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Emergency department ultrasound

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https://www.readbyqxmd.com/read/29774966/test-characteristics-of-point-of-care-ultrasound-for-the-diagnosis-of-retinal-detachment-in-the-emergency-department
#1
Daniel J Kim, Mario Francispragasam, Gavin Docherty, Byron Silver, Ross Prager, Donna Lee, David Maberley
Previous studies of point of care ultrasound (POCUS) have reported high sensitivities and specificities for retinal detachment (RD). Our primary objective was to assess the test characteristics of POCUS performed by a large heterogeneous group of emergency physicians (EPs) for the diagnosis of RD. METHODS: This was a prospective diagnostic test assessment of POCUS performed by EPs with varying ultrasound experience on a convenience sample of emergency department (ED) patients presenting with flashes or floaters in one or both eyes...
May 18, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29773479/emergency-department-diagnosis-of-septic-pulmonary-embolism-due-to-infectious-endocarditis-using-bedside-ultrasound
#2
Jason Arthur, Juvenal Havyarimana, Ashley Booth Norse
BACKGROUND: Septic pulmonary embolism (SPE) is a rare disorder caused by metastasis of infectious thrombi to the lungs. Most commonly, this occurs as a result of infectious endocarditis. This clinical entity may easily be confused for more common and less mortal diagnoses such as pneumonia, bronchitis, or pulmonary embolism. CASE REPORT: A 47-year-old woman presented in respiratory distress with a complaint of cough productive of rusty sputum, shortness of breath, and pleuritic chest pain...
May 14, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29769153/point-of-care-ultrasound-to-diagnose-appendicitis-in-a-canadian-emergency-department
#3
Sameer Sharif, Steven Skitch, Dean Vlahaki, Andrew Healey
OBJECTIVES: Appendicitis is a common surgical condition that frequently requires diagnostic imaging. Abdominal computed tomography (CT) is the gold standard for diagnosing appendicitis. Ultrasound offers a radiation-free modality; however, its availability outside business hours is limited in many emergency departments (EDs). The purpose of this study is to evaluate the test characteristics of emergency physician-performed point-of-care ultrasound (POCUS) to diagnose appendicitis in a Canadian ED...
May 17, 2018: CJEM
https://www.readbyqxmd.com/read/29768359/case-report-of-gastric-distension-due-to-superior-mesenteric-artery-syndrome-mimicking-hollow-viscus-perforation-considerations-in-critical-care-ultrasound
#4
Yan-Mei Feng, Dong Wan, Rui Guo
RATIONALE: Critical care ultrasound identifies the signs of free intraperitoneal air and echogenic free fluid always indicates hollow viscus perforation (HVP) and needs immediate surgical interventions. However, in rare cases, these classic signs may also mislead proper clinical decisions. We report perforated viscus associated large peritoneal effusion with initial critical care ultrasound findings, whereas computed tomography (CT) examination confirmed a giant stomach due to superior mesenteric artery syndrome (SMAS)...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29764827/not-so-mass-effect-finding-of-a-remarkable-incidentaloma-in-a-teenager-with-neurofibromatosis
#5
Daniel John Keen, Hannah Norman-Bruce, Salah Mansy
A 13-year-old boy with neurofibromatosis type 1 presented to the emergency department twice in a fortnight with moderate intermittent abdominal pain, radiating to the back and associated with nausea and vomiting. He examined as a well child with a soft abdomen and minimal tenderness. A history of constipation was identified but he failed to respond to a trial of laxatives. Subsequent ultrasound abdomen demonstrated a large mass surrounding the porta hepatis. MRI further characterised a focal, non-aggressive lesion extending from his liver, encapsulating his pancreas, portal vessels and laterally displacing his spleen and left kidney...
