Ultrasound Intervention Research Articles

Segmentation and recognition of breast ultrasound images based on an expanded U-Net.

This paper establishes a fully automatic real-time image segmentation and recognition system for breast ultrasound intervention robots. It adopts the basic architecture of a U-shaped convolutional network (U-Net), analyses the actual application scenarios of semantic segmentation of breast ultrasound images, and adds dropout layers to the U-Net architecture to reduce the redundancy in texture details and prevent overfitting. The main innovation of this paper is proposing an expanded training approach to obtain an expanded of U-Net. The output map of the expanded U-Net can retain texture details and edge features of breast tumours. Using the grey-level probability labels to train the U-Net is faster than using ordinary labels. The average Dice coefficient (standard deviation) and the average IOU coefficient (standard deviation) are 90.5% (±0.02) and 82.7% (±0.02), respectively, when using the expanded training approach. The Dice coefficient of the expanded U-Net is 7.6 larger than that of a general U-Net, and the IOU coefficient of the expanded U-Net is 11 larger than that of the general U-Net. The context of breast ultrasound images can be extracted, and texture details and edge features of tumours can be retained by the expanded U-Net. Using an expanded U-Net can quickly and automatically achieve precise segmentation and multi-class recognition of breast ultrasound images.

Decreasing 30-day Readmissions for Pleural Effusions after Lung Transplant

<h3>Purpose</h3> Pleural effusions (PEF) after lung transplant (LT) are a common cause of early readmissions, leading to patient suffering and increased cost. We conducted a quality improvement intervention to reduce 30-day readmissions for PEF after LT by 50% over six months. <h3>Methods</h3> We determined the baseline conditions of 30-day readmissions for PEF among patients transplanted in 2018 and 2019 at our institution. Then, we analyzed clinical, laboratory, and radiological data and interviewed LT providers to identify root causes. Finally, we explored countermeasures, implemented targeted interventions from March to September 2020, and tracked monthly performance. <h3>Results</h3> At baseline, 16/115 (14%) patients were readmitted within 30 days, 7/16 (44%) for PEF. CT scans at week 2 and 4 after LT were done in 108 (93%) patients. At week 2, 75 (69%) had small PEF and 1 (1%) had moderate PEF. At week 4, 70 (65%) had small PEF and 9 (8%) had moderate or large PEF. PEF enlarged in 5/7 (71%) patients readmitted for PEF compared to 1/9 (11%) patients readmitted for other causes, and 3/92 (3%) not readmitted. We identified enlarging PEF as a root cause for readmissions. We implemented an ultrasound intervention to assess PEF size at discharge, volume status, feasibility of increasing diuresis, and need for PEF drainage. During the intervention, 30/42 discharged patients (71%) had ultrasound. Monthly ultrasound performance increased from 57% to 75-100%. Ultrasound prompted PEF drainage before discharge in one patient. PEF enlargement was detected in 2/38 patients (5%) in CT scans. Four patients had ultrasound to reassess PEF after discharge. Seven patients (16%) were readmitted within 30 days, one (14%) for PEF. Two patients had small PEF on ultrasound and CT scan but were not the cause of their readmissions. <h3>Conclusion</h3> Small PEF are common after LT, yet only a subset enlarge and lead to 30-day readmissions. While better understanding of PEF development after LT is needed, ultrasound at discharge is feasible and allows timely interventions to decrease readmissions.

