Ultrasound Results Research Articles

Nomogram for predicting lymph node metastasis in patients with ovarian cancer using ultrasonography: a multicenter retrospective study

BackgroundOvarian cancer is a common cancer among women globally, and the assessment of lymph node metastasis plays a crucial role in the treatment of this malignancy. The primary objective of our study was to identify the risk factors associated with lymph node metastasis in patients with ovarian cancer and develop a predictive model to aid in the selection of the appropriate surgical procedure and treatment strategy.MethodsWe conducted a retrospective analysis of data from patients with ovarian cancer across three different medical centers between April 2014 and August 2022. Logistic regression analysis was employed to establish a prediction model for lymph node metastasis in patients with ovarian cancer. We evaluated the performance of the model using receiver operating characteristic (ROC) curves, calibration plots, and decision analysis curves.ResultsOur analysis revealed that among the 368 patients in the training set, 101 patients (27.4%) had undergone lymph node metastasis. Maximum tumor diameter, multifocal tumor, and Ki67 level were identified as independent risk factors for lymph node metastasis. The area under the curve (AUC) of the ROC curve in the training set was 0.837 (95% confidence interval [CI]: 0.792–0.881); in the validation set this value was 0.814 (95% CI: 0.744–0.884). Calibration plots and decision analysis curves revealed good calibration and clinical application value.ConclusionsWe successfully developed a model for predicting lymph node metastasis in patients with ovarian cancer, based on ultrasound examination results and clinical data. Our model accurately identified patients at high risk of lymph node metastasis and may guide the selection of appropriate treatment strategies. This model has the potential to significantly enhance the precision and efficacy of clinical management in patients with ovarian cancer.

On the two rhotic schwas in Southwestern Mandarin: when homophony meets morphology in articulation.

This is an acoustic and articulatory study of the two rhotic schwas in Southwestern Mandarin (SWM), i.e.,the er-suffix (a functional morpheme) and therhotic schwa phoneme. Electromagnetic Articulography (EMA) and ultrasound results from 10 speakers show that the two rhotic schwas were both produced exclusively with the bunching of the tongue body. No retroflex versions of the two rhotic schwas were found, nor was retraction of the tongue root into the pharynx observed. On the other hand, the er-suffix and the rhotic schwa, though homophonous, significantly differ in certain types of acoustic and articulatory measurements. In particular, more pronounced lip protrusion is involved in the production of the rhotic schwa phoneme than in the er-suffix. It is equally remarkable that contrast preservation is not an issue because the two rhotic schwas are in complementary distribution. Taken together, the present results suggest that while morphologically-induced phonetic variation can be observed in articulation, gestural economy may act to constrain articulatory variability, resulting in the absence of retroflex tongue variants in the two rhotic schwas, the only two remaining r-colored sounds in SWM.

Subclinical giant cell arteritis increases the risk of relapse in polymyalgia rheumatica

ObjectiveThe aim of the present study was to determine the clinical significance of subclinical giant cell arteritis (GCA) in polymyalgia rheumatica (PMR) and ascertain its optimal treatment approach.MethodsPatients with PMR...

The Association of Platelet Index with Event of Deep Vein Thrombosis in Acute Ischemic Stroke Patients at Rumah Sakit Umum Pusat Haji Adam Malik Medan

Introduction: Deep Vein Thrombosis (DVT) occurs in stroke with an incidence varying from 10-75%, depending on the diagnostic method and time of evaluation. Platelets play important role in the pathogenesis of thromboembolism. Large size platelets are more metabolically and enzymatically active also hemostatically more reactive and prone to the development of thrombosis. This study aims to determine the association between platelet index and the occurrence of DVT in patients with acute ischemic stroke. Method: Prospective study with a total of 42 samples acute ischemic stroke patients who were treated ≤ 3 days in the stroke corner of RSUP. H Adam Malik Medan. Compression ultrasonography to diagnose DVT was performed on the lower extremities. Platelet indices assessed were mean platelet volume (MPV), platelet volume distribution width (PDW), and plateletcrit (PCT) based on the results of a complete blood test on admission. Results: The mean age was 59.7 years with male gender as much as 66.7%. The majority of research subjects had a history of hypertension (42.9%) The mean body mass index was 28, 18 kg/mm2. 97.6% were found to have asymptomatic DVT with Well's score of 1 (moderate probability of DVT occurrence). 54.8% of the study subjects with positive DVT results based on compression ultrasound results. There is an association between increased MPV and the incidence of DVT in acute ischemic stroke patients (p = 0.002). Conclusion: There is an association between an increase in MPV value and the incidence of DVT in acute ischemic stroke patients. Keywords: Platelet Index, Deep Vein Thrombosis, Acute Ischemic Stroke, Mean Platelet Volume, Platelet Distribution Width, Plateletcrit

