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https://www.readbyqxmd.com/read/29688110/a-mixed-methods-evaluation-of-a-multidisciplinary-point-of-care-ultrasound-program
#1
Andrew Smith, Michael Parsons, Tia Renouf, Sarah Boyd, Peter Rogers
BACKGROUND: Point of Care Ultrasound (PoCUS) is well established within emergency medicine, however, the availability of formal training for other clinical disciplines is limited. Memorial University has established a cost-efficient, multidisciplinary PoCUS training program focusing on training residents' discipline-specific ultrasound skills. This study evaluates the skills, knowledge, and attitudes of residents who participated in the program. METHODS: Analysis was conducted using a mixed-methods, sequential exploratory approach...
April 24, 2018: Medical Teacher
https://www.readbyqxmd.com/read/29685110/wirsung-atraumatic-rupture-in-patient-with-pancreatic-pseudocysts-a-case-presentation
#2
Martino Gerosa, Marco Chiarelli, Angelo Guttadauro, Matilde De Simone, Fulvio Tagliabue, Melchiorre Costa, Sabina Terragni, Ugo Cioffi
BACKGROUND: Pancreatic duct disruption is a challenging condition leading to pancreatic juice leakage and consequently to pancreatic fluid collections. The manifestations of pancreatic main duct leak include pseudocysts, walled-off necrosis, pancreatic fistulas, ascites, pleural and pericardial effusions. Pseudocyst formation is the most frequent outcome of a pancreatic duct leak. CASE PRESENTATION: We describe a case of a 64-year old man with large multiple pancreatic cysts discovered for progressive jaundice and significant weight loss in the absence of a previous episode of acute pancreatitis...
April 23, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29683962/pulmonary-ultrasound-a-new-era-in-critical-care-medicine
#3
Silvio A Ñamendys-Silva, Eduardo Garrido-Aguirre, Juan P Romero-González, Roger G Mena-Arceo, Oscar Rojo Del Moral, Octavio González-Chon
Pulmonary ultrasonography is a complementary study that is easy to perform at the patient bedside with no need to transfer the patient to special areas. The technique provides information with high sensitivity and specificity for different pathologies. Pulmonary ultrasonography is a very important diagnostic tool in the assessment of lung, pleural, and chest wall diseases. Pulmonary ultrasound provides low-cost analysis, easy real-time reproduction, and safety, all of which have made it a beneficial tool in the diagnostic arsenal available to medical personnel...
April 20, 2018: Ultrasound Quarterly
https://www.readbyqxmd.com/read/29679518/new-insights-in-the-use-of-pleural-ultrasonography-for-diagnosis-and-treatment-of-pleural-disease
#4
Giampietro Marchetti, Sabrina Arondi, Francesca Baglivo, Sara Lonni, Federico Quadri, Alberto Valsecchi, Nicola Venturoli, Paolo Ceruti
The use of transthoracic ultrasound has acquired a wide consensus among respiratory physicians during the last few years. The developing of portable and easily available devices favorites patient's bedside evaluation. Transthoracic ultrasound provides rapid, real-time and low-cost diagnostic information, allowing image-guided chest interventions and reducing procedural risks. The different acoustic impedance between aerated and not aerated organs produces artifacts known as A lines, B lines, sliding sign, lung point, etc...
April 21, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29675063/chylothorax-after-endoscopic-ultrasound-with-fine-needle-aspiration-causing-migrating-appearance-of-a-solitary-fibrous-tumor-of-the-pleura
#5
Francesco Mongelli, Maurice FitzGerald, Stefano Cafarotti, Rolf Inderbitzi
Trans-esophageal endoscopic ultrasound with fine-needle aspiration (EUS-FNA) is widely used to assess mediastinal masses. Common complications are self-limiting bleeding or pain, but occasionally, more serious accidents have been reported. A 54-year-old woman with a huge mass located in the left middle mediastinum presented 2 days after an EUS-FNA with dyspnea and chest pain. Computed tomography scan showed a massive left pleural effusion. A chest tube was inserted revealing a chylothorax (1800 ml). Over the following days, the pleural effusion did not diminish, requiring a left mini-thoracotomy...
