To investigate the effects of ultrasonic evaluation of a progressive yoga exercise program on reducing the inter-recti distance (IRD) among women in the early postpartum period. Postpartum women (
n
=
116
), free of obstetric complications and in recovery following vaginal delivery between weeks 1 and 12, were recruited. Participants were randomly assigned to the control and yoga exercise group in the pre- and post-intervention design. The control group received no treatment, while the yoga exercise group participated in a guided 12-week progressive yoga exercise program started at postpartum week 1. The IRD was examined using high-frequency ultrasound at postpartum weeks 6 and 12. The results showed that the supraumbilical, umbilical, and subumbilical IRD were significantly decreased in the yoga exercise group after the 12-week progressive yoga exercise intervention compared with the first (week 6) and second (week 12) measurements. The differences in IRD at supraumbilical, umbilical, and subumbilical intervals between weeks 6 and 12 significantly increased in the yoga exercise group. Progressive yoga exercises are effective program that reduce IRD among women in the early postpartum period through ultrasound evaluation. In conclusion, women should advocate combined yoga exercise in the early postpartum days following a supervised program.
This study aimed to evaluate the diagnostic value of HyCoSy using sulfur hexafluoride microbubbles for fallopian tubal patency assessment in infertile females. Twenty-four studies, including 1358 females with 2661 detected fallopian tubes published from January 2003 to May 2019, were identified. The pooled sensitivity was 93% (95% CI: 90-95%), while the specificity was 90% (95% CI: 87-92%). The area under the receiver-operating characteristic curve was 0.96 (95% CI: 94-98%). The specificity of the four-dimensional HyCoSy subgroup was higher than the 2D/3D subgroup; an increased dose of contrast agent did not affect the specificity, with only a slightly reduced sensitivity.
Objectives
To evaluate the individual and combined performances of the Ovarian‐adnexal Reporting and Data System Ultrasound (O‐RADS US) and serum cancer antigen 125 (CA‐125) in assessing adnexal malignancy risk in women with different menopausal status.
Methods
This retrospective study included patients with adnexal masses scheduled for surgery based on their preoperative US and histopathology results between January 2018 and January 2020. O‐RADS were used to assess adnexal malignancy by two experienced radiologists. The area under the receiver operating characteristic curves (AUCs) were used to compare the accuracy of O‐RADS and a combination of O‐RADS and CA‐125. The weighted κ index was used to evaluate the inter‐reviewer agreement.
Results
Overall, the data of 443 lesions in 443 patients were included, involving 312 benign lesions and 131 malignant lesions. There were 361 premenopausal and 82 postmenopausal patients. The inter‐reviewer agreement for the two radiologists was very good (weighted κ: 0.833). Combing O‐RADS US and CA‐125 significantly increased diagnostic accuracy for classifying malignant from benign adnexal masses, compared with O‐RADS US alone (AUC: 0.97 vs 0.95, P < .001 for premenopausal population and AUC: 0.93 vs 0.85, P < .001 for postmenopausal population). The AUCs of O‐RADS with and without CA‐125 ranged from 0.50 to 0.99 for different adnexal pathology subtypes (ie, benign, borderline, Stage I–IV, and metastatic tumors).
Conclusion
The addition of CA‐125 helps improve discrimination of O‐RADS US between benign and malignant adnexal masses, especially in postmenopausal women.
Immediate feedback and hands-on teaching were provided after the observer's official classification. In order to evaluate the number of scans needed to gain proficiency, the learning curve using the cumulative sum (LC-CUSUM) was utilized. The acceptable performance rate (proficiency) was set at 15% failure, the unacceptable performance rate was set at 30%, and the equivalence zone was set at 5%. Results: One hundred and fifty learning curve TVS examinations were performed. Twenty-six (17.3%) patients had rectal DE and 34 (22.7%) had a negative sliding sign by the reference standard. Each observer performed 50 scans supervised by the reference standard. The overall accuracy of presence or absence of rectal DE was 90%, ranging from 82À94% amongst the three observers. The accuracy of POD state classification was 92.7%, ranging from 90À96% amongst the three observers. LC-CUSUM for rectal DE demonstrated observer 1 did not reach proficiency, whereas observers 2 and 3 required 32 and 20 TVS examinations, respectively. For POD obliteration state classification, observer 1 did not reach proficiency, whereas observers 2 and 3 required 46 and 30 TVS examinations, respectively. Conclusion: For two of the three gynaecological sonology trainees, proficiency in diagnosing rectal DE and POD obliteration was attainable in less than the 50 planned supervised ultrasounds. Contrary to other studies on the topic, this study suggests that not all trainees can reach proficiency during a program based upon a pre-defined number of scans. Overall, we demonstrate that a one-size-fits-all approach may not be appropriate for teaching trainees these advanced ultrasound skills.
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