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https://www.readbyqxmd.com/read/29914554/prehospital-point-of-care-emergency-ultrasound-a-cohort-study
#1
Maximilian Scharonow, Christian Weilbach
BACKGROUND: In the prehospital situation, the diagnostic armamentarium available to the rescue physician is limited. Emergency ultrasound has proven to be a useful diagnostic tool, providing crucial information for the management of critically ill and injured patients. The proportion of performed ultrasound scans in all patients attended to by the rescue service team, the quality of the findings and the ultrasound-related changes in management approach and patient transport were evaluated...
June 18, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29883008/transorbital-sonography-for-early-prognostication-of-hypoxic-ischemic-encephalopathy-after-cardiac-arrest
#2
Michael Ertl, Sarah Weber, Gertrud Hammel, Christoph Schroeder, Christos Krogias
BACKGROUND AND PURPOSE: Early prognostication of the outcome in resuscitated post cardiac arrest (CA) patients remains challenging especially if treated with therapeutic hypothermia. Brain edema caused by hypoxic-ischemic encephalopathy (HIE) can indirectly be estimated by transorbital sonography (TOS) taking in account the optic nerve sheath diameter (ONSD). The prognostic value of this easy, safe, and reproducible technique was investigated in this study. METHODS: A total of 49 patients, initially unconscious (Glasgow Coma Scale ≤6) after successful resuscitation, were enrolled into this prospective observational study...
June 8, 2018: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/29740831/do-emergency-physicians-rely-on-point-of-care-ultrasound-for-clinical-decision-making-without-additional-confirmatory-testing
#3
Mohamad Moussa, Julie M Stausmire
PURPOSE: It is unknown if Emergency Physicians (EPs) rely solely on Emergency Medicine performed Point-Of-Care Ultrasound (EM-POCUS) for clinical decision making or if they proceed to subsequent "gold standard" studies for confirmatory diagnosis. METHODS: After Institutional Review Board approval, an online survey was distributed by the Ohio Chapter of the American College of Emergency Physicians to its members. RESULTS: The most common EM-POCUS procedures used without confirmatory testing were: determination of cardiac activity during cardiac arrest (81...
May 8, 2018: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29688110/a-mixed-methods-evaluation-of-a-multidisciplinary-point-of-care-ultrasound-program
#4
Andrew Smith, Michael Parsons, Tia Renouf, Sarah Boyd, Peter Rogers
BACKGROUND: Point of Care Ultrasound (PoCUS) is well established within emergency medicine, however, the availability of formal training for other clinical disciplines is limited. Memorial University has established a cost-efficient, multidisciplinary PoCUS training program focusing on training residents' discipline-specific ultrasound skills. This study evaluates the skills, knowledge, and attitudes of residents who participated in the program. METHODS: Analysis was conducted using a mixed-methods, sequential exploratory approach...
April 24, 2018: Medical Teacher
https://www.readbyqxmd.com/read/29644294/isolated-right-atrial-appendage-rupture-following-blunt-chest-trauma
#5
Rakesh Hegde, Nathan Lafayette, Michael Sywak, Gregory Ricketts, Jorge Otero, Scott Kurtzman, Zhongqiu Zhang
Background: Right sided tears or rupture are the most common injury to the heart after blunt chest trauma. The majority of these injuries are to the thin walled atrium. Reports of localized right atrial appendage rupture are rare. The classical features of Beck's triad are unreliable in the trauma bay. With the advent of EFAST (Focused assessment with sonography for trauma extended to thorax), Beck's triad should be considered but not used as the primary clinical tool for diagnosis of cardiac tamponade [1]...
February 2018: Trauma Case Reports
https://www.readbyqxmd.com/read/29644270/importance-of-the-capability-for-complete-resuscitative-treatment-combining-surgery-and-interventional-radiology-for-potentially-lethal-multiple-injuries-a-case-report
#6
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
Background: Recently, trauma management has been complicated owing to the introduction of damage-control strategies and interventional radiology. Here, we discuss important aspects regarding survival of patients with severe trauma. Case presentation: A 74-year-old Japanese woman experienced a traffic accident on a highway. On arrival, paramedics were unable to measure her blood pressure, and her condition deteriorated. The patient was immediately transferred to our hospital in a physician-staffed emergency helicopter, during which she was administered emergency blood transfusions...
