Portable Ultrasonography to Assess Adult Hepatosteatosis in Rural Ecuador

2020 ◽  
Vol 120 (9) ◽  
pp. 553
Author(s):  
Boris Joutovsky ◽  
Alexander Ortiz ◽  
Camille Bentley ◽  
Jing Gao
Keyword(s):  
Portable Ultrasonography

Portable Ultrasonography Onboard Deployment in the PLA(N) Peace Ark Hospital Ship in Mission Harmony 2018

2021 ◽  
pp. 1-5
Author(s):  
Jiaqi Zhao ◽  
Yi Zhou ◽  
Jiafeng Wang ◽  
Chong Zhang ◽  
Zhuhong Cai
Keyword(s):  
Medical Service ◽  
Humanitarian Assistance ◽  
South American ◽  
Pacific Island ◽  
Medical Support ◽  
Medical Assistance ◽  
The Future ◽  
Examination Methods ◽  
Medical Teams ◽  
Portable Ultrasonography

Abstract From June 28 to November 22, 2018, the Chinese People’s Liberation Army Navy – PLA(N) – Peace Ark hospital ship had conducted Mission Harmony 2018, providing humanitarian medical assistance and carrying out international cooperation, in 4 Pacific island countries and 6 Central and South American countries. Compared with its application only in onshore outreach medical teams in the previous Mission Harmony, portable ultrasonography was used both onboard and onshore in Mission Harmony 2018. The purpose of this study was to assess the performance of onboard portable ultrasonography in PLA(N) Peace Ark hospital ship during Mission Harmony-2018, share our onboard working experience, and provide a reference for humanitarian assistance missions in the future. A retrospective review was performed on a cohort of patients checked by onboard portable ultrasonography. Patients’ gender, age, the distribution of examined organs, and multiple applications of the portable ultrasonography were analyzed. Some limitations of portable ultrasonography on the mission and possible improvements in the future were also discussed. A total of 5277 cases (mean age: 43.74 years; range: 2 months–105 years) of ultrasound examinations were performed during the mission; among them, 3126 (59.2%) cases were performed by portable ultrasonography, including 3024 onboard cases and 102 onshore cases. The portable ultrasonography had been applied in many scenarios, for example, onboard emergency triage process, onboard bedside medical support, and onshore outreach medical service, which had become one of the indispensable auxiliary examination methods for its compatibility, portability, and flexibility. The onboard deployment of portable ultrasonography played a versatile and irreplaceable role in the humanitarian medical assistance and medical cooperation carried out by the PLA(N) Peace Ark hospital ship, and will contribute to such kind of missions in the future.

scholarly journals Surgeon-operated ultrasonography in a one-stop shoulder clinic

2011 ◽  
Vol 93 (7) ◽  
pp. 528-531 ◽  
Author(s):  
R Seagger ◽  
T Bunker ◽  
P Hamer
Keyword(s):  
Rotator Cuff ◽  
Surgical Repair ◽  
Rotator Cuff Tears ◽  
Financial Cost ◽  
Time Saving ◽  
One Stop ◽  
Group A ◽  
Group B ◽  
Portable Ultrasonography

INTRODUCTION Nearly 1 in 40 of the population seeks medical advice related to a shoulder problem every year. The majority pertain to rotator cuff pathology. Prior to intervention in such patients it is imperative to define whether the tendons are intact or torn. Ultrasonography has become an essential adjunct to clinical assessment in diagnosing rotator cuff tears. This study was designed to investigate if a surgeon using a portable ultrasonography machine in a one-stop shoulder clinic could significantly reduce the time a patient waited from initial outpatient presentation to the end of the treatment episode (be it surgery, injection or conservative management). METHODS A total of 77 patients were allocated to one of two groups: Group A, consisting of 37 patients who were assessed and had ultrasonography as outpatients, and Group B, consisting of 40 patients who were assessed and referred for departmental ultrasonography where appropriate. Three clear outcome groups were defined: those who required surgical repair, those who had irreparable tears and those who declined surgery. RESULTS For all outcomes (surgery, irreparable tears and conservative treatment), the patients in Group A all completed their clinical episodes significantly quicker than those in Group B (p<0.02). As well as the time saving benefits, there was a substantial financial saving for Group A. By performing ultrasonography in the outpatients department, those patients avoided the requirement of departmental imaging (£120) and subsequent follow-up appointments (£73) to discuss results and management, resulting in a saving of nearly £200 per patient. CONCLUSIONS The use of a portable ultrasonography machine by an orthopaedic surgeon can significantly reduce the time to treatment and the financial cost for patients with rotator cuff tears.

