The role of ultrasound examination in early detection and follow-up of arterio-portal shunts

2008 ◽  
Vol 29 (S 1) ◽  
Author(s):  
S Ioanitescu ◽  
L Micu ◽  
A Rampoldi ◽  
N Masala ◽  
V Marcu ◽  
...  
Keyword(s):  
Early Detection ◽  
Ultrasound Examination

External Investigators' Follow-Up Intentions When Whistleblowers Report Healthcare Fraud: The Effects of Report Anonymity and Previous Confrontation

2020 ◽  
Vol 32 (2) ◽  
pp. 91-101
Author(s):  
Steven E. Kaplan ◽  
Danny Lanier ◽  
Kelly R. Pope ◽  
Janet A. Samuels
Keyword(s):  
Experimental Study ◽  
Early Detection ◽  
Data Availability ◽  
Medical Provider ◽  
Perceived Credibility ◽  
The Relationship ◽  
Critical Investigation

ABSTRACT Whistleblowing reports, if properly investigated, facilitate the early detection of fraud. Although critical, investigation-related decisions represent a relatively underexplored component of the whistleblowing process. Investigators are responsible for initially deciding whether to follow-up on reports alleging fraud. We report the results of an experimental study examining the follow-up intentions of highly experienced healthcare investigators. Participants, in the role of an insurance investigator, are asked to review a whistleblowing report alleging billing fraud occurring at a medical provider. Thus, participants are serving as external investigators. In a between-participant design, we manipulate the report type and whether the caller previously confronted the wrongdoer. We find that compared to an anonymous report, a non-anonymous report is perceived as more credible and follow-up intentions stronger. We also find that perceived credibility fully mediates the relationship between report type and follow-up intentions. Previous confrontation is not significantly associated with either perceived credibility or follow-up intentions. Data Availability: Data are available upon request.

The role of primary care in early detection and follow-up of cancer

2013 ◽  
Vol 11 (1) ◽  
pp. 38-48 ◽  
Author(s):  
Jon D. Emery ◽  
Katie Shaw ◽  
Briony Williams ◽  
Danielle Mazza ◽  
Julia Fallon-Ferguson ◽  
...  
Keyword(s):  
Primary Care ◽  
Early Detection

scholarly journals The radiologic roadmap for treatment of an acute appendicitis patient who tested positive for coronavirus disease 19

2021 ◽  
Author(s):  
Şeref Barbaros Arik ◽  
Elif Gunaydin ◽  
Celal İsmail Bİlgiç ◽  
İnanç Güvenç
Keyword(s):  
Emergency Department ◽  
Acute Appendicitis ◽  
Standard Treatment ◽  
Surgical Intervention ◽  
Ultrasound Examination ◽  
Bridging Therapy ◽  
Emergency Surgical Intervention ◽  
Pelvic Ct Scan

Objective: In this study, we aimed to emphasize the role of radiological imaging in determining the treatment of a patient, who tested positive for COVID-19 and diagnosed with acute appendicitis during the pandemic. Methods: A 31-year-old patient presented to the emergency department due to abdominal pain. Ultrasound examination, thoracic and pelvic CT scan were performed. Results: Non-complicated appendicitis can be treated conservatively with antibiotics. Treatment can be maintained by starting with IV antibiotics and bridging therapy with oral antibiotics. Conclusion: This study aims to summarize how radiological follow-up can be used to decide on the suitability of the patient for appropriate medical treatment as an alternative to surgery in a patient, whose gold standard treatment is emergency surgical intervention, which is frequently encountered in the emergency department during the COVID-19 pandemic.

scholarly journals Role of myocardial deformation analysis in the early detection of subclinical Left Ventricular dysfunction in breast cancer under anthracyclines and trastuzumab

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
R Benmalek ◽  
I Krikez ◽  
A Maaroufi ◽  
A Abouriche ◽  
H Bendahou ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Cancer Patients ◽  
Cardiac Dysfunction ◽  
Left Ventricular ◽  
Myocardial Deformation ◽  
Left Ventricular Ejection ◽  
Deformation Analysis