May 14, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29761678/ultrasound-of-jugular-veins-for-assessment-of-acute-dyspnea-in-emergency-departments-and-for-the-assessment-of-acute-heart-failure
#6
Batsheva Tzadok, Shay Shapira, Eran Tal-Or
BACKGROUND: When a patient arrives at the emergency department (ED) presenting with symptoms of acute decompensated heart failure (ADHF), it is possible to reach a definitive diagnosis through many different venues, including medical history, physical examination, echocardiography, chest X-ray, and B-type natriuretic peptide (BNP) levels. Point-of-care ultrasound (POCUS) has become a mainstream tool for diagnosis and treatment in the field of emergency medicine, as well as in various other departments in the hospital setting...
May 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29761151/endoscopic-ultrasound-guided-choledochoduodenostomy-as-palliative-treatment-a-challenging-case-report
#7
Helena Ribeiro, Richard Azevedo, Ana Caldeira, Rui Sousa, Eduardo Pereira, António Banhudo
We report the case of an 88-year-old female with obstructive jaundice due to a periampullary tumor. The patient developed acute cholangitis and consequent clinical deterioration, so it was decided to perform palliative biliary drainage. Due to duodenal tumor invasion, it was not possible to perform endoscopic retrograde cholangiopancreatography. A different approach was attempted and it was decided to carry out an endoscopic ultrasound-guided choledochoduodenostomy. This procedure was performed with a linear echoendoscope, and using a duodenal bulbar approach, a fistula was created between the bulb and the common bile duct...
April 2018: GE Portuguese Journal of Gastroenterology
https://www.readbyqxmd.com/read/29754963/predictors-of-a-drainable-suppurative-adenitis-among-children-presenting-with-cervical-adenopathy
#8
Amir A Kimia, Tiffany F Rudloe, Nadine Aprahamian, Jennifer McNamara, David Roberson, Assaf Landschaft, Jennifer Vaughn, Marvin B Harper
OBJECTIVES: We sought to identify predictors for a drainable suppurative adenitis [DSA] among patients presenting with acute cervical lymphadenitis. METHODS: A retrospective cross sectional study of all patients admitted to an urban pediatric tertiary care emergency department over a 15 year period. Otherwise healthy patients who underwent imaging for an evaluation of cervical lymphadenitis were included. Cases were identified using a text-search module followed by manual review...
May 5, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29753570/xanthogranulomatous-pyelonephritis-a-complicated-febrile-urinary-tract-infection-detected-by-point-of-care-ultrasound-in-the-emergency-department
#9
Ryan Gibbons, Nicole Leonard, Mark Magee, Allison Zanaboni, Jessica Patterson, Thomas Costantino
BACKGROUND: Febrile urinary tract infections (UTIs) include a spectrum of pathologies from uncomplicated pyelonephritis to urosepsis, including xanthogranulomatous pyelonephritis (XGP). Most febrile UTIs are treated with antibiotics alone, but studies indicate nearly 12% of cases of presumed simple pyelonephritis require emergent urologic intervention. How to identify these individuals, while limiting unnecessary advanced imaging and delays in diagnosis, challenges all emergency providers...
May 9, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29748981/trial-of-life-well-infants-presenting-more-than-24-h-after-head-injury-with-a-scalp-haematoma-a-10-year-review
#10
Ahilan Parameswaran, Shmuel Heitner, Deepali Thosar, Adam Fowler, Susan Marks, Fenton O'Leary
AIM: To review the investigation, patterns of injury and short-term outcomes of infants younger than 12 months of age who presented more than 24 h after head injury with an isolated scalp haematoma. METHODS: A retrospective chart review of infants who presented with a head injury to the emergency department of a major paediatric hospital between 2006 and 2016. Patients were included if they presented more than 24 h after the injury, were clinically well and had a documented scalp haematoma...