Exploring the diagnostic and prognostic value of the C-reactive protein/lymphocyte ratio for dilated cardiomyopathy based on a real-world study

To determine the risk factors for dilated cardiomyopathy (DCM) and construct a risk model for predicting HF in patients with DCM, We enrolled a total of 2122 patients, excluding those who did not meet the requirements. A total of 913 patients were included in the analysis (611 males and 302 females) from October 2012 to May 2020, and data on demographic characteristics, blood biochemical markers, and cardiac ultrasound results were collected. Patients were strictly screened for DCM based on the diagnostic criteria. First, these patients were evaluated using propensity score matching (PSM). Next, unconditional logistic regression was used to assess HF risk. Furthermore, receiver operating characteristic (ROC) curve analysis was conducted to determine diagnostic efficiency, and a nomogram was developed to predict HF. Finally, the Kaplan‒Meier survival curve was plotted. Of the initial 2122 patients, the ejection fraction (EF) in males was worse. We included 913 patients after the final DCM diagnosis. The results showed that the levels of NT-proBNP, WBC, PLT, neutrophils, lymphocytes, eosinophils, and IL-6, C-reactive protein (CRP) and the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and CRP/lymphocyte ratio (CLR) were higher in males than in females (P < 0.001–0.009). The nomogram showed that factors such as sex, WBC, neutrophils, PLR, and CLR could predict the risk of worsening cardiac function in patients with DCM before and after PSM (P < 0.05). The ROC curve showed that CLR with an 85.6% area demonstrated higher diagnostic efficacy than the NLR (77.0%) and PLR (76.6%, P < 0.05). Survival analysis showed a higher mortality risk in females with higher CLR levels (P < 0.001–0.009). However, high CLR levels indicated a higher mortality risk (P < 0.001) compared to sex. Male EF is lower in DCM patients. CLR could predict the risk of declined cardiac function in patients with DCM. The mortality in females with higher CLR levels was highest; however, the exact mechanism should be investigated.

Cutaneous Metastasis as a Diagnostic Prelude in a 48-year-old Female

Abstract Cutaneous metastasis (CM) describes the spread of a distant primary tumor into the skin. The overall incidence of CM ranges from 5% to 10% with breast cancer having the highest rate in women. CM of breast carcinoma origin may manifest as erysipelas-like erythema on the chest, having distinct raised borders and edema due to lymphatic obstruction termed as carcinoma erysipeloides. In most cases, CM is recognized after the initial diagnosis of primary internal malignancy. However, in 0.6–1% of cases, CM served as the first presenting sign of malignancy. A 48-year-old female presented with multiple, erythematous patches, and plaques with clear-cut raised margins, some topped with violaceous pinpoint papules and nodules on the chest, abdomen, and back. No palpable breast mass was appreciated. There was noted nipple retraction and axillary lymphadenopathy. A 4-mm skin punch biopsy revealed nests of large pleomorphic cells on the papillary dermis admixed with mitotic figures and attempts of ductal formation. CK7 and CEA were positive. Results of ultrasonography and mammogram were highly suspicious of malignancy. Core needle biopsy of the breast mass revealed an invasive ductal carcinoma. In the context of an eczematous presentation on the chest area without palpable nodules or mass on breast examination, a diagnostic challenge is expected. Interestingly, our patient represents a small group of CM having cutaneous lesions as their primary manifestation. A high index of suspicion supplemented with proper clinicopathologic and radiologic correlation is crucial for the diagnosis of CM. A multidisciplinary referral is required for adequate management and overall survival rate.