April 2018: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/29666966/point-of-care-lung-ultrasound-for-diagnosis-of-pneumocystis-jirovecii-pneumonia-notes-from-the-field
#6
Maria Teresa Giordani, Francesca Tamarozzi, Daniel Kaminstein, Enrico Brunetti, Tom Heller
BACKGROUND: Thoracic ultrasound is helpful to evaluate lung pathology in patients with acute dyspnea. Several studies have demonstrated the efficacy of point-of-care ultrasound in patients with extrapulmonary TB and HIV co-infection. This retrospective, open-label case-control study explores the role of lung ultrasound in the diagnosis of Pneumocystis jirovecii pneumonia (PJP) in HIV-positive patients. In particular, it highlights the potential role of specific sonographic features that may be unique to this population...
April 17, 2018: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29666098/a-misplaced-peripherally-inserted-central-catheter-presenting-as-contralateral-pleural-effusion
#7
Jogender Kumar, Sudeep K C, Kanya Mukhopadhyay, Somosri Ray
A preterm neonate born at 27 weeks, with a birth weight of 555 g, was on continuous positive airway pressure (CPAP) for apnoea of prematurity and initially received total parenteral nutrition (TPN) through the umbilical venous catheter. Peripherally inserted central catheter (PICC) was inserted in the left basilica vein on day 8 to continue TPN. The baby developed respiratory distress with persistent hypoxia after TPN was initiated through the PICC line. The baby required mechanical ventilation due to worsening of respiratory distress, and chest X-ray, as well as ultrasound conducted 12 hours, postinfusion of TPN revealed right-sided pleural effusion...
April 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29656607/expert-agreement-in-the-interpretation-of-lung-ultrasound-studies-performed-on-mechanically-ventilated-patients
#8
Scott J Millington, Robert T Arntfield, Robert Jie Guo, Seth Koenig, Pierre Kory, Vicki Noble, Haney Mallemat, Jordan R Schoenherr
OBJECTIVES: Although lung ultrasound (US) has been shown to have high diagnostic accuracy in patients presenting with acute dyspnea, its precision in critically ill patients is unknown. We investigated common areas of agreement and disagreement by studying 6 experts as they interpreted lung US studies in a cohort of intensive care unit (ICU) patients. METHODS: A previous study by our group asked experts to rate the quality of 150 lung US studies performed by 10 novices in a population of mechanically ventilated patients...
April 15, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29651944/role-of-point-of-care-ultrasonography-for-management-of-sepsis-and-septic-shock
#9
Gentle Sunder Shrestha, Shrikanth Srinivasan
BACKGROUND: Sepsis and septic shock remain a major cause of morbidity and mortality globally. In recent years, outcome of patients with sepsis and septic shock has gradually improved, in part due to early recognition and timely appropriate management. Bedside physical examination can be of limited value to identify the source of infection and to decide appropriate management. Moreover, the clinical status of these patients can change rapidly, as a part of disease progression or in response to treatment or intervention...
April 12, 2018: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/29644060/infected-renal-cyst-presented-with-pleural-effusion-in-a-woman-with-autosomal-dominant-polycystic-kidney-disease
#10
Ester Casillas-Sagrado, Victor Burguera, Maria Eugenia Rioja-Martín, Maite Rivera-Gorrín
We present a 64-year-old woman with autosomal dominant polycystic kidney disease and hepatic cysts admitted to our hospital for high fever, intense coughing and right abdominal pain. The chest X-ray showed right pleural effusion suggestive of pneumonia. An abdominal ultrasound and computed tomography (CT) were done but did not show evidence of cyst infection or other abdominal complications. A gallium-67-citrate single-photon emission CT/CT, a relatively cheaper technique than positron emission tomography/CT was performed...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29619581/approach-to-undifferentiated-dyspnea-in-emergency-department-aids-in-rapid-clinical-decision-making
#11
Siva Nageswara Rao Guttikonda, Kiran Vadapalli
BACKGROUND: Diagnosis and management of patients presenting with acute dyspnea is one of the major challenges for physicians in emergency department (ED). A correct diagnosis is frequently delayed and difficult to ascertain, and clinical uncertainty is common, explaining the need for rapid diagnosis and a management plan. The primary aim of our study is to assess a diagnostic strategy using multiorgan point of care ultrasonography (USG) to differentiate patients presenting with acute dyspnea to ED into different diagnostic categories for timely management in a resource-limited setting...
