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Comparison associated with Telemedicine Screening process regarding Person suffering from diabetes Retinopathy by simply Mydriatic Smartphone-Based compared to Nonmydriatic Table Camera-Based Fundus Photo.
We re-expressed FBM's algebraic expressions for velocity and observed for the first time that both models' expressions are identical e'(t) = g e- at sinh(bt). We also provide exact algebraic relations relating the three PDF to the six FBM parameters. The model-predicted expression for e'(t) does not dependent on the model-specific framework for suction or equilibrium volume. Prior experiments by Opdahl (16) and the current exact intermodel agreement establish that 3 PDF parameters relaxation, stiffness (restoring forces) and load are unique DF/[e'(t)] determinants. Thus, we show that only the PDF formalism can compute unique, independent, physiologic determinants of long-axis cardiac velocity during diastole.Myocardial edema is a consequence of many cardiovascular stressors, including myocardial infarction, cardiac bypass surgery, and hypertension. The aim of this study was to establish a murine model of myocardial edema and elucidate the response of cardiac lymphatics and the myocardium. Myocardial edema without infarction was induced in mice by cauterizing the coronary sinus, increasing pressure in the coronary venous system, and inducing myocardial edema. In male mice, there was rapid development of edema 3 h following coronary sinus cauterization (CSC), with associated dilation of cardiac lymphatics. By 24 h, males displayed significant cardiovascular contractile dysfunction. In contrast, female mice exhibited a temporal delay in the formation of myocardial edema, with onset of cardiovascular dysfunction by 24 h. Furthermore, myocardial edema induced a ring of fibrosis around the epicardial surface of the left ventricle in both sexes that included fibroblasts, immune cells, and increased lymphatics. Interestironary sinus pressure to induce myocardial edema, demonstrating distinct sex differences in the response to myocardial edema. The temporal pattern of myocardial edema induction and resolution is different between males and females, underscoring sex-dependent differences in the response to myocardial edema. This model provides an important platform for future research in cardiovascular and lymphatic fields with the potential to develop therapeutic interventions for many common cardiovascular diseases.Using high-fidelity micromanometers and flow velocity sensors at right heart catheterization, we compared pulmonary hemodynamics and wave reflections in age-matched normal adults and those with atrial septal defects, separated into three subgroups based on levels of mean pulmonary artery pressure low ( 26 mmHg). We made baseline measurements in all groups and after intravenous sodium nitroprusside in the subgroups. All the subgroups had higher than normal baseline pulmonary flows and corresponding power - which did not differ among the subgroups. The pulmonary vascular resistance, input resistance and characteristic impedance in the subgroups did not differ from normal. Aside from the elevated flow and power, the hemodynamics in the low subgroup did not differ from normal. The intermediate subgroup had significantly higher than normal right ventricular and pulmonary artery pressures, wave reflections, and shorter wave reflection time - which all reverted to normal after nitroprusside. The high subgroup had similar changes as the intermediate subgroup . Blasticidin S in vivo Unlike that subgroup, however, the pressures, wave reflections and reflection return time did not revert to normal after nitroprusside. Hence, elevated wave reflections, but not resistance or characteristic impedance, are the hallmark of pulmonary hypertension in adults with atrial septal defects. Our results demonstrate that detailed measurements of hemodynamics and assessment of responsiveness to vasodilators, provide important information about the pulmonary circulation in atrial septal defect. Coupled with studies after defect closure, those results may be a better foundation than current ones for clinical decisions.There is a sustained reduction in arterial blood pressure that occurs in aged adults following exposure to acute leg heating. We tested the hypothesis that acute leg heating would decrease arterial blood pressure in aged adults secondary to sympathoinhibition. Thirteen young and 10 aged adults were exposed to 45 min of leg heating. Muscle sympathetic nerve activity (radial nerve) was measured before leg heating (Pre-heat) and 30 min after (Recovery), and is expressed as burst frequency. Neurovascular transduction was examined by assessing the slope of the relation between muscle sympathetic nerve activity and leg vascular conductance measured at rest and during isometric handgrip exercise performed to fatigue. Arterial blood pressure was well maintained in young adults (Pre-heat, 86 ± 6 mmHg vs. Recovery, 88 ± 7 mmHg; P = 0.4) due to increased sympathetic nerve activity (Pre-heat, 16 ± 7 bursts min-1 vs. Recovery, 22 ± 10 bursts min-1; P less then 0.01). However, in aged adults, sympathetic nerve activity did not differ from Pre-heat (37 ± 5 bursts min-1) to Recovery (33 ± 6 bursts min-1, P = 0.1), despite a marked reduction in arterial blood pressure (Pre-heat, 101 ± 7 mmHg vs. Recovery, 94 ± 6 mmHg; P less then 0.01). Neurovascular transduction did not differ from Pre-heat to Recovery for either age group (P ≥ 0.1). The reduction in arterial blood pressure that occurs in aged adults following exposure to acute leg heating is mediated, in part, by a sympathoinhibitory effect that alters the compensatory neural response to hypotension.OBJECTIVES Magnetic resonance imaging (MRI) is established for measurement of body fat mass (FM) and abdominal visceral adipose tissue (VAT). Anthropometric measurements and bioelectrical impedance analysis (BIA) have been proposed as surrogates to estimation by MRI. Aim of this work is to assess the predictive value of these methods for FM and VAT measured by MRI. METHODS Patients were selected from cohort study XXXXXXXX (prediction, prevention and subclassification of Type 2 Diabetes). Total FM and VAT were quantified