- and postinterventional examinations were carried out. Sono-morphologically, the kidneys examined were inconspicuous (pre: size at least 107.1x52.4 mm, parenchymal margin 18.3 mm versus post: size at least 107.9x52.9 mm, parenchymal margin 18.6 mm, p>0.4). The arborization of the renal perfusion was preserved pre and post implantation. The RI did not differ before and after implantation (0.66±0.06 versus 0.67±0.07; p=0.10). None of the patients experienced severe impairment of renal function. Conclusion After successful implantation of a bridging stent-graft in a non-stenosed renal artery, there is no relevant change in the RI of the kidney. The RI seems therefore to be suitable for assessing renal perfusion after complex endovascular aortic therapy.

Resistance patterns and molecular basis to ACCase-inhibiting herbicides

Abstract Digitaria ciliaris var. chrysoblephara (Fig. & De Not.) R.R. Stewart is an annual xeromorphic weed that severely infests direct-seeded rice fields in China. Herbicide resistance is emerging in D. ciliaris var. chrysoblephara owing to extensive and recurrent use of the acetyl-CoA carboxylase (ACCase)-inhibiting herbicide metamifop. In this study, a total of 53 D. ciliaris var. chrysoblephara populations randomly sampled from direct-seeded rice fields across Jiangsu Province were investigated for metamifop resistance and potential resistance-endowing mutations. Single-dose assays revealed that 17 (32.1%) populations evolved resistance to metamifop and 5 (9.4%) populations were in the process of developing resistance. The resistance index (RI) of metamifop-resistant populations ranged from 2.7 to 32.1. Amino acid substitutions (Ile-1781-Leu, Trp-2027-Cys/Ser, and Ile-2041-Asn) in ACCase genes were detected in resistant D. ciliaris var. chrysoblephara plants and caused various cross-resistance patterns to ACCase-inhibiting herbicides. All of four resistant populations (YC07, YZ09, SQ03, and HA06), with different ACCase mutations, exhibited cross-resistance to the aryloxyphenoxypropionate (APP) herbicides cyhalofop-butyl (RI values: 10.0 to 19.9), fenoxaprop-P-ethyl (RI values: 53.7 to 132.8), and haloxyfop-P-methyl (RI values: 6.2 to 62.6), and the phenylpyrazoline (DEN) pinoxaden (RI values: 2.3 to 5.4), but responded differently to the cyclohexanedione (CHD) herbicides clethodim and sethoxydim. It is noteworthy that four postemergence herbicides used for rice cropping, including bispyribac-sodium, pyraclonil, quinclorac, and anilofos, showed poor control effect against D. ciliaris var. chrysoblephara, suggesting few alternations for managing this weed in rice fields except ACCase inhibitors. In conclusion, this work demonstrated that the D. ciliaris var. chrysoblephara had developed resistance to ACCase-inhibiting herbicides in rice cultivation of China, and target-site amino acid substitutions in ACCase were primarily responsible for metamifop resistance.

Assessment of Dynamic Cerebral Autoregulation During Long-Term Exposure to High Altitude in Normal Subjects by Ultrasonography.

To evaluate changes in dynamic cerebral autoregulation (CA) during short-term and long-term exposure to high altitude with ultrasonography, and also study the sex differences in the response of CA to altitude. We assessed the differences in dynamic CA and measured with Doppler ultrasound of the bilateral internal carotid artery (ICA), vertebral artery (VA), and middle cerebral artery (MCA) and the values of basic information within 48 hours and at 2 years after arrival at Tibet in 65 healthy Han young Chinese volunteers, meanwhile, we compared the resistance index (RI) and pulsatility index (PI) of the right MCA at inhale oxygen 8 minutes when a newcomer with 2 years after arrival at Tibet. With 2 years of altitude exposure, the SaO2 of all subjects was above 90%, the mean PEF, DAP, and HR values decreased, HGB increased compared within 48 hours in same-gender groups. Comparisons of cerebral hemodynamics between before 2 years and after 2 years within male and female groups, the mean RI and PI values of bilateral MCA after 2 years were significantly higher than before 2 years, at the same time, the mean RI and PI values of bilateral ICA were significant differences (P < .05) between male groups, with regard to female groups, showed that the mean RI and PI values of bilateral VA were significant differences (P < .05). Comparisons of Right MCA hemodynamics between after oxygen uptake 8 minutes and 2 years, the mean RI and PI values were no significant difference within male and female groups (P > .05). Acute mountain sickness could result from an alteration of dynamic autoregulation of cerebral blood flow, but the impaired autoregulation may be corrected with the extension of time, furthermore, the response of CA to altitude in males and females are different.

