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https://www.readbyqxmd.com/read/28223817/emergency-thoracic-ultrasound-and-clinical-risk-management
#1
Maria Concetta Interrigi, Francesca M Trovato, Daniela Catalano, Guglielmo M Trovato
PURPOSE: Thoracic ultrasound (TUS) has been proposed as an easy-option replacement for chest X-ray (CXR) in emergency diagnosis of pneumonia, pleural effusion, and pneumothorax. We investigated CXR unforeseen diagnosis, subsequently investigated by TUS, considering its usefulness in clinical risk assessment and management and also assessing the sustainability of telementoring. PATIENTS AND METHODS: This observational report includes a period of 6 months with proactive concurrent adjunctive TUS diagnosis telementoring, which was done using freely available smartphone applications for transfer of images and movies...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28217437/spontaneous-pneumomediastinum-in-a-healthy-young-female-a-case-report-and-literature-review
#2
Ahmed Dirweesh, Chikezie Alvarez, Muhammad Khan, Donald Christmas
Spontaneous pneumomediastinum (SPM) is an uncommon finding in young adults presenting usually without any comorbidities or an underlying pathology. It is most commonly due to alveolar rupture in the setting of an inciting event such an underlying asthma, barotrauma, valsalva maneuver, or esophageal rupture. Individuals can have varying presentations, from chest pain, dyspnea and dysphagia, to anxiety, weakness, or facial and neck swelling. The majority of patients have subcutaneous emphysema on examination and can have abnormal laboratory findings such as an elevated C-reactive proteins and leukocytosis...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28217237/-caught-by-the-eye-of-sound-epigastric-swelling-due-to-xiphisternal-tuberculosis
#3
Shabnam Bhandari Grover, Sumit Arora, Amit Kumar, Hemal Grover, Amit Katyan, Deepthi Mohan Nair
BACKGROUND: Common causes of an epigastric mass include hepatomegaly, pancreatic pseudocyst and epigastric hernia, less common causes being carcinoma of the stomach or pancreas, whereas diseases of the sternum presenting as an epigastric swelling is extremely uncommon. We report a case of tubercular infection of the sternum located in the xiphoid process resulting in its presentation as an epigastric swelling. CASE REPORT: A 30-year-old immunocompetent woman with complaints of an epigastric swelling and undocumented pyrexia for four months was referred for sonographic evaluation with a clinical suspicion of an incompletely treated liver abscess...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28217076/lung-ultrasound-versus-chest-radiography-for-the-diagnosis-of-pneumothorax-in-critically-ill-patients-a-prospective-single-blind-study
#4
Mahmood Dhahir Al-Mendalawi
No abstract text is available yet for this article.
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28204920/a-review-of-congenital-lung-malformations-with-a-simplified-classification-system-for-clinical-and-research-use
#5
REVIEW
Michael Seear, Jennifer Townsend, Amy Hoepker, Douglas Jamieson, Deborah McFadden, Patrick Daigneault, William Glomb
PURPOSE: Congenital lung abnormalities are rare malformations increasingly detected early by prenatal ultrasound. Whether management of these frequently asymptomatic lesions should be surgical or conservative is an unresolved issue. The necessary prospective studies are limited by the absence of a widely accepted practical classification system. Our aim was to develop a simple, clinically relevant system for classifying and studying congenital lung abnormalities. MATERIALS AND METHODS: We based our proposed grouping on a detailed analysis of clinical, radiological, and histological data from well-documented cases, plus an extensive review of the literature...
February 15, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28204915/-acute-chest-pain-and-new-ecg-changes-in-pacemaker-patients-a%C3%A2-clinical-challenge
#6
Matthias Hoyme, Ralf Surber, P Christian Schulze, Dirk Prochnau
We report the case of a 82-year-old woman who was admitted to our institution with acute chest pain, nausea, and vomiting. Because of atrial fibrillation with intermittent bradycardia, a single-chamber pacemaker was implanted 4 years ago. The initial 12-lead ECG showed atrial fibrillation with a heart rate of 70 bpm, narrow QRS, and T‑wave inversions in the inferolateral leads. Coronary artery disease was excluded by immediate cardiac catheterization. A subsequent ECG three hours later showed a ventricular paced rhythm...
