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1.

Objectives

This study is to present the diagnostic values of the novel sonographic visualization of the inferoposterior thoracic wall (VIP) and boomerang signs in detecting right pleural effusion by sonologists with little to no experience in ultrasound.

Methods

A prospective analysis of a convenience sample of patients who were assessed by junior intensive care physicians was performed. The patients all underwent computed tomography (CT) of the chest or abdomen with lung bases as part of their care regardless of indication; the results were interpreted by radiologists and were considered the gold standard. Sonography was performed to assess for the presence of the VIP and boomerang signs. Sonographic and chest radiographic findings were compared against CT results.

Results

73 patients were enrolled. The sensitivity and specificity for the VIP sign were 0.85 (95% confidence interval [CI], 0.67–0.94) and 0.86 (95% CI, 0.70–0.95). The sensitivity and specificity for the boomerang sign were 0.78 (95% CI, 0.60–0.90) and 0.87 (95% CI, 0.71–0.95). However, the sensitivity and specificity for the traditional approach of detecting an anechoic collection above the diaphragm to indicate pleural effusion were only 0.54 (95% CI, 0.37–0.71) and 0.86 (95% CI, 0.80–0.99).

Conclusions

Despite inexperience in sonography, the novel VIP and boomerang signs show high diagnostic values in detecting right pleural effusion compared to the traditional methods.  相似文献   
2.
目的评价冠状动脉造影或经皮冠状动脉介入治疗(PCI)后,应用新型血管闭合器Boomerang的有效性及安全性。方法 入选2005年2月至2007年3月在北京军区总医心血管内科进行冠状动脉造影或PCI的112例患者,随机应用血管闭合器BoomerangBoomerang组,68例)和Angioseal(Angioseal组,44例)对股动脉穿刺部位进行封闭止血,观察两组止血时间、下肢制动时间,术后即刻、术后4h、出院前24h内出血发生率。结果两组即刻闭合成功率均较高(94%vs91%,P=0.78),两组止血时间[(1.89±1.23)min vs(2.01±1.21)min,P=0.633、下肢制动时间[(5.76±2.23)h vs(5.01±2.05)h,P=0.54)、术后即刻(16%vs15%,P=0.86)和出院前24h内(1%vs3%,P=0.75)的小出血发生率等均无显著性差异,但术后4h Boomerang组小出血发生率明显低于Angioseal组(7%vs13%,P=0.04),两组均无大出血发生。与合并高血压、高脂血症的患者比较,有糖尿病和吸烟史的患者术后即刻、术后4h和出院前24h内小出血发生率均显著增加(P〈0.05)。结论新型血管闭合器Boomerang。闭合股动脉穿刺口有效、安全,但对于有糖尿病和吸烟史的患者应谨慎选择。  相似文献   
3.
Transient signal abnormality in the splenium of corpus callosum on magnetic resonance imaging (MRI) is occasionally encountered in clinical practice. It has been reported in various clinical conditions apart from patients with epilepsy. We describe 4 patients with different etiologies presenting with signal changes in the splenium of corpus callosum. They were diagnosed as having progressive myoclonic epilepsy (case 1), localization-related epilepsy (case 2), hemicrania continua (case 3), and postinfectious parkinsonism (case 4). While three patients had complete involvement of the splenium on diffusion-weighted image (“boomerang sign”), the patient having hemicrania continua showed semilunar involvement (“mini-boomerang”) on T2-weighted and FLAIR image. All the cases had noncontiguous involvement of the splenium. We herein, discuss these cases with transient splenial involvement and stress that such patients do not need aggressive diagnostic and therapeutic interventions. An attempt has been made to review the literature regarding the pathophysiology, etiology, and outcome of such lesions.  相似文献   
4.
The Montana Meth Project (MMP) is an organization that launched a large-scale methamphetamine prevention program in Montana in 2005. The central component of the program is a graphic advertising campaign that portrays methamphetamine users as unhygienic, dangerous, untrustworthy, and exploitive. Montana teenagers are exposed to the advertisements three to five times a week. The MMP, media and politicians have portrayed the advertising campaign as a resounding success that has dramatically increased anti-methamphetamine attitudes and reduced drug use in Montana. The program is currently being rolled out across the nation, and is receiving considerable public funding. This article critically reviews the evidence