scholarly journals Thyroid Lymphoepithelial Cysts Mimicking Calcified or Solid Nodules on Ultrasonography

2019 ◽  
Vol 05 (02) ◽  
pp. E60-E64
Author(s):  
Yukie Tsutsuura ◽  
Mitsuyoshi Hirokawa ◽  
Ayana Suzuki ◽  
Hisashi Ota ◽  
Maki Oshita ◽  
...  
Keyword(s):  
Histological Examination ◽  
Medical Records ◽  
Diagnostic Problems ◽  
The Us ◽  
Lymphoepithelial Cysts ◽  
Us Findings

AbstractThyroid lymphoepithelial cysts (TLECs) are rare, and detailed ultrasonography (US) findings have not been reported. This study aimed to examine in detail the US findings for 32 TLECs and to clarify the diagnostic problems associated with them.We examined 32 TLECs resected from 21 patients at the Kuma hospital between January 2008 and April 2018. All patients underwent US before resection. From the patients’ medical records, we retrospectively assessed US reports and photographs of TLECs.The following four types of TLECs were classified: cystic, mixed solid and cystic, pseudo-solid, and pseudo-calcified types. The incidences were 50.0%, 12.5%, 12.5%, and 25.0%, respectively. Among the four types, pseudo-calcified TLECs were the smallest in size (mean: 7.1 mm). Of 24 nodules that had been interpreted in US reports, 11, 9, 1, 2, and 1 were benign, very low, low, intermediate, and high, respectively. Calcification and intramural solid growth were not identified by histological examination.We should be aware that approximately half of TLECs do not exhibit US appearances typical of simple cysts, and TLECs may mimic calcified or solid nodules on US, although the reason remains unknown.

scholarly journals AB0115 COMPARISON OF ULTRASOUND FINDINGS BETWEEN TNF INHIBITORS AND NON-TNF INHIBITORS AT FIRST BIOLOGICS IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1086.2-1087
Author(s):  
T. Okano ◽  
T. Koike ◽  
K. Inui ◽  
K. Mamoto ◽  
Y. Yamada ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Disease Duration ◽  
Power Doppler ◽  
Tnf Inhibitors ◽  
Tnf Inhibitor ◽  
Significant Difference ◽  
The Us ◽  
Us Findings ◽  
Improvement Ratio

Background:In rheumatoid arthritis (RA), biologics treatment is one of the effective treatment options. Usually, there is no difference in therapeutic effect regardless of which biologics is used, but the effect for joint synovitis is unknown. Recently, ultrasound (US) has played a role of sensitive imaging modality in the diagnosis and follow-up of patients with RA.Objectives:The aim of this study was to compare the improvement of US findings between TNF inhibitors and non-TNF inhibitors at first biologics in patients with RA.Methods:Fifty-four RA patients who started the first biologics from September 2016 to December 2018 were included in this longitudinal study (SPEEDY study, UMIN000028260). All the patients were performed clinical examination, blood test and US examination at baseline, 4, 12, 24, 36 and 52 weeks. A US examination was performed at the bilateral first to fifth metacarpophalangeal (MCP) joints, first interphalangeal (IP) and second to fifth proximal interphalangeal (PIP) joints, wrist joints (three part of radial, medial and ulnar) and first to fifth metatarsophalangeal (MTP) joints, by using HI VISION Ascendus (Hitachi Medical Corporation, Japan) with a multifrequency linear transducer (18-6 MHz). The gray scale (GS) and power Doppler (PD) findings were assessed by the semi-quantitative method (0-3). GS score and PD score (both 0-108 points) were defined as the sum of each score. The change of disease activity and US findings were compared between TNF group and non-TNF group.Results:Among 54 cases, 32 patients were used TNF inhibitor and 22 were non-TNF inhibitor. Age and duration of RA were significantly higher in the non-TNF group, and MTX dose was significantly lower in the non-TNF group. The baseline inflammatory markers tended to be higher in the non-TNF group and the disease activity was also higher in the non-TNF group. However, the US findings showed no significant difference in both GS and PD between two groups at baseline. US improvement ratio was no difference between TNF group and non-TNF group at 4, 12, 24, 36 and 52 weeks in both GS and PD score. Regardless of the type of biologics, patients with long-term disease duration tended to have poor improvement in US synovial fingings.Table 1.Baseline patient and disease characteristicsTNF (n=32)non-TNF (n=22)P valueFemale patients, n (%)21 (65.6)16 (72.7)0.767Age (years)63.5±15.471.0±9.00.030Disease duration (years)6.5±8.213.0±11.70.032CRP (mg/dl)1.8±2.53.0±3.20.170DAS28-ESR5.0±1.45.8±1.20.022GS score26.1±18.831.8±21.10.313PD score17.6±11.423.1±14.60.150Figure 1.GS and PD improvement ratio at 4, 12, 24, 36 and 52 weeksConclusion:There was no difference in the US findings improvement between patients with TNF inhibitor and non-TNF inhibitor at first biologics in patients with RA.References:[1]Grassi W, Okano T, Di Geso L, Filippucci E. Imaging in rheumatoid arthritis: options, uses and optimization. Expert Rev Clin Immunol. 2015;11:1131-46.[2]Nishino A, Kawashiri SY, Koga T, et al. Ultrasonographic Efficacy of Biologic andTargeted Synthetic Disease-ModifyingAntirheumatic Drug Therapy in RheumatoidArthritis From a Multicenter RheumatoidArthritis Ultrasound Prospective Cohort in Japan. Arthritis Care Res (Hoboken). 2018;70:1719-26.Acknowledgements:We wish to thank Atsuko Kamiyama, Tomoko Nakatsuka for clinical assistant, Setsuko Takeda, Emi Yamashita, Yuko Yoshida, Rika Morinaka, Hatsue Ueda and Tomomi Iwahashi for their special efforts as a sonographer and collecting data.Disclosure of Interests:None declared

