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Emergency use of ultrasounds

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https://www.readbyqxmd.com/read/29904471/spectral-doppler-findings-in-a-rare-case-of-acute-compartment-syndrome-following-leg-burn
#1
Omer A Mahmoud, Mustafa Z Mahmoud
Acute compartment syndrome (ACS) is an orthopedic emergency condition, which is rarely attributed to burns. It occurs when pressure in an enclosed space rises to a point where it reduces blood flow and impairs tissue perfusion. Its consequences often lead to ischemia and possible necrosis within that space. Until now, the use of Doppler assessment to explore different types of compartment syndrome has yielded contradictory findings. Here, we present a significant increase of blood flow velocity in the arteries proximal to the burned area...
April 2018: Radiology Case Reports
https://www.readbyqxmd.com/read/29903734/ige-to-the-mammalian-oligosaccharide-galactose-%C3%AE-1-3-galactose-is-associated-with-increased-atheroma-volume-and-plaques-with-unstable-characteristics
#2
Jeffrey M Wilson, Anh T Nguyen, Alexander J Schuyler, Scott P Commins, Angela M Taylor, Thomas A E Platts-Mills, Coleen A McNamara
OBJECTIVE: Emerging evidence suggests a link between coronary artery disease and type 2 immunity. We sought to test the hypothesis that IgE sensitization to the mammalian oligosaccharide galactose-α-1,3-galactose (α-Gal)-the target allergen of delayed anaphylaxis to red meat-is associated with coronary artery disease. APPROACH AND RESULTS: Total IgE and specific IgE to α-Gal were assayed on sera from 118 subjects who presented for cardiac catheterization and underwent intravascular ultrasound...
June 14, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/29903440/ultrasound-and-ct-of-the-posterior-fossa-in-neonates
#3
Elizabeth Snyder, Misun Hwang, Bruno P Soares, Aylin Tekes
Ultrasound, CT and MRI may all be used in the evaluation of the posterior fossa in neonates depending on the clinical scenario. Ultrasonography is particularly valuable for the evaluation of the neonatal brain because of the lack of ionizing radiation and the ability to perform exams at the bedside and, importantly, advancements in ultrasound technology now allow for diagnostic-quality imaging. While CT is still the initial imaging modality of choice in most neurologic emergencies, in the neonate, ultrasound is the first line in nontraumatic emergencies...
2018: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29901534/risk-factors-for-loss-of-lung-sliding-in-a-medical-intensive-care-population-with-acute-respiratory-failure
#4
Christopher Mallow, Warren Isakow
BACKGROUND: Point of care bedside ultrasound is widely utilized as a rapid technique to evaluate patients with acute pulmonary emergencies, including acute pneumothorax. The presence of a pneumothorax is a known cause of loss of lung sliding by ultrasound examination, but no other risk factors have been clearly identified. We attempted to identify demographic and patient characteristics that are risk factors for loss of ultrasonographic lung sliding in the absence of a pneumothorax. METHODS: Data were collected on 159 patients admitted to the medical intensive care unit with acute respiratory failure, undergoing routine admission lung ultrasound...
June 12, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29901315/should-nurses-be-trained-to-use-ultrasound-for-intravenous-access-to-patients-with-difficult-veins
#5
Claire Smith
Peripheral venous access is the most common invasive procedure performed on patients in the UK and is traditionally the responsibility of nursing staff. In an emergency, intravenous therapy can be lifesaving. Approximately 11% of adults have difficult venous access and are often subjected to repeated failed attempts, resulting in delayed diagnosis and treatment. Eventually, rescue methods are used by a doctor, but this increases demand on their time and the workflow of emergency departments. This article explores whether training nurses to obtain venous access using ultrasound would have a positive effect on doctors' workload and benefit adult patients with difficult veins...
