End-diastolic Velocity Values Research Articles

The use of ultrasound for noninvasive monitoring of anesthetic effects in renal ischemia-reperfusion injury.

Compared with the use of ultrasound for noninvasive monitoring of the anesthetic sodium pentobarbital versus tribromoethanol in an animal model of renal ischemia-reperfusion injury in rats. Adult rats were randomly assigned to a renal ischemia-reperfusion injury model, and preoperative anesthetics were administered as either sodium pentobarbital or tribromoethanol. Color Doppler ultrasound and spectral Doppler ultrasound were used to detect changes in respiratory rate and heart rate during and after the surgery, as well as measure renal hemodynamic parameters including peak systolic velocity, end-diastolic velocity, and resistance index. The frequency of changes in respiration and heart rate was significantly higher in the sodium pentobarbital anesthesia group compared to the tribromoethanol anesthesia group. The peak systolic velocity and end-diastolic velocity values in the sodium pentobarbital anesthesia group were significantly lower than those in the tribromoethanol group. However, the resistance index in the sodium pentobarbital group was higher than that in the tribromoethanol group. Ultrasound can be used to dynamically monitor the effects of anesthesia during the experiment, including changes in respiratory rate and heart rate, as well as semi-quantitatively monitor hemodynamic changes in the kidneys, which indirectly reflects whole-body hemodynamic changes in rats.

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

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

Color Doppler ultrasound and real-time elastography in patients with hypothyroidism for the prediction of levothyroxine replacement: a cross-sectional study of 338 patients.

While hormonal assays are commonly used for thyroid function assessment, Doppler sonography provides valuable information on vascularization and blood flow. This study aimed to examine the potential associations between Doppler parameters and clinical characteristics of hypothyroid patients, such as the autoimmune nature of the disease and adequacy of LT4 replacement. A total of 338 patients with hypothyroidism, primarily caused by autoimmune thyroiditis (AT), were enrolled in this study. Exclusion criteria comprised specific medical conditions, medication history, and nodular abnormalities of the thyroid gland. Patient demographics (age, sex, BMI), treatment parameters (LT4 daily dose), and thyroid hormone levels (TSH, fT4) were recorded. Among the enrolled patients, 85.2% had autoimmune thyroiditis. Suboptimal levothyroxine (LT4) replacement was observed in 20.1% of patients at the time of enrollment. Patients with autoimmune thyroiditis had increased elastography ratios compared to those without autoimmune disease and present a positive association of elastography ratios with vascularity. In patients without autoimmune thyroiditis, those with suboptimal LT4 replacement had lower total thyroid volume. Patients with suboptimal LT4 replacement had higher peak systolic velocity (PSV) and end-diastolic velocity (EDV) in the inferior thyroid artery and lower resistive index (RI). The severity of hypothyroidism, as indicated by LT4 dose/body mass index (BMI), was negatively correlated with thyroid volume and EDV values of superior and inferior thyroid arteries. PSV of the inferior thyroid artery can predict suboptimal LT4 replacement (sensitivity 81.8%, specificity 42%). In situations where obtaining blood tests may be challenging, utilizing color Doppler ultrasound can serve as an alternative method to assess treatment responses and identify patients who require further hormonal examinations.

(322) Predictors of Erection Reversal After Penile Doppler Ultrasound

Abstract Introduction Erection hardness (EH) is a physiologic response graded subjectively on the Erection Hardness Grading Scale during penile Doppler ultrasound (PDUS). Objective This study aims to gather data on the reversal rate following persistent EH sufficient for penetration or higher after PDUS and identify associated predictors. Methods The study population consisted of (i) men with poor response to PDE5i and ICI or (ii) who need curvature assessment due to Peyronie’s disease (PD), (iii) and underwent penile duplex Doppler ultrasound (PDUS), (iv) using a vasoactive agent redosing schedule were included and reviewed retrospectively. Patients with incomplete data were excluded. We performed a descriptive assessment of demographics and comorbidities, including a history of cancer, PD, depression, or anxiety. EH was evaluated by a sexual medicine-trained physician for each case and reported before and 30 minutes after PDUS. EH was assessed on a scale between 0 (no erection) to 10 (erection hard as a rock), with 6 being good enough for penetration. We also described the number of injections, the dose, and PDUS hemodynamic parameters, including peak systolic velocity (PSV) and end-diastolic velocity (EDV). Arterial insufficiency (AI) diagnosis was made with PSV values ≤25 cm/sec bilaterally and corpora veno-occlusive dysfunction (CVOD) with EDV values ≥5 cm/sec bilaterally. We also reported a reversal procedure rate performed due to persistent erection after PDUS, and predictors were assessed. Factors entered into the model included: patient age, EH for PDUS (8 or greater), and dose of vasoactive agent used (Table 1). A p-value ≤0.05 was considered statistically significant. Results 2439 individuals were included. The median age of 59 (50,67) years. 12% had diabetes, 13% reported ≥ 3 comorbidities, 44% had prostate cancer, 17% had a history of depression, and 14% had a history of anxiety. 44% described PD. The vasoactive agent used for PDUS was Trimix 86% and 14% others. The median dose used was 20 (10, 50), and the median of injections applied was 2 (1, 2). The EH median was 8 (6, 9) for PDUS, and 65% had an EH of 8 or greater. The PDUS diagnosis was normal in 62% of the patients; 8% had AI, 29% had CVOD, and 1% had AI+CVOD. The reversal procedure rate was 41%. In the MVA, significant predictors of erection reversal were higher vasoactive agent dose used, age 50 years or younger, and EH 8 or greater for PDUS (Table 1). Conclusions Erection reversal in our redosing PDUS was highly prevalent; predictors of reversal were younger age, greater EH for PDUS, and higher vasoactive agent dose. Disclosure No.

