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Diaphragmatic ultrasound

Lisandra Stein Bernardes, Juliana Fontan Ottolia, Marina Cecchini, Antônio Gomes de Amorim Filho, Manoel Jacobsen Teixeira, Rossana Pulcineli Vieira Francisco, Daniel Ciampi de Andrade
Introduction: Although pain facial assessment is routinely performed in term and preterm newborns by the use of facial expression-based tools such as the Neonatal Facial Coding System, the assessment of pain during the intrauterine life has not been extensively explored. Objective: Describe for the first time, an experimental model to assess and quantify responses due to acute pain in fetuses undergoing anaesthesia for intrauterine surgery recorded by high-resolution 4D ultrasound machines...
September 2018: Pain Reports (Baltimore, Md.)
Ramona Dolscheid-Pommerich, Alexander Kreuzer, Ingo Graeff, Birgit Stoffel-Wagner, Andreas Mueller, Florian Kipfmueller
Background Extracorporeal membrane oxygenation procedure (ECMO) has been established in the therapy of respiratory insufficient infants with congenital diaphragmatic hernia (CDH). In CDH newborns, a delay in transfer to an ECMO center is associated with a sharp increase in mortality. Predictive factors for ECMO support are urgently needed. We evaluated routine parameters of the first blood withdrawal after birth in CDH infants, hypothesizing that early signs in bone marrow affecting hematology parameters for early regulation of potentially post birth hypoxia are predictive factors for ECMO support...
December 4, 2018: Annals of Clinical Biochemistry
J Ricoy, N Rodríguez-Núñez, J M Álvarez-Dobaño, M E Toubes, V Riveiro, L Valdés
The diaphragm is the main breathing muscle and contraction of the diaphragm is vital for ventilation so any disease that interferes with diaphragmatic innervation, contractile muscle function, or mechanical coupling to the chest wall can cause diaphragm dysfunction. Diaphragm dysfunction is associated with dyspnoea, intolerance to exercise, sleep disturbances, hypersomnia, with a potential impact on survival. Diagnosis of diaphragm dysfunction is based on static and dynamic imaging tests (especially ultrasound) and pulmonary function and phrenic nerve stimulation tests...
November 30, 2018: Pulmonology
Hariprashanth Elangovan, Wei Yao, Kypros Nicolaides
This article presents a multi-modality tracking and navigation system achieved by merging optical tracking and ultrasound imaging into a novel navigation software to help in surgical pre-planning and real-time target setting and guidance. Fetal surgeries require extensive experience in coordination of hand-eye-ultrasound-surgical equipment, knowledge, and precise assessment of relative anatomy. While there are navigation systems available for similar constrained working spaces in arthroscopic and cardiovascular procedures, fetal minimally invasive surgery does not yet have a dedicated navigation platform capable of supporting robotic instruments that can be adapted to the set of unique procedures...
November 28, 2018: Surgical Innovation
Akiko Yokoi, Satoko Ohfuji, Seiji Yoshimoto, Yusuke Sugioka, Yoshinobu Akasaka, Toru Funakoshi
Background: Congenital diaphragmatic hernia (CDH) is a condition with a wide range of severity. Prenatal diagnosis is essential to optimize postnatal management, especially for severe cases. The lung to head ratio (LHR) and liver herniation estimated by prenatal ultrasound has been used as prenatal predictors in CDH. However, reliability of these factors remains to be proven and prediction of outcome from prenatal imaging is still challenging. We propose our new stratification system using lung to liver signal intensity ratio (LLSIR) in fetal MRI, which has been shown to be related to pulmonary maturation...
October 2018: Translational Pediatrics
Rausei Stefano, Pappalardo Vincenzo, Boni Luigi, Dionigi Gianlorenzo
BACKGROUND: Gastrointestinal tract involvements of metastatic melanoma are rare; 7% of gastrointestinal tract metastases of melanoma concerns the stomach [1]. Actually, bleeding from gastric melanoma metastasis is very rare. For the first time in Literature, this video shows a laparoscopic intragastric resection [2] of a cardial lesion of melanoma. A 64-year old patient with history of a skin melanoma resection with lung and liver metastatic disease confirmed by FDG PET, stable after repeated cycles of Pembrolizumab, presented anemia with gastrointestinal bleeding signs...
December 2018: Surgical Oncology
Karen M Frank
Advances made in the last several decades in the care of the fetus and newborn have had a significant impact on morbidity and mortality. Delayed umbilical cord clamping in the preterm newborn results in fewer transfusions for anemia, decreased intraventricular hemorrhage, and decreased necrotizing enterocolitis. Because of advances made in fetal ultrasound diagnosis and technological advances, fetal surgeries to treat congenital diaphragmatic hernia, myelomeningocele, twin-to-twin transfusion syndrome, fetal lower urinary tract obstructions, amniotic band syndrome, and congenital cystic adenoid malformation or congenital pulmonary airway malformations have improved the quality of life and survival for these patients...