The effect of homocysteine-lowering therapy on the formation of carotid atherosclerosis: A follow-up study in the rural areas of northwest China

ObjectiveTo explore the risk factors for carotid atherosclerosis in the rural areas of Northwest China, and to assess whether reducing serum homocysteine can prevent carotid atherosclerosis in subjects with hyperhomocysteinemia. MethodThis observational study with 767 participants aged 40 years or older was conducted over 3 years. Color Doppler ultrasonography was performed to measure carotid atherosclerosis. We recorded biochemical indexes and carotid ultrasound results in the first and fourth years. ResultA total of 767 individuals (48.5 % men) were analyzed. Older age, hypertension, and higher levels of baseline low-density lipoprotein cholesterol (LDL-C) were risk factors for increased carotid intima-media thickness (CIMT), carotid plaque, and carotid stenosis (All P < 0.05). No association was found between decreased serum homocysteine (Hcy) levels and CIMT, carotid plaque, or carotid stenosis in individuals with hyperhomocysteinemia. ConclusionOlder age, hypertension, and higher baseline levels of LDL-C were independent risk factors for carotid atherosclerosis. Reducing serum Hcy levels may not prevent carotid atherosclerosis in the general population with hyperhomocysteinemia.

Utilization of spontaneous breathing trial, objective cough test, and diaphragmatic ultrasound results to predict extubation success: COBRE-US trial

BackgroundThe results of clinical and weaning readiness tests and the spontaneous breathing trial (SBT) are used to predict the success of the weaning process and extubation.MethodsWe evaluated the capacity of the cuff leak test, rate of rapid and shallow breathing, cough intensity, and diaphragmatic contraction velocity (DCV) to predict the success of the SBT and extubation in a prospective, multicenter observational study with consecutive adult patients admitted to four intensive care units. We used receiver operating characteristic (ROC) curves to assess the tests’ predictive capacity and built predictive models using logistic regression.ResultsWe recruited 367 subjects who were receiving invasive mechanical ventilation and on whom 456 SBTs were performed, with a success rate of 76.5%. To predict the success of the SBT, we derived the following equation: (0.56 × Cough) − (0.13 × DCV) + 0.25. When the cutoff point was ≥ 0.83, the sensitivity was 91.5%, the specificity was 22.1%, and the overall accuracy was 76.2%. The area under the ROC curve (AUC-ROC) was 0.63. To predict extubation success, we derived the following equation: (5.7 × SBT) + (0.75 × Cough) − (0.25 × DCV) − 4.5. When the cutoff point was ≥ 1.25, the sensitivity was 96.8%, the specificity was 78.4%, and the overall accuracy was 91.5%. The AUC-ROC of this model was 0.91.ConclusionObjective measurement of cough and diaphragmatic contraction velocity could be used to predict SBT success. The equation for predicting successful extubation, which includes SBT, cough, and diaphragmatic contraction velocity values, showed excellent discriminative capacity.

Advancements in Laser and Ultrasound Therapeutic Strategies for Cancer Cells: Recent Review

Cancer is a disease caused by uncontrollable cell growth and division. Surgery, chemotherapy, radiotherapy, and hormonotherapy are all cancer treatment options. In addition to noninvasive cancer ablative therapy. As an example, ultrasonic therapy, even with low-intensity pulsed ultrasound (LIPUS) or high-intensity focused ultrasound (HIFU), and Laser therapy (photo-biomodulation therapy) in low-level laser therapy (LLLT) with different wavelength ranges from ultraviolet (UV), visible and infrared (IR) that all have demonstrated different results depending on the target of treatment so previous trials therapies are being studied. This paper reviews recent studies on the in vitro treatment effect of ultrasound therapy and laser therapy on normal and cancerous cell lines with specific parameters. The effect of ultrasound results showed a decrease in cell proliferation and an increase in apoptosis in different types of cells, depending especially on sound intensity, known as Special Peak Temporal Average Intensity (ISPTA). While the laser effect is noticed on cell viability, either enhance or inhibit their viability depending upon the dose of exposure and other specific parameters like wavelength, energy density, and power density used in each treatment protocol. The previous studies conclude that each response would have a treatment method with specific parameters, even an increase or decrease in cell viability. Further studies need to be applying these methods in vivo.

