scholarly journals Use and impact of point-of-care ultrasonography in general practice: a prospective observational study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037664
Author(s):  
Camilla Aakjær Andersen ◽  
John Brodersen ◽  
Annette Sofie Davidsen ◽  
Ole Graumann ◽  
Martin Bach B Jensen
Keyword(s):  
General Practice ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Point Of Care ◽  
Secondary Outcome ◽  
Diagnostic Process ◽  
Median Frequency ◽  
Frequency Of Use ◽  
Point Of Care Ultrasonography ◽  
The Relationship

ObjectivesTo describe how general practitioners (GPs) use point-of-care ultrasonography (POCUS) and how it influences the diagnostic process and treatment of patients.DesignProspective observational study using an online questionnaire before and after POCUS.SettingOffice-based general practice.ParticipantsTwenty GPs consecutively recruited all patients examined with POCUS in 1 month.Primary and secondary outcome measuresWe estimated the use of POCUS through the indication for use, the frequency of use, the time consumption, the extent of modification of the examination and the findings.The influence on the diagnostic process was estimated through change in the tentative diagnoses, change in confidence, the ability to produce ultrasound images and the relationship between confidence and organs scanned or tentative diagnoses.The influence of POCUS on patient treatment was estimated through change in plan for the patient, change in patient’s treatment and the relationship between such changes and certain findings.ResultsThe GPs included 574 patients in the study. POCUS was used in patient consultations with a median frequency of 8.6% (IQR: 4.9–12.6). Many different organs were scanned covering more than 100 different tentative diagnoses. The median time taken to perform POCUS was 5 min (IQR: 3–8). Across applications and GPs, POCUS entailed a change in diagnoses in 49.4% of patients; increased confidence in a diagnosis in 89.2% of patients; a change in the management plan for 50.9% of patients including an absolute reduction in intended referrals to secondary care from 49.2% to 25.6%; and a change in treatment for 26.5% of patients.ConclusionsThe clinical utilisation of POCUS was highly variable among the GPs included in this study in terms of the indication for performing POCUS, examined scanning modalities and frequency of use. Overall, using POCUS altered the GPs’ diagnostic process and clinical decision-making in nearly three out of four consultations.Trial registration numberNCT03375333.

scholarly journals Prospective, observational study comparing automated and visual point-of-care urinalysis in general practice

BMJ Open ◽  
2016 ◽  
Vol 6 (8) ◽  
pp. e011230 ◽  
Author(s):  
Sanne van Delft ◽  
Annelijn Goedhart ◽  
Mark Spigt ◽  
Bart van Pinxteren ◽  
Niek de Wit ◽  
...  
Keyword(s):  
General Practice ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Point Of Care

scholarly journals Prospective observational study of point-of-care creatinine in trauma

2016 ◽  
Vol 1 (1) ◽  
pp. e000014 ◽  
Author(s):  
Anthony J Carden ◽  
Edgardo S Salcedo ◽  
Nam K Tran ◽  
Eric Gross ◽  
Jennifer Mattice ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Point Of Care

scholarly journals A prospective observational study to analyse the relationship between fundus changes in pregnancy induced hypertension with visual impairment and its reversibility

2021 ◽  
Vol 10 (11) ◽  
pp. 4272
Author(s):  
Vinitha Dharmalingam ◽  
R. Kala
Keyword(s):  
Observational Study ◽  
Visual Impairment ◽  
Prospective Observational Study ◽  
Hypertensive Retinopathy ◽  
Pregnancy Induced Hypertension ◽  
Choroidal Ischemia ◽  
Induced Hypertension ◽  
Changes In Pregnancy ◽  
The Relationship ◽  
In Pregnancy

Background: Irreversible visual impairment and morbidity are associated with pregnancy induced hypertension. It causes pathological changes in vascularity of placenta, kidney and brain along with two major pathological types of changes in fundus namely arteriolar vasospasm and permeability changes in vascular endothelium. The aim of our study was to analyse the relationship between fundus changes in pregnancy induced hypertension with visual impairment and its reversibility.Methods: A prospective observational study done on pregnant women with any grade of pregnancy induced hypertension with recent visual impairment from 24 completed weeks of pregnancy.Results: Out of 75 patients with PIH, all the patients had varying degree of fundus changes in one or both eyes. In 150 eyes of the 75 patients, 86 (57.30%) eyes had isolated arteriolar vasospasm, 14 (9.33%) had grade III hypertensive retinopathy, 4 (2.66%) had grade IV hypertensive retinopathy, 30 (20%) had macular oedema, 4 (2.66%) had central serous chorioretinopathy, 2 (1.33%) had vascular occlusion, 2 (2.66%) eyes had normal fundus with cortical blindness, 2 (2.66%) had exudative retinal detachment, 6 (4%) eyes had normal fundus with changes in the other eye.Conclusions: Out of 75 patients, 7 (9.3%) patients had irreversible loss of vision, 3 (42.85%) due to arteriolar vasospasm, and 4 (57.15%) due to choroidal ischemia. Among the 4 patients with choroidal ischemia, 3 (75%) were in the group of eclampsia and 1 (25%) in gestational hypertension.