(321) Penile Doppler Ultrasound (PDUS) Procedure Anxiety and Its Impact on the Erection Hardness (EH) and Corporo-venocclusive Dysfunction (CVOD) Diagnosis

Abstract Introduction Procedure anxiety is an excessive fear of medical, dental, or surgical procedures that result in acute distress or interference with completing necessary procedures. Previous work has shown that anxiety affects penile hemodynamics. Objective This study aims to examine the impact of PDUS procedure anxiety on the erection hardness (EH) achieved during and after PDUS and the diagnosis of CVOD. Methods The patient population included (i) men with poor response to erectogenic agents or (ii) who need curvature assessment due to Peyronie’s disease (PD), (iii) who underwent PDUS, (iv) using ICI vasoactive agent redosing schedule. We performed a descriptive assessment of demographics and comorbidities. We reported EH reached before and 30 minutes after PDUS, which was evaluated by a sexual medicine-trained physician for each case. EH was measured on a 0 (no erection) to 10 (erection hard as a rock). We also described the number of injections, the dose, and PDUS hemodynamic parameters, including peak systolic velocity (PSV) and end-diastolic velocity (EDV). Arterial insufficiency (AI) diagnosis was made with PSV values ≤30 cm/sec bilaterally, and CVOD diagnosis with EDV values ≥5 cm/sec bilaterally. A visual analog scale (VAS) evaluated the anxiety related to the procedure using a single question: “How anxious are you about your PDUS procedure?” This was measured on a 0 (not at all anxious) to 10 (extremely anxious) Likert scale. 7 or higher was defined as high anxiety, 4 to 6 as moderate anxiety, 1 to 3 as mild anxiety, 0 was no anxiety. We compared the EH pre and post-PDUS and the prevalence of CVOD based on the procedure anxiety category (high vs. no high anxiety). Predictors of persistent EH (6/10 or higher) after PDUS was analyzed using a logistic regression model. Factors entered into the model included: patient age, PD, and procedure high anxiety. A p-value ≤0.05 was considered statistically significant. Results 162 individuals were included. The median age of 65 (59,72) years. 19% had diabetes, 19% reported ≥ 3 comorbidities, 10% had a history of depression, and 11% had a history of anxiety. 72% had prostate cancer, 6% had bladder cancer, 3% had other cancer, and 19% had no cancer history. 35% reported PD. The VAS procedure anxiety median was 3 (1, 5), on which 22% reported no anxiety, 34% mild, 26% moderate, and 18% high anxiety. For men with high anxiety procedure, the median EH before and after PDUS was 6 (4, 8) and 5 (2, 8), respectively; 62% had CVOD diagnosis, 48% remained with an EH 6 or greater after PDUS, and 45% needed a reversal injection. No significant differences were observed compared to men without high anxiety procedures. In the MVA, only age significantly predicted EH 6 or greater after PDUS (Table 1). Conclusions High PDUS Procedure Anxiety does not affect EH pre and post-PDUS, CVOD diagnosis, or reversal rate after PDUS. Only younger age significantly predicted persistent EH 6 or greater after PDUS. Disclosure No.

