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Liver fibrosis, a major global health issue, is marked by excessive collagen deposition that impairs liver function. Noninvasive methods for the direct visualization of collagen content are crucial for the early detection and monitoring of fibrosis progression. This study investigates the potential of spectral photoacoustic imaging (sPAI) to monitor collagen development in liver fibrosis. Utilizing a novel data-driven superpixel photoacoustic unmixing (SPAX) framework, we aimed to distinguish collagen presence and evaluate its correlation with fibrosis progression. We employed an established diethylnitrosamine (DEN) model in rats to study liver fibrosis over various time points. Our results revealed a significant correlation between increased collagen photoacoustic signal intensity and advanced fibrosis stages. Collagen abundance maps displayed dynamic changes throughout fibrosis progression. These findings underscore the potential of sPAI for the noninvasive monitoring of collagen dynamics and fibrosis severity assessment. This research advances the development of noninvasive diagnostic tools and personalized management strategies for liver fibrosis. [ABSTRACT FROM AUTHOR]

Objective: Our objective was to compare care-seeking patterns in Mosul, Iraq, in 2018, 1 y after Islamic State of Iraq and Syria (ISIS) control, with findings from neighborhoods that had been sampled in 2017 Methods: For this multi-stage randomized cluster household survey, we created one cluster in each of 20 neighborhoods randomly selected from the 40 neighborhoods in the 2016/17 survey; 12 in east Mosul, 8 in west Mosul. In each, 30 households were interviewed beginning at a randomly selected start house. Questions were derived from the 2016/2017 post-ISIS survey. Results: We interviewed the head of household or senior female in 600 households containing 3375 persons. One year after ISIS, some household demographic shifts had occurred. Diarrhea in children during the past 2 wk decreased from 50.1% to 7.5% (P < 0.001); however, cough/difficulty breathing increased from 15.5% to 33.6% (P < 0.01). Among adults, care-seeking for noncommunicable diseases increased from 22.3% to 43.5% (P < 0.001). Emotional and psychological complaints common in the previous survey were now nearly absent. Pregnancy complications diminished from 65.2% to 15.4% (P < 0.001). Conclusions: Communicable diseases predominated among children and noncommunicable diseases among adults. Access to health care substantially improved, although barriers remained. Satisfaction with services was mixed, with dissatisfaction expressed about testing, medicine access, and costs, but the work of health providers was rated highly. [ABSTRACT FROM AUTHOR]

Purpose: Lung ultrasound (LUS) has been widely used for detecting pneumonia in children. Although LUS offers multiple advantages, its diagnostic accuracy compared to an imaging gold standard, e.g., computed tomography (CT) is in question. We evaluated the existing literature comparing the use of LUS for diagnosing pneumonia in children to CT., Methods: PubMed, EMBASE and Scopus databases were searched for relevant studies published from inception to June 13, 2024, using controlled vocabulary (MESH, EMTREE) with keywords., Results: The initial search identified 1065 articles. After the removal of duplicates (n = 350), the abstracts and titles of 715 studies were screened. 34 relevant studies were reviewed in detail for eligibility and shortlisted to 19 studies. Only 5 usable studies were identified. Of the five studies, three were published in journals that are not indexed in MEDLINE. The study with largest sample size (949 children) reported a sensitivity of LUS of 0.906 with 0.661 accuracy in comparison to chest CT., Conclusion: There was very limited and relatively low-quality current evidence regarding the accuracy of LUS in comparison to CT for diagnosing pneumonia in children., (© 2024 The Author(s). Pediatric Pulmonology published by Wiley Periodicals LLC.)

