Cohorte descriptiva de pacientes adultos con hipertensión portal en una institución de tercer nivel en Colombia / Descriptive cohort of adult patients with portal hypertension at a tertiary care institution in Colombia

Introducción. La hipertensión portal (HTP) se define como una elevación anormal de la presión venosa en el sistema portal que lleva al desarrollo de vías colaterales para desviar el flujo sanguíneo de la zona. Dentro de su etiología están las relacionadas con la cirrosis hepática y otras causas denominadas no cirróticas. El objetivo de este estudio fue evaluar los principales hallazgos demográficos, clínicos y paraclínicos en un grupo de pacientes con HTP, y determinar el uso de ayudas invasivas y no invasivas, y su disponibilidad para el diagnóstico y seguimiento de los pacientes en los centros que no cuentan con laboratorio de hemodinamia hepática, reflejando la dinámica de múltiples escenarios en Colombia. Metodología. Se realizó un estudio descriptivo de corte transversal, retrospectivo, en pacientes atendidos en una institución de tercer nivel del sur de Colombia, entre enero del año 2015 y diciembre del año 2020. Resultados. Se obtuvo una muestra de 61 pacientes en donde la mayoría de casos correspondían a hombres en la séptima década de la vida, procedentes del área urbana. La principal causa de consulta fue el sangrado digestivo (39,3 %), asociado a la presencia de telangiectasias (arañas vasculares) en el 37,2 %, seguido de circulación colateral (31,3 %) e ictericia (19,7 %). En la ecografía abdominal (realizada en el 57,4 % de los pacientes) predominaron la cirrosis (68 %) y la presencia de esplenomegalia (14,2 %), y en lospacientes con Doppler portal (realizado en el 16,4 %) se encontró hígado cirrótico (80 %) y dilatación portal (40 %). Con respecto a los hallazgos en la esofagogastroduodenoscopia predominó la presencia de várices esofágicas y gastritis crónica. Conclusión. El principal motivo de consulta fue el sangrado digestivo, en tanto que la cirrosis fue el antecedente y el hallazgo imagenológico más frecuente, seguido de las várices esofágicas. Se encontró que el uso de paraclínicos, ecografía abdominal, ecografía con Doppler portal y esofagogastroduodenoscopia fueron los más utilizados en el contexto clínico de los pacientes con el diagnóstico de HTP.

Introduction. Portal hypertension (PHT) is defined as an abnormal elevation of venous pressure in the portal system that leads to the development of collateral pathways to divert blood flow from the area. Within its etiology are those related to liver cirrhosis and other so-called non cirrhotic causes. The aim of this study was to evaluate the main demographic, clinical and paraclinical findings in a group of patients with PHT, and to determine the use of invasive and non-invasive aids, and their availability for the diagnosis and follow-up of patients in centers that do not have a hepatic hemodynamics laboratory, reflecting the dynamics of multiple scenarios in Colombia. Methodology. A descriptive, retrospective, cross-sectional, retrospective study was conducted in patients attended in a third level institution in Southern Colombia, between January 2015 and December 2020. Results. A sample of 61 patients was obtained where the majority of cases corresponded to men in the seventh decade of life, from the urban area. The main cause of consultation was digestive bleeding (39.3%), associated with the presence of telangiectasias (spider veins) in 37.2%, followed by collateral circulation (31.3%) and jaundice (19.7%). In abdominal ultrasound (performed in 57.4% of the patients), cirrhosis (68%) and the presence of splenomegaly (14.2%) predominated, and in patients with portal Doppler (performed in 16.4%), cirrhotic liver (80%) and portal dilatation (40%) were found. With respect to the findings in the esophagogastroduodenoscopy, esophageal varices and chronic gastritis were predominant. Conclusion. The main reason for consultation was gastrointestinal bleeding, while cirrhosis was the most frequent history and imaging finding, followed by esophageal varices. It was found that the use of paraclinics, abdominal ultrasound, ultrasound with portal Doppler and esophagogastroduodenoscopy were the most used in the clinical context of patients diagnosed with PHT.

Clinical features and prognosis of 44 neonates with ovarian cysts / 中国新生儿科杂志

Objective:To study the clinical characteristics and imaging features of neonatal ovarian cysts and to analyze treatment and prognosis of ovarian torsion.Methods:From January 2011 to December 2021,neonates with ovarian cysts admitted to the department of neonatology and pediatric surgery of our hospital were retrospectively studied. They were assigned into ovarian torsion group and non-torsion group. Their clinical manifestations, imaging features, pathological results, treatment and prognosis were reviewed and compared.Results:A total of 44 neonates with ovarian cysts were included, all without specific clinical manifestations. 10 neonates were treated with conservative therapy and 34 received surgery. Ovarian torsion were confirmed during surgery in 23 patients. All 34 patients received abdominal ultrasound preoperatively and 31 (91.2%, 31/34) were diagnosed with ovarian cysts. The accuracy rates of ultrasound for cyst location and ovarian torsion were 85.3% (29/34) and 82.6% (19/23),respectively. 30 patients received abdominal CT scan and 23 (76.7%, 23/30) were diagnosed with ovarian cysts. The accuracy rates of CT scan for cyst location and ovarian torsion were 53.3% (16/30) and 47.8% (11/23), respectively. Among the 34 patients treated with surgery, ovarian cyst dissection was performed in 11 patients and cyst resection in 23 patients with torsion necrosis. 24 patients had simple cysts including 15 torsion necrosis (62.5%, 15/24) and 10 had complicated cysts including 8 torsion necrosis(80.0%, 8/10). The average diameter of ovarian cysts was significantly larger in the torsion group [(8.4±1.6) cm] than the non-torsion group [(4.7±1.2) cm] ( P<0.05). Conclusions:Neonatal ovarian cysts are mostly unilateral without specific clinical manifestations. Large, bilateral and complex cysts are prone to torsion necrosis. Abdomen ultrasound has advantages than CT scan for the localization of the ovarian cyst and diagnosis of ovarian torsion. Surgical treatment is necessary after diagnosis.

