Performance of a handheld point of care ultrasonography to assess IUD position compared to conventional transvaginal ultrasonography.

OBJECTIVE: To compare the performance of the abdominal handheld point-of-care ultrasonography (POCUS) Butterfly-iQ to gold standard transvaginal ultrasonography (US) in identifying the position of intrauterine devices (IUDs) in the hands of a medical doctor specialised in ultrasonography. METHODS: In this diagnostic accuracy study, a single operator conducted abdominal POCUS followed by conventional transvaginal US. Seventy patients utilising copper or hormonal IUDs were assessed between June 2021 and October 2022. IUDs were categorised as entirely within the uterine cavity or malpositioned. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for detecting malpositioned IUDs, with conventional US results serving as the reference standard. Concordance rate and Kappa coefficient were computed to assess the agreement between the two ultrasound modalities. RESULTS: Among the 70 patients, 46 (65.7%) used copper IUDs, and 24 (34.3%) used hormonal IUDs. Conventional transvaginal US showed IUDs entirely within the uterine cavity in 56 (80%) patients and 14 (20%) IUDs were malpositioned. Of the 14 malpositioned IUDs seen by conventional US, POCUS identified 13 demonstrating a sensitivity of 92.9% (66.1-99.8). Of the 56 IUDs entirely within the uterine cavity shown by conventional US, only two cases were considered malpositioned by POCUS demonstrating a specificity of 96.4% (87.7-99.6). The concordance rate was 95.7%, and the Kappa value was 0.87 in differentiating between IUDs entirely within the uterine cavity and those that were malpositioned. CONCLUSION: Abdominal POCUS using Butterfly-iQ, when administered by an imaging specialist, exhibited excellent performance in confirming IUDs entirely within the uterine cavity.

Through a smartphone-based handheld point-of-care ultrasonography it was possible to correctly evaluate the position of intrauterine devices (IUDs) in a sample of 70 patients (46 using copper and 24 using hormonal IUDs).

Performance of the IOTA ADNEX model in preoperative discrimination of adnexal masses in a gynecological oncology center.

OBJECTIVE: To evaluate the performance of the International Ovarian Tumor Analysis (IOTA) ADNEX model in the preoperative discrimination between benign ovarian (including tubal and para-ovarian) tumors, borderline ovarian tumors (BOT), Stage I ovarian cancer (OC), Stage II-IV OC and ovarian metastasis in a gynecological oncology center in Brazil. METHODS: This was a diagnostic accuracy study including 131 women with an adnexal mass invited to participate between February 2014 and November 2015. Before surgery, pelvic ultrasound examination was performed and serum levels of tumor marker CA 125 were measured in all women. Adnexal masses were classified according to the IOTA ADNEX model. Histopathological diagnosis was the gold standard. Receiver-operating characteristics (ROC) curve analysis was used to determine the diagnostic accuracy of the model to classify tumors into different histological types. RESULTS: Of 131 women, 63 (48.1%) had a benign ovarian tumor, 16 (12.2%) had a BOT, 17 (13.0%) had Stage I OC, 24 (18.3%) had Stage II-IV OC and 11 (8.4%) had ovarian metastasis. The area under the ROC curve (AUC) was 0.92 (95% CI, 0.88-0.97) for the basic discrimination between benign vs malignant tumors using the IOTA ADNEX model. Performance was high for the discrimination between benign vs Stage II-IV OC, BOT vs Stage II-IV OC and Stage I OC vs Stage II-IV OC, with AUCs of 0.99, 0.97 and 0.94, respectively. Performance was poor for the differentiation between BOT vs Stage I OC and between Stage I OC vs ovarian metastasis with AUCs of 0.64. CONCLUSION: The majority of adnexal masses in our study were classified correctly using the IOTA ADNEX model. On the basis of our findings, we would expect the model to aid in the management of women with an adnexal mass presenting to a gynecological oncology center. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Efeito da adição de farinha de linhaça à dieta sobre a concentração de colesterol e ácidos graxos em camarões / The effect of feed added of linseed on cholesterol and fatty acids in shrimp

