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1.
Bülent Çekiç Ömer Tarık Selçuk İclal Erdem Toslak Üstün Osma Hülya Eyigör Muhammed Kazım Erol 《Journal of Medical Ultrasonics》2018,45(3):487-492
Purpose
To evaluate extraocular orbital vessels with color Doppler ultrasound (CDU) and investigate the effects of severe obstructive sleep apnea (OSA) on retrobulbar blood flow.Methods
Between February 2014 and September 2015, 30 patients with severe OSA (apnea–hypopnea index (AHI) > 30) and 28 controls were prospectively included in this study. Intraocular pressure (IOP) was measured with a Goldmann applanation tonometer, and CDU was used to evaluate the retrobulbar vessels.Results
The mean AHI score for the OSA group was 63.2 ± 21.5 per hour. The IOP values were significantly higher in the severe OSA group (p < 0.05). The central retinal artery peak systolic velocity (PSV) (p < 0.05) and end-diastolic velocity (EDV) (p < 0.02), and the ophthalmic artery (OA) PSV and EDV, were found to be significantly lower in the OSA group (p < 0.05).Conclusion
Severe OSA causes an increase in IOP and a decrease in flow velocity in the retrobulbar circulation.2.
Purpose
Contrast-enhanced ultrasound (CEUS) can distinguish between central lung cancer and atelectatic lung tissue. The aim of this study was to explore the clinical value of CEUS for biopsy in patients with central lung cancer with obstructive atelectasis.Methods
One hundred and twelve patients were selected and CEUS was performed to display central lung cancer and atelectatic lung tissue. The front edge of central lung cancer was punctured with a needle, avoiding the necrotic area, under the guidance of CEUS.Results
All of the 112 lesions were diagnosed with a clear central lung cancer mass and atelectatic lung tissue. In 104 cases, the central lung cancer mass presented with a “slow-in and fast-out” pattern compared to atelectatic lung tissue. In eight cases, the central lung cancer mass presented with a “fast-in and fast-out” pattern compared to atelectatic lung tissue. The mean number of punctures was 2.6, and the success rate of puncture biopsy was 98%. Of the 112 patients, six cases had hemoptysis during the procedure and 10 patients had bloody sputum in the postoperative period. No complications were found in the other cases.Conclusion
CEUS has important clinical value for needle biopsy of central lung cancer with atelectasis.3.
Paul Flechsig Clemens Kratochwil Arne Warth Daniel Rath Viktoria Eichwald Peter E. Huber Hans-Ulrich Kauczor Uwe Haberkorn Frederik L. Giesel 《Molecular imaging and biology》2016,18(2):243-248
Purpose
The demand to optimize multidisciplinary treatment strategies in patients with benign and malignant diseases of the lung and other organs has led to the increased need of mechanistic proof-of-concept studies in preclinical small animal models using new non-invasive imaging methods. Therefore, we evaluated the role of microPET and microCT for mediastinal lymph node staging in an orthotopic lung cancer model in rats.Procedures
Human lung cancer cells (NCI-H460) were injected transthoracically in nude rats (NIH-RNU). After 2 weeks of tumour growth, animals underwent multiphase contrast-enhanced microCT using ExiTron nano 12000 as a contrast agent and dynamic microPET using the tracer 2-deoxy-2-[18F]fluoro-d-glucose ([18F]FDG). Thereafter, animals were sacrificed for histological analysis.Results
Late phase micro X-ray computed tomography (microCT) revealed the best delineation of lymph node metastases, as compared to earlier scans. In terms of an increased [18F]FDG uptake over time, dynamic micro positron emission tomography (microPET) delineated lymph node metastases and enabled metabolic examinations of the induced lung cancer metastases.Conclusion
The combination of contrast-enhanced microCT and dynamic microPET is feasible in rats for the visualization of mediastinal lymph node metastases.4.
