Electronic business in the home medical equipment industry.

PubMed

Wei, June; Graham, Michael J; Liu, Lai C

2011-01-01

This paper aims at developing electronic business solutions to increase value for the home medical equipment industry. First, an electronic strategic value chain model was developed for the home medical equipment industry. Second, electronic business solutions were mapped from this model. Third, the top 20 dominant companies in the home medical equipment industry were investigated to see the current adoption patterns of these electronic business solutions. The solutions will be beneficial to decision-makers in the information technology adoptions in the home medical equipment industry to increase the business values.

[Suggestions for buying medical equipment in hospitals].

PubMed

Trontzos, Christos

2004-01-01

TO THE EDITOR: Both in Greece and in other European countries there are plans to buy more medical equipment. If the whole procedure is not effective, it may result to a large deficit in the hospital budget. The total hospital deficit now in Greece is about 2.5 billion euros. It is suggested that in every hospital, the Authorized Committee for Medical Equipment Purchasing, should include the following: One Director of a Medical Department related to the equipment to be bought and another Director of a Medical Department, unrelated. One accountant. One legal advisor specialized in hospital affairs. One economical advisor specialized in banking who will be able to suggest leasing or other means of financing the purchase of the relevant equipment. A cost accounting analysis described by a detailed report, should be provided to secure that the equipment to be bought should be cost-effective and leaving a reasonable surplus after not more than 10 years from the time it is installed. Finally, the possibility of using one expensive equipment to cover the needs of more than one hospitals either by moving the equipment (i.e. the PET/CT camera by a large vehicle) or by transferring the patients to a central hospital, may be provided by the above Authorized Committee.

Medical equipment libraries: implementation, experience and user satisfaction.

PubMed

Keay, S; McCarthy, J P; Carey-Smith, B E

2015-01-01

The hospital-wide pooling and sharing of certain types of medical equipment can lead to both significant improvements in patient safety and financial advantages when compared with a department or ward-level equipment ownership system. In September 2003, a Medical Equipment Loan Service (MELS) was established, focusing initially on infusion pumps. The aims and expected benefits included; improving availability of equipment for both patients and clinical users, managing and reducing clinical risk, reducing equipment diversity, improving equipment management and reducing the overall cost of equipment provision. A user survey was carried out in 2005 and repeated in 2011. The results showed wide and continued satisfaction with the service. The process and difficulties of establishing the service and its development to include additional types of equipment are described. The benefits of managing medical equipment which is in widespread general use, through a MELS as part of a Clinical Engineering Department, are presented.

High-resolution ultrasonography in assessing temporomandibular joint disc position.

PubMed

Talmaceanu, Daniel; Lenghel, Lavinia Manuela; Bolog, Nicolae; Popa Stanila, Roxana; Buduru, Smaranda; Leucuta, Daniel Corneliu; Rotar, Horatiu; Baciut, Mihaela; Baciut, Grigore

2018-02-04

The purpose of this study was to determine the diagnostic value of high-resolution ultrasonography (US) in temporomandibular joint (TMJ) disc displacements. A number of 74 patients (148 TMJs) with signs and symptoms of TMJ disorders, according to the Research Diagnostic Criteria for Temporomandibular Disorders, were included in this study. All patients received US and magnetic resonance imaging (MRI) of both TMJs 1 to 5 days after the clinical examination. MRI examinations were performed using 1.5 T MRI equipment (Siemens Avanto, Siemens, Erlangen). Ultrasonographic examination was performed on a Hitachi EUB 8500 (Hitachi Medical Corp., Tokyo, Japan) scanner with L 54 M6.5-13 MHz linear transducer. MRI depicted 68 (45.95%) normal joints, 47 (31.76%) with disc displacement with reduction, 33 (22.3%) with disc displacement without reduction and 34 (22.97%) with degenerative changes. US detected 78 (52.7%) normal joints, 37 (25%) with disc displacement with reduction, 33 (22.3%) with disc displacement without reduction and 21 (14.19%) with degenerative changes. Compared to MRI, US showed a sensitivity of 93.1%, specificity of 87.88%, accuracy of 90.32%, a positive predictive value of 87.1% and a negative predictive value of 93.55% for overall diagnosis of disc displacement. The Youden index was 0.81. Based on our results, high-resolution ultrasonography showed high sensitivity, specificity and accuracy in the diagnosis of TMJ disc displacement. It could be a valuable imaging technique in assessing TMJ disc position. The diagnostic value of high-resolution ultrasonography depends strictly on the examiner's skills and on the equipment used.

Innovation design of medical equipment based on TRIZ.

PubMed

Gao, Changqing; Guo, Leiming; Gao, Fenglan; Yang, Bo

2015-01-01

Medical equipment is closely related to personal health and safety, and this can be of concern to the equipment user. Furthermore, there is much competition among medical equipment manufacturers. Innovative design is the key to success for those enterprises. The design of medical equipment usually covers vastly different domains of knowledge. The application of modern design methodology in medical equipment and technology invention is an urgent requirement. TRIZ (Russian abbreviation of what can be translated as `theory of inventive problem solving') was born in Russia, which contain some problem-solving methods developed by patent analysis around the world, including Conflict Matrix, Substance Field Analysis, Standard Solution, Effects, etc. TRIZ is an inventive methodology for problems solving. As an Engineering example, infusion system is analyzed and re-designed by TRIZ. The innovative idea is generated to liberate the caretaker from the infusion bag watching out. The research in this paper shows the process of the application of TRIZ in medical device inventions. It is proved that TRIZ is an inventive methodology for problems solving and can be used widely in medical device development.

Cellular telephone interference with medical equipment.

PubMed

Tri, Jeffrey L; Severson, Rodney P; Firl, Allen R; Hayes, David L; Abenstein, John P

2005-10-01

To assess the potential electromagnetic interference (EMI) effects that new or current-generation cellular telephones have on medical devices. For this study, performed at the Mayo Clinic in Rochester, Minn, between March 9, 2004, and April 24, 2004, we tested 16 different medical devices with 6 cellular telephones to assess the potential for EMI. Two of the medical devices were tested with both new and old interface modules. The 6 cellular telephones chosen represent the different cellular technology protocols in use: Code Division Multiple Access (2 models), Global System for Mobile communications, Integrated Digital Enhanced Network, Time Division Multiple Access, and analog. The cellular telephones were tested when operating at or near their maximum power output. The medical devices, connected to clinical simulators during testing, were monitored by observing the device displays and alarms. Of 510 tests performed, the incidence of clinically important interference was 1.2%; EMI was Induced in 108 tests (21.2%). Interference occurred in 7 (44%) of the 16 devices tested. Cellular telephones can interfere with medical equipment. Technology changes in both cellular telephones and medical equipment may continue to mitigate or may worsen clinically relevant interference. Compared with cellular telephones tested in previous studies, those currently in use must be closer to medical devices before any interference is noticed. However, periodic testing of cellular telephones to determine their effects on medical equipment will be required.

Discussion of the quality control and performance testing of ultrasound diagnostic equipment

NASA Astrophysics Data System (ADS)

Jiang, Junjie

2018-03-01

In recent years, with the rapid development of ultrasonography, the application and popularization of new technology used in ultrasound equipment, the level of providing diagnostic information for doctors enhances unceasingly, which has become the indispensable diagnostic tool for medical institutions. The performance of equipment is directly related to the doctor’s diagnosis and the patient’s health, therefore, it is very important to choose a good method for quality control and performance testing.

Technology and the future of medical equipment maintenance.

PubMed

Wear, J O

1999-05-01

Maintenance of medical equipment has been changing rapidly in the past few years. It is changing more rapidly in developed countries, but changes are also occurring in developing countries. Some of the changes may permit improved maintenance on the higher technology equipment in developing countries, since they do not require onsite expertise. Technology has had an increasing impact on the development of medical equipment with the increased use of microprocessors and computers. With miniaturization from space technology and electronic chip design, powerful microprocessors and computers have been built into medical equipment. The improvement in manufacturing technology has increased the quality of parts and therefore the medical equipment. This has resulted in increased mean time between failures and reduced maintenance needs. This has made equipment more reliable in remote areas and developing countries. The built-in computers and advances in software design have brought about self-diagnostics in medical equipment. The technicians now have a strong tool to be used in maintenance. One problem in this area is getting access to the self-diagnostics. Some manufacturers will not readily provide this access to the owner of the equipment. Advances in telecommunications in conjunction with self-diagnostics make available remote diagnosis and repair. Since components can no longer be repaired, a remote repair technician can instruct an operator or an on-site repairman on board replacement. In case of software problems, the remote repair technician may perform the repairs over the telephone. It is possible for the equipment to be monitored remotely by modern without interfering with the operation of the equipment. These changes in technology require the training of biomedical engineering technicians (BMETs) to change. They must have training in computers and telecommunications. Some of this training can be done with telecommunications and computers.

Durable medical equipment recycling: a pilot program.

PubMed

Wright, Aaron J

2012-01-01

Our unfunded trauma patients often lack the access to adequate health care services and equipment after hospital discharge. We have developed and implemented a pilot program to provide reclaimed durable medical equipment to medically indigent trauma patients. Our program includes the reuse of items such as front-wheeled walkers, bedside commodes, shower chairs, crutches, and canes.

77 FR 62479 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-15

...-0003] RIN 3014-AA40 Medical Diagnostic Equipment Accessibility Standards Advisory Committee AGENCY.... SUMMARY: The Medical Diagnostic Equipment Accessibility Standards Advisory Committee (Committee) will hold... Proposed Rulemaking (NPRM) on Medical Diagnostic Equipment Accessibility Standards. DATES: The Committee...

77 FR 53163 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-31

...-0003] RIN 3014-AA40 Medical Diagnostic Equipment Accessibility Standards Advisory Committee AGENCY.... SUMMARY: The Medical Diagnostic Equipment Accessibility Standards Advisory Committee (Committee) will hold... previously published Notice of Proposed Rulemaking (NPRM) on Medical Diagnostic Equipment Accessibility...

78 FR 10582 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-14

...-0003] RIN 3014-AA40 Medical Diagnostic Equipment Accessibility Standards Advisory Committee AGENCY.... SUMMARY: The Medical Diagnostic Equipment Accessibility Standards Advisory Committee will hold its fourth...) on Medical Diagnostic Equipment Accessibility Standards. DATES: The Committee will meet on February...

How useful is abdominal ultrasonography in dogs with diarrhoea?

PubMed

Mapletoft, E K; Allenspach, K; Lamb, C R

2018-01-01

To assess the utility of abdominal ultrasonography in the diagnostic work-up of dogs with diarrhoea. Retrospective cross-sectional study based on a referral population of dogs with diarrhoea. Associations between the clinical signs, use of abdominal ultrasonography, results of abdominal ultrasonography and subsequent work-up were examined. The utility of abdominal ultrasonography was scored as high, moderate, none or counterproductive based on review of medical records. Medical records of 269 dogs were reviewed, of which 149 (55%) had abdominal ultrasonography. The most frequent result was no ultrasonographic abnormalities affecting the intestine in 65 (44%) dogs. Ultrasonography results were associated with subsequent work-up as follows: (1) no detected abnormalities and dietary trial; (2) focal thickening of the intestinal wall, loss of intestinal wall layers or enlarged abdominal lymph nodes and ultrasound-guided fine-needle aspirates; (3) diffuse thickening of the intestinal wall or hyperechoic striations in the small intestinal mucosa and endoscopy; and (4) small intestinal foreign body and coeliotomy. Abdominal ultrasonography was considered to be diagnostic without further testing in only four (3%) dogs: two had a portosystemic shunt identified ultrasonographically, one had a linear foreign body and one had a perforated pyloric ulcer. Abdominal ultrasonography had moderate utility in 56 (38%) dogs and no utility in 79 (53%) dogs. Abdominal ultrasonography was considered counterproductive in 10 (7%) dogs because results were either falsely negative or falsely positive. These results should prompt clinicians to reconsider routine use of abdominal ultrasonography in dogs with diarrhoea. © 2017 British Small Animal Veterinary Association.

78 FR 32612 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-31

...-0003] RIN 3014-AA40 Medical Diagnostic Equipment Accessibility Standards Advisory Committee AGENCY.... SUMMARY: The Medical Diagnostic Equipment Accessibility Standards Advisory Committee will hold its seventh...) on Medical Diagnostic Equipment Accessibility Standards. DATES: The Committee will meet on June 17...

78 FR 1166 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-08

...-0003] RIN 3014-AA40 Medical Diagnostic Equipment Accessibility Standards Advisory Committee AGENCY.... SUMMARY: The Medical Diagnostic Equipment Accessibility Standards Advisory Committee will hold its third...) on Medical Diagnostic Equipment Accessibility Standards. DATES: The Committee will meet on January 22...

78 FR 23872 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-23

...-0003] RIN 3014-AA40 Medical Diagnostic Equipment Accessibility Standards Advisory Committee AGENCY.... SUMMARY: The Medical Diagnostic Equipment Accessibility Standards Advisory Committee will hold its sixth...) on Medical Diagnostic Equipment Accessibility Standards. DATES: The Committee will meet on May 7...

78 FR 16448 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-15

...-0003] RIN 3014-AA40 Medical Diagnostic Equipment Accessibility Standards Advisory Committee AGENCY.... SUMMARY: The Medical Diagnostic Equipment Accessibility Standards Advisory Committee will hold its fifth...) on Medical Diagnostic Equipment Accessibility Standards. DATES: The Committee will meet on March 26...

Lack of security of networked medical equipment in radiology.

PubMed

Moses, Vinu; Korah, Ipeson

2015-02-01

OBJECTIVE. There are few articles in the literature describing the security and safety aspects of networked medical equipment in radiology departments. Most radiologists are unaware of the security issues. We review the security of the networked medical equipment of a typical radiology department. MATERIALS AND METHODS. All networked medical equipment in a radiology department was scanned for vulnerabilities with a port scanner and a network vulnerability scanner, and the vulnerabilities were classified using the Common Vulnerability Scoring System. A network sniffer was used to capture and analyze traffic on the radiology network for exposure of confidential patient data. We reviewed the use of antivirus software and firewalls on the networked medical equipment. USB ports and CD and DVD drives in the networked medical equipment were tested to see whether they allowed unauthorized access. Implementation of the virtual private network (VPN) that vendors use to access the radiology network was reviewed. RESULTS. Most of the networked medical equipment in our radiology department used vulnerable software with open ports and services. Of the 144 items scanned, 64 (44%) had at least one critical vulnerability, and 119 (83%) had at least one high-risk vulnerability. Most equipment did not encrypt traffic and allowed capture of confidential patient data. Of the 144 items scanned, two (1%) used antivirus software and three (2%) had a firewall enabled. The USB ports were not secure on 49 of the 58 (84%) items with USB ports, and the CD or DVD drive was not secure on 17 of the 31 (55%) items with a CD or DVD drive. One of three vendors had an insecure implementation of VPN access. CONCLUSION. Radiologists and the medical industry need to urgently review and rectify the security issues in existing networked medical equipment. We hope that the results of our study and this article also raise awareness among radiologists about the security issues of networked medical equipment.

Effectiveness of medical equipment donations to improve health systems: how much medical equipment is broken in the developing world?

PubMed

Perry, Lora; Malkin, Robert

2011-07-01

It is often said that most of the medical equipment in the developing world is broken with estimates ranging up to 96% out of service. But there is little documented evidence to support these statements. We wanted to quantify the amount of medical equipment that was out of service in resource poor health settings and identify possible causes. Inventory reports were analyzed from 1986 to 2010, from hospitals in sixteen countries across four continents. The UN Human Development Index was used to determine which countries should be considered developing nations. Non-medical hospital equipment was excluded. This study examined 112,040 pieces of equipment. An average of 38.3% (42,925, range across countries: 0.83-47%) in developing countries was out of service. The three main causes were lack of training, health technology management, and infrastructure. We hope that the findings will help biomedical engineers with their efforts toward effective designs for the developing world and NGO's with efforts to design effective healthcare interventions.

Immunity of medical electrical equipment to radiated RF disturbances

NASA Astrophysics Data System (ADS)

Mocha, Jan; Wójcik, Dariusz; Surma, Maciej

2018-04-01

Immunity of medical equipment to radiated radio frequency (RF) electromagnetic (EM) fields is a priority issue owing to the functions that the equipment is intended to perform. This is reflected in increasingly stringent normative requirements that medical electrical equipment has to conform to. A new version of the standard concerning electromagnetic compatibility of medical electrical equipment IEC 60601-1-2:2014 has recently been published. The paper discusses major changes introduced in this edition of the standard. The changes comprise more rigorous immunity requirements for medical equipment as regards radiated RF EM fields and a new requirement for testing the immunity of medical electrical equipment to disturbances coming from digital radio communication systems. Further on, the paper presents two typical designs of the input block: involving a multi-level filtering and amplification circuit and including a solution which integrates an input amplifier and an analog-to-digital converter in one circuit. Regardless of the applied solution, presence of electromagnetic disturbances in the input block leads to demodulation of the disturbance signal envelope. The article elaborates on mechanisms of amplitude detection occurring in such cases. Electromagnetic interferences penetration from the amplifier's input to the output is also described in the paper. If the aforementioned phenomena are taken into account, engineers will be able to develop a more conscious approach towards the issue of immunity to RF EM fields in the process of designing input circuits in medical electrical equipment.

Application and preventive maintenance of neurology medical equipment in isfahan alzahra hospital.

PubMed

Alikhani, Parivash; Vesal, Sahar; Kashefi, Parviz; Pour, Ramin Etamadi; Khorvash, Fariborz; Askari, Gholamreza; Meamar, Rokhsareh

2013-05-01

Nowadays Medical equipment plays an important role in the treatment and in the medical education. Using outdated preventive maintenance (PM) system may cause problems in the cutting edge medical equipment, Nervous system disease's equipment (In diagnosis and treatment) which are crucial for every medical center. Based on above facts we focused on nervous system treat units' equipment and informed the supervisors and their colleagues about the latest equipment maintenance status and promoted methodical and correct method to be used for medical equipment maintenance. This research is an analytical descriptive and has been done on the base information from a particular time to past. We gathered our required information of 2009 from Alzahra Medical Center. We divided this research info 2 main phases. In the first phase, we picked out Neurosurgery and Neourology diseases medical equipment (diagnosis and therapy equipment) and in the second phase, we need to implement a methodical PM for every equipment. Research has shown that there are 19nervous system equipment in Alzahra Medical center, categorized in diagnostic (13 pcs), therapeutic (4 pcs) and diagnostic-therapeutic (2 pcs). As we declare in methods part of this research, we categorized medical equipment in Food and Drug Administration (FDA) segmentation. Capital-scarce equipment: Magnetic resonance imaging, Eco Doppler, Kamalaarak ultrasonic surgical aspirator, Stereotactic, computed tomography-scan, euroendoscope/vital-scarce equipment: Coblation, Sonoco, vaterjet/scarce equipment: Transcranial color Doppler, electroencephalogram, electromyography, surgical microscope. Survey of application and preventive maintenance of neurology medical equipment in Isfahan Alzahra hospital show there is no P.M system. Implementing a complete P.M system for this medical center is crucial to preventing cause problems for these medical equipment and decreasing maintenance costs and gaining uptime. Researchers of this article have

Effect of Ultrasonography on Student Learning of Shoulder Anatomy and Landmarks.

PubMed

de Vries, Kristen D; Brown, Rebecca; Mazzie, Joseph; Jung, Min-Kyung; Yao, Sheldon C; Terzella, Michael J

2018-01-01

Ultrasonography is becoming more common in clinical use, and it has been shown to have promising results when introduced into medical school curricula. To determine whether the use of ultrasonography as an educational supplement can improve osteopathic medical students' confidence and ability to locate 4 specific shoulder anatomical landmarks: the coracoid process, the transverse process of T1, the long head of the biceps within the bicipital groove, and the supraspinatus tendon. In this randomized controlled study, first-year osteopathic medical students aged 18 years or older were recruited and randomly assigned to a group with exposure (ultrasonography group) or without exposure (control group) to an ultrasonography machine. First, a survey was administered to measure students' baseline knowledge of shoulder anatomy, confidence in palpation skills, and opinion on anatomical landmark identification teaching methods. Next, students were shown presentations on shoulder anatomy and allowed to practice locating and palpating the specified landmarks. Students in the ultrasonography group were also given instruction on the use of ultrasonography. All students were asked to locate each of the 4 specified anatomical landmarks and then given a follow-up survey. A Mann Whitney U test was used to compare the confidence of the students before and after the intervention. A secondary analysis was performed to compare the degree of deviance from the correct position of the specified anatomical landmark between the ultrasonography and control groups. P values less than .05 were considered statistically significant. Sixty-four students participated. Compared with the control group, students in the ultrasonography group had a greater increase in confidence after the session in their ability to locate the coracoid process, bicipital tendon, and supraspinatus tendon (P=.022, P=.029, P=.44, respectively). Students in the ultrasonography group were also able to more accurately palpate

Emergency medical equipment on board German airliners.

PubMed

Hinkelbein, Jochen; Neuhaus, Christopher; Wetsch, Wolfgang A; Spelten, Oliver; Picker, Susanne; Böttiger, Bernd W; Gathof, Birgit S

2014-01-01

Medical emergencies often occur on commercial airline flights, but valid data on their causes and consequences are rare. Therefore, it is unclear what emergency medical equipment is necessary. Although a minimum standard for medical equipment is defined in regulations, additional material is not standardized and may vary significantly between different airlines. German airlines operating aircrafts with more than 30 seats were selected and interviewed with a 5-page written questionnaire between August 2011 and January 2012. Besides pre-packed and required emergency medical material, drugs, medical devices, and equipment lists were queried. If no reply was received, airlines were contacted another three times by e-mail and/or phone. Descriptive analysis was used for data presentation and interpretation. From a total of 73 German airlines, 58 were excluded from analysis (eg, those not providing passenger transport). Fifteen airlines were contacted and data of 13 airlines were available for analysis (two airlines did not participate). A first aid kit was available on all airlines. Seven airlines reported having a doctor's kit, and another four provided an "emergency medical kit." Four airlines provided an automated external defibrillator (AED)/electrocardiogram (ECG). While six airlines reported providing anesthesia drugs, a laryngoscope, and endotracheal tubes, another four airlines did not provide even a resuscitator bag. One airline did not provide any material for cardiopulmonary resuscitation (CPR). Although the minimal material required according to European aviation regulations is provided by all airlines for medical emergencies, there are significant differences in the provision of additional material. The equipment on most airlines is not sufficient for the treatment of specific emergencies according to published medical guidelines (eg, for CPR or acute myocardial infarction). © 2014 International Society of Travel Medicine.

Management information system of medical equipment using mobile devices

NASA Astrophysics Data System (ADS)

Núñez, C.; Castro, D.

2011-09-01

The large numbers of technologies currently incorporated into mobile devices transform them into excellent tools for capture and to manage the information, because of the increasing computing power and storage that allow to add many miscellaneous applications. In order to obtain benefits of these technologies, in the biomedical engineering field, it was developed a mobile information system for medical equipment management. The central platform for the system it's a mobile phone, which by a connection with a web server, it's capable to send and receive information relative to any medical equipment. Decoding a type of barcodes, known as QR-Codes, the management process is simplified and improved. These barcodes identified the medical equipments in a database, when these codes are photographed and decoded with the mobile device, you can access to relevant information about the medical equipment in question. This Project in it's actual state is a basic support tool for the maintenance of medical equipment. It is also a modern alternative, competitive and economic in the actual market.

[Fundamental aspects for accrediting medical equipment calibration laboratories in Colombia].

PubMed

Llamosa-Rincón, Luis E; López-Isaza, Giovanni A; Villarreal-Castro, Milton F

2010-02-01

Analysing the fundamental methodological aspects which should be considered when drawing up calibration procedure for electro-medical equipment, thereby permitting international standard-based accreditation of electro-medical metrology laboratories in Colombia. NTC-ISO-IEC 17025:2005 and GTC-51-based procedures for calibrating electro-medical equipment were implemented and then used as patterns. The mathematical model for determining the estimated uncertainty value when calibrating electro-medical equipment for accreditation by the Electrical Variable Metrology Laboratory's Electro-medical Equipment Calibration Area accredited in compliance with Superintendence of Industry and Commerce Resolution 25771 May 26th 2009 consists of two equations depending on the case; they are: E = (Ai + sigmaAi) - (Ar + sigmaAr + deltaAr1) and E = (Ai + sigmaAi) - (Ar + sigmaA + deltaAr1). The mathematical modelling implemented for measuring uncertainty in the Universidad Tecnológica de Pereira's Electrical Variable Metrology Laboratory (Electro-medical Equipment Calibration Area) will become a good guide for calibration initiated in other laboratories in Colombia and Latin-America.

Isolating USB connections in medical equipment.

PubMed

Broeders, Jan-Hein

2009-01-01

Although offering several benefits, the universal serial bus (USB) port has not been rapidly adopted for connecting medical equipment. This is because it could affect safety procedures, with equipment not operating isolated from the mains. To overcome this, a single package isolation device has been developed that can be inserted directly into the USB signal path.

Medical Equipment Used to Support Operations in Southwest Asia

DTIC Science & Technology

2009-09-30

services. USCENTCOM Medical Logistics Management In February 2006, the Chairman of the Joint Chiefs of Staff designated the U.S. Army Medical...Microbiology Psychiatry/Mental Health Pediatrics Radiology* Prosthesis Trauma Surgery (General, Orthopedic, Urologic, Obstetrics and Gynecology... automated capability to manage equipment assets from the time a customer starts the research for an equipment item to the point at which the equipment

77 FR 67595 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-13

...-0003] RIN 3014-AA40 Medical Diagnostic Equipment Accessibility Standards Advisory Committee AGENCY.... SUMMARY: The Medical Diagnostic Equipment Accessibility Standards Advisory Committee (Committee) will hold... Equipment Accessibility Standards. DATES: The Committee will meet on December 3, 2012, from 10:00 a.m. to 5...

Medical equipment donations in Haiti: flaws in the donation process.

PubMed

Dzwonczyk, Roger; Riha, Chris

2012-04-01

The magnitude 7.0 earthquake that struck Haiti on 12 January 2010 devastated the capital city of Port-au-Prince and the surrounding area. The area's hospitals suffered major structural damage and material losses. Project HOPE sought to rebuild the medical equipment and clinical engineering capacity of the country. A team of clinical engineers from the United States of America and Haiti conducted an inventory and assessment of medical equipment at seven public hospitals affected by the earthquake. The team found that only 28% of the equipment was working properly and in use for patient care; another 28% was working, but lay idle for technical reasons; 30% was not working, but repairable; and 14% was beyond repair. The proportion of equipment in each condition category was similar regardless of whether the equipment was present prior to the earthquake or was donated afterwards. This assessment points out the flaws that existed in the medical equipment donation process and reemphasizes the importance of the factors, as delineated by the World Health Organization more than a decade ago, that constitute a complete medical equipment donation.

[Design of medical equipment service management system].

PubMed

Jiang, Youhao; PengWen; Jiang, Ningfeng; Ma, Li; Kong, Lingwei; Yin, PeiHao; Sun, Cheng

2012-09-01

To develop a maintenance management system for medical equipment based on HIS. The system contains some special functions( including preventive maintenance, automatic job dispatch, performance assessment, etc.) which are very useful for confirming the medical equipment in proper conditions and promoting the working efficiency of the staff. The system provides technical support for the improvement of the maintenance management level. The system, completed the software design using C/S, B/S combination mode. The system realized clients of various sections of zero maintenance, and make the data manipulation, statistical features of equipment management department more convenient. the system connects the subsystems closer and interacts information from time to time, forming a tight network structure. This provides a basis for future hospital-wide information integration.

[Analysis of the security risk in home medical equipment].

PubMed

Peng, Xiaolong; Xu, Honglei; Tian, Xiaojun

2014-01-01

The popularization of home medical equipment facilitates the treatment and management of many diseases, improving the patient compliance. However, due to the absence of medical background, most of their users have various security risk in the course of reorganization, choosing, using and maintenance of the products. This paper analyzed the property of security risk in home medical equipment, and described the matters needing attention in the using of several common products.

Evidence-based analysis of field testing of medical electrical equipment.

PubMed

Taktak, A G; Brown, M C

2006-01-01

Field testing of medical electrical equipment remains a topic of debate amongst biomedical engineers. A questionnaire was circulated among members of the main professional body for Medical Engineering Departments in the UK and Ireland and in the Medical Physics and Engineering Mailbase Server. The aim of the questionnaire was to establish consensus on common practice on the frequency and type of safety tests carried out in the field and common sources of hazards and risk management. Twenty-six replies were received in total. A clear majority of 54% of the respondents reported that they carried out safety tests on hospital-based medical equipment on a yearly basis. For other equipment, regular tests were carried out by 58% on loan equipment and by 69% on medical electrical systems. Laboratory equipment on the other hand were not tested in 42% of the cases. Domiciliary and research equipment were only tested in 11% and 15% of the cases respectively. A clear majority of 93% said that they label equipment after tests, 34% said that they always record the actual values (as opposed to pass or fail) and 54% said they carry out functional test as part of the safety test. Although 61% of failures were attributed to the mains lead, only 50% of the respondents said that they had a management system in place for detachable mains leads.

Medical equipment industry in India: Production, procurement and utilization.

PubMed

Chakravarthi, Indira

2013-01-01

This article presents information on the medical equipment industry in India-on production, procurement and utilization related activities of key players in the sector, in light of the current policies of liberalization and growth of a "health-care industry" in India. Policy approaches to medical equipment have been discussed elsewhere.

MRI versus ultrasonography to assess meniscal abnormalities in acute knees.

PubMed

Cook, James L; Cook, Cristi R; Stannard, James P; Vaughn, Gavin; Wilson, Nichole; Roller, Brandon L; Stoker, Aaron M; Jayabalan, Prakash; Hdeib, Moses; Kuroki, Keiichi

2014-08-01

meniscal pathology was associated with Sn = 91.7%, Sp = 66.7%, PPV = 84.6%, NPV = 80.0%, CCR = 81.1%, LR(+) = 2.75, and LR(-) = 0.13. Ultrasonography was two times more likely than MRI to correctly determine presence or absence of meniscal pathology seen arthroscopically in this study. Ultrasonography is a useful tool for diagnosis of meniscal pathology with potential advantages over MRI. Based on these data and available portable equipment, ultrasonography could be considered for use as a point-of-injury diagnostic modality for meniscal injuries. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The research of medical equipment on-line detection system based on Android smartphone

NASA Astrophysics Data System (ADS)

Jiang, Junjie; Dong, Xinyu; Zhang, Hongjie; Liu, Mengjun

2017-06-01

With the unceasing enhancement of medical level, the expanding scale of medical institutions, medical equipment as an important tool for disease diagnosis, treatment and prevention, used in all levels of medical institutions. The quality and accuracy of the Medical equipment play a key role in the doctor's diagnosis and treatment effect, medical metrology as the important technical foundation is to ensure that the equipment, technology, material components are accurate and the application is safe and reliable. Medical equipment have the feature of variety, large quantity, long using cycle, expensive and multi-site, which bring great difficulty in maintenance, equipment management and verification. Therefore, how to get the medical measurement integrate deeply into the advanced internet technology, information technology and the new measuring method, for real-time monitoring of medical equipment, tracking, positioning, and query is particularly important.

42 CFR 414.229 - Other durable medical equipment-capped rental items.

Code of Federal Regulations, 2011 CFR

2011-10-01

... AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for Durable Medical Equipment and Prosthetic and Orthotic Devices § 414.229 Other durable medical... 42 Public Health 3 2011-10-01 2011-10-01 false Other durable medical equipment-capped rental items...

42 CFR 414.229 - Other durable medical equipment-capped rental items.

Code of Federal Regulations, 2010 CFR

2010-10-01

... AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Payment for Durable Medical Equipment and Prosthetic and Orthotic Devices § 414.229 Other durable medical... 42 Public Health 3 2010-10-01 2010-10-01 false Other durable medical equipment-capped rental items...

Ethical home medical equipment business practices.

PubMed

Parver, C

1991-11-01

National uniform standards as a condition for receipt of a Medicare provider number would help rid the home medical equipment industry of those unethical and unscrupulous suppliers who have tarnished the industry's reputation.

The role for peer-assisted ultrasound teaching in medical school.

PubMed

Dickerson, Jonathan; Paul, Katie; Vila, Pierre; Whiticar, Rebecca

2017-06-01

Bedside ultrasonography has an increasing role in medicine yet medical students have limited exposure. Although countless hours are devoted to plain radiograph and electrocardiogram (ECG) interpretation, ultrasound is frequently glossed over. Yet this imaging modality could enhance students' understanding of anatomy, physiology and pathology, and may increase their integration into hospital teams. We aimed to investigate whether a peer-assisted ultrasound course has a place within the undergraduate medical curriculum. We describe the implementation of a course and discuss its acceptability and utility in student education. Bedside ultrasonography has an increasing role in medicine yet medical students have limited exposure METHODS: Following consultation with the medical school, an improved ultrasonography course was developed with expert guidance from an ultrasonographer and with new equipment. Sessions involved peer-tutors teaching ultrasonography techniques to medical students during emergency medicine placements. Tutees completed questionnaires to assess the quality and perceived benefits of the course and of learning ultrasonography. Both quantitative and thematic analyses of the responses were conducted by the authors. Over a period of 8 months, 105 medical students received teaching across four sessions. A total of 103 students (98%) returned questionnaires on their evaluation of the course and tutors, and on their confidence in using ultrasound. Ninety-eight per cent felt that the teaching was well delivered, 100 per cent felt that their knowledge of ultrasound had improved and 100 per cent would recommend the course. The peer-assisted ultrasound course described here enabled the majority of students to feel confident gaining elementary ultrasound views, and performing abdominal aneurysm screening and trauma assessments: techniques that they could hopefully put to use during their placements. The peer-assisted model has an acceptable role in teaching

The influence of experiential learning on medical equipment adoption in general practices.

PubMed

Bourke, Jane; Roper, Stephen

2014-10-01

The benefits of the availability and use of medical equipment for medical outcomes are understood by physicians and policymakers alike. However, there is limited understanding of the decision-making processes involved in adopting and using new technologies in health care organisations. Our study focuses on the adoption of medical equipment in Irish general practices which are marked by considerable autonomy in terms of commercial practice and the range of medical services they provide. We examine the adoption of six items of medical equipment taking into account commercial, informational and experiential stimuli. Our analysis is based on primary survey data collected from a sample of 601 general practices in Ireland on practice characteristics and medical equipment use. We use a multivariate Probit to identify commonalities in the determinants of the adoption. Many factors, such as GP and practice characteristics, influence medical equipment adoption. In addition, we find significant and consistent evidence of the influence of learning-by-using effects on the adoption of medical equipment in a general practice setting. Knowledge generated by experiential or applied learning can have commercial, organisational and health care provision benefits in small health care organisations. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Theoretical model study about the application risk of high risk medical equipment].

PubMed

Shang, Changhao; Yang, Fenghui

2014-11-01

Research for establishing a risk monitoring theoretical model of high risk medical equipment at applying site. Regard the applying site as a system which contains some sub-systems. Every sub-system consists of some risk estimating indicators. After quantizing of each indicator, the quantized values are multiplied with corresponding weight and then the products are accumulated. Hence, the risk estimating value of each subsystem is attained. Follow the calculating method, the risk estimating values of each sub-system are multiplied with corresponding weights and then the product is accumulated. The cumulative sum is the status indicator of the high risk medical equipment at applying site. The status indicator reflects the applying risk of the medical equipment at applying site. Establish a risk monitoring theoretical model of high risk medical equipment at applying site. The model can monitor the applying risk of high risk medical equipment at applying site dynamically and specially.

Advances in diagnostic ultrasonography.

PubMed

Reef, V B

1991-08-01

A wide variety of ultrasonographic equipment currently is available for use in equine practice, but no one machine is optimal for every type of imaging. Image quality is the most important factor in equipment selection once the needs of the practitioner are ascertained. The transducer frequencies available, transducer footprints, depth of field displayed, frame rate, gray scale, simultaneous electrocardiography, Doppler, and functions to modify the image are all important considerations. The ability to make measurements off of videocassette recorder playback and future upgradability should be evaluated. Linear array and sector technology are the backbone of equine ultrasonography today. Linear array technology is most useful for a high-volume broodmare practice, whereas sector technology is ideal for a more general equine practice. The curved or convex linear scanner has more applications than the standard linear array and is equipped with the linear array rectal probe, which provides the equine practitioner with a more versatile unit for equine ultrasonographic evaluations. The annular array and phased array systems have improved image quality, but each has its own limitations. The new sector scanners still provide the most versatile affordable equipment for equine general practice.

Accessible medical equipment for patients with disabilities in primary care clinics: why is it lacking?

PubMed

Pharr, Jennifer

2013-04-01

Previous research has identified inaccessible medical equipment as a barrier to health care services encountered by people with disabilities. However, no research has been conducted to understand why medical practices lack accessible equipment. The purpose of this study was to examine practice administrators' knowledge of accessible medical equipment and cost of accessible medical equipment to understand why medical practices lack such equipment. Hypotheses were: 1) Practice administrators lacked knowledge about accessible medical equipment and 2) The cost of accessible medical equipment was too great compared to standard equipment for the clinic. This study was a mixed methods survey of primary care practice administrators. The sixty-three participates were members of a medical management organization. Data were collected between December 20, 2011 and January 17, 2012. Proportions, Guttman scalogram, and Spearman's Rho correlation analyses were utilized. For this sample, less than half of the administrators knew that accessible equipment existed and a fourth knew what accessible equipment existed. There was a significant (p < 0.01), positive correlation between knowledge of accessible equipment and pieces of accessible equipment in the clinics. Because less than half of the administrators had ever considered purchasing accessible equipment, it was inconclusive if cost of accessible equipment was too great. Practice administrators' lack of knowledge of accessible medical equipment emphasizes the need not only for more education about the availability of accessible equipment but also about the importance of accessible equipment for their patients with disabilities and for physicians who provide them care. Copyright © 2013 Elsevier Inc. All rights reserved.

77 FR 39656 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-05

...-0003] RIN 3014-AA40 Medical Diagnostic Equipment Accessibility Standards Advisory Committee AGENCY... Diagnostic Equipment Accessibility Standards. DATES: The first meeting of the committee will be held at a... Equipment Accessibility Standards. See 77 FR 14706 (March 13, 2012). Section 510 of the Rehabilitation Act...

Reimbursement for Durable Medical Equipment

PubMed Central

Janssen, Theodore J.; Saffran, G. Theodore

1981-01-01

The use of durable medical equipment in the home, while not a recent development, was formally recognized by the Congress with the passage of the original Medicare legislation. Since that time the statute has been amended to provide for a more workable, economical, and desirable interface among the administrative, supplier, and user communities. To assist in achieving this end, a research project was begun in October 1976 that has yielded data on Federal expenditures for reimbursement of rental and purchase costs of this equipment. Data were extracted from the Beneficiary History Files of five Part B carriers in 11 geographic areas covering the period 1976-1977. These data included the type of equipment; rental or purchase decision; submitted charges; allowed charges; and reimbursement by Medicare. Some 1.3 million individual records, from approximately 400,000 beneficiaries, were tabulated and analyzed. The exploratory nature of this research has provided a benchmark for future research and policy considerations. This article details various characteristics of the data collected for the project. PMID:10309365

[Strategy Discussion for Pollution Control of Post-Consumer Home Medical Equipment].

PubMed

Zhang, Xu; Xu, Honglei; Huang, Yanhong; Peng, Xiaolong

2015-09-01

Compared with the recycle of post-consumer medical equipments in medical institutions, the treatment of post-consumer home medical equipments (HME) should be consummated in the field of academic research, policy and regulatory plus corresponding supporting industries. The HME industry situation and its classification, main components and properties are reviewed in this paper. The merits and demerits of various pollution control techniques in the recycle of post-consumer medical equipments are analysed. For instance, the source control techniques to improve the property of raw materials, the end treatment technique to recycle the HME and regenerate energy are also discussed. Further, the development prospect of pollution control technique in the recycle of HME and the challenges must face up to are also probed.

Teaching of clinical ultrasonography to undergraduates: students as mentors.

PubMed

García de Casasola Sánchez, G; González Peinado, D; Sánchez Gollarte, A; Muñoz Aceituno, E; Peña Vázquez, I; Torres Macho, J

2015-05-01

Ultrasonography is a highly useful diagnostic technique that supplements traditional physical examinations. To demonstrate that students previously trained in clinical ultrasonography are capable of instructing other students in a similar manner in a short period of time ("peer mentoring"). Five medical students in their 5th year, trained in abdominal and cardiac ultrasonography by physicians with experience, instructed 24 other students in the same procedure. The training consisted of an online theoretical course and practical training lasting about 12hours, in which each student had to perform 6 basic abdominal planes and 4 basic cardiac planes on 20 healthy volunteers. Subsequently, the students underwent an objective assessment test on healthy models performed by expert physicians in clinical ultrasonography. The students managed to correctly identify 90.2% of the basic abdominal planes, except for the left coronal (spleen and left kidney) and subcostal (gallbladder) planes, with slightly lower success rates of 82.5% and 80%, respectively. Due to the greater difficulty of obtaining cardiac planes, the success rate was lower: 70.3%, in the subxiphoid, short parasternal and four chamber planes. The cardiac plane with the fewest errors in identification was the parasternal long plane (90% success). We observed no statistically significant differences between the results (teaching capacity) of the various mentors. Medical students are capable of instructing other colleagues (peer mentoring) on the basic aspects of abdominal and cardiac ultrasonography after a relatively short training period. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Developing viable medical equipment, in general and for patient monitoring

PubMed Central

Taylor, D. J. W.

1970-01-01

The importance of the relationship between demonstrable clinical advantage and total costs in the use of equipment, the role of the professional medical administrator in its development and the differences between the industrial and the ethical medical approaches to marketing are stressed. In the final analysis routine service equipment should be assessed by actual profitability, recognizing the effects of philanthropic or research funding when it occurs. PMID:5476131

[The use of medical equipment in medical rehabilitation: evidence and therapeutic aspects of security].

PubMed

Sgalambro, Maria Luisa; Nataletti, Pietro; Ioppolo, Francesco; Bernetti, Andrea; Santilli, Valter

2012-01-01

Electro-medical equipment is widely used in order to treat bony and muscular disorders and some neurological disease in rehabilitation. However, the scientific evidence regarding the safety and efficacy of this equipment is meagre and contradictory. We have studied the subject, taking into account current regulations for the management and use of this electro-medical equipment. Following the criteria for Evidence Based Medicine, we have analysed the international literature so as to evaluate the evidence for physical energy in different clinical applications. Because the vast quantity of publications dealing with this material, priority was given to peer-reviewed articles and randomised trials. The publications were divided into categories according to disorder, so as to illustrate how some may provide positive proof whereas others require further study.

Malfunction of medical equipment as a result of mains borne interference.

PubMed

Railton, R; Currie, G D; Corner, G A; Evans, A L

1993-08-01

Medical equipment has become more intelligent as the manufacturers have incorporated the latest microprocessor based technology. Equipment malfunction can be caused at any time by inherent errors in the control program but it is particularly important that this is designed to cope with the effects of electrical interference which, in addition, may cause corruption of the software. We have considered interference found in the mains supply in the hospital environment. Using a test protocol with appropriate interference simulators, a wide range of medical equipment was removed temporarily from use and its immunity to electrical mains borne interference tested. Battery operated mains rechargeable devices were unaffected by mains voltage variations including drop-outs and sags whereas mains powered devices were affected to varying degrees of severity. In particular, repetitive drop-outs caused loss of power due to fuse blowing in some life support equipment. Impulses affected 25% and pulse bursts 50% of the equipment tested with some evidence that the more recent designs coped better. The EEC Directive on electro-medical compatibility compliance may cause the design of equipment to be improved but hospitals will have to cope with the above problems in their existing equipment for many years to come.

Biomedical equipment and medical services in India.

PubMed

Sahay, K B; Saxena, R K

Varieties of Biomedical Equipment (BME) are now used for quick diagnosis, flawless surgery and therapeutics etc. Use of a malfunctioning BME could result in faulty diagnosis and wrong treatment and can lead to damaging or even devastating aftermath. Modern Biomedical Equipments inevitably employ highly sophisticated technology and use complex systems and instrumentation for best results. To the best of our knowledge the medical education in India does not impart any knowledge on the theory and design of BME and it is perhaps not possible also. Hence there is need for a permanent mechanism which can maintain and repair the biomedical equipments routinely before use and this can be done only with the help of qualified Clinical Engineers. Thus there is a genuine need for well organized cadre of Clinical Engineers who would be persons with engineering background with specialization in medical instrumentation. These Clinical engineers should be made responsible for the maintenance and proper functioning of BME. Every hospital or group of hospitals in the advanced countries has a clinical engineering unit that takes care of the biomedical equipments and systems in the hospital by undertaking routine and preventive maintenance, regular calibration of equipments and their timely repairs. Clinical engineers should be thus made an essential part of modern health care system and services. Unfortunately such facilities and mechanism do not exist in India. To make BME maintenance efficient and flawless in India, study suggests following measures and remedies: (i) design and development of comprehensive computerized database for BME (ii) cadre of Clinical engineers (iii) online maintenance facility and (iv) farsighted managerial skill to maximize accuracy, functioning and cost effectiveness.

[The digital information platform after-sale service of medical equipment].

PubMed

Cao, Shaoping; Li, Bin

2015-01-01

This paper describes the after-sale service of medical equipment information management platform, with large data sharing resources to further enhance customer service in the whole management process of medical service, to strengthen quality management, to control medical risk.

Ultrasonography in diagnosing chronic pancreatitis: New aspects

PubMed Central

Dimcevski, Georg; Erchinger, Friedemann G; Havre, Roald; Gilja, Odd Helge

2013-01-01

The course and outcome is poor for most patients with pancreatic diseases. Advances in pancreatic imaging are important in the detection of pancreatic diseases at early stages. Ultrasonography as a diagnostic tool has made, virtually speaking a technical revolution in medical imaging in the new millennium. It has not only become the preferred method for first line imaging, but also, increasingly to clarify the interpretation of other imaging modalities to obtain efficient clinical decision. We review ultrasonography modalities, focusing on advanced pancreatic imaging and its potential to substantially improve diagnosis of pancreatic diseases at earlier stages. In the first section, we describe scanning techniques and examination protocols. Their consequences for image quality and the ability to obtain complete and detailed visualization of the pancreas are discussed. In the second section we outline ultrasonographic characteristics of pancreatic diseases with emphasis on chronic pancreatitis. Finally, new developments in ultrasonography of the pancreas such as contrast enhanced ultrasound and elastography are enlightened. PMID:24259955

[Development of a medical equipment support information system based on PDF portable document].

PubMed

Cheng, Jiangbo; Wang, Weidong

2010-07-01

According to the organizational structure and management system of the hospital medical engineering support, integrate medical engineering support workflow to ensure the medical engineering data effectively, accurately and comprehensively collected and kept in electronic archives. Analyse workflow of the medical, equipment support work and record all work processes by the portable electronic document. Using XML middleware technology and SQL Server database, complete process management, data calculation, submission, storage and other functions. The practical application shows that the medical equipment support information system optimizes the existing work process, standardized and digital, automatic and efficient orderly and controllable. The medical equipment support information system based on portable electronic document can effectively optimize and improve hospital medical engineering support work, improve performance, reduce costs, and provide full and accurate digital data

Emission of volatile organic compounds from medical equipment inside neonatal incubators.

PubMed

Colareta Ugarte, U; Prazad, P; Puppala, B L; Schweig, L; Donovan, R; Cortes, D R; Gulati, A

2014-08-01

To determine emission of volatile organic compounds (VOCs) from plastic medical equipment within an incubator. Air samples from incubators before and after adding medical equipment were analyzed using EPA TO-15 methodology. Headspace analysis was used to identify VOC emissions from each medical equipment item. Air changes per hour (ACH) of each incubator were determined and used to calculate the emission rate of identified VOCs. Cyclohexanone was identified in all incubator air samples. At 28 °C, the mean concentration before and after adding medical equipment items was 2.1 ± 0.6 and 57.2 ± 14.9 μg m(-3),respectively (P<0.01). Concentrations increased to a mean of 83.8 ± 23.8 μg m(-)(3) (P<0.01) at 37(o)C and 93.0 ± 45.1 μg m(-)(3) (P=0.39) after adding 50% humidity. Intravenous tubing contributed 89% of cyclohexanone emissions. ACH were determined with access doors closed and open with means of 11.5 ± 1.7 and 44.1 ± 6.7 h(-1), respectively. Cyclohexanone emission rate increased from a mean of 102.2 μg h(-1) at 28(°C to 148.8 μg h(-1) (P<0.01) at 37 °C. Cyclohexanone was quantified in all incubator air samples containing plastic medical equipment. The concentration of cyclohexanone within the incubator was inversely related to ACH in the closed mode. The cyclohexanone concentration as well as the emission rate increased with higher temperature.

[Hospital clinical engineer orientation and function in the maintenance system of hospital medical equipment].

PubMed

Li, Bin; Zheng, Yunxin; He, Dehua; Jiang, Ruiyao; Chen, Ying; Jing, Wei

2012-03-01

The quantity of medical equipment in hospital rise quickly recent year. It provides the comprehensive support to the clinical service. The maintenance of medical equipment becomes more important than before. It is necessary to study on the orientation and function of clinical engineer in medical equipment maintenance system. Refer to three grade health care system, the community doctors which is called General practitioner, play an important role as the gatekeeper of health care system to triage and cost control. The paper suggests that hospital clinical engineer should play similar role as the gatekeeper of medical equipment maintenance system which composed by hospital clinical engineer, manufacture engineer and third party engineer. The hospital clinical engineer should be responsible of guard a pass of medical equipment maintenance quality and cost control. As the gatekeeper, hospital clinical engineer should take the responsibility of "General engineer" and pay more attention to safety and health of medical equipment. The responsibility description and future transition? development of clinical engineer as "General Engineer" is discussed. More attention should be recommended to the team building of hospital clinical engineer as "General Engineer".

15 CFR Notes Applicable to State... - Notes applicable to State of Understanding related to Medical Equipment:

Code of Federal Regulations, 2010 CFR

2010-01-01

... Understanding related to Medical Equipment: applicable Notes applicable to State of Understanding related to Medical Equipment: Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade... Statement of Understanding—medical equipment: Commodities that are “specially designed for medical end-use...

Primary Salvage Survey of the Interference of Radiowaves Emitted by Smartphones on Medical Equipment.

PubMed

Takao, Hiroyuki; Yeh, Yu Chih; Arita, Hiroyuki; Obatake, Takumi; Sakano, Teppei; Kurihara, Minoru; Matsuki, Akira; Ishibashi, Toshihiro; Murayama, Yuichi

2016-10-01

Use of mobile phones has become a standard reality of everyday living for many people worldwide, including medical professionals, as data sharing has drastically helped to improve quality of care. This increase in the use of mobile phones within hospitals and medical facilities has raised concern regarding the influence of radio waves on medical equipment. Although comprehensive studies have examined the effects of electromagnetic interference from 2G wireless communication and personal digital cellular systems on medical equipment, similar studies on more recent wireless technologies such as Long Term Evolution, wideband code division multiple access, and high-speed uplink access have yet to be published. Numerous tests targeting current wireless technologies were conducted between December 2012 and March 2013 in an anechoic chamber, shielded from external radio signals, with a dipole antenna to assess the effects of smartphone interference on several types of medical equipment. The interference produced by electromagnetic waves across five frequency bands from four telecommunication standards was assessed on 49 components from 22 pieces of medical equipment. Of the 22 pieces of medical equipment tested, 13 experienced interference at maximum transmission power. In contrast, at minimum transmission power, the maximum interference distance varied from 2 to 5 cm for different wireless devices. Four machines were affected at the minimum transmission power, and the maximum interference distance at the maximum transmission power was 38 cm. Results show that the interference from smartphones on medical equipment is very controllable.

Mobile phone interference with medical equipment and its clinical relevance: a systematic review.

PubMed

Lawrentschuk, Nathan; Bolton, Damien M

2004-08-02

To conduct a systematic review of studies on clinically relevant digital mobile phone electromagnetic interference with medical equipment. MEDLINE and SUMSEARCH were searched for the period 1966-2004. The Cochrane Library and Database of Abstracts of Reviews of Effects were also searched for systematic reviews. Studies were eligible if published in a peer-reviewed journal in English, and if they included testing of digital mobile phones for clinically relevant interference with medical equipment used to monitor or treat patients, but not implantable medical devices. As there was considerable heterogeneity in medical equipment studied and the conduct of testing, results were summarised rather than subjected to meta-analysis. Clinically relevant electromagnetic interference (EMI) secondary to mobile phones potentially endangering patients occurred in 45 of 479 devices tested at 900 MHz and 14 of 457 devices tested at 1800 MHz. However, in the largest studies, the prevalence of clinically relevant EMI was low. Most clinically relevant EMI occurred when mobile phones were used within 1 m of medical equipment. Although testing was not standardised between studies and equipment tested was not identical, it is of concern that at least 4% of devices tested in any study were susceptible to clinically relevant EMI. All studies recommend some type of restriction of mobile phone use in hospitals, with use greater than 1 m from equipment and restrictions in clinical areas being the most common.

The benefits and limitations of using ultrasonography to supplement anatomical understanding.

PubMed

Sweetman, Greg M; Crawford, Gail; Hird, Kathryn; Fear, Mark W

2013-01-01

Anatomical understanding is critical to medical education. With reduced teaching time and limited cadaver availability, it is important to investigate how best to utilize in vivo imaging to supplement anatomical understanding and better prepare medical graduates for the proliferation of point-of-care imaging in the future. To investigate whether using short sessions of in vivo imaging using ultrasonography could benefit students' anatomical knowledge and clinical application, we conducted a 2-hour session on abdominal anatomy using ultrasonography in small groups of five to six students, for both first- and second-year student cohorts. Individual feedback was collected to assess student perceptions. To measure retention and understanding, a short examination containing ultrasound images and questions and performance of a clinical skill (gastrointestinal' tract examination) were assessed. Ultrasonography sessions were highly valued by the students, with 90% of the students reporting their understanding was improved, and over 70% reporting increased confidence in their anatomical knowledge. However, the assessments showed no appreciable impact on skills or understanding related to abdominal anatomy and examination. We conclude that the risk associated with limited exposure increasing confidence without increasing skills remains real and that in vivo imaging is not effective when used as a short adjunct teaching tool. The widespread use of ultrasonography means finding the best way to incorporate ultrasound into medical education remains important. To this end, we are currently implementing an extended program including echocardiography and multiple anatomical sessions that will determine if frequency and repetition of use can positively impact on student performance and understanding. Copyright © 2012 American Association of Anatomists.

Use of medical and dental X-ray equipment for nondestructive testing

NASA Technical Reports Server (NTRS)

1969-01-01

Industrial X ray equipment is used for nondestructive testing to detect defects in metal joints, electrical terminal blocks, sealed assemblies, and other hardware. Medical and dental X ray equipment is also used for hardware troubleshooting.

A framework of medical equipment management system for in-house clinical engineering department.

