Current status of extracorporeal shock wave lithotripsy in urinary lithiasis.
[Current status of extracorporeal shock wave lithotripsy in urinary lithiasis.] Arch Esp Urol. 2017 Mar;70(2):263-287 Authors: Pereira-Arias JG, Gamarra-Quintanilla M, Urdaneta-Salegui LF, Mora-Christian JA, Sánchez-Vazquez A, Astobieta-Odriozola A, Ibarluzea-González G Abstract Over the last decade, urinary lithiasis' prevalence has dramatically increased due to diet and lifestyle changes, growing 10.6% and 7.1% in men and women respectively. Extracorporeal shock wave lithotripsy has lost relevance in current practice due to endoscopic device development and unpredictability of results. Instrument miniaturization is leading to an increase of the percutaneous approach of increasingly smaller stones, while most flexible ureteroscopes durability and digitalization has allowed urologists to address larger stones. So that, decision algorithm is now impossible to define, but what is clear is that ESWL has declined worldwide. Can it disappear as a urinary lithiasis treatment modality? If we don't improve appropriate candidate selection and optimize disintegration efficiency, guidelines are going to replace the more "boring" ESWL by popular and more attractive endoscopes. Shock wave technology has evolved in the last two decades, however lithotripsy fundamental principle has not changed. ESWL has passed the test of time and centers dedicated to stone treatment should have a lithotripter in order to offer an appropriate balance in differen...
ConclusionGiven the very low incidence of PFO and postoperative delirium in this study, we could not form any conclusions regarding the impact of a PFO on important outcomes including delirium or other major adverse events. No recommendation can be made regarding screening for PFO in patients scheduled for lower extremity arthroplasty surgery.Trial registrationClinicalTrials.gov (NCT02400892). Registered 27 March 2015.
(Anaesthesia. 2017;72:811–825) Reliable and timely administration of epidural analgesia during labor is a major goal for both parturients and anesthesiologists. Although maternal anatomy sometimes contributes to epidural failures, the incorrect placement of the epidural catheter is the major contributor to failed epidural labor analgesia. The “loss of resistance” technique is the most common method used to identify the epidural space, but it lacks specificity as advancement through other tissues may also provide what is often referred to as a “false loss of resistance.” Ultrasound can aid wit...
This study aimed to evaluate the ability of a 3D power Doppler technique to diagnose MAP and severe MAP, as compared with gray-scale 2D ultrasound.
DEEP VENOUS THROMBOSIS (DVT) and pulmonary embolism (PE) are relatively common postoperative complications in the surgical patient population. Estimates of the incidence of DVT and/or PE in the lung transplant population vary significantly. A recent Nationwide Inpatient Sample inquiry estimated that venous thromboembolism (VTE) is diagnosed in 6.3% of lung transplant recipients during their index admission for transplantation, with DVT alone diagnosed in 5.4%, or concurrent with PE in 1.1%.1 However, this statistic is based primarily on reported diagnosis codes and may not capture all cases of interest.
Pulmonary capillary hemorrhage (PCH) can be induced by diagnostic ultrasound —a potential safety issue. Anesthetized rats were intubated for intermittent positive-pressure ventilation (IPPV) with 0 end-expiratory pressure, +4 cm H2O end-expiratory pressure (PEEP) and −4 cm H2O end-expiratory pressure (NEEP). Rats were imaged at 7.6 MHz with a Philips HDI 5000 ultra sound machine. The output was low (mechanical index [MI] = 0.22) for aiming and then was raised for 5 min in 20 different exposure groups with n = 8.
Transesophageal echocardiography (TEE) has been used clinically for decades1 and is now a standard intraoperative diagnostic technique for cardiac and noncardiac surgeries.2 –6 As TEE plays a major role in quantitative and qualitative evaluations of the heart, accurate assessment is critical.7,8 Despite remarkable progress in spatial resolution and postprocessing,9–14 image quality for TEE requires improvement for assistance with transmitting ultrasound.15–17 We d evised an orogastric tube attached TEE probe (OGT-TEE probe) (Fig 1) to allow pinpoint suction and prevent stomach distension during the TEE examination.
ENSURING optimal needle visualization is paramount for safe and successful ultrasound-guided nerve block.1 Although a variety of technologies have been tried to increase needle visibility during puncture, it is still a challenge to clearly visualize the needle at steep insertion angles, even for experienced practitioners.2
Condition: Malignant Neoplasms of Respiratory and Intrathoracic Organs Intervention: Procedure: Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA) Sponsor: M.D. Anderson Cancer Center Recruiting
While opioids are the mainstay for post-operative analgesia after lower segment caesarean section, they are associated with various untoward effects. Ultrasound guided transversus abdominis plane (TAP) block h...