von Ungern-Sternberg BS Hammer J Frei FJ Jordi Ritz EM Schibler A Erb TO 《Intensive care medicine》2007,33(10):1771-1777
Objectives
Although the prone position is effectively used to improve oxygenation, its impact on functional residual capacity is controversial. Different techniques of body positioning might be an important confounding factor. The aim of this study was to determine the impact of two different prone positioning techniques on functional residual capacity and ventilation distribution in anesthetized, preschool-aged children.Design
Functional residual capacity and lung clearance index, a measure of ventilation homogeneity, were calculated using a sulfur-hexafluoride multibreath washout technique. After intubation, measurements were taken in the supine position and, in random order, in the flat prone position and the augmented prone position (gel pads supporting the pelvis and the upper thorax).Setting
Pediatric anesthesia unit of university hospital.Patients and participants
Thirty preschool children without cardiopulmonary disease undergoing elective surgery.Measurements and results
Mean (range) age was 48.5 (24–80) months, weight 17.2 (10.5–26.9)?kg, functional residual capacity (mean ±?SD) 22.9?±?6.2?ml.kg ?1 in the supine position and 23.3?±?5.6?ml.kg ?1 in the flat prone position, while lung clearance indices were 8.1?±?2.3 vs. 7.9?±?2.3, respectively. In contrast, functional residual capacity increased to 27.6 ± 6.5 ml.kg ?1 (p0.001) in the augmented prone position while at the same time the lung clearance index decreased to 6.7?±?0.9 (p0.001).Conclusions
Functional residual capacity and ventilation distribution were similar in the supine and flat prone positions, while these parameters improved significantly in the augmented prone position, suggesting that the technique of prone positioning has major implications for pulmonary function.5.
Noriya Takayama Yasunao Ishiguro Nobuyuki Taniguchi Kazuki Akai Hideki Sasanuma Yoshikazu Yasuda Naotaka Nitta Iwaki Akiyama 《Journal of Medical Ultrasonics》2016,43(4):481-485
Purpose
Acoustic radiation force (ARF) elastography has recently become available. The previous animal studies have revealed lung injuries induced by diagnostic ultrasound, but the effects on the lung resulting from exposure to ultrasound with ARF are unknown. This study aimed to assess the risk of lung injury associated with ultrasound with ARF.Methods
A focused 2.5-MHz transducer that emits ultrasound with ARF was used. A rabbit was anesthetized, and the transducer was placed in the right subcostal region. Exposure settings of mechanical index (MI) 0.80, pulse duration 10 ms, pulse repetition time 5 s, and exposure time 150 s were applied.Results
One red spot (7 × 6 mm) was observed on the surface of the right lung corresponding to the area of exposure. Alveolar hemorrhage was observed microscopically. This lesion was visible across a range of 20–170 μm in depth from the pleural surface.Conclusion
The first example of lung hemorrhage induced by ultrasound with ARF was observed in this study. This observation suggests the possibility of lung injury in humans when ARF elastography is applied with the transducer directed toward the lung. Further studies are needed to determine the safety of this modality.6.
7.
Ivica Grgurevic Milan Kujundzic Marko Banic Rajko Kusec Tomislav Bokun Mirjana Vukelic-Markovic Zoran Bogdanovic Anita Lukic Emmanouil Tsochatzis Boris Brkljacic 《Abdominal imaging》2016,41(3):476-484
Purpose
To investigate (1) diagnostic performance of transabdominal color doppler ultrasound (US) and endoscopic ultrasound (EUS) for detection and sub-classification of common bile duct varices (CBDV) in patients with portal vein thrombosis (PVT), and (2) clinical significance and natural history of CBDV subtypes.Patients and Methods
During a 4-year period, 56 patients with PVT underwent US and EUS for the presence and subtypes of CBDV. Natural history was analyzed for patients who attended control visits.Results
CBDV were diagnosed in 57 and 59 % of patients with US and EUS, respectively. In 19 % of patients, EUS revealed different CBDV subtypes than previously seen by US. The most common were paracholedochal (PCV), while the least common were epicholedochal (ECV) and Submucosal varices (SMV). Nine patients had obstructive jaundice and underwent ERCP which was complicated by hemobilia in two patients with SMV. Among eight patients who underwent control EUS (median follow-up 60 months), the form of CBDV remained unchanged. Two patients bled from esophageal varices, both with ECV.Conclusion
While abdominal US and EUS are equally sensitive for detection of CBDV, EUS allows more precise determination of CBDV subtype. Patients with SMV might be at increased risk of bleeding upon ERCP.8.
