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https://www.readbyqxmd.com/read/29141266/-impact-of-abdominal-ultrasound-on-the-identification-of-the-site-of-infection-in-the-emergency-department-analysis-whether-it-makes-sense-to-perform-abdominal-ultrasound-examination-for-the-identfication-of-the-site-of-infection-if-medical-history-and-clinical
#1
Barbara Werkmeister, Julia Langgartner, Doris Schacherer, Arno Mohr
Introduction A very high number of patients presenting in emergency departments suffer from an unknown infection or rather fever. If diagnostic imaging is necessary ultrasound can be performed. Whether ultrasound is superior to medical history and clinical examination considering the significantly enhanced technology in recent years and hence has to be performed in patients without abdominal symptoms with non-obvious focus cannot be answered by review of the literature. The objective of this study was to evaluate the relevance of abdominal ultrasound in the determination of the site of infection and to analyse whether an abdominal ultrasound for the identification of the source of infection is dispensable in patients in whom history and clinical examination do not indicate an abdominal focus...
November 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29131347/critical-care-ultrasound-a-national-survey-across-specialties
#2
Jeffrey R Stowell, Ross Kessler, Resa E Lewiss, Igor Barjaktarevic, Bikash Bhattarai, Napatkamon Ayutyanont, John L Kendall
PURPOSE: Management of the critically ill patient requires rapid assessment and differentiation. Point-of-care ultrasound (POCUS) improves diagnostic accuracy and guides resuscitation. This study sought to describe the use of critical care related POCUS amongst different specialties. METHODS: This study was conducted as an online 18-question survey. Survey questions queried respondent demographics, preferences for POCUS use, and barriers to implementation. RESULTS: 2735 recipients received and viewed the survey with 416 (15...
November 13, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29131073/an-introduction-to-contrast-enhanced-ultrasound-for-nephrologists
#3
Emily H Chang
Contrast-enhanced ultrasound (CEUS) is an emerging technology with no known nephrotoxicity. CEUS has been utilized in cardiac and abdominal imaging for decades in Asia and Europe and has recently received greater attention in the United States with its approval for characterization of indeterminate liver lesions. Emerging data suggest that CEUS has potential as a diagnostic imaging tool among individuals who have contraindications to CT and MRI. Few nephrologists are aware of CEUS and even fewer are aware of its potential applications among individuals with kidney disease...
November 9, 2017: Nephron
https://www.readbyqxmd.com/read/29130772/assessment-of-left-ventricular-function-using-the-myocardial-performance-index-in-term-fetuses-that-develop-intrapartum-compromise
#4
Amal A Alsolai, Larissa N Bligh, Ristan M Greer, Alexander Gooi, Sailesh Kumar
OBJECTIVE: To investigate the relationship between the prelabour left ventricular myocardial Performance Index (LVMPI) and intrapartum fetal compromise (IFC) in low risk term pregnancies. METHODS: A blinded, prospective observational cohort study at the Mater Mother's Hospital, Brisbane, Australia. A cohort of 284 women with uncomplicated singleton pregnancies underwent fortnightly ultrasound from 36 weeks until delivery. The LVMPI was assessed by conventional Doppler ultrasound and correlated with intrapartum outcomes...
November 12, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29128035/bedside-identification-of-massive-pulmonary-embolism-with-point-of-care-transesophageal-echocardiography
#5
Tomislav Jelic, Melanie Baimel, Jordan Chenkin
BACKGROUND: Pulmonary embolism can be difficult to diagnose, particularly in those who are hemodynamically unstable and cannot be imaged to confirm the diagnosis. Echocardiography can allow for rapid assessment of patients in shock, but requires adequate transthoracic windows to obtain clinically useful information. Emergency physician-performed transesophageal echocardiography (TEE) may be a useful tool when transthoracic echocardiography fails. CASE REPORT: An 86-year-old woman presented to the emergency department after a fall at home...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29128002/update-in-parathyroid-imaging
#6
REVIEW
Samuel J Kuzminski, Julie A Sosa, Jenny K Hoang
Primary hyperparathyroidism (PHPT) is characterized by excessive, dysregulated production of parathyroid hormone (PTH) by 1 or more abnormal parathyroid glands. Minimally invasive surgical techniques have created a need for more precise localization of the parathyroid lesion by imaging. A variety of imaging protocols and techniques have been used for this purpose, but no one modality is clearly superior. Nuclear medicine scintigraphy and ultrasound imaging are established modalities, although multiphase or 4-dimensional computed tomography is an emerging modality with several advantages...
February 2018: Magnetic Resonance Imaging Clinics of North America
https://www.readbyqxmd.com/read/29126559/outcomes-of-a-simplified-ultrasound-guided-intravenous-training-course-for-emergency-nurses
#7
Sarah Feinsmith, Ryan Huebinger, Michael Pitts, Emily Baran, Sheila Haas
INTRODUCTION: Various medical or anatomical conditions can lead to difficult intravenous access (DIVA) in the emergency department. It was hypothesized that developing an emergency nurse-training program could reduce IV attempts in the emergency department, improving throughput and patient care. METHODS: Emergency nurses completed a 4-hour ultrasound-guided intravenous (USGIV) access course and achieved competency after 10 successful supervised USGIV insertions on patients...