June 14, 2018: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29897053/listening-in-on-the-microbubble-crowd-advanced-acoustic-monitoring-for-improved-control-of-blood-brain-barrier-opening-with-focused-ultrasound
#6
EDITORIAL
Catherine M Gorick, Natasha D Sheybani, Colleen T Curley, Richard J Price
Non-invasive drug and gene delivery to the brain to treat central nervous system pathologies has long been inhibited by the blood-brain barrier. The activation of microbubbles with focused ultrasound has emerged as a promising non-invasive approach to circumvent this obstacle, by transiently disrupting the blood-brain barrier and permitting passage of systemically administered therapeutics into the tissue. Clinical trials are underway to evaluate the safety of this technique; however, concerns remain regarding the potential for the treatment to induce sterile inflammation or petechiae...
2018: Theranostics
https://www.readbyqxmd.com/read/29890356/laparoscopic-resection-of-cesarean-scar-ectopic-pregnancy-after-unsuccessful-systemic-methotrexate-treatment
#7
L Pirtea, O Balint, C Secosan, D Grigoras, R Ilina
STUDY OBJECTIVE: To present a case of a cesarean scar ectopic pregnancy treated by laparoscopic resection followed by isthmocele repair. DESIGN: Case report SETTINGS: University Gynecology Clinic of the Emergency Clinical City Hospital Timișoara, România. BACKGROUND: Cesarean scar pregnancy is a rare form of ectopic pregnancy. In the last years its prevalence has risen due to the increasing number of cesarean section. An early diagnosis can lead to an early management decreasing the risk of life-threatening complication such as uterine rupture and massive haemorrhage...
June 8, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29890272/emerging-strategies-and-future-perspective-in-neuro-oncology-using-transcranial-focused-ultrasound-technology
#8
REVIEW
Giada Toccaceli, Roberto Delfini, Claudio Colonnese, Antonino Raco, Simone Peschillo
Despite the progress achieved in recent years, the prognosis of patients with primary brain tumors remains poor. Research efforts have therefore focused on identifying more effective and minimally invasive treatment methods. MR guided transcranial focused ultrasound (MRgFUS) is a consolidated minimally invasive therapeutic technique, which has recently acquired a role also in the treatment of some non-oncological intracranial pathologies. In this article, we've reviewed the latest studies to take stock of the potential that this method can offer...
June 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29887195/misconceptions-in-acute-heart-failure-diagnosis-and-management-in-the-emergency-department
#9
REVIEW
Brit Long, Alex Koyfman, Eric J Chin
INTRODUCTION: Acute heart failure (AHF) accounts for a significant number of emergency department (ED) visits, and the disease may present along a spectrum with a variety of syndromes. OBJECTIVE: This review evaluates several misconceptions concerning heart failure evaluation and management in the ED, followed by several pearls. DISCUSSION: AHF is a heterogeneous syndrome with a variety of presentations. Physicians often rely on natriuretic peptides, but the evidence behind their use is controversial, and these should not be used in isolation...
June 1, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29885735/grow-the-pie-interdepartmental-cooperation-as-a-method-for-achieving-operational-efficiency-in-an-emergency-department
#10
Jesse A Guittard, Gabe Wardi, Edward M Castillo, Blake J Stock, Shannon Heuberger, Christian A Tomaszewski
BACKGROUND: Despite sufficient literature analyzing macroscopic and microscopic methods of addressing emergency department (ED) operations, there is a paucity of studies that analyze methods between these extremes. OBJECTIVE: We conducted a quasi-experimental study incorporating a pre/post-intervention comparison to determine whether interdepartmental cooperation is effective at improving ED operations by combining microscopic and macroscopic concepts. METHODS: We performed an analysis of operational and financial data from a cooperative investment in imaging transport personnel between the emergency and radiology departments...
