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https://www.readbyqxmd.com/read/28509402/a-combined-hands-on-teaching-program-and-clinical-pathway-focused-on-pleural-ultrasound-and-procedure-supervision-transforms-pleural-procedure-outcomes
#1
Timothy Edwards, Alistair Cook, Matthew Salamonsen, Farzad Bashirzadeh, David Fielding
INTRODUCTION: Management of pleural effusions is a common diagnostic and management problem. We reviewed the outcomes from pleural procedures after the instigation of pleural effusion management guidelines focusing on pleural ultrasound and a hands-on teaching program followed with procedure supervision that enabled many operators to perform such procedures. METHODS: A retrospective analysis of all procedures performed for pleural effusions on medical patients. Outcomes were assessed prior to the instigation of pleural effusion management guidelines (pleural pathway) and hands-on teaching (January 2010 to June 2011) and following these interventions (January 2012 to June 2013)...
May 16, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28502520/-exploring-the-diaphragm-ultrasound-is-essential
#2
REVIEW
P Richard
The diaphragm is the muscle most implicated in breathing. Its morphological exploration usually depends on pulmonary radiography, fluoroscopy, CT-scanning and MRI. Its function is evaluated by the classical respiratory functional tests, the measurement of maximum inspiratory and expiratory pressures, the transdiaphragmatic pressure and even an electromyogram. Ultrasound is a technique still insufficiently used in respiratory medicine. It offers, however, many advantages: it is easy to implement, there is no irradiation, it is usable at the bedside, particularly when the patient is immobile or in intensive care...
May 12, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28497416/internal-medicine-point-of-care-ultrasound-curriculum-consensus-recommendations-from-the-canadian-internal-medicine-ultrasound-cimus-group
#3
Irene W Y Ma, Shane Arishenkoff, Jeffrey Wiseman, Janeve Desy, Jonathan Ailon, Leslie Martin, Mirek Otremba, Samantha Halman, Patrick Willemot, Marcus Blouw
Bedside point-of-care ultrasound (POCUS) is increasingly used to assess medical patients. At present, no consensus exists for what POCUS curriculum is appropriate for internal medicine residency training programs. This document details the consensus-based recommendations by the Canadian Internal Medicine Ultrasound (CIMUS) group, comprising 39 members, representing 14 institutions across Canada. Guiding principles for selecting curricular content were determined a priori. Consensus was defined as agreement by at least 80% of the members on POCUS applications deemed appropriate for teaching and assessment of trainees in the core (internal medicine postgraduate years [PGY] 1-3) and expanded (general internal medicine PGY 4-5) training programs...
May 11, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28497206/-current-status-of-teaching-in-lung-ultrasound-query-of-knowledge-utilization-need-and-preferred-teaching-method
#4
R Tomasi, J Aichner, M Heim, T Edrich, D Hinzmann, E Kochs, B Zwißler, P Scheiermann
BACKGROUND: Lung ultrasound (LUS) is a point-of-care technique which can quickly identify or rule out pathological findings. To date, it is unclear if knowledge about the use of LUS is readily available. OBJECTIVES: We aimed to identify how much knowledge about the use of LUS is present, if there is a need for teaching in LUS, as well as the preferred teaching method in LUS. MATERIALS AND METHODS: A total of 54 participants from two university departments of anesthesiology were randomized into the groups Online, Classroom, and Control...
May 11, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28485200/assessment-of-early-treatment-response-by-rapid-cardiothoracic-ultrasound-in-acute-heart-failure-cardiac-filling-pressures-pulmonary-congestion-and-mortality
#5
Jonas Öhman, Veli-Pekka Harjola, Pasi Karjalainen, Johan Lassus
BACKGROUND: It is unclear how to optimally monitor acute heart failure (AHF) patients. We evaluated the timely interplay of cardiac filling pressures, brain natriuretic peptides (BNPs), lung ultrasound (LUS) and symptoms during AHF treatment. METHODS: We enrolled 60 patients who had been hospitalised for AHF. Patients were examined with a rapid cardiothoracic ultrasound (CaTUS) protocol, combining LUS and focused echocardiographic evaluation of cardiac filling pressures (i...
