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https://www.readbyqxmd.com/read/29350100/transorbital-doppler-with-carotid-siphon-monitoring-detects-right-to-left-shunt-effectively
#1
Zhihui Duan, Zhiyuan Yang, Binbin Song, Congmin Ma, Yan Li, Yanjiao Du, Dandan Shang, Shao Li, Jiyu Lou
Background Transtemporal Doppler (TTD) with middle cerebral artery (MCA) is widely used for right-to-left shunt (RLS) detection. However, an alternative method for patients without suitable temporal bone windows should be established. The present study prospectively evaluated the effectiveness of transorbital Doppler (TOD) with carotid siphon (CS) monitoring in detecting RLS. Methods A total of 357 subjects with sufficient temporal bone windows underwent simultaneous TTD with MCA and TOD with CS. After injection of microbubbles, the numbers of artificial high-intensity signals were recorded at rest and after Valsalva maneuver...
January 19, 2018: Neurological Research
https://www.readbyqxmd.com/read/29349582/can-we-evaluate-the-levator-ani-after-kegel-exercise-in-women-with-pelvic-organ-prolapse-by-transperineal-elastography-a-preliminary-study
#2
Meng Xie, Xuyin Zhang, Xiaodan Zhang, Wenping Wang, Keqin Hua
OBJECTIVES: The aim of this study was to evaluate the stiffness variation of the levator ani in patients with stage I/II pelvic organ prolapse (POP) before and after Kegel exercises by transperineal elastography. METHODS: A total of 20 patients who were diagnosed with staged I/II POP underwent conventional transperineal ultrasound and elastography. For each patient, the levator ani was located and evaluated in the state of Valsalva. After Kegel exercises for 12 weeks, transperineal ultrasound and elastography were repeated...
January 18, 2018: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/29347958/correlation-of-structural-defects-in-the-ascending-aortic-wall-to-ultrasound-parameters-benefits-for-decision-making-process-in-aortic-valve-surgery
#3
Saša D Borović, Milica M Labudović Borović, Ivan V Zaletel, Vera N Todorović, Petar A Dabić, Jelena T Rakočević, Jelena M Marinković-Erić, Predrag S Milojević
BACKGROUND: Histopathological changes in the ascending aorta wall in patients with severe tricuspid aortic valve (TAV) stenosis were graded and correlated to echocardiographic parameters. Objective was to associate threshold echocardiographic values with structural defects in the ascending aorta providing a tool to improve decision-making process in cases when simultaneous aortic valve replacement (AVR) and ascending aorta replacement is considered. METHODS: Biopsies from 108 TAV stenosis patients subjected to AVR were graded into three grades according to severity of aortic wall changes...
January 18, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29340289/automatic-segmentation-method-of-pelvic-floor-levator-hiatus-in-ultrasound-using-a-self-normalizing-neural-network
#4
Ester Bonmati, Yipeng Hu, Nikhil Sindhwani, Hans Peter Dietz, Jan D'hooge, Dean Barratt, Jan Deprest, Tom Vercauteren
Segmentation of the levator hiatus in ultrasound allows the extraction of biometrics, which are of importance for pelvic floor disorder assessment. We present a fully automatic method using a convolutional neural network (CNN) to outline the levator hiatus in a two-dimensional image extracted from a three-dimensional ultrasound volume. In particular, our method uses a recently developed scaled exponential linear unit (SELU) as a nonlinear self-normalizing activation function, which for the first time has been applied in medical imaging with CNN...
April 2018: Journal of Medical Imaging
https://www.readbyqxmd.com/read/29334594/thoracic-aortic-aneurysm-in-patients-with-loss-of-function-filamin-a-mutations-clinical-characterization-genetics-and-recommendations
#5
Ming Hui Chen, Sangita Choudhury, Mami Hirata, Siri Khalsa, Bernard Chang, Christopher A Walsh
The frequency and gender distribution of thoracic aortic aneurysm as a cardiovascular manifestation of loss-of-function (LOF) X-linked FilaminA (FLNA) mutations are not known. Furthermore, there is very limited cardiovascular morbidity or mortality data in children and adults. We analyzed cardiac data on the largest series of 114 patients with LOF FLNA mutations, both children and adults, with periventricular nodular heterotopia (PVNH), including 48 study patients and 66 literature patients, median age of 22...
