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Ultrasound primary care

Benjamin C Gibson, Joseph L Sanguinetti, Bashar W Badran, Alfred B Yu, Evan P Klein, Christopher C Abbott, Jeffrey T Hansberger, Vincent P Clark
Background: Transcranial Ultrasound Stimulation (tUS) is an emerging technique that uses ultrasonic waves to noninvasively modulate brain activity. As with other forms of non-invasive brain stimulation (NIBS), tUS may be useful for altering cortical excitability and neuroplasticity for a variety of research and clinical applications. The effects of tUS on cortical excitability are still unclear, and further complications arise from the wide parameter space offered by various types of devices, transducer arrangements, and stimulation protocols...
2018: Frontiers in Neurology
Karthik N Rao, Mohan Jagade, Vitthal D Kale, Devkumar Rengaraja, Amol Hekare
Tongue is one of the most common subsites involved by oral cancer. Improved surgical care and adjuvant therapy, along with better rehabilitation has significantly improved long-term survival and quality of life in patients with oral cancer. Primary surgical treatment is the preferred modality of treatment in cancers of the oral tongue. Although the surgical techniques have remained unchanged, various devices have been used to aid primary tumour resection, with a view to reduce bleeding and scarring. The purpose of this study is to compare resection of oral tongue tumours using ultrasonic coagulation device with conventional electrodiathermy...
December 2018: Indian Journal of Surgical Oncology
Sofia Pihl, Eva Uustal, Marie Blomberg
INTRODUCTION AND HYPOTHESIS: No measurements are available for diagnosing the extent of obstetric lacerations. The primary aim of this study was to evaluate the relation between the anovaginal distance (AVD) measured with transperineal ultrasound immediately after delivery and external anal sphincter injury. A secondary aim was to assess whether the palpated perineal thickness was associated with the AVD. METHODS: A prospective observational study of 150 primiparous women at the University Hospital, Linköping, Sweden...
December 10, 2018: International Urogynecology Journal
Ulf Näslund, Nawi Ng, Anna Lundgren, Eva Fhärm, Christer Grönlund, Helene Johansson, Bernt Lindahl, Bertil Lindahl, Kristina Lindvall, Stefan K Nilsson, Maria Nordin, Steven Nordin, Emma Nyman, Joacim Rocklöv, Davide Vanoli, Lars Weinehall, Patrik Wennberg, Per Wester, Margareta Norberg
BACKGROUND: Primary prevention of cardiovascular disease often fails because of poor adherence among practitioners and individuals to prevention guidelines. We aimed to investigate whether ultrasound-based pictorial information about subclinical carotid atherosclerosis, targeting both primary care physicians and individuals, improves prevention. METHODS: Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA) is a pragmatic, open-label, randomised controlled trial that was integrated within the Västerbotten Intervention Programme, an ongoing population-based cardiovascular disease prevention programme in northern Sweden...
December 3, 2018: Lancet
C Ouarab, M Brouri, J P Laroche, S Ayoub
INTRODUCTION: The prevalence of abdominal aortic aneurysm (AAA) in the general population in our country is not known, our aim was to evaluate it in patients over 60 years of age, to specify the risk factors and to evaluate the extension of aneurysmal disease and multisite subclinical atherosclerosis. METHODS: Descriptive, transversal, study collecting the data of a systematic ultrasound screening of sub-renal AAA in subjects receiving care in two Algerian hospital structures...
December 2018: Journal de Médecine Vasculaire
Xiao Lu, ChunShuang Wu, YuZhi Gao, Mao Zhang
BACKGROUND: High-flow nasal cannula (HFNC) oxygen therapy has been shown to reduce the need for mechanical ventilation and decrease the duration of hospital and intensive care unit (ICU) stays for patients with a severely compromised respiratory system. This study aims to observe the evolution of lung aeration via lung ultrasound score (LUS) in a chest-injured population who had been treated with HFNC oxygen therapy, and to assess the benefit of the HFNC oxygen therapy in trauma patients...
December 4, 2018: Journal of Intensive Care Medicine
C Strumann, K Flägel, T Emcke, J Steinhäuser
BACKGROUND: In response to a rising shortage of general practitioners (GPs), physicians in general internal medicine (GIM) have become part of the German primary care physician workforce. Previous studies have shown substantial differences in practice patterns between both specialties. The aim of this study was to analyse and compare the application of procedures by German GPs and GIM physicians based on routine data. METHODS: The Association of Statutory Health Insurance Physicians in the federal state Schleswig-Holstein (Northern Germany) provided invoicing data of the first quarters of 2013 and 2015...
