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https://www.readbyqxmd.com/read/28027224/ultrasound-guided-bilateral-thoracic-paravertebral-blocks-as-an-adjunct-to-general-anesthesia-in-patients-undergoing-reduction-mammaplasty-a-historical-cohort-study
#1
Emine A Salviz, Nukhet Sivrikoz, Anil Ozonur, Mukadder Orhan-Sungur, Meltem Savran-Karadeniz, Demet Altun, Emre Hocaoglu, Burcu Celet-Ozden, Kamil M Tugrul
BACKGROUND: This study investigates whether ultrasound-guided thoracic paravertebral blocks would improve postoperative analgesia in patients undergoing bilateral reduction mammaplasty. METHODS: After obtaining ethics committee approval, data of 70 patients who underwent bilateral reduction mammaplasty were reviewed. Sixty-four patients' data were evaluable; 30 were in the general anesthesia group and 34 were in the thoracic paravertebral block group. Data such as time to first pain, intraoperative fentanyl requirement, postoperative numeric rating scale scores, number of patients who required tramadol in the postoperative care unit, and rescue analgesic consumption through the first 2 postoperative days were analyzed...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28004170/uterine-artery-embolization-for-retained-products-of-conception-with-marked-vascularity-a-safe-and-efficient-first-line-treatment
#2
Paul Bazeries, Francine Paisant-Thouveny, Sultan Yahya, Antoine Bouvier, Cosmina Nedelcu, Francoise Boussion, Loic Sentilhes, Serge Willoteaux, Christophe Aubé
OBJECTIVE: To report our clinical practice regarding a case series of retained products of conception (RPOC) with marked vascularity (MV) managed with selective uterine artery embolization (UAE) as first-line treatment. METHODS: This was a monocentric, retrospective study of 31 consecutive cases of RPOC with MV diagnosed by Doppler ultrasound in the context of postpartum/postabortal bleeding. The primary outcome was the absence of rebleeding following embolization...
December 21, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27994100/the-impact-of-systematic-point-of-care-ultrasound-on-management-of-patients-in-a-resource-limited-setting
#3
Alastair Stanley, Bahati M K Wajanga, Hyasinta Jaka, Rachael Purcell, Lauren Byrne, Felicity Williams, Candace Rypien, Abigail Sharpe, Patrick Laws, Lucas Faustine, Tshepo Leeme, Emmanuel Mwabutwa, Robert Peck, Matthew Stephens, Daniel Kaminstein
Although target point-of-care (POC) ultrasonography has been shown to benefit patients in resource-limited settings, it is not clear whether a systematic POC ultrasound assessment in these settings can also lead to similar changes in patient management. A predefined systematic set of POC ultrasound scans were performed on inpatients at a tertiary referral hospital in Tanzania to see if this resulted in changes to patient management. Of the 55 patients scanned, an abnormality was detected in 75% (N = 41), and a change in patient management was recommended or implemented on the basis of POC ultrasound findings in 53% (N = 29)...
December 19, 2016: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/27957515/ultrasound-skill-and-application-of-knowledge-assessment-using-an-innovative-osce-competition-based-simulation-approach
#4
Annette Rebel, Habib Srour, Amy DiLorenzo, Dung Nguyen, Shelly Ferrell, Sanjay Dwarakanatli, Emily Haas, Randall M Schell
BACKGROUND: Despite Point-of Care Ultrasound (PoC US) rapidly becoming an important tool in perioperative medicine structured education, PoC US is currently rarely integrated into the anesthesiology residency curriculum. The aim of this project was to assess the current ultrasound skills of anesthesiology residents at one institution and evaluate the needs for development of a formal ultrasound curriculum. METHODS: A event containing 6 different OSCE PoC US stations was developed with following stations: vascular, peripheral nerve block, lung ultrasound, transthoracic echocardiography (TTE) human model, pathologic TTE (simulator), and inferior vena cava (IVC) evaluation (simulator)...
