bluuebunny/crossref_metadata_2025 huggingface dataset:
Fetal intracardiac echogenic foci: visualization depends on the orientation of the 4‐chamber view.
Authors: Ranzini A C , McLean D A , Sharma S , Vintzileos A M
Published: January 2017

To compare the frequency of visualization of echogenic intracardiac foci in different cardiac views.

Women having ultrasonographic examinations between October 1997 and July 1998 were prospectively evaluated if a fetal echogenic intracardiac focus was seen in either ventricle.

Echogenic intracardiac foci were seen in 89 fetuses in whom both the apical and lateral 4‐chamber heart views were obtained. Eight‐six fetuses (97%) had a single focus (83 in the left ventricle and 3 in the right ventricle), and 3 (3%) had 2 foci. Echogenic intracardiac foci were seen in the apical 4‐chamber view in 89 (100%) and in the lateral 4‐chamber view in only 26 (29%; P = .001).

Echogenic intracardiac foci are not easily seen in the lateral 4‐chamber view. Studies that suggest an increased risk of aneuploidy when echogenic foci are seen should specify the orientation of the 4‐chamber view used.
Sonographic and Doppler characteristics of the corpus luteum: can they predict pregnancy outcome?
Authors: Frates M C , Doubilet P M , Durfee S M , Di Salvo D N , Laing F C , Brown D L , Benson C B , Hill J A
Published: January 2017

To determine whether there is a relationship between gray scale or Doppler characteristics of the corpus luteum and first‐trimester pregnancy outcome.

We conducted a prospective study of patients with spontaneous singleton pregnancies between 5 and 8 weeks' gestation. The corpus luteum size, sonographic appearance, resistive index, and peak systolic velocity were measured on transvaginal sonography. Maternal use of exogeneous progesterone was recorded. Only patients with known first‐trimester outcome were included.

There were 201 study patients. The corpus luteum could be visualized in 197 (98%) and had a mean +/‐ SD size of 1.9 +/‐ 0.6 cm, a mean resistive index of 0.50 +/‐ 0.08, and a peak systolic velocity of 20.5 +/‐ 11.2 cm/s. There were 151 first‐trimester survivors (75.1 %) and 50 spontaneous losses (24.9%). In a comparison of the survivors and losses, there was no significant difference in mean corpus luteum size (1.9 versus 1.7 cm; P = .10, t test), mean resistive index (0.50 versus 0.50; P = .71, t test), peak systolic velocity (21 versus 19 cm/s; P = .29, t test), or sonographic appearance (P = .78, chi2 test). The lack of association between corpus luteum characteristics and outcome persisted when cases were stratified by progesterone use and the presence or absence of a heartbeat on the study sonogram.

There is no apparent relationship between the characteristics of the corpus luteum and first‐trimester pregnancy outcome.
Sonographic diagnosis of pelvic adhesions in patients after ovum pickup.
Authors: Shalev J , Mashiach R , Fisch B , Royburt M , Bar-Hava I , Krissi H , Meizner I
Published: January 2017

To evaluate the use of transvaginal sonography for the detection of pelvic adhesions by using clear free fluid in the pouch of Douglas found after ovum pickup.

A prospective clinical study was performed in an infertility unit of an academic research facility. Sonography was performed in 50 women with infertility 3 days after ovum pickup, and the visceral peritoneum of the uterus, the ovaries, and the fallopian tubes was scanned for possible pelvic adhesions.

The serosal surfaces of the uterus, ovaries, and fallopian tubes were successfully observed for the presence of adhesions in 86%, 68%, and 20% of the patients, respectively. Improved visualization was associated with an increased amount of pelvic fluid for the uterus (P = .01) but not for the ovaries and fallopian tubes. The amount of fluid in the pelvis correlated with an increased number of retrieved oocytes (P = .07) and a decreased need for manual manipulation to achieve proper imaging of the uterus (P = .001).

Transvaginal sonography performed in the presence of fluid in the pelvis may show adhesions mainly attached to the uterus and ovaries. Assessment of possible mechanical factors is important in planning treatment of patients with infertility.
Predicting Atypia Inside Endometrial Polyps
Authors: Perez‐Medina Tirso , Bajo Jose , Huertas Miguel A. , Rubio Angel
Published: January 2017

Objective. To evaluate the efficacy of color Doppler exploration for assessing atypia inside endometrial polyps. Methods. A prospective study was conducted in a tertiary university hospital. Eight hundred six patients with endometrial polyps were studied with color Doppler sonography, and the resistive index inside the polyp stalk was obtained. The patients were then referred for hysteroscopic resection, and pathologic analysis was performed. Results. Thirty‐five polyps with sonographic indications of atypia were pathologically confirmed. Sonographic indications of atypia inside 16 polyps were not confirmed. Three nonquestionable endometrial polyps had atypia inside them. Conclusions. Low Doppler resistance is highly predictive of atypia inside endometrial polyps.
Impact of Added Biopsy Areas on Prostate Cancer Detection
Authors: Arger Peter H. , Malkowicz S. Bruce , Van Arsdalen Keith N. , Sehgal Chandra M. , Holzer Anson , Barrett Ronald
Published: January 2017