The liver's intricate vascular network is pivotal to its function, requiring a comprehensive understanding for improved diagnostic and treatment strategies in liver diseases. In this pilot study we explore the efficacy of contrast-enhanced ultrasound in identifying microvascular flow in pediatric chronic liver disease (CLD), highlighting the need for objective tools to gain deeper insights. We focused on two novel methods: microvasculature texture analysis and quantitative microvascular flow analysis. CEUS liver images were acquired from 8 patients with CLD related to different etiologies. These images underwent texture analysis, incorporating techniques like first-order histogram analysis, gray-level co-occurrence matrices, and run-length matrix analysis. We also employed a delta projection method to assess microvascular perfusion dynamics. For comparative purposes, liver CEUS images from four healthy individuals were also analyzed. Our texture analysis showed distinct vessel arrangement, and heterogeneity patterns with different liver diseases. For example, patients with primary sclerosing cholangitis exhibited average heterogeneity values of 1411.9. In contrast, those with biliary atresia had different echogenicity heterogeneity (1149.3). The delta projection technique further differentiated microvascular perfusion patterns across liver diseases, with each condition displaying unique perfusion index (PI) and peak enhancement (PE) values. Patients with primary sclerosing cholangitis exhibited comparable perfusion index (PI) values (3.2-3.5) and peak enhancement (PE) values (49.8-53.5). Biliary atresia cases perfusion values were (Pl of 1.3-1.7 and a PE of 40-45.4). Microvasculature texture analysis use is feasible, and with quantitative CEUS analysis, can provide valuable insights into microvascular patterns, enhancing diagnostic precision for pediatric CLD.

Avascular necrosis (AVN) is a major morbidity that can occur after surgical reduction of a hip with developmental dysplasia. Early detection of changes in femoral head perfusion during surgery may help detect a hip at risk for AVN and guide intraoperative management. Contrast-enhanced ultrasound (CEUS) can be employed for visualization of femoral head perfusion. In this study we evaluate a quantitative CEUS technique to assess femoral head perfusion pre- and post-surgical reduction. CEUS images were obtained following a bolus injection of an ultrasound contrast agent, prior to and again following surgical reduction and casting. An image processing technique called delta projection was used to quantify hip perfusion, measuring peak enhancement (PE) and perfusion index (PI). We analyzed CEUS images of the hips of eight patients, including seven females, whose ages ranged from 4 months to 1 year. In five hips, perfusion increased following surgery, with a mean pre-surgery PE of 6.7 ±2.5(± SE) and PI of 10.5 ±6.3; and a post-reduction PE of 13.1±6.1 (p=0.07) and PI of 14.2 ±6.2 (p=0.008). The change in contrast visualization was observed to be greater within the central aspect of the cartilaginous femoral epiphysis. The proposed technique can quantify pre- and post-surgical perfusion changes on CEUS images in patients with developmental dysplasia. This quantitative technique may provide a more objective and accurate assessment of changes in femoral head perfusion that may have the potential to be indicative of the risk of developing AVN.

Modulating aberrant tumor microvasculature provides unique opportunities for enhancing ultrasound imaging of hepatocellular carcinoma (HCC). This study aims to use contrast-enhanced ultrasound to evaluate the potential of a potent vasodilator, hydralazine, to attenuate blood flow in HCC while enhancing it in the surrounding liver tissue. The "steel effect," where blood flow is diverted from the lesion to the surrounding tissue aims to enhance lesion-tissue contrast. Methods: HCC was induced in six rats by oral ingestion of diethylnitrosamine for 12 weeks. 10 tumors were studied to assess the enhancement in HCC tumors and surrounding tissue. Contrast-enhanced ultrasound images (CEUS) of each tumor were acquired before and after hydralazine injection. The enhancement of images was analyzed for the qualitative and quantitative assessment of HCC enhancement. Peak enhancement (PE) was calculated, representing the maximum signal intensity reached during the transit of the contrast bolus for both the tumor and the surrounding tissue. Intravenous administration of hydralazine significantly reduced CEUS signals in HCC tumors. The visual examination of images showed that the enhancement of tumors dramatically decreased after hydralazine injection. On the other hand, the surrounding tissue showed an increased enhancement. PE for the HCC changed from (71.8 ± 5) pre hydralazine to (28.7± 4.9), a 61.7% reduction after hydralazine injection, p=0.01. Future studies validating the technique in clinical settings for enhancing lesion-tissue contrast may allow physicians greater precision and accuracy in HCC surveillance for early detection of small tumors.