Comparison of Antiphospholipid Antibody Levels in Children with and Without COVID-19

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to the recent pandemic. According to published reports, respiratory symptoms, such as pneumonia and inflammatory conditions, are common in this disease. Objectives: The current study aimed to investigate the level of antiphospholipid (aPL) antibodies in children with and without coronavirus disease 2019 (COVID-19). Methods: This descriptive-analytic cross-sectional study was conducted on patients under 16 years of age with and without COVID-19 admitted to Ali Asghar Hospital between December 2021 and February 2022. Patient information was collected by the researcher in a checklist. The checklist included demographic information, clinical findings, and information on laboratory and ultrasound results. Results: In this study, 99 patients were evaluated in three groups: control (without COVID-19), moderate, and severe. The means (standard deviation [SD]) of C-reactive protein (CRP) and D-dimer were significantly higher in the severe group. The Pearson correlation coefficient test was used to examine the relationship between aPL and anticardiolipin (aCL) antibodies with laboratory results. The only significant and direct relationship was observed between aCL antibody and D-dimer. Conclusions: Increased CRP and D-dimer in children with COVID-19 are associated with the severe form of this serious disease. However, there was no significant association between the severity of the disease and the levels of aCL and aPL antibodies and anti-beta 2-glycoprotein I antibodies (aβ2GPI) in children.

Analisis Masalah Kesehatan di Kelurahan Asemrowo Kecamatan Asemrowo Kota Surabaya

This activity aims to identify and analyze health problems, develop program plans, implement and evaluate programs that have been implemented. Ex. Asemrowo has five problems based on the analysis of the data collected. These problems include open defecation, stunting, waste management, food and beverage management, and smoking in the house. The priority problem obtained from the ultrasound results is open defecation. To find the cause of the problem and alternative solutions, the metaplan method is carried out based on an epidemiological approach. The data obtained is processed using a problem tree to find the root of the problem. From the problem tree, the root of the problem is the poor habit of defecating, the absence of a septic tank and latrines at home. In addition, alternative solutions were generated in the form of outreach regarding the construction of a simple septic tank, triggering awareness of defecating in latrines, emo demonstrations related to latrines sanitation, community service, and provision of latrines. Next, an alternative solution was determined using the MEER method, and the Healthy Environment Movement program in Asemrowo (GELIS ASRO) was obtained as an alternative solution that was used as an intervention for open defecation control problems. Then the ASRO GELIS program was compiled. ASRO's GELIS program consists of two details of activities, namely PEMIKAHATI (Community Triggering for Healthy BABs, Ihiyyy) and HAI UJANG (Hello Work Community Service to Protect the Environment). PEMIKAHATI is a movement to invite the community to analyze their sanitation conditions through a triggering process so that the community can think and take action to leave their bad habits regarding open defecation. HAI UJANG is a community service to improve the environment of houses and rivers to improve the degree of environmental health and sanitation in Kel. Asemrowo.

PKD1 gene mutation and ultrasonographic characterization in cats with renal cysts.

Polycystic kidney disease (PKD) has a complex phenotype partly explained by genetic variants related to this disease. Ultrasonography is a promising approach for defining clinical signs. This study aimed to assess kidney characteristics in cats with Polycystin-1 (PKD1) gene mutations and wild-type cats. Kidney characteristics were identified by ultrasonography. A total of 108 cats of variable breeds aged an average of 37.01±3.50 months were included. Blood examination and biochemical tests were evaluated. For cystic formation, renal ultrasound was performed. The PKD1 gene mutation was identified via polymerase chain reaction (PCR) and DNA sequencing. Matrix correlation and effectiveness of ultrasound for PKD1 mutation detection were determined. The results showed that 19.44% of cats had PKD1 mutations, a high prevalence in Persian and Persian-related breed cats. Our results demonstrated the characteristics of kidneys in wild-type cats and cats with gene mutations. Based on ultrasonography results, there was an association between cats with gene mutations and cyst formation. The findings indicated that ultrasound did not detect cysts in cats aged 4-36 months, supporting the evidence that PKD1 gene mutations may not be present. This study found high sensitivity and renal specificity ultrasound for PKD1 heterozygous mutation. Moreover, cystic formation via renal ultrasound showed an increased risk for PKD1 mutation 2,623 times compared to normal kidneys. Ultrasonographic examination, coupled with genetic investigations, may help to clarify the phenotypic variability of PKD1. The phenotypic profile of PKD1 will guide therapeutic outcomes and reduce the prevalence of PKD morbidity and mortality in cats.

Comparison of muscle ultrasound and needle electromyography findings in neuromuscular disorders.