DIAGNOSTIC VALUE OF ADDITIONAL MARKERS FOR ACUTE KIDNEY INJURY IN PRETERM NEONATES WITH PATENT DUCTUS ARTERIOSUS

DIAGNOSTIC VALUE OF ADDITIONAL MARKERS FOR ACUTE KIDNEY INJURY IN PRETERM NEONATES WITH PATENT DUCTUS ARTERIOSUS

(122) Erectile Hemodynamics Asessment In ED Patients With Self-Diagnosed Post-finasteride syndrome (PFS)

Abstract Introduction Much debate exists regarding the concept of PFS and its etiology. There exists data suggesting abnormal erectile hemodynamic alterations in this population. Objective This analysis was performed to define erectile hemodynamics in this population. Methods Patients attending the sexual medicine clinic at our institution presenting with (i) new onset ED after commencement of 5-ARI (ii) 5-ARI use specifically for hair loss (iii) with no prior ED history (iv) presenting ≥6 months after cessation of 5-ARI (v) and with at least 3 months use of 5-ARI (finasteride). All completed the IIEF EF domain questionnaire. B-mode assessment was conducted at 15MHz. Duplex ultrasound (PDDU) was conducted using a vasoactive agent-redosing schedule using trimix. On PDDU, a best quality erection (BQE) (equivalent to the best erection obtainable at home without erectogenic medication) was required for inclusion. Redosing was conducted if the patient failed to obtain a BQE up to a maximum of three doses. The criteria for normalcy on DUS included a peak systolic velocity (PSV) >30cms/s and an end-diastolic velocity (EDV) <5 cms/s. Results 141 men were included in the analysis. Mean patient age was 31±12 (18-42) years. All had used finasteride 1mg. Median vascular risk factor (VRF) number = 1 (0,1). Median duration of 5-ARI exposure = 16 (4, 46) months. Median duration off 5-ARI at first presentation to clinic = 11 (6, 28) months. No patients had ED prior to 5-ARI use. One third developed ED only after cessation of finasteride, at a mean duration off finasteride of 6±3 months. Median IIEF EFD score at presentation = 14 (6,18). Median (range) number of injections needed for BQE sufficiently suitable for DUS measurement was 2 (1, 3). Overall, mean PSV and EDV values were 60±18cm/s and 1.5±1.5 cm/s respectively. 29% required phenylephrine reversal before discharge from clinic. Conclusions These data suggest that hemodynamic alterations are not present in men complaining of ED with self-diagnosed PFS. Disclosure No

(110) Evaluation of Men Under 35 Who Underwent Penile Implant Surgery

Abstract Introduction Erectile Dysfunction (ED) has become an increasingly common disorder in young adult males. There are multiple etiologies of ED ranging from vascular, neurogenic, and structural causes. Often times, ED presenting in young men is psychiatric in nature as opposed to the other causes that typically present in older patients. ED found in young, healthy men with no history of systemic disease or traumatic injury, can be challenging. Past research has shown that men ages 18-35 typically have normal lab results and are treated with PDE-5 inhibitors. However, our data suggests that patients whose symptoms do not improve following the use of PDE-5 inhibitors may have a vascular etiology of ED. Objective Our objective is to determine the prevalence of venous leaks in young adult males who present with ED, but do not respond well to PDE-5 inhibitors. Methods Patients who underwent inflatable penile prosthesis (IPP) surgery for the treatment of ED over a 36-month period under the age of 35 who had failed PDE-5 inhibitors were identified from our database retrospectively. All patients completed an IIEF-5 questionnaire and had a penile doppler ultrasound (PDUS) performed preoperatively. PDUS was used to identify and record cavernous arterial flow signals before and after stimulation. Veno-occlusive ED was described as persistent End Diastolic Velocity (EDV) over 5 cm/sec during all phases of erection. The relationships, according to Doppler diagnosis, IIEF-5 score, SHIM scale, and erection score were evaluated as well as surgical outcomes and patient comorbidities. Results 1,558 patients were evaluated in this series, of whom 32 met inclusion criteria. Patients ages ranged from 18 to 35, with a mean age of 28.4. PDUS determined that 27 (84%) suffered from veno-occlusive disease, while 3 (9%) had arterial insufficiency due to DMI and 2 (7%) had neuropraxia. Of those veno-occlusive disease patients, EDV values ranged from 7.4 to 21.2, with a mean of 13.4, with peak systolic velocity values ranging from 45 to 122cm, with a mean of 97. All patients in this cohort had successful penile prosthesis implantation without complications or need for revision. Conclusions Doppler examination does indeed suggest that patients with cavernous venous occlusive dysfunction have moderate to severe leaks. We strongly recommend a baseline PDUS following PDE-5 inhibitor failure due to the significant prevalence of veno-ccclusive disease in this rare patient population. Furthermore, if veno-occlusive disease is identified during PDUS, we encourage frank discussion of penile prosthesis placement with the patient as well as the severity of veno-occlusive disease and its resultant effect of worsening ED. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: coloplast, boston scientific