Exploiting ultrasound tongue imaging for the automatic detection of speech articulation errors

Speech sound disorders are a common communication impairment in childhood. Because speech disorders can negatively affect the lives and the development of children, clinical intervention is often recommended. To help with diagnosis and treatment, clinicians use instrumented methods such as spectrograms or ultrasound tongue imaging to analyse speech articulations. Analysis with these methods can be laborious for clinicians, therefore there is growing interest in its automation. In this paper, we investigate the contribution of ultrasound tongue imaging for the automatic detection of speech articulation errors. Our systems are trained on typically developing child speech and augmented with a database of adult speech using audio and ultrasound. Evaluation on typically developing speech indicates that pre-training on adult speech and jointly using ultrasound and audio gives the best results with an accuracy of 86.9%. To evaluate on disordered speech, we collect pronunciation scores from experienced speech and language therapists, focusing on cases of velar fronting and gliding of /r/. The scores show good inter-annotator agreement for velar fronting, but not for gliding errors. For automatic velar fronting error detection, the best results are obtained when jointly using ultrasound and audio. The best system correctly detects 86.6% of the errors identified by experienced clinicians. Out of all the segments identified as errors by the best system, 73.2% match errors identified by clinicians. Results on automatic gliding detection are harder to interpret due to poor inter-annotator agreement, but appear promising. Overall findings suggest that automatic detection of speech articulation errors has potential to be integrated into ultrasound intervention software for automatically quantifying progress during speech therapy.

Fuzzy model based on local injection of MTX combined with traditional Chinese medicine guided by ultrasound intervention to treat CSP

In view of pregnancy at the uterine scar after cesarean section, there is an urgent need to find a conservative treatment mode with drugs that can improve the success rate of treatment, shorten the conservative treatment time, and cause little harm to the body. This research combines ultrasound intervention technology to construct a fuzzy model to comprehensively evaluate the clinical effects of traditional Chinese medicine combined with western medicine in the treatment of CSP. Moreover, this research combines the current application algorithms of machine vision to explain the relevant principles of ultrasound interventional vision. In addition, this research uses the background subtraction method to extract the target, and uses the machine vision algorithm to extract the ultrasonic detection target object. Finally, this research adjusts the control parameters according to the fuzzy control, and outputs the optimal control plan with BP network training. The results of this study show that the combination of Chinese and Western medicines in the treatment of uterine scars after cesarean section has the advantages of small gestational sacs, short pregnancy, and low blood β-HCG, and it has the advantages of less pain, economy, fewer side effects, and successfully preserves the uterus. Therefore, it is worthy of clinical application.

Low intensity pulsed ultrasound information technology intervention in diagnosis and prediction of Muscle Atrophy.

Objective:To discuss the effects and function of LIPUS on muscle atrophy (MA), analysis from various aspects through the study of low-intensity pulsed ultrasound (LIPUS) information technology intervention (ITI) in diagnosis and the prediction of muscle atrophy..Method:In this study conducted in our university, 74 healthy female SD rats aged three months, weighing 100-200g were selected. All rats were placed in sterile cages from June 2020 to September 2020. They were divided into three groups. In the OVO group and OVE group, the mice are treated with LIPUS, Finally, the changes of body weight, grasping power, biochemical indexes and glycogen content of gastrocnemius muscle were analyzed and recorded to explore the effect and value of LIPUS ITI combined with intermittent weight-bearing exercise in the treatment of MAResults:After weight-bearing running, the body weight of model (OVO) group, exercise (OVE) group and NC group had significant statistical significance (P<0.01). It was found that the weight of OVE group was much more as compared to OVO group. There was significant difference in body weight between OVO group and NC group (P<0.05). After LIPUS treatment, it was found that the weight of OVO group, OVE group, LIPUS group and OVE +LIPUS group increased. Compared with the NC group, there was significant statistical difference (P<0.01).Conclusion:Low intensity pulsed ultrasound ITI has a good effect on improving MA, so as to effectively improve the weight of gastrocnemius muscle. The combined application of the two is better for the improvement of muscular atrophy.