Application of multi-slice spiral CT and abdominal ultrasound in clinical diagnosis of acute appendicitis in children / 中国基层医药

Objective:To investigate the application value of multi-slice spiral CT and abdominal ultrasound methods in the clinical diagnosis of acute appendicitis in children.Methods:We included 50 children patients who were pathologically diagnosed with acute appendicitis by the Department of Surgery, Dongyang Maternal and Child Health Hospital from August 2016 to August 2019. Before surgery, all patients underwent multi-slice spiral CT and abdominal ultrasound examinations. We recorded the time taken to complete multi-slice spiral CT and abdominal ultrasound examinations. Taking pathological results as the diagnosis criteria, we also calculated the coincidence rate of each imaging method.Results:The time we took to complete multi-slice spiral CT examination was shorter than that for abdominal ultrasound examination [(13.34 ± 3.86) minutes vs. (23.45 ± 4.77) minutes, t = 11.65, P < 0.05]. The coincidence rate of multi-slice spiral CT in identifying acute simple appendicitis, acute phlegmonous appendicitis, and acute gangrenous appendicitis was 95.24%, 95.00%, and 100.0%, respectively, and it was 71.73%, 70.00%, 88.89%, respectively for abdominal ultrasound examination. The coincidence rates in identifying acute simple appendicitis, acute phlegmonous appendicitis, and acute gangrenous appendicitis were significantly different between multi-slice spiral CT and abdominal ultrasound examinations ( χ2 = 4.29, 4.33, 1.06, all P < 0.05). Conclusion:Compared with abdominal ultrasound, multi-slice spiral CT is easier to operate, takes a shorter time in manipulation, provides more distinct images, and has a higher coincidence rate. Therefore, multi-slice spiral CT is of great diagnostic value for acute appendicitis in children.

Efficacy of abdominal ultrasound inspection in the diagnosis and prognosis of neonatal necrotizing enterocolitis

OBJECTIVE: This study aimed to identify the most useful ultrasound (US) features associated with definite neonatal necrotizing enterocolitis (NEC) and their prognostic values, particularly the calculated markers combined with important features. METHODS: A total of 213 suspected NEC cases were collected from the neonatal department of our hospital from January 2015 to August 2017. Each infant received both X-ray and US examinations. RESULTS: No differences were found in sex composition and delivery modes between groups. NEC-positive neonates had poorer prognosis compared to negative ones. The NEC group showed a higher frequency of abnormal signals. US showed higher NEC-related frequencies in different parameters. A variable (named predictor in US [PUS]) with five features was constructed. For NEC diagnosis, this variable provided a much higher area under the curve Q2 (AUC) (0.965) than other parameters. In this model, PUS had a cutoff value of 0.376 with a 0.900 sensitivity and 0.922 specificity. In prognosis, the closest factors were selected to draw a receiver operating characteristic curve, as well as a novel calculated variable US prognostic (USPro) marker. USPro had a much higher AUC (0.86) than other single features and showed a cutoff value of 0.18145, with 0.75 sensitivity and 0.84 specificity. This variable had a weaker power in prognosis when compared with PUS in diagnosis. CONCLUSIONS: The application of abdominal color Doppler US can provide high accuracy and sensitivity in NEC diagnosis and also contribute to its prognosis, without induction of radiation. Suspected neonates should be examined using this technique as early as possible.

Alteraciones bioquímicas y ecográficas a nivel hepático en pacientes que viven con VIH/Sida

Los pacientes con Virus de inmunodeficiencia humana (VIH) pueden presentar alteraciones del funcionalismo y estructura hepática como consecuencia de la terapia antirretroviral (TARV), de otras coinfecciones o de patologías metabólicas o neoplásicas que pueden presentarse en cualquier estadio de la enfermedad. La realización de las pruebas de laboratorio y el ultrasonido abdominal son herramientas fundamentales para la detección y seguimiento de estos casos. Objetivo: Describir las alteraciones bioquímicas y ecográficas a nivel hepático en pacientes que viven con condición de VIH/Sida que reciben TARV. Metodología: Investigación clínica, descriptiva, de campo, de corte transversal, donde se incluyeron pacientes con VIH mayores de 18 años que acudieron a la consulta de Infectología del Hospital Central de Maracay en el período marzo-junio de 2017. Se excluyeron pacientes con coinfecciones y patologías metabólicas. Se registraron datos epidemiológicos, clínicos y paraclínicos. Resultados: Se incluyeron 23 pacientes que recibían TARV, predominando el sexo masculino y el rango etario de 20-29 años. 60,87 % tenían entre 1 y 3 años en TARV regular. 21,73 % de los pacientes mostraron elevación de las transaminasas tanto glutámico-pirúvica (TGP) como glutámico-oxalacética (TGO), destacándose que todos los pacientes de este grupo recibían terapia con inhibidores de la transcriptasa reversa análogo de nucleósido más inhibidores de la transcriptasa reversa no análogo de nucleósido (ITRN/ ITRNN); en cuanto a los valores de bilirrubina se evidenció que quienes recibían la combinación ITRN/Inhibidores de la proteasa (IP) presentaron elevación de los niveles de bilirrubina a predominio de la indirecta (21,7 %). Para la GGT solo un paciente presentó alteración. El hallazgo ecográfico más frecuente fue la esteatosis hepática (69,56 %), predominando la esteatosis hepática grado II. Conclusión: Es necesario en los pacientes con condición VIH la evaluación regular e integral de parámetros hepáticos, en búsqueda de efectos adversos de la terapéutica, u otras condiciones médicas y nutricionales que puedan incrementar el riesgo de patología hepática