July 2016: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/27861982/following-up-adult-patients-with-tetralogy-of-fallot-the-role-of-echocardiography
#5
REVIEW
Ana Maria Daraban, Ruxandra Jurcuţ, Elisabeta Bădilă, Daniela Bartoş, Gheorghe Andrei Dan
Tetralogy of Fallot (TOF) is one of the most common cyanotic congenital heart diseases. With surgical repair and the advances in postoperative care, contemporary mortality has dramatically improved and an increasing number of patients survive into adulthood, leading to a growing number of adult TOF. However, residual anatomic and hemodynamic abnormalities are encountered in nearly all patients, making follow-up mandatory. Furthermore, mortality starts to increase 25 years after surgery, emphasizing that, in adult TOF, closer monitoring is necessary...
November 10, 2016: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/27859801/a-prospective-evaluation-of-ultrasound-accuracy-in-the-prediction-of-rectosigmoid-infiltration-in-patients-with-epithelial-ovarian-cancer
#6
M Zikan, D Fischerova, I Semeradova, J Slama, P Dundr, V Weinberger, L Dusek, D Cibula
OBJECTIVES: The aim of this prospective study was to examine the accuracy of ultrasound in predicting the rectosigmoid tumor infiltration in patients with epithelial ovarian cancer. METHODS: Patients referred for suspicious pelvic mass underwent ultrasound examination within the standard protocol for the assessment of tumor infiltration. We prospectively examined 245 patients in total and included 191 patients with proven ovarian cancer who underwent primary surgery into analysis...
November 18, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27853850/clinical-and-imaging-predictors-of-management-in-retained-products-of-conception
#7
Aya Kamaya, Priya Menon Krishnarao, Nita Nayak, R Brooke Jeffrey, Katherine E Maturen
OBJECTIVES: To determine if clinical and ultrasound (US) imaging features help predict management in clinically suspected retained products of conception (RPOC). METHODS: 334 patients sonographically evaluated for RPOC were included in this IRB-approved retrospective study. Of the 334 patients, 176 had sonographic diagnosis of RPOC and comprised the final study group. Patients were managed expectantly, medically, or surgically in accordance with clinical judgment of treating physicians...
December 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27802866/point-of-care-ultrasonography-as-a-training-milestone-for-internal-medicine-residents-the-time-is-now
#8
Bruce F Sabath, Gurkeerat Singh
Point-of-care (POC) ultrasonography is considered fundamental in emergency medicine training and recently has become a milestone in critical care fellowship programs as well. Currently, there is no such standard requirement for internal medicine residency programs in the United States. We present a new case and briefly review another case at our institution - a community hospital - in which internal medicine house staff trained in ultrasonography were able to uncover unexpected and critical diagnoses that significantly changed patient care and outcomes...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27794400/pre-and-postoperative-care-for-stage-i-iii-nsclc-which-quality-of-care-indicators-are-evidence-based
#9
REVIEW
Rachel C Numan, Martijn Ten Berge, Jacobus A Burgers, Houke M Klomp, Johanna W van Sandick, Paul Baas, Michel W Wouters
Identification of evidenced-based Quality of Care (QoC) indicators for lung cancer care is essential to quality improvement. The aim of this review was to identify evidence-based quality indicators for the pre- and postoperative care of stage I-III Non Small Cell Lung Cancer (NSCLC) provided by the lung physician. To obtain these indicators, a search in PubMed, Embase and the Cochrane library database was performed. English literature published between 1980 and 2012 was included and search terms regarding 'lung neoplasms', 'quality of care', 'pathology', 'diagnostic methods', 'preoperative and postoperative treatment' were used...
November 2016: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
https://www.readbyqxmd.com/read/27749905/real-time-tele-mentored-low-cost-point-of-care-us-in-the-hands-of-paediatricians-in-the-emergency-department-diagnostic-accuracy-compared-to-expert-radiologists
#10
Floriana Zennaro, Elena Neri, Federico Nappi, Daniele Grosso, Riccardo Triunfo, Francesco Cabras, Francesca Frexia, Stefania Norbedo, Pierpaolo Guastalla, Massino Gregori, Elisabetta Cattaruzzi, Daniela Sanabor, Egidio Barbi, Marzia Lazzerini
BACKGROUND: The use of point-of-care ultrasonography (POC US) in paediatrics is increasing. This study investigated the diagnostic accuracy of POC US in children accessing the emergency department (ED) when performed by paediatricians under the remote guidance of radiologists (TELE POC). METHODS: Children aged 0 to 18 years accessing the ED of a third level research hospital with eight possible clinical scenarios and without emergency/severity signs at the triage underwent three subsequent US tests: by a paediatrician guided remotely by a radiologist (TELE POC); by the same radiologist (UNBLIND RAD); by an independent blinded radiologist (BLIND RAD)...
