Ultrasonographic Alterations Research Articles

Dural and deep cervical musculature anesthetic blockade for atlantoaxial collection of cerebrospinal fluid in horses

The analysis of cerebrospinal fluid has diagnostic, prognostic, and therapeutic value in neurological illnesses in horses. There are different methods for obtaining cerebrospinal fluid, with the collection between the C1 and C2 vertebrae being a more recent methodology, which allows the procedure to be performed in standing patients, without the limitations of general anesthesia and with a low contamination of the sample with blood, presenting itself as a practical alternative. This study evaluated the efficacy and safety of a local dural blockade in healthy horses submitted to cerebrospinal fluid collection by atlantoaxial puncture and the quality of the samples obtained by this procedure, which were submitted to physical, chemical, and cytological analyses. The animals were evaluated considering aspects such as pain, sensitivity, the presence of edema, temperature variations, and ultrasonographic alterations post-collection. Discrete local changes were observed after the puncture, and the procedure was considered safe and simple to perform. Lidocaine blockade could reduce the reaction elicited by the needle passing through the dura mater, and the samples obtained showed satisfactory quality and laboratory results consistent with the values compiled in the literature. Transient hyperthermia was observed in 70% (7/10) of the animals in the dural blockade group, and 80%(8/10) of the patients from the control group, totalizing 75% of all individuals evaluated. The rectal temperature alteration was observed 4 to 12 hours after the procedure and was entirely resolved without intervention by the 24-hour evaluation.

Investigating the Association Between Muscular Ultrasonographic Alterations and Clinical Symptoms in Patients With Inflammatory Myopathy.

Muscle biopsy is commonly used to diagnose inflammatory myopathies. We evaluated the ability of muscle ultrasound, a non-invasive and simple tool, to distinguish between healthy subjects and patients with inflammatory myopathy. This study was conducted on 17 patients recently diagnosed with biopsy inflammatory myopathies (12 dermatomyositis, 5 polymyositis) compared with 17 age- and gender-matched healthy control adults. All patients underwent clinical assessments, including manual muscle testing, hand-held dynamometry, and muscle ultrasound evaluations, including thickness and echo intensity in predefined muscle groups. The disease duration was seven months (interquartile range: 3 to 11 months). Except for the biceps and gastrocnemius, patients' muscles had significantly higher echo intensity and lower thickness than the control group. The echo intensity sum-score manifested the highest area under the curve compared to the sum-scores of other variables (echo intensity vs manual muscle testing: Area under curves-difference=0.18, P<0.01; echo intensity vs dynamometry: Area under curves-difference=0.14, P=0.02; echo intensity vs thickness: Area under curves-differences-difference=0.25, P<0.01). The echo intensity of muscles differed significantly between healthy individuals and patients with inflammatory myopathies and may serve as a useful diagnostic biomarker.

Congenital syphilis evaluated for syphilitic hepatitis - case series

Objective: To report case series evaluated for congenital syphilitic hepatitis. Method: Study conducted at Maternity Santa Isabel from December 2021 to May 2022. We evaluated newborns with congenital syphilis using data taken from the pregnant woman’s card, the child’s card, the anamnesis and exams performed in the follow-up consultations of these families. Complete medical records of infants who presented the criteria for the diagnosis of congenital syphilis of the Ministry of Health and the Center for Disease Transmission Control were included. Results: The review was 15 of which were selected that fit all the inclusion criteria. The babies were born with good vitality, term, one had low birth weight, six hepatomegaly, all treated with penicillin, nine had altered liver biochemical tests. At ultrasonography, Doppler was normal for all, one case of hepatosplenomegaly and one with splenomegaly. Two mothers who were diagnosed at the time of delivery had fewer than six consultations, their babies had neurosyphilis and presented developmental alertness. The child who had microcephaly and low birth weight also presented altered neurodevelopment. Of the pregnant women, three were over 30 years old, one was white, five had studied less than 8 years, thirteen were not working, family income of 1 minimum wage or less in twelve families. Eight were inadequately treated. Of the parents, eleven had studied less than 8 years and eleven were inadequately treated. Conclusion: The children with syphilis were born vigorous and had adequate treatment. Nine had altered hepatic biochemical exams, two had ultrasonographic alterations, however, without alterations in the Doppler. The children of untreated mothers had neurosyphilis and neurodevelopmental changes.