scholarly journals A physician-led medical emergency team increases the rate of medical interventions: A multicenter study in Korea

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258221
Author(s):  
Su Yeon Lee ◽  
Jee Hwan Ahn ◽  
Byung Ju Kang ◽  
Kyeongman Jeon ◽  
Sang-Min Lee ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Medical Emergency Team ◽  
Rapid Response ◽  
Medical Emergency ◽  
Arterial Line ◽  
Screening System ◽  
Emergency Team ◽  
Line Insertion ◽  
Icu Transfer ◽  
Portable Ultrasonography

Background According to the rapid response system’s team composition, responding teams were named as rapid response team (RRT), medical emergency team (MET), and critical care outreach. A RRT is often a nurse-led team, whereas a MET is a physician-led team that mainly plays the role of an efferent limb. As few multicenter studies have focused on physician-led METs, we comprehensively analyzed cases for which physician-led METs were activated. Methods We retrospectively analyzed cases for which METs were activated. The study population consisted of subjects over 18 years of age who were admitted in the general ward from January 2016 to December 2017 in 9 tertiary teaching hospitals in Korea. The data on subjects’ characteristics, activation causes, activation methods, performed interventions, in-hospital mortality, and intensive care unit (ICU) transfer after MET activation were collected and analyzed. Results In this study, 12,767 cases were analyzed, excluding those without in-hospital mortality data. The subjects’ median age was 67 years, and 70.4% of them were admitted to the medical department. The most common cause of MET activation was respiratory distress (35.1%), followed by shock (11.8%), and the most common underlying disease was solid cancer (39%). In 7,561 subjects (59.2%), the MET was activated using the screening system. The commonly performed procedures were arterial line insertion (17.9%), intubation (13.3%), and portable ultrasonography (13.0%). Subsequently, 29.4% of the subjects were transferred to the ICU, and 27.2% died during hospitalization. Conclusions This physician-led MET cohort showed relatively high rates of intervention, including arterial line insertion and portable ultrasonography, and low ICU transfer rates. We presume that MET detects deteriorating patients earlier using a screening system and begins ICU-level management at the patient’s bedside without delay, eventually preventing the patient’s condition from worsening and transfer to the ICU.

scholarly journals Usefulness of portable ultrasonography for Neurosurgical treatment Technical note

Neurosonology ◽  
2010 ◽  
Vol 23 (2-3) ◽  
pp. 112-115
Author(s):  
Kentaro HAYASHI ◽  
Takayuki MATSUO ◽  
Nobutaka HORIE ◽  
Kazuhiko SUYAMA ◽  
Izumi NAGATA
Keyword(s):  
Technical Note ◽  
Neurosurgical Treatment ◽  
Portable Ultrasonography

Diagnostic accuracy of point-of-care knee ultrasound for evaluation of meniscus and collateral ligaments pathology in comparison with MRI

2021 ◽  
pp. 028418512110582
Author(s):  
Ahmed Elshimy ◽  
Ahmed M Osman ◽  
Mohamed El Sayed Awad ◽  
Mohamed M Abdel Aziz
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Point Of Care ◽  
Operative Procedure ◽  
Point Of Care Ultrasound ◽  
Collateral Ligaments ◽  
Collateral Ligament ◽  
Diagnostic Modality ◽  
Cross Sectional ◽  
Portable Ultrasonography

Background Although magnetic resonance imaging (MRI) is often the “gold standard” for diagnosing knee problems, it has many limitations. Therefore, ultrasonography has been suggested as an effective rapid alternative in many knee abnormalities, especially after injuries of the meniscus and collateral ligaments. Purpose To determine the diagnostic accuracy of point-of-care ultrasound (POCUS) in detecting injuries of the meniscus and collateral ligament compared to MRI. Material and Methods An observational cross-sectional blinded study was conducted of 60 patients with clinically suspicious meniscus and collateral ligament injuries who were planned for an arthroscopy and or operative procedure. These patients underwent both blinded POCUS and MRI of the knees before the intervention procedure and results of both imaging modalities were compared according to the operative and arthroscopic findings. Results The preoperative reliability of POCUS compared to MRI for the assessment of meniscus injuries was sensitivity (92.9% vs. 90.5%), specificity (88.9% vs. 83.3%), positive predictive value (PPV; 95.1% vs. 92.7%), negative predictive value (NPV; 84.2% vs. 79%), and overall accuracy (91.7% vs. 88.3%). However, for diagnosing collateral ligament injures, POCUS versus MRI assessed sensitivity (92.3% vs. 88.5%), specificity (100% vs. 97.1%), PPV (100% vs. 95.8%), NPV (94.4% vs. 91.7%), and overall accuracy (96.7% vs. 93.3%). Conclusion Ultrasonography is a useful screening tool for the initial diagnosis of meniscal and collateral ligament pathology compared to or even with potential advantages over MRI, especially when MRI is unavailable or contraindicated. As newly advanced portable ultrasonography becomes available, it could be considered as a point-of-injury diagnostic modality.