Patients with Human Immunodeficiency Virus (HIV) may have alterations in liver function and structure because of antiretroviral therapy (ART), other coinfections or metabolic or neoplastic diseases that can occur at any stage of the disease. The performance of laboratory tests and abdominal ultrasound are essential tools for the detection and monitoring of these cases. Objective: Describe the biochemical and ultrasound alterations at a hepatic level in patients living with HIV/ AIDS who receive ART. Methodology: Clinical research, descriptive, field, cross-sectional, which included patients with HIV over 18 years who attended the consultation of Infectious Diseases at the Central Hospital of Maracay in the period March-June 2017. Patients with coinfections and metabolic pathologies were excluded. Epidemiological, clinical and paraclinical data were recorded. Results: Twenty-three patients receiving ART were included, predominantly male and with an age range of 20-29 years. 60.87 % were between 1 and 3 years on regular ART. 21.73 % of the patients showed elevation of both glutamic-pyruvic transaminase (GPT) and glutamic-oxalacetic transaminase (GOT), highlighting that all patients in this group received therapy with nucleoside analogue reverse transcriptase inhibitors plus non-nucleoside analogue reverse transcriptase inhibitors (NRTIs/NNRTIs). In terms of bilirubin values, it was shown that those receiving the combination of NRTIs/Protease Inhibitors (PI) showed an increase in bilirubin levels with a predominance of hint (21.7 %). About GGT only one patient presented alteration. The most frequent ultrasound finding was Hepatic Steatosis (69.56 %), with predominance of hepatic steatosis grade II. Conclusion: It is necessary in patients with HIV condition regular and comprehensive assessment of liver parameters, in search of adverse effects of therapy, or other medical and nutritional conditions that may increase the risk of liver disease.

The importance of visualization of appendix on abdominal ultrasound for the diagnosis of appendicitis in children: A quality assessment review / 世界急诊医学杂志（英文）

@#BACKGROUND: Ultrasound has the fi rst line investigation role in the diagnosis of acute appendicitis in children. The purpose of this study was to perform a quality assessment review on the visualization rate of appendix on ultrasound in children in the community hospital setting. METHODS: A retrospective chart review of the abdominal ultrasound findings for the visualization of the appendix was performed on paediatric patients ranging from 5 to 18 years. Data were collected from the two community hospitals of Toronto by using hospital electronic medical record for the ultrasound fi ndings in patients presented with abdominal pain. RESULTS: Data from two community hospitals indicated visualization rate of the appendix as 11.0% and 23.2% for site 1 and site 2 respectively. In cases where the ultrasound was repeated the visualization rate remains the same. A two-proportion z-test was performed to find whether the visualization of appendix increases the likelihood of diagnosing appendicitis. The results revealed that the visualization of an appendix (P=0.52), signifi cantly improved the diagnosis of appendicitis (z=34, P<0.001). CONCLUSION: Visualization of an appendix on ultrasound increases the likelihood of correctly diagnosing appendicitis. In our study, we found low visualization rate of appendix on ultrasound that could be the result of many factors that contribute towards the low visualization rate of an appendix on ultrasound. Hence, the challenges in identifying appendix should be minimized to improve the visualization and diagnosis of appendicitis on ultrasound.

Whole body ultrasound in the operating room and intensive care unit / 대한마취과학회지

Whole body ultrasound can be used to improve the speed and accuracy of evaluation of an increasing number of organ systems in the critically ill. Cardiac and abdominal ultrasound can be used to identify the mechanisms and etiology of hemodynamic instability. In hypoxemia or hypercarbia, lung ultrasound can rapidly identify the etiology of the condition with an accuracy that is equivalent to that of computed tomography. For encephalopathy, ocular ultrasound and transcranial Doppler can identify elevated intracranial pressure and midline shift. Renal and bladder ultrasound can identify the mechanisms and etiology of renal failure. Ultrasound can also improve the accuracy and safety of percutaneous procedures and should be currently used routinely for central vein catheterization and percutaneous tracheostomy.

Accuracy of abdominal ultrasound for the diagnosis of small bowel obstruction in the emergency department / 世界急诊医学杂志（英文）

BACKGROUND: Emergency physicians frequently encounter patients with acute small bowel obstructions (SBO). Although computed tomography (CT) imaging is the current gold standard in the assessment of patients with suspected SBO in the emergency department, a few studies have examined the use of ultrasound as an alternative imaging technique. METHODS: We evaluated the accuracy of ultrasound performed in the ED by a variety of providers (physicians with various levels of training, physician assistants) compared to CT imaging in 47 patients with suspected SBOs. RESULTS: Our data demonstrated a sensitivity of 93.8％ and a specificity of 93.3％ when compared to abdominal CT, and a sensitivity of 94.3％ and specificity of 95.2％ using a composite endpoint of abdominal CT and discharge diagnosis. CONCLUSION: Ultrasound can play an important role in the identification of small bowel obstructions in ED patients.

Morbidity of schistosomiasis mansoni in a low endemic setting in Ouro Preto, Minas Gerais, Brazil

Abstract INTRODUCTION: Despite the advances of disease control programs, severe forms of schistosomiasis are prevalent. The prevalence of the disease in areas frequented by tourists urges for permanent prevention and control. The aim of this study was to describe the morbidity of schistosomiasis in the district of Antônio Pereira, Ouro Preto, Minas Gerais, Brazil. METHODS: The proportion of positives was defined by Kato-Katz coproscopy and urinary POC-CCA rapid test. Hepatosplenic form was diagnosed using abdominal ultrasound. RESULTS: Out of 180 participants,97 were examined by Kato-Katz, with 4 (4.1%) being positive. Thirty-four (22.1%) out of 154 were positive by POC-CCA. Five (2.8%) of 177 examined by ultrasound had hepatosplenic form. One of them had undergone splenectomy. One (0.6%)participant had myeloradiculopathy. CONCLUSIONS: Severe forms of schistosomiasis are still prevalent in low endemic areas and should be thoroughly investigated.