February 2018: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29329523/early-commitment-of-cardiovascular-autonomic-modulation-in-brazilian-patients-with-congenital-generalized-lipodystrophy
#6
Clarisse Mourão Melo Ponte, Virgínia Oliveira Fernandes, Maria Helane Costa Gurgel, Izabella Tamira Galdino Farias Vasconcelos, Lia Beatriz de Azevedo Souza Karbage, Christiane Bezerra Rocha Liberato, Carlos Antônio Negrato, Marília de Brito Gomes, Ana Paula Dias Rangel Montenegro, Renan Magalhães Montenegro Júnior
BACKGROUND: Metabolic abnormalities in congenital generalized lipodystrophy (CGL) are associated with microvascular complications. However, the evaluation of different types of neuropathy in these patients, including the commitment of cardiovascular autonomic modulation, is scarce. The objective of the present study was to determine the prevalence of cardiovascular autonomic neuropathy (CAN) in patients with CGL compared with individuals with type 1 diabetes and healthy subjects. METHODS: Ten patients with CGL, 20 patients with type 1 diabetes and 20 healthy subjects were included in the study...
January 12, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29326113/acute-heart-failure-with-new-onset-continuous-murmur-in-a-26-year-old-man
#7
Yi-Chen Wang, Chen-Wei Huang, Ting-Wei Lin
CLINICAL INTRODUCTION: A 26-year-old man with an unremarkable medical history sensed a momentary retrosternal 'pop' followed by overwhelming dyspnoea, without reporting any prodromal symptoms. At the emergency department, he had a significant tachycardia (170 bpm) and an extreme low diastolic blood pressure (<30 mm Hg). A loud, harsh and continuous murmur could be maximally auscultated at the right lower sternal border. ECG revealed global ST depression with ST elevation in lead aVR...
January 11, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29323752/congenital-aortocaval-fistula-between-right-aortic-sinus-of-valsalva-and-superior-vena-cava-a-rare-case-report
#8
Mozhdeh Dabirian, Ali Ghaemian, Maryam Nabati, Samad Golshani, Mojtaba Shokri
Thoracic aortocaval fistula is a very rare cause of left to right shunt. Drainage of fistula into the superior vena cava (SVC) is very uncommon. Clinical symptoms depend on the size of the shunt. We report a rare case of an asymptomatic 27-year-old woman with congenital aortocaval fistula to the SVC with a small amount of left to right shunt that was considered for serial medical follow-up.
January 11, 2018: Echocardiography
https://www.readbyqxmd.com/read/29321426/percutaneous-coronary-intervention-for-a-patient-with-left-main-coronary-compression-syndrome
#9
Ryutaro Ikegami, Kazuyuki Ozaki, Takuaya Ozawa, Satoru Hirono, Masahiro Ito, Tohru Minamino
Left main coronary compression syndrome rarely occurs in patients with severe pulmonary hypertension. A 65-year-old woman with severe pulmonary hypertension due to an atrial septal defect suffered from angina on effort. Cardiac computed-tomography and coronary angiography revealed considerable stenosis of the left main coronary artery (LMA) caused by compression between the dilated main pulmonary artery trunk and the sinus of valsalva. Stenting of the LMA under intravascular ultrasound imaging was effective for the treatment of angina...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29319536/new-photoplethysmogram-indicators-for-improving-cuffless-and-continuous-blood-pressure-estimation-accuracy
#10
Wan-Hua Lin, Hui Wang, Oluwarotimi Williams Samuel, Gengxing Liu, Zhen Huang, Guanglin Li
Objective: The accuracy of cuffless and continuous blood pressure (BP) estimation has been improved, but it is still unsatisfactory for clinical uses. This study was designed to further increase BP estimation accuracy. Approach: In this study, a number of new indicators were extracted from photoplethysmogram (PPG) recordings and linear regression method was used to construct BP estimation models based on the PPG indicators and pulse transit time (PTT). The performance of the BP estimation models was evaluated by the PPG recordings from 22 subjects when they performed mental arithmetic stress and Valsalva's manoeuvre tasks that could induce BP fluctuations...