PubMed

Chien, Chia-Hung; Huang, Yi-You; Chong, Fok-Ching

2010-01-01

Medical equipment management is an important issue for safety and cost in modern hospital operation. In addition, the use of an efficient information system effectively promotes the managing performance. In this study, we designed a framework of medical equipment management system used for in-house clinical engineering department. The system was web-based, and it integrated clinical engineering and hospital information system components. Through related information application, it efficiently improved the operation management of medical devices immediately and continuously. This system has run in the National Taiwan University Hospital. The results showed only few examples in the error analysis of medical equipment by the maintenance sub-system. The information can be used to improve work quality, to reduce the maintenance cost, and to promote the safety of medical device used in patients and clinical staffs.

Using web technique in the managing regulatory requirements of medical equipment for the nursing department.

PubMed

Chien, Chia-Hung; Hwang, Bao-Hwa; Lin, Thuey-Ru; Wang, Cheng-Yi; Chong, Fok-Ching

2006-01-01

The centralized and information management are in common use technique of modern management. The management of the medical equipment emphasized in the purchase and the maintenance management in early days,and cost down now is import factor for medical equipment management because the health insurance system causes the hospital budget reduced, so in the cost down strategy is to reduce the amount of money and promoting the efficient of use . Another important subject in medical equipment management is patient safety, so how to ensuring the quality of medical equipment is also having to notice. In the paper, we will provide an architecture for assistant the nursing department to develop a information system on the centralized and information management of valuable medical equipment. Through the system operation we hope can promote the effect and the quality of the medical equipment usage. This system implement up to now has more than half a year, and could acquired some concrete result: the utilization rate promotes doubly, the rate of breaking downs, the borrowed time cuts 75%, the cost downs for equipment purchase and satisfaction increases for user. In this paper, in addition to explaining the above-mentioned result,also discusses the design principle and structure on the whole system. We hope the protocol could be used as for clinical unit to control their valuable equipments and match the authority expectation.

Integrated software system for improving medical equipment management.

PubMed

Bliznakov, Z; Pappous, G; Bliznakova, K; Pallikarakis, N

2003-01-01

The evolution of biomedical technology has led to an extraordinary use of medical devices in health care delivery. During the last decade, clinical engineering departments (CEDs) turned toward computerization and application of specific software systems for medical equipment management in order to improve their services and monitor outcomes. Recently, much emphasis has been given to patient safety. Through its Medical Device Directives, the European Union has required all member nations to use a vigilance system to prevent the reoccurrence of adverse events that could lead to injuries or death of patients or personnel as a result of equipment malfunction or improper use. The World Health Organization also has made this issue a high priority and has prepared a number of actions and recommendations. In the present workplace, a new integrated, Windows-oriented system is proposed, addressing all tasks of CEDs but also offering a global approach to their management needs, including vigilance. The system architecture is based on a star model, consisting of a central core module and peripheral units. Its development has been based on the integration of 3 software modules, each one addressing specific predefined tasks. The main features of this system include equipment acquisition and replacement management, inventory archiving and monitoring, follow up on scheduled maintenance, corrective maintenance, user training, data analysis, and reports. It also incorporates vigilance monitoring and information exchange for adverse events, together with a specific application for quality-control procedures. The system offers clinical engineers the ability to monitor and evaluate the quality and cost-effectiveness of the service provided by means of quality and cost indicators. Particular emphasis has been placed on the use of harmonized standards with regard to medical device nomenclature and classification. The system's practical applications have been demonstrated through a pilot

Portable ultrasonography in mass casualty incidents: The CAVEAT examination.

PubMed

Stawicki, Stanislaw Peter; Howard, James M; Pryor, John P; Bahner, David P; Whitmill, Melissa L; Dean, Anthony J

2010-11-18

Ultrasonography used by practicing clinicians has been shown to be of utility in the evaluation of time-sensitive and critical illnesses in a range of environments, including pre-hospital triage, emergency department, and critical care settings. The increasing availability of light-weight, robust, user-friendly, and low-cost portable ultrasound equipment is particularly suited for use in the physically and temporally challenging environment of a multiple casualty incident (MCI). Currently established ultrasound applications used to identify potentially lethal thoracic or abdominal conditions offer a base upon which rapid, focused protocols using hand-carried emergency ultrasonography could be developed. Following a detailed review of the current use of portable ultrasonography in military and civilian MCI settings, we propose a protocol for sonographic evaluation of the chest, abdomen, vena cava, and extremities for acute triage. The protocol is two-tiered, based on the urgency and technical difficulty of the sonographic examination. In addition to utilization of well-established bedside abdominal and thoracic sonography applications, this protocol incorporates extremity assessment for long-bone fractures. Studies of the proposed protocol will need to be conducted to determine its utility in simulated and actual MCI settings.

[Intraoperative ultrasonography during laparoscopic surgery].

PubMed

Alecu, L; Lungu, C; Pascu, A; Costan, I; Corodeanu, G; Deacu, A; Marin, A

2000-01-01

Of this study is the introduction and the results evaluation of laparoscopic ultrasonography performed. We realize a prospective study about laparoscopic ultrasonography performed in 37 cases with laparoscopic surgical treatment. The Aloka SSD 2000 mobile scanner is used. This system make possible the use of an linear-array transducer, with mechanical flexibility and availability of Doppler analysis. Most frequently we used intraoperative ultrasonography in laparoscopic cholecystectomy as an alternative for cholangiography to exclude CBD pathology. Because of various surgical pathology with laparoscopic approach, the laparoscopic ultrasonography utilization range was vastly. In all the cases we could performed the laparoscopic ultrasonography. In 6 of 27 cases with laparoscopic cholecystectomy we found pathological disorders of bile ducts. CBD with diameter found between 5-12 mm. We properly saw the distal segment of CBD in 23 cases (89.2%), and common hepatic duct in 26 cases (97.3%). The quality of visualization was very good in 21 cases (83.8%) and moderate in 6 cases (16.2%). We easy identify CBD stones and we successfully used Doppler color mode in differentiating vascular from non-vascular from non-vascular structures. Laparoscopic ultrasonography performed in a case with left colon cancer excluded liver metastasis and lymph nodes metastasis. 1. Laparoscopic ultrasonography combines the advantages of diagnostic laparoscopy and intraoperative contact ultrasonography; 2. Laparoscopic ultrasonography is a simple and very efficient intraoperative examination procedure; 3. Laparoscopic ultrasonography is the technique to choose in CBD intraoperative exploration; 4. Laparoscopic ultrasonography improve abdominal malignancy exploration, thus modifying therapeutic decisions; 5. Color Doppler mode guides the surgeon's steps in difficult directions.

Supporting management of medical equipment for inpatient service in public hospitals: a case study.

PubMed

Figueroa, Rosa L; Vallejos, Guido E

2013-01-01

This work presents a study of medical equipment availability in the short and long term. The work is divided in two parts. The first part is an analysis of the medical equipment inventory for the institution of study. We consider the replacement, maintenance, and reinforcement of the available medical equipment by considering local guidelines and surveying clinical personnel appreciation. The resulting recommendation is to upgrade the current equipment inventory if necessary. The second part considered a demand analysis in the short and medium term. We predicted the future demand with a 5-year horizon using Holt-Winters models. Inventory analysis showed that 27% of the medical equipment in stock was not functional. Due to this poor performance result we suggested that the hospital gradually addresses this situation by replacing 29 non-functional equipment items, reinforcing stock with 40 new items, and adding 11 items not available in the inventory but suggested by the national guidelines. The results suggest that general medicine inpatient demand has a tendency to increase within the time e.g. for general medicine inpatient service the highest increment is obtained by respiratory (12%, RMSE=8%) and genitourinary diseases (20%, RMSE=9%). This increment did not involve any further upgrading of the proposed inventory.

Electromagnetic pulse (EMP), Part I: Effects on field medical equipment.

PubMed

Vandre, R H; Klebers, J; Tesche, F M; Blanchard, J P

1993-04-01

The electromagnetic pulse (EMP) from a high-altitude nuclear detonation has the potential to cover an area as large as the continental United States with damaging levels of EMP radiation. In this study, two of seven items of medical equipment were damaged by an EMP simulator. Computer circuit analysis of 17 different items showed that 11 of the 17 items would be damaged by current surges on the power cords, while two would be damaged by current surges on external leads. This research showed that a field commander can expect approximately 65% of his electronic medical equipment to be damaged by a single nuclear detonation as far as 2,200 km away.

Human Factors and ISS Medical Systems: Highlights of Procedures and Equipment Findings

NASA Technical Reports Server (NTRS)

Byrne, V. E.; Hudy, C.; Smith, D.; Whitmore, M.

2005-01-01

As part of the Space Human Factors Engineering Critical Questions Roadmap, a three year Technology Development Project (TDP) was funded by NASA Headquarters to examine emergency medical procedures on ISS. The overall aim of the emergency medical procedures project was to determine the human factors issues in the procedures, training, communications and equipment, and to recommend solutions that will improve the survival rate of crewmembers in the event of a medical emergency. Currently, each ISS crew remains on orbit for six month intervals. As there is not standing requirement for a physician crewmember, during such time, the maintenance of crew health is dependant on individual crewmembers. Further, in the event of an emergency, crew will need to provide prolonged maintenance care, as well as emergency treatment, to an injured crewmember while awaiting transport to Earth. In addition to the isolation of the crew, medical procedures must be carried out within the further limitations imposed by the physical environment of the space station. For example, in order to administer care on ISS without the benefit of gravity, the Crew Medical Officers (CMOs) must restrain the equipment required to perform the task, restrain the injured crewmember, and finally, restrain themselves. Both the physical environment and the physical space available further limit the technology that can be used onboard. Equipment must be compact, yet able to withstand high levels of radiation and function without gravity. The focus here is to highlight the human factors impacts from our three year project involving the procedures and equipment areas that have been investigated and provided valuable to ISS and provide groundwork for human factors requirements for medical applications for exploration missions.

[Experiences in maintenance and repair cost control of medical equipments].

PubMed

Liu, Jin-chu; Wu, Yun-fang

2005-07-01

This paper introduces methods to control the cost of maintenance and repair for medical equipments through service team training, service contract control, system establishment and outside service resources, etc..

Performance of on-site Medical waste disinfection equipment in hospitals of Tabriz, Iran

PubMed Central

Taghipour, Hassan; Alizadeh, Mina; Dehghanzadeh, Reza; Farshchian, Mohammad Reza; Ganbari, Mohammad; Shakerkhatibi, Mohammad

2016-01-01

Background: The number of studies available on the performance of on-site medical waste treatment facilities is rare, to date. The aim of this study was to evaluate the performance of onsite medical waste treatment equipment in hospitals of Tabriz, Iran. Methods: A various range of the on-site medical waste disinfection equipment (autoclave, chemical disinfection, hydroclave, and dry thermal treatment) was considered to select 10 out of 22 hospitals in Tabriz to be included in the survey. The apparatus were monitored mechanically, chemically, and biologically for a six months period in all of the selected hospitals. Results: The results of the chemical monitoring (Bowie-Dick tests) indicated that 38.9% of the inspected autoclaves had operational problems in pre-vacuum, air leaks, inadequate steam penetration into the waste, and/or vacuum pump. The biological indicators revealed that about 55.55% of the samples were positive. The most of applied devices were not suitable for treating anatomical, pharmaceutical, cytotoxic, and chemical waste. Conclusion: Although on-site medical waste treating facilities have been installed in all the hospitals, the most of infectious-hazardous medical waste generated in the hospitals were deposited into a municipal solid waste landfill, without enough disinfection. The responsible authorities should stringently inspect and evaluate the operation of on-site medical waste treating equipment. An advanced off-site central facility with multi-treatment and disinfection equipment and enough capacity is recommended as an alternative. PMID:27766238

Performance of on-site Medical waste disinfection equipment in hospitals of Tabriz, Iran.

PubMed

Taghipour, Hassan; Alizadeh, Mina; Dehghanzadeh, Reza; Farshchian, Mohammad Reza; Ganbari, Mohammad; Shakerkhatibi, Mohammad

2016-01-01

Background: The number of studies available on the performance of on-site medical waste treatment facilities is rare, to date. The aim of this study was to evaluate the performance of onsite medical waste treatment equipment in hospitals of Tabriz, Iran. Methods: A various range of the on-site medical waste disinfection equipment (autoclave, chemical disinfection, hydroclave, and dry thermal treatment) was considered to select 10 out of 22 hospitals in Tabriz to be included in the survey. The apparatus were monitored mechanically, chemically, and biologically for a six months period in all of the selected hospitals. Results: The results of the chemical monitoring (Bowie-Dick tests) indicated that 38.9% of the inspected autoclaves had operational problems in pre-vacuum, air leaks, inadequate steam penetration into the waste, and/or vacuum pump. The biological indicators revealed that about 55.55% of the samples were positive. The most of applied devices were not suitable for treating anatomical, pharmaceutical, cytotoxic, and chemical waste. Conclusion: Although on-site medical waste treating facilities have been installed in all the hospitals, the most of infectious-hazardous medical waste generated in the hospitals were deposited into a municipal solid waste landfill, without enough disinfection. The responsible authorities should stringently inspect and evaluate the operation of on-site medical waste treating equipment. An advanced off-site central facility with multi-treatment and disinfection equipment and enough capacity is recommended as an alternative.

Ultrasonography of the male breast.

PubMed

Draghi, F; Tarantino, C C; Madonia, L; Ferrozzi, G

2011-09-01

The male breast has been insufficiently explored in the medical literature, particularly that dealing with ultrasonography, although this topic is almost as vast and varied as that of the female breast. The purpose of this article is to provide a schematic review of the most frequent breast lesions encountered in males and their sonographic appearances. After a brief introduction on the anatomy of the male breast, the authors review the non-neoplastic (gynecomastia, pseudogynecomastia, cysts, inflammatory diseases, and Mondor disease) and neoplastic (benign and malignant) lesions encountered in this organ.

Ultrasonography of the male breast

PubMed Central

Draghi, F.; Tarantino, C.C.; Madonia, L.; Ferrozzi, G.

2011-01-01

The male breast has been insufficiently explored in the medical literature, particularly that dealing with ultrasonography, although this topic is almost as vast and varied as that of the female breast. The purpose of this article is to provide a schematic review of the most frequent breast lesions encountered in males and their sonographic appearances. After a brief introduction on the anatomy of the male breast, the authors review the non-neoplastic (gynecomastia, pseudogynecomastia, cysts, inflammatory diseases, and Mondor disease) and neoplastic (benign and malignant) lesions encountered in this organ. PMID:23397020

Diagnostic utility of abdominal ultrasonography in dogs with chronic diarrhea.

PubMed

Leib, M S; Larson, M M; Grant, D C; Monroe, W E; Troy, G C; Panciera, D L; Rossmeisl, J H; Werre, S R

2012-01-01

Chronic diarrhea is common in dogs and has many causes. Ultrasonographic descriptions of many gastrointestinal diseases have been published, but the diagnostic utility of ultrasonography in dogs with chronic diarrhea has not been investigated. Diagnostic utility of abdominal ultrasound will be highest in dogs with GI neoplasia and lowest in those with inflammatory disorders. 87 pet dogs with chronic diarrhea. Prospective study in which medical records were reviewed and contribution of abdominal ultrasound toward making diagnosis was scored. In 57/87 (66%) of dogs, the same diagnosis would have been reached without ultrasonography. In 13/87 (15%) of dogs, the ultrasound examination was vital or beneficial to making the diagnosis. Univariable analysis identified that increased diagnostic utility was associated with weight loss (P = .0086), palpation of an abdominal or rectal mass (P = .0031), diseases that commonly have mass lesions visible on ultrasound examination (P < .0001), and a final diagnosis of GI neoplasia. Multivariable regression indicated that utility of abdominal ultrasonography would be 30 times more likely to be high in dogs in which an abdominal or rectal mass was palpated (odds ratio 30.5, 95% CI 5.5-169.6) (P < .0001) versus dogs without a palpable mass. In 15/87 (17%) of dogs, additional benefits of ultrasonography to case management, independent of the contribution to the diagnosis of diarrhea, were identified. Overall, the diagnostic utility of abdominal ultrasonography was low in dogs with chronic diarrhea. Identification of factors associated with high diagnostic utility is an indication to perform abdominal ultrasonography in dogs with chronic diarrhea. Copyright © 2012 by the American College of Veterinary Internal Medicine.

Diagnostic utility of abdominal ultrasonography in dogs with chronic vomiting.

PubMed

Leib, M S; Larson, M M; Panciera, D L; Troy, G C; Monroe, W E; Rossmeisl, J H; Forrester, S D; Herring, E S

2010-01-01

Chronic vomiting is a common problem in dogs that has many causes. Ultrasonographic descriptions of many gastrointestinal (GI) diseases have been published. However, diagnostic utility of ultrasonography in dogs with chronic vomiting has not been investigated. Diagnostic utility of abdominal ultrasound will be highest in dogs with GI neoplasia and lowest in those with inflammatory disorders. Eighty-nine pet dogs with chronic vomiting. Medical records were reviewed and the contribution of abdominal ultrasound to the clinical diagnosis was subjectively scored. In 68.5% of dogs, the reviewers thought that the same diagnosis would have been reached without performing ultrasonography. In 22.5% of dogs, the ultrasound examination was considered to be vital or beneficial to the diagnosis. Univariable analysis identified that increased diagnostic utility was associated with increasing age, a greater number of vomiting episodes per week, presence of weight loss, a greater percentage of lost body weight, and a final diagnosis of GI lymphoma or gastric adenocarcinoma. However, multivariate analysis only identified increasing age and a final diagnosis of gastric adenocarcinoma or GI lymphoma to be associated with increased diagnostic utility. In 12.4% of dogs, additional benefits of ultrasonography to case management, excluding the contribution to the vomiting problem, were identified. The diagnostic utility of abdominal ultrasonography was high in 27% of dogs. The presence of factors that are associated with high diagnostic utility is an indication to perform abdominal ultrasonography in dogs with chronic vomiting.

An intelligent healthcare management system: a new approach in work-order prioritization for medical equipment maintenance requests.

PubMed

Hamdi, Naser; Oweis, Rami; Abu Zraiq, Hamzeh; Abu Sammour, Denis

2012-04-01

The effective maintenance management of medical technology influences the quality of care delivered and the profitability of healthcare facilities. Medical equipment maintenance in Jordan lacks an objective prioritization system; consequently, the system is not sensitive to the impact of equipment downtime on patient morbidity and mortality. The current work presents a novel software system (EQUIMEDCOMP) that is designed to achieve valuable improvements in the maintenance management of medical technology. This work-order prioritization model sorts medical maintenance requests by calculating a priority index for each request. Model performance was assessed by utilizing maintenance requests from several Jordanian hospitals. The system proved highly efficient in minimizing equipment downtime based on healthcare delivery capacity, and, consequently, patient outcome. Additionally, a preventive maintenance optimization module and an equipment quality control system are incorporated. The system is, therefore, expected to improve the reliability of medical equipment and significantly improve safety and cost-efficiency.

[Current Situation and Prospects of Emergency Medical Equipment in Our Country].

PubMed

Qi, Lijing; Cheng, Feng

2016-03-01

This article analyzes the new demand of emergency medical equipment in the current development trend based on the analysis of the development and current situation of emergency medicine in our country. At the same time it introduces the current industrial characteristics of our country. Finally it analyzes the development trend of this kind of equipment in the new emergency medicine field.

Comparison of the diagnostic value of ultrasonography and standing radiography for pelvic-femoral disorders in horses.

PubMed

Geburek, Florian; Rötting, Anna K; Stadler, Peter M

2009-04-01

To assess agreement between ultrasonography (transcutaneous and transrectal) and standing radiography in horses with fractures in the pelvic region and disorders of the coxofemoral joint. Case series. Warmblood horses (n=23) and 2 ponies. Medical records (1999-2008) of equids with pelvic or coxofemoral disorders that had pelvic radiography and ultrasonography were retrieved and results of both techniques compared. Radiography and ultrasonography each identified equal numbers of fractures of the tuber coxa (n=4), ilial shaft (2), ischium (3), femoral neck (2), and osteoarthritis/osis of the coxofemoral joint (6). Fractures of the ilial wing (4) were only identified by ultrasonography not by standing radiography. Of 9 acetabular fractures, 3 were identified on radiographs only, 5 were identified with both modalities. One pubic fracture was identified using ultrasonography and radiography. One acetabular and 1 pubic fracture were only diagnosed on necropsy. We found reasonable agreement (73%; 24/33) between ultrasonography and standing radiography for diagnosis of pelvic-femoral disorders. Ultrasonography was more useful for ilial wing fractures and radiography for acetabular fractures. Ultrasonography is a rapid, safe imaging technique for detecting disorders of the pelvic region with a high diagnostic yield and is a preferred initial approach in horses with severe hindlimb lameness.

In-flight medical emergencies during airline operations: a survey of physicians on the incidence, nature, and available medical equipment

PubMed Central

Hinkelbein, Jochen; Neuhaus, Christopher; Böhm, Lennert; Kalina, Steffen; Braunecker, Stefan

2017-01-01

Background Data on the incidence of in-flight medical emergencies on-board civil aircraft are uncommon and rarely published. Such data could provide information regarding required medical equipment on-board aircraft and requisite training for cabin crew. The aim of the present study was to gather data on the incidences, nature, and medical equipment for in-flight medical emergencies by way of a survey of physician members of a German aerospace medical society. Materials and methods Using unipark.de (QuestBack GmbH, Cologne, Germany), an online survey was developed and used to gather specific information. Members of the German Society for Aviation and Space Medicine (Deutsche Gesellschaft für Luft- und Raumfahrtmedizin e.V.; DGLRM) were invited to participate in the survey during a 4-week period (21 March 2015 to 20 April 2015). Chi-square test was used for statistical analysis (p<0.05 was considered significant). Results Altogether, 121 members of the society responded to the survey (n=335 sent out). Of the 121 respondents, n=54 (44.6%) of the participants (89.9% male and 10.1% female; mean age, 54.1 years; n=121) were involved in at least one in-flight medical emergency. Demographic parameters in this survey were in concordance with the society members’ demographics. The mean duration of flights was 5.7 hours and the respondents performed 7.1 airline flights per year (median). Cardiovascular (40.0%) and neurological disorders (17.8%) were the most frequent diagnoses. The medical equipment (78.7%) provided was sufficient. An emergency diversion was undertaken in 10.6% of the cases. Although using a different method of data acquisition, this survey confirms previous data on the nature of emergencies and gives plausible numbers. Conclusion Our data strongly argue for the establishment of a standardized database for recording the incidence and nature of in-flight medical emergencies. Such a database could inform on required medical equipment and cabin crew training

In-flight medical emergencies during airline operations: a survey of physicians on the incidence, nature, and available medical equipment.

PubMed

Hinkelbein, Jochen; Neuhaus, Christopher; Böhm, Lennert; Kalina, Steffen; Braunecker, Stefan

2017-01-01

Data on the incidence of in-flight medical emergencies on-board civil aircraft are uncommon and rarely published. Such data could provide information regarding required medical equipment on-board aircraft and requisite training for cabin crew. The aim of the present study was to gather data on the incidences, nature, and medical equipment for in-flight medical emergencies by way of a survey of physician members of a German aerospace medical society. Using unipark.de (QuestBack GmbH, Cologne, Germany), an online survey was developed and used to gather specific information. Members of the German Society for Aviation and Space Medicine (Deutsche Gesellschaft für Luft- und Raumfahrtmedizin e.V.; DGLRM) were invited to participate in the survey during a 4-week period (21 March 2015 to 20 April 2015). Chi-square test was used for statistical analysis ( p <0.05 was considered significant). Altogether, 121 members of the society responded to the survey (n=335 sent out). Of the 121 respondents, n=54 (44.6%) of the participants (89.9% male and 10.1% female; mean age, 54.1 years; n=121) were involved in at least one in-flight medical emergency. Demographic parameters in this survey were in concordance with the society members' demographics. The mean duration of flights was 5.7 hours and the respondents performed 7.1 airline flights per year (median). Cardiovascular (40.0%) and neurological disorders (17.8%) were the most frequent diagnoses. The medical equipment (78.7%) provided was sufficient. An emergency diversion was undertaken in 10.6% of the cases. Although using a different method of data acquisition, this survey confirms previous data on the nature of emergencies and gives plausible numbers. Our data strongly argue for the establishment of a standardized database for recording the incidence and nature of in-flight medical emergencies. Such a database could inform on required medical equipment and cabin crew training.

Grey-scale ultrasonography for monitoring industrial exposure to hepatotoxic agents.

PubMed

Taylor, K J; Williams, D M; Smith, P M; Duck, B W

1975-05-31

Industrial exposure to several potentially hepatotoxic agents, such as vinyl-chloride monomer may occur, and there is a need for non-vasive, diagnostic techniques to detect and monitor progressive pathological processes in liver or spleen. Grey-scale ultrasonography permits display of detailed anatomy and pathology in the liver, portal veins, and spleen. The combination of fine resolution, non-invasiveness, absence of ionising radiation hazard, and portable equipment makes the technique ideal for screening populations at risk.

Development of Skylab medical equipment and flight preparations

NASA Technical Reports Server (NTRS)

Johnston, R. S.; Stonesifer, J. C.; Hawkins, W. R.

1975-01-01

The major medical systems in the Skylab orbital workshop are described. They comprise the food system, the waste management system, operational bioinstrumentation, personal hygiene, gas sampling, an inflight medical support system, and a cardiovascular counterpressure garment. Life sciences experiments carried out aboard Skylab are also reviewed; these include an ergometer and metabolic analyzer, a lower-body negative pressure device, an electrode harness and body temperature probe, a blood pressure cuff, a leg volume measuring band, sleep studies, a body-mass measuring device, a rotating litter chair, a blood sample processor, and small-mass measuring apparatus. All performance requirements were met with the equipment, and no failures were encountered.

Evidence-based approach to the maintenance of laboratory and medical equipment in resource-poor settings.

PubMed

Malkin, Robert; Keane, Allison

2010-07-01

Much of the laboratory and medical equipment in resource-poor settings is out-of-service. The most commonly cited reasons are (1) a lack of spare parts and (2) a lack of highly trained technicians. However, there is little data to support these hypotheses, or to generate evidence-based solutions to the problem. We studied 2,849 equipment-repair requests (of which 2,529 were out-of-service medical equipment) from 60 resource-poor hospitals located in 11 nations in Africa, Europe, Asia, and Central America. Each piece of equipment was analyzed by an engineer or an engineering student and a repair was attempted using only locally available materials. If the piece was placed back into service, we assumed that the engineer's problem analysis was correct. A total of 1,821 pieces of medical equipment were placed back into service, or 72%, without requiring the use of imported spare parts. Of those pieces repaired, 1,704 were sufficiently documented to determine what knowledge was required to place the equipment back into service. We found that six domains of knowledge were required to accomplish 99% of the repairs: electrical (18%), mechanical (18%), power supply (14%), plumbing (19%), motors (5%), and installation or user training (25%). A further analysis of the domains shows that 66% of the out-of-service equipment was placed back into service using only 107 skills covering basic knowledge in each domain; far less knowledge than that required of a biomedical engineer or biomedical engineering technician. We conclude that a great majority of laboratory and medical equipment can be put back into service without importing spare parts and using only basic knowledge. Capacity building in resource-poor settings should first focus on a limited set of knowledge; a body of knowledge that we call the biomedical technician's assistant (BTA). This data set suggests that a supported BTA could place 66% of the out-of-service laboratory and medical equipment in their hospital back

[Improvement of medical equipment setting for the hospital link of the medical service during wartime].

PubMed

Miroshnichenko, Yu V; Goryachev, A B; Popov, A A; Rodionov, E O

2016-04-01

One of the priorities of the military health care is to improve the system of rationing medical equipment for the hospital unit of the medical service of the Armed Forces in wartime. This is determined the fact that the effectiveness of measures to provide military field hospitals with medical supplies depends on the quality of medical care for the wounded and sick, as well as the level of their return to duty. The article presents the characteristics of modern standards medical supplies procurement of military field hospitals included in the new regulatory legal act of the Russian Federation Ministry of Defence--"Standards of supplies medical supplies medical and pharmaceutical organizations (units) of the Russian Federation on the wartime armed forces", approved and put into effect in 2015 by order of the Minister of Defence of the Russian Federation.

Medical equipment management strategies.

PubMed

Wang, Binseng; Furst, Emanuel; Cohen, Ted; Keil, Ode R; Ridgway, Malcolm; Stiefel, Robert

2006-01-01

Clinical engineering professionals need to continually review and improve their management strategies in order to keep up with improvements in equipment technology, as well as with increasing expectations of health care organizations. In the last 20 years, management strategies have evolved from the initial obsession with electrical safety to flexible criteria that fit the individual institution's needs. Few hospitals, however, are taking full advantage of the paradigm shift offered by the evolution of joint Commission standards. The focus should be on risks caused by equipment failure, rather than on equipment with highest maintenance demands. Furthermore, it is not enough to consider risks posed by individual pieces of equipment to individual patients. It is critical to anticipate the impact of an equipment failure on larger groups of patients, especially when dealing with one of a kind, sophisticated pieces of equipment that are required to provide timely and accurate diagnoses for immediate therapeutic decisions or surgical interventions. A strategy for incorporating multiple criteria to formulate appropriate management strategies is provided in this article.

3D web based learning of medical equipment employed in intensive care units.

PubMed

Cetin, Aydın

2012-02-01

In this paper, both synchronous and asynchronous web based learning of 3D medical equipment models used in hospital intensive care unit have been described over the moodle course management system. 3D medical equipment models were designed with 3ds Max 2008, then converted to ASE format and added interactivity displayed with Viewpoint-Enliven. 3D models embedded in a web page in html format with dynamic interactivity-rotating, panning and zooming by dragging a mouse over images-and descriptive information is embedded to 3D model by using xml format. A pilot test course having 15 h was applied to technicians who is responsible for intensive care unit at Medical Devices Repairing and Maintenance Center (TABOM) of Turkish High Specialized Hospital.

Private sector involvement in times of armed conflict: What are the constraints for trading medical equipment?

PubMed

Schmidt, Georg

Today, healthcare facilities are highly dependent on the private sector to keep their medical equipment functioning. Moreover, private sector involvement becomes particularly important for the supply of spare parts and consumables. However, in times of armed conflict, the capacity of the corporate world appears to be seriously hindered. Subsequently, this study researches the influence of armed conflict on the private medical equipment sector. This study follows a qualitative approach by conducting 19 interviews with representatives of the corporate world in an active conflict zone. A semistructured interview guide, consisting of 10 questions, was used to examine the constraints of this sector. The results reveal that the lack of skilled personnel, complicated importation procedures, and a decrease in financial capacity are the major constraints faced by private companies dealing in medical equipment in conflict zones. Even when no official sanctions and embargoes for medical items exist, constraints for trading medical equipment are clearly recognizable. Countries at war would benefit from a centralized structure that deals with the importation procedures for medical items, to assist local companies in their purchasing procedures. A high degree of adaption is needed to continue operating, despite the emerging constraints of armed conflict. Future studies might research the constraints for manufacturers outside the conflict to export medical items to the country of war.

Postoperative ultrasonography of the musculoskeletal system.

PubMed

Chun, Kyung Ah; Cho, Kil-Ho

2015-07-01

Ultrasonography of the postoperative musculoskeletal system plays an important role in the accurate diagnosis of abnormal lesions in the bone and soft tissues. Ultrasonography is a fast and reliable method with no harmful irradiation for the evaluation of postoperative musculoskeletal complications. In particular, it is not affected by the excessive metal artifacts that appear on computed tomography or magnetic resonance imaging. Another benefit of ultrasonography is its capability to dynamically assess the pathologic movement in joints, muscles, or tendons. This article discusses the frequent applications of musculoskeletal ultrasonography in various postoperative situations including those involving the soft tissues around the metal hardware, arthroplasty, postoperative tendons, recurrent soft tissue tumors, bone unions, and amputation surgery.

Implementing the EQUiPPED Medication Management Program at 5 VA Emergency Departments.

PubMed

Vandenberg, Ann E; Stevens, Melissa; Echt, Katharina V; Hastings, S Nicole; Powers, James; Markland, Alayne; Hwang, Ula; Hung, William; Belbis, Stephanie; Vaughan, Camille P

2016-04-01

The Enhancing Quality of Prescribing Practices for Older Veterans Discharged From the Emergency Department (EQUiPPED) program aimed to reduce potentially inappropriate medication prescribing to older adults at 5 VAMCs.

Ultrasonography versus computed tomography for suspected nephrolithiasis.

PubMed

Smith-Bindman, Rebecca; Aubin, Chandra; Bailitz, John; Bengiamin, Rimon N; Camargo, Carlos A; Corbo, Jill; Dean, Anthony J; Goldstein, Ruth B; Griffey, Richard T; Jay, Gregory D; Kang, Tarina L; Kriesel, Dana R; Ma, O John; Mallin, Michael; Manson, William; Melnikow, Joy; Miglioretti, Diana L; Miller, Sara K; Mills, Lisa D; Miner, James R; Moghadassi, Michelle; Noble, Vicki E; Press, Gregory M; Stoller, Marshall L; Valencia, Victoria E; Wang, Jessica; Wang, Ralph C; Cummings, Steven R

2014-09-18

There is a lack of consensus about whether the initial imaging method for patients with suspected nephrolithiasis should be computed tomography (CT) or ultrasonography. In this multicenter, pragmatic, comparative effectiveness trial, we randomly assigned patients 18 to 76 years of age who presented to the emergency department with suspected nephrolithiasis to undergo initial diagnostic ultrasonography performed by an emergency physician (point-of-care ultrasonography), ultrasonography performed by a radiologist (radiology ultrasonography), or abdominal CT. Subsequent management, including additional imaging, was at the discretion of the physician. We compared the three groups with respect to the 30-day incidence of high-risk diagnoses with complications that could be related to missed or delayed diagnosis and the 6-month cumulative radiation exposure. Secondary outcomes were serious adverse events, related serious adverse events (deemed attributable to study participation), pain (assessed on an 11-point visual-analogue scale, with higher scores indicating more severe pain), return emergency department visits, hospitalizations, and diagnostic accuracy. A total of 2759 patients underwent randomization: 908 to point-of-care ultrasonography, 893 to radiology ultrasonography, and 958 to CT. The incidence of high-risk diagnoses with complications in the first 30 days was low (0.4%) and did not vary according to imaging method. The mean 6-month cumulative radiation exposure was significantly lower in the ultrasonography groups than in the CT group (P<0.001). Serious adverse events occurred in 12.4% of the patients assigned to point-of-care ultrasonography, 10.8% of those assigned to radiology ultrasonography, and 11.2% of those assigned to CT (P=0.50). Related adverse events were infrequent (incidence, 0.4%) and similar across groups. By 7 days, the average pain score was 2.0 in each group (P=0.84). Return emergency department visits, hospitalizations, and diagnostic

Implementing the EQUiPPED Medication Management Program at 5 VA Emergency Departments

PubMed Central

Vandenberg, Ann E.; Stevens, Melissa; Echt, Katharina V.; Hastings, S. Nicole; Powers, James; Markland, Alayne; Hwang, Ula; Hung, William; Belbis, Stephanie; Vaughan, Camille P.

2016-01-01

The Enhancing Quality of Prescribing Practices for Older Veterans Discharged From the Emergency Department (EQUiPPED) program aimed to reduce potentially inappropriate medication prescribing to older adults at 5 VAMCs. PMID:27773986

Accuracy of ultrasonography and magnetic resonance imaging in the diagnosis of placenta accreta.

PubMed

Riteau, Anne-Sophie; Tassin, Mikael; Chambon, Guillemette; Le Vaillant, Claudine; de Laveaucoupet, Jocelyne; Quéré, Marie-Pierre; Joubert, Madeleine; Prevot, Sophie; Philippe, Henri-Jean; Benachi, Alexandra

2014-01-01

To evaluate the accuracy of ultrasonography and magnetic resonance imaging (MRI) in the diagnosis of placenta accreta and to define the most relevant specific ultrasound and MRI features that may predict placental invasion. This study was approved by the institutional review board of the French College of Obstetricians and Gynecologists. We retrospectively reviewed the medical records of all patients referred for suspected placenta accreta to two university hospitals from 01/2001 to 05/2012. Our study population included 42 pregnant women who had been investigated by both ultrasonography and MRI. Ultrasound images and MRI were blindly reassessed for each case by 2 raters in order to score features that predict abnormal placental invasion. Sensitivity in the diagnosis of placenta accreta was 100% with ultrasound and 76.9% for MRI (P = 0.03). Specificity was 37.5% with ultrasonography and 50% for MRI (P = 0.6). The features of greatest sensitivity on ultrasonography were intraplacental lacunae and loss of the normal retroplacental clear space. Increased vascularization in the uterine serosa-bladder wall interface and vascularization perpendicular to the uterine wall had the best positive predictive value (92%). At MRI, uterine bulging had the best positive predictive value (85%) and its combination with the presence of dark intraplacental bands on T2-weighted images improved the predictive value to 90%. Ultrasound imaging is the mainstay of screening for placenta accreta. MRI appears to be complementary to ultrasonography, especially when there are few ultrasound signs.

Medical equipment classification: method and decision-making support based on paraconsistent annotated logic.

PubMed

Oshiyama, Natália F; Bassani, Rosana A; D'Ottaviano, Itala M L; Bassani, José W M

2012-04-01

As technology evolves, the role of medical equipment in the healthcare system, as well as technology management, becomes more important. Although the existence of large databases containing management information is currently common, extracting useful information from them is still difficult. A useful tool for identification of frequently failing equipment, which increases maintenance cost and downtime, would be the classification according to the corrective maintenance data. Nevertheless, establishment of classes may create inconsistencies, since an item may be close to two classes by the same extent. Paraconsistent logic might help solve this problem, as it allows the existence of inconsistent (contradictory) information without trivialization. In this paper, a methodology for medical equipment classification based on the ABC analysis of corrective maintenance data is presented, and complemented with a paraconsistent annotated logic analysis, which may enable the decision maker to take into consideration alerts created by the identification of inconsistencies and indeterminacies in the classification.

Renewal of radiological equipment.

PubMed

2014-10-01

In this century, medical imaging is at the heart of medical practice. Besides providing fast and accurate diagnosis, advances in radiology equipment offer new and previously non-existing options for treatment guidance with quite low morbidity, resulting in the improvement of health outcomes and quality of life for the patients. Although rapid technological development created new medical imaging modalities and methods, the same progress speed resulted in accelerated technical and functional obsolescence of the same medical imaging equipment, consequently creating a need for renewal. Older equipment has a high risk of failures and breakdowns, which might cause delays in diagnosis and treatment of the patient, and safety problems both for the patient and the medical staff. The European Society of Radiology is promoting the use of up-to-date equipment, especially in the context of the EuroSafe Imaging Campaign, as the use of up-to-date equipment will improve quality and safety in medical imaging. Every healthcare institution or authority should have a plan for medical imaging equipment upgrade or renewal. This plan should look forward a minimum of 5 years, with annual updates. Teaching points • Radiological equipment has a definite life cycle span, resulting in unavoidable breakdown and decrease or loss of image quality which renders equipment useless after a certain time period.• Equipment older than 10 years is no longer state-of-the art equipment and replacement is essential. Operating costs of older equipment will be high when compared with new equipment, and sometimes maintenance will be impossible if no spare parts are available.• Older equipment has a high risk of failure and breakdown, causing delays in diagnosis and treatment of the patient and safety problems both for the patient and the medical staff.• Every healthcare institution or authority should have a plan for medical imaging equipment upgrade or replacement. This plan should look forward a

[Investigation of non-ionizing radiation hazards from physiotherapy equipment in 16 medical institutions].

PubMed

He, Jia-xi; Zhou, Wei; Qiu, Hai-li; Yang, Guang-tao

2013-12-01

To investigate the non-ionizing radiation hazards from physiotherapy equipment in medical institutions and to explore feasible control measures for occupational diseases. On-site measurement and assessment of ultra-high-frequency radiation, high-frequency electromagnetic field, microwave radiation, and laser radiation were carried out in 16 medical institutions using the methods in the Measurement of Physical Agents in Workplace (GBZ/T189-2007). All the investigated medical institutions failed to take effective protective measures against non-ionizing radiation. Of the 17 ultra-short wave therapy apparatus, 70.6%, 47.1%, and 17.64% had a safe intensity of ultra-high-frequency radiation on the head, chest, and abdomen, respectively. Of the 4 external high-frequency thermotherapy apparatus, 100%, 75%, and 75%had a safe intensity of high-frequency electromagnetic field on the head, chest, and abdomen, respectively. In addition, the intensities of microwave radiation and laser radiation produced by the 18 microwave therapy apparatus and 12 laser therapeutic apparatus met national health standards. There are non-ionizing radiation hazards from physiotherapy equipment in medical institutions, and effective prevention and control measures are necessary.

Experiences of nurses on the critical shortage of medical equipment at a rural district hospital in South Africa: a qualitative study.

PubMed

Moyimane, Merriam Bautile; Matlala, Sogo France; Kekana, Mokoko Percy

2017-01-01

Medical equipment is an essential health intervention tool used by nurses for prevention, diagnosis and treatment of disease and for rehabilitation of patients. However, access to functioning medical equipment is a challenge in low- and middle-income countries. The World Health Organization estimated that 50 to 80 percent of medical equipment in developing countries is not working, creating a barrier to the ability of the health system to deliver health services to patients. This study explored and described the lived experiences of nurses working at a district hospital with a critical shortage of medical equipment. A qualitative, exploratory, phenomenological and descriptive study design was used. A purposive sampling was used to select participants and due to saturation of data 14 nurses participated in the study. Research ethics were observed. Data was collected through semi-structured interviews using an interview guide. Interviews were audio-taped and field notes were taken. Voice recordings were transcribed verbatim and Tesch's open coding method was used for data analysis. Findings were confirmed by an independent coder. Critical shortage of medical equipment at the hospital occurred in the form of unavailability of equipment, low quality and poor maintenance of the few that were available. Shortage impacted negatively on nursing care, nursing profession and the hospital. Nurses should be provided with functional medical equipment in order to provide quality nursing care. Management, leadership and governance structures should be strengthened to ensure that procurement and maintenance plans for medical equipment are developed and implemented.

EVALUATION OF CONTRAST-ENHANCED ULTRASONOGRAPHY AS A METHOD FOR DETECTING GALLBLADDER NECROSIS OR RUPTURE IN DOGS.

PubMed

Bargellini, Paolo; Orlandi, Riccardo; Paloni, Chiara; Rubini, Giuseppe; Fonti, Paolo; Peterson, Mark E; Rishniw, Mark; Boiti, Cristiano

2016-11-01

Gall bladder necrosis and rupture are life-threatening conditions in dogs requiring surgical intervention and early diagnosis is essential. Human patients with suspected gall bladder necrosis/rupture are commonly evaluated with contrast-enhanced ultrasonography (CEUS), however this procedure has not been described in dogs with suspected gall bladder necrosis/rupture. In a prospective diagnostic cohort study, CEUS (using SonoVue contrast medium) was performed in 93 dogs with gallbladder lesions identified by abdominal conventional ultrasonography. Necrosis/rupture was identified by CEUS as a focal lack of enhancement of the gallbladder wall. Dogs with positive CEUS finding for necrosis/rupture (complete lack of regional wall enhancement) underwent immediate surgery as did dogs with other biliary disorders requiring surgery. Dogs with negative CEUS findings or those not requiring surgery were managed medically. In cases undergoing surgery, necrosis/rupture was confirmed intraoperatively (and via histopathology). Absence of necrosis/rupture was confirmed either intraoperatively (via histopathology) or was assumed to be absent by complete recovery with medical management. Forty-nine dogs underwent surgery and cholecystectomy: 24 had necrosis/rupture. CEUS was more accurate (100% sensitive and specific) in diagnosing gallbladder wall necrosis/rupture than conventional ultrasonography (75% sensitive and 81% specific) (P < 0.03). In conclusion, CEUS provides accurate characterization of gallbladder wall integrity that can impact decisions regarding clinical management, either surgical or medical. © 2016 American College of Veterinary Radiology.

Value of ultrasonography for detecting chronic injury of the lateral ligaments of the ankle joint compared with ultrasonography findings.

PubMed

Cheng, Y; Cai, Y; Wang, Y

2014-01-01

The aim of this study was to assess the accuracy of ultrasonography in the diagnosis of chronic lateral ankle ligament injury. A total of 120 ankles in 120 patients with a clinical suspicion of chronic ankle ligament injury were examined by ultrasonography by using a 5- to 17-MHz linear array transducer before surgery. The results of ultrasonography were compared with the operative findings. There were 18 sprains and 24 partial and 52 complete tears of the anterior talofibular ligament (ATFL); 26 sprains, 27 partial and 12 complete tears of the calcaneofibular ligament (CFL); and 1 complete tear of the posterior talofibular ligament (PTFL) at arthroscopy and operation. Compared with operative findings, the sensitivity, specificity and accuracy of ultrasonography were 98.9%, 96.2% and 84.2%, respectively, for injury of the ATFL and 93.8%, 90.9% and 83.3%, respectively, for injury of the CFL. The PTFL tear was identified by ultrasonography. The accuracy of identification between acute-on-chronic and subacute-chronic patients did not differ. The accuracies of diagnosing three grades of ATFL injuries were almost the same as those of diagnosing CFL injuries. Ultrasonography provides useful information for the evaluation of patients presenting with chronic pain after ankle sprain. Intraoperative findings are the reference standard. We demonstrated that ultrasonography was highly sensitive and specific in detecting chronic lateral ligments injury of the ankle joint.

Quantitative assessment of interactions between hospitalized patients and portable medical equipment and other fomites.

PubMed

Suwantarat, Nuntra; Supple, Laura A; Cadnum, Jennifer L; Sankar, Thriveen; Donskey, Curtis J

2017-11-01

In an observational study, we demonstrated that hospitalized patients frequently had direct or indirect interactions with medical equipment and other fomites that are shared among patients, and these items were often contaminated with health care-associated pathogens. There is a need for protocols to ensure routine cleaning of shared portable equipment. Published by Elsevier Inc.

Compression ultrasonography of the lower extremity with portable vascular ultrasonography can accurately detect deep venous thrombosis in the emergency department.

PubMed

Crisp, Jonathan G; Lovato, Luis M; Jang, Timothy B

2010-12-01

Compression ultrasonography of the lower extremity is an established method of detecting proximal lower extremity deep venous thrombosis when performed by a certified operator in a vascular laboratory. Our objective is to determine the sensitivity and specificity of bedside 2-point compression ultrasonography performed in the emergency department (ED) with portable vascular ultrasonography for the detection of proximal lower extremity deep venous thrombosis. We did this by directly comparing emergency physician-performed ultrasonography to lower extremity duplex ultrasonography performed by the Department of Radiology. This was a prospective, cross-sectional study and diagnostic test assessment of a convenience sample of ED patients with a suspected lower extremity deep venous thrombosis, conducted at a single-center, urban, academic ED. All physicians had a 10-minute training session before enrolling patients. ED compression ultrasonography occurred before Department of Radiology ultrasonography and involved identification of 2 specific points: the common femoral and popliteal vessels, with subsequent compression of the common femoral and popliteal veins. The study result was considered positive for proximal lower extremity deep venous thrombosis if either vein was incompressible or a thrombus was visualized. Sensitivity and specificity were calculated with the final radiologist interpretation of the Department of Radiology ultrasonography as the criterion standard. A total of 47 physicians performed 199 2-point compression ultrasonographic examinations in the ED. Median number of examinations per physician was 2 (range 1 to 29 examinations; interquartile range 1 to 5 examinations). There were 45 proximal lower extremity deep venous thromboses observed on Department of Radiology evaluation, all correctly identified by ED 2-point compression ultrasonography. The 153 patients without proximal lower extremity deep venous thrombosis all had a negative ED compression

Interference by new-generation mobile phones on critical care medical equipment.

PubMed

van Lieshout, Erik Jan; van der Veer, Sabine N; Hensbroek, Reinout; Korevaar, Johanna C; Vroom, Margreeth B; Schultz, Marcus J

2007-01-01

The aim of the study was to assess and classify incidents of electromagnetic interference (EMI) by second-generation and third-generation mobile phones on critical care medical equipment. EMI was assessed with two General Packet Radio Service (GPRS) signals (900 MHz, 2 W, two different time-slot occupations) and one Universal Mobile Telecommunications System (UMTS) signal (1,947.2 MHz, 0.2 W), corresponding to maximal transmit performance of mobile phones in daily practice, generated under controlled conditions in the proximity of 61 medical devices. Incidents of EMI were classified in accordance with an adjusted critical care event scale. A total of 61 medical devices in 17 categories (27 different manufacturers) were tested and demonstrated 48 incidents in 26 devices (43%); 16 (33%) were classified as hazardous, 20 (42%) as significant and 12 (25%) as light. The GPRS-1 signal induced the most EMI incidents (41%), the GRPS-2 signal induced fewer (25%) and the UMTS signal induced the least (13%; P < 0.001). The median distance between antenna and medical device for EMI incidents was 3 cm (range 0.1 to 500 cm). One hazardous incident occurred beyond 100 cm (in a ventilator with GRPS-1 signal at 300 cm). Critical care equipment is vulnerable to EMI by new-generation wireless telecommunication technologies with median distances of about 3 cm. The policy to keep mobile phones '1 meter' from the critical care bedside in combination with easily accessed areas of unrestricted use still seems warranted.

Experiences of nurses on the critical shortage of medical equipment at a rural district hospital in South Africa: a qualitative study

PubMed Central

Moyimane, Merriam Bautile; Matlala, Sogo France; Kekana, Mokoko Percy

2017-01-01

Introduction Medical equipment is an essential health intervention tool used by nurses for prevention, diagnosis and treatment of disease and for rehabilitation of patients. However, access to functioning medical equipment is a challenge in low- and middle-income countries. The World Health Organization estimated that 50 to 80 percent of medical equipment in developing countries is not working, creating a barrier to the ability of the health system to deliver health services to patients. This study explored and described the lived experiences of nurses working at a district hospital with a critical shortage of medical equipment. Methods A qualitative, exploratory, phenomenological and descriptive study design was used. A purposive sampling was used to select participants and due to saturation of data 14 nurses participated in the study. Research ethics were observed. Data was collected through semi-structured interviews using an interview guide. Interviews were audio-taped and field notes were taken. Voice recordings were transcribed verbatim and Tesch’s open coding method was used for data analysis. Findings were confirmed by an independent coder. Results Critical shortage of medical equipment at the hospital occurred in the form of unavailability of equipment, low quality and poor maintenance of the few that were available. Shortage impacted negatively on nursing care, nursing profession and the hospital. Conclusion Nurses should be provided with functional medical equipment in order to provide quality nursing care. Management, leadership and governance structures should be strengthened to ensure that procurement and maintenance plans for medical equipment are developed and implemented. PMID:29515718

Reducing chronic obstructive pulmonary disease readmissions: the role of the durable medical equipment provider.

PubMed

Messenger, Robert W

2012-01-01

Exacerbation and frequent rehospitalization in chronic obstructive pulmonary disease exacts a heavy toll on the US health care system. To address these issues, new initiatives have been proposed that are largely based on financial penalties to promote patient education and postdischarge care. However, as laudable as these goals are, improving outcomes in the chronic obstructive pulmonary disease population is more confounding than it may first appear. Chronic hypoxia, cognitive dysfunction, poor nutrition, and economic disadvantage are just a few of the challenges that require creative solutions and ongoing support. Case managers need to utilize all the potential products and services that can assist in improving outcomes for these patients. Durable medical equipment providers are often viewed as purveyors of medical equipment that offer little in the form of clinical support. However, in many cases these providers represent an overlooked resource that provides individualized, highly structured patient education and ongoing support programs. The challenge is in identifying those durable medical equipment providers that offer patients contemporary technology, and have both the resources and the commitment to provide patient support that is amenable to the goals of the hospital. This article reviews many of the confounding issues that contribute to the frequent rehospitalization of chronic obstructive pulmonary disease patients. Recommendations to improve patient education and oxygen therapy outcomes are provided along with suggestions to aid in the vetting of durable medical equipment providers. Acute care hospitals, long-term acute care hospitals, extended care facilities, integrated delivery systems. 1. An understanding of the complex variables that play in the management of chronic obstructive pulmonary disease will help the case manager to plan an effective course of care. 2. Case managers need to ensure that patients receive long-term oxygen technology that

DEVELOPMENT AND EVALUATION OF EDUCATIONAL PROGRAMS IN BIO-MEDICAL EQUIPMENT TECHNOLOGY, PHASE I. FINAL REPORT.

ERIC Educational Resources Information Center

Technical Education Research Center, Cambridge, MA.

OFFICIALS OF A REPRESENTATIVE SAMPLE OF HOSPITALS, BIOMEDICAL EQUIPMENT MANUFACTURERS, AND MEDICAL RESEARCH INSTITUTES IN NEW ENGLAND AND THREE MIDDLE ATLANTIC STATES WERE INTERVIEWED TO DETERMINE THE NEED FOR TECHNICIANS TO SERVICE AND MAINTAIN EQUIPMENT FOUND IN HOSPITALS AND BIOMEDICAL RESEARCH INSTITUTIONS. RESPONSES INDICATED A NEED FOR…

Prenatal Imaging: Ultrasonography and Magnetic Resonance Imaging

PubMed Central

Reddy, Uma M.; Filly, Roy A.; Copel, Joshua A.

2009-01-01

The Eunice Kennedy Shriver National Institute of Child Health and Human Development held a workshop on September 18–19, 2006, to summarize the available evidence on the role and performance of current fetal imaging technology and to establish a research agenda. Ultrasonography is the imaging modality of choice for pregnancy evaluation due to its relatively low cost, real-time capability, safety, and operator comfort and experience. First-trimester ultrasonography extends the available window for fetal observation and raises the possibility of performing an early anatomic survey. Three-dimensional ultrasonography has the potential to expand the clinical application of ultrasonography by permitting local acquisition of volumes and remote review and interpretation at specialized centers. New advances allow performance of fetal magnetic resonance imaging (MRI) without maternal or fetal sedation, with improved characterization and prediction of prognosis of certain fetal central nervous system anomalies such as ventriculomegaly when compared with ultrasonography. Fewer data exist on the usefulness of fetal MRI for non–central nervous system anomalies. PMID:18591320

Ultrasonography of adnexal causes of acute pelvic pain in pre-menopausal non-pregnant women

PubMed Central

Dupuis, Carolyn S.; Kim, Young H.