December 3, 2018: BMC Family Practice
Monica L Zigman Suchsland, Elizabeth Witwer, Anjali R Truitt, Danielle C Lavallee, Ying Zhang, Philip Posner, Brian Do, Patrick M Bossuyt, Victoria Hardy, Matthew J Thompson
BACKGROUND: Imaging tests are one of the most sophisticated types of diagnostic tools used in health care, yet there are concerns that imaging is overused. Currently, tests are typically evaluated and implemented based on their accuracy, and there is limited knowledge about the range of patient-centered outcomes (PCOs) that imaging tests may lead to. This study explores patients' experiences and subsequent outcomes of imaging tests most notable to patients. METHODS: Adult patients from four primary care clinics who had an x-ray, CT, MRI, or ultrasound in the 12 months before recruitment participated in a single semistructured interview to recount their imaging experience...
October 25, 2018: Journal of the American College of Radiology: JACR
Fraser D Mackay, Felix Zhou, David Lewis, Jacqueline Fraser, Paul R Atkinson
Introduction Self-directed learning in medical professions is established as an effective method of training in certain modalities. Furthermore, simulation technology is becoming widely used and accepted as a valid method of training for various medical skills, with ultrasound being one of the best studied. The use of point-of-care ultrasound (PoCUS) in the practice of emergency medicine is well established, and PoCUS is a core competency of the Royal College of Physicians and Surgeons of Canada emergency medicine standards...
September 17, 2018: Curēus
Joseph R Pare, Samara E Pollock, James H Liu, Megan M Leo, Kerrie P Nelson
OBJECTIVES: Ultrasound guided peripheral intravenous catheters (USPIV) are frequently utilized in the Emergency Department (ED) and lead to reduced central venous catheter (CVC) placements. USPIVs, however, are reported to have high failure rates. Our primary objective was to determine the proportion of patients that required CVC after USPIV. Our secondary objective was to determine if classic risk factors for difficult vascular access were predictive of future CVC placement. METHODS: We performed a retrospective review for patients treated at a large academic hospital...
November 17, 2018: American Journal of Emergency Medicine
Lucille A Howard, Abigail C Mancuso, Ginny L Ryan
BACKGROUND: Müllerian aplasia or Mayer-Rokitansky-Küster-Hauser syndrome is described as congenital absence of the proximal vagina with or without absence of the cervix and uterus, most often recognized following the onset of primary amenorrhea. CASE: An 18-year-old female presented to a free medical clinic in Arcahaie, Haiti with primary amenorrhea, abdominal distention and cyclic monthly abdominal pain. Physical exam was significant for uterus palpable superior to the umbilicus, absence of vagina, and rectal exam without palpable vagina or cervix...
November 21, 2018: Journal of Pediatric and Adolescent Gynecology
Kun-Long Huang, Ching-Chang Tsai, Hung-Chun Fu, Hsin-Hsin Cheng, Yun-Ju Lai, Hsuan-Ning Hung, Leo Leung-Chit Tsang, Te-Yao Hsu
OBJECTIVES: The purpose of this article is to investigate the estimated blood loss in pregnant women undergoing cesarean section and placental extirpation to treat abnormal placentation and compare the outcomes of those who underwent prophylactic transcatheter arterial embolization (TAE) with those who did not. METHODS: A retrospective study was conducted on 17 pregnant women diagnosed with abnormal placentation in 2001⁻2018 in a single tertiary center. The patients were diagnosed by surgical finding, ultrasound, or magnetic resonance imaging (MRI)...
November 21, 2018: Journal of Clinical Medicine
Jean-Eudes Bourcier, Emeric Gallard, Jean-Philippe Redonnet, Magali Majourau, Dominique Deshaie, Jean-Marie Bourgeois, Didier Garnier, Thomas Geeraerts
BACKGROUND: Right iliac fossa abdominal pain is a common reason for emergency ward admissions, its etiology is difficult to diagnose. It can be facilitated by an imaging examination, such as a Computerized Tomography scan which exposes the patient to ionizing radiation and implies delays. A bedside ultrasound performed by emergency physicians could avoid these issues. The aim of our study was to assess the performance of ultrasound carried out at the patient's bedside by an emergency physician compared with a clinical-laboratory examination for the diagnosis of a surgical pathology in right iliac fossa pain...
November 23, 2018: Critical Ultrasound Journal
Lauro Cortigiani, Pamela Ramirez, Maico Coltelli, Francesco Bovenzi, Eugenio Picano
Previous studies have suggested a decline in positivity of stress cardiac imaging based on regional wall motion abnormalities (RWMA). To assess the rate of RWMA positivity of stress echocardiography (SE) over 3 decades in the same primary care SE lab. We retrospectively assessed the rate of SE positivity in 7626 SE tests (dipyridamole in 5053, dobutamine in 2496, exercise in 77) in consecutive patients with known or suspected coronary artery disease and /or heart failure who performed SE in a primary care referral center from April 1991 to May 2018...
