An overview of opioid usage and regional anesthesia for patients undergoing repair of anorectal malformation

xlomafota.13 shared this article with you from Inoreader An overview of opioid usage and regional anesthesia for patients undergoing repair of anorectal malformation Via Latest Results for Pediatric Surgery International Abstract Purpose The recent opioid crisis in the USA compelled us to evaluate our practice of opioid use for postoperative pain management and the influence of regional anesthesia on opioid requirement in patients undergoing repair of anorectal malformations. Methods A retrospective chart review was performed evaluating patients who underwent posterior sagittal anorectoplasty (PSARP) and posterior sagittal anorecto-vagino-urethroplasty (PSARVUP), with or without laparotomy, between January 2016 and March 2020. Morphine milligram equivalents per kilogram (MME/kg) were calculated. IRB approval was obtained for this study. Results A total of 105 surgical patients had either a PSARP (74 without laparotomy, 10 with laparotomy) or PSARVUP (13 without laparotomy, 8 with laparotomy). Regional anesthesia included epidurals, transversus abdominis plane block, caudal block or paravertebral catheters. Of the PSARP patients, 4 without laparotomy and 7 with laparotomy received regional anesthesia. For PSARVUP with laparotomy, 4/8 received regional. 44% of PSARP patients without laparotomy did not require opioids postoperatively. The MME/kg required exponentially increased for patients over the age of 5 who underwent PSARP. Conclusions Regional anesthesia is a useful modality for pain control for PSARP/PSARVUP with laparotomy, decreasing the opioid usage, but it is unnecessary for the already low opioid requirements, in patients younger than 5 years of age, without laparotomy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A novel partition selection method for modular face recognition approaches on occlusion problem

xlomafota.13 shared this article with you from Inoreader A novel partition selection method for modular face recognition approaches on occlusion problem Via Latest Results for Machine Vision and Applications Abstract Recognizing the face with partial occlusion is an important problem for many face recognition applications. Since the occluded parts have no contribution to recognize the face, these parts should be excluded when performing the classification. In this paper, we propose a new method to detect and to use the non-occluded parts of face image for modular face recognition approaches. The occlusion of a partition is decided using the combination of three coefficients which can be easily derived: (i) image entropy, (ii) image correlation, (iii) root-mean-square error. The performance of the proposed partition selection method is tested using the modular extensions of three subspace-based approaches, namely linear regression classification (LRC), common vector approach (CVA), and discriminative common vector approach (DCVA). Modular DCVA is also proposed for the first time in this paper. After the selection of the non-occluded partitions of the face image, LRC, CVA, an d DCVA are applied to each of the partitions independently. Then the classifier supports acquired from each of the partitions are combined using three well-known (product, sum, and Borda count) methods to get the final decision. The experiments implemented on the AR and the Extended Yale B face databases show that selection of the face partitions using the proposed strategy improves the recognition accuracy and outperforms state-of-the-art methods. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Fast approach for moving vehicle localization and bounding box estimation in highway traffic videos

xlomafota.13 shared this article with you from Inoreader Fast approach for moving vehicle localization and bounding box estimation in highway traffic videos Via Latest Results for Signal, Image and Video Processing Abstract Detection and accurate localization of position of moving vehicles in a video sequence are the primary tasks in every computer vision-based traffic monitoring system. In this paper, a moving vehicle localization and bounding box estimation algorithm is proposed. The moving vehicle foreground is separated from the static background by the adaptive background subtraction method, and the bounding box of moving vehicles is estimated with two-dimensional binary histogram projection profile (2D-BHPP) algorithm. The foreground object refinement is performed by means of morphological closing operation prior to apply the 2D-BHPP algorithm. The proposed method only computes the four necessary minimum bounding box coordinates, i.e., left, right, upper, and lower of moving vehicles in every frame. The proposed method is tested over three publicly available data sets, and the results show that the localization algorithm works comparatively faster and accurately than the exist ing localization methods. The detection error rate, IoU metric, and execution time per frame signify that this approach can be implemented in edge-based real-time applications. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ultrasound evaluation of ductal carcinoma in situ of the breast

