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https://www.readbyqxmd.com/read/29149961/practice-variation-in-the-immediate-postoperative-care-of-pediatric-kidney-transplantation-a-national-survey
#1
S Abu-Sultaneh, M J Hobson, A C Wilson, W C Goggins, M E Nitu, R Lutfi
INTRODUCTION: Advances in organ allocation, surgical technique, immunosuppression, and long-term follow-up have led to a significant improvement in kidney transplant outcomes. Although there are clear recommendations for several aspects of kidney transplant management, there are no pediatric-specific guidelines for immediate postoperative care. The aim of this survey is to examine practice variations in the immediate postoperative care of pediatric kidney transplant patients. METHODS: We surveyed medical directors of Pediatric Acute Lung Injury and Sepsis Investigators (PALISI)-affiliated pediatric intensive care units regarding center-specific immediate postoperative management of pediatric kidney transplantation...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29144490/neonatal-lung-ultrasound-exam-guidelines
#2
D Kurepa, N Zaghloul, L Watkins, J Liu
Point-of-care ultrasound (POC-US) is increasingly used especially in emergency and critical-care medicine. It is focused, quick and does not expose patients to ionizing radiation. It encompasses all organ systems and has well-defined indications. Lung ultrasound (LUS) represents one of the most exciting applications in the field of POC-US. It is particularly important to emphasize the role of LUS in neonatology due to the specific pathology inherent in lung immaturity as well as in the particular sensitivity of neonates to repeated radiation exposure...
November 16, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29127960/thoracoscopic-lobectomy-for-congenital-lung-lesions
#3
REVIEW
Jarrett Moyer, Hanmin Lee, Lan Vu
Congenital lung lesions (CLLs) comprise a heterogeneous group of developmental and histologic entities often diagnosed on screening prenatal ultrasound. Most fetuses with CLL are asymptomatic at birth; however, the risk of malignancy and infection drives the decision to prophylactically resect these lesions. The authors describe their approach to minimally invasive lobectomy in children with CLLs, postoperative care, and management of procedure-specific complications.
December 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/29124818/diagnosis-and-management-of-patients-with-enhanced-myometrial-vascularity-associated-with-retained-products-of-conception
#4
Yvette S Groszmann, Amie Lynn Healy Murphy, Beryl R Benacerraf
OBJECTIVES: We performed this study to assess the complication rate, including the estimated amount of blood loss, in patients who underwent dilation and curettage for treatment of retained products of conception with markedly enhanced myometrial vascularity mimicking arteriovenous malformations. METHODS: This is a retrospective medical records review study of patients with retained products of conception with enhanced myometrial vascularity presenting to our ultrasound unit between August 1, 2015 and August 1, 2017...
November 10, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29075301/insulinoma-masquerading-as-a-loss-of-consciousness-in-a-teenage-girl-case-report-and-literature-review
#5
Meghana Gudala, Mahmuda Ahmed, Rushika Conroy, Ksenia Tonyushkina
BACKGROUND: Hypoglycemia due to a pancreatic beta cell neoplasm - insulinoma, is uncommon with only a few cases described. We report on a previously healthy 15-year-old Hispanic female with insulinoma who presented with a loss of consciousness due to hypoglycemia unawareness. CASE PRESENTATION: EM was first brought to the emergency department (ED) after she was found unresponsive at home with point of care (POC) glucose of 29 mg/dL(1.6 mmol/L) documented by emergency medical services (EMS) upon arrival...
2017: International Journal of Pediatric Endocrinology
https://www.readbyqxmd.com/read/29052024/multimodality-imaging-in-secondary-postpartum-or-postabortion-hemorrhage-retained-products-of-conception-and-related-conditions
#6
REVIEW
Yuko Iraha, Masahiro Okada, Masafumi Toguchi, Kimei Azama, Keiko Mekaru, Tadatsugu Kinjo, Wataru Kudaka, Yoichi Aoki, Hajime Aoyama, Akiko Matsuzaki, Sadayuki Murayama
Secondary postpartum hemorrhage (PPH) and postabortion hemorrhage are rare complications. Retained products of conception (RPOC) is among the most common causes of both secondary PPH and postabortion hemorrhage. Other less common causes of secondary PPH are uterine vascular abnormalities such as arteriovenous malformations and pseudoaneurysms. These are usually related to a history of a procedure such as dilation and curettage or cesarean delivery. Subinvolution of the placental site is an idiopathic cause of secondary PPH; this condition may be underrecognized and therefore could have a higher incidence than currently reported...