2015-01-01

Acute-onset pelvic pain is an extremely common symptom in premenopausal women presenting to the emergency department. After excluding pregnancy in reproductive-age women, ultrasonography plays a major role in the prompt and accurate diagnosis of adnexal causes of acute pelvic pain, such as hemorrhagic ovarian cysts, endometriosis, ovarian torsion, and tubo-ovarian abscess. Its availability, relatively low cost, and lack of ionizing radiation make ultrasonography an ideal imaging modality in women of reproductive age. The primary goal of imaging in these patients is to distinguish between adnexal causes of acute pelvic pain that may be managed conservatively or medically, and those requiring emergency/urgent surgical or percutaneous intervention. PMID:26062637

Value of ultrasonography for detecting chronic injury of the lateral ligaments of the ankle joint compared with ultrasonography findings

PubMed Central

Cheng, Y; Cai, Y

2014-01-01

Objective: The aim of this study was to assess the accuracy of ultrasonography in the diagnosis of chronic lateral ankle ligament injury. Methods: A total of 120 ankles in 120 patients with a clinical suspicion of chronic ankle ligament injury were examined by ultrasonography by using a 5- to 17-MHz linear array transducer before surgery. The results of ultrasonography were compared with the operative findings. Results: There were 18 sprains and 24 partial and 52 complete tears of the anterior talofibular ligament (ATFL); 26 sprains, 27 partial and 12 complete tears of the calcaneofibular ligament (CFL); and 1 complete tear of the posterior talofibular ligament (PTFL) at arthroscopy and operation. Compared with operative findings, the sensitivity, specificity and accuracy of ultrasonography were 98.9%, 96.2% and 84.2%, respectively, for injury of the ATFL and 93.8%, 90.9% and 83.3%, respectively, for injury of the CFL. The PTFL tear was identified by ultrasonography. The accuracy of identification between acute-on-chronic and subacute–chronic patients did not differ. The accuracies of diagnosing three grades of ATFL injuries were almost the same as those of diagnosing CFL injuries. Conclusion: Ultrasonography provides useful information for the evaluation of patients presenting with chronic pain after ankle sprain. Advances in knowledge: Intraoperative findings are the reference standard. We demonstrated that ultrasonography was highly sensitive and specific in detecting chronic lateral ligments injury of the ankle joint. PMID:24352708

Medicare Beneficiary Satisfaction with Durable Medical Equipment Suppliers

PubMed Central

Hoerger, Thomas J.; Finkelstein, Eric A.; Bernard, Shulamit L.

2001-01-01

CMS has recently launched a series of initiatives to control Medicare spending on durable medical equipment (DME) and prosthetics, orthotics, and supplies (DMEPOS). An important question is how these initiatives will affect beneficiary satisfaction. Using survey data, we analyze Medicare beneficiary satisfaction with DMEPOS suppliers in two Florida counties. Our results show that beneficiaries are currently highly satisfied with their DMEPOS suppliers. Beneficiary satisfaction is positively related to rapid delivery, training, dependability, and frequency of service. Results of our analysis can be used as baseline estimates in evaluating CMS initiatives to reduce Medicare payments for DMEPOS. PMID:12500367

Accuracy of Ultrasonography and Magnetic Resonance Imaging in the Diagnosis of Placenta Accreta

PubMed Central

Riteau, Anne-Sophie; Tassin, Mikael; Chambon, Guillemette; Le Vaillant, Claudine; de Laveaucoupet, Jocelyne; Quéré, Marie-Pierre; Joubert, Madeleine; Prevot, Sophie; Philippe, Henri-Jean; Benachi, Alexandra

2014-01-01

Purpose To evaluate the accuracy of ultrasonography and magnetic resonance imaging (MRI) in the diagnosis of placenta accreta and to define the most relevant specific ultrasound and MRI features that may predict placental invasion. Material and Methods This study was approved by the institutional review board of the French College of Obstetricians and Gynecologists. We retrospectively reviewed the medical records of all patients referred for suspected placenta accreta to two university hospitals from 01/2001 to 05/2012. Our study population included 42 pregnant women who had been investigated by both ultrasonography and MRI. Ultrasound images and MRI were blindly reassessed for each case by 2 raters in order to score features that predict abnormal placental invasion. Results Sensitivity in the diagnosis of placenta accreta was 100% with ultrasound and 76.9% for MRI (P = 0.03). Specificity was 37.5% with ultrasonography and 50% for MRI (P = 0.6). The features of greatest sensitivity on ultrasonography were intraplacental lacunae and loss of the normal retroplacental clear space. Increased vascularization in the uterine serosa-bladder wall interface and vascularization perpendicular to the uterine wall had the best positive predictive value (92%). At MRI, uterine bulging had the best positive predictive value (85%) and its combination with the presence of dark intraplacental bands on T2-weighted images improved the predictive value to 90%. Conclusion Ultrasound imaging is the mainstay of screening for placenta accreta. MRI appears to be complementary to ultrasonography, especially when there are few ultrasound signs. PMID:24733409

Optimal Medical Equipment Maintenance Service Proposal Decision Support System combining Activity Based Costing (ABC) and the Analytic Hierarchy Process (AHP).

PubMed

da Rocha, Leticia; Sloane, Elliot; M Bassani, Jose

2005-01-01

This study describes a framework to support the choice of the maintenance service (in-house or third party contract) for each category of medical equipment based on: a) the real medical equipment maintenance management system currently used by the biomedical engineering group of the public health system of the Universidade Estadual de Campinas located in Brazil to control the medical equipment maintenance service, b) the Activity Based Costing (ABC) method, and c) the Analytic Hierarchy Process (AHP) method. Results show the cost and performance related to each type of maintenance service. Decision-makers can use these results to evaluate possible strategies for the categories of equipment.

Interference by new-generation mobile phones on critical care medical equipment

PubMed Central

van Lieshout, Erik Jan; van der Veer, Sabine N; Hensbroek, Reinout; Korevaar, Johanna C; Vroom, Margreeth B; Schultz, Marcus J

2007-01-01

Introduction The aim of the study was to assess and classify incidents of electromagnetic interference (EMI) by second-generation and third-generation mobile phones on critical care medical equipment. Methods EMI was assessed with two General Packet Radio Service (GPRS) signals (900 MHz, 2 W, two different time-slot occupations) and one Universal Mobile Telecommunications System (UMTS) signal (1,947.2 MHz, 0.2 W), corresponding to maximal transmit performance of mobile phones in daily practice, generated under controlled conditions in the proximity of 61 medical devices. Incidents of EMI were classified in accordance with an adjusted critical care event scale. Results A total of 61 medical devices in 17 categories (27 different manufacturers) were tested and demonstrated 48 incidents in 26 devices (43%); 16 (33%) were classified as hazardous, 20 (42%) as significant and 12 (25%) as light. The GPRS-1 signal induced the most EMI incidents (41%), the GRPS-2 signal induced fewer (25%) and the UMTS signal induced the least (13%; P < 0.001). The median distance between antenna and medical device for EMI incidents was 3 cm (range 0.1 to 500 cm). One hazardous incident occurred beyond 100 cm (in a ventilator with GRPS-1 signal at 300 cm). Conclusion Critical care equipment is vulnerable to EMI by new-generation wireless telecommunication technologies with median distances of about 3 cm. The policy to keep mobile phones '1 meter' from the critical care bedside in combination with easily accessed areas of unrestricted use still seems warranted. PMID:17822524

38 CFR 17.351 - Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Philippines § 17.351 Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center. Grants to assist the Republic of the Philippines in the replacement and upgrading of equipment and in...

38 CFR 17.351 - Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Philippines § 17.351 Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center. Grants to assist the Republic of the Philippines in the replacement and upgrading of equipment and in...

38 CFR 17.351 - Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Philippines § 17.351 Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center. Grants to assist the Republic of the Philippines in the replacement and upgrading of equipment and in...

38 CFR 17.351 - Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Philippines § 17.351 Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center. Grants to assist the Republic of the Philippines in the replacement and upgrading of equipment and in...

38 CFR 17.351 - Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Philippines § 17.351 Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center. Grants to assist the Republic of the Philippines in the replacement and upgrading of equipment and in...

The use of fault reporting of medical equipment to identify latent design flaws.

PubMed

Flewwelling, C J; Easty, A C; Vicente, K J; Cafazzo, J A

2014-10-01

Poor device design that fails to adequately account for user needs, cognition, and behavior is often responsible for use errors resulting in adverse events. This poor device design is also often latent, and could be responsible for "No Fault Found" (NFF) reporting, in which medical devices sent for repair by clinical users are found to be operating as intended. Unresolved NFF reports may contribute to incident under reporting, clinical user frustration, and biomedical engineering technologist inefficacy. This study uses human factors engineering methods to investigate the relationship between NFF reporting frequency and device usability. An analysis of medical equipment maintenance data was conducted to identify devices with a high NFF reporting frequency. Subsequently, semi-structured interviews and heuristic evaluations were performed in order to identify potential usability issues. Finally, usability testing was conducted in order to validate that latent usability related design faults result in a higher frequency of NFF reporting. The analysis of medical equipment maintenance data identified six devices with a high NFF reporting frequency. Semi-structured interviews, heuristic evaluations and usability testing revealed that usability issues caused a significant portion of the NFF reports. Other factors suspected to contribute to increased NFF reporting include accessory issues, intermittent faults and environmental issues. Usability testing conducted on three of the devices revealed 23 latent usability related design faults. These findings demonstrate that latent usability related design faults manifest themselves as an increase in NFF reporting and that devices containing usability related design faults can be identified through an analysis of medical equipment maintenance data. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Questionnaire-based evaluation of mobile phone interference with medical-electrical equipment in Swedish hospitals.

PubMed

Wiinberg, Stig; Samuelsson, Göran; Larsson, Stefan; Nilsson, Barbro; Jönsson, Patrik X; Ivarsson, Bodil; Olofsson, Per-Åke

2017-08-09

National recommendations in Sweden recommend a safety distance of 3 meter (m) between mobile phones and medical-electrical (ME) equipment in hospitals. A questionnaire was used to investigate how often mobile phones were reported to interfere with ME products in clinical practice across Sweden. The results confirmed that ME equipment can be affected by mobile phone use but, the risk of the patient's outcome being affected were minimal; no cases were identified which led to injury or death. In conclusion, the results support recommendations for a general safety distance of 0.5 m between mobile phones and ME equipment in care environments.

[Organization of medical equipment and stock supply of military medical facilities and groups of Disaster Medicine Service of the Russian Defense Ministry in emergency situations].

PubMed

Korniushko, I G; Iakovlev, S V; Krasavin, K D; Lemeshkin, R N

2011-10-01

The article outlined the modern concept of medical equipment and stock supply of medical facilities and groups of Disaster Medicine Service of the Russian Defense Ministry involved into the remedial of the medical actions of emergency situations. The structure of the units of medical supplies in these conditions is presented.

Point-of-care ultrasonography by pediatric emergency medicine physicians.

PubMed

Marin, Jennifer R; Lewiss, Resa E

2015-04-01

Emergency physicians have used point-of-care ultrasonography since the 1990 s. Pediatric emergency medicine physicians have more recently adopted this technology. Point-of-care ultrasonography is used for various scenarios, particularly the evaluation of soft tissue infections or blunt abdominal trauma and procedural guidance. To date, there are no published statements from national organizations specifically for pediatric emergency physicians describing the incorporation of point-of-care ultrasonography into their practice. This document outlines how pediatric emergency departments may establish a formal point-of-care ultrasonography program. This task includes appointing leaders with expertise in point-of-care ultrasonography, effectively training and credentialing physicians in the department, and providing ongoing quality assurance reviews. Copyright © 2015 by the American Academy of Pediatrics.

The core content of clinical ultrasonography fellowship training.

PubMed

Lewiss, Resa E; Tayal, Vivek S; Hoffmann, Beatrice; Kendall, John; Liteplo, Andrew S; Moak, James H; Panebianco, Nova; Noble, Vicki E

2014-04-01

The purpose of developing a core content for subspecialty training in clinical ultrasonography (US) is to standardize the education and qualifications required to provide oversight of US training, clinical use, and administration to improve patient care. This core content would be mastered by a fellow as a separate and unique postgraduate training, beyond that obtained during an emergency medicine (EM) residency or during medical school. The core content defines the training parameters, resources, and knowledge of clinical US necessary to direct clinical US divisions within medical specialties. Additionally, it is intended to inform fellowship directors and candidates for certification of the full range of content that might appear in future examinations. This article describes the development of the core content and presents the core content in its entirety. © 2014 by the Society for Academic Emergency Medicine.

21 CFR 225.30 - Equipment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS Construction and Maintenance of Facilities and Equipment § 225.30 Equipment. (a) Equipment which is designed to perform its intended function and is properly installed and used is essential to the manufacture of medicated feeds. Such equipment permits...

A feasibility study on bedside upper airway ultrasonography compared to waveform capnography for verifying endotracheal tube location after intubation

PubMed Central

2013-01-01

Background In emergency settings, verification of endotracheal tube (ETT) location is important for critically ill patients. Ignorance of oesophageal intubation can be disastrous. Many methods are used for verification of the endotracheal tube location; none are ideal. Quantitative waveform capnography is considered the standard of care for this purpose but is not always available and is expensive. Therefore, this feasibility study is conducted to compare a cheaper alternative, bedside upper airway ultrasonography to waveform capnography, for verification of endotracheal tube location after intubation. Methods This was a prospective, single-centre, observational study, conducted at the HRPB, Ipoh. It included patients who were intubated in the emergency department from 28 March 2012 to 17 August 2012. A waiver of consent had been obtained from the Medical Research Ethics Committee. Bedside upper airway ultrasonography was performed after intubation and compared to waveform capnography. Specificity, sensitivity, positive and negative predictive value and likelihood ratio are calculated. Results A sample of 107 patients were analysed, and 6 (5.6%) had oesophageal intubations. The overall accuracy of bedside upper airway ultrasonography was 98.1% (95% confidence interval (CI) 93.0% to 100.0%). The kappa value (Κ) was 0.85, indicating a very good agreement between the bedside upper airway ultrasonography and waveform capnography. Thus, bedside upper airway ultrasonography is in concordance with waveform capnography. The sensitivity, specificity, positive predictive value and negative predictive value of bedside upper airway ultrasonography were 98.0% (95% CI 93.0% to 99.8%), 100% (95% CI 54.1% to 100.0%), 100% (95% CI 96.3% to 100.0%) and 75.0% (95% CI 34.9% to 96.8%). The likelihood ratio of a positive test is infinite and the likelihood ratio of a negative test is 0.0198 (95% CI 0.005 to 0.0781). The mean confirmation time by ultrasound is 16.4 s. No adverse effects

75 FR 2105 - Publication of OIG Updated Special Fraud Alert on Telemarketing by Durable Medical Equipment...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-14

... Inspector General Publication of OIG Updated Special Fraud Alert on Telemarketing by Durable Medical... Register notice sets forth the recently issued OIG Updated Special Fraud Alert addressing telemarketing by durable medical equipment (DME) suppliers. For the most part, OIG Special Fraud Alerts address national...

Offering integrated medical equipment management in an application service provider model.

PubMed

Cruz, Antonio Miguel; Barr, Cameron; Denis, Ernesto Rodríguez

2007-01-01

With the advancement of medical technology and thus the complexity of the equipment under their care, clinical engineering departments (CEDs) must continue to make use of computerized tools in the management of departmental activities. Authors of this paper designed, installed, and implemented an application service provider (ASP) model at the laboratory level to offer value added management tools in an online format to CEDs. The project, designed to investigate how to help meet demands across multiple healthcare organizations and provide a means of access for organizations that otherwise might not be able to take advantage of the benefits of those tools, has been well received. Ten hospitals have requested the service, and five of those are ready to proceed with the implementation of the ASP. With the proposed centralized system architecture, the model has shown promise in reducing network infrastructure labor and equipment costs, benchmarking of equipment performance indicators, and developing avenues for proper and timely problem reporting. The following is a detailed description of the design process from conception to implementation of the five main software modules and supporting system architecture.

Medical Equipment Management through the Use of Radio Frequency Identification (RFID)

DTIC Science & Technology

2004-12-01

Report 4. TITLE AND SUBTITLE: Medical Equipment Management Through the Use of Radio Frequency Identification (RFID) 6. AUTHOR( S ) Joaquín A...Sánchez, Sergio Chávez, Richard A. Nixon 5. FUNDING NUMBERS 7. PERFORMING ORGANIZATION NAME( S ) AND ADDRESS(ES) Naval Postgraduate School Monterey, CA...93943-5000 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING / MONITORING AGENCY NAME( S ) AND ADDRESS(ES) N/A 10. SPONSORING

Equipment for pre-hospital airway management on Helicopter Emergency Medical System helicopters in central Europe.

PubMed

Schmid, M; Schüttler, J; Ey, K; Reichenbach, M; Trimmel, H; Mang, H

2011-05-01

For advanced out-of-hospital airway management, skilled personnel and adequate equipment are key prerequisites. There are little data on the current availability of airway management equipment and standards of medical staff on Helicopter Emergency Medical System (HEMS) helicopters in central Europe. An internet search identified all HEMS helicopters in Austria, Switzerland and Luxembourg. We identified 15 HEMS helicopter bases in Switzerland, 28 in Austria and three in Luxembourg. A questionnaire was sent to all bases, asking both for the details of the clinical background and experience of participating staff, and details of airway management equipment carried routinely on board. Replies were received from 14 helicopter bases in Switzerland (93%), 25 bases in Austria (89%) and all three bases in Luxembourg. Anaesthesiologists were by far the most frequent attending physicians (68-85%). All except one bases reported to have at least one alternative supraglottic airway device. All bases had capnometry and succinylcholine. All bases in the study except two in Austria had commercial pre-packed sets for a surgical airway. All helicopters were equipped with automatic ventilators, although not all were suitable for non-invasive ventilation (NIV; Switzerland: 43%, Austria: 12%, Luxembourg: 100%). Masks for NIV were rarely available in Switzerland (two bases; 14%) and in Austria (three bases; 12%), whereas all three bases in Luxembourg carried those masks. Most HEMS helicopters carry appropriate equipment to meet the demands of modern advanced airway management in the pre-hospital setting. Further work is needed to ensure that appropriate airway equipment is carried on all HEMS helicopters.

Intuitive ultrasonography for autonomous medical care in limited-resource environments

NASA Astrophysics Data System (ADS)

Dulchavsky, Scott A.; Sargsyan, Ashot E.; Garcia, Kathleen M.; Melton, Shannon L.; Ebert, Douglas; Hamilton, Douglas R.

2011-05-01

Management of health problems in limited resource environments, including spaceflight, faces challenges in both available equipment and personnel. The medical support for spaceflight outside Low Earth Orbit is still being defined; ultrasound (US) imaging is a candidate since trials on the International Space Station (ISS) prove that this highly informative modality performs very well in spaceflight. Considering existing estimates, authors find that US could be useful in most potential medical problems, as a powerful factor to mitigate risks and protect mission. Using outcome-oriented approach, an intuitive and adaptive US image catalog is being developed that can couple with just-in-time training methods already in use, to allow non-expert crew to autonomously acquire and interpret US data for research or diagnosis. The first objective of this work is to summarize the experience in providing imaging expertise from a central location in real time, enabling data collection by a minimally trained operator onsite. In previous investigations, just-in-time training was combined with real-time expert guidance to allow non-physician astronauts to perform over 80 h of complex US examinations on ISS, including abdominal, cardiovascular, ocular, musculoskeletal, dental/sinus, and thoracic exams. The analysis of these events shows that non-physician crew-members, after minimal training, can perform complex, quality US examinations. These training and guidance methods were also adapted for terrestrial use in professional sporting venues, the Olympic Games, and for austere locations including Mt. Everest. The second objective is to introduce a new imaging support system under development that is based on a digital catalog of existing sample images, complete with image recognition and acquisition logic and technique, and interactive multimedia reference tools, to guide and support autonomous acquisition, and possibly interpretation, of images without real-time link with a human

Evaluation of Electromagnetic Fields in a Hospital for Safe Use of Electronic Medical Equipment.

PubMed

Ishida, Kai; Fujioka, Tomomi; Endo, Tetsuo; Hosokawa, Ren; Fujisaki, Tetsushi; Yoshino, Ryoji; Hirose, Minoru

2016-03-01

Establishment of electromagnetic compatibility is important in use of electronic medical equipment in hospitals. To evaluate the electromagnetic environment, the electric field intensity induced by electromagnetic radiation in broadcasting spectra coming from outside the hospital was measured in a new hospital building before any patients visited the hospital and 6 months after the opening of the hospital. Various incoming radio waves were detected on the upper floors, with no significant difference in measured levels before and after opening of the hospital. There were no cellphone terminal signals before the hospital opened, but these signals were strongly detected at 6 months thereafter. Cellphone base stations signals were strongly detected on the upper floors, but there were no signals at most locations in the basement and in the center of the building on the lower floors. A maximum electrical intensity of 0.28 V/m from cellphone base stations (2.1 GHz) was detected at the south end of the 2nd floor before the hospital opened. This value is lower than the EMC marginal value for general electronic medical equipment specified in IEC 60601-1-2 (3 V/m). Therefore, electromagnetic interference with electronic medical equipment is unlikely in this situation. However, cellphone terminal signals were frequently detected in non-base station signal areas. This is a concern, and understanding signal strength from cellphone base stations at a hospital is important for promotion of greater safety.

Role of ultrasonography in the management of twin gestation.

PubMed

Smith, Jessica; Treadwell, Marjorie C; Berman, Deborah R

2018-06-01

Twins represent 1%-2% of all pregnancies, yet continue to account for a disproportionate share of neonatal adverse events including neonatal intensive care admission, morbidity, and mortality. Ultrasonography is central to the proper diagnosis of the type of twinning. Ideally, ultrasonography is performed before 14 weeks of gestation to determine chorionicity and amnionicity. Correct identification of the chorionicity in a twin pregnancy facilitates proper counseling and management of the gestation, including ultrasonography follow-up. Herein, the different types of twinning are reviewed, together with the implications for ultrasonography monitoring of each specific type of twin gestation. © 2018 International Federation of Gynecology and Obstetrics.

Ultrasonography and C-reactive protein can predict the outcomes of voiding cystography after the first urinary tract infection.

PubMed

Kido, Jun; Yoshida, Fuminori; Sakaguchi, Katsuya; Ueno, Yasushi; Yanai, Masaaki

2015-05-01

This study evaluated whether sex, clinical variables, laboratory variables or ultrasonography predicted the presence of vesicoureteric reflux during the first episode of urinary tract infection in paediatric patients. We also aimed to define the criteria that indicated the need for voiding cystography testing. We used voiding cystography to investigate 200 patients who experienced their first urinary tract infection at our institution between 2004 and 2013 and retrospectively analysed the data by reviewing their medical records. Sex (p = 0.001), peak blood C-reactive protein levels (p < 0.001), the duration of fever after antibiotic administration (p = 0.007) and the ultrasonography findings grade (p < 0.001) were significantly different between patients with and without vesicoureteric reflux. Grade IV-V ultrasonography findings and C-reactive protein levels of ≥80 mg/L predicted vesicoureteric reflux with a sensitivity, specificity and odds ratio of 47.8%, 87.8% and 6.59 (95% confidence interval = 3.26-13.33), respectively (p < 0.001). Voiding cystography should be performed for patients with C-reactive protein levels of ≥80 mg/L and grade IV-V ultrasonography findings, but is not necessary in patients with C-reactive protein levels of <80 mg/L and grade I-III ultrasonography findings. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Periportal fibrosis and other liver ultrasonography findings in vinyl chloride workers

PubMed Central

Maroni, M; Mocci, F; Visentin, S; Preti, G; Fanetti, A

2003-01-01

Aims: To investigate the presence of liver lesions and their relation with vinyl chloride monomer (VCM) exposure or other personal risk factors, in workers involved in the production of VCM and polyvinyl chloride (PVC). Methods: A liver ultrasonography examination was conducted in 757 workers, some of whom had long standing service in the production of VCM and PVC. The study involved: assessment of individual past and present VCM exposure of each worker; collection of past personal health history, lifestyle and personal data; routine liver function tests; and liver ultrasonography. Results: No cases of liver malignancies were detected. Angiomas and liver cysts were found with a frequency of occurrence within the expected range of the general population. The main findings consisted of hepatomegaly (34.7%), steatosis (31.8%), and periportal fibrosis (16.0%). A logistic regression analysis indicated that hepatomegaly and steatosis were associated with obesity and lipid metabolism disturbances and not with VCM exposure. Periportal fibrosis, in addition to constitutional or dietary factors, was shown to be associated with VCM exposure, but only when maximum exposure in the subject's history had been at least 200 ppm as a yearly average; no effects were observed at 50 ppm or below. Conclusions: Workers exposed to 200 ppm VCM for at least one year have a fourfold increased risk of developing periportal liver fibrosis. Liver ultrasonography is a suitable and important diagnostic test for the medical surveillance of vinyl chloride workers. PMID:12499459

Real-life feasibility and effectiveness of home-based pulmonary rehabilitation in chronic obstructive pulmonary disease requiring medical equipment.

PubMed

Coquart, Jérémy B; Le Rouzic, Olivier; Racil, Ghazi; Wallaert, Benoit; Grosbois, Jean-Marie

2017-01-01

Pulmonary rehabilitation (PR) is a key treatment of chronic obstructive pulmonary disease (COPD) but studies are still needed to identify the most pertinent criteria to personalize this intervention and improve its efficacy. This real-life retrospective study compared the effects of home-based PR on exercise tolerance, anxiety, depression, and health-related quality of life (HRQoL) in COPD patients, according to their medical equipment. Exercise tolerance, anxiety, depression, and HRQoL were evaluated in 109 patients equipped with long-term oxygen therapy (LTOT), 84 patients with noninvasive ventilation (NIV), 25 patients with continuous positive airway pressure (CPAP), and 80 patients with no equipment (NE), before, just after, and 6 and 12 months after PR. At baseline, the body mass index in the CPAP and NIV groups was higher ( p <0.05) than in the other two groups, and the forced expiratory volume in 1 second was lower in the LTOT and NIV groups ( p <0.001). All parameters improved after PR in the four groups ( p <0.05), but for exercise tolerance, only the 6-minute stepper test showed maintained improvement after 6 and 12 months, whereas the 10 times sit-to-stand and timed up-and-go tests were only improved just after PR. At every time point, exercise tolerance was lower in the LTOT group ( p <0.05), with a similar trend in the NIV group. Despite differences in the medical equipment to treat COPD, home-based PR showed comparable feasibility, safety, and efficacy in all equipment-based groups. Medical equipment should therefore not be a barrier to home-based PR.

The role of orbital ultrasonography in distinguishing papilledema from pseudopapilledema

PubMed Central

Carter, S B; Pistilli, M; Livingston, K G; Gold, D R; Volpe, N J; Shindler, K S; Liu, G T; Tamhankar, M A

2014-01-01

Purpose To determine the sensitivity and specificity of orbital ultrasonography in distinguishing papilledema from pseudopapilledema in adult patients. Methods The records of all adult patients referred to the neuro-ophthalmology service who underwent orbital ultrasonography for the evaluation of suspected papilledema were reviewed. The details of history, ophthalmologic examination, and results of ancillary testing including orbital ultrasonography, MRI, and lumbar puncture were recorded. Results of orbital ultrasonography were correlated with the final diagnosis of papilledema or pseudopapilledema on the basis of the clinical impression of the neuro-ophthalmologist. Ultrasound was considered positive when the optic nerve sheath diameter was ≥3.3 mm along with a positive 30° test. Results The sensitivity of orbital ultrasonography for detection of papilledema was 90% (CI: 80.2–99.3%) and the specificity in detecting pseudopapilledema was 79% (CI: 67.7–90.7%). Conclusions Orbital ultrasonography is a rapid and noninvasive test that is highly sensitive, but less specific in differentiating papilledema from pseudopapilledema in adult patients, and can be useful in guiding further management of patients in whom the diagnosis is initially uncertain. PMID:25190532

Effect of Provider Experience on Clinician-Performed Ultrasonography for Hydronephrosis in Patients With Suspected Renal Colic

PubMed Central

Herbst, Meghan K.; Rosenberg, Graeme; Daniels, Brock; Gross, Cary P.; Singh, Dinesh; Molinaro, Annette M.; Luty, Seth; Moore, Christopher L.

2016-01-01

Study objective Hydronephrosis is readily visible on ultrasonography and is a strong predictor of ureteral stones, but ultrasonography is a user-dependent technology and the test characteristics of clinician-performed ultrasonography for hydronephrosis are incompletely characterized, as is the effect of ultrasound fellowship training on predictive accuracy. We seek to determine the test characteristics of ultrasonography for detecting hydronephrosis when performed by clinicians with a wide range of experience under conditions of direct patient care. Methods This was a prospective study of patients presenting to an academic medical center emergency department with suspected renal colic. Before computed tomography (CT) results, an emergency clinician performed bedside ultrasonography, recording the presence and degree of hydronephrosis. CT data were abstracted from the dictated radiology report by an investigator blinded to the bedside ultrasonographic results. Test characteristics of bedside ultrasonography for hydronephrosis were calculated with the CT scan as the reference standard, with test characteristics compared by clinician experience stratified into 4 levels: attending physicians with emergency ultrasound fellowship training, attending physicians without emergency ultrasound fellowship training, ultrasound experienced non–attending physician clinicians (at least 2 weeks of ultrasound training), and ultrasound inexperienced non–attending physician clinicians (physician assistants, nurse practitioners, off-service rotators, and first-year emergency medicine residents with fewer than 2 weeks of ultrasound training). Results There were 670 interpretable bedside ultrasonographic tests performed by 144 unique clinicians, 80.9% of which were performed by clinicians directly involved in the care of the patient. On CT, 47.5% of all subjects had hydronephrosis and 47.0% had a ureteral stone. Among all clinicians, ultrasonography had a sensitivity of 72.6% (95

Effect of provider experience on clinician-performed ultrasonography for hydronephrosis in patients with suspected renal colic.

PubMed

Herbst, Meghan K; Rosenberg, Graeme; Daniels, Brock; Gross, Cary P; Singh, Dinesh; Molinaro, Annette M; Luty, Seth; Moore, Christopher L

2014-09-01

Hydronephrosis is readily visible on ultrasonography and is a strong predictor of ureteral stones, but ultrasonography is a user-dependent technology and the test characteristics of clinician-performed ultrasonography for hydronephrosis are incompletely characterized, as is the effect of ultrasound fellowship training on predictive accuracy. We seek to determine the test characteristics of ultrasonography for detecting hydronephrosis when performed by clinicians with a wide range of experience under conditions of direct patient care. This was a prospective study of patients presenting to an academic medical center emergency department with suspected renal colic. Before computed tomography (CT) results, an emergency clinician performed bedside ultrasonography, recording the presence and degree of hydronephrosis. CT data were abstracted from the dictated radiology report by an investigator blinded to the bedside ultrasonographic results. Test characteristics of bedside ultrasonography for hydronephrosis were calculated with the CT scan as the reference standard, with test characteristics compared by clinician experience stratified into 4 levels: attending physicians with emergency ultrasound fellowship training, attending physicians without emergency ultrasound fellowship training, ultrasound experienced non-attending physician clinicians (at least 2 weeks of ultrasound training), and ultrasound inexperienced non-attending physician clinicians (physician assistants, nurse practitioners, off-service rotators, and first-year emergency medicine residents with fewer than 2 weeks of ultrasound training). There were 670 interpretable bedside ultrasonographic tests performed by 144 unique clinicians, 80.9% of which were performed by clinicians directly involved in the care of the patient. On CT, 47.5% of all subjects had hydronephrosis and 47.0% had a ureteral stone. Among all clinicians, ultrasonography had a sensitivity of 72.6% (95% confidence interval [CI] 65.4% to 78

A report on an acute, in-hours, outpatient review clinic with ultrasonography facilities for the early evaluation of general surgical patients.

PubMed

Pidgeon, T E; Shariff, U; Devine, F; Menon, V

2016-09-01

Introduction In 2013 our hospital introduced an in-hours, consultant-led, outpatient acute surgical clinic (ASC) for emergency general surgical patients. In 2014 this clinic was equipped with a dedicated ultrasonography service. This prospective cohort study evaluated this service before and after the introduction of ultrasonography facilities. Methods Data were recorded prospectively for all patients attending the clinic during 2013 and 2014. The primary outcome was patient destination (whether there was follow-up/admission) after clinic attendance. Results The ASC reviewed patients with a wide age range and array of general surgical complaints. In 2013, 186 patients attended the ASC. After the introduction of the ultrasonography service in 2014, 304 patients attended. In 2014, there was a reduction in the proportion of patients admitted to hospital from the clinic (18.3% vs 8.9%, p=0.002). However, the proportion of patients discharged after ASC review remained comparable with 2013 (30.1% in 2013 vs 38.8% in 2014, p=0.051). The proportion of patients undergoing computed tomography (CT) scans also fell (14.0% vs 4.9%, p<0.001). Conclusions The ASC assessed a wide array of general surgical complaints. Only a small proportion required hospital admission. The introduction of an ultrasonography service was associated with a further reduction in admission rates and computed tomography.

[Diagnostic utility of endoscopic ultrasonography elastography and contrast-enhanced harmonic endoscopic ultrasonography in a patient with type 2 autoimmune pancreatitis].

PubMed

Yokode, Masataka; Shiomi, Hideyuki; Itai, Ryosuke; Mikami, Sakae; Yamashita, Yukimasa; Nakano, Ryota; Ezaki, Takeshi; Masuda, Atsuhiro; Zen, Yoh

2018-01-01

A referring hospital diagnosed a 57-year-old man with a pancreatic head mass. The initial endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) was inconclusive because of the small sample size. Endoscopic ultrasonography elastography (EUS-EG) and contrast-enhanced harmonic endoscopic ultrasonography (CE-EUS), conducted at our institute, raised the possibility of mass-forming pancreatitis or autoimmune pancreatitis (AIP). A repeat EUS-FNA revealed inflammatory changes, including a neutrophilic duct injury suggestive of type 2 AIP. The pancreatic lesion responded well to the steroid therapy. The present case suggests that EUS-EG and CE-EUS may be useful for diagnostic exclusion of pancreatic cancers, and the combined use of EUS-EG and CE-EUS, with EUS-FNA, may help characterize inflammatory pancreatic lesions.

Electromagnetic interference from radio frequency identification inducing potentially hazardous incidents in critical care medical equipment.

PubMed

van der Togt, Remko; van Lieshout, Erik Jan; Hensbroek, Reinout; Beinat, E; Binnekade, J M; Bakker, P J M

2008-06-25

Health care applications of autoidentification technologies, such as radio frequency identification (RFID), have been proposed to improve patient safety and also the tracking and tracing of medical equipment. However, electromagnetic interference (EMI) by RFID on medical devices has never been reported. To assess and classify incidents of EMI by RFID on critical care equipment. Without a patient being connected, EMI by 2 RFID systems (active 125 kHz and passive 868 MHz) was assessed under controlled conditions during May 2006, in the proximity of 41 medical devices (in 17 categories, 22 different manufacturers) at the Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. Assessment took place according to an international test protocol. Incidents of EMI were classified according to a critical care adverse events scale as hazardous, significant, or light. In 123 EMI tests (3 per medical device), RFID induced 34 EMI incidents: 22 were classified as hazardous, 2 as significant, and 10 as light. The passive 868-MHz RFID signal induced a higher number of incidents (26 incidents in 41 EMI tests; 63%) compared with the active 125-kHz RFID signal (8 incidents in 41 EMI tests; 20%); difference 44% (95% confidence interval, 27%-53%; P < .001). The passive 868-MHz RFID signal induced EMI in 26 medical devices, including 8 that were also affected by the active 125-kHz RFID signal (26 in 41 devices; 63%). The median distance between the RFID reader and the medical device in all EMI incidents was 30 cm (range, 0.1-600 cm). In a controlled nonclinical setting, RFID induced potentially hazardous incidents in medical devices. Implementation of RFID in the critical care environment should require on-site EMI tests and updates of international standards.

Cardiovascular ultrasonography detection of embolic sources in trauma.

PubMed

Saranteas, Theodosios; Mavrogenis, Andreas F; Poularas, John; Kostroglou, Andreas; Mandila, Christina; Panou, Fotios

2018-06-01

Venous thromboembolism (deep vein thrombosis and pulmonary embolism) and bone cement implantation syndrome are major sources of embolic events in trauma patients. In these patients, embolic events due to venous thromboembolism and bone cement implantation syndrome have been detected with cardiac and vascular ultrasonography in the emergency setting, during the perioperative period, and in the intensive care unit. This article discusses the ultrasonography modalities and imaging findings of embolic events related to venous thromboembolism and bone cement implantation syndrome. The aim is to present a short review with exceptional illustrations that can enable physicians to identify sources of emboli in trauma patients with cardiovascular ultrasonography. Copyright © 2018 Elsevier Inc. All rights reserved.

[2008 Shanghai Customer Satisfaction Survey report of after-sales service for medical imaging equipments].

PubMed

Li, Bin; Wang, Li-Jun; Zhang, Li-Fang; Qian, Jian-Guo; Zheng, Jia-Gang; Zhu, Gao-Jie; He, De-Hua; Xu, Zi-Tian

2009-07-01

To improve the after-sales service, a survey aimed at the after-serveis of 3 kinds of medical equipment is applied among 68 hospitals in Shanghai Area in 2008.The Stat. and analysis results are showed in the paper, which will certainly channel off suppliers to set up a harmonious market together.

Investments for medical equipment in a mother and child health hospital: correlation with level of services/departments.

PubMed

Trevisanuto, Daniele; Raggi, Roberto; Bavuusuren, Bayasgalantai; Tudevdorj, Erkhembaatar; Doglioni, Nicoletta; Zanardo, Vincenzo

2011-02-01

To assess whether investments for medical equipments assigned by a team of experts to a mother and child health hospital located in Mongolia were correlated with structural, organizational, and educational level of its services/departments. A score was used for evaluating the level of each service/department. It was based on a 'structural area' and an 'organizational and educational area'. Destination of funds was determined by a team of experts in collaboration with the head of the service/department. Thirty-three of 36 services/departments (91.6%) were evaluated. A total sum of 4,432,140 Euros to invest in medical equipment was estimated. Assigned investments were inversely correlated with the total (structural plus organizational and educational area) score (n = 33; r =  -0.59; p = 0.0002), and the specific scores for structural area (n = 33; r = -0.46; p = 0.005) and organizational and educational area (n = 33; r =  -0.56; p = 0.0006). A large part of the funds for medical equipment was destined to services/departments with low organizational and educational conditions, limiting the potential effect of the aid meanwhile supporting the most in need departments. Educational efforts and monitoring of specific long-term indicators are mandatory.

Interaction of healthcare worker hands and portable medical equipment: a sequence analysis to show potential transmission opportunities.

PubMed

Jinadatha, Chetan; Villamaria, Frank C; Coppin, John D; Dale, Charles R; Williams, Marjory D; Whitworth, Ryan; Stibich, Mark

2017-12-28

While research has demonstrated the importance of a clean health care environment, there is a lack of research on the role portable medical equipment (PME) play in the transmission cycle of healthcare-acquired infections (HAIs). This study investigated the patterns and sequence of contact events among health care workers, patients, surfaces, and medical equipment in a hospital environment. Research staff observed patient care events over six different 24 h periods on six different hospital units. Each encounter was recorded as a sequence of events and analyzed using sequence analysis and visually represented by network plots. In addition, a point prevalence microbial sample was taken from the computer on wheels (COW). The most touched items during patient care was the individual patient (850), bedrail (375), bed-surface (302), and bed side Table (223). Three of the top ten most common subsequences included touching PME and the patient: computer on wheels ➔ patient (62 of 274 total sequences, 22.6%, contained this sequence), patient ➔ COW (20.4%), and patient ➔ IV pump (16.1%). The network plots revealed large interconnectedness among objects in the room, the patient, PME, and the healthcare worker. Our results demonstrated that PME such as COW and IV pump were two of the most highly-touched items during patient care. Even with proper hand sanitization and personal protective equipment, this sequence analysis reveals the potential for contamination from the patient and environment, to a vector such as portable medical equipment, and ultimately to another patient in the hospital.

Ultrasonography of the hand, wrist, and elbow.

PubMed

Bodor, Marko; Fullerton, Brad

2010-08-01

High-frequency diagnostic ultrasonography of the hand, wrist and elbow has significant potential to improve the quality of diagnosis and care provided by neuromuscular and musculoskeletal specialists. In patients referred for weakness, pain and numbness of the hand, wrist or elbow, diagnostic ultrasonography can be an adjunct to electrodiagnosis and help in identifying ruptured tendons and treating conditions such as carpal tunnel syndrome or trigger finger. Use of a small high-frequency (>10-15 MHz) transducer, an instrument with a blunt pointed tip to enhance sonopalpation and a model of the hand, wrist and elbow is advised to enhance visualization of small anatomical structures and complex bony contours. A range of conditions, including tendon and ligament ruptures, trigger finger, de Quervain tenosynovitis, intersection syndrome, lateral epicondylitis, and osteoarthritis, is described along with detailed ultrasonography-guided injection techniques for carpal tunnel syndrome and trigger finger. Copyright 2010 Elsevier Inc. All rights reserved.

[Research and realization of signal processing algorithms based on FPGA in digital ophthalmic ultrasonography imaging].

PubMed

Fang, Simin; Zhou, Sheng; Wang, Xiaochun; Ye, Qingsheng; Tian, Ling; Ji, Jianjun; Wang, Yanqun

2015-01-01

To design and improve signal processing algorithms of ophthalmic ultrasonography based on FPGA. Achieved three signal processing modules: full parallel distributed dynamic filter, digital quadrature demodulation, logarithmic compression, using Verilog HDL hardware language in Quartus II. Compared to the original system, the hardware cost is reduced, the whole image shows clearer and more information of the deep eyeball contained in the image, the depth of detection increases from 5 cm to 6 cm. The new algorithms meet the design requirements and achieve the system's optimization that they can effectively improve the image quality of existing equipment.

[Technique of abdominal ultrasonography in newborn foals and normal findings].

PubMed

Behn, C; Bostedt, H

2000-09-01

Under field conditions, the diagnosis of foal's diseases relies almost exclusively on the physical examination. As the signs of illness in the equine neonate are frequently vage and non-localizing, the diagnosis of diseases may be problematic. This often causes misinterpretations and leads to ineffective prophylaxis and treatment. The purpose of this study was to evaluate the usefulness of diagnostic ultrasonography of the foal's abdomen under field conditions to provide an optimized technique and to describe the normal findings. Diagnostic ultrasonography of the abdomen was performed after obtaining clinical history and passing the physical examination of 25 foals without signs of abdominal problems. The foals were scanned in a stable box, being restrained by three persons in semi-lateral recumbency. Usually, sedation was not necessary. The ventral abdominal wall was clipped, a generous amount of ultrasound coupling gel was applied and massaged on the skin surface. The ultrasonographic examination was carried out using a portable sector scanner ("Microimager 2000", Ausonics) with 5.0 and 7.5-MHz transducers or a combined 5.0 and 7.5-MHz transrectal linear-array scanner ("450 Enhanced", Pie Medical). Employing the 5.0-MHz sector scanner first, the abdomen was explored from caudal to cranial in left and right semi-lateral recumbency. The 7.5-MHz scanner was used to attain higher resolution of certain structures. The sector scanner turned out to be suitable under field conditions and adequate to examine the abdominal organs. The transrectal linear-array scanner also provided the most important informations, although it was difficult to maintain a good contact area of the scan head. By ultrasonography it was possible to identify the urinary bladder, kidneys, spleen, liver and part of the gastrointestinal tract. Thus, application of ultrasound could successfully be performed on newborn foals under field conditions.

Design of a medical and laboratory equipment management program for the new standards certification achievement in Mexico.

PubMed

Franco-Clark, D; Pimentel-Aguilar, A B; Rodriguez-Vera, R

2010-01-01

Certification for healthcare institutions in Mexico is ruled by 2009 standards homologated with the Joint Commission International criteria. Nowadays, healthcare requires of medical equipment and devices, so it has become necessary to implement guidelines for its adequate management in order to reach the highest level of quality and safety at the lowest cost. The objective of this work was to develop a Medical and Laboratory Equipment Management Program, oriented to the improvement of quality, effectiveness and efficiency of the technological resources in order to meet the certification requirements. The result of this work allows to have an auto evaluation tool that focuses the efforts of the National Institute for Respiratory Diseases to the achievement of the new requirements established for the certification.

[Analysis of eye ultrasonography in patients with trinitrotoluene cataract].

PubMed

Huang, Dongmei; Zhu, Linping; Yang, Jinping; Wu, Donping

2015-04-01

To evaluate the diagnostic value of ultrasonography for trinitrotoluene (TNT) cataract. The morphology and internal echoes of 90 lenses of 45 TNT cataract patients and 120 lenses of 60 healthy adults were observed and compared using ultrasonography and slit lamp, and the hemodynamic parameters of the post-ophthalmic artery were also measured. The findings of the slit-lamp microscope were regarded as diagnostic criteria, and the sensitivity, specificity, and accordance rate of ultrasonography in the diagnosis of TNT cataract were calculated. The sensitivity, specificity, and accordance rate of ultrasonography in the diagnosis of TNT cataract were 93.33%, 100.00%, and 97.14%, respectively; the positive and negative predictive values were 100% and 95.23%, respectively; the positive and negative likelihood ratios were 93.33 and 0.67, especuvey. With the progression TNT cataract, utrasonography showed that the lenses demonstrated morphological changes (spindle-shaped, spherical, and discoid morphologies), and the arc echoes of the posterior capsule were thickened and enhanced. The TNT cataract patients showed significantly lower peak systolic velocity and end-diastolic velocity of the ophthalmic artery (OA) and central retinal artery (P<0.01) and a significantly higher resistance index (P<0.05) than the healthy adults. The sensitivity of ultrasonography in the diagnosis of TNT cataract is similar to that of slit lamp. Ultrasonography can demonstrate objectively the shape, range, and degree of lens opacity in an efficient manner, which is conducive to the diagnosis and staging of TNT cataract by slit lamp, and can also provide hemodynamic information of the OA, thus providing new ideas for clinical physicians in evaluating the disease and clinical efficacy as well as exploring therapies.

Anatomy, histology, and ultrasonography of the normal adrenal gland in brown lemur: Eulemur fulvus.

PubMed

Raharison, Fidiniaina; Bourges Abella, Nathalie; Sautet, Jean; Deviers, Alexandra; Mogicato, Giovanni

2017-04-01

The medical care currently to brown lemurs (Eulemur fulvus) is limited by a lack of knowledge of their anatomy. The aim of this study was to describe the anatomy and histology and obtain ultrasonographic measurements of normal adrenal glands in these animals. The adrenal glands of four lemurs cadavers were used for the anatomical and histological studies, and those of 15 anesthetized lemurs were examined by ultrasonography. Anatomically, the adrenal glands of brown lemurs are comparable to those of other species. The histological findings showed that the cortex is organized into three distinct layers, whereas most domestic mammals have an additional zone. The surface area of the adrenal glands increased with body weight, and the area of the right adrenal was slightly larger than the left. We suggest using ultrasonography to aid the etiological diagnosis of behavioral abnormalities that might be due to dysfunctions of the adrenal gland. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Hyperbaric Chamber Equipment: A Consolidated Equipment List from Selected Multiplace Hyperbaric Facilities.

DTIC Science & Technology

1983-12-01

carbon dioxide scrubbers , air conditioning, communications, lighting, and fire detecting and fire extinguishing systems. Medical support equipment was...10 14 Humidity...............................11 5. Hydrocarb on...........................11 B. Carbon Dioxide Scrubbers .....................11 C...and ancillary equipment included gas/vapor monitoring equipment, carbon dioxide scrubbers , air conditioning, communications, lighting, and fire

Immersion ultrasonography: simultaneous A-scan and B-scan.

PubMed

Coleman, D J; Dallow, R L; Smith, M E

1979-01-01

In eyes with opaque media, ophthalmic ultrasound provides a unique source of information that can dramatically affect the course of patient management. In addition, when an ocular abnormality can be visualized, ultrasonography provides information that supplements and complements other diagnostic testing. It provides documentation and differentiation of abnormal states, such as vitreous hemorrhage and intraocular tumor, as well as differentiation of orbital tumors from inflammatory causes of exophthalmos. Additional capabilities of ultrasound are biometric determinations for calculation of intraocular lens implant powers and drug-effectiveness studies. Maximal information is derived from ultrasonography when A-scan and B-scan techniques are employed simultaneously. Flexibility of electronics, variable-frequency transducers, and the use of several different manual scanning patterns aid in detection and interpretation of results. The immersion system of ultrasonography provides these features optimally.

Learning curve of office-based ultrasonography for rotator cuff tendons tears.

PubMed

Ok, Ji-Hoon; Kim, Yang-Soo; Kim, Jung-Man; Yoo, Tae-Wook

2013-07-01

To compare the accuracy of ultrasonography and MR arthrography (MRA) imaging in detecting of rotator cuff tears with arthroscopic finding used as the reference standard. The ultrasonography and MRA findings of 51 shoulders that underwent the arthroscopic surgery were prospectively analysed. Two orthopaedic doctors independently performed ultrasonography and interpreted the findings at the office. The tear size measured at ultrasonography and MRA was compared with the size measured at surgery using Pearson correlation coefficients (r). The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and false-positive rate were calculated for a diagnosis of partial-and full-thickness rotator cuff tears. The kappa coefficient was calculated to verify the inter-observer agreement. The sensitivity of ultrasonography and MRA for detecting partial-thickness tears was 45.5 and 72.7 %, and that for full-thickness tears was 80.0 and 100 %, respectively. The accuracy of ultrasonograpy and MRA for detecting partial-thickness tears was 45.1 and 88.2 %, and that for full-thickness tears was 82.4 and 98 %, respectively. Tear size measured based on ultrasonography examination showed a poor correlation with the size measured at arthroscopic surgery (r = 0.21; p < 0.05). However, tear size estimated by MRA showed a strong correlation (r = 0.75; p < 0.05). The kappa coefficient was 0.47 between the two independent examiners. The accuracy of office-based ultrasonography for beginner orthopaedic surgeons to detect full-thickness rotator cuff tears was comparable to that of MRA but was less accurate for detecting partial-thickness tears and torn size measurement. Inter-observer agreement on the interpretation was fair. These results highlight the importance of the correct technique and experience in operation of ultrasonography in shoulder joint. Diagnostic study, Level II.

Diagnostic accuracy of transabdominal ultrasonography for gallbladder polyps: systematic review.

PubMed

Martin, Erin; Gill, Richdeep; Debru, Estifanos

2018-06-01

Previous research has shown variable but generally poor accuracy of transabdominal ultrasonography in the diagnosis of gallbladder polyps. We performed a systematic review of the literature with the aim of helping surgeons interpret and apply these findings in the preoperative assessment and counselling of their patients. We searched PubMed, MEDLINE and the Cochrane database using the keywords "gallbladder," "polyp," "ultrasound," "pathology" and "diagnosis" for English-language articles published after 1990 with the full-text article available through our institutional subscriptions. Polyps were defined as immobile features that on transabdominal ultrasonography appear to arise from the mucosa and that lack an acoustic shadow, and pseudopolyps were defined as features such as inflammation, hyperplasia, cholesterolosis and adenomyomatosis that convey no risk of malignant transformation. The search returned 1816 articles, which were narrowed down to 14 primary sources involving 15 497 (range 23-13 703) patients who had preoperative transabdominal ultrasonography, underwent cholecystectomy and had postoperative pathology results available. Among the 1259 patients in whom a gallbladder polyp was diagnosed on ultrasonography, 188 polyps were confirmed as true polyps on pathologic examination, and 81 of these were found to be malignant. Of the 14 238 patients for whom a polyp was not seen on ultrasonography, 38 had a true polyp on pathologic examination, none of which were malignant. For true gallbladder polyps, transabdominal ultrasonography had a sensitivity of 83.1%, specificity of 96.3%, positive predictive value of 14.9% (7.0% for malignant polyps) and negative predictive value of 99.7%. Transabdominal ultrasonography has a high false-positive rate (85.1%) for the diagnosis of gallbladder polyps. Further study of alternative imaging modalities and reevaluation of existing management guidelines are warranted.

Xeroradiography and ultrasonography in the evaluation of a penile injury.

PubMed

Oesterling, J E; Bromberg, W D; Albertsen, P C

1986-04-01

A 34-year-old white man presented with severe penile cellulitis following injection of epoxy glue into the shaft of the penis. Preoperative xeroradiography and ultrasonography localized the hardened masses of glue to the left corpus cavernosum and subcutaneous tissues. Under the guidance of intraoperative ultrasonography this foreign material was removed surgically. Postoperatively, the cellulitis resolved promptly and xeroradiography demonstrated no residual fragments. Although various modalities, including computerized tomography and roentgenography, are available to detect foreign bodies in soft tissues, xeroradiography and ultrasonography are ideally suited for use in the male external genitalia.

75 FR 26196 - Publication of OIG Updated Special Fraud Alert on Telemarketing by Durable Medical Equipment...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-11

... Special Fraud Alert on Telemarketing by Durable Medical Equipment Suppliers AGENCY: Office of Inspector... Special Fraud Alert. Specifically, the Updated Special Fraud Alert addressed the statutory provision...) 205-0007. SUPPLEMENTARY INFORMATION: In our publication of the OIG Updated Special Fraud Alert on...

A Comparative Study on Quantitative Assessment of Blood Flow and Vascularization in Polycystic Ovary Syndrome Patients and Normal Women Using Three-Dimensional Power Doppler Ultrasonography.

PubMed

Garg, Nitasha; Khaira, Harkiran Kaur; Kaur, Manjot; Sinha, Smita

2018-04-01

To compare the quantitative assessment of blood flow and vascularization of ovaries in polycystic ovary syndrome patients and normal women using three-dimensional power Doppler ultrasonography. This cross-sectional quantitative study was conducted on women of reproductive age group (15-45 years) attending Gynaecology OPD AIMSR, Bathinda, Punjab. Thirty women were enrolled in polycystic ovarian syndrome (PCOS) group and 30 healthy women in control group. Women were categorized as polycystic ovary syndrome according to Rotterdam's criteria. The women with PCOS underwent transvaginal USG Doppler on day 6 of the cycle using 3D power Doppler USG equipment (GE Voluson E8), and vascularization index (VI), flow index (FI) and vascularization flow index (VFI) were measured. The mean values of VI, FI and VFI measured by power Doppler ultrasonography were significantly increased ( P value = 0.000) in women with PCOS when compared with healthy women. This study suggests that blood flow and vascularization measured by 3D power Doppler ultrasonography in ovaries of polycystic ovary syndrome patients were significantly more than the ovaries of normal women.

Point-of-care ultrasonography by pediatric emergency physicians. Policy statement.

PubMed

Marin, Jennifer R; Lewiss, Resa E

2015-04-01

Point-of-care ultrasonography is increasingly being used to facilitate accurate and timely diagnoses and to guide procedures. It is important for pediatric emergency physicians caring for patients in the emergency department to receive adequate and continued point-of-care ultrasonography training for those indications used in their practice setting. Emergency departments should have credentialing and quality assurance programs. Pediatric emergency medicine fellowships should provide appropriate training to physician trainees. Hospitals should provide privileges to physicians who demonstrate competency in point-of-care ultrasonography. Ongoing research will provide the necessary measures to define the optimal training and competency assessment standards. Requirements for credentialing and hospital privileges will vary and will be specific to individual departments and hospitals. As more physicians are trained and more research is completed, there should be one national standard for credentialing and privileging in point-of-care ultrasonography for pediatric emergency physicians.

Design and implementation of a portal for the medical equipment market: MEDICOM.

