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Perfusion Index and ultrasonography in the evaluation of infraclavicular block

Bereket M.M. | Aydin B.G. | Küçükosman G. | Pişkin Ö. | Okyay R.D. | Ayoğlu F.N. | Ayoğlu H.

Article | 2019 | Minerva Anestesiologica85 ( 7 ) , pp.746 - 755

BACKGROUND: It has been reported that noninvasive, objective tests are needed for determining the success of peripheral nerve blocks because conventional methods necessitate the cooperation of the patient. It is also known that the brachial plexus block causes vasodilatation and an increase in blood flow due to its sympathectomy effect. Our study aimed to determine whether Perfusion Index (PI) and measured regional hemodynamic changes using ultrasound were reliable parameters in evaluating the early success of an infraclavicular block. METHODS: Forty ASA I-III patients who were administered a successful infraclavicular block were in . . .cluded in this study. In addition to the baseline hemodynamic measurements, PI and regional hemodynamic parameters, such as brachial artery diameter (BAD), brachial arterial area (BAA), blood flow (BF), end-diastolic velocity (EDV), Resistance Index (RI), peak systolic velocity (PSV), and time average velocity (TAV) were measured. After completing the block procedure, all values were rerecorded at the 10th, 20th, and 30th minute. Patients with a successful block during the first 10 minutes were assigned to Group A, while patients with a successful block after the 10th minute were assigned to Group B. RESULTS: Statistically significant differences were observed for all regional hemodynamic variables and PI after 10 minutes. When the regional hemodynamic data and PI were compared between the groups, differences were identified for PI, BF, PSV, EDV, and TAV. Within the measured parameters, EDV was the parameter showing the greatest proportional change. CONCLUSIONS: Changes in EDV, especially RI and PI, provide more effective and objective results for the assessment of early regional block success. © 2018 EDIZIONI MINERVA MEDIC Daha fazlası Daha az

Clinical and ultrasonographic evaluation of pelvic masses [Pelvik kitlelerin klinik ve ultrasonografik degerlendirmesi]

Tanriverdi H.A. | Sade H. | Akbulut V. | Barut A. | Bayar Ü.

Article | 2007 | Journal of the Turkish German Gynecology Association8 ( 1 ) , pp.67 - 70

Objective: Ultrasonographic findings, CA-125 levels, risk of malignity index, resistance index and pathologic results of pelvic masses were examined to determine their efficacy in malignant and benign differentiation. Materials and Methods: One hundred and fourteen patients with a diagnosis of pelvic mass between 2002 and 2004 were evaluated. The menopausal status, ultrasonographic appearance (mass lesion greater than 4 cm, solid, cystic, multiloculated, uniloculated, septated, complicated and existence of papillary structures), serum CA-125 levels (cut-of ?35 U/ml), Doppler sonographic resistance index (cut-off ?0.42) and RMI (risk . . . of malignancy index, cut-off ?200) were recorded. Ovarian carcinomas and borderline tumours were classified in the malignant group in the evaluation of the efficacy of these paramaters in malignant/benign differentiation. Results: Mean age of the patients was 39 years (range 12-75 years). Sixteen patients were postmenopausal. Ninety-one (79%) of 114 patients were operated. Fifty-four patients (59%) were laparoscopically operated (none of them was malignant), whereas explorative laparotomy was performed for 37 (41%) patients (13 of them were malignant). Eighteen (15.8%) of the remaining patients were followed-up by ultrasonography and serum CA-125 determinations, and ultrasonographic cyst aspiration was performed in 5 patients (4-4%). Postoperative histopathology of 13 patients showed malignant characteristics (1 clear cell carcinoma, 1 undifferentiated carcinoma, 1 adenocarcinoma, 1 Brenner tumor, 1 carcinoma metastasis, and 4 borderline tumors) and 78 patients showed benign characteristics (13 endometriomas, 3 mature cystic teratomas, 3 ovarian torsions, 2 tuboovarian abcesses, 1 degenerated myoma, 56 benign cysts). The sensitivity of RMI, CA-125 and RI in the differentiation of malignant/benign tumors ranged between 38% and 69%, the specificity between 71% and 99%, the positive predictive value between 23% and 83% and the negative predictive value between 92% and 94%. Discussion: In the differentiation of malignant/benign lesions Doppler ultrasonography was found to be more effective than only ultrasonography and CA-125 or RMI. The low sensitivity of RMI was attributed to the insufficient number of cases in our study. The combination of these 3 parameters will increase the effectivity of clinical judgement of pelvic masses Daha fazlası Daha az

Doppler evaluation of pediatric goiter: Effect of mandatory iodination

Özer T. | Demirel F. | Mahmutyazicioglu K. | Gürel A. | Özdemir H. | Savranlar A. | Demircan N.

