Thrombotic complications of COVID-19.

Introduction: The novel coronavirus disease of 2019 (COVID-19) is associated with significant morbidity and mortality. The impact of thrombotic complications has been increasingly recognized as an important component of this disease.

Objective: This narrative review summarizes the thrombotic complications associated with COVID-19 with an emphasis on information for Emergency Medicine clinicians.

Impact of endotracheal tube twisting on the diagnostic accuracy of ultrasound for intubation confirmation.

Introduction: Ultrasound is a readily-available technique used to identify accurate placement of an endotracheal tube (ETT) after an intubation attempt. There is limited research on using manipulation of the ETT to improve the diagnostic accuracy of ETT location confirmation. Our study sought to directly assess whether ETT twisting during the standard grayscale technique influenced the accuracy of intubation confirmation by ultrasound.

Ultrasound for airway management: An evidence-based review for the emergency clinician.

Background: Airway management is a common procedure performed in the Emergency Department with significant potential for complications. Many of the traditional physical examination maneuvers have limitations in the assessment and management of difficult airways. Point-of-care ultrasound (POCUS) has been increasingly studied for the evaluation and management of the airway in a variety of settings.

Current Approach to the Evaluation and Management of Septic Arthritis.

Septic arthritis is an emergent condition caused by bacterial infection of a joint space. The most common etiology is hematogenous spread from bacteremia, but it can also occur from direct inoculation from bites, injection injuries, cellulitis, abscesses, or local trauma. Septic arthritis occurs most frequently in the lower extremities, with the hips and knees serving as the most common locations.

Current Approach to the Evaluation and Management of Hair-Thread Tourniquets.

Hair-thread tourniquet syndrome is a rare, painful condition that occurs when a strand of hair or thread becomes wrapped around toes, fingers, or other appendages. This causes focal edema, which eventually reduces arterial blood flow and can lead to ischemia and necrosis. A thorough physical examination and assessment of risk factors are important.

Accuracy of ultrasound for endotracheal intubation between different transducer types.

Introduction: Ultrasound has been increasingly utilized for the identification of endotracheal tube (ETT) location after an intubation attempt, particularly among patients in cardiac arrest. However, prior studies have varied with respect to the choice of transducer and no studies have directly compared the accuracy between transducer types. Our study is the first to directly compare the accuracy of ETT confirmation between the linear and curvilinear transducer.

Point-of-care ultrasound for the diagnosis of shoulder dislocation: A systematic review and meta-analysis.

Introduction: Shoulder dislocations are a common injury causing patients to present to the emergency department. Point-of-care ultrasound (POCUS) has the potential to reduce time, radiation exposure, and healthcare costs among patients presenting with shoulder dislocations. We performed this systematic review and meta-analysis to determine the diagnostic accuracy of ultrasound compared with plain radiography in the assessment of shoulder dislocations.

Point-of-Care Ocular Ultrasound for the Diagnosis of Retinal Detachment: A Systematic Review and Meta-Analysis.

Background: Ocular complaints are common presentations to the emergency department (ED). Among these, retinal detachment can cause significant vision loss if not rapidly diagnosed and referred for appropriate treatment. Point-of-care ultrasound has been suggested to identify the diagnosis rapidly when the ocular examination is limited or the ophthalmology service is not readily available.

Ultrasound-assisted Lumbar Punctures: A Systematic Review and Meta-Analysis.

Background: Lumbar punctures (LPs) are a common procedure in emergency medicine. However, studies have found that failed procedure rates can be as high as 50%. Ultrasound has been suggested to improve success rates by visually identifying the location and trajectory for the LP procedure.

Ultrasonography for the Confirmation of Endotracheal Tube Intubation: A Systematic Review and Meta-Analysis.

Study Objective: Intubation is routinely performed in the emergency department, and rapid, accurate confirmation is essential to avoid potentially serious adverse outcomes. The number of studies assessing ultrasonography for the verification of endotracheal tube placement has expanded rapidly in recent years. We performed this systematic review and meta-analysis to determine the sensitivity and specificity of transtracheal ultrasonography for the verification of endotracheal tube location.

Comparison of Short- vs Long-axis Technique for Ultrasound-guided Peripheral Line Placement: A Systematic Review and Meta-analysis.

Ultrasound-guided peripheral intravenous line (PIV) placement is associated with increased success rates, decreased time to cannulation, and fewer skin punctures than traditional, landmark-based techniques. However, it is unclear which technique is best. This review compares the short-axis (SA) and long-axis (LA) techniques for PIV placement.

Variation in the accuracy of ultrasound for the detection of intubation by endotracheal tube size.

