scholarly journals Elastofibroma Dorsi: Case Report with Point of Care Ultrasound Primary Care Applications

POCUS Journal ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 60-63
Author(s):  
Trent Mazer ◽  
Karam Nabeel Gagi ◽  
Michael Bishop
Keyword(s):  
Primary Care ◽  
Soft Tissue Tumor ◽  
Point Of Care ◽  
Treatment Options ◽  
Care Physician ◽  
Point Of Care Ultrasound ◽  
Elastofibroma Dorsi ◽  
Unclear Etiology ◽  
Slow Growing ◽  
Review Current

Elastofibroma dorsi (ED) is an uncommon, benign, slow-growing soft tissue tumor with an unclear etiology. The growth often presents as a local deformity with mild pain or discomfort in the subscapular region of geriatric populations. The following paper discusses a 73 year old female with mildly painful ED who presented to her primary care physician. We further review current literature on epidemiology, utilization of point of care ultrasound (POCUS) and treatment options.

scholarly journals Moving the needle towards the democratization of echocardiography: a case report

2019 ◽  
Author(s):  
Jonathan dos Santos ◽  
Patrícia Borges Fernandes ◽  
Francisco Rocha Gonçalves ◽  
Alexandra Gonçalves
Keyword(s):  
Primary Care ◽  
Physical Examination ◽  
Primary Care Physician ◽  
Primary Care Physicians ◽  
Point Of Care ◽  
Family Doctor ◽  
Vena Cava ◽  
Left Ventricular ◽  
Care Physician ◽  
Point Of Care Ultrasound

Abstract Background Echocardiography has been traditionally performed in echo labs and the potential benefits of its use by primary care physicians (PCPs) are still unexplored. We present a case where POCUS (point-of-care ultrasound) was used as a complement of physical examination by a family doctor, allowing a prompt clinical decision in a heart failure (HF) patient. Case summary An 85-year-old woman, living independently, asks her family doctor for a home consultation due to increasing dyspnoea. On examination, severe dyspnoea and bilateral ankle oedema was noted and a point-of-care echocardiogram was performed by the primary care physician, who observed: severely compromised left ventricular systolic function, moderate mitral and tricuspid regurgitation, and severe dilation of the inferior vena cava. As a result, the diagnosis of HF with decreased ejection fraction was formed supporting the therapeutic decision. Discussion This case represents an elderly patient with dyspnoea, without previous HF diagnosis. The primary care physician, used portable ultrasound as a complement of physical examination, which confirmed a HF diagnosis, allowing a prompt decision-making on therapy. POCUS, can be a powerful tool to expedite treatment in different settings, including the home consultations by PCPs.

scholarly journals Cardio-Pulmonary Sequelae in Recovered COVID-19 Patients: Considerations for Primary Care

2021 ◽  
Vol 12 ◽  
pp. 215013272110237
Author(s):  
Zouina Sarfraz ◽  
Azza Sarfraz ◽  
Alanna Barrios ◽  
Radhika Garimella ◽  
Asimina Dominari ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Infection ◽  
Clinical Laboratory ◽  
Point Of Care ◽  
Case Reports ◽  
Case Series ◽  
Infectious Complications ◽  
Care Physician ◽  
Cross Sectional ◽  
Infection Period

Background: Current literature lacks characterization of the post-recovery sequelae among COVID-19 patients. This review characterizes the course of clinical, laboratory, radiological findings during the primary infection period, and the complications post-recovery. Primary care findings are presented for long-COVID care. Methods: Adhering to PRISMA guidelines, 4 databases were searched (PubMed, Embase, CINAHL Plus, Scopus) through December 5, 2020, using the keywords “COVID-19 and/or recovered and/or cardiovascular and/or long-term and/or sequelae and/or sub-acute and/or complication.” We included published peer-reviewed case reports, case series, and cross-sectional studies providing the clinical course of COVID-19 infection, and cardiopulmonary complications of patients who recovered from COVID-19, while making healthcare considerations for primary care workers. Results: We identified 29 studies across 9 countries including 37.9% Chinese and 24.1% U.S. studies, comprising 655 patients (Mean Age = 45) with various ethnical backgrounds including Asian and European. Based on the WHO COVID-19 severity classification scale, initial disease severity was mild for 377 patients and severe for 52 patients. Treatments during primary infection included corticosteroids, oxygen support, and antivirals. The mean value (in days) for complication onset after acute recovery was 28 days. Complete blood counts and RT-PCR tests were the most common laboratory results described. In 22 of the studies, patients showed signs of clinical improvement and were prescribed medications such as anticoagulants or corticosteroids. Conclusion: Post-recovery infectious complications are common in long-COVID-19 patients ranging from mild infections to life-threatening conditions. International thoracic and cardiovascular societies need to develop guidelines for patients recovering from COVID-19 pneumonia, while focused patient care by the primary care physician is crucial to curb preventable adverse events. Recommendations for real-time and lab-quality diagnostic tests are warranted to establish point-of-care testing, detect early complications, and provide timely treatment.