Frecuencia de hígado graso no alcohólico diagnosticado por ecografía abdominal en pacientes obesos / Frequency of fatty liver nonalcoholic diagnosed by abdominal ultrasound in patients obese

El hígado graso no alcohólico (HGNA) es una complicación asociada a la obesidad, debido a la acumulación excesiva de grasa en el hígado. Con el objetivo de determinar la frecuencia de hígado graso no alcohólico diagnosticado por ecografía abdominal en pacientes que asisten a la Unidad del Manejo Integral del Paciente Obeso del Hospital de Clínicas, FCM ­ UNA, se realizó un estudio observacional descriptivo retrospectivo que incluyó a 188 pacientes, de los cuales 146 fueron mujeres y 42 hombres, la edad media en los pacientes con diagnóstico de HGNA fue de 41,3±11,4 años con un rango de edad de 20 a 65 años. Los resultados señalan la frecuencia de HGNA con el 56,9% (n=107) por ecografía abdominal, siendo 39,9% (n=75) mujeres y 17% (n=32) hombres, mientras que 43,1% (n=81) presentó hígado de aspecto normal. El 43,9% (n=47) de los pacientes con HGNA exhibió obesidad grado III. Al comparar la circunferencia abdominal en los 107 pacientes con HGNA se obtuvo una media de 139,1±97,8 cm. Con respecto al grado de esteatosis el 43,1% (n=81) mostró grado 0, 31,9% (n=60) grado 1, 20,7% (n=39) grado 2 y 4,3% (n=8) grado 3. Se observaron en los datos de laboratorio elevación de las transaminasas GPT 35,5% (n=38), 25,2% (n=27) en la GOT y 24,3% (n=26) FA, se notó aumento en los valores de las bilirrubinas directa e indirecta, 65,4% (n=70) BD y 69,2% (n=74) BI, por otra parte el 47,7% (n=51) enseñó CT elevado, 49% (n=45,7) HDL disminuido, 36,4% (n=39) LDL elevado y 29% (n=31) con triglicéridos elevados. Se halló que el 69,1% (n=74) de los pacientes con HGNA tienen HTA. Al realizar la comparación de las variables mencionadas entre los pacientes con y sin HGNA, arrojó que las transaminasas GPT, GOT y triglicéridos estuvieron en niveles más altos en los pacientes con HGNA. Se evidenció que la obesidad es un factor determinante para el desarrollo de HGNA, la caracterización del perfil hepático y lipídico, asimismo la presión arterial constituyen puntos fundamentales para asociar el aumento de estos con la presencia de HGNA.

Nonalcoholic fatty liver disease (NAFLD) is a complication associated with obesity, due to excessive accumulation of fat in the liver. In order to determine the frequency of NAFLD diagnosed by abdominal ultrasound in patients attending the unit Comprehensive Patient Management Obese the Hospital of Clinics, FCM - UNA, a retrospective observational study involving performed in 188 patients, of which 146 were women and 42 men, average age in patients with NAFLD diagnosis was 41,3±11,4 years with an age range of 20 - 65 years. The results indicate the frequency of NAFLD with 56,9% (n=107) for abdominal ultrasound, being 39,9% (n=75) women and 17% (n=32) were men, while 43,1% (n=81) presented liver normal. 43.9% (n=47) of patients with NAFLD showed grade III obesity. By comparing the abdominal circumference in 107 patients with NAFLD an average of 139,1±97,8 cm was obtained. With respect to the degree of steatosis 43,1% (n=81) showed grade 0, 31,9% (n=60) grade 1, 20,7% (n=39) grade 2 and 4,3% (n=8) grade 3 were observed in laboratory data GPT transaminases elevation of 35,5% (n=38), 25.2% (n=27) in the GOT and 24,3% (n=26) FA, increased values of direct and indirect bilirubin, 65,4% (n = 70) BD and 69.2% (n=74) BI was noted, moreover 47,7% (n=51) CT taught high, 49% (n=45,7) decreased HDL, 36,4% (n=39) high LDL and 29% (n=31) with elevated triglycerides. It was found that 69,1% (n=74) of patients with NAFLD have hypertension. When comparing the variables mentioned among patients with and without NAFLD, he threw the GPT, GOT transaminases and triglycerides were at higher levels in patients with NAFLD. It was evident that obesity is a determining factor NAFLD development, characterization of liver and lipid profile, blood pressure also are key points to associate these increased with the presence of NAFLD.

Effect of transabdominal ultrasound interventional puncture combined with medicine on ovarian chocolate cyst / 中国生化药物杂志

Objective To investigate the efficacy of transabdominal ultrasound interventional puncture combined with medicine in the treatment of ovarian chocolate cysts. Methods According to the different treatment methods will be January 2015 to December 2016 in Yuyao People's Hospital 70 cases of patients with ovarian chocolate cyst group: the control group with washed cysts + ethanol sclerotherapy by transabdominal ultrasound interventional puncture + urokinase solution, the observation group in the control group based on the addition of triptorelin;observed the body hormone before and after E2 two patients in the treatment group, follicle stimulating hormone, serum luteinizing hormone, FSH/LH, antral follicles level changes, complications, clinical treatment, and the relevant data for comparative analysis. Results Abdominal ultrasound interventional puncture and drug treatment (observation group) treatment of ovarian chocolate cyst is better than transabdominal ultrasound interventional treatment (control group), the stability of the body hormone levels of patients than the control group, the complication rate was lower than the control group, the total efficiency of clinical treatment was higher than the control group, the difference was statistically significant (P <0.05). Conclusion The patients with ovarian chocolate cyst transabdominal ultrasound interventional puncture and drug treatment effect significantly, can effectively improve the patients body hormone level, low complication rate, the total effective rate of the treatment is high, it is worthy of widely used treatment of patients with ovarian chocolate cyst.