Purpose
On a regular basis, the intensivist encounters the patient who is difficult to wean from mechanical ventilatory support. The causes for failure to wean from mechanical ventilatory support are often multifactorial and involve a complex interplay between cardiac and pulmonary dysfunction. A potential application of point of care ultrasonography relates to its utility in the process of weaning the patient from mechanical ventilatory support.Methods
This article reviews some applications of ultrasonography that may be relevant to the process of weaning from mechanical ventilatory support.Results
The authors have divided these applications of ultrasonography into four separate categories: the assessment of cardiac, diaphragmatic, and lung function; and the identification of pleural effusion; which can all be evaluated with ultrasonography during a dynamic process in which the intensivist is uniquely positioned to use ultrasonography at the point of care.Conclusions
Ultrasonography may have useful application during the weaning process from mechanical ventilatory support.9.
Maneesh Gupta 《Clin Pract Epidemiol Ment Health》2007,3(1):12
Background
Quetiapine causes less prolactin elevation and/or galactorrhoea than other atypical antipsychotics.Case Presentation
Ms AB had galactorrhoea and raised prolactin levels at only 100 mg of quetiapine daily.Conclusion
Low dose quetiapine can also cause galactorrhoea.10.
Anna Theodorou-Kanakari Spyridon Karampitianis Vasiliki Karageorgou Eleni Kampourelli Efstathios Kapasakis Panagiotis Theodossiadis Irini Chatziralli 《Advances in therapy》2018,35(10):1510-1518
Introduction
The purpose of this review is to present the current and emerging treatment alternatives for Leber’s hereditary optic neuropathy (LHON), emphasizing the most recent use of idebenone and stem cells or gene therapy.Methods
A comprehensive literature review was performed at the PubMed database regarding the various treatment modalities for LHON.Results
Treatment modalities for LHON include nutritional supplements, activators of mitochondrial biogenesis, brimonidine, and symptomatic and supportive treatment, but nowadays attention is being paid to idebenone and gene therapy or stem cells.Conclusion
The treatment of LHON remains challenging, given the nature of the disease and its prognosis.11.
Background
Aim was to determine the predictive factors for polypharmacy among inpatient children and adolescents with psychiatric disorders.Methods
Blinded, case-note review of children and adolescents with ICD 10 diagnosis of psychiatric disorders on psychotropic medication was conducted. Data on demography, illness, and treatment was analyzed with univariate and multivariate techniques.Results
Proscribing non-pharmacological interventions (OR = 4.7) and pro re nata medication (OR = 3.3), increased the risk of polypharmacy. Prescribing physical restraint reduced the risk of receiving multiple medications (OR = 0.3).Conclusion
Proscribing non-pharmacological interventions, pro re nata medication and physical restraints increased polypharmacy.12.
Aims
Create an educational program in chronic pain (EPCP).Material and methods
We used a four-step process to create the EPCP tailored to patient’s needs.Results
Five groups of patients can benefit from the program annually. Based on their own assessment, patients stated that their knowledge of chronic pain improved between 2.8 to 24%. The satisfaction with the EPCP was 8.67/10.Conclusion
Our EPCP helps patients gain and maintain the skills they need to best manage their lives with a chronic pain.13.
Marjolein EJ Oerlemans Marjan van den Akker Agnes G Schuurman Eliane Kellen Frank Buntinx 《Clin Pract Epidemiol Ment Health》2007,3(1):29
Background
The authors tested the hypothesis that depression is a possible factor influencing the course of cancer by reviewing prospective epidemiological studies and calculating summary relative risks.Methods
Studies were identified by computerized searches of Medline, Embase and PsycINFO. as well as manual searches of reference lists of selected publications. Inclusion criteria were cohort design, population-based sample, structured measurement of depression and outcome of cancer known for depressed and non-depressed subjectsResults
Thirteen eligible studies were identified. Based on eight studies with complete crude data on overall cancer, our summary relative risk (95% confidence interval) was 1.19 (1.06–1.32). After adjustment for confounders we pooled a summary relative risk of 1.12 (0.99–1.26).No significant association was found between depression and subsequent breast cancer risk, based on seven heterogeneous studies, with or without adjustment for possible confounders. Subgroup analysis of studies with a follow-up of ten years or more, however, resulted in a statistically significant summary relative risk of 2.50 (1.06–5.91).No significant associations were found for lung, colon or prostate cancer.Conclusion
This review suggests a tendency towards a small and marginally significant association between depression and subsequent overall cancer risk and towards a stronger increase of breast cancer risk emerging many years after a previous depression.14.
