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Emergency department ultrasound

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https://www.readbyqxmd.com/read/28719480/a-rare-pediatric-case-of-posttraumatic-pseudoaneurysm-case-report-and-literature-review
#1
Ada Gu, April J Kam
Posttraumatic pseudoaneurysms are extremely rare in pediatric populations. In many cases, pseudoaneurysms may be confused with abscesses, epidermoid cysts, arteriovenous fistula, foreign objects, and ganglion cysts, as well as tumors. They are associated with distinguishing findings of "pulsatile mass, a palpable thrill, and an audible to-and-fro murmur" (1), which can be confirmed by various imaging techniques. In this report, we describe the case of a 4-year-old boy who presented to the pediatric emergency department 3 weeks after falling and subsequently getting cut by glass...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28714490/current-diagnostic-approach-and-initial-treatment-patterns-for-renal-colic-in-emergency-department
#2
R Shrestha, Y Bista, A Khan
BACKGROUND: Renal colic is a common clinical presentation in emergency. The goal of this study was to describe the epidemiology, current diagnostic and treatment strategies of ureteric colic in our emergency department. METHODS: This is a retrospective study performed over a six months period of patients with clinically suspected renal colic. Data collected included age, sex, urine analysis, ultrasound studies regarding size, site of the stone and presence of hydronephrosis...
January 2017: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28705754/progression-of-lyme-disease-to-bell-s-palsy-despite-treatment-with-doxycycline
#3
Luis A Marcos, Zengmin Yan
A 54 year-old healthy woman presented to the emergency department with a right sided facial paralysis. About 3 weeks ago, she woke up and noticed an attached engorged tick in her right lower extremity. A week later, she noticed a mild to moderate right jaw pain which progressed to a severe right facial pain so she visited her doctor. On physical, II to XII cranial nerve examination was unremarkable. Doppler ultrasound did not show any vascular abnormalities in temporal artery. Her inflammatory markers were within normal limits (C-reactive protein:0...
July 10, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28702139/ramipril-associated-cholestasis-in-the-setting-of-recurrent-drug-induced-liver-injury
#4
David Forner, Tasha Kulai, Thomas Arnason, Steven E Gruchy, Magnus MacLeod
Aim: Angiotensin-converting enzyme inhibitors (ACEIs) are commonly used to treat hypertension. Although generally well tolerated, the adverse effects of ACEIs include hypotension, cough, acute kidney injury and hyperkalemia. Rare reports of ACEI-induced hepatotoxicity have been described, most notably a cholestatic pattern of injury related to captopril. A 67-year-old male presented to the emergency department with a three-week history of jaundice, pruritis and weakness. Eight weeks before, he began taking ramipril and clopidogrel...
2017: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/28702136/chronic-cholecystitis-in-the-pediatric-population-an-underappreciated-disease-process
#5
Brian P Blackwood, Julia Grabowski
AIM: We hypothesize that chronic cholecystitis accounts for the majority of inflammatory diseases in the pediatric population and it is difficult to predict with preoperative ultrasound. BACKGROUND: Despite the increase in gallbladder disease, there is a paucity of data on pediatric cholecystitis. Most pediatric studies focus on cholelithiasis and biliary dyskinesia rather than inflammatory gallbladder disease. METHODS: We performed a single center retrospective review of all patients who underwent cholecystectomy from 1/1/10 - 1/1/15...
2017: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/28695643/diagnostic-value-and-effect-of-bedside-ultrasound-in-acute-appendicitis-in-the-emergency-department
#6
Brian C Weiner
In their introduction, Gungor et al described ultrasound as a technique for evaluation of patients with low prior probability of acute appendicitis. This testing protocol for appendicitis is being proposed to challenge and perhaps replace the current standard of care for imaging, CT scanning. Specificity of CT scanning is reported in the range of 92-98% and CT is generally felt to be more accurate than ultrasonography The finding of 95.8% specificity for their method appears competitive and may be arithmetically correct but is seriously flawed...
July 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28688887/predicting-need-for-additional-ct-scan-in-children-with-a-non-diagnostic-ultrasound-for-appendicitis-in-the-emergency-department
#7
Takuya Nishizawa, Shigenobu Maeda, Ran D Goldman, Hiroyuki Hayashi
OBJECTIVE: This study aimed to determine which children with suspected appendicitis should be considered for a computerized tomography (CT) scan after a non-diagnostic ultrasound (US) in the Emergency Department (ED). METHODS: We retrospectively reviewed patients 0-18year old, who presented to the ED with complaints of abdominal pain, during 2011-2015 and while in the hospital had both US and CT. We recorded demographic and clinical data and outcomes, and used univariate and multivariate methods for comparing patients who did and didn't have appendicitis on CT after non-diagnostic US...