xlomafota.13 shared this article with you from Inoreader Ultrasound evaluation of ductal carcinoma in situ of the breast Via Latest Results for Journal of Ultrasound Abstract Purpose To assess the role of ultrasound (US) in detecting and characterizing ductal carcinoma in situ (DCIS) of the breast and to investigate the correlation between ultrasonographic and biological features of DCIS. Methods In total, 171 patients (mean age 44; range 39–62) with 178 lesions were retrospectively evaluated by two independent radiologists searching for US mass or non-mass lesions. Immunohistochemistry analysis was performed to determine estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression. The US detection rate and pattern distribution among the lesion types were evaluated. The χ2 test was used to evaluate the correlation between the US findings and the biological factors. Statistical significance was indicated by p values < 0.05. Inter-observer agreement was calculated by Kohen's k test. Results US detected 35% (63/178) of all lesions. Fifty-two (83%) lesions were classified as mass lesions, and 11 (17%) as non-mass lesions (p < 0.0001). Among the mass lesions, the most common shape was irregular (79%; p < 0.0001), with 45 (87%) lesions having indistinct margins. Hypoechogenicity was the most common echo pattern (49 cases, 94%; p < 0.0001). Microcalcifications were found in 23 cases (37%; p = 0.004) and were associated with mass lesions in 15 cases (65%) and with non-mass lesions in 8 cases (35%) (p = 0.21). An almost perfect inter-observer agreement (k = 0.87) was obtained between the two radiologists. A significant ER expression was found in mass lesions (83%; p < 0.0001), with no significant PR (p = 0.89) or HER2 expression (p = 0.81). Among the lesions with microcalcifications, only 7 out of 23 cases (30%) were positive f or HER2 (p = 0.09). Conclusion DCIS represents a heterogeneous pathological process with variable US appearance (mass-like, non-mass-like, or occult). The most common US finding is represented by mass-type, hypoechogenic lesions with indistinct margins. A significant ER expression exists among mass-type lesions, while microcalcifications seem not to be associated with HER2 expression. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of testicular vascularity via superb microvascular imaging in varicocele patients with contralateral normal testis and healthy volunteers

xlomafota.13 shared this article with you from Inoreader Comparison of testicular vascularity via superb microvascular imaging in varicocele patients with contralateral normal testis and healthy volunteers Via Latest Results for Journal of Ultrasound Abstract Purpose In this study, we aimed to determine vascular changes in the testes in patients with varicocele using the two-dimensional color superb microvascular imaging vascular index (2DcSMIVI) and compared them with those of the normal contralateral testes of the same patients as well as the normal testes of control subjects without varicocele. Methods A total of 114 participants and 228 testes were included in the study. 63 patients with varicocele and 51 asymptomatic volunteers were included. In total, 70 testes with varicocele (group A), 56 normal contralateral testes (Group B), and 102 bilateral normal testes were classified (Group C). Participants' testicular volume and 2DcSMIVI values were obtained via superb microvascular imaging. Testes with varicocele were graded according to Sarteschi classification. Results Statistically significant differences in mean testicular volume were observed among the three groups. The volume and 2DcSMIVI values of the varicocele side testes were significantly lower than those of groups B and C. Significant differences were also observed between Sarteschi grade and 2DcSMIVI values in group A. Conclusion We can determine impaired microcirculation of varicocele side testes quantitatively with the 2DcSMIVI technique, and obtained VI values can be used effectively in diagnosis and follow-up of the damage in testes. Our results show that 2DcSMIVI values can play a significant role in the evaluation of testicular blood flow as a predictive sign of testicular damage. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ultrasound evaluation of the first finger’s sesamoid bones: diagnostic value of sesamoid and subsesamoid indices

xlomafota.13 shared this article with you from Inoreader Ultrasound evaluation of the first finger's sesamoid bones: diagnostic value of sesamoid and subsesamoid indices Via Latest Results for Journal of Ultrasound Abstract Purpose Our analysis focuses explicitly on applying two sonographic and morphological indexes (sesamoid index and subsesamoid index) to better evaluate post-traumatic consequences to the sesamoids of the first finger. Methods In 2 years, we enrolled 75 patients, divided into two groups: 60 without any history of trauma and 15 reporting hyperextension trauma of the first finger. We performed clinical and instrumental examinations (sonography and X-ray) on patients with one or more symptoms compatible with sesamoiditis, while an MRI scan was performed only on patients with an acute onset and severe symptomatology. We measured both the short and long-axis diameter (in mm) for each sesamoid as well as the relation between the two parameters (sesamoid index, SI and subsesamoid index, SubI). Results All 15 patients showed sonographic alterations of the SI above the reference range, while the alterations of SubI varied according to the acuteness and gravity of trauma. In all cases, the X-ray did not show any relevant alterations. MRI scans in patients with acute symptoms confirmed the sonographic findings. Conclusion Sonography enabled diagnosis of micro-injuries which were invisible to X-Ray and allowed to detect possible damages to the sesamoid complex, providing a qualitative and quantitative evaluations of the post-traumatic alteration of the metacarpophalangeal joint of the 1st finger and is therefore valid, combined with clinical examination and hand X-ray, in the evaluation of sesamoiditis without the need to perform further examinations. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Contrast-enhanced ultrasound features of breast capillary hemangioma: a case report and review of literature

xlomafota.13 shared this article with you from Inoreader Contrast-enhanced ultrasound features of breast capillary hemangioma: a case report and review of literature Via Latest Results for Journal of Ultrasound Abstract Breast capillary hemangioma is a rare benign vascular tumor. A 59‐year‐old asymptomatic woman underwent screening mammography and breast ultrasound. B-mode ultrasound revealed a lobulated, hypoechoic mass. Color Doppler ultrasound showed no intratumoral blood flow. Contrast-enhanced ultrasound (CEUS) revealed internal fast homogeneous contrast enhancement of the mass and persistent enhancement after 4 min. A 14‐gauge core needle biopsy was then performed. The radiologic and pathologic appearances were concordant with breast capillary hemangioma. The ultrasonic manifestations of breast hemangioma may vary, and differentiation from other inflammatory diseases and malignancies is challenging. CEUS may help in observing the vascular characteristics of breast capillary hemangioma. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Air bronchogram integrated lung ultrasound score to monitor community-acquired pneumonia in a pilot pediatric population