April 4, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29617577/ultrasound-guidance-for-pleural-catheter-placement
#12
Adriano Peris, Lorenzo Tutino, Giovanni Cianchi, Gianfranco Gensini
New England Journal of Medicine, Volume 378, Issue 14, April 2018.
April 5, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29595647/ultrasound-guided-minimally-invasive-percutaneous-nephrolithotomy-in-the-treatment-of-pediatric-patients-6-years-a-single-center-10-years-experience
#13
Yang Hong, Qingquan Xu, Xiaobo Huang, Zhenjie Zhu, Qingya Yang, Lizhe An
Owing to the fragile kidney and relative small collecting system of pediatric patients, urologists were always reluctant to treat pediatric urolithiasis with PCNL. Here we conduct a study to assess the effectiveness and safety of pediatric patients with renal calculi <6 years.A total of 88 pediatric patients (99 kidney units) <6 years underwent the ultrasound (US)-guided minimally invasive percutaneous nephrolithotomy in our institute from March 2006 to April 2016. The mean age was 30.9 months (range, 7-72 months)...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29578263/telomere-length-determined-by-the-fluorescence-in-situ-hybridisation-distinguishes-malignant-and-benign-cells-in-cytological-specimens
#14
Y Matsuda, A Suzuki, S Esaka, Y Hamashima, M Imaizumi, M Kinoshita, H Shirahata, Y Kiso, H Kojima, M Matsukawa, Y Fujii, N Ishikawa, J Aida, K Takubo, T Ishiwata, M Nishimura, T Arai
BACKGROUND: Telomeres are tandem repeats of TTAGGG at the end of eukaryotic chromosomes that play a key role in preventing chromosomal instability. The aim of the present study is to determine telomere length using fluorescence in situ hybridisation (FISH) on cytological specimens. METHODS: Aspiration samples (n = 41) were smeared on glass slides and used for FISH. RESULTS: Telomere signal intensity was significantly lower in positive cases (cases with malignancy, n = 25) as compared to negative cases (cases without malignancy, n = 16), and the same was observed for centromere intensity...
March 26, 2018: Cytopathology: Official Journal of the British Society for Clinical Cytology
https://www.readbyqxmd.com/read/29575312/lung-ultrasound-reclassification-of-chest-x-ray-data-after-pediatric-cardiac-surgery
#15
Massimiliano Cantinotti, Lamia Ait Ali, Marco Scalese, Raffaele Giordano, Manuel Melo, Ettore Remoli, Eliana Franchi, Alberto Clemente, Riccardo Moschetti, Pierluigi Festa, Dorela Haxiademi, Luna Gargani
INTRODUCTION: Lung ultrasound is gaining consensus for the diagnosis of some pulmonary conditions. Pulmonary complications are common in pediatric cardiac surgery. However, its use remains limited in this setting. Our aim was to test the feasibility of lung ultrasound following pediatric cardiac surgery and to compare lung ultrasound and chest X-ray findings, assessing whether lung ultrasound may provide additional information. METHODS: One hundred and thirty-eight lung ultrasound examinations were performed in 79 children (median age 9...
March 25, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29574857/accuracy-of-medical-students-in-detecting-pleural-effusion-using-lung-ultrasound-as-an-adjunct-to-the-physical-examination
#16
Peter Steinmetz, Sharon Oleskevich, Alina Dyachenko, Jane McCusker, John Lewis
OBJECTIVES: This study compared the accuracy of medical students in identifying pleural effusion in hospitalized patients using the physical examination versus lung ultrasound (US). METHODS: Fourth-year medical students (n = 14) received 20 hours of general practical US training (including 2 hours of specialized lung US training) plus theoretical and video documentation. The students used the physical examination alone versus the physical examination plus lung US to document the presence or absence of pleural effusion in the right and left hemithoraces of hospitalized patients (n = 11 patients; 22 hemithoraces examined 544 times in total)...