Retinal nerve fiber layer and ophthalmic artery blood flow parameters in pseudoexfoliation syndrome and pseudoexfoliative glaucoma

To investigate the relationship between ophthalmic artery (OA) blood flow parameters and retinal nerve fiber layer (RNFL) thickness in eyes with pseudoexfoliation (PEX). We compared PEX eyes without glaucoma (group A, n=53) and those with glaucoma (group B, n=18) with control eyes (group C, n=44). Subsequently, eyes in groups A and B were compared. Finally, OA color Doppler imaging measurements were recorded, and peripapillary RNFL analysis was performed. The total RNFL measurements differed significantly among the groups (P=0.012), being thicker in group C than in group A (P=0.010) and significantly different between group B and groups A and C (both P=0.001). The peak systolic velocity (PSV) and end diastolic velocity (EDV) measurements of groups A and B were lower than those of group C (PSV: P=0.001 and P=0.001, respectively; EDV: P=0.001 and P=0.001, respectively). No significant difference was noted in resistive index (RI) measurements (P=0.370). In group B, significant negative correlations were noted between total RNFL and PSV (r=-0.743; P=0.001) and between total RNFL and EDV (r=-0.691; P=0.001), but not between total RNFL and RI measurements (P=0.548). Pseudoexfoliation syndrome (PXS) with or without glaucoma was associated with a decrease in the PSV and EDV values of the OA. An extensive study may be needed to further explore the role of PXS in OA blood flow parameters. Total RNFL thickness values were lower in eyes with PEX than in those without.

Pulse wave Doppler ultrasound of umbilical cord in experimentally induced pregnancy toxemia in sheep

Contrary to its widespread use in human cases, the use of Doppler ultrasonography is only recently becoming prevalent in farm animals. This study aimed to determine the effects of maternal metabolic and clinical changes on fetal hemodynamics during pregnancy toxemia with the doppler examination of umbilical cord. In the study twenty ewes with a single healthy fetus were included in the study. At the end of the 120th day of pregnancy, 20 single-bearing pregnant ewes were randomly categorized into two groups. Ewes in the control group were fed to meet all nutritional requirements. On the other contrary, the experimental ewes were fed to meet equivalent to 50 % of the daily needs and then fasted for 96 h. Doppler ultrasonographic examinations of umbilical cord were performed once every two days and once a day during fasting. Beta hydroxybutyric acid (BHBA) concentration was measured by taking blood from sheep on examination days. Pulse systolic velocity (PSV), end diastolic velocity (EDV), PSV/EDV, pulsatility index (PI), resistance index (RI), and fetal heart rate (FHR) as well as BHBA values and how those parameters has changed over time (time by treatment effect) due to energy deprivation during pregnancy were evaluated using repeated measure analysis of variance. No clinical signs were observed in both toxemia and control groups during restricted feeding. BHBA concentration increased and there was a significant time, time by treatment and main effect of treatment effect between groups. No significant main effect of treatment and time by treatment interaction was observed in the changes of PI, RI, FHR, and systolic/diastolic velocity values over time in both groups. FHR was reduced over time, and there was a significant time effect in FHR in both groups. Although doppler indices didn't increase, both PSV and EDV values increased significantly in the pregnancy toxemia group compared with the controls (Time P = 0.03, time by treatment interaction P < 0.05) and the main effect of treatment P < 0.05). The marked increase in blood velocities (PSV and EDV) in the umbilical cord is probably due to the compensatory functioning for excessive energy deprivation of the fetus. Therefore, PSV and EDV might be a valuable indicator for evaluating the fetus's health status during the management of the PT.

Changes in cerebral blood flow parameters among preterm 30–34 week neonates who are initiated on kangaroo mother care - A prospective analytical observational study

