The correlates of post-surgical haematoma in older adults with proximal femoral fractures.

BACKGROUND: Little is known about the incidence of haematoma, and clinical correlates among orthogeriatric patients. AIMS: This study aims to describe the incidence of haematoma after surgical repair of hip fracture and to identify the clinical correlates of haematoma among orthogeriatric patients. METHODS: Two orthopaedic surgeons and a dedicated operator using ultrasound technique, each other in blindness, evaluated 154 orthogeriatric patients during their hospital stay. All patients received a comprehensive geriatric assessment. We investigated the concordance between clinical diagnosis and ultrasound detection of haematoma, and then we explored the clinical correlates of the onset of post-surgical haematoma. RESULTS: Blood effusion at the surgical site was detected in 77 (50%) patients using ultrasound technique; orthopaedic surgeons reached a clinical agreement about post-surgical haematoma in 18 (23%) patients. The sensitivity of clinical evaluation was 0.66, and the specificity was 0.70. Independent of age, clinical, pharmacological, and surgical confounders, proton pump inhibitors (PPIs) were associated with post-surgical haematoma (OR 2.28; 95% CI 1.15-4.49). A tendency towards association was observed between selective serotonin reuptake inhibitors and post-surgical haematoma (OR 2.10; 95% CI 0.97-4.54), CONCLUSIONS: Half of older patients undergoing surgical repair of proximal femoral fracture develop a post-surgical haematoma. Clinical assessment, even if made by senior orthopaedic surgeons, underestimates the actual occurrence of post-surgical haematoma compared to ultrasound detection. Ultrasound technique may help to detect haematoma larger than 15 mm better than clinical assessment. PPIs's use is a risk factor for post-surgical haematoma independent of several medical and surgical confounders.

All-Optical, Air-Coupled Ultrasonic Detection of Low-Pressure Gas Leaks and Observation of Jet Tones in the MHz Range.

We used an ultrasensitive, broadband optomechanical ultrasound sensor to study the acoustic signals produced by pressurized nitrogen escaping from a variety of small syringes. Harmonically related jet tones extending into the MHz region were observed for a certain range of flow (i.e., Reynolds number), which is in qualitative agreement with historical studies on gas jets emitted from pipes and orifices of much larger dimensions. For higher turbulent flow rates, we observed broadband ultrasonic emission in the ~0-5 MHz range, which was likely limited on the upper end due to attenuation in air. These observations are made possible by the broadband, ultrasensitive response (for air-coupled ultrasound) of our optomechanical devices. Aside from being of theoretical interest, our results could have practical implications for the non-contact monitoring and detection of early-stage leaks in pressured fluid systems.

Detecting Ultrasound Vibrations with Graphene Resonators.

Ultrasound detection is one of the most-important nondestructive subsurface characterization tools for materials, the goal of which is to laterally resolve the subsurface structure with nanometer or even atomic resolution. In recent years, graphene resonators have attracted attention for their use in loudspeakers and ultrasound radios, showing their potential for realizing communication systems with air-carried ultrasound. Here, we show a graphene resonator that detects ultrasound vibrations propagating through the substrate on which it was fabricated. We ultimately achieve a resolution of ∼7 pm/[Formula: see text] in ultrasound amplitude at frequencies up to 100 MHz. Thanks to an extremely high nonlinearity in the mechanical restoring force, the resonance frequency itself can also be used for ultrasound detection. We observe a shift of 120 kHz at a resonance frequency of 65 MHz for an induced vibration amplitude of 100 pm with a resolution of 25 pm. Remarkably, the nonlinearity also explains the generally observed asymmetry in the resonance frequency tuning of the resonator when it is pulled upon with an electrostatic gate. This work puts forward a sensor design that fits onto an atomic force microscope cantilever and therefore promises direct ultrasound detection at the nanoscale for nondestructive subsurface characterization.