May 10, 2018: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29748081/day-of-week-site-of-service-and-patient-complexity-differences-in-venous-ultrasound-interpreted-by-radiologists-versus-nonradiologists
#11
Anand M Prabhakar, Ravi V Gottumukkala, Wenyi Wang, Danny R Hughes, Richard Duszak
OBJECTIVE: Nationally, nonradiologists interpret an increasing proportion of lower extremity venous duplex ultrasound (LEVDU) examinations. We aimed to study day of week, site of service, and patient complexity differences in LEVDU services interpreted by radiologists versus nonradiologists. MATERIALS AND METHODS: Using carrier claims files for a 5% national sample of Medicare beneficiaries from 2012 to 2015, we retrospectively classified all LEVDU examinations by physician specialty (radiologist versus nonradiologist), day of week (weekday versus weekend), site of service, and patient Charlson Comorbidity Index (CCI) scores...
May 7, 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29746359/evaluation-of-a-focused-cardiac-ultrasound-protocol-in-a-pediatric-emergency-department
#12
Antonio Riera, Bevin Weeks, Beth L Emerson, Lei Chen
OBJECTIVES: The objective of this study was to evaluate the implementation of a focused cardiac ultrasound (FoCUS) protocol in a pediatric emergency department (PED). METHODS: We conducted a cross-sectional, observational, quality improvement project in a PED of an urban tertiary care children's hospital. A FoCUS protocol was collaboratively developed by pediatric cardiology and pediatric emergency medicine. This included a reference document with definitions, indications, image acquisition guidelines, and interpretation expectations...
May 9, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29738103/bedside-sonography-performed-by-emergency-physicians-to-detect-appendicitis-in-children
#13
Marie Nicole, Marie Pier Desjardins, Jocelyn Gravel
OBJECTIVE: The aim of this study was to evaluate the ability of emergency physicians with various levels of Point of Care Ultrasound (POCUS) experience to detect appendicitis with POCUS among children visiting a pediatric Emergency Department (ED). METHODS: A prospective cohort study was conducted in an urban, tertiary care pediatric ED. Children aged 2 to 18 years old who presented with acute abdominal pain suggesting appendicitis were included. Patients were excluded if they had a history of appendectomy, hemodynamic instability requiring resuscitation, or were transferred with proven diagnosis of appendicitis...
May 8, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29730945/-diverticulosis-and-diverticulitis-of-the-vermiform-appendix-report-of-a-case-and-review-of-the-literature
#14
Tamás Vass, Attila Zaránd, Dániel Horányi, László Harsányi
Diverticulitis of the vermiform appendix is a rare disease with clinical features often similar to conventional acute appendicitis. The importance of appendiceal diverticulosis is the fact that it can lead to an early and a higher incidence of perforation and therefore a higher mortality rate, in contrast to acute appendicitis alone. In this study we present the clinicopathology, diagnosis and therapy of the disease with a review of the literature. A 65-year-old woman presented to the emergency department with a 48-hour history of intermittent pain in the right iliac fossa...
May 2018: Orvosi Hetilap
https://www.readbyqxmd.com/read/29730687/echogenicity-and-ultrasound-visibility-of-peripheral-nerves-of-the-upper-extremity
#15
Lori A Stolz, Josie Galarza Acuna, Kevin Gaskin, Amanda M Murphy, Lucas Friedman, Summer Stears-Ellis, Parisa Javedani, Uwe Stolz, Srikar Adhikari
AIM: Regional anesthesia with ultrasound-guidance is an excellent option for pain control if nerves are adequately visualized. Gender, body mass index (BMI), history of diabetes, neck and forearm circumference may affect echotexture and visualization. This study evaluates patient characteristics for their ability to predict the echogenicity or visibility of upper extremity peripheral nerves. MATERIAL AND METHODS: This is a prospective observational study. A convenience sample of adult emergency department patients were enrolled...
