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https://www.readbyqxmd.com/read/28808369/ultrasound-guidance-for-central-venous-catheterization-a-step-further-to-prevent-malposition-of-central-venous-catheter-before-radiographic-confirmation
#1
Devinder Midha, Vipal Chawla, Arun Kumar, Amit Kumar Mandal
Ultrasound (USG) guidance has long been used for guiding central venous catheterization. USG provides direct visualization of needle puncture through the skin into the vein. Most of the time USG guidance is just limited to puncturing of the vein and seeing guidewire entering the vein while malpositioning of catheter occurs after that which is seen later on while checking chest radiograph. Repositioning of catheter after that becomes not only difficult requiring repeated chest radiograph to reconfirm position of catheter but also increases chances of infection with repeated manipulations...
July 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28803375/lung-ultrasound-in-internal-medicine-efficiently-drives-the-management-of-patients-with-heart-failure-and-speeds-up-the-discharge-time
#2
Chiara Mozzini, Marco Di Dio Perna, Giancarlo Pesce, Ulisse Garbin, Anna Maria Fratta Pasini, Andrea Ticinesi, Antonio Nouvenne, Tiziana Meschi, Alder Casadei, Maurizio Soresi, Luciano Cominacini
Lung ultrasound (LUS) is a valid tool for the assessment of heart failure (HF) through the quantification of the B-lines. This study in HF patients aims to evaluate if LUS: (1) can accelerate the discharge time; (2) can efficiently drive diuretic therapy dosage; and (3) may have better performance compared to the amino-terminal portion of B type natriuretic peptide (NT-proBNP) levels in monitoring HF recovery. A consecutive sample of 120 HF patients was admitted from the Emergency Department (ED) to the Internal Medicine Department (Verona University Hospital)...
August 12, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28801331/autoimmune-gastrointestinal-dysmotility-due-to-small-cell-lung-cancer
#3
Anna Maria Lipowska, Dejan Micic, Allison Cavallo, Edwin McDonald
The diagnosis of autoimmune gastrointestinal dysmotility requires a high level of clinical suspicion when standard work-up is unrevealing. We report the case of a 56-year-old male patient with history of tobacco use and a subacute presentation of weight loss, vomiting and cerebellar ataxia. The discovery of paraneoplastic type 1 antineuronal nuclear antibodies and neuronal acetylcholine receptor antibodies led to further directed imaging and diagnostic studies in spite of prior negative chest imaging. Bronchoscopy with endobronchial ultrasound was used to confirm a diagnosis of small cell lung cancer and paraneoplastic syndrome as the cause of the presenting upper gastrointestinal symptoms...
August 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28797399/a-54-year-old-man-with-anasarca-dyspnea-and-recurrent-bilateral-pleural-effusions
#4
Pradnya D Patil, Yvette M Cua, Carol Farver, Rafael L Perez, Atul C Mehta, Tanmay S Panchabhai
A 54-year-old African-American man presented with 2 years of progressively worsening dyspnea and anasarca. Over the past 6 months he gained 30 lbs with worsening lower extremity, abdominal wall, and scrotal edema. A recent workup for cardiac, renal, and liver disease, including two-dimensional echocardiogram, liver and renal function tests, and abdominal ultrasound, was unremarkable. He reported a 15-pack year history of smoking and quit 3 years ago. Chest radiograph at that time revealed bilateral pleural effusions that were both reportedly milky in appearance when drained by thoracenteses...
August 2017: Chest
https://www.readbyqxmd.com/read/28794870/cost-and-morbidity-analysis-of-chest-port-insertion-in-adults-outpatient-clinic-versus-operating-room-placement
#5
Claudio F Feo, Giorgio C Ginesu, Alessandro Bellini, Giuseppe Cherchi, Antonio M Scanu, Maria Laura Cossu, Alessandro Fancellu, Alberto Porcu
BACKGROUND: Totally implantable venous access devices (TIVADs) represent a convenient way for the administration of medications or nutrients. Traditionally, chest ports have been positioned by surgeons in the operating room, however there has been a transition over the years to port insertion by interventional radiologists in the radiology suite. The optimal method for chest port placement is still under debate. MATERIALS AND METHODS: Data on all adult patients undergoing isolated chest port placement at our institution in a 12-year period were retrospectively reviewed...