2016: PloS One
https://www.readbyqxmd.com/read/27689155/point-of-care-clinical-ultrasound-for-medical-students
#11
J Heiberg, L S Hansen, K Wemmelund, A H Sørensen, C Ilkjaer, E Cloete, D Nolte, F Roodt, R Dyer, J Swanevelder, E Sloth
PURPOSE: Our institution has recently implemented a point-of-care (POC) ultrasound training program, consisting of an e-learning course and systematic practical hands-on training. The aim of this prospective study was to evaluate the learning outcome of this curriculum. MATERIALS AND METHODS: 16 medical students with no previous ultrasound experience comprised the study group. The program covered a combination of 4 well-described point-of-care (POC) ultrasound protocols (focus assessed transthoracic echocardiography, focused assessment with sonography in trauma, lung ultrasound, and dynamic needle tip positioning for ultrasound-guided vascular access) and it consisted of an e-learning course followed by 4 h of practical hands-on training...
November 2015: Ultrasound International Open
https://www.readbyqxmd.com/read/27687310/vectorized-gene-therapy-of-liver-tumors-proof-of-concept-of-tg4023-mva-fcu1-in-combination-with-flucytosine
#12
F Husseini, J-P Delord, C Fournel-Federico, J Guitton, P Erbs, M Homerin, C Halluard, C Jemming, C Orange, J-M Limacher, J-E Kurtz
BACKGROUND: TG4023 is a modified vaccinia virus Ankara (MVA) containing the yeast-originated transgene FCU1, expressing cytosine deaminase and uracil phosphoribosyltransferase enzymes that transform the prodrug flucytosine (5-FC) into cytotoxic 5-fluorouracil (5-FU) and 5-fluorouridine-5'-monophosphate (5-FUMP), respectively. This first-in-human study aimed to assess the maximum tolerated dose (MTD) of intra-tumoral (IT) TG4023 and the safety, feasibility, and proof-of-concept (PoC) of TG4023/5-FC combination to deliver high 5-FU concentrations in tumors...
September 29, 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/27531563/technical-tips-for-peroral-transluminal-cholangioscopy-using-novel-single-operator-cholangioscope-with-videos
#13
Takeshi Ogura, Wataru Takagi, Yoshitaka Kurisu, Kazuhide Higuchi
Endoscopic retrograde cholangiopancreatography (ERCP) is the gold-standard modality for diagnosis and therapy of bilio-pancreatic disease. In particular, peroral cholangiography (POCS) is a useful modality not only for diagnosing biliary disease, but also for therapeutic procedures such as electrohydraulic lithotripsy. The SPY-DS single-operator cholangioscope has recently become available, and offers favorable visualization, a wide view, suction function and a larger accessory working channel. However, if the duodenoscope cannot be advanced into the ampulla of Vater for reasons such as surgical anatomy, POCS cannot be performed...
October 2016: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/27472989/point-of-care-ultrasound-a-wfumb-position-paper
#14
REVIEW
Christoph F Dietrich, Adrian Goudie, Liliana Chiorean, Xin Wu Cui, Odd Helge Gilja, Yi Dong, Jacques S Abramowicz, Sudhir Vinayak, Susan Campbell Westerway, Christian Pállson Nolsøe, Yi-Hong Chou, Michael Blaivas
Over the last decade, the use of portable ultrasound scanners has enhanced the concept of point of care ultrasound (PoC-US), namely, "ultrasound performed at the bedside and interpreted directly by the treating clinician." PoC-US is not a replacement for comprehensive ultrasound, but rather allows physicians immediate access to clinical imaging for rapid and direct solutions. PoC-US has already revolutionized everyday clinical practice, and it is believed that it will dramatically change how ultrasound is applied in daily practice...
