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Ultrasound primary care

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https://www.readbyqxmd.com/read/30323322/a-pilot-randomised-blinded-placebo-controlled-trial-of-paracetamol-for-later-treatment-of-a-patent-ductus-arteriosus
#1
Martin Kluckow, Hazel Carlisle, Margaret Broom, Patricia Woods, Michele Jeffery, Deepa Desai, Nick Evans
OBJECTIVE: To explore the efficacy and risks of oral paracetamol in later (>2 weeks old) treatment of patent ductus arteriosus (PDA). STUDY DESIGN: A multicentre double-blind placebo-controlled randomised pilot trial in three neonatal intensive care units in Australia. Infants born <33 weeks with haemodynamically significant PDA were treated with a 5-day course of oral paracetamol or placebo. Cardiac ultrasounds were used to document haemodynamic parameters...
October 15, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/30315778/burden-and-cost-of-gastrointestinal-liver-and-pancreatic-diseases-in-the-united-states-update-2018
#2
REVIEW
Anne F Peery, Seth D Crockett, Caitlin C Murphy, Jennifer L Lund, Evan S Dellon, J Lucas Williams, Elizabeth T Jensen, Nicholas J Shaheen, Alfred S Barritt, Sarah R Lieber, Bharati Kochar, Edward L Barnes, Y Claire Fan, Virginia Pate, Joseph Galanko, Todd H Baron, Robert S Sandler
BACKGROUND & AIMS: Estimates of disease burden can inform national health priorities for research, clinical care, and policy. We aimed to estimate health care use and spending among gastrointestinal (GI) (including luminal, liver, and pancreatic) diseases in the United States. METHODS: We estimated health care use and spending based on the most currently available administrative claims from commercial and Medicare Supplemental plans, data from the GI Quality Improvement Consortium Registry, and national databases...
October 10, 2018: Gastroenterology
https://www.readbyqxmd.com/read/30315038/canadian-national-survey-of-point-of-care-ultrasound-training-in-family-medicine-residency-programs
#3
Taft Micks, David Braganza, Shuo Peng, Patti McCarthy, Kyle Sue, Pamela Doran, Jeffrey Hall, Harland Holman, Danielle O'Keefe, Peter Rogers, Peter Steinmetz
OBJECTIVE: To assess the current state of point-of-care ultrasound (POCUS) training in Canadian family medicine residency programs. DESIGN: Cross-sectional survey to evaluate POCUS education in accredited Canadian family medicine residency programs; only 1 completed survey was accepted per residency program. SETTING: Seventeen accredited Canadian family medicine residency programs. PARTICIPANTS: Fourteen directors of family medicine programs across Canada...
October 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/30309438/screening-to-detect-precursor-lesions-of-pancreatic-adenocarcinoma-in-high-risk-individuals-a-single-center-experience
#4
Jesse Lachter, Carly Rosenberg, Tomer Hananiya, Iyad Khamaysi, Amir Klein, Kamel Yassin, Elizabeth Half
OBJECTIVE OF THE WORK: Pancreatic cancer (PC) is a deadly disease that is most commonly diagnosed at an incurable stage. Early diagnosis is the most important factor for improving prognosis. Evidence is beginning to accumulate that screening and surveillance may lead to the early detection of precursor lesions and/or pancreatic cancer in asymptomatic individuals. Proper screening methods and identification of such precursor lesions may enable effective pre-emptive interventions to prevent further fatalities...
October 4, 2018: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/30304457/oral-dydrogesterone-versus-intravaginal-micronized-progesterone-gel-for-luteal-phase-support-in-ivf-a-randomized-clinical-trial
#5
Georg Griesinger, Christophe Blockeel, Gennady T Sukhikh, Ameet Patki, Bharati Dhorepatil, Dong-Zi Yang, Zi-Jiang Chen, Elke Kahler, Claire Pexman-Fieth, Herman Tournaye
STUDY QUESTION: Is oral dydrogesterone 30 mg daily non-inferior to 8% micronized vaginal progesterone (MVP) gel 90 mg daily for luteal phase support in IVF? SUMMARY ANSWER: Oral dydrogesterone demonstrated non-inferiority to MVP gel for the presence of fetal heartbeats at 12 weeks of gestation (non-inferiority margin 10%). WHAT IS KNOWN ALREADY: The standard of care for luteal phase support in IVF is the use of MVP; however, it is associated with vaginal irritation, discharge and poor patient compliance...