Medición de la longitud del cérvix por ecografía abdominal en gestantes normales entre 21 a 23 semanas

Objetivos: Evaluar la factibilidad técnica para medir la longitud del cérvix por ecografía abdominal en gestantes entre 20 y 23 semanas, y la correlación entre los valores obtenidos por ecografía abdominal versus ecografía vaginal. Diseño: Estudio observacional transversal. Lugar: Instituto Latinoamericano de Salud Reproductiva (ILSAR), Lima, Perú. Participantes: Gestantes. Métodos: En 67 gestantes normales sin factores de riesgo para parto pretérmino (PP), entre las 20 y 23 semanas de gestación, se midió la longitud cervical, en 30 de ellas tanto por ecografía abdominal utilizando transductor convexo de 3-5 MHZ como por ecografía vaginal con transductor endocavitario de 5-7 MHZ. Principales medidas de resultados: Correlación de la medida de la longitud del cérvix por ecografía abdominal y transvaginal. Resultados: En 65 gestantes se obtuvo una medida satisfactoria de la longitud del cérvix mediante ecografía abdominal (97% de casos). Se encontró correlación entre las mediciones por ecografía abdominal y vaginal (coeficiente Pearson 0,646, p<0,0001) y no existió diferencia significativa entre ambos valores (p:0,126) para IC del 95%. Conclusiones: En 97% de los casos estudiados se obtuvo una medida satisfactoria de la longitud del cérvix por ecografía abdominal. Hubo correlación, sin diferencia significativa, entre las mediciones obtenidas por vía abdominal y vaginal.

Objectives: To determine the feasibility of cervical length measurement by transabdominal ultrasound at 20-23 weeks of gestation and to correlate this measurements with those obtained by tansvaginal ultrasound. Design: Observational cross-sectional study. Setting: Instituto Latinoamericano de Salud Reproductiva (ILSAR), Lima, Peru. Participants: Pregnant women. Methods: In 67 pregnant women with no risk factors for preterm delivery (PTD) measurement of the uterine cervix at 20-23 weeks of gestation was performed. Thirty women (30) underwent both transabdominal and transvaginal ultrasound measurement. Main outcome measures: Correlation of uterine cervix measurement by abdominal and transvaginal ultrasound. Results: The cervix could be measured satisfactorily by transabdominal measurement in 65 women (97%). There was a good correlation between transabdominal and transvaginal measurement (r<.0.646, p<0.001) and there was no significant difference between both measurements (p:0.126). Conclusions: The uterine cervix could be measured by transabdominal ultrasound in 97% of pregnant women. There was correlation between measurements obtained by transabdominal and transvaginal ultrasound.

Ultrasonido abdominal en pacientes con infección por virus de inmunodeficiencia humana / Abdominal ultrasound in patients infected with human immunodeficiency virus

Introducción: La infección por el virus de inmunodeficiencia humana constituye un grave problema sanitario. En el 2011, el Ministerio del Poder Popular para la Salud señaló una prevalencia del 0,91%, calculando 111.324 casos en mayores de 15 años. Los reportes ecográficos en pacientes con VIH son escasos. Sin embargo, la ecografía es un método seguro, económico y accesible que permite el estudio de un gran número de condiciones. Pacientes y Métodos: Estudio prospectivo, descriptivo y de corte transversal, que incluye pacientes portadores de infección de VIH, que acudieron al servicio de Gastroenterología del Hospital General del Oeste, entre mayo de 2012 a mayo de 2013. A los cuales se les realizó eco abdominal. Resultados: 80 pacientes. 95% presentó alteraciones ecográficas, 52% cursaba con síntomas gastrointestinales, de ellos, el 100% presentaba alteraciones ecográficas. 42,5% pertenecían a la Categoría C de VIH, de los cuales el 100% tuvo alteraciones ecográficas. Se identificaron alteraciones hepáticas en el 85% de los casos, vesiculares en el 65%, retroperitoneales 51,25 %, renales 37,5%, esplénicas 25,25% y pancreáticas 3,75%. Conclusiones: La ecografía abdominal constituye una herramienta útil y accesible para el médico gastroenterólogo en la detección y/o diagnóstico de alteraciones intra-abdominales en pacientes VIH.

Introduction: Human Immunodeficiency Virus Infection (HIV) is a serious health problem.In 2011, the Ministry of People's Power for Health estimated a prevalence of 0.91% with 111,324 cases over 15 year’s population. Ultrasound reports in patients with HIV are scarce. However, ultrasound is safe, non-invasive, affordable and accessible to study a large number of conditions. Patients and methods: A Prospective, descriptive and cross-sectional study was performed. HIV infected patients who underwent the Gastroenterology Service ofWestern General Hospital, from May 2012 to May 2013, to an abdominal echo were included. Results: 80 patients. 95% had abnormal ultrasound, 52% had gastrointestinal symptoms and of these, 100% had ultrasound abnormalities. 42.5% were C category, of which 100% had ultrasound abnormalities. We identified lesions in the liver (85%), gallbladder (65%), retroperitoneum (51,25%), Kidneys (37,5%), spleen (26,25%) and pancreas (3,75%) of the patients. Conclusions: Abdominal ultrasound is a useful and accessible diagnostic tool for the gastroenterologist to detect abdominal abnormalities in HIV patients.

