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Ultrasound primary care

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https://www.readbyqxmd.com/read/30097422/comparing-internet-based-cognitive-behavioral-therapy-with-standard-care-for-women-with-fear-of-birth-randomized-controlled-trial
#1
Elisabet Rondung, Elin Ternström, Ingegerd Hildingsson, Helen M Haines, Örjan Sundin, Johanna Ekdahl, Annika Karlström, Birgitta Larsson, Birgitta Segeblad, Rebecca Baylis, Christine Rubertsson
BACKGROUND: Although many pregnant women report fear related to the approaching birth, no consensus exists on how fear of birth should be handled in clinical care. OBJECTIVE: This randomized controlled trial aimed to compare the efficacy of a guided internet-based self-help program based on cognitive behavioral therapy (guided ICBT) with standard care on the levels of fear of birth in a sample of pregnant women reporting fear of birth. METHODS: This nonblinded, multicenter randomized controlled trial with a parallel design was conducted at three study centers (hospitals) in Sweden...
August 10, 2018: JMIR Mental Health
https://www.readbyqxmd.com/read/30095337/the-efficacy-and-limits-of-magnetic-resonance-guided-focused-ultrasound-pallidotomy-for-parkinson-s-disease-a-phase-i-clinical-trial
#2
Na Young Jung, Chang Kyu Park, Minsoo Kim, Phil Hyu Lee, Young Ho Sohn, Jin Woo Chang
OBJECTIVE Recently, MR-guided focused ultrasound (MRgFUS) has emerged as an innovative treatment for numerous neurological disorders, including essential tremor, Parkinson's disease (PD), and some psychiatric disorders. Thus, clinical applications with this modality have been tried using various targets. The purpose of this study was to determine the feasibility, initial effectiveness, and potential side effects of unilateral MRgFUS pallidotomy for the treatment of parkinsonian dyskinesia. METHODS A prospective, nonrandomized, single-arm clinical trial was conducted between December 2013 and May 2016 at a single tertiary medical center...
August 10, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/30094401/a-pragmatic-approach-identifies-a-high-rate-of-nonalcoholic-fatty-liver-disease-with-advanced-fibrosis-in-diabetes-clinics-and-at-risk-populations-in-primary-care
#3
PreyaJanubhai Patel, Fabrina Hossain, Leigh Ula Horsfall, Xuan Banh, Kelly Lee Hayward, Suzanne Williams, Tracey Johnson, Anne Bernard, Nigel Neil Brown, Guy Lampe, Lyndall Buck, Nivene Saad, Anthony William Russell, Patricia Casarolli Valery, Katharine Margaret Irvine, Andrew Donald Clouston, Katherine Anne Stuart, William Rosenberg, Elizabeth Ellen Powell
Noninvasive serum biomarkers (nonalcoholic fatty liver disease fibrosis score [NFS], fibrosis 4 score [FIB-4], or enhanced liver fibrosis [ELF] test) are recommended as first-line tools to determine the risk of advanced fibrosis in nonalcoholic fatty liver disease. We aimed to assess the utility of a pragmatic approach to screening for clinically significant fibrosis in primary care and diabetes clinics. We recruited 252 patients from an endocrine clinic or primary care facility. Anthropometric measurements, ELF test, ultrasound, and liver stiffness measurements (LSMs) were performed...
August 2018: Hepatology communications
https://www.readbyqxmd.com/read/30079389/cost-effectiveness-of-treatments-for-superficial-venous-reflux-in-patients-with-chronic-venous-ulceration
#4
D Epstein, M Gohel, F Heatley, A H Davies
Background: Venous leg ulcers impair quality of life significantly, with substantial costs to health services. The aim of this study was to estimate the cost-effectiveness of interventional procedures alongside compression therapy versus compression therapy alone for the treatment of chronic venous leg ulceration. Methods: A Markov decision analytical model was developed. The main outcome measures were quality-adjusted life-years (QALYs) and lifetime costs per patient, from the perspective of the UK National Health Service at 2015 prices...
