scholarly journals Thyroid and Hepatic Haemodynamic Alterations among Egyptian Children with Liver Cirrhosis

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Zeinab A. El-Kabbany ◽  
Rasha T. Hamza ◽  
Ahmed S. Abd El Hakim ◽  
Lamis M. Tawfik
Keyword(s):  
Hepatic Artery ◽  
Pulsatility Index ◽  
Standard Deviation Score ◽  
Resistance Index ◽  
Thyroid Volume ◽  
Thyroid Stimulating Hormone ◽  
Inferior Thyroid Artery ◽  
Egyptian Children ◽  
Cirrhotic Patients ◽  
Arterial Haemodynamics

Background. Alterations in thyroid hormones regulation and metabolism are frequently observed in patients with cirrhosis. Aims. To assess alterations in thyroid volume (TV), haemodynamics, and hormones in patients with cirrhosis and their relation to hepatic arterial haemodynamics, and disease severity. Methods. Forty cirrhotic patients were compared to 30 healthy subjects regarding TV, free triiodiothyronine (fT3), free tetraiodothyronine (fT4), thyroid stimulating hormone (TSH), and pulsatility and resistance indices in the inferior thyroid and hepatic arteries. Results. TV (P=0.042), thyroid volume standard deviation score (TVSDS, P=0.001), Inferior Thyroid Artery Pulsatility Index (ITAPI, P=0.001), Inferior Thyroid Artery Resistance Index (ITARI, P=0.041), Hepatic Artery Pulsatility Index (HAPI, P=0.029) and Hepatic Artery Resistance Index (HARI, P=0.035) were higher among cases being highest in Child-C patients. FT3 was lower in patients than controls (P=0.001) and correlated negatively with ITAPI (r=−0.71, P=0.021) and ITARI (r=−0.79, P=0.011). ITAPI and ITARI correlated directly with HAPI and HARI (r=0.62, P=0.03, and r=0.42, P=0.04, resp.). Conclusions. Thyroid is involved in the haemodynamic alterations of cirrhosis. Routine study of thyroid by Doppler and assessment of thyroid functions should be performed in patients with cirrhosis to offer proper treatment if needed.

Thyroid Volume and Thyroid Function Parameters Are Independently Associated with Weight Status in Overweight Children

2020 ◽  
Vol 93 (5) ◽  
pp. 279-286
Author(s):  
Nina Lass ◽  
Andre Barth ◽  
Thomas Reinehr
Keyword(s):  
Insulin Resistance ◽  
Thyroid Function ◽  
Weight Status ◽  
Resistance Index ◽  
Thyroid Volume ◽  
Thyroid Stimulating Hormone ◽  
Normal Weight ◽  
Function Parameter ◽  
Overweight Children ◽  
Cross Sectional

<b><i>Background:</i></b> A relation between thyroid-stimulating hormone (TSH), insulin resistance – both of which are related to obesity – and thyroid volume has been suggested. Therefore, we analyzed thyroid volume and structure in relation to thyroid function parameters, weight status, and insulin resistance. <b><i>Methods:</i></b>This is a cross-sectional study in which weight status (BMI-SDS), thyroid function parameters (TSH, free tri-iodothyronine [fT3], and free thyroxine [fT4]), insulin resistance index (HOMA-IR), and thyroid volume (ultrasound) were determined in 617 overweight children (aged 10.4 ± 2.2 years, 50% male, BMI-SDS 2.5 ± 0.6) and in 27 normal-weight children of a similar age and gender. Furthermore, changes in thyroid volume and structure, and thyroid function parameters were analyzed in 83 obese children (51% male, mean age 10.3 ± 2.2) at baseline and at the end of a 1-year lifestyle intervention. <b><i>Results:</i></b> Overweight children had a significant greater thyroid volume (4.2 ± 1.8 vs. 4.1 ± 0.5 mL) and higher TSH (3.1 ± 1.5 vs. 2.4 ± 1.1 mU/L) and fT3 (4.4 ± 0.7 vs. 4.1 ± 0.5 pg/mL) concentrations compared to normal-weight children. In multiple linear regression analyses adjusted to multiple confounders, thyroid volume was significantly related to BMI-SDS (<i>b</i> coefficient 0.44 ± 0.10, <i>r</i><sup>2</sup> = 0.41) but not to any thyroid function parameter or HOMA-IR. Changes in BMI-SDS were significantly associated with changes in thyroid volume (<i>r</i> = 0.22). The changes in thyroid volume were not correlated to changes of any thyroid function parameter or HOMA-IR. <b><i>Conclusions:</i></b> Thyroid volume is positively correlated to weight status in childhood obesity and the change is reversible after weight loss independently of thyroid function parameters and insulin resistance. Further studies are needed to understand why thyroid volume is increased reversibly in overweight children.