Nadir Yehya Neal J. Thomas Nuala J. Meyer Jason D. Christie Robert A. Berg Susan S. Margulies 《Intensive care medicine》2016,42(7):1137-1145
Purpose
Angiopoietin 2 (Ang2) and soluble receptor for advanced glycation end products (sRAGE) are markers of endothelial and pulmonary epithelial damage with prognostic implications in adult acute respiratory distress syndrome (ARDS), but unclear significance in pediatric ARDS (PARDS).Methods
This was a prospective, observational study in children with PARDS (2012 Berlin and 2015 PALICC definitions) at the Children’s Hospital of Philadelphia. Plasma was collected within 48 h of PARDS onset and biomarkers quantified by enzyme-linked immunosorbent assay.Results
In 82 children with PARDS (12 deaths, 15 %), Ang2 and sRAGE were higher in non-survivors than survivors (p < 0.01 for both). Mortality was highest in patients with Ang2 and sRAGE levels both above median values. Ang2 and sRAGE correlated with the number of non-pulmonary organ failures (both p < 0.001). Ang2 was higher in indirect lung injury and in immunocompromised children. In stratified analysis, both Ang2 and sRAGE were associated with mortality only in direct lung injury and in immunocompetent children, with no association evident in indirect lung injury or in immunocompromised children.Conclusions
Ang2 and sRAGE in early PARDS were higher in non-survivors than survivors and strongly correlated with number of non-pulmonary organ failures. When stratified by type of lung injury, Ang2 and sRAGE were associated with mortality only in direct lung injury. Similarly, when stratified by immunocompromised status, Ang2 and sRAGE were associated with mortality only in immunocompetent children. The utility of these biomarkers for prognostication and risk stratification requires investigation.15.
Xiwen Wang Hang Chi Qianxue Li Wenliang Li Jiakuan Li Bo Li Weicun Gao Da Zhang Yu Sun Le Yi Han Qu Yutian Wang Zhiping Li Zhiping Xia 《Molecular imaging and biology》2018,20(1):21-26
Purpose
The present study aims to develop five Gram-negative bacteria expressing bacterial luciferase for use to evaluate the influence of different antibiotics on bacterial bioluminescence.Procedures
The pBBR-lux plasmid was introduced into five Gram-negative bacteria; the bioluminescent signals and colony-forming unit (CFU)/ml of all the bioluminescent strains were monitored with six antibiotics at various concentrations.Results
Dose-dependent bioluminescence signals can be used for rapid bacterial antibiotic susceptibility test (AST). All five bioluminescent bacterial strains have similar bioluminescence and CFU enhancement at sub-minimum inhibitory concentration (MIC) of six different antibiotics.Conclusion
The bioluminescent signals and CFU enhancement at sub-MIC antibiotic concentrations should be of value in the research of new antibiotic drugs and bioluminescent imaging.16.
Objectives
1) to assess the prevalence of hepatitis C virus (HCV) infection in a population of acute psychiatric in-patients; 2) to find out relationships between HCV comorbidity and clinical features of psychiatric patients.Methods
Prospective observational study in a 6-year period.Results
2396 cases (1492 patients) were admitted in the considered period. Forty-two patients (2.8%) were affected by HCV infection. HCV infection was more frequent in patients with less years of education, lower social class, lower last year best Global Assessment of Functioning score, more hostile or violent behavior in hospital, with a lifetime history of previous suicide attempt, and with substance-related disorders.Conclusion
HCV infection in psychiatric patients constitutes a major threat to the health of psychiatric patients and is related with unfavorable social background, worse global functioning, hostile or violent behavior, substance-related disorders. It appears also to be a significant risk of suicidal behavior.17.