May 2, 2018: Medical Ultrasonography
https://www.readbyqxmd.com/read/29729173/indscators-of-blood-lipid-profile-acute-phase-reactions-and-uric-acid-in-patients-with-arterial-hypertension-combined-with-connective-tissue-dysplasia
#16
Yevheniya H Zaremba, Nataliya O Rak, Olha V Zaremba, Olena V Zaremba-Fedchyshyn, Marianna M Virna, Liliya O Odnorih
OBJECTIVE: Introduction:Changes in the cardiovascular system can be divided into 2 groups due to the connective tissue dysplasia (CTD) and changes in the circulatory system, caused by pathological processes that arose on the basis of the connective structures failure. One of the risk factors of arterial hypertension (AH) remaining insufficiently studied is collagen pathology - nondifferentiated connective tissue dysplasia (NCTD). The presence of connective tissue in all organs and systems, the common origin of smooth muscles, blood and lymph from mesenchyma leads to dysplastic changes in any organ and system...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29728285/comparison-of-bedside-screening-methods-for-frailty-assessment-in-older-adult-trauma-patients-in-the-emergency-department
#17
Sachita P Shah, Kevin Penn, Stephen J Kaplan, Michael Vrablik, Karl Jablonowski, Tam N Pham, May J Reed
BACKGROUND: Frailty is linked to poor outcomes in older patients. We prospectively compared the utility of the picture-based Clinical Frailty Scale (CFS9), clinical assessments, and ultrasound muscle measurements against the reference FRAIL scale in older adult trauma patients in the emergency department (ED). METHODS: We recruited a convenience sample of adults 65 yrs. or older with blunt trauma and injury severity scores <9. We queried subjects (or surrogates) on the FRAIL scale, and compared this to: physician-based and subject/surrogate-based CFS9; mid-upper arm circumference (MUAC) and grip strength; and ultrasound (US) measures of muscle thickness (limbs and abdominal wall)...
April 14, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29724580/derivation-and-validation-of-a-practical-bedside-score-for-the-diagnosis-of-cholecystitis
#18
D Dante Yeh, Yuchiao Chang, Maryam Bita Tabrizi, Liyang Yu, Catrina Cropano, Peter Fagenholz, David R King, Haytham M A Kaafarani, Marc de Moya, George Velmahos
OBJECTIVE: We sought to develop a practical Bedside Score for the diagnosis of cholecystitis and test its accuracy against the Tokyo Guidelines (TG13). METHODS: We conducted a retrospective study of 438 patients undergoing urban, academic Emergency Department (ED) evaluation of RUQ pain. Symptoms, physical signs, ultrasound signs, and labs were scoring system candidates. A random split-sample approach was used to develop and validate a new clinical score. Multivariable regression analysis using development data was conducted to identify predictors of cholecystitis...
April 25, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29716799/emergency-and-critical-care-applications-for-contrast-enhanced-ultrasound
#19
REVIEW
Tobias Kummer, Laura Oh, Mary Beth Phelan, Robert D Huang, Jason T Nomura, Srikar Adhikari
INTRODUCTION: Contrast-enhanced ultrasound (CEUS) using intravascular microbubbles has potential to revolutionize point-of-care ultrasonography by expanding the use of ultrasonography into clinical scenarios previously reserved for computed tomography (CT), magnetic resonance imaging, or angiography. METHODS: We performed a literature search and report clinical experience to provide an introduction to CEUS and describe its current applications for point-of-care indications...
April 22, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29705114/review-of-interventions-and-radiation-exposure-from-chest-computed-tomography-in-children-with-blunt-trauma
#20
Victor Hsiao, Genevieve Santillanes, Daniel Malek, Ilene Claudius
OBJECTIVE: To determine the radiation risk to a child undergoing trauma evaluation with chest computed tomography (CCT) for every clinically actionable injury identified. STUDY DESIGN: This observational, cross-sectional study included all blunt trauma patients under 18 years of age undergoing CCT in a single urban emergency department. Via a retrospective chart review, therapeutic interventions done exclusively for chest injuries identified on CCT scan were identified...
April 25, 2018: Journal of Pediatrics
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