October 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29627929/first-cardiac-manifestation-of-hypotonia-cystinuria-syndrome
#7
Mustafa Kılıç, Ahmet Cevdet Ceylan, Utku Arman Örün, Esra Kılıç
Hypotonia-cystinuria syndrome is a very rare autosomal recessive contiguous gene deletion syndrome of PREPL and SLC3A1 at 2p21 with neuromuscular and neuroendocrinologic presentation. We report a two-year-six-month-old affected female infant and her five-month-old affected brother with a novel homozygous deletion in SLC3A1 and PREPL gene. Both of siblings had mild facial dysmorphism, hypotonia, feeding problems, failure to thrive, developmental delay. She also had dilated cardiomyopathy which differ from other reported patients...
April 7, 2018: Metabolic Brain Disease
https://www.readbyqxmd.com/read/29485961/cerebral-function-and-perfusion-during-cardiopulmonary-bypass-a-plea-for-a-multimodal-monitoring-approach
#8
Marcus Thudium, Ingo Heinze, Richard K Ellerkmann, Tobias Hilbert
BACKGROUND: Postoperative neurological injury still represents a major cause of morbidity after cardiac surgery. Our objective was to compare the limits as well as advantages of routine monitoring tools for the detection of cerebral function and perfusion deficits during cardiopulmonary bypass in a daily clinical setting. METHODS: Adult patients undergoing elective cardiac surgery with use of cardiopulmonary bypass were included. Patients received monitoring comprising Bispectral Index (BIS), Near Infrared Spectroscopy (NIRS) and assessment of middle cerebral artery flow velocity (MCAV) using transcranial Doppler (TCD) sonography...
January 31, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29234808/effect-of-levothyroxine-on-miscarriage-among-women-with-normal-thyroid-function-and-thyroid-autoimmunity-undergoing-in-vitro-fertilization-and-embryo-transfer-a-randomized-clinical-trial
#9
RANDOMIZED CONTROLLED TRIAL
Haining Wang, Hongwei Gao, Hongbin Chi, Lin Zeng, Wenhua Xiao, Yanrong Wang, Rong Li, Ping Liu, Chen Wang, Qing Tian, Zehong Zhou, Jin Yang, Ye Liu, Rui Wei, Ben Willem J Mol, Tianpei Hong, Jie Qiao
Importance: Presence of thyroid autoantibodies in women with normal thyroid function is associated with increased risk of miscarriage. Whether levothyroxine treatment improves pregnancy outcomes among women undergoing in vitro fertilization and embryo transfer (IVF-ET) is unknown. Objective: To determine the effect of levothyroxine on miscarriage among women undergoing IVF-ET who had normal thyroid function and tested positive for thyroid autoantibodies. Design, Setting, and Participants: An open-label, randomized clinical trial involving 600 women who tested positive for the antithyroperoxidase antibody and were being treated for infertility at Peking University Third Hospital from September 2012 to March 2017...
December 12, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29207924/speckle-tracking-in-transcranial-ultrasound-allows-noninvasive-analysis-of-pulsation-patterns-of-the-third-ventricle
#10
Benjamin Würzer, Cristina Laza, Jörn Pons-Kühnemann, Manfred Kaps, Bernd Junge, Florian C Roessler
Cerebrospinal fluid (CSF) flow is sensitive to many cerebral disorders. We aimed to develop a noninvasive bedside method to detect physiological and pathological CSF phenomena by measuring pulsation patterns of the third ventricle. By transcranial B-mode ultrasound, electrocardiography (ECG)-gated video loops of the third ventricle were acquired. "Speckle tracking" software was used to quantify the relative change of its width. We conducted measurements of nine cardiac cycles in 11 healthy subjects in sitting and in supine position during Valsalva maneuver to investigate the influence of an increased intracranial pressure on the relative deformation of the third ventricle...
March 2018: Ultrasonic Imaging
https://www.readbyqxmd.com/read/29207432/-sonography-of-the-optic-nerve-a-new-bedside-tool-in-intensive-care
#11
Christopher Hohmann, Konrad R Koch, Roman Pfister, Guido Michels
History and clinical findings  Here, we present the case history of a 76-year old man with out-of-hospital cardiac arrest due to a cardiogenic shock and a consecutive no-flow-time of approximately 10 minutes. After 25 minutes of resuscitation procedures a spontaneous return of circulation could be established. The patient was admitted to our center for emergency coronary angiography. After coronary stenting the patient was admitted to our intensive care unit and treated in accordance with the guidelines on cardiogenic shock due to myocardial infarction...