scholarly journals It Is Always Early with Point-of-Care Ultrasound

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Zouheir Ibrahim Bitar ◽  
Tamer Mohamed Zaalouk ◽  
Ossama Sajeh Maadarani ◽  
Ragab Desouky Elshabasy
Keyword(s):  
Point Of Care ◽  
Care Physician ◽  
Point Of Care Ultrasound ◽  
Resonance Imaging ◽  
Critical Care Physician ◽  
Unstable Condition ◽  
Abdominal Magnetic Resonance Imaging ◽  
Source Of Infection ◽  
Time To Diagnosis ◽  
Tentative Diagnosis

A 56-year-old male was admitted to the emergency department for acute pulmonary edema and septic shock, yet no clear source of infection was noted upon physical examination. Due to his unstable condition, bedside ultrasound was performed. A heterogeneous mass in the liver was noted; hence, a tentative diagnosis of liver abscess was made. The abscess was confirmed by abdominal magnetic resonance imaging. Drainage of the abscess was attempted and guided by early ultrasound. This case highlights that point-of-care ultrasound, when performed by an ultrasound-capable critical care physician, can significantly decrease the time to diagnosis for septic patients.

scholarly journals Images in Primary Care Medicine: Point-of-Care Ultrasound in Gout

Cureus ◽  
2021 ◽  
Author(s):  
Dennis Espejo ◽  
Elizabeth Dearing ◽  
Kathleen Y Ogle ◽  
Maria Portela ◽  
Keith S Boniface
Keyword(s):  
Primary Care ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Primary Care Medicine

A Late-Career Internist and Point-of-Care-Ultrasound in a Primary Care Clinic

2018 ◽  
Vol 111 (7) ◽  
pp. 418-420 ◽  
Author(s):  
Terry K. Rosborough ◽  
David M. Tierney
Keyword(s):  
Primary Care ◽  
Point Of Care ◽  
Primary Care Clinic ◽  
Point Of Care Ultrasound ◽  
Care Clinic

scholarly journals Painful Elastofibroma Dorsi: A Report of a Case and a Brief Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Evangelos Falidas ◽  
Dimitrios Arvanitis ◽  
Georgios Anyfantakis ◽  
Angelos Pazidis ◽  
Zacharoula Koukouli ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Elderly People ◽  
Clinical Features ◽  
Soft Tissue Tumor ◽  
Review Of The Literature ◽  
Tissue Tumor ◽  
Elastofibroma Dorsi ◽  
Pathologic Findings ◽  
Benign Soft Tissue Tumor ◽  
Slow Growing

Elastofibroma dorsi (ED) is an uncommon, slow-growing, benign, soft tissue tumor of unclear pathogenesis, typically located at the subscapular region of elderly people. It may be unilateral or bilateral. Though many patients are asymptomatic, ED can cause local deformity and symptoms such as periscapular pain or discomfort. Herein we report a case of a 65-year-old woman with painful ED. Clinical features, radiodiagnostic, intraoperative, and pathologic findings, and a brief review of the literature are performed.

scholarly journals Environmental and Patient Impact of Applying a Point-of-Care Ultrasound Model in Primary Care: Rural vs. Urban Centres

2020 ◽  
Vol 17 (9) ◽  
pp. 3333
Author(s):  
Francesc X Marín-Gomez ◽  
Jacobo Mendioroz Peña ◽  
Vicenç Canal Casals ◽  
Marcos Romero Mendez ◽  
Ana Darnés Surroca ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Primary Care ◽  
Air Pollution ◽  
Air Pollutants ◽  
Point Of Care ◽  
Motor Vehicles ◽  
Point Of Care Ultrasound ◽  
Major Contributor ◽  
Specialized Service ◽  
The Impact

Motor vehicles are a major contributor to air pollution, and the exposure to this human-caused air pollution can lead to harmful health effects. This study evaluates the impact of the provision of point-of-care ultrasounds (POCUS) by primary care (PC) to avoid the patient’s need to travel to a specialized service. The study estimates the costs and air pollution avoided during 2019. The results confirm that performing this ultrasound at the point of care reduces the emission of 61.4 gr of carbon monoxide, 14.8 gr of nitric oxide and 2.7 gr of sulfur dioxide on each trip. During the study, an average of 17.8 km, 21.4 min per trip and almost 2000 L of fuel consumed in a year were avoided. Performing POCUS from PC reduces fuel consumption and the emission of air pollutants and also saves time and money. Furthermore, only 0.3% of the scans had to be repeated by radiologists. However, more studies with more participants need to be done to calculate the exact impact that these pollution reductions will have on human health.