A Comparative Analysis of Follicular Diameter Assessment Versus Doppler Ultrasound in Predicting Ovulation Timing for the Infertility Treatment: Insights From a Prospective Study.

Background Infertility remains a significant challenge affecting millions of couples worldwide, with ovulation abnormalities being a common underlying cause. Pharmacological methods, such as clomiphene citrate, are often used to stimulate ovulation. However, the optimal timing for sexual intercourse during ovulation induction remains contentious. Objectives This study aimed to compare the efficacy of transvaginal ultrasonography (TVS) for measuring follicle size with Doppler ultrasound for assessing changes in blood flow to predict the timing of ovulation. Methods We conducted a comparative analysis involving 64 women undergoing infertility therapy. Participants were evaluated using both TVS to measure follicle diameter and Doppler ultrasound to assess perifollicular blood flow dynamics. The primary outcomes measured included ovulation rates, resistive index (RI) values, peak systolic velocity (PSV) values, and conception rates. Results The analysis showed comparable age distributions between the TVS and Doppler groups. There was no significant correlation between follicle diameter and ovulation when assessed by TVS. However, Doppler ultrasound revealed a substantial association between perifollicular blood flow dynamics and ovulation. Higher ovulation rates were linked to lower RI values and higher PSV values, indicating their potential as predictors of ovulation. Additionally, higher conception rates were positively correlated with increased vascularity in Zone 4 of the endometrium. Conclusion Doppler ultrasonography indices, particularly RI and PSV values, provide critical insights into perifollicular blood flow dynamics and endometrial vascularity, which can enhance the effectiveness of fertility treatments. While these findings highlight the potential of Doppler ultrasound in predicting ovulation and improving treatment outcomes, further research is required to understand the underlying mechanisms and validate these results for personalised treatment strategies.

RENAL PROTECTIVE EFFECT AND CLINICAL ANALYSIS OF VITAMIN B 6 IN PATIENTS WITH SEPSIS.

Objective: To investigate the protective effect and possible mechanisms of vitamin B 6 against renal injury in patients with sepsis. Methods: A total of 128 patients with sepsis who met the entry criteria in multiple centers were randomly divided into experimental (intravenous vitamin B 6 therapy) and control (intravenous 0.9% sodium chloride therapy) groups based on usual care. Clinical data, the inflammatory response indicators interleukin 6 (IL-6), interleukin 8 (IL-8), tumor necrosis factor (TNF-α), and endothelin-1 (ET-1), the oxidative stress response indicators superoxide dismutase, glutathione and malondialdehyde, and renal function (assessed by blood urea nitrogen, serum creatinine, and renal resistance index monitored by ultrasound) were compared between the two groups. Results: After 7 d of treatment, the IL-6, IL-8, TNF-α, and ET-1 levels in the experimental group were significantly lower than those in the control group, the oxidative stress response indicators were significantly improved in the experimental group and the blood urea nitrogen, serum creatinine, and renal resistance index values in the experimental group were significantly lower than those in the control group ( P < 0.05). There was no statistical difference between the two groups in the rate of renal replacement therapy and 28 d mortality ( P > 0.05). However, the intensive care unit length of stay and the total hospitalization expenses in the experimental group were significantly lower than those in the control group ( P < 0.05). Conclusion: The administration of vitamin B 6 in the treatment of patients with sepsis attenuates renal injury, and the mechanism may be related to pyridoxine decreasing the levels of inflammatory mediators and their regulation by redox stress.