scholarly journals Optimal clamping time in meatotomy procedure for children with meatal stenosis: Experience with 120 cases

2021 ◽  
Vol 93 (2) ◽  
pp. 244-247
Author(s):  
Mehdi Shirazi ◽  
Umayir Chowdhury ◽  
Faisal Ahmed ◽  
Mohammad-Bagher Rajabalian ◽  
Hossein-Ali Nikbakht ◽  
...  
Keyword(s):  
Bladder Wall ◽  
Postoperative Bleeding ◽  
Urine Flow ◽  
Penile Curvature ◽  
Optimum Time ◽  
Meatal Stenosis ◽  
The Us ◽  
Urinary Stream ◽  
Us Findings

Objective: During meatotomy procedure for children with meatal stenosis (MS), a straight clamp used as a hemostat on the ventrum of the meatus before incised with scissors for clamping and holding bleeding from the site of operation. The aim of this study was to evaluate the optimum clamping time for meatotomy in children with MS. Materials and methods: All the patients with MS between 2014 to 2019 were enrolled in this retrospective study. Patients with uncircumcised penis, traumatic catheterization, any kind of penile abnormality such as hypospadias or penile curvature, and active urinary tract infection (UTI) were excluded. The indication of meatotomy was a pinpoint meatus that develops with dorsal or lateral deflection of the urinary stream and high-velocity urine flow. During meatotomy procedure, clamping time was examined in different groups such as 2, 3, and 4 minutes. The main symptoms of presentation and ultrasonography (US) findings were recorded and compared between groups. To assess the optimum time clamping, postoperative bleeding was noted carefully in all groups. The success rate was recorded at onemonth postoperative follow-up in the clinic. Results: Of the 120 patients with MS who underwent a meatotomy procedure, there were 40 (33.3%) participants in each group. The main symptoms were painful urination and urine stream deviation that represented in 54 (46%) patients. Bladder wall thickness was the main pre-operation finding in the US which was observed in 67 (55.8%) patients. In comparison between the groups related to clamping time, bleeding was observed and required suturing when clamping was applied for 2 minutes in 4 (3.3%) patients (p = 0.016). With a minimum follow-up of 12 months, no recurrent meatal stenosis was reported. Conclusions: Clamping time for more than 2 minutes may prevent bleeding during and after meatotomy.

scholarly journals Clostridium difficile Laboratory Identification Event Reporting – A Need for Diagnostic Stewardship