February 15, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28203309/a-recurrent-case-of-pentalogy-of-cantrell-a-rare-case-with-sonological-findings-and-review-of-literature
#7
Srinivas M Naren Satya, Kamala Retnam Mayilvaganan, Ivvala Sai Prathyusha, Munnangi Satya Gautam, Deepthi Raidu, V N Amogh
BACKGROUND: Pentalogy of Cantrell (POC) is an extremely rare and complex congenital anomaly. Ultrasound is a valuable, safe, nonionizing, cost effective, widely available, and easily reproducible imaging tool and is indispensible in the diagnosis of POC. Despite the rarity of POC, it is imperative for a radiologist to be aware of its wide spectrum of presentation on ultrasound in first trimester of gestation. Most reported cases in literature till now have been sporadic. In this paper, we aimed to report for the first time in literature, a recurrent case of POC detected in the first trimester in a mother whose previous pregnancy also was terminated in the second trimester medically due to the ultrasound diagnosis of POC...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28202294/point-of-care-lung-ultrasound-in-children-with-community-acquired-pneumonia
#8
Hayri Levent Yilmaz, Ahmet Kağan Özkaya, Sinem Sarı Gökay, Özlem Tolu Kendir, Hande Şenol
OBJECTIVES: To present lung ultrasound findings in children assessed with suspected pneumonia in the emergency department and to show the benefit of lung ultrasound in diagnosing pneumonia in comparison with chest X-rays. METHODS: This observational prospective study was performed in the pediatric emergency department of a single center. Point of care lung ultrasound was performed on each child by an independent sonographer blinded to the patient's clinical and chest X-ray findings...
February 1, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28198075/exercise-induced-b-lines-identify-worse-functional-and-prognostic-stage-in-heart-failure-patients-with-depressed-left-ventricular-ejection-fraction
#9
Maria Chiara Scali, Lauro Cortigiani, Anca Simionuc, Dario Gregori, Mario Marzilli, Eugenio Picano
AIMS: Exercise stress echocardiography (ESE) is recommended by the European Society of Cardiology guidelines for the evaluation of heart failure (HF) patients. Recently, lung ultrasound (LUS) has been proposed for the assessment of extravascular lung water through B-lines. The aim of this study was to assess B-lines during ESE in HF. METHODS AND RESULTS: Standard transthoracic and LUS evaluation was performed during semi-supine ESE in 103 NYHA class I-III HF patients (76 male; mean age 64 ± 12 years) with depressed LVEF (35 ± 8%)...
February 15, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28195963/mediastinitis-following-endobronchial-ultrasound-guided-transbronchial-needle-aspiration
#10
Aruna Jahoor, Shekhar Ghamande, Shirley Jones, Carl Boethel, Heath D White
Mediastinitis is a rare complication of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Recent reports of infectious complications following EBUS-TBNA involved oropharyngeal bacteria. Here, we report 2 unusual cases of post-EBUS-TBNA mediastinitis involving Streptococcus pneumoniae and Pseudomonas aeruginosa, which were likely the result of direct inoculation of the organisms at the time of transbronchial needle aspiration. The first case was successfully treated with computed tomography-guided drainage and antibiotics, whereas the second case had >50% distal tracheal obstruction and near total occlusion of the left main stem bronchus, requiring rigid bronchoscopy, stent placement, debulking, and antibiotics...