BackgroundKangaroo mother care (KMC) is recommended standard of care for preterm neonates. They are vulnerable for cerebral blood flow (CBF) fluctuations linked to intraventricular hemorrhage and periventricular leukomalacia, which have implications on neurodevelopment. This study was designed to document any change in CBF in middle cerebral artery (MCA) of stabilized preterm 30–34 weeks neonates who are initiated on KMC. MethodsWe designed a prospective analytical observational study in a tertiary care neonatal unit. We enrolled 30–34 weeks preterm neonates eligible for KMC after their stabilization (n = 40). CBF was measured in supine position via right MCA Doppler through the temporal window before any KMC, after 2 h of 1st KMC session and following 24 h of 1st session. CBF was quantified in terms of pulsatility index (PI), Resistive Index (RI), peak systolic velocity (PSV), end-diastolic velocity (EDV), mean velocity (MV) and values were compared against the existing normative values. ResultsMean gestation of study population was 31.91 weeks with a mean birth weight of 1432.75 g. Median day of initiation of KMC was 7 days with mean duration of KMC on day 1 was 4.56 h. We could find statistically significant decrease in the values of PI and RI from 90th centile towards 50th centile of normative values with a mean difference of 0.22 (99 % CI 0.02–0.43, p 0.005) for PI and 0.05 (99 % CI 0.02–0.07, p = 0.000) for RI post the first session of KMC. Following 24 h of 1st KMC session, we could find a significant increase in values of PSV, EDV and MV comparing values of pre-initiation with day 2 pre-KMC but values of PI and RI were not significantly different. ConclusionCBF among 30–34 week preterm neonates tend to optimize after initiation of KMC.

Retrobulbar Blood Flow Parameters in Patients With Anisometropic Amblyopia.

Introduction We aim to compare retrobulbar blood flow parameters between the amblyopic eye and the fellow eye in patients with anisometropic amblyopia. Methods Peak systolic velocity (PSV) and end-diastolic velocity (EDV) of the ophthalmic artery (OA), central retinal artery (CRA), and posterior ciliary artery (PCA) were measured by color Doppler imaging (CDI), and the resistivity index (RI) and pulsatility index (PI) were calculated in 62 patients aged 12-40 years with anisometropic amblyopia. Results The mean PSV values of OA, CRA, and PCA in amblyopic and fellow eyes were 30.38 ± 10.34, 8.45 ± 2.27, and 8.03 ± 2.77, and33.73 ± 14.46, 8.35 ± 2.05, and 8.81 ± 2.77, respectively. The mean EDV values of OA, CRA, and PCA in amblyopic and fellow eyes were 6.86 ± 2.64, 1.47 ± 1.59, and 1.94 ± 2.03, and 8.57 ± 4.30, 1.80 ± 1.73, and 2.32 ± 1.20, respectively. The mean RI values of OA, CRA, and PCA in amblyopic and fellow eyes were 0.77 ± 0.10, 0.85 ± 0.14, and 0.78 ± 0.15, and 0.75 ± 0.07, 0.79 ± 0.20, and 0.74 ± 0.13, respectively. OA-PSV and OA-EDV values were significantly lower in the amblyopic eye than in the healthy eye (p < 0.05). OA-RI values were significantly higher (p < 0.05) in the amblyopic eye than in the healthy eye. Conclusions Considering the decrease in PSV and EDV and the increase in RI, which are the blood flow parameters of the amblyopic eye, our study may provide guidance to focus on increasing blood flow in the treatment of amblyopia.

The impact of obesity on ocular hemodynamics and choroidal thickness.

Obesity affects microvascular structures. The effect of obesity on the ocular vascular system can be evaluated by changes in the choroidal thickness (CT) and retrobulbar blood flow (RBF). To evaluate the CT and RBF parameters in obese patients with various body mass index (BMI) values and compare these parameters with normal weight, healthy subjects. A prospective study. The study included 102 eyes of 102 female patients. Patients were divided into three groups according to BMI as group 1 with a BMI of 18.5-24.99 (n = 32), normal weight group; group 2 with a BMI of 30-34.99 (n = 35), as obese class I; and group 3 with a BMI of 35-39.99 (n = 35), as obese class II. The peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index, and pulsatility index values of the central retinal artery (CRA) and ophthalmic artery (OA) were evaluated with color Doppler ultrasonography. CT was measured at the subfoveal area and at 500-µm intervals nasal and temporal to the fovea up to a distance of 1500 µm by using the enhanced depth imaging technique of optical coherence tomography. Intraocular pressure (IOP) was measured with a Goldmann applanation tonometry. There was a significant difference in IOP values within the groups with the highest values in group 3 (17.6 ± 2.1 mmHg) and the lowest in group 1 (12.4 ± 1.7 mmHg). The CT in groups 2 and 3 was found to be statistically significantly lower than that in group 1 at all measurement points (p < 0.001). There was a statistically significant negative correlation between CT at all measurement points and BMI (p < 0.001). The mean CRA PSV, EDV, and OA EDV values were statistically significantly lower in each obese group than those values in group 1 (p < 0.001). The OA PSV values were significantly lower in group 3 (36.5 ± 5.9 cm/s) than those in group 2 (43.8 ± 4 cm/s) and group 1 (44.6 ± 5.2 cm/s) (p < 0.001). Also, significant associations were found between BMI and CRA PSV, CRA EDV, and OA PSV values (p < 0.001). Obesity may predispose to eye pathologies by changing the ocular vascular circulation.

