Ultrasound joint examination by an automated system versus by a rheumatologist: from a patient perspective

Abstract Background: The Arthritis Ultrasound Robot (ARTHUR) is an automated system for ultrasound scanning of the joints of both hands and wrists, with subsequent disease activity scoring using artificial intelligence. The objective was to describe the patient's perspective of being examined by ARTHUR, compared to an ultrasound examination by a rheumatologist. Further, to register any safety issues with the use of ARTHUR. Methods: Twenty-five patients with rheumatoid arthritis (RA) had both hands and wrists examined by ultrasound, first by a rheumatologist and subsequently by ARTHUR. Patient-reported outcomes (PROs) were obtained after the examination by the rheumatologist and by ARTHUR. PROs regarding pain, discomfort and overall experience were collected, including willingness to be examined again by ARTHUR as part of future clinical follow-up. All ARTHUR examinations were observed for safety issues. Results: There was no difference in pain or discomfort between the examination by a rheumatologist and by ARTHUR ( p =0.29 and p =0.20, respectively). The overall experience of ARTHUR was described as very good or good by 92% (n =23), with no difference compared to the examination by the rheumatologist ( p =0.50). All (n =25) patients were willing to be examined by ARTHUR again, and 92% (n =23) would accept ARTHUR as a regular part of their RA clinical follow up. No safety issues were registered. Conclusion: Joint ultrasound examination by ARTHUR was safe and well-received, with no difference in PRO components compared to ultrasound examination by a rheumatologist. Fully automated systems for RA disease activity assessment could be important in future strategies for managing RA patients. Trial registration: The study was evaluated by the regional ethics committee (ID: S-20200145), which ruled it was not a clinical trial necessary for their approval. It was a quality assessment project, as there was no intervention to the patient. The study was hereafter submitted and registered to Odense University Hospital, Region of Southern Denmark as a quality assessment project and approved (ID: 20/55294).

Visualization of gross anatomy for ultrasound scanning planes using a virtual dissection table / Visualización de la anatomía macroscópica para planos de escaneo de ultrasonido utilizando una mesa de disección virtual

SUMMARY: There is a lack of visualization on gross anatomy planes for the non-orthogonal sections, such as subcostal and intercostal oblique scanning planes of ultrasound imaging. The aim of the present study was to visualize the anatomical image of corresponding plane for the oblique ultrasound scanning using a virtual dissection system. the oblique gross anatomy plane was constructed by appropriate segmentation using a virtual dissection table. A suitable cutting of the body plane was accomplished by turning on and off the organ systems, particularly the skeletal system, category, and structure. The right hepatic vein (RHV), middle hepatic vein (MHV), and left hepatic vein (LHV) for the right subcostal oblique plane appeared in the single slice plane. The location of the liver, gallbladder, and kidneys differently appeared in the oblique anatomical plane and body position. The results of this study suggest that using a virtual anatomy system contributes to improving the sonographer's ability to understand anatomy.

RESUMEN: Existe una falta de visualización en los planos de anatomía macroscópica para las secciones no ortogonales, tal como los planos de exploración oblicuos subcostales e intercostales en las imágenes de ultrasonido. El objetivo del presente estudio fue visualizar la imagen anatómica del plano correspondiente para la ecografía oblicua mediante un sistema de disección virtual. El plano de anatomía macroscópica oblicua se construyó mediante una adecuada segmentación utilizando una mesa de disección virtual. Se logró un corte correcto del plano corporal al encender y apagar los sistemas de órganos, particularmente el sistema esquelético, la categoría y la estructura. La vena hepática derecha, la vena hepática media y la vena hepática izquierda para el plano oblicuo subcostal derecho aparecieron en el plano de corte único. La ubicación del hígado, la vesícula biliar y los riñones aparecieron de manera diferente en el plano anatómico oblicuo y en la posición del cuerpo. Los resultados de este estudio sugieren que el uso de un sistema de anatomía virtual ayuda a mejorar la capacidad del ecografista para comprender la anatomía humana.

Is the right testis more affected by cryptorchidism than the left testis? An ultrasonographic approach in dogs of different sizes and breeds.

