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- Effectiveness of Diathermy in Comparison With Ultrasound or Corticosteroids in Patients With Tendinopathy: A Critically Appraised Topic. [JOURNAL ARTICLE]
- J Sport Rehabil 2014 Nov; 23(4):370-375.
Clinical Scenario: Many therapeutic modalities have been used to treat the pain and inflammation commonly associated with tendinopathies. One modality that has been used to treat patients with tendinopathies is diathermy. Focused Clinical Question: Is there evidence to suggest that diathermy is more or equally as effective at reducing pain in patients with tendinopathy when compared with ultrasound or corticosteroid treatments? Summary of Search, "Best Evidence" Appraised, and Key Findings: The literature was searched for randomized control trials (RCTs) that investigated the effects of diathermy treatments in comparison with ultrasound or corticosteroid treatments on pain in patients with tendinopathy. Three RCTs were selected from the search results and included in this critically appraised topic. Clinical Bottom Line: There is moderate evidence to support that diathermy is more effective at reducing pain in patients with tendinopathy than ultrasound and equally as effective as corticosteroid treatments. Strength of Recommendation: There is grade B evidence to support that diathermy is more effective at reducing pain in patients with tendinopathy than ultrasound and equally effective at reducing pain as corticosteroid treatments.
- Design and application of pulse information acquisition and analysis system with dynamic recognition in traditional Chinese medicine. [Journal Article]
- Afr Health Sci 2014 Sep; 14(3):743-52.
To design the pulse information which includes the parameter of pulse-position, pulse-number, pulse-shape and pulse-force acquisition and analysis system with function of dynamic recognition, and research the digitalization and visualization of some common cardiovascular mechanism of single pulse.To use some flexible sensors to catch the radial artery pressure pulse wave and utilize the high frequency B mode ultrasound scanning technology to synchronously obtain the information of radial extension and axial movement, by the way of dynamic images, then the gathered information was analyzed and processed together with ECG. Finally, the pulse information acquisition and analysis system was established which has the features of visualization and dynamic recognition, and it was applied to serve for ten healthy adults.The new system overcome the disadvantage of one-dimensional pulse information acquisition and process method which was common used in current research area of pulse diagnosis in traditional Chinese Medicine, initiated a new way of pulse diagnosis which has the new features of dynamic recognition, two-dimensional information acquisition, multiplex signals combination and deep data mining.The newly developed system could translate the pulse signals into digital, visual and measurable motion information of vessel.
- Normative ultrasound values of renal parenchymal thickness among adults in Enugu, South-East Nigeria. [Journal Article]
- Afr Health Sci 2014 Sep; 14(3):689-97.
Reduction in renal length was found to be an insufficient independent indicator of chronic renal disease.To determine the ultrasound normative values of renal parenchymal thickness (RPT) among adults and correlate them with age and somatometric parameters.This was a prospective clinic based study involving 310 normal adults (135 males and 175 females) scanned at University of Nigeria Teaching Hospital, Enugu between August 2003 and November 2004. The RPT measurements were made from the outer renal cortical margin to the outer margin of the sinus echoes at the three major poles. The age, height, weight and body mass index were recorded for each subject.The average RPT are 1.85 ± 0.20 cm for the right kidney and 1.95 ± 0.19 cm for the left kidney. RPT exhibited strong positive correlation with height, weight and body mass index and significant negative correlation with age. No significant difference in mean RPT of both kidneys between genders (p > 0.05). The mean RPT of the left kidney was found to be statistically higher than that of the right kidney (p < 0.05).Normal values of RPT are important in the evaluation of patients with chronic renal disease.
- Scrotal sparganosis mimicking scrotal teratoma in an infant: a case report and literature review. [Journal Article]
- Korean J Parasitol 2014 Oct; 52(5):545-9.
Sparganosis is an infection with a parasitic tapeworm larva that occurs by eating infected foods or drinking contaminated water. The larvae can migrate to a tissue or muscle in the chest, abdominal wall, extremities, eyes, brain, urinary tract, pleura, pericardium, spinal canal, or scrotum. Herein, we report a 5-month old infant with scrotal sparganosis who was initially suspected to have a scrotal inflammatory mass with a history of applying raw frog meat into the umbilicus. Preoperative ultrasound examinations and computed tomography (CT) scanning misdiagnosed the mass as a scrotal teratoma. The scrotal mass was surgically removed, and the histopathology proved it to be scrotal sparganosis. This case displays the youngest patient ever reported with scrotal sparganosis, and the first description of CT characteristics of scrotal sparganosis. A detailed medical history is necessary for patients with scrotal masses suspected of sparganosis. In addition, ultrasound and CT examinations are helpful to rule out other causes of a scrotal mass.