Article | 2005 | Journal of Clinical Ultrasound33 ( 7 ) , pp.339 - 344

Purpose. The aim of this study was to evaluate the hemodynamic status of the thyroid in children with goiter after the use of iodinated dietary salt for 3 years in a region of endemic iodine deficiency. Methods. Sixty-six children between 7 and 12 years of age were included in the study. Three groups were constituted according to sonographically measured thyroid volume and urinary iodine excretion levels. Group 1 included 11 children with thyroid volumes greater than the 97th percentile according to age and sex criteria suggested by the World Health Organization International Council for Control of Iodine Deficiency Disorders and ur . . .inary iodine level lower than 100 µg/l. Group 2 included 30 children with thyroid volumes greater than the 97th percentile and urinary iodine level equal to or higher than 100 µg/l. The control group included 25 children who had normal thyroid volume and urinary iodine level. All children were examined by thyroid duplex sonography. Peak systolic velocity (PSV) and resistance index (RI) were measured in the inferior thyroid artery bilaterally. Results. PSV in group 1 was significantly higher than in group 2 and in the control group (P < 0.05 and P < 0.01, respectively). There was no significant difference between the PSV of group 2 and the control group. The RI in groups 1 and 2 was significantly lower than in the control group (P < 0.01 and P < 0.01, respectively). There was no significant difference between the RIs of group 1 and group 2. Conclusions. These findings suggest an effect of iodination on thyroid hemodynamics before the size of the hyperplastic thyroid returned to normal, in keeping with normalization of the urinary iodine level. © 2005 Wiley Periodicals, Inc Daha fazlası Daha az

Impact of COPD exacerbation on cerebral blood flow

Yildiz S. | Kaya I. | Cece H. | Gencer M. | Ziylan Z. | Yalcin F. | Turksoy O.

Article | 2012 | Clinical Imaging36 ( 3 ) , pp.185 - 190

We aimed to investigate the impact of chronic obstructive pulmonary disease (COPD) exacerbation on cerebral blood flow (CBF). In 21 COPD patients - in both exacerbation and stable phases -Doppler ultrasonographies of internal carotid artery (ICA) and vertebral artery (VA) were performed. There were significant differences in total, anterior and posterior CBF, ICA and VA flow volumes in exacerbated COPD compared to stable COPD. Total CBF was correlated with cross-sectional areas of left and right ICA, whereas independent predictor of total CBF was cross-sectional area of right ICA. Increased CBF might indicate cerebral autoregulation . . .-mediated vasodilatation to overcome COPD exacerbation induced hypoxia. © 2012 Elsevier Inc Daha fazlası Daha az

Impact of passive smoking on uterine, umbilical, and fetal middle cerebral artery blood flows

Yildiz S. | Sezer S. | Boyar H. | Cece H. | Ziylan S.Z. | Vural M. | Turksoy O.

Article | 2011 | Japanese Journal of Radiology29 ( 10 ) , pp.718 - 724

Purpose. The aim of this study was to evaluate the influence of passive maternal smoking on blood flow velocities in arteries of the fetal-placental-maternal circulation. Materials and methods. A total of 79 pregnant women in their third trimester, including 33 passive smokers, 23 active smokers, and 23 nonsmoking controls, were enrolled in the study. Fetal biophysical indices were evaluated with B-mode scanning, whereas blood flow waveforms of uterine, umbilical, and fetal middle cerebral (MCA) arteries were analyzed with Doppler ultrasonography. Results. There were signifi cant differences among active smokers vs. passive smokers . . .vs. controls with regard to the presence of a uterine artery diastolic notch (39.1% vs. 18.2% vs. 4.3%; P = 0.012); ratio of peak systolic/ end-diastolic velocity of fetal MCA [3.73 ±1.27 vs. 4.26 ± 1.20 vs. 5.00 ± 2.15, analysis of variance (ANOVA) P = 0.026]; resistance index of fetal MCA (0.74 ± 0.08 vs. 0.75 ± 0.07 vs. 0.80 ± 0.09; ANOVA P = 0.014); ratio of fetal MCA/umbilical artery resistance index (1.27 ± 0.20 vs. 1.24 ± 0.14 vs. 1.39 ± 0.21; ANOVA P = 0.011); and ratio of fetal MCA/umbilical artery pulsatility index (1.56 ± 0.44 vs. 1.63 ± 0.43 vs. 1.97 ± 0.54; ANOVA P = 0.046). Conclusion. Effects of passive maternal smoking on the fetal-placental-maternal unit were comparable to those with active maternal smoking as determined by the means of increased resistance in the maternal vasculature and adaptive changes of cerebroplacental circulation for maintaining fetal cerebral circulation. © 2011 Japan Radiological Society Daha fazlası Daha az

Doppler Evaluation of the Thyroid in Pediatric Goiter

Mahmutyazicioglu K. | Turgut M.

Article | 2004 | Journal of Clinical Ultrasound32 ( 1 ) , pp.24 - 28

Purpose. The aim of this study was to identify any changes in Doppler parameters in the thyroid arteries of pediatric patients with a clinical diagnosis of goiter living in an area where goiter is endemic. Patients and Methods. In this prospective study, 20 pediatric patients with simple endemic goiter and 20 age-matched healthy subjects underwent sonographic examination. The resistance index (RI) and peak systolic velocity (PSV) on duplex sonography were measured from the inferior thyroid arteries, and the thyroid gland volume was recorded. Serum thyrotropin, free T3 hormone, and free T4 hormone levels were measured in both groups. . . . Results. The mean thyroid volume (± standard deviation) was significantly higher in the patients than in the healthy subjects (7.2 ± 1.4 ml versus 3.2 ± 1.1 ml; p < 0.01). The mean RI values for the thyroid arteries were significantly lower in the patient than in the control group (0.58 versus 0.70, respectively; p < 0.05). The mean PSV of the thyroid arteries was significantly higher for the patients than for the healthy subjects (mean, 36.7 cm/second versus 18.3 cm/second, respectively; p < 0.05). There was no correlation between the Doppler parameters and any of the hormone levels evaluated. Conclusions. In the arteries supplying the thyroid gland in a pediatric population, Rls were lower and PSVs higher in the patients with diffuse goiter than in the healthy control group. We discuss iodine deficiency as a possible mechanism for these changes. © 2003 Wiley Periodicals, Inc Daha fazlası Daha az

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