893 resultados para Musculoskeletal ultrasound


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A fast, simple and environmentally friendly ultrasound-assisted dispersive liquid-liquid microextraction (USA-DLLME) procedure has been developed to preconcentrate eight cyclic and linear siloxanes from wastewater samples prior to quantification by gas chromatography-mass spectrometry (GC-MS). A two-stage multivariate optimization approach has been developed employing a Plackett-Burman design for screening and selecting the significant factors involved in the USA-DLLME procedure, which was later optimized by means of a circumscribed central composite design. The optimum conditions were: extractant solvent volume, 13 µL; solvent type, chlorobenzene; sample volume, 13 mL; centrifugation speed, 2300 rpm; centrifugation time, 5 min; and sonication time, 2 min. Under the optimized experimental conditions the method gave levels of repeatability with coefficients of variation between 10 and 24% (n=7). Limits of detection were between 0.002 and 1.4 µg L−1. Calculated calibration curves gave high levels of linearity with correlation coefficient values between 0.991 and 0.9997. Finally, the proposed method was applied for the analysis of wastewater samples. Relative recovery values ranged between 71–116% showing that the matrix had a negligible effect upon extraction. To our knowledge, this is the first time that combines LLME and GC-MS for the analysis of methylsiloxanes in wastewater samples.

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High intensity ultrasound can be used for the production of novel nanomaterials, including metal oxides. According to previous works in this field, the most notable effects are consequence of acoustic cavitation. In this context, we have studied the preparation of different materials in the presence of ultrasound, including N-doped TiO2 nanopowder, NiTiO3 nanorods and MnOx thin films. Ultrasound did not show a significant effect in all the cases. Exclusively for NiTiO3 nanorods a reduction of the final particle size occurs upon ultrasonic irradiation. From these results, it can be concluded that the ultrasound irradiation does not always play a key role during the synthesis of metal oxides. The effects seem to be particularly relevant in those cases where mass transport is highly hindered and in those procedures that require the rupture of nanoparticle aggregates to obtain a homogenous dispersion.

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The selective hydrogenation of 2-methyl-3-butyn-2-ol (MBY) was performed in the presence of Lindlar catalyst, comparing conventional stirring with sonication at different frequencies of 40, 380 and 850 kHz. Under conventional stirring, the reaction rates were limited by intrinsic kinetics, while in the case of sonication, the reaction rates were 50–90% slower. However, the apparent reaction rates were found to be significantly frequency dependent with the highest rate observed at 40 kHz. The original and the recovered catalysts after the hydrogenation reaction were compared using bulk elemental analysis, powder X-ray diffraction and scanning and transmission electron microscopy coupled with energy-dispersive X-ray analysis. The studies showed that sonication led to the frequency-dependent fracturing of polycrystalline support particles with the highest impact caused by 40 kHz sonication, while monocrystals were undamaged. In contrast, the leaching of Pd/Pb particles did not depend on the frequency, which suggests that sonication removed only loosely-bound catalyst particles.

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In this study, we compared contrast-enhanced ultrasound perfusion imaging with magnetic resonance perfusion-weighted imaging or perfusion computed tomography for detecting normo-, hypo-, and nonperfused brain areas in acute middle cerebral artery stroke. We performed high mechanical index contrast-enhanced ultrasound perfusion imaging in 30 patients. Time-to-peak intensity of 10 ischemic regions of interests was compared to four standardized nonischemic regions of interests of the same patient. A time-to-peak >3 s (ultrasound perfusion imaging) or >4 s (perfusion computed tomography and magnetic resonance perfusion) defined hypoperfusion. In 16 patients, 98 of 160 ultrasound perfusion imaging regions of interests of the ischemic hemisphere were classified as normal, and 52 as hypoperfused or nonperfused. Ten regions of interests were excluded due to artifacts. There was a significant correlation of the ultrasound perfusion imaging and magnetic resonance perfusion or perfusion computed tomography (Pearson`s chi-squared test 79.119, p < 0.001) (OR 0.1065, 95% CI 0.06-0.18). No perfusion in ultrasound perfusion imaging (18 regions of interests) correlated highly with diffusion restriction on magnetic resonance imaging (Pearson's chi-squared test 42.307, p < 0.001). Analysis of receiver operating characteristics proved a high sensitivity of ultrasound perfusion imaging in the diagnosis of hypoperfused area under the curve, (AUC = 0.917; p < 0.001) and nonperfused (AUC = 0.830; p < 0.001) tissue in comparison with perfusion computed tomography and magnetic resonance perfusion. We present a proof of concept in determining normo-, hypo-, and nonperfused tissue in acute stroke by advanced contrast-enhanced ultrasound perfusion imaging.