Ultrasound Intervention Techniques in Patellar Tendinopathy: A Review

Patellar tendinopathy is a very common, yet very difficult pathology to treat. Its’ frequency in elite athletes, especially in jumping sports, can go as high as 14%. Recently it has been suggested that chronic tendinopathy may be an active process of ongoing tendon degeneration bearing close relation with inflammation-mediated responses, the intensity of pain in patellar tendinopathy appears to have a stronger relation with the number of newly formed blood vessels observed on Doppler ultrasound. This article is a descriptive review of the available information which was obtained during a 1-month period (September 2021) and the following search keywords were used: interventional ultrasonography; patellar ligament; tendinopathy. Based on the information obtained, a total of 787 articles were revied, mainly published in the last 10 years in Pubmed, Medline, and SciELO databases; out of these, a total of 15 articles were used as citations. Even though conservative treatment is preferred as a first-line treatment, if, during a 6-month period it fails, then surgical treatment is proposed; however, recovery time is a crucial issue for elite athletes. Treatment by ultrasound-guided interventionism is presented as an effective alternative and allows athletes to return to their regular activities in less time, with optimal results. In the literature there are not many articles that describe the various techniques of ultrasound-guided interventionism for the treatment of patellar tendinopathy, thus, we have carried out this bibliographic review. Keywords: Interventional ultrasonography, Patellar ligament, Tendinopathy.

운동 전 적용된 지속초음파와 맥동초음파가 운동 유발성 근육 손상의 통증과 근피로대사산물에 미치는 효과

운동 전 적용된 지속초음파와 맥동초음파가 운동 유발성 근육 손상의 통증과 근피로대사산물에 미치는 효과

Ultrasound-Guided Central Venous Catheters in Elderly Patients with Cardiopulmonary Resuscitation

Objective: The elderly patients with cardiopulmonary resuscitation in intensive care unit (ICU), usually need timely and effective central vein catheterization to ensure the effective treatment. The aim of this study was to investigate the effect and safety of ultrasound-guided peripherally inserted central venous catheters (PICC) in elderly patients with cardiopulmonary resuscitation in ICU. Method: A total of 80 elderly patients with cardiopulmonary resuscitation from September 2016 to December 2019 were selected in Lu'An Hospital of Traditional Chinese Medicine. They were randomly divided into ultrasound group (40 cases) and conventional group (40 cases). The patients in conventional group were treated with conventional PICC, while the patients in ultrasound group were treated with ultrasound-guided PICC. The surgery, puncture success rate and complications were compared between ultrasound group and conventional group. Result: Ultrasound intervention showed the location of vessel at the puncture site and the whole process of catheter entry. Compared with the conventional group, the operation time, puncture time and intraoperative blood loss in ultrasound group was significantly less (P &lt; 0.05). The success rate of once puncture in the ultrasound group was higher than that in conventional group (93% vs. 70%, P&lt; 0.05). Compared with conventional group, the incidence of complications in ultrasound group was significantly lower than (P &lt; 0.05). Conclusion: Compared with conventional PICC, ultrasound-guided PICC can provide better effect and reduce the incidence of complications for the elderly patients with cardiopulmonary resuscitation in ICU.

Randomized Controlled Trial of Point-of-Care Ultrasound Education for the Recognition of Tension Pneumothorax by Paramedics in Prehospital Simulation.