Prognostic value of resistive index (measured in anterior cerebral artery) in term neonates with hypoxic ischemic encephalopathy

Background: Perinatal asphyxia refers to a condition during the first and second stage of labor and soon after birth in which impaired gas exchange leads to acidosis, hypoxemia, and hypercarbia. The Doppler technique is a non-invasive method that can be used at the bed side without disturbing patients, for risk of subsequent neurodevelopment impairment in HIE. It has been proven that impaired cerebral circulation plays the main role in the pathogenesis of hypoxic ischemic brain injury in neonates. Methods: Doppler sonography conducted in all enrolled subjects. Cerebral blood flow parameters-peak systolic velocity, end diastolic velocity and resistive index were measured in anterior cerebral artery bilaterally on parasagittal planes obtaining the images through the anterior fontanelle with in first 72 hours. Results: In our study we found that death during hospital stay in neonates with normal RI and abnormal RI is 13% and 28.6% respectively (p&lt;0.01). Abnormal neurological outcome of 70.6% at 6 months and 64.7% at 12 months in patients with abnormal RI and 23.3% at 6 months and 18.6% at 12 months in patients with normal RI (p&lt;0.01). Conclusions: There is a significant correlation between neurodevelopmental disabilities and cerebral blood flow parameters in neonates with hypoxic ischemic encephalopathy. Detection of increased or decreased in cerebral blood flow velocities in neonates with in first 72 hours postpartum has a significant prognostic value related to death and long-term neurodevelopmental outcome.

Efficacy of drug-coated balloon catheters for patients with short-term recurrent dysfunction of arteriovenous fistula.

In this study, we aimed at clarifying the usefulness of drug-coated balloon catheters (DCBs) for arteriovenous fistulas (AVFs) that repeatedly undergo restenosis over a short period and to examine the factors that influence the patency period after DCB use. This retrospective observational study was conducted using IN.PACT AV in 29 cases of AVFs with repeated restenosis within approximately 3 months, and temporary patency before and after DCB use in the same patients was compared. For target participants, the flow volume, resistive index (RI), and vascular diameter of the brachial artery were measured using an ultrasound diagnostic device. Stenosis diameter, reference vessel diameter, and stenosis length of the lesion were measured before and after DCB dilatation using digital subtraction angiography. Before DCB angioplasty, the postintervention primary patency at 3 months was 66%, and the average interval was 92 ± 21 days (mean ± standard deviation). After DCB angioplasty, the postintervention primary patency rates at 3 and 6 months were 92% and 36%, respectively. The postintervention primary patency was significantly higher after than before DCB angioplasty (p < 0.0001). A sub-analysis was performed on 25 patients who were followed up for 4 months or more after DCB. The RI values before and after dilatation with DCB significantly differed between the patency group 4 or more months after DCB and the patency group less than 4 months after DCB. For AVFs that require frequent PTA over a short period of time, DCB improved the patency rate 3 months after PTA, but the improvement effect at 6 months was limited. The effect of DCB on prolonging the patency rate of AVFs that require frequent PTA over a short period of time may be correlated with the RI value before and after PTA.

Assessing the predictive value of insulin resistance indices for metabolic syndrome risk in type 2 diabetes mellitus patients

Limited research has explored the effectiveness of insulin resistance (IR) in forecasting metabolic syndrome (MetS) risk, especially within the Iranian population afflicted with type 2 diabetes mellitus (T2DM). The present investigation aimed to assess the efficacy of IR indices in predicting the risk of MetS among T2DM patients. Convenient sampling was utilized to select four hundred subjects with T2DM. Metabolic factors and IR indices, including the Waist Circumference-Triglyceride Index (WTI), Triglyceride and Glucose Index (TyG index), the product of TyG index and abdominal obesity indices, and the Metabolic Score for Insulin Resistance (METS-IR), were evaluated. Logistic regression, coupled with modeling, was employed to explore the risk of MetS. The predictive performance of the indices for MetS stratified by sex was evaluated via receiver operating characteristic (ROC) curve analysis and estimation of the area under the curve (AUC) values. The TyG-Waist Circumference (TyG-WC) index exhibited the largest AUCs in both males (0.91) and females (0.93), while the TyG-Body Mass Index (TyG-BMI) demonstrated the smallest AUCs (0.77 in males and 0.74 in females). All indices significantly predicted the risk of MetS in all subjects before and after adjustment (p < 0.001 for all). The TyG-WC index demonstrated the highest odds ratios for MetS (8.06, 95% CI 5.41–12.00). In conclusion, all IR indices assessed in this study effectively predicted the risk of MetS among Iranian patients with T2DM, with the TyG-WC index emerging as the most robust predictor across both genders.

