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Ultrasound in Emergency Medicine

German Devia Jaramillo, Jenny Castro Canoa, Emiro Valverde Galván
Sepsis and septic shock constitute a complex disease condition that requires the engagement of several medical specialties. A great number of patients with this disease are constantly admitted to the emergency department, which warrants the need for emergency physicians to lead in the recognition and early management of septic patients. Timely and appropriate interventions may help reduce mortality in a disease with an unacceptably high mortality rate. Poor control of cellular hypoperfusion is one of the most influential mechanisms contributing to the high mortality rate in these patients...
2018: Open Access Emergency Medicine: OAEM
Rosemary Thomas-Mohtat, Craig Sable, Kristen Breslin, Jacqueline G Weinberg, Aparna Prasad, Lauren Zinns, Joanna S Cohen
BACKGROUND: Focused cardiac ultrasound (FOCUS) is a core competency for pediatric emergency medicine (PEM) fellows. The objectives of this study were (1) to evaluate test characteristics of PEM-fellow-performed FOCUS for pericardial effusion and diminished cardiac function and (2) to assess image interpretation independent of image acquisition. METHODS: PEM fellows performed and interpreted FOCUS on patients who also received cardiology service echocardiograms, the reference standard...
December 9, 2018: Critical Ultrasound Journal
Carlos Guillén Astete, Sara Rodrigo González, Desiree Alfonso Pérez, Mónica Luque Alarcón, Roberto Penedo Alonso, María Jesús Estévez Rueda
For the purpose of assessing the impact of ultrasound in patients with acute shoulder pain, we conducted an analysis of quality health care indicators: need for reevaluation of the pain, rate of referral to specialized medicine and length of time in the emergency department. We reviewed the 1,433 records of patients attended to between 2015 and 2016. Thirty days after the first examination, 90 patients (10.1%) had returned to the control group (56 through the emergency department and 34 because of the), whereas, in the ultrasound (US) group, 14 (2...
December 5, 2018: Reumatología Clinica
Brit Long, Jennifer Robertson, Alex Koyfman
BACKGROUND: Small bowel obstruction (SBO) is a commonly diagnosed disease in the emergency department (ED). Recent literature has evaluated the ED investigation and management of SBO. OBJECTIVE: This review evaluates the ED investigation and management of adult SBO based on the current literature. DISCUSSION: SBO is most commonly due to occlusion of the small intestine, resulting in fluid and gas accumulation. This may progress to mucosal ischemia, necrosis, and perforation...
December 6, 2018: Journal of Emergency Medicine
M Priyanga Jayamal Dharmaratne, Amirthasingam Manoraj, Vasanthi Thevanesam, Asela Ekanayake, Nimal Savitri Kumar, Veranja Liyanapathirana, Eranga Abeyratne, B M Ratnayake Bandara
BACKGROUND: Identification of novel sources for developing new antibiotics is imperative with the emergence of antibiotic resistant bacteria. The fruits of Terminalia bellirica (Gaertn) Roxb., widely used in traditional medicine, were evaluated for antibacterial activity against multidrug-resistant (MDR) bacteria, antioxidant activity and cytotoxicity. METHODS: Twelve solvent extracts of T. bellirica fruits were prepared by direct aqueous extraction and sequential extraction with dichloromethane, methanol and water using Soxhlet, bottle-shaker and ultrasound sonicator methods...
December 7, 2018: BMC Complementary and Alternative Medicine
Quentin Daffos, Erwin Hansconrad, Patrick Plaisance, Dominique Pateron, Youri Yordanov, Anthony Chauvin
INTRODUCTION: Interest in ultrasonography in emergency medicine has increased in recent years, as reflected by a marked increase in publications on the topic. The aim of this study was to 1) describe and evaluate methodological characteristics of randomized controlled trials (RCTs) evaluating an ultrasound intervention in emergency department and 2) estimate whether the reports adequately described the intervention to allow replication. METHODS: We searched MEDLINE via PubMed for RCTs published in 2015 assessing an ultrasound intervention, regardless of type, that were performed in an emergency department or evaluated in an emergency situation...