December 2018: Critical Care Nursing Clinics of North America
Julio E González-Aguirre, Claudia Paola Rivera-Uribe, Erick Joel Rendón-Ramírez, Rogelio Cañamar-Lomas, Juan Antonio Serna-Rodríguez, Roberto Mercado-Longoría
INTRODUCTION: Invasive respiratory support is a cornerstone of Critical Care Medicine, however, protocols for withdrawal of mechanical ventilation are still far from perfect. Failure to extubation occurs in up to 20% of patients, despite a successful spontaneous breathing trial (SBT). METHODS: We prospectively included ventilated patients admitted to medical and surgical intensive care unit in a university hospital in northern Mexico. At the end of a successful SBT, we measured diaphragmatic shortening fraction (DSF) by the formula: diaphragmatic thickness at the end of inspiration - diaphragmatic thickness at the end of expiration/diaphragmatic thickness at the end of expiration×100, and the presence of B-lines in five regions of the right and left lung...
November 13, 2018: Archivos de Bronconeumología
Priya Ramakrishnan, Shahla Siddiqui
No abstract text is available yet for this article.
October 2018: Indian Journal of Anaesthesia
Christos P Loizou, Dimitrios Matamis, Giorgos Minas, Theodoros Kyprianou, Christakis D Loizou, Eleni Soilemezi, Entela Kotco, Constantinos S Pattichis
Measurements of ultrasound diaphragmatic motion, amplitude, force, and velocity of contraction may provide important and essential information about diaphragmatic fatigue, weakness, or paralysis. In this paper, we propose and evaluate a semi-automated analysis system for measuring the diaphragmatic motion and estimating the maximum relaxation rate (MRR_SAUS) from ultrasound M-mode images of the diaphragmatic muscle. The system was evaluated on 27 M-mode ultrasound images of the diaphragmatic muscle [20 with no resistance (NRES) and 7 with resistance (RES)]...
2018: IEEE Journal of Translational Engineering in Health and Medicine
Robert Da Costa, Pezad Doctor, Kaustubh Mahajan, Vidyadhara G Lakkappan
Neuropathy is one of the major reasons of morbidity in diabetes mellitus (DM). We presented a 64-year-old male who was a case of type 2 DM for >6 years. He presented with orthopnea and respiratory failure secondary to bilateral phrenic neuropathy and resultant diaphragmatic palsy. Clinical examination, ultrasound, and nerve conduction studies confirmed the bilateral involvement of the phrenic nerves. Phrenic neuropathy may be an important, albeit a rare complication of diabetes, and hence, diaphragmatic dysfunction associated with diabetic phrenic neuropathy should be considered in any patient with unexplained breathlessness, orthopnea, and respiratory failure...
October 2018: Indian Journal of Critical Care Medicine
Przemyslaw Kosinski, Katarzyna Luterek, Dorota Bomba-Opon, Michal Lipa, Miroslaw Wielgos
OBJECTIVE: To evaluate the impact of cervical length and cervical pessary application in congenital diaphragmatic hernia (CDH) treated by the fetoscopic endotracheal occlusion (FETO) procedure. METHODS: The study group consisted of 80 patients with severe CDH treated by FETO. Cervical length measurement was performed by transvaginal ultrasound in all patients within the 24 h prior to the FETO procedure. The study group (n = 44) had cervical pessaries applied routinely within the 24 h following the FETO procedure, whereas the control group (n = 36) were not offered pessaries and only had cervical length measurement performed...
November 7, 2018: Fetal Diagnosis and Therapy
Jordina Torrents-Barrena, Gemma Piella, Narcís Masoller, Eduard Gratacós, Elisenda Eixarch, Mario Ceresa, Miguel Ángel González Ballester
Fetal imaging is a burgeoning topic. New advancements in both magnetic resonance imaging and (3D) ultrasound currently allow doctors to diagnose fetal structural abnormalities such as those involved in twin-to-twin transfusion syndrome, gestational diabetes mellitus, pulmonary sequestration and hypoplasia, congenital heart disease, diaphragmatic hernia, ventriculomegaly, etc. Considering the continued breakthroughs in utero image analysis and (3D) reconstruction models, it is now possible to gain more insight into the ongoing development of the fetus...