by MRI and BIA together with clinical variables like age, waist and hip circumference and height. Least-angle regressions were utilized to select anthropometric and BIA parameters for their use in multivariable linear regression models to predict total FM and VAT. Bland-Altman plots, Pearson correlation coefficients, Wilcoxon signed-rank tests and univariate linear regression models were applied. RESULTS 116 females with 35 ± 3 years and a body mass index of 25.1 ± 5.3 kg/m2 were included into the analysis. A multivariable model revealed weight (β = 0.516, p less then 0.001), height (β = -0.223, p less then 0.001) and hip circumference (β = 0.156, p = 0.003) as significantly associated with total FM measured by MRI. A additional multivariable model also showed a significant predictive value of FMBIA (β = 0.583, p less then 0.001) for FM. In addition, waist circumference (β = 0.054, p less then 0.001), weight (β = 0.016, p = 0.031) in one model and FMBIA (β = 0.026, p = 0.018) in another model were significantly associated with VAT quantified by MRI. However, deviations reached more than 5 kg for total FM and more than 1 kg for VAT. CONCLUSIONS Anthropometric measurements and BIA show significant association with total FM and VAT. ADVANCES IN KNOWLEDGE As these measurements show significant deviations from the absolute measured values determined by MRI, MRI should be considered the gold standard for quantification.RATIONALE Chronic rhinosinusitis (CRS) contributes to disease burden of patients with cystic fibrosis (CF). However, its onset and progression in infants and preschool children with CF remain poorly understood. OBJECTIVES To determine the prevalence and extent of CRS in young children with CF using magnetic resonance imaging (MRI). METHODS MRI was performed in sedation in 67 infants and pre-school children with CF (mean age 2.3±2.1y, range 0-6y) and 30 non-CF controls (3.5±2.0y, range 0-6y). Paranasal sinus dimensions and structural abnormalities incl. mucosal swelling, mucopyoceles, and nasal polyps of the maxillary, frontal, sphenoid and ethmoid sinuses, and in addition medial maxillary sinus wall deformation were assessed using a dedicated CRS MRI scoring system. RESULTS Pneumatization and dimensions of paranasal sinuses did not differ between the two groups. MRI detected an increased prevalence of mucosal swelling (83% vs 17%, P less then 0.001), mucopyoceles (75% vs 2%, P less then 0.001), polyps (26% vs 7%, P less then 0.001) and maxillary sinus wall deformation (68% vs 2%, P less then 0.001) in infants and preschool children with CF compared to age-matched controls. Further, the extent of these abnormalities was also increased with a MRI sum score of 22.9±10.9 in CF compared to 4.5±7.6 in non-CF controls (P less then 0.001). CONCLUSIONS MRI detected normal dimensions of paranasal sinuses, and a high prevalence and severity of paranasal sinus abnormalities due to CRS in infants and preschool children with CF without radiation exposure. Our results support the development of MRI for sensitive non-invasive diagnosis and monitoring of CRS in young children with CF, and as outcome measure for clinical trials.OBJECTIVE Ultrasound elastography is increasingly used in the diagnosis of prostate cancer, however results are heterogeneous. We correlate in a large sample-size prospective study the accuracy of elastography, aiming to settle an accurate cut-off point for diagnosis and possibility of use as a screening tool. METHODS Prospective study that included 120 patients with mean age 59.5 ± 9.8 years, showing enlarged prostate by clinical examination with prostate-specific antigen >4 ng ml-1.The study was done using high frequency high resolution endorectal probe with real time tissue elastography.Grayscale ultrasound examination was done first with Doppler followed by elastography color-coded map and strain ratio measurement. Then, transrectal ultrasound-guided core biopsy was done from suspicious areas detected by elastography (totally or partly stiff by color-coded map or with relative increased strain ratio), besides standard six-quadrant core biopsy samples. RESULTS There was statistically significant difference (p less then 0.001) regarding strain ratio in benign and malignant lesions. Strain ratio showed significant proportionate correlation with prostate-specific antigen level and Gleason pathological score, while no significant correlation noted with the age or the prostatic volume. A strain ratio with a cut-off value of 1.9 showed a sensitivity of 100%, specificity 93.8%, positive predictive value of 79.3%, negative predictive value 100 and 95% accuracy in differentiating between malignant and benign lesions. CONCLUSION Strain ratio improves the detection of prostatic cancer with high sensitivity (100%) and high negative predictive value (100%). ADVANCES IN KNOWLEDGE Different prostatic lesions are mostly similar in grayscale ultrasound.Imaging plays an important role in differentiation of prostatic nodules.Ultrasound elastography may play an important role in distinguishing benign from malignant nodules.OBJECTIVES Assessment of the extent of variation in delineations and dose optimisation performed at multiple UK centres as a result of inter-observer variation and protocol differences. METHODS CT/MR images of two cervical cancer patients previously treated with External Beam Radiotherapy (EBRT) and Brachytherapy were distributed to eleven UK centres. Centres delineated structures and produced treatment plans following their local protocol. OAR delineations were assessed dosimetrically through application of the original treatment plan and target volume delineations were assessed in terms of variation in absolute volume and length, width and height. Treatment plan variation was assessed across all centres and across centres that followed EMBRACE II. Treatment plans were assessed using total EQD 2 delivered and were compared to EMBRACE II dose aims. Variation in combined intracavitary/interstitial Brachytherapy treatments was also assessed. RESULTS Brachytherapy target volume delineations contained variation due to differences in protocol used, window/level technique and differences in interpretations of grey zones.
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