September 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28793969/lung-ultrasound-in-internal-medicine-a-bedside-help-to-increase-accuracy-in-the-diagnosis-of-dyspnea
#6
Tiziano Perrone, Alessia Maggi, Carmelo Sgarlata, Ilaria Palumbo, Elisa Mossolani, Sara Ferrari, Ariel Melloul, Roberta Mussinelli, Michele Boldrini, Ambra Raimondi, Aderville Cabassi, Francesco Salinaro, Stefano Perlini
BACKGROUND: Dyspnea is one of the most frequent causes of admission in Internal Medicine wards, leading to a sizeable utilization of medical resources. STUDY DESIGN AND METHODS: The role of bedside lung ultrasound (LUS) was evaluated in 130 consecutive patients (age: 81±9years), in whom blindly collected LUS results were compared with data obtained by clinical examination, medical history, blood analysis, and chest X-ray. Dyspnea etiology was classified as "cardiac" (n=80), "respiratory" (n=36) or "mixed" (n=14), according to the discharge diagnosis (congestive heart failure either alone [n=80] or associated with pneumonia [n=14], pneumonia [n=24], and obstructive disventilatory syndrome [n=12])...
August 6, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28780835/-prognostic-value-of-modified-lung-ultrasound-aeration-loss-score-in-shock-patient-in-intensive-care-unit
#7
T J Zou, M G Yin, Y Qin, Y Li, X Y Zeng, Y Kang
Objective: To investigate the prognostic value of modified lung ultrasound aeration loss score(mLUS) in shock patients in intensive care unit(ICU). Methods: This was a prospective study.Shock patients who were admitted to ICU from April 2016 to August 2016 were eligible; 90 consecutive shock patients were enrolled.Chest ultrasound examination were done within the first 6 hours after included. The mLUS and other ultrasound variables were recorded as well as the clinical data and the outcome. Data has been analyzed, and a bivariate logistic regression model was established to identify the correlation between mLUS on admission and the ICU mortality...
August 1, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28780235/dilated-right-coronary-sinus-identified-on-point-of-care-ultrasound
#8
Damali Nakitende, Michael Gottlieb
Point-of-care cardiac ultrasound (POCUS) is a common application in Emergency Medicine. Here we present a case of an incidentally discovered dilated right coronary sinus on ultrasound. This case involved a 55-year-old female who presented with chest pain, shortness of breath, and lightheadedness. Her initial presentation was concerning for congestive heart failure (CHF) exacerbation. A bedside ultrasound was performed to assess cardiac function, where a dilated right coronary sinus was discovered. The right coronary sinus is the vein that serves as the venous return for the coronary system...
July 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28777479/an-interposed-pad-in-open-chest-echocardiographic-porcine-scans-for-mimicking-ultrasound-signal-attenuation-in-a-human-chest
#9
Randall R Kinnick, Minako Katayama, Marek Belohlavek
Opening a chest in an experimental echocardiographic animal study eliminates ultrasound signal attenuation by the chest wall. We developed a scanning technique that involves the use of an attenuative pad created from a mixture of urethane and titanium dioxide. The pad was interposed within transmission gel between the transducer face and cardiac surface in open-chest scans in a porcine model. Comparative measurements of left ventricular echogenicity without and with the pad demonstrate that the pad reproducibly causes ultrasound signal attenuation that closely mimics chest attenuation in clinical transthoracic echocardiographic studies...
August 4, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28767771/parapneumonic-pleural-effusion-early-versus-late-thoracoscopy
#10
Rodrigo Romualdo Pereira, Cristina Gonçalves Alvim, Cláudia Ribeiro de Andrade, Cássio da Cunha Ibiapina
Objective: To evaluate the best time to perform thoracoscopy for the treatment of complicated parapneumonic pleural effusion in the fibrinopurulent phase in patients ≤ 14 years of age, regarding the postoperative evolution and occurrence of complications. Methods: This was a retrospective comparative study involving patients with parapneumonic pleural effusion presenting with septations or loculations on chest ultrasound who underwent thoracoscopy between January of 2000 and January of 2013...