xlomafota.13 shared this article with you from Inoreader Air bronchogram integrated lung ultrasound score to monitor community-acquired pneumonia in a pilot pediatric population Via Latest Results for Journal of Ultrasound Abstract Aims Chest ultrasound is a non-invasive method for evaluating children with suspected community-acquired pneumonia (CAP). We evaluated the prognostic role of change of ultrasonographic (US) air bronchogram in management of CAP in terms of: rate of complicated CAP, change of empiric antibiotic therapy, relationship to defervescence time, and length of hospitalization. Methods Patients with CAP and radiographic evidence of lung consolidation were prospectively enrolled. Chest US examinations were performed within 12 h from admission and after 48 h. A new grading system (USINCHILD score) based on presence and features of air bronchogram was adopted. Results Thirty six patients were stratified into two groups according to the presence of an increase of at least 1 grade of US score (Δ US grade), expression of an improvement of lung consolidation. Δ US grade after 48 h ≥ 1 was associated with an increased risk of complicated CAP (p value 0.027) and a longer defervescence time (p value 0.036). Moreover, Δ US grade ≥ 1 was predictive of a short hospitalization (p value 0.008). Conclusions USINCHILD score could be an innovative biotechnology tool for the management of pediatric CAP. Trial registration number and date of registration NCT03556488, June 14, 2018. Graphic abstract View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Smoothed particle hydrodynamics simulation of biphasic soft tissue and its medical applications

xlomafota.13 shared this article with you from Inoreader Smoothed particle hydrodynamics simulation of biphasic soft tissue and its medical applications Via Latest Results for Medical & Biological Engineering & Computing Abstract Modeling the coupled fluid and elastic mechanics of blood perfused soft tissues is important for medical applications. In particular, the current study aims to capture the effect of tissue swelling and the transport of blood through damaged tissue under bleeding or hemorrhaging conditions. The soft tissue is considered a dynamic poro-hyperelastic material with blood-filled voids. A biphasic formulation—effectively, a generalization of Darcy's law—is utilized, treating the phases as occupying fractions of the same volume. A Stokes-like friction force and a pressure that penalizes deviations from volume fractions summing to unity serve as the interaction force between solid and liquid phases. The resulting equations for both phases are discretized with the method of smoothed particle hydrodynamics (SPH). The solver is validated separately on each phase and demonstrates good agreement with exact solutions in test problems. Simulations of oozing, hysteresis, sw elling, drying and shrinkage, and tissue fracturing and hemorrhage are shown in the paper. Graphical Abstract In the paper, a new methodology for the numerical simulation of the full dynamic response of blood-perfused soft tissues was developed. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Closure of Gastrointestinal Fistulas and Leaks with the Over-the-Scope Clip: Case-Series Analysis

xlomafota.13 shared this article with you from Inoreader Closure of Gastrointestinal Fistulas and Leaks with the Over-the-Scope Clip: Case-Series Analysis Via Latest Results for Indian Journal of Surgery Abstract Over-the-scope clip (OTSC) is widely used in clinics for the treatment of iatrogenic perforations and fistulas and for hemostasis. The aim of this study was to retrospectively evaluate cases applied with the over-the-scope clip for gastrointestinal fistula or leakage. The study included patients on whom over-the-scope clip was performed because of leakage or fistula in the gastroenterology surgery endoscopy unit between June 2016 and January 2020. The cases were evaluated in terms of age, gender, diagnosis, localization of the defect, additional disease, size of the defect, procedure success, clinical success, number of clips, time of over-the-scope-clip application after the first procedure and duration of follow-up. In 9 patients, 11 over-the-scope clips were used. The procedure was performed in the upper gastrointestinal tract in 5 (55.56%) cases and in the lower gastrointestinal tract in 4 (44.44%) cases. Technical success was achieved in all 11 procedures pe rformed in 9 cases. Long-term clinical success was achieved in 8 of 9 cases. The over-the-scope clip is an endoscopic method that can be used safely in the treatment of gastrointestinal fistulas and leakage of < 1 cm with a low possibility of morbidity and a high success rate. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Trans-pulmonary closure of an aorto-pulmonary window in a patient of tetralogy of Fallot: a case report

xlomafota.13 shared this article with you from Inoreader Trans-pulmonary closure of an aorto-pulmonary window in a patient of tetralogy of Fallot: a case report Via Latest Results for Indian Journal of Thoracic and Cardiovascular Surgery Abstract We present a case of tetralogy of Fallot (TOF) accompanied by a type II aorto-pulmonary window with severe pulmonary arterial hypertension in a pediatric patient. A successful repair of tetralogy of Fallot with trans-pulmonary patch closure of aorto-pulmonary window was done. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.