December 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29164683/is-hypertension-the-fate-of-aortic-coarctation-patients-treated-with-cheatham-platinum-cp-stent
#12
Ali Baykan, Ayse G Demiraldi, Onur Tasci, Ozge Pamukcu, Suleyman Sunkak, Kazım Uzum, Sadettin Sezer, Nazmi Narin
AIM: The aim of this study is to address the presence of hypertension and risk for cardiovascular diseases in patients with Coarctation of the Aorta (CoA) who were treated with endovascular stent placement. METHODS: Twenty patients (mean age: 14.2 ± 3.9 years) who were treated with stent and 20 age- and sex-matched controls were included to the study. Structure and functions of left ventricle were assessed by echocardiography. Carotid intima media (CIM) thickness was measured by using sonography as a marker for detecting cardiovascular risk...
April 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29115044/a-leg-ulcer-with-pulsating-varicose-veins-from-the-legs-to-the-heart
#13
Sabrina Johanna Swoboda, Hauke Schumann, Dimitra Kiritsi
We present the case of a 58-year-old man who presented to our wound care centre with a 7 -month history of a progressive unilateral leg ulcer. He reported intermittent, heavy bleeding at the ulcer. The duplex sonography showed a bilateral incompetence of the saphenofemoral junctions and the entire course of the great saphenous veins and, surprisingly, also a bilateral reversed arterial-like pulsating flow in the great and small saphenous veins as well as in the deep veins of the lower extremities. During cardiac examination by auscultation and echocardiography, we detected a previously undescribed severe tricuspid insufficiency with strongly reduced systolic ejection of both the left and the right ventricle and repercussions on the peripheral venous system as a cause for the pulsating veins...
February 2018: International Wound Journal
https://www.readbyqxmd.com/read/29046071/clinical-significance-of-the-serotonin-release-assay-and-platelet-count-monitoring-after-cardiac-surgery
#14
Shinya Motohashi, Takefumi Matsuo, Hidenori Inoue, Makoto Kaneko, Shunya Shindo
Heparin-induced thrombocytopenia (HIT) is one of the serious complications in patients who undergo cardiac surgery. However, there remains a major problem in diagnosing HIT because the current immunological assays for detection of HIT antibody have limitations. Furthermore, the clinical course of thrombocytopenia in this surgery makes it increasingly difficult to diagnose HIT. We investigated the relationship between platelet count and HIT antibody in 59 patients who underwent cardiac surgery using cardiopulmonary bypass (CPB)...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29033272/graduating-surgical-residents-lack-competence-in-critical-care-ultrasound
#15
Renuka Tripu, Margaret H Lauerman, Daniel Haase, Syeda Fatima, Jacob Glaser, Cassandra Cardarelli, Thomas M Scalea, Sarah Murthi
OBJECTIVE: Ultrasound provides accessible imaging for bedside diagnostics and procedural guidance, but may lead to misdiagnosis in untrained users. The main objective of this study was to determine observed and self-perceived competence with critical care ultrasound in graduated general surgery residents. DESIGN: The design of this study was a retrospective review. Ultrasound training program records were reviewed for number of prior ultrasound examinations performed, self-perceived competence, observed competence on faculty examinations, and intended future use of individual critical care ultrasound examinations...
October 13, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29024133/plasma-natriuretic-peptide-levels-in-fetuses-with-congenital-heart-defect-and-arrhythmia-a-single-center-prospective-study
#16
Takekazu Miyoshi, Takashi Umekawa, Hiroshi Hosoda, Takashi Asada, Akihiro Fujiwara, Ken-Ichi Kurosaki, Isao Shiraishi, Michikazu Nakai, Kunihiro Nishimura, Mikiya Miyazato, Kenji Kangawa, Tomoaki Ikeda, Jun Yoshimatsu, Naoto Minamino
OBJECTIVES: Diagnosing fetal heart failure remains challenging because it is difficult to know how well the fetal myocardium will perform as loading conditions change. In adult cardiology, natriuretic peptides (NPs) are established marker of heart failure. However, the number of studies investigating NP levels in fetuses is quite limited. The aim of this study was to evaluate the significance of plasma NP levels in the assessment of heart failure in fetuses with congenital heart defect (CHD) and arrhythmia...