November 20, 2018: International Journal of Cardiovascular Imaging
Zhengshang Ruan, Rongrong Ren, Wenwen Dong, Junjie Ma, Zhenyu Xu, Yanfei Mao, Lai Jiang
PURPOSE: Ultrasound can be used to non-invasively and rapidly examine airway conditions, but vocal cord visualization with the traditional approaches is poor. Our aim was to compare the accuracies of front-side transverse-axis ultrasound (FTU), lateral-side longitudinal-axis ultrasound (LLU), and the combination of both approaches for vocal cord movement disorder diagnoses (e.g., vocal cord paralysis or arytenoid cartilage dislocation). METHODS: We compared FTU, LLU, and the combination of both methods for patients in the intensive care unit (ICU)...
November 20, 2018: Intensive Care Medicine
Varun Mehta, Rajesh Kumar, Siddharth Parkash, Sanjeev Singla, Arshdeep Singh, Jagdeep Chaudhary, Hardeep Bains
BACKGROUND/AIMS: Necrotizing pancreatitis has morbidity and mortality rates exceeding most of the other acute medical emergencies despite the best possible medical and surgical care. Early surgical intervention has a high operative risk. MATERIALS AND METHODS: This prospective open-label study was designed to evaluate the role of percutaneous catheter drainage (PCD) of pancreatic necrosis as primary treatment of acute necrotizing pancreatitis. An ultrasound/computed tomography-guided drainage was performed with 10 or 12 Fr catheters using a 0...
November 16, 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Mythili Kalladka, Anuradha Navaneetham, Eli Eliav, Junad Khan, Gary Heir, Mel Mupparapu
Orofacial pain can often be the chief complaint of many systemic disorders. Cysticercosis involving the lateral pterygoids may cause limitation of mouth opening and may mimic clinical symptoms of a temporomandibular disorder. A 37-year-old female presented with 1-month-old complaint of limited mandibular range of motion. She reported a similar episode a year earlier and was diagnosed with a temporomandibular joint disorder by her primary dentist. Comprehensive intra- and extra-oral examinations were performed, which revealed a limitation of mouth opening accompanied by mild limitation of contralateral excursion...
October 2018: Journal of Indian Prosthodontic Society
Frances M Russell, Robert R Ehrman, Robinson Ferre, Luna Gargani, Vicki Noble, Jordan Rupp, Sean P Collins, Benton Hunter, Kathleen A Lane, Phillip Levy, Xiaochun Li, Christopher O'Connor, Peter S Pang
BACKGROUND: Medical treatment for acute heart failure (AHF) has not changed substantially over the last four decades. Emergency department (ED)-based evidence for treatment is limited. Outcomes remain poor, with a 25% mortality or re-admission rate within 30 days post discharge. Targeting pulmonary congestion, which can be objectively assessed using lung ultrasound (LUS), may be associated with improved outcomes. METHODS: BLUSHED-AHF is a multicenter, randomized, pilot trial designed to test whether a strategy of care that utilizes a LUS-driven treatment protocol outperforms usual care for reducing pulmonary congestion in the ED...
November 15, 2018: Heart & Lung: the Journal of Critical Care
Mette M Berger, Olivier Pantet, Nathalie Jacquelin-Ravel, Mélanie Charrière, Sabine Schmidt, Fabio Becce, Régine Audran, François Spertini, Luc Tappy, Claude Pichard
BACKGROUND & AIMS: Individualized supplemental parenteral nutrition (SPN) providing measured energy expenditure from day 4 reduced infectious complications in a previous study including 305 intensive care (ICU) patients. The study aimed at investigating the metabolic, and immune responses underlying the clinical response of the previous trial. METHODS: Randomized controlled trial enrolling 23 critically ill patients on day 3 (D3) of admission to the ICU who were fed less than 60% of their energy target by the enteral nutrition (EN) alone: allocation to either continued EN or to SPN to a target validated by indirect calorimetry...
November 5, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Julio E González-Aguirre, Claudia Paola Rivera-Uribe, Erick Joel Rendón-Ramírez, Rogelio Cañamar-Lomas, Juan Antonio Serna-Rodríguez, Roberto Mercado-Longoría
INTRODUCTION: Invasive respiratory support is a cornerstone of Critical Care Medicine, however, protocols for withdrawal of mechanical ventilation are still far from perfect. Failure to extubation occurs in up to 20% of patients, despite a successful spontaneous breathing trial (SBT). METHODS: We prospectively included ventilated patients admitted to medical and surgical intensive care unit in a university hospital in northern Mexico. At the end of a successful SBT, we measured diaphragmatic shortening fraction (DSF) by the formula: diaphragmatic thickness at the end of inspiration - diaphragmatic thickness at the end of expiration/diaphragmatic thickness at the end of expiration×100, and the presence of B-lines in five regions of the right and left lung...
November 13, 2018: Archivos de Bronconeumología
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