October 10, 2018: Human Reproduction
https://www.readbyqxmd.com/read/30303419/comparison-of-effectiveness-of-epidural-analgesia-and-monitored-anesthesia-care-for-high-intensity-focused-ultrasound-treatment-of-adenomyosis
#6
Chang-Soon Lee, Jae Young Lee, Soohan Ro, Seungeun Choi, Jee Youn Moon
BACKGROUND: High-intensity focused ultrasound (HIFU) is a noninvasive thermodestructive procedure targeting internal organs with concentrated sonification energy that may cause pain. We aimed to compare the effectiveness of epidural analgesia (EA) and monitored anesthesia care (MAC) in HIFU treatment of uterine adenomyosis. MATERIALS AND METHODS: Sixty-eight patients were included in this case-control study. Thirty-seven patients underwent MAC; 31 patients underwent fluoroscope-guided epidural analgesia...
October 10, 2018: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/30301606/ultrasound-guidance-improves-safety-and-efficiency-of-central-line-placements
#7
Cory N Criss, Samir K Gadepalli, Niki Matusko, Marcus D Jarboe
BACKGROUND: Use of ultrasound-guidance for central venous access in adults is the standard of care. There is, however, less clarity in the role of routine ultrasound use in obtaining venous access in children. We sought to evaluate safety and efficiency of the placement of central lines utilizing an ultrasound-guided approach compared to the traditional, landmark approach in pediatric patients. STUDY DESIGN: A single-institution retrospective chart review, using CPT codes, was performed for all tunneled central venous catheters in children between 2005 and 2017 by the same pediatric surgery group...
September 13, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/30300982/primary-gastric-small-cell-carcinoma-presenting-as-linitis-plastica-diagnosed-using-endoscopic-ultrasound-guided-biopsy-a-case-report
#8
Ra Ri Cha, Jin Kyu Cho, Wan Soo Kim, Jin Joo Kim, Jae Min Lee, Sang Soo Lee, Hyun Jin Kim
Small cell carcinomas are the most aggressive, highly malignant neuroendocrine tumors; among these, gastric small cell carcinoma (GSCC) is extremely rare. Here we report a case of a patient with primary GSCC, presenting as linitis plastic, who was diagnosed using endoscopic ultrasound (EUS)-guided biopsy. With undiagnosed linitis plastica, an 80-year-old woman was referred to our institution. Abdominal computed tomography revealed irregular wall thickening extending from the gastric body to the antrum. Endoscopy suspected to have Borrmann type IV advanced gastric cancer...
October 5, 2018: Clinical Endoscopy
https://www.readbyqxmd.com/read/30294182/prevalence-of-osteoporosis-in-peri-and-post-menopausal-women-in-slum-area-of-mumbai-india
#9
Omna Shaki, Sanjay Kumar Rai, Manoj Kashid, Barun K Chakrabarty
Objective: We conducted our study involving 1400 peri- and post-menopausal women who live in a slum area of Mumbai to determine the prevalence of osteoporosis, awareness about osteoporosis, education (knowledge regarding osteoporosis), treatment and prevention of osteoporosis. Material and Methods: A detailed medical, surgical, obstetrical & gynecological, menstrual, and drug history was recorded in a predesigned questionnaire designated for the study. Height and weight and body mass index were measured, physical activity level especially load bearing exercise was recorded, and amount of sunlight exposure per day was also recorded...
July 2018: Journal of Mid-life Health
https://www.readbyqxmd.com/read/30293920/methods-of-gestational-age-assessment-influence-the-observed-association-between-antiretroviral-therapy-exposure-preterm-delivery-and-small-for-gestational-age-infants-a-prospective-study-in-cape-town-south-africa
#10
Thokozile Rosemary Malaba, Marie-Louise Newell, Hlengiwe Madlala, Alexander Perez, Clive Gray, Landon Myer
PURPOSE: Heterogeneous findings exist on antiretroviral therapy (ART) use in pregnancy and preterm delivery (PTD) or infants born small-for-gestational age (SGA). Whether reported differences may be explained by methods used to ascertain gestational age (GA) has not been explored. METHODS: We enrolled consecutive pregnant women attending a large primary care antenatal clinic in South Africa. Public-sector midwives assessed GA by last menstrual period (LMP) and symphysis-fundal height (SFH)...