The primary goal of this study was to determine if ultrasound (US) use after brief point-of-care ultrasound (POCUS) training on cardiac and lung exams would result in more paramedics correctly identifying a tension pneumothorax (TPTX) during a simulation scenario. A randomized controlled, simulation-based trial of POCUS lung exam education investigating the ability of paramedics to correctly diagnose TPTX was performed. The US intervention group received a 30-minute cardiac and lung POCUS lecture followed by hands-on US training. The control group did not receive any POCUS training. Both groups participated in two scenarios: right unilateral TPTX and undifferentiated shock (no TPTX). In both scenarios, the patient continued to be hypoxemic after verified intubation with pulse oximetry of 86%-88% and hypotensive with a blood pressure of 70/50. Sirens were played at 65 decibels to mimic prehospital transport conditions. A simulation educator stated aloud the time diagnoses were made and procedures performed, which were recorded by the study investigator. Paramedics completed a pre-survey and post-survey. Thirty paramedics were randomized to the control group; 30 paramedics were randomized to the US intervention group. Most paramedics had not received prior US training, had not previously performed a POCUS exam, and were uncomfortable with POCUS. Point-of-care US use was significantly higher in the US intervention group for both simulation cases (P <.001). A higher percentage of paramedics in the US intervention group arrived at the correct diagnosis (77%) for the TPTX case as compared to the control group (57%), although this difference was not significantly different (P = 0.1). There was no difference in the correct diagnosis between the control and US intervention groups for the undifferentiated shock case. On the post-survey, more paramedics in the US intervention group were comfortable with POCUS for evaluation of the lung and comfortable decompressing TPTX using POCUS (P <.001). Paramedics reported POCUS was within their scope of practice. Despite being novice POCUS users, the paramedics were more likely to correctly diagnose TPTX during simulation after a brief POCUS educational intervention. However, this difference was not statistically significant. Paramedics were comfortable using POCUS and felt its use improved their TPTX diagnostic skills.

Care redesign of pelvic radiotherapy using Design Thinking: An enhanced quality improvement initiative.

246 Background: Cone Beam Computed Tomography(CBCT) is the cornerstone of image guided radiotherapy(IGRT) which is an integral part of pelvic cancers like prostate cancer. Each pelvic radiotherapy (RT) session is preceded by a planned CBCT to ensure target localisation and organ at risk avoidance. When these criteria are not met, an unplanned CBCT is performed until the CBCT is satisfactory. Possible reasons for an unsatisfactory CBCT include an under filled bladder, distended rectum or prostate gland movement. Repeated unplanned CBCT results in unnecessary excess radiation for patients. We aimed to reduce the incidence of unplanned CBCT from a baseline of 21% to 9% over 5 months. Methods: We conducted the project using both conventional quality improvement methodology and the design thinking methodology. In the diagnostic phase up to March 2017, the baseline incidence of CBCT in patients receiving pelvic RT was 21%. We hypothesized that there were reversible factors leading to a higher incidence of unplanned CBCT and sought to identify and rectify these reversible factors to reduce the incidence of unplanned CBCT. Using human centred design, we designed a new process of performing a bladder ultrasound prior to CBCT to ensure a full bladder prior to RT using the steps empathy, define, ideation, prototype, testing, sharing. Results: A total of 97 patients that underwent pelvic radiotherapy were included in this study, 40 patients were pre intervention and 61 patients received the bladder ultrasound intervention implemented from April 2017 onwards. After intervention, incidence of unplanned decreased from 21% to 5.8%. A 2 sample t test was used to compare the unplanned CBCT pre and post intervention. We found the mean pre and post intervention difference in pooled mean incidence of unplanned CBCT to be significantly different by 13.3%. The reduction in unplanned CBCT translated to saving each patient on average equivalent to 3000 chest x rays worth of unnecessary radiation. Conclusions: Design Thinking is a feasible strategy in quality improvement. We report the first design thinking project in radiation oncology quality improvement. An automated ultrasound bladder is a feasible strategy to screen for bladder filling prior to each CBCT to reduce reliance on CBCT and also patient exposure to radiation in IGRT of pelvic cancers.

Accelerated convective drying of sunflower seeds by high-power ultrasound: Experimental assessment and optimization approach