February 10, 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28185691/thoracic-ultrasound-technique-applications-and-interpretation
#11
REVIEW
Suraj H Rambhia, Catherine A D'Agostino, Ali Noor, Robert Villani, Jason J Naidich, John S Pellerito
Thoracic ultrasound is used at the bedside in emergency and critical care settings. Advantages of ultrasound include rapid real-time, low-cost, diagnostic information that can direct patient care without the use of ionizing radiation. We describe methods on how to perform lung ultrasound, with the intent to educate the radiologist who might otherwise be relatively unfamiliar with thoracic sonography. We describe and depict the normal sonographic appearance of lung anatomy. We also show the sonographic appearance of a wide range of lung and pleural pathologies such as pneumonia, pneumothorax, as well as lung and pleural masses...
December 15, 2016: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28174189/sternal-stress-fracture-in-a-middle-aged-woman
#12
Justin Lee, Karl Bertrand Fields
A middle-aged premenopausal woman presented with 3 months of right chest wall pain after beginning a new weight training programme. Examination was significant only for mild-to-moderate tenderness to palpation over the right pectoral muscle and sternoclavicular joint. In-office musculoskeletal ultrasound scan, chest X-ray and shoulder X-rays were unremarkable. Subsequent MRI of the chest wall showed oedema in the sternum at the level of the sternoclavicular joint consistent with a sternal stress fracture...
February 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28170371/imaging-tests-in-staging-and-surveillance-of-non-metastatic-breast-cancer-changes-in-routine-clinical-practice-and-cost-implications
#13
S De Placido, C De Angelis, M Giuliano, C Pizzi, R Ruocco, V Perrone, D Bruzzese, G Tommasielli, M De Laurentiis, S Cammarota, G Arpino, G Arpino
BACKGROUND: Although guidelines do not recommend computerised tomography (CT), positron emission tomography (PET) or magnetic resonance imaging (MRI) for the staging or follow-up of asymptomatic patients with non-metastatic breast cancer, they are often requested in routine clinical practice. The aim of this study was to determine the staging and follow-up patterns, and relative costs in a large population of breast cancer patients living and treated in a Southern Italian region. METHODS: We analysed the clinical computerised information recorded by 567 primary-care physicians assisting about 650 000 inhabitants in the Campania region...
February 7, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28166154/intrathoracic-accessory-lobe-of-liver-masquerading-as-a-paraesophageal-mass
#14
Christopher Ball, Jason Wayne Wachsmann
Heterotopic liver tissue is a relatively rare finding, which has historically been discovered incidentally during surgery or at autopsy. However, we present a 28-year-old woman who presented to the emergency department with shortness of breath and stabbing chest pain. An emergent CT angiogram of the chest was performed, which incidentally revealed a mediastinal paraesophageal mass. Subsequent endoscopic ultrasound showed a hypoechoic area that appeared to connect to the liver. A liver/spleen scan with SPECT/CT with Tc sulfur colloid demonstrated that the mass was paraesophageal heterotopic liver tissue with a connection to the orthotropic liver by a small stalk...
February 3, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28151908/implantation-of-vvi-pacemaker-in-a-patient-with-dextrocardia-persistent-left-superior-vena-cava-and-sick-sinus-syndrome-a-case-report
#15
Gongliang Guo, Lili Yang, Jinyi Wu, Liqun Sun
BACKGROUND: Dextrocardia, or right-lying heart, is an uncommon congenital heart disease in which the apex of the heart is located on the right side of chest. Persistent left superior vena cava (PLSVA) is a rare venous anomaly that is often associated with the abnormalities of cardiac transduction system. A case with combination of dextrocardia, persistent left superior vena cava, and sick sinus syndrome has not been reported. METHODS: We used different techniques including cardiac color Doppler echocardiography, 24-hour Holter monitoring, and abdominal ultrasound to make a diagnosis and treated the patient by implanting a VVI pacemaker...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28139259/dalteparin-thromboprophylaxis-in-cancer-patients-at-high-risk-for-venous-thromboembolism-a-randomized-trial
#16
Alok A Khorana, Charles W Francis, Nicole M Kuderer, Marc Carrier, Thomas L Ortel, Ted Wun, Deborah Rubens, Susan Hobbs, Renuka Iyer, Derick Peterson, Andrea Baran, Katherine Kaproth-Joslin, Gary H Lyman
BACKGROUND: Ambulatory cancer patients at high-risk for venous thromboembolism (VTE) can be identified using a validated risk score (Khorana score). We evaluated the benefit of outpatient thromboprophylaxis with dalteparin in high-risk patients in a multicenter randomized study. METHODS: Cancer patients with Khorana score≥3 starting a new systemic regimen were screened for VTE and if negative randomized to dalteparin 5000units daily or observation for 12weeks...