August 29, 2018: Annals of Epidemiology
https://www.readbyqxmd.com/read/30288324/-b-in-it-a-community-based-model-for-the-management-of-hepatitis-b-patients-in-primary-care-clinics-using-a-novel-web-based-clinical-tool
#11
Debra A O'Leary, Eleanor Cropp, David Isaac, Paul V Desmond, Sally Bell, Tin Nguyen, Darren Wong, Jessica Howell, Jacqui Richmond, Jenny O'Neill, Alexander J Thompson
Background: The current model of care for the treatment of chronic hepatitis B (CHB) in Australia is through specialist Hepatology or Infectious Diseases clinics, and limited accredited primary care practices. Capacity is limited, and less than 5% of Australians living with CHB currently access therapy. Increasing treatment uptake is an urgent area of clinical need. Nucleos(t)ide analogue therapy is safe and effective treatment for CHB that is suitable for community prescribing. We have evaluated the success of a community-based model for the management of CHB in primary care clinics using a novel web-based clinical tool...
2018: Hepatology, Medicine and Policy
https://www.readbyqxmd.com/read/30285523/proximal-external-aortic-compression-for-life-threatening-abdominal-pelvic-and-junctional-hemorrhage-an-ultrasonographic-study-in-adult-volunteers
#12
Matthew J Douma, Christopher Picard, Domhnall O'Dochartaigh, Peter G Brindley
INTRODUCTION: Following life-threatening junctional trauma, the goal is to limit blood loss while expediting transfer to operative rescue. Unfortunately, life-threatening abdominal-pelvic or junctional hemorrhage is often not amenable to direct compression and few temporizing strategies are available beyond hemostatic dressings, hypotensive resuscitation, and balanced transfusion. OBJECTIVES: In this study, we evaluated proximal external aortic compression to arrest blood flow in healthy adult men...
October 4, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/30275785/successful-treatment-of-cesarean-scar-pregnancy-with-suction-curettage-our-experiences-in-early-pregnancy
#13
Ayşe Karahasanoglu, Işıl Uzun, Ayşegül Deregözü, Mucize Ozdemir
Background: Cesarean scar pregnancy is an ectopic pregnancy embedded in the myometrium of a cesarean scar. Several types of conservative treatment have been used to treat cesarean scar pregnancy, but no management protocol has been established for this rare, life-threatening condition. The purpose of this study was to evaluate the feasibility of suction curettage as a first-line treatment in early cesarean scar pregnancy. Methods: During a 4-year period, 19 cases of cesarean scar pregnancy were diagnosed at Süleymaniye Maternity Hospital in Istanbul, Turkey...
2018: Ochsner Journal
https://www.readbyqxmd.com/read/30267194/children-with-appendicitis-on-the-us-mexico-border-have-socioeconomic-challenges-and-are-best-served-by-a-freestanding-children-s-hospital
#14
Clark Anderson, Sarah Peskoe, Megan Parmer, Nelda Eddy, Jarett Howe, Tamara N Fitzgerald
INTRODUCTION: The US-Mexico border is medically underserved. Recent political changes may render this population even more vulnerable. We hypothesized that children on the border present with high rates of perforated appendicitis due to socioeconomic barriers. METHODS: A prospective survey was administered to children presenting with appendicitis in El Paso, Texas. Primary outcomes were rate of perforation and reason for diagnostic delay. We evaluated the association between demographics, potential barriers to care, risk of perforation and risk of misdiagnosis using logistic regression...
September 28, 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/30264769/use-of-transrectal-ultrasound-in-the-management-of-urologic-diseases-in-a-tertiary-hospital-in-north-western-nigeria
#15
Abubakar Sadiq Muhammad, Abdullahi Abdulwahab-Ahmed, Ngwobia Peter Agwu, Garba Yunusa, Khalid Abdullahi, Ismaila Arzika Mungadi
Background: Transrectal ultrasound (TRUS)-guided biopsy of the prostate is considered as a standard of care for diagnosis of prostate cancer. The objective of this study was to document our experience in the use of TRUS in the management of urologic diseases in Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. Materials and Methods: This was a retrospective study of patients who had TRUS at UDUTH from December 2009 to November 2017. Relevant data were extracted from the procedure register, and case folders of the patients...