Retrobulbar ocular blood flow and choroidal vascular changes in patients recovering from COVID-19 infection

BackgroundTo evaluate the effects of COVID-19 infection on the ocular vascular structure including choroidal thickness and retrobulbar blood flow values in comparison with healthy subjects. MethodsNinety eyes of 90 patients were included in this study. Participants were divided into Group 1 (n = 30) with mild COVID-19 infection, Group 2 (n = 31) with moderate disease, and Group 3 with age- and sex-matched healthy subjects (n = 29). Choroidal thickness was measured at the subfoveal area and at 500-µm intervals nasal and temporal to the fovea up to a distance of 1500 µm, using the enhanced depth imaging (EDI) technique of spectral coherence tomography (SD-OCT). The peak systolic velocity (PSV), end diastolic velocity (EDV), resistive index (RI), and pulsatility index (PI) values of the central retinal artery (CRA) and ophthalmic artery (OA) were evaluated with color Doppler ultrasonography (CDU). ResultsThe choroidal thickness was significantly thinner in Group 1 and Group 2 than in Group 3 at all measurement points (p <0.001). This difference was not present between Group 1 and Group 2 who had COVID-19 disease of different severity (p>0.05).Among the retrobulbar blood flow parameters, OA PSV value was significantly lower in Group 1 and Group 2 compared to Group 3 (p = 0.025, p = 0.016, respectively). However, the CRA PSV and EDV and OA EDV values, and the CRA and OA PI and RI values were not statistically different between the groups (p> 0.05). ConclusionCOVID-19 infection may predispose patients to ocular vascular pathologies by affecting both choroidal and retrobulbar blood flow.

Ocular blood flow and retinal, choroidal, and retinal nerve fiber layer thickness in children with familial Mediterranean fever with at least five attacks.

This study aimed to evaluate ocular blood flow and, retinal, choroidal and retinal nerve fiber layer thickness in children with familial Mediterranean fever (FMF) with patients who had at least five attacks. Fifty-six patients with FMF and 56 healthy subjects were enrolled in the study. Each participant's choroidal thickness (CT) and retinal thickness (RT) measurements were performed in the foveola and at horizontal nasal and temporal quadrants within 500-μm intervals up to 1.500μm from the foveola using spectral-domain optical coherence tomography as well as the retinal nerve fiber layer thickness (RNFLT). Disc boundaries were determined manually by identifying seven points on the inner edge of the scleral ring. Following complete ophthalmological evaluation, peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistivity index (RI) values in the central retinal artery (CRA), ophthalmic artery (OA), and nasal posterior ciliary artery (NPCA) were measured using color Doppler ultrasonography (CDU) in the left eyes of the patients diagnosed with FMF and the controls. The results were subsequently compared. No statistically significant differences were observed between the groups in terms of all RNFLT quadrant and RT measurements. All CT measurements were thinner in patients with FMF than in the controls (For Central and Temporal_1500 p = 0.01; For Temporal_500, Nasal 500 and Nasal_1000 p < 0.001; Temporal_1000 p = 0.002) except than the Nasal_1500 point. For nasal_1500 p = 0.121). The PSV and EDV values in the OA, CRA, and NPCA were significantly lower in patients with FMF compared to healthy controls (p < 0.001 for all). In contrast, the RI values of all arteries were significantly higher than in the control group (Regarding OA, CRA and NPCA RI, p = 0.003, p = 0.039, and p = 0.039, respectively). The results of this study support the idea that chronic inflammation and frequent attacks in FMF may have an effect on decreased ocular blood flow and choroidal thinning.