scholarly journals Adoptability and Accuracy of Point-of-Care Ultrasound in Screening for Valvular Heart Disease in the Primary Care setting

2021 ◽  
Author(s):  
Yashasvi Chugh ◽  
Opema Lohese ◽  
Paul Sorajja ◽  
Ross Garberich ◽  
Lariss Stanberry ◽  
...  
Keyword(s):  
Primary Care ◽  
Heart Disease ◽  
Valvular Heart Disease ◽  
Care Setting ◽  
Primary Care Setting ◽  
Point Of Care ◽  
Primary Care Providers ◽  
Left Ventricular ◽  
Point Of Care Ultrasound ◽  
Care Providers

Background: Despite continued efforts, the majority of patients with valvular heart disease (VHD) remain undiagnosed and untreated. This study aimed to assess the adoptability and accuracy of point-of-care handheld echocardiographic assessments (POCE) in the primary care setting. Methods: Eleven previously untrained primary care providers were trained to use the Vscan Extend (GE, WI) POCE to assess VHD, left ventricular function (LVEF), and major extra-cardiac findings. Their assessments were compared to those of 3 blinded expert readers. A total of 180 assessments were evaluated using Kappa statistics (κ) together with their estimated standard error, p-value, and 95% CI bounds. Results: Identical or nearly identical agreement between previously untrained primary providers and expert readers was evident for the diagnosis of tricuspid regurgitation, mitral regurgitation, pericardial effusion, volume status. These agreements were strongest in apical long axis (κ =1, p<0.001) and parasternal long and short axis views (k>=0.82 p<0.001), though agreement remained robust in apical 4-chamber views (k>=0.76). The agreements in LVEF assessment were identical in the apical long axis view (κ =1, p<0.001) and robust in the remaining 3 views (κ>=0.66, p<0.001). The assessments of aortic stenosis (parasternal/long, κ =0.42, and parasternal/short, κ =0.47, both p<0.001) were weak in their agreement. Conclusion: Compared to expert echocardiography readers, the untrained providers’ use of POCE for VHD shows high user adoptability and diagnostic accuracies in the primary care setting.

scholarly journals Patient Perceptions About Prediabetes and Preferences for Diabetes Prevention

2016 ◽  
Vol 42 (6) ◽  
pp. 667-677 ◽  
Author(s):  
Matthew J. O’Brien ◽  
Margaret R. Moran ◽  
Joyce W. Tang ◽  
Maria C. Vargas ◽  
Mary Talen ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Lifestyle Intervention ◽  
Treatment Options ◽  
Care Physician ◽  
Specific Information ◽  
Evidence Based ◽  
Patient Centered ◽  
Evidence Based Treatment ◽  
Intensive Lifestyle Intervention

Purpose The purpose of this study was to explore how adults with prediabetes perceive their risk of developing diabetes and examine their preferences for evidence-based treatment options to prevent diabetes. Methods A qualitative study was conducted in 2 large Midwest primary care practices, involving in-depth semistructured interviews with 35 adult patients with prediabetes. Results This ethnically diverse (77% nonwhite) sample of middle-aged primary care patients exhibited multiple diabetes risk factors. Knowledge gaps about prediabetes and its medical management were pervasive. Most patients overestimated the risk of developing diabetes and were not familiar with evidence-based treatment options for prediabetes. They suggested that receiving brief, yet specific information about these topics during the study interview motivated them to act. The majority of participants considered both intensive lifestyle intervention and metformin acceptable treatment options. Many preferred initial treatment with intensive lifestyle intervention but would take metformin if their efforts at lifestyle change failed and their primary care physician recommended it. Some participants expressed wanting to combine both treatments. Conclusions This qualitative study highlights potential opportunities to promote patient-centered dialogue about prediabetes in primary care settings. Providing patients specific information about the risk of developing diabetes and evidence-based treatment options to prevent or delay its onset may encourage action. Physicians’ prediabetes counseling efforts should be informed by the finding that most patients consider both intensive lifestyle intervention and metformin acceptable treatment options.

scholarly journals ADOPTABILITY AND ACCURACY OF POINT-OF-CARE ULTRASOUND IN SCREENING FOR VALVULAR HEART DISEASE IN THE PRIMARY CARE SETTING

2021 ◽  
Vol 77 (18) ◽  
pp. 1711
Author(s):  
Opema Lohese ◽  
Ross Garberich ◽  
Larissa Stanberry ◽  
Paul Sorajja ◽  
Joao Cavalcante ◽  
...  
Keyword(s):  
Primary Care ◽  
Heart Disease ◽  
Valvular Heart Disease ◽  
Care Setting ◽  
Primary Care Setting ◽  
Point Of Care ◽  
Point Of Care Ultrasound
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