October 19, 2017: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/29042095/can-emergency-physicians-accurately-distinguish-retinal-detachment-from-posterior-vitreous-detachment-with-point-of-care-ocular-ultrasound
#7
Nicola Baker, Richard Amini, Elaine H Situ-LaCasse, Josie Acuña, Tomas Nuño, Uwe Stolz, Srikar Adhikari
STUDY OBJECTIVE: There is significant overlap between the symptoms of patients presenting with retinal detachment (RD) and posterior vitreous detachment (PVD). Urgency to obtain consultation and treatment are dependent on the ability to accurately distinguish these two conditions. The objective of this study was to determine the ability of emergency physicians to differentiate RDs from PVDs using point-of-care (POC) ocular ultrasound. METHODS: Single blinded cross-sectional study at an academic medical center...
October 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29034764/indeterminate-biliary-strictures-a-simplified-approach
#8
Chencheng Xie, Khalil Aloreidi, Bhavesh Patel, Timothy Ridgway, Thavam Thambi-Pillai, Gary Timmerman, Adeel Khan, Muslim Atiq
Pre-operative evaluation of biliary strictures remains challenging. The dilemma that exists is how to balance the risk of failing to detect malignancy and the potential morbidity caused by unnecessary surgery in patients with benign etiologies. With emerging novel diagnostic modalities, this study aims to assess the efficacy of diagnostic techniques and facilitate a clinical approach to indeterminate biliary strictures. Areas covered: Conventional imaging modalities are crucial in identifying the location of a stricture and are helpful for choosing further diagnostic modalities...
October 23, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28974845/challenges-in-the-routine-praxis-diagnosis-of-hydatidiform-mole-a-tertiary-health-center-experience
#9
Melisa Lelic, Zlatan Fatusic, Ermina Iljazovic, Suada Ramic, Sergije Markovic, Selma Alicelebic
INTRODUCTION: Hydatidiform moles (HM), presenting as complete (CHM) and partial (PHM) form, are rare pregnancy disorder. Diagnosis is based on clinical presentation, ultrasound imaging findings and pathological examination of products of conception. Protein p57, encoded by CKDN1C gene, is paternally imprinted and maternally expressed gene and provides quick insight in genetic basis of HM and allows distinction of CHM from all other conceptions. compare the preevacuational and pathohistological diagnosis with outcome of p57 immunostaining...
August 2017: Medical Archives
https://www.readbyqxmd.com/read/28948411/first-trimester-emergencies-a-radiologist-s-perspective
#10
REVIEW
Catherine H Phillips, Jeremy R Wortman, Elizabeth S Ginsburg, Aaron D Sodickson, Peter M Doubilet, Bharti Khurana
The purpose of this article is to help the practitioner ensure early diagnosis and response to emergencies in the first trimester by reviewing anatomy of the developing embryo, highlighting the sonographic appearance of common first-trimester emergencies, and discussing key management pathways for treating emergent cases. First-trimester fetal development is a stepwise process that can be challenging to evaluate in the emergency department (ED) setting. This is due, in part, to the complex anatomy of early pregnancy, subtlety of the sonographic findings, and the fact that fewer than half of patients with ectopic pregnancy present with the classic clinical findings of a positive pregnancy test, vaginal bleeding, pelvic pain, and tender adnexa...
September 25, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28939480/hysteroscopic-removal-of-retained-products-of-conception-implanted-over-a-focal-area-of-adenomyosis-a-case-report
#11
Luis Alonso, Laura Nieto, Jose Carugno
STUDY OBJECTIVE: To describe a technique for hysteroscopic removal of retained products of conception (RPOC) implanted over an area of adenomyosis. DESIGN: A case report (Canadian Task Force classification III). SETTING: RPOC is an unfortunate complication that may occur after the resolution of a normal pregnancy; it is more common after early pregnancy termination or spontaneous miscarriage [1]. Immediate consequences of RPOC include persistent vaginal bleeding, abdominal pain, pelvic infection, fever, and dilated cervix...