Radiographic and ultrasonographic alterations in the metacarpophalangeal joints in older horses do not necessariliy correlate to lameness

Radiographic and ultrasonographic alterations in the metacarpophalangeal joints in older horses do not necessariliy correlate to lameness

Relationship between Serum Protein Electrophoresis, Endoscopic and Histopathological Scores in 99 Cats with Chronic Enteropathy.

Simple SummarySerum protein electrophoresis (SPE) is a laboratory test used to separate different protein fractions. It is used to investigate animals with hyperglobulinemia and to distinguish between monoclonal and polyclonal gammopathies. SPE can also highlight acute or chronic inflammation patterns which are useful in disease monitoring. SPE is effective in humans with intestinal bowel disease (IBD) and chronic liver diseases. In addition, hypergammaglobulinemia is a marker of extraintestinal manifestations in human IBD patients, which often includes hepatic and pancreatic disease. Concurrent pancreatic and/or hepatic diseases in cats with chronic enteropathy (CE) have often been found, which may contribute to SPE alterations. The present study investigated the relationship between SPE and endoscopy, histopathology, and hepatic and pancreatic ultrasonographic findings in ninety-nine cats diagnosed with CE. No significant differences were observed between SPE and endoscopic and histopathological severity scores. Cats with concurrent pancreatic and/or hepatic ultrasonographic alterations showed lower albumin, lower α-globulin, and higher γ-globulin levels than cats diagnosed with enteropathy alone. This study suggests that hepatic and/or pancreatic alterations may influence SPE fractions in cats with CE, and should form the basis for further prospective studies on cats with diaditis and triaditis.Few studies have investigated total protein (TP) and serum protein electrophoresis (SPE) in cats with chronic enteropathy (CE). Cats diagnosed with CE were evaluated to investigate the relationships between TP, SPE and endoscopy, histopathology, and extraintestinal involvement. Medical records were searched for cats with a history of chronic gastrointestinal signs and a final diagnosis of CE. Information on signalment, TP, SPE, endoscopic score, histopathological diagnosis and score, and concurrent hepatic or pancreatic ultrasonographic alterations was collected. Relationships between protein profiles and other variables were investigated. Ninety-nine cats were included in the study, 63 diagnosed with various degrees of bowel inflammation and 36 with small-cell alimentary lymphoma. The most common TP alteration was hypoproteinemia (24%). No significant differences were observed between protein profiles and endoscopic and histopathological severity scores. Forty-five cats showing concurrent pancreatic and/or hepatic ultrasonographic alterations, had significantly lower albumin, lower α-globulin, and higher γ-globulin levels than cats not showing concurrent alterations. Disease severity scores did not seem to influence the protein profile in cats with CE. Extraintestinal involvement may be suspected in cats with lower albumin and α-globulins and higher γ-globulins.

Early predictors of psoriatic arthritis: a Delphi-based consensus from Italian dermatology centers

Psoriatic arthritis (PsA) is an inflammatory condition which can affect up to 41% of psoriatic patients [1]. In 40-60% of patients, PsA can determine cartilage destruction and joint deformities, hereby heavily impacting physical function and quality of life, even increasing the risk of death compared to the general population [1]. PsA manifestations usually develop after psoriasis onset; therefore, dermatologists play a crucial role in the detection of early signs of arthritis. In our study, we aimed to identify simply detectable clinical and ecographic signs of early PsA and to assess their reliability. We assessed the opinion of a group of expert dermatologists, who were asked to express their opinion on the level of association between the selected anamnestic, clinical or instrumental signs and the onset of psoriatic arthritis by giving a score to each item. Psoriatic onycopathy, signs of dactylitis and ultrasonographic alterations of selected joints were, respectively, the dermatologic, rheumatologic and imaging signs which had the strongest significance in the opinion of the experts. These signs should be carefully looked for during dermatological examinations in order to detect early PsA.

Platynosomum fastosum in domestic cats in Cuiabá, Midwest region of Brazil.