- A traumatic superficial temporal artery aneurysm after a bicycle accident. [Journal Article]
- J Surg Case Rep 2014; 2014(10)
A male cyclist presented with a swelling on the forehead. Six weeks before, he fell of his bike and smashed his head on the ground while wearing a helmet. A smooth lump of 1 cm had evolved on the temporal side of his forehead in a few weeks. Duplex ultrasonography demonstrated a dilated vessel with a minor defect in the luminal wall. Surgical exploration revealed an aneurysm of the superficial temporal artery (STA). The aneurysm was surgically removed and the patient recovered uneventfully. Owing to its superficial course, the STA is vulnerable to blunt head trauma. Traumatic aneurysms of the STA should be a differential diagnostic consideration in patients with a history of trauma and a swelling on their head.
- CT finding of parapharyngeal space ectopic pituitary adenoma: Case report and review of literature. [JOURNAL ARTICLE]
- Head Neck 2014 Oct 28.
Background: Ectopic pituitary adenoma (EPA) was first described by Erdheim in 1909, about 100 cases had been reported in literature, to the best of our knowledge, an EPA located in the parapharyngeal space has not been reported thus far. Method A 59-year old female presenting with a neck lump, which was painlessness and growing, without any neurological disorders or endocrine disorders. Auxiliary examinations includes ultrasound, electronic nasopharyngolarygnoscope, endocrine assessment, CT and CT angiography (CTA). Results CT showed a soft tissue density mass with clear boundary involving carotid sheath area. The contrast enhanced CT had heterogeneous density. Tissues around the mass were pushed and displaced. CTA showed the mass was hypervascular and supported by the right internal carotid artery and branches of external carotid artery. The tumor underwent a total removal and was confirmed as an adenoma with pituitary cells by histopathologic examinations, and postoperative recovery was wel1. Conclusions It is rarely seen that pituitary adenoma ectopic to parapharyngeal space. Diagnosis is difficult and mainly depends on the postoperative pathological examination. Head Neck, 2014.
- Focused Cardiac Ultrasound Using a Pocket-Size Device in the Emergency Room. [JOURNAL ARTICLE]
- Arq Bras Cardiol 2014 Oct 28.
Background: Cardiovascular urgencies are frequent reasons for seeking medical care. Prompt and accurate medical diagnosis is critical to reduce the morbidity and mortality of these conditions. Objective: To evaluate the use of a pocket-size echocardiography in addition to clinical history and physical exam in a tertiary medical emergency care. Methods: One hundred adult patients without known cardiac or lung diseases who sought emergency care with cardiac complaints were included. Patients with ischemic changes in the electrocardiography or fever were excluded. A focused echocardiography with GE Vscan equipment was performed after the initial evaluation in the emergency room. Cardiac chambers dimensions, left and right ventricular systolic function, intracardiac flows with color, pericardium, and aorta were evaluated. Results: The mean age was 61 ± 17 years old. The patient complaint was chest pain in 51 patients, dyspnea in 32 patients, arrhythmia to evaluate the left ventricular function in ten patients, hypotension/dizziness in five patients and edema in one patient. In 28 patients, the focused echocardiography allowed to confirm the initial diagnosis: 19 patients with heart failure, five with acute coronary syndrome, two with pulmonary embolism and two patients with cardiac tamponade. In 17 patients, the echocardiography changed the diagnosis: ten with suspicious of heart failure, two with pulmonary embolism suspicious, two with hypotension without cause, one suspicious of acute coronary syndrome, one of cardiac tamponade and one of aortic dissection. Conclusion: The focused echocardiography with pocket-size equipment in the emergency care may allow a prompt diagnosis and, consequently, an earlier initiation of the therapy.Fundamento: As urgências cardiovasculares são causas importantes de procura por atendimento médico, sendo fundamentais a rapidez e a precisão no diagnóstico para diminuir sua morbimortalidade. Objetivo: Avaliar o uso da ecocardiografia direcionada como complemento diagnóstico ao exame físico em um serviço terciário de emergências clínicas. Métodos: Foram incluídos cem pacientes adultos sem doenças cardíacas ou pulmonares conhecidas que procuraram atendimento de urgência com queixas cardiológicas. Foram excluídos pacientes com alterações isquêmicas no eletrocardiograma ou febre. A ecocardiografia direcionada foi realizada logo após a avaliação inicial do paciente na sala de emergência, com aparelho ultraportátil GE Vscan, avaliando subjetivamente: dimensões das cavidades, função sistólica ventricular, fluxos intracardíacos pelo mapeamento de fluxo em cores, pericárdio e aorta. Resultados: A idade média dos pacientes foi 61 ± 17 anos. O quadro clínico inicial foi dor torácica (52 pacientes), dispneia (32 pacientes), arritmia/avaliação da função ventricular (dez pacientes), hipotensão/tontura (cinco pacientes) e edema periférico (um paciente). Em 28 pacientes a ecocardiografia direcionada confirmou a hipótese diagnóstica inicial: 19 pacientes com insuficiência cardíaca, cinco com síndrome coronariana aguda, dois com tromboembolismo pulmonar e dois com tamponamento cardíaco. Em 17 pacientes, a ecocardiografia direcionada alterou o diagnóstico, afastando a hipótese clínica inicial em dez casos com suspeita de insuficiência cardíaca, dois com suspeita de tromboembolismo pulmonar, dois com hipotensão a esclarecer, e em cada um dos três restantes com suspeitas de síndrome coronariana aguda, tamponamento cardíaco e dissecção de aorta. Conclusão: A ecocardiografia direcionada ultraportátil em serviço de emergências clínicas pode definir rapidamente o diagnóstico e, com isso, é possível iniciar mais precocemente o tratamento adequado.