Medición de la longitud del cérvix por ecografía abdominal en gestantes normales entre 20 a 23 semanas

Objetivos: Evaluar la factibilidad técnica para medir la longitud del cérvix por ecografía abdominal en gestantes entre 20 y 23 semanas, y la correlación entre los valores obtenidos por ecografía abdominal vs. ecografía vaginal. Diseño: Estudio observacional transversal. Institución: Instituto Latinoamericano de Salud Reproductiva (ILSAR), Lima, Perú. Participantes: Gestantes normales de 20 a 23 semanas de gestación. Métodos: Se midió la longitud cervical por ecografía a 67 gestantes normales sin factores de riesgo para parto pretérmino, entre las 20 y 23 semanas de gestación, con la finalidad de medir la longitud cervical. En 30 de las embarazadas se midió la longitud cervical por ecografía abdominal utilizando transductor convexo de 3-5 MHZ y por ecografía vaginal con transductor endocavitario de 5-7 MHZ. Principales medidas de resultados: Medida de la longitud del cérvix. Resultados: En 65 gestantes se obtuvo una medida satisfactoria de la longitud del cérvix mediante ecografía abdominal (97% de los casos). Se encontró correlación entre las mediciones por ecografía abdominal y vaginal (coeficiente de Pearson 0,646, p<0,001) y no existió diferencia significativa entre ambas mediciones (p: 0,126). Conclusiones: En 97% de los casos estudiados se obtuvo una medida satisfactoria de la longitud del cérvix por ecografía abdominal. Hubo correlación entre las mediciones obtenidas por vía abdominal y vaginal.

Objectives: To assess the feasibility of measuring cervical by transabdominal ultrasound between 20 and 23 weeks of gestation and compare these measurements with those obtained by transvaginal ultrasound. Design: Crosssectional study. Setting: Instituto Latinoamericano de Salud Reproductiva (ILSAR), Lima, Peru. Participants: Normal pregnant women with no risk factors for preterm delivery (PTD). Methods: Cervical length was measured to 67 normal pregnant women 20-23 weeks by transabdominal ultrasound. In 30 women cervical length was measured by abdominal ultrasound using 3-5 MHZ convex transducer and by vaginal ultrasound with 5-7 MHZ endotransducer. Main outcome measures: Cervical length measurement. Results: The cervix was satisfactorily measured by transabdominal ultrasound in 65 women (97%). There was good correlation between transabdominal and transvaginal measurement (r<.0.646, p<0.001) with no significant difference between those measurements (p: 0.126). Conclusions: The cervix could be measured by transabdominal ultrasound in 97% of women. There was correlation between transabdominal and transvaginal ultrasound measurements.

Abdominal and pelvic ultrasound study of the maned wolf (Chrysocyon brachyurus) / Estudo ultrassonográfico abdominal e pélvico de lobo-guará (Chrysocyon brachyurus)

The aim of the present study was the ultrasound characterization of the abdominal and pelvic regions of five maned wolves kept in captivity at the Triage Center of Wild Animals of the Federal University of Viçosa (Centro de Triagem de Animais Silvestres, Universidade Federal de Viçosa). This characterization included descriptions of ultrasonographic aspects and measurements of various structures using B-mode ultrasound. Biometric data were collected to assess the existence of significant linear correlations between these measurements and the measurements obtained by ultrasound. Additionally, hematological and serum biochemistry evaluations of the animals were performed. The ultrasound findings were similar to those available in the literature on domestic dogs, which were used for comparison as a result of the lack of published data regarding maned wolves. The latter species showed characteristics closely resembling those of the former, differing in the spleen and left renal cortex echogenicities, in the appearance of the prostatic and testicular regions and in the hepatic portal vein morphology. In the current study, the biometric values were similar to those previously published; however, no data regarding thoracic perimeter, modified crown-rump length or thoracic depth were found in the literature for this Canidae species. Statistical analysis showed the existence of a strong negative correlation between the modified crown-rump length and left renal length, between the modified crown-rump length and the right renal volume, between the thoracic perimeter and the height at the cranial pole of the left adrenal gland and between the thoracic perimeter and the height at the caudal pole of the left adrenal gland. Laboratory findings, including segmented neutrophil, eosinophil, monocyte and lymphocyte counts and the serum levels of glucose, ALT, alkaline phosphatase, urea, total protein, globulin, creatine phosphokinase, triglyceride, sodium, phosphate, potassium and chloride, were inconsistent with values found by other authors. The ultrasound is a diagnostic imaging method that must be further explored in the medicine of wild animals; therefore, additional research in this area is required.

