A telerobotic ultrasound system is feasible for performing abdominal ultrasound examinations at a distant location with minimal training and setup requirements and a moderate learning curve. Telerobotic sonography (robotic telesonography) may open up the possibility of remote ultrasound clinics for communities that lack skilled sonographers and radiologists, thereby improving access to care.

A telerobotic approach is feasible for remotely performing prenatal sonographic examinations. Telerobotic sonography (robotic telesonography) may allow for the development of satellite ultrasound clinics in rural, remote, or low-volume communities, thereby increasing access to prenatal imaging in underserved communities.

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This audit of anatomy departments suggests that diagnostic imaging has an important role to play in anatomy teaching in Canadian English-speaking medical schools.

Depletion of activated neutrophils by a filter during cardiac valve surgeryPurpose: To determine whether inclusion of a neutrophil-speciflc filter into the extracorporeal circuit during open heart valve surgery alters postoperative outcomes.Methods: Convenience sampling of 24 patients undergoing elective open heart valve surgery between July 1993 and June 1994. Patients were randomized to a neutrophil-specific filter (n= I I) orto a standard blood filter (n= 13) during cardiopulmonary bypass.Results: Neutrophil-specific filter diminished (P <0,02) the expression of CD 18, a neutrophil surface adhesion molecule, at I (84,5 + 4.2 vs 94,8 _+ 3.8%), 4 (80.0 -4.2 vs 95. I ___ 3.9%) and 24 hr (75.2 + 4.2 vs 98,2 _+ 3.9%) post-operatively compared with standard filter. Total white blood cell count, neutrophil count, and proinflammatory cytokines (IL-6, IL-8) were similar between groups at all times. Measured outcomes including: F'aO 2, cardiac index, ejection fraction, haemodynamic variables, use of inotropes, spirometry (FEV~. FVC), and hospitalization duration were similar between groups.Conclusions: Inclusion of the neutrophil filter during open heart valve surgery selectively depletes activated neutrophils. There were no other detectable differences between the two groups and the use of a neutrophilspecific filter in routine clinical practice for patients undergoing open heart valve surgery is not supported.Objectif : D&erminer si I'ajout au circuit extracorporel d'un filtre sp&ifique aux neutrophiles pendant une chirurgie valvulaire modifiait les r&ultats de I'intervention M&hodes : Un &hantillonnage de 24 patients subissant une intervention valvulaire ~ coeur ouvert entre juillet 1993 et juin 1994. Les patients ont ~t~ r~partis al~atoirement ~ un circuit extracorporel incluant un filtre sp&i-fique aux neutrophites (n = I I) ou un filtre standard (n= 13).R&ultats : Le filtre sp&ifique aux neutrophiles a diminu~ I'expression de CDI 8, une mol&ule adh&ive de surface, une heure (84,5 + 4,2 vs 98,8 _ 3,8%), quatre heures (80 +-4,2 vs 95,1 +_ 3,9%) et 24 heures (75,2 +_ 4,2 vs 98,2 -+ 3,9%) apr~s I'op&ation comparativement au flltre standard. Le d&ompte total des globules blancs, des neutrophiles et des cytokines pro-inflammatoires (IL-6, IL8) &aient ~ tous les moments identiques entre les groupes. Les mesures de r&ultats incluant la PaO 2, I'index cardiaque, la fraction d'~jection, les donn~es h~modynamiques, I'utilisation d'inotropes, la spirom~trie (VEMS, CVF) et la dur~e du s~jour hospitalier ~taient identiques entre les groupes, Conclusion : !Lajout d'un filtre sp&ifique aux neutrophiles pendant la chirurgie ~ coeur ouvert ~puise s~lec-tivement les neutrophiles activ~s. Aucune autre diff&ence n'est discernable entre les groupes, l'utilisation courante de filtres sp&ifiques aux neutrophiles en clinique chez des patients soumis ~ une chirurgie valvulaire coeur ouvert n'est pas justifi6e.

Introduction Obstetrical ultrasound imaging is critical in identifying at-risk pregnancies and informing clinical management. The coronavirus disease 2019 (COVID-19) pandemic has exacerbated challenges in accessing obstetrical ultrasound for patients in underserved rural and remote communities where this service is not available. This prospective descriptive study describes our experience of providing obstetrical ultrasound services remotely using a telerobotic ultrasound system in a northern Canadian community isolated due to a COVID-19 outbreak. Methods A telerobotic ultrasound system was used to perform obstetrical ultrasound exams remotely in La Loche, Canada, a remote community without regular access to obstetrical ultrasound. Using a telerobotic ultrasound system, a sonographer 605 km away remotely controlled an ultrasound probe and ultrasound settings. Twenty-one exams were performed in a five-week period during a COVID-19 outbreak in the community, including limited first-, second- and third-trimester exams ( n = 11) and complete second-trimester exams ( n = 10). Participants were invited to complete a survey at the end of the telerobotic ultrasound exam describing their experiences with telerobotic ultrasound. Radiologists subsequently interpreted all exams and determined the adequacy of the images for diagnosis. Results Of 11 limited obstetrical exams, radiologists indicated images were adequate in nine (81%) cases, adequate with some reservations in one (9%) case and inadequate in one (9%) case. Of 10 second-trimester complete obstetrical exams, radiologists indicated images were adequate in two (20%) cases, adequate with some reservations in three (30%) cases and inadequate in five (50%) cases. Second-trimester complete obstetrical exams were limited due to a combination of body habitus, foetal lie and telerobotic technology. Discussion A telerobotic ultrasound system may be used to answer focused clinical questions such as foetal viability, dating and foetal presentation in a timely manner while minimising patient travel to larger centres and potential exposure to severe acute respiratory virus coronavirus 2 during the COVID-19 pandemic.