May 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28474458/accuracy-of-complement-activation-product-levels-to-detect-infected-pleural-effusion-in-rats
#6
Guilherme E Peterson, Samanta S Silva, Sérgio L Amantéa, Patrícia Miorelli, Paulo Sanches, Jane Kulczynski, Eliane Roesch, José Carlos Fraga
BACKGROUND: Pleural empyema is a well-known complication of pneumonia. If treatment is delayed, empyema may increase morbidity and mortality in affected patients. Therefore, the identification of empyema biomarkers in parapneumonic pleural effusion is desirable. Previous research has suggested complement activation products as candidate empyema markers. OBJECTIVE: To compare the levels of complement activation products C3a, C5a, and C5b9 in pleural effusion induced by Staphylococcus aureus (SA), Streptococcus pneumoniae (SP), or turpentine (control)...
May 5, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28462650/mechanical-complications-of-central-venous-catheterisation-in-trauma-patients
#7
J Odendaal, V Y Kong, B Sartorius, T Y Liu, Y Y Liu, D L Clarke
INTRODUCTION Central venous catheterisation (CVC) is a commonly performed procedure in a wide variety of hospital settings and is associated with appreciable morbidity. There is a paucity of literature focusing on mechanical complications specifically in the trauma setting. The aim of our study was to determine the spectrum of mechanical complications in a high-volume trauma centre in a developing world setting where ultrasound guidance was not available. METHODS A retrospective study was performed analysing data from a four-year period at the Pietermaritzburg Metropolitan Trauma Service in South Africa...
May 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28453379/pseudoamniotic-band-syndrome-post-fetal-thoracoamniotic-shunting-for-bilateral-hydrothorax
#8
Michelle Han, Yalda Afshar, Andrew H Chon, Emily Scibetta, Rashmi Rao, Ramen H Chmait
INTRODUCTION: Pseudoamniotic band syndrome (PABS) occurs iatrogenically after fetal surgery or amniocentesis due to chorioamniotic membrane separation. Separation of the amnion from the chorion can expand to form fibrous amniotic bands that can envelope fetal limbs or the umbilical cord, with consequences ranging from limb constriction to fetal demise. CASE REPORT: We report a case of bilateral fetal pleural effusions at 27 weeks' gestation treated by bilateral thoracoamniotic shunts...
April 28, 2017: Fetal and Pediatric Pathology
https://www.readbyqxmd.com/read/28449461/correlation-of-pleural-effusions-grayscale-sonographic-parameters-with-fluid-s-analysis-results
#9
Alexandros Kalkanis, Charalampos Varsamas, Konstantinos Gourgoulianis
BACKGROUND: Quantitative sonographic methods are used to assess pleural fluid's volume but no validated method exists for the measurement of the fluids' density and other qualitative values. We suggest a quantitative method, based on the pixel density of the pleural effusion's image, in order to evaluate the echogenicity of pleural effusion. METHODS: Pleural ultrasound (US) was performed in 62 patients with pleural effusion. Five consequent images of the pleural effusion were retrieved through axial view between the 9(th) and the 10(th) rib and one from the 10(th) rib through coronal view and converted into the high-resolution tagged image file format...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28444433/boundaries-of-the-thoracic-paravertebral-space-potential-risks-and-benefits-of-the-thoracic-paravertebral-block-from-an-anatomical-perspective
#10
Esther A C Bouman, Judith M Sieben, Andrea J R Balthasar, Elbert A Joosten, Hans-Fritz Gramke, Maarten van Kleef, Arno Lataster
PURPOSE: Thoracic paravertebral block (TPVB) may be an alternative to thoracic epidural analgesia. A detailed knowledge of the anatomy of the TPV-space (TPVS), content and adnexa is essential in understanding the clinical consequences of TPVB. The exploration of the posterior TPVS accessibility in this study allows (1) determination of the anatomical boundaries, content and adnexa, (2) description of an ultrasound-guided spread of low and high viscous liquid. METHODS: In two formalin-fixed specimens, stratification of the several layers and the 3D-architecture of the TPVS were dissected, observed and photographed...