September 20, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28934813/postpartum-retained-products-of-conception-a-novel-approach-to-follow-up-and-early-diagnosis
#12
Noam Smorgick, Ayala Krakov, Ron Maymon, Moshe Betser, Josef Tovbin, Moty Pansky
Purpose To investigate whether ultrasound follow-up for the detection of postpartum retained products of conception (RPOC) in women considered at risk for this condition may allow for early diagnosis. Methods Parturients at risk for RPOC underwent an ultrasound exam on the second postpartum day. Based on the ultrasound findings, women were either: (1) discharged to routine postpartum care in cases of normal scans, (2) invited for follow-up in cases of abnormal scans. We retrospectively analyzed the rates of women requiring uterine evacuation due to persistent abnormal scans...
September 21, 2017: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/28924922/assessing-the-non-tumorous-liver-implications-for-patient-management-and-surgical-therapy
#13
Pallavi Pandey, Ankur Pandey, Mary Dillhoff, Carl Schmidt, Ihab R Kamel, Timothy M Pawlik
INTRODUCTION: Hepatic resection is performed for various benign and malignant liver tumors. Over the last several decades, there have been improvements in the surgical technique and postoperative care of patients undergoing liver surgery. Despite this, liver failure following an extended hepatic resection remains a critical potential postoperative complication. Patients with underlying parenchymal liver diseases are at particular risk of liver failure due to impaired liver regeneration with an associated mortality risk as high as 60 to 90%...
September 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28902042/performance-of-a-quick-pregnancy-test-on-whole-blood-in-early-pregnancy-units-a-prospective-cohort-study
#14
Caroline Legoupil, Isabelle Enderle, Flore-Anne Le Baccon, Claude Bendavid, Lucas Peltier, Estelle Bauville, Jean Leveque, Vincent Lavoue, Maela Le Lous
OBJECTIVE: To assess the diagnostic performance of the NG-Test human chorionic gonadotropin (hCG) WB, which is a new point-of-care (POC) hCG whole-blood test. MATERIALS AND METHODS: This prospective study included women consulted in early pregnancy units for vaginal bleeding and/or pelvic pain with unknown pregnancy status after medical consultation including a pelvic ultrasound scan. A new POC test (the NG-Test hCG WB) and the usual laboratory serum test (considered the gold standard) were performed in patients...
September 8, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28762248/engineering-brown-fat-into-skeletal-muscle-using-ultrasound-targeted-microbubble-destruction-gene-delivery-in-obese-zucker-rats-proof-of-concept-design
#15
Raul A Bastarrachea, Jiaxi Chen, Jack W Kent, Edna J Nava-Gonzalez, Ernesto Rodriguez-Ayala, Marcel M Daadi, Barbara Jorge, Hugo Laviada-Molina, Anthony G Comuzzie, Shuyuan Chen, Paul A Grayburn
Ultrasound-targeted microbubble destruction (UTMD) is a novel means of tissue-specific gene delivery. This approach systemically infuses transgenes precoupled to gas-filled lipid microbubbles that are burst within the microvasculature of target tissues via an ultrasound signal resulting in release of DNA and transfection of neighboring cells within the tissue. Previous work has shown that adenovirus containing cDNA of UCP-1, injected into the epididymal fat pads in mice, induced localized fat depletion, improving glucose tolerance, and decreasing food intake in obese diabetic mice...
