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Goal directed ultrasonography

Yonatan Y Greenstein, Ross Littauer, Mangala Narasimhan, Paul H Mayo, Seth J Koenig
BACKGROUND: Widespread use of critical care ultrasonography (CCUS) for the management of patients in the intensive care unit requires an effective training program. The effectiveness of national and regional CCUS training courses is not known. This study describes a national level, simulation-based, three day CCUS training program and evaluates its effectiveness. METHODS: Five consecutive CCUS courses, with a total of 363 people, were studied. The three day CCUS training program consisted of didactic lectures, ultrasonography interpretation sessions, and hands-on modules with live models...
September 16, 2016: Chest
Markus Stenner, Mario Koopmann, Claudia Rudack
Although septorhinoplasty is the most commonly performed operation in plastic surgery, and the surgical plan as well as its outcome is directly related to the configuration of the anatomical structures in the nose, these are not routinely assessed preoperatively. The aim of our study was to evaluate the nasal soft tissue and cartilaginous structures by means of high-resolution ultrasonography to set up clinical correlations and standard values. We examined 44 patients before septorhinoplasty by high-resolution ultrasonography in noncontact mode...
September 15, 2016: European Archives of Oto-rhino-laryngology
Micah R Whitson, Paul H Mayo
Point-of-care ultrasonography (POCUS) is a useful imaging technique for the emergency medicine (EM) physician. Because of its growing use in EM, this article will summarize the historical development, the scope of practice, and some evidence supporting the current applications of POCUS in the adult emergency department. Bedside ultrasonography in the emergency department shares clinical applications with critical care ultrasonography, including goal-directed echocardiography, echocardiography during cardiac arrest, thoracic ultrasonography, evaluation for deep vein thrombosis and pulmonary embolism, screening abdominal ultrasonography, ultrasonography in trauma, and guidance of procedures with ultrasonography...
August 15, 2016: Critical Care: the Official Journal of the Critical Care Forum
Carmen V Villabona, Vineeth Mohan, Karla M Arce, Julia Diacovo, Alisha Aggarwal, Jessica Betancourt, Hassan Amer, Tessey Jose, Pascual DeSantis, Jose Cabral
INTRODUCTION: Thyroid nodules with fine needle aspiration (FNA) cytology categorized as atypia of undetermined significance(AUS) often undergo additional diagnostic analysis with the Afirma Gene Expression Classifier(GEC) which classifies these as either high probability of being benign(GEC-B) or suspicious for malignancy(GEC-S). Our goal was to assess the clinical validity and utility of GEC in the evaluation of AUS cytology and evaluate the performance of ultrasonography (USG) for predicting malignancy in this subset...
July 13, 2016: Endocrine Practice
Justin K Lui, Gisela I Banauch
Bedside goal-directed ultrasound is a powerful tool for rapid differential diagnosis and monitoring of cardiopulmonary disease in the critically ill patient population. The bedside intensivist is in a unique position to integrate ultrasound findings with the overall clinical situation. Medically critically ill patients who require urgent bedside diagnostic assessment fall into 2 categories: (1) acute respiratory failure and (2) hemodynamic derangements. The first portion of this review outlines the diagnostic role of bedside ultrasound in the medically critically ill patient population for the diagnosis and treatment of acute respiratory failure, acute respiratory distress, and severe hypoxemia...
July 8, 2016: Journal of Intensive Care Medicine
Ahmed Radwan, Jordan Bakowski, Stephanie Dew, Bridget Greenwald, Eryn Hyde, Nicole Webber
BACKGROUND: Chronic ankle instability (CAI) is a condition that often develops after repeated ankle sprains, increasing the suceptability of the ankle to move into excessive inversion when walking on unstable surfaces. Treatment for CAI costs approximately three billion health care dollars annually. Currently, common diagnostic tools used to identify ankle instability are arthroscopy, imaging, manual laxity testing, and self-reported questionnaires. PURPOSE: The purpose of this systematic review was to investigate the effectiveness of ultrasonography in diagnosing CAI, in comparison with other diagnostic tools...
April 2016: International Journal of Sports Physical Therapy
Soo-Jung Rew, Du-Hyeon Lee, Chang-Hwan Park, Jin Jeon, Hyun-Soo Kim, Sung-Kyu Choi, Jong-Sun Rew
BACKGROUND/AIMS: Endoscopic retrograde biliary drainage (ERBD) has become a standard procedure in patients with a biliary obstruction. Intraductal ultrasonography (IDUS) has emerged as a new tool for managing extrahepatic biliary diseases. IDUS-directed ERBD can be performed without conventional cholangiography (CC). The goal of this study was to assess the effectiveness and safety of IDUS-directed ERBD compared to CC-directed ERBD in patients with an extrahepatic biliary obstruction...