November 7, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29124412/evaluation-of-a-short-formation-on-the-performance-of-point-of-care-renal-ultrasound-performed-by-physicians-without-previous-ultrasound-skills-prospective-observational-study
#8
François Javaudin, François Mounier, Philippe Pes, Idriss Arnaudet, Frédéric Vignaud, Eric Frampas, Philippe Le Conte
BACKGROUND: Point-of-Care Ultrasound (PoCUS) is recommended by emergency medicine societies for the detection of hydronephrosis. Training of certified Emergency Physicians (EP) without prior ultrasound experience remains debated. We investigate performance of a brief training session for the detection of hydronephrosis with PoCUS performed by EP without previous ultrasound experience. PATIENTS AND METHODS: This was a prospective observational study of a convenience sample of patients older than 18 years with presumed renal colic, acute pyelonephritis or documented acute renal failure...
November 9, 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29123898/better-documentation-in-electronic-medical-records-would-lead-to-an-increased-use-of-lower-extremity-venous-ultrasound-in-the-inpatient-setting-a-retrospective-study
#9
Daisuke Takechi, Naoto Kuroda, Hisashi Dote, Euido Kim, Osamu Yonekawa, Takuya Watanabe, Tetsumei Urano, Yoichiro Homma
Aim: We hypothesized that the quality of the assessment of abnormal laboratory data in the emergency department (ED) could affect the hospital-attending physicians' decision-making after a patient's hospitalization. To test this hypothesis, we investigated how patients with a positive D-dimer result were reported by ED physicians in electronic medical records, and measured whether lower extremity venous ultrasonography examination was undertaken during hospitalization by the hospital-attending physicians...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123361/personalized-learning-in-medical-education-designing-a-user-interface-for-a-dynamic-haptic-robotic-trainer-for-central-venous-catheterization
#10
Mary Yovanoff, David Pepley, Katelin Mirkin, Jason Moore, David Han, Scarlett Miller
While Virtual Reality (VR) has emerged as a viable method for training new medical residents, it has not yet reached all areas of training. One area lacking such development is surgical residency programs where there are large learning curves associated with skill development. In order to address this gap, a Dynamic Haptic Robotic Trainer (DHRT) was developed to help train surgical residents in the placement of ultrasound guided Internal Jugular Central Venous Catheters and to incorporate personalized learning...
September 2017: Proceedings of the Human Factors and Ergonomics Society ... Annual Meeting
https://www.readbyqxmd.com/read/29122375/blunt-traumatic-axillary-artery-truncation-in-the-absence-of-associated-fracture
#11
Emily Bokser, William Caputo, Barry Hahn, Josh Greenstein
BACKGROUND: Axillary artery injuries can be associated with both proximal humeral fractures (Naouli et al., 2016; Ng et al., 2016) [1,2] as well as shoulder dislocations (Leclerc et al., 2017; Karnes et al., 2016) [3,4]. We report a rare case of an isolated axillary artery truncation following blunt trauma without any associated fracture or dislocation. CASE REPORT: A 58-year-old male presented to the emergency department for evaluation after falling on his outstretched right arm...
October 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29119588/an-early-pregnancy-unit-in-the-united-states-an-effective-method-for-evaluating-first-trimester-pregnancy-complications
#12
Polina Rovner, Elaine Stickrath, Meredith Alston, Kirsten Lund
In the United Kingdom, early pregnancy assessment clinics have existed since the early 1990s and have become the reference standard for evaluating and treating women with first-trimester pregnancy complications. These units have now been established in many countries and have been found to be effective and efficient, saving money and unnecessary emergency department visits and hospital admissions. To our knowledge, no such model has been described in the United States. A PubMed search using a combination of "early pregnancy unit," "early pregnancy assessment clinic," and "United States," "U...
November 9, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29118844/ultrasound-probe-grip-the-afternoon-tea-technique
#13
Luke McMenamin, Stephen Wolstenhulme, Max Hunt, Stuart Nuttall, Asoka Weerasinghe
Background: Globally, ultrasound is being used to assist in central venous and difficult peripheral intravenous access in a variety of emergency and non-emergency clinical settings. Context: After reading Flood's paper on safe central venous access and noting the difficulties clinicians find in probe stabilisation whilst performing dynamic intravenous access, we decided to share our teaching technique. Innovation: The purpose of this correspondence is to highlight the 'afternoon tea technique' as a potential teaching method for probe stabilisation...
August 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29117662/acute-gallbladder-torsion-with-gangrene-and-cholelithiasis-%C3%A2-a-rare-condition
#14
Leon Kunišek, Miodrag Gudelj, Marko Zelić, Dorian Kršul, Juraj Kunišek
We report a case of a 75-year-old female with acute torsion of the gallbladder with gangrene and cholelithiasis. On admission, the patient underwent physical examination, laboratory blood analysis, abdominal ultrasound and plain abdominal x-ray. Due to the signs of acute abdomen and poor general condition of the patient, urgent surgical procedure was indicated. Intraoperatively, the gallbladder was found to be greatly enlarged, gangrenous and greatly distended with 360° clockwise torsion around its mesentery...