August 2018: BJS open
https://www.readbyqxmd.com/read/30075507/radiopathological-characteristics-and-outcomes-of-phyllodes-tumor-of-the-breast-in-malaysian-women
#5
Shamsiah Abdul Hamid, Kartini Rahmat, Marlina Tanty Ramli, Farhana Fadzli, Suniza Jamaris, Mee Hoong See, Kean Hooi Teoh, Nur Aishah Mohd Taib
Phyllodes tumor or cystosarcoma phyllodes is a rare fibroepithelial neoplasm which arises from the periductal stroma of the breast. They are classified as benign, borderline, and malignant based on the histologic features. However, all phyllodes tumor (PT) subtypes are regarded as having malignant potential and correct diagnosis is important for surgical management and optimal care. This study is a retrospective review of 76 women diagnosed as PT with highlights on the imaging characteristics, pathology, and surgical treatment over a 7-year period in a tertiary medical center of urban population in Malaysia...
August 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/30060799/metastatic-squamous-cell-carcinoma-versus-primary-high-grade-serous-carcinoma-of-the-ovary
#6
Feng Zhou, Wen Wang, Lili Huang
We report an extremely rare case of abnormal vaginal bleeding in a 66-year postmenopausal woman. A sterile speculum examination revealed no obvious tumour mass in the cervix. Serum levels of cancer antigen 125 and carcinoembryonic antigen were elevated at 480.3 IU/L and 19.3 ng/ml, respectively. Ultrasound showed a 4 × 3 × 2 cm hypoechoic solid mass on the left uterine adnexa, a 4-5 cm mass in the right adnexa, a 4 cm mass in the vesicouterine excavation and a 4-5 cm mass in the omentum. Finally, debulking surgery with tumour resection was performed...
August 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/30060741/endometrial-sampling-in-low-risk-patients-with-abnormal-uterine-bleeding-a-systematic-review-and-meta-synthesis
#7
Brenda F Narice, Brigitte Delaney, Jon M Dickson
BACKGROUND: One million women per year seek medical advice for abnormal uterine bleeding (AUB) in the United Kingdom. Many low-risk patients who could be managed exclusively in primary care are referred to hospital based gynaecology services. Performing endometrial sampling (ES) in the community may improve care, reduce the rate of referrals and minimise costs. We aimed to search and synthesise the literature on the effectiveness of ES (Pipelle versus other devices) in managing AUB in low-risk patients...
July 30, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/30056183/primary-care-provider-practice-patterns-and-barriers-to-hepatocellular-carcinoma-surveillance
#8
Okeefe L Simmons, Yuan Feng, Neehar D Parikh, Amit G Singal
BACKGROUND & AIMS: Low rates of hepatocellular carcinoma (HCC) surveillance are primarily due to provider-related process failures. However, few studies have evaluated primary care provider (PCP) practice patterns, attitudes, and barriers to HCC surveillance at academic tertiary care referral centers. METHODS: We conducted a web-based survey of PCPs at 2 tertiary care referral centers (132 clinics) from June 2017 through December 2017. The survey was adapted from pre-tested surveys and included questions about practice patterns, attitudes, and barriers to HCC surveillance...
July 26, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/30051080/development-of-hospice-and-palliative-medicine-knowledge-and-skills-for-emergency-medicine-residents-using-the-accreditation-council-for-graduate-medical-education-milestone-framework
#9
Jan Shoenberger, Sangeeta Lamba, Rebecca Goett, Paul DeSandre, Kate Aberger, Suzanne Bigelow, Todd Brandtman, Garrett K Chan, Robert Zalenski, David Wang, Mark Rosenberg, Karen Jubanyik
Objectives: Emergency medicine (EM) physicians commonly care for patients with serious life-limiting illness. Hospice and palliative medicine (HPM) is a subspecialty pathway of EM. Although a subspecialty level of practice requires additional training, primary-level skills of HPM such as effective communication and symptom management are part of routine clinical care and expected of EM residents. However, unlike EM residency curricula in disciplines like trauma and ultrasound, there is no nationally defined HPM curriculum for EM resident training...
April 2018: AEM education and training
https://www.readbyqxmd.com/read/30050254/clinical-radiology-going-an-extra-mile-for-patient-care
#10
Upendra Kumar Joish, Hirdesh Sahni, R Harikiran Reddy, Vivek Sreekanth
Context: Clinical details help radiologists report accurately. However, the clinical aspect has taken a backseat among radiologists, who are overdependent on referral notes. This leads to inaccurate assessment, financial burden, and loss of man hours. Aims: To re-emphasize the benefits of detailed clinical evaluation and real-time monitoring of imaging in interpreting images. Settings and Design: Prospective study. Materials and Methods: A study was done in the Department of Radiodiagnosis for 10 days, including all referred patients above 18 years of age...
