Franz Karl Naegele (1778–1851)

The date of the expected birth is important not just for future parents but rather for obstetricians and gynecologists. Midwives and doctors of all generations know and apply the Naegele rule, based on the dates of menstruation for determining duration of pregnancy. Despite the advent of ultrasound diagnostics that provides a more accurate method to calculate an expected date of birth, up until now the Naegele rule remains relevant.

EVALUATION OF PREDICTIVE CAPABILITIES OF TIRADS, EU-TIRADS, TLA_RU SYSTEMS IN THE ULTRASOUND DIAGNOSIS OF THYROID NODULAR PATHOLOGY

The aim of the study was to evaluate the prognostic capabilities of EU-TIRADS, TIRADS, TLA_RU systems in ultrasound diagnostics of thyroid nodular masses. A retrospective independent continuous blind study of ultrasound examination protocols was conducted in 665 patients, 241 patients had benign non-cancerous thyroid diseases, 86 patients had benign tumors (adenomas), 338 patients had thyroid cancer. During the preoperative examination, all patients underwent a multiparametric ultrasound examination of the neck organs according to the standard procedure, with the registration of identified thyroid nodes, with examining the prognostic capabilities of stratification systems – TIRADS, EU-TIRADS, TLA_RU. It was found that the TIRADS system has a sensitivity of 91.04%, specificity – 91.41%. Focusing on the scale of AUC values reflecting the quality of the diagnostic test, it can be stated that TIRADS is a test with excellent quality (AUC =0.972). Basing on the results of the analyzing the data obtained by the EU-TIRADS system, it was revealed that it is a high-quality test (AUC=0.826), but its predictive capabilities are worse than those of TIRADS. The original TLA_RU model has 87.5% sensitivity and 95.7% specificity. During the ROC analysis, it was found that the AUC is equal to 0.954±0.00894, which suggests that the TLA_RU model is an excellent quality test in the differential diagnosis of thyroid nodular masses. Multivariate statistical comparative analysis of thyroid imaging assessment systems (TIRADS, EU-TIRADS and TLA_RU) from the standpoint of evidence-based medicine has shown that thyroid cancer risk stratification systems based on the assessment of multiparametric ultrasound signs have great diagnostic capabilities.

ULTRASOUND DIAGNOSTICS OF CHRONIC CONSTIPATION IN CHILDREN: RESULTS OF A CLINICAL STUDY

Chronic constipation (CC) is an important medical and social problem, as it can lead to the development of complications, fecal intoxication, social disadaptation and self-isolation of a child, as well as significantly reduce the quality of life. The article presents the results of a clinical study of CC in children using a new diagnostic method - transabdominal and transperianal ultrasound examination (US) of the colon and anorectal zone. The objective of the study was to analyze the course of CC in children depending on the mechanism of its formation according to US of the colon and anorectal zone. Materials and methods of research: the prospective cohort study included 470 children with an established diagnosis of CC at the age of 1 month to 17 years old. The patients were divided into 3 age groups: 1 month. – 3 years (n=166), 4–10 years (n=102), 11–17 years (n=202). The median follow-up was 48 months. The age distribution of children with CC was carried out on the basis of the frequency of visits, against the background of the beginning of attending kindergarten and/or elementary school groups, and the emergence of psychological problems due to the difficulty of going to a public toilet. An evaluation of analysis of the dynamics of US changes in the colon and anorectal zone was carried out by the method of ultrasound diagnosis of Hirschsprung's disease in children (patent № 2547614, authors M.I. Pykov, M.M. Kolisnichenko, I.V. Poddubny). Results: in children aged 1 month to 3 years, 66.9% of cases are statistically significantly dominated by proctogenic constipation type of constipation with US signs of anus spasm and anal sphincter insufficiency. In children aged 4 to 10 years, the mixed mechanism of CC formation prevails (41.1%), and in patients aged 11 to 17 years – cologenic (77.7%), for which the most typical ultrasound signs are dolichocolon (22.8%), anus spasm (8.7%), anal sphincter insufficiency (4.7%). It has been established that despite adequate therapy, the number of patients with the above-described mechanisms of formation of CC increases, which indicates the recurrence and progression of pathological process in children of different age groups. Conclusion: the proposed diagnostic method – transabdominal and transperianal US of the colon and anorectal zone is a highly informative, pathogenetically substantiated method for examining the state of the colon and anorectal zone in children with CC, built on precise objective criteria that are available at any age.

FEATURES OF ULTRASONIC CHARACTERISTICS OF MESENTERIC LYMPH NODES IN COVID-19 IN CHILDREN WITH ACUTE ABDOMINAL SYNDROME: DESCRIPTION OF CLINICAL CASES

The authors describe clinical observations of children with acute mesenteric adenitis with PCRconfirmed COVID-19 infection. Attention during ultrasound diagnostics is drawn to the condition of the lymph nodes – mesenteric adenitis in COVID-19 infection was manifested by a significant increase in the size of the nodes – more than 15 mm, a large number of nodes in the cut with a tendency to form a conglomerate, a more rounded shape, significantly increased blood flow, a reaction of the peritoneum in the form its thickening and the presence of free fluid in the abdominal cavity. Unusual for a «ordinary» respiratory viral or intestinal infection type of lymph nodes was the only sign that distinguishes the manifestations of mesenteric infection in COVID-19 infection.