Abstract Funding Acknowledgements Type of funding sources: None. Introduction : Cardio-oncology field has notably raised interest this past decade, it considerably improved cancer patients’ quality of care by monitoring and preventing complications of cardiotoxic treatment like anthracyclines and trastuzumab. Transthoracic echocardiography (TEE) plays a major role in the baseline assessment and follow-up of cardio-oncology patients. While left ventricular ejection fraction (LVEF) still has its place in cardiac monitoring, new modalities like myocardial deformation imaging with speckle tracking strain analysis, show great potential for early detection of subclinical LV dysfunction. Purpose : The aim of this study was to evaluate the role of Global Longitudinal Strain (GLS) in the early detection of cardiotoxicity and its correlation to LVEF. Methods : We conducted a longitudinal prospective study including all the breast cancer patients treated with anthracyclines and/or trastuzumab  followed in the Casablanca cardio-oncology unit from January 2017 to December 2019. All patients underwent baseline TEE, and were followed-up every 3 months after that, with GLS assessment whenever it was possible. We evaluated the frequency of GLS drop and its correlation to LVEF reduction. Results : Out of a total of 793 patients, 677 had available LV GLS assessment. Among them, 83 (12,3%) decreased their GLS during follow-up, 67% of which had no concomitant drop in LVEF. In these patients, impaired LV GLS values were noted at 1 month after chemotherapy and at 3, 6, and 12 months compared with baseline (-22,3 ± 1.8% at baseline, -18.1 ± 2.3% at 1 month, -17.7 ± 2.1% at 3 months, -17.1 ± 2.2% at 6 months, and -16.9 ± 2.1% at 12 months (p < 0,0001). LV GLS at 3 months was strongly correlated to cardiotoxicity (LVEF < 50%) at 12 months (p < 0,0001). A cut-off LV GLS value of -17,7% was then retained to identify LVEF alteration at the end of follow-up. Moreover, lower GLS values were observed in patients under Doxorubicin with a mean cumulative dose >180 mg/m2 (p = 0,0019), while LVEF remained normal. Finally, our study found that GLS at 1 month and 3 months had a prognostic value, since the lower GLS was, the poorest the patient’s clinical outcome was, with further development of symptomatic heart failure (p = 0,0038). Conclusion : Our study demonstrates that myocardial deformation analysis enables detection of early and progressive subclinical cardiac dysfunction, and GLS at 3 month was positively correlated to LVEF drop at 12 months. Thus, routine GLS should be used in patients undergoing cardiotoxic chemotherapy in order to early detect cardiotoxicity and prevent irreversible cardiac dysfunction by early initiating cardio-protective treatment.

scholarly journals Ultrasound examination of regional lymph nodes significantly improves early detection of locoregional metastases during the follow-up of patients with cutaneous melanoma

Cancer ◽  
2000 ◽  
Vol 88 (11) ◽  
pp. 2534-2539 ◽  
Author(s):  
Andreas Blum ◽  
Bettina Schlagenhauff ◽  
Waltraud Stroebel ◽  
Helmut Breuninger ◽  
Gernot Rassner ◽  
...  
Keyword(s):  
Early Detection ◽  
Lymph Nodes ◽  
Cutaneous Melanoma ◽  
Ultrasound Examination ◽  
Regional Lymph Nodes

Ultrasound Determination of Chorionicity in Twin Pregnancy: Accuracy and Operator Experience

Twin Research ◽  
2001 ◽  
Vol 4 (4) ◽  
pp. 223-226 ◽  
Author(s):  
Roland G.L. Devlieger ◽  
Thomas Demeyere ◽  
Jan A. Deprest ◽  
Dominique Van Schoubroeck ◽  
Ingrid Witters ◽  
...  
Keyword(s):  
Early Detection ◽  
Twin Pregnancy ◽  
Correct Prediction ◽  
Variable Degree ◽  
Operator Experience ◽  
Accuracy Of Prediction ◽  
Twin Pregnancies

AbstractTo evaluate the accuracy of ultrasound in early detection of chorionicity and amnionicity in twin pregnancies and evaluate the role of operator-experience, a prospective follow up of 87 consecutive twin pregnancies was performed. Chorionicity and amnionicity were determined by 17 different observers, divided in 2 groups on the basis of their experience, using a composite of US markers at the first US examination confirming a viable intrauterine twin pregnancy. Accuracy of prediction was determined for both groups by comparison with postnatal pathology. From the 87 pregnancies examined at 10.1 (minimum 5.5 weeks, maximum 26.0) weeks of gestation, pathology was available in 82 cases and a correct prediction of chorionicity was made in all but two cases, both being diagnosed as monochorionic while dichorionic by observers belonging the more experienced group. No monochorionic pregnancy was missed and amnionicity was correctly diagnosed in all cases, including two monoamniotic twins. We conclude that use of a composite of ultrasound markers for early detection of chorionicity and amnionicity is reliable in a clinical setting where physicians with a variable degree of experience perform ultrasound examination.

Role Of Cytogenetic Abnormalities At Baseline and During 5-Year Follow-Up In Multiple Myeloma Patients Treated On The Total Therapy 3 Protocol

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 3137-3137
Author(s):  
Sarah Waheed ◽  
Jeffrey Sawyer ◽  
Adam Rosenthal ◽  
Frits van Rhee ◽  
Nathan M Petty ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Early Detection ◽  
Research Funding ◽  
Progression Free Survival ◽  
Cost Effective ◽  
Early Detection Of Disease ◽  
Cytogenetic Abnormalities ◽  
Total Therapy

