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Ultrasound in ED

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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/29761678/ultrasound-of-jugular-veins-for-assessment-of-acute-dyspnea-in-emergency-departments-and-for-the-assessment-of-acute-heart-failure
#4
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/29738103/bedside-sonography-performed-by-emergency-physicians-to-detect-appendicitis-in-children
#5
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/29728285/comparison-of-bedside-screening-methods-for-frailty-assessment-in-older-adult-trauma-patients-in-the-emergency-department
#6
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
#7
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/29703561/tension-hydrothorax-emergency-decompression-of-a-pleural-cause-of-cardiac-tamponade
#8
E E Vinck, J C Garzón, T Peterson, R Villarreal, L Cabrera, L Van den Eijnden
INTRODUCTION: A tension hydrothorax is defined as a massive pleural effusion presenting with hemodynamic abnormalities secondary to mediastinal compression. In these patients pleural volume increases intrathoracic pressure to the point of compromising diastolic filling and cardiac output simulating a cardiac tamponade physiology. This is an uncommon yet potentially fatal medical emergency that if left untreated may progress to cardiac arrest. Early detection and rapid intervention of these patients prevents cardiorespiratory collapse...
April 21, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29695058/hplc-ed-analysis-of-phenolic-compounds-in-three-bosnian-crataegus-species
#9
Dušan Čulum, Amira Čopra-Janićijević, Danijela Vidic, Lejla Klepo, Azra Tahirović, Neđad Bašić, Milka Maksimović
The aim of this work was the qualitative and quantitative determination of selected phenolic compounds in three Crataegus species grown in Bosnia. Crataegus plants are consumed for medicinal purposes and as foodstuff in the form of canned fruit, jam, jelly, tea, and wine. Two samples of plant material, dry leaves with flowers, and berries of three Crataegus species&mdash; Crataegus rhipidophylla Gand., Crataegus x subsphaericea Gand., and Crataegus x macrocarpa Hegetschw.&mdash;were analyzed. Twelve ethanolic extracts were isolated from the selected plant material using Soxhlet and ultrasound extraction, respectively...
April 24, 2018: Foods (Basel, Switzerland)
https://www.readbyqxmd.com/read/29685466/gonococcal-tenosynovitis-diagnosed-with-the-aid-of-emergency-department-bedside-ultrasound
#10
Edward Carlin, Colleen Urban, Jessica Sidle, Angela Cirilli, Jennifer Larson, Mark Richman, Daniel Dexeus
BACKGROUND: Gonorrhea is the second most common sexually transmitted infection. Disseminated gonococcal infection (DGI) consists of gonococcal infection plus one or more of the triad of arthritis, tenosynovitis, and dermatitis. Diagnosis in the emergency department (ED) must be suspected clinically, as confirmatory tests are often not available. Point-of-care ultrasound (POCUS) can aid in diagnosis and appropriate management by identifying tenosynovitis and excluding arthritis. CASE REPORT: A 26-year-old man with multiple recent sex partners presented to the ED with slowly progressing right wrist pain and swelling over 5 days...
April 20, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29683199/comparison-of-superb-microvascular-imaging-with-color-flow-and-power-doppler-imaging-of-small-hepatocellular-carcinomas
#11
Theodore J Dubinsky, Jonathan Revels, Sherry Wang, Giuseppe Toia, Rachelle Sonneborn, Daniel S Hippe, Todd Erpelding
OBJECTIVES: The purpose of this study was to compare Superb Microvascular Imaging (SMI; Toshiba America Medical Systems, Tustin, CA) with conventional color flow Doppler (CFD) and power Doppler (PD) imaging in the liver to distinguish between malignant and benign liver neoplasms. METHODS: After Institutional Review Board approval (number 449984-ED), patients undergoing routine pre-radiofrequency ablation planning ultrasound examinations for suspected hepatocellular carcinomas (HCCs) of less than 2 cm in diameter between January 1, 2015, and July 1, 2016, were prospectively identified...
April 23, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29666716/survival-after-cardiac-arrest-secondary-to-massive-pulmonary-embolism
#12
Abdullah E Laher, Muhammed Moolla, Feroza Motara, Fathima Paruk, Guy Richards
Introduction: It is estimated that the diagnosis of pulmonary embolism (PE) is missed in as many as 84% of all cases of PE. Cardiac arrest following PE is generally associated with poor outcomes. Case Report: A 43-year-old man presented to the Emergency Department (ED) in cardiac arrest. Swelling of his right lower limb was noted on arrival. Point of care ultrasound was performed during ongoing cardiopulmonary resuscitation (CPR) and showed a thrombus in the right iliofemoral vein as well as dilatation of the right ventricle...
2018: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29663580/emergency-physician-interpretation-of-point-of-care-ultrasound-for-identifying-and-grading-of-hydronephrosis-in-renal-colic-compared-with-consensus-interpretation-by-emergency-radiologists
#13
Sameer A Pathan, Biswadev Mitra, Salman Mirza, Umais Momin, Zahoor Ahmed, Lubna G Andraous, Dharmesh Shukla, Mohammed Y Shariff, Magid M Makki, Tinsy T George, Saad S Khan, Stephen H Thomas, Peter A Cameron
OBJECTIVE: The ability of emergency physicians (EP) to identify hydronephrosis using point-of-care ultrasound (POCUS) has been assessed in the past using CT scans as the reference standard. We aimed to determine the ability of EP for identifying and grading of hydronephrosis on POCUS using the consensus interpretation of POCUS by emergency radiologists as the reference standard. METHODS: The study was conducted at an urban academic emergency department (ED) as a secondary analysis of previously collected ultrasound data from the EP performed POCUS-databank...