Ultrasound examination of myometrial changes after conservative myomectomy, with the aim of predicting the course of pregnancy and choosing the optimal method of delivery

Introduction. The article provides a methodology for assessing and predicting complications during pregnancy for selectionof the optimal method of delivery.Goals and objectives. The work assessed the degree of myometrium changes, according to ultrasound studies, after using standard instrumentation and electrocoagulation, in order to predict the course of pregnancy and select the optimal method of delivery.Materials and methods. The details of the surgical anatomy, the plan of the surgeon’s action before the operation, formed according to the data of ultrasound diagnostics and operative surgery, were analyzed. Ultrasound was performed using GE Logiq S8 (USA) and Medisan Accuvix (South Korea) devices with 3,5 MHz convex transducers for transabdominal examination and with a frequency of 5 MHz for transvaginal examination.Research results. Laparoscopic myomectomy was performed in 18 women, 31 patients underwent laparotomic myomectomy, in 11 patients a combined operation technique was used: laparoscopy with minilaparotomy. According to our data, in half of the cases considered, the effects of interventions were absent or minimal. We assigned these results to group I (A — A1, A2, A3). In all other observations, cicatricial changes were revealed — group II (B, C, D, E). To predict the possible consequences, we proposed a point assessment of the ultrasound postoperative changes in the uterus, with the help of which it is possible to assess the degree of risk when planning pregnancy for each patient individually. Each group corresponds to a certain number of points.Conclusions. The presented division according to the degree of severity into groups can make it possible to individualize the approach to each patient and ensure the safest possible management of her during pregnancy and childbirth. This assessment can be used by ultrasound doctors and obstetricians-gynecologists of antenatal clinics and hospitals. The assessment presented by us at the moment is of a recommendatory nature.

Endocrinological carefor children of Kharkiv in the period 2015—2020

The purpose of the work was to analyze the state of medical care for children with endocrine pathology in the city of Kharkov in the period 2015—2019, to analyze the prevalence and structure of diseases of the endocrine system.Materials and methods. The data of the Center for Medical Statistics of the Ministry of Health of Ukraine were used (statistical reporting form 31 «Report on medical care for children»), with mathematical­statistical, bibliosemanticand content analysis.Results and discussion. A new form of endocrinological care for the child population is the creation of a city endocrinological office at a scientific multidisciplinary pediatric institution (State Institution «IOZDPNAMS»), which improved the registration of children, ensured the completeness of medical examination, the appointment of rehabilitation measures. Children who apply to the city endocrinology office have the opportunity to get a free consultation of a neurologist, psychiatrist, psychologist, ophthalmologist, ENT, dentist, gastroenterologist, undergo ultrasound diagnostics, REG, EEG, study at a school for self­monitoring of diabetes mellitusand obesity on the basis of the State Institution «IOZDPNAMS» In patients with diabetes mellitus and labile course, it is possible to control diabetes both by test systems and to carry out professional monitoring of glycemia free of charge at home, with an analysis of glycemic indicators by an endocrinologist.Conclusion. The most common endocrine pathology among all children of the city endocrinology office is type 1 diabetes. The specialists of the State Institution «IOZDPNAMS» have proposed an algorithm for staged support of children with type 1 diabetes, which includes glucose monitoring, training in injection techniques and increasing knowledge about diet and daily routine, physical activity. Also, for practical use, there are examples of calculations of some individual indicators, including in the presence of flash monitoring in a child. This will help to optimize the work of primary care specialists in helping children with endocrine pathology.