July 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28679312/age-adjusted-d-dimer-for-the-diagnosis-of-deep-vein-thrombosis
#8
Efrem Gómez-Jabalera, Sergio Bellmunt Montoya, Eva Fuentes-Camps, José Román Escudero Rodríguez
Objective In the diagnosis of deep vein thrombosis, new D-dimer cut-off values were defined by multiplying 10 µg/L × age. The objective of the present study is to define a more specific age-adjusted value, including the pre-test Wells score, without worsening sensitivity. Methods We designed a case-control study in patients attended in the emergency department with clinically suspected deep vein thrombosis. Demographics, Wells score, D-dimer and ultrasound data were collected. In low and intermediate clinical probability cases for deep vein thrombosis, we determined the specificity and sensitivity (false-negative rates) for the following cut-off values of D-dimer: age × 10 µg/L, age × 15 µg/L, age × 20 µg/L, age × 25 µg/L and age × 30 µg/L...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28676304/imaging-trends-in-acute-venous-thromboembolic-disease-2000-to-2015
#9
Isaac Wang, Matthew S Davenport, Ella A Kazerooni
PURPOSE: To measure diffusion of new knowledge and correlate imaging utilization for suspected acute venous thromboembolism (VTE) with d-dimer utilization, landmark publications, and institutional guidelines. MATERIALS: Between 2000 and 2015, the number of CT pulmonary angiograms (CTPAs), CTPA combined with indirect CT venography (CTV), ventilation-perfusion (VQ) scans, and lower extremity venous Doppler ultrasound (US) examinations were obtained for inpatients and emergency department (ED) patients and correlated with d-dimer utilization, landmark publications regarding radiation and VTE imaging, and an institutional inpatient best-practice alert requiring VTE prophylaxis assessment (2008)...
July 1, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28673696/appendicitis-following-blunt-abdominal-trauma
#10
Travis Cobb
Appendicitis is a frequently encountered surgical problem in the Emergency Department (ED). Appendicitis typically results from obstruction of the appendiceal lumen, although trauma has been reported as an infrequent cause of acute appendicitis. Intestinal injury and hollow viscus injury following blunt abdominal trauma are well reported in the literature but traumatic appendicitis is much less common. The pathophysiology is uncertain but likely results from several mechanisms, either in isolation or combination...
June 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28667280/diagnostic-accuracy-of-contrast-enhanced-ultrasound-in-patients-with-blunt-abdominal-trauma-presenting-to-the-emergency-department-a-systematic-review-and-meta-analysis
#11
Zhongheng Zhang, Yucai Hong, Ning Liu, Yuhao Chen
We aimed to investigate the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) in evaluating blunt abdominal trauma for patients presenting to the emergency department. Electronic search of Scopus and Pubmed was performed from inception to September 2016. Human studies investigating the diagnostic accuracy of CEUS in identifying abdominal solid organ injuries were included. Risk of bias was assessed using the QUADAS tool. A total of 10 studies were included in the study and 9 of them were included for meta-analysis...
June 30, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28665898/a-case-of-testicular-rupture-diagnosed-by-point-of-care-ultrasound
#12
Sean Indra, Nirupama Kannikeswaran, Rajan Arora
Point-of-care ultrasound is an expanding diagnostic tool in the pediatric emergency department. We describe a case of testicular rupture diagnosed by ultrasound at the bedside, which led to prompt surgical intervention and repair.
July 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28660688/use-of-contrast-enhanced-ultrasound-for-confirmation-of-central-venous-catheter-placement-systematic-review-and-meta-analysis
#13
Ralph Bou Chebl, Shafeek Kiblawi, Christopher El Khuri, Nadine El Hajj, Rana Bachir, Roni Aoun, Gilbert Abou Dagher
OBJECTIVES: The purpose of this meta-analysis was to determine the sensitivity, specificity, and positive and negative predictive values of contrast-enhanced ultrasound (US) for confirming the tip location and placement of central venous catheters in adult patients. METHODS: A systematic review was performed using electronic databases, including MEDLINE, ClinicalTrials.gov, Cochrane, Embase, PubMed, and Scopus. Inclusion criteria were studies conducted on adult patients receiving an internal jugular or a subclavian central venous catheter in the emergency department or intensive care unit...