used by the MMP to claim that its advertising campaign is effective. The main finding is that empirical support for the campaign is weak. Claims that the campaign is effective are not supported by data. The campaign has been associated with increases in the acceptability of using methamphetamine and decreases in the perceived danger of using drugs. These and other negative findings have been ignored and misrepresented by the MMP. There is no evidence that reductions in methamphetamine use in Montana are caused by the advertising campaign. On the basis of current evidence, continued public funding and rollout of Montana-style methamphetamine programs is inadvisable.  相似文献   
5.
Chen SL  Chiou TF 《Injury》2007,38(11):1273-1278
The boomerang flap originates from the dorsolateral aspect of the proximal phalanx of an adjacent digit and is supplied by the retrograde blood flow through the vascular arcades between the dorsal and palmar digital arteries. To provide sensation of the boomerang flap for finger pulp reconstruction, the dorsal sensory branch of the proper digital nerve and the superficial sensory branch of the corresponding radial or ulnar nerve are included within the skin flap. After transfer of the flap to the injured site, epineural neurorrhaphies are done between the digital nerves of the pulp and the sensory branches of the flap. We used this sensory flap in five patients, with more than 1 year follow-up, and all patients achieved measurable two-points discrimination. The boomerang flap not only preserves the proper palmar digital artery but also provides an extended and innervated skin paddle. It seems to be an alternative choice for one-stage reconstruction of major pulp defect.  相似文献   
6.
An increasing spectrum of complex peripheral arterial disease may be successfully treated using percutaneous revascularization techniques. A pair of challenging peripheral revascularization procedures in patients with critical limb ischemia is presented, where an array of inteventional tools and techniques were required, and the off‐label use of the Boomerang catalyst system closure device was important in managing a variety of complex arterial access issues and ultimately allowing procedural success. © 2009 Wiley‐Liss, Inc.  相似文献   
7.
目的评价冠状动脉造影或经皮冠状动脉介入治疗(PCI)后,应用新型血管闭合器Boomerang的有效性及安全性。方法2005年2月-2007年3月在北京军区总医院心脏中心进行冠状动脉造影或PCI的112例患者,随机应用血管闭合器BoomerangBoomerang组,68例)和Angioseal(Angioseal组,44例)对股动脉穿刺部位进行封闭止血,观察两组止血时间、下肢制动时间,术后即刻、术后4h、出院前24h内出血发生率。结果两组即刻成功率均较高(94%vs91%,P〉0.05),止血时间[(1.89±1.23)min vs(2.01±1.21)min,P〉0.05)],制动时间[(5.76±2.23)h vs(5.01±2.05)h,P〉0.05)],两组差异均无统计学意义。术后4hBoomerang组小出血发生率明显低于Angioseal组(7%ws14%,P〈0.05),两组均无大出血发生。结论新型血管闭合器Boomerang闭合股动脉穿刺口有效、安全。  相似文献   
8.
With a shifting economic climate and changes in social norms, young adults are increasingly reported to be living with their parents, either through delayed launch or by launch and return. For young adults grappling with financial and domestic independence, the family home can represent a safe haven; however, living with parents can also pose a threat to autonomy and self-image as they strive for adult status. Parents, on the other hand, are often beleaguered by the economic and emotional demands of their dependent adult children and struggle to maintain their own independence. The roles and expectations of both parties need to be redefined in order to achieve optimal household functioning.  相似文献   
9.
Boomerang血管封堵器在老年冠状动脉介入治疗患者中的应用   总被引:1,自引:0,他引:1  
【目的】与YM-GU-动脉压迫止血器对比,观察Boomerang血管封堵器在老年患者冠状动脉介入(percutaneous coronary intervention,PCI)术后股动脉止血中的安全性、有效性和优势。【方法】2007年4月-2008年4月在我科住院,经股动脉行PCI的老年患者81例,其中26例采用Boomerang血管封堵器(观察组),55例采用YM-GU-动脉压迫止血器(对照组)。观察两组患者术后止血时间、制动时间和股动脉局部并发症。【结果】两组围手术期抗凝治疗方案一致。观察组制动时间(4.6±0.8)h与对照组(6.4±0.9)h相比,有显著性差异(P〈0.05)。两组止血时间无明显差异。对照组出现3例皮肤溃破(P〈0.05),血肿和假性动脉瘤两组间无明显差异。【结论】与YM-GU-动脉压迫止血器相比,Boomerang血管封堵器更安全,术后制动时间短,对皮肤损伤小,尤其适于老年体弱不能强力压迫局部软组织的患者。  相似文献   
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