Abstract The presence of metaphase cytogenetic abnormalities (CA) has long been considered an adverse prognosticator in multiple myeloma (MM). An update is provided of overall survival (OS) and progression-free survival (PFS) of patients treated with Total Therapy 3 (TT3). The prognostic role of CA was assessed relative to its presence at baseline (BL) and during 2 landmarks (LM) of 2 (LM2) and 5 years of follow-up (LM5). For both LM, the following CA combinations were considered: no CA at BL and up to LM; CA at BL and till LM; CA at BL, no CA till LM; no CA at BL, CA toward LM. Patients considered for evaluation had at least one cytogenetic evaluation prior to the start of therapy and at least one cytogenetic evaluation during follow-up. In Cox modeling, only patients with at least one cytogenetic evaluation prior to baseline were considered. The time-dependent variable indicating whether patients lived to reach a certain LM, and had a CA during the time between enrollment and that LM, was considered along with several typical MM predictor variables. Results showed that, for the LM2, patients with BL-no CA/LM-no CA fared best followed by the BL-CA/LM-no CA combination, with worst outcomes seen in the remainder sharing LM-CA (Figure 1a). In case of the LM5, LM-no CA was superior regardless of BL-CA status, while LM-CA conferred equally poor OS regardless of BL-CA status (Figure 1b). On multivariate analysis, LM5-CA retained the highest HR along with GEP-70-defined high-risk MM, BL-CA and creatinine elevation. We conclude that serial CA monitoring provides a simple cost-effective tool contributing to early detection of disease relapse often without clinical progression (data not shown) that also affords the early detection of MDS-associated CA, an increasing complication of MM therapy. Data will be presented on the detection at BL of GEP features forecasting CA development during 2 and 5 years of follow up. Disclosures: Usmani: Celgene: Consultancy, Research Funding, Speakers Bureau; Onyx: Research Funding, Speakers Bureau.

scholarly journals Occult Leydig Cell Testicular Tumour Presenting with Gynaecomastia

1989 ◽  
Vol 82 (1) ◽  
pp. 49-50 ◽  
Author(s):  
J J O'Donovan ◽  
T R Terry ◽  
G Williams
Keyword(s):  
High Resolution ◽  
Early Detection ◽  
Clinical Examination ◽  
Leydig Cell ◽  
Ultrasound Examination ◽  
Testicular Tumour ◽  
Hormonal Profile ◽  
Testicular Tumours ◽  
Leydig Cell Tumour

Certain testicular tumours may present with gynaecomastia1–3. Rarely in these cases is the testicular tumour not palpable at the initial clinical examination or at follow-up examinations. To enable early detection of these occult testicular tumours a serum hormonal profile followed by high resolution ultrasound examination of the testes are necessary3–7. We report a case of a Leydig cell tumour in which gynaecomastia antedated the clinical presence of a testicular swelling by 7 months.

Modulation of carotid strain by statin therapy in atherosclerosis patients

VASA ◽  
2017 ◽  
Vol 46 (2) ◽  
pp. 108-115 ◽  
Author(s):  
Christian Alexander Schaefer ◽  
Anna Katharina Blatzheim ◽  
Sebastian Gorgonius Passon ◽  
Kristin Solveig Pausewang ◽  
Nadjib Schahab ◽  
...  
Keyword(s):  
Statin Therapy ◽  
Pulse Wave ◽  
Ultrasound Examination ◽  
Ankle Brachial Index ◽  
Radial Strain ◽  
Strain Analysis ◽  
Duplex Ultrasound ◽  
Strain Imaging ◽  
The Common

Abstract. Background: The beneficial effect of statin therapy on the progress of atherosclerotic disease has been demonstrated by numerous studies. Vascular strain imaging is an arising method to evaluate arterial stiffness. Our study examined whether an influence of statin therapy on the vessel wall could be detected by vascular strain imaging. Patients and methods: 88 patients with recently detected atherosclerosis underwent an angiological examination including ankle-brachial index (ABI), pulse wave index (PWI), central puls ewave velocity and duplex ultrasound. Captures for vascular strain analysis were taken in B-mode during ultrasound examination of the common carotid artery and evaluated using a workstation equipped with a speckle tracking based software. A statin therapy was recommended and after six months a follow-up examination took place. Meanwhile, the non-adherence of a group of patients (N = 18) lead to a possibility to observe statin effects on the vascular strain. Results: In the statin non-adherent group the ABI decreased significantly to a still non-pathological level (1.2 ± 0.2 vs. 1.0 ± 0.2; p = 0.016) whereas it stagnated in the adherent group (1.0 ± 0.2 vs. 1.0 ± 0.2; p = 0.383). The PWI did not differ in the non-adherent group (180.5 ± 71.9 vs. 164.4 ± 75.8; p = 0.436) but under statin therapy it decreased significantly (261.8 ± 238.6 vs. 196.4 ± 137.4; p = 0.016). In comparison to the adherent group (4.2 ± 2.0 vs. 4.0 ± 1.8; p = 0.548) under statin therapy the radial strain decreased significantly in the non-adherent group (4.7 ± 2.0 vs. 3.3 ± 1.1; p = 0.014). Conclusions: Our findings reveal a beneficial influence of statin therapy on the arterial wall detected by vascular strain analysis.

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