Platynosomum fastosum, which is distributed in tropical and subtropical regions, is the main parasite in the biliary system of domestic cats. Cats can be asymptomatic or show severe signs of cholangitis. Although the infection is reported throughout Brazil, only post-mortem studies are available from the Midwest region of the country. This cross-sectional study investigated the frequency of P. fastosum parasitism in domestic cats treated at the University Veterinary Hospital in Cuiabá city, Mato Grosso, Brazil, by three coproparasitological techniques (formalin-ether sedimentation, Faust, and Hoffmann), associating clinical, laboratory (haematological, biochemical) and ultrasonographic alterations. Based on the sample calculation, 171 cats were evaluated in the clinical and laboratory and a semi-structured epidemiological questionnaire was designed and used by the tutors. The prevalence observed was 26.90%, with no significant association with sex, reproductive status, age, hunting habit, access to the street, recent anthelmintic treatment, and the guardian's lack of knowledge regarding parasitism. Of the 171 cats evaluated, 55 (32.16%) showed clinical signs suggestive of cholangitis, with a significant association of this variable. Regarding the clinical and pathological variables, mild neutrophilia and elevated serum activity of alanine amino transferase and alkaline phosphatase was observed (but not significantly), while the mean values of eosinophils, leucocytes, total protein, albumin, and globulin were normal. The ultrasound findings were like those previously described. Thus, it was observed that P. fastosum occurs in moderate prevalence in cats from Cuiabá-MT, with a significant association with clinical signs and a regular agreement between the parasitological techniques employed.

INTRAOVARIAN INJECTION OF ALLOGENEIC MESENCHYMAL STEM CELLS: FEASIBILITY AND SAFETY ASSESSMENT IN BOVINES

<h3>Background</h3> Ovum pick-up (OPU) is a technique widely used for production of bovine embryos in-vitro. However, continuous OPU can be associated with the appearance of often irreversible ovarian lesions. The possibility of using stem cell therapy for treatment of infertility both in animals and in humans is currently under investigation, but the safety of intraovarian infusion of stem cells in bovines has not been established at this point. Therefore, in the present study we determined the feasibility and safety of intraovarian application of allogeneic MSC derived from adipose tissue of healthy cows. <h3>Methods</h3> Two OPU procedures were executed 15 days apart. Immediately following the second OPU, 2.5 million allogeneic MSCs were injected to the ovarian cortex of healthy nelore (n=5) and girolando (N=5) cows. The animals were subsequently evaluated by ultrasonography and clinical examination at 24, 48 and 72 hs post MSC injection. At 15, 30 and 45 days post MSC injection, new OPU procedures were executed and the number of viable oocytes collected, and rate of embryo production were determined. <h3>Results</h3> No clinical nor ultrasonographic alterations were detected in treated animals. Furthermore, similar numbers of viable oocytes, embryos produced, and rate of embryo production before and after MSC application were observed. <h3>Conclusion</h3> Based on these data, it can be concluded that the intra-ovarian application of 2.5 million adipose-derived MSC is safe. Future steps include the MSC treatment of individuals which present ovarian degeneration or lesions. <h3>Financial support</h3> This work was supported by CNPq, CAPES, FAPDF, FAPESP and Universidade of Brasilia.

Oxidative Stress and Abnormal Tendon Sonographic Features in Elite Soccer Players (A Pilot Study).

Objective Sound experimental data suggest that oxidative stress plays an important role in the pathogenesis of tendinopathies. However, this hypothesis in humans remains speculative given that clinical data are lacking to confirm it. Recently, a new methodology has allowed to quantify the oxidative stress in vivo by measuring the concentration of hydroperoxides of organic compounds, which have been utilized as an oxidative stress-related marker in several pathologic and physiologic conditions. Given the reliability of this test and the lack of information in subjects with tendinopathies, the aim of the present study was to assess the oxidative stress status in elite professional soccer players with and without ultrasonographic features of tendon damage. Methods In 73 elite players, blood metabolic parameters were evaluated and oxidative stress was measured by means of a specific test (expressed as U-Carr units). Therefore, an ultrasonographic evaluation of the Achilles and patellar tendons was performed. Results No significant relationships were observed between metabolic parameters and oxidative stress biomarkers. The Achilles and patellar tendons showed a normal echographic pattern in 58 athletes, and sonographic abnormalities in 15. The athletes with ultrasonographic alterations, compared to those with normal US picture, showed significantly higher U-Carr levels ( p = 0.000), body mass index (BMI) values ( p = 0.03) and were older ( p = 0.005). The difference in U-Carr values among the subjects remained significant also after adjustment for age and BMI. Conclusion The results of the present study support the hypothesis that oxidative substances, also increased at systemic and not only at local level, may favor tendon damage. Level of Evidence IV (pilot study).