Partial Discharge Ultrasound Detection Using the Sagnac Interferometer System.

Partial discharge detection is crucial for electrical cable safety evaluation. The ultrasonic signals frequently generated in the partial discharge process contains important characteristic information. However, traditional ultrasonic transducers are easily subject to strong electromagnetic interference in environments with high voltages and strong magnetic fields. In order to overcome this problem, an optical fiber Sagnac interferometer system is proposed for partial discharge ultrasound detection. Optical fiber sensing and time-frequency analysis of the ultrasonic signals excited by the piezoelectric ultrasonic transducer is realized for the first time. The effective frequency band of the Sagnac interferometer system was up to 175 kHz with the help of a designed 10 kV partial discharge simulator device. Using the cumulative histogram method, the characteristic ultrasonic frequency band of the partial discharges was between 28.9 kHz and 57.6 kHz for this optical fiber partial discharge detection system. This new ultrasound sensor can be used as an ideal ultrasonic source for the intrinsically safe detection of partial discharges in an explosive environment.

Antenatal Ultrasound Detection of Cleft in Western Australia from 2003 to 2012: A Follow-Up Study.

AIM: To investigate trends in the rate of antenatal detection of cleft lip and palate (CLP) patients referred to the CLP Unit at Princess Margaret Hospital for Children in Perth, Western Australia during the period 2003-2012 and compare data with a previously published report covering the years 1996-2003. METHODS: This is a single-center, retrospective survey of antenatal transabdominal ultrasound screenings of mothers of infants born between July 1, 2003 and June 30, 2012 that were referred to the CLP Unit at Princess Margaret Hospital. RESULTS: Detection rates of oral clefts increased significantly when compared with outcomes reported in the same population between 1996 and 2003 (P < .05). An overall detection rate of 71.7% (165/230) was achieved for clefts involving lip and palate. Detection of isolated cleft palate (1/99) and microform (0/8) remained elusive. Most detections (76.5%) were achieved at 15 to 20 weeks of gestational age, corresponding with routine anatomical screening. A further 16.8% were detected post-20 weeks of gestation. Scans were performed by specialist obstetricians, and sonography clinics reported a detection rate of 84.6% (55/65), whereas nonspecialist clinics reported a detection rate of only 67.1% (110/164). CONCLUSION: The antenatal detection rates of oral clefts involving the lip have improved to the extent that the majority of mothers are now being referred to a cleft unit in Western Australia prior to the births of their children. As a result of this improvement, antenatal counseling is now a common facet of cleft management.

Optical ultrasound sensors for photoacoustic imaging: a review.

Significance: Photoacoustic (PA) imaging is an emerging biomedical imaging modality that can map optical absorption contrast in biological tissues by detecting ultrasound signal. Piezoelectric transducers are commonly used in PA imaging to detect the ultrasound signals. However, piezoelectric transducers suffer from low sensitivity when the dimensions are reduced and are easily influenced by electromagnetic interference. To avoid these limitations, various optical ultrasound sensors have been developed and shown their great potential in PA imaging. Aim: Our study aims to summarize recent progress in optical ultrasound sensor technologies and their applications in PA imaging. Approach: The commonly used optical ultrasound sensing techniques and their applications in PA systems are reviewed. The technical advances of different optical ultrasound sensors are summarized. Results: Optical ultrasound sensors can provide wide bandwidth and improved sensitivity with miniatured size, which enables their applications in PA imaging. Conclusions: The optical ultrasound sensors are promising transducers in PA imaging to provide higher-resolution images and can be used in new applications with their unique advantages.

Prenatal Detection and Conservative Management of Uterine Scar Dehiscence in Patient with Previous Uterine Rupture and Multiple Surgeries-A Case Report.

