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1.
Itay Zmora Yonit Wiener-Well Evan Avraham Alpert 《The American journal of emergency medicine》2019,37(5):1006.e5-1006.e7
Background
Purulent bacterial pericarditis is a rare and potentially fatal disease. The course may be fulminant, and the presentation may pose a diagnostic challenge.Case report
An otherwise healthy 75-year-old male was brought to the emergency department in a state of general deterioration, confusion, and shock. Bedside ultrasound showed a significant pericardial effusion. His condition quickly deteriorated and the resuscitation included emergent bedside pericardiocentesis. The drainage was purulent and later cultures grew out Streptococcus pneumoniae.Why should an emergency physician be aware of this?
Purulent pericarditis is extremely rare but should be considered in the patient with a fulminant infectious process (particularly pneumonia) and signs of pericardial effusion. Treatment should include appropriate antibiotics and early drainage. 相似文献2.
Josh Greenstein Devjani Das Josie Acuna Monica Kapoor Cara Brown Abbas Husain Brendan Lally Barry Hahn 《The American journal of emergency medicine》2019,37(2):313-316
Background
In the emergency department, rib fractures are a common finding in patients who sustain chest trauma. Rib fractures may be a sign of significant, underlying pathology, especially in the elderly patients where rib fractures are associated with significant morbidity and mortality. To date, no studies have evaluated the ability of ultrasound to detect rib fractures using cadaver models and subsequently use this model as a teaching tool.Objectives
The purpose of this study was to determine if it is possible to generate rib fractures on cadaver models which could be accurately identified using ultrasound.Methods
This was a cross-sectional study performed during one session at a cadaver lab. A single hemithorax from four adult cadavers were used as models. Single rib fractures on each of rib five through eight were created. Four subjects, blinded to the normal versus fractured ribs, were asked to identify the presence of a fracture on each rib.Results
A total of 8 of 16 potential ribs had fractured induced by study staff. Mean accuracy was 55% for all subjects. The overall sensitivity and specificity for detecting rib fractures was 50% (CI: 31.89–68.11) and 59.38% (CI: 35.69–73.55) respectively. The overall PPV and NPV was 55.17% and 54.29% respectively.Conclusions
In this pilot study, subjects were not able to detect induced rib fractures using ultrasound on cadaver models. The use of this model as a teaching tool in the detection of rib fractures requires further investigation. 相似文献3.
肿胀法超声抽吸术治疗腋臭83例疗效观察 总被引:1,自引:0,他引:1
目的观察肿胀法超声抽吸术治疗液臭的效果,寻找一种治疗腋臭的新方法。方法在腋窝毛发区皮下注入肿胀液80~100ml,经5mm大小切口将超声探头在腋部皮下组织快速移动,直到皮肤发红发热为止,再用负压抽吸被乳化的皮下组织加压包扎。结果83例受术者,术后6~12个月随访,效果良好者76例(91.5%),有效5例(6.25%),无效2例(2.25%)。结论肿胀法超声抽吸术治疗腋臭,操作简单,不留瘢痕,安全有效,是目前治疗腋臭较为理想的方法。 相似文献
4.
5.
Teng-Yi Huang Hsiao-Wen Chung Fu-Nien Wang Cheng-Wen Ko Cheng-Yu Chen 《Magnetic resonance in medicine》2004,51(2):243-247
In this work the feasibility of separating fat and water signals using the balanced steady-state free precession (SSFP) technique is demonstrated. The technique is based on the observation (Scheffler and Hennig, Magnetic Resonance in Medicine 2003;49:395-397) that at the nominal values of TE = TR/2 in SSFP imaging, phase coherence can be achieved at essentially only two orientations (0 degrees and 180 degrees ) relative to the RF pulses in the rotating frame, under the assumption of TR < T2, and independently of the SSFP angle. This property allows in-phase and out-of-phase SSFP images to be obtained by proper choices of the center frequency offset, and thus allows the Dixon subtraction method to be utilized for effective fat-water separation. The TR and frequency offset for optimal fat-water separation are derived from theories. Experimental results from healthy subjects, using a 3.0 Tesla system, show that nearly complete fat suppression can be accomplished. 相似文献
6.
李阳春 《南通大学学报(哲学社会科学版)》2002,18(2):117-120
八十年代初中期 ,中国戏剧积极拓展我国传统戏剧的时空观、写意性特征 ,大胆借鉴西方现代戏剧的荒诞化、意象性技巧 ,出现了探索创新、多元发展的崭新局面。其中对“三一律、一堵墙”戏剧观的突破 ,运用意识形象外显人物的内心世界 ,嫁接多种艺术手段将现实时空转化为艺术时空 ,是新时期戏剧艺术探索最突出的三项成就。而过分强调形式技巧 ,脱离观众欣赏习惯 ,致使演出市场萎缩 ,观众锐减 ,无疑是新时期戏剧艺术探索中面临的最大困顿。 相似文献
7.
S. Aziz L. A. Soine S. L. Lewis A. P. Kruse W. C. Levy K. M. Wehe D. P. Fishbien M. D. Allen 《Transplant international》1997,10(6):446-450
A review of factors contributing to early mortality after cardiac transplantation revealed that up to 25 % of deaths were
due to primary graft dysfunction unrelated to rejection or infection. In light of this finding, evaluation of a donor heart
with regard to its suitability for transplantation takes on added importance. In an effort to screen the suitability of donor
hearts in the region covered by the Northwest Organ Procurement Agency (USA), all donors are evaluated by two-dimensional
transthoracic echocardiography as part of the initial evaluation. A total of 110 donor echocardiograms were reviewed and an
attempt was made to correlate the 30-day outcome with the parameters measured. An unexpected finding was that the presence
of left ventricular hypertrophy in the donor heart was associated with an increase in the incidence of donor heart dysfunction
compared with donors with normal echocardiographic profiles (33 % vs 3 %, P = 0.007).
Received: 12 February 1996 Received after resision: 27 June 1997 Accepted: 14 July 1997 相似文献
8.
目的:探讨子宫内膜增生性病变与子宫内膜癌的超声鉴别诊断及内膜癌肌浸程度的估价.方法:采用术前B超、术后大体标本观察测量,对123例子宫内膜病变患者的声像图资料进行分析并与手术后病理结果对照.结果:①子宫内膜病变者子宫三径之和平均值均大于正常值;②58.6%的子宫内膜增生过长病变患者内膜形态以条形、梭形和正常形态回声;35%的Ⅱ期以上子宫内膜癌患者内膜回声以积液为主兼有其它图像类型;③大于50岁患者不同病理类型病变的子宫内膜平均厚度均超过其正常内膜厚度值,但无明显的规律性.小于50岁的患者内膜增厚主要以子宫内膜增生过长病变为主占48%;④通过超声测量子宫内膜厚度判断子宫内膜癌浅肌层和深肌层浸润符合率均为71.4%.结论:超声检查对判断子宫内膜病变病理类型有一定帮助,内膜厚度、内膜形态、回声特点、及内膜与肌层间的关系等,仅提示病变存在的可能性,要鉴别病变的良恶性、肌层浸润深度,须根据上述回声特点进行综合分析. 相似文献
9.
10.