Point-of-Care Ultrasound Overview and Curriculum Implementation in Internal Medicine Residency Training Programs in the United States.

Point-of-care ultrasonography (POCUS) augments physical examination and expedites diagnostic care and clinical decision-making. The use of POCUS in internal medicine (IM) appears inconsistent despite its commendable benefits. It is not fully incorporated into the IM residency core competency skills or academic curriculum.

Femoral micropuncture or routine introducer study (FEMORIS).

Objectives: The Micropuncture® 21-gauge needle may reduce complications related to vessel trauma from inadvertent venous or posterior arterial wall puncture.

Methods: This was a single-center, multiple-user trial. Four hundred and two patients undergoing possible or definite percutaneous coronary intervention (PCI) were randomized 1:1 to an 18-gauge versus a 21-gauge needle.

Treating and preventing no reflow in the cardiac catheterization laboratory.

The no reflow phenomenon can happen during elective or primary percutaneous coronary intervention. This phenomenon is thought to be a complex process involving multiple factors that eventually lead to microvascular obstruction and endothelial disruption. Key pathogenic components include distal atherothrombotic embolization, ischemic injury, reperfusion injury, and susceptibility of coronary microcirculation to injury.

Acute cigarette smoke exposure reduces clot lysis--association between altered fibrin architecture and the response to t-PA.

Background: Enhanced thrombolysis is a proposed mechanism for reduced mortality in cigarette smokers with STEMI ("smoker's paradox"). The mechanisms remain unclear but studies suggest fibrin architecture (FA) may affect thrombolysis. Our group has previously shown that acute cigarette smoke exposure (CSE) alters FA.

Effects of cigarette smoke exposure on clot dynamics and fibrin structure: an ex vivo investigation.

Objective: The purpose of this study was to examine the effect of cigarette smoke exposure (CSE) on clot dynamics and fibrin architecture and to isolate the relative contribution of platelets and fibrinogen to clot dynamics.

Methods And Results: From young healthy males smokers (n=34) and nonsmokers (n=34) a baseline blood was drawn, and smokers had another blood draw after smoking 2 regular cigarettes. Using thromboelastography (TEG) the degree of platelet-fibrin interaction was measured.

Initial stability of cemented femoral stems as a function of surface finish, collar, and stem size.

Background: The optimum surface roughness of cemented femoral stems used for total hip replacement is a subject of controversy. While rougher surfaces provide stronger cement adhesion, it has been hypothesized that polished, tapered, noncollared stems settle into the cement mantle, providing improved stability. However, the effects of surface finish on the stability of straight, cemented stems tapered only in the coronal plane are not known.