Ultrasonographic alterations of bovine claws sole soft tissues associated with claw horn disruption lesions, body condition score and locomotion score in Holstein dairy cows

Claw Horn Disruption Lesions (CHDL) negatively affect the sole soft tissue structures located beneath the sole horn. The aim of the present study was to investigate the effect of CHDL on sole soft tissues by ultrasound means, correlating Body condition score (BCS), locomotion score and CHDL with ultrasonography evaluations of sole soft tissues in Holstein dairy cows. 100 Holstein dairy cows were enrolled in the study. BCS and locomotion score were assessed and functional trimming was performed on all animals. 84 healthy claws and 174 claws with solely one CHDL per claw were evaluated both clinically and with ultrasound, and CHDL were identified and recorded. Sole soft tissues thickness (mm) and echogenicity was determined, and ultrasonographic alterations, related to CHDL presence, where measured long their vertical (L1) and horizontal (L2) axis. Statistically significant (P < .001) differences were found in echogenicity between healthy claws and all the affected ones, with the healthy ones being mainly anechoic. Statistically significant (P < .001) differences were found for vertical (L1) and horizontal (L2) axis measures between the diverse CHDL, confirming ultrasonography as a useful tool to distinguish lesions and their extension by measuring L1 and L2. BCS had an influence both on sole soft tissues ultrasonographic appearance and on CHDL insurgency.These results confirm ultrasonography as a reliable tool for detecting an increase in sole soft tissues echogenicity, that was seen to occur with CHDL insurgency, and in determining lesion extension.

Clinical and Ultrasonographic Alterations in Canine Babesiosis

Canine babesiosis is a worldwide tick borne disease. Dogs with fever, in appetence and enlarged lymph nodes were screened for the presence of haemoprotozoan parasites during the one year period of study at T.V.C.C., C.V.Sc., Mhow (M.P. , India ). Based on the stained peripheral blood smears examination, dogs were found to be affected with babesiosis. Clinical examination of the dogs revealed ticks over the body, highest frequency (75.00%) of petechial/epistaxis followed by ticks (72.22%) on the body, recumbency (69.44%), dullness (66.66%), dehydration (63.88%), pale mucous membrane (50.00%) . Sonographic changes in dogs infected with babesiosis revealed hepatomegaly with architectural changes, hypo-echoic changes in the liver parenchyma in 7 dogs, splenomegaly with disturbed architecture and multiple lesions was observed in 9 dogs, cystitis in 5 dogs , distended gall bladder in 3 dogs and in 4 dogs Kidneys structures were not clear in image and no demarcation noticed between cortex and medulla.

Ultrasonographic Alterations of Pancreas in Diabetic Patients

Ultrasonographic Alterations of Pancreas in Diabetic Patients

Subclinical enthesopathy of extensor digitorum tendon is highly prevalent and associated with clinical and ultrasound alterations of the adjacent fingernails in patients with psoriatic disease.