June 6, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29884096/discriminative-value-of-ca-125-he4-risk-of-malignancy-index-ii-rmi-ii-and-risk-of-malignancy-algorithm-roma-in-the-differential-diagnosis-of-pelvic-masses-conclusions-from-a-referral-centre-in-portugal
#11
Ângela Melo, Renata Veríssimo, Margarida Farinha, Nuno Nogueira Martins, Francisco Nogueira Martins
The major purpose of this article was to compare the discriminative value of different algorithms and serum biomarkers in the differential diagnosis of adnexal masses. We performed a retrospective study with 247 women with adnexal neoplasia, submitted to surgical treatment and with a histological diagnosis. The evaluation of the area under the curve (AUC) for isolated CA-125 and HE4, and for ROMA and RMI-II, showed a better specificity of HE4 and RMI-II in premenopausal women. In the postmenopausal group, ROMA and RMI-II were the algorithms with a better performance...
June 8, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29880545/prospective-observational-study-of-point-of-care-ultrasound-for-diagnosing-pneumonia
#12
Claire Lissaman, Panida Kanjanauptom, Cyril Ong, Mark Tessaro, Elliot Long, Adam O'Brien
OBJECTIVES: The clinical diagnosis of pneumonia lacks specificity and may lead to antibiotic overuse, whereas radiological diagnoses can lack sensitivity. Point-of-care lung ultrasound is an emerging diagnostic tool. There are limited prospective data, however, on the accuracy of sonologists in the paediatric emergency department setting. We aimed to test the diagnostic accuracy of lung ultrasound for pneumonia using chest radiograph (CR) as the reference standard. METHODS: This prospective observational cohort study in a paediatric emergency department enrolled children aged 1 month to <18 years, who had a CR ordered for possible pneumonia...
June 7, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29877908/evaluation-of-ventricle-size-measurements-in-infants-by-pediatric-emergency-medicine-physicians
#13
Brunhild M Halm, Tina A Leone, Lindsey T Chaudoin, Kenneth W McKinley, Carrie Ruzal-Shapiro, Adrian A Franke, Daniel S Tsze
OBJECTIVES: The identification of hydrocephalus in infants by pediatric emergency medicine (PEM) physicians using cranial point-of-care ultrasound (POCUS) has not been evaluated. We aimed to conduct a pilot/proof-of-concept study to evaluate whether PEM physicians can identify hydrocephalus (anterior horn width >5 mm) in 15 infants (mean 69 ± 42 days old) from the neonatal intensive care unit using POCUS. Our exploratory aims were to determine the test characteristics of cranial POCUS performed by PEM physicians for diagnosing hydrocephalus and the interrater reliability between measurements made by the PEM physicians and the radiologist...
June 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29876711/ultrasound-features-of-purulent-skin-and-soft-tissue-infection-without-abscess
#14
Courtney E Nelson, Aaron E Chen, Richard D Bellah, David M Biko, Victor M Ho-Fung, Michael L Francavilla, Rui Xiao, Summer L Kaplan
PURPOSE: Ultrasound (US) aids clinical management of skin and soft tissue infection (SSTI) by differentiating non-purulent cellulitis from abscess. However, purulent SSTI may be present without abscess. Guidelines recommend incision and drainage (I & D) for purulent SSTI, but US descriptions of purulent SSTI without abscess are lacking. METHODS: We retrospectively reviewed pediatric emergency department patients with US of the buttock read as negative for abscess...
June 6, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29876127/incidence-of-deep-venous-thrombosis-following-periacetabular-and-derotational-femoral-osteotomy-a-case-for-mechanical-prophylaxis
#15
Matthew J Kraeutler, Sivashanmugam Raju, Tigran Garabekyan, Omer Mei-Dan
There are currently no established guidelines for appropriate antithrombotic prophylaxis following periacetabular osteotomy (PAO) or derotational femoral osteotomy (DFO). The purpose of this study was to determine the incidence of clinical deep venous thrombosis (DVT) following PAO and/or DFO wherein a portable, mechanical device and low-dose aspirin were used postoperatively for DVT prophylaxis. Patients who had undergone staged hip arthroscopy and primary PAO and/or DFO were prospectively reviewed. Following PAO/DFO, patients were prophylactically treated for thromboembolic disease with a portable, mechanical compression device for 3 weeks and low-dose aspirin for 4 weeks...