Study of testicular vascularity after totally extraperitoneal repair in inguinal hernia

Background: Totally extra-peritoneal repair is one of the commonly used method for repair of inguinal hernia which is gaining popularity in recent days. Its effect on testicular vascularity has not been well established. The objective of this study was to study testicular vascularity following totally extra-peritoneal repair [TEP] in inguinal hernia.Methods: This study was prospective observational study performed on patients with inguinal hernia undergoing TEP where testicular USG doppler parameters like peak systolic velocity (PSV), end diastolic velocity (EDV), resistivity index (RI) and pulsatilty index (PI) were measured on pre-operative day, on 3rd postoperative day and 90th postoperative day, and serum values of FSH, LH and Testosterone were measured preoperatively and 90th postoperative day and these values were compared.Results: 42 patients were included in this study. There was no statistically significant difference in the values of PSV (p=0.497), EDV (p=0.981), RI (p=0.290) and PI (p=0.733) between preoperative value, 3rd postoperative day, and 90th postoperative day. There was no statistically significant difference in the serum values of FSH (p=0.376), LH (p=0.101) and Testosterone (p=0.506) between preoperative and 90th postoperative day level.Conclusions: It was concluded that totally extra-peritoneal repair (TEP) do not affect testicular perfusion. However large scale multi-institute trails with bigger sample size is required to find out effect of TEP on testicular vascularity.

Exogenous L-carnitine Administration Ameliorates the Adverse Effects of Heat Stress on Testicular Hemodynamics, Echotexture, and Total Antioxidant Capacity in Rams.

Heat stress (HS) diminishes the testicular antioxidant defense systems, which adversely affect the testicular blood perfusion. Improving the testicular hemodynamics during HS conditions is of a great impact on the whole reproductive performance in rams. This study aimed to evaluate the ameliorative effects of L-carnitine (LC) on the testicular blood flow and echotextures and also on the total antioxidants (TAC) and nitric oxide (NO) concentrations in the serum during HS conditions in rams. Testicular blood flow was evaluated through scanning of the supra-testicular artery (STA) spectral patterns through pulsed Doppler ultrasonography [peak systolic velocity (PSV), end-diastolic velocity (EDV), time average maximum velocity (TAMAX), resistive index (RI), and pulsatility index (PI)], while the echotexture assessment of testicular parenchyma was performed by a computerized software program. Moreover, TAC and NO concentrations were assayed colorimetrically using the spectrophotometer. There were significant decreases (P < 0.05) in values of PSV at 48 and 168 h (23.45 ± 0.39 and 23.37 ± 1.41 cm/s, respectively), and TAMAX at 1, 48, and 168 h (17.65 ± 0.95, 17.5 ± 0.13, and 16.9 ± 1.05 cm/s, respectively) after LC administration compared to just before administration (31.92 ± 1.13 and 21.58 ± 0.92 cm/s, respectively). Values of RI and PI of the examined STA significantly decreased, especially at 1 h for RI (0.45 ± 0.02) and 1 and 48 h for PI (0.66 ± 0.06 and 0.65 ± 0.05, respectively) after LC treatment to 0 h (0.55 ± 0.03 and 0.84 ± 0.06, respectively). The EDV values did not show any significant (P < 0.05) changes in all the experimental time points. There were significant (P < 0.05) increases in the values of pixel intensity of the testicular parenchyma, especially at 1 and 168 h (78.71 ± 2.50 and 88.56 ± 4.10, respectively) after LC administration, compared to just before administration (69.40 ± 4.75). Serum NO levels tend to increase after LC administration (P = 0.07) concerning just before administration. While TAC values showed significant gradual increase and reached the highest values at 168 h (2.75 ± 0.58 mM/l) after LC administration, compared to 0 h (1.12 ± 0.05 mM/l). In conclusion, exogenous LC administration ameliorates testicular hemodynamic disruptions, as measured by spectral Doppler ultrasonography, via augmentation of the rams' total antioxidant capacity under HS conditions.

Clitoral blood flow using color Doppler ultrasonography in women with and without provoked vestibulodynia.

To compare blood flow of the dorsal clitoral artery in women diagnosed with provoked vestibulodynia (PVD) and in healthy controls using color Doppler ultrasonography. We hypothesized that women with PVD would have a restricted blood flow compared to controls. This cross-sectional study evaluated the function of the dorsal clitoral artery through the spectral wave analysis of color Doppler ultrasonography (US) in 20 women diagnosed with PVD according to Friedrich's criteria and 21 healthy controls. Participants were evaluated during their follicular phase and were asked to abstain from sexual activities 24 ho prior the examination. Assessment was performed by an assessor blinded to participant diagnosis, in the morning after a 10-min rest period in a supine lying position in a room with temperature set at 22 °C. Measurements of the peak systolic velocity (PSV), time-averaged maximum velocity (TAMX), end-diastolic velocity (EDV), pulsatility (PI) and resistance index (RI) were performed at rest considering the mean value of three consecutive waveforms. Women with PVD and healthy controls did not present any statistically different baseline characteristics. Participants with PVD presented higher values of Doppler-US PSV, TAMX, EDV and RI compared to controls (p ≤ 0.05), which are suggestive of a decrease in blood flow. However, non-significant difference was found regarding PI values between the two groups (p > 0.05). Our findings revealed decreased peripheral tissue perfusion in women with PVD compared to healthy controls using color Doppler US, based on the alteration of four of the five assessed data of US parameters.