June 29, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28656661/sonographic-localization-of-a-retained-urethral-foreign-body-in-an-elderly-patient
#14
Hamid Shokoohi, Zachary Kendrick, Neal Sikka, Keith S Boniface
A retained urethral foreign body is an uncommon presentation in the Emergency Department. The diagnosis and treatment of retained urethral foreign bodies are determined by their size, location, shape, and mobility and often require specialty consultation and operative intervention. In this case of a 74-year-old man with a self-inserted, retained urethral foreign body, we present the utility of a bedside ultrasound to detect the depth, size, and distance from the meatus of the object to guide the approach to extraction of the object at the bedside in the Emergency Department...
June 27, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28652122/predictors-of-hospital-admission-and-urologic-intervention-in-adult-emergency-department-patients-with-ct-confirmed-ureteral-stones
#15
Brock Daniels, Elizabeth Schoenfeld, Andrew Taylor, Karrin Weisenthal, Dinesh Singh, Christopher L Moore
PURPOSE: Over one million patients seek care in an Emergency Department (ED) for kidney stones annually, but a minority require admission or urologic procedure. We aim to describe predictors of hospital admission or urologic intervention. MATERIALS AND METHODS: This secondary analysis of prospective data includes ED patients with CT-confirmed obstructing ureteral stone. All patients also received a point-of-care limited renal ultrasound (PLUS). Need for urologic intervention at 90 days was assessed by follow-up interview...
June 23, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28651954/case-report-ultrasound-guided-infraclavicular-brachial-plexus-block-for-a-case-with-posterior-elbow-dislocation
#16
Sinan Akay, Sami Eksert, Murtaza Kaya, Kenan Keklikci, Ali Kantemir
BACKGROUND: The interest in regional anesthesia procedures for the management of upper-extremity emergencies has increased. Toward that end, supraclavicular, interscalene, or infraclavicular approaches, with or without ultrasound guidance, are used for brachial plexus nerve blocks. Although many studies have reported on the use of ultrasound-guided supraclavicular and interscalene brachial plexus blocks for upper-extremity dislocations, very few studies have reported on the use of ultrasound-guided infraclavicular brachial plexus blocks...
June 23, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28646595/point-of-care-ultrasound-work-flow-innovation-impact-on-documentation-and-billing
#17
Matthew J Flannigan, Srikar Adhikari
OBJECTIVES: To evaluate the impact that an innovative automated ultrasound (US) work flow, which allows for bedside performance of examination documentation and order placement, has on point-of-care US billing compared to ordering US examinations through an electronic medical record. METHODS: We conducted a retrospective review of point-of-care US billing data (March 2014-February 2016) for adult and pediatric emergency departments with an emergency medicine residency and a US fellowship...
June 24, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28640133/effectiveness-of-education-in-point-of-care-ultrasound-assisted-physical-examinations-in-an-emergency-department-a-before-and-after-study
#18
Yoo Jin Choi, Jae Yun Jung, Hyuksool Kwon
Implementation of point-of-care ultrasonography (POCUS)-assisted physical examination (PE) in emergency departments (EDs) was conducted in the ED of an urban tertiary teaching hospital. This study examines the effect of POCUS implementation in emergency medicine departments by using a systematic education program on image acquisition to analyze decision making.Educating staff on POCUS involved a technique related to image acquisition and then accurately diagnosing subsequent POCUS results. The quasi-experimental, uncontrolled before-and-after study was performed to evaluate the education effect...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28638256/comparison-of-ultrasonography-and-low-dose-computed-tomography-for-the-diagnosis-of-pediatric-urolithiasis-in-the-emergency-department
#19
Recep Sade, Hayri Ogul, Suat Eren, Akin Levent, Mecit Kantarci
OBJECTIVE: This study aimed to compare ultrasonography (US) and low-dose computed tomography (LDCT) for diagnosing pediatric urolithiasis in the emergency department. MATERIALS AND METHODS: This retrospective study was approved by our institutional ethics committee, and informed consent was waived. From March 2016 to March 2017, 100 consecutive patients met the selection criteria and were enrolled in the study. Patients were randomly selected in a 1:1 ratio and were allocated to one of the following two imaging groups: US or abdominal LDCT...
June 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28636566/detection-of-muscle-gap-by-l-bia-in-muscle-injuries-clinical-prognosis
#20
L Nescolarde, J Yanguas, J Terricabras, H Lukaski, X Alomar, J Rosell-Ferrer, G Rodas
Sport-related muscle injury classifications are based basically on imaging criteria such as ultrasound (US) and magnetic resonance imaging (MRI) without consensus because of a lack of clinical prognostics for return-to-play (RTP), which is conditioned upon the severity of the injury, and this in turn with the muscle gap (muscular fibers retraction). Recently, Futbol Club Barcelona's medical department proposed a new muscle injury classification in which muscle gap plays an important role, with the drawback that it is not always possible to identify by MRI...
June 21, 2017: Physiological Measurement
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