January 26, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28133553/congenital-diaphragmatic-hernia-presenting-in-a-7-day-old-infant
#17
Christopher Rouse, Luke Schmidt, Lee Brock, Angela Fagiana
A 7-day-old male infant presented to the emergency room after respiratory distress was noted at an outpatient well child check. On exam, he was observed to have tachypnea, increased work of breathing, and decreased breath sounds on the left side of the chest. On chest X-ray, he was found to have a left-sided congenital diaphragmatic hernia. The infant was transported to a tertiary care facility where the defect was repaired without complication. Interestingly, the mother had a history of a normal antenatal ultrasound, completed at 19 + 2 weeks of gestational age...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28123741/hepatocellular-carcinoma-with-inferior-vena-caval-and-right-atrial-tumor-thrombi-and-massive-pulmonary-artery-embolism-a-case-report
#18
Jian Huang, Ze-Ya Pan, Li Li, Bei-Ge Jiang, Fang-Ming Gu, Zhen-Guang Wang, Zhi-Hong Wang, Wei-Ping Zhou
The aim of the present study was to report the case of a 55-year-old female patient with a sizeable (7.1×6.2 cm) hepatocellular carcinoma (HCC), who succumbed to massive pulmonary artery embolism. The main symptoms included sudden thoracodynia, dyspnea and transient coma. The initial diagnosis was HCC according to the typical abdominal ultrasound and triple-phase abdominal computed tomography (CT) findings, chronic hepatitis B infection and elevated α-fetoprotein levels (1,036 µg/l; normal, 0-20 µg/l). Two days following admission, the patient developed recurrent chest pain and shortness of breath...
January 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28123616/simplified-point-of-care-ultrasound-protocol-to-confirm-central-venous-catheter-placement-a-prospective-study
#19
Sean P Wilson, Samer Assaf, Shadi Lahham, Mohammad Subeh, Alan Chiem, Craig Anderson, Samantha Shwe, Ryan Nguyen, John C Fox
BACKGROUND: The current standard for confirmation of correct supra-diaphragmatic central venous catheter (CVC) placement is with plain film chest radiography (CXR). We hypothesized that a simple point-of-care ultrasound (POCUS) protocol could effectively confirm placement and reduce time to confirmation. METHODS: We prospectively enrolled a convenience sample of patients in the emergency department and intensive care unit who required CVC placement. Correct positioning was considered if turbulent flow was visualized in the right atrium on sub-xiphoid, parasternal or apical cardiac ultrasound after injecting 5 cc of sterile, non-agitated, normal saline through the CVC...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28117110/hemorrhagic-pericardial-cyst-diagnosis-accelerated-by-emergency-physician-echocardiography-a-case-report
#20
Michael F Yip, Brooks M Walsh
BACKGROUND: The differential diagnosis for chest pain in the emergency department is broad and includes both benign and life-threatening conditions-with pericardial cyst as a rare example. Emergency physician-performed point-of-care focused cardiac ultrasound (FOCUS) is increasingly recognized as a useful modality in the evaluation of patients with chest pain. CASE REPORT: We report a case of hemorrhagic pericardial cyst in a young woman presenting with chest pain in which findings on FOCUS contradicted findings on chest x-ray study and thus, accelerated diagnosis and definitive treatment...
January 20, 2017: Journal of Emergency Medicine
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