Risk factors for the failure of ibuprofen treatment in preterm infants with hemodynamically significant patent ductus arteriosus

To investigate the risk factors for the failure of ibuprofen treatment in preterm infants with hemodynamically significant patent ductus arteriosus (hsPDA). A retrospective collection of clinical data was conducted on preterm infants with a gestational age of <34 weeks who were diagnosed with hsPDA and treated at the Department of Neonatology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, from January 2018 to June 2023. The subjects were divided into two groups based on the treatment approach: the ibuprofen group (95 cases) and the ibuprofen plus surgery group (44 cases). The risk factors for the failure of ibuprofen treatment in preterm infants with hsPDA were identified by binary logistic regression analysis. The binary logistic regression analysis revealed that an increased diameter of the ductus arteriosus, a resistance index (RI) value of the middle cerebral artery ≥0.80, and prolonged total invasive mechanical ventilation time were risk factors for the failure of ibuprofen treatment in preterm infants with hsPDA (P<0.05). Receiver operating characteristic curve analysis showed that a ductus arteriosus diameter >2.85 mm, a middle cerebral artery RI value ≥0.80, and a total invasive mechanical ventilation time >16 days had significant predictive value for the failure of ibuprofen treatment in preterm infants with hsPDA (P<0.05). The combined predictive value of these three factors was the highest, with an area under the curve of 0.843, a sensitivity of 86.5%, and a specificity of 75.0% (P<0.05). A ductus arteriosus diameter >2.85 mm, a middle cerebral artery RI value ≥0.80, and a total invasive mechanical ventilation time >16 days are risk factors for the failure of ibuprofen treatment in preterm infants with hsPDA, and they are of significant predictive value for the necessity of surgical treatment following the failure of ibuprofen treatment.

The pattern of renal artery Doppler indices in patients with sickle cell disease.

To evaluate the pattern of renal artery Doppler indices in patients with sickle cell disease who do not have laboratory evidence of renal impairment. A case-control study was carried out after enrolling 50 patients with sickle cell disease (HbSS phenotype) (sickle cell disease group) and 50 control subjects (control group). All the participants underwent ultrasound and color Doppler examination, and the pulsatility index and resistive index values of the main renal artery, segmental artery, and interlobar artery in both kidneys were recorded and compared. The Doppler measurements of the main renal artery, segmental artery, and interlobar artery were compared between the control and sickle cell disease groups. It was found that both pulsatility index and resistive index were significantly higher in the sickle cell disease group, as compared to the control group, for the main renal artery, segmental artery, and interlobar artery (p <0.0001, p <0.0001, and p <0.0001, respectively). The optimal cut-off points for mean pulsatility index and resistive index, as measured by the Youden index, were found to be >1.08 (72% sensitivity and 88% specificity) and >0.635 (66% sensitivity and 98% specificity), respectively. Resistive index and pulsatility index values in renal Doppler sonography can serve as early radiologic predictors of renal vascular changes in sickle cell disease patients who do not have laboratory evidence of renal impairment.

Prevalence, genetic diversity, and antimicrobial susceptibility of Vibrio spp. infected gilthead sea breams from coastal farms at Damietta, Egypt