Nail psoriasis disease is associated with an increased probability of psoriatic arthritis, and its clinical signs may have different correlates with the pathogenesis of adjacent bone destruction and have different prognostic value. Recent publications about psoriasis and nail psoriatic disease describe different ultrasonographic findings but the relationship between these ungueal alterations measured by ultrasonography and the presence of enthesopathy of the extensor digitorum has yet to be discovered. To describe which ultrasonographic characteristics of nail psoriasis are associated with the presence of subclinical enthesopathy in patients with PsO and asymptomatic PsA. Patients with psoriasis and asymptomatic psoriatic arthritis were included in the prospective study. Demographic, clinical data and PASI and NAPSI indexes were recorded of all the patients in the assessment visit. The US assessment included Achilles tendon, extensor digitorum tendon and US scan of the nail plate, nail matrix, nail bed and adjacent skin over nail matrix of the five nails of each hand. Forty-eight patients were included in the study; 33 of them presented ultrasound evidence of extensor digitorum tendon enthesopathy. Nails of the patients with subclinical enthesopathy had a higher NAPSI and skin thickness than the nails of the patients without subclinical enthesopathy (P = 0.047). Patients with asymptomatic enthesopathy had significantly thicker proximal nail folds (1.44 ± 0.312 vs. 1.23 ± 0.27, P = 0.023). Nail beds and matrices were also thicker but the differences were not statistically significant (1.77 ± 0.27 vs. 1.74 ± 0.21, P = 0.66, and 1.79 ± 0.28 vs. 1.67 ± 0.19, P = 0.10, respectively). No statistically significant differences in the trilaminar structure were found between both groups. Patients with and without asymptomatic enthesopathy of extensor digitorum tendons did not statistically differ as regards ultrasonographic alterations of the Achilles tendons (60.6% vs. 46.4%, P 0.368). Enthesopathy abnormalities can be detected by US in patients with psoriasis without musculoskeletal complaints frequently. There is a close relationship between subclinical enthesopathy of the extensor digitorum tendon and the presence of nail alterations. Further studies are required to research what implications have the presence of these ungual alterations measured by US, and how it affects later development of a PsA.

Biochemical and ultrasonographic evaluation of exertional rhabdomyolysis and myositis in draft horses

The purpose of this study was to evaluate the biochemical alterations in horses with exertional rhabdomyolysis (ER) and those with myositis and to characterize the progressive changes of both diseases by using ultrasonography (US). For this reason, 40 horses with various symptoms of musculoskeletal disorders were studied. Based on the competent case history, clinical symptoms, and in combination with clinicopathological findings as well as ultrasonographic alterations, the investigated horses were allocated into two main groups: ER-group (n = 7) and myositis group (n = 33). Blood samples were drawn from all investigated horses for laboratory assessment. The obtained findings revealed that horses with mild and severe forms of ER had a statistically significant (P < 0.05) high serum enzymatic activity of creatine phosphokinase (CPK), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST), with significant (P < 0.05) low values of serum calcium compared with those of myositis as well as a control group. Horses with severe ER also demonstrated a statistically significant (P < 0.05) high value of blood urea nitrogen, serum magnesium, phosphorus, and potassium, with significant (P < 0.05) low values of serum chloride and sodium compared with other groups. Ultrasonically, it appeared that horses with severe ER have had hypoechoic loss of muscle texture, while mildly affected cases showed small hypoechoic cavities replacing the affected muscles. Small hypoechoic cavities separating muscle fibers were also observed in mild cases of myositis, but fibrinous hyperechoic dots prevailed in severe cases. From the results obtained, it can be concluded that the sole use of US for the diagnosis of ER and myositis in investigated horses was not really conclusive, but a combination of serum biochemical analyses, clinical examination findings, and US could facilitate early diagnosis of the studied diseases.

Canine prostate specific esterase (CPSE) as an useful biomarker in preventive screening programme of canine prostate: CPSE threshold value assessment and its correlation with ultrasonographic prostatic abnormalities in asymptomatic dogs.

