Focused Intensive Care Ultrasound

2019 ◽  
Keyword(s):  
Distress Syndrome ◽  
Percutaneous Tracheostomy ◽  
Vascular Anatomy ◽  
Invasive Procedures ◽  
Advanced Level ◽  
Clinical Presentations ◽  
Ultrasound Assessment ◽  
Machine Setting ◽  
Algorithmic Approaches ◽  
Effective Service

This book is written for clinicians who are new to ultrasound and those who want to progress further from the basics to more advanced-level scanning. Consequently, it covers a broad range of subjects, and its text is divided into five sections. Section 1 is imaging-based. Chapters in Section 1, such as physics, machine setting, and sonoanatomy, provide the foundation that underpins the rest of the book. Section 2 is structure-based. Chapters in Section 2 cover cardiac, lung, abdominal, and vascular anatomy and enable the reader to start scanning in these areas. Section 3 is problem-based. Chapters in Section 3 cover the major differential diagnoses and algorithmic approaches to ultrasound assessment of the most common clinical presentations, including shock, dyspnoea, trauma, cardiac arrest, sepsis, acute respiratory distress syndrome, and many more. Section 4 is procedure-based. Chapters in Section 4, such as thoracocentesis, lumbar puncture, and percutaneous tracheostomy, cover the technical and non-technical aspects of invasive procedures performed in critically ill patients. Section 5 is governance-based and covers how to deliver a safe and effective service.

scholarly journals Physical Examination and Ultrasound Evaluation of Patients with Superficial Venous Disease

2021 ◽  
Vol 38 (02) ◽  
pp. 167-175
Author(s):  
Leigh C. Casadaban ◽  
John M. Moriarty ◽  
Cheryl H. Hoffman
Keyword(s):  
Physical Examination ◽  
Venous Insufficiency ◽  
Duplex Ultrasonography ◽  
Venous Disease ◽  
Venous Anatomy ◽  
Ultrasound Evaluation ◽  
Clinical Presentations ◽  
Ultrasound Assessment ◽  
Anatomic Variants ◽  
Tools And Techniques

AbstractSystematic and standardized evaluation of superficial venous disease, guided by knowledge of the various clinical presentations, venous anatomy, and pathophysiology of reflux, is essential for appropriate diagnosis and optimal treatment. Duplex ultrasonography is the standard for delineating venous anatomy, detecting anatomic variants, and identifying the origin of venous insufficiency. This article reviews tools and techniques essential for physical examination and ultrasound assessment of patients with superficial venous disease.

scholarly journals Translational Research in Intensive Care Unit: Novel Approaches for Drug Development and Personalized Medicine

2019 ◽  
Vol 40 (05) ◽  
pp. 687-698
Author(s):  
Romit J. Samanta ◽  
Charlotte Summers
Keyword(s):  
Distress Syndrome ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Clinical Syndromes ◽  
Clinical Presentations ◽  
Novel Approaches ◽  
And Personalized Medicine ◽  
Insight Into ◽  
Made In

AbstractThe major clinical presentations seen by critical care physicians are sepsis and acute respiratory distress syndrome (ARDS), both of which are heterogeneous clinical syndromes rather than specific diagnoses. The current diagnostic criteria provide little insight into the mechanisms underlying these heterogeneous syndromes and minimal progress has been made with regard to the development of therapies, despite many large randomized controlled trials being undertaken. This review outlines the advances made in improved characterization of critically-ill patients, using ARDS as an exemplar, and highlights the need for this improved patient characterization to be coupled with mechanistic science to develop therapies that target specific pathomechanisms.

scholarly journals Chronic endometritis. Towards the improvement of diagnostic methods

2021 ◽  
Vol 4 (3) ◽  
pp. 243-249
Author(s):  
A.M. Shamilova ◽  
◽  
I.Yu. Il’ina ◽  
E.I. Borovkova ◽  
Yu.E. Dobrokhotova ◽  
...  
Keyword(s):  
Reproductive Potential ◽  
Diagnostic Techniques ◽  
Endometrial Receptivity ◽  
Diagnostic Methods ◽  
Chronic Endometritis ◽  
Promising Tool ◽  
Clinical Presentations ◽  
Autoimmune Processes ◽  
Ultrasound Assessment ◽  
Diagnostic Hysteroscopy