BackgroundVibriosis is one of the most serious bacterial diseases and causes high morbidity and mortality among cultured sea breams. This study was undertaken to track the surveillance of Vibrio infection and its correlation to environmental factors. A total of 115 gilthead sea breams were collected seasonally from a private earthen pond fish farm in the Shatta area of Damietta, Egypt from September 2022 to July 2023. Physicochemical parameters of water were analyzed, and heavy metal levels were measured. The fish samples were subjected to clinical, bacteriological, Enterobacterial Repetitive Intergenic Consensus (ERIC) fingerprinting, and hematoxylin and Eosin histopathological staining.ResultsThe results revealed significant variations in the water quality parameters over different seasons, in addition to an increase in heavy metals. Naturally infected fish showed external signs and postmortem lesions that were relevant to bacterial infection. Two dominant Vibrio subspecies of bacteria were identified: V. alginolyticus (205 isolates) and V. fluvialis (87 isolates). PCR confirmed the presence of V. alginolyticus using the species-specific primer collagenase at 737 bp. The highest prevalence of V. alginolyticus was detected during the summer season (57.72%), and the lowest prevalence was observed in autumn (39.75%). The correlation analysis revealed a positive relationship between V. alginolyticus and water temperature (r = 0.69). On the other hand, V. fluvialis showed a high prevalence during the autumn season (25.30%) and the lowest prevalence during the summer season (10.56%), where it was negatively correlated with water temperatures (r =—0.03). ERIC fingerprinting showed genetic variation within the Vibrio isolates. Antimicrobial susceptibility testing revealed sensitivity to ciprofloxacin and doxycycline, and resistance to amoxicillin and erythromycin. The multiple antibiotic resistance (MAR) index values for V. alginolyticus and V. fluvialis ranged from 0.3 to 0.7, with a multi-drug resistance pattern to at least three antibiotics. Histopathological alterations in the affected tissues revealed marked hemorrhage, vascular congestion, and hemosiderosis infiltration.ConclusionThis study provides insights into the potential propagation of waterborne diseases and antibiotic resistance in the environment. Ensuring that the environment does not serve as a reservoir for virulent and contagious Vibrio species is a critical concern for regional aquaculture industries. Therefore, we recommend implementing environmental context-specific monitoring and surveillance tools for microbial resistance.

Hepatic arterial hemodynamics and model for end-stage liver disease (MELD) scores in chronic liver disease: insights from Doppler ultrasonography

BackgroundDoppler ultrasonography is essential to provide insights into hemodynamic alterations and liver function changes in pre-cirrhotic and cirrhotic patients. Utilizing Doppler examinations, this study aims to explore the correlation between hepatic arterial hemodynamics and Model for end-stage liver disease (MELD) scores in chronic liver disease patients.MethodsA study of 50 chronic liver disease patients included sonographic assessments, measuring liver, portal vein size, and flow. Hepatic artery velocity, resistive index (RI), pulsatility index (PI), and acceleration time (AT) were evaluated. Biochemical parameters (serum bilirubin, creatinine, INR) were used to calculate MELD scores, compared with different Doppler sonographic parameters.ResultsThe study found a mean peak systolic velocity (PSV) of 107.42 ± 48.10, with end-diastolic velocity (EDV) of 26.40 ± 14.68, RI of 0.74 ± 0.06, and PI of 1.47 ± 0.24. The mean MELD score was 19.28 ± 6.09. Correlations between MELD scores and PSV, EDV, RI, PI, and AT did not yield statistically significant correlations. 80% of subjects displayed high RI (> 0.7) values in the hepatic artery, and a significant correlation was found between portal vein thrombosis and hepatic artery PSV and RI (p < 0.05).ConclusionsHepatic artery RI and PSV show a significant correlation with portal vein thrombosis. Doppler ultrasonography, while not directly tied to MELD scores, is valuable for non-invasive liver disease monitoring when invasive methods are impractical. Further research is needed to unravel the relationships between hemodynamic changes, MELD scores, and clinical outcomes in a broader patient population.