scholarly journals Role of portal color Doppler ultrasonography as noninvasive predictive tool for esophageal varices in cirrhotic patients

2022 ◽  
Vol 53 (1) ◽  
Author(s):  
Mohamed Alaa ELdin Nouh ◽  
Mohamed Kamel Abd-Elmageed ◽  
Amany Abas Mohamed Amer ◽  
Moamena Said ELhamouly
Keyword(s):  
Portal Vein ◽  
Hepatic Artery ◽  
Esophageal Varices ◽  
Resistance Index ◽  
Cirrhotic Liver ◽  
Control Group ◽  
Predictive Tool ◽  
Endoscopic Screening ◽  
Cirrhotic Patients

Abstract Background Esophageal varices (EV) is the most common apprehensive complication of portal hypertension in patients with cirrhotic liver. Guidelines recommend Upper gastro-intestinal endoscopic screening for EV in patients with newly diagnosed chronic cirrhosis (Imperiale et al. in Hepatology 45(4):870–878, 2007). Yet, it is invasive, time consuming and costly. To avoid unnecessary endoscopy, some studies have suggested Doppler ultrasound examination as simple, and noninvasive tool in prediction and assessment of severity of EV (Agha et al. in Dig Dis Sci 54(3):654–660, 2009). Our study was to assess the role of different Doppler indices of portal vein, hepatic and splenic arteries as a noninvasive tool for prediction of esophageal varices in cirrhotic patients. Results This prospective case control study was conducted on 100 cirrhotic liver patients and 100 of healthy volunteers as control group. Patients were subjected to clinical examination, upper gastrointestinal tract endoscopy, abdominal ultrasonography with duplex Doppler evaluation of different portal Doppler hemodynamic indices were done for each patient. The results revealed that portal vein diameter, hepatic artery pulsatility index, portal hypertensive index, portal vein flow velocity, portal congestion index have high sensitivity for prediction of EV. However, Splenic artery resistance index, hepatic artery resistance index HARI, liver vascular index and platelet count/spleen diameter have less sensitivity for prediction of EV. Conclusion Measuring the portal hemodynamic indices can help physicians as noninvasive predictors of EV in cirrhotic patients to restrict the need for unnecessary endoscopic screening especially when endoscopic facilities are limited.

scholarly journals Doppler ultrasound in liver cirrhosis: correlation of hepatic artery and portal vein measurements with model for end-stage liver disease score in Egypt

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Ahmed Abdelrahman Mohamed Baz ◽  
Rana Magdy Mohamed ◽  
Khaled Helmy El-kaffas
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Portal Vein ◽  
Hepatic Artery ◽  
Meld Score ◽  
Hepatic Decompensation ◽  
End Stage Liver Disease ◽  
Cirrhotic Patients ◽  
Us Findings ◽  
End Stage

Abstract Background Liver cirrhosis is a multi-etiological entity that alters the hepatic functions and vascularity by varying grades. Hereby, a cross-sectional study enrolling 100 cirrhotic patients (51 males and 49 females), who were diagnosed clinically and assessed by model for end-stage liver disease (MELD) score, then correlated to the hepatic Doppler parameters and ultrasound (US) findings of hepatic decompensation like ascites and splenomegaly. Results By Doppler and US, splenomegaly was evident in 49% of patients, while ascites was present in 44% of them. Increased hepatic artery velocity (HAV) was found in70% of cases, while 59% showed reduced portal vein velocity (PVV). There was a statistically significant correlation between HAV and MELD score (ρ = 0.000), but no significant correlation with either hepatic artery resistivity index (HARI) (ρ = 0.675) or PVV (ρ =0.266). Moreover, HAV had been correlated to splenomegaly (ρ = 0.000), whereas HARI (ρ = 0.137) and PVV (ρ = 0.241) did not significantly correlate. Also, ascites had correlated significantly to MELD score and HAV (ρ = 0.000), but neither HARI (ρ = 0.607) nor PVV (ρ = 0.143) was significantly correlated. Our results showed that HAV > 145 cm/s could confidently predict a high MELD score with 62.50% and 97.62 % sensitivity and specificity. Conclusion Doppler parameters of hepatic vessels (specifically HAV) in addition to the US findings of hepatic decompensation proved to be a non-invasive and cost-effective imaging tool for severity assessment in cirrhotic patients (scored by MELD); they could be used as additional prognostic parameters for improving the available treatment options and outcomes.