Objective. To evaluate variations in prostate cancer detection relevant to the number and areas of biopsy cores. Methods. Ninety patients with elevated prostate‐specific antigen levels, abnormal physical examination findings, or both had ultrasound examinations plus biopsies. Forty‐nine patients had 11 biopsies, and 41 patients had 6 biopsies. The numbers of cancers detected were compared on a patient‐by‐patient basis and by all biopsy sites grouped together. An analysis of the relationship between a positive gray scale sonographic finding and the presence of adenocarcinoma was done. Results. On a patient‐by‐patient basis, 43% of patients who had 11 biopsies had adenocarcinoma. In patients who had 6 biopsies, 32% had adenocarcinoma. Thirty‐eight percent of the additional cancers found in the 11‐biopsy group were in 5 additional areas not sampled in the 6‐biopsy group. Of the total of 539 biopsy specimens obtained in the 11‐biopsy group, 56 (10%) had adenocarcinoma; 43% of these 56 were positive in the 5 additional areas not sampled in the 6‐biopsy group. No statistical differences (P > .05) were found for mean age, mean prostate‐specific antigen level, and mean volume in the groups with 11 and 6 biopsies. This indicated that the observed difference was not related to any of these factors. Similar pathologic data were found for patients with prostatic intraepithelial neoplasia. Conclusions. Our data indicate the added value of additional biopsy sites over the usual 6 biopsies to increase the yield of adenocarcinoma and prostatic intraepithelial neoplasia detected. The added biopsy sites of the central and midperipheral glands were areas where additional specimens positive for adenocarcinoma and prostatic intraepithelial neoplasia were obtained.
Color Doppler Sonography of Endometrial Masses
Authors: Fleischer Arthur C. , Shappell Heidi W. , Parker Lynn P. , Hanemann Cynthia W.
Published: January 2017

Objective. To correlate the color Doppler sonographic features of endometrial masses with histologic characteristics and microvessel density. Methods. We performed a retrospective analysis of 10 postmenopausal and 5 premenopausal women with abnormal bleeding who had color Doppler sonography and histologic studies of endometrial masses. Results. Endometrial masses that contained multiple branches on color Doppler sonography were more likely carcinomas, even though both polyps and carcinomas were vascular on color Doppler sonography and their microvessel densities were similar. On color Doppler sonography, polyps averaged 1.2 detectable vessels versus 3.4 for carcinomas. Conclusions. Color Doppler sonography may be useful in distinguishing carcinomas from polyps in women with thickened endometria.
Power Doppler Imaging of the Fetal Upper Aerodigestive Tract Using a 4‐Point Standardized Evaluation
Authors: Macedonia Christian , Miller Jeri L. , Sonies Barbara C.
Published: January 2017

Objective. Our investigation of fetal swallowing has identified potential limitations in the use of color Doppler imaging for detection of amniotic fluid flow and discrimination of respiratory from ingestive activity. The objective of this study was to evaluate an alternative imaging modality, power Doppler sonography, as a technique to enhance detection of amniotic fluid flow in the upper aerodigestive tract. Methods. We applied a standardized 4‐axis sonographic examination of upper aerodigestive structures and used power Doppler imaging to document amniotic fluid flow. Normal aerodigestive activities from 62 healthy control subjects were compared with 4 abnormal cases. Results. Our longitudinal experience with 66 subjects showed that a directed evaluation of the fetal upper aerodigestive tract with power Doppler imaging provided a systematic approach for studying the physiologic development of this region in both healthy and at‐risk fetuses. Conclusions. A standardized 4‐axis examination with power Doppler imaging is a useful adjunct in addressing ingestive and respiratory functions in the developing fetus.
Sonographic Spectrum of Hemorrhagic Ovarian Cysts
Authors: Jain Kiran A.
Published: January 2017

Objective. To present the spectrum of sonographic findings associated with hemorrhagic ovarian cysts. Methods. Experience with making specific and correct diagnosis of hemorrhagic cysts with the use of sonography was reviewed, and the spectrum of sonographic findings was identified. Results. Endovaginal sonography facilitated excellent visualization of internal architectural details of an adnexal mass, which enabled specific diagnosis of hemorrhagic cysts instead of other adnexal masses. Conclusions. A hemorrhagic cyst is a common and important entity to recognize and diagnose correctly, and because it can be confused with more ominous conditions, it is important to recognize its specific diagnostic patterns.
Combined Sonographic and Biochemical Markers for Down Syndrome Screening
Authors: Pinette Michael G. , Egan James F.X. , Wax Joseph R. , Blackstone Jacquelyn , Cartin Angelina , Benn Peter A.
Published: January 2017

Objective. To evaluate the efficacy of fetal nuchal fold thickness and proximal long bone biometric measurements in modifying Down syndrome serum screening risk in a population of women referred for second‐trimester sonography. Methods. Sonographic biometric measurements and biochemical markers were combined retrospectively for 2533 women with known pregnancy outcomes. Four different screening methods were compared: (1) advanced maternal age; (2) biochemical serum screening markers; (3) modification of serum screening risks on the basis of categorical cutoffs for nuchal fold and femur and humerus length; and (4) a combined approach in which the sonographic measurements were treated as multiples of the medians and entered, together with the serum screening results, into a multivariable algorithm. The efficacy was compared at second‐trimester risk cutoffs of 1:270 and 1:100. Results. Down syndrome was present in 30 of the 2533 pregnancies (1 in 84). With the use of the 1:270 cutoff, biochemical screening had 93% sensitivity and a 40% false‐positive rate. With application of the categorical method of fixed cutoffs to incorporate fetal biometry, the false‐positive rate was reduced to 33% with no loss of sensitivity. The combined model had 83% sensitivity and a 19% false‐positive rate. The combined method had the highest positive predictive value (1 in 20). Similar gains in efficacy could be shown with the 1:100 cutoff. Conclusions. For this high‐risk group, the multivariate model that combines serum screening and sonography can result in a substantial reduction in the number of amniocenteses. Although the addition of the sonographic biometric measurements resulted in some Down syndrome cases being missed, the net effect was a large improvement in the overall positive predictive value of the screening.
Prenatal Detection of Fetal Trisomy 18 Through Abnormal Sonographic Features
Authors: Yeo Lami , Guzman Edwin R. , Day-Salvatore Debra , Walters Christine , Chavez Donna , Vintzileos Anthony M.
Published: January 2017