Due to the increased attention that pet-owners devote to their animals and to the improved veterinary care, investigations regarding methods to early detect prostatic disorders that might affect canine life quality have been performed. Canine prostate specific esterase (CPSE) concentration was reported to be higher in dogs suffering from prostatic diseases. This study aimed to estimate the CPSE threshold as a biomarker to early identify prostatic diseases in asymptomatic dogs. The ultrasonographic examination of the prostate was performed in 19 dogs (6-40kg; 1-5years) with no symptoms of prostatic diseases. Dogs were grouped according to the presence (Group A) or absence (Group B) of prostatic disorders at the ultrasound (altered appearance, the presence of cysts or irregular borders). For each dog, a venous blood sample was collected to measure serum CPSE and the ratio between calculated and normal expected prostatic volume was assessed for each dog. The CPSE data were statistically analysed (t test, p<.05), and the CPSE threshold in blood serum between groups was calculated by ROC. In 11 dogs, ultrasonography showed signs of prostatic abnormalities (Group A, 2-5years), while no signs were detected in eight dogs (Group B, 1-3years). The calculated/estimated volume ratio resulted greater than 1.5 in Group A dogs. The CPSE was statistically different between groups (p<.0001): higher in Group A (mean=184.9, SD=126ng/ml) than in Group B (38.9±22.1ng/ml). The cut-off CPSE threshold was 52.3ng/ml (ROC, AUC=0.974, SE 95.6%, SP 89.2%). This study suggests that CPSE serum concentration higher than 50ng/ml in asymptomatic dogs is associated with ultrasonographic alterations and increased the prostatic size (volume by 1.5 times greater than the normal size). As the onset of prostatic disorders often remains asymptomatic, the rapid assessment of CPSE could be suitable for selecting preventively those animals that would require further accurate evaluation.

Thyroid hormone autoantibodies: are they a better marker to detect early thyroid damage in patients with hematologic cancers receiving tyrosine kinase inhibitor or immunoregulatory drug treatments?

Unlike cytotoxic agents, novel antineoplastic drugs can variably affect thyroid function and so impair patient outcomes. However, the widely used standard thyroid tests have demonstrated low sensitivity for detecting early thyroid damage that leads to dysfunction of the gland. To find a more reliable thyroid marker, we assessed the presence of antibodies binding thyroid hormones (thAbs) in a cancer population undergoing potentially thyrotoxic treatment. From April 2010 to September 2013, 82 patients with hematologic malignancies treated with tyrosine kinase inhibitors or immunoregulatory drugs were recruited. Healthy volunteers (n = 104) served as control subjects. Thyroid function, autoimmunity tests, thAbs, and thyroid sonography were assessed once during treatment. Overall, thAb positivity was recorded in 13% of the entire cohort. In most cases, the thAbs were of a single type, with a predominance of T3 immunoglobulin G. More specifically, thAbs were detected in 11 cancer patients; and abnormal levels of thyroid-stimulating hormone, thyroglobulin antibody, and thyroperoxidase antibody were detected in 6 (p = 0.05), 0 (p = 0.0006), and 2 cancer patients (p = 0.001) respectively. Ultrasonographic alterations of the thyroid were observed in 12 cancer patients. In contrast, of the 104 healthy control subjects, only 1 was positive for thAbs (1%). We have demonstrated for the first time that thAbs are a reliable marker of early thyroid dysfunction when compared with the widely used standard thyroid tests. A confirmatory prospective trial aiming at evaluating thAbs at various time points during treatment could clarify the incidence and timing of antibody appearance.

Avaliação ultrassonográfica do bulbo ocular em cães submetidos à facoemulsificação com ou sem implante de lente intraocular

Este trabalho objetivou descrever e comparar as alterações ultrassonográficas encontradas em bulbos oculares de cães submetidos à facoemulsificação, com ou sem implante de lente intraocular (LIO), no intuito de auxiliar no diagnóstico de alterações decorrentes da cirurgia e do implante da LIO, bem como sua correspondência com alterações clínicas. Dezenove cães portadores de catarata (21 olhos) foram submetidos ao procedimento de facoemulsificação e avaliados no pós-operatório tardio, aos cinco anos de evolução. Constituíram-se três grupos experimentais: afácicos (CA), formados por 11 cães; pseudofácicos (PP), com implante de duas LIOs em piggyback (n=5); e pseudofácicos (PL), com implante de uma LIO veterinária (n=5). Após exame oftálmico, todos foram submetidos ao exame ultrassonográfico, sob anestesia tópica, com transdutor linear multifrequencial de 10MHz; adicionalmente foram avaliadas medidas biométricas dos bulbos do olho. As principais alterações observadas foram: luxação da LIO, descolamento de retina, hialose asteroide e degeneração vítrea. O exame ultrassonográfico mostrou-se como excelente ferramenta diagnóstica e possibilitou a confirmação e a classificação dessas alterações. Na biometria ocular, pelas medidas entre o corpo ciliar e a câmara vítrea, o implante em piggyback resultou em redução destas em relação aos demais procedimentos instituídos, não havendo diferença ente o comprimento axial e a câmara anterior.