scholarly journals Post-exercise pulsatility index indicates treatment effects in peripheral arterial occlusive disease (PAOD)

2021 ◽  
Author(s):  
Andrej Udelnow ◽  
Maria Hawemann ◽  
Ivo Buschmann ◽  
Frank Meyer ◽  
Zuhir Halloul
Keyword(s):  
Repeated Measures ◽  
Pulsatility Index ◽  
Treatment Effects ◽  
Resistance Index ◽  
Peak Systolic Velocity ◽  
Arterial Tree ◽  
Post Exercise ◽  
Diastolic Velocity ◽  
Before And After ◽  
Healthy Persons

Summary Background Hypothesis: Post-exercise measurements better discriminate PAOD-patients from healthy persons and they more sensitively detect hemodynamic improvements after treatment procedures than resting measurements. Methods A total of 19 healthy volunteers and 23 consecutive PAOD-patients underwent measurements of peak systolic velocity (PSV), end-diastolic velocity (EDV), minimal diastolic velocity (MDV), time-averaged maximum velocities (TAMAX), resistance index (RI) and pulsatility index (PI) before and after a standard exercise test (at 1, 2, 3, 4 and 5 min) before and after treatment (incl. epidemiological data, PAOD risk factors and comorbidities). Results In resting values, healthy persons and PAOD-patients did not differ significantly in any of the hemodynamic parameters. PSV increased after treatment in PAOD-patients by 5 cm/s (paired t‑test, p: 0.025); however, when the amplitude of autoregulatory changes related to the resting values were calculated, PAOD-patients showed clearly less hemodynamic changes after exercise than healthy persons (p: 0.04; 0.002; <0.001 for PSV, TAMAX and PI, resp.). The time course after exercise was compared by repeated measures of ANOVA. Healthy persons differed significantly in PI, RI and PSV from PAOD patients before and after treatment (p<0.001 each). The PAOD-patients revealed a significantly improved PI after treatment (p: 0.042). The only factor contributing significantly to PI independently from grouping was direct arterial vascularization as compared to discontinuous effects by an obstructed arterial tree. Conclusion Healthy persons cannot be well differentiated from PAOD-patients solely by hemodynamics at rest but by characteristic changes after standard exercise. Treatment effects are reflected by higher PI-values after exercise.

Waveform Shape Analysis: Extraction of Physiologically Relevant Information from Doppler Recordings

1994 ◽  
Vol 86 (5) ◽  
pp. 557-565 ◽  
Author(s):  
Margaret M. Ramsay ◽  
Fiona Broughton Pipkin ◽  
Peter C. Rubin ◽  
Robert Skidmore
Keyword(s):  
Laplace Transform ◽  
Pulsatility Index ◽  
Flow Characteristics ◽  
Resistance Index ◽  
Relevant Information ◽  
Peripheral Circulation ◽  
Valsalva Manoeuvre ◽  
Flow Conditions ◽  
Physiological Relevance ◽  
Healthy Female

1. Doppler recordings were made from the brachial artery of healthy female subjects during a series of manoeuvres which altered the pressure—flow characteristics of the vessel. 2. Changes were induced in the peripheral circulation of the forearm by the application of heat or icepacks. A sphygmomanometer cuff was used to create graded occlusion of the vessel above and below the point of measurement. Recordings were also made whilst the subjects performed a standardized Valsalva manoeuvre. 3. The Doppler recordings were analysed both with the standard waveform indices (systolic/diastolic ratio, pulsatility index and resistance index) and by the method of Laplace transform analysis. 4. The waveform parameters obtained by Laplace transform analysis distinguished the different changes in flow conditions; they thus had direct physiological relevance, unlike the standard waveform indices.