Use of portable ultrasonography for the diagnosis of lateral ankle instability

2022 ◽  
Author(s):  
Jirawat Saengsin ◽  
Rohan Bhimani ◽  
Go Sato ◽  
Noortje Hagemeijer ◽  
Karina Mirochnik ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Lateral Ankle ◽  
Lateral Ankle Instability ◽  
Portable Ultrasonography

442 ULTRASONOGRAPHIC TESTICULAR ECHOTEXTURE IN NELORE BULLS

2010 ◽  
Vol 22 (1) ◽  
pp. 378
Author(s):  
D. S. Costa ◽  
F. J. C. Faria ◽  
J. C. Borges
Keyword(s):  
Tunica Albuginea ◽  
Specific Area ◽  
Mato Grosso ◽  
Ultrasound Waves ◽  
Scanning Area ◽  
Significant Difference ◽  
Lilliefors Test ◽  
Pixel Value ◽  
Portable Ultrasonography ◽  
The Right

The objective of this research was to determine the minimum area representative of the testicular parenchyma echotexture in Nelore bulls, and to evaluate the presence of echotexture homogeneity between the right and left testicles and between different regions of testicle. Twenty-nine Nelore bulls raised under extensive management and free of reproductive disorders were used. The average body weight was 352.8 ± 51.0 kg and age ranged between 18 and 24 months. Echotexture was assessed using a portable ultrasonography device equipped with a 7.5-MHz linear transducer. All measurement was done by a single, experienced operator, and scanner settings that affect image attributes (i.e. proximal, distal, and total gains; focus area; brightness and contrast) were standardized to predetermined values. In the examinations, a layer of gel was applied to the transducer scanning area, which was positioned in the testicular longitudinal plane, proceeding with enough pressure to capture an image. The frozen images were obtained with minimal artifacts (refraction, dispersion, and attenuation of ultrasound waves) taking care to avoid the mediastinum testis and tunica albuginea, and recorded as .bmp files in a USB pen drive connected to the ultrasound device. Echotexture was defined in terms of mean pixel value quantified using values from 0 (black) to 255 (white) through the ImageJ 1.41 software. After the selection of a specific area of testicular parenchyma, the average tonality of the gray pixels in the selected region was calculated by the software and expressed in 256 gray-scales. Squares selections of 400 (20 × 20), 1600 (40 × 40), 3600 (60 × 60), and 6400 (80 × 80) pixels were assessed from images of the extremitas capitata, middle, and extremitas caudata regions of both testicles to determine the minimum sampling area of an image needed to represent the echotexture of testicular parenchyma. The normal distribution verification (Lilliefors test) of the variable mean pixel value was tested in each area, followed by variance analysis. The averages were compared through Tukey’s test with 5% significance. There was no significant difference between the different pixel areas assessed (P > 0.05), indicating that all were samples representative of testicular echotexture. Furthermore, the extremitas capitata, middle, and extremitas caudata regions showed no significant difference in echotexture (P > 0.05) regardless of the area analyzed, and there was no significant difference between the right and left testicles (P > 0.05) in any of the assessed areas. In conclusion, this research shows that testicular echotexture assessments can be made in Nelore bulls through selections of 400, 1600, 3600, or 6400 pixels, and that images can be captured from any region of any testicle. Fundect - Fundação deApoio ao Desenvolvimento do Ensino, CiÊncia e Tecnologia do Estado de Mato Grosso do Sul.

scholarly journals Using Dynamic Portable Ultrasonography for the Diagnosis of Lateral Ankle Instability

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0007
Author(s):  
Jirawat Saengsin ◽  
Rohan Bhimani ◽  
Go Sato ◽  
Noortje Hagemeijer ◽  
Bart Lubberts ◽  
...  
Keyword(s):  
Ankle Instability ◽  
Rank Correlation ◽  
Tilt Test ◽  
Lateral Ankle ◽  
Anterior Translation ◽  
Spearman’S Rank Correlation ◽  
Cutoff Values ◽  
Lateral Ankle Instability ◽  
Talar Tilt ◽  
Portable Ultrasonography

