ABSTRACT
BACKGROUND: Placement of gastric tubes is commonly performed in infants and children but malpositioning is common and is associated with significant complications. OBJECTIVE: The aim of this systematic review is to identify the evidence on the use of ultrasound to verify correct gastric tube placement in infants and children and gaps in the research. METHODS: This review was performed using CINAHL, PUBMED, EMBASE and Web of Science databases. Studies were included if they used an empirical study design, were published in English, included infants or children, and evaluated the use of ultrasound to verify correct gastric tube placement compared to radiograph. Sensitivity, specificity, positive and negative predictive values were evaluated. RESULTS: Four articles were included in the review. Sensitivity estimates were 0.88 to 1.00 and a positive predictive value of 0.99 was reported in one study. Specificity was not reported in any of the included studies. Ultrasound may be an important method to correctly identify gastric tube placement in infants and children with less radiation exposure and cost. IMPLICATIONS FOR PRACTICE: Ultrasound could be a used to verify gastric tube positioning in infants and children for both initial placement and continued verification leading to reduced radiation exposure and cost. IMPLICATIONS FOR RESEARCH: Research should focus on evaluating ultrasound specificity and the clinical feasibility of using ultrasound as a standard practice, including cost and time required to complete the exam, as well as the ability of ultrasound to verify gastric tube placement in infants weighing less than 1500 grams.
Subject(s)
Intubation, Gastrointestinal , Stomach , Infant , Child , Humans , Intubation, Gastrointestinal/methods , Ultrasonography , Stomach/diagnostic imaging , RadiographyABSTRACT
Introdução: Osteoblastoma é um tumor benigno rara do osso, ocorrendo geralmente em vértebras, ossos longo tubulares. Sua ocorrência na região craniofacial é extremamente rara, especialmente nas áreas nasal e paranasal. Relato do Caso: Nós relatamos um caso atípico de osteoblastoma do seio maxilar com envolvimento de palato duro e estruturas nasal. Características clínicas e radiológicas foram inconclusivas, com padrão de tomografia computadorizada (TC) atípicos que foi sugestiva de vários lesões fibro-ósseas (LFO) como a displasia fibrosa, displasia cementificante, fibroma cemento ossificante. Exames histopatológicas revelou osteoblastoma. Comentários Finais: Dada as imagens de TC atípicas e o enorme envolvimento facial, diagnósticos diferenciais de tais lesões devem ser cuidadosamente avaliados sobre aparência radiográfico e critérios histológicos.
Introduction: Osteoblastoma is a rare benign tumor of the bone, usually occurring in vertebrae and in long tubular bones. Its occurrence in the craniofacial region is extremely rare, especially in the nasal and paranasal areas. Case Report: We report an atypical case of osteoblastoma of the maxillary sinus with involvement of hard palate and nasal structures. Clinical and radiological features were inconclusive, with atypical computed tomography (CT) pattern that was suggestive of various fibrous osseous lesions (FOL) like fibrous dysplasia, cementifying dysplasia, cemento-ossifying fibroma. Final Comments: Given the anomalous CT features and massive facial involvement, differential diagnoses of such lesions must be carefully evaluated regarding radiographic appearance and histological criteria.
Subject(s)
Humans , Male , Adult , Diagnosis, Differential , Bone Diseases/diagnosis , Osteoblastoma , Tomography, X-Ray ComputedABSTRACT
Spermatogenesis of 'corvina' P. squamosissimus starts from a stem cell that gives rise to germ cells. These cells are enveloped by Sertoli cells, forming cysts. The germ cells in the cysts are all at the same stage of development and are interconnected by cytoplasmic bridges. Spermatogonia are the largest germ cells. In the cysts, these cells differentiate into primary spermatogonia and secondary spermatogonia. The primary spermatogonia are isolated in the cyst and give rise to the secondary spermatogonia. After several mitotic divisions, they produce spermatocytes I, which can be identified by synaptonemal complexes in the nucleus. The spermatocytes I enter the first phase of meiosis to produce the spermatocytes II. These are not very frequently seen because they rapidly undergo a second phase of meiosis to produce spermatids.
Subject(s)
Meiosis/physiology , Perciformes/physiology , Spermatogenesis/physiology , Spermatozoa/physiology , Spermatozoa/ultrastructure , Animals , Male , Microscopy, ElectronABSTRACT
Spermiogenesis in Plagioscion squamosissimus occurs in cysts. It involves a gradual differentiation process of spermatids that is characterized mainly by chromatin compaction in the nucleus and formation of the flagellum, resulting in the spermatozoa, the smallest germ cells. At the end of spermiogenesis, the cysts open and release the newly formed spermatozoa into the lumen of the seminiferous tubules. The spermatozoa do not have an acrosome and are divided into head, midpiece, and tail or flagellum. The spermatozoa of P. squamosissimus are of perciform type with the flagellum parallel to the nucleus and the centrioles located outside the nuclear notch.
