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Biomedical subjects

T Dubinsky

Publications and source records attributed to T Dubinsky.

6 recordsLinked to original sources
PubMed2001

Thoracic sonography.

Sonography has inherent limitations for thoracic imaging because sound waves are reflected by bone and air space (such as in lung parenchyma). However, sonography is less expensive and more convenient than computed tomography (CT) or magnetic resonance imaging (MRI); it provides immediate information with real-time imaging; and it can provide information not available from a standard radiograph. This review describes the utility and limitations of sonography and compares sonography to radiography, CT, and MRI with regard to diagnosing pleural, pulmonary, and aortic diseases, including pneumothorax, pleural effusions and masses, hemothorax, empyema, consolidated lung, pneumonia, pulmonary abscess, pulmonary embolism, mediastinal masses, aortic dissection, aortic intramural hematoma, and penetrating aortic ulcers.

Aortic Dissection↗
PubMed1999

Is color Doppler ultrasound useful in diagnosing ovarian cancer?

In summary, the emergence of CDUS presented an interesting new technical approach to the study of neovascularization in ovarian cancers. Techniques for CDUS are technically difficult and plagued with artifacts making correct interpretation difficult. Measures of blood flow (such as the resistive index) overlap significantly between ovarian cancers and benign ovarian tumors. Wide differences in estimates of the sensitivity and specificity of CDUS have been published, and fundamental norms such as resistive index also vary greatly among studies. Explanations for these differences are lacking. Most studies were performed in academic centers with referrals of high risk patients. This limits the ability to generalize results to the community. Data are insufficient to include CDUS in diagnostic protocols for ovarian cancer.

Evidence-Based Medicine↗
PubMed1997

Predicting poor neonatal outcome: a comparative study of noninvasive antenatal testing methods.

OBJECTIVE: The assessment of fetal well-being in the third trimester of pregnancy depends on many variables including fetal size, amniotic fluid volume, umbilical cord arterial Doppler waveforms, the nonstress test, and the biophysical profile, yet little has been written that directly compares these variables. In this study, we compared amniotic fluid indexes, umbilical cord arterial Doppler waveforms, nonstress tests, and biophysical profiles for predicting poor neonatal outcomes in fetuses who are small for gestational age (SGA). SUBJECTS AND METHODS: From April 11, 1994, through August 1, 1995, a cohort of 108 SGA fetuses was identified. Follow-up was available in 97 of these cases. Receiver operating characteristic curves were constructed for Doppler systolic:diastolic ratios and for amniotic fluid indexes. Student's t test and logistic regression analysis were used to compare umbilical cord arterial Doppler imaging, amniotic fluid indexes, the nonstress test, and the biophysical profile for predicting poor neonatal outcome. RESULTS: Of the 30 fetuses who had poor outcomes, five were emergency cesarean deliveries, three died, three had intracranial hemorrhages, one had a cerebral infarct, 12 had prolonged admission to the neonatal intensive care unit (NICU) (> 10 days), and six had NICU admissions at term. Of the variables we assessed, the sensitivities for predicting poor outcome were as follows: cord Doppler imaging, 64%; low amniotic fluid volume (oligohydramnios), 32%; biophysical profile, 18%; and nonstress test, 14%. Receiver operating characteristic curves showed that a systolic:diastolic ratio of 4.0 and an amniotic fluid index of 5 cm (independent of gestational age) were the most accurate cutoff values for predicting poor outcome. Logistic regression analysis showed that amniotic fluid indexes and umbilical cord arterial Doppler imaging were independent predictors of poor outcome and that the predictive value of the biophysical profile varied according to the amniotic fluid index. CONCLUSION: Doppler waveform abnormalities were the most accurate predictor of poor neonatal outcome in a cohort of SGA fetuses. Umbilical cord arterial Doppler waveform analysis should be included in the surveillance of SGA fetuses.

Amniotic Fluid↗
PubMed1993

Fetal hyperechogenic bowel and Down's syndrome.

Hyperechogenic bowel was identified among 55 of 6781 (0.81%) fetuses prior to second-trimester genetic amniocentesis. Trisomy 21 was found in eight of the 55 (14.5%) fetuses identified with hyperechogenic bowel compared to 60 of 6726 (0.89%) fetuses with normal bowel echogenicity (p < 0.001). Hyperechogenic bowel carried a 16-fold greater risk for Down's syndrome than normal bowel echogenicity (relative risk 16.8, 95% confidence intervals 8.2-32.5). Chromosome abnormalities other than trisomy 21 were found in four additional fetuses with hyperechogenic bowel (two triploid and one each with 47,XXX; 45,X/47,XXX mosaicisim). Combining these four cases with the eight fetuses having trisomy 21, 21.8% (12 of 55) of fetuses with hyperechogenic bowel proved to have a chromosome abnormality. We conclude that hyperechogenic bowel is associated with chromosome abnormalities, particularly Down's syndrome, when detected during the second trimester.

Journal Article↗
PubMed1993

Echogenic fetal bowel during the second trimester: clinical importance.

Clinical outcomes of 95 second-trimester fetuses prospectively considered to have echogenic bowel at ultrasound were compared with a control group of 110 consecutive second-trimester fetuses. Among the 95 fetuses in the study group, 64 (67%) had moderately echogenic (grade 2) or markedly echogenic (grade 3) bowel relative to the liver. Among the 110 fetuses in the control group, only two (1.8%) had moderately echogenic (grade 2) bowel; the rest (98.2%) had isoechoic (grade 0) or midly echogenic (grade 1) bowel relative to the liver. Adverse outcomes occurred in 45 of the 95 fetuses (47%) with echogenic bowel compared with eight of the 110 fetuses (7.27%) in the control group (P < .01; relative risk, 6.5; 95% confidence interval, 3.2, 13.1). Adverse outcomes included chromosomal abnormalities, intrauterine growth retardation, fetal demise, or other fetal anomalies. Within the study group, adverse outcomes occurred in 40 of the 64 fetuses (62%) with grade 2 or 3 bowel echogenicity, compared with five of the 31 fetuses (16%) with grade 1 echogenicity. Echogenic bowel is associated with an increased risk of adverse fetal outcome and this risk is confined primarily to grades 2 and 3 echogenicity.

Chromosome Aberrations↗