Needle electromyography (EMG) and muscle ultrasound can be used to evaluate patients with suspected neuromuscular disorders. The relation between muscle ultrasound pathology and the corresponding needle EMG findings is unknown. In this study we compared the results of concurrent ultrasound and needle EMG examinations in patients suspected of a neuromuscular disorder. Retrospective data from 218 patients with pairwise ultrasound and EMG results of 796 muscles were analyzed. We compared overall quantitative and visual muscle ultrasound results to EMGs with neurogenic and myopathic abnormalities and assessed the congruency of both methods in the different clinical diagnosis categories. In muscles of patients with a neuromuscular disorder, abnormalities were found with EMG in 71.8%, and quantitative and visual muscle ultrasound results were abnormal in 19.3% and 35.4% respectively. In muscles with neurogenic EMG abnormalities, quantitative and visual muscle ultrasound results were abnormal in 18.9% versus 35.6%, increasing up to 43.7% versus 87.5% in muscles with the most pronounced signs of denervation. Congruency of EMG and ultrasound was better for more proximal and cranial muscles than for muscles in the hand and lower limb. Needle EMG and muscle ultrasound typically produce disparate results and identify different aspects of muscle pathology. Muscle ultrasound seems less suited for detecting mild neurogenic abnormalities. As the severity of neurogenic needle EMG abnormalities increased, muscle ultrasound abnormalities were also increasingly found. Visual analysis seems better suited than grayscale quantification for detecting neurogenic abnormalities.

The Relationship between Transcranial Doppler Ultrasonography and Visual Field Test Results in Glaucoma and Glaucoma Suspect Patients.

To evaluate the relationships between parameters of transcranial ultrasonography and results of visual field tests in patients with open angle glaucoma or suspected of having glaucoma. This retrospective study was based on data from medical records of patients who visited the Department of Ophthalmology in __________ Hospital from January 1, 2016 to October 17, 2019 and underwent transcranial Doppler ultrasonography as part of a routine health examination. Ophthalmic data were visual acuity, intraocular pressure, optical coherence tomography (OCT), and Humphrey visual field test results. Retinal nerve fiber layer defect was confirmed by a glaucoma specialist. Patients' ophthalmic data, such as average ganglion cell layer thickness, visual field index (VFI), pattern standard deviation (PSD), and mean deviation (MD), were divided into quartiles. Each ophthalmic artery parameter from transcranial Doppler ultrasonography was compared between quartiles. A total of 162 patients were reviewed. There was no difference in Doppler ophthalmic artery (OA) parameters between patients with or without retinal nerve fiber layer defect. None of the quartile groups of average ganglion cell layer thickness showed significant difference in any OA parameters. Patients in the low-VFI quartile showed significant low peak systolic velocities of OAs when adjusted for age, gender, and presence of diabetes mellitus or hypertension (p = 0.016). A higher PSD showed lower peak systolic velocity (p = 0.046). There was no significant tendency between any other OA parameter and MD value. Our study suggests that hemodynamic parameters of ophthalmic arteries might be associated with visual field status of patients. Further large-population studies are needed in order to better understand the relationship between visual function and ocular blood flow.

Congenital lower urinary tract obstruction with spontaneous fetal bladder rupture due to posterior urethral valves: a case report

BackgroundCongenital lower urinary tract obstruction (LUTO) is a rare but significant condition affecting fetal urinary tract development. LUTO has a range of etiologies, with posterior urethral valves (PUV) being the most common cause. The prenatal diagnosis of LUTO plays a crucial role in recognizing the condition and guiding management decisions. Prenatal ultrasound serves as the primary tool for identifying LUTO, with key findings including megacystis, bladder wall thickening, oligohydramnios, hydronephrosis, and the 'keyhole sign' indicating dilatation of the posterior urethra. We present a case of congenital LUTO with a rare complication of spontaneous fetal bladder rupture and urinary ascites, treated by peritoneo-amniotic shunt placement.Case presentationA 27-year-old pregnant Caucasian women was referred at 28 weeks of pregnancy due to the presence of megacystis and bilateral hydronephrosis on routine ultrasound and suspicion of LUTO. Repeat ultrasound at 29 weeks showed significant fetal ascites, oligohydramnios and resolution of megacystis and hydronephrosis, after which diagnosis of spontaneous bladder rupture was made. Despite ascites aspiration and amnio-infusion, there was persistent ascites and oligohydramnios. A peritoneo-amniotic shunt was placed with resolution of ascites and normalization of the amniotic fluid volume. At 35 weeks, relapse of the megacystis was observed with bilateral pyelectasis and oligohydramnios, possibly due to healing of the bladder rupture, after which elective cesarean section was planned. Cystography confirmed spontaneous healing of the bladder rupture and the presence of posterior urethral valves, which were resected in the neonatal period with cold knife incision. Total follow-up of 8 years continued to show positive ultrasonographic results and good renal function, but the child suffers from bladder dysfunction, manifesting as overactive bladder disease.ConclusionsLUTO might lead to important renal dysfunction and pulmonary hypoplasia in case of increasing disease severity. Spontaneous bladder rupture might improve renal prognosis, acting as a pop-off mechanism by decompression of the urinary tract. However, fetal bladder rupture is rare and only few cases have been reported. Prenatal intervention can be considered for moderate or severe LUTO, but the benefit for long-term outcome remains uncertain and further studies are needed.