99mTc-Szintigraphie versus Farbduplex-Sonographie

2013 ◽  
Vol 52 (05) ◽  
pp. 186-191 ◽  
Author(s):  
P. N. Truong ◽  
B. Bockisch ◽  
K. Zaplatnikov ◽  
W. T. Kranert ◽  
H. Korkusuz ◽  
...  
Keyword(s):  
Pulsatility Index ◽  
Thyroid Nodules ◽  
Resistance Index ◽  
Duplex Sonography ◽  
Flow Speed ◽  
Statistic Analysis ◽  
Thyroid Scintigraphy ◽  
Focal Lesions ◽  
Thyroid Autonomy ◽  
Blood Tests

SummarySince the development of colour coded duplex-sonography (ccds), several attempts have been made to implement this technique for diagnosis of focal lesions in the thyroid. There are controversial discussions on whether ccds might replace thyroid scintigraphy in diagnosis of hyperfunctional thyroid nodules. Aim of this study was the comparison of ccds and thyroid scintigraphy in diagnosis of functional thyroid autonomy. Patients, material and methods: 192 patients with thyroid nodules > 10mm detected by conventional sonography underwent thyroid scintigraphy. Additionally, these patients were subjected to ccds of the thyroid. In total, 286 thyroid nodules were examined by scintigraphy, ccds and blood tests. Results: Thyroid scintigraphy showed 67% of thyroid nodules as hyperfunctional, 19% indifferent and 14% as hypofunctional. Mean 99mTc uptake of hyperfunctional nodules was 2.19%, of indifferent nodules 1.12% and of hypofunctional nodules 1.06% respectively. The ccds allowed perinodular measurement of flow speed (hyperfunctional: 0.23 ± O.1 m/s; hypofunctional: 0.22 ± 0.1; indifferent: 0.21 ± 0.09), resistance index (hyperfunctional: 1.21 ± 1.16; hypofunctional: 0.62 ± 0.48; indifferent: 0.93 ± 1.02) and pulsatility index (hyperfunctional: 0.97 ± 0.45; hypofunctional: 0.84 ± 0.4; indifferent: 1.04 ± 0.6) in all nodules as well as intranodular measurement in some of the nodules (24% in hyperfunctional, 2% in indifferent and 15% in hypofunctional nodules). Statistic analysis of the obtained ccds data did not show any practically relevant correlations (p>0.05) with 99mTc uptake, basal TSH, fT3 or fT4. Conclusion: Thyroid scintigraphy cannot be replaced by ccds for diagnosis of functional thyroid autonomy. Reliable diagnostics still require a combination of thyroid scintigraphy, sonography and blood tests.

scholarly journals THE POTENTIAL BENEFIT AND THE MECHANISM OF ACTION OF THYROXINE ON SERUM LIPIDS AND BLOOD FLOW INDEXES IN SUBCLINICAL HYPOTHYROIDISM WOMEN

2018 ◽  
Vol 11 (8) ◽  
pp. 491
Author(s):  
Sinaaabdul Amir Kadhim ◽  
Shaimaa Abdul Ameer Kadhum ◽  
Ali Jawad Hamza
Keyword(s):  
Blood Flow ◽  
Subclinical Hypothyroidism ◽  
Potential Benefit ◽  
Serum Lipids ◽  
Color Doppler ◽  
Resistance Index ◽  
Thyroid Stimulating Hormone ◽  
Follicular Phase ◽  
Intrauterine Death ◽  
Lipids Profile

Objective: Even previous reports mentioned that thyroxine has beneficial effects on subclinical hypothyroidism (SCH); however, the mechanism by which thyroxine mediated such effect still unclear. Thus, we aim to find out the potential benefit of thyroxine administration in women with SCH through assessment of lipids profile with evaluation of uterine and ovarian blood flow indexes.Methods: The current study included 80 women with SCH who had a history of recurrent intrauterine death. Those women were chosen from the cohort of pregnant ladies that routinely seek medical advice. For each woman, estimation of serum thyroid-stimulating hormone (TSH), serum lipids profile (low-density lipoprotein [LDL], total cholesterol [TC], and triglyceride [TG]), and also uterine and ovarian pulsatile index (PI) and resistance index (RI) using color Doppler ultrasound, was done at the beginning of study and then repeated following 2 months during which women were given oral thyroxine supplementation (50 μg/d). The study was carried out in Al-Diwaniyah Maternity and Child Teaching Hospital in Al-Diwaniyah province, Iraq and extended from September 2016 to January 2018.Results: Mean serum TSH, LDL, TG, and TC were significantly reduced (p<0.05). Mean early follicular phase ovarian RI and PI and uterine RI were significantly reduced (p<0.05). In addition, mean late follicular phase ovarian RI and PI and uterine RI were significantly reduced (p<0.05).Conclusion: Thyroxine administration to women with SCH significantly decreases serum lipids and increases uterine and ovarian blood flow by mechanism involving reduction in arterial RI and PI.

scholarly journals Controversies in radioiodine therapy: relation to ophthalmopathy, the possible radioprotective effect of antithyroid drugs, and use in large goitres