Objective. To describe the prenatal detection of fetal trisomy 18 through abnormal sonographic features and to determine the sensitivity of sonographically detecting fetuses with trisomy 18. Methods. All genetic and cytogenetic records of fetuses with trisomy 18 were reviewed retrospectively (1992‐2002). From these, singleton fetuses who had prenatal sonography at our unit were identified. The maximal numbers of individual abnormalities from 1 sonographic examination (not limited to type of organ system) were recorded. Each abnormality was classified as major, minor, or “other,” and each organ system was classified as abnormal only once, regardless of the number of individual abnormalities identified in that system. The sensitivity of sonography in detecting abnormalities of trisomy 18 was determined. Results. Of 38 fetuses identified with trisomy 18, all had 4 or more prenatally detected sonographic abnormalities (sensitivity of sonographic detection of fetuses with trisomy 18, 100%). The median number of abnormalities per examination was 8 (range, 4‐19). Sonographically detected major abnormalities were cardiac (84%; n = 32), central nervous system (87%; n = 33), gastrointestinal (26%; n = 10), and genitourinary (16%; n = 6). Sonographically detected minor abnormalities were short ear length below the 10th percentile for gestational age (96%; n = 26/27), upper extremities and hands (95%; n = 36), lower extremities and feet (63%; n = 24), and face (53%; n = 20). Fifty percent (19 of 38) had choroid plexus cysts identified, but this was never an isolated finding. Conclusions. In experienced hands, the sensitivity of detecting fetal trisomy 18 on prenatal sonography is 100%, and all cases will have multiple anomalies visualized.
Evaluation of Extremity Trauma With Sonography
Authors: Lyon Matt , Blaivas Michael
Published: January 2017

Objective. To report on the use of bedside sonography in the diagnosis and treatment of penetrating extremity trauma. Methods. Sonography was performed in the emergency department of a level 1 trauma center with both curved and linear array transducers. Results. In both cases, foreign bodies and fractures resulting from gunshot wounds to the extremities were found. In addition, intra‐abdominal and thoracic injuries were evaluated for using sonography. Conclusions. The increasing mobility and portability of sonography has led to its increasing use at the patient's bedside to diagnose a variety of conditions. It provides potential immediate diagnosis and has the flexibility for evaluating a multitude of injuries normally requiring several different imaging technologies. In circumstances in which conventional radiography is unavailable, such as at trauma scenes, mass casualty situations, or at the bedside with unstable patients, sonography can provide unique and essential information about these patients.
Dance of Live Adult Filarial Worms Is a Reliable Sign of Scrotal Filarial Infection
Authors: Chaubal Nitin G. , Pradhan Gautam M. , Chaubal Jyoti N. , Ramani Subhash K.
Published: January 2017

Objective. To determine the value of the filarial dance sign as a diagnostic sign of scrotal filarial infection and to recognize unsuspected scrotal filariasis by this sign. Methods. Eight symptomatic patients in whom the filarial dance sign was shown on high‐resolution ultrasonography were studied, investigated, and followed after treatment with diethylcarbamazine citrate. Two patients underwent fine‐needle aspiration. Results. Multiple foci (nests) of motile (live) filarial worms were observed in most patients. Fine‐needle aspiration of the dilated lymphatic vessels in 2 patients confirmed the presence of microfilariae. Five of 8 patients had a favorable response to treatment with diethylcarbamazine citrate. Conclusions. High‐resolution ultrasonography is a useful technique for diagnosing scrotal filariasis in symptomatic patients and is very useful in the follow‐up period for assessing the response of worms to treatment.
The Onion Skin Sign
Authors: Caspi Benjamin , Cassif Eran , Auslender Roni , Herman Arie , Hagay Zion , Appelman Zvi
Published: January 2017

Objective. To evaluate the association of the onion skin sign as a sonographic marker for appendiceal mucocele. Methods. The sonographic onion skin sign was considered specific for the preoperative diagnosis of appendiceal mucocele. Therefore, detection of this sign in a mass located in the right lower abdomen, unrelated to the female reproductive organs, indicated surgical intervention with a presumptive diagnosis of appendiceal mucocele. From 1998 through 2001, female patients who were found to have atypical cysts containing this sign underwent surgery. The cases were closely followed, and intraoperative findings and final histologic diagnoses were recorded. Results. Appendiceal mucocele was the final diagnosis in all 7 patients in whom the onion skin sign was observed. One additional patient had an appendiceal mucocele with a sonographic picture of a clear tubular cystic structure. Conclusions. A sonographically layered cystic mass in the right lower quadrant of the abdomen in the presence of a normal ovary strongly suggests the diagnosis of appendiceal mucocele. Recognition of the sonographic onion skin sign in a cystic mass in the right lower quadrant may facilitate the accurate preoperative diagnosis of appendiceal mucocele.
Fetal Lung Volume Estimated by 3‐Dimensional Ultrasonography and Magnetic Resonance Imaging in Cases With Isolated Congenital Diaphragmatic Hernia
Authors: Ruano Rodrigo , Joubin Laurence , Sonigo Pascale , Benachi Alexandra , Aubry Marie-Cecile , Thalabard Jean-Christophe , Brunelle Francis , Dumez Yves , Dommergues Marc
Published: January 2017

Objective. To assess the agreement of 3‐dimensional ultrasonography and magnetic resonance imaging in estimating fetal lung volume in cases with isolated congenital diaphragmatic hernia. Methods. Fetal lung volume was measured in 11 cases of congenital diaphragmatic hernia (10 left and 1 right) by 3‐dimensional ultrasonography and magnetic resonance imaging. These examinations were performed during the same week. The operators were blinded to each other's results. Intraclass correlation was used to evaluate the agreement between 3‐dimensional ultrasonography and magnetic resonance imaging estimations of the ipsilateral, contralateral, and total fetal lung volume. A Bland‐Altman graph was plotted to detect possible discordant observations. Results. The global intraclass correlation coefficient between magnetic resonance imaging and 3‐dimensional ultrasonographic measurement of fetal lung volume was 0.94 (95% confidence interval, 0.78–0.98) with no outliers observed on the Bland‐Altman plot. Conclusions. There is a good agreement between 3‐dimensional ultrasonography and magnetic resonance imaging for fetal lung volume estimation in cases with congenital diaphragmatic hernia.
Increased Through‐Transmission in Abdominal Tuberculous Lymphadenitis
Authors: Ghazinoor Shaya , Desser Terry , Jeffrey R. Brooke
Published: January 2017