March 25, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29557577/a-challenging-diagnosis-of-dyspnea-a-case-report-of-contralateral-reexpansion-pulmonary-edema
#17
Alfonso Sforza, Maria V Carlino, Giovanni Albano, Maria I Arnone, Giuliano De Stefano, Andrea D'Amato, Federica De Pisapia, Giovanni De Simone, Costantino Mancusi
Reexpansion pulmonary edema (RPE) is an uncommon complication of thoracentesis or chest drainage. It occurs in the ipsilateral or contralateral lung. Causes, pathogenesis and therapy are not well understood especially for contralateral RPE. We describe a case of fatal contralateral RPE in a 59-years-old woman with right lung cancer underwent ultrasound-guided thoracentesis for massive pleural effusion and severe dyspnea. Pathogenesis of contralateral RPE is probably multifactorial and in this case is mostly due to the overperfusion of the healthy lung and consequent capillary damage...
March 19, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29524388/a-pilot-feasibility-study-in-establishing-the-role-of-ultrasound-guided-pleural-biopsies-in-pleural-infection-the-audio-study
#18
Ioannis Psallidas, Nikolaos I Kanellakis, Rahul Bhatnagar, Rahul Ravindran, Ahmed Yousuf, Anthony J Edey, Rachel M Mercer, John P Corcoran, Robert J Hallifax, Rachelle Asciak, Prashanth Shetty, Tao Dong, Hania E G Piotrowska, Colin Clelland, Nick A Maskell, Najib M Rahman
BACKGROUND: Pleural infection is a common complication of pneumonia associated with high mortality and poor clinical outcome. Treatment of pleural infection relies on the use of broad-spectrum antibiotics, since reliable pathogen identification occurs infrequently. We performed a feasibility interventional clinical study assessing the safety and significance of ultrasound (US)-guided pleural biopsy culture to increase microbiological yield. In an exploratory investigation, the 16S rRNA technique was applied to assess its utility on increasing speed and accuracy versus standard microbiological diagnosis...
March 7, 2018: Chest
https://www.readbyqxmd.com/read/29517587/chest-imaging-for-the-diagnosis-of-complicated-parapneumonic-effusions
#19
José M Porcel
PURPOSE OF REVIEW: To provide an overview of the contribution of thoracic ultrasound (TUS) and computed tomography (CT) in the identification of complicated parapneumonic effusions (CPPE), defined as those which need chest tube drainage for resolution. RECENT FINDINGS: A recent retrospective study found that visualization of complex (nonanechoic) effusions on TUS (likelihood ratio positive = 6.92) outperformed the recognition of loculated/septated effusions on CT (likelihood ratio = 2...
March 6, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29513814/transforming-growth-factor-beta1-tgf-%C3%A3-1-levels-in-a-rat-model-of-induced-pleural-empyema
#20
Samanta Sarmento da Silva, Guilherme Eckert Peterson, Sérgio Luis Amantéa, Patrícia Miorelli, Jane Maria Ulbrich, Eliane Roesch, Paulo Roberto Sanches, Jose Carlos Fraga
PURPOSE: To evaluate the concentration of transforming growth factor beta 1 (TGFB1) levels in a rat pleural effusion obtained by inoculation of intrapleural bacteria or turpentine through thoracentesis. METHODS: Thirty-Nine Wistar rats were divided into three groups: Staphylococcus aureus (SA, n = 17); Streptococcus pneumoniae (SP, n = 12); and turpentine (control, n = 10). Pleural fluid was collected through ultrasound-guided thoracentesis 12 h, 24 h, and 36 h after instillation of bacteria or turpentine...
February 2018: Acta Cirúrgica Brasileira
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