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Mode of access: Internet.

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"Cooperative agreement no. CR818353."

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Mode of access: Internet.

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Mode of access: Internet.

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"From the longitudinal sample of disability insurance applicants."

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Background: Infraclavicular brachial plexus nerve blockade (ICNB) is a very common anesthetic procedure performed for upper extremity surgery at the elbow and distally, however the rate of adequate analgesia is variable among patients. Ultrasound guidance (US) has not been demonstrated to increase the success rate of ICNB when compared to nerve stimulator (NS) guidance. Combined US and NS guided ICNB have not been reported, although there is a call for more trials comparing the two techniques. This study was performed to observe if a specific anatomic region near the axillary artery of the brachial plexus identified by finger flexion with nerve stimulation results in improved postoperative analgesia. Method: Patients undergoing elective elbow arthroplasty received a postoperative ICNB. The angle of the nerve stimulator needle tip and the radial distance from the center of the arterial lumen at which an optimal finger flexion twitch response was observed were measured with ultrasound imaging. Pain scores and postoperative opioid dosages on discharge from the post anesthesia care unit and at 24 hours after surgery were recorded. Results: 11 patients enrolled in this study. Adequate finger flexion response to nerve stimulation that resulted in complete analgesia was more frequently observed when the needle was located in the postero-superior quadrant in relation to the axillary artery. Identifying a specific point near the brachial plexus in relation to the artery that consistently provides superior analgesia is desirable and would lead to improved analgesia and faster onset time of nerve blockade and would reduce the need for other approaches for brachial plexus blockade with their associated disadvantages.

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1.1 Background and Purpose: Ultrasound guided sciatic nerve blockade has rapid onset but at 24 hours pain is greater than nerve stimulator techniques. Injection of the nerve branches or trunk and sub-sheath blockade increase success and reduce onset times but risk injury. This study mapped needle coordinates for sciatic nerve blockade with nerve stimulation and its relation to postoperative pain scores. 1.2 Method: Angle and distance of the needle tip and infusion catheter from the popliteal sciatic nerve at which stimulated plantar flexion occurred were measured. Pain scores at postanesthesia unit discharge and 24 hours were recorded. 1.3 Results: 81% of opioid naïve patients reported immediate analgesia and 20.8% at 24 hours. In opioid tolerant patients 56.8% reported immediate analgesia and 9.1% at 24 hours. Plantar flexion was observed with the needle in the posterior medial quadrant near the sciatic nerve. Opioid tolerant patients reported adequate analgesia when the needle was located more medially and proximally to the sciatic nerve. 1.4 Conclusion: Stimulated plantar flexion is isolated to a narrow angular range in the posterior medial quadrant adjacent to the sciatic nerve. Opioid tolerant patients report adequate analgesia if the needle and catheter are more medial and proximal to the nerve surface.

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Background and Objectives: Improved ultrasound and needle technology make popliteal sciatic nerve blockade a popular anesthetic technique and imaging to localize the branch point of the common peroneal and posterior tibial components is important because successful blockade techniques vary with respect to injection of the common trunk proximally or separate injections distally. Nerve stimulation, ultrasound, cadaveric and magnetic resonance studies demonstrate variability in distance and discordance between imaging and anatomic examination of the branch point. The popliteal crease and imprecise, inaccessible landmarks render measurement of the branch point variable and inaccurate. The purpose of this study was to use the tibial tuberosity, a fixed bony reference, to measure the distance of the branch point. Method: During popliteal sciatic nerve blockade in the supine position the branch point was identified by ultrasound and the block needle was inserted. The vertical distance from the tibial tuberosity prominence and needle insertion point was measured. Results: In 92 patients the branch point is a mean distance of 12.91 cm proximal to the tibial tuberosity and more proximal in male (13.74 cm) than female patients (12.08 cm). Body height is related to the branch point distance and is more proximal in taller patients. Separation into two nerve branches during local anesthetic injection supports notions of more proximal neural anatomic division. Limitations: Imaging of the sciatic nerve division may not equal its true anatomic separation. Conclusion: Refinements in identification and resolution of the anatomic division of the nerve branch point will determine if more accurate localization is of any clinical significance for successful nerve blockade.