O presente trabalho objetivou a caracterização ultrassonográfica das regiões abdominal e pélvica de cinco lobos-guarás mantidos em cativeiro no Centro de Triagem de Animais Silvestres da Universidade Federal de Viçosa, com descrição dos aspectos ultrassonográficos e obtenção de medidas de suas diversas estruturas, por meio de ultrassonografia modo-B. Coletaram-se dados de biometria corporal com a finalidade de se verificar a existência de correlação linear significativa entre estas medidas e as mensurações obtidas ultrassonograficamente. Adicionalmente, efetuou-se avaliação hematológica e bioquímica sérica dos animais. Os achados ultrassonográficos foram equiparados aos existentes na literatura de cães domésticos devido à inexistência de dados publicados referentes a lobos-guarás. Esta espécie apresentou características muito semelhantes às do cão, diferindo nas ecogenicidades do baço e córtex renal esquerdo, no aspecto da região prostática, testicular e na morfologia da veia porta hepática. No presente estudo, os valores de biometria corporal foram semelhantes aos anteriormente publicados, porém não se encontraram dados na literatura referentes a perímetro torácico, comprimento vértice-caudal modificado e profundidade torácica para esta espécie de canídeo. A análise estatística revelou a existência de forte correlação negativa entre o comprimento vértice caudal modificado e o comprimento renal esquerdo, entre o comprimento vértice caudal modificado e o volume renal direito, entre o perímetro torácico e a altura do polo cranial da glândula adrenal esquerda e entre o perímetro torácico e a altura do polo caudal da glândula adrenal esquerda. Laboratorialmente, a contagem de neutrófilos segmentados, eosinófilos, monócitos e linfócitos e os níveis séricos de glicose, ALT, fosfatase alcalina, ureia, proteína total, globulina, creatina fosfoquinase, triglicérides, sódio, fosfato, potássio e cloreto foram discordantes de valores obtidos por outros autores. A ultrassonografia é um método de diagnóstico por imagem que necessita ser mais explorado na medicina de animais silvestres, sendo, portanto necessário o incremento de pesquisas nesta área.

Beneficio de la ecosonografía abdominal en la evaluación pediátrica de rutina / Routine abdominal ecosonografic scan in children

La ecografía abdominal es importante en el diagnóstico y tratamiento de un número elevado de patologías abdominales. El dolor abdominal es la principal indicación de ecografía. Se plan-tea la posibilidad de diagnosticar alteraciones y/o patologías asintomáticas, que pueden requerir intervención temprana. Determinar el beneficio de la ecosonografía abdominal en la evaluación pediátrica de rutina. Trabajo prospectivo y transversal. Se incluyen pacientes escogidos al azar, para realizarles ecografía abdominal. Distribuidos en grupo A, los niños con solicitud de evaluación gastrointestinal y grupo B, niños sin patología gastrointestinal. Se solicita consentimiento informado. Un total de 182 niños, promedio de edad 4,70 años (rango 1m-14 años), 92 varones y 90 hembras. De 131 niños, con enfermedad gastrointestinal, grupo A, 32(24,42%) presentaron alteraciones a la ecografía. De ellos 17/32(53,12%) con hallazgos ecográficos en relación a la enfermedad de base siendo lo más frecuentes hepatopatías (esteatosis, hepatomegalia, fibrosis periportal), litiasis vesicular, cambios en vísceras huecas y reflujo gastroesofágico; 15/32(46,88%) se detectaron alteraciones no relacionados con la enfermedad de base, como: enfermedad renal, tumoración abdominal, esplenomegalia. Grupo B: 16/51 (31,37%) se detectó alteraciones en órganos abdominales: barro biliar, esplenomegalia, hepatopatía, alteraciones renales y otras. Se encontró una diferencia significativa entre los grupos, en relación al hallazgo de alteraciones ecográficas no relacionadas con el motivo de consulta. Los resultados permiten inferir que la ecografía es una herramienta sensible que puede ser utilizada de rutina en la evaluación pediátrica para detectar alteraciones en órganos abdominales para una intervención temprana y tratamiento oportuno.

Abdominal ultrasound is important in the diagnosis and treatment of a large number of abdominal pathology. Abdominal pain is the main indication for ultrasound. It raises the possibility of diagnosing disorders and/or asymptomatic pathologies that may require early intervention. To determine the benefit of abdominal sonography in the routine pediatric evaluation. Prospective and cross. Includes patients are randomly selected for abdominal ultrasound and distributed in two groups: Group A, children with gastrointestinal application indication for assessment and group B, children without gastrointestinal pathology. Informed consent is requested. Results: A total of 182 children, mean age 4.70 years (range 1 m-14 years), 92 males and 90 females. Of 131 children with gastrointestinal disease, group A, 32 (24.42%) had alterations to the ultrasound. Of these 17/32 (53.12%) with ultrasound findings in relation to the underlying disease being the most common liver disease (steatosis, hepatomegaly, periportal fibrosis), gallstones, changes in hollow viscera and gastroesophageal reflux; 15/32 (46.88%) were detected abnormalities not related to underlying disease, such as kidney disease, abdominal tumor, splenomegaly. Group B: 16/51 (31.37%) resulted with detected abnormalities in abdominal organs, biliary sludge, spleen, liver, renal and others. We found a significant difference between groups in relation to the discovery of ultrasound abnormalities unrelated to the complaint. The results allow to conclude that ultrasound is a sensitive tool that can be used in routine pediatric evaluation to detect changes in abdominal organs for early intervention and treatment.

Contrast Enhanced US in the Abdomen

Contrast enhanced ultrasound, which was introduced in 1996, has been widely used in Europe and Eastern Asia. Ultrasound contrast agent can be classified as first generation and second generation, depending on the gas within the microbubble. With the first generation contrast agent, the high MI technique was used, and only intermittent scanning was possible due to destruction of the microbubble during scanning. Use of the second generation contrast agent with the low MI technique makes continuous scanning possible. Contrast enhanced US can be used in detection and differentiation of focal liver lesions. It is also helpful for monitoring of radiofrequency ablation and for targeting of US guided biopsy. Currently, because morphologic criteria alone may not reflect the response of the tumor to treatment, new criteria are needed for treatment evaluation after administration of anti-angiogenic agents. Contrast enhanced US could provide quantitative markers for evaluation of the response to treatment via use of dynamic contrast enhanced US. Due to cost-effectiveness, contrast enhanced US is not yet widely used in Korea; however, considering recent issues regarding contrast agent related adverse reaction, such as contrast induced nephropathy and nephrogenic systemic fibrosis, and radiation exposure, contrast enhanced US might be more widely used in Korea, as an alternative imaging modality in the future.