- Pseudoaneurysm of the breast. [JOURNAL ARTICLE]
- Breast Dis 2014 Oct 28.
Pseudoaneurysm of the breast is a very rare complication, which may occur after breast biopsy with a large core needle. We report a case of pseudoaneurysm of the breast that occurred after biopsy of a breast mass.The patient underwent core biopsy of a breast mass, progressing with extensive hematoma after the initial firing of the biopsy gun. Regression of the hematoma occurred but a nodular area persisted. A pseudoaneurysm was detected on ultrasonography and magnetic resonance imaging.An extensive breast hematoma following core needle biopsy usually regresses completely within a few weeks. The persistence of a vascularized lesion on ultrasound should draw attention to the diagnosis of pseudoaneurysm. This condition may be managed by endovascular procedure or surgical resection of the lesion.
- Does Nonsurgical Treatment Improve Longitudinal Outcomes of Lateral Epicondylitis Over No Treatment? A Meta-analysis. [JOURNAL ARTICLE]
- Clin Orthop Relat Res 2014 Oct 29.
Lateral epicondylitis is a painful tendinopathy for which several nonsurgical treatment strategies are used. Superiority of these nonsurgical treatments over nontreatment has not been definitively established.We asked whether nonsurgical treatment of lateral epicondylitis compared with observation only or placebo provides (1) better overall improvement, (2) less need for escape interventions, (3) better outcome scores, and (4) improved grip strength at intermediate- to long-term followup.The English-language literature was searched using PubMed and the Cochrane Central Register of Controlled Trials. Randomized-controlled trials (RCTs) comparing any form of nonsurgical treatment with either observation only or placebo at followup of at least 6 months were included. Nonsurgical treatments included injections (corticosteroid, platelet-rich plasma, autologous blood, sodium hyaluronate, or glycosaminoglycan polysulfate), physiotherapy, shock wave therapy, laser, ultrasound, corticosteroid iontophoresis, topical glyceryl trinitrate, or oral naproxen. Methodologic quality was assessed with the Consolidated Standards of Reporting Trials (CONSORT) checklist, and 22 RCTs containing 2280 patients were included. Pooled analyses were performed to evaluate overall improvement; requirement for escape interventions (treatment of any kind, outside consultation, and surgery); outcome scores (Patient-Rated Tennis Elbow Evaluation [PRTEE]; DASH; Pain-Free Function Index [PFFI]; EuroQoL [EQ]-5D; and overall function); and maximum and pain-free grip strength. Sensitivity analyses were performed using only trials of excellent or good quality. Heterogeneity analyses were performed, and funnel plots were constructed to assess for publication bias.Nonsurgical treatment was not favored over nontreatment based on overall improvement (risk ratio [RR] = 1.05 [0.96-1.15]; p = 0.32), need for escape treatment (RR = 1.50 [0.84-2.70]; p = 0.17), PRTEE scores (mean difference [MD] = 1.47, [0.68-2.26]; p < 0.001), DASH scores (MD = -2.69, [-15.80 to 10.42]; p = 0.69), PFFI scores (standardized mean difference [SMD] = 0.25, [-0.32 to 0.81]; p = 0.39), overall function using change-from-baseline data (SMD = 0.11, [-0.14 to 0.36]; p = 0.37) and final data (SMD = -0.16, [-0.79 to 0.47]; p = 0.61), EQ-5D scores (SMD = 0.08, [-0.52 to 0.67]; p = 0.80), maximum grip strength using change-from-baseline data (SMD = 0.12, [-0.11 to 0.35]; p = 0.31) and final data (SMD = 4.37, [-0.65 to 9.38]; p = 0.09), and pain-free grip strength using change-from-baseline data (SMD = -0.20, [-0.84 to 0.43]; p = 0.53) and final data (SMD = -0.03, [-0.61 to 0.54]; p = 0.91).Pooled data from RCTs indicate a lack of intermediate- to long-term clinical benefit after nonsurgical treatment of lateral epicondylitis compared with observation only or placebo.Level II, therapeutic study.
- Reply to the Letter to the Editor: Does the Use of Ultrasound Affect Contamination of Musculoskeletal Injections Sites? [JOURNAL ARTICLE]
- Clin Orthop Relat Res 2014 Oct 29.