The objective of the present issue was to inquire the effect of ultrasound assisted convective drying on a thin layer of sunflower seeds. The process was carried out utilizing a hybrid chamber dryer, outfitted with an ultrasound generator with indirect transmission toward the material surface. Drying behavior was analyzed by drying time, effective moisture diffusivity (Deff), energy consumption (EC), water activity (aw), and total color change (ΔE). Independent variables of air temperature and ultrasound power determined the efficiency of sonication during drying. So that, ultrasound contributed to a noticeable increase in Deff up to 44.84%. Thereafter, a reasonable decrease was found in drying time, energy consumption, and total color change up to 40.85%, 32.95%, and 44.56%, respectively when collocating the variables of 35°C, 3.5m/s, and 2.4W/g. The optimum drying condition in the pure convective drying domain was improved from 50.74°C and 2m/s to the condition of 40.64°C, 2m/s, and 3.932W/g after sonication. In this point, significant reductions of 19.89% and 19.32% were observed in drying time and energy consumption. Optimization results confirmed that ultrasound intervention could provide an intensified and energy-efficient drying process, which generates sustainable and qualified dried seeds.

Progress in the Application of Ultrasound Elastography for Brain Diseases.

Ultrasound (US) can be used to evaluate the brain structure and nervous system damage. Patients with neurologic symptoms need rapid, noninvasive imaging with high spatial resolution and tissue contrast. Magnetic resonance imaging is currently the most sensitive and specific imaging method for evaluating neuropathologic conditions. This approach does present some challenges, such as the need to transport patients who may be seriously ill to the magnetic resonance imaging suite and the need for patients to remain for a considerable time. Cranial US provides a very valuable imaging method for clinicians, which can make a rapid diagnosis and evaluation without ionizing radiation. The main disadvantage of cranial US is its low sensitivity and specificity for subtle/early lesions. In recent years, with the rapid development of anatomic and functional US technology, the practicability of US diagnosis and intervention has been greatly improved. Ultrasound elastography may have the potential to improve the sensitivity and specificity of various cranial nerve conditions. Ultrasound elastography has received considerable critical attention, and an increasing number of studies have recognized its critical role in evaluating brain diseases. At present, US elastography has been applied to the evaluation of traumatic brain injury, ischemic stroke, intraoperative brain tumors, and hypoxic ischemic encephalopathy. The latest animal experiments and human clinical trial developments in the applications of US elastography for brain diseases are summarized in this review.

A New Parental Mentalization Focused Ultrasound Intervention for Substance Using Pregnant Women. Effect on Self-reported Prenatal Mental Health, Attachment and Mentalization in a Randomized and Controlled Trial

The effect of a novel mentalization-based parenting intervention was explored on prenatal self-reported mentalization (P-PRFQ), attachment (MFAS), depression (EPDS) and anxiety (STAI) among women with substance use problems. The participants were 90 pregnant women referred to obstetric outpatient care due to recent or current substance use and randomized into intervention (n = 46) and control (n = 44) groups. The intervention group received three interactive 4D ultrasound sessions and a week-by-week pregnancy diary. The control condition was constituted of treatment-as-usual in obstetric care. Unfortunately, the efficacy of the intervention on maternal prenatal mental health, attachment, and parental mentalization was not substantiated. The negative results may be related to the small sample size, the patient-reported outcomes, or insufficient efficacy within this high-risk group. In the context of high psychosocial risks and follow-up by Child Welfare Services, the patient-reported outcomes may have underestimated prenatal adversity. The role of the research context, methodology, and possible sources of bias in the outcome assessment are discussed.The trial registration number in the ClinicalTrials.gov: NCT03413631

Is There a Role for Titre Monitoring in Kell Alloimmunized Pregnancies?