This paper reviews an important issue that significantly affects female fertility, chronic endometritis. This condition is characterized by clinical presentations of various severity and abnormalities of endometrial morphology. The rate of chronic endometritis varies greatly, mainly due to predominantly asymptomatic course and imperfect diagnostics. Pathogenic mechanisms of endometrial inflammation and different views on its effects on female reproductive potential are addressed. Further search for endometrial receptivity markers is needed as these markers will allow for assessing the severity of endometrial damage to develop the algorithm of preconception care. The authors focus on diagnostic techniques for chronic endometritis and their value. Immunohistochemistry of endometrium is a promising tool to be applied to diagnose endometrial inflammation and monitor treatment efficacy. A complex diagnostic approach to chronic endometritis that includes pelvic ultrasound, Doppler ultrasound, assessment of endometrial microbiota, diagnostic hysteroscopy and endometrial histopathology, and evaluation of endometrial receptivity is useful. KEYWORDS: chronic endometritis, termination of pregnancy, infertility, autoimmune processes, chronic inflammation, endometrial structure, immunohistochemistry. FOR CITATION: Shamilova A.M., Il’ina I.Yu., Borovkova E.I., Dobrokhotova Yu.E. Chronic endometritis. Towards the improvement of diagnostic methods. Russian Journal of Woman and Child Health. 2021;4(3):243–249 (in Russ.). DOI: 10.32364/2618-8430-2021-4-3-243-249.

scholarly journals Grade 4 Pneumonitis in a Patient Treated with a Combination of Gemcitabine and Docetaxel for Recurrent Leiomyosarcoma of the Uterus

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Connor Wang ◽  
Stephen Rose ◽  
Lori Mankowski Gettle ◽  
Ryan Spencer
Keyword(s):  
Distress Syndrome ◽  
Early Recognition ◽  
Standard Of Care ◽  
Diffuse Alveolar Hemorrhage ◽  
Uterine Leiomyosarcoma ◽  
Early Administration ◽  
Radiographic Findings ◽  
Clinical Presentations ◽  
Life Threatening ◽  
Treatment Responses

Gemcitabine and docetaxel combination chemotherapy is the standard of care for patients with unresectable recurrent or metastatic leiomyosarcoma of the uterus. Although they are generally well-tolerated agents, they can also cause severe and life-threatening pulmonary toxicities. Here, we describe a case of grade 4 pneumonitis due to gemcitabine and docetaxel in a 74-year-old woman with recurrent, metastatic uterine leiomyosarcoma. Despite early recognition of chemotherapy-induced lung injury and early administration of corticosteroid, she developed noncardiogenic pulmonary edema, diffuse alveolar hemorrhage, and acute respiratory distress syndrome. She required multiple intubations and a tracheostomy. Physicians should not only be aware of gemcitabine and docetaxel’s potential to cause life-threatening pulmonary injuries but also recognize the variability in clinical presentations and treatment responses, the radiographic findings of these lung toxicities, and the need for early corticosteroid therapy in these cases.

scholarly journals Delay in Diagnosis of Influenza Virus in an Elderly Hospitalized Patient: A Fatal Outcome

2012 ◽  
Vol 5 ◽  
pp. CCRep.S8460 ◽  
Author(s):  
Nicole Haber ◽  
Djamal Khelili ◽  
Delphine Martineau ◽  
Siham Dekimeche ◽  
Carol Szekely ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Older Persons ◽  
Distress Syndrome ◽  
Influenza Season ◽  
Fluorescent Antibody ◽  
Fatal Outcome ◽  
Delay In Diagnosis ◽  
Clinical Presentations ◽  
Direct Fluorescent Antibody ◽  
History Of

Influenza is a well established cause of seasonal hospitalizations and deaths among older persons. However, influenza is frequently underdiagnosed by physicians, because its clinical presentations are often complex, particularly in elderly patients. We report the case of a 78-year-old woman admitted to the emergency department in January 2008 with fever, vomiting, and a history of asthenia and falls in the preceding three days. Diagnosis of influenza at admission was missed. Influenza was diagnosed by direct fluorescent antibody in a sputum specimen four days later, but the evolution was rapidly unfavorable with fatal respiratory distress syndrome. This case illustrates that, during the influenza season, influenza should be suspected in elderly patients admitted to hospital even if they do not present with classical symptoms. Immunofluorescence testing on sputum specimens can provide a rapid diagnosis and merits further evaluation.