PubMed

Palamas, S; Kalivas, D; Panou-Diamandi, O; Zeelenberg, C; van Nimwegen, C

2001-01-01

The MEDICOM (Medical Products Electronic Commerce) Portal provides the electronic means for medical-equipment manufacturers to communicate online with their customers while supporting the Purchasing Process and Post Market Surveillance. The Portal offers a powerful Internet-based search tool for finding medical products and manufacturers. Its main advantage is the fast, reliable and up-to-date retrieval of information while eliminating all unrelated content that a general-purpose search engine would retrieve. The Universal Medical Device Nomenclature System (UMDNS) registers all products. The Portal accepts end-user requests and generates a list of results containing text descriptions of devices, UMDNS attribute values, and links to manufacturer Web pages and online catalogues for access to more-detailed information. Device short descriptions are provided by the corresponding manufacturer. The Portal offers technical support for integration of the manufacturers Web sites with itself. The network of the Portal and the connected manufacturers sites is called the MEDICOM system. To establish an environment hosting all the interactions of consumers (health care organizations and professionals) and providers (manufacturers, distributors, and resellers of medical devices). The Portal provides the end-user interface, implements system management, and supports database compatibility. The Portal hosts information about the whole MEDICOM system (Common Database) and summarized descriptions of medical devices (Short Description Database); the manufacturers servers present extended descriptions. The Portal provides end-user profiling and registration, an efficient product-searching mechanism, bulletin boards, links to on-line libraries and standards, on-line information for the MEDICOM system, and special messages or advertisements from manufacturers. Platform independence and interoperability characterize the system design. Relational Database Management Systems are used for

Design and Implementation of a Portal for the Medical Equipment Market: MEDICOM

PubMed Central

Kalivas, Dimitris; Panou-Diamandi, Ourania; Zeelenberg, Cees; van Nimwegen, Chris

2001-01-01

Background The MEDICOM (Medical Products Electronic Commerce) Portal provides the electronic means for medical-equipment manufacturers to communicate online with their customers while supporting the Purchasing Process and Post Market Surveillance. The Portal offers a powerful Internet-based search tool for finding medical products and manufacturers. Its main advantage is the fast, reliable and up-to-date retrieval of information while eliminating all unrelated content that a general-purpose search engine would retrieve. The Universal Medical Device Nomenclature System (UMDNS) registers all products. The Portal accepts end-user requests and generates a list of results containing text descriptions of devices, UMDNS attribute values, and links to manufacturer Web pages and online catalogues for access to more-detailed information. Device short descriptions are provided by the corresponding manufacturer. The Portal offers technical support for integration of the manufacturers' Web sites with itself. The network of the Portal and the connected manufacturers' sites is called the MEDICOM system. Objective To establish an environment hosting all the interactions of consumers (health care organizations and professionals) and providers (manufacturers, distributors, and resellers of medical devices). Methods The Portal provides the end-user interface, implements system management, and supports database compatibility. The Portal hosts information about the whole MEDICOM system (Common Database) and summarized descriptions of medical devices (Short Description Database); the manufacturers' servers present extended descriptions. The Portal provides end-user profiling and registration, an efficient product-searching mechanism, bulletin boards, links to on-line libraries and standards, on-line information for the MEDICOM system, and special messages or advertisements from manufacturers. Platform independence and interoperability characterize the system design. Relational Database

Clinical utility of colour flow Doppler ultrasonography in planning anterolateral thigh flap harvest.

PubMed

Patel, Rajan S; Higgins, Kevin M; Enepekides, Danny J; Hamilton, Paul A

2010-10-01

The anatomic variability of cutaneous perforators contributes to the technical challenges of anterolateral thigh (ALT) free flap harvest. The objective of this study was to assess the accuracy and clinical utility of preoperative colour flow Doppler (CFD) ultrasonography in evaluating planned ALT flap donor sites. A prospective study of the infrainguinal vasculature (profunda femoris and lateral circumflex femoral arteries) in 16 consecutive patients scheduled for ALT free flap transfer for reconstruction of head and neck surgical defects was undertaken. All patients underwent CFD ultrasonography. The location of perforators and the thigh thickness determined by CFD ultrasonography were correlated with the actual intraoperative findings using a scatter plot and paired t-test. Two patients were diagnosed with bilateral silent infrainguinal claudication, which precluded safe use of the ALT donor site. In two other patients, the planned ALT donor site ipsilateral to the defect was not used because of silent infrainguinal claudication diagnosed by CFD ultrasonography. In the 14 patients who underwent ALT flap harvest, CFD ultrasonography identified 48 perforators, which coincided with 43 actual perforators found intraoperatively. CFD ultrasonography demonstrated a statistically significant correlation with the actual perforator locations (Spearman coefficient .76; p = .55). Although CFD ultrasonography tended to underestimate flap thickness, there was a statistically significant correlation (Spearman coefficient .94; p ≤ .0001) with the actual flap thickness. CFD ultrasonography has clinical utility in facilitating decision making and planning ALT flap harvest.

Reliability, validity and feasibility of nail ultrasonography in psoriatic arthritis.

PubMed

Arbault, Anaïs; Devilliers, Hervé; Laroche, Davy; Cayot, Audrey; Vabres, Pierre; Maillefert, Jean-Francis; Ornetti, Paul

2016-10-01

To determine the feasibility, reliability and validity of nails ultrasonography in psoriatic arthritis as an outcome measure. Pilot prospective single-centre study of eight ultrasonography parameters in B mode and power Doppler concerning the distal interphalangeal (DIP) joint, the matrix, the bed and nail plate. Intra-observer and inter-observer reliability was evaluated for the seven quantitative parameters (ICC and kappa). Correlations between ultrasonography and clinical variables were searched to assess external validity. Feasibility was assessed by the time to carry out the examination and the percentage of missing data. Twenty-seven patients with psoriatic arthritis (age 55.0±16.2 years, disease duration 13.4±9.4 years) were included. Of these, 67% presented nail involvement on ultrasonography vs 37% on physical examination (P<0.05). Reliability was good (ICC and weighted kappa>0.75) for the seven quantitative parameters, except for synovitis of the DIP joint in B mode. The synovitis of the DIP joint revealed by ultrasonography correlated with the total number of clinical synovitis and Doppler US of the nail (matrix and bed). Doppler US of the matrix correlated with VAS pain but not with the ASDAS-CRP or with clinical enthesitis. No significant correlation was found with US nail thickness. The feasibility and reliability of ultrasonography of the nail in psoriatic arthritis appear to be satisfactory. Among the eight parameters evaluated, power Doppler of the matrix which correlated with local inflammation (DIP joint and bed) and with VAS pain could become an interesting outcome measure, provided that it is also sensitive to change. Copyright © 2015 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

42 CFR 409.50 - Coinsurance for durable medical equipment (DME) furnished as a home health service.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Coinsurance for durable medical equipment (DME) furnished as a home health service. 409.50 Section 409.50 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Home Health...

Retrospective comparison of abdominal ultrasonography and radiography in the investigation of feline abdominal disease

PubMed Central

Won, Wylen Wade; Sharma, Ajay; Wu, Wenbo

2015-01-01

Abdominal radiography and ultrasonography are commonly used as part of the initial diagnostic plan for cats with nonspecific signs of abdominal disease. This retrospective study compared the clinical usefulness of abdominal radiography and ultrasonography in 105 feline patients with signs of abdominal disease. The final diagnosis was determined more commonly with ultrasonography (59%) compared to radiography (25.7%). Ultrasonography was also able to provide additional clinically relevant information in 76% of cases, and changed or refined the diagnosis in 47% of cases. Based on these findings, ultrasonography may be sufficient as an initial diagnostic test for the investigation of feline abdominal disease. PMID:26483582

The METIS project for generalist ultrasonography.

PubMed

Bono, F; Campanini, A

2007-12-01

Reorganization of the community healthcare system and the growing presence of group practices in the field of general medicine have increased the demands placed on primary-care medicine, in terms of the skills required and the level of responsibility. Satisfying the need for rapid, effective primary-care solutions to the health problems of citizens is easier thanks to technological and medical advances that provide high level equipment at costs within the reach of general practitioners (GPs). In the near future, trained GPs equipped with appropriate diagnostic scanners will be able to handle up to 40% of the requests of ultrasound examinations of each primary-care group (each PCG includes approximately 15,000-20,000 citizens). The Italian Federation of General Practitioners (Federazione Italiana dei Medici di Medicina Generale - FIMMG) and its Scientific Society, METIS, have organized national courses for those GPs who wish to become generalist ultrasonographers, in a joint effort with the two most important Italian scientific societies of imaging, the Italian Society of Ultrasonology in Medicine and Biology and the Italian Society of Medical Radiology.

Linear array ultrasonography to stage rectal neoplasias suitable for local treatment.

PubMed

Ravizza, Davide; Tamayo, Darina; Fiori, Giancarla; Trovato, Cristina; De Roberto, Giuseppe; de Leone, Annalisa; Crosta, Cristiano

2011-08-01

Because of the many therapeutic options available, a reliable staging is crucial for rectal neoplasia management. Adenomas and cancers limited to the submucosa without lymph node involvement may be treated locally. The aim of this study is to evaluate the diagnostic accuracy of endorectal ultrasonography in the staging of neoplasias suitable for local treatment. We considered all patients who underwent endorectal ultrasonography between 2001 and 2010. The study population consisted of 92 patients with 92 neoplasias (68 adenocarcinomas and 24 adenomas). A 5 and 7.5MHz linear array echoendoscope was used. The postoperative histopathologic result was compared with the preoperative staging defined by endorectal ultrasonography. Adenomas and cancers limited to the submucosa were considered together (pT0-1). The sensitivity, specificity, overall accuracy rate, positive predictive value, and negative predictive value of endorectal ultrasonography for pT0-1 were 86%, 95.6%, 91.3%, 94.9% and 88.7%. Those for nodal involvement were 45.4%, 95.5%, 83%, 76.9% and 84%, with 3 false positive results and 12 false negative. For combined pT0-1 and pN0, endorectal ultrasonography showed an 87.5% sensitivity, 95.9% specificity, 92% overall accuracy rate, 94.9% positive predictive value and 90.2% negative predictive value. Endorectal linear array ultrasonography is a reliable tool to detect rectal neoplasias suitable for local treatment. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Changes in ultrasonography indicators of abnormally invasive placenta during pregnancy.

PubMed

Calì, Giuseppe; Timor-Trisch, Ilan E; Palacios-Jaraquemada, Josè; Monteaugudo, Ana; Forlani, Francesco; Minneci, Gabriella; Foti, Francesca; Buca, Danilo; Familiari, Alessandra; Scambia, Giovanni; Liberati, Marco; D'Antonio, Francesco

2018-03-01

To ascertain whether the prevalence of ultrasonography signs of abnormally invasive placenta (AIP) changes during pregnancy. The present retrospective analysis included women with a prenatal diagnosis of AIP that was confirmed at delivery between January 1, 2007, and April 30, 2017, at the Department of Obstetrics and Gynaecology, Arnas Civico Hospital, Palermo, Italy. Ultrasonography signs of AIP were recorded at four different intervals during pregnancy: early first (6-9 weeks), first (11-14 weeks), second (15-24 weeks), and third trimester (25-36 weeks). There were 105 pregnancies included. Low implantation of the gestational sac was present on all ultrasonography images from the early first trimester compared with on 23 of 83 (27.7%) images from 11-14 weeks of pregnancy. The identification of loss of the clear space, placental lacunae, bladder wall interruption, and uterovesical hypervascularity all increased (all P<0.001) from the early first trimester onwards; these could all be identified in a majority of patients at 11-14 weeks of pregnancy. The prevalence of ultrasonography signs suggestive of AIP varied throughout pregnancy. During the early first trimester, indicators of AIP were similar to those of a cesarean scar pregnancy; classical ultrasonography signs of AIP were already present at 11-14 weeks of pregnancy for most patients. © 2017 International Federation of Gynecology and Obstetrics.

The Efficacy of Thoracic Ultrasonography in Postoperative Newborn Patients after Cardiac Surgery

PubMed Central

Ozturk, Erkut; Tanidir, Ibrahim Cansaran; Yildiz, Okan; Ergul, Yakup; Guzeltas, Alper

2017-01-01

Objective In this study, the efficacy of thoracic ultrasonography during echocardiography was evaluated in newborns. Methods Sixty newborns who had undergone pediatric cardiac surgery were successively evaluated between March 1, 2015, and September 1, 2015. Patients were evaluated for effusion, pulmonary atelectasis, and pneumothorax by ultrasonography, and results were compared with X-ray findings. Results Sixty percent (n=42) of the cases were male, the median age was 14 days (2-30 days), and the median body weight was 3.3 kg (2.8-4.5 kg). The median RACHS-1 score was 4 (2-6). Atelectasis was demonstrated in 66% (n=40) of the cases. Five of them were determined solely by X-ray, 10 of them only by ultrasonography, and 25 of them by both ultrasonography and X-ray. Pneumothorax was determined in 20% (n=12) of the cases. Excluding one case determined by both methods, all of the 11 cases were diagnosed by X-ray. Pleural effusion was diagnosed in 26% (n=16) of the cases. Four of the cases were demonstrated solely by ultrasonography, three of them solely by X-ray, and nine of the cases by both methods. Pericardial effusion was demonstrated in 10% (n=6) of the cases. Except for one of the cases determined by both methods, five of the cases were diagnosed by ultrasonography. There was a moderate correlation when all pathologies evaluated together (k=0.51). Conclusion Thoracic ultrasonography might be a beneficial non-invasive method to evaluate postoperative respiratory problems in newborns who had congenital cardiac surgery. PMID:28977200

2 CFR 200.89 - Special purpose equipment.

Code of Federal Regulations, 2014 CFR

2014-01-01

... equipment. Special purpose equipment means equipment which is used only for research, medical, scientific... machines, surgical instruments, and spectrometers. See also §§ 200.33 Equipment and 200.48 General purpose...

Screening ultrasonography of 2,204 patients with blunt abdominal trauma in the Wenchuan earthquake.

PubMed

Zhou, Jixiang; Huang, Jiwei; Wu, Hong; Jiang, Hui; Zhang, Heqing; Prasoon, Pankaj; Xu, Yinglong; Bai, Yannan; Qiu, Jianguo; Zeng, Yong

2012-10-01

Abdominal injuries constitute a small proportion of all earthquake-related traumas; however, it often resulted in fatal hemorrhage. Ultrasonography has been described as an effective triage tool in the evaluation of blunt abdominal trauma. We aimed to present an overview of the diagnostic accuracy of screening ultrasonography for patients with blunt abdominal trauma admitted to various hospitals during the Wenchuan earthquake in China. We retrospectively analyzed the patients with blunt abdominal trauma who underwent ultrasonography after admission to various hospitals. Ultrasonography findings were considered positive if evidence of free fluid or a parenchymal injury was identified. Ultrasonography findings were compared with the findings of computed tomography, diagnostic peritoneal lavage, repeated ultrasonography, cystography, operation, and/or the clinical course. Findings from 2,204 ultrasonographic examinations were evaluated. Findings of 199 ultrasonographic examinations (9.0%) were considered positive. Of the patients, 12 (0.5%) had a false-negative ultrasonographic findings; of this group, 3 (25%) required exploratory laparotomy. Ultrasonography had a sensitivity of 91.9%, specificity of 96.9%, and an accuracy of 96.6% for detection of abdominal injuries. Positive predictive value was 68.3%, and negative predictive value was 99.4%. Screening ultrasonography is highly reliable in the setting of blunt abdominal trauma after earthquake. It should be used as an initial diagnostic modality in the evaluation of most blunt abdominal trauma. Diagnostic study, level III.

47 CFR 18.203 - Equipment authorization.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 1 2011-10-01 2011-10-01 false Equipment authorization. 18.203 Section 18.203 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL INDUSTRIAL, SCIENTIFIC, AND MEDICAL EQUIPMENT Applications and Authorizations § 18.203 Equipment authorization. (a) Consumer ISM equipment, unless otherwise specified, must be authorized...

47 CFR 18.203 - Equipment authorization.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 1 2012-10-01 2012-10-01 false Equipment authorization. 18.203 Section 18.203 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL INDUSTRIAL, SCIENTIFIC, AND MEDICAL EQUIPMENT Applications and Authorizations § 18.203 Equipment authorization. (a) Consumer ISM equipment, unless otherwise specified, must be authorized...

47 CFR 18.203 - Equipment authorization.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 1 2014-10-01 2014-10-01 false Equipment authorization. 18.203 Section 18.203 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL INDUSTRIAL, SCIENTIFIC, AND MEDICAL EQUIPMENT Applications and Authorizations § 18.203 Equipment authorization. (a) Consumer ISM equipment, unless otherwise specified, must be authorized...

47 CFR 18.203 - Equipment authorization.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 1 2013-10-01 2013-10-01 false Equipment authorization. 18.203 Section 18.203 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL INDUSTRIAL, SCIENTIFIC, AND MEDICAL EQUIPMENT Applications and Authorizations § 18.203 Equipment authorization. (a) Consumer ISM equipment, unless otherwise specified, must be authorized...

47 CFR 18.203 - Equipment authorization.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Equipment authorization. 18.203 Section 18.203 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL INDUSTRIAL, SCIENTIFIC, AND MEDICAL EQUIPMENT Applications and Authorizations § 18.203 Equipment authorization. (a) Consumer ISM equipment, unless otherwise specified, must be authorized...

21 CFR 226.30 - Equipment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... CURRENT GOOD MANUFACTURING PRACTICE FOR TYPE A MEDICATED ARTICLES Construction and Maintenance of Facilities and Equipment § 226.30 Equipment. Equipment used for the manufacture, processing, packaging, bulk... maintained in a clean and orderly manner and shall be of suitable design, size, construction, and location to...

The diagnosis of neonatal pulmonary atelectasis using lung ultrasonography.

PubMed

Liu, Jing; Chen, Shui-Wen; Liu, Fang; Li, Qiu-Ping; Kong, Xiang-Yong; Feng, Zhi-Chun

2015-04-01

Ultrasonography has been used for the diagnosis of many kinds of lung conditions, but few studies have investigated ultrasound for the diagnosis of neonatal pulmonary atelectasis (NAP). In this study, we evaluated the usefulness of lung ultrasonography for the diagnosis of NPA. From May 2012 to December 2013, 80 neonates with NPA and 50 neonates without lung disease were enrolled in this study. Each lung of every infant was divided into the anterior, lateral, and posterior regions by the anterior and posterior axillary lines. Each region was scanned carefully with the probe perpendicular or parallel to the ribs. The ultrasound findings were confirmed by chest radiograph (CXR) or CT scan. Sixty of the 80 patients with signs of NPA on lung ultrasound also had signs of NPA on CXR (termed focal-type atelectasis), and the other 20 patients had signs of NPA on chest CT scan while there were no abnormal findings on CXR (termed occult lung atelectasis). In patients with NPA, the main ultrasound findings were large areas of lung consolidation with clearly demarcated borders, air bronchograms, pleural line abnormalities, and absence of A-lines, as well as the presence of lung pulse and absence of lung sliding on real-time ultrasound. The sensitivity of lung ultrasonography for the diagnosis of NPA was 100%, whereas the sensitivity of CXR was 75%. Large areas of lung consolidation with clearly demarcated borders were only observed in patients with NPA. Lung ultrasonography is an accurate and reliable method for diagnosing NPA; most importantly, it can find those occult lung atelectasis that could not be detected on CXR. Routine lung ultrasonography is a useful method of diagnosing or excluding NPA in neonates.

Effect of negative air ions on the potential for bacterial contamination of plastic medical equipment.

PubMed

Shepherd, Simon J; Beggs, Clive B; Smith, Caroline F; Kerr, Kevin G; Noakes, Catherine J; Sleigh, P Andrew

2010-04-12

In recent years there has been renewed interest in the use of air ionizers to control the spread of infection in hospitals and a number of researchers have investigated the biocidal action of ions in both air and nitrogen. By comparison, the physical action of air ions on bacterial dissemination and deposition has largely been ignored. However, there is clinical evidence that air ions might play an important role in preventing the transmission of Acinetobacter infection. Although the reasons for this are unclear, it is hypothesized that a physical effect may be responsible: the production of air ions may negatively charge items of plastic medical equipment so that they repel, rather than attract, airborne bacteria. By negatively charging both particles in the air and items of plastic equipment, the ionizers minimize electrostatic deposition on these items. In so doing they may help to interrupt the transmission of Acinetobacter infection in certain healthcare settings such as intensive care units. A study was undertaken in a mechanically ventilated room under ambient conditions to accurately measure changes in surface potential exhibited by items of plastic medical equipment in the presence of negative air ions. Plastic items were suspended on nylon threads, either in free space or in contact with a table surface, and exposed to negative ions produced by an air ionizer. The charge build-up on the specimens was measured using an electric field mill while the ion concentration in the room air was recorded using a portable ion counter. The results of the study demonstrated that common items of equipment such as ventilator tubes rapidly developed a large negative charge (i.e. generally >-100V) in the presence of a negative air ionizer. While most items of equipment tested behaved in a similar manner to this, one item, a box from a urological collection and monitoring system (the only item made from styrene acrylonitrile), did however develop a positive charge in the

Using Lean methodologies to streamline processing of requests for durable medical equipment and supplies for children with complex conditions.

PubMed

Fields, Elise; Neogi, Smriti; Schoettker, Pamela J; Lail, Jennifer

2017-12-12

An improvement team from the Complex Care Center at our large pediatric medical center participated in a 60-day initiative to use Lean methodologies to standardize their processes, eliminate waste and improve the timely and reliable provision of durable medical equipment and supplies. The team used value stream mapping to identify processes needing improvement. Improvement activities addressed the initial processing of a request, provider signature on the form, returning the form to the sender, and uploading the completed documents to the electronic medical record. Data on lead time (time between receiving a request and sending the completed request to the Health Information Management department) and process time (amount of time the staff worked on the request) were collected via manual pre- and post-time studies. Following implementation of interventions, the median lead time for processing durable medical equipment and supply requests decreased from 50 days to 3 days (p < 0.0001). Median processing time decreased from 14min to 9min (p < 0.0001). The decrease in processing time realized annual cost savings of approximately $11,000. Collaborative leadership and multidisciplinary training in Lean methods allowed the CCC staff to incorporate common sense, standardize practices, and adapt their work environment to improve the timely and reliable provision of equipment and supplies that are essential for their patients. The application of Lean methodologies to processing requests for DME and supplies could also result in a natural spread to other paperwork and requests, thus avoiding delays and potential risk for clinical instability or deterioration. Copyright © 2017 Elsevier Inc. All rights reserved.

An economic evaluation of second-trimester genetic ultrasonography for prenatal detection of down syndrome.

PubMed

Vintzileos, A M; Ananth, C V; Fisher, A J; Smulian, J C; Day-Salvatore, D; Beazoglou, T; Knuppel, R A

1998-11-01

The objective of this study was to perform an economic evaluation of second-trimester genetic ultrasonography for prenatal detection of Down syndrome. More specifically, we sought to determine the following: (1) the diagnostic accuracy requirements (from the cost-benefit point of view) of genetic ultrasonography versus genetic amniocentesis for women at increased risk for fetal Down syndrome and (2) the possible economic impact of second-trimester genetic ultrasonography for the US population on the basis of the ultrasonographic accuracies reported in previously published studies. A cost-benefit equation was developed from the hypothesis that the cost of universal genetic amniocentesis of patients at increased risk for carrying a fetus with Down syndrome should be at least equal to the cost of universal genetic ultrasonography with amniocentesis used only for those with abnormal ultrasonographic results. The main components of the equation included the diagnostic accuracy of genetic ultrasonography (sensitivity and specificity for detecting Down syndrome), the costs of the amniocentesis package and genetic ultrasonography, and the lifetime cost of Down syndrome cases not detected by the genetic ultrasonography. After appropriate manipulation of the equation a graph was constructed, representing the balance between sensitivity and false-positive rate of genetic ultrasonography; this was used to examine the accuracy of previously published studies from the cost-benefit point of view. Sensitivity analyses included individual risks for Down syndrome ranging from 1:261 (risk of a 35-year-old at 18 weeks' gestation) to 1:44 (risk of a 44-year-old at 18 weeks' gestation). This economic evaluation was conducted from the societal perspective. Genetic ultrasonography was found to be economically beneficial only if the overall sensitivity for detecting Down syndrome was >74%. Even then, the cost-benefit ratio depended on the corresponding false-positive rate. Of the 7

Imaging of juvenile spondyloarthritis. Part II: Ultrasonography and magnetic resonance imaging

PubMed Central

Znajdek, Michał; Gietka, Piotr; Vasilevska-Nikodinovska, Violeta; Patrovic, Lukas; Salapura, Vladka

2017-01-01

Juvenile spondyloarthropathies are mainly manifested by symptoms of peripheral arthritis and enthesitis. Early involvement of sacroiliac joints and spine is exceptionally rare in children; this usually happens in adulthood. Conventional radiographs visualize late inflammatory lesions. Early diagnosis is possible with the use of ultrasonography and magnetic resonance imaging. The first part of the article presented classifications and radiographic presentation of juvenile spondyloarthropathies. This part discusses changes seen on ultrasonography and magnetic resonance imaging. In patients with juvenile spondyloarthropathies, these examinations are conducted to diagnose inflammatory lesions in peripheral joints, tendon sheaths, tendons and bursae. Moreover, magnetic resonance also shows subchondral bone marrow edema, which is considered an early sign of inflammation. Ultrasonography and magnetic resonance imaging do not show specific lesions for any rheumatic disease. Nevertheless, they are conducted for early diagnosis, treatment monitoring and identifying complications. This article presents a spectrum of inflammatory changes and discusses the diagnostic value of ultrasonography and magnetic resonance imaging. PMID:29075522

Mobile kidney pain provocation ultrasonography before surgery for symptomatic mobile kidney: A prospective study of 43 consecutive patients.

PubMed

Arnerlöv, Conny; Söderström, Minette; Öhberg, Lars

2016-01-01

The aim of this study was to evaluate whether mobile kidney pain provocation ultrasonography together with intravenous pyelography in supine and standing positions and a full medical history can confirm the diagnosis of the clinical condition of symptomatic mobile kidney and aid the selection of patients for surgical treatment. In a consecutive study, 43 patients with the clinical picture of symptomatic mobile kidney, a positive mobile kidney pain provocation ultrasonography and a renal descent of at least 2 lumbar vertebral heights on intravenous pyelography in the standing position, were operated on with nephropexy. Patients' pain relief after nephropexy was evaluated by clinical follow-up, a questionnaire and visual analogue scale (VAS) scoring. Reduction of pain after nephropexy was associated with a significant decrease in VAS scoring from a median of 8 (range 4-10) preoperatively to a median of 0 (range 0-7) postoperatively (p < 0.001). Thirty-four patients (79%) were cured of their pain and seven patients (16%) experienced substantial relief from their pain symptoms. In two patients (5%) the symptoms were unchanged. The results indicate that mobile kidney pain provocation ultrasonography and intravenous pyelography in supine and standing positions can verify the diagnosis of symptomatic mobile kidney and aid the selection of patients who will benefit from nephropexy.

Cognitive Load Imposed by Knobology May Adversely Affect Learners' Perception of Utility in Using Ultrasonography to Learn Physical Examination Skills, but Not Anatomy

ERIC Educational Resources Information Center

Jamniczky, Heather A.; McLaughlin, Kevin; Kaminska, Malgorzata E.; Raman, Maitreyi; Somayaji, Ranjani; Wright, Bruce; Ma, Irene W. Y.

2015-01-01

Ultrasonography is increasingly used for teaching anatomy and physical examination skills but its effect on cognitive load is unknown. This study aimed to determine ultrasound's perceived utility for learning, and to investigate the effect of cognitive load on its perceived utility. Consenting first-year medical students (n?=?137) completed…

Ultrasonography evaluation during the weaning process: the heart, the diaphragm, the pleura and the lung.

PubMed

Mayo, P; Volpicelli, G; Lerolle, N; Schreiber, A; Doelken, P; Vieillard-Baron, A

2016-07-01

On a regular basis, the intensivist encounters the patient who is difficult to wean from mechanical ventilatory support. The causes for failure to wean from mechanical ventilatory support are often multifactorial and involve a complex interplay between cardiac and pulmonary dysfunction. A potential application of point of care ultrasonography relates to its utility in the process of weaning the patient from mechanical ventilatory support. This article reviews some applications of ultrasonography that may be relevant to the process of weaning from mechanical ventilatory support. The authors have divided these applications of ultrasonography into four separate categories: the assessment of cardiac, diaphragmatic, and lung function; and the identification of pleural effusion; which can all be evaluated with ultrasonography during a dynamic process in which the intensivist is uniquely positioned to use ultrasonography at the point of care. Ultrasonography may have useful application during the weaning process from mechanical ventilatory support.

Shear-wave elastography in breast ultrasonography: the state of the art

PubMed Central

2017-01-01

Shear-wave elastography (SWE) is a recently developed ultrasound technique that can visualize and measure tissue elasticity. In breast ultrasonography, SWE has been shown to be useful for differentiating benign breast lesions from malignant breast lesions, and it has been suggested that SWE enhances the diagnostic performance of ultrasonography, potentially improving the specificity of conventional ultrasonography using the Breast Imaging Reporting and Data System criteria. More recently, not only has SWE been proven useful for the diagnosis of breast cancer, but has also been shown to provide valuable information that can be used as a preoperative predictor of the prognosis or response to chemotherapy. PMID:28513127

Role of ultrasonography in detecting mammographically occult breast carcinoma in women with dense breasts.

PubMed

Corsetti, V; Ferrari, A; Ghirardi, M; Bergonzini, R; Bellarosa, S; Angelini, O; Bani, C; Ciatto, S

2006-04-01

The purpose of this study was to assess the usefulness of routine ultrasonography in women with negative mammography and dense breasts [Breast Imaging Reporting and Data System (BIRADS D3-4)]. We applied a protocol involving routine ultrasonography in a consecutive series of subjects with negative mammography and dense breasts. After evaluation by internal and external reviewers of cancers detected by ultrasonography performed to confirm negative mammography, we determined the additional cancer detection rate of ultrasonography and the cost of the protocol. Out of 17,883 total mammographies, 167 cancers were diagnosed (detection rate: 0.93%). Out of 257 suspicious mammographies, 138 cancers were detected. Out of 17,626 negative mammographies, 6,449 (36.5%) were classified as "dense breast" and underwent ultrasonography: 29 cancers were detected (detection rate: 0.44%, or 17.3% of total cancers). Out of 25 cancer cases reviewed, negative mammography and asymptomatic status was confirmed in 15 (detection rate 0.23%, or 8.9% of total cancers). The cancer detection rate was 0.11%, 0.22%, 0.32% and 0.14% for age groups <40, 40-49, 50-59 and >59, respectively. The cost per additional carcinoma detected by ultrasonography alone was euro 25,847.85 whereas that per examined woman was euro 21.68. The study confirms the possibility that ultrasonography can detect mammographically occult breast carcinoma in dense breasts. The evidence is insufficient to recommend this policy in routine screening practice but suggests that, at least in current clinical practice, adding ultrasonography in dense breasts may be useful despite the substantial costs.

Medicare program; end-stage renal disease prospective payment system, quality incentive program, and durable medical equipment, prosthetics, orthotics, and supplies.

PubMed

2013-12-02

This rule updates and makes revisions to the End-Stage Renal Disease (ESRD) prospective payment system (PPS) for calendar year (CY) 2014. This rule also sets forth requirements for the ESRD quality incentive program (QIP), including for payment year (PY) 2016 and beyond. In addition, this rule clarifies the grandfathering provision related to the 3-year minimum lifetime requirement (MLR) for Durable Medical Equipment (DME), and provides clarification of the definition of routinely purchased DME. This rule also implements budget-neutral fee schedules for splints and casts, and intraocular lenses (IOLs) inserted in a physician's office. Finally, this rule makes a few technical amendments and corrections to existing regulations related to payment for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) items and services.

Ultrasonography and magnetic resonance imaging in the diagnosis of Morton's neuroma.

PubMed

Fazal, Muhammad Ali; Khan, Ishrat; Thomas, Cherian

2012-01-01

Magnetic resonance imaging (MRI) and ultrasonography are used widely for the diagnosis of Morton's neuroma. The aim of this study was to assess the accuracy of these two modalities as diagnostic tools in Morton's neuroma. Fifty feet of 47 consecutive patients (39 women and 8 men; mean age, 46 years; age range, 36-64 years) who presented between January 1, 2005, and June 30, 2008, were included in the study. Twenty-five feet were investigated with ultrasonography and 25 with MRI. Morton's neuroma was confirmed surgically and histologically in all of the patients. A Student unpaired t test was applied. Twenty-two MRIs were diagnostic (sensitivity, 88%). Three patients with negative MRI findings underwent ultrasonography and were found to have a neuroma smaller than 5 mm. Twenty-four ultrasound scans demonstrated the neuroma (sensitivity, 96%), with five neuromas being smaller than 5 mm. Ultrasonography has a slightly higher sensitivity in the diagnosis of Morton's neuroma, particularly of neuromas smaller than 5 mm, and should be the preferred imaging modality in suspected cases, and MRI should be reserved for cases with equivocal diagnosis.

Comparison of Radiography and Ultrasonography for Diagnosis of Diaphragmatic Hernia in Bovines

PubMed Central

Athar, Hakim; Mohindroo, Jitender; Singh, Kiranjeet; Kumar, Ashwani; Raghunath, Mulinti

2010-01-01

The present study was conducted on 101 animals suffering from thoracoabdominal disorders; out of which twenty seven animals (twenty six buffaloes and one cow) were diagnosed with diaphragmatic hernia based on clinical signs, radiography, ultrasonography, and left flank laparorumenotomy. Radiography alone confirmed diaphragmatic hernia in 18 cases (66.67%) with a sac-like structure cranial to the diaphragm. In 15 animals the sac contained metallic densities while in three cases a sac-like structure with no metallic densities was present. Ultrasonography was helpful in confirming diaphragmatic hernia in 23 cases (85.18%) and ultrasonographically reticular motility was evident at the level of 4th/5th intercostal space in all the animals. B+M mode ultrasonography was used for the first time for diagnosis of diaphragmatic hernia in bovines and the results suggested that ultrasonography was a reliable diagnostic modality for diaphragmatic hernia in bovines. PMID:20445795

Performance of physical examination versus ultrasonography to detect stenosis in haemodialysis arteriovenous fistula.

PubMed

Maldonado-Cárceles, Ana B; García-Medina, José; Torres-Cantero, Alberto M

2017-01-18

The overall purpose of this study is to compare the accuracy of physical examination (PE) versus ultrasonography (US) in people with arteriovenous fistula (AVF). This is a cross-sectional study with a total of 99 patients attended by the vascular radiology unit for AVF evaluation during January - March 2015. PE and ultrasonography were blinded performed by different radiologists. For complete and individual signs of PE, sensitivity, specificity, predictive positive (PPV) and negative (PNV) value, likelihood ratios (LR) and Cohen's κ value were measured. According to ultrasonography, the presence of stenosis was identified in 57 (58%) patients, and 61 (62%) by PE. The accuracy of PE for the diagnosis of AVF was sensitivity 82%, specificity 67%, PPV 77%, NPV 74%, LR 2.74 and 0.26. There was a moderate agreement beyond chance between PE and ultrasonography (κ = 0.5). PE has shown a moderate accuracy to detect stenosis. With non-ultrasonography availability Haemodialysis Units can get benefit to optimize VA survival and professionals should improve its basic skills.

Brain Ultrasonography Findings in Neonatal Seizure; a Cross-sectional Study.

PubMed

Nabavi, Seyed Saeed; Partovi, Parinaz

2017-01-01

Screening of newborns with seizure, who have curable pathologic brain findings, might be able to improve their final outcome by accelerating treatment intervention. The present study aimed to evaluate the brain ultrasonography findings of newborns hospitalized with complaint of seizure. The present cross-sectional study designed to evaluate brain ultrasonography findings of hospitalized newborns complaining seizure. Neonatal seizure was defined as presence of tonic, clonic, myoclonic, and subtle attacks in 1 - 28 day old newborns. 100 newborns with the mean age of 5.82 ± 6.29 days were evaluated (58% male). Most newborns were in the < 10 days age range (76%), term (83%) and with normal birth weight (81%). 22 (22%) of the ultrasonography examinations showed a pathologic finding. A correlation was only found between birth age and probability of the presence of a pathologic problem in the brain as the frequency of these problems was significantly higher in pre-term newborns (p = 0.023). Based on the findings of the present study, frequency of pathologic findings in neonatal brain ultrasonography was 22%. Hemorrhage (12%) and hydrocephaly (7%) were the most common findings. The only factor correlating with increased probability of positive findings was the newborns being pre-term.

Ultrasonography of hydronephrosis in the newborn: a practical review

PubMed Central

2016-01-01

Widespread use of fetal ultrasonography is accompanied by more frequent detection of antenatal hydronephrosis. Therefore, sonographic evaluation of neonates with a history of antenatal hydronephrosis is becoming more widespread. As an initial postnatal non-invasive imaging modality, ultrasonography is used to screen for persistence of hydronephrosis, determine the level and severity of obstruction, and contribute to appropriate diagnosis and treatment. This review aims to provide a practical overview of the sonographic evaluation of neonatal hydronephrosis and to describe the sonographic findings of conditions associated with hydronephrosis in the newborn. PMID:27156562

Application of integral imaging autostereoscopic display to medical training equipment

NASA Astrophysics Data System (ADS)

Nagatani, Hiroyuki

2010-02-01

We applied an autostereoscopic display based on the integral imaging method (II method) to training equipment for medical treatment in an attempt to recover the binocular vision performance of strabismus or amblyopia (lazy eye) patients. This report summarizes the application method and results. The point of the training is to recognize the parallax using both eyes. The strabismus or amblyopia patients have to recognize the information on both eyes equally when they gaze at the display with parallax and perceive the stereo depth of the content. Participants in this interactive training engage actively with the image. As a result, they are able to revive their binocular visual function while playing a game. Through the training, the observers became able to recognize the amount of parallax correctly. In addition, the training level can be changed according to the eyesight difference between a right eye and a left eye. As a result, we ascertained that practical application of the II method for strabismus or amblyopia patients would be possible.

Repeatability of diagnostic ultrasonography in the assessment of the equine superficial digital flexor tendon.

PubMed

Pickersgill, C H; Marr, C M; Reid, S W

2001-01-01

A quantitative investigation of the variation that can occur during the course of ultrasonography of the equine superficial digital flexor tendons (SDFT) was undertaken. The aim of this investigation was to use an objective measure, namely the measurement of CSA, to quantify the variability occurring during the course of the ultrasonographic assessment of the equine SDFT. The effects of 3 variables on the CSA measurements were determined. 1) Image acquisition operator (IAc): two different operators undertaking the ultrasonographic examination; 2) image analysis operator (IAn): two different operators undertaking the calculation of CSA values from previously stored images; and 3) analytical equipment (used during CSA measurement) (IEq): the use of 2 different sets of equipment during calculation of CSA values. Tendon cross-sectional area (CSA) measurements were used as the comparative variable of 3 potential sources: interoperator, during image acquisition; interoperator, during CSA measurement; and intraoperator, when using different analytical equipment. Two operators obtained transverse ultrasonographic images from the forelimb SDFTs of 16 National Hunt (NH) Thoroughbred (TB) racehorses, each undertaking analysis of their own and the other operator's images. One operator undertook analysis of their images using 2 sets of equipment. There was no statistically significant difference in the results obtained when different operators undertook image acquisition (P>0.05). At all but the most distal level, there was no significant difference when different equipment was used during analysis (P>0.05). A significant difference (P<0.01) was reported when different operators undertook image analysis, one operator consistently returning larger measurements. Different operators undertaking different stages of an examination can result in significant variability. To reduce confounding during ultrasonographic investigations involving multiple persons, one operator should

42 CFR 414.226 - Oxygen and oxygen equipment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 3 2014-10-01 2014-10-01 false Oxygen and oxygen equipment. 414.226 Section 414... Durable Medical Equipment, Prosthetic and Orthotic Devices, and Surgical Dressings § 414.226 Oxygen and oxygen equipment. (a) Payment rules—(1) Oxygen equipment. Payment for rental of oxygen equipment is made...

Survey identifies trends in equipment acquisitions.

PubMed

Anderson, H J

1990-09-20

Automated laboratory equipment, medical imaging equipment, and patient monitors top the list of hospitals' priorities for equipment acquisition during the next year. This is according to an exclusive survey sponsored by the Linc Group, Inc., Chicago, and Hospitals magazine. The new survey also found that equipment acquisitions are most often financed with internal funds and gifts; that equipment purchasing budgets are on the rise; and that executives believe that most equipment makes money for their hospitals. Find out what your peers have to say about anticipated trends in equipment acquisition and financing during the next year.

42 CFR 414.226 - Oxygen and oxygen equipment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false Oxygen and oxygen equipment. 414.226 Section 414... Durable Medical Equipment and Prosthetic and Orthotic Devices § 414.226 Oxygen and oxygen equipment. (a) Payment rules—(1) Oxygen equipment. Payment for rental of oxygen equipment is made based on a monthly fee...

42 CFR 414.226 - Oxygen and oxygen equipment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 3 2013-10-01 2013-10-01 false Oxygen and oxygen equipment. 414.226 Section 414... Durable Medical Equipment and Prosthetic and Orthotic Devices § 414.226 Oxygen and oxygen equipment. (a) Payment rules—(1) Oxygen equipment. Payment for rental of oxygen equipment is made based on a monthly fee...

38 CFR 17.157 - Definition-adaptive equipment.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Definition-adaptive equipment. 17.157 Section 17.157 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Automotive Equipment and Driver Training § 17.157 Definition-adaptive equipment. The term...

38 CFR 17.157 - Definition-adaptive equipment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Definition-adaptive equipment. 17.157 Section 17.157 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Automotive Equipment and Driver Training § 17.157 Definition-adaptive equipment. The term...

38 CFR 17.157 - Definition-adaptive equipment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Definition-adaptive equipment. 17.157 Section 17.157 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Automotive Equipment and Driver Training § 17.157 Definition-adaptive equipment. The term...

38 CFR 17.157 - Definition-adaptive equipment.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Definition-adaptive equipment. 17.157 Section 17.157 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Automotive Equipment and Driver Training § 17.157 Definition-adaptive equipment. The term...

Evaluation of clinical breast examination and breast ultrasonography among pregnant women in Abakaliki, Nigeria

PubMed Central

Ezeonu, Paul Olisaemeka; Ajah, Leonard Ogbonna; Onoh, Robinson Chukwudi; Lawani, Lucky Osaheni; Enemuo, Vincent Chidi; Agwu, Uzoma MaryRose

2015-01-01

Background Breast cancer in pregnancy accounts for 2%–3% of all breast cancers. The increased vascularity and lymphatic drainage from the breast during pregnancy potentiate the metastatic spread of the cancer to the regional lymph nodes. However, the increased breast density in pregnancy makes it difficult to detect breast lesions early. Aim To evaluate and compare the detection rate of breast lesions using clinical breast examination (CBE) and breast ultrasonography among pregnant women. Methodology A cross-sectional comparative study involving antenatal clinic attendees at the Federal Teaching Hospital, Abakaliki, was conducted between March 3, 2014, and December 31, 2014. CBE and breast ultrasonography were done in the participants at booking and repeated at 6 weeks postpartum. Fine-needle aspiration cytology and histology were done in women with suspicious breast lesions on CBE or breast ultrasonography or both. Data analysis was both descriptive and inferential at the 95% confidence level using the Statistical Package for the Social Sciences (SPSS) software version 17.0. Test of significance was done using chi-square test. A P-value of less than or equal to 0.05 was considered statistically significant. Results A total of 320 pregnant women participated in the study. Of these, 267 (83.4%) were aware of breast cancer. Although more lesions were detected with breast ultrasonography than by CBE, there was no statistically significant difference between them (25 versus 17; P=0.26). The histology of the lesions revealed 21 benign lesions and 4 normal breast tissues. The sensitivity of breast ultrasonography was 95.2%, while that of CBE was 66.7%. The specificity, positive predictive value, and negative predictive value were similar between CBE and breast ultrasonography. Conclusion The detection rates of breast lesions by both CBE and breast ultrasonography were equivalent during pregnancy and 6 weeks postpartum, making CBE a convenient and very cost

Feasibility of Using Ultrasonography to Establish Relationships Among Sacral Base Position, Sacral Sulcus Depth, Body Mass Index, and Sex.

PubMed

Lockwood, Michael D; Kondrashova, Tatyana; Johnson, Jane C

2015-11-01

Identifying relationships among anatomical structures is key in diagnosing somatic dysfunction. Ultrasonography can be used to visualize anatomical structures, identify sacroiliac landmarks, and validate anatomical findings and measurements in relation to somatic dysfunction. As part of the osteopathic manipulative medicine course at A.T. Still University-Kirksville College of Osteopathic Medicine, first-year students are trained to use ultrasonography to establish relationships among musculoskeletal structures. To determine the ability of first-year osteopathic medical students to establish sacral base position (SBP) and sacral sulcus depth (SSD) using ultrasonography and to identify the relationship of SBP and SSD to body mass index (BMI) and sex. Students used ultrasonography to obtain the distance between the skin and the sacral base (the SBP) and the distance between the skin and the tip of the posterior superior iliac spine bilaterally. Next, students calculated the SSD (the distance between the tip of the posterior superior iliac spine and the SBP). Data were analyzed with respect to side of the body, BMI, sex, and age. The BMI data were subdivided into normal (18-25 mg/kg) and overweight (25-30 mg/kg) groups. Ultrasound images of 211 students were included in the study. The SBP was not significantly different between the left and right sides (36.5 mm vs 36.5 mm; P=.95) but was significantly different between normal and overweight BMI categories (33.0 mm vs 40.0 mm; P<.001) and between men and women (34.1 mm vs 39.0 mm; P<.001). The SSD was not significantly different between left and right sides (18.9 mm vs 19.8 mm; P=.08), normal and overweight BMI categories (18.9 mm vs 19.7 mm, P=.21), or men and women (19.7 mm vs 19.0 mm; P=.24). No significant relationship was identified between age and SBP (P=.46) or SSD (P=.39); however, the age range was narrow (21-33 years). The study yielded repeatable and reproducible results when establishing SBP and SSD using

38 CFR 17.157 - Definition-adaptive equipment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... includes, but is not limited to, a basic automatic transmission, power steering, power brakes, power window lifts, power seats, air-conditioning equipment when necessary for the health and safety of the veteran... MEDICAL Automotive Equipment and Driver Training § 17.157 Definition-adaptive equipment. The term...

Follow-up of renal and mesenteric artery revascularization with duplex ultrasonography

PubMed Central

Taylor, David C.; Houston, Gordon T.M.; Anderson, Caroline; Jameson, Margot; Popatia, Shelley

1996-01-01

Objective To evaluate the long-term anatomic results of renal revascularization procedures using duplex ultrasonography. Design A case series. Setting A university-affiliated hospital. Patients Twenty-five patients who had undergone renal percutaneous transluminal angioplasty (PTA) (18 arteries), renal bypass (10 arteries) and mesenteric bypass (6 arteries). The mean follow-up was 22 months (range from 3 to 48 months) for those who underwent renal PTA, 23 months (range from 1.5 to 70 months) for those who underwent renal bypass and 34 months (range from 8 to 144 months) for those who underwent mesenteric bypass. Main Outcome Measures Patency rates for the three procedures as assessed by duplex ultrasonography. Results Duplex ultrasonography demonstrated patency without stenosis after renal and mesenteric artery revascularization in 14 arteries subjected to renal PTA, 9 arteries subjected to renal bypass and 6 arteries subjected to mesenteric bypass. Three arteries that had renal PTA had recurrent vessel stenosis and one had occlusion. One artery that had renal bypass showed occlusion. Conclusions Renal PTA, renal bypass and mesenteric bypass are durable procedures at 2 years of follow-up, and duplex ultrasonography is a valuable method for assessing the patency of arteries after renal and mesenteric revascularization. PMID:8599785

Validation of ultrasonography of the thyroid gland for epidemiological purposes.

PubMed

Knudsen, N; Bols, B; Bülow, I; Jørgensen, T; Perrild, H; Ovesen, L; Laurberg, P

1999-11-01

Ultrasonography of the thyroid is often used in epidemiological surveys, thus thorough characterization of the interobserver variation of the different parameters obtained is important. Various methods have been used for measuring thyroid volume, and different formulas have been used for calculation of thyroid volume from the measured dimensions. In this article, two principles of thyroid volume measurement are described in detail: the wellknown method based on the three axes of each lobe and a new principle based on planimetry in two planes. The interobserver variation of the examination and the measuring procedure in itself were tested on 25 participants in a population study. A comparison of postmortem ultrasonography of the thyroid and results of an autopsy was performed. Good correlation and agreement between observers was found for thyroid volume (r = 0.98) and prevalence of thyroid nodules (kappa = 0.72), whereas echogenecity and echopattern showed little agreement. The correlation of thyroid volume by ultrasonography to autopsy results was satisfactory (r = 0.93), but the volume tended to be slightly underestimated even when using the formula pi/6(= 0.52)*length*width*depth. No major differences were found between the performance of the two principles of volume calculation. We conclude that when the measuring procedure is well defined, results of ultrasonography are comparable between observers for thyroid volume and prevalence of thyroid nodules, but not for echogenecity or echopattern. The formula of length*depth*width*pi/6 is suitable for thyroid volume measurement.

Ultrasonography of the equine shoulder: technique and normal appearance.

PubMed

Tnibar, M A; Auer, J A; Bakkali, S

1999-01-01

This study was intended to document normal ultrasonographic appearance of the equine shoulder and anatomic landmarks useful in clinical imaging. Both forelimbs of five equine cadavers and both forelimbs of six live adult horses were used. To facilitate understanding of the images, a zoning system assigned to the biceps brachii and to the infraspinatus tendon was developed. Ultrasonography was performed with a real-time B-mode semiportable sector scanner using 7.5- and 5-MHz transducers. On one cadaver limb, magnetic resonance imaging (MRI) was performed using a system at 1.5 Tesla, T1-weighted spin-echo sequence. Ultrasonography images were compared to frozen specimens and MRI images to correlate the ultrasonographic findings to the gross anatomy of the shoulder. Ultrasonography allowed easy evaluation of the biceps brachii and the infraspinatus tendon and their bursae, the supraspinatus muscle and tendons, the superficial muscles of the shoulder, and the underlying humerus and scapula. Only the lateral and, partially, the caudal aspects of the humeral head could be visualized with ultrasound. Ultrasonographic appearance, orientation, and anatomic relationships of these structures are described. Ultrasonographic findings correlated well with MRI images and with gross anatomy in the cadavers' limbs.

Determining the utility and durability of medical equipment donated to a rural clinic in a low-income country

PubMed Central

Bauserman, Melissa; Hailey, Claire; Gado, Justin; Lokangaka, Adrien; Williams, Jessica; Richards-Kortum, Rebecca; Tshefu, Antoinette; Bose, Carl

2015-01-01

Background Health centers in low-income countries often depend on donations to provide appropriate diagnostic equipment. However, donations are sometimes made without an understanding of the recipient's needs, practical constraints or sustainability of supplies. Methods We donated a set of physical diagnostic equipment, non-invasive instrument tests and laboratory supplies to a rural health center in the Democratic Republic of Congo. We collected information on the usage and durability of equipment and supplies for each patient encounter over a 1-year period. Results We recorded 913 patient encounters. The most commonly used physical diagnostic equipment were the stethoscope (98.9%; 903/913), thermometer (81.7%; 746/913), adult scale (81.4%; 744/913), stop watch (62.6%; 572/913), adult sphygmomanometer (55.8%; 510/913), infant scale (24.9%; 228/913), measuring tape (24.3%; 222/913) and fetoscope (23.8%; 218/913). The most commonly used laboratory tests were the blood smear for malaria (53.7%; 491/913), hematocrit (23.5%; 215/913), urinalysis (20.1%; 184/913) and sputum stain for TB (13.3%; 122/913). With the exception of a penlight and solar lantern, all equipment remained functional. Conclusions This study adds valuable information about the utility and durability of equipment supplied to a health center in the Democratic Republic of Congo. Our results might aid in determining the appropriateness of donated medical equipment in similar settings. The selection of donated goods should be made with knowledge of the context in which it will be used, and utilization should be monitored. PMID:25525132

[Pancreatic ultrasonography].

PubMed

Fernández-Rodríguez, T; Segura-Grau, A; Rodríguez-Lorenzo, A; Segura-Cabral, J M

2015-04-01

Despite the recent technological advances in imaging, abdominal ultrasonography continues to be the first diagnostic test indicated in patients with a suspicion of pancreatic disease, due to its safety, accessibility and low cost. It is an essential technique in the study of inflammatory processes, since it not only assesses changes in pancreatic parenchyma, but also gives an indication of the origin (bile or alcoholic). It is also essential in the detection and tracing of possible complications as well as being used as a guide in diagnostic and therapeutic punctures. It is also the first technique used in the study of pancreatic tumors, detecting them with a sensitivity of around 70% and a specificity of 90%. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

Ultrasonography of ovarian hyperandrogenemia

NASA Astrophysics Data System (ADS)

Kuzmina, Svetlana A.; Zharkin, Nikolay A.

2001-05-01

The method of ultrasonography is high informative and widely used in diagnostics of ovarian hyperandrogenaemia. The majority of authors consider that a hyperplasia of a stroma is the main pathognomonic marker of polycystic ovaries (PCO). Still recently swell of a stroma was valued visually, that had subjective nature. We offer for the first time a way of diagnostics of stromal hyperplasia grounded on measurement of a volume of a stroma and ovary with ultrasound method, calculation of the ratio of a volume of the ovary to a volume of a stroma for every patient.

Real-time tracheal ultrasonography for confirmation of endotracheal tube placement during cardiopulmonary resuscitation.

PubMed

Chou, Hao-Chang; Chong, Kah-Meng; Sim, Shyh-Shyong; Ma, Matthew Huei-Ming; Liu, Shih-Hung; Chen, Nai-Chuan; Wu, Meng-Che; Fu, Chia-Ming; Wang, Chih-Hung; Lee, Chien-Chang; Lien, Wan-Ching; Chen, Shyr-Chyr

2013-12-01

This study aimed to evaluate the accuracy of tracheal ultrasonography for assessing endotracheal tube position during cardiopulmonary resuscitation (CPR). We performed a prospective observational study of patients undergoing emergency intubation during CPR. Real-time tracheal ultrasonography was performed during the intubation with the transducer placed transversely just above the suprasternal notch, to assess for endotracheal tube positioning and exclude esophageal intubation. The position of trachea was identified by a hyperechoic air-mucosa (A-M) interface with posterior reverberation artifact (comet-tail artifact). The endotracheal tube position was defined as endotracheal if single A-M interface with comet-tail artifact was observed. Endotracheal tube position was defined as intraesophageal if a second A-M interface appeared, suggesting a false second airway (double tract sign). The gold standard of correct endotracheal intubation was the combination of clinical auscultation and quantitative waveform capnography. The main outcome was the accuracy of tracheal ultrasonography in assessing endotracheal tube position during CPR. Among the 89 patients enrolled, 7 (7.8%) had esophageal intubations. The sensitivity, specificity, positive predictive value, and negative predictive value of tracheal ultrasonography were 100% (95% confidence interval [CI]: 94.4-100%), 85.7% (95% CI: 42.0-99.2%), 98.8% (95% CI: 92.5-99.0%) and 100% (95% CI: 54.7-100%), respectively. Positive and negative likelihood ratios were 7.0 (95% CI: 1.1-43.0) and 0.0, respectively. Real-time tracheal ultrasonography is an accurate method for identifying endotracheal tube position during CPR without the need for interruption of chest compression. Tracheal ultrasonography in resuscitation management may serve as a powerful adjunct in trained hands. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Methods for medical device and equipment procurement and prioritization within low- and middle-income countries: findings of a systematic literature review.