Role of bedside-focused ultrasonographic evaluation in the critical patient: a case report

We present the case report of an 80 years old woman with late posttraumatic (of low intensity without any immediate clinical alteration) onset of dysphnoea, chest pain and hypotension, in which bedside ultrasonography has been a very useful tool in immediate diagnostic definition (acute respiratory distress syndrome – ARDS due to multiple pulmonary contusions), considering and excluding all possible alternative diagnosis with the same clinical presentation, but also providing a “real time” evaluation of therapeutic regimen (hypovolemia versus excessive fluid embalance) and, last but not least, the chance to perform a close follow up of the ultrasonographic alterations (pleural effusion, signs of alveolar consolidation) pointed out at initial diagnosis. Moreworthly, it has been possible to identify the previous mentioned lesion before they had become evident to standard X-Ray chest evaluation.

Blood Pressure, Thyroid-Stimulating Hormone, and Thyroid Disease Prevalence in Primary Aldosteronism and Essential Hypertension

A positive correlation between thyroid-stimulating hormone (TSH) and blood pressure (BP) has been identified in normotensives and in patients with essential hypertension (EH). This study was designed to evaluate, in primary aldosteronism (PA) and in EH, potential association of BP, TSH, and ultrasonographic changes of the thyroid. We studied 188 patients: 92 with PA and 96 matched essential hypertensives. Clinical and ambulatory BP (ABP), and thyroid function were evaluated in all patients. In PA and in a subgroup of EH patients (n = 65) thyroid ultrasonography was performed. In PA patients, diastolic office and diastolic ABP increased across TSH quartiles and multivariate analysis confirmed a positive significant correlation between TSH and diastolic BP, independently of aldosterone levels, body mass index (BMI), duration of hypertension, and age. In EH patients, we found a significant linear increase in systolic and diastolic ABP with increasing TSH. The prevalence of thyroid dysfunctions was similar in PA and EH (15% and 19%, respectively). In PA patients, we found a higher prevalence of ultrasonographic alterations than in EH (66% vs. 46%, P < 0.05). PA patients presenting morphological abnormalities had higher homeostasis model assessment-insulin resistance levels than patients with normal gland at ultrasonography (4.2 ± 1.8 vs. 3.1 ± 0.8 P < 0.05). We found a positive correlation between TSH and BP both in PA and EH patients. Moreover, in PA patients we observed a high prevalence of thyroid morphological alterations.

A and B mode ultrasonography in preoperative evaluation of lens and posterior segment of dogs eyes with cataract

Ultrasonography of the lens and posterior segment is an indispensable step in the preoperative evaluation of dogs with cataracts, since ophthalmoscopy is not feasible when there is opacification of the lens. This study evaluated the echographic conditions of cataractous lens and fundus of the eye in dogs affected by cataracts. The study was conducted in 30 dogs (56 eyes), 10 males and 20 females, with different types of cataracts at different stages of development. Echography in A and B modes, simultaneously, was carried out for the examination of the lens and posterior segment. The examinations revealed anterior cortical, posterior cortical and nuclear cataract in 12 eyes (21.4%), anterior cortical, posterior cortical, nuclear and posterior capsular in 23 eyes (41%), anterior cortical, posterior cortical and posterior capsular cataract in one eye (1.7%), anterior cortical and nuclear cataract in one eye (1.7%), anterior cortical, nuclear and posterior capsular cataract in five eyes (8.9%), and anterior cortical cataract in seven eyes (12.5%). Abnormal ultrasonographic alterations were observed in the posterior segment in 26 eyes evaluated (46.4%). Vitreal degeneration was detected in 12 eyes (21.4%), images of vitreal exudate or hemorrhage in seven eyes (12.5%), persistence of hyaloid artery in four eyes (7.1%) and lens subluxation in three eyes (5.3%). The results obtained reiterate the importance of ultrasonography in canine patients presented for cataract surgery given that alterations of the posterior segment are difficult to identify in a clinical examination when the lens is opacified.