Category: Sports; Ankle Introduction/Purpose: Destabilizing injuries to the lateral ligament have relied on physical examination and radiographic stress test for diagnosis, with a focus on anterior translation and tilting of the talus relative to the tibial bone. Portable ultrasonography (PUS) has increasingly been used in the clinical setting, allowing dynamic and non-invasive evaluation. The primary aim of this study was to assess the anterior translation and tilting of the talus with PUS in various stages of lateral ankle ligamentous injury. Secondary, we compared the instability values measured with PUS with those measured on fluoroscopy. Third, we aimed to determine the optimal cutoff values of the PUS that distinguish stable from unstable state. Methods: 8 fresh-frozen cadaveric specimens underwent PUS and fluoroscopic evaluation for lateral ankle stability. The assessment was done with all ligaments intact and later with sequential transection of the anterior-talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior-talofibular ligament (PTFL). In all scenarios, 2 loading conditions were considered; 1) Performing the anterior drawer test under 50N and 80N of force, anterior translation was measured with PUS and fluoroscopy; 2) Performing the talar tilt test under 1.7Nm of torque, the lateral clear space (the distance between the fibular tip and lateral process of the talus) was measured with PUS, and the talar tilt angle was measured with fluoroscopy (Figure1). Pearson’s and Spearman’s rank correlation was used to determine the correlation. Youden’s J statistic was used to determine the optimal cutoff values for the PUS to distinguish intact or ATFL injury versus ATFL-CFL or ATFL-CFL-PTFL injuries under various loading conditions. Results: Strong positive correlations were found between PUS and fluoroscopic measurements (Pearson correlation:r=0.78- 0.85). PUS and fluoroscopic measurements during anterior translation and talar tilt test increased as additional ligaments were transected (Spearman’s rank correlation: anterior translation; r=0.74, p < 0.001: talar tilt; r=0.81, p<0.001). Inter-rater and intra- rater reliability for PUS and fluoroscopic measurements were all excellent (ICCs >=0.8). The optimal PUS cutoff values for distinguishing intact or ATFL injury from ATFL-CFL or ATFL-CFL-PTFL injuries were >=3.40mm (sensitivity 87.5%, specificity 81.25%) and >=4.78mm (sensitivity 87.5%, specificity 81.25%) of anterior talar translation under 50N and 80N of force respectively, as well as >=3.09mm (sensitivity 75%, specificity 93.75%) of the lateral clear space under 1.7Nm of torque. Conclusion: Portable ultrasonography for the diagnosis of lateral ankle instability was strongly correlated with fluoroscopic findings, and thus, can be a valuable diagnostic tool at the point of care. We recommend future in vivo research to investigate the accuracy of this new ultrasound application in a clinical setting.

scholarly journals Intestinal schistosomiasis in chimpanzees on Ngamba Island, Uganda: observations on liver fibrosis, schistosome genetic diversity and praziquantel treatment

Parasitology ◽  
2012 ◽  
Vol 140 (3) ◽  
pp. 285-295 ◽  
Author(s):  
C. J. STANDLEY ◽  
L. MUGISHA ◽  
M. ADRIKO ◽  
M. ARINAITWE ◽  
J. RUKUNDO ◽  
...  
Keyword(s):  
Genetic Diversity ◽  
Liver Fibrosis ◽  
Progressive Disease ◽  
Management Plan ◽  
Dna Barcodes ◽  
Oral Gavage ◽  
Intestinal Schistosomiasis ◽  
Praziquantel Treatment ◽  
Portable Ultrasonography

SUMMARYDespite treatment with praziquantel (PZQ) at 40 mg/kg in food, several chimpanzees on Ngamba Island Chimpanzee Sanctuary (NICS) continue to excrete eggs of Schistosoma mansoni. To monitor disease, 8 animals were closely examined under anaesthesia in March 2011 with portable ultrasonography and by rectal snip biopsy. Schistosome genetic diversity had been previously assayed within 4 of these chimpanzees, finding extensive diversity with 27 DNA barcodes encountered, although none was common to all animals. Calcified schistosome eggs were found in the rectal snips from 5 chimpanzees and liver fibrosis was clearly documented, indicative of progressive disease in 6 animals, the latter being surprisingly advanced in a younger chimpanzee. All 8 animals were treated under anaesthesia by oral gavage with PZQ at 60 mg/kg dosing that was well tolerated. These animals were again re-examined in June 2012 using stool and urine sampling. Only 1 chimpanzee appeared to be free from infection and active egg excretion was confirmed in 6 animals. If intestinal schistosomiasis is to be controlled within this setting, a long-term disease management plan is required which should combine active case-detection with an insistent treatment regime with praziquantel for these chimpanzees, exploring perhaps the performance of even higher dosing.

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