Objective. To describe 2 cases of abdominal tuberculosis in which sonographic evaluation of mesenteric lymphadenopathy showed increased through‐transmission suggestive of caseating necrosis. Methods. Two patients with abdominal pain and other symptoms (including fever, diarrhea, and weight loss) underwent abdominal sonography with a 6‐MHz curved array transducer. One patient also underwent sonographically guided fine‐needle aspiration of multiple lymph nodes, and the other underwent computed tomography, colonoscopy, and colon biopsy. Results. In both patients, sonography showed multiple rounded hypoechoic lesions with increased ultrasound through‐transmission suggestive of necrotic lymphadenopathy. No color flow was shown. In 1 case, the posterior acoustic enhancement was accentuated in the harmonic imaging mode. In the other case, the lesions shown on sonography corresponded to computed tomographic findings of low‐density lymph nodes. Results of fine‐needle aspiration and colon biopsy were positive for tuberculosis. Conclusions. Posterior acoustic enhancement in abdominal lymphadenopathy can suggest the diagnosis of tuberculous lymphadenitis. Detection of this finding is facilitated by scanning in the harmonic mode. Necrotic nodes will lack color flow and can be distinguished from lymphadenopathy of other causes. Sonography can also be used for fine‐needle aspiration of necrotic nodes to yield a definitive diagnosis.
Color Doppler Sonographic Findings of Inflamed and Perforated Meckel Diverticulum
Authors: Baldisserotto Matteo
Published: January 2017

Objective. To describe color Doppler sonographic findings in 2 cases of inflamed and perforated Meckel diverticulum. Methods. Two patients with inflamed and perforated Meckel diverticulum underwent color Doppler sonographic studies. Results. Gray scale sonographic examination identified a fixed cystlike structure with a gut signature surrounded by a hyperechoic layer. Color Doppler sonography revealed hyperemia in the diverticular wall and hyperechoic layer, which was more intense in 1 patient. Conclusions. Identification of a fixed cystlike structure with a gut signature and wall hyperemia suggests the diagnosis of inflamed Meckel diverticulum; when a hyperechoic layer surrounds this structure, perforation of the diverticulum should be suspected.
Celiac Artery Compression Syndrome in Children, Adolescents, and Young Adults
Authors: Scholbach Thomas
Published: January 2017

Objective. Abdominal pain is one of the most common conditions in childhood and adolescence. Celiac artery compression syndrome (CACS) is rarely suspected in this population. We present clinical and sonographic features from a series of 59 patients with this disorder. Methods. A total of 3449 patients from 0 to 18 years were investigated with 7639 abdominal color duplex sonographic examinations. Celiac artery flow velocity was measured at the branching off from the aorta in inspiration, expiration, and in between. Diagnosis of CACS was made if a greater than 2‐fold acceleration of peak systolic flow in the celiac artery compared to the abdominal aorta or a peak systolic velocity greater than 200 cm/s was measured in the mid position and if a variation of flow velocity occurred during respiration. In 22 cases, angiography (21 magnetic resonance angiography and 1 digital subtraction angiography) was used to prove sonographic diagnosis. Results. Fifty‐nine patients (among them 81% female) from 22 months to 19 years (clustering between 14 and 17 years) fulfilling color Doppler sonographic criteria of CACS were found, for a prevalence of 1.7%. Their symptoms included, among others, abdominal pain (71%), nausea (29%), thoracic pain (22%), heartburn (17%), weight loss (15%), vomiting (15%), systolic murmur (15%), postprandial accentuation of symptoms (15%), diarrhea (14%), respiratory discomfort (14%), and syncope (12%). Conclusions. Celiac artery compression syndrome is more prevalent than expected, and conditions not usually connected to the disease were found. Alertness to CACS is recommended, especially in patients with a combination of characteristic symptoms. Color Doppler sonography is the modality of choice for diagnosing CACS.
Nonmedical Fetal Ultrasound
Authors: Wax Joseph R. , Cartin Angelina , Pinette Michael G. , Blackstone Jacquelyn
Published: January 2017

Objective. The purpose of this study was to evaluate knowledge and opinions regarding nonmedical fetal ultrasound (NMFU) in obstetricians (OB) and radiologists (R). Methods. A questionnaire was sent to all Maine fellows of the American College of Obstetricians and Gynecologists practicing obstetrics and members of the Maine Society of Radiology in April 2005. Results. Among OB, 52 (81.2%), 24 (37.5%), 45 (75.0%), and 56 (87.5%) did not know whether the American College of Radiology, American College of Obstetricians and Gynecologists, American Institute of Ultrasound in Medicine, or US Food and Drug Administration held positions on NMFU. Among R, 11 (37.9%), 27 (93.1%), 19 (65.5%), and 24 (82.7%) did not know whether the organizations held positions. More R than OB agreed that women might forego medical ultrasound after NMFU (62.1% versus 49.2%; P = .05), whereas more OB than R believed fetal anomalies would go undetected during NMFU (79.4% versus 62.1%; P = .04). OB and R had concerns for false‐positive NMFU diagnoses (41.9% and 31.0%), false reassurance by NMFU (76.2% and 62.1%), poor imaging causing anxiety (39.7% and 51.7%), and lack of physician availability to review suspected abnormalities on NMFU (73.0% and 65.5%). Sizable minorities of OB and R believed NMFU providers should be disciplined by licensing boards (33.9% and 44.8%), excluded from society memberships (22.9% and 37.9%), or reported to the Food and Drug Administration (21.3% and 31.0%). Conclusions. Most Maine OB and R are aware of their own but not each other's professional or regulatory NMFU positions yet practice within these guidelines. Most respondents do not favor sanctioning colleagues performing NMFU.
Sonography in Budd‐Chiari Syndrome
Authors: Chaubal Nitin , Dighe Manjiri , Hanchate Vijay , Thakkar Hemangini , Deshmukh Hemant , Rathod Krantikumar
Published: January 2017