2002 ◽  
pp. 1-11 ◽  
Author(s):  
SJ Bonnema ◽  
L Bartalena ◽  
AD Toft ◽  
L Hegedus
Keyword(s):  
Side Effects ◽  
Radioiodine Therapy ◽  
Thyroid Volume ◽  
Thyroid Stimulating Hormone ◽  
Radioprotective Effect ◽  
Antithyroid Drugs ◽  
Favourable Effect ◽  
Glucocorticoid Treatment ◽  
Graves Ophthalmopathy ◽  
First Choice

In routine use for more than 50 years, radioiodine ((131)I) is generally considered safe and devoid of major side effects. Therefore, it is surprising that relatively many aspects of radioiodine therapy are controversial, as illustrated by recent international questionnaire studies. Our review aims at highlighting three of these areas - namely, the influence of (131)I on the course of Graves' ophthalmopathy, the possible radioprotective effects of antithyroid drugs, and the use of (131)I in large goitres. (131)I therapy carries a small (but definite) risk of causing progression of Graves' ophthalmopathy. Identification of risk factors (thyroid dysfunction, high level of thyroid-stimulating hormone (TSH) receptor antibodies, cigarette smoking) allows the identification of patients at risk and the institution of concomitant glucocorticoid treatment, thereby hindering progression of eye disease. On the basis, largely, of retrospective data, it appears that carbimazole (or methimazole), if stopped 3-5 days before treatment, does not influence the outcome of (131)I therapy. Simultaneous thyrostatic medication most probably reduces the efficacy of (131)I, as does restarting it within 7 days. Propylthiouracil seems to have a more prolonged radioprotective effect than carbimazole. Surgery is the treatment of first choice in patients with a large goitre. However, in the case of patient ineligibility or preference, (131)I therapy may be an option. The treatment has a favourable effect on tracheal compression and inspiratory capacity, but the reduction in thyroid volume is only 30-40%. Inpatient treatment, necessitated by the large doses, makes the treatment cumbersome. Controversy related to radioiodine therapy is mainly based on the lack of adequate prospective randomised studies comparing efficacy, side effects, cost and patient satisfaction.

scholarly journals Relation between Fetal Renal Artery Doppler ‎Indices and Non-PROM Oligohydramnios in ‎Third Trimester of Pregnancy

2021 ◽  
pp. 1-8
Author(s):  
Asmaa Ibrahim Laag ◽  
Nareman Mahmoud Elhamamy ◽  
Amr‏ ‏Mohamed Tawfek Elbadry ◽  
Atef Hammad Teama
Keyword(s):  
Amniotic Fluid ◽  
Renal Artery ◽  
Flow Velocity ◽  
Pulsatility Index ◽  
Resistance Index ◽  
Normal Amount ◽  
Amniotic Fluid Index ◽  
Group I ◽  
Significant Difference ◽  
Artery Flow

Background: Amniotic fluid is the liquid which surround the fetus after the first few weeks of gestation. Amniotic fluid is derived mostly from the fetus and has many functions that are essential for normal growth and development. The aim of this work is to study the relation between fetal renal artery flow velocity waveforms and amniotic fluid volume in normal pregnancies and those complicated by oligohydramnios. Methods: This prospective observational study was carried out on 40pregnant women (10) of them were with normal amount of amniotic fluid (group I), while (30) of them suffered from oligohydramnios (group II).By using color doppler ultrasound imaging, the fetal renal circulation can be assessed. Intermittent assessment of renal artery flow velocity waveforms during the early stages of pregnancy may help in predicting changes in amniotic fluid dynamics. Results: There was a non-significant difference between cases with normal amount of amniotic fluid and cases with oligohydramnios in Gestational age, Maternal age, fetal femur length, bi parietal diameter, abdominal circumference and Fetal weight. There were increased values of fetal renal artery Resistance index (RI) and Pulsatility index (PI) in cases of oligohydramnios than cases with normal amount of amniotic fluid. There was no correlation between Peak systolic velocity (PSV) and Amniotic fluid index (AFI). There was a significant difference in End diastolic velocity (EDV) between cases with normal amount of amniotic fluid and cases with oligohydramnios. Also, there was a significant difference in Systolic diastolic ratio (S/D) and Amniotic fluid index (AFI) between cases with normal amount of amniotic fluid and cases with oligohydramnios. Conclusions: There is a relation between renal artery flow velocity waveforms and oligohydramnios using Pulsed wave Doppler Ultrasonography. There are higher values of renal artery Resistance index and Pulsatility index in cases of oligohydramnios more than cases with normal amount of amniotic fluid.

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