September 2016: Korean Journal of Internal Medicine
Pyng Lee, Praveen N Mathur
PURPOSE OF REVIEW: Medical thoracoscopy provides the physician a window into the pleural space. The procedure allows biopsy of the parietal pleura under direct visualization with good accuracy. In addition, it achieves therapeutic goals of fluid drainage, guided chest tube placement, and pleurodesis. RECENT FINDINGS: Comparable diagnostic yield is achieved with the flexi-rigid pleuroscope even though pleural biopsies are smaller using the flexible forceps as compared to rigid thoracoscopy...
May 2016: Current Opinion in Pulmonary Medicine
Tatjana Stopar-Pintaric, Kamen Vlassakov, Josip Azman, Erika Cvetko
STUDY OBJECTIVE: The objective was to present a proof of concept for a simple and consistently successful ultrasonograpy (US)-guided technique to block the internal branch of the superior laryngeal nerve (iSLN). DESIGN: This was a volunteer and cadaver anatomy study. SETTING: The setting was an anesthesiology department and an anatomy laboratory at a medical school MEASUREMENTS: H13-6 MHz US scans were performed in 40 healthy volunteers positioned supine and with extended necks...
November 2015: Journal of Clinical Anesthesia
Hidetaka Mitsumura, Shinji Miyagawa, Teppei Komatsu, Toshiaki Hirai, Yu Kono, Yasuyuki Iguchi
BACKGROUND: Carotid duplex ultrasonography (CUS) has been used to identify reversed vertebral artery flow (RVAF) at the extracranial cervical artery in some patients with subclavian steal syndrome. However, the characteristics of intracranial RVAF as evaluated by transcranial color flow imaging (TC-CFI), which can examine intracranial hemodynamics in a real-time and noninvasive fashion, remain unclear. The goal of this study was to analyze the prevalence of intracranial RVAF and its associated clinical characteristics...
August 2015: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Neslihan Sayrac, Firat Bektas, Secgin Soyuncu, Vefa Sayrac
The aim of study was to determine the impact of "goal-directed transvaginal ultrasonography" (TVUSG) on real-time clinical decision making of attending emergency physicians evaluating their level of certainty for preliminary diagnosis, admission, surgery, treatment, additional laboratory, and discharge in patients presenting with acute pelvic pain to the emergency department (ED). This prospective cross-sectional clinical study was conducted on sexually active female patients older than 18 years who presented with acute pelvic pain in the ED...
July 2015: American Journal of Emergency Medicine
Sid Ahmed Faraoun, Mohamed El Amine Boudjella, Nabil Debzi, Nawel Afredj, Youcef Guerrache, Naima Benidir, Chafik Bouzid, Kamel Bentabak, Philippe Soyer, Salah Eddine Bendib
PURPOSE: The goal of this study was to prospectively describe the imaging presentation of hepatic vein (HV) obstruction in patients with Budd-Chiari syndrome (BCS) on duplex and color Doppler ultrasonography (DCD-US), multidetector-row computed tomography (MDCT) and magnetic resonance imaging (MRI). MATERIALS AND METHODS: A total of 176 patients with primary BCS (mean age, 33 years; 101 women) were prospectively included. BCS diagnosis was made by direct visualization of HV and/or upper portion of the inferior vena cava (IVC) obstruction on DCD-US and/or MDCT and/or MRI...
August 2015: Abdominal Imaging
Raheleh Mirzania, Kiyanoosh Shapoori, Eugene Malyarenko, Roman Gr Maev
The main goal of this study is to develop a new image reconstruction approach for the ultrasonic detection of small objects (comparable to or smaller than the ultrasonic wavelength) behind an aberrating layer. Instead of conventional pulse-echo experimental setup we used through transmission, as the backscattered field after going twice through the layer becomes much weaker than the through-transmitted field. The proposed solution is based on the Harmonic Phase Conjugation (HPC) technique. The developed numerical model allows to calculate the amplitude and phase distributions of the through-transmitted acoustic field interacting with the objects and received by a linear transducer array either directly or after passing through an additional aberrating layer...