April 25, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28443595/evaluation-of-the-diagnostic-role-of-bedside-lung-ultrasonography-in-patients-with-suspected-pulmonary-embolism-in-the-emergency-department
#11
Hüseyin Acar, Serkan Yılmaz, Elif Yaka, Nurettin Özgür Doğan, Asım Enes Özbek, Murat Pekdemir
BACKGROUND: Despite the existence of detailed consensus guidelines, challenges continue to exist regarding efficient, appropriate and safe imaging methods for the diagnosis of suspected pulmonary embolism. AIMS: This study was conducted to investigate the role of wedge sign, B-lines and pleural effusion seen on bedside lung ultrasound in the diagnosis of pulmonary embolism. STUDY DESIGN: Diagnostic accuracy study. METHODS: During the first evaluation of patients with suspected pulmonary embolism, bedside lung ultrasound was performed, and the B-lines, wedge sign, and pleural effusion were investigated...
April 6, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28440869/massive-pleural-effusion-on-the-contralateral-side-of-a-venous-peripherally-inserted-central-catheter
#12
Selim Sancak, Abdulhamit Tuten, Tulin Gokmen Yildirim, Guner Karatekin
A preterm newborn infant, delivered at 30 weeks of gestation and 965 g birth weight, developed respiratory distress with resistant hypoxia after a central catheter line was inserted via the right venae brachialis on postnatal day 21. Left-sided massive pleural effusion, collapsed left lung with air bronchograms, and bidirectional shunting through reopened ductus arteriosus were detected by targeted neonatal echocardiography. Hydrothorax was drained under sonographic guidance, producing a milky-white fluid biochemically compatible with parenteral nutrition...
April 25, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28435782/thoracic-ultrasound-what-non-radiologists-need-to-know
#13
REVIEW
Jonathan P Williamson, Chris Grainge, Ahilan Parameswaran, Scott H Twaddell
PURPOSE OF REVIEW: The aim of this review is to provide the theoretical and practical knowledge essential for non-radiologists to develop the skills necessary to apply thoracic ultrasound as an extension of clinical assessment and intervention. RECENT FINDINGS: Issues relating to training and competence are discussed and a library of thoracic ultrasound videos is provided to illustrate artefacts, pleural, parenchymal and pneumothorax pathology as well as important pitfalls to consider...
2017: Current Pulmonology Reports
https://www.readbyqxmd.com/read/28430713/a-national-survey-of-neonatologists-barriers-and-prerequisites-to-introduce-point-of-care-ultrasound-in-neonatal-icus
#14
Hussnain S Mirza, Gregory Logsdon, Anoop Pulickal, Mark Stephens, Rajan Wadhawan
Point-of-care (POC) ultrasound refers to the use of portable imaging. Although POC ultrasound is widely available to the neonatologists in Australia and Europe, neonatologists in the United States report limited availability. Our objective was to seek the US neonatologists' perception of barriers and prerequisites in adopting POC ultrasound in neonatal intensive care units. An online survey link was sent via e-mail to 3000 neonatologists included in the database maintained by the American Academy of Pediatrics...
April 20, 2017: Ultrasound Quarterly
https://www.readbyqxmd.com/read/28416051/-mirror-syndrome-is-a-rare-complication-in-pregnancy-characterized-by-oedema-and-hydrops-fetalis
#15
Signe Eiland, Eleonora Cvetanovska, Anne Høyrup Bjerre, Henrik Nyholm, Karin Sundberg, Lone Nikoline Nørgaard
We describe a case of mirror syndrome. A 41-year-old woman, para 4, was referred to hospital at 32 weeks of gestational age with excessive oedema. She developed oliguria, mild hypertension and proteinuria. Fetal ultrasound confirmed severe hydrops fetalis. Intrauterine pleural drainage was performed without improvement of the condition. Since maternal symptoms worsened, a caesarean section was performed at 34 weeks with delivery of a live hydropic girl who died after 17 hours. Maternal symptoms decreased four days after delivery with full recovery two weeks post-partum...