September 2017: IUBMB Life
https://www.readbyqxmd.com/read/28759423/point-of-care-ultrasound-as-an-adjunct-in-the-diagnosis-of-neonatal-and-pediatric-superficial-soft-tissue-infection-a-report-of-two-cases
#16
Dalibor Kurepa, Colleen Galiczewski, Alison Civale, Vitaliya Boyar
Considerable technological advances, good safety profile, and ease of use have converged to support the use of ultrasound (US) as an important adjunct in the evaluation of superficial soft tissue infections (SSTI) in general and the differential diagnosis of cellulitis and abscess in particular. However, its use in neonatal populations has not been described. Pediatric studies report clinical examination is not always a reliable method of distinguishing cellulitis from abscess. Two (2) case reports are presented to supplement the growing body of published data that describe US imaging of SSTIs...
July 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28753590/ectopic-abdominal-pregnancy-due-to-uterine-perforation-after-an-attempt-to-terminate-pregnancy-a-case-presentation
#17
Jónathan Hernández Núñez, Alexander Abreu Díaz, Ndivhuwo Michael Ndwambi, Fermín Luis Martínez
Secondary abdominal ectopic pregnancy is rare in clinical practice, but may lead to an increased maternal mortality. We present the case of a patient with an abdominal pregnancy secondary to a uterine perforation caused by a voluntary attempt to interrupt pregnancy that presented with nine weeks of abdominal pain and minimal vaginal bleeding which was mistakenly diagnosed as acute pelvic inflammatory disease, urinary tract infection, and post-abortion products of conception. Finally, the abdominal ultrasound test found an abdominal ectopic pregnancy...
July 17, 2017: Medwave
https://www.readbyqxmd.com/read/28700054/sensitivity-and-specificity-of-the-circulating-cathodic-antigen-rapid-urine-test-in-the-diagnosis-of-schistosomiasis-mansoni-infection-and-evaluation-of-morbidity-in-a-low-endemic-area-in-brazil
#18
Fernanda Teixeira Ferreira, Thiago André Fidelis, Thiago Almeida Pereira, Alba Otoni, Leonardo Campos Queiroz, Frederico Figueiredo Amâncio, Carlos Maurício Antunes, José Roberto Lambertucci
INTRODUCTION: The Kato-Katz technique is the standard diagnostic test for Schistosoma mansoni infection in rural areas. However, the utility of this method is severely limited by the day-to-day variability in host egg excretion in the stool. In high-transmission areas, the point-of-care circulating cathodic antigen (POC-CCA) urine assay has proven to be a reliable test. However, investigations of the reliability of the POC-CCA assay in low-transmission regions are under way. This study aimed to evaluate the sensitivity and specificity of the POC-CCA assay and the morbidity of schistosomiasis in a low-endemic area in Brazil...
May 2017: Revista da Sociedade Brasileira de Medicina Tropical
https://www.readbyqxmd.com/read/28642091/a-see-and-treat-office-procedure-for-retained-products-of-conception-removal-after-normal-vaginal-delivery-using-manual%C3%A2-vacuum-aspiration-preliminary-efficacy-and-reproductive%C3%A2-outcomes
#19
Gilad Karavani, Raz Bahar, Shmuel Herzberg, Nili Yanai
STUDY OBJECTIVE: To compare the efficacy and reproductive outcomes of an ultrasound-guided manual vacuum aspiration (MVA) procedure with the widely accepted operative hysteroscopic (OH) procedure in the removal of retained products of conception (RPOCs) after normal vaginal delivery. DESIGN: A retrospective cohort study (Canadian Task Force classification II-2). SETTING: A university-affiliated tertiary medical center. PATIENTS: Eighty-six patients after normal vaginal delivery diagnosed with RPOCs from 2005 through 2015...
June 19, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28636237/microperforate-hymen-presenting-with-incomplete-abortion-a-case-report
#20
Maya Padhi, Priyadarshini Tripathy, Asutosh Sahu
A 20-year-old patient with 3 months of amenorrhea presented in the labor room with bleeding per vaginum and having experienced lower abdominal pain for 2 h. She had a history of difficult intercourse and prolonged menstrual flow. Inspection revealed a bleeding point over an obstructing membrane at the level of the vaginal introitus. Subsequent vaginal examination confirmed the diagnosis of microperforate hymen. Her urine pregnancy test was positive and an ultrasound examination revealed the presence of retained products of conception in the endometrial cavity...
June 21, 2017: Journal of Obstetrics and Gynaecology Research
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