April 16, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29661666/pseudo-wellens-syndrome-and-intermittent-left-bundle-branch-block-in-a-case-of-acute-cholecystitis
#14
Steffen Grautoff, Martin Balog, Guenther Winde
We present a case of a 54-year-old male patient who was admitted to our Emergency Department (ED) with localized epigastric pain. Inflammation markers, ultrasound, and CT scan were inconsistent with an initial diagnosis of cholecystitis. However, there was additional evidence of cholecystolithiasis. The ECG showed new anterior biphasic T waves typical for a Wellens' type A ECG. Additionally, the patient had an intermittent left bundle branch block (LBBB). The diagnostic challenges in differentiating possible diagnoses will be described, to which in this case, were either acute cholecystitis or acute coronary syndrome (ACS)...
April 7, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29656593/review-article-investigations-and-the-pregnant-woman-in-the-emergency-department-part-1-laboratory-investigations
#15
REVIEW
Adam Morton, Stephanie Teasdale
Accurate assessment of the pregnant patient in the ED depends on knowledge of physiological changes in pregnancy, and how these changes may impact on pathology tests, appearance on point-of-care ultrasound and electrocardiography. In addition the emergency physician needs to be cognisant of disorders that are unique to or more common in pregnancy. Part 1 of this review addresses potential deviations in laboratory investigation reference intervals resulting from physiological alterations in pregnancy, and the important causes of abnormal laboratory results in pregnancy...
April 15, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29651604/patterns-and-frequency-of-renal-abnormalities-in-fanconi-anaemia-implications-for-long-term-management
#16
Vijaya Sathyanarayana, Beth Lee, Neville B Wright, Rui Santos, Denise Bonney, Robert Wynn, Leena Patel, Kate Chandler, Ed Cheesman, Detlev Schindler, Nicholas J A Webb, Stefan Meyer
BACKGROUND: Fanconi anaemia (FA) is an inherited disease with bone marrow failure, variable congenital and developmental abnormalities, and cancer predisposition. With improved survival, non-haematological manifestations of FA become increasingly important for long-term management. While renal abnormalities are recognized, detailed data on patterns and frequency and implications for long-term management are sparse. METHODS: We reviewed clinical course and imaging findings of FA patients with respect to renal complications in our centre over a 25-year period to formulate some practical suggestions for guidelines for management of renal problems associated with FA...
April 12, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29619917/emergency-department-ultrasound-for-the-detection-of-b-lines-in-the-early-diagnosis-of-acute-decompensated-heart-failure-a-systematic-review-and-meta-analysis
#17
Kyle McGivery, Paul Atkinson, David Lewis, Luke Taylor, Tim Harris, Kathleen Gadd, Jacqueline Fraser, George Stoica
CLINICIAN'S CAPSULE What is known about the topic? Current diagnostic tools for heart failure in the emergency department (ED) have limited accuracy and often lead to delays in management. What did this study ask? What is the accuracy of early bedside lung ultrasound in the diagnosis of acute decompensated heart failure? What did this study find? This meta-analysis found that the sensitivity and specificity of bedside lung US in ADHF is 82.5% and 83.6%, respectively. Why does this study matter to clinicians? The implementation of early bedside lung US in the ED may lead to more accurate and timely diagnoses of ADHF...
April 5, 2018: CJEM
https://www.readbyqxmd.com/read/29619581/approach-to-undifferentiated-dyspnea-in-emergency-department-aids-in-rapid-clinical-decision-making
#18
Siva Nageswara Rao Guttikonda, Kiran Vadapalli
BACKGROUND: Diagnosis and management of patients presenting with acute dyspnea is one of the major challenges for physicians in emergency department (ED). A correct diagnosis is frequently delayed and difficult to ascertain, and clinical uncertainty is common, explaining the need for rapid diagnosis and a management plan. The primary aim of our study is to assess a diagnostic strategy using multiorgan point of care ultrasonography (USG) to differentiate patients presenting with acute dyspnea to ED into different diagnostic categories for timely management in a resource-limited setting...
April 4, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29611369/the-role-of-neutrophil-to-lymphocyte-ratio-in-men-with-erectile-dysfunction-preliminary-findings-of-a-real-life-cross-sectional-study
#19
E Ventimiglia, W Cazzaniga, F Pederzoli, N Frego, F Chierigo, P Capogrosso, L Boeri, F Dehò, C Abbate, D Moretti, L Piemonti, F Montorsi, A Salonia
The aim of this study was to investigate the role of systemic inflammation by means of the neutrophil-to-lymphocyte ratio (NLR) in men with erectile dysfunction (ED). Complete demographic, clinical, and laboratory data from 279 consecutive men with newly diagnosed ED were analyzed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). A complete blood count was requested for every man, and the NLR was calculated for every individual. Patients were invited to complete the IIEF questionnaire...
April 2, 2018: Andrology
https://www.readbyqxmd.com/read/29602721/efficacy-and-safety-of-tadalafil-5-mg-once-daily-for-the-treatment-of-erectile-dysfunction-after-robot-assisted-laparoscopic-radical-prostatectomy-a-2-year-follow-up
#20
Soodong Kim, Gyung Tak Sung
BACKGROUND: Although nerve-sparing robot-assisted radical prostatectomy (NS-RALP) is performed, a large number of patients still experience erectile dysfunction (ED) after surgery. AIM: To evaluate the efficacy and safety of tadalafil 5 mg once daily (OaD) in ED treatment over 2 years and investigate the cause of vascular ED after NS-RARP. METHODS: We retrospectively evaluated 95 men who underwent NS-RARP and had a penile rehabilitation treatment with tadalafil 5 mg OaD...
March 27, 2018: Sexual Medicine
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