Objective. The objective of this presentation is to provide an overview of sonographic manifestations of Budd‐Chiari syndrome (BCS). Methods. Patients were scanned with ultrasound systems using mainly a 2‐ to 5‐MHz curvilinear transducer and in some patients a 5‐ to 12‐MHz linear transducer. The patients were asked to fast from the previous night or for at least 6 hours. Color and spectral Doppler sonography was performed in all patients. Results. Commonly seen findings in BCS include inferior vena cava (IVC) webs and thrombi, IVC narrowing, hepatic venous thrombosis, enlarged caudate lobes, ascites, intrahepatic or extrahepatic collaterals, monophasic to absent flow in the hepatic veins, and high flow velocities in areas of stenosis in the IVC or hepatic veins. Inferior vena cava stents used in the treatment of BCS could also be seen. Conclusions. Budd‐Chiari syndrome is an uncommon disorder; outcome is poor in many cases; and the condition is often misdiagnosed or underdiagnosed. Sonography is a noninvasive and effective modality for diagnosis of BCS.
The Chorionic Bump
Authors: Harris Robert D. , Couto Corey , Karpovsky Clara , Porter Misty M. Blanchette , Ouhilal Sophia
Published: January 2017

Objective. We describe a series of patients with a previously unreported sonographic finding, the chorionic “bump,” which is an irregular, convex bulge from the choriodecidual surface into the first‐trimester gestational sac. The pregnancy outcome is investigated in this series of patients and compared with the general population and infertility first‐trimester control groups. Methods. We prospectively noted a cohort of 15 cases with the chorionic bump on first‐trimester sonograms (in a total of 2178 patients) performed over 3 years at our institution (prevalence, 0.7%). We then compared pregnancy outcomes against 2 pregnant control groups (15 general, noninfertility patients and 15 infertility patients) who were maternal age and gestational age matched to our patient group. Results. The difference in outcomes between the patients with bumps and the healthy control subjects was statistically significant (7 live births versus 13 live births; P < .03), but the difference in outcomes between the patients with bumps and infertility control subjects was not statistically significant (7 live births versus 11 live births; P = .1). Bump size was not correlated with pregnancy outcome. In most patients with serial sonograms, the bump showed evolutionary changes typical for hematoma. Conclusions. The finding of a chorionic bump on the first‐trimester sonogram is associated with a guarded prognosis for the early pregnancy (live birth rate <50%); it probably represents a small hematoma that bulges into the gestational sac, and, in our series, most patients had a history of infertility treatments.
Sonographic Appearance of the Normal Appendix in Adults
Authors: Yabunaka Koichi , Katsuda Toshizo , Sanada Shigeru , Fukutomi Tsunemasa
Published: January 2017

Objectives

To evaluate the sonographic visualization of the normal adult appendix, a large series of sonographic images from consecutive asymptomatic patients was analyzed.

Methods

A total of 788 consecutive adult patients (402 male and 386 female; median age ± SD, 51.1 ± 17.2 years; range, 16–91 years) were examined by appendiceal transabdominal sonography with tissue harmonic imaging. The detection rate, outer appendiceal diameter, intraluminal content, and location of the appendix were estimated. The overall normal appendix was separated into appendix‐visualized and appendix‐not‐visualized groups, which were then examined for the relationship with abdominal wall thickness, body mass index (in kilograms per square meter), age, and sex.

Results

The normal appendix was detected in 388 (49.2%) of 788 patients. The outer appendiceal diameter ± SD was 4.27 ± 1.2 mm (range, 1.0–11.1 mm). In 291 (75%) of the 388 patients, appendices could be depicted in the intra‐luminal gas during sonography. The location of the appendix was classified according to the appendiceal tip, which was found to be abdominal in 37 (9.5%), pelvic in 291 (75%), retrocecal in 23 (6.0%), and a midline extension in 37 (9.5%). In both body mass index and abdominal wall thickness, significant differences were found between appendix‐visualized and appendix‐not‐visualized cases (P < .05). There was no significant difference in age (P = .37) or sex (P = .23) between appendix‐visualized and appendix‐not‐visualized cases.

Conclusions

The results show that the normal adult appendix can be revealed by sonographic visualization in a large series of asymptomatic patients.
Chronic Constipation as a Causative Factor for Development of Varicocele in Men
Authors: Turgut Ahmet T. , Özden Eriz , Koşar Pinar , Koşar Uğur , Çakal Başak , Karabulut Ayhan
Published: January 2017

Objectives

The purpose of this study was to determine the role of chronic constipation in the etiopathogenesis of varicocele in men.

Methods

In this prospective study, group 1 included 25 male patients who had symptoms of chronic constipation for a mean duration ± SD of 17.0 ± 20.3 months (range, 3–96 months), and group 2 included 26 male subjects without any symptoms associated with constipation. All subjects were evaluated by both physical examination and scrotal ultrasonography. For the plexus pampiniformis (PP) veins, a mean diameter exceeding 2 mm and reflux for more than 1 second were accepted as suggestive findings for varicocele, as described previously.