PubMed

Diaconu, Karin; Chen, Yen-Fu; Cummins, Carole; Jimenez Moyao, Gabriela; Manaseki-Holland, Semira; Lilford, Richard

2017-08-18

Forty to 70 % of medical devices and equipment in low- and middle-income countries are broken, unused or unfit for purpose; this impairs service delivery to patients and results in lost resources. Undiscerning procurement processes are at the heart of this issue. We conducted a systematic review of the literature to August 2013 with no time or language restrictions to identify what product selection or prioritization methods are recommended or used for medical device and equipment procurement planning within low- and middle-income countries. We explore the factors/evidence-base proposed for consideration within such methods and identify prioritization criteria. We included 217 documents (corresponding to 250 texts) in the narrative synthesis. Of these 111 featured in the meta-summary. We identify experience and needs-based methods used to reach procurement decisions. Equipment costs (including maintenance) and health needs are the dominant issues considered. Extracted data suggest that procurement officials should prioritize devices with low- and middle-income country appropriate technical specifications - i.e. devices and equipment that can be used given available human resources, infrastructure and maintenance capacity. Suboptimal device use is directly linked to incomplete costing and inadequate consideration of maintenance services and user training during procurement planning. Accurate estimation of life-cycle costing and careful consideration of device servicing are of crucial importance.

Assessment of technical equipment supply in healthcare institutions: example of Almaty.

PubMed

Kurakbayev, Kuralbai K; Issayev, Daniyar S; Koshimbekov, Murat K; Kumar, Ainur B

2014-09-01

The share of healthcare-related expenditure in the Gross Domestic Product of Kazakhstan is relatively small, and it is strategically important to restructure budgetary expenses in favor of healthcare with simultaneous redistribution of resources in accordance with changing demands and prioritization of high-quality medical care. The aim of this study was to analyze resource provision to healthcare organizations in Kazakhstan and its structure and level assessment. The study is based on a comparative assessment of technical and technological equipment of medical institutions in Almaty, Kazakhstan. We analyzed the scope and structure of the financial component of the resource base in Almaty. We carried out information processing and analysis methods, content analysis, mathematical treatment, as well as conducted case studies. Also, we held opinion poll among medical staff (specialists, managerial staff) (n = 300) P for trend < 0.001 and patients (n = 210) P for trend < 0.001. About 18.8% of patients do not receive medical care because of defects of the equipment, whereas 19.9% of patients claim that the reason of refusal of the provision of medical services is an equipment overload. Most of the respondents referred to on poor technical equipment, mismatch with the world standards of performance and competitiveness. Lack of advanced medical technology, inadequate financing, insufficient supply of domestic medical equipment, and inadequate procurement by tender were also noted. The obtained data point to the need for optimization and upgrading medical equipment at various levels of healthcare.

42 CFR 457.222 - FFP for equipment.

Code of Federal Regulations, 2010 CFR

2010-10-01

...; Reduction of Federal Medical Payments § 457.222 FFP for equipment. Claims for Federal financial.... Requirements concerning the management and disposition of equipment under CHIP are also prescribed in subpart G... 42 Public Health 4 2010-10-01 2010-10-01 false FFP for equipment. 457.222 Section 457.222 Public...

42 CFR 457.222 - FFP for equipment.

Code of Federal Regulations, 2011 CFR

2011-10-01

...; Reduction of Federal Medical Payments § 457.222 FFP for equipment. Claims for Federal financial.... Requirements concerning the management and disposition of equipment under CHIP are also prescribed in subpart G... 42 Public Health 4 2011-10-01 2011-10-01 false FFP for equipment. 457.222 Section 457.222 Public...

Is intravenous urography required when ultrasonography and KUB evidence a ureteroscopy plan?

PubMed

Aghamir, Seyed Mohammad Kazem; Modaresi, Seyed Saeed; Salavati, Alborz; Aloosh, Mehdi; Meysami, Ali Pasha

2012-01-01

To determine whether pre-ureteroscopic stone extraction (USE) evaluation by intravenous urography (IVU) can change the clinical decision made on the basis of a plain X-ray of the kidneys, ureters, and bladder (KUB) plus an ultrasonography in the case of ureteral calculi. From October 2005 to November 2007, 139 USE candidates were selected based on ultrasonography and KUB, and were randomly divided into two groups. Each group was assessed by an expert urologist to decide about the treatment plans. Thereafter, all the patients underwent an IVU pre-operatively and were evaluated for the second time by the other urologist considering IVU. Presence of a hydronephrotic kidney on the ultrasonography, existence of a density in the probable tract of the ureter on KUB, and previous episodes of renal colic were considered as inclusion criteria. Exclusion criteria were non-opaque stones on KUB, hypersensitivity to contrast media, and serum creatinine > 1.5 mg/dL. On the basis of ultrasonography and KUB assessment, all of the patients were identified candidate for USE. According to secondary IVU-based planning, of 139 patients, 127 (91.3%) required USE, 10 (7.1%) ureteroscopy, and 2 (1.4%) non-operative treatment. About 8.7% of treatment plans was changed by IVU, which was not statistically significant (P = .35). Positive predictive value of ultrasonography plus KUB to diagnose a ureteral stone which needed USE was 92.8% while IVU is the gold standard (95% confidence interval: 92.38 to 93.22). Intravenous urography is not useful enough to be performed routinely before entire USEs.

Use of ultrasonography to make management decisions

USDA-ARS?s Scientific Manuscript database

Transrectal ultrasonography has been available for making management decisions since the mid 1980’s. This technology allows for the real-time visualization of internal structures (i.e. ovary and fetus) that are otherwise difficult to evaluate. The use of this technology in making reproductive manag...

21 CFR 866.4500 - Immunoelectrophoresis equipment.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Immunoelectrophoresis equipment. 866.4500 Section 866.4500 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Immunology Laboratory Equipment and Reagents...

21 CFR 866.4500 - Immunoelectrophoresis equipment.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Immunoelectrophoresis equipment. 866.4500 Section 866.4500 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Immunology Laboratory Equipment and Reagents...

21 CFR 866.4500 - Immunoelectrophoresis equipment.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Immunoelectrophoresis equipment. 866.4500 Section 866.4500 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Immunology Laboratory Equipment and Reagents...

45 CFR 95.707 - Equipment management and disposition.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Equipment management and disposition. 95.707... ADMINISTRATION-GRANT PROGRAMS (PUBLIC ASSISTANCE, MEDICAL ASSISTANCE AND STATE CHILDREN'S HEALTH INSURANCE PROGRAMS) Equipment Acquired Under Public Assistance Programs § 95.707 Equipment management and disposition...

45 CFR 95.707 - Equipment management and disposition.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Equipment management and disposition. 95.707... ADMINISTRATION-GRANT PROGRAMS (PUBLIC ASSISTANCE, MEDICAL ASSISTANCE AND STATE CHILDREN'S HEALTH INSURANCE PROGRAMS) Equipment Acquired Under Public Assistance Programs § 95.707 Equipment management and disposition...

Carotid artery Doppler ultrasonography in retinal macroaneurysms.

PubMed

Thurairajan, G; Potamitis, T; Naylor, G; Gibson, J

1998-01-01

It is postulated that retinal arterial macroaneurysms (RAMs) occur at the site of incomplete embolic occlusion of a branch retinal artery. Embolic events of the retinal vessels are related to the state of the carotid artery tree and therefore Doppler ultrasonography of the carotid arteries in these patients is of particular interest. We have examined 13 patients with retinal artery macroaneurysms with carotid artery Doppler ultrasonography (CADU). Eight of these patients (61.5%) exhibited atheromatous plaques on the same side as the RAM with a moderate degree of arterial narrowing. Although our group of patients did not show advanced carotid artery disease, alterations of the arterial wall found at the level of the carotid artery were higher than expected in a similar hypertensive population. To our knowledge this is the first study of the carotid arterial tree in these patients. Our results support the theory that RAMs may be of embolic origin. Furthermore they demonstrate that CADU is a useful investigation in patients with RAMs.

Creation and Validation of a Simulator for Neonatal Brain Ultrasonography: A Pilot Study.

PubMed

Tsai, Andy; Barnewolt, Carol E; Prahbu, Sanjay P; Yonekura, Reimi; Hosmer, Andrew; Schulz, Noah E; Weinstock, Peter H

2017-01-01

Historically, skills training in performing brain ultrasonography has been limited to hours of scanning infants for lack of adequate synthetic models or alternatives. The aim of this study was to create a simulator and determine its utility as an educational tool in teaching the skills that can be used in performing brain ultrasonography on infants. A brain ultrasonography simulator was created using a combination of multi-modality imaging, three-dimensional printing, material and acoustic engineering, and sculpting and molding. Radiology residents participated prior to their pediatric rotation. The study included (1) an initial questionnaire and resident creation of three coronal images using the simulator; (2) brain ultrasonography lecture; (3) hands-on simulator practice; and (4) a follow-up questionnaire and re-creation of the same three coronal images on the simulator. A blinded radiologist scored the quality of the pre- and post-training images using metrics including symmetry of the images and inclusion of predetermined landmarks. Wilcoxon rank-sum test was used to compare pre- and post-training questionnaire rankings and image quality scores. Ten residents participated in the study. Analysis of pre- and post-training rankings showed improvements in technical knowledge and confidence, and reduction in anxiety in performing brain ultrasonography. Objective measures of image quality likewise improved. Mean reported value score for simulator training was high across participants who reported perceived improvements in scanning skills and enjoyment from simulator use, with interest in additional practice on the simulator and recommendations for its use. This pilot study supports the use of a simulator in teaching radiology residents the skills that can be used to perform brain ultrasonography. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

38 CFR 17.156 - Eligibility for automobile adaptive equipment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... automobile adaptive equipment. 17.156 Section 17.156 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Automotive Equipment and Driver Training § 17.156 Eligibility for automobile adaptive equipment. Automobile adaptive equipment may be authorized if the Under Secretary for Health or...

38 CFR 17.156 - Eligibility for automobile adaptive equipment.

Code of Federal Regulations, 2012 CFR

2012-07-01

... automobile adaptive equipment. 17.156 Section 17.156 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Automotive Equipment and Driver Training § 17.156 Eligibility for automobile adaptive equipment. Automobile adaptive equipment may be authorized if the Under Secretary for Health or...

38 CFR 17.156 - Eligibility for automobile adaptive equipment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... automobile adaptive equipment. 17.156 Section 17.156 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Automotive Equipment and Driver Training § 17.156 Eligibility for automobile adaptive equipment. Automobile adaptive equipment may be authorized if the Under Secretary for Health or...

38 CFR 17.156 - Eligibility for automobile adaptive equipment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... automobile adaptive equipment. 17.156 Section 17.156 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Automotive Equipment and Driver Training § 17.156 Eligibility for automobile adaptive equipment. Automobile adaptive equipment may be authorized if the Under Secretary for Health or...

38 CFR 17.156 - Eligibility for automobile adaptive equipment.

Code of Federal Regulations, 2013 CFR

2013-07-01

... automobile adaptive equipment. 17.156 Section 17.156 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Automotive Equipment and Driver Training § 17.156 Eligibility for automobile adaptive equipment. Automobile adaptive equipment may be authorized if the Under Secretary for Health or...

Assessment of technical equipment supply in healthcare institutions: example of Almaty

PubMed Central

Kurakbayev, Kuralbai K.; Issayev, Daniyar S.; Koshimbekov, Murat K.; Kumar, Ainur B.

2014-01-01

Background: The share of healthcare-related expenditure in the Gross Domestic Product of Kazakhstan is relatively small, and it is strategically important to restructure budgetary expenses in favor of healthcare with simultaneous redistribution of resources in accordance with changing demands and prioritization of high-quality medical care. The aim of this study was to analyze resource provision to healthcare organizations in Kazakhstan and its structure and level assessment. Materials and Methods: The study is based on a comparative assessment of technical and technological equipment of medical institutions in Almaty, Kazakhstan. We analyzed the scope and structure of the financial component of the resource base in Almaty. We carried out information processing and analysis methods, content analysis, mathematical treatment, as well as conducted case studies. Also, we held opinion poll among medical staff (specialists, managerial staff) (n = 300) P for trend < 0.001 and patients (n = 210) P for trend < 0.001. Results: About 18.8% of patients do not receive medical care because of defects of the equipment, whereas 19.9% of patients claim that the reason of refusal of the provision of medical services is an equipment overload. Conclusion: Most of the respondents referred to on poor technical equipment, mismatch with the world standards of performance and competitiveness. Lack of advanced medical technology, inadequate financing, insufficient supply of domestic medical equipment, and inadequate procurement by tender were also noted. The obtained data point to the need for optimization and upgrading medical equipment at various levels of healthcare. PMID:25535494

[Color Doppler ultrasonography--a new imaging procedure in maxillofacial surgery].

PubMed

Reinert, S; Lentrodt, J

1991-01-01

Colour Doppler ultrasonography shows blood flow in real time and colour by combining the features of real time B mode ultrasound and Doppler. At each point in the image the returning signal is interrogated for both amplitude and frequency information. The resulting image shows all non-moving structures in shades of gray and moving structures in shades of red or blue depending on direction and velocity. The technique of colour Doppler ultrasonography and our experiences in 63 examinations are described. The clinical application of this new simple non-invasive method in maxillo-facial surgery is discussed.

21 CFR 866.4520 - Immunofluorometer equipment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Immunofluorometer equipment. 866.4520 Section 866.4520 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Immunology Laboratory Equipment and Reagents § 866...

21 CFR 866.4540 - Immunonephelometer equipment.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Immunonephelometer equipment. 866.4540 Section 866.4540 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Immunology Laboratory Equipment and Reagents § 866...

21 CFR 866.4520 - Immunofluorometer equipment.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Immunofluorometer equipment. 866.4520 Section 866.4520 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Immunology Laboratory Equipment and Reagents § 866...

21 CFR 866.4540 - Immunonephelometer equipment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Immunonephelometer equipment. 866.4540 Section 866.4540 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Immunology Laboratory Equipment and Reagents § 866...

21 CFR 866.4520 - Immunofluorometer equipment.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Immunofluorometer equipment. 866.4520 Section 866.4520 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Immunology Laboratory Equipment and Reagents § 866...

21 CFR 866.4540 - Immunonephelometer equipment.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Immunonephelometer equipment. 866.4540 Section 866.4540 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Immunology Laboratory Equipment and Reagents § 866...

21 CFR 866.4520 - Immunofluorometer equipment.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Immunofluorometer equipment. 866.4520 Section 866.4520 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Immunology Laboratory Equipment and Reagents § 866...

21 CFR 866.4540 - Immunonephelometer equipment.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Immunonephelometer equipment. 866.4540 Section 866.4540 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Immunology Laboratory Equipment and Reagents § 866...

21 CFR 866.4540 - Immunonephelometer equipment.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Immunonephelometer equipment. 866.4540 Section 866.4540 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Immunology Laboratory Equipment and Reagents § 866...

21 CFR 866.4520 - Immunofluorometer equipment.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Immunofluorometer equipment. 866.4520 Section 866.4520 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Immunology Laboratory Equipment and Reagents § 866...

Diagnostic accuracy of oblique chest radiograph for occult pneumothorax: comparison with ultrasonography.

PubMed

Matsumoto, Shokei; Sekine, Kazuhiko; Funabiki, Tomohiro; Orita, Tomohiko; Shimizu, Masayuki; Hayashida, Kei; Kazamaki, Taku; Suzuki, Tatsuya; Kishikawa, Masanobu; Yamazaki, Motoyasu; Kitano, Mitsuhide

2016-01-01

An occult pneumothorax is a pneumothorax that is not seen on a supine chest X-ray but is detected by computed tomography scanning. However, critical patients are difficult to transport to the computed tomography suite. We previously reported a method to detect occult pneumothorax using oblique chest radiography (OXR). Several authors have also reported that ultrasonography is an effective technique for detecting occult pneumothorax. The aim of this study was to evaluate the usefulness of OXR in the diagnosis of the occult pneumothorax and to compare OXR with ultrasonography. All consecutive blunt chest trauma patients with clinically suspected pneumothorax on arrival at the emergency department were prospectively included at our tertiary-care center. The patients underwent OXR and ultrasonography, and underwent computed tomography scans as the gold standard. Occult pneumothorax size on computed tomography was classified as minuscule, anterior, or anterolateral. One hundred and fifty-nine patients were enrolled. Of the 70 occult pneumothoraces found in the 318 thoraces, 19 were minuscule, 32 were anterior, and 19 were anterolateral. The sensitivity and specificity of OXR for detecting occult pneumothorax was 61.4 % and 99.2 %, respectively. The sensitivity and specificity of lung ultrasonography was 62.9 % and 98.8 %, respectively. Among 27 occult pneumothoraces that could not be detected by OXR, 16 were minuscule and 21 could be conservatively managed without thoracostomy. OXR appears to be as good method as lung ultrasonography in the detection of large occult pneumothorax. In trauma patients who are difficult to transfer to computed tomography scan, OXR may be effective at detecting occult pneumothorax with a risk of progression.

Ultrasonography in gastroenterology.

PubMed

Ødegaard, Svein; Nesje, Lars B; Hausken, Trygve; Gilja, Odd Helge

2015-06-01

Ultrasonography (US) is a safe and available real-time, high-resolution imaging method, which during the last decades has been increasingly integrated as a clinical tool in gastroenterology. New US applications have emerged with enforced data software and new technical solutions, including strain evaluation, three-dimensional imaging and use of ultrasound contrast agents. Specific gastroenterologic applications have been developed by combining US with other diagnostic or therapeutic methods, such as endoscopy, manometry, puncture needles, diathermy and stents. US provides detailed structural information about visceral organs without hazard to the patients and can play an important clinical role by reducing the need for invasive procedures. This paper presents different aspects of US in gastroenterology, with a special emphasis on the contribution from Nordic scientists in developing clinical applications.

Diagnostic ultrasonography in cattle with abdominal fat necrosis.

PubMed

Tharwat, Mohamed; Buczinski, Sébastien

2012-01-01

This study describes the ultrasonographic findings in 14 cows with abdominal fat necrosis. Ultrasonography of the abdomen revealed the presence of heterogeneous hyperechoic masses and hyperechoic omentum with localized masses floating in a hypoechoic peritoneal fluid. A hyperechogenic rim was imaged around both kidneys. The intestines were coated with hyperechoic capsules and the intestinal lumens were constricted. Ultrasonographic examination of the pancreatic parenchyma showed an overall increased echogenicity which was homogenously distributed in 3 cases. A diagnosis of abdominal fat necrosis was made with ultrasound-guided biopsy of the echogenic masses, and thereafter at postmortem examination. Results from this study demonstrate the efficacy of ultrasonography as an imaging modality for antemortem diagnosis of abdominal lipomatosis in cattle. To the authors' knowledge, this study is the first that illustrates ultrasonographic findings in cattle affected with abdominal lipomatosis.

Diagnosis of Nipple Discharge: Value of Magnetic Resonance Imaging and Ultrasonography in Comparison with Ductoscopy.

PubMed

Yılmaz, Ravza; Bender, Ömer; Çelik Yabul, Fatma; Dursun, Menduh; Tunacı, Mehtap; Acunas, Gülden

2017-04-05

Pathologic nipple discharge, which is a common reason for referral to the breast imaging service, refers to spontaneous or bloody nipple discharge that arises from a single duct. The most common cause of nipple discharge is benign breast lesions, such as solitary intraductal papilloma and papillomatosis. Nevertheless, in rare cases, a malignant cause of nipple discharge can be found. To study the diagnostic value of ultrasonography, magnetic resonance imaging, and ductoscopy in patients with pathologic nipple discharge, compare their efficacy, and investigate the importance of magnetic resonance imaging in the diagnosis of intraductal pathologies. Diagnostic accuracy study. Fifty patients with pathologic nipple discharge were evaluated by ultrasonography and magnetic resonance imaging. Of these, 44 ductoscopic investigations were made. The patients were classified according to magnetic resonance imaging, ultrasonography, and ductoscopy findings. A total of 25 patients, whose findings were reported as intraductal masses, underwent surgery oincluding endoscopic excision for two endoscopic excision. Findings were compared with the pathology results that were accepted as the gold standard in the description of the aetiology of nipple discharge. In addition, magnetic resonance imaging, ultrasonography and ductoscopy findings were analysed comparatively in patients who had no surgery. Intraductal masses were reported in 26 patients, 20 of whom operated and established accurate diagnosis of 18 patients on magnetic resonance imaging. According to the ultrasonography, intraductal masses were identified in 22 patients, 17 of whom underwent surgery. Ultrasonography established accurate diagnoses in 15 patients. Intraductal mass was identified in 22 patients and ductoscopy established accurate diagnoses based on histopathologic results in 16 patients. The sensitivities of methods were 75% in ultrasonography, 90% in magnetic resonance imaging, and 94.6% in ductoscopy. The

Carcinoma of the pancreatic head and periampullary region. Tumor staging with laparoscopy and laparoscopic ultrasonography.

PubMed Central

John, T G; Greig, J D; Carter, D C; Garden, O J

1995-01-01

OBJECTIVE: The authors performed a prospective evaluation of staging laparoscopy with laparoscopic ultrasonography in predicting surgical resectability in patients with carcinomas of the pancreatic head and periampullary region. SUMMARY BACKGROUND DATA: Pancreatic resection with curative intent is possible in a select minority of patients who have carcinomas of the pancreatic head and periampullary region. Patient selection is important to plan appropriate therapy and avoid unnecessary laparotomy in patients with unresectable disease. Laparoscopic ultrasonography is a novel technique that combines the proven benefits of staging laparoscopy with high resolution intraoperative ultrasound of the liver and pancreas, but which has yet to be evaluated critically in the staging of pancreatic malignancy. METHODS: A cohort of 40 consecutive patients referred to a tertiary referral center and with a diagnosis of potentially resectable pancreatic or periampullary cancer underwent staging laparoscopy with laparoscopic ultrasonography. The diagnostic accuracy of staging laparoscopy alone and in conjunction with laparoscopic ultrasonography was evaluated in predicting tumor resectability (absence of peritoneal or liver metastases; absence of malignant regional lymphadenopathy; tumor confined to pancreatic head or periampullary region). RESULTS: "Occult" metastatic lesions were demonstrated by staging laparoscopy in 14 patients (35%). Laparoscopic ultrasonography demonstrated factors confirming unresectable tumor in 23 patients (59%), provided staging information in addition to that of laparoscopy alone in 20 patients (53%), and changed the decision regarding tumor resectability in 10 patients (25%). Staging laparoscopy with laparoscopic ultrasonography was more specific and accurate in predicting tumor resectability than laparoscopy alone (88% and 89% versus 50% and 65%, respectively). CONCLUSIONS: Staging laparoscopy is indispensable in the detection of "occult" intra

Prenatal diagnosis of placenta accreta by colour Doppler ultrasonography: 5-year review.

PubMed

Pongrojpaw, Densak; Chanthasenanont, Athita; Nanthakomon, Tongta; Suwannarurk, Komsun

2014-08-01

To determine the accuracy of colour Doppler ultrasonography to diagnose placenta accreta. The authors reviewed cases of placenta accreta between January, 2008 and December, 2012. Ultrasonographic images consistent with signs ofplacenta accreta (numerous vascular lacunae, loss ofsubplacentalsonolucent space, absent lower uterine segment between bladder-placenta, turbulent or complicated blood flow at the uteroplacental interface) were correlated with findings at the time of surgery and pathologic examination. Over 60 months, 12 cases (0.48/1,000 deliveries) with suspected placenta accreta by ultrasonography were studied. The median gestational age atfirst diagnosis was 24 weeks. All cases had at least one previous cesarean delivery. At surgery, all cases had an adherent placenta requiring hysterectomy (five accreta, three increta, andfourpercreta). Four cases (33%) had accidental tear of urinary bladder Nine cases (75%) required blood transfusions. Colour Doppler ultrasonography appears useful in antenatal diagnosis ofplacenta accreta.

Medicare Program; Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies. Final rule.

PubMed

2015-12-30

This final rule establishes a prior authorization program for certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) items that are frequently subject to unnecessary utilization. This rule defines unnecessary utilization and creates a new requirement that claims for certain DMEPOS items must have an associated provisional affirmed prior authorization decision as a condition of payment. This rule also adds the review contractor's decision regarding prior authorization of coverage of DMEPOS items to the list of actions that are not initial determinations and therefore not appealable.

Semi-closed reduction of tripod fractures of zygoma under intraoperative assessment using ultrasonography.

PubMed

Soejima, Kazutaka; Sakurai, Hiroyuki; Nozaki, Motohiro; Kitazawa, Yoshihiko; Takeuchi, Masaki; Yamaki, Takashi; Kono, Taro

2009-04-01

We conducted semi-closed reduction of isolated tripod fractures of the zygoma through only a brow incision under intraoperative assessment with ultrasonography. Twenty-three patients with unilateral, non-comminuted tripod fractures of zygoma were selected for application of this method at Tokyo Women's Medical University and Tokyo Metropolitan Hiroo General Hospital between April 2002 and April 2006. Patients with orbital floor blowout fractures were excluded. A skin incision was made only at the lateral brow region and the reduction was performed by inserting an elevator beneath the zygomatic arch. The bone alignment was intraoperatively assessed by ultrasonography. When the reduction was accurate, the frontozygomatic suture was immobilised with a mini-plate under direct visualisation and transmaler Kirshner wire fixation was performed. The accuracy of the reduction and postoperative movement were evaluated by computed tomography (CT) scans taken at 1 and 6 months. In five cases, the DICOM (Digital Imaging and Communication in Medicine) data from the CT were analysed with 3D imaging software (V-works, CyberMed Co., Korea). In all cases, accurate reduction was obtained. The analysis of the 3D imaging data revealed that postoperative movement of bone fragment was minimal. When the accurate reduction was obtained under intraoperative assessment, the semi-closed reduction and one-plate fixation with transmaler Kirshner wire is enough to treat the simple tripod fractures of zygoma. This method is minimally invasive and takes less operative time.

[Practical Use of Doppler Ultrasonography of the Cardiovascular System and Clinical Laboratory Tests for the Management of Pulmonary Embolism].

PubMed

Mizukami, Naoko

2015-08-01

Acute or chronic pulmonary embolism (PE) is a serious disease, and the risk of mortality is increased if untreated. In 90% of cases the embolus source is deep vein thrombosis (DVT) of the lower limbs or pelvic cavity. Therefore, it is necessary to recognize these as venous thromboembolism (VTE) which includes both DVT and PE. I suggest that Doppler ultrasonography of cardiovascular and clinical laboratory tests provide very valuable medical support for the management of VTE. Specifically, in the early diagnosis of VTE and the prevention of fatal PE, Doppler ultrasonography (cardiac and vascular) can provide very useful information. On the other hand, blood coagulation and thrombophilia tests are important to determine the risk of VTE and evaluate the effect of anticoagulant therapy on VTE. In this paper, I explain the main points of each examination of VTE by describing representative cases. I also show the results on investigating cases in our hospital involving diseases related to VTE and the onset site of DVT. In addition, I introduce how we convey the results of analysis to the clinical side.

Determining the utility and durability of medical equipment donated to a rural clinic in a low-income country.

PubMed

Bauserman, Melissa; Hailey, Claire; Gado, Justin; Lokangaka, Adrien; Williams, Jessica; Richards-Kortum, Rebecca; Tshefu, Antoinette; Bose, Carl

2015-07-01

Health centers in low-income countries often depend on donations to provide appropriate diagnostic equipment. However, donations are sometimes made without an understanding of the recipient's needs, practical constraints or sustainability of supplies. We donated a set of physical diagnostic equipment, non-invasive instrument tests and laboratory supplies to a rural health center in the Democratic Republic of Congo. We collected information on the usage and durability of equipment and supplies for each patient encounter over a 1-year period. We recorded 913 patient encounters. The most commonly used physical diagnostic equipment were the stethoscope (98.9%; 903/913), thermometer (81.7%; 746/913), adult scale (81.4%; 744/913), stop watch (62.6%; 572/913), adult sphygmomanometer (55.8%; 510/913), infant scale (24.9%; 228/913), measuring tape (24.3%; 222/913) and fetoscope (23.8%; 218/913). The most commonly used laboratory tests were the blood smear for malaria (53.7%; 491/913), hematocrit (23.5%; 215/913), urinalysis (20.1%; 184/913) and sputum stain for TB (13.3%; 122/913). With the exception of a penlight and solar lantern, all equipment remained functional. This study adds valuable information about the utility and durability of equipment supplied to a health center in the Democratic Republic of Congo. Our results might aid in determining the appropriateness of donated medical equipment in similar settings. The selection of donated goods should be made with knowledge of the context in which it will be used, and utilization should be monitored. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Pleural ultrasonography versus chest radiography for the diagnosis of pneumothorax: review of the literature and meta-analysis.

PubMed

Alrajab, Saadah; Youssef, Asser M; Akkus, Nuri I; Caldito, Gloria

2013-09-23

Ultrasonography is being increasingly utilized in acute care settings with expanding applications. Pneumothorax evaluation by ultrasonography is a fast, safe, easy and inexpensive alternative to chest radiographs. In this review, we provide a comprehensive analysis of the current literature comparing ultrasonography and chest radiography for the diagnosis of pneumothorax. We searched English-language articles in MEDLINE, EMBASE and Cochrane Library dealing with both ultrasonography and chest radiography for diagnosis of pneumothorax. In eligible studies that met strict inclusion criteria, we conducted a meta-analysis to evaluate the diagnostic accuracy of pleural ultrasonography in comparison with chest radiography for the diagnosis of pneumothorax. We reviewed 601 articles and selected 25 original research articles for detailed review. Only 13 articles met all of our inclusion criteria and were included in the final analysis. One study used lung sliding sign alone, 12 studies used lung sliding and comet tail signs, and 6 studies searched for lung point in addition to the other two signs. Ultrasonography had a pooled sensitivity of 78.6% (95% CI, 68.1 to 98.1) and a specificity of 98.4% (95% CI, 97.3 to 99.5). Chest radiography had a pooled sensitivity of 39.8% (95% CI, 29.4 to 50.3) and a specificity of 99.3% (95% CI, 98.4 to 100). Our meta-regression and subgroup analyses indicate that consecutive sampling of patients compared to convenience sampling provided higher sensitivity results for both ultrasonography and chest radiography. Consecutive versus nonconsecutive sampling and trauma versus nontrauma settings were significant sources of heterogeneity. In addition, subgroup analysis showed significant variations related to operator and type of probe used. Our study indicates that ultrasonography is more accurate than chest radiography for detection of pneumothorax. The results support the previous investigations in this field, add new valuable information

[Abdominal ultrasonography in patients with diabetes mellitus. Part 1: Liver].

PubMed

Jenssen, C; Pietsch, C; Gottschalk, U; Barreiros, A P; Teufel, A; Cui, X W; Dietrich, C F

2015-04-01

In patients with diabetes mellitus, abdominal ultrasonography is the appropriate diagnostic technique to detect and to follow-up secondary and accompanying diseases of the liver, the kidneys, the pancreas, the gastrointestinal tract and of abdominal vessels. Moreover, pancreatic and hepatic diseases may be realized which are of etiological importance for diabetes mellitus. Based on a systematic survey of the published literature, this review in 3 parts will describe the value of abdominal ultrasonography in patients with diabetes mellitus. Part 1 deals with the diagnostic relevance and particular findings of ultrasonographic methods in hepatic manifestations and complications of diabetes mellitus. © Georg Thieme Verlag KG Stuttgart · New York.

Performance analysis of medical video streaming over mobile WiMAX.

PubMed

Alinejad, Ali; Philip, N; Istepanian, R H

2010-01-01

Wireless medical ultrasound streaming is considered one of the emerging application within the broadband mobile healthcare domain. These applications are considered as bandwidth demanding services that required high data rates with acceptable diagnostic quality of the transmitted medical images. In this paper, we present the performance analysis of a medical ultrasound video streaming acquired via special robotic ultrasonography system over emulated WiMAX wireless network. The experimental set-up of this application is described together with the performance of the relevant medical quality of service (m-QoS) metrics.

Reversible Causes in Cardiovascular Collapse at the Emergency Department Using Ultrasonography (REVIVE-US).

PubMed

Chua, Mui Teng; Chan, Gene Wh; Kuan, Win Sen

2017-08-01

Ultrasonographic evaluation of patients in cardiac arrest is currently not protocolised in the advanced cardiac life support (ACLS) algorithm. Potentially reversible causes may be identified using bedside ultrasonography that is ubiquitous in most emergency departments (EDs). This study aimed to evaluate the incidence of sonographically detectable reversible causes of cardiac arrest by incorporating an ultrasonography protocol into the ACLS algorithm. Secondary objectives include rates of survival to hospital admission, hospital discharge, and 30-day mortality. We conducted a prospective study using bedside ultrasonography to evaluate for potentially reversible causes in patients with cardiac arrest at the ED of National University Hospital, Singapore, regardless of the initial electrocardiogram rhythm. A standardised ultrasonography protocol was performed during the 10-second pulse check window. Between June 2015 and April 2016, 104 patients were recruited, corresponding to 65% of all out-of-hospital cardiac arrest patients conveyed to the ED. Median age was 71 years (interquartile range, 55 to 80) and 71 (68.3%) patients were male. The most common rhythm on arrival was asystole (45.2%). Four (3.8%) patients had ultrasonographic findings suggestive of massive pulmonary embolism while 1 received intravenous thrombolysis and survived until discharge. Pericardial effusion without tamponade was detected in 4 (3.8%) patients and 6 (5.8%) patients had intra-abdominal free fluid. Twenty (19.2%) patients survived until admission, 2 of whom (1.9%) survived to discharge and beyond 30 days. Bedside ultrasonography can be safely incorporated into the ACLS protocol. Detection of any reversible causes may alter management and improve survival in selected patients.

Ability of Ultrasonography in Detection of Different Extremity Bone Fractures; a Case Series Study

PubMed Central

Bozorgi, Farzad; Shayesteh Azar, Massoud; Montazer, Seyed Hossein; Chabra, Aroona; Heidari, Seyed Farshad; Khalilian, Alireza

2017-01-01

Introduction: Despite radiography being the gold standard in evaluation of orthopedic injuries, using bedside ultrasonography has several potential supremacies such as avoiding exposure to ionizing radiation, availability in pre-hospital settings, being extensively accessible, and ability to be used on the bedside. The aim of the present study is to evaluate the diagnostic accuracy of ultrasonography in detection of extremity bone fractures. Methods: This study is a case series study, which was prospectively conducted on multiple blunt trauma patients, who were 18 years old or older, had stable hemodynamic, Glasgow coma scale 15, and signs or symptoms of a possible extremity bone fracture. After initial assessment, ultrasonography of suspected bones was performed by a trained emergency medicine resident and prevalence of true positive and false negative findings were calculated compared to plain radiology. Results: 108 patients with the mean age of 44.6 ± 20.4 years were studied (67.6% male). Analysis was done on 158 sites of fracture, which were confirmed with plain radiography. 91 (57.6%) cases were suspected to have upper extremity fracture(s) and 67 (42.4%) to have lower ones. The most frequent site of injuries were forearm (36.7%) in upper limbs and leg (27.8%) in lower limbs. Prevalence of true positive and false negative cases for fractures detected by ultrasonography were 59 (64.8%) and 32 (35.52%) for upper and 49 (73.1%) and 18 (26.9%) for lower extremities, respectively. In addition, prevalence of true positive and false negative detected cases for intra-articular fractures were 24 (48%) and 26 (52%), respectively. Conclusion The present study shows the moderate sensitivity (68.3%) of ultrasonography in detection of different extremity bone fractures. Ultrasonography showed the best sensitivity in detection of femur (100%) and humerus (76.2%) fractures, respectively. It had low sensitivity in detection of in intra-articular fractures. PMID:28286822

Ability of Ultrasonography in Detection of Different Extremity Bone Fractures; a Case Series Study.

PubMed

Bozorgi, Farzad; Shayesteh Azar, Massoud; Montazer, Seyed Hossein; Chabra, Aroona; Heidari, Seyed Farshad; Khalilian, Alireza

2017-01-01

Despite radiography being the gold standard in evaluation of orthopedic injuries, using bedside ultrasonography has several potential supremacies such as avoiding exposure to ionizing radiation, availability in pre-hospital settings, being extensively accessible, and ability to be used on the bedside. The aim of the present study is to evaluate the diagnostic accuracy of ultrasonography in detection of extremity bone fractures. This study is a case series study, which was prospectively conducted on multiple blunt trauma patients, who were 18 years old or older, had stable hemodynamic, Glasgow coma scale 15, and signs or symptoms of a possible extremity bone fracture. After initial assessment, ultrasonography of suspected bones was performed by a trained emergency medicine resident and prevalence of true positive and false negative findings were calculated compared to plain radiology. 108 patients with the mean age of 44.6 ± 20.4 years were studied (67.6% male). Analysis was done on 158 sites of fracture, which were confirmed with plain radiography. 91 (57.6%) cases were suspected to have upper extremity fracture(s) and 67 (42.4%) to have lower ones. The most frequent site of injuries were forearm (36.7%) in upper limbs and leg (27.8%) in lower limbs. Prevalence of true positive and false negative cases for fractures detected by ultrasonography were 59 (64.8%) and 32 (35.52%) for upper and 49 (73.1%) and 18 (26.9%) for lower extremities, respectively. In addition, prevalence of true positive and false negative detected cases for intra-articular fractures were 24 (48%) and 26 (52%), respectively. The present study shows the moderate sensitivity (68.3%) of ultrasonography in detection of different extremity bone fractures. Ultrasonography showed the best sensitivity in detection of femur (100%) and humerus (76.2%) fractures, respectively. It had low sensitivity in detection of in intra-articular fractures.

Ultrasonography in determining pubertal growth and bone age.

PubMed

Torenek Ağırman, Kubra; Bilge, Osman Murat; Miloğlu, Özkan

2018-05-02

The purpose of this study is to evaluate the compatibility of ultrasonographic data with hand-wrist radiographs taken to determine the extent of pubertal growth and bone age in patients and investigate the usability of ionizing radiation-free ultrasonography instead of conventional radiography. In this study, a total of 120 children from 10 to 17 years old (mean age was 168 months ± 27.5 months) were treated with routine radiographs before orthodontic treatment, and ultrasonographic imaging was performed on the wrists the same day. Researchers examined the phalanges, sesamoid bone, and radial bone distal epiphysis-diaphysis comparatively in each patient by both imaging methods and statistical evaluation. There was no statistically significant difference between conventional radiography and ultrasonography values at 13 points except for PP1 (proximal phalanges of the first finger), PP2 (proximal phalanges of the second finger), and radial epiphysis (p > 0.05). PP1, PP2, and radial epiphysis showed a statistically significant difference (p < 0.05). The CBA (bone age obtained from conventional radiographs) of the females was found to be larger than their CA (chronological age) and their UBA (ultrasonographic bone age). For males; the means of the CBA, UBA and CA values close to each other. In females and males; there was a strong correlation between the CA, the UBA and the CBA (p < 0.01). Ultrasonography gives detailed information about epiphyseal diaphysis relations. It can be used as an alternative to conventional radiography in the detection of bone age and pubertal growth, owing to the absence of ionizing radiation.

Solar Equipment

NASA Technical Reports Server (NTRS)

1983-01-01

A medical refrigeration and a water pump both powered by solar cells that convert sunlight directly into electricity are among the line of solar powered equipment manufactured by IUS (Independent Utility Systems) for use in areas where conventional power is not available. IUS benefited from NASA technology incorporated in the solar panel design and from assistance provided by Kerr Industrial Applications Center.

Assessment of Oropharyngeal Dysphagia in Patients With Parkinson Disease: Use of Ultrasonography.

PubMed

Oh, Eun Hyun; Seo, Jin Seok; Kang, Hyo Jung

2016-04-01

To compare tongue thickness, the shortest hyoid-thyroid approximation (distance between the hyoid bone and thyroid cartilage), and the time interval between the initiation of tongue movement and the time of the shortest hyoid-thyroid approximation, by using ultrasonography in healthy controls and patients with Parkinson disease (PD). Healthy controls and PD patients with dysphagia were compared. Ultrasonography was performed 3 times for the evaluation of tongue thickness, the shortest hyoid-thyroid approximation, and the time between the initiation of tongue movement and the shortest hyoid-thyroid approximation. A total of 24 healthy controls and 24 PD patients with dysphagia were enrolled. No significant differences were demonstrated between the two groups for the shortest hyoid-thyroid approximation (controls, 1.19±0.34 cm; PD patients, 1.37±0.5 cm; p=0.15) and tongue thickness (controls, 4.42±0.46 cm; PD patients, 4.27±0.51 cm; p=0.3). In contrast, the time to the shortest hyoid-thyroid approximation was significantly different between the two groups (controls, 1.53±0.87 ms; PD patients, 2.4±1.4 ms, p=0.048). Ultrasonography can be useful in evaluating dysphagia in patients with PD by direct visualization and measurement of the hyoid bone. Moreover, ultrasonography might contribute to a greater understanding of the pathophysiology of dysphagia in PD.

Study of endometrial thickness by ultrasonography in regular and irregular menstrual cycles.

PubMed

Shinde, Charushila D; Patil, Pankaj G; Katti, Karuna; Geetha, K N

2013-10-01

Endometrium is the mucosal layer of uterus. Throughout the reproductive age endometrium undergoes cyclical changes during each lunar month to prepare the uterus for implantation. Endometrium proliferates and regenerates during menstrual cycle. The most common cause of abnormal vaginal bleeding during a woman's reproductive years is dysfunctional uterine bleeding. Aim of this study was to compare endometrial thickness in regular and irregular menstrual cycles. A total of 111 patients with regular and irregular menstrual bleeding were selected. Age, duration of menstrual cycle, detailed menstrual history, endometrial thickness, difference in endometrial thickness before and after treatment were recorded. Endometrial thickness was recorded by ultrasonography. In patients with abnormal uterine bleeding, if endometrial thickness was less than 8mm first medical line of treatment was advised. If endometrial thickness was greater than 8mm, line of treatment depended on age and pattern of bleeding.

21 CFR 225.65 - Equipment cleanout procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS Product Quality Control § 225.65 Equipment cleanout procedures. (a) Adequate cleanout procedures for all equipment used in the manufacture... sequential production of feeds. (2) If flushing is utilized, the flush material shall be properly identified...

Information needs assessment of medical equipment offices based on Critical Success Factors (CSF) and Business System Planning (BSP) methods.

PubMed

Khorrami, F; Ahmadi, M; Alizadeh, A; Roozbeh, N; Mohseni, S

2015-01-01

Introduction: Given the ever-increasing importance and value of information, providing the management with a reliable information system, which can facilitate decision-making regarding planning, organization and control, is vitally important. This study aimed to analyze and evaluate the information needs of medical equipment offices. Methods: This descriptive applied cross-sectional study was carried out in 2010. The population of the study included the managers of statistic and medical records at the offices of vice-chancellor for treatment in 39 medical universities in Iran. Data were collected by using structured questioners. With regard to different kinds of designing information systems, sampling was done by two methods, BSP (based on processes of job description) and CSF method (based on critical success factors). The data were analyzed by SPSS-16. Results: Our study showed that 41% of information needs were found to be critical success factors of managers of office. The first priority of managers was "the number of bed and bed occupancy in hospitals". Of 29 identified information needs, 62% were initial information needs of managers (from the viewpoints of managers). Of all, 4% of the information needs were obtained through the form, 14% through both the form and database, 11% through the web site, and 71% had no sources (forms, databases, web site). Conclusion: Since 71% of the information needs of medical equipment offices managers had no information sources, the development of information system in these offices seems to be necessary. Despite the important role of users in designing the information systems (identifying 62% of information needs), other scientific methods is also needed to be utilized in designing the information systems.

Information needs assessment of medical equipment offices based on Critical Success Factors (CSF) and Business System Planning (BSP) methods

PubMed Central

Khorrami, F; Ahmadi, M; Alizadeh, A; Roozbeh, N; Mohseni, S

2015-01-01

Introduction: Given the ever-increasing importance and value of information, providing the management with a reliable information system, which can facilitate decision-making regarding planning, organization and control, is vitally important. This study aimed to analyze and evaluate the information needs of medical equipment offices. Methods: This descriptive applied cross-sectional study was carried out in 2010. The population of the study included the managers of statistic and medical records at the offices of vice-chancellor for treatment in 39 medical universities in Iran. Data were collected by using structured questioners. With regard to different kinds of designing information systems, sampling was done by two methods, BSP (based on processes of job description) and CSF method (based on critical success factors). The data were analyzed by SPSS-16. Results: Our study showed that 41% of information needs were found to be critical success factors of managers of office. The first priority of managers was “the number of bed and bed occupancy in hospitals”. Of 29 identified information needs, 62% were initial information needs of managers (from the viewpoints of managers). Of all, 4% of the information needs were obtained through the form, 14% through both the form and database, 11% through the web site, and 71% had no sources (forms, databases, web site). Conclusion: Since 71% of the information needs of medical equipment offices managers had no information sources, the development of information system in these offices seems to be necessary. Despite the important role of users in designing the information systems (identifying 62% of information needs), other scientific methods is also needed to be utilized in designing the information systems. PMID:28255389

Transabdominal ultrasonography as a screening test for second-trimester placenta previa.

PubMed

Quant, Hayley S; Friedman, Alexander M; Wang, Eileen; Parry, Samuel; Schwartz, Nadav

2014-03-01

To determine the test characteristics of transabdominal ultrasonography as a screening test for second-trimester placenta previa. This secondary analysis of a prospective cohort study evaluated the distance from the placental edge to the internal os (placenta-cervix distance) through both transabdominal and transvaginal ultrasonography during the anatomic survey. Patients were recruited in the Maternal-Fetal Medicine Ultrasound Unit at the Hospital of the University of Pennsylvania, an urban tertiary care center. Transabdominal placenta-cervix distance cutoffs with high sensitivity for detection of previa and low-lying placenta were identified, and test characteristics were calculated. Follow-up ultrasound data, pregnancy, and delivery outcomes for those with second-trimester previa or low-lying placenta were obtained. One thousand two hundred fourteen women were included in the analysis. A transabdominal placenta-cervix distance cutoff of 4.2 cm was 93.3% sensitive and 76.7% specific for detection of previa with a 99.8% negative predictive value at a screen-positive rate of 25.0%. A cutoff of 2.8 cm was 86.7% sensitive and 90.5% specific with a 99.6% negative predictive value at a screen-positive rate of 11.4%. Only 9.8% (four of 41) of previas and low-lying placentas persisted through delivery. Transabdominal ultrasonography is an effective screening test for second-trimester placenta previa. At centers not performing universal transvaginal ultrasonography at the time of the anatomic survey, evidence-based transabdominal placenta-cervix distance cutoffs can optimize the identification of patients who require further surveillance for previa.

Use of ultrasonography to make reproductive management decisions

USDA-ARS?s Scientific Manuscript database

Transrectal ultrasonography has been available for making management decisions since the mid 1980’s. This technology allows for the real-time visualization of internal structures (i.e. ovary and fetus) that are otherwise difficult to evaluate. The use of this technology in making reproductive manag...

Vascular access: the impact of ultrasonography

PubMed Central

de Almeida, Carlos Eduardo Saldanha

2016-01-01

ABSTRACT Vascular punctures are often necessary in critically ill patients. They are secure, but not free of complications. Ultrasonography enhances safety of the procedure by decreasing puncture attempts, complications and costs. This study reviews important publications and the puncture technique using ultrasound, bringing part of the experience of the intensive care unit of the Hospital Israelita Albert Einstein, São Paulo (SP), Brazil, and discussing issues that should be considered in future studies. PMID:28076607

[The set of wearable medical equipment for medical and nursing teams].

PubMed

Efimenko, N a; Valevskii, V V; Lyutov, V V; Makhnovskii, A I; Sorokin, S I; Blinda, I V

2015-06-01

The kit is designed in accordance with the list of the first medical aid procedures and syndromic standards of emergency medical care providing. The kit contains modern local hemostatic agents, vent tubes, cricothyrotomy, needles to eliminate pneumothorax, portable oxygen machine, sets for intravenous and intraosseous infusion therapy, collapsible plastic tires, anti-shock pelvic girdle, and other medical products and pharmaceuticals. As containers used backpack and trolley bag on wheels camouflage colours. For the convenience and safety of the personnel of the vest is designed discharge to be converted in the body armour.

Endoscopic ultrasonography in chronic pancreatitis: a comparative prospective study with conventional ultrasonography, computed tomography, and ERCP.

PubMed

Buscail, L; Escourrou, J; Moreau, J; Delvaux, M; Louvel, D; Lapeyre, F; Tregant, P; Frexinos, J

1995-04-01

The usefulness and accuracy rate of endoscopic ultrasonography (EUS) in the diagnosis of chronic pancreatitis (CP) were prospectively evaluated in 81 patients with suspected pancreatic disease. All underwent EUS, abdominal ultrasonography (AUS), and computed tomography (CT), and endoscopic retrograde cholangiopancreatography (ERCP) was performed in 55 of the cases. The diagnosis of CP was established in 44 patients (CP group) including 24 with a calcified form. No pancreatic disease was observed in 18 patients (control group), and 19 patients had a pancreatic tumor. In the CP group AUS was less accurate than EUS in visualizing the pancreas, performances of CT scan being identical to EUS in this respect. A good correlation was observed between EUS and ERCP for visualization and measurement of the Wirsung duct. The most significant changes observed by EUS in the CP group were dilatation of the main pancreatic duct, heterogeneous echogenicity of the pancreatic parenchyma, and cysts < 20 mm in size even in noncalcified CP or with normal pancreatograms. Sensitivity of EUS for diagnosis of CP was 88% (AUS, 58%; ERCP, 74%; CT scan, 75%), the specificity being 100% for ERCP and EUS, 95% for CT scan, and 75% for AUS. The good performances of EUS allow early diagnosis of CP in symptomatic patients since heterogeneous echogenicity of the pancreatic parenchyma seems to be almost specifically associated with the disease.

Medicare program; competitive acquisition for certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) and other issues. Final rule.

PubMed

2007-04-10

This final rule establishes competitive bidding programs for certain Medicare Part B covered items of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) throughout the United States in accordance with sections 1847(a) and (b) of the Social Security Act. These competitive bidding programs, which will be phased in over several years, utilize bids submitted by DMEPOS suppliers to establish applicable payment amounts under Medicare Part B.

Use of contrast ultrasonography in the diagnosis of metastatic feline visceral haemangiosarcoma.

PubMed

Webster, Natalie; Holloway, Andrew

2008-08-01

A 12-year-old cat was presented for investigation of weight loss and inappetence. Radiography and conventional grey-scale ultrasonography showed a large mid-body splenic mass. Contrast enhanced ultrasonography of the liver demonstrated a hypoechoic left lateral lobe nodular mass during the peak and late portal-phases of liver enhancement. Histopathology of the splenic mass and hepatic nodular mass confirmed haemangiosarcoma. The use of ultrasound microbubble contrast media in the diagnosis of hepatic metastasis in the cat has not been previously reported in the cat.

The management of ultrasound equipment at Sheffield Teaching Hospitals NHS Foundation Trust

PubMed Central

Peacock, M

2013-01-01

Management of ultrasound equipment at Sheffield Teaching Hospitals NHS Foundation Trust is described. The organisation and input of various stakeholders and their involvement with ultrasound equipment management and scientific ultrasound is discussed. Two important stakeholders are the Medical Equipment Management Group and the Radiation Safety Steering Committee. The Medical Equipment Management Group has a specific sub-group, the Ultrasound sub-group, and its role is to coordinate the purchase, replacement and quality assurance of ultrasound equipment in the Trust. The Radiation Safety Steering Committee has a non-ionising radiation representative and the role of this committee is to provide corporate assurance that any health and safety issues arising from the use of radiation to either patients, members of the public or staff within the Trust are being effectively managed. The Ultrasound sub-group of the Medical Equipment Management Group has successfully brought together management of all ultrasound equipment within the Trust and is in the process of fulfilling the quality assurance and training milestones set out by the Medical Equipment Management Group. Advice from the Radiation Safety Steering Committee has helped to increase awareness of ultrasound safety and good scanning practice, especially in the case of neonatal ultrasound imaging, within the Trust. In addition, the RSSC has given advice on clinical pathways for patients undergoing ionising radiation imaging while being treated by extra-corporeal shockwave lithotripsy. PMID:27433195

47 CFR 95.1109 - Equipment authorization requirement.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Section 95.1109 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PERSONAL RADIO SERVICES Wireless Medical Telemetry Service (WMTS) General Provisions § 95.1109 Equipment authorization requirement. (a) Wireless medical telemetry devices operating under this part must...

Effective electromagnetic interference shielding for electronic equipment.

PubMed

Sheedy, Billy

2003-11-01

With the development of tough, durable compounds, plastics are the preferred material for electronic equipment housings. The availability of economical, effective coating materials that can give plastics some of the desirable properties lost in the switch from metals are helping to allow the design of reliable medical equipment.

46 CFR 197.454 - First aid and treatment equipment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false First aid and treatment equipment. 197.454 Section 197.454 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE OCCUPATIONAL SAFETY AND... Equipment § 197.454 First aid and treatment equipment. The diving supervisor shall ensure that medical kits...

Forecasting of the development of professional medical equipment engineering based on neuro-fuzzy algorithms

NASA Astrophysics Data System (ADS)

Vaganova, E. V.; Syryamkin, M. V.

2015-11-01

The purpose of the research is the development of evolutionary algorithms for assessments of promising scientific directions. The main attention of the present study is paid to the evaluation of the foresight possibilities for identification of technological peaks and emerging technologies in professional medical equipment engineering in Russia and worldwide on the basis of intellectual property items and neural network modeling. An automated information system consisting of modules implementing various classification methods for accuracy of the forecast improvement and the algorithm of construction of neuro-fuzzy decision tree have been developed. According to the study result, modern trends in this field will focus on personalized smart devices, telemedicine, bio monitoring, «e-Health» and «m-Health» technologies.

Endoanal ultrasonography in fecal incontinence: Current and future perspectives.

PubMed

Albuquerque, Andreia

2015-06-10

Fecal incontinence has a profound impact in a patient's life, impairing quality of life and carrying a substantial economic burden due to health costs. It is an underdiagnosed condition because many affected patients are reluctant to report it and also clinicians are usually not alert to it. Patient evaluation with a detailed clinical history and examination is very important to indicate the type of injury that is present. Endoanal ultrasonography is currently the gold standard for sphincter evaluation in fecal incontinence and is a simple, well-tolerated and non-expensive technique. Most studies revealed 100% sensitivity in identifying sphincter defect. It is better than endoanal magnetic resonance imaging for internal anal sphincter defects, equivalent for the diagnosis of external anal sphincter defects, but with a lower capacity for assessment of atrophy of this sphincter. The most common cause of fecal incontinence is anal sphincter injury related to obstetric trauma. Only a small percentage of women are diagnosed with sphincter tears immediately after vaginal delivery, but endoanal ultrasonography shows that one third of these women have occult sphincter defects. Furthermore, in patients submitted to primary repair of these tears, ultrasound revealed a high frequency of persistent sphincter defects after surgery. Three-dimensional endoanal ultrasonography is currently largely used and accepted for sphincter evaluation in fecal incontinence, improving diagnostic accuracy and our knowledge of physiologic and pathological sphincters alterations. Conversely, there is currently no evidence to support the use of elastography in fecal incontinence evaluation.