Evaluation of HOMA IR in perimenopause patients with abnormal uterine bleeding

Introduction: Perimenopause as a clinical entity is characterized by a series of symptoms that occur due to estrogen deficiency in multiple organs and systems. Obesity is a risk factor that favors all these changes, especially hyperplasia. Glucose homeostasis is often impaired in these patients, insulin levels are increased, and HOMA IR is increased. Goals: to detect hyperplasia in obese perimenopausal patients with abnormal uterine bleeding to determine insulin levels, HOMA IR, to determine the association between hyperplasia and HOMA IR. Material and Methods: This was a prospective cohort study, performed at the OB/GYN Clinic, over 1 year. 100 patients with abnormal uterine bleeding during the perimenopause were involved, aged 45–50, divided into two groups based on BMI. 1-patients with a BMI above 30, 2-patients with a BMI under 30, and the control group consisted of 40 asymptomatic patients. Results: The average value of glycemia in the first group was higher and was 5.7 mmol/l, the cut-off value was 5,5. The average value of the HOMA-IR insulin resistance index in the first group was highest - 2.8 (the cut-off value was 1.8). Endometrial hyperplasia was registered in the first group at 40.9%. Discussion: The first group registered a significant association between HOMA IR and hyperplasia, the risk of endometrial hyperplasia occurring was eight times higher. The first group registered a significant association between glycemia and endometrial hyperplasia. High levels of glycemia increase the risk of endometrial hyperplasia occurring three times. Conclusion: In menopausal transition patients with abnormal uterine bleeding there is an increased incidence of endometrial hyperplasia, hyperglycemia, and increased HOMA IR. There is a strong association between these changes and the risk of cardiovascular disease increases. Menopause is a period in a woman’s life that requires a multidisciplinary approach to diagnostics and treatment. Keywords: HOMA IR, perimenopause, abnormal bleeding, hyperplasia.

Renal morphometric and doppler studies in different stages of canine chronic kidney disease &lt;b&gt;&lt;/b&gt;

Doppler ultrasound is a useful diagnostic tool to evaluate renal blood flow in canine chronic kidney disease (CKD). This study aimed to describe and compare renal blood flow in different stages of CKD dogs based on the ultrasonographic appearance of kidneys. The study included one hundred and three dogs with CKD confirmed clinically, hematologically, biochemically and ultrasonographically. Ten healthy dogs with no haematological and ultrasonographic abnormalities of kidneys were also included in the study as a control group. Based on SDMA levels, the dogs with CKD were divided into four groups viz., Stage I (n=17), Stage II ( n=15), Stage III ( n=25) and Stage IV ( n=46). The Renal volume was measured with two-dimensional ultrasonography. All the dogs were subjected to pulsed-wave Doppler to obtain hemodynamic parameters such as resistance index (RI) and pulsatility index (PI) which were significantly (P&lt;0.05) higher in CKD stage III and IV dogs than in control. However, no significant difference was reported in RI and PI values in dogs with CKD Stages I and II (P&gt;0.05). Hemodynamic parameters appear useful markers for understanding the pathological process and progression in dogs with CKD.

Ultrasonography Findings in Post-Methotrexate Treatment of Cesarean Scar Pregnancy

Background: Cesarean scar pregnancy (CSP) can cause life-threatening complications for pregnant women, so early diagnosis and treatment are crucial for the prevention of maternal mortality. Transvaginal color Doppler ultrasonography, along with serum beta-human chorionic gonadotropin (β-hCG) level follow-up, can be a noninvasive and proper method for the post-treatment follow-up of a CSP. The present study investigated the Doppler resistance index (RI) changes in CSPs after medical management with methotrexate (MTX), evaluated by sac diameter and serum β-hCG level measurement. Methods: Overall, 28 patients with CSP and a history of previous cesarean delivery, a gestational age of less than 9 completed weeks at ultrasonography, the decision to medical management by the gynecologist, and having a β-hCG level before treatment were enrolled and initially examined by ultrasound and Doppler studies. The RI of the closest myometrial artery to the CSP mass and its diameter underwent measurement. After 72 hours, 1 week, and 2 weeks of medical therapy with MTX, the mentioned variables were measured again and compared with the values of the pretreatment time point. Results: RI values were significantly higher at all the follow-up time points compared with the pre-treatment time points, while serum β-hCG levels were significantly lower. Moreover, sac diameter values increased 72 hours post-treatment and then represented a decline. Conclusion: Serial Doppler ultrasound examination can be a useful method to evaluate the success or failure of the medical management of CSPs, as the increase in RI values occurs rapidly after medical treatment and correlates well with serum β-hCG levels.