Endotracheal tubes positioning detection in adult portable chest radiography for intensive care unit
Sheng Chen Min Zhang Liping Yao Wentao Xu 《International journal of computer assisted radiology and surgery》2016,11(11):2049-2057
Purpose
To present an automated method for detecting endotracheal (ET) tubes and marking their tips in portable chest radiography (CXR) for intensive care units (ICUs).Methods
In this method, the lung region is first estimated and then the spine is detected between the right lung and the left lung. Because medical tubes are inserted into the body through the throat, the region of interest (ROI) is obtained across the spine. A seed point is determined in the cervical region of the ROI, and then the line path is selected from the seed point. In order to detect ET tubes, the ICU CXR image is preprocessed by contrast-limited adaptive histogram equalization. Then, a feature-based threshold method is applied to the line path to determine the tip location. A comparison to the method by use of Hough transform is also presented. The distance (error) between the detected locations and the locations annotated by a radiologist is used to evaluate the detection precision for the tip location.Results
The proposed method is evaluated using 44 images with ET tubes and 43 images without ET tubes. The discriminant performance for detecting the existence of ET tubes in this study was 95 %, and the average of detection error for the tip location was approximately 2.5 mm.Conclusions
The proposed method could be useful for detecting malpositioned ET tubes in ICU CXRs.18.
Mohamed Hassanein Matthew R. Hight Jason R. Buck Mohammed N. Tantawy Michael L. Nickels Megan D. Hoeksema Bradford K. Harris Kelli Boyd Pierre P. Massion H. Charles Manning 《Molecular imaging and biology》2016,18(1):18-23
Purpose
Alanine-serine-cysteine transporter 2 (ASCT2) expression has been demonstrated as a promising lung cancer biomarker. (2S,4R)-4-[18F]Fluoroglutamine (4-[18F]fluoro-Gln) positron emission tomography (PET) was evaluated in preclinical models of non-small cell lung cancer as a quantitative, non-invasive measure of ASCT2 expression.Procedures
In vivo microPET studies of 4-[18F]fluoro-Gln uptake were undertaken in human cell line xenograft tumor-bearing mice of varying ASCT2 levels, followed by a genetically engineered mouse model of epidermal growth factor receptor (EGFR)-mutant lung cancer. The relationship between a tracer accumulation and ASCT2 levels in tumors was evaluated by IHC and immunoblotting.Result
4-[18F]Fluoro-Gln uptake, but not 2-deoxy-2-[18F]fluoro-D-glucose, correlated with relative ASCT2 levels in xenograft tumors. In genetically engineered mice, 4-[18F]fluoro-Gln accumulation was significantly elevated in lung tumors, relative to normal lung and cardiac tissues.Conclusions
4-[18F]Fluoro-Gln PET appears to provide a non-invasive measure of ASCT2 expression. Given the potential of ASCT2 as a lung cancer biomarker, this and other tracers reflecting ASCT2 levels could emerge as precision imaging diagnostics in this setting.19.
Introduction
To present short-term safety and efficacy data of men with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) treated with Aquablation.Methods
Men with LUTs secondary to BPH (60–150 cc) underwent Aquablation treatment from February 2016 to December 2017 across 17 investigational sites in the USA from two contemporary investigational device exemption (IDE) studies called WATER (NCT02505919) and WATER II (NCT03123250).Results
One hundred seven males with mean age of 67.3?±?6.5 years were treated with Aquablation; mean prostate volume was 99.4?±?24.1 cc. The pooled results show that large prostates have an average procedure time of less than 36 min and discharge on average 1.6?±?1 days. The IPSS decreased by 16.7?±?8.1 points at 3 months and Qmax increased by 11.2?±?12.4 ml/s. The Clavien-Dindo (CD) grade 2 or higher event rate at 3 months was 29%. A non-hierarchical breakdown for CD events yielded 18% grade 2 and 19% grade 3 or higher.Conclusion
Men with LUTS secondary to BPH (60–150 cc) in a pooled analysis were treated safely and effectively with Aquablation up to 3 months postoperatively.Trial Registration
ClinicalTrials.gov identifiers, NCT02505919 and NCT03123250.Funding
PROCEPT BioRobotics.20.
Yoshiko Sagara Shunro Matsumoto Masatoshi Oga Norio Hongo Norimasa Kaneko Hiromu Mori 《Abdominal imaging》2016,41(9):1722-1727