Ultrasound Phantom Using Sodium Alginate as a Gelling Agent

For medical workers, ultrasound phantoms for human soft tissue are used not only for accuracy management of ultrasound diagnosis but also to aid ultrasound‐guided needle and blind catheter insertion training without risk to real patients. For the phantoms, ultrasound characteristics and a texture are required to mimic the human soft tissue. The proposed phantom was composed of sodium alginate, calcium sulfate dihydrate, trisodium phosphate 12‐hydrate, glycerol, and water. The propagation speed, attenuation coefficient, acoustic impedance, and texture of the proposed phantom were almost the same as those of human soft tissue. Expensive chemicals and special equipment are not required.     

Apical hypertrophic cardiomyopathy with left ventricular apical aneurysm: Importance of multi‐modality imaging

Apical hypertrophic cardiomyopathy (HCM) is an uncommon variant of HCM characterized by apical hypertrophy without the septal predominance seen in the majority of HCM cases. In 2% of patients, a concomitant left ventricular apical aneurysm is observed, which increases the risk of sudden death and adverse HCM‐related events. Multimodality imaging is helpful for appropriate identification of this particular morphologic pattern. Herein, we present a case of apical HCM with a left ventricular apical aneurysm, exemplifying the utility of a multimodality approach from resting electrocardiogram, transthoracic echocardiogram, left ventriculography, and cardiac magnetic resonance imaging, for proper risk stratification and treatment planning.     

Supervising Client Conversation

No abstract available for this article.     

Elucidating inconsistencies in dysphagia diagnostics: Redefining normal

Speech–language pathologists (SLPs) are the primary healthcare providers responsible for the evaluation and treatment of dysphagia. Fundamental to this role is the ability to make accurate clinical judgements to distinguish between normal versus disordered swallowing for subsequent treatment planning. In this review, we highlight recent data collected from practising clinicians in the USA that reveal low levels of agreement across clinicians and poor to moderate levels of accuracy for making binary diagnostic ratings (normal vs. disordered). We then propose and discuss barriers that may represent challenges to practising SLP’s understanding of normal swallowing physiology. Proposed barriers include: (1) an educational focus on the disordered system; (2) system 1 processing; (3) complexity of the swallowing system; (4) inability to directly visualise the swallowing process; (5) degree of variability of normal swallowing; and (6) high clinical productivity requirements. This article concludes with suggestions for reducing identified educational and clinical barriers to ultimately improve diagnostic decision-making practices and to benefit patient-related outcomes in dysphagia management.     

Management of Neurogenic Orthostatic Hypotension

The burden of orthostatic hypotension (OH) on public health is a universally recognized enigmatic clinical condition that is associated with significant increases on morbidity and mortality rates, and can take a major toll on one's quality of life. Orthostatic hypotension is predictive of vascular deaths from acute myocardial infarction, strokes in the middle aged population, and increases mortality rates when associated with diabetes, hypertension, Parkinson's disease, and patients receiving renal dialysis. The consensus definition for OH is a fall in systolic blood pressure of at least 20 mm Hg and/or diastolic blood pressure of at least 10 mm Hg within 3 minutes of quiet standing. Because neurogenic OH is often accompanied by supine hypertension, the treatment program should aim toward minimizing OH and the potential fall injuries related to cerebral hypoperfusion without exacerbating nocturnal hypertension that may lead to excessive cardiovascular complications.     

Considerations for appraising diagnostic studies of communication disorders

Clinicians have always been aware of the importance of using valid and reliable clinical tests and measures—and of avoiding those that are not. However, the choice of which tests and measures to use is often more a matter of personal preference, arising out of knowledge of a test's psychometric properties and one's experience with the test, rather than being based on a systematic, critical appraisal of assessment tools. This paper proposes a method of critically appraising clinical assessments in the speech and language sciences, for the purpose of deciding whether they are likely to be informative in diagnosing individuals with communication disorders. QUADAS (Quality Assessment of Diagnostic Accuracy Studies)—a 14-item, evidence-based critical appraisal tool (Whiting, Rutjes, Reitsma, Bossuyt,?&?Kleijnen, 2003) originally designed to assess the quality of diagnostic-accuracy studies used in systematic reviews in medicine—is presented, with an example of how it can be applied in the field of communication disorders.