Abstract
One centre investigated 606 men aged 65 years or older who underwent emergency imaging for abdominal pain but had previously had CT or ultrasound on which a normal calibre abdominal aorta had been seen. Of these men, only three (0.5%) had a minimally dilated abdominal aorta not requiring intervention. The authors say this result supports the notion that aneurysmal changes and/or rupture after an initial normal scan are extremely rare in men ≥65 with abdominal pain.
The mathematical models used in this study involved calculations based on patient's age, endometrial thickness, vascularisation of endometrium and use of hormone therapy. Both models were robust with high sensitivity and specificity, and showed promise for informing individualised patient care.
Two radiologists examined 76 patients with suspected peripheral limb vascular disease with a Sonoscape 6000 and, unsurprisingly, found pathology that may otherwise have been missed since previously, diagnosis would have been made on radiographs and clinical assessment only. Doppler ultrasound, not readily available in the developing world, has revolutionised their practice, and they urge other similar areas to embrace mobile Doppler.
In this study, there was no significant difference in 29 trainees' practical skills whether using an ultrasound simulator or scanning a pregnant volunteer. Therefore, the researchers state that simulators could be used to measure trainees' dexterity and have the advantage of being available any time. A disadvantage is that the trainees' ability to communicate effectively with the patient cannot be evaluated.
Another paper from this experienced team states that soft-embalmed Thiel cadavers are highly durable and reliable for providing multiple realistic training experiences for anaesthetists. In one cadaver, nerves were identified with the same ease up to 28 weeks after embalming, and there was minimal tissue distortion in another, which underwent 934 left interscalene blocks in 10 days.
This long-term study looked at 115 children who had had a urinary tract abnormality diagnosed on ultrasound prenatally. Those with the best outcomes were the ones with isolated uni- or bilateral hydronephrosis diagnosed before birth. Those with poorer outcomes tended to have had oligohydramnios and postnatal bilateral abnormalities.
In view of the recent UK recommendation to introduce the fetal cardiac ‘3VT’ view into the anomaly scan, this China-North America review article is welcome and timely. It suggests that management and prognosis of Fallot's tetralogy are quite different depending on the appearances of the pulmonary artery. Looking at the researchers' criteria, most of these appearances should be visible on the 3VT view.
Advanced age is a risk factor for developing non-alcoholic fatty liver disease (NAFLD) but researchers in Brazil investigated a cohort of 229 older people of whom 103 had NAFLD. Four dietary patterns were noted within the group; traditional, regional snacks, high energy, or healthy. Those who adhered to a healthy diet were less likely to have a fatty liver. The opposite was true for those consuming regional snacks.
It seems that contrast-enhanced ultrasound is safe for horses as well as humans and is useful for evaluating vasculature in the distal portion of the leg. No serious complications were seen in this small North American study of six horses.
Considering how frequently we scan for ‘reduced fetal movement’, this interesting project cleverly compared actual third trimester fetal movements, as observed by the ultrasound operator, with movements perceived by the mother. The operator judged the fetus to be moving for a much greater proportion of time during the 30-min observation compared to the mother. There was no link between maternal perception and placental site, amniotic fluid volume or BMI.
In order to aid early detection of injury to the posterior circumflex humeral artery, which can occur in elite athletes who perform repetitive overarm movements, this Dutch team has devised a vascular ultrasound protocol to standardise technique and improve reproducibility of measurements.
Of course it does. The researchers looked at obstetrical and gynaecology trainees' ability to assess the cervix using transvaginal ultrasound before and after a lecture-based teaching module. Images collected by the trainees before and after the teaching session were scored independently by two maternal–fetal medicine physicians and 79% showed improvement.