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S398-S399
Author(s):  
Clare Rock ◽  
Zoi Pana ◽  
Surbhi Leekha ◽  
Polly Trexler ◽  
Jennifer Andonian ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Medical Records ◽  
Chart Review ◽  
Nucleic Acid Amplification ◽  
Event Reporting ◽  
Laxative Use ◽  
Academic Center ◽  
The Us ◽  
Clinically Significant ◽  
Present On Admission

Abstract Background Clostridium difficile LabID event reporting uses electronic laboratory results without chart review. Nucleic acid amplification testing is common in the US. A positive result may represent colonization or C. diff infection (CDI). We review C.difflabID events to ascertain if Hospital-Onest CDI (HO CDI). For non-HO CDI, we identify reason and use a matrix to prioritize clinical areas for intervention efforts. Methods Each C. difflab ID event from Jan 2015 to June 2016 at academic center had chart review for HO CDI; defined significant diarrhea, not present on admission, with no laxatives in prior 48 hours. For non HO-CDI events, reason and receipt of antibiotic treatment within 14 days of the positive test were retrospectively noted. A prioritization matrix, where clinical services were ranked according to number of lab ID events (service’s contribution to the facility C. diffLabID), was multiplied by a rank based on percent of inappropriate tests giving an overall prioritization score for where intervention resources could potentially best be used. Results There were 490 C difficile LabID events; 284 (58%) were HO-CDI; 206 (42%) were inappropriate or delayed testing. Of the 190 with available medical records at time of retrospective review, reasons for not meeting the HO-CDI included laxative use within the previous 48 hours (41%), no clinically significant diarrhea (49.5%); delayed testing (9.5%). See figure. Of 172 patients with inappropriate testing, 159 (92%) were treated for CDI. Medicine and psychiatry ranked first and second on prioritization matrix. See table. Conclusion Nearly half of C. diff LabID events were not true HO CDI, but inappropriate or delayed tests. Prioritization matrix identified medicine and psychiatry as areas where diagnostic stewardship interventions could affect most on facility C. diff LabID. Disclosures K. C. Carroll, GenePOC, Inc.: Grant Investigator, Grant recipient

Pleuro-Pulmonary Aspergillosis

1995 ◽  
Vol 36 (2) ◽  
pp. 122-126 ◽  
Author(s):  
T. Tikkakoski ◽  
P. Lohela ◽  
M. Päivänsalo ◽  
T. Kerola
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Diagnostic Yield ◽  
Pleural Empyema ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Pulmonary Aspergillosis ◽  
Fine Needle ◽  
The Us ◽  
Us Findings

We reviewed the US findings and the diagnostic yield of fine-needle aspiration biopsy (FNAB) for cytologic and microbiologic samples in 4 patients with pulmonary or pleural aspergillosis. All 3 apical Aspergillus abscesses were round, hypoechoic with irregular margins and one contained echo-densities with shadowing consistent with air. One pleural empyema was oval and hypoechoic. Cytology suggested inflammation in all cases and Aspergillus hyphae were detected in 2 of 4 aspirates. Culture of the aspirate was positive for Aspergillus in 3 of 4 cases, while one diagnosis was made after surgery. No complications occurred. Apico-pleural Aspergillus lesions are suitable targets for US-guided FNAB, thus avoiding more invasive methods. Our results suggest wider use of this procedure.

Copperhead (Agkistrodon contortrix) Envenomation of Dogs: 52 Cases (2004–2011)

2014 ◽  
Vol 50 (5) ◽  
pp. 338-344 ◽  
Author(s):  
Jessica C. Pritchard ◽  
Adam J. Birkenheuer ◽  
Rita M. Hanel ◽  
Michael W. Wood
Keyword(s):  
Medical Records ◽  
Retrospective Studies ◽  
Clinical Course ◽  
Clinical Signs ◽  
Agkistrodon Contortrix ◽  
The Us ◽  
Blood Cell Morphology ◽  
Almost All ◽  
Morphology Changes ◽  
All Treatment