October 11, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28928674/the-gly-16-allele-of-the-g16r-single-nucleotide-polymorphism-in-the-%C3%AE-2-adrenergic-receptor-gene-augments-the-glycemic-response-to-adrenaline-in-humans
#17
Kim Z Rokamp, Jonatan M Staalsø, Morten Zaar, Peter Rasmussen, Lonnie G Petersen, Rikke V Nielsen, Niels H Secher, Niels V Olsen, Henning B Nielsen
Cerebral non-oxidative carbohydrate consumption may be driven by a β2-adrenergic mechanism. This study tested whether the 46G > A (G16R) single nucleotide polymorphism of the β2-adrenergic receptor gene (ADRB2) influences the metabolic and cerebrovascular responses to administration of adrenaline. Forty healthy Caucasian men were included from a group of genotyped individuals. Cardio- and cerebrovascular variables at baseline and during a 60-min adrenaline infusion (0.06 μg kg(-1) min(-1)) were measured by Model flow, near-infrared spectroscopy and transcranial Doppler sonography...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28846541/a-randomised-comparison-of-incidence-of-radial-artery-occlusion-and-symptomatic-radial-artery-spasm-associated-with-elective-transradial-coronary-intervention-using-6-5-fr-sheathless-eaucath-guiding-catheter-vs-6-0-fr-glidesheath-slender
#18
Kazunori Horie, Norio Tada, Tsuyoshi Isawa, Takashi Matsumoto, Masataka Taguri, Shigeaki Kato, Taku Honda, Tatsushi Ootomo, Naoto Inoue
AIMS: The aim of this study was to compare incidences of radial artery occlusion (RAO) and spasm (RAS) associated with transradial coronary intervention (TRI) using a 6.5 Fr SheathLess hydrophilic-coated guide catheter (SH-GC) vs. a 6.0 Fr Glidesheath Slender (GSS). METHODS AND RESULTS: We conducted an open-label, single-centre, randomised study to compare radial complications in 600 consecutive patients undergoing elective TRI using 6.5 Fr SH-GC (n=300) or 6.0 Fr GSS (n=300) between 2015 and 2016...
April 20, 2018: EuroIntervention
https://www.readbyqxmd.com/read/28806284/is-extracorporeal-cardiopulmonary-resuscitation-practical-in-severe-chest-trauma-a-systematic-review-in-single-center-of-developing-country
#19
Up Huh, Seunghwan Song, Sung Woon Chung, Sang-Pil Kim, Chung Won Lee, Hyo Young Ahn, Miju Bae, Seon Hee Kim
BACKGROUND: We report our experience with extracorporeal cardiopulmonary resuscitation (ECPR) in patients with rupture of heart and major vessels caused by severe chest trauma. METHODS: From April 2015 to May 2016, 10 patients with suspected injuries to the heart and major vessels after focused assessment with sonography in trauma or computed tomography were selected from patients admitted at a Level I trauma center presenting with cardiac tamponade and tension hemothorax due to severe chest trauma...
November 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28738837/assessment-of-cerebral-circulation-in-a-porcine-model-of-intravenously-given-e-coli-induced-fulminant-sepsis
#20
Levente Molnár, Norbert Németh, Mariann Berhés, Endre Hajdú, Lóránd Papp, Ábel Molnár, Judit Szabó, Ádám Deák, Béla Fülesdi
BACKGROUND: The aim of the present work was to assess cerebral hemodynamic changes in a porcine model of E.coli induced fulminant sepsis. METHODS: Nineteen healthy female Hungahib pigs, 10-12 weeks old, randomly assigned into two groups: Control (n = 9) or Septic Group (n = 10). In the Sepsis group Escherichia coli culture suspended in physiological saline was intravenously administrated in a continuously increasing manner according to the following protocol: 2 ml of bacterial culture suspended in physiological saline was injected in the first 30 min, then 4 ml of bacterial culture was administered within 30 min, followed by infusion of 32 ml bacterial culture for 2 h...
July 24, 2017: BMC Anesthesiology
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