Orthogonal Interlocking Tandem Clipping Technique for the Reconstruction of Complex Middle Cerebral Artery Aneurysms

2006 ◽  
Vol 59 (suppl_4) ◽  
pp. ONS-347-ONS-352 ◽  
Author(s):  
Richard E. Clatterbuck ◽  
Robert M. Galler ◽  
Rafael J. Tamargo ◽  
David J. Chalif
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Vascular Anatomy ◽  
Line Of Sight ◽  
Aneurysm Clip ◽  
Neurological Outcomes ◽  
Complex Aneurysms ◽  
Clinical Presentations ◽  
Clipping Technique ◽  
Middle Cerebral Artery Aneurysms

Abstract OBJECTIVE: Complex aneurysms arising at the middle cerebral artery (MCA) bifurcation frequently present a microsurgical challenge to effectively obliterate while maintaining patency of the distal MCA branches. These aneurysms are often multilobed, with their long axis aligned with the long axis of the M1 trunk, placing the dome of the aneurysm in the surgeons' line of sight, preventing an unobstructed view of the entire bifurcation and proximal M1 segment. MCA aneurysms often have a broad neck, splaying the bifurcation. An orthogonal interlocking tandem clipping technique, maximizing the use of fenestrated aneurysm clips, is presented as a means to completely obliterate the aneurysm and simultaneously “reconstruct” the MCA bifurcation. CLINICAL PRESENTATIONS AND INTERVENTION: Fifteen complex MCA aneurysms were treated using an interlocking tandem clipping technique. In its simplest application, the blades of the initial aneurysm clip are incorporated into the fenestration of the second clip. Obliteration of the residual aneurysm is achieved with the blades of the second, fenestrated clip. RESULTS: Satisfactory aneurysm obliteration and reconstruction of the MCA bifurcation was achieved in all cases using this technique, with excellent neurological outcomes. CONCLUSION: Morphologically complex multilobed MCA aneurysms can be effectively clipped with “reconstruction” of the normal vascular anatomy using a tandem interlocking clipping technique. A fenestrated clip is used to incorporate the blades of the initial clip, while obliterating the remainder of the aneurysm.

Acute respiratory distress syndrome

2019 ◽  
pp. 225-234
Author(s):  
Kelly Victor ◽  
Justin Kirk-Bayley ◽  
Nicholas Ioannou
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Systolic Function ◽  
Systolic Pressure ◽  
Cor Pulmonale ◽  
Volume Assessment ◽  
Ultrasound Assessment ◽  
Pulmonary Arterial

This chapter will review the targets for ultrasound assessment, including biventricular function, extravascular water, and systemic volume assessment. Importantly, it will discuss how to differentiate cardiogenic from non-cardiogenic pulmonary oedema, how to recognize acute cor pulmonale, and when to look for a patent foramen ovale. The advanced section will introduce Doppler-based methods to evaluate right ventricular systolic function and pulmonary arterial systolic pressure, which can both become compromised in acute respiratory distress syndrome.

scholarly journals Transient ST Segment Elevation in a Patient with COVID-19 and a Normal Transthoracic Echocardiogram

2020 ◽  
Author(s):  
Tareq Tuaima ◽  
Abdulhalim Jamal Kinsara ◽  
Amtalkaliq Alrajawi ◽  
Hassan Allam ◽  
Shadwan Alfakih
Keyword(s):  
Distress Syndrome ◽  
Interesting Case ◽  
Preserved Ejection Fraction ◽  
Invasive Procedures ◽  
Careful Evaluation ◽  
Severe Respiratory Distress ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Severe Respiratory Distress Syndrome

The effect of COVID-19 on the cardiovascular system still needs to be clarified. Patients can develop a spectrum of cardiac diseases, from mild myocarditis to acute coronary syndrome with an impaired systolic fraction. We describe an interesting case of transient ST segment elevation in a COVID-19 patient admitted to ICU for severe respiratory distress syndrome. During his stay in ICU, the patient developed transient ST segment elevation in inferior-lateral leads which promptly resolved without requiring any additional invasive and/or pharmacological treatment. Transthoracic echocardiography showed a preserved ejection fraction without any regional abnormalities and the rise in enzyme biomarkers was insignificant. The case highlights the importance of avoiding invasive procedures in this subset of patients to reduce both patient complications and medical staff exposure. Careful evaluation including echocardiogram and second-line examinations should be performed before invasive and aggressive treatment is undertaken.

Sign in / Sign up

Export Citation Format

Share Document