Results

Left varicocele was detected in 13 (52%) of the 25 patients in group 1 and in 5 (19%) of the 26 subjects in group 2 (P = .02). The mean diameters of the left PP veins were 2.58 ± 0.97 mm (range, 1.2–4.3 mm) in group 1 and 1.71 ± 0.53 mm (range, 1.0–3.0 mm) in group 2 (P < .001). A significant difference was detected between the two groups for varicocele prevalence and the mean diameter of the left PP veins.

Conclusions

Chronic constipation is a significant causative factor for the development of left varicocele, which may be attributable to the accompanying distention of the sigmoid colon and distal part of the descending colon, with resultant compression of the left testicular vein in the retroperitoneum. Therefore, we propose routine ultrasonographic examinations for the possible development of varicocele in men with chronic constipation.
Sonographic Measurement of Thyroid Volumes in Healthy Chinese Infants Aged 0 to 12 Months
Authors: Yao Dan , He Xue , Yang Ru-Lai , Jiang Guo-Ping , Xu Yan-Hua , Zou Chao-Chun , Zhao Zheng-Yan
Published: January 2017

Objectives

The purposes of this study were to determine thyroid volumes in healthy Chinese infants aged 0 to 12 months and to provide reference data for normal thyroid growth.

Methods

A total of 408 healthy infants (229 male and 179 female) were enrolled in the study. The length, breadth, and depth of the thyroid gland were measured with sonography. The volume of each lobe was calculated by the correct ellipsoid formula (volume = length × breadth × depth × 0.479).

Results

All of the infants' thyroids showed a normal uniform echo texture on sonography. The thyroid volume increased with age (r = 0.519; P < .001). Moreover, positive associations were noted between thyroid volume and height and weight (r = 0.517; P < . 001; r = 0.499; P < .001, respectively). No significant differences based on sex were found (t = 1.784; P = .075).

Conclusions

The thyroid volumes in these healthy Chinese infants varied from those reported in the published literature on healthy European infants. It is important to establish local reference ranges for thyroid volumes in healthy infants.
Gray Scale and Power Doppler Study of Biopsy‐Proven Kikuchi Disease
Authors: Yoo Jung Lim , Suh Sang-il , Lee Young Hen , Seo Hyung Suk , Kim Kyoung Min , Shin Bong Kyung , Song Joon Young , Seol Hae Young
Published: January 2017

Objectives

Kikuchi disease is a benign, self‐limiting cause of cervical lymphadenopathy. It can show sonographic features similar to those of other common causes of lymphadenopathy. The purpose of this study was to characterize the sonographic features of Kikuchi disease that can contribute in differentiating between Kikuchi disease and other diseases causing cervical lymphadenopathy.

Methods

Sonographic findings of 175 patients with biopsy‐proven Kikuchi disease were retrospectively reviewed. The mean age of the patients was 27.3 years, and the female to male ratio was 3.5:1. All patients had undergone sonographically guided core biopsy. Pathologic findings were classified into proliferative (n = 57), necrotizing (n = 109), and xanthomatous (n = 9) types. On gray scale sonography, lymph nodes were assessed by their size, shape (shortest/longest axis ratio), location, echogenicity, presence of conglomeration, gross necrosis, calcification, echogenic nodal hilum, and increased perinodal echogenicity. The vascular pattern was assessed on power Doppler imaging.

Results

The mean maximum diameter of the lymph nodes was 1.6 cm. Forty‐four percent of them (77 of 175) were oval (shortest/longest axis ratio, 0.5–0.7) and 48% (84 of 175) were elongated (shortest/longest axis ratio, <0.5). Most were located in levels II and V. Seventeen lymph nodes showed gross necrosis, and none showed calcification. One hundred fifty‐two lymph nodes (86.8%) had an echogenic hilum, and 76% (133 of 175) showed increased perinodal echogenicity. Increased perinodal echogenicity was seen in 93.5% of the necrotizing type (102 of 109) and 43.8% of the proliferative type (25 of 57); the difference between the two types was statistically significant (P = .001). Normal (n = 161), displaced (n = 13), and absent (n = 1) hilar vascularity was seen on power Doppler studies.

Conclusions

Sonographic findings of Kikuchi disease can contribute to the differentiation between Kikuchi disease and other causes of cervical lymphadenopathy.
A visita domiciliar em diálise peritoneal: aspectos relevantes ao cuidado de enfermagem The home visit in peritoneal dialysis: relevant aspects to nursing care
Authors: Cunha Lidiane Passos , Silva Frances Valéria Costa e , Santos Felipe Kaezer dos , Pires Ariane da Silva , Leone Denise Rocha Raimundo , Silva Luana Christina Souza da
Published: January 2017

Objetivos: Descrever a visita domiciliar (VD) em diálise peritoneal (DP) a partir do olhar dos usuários que ingressam em diálise peritoneal ambulatorial e discutir o significado da VD para tais sujeitos. Método: Investigação de natureza qualitativa, exploratório-descritiva, teve como cenário o ambulatório de DP de um hospital público. Os sujeitos foram sete pessoas tratadas através da DP e quatro familiares. Para a coleta de dados utilizou-se a entrevista semiestruturada. Resultados: Da análise de conteúdo do material emergiram duas categorias: I) Caracterizando a visita domiciliar a partir da ótica dos usuários que realizam Diálise Peritoneal e de seus familiares e II) Percebendo a visita domiciliar: dimensão subjetiva dos usuários que realizam Diálise Peritoneal e de seus familiares. Conclusão: A VD é um momento rico de interação enfermeiro e usuário e uma grande ferramenta para a otimização do cuidado com o indivíduo em seu domicílio.  Descritores:  Enfermagem, Visita domiciliar, Diálise peritoneal, Nefrologia.
Avaliação da adesão à terapia antirretroviral em pacientes com AIDS Evaluation of adherence to antiretroviral therapy for AIDS patients
Authors: Silva Richardson Augusto Rosendo da , Nelson Ana Raquel Cortês , Duarte Fernando Hiago da Silva , Prado Nanete Caroline da Costa , Holanda Jose Rebberty Rodrigo , Costa Danyella Augusto Rosendo da Silva
Published: January 2017