Children With Type 1 Spinal Muscular Atrophy Are at Increased Risk for Nephrolithiasis

BackgroundNephrolithiasis is not a well-documented condition in children with spinal muscular atrophy (SMA). It is possible that this condition was underestimated before the era of nusinersen because of a much shorter life expectancy. We present our observational data on nephrolithiasis and its possible risk factors in children with type 1 SMA. MethodsWe retrospectively reviewed the charts of 20 children with genetically confirmed type 1 SMA. Thirteen patients (aged 9 to 55 months) who underwent urinary tract ultrasonography were included in the study. Medical records were retrospectively reviewed for demographic and clinical characteristics, ultrasound results, and metabolic abnormalities. ResultsSeven children (54%) had nephrolithiasis; 5 had multiple stones and two had a single stone. Two patients had microlithiasis (<3 mm), three had a stone in the size of 3 to 5 mm, and one had a stone in the size of more than 8 mm. Two patients with nephrolithiasis had urinary tract abnormalities. Patients with nephrolithiasis were more likely to have a history of urinary tract infections (UTIs) (P = 0.048) and higher urine specific gravity (P = 0.014) than patients without nephrolithiasis. Five of seven children with nephrolithiasis had a urine metabolic evaluation; all had hypercalciuria, three had hyperuricosuria, but none had hyperoxaluria, hypocitraturia, or hypomagnesemia. ConclusionChildren with SMA type 1 are at an increased risk for nephrolithiasis. Hypercalciuria and high urine specific gravity appear to be the most common risk factors for the occurrence of nephrolithiasis. In addition, UTI is more common in patients with type 1 SMA with nephrolithiasis.

Positive Feedback Mechanism of Probe Sonication for the Perovskite Films in Solar Cells.

The performance of perovskite solar cells (PSCs) is governed by the quality of perovskite films, whereby compact, pinhole-free perovskite films are desired, in addition to its composition. We have demonstrated probe sonication as a processing technique to provide positive feedback for enhancing the perovskite film quality and photovoltaic parameters, with two systems, CH3NH3PbI3 (MAPbI3) and Cs0.17FA0.83Pb(I0.83Br0.17)3. In probe sonication, the ultrasound results in the formation, growth, and collapse of the bubbles through shock wave inside the gas phase of the collapsing bubble. This phenomenon has a chemical impact on the nucleation of the perovskite phases and interconnectivity of the grains. The 60 min sonicated films with stronger hydrogen bonding network are devoid of unwanted Pb0, δ-FAPbI3, and PbI2 phases, having tightly packed homogeneous grains, minimum electron-hole recombination pathways, and improved light absorption. The surface potential remains mostly unaltered across the grains and grain boundaries, and the realignment of the Fermi energy (EF) favors facile carrier transport. The photoconversion efficiency (PCE) of the MAPbI3 and Cs0.17FA0.83Pb(I0.83Br0.17)3 devices is improved by 28.1 and 17.2% in comparison to the pristine perovskites, respectively. The 60 min sonicated Cs0.17FA0.83Pb(I0.83Br0.17)3 PSC has 20.20 ± 0.40% PCE with 1000 h ambient stability having >60% retention of the original PCE.