January 2019: Medical Image Analysis
Claudia Crimi, Enrico Heffler, Teresa Augelletti, Raffaele Campisi, Alberto Noto, Carlo Vancheri, Nunzio Crimi
Background: Pulmonary rehabilitation (PR) may improve respiratory symptoms and skeletal muscle strength in patients with COPD. We aimed to evaluate changes in ultrasound (US) measurements of diaphragmatic mobility and thickness after PR in COPD patients and to test its correlation with PR outcomes. Methods: Twenty-five COPD patients were enrolled and underwent a diaphragm US assessment before and after a 12-week PR program. Results: We found a correlation between the intraindividual percentage of change in the diaphragmatic length of zone of apposition at functional residual capacity (ΔLzapp%) and the change in 6-minute walking distance (6MWD) after PR (rho=0...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Takahiro Hosokawa, Hiroaki Takahashi, Yutaka Tanami, Yumiko Sato, Mayumi Hosokawa, Reiko Kato, Hiroshi Kawashima, Eiji Oguma
This report describes the evaluations of 2 patients with congenital diaphragmatic hernias using ultrasound (US). Identifying the size of the diaphragmatic defect is important when determining the type of surgical repair required. In case 1, the US evaluation of a Bochdalek hernia showed the rim of the anterolateral diaphragm; therefore, thoracoscopic primary repair was performed. In case 2, (Morgagni-Larrey hernia), US revealed the left side of a retrosternal diaphragmatic hernia sac; therefore, thoracoscopic repair from the left thorax was performed...
October 22, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
E Salzano, S E Raible, M Kaur, A Wilkens, G Sperti, R K Tilton, L R Bettini, A Rocca, G Cocchi, A Selicorni, L K Conlin, D McEldrew, R Gupta, S Thakur, K Izumi, I D Krantz
Pallister-Killian syndrome (PKS) is a tissue limited mosaic disorder, characterized by variable degrees of neurodevelopmental delay and intellectual disability, typical craniofacial findings, skin pigmentation anomalies and multiple congenital malformations. The wide phenotypic spectrum of PKS in conjunction with the mosaic distribution of the i(12p) makes PKS an underdiagnosed disorder. Recognition of prenatal findings that should raise a suspicion of PKS is complicated by the fragmentation of data currently available in the literature and challenges in diagnosing a mosaic diagnosis on prenatal testing...
October 5, 2018: American Journal of Medical Genetics. Part A
Zhicheng Qian, Ming Yang, Lin Li, Yaolong Chen
OBJECTIVE: The aim of this systematic review was to assess the diaphragmatic dysfunction (DD) as a predictor of weaning outcome. BACKGROUND: Successful weaning depends on several factors: muscle strength, cardiac, respiratory and metabolic. Acquired weakness in mechanical ventilation is a growing important cause of weaning failure. With the development of ultrasonography, DD can be evaluated with ultrasound in weakness patients to predict weaning outcomes. METHODS: The Cochrane Library, PubMed, Embase, Ovid Medline, WanFang Data and CNKI were systematically searched from the inception to September 2017...
October 4, 2018: BMJ Open
Rachel B Davy, Philip E Hamel, Yu Su, Clifford R Berry, Bobbi J Conner
Ultrasound techniques, including focused assessment with sonography for trauma (FAST) examinations, are commonly used in veterinary practice, making inclusion of ultrasound in veterinary curricula increasingly important. The best approach for teaching ultrasound techniques in veterinary medicine has not been evaluated. This study compared the results of two training techniques, live-animal training and online video instruction, on students' performance during abdominal FAST (A-FAST) examinations. Thirty-eight first- and second-year veterinary students were randomly assigned to learn A-FAST via a live-animal laboratory or an instructional video...
October 4, 2018: Journal of Veterinary Medical Education
Kit Fai Lee, Hon Ting Lok, Andrew K Y Fung, Charing C N Chong, Yue Sun Cheung, John Wong, Paul B S Lai
A 51-year-old man who was a hepatitis B carrier presented with ruptured hepatocellular carcinoma (HCC). Hepatic arterial embolization was performed for control of bleeding which was followed by staged open left lateral sectionectomy for tumor removal. Pathology confirmed a 3.5 cm ruptured subcapsular HCC in a cirrhotic liver with clear resection margin. However, the alpha-fetoprotein (AFP) increased from 14 to 72 µg/L after 7 months. A 1.7 × 0.8 cm nodule at left subdiaphragmatic region abutting on the spleen but no intrahepatic lesion was seen on computed tomography (CT)...
September 29, 2018: Journal of Robotic Surgery
Victoria Arruga Novoa Y Novoa, Laura F Sutton, Allan E Neis, Amber M Marroquin, Tracey M Coleman, Kathleen A Praska, Tamara A Freimund, Krystal L Ruka, Vicki L Warzala, Haleh Sangi-Haghpeykar, Rodrigo Ruano
OBJECTIVES: The aim of this study was to investigate the reproducibility of a standardized method to assess the ultrasound liver-to-thoracic area ratio in fetuses with congenital diaphragmatic hernia. METHODS: We selected 24 images of 9 fetuses diagnosed with left-sided at our institution between January 2010 and December 2017. Eight operators (1 maternal-fetal medicine specialist and 7 sonographers) reviewed the selected images and assessed the ultrasound liver-to-thoracic area ratio according to a standardized protocol...
September 23, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
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