April 2018: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/30045354/acute-scrotal-pain-and-a-different-use-of-an-old-imaging-method
#11
Despoina Tramma, Maria Gogou, Vasilios Lambropoulos
The differential diagnosis of scrotal pain in childhood is a challenge for every primary care physician. We report the case of a 5-year-old boy presenting to the emergency department owing to acute left scrotal pain. Ultrasound screening revealed a Morgagni hydatid in the left testis, which was surgically removed. X-rays revealed microcalcifications of the cyst wall and stroma, signs indicative of chronic inflammation. Results of histological examination confirmed radiographic evaluation. No similar use of x-rays has been described in literature before, to the best of our knowledge...
July 24, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/30045038/early-detection-of-structural-anomalies-in-a-primary-care-setting-in-the-netherlands
#12
Francesca Bardi, Eric Smith, Maja Kuilman, Rosalinde J M Snijders, Caterina Maddalena Bilardo
OBJECTIVE: This study assessed the percentage and type of congenital anomalies diagnosed at first-trimester ultrasound (US) scan in a primary care setting without following a standardized protocol for fetal anatomical assessment. MATERIALS AND METHODS: US scans performed between 11+0 and 13+6 weeks of gestation in pregnancies with estimated date of delivery between January 1, 2012 and January 1, 2016 were searched. Data were supplemented with results of 20-week scans and pregnancy outcome...
July 25, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/30037560/standard-long-iv-catheters-versus-extended-dwell-catheters-a-randomized-comparison-of-ultrasound-guided-catheter-survival
#13
Amit Bahl, Bophal Hang, Abigail Brackney, Steven Joseph, Patrick Karabon, Ammanee Mohammad, Ijeoma Nnanabu, Paul Shotkin
INTRODUCTION: Establishing peripheral intravenous (IV) access is a vital step in providing emergency care. Ten to 30% of Emergency Department (ED) patients have difficult vascular access (DVA). Even after cannulation, early failure of US-guided IV catheters is a common complication. The primary goal of this study was to compare survival of a standard long IV catheter to a longer extended dwell catheter. METHODS: This study was a prospective, randomized comparative evaluation of catheter longevity...
July 19, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30026813/effectiveness-of-a-multicenter-training-programme-to-teach-point-of-care-vascular-ultrasound-for-the-detection-of-peripheral-arterial-disease-in-people-with-diabetes
#14
Pasha Normahani, Rishi Agrawal, Vasilliki Bravis, Agnieszka Falinska, Linda Bloomfield, Zaheer Mehar, Dawn Gaulton, Alex Sangster, Tracey Arkle, Corinna Gomm, Mohamed Aslam, Nigel J Standfield, Usman Jaffer
Background: The primary aim of this study was to evaluate the effectiveness of a training programme to teach a focused bedside ultrasound scan (PAD-scan; Podiatry Ankle Duplex Scan) for the detection of arterial disease in people with diabetes. Methods: Five podiatrists and one diabetologist across two hospitals were enrolled in a structured training programme consisting of a training course (1-day), supervised scanning (5-weeks), independent scanning (3-weeks) and a final evaluation of performance (1-day)...
2018: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/30019140/the-role-of-wall-shear-stress-in-the-parent-artery-as-an-independent-variable-in-the-formation-status-of-anterior-communicating-artery-aneurysms
#15
Xin Zhang, Zhi-Qiang Yao, Tamrakar Karuna, Xu-Ying He, Xue-Min Wang, Xi-Feng Li, Wen-Chao Liu, Ran Li, Shen-Quan Guo, Yun-Chang Chen, Gan-Cheng Li, Chuan-Zhi Duan
OBJECTIVES: The study aimed to determine which hemodynamic parameters independently characterize anterior communicating artery (AcomA) aneurysm formation and explore the threshold of wall shear stress (WSS) of the parent artery to better illustrate the correlation between the magnitude of WSS and AcomA aneurysm formation. METHODS: Eighty-one patients with AcomA aneurysms and 118 patients without intracranial aneurysms (control population), as confirmed by digital subtraction angiography (DSA) from January 2014 to May 2017, were included in this cross-sectional study...