Transoral Dermoid Cyst Excision: A Multicenter Prospective Observational Study

2018 ◽  
Vol 159 (6) ◽  
pp. 981-986 ◽  
Author(s):  
Jin Pyeong Kim ◽  
Dong Kun Lee ◽  
Jeong Hwan Moon ◽  
Jung Je Park ◽  
Seung Hoon Woo
Keyword(s):  
Observational Study ◽  
Oral Cavity ◽  
Dermoid Cyst ◽  
Prospective Observational Study ◽  
University Hospital ◽  
Secondary Outcome ◽  
Transoral Surgery ◽  
Cyst Excision ◽  
Surgery Group ◽  
Multicenter Prospective Observational Study

Objective Transoral surgery is becoming a preferred technique because it does not leave any scar after surgery. However, transoral surgery for a dermoid cyst of the oral cavity is not standardized yet, due to the anatomic complexity of this region. The aim of this study was to evaluate the safety and efficacy of a transoral dermoid cyst excision. Study Design Multicenter prospective observational study. Setting University hospital. Subjects and Methods This study was designed as a 4-year prospective multicenter evaluation of dermoid cyst excisions within the floor of mouth. Clinical outcomes and complications related to procedures were evaluated among patients. The primary outcome was the efficacy of the procedure, and the secondary outcome was cosmetic satisfaction of each procedure. Results Twenty-one patients underwent transoral dermoid cyst excisions, and 22 underwent transcervical excisions. In the transoral surgery group, the mean size of the dermoid cyst was 5.35 cm (95% CI, 4.79-5.91), and in the transcervical surgery group, it was 6.19 cm (95% CI, 5.67-6.71). There was no significant differences with respect to overall demographic characteristics between the groups. However, the duration of the operation was shorter with the transoral group than with the transcervical group ( P = .001), and cosmetic satisfaction was much better in the transoral group ( P < .001). Conclusion Transoral dermoid cyst excision is a potentially safe and effective method that can lead to easy and quick removal of an oral cavity dermoid cyst, with excellent cosmetic outcomes.

QRS complex characteristics and patient outcomes in out-of-hospital pulseless electrical activity cardiac arrest

2020 ◽  
Vol 38 (1) ◽  
pp. 53-58
Author(s):  
Jung Ho Kim ◽  
Hyun Wook Ryoo ◽  
Jong-yeon Kim ◽  
Jae Yun Ahn ◽  
Sungbae Moon ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Electrical Activity ◽  
Hospital Discharge ◽  
Neurological Outcome ◽  
Prospective Observational Study ◽  
Pulseless Electrical Activity ◽  
Secondary Outcome ◽  
Qrs Complex ◽  
The Relationship ◽  
Hospital Cardiac Arrest

BackgroundPulseless electrical activity (PEA) is increasingly observed in out-of-hospital cardiac arrest (OHCA), but outcomes are still poor. We aimed to assess the relationship between QRS characteristics and outcomes of patients with OHCA with initial PEA (OHCA-P).MethodsThis prospective observational study included patients aged at least 18 years who developed OHCA-P between 1 January 2016 and 31 December 2018, and were enrolled in the Daegu Emergency Medical Services registry, South Korea. We performed multivariable logistic regression analyses to identify the associations between QRS characteristics and OHCA-P outcomes, in which QRS complexes were considered separately (model 1) and simultaneously (model 2). The primary outcome was survival to hospital discharge and the secondary outcome was a favourable neurological outcome.ResultsOf the 3659 patients with OHCA, 576 were enrolled (median age 73 years; 334 men). A higher QRS amplitude was associated with survival to hospital discharge and a favourable neurological outcome in model 1 (adjusted OR (aOR) 1.077 and 1.106, respectively; 95% CI 1.021 to 0.136 and 1.029 to 1.190, respectively) and model 2 (aOR 1.084 and 1.123, respectively; 95% CI 1.026 to 1.145 and 1.036 to 1.216, respectively). A QRS width of <120 ms was associated with survival to hospital discharge and a favourable neurological outcome in model 1 (aOR 3.371 and 4.634, respectively; 95% CI 1.633 to 6.960 and 1.562 to 13.144, respectively) and model 2 (aOR 3.213 and 5.103, respectively; 95% CI 1.568 to 6.584 and 1.682 to 15.482, respectively). Survival to hospital discharge and neurological outcome were not associated with QRS frequency.ConclusionOHCA-P outcomes were better when the initial QRS complex showed a higher amplitude or narrower width.

scholarly journals Can point-of-care ultrasound predict spinal hypotension during caesarean section? A prospective observational study

Anaesthesia ◽  
2017 ◽  
Vol 73 (1) ◽  
pp. 15-22 ◽  
Author(s):  
L. Zieleskiewicz ◽  
A. Noel ◽  
G. Duclos ◽  
M. Haddam ◽  
A. Delmas ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Spinal Hypotension
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