Bedside Ultrasound to Identify and Predict Severity of Dysphagia Following Ischemic Stroke: Human Versus Artificial Intelligence

Dysphagia is a significant ischemic stroke complication that can lead to aspiration. Identification of at-risk patients can be logistically difficult and costly. Researchers investigated whether quantitative ultrasound assessment of hyoid bone movement during induced swallowing would predict failure of videofluoroscopy (VFS) or fiberoptic endoscopic evaluation of swallowing (FEES), as determined by a penetration-aspiration scale (PAS) score. Additionally, ability of a machine learning (ML) algorithm to predict PAS success or failure from real-time ultrasound video recordings was assessed. A prospective, single-blinded, observational pilot study was conducted from June 2019 through March 2020 at a comprehensive stroke center on a convenience sample of patients admitted with diagnosis of acute ischemic stroke undergoing VFS or FEES as part of dysphagia assessment. Researchers performed a midsagittal airway ultrasound during swallowing in patients receiving an objective swallowing assessment by speech language pathologists who were blinded to ultrasound results. Sonologists measured hyoid bone movement, and researchers then constructed an ML algorithm designed for real-time video analysis using a long short-term memory network with an embedded VGG16 convolutional neural network. Videos from 69 patients were obtained with their respective PAS results. In total, 90% of available videos were used for algorithm training. After training, the ML algorithm was challenged with the 10% previously unseen videos and then compared with PAS outcomes. Statistical analysis included logistic regression and correlation matrix testing on human ultrasound measurements. Cohen's κ was calculated to compare deep learning algorithm prediction with PAS results. Measurement of hyoid bone elevation, forward displacement, total displacement and mandible length was unable to predict PAS assessment outcome (p values=0.36, 0.13, 0.11 and 0.32, respectively). The ML algorithm showed substantial agreement with PAS testing results for predicting test outcome (κ=0.79; 95% confidence interval: 0.52-1.0) CONCLUSION: Manual ultrasound measurement of hyoid movement during swallowing in stroke patients failed to predict PAS swallowing results. However, an ML algorithm showed substantial agreement with PAS results despite a small data set, which could greatly improve access to dysphagia assessment in the future.

A Study on Clinico-Pathological Presentation and Management Prospective of Venolymphatic Malformation.

To evaluate the clinical perspective of Veno lymphatic malformation and definitive management in respect to outcome. (1) To discuss clinical presentation, symptomatology of Veno lymphatic malformation. (2) Demonstration of radiological features, diagnosis and management of Veno lymphatic malformation with its complication. This prospective study was conducted on four patients attending ENT-OPD of R.G.Kar Medical College, Kolkata, India who had presented with suspected vascular malformation. The study was conducted from March 2021 to March 2023 for a period of 2years. The patients were subjected to detailed history and examination. The diagnosis of the Veno lymphatic malformation was based on the results of Doppler ultrasonography, computed tomography and magnetic resonance imaging. In our study there was male predominance. Most of the patients belonged to the 2nd and 3rd decade of life. The main sites of involvement were lateral neck followed by parotid region. The lesion size ranged in between 3.5 × 3.5cm and 7 × 5cm. The patient with parotid lesion was found to have phlebolith. Since most of the lesions were small with well-defined margins, we were able to excise the lesions completely without leaving any residue. Out of four cases one patient developed temporary paresis of spinal accessory nerve which resolved eventually. Veno lymphatic malformations are rare and there is no definitive protocol for management and to be individualized. Our study will be helpful for furthering the existing knowledge regarding the management of Veno lymphatic lesion emphasizing the need of multimodality approach in surgical decision making.

A Study to Evaluate the Efficacy of Ultrasonography as a Diagnostic Screening Tool in Maxillofacial Fractures: A Prospective Study.

The aim of the study was to estimate the diagnostic efficacy of high-resolution ultrasonography (USG) in the diagnosis of maxillofacial fractures. A descriptive diagnostic evaluation study was carried out on 30 patients with suspected maxillofacial fractures, out of which 26 were male (86.7%) and 4 were female (13.3%). After initial management, detailed clinical examinations were carried out and significant findings were noted. Computed tomography (CT) scans were performed in fracture-suspecting patients followed by USG examination which was done in a standardized pattern on both sides of the face. The result of USG was compared with the CT scan report. Based on CT findings, 65 sites were found to be fractured, and this was considered the gold standard. Ultrasonography detected 58 fractures at these 780 sites, of which 54 were true fractures, while 4 were false-positive results. However, USG was not able to detect eleven fractures. The overall sensitivity and specificity of USG were 83.1% and 99%, respectively. The positive and negative predictive values were 93% and 98%, respectively. According to our study, it may be concluded that USG may be recommended as a diagnostic screening tool to detect superficial maxillofacial fractures. Ultrasonography provides a safe, cost-effective, reliable, non-invasive, easily available, and portable imaging modality to screen for maxillofacial fractures.