April 2015: Ultrasonics
Juan Pablo Ciria, Mikel Eguiguren, Sergio Cafiero, Intza Uranga, Ivan Diaz de Cerio, Arrate Querejeta, Jose Maria Urraca, Julian Minguez, Elena Guimon, Jose Ramón Puertolas
Short-course preoperative radiotherapy (RT) is widely used in northern Europe for locally advanced resectable rectal cancer, but its role in the era of advanced imaging techniques is uncertain. Here, we reviewed articles and abstracts on SCRT published from 1974 through 2013 with the goal of identifying patients who might be best suited for short-course RT. We included relevant articles comparing surgery with or without preoperative radiation published before and after the advent of total mesorectal excision...
January 2015: Reports of Practical Oncology and Radiotherapy
Christoph Hennersperger, Diana Mateus, Maximilian Baust, Nassir Navab
We present a flexible and general framework to iteratively solve quadratic energy problems on a non uniform grid, targeted at ultrasound imaging. Therefore, we model input samples as the nodes of an irregular directed graph, and define energies according to the application by setting weights to the edges. To solve the energy, we derive an effective optimization scheme, which avoids both the explicit computation of a linear system, as well as the compounding of the input data on a regular grid. The framework is validated in the context of 3D ultrasound signal loss estimation with the goal of providing an uncertainty estimate for each 3D data sample...
2014: Medical Image Computing and Computer-assisted Intervention: MICCAI ..
F L Lefarth, A Prescher, W Angerstein
BACKGROUND: High-resolution ultrasonography of the lips offers the opportunity to investigate the orbicularis oris muscle (OOM) and evaluate its morphology and function. OBJECTIVES: The goals of this paper are verification of the lip structures visible on ultrasound images by using histological section preparations and recommendation of uniform standards for sonographic examinations of the lips. MATERIALS AND METHODS: The lips of 78 healthy volunteers (age 4-77 years) where scanned with a Hitachi Hi Vision Avius ultrasound device equipped with a linear transducer (L75, variable frequency range 5...
December 2014: HNO
Usman Jaffer, Pasha Normahani, Prashant Singh, Mohammed Aslam, Nigel J Standfield
OBJECTIVES: In vascular surgery, duplex ultrasonography is a valuable diagnostic tool in patients with peripheral vascular disease, and there is increasing demand for vascular surgeons to be able to perform duplex scanning. This study evaluates the role of a novel simulation training package on vascular ultrasound (US) skill acquisition. MATERIALS AND METHODS: A total of 19 novices measured predefined stenosis in a simulated pulsatile vessel using both peak systolic velocity ratio (PSVR) and diameter reduction (DR) methods before and after a short period of training using a simulated training package...
March 2015: Journal of Surgical Education
Erdogan Sozuer, Muhammet Akyuz, Sami Akbulut
Hydatid disease is a zoonosis caused by the larvae of Echinococcus granulosus . Humans are an intermediate host and are usually infected by direct contact with dogs or indirectly by contaminated foods. Hydatid disease mainly involves the liver and lungs. The disease can be asymptomatic. Imaging techniques such as ultrasonography and computed tomography are used for diagnosis. The growth of hydatid cysts can lead to complications. Communication between bile duct and cysts is a common complication. The goal of treatment for hydatid disease is to eliminate the parasite with minimum morbidity and mortality...
November 2014: International Surgery
Jose Cardenas-Garcia, Paul H Mayo
Critical care ultrasonography is a bedside technique performed by the frontline clinician at the point of care. Point-of-care ultrasonography is conceptually related to physical examination. The intensivist uses visual assessment, auscultation, and palpation on an ongoing basis to monitor the patient. Ultrasonography adds to traditional physical examination by allowing the intensivist to visualize the anatomy and function of the body in real time. Initial, repeated, and goal-directed ultrasonography is an extension of the physical examination that allows the intensivist to establish a diagnosis and monitor the condition of the patient on a regular basis...
January 2015: Critical Care Clinics
T D Phan, B D'Souza, M J Rattray, M J Johnston, B S Cowie
There is continued controversy regarding the benefits of goal-directed fluid therapy, with earlier studies showing marked improvement in morbidity and length-of-stay that have not been replicated more recently. The aim of this study was to compare patient outcomes in elective colorectal surgery patients having goal-directed versus restrictive fluid therapy. Inclusion criteria included suitability for an Enhanced Recovery After Surgery care pathway and patients with an American Society of Anesthesiologists Physical Status score of 1 to 3...
November 2014: Anaesthesia and Intensive Care
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