July 2018: Nigerian Postgraduate Medical Journal
https://www.readbyqxmd.com/read/30257634/management-of-inflammatory-bowel-disease
#16
Emily K Wright, Nik S Ding, Ola Niewiadomski
Australia has one of the highest incidence rates of inflammatory bowel disease (IBD) in the world. Early diagnosis and treatment for IBD is critical. For Crohn disease, in particular, this may change the natural history of disease and reduce disability. Faecal calprotectin is a sensitive test that can be used by primary care physicians to assist in determining which patients with gastrointestinal symptoms may have IBD. This allows for prompt identification of patients who may benefit from endoscopy. Regular re-evaluation of disease status with strategies that can safely, readily and reliably detect the presence of inflammation with faecal biomarkers and imaging is important...
September 1, 2018: Medical Journal of Australia
https://www.readbyqxmd.com/read/30254912/a-case-of-bilateral-tubal-pregnancy
#17
Ayano Funamizu, Atsushi Fukui, Rie Fukuhara, Asami Kobayashi, Hitomi Chiba, Yukiko Matsumura, Asami Ito, Hideki Mizunuma
Bilateral tubal pregnancy is very rare and occurs in only 1 out of every 200,000 spontaneous pregnancies. In this case, a 29-year-old woman with a history of primary infertility underwent treatment with human menopausal gonadotropin (hMG)-human chorionic gonadotropin (hCG), and became pregnant. A gestational sac (GS) was not detected in the uterus and transvaginal ultrasonography (USG) revealed GS with fetal heartbeat in the left adnexa at 7 weeks and 6 days of gestation. The patient underwent laparoscopic surgery and ultimately, bilateral tubal pregnancy was diagnosed...
October 2017: Gynecology and minimally invasive therapy
https://www.readbyqxmd.com/read/30254746/pre-diagnostic-delays-caused-by-gastrointestinal-investigations-do-not-affect-outcomes-in-pancreatic-cancer
#18
Jeyakumar R Apollos, Sharukh Sami, Manju Nadh Prasanth, Jerusha Jeyakumar, Angus K McFadyen
Background: Pancreatic ductal adenocarcinomas are poor prognostic cancers accounting for 3% of all cancer cases in the UK. They often present late in the course of the disease process with non-specific symptoms, including gastro-intestinal(GI) symptoms. Delays in diagnosis occur when investigations are carried out in a primary care setting for GI symptoms. The aim of this study was to assess delays in pancreatic cancer diagnosis when patients were referred for GI investigations and evaluate its effect on survival...
October 2018: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/30228684/a-comparison-of-point-of-care-ultrasonography-use-in-rural-versus-urban-emergency-departments-throughout-missouri
#19
Michael Mengarelli, Anthony Nepusz, Tatyana Kondrashova
We surveyed emergency department directors at 56 Missouri hospitals about availability of ultrasound equipment, primary uses for ultrasonography, and factors that could increase ultrasonography use in the emergency departments. Results indicated large-sized hospitals, typically in urban areas, used ultrasonography more than medium-sized or small-sized hospitals. Lack of ultrasound equipment and appropriately trained physicians contributed to limited use of ultrasonography in small-sized hospitals, typically in rural areas...
January 2018: Missouri Medicine
https://www.readbyqxmd.com/read/30211771/point-of-care-ultrasound-abnormalities-in-late-onset-severe-preeclampsia-prevalence-and-association-with-serum-albumin-and-brain-natriuretic-peptide
#20
Clemens M Ortner, Vijay Krishnamoorthy, Elmari Neethling, Margot Flint, Justiaan L Swanevelder, Carl Lombard, Susan Fawcus, Robert A Dyer
BACKGROUND: Pilot studies applying point-of-care ultrasound (POCUS) in preeclampsia indicate the presence of pulmonary interstitial edema, cerebral edema, and cardiac dysfunction. Laboratory markers of oncotic pressure (albumin) and cardiac dysfunction (brain natriuretic peptide [BNP]) may be abnormal, but the clinical application remains unclear. We investigated the prevalence of pulmonary interstitial syndrome (PIS), cardiac dysfunction, and increased optic nerve sheath diameter (ONSD) in late-onset preeclampsia with severe features...
September 10, 2018: Anesthesia and Analgesia
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