Comparison between clinical and ultrasonographic findings in cases of periportal fibrosis in an endemic area for schistosomiasis mansoni in Brazil / Comparação entre achados clínicos e ultrassonográficos no diagnóstico da fibrose periportal em uma área endêmica de esquistossomose no Brasil

INTRODUCTION: Abdominal palpation and ultrasound findings among patients from an endemic area for schistosomiasis in Brazil who had been followed up for 27 years were compared. METHODS: In 2004, 411 patients from Brejo do Espírito Santo, in the State of Bahia, were selected for the present investigation after giving their written informed consent. Based on clinical data, they were divided into three groups: 41 patients with evidence of liver fibrosis in 2004 (Group 1); 102 patients with evidence of liver fibrosis in the past (1976-1989) but not in 2004 (Group 2); and 268 patients without evidence of liver fibrosis at any time during the 27-year follow-up (Group 3). All of the patients underwent abdominal ultrasound in which the examiner did not know the result from the clinical examination. The data were stored in a database. RESULTS: The prevalence of periportal fibrosis on ultrasound was 82.9 percent, 56.9 percent and 13.4 percent in Groups 1, 2 and 3, respectively. In the presence of hard, nodular liver or prominent left lobe and a hard palpable spleen, ultrasound revealed periportal fibrosis in 70.9 percent. However, periportal fibrosis was diagnosed using ultrasound in 25.4 percent of the patients in the absence of clinical evidence of liver involvement. Thus, ultrasound diagnosed periportal fibrosis 3.1 times more frequently than clinical examination did. CONCLUSIONS: Although clinical examination is important in evaluating morbidity due to Manson's schistosomiasis in endemic areas, ultrasound is more accurate in diagnosing liver involvement and periportal fibrosis.

INTRODUÇÃO: Neste estudo, se comparou os achados da palpação abdominal e do ultrassom em pacientes de área endêmica de esquistossomose que foram acompanhados por 27 anos no Brasil. MÉTODOS: Em 2004, 411 pacientes de Brejo do Espírito Santo, no estado da Bahia, após consentimento informado e por escrito foram selecionados para o presente estudo. Baseando-se no exame clínico eles foram divididos em 3 grupos: 41 (Grupo 1) com evidência de fibrose hepática no ano de 2004; 102 (Grupo 2) com evidência de fibrose hepática no passado (1976-1989) mas não em 2004; e 268 (Grupo 3) sem evidência de fibrose hepática em 27 anos de seguimento. Todos foram submetidos a exame ultrassonográfico do abdome em que o examinador não sabia o resultado do exame clínico. Os dados foram armazenados em banco de dados. RESULTADOS: A prevalência de fibrose periportal ao ultrassom foi de 82,9 por cento, 56,9 por cento e 13,4 por cento nos Grupos 1, 2 e 3, respectivamente. Na presença de fígado duro, nodular ou lobo esquerdo proeminente e baço palpável duro, o ultra-som revelou fibrose periportal em 70,9 por cento. Porém, fibrose periportal foi diagnosticada através do ultrassom em 25,4 por cento dos pacientes, na ausência de evidência clínica de envolvimento hepático. Assim, o ultrassom diagnosticou fibrose periportal 3,1 vezes mais frequentemente que o exame clínico. CONCLUSÕES: O exame clínico tem importância na avaliação da morbidade da esquistossomose mansônica em áreas endêmicas, mas o ultrassom mostra-se mais preciso quando se pretende diagnosticar o envolvimento hepático e a fibrose periportal.

Added Value of Screening Low Dose Computed Tomography of the Chest for the Evaluation of Abdominal Solid Organs by Ultrasound in Physical Check-up Patients

PURPOSE: The purpose of this study was to assess the added value of screening low-dose computed tomography of the chest (LDCT) covering the abdomen in evaluating abdominal solid organs to the screening abdominal ultrasonography (US). MATERIALS AND METHODS: We prospectively enrolled a consecutive series of 393 physical check-up patients, who underwent screening abdominal US and LDCT of the chest from January to February, 2008. LDCT covered the lungs, liver, pancreas, gallbladder, spleen, and both kidneys. The 1st screening abdominal US were performed without information from the LDCT, and then abdominal images covered by LDCT were immediately evaluated. Then a 2nd US session was done with additional information from LDCT and US examination was focused to the findings of LDCT. Perpatient and per-lesion analyses were performed. RESULTS: In per-patient analysis, additional focal lesions were found in 20 patients (5.1%) for liver and 9 patients (2.3%) for kidneys in the 2nd US sessions. In per-lesion analysis, 154 and 73 focal lesions were found in liver and kidneys, respectively, in the 1st US sessions. On the 2nd US session, 186 and 86 lesions were found in liver and kidneys, respectively. 20.8% and 17.8% of focal lesions were additionally found on 2nd US session in liver and kidneys, respectively. Most (62.5%) of the additional lesions detected in liver were located in segment 7 and 8, the hepatic dome. CONCLUSION: Previewing LDCT of the chest and abdominal solid organs before performing screening abdominal US can enhance the diagnostic performance of US in physical check-up patients.

The diagnositic value of trans-abdominal and trans-virginal ultrasound for hysteromyoma / 中国基层医药

Objective To compare the diagnostic value for hysteromyona with trans-abdominal ultrasound (TAS) and trans-virginal ultrasound(TVS). Methods Two empirical doctors detected respectively 82 patients by TAS and TVS in double blind method. The results were compared with pathological results. Result The correct rate of diagnosis in 82 patients with 123 hysteromyoma focus by TVS and TAS was 96.75% and 86.18% respectively.There was statistical difference between TAS and TVS. The correct rate of combining use of the two method was 98. 37%. Couclusion Either TVS or TAS had its own merit and defect, Combining use of the two method could raise the correct rate.