BACKGROUND: Considered the most common congenital testicular abnormality of companion animals and a predisposition factor to the development of testicular neoplasia, cryptorchidism is defined as the non-descent of one or both testes to their normal anatomical location. Data on the occurrence of cryptorchidism in Brazil are scarce. The purpose of this work was to verify the occurrence of cryptorchidism in dogs of different sizes and breeds. MATERIALS AND METHODS: Cryptorchidism identification was carried out by ultrasound scanning, from November, 1994 to March, 2007, at the Centre for Veterinarian Diagnosis and Support (Centro de Apoio e Diagnóstico Veterinário - CAD), in Rio de Janeiro. 4924 male dogs of different breeds were examined, revealing 403 (8.2%) cryptorchidism. RESULTS: In this study, occurrence took place more often on the right testicle (59.5%), more frequently displaying inguinal localisation (59.5%) and unilateral occurrence (70%). Regarding bilateral presentation, the symmetrical form was the most common (86.8%). Cryptorchidism was more common in the inguinal region of dog of small sized breeds and in the abdominal region in dogs of medium- and large-sized breeds. CONCLUSIONS: Ultrasound scan proved a valuable diagnosis tool for cryptorchid testes, giving precise localisation and parenchymal changes thus leading to a safe clinical treatment.

Cystic fibrosis and pregnancy: counseling, obstetrical management and perinatal outcome / Fibrosis quística y embarazo: asesoría, manejo obstétrico y del resultado perinatal

The progress in research of in vitro fertilization and fetal-maternal medicine allows more women and men, with fertility problems due to cystic fibrosis, to have a baby. In the majority of cases, pregnancy in women with cystic fibrosis results in favorable maternal and fetal outcomes. However, the incidence of preterm delivery, intrauterine growth restriction, caesarean section and deterioration of the maternal health are increased. Pre-pregnancy counseling is a crucial component of overall obstetric care, especially in women with poor pulmonary function. Additionally, closer monitoring during pregnancy with a multidisciplinary approach is required. The value of serial ultrasound scans and fetal Doppler assessment is important for the control of maternal and fetal wellbeing, as well as for the definition of the appropriate timing of delivery. In this article, clinical issues of pregnant women with cystic fibrosis are reviewed; counseling, obstetrical management and perinatal outcomes are being discussed.

Los avances en la investigación de la reproducción asistida y también en la medicina fetal, permiten cada vez a más mujeres y hombres con infertilidad debido a la fibrosis quística tener un hijo. En general, el embarazo en las mujeres con fibrosis quística tiene buen resultado perinatal, aunque hay mayor riesgo de prematuridad, de retraso crecimiento del feto, cesárea y un posible empeoramiento de la enfermedad de la madre. El rol de la asesoría antes del embarazo es un componente particularmente importante del control obstétrico general, especialmente en mujeres con pobre función pulmonar. Aún más, se requiere una vigilancia más estrecha del embarazo, con la participación de médicos de diversas especialidades. La valoración de los ultrasonidos sucesivos y del examen Doppler fetal son importantes y necesarios para el control del bienestar maternal y fetal, así como para la determinación del tiempo apropiado para la culminación del embarazo. En este artículo, se analizan los problemas clínicos que surgen durante el embarazo en mujeres con fibrosis quística. También se analizan la asesoría, el manejo obstétrico y el resultado perinatal.

DIAGNÓSTICO DE GESTAÇÃO POR ULTRA-SONOGRAFIA

The advantagens, the principles, the technic and the updated status of pregnancy diagnosis in the cow, mare and ewe, by ultrasound scanning are presented in this paper. The early diagnosis twin pregnancies, evaluation of embryo viability and inocuity are some of the advantages of ultrasonography in domestic species. Pregnancy diagnosis through ultrasound scanning allows safe early recognition of this state with imediate positive ecnonomic benefits.

Apresentam-se as vantagens, os princípios fundamentais da técnica e a situação atual do diagnóstico de gestação por ultra-sonografia nas espécies bovina, eqüina e ovina. Entre as vantagens da ultra-sonografia para o diagnóstico de gestação destaca-se a precocidade, a inocuidade, o diagnóstico de prenhez gemelar e a possibilidade de estimar a viabilidade embrionária. O diagnóstico de gestação por ultra-sonografia possibilita um reconhecimento precoce e seguro desse estado com reflexos econômicos positivos e imediatos.

Diagnóstico de gestação por ultra-sonografia

The advantagens, the principles, the technic and the updated status of pregnancy diagnosis in the cow, mare and ewe, by ultrasound scanning are presented in this paper. The early diagnosis twin pregnancies, evaluation of embryo viability and inocuity are some of the advantages of ultrasonography in domestic species. Pregnancy diagnosis through ultrasound scanning allows safe early recognition of this state with imediate positive ecnonomic benefits.

Apresentam-se as vantagens, os princípios fundamentais da técnica e a situação atual do diagnóstico de gestação por ultra-sonografia nas espécies bovina, eqüina e ovina. Entre as vantagens da ultra-sonografia para o diagnóstico de gestação destaca-se a precocidade, a inocuidade, o diagnóstico de prenhez gemelar e a possibilidade de estimar a viabilidade embrionária. O diagnóstico de gestação por ultra-sonografia possibilita um reconhecimento precoce e seguro desse estado com reflexos econômicos positivos e imediatos.