Background: Kell and Rhesus (Rh) maternal red blood cell (RBC) alloimmunization are the most common causes of severe fetal haemolytic disease. Widespread use of anti-D immune globulin has dramatically reduced the incidence of Rh(D) alloimmunization, leaving K alloimmunization responsible for a significant proportion of cases of fetal anemia requiring intrauterine transfusion ( ). K antigens are expressed on fetal erythrocytes at 10-11 weeks and k antigens at 6-7 weeks gestation (Tovey et al, 1986). In alloimmunized women, erythroid specific antibodies traverse the placenta, causing immune destruction of fetal erythroid cells leading to progressive haemolytic anaemia. The mechanism of fetal anaemia in K alloimmunization differs somewhat from that in Rh-D, in that anti-K antibodies cause suppression of fetal erythropoiesis (Gariod et al, 2004; Weiner et al, 1996). Whilst IUT of RBCs has improved fetal and neonatal survival, important information such as the critical anti-K titres to guide appropriate timing and frequency of IUT, is somewhat conflicting. Currently anti-K alloimmunized pregnancies do not have a standardized protocol for titer monitoring throughout pregnancy and, once alloimmunized, patients are usually referred to a regional fetal center for close ultrasound (US) surveillance. Our primary objective is to determine from a retrospective analysis of our population whether there is a critical anti-K titer that should trigger intensive US monitoring or intervention and to investigate the rate of progression of fetal anemia following IUTs. Methods: This is a retrospective single-center study at Mount Sinai Hospital (MSH), Toronto, Canada, of all pregnant patients with anti-K as the primary alloimmunizing antibody, between 1991 and 2018. MSH is the largest fetal medicine center in Canada and the largest referral center for IUTs. Ethical approval was granted by the Research Ethics Board (REB # 12-0113-C). Data were obtained from a database of patient medical records, US reports and the transfusion medicine laboratory, including maternal demographics, pregnancy history, presence of other alloantibodies and hemoglobin concentration before and after all IUTs. Neonatal outcomes included survival, mode of delivery, gestational age (GA) at delivery, birth weight and need for neonatal exchange transfusion, phototherapy or IVIG. Data were analyzed using GraphPad Prism 6 and linear correlations are expressed as a p-value. Results: Thirty-eight women underwent 163 IUTs in 44 pregnancies where K was the predominant antibody. Two patients in whom anti-K was a secondary antibody were excluded. In 5 of these pregnancies, 2 had a total of three alloantibodies and 5 had 2 alloantibodies each. The median maternal age was 31 (29 - 35) years. Four women had a history of intrauterine fetal death (IUFD) and 9 of neonatal haemolytic disease. The median GA at 1st IUT was 24.2 weeks (14.9-34.7), and there was a median of 4 IUTs per patient. There were seven cases of hydrops fetalis. The number of IUTs a patient received throughout pregnancy was correlated directly with the anti-K titer (Figure 1). Every 4-fold dilution resulted in a further increase in the IUT number by 2.2 above the mean of 2.5 at a titer of 1:32 (p=0.0137). Figure 2 illustrates the correlation between the GA at 1st IUT and antibody titer. IUTs were required at earlier GAs if the titers were higher. Following a 1:32 titer, every 2-fold titer increase reduced the mean gestational age at 1st IUT by 2 weeks (p&lt;0.0001). No pregnancy required an intervention with an anti-K titer &lt; 1:32. The median fetal Hb at the first IUT was 48 (8-91) g/L with an average daily decrease of hemoglobin of 4.7 g/L/day between the first and second IUT (Figure 3), which is similar to the 4.1 g/L/day previously reported in Rh(D) alloimmunization. The median GA was 37.1 (24-39.7) weeks at delivery with median birth weight centile of 59.5%; 8.9% of neonates required a blood transfusion and 24.4% required phototherapy. There were four IUFDs and one neonatal . Conclusion: Our data support a critical anti-K titer of 1:32 and support a role for anti-K titer monitoring as a predictor of disease severity, counselling women appropriately and establishing a balance between paternal K antigen typing, US middle cerebral artery peak systolic velocity monitoring of the fetus and IUTs. Disclosures Garbowski: Vifor Pharma: Consultancy; Imara: Consultancy.

