JAMA: 25% of U.S. healthcare spending is waste

Approximately 25% of annual U.S. healthcare spending -- $760 billion to $935...Read more on AuntMinnie.comRelated Reading: JAMA: Medical imaging use rates continue to rise Trump administration hits brakes on law to curb unneeded Medicare CT scans, MRIs AI may help cut back on overutilization of CT for PE More pregnant women are undergoing imaging Better ultrasound protocols slash trauma imaging overuse
Source: AuntMinnie.com Headlines - Category: Radiology Source Type: news

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Abstract Point-of-care ultrasonography (POCUS) is performed by a physician at the bedside and is standard practice in obstetric, emergency, and musculoskeletal medicine. When compared with formal sonography, POCUS is equivalent in screening for abdominal aortic aneurysm and as accurate in diagnosing deep venous thrombosis. POCUS has high accuracy for diagnosing pneumonia and detecting acute decompensated heart failure but is less accurate than computed tomography for identifying pulmonary embolism. POCUS confirmation of intrauterine pregnancy rules out an ectopic pregnancy. In the third trimester of high-risk preg...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research
ConclusionIn such cases, whenever the conventional imaging modalities like the X-rays such as intra oral peri-apical views and orthopantomograms are unavailable, or where use of ionizing radiation is a grave concern (especially in children and pregnant patients), ultrasonography offers a non-invasive diagnostic imaging method which helps in diagnosis of the condition and also helps in supplementing the clinical information, thereby helping in better understanding of the underlying condition.
Source: African Journal of Emergency Medicine - Category: Emergency Medicine Source Type: research
AbstractAcute gynaecologic disorders are commonly encountered in daily clinical practice of emergency departments (ED) and predominantly occur in reproductive-age women. Since clinical presentation may be nonspecific and physical findings are often inconclusive, imaging is required for a timely and accurate diagnosis. Although ultrasound is the ideal non-invasive first-line technique, nowadays multidetector computed tomography (CT) is extensively used in the ED, particularly when a non-gynaecologic disorder is suspected and differential diagnosis from gastrointestinal and urologic diseases is needed. As a result, CT often ...
Source: Insights into Imaging - Category: Radiology Source Type: research
(Aust N Z J Obstet Gynaecol. 2019;59:45–53) The most common emergency nonobstetric abdominal surgery performed in parturients is appendicectomy, which occurs in ∼0.3% of pregnancies. Establishing the diagnosis of appendicitis is more challenging in pregnant women as a result of the physiological changes of pregnancy and the many non-specific symptoms experienced during normal pregnancy. In addition, the use of ultrasound to make the diagnosis is less effective due to the presence of the gravid uterus and computed tomography scanning is sometimes avoided to prevent fetal radiation exposure. Appendiceal perforatio...
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Epidemiologic Reports Surveys Source Type: research
Publication date: Available online 5 March 2019Source: Seminars in Ultrasound, CT and MRIAuthor(s): Lawrence Hsu Lin, Rodrigo Polizio, Koji Fushida, Rossana Pulcineli Vieira FranciscoAbstractGestational trophoblastic disease (GTD) is a spectrum of disorders characterized by abnormal trophoblastic proliferation. GTD includes benign conditions such as hydatidiform moles and malignant diseases that are referred as gestational trophoblastic neoplasia (GTN). Ultrasound plays a central role in the diagnosis of patients with hydatidiform mole. Other imaging modalities are useful in molar pregnancy, mainly for evaluating pulmonary...
Source: Seminars in Ultrasound, CT and MRI - Category: Radiology Source Type: research
Stroke is an uncommon but serious potential complication of pregnancy. The management of acute ischemic stroke in pregnant women remains a complex challenge that extends beyond the limits of clinical trial evidence. Patient 1 was a 29-year-old woman 27 weeks into her first pregnancy, without remarkable past medical history or vascular risk factors. She was admitted 1 h after sudden onset of a left total anterior circulation syndrome (National Institute of Health Stroke Scale [NIHSS] score of 23). CT and angio-CT scans were normal. Thrombolysis was performed, with mild clinical improvement. Brain MRI showed multi-territoria...
Source: Case Reports in Neurology - Category: Neurology Source Type: research
Publication date: Available online 30 October 2018Source: Journal of Visceral SurgeryAuthor(s): M. Bougard, L. Barbier, B. Godart, A.-G. Le Bayon-Bréard, F. Marques, E. SalaméSummaryAcute pancreatitis is a frequent pathology with 11,000 to 13,000 new cases per year in France. A biliary origin (30 to 70% of the cases) should be suspected when alanine amino-transferases are elevated during the first 48 hours, and it is confirmed by the presence of gallstones at trans abdominal ultrasound. Abdominal computed-tomography scan is performed around the fifth day, and is repeated according to clinical and biological e...
Source: Journal of Visceral Surgery - Category: Surgery Source Type: research
Conclusion: A diagnostic strategy based on assessment of clinical probability, D-dimer measurement, CUS, and CTPA can safely rule out PE in pregnant women. Primary Funding Source: Swiss National Foundation for Scientific Research, Groupe d'Etude de la Thrombose de Bretagne Occidentale, and International Society on Thrombosis and Haemostasis. PMID: 30357273 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - Category: Internal Medicine Authors: Tags: Ann Intern Med Source Type: research
Conclusion: The site of an ectopic pregnancy should be sought thoroughly to avoid missing an abdominal pregnancy and hence disastrous hemoperitoneum. While medical therapy with high-dose methotrexate is not a standard treatment, it can be considered after failing the traditional therapy, provided that there is adequate treatment monitoring and expertise in handling the side effects of the medication. PMID: 30226730 [PubMed - in process]
Source: Journal of Reproductive Medicine - Category: Reproduction Medicine Tags: J Reprod Med Source Type: research
We describe the case of a healthy 31-year-old G2P1 who presented with visual changes and dysarthria during pregnancy. Imaging showed cerebral infarcts. Her thrombophilia evaluation was negative. During delivery, she was diagnosed with fulminant Budd-Chiari Syndrome. Hepatic ultrasound suggested malignancy or metastasis, and postpartum CT scan and biopsy confirmed the diagnosis of Stage IV pancreatic cancer. Although rare in pregnancy, a new diagnosis of malignancy should be considered in patients with recurrent unexplained hypercoagulable complications. We propose an evidence-based algorithm for evaluation of occult malign...
Source: Gynecologic and Obstetric Investigation - Category: OBGYN Source Type: research
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