Basilar artery flow characteristics and color Doppler sonography findings in healthy infants

Aim: Transcranial​ ​Doppler​ ​(TCD)​ is a widely used method for the evaluation of vertebrobasilar system. There is not neither a consensus nor significant number of publications about normal spectral Doppler waveform and resistance index (RI), peak systolic velocity (PSV), and end diastolic velocity (EDV) values of basilar artery (BA). We aim to define normal PSV, EDV, RI values of BA via TCD in healthy infants. &#x0D; Material and Method: BA was evaluated from anterior fontanelle by creating sagittal and coronal images. Color doppler ultrasonography (CDUS) and spectral Doppler examinations were performed by placing the cursor in the middle portion of BA. PSV, EDV, and RI values were recorded. Patients were divided into 4 subgroups to analyze the change of normal values according to age groups: (1) 0-120 days, (2) 121-180 days, (3) 181-270 days, (4) &gt;271 days.&#x0D; Results: 115 healthy infants were included into the study. A weak positive correlation was found between PSV, EDV values and age; meanwhile a weak but significant negative correlation was present between age and RI values. We cannot find any correlation between sex and CDUS parameters. &#x0D; Conclusion: BA PSV, EDV and RI values change by age. No correlation is present between CDUS characteristics and sex. BA pathologies are rare in pediatric population, nevertheless knowing normal CDUS characteristics can help radiologists for an appropriate assessment.

Carotid doppler indices with age and body mass index in a sampled Nigerian population

Background: Carotid doppler studies are frequently carried out to assess for possible stenosis resulting from presence of carotid plaques. The carotid peak systolic velocity (PSV) and end diastolic velocity (EDV) are key indices for determining the severity of the stenosis. However, normative values of these parameters may be dependent on anthropological variables like age and body mass index (BMI)Objective: The study was aimed at assessing the variations of PSV and EDV with age and BMI in a sampled Nigerian population.Materials and Methods: A total of 204 participants (72 males and 132 non-gravid females) aged between 20 and 70 years who were normotensive with no cardiovascular diseases were selected. Their ages, BMI, PSV and the EDV were measured using standard protocols for the four segments of the carotid artery: common carotid (CC), carotid bulb (CB), internal carotid (IC) and the external carotid (EC). Data obtained were presented using tables and line graphs while the analysis of variance (ANOVA) was used to determine significant difference in measurement across the groups.Results: The mean PSV recorded were 88.25 ± 7.43 cm/s for the CC, 73.93 ± 6.23 cm/s for the IC, 51.01 ± 4.30 cm/s for the CB and 50.41 ± 4.25 cm/s for the EC. There was a steady increase of the PSV between 20 and 46 years from 74.91 cm/s to 98.78 cm/s for the CC, from 62.76 cm/s to 82.75 cm/s for the IC, from 42.80 cm/s to 56.43 cm/s for the EC and from 43.30 cm/s to 57.10 cm/s for the CB. The maximum EDV measured for the IC was (24.75 ± 2.11 cm/s). Others were 21.12 ± 1.8 cm/s for the CC, 19.38 ± 1.65 cm/s for CB and 16.92 ± 1.44 cm/s for the EC. The EDV also increased steadily between 20 to 46 years from 17.76 cm/s to 23.68 cm/s for the CC, from 21.04 cm/s to 27.75 cm/s for the IC, from 14.38 cm/s to 18.97 cm/s for the EC and from 16.48 cm/s to 21.73 cm/s for the CB. The PSV and EDV varied significantly with age (p &gt;0.05). Also, the PSV and EDV increased slightly with increasing BMI from 30 – 31.9 kg/m2. For a BMI of 20 kg/m2 to 32 kg/m2, the increase in PSV were from 79.48 cm/s to 90.75 cm/s for the CC, from 66.58 cm/s to 76.03 cm/s for the IC, from 45.40 cm/s to 51.85 cm/s for the EC and from 45.94 cm/s to 52.46 cm/s for the CV. Similarly, the PSV and EDV values decreased at a BMI of 30 – 31.99 kg/m2. Thus, the BMI was significantly associated with PSV and EDV across all segments of the carotid artery (p &gt; 0.05).Conclusion: arotid PSV and EDV with age and BMI. These variations should be taken in to consideration when diagnosis on alterations in carotid artery flow are to be made using PSV and EDV values.