Clinico-echographic manifestation of endometritis in cows

Purpose: to study the clinical and echographic manifestation of endometritis.Materials and methods. Clinical and echographic research was carried out on 19 red-and-white cows, in the conditions of the agricultural farm of the Druzhba breeding plant, Pavlovsky district, Voronezh region on the 30-32th day after calving using the Easi-Scan scanner from BCF Technology Ltd, Scotland. Before ultrasound examination to establish the diagnosis, all animals were examined, transrectal palpation of the uterus. Simultaneously with the ultrasound examination, a cytological study of the uterine mucosa was carried out. For this purpose, a probe was constructed from a metal catheter intended for artificial insemination of cows with sequins by the deep cervical method with rectal fixation of the cervix; a cytobrush of the Juno probe was attached to the tip of the instrument. To confirm the diagnosis, a laboratory study of cervical mucus was additionally carried out by the express method according to Whiteside, modified by N. I. Polyantsev and Yu. N. Popov.Results. According to the results of rectal examination and ultrasound diagnostics, the cows were divided into three groups: clinically healthy, animals with clinically pronounced chronic endometritis and with latent endometritis. In the group of healthy animals, individual superficial and vacuolated intermediate cells (6.17 ± 0.51) and single neutrophils (2.31 ± 0.32) were detected in smears. In the group of clinically healthy cows, no gram-positive coccobacillary microorganisms and cells of the basal layer of the uterine mucosa were detected. In the second group, in animals with clinically pronounced chronic endometritis, a large number of segmented neutrophils, lymphocytes and a large number of cocci were detected in smears. Thus, in one visual field, the number of gram-positive cocobacillary microorganisms fluctuated on average 764.45 ± 4.56 microbial bodies, while the number of neutrophils increased in comparison with clinically healthy animals by 20.84 times and averaged 48.14 ± 2 in the group. , 91, the percentage of the score averaged around 12.1%. Simultaneously with an increase in the number of leukocytes in animals, the number of epithelial cells of the uterine mucosa increased by 2.21 times, while individual basal cells were detected simultaneously with superficial and intermediate cells (0.75 ± 0.48). In smears obtained from animals of the third group of cows, there was a significant decrease in the number of coccobacillary microorganisms to 75-360 in one visual field in comparison with similar results in the group with a clinically pronounced form of chronic endometritis. The indicator for segmented neutrophils was 8.05 times higher than in clinically healthy cows, while in relation to clinically sick cows by 61.4% and amounted to 18.60 ± 2.23. In terms of the number of superficial, vacuolated intermediate and basal cells in sick animals with chronic clinically pronounced endometritis and latent endometritis, no significant changes were revealed (1.08 times), while in relation to clinically healthy animals, these indicators were 2.38 times higher. The degree of variation in the number of epithelial cells in the group of cows with latent chronic endometritis was insignificant, which indicates the stability of the trait.Conclusion. Ultrasound scanning allows you to identify the latent form of endometritis and establish degenerative changes in the tissues of the uterus. Ultrasound examination in cows in establishing a diagnosis - endometritis should be the decisive diagnostic method.

Using the automated Verasonics system for physical modeling of skeletal muscle biomechanics

The paper describes the use of the Verasonics research system for physical modeling of skeletal muscle biomechanics. The scheme of the acoustic system is described. The path of receiving and processing the signal is presented. A brief overview of the operation of software algorithms for the implementation of methods of ultrasound diagnostics is made. A mathematical model of skeletal muscle as a flat-layered medium is considered. The implementation of this model in the form of a fibers agar phantom is proposed. Using the Verasonics acoustic system shear velocities of physical fibers agar phantom were measured. Shear modules for agar and fibers were calculated. The obtained values are consistent with similar characteristics of native muscles and connective tissue fibers.

ON THE ISSUE OF DIAGNOSTIC SIGNIFICANCE OF INTESTINAL ULTRASOUND IN FOREIGN BODY DETECTION

The method of ultrasound diagnostics in suspected for-eign intestinal body in small pets is discussed. This method is characterized by its noninvasiveness. The research goal was to reveal diagnostic significance of ultrasound exami-nation of the intestine in the presence of foreign bodies. The research objectives were as following: to study basic ultrasound characteristics of foreign bodies in the intestine of small domestic animals; to study the influence of antie-metic preparation based on maropitrate citrate on the in-formative value of the study. The research was carried out in the Department of Anatomy and Physiology of the State Agricultural University of Northern Trans-Uralsand in the veterinary clinics of the City of Tyumen. Ultrasonic diagnos-tics was carried out in 73 cats and 38 dogs with suspected foreign intestinal bodies. The examination was carried out using linear, convex and microconvex transducers with different frequencies according to standard research meth-ods. Fifteen cats were given an antiemetic drug -maropi-tant citrate at a dose of 1 mg per 1 kg before the ultrasound examination. It has been found that ultrasound is an in-formative method of diagnosing linear foreign bodies; they collect the intestine in a corrugation and go as a linear hy-perechogenic formation. Solid foreign bodies give an echo-genic appearance which suggests their presence in the intestine. Other foreign bodies may be detected by indirect signs. The main indirect signs of obstruction on ultrasound examination include pendulous peristalsis, dilatation above the obstruction site, decreased peristalsis, and overflow of intestinal contents. When studying the peculiarity of ultra-sound examination when using maropitrate citrate, de-creased peristalsis was detected and subsequently poor recognition of pendulum-like movements which negatively affected the diagnostic value of the method.

Focus ultrasound for cardiology practice. Russian consensus document

This document is a consensus document of Russian Specialists in Heart Failure, Russian Society of Cardiology, Russian Association of Specialists in Ultrasound Diagnostics in Medicine and Russian Society for the Prevention of Noncommunicable Diseases. In the document a definition of focus ultrasound is stated and discussed when it can be used in cardiology practice in Russian Federation.