January 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/27261221/intrauterine-adhesions-following-miscarriage-look-and-learn
#15
Ashley R Gilman, Kathryn M Dewar, Stephanie A Rhone, Margo R Fluker
OBJECTIVE: To examine the incidence of intrauterine adhesions (IUA) following the management of miscarriage in women with previously documented normal uterine cavities. METHODS: We conducted a retrospective cohort study from two fertility clinics with standard practice protocols for evaluating the uterine cavity prior to infertility treatment and following clinical pregnancy loss. A database query and manual chart review identified 144 women with normal uterine cavities who experienced a miscarriage between January 2010 and November 2012 and returned to the clinic for follow-up hysteroscopy...
May 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27260690/diagnosis-of-acquired-uterine-arteriovenous-malformation-by-doppler-ultrasound
#16
Drew Scribner, Robert Fraser
BACKGROUND: Acquired uterine arteriovenous malformation (AVM) is a rare cause of postpartum vaginal bleeding and can often be confused with retained products of conception (RPOC). Certain findings on ultrasound (US) increase the likelihood for AVM, such as hypoechoic areas in the myometrium and high velocity, multidirectional blood flow. Recognizing these changes on bedside US can cue the physician to send the patient for further studying and lead to the correct diagnosis. CASE REPORT: A 31-year-old, multigravida, multiparous female presented 5 weeks post-cesarean section with heavy, intermittent vaginal bleeding...
August 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27207087/a-workflow-task-force-affects-emergency-physician-compliance-for-point-of-care-ultrasound-documentation-and-billing
#17
Resa E Lewiss, Jessica Cook, Allison Sauler, Nicholas Avitabile, Nicole L Kaban, Jeffrey Rabrich, Turandot Saul, Sebastian D Siadecki, Dan Wiener
BACKGROUND: Emergency point-of-care ultrasound (POC u/s) is an example of a health information technology that improves patient care and time to correct diagnosis. POC u/s examinations should be documented, as they comprise an integral component of physician decision making. Incomplete documentation prevents coding, billing and physician group compensation for ultrasound-guided procedures and patient care. We aimed to assess the effect of directed education and personal feedback through a task force driven initiative to increase the number of POC u/s examinations documented and transferred to medical coders by emergency medicine physicians...
December 2016: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/27147768/training-of-midwives-in-advanced-obstetrics-in-liberia
#18
Obed Dolo, Alice Clack, Hannah Gibson, Naomi Lewis, David P Southall
PROBLEM: The shortage of doctors in Liberia limits the provision of comprehensive emergency obstetric and neonatal care. APPROACH: In a pilot project, two midwives were trained in advanced obstetric procedures and in the team approach to the in-hospital provision of advanced maternity care. The training took two years and was led by a Liberian consultant obstetrician with support from international experts. LOCAL SETTING: The training took place in CB Dunbar Maternity Hospital...
May 1, 2016: Bulletin of the World Health Organization
https://www.readbyqxmd.com/read/27118381/considerations-for-management-of-interstitial-ectopic-pregnancies-two-case-reports
#19
Natalia M Grindler, June Ng, Kristina Tocce, Ruben Alvero
BACKGROUND: Conventional treatment of interstitial pregnancies includes systemic methotrexate, direct methotrexate injection, wedge resection, or hysterectomy. We present two cases of interstitial pregnancies that were successfully managed by different minimally invasive surgical techniques. We also report the novel use of hysteroscopic urologic stone retrieval forceps in the transvaginal removal of persistent products of conception after systemic methotrexate for an interstitial pregnancy...
April 27, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27081223/magnetic-resonance-imaging-a-troubleshooter-in-obstetric-emergencies-a-pictorial-review
#20
Rohini Gupta, Sunil Kumar Bajaj, Nishith Kumar, Ranjan Chandra, Ritu Nair Misra, Amita Malik, Brij Bhushan Thukral
The application of magnetic resonance imaging (MRI) in pregnancy faced initial skepticism of physicians because of fetal safety concerns. The perceived fetal risk has been found to be unwarranted and of late, the modality has attained acceptability. Its role in diagnosing fetal anomalies is well recognized and following its safety certification in pregnancy, it is finding increasing utilization during pregnancy and puerperium. However, the use of MRI in maternal emergency obstetric conditions is relatively limited as it is still evolving...
January 2016: Indian Journal of Radiology & Imaging
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