December 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29116601/abnormal-cervical-lymph-nodes-in-multiple-sclerosis-a-preliminary-ultrasound-study
#15
Francesca Di Giuliano, Maria Albanese, Eliseo Picchi, Francesco Mori, Fabio Buttari, Girolama Alessandra Marfia, Francesco Garaci, Nicola Biagio Mercuri, Roberto Floris, Diego Centonze, Simone Marziali
BACKGROUND: Cervical lymph nodes are the first drainage stations of the brain and therefore play a key role in neuroinflammatory disorders such as multiple sclerosis. OBJECTIVE: The aim of this study was to evaluate, by using ultrasound imaging, cervical lymph nodes in patients with multiple sclerosis and to ascertain if such patients have any clinical features to attest their role. METHODS: We enrolled 43 patients affected by relapsing-remitting multiple sclerosis (22 drug free and 21 under treatment with natalizumab or fingolimod), who underwent ultrasound examination...
November 7, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/29112915/acute-abdomen-secondary-to-a-spontaneous-perforation-of-the-biliary-tract-a-rare-complication-of-choledocholithiasis
#16
G A Gómez-Torres, F M Rodríguez-Navarro, C R López-Lizárraga, C A Bautista-López, O S Ortega-García, G Becerra-Navarro, A Águila-Barragán, C F Ploneda-Valencia
INTRODUCTION: The spontaneous perforation of the biliary tract (SPBT) is an extremely rare cause of peritonitis, which was first described by Freeland in 1982, to date only around 70 cases have been reported. Here we present a case of spontaneous perforation of the biliary tract, in a patient with choledocholithiasis, which was treated with ultrasound-guided drainage and ERCP. CASE REPORT: A 51-year-old male was admitted to the emergency room for 15-day evolution jaundice, localized pain in the right flank and hypochondrium of 3days...
October 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29112910/biomechanical-characterization-of-ex-vivo-human-brain-using-ultrasound-shear-wave-spectroscopy
#17
Emmanuel Nicolas, Samuel Callé, Stéphane Nicolle, David Mitton, Jean-Pierre Remenieras
The characterization of brain tissue is crucial to better understand neurological disorders. Mechanical characterization is an emerging tool in that field. The purpose of this work was to validate a transient ultrasound technique aimed at measuring dispersion of mechanical parameters of the brain tissue. The first part of this work was dedicated to the validation of that technique by comparing it with two proven rheology methods: a rotating plate rheometer, and a viscoelastic spectroscopy apparatus. Experiments were done on tissue mimicking gels...
November 4, 2017: Ultrasonics
https://www.readbyqxmd.com/read/29110982/point-of-care-ultrasound-is-associated-with-decreased-length-of-stay-in-children-presenting-to-the-emergency-department-with-soft-tissue-infection
#18
Margaret J Lin, Mark Neuman, Rachel Rempell, Michael Monuteaux, Jason Levy
BACKGROUND: Point-of-care ultrasound (POCUS) is increasingly being used to differentiate cellulitis from abscess in the pediatric emergency department (ED). POCUS has also been shown to decrease length of stay (LOS) for other applications among adult patients. OBJECTIVE: We sought to determine if ED LOS differed for children presenting with skin and soft tissue infections who received POCUS versus radiology-performed ultrasound. METHODS: We performed a retrospective cohort study of children presenting to an urban pediatric ED between January 2011 and June 2013 with a diagnosis of cellulitis or abscess who underwent soft tissue ultrasound...
October 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29110981/distributive-shock-in-a-neonate-with-diffuse-infantile-hepatic-hemangioma
#19
James Brown, Rajan Arora, Usha Sethuraman
BACKGROUND: Hemangiomas are common cutaneous findings on healthy infants. These vascular malformations are generally benign, though in rare circumstances they can potentially be fatal. This is particularly true when the hemangiomas are large or numerous and occurring in visceral organs. Previously unrecognized visceral hemangiomas are part of the differential for any neonate presenting unexpectedly in shock. CASE REPORT: A 10-day-old neonate presented to the pediatric emergency department with difficulty breathing...
October 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29110976/emergency-medicine-myths-ectopic-pregnancy-evaluation-%C3%A2-risk%C3%A2-factors-and-presentation
#20
Jennifer J Robertson, Brit Long, Alex Koyfman
BACKGROUND: Ectopic pregnancy (EP) is an important cause of morbidity and mortality in females of reproductive age. Proper diagnosis and treatment are critical, as complications such as rupture, hemorrhagic shock, and even death can occur. OBJECTIVE: EP is a condition emergency physicians are trained to detect, yet there are multiple myths concerning its evaluation and diagnosis. This article reviews several of these myths in order to improve emergency department (ED) evaluation and diagnosis...
October 27, 2017: Journal of Emergency Medicine
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