Uterine rupture is a rare and life-threatening condition. It usually occurs in patients with uterine scars (most commonly for a previous myomectomy or caesarean section), but it can also affect an unharmed uterus. This complication is more frequent in the third trimester and during delivery. There is not yet a recognised method of prediction of uterine rupture and the ultrasound features still need a consensus. In this article, we have reported a case of uterine dehiscence diagnosed by a pelvic ultrasound and magnetic resonance (MRI) at 24 weeks of gestation. The finding was confirmed intraoperatively at the caesarean section at 29 weeks of gestation. The 40-year-old patient has had a previous pregnancy complicated by uterine rupture at 22 weeks of gestation, following six previous abdominal surgeries for stage IV endometriosis, diffuse and nodular adenomyosis, and pelvic adhesion syndrome. The early detection of uterine dehiscence allowed us to prolong the pregnancy and perform a subsequent fertility-sparing surgery, reducing maternal and neonatal morbidity and mortality. Our case report proves that women with severe endometriosis/adenomyosis are at a high risk of uterine rupture and scar dehiscence. The antenatal ultrasound can describe a uterine dehiscence (even in asymptomatic patients) and prevent complications.

Segmentation of ovarian cyst in ultrasound images using AdaResU-net with optimization algorithm and deep learning model.

Ovarian cysts pose significant health risks including torsion, infertility, and cancer, necessitating rapid and accurate diagnosis. Ultrasonography is commonly employed for screening, yet its effectiveness is hindered by challenges like weak contrast, speckle noise, and hazy boundaries in images. This study proposes an adaptive deep learning-based segmentation technique using a database of ovarian ultrasound cyst images. A Guided Trilateral Filter (GTF) is applied for noise reduction in pre-processing. Segmentation utilizes an Adaptive Convolutional Neural Network (AdaResU-net) for precise cyst size identification and benign/malignant classification, optimized via the Wild Horse Optimization (WHO) algorithm. Objective functions Dice Loss Coefficient and Weighted Cross-Entropy are optimized to enhance segmentation accuracy. Classification of cyst types is performed using a Pyramidal Dilated Convolutional (PDC) network. The method achieves a segmentation accuracy of 98.87%, surpassing existing techniques, thereby promising improved diagnostic accuracy and patient care outcomes.

Transparent microfiber Fabry-Perot ultrasound sensor with needle-shaped focus for multiscale photoacoustic imaging.

Photoacoustic tomography emerged as a promising tool for noninvasive biomedical imaging and diseases diagnosis. However, most of the current piezoelectric ultrasound transducers suffer optical opacity and tissue-mismatched acoustic impedance, hindering the miniaturization and integration of the system for multiscale and multimodal imaging. Here, a transparent polydimethylsiloxane (PDMS) encapsulated optical microfiber ultrasound sensor was demonstrated for photoacoustic imaging with scalable spatial resolution and penetration depth. The sensor comprised a microfiber loop sandwiched by a pair of in-line Bragg gratings, which formed an ultrasound-sensitive Fabry-Perot cavity allowing free delivery of ultrasound/light beams and unique needle-shaped ultrasound focusing along the penetration depth. The sensor with a detection limit of ∼ 700 Pa and a bandwidth of ∼ 10 MHz was applied for multiscale photoacoustic imaging of mouse ear and brain vasculatures. With advantages of flexibility, optical transparence and focusing capability, the sensor offers new opportunities for developing photoacoustic/ultrasound imaging devices for biomedical and clinic applications.

Uterine Dehiscence in the Early Third Trimester: A Report of Two Cases.

As the incidence of cesarean deliveries increases, so do its accompanying complications. Although the incidence of uterine dehiscence in the late second trimester to the early third trimester is rare, it may be a potentially catastrophic complication if uterine rupture occurs. Here, we present two cases of uterine dehiscence at 28 and 29 weeks, which were diagnosed on prenatal ultrasound and confirmed intraoperatively at the time of cesarean delivery. We recommend consideration of earlier screening for preoperative detection of uterine dehiscence to help prevent maternal and neonatal morbidity and mortality.