Electrophysiological examination and high frequency ultrasonography for diagnosis of radial nerve torsion and compression

PubMed Central

Shi, Miao; Qi, Hengtao; Ding, Hongyu; Chen, Feng; Xin, Zhaoqin; Zhao, Qinghua; Guan, Shibing; Shi, Hao

2018-01-01

Abstract This study aims to evaluate the value of electrophysiological examination and high frequency ultrasonography in the differential diagnosis of radial nerve torsion and radial nerve compression. Patients with radial nerve torsion (n = 14) and radial nerve compression (n = 14) were enrolled. The results of neurophysiological and high frequency ultrasonography were compared. Electrophysiological examination and high-frequency ultrasonography had a high diagnostic rate for both diseases with consistent results. Of the 28 patients, 23 were positive for electrophysiological examination, showing decreased amplitude and decreased conduction velocity of radial nerve; however, electrophysiological examination cannot distinguish torsion from compression. A total of 27 cases showed positive in ultrasound examinations among all 28 cases. On ultrasound images, the nerve was thinned at torsion site whereas thickened at the distal ends of torsion. The diameter and cross-sectional area of torsion or compression determined the nerve damage, and ultrasound could locate the nerve injury site and measure the length of the nerve. Electrophysiological examination and high-frequency ultrasonography can diagnose radial neuropathy, with electrophysiological examination reflecting the neurological function, and high-frequency ultrasound differentiating nerve torsion from compression. PMID:29480857

Equipment for the Disabled. Volumes 1 - 4.

ERIC Educational Resources Information Center

Wilshere, E. Rosamond, Comp.

Four volumes of equipment for the disabled which can simplify their lives and those who live with them are presented. The authors have not included surgical, medical, therapeutic, corrective or gymnastic equipment in the publication. Voume one includes house adaptations and planning, beds and bed accessories, chairs, and wheelchairs and…

An unanticipated diagnosis with bedside ultrasonography in patients with acute abdominal pain: rectus hematoma.

PubMed

Ünlüer, Erden Erol; Kaykısız, Eylem Kuday

2017-01-01

Although abdominal pain is a common presentation in emergency departments, rectus sheath hematoma (RSH) is among the rarest diagnosis. Here we present 2 cases of RSH likely caused by coughing due to upper respiratory tract infection. The two described cases were diagnosed by bedside ultrasonography and confirmed as RSH by computed tomography. Review of patient history and use of ultrasonography are important to avoid misdiagnosisof RSH.

Delivering health information about self-medication to older adults: use of touchscreen-equipped notebook computers.

PubMed

Neafsey, P J; Strickler, Z; Shellman, J; Padula, A T

2001-11-01

Preventing Drug Interactions in Active Older Adults is an educational intervention to prevent prescription and over-the-counter (OTC) drug and alcohol interactions in active, community-living older adults. The objectives of the program are to increase older adults' knowledge of potential interactions of prescription medications with OTC drugs and alcohol and to increase their confidence (self-efficacy) about how to avoid such interactions. An interactive multimedia computer software program (Personal Education Program or PEP) was designed for the learning styles and psychomotor skills of older adults. Focus groups of older adults evaluated PEP components in a formative manner during development. The program content dealing with antacids, calcium supplements, and acid reducers was pilot tested with 60 older adults recruited from local senior centers. Participants used the PEP on notebook computers equipped with infrared-sensitive touchscreens. Users of PEP had greater knowledge and self-efficacy scores than controls. Participants indicated a high degree of satisfaction with the PEP and reported their intent to make specific changes in self-medication behaviors.

Failure of pre-natal ultrasonography to prevent urinary infection associated with underlying urological abnormalities.

PubMed

Lakhoo, K; Thomas, D F; Fuenfer, M; D'Cruz, A J

1996-06-01

To analyse the reasons underlying the failure of routine pre-natal ultrasonography to prevent the subsequent development of urinary tract infection (UTI) in children with predisposing urological abnormalities. This retrospective study comprised 39 children (22 females and 17 males) who had at least one documented UTI, the presence of an anatomical anomaly of the urinary tract recognized as predisposing to UTI and had undergone ultrasonography of the urinary tract undertaken in fetal life as part of routine maternal ante-natal ultrasonography. Four categories of patients were defined: Group A, those with normal findings on pre-natal ultrasonography and no urological abnormality detected; Group B, those with a urological abnormality detected but where there was a subsequent failure of communication among clinicians; Group C, those with a urological abnormality but who received inappropriate or sub-optimal post-natal management and; Group D, those with a urological abnormality but who had a UTI despite appropriate post-natal management. In each case, the most severe documented episode of UTI was categorized as: Grade I, asymptomatic bacteriuria; Grade II, mild/moderate symptomatic UTI and; Grade III, severe symptomatic UTI necessitating hospital admission. Group A comprised 22 (56%), Group B three (9%), Group C two (5%) and Group D 12 children (31%). Of the 22 children in Group A, nine experienced a UTI of sufficient severity to necessitate hospital admission. Of the 12 children in Group D only one required hospital admission. The failure of pre-natal ultrasonography to identify the underlying predisposing urological abnormality was the most important factor contributing to subsequent UTI in post-natal life. Failure of communication and inappropriate post-natal management were numerically unimportant. In some children, UTI occurred despite pre-natal detection of their underlying anomaly and appropriate post-natal management. However, in this group the UTI was less

[The diagnostic value of ultrasonic elastography and ultrasonography comprehensive score in cervical lesions].

PubMed

Lu, R; Xiao, Y

2017-07-18

Objective: To evaluate the clinical value of ultrasonic elastography and ultrasonography comprehensive scoring method in the diagnosis of cervical lesions. Methods: A total of 116 patients were selected from the Department of Gynecology of the first hospital affiliated with Central South University from March 2014 to September 2015.All of the lesions were preoperatively examined by Doppler Ultrasound and elastography.The elasticity score was determined by a 5-point scoring method. Calculation of the strain ratio was based on a comparison of the average strain measured in the lesion with the adjacent tissue of the same depth, size, and shape.All these ultrasonic parameters were quantified, added, and arrived at ultrasonography comprehensive scores.To use surgical pathology as the gold standard, the sensitivity, specificity, accuracy of Doppler Ultrasound, elasticity score and strain ratio methods and ultrasonography comprehensive scoring method were comparatively analyzed. Results: (1) The sensitivity, specificity, and accuracy of Doppler Ultrasound in diagnosing cervical lesions were 82.89% (63/76), 85.0% (34/40), and 83.62% (97/116), respectively.(2) The sensitivity, specificity, and accuracy of the elasticity score method were 77.63% (59/76), 82.5% (33/40), and 79.31% (92/116), respectively; the sensitivity, specificity, and accuracy of the strain ratio measure method were 84.21% (64/76), 87.5% (35/40), and 85.34% (99/116), respectively.(3) The sensitivity, specificity, and accuracy of ultrasonography comprehensive scoring method were 90.79% (69/76), 92.5% (37/40), and 91.38% (106/116), respectively. Conclusion: (1) It was obvious that ultrasonic elastography had certain diagnostic value in cervical lesions. Strain ratio measurement can be more objective than elasticity score method.(2) The combined application of ultrasonography comprehensive scoring method, ultrasonic elastography and conventional sonography was more accurate than single parameter.

Medical technology in India: Tracing policy approaches.

PubMed

Chakravarthi, Indira

2013-01-01

Medical devices and equipment have become an indispensable part of modern medical practice. Yet these medical technologies receive scant attention in the Indian context, both at the health policy level and as an area of study. There has been little attempt to systematically address the issue of equipment based medical technologies and how to regulate their use. There is paucity of primary data on the kind of medical equipment and techniques being introduced, on their need and relative usefulness, reliability, patterns of utilization, on their production, procurement, distribution, costs, and accessibility. This article reviews some of the policy issues relating to equipment based medical technology in India, in light of the specific choices and policies made during and after the colonial period in favour of modern medicine and a technology-based public health system, attempts at self-sufficiency and the current international environment with respect to the medical equipment and health-care industry.

Comparison of the accuracy of radiography and ultrasonography for detection of articular lesions in horses.

PubMed

Hinz, Antje; Fischer, Andrew T

2011-10-01

To compare the accuracy of ultrasonographic and radiographic examination for evaluation of articular lesions in horses. Cross-sectional study. Horses (n = 137) with articular lesions. Radiographic and ultrasonographic examinations of the affected joint(s) were performed before diagnostic or therapeutic arthroscopic surgery. Findings were recorded and compared to lesions identified during arthroscopy. In 254 joints, 432 lesions were identified by arthroscopy. The overall accuracy was 82.9% for ultrasonography and 62.2% for radiography (P < .0001) with a sensitivity of 91.4% for ultrasonography and 66.7% for radiography (P < .0001). The difference in specificity was not statistically significant (P = .2628). The negative predictive value for ultrasonography was 31.5% and 13.2% for radiography (P = .0022), the difference for the positive predictive value was not statistically significant (P = .3898). The accuracy for ultrasonography and radiography for left versus right joints was equal and corresponded with the overall results. Ultrasonographic evaluation of articular lesions was more accurate than radiographic evaluation. © Copyright 2011 by The American College of Veterinary Surgeons.

Making the right long-term prescription for medical equipment financing.

PubMed

Conbeer, George P

2007-06-01

For hospital financial executives charged with assessing new technologies, obtaining access to sufficient information to support an in-depth analysis can be a daunting challenge. The information should come not only from direct sources, such as the equipment manufacturer, but also from indirect sources, such as leasing companies. A thorough knowledge of financing methods--including tax-exempt bonds, bank debt, standard leasing, tax-exempt leasing, and equipment rental terms-is critical.

42 CFR 433.35 - Equipment-Federal financial participation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 CFR part 95. Requirements concerning the management and disposition of equipment under the... 42 Public Health 4 2011-10-01 2011-10-01 false Equipment-Federal financial participation. 433.35... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE FISCAL ADMINISTRATION Federal Matching and General...

42 CFR 433.35 - Equipment-Federal financial participation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 CFR part 95. Requirements concerning the management and disposition of equipment under the... 42 Public Health 4 2010-10-01 2010-10-01 false Equipment-Federal financial participation. 433.35... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE FISCAL ADMINISTRATION Federal Matching and General...

Ultrasonography and progesterone concentration at a single time point for the detection of puberty in dairy heifers.

PubMed

Archbold, H; Buckley, F; Pierce, K M; Begley, N; Mee, J F

2012-06-01

Data were available from 1657 heifers across 48 dairy farms which were visited once, on average 9 days (± 5.2) prior to the mating start date (23 April, ± 12.6). Blood samples were collected via coccygeal venepuncture for progesterone (P4) analysis, and animals were scanned for the presence or absence of corpora lutea (CL), to determine the luteal status. A comparison of luteal status between ultrasound (CL identified) and P4 (≥ 1 ng/ml), based on a single measurement point, showed poor agreement (K = 0.32). The majority of animals were classified as luteal (76%) using both ultrasonography and P4. There was excellent agreement between luteal status detected by ultrasonography alone and luteal status assigned by a combination of ultrasonography and P4 (K = 0.93). The agreement between luteal status assigned by P4 and luteal status assigned by the combination of ultrasonography and P4 was poor (K = 0.37). These results indicate that at a single examination, ultrasonography is the preferred modality to determine the luteal status of maiden heifers. © 2011 Blackwell Verlag GmbH.

Comparison of Portable Crewmember Protective Breathing Equipment (CPBE) Designs

DTIC Science & Technology

1993-04-01

lower posterior portion of the Equipment: The ground level tests were conducted in hood, as is the lithium hydroxide CO2 scrubber . the Civil Aeromedical...equipped with a medical monitoring venturi nozzle. The venturi effect causes the atmo- system was used to effect the required subject workload. sphere...inside the hood to be drawn across the CO2 Two Perkin-Elmer medical gas analyzers were used to scrubber , which emits its effluent back into the

Equipment for nuclear medical centers, production capabilities of Rosatom enterprises

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gavrish, Yu. N., E-mail: gavrish@luts.niiefa.spb.su; Koloskov, S. A.; Smirnov, V. P.

2015-12-15

Analysis of the capabilities of the State Corporation Rosatom enterprises on the development and production of diagnostic and therapeutic equipment for nuclear medicine centers is presented. Prospects of the development of accelerator equipment for the production of a wide range of radioisotope products are shown, and the trends of its development are determined. A comparative analysis of the technical parameters of domestic tomographs and devices for brachytherapy with foreign counterparts is given.

An unanticipated diagnosis with bedside ultrasonography in patients with acute abdominal pain: rectus hematoma

PubMed Central

Ünlüer, Erden Erol; Kaykısız, Eylem Kuday

2017-01-01

Although abdominal pain is a common presentation in emergency departments, rectus sheath hematoma (RSH) is among the rarest diagnosis. Here we present 2 cases of RSH likely caused by coughing due to upper respiratory tract infection. The two described cases were diagnosed by bedside ultrasonography and confirmed as RSH by computed tomography. Review of patient history and use of ultrasonography are important to avoid misdiagnosisof RSH. PMID:28748020

Can contrast-enhanced ultrasonography improve Zone III REBOA placement for prehospital care?

PubMed

Chaudery, Muzzafer; Clark, James; Morrison, Jonathan J; Wilson, Mark H; Bew, Duncan; Darzi, Ara

2016-01-01

Torso hemorrhage is the primary cause of potentially preventable mortality in trauma. Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been advocated as an adjunct to bridge patients to definitive hemorrhage control. The primary aim of this study was to assess whether contrast-enhanced ultrasonography can improve the accuracy of REBOA placement in the infrarenal aorta (Zone III). A fluoroscopy-free "enhanced" Zone III REBOA technique was developed using a porcine cadaver model. A "standard" over-the-wire Seldinger technique was used, which was enhanced with the addition of a microbubble contrast medium to inflate the balloon, observed with ultrasonography. Following this, attending- and resident-level physicians were randomized into two groups. They were taught either the enhanced with ultrasonography guidance (Group A) or the standard measuring length of catheter insertion (Group B) technique as part of a human cadaver trauma skills course. Outcomes assessed included time (seconds) from insertion to inflation, accuracy, and missed targets. All results were benchmarked against three endovascular experts. There were 20 participants who performed REBOA with Group A (51 [31]) being significantly faster than Group B (90 [63]) (p = 0.003) and more accurate (p = 0.023) with no missed targets. Group B had five missed targets, the most common error being inflation within Zone II. For Zone III REBOA, contrast-enhanced ultrasonography technique is faster and more accurate than the standard technique. This may have value in time-critical and austere environments. Clinical studies are now required to evaluate this approach further.

High-resolution ultrasonography in assessment of nail-related disorders.

PubMed

Singh, R; Bryson, D; Singh, H P; Jeyapalan, K; Dias, J J

2012-09-01

Disorders of the nail can pose a diagnostic challenge, and non-invasive imaging is frequently required to clarify diagnosis and delineate anatomy pre-operatively. We explored the use of high-resolution ultrasonography in the assessment of patients with nail disorders attending orthopaedic hand clinics. A search of a university teaching hospital musculoskeletal radiology database identified 36 patients (mean age 54.2 years) where ultrasonography was used to assess nail-related disorders between April 2003 and January 2007. Clinical, surgical and histological findings were correlated in these cases with ultrasound reports. Ultrasound findings correlated with the provisional diagnosis in 20 (61%) of 33 patients and provided a diagnosis in 3 patients where a provisional diagnosis was unavailable. In 7 of the 13 cases where the clinical diagnosis differed from ultrasound findings, a lump originally diagnosed as cystic in origin was shown to be solid on ultrasound. Different nail pathologies showed different characteristics on ultrasonography, including differences in vascularity, echogenicity, changes in nail structure/shape and extension into the nail bed, matrix, fold or evidence of bony erosion. The ultrasound findings correlated with histological analysis and intra-operative assessment in 10 of 15 patients who underwent operative treatment. Ultrasound provides important information on the anatomy of the nail apparatus and can differentiate solid and cystic lesions. It can be used as a diagnostic tool and can therefore help in pre-operative planning of nail-related disorders. In our series ultrasound supported or improved upon the clinical diagnosis in 31 (86%) out of the 36 patients presenting with nail-related disorders.

Comparison of ultrasonography and physical examination in the diagnosis of incisional hernia in a prospective study.

PubMed

Bloemen, A; van Dooren, P; Huizinga, B F; Hoofwijk, A G M

2012-02-01

Incisional hernia is a frequent complication of abdominal surgery (incidence 2-20%). Diagnosis by physical examination is sometimes difficult, especially in small incisional hernias or in obese patients. The additional diagnostic value of standardized ultrasonography was evaluated in this prospective study. A total of 456 patients participating in a randomized trial comparing two suture materials for closure of the abdominal fascia underwent physical examination and ultrasonography at 6-month intervals. Wound complaints and treatment of incisional hernia were also noted. Statistical analysis was performed using the Chi-squared and Fisher's exact tests (SPSS). Interest variability analysis was performed. During a median follow-up of 31 months, 103 incisional hernias were found. A total of 82 incisional hernias were found by physical examination and an additional 21 with ultrasonography. Six of these additional hernias were symptomatic and only one of the additional hernias received operative treatment. The false-negative rates for physical examination and ultrasonography were 25.3 and 24.4%, respectively. Interest variability was low, with a Kappa of 0.697 (P < 0.001). There are no clear diagnostic criteria for incisional hernia available in the literature. Standardized combination of ultrasonography with physical examination during follow-up yields a significant number of, mostly asymptomatic, hernias, which would not be found using physical examination alone. This is especially relevant in research settings.

In-utero diagnosis of Norrie disease by ultrasonography.

PubMed

Redmond, R M; Vaughan, J I; Jay, M; Jay, B

1993-03-01

Obstetric ultrasonography of an obligate Norrie disease carrier revealed bilateral retinal detachments in a third trimester male fetus. Postnatal examination confirmed the diagnosis of Norrie disease. DNA linkage analysis with the markers L1.28 and MAO had been uninformative for this family. This report suggests that retinal detachment occurs late in the gestation of the affected fetus.

[Medical equipment companies and their ties with technology development centers in Mexico].

PubMed

Hernández, B; Arredondo, A; Cruz, C; Sánchez, E; Damián, T

1993-10-01

The purpose of this study was to determine the characteristics of the companies that produce, distribute, and service medical equipment in Mexico and the factors related to whether or not they had established ties with research and technology development centers. The data analyzed came from a survey of such companies carried out in Mexico City and environs in 1989. The information was updated in 1991. Multivariate analyses were carried out in order to identify the characteristics of companies that had established ties or wished to do so and the areas of interest of those companies. Of 208 companies surveyed, only 23% had ties with research centers. The companies that had such ties or were interested in establishing them tended to invest in research and to have made plans for expansion. The establishment of ties appeared to be a two-way process, with positive consequences for the companies involved, the research centers, and the health sector. It was concluded that it would be advantageous to design programs to promote ties with companies having the characteristics mentioned.

Does ultrasonography accurately diagnose acute cholecystitis? Improving diagnostic accuracy based on a review at a regional hospital

PubMed Central

Hwang, Hamish; Marsh, Ian; Doyle, Jason

2014-01-01

Background Acute cholecystitis is one of the most common diseases requiring emergency surgery. Ultrasonography is an accurate test for cholelithiasis but has a high false-negative rate for acute cholecystitis. The Murphy sign and laboratory tests performed independently are also not particularly accurate. This study was designed to review the accuracy of ultrasonography for diagnosing acute cholecystitis in a regional hospital. Methods We studied all emergency cholecystectomies performed over a 1-year period. All imaging studies were reviewed by a single radiologist, and all pathology was reviewed by a single pathologist. The reviewers were blinded to each other’s results. Results A total of 107 patients required an emergency cholecystectomy in the study period; 83 of them underwent ultrasonography. Interradiologist agreement was 92% for ultrasonography. For cholelithiasis, ultrasonography had 100% sensitivity, 18% specificity, 81% positive predictive value (PPV) and 100% negative predictive value (NPV). For acute cholecystitis, it had 54% sensitivity, 81% specificity, 85% PPV and 47% NPV. All patients had chronic cholecystitis and 67% had acute cholecystitis on histology. When combined with positive Murphy sign and elevated neutrophil count, an ultrasound showing cholelithiasis or acute cholecystitis yielded a sensitivity of 74%, specificity of 62%, PPV of 80% and NPV of 53% for the diagnosis of acute cholecystitis. Conclusion Ultrasonography alone has a high rate of false-negative studies for acute cholecystitis. However, a higher rate of accurate diagnosis can be achieved using a triad of positive Murphy sign, elevated neutrophil count and an ultrasound showing cholelithiasis or cholecystitis. PMID:24869607

Normal accidents: human error and medical equipment design.

PubMed

Dain, Steven

2002-01-01

High-risk systems, which are typical of our technologically complex era, include not just nuclear power plants but also hospitals, anesthesia systems, and the practice of medicine and perfusion. In high-risk systems, no matter how effective safety devices are, some types of accidents are inevitable because the system's complexity leads to multiple and unexpected interactions. It is important for healthcare providers to apply a risk assessment and management process to decisions involving new equipment and procedures or staffing matters in order to minimize the residual risks of latent errors, which are amenable to correction because of the large window of opportunity for their detection. This article provides an introduction to basic risk management and error theory principles and examines ways in which they can be applied to reduce and mitigate the inevitable human errors that accompany high-risk systems. The article also discusses "human factor engineering" (HFE), the process which is used to design equipment/ human interfaces in order to mitigate design errors. The HFE process involves interaction between designers and endusers to produce a series of continuous refinements that are incorporated into the final product. The article also examines common design problems encountered in the operating room that may predispose operators to commit errors resulting in harm to the patient. While recognizing that errors and accidents are unavoidable, organizations that function within a high-risk system must adopt a "safety culture" that anticipates problems and acts aggressively through an anonymous, "blameless" reporting mechanism to resolve them. We must continuously examine and improve the design of equipment and procedures, personnel, supplies and materials, and the environment in which we work to reduce error and minimize its effects. Healthcare providers must take a leading role in the day-to-day management of the "Perioperative System" and be a role model in

Cost-effectiveness analysis of ultrasonography screening for nonalcoholic fatty liver disease in metabolic syndrome patients.

PubMed

Phisalprapa, Pochamana; Supakankunti, Siripen; Charatcharoenwitthaya, Phunchai; Apisarnthanarak, Piyaporn; Charoensak, Aphinya; Washirasaksiri, Chaiwat; Srivanichakorn, Weerachai; Chaiyakunapruk, Nathorn

2017-04-01

Nonalcoholic fatty liver disease (NAFLD) can be diagnosed early by noninvasive ultrasonography; however, the cost-effectiveness of ultrasonography screening with intensive weight reduction program in metabolic syndrome patients is not clear. This study aims to estimate economic and clinical outcomes of ultrasonography in Thailand. Cost-effectiveness analysis used decision tree and Markov models to estimate lifetime costs and health benefits from societal perspective, based on a cohort of 509 metabolic syndrome patients in Thailand. Data were obtained from published literatures and Thai database. Results were reported as incremental cost-effectiveness ratios (ICERs) in 2014 US dollars (USD) per quality-adjusted life year (QALY) gained with discount rate of 3%. Sensitivity analyses were performed to assess the influence of parameter uncertainty on the results. The ICER of ultrasonography screening of 50-year-old metabolic syndrome patients with intensive weight reduction program was 958 USD/QALY gained when compared with no screening. The probability of being cost-effective was 67% using willingness-to-pay threshold in Thailand (4848 USD/QALY gained). Screening before 45 years was cost saving while screening at 45 to 64 years was cost-effective. For patients with metabolic syndromes, ultrasonography screening for NAFLD with intensive weight reduction program is a cost-effective program in Thailand. Study can be used as part of evidence-informed decision making. Findings could contribute to changes of NAFLD diagnosis practice in settings where economic evidence is used as part of decision-making process. Furthermore, study design, model structure, and input parameters could also be used for future research addressing similar questions.

Role of ultrasonography in the differential diagnosis of thyrotoxicosis: a noninvasive, cost-effective, and widely available but underutilized diagnostic tool.

PubMed

Alzahrani, Ali S; Ceresini, Graziano; Aldasouqi, Saleh A

2012-01-01

To explore the use of ultrasonography as a diagnostic alternative to the traditional "gold standard" imaging study of nuclear scintigraphy in the evaluation of thyrotoxicosis. We review the relevant literature and share our own experience to highlight the promising role of ultrasonography in thyrotoxicosis. In addition, we present a diagnostic algorithm suggesting liberal use of ultrasonography in the evaluation of thyrotoxicosis. Ultrasonography has proved effective not only in the differentiation of Graves disease from other types and causes of thyrotoxicosis but also in the detection of subtle thyroid nodules. The latter role is emphasized in light of the recent observation of an increased risk of occurrence of papillary thyroid carcinoma in patients with Graves disease. Ultrasonography is a cost-effective, noninvasive, portable, and safe imaging modality in the evaluation of thyrotoxicosis, both for physiologic assessment and for detection of nonpalpable thyroid cancers that may elude identification on physical examination and nuclear imaging studies. Although thyroid scintigraphy remains a standard radiologic study, thyroid ultrasonography can be a practical alternative in many cases and the primary imaging modality in some situations such as during pregnancy and lactation and for evaluation and management of amiodarone-induced thyrotoxicosis.

“Nodule in Nodule” on Thyroid Ultrasonography: Possibility of Follicular Carcinoma Transformed from Benign Thyroid Tumor

PubMed Central

Kobayashi, Kaoru; Ota, Hisashi; Hirokawa, Mitsuyoshi; Yabuta, Tomonori; Fukushima, Mitsuhiro; Masuoka, Hiroo; Higashiyama, Takuya; Kihara, Minoru; Ito, Yasuhiro; Miya, Akihiro; Miyauchi, Akira

2017-01-01

Background It is generally considered impossible to differentiate follicular carcinomas from follicular adenomas by means of ultrasonography or cytology before surgery. Therefore, follicular carcinoma is histopathologically diagnosed by verifying capsular and/or vascular invasion after surgery. However, ultrasonography may play an important role in diagnosing follicular carcinoma preoperatively in a small number of cases. Case Description Four cases of follicular carcinoma or follicular neoplasm that transformed from a benign thyroid tumor and demonstrated a “nodule in nodule” appearance on ultrasonography are presented in this report. Characteristic ultrasound features of such patients are: (1) a “nodule in nodule” appearance, (2) a well-defined boundary line between the nodules, and (3) separate distribution of blood signals within each nodule. Conclusion A small number of patients with follicular carcinomas or follicular neoplasms may present with a “nodule in nodule” appearance on ultrasonography. It was suggested a long time ago that follicular carcinomas may develop from benign thyroid tumors. The fact that follicular carcinomas appear within benign tumors may be evidence of thyroid tumorigenesis. PMID:28589092

The effectiveness of ultrasonography in verifying the placement of a nasogastric tube in patients with low consciousness at an emergency center

PubMed Central

2012-01-01

Background This study was designed to compare the effectiveness of using auscultation, pH measurements of gastric aspirates, and ultrasonography as physical examination methods to verify nasogastric tube(NGT) placement in emergency room patients with low consciousness who require NGT insertion. Methods The study included 47 patients who were all over 18 years of age. In all patients, tube placement was verified by chest X-rays. Auscultation, pH analysis of gastric aspirates, and ultrasonography were conducted on each patient in random order. The mean patient age was 57.62 ± 17.24 years, and 28 males (59.6%) and 19 females (40.4%) were included. The NGT was inserted by an emergency room resident. For pH testing, gastric aspirates were dropped onto litmus paper, and the resulting color of the paper was compared with a reference table. Ultrasonography was performed by an emergency medicine specialist, and the chest X-ray examination was interpreted by a different emergency medicine specialist who did not conduct the ultrasonography test. The results of the auscultation, gastric aspirate pH, and ultrasonography examinations were compared with the results of the chest x-ray examination. Results The sensitivity and specificity were 100% and 33.3%, respectively, for auscultation and 86.4% and 66.7%, respectively, for ultrasonography. Kappa values were the highest for auscultation at 0.484 compared to chest x-rays, followed by 0.299 for ultrasonography and 0.444 for pH analysis of the gastric aspirate. The ultrasonography has a positive predictive value of 97.4% and a negative predictive value of 25%. Conclusions Ultrasonography is useful for confirming the results of auscultation after NGT insertion among patients with low consciousness at an emergency center. When ultrasound findings suggest that the NGT placement is not gastric, additional chest X-ray should be performed. PMID:22691418

The effectiveness of ultrasonography in verifying the placement of a nasogastric tube in patients with low consciousness at an emergency center.

PubMed

Kim, Hyung Min; So, Byung Hak; Jeong, Won Jung; Choi, Se Min; Park, Kyu Nam

2012-06-12

This study was designed to compare the effectiveness of using auscultation, pH measurements of gastric aspirates, and ultrasonography as physical examination methods to verify nasogastric tube(NGT) placement in emergency room patients with low consciousness who require NGT insertion. The study included 47 patients who were all over 18 years of age. In all patients, tube placement was verified by chest X-rays. Auscultation, pH analysis of gastric aspirates, and ultrasonography were conducted on each patient in random order. The mean patient age was 57.62 ± 17.24 years, and 28 males (59.6%) and 19 females (40.4%) were included. The NGT was inserted by an emergency room resident. For pH testing, gastric aspirates were dropped onto litmus paper, and the resulting color of the paper was compared with a reference table. Ultrasonography was performed by an emergency medicine specialist, and the chest X-ray examination was interpreted by a different emergency medicine specialist who did not conduct the ultrasonography test. The results of the auscultation, gastric aspirate pH, and ultrasonography examinations were compared with the results of the chest x-ray examination. The sensitivity and specificity were 100% and 33.3%, respectively, for auscultation and 86.4% and 66.7%, respectively, for ultrasonography. Kappa values were the highest for auscultation at 0.484 compared to chest x-rays, followed by 0.299 for ultrasonography and 0.444 for pH analysis of the gastric aspirate. The ultrasonography has a positive predictive value of 97.4% and a negative predictive value of 25%. Ultrasonography is useful for confirming the results of auscultation after NGT insertion among patients with low consciousness at an emergency center. When ultrasound findings suggest that the NGT placement is not gastric, additional chest X-ray should be performed.

Comparing Magnetic Resonance Imaging and High-Resolution Dynamic Ultrasonography for Diagnosis of Plantar Plate Pathology: A Case Series.

PubMed

Donegan, Ryan J; Stauffer, Anthony; Heaslet, Michael; Poliskie, Michael

Plantar plate pathology has gained noticeable attention in recent years as an etiology of lesser metatarsophalangeal joint pain. The heightened clinical awareness has led to the need for more effective diagnostic imaging accuracy. Numerous reports have established the accuracy of both magnetic resonance imaging and ultrasonography for the diagnosis of plantar plate pathology. However, no conclusions have been made regarding which is the superior imaging modality. The present study reports a case series directly comparing high-resolution dynamic ultrasonography and magnetic resonance imaging. A multicenter retrospective comparison of magnetic resonance imaging versus high-resolution dynamic ultrasonography to evaluate plantar plate pathology with surgical confirmation was conducted. The sensitivity, specificity, and positive and negative predictive values for magnetic resonance imaging were 60%, 100%, 100%, and 33%, respectively. The overall diagnostic accuracy compared with the intraoperative findings was 66%. The sensitivity, specificity, and positive and negative predictive values for high-resolution dynamic ultrasound imaging were 100%, 100%, 100%, and 100%, respectively. The overall diagnostic accuracy compared with the intraoperative findings was 100%. The p value using Fisher's exact test for magnetic resonance imaging and high-resolution dynamic ultrasonography was p = .45, a difference that was not statistically significant. High-resolution dynamic ultrasonography had greater accuracy than magnetic resonance imaging in diagnosing lesser metatarsophalangeal joint plantar plate pathology, although the difference was not statistically significant. The present case series suggests that high-resolution dynamic ultrasonography can be considered an equally accurate imaging modality for plantar plate pathology at a potential cost savings compared with magnetic resonance imaging. Therefore, high-resolution dynamic ultrasonography warrants further investigation in

Return to contact sports following infectious mononucleosis: the role of serial ultrasonography.

PubMed

O'Connor, Tony E; Skinner, Liam J; Kiely, Patrick; Fenton, John E

2011-08-01

Splenic rupture is a rare but potentially fatal complication of infectious mononucleosis. Athletes returning to contact sports following infectious mononucleosis are at potential risk of splenic rupture secondary to abdominal trauma. No clear consensus exists as to when it is safe to allow these athletes to return to contact sports. Suggested periods of abstinence have ranged from 2 weeks to 6 months. We outline our experiences with the use of abdominal ultrasonography at 1 month after the diagnosis of infectious mononucleosis as a means of determining when athletes can safely return to contact sports. Our study group was made up of 19 such patients (mean age: 16.7 yr). We found that 16 of these patients (84%) had normal splenic dimensions on ultrasonography 1 month after diagnosis, and they were therefore allowed to return to contact sports. While the remaining 3 patients had an enlarged spleen at 1 month, their splenic dimensions had all returned to normal when ultrasonographic examination was repeated at 2 months postdiagnosis. We conclude that serial abdominal ultrasonography allows for informed decision making in determining when athletes can safely return to contact sports following infectious mononucleosis.

Diagnostic Accuracy of Ultrasonography and Radiography in Initial Evaluation of Chest Trauma Patients.

PubMed

Vafaei, Ali; Hatamabadi, Hamid Reza; Heidary, Kamran; Alimohammadi, Hosein; Tarbiyat, Mohammad

2016-01-01

Application of chest radiography for all multiple trauma patients is associated with a significant increase in total costs, exposure to radiation, and overcrowding of the emergency department. Ultrasound has been introduced as an alternative diagnostic tool in this regard. The aim of the present study is to compare the diagnostic accuracy of chest ultrasonography and radiography in detection of traumatic intrathoracic injuries. In the present prospective cross-sectional study, patients with traumatic intrathoracic injuries, who were referred to the emergency department from December 2013 to December 2014, were assessed. The patients underwent bedside ultrasound, radiographic and computed tomography (CT) scan examinations based on ATLS recommendations. Screening performance characteristics of ultrasonography and radiography were compared using SPSS 21.0. Chest CT scan was considered as gold standard. 152 chest trauma patients with a mean age of 31.4 ± 13.8 years (range: 4 ‒ 67), were enrolled (77.6% male). Chest CT scan showed pulmonary contusion in 48 (31.6%) patients, hemothorax in 29 (19.1%), and pneumothorax in 55 (36.2%) cases. Area under the ROC curve of ultrasonography in detection of pneumothorax, hemothorax, and pulmonary contusion were 0.91 (95% CI: 0.86‒0.96), 0.86 (95% CI: 0.78‒0.94), and 0.80 (95% CI: 0.736‒0.88), respectively. Area under the ROC curve of radiography was 0.80 (95% CI: 0.736‒0.87) for detection of pneumothorax, 0.77 (95% CI: 0.68‒0.86) for hemothorax, and 0.58 (95% CI: 0.5‒0.67) for pulmonary contusion. Comparison of areas under the ROC curve declared the significant superiority of ultrasonography in detection of pneumothorax (p = 0.02) and pulmonary contusion (p < 0.001). However, the diagnostic value of the two tests was equal in detection of hemothorax (p = 0.08). The results of the present study showed that ultrasonography is preferable to radiography in the initial evaluation of patients with traumatic injuries to the

Improved Submariner Eyewear for Routine Wear and Emergency Equipment Use Underway

DTIC Science & Technology

2010-01-15

information. 2.0 DESCRIPTION Naval Submarine Medical Research Laboratory (NSMRL) is seeking information from the eyewear industry that will provide...Improved Submariner Eyewear for Routine Wear and Emergency Equipment Use Underway by Alison America, MA Wayne G. Horn, MD...Submariner Eyewear for Routine Wear and Emergency Equipment Use Underway 50818 Alison America, MA Wayne G. Horn, MD Naval Submarine Medical Research

Impact of the presence of medical equipment in images on viewers' perceptions of the trustworthiness of an individual on-screen.

PubMed

Jiwa, Moyez; Millett, Stephan; Meng, Xingqiong; Hewitt, Vivien M

2012-07-10

It is now common practice for doctors to consult patients by means other than face-to-face, often appearing before the patient on a computer screen. Also, many websites are using depictions of health professionals to increase the credibility of their services. Being trustworthy is an essential attribute for successful ehealth services. Little is known about which depicted accessories make a health professional appear more trustworthy. To estimate the odds of an individual on-screen being rated trustworthy when viewed in a static image holding or wearing specific items of medical equipment. We surveyed consecutive people attending community pharmacies to collect prescriptions in Western Australia. Respondents were presented with a series of 10 photographs, generated at random, of a man with varying numbers and combinations of medical equipment: stethoscope, reflex hammer, surgical scrubs, otoscope, and pen. They were then invited to rate the man as honest, trustworthy, honorable, moral, ethical, or genuine, or a combination of these, on the Source Credibility Scale. A total of 168 of 250 people gave informed consent, for a participation rate of 67.2%. There were 102 female and 66 male respondents. Of the 168 respondents, 96 (57%) were born in Australia and 102 (60.7%) were attending medical practices with more than one general practitioner. The mean age of respondents was 47 (SD 16) years (range 26-92 years). When only 1 item was present in an image, the stethoscope was associated with the highest odds for the person being considered honest (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.6-4.3), trustworthy (OR 2.3, 95% CI 1.4-3.8), honorable (OR 2.7, 95% CI 1.6-4.5), moral (OR 2.4 95% CI 1.4-4.1), ethical (OR 2.6, 95% CI 1.5-4.6), and genuine (OR 1.8, 95% CI 1.0-3.1). The presence of a stethoscope increased the odds of the person being rated in a positive light in all photographs in which it was included. When an individual is portrayed in a static image

Doppler ultrasonography of the pectinis oculi artery in harpy eagles (Harpia harpyja)

PubMed Central

de Moraes, Wanderlei; Ferreira, Thiago A.C.; Somma, André T.; Cubas, Zalmir S.; Moore, Bret A.; Montiani-Ferreira, Fabiano

2017-01-01

Twenty harpy eagles (Harpia harpyja) without systemic or ocular diseases were examined to measure blood velocity parameters of the pectinis oculi artery using Doppler ultrasonography. Pectinate artery resistive index (RI) and pulsatility index (PI) were investigated using ocular Doppler ultrasonography. The mean RI and PI values across all eyes were 0.44±0.10 and 0.62±0.20 respectively. Low RI and PI values found in the harpy eagle´s pectinis oculi artery compared with the American pekin ducks one and other tissue suggest indeed a high metabolic activity in pecten oculi and corroborates the hypothesis of a nutritional function and/or intraocular pressure regulation. PMID:28540254

Sensitivity and specificity of ultrasonography and low-field magnetic resonance imaging for diagnosing arthritis.

PubMed

Broll, Matthias; Albrecht, Katinka; Tarner, Ingo; Müller-Ladner, Ulf; Strunk, Johannes

2012-01-01

To evaluate the value of grey-scale ultrasonography (US) including power Doppler ultrasonography (PDUS) and low-field magnetic resonance imaging (MRI) for the diagnosis of arthritis in a diagnostic phase III study. Fifty consecutive patients with suspected arthritis were included in the study. Following a standardised protocol, US of the carpus and the metacarpophalangeal (MCP) joints of the dominant hand was performed. Subsequently, low-field MRI was done using standard sequences, with contrast agent (Gadolinium DTPA) administered to 29 patients. In 32 out of 50 patients a clinical diagnosis of arthritis was established. In grey-scale ultrasonography including PDUS, sensitivity and specificity were determined as 0.94 and 0.5, respectively, for synovitis (effusion and hypertrophy), 0.72 and 0.94, respectively, for Doppler signals, and 0.38 and 1.0, respectively, for bone erosions. In low-field MRI, sensitivity and specificity values were 0.77 and 0.75, respectively, for synovitis (when using contrast agent), 0.48 and 0.78, respectively, for bone marrow oedema, and 0.58 and 0.83, respectively, for bone erosion. Both grey-scale ultrasonography including PDUS and low-field MRI are suitable imaging methods for diagnosing arthritis at an early stage. However, PDUS displays a higher specificity and almost the same sensitivity as compared to contrast-enhanced MRI, while being a much simpler and less costly procedure.

[Development of Hospital Equipment Maintenance Information System].

PubMed

Zhou, Zhixin

2015-11-01

Hospital equipment maintenance information system plays an important role in improving medical treatment quality and efficiency. By requirement analysis of hospital equipment maintenance, the system function diagram is drawed. According to analysis of input and output data, tables and reports in connection with equipment maintenance process, relationships between entity and attribute is found out, and E-R diagram is drawed and relational database table is established. Software development should meet actual process requirement of maintenance and have a friendly user interface and flexible operation. The software can analyze failure cause by statistical analysis.

Inflight medical emergencies.

PubMed

Lyznicki, J M; Williams, M A; Deitchman, S D; Howe, J P

2000-08-01

This report responds to resolutions asking the American Medical Association (AMA) to develop recommendations for the use of medical equipment and technology onboard commercial airlines. Information for the report was derived from a search of the MEDLINE database and references listed in pertinent articles, as well as through communications with experts in aerospace and emergency medicine. Based on this information, the AMA Council on Scientific Affairs determined that, while inflight morbidity and mortality are uncommon, serious events do occur, which require immediate emergency care. Management of serious problems requires an integrated emergency response system that ensures rapid notification of medical personnel on the ground, assistance from appropriately trained flight crews and passenger volunteers (if available), and adequate medical supplies and equipment to stabilize the victim. Physicians have an important role in the preflight evaluation and counseling of potential passengers who are at risk of inflight medical complications, and in providing inflight medical assistance. Some U.S. and foreign air carriers are upgrading inflight emergency medical kits and placing automated external defibrillators aboard aircraft. Few data are available regarding the effectiveness of such improvements in improving health or survival outcomes. Recent federal legislation requires assessment of the extent of inflight medical emergencies, including the adequacy of emergency medical supplies and equipment carried onboard commercial airliners. This legislation also should alleviate liability concerns by providing immunity for physicians and others who render inflight medical assistance.

Cost-effectiveness analysis of ultrasonography screening for nonalcoholic fatty liver disease in metabolic syndrome patients

PubMed Central

Phisalprapa, Pochamana; Supakankunti, Siripen; Charatcharoenwitthaya, Phunchai; Apisarnthanarak, Piyaporn; Charoensak, Aphinya; Washirasaksiri, Chaiwat; Srivanichakorn, Weerachai; Chaiyakunapruk, Nathorn

2017-01-01

Abstract Background: Nonalcoholic fatty liver disease (NAFLD) can be diagnosed early by noninvasive ultrasonography; however, the cost-effectiveness of ultrasonography screening with intensive weight reduction program in metabolic syndrome patients is not clear. This study aims to estimate economic and clinical outcomes of ultrasonography in Thailand. Methods: Cost-effectiveness analysis used decision tree and Markov models to estimate lifetime costs and health benefits from societal perspective, based on a cohort of 509 metabolic syndrome patients in Thailand. Data were obtained from published literatures and Thai database. Results were reported as incremental cost-effectiveness ratios (ICERs) in 2014 US dollars (USD) per quality-adjusted life year (QALY) gained with discount rate of 3%. Sensitivity analyses were performed to assess the influence of parameter uncertainty on the results. Results: The ICER of ultrasonography screening of 50-year-old metabolic syndrome patients with intensive weight reduction program was 958 USD/QALY gained when compared with no screening. The probability of being cost-effective was 67% using willingness-to-pay threshold in Thailand (4848 USD/QALY gained). Screening before 45 years was cost saving while screening at 45 to 64 years was cost-effective. Conclusions: For patients with metabolic syndromes, ultrasonography screening for NAFLD with intensive weight reduction program is a cost-effective program in Thailand. Study can be used as part of evidence-informed decision making. Translational Impacts: Findings could contribute to changes of NAFLD diagnosis practice in settings where economic evidence is used as part of decision-making process. Furthermore, study design, model structure, and input parameters could also be used for future research addressing similar questions. PMID:28445256

Cost-effectiveness analysis of population-based screening of hepatocellular carcinoma: Comparing ultrasonography with two-stage screening

PubMed Central

Kuo, Ming-Jeng; Chen, Hsiu-Hsi; Chen, Chi-Ling; Fann, Jean Ching-Yuan; Chen, Sam Li-Sheng; Chiu, Sherry Yueh-Hsia; Lin, Yu-Min; Liao, Chao-Sheng; Chang, Hung-Chuen; Lin, Yueh-Shih; Yen, Amy Ming-Fang

2016-01-01

AIM: To assess the cost-effectiveness of two population-based hepatocellular carcinoma (HCC) screening programs, two-stage biomarker-ultrasound method and mass screening using abdominal ultrasonography (AUS). METHODS: In this study, we applied a Markov decision model with a societal perspective and a lifetime horizon for the general population-based cohorts in an area with high HCC incidence, such as Taiwan. The accuracy of biomarkers and ultrasonography was estimated from published meta-analyses. The costs of surveillance, diagnosis, and treatment were based on a combination of published literature, Medicare payments, and medical expenditure at the National Taiwan University Hospital. The main outcome measure was cost per life-year gained with a 3% annual discount rate. RESULTS: The results show that the mass screening using AUS was associated with an incremental cost-effectiveness ratio of USD39825 per life-year gained, whereas two-stage screening was associated with an incremental cost-effectiveness ratio of USD49733 per life-year gained, as compared with no screening. Screening programs with an initial screening age of 50 years old and biennial screening interval were the most cost-effective. These findings were sensitive to the costs of screening tools and the specificity of biomarker screening. CONCLUSION: Mass screening using AUS is more cost effective than two-stage biomarker-ultrasound screening. The most optimal strategy is an initial screening age at 50 years old with a 2-year inter-screening interval. PMID:27022228

[Ultrasonography-guided therapeutic procedures in the neck region].

PubMed

Brzac, Hrvojka Tomić

2009-12-01

in the parathormone level. PEIT produced best results in cysts (thyroid cysts, parathyroid cysts or other cysts on the neck), and can replace surgery. In most cases, results are achieved after the first injection. Volume reduction is between 50% and 95%, depending on the size and content of the cyst (clear, colloidal, or hemorrhagic) and presence of solid tissue. Therapy for toxic and autonomous thyroid adenoma and toxic nodular goiter by ethanol injection is accepted as one of the methods for treating patients that refuse radiation therapy or surgery. The goals of the treatment are nodal size reduction, normalization of thyroid hormones and TSH, and an improved subjective condition of the patient. Complete cure has been achieved in more than 75% of patients. Post-therapeutic development of hypothyroidism is extremely rare. The treatment can also be used for non-toxic goiter, especially those with cystic changes. PEIT is also recommended for the treatment of thyroid cancer neck metastases as an alternative procedure in patients at a high risk of reoperation, those that refuse surgery, and those with radioiodine-negative metastasis. The results of PEIT show significant reduction in nodal size or complete disappearance of the node in more than 70% of patients, with a decrease in serum thyroglobulin, except for patients with distant metastases. The procedure can be repeated until the desired effect is achieved, and is well tolerated by patients. Therapeutic procedures under ultrasonography guidance are becoming ever more important in medical protocols. In the head and neck region, PEIT is the most widely used method because of a number of advantages. The simplicity of the procedure, relatively few side effects, low cost, outpatient treatment and good results make this method preferable to other, invasive therapeutic procedures.

Endoscopic Ultrasonography in the Diagnosis and Treatment Strategy Choice of Esophageal Leiomyoma.

PubMed

Sun, Ling-Jia; Chen, Xin; Dai, Yi-Ning; Xu, Cheng-Fu; Ji, Feng; Chen, Li-Hua; Chen, Hong-Tan; Chen, Chun-Xiao

2017-04-01

Esophageal leiomyoma is the most common benign tumor of the esophagus, and it originates from mesenchymal tissue. This study analyzed the clinicopathological characteristics of esophageal leiomyoma and aimed to evaluate the role of endoscopic ultrasonography in the diagnosis and treatment selection for these lesions. Two hundred and twenty-five patients who had suspected esophageal leiomyomas in endoscopic ultrasonography were enrolled at the Endoscopy Center of The First Affiliated Hospital, Zhejiang University from January 1st, 2009 to May 31th, 2015. The main outcomes included the demographic and morphological characteristics, symptoms, comparisons of diagnosis and treatment methods, adverse events, and prognosis. One hundred and sixty-seven patients were diagnosed as having an esophageal leiomyoma by pathological examination. The mean patient age was 50.57±9.983 years. In total, 62.9% of the lesions originated from the muscularis mucosa, and the others originated from the muscularis propria. The median distance to the incisors was 30±12 cm. The median diameter was 0.72±0.99 cm. As determined by endoscopic ultrasonography, most existing leiomyomas were homogeneous, endophytic, and spherical. The leiomyomas from the muscularis mucosa were smaller than those from the muscularis propria and much closer to the incisors (p<0.05). SMA (smooth muscle antibody) (97.2%) and desmin (94.5%) were positive in the majority of patients. In terms of treatments, patients preferred endoscopic therapies, which led to less adverse events (e.g., intraoperative bleeding, local infection, pleural effusion) than surgical operations (p<0.05). The superficial leiomyomas presented less adverse events and better recovery (p<0.05) than deep leiomyomas. Endoscopic ultrasonography has demonstrated high accuracy in the diagnosis of esophageal leiomyomas and provides great support in selecting treatments; however, EUS cannot completely avoid misdiagnosis, so combining it with other

Evaluation of prenatal hydronephrosis: novel criteria for predicting vesicoureteral reflux on ultrasonography.

PubMed

Lee, Nora G; Rushton, H Gil; Peters, Craig A; Groves, Danja S; Pohl, Hans G

2014-09-01

Radiographic evaluation for prenatal hydronephrosis often includes voiding cystourethrography to ascertain whether vesicoureteral reflux is present. We sought to determine whether use of voiding cystourethrography could be limited to those patients at greatest risk for vesicoureteral reflux. We hypothesized that vesicoureteral reflux could be predicted by findings on renal/bladder ultrasonography of hydroureter, renal dysmorphia and/or duplication. We reviewed the records of patients with prenatal hydronephrosis who underwent initial postnatal ultrasonography and voiding cystourethrography during a 3-year period. The presence of vesicoureteral reflux on voiding cystourethrogram was correlated to ultrasound findings, including hydronephrosis grade, presence of hydroureter, renal dysmorphia or duplication, with ultrasound considered positive for any of the latter 3 findings. Of 262 patients 47 (18%) had vesicoureteral reflux. Ultrasound was positive in 24 of 29 patients (83%) with high grade reflux and 12 of 18 (67%) with low grade reflux. If ultrasonography showed any of the 3 positive findings, the odds ratio of detecting vesicoureteral reflux was 8.07 (95% CI 3.86, 16.87). Using these criteria, among all cases of prenatal hydronephrosis 5 (2%) with high grade vesicoureteral reflux and 6 (2%) with low grade reflux would have been missed. Among the 47 cases of reflux overall 5 of 29 high grade (17%) and 6 of 18 low grade cases (33%) would have been missed. By using ultrasonography criteria of hydroureter, duplication and renal dysmorphia for patients with prenatal hydronephrosis, vesicoureteral reflux can be detected more specifically. Using our criteria, 165 of 262 voiding cystourethrograms (63%) could have been avoided in patients with prenatal hydronephrosis during a 3-year period. Reducing these evaluations may decrease risks regarding radiation exposure, family anxiety and health care costs. Copyright © 2014 American Urological Association Education and

Evaluation of acute radiation optic neuropathy by B-scan ultrasonography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lovato, A.A.; Char, D.H.; Quivey, J.M.

1990-09-15

We studied the accuracy of B-scan ultrasonography to diagnose radiation-induced optic neuropathy in 15 patients with uveal melanoma. Optic neuropathy was diagnosed by an observer masked as to clinical and photographic data. We analyzed planimetry area measurements of the retrobulbar nerve before and after irradiation. The retrobulbar area of the optic nerve shadow on B-scan was quantitated with a sonic digitizer. Increased optic nerve shadow area was confirmed in 13 of 15 patients who had radiation optic neuropathy (P less than .004). The correct diagnosis was confirmed when the results of ultrasound were compared to fundus photography and fluorescein angiography.more » In 13 patients there was acute radiation optic neuropathy. Two patients did not show an enlarged retrobulbar optic nerve, and the clinical appearance suggested early progression to optic atrophy. Ultrasonography documents the enlargement of the optic nerve caused by acute radiation changes.« less

Skylab medical technology utilization

NASA Technical Reports Server (NTRS)

Stonesifer, J. C.

1974-01-01

To perform the extensive medical experimentation on man in a long-term, zero-g environment, new medical measuring and monitoring equipment had to be developed, new techniques in training and operations were required, and new methods of collecting and analyzing the great amounts of medical data were developed. Examples of technology transfers to the public sector resulted from the development of new equipment, methods, techniques, and data. This paper describes several of the examples that stemmed directly from Skylab technology.

Comparison of contrast media for visualization of the colon of healthy dogs during computed tomography and ultrasonography.

PubMed

Cheon, Byunggyu; Moon, Sohyeon; Park, Seungjo; Lee, Sang-Kwon; Hong, Sunghwa; Cho, Hyun; Choi, Jihye

2016-11-01

OBJECTIVE To evaluate contrast agents for their ability to improve visualization of the colon wall and lumen during CT and ultrasonography. ANIMALS 10 healthy adult Beagles. PROCEDURES Food was withheld from dogs for 36 hours, after which dogs consumed 250 mL of polyethylene glycol solution. Dogs were then anesthetized, a contrast agent (tap water, diluted barium, or air; order randomly assigned) was administered rectally, iodine contrast medium (880 mg of I/kg) was administered IV, and CT and ultrasonography of the colon were performed. After a 1-week washout period, this process was repeated with a different contrast agent until all agents had been evaluated. Two investigators reviewed the CT and ultrasonographic images for colon wall thickness, conspicuity, artifacts, wall layering, and degree of lumen dilation at 4 sites. RESULTS Thickness of the colon wall was greatest in CT and ultrasonographic images with water used as contrast agent, followed by barium and then air. The CT images obtained after water administration had a smooth appearance that outlined the colonic mucosa and had the highest score of the 3 contrast agents for wall conspicuity. Although no substantial artifacts related to any of the contrast agents were identified on CT images, barium- and gas-induced shadowing and reverberation artifacts hindered wall evaluation during ultrasonography. For ultrasonography, the degree of conspicuity was highest with barium in the near-field wall and with water in the far-field wall. In contrast to CT, ultrasonography could be used to distinguish wall layering, and the mucosal and muscular layers were distinct with all contrast agents. CONCLUSIONS AND CLINICAL RELEVANCE Use of water as a contrast agent for both CT and ultrasonography of the colon in dogs compensated for each imaging modality's disadvantages and could be beneficial in the diagnosis of colon disease.