November 17, 2018: American Journal of Emergency Medicine
Alejandro J Centurion, Harrison Youmans, Ibrahim Mamdouh Zeini
Improvements in ultrasound technology have increased the popularity and use of ultrasound as a diagnostic and therapeutic modality for many soccer-related musculoskeletal (MSK) injuries. As a dynamic imaging modality, ultrasound offers increased accuracy and efficacy with minimally invasive procedures, such as guided injections, percutaneous tenotomy, and regenerative therapies, in the clinical setting. Emerging evidence indicates that regenerative therapies, such as platelet-rich-plasma (PRP), mesenchymal stem cells, and amniotic products, are a promising treatment for many MSK injuries and are gaining popularity among professional athletes...
October 2018: American Journal of Orthopedics
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
Andrew J Degnan, Paul H Yi, Nathan Kim, John Swietlik, Eric Huh, Jie C Nguyen
INTRODUCTION: Nonradiologist providers increasingly perform diagnostic imaging examinations and imaging-guided interventions traditionally performed by radiologists, which have raised concerns regarding appropriate utilization and self-referral. The purpose of this study was to assess the contribution of imaging studies to Medicare reimbursements for highly compensated nonradiologist providers in specialties often performing imaging studies. METHODS: The Medicare Provider Utilization and Payment Database was queried for provider information regarding overall reimbursement for providers in anesthesiology, cardiology, emergency medicine, neurology, obstetrics and gynecology, orthopedic surgery, neurology, and vascular surgery...
November 2, 2018: Current Problems in Diagnostic Radiology
Marisa C Louie, Todd P Chang, Robert W Grundmeier
Advances in technology are continuously transforming medical care, including pediatric emergency medicine. The increasing adoption of point-of-care ultrasound examination can improve timely diagnoses without radiation and aids the performance of common procedures. The recent dramatic increase in electronic health record adoption offers an opportunity for enhanced clinical decision-making support. Simulation training and advances in technologies can provide continued proficiency training despite decreasing opportunities for pediatric procedures and cardiorespiratory resuscitation performance...
December 2018: Pediatric Clinics of North America
Minu Ambika Rajendran
Microbubble is an emerging modality in the field of Medicine for treatment and imaging. Ultrasound-guided microbubble is an effective diagnosing and treatment technique as it can reduce the systemic toxicity of chemotherapeutic drugs. It is also used in targeted gene delivery in gene therapy. The objective of the review article is to formulate a narrative review on the emerging importance of microbubbles in the diagnosis and treatment of cancer and its future in cancer management. The article focuses on the effectiveness of ultrasound-targeted microbubble in the treatment of malignancy...
September 4, 2018: Curēus
Tanvi Vaidya, Archi Agrawal, Shivani Mahajan, Meenakshi H Thakur, Abhishek Mahajan
The present era of precision medicine sees 'cancer' as a consequence of molecular derangements occurring at the commencement of the disease process, with morphologic changes happening much later in the process of tumorigenesis. Conventional imaging techniques, such as computed tomography (CT), ultrasound, and magnetic resonance imaging (MRI), play an integral role in the detection of disease at a macroscopic level. However, molecular functional imaging (MFI) techniques entail the visualisation and quantification of biochemical and physiological processes occurring during tumorigenesis, and thus has the potential to play a key role in heralding the transition from the concept of 'one size fits all' to 'precision medicine'...
November 8, 2018: Molecular Diagnosis & Therapy
Robert D Simard, Steve Socransky, Jordan Chenkin
BACKGROUND: Parapharyngeal space abscesses (PPSA) are deep-space neck infections that are associated with significant morbidity and, rarely, mortality if not promptly diagnosed and treated. The diagnosis is often difficult, as the clinical presentation can mimic peritonsillar abscesses (PTA). Transoral point-of-care ultrasound (POCUS) may be a useful tool to help distinguish PTAs from other deep-space infections such as PPSAs. CASE REPORT: A woman presented to the Emergency Department (ED) with fever, sore throat, trismus, and unilateral tonsillar swelling from a walk-in clinic with a preliminary diagnosis of PTA for drainage...