April 10, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28411293/safe-and-effective-bedside-thoracentesis-a-review-of-the-evidence-for-practicing-clinicians
#16
REVIEW
Richard Schildhouse, Andrew Lai, Jeffrey H Barsuk, Michelle Mourad, Vineet Chopra
BACKGROUND: Physicians often care for patients with pleural effusion, a condition that requires thoracentesis for evaluation and treatment. We aim to identify the most recent advances related to safe and effective performance of thoracentesis. METHODS: We performed a narrative review with a systematic search of the literature. Two authors independently reviewed search results and selected studies based on relevance to thoracentesis; disagreements were resolved by consensus...
April 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28411248/state-of-the-art-thoracic-ultrasound-intervention-and-therapeutics
#17
John P Corcoran, Rachid Tazi-Mezalek, Fabien Maldonado, Lonny B Yarmus, Jouke T Annema, Coenraad F N Koegelenberg, Victoria St Noble, Najib M Rahman
The use of thoracic ultrasound outside the radiology department and in everyday clinical practice is becoming increasingly common, having been incorporated into standards of care for many specialties. For the majority of practitioners, their experience of, and exposure to, thoracic ultrasound will be in its use as an adjunct to pleural and thoracic interventions, owing to the widely recognised benefits for patient safety and risk reduction. However, as clinicians become increasingly familiar with the capabilities of thoracic ultrasound, new directions for its use are being sought which might enhance practice and patient care...
April 14, 2017: Thorax
https://www.readbyqxmd.com/read/28410259/central-venous-catheter-placement-in-the-left-internal-jugular-vein-complicated-by-perforation-of-the-left-brachiocephalic-vein-and-massive-hemothorax-a-case-report
#18
Lindsay R Wetzel, Priyesh R Patel, Nicholas L Pesa
An elderly male presented for emergent repair of a ruptured abdominal aortic aneurysm. For anticipated volume resuscitation, vasopressor administration, and hemodynamic monitoring, a large-bore central venous catheter was placed in the left internal jugular vein under ultrasound guidance before surgical incision. Initially, there were no readily apparent signs of venous perforation. However, a massive left hemothorax developed because of perforation of the brachiocephalic vein and violation of the pleural space...
April 13, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28404216/lung-ultrasonography-to-diagnose-pneumothorax-of-the-newborn
#19
Jing Liu, Jing-Han Chi, Xiao-Ling Ren, Jie Li, Ya-Juan Chen, Zu-Lin Lu, Ying Liu, Wei Fu, Rong-Ming Xia
OBJECTIVE: To explore the reliability and accuracy of lung ultrasound for diagnosing neonatal pneumothorax. METHODS: This study was divided into two phases. (1) In the first phase, from January 2013 to June 2015, 40 patients with confirmed pneumothorax had lung ultrasound examinations performed to identify the sonographic characteristics of neonatal pneumothorax. (2) In the second phase, from July 2015 to August 2016, lung ultrasound was undertaken on 50 newborn infants with severe lung disease who were suspected of having pneumothorax, to evaluate the sonographic accuracy and reliability to diagnose pneumothorax...
April 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28402981/prenatal-nonvisualization-of-the-gallbladder-a-diagnostic-and-prognostic-dilemma
#20
Aina Ruiz, Ana Robles, Francisca Salva, Ana Filgueira, Cristina Díaz, Miquel Juan, Albert Tubau
INTRODUCTION: Nonvisualization of the fetal gallbladder has been associated with benign conditions such as isolated gallbladder agenesis or severe diseases such as biliary atresia (BA). Recently, gamma-glutamyl transpeptidase (GGTP) fetal blood levels were reported as useful after 22 weeks. OBJECTIVE: To determine the contribution of fetal blood GGTP levels after 22 weeks, based on 2 cases. Case 1: 20+4-week secundipara, with subcutaneous edema and pleural effusion...
April 13, 2017: Fetal Diagnosis and Therapy
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