INTERVENSI ULTRASOUND DAN MUSCLE ENERGY TECHNIQUE LEBIH MENURUNKAN DISABILITAS LEHER DARIPADA INTERVENSI ULTRASOUND DAN MYOFASCIAL RELEASE TECHNIQUE PADA KASUS MYOFASCIAL PAIN SYNDROME OTOT UPPER TRAPEZIUS DI DENPASAR

Background: Myofascial Pain Upper trapezius muscle syndrome is a condition of both acute and chronic pain from muscle or fascia involving sensory, motoric, or autonomic functions. Myofascial pain can be local or regional, such as the neck, shoulders, usually unilateral or more severe in one side. Objective: To prove Ultrasound and Muscle Energy Technique Interventions to reduce neck disability more than Ultrasound and Myofascial Release Technique Interventions in the case of Myofascial Pain Syndrome Upper Trapezius muscle in Denpasar. Method: This study uses the Randomized Pre-test method and the Design Group Post Test Control. This study used 36 subjects divided into 2 groups, First Treatment Group with Ultrasound and Muscle Energy Technique and II Treatment Group with Ultrasound and Myofascial Release Technique. The two treatment groups were given treatment for 4 weeks. The measuring instrument used for neck disability is the Neck Disability Index (NDI). Results: The results of the independent t-test which showed the results of the calculation of the difference in mean neck disability obtained p = 0.372 (p&gt; 0.05). Conclusion: Ultrasound intervention and muscle energy technique further reduced neck disability than an ultrasound intervention and myofascial release technique in the case of myofascial pain syndrome upper trapezius muscleKeywords: Myofascial Pain Syndrome, upper trapezius muscle, Ultrasound, muscle energy technique, myofascial release technique, Neck Disability Index.

PENGARUH PEMBERIAN ULTRASOUND THERAPY DAN NEUROMUSCULAR TAPING DALAM MENINGKATAN AKTIVITAS FUNGSIONAL PADA KASUS OSTEOARTHRITIS LUTUT

Background: Osteoarthritis is a complaint characterized by abnormalities in the cartilage of joints and bones nearby, this complaint is commonly felt and has become a chronic joint disease. Cartilage abnormalities will result in bones rubbing against each other, resulting in symptoms of stiffness, pain and restriction of movement in the joints that will affect the quality of functional activities performed. The aim of this study was to determine the effect of ultrasound therapy and neuromuscular taping (nmt) in increasing functional activity in cases of knee osteoarthritis.Research method: The study used experimental with randomized design type pre test and post test control group design. The study was divided into 2 groups, namely group 1 would receive Ultrasound intervention and group 2 would receive Ultrasound and neuromuscular taping intervention. The number of samples in this study was 11 samples per group so that the total number of samples in the two groups was 22 respondents. Measurements of knee functional activity values were measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire.Results: Group 1 with a value of p = 0,000 (p &lt;0.05) which showed a significant difference between the value of tenderness before and after the intervention of ultrasound therapy. Group 2 obtained a value of p = 0,000 (p &lt;0.05) indicating there was a significant difference between the value of tenderness before and after the intervention of ultrasound therapy and neuromuscular taping. The results of the calculation of the mean difference were p = 0,0001, the data showed that there was no difference in influence between groups, which means that the provision of ultrasound therapy and neuromuscular taping was no better in increasing functional activities of knee OA patients compared to ultrasound therapy.Conclusion: the provision of ultrasound therapy and neuromuscular taping is not better in increasing

Ultrasound therapy reduces persistent post-thoracotomy tactile allodynia and spinal substance P expression in rats

BackgroundTherapeutic ultrasound (TU) alleviates nerve injury-associated pain, while the molecular mechanisms are less clear. This is an investigator-initiated experimental study to evaluate the mechanisms and effects of ultrasound on prolonged...