Diagnostic value of multi-parameter ultrasound evaluation in sepsis complicated by acute kidney injury

Background This study aimed to discuss the diagnostic value of multi-parameter ultrasound evaluation in sepsis complicated with acute kidney injury (AKI). Methods Patients were divided into an AKI group (n = 50) and a non-injury group (n = 50) based on the presence of AKI. The clinical characteristics were collected, and renal function parameters between the two groups were compared, including 24-h urine volume, serum creatinine, urea, serum cystatin C (CysC), renal parenchymal thickness (RPT), renal artery resistance index (RI), and multi-parameter ultrasound scoring (MPUS). Additionally, logistic regression analysis was conducted to determine the influencing factors of sepsis complicated with AKI. The prediction value was evaluated using a receiver operating characteristic (ROC) curve. Results In the AKI group, creatinine, CysC, urea, MPUS score, RPT, and RI values were significantly higher, while the 24-h urine volume was lower than those in the non-injury group (p < 0.01). Moreover, multivariate logistic analysis indicated that high CysC and RI values were independent risk factors, whereas high 24-h urine volume and low MPUS were independent protective factors for sepsis-induced AKI. The ROC curve demonstrated that RI (AUC = 0.906) was more effective than 24-h urine volume (AUC = 0.797), CysC (AUC = 0.730), and MPUS (AUC = 0.794) in identifying sepsis-induced AKI. Conclusion High RI values increase the risk of sepsis-induced AKI, whereas low MPUS may reduce it. RI showed high diagnosis values for sepsis complicated with AKI.

Molecular characterization and antibiotics resistance of Aeromonas species isolated from farmed African catfish Clarias gariepinus Burchell, 1822

BackgroundAeromonas species are one of the most important etiologies of diseases in fish farms, leading to clinical manifestation and mortality and are associated with public health risks. This study aimed to investigate the prevalence, phenotypic and molecular characteristics of Aeromonas species isolated from farmed Clarias gariepinus using 16 S rRNA sequencing. Additionally, their antibiogram and multiple antibiotic resistance index were determined using a disc diffusion test.ResultsA total of 230 Aeromonas strains were isolated from Clarias gariepinus with 40.9% obtained from diseased fish, and 25% isolated from apparently healthy ones. Five different species including Aeromonas caviae, Aeromonas veronii, Aeromonas hydrophila, Aeromonas dhakensis and Aeromonas enteropelogenes were fully identified and genetically characterized. Based on the available literature, this is the first report of Aeromonas enteropelogenes from the study area. The phylogenetic analysis showed genetic heterogeneity and distance within the species and the reference strains. The multiple resistant Aeromonas species were susceptible to ciprofloxacin, gentamycin, and florfenicol. The Aeromonas species’ multiple antibiotic resistance index values varied between 0.20 and 0.80 and were isolated from the farms where antibiotics were intensively used.ConclusionsThe diversity of multidrug-resistant Aeromonas species isolated from fish farms is a major threat to fish production giving us more understanding of epidemiology and the multidrug Aeromonas species with a MAR index of greater than 0.2 were isolated from farms where antibiotic use was widespread. As a result, a considerably increased danger of multiple antibiotic resistance spreading to the fish culture environment may impact aquaculture production. Hence there is a need for appropriate and monitored drug usage.

Determination of the effects of oxytocin and carazolol on uterine involution by pulsed-wave Doppler ultrasonography in Kıvırcık ewes

The aim of this study was to determine the effects of oxytocin and carazolol on uterine involution in postpartum Kıvırcık ewes. Thirty primiparous suckling Kıvırcık ewes were divided into 3 groups: carazolol, oxytocin, and control. The ewes underwent transcutaneous B-mode USG in the 1st week after birth, and the examinations continued via transrectal USG until the 28th day of postpartum (pp). The pulsatility index (PI), resistive index (RI), and systolic/diastolic (S/D) velocity ratio were recorded for uterine artery by Doppler USG. On postpartum 21st day, gravid horn diameter reduction was best achieved in the carazolol group. The PI values were found to be statistically significant (P˂0.001) on days 14 and 21 pp. The mean RI values of uterine artery were statistically higher (P˂0.01) in the oxytocin group. The highest RI value was detected on the 14th day of pp. The carazolol group had statistically higher (P˂0.05) mean S/D values when compared to other groups. In conclusion, the most effective drug used to accelerate involution was found to be carazolol. The drugs used in this study appeared to have a contraction effect on the uterine arteries.