RESUMO:Objetivo: Avaliar a adesão ao tratamento antirretroviral de pacientes com AIDS. Método: Trata-se de um estudo transversal e descritivo, com abordagem quantitativa realizado em um Centro de referência de doenças infectocontagiosas em Natal/RN, no período de agosto de 2010 a julho de 2011. Coletaram-se os dados por meio dos prontuários, questionário, e registro de dispensação da farmácia. Resultados: Dos 402 pacientes estudados, 70,2% eram do gênero masculino, com média de 35 anos, e 90,0% apresentou tempo de contaminação de 1 a 5 anos. Observou-se que apenas 30% dos pacientes aderiram adequadamente ao tratamento. Conclusão: A adesão encontrada está aquém do preconizado na literatura, para aumentar a adesão à terapia antirretroviral (TARV) é indispensável a realização de estratégias de conscientização e envolvimento do usuário. Descritores: Adesão à Medicação; Terapia Antirretroviral de Alta Atividade; Infecções por HIV.  ABSTRACT:Objective: The objective of the present study was to evaluate adherence to antiretroviral treatment for AIDS patients. Method: This is a quantitative study, field,and descriptive, at Reference Center for infectious diseases in Natal/RN, from August 2010 to July 2011. Data were collected through medical records, interviews and the pharmacy dispensing records.Results: Participated in the study 402 patients, among whom (70.2%) were male, the mean age was 35 years, and 90.0 had been diagnosed of HIV infection between 1 to 5 years. It was observed that 30% of the patients adhered to treatment. Conclusion: The Adherence in the present study are lower than those recommended in the literature, to increase adherence to ART is essential to carry out strategies to increase awareness and user engagement. Descriptors: Medication Adherence; Antiretroviral Therapy; HIV Infections. RESUMEN: Objetivo: Este estudio tuvo como objetivo evaluar la adherencia al tratamiento antirretroviral para pacientes con SIDA.Método: Estudio de carácter cuantitativo, campo, llevado a cabo en un centro de referencia para las enfermedades infecciosas en Natal / RN, de agosto 2010 a julio 2011. Se recogieron los datos a través de gráficos, cuestionarios y registros de farmacia dispensadora.Resultados: De los 402 pacientes estudiados (70,2%) eran varones, con una media de 35 años, y el 90,0% mostraron contaminación momento 1-5 años. Se observó que el 30% de los pacientes se adhirió al tratamiento. Conclusión: La adherencia se encuentra más baja que las recomendadas en la literatura, para aumentar la adherencia al tratamiento antirretroviral es esencial para llevar a cabo las estrategias para aumentar el conocimiento y la participación de los usuarios. Descriptores:Cumplimiento de la Medicación; Terapia Antirretroviral Altamente Activa; Infecciones por VIH.
Como o enfermeiro líder se comunica no hospital: uma análise das práticas discursivas How leader nurse communicates in a hospital: an analysis of discursive practices
Authors: Faria Camila Cortez de , Santos Mayra Cristina Martins dos , Luz Nadia Carolline , Pereira Laiane de Fátima , Lima Rogério Silva , Haddad Jerusa Gomes Vasconcelos
Published: January 2017

Objetivo: Compreender como os enfermeiros percebem a comunicação no exercício da liderança. Métodos: Estudo de abordagem qualitativa, do tipo exploratório e descritivo com corte transversal. Foram entrevistados 13 enfermeiros assistenciais de uma instituição hospitalar. A coleta de dados ocorreu por meio de entrevista, com uso de roteiro semi-estruturado. Para organização e análise dos dados utilizou-se o referencial teórico-metodológico da análise das práticas discursivas. O estudo recebeu parecer favorável pelo Comitê de Ética e Pesquisa (Parecer nº. 476.254). Resultados: O uso da comunicação na liderança do enfermeiro é importante na condução da equipe, porém apresentou uma perspectiva unidirecional, mantendo a relação líder/subordinado. Conclusão: A comunicação se configura, predominantemente, como processo hierárquico, unidirecional, pouco aberto à dialogicidade e voltado para manutenção da ordem do trabalho no hospital, reproduzindo os pressupostos da administração clássica e pautada na divisão técnica e social da profissão.
Fatores associados às alterações cérvico-uterinas de mulheres atendidas em um município polo do oeste catarinense Factors associated to uterine-cervix changes in women assisted in a pole town in western Santa Catarina
Authors: Bedin Rafaela , Gasparin Vanessa Aparecida , Pitilin Érica de Brito
Published: January 2017

Objetivo: Identificar as alterações cérvico-uterinas nos exames citopatológicos e seus fatores associados. Métodos: Estudo retrospectivo realizado pela análises dos exames citopatológicos registrados no Sistema de Informação do Câncer no sul do país em 2014. A amostra final resultou em 1.157 laudos. Para a análise dos dados foi utilizado o software SSPP. O estudo foi aprovado pelo Comitê de Ética e Pesquisa com seres humanos da Universidade Federal da Fronteira Sul sob CAAE nº 46421815.0.0000.5564. Resultados: Predominou nas amostras os lactobacilos como agentes microbiológicos e a Gardnerella vaginalis como agente infeccioso. O colo uterino alterado, a presença de células metaplásicas associado ao diagnóstico de metaplasia foi prevalente nas mulheres de 25 a 34 anos. As inflamações(18,9%), seguido dos achados citológicos(11,8%) foram as alterações mais frequentes. Conclusão: Associaram-se ao risco de ocorrência das alterações celulares idade entre 25 a 64 anos, uso da pílula anticoncepcional, Terapia de Reposição Hormonal e epitélio metaplásico.
O processo de trabalho em um ambulatório de oncologia na percepção dos técnicos de enfermagem The process of working in an oncology outpatient clinic in the perception of the nursing technical team
Authors: Aguiar Ana Maria Zanoti , Lima Eliane de Fátima Almeida , Coelho Maria Carlota Rezende , Massaroni Leila
Published: January 2017