July 17, 2018: European Radiology
https://www.readbyqxmd.com/read/30012363/cost-effectiveness-of-selectmdx-in-prostate-cancer-risk-assessment
#16
Tim Govers, Laura Caba, Matthew J Resnick
PURPOSE: SelectMDx is a panel of urinary biomarkers used in conjunction with traditional risk factors to individualize risk prediction for clinically significant prostate cancer. In this study, we sought to characterize the cost-effectiveness of SelectMDx in a population of U.S. men with elevated PSA. MATERIALS AND METHODS: We developed a Markov decision-analytic model to simulate the chain of events and downstream outcomes associated with ultrasound-guided prostate biopsy and a strategy in which SelectMDx is implemented prior to biopsy...
July 13, 2018: Journal of Urology
https://www.readbyqxmd.com/read/29997720/symptomatic-cholelithiasis-in-an-ectopic-retrocolic-retroduodenal-subhepatic-duplicated-gallbladder
#17
Roman O Kowalchuk, Roman M Kowalchuk, Katia Kaplan-List, Theodore K Oates, Sean C Smith
Gallbladder duplication is a rare anatomic variant of biliary anatomy, which can present diagnostic and treatment challenges. In this case, a 49-year-old male presented with classic symptoms of biliary colic to his primary care physician, and while computed tomography (CT) noted the presence of gallstones, neither CT nor ultrasound was able to locate a gallbladder within the gallbladder fossa. Initial surgery found and cauterized a rudimentary gallbladder, but symptoms persisted, requiring a second surgery and secondary analysis of CT, ultrasound, and magnetic resonance imaging with magnetic resonance cholangiopancreatography...
August 2018: Radiology Case Reports
https://www.readbyqxmd.com/read/29996169/endoscopic-ultrasound-guided-drainage-and-treatment-of-symptomatic-pancreatic-fluid-collection-following-acute-or-acute-on-chronic-pancreatitis-a-single-center-case-series
#18
Dominik J Kaczmarek, Jacob Nattermann, Christian P Strassburg, Tobias J Weismüller
INTRODUCTION: Pancreatic fluid collection (PFC) is a common complication of acute pancreatitis. Endoscopic ultrasound (EUS)-guided drainage, which is often followed by direct endoscopic necrosectomy (DEN), has become the primary approach to treat PFC, including pancreatic pseudocysts (PP) and walled-off necrosis (WON). We aimed to determine retrospectively the short- and long-term results of patients treated in our endoscopy unit and to identify parameters that are associated with treatment efficacy and outcome...
July 11, 2018: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29992167/the-evolving-role-of-ultrasound-guided-percutaneous-laser-ablation-in-elderly-unresectable-breast-cancer-patients-a-feasibility-pilot-study
#19
Jacopo Nori, Maninderpal Kaur Gill, Icro Meattini, Camilla Delli Paoli, Dalmar Abdulcadir, Ermanno Vanzi, Cecilia Boeri, Silvia Gabbrielli, Elisabetta Giannotti, Francesco Lucci, Vania Vezzosi, Diego De Benedetto, Giulia Bicchierai, Simonetta Bianchi, Luis Sanchez, Lorenzo Orzalesi, Guido Carmelo, Vittorio Miele, Lorenzo Livi, Donato Casella
Background and Objectives: Breast-conserving surgery represents the standard of care for the treatment of small breast cancers. However, there is a population of patients who cannot undergo the standard surgical procedures due to several reasons such as age, performance status, or comorbidity. Our aim was to investigate the feasibility and safety of percutaneous US-guided laser ablation for unresectable unifocal breast cancer (BC). Methods: Between December 2012 and March 2017, 12 consecutive patients underwent percutaneous US-guided laser ablation as radical treatment of primary inoperable unifocal BC...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29983584/comparing-efficacy-of-lumen-apposing-stents-to-plastic-stents-in-the-endoscopic-management-of-mature-peripancreatic-fluid-collections-a-single-center-experience
#20
Matthew Fasullo, Yasir Al-Azzawi, Joan Kheder, Jeffrey Abergel, Wahid Wassef
Introduction: Mature peripancreatic fluid collection (MPFC) is a known and often challenging consequence of acute pancreatitis and often requires intervention. The most common method accepted is the "step-up approach," which consists of percutaneous drainage followed, if necessary, by minimally invasive retroperitoneal necrosectomy. Our paper aims to distinguish between plastic stents and lumen-apposing stents in the endoscopic management of MPFC in terms of morbidity, mortality, and haste of fluid collection resolution...
2018: Clinical and Experimental Gastroenterology
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