Copperhead envenomation is common within the US, and no studies exist describing the clinical course of copperhead envenomation in dogs. Almost all treatment decisions regarding those bites are extrapolated from retrospective studies evaluating the clinical course of rattlesnake bites. Because copperheads and rattlesnakes produce venom with different potency, assumptions that treatment of the different envenomations should be similar may be incorrect. The purpose of this retrospective study was to evaluate the clinical course of copperhead envenomation in dogs and administered treatments. Medical records of 52 dogs treated for copperhead envenomation were reviewed, and owners were contacted regarding outcome. The most common clinical signs associated with copperhead envenomation included swelling, pain, and ecchymosis. Clinicopathological abnormalities (e.g., thrombocytopenia, elevated clotting times, leukocytosis) were mild, and red blood cell morphology changes and coagulopathies were rare. Most dogs were treated with antimicrobials, analgesics, and fluid therapy. No dogs in this study required the use of antivenin and all survived to discharge. This study found that the clinical course after copperhead envenomation is generally limited to local rather than systemic illness. Copperhead envenomation in dogs is largely self-limiting and responsive to supportive care with hospitalization for monitoring.

Patient use of online medical records: an application of technology acceptance framework

2019 ◽  
Vol 28 (1) ◽  
pp. 97-115
Author(s):  
Surma Mukhopadhyay ◽  
Ramsankar Basak ◽  
Darrell Carpenter ◽  
Brian J. Reithel
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Records ◽  
Perceived Usefulness ◽  
Security And Privacy ◽  
Care Providers ◽  
Content Type ◽  
The Us ◽  
Continued Use ◽  
Patient Use

Purpose Little is known about factors that affect patient use of online medical records (OMR). Specifically, with rising vulnerability concerns associated with security and privacy breaches, patient use of OMR requires further attention. This paper aims to investigate patient use of OMR. Using the Unified Theory of Acceptance and Use of Technology (UTAUT), factors affecting continued use of OMR were examined. Design/methodology/approach The Health Information National Trends Survey 5 (HINTS 5), Cycle 1 data were used. This is an ongoing nation-wide survey sponsored by the National Cancer Institute (NCI) of the USA. The subjects were 31-74 years old with access to the Internet. Descriptive information was projected to the US population. Findings In total, 765 respondents representing 48.7 million members of the US population were analyzed. Weighted regression results showed significant effects of perceived usefulness, visit frequency and provider encouragement on continued use of OMR while vulnerability perception was not significant. Moderating effects of these variables were also noted. Perceived usefulness and provider encouragement emerged as important predictors. Practical implications Insights may help design interventions by health-care providers and policymakers. Social implications Insights should help patient empowerment and developers with designing systems. Originality/value This is the first study to examine health-care consumers’ continued use of OMR using nationally representative data and real-world patients, many of who have one or more chronic diseases (e.g. diabetes, hypertension, asthma) or are cancer survivors. Results highlight factors helping or hindering continuing OMR use. As such, insights should help identify opportunities to increase the extent of use, project future OMR usage patterns and spread the benefits of OMR, including bringing forth positive health outcomes.

scholarly journals The Relationship Between Physical Examination and Ultrasonography of Large Entheses of the Achilles Tendon and Patellar Tendon Origin

2019 ◽  
Vol 47 (7) ◽  
pp. 1026-1030 ◽  
Author(s):  
Sibel Zehra Aydin ◽  
Sibel Bakirci ◽  
Esen Kasapoglu ◽  
Concepcion Castillo-Gallego ◽  
Fatıma Arslan Alhussain ◽  
...  
Keyword(s):  
Physical Examination ◽  
Achilles Tendon ◽  
Patellar Tendon ◽  
Anatomical Site ◽  
Plantar Aponeurosis ◽  
The Us ◽  
Doppler Signals ◽  
Us Findings ◽  
Tendon Insertion ◽  
The Relationship

Objective.To investigate the relationship between physical examination (PE) and sonographic features of enthesitis, based on anatomical sites.Methods.The analysis was done using merged raw data of 3 studies on 2298 entheses.Results.Patients with clinical Achilles enthesitis had more abnormalities on ultrasound (US): hypoechogenicity, p < 0.001; thickening, p = 0.001; Doppler signals, p = 0.002; and erosions, p = 0.02. The patellar tendon origin also correlated with PE but distal patellar tendon insertion and plantar aponeurosis were uncoupled from the US.Conclusion.The relationship between clinical and sonographic findings for large entheses is dependent on the anatomical site. For the patellar tendon origin and Achilles entheses, PE is significantly linked to US findings.