July 31, 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28765490/incidental-finding-of-persistent-left-superior-vena-cava-after-bubble-study-verification-of-central-venous-catheter
#11
Miguel Agustin Pardinas Gutierrez, Luis A Escobar, Vanessa Blumer, Jorge Luis Cabrera
We report a case of a patient with septic shock who underwent central venous catheter placement in the left internal jugular vein, and a bedside ultrasound 'bubble study' revealed venous cannulation. A chest X-ray postprocedure revealed concern for arterial system catheterisation. However, the possibility of a persistent left superior vena cava was discussed and confirmed with a formal transthoracic echocardiogram and CT. This case demonstrates the importance of ultrasound-guided visualisation of anatomical structures in real time during central venous catheterisation...
July 31, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28763628/the-value-of-18f-fdg-pet-ct-imaging-in-breast-cancer-staging
#12
Ulkem Yararbas, Neslihan Çetin, Levent Yeniay, Aziz Murat Argon
The National Comprehensive Cancer Network (NCCN) guidelines recommend assessment with positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro- D-glucose integrated with computed tomography (18F-FDG PET/CT) in staging of breast cancer, starting from the stage IIIA. Previously, PET/CT contributed to the accurate staging from the stage IIB. Our aim is to evaluate the contribution of 18F-FDG PET/CT in staging of breast cancer patients. A total of 234 patients were retrospectively evaluated. PET/CT was performed preoperatively in 114/234 and postoperatively in 120/234 patients...
August 1, 2017: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/28757299/the-incidence-of-subclinical-forms-of-urogenital-tuberculosis-in-patients-with-pulmonary-tuberculosis
#13
Roman Zachoval, Petr Nencka, Martina Vasakova, Emilie Kopecka, Vladimir Borovička, Jiri Wallenfels, Pavel Cermak
The aim of our study was to determine whether patients with pulmonary tuberculosis may have subclinical forms of urogenital tuberculosis. Between 2011 and 2012, a prospective study was conducted. Basic demographic parameters were recorded and the following investigations were performed: direct bacilloscopy of sputum, evaluation of affected lung fields and presence of cavities on chest X-ray, Mantoux tuberculin skin test II, and interferon gamma release assay. Culture and molecular methods for Mycobacterium tuberculosis in urine were performed...
July 27, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28756339/whole-body-mri-for-systemic-staging-of-breast-cancer-in-pregnant-women
#14
Fedro A Peccatori, Giovanni Codacci-Pisanelli, Maria Del Grande, Giovanna Scarfone, Fabio Zugni, Giuseppe Petralia
When breast cancer is diagnosed during pregnancy, treatment should be as close; as possible to what is used in non-pregnant patients. This requires accurate local and systemic staging: ultrasound (US) is used for local staging and allows adequate evaluation of the liver and pelvis, but chest and bones cannot be explored and imaging techniques involving exposure to ionizing radiation would be needed. However, since imaging techniques involving ionizing radiation and the use of radionuclides should be limited, whole body magnetic resonance imaging (WB-MRI) without administration of contrast agent represents a very interesting alternative, but limited data is available...
July 27, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28754527/ultrasound-use-during-cardiopulmonary-resuscitation-is-associated-with-delays-in-chest-compressions
#15
Maite A Huis In 't Veld, Michael G Allison, David S Bostick, Kiondra R Fisher, Olga G Goloubeva, Michael D Witting, Michael E Winters
AIM: High-quality chest compressions are a critical component of the resuscitation of patients in cardiopulmonary arrest. Point-of-care ultrasound (POCUS) is used frequently during emergency department (ED) resuscitations, but there has been limited research assessing its benefits and harms during the delivery of cardiopulmonary resuscitation (CPR). We hypothesized that use of POCUS during cardiac arrest resuscitation adversely affects high-quality CPR by lengthening the duration of pulse checks beyond the current cardiopulmonary resuscitation guidelines recommendation of 10s...