July 2018: Journal of Hip Preservation Surgery
https://www.readbyqxmd.com/read/29875957/-strangulated-inguinal-hernia-complicated-by-testicular-ischemia-due-to-permeability-of-peritoneo-vaginal-canal
#16
Nfally Badji, Chaouch Abdesslem, Niang El Hadji
Inguinal hernia is frequent in children. Strangulated hernia is the main complication of this disease and it is a diagnostic and therapeutic emergency. Imaging techniques, in particular Ultrasound, play a key role in case of diagnostic doubt, especially when the hernia occurs in a context of oscillating testicles because this may mimic a torsion of the spermatic cord. Ultrasound should be used in patients with strangulated hernia associated with oscillating testicles in order to eliminate testicular ischemia...
2018: Pan African Medical Journal
https://www.readbyqxmd.com/read/29872354/ultrasound-guided-central-venous-catheter-placement-in-the-emergency-department-experience-in-a-hospital-in-bogot%C3%A3-colombia
#17
German Devia Jaramillo, Jenny Torres Castillo, Freddy Lozano, Angélica Ramírez
Introduction: The use of central venous catheters (CVCs) in the emergency room (ER) is a valuable tool for the comprehensive management of critically ill patients; however, the positioning of these devices is not free of complications. Currently, the use of ultrasound is considered a useful and safe tool to carry out these procedures, but in Colombia, the number of emergency departments providing this tool is scarce and there is no literature describing the experience in our country. Objective: The objective of this study was to describe the experience regarding placement of ultrasound-guided CVCs by emergency physicians in an institution in Bogotá, as well as the associated complications...
2018: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29870467/mr-guided-sclerotherapy-for-the-treatment-of-low-flow-vascular-malformations
#18
Won Kyu Choi, Christopher R Bailey, Jan Fritz, Clifford R Weiss
Low-flow vascular malformations are congenital lesions that can occur throughout the body. Treatment of these lesions is indicated to ameliorate pain, cosmetic disfigurement, and functional impairment. The first-line treatment of low-flow vascular malformations is percutaneous sclerotherapy. Traditionally, sclerotherapy is performed with a combination of ultrasound and fluoroscopy. However, malformations that are deep in the abdomen and pelvis or are obscured by overlying fascia or scar may be difficult to be visualized with ultrasound and fluoroscopy...
June 2018: Topics in Magnetic Resonance Imaging: TMRI
https://www.readbyqxmd.com/read/29866441/bilateral-single-shot-erector-spinae-plane-block-for-pectus-excavatum-and-pectus-carinatum-surgery-in-2-pediatric-patients
#19
M A Nardiello, M Herlitz
Numerous publications have emerged on the application of erector spinae plane block in adult population. There are few reports of the use of this block in pediatric patients. The objective is to report 2 cases of adolescents, one diagnosed with pectus excavatum and the other one with pectus carinatum undergoing reconstructive surgery in which a bilateral single-shot erector spinae plane block was performed as an analgesic technique. The block was performed before surgery under general anesthesia in lateral decubitus position, guided by ultrasound using 20ml of 0...
June 1, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29866410/follow-up-imaging-after-acute-evaluations-for-pediatric-nephrolithiasis-trends-from-a-national-database
#20
Jonathan S Ellison, Paul A Merguerian, Benjamin C Fu, Sarah K Holt, Thomas S Lendvay, John L Gore, Margarett Shnorhavorian
BACKGROUND: Overuse of computed tomography (CT) in the initial evaluation of children with upper urinary tract calculi (UUTC) has been well documented. Follow-up imaging patterns, however, remain undefined. Sequential imaging following an acute episode of UUTC represents additional opportunity for enacting good imaging stewardship, with the optimal goal to reduce unnecessary radiation exposure and cost while ensuring appropriate follow-up. OBJECTIVE: We explored nationwide imaging patterns for children following emergency department (ED) evaluations for UUTC, hypothesizing that initial imaging choice and complicated visits for UUTC increase the risk of follow-up CT scans...
May 24, 2018: Journal of Pediatric Urology
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