December 28, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/29317805/compression-of-the-right-coronary-artery-by-an-aortic-pseudoaneurysm-after-infective-endocarditis-an-unusual-case-of-myocardial-ischemia
#11
Juan Lacalzada-Almeida, Alejandro De la Rosa-Hernández, María Manuela Izquierdo-Gómez, Javier García-Niebla, Iván Hernández-Betancor, Juan Alfonso Bonilla-Arjona, Antonio Barragán-Acea, Ignacio Laynez-Cerdeña
A 61-year-old male with a prosthetic St Jude aortic valve size 24 presented with heart failure symptoms and minimal-effort angina. Eleven months earlier, the patient had undergone cardiac surgery because of an aortic root dilatation and bicuspid aortic valve with severe regurgitation secondary to infectious endocarditis by Coxiela burnetii and coronary artery disease in the left circumflex coronary artery. Then, a prosthesis valve and a saphenous bypass graft to the left circumflex coronary artery were placed...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29313115/-diagnosis-and-treatment-of-eustachian-tube-dysfunction
#12
S Schröder, J Ebmeyer
The Eustachian tube protects against secretion, germs and sound pressure from the nasopharynx, it acts as a drain, and serves pressure equalization in both directions so that the ear drum and sound-conducting apparatus can vibrate optimally. The incidence of Eustachian tube dysfunction in adults is about 1%, in children almost 40%. Symptoms are often unspecific. For diagnosis, the Eustachian tube score (ETS-5) can be used in patients with a perforated ear drum, and the ETS-7 score in patients with intact ear drum...
January 8, 2018: HNO
https://www.readbyqxmd.com/read/29303373/cardiac-autonomic-function-and-reactivity-tests-in-physically-active-subjects-with-moderately-severe-copd
#13
Jibril Mohammed, Eric Derom, Tine De Backer, Inge De Wandele, Patrick Calders
Patients with chronic obstructive pulmonary disease (COPD) show impairments in the autonomic nervous systems (ANS) function, which is responsible for cardiac autonomic regulation. This study assessed the autonomic function and cardio-vagal reactivity in conveniently sampled subjects with COPD participating in a pulmonary rehabilitation (PR) program. Twenty-six subjects with COPD and 22 age and gender matched control subjects were evaluated. R-R intervals were collected at rest in supine position. Thereafter, resting autonomic function parameters comprising linear and nonlinear analyses of heart rate variability (HRV) and baroreceptor sensitivity (BRS) were calculated...
January 5, 2018: COPD
https://www.readbyqxmd.com/read/29300074/the-ross-reimplantation-technique
#14
Adriaan Schneider, R J M Klautz, Mark Hazekamp
Pulmonary autograft replacement of a diseased aortic valve (the Ross procedure) is effective in children, where growth is essential, and in young patients for whom a biological solution is preferred. Long-term outcomes are generally good. However eventual autograft dilatation may necessitate reoperation. In order to diminish the risk of autograft dilatation, several 'wrapping' techniques have been developed. Here, we present our technique of choice: the reimplantation of the pulmonary autograft in a vascular tube graft, scalloping the sinuses of Valsalva...
September 25, 2017: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/29299505/utility-of-adjunctive-procedures-with-balloon-dilation-of-the-eustachian-tube
#15
Yehia Ashry, Kosuke Kawai, Dennis Poe
Objective: To assess the role and effect of concomitant adjunctive procedures when combined with balloon dilation of the Eustachian tube (BDET), including a new technique for treating obstructive disease within the bony Eustachian tube (ET). Study Design: Retrospective case series. Setting: Tertiary medical center. Subjects: Adults with persistent (≥2 years): 1) OME or non-fixed TM retraction AND type B or C tympanogram OR 2) Consistent symptoms of barochallenge with flights or diving, all despite medical treatment for ≥6 weeks...