International guidelines for contrast-enhanced ultrasonography: ultrasound imaging in the new millennium

PubMed Central

Lorentzen, Torben

2016-01-01

The intent of this review is to discuss and comment on common clinical scenarios in which contrast-enhanced ultrasonography (CEUS) may play a decisive role and to illustrate important points with typical cases. With the advent of CEUS, the scope of indications for ultrasonography has been dramatically extended, and now includes functional imaging and tissue characterization, which in many cases enable tumor diagnosis without a biopsy. It is virtually impossible to imagine the practice of modern medicine as we know it in high-income countries without the use of imaging, and yet, an estimated two thirds of the global population may receive no such care. Ultrasound imaging with CEUS has the potential to correct this inequity. PMID:26867761

Colour Doppler and microbubble contrast agent ultrasonography do not improve cancer detection rate in transrectal systematic prostate biopsy sampling.

PubMed

Taverna, Gianluigi; Morandi, Giovanni; Seveso, Mauro; Giusti, Guido; Benetti, Alessio; Colombo, Piergiuseppe; Minuti, Francesco; Grizzi, Fabio; Graziotti, Pierpaolo

2011-12-01

What's known on the subject? and What does the study add? Transrectal gray-scale ultrasonography guided prostate biopsy sampling is the method for diagnosing prostate cancer (PC) in patients with an increased prostate specific antigen level and/or abnormal digital rectal examination. Several imaging strategies have been proposed to optimize the diagnostic value of biopsy sampling, although at the first biopsy nearly 10-30% of PC still remains undiagnosed. This study compares the PC detection rate when employing Colour Doppler ultransongraphy with or without the injection of SonoVue™ microbubble contrast agent, versus the transrectal ultrasongraphy-guided systematic biopsy sampling. The limited accuracy, sensitivity, specificity and the additional cost of using the contrast agent do not justify its routine application in PC detection. • To compare prostate cancer (PC) detection rate employing colour Doppler ultrasonography with or without SonoVue™ contrast agent with transrectal ultrasonography-guided systematic biopsy sampling. • A total of 300 patients with negative digital rectal examination and transrectal grey-scale ultrasonography, with PSA values ranging between 2.5 and 9.9 ng/mL, were randomized into three groups: 100 patients (group A) underwent transrectal ultrasonography-guided systematic bioptic sampling; 100 patients (group B) underwent colour Doppler ultrasonography, and 100 patients (group C) underwent colour Doppler ultrasonography before and during the injection of SonoVue™. • Contrast-enhanced targeted biopsies were sampled into hypervascularized areas of peripheral, transitional, apical or anterior prostate zones. • All the patients included in Groups B and C underwent a further 13 systematic prostate biopsies. The cancer detection rate was calculated for each group. • In 88 (29.3%) patients a histological diagnosis of PC was made, whereas 22 (7.4%) patients were diagnosed with high-grade prostatic intraepithelial

Accuracy of Physical Examination, Ultrasonography, and Mammography in Predicting Residual Pathologic Tumor Size in Patients Treated With Neoadjuvant Chemotherapy

PubMed Central

Chagpar, Anees B.; Middleton, Lavinia P.; Sahin, Aysegul A.; Dempsey, Peter; Buzdar, Aman U.; Mirza, Attiqa N.; Ames, Fredrick C.; Babiera, Gildy V.; Feig, Barry W.; Hunt, Kelly K.; Kuerer, Henry M.; Meric-Bernstam, Funda; Ross, Merrick I.; Singletary, S Eva

2006-01-01

Objective: To assess the accuracy of physical examination, ultrasonography, and mammography in predicting residual size of breast tumors following neoadjuvant chemotherapy. Background: Neoadjuvant chemotherapy is an accepted part of the management of stage II and III breast cancer. Accurate prediction of residual pathologic tumor size after neoadjuvant chemotherapy is critical in guiding surgical therapy. Although physical examination, ultrasonography, and mammography have all been used to predict residual tumor size, there have been conflicting reports about the accuracy of these methods in the neoadjuvant setting. Methods: We reviewed the records of 189 patients who participated in 1 of 2 protocols using doxorubicin-containing neoadjuvant chemotherapy, and who had assessment by physical examination, ultrasonography, and/or mammography no more than 60 days before their surgical resection. Size correlations were performed using Spearman rho analysis. Clinical and pathologic measurements were also compared categorically using the weighted kappa statistic. Results: Size estimates by physical examination, ultrasonography, and mammography were only moderately correlated with residual pathologic tumor size after neoadjuvant chemotherapy (correlation coefficients: 0.42, 0.42, and 0.41, respectively), with an accuracy of ±1 cm in 66% of patients by physical examination, 75% by ultrasonography, and 70% by mammography. Kappa values (0.24–0.35) indicated poor agreement between clinical and pathologic measurements. Conclusion: Physical examination, ultrasonography, and mammography were only moderately useful for predicting residual pathologic tumor size after neoadjuvant chemotherapy. PMID:16432360

Effectiveness of disinfectant wipes for decontamination of bacteria on patients' environmental and medical equipment surfaces at Siriraj Hospital.

PubMed

Seenama, Chakkraphong; Tachasirinugune, Peenithi; Jintanothaitavorn, Duangporn; Kachintorn, Kanchana; Thamlikitkul, Visanu

2013-02-01

To determine the effectiveness of Virusolve+ disinfectant wipes and PAL disinfectant wipes for decontamination of inoculated bacteria on patients' environmental and medical equipment surfaces at Siriraj Hospital. Tryptic soy broths containing MRSA and XDR A. baumannii were painted onto the surfaces of patient's stainless steel bed rail, patient's fiber footboard, control panel of infusion pump machine and control panel of respirator. The contaminated surfaces were cleaned by either tap water, tap water containing detergent, Virusolve+ disinfectant wipes or PAL disinfectant wipes. The surfaces without any cleaning procedures served as the control surface. The contaminated surfaces cleaned with the aforementioned procedures and control surfaces were swabbed with cotton swabs. The swabs were streaked on agar plates to determine the presence of MRSA and XDR A. baumannii. MRSA and XDR A. baumannii were recovered from all control surfaces. All surfaces cleaned with tap water or tap water containing detergent revealed presence of both MRSA and XDR A. baumannii. However the amounts of bacteria on the surfaces cleaned with tap water containing detergent were less than those cleaned with tap water alone. All surfaces cleaned with PAL disinfectant wipes also revealed presence of both MRSA and XDR A. baumannii. However the amounts of bacteria on the surfaces cleaned with PAL disinfectant wipes were less than those cleaned with tap water containing detergent. No bacteria were recovered from all surfaces cleaned with Virusolve+ disinfectant wipes. Virusolve+ disinfectant wipes were more effective than tap water; tap water containing detergent and PAL disinfectant wipes for decontamination of bacteria inoculated on patients environmental and medical equipment surfaces at Siriraj Hospital.

Screening Performance Characteristic of Ultrasonography and Radiography in Detection of Pleural Effusion; a Meta-Analysis.

PubMed

Yousefifard, Mahmoud; Baikpour, Masoud; Ghelichkhani, Parisa; Asady, Hadi; Shahsavari Nia, Kavous; Moghadas Jafari, Ali; Hosseini, Mostafa; Safari, Saeed

2016-01-01

The role of ultrasonography in detection of pleural effusion has long been a subject of interest but controversial results have been reported. Accordingly, this study aims to conduct a systematic review of the available literature on diagnostic value of ultrasonography and radiography in detection of pleural effusion through a meta-analytic approach. An extended search was done in databases of Medline, EMBASE, ISI Web of Knowledge, Scopus, Cochrane Library, and ProQuest. Two reviewers independently extracted the data and assessed the quality of the articles. Meta-analysis was performed using a mixed-effects binary regression model. Finally, subgroup analysis was carried out in order to find the sources of heterogeneity between the included studies. 12 studies were included in this meta-analysis (1554 subjects, 58.6% male). Pooled sensitivity of ultrasonography in detection of pleural effusion was 0.94 (95% CI: 0.88-0.97; I2= 84.23, p<0.001) and its pooled specificity was calculated to be 0.98 (95% CI: 0.92-1.0; I2= 88.65, p<0.001), while sensitivity and specificity of chest radiography were 0.51 (95% CI: 0.33-0.68; I2= 91.76, p<0.001) and 0.91 (95% CI: 0.68-0.98; I2= 92.86, p<0.001), respectively. Sensitivity of ultrasonography was found to be higher when the procedure was carried out by an intensivist or a radiologist using 5-10 MHz transducers. Chest ultrasonography, as a screening tool, has a higher diagnostic accuracy in identification of plural effusion compared to radiography. The sensitivity of this imaging modality was found to be higher when performed by a radiologist or an intensivist and using 5-10MHz probes.

Postnatal Brain Growth Assessed by Sequential Cranial Ultrasonography in Infants Born <30 Weeks' Gestational Age.

PubMed

Cuzzilla, R; Spittle, A J; Lee, K J; Rogerson, S; Cowan, F M; Doyle, L W; Cheong, J L Y

2018-06-01

Brain growth in the early postnatal period following preterm birth has not been well described. This study of infants born at <30 weeks' gestational age and without major brain injury aimed to accomplish the following: 1) assess the reproducibility of linear measures made from cranial ultrasonography, 2) evaluate brain growth using sequential cranial ultrasonography linear measures from birth to term-equivalent age, and 3) explore perinatal predictors of postnatal brain growth. Participants comprised 144 infants born at <30 weeks' gestational age at a single center between January 2011 and December 2013. Infants with major brain injury seen on cranial ultrasonography or congenital or chromosomal abnormalities were excluded. Brain tissue and fluid spaces were measured from cranial ultrasonography performed as part of routine clinical care. Brain growth was assessed in 3 time intervals: <7, 7-27, and >27 days' postnatal age. Data were analyzed using intraclass correlation coefficients and mixed-effects regression. A total of 429 scans were assessed for 144 infants. Several linear measures showed excellent reproducibility. All measures of brain tissue increased with postnatal age, except for the biparietal diameter, which decreased within the first postnatal week and increased thereafter. Gestational age of ≥28 weeks at birth was associated with slower growth of the biparietal diameter and ventricular width compared with gestational age of <28 weeks. Postnatal corticosteroid administration was associated with slower growth of the corpus callosum length, transcerebellar diameter, and vermis height. Sepsis and necrotizing enterocolitis were associated with slower growth of the transcerebellar diameter. Postnatal brain growth in infants born at <30 weeks' gestational age can be evaluated using sequential linear measures made from routine cranial ultrasonography and is associated with perinatal predictors of long-term development. © 2018 by American Journal of

B-Flow Imaging in Lower Limb Peripheral Arterial Disease and Bypass Graft Ultrasonography.

PubMed

D'Abate, Fabrizio; Ramachandran, Veni; Young, Mark A; Farrah, John; Ahmed, Mudasar H; Jones, Keith; Hinchliffe, Robert J

2016-09-01

Doppler ultrasonography plays a key role in the diagnosis of peripheral arterial disease, but is often limited by pitfalls that may be overcome by B-flow imaging. Thus far, there is little information on B-flow imaging for the assessment of peripheral arterial disease and bypass grafts in lower limbs. This article describes the authors' early experience with B-flow in the lower extremities. Sixty patients were included among a large cohort of patients routinely referred to the vascular laboratory for peripheral arterial disease and bypass graft assessments. Two experienced vascular sonographers performed all scans, comparing color Doppler ultrasonography with B-flow imaging. All scans were performed using a combination of the 9 L linear and C2-9 curvilinear transducers with the LOGIQ E9 system (GE Healthcare, Waukesha, WI, USA). Our experience indicates that this relatively unexplored technology has the potential to significantly improve peripheral blood flow evaluation. Nevertheless, B-flow imaging is not exempt from limitations and should be considered complementary to color Doppler ultrasonography. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Intrarater reliability of measuring the patella position by ultrasonography in weight-bearing condition.

PubMed

Chen, Chia Lin; Lo, Chu Ling; Huang, Kai Chu; Huang, Chen Fu

2017-10-01

[Purpose] The aim of this study was to determine the intrarater reliability of using ultrasonography as a measurement tool to assess the patella position in a weight-bearing condition. [Subjects and Methods] Ten healthy adults participated in this study. Ultrasonography was used to assess the patella position during step down with the loading knee in flexion (0° and 20°). The distance between the patella and lateral condyle was measured to represent the patella position on the condylar groove. Two measurements were obtained on the first day and the day after 1 week by the same investigator. [Results] Excellent intrarater reliability, ranging from 0.83 to 0.93, was shown in both conditions. Standard errors of the measurements were 0.5 mm in the straight knee and 0.7 mm in the knee flexion at 20°. Minimal differences in knee flexion at 0° and knee flexion at 20° were 1.5 mm and 1.9 mm, respectively. [Conclusion] Ultrasonography is a reliable assessment tool for evaluating the positional changes of the patella in weight-bearing activities, and it can be easily used by practitioners in the clinical setting.

Medical Issues: Breathing

MedlinePlus

... Funding Opportunities Research Conference Recruit for Clinical Trials Research Publications Spinraza Support & Care For Newly Diagnosed Care Packages Information Packets Equipment Pool Living With SMA Medical Issues Palliative Breathing Orthopedics Nutrition Equipment Daily Life At School At Home ...

Medical Issues: Nutrition

MedlinePlus

... Funding Opportunities Research Conference Recruit for Clinical Trials Research Publications Spinraza Support & Care For Newly Diagnosed Care Packages Information Packets Equipment Pool Living With SMA Medical Issues Palliative Breathing Orthopedics Nutrition Equipment Daily Life At School At Home ...

Medical Device Guidebook: A browser information resource for medical device users.

PubMed

Clarkson, Douglas M

2017-03-01

A web based information resource - the 'Medical Device Guidebook' - for the enabling of safe use of medical devices is described. Medical devices are described within a 'catalogue' of specific models and information on a specific model is provided within a consistent set of information 'keys'. These include 'user manuals', 'points of caution', 'clinical use framework', 'training/assessment material', 'frequently asked questions', 'authorised user comments' and 'consumables'. The system allows identification of known risk/hazards associated with specific devices, triggered, for example, by national alerts or locally raised safety observations. This provides a mechanism for more effective briefing of equipment users on the associated hazards of equipment. A feature of the system is the inclusion of a specific 'Operational Procedure' for each device, where the lack of this focus is shown in the literature to often be a key factor in equipment misuse and associated patient injury. The 'Guidebook' provides a mechanism for the development of an information resource developed within local clinical networks and encourages a consistent approach to medical device use. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

University of Kansas Medical center Cancer Research Equipment Award Type: Construction Grant

DOE Office of Scientific and Technical Information (OSTI.GOV)

Caldwell, Jamie

A major mechanism to strengthen the overall cancer focus of KUCC and expand specific research programs is through targeted recruitment of additional cancer researchers to increase the national and international status of the Cancer Center, enhance the number of NCI/cancer-related grants, fill critical research needs, and enable new collaborative projects. Over the last five years KUCC has demonstrated the ability to recruit nationally recognized basic, translational and clinical scientists to fill key leadership positions and strengthen our research programs. These researchers require new and renovated research facilities require state-of-the-art laboratory equipment. This includes standard equipment for the renovated laboratories andmore » more specialized equipment as part of new investigator start-up packages. This funding is used to support recruitment, facilities, equipment, shared resources, administration, and patient care services. KUCC is committed to recruiting additional cancer researchers to increase the national and international status of the Cancer Center, enhance the number of NCI/cancer-related grants, fill critical research positions and build the four cancer research programs. Each purposeful hire aims to further the scientific vision, mission, and goals of the Cancer Center research programs. The funds requested will be used to supplement the recruitment packages of future cancer center recruits primarily through purchase of key equipment items.« less

Characterization of the biliary tract by virtual ultrasonography constructed by gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging.

PubMed

Koizumi, Yohei; Hirooka, Masashi; Ochi, Hironori; Tokumoto, Yoshio; Takechi, Megumi; Hiraoka, Atsushi; Ikeda, Yoshio; Kumagi, Teru; Matsuura, Bunzo; Abe, Masanori; Hiasa, Yoichi

2015-04-01

This study aimed at prospectively evaluating bile duct anatomy on ultrasonography and evaluating the safety and utility of radiofrequency ablation (RFA) assisted by virtual ultrasonography from gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI). The institutional review board approved this study, and patients provided written informed consent prior to entry into the study. Bile duct anatomy was assessed in 201 patients who underwent Gd-EOB-DTPA-enhanced MRI for the evaluation of hepatic tumor. Eighty-one of these patients subsequently underwent RFA assisted by ultrasound imaging. In 23 patients, the tumor was located within 5 mm of the central bile duct, as demonstrated by MRI. Virtual ultrasonography constructed by Gd-EOB-enhanced MRI was able to visualize the common bile duct, left hepatic duct, and right hepatic duct in 96.5, 94.0, and 89.6 % of cases, respectively. The target hepatic tumor nodule and biliary duct could be detected with virtual ultrasonography in all patients, and no severe complications occurred. The running pattern of the bile ducts could be recognized on conventional ultrasound by referencing virtual ultrasonography constructed by Gd-EOB-DTPA-enhanced MRI. RFA assisted by this imaging strategy did not result in bile duct injury.

Medical technology advances from space research.

NASA Technical Reports Server (NTRS)

Pool, S. L.

1971-01-01

NASA-sponsored medical R & D programs for space applications are reviewed with particular attention to the benefits of these programs to earthbound medical services and to the general public. Notable among the results of these NASA programs is an integrated medical laboratory equipped with numerous advanced systems such as digital biotelemetry and automatic visual field mapping systems, sponge electrode caps for electroencephalograms, and sophisticated respiratory analysis equipment.

Medical technology advances from space research

NASA Technical Reports Server (NTRS)

Pool, S. L.

1972-01-01

Details of medical research and development programs, particularly an integrated medical laboratory, as derived from space technology are given. The program covers digital biotelemetry systems, automatic visual field mapping equipment, sponge electrode caps for clinical electroencephalograms, and advanced respiratory analysis equipment. The possibility of using the medical laboratory in ground based remote areas and regional health care facilities, as well as long duration space missions is discussed.

Comparison of radiography and ultrasonography for diagnosing small-intestinal mechanical obstruction in vomiting dogs.

PubMed

Sharma, Ajay; Thompson, Margret S; Scrivani, Peter V; Dykes, Nathan L; Yeager, Amy E; Freer, Sean R; Erb, Hollis N

2011-01-01

A cross-sectional study was performed on acutely vomiting dogs to compare the accuracy of radiography and ultrasonography for the diagnosis of small-intestinal mechanical obstruction and to describe several radiographic and ultrasonographic signs to identify their contribution to the final diagnosis. The sample population consisted of 82 adult dogs and small-intestinal obstruction by foreign body was confirmed in 27/82 (33%) dogs by surgery or necropsy. Radiography produced a definitive result (obstructed or not obstructed) in 58/82 (70%) of dogs; ultrasonography produced a definitive result in 80/82 (97%) of dogs. On radiographs, a diagnosis of obstruction was based on detection of segmental small-intestinal dilatation, plication, or detection of a foreign body. Approximately 30% (8/27) of obstructed dogs did not have radiographic signs of segmental small-intestinal dilatation, of which 50% (4/8) were due to linear foreign bodies. The ultrasonographic diagnosis of small-intestinal obstruction was based on detection of an obstructive lesion, sonographic signs of plication or segmental, small-intestinal dilatation. The ultrasonographic presence or absence of moderate-to-severe intestinal diameter enlargement (due to lumen dilatation) of the jejunum (>1.5 cm) was a useful discriminatory finding and, when present, should prompt a thorough search for a cause of small-intestinal obstruction. In conclusion, both abdominal radiography and abdominal ultrasonography are accurate for diagnosing small-intestinal obstruction in vomiting dogs and either may be used depending on availability and examiner choice. Abdominal ultrasonography had greater accuracy, fewer equivocal results and provided greater diagnostic confidence compared with radiography. © 2010 Veterinary Radiology & Ultrasound.

Cardiac ultrasonography over 4G wireless networks using a tele-operated robot

PubMed Central

Panayides, Andreas S.; Jossif, Antonis P.; Christoforou, Eftychios G.; Vieyres, Pierre; Novales, Cyril; Voskarides, Sotos; Pattichis, Constantinos S.

2016-01-01

This Letter proposes an end-to-end mobile tele-echography platform using a portable robot for remote cardiac ultrasonography. Performance evaluation investigates the capacity of long-term evolution (LTE) wireless networks to facilitate responsive robot tele-manipulation and real-time ultrasound video streaming that qualifies for clinical practice. Within this context, a thorough video coding standards comparison for cardiac ultrasound applications is performed, using a data set of ten ultrasound videos. Both objective and subjective (clinical) video quality assessment demonstrate that H.264/AVC and high efficiency video coding standards can achieve diagnostically-lossless video quality at bitrates well within the LTE supported data rates. Most importantly, reduced latencies experienced throughout the live tele-echography sessions allow the medical expert to remotely operate the robot in a responsive manner, using the wirelessly communicated cardiac ultrasound video to reach a diagnosis. Based on preliminary results documented in this Letter, the proposed robotised tele-echography platform can provide for reliable, remote diagnosis, achieving comparable quality of experience levels with in-hospital ultrasound examinations. PMID:27733929

Transthoracic ultrasonography for the immunocompromised patient. A pilot project that introduces transthoracic ultrasonography for the follow-up of hematological patients in Romania.

PubMed

Frinc, Ioana; Ilies, Petru; Zaharie, Florin; Dima, Delia; Tanase, Alina; Petrov, Ljubomir; Irimie, Alexandru; Berce, Cristian; Lisencu, Cosmin; Berindan-Neagoe, Ioana; Tomuleasa, Ciprian; Bojan, Anca

2017-06-01

In the past decade, there has been significant progress in clinical hematology with the discovery of targeted molecules and thus the achievement of both hematologic and molecular responses. Nevertheless, chemotherapy remains the treatment of choice for many types of hematological malignancies. Aggressive chemotherapy leads to immunosuppression, accompanied by a high rate of infections and an increased rate of treatment-related mortality. Invasive fungal infections as well as more common bacterial and viral infections are frequent in immunocompromised patients as they are difficult to diagnose and treat. Pleuropulmonary infections in immunocompromised patients are diagnosed using clinical examination, imaging and laboratory tests. Many laboratory tests are run for several days before a final result is given and are expensive. Computer tomography is a reliable technique, but it is encumbered by high irradiation and high cost, and can assess lesions larger than 1 cm. Transthoracic ultrasound is a modern method, used in the diagnostic algorithm of pleuropulmonary pathology. It allows the diagnosis of small lesions, can be performed at the patients' bedside, with acceptable costs and no irradiation. A fast, informed and accurate medical decision is essential for a favorable outcome in immunosuppressed patients with an adjacent infection. In the current case series we present the implementation of a new protocol for the follow-up of immunocompromised patients using transthoracic ultrasonography, of great potential use in the clinic.

Comparison of conventional ultrasonography and ultrasonography-computed tomography fusion imaging for target identification using digital/real hybrid phantoms: a preliminary study.

PubMed

Soyama, Takeshi; Sakuhara, Yusuke; Kudo, Kohsuke; Abo, Daisuke; Wang, Jeff; Ito, Yoichi M; Hasegawa, Yu; Shirato, Hiroki

2016-07-01

This preliminary study compared ultrasonography-computed tomography (US-CT) fusion imaging and conventional ultrasonography (US) for accuracy and time required for target identification using a combination of real phantoms and sets of digitally modified computed tomography (CT) images (digital/real hybrid phantoms). In this randomized prospective study, 27 spheres visible on B-mode US were placed at depths of 3.5, 8.5, and 13.5 cm (nine spheres each). All 27 spheres were digitally erased from the CT images, and a radiopaque sphere was digitally placed at each of the 27 locations to create 27 different sets of CT images. Twenty clinicians were instructed to identify the sphere target using US alone and fusion imaging. The accuracy of target identification of the two methods was compared using McNemar's test. The mean time required for target identification and error distances were compared using paired t tests. At all three depths, target identification was more accurate and the mean time required for target identification was significantly less with US-CT fusion imaging than with US alone, and the mean error distances were also shorter with US-CT fusion imaging. US-CT fusion imaging was superior to US alone in terms of accurate and rapid identification of target lesions.

Blood flow in intracranial aneurysms treated with Pipeline embolization devices: computational simulation and verification with Doppler ultrasonography on phantom models

PubMed Central

2015-01-01

Purpose: The aim of this study was to validate a computational fluid dynamics (CFD) simulation of flow-diverter treatment through Doppler ultrasonography measurements in patient-specific models of intracranial bifurcation and side-wall aneurysms. Methods: Computational and physical models of patient-specific bifurcation and sidewall aneurysms were constructed from computed tomography angiography with use of stereolithography, a three-dimensional printing technology. Flow dynamics parameters before and after flow-diverter treatment were measured with pulse-wave and color Doppler ultrasonography, and then compared with CFD simulations. Results: CFD simulations showed drastic flow reduction after flow-diverter treatment in both aneurysms. The mean volume flow rate decreased by 90% and 85% for the bifurcation aneurysm and the side-wall aneurysm, respectively. Velocity contour plots from computer simulations before and after flow diversion closely resembled the patterns obtained by color Doppler ultrasonography. Conclusion: The CFD estimation of flow reduction in aneurysms treated with a flow-diverting stent was verified by Doppler ultrasonography in patient-specific phantom models of bifurcation and side-wall aneurysms. The combination of CFD and ultrasonography may constitute a feasible and reliable technique in studying the treatment of intracranial aneurysms with flow-diverting stents. PMID:25754367

Supplies and equipment for pediatric emergency mass critical care.

PubMed

Bohn, Desmond; Kanter, Robert K; Burns, Jeffrey; Barfield, Wanda D; Kissoon, Niranjan

2011-11-01

Epidemics of acute respiratory disease, such as severe acute respiratory syndrome in 2003, and natural disasters, such as Hurricane Katrina in 2005, have prompted planning in hospitals that offer adult critical care to increase their capacity and equipment inventory for responding to a major demand surge. However, planning at a national, state, or local level to address the particular medical resource needs of children for mass critical care has yet to occur in any coordinated way. This paper presents the consensus opinion of the Task Force regarding supplies and equipment that would be required during a pediatric mass critical care crisis. In May 2008, the Task Force for Mass Critical Care published guidance on provision of mass critical care to adults. Acknowledging that the critical care needs of children during disasters were unaddressed by this effort, a 17-member Steering Committee, assembled by the Oak Ridge Institute for Science and Education with guidance from members of the American Academy of Pediatrics, convened in April 2009 to determine priority topic areas for pediatric emergency mass critical care recommendations.Steering Committee members established subcommittees by topic area and performed literature reviews of MEDLINE and Ovid databases. The Steering Committee produced draft outlines through consensus-based study of the literature and convened October 6-7, 2009, in New York, NY, to review and revise each outline. Eight draft documents were subsequently developed from the revised outlines as well as through searches of MEDLINE updated through March 2010.The Pediatric Emergency Mass Critical Care Task Force, composed of 36 experts from diverse public health, medical, and disaster response fields, convened in Atlanta, GA, on March 29-30, 2010. Feedback on each manuscript was compiled and the Steering Committee revised each document to reflect expert input in addition to the most current medical literature. The Task Force endorsed the view that

A comparison between intrastomal 3D ultrasonography, CT scanning and findings at surgery in patients with stomal complaints.

PubMed

Näsvall, P; Wikner, F; Gunnarsson, U; Rutegård, J; Strigård, K

2014-10-01

Since there are no reliable investigative tools for imaging parastomal hernia, new techniques are needed. The aim of this study was to assess the validity of intrastomal three-dimensional ultrasonography (3D) as an alternative to CT scanning for the assessment of stomal complaints. Twenty patients with stomal complaints, indicating surgery, were examined preoperatively with a CT scan in the supine position and 3D intrastomal ultrasonography in the supine and erect positions. Comparison with findings at surgery, considered to be the true state, was made. Both imaging methods, 3D ultrasonography and CT scanning, showed high sensitivity (ultrasound 15/18, CT scan 15/18) and specificity (ultrasound 2/2, CT scan 1/2) when judged by a dedicated radiologist. Corresponding values for interpretation of CT scans in routine clinical practice was for sensitivity 17/18 and for specificity 1/2. 3D ultrasonography has a high validity and is a promising alternative to CT scanning in the supine position to distinguish a bulge from a parastomal hernia.

Pattern analysis of nerve enlargement using ultrasonography in chronic inflammatory demyelinating polyneuropathy.

PubMed

Jang, Jae Hong; Cho, Charles S; Yang, Kyung-Sook; Seok, Hung Youl; Kim, Byung-Jo

2014-09-01

Focal nerve enlargement is a characteristic finding in chronic inflammatory demyelinating polyneuropathy (CIDP). We performed this study to assess the distribution of nerve enlargement through ultrasonographic examination of peripheral nerves and to correlate the ultrasonographic findings with clinical features. To compare the ultrasonographic features of 10 subjects with CIDP with those of 18 healthy controls, we bilaterally measured the cross-sectional areas (CSA) of the vagus, brachial plexus, musculocutaneous, median, ulnar, radial, sciatic, tibial, common peroneal, and sural nerves. We also analyzed correlations between CSAs and various clinical and electrophysiological features. Mean CSAs were significantly larger in CIDP patients than controls, especially at proximal and non-entrapment sites. CSAs were significantly correlated with muscle strength at initial presentation, but not at the time of ultrasonography. The CSAs of the median and ulnar nerves at the mid-forearm, tibial nerve at 7 cm proximal to the medial malleolus, and sural nerve correlated with the nerve conduction velocity of the corresponding region. Ultrasonography revealed widely distributed nerve enlargement, especially in proximal regions and non-entrapment sites, in patients with CIDP compared with healthy controls. Nerve enlargement correlated well with the electrophysiologic function of the nerve, but not current clinical status. Pattern analysis of nerve enlargement using ultrasonography is a supportive tool in the diagnosis of CIDP. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Comparison of Ultrasonography-Guided Central Venous Catheterization Between Adult and Pediatric Populations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tercan, Fahri; Oguzkurt, Levent; Ozkan, Ugur

2008-05-15

The purpose of this study was to compare the technical success and complication rates of ultrasonography-guided central venous catheterization between adult and pediatric patients which have not been reported previously. In a 4-year period, 859 ultrasonography-guided central vein catheterizations in 688 adult patients and 247 catheterizations in 156 pediatric patients were retrospectively evaluated. Mean age was 56.3 years (range, 18 to 95 years) for adults and 3.3 years (range, 0.1 to 16.3 years) for children. The preferred catheterization site was internal jugular vein in 97% of adults and 85% of children. The technical success rate, mean number of punctures, andmore » rate of single wall puncture were 99.4%, 1.04 (range, 1-3), and 83% for adults and 90.3%, 1.25 (range, 1-5), and 49% for children, respectively. All the differences were statistically significant (p < 0.05). Complication rates were 2.3% and 2.4% for adults and children, respectively (p > 0.05). Major complications such as pneumothorax and hemothorax were not seen in any group. In conclusion, ultrasonography-guided central venous catheterization has a high technical success rate, lower puncture attempt rate, and higher single wall puncture rate in adults compared to children. Complication rates are comparable in the two groups.« less

Impact on Clinical Management of After-Hours Emergent or Urgent Breast Ultrasonography in Patients with Clinically Suspected Breast Abscesses

PubMed Central

Moseley, Tanya W.; Stanley, Ashley; Wei, Wei; Parikh, Jay R.

2018-01-01

Newly diagnosed breast abscesses are generally treated as a medical emergency that may necessitate immediate interventional treatment. At our institution, there is no in-house after-hours coverage for breast ultrasonography. We could find no peer-reviewed studies on the cost-effectiveness or clinical management impact of on-call ultrasound technologist coverage for imaging of breast abscesses. The purposes of this study were to determine the incidence of breast abscess in patients with clinical findings highly suggestive of abscess, identify clinical factors associated with breast abscess in such patients, and determine the impact of after-hours emergent or urgent breast ultrasonography on the clinical management of breast abscesses in both outpatients and inpatients. We retrospectively reviewed 100 after-hours breast ultrasound studies performed at our tertiary care center from 2011 to 2015 for evaluation of a suspected breast abscess. Only 26% of our patients with clinically suspected abscess ultimately had a confirmed abscess. Factors associated with breast abscess were a palpable abnormality and a history of breast surgery within the eight weeks before presentation. After-hours diagnosis of an abscess was associated with after-hours clinical intervention. Of the 74 patients in whom after-hours ultrasound imaging showed no evidence of abscess, only three patients underwent after-hours drainage. Our findings support overnight and weekend breast ultrasound coverage in large tertiary care centers. PMID:29473859

Comprasion of ovarian stromal blood flow measured by color Doppler ultrasonography in polycystic ovary syndrome patients and healthy women with ultrasonographic evidence of polycystic.

PubMed

Ozdemir, Ozhan; Sari, Mustafa Erkan; Kalkan, Dilek; Koc, Esra Meltem; Ozdemir, Seyda; Atalay, Cemal Resat

2015-04-01

To compare ovarian stromal artery blood flows measured by Doppler ultrasonography of polycystic ovary syndrome (PCOS) patients and healthy women with polycystic ovarian image in ultrasonography. Forty-two patients diagnosed with PCOS according to the criteria of 2003 Rotterdam Concencus Conferance on PCOS and 38 healthy volunteers with polycystic ovarian image in ultrasonography were included in the study. Ovarian volumes and ovarian stromal artery blood flows were measured by 3-dimensional (3-D) ultrasonography and Doppler ultrasonography in all patients. In patients with PCOS, ovarian stromal artery pulsatility index (PI) and resistivity index (RI) were found significantly different from healthy women with polycystic ovarian image in ultrasonography (p < 0.05). 3-D ovarian volumes were found significantly higher in patients with PCOS (p < 0.05), and a negative correlation was also obtained between ovarian volumes and ovarian stromal artery resistivity indices. Ovarian stromal artery Doppler examination could have an importance to explain the pathophysiology of PCOS, but there are few publications in the literature about PCOS and the details of ovarian stromal artery Doppler parameters in patients with polycystic ovarian image only. We conclude that Doppler ultrasonography findings of PCOS patients might be helpful in understanding the clinical follow-up and etiology of the disease.

Accurate evaluation of axillary sentinel lymph node metastasis using contrast-enhanced ultrasonography with Sonazoid in breast cancer: a preliminary clinical trial.

PubMed

Matsuzawa, Fumihiko; Omoto, Kiyoka; Einama, Takahiro; Abe, Hironori; Suzuki, Takashi; Hamaguchi, Jun; Kaga, Terumi; Sato, Mami; Oomura, Masako; Takata, Yumiko; Fujibe, Ayako; Takeda, Chie; Tamura, Etsuya; Taketomi, Akinobu; Kyuno, Kenichi

2015-01-01

Breast cancer is the most common type of cancer in women. The 5-year survival rate in patients with breast cancer ranges from 74 to 82 %. Sentinel lymph node biopsy has become an alternative to axillary lymph node dissection for nodal staging. We evaluated the detection of the sentinel lymph node and metastasis of the lymph node using contrast enhanced ultrasonography with Sonazoid. Between December 2013 and May 2014, 32 patients with operable breast cancer were enrolled in this study. We evaluated the detection of axillary sentinel lymph nodes and the evaluation of axillary lymph nodes metastasis using contrast enhanced computed tomography, color Doppler ultrasonography and contrast enhanced ultrasonography with Sonazoid. All the sentinel lymph nodes were identified, and the sentinel lymph nodes detected by contrast enhanced ultrasonography with Sonazoid corresponded with those detected by computed tomography lymphography and indigo carmine method. The detection of metastasis based on contrast enhanced computed tomography were sensitivity 20.0 %, specificity 88.2 %, PPV 60.0 %, NPV 55.6 %, accuracy 56.3 %. Based on color Doppler ultrasonography, the results were sensitivity 36.4 %, specificity 95.2 %, PPV 80.0 %, NPV 74.1 %, accuracy 75.0 %. Based on contrast enhanced ultrasonography with Sonazoid, the results were sensitivity 81.8 %, specificity 95.2 %, PPV 90.0 %, NPV 90.9 %, accuracy 90.6 %. The results suggested that contrast enhanced ultrasonography with Sonazoid was the most accurate among the evaluations of these modalities. In the future, we believe that our method would take the place of conventional sentinel lymph node biopsy for an axillary staging method.

The value of ultrasonography alone in screening surveys of cystic echinococcosis in children in Turkey.

PubMed

Kilimcioğlu, Ali A; Ozkol, Mine; Bayindir, Petek; Girginkardeşler, Nogay; Ostan, Ipek; Ok, Ulgen Z

2006-12-01

A total of 1,205 primary school children were examined for cystic echinococcosis in five villages of Manisa, Turkey, to evaluate the efficacy of diagnostic methods of this infection in community-based screening surveys. Six hundred and thirty children from three villages, examined by a portable ultrasound scanner, chest microfilm and serological methods (ELISA, indirect hemagglutination) in our previous study, were designated as Study Group 1; and 575 children, from two adjacent villages, examined by ultrasonography alone in the present study, were designated as Study Group 2. In Study Group 1, hepatic cystic echinococcosis was detected in two cases (0.3%) by ultrasonography, while 43 (8.9%) and 49 (10.1%) cases were found to be positive for cystic echinococcosis by ELISA and indirect hemagglutination, respectively. Three of 575 children (0.5%) were diagnosed with cystic echinococcosis (two hepatic and one renal involvement) by ultrasonography alone in Study Group 2; and lung lesions were later detected in both cases with liver involvement by chest radiography. Our results suggested that serological tests may be beneficial in suspected cases for confirmation and differential diagnosis, but have some drawbacks, such as discrepancy in results and high false seropositivity rates. Chest microfilm is not easy in field studies and exposure to X-ray is undesirable. As a reliable, simple, inexpensive and rapid technique, ultrasonography alone is recommended to be used in community-based screening surveys for cystic echinococcosis with confirmatory tests for suspected cases found during the screening program.

Assessment of ultrasonography and computed tomography for the evaluation of unilateral orbital disease in dogs.

PubMed

Boroffka, Susanne A E B; Verbruggen, Anne-Marie; Grinwis, Guy C M; Voorhout, George; Barthez, Paul Y

2007-03-01

To describe clinical, ultrasonographic, and computed tomographic (CT) features of confirmed neoplastic and nonneoplastic disease in dogs with unilateral orbital diseases, determine criteria to differentiate between the 2 conditions, and assess the relative value of ultrasonography and CT for the differential diagnosis of these 2 conditions. Prospective study. 29 dogs with unilateral neoplastic orbital disease and 16 dogs with unilateral nonneoplastic orbital disease. Clinical history and results of physical and ophthalmologic examinations were recorded. Ultrasonographic and CT images were evaluated, and discriminating factors were identified to differentiate neoplastic from nonneoplastic diseases. Diagnostic value of ultrasonography and CT was assessed. Dogs with neoplastic disease were significantly older; had clinical signs for a longer time before initial examination; had more progressive onset of clinical signs; and more frequently had protrusion of the nictitating membrane, fever, and anorexia. The most discriminating factor for both imaging modalities was delineation of the margins (odds ratio was 41.7 for ultrasonography and 45 for CT), with neoplastic lesions clearly delineated more often. Ultrasonographically, neoplastic lesions were more frequently hypoechoic and homogeneous, with indentation of the globe and bone involvement evident more frequently than for nonneoplastic lesions. Mineralization was detected only with neoplasia. Fluctuant fluid was seen more frequently in dogs with nonneoplastic disease. Computed tomography more frequently revealed extraorbital involvement. Diagnostic value was similar for both imaging modalities. Ultrasonography and CT are valuable imaging modalities to assist in differentiating neoplastic from nonneoplastic unilateral orbital disease in dogs.

Practical application of color Doppler ultrasonography in patients with ejaculatory dysfunction.

PubMed

Hara, Ryoei; Nagai, Atsushi; Fujii, Tomohiro; Fukumoto, Kazuhiko; Ohira, Shin; Jo, Yoshimasa; Yokoyama, Teruhiko; Miyaji, Yoshiyuki

2015-06-01

We describe two cases in which dynamic analysis of ejaculation using color Doppler ultrasonography was useful in diagnosis of ejaculatory dysfunction and planning of therapy. The first patient was a 32-year-old man with a diagnosis of retrograde ejaculation. A bladder neck collagen injection was carried out, as the main cause was thought to be the bladder neck remaining open during ejaculation. The patient had antegrade ejaculation 1 week later. The second patient was a 48-year-old man with a diagnosis of anorgasmia accompanied by decreased seminal emission and insufficient function of the rhythmic pelvic striated muscles. The patient was prescribed etilefrine hydrochloride 15 mg/day. The symptom improved 2 weeks after starting this drug. These cases suggest that the use of color Doppler ultrasonography during ejaculation can improve the understanding of ejaculatory dysfunction and therapy for this condition. © 2015 The Japanese Urological Association.

21 CFR 870.4200 - Cardiopulmonary bypass accessory equipment.

Code of Federal Regulations, 2014 CFR

2014-04-01

... SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4200... mounting bracket or system-priming equipment. (b) Classification. (1) Class I. The device is classified as...

21 CFR 870.4200 - Cardiopulmonary bypass accessory equipment.

Code of Federal Regulations, 2012 CFR

2012-04-01

... SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4200... mounting bracket or system-priming equipment. (b) Classification. (1) Class I. The device is classified as...

21 CFR 870.4200 - Cardiopulmonary bypass accessory equipment.

Code of Federal Regulations, 2013 CFR

2013-04-01

... SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Surgical Devices § 870.4200... mounting bracket or system-priming equipment. (b) Classification. (1) Class I. The device is classified as...

Enteral nutrition tube placement assisted by ultrasonography in patients with severe acute pancreatitis

PubMed Central

Li, Gang; Pan, Yiyuan; Zhou, Jing; Tong, Zhihui; Ke, Lu; Li, Weiqin

2017-01-01

Abstract To evaluate the effect of a novel procedure using real-time ultrasonography to assist nasojejunal tube placement at bedside in patients with severe acute pancreatitis (SAP). Single center, prospective descriptive study in a 15-bed surgery intensive care unit of a university hospital. Thirty SAP patients were enrolled. The whole procedure of placing nasojejunal tube was performed by a single physician, who places nasojejunal tube at the bedside and performs ultrasonography to guide the tube positioning. The final nasojejunal tube position was confirmed by abdominal radiograph. The successful rate of the procedure as well as the time it took, the time from the decision of enteral feeding to commencement of feeding, and complications were recorded. Thirty-six intubations were performed in 30 patients by using ultrasonography-assisted method at bedside. Nasojejunal tubes were successful placed in 28 of 30 patients (93.3%). The average time of successful placement was 22.07 ± 5.78 minutes. The median time between physician's decision for tube placement and feeding initiation was 5.5 (2, 24) hours. No adverse events occurred in all of patients. This novel method of nasojejunal tube placement under ultrasound guidance is practical, less time consuming and reliable. PMID:29137035

Situation-Dependent Medical Device Risk Estimation: Design and Evaluation of an Equipment Management Center For Vendor-Independent Integrated Operating Rooms.

PubMed

Maktabi, Marianne; Neumuth, Thomas

2017-12-22

The complexity of surgical interventions and the number of technologies involved are constantly rising. Hospital staff has to learn how to handle new medical devices efficiently. However, if medical device-related incidents occur, the patient treatment is delayed. Patient safety could therefore be supported by an optimized assistance system that helps improve the management of technical equipment by nonmedical hospital staff. We developed a system for the optimal monitoring of networked medical device activity and maintenance requirements, which works in conjunction with a vendor-independent integrated operating room and an accurate surgical intervention Time And Resource Management System. An integrated situation-dependent risk assessment system gives the medical engineers optimal awareness of the medical devices in the operating room. A qualitative and quantitative survey among ten medical engineers from three different hospitals was performed to evaluate the approach. A series of 25 questions was used to evaluate various aspects of our system as well as the system currently used. Moreover, the respondents were asked to perform five tasks related to system supervision and incident handling. Our system received a very positive feedback. The evaluation studies showed that the integration of information, the structured presentation of information, and the assistance modules provide valuable support to medical engineers. An automated operating room monitoring system with an integrated risk assessment and Time And Resource Management System module is a new way to assist the staff being outside of a vendor-independent integrated operating room, who are nevertheless involved in processes in the operating room.

Two-dimensional ultrasonography of the brain: its diagnostic usefullness in herpes simplex encephalitis and cytomegalic inclusion disease.

PubMed

Matsumoto, N; Yano, S; Miyao, M; Kamoshita, S; Itoh, K

1983-01-01

We have used brain ultrasonography in diagnosing and following up two infants, one with herpes simplex encephalitis and the other with cytomegalic inclusion disease. It was found that this technique was very useful to observe the changes of the brain parenchyma such as cystic degeneration and periventricular calcification. Also because it is non-invasive and an easy procedure, ultrasonography can be applied even for infants in critical condition when needed.

Application of Ultrasonography and Radiography in Detection of Hemothorax; a Systematic Review and Meta-Analysis.

PubMed

Rahimi-Movaghar, Vafa; Yousefifard, Mahmoud; Ghelichkhani, Parisa; Baikpour, Masoud; Tafakhori, Abbas; Asady, Hadi; Faridaalaee, Gholamreza; Hosseini, Mostafa; Safari, Saeed

2016-01-01

Hemothorax is one of the most prevalent injuries caused by thoracic traumas. Early detection and treatment of this injury is of utmost importance in prognosis of the patient, but there are still controversial debates on the diagnostic value of imaging techniques in detection of hemothorax. Therefore, the present study aimed to evaluate the diagnostic value of chest ultrasonography and radiography in detection of hemothorax through a systematic review and meta-analysis. Two independent reviewers performed an extended systematic search in databases of Medline, EMBASE, ISI Web of Knowledge, Scopus, Cochrane Library, and ProQuest. Data were extract and quality of the relevant studies were assessed. The number of true positive, false positive, true negative and false negative cases were extracted and screening performance characteristics of two imaging techniques were calculated using a mixed-effects binary regression model. Data from 12 studies were extracted and included in the meta-analysis (7361 patients, 77.1% male). Pooled sensitivity and specificity of ultrasonography in detection of hemothorax were 0.67 (95% CI: 0.41-0.86; I2= 68.38, p<0.001) and 0.99 (95% CI: 0.95-1.0; I2= 88.16, p<0.001), respectively. These measures for radiography were 0.54 (95% CI: 0.33-0.75; I2= 92.85, p<0.001) and 0.99 (95% CI: 0.94-1.0; I2= 99.22, p<0.001), respectively. Subgroup analysis found operator of the ultrasonography device, frequency of the transducer and sample size to be important sources of heterogeneity of included studies. The results of this study showed that although the sensitivity of ultrasonography in detection of hemothorax is relatively higher than radiography, but it is still at a moderate level (0.67%). The specificity of both imaging modalities were found to be at an excellent level in this regard. The screening characteristics of ultrasonography was found to be influenced of the operator and frequency of transducer.

Application of Ultrasonography and Radiography in Detection of Hemothorax; a Systematic Review and Meta-Analysis

PubMed Central

Rahimi-Movaghar, Vafa; Yousefifard, Mahmoud; Ghelichkhani, Parisa; Baikpour, Masoud; Tafakhori, Abbas; Asady, Hadi; Faridaalaee, Gholamreza; Hosseini, Mostafa; Safari, Saeed

2016-01-01

Introduction: Hemothorax is one of the most prevalent injuries caused by thoracic traumas. Early detection and treatment of this injury is of utmost importance in prognosis of the patient, but there are still controversial debates on the diagnostic value of imaging techniques in detection of hemothorax. Therefore, the present study aimed to evaluate the diagnostic value of chest ultrasonography and radiography in detection of hemothorax through a systematic review and meta-analysis. Methods: Two independent reviewers performed an extended systematic search in databases of Medline, EMBASE, ISI Web of Knowledge, Scopus, Cochrane Library, and ProQuest. Data were extract and quality of the relevant studies were assessed. The number of true positive, false positive, true negative and false negative cases were extracted and screening performance characteristics of two imaging techniques were calculated using a mixed-effects binary regression model. Results: Data from 12 studies were extracted and included in the meta-analysis (7361 patients, 77.1% male). Pooled sensitivity and specificity of ultrasonography in detection of hemothorax were 0.67 (95% CI: 0.41-0.86; I2= 68.38, p<0.001) and 0.99 (95% CI: 0.95-1.0; I2= 88.16, p<0.001), respectively. These measures for radiography were 0.54 (95% CI: 0.33-0.75; I2= 92.85, p<0.001) and 0.99 (95% CI: 0.94-1.0; I2= 99.22, p<0.001), respectively. Subgroup analysis found operator of the ultrasonography device, frequency of the transducer and sample size to be important sources of heterogeneity of included studies. Conclusion: The results of this study showed that although the sensitivity of ultrasonography in detection of hemothorax is relatively higher than radiography, but it is still at a moderate level (0.67%). The specificity of both imaging modalities were found to be at an excellent level in this regard. The screening characteristics of ultrasonography was found to be influenced of the operator and frequency of transducer

Testicular volume measurement: comparison of ultrasonography, orchidometry, and water displacement.

PubMed

Sakamoto, Hideo; Saito, Katsuyuki; Oohta, Michiya; Inoue, Katuki; Ogawa, Yoshio; Yoshida, Hideki

2007-01-01

To determine the accuracy of orchidometry and ultrasonography for measuring the testicular volume by comparing the resultant measurements with the actual testicular volume in humans. The testicular volume of 40 testes from 20 patients with prostate cancer (mean age +/- SD 74.5 +/- 7.5 years) was measured using the Prader orchidometer and ultrasonography before therapeutic bilateral orchiectomy. The ultrasound measurements of testicular volume were calculated using three formulas: length (L) x width (W) x height (H) x 0.52, L x W2 x 0.52, and L x W x H x 0.71. The actual testicular volumes were determined by water displacement of the surgical specimen. The mean actual testicular volume of the 40 testes was 9.3 cm3 (range 2.5 to 23.0). A strong correlation was found between the testicular volume calculated by the three ultrasound formulas and the actual volume (r = 0.910 to 0.965, P <0.0001) and was stronger than the correlation with the Prader orchidometer (r = 0.818, P <0.0001). The smallest mean difference from the actual testicular volume was observed with the formula L x W x H x 0.71, which overestimated the actual volume by 0.80 cm3 (7.42%). The measurements using the Prader orchidometer correlated with the actual testicular volume and with the testicular volume calculated using the three ultrasound formulas (r = 0.801 to 0.816, P <0.0001). However, the orchidometer measurements had the largest mean difference from the actual testicular volume (6.68 cm3, 81.7%). The results of this study have shown that measuring the testicular volume by ultrasonography is more accurate than by the Prader orchidometer, and the formula L x W x H x 0.71 was the most accurate for calculating the testicular volume.

75 FR 49506 - Recovery Policy, RP9525.16, Research-Related Equipment and Furnishings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-13

...] Recovery Policy, RP9525.16, Research-Related Equipment and Furnishings AGENCY: Federal Emergency Management... Management Agency (FEMA) is accepting comments on Recovery Policy RP9525.16 Research-related Equipment and... function such as an educational or medical function in order for the facilities, equipment and/or...

Apollo experience report: Crew provisions and equipment subsystem

NASA Technical Reports Server (NTRS)

Mcallister, F.

1972-01-01

A description of the construction and use of crew provisions and equipment subsystem items for the Apollo Program is presented. The subsystem is composed principally of survival equipment, bioinstrumentation devices, medical components and accessories, water- and waste-management equipment, personal-hygiene articles, docking aids, flight garments (excluding the pressure garment assembly), and various other crew-related accessories. Particular attention is given to items and assemblies that presented design, development, or performance problems: the crew optical alinement sight system, the metering water dispenser, and the waste-management system. Changes made in design and materials to improve the fire safety of the hardware are discussed.

Intra-abdominal fat measurement by ultrasonography: association with anthropometry and metabolic syndrome in adolescents.

PubMed

Novais, Rommel L R; Café, Ana Carolina C; Morais, Aisha A; Bila, Wendell C; Santos, Gilson D da S; Lopes, Carlos Alexandre de O; Belo, Vinícius S; Romano, Márcia Christina C; Lamounier, Joel A

2018-04-27

To associate intra-abdominal fat thickness measured by ultrasonography to the factors related to metabolic syndrome and to determine cutoff points of intra-abdominal fat measurement associated with a greater chance of metabolic syndrome in adolescents. This was a cross-sectional study, with 423 adolescents from public schools. Intra-abdominal fat was measured by ultrasonography. Anthropometric data were collected, and biochemical analyses were performed. Intra-abdominal fat was measured by ultrasonography, showing a statistically significant association with the diagnosis of metabolic syndrome (p=0.037), body mass index (p<0.001), elevated triglyceride levels (p=0.012), decreased plasma HDL levels (p=0.034), and increased systemic blood pressure values (p=0.023). Cutoff values of intra-abdominal fat thickness measurements were calculated by ultrasound to estimate the individuals most likely to develop metabolic syndrome. In the logistic regression models, the cutoff values that showed the highest association with metabolic syndrome in males were 4.50, 5.35, 5.46, 6.24, and 6.50cm for the ages of 14, 15, 16, 17, and 18/19 years, respectively. In the female gender, the cutoff values defined for the same age groups were 4.46, 4.55, 4.45, 4.90, and 6.46cm. In an overall analysis using the ROC curve, without gender and age stratification, the cut-off of 3.67cm showed good sensitivity, but low specificity. Ultrasonography is a useful method to estimate intra-abdominal adipose tissue in adolescents, which is associated with the main factors related to obesity and metabolic syndrome. Copyright © 2018 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

38 CFR 17.154 - Dog-guides and equipment for blind.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Dog-guides and equipment... AFFAIRS MEDICAL Prosthetic, Sensory, and Rehabilitative Aids § 17.154 Dog-guides and equipment for blind... disability may be furnished a trained dog-guide. In addition, they may be furnished necessary travel expense...

38 CFR 17.154 - Dog-guides and equipment for blind.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Dog-guides and equipment... AFFAIRS MEDICAL Prosthetic, Sensory, and Rehabilitative Aids § 17.154 Dog-guides and equipment for blind... disability may be furnished a trained dog-guide. In addition, they may be furnished necessary travel expense...

38 CFR 17.154 - Dog-guides and equipment for blind.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Dog-guides and equipment... AFFAIRS MEDICAL Prosthetic, Sensory, and Rehabilitative Aids § 17.154 Dog-guides and equipment for blind... disability may be furnished a trained dog-guide. In addition, they may be furnished necessary travel expense...

Validation of equations for pleural effusion volume estimation by ultrasonography.

PubMed

Hassan, Maged; Rizk, Rana; Essam, Hatem; Abouelnour, Ahmed

2017-12-01

To validate the accuracy of previously published equations that estimate pleural effusion volume using ultrasonography. Only equations using simple measurements were tested. Three measurements were taken at the posterior axillary line for each case with effusion: lateral height of effusion ( H ), distance between collapsed lung and chest wall ( C ) and distance between lung and diaphragm ( D ). Cases whose effusion was aspirated to dryness were included and drained volume was recorded. Intra-class correlation coefficient (ICC) was used to determine the predictive accuracy of five equations against the actual volume of aspirated effusion. 46 cases with effusion were included. The most accurate equation in predicting effusion volume was ( H  +  D ) × 70 (ICC 0.83). The simplest and yet accurate equation was H  × 100 (ICC 0.79). Pleural effusion height measured by ultrasonography gives a reasonable estimate of effusion volume. Incorporating distance between lung base and diaphragm into estimation improves accuracy from 79% with the first method to 83% with the latter.