Objetivo: descrever como a equipe técnica de Enfermagem percebe e relata o processo de trabalho em um Ambulatório de Oncologia. Método: Estudo qualitativo, os dados foram obtidos por meio da utilização de grupo focal e analisados através da modalidade de Análise de Conteúdo. Resultado: A partir da análise dos relatos das participantes emergiu  a seguinte categoria: (re) organização do trabalho em equipe. Foram estabelecidas as unidades de análise para organizar e sequenciar as discussões: Entraves na Rede de Atenção à Saúde; Organização do trabalho centrado no profissional; Assistência fornecida ao paciente como personagem central; Dificuldade na articulação entre os micro processos realizada no Ambulatório. Conclusão: Conclui-se que o trabalho é exercido de forma fragmentada e que o processo de trabalho se reorganiza, alterando seus componentes, porém mantendo o mesmo produto.Descritores: Processo de Trabalho em Saúde, Trabalho em Enfermagem, Trabalho.
The perception of the companion of the humanized care in a pediatric intensive care unit / A percepção do acompanhante sobre o atendimento humanizado em unidade de terapia intensiva pediátrica
Authors: Villa Louise Lisboa de Oliveira , Silva Josielson Costa da , Costa Fabiana Rodrigues , Camargo Climene Laura de
Published: January 2017

Objetivo: Compreender a percepção do acompanhante da criança hospitalizada acerca do atendimento humanizado no contexto da unidade de terapia intensiva pediátrica. Métodos: Estudo descritivo e exploratório com abordagem qualitativa, desenvolvido na unidade de terapia intensiva pediátrica de um Hospital Pediátrico em Salvador, onde foram entrevistados os acompanhantes das crianças hospitalizadas. Os depoimentos foram analisados através da Técnica de Análise de Conteúdo. Resultados: As percepções dos familiares associam o significado de cuidado humanizado a um carinho e atenção maiores; valorizam as orientações dadas pela equipe de saúde e enfatizam a importância da sua presença durante toda assistência. As inquietações acerca do “não cuidado” são oriundas do sofrimento inerente à própria situação da criança. Conclusão: A percepção dos acompanhantes sobre o conceito de humanização envolve atenção, zelo, preocupação e muitas vezes até um envolvimento afetivo com o paciente e compreender a sua percepção significa estar alerta às suas reais necessidades.
Atenção à saúde de portadores de HIV: avaliação de usuários Health care for people with HIV: evaluation of users
Authors: Silva Richardson Augusto Rosendo da , Torres Gilson de Vasconcelos , Dantas Sueleide Cristina , Nelson Ana Raquel Cortês , Duarte Fernando Hiago da Silva , Costa Danyella Augusto Rosendo da Silva
Published: January 2017

Objetivo: Trata-se de um estudo avaliativo, com abordagem quantitativa que objetivou avaliar a satisfação de usuários durante o atendimento ambulatorial, realizado em um hospital referência no tratamento da AIDS em Natal/RN. Métodos: A amostra foi composta por 626 portadores de HIV em acompanhamento. Como instrumento de coleta de dados utilizou-se um formulário estruturado. Os dados foram analisados por meio de estatística descritiva e inferencial. Resultados: Observou-se que o perfil dos portadores de HIV caracterizou-se por serem do sexo masculino, com média de idade de 38 anos, procedentes da capital, com ensino fundamental, renda familiar de até dois salários mínimos, e tipo de exposição heterossexual. A avaliação do serviço foi considerada insatisfatória pela maioria dos usuários com uma diferença significativa (ρ<0,001) entre a variável satisfação e as variáveis preditoras. Conclusão: Conclui-se que a atenção à saúde no serviço, foi apontada como insatisfatória pelos pesquisados sendo esta demonstrada pelos testes estatísticos. Descritores: HIV; Síndrome de Imunodeficiência Adquirida; Avaliação de serviços de saúde; Qualidade da Assistência à Saúde.
Cuidados paliativos e comunicação: estudo com profissionais de saúde do serviço de atenção domiciliar Palliative care and communication: study with health professionals of the home care service
Authors: Brito Fabiana Medeiros , Coutinho Márcio José Ferreira , Andrade Cristiani Garrido de , Costa Solange Fátima Geraldo da , Costa Isabelle Cristinne Pinto , Santos Kamyla Félix Oliveira dos
Published: January 2017

Objetivo: Investigar se profissionais do Serviço de Atenção Domiciliar valorizam a comunicação, no âmbito dos cuidados paliativos, ao assistir o paciente sem possibilidades de cura, e averiguar quais são as estratégias comunicacionais facilitadoras que estes profissionais utilizam para promoção dos cuidados paliativos. Métodos: Pesquisa exploratória, de natureza qualitativa, realizada com 22 profissionais do Serviço de Atenção Domiciliar localizado na cidade de João Pessoa-PB. Os dados foram analisados por meio da técnica de análise de conteúdo. Resultados: Da análise, emergiram duas categorias: “Valorização da comunicação na relação entre os profissionais de saúde e o paciente sob cuidados paliativos” e “Estratégias comunicacionais utilizadas para promoção de cuidados paliativos pelos profissionais do Serviço de Atenção Domiciliar”. Conclusão: Conclui-se que a comunicação configura-se como um componente fundamental do cuidado com o paciente e é de suma relevância para a promoção dos cuidados paliativos. Descritores: Cuidados Paliativos, Comunicação, Domicílio.