December 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29296165/skull-base-and-craniocervical-bone-pneumatisation-two-case-reports-of-differing-presentations-and-a-review-of-the-literature
#16
Olivia Francies, Simon Morley, Tim Beale
We report two patients with increased central skull base and craniocervical junction bone pneumatisation complicated by extra-osseous gas. One patient presented with symptoms of increasing nasal blockage and 'sinus pressure' on a background of extensive nasal polyposis. He was subsequently found to have a history of repeated Valsalva's manoeuvre, the cessation of which resulted in a rapid decrease in the amount of extra-osseous gas on imaging. The second patient presented following a minor head trauma with dysarthria from a hypoglossal nerve palsy and neck pain, with extensive intra- and extra-cranial gas including within the spinal canal (pneumorrhachis)...
November 2017: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/29288123/correlations-between-sonographic-and-urodynamic-findings-after-mid-urethral-sling-surgery
#17
Lieming Wen, Ka Lai Shek, Subramaniam Nishamini, Friedman Talia, Hans Peter Dietz
PURPOSE: To study correlations between sonographic and urodynamic findings after suburethral sling surgery. METHODS: This is a retrospective study on 141 women who had multichannel urodynamic testing and translabial 4D ultrasound after suburethral sling surgery between 2006 and 2016. The sling-pubis gap, i.e., the distance between sling and infero-posterior margin of the pubic symphysis on Valsalva, and urethral motion profile were determined. The urethral motion profile was assessed by calculating the mobility vectors of 6 equidistant points along the length of urethra from bladder neck to external urethral meatus, against the dorsocaudal margin of the symphysis pubis on Valsalva...
December 26, 2017: Journal of Urology
https://www.readbyqxmd.com/read/29285624/balloon-dilatation-of-the-eustachian-tube-in-adult-patients-with-chronic-dilatory-tube-dysfunction-a-retrospective-cohort-study
#18
M C Satmis, M van der Torn
OBJECTIVES: The aim of this study is to assess the subjective and objective short-term results and safety of transnasal balloon dilatation of the Eustachian tube (BET) in adult patients with chronic dilatory Eustachian tube dysfunction (ETD). DESIGN: Retrospective cohort study. Data collection was performed preoperatively, 1 and 3 months after BET. SETTING: Tertiary referral hospital. PARTICIPANTS: A cohort of 42 consecutive patients (66 ears)...
December 29, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29281192/dried-salted-plum-consumption-ameliorates-hyperbaric-oxygen-therapy-induced-otalgia-severity-at-the-first-chamber-session-a-prospective-randomized-controlled-study
#19
Fan-Chun Meng, Chih-Hao Shen, Di Wu, Chi-Ming Chu, Cheng-Ping Shih, Hung-Che Lin, Chung-Kan Peng, Shun Cheng Chang, Kun-Lun Huang
PURPOSE: One of the most common complications of hyperbaric oxygen (HBO₂) therapy is middle ear barotrauma (MEB), occasionally causing otalgia. The objective of this study was to evaluate the effect of dried salted plum consumption on MEB and otalgia associated with HBO₂ therapy. MATERIALS AND METHODS: Patients undergoing the first chamber session of HBO₂ therapy were included in the present prospective randomized controlled trial. The Valsalva maneuver was administered to all patients before HBO₂...
November 2017: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/29280039/left-ventricular-outflow-tract-arrhythmias-with-divergent-qrs-morphology-mapping-of-different-exits-and-ablation-strategy
#20
Christopher Reithmann, Michael Fiek
BACKGROUND: Ventricular arrhythmias (VAs) from the left ventricular outflow tract (LVOT) can have multiple exits exhibiting divergent ECG features. METHODS: In a series of 131 patients with VAs with LVOT origin, 10 patients presented with divergent QRS morphologies. Multisite endo- and epicardial mapping of different exit sites was performed. RESULTS: The earliest ventricular activity of 23 LVOT VAs in 10 patients was detected in the endocardium of the LV in 7 patients, the aortic sinuses of Valsalva (SoV) in 3 patients, the distal coronary sinus in 6 patients, the anterior interventricular vein in 3 patients, and the posterior right ventricular outflow tract (RVOT) in 4 patients...
December 27, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
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