[Hydrotherapy equipment].

PubMed

Tsibikov, V B; Ragozin, S I; Mikheeva, L V

1985-01-01

A flow-chart is developed demonstrating the relation between medical and prophylactic institutions within the organizational structure of the rehabilitation system and main types of rehabilitation procedures. In order to ascertain the priority in equipping rehabilitation services with adequate hardware the special priority criterion is introduced. The highest priority is assigned to balneotherapeutic and fangotherapeutic services. Based on the operation-by-operation analysis of clinical processes related to service and performance of balneologic procedures the preliminary set of clinical devices designed for baths, basins and showers in hospitals and rehabilitation departments is defined in a generalized form.

The role of transvaginal ultrasonography for detecting ovarian cancer in an asymptomatic screening population: a systematic review.

PubMed

Buhling, Kai J; Lezon, S; Eulenburg, C; Schmalfeldt, B

2017-05-01

The purpose of this study was to systematically analyze the effect of transvaginal ultrasonography in an asymptomatic female population as an annual screening procedure with regard to mortality data. Studies were evaluated descriptively on their strengths and weaknesses considering the methods and results. We evaluated 632 international studies by selecting only randomized controlled trials (RCTs). Three RCTs concerning transvaginal ultrasonography were found, performed in Japan, the USA, and Great Britain. Currently, no clear recommendation for the screening for ovarian cancer in an asymptomatic population can be given based on these three studies. The authors could not show a change in mortality using transvaginal ultrasonography for annual screening. An annual palpation does not offer a beneficial effect. The development of new ultrasound machines with higher image resolution in combination with a well-standardized algorithm for ovarian cancer in upcoming years might provide an improvement regarding mortality. The current studies do not show a benefit in screening an asymptomatic population annually with transvaginal ultrasonography, but the most recent publication showed a trend toward lower mortality in patients who underwent screening after 7-14 years of follow-up. Nevertheless, all three heterogeneous RCTs had weaknesses in their methods and therefore they neither contradict the general recommendation for screening in an asymptomatic population nor do they support it.

Medical technology management: from planning to application.

PubMed

David, Y; Jahnke, E

2005-01-01

Appropriate deployment of technological innovation contributes to improvement in the quality of healthcare delivered, the containment of cost, and access to the healthcare system. Hospitals have been allocating a significant portion of their resources to procuring and managing capital assets; they are continuously faced with demands for new medical equipment and are asked to manage existing inventory for which they are not well prepared. To objectively manage their investment, hospitals are developing medical technology management programs that need pertinent information and planning methodology for integrating new equipment into existing operations as well as for optimizing costs of ownership of all equipment. Clinical engineers can identify technological solutions based on the matching of new medical equipment with hospital's objectives. They can review their institution's overall technological position, determine strengths and weaknesses, develop equipment-selection criteria, supervise installations, train users and monitor post procurement performance to assure meeting of goals. This program, together with cost accounting analysis, will objectively guide the capital assets decision-making process. Cost accounting analysis is a multivariate function that includes determining the amount, based upon a strategic plan and financial resources, of funding to be allocated annually for medical equipment acquisition and replacement. Often this function works closely with clinical engineering to establish equipment useful life and prioritization of acquisition, upgrade, and replacement of inventory within budget confines and without conducting time consuming, individual financial capital project evaluations.

Medical Secretary and Medical Office Assistant Curriculum Guide.

ERIC Educational Resources Information Center

Michigan State Univ., East Lansing. Coll. of Agriculture and Natural Resources Education Inst.

This curriculum guide consists of materials for use in teaching a competency-based course to prepare students for employment as medical secretaries or medical office assistants. The first part of the guide contains introductory information, including a description of the development of the guide, an equipment list, a list of criteria for…

Ocular ultrasonography focused on the posterior eye segment: what radiologists should know.

PubMed

De La Hoz Polo, Marcela; Torramilans Lluís, Anna; Pozuelo Segura, Oscar; Anguera Bosque, Albert; Esmerado Appiani, Catalina; Caminal Mitjana, Josep Maria

2016-06-01

Ocular B-mode ultrasonography (US) is an important adjuvant for the clinical assessment of a variety of ocular diseases. When ophthalmoscopy is not possible, mainly due to opacification of the transparent media (e.g., mature cataract or vitreous haemorrhage), US can guide the ophthalmologist in diagnosing disease and choosing treatment. The superficial location and cystic structure of the eye make US ideal for imaging of the eye. Moreover, dynamic study helps distinguish between various conditions that would otherwise be difficult to differentiate in some clinical setting, such as vitreous, retinal, and choroidal detachment. US is also good technique for detecting other pathologic conditions such as lens dislocation, vitreous haemorrhage, asteroid hyalosis, optic disc drusen, and tumors (e.g., choroidal melanoma, metastases, hemangioma). An understanding of the basic anatomy of the eye, the US technique, and common entities that affect the ocular globe will allow radiologists to offer this valuable imaging modality to patients and referring clinicians. This article focuses on the US anatomy and pathologic conditions that affect the posterior ocular segment. • US is specially indicated when ocular fundus cannot be assessed on ophthalmoscopy. • Multipurpose equipment with high-frequency transducers is optimal for imaging the eye. • Ultrasound can reliably depict ocular anatomy and pathology as detachments and tumours. • Dynamic examination is vital for distinguishing certain pathologic conditions as detachments.

Fecal retention in childhood: Evaluation on ultrasonography.

PubMed

Hatori, Reiko; Tomomasa, Takeshi; Ishige, Takashi; Tatsuki, Maiko; Arakawa, Hirokazu

2017-04-01

To assess the usefulness of rectal diameter measurement on ultrasonography as a diagnostic tool for fecal retention in children. One hundred children (median age, 5.0 years), consisting of 80 with functional constipation and 20 without constipation, participated in the study. All patients underwent physical examination that included digital rectal examination. Forty-five children underwent ultrasonography in three differential planes: transection above the symphysis; under the ischial spine; and at the bladder neck. The measurement of the rectal diameter at the transection above the symphysis could most easily detect fecal retention and had the closest correlations with retention among the three planes. Rectal diameter was wider at all measuring points (35.2 vs 20.9 mm above the symphysis, P < 0.0001; 35.7 vs 24.0 mm under the ischial spine, P < 0.0001; and 19.4 vs 8.7 mm at the bladder neck, P < 0.0001) in children with fecal retention than in those with no fecal retention. With regard to presence of constipation, children with fecal retention had a wider rectal diameter above the symphysis than those with no fecal retention (children with functional constipation, 35.3 vs 20.0 mm, P < 0.0001; children without constipation: 32.6 vs 14.6 mm, P = 0.0026). The cut-off for the rectal diameter measured above the symphysis to identify fecal retention was 27 mm, with high sensitivity and specificity (95.5% and 94.1%, respectively). Ultrasound rectal diameter measurement can be used to detect fecal retention in children. © 2016 Japan Pediatric Society.

Ultrasonography in neuralgic amyotrophy: Sensitivity, spectrum of findings, and clinical correlations.

PubMed

ArÁnyi, Zsuzsanna; Csillik, Anita; DéVay, Katalin; Rosero, Maja; Barsi, PéTer; BÖhm, Josef; Schelle, Thomas

2017-12-01

The aim of this study was to assess the value of ultrasonography in neuralgic amyotrophy. Fifty-three patients with 70 affected nerves were examined with high-resolution ultrasound. The most commonly affected nerve was the anterior interosseous (23%). Ultrasonographic abnormalities in the affected nerves, rather than in the brachial plexus, were observed, with an overall sensitivity of 74%. Findings included the swelling of the nerve/fascicle with or without incomplete/complete constriction and rotational phenomena (nerve torsion and fascicular entwinement). A significant difference was found among the categories of ultrasonographic findings with respect to clinical outcome (P = 0.01). In nerves with complete constriction and rotational phenomena, reinnervation was absent or negligible, indicating surgery was warranted. Ultrasonography may be used as a diagnostic aid in neuralgic amyotrophy, which was hitherto a clinical and electrophysiological diagnosis, and may also help in identifying potential surgical candidates. Muscle Nerve 56: 1054-1062, 2017. © 2017 Wiley Periodicals, Inc.

Age, tumor size, and in-office ultrasonography are predictive parameters of malignancy in follicular neoplasms of the thyroid.

PubMed

Paramo, Juan C; Mesko, Thomas

2008-01-01

To identify clinical predictors of malignancy in patients with intraoperative frozen-section diagnosis of follicular neoplasm of the thyroid. We performed a retrospective cross-sectional study of 71 patients with intraoperative frozen-section diagnosis of follicular neoplasm who underwent thyroidectomy between January 1992 and December 2000. Age, sex, tumor size, and in-office ultrasonography characteristics of the lesions were assessed. These clinical factors were compared between cases that had benign definitive pathologic findings and those that were found to be carcinomas on permanent sections. Nine (13%) of the 71 follicular neoplasms were found to be carcinomas after definitive pathologic evaluation. The incidence of malignancy was 13% (2/16) in men and 13% (7/55) in women (P>.5). Patients younger than 45 years had a 27% (8/30) incidence of malignancy compared with 2% (1/41) in patients 45 years or older (P<.01). Of tumors smaller than 4 cm, 7% (4/55) were ultimately diagnosed as carcinomas compared with 31% (5/16) of those 4 cm or larger (P = .05). When the in-office ultrasonography findings were interpreted as benign, only 7% (3/46) of cases were malignant compared with 40% (4/10) when the ultrasonography findings were suspicious (P = .02). Age and tumor size are predictive parameters of malignancy in follicular neoplasm of the thyroid. Suspicious ultrasonography findings also have an important predictive role. Total thyroidectomy is reasonable in patients with follicular neoplasm on frozen section if they are young (<45 years old), with large (>4 cm) tumors or if there are suspicious findings on in-office ultrasonography.

Affects of Anxiety and Depression on Health-Related Quality of Life among Patients with Benign Breast Lumps Diagnosed via Ultrasonography in China.

PubMed

Lou, Zhe; Li, Yinyan; Yang, Yilong; Wang, Lie; Yang, Jun

2015-08-28

There is a high incidence of benign breast lumps among women, and these lumps may lead to physical and psychological problems. This study aims to evaluate anxiety and depressive symptoms among patients with benign breast lumps diagnosed via ultrasonography and investigate their impacts on health-related quality of life (HRQOL). A cross-sectional survey was conducted in Shenyang, China, from January to November 2013. Data were collected with self-administered questionnaires, including the Zung Self-Rating Anxiety Scale (SAS), the Center for Epidemiologic Studies Depression Scale (CES-D), and the 36-item Short-Form Health Survey (SF-36), together with demographic characteristics, from patients of the Department of Breast Surgery of the First Affiliated Hospital of China Medical University. Hierarchical multiple regression analysis (HMR) was performed to explore the effects of anxiety and depression on HRQOL. The overall prevalences of anxiety (SAS score ≥ 40) and depression (CES-D scores ≥ 16) were 40.2% and 62.0%, respectively, and 37.5% of the participants had both of these psychological symptoms. The means and standard deviations of PCS and MCS were 75.42 (15.22) and 68.70 (17.71), respectively. Anxiety and depressive symptoms were significantly negatively associated with the HRQOL of patients with benign breast lumps diagnosed via ultrasonography. Women with benign breast lumps diagnosed via ultrasonography in China experienced relatively high levels of anxiety and depressive symptoms. Anxiety and depressive symptoms had significant negative impacts on both the mental and physical quality of life (QOL) of women with benign breast lumps. Beyond the necessary clinical treatment procedures, psychological guidance and detailed explanations of the disease should be offered to alleviate the anxiety and depressive symptoms and enhance the HRQOL of patients with benign breast lumps.

Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 2. Equipment, Safe Driving Practices, Legal Aspects, Controlling the Situation, Action Evaluation Conference. Revised.

ERIC Educational Resources Information Center

Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

This student manual, the second in a set of 14 modules, is designed to train emergency medical technicians (EMTs) in Ohio. The module contains five sections that cover the following course content: ambulance equipment, safe driving practices for emergency vehicle drivers, legal aspects of the EMT's job, how to maintain control at an accident scene…

Association Between Years of Experience and Ankle Joint Disorder in Male Student Basketball Players Based on Ultrasonography.

PubMed

Fukushima, Yaeko

2017-04-01

The goal of the study was to survey ankle joint disorder in male senior high school and college student basketball players based on the results of an ultrasonographic medical check-up of the ankle joint. The subjects were 17 senior high school student and 19 college student basketball players. Ultrasonography, evaluation of ATFL injury, and examination of the talocrural joint region were performed. The subjects were grouped based on the presence or absence of old ATFL injury, and subjects with ATFL injury were classified by the injured region: fibular insertion site, parenchyma, and talar insertion site. The talocrural joint region was evaluated based on the areas of the lateral margin, central region, and medial margin, and sites with an irregular bone contour and osteophyte were counted individually. The questionnaire asked about the patients' history of ankle injuries. A questionnaire survey revealed that 70-79% of all subjects had experienced a sprain at least once and 21-29% had frequently sprained the left or right foot 10 or more times in the past. On ultrasonography, there was no significant difference in ligament injury or injured site between the senior high school and college students, but the number of osteochondral findings in the talocrural joint region was significantly higher in the college students. In addition, the number of injured sites significantly increased in those with 10 or more years of playing experience. These results suggest that disorder of the talocrural joint region progresses with an increase in years of experience in student basketball players who do not take specific preventive measures against this injury.

Equipping future doctors: incorporating management and leadership into medical curriculums in the United Kingdom.

PubMed

Sonsale, Aniket; Bharamgoudar, Reshma

2017-04-01

Throughout their careers, doctors are likely to come across complex management and leadership scenarios that many would not have had prior training in. Expectations of doctors are rising and it is becoming increasingly necessary to be able to astutely handle a variety of situations. Medical curricula must reflect this change and adapt to include the teaching of key management and leadership skills. Despite budgeting pressures, the National Health Service continues to spend vast sums of money on external management consultants. The 2013 Francis Report stressed the need for better management skills and leadership, especially in doctors who were identified as the spearheads of change. This view is backed up by senior professionals who stress that by incorporating it into undergraduate curricula, doctors will be equipped with the skills to flourish in the future. The challenges of doing so must be highlighted, since the teaching of managerial and leadership concepts must effectively combine theoretical approaches with practical applications. Empowering students of today will enable them as tomorrow's doctors to tackle the challenges of modern medicine.

Emergency medical equipment storage: benefits of visual cues tested in field and simulated settings.

PubMed

Grundgeiger, Tobias; Harris, Bonnie; Ford, Nicholas; Abbey, Michael; Sanderson, Penelope M; Venkatesh, Balasubramanian

2014-08-01

We tested the effectiveness of an illustrated divider ("the divider") for bedside emergency equipment drawers in an intensive care unit (ICU). In Study I, we assessed whether the divider increases completeness and standardizes the locations of emergency equipment within the drawer. In Study 2, we investigated whether the divider decreases nurses' restocking and retrieval times and decreases their workload. Easy access to fully stocked emergency equipment is important during emergencies. However, inefficient equipment storage and cognitively demanding work settings might mean that drawers are incompletely stocked and access to items is slow. A pre-post-post study investigated drawer completeness and item locations before and after the introduction of the divider to 30 ICU drawers. A subsequent experiment measured item restocking time, item retrieval time, and subjective workload for nurses. At 2 weeks and 10 weeks after the divider was introduced, the completeness of the drawer increased significantly compared with before the divider was introduced. The divider decreased the variability of the locations of the 17 items in the drawer to 16% of its original value. Study 2 showed that restocking times but not retrieval times were significantly faster with the divider present For both tasks, nurses rated their workload lower with the divider. The divider improved the standardization and completeness of emergency equipment. In addition, restocking times and workload were decreased with the divider. Redesigning storage for certain equipment using human factors design principles can help to speed and standardize restocking and ease access to equipment.

Supplies and equipment for pediatric emergency mass critical care

PubMed Central

Bohn, Desmond; Kanter, Robert K.; Burns, Jeffrey; Barfield, Wanda D.; Kissoon, Niranjan

2015-01-01

Introduction Epidemics of acute respiratory disease, such as severe acute respiratory syndrome in 2003, and natural disasters, such as Hurricane Katrina in 2005, have prompted planning in hospitals that offer adult critical care to increase their capacity and equipment inventory for responding to a major demand surge. However, planning at a national, state, or local level to address the particular medical resource needs of children for mass critical care has yet to occur in any coordinated way. This paper presents the consensus opinion of the Task Force regarding supplies and equipment that would be required during a pediatric mass critical care crisis. Methods In May 2008, the Task Force for Mass Critical Care published guidance on provision of mass critical care to adults. Acknowledging that the critical care needs of children during disasters were unaddressed by this effort, a 17-member Steering Committee, assembled by the Oak Ridge Institute for Science and Education with guidance from members of the American Academy of Pediatrics, convened in April 2009 to determine priority topic areas for pediatric emergency mass critical care recommendations. Steering Committee members established subcommittees by topic area and performed literature reviews of MEDLINE and Ovid databases. The Steering Committee produced draft outlines through consensus-based study of the literature and convened October 6 –7, 2009, in New York, NY, to review and revise each outline. Eight draft documents were subsequently developed from the revised outlines as well as through searches of MEDLINE updated through March 2010. The Pediatric Emergency Mass Critical Care Task Force, composed of 36 experts from diverse public health, medical, and disaster response fields, convened in Atlanta, GA, on March 29 –30, 2010. Feedback on each manuscript was compiled and the Steering Committee revised each document to reflect expert input in addition to the most current medical literature. Task Force

Clients' reasons for prenatal ultrasonography in Ibadan, South West of Nigeria

PubMed Central

Enakpene, Christopher A; Morhason-Bello, Imran O; Marinho, Anthony O; Adedokun, Babatunde O; Kalejaiye, Adegoke O; Sogo, Kayode; Gbadamosi, Sikiru A; Awoyinka, Babatunde S; Enabor, Obehi O

2009-01-01

Background Prenatal ultrasonography has remained a universal tool but little is known especially from developing countries on clients' reasons for desiring it. Then aim was to determine the reasons why pregnant women will desire a prenatal ultrasound. Methods It was a cross-sectional survey of consecutive 222 women at 2 different ultrasonography facilities in Ibadan, South-west Nigeria. Results The mean age of the respondents was 30.1 ± 4.5 years. The commonest reason for requesting for prenatal ultrasound scans was to check for fetal viability in 144 women (64.7%) of the respondents, followed by fetal gender determination in 50 women (22.6%. Other reasons were to check for number of fetuses, fetal age and placental location. Factors such as younger age, artisans profession and low level of education significantly influenced the decision to check for fetal viability on bivariate analysis but all were not significant on multivariate analysis. Concerning fetal gender determination, older age, Christianity, occupation and gravidity were significant on bivariate analysis, however, only gravidity and occupation remained significant independent predictor on logistic regression model. Women with less than 3 previous pregnancies were about 4 times more likely to request for fetal sex determination than women with more than 3 previous pregnancies, (OR 3.8 95%CI 1.52 – 9.44). The professionals were 7 times more likely than the artisans to request to find out about their fetal sex, (OR 7.0 95%CI 1.47 – 333.20). Conclusion This study shows that Nigerian pregnant women desired prenatal ultrasonography mostly for fetal viability, followed by fetal gender determination. These preferences were influenced by their biosocial variables. PMID:19426518

[Prevention of medical device-related adverse events in hospitals: Specifying the recommendations of the German Coalition for Patient Safety (APS) for users and operators of anaesthesia equipment].

PubMed

Bohnet-Joschko, Sabine; Zippel, Claus; Siebert, Hartmut

2015-01-01

The use and organisation of medical technology has an important role to play for patient and user safety in anaesthesia. Specification of the recommendations of the German Coalition for Patient Safety (APS) for users and operators of anaesthesia equipment, explore opportunities and challenges for the safe use and organisation of anaesthesia devices. We conducted a literature search in Medline/PubMed for studies dealing with the APS recommendations for the prevention of medical device-related risks in the context of anaesthesia. In addition, we performed an internet search for reports and recommendations focusing on the use and organisation of medical devices in anaesthesia. Identified studies were grouped and assigned to the recommendations. The division into users and operators was maintained. Instruction and training in anaesthesia machines is sometimes of minor importance. Failure to perform functional testing seems to be a common cause of critical incidents in anaesthesia. There is a potential for reporting to the federal authority. Starting points for the safe operation of anaesthetic devices can be identified, in particular, at the interface of staff, organisation, and (anaesthesia) technology. The APS recommendations provide valuable information on promoting the safe use of medical devices and organisation in anaesthesia. The focus will be on risks relating to the application as well as on principles and materials for the safe operation of anaesthesia equipment. Copyright © 2015. Published by Elsevier GmbH.

38 CFR 17.155 - Minimum standards of safety and quality for automotive adaptive equipment.

Code of Federal Regulations, 2012 CFR

2012-07-01

... safety and quality for automotive adaptive equipment. 17.155 Section 17.155 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Automotive Equipment and Driver Training § 17.155 Minimum standards of safety and quality for automotive adaptive equipment. (a) The Under Secretary for...

38 CFR 17.155 - Minimum standards of safety and quality for automotive adaptive equipment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... safety and quality for automotive adaptive equipment. 17.155 Section 17.155 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Automotive Equipment and Driver Training § 17.155 Minimum standards of safety and quality for automotive adaptive equipment. (a) The Under Secretary for...

38 CFR 17.155 - Minimum standards of safety and quality for automotive adaptive equipment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... safety and quality for automotive adaptive equipment. 17.155 Section 17.155 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Automotive Equipment and Driver Training § 17.155 Minimum standards of safety and quality for automotive adaptive equipment. (a) The Under Secretary for...

38 CFR 17.155 - Minimum standards of safety and quality for automotive adaptive equipment.

Code of Federal Regulations, 2013 CFR

2013-07-01

... safety and quality for automotive adaptive equipment. 17.155 Section 17.155 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Automotive Equipment and Driver Training § 17.155 Minimum standards of safety and quality for automotive adaptive equipment. (a) The Under Secretary for...

21 CFR 864.2240 - Cell and tissue culture supplies and equipment.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cell and tissue culture supplies and equipment... SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Cell And Tissue Culture Products § 864.2240 Cell and tissue culture supplies and equipment. (a) Identification. Cell and tissue culture...

21 CFR 864.2240 - Cell and tissue culture supplies and equipment.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cell and tissue culture supplies and equipment... SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Cell And Tissue Culture Products § 864.2240 Cell and tissue culture supplies and equipment. (a) Identification. Cell and tissue culture...

21 CFR 864.2240 - Cell and tissue culture supplies and equipment.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cell and tissue culture supplies and equipment... SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Cell And Tissue Culture Products § 864.2240 Cell and tissue culture supplies and equipment. (a) Identification. Cell and tissue culture...

21 CFR 864.2240 - Cell and tissue culture supplies and equipment.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cell and tissue culture supplies and equipment... SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Cell And Tissue Culture Products § 864.2240 Cell and tissue culture supplies and equipment. (a) Identification. Cell and tissue culture...

21 CFR 864.2240 - Cell and tissue culture supplies and equipment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cell and tissue culture supplies and equipment... SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Cell And Tissue Culture Products § 864.2240 Cell and tissue culture supplies and equipment. (a) Identification. Cell and tissue culture...

38 CFR 17.155 - Minimum standards of safety and quality for automotive adaptive equipment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... justify development of formal standards, such equipment will be inspected and, if in order, approved for... safety and quality for automotive adaptive equipment. 17.155 Section 17.155 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Automotive Equipment and Driver Training § 17.155...

Doppler ultrasonography in living donor liver transplantation recipients: Intra- and post-operative vascular complications

PubMed Central

Abdelaziz, Omar; Attia, Hussein

2016-01-01

Living-donor liver transplantation has provided a solution to the severe lack of cadaver grafts for the replacement of liver afflicted with end-stage cirrhosis, fulminant disease, or inborn errors of metabolism. Vascular complications remain the most serious complications and a common cause for graft failure after hepatic transplantation. Doppler ultrasound remains the primary radiological imaging modality for the diagnosis of such complications. This article presents a brief review of intra- and post-operative living donor liver transplantation anatomy and a synopsis of the role of ultrasonography and color Doppler in evaluating the graft vascular haemodynamics both during surgery and post-operatively in accurately defining the early vascular complications. Intra-operative ultrasonography of the liver graft provides the surgeon with useful real-time diagnostic and staging information that may result in an alteration in the planned surgical approach and corrections of surgical complications during the procedure of vascular anastomoses. The relevant intra-operative anatomy and the spectrum of normal and abnormal findings are described. Ultrasonography and color Doppler also provides the clinicians and surgeons early post-operative potential developmental complications that may occur during hospital stay. Early detection and thus early problem solving can make the difference between graft survival and failure. PMID:27468207

Diagnosis of a sigmoid volvulus in pregnancy: ultrasonography and magnetic resonance imaging findings

PubMed Central

Palmucci, Stefano; Lanza, Maria Letizia; Gulino, Fabrizio; Scilletta, Beniamino; Ettorre, Giovanni Carlo

2014-01-01

Sigmoid volvulus complicating pregnancy is a rare, non-obstetric cause of abdominal pain that requires prompt surgical intervention (decompression) to avoid intestinal ischemia and perforation. We report the case of a 31-week pregnant woman with abdominal pain and subsequent development of constipation. Preoperative diagnosis was achieved using magnetic resonance imaging and ultrasonography: the large bowel distension and a typical whirl sign - near a sigmoid colon transition point - suggested the diagnosis of sigmoid volvulus. The decision to refer the patient for emergency laparotomy was adopted without any ionizing radiation exposure, and the pre-operative diagnosis was confirmed after surgery. Imaging features of sigmoid volvulus and differential diagnosis from other non-obstetric abdominal emergencies in pregnancy are discussed in our report, with special emphasis on the diagnostic capabilities of ultrasonography and magnetic resonance imaging. PMID:24967020

Diagnosis of a sigmoid volvulus in pregnancy: ultrasonography and magnetic resonance imaging findings.

PubMed

Palmucci, Stefano; Lanza, Maria Letizia; Gulino, Fabrizio; Scilletta, Beniamino; Ettorre, Giovanni Carlo

2014-02-01

Sigmoid volvulus complicating pregnancy is a rare, non-obstetric cause of abdominal pain that requires prompt surgical intervention (decompression) to avoid intestinal ischemia and perforation. We report the case of a 31-week pregnant woman with abdominal pain and subsequent development of constipation. Preoperative diagnosis was achieved using magnetic resonance imaging and ultrasonography: the large bowel distension and a typical whirl sign - near a sigmoid colon transition point - suggested the diagnosis of sigmoid volvulus. The decision to refer the patient for emergency laparotomy was adopted without any ionizing radiation exposure, and the pre-operative diagnosis was confirmed after surgery. Imaging features of sigmoid volvulus and differential diagnosis from other non-obstetric abdominal emergencies in pregnancy are discussed in our report, with special emphasis on the diagnostic capabilities of ultrasonography and magnetic resonance imaging.

Robot-assisted laparoscopic ultrasonography for hepatic surgery.

PubMed

Schneider, Caitlin M; Peng, Peter D; Taylor, Russell H; Dachs, Gregory W; Hasser, Christopher J; DiMaio, Simon P; Choti, Michael A

2012-05-01

This study describes and evaluates a novel, robot-assisted laparoscopic ultrasonographic device for hepatic surgery. Laparoscopic liver surgery is being performed with increasing frequency. One major drawback of this approach is the limited capability of intraoperative ultrasonography (IOUS) using standard laparoscopic devices. Robotic surgery systems offer the opportunity to develop new tools to improve techniques in minimally invasive surgery. This study evaluates a new integrated ultrasonography (US) device with the da Vinci Surgical System for laparoscopic visualization, comparing it with conventional handheld laparoscopic IOUS for performing key tasks in hepatic surgery. A prototype laparoscopic IOUS instrument was developed for the da Vinci Surgical System and compared with a conventional laparoscopic US device in simulation tasks: (1) In vivo porcine hepatic visualization and probe manipulation, (2) lesion detection accuracy, and (3) biopsy precision. Usability was queried by poststudy questionnaire. The robotic US proved better than conventional laparoscopic US in liver surface exploration (85% success vs 73%; P = .030) and tool manipulation (79% vs 57%; P = .028), whereas no difference was detected in lesion identification (63 vs 58; P = .41) and needle biopsy tasks (57 vs 48; P = .11). Subjects found the robotic US to facilitate better probe positioning (80%), decrease fatigue (90%), and be more useful overall (90%) on the post-task questionnaire. We found this robot-assisted IOUS system to be practical and useful in the performance of important tasks required for hepatic surgery, outperforming free-hand laparoscopic IOUS for certain tasks, and was more subjectively usable to the surgeon. Systems such as this may expand the use of robotic surgery for complex operative procedures requiring IOUS. Copyright © 2012 Mosby, Inc. All rights reserved.

Contrast-enhanced endoscopic ultrasonography in digestive diseases.

PubMed

Hirooka, Yoshiki; Itoh, Akihiro; Kawashima, Hiroki; Ohno, Eizaburo; Itoh, Yuya; Nakamura, Yosuke; Hiramatsu, Takeshi; Sugimoto, Hiroyuki; Sumi, Hajime; Hayashi, Daijiro; Ohmiya, Naoki; Miyahara, Ryoji; Nakamura, Masanao; Funasaka, Kohei; Ishigami, Masatoshi; Katano, Yoshiaki; Goto, Hidemi

2012-10-01

Contrast-enhanced endoscopic ultrasonography (CE-EUS) was introduced in the early 1990s. The concept of the injection of carbon dioxide microbubbles into the hepatic artery as a contrast material (enhanced ultrasonography) led to "endoscopic ultrasonographic angiography". After the arrival of the first-generation contrast agent, high-frequency (12 MHz) EUS brought about the enhancement of EUS images in the diagnosis of pancreatico-biliary diseases, upper gastrointestinal (GI) cancer, and submucosal tumors. The electronic scanning endosonoscope with both radial and linear probes enabled the use of high-end ultrasound machines and depicted the enhancement of both color/power Doppler flow-based imaging and harmonic-based imaging using second-generation contrast agents. Many reports have described the usefulness of the differential diagnosis of pancreatic diseases and other abdominal lesions. Quantitative evaluation of CE-EUS images was an objective method of diagnosis using the time-intensity curve (TIC), but it was limited to the region of interest. Recently developed Inflow Time Mapping™ can be generated from stored clips and used to display the pattern of signal enhancement with time after injection, offering temporal difference of contrast agents and improved tumor characterization. On the other hand, three-dimensional CE-EUS images added new information to the literature, but lacked positional information. Three-dimensional CE-EUS with accurate positional information is awaited. To date, most reports have been related to pancreatic lesions or lymph nodes. Hemodynamic analysis might be of use for diseases in other organs: upper GI cancer diagnosis, submucosal tumors, and biliary disorders, and it might also provide functional information. Studies of CE-EUS in diseases in many other organs will increase in the near future.

Ultrasonography in lung pathologies: new perspectives.

PubMed

Demi, Libertario; Demi, Marcello; Smargiassi, Andrea; Inchingolo, Riccardo; Faita, Francesco; Soldati, Gino

2014-01-01

Nowadays, ultrasound techniques have not gained importance in the diagnosis and monitoring of lung pathologies yet because of the high mismatch in acoustic impedance between air and intercostal tissues. However, it is evident that B-mode imaging provides important information on pulmonary tissue, although in the form of image artifacts. Notwithstanding medical evidences, there exists no ultrasound-based method dedicated to the lung, hampering de facto the full exploitation of ultrasound potentials. A chance is given by the experience acquired in other fields, where acoustic attenuation is used to estimate concentrations of suspended particles in liquids and of air-bubbles in aerated foods. Custom hardware must be developed since commercial echographic equipment has been optimized to work with low acoustic impedance mismatches, and, in general, does not provide the primitive radiofrequency (RF) signals nor the possibility to tune key acquisition parameters such as ultrasound carrier frequency and pulse bandwidth, which are surely needed for our application.

Ultrasonography in lung pathologies: new perspectives

PubMed Central

2014-01-01

Background Nowadays, ultrasound techniques have not gained importance in the diagnosis and monitoring of lung pathologies yet because of the high mismatch in acoustic impedance between air and intercostal tissues. However, it is evident that B-mode imaging provides important information on pulmonary tissue, although in the form of image artifacts. Findings Notwithstanding medical evidences, there exists no ultrasound-based method dedicated to the lung, hampering de facto the full exploitation of ultrasound potentials. A chance is given by the experience acquired in other fields, where acoustic attenuation is used to estimate concentrations of suspended particles in liquids and of air-bubbles in aerated foods. Conclusions Custom hardware must be developed since commercial echographic equipment has been optimized to work with low acoustic impedance mismatches, and, in general, does not provide the primitive radiofrequency (RF) signals nor the possibility to tune key acquisition parameters such as ultrasound carrier frequency and pulse bandwidth, which are surely needed for our application. PMID:24834347

[Legionella pneumonia after the use of CPAP equipment].

PubMed

Stolk, Jaap M; Russcher, Anne; van Elzakker, Erika P M; Schippers, Emile F

2016-01-01

Continuous positive airway pressure (CPAP) equipment can be colonised by Legionellae and might cause Legionella pneumonia in the user. However, there is no reported case of Legionella pneumonia related to CPAP equipment in which an identical Legionella was found in both the patient and the CPAP equipment. A 51-year-old man came to the Emergency Department with fever, confusion and dyspnoea that had been present for 3 days. His medical history included obstructive sleep apnoea, for which he had been using CPAP therapy at home for 10 weeks. The CPAP equipment showed signs of poor maintenance. Chest X-ray revealed a pulmonary consolidation. Laboratory investigation resulted in a positive urine antigen test for Legionella. Water from the CPAP equipment and sputum from the patient revealed Legionella pneumophila. Serotyping and sequence-based typing showed an identical L. pneumophila serotype 1 ST37. It is important to be aware that CPAP equipment can be colonised with Legionellae and might cause Legionella pneumonia. It is therefore necessary to ask about CPAP therapy in a patient with community-acquired pneumonia.

Usefulness of intraoperative ultrasonography in liver resections due to colon cancer metastasis.

PubMed

Lucchese, Angélica Maria; Kalil, Antônio Nocchi; Schwengber, Alex; Suwa, Eiji; Rolim de Moura, Gabriel Garcia

2015-08-01

Intraoperative ultrasonography (IOUS) of the liver has been used both as an aid for intraoperative anatomical definition and for the detection of new lesions. The present study aimed to evaluate the impact of IOUS and to identify factors that can predict the detection of new lesions intraoperatively. In this observational and prospective study, with a cross-sectional design, patients with colorectal cancer metastases who underwent hepatectomy were selected. Abdominal computed tomography, magnetic resonance imaging, and positron emission tomography were the preoperative evaluation tests. All patients underwent IOUS performed by the same surgeon. The intraoperative findings were compared with the preoperative tests results. In total, 56 hepatectomies were evaluated. Half of the patients were men, with a mean age of 57 (30-85) years. New lesions were found intraoperatively in 12 patients (21.4% of cases) and were detected on both palpation and ultrasonography in 11 of these patients. Ultrasonography helped to revise the surgical plans by providing additional information in 35.7% of cases. On multivariate analysis, the presence of more than 4 preoperative nodules was predictive of the intraoperative occurrence of new lesions. IOUS remains the only way to evaluate the relationships between tumors, liver vascular structures, and bile ducts intraoperatively. Alone, IOUS was not useful for identifying new lesions intraoperatively, as all new lesions were also detected on palpation. The number of lesions diagnosed on preoperative tests influenced the probability of identifying new lesions intraoperatively. There may be additional influential factors. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Sporotrichal Tenosynovitis Diagnosed Helpfully by Musculoskeletal Ultrasonography

PubMed Central

Shimizu, Takashi; Akita, Shosuke; Harada, Yoshinori; Oguro, Eri; Okita, Yasutaka; Shigesaka, Minoru; Matsuoka, Hidetoshi; Nii, Takuro; Teshigawara, Satoru; Kudo-Tanaka, Eriko; Tsuji, Soichiro; Matsushita, Masato; Ohshima, Shiro; Hoshida, Yoshihiko; Hashimoto, Jun; Saeki, Yukihiko

2017-01-01

A 72-year-old man presented with persistent oligoarthritis and positive results for rheumatoid factor and was suspected of having rheumatoid arthritis (RA). However, the musculoskeletal ultrasonography (MSUS) findings were not consistent with those of typical RA. He had undergone surgery for carpal tunnel syndrome, which allowed both histopathological and microbiological examinations to be performed. A synovial tissue culture was positive for Sporothrix schenckii, and he was diagnosed with sporotrichal tenosynovitis. He received anti-fungal therapy, and the sporotrichal tenosynovitis resolved. This case suggests that MSUS is a useful modality, and sporotrichal tenosynovitis, though rare, should be considered in the differential diagnosis of RA. PMID:28502945

Accuracy of determining preoperative cancer extent measured by automated breast ultrasonography.

PubMed

Tozaki, Mitsuhiro; Fukuma, Eisuke

2010-12-01

The aim of this study was to determine the accuracy of measuring preoperative cancer extent using automated breast ultrasonography (US). This retrospective study consisted of 40 patients with histopathologically confirmed breast cancer. All of the patients underwent automated breast US (ABVS; Siemens Medical Solutions, Mountain View, CA, USA) on the day before the surgery. The sizes of the lesions on US were measured on coronal multiplanar reconstruction images using the ABVS workstation. Histopathological measurement of tumor size included not only the invasive foci but also any in situ component and was used as the gold standard. The discrepancy of the tumor extent between automated breast US and the histological examination was calculated. Automated breast US enabled visualization of the breast carcinomas in all patients. The mean size of the lesions on US was 12 mm (range 4-62 mm). The histopathological diagnosis was ductal carcinoma in situ (DCIS) in seven patients and invasive ductal carcinoma in 33 patients (18 without an intraductal component, 15 with an intraductal component). Lesions ranged in diameter from 4 to 65 mm (mean 16 mm). The accuracy of determination of the tumor extent with a deviation in length of <2 cm was 98% (39/40). Automated breast US is thought to be useful for evaluating tumor extent preoperatively.

Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study.

PubMed

Sovio, Ulla; White, Ian R; Dacey, Alison; Pasupathy, Dharmintra; Smith, Gordon C S

2015-11-21

�9, 95% CI 2·4-3·5, p<0·0001). Of the 3977 fetuses, 562 (14·1%) were identified by universal ultrasonography with an estimated fetal weight of less than the 10th percentile and were at an increased risk of neonatal morbidity (relative risk [RR] 1·60, 95% CI 1·22-2·09, p=0·0012). However, estimated fetal weight of less than the 10th percentile was only associated with the risk of neonatal morbidity (pinteraction=0·005) if the fetal abdominal circumference growth velocity was in the lowest decile (RR 3·9, 95% CI 1·9-8·1, p=0·0001). 172 (4%) of 3977 pregnancies had both an estimated fetal weight of less than the 10th percentile and abdominal circumference growth velocity in the lowest decile, and had a relative risk of delivering an SGA infant with neonatal morbidity of 17·6 (9·2-34·0, p<0·0001). Screening of nulliparous women with universal third trimester fetal biometry roughly tripled detection of SGA infants. Combined analysis of fetal biometry and fetal growth velocity identified a subset of SGA fetuses that were at increased risk of neonatal morbidity. National Institute for Health Research, Medical Research Council, Sands, and GE Healthcare. Copyright © 2015 Sovio et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd.. All rights reserved.

NASA Johnson Space Center Medical Licensing Opportunities

NASA Technical Reports Server (NTRS)

Hernandez-Moya, Sonia

2009-01-01

This presentation reviews patented medical items that are available for licensing in the areas of Laboratory Technologies, Medical Devices, Medical Equipment and other technologies that are of interest to the medical community.

The potential of ultrasonography in the evaluation of foot orthotics therapy.

PubMed

Petcu, Daniel; Mitrea, Delia Alexandrina; Bondor, Cosmina Ioana; Perciun, Elena Rodica

2017-11-29

Foot orthotics prescription is based on the foot functioning paradigms with tissue stress theory being in avant-garde. The main goal of orthotic therapy is to reduce the internal tissue's pathological stresses in the foot structures. Traditionally, ultrasound scanning technique depicts anatomic related data of both common and uncommon pathology encountered in the clinical practice, helping in diagnosing, treating and evaluating, which are equally important for the practitioners. Its accessibility, compared to biomechanical modelling, makes this technique a valuable tool in the field of foot and ankle disorders. Despite its user-dependent limitation, the ongoing technical progress improves the ability of ultrasonography as a highly advanced procedure in musculoskeletal imaging, being also a valuable searching tool for musculotendinous mechanics or morphological changes as a result of a conservative intervention. The aim of the present work was to perform a review of the state of the art concerning the usefulness of ultrasonography in the study of foot orthotic therapy and to analyze its effectiveness.

21 CFR 864.3010 - Tissue processing equipment.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Tissue processing equipment. 864.3010 Section 864.3010 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Pathology Instrumentation and Accessories § 864.3010...

21 CFR 864.3010 - Tissue processing equipment.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Tissue processing equipment. 864.3010 Section 864.3010 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Pathology Instrumentation and Accessories § 864.3010...

21 CFR 864.3010 - Tissue processing equipment.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Tissue processing equipment. 864.3010 Section 864.3010 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Pathology Instrumentation and Accessories § 864.3010...

21 CFR 864.3010 - Tissue processing equipment.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Tissue processing equipment. 864.3010 Section 864.3010 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Pathology Instrumentation and Accessories § 864.3010...

21 CFR 864.3010 - Tissue processing equipment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Tissue processing equipment. 864.3010 Section 864.3010 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Pathology Instrumentation and Accessories § 864.3010...

21 CFR 890.5360 - Measuring exercise equipment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Measuring exercise equipment. 890.5360 Section 890.5360 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5360 Measuring...

21 CFR 890.5370 - Nonmeasuring exercise equipment.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Nonmeasuring exercise equipment. 890.5370 Section 890.5370 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5370...

21 CFR 890.5370 - Nonmeasuring exercise equipment.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Nonmeasuring exercise equipment. 890.5370 Section 890.5370 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5370...

21 CFR 890.5370 - Nonmeasuring exercise equipment.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Nonmeasuring exercise equipment. 890.5370 Section 890.5370 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5370...

21 CFR 890.5380 - Powered exercise equipment.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Powered exercise equipment. 890.5380 Section 890.5380 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5380 Powered...

21 CFR 890.5380 - Powered exercise equipment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Powered exercise equipment. 890.5380 Section 890.5380 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5380 Powered...

21 CFR 890.5380 - Powered exercise equipment.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Powered exercise equipment. 890.5380 Section 890.5380 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5380 Powered...

21 CFR 890.5380 - Powered exercise equipment.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Powered exercise equipment. 890.5380 Section 890.5380 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5380 Powered...

21 CFR 890.5370 - Nonmeasuring exercise equipment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nonmeasuring exercise equipment. 890.5370 Section 890.5370 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5370...

21 CFR 890.5360 - Measuring exercise equipment.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Measuring exercise equipment. 890.5360 Section 890.5360 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5360 Measuring...

21 CFR 890.5360 - Measuring exercise equipment.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Measuring exercise equipment. 890.5360 Section 890.5360 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5360 Measuring...

21 CFR 890.5380 - Powered exercise equipment.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Powered exercise equipment. 890.5380 Section 890.5380 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5380 Powered...

21 CFR 890.5370 - Nonmeasuring exercise equipment.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Nonmeasuring exercise equipment. 890.5370 Section 890.5370 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5370...

21 CFR 890.5360 - Measuring exercise equipment.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Measuring exercise equipment. 890.5360 Section 890.5360 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5360 Measuring...

21 CFR 890.5360 - Measuring exercise equipment.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Measuring exercise equipment. 890.5360 Section 890.5360 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5360 Measuring...

Visualizing the Vibration of Laryngeal Tissue during Phonation Using Ultrafast Plane Wave Ultrasonography.

PubMed

Jing, Bowen; Tang, Shanshan; Wu, Liang; Wang, Supin; Wan, Mingxi

2016-12-01

Ultrafast plane wave ultrasonography is employed in this study to visualize the vibration of the larynx and quantify the vibration phase as well as the vibration amplitude of the laryngeal tissue. Ultrasonic images were obtained at 5000 to 10,000 frames/s in the coronal plane at the level of the glottis. Although the image quality degraded when the imaging mode was switched from conventional ultrasonography to ultrafast plane wave ultrasonography, certain anatomic structures such as the vocal folds, as well as the sub- and supraglottic structures, including the false vocal folds, can be identified in the ultrafast plane wave ultrasonic image. The periodic vibration of the vocal fold edge could be visualized in the recorded image sequence during phonation. Furthermore, a motion estimation method was used to quantify the displacement of laryngeal tissue from hundreds of frames of ultrasonic data acquired. Vibratory displacement waveforms of the sub- and supraglottic structures were successfully obtained at a high level of ultrasonic signal correlation. Moreover, statistically significant differences in vibration pattern between the sub- and supraglottic structures were found. Variation of vibration amplitude along the subglottic mucosal surface is significantly smaller than that along the supraglottic mucosal surface. Phase delay of vibration along the subglottic mucosal surface is significantly smaller than that along the supraglottic mucosal surface. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Intraoral ultrasonography: development of a specific high-frequency probe and clinical pilot study.

PubMed

Salmon, Benjamin; Le Denmat, Dominique

2012-04-01

Although ultrasonography is a non-invasive, inexpensive and painless diagnostic tool for soft tissue imaging, this technique is not currently used for oral exploration. Therefore, we developed a 25-MHz high-frequency ultrasound probe, specially designed for intraoral applications. This paper aims to present clinical intraoral ultrasound images actually interpretable, in order to identify the relevant applications of this novel tool and to design future oral studies. Two independent radiologists performed ultrasound examinations on three healthy volunteers. All the teeth were explored on the lingual and buccal sides (162 samples) to evaluate the ergonomics of the system and the visualisation of anatomic structures. Osseointegrated dental implants and a mucocele were also scanned. At the gingivodental junction of the maxillary and mandibular teeth, the device clearly identifies the tooth surfaces, the alveolar bone reflection with its surrounding subepithelial connective tissue of the gingiva and the gingival epithelia. The bone level and the thickness of soft tissue around the implant are measurable on the buccal and lingual sides. Therefore, intraoral ultrasonography provides additional morphological information that is not accessible by conventional dental x-rays. We propose a novel diagnostic tool that explores the biological width and is able to define the thin or thick nature of the gums. Moreover, intraoral ultrasonography may help to monitor precancerous lesions. This promising device requires large-scale clinical studies to determine whether it should remain a research tool or be used as a diagnostic tool for daily dental practice.

Quantitative Lingual, Pharyngeal and Laryngeal Ultrasonography in Swallowing Research: A Technical Review

ERIC Educational Resources Information Center

Chi-Fishman, Gloria

2005-01-01

Because of its distinct advantage in radiation-free soft tissue imaging, ultrasonography has been widely used to study lingual, pharyngeal, hyoid, laryngeal, and even esophageal action during swallowing in individuals of all ages. Qualitative ultrasonographic observations have made considerable contributions to our understanding of deglutition.…

The role of ultrasonography in the management of lung and pleural diseases.

PubMed

Rumende, C Martin

2012-04-01

Ultrasonographic examination in pulmonology provides a revolutionary advance because it is very helpful in the diagnosis and management of various pleural and peripheral pulmonary defects. Lung ultrasonography allows the clinicians to diagnose some pulmonary abnormalities more rapidly, including the diagnosis of pleural effusion. Ultrasound examination also provides great assistance for the clinicians to perform invasive techniques in the field of pulmonology, which may increase the success rate and reduce the likelihood of complications. In addition to pleural effusion, other lung disorders can be diagnosed by ultrasound such as peripheral lung tumors and other pleural abnormalities caused by pleural fibrosis and tumor metastasis as well as the primary pleural tumor (mesothelioma). Ultrasound-guided invasive procedures include aspiration of minimal effusion, Transthoracal Needle Aspiration, Transthoracal biopsies and chest tube insertion. Lung ultrasound also offers other advantages, i.e. free from radiation hazards, portable, non-invasive and relatively inexpensive. Ultrasonography in the thorax also has its limitations, especially in detecting mediastinal abnormalities.

Circulating Magnetic Microbubbles for Localized Real-Time Control of Drug Delivery by Ultrasonography-Guided Magnetic Targeting and Ultrasound

PubMed Central

Chertok, Beata; Langer, Robert

2018-01-01

Image-guided and target-selective modulation of drug delivery by external physical triggers at the site of pathology has the potential to enable tailored control of drug targeting. Magnetic microbubbles that are responsive to magnetic and acoustic modulation and visible to ultrasonography have been proposed as a means to realize this drug targeting strategy. To comply with this strategy in vivo, magnetic microbubbles must circulate systemically and evade deposition in pulmonary capillaries, while also preserving magnetic and acoustic activities in circulation over time. Unfortunately, challenges in fabricating magnetic microbubbles with such characteristics have limited progress in this field. In this report, we develop magnetic microbubbles (MagMB) that display strong magnetic and acoustic activities, while also preserving the ability to circulate systemically and evade pulmonary entrapment. Methods: We systematically evaluated the characteristics of MagMB including their pharmacokinetics, biodistribution, visibility to ultrasonography and amenability to magneto-acoustic modulation in tumor-bearing mice. We further assessed the applicability of MagMB for ultrasonography-guided control of drug targeting. Results: Following intravenous injection, MagMB exhibited a 17- to 90-fold lower pulmonary entrapment compared to previously reported magnetic microbubbles and mimicked circulation persistence of the clinically utilized Definity microbubbles (>10 min). In addition, MagMB could be accumulated in tumor vasculature by magnetic targeting, monitored by ultrasonography and collapsed by focused ultrasound on demand to activate drug deposition at the target. Furthermore, drug delivery to target tumors could be enhanced by adjusting the magneto-acoustic modulation based on ultrasonographic monitoring of MagMB in real-time. Conclusions: Circulating MagMB in conjunction with ultrasonography-guided magneto-acoustic modulation may provide a strategy for tailored minimally

Transrectal contrast-enhanced ultrasonography, transrectal ultrasonography and retrograde cystography for the detection of vesicourethral anastomosis leakage after radical retropubic prostatectomy: a prospective comparative evaluation.

PubMed

Cantiello, Francesco; Cicione, Antonio; Autorino, Riccardo; De Nunzio, Cosimo; Tubaro, Andrea; Damiano, Rocco

2013-01-01

To evaluate the diagnostic accuracy of cystography (CG), transrectal ultrasonography (TRUS) and transrectal contrast-enhanced ultrasonography (CEUS) for the detection of vesicourethral extravasation (VE) after radical retropubic prostatectomy (RRP). In 80 consecutive patients who underwent RRP, the strength of the vesicourethral anastomosis (VUA) was assessed by CG, TRUS and transrectal CEUS. The investigation started with a conventional CG evaluated by an experienced uroradiologist. Following this, patients underwent TRUS which was performed by an experienced urologist who was blinded to the CG findings. The examination started with a conventional B-scan and, subsequently, a CEUS was performed by emptying and refilling the bladder with 90 ml of NaCl 0.9% + 10 ml suspension of 1:10 SonoVue and NaCl 0.9%. 26 patients (32.5%) presented urinary VE and 54 (67.5%) a watertight VUA. In 16 patients (61%) we observed a small leakage, 9 patients (35%) presented a moderate VE, and a large VE was detected in 1 patient (4%). No statistically significant difference in detection of VE was found among the three tests (p = 0.472). TRUS and CEUS are able to provide information about the integrity of the VUA that is comparable with that of CG. Copyright © 2013 S. Karger AG, Basel.

Equipment for surgical interventions and childbirth in weightlessness

NASA Astrophysics Data System (ADS)

Mutke, H. G.

A transparent plastic sack has been devised for surgical interventions in space. Fixed airtight on the patient, containing sterilized medical equipment and comprising long sleeves for the operations, it retains all its contents for the rest of the flight.

[The role of ultrasonography exam in orbital-ocular tumors].

PubMed

Ciocâlteu, Alina Mihaela; Ardeleanu, S; Checheriţă, I A

2011-01-01

Ophthalmology is one of the specialties that have particularly benefited from the contribution of ultrasonography exam as a method of investigation. Ultrasonography is very much essential for diagnostic to complement other clinical and laboratory investigations, providing images in real time. The basic principle of diagnostic ultrasound is to study and to interpret the changes they undergo when crossing ultrasonic waves diverse biological properties different sound, and such injuries can be traced in the dynamics or can be documented on photographic paper and thus can diagnose correct certain eye diseases. The indications for performing ultrasound consist in: measurement of distances and volumes, examine difficult or inaccessible case of opaque media; ophthalmoscopic view of a mass lesion, examine the orbit or optic nerve. The advantages of ultrasound for orbital-ocular tumors are represented by the fact that ultrasound is a noninvasive method, safe, well tolerated, less expensive that the advantage of determining the position and distance from structures ocular tumor. High frequency ultrasound provides excellent resolution of 0-1 to 0.01 mm, and serial scans allow tracking progress and measuring lesion diameters tumor while allowing monitoring and evaluation of stereotactic radiation treatments applied to small tumors. In conclusion ultrasound allows not only early diagnosis of eye tumors, but accurate assessment of the proposed therapy and of the evolution of detected mass lesions or tumors.

Association Between Years of Experience and Ankle Joint Disorder in Male Student Basketball Players Based on Ultrasonography

PubMed Central

Fukushima, Yaeko

2017-01-01

Purpose The goal of the study was to survey ankle joint disorder in male senior high school and college student basketball players based on the results of an ultrasonographic medical check-up of the ankle joint. Materials and Methods The subjects were 17 senior high school student and 19 college student basketball players. Ultrasonography, evaluation of ATFL injury, and examination of the talocrural joint region were performed. The subjects were grouped based on the presence or absence of old ATFL injury, and subjects with ATFL injury were classified by the injured region: fibular insertion site, parenchyma, and talar insertion site. The talocrural joint region was evaluated based on the areas of the lateral margin, central region, and medial margin, and sites with an irregular bone contour and osteophyte were counted individually. The questionnaire asked about the patients’ history of ankle injuries. Results A questionnaire survey revealed that 70–79% of all subjects had experienced a sprain at least once and 21–29% had frequently sprained the left or right foot 10 or more times in the past. On ultrasonography, there was no significant difference in ligament injury or injured site between the senior high school and college students, but the number of osteochondral findings in the talocrural joint region was significantly higher in the college students. In addition, the number of injured sites significantly increased in those with 10 or more years of playing experience. Conclusion These results suggest that disorder of the talocrural joint region progresses with an increase in years of experience in student basketball players who do not take specific preventive measures against this injury. PMID:28603784

21 CFR 225.165 - Equipment cleanout procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Equipment cleanout procedures. 225.165 Section 225.165 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS Product Quality Assurance § 225...

21 CFR 890.5900 - Power traction equipment.