July 25, 2017: Resuscitation
https://www.readbyqxmd.com/read/28752731/cardiac-imaging-in-patients-with-dyspnea
#16
Pierfranco Dellavesa, Federico Nardi
Acute dyspnea is a frequent cause of access to the Discharge Department (DEA); Differentiation between cardiogenic and respiratory causes does not always seem simple and certain, causing a delay in initiating targeted therapies and prolonging the Patient's stay in the emergency department. The basic elements for the diagnosis remain the history and the objective examination, supplemented by the execution of an electrocardiogram, a determination of blood parameters and the execution of a chest X-ray. The limits of radiological semeiotics, related to a low sensitivity to high specificity, promote other methods available to the physician of First Aid...
July 27, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28749359/systolic-time-interval-estimation-using-continuous-wave-radar-with-on-body-antennas
#17
Dilpreet Buxi, Evelien Hermeling, Marco Mercuri, Fabian Beutel, Roberto Garcia van der Westen, Tom Torfs, Jean-Michel Redoute, Mehmet Rasit Yuce
The estimation of systolic time interval (STI)s is done using continuous wave (CW) radar at 2.45GHz with an on-body antenna. MOTIVATION: In the state of the art, typically bioimpedance, heart sounds and / or ultrasound is used to measure STIs. All three methods suffer from insufficient accuracy of STI estimation due to various reasons. CW radar is investigated for its ability to overcome the deficiencies in the state of the art. METHODS: Ten healthy male subjects aged 25-45 were asked to lie down at a 30 degree incline...
July 25, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28747379/advances-in-the-diagnosis-of-pneumonia-in-children
#18
REVIEW
Heather J Zar, Savvas Andronikou, Mark P Nicol
Pneumonia remains a major cause of childhood mortality and morbidity globally. Accurate diagnosis and attribution of the causes of pneumonia are important for measuring the burden of disease, implementing appropriate preventive or treatment strategies, and developing more effective interventions. This review summarizes recent diagnostic advances in radiological techniques, specimen collection, and laboratory methods. Although chest ultrasound and chest magnetic resonance imaging are promising modalities for radiological diagnosis, their role in clinical management and their impact on outcomes need further study...
July 26, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28746529/ultrasound-guided-intrapleural-positioning-of-pleural-catheters-influence-on-immediate-lung-expansion-and-pleurodesis-in-patients-with-recurrent-malignant-pleural-effusion
#19
Pedro Henrique Xavier Nabuco de Araujo, Ricardo Mingarini Terra, Thiago da Silva Santos, Rodrigo Caruso Chate, Antonio Fernando Lins de Paiva, Paulo Manuel Pêgo-Fernandes
Objective: To evaluate the role of intrapleural positioning of a pleural catheter in early lung expansion and pleurodesis success in patients with recurrent malignant pleural effusion (RMPE). Methods: This was a retrospective study nested into a larger prospective cohort study including patients with RMPE recruited from a tertiary university teaching hospital between June of 2009 and September of 2014. The patients underwent pleural catheter insertion followed by bedside pleurodesis...
May 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28740394/a-case-of-iatrogenic-pneumothorax-in-which-chest-tube-placement-could-be-avoided-by-intraoperative-evaluation-with-transthoracic-ultrasonography
#20
Izumi Sato, Hirotsugu Kanda, Megumi Kanao-Kanda, Atsushi Kurosawa, Takayuki Kunisawa
We report a case of iatrogenic pneumothorax in which chest tube placement was avoided by continuous intraoperative evaluation with transthoracic ultrasonography. A 53-year-old man had undergone a subsegmentectomy. While attempting to place a central venous catheter in the right internal jugular vein after the induction of anesthesia, we identified gas absorption during the puncture and suspected a pneumothorax. Chest X-ray revealed an ~5-mm collapse of the right lung apex. Tension pneumothorax was a concern during surgery because of the long-term positive pressure ventilation, but we decided to start the operation without preventative chest tube placement...
2017: Therapeutics and Clinical Risk Management
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