October 31, 2018: Journal of Emergency Medicine
Marla C Levine, Alexander Arroyo, Antonios Likourezos, Peter Homel, Eitan Dickman
OBJECTIVE: Most soft tissue neck masses represent benign inflammatory or infectious processes; however, in some cases the diagnosis is not clear and a broader differential must be considered. The aim of this study was to compare point-of-care ultrasound (POCUS) to radiology department imaging (RDI) in the diagnosis of soft tissue neck masses. METHODS: This prospective pilot study involved a convenience sample of patients ranging in age from 1 month to 18 years of age presenting to the Pediatric Emergency Department (PED) with a soft tissue neck mass...
October 23, 2018: American Journal of Emergency Medicine
Tanvi Vaidya, Archi Aggarwal, Shivani Mahajan, M H Thakur, Abhishek Mahajan
The present era of precision medicine sees "cancer" as a consequence of molecular derangements occurring at the commencement of the disease process, with morphological changes happening much later in the process of tumourigenesis. Conventional imaging techniques, such as computed tomography (CT), ultrasound (US) and magnetic resonance imaging (MRI) play an integral role in the detection of disease at the macroscopic level. However, molecular functional imaging (MFI) techniques entail the visualisation and quantification of biochemical and physiological processes occurring during tumourigenesis...
November 1, 2018: Molecular Diagnosis & Therapy
Michael Gottlieb, Kimbia Arno, Matthew Kuhns, Teresa M Chan
Introduction: There are over 200 emergency medicine (EM) residency programs in the United States. While there are basic criteria defined by the Accreditation Council for Graduate Medical Education (ACGME), there can be significant variation between programs with regard to rotation distribution. Therefore, it would be valuable to have a benchmark for programs to understand their rotation mix in the context of the national landscape. This study aimed to provide a breakdown of the length and percentage of EM residency programs with each clinical rotation in the United States...
October 2018: AEM education and training
Oguz Eroglu, Figen Coskun
Introduction: The use of simulation devices in medical education is becoming more prevalent with each passing day. The present study aimed to teach medical students to perform ultrasonography via a simulation-based ultrasound training program. Methods: The study was prospectively conducted on final year medical students who had not received previous ultrasound training and who came to the Emergency Department of the Kirikkale University Faculty of Medicine between July 2015 and July 2016...
2018: Pan African Medical Journal
Timothy Witalka, Matthew Smith, Sangil Lee
Ventricular pseudoaneurysm rupture is a rare finding in emergency departments in the era of percutaneous coronary intervention. It is an infrequent complication after acute myocardial infarction. We present a case of ventricular pseudoaneurysm rupture and examine current literature on the pathophysiology and imaging guidelines on the topic. The patient is a 58-year-old male that presented to the emergency department with dizziness and syncope. Imaging in the emergency department included computed tomography of the chest and an ultrasound that showed pseudoaneurysm with hemopericardium and early cardiac tamponade...
October 1, 2018: American Journal of Emergency Medicine
Jason L Zaremski, Ashwin Rao, Rebecca Myers, Ken Mautner, David Berkoff, David Ross, Kelsey Logan, MaryBeth Horodyski, Irfan M Asif
OBJECTIVE: To identify factors associated with entry into primary care sports medicine (PCSM) fellowship programs. DESIGN: Primary care sports medicine fellowship directors (FDs) and fellowship faculty were surveyed regarding preferences for accepting applicants into their programs. SETTING: Survey study. PARTICIPANTS: Primary care sports medicine FDs and fellowship faculty. ASSESSMENT OF RISK FACTORS: Questions were designed to delineate factors [clinical experience, letters of recommendation (LOR), scholarship, service commitment, interview performance, etc] perceived to be associated with entry into PCSM fellowship (1-10 scale; 10 = highest value)...
November 12, 2018: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Lindsay A Taylor, Michael J Vitto, Michael Joyce, Jordan Tozer, David P Evans
BACKGROUND: Traditional landmark thoracostomy technique has a known complication rate up to 30%. The goal of this study is to determine whether novice providers could more accurately identify the appropriate intercostal site for thoracostomy by ultrasound guidance. METHODS: 33 emergency medicine residents and medical students volunteered to participate in this study during routine thoracostomy tube education. A healthy volunteer was used as the standardized patient for this study...
October 15, 2018: Critical Ultrasound Journal
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