scholarly journals Comparison of ultrasonographic, radiographic and intra-operative findings in severe hip osteoarthritis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Mika T. Nevalainen ◽  
Kyösti V. Kauppinen ◽  
Tuukka Niinimäki ◽  
Simo S. Saarakkala
Keyword(s):  
Femoral Head ◽  
Gold Standard ◽  
Diagnostic Performance ◽  
Hip Osteoarthritis ◽  
Conventional Radiography ◽  
Rater Reliability ◽  
The Us ◽  
Oxford Hip Score ◽  
Us Findings ◽  
Operative Findings

AbstractAim of this study was to assess the US findings of patients with late-stage hip OA undergoing total hip arthroplasty (THA), and to associate the US findings with conventional radiography (CR) and intraoperative findings. Moreover, the inter-rater reliability of hip US, and association between the US and Oxford Hip Score (OHS) were evaluated. Sixty-eight hips were included, and intraoperative findings were available on 48 hips. Mean patient age was 67.6 years and 38% were males. OA findings—osteophytes at femoral collum and anterosuperior acetabulum, femoral head deformity and effusion—were assessed on US, CR and THA. The diagnostic performance of US and CR was compared by applying the THA findings as the gold standard. Osteoarthritic US findings were very common, but no association between the US findings and OHS was observed. The pooled inter-rater reliability (n = 65) varied from moderate to excellent (k = 0.538–0.815). When THA findings were used as the gold standard, US detected femoral collum osteophytes with 95% sensitivity, 0% specificity, 81% accuracy, and 85% positive predictive value. Concerning acetabular osteophytes, the respective values were 96%, 0%, 88% and 91%. For the femoral head deformity, they were 92%, 36%, 38% and 83%, and for the effusion 49%, 85%, 58% and 90%, respectively. US provides similar detection of osteophytes as does CR. On femoral head deformity, performance of the US is superior to CR. The inter-rater reliability of the US evaluation varies from moderate to excellent, and no association between US and OHS was observed in this patient cohort.

Access and Confidentiality of Medical Records: A Legislative Response in the United States

1996 ◽  
Vol 26 (1) ◽  
pp. 33-40
Author(s):  
Judith Mair
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Records ◽  
The United States ◽  
Personal Privacy ◽  
Related Information ◽  
The Us ◽  
Us Senate

The Bennett Bill was introduced to the US Senate with the intention by its sponsors to ensure personal privacy with respect to medical records and health care-related information in the United States. The Bennett Bill has been passed into legislation by the US Senate as the Medical Records Confidentiality Act of 1995.

scholarly journals How Ultrasound Can Be Useful for Staging Chronic Kidney Disease in Dogs: Ultrasound Findings in 855 Cases

2020 ◽  
Vol 7 (4) ◽  
pp. 147
Author(s):  
Francesca Perondi ◽  
Ilaria Lippi ◽  
Veronica Marchetti ◽  
Barbara Bruno ◽  
Antonio Borrelli ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diagnostic Test ◽  
Medical Records ◽  
Functional Parameters ◽  
Significant Difference ◽  
Ultrasound Findings ◽  
The Us ◽  
Abnormal Ratio ◽  
Better Than

In patients affected by chronic kidney disease (CKD), some ultrasonographic (US) abnormalities have been shown to correlate better than others with the progression of the disease. The aim of the study was to evaluate the prevalence of the most frequent renal US abnormalities in dogs at different stages of CKD, and to investigate their association with CKD International Renal Interest Society (IRIS) stages. Medical records and ultrasonographical report of 855 dogs were retrospectively included. The most frequent renal ultrasonographic abnormalities were: increased cortical echogenicity, abnormal ratio of cortico-medullary junction (C/M) and pyelectasia. A statistically significant difference in the prevalence of irregular contour, abnormal cortico-medullary junction, abnormal C/M, increased cortical echogenicity, and pyelectasia was found for dogs at different IRIS stages. The number of dogs with more than one US abnormality increased significantly with the progression of IRIS stage. In conclusion, increased cortical echogenicity, abnormal C/M junction and pyelectasia were the most prevalent US abnormalities in our CKD population. Although none of the US abnormalities showed a significantly higher prevalence, the number of dogs presenting > 3 US abnormalities increased significantly from IRIS 2 to IRIS 4. Renal US is an excellent ancillary diagnostic test, which should be used together with renal functional parameters, to monitor the progression of CKD.

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