Surgical and intervention treatment of secondary pancreatic infections

Introduction. Many experimental and clinical studies have improved our understanding of the pathophysiology of acute pancreatitis. Today, there are no disagreements over the timing and basic indications for surgery in this disease, but there are still various surgical approaches.&#x0D; Methods. A retrospective and prospective two-center controlled study was conducted in 582 patients with acute pancreatitis treated in 2004–2018. Age of patients was 53 ± 12,5 years. The classification of the disease was used according to the recommendations of the International Consensus 2012. Patients included in the study were treated in accordance with the IAP/APA (2013) recommendations adapted to local resources and procedures. Of 582 patients, 387 (66,5%) patients with mild to moderate heaviness performed complex treatment, including 89 patients undergoing surgery. According to the goals and objectives of the study, other patients were divided into two groups: the main group – 103 patients with secondary pancreatic infection, who used the tactic of treatment «step-up approach»; а comparison group – 92 patients with open surgical intervention.&#x0D; Results. In the comparison group were used open necrosectomy and drainage. Postoperative complicationshavearisenin52 (56,2%)patients. After surgery died 26 patients (28,3%), 19 had a 30-day mortality and 7 had a 90-daymortalityof them. In the main group 62 (60,2%) patients were treated by percutaneous controlled ultrasound intervention, 26 (25,2%) by videolaparoscopic necrosectomy and drainage and at 5 (4,9%) drainage through the wall of the stomach or duodenum. In 10 (9,7%) open operations were performed (minilumbotomy, upper medial, left or right-winged minilaparotomy with formation of mini-bursostomy) with pancreatic necrosectomy, including at 5 decompressive VAC-laparostomy local access. Postoperative complications have arisen in 33 (32%) patients. After surgery died 15 patients (14,6%), 6 had a 30-day mortality and 9 had a 90-day mortality of them. When comparing the two strategies of the treatment-tactical approach, the number of postoperative complications and mortality were lower than in the group of patients who performed only open surgical interventions (х2 = 6,976, p = 0,011).&#x0D; Conclusion. The our research showed that an individualized approach to patients with secondary pancreatic infection using the step-up approach provides a reduction in the number of laparotomic pancreatic necrosectomies and allows postponing «open» surgical interventions for a period after the 4th week from the onset of the disease and reducing the number of postoperative complications and mortality (х2 = 6,976, р = 0,031).

Moving toward Noninvasive, Focused Ultrasound Therapeutic Delivery of Drugs in the Brain: Prolonged Opening of Blood-Brain Barrier May Not Be Needed.

Moving toward Noninvasive, Focused Ultrasound Therapeutic Delivery of Drugs in the Brain: Prolonged Opening of Blood-Brain Barrier May Not Be Needed.

Deep bed rough rice air-drying assisted with airborne ultrasound set at 21 kHz frequency: A physicochemical investigation and optimization

This study investigates the feasibility of achieving a modified rough rice air-drying with ultrasound intervention (US) set at 21 kHz frequency. The process was carried out using an ultrasound assisted convective dryer and analyzed in terms of drying time, energy consumption (EC), evaporation rate (ER), broken kernel (BK), water activity (aw), vitamin B3 (niacin), and total phenolic content (TPC). The lab-scale dryer was set to transmit energy at power levels of 30, 60, 90, 120, and 150 W in the air temperatures of 35, 40, 45, 50, and 55 °C and velocities of 0.2, 0.5, 0.8, 1.1, and 1.4 m/s for a thickness of 20 cm. The results showed that in-range drying parameters played a major role in response analysis, suggesting that ultrasound efficiency during convective drying heavily depends on the power, air temperature, and velocity levels. Ultrasound assistance significantly increased bed evaporation rate up to 38.93%. Subsequently, it caused a reasonable reduction in total drying time, EC, and BK percentage up to 27.92%, 25.98%, and 34.22%, respectively in the case of 35 °C, v = 0.8 m/s, and P = 90 W. Remarkable advances were attained in the ultrasound assisted drying domain in grain quality via acceptable decrease in niacin and TPC losses within shorter drying time. There was a significant linear trend in BK, niacin, and TPC values across the bed thickness, which all was increased by the ultrasound application. The highest nutrient retention and physical quality preservation belonged to the top layer, which was influenced by the ultrasound radiation by the highest degree.