Avaliou-se a expressão de ácidos graxos, macronutrientes e colesterol de camarões-da-malásia alimentados com dieta adicionada de sementes de linhaça. Quinhentos camarões foram distribuídos em dois grupos e alimentados durante 90 dias com dietas contendo: 1) lipídeo proveniente de linhaça e 2) óleo de soja (controle). A concentração de proteína foi maior (Р<0,05) para o grupo-linhaça, 15,8±0,09%, em relação ao grupo-controle, 15,2±0,04%. O peso corporal também se apresentou maior no grupo-linhaça, 1,38±0,93g, em relação ao grupo-controle, 0,93±0,48g. O grupo-linhaça apresentou teor de colesterol de 120,8±23,9mg/100g e o grupo-controle, 130,2±13,9mg/100g, porém sem diferença estatística significativa. Em relação ao perfil lipídico, a suplementação da dieta com linhaça influenciou a incorporação do ácido oleico (C18:1, ω-9) e melhorou a relação ω-6/ω-3 na carne do camarão (Р<0,05). Concluiu-se que a adição de linhaça à ração promoveu importantes modificações na qualidade nutricional dos tecidos do camarão.

The aim of the present study was to analyze the chemical composition of shrimp fed with a diet added of linseed flour. Five hundred post larvae shrimp were divided into two groups: a linseed group fed with a diet based on casein complemented with linseed and a control group, fed a diet without linseed flour. The cholesterol content for the linseed group was 120.8±23.9 mg/100g while for the control group it was 130.2±13.9 mg/100g. However, the protein content of 15.8±0.09 % and the body weight of 1.38±0.93g for the linseed group were higher than for the control group. It was concluded that the addition of linseed to the diet seems to increase the protein, weight and oleic acid (C18:1, ω-9) in the shrimp tissue. The ratio of polyunsaturated fatty acids/saturated fatty acids and ω-6/ω-3 for the linseed group was more suitable than for the control group.

Effect of calcium addition and pH on yield and texture of Minas cured cheese / Efeito da adição de cálcio e do pH sobre o rendimento e a textura de queijo-de-Minas curado

Milk calcium concentration is a factor related to cheese texture, an important rheological property of cheese quality as perceived by consumers. This study aimed to evaluate the effect of different pH conditions (5.8 and 6.6) and calcium addition (0, 150, 300 ppm of CaCl2), on yield and nutrient retention of the clots obtained and on the texture of Minascured cheese. Clots were analyzed for wet and dry yield, percentage content and retention of protein, fat and calcium. The texture of the cheese was evaluated by instrumental and sensorial tests. No differences were observed on the wet and dry yields, or on the protein content, fat and calcium retention of clots produced in the different experimental conditions. The instrumental evaluation showed that calcium addition significantly influenced the texture of cheeses, regardless of the pH of milk clotting. The sensory panel did not find a difference in the hardness ofcheeses produced at the same pH of milk clotting in function of CaCl2 addition. There was no difference in the texture of Minascured cheese due to the calcium addition to milk for dairy product consumers, which brings a new perspective on manufacture for cheese markers.

Avaliou-se o efeito de diferentes condições de pH ­5,8 e 6,6 ­e da adição de cálcio ­0, 150, 300ppm de CaCl2 - sobre o rendimento, a retenção de nutrientes nos coágulos produzidos e a textura de queijo-de-Minas curado. Foram analisados nos coágulos os rendimentos úmido e seco, o percentual e a retenção de proteína, de gordura e de cálcio. A textura dos queijos foi avaliada por testes instrumental e sensorial. Não foram observadas diferenças nos rendimentos úmido e seco, no conteúdo percentual e na retenção de proteína, gordura e cálcio nos coágulos produzidos em diferentes condições experimentais. A análise instrumental mostrou que a adição ou não de cálcio influenciou a textura dos queijos, independentemente do pH de coagulação do leite. O painel sensorial não diferiu quanto à dureza dos queijos produzidos em um mesmo valor de pH de coagulação do leite mediante a adição de CaCl2. Para os consumidores, não houve diferença na textura do queijo Minas curado em razão da adição de cálcio ao leite. Isto traz nova perspectiva na fabricação para os produtores de queijo.