Introduction: Rapid and accurate confirmation of endotracheal tube (ETT) placement is a fundamental step in definitive airway management. Multiple techniques with different limitations have been reported. Recent studies have evaluated the accuracy, time to performance, and physician confidence for ultrasound in both cadaveric models and live patients.

Comparison of color flow with standard ultrasound for the detection of endotracheal intubation.

Introduction: Intubation is a frequently performed procedure in emergency medicine that is associated with significant morbidity and mortality when unrecognized esophageal intubation occurs. However, it may be difficult to visualize the endotracheal tube (ETT) in some patients. This study assessed whether the addition of color Doppler was able to improve the ability to visualize the ETT location.

Ultrasound-Guided Peripheral Intravenous Line Placement: A Narrative Review of Evidence-based Best Practices.

Peripheral intravenous line placement is a common procedure in emergency medicine. Ultrasound guidance has been demonstrated to improve success rates, as well as decrease complications and pain. This paper provides a narrative review of the literature focusing on best practices and techniques to improve performance with this procedure.

A syndrome of hereditary pancreatic adenocarcinoma and cysts of the liver and kidneys.

Pancreatic adenocarcinoma is the fifth leading cause of cancer death in developed countries. Several family and population studies have suggested that there is a genetic predisposition in about 10% of cases. Despite this, pedigrees showing a definite Mendelian inheritance pattern are quite rare.

Prostate specific antigen bounce after radioactive seed implantation followed by external beam radiation for prostate cancer.

Purpose: Prostate specific antigen (PSA) may temporarily increase following radiotherapy for prostate cancer without signaling cancer recurrence. We describe this phenomenon which is called PSA bounce.

Materials And Methods: From 1984 to 1995, 779 stage T1T2N0 cancer cases were treated with simultaneous radiotherapy with a 125iodine prostate implant followed by external beam radiation.

Post-treatment PSA < or = 0.2 ng/mL defines disease freedom after radiotherapy for prostate cancer using modern techniques.

Objectives: The prostate-specific antigen (PSA) definition of disease freedom after radiotherapy for prostate cancer is still in dispute. This report focuses on the PSA nadir achieved in men treated by modern radiotherapy techniques.

Methods: From 1984 to 1994, 489 consecutive men with clinical Stage T1 -T2 prostate cancer were treated by simultaneous radiation: prostate iodine-125 implant followed by external beam radiation.

BRCA1-related and sporadic ovarian cancer in the same family: implications for genetic testing.

Objective: The aim of this study was to present a family with both BRCA1-related and sporadic ovarian cancer and address current difficulties in genetic testing.

Methods: BRCA1 mutation detection was performed on a family having four confirmed cases of ovarian cancer, two cases of breast cancer, and one case each of colon, stomach, and prostate cancer. The incidence and types of cancer were consistent with a BRCA1 mutation although previous linkage analysis had excluded this family as being due to BRCA1.

Prostate specific antigen nadir achieved by men apparently cured of prostate cancer by radiotherapy.

Purpose: The role of prostate specific antigen (PSA) nadir in the definition of disease freedom after radiotherapy of prostate cancer is controversial. We evaluate post-irradiation PSA nadir in men apparently cured of this disease.

Materials And Methods: From 1984 to 1993, 354 men with clinical stage T1T2N0 prostate cancer were treated with radioactive 125iodine prostate implant followed by external beam radiation.

Simultaneous radiotherapy for prostate cancer: 125I prostate implant followed by external-beam radiation.

Purpose: Using a rigorous prostate-specific antigen definition of disease-freedom, the 10-year disease-free survival rates after simultaneous radiation of prostate cancer are presented.

Patients And Materials: From January 1984 through December 1996, 1020 men with clinical stage T1T2N0 prostate cancer were treated by simultaneous radiation: radioactive 125I prostate implantation followed by external-beam radiation. The median pretreatment prostate-specific antigen was 7.

Prostate-specific antigen nadir of 0.5 ng/mL or less defines disease freedom for surgically staged men irradiated for prostate cancer.

Objectives: This report describes treatment results of men with prostate cancer staged with a pelvic lymph node dissection. Disease freedom was defined by a prostate-specific antigen (PSA) level nadir of 0.5 ng/mL or less.

The PSA nadir that indicates potential cure after radiotherapy for prostate cancer.

Objectives: The prostate-specific antigen nadir that indicates potential cure by radiotherapy has never been established. We determined this nadir level and used it to define precisely disease freedom after radiotherapy.

Methods: Combination radioactive 125I prostate implant followed by external-beam radiation was administered to 660 men with clinical Stage T1T2N0 prostate cancer.

Prostate-specific antigen nadir: the optimum level after irradiation for prostate cancer.

Purpose: The prostate-specific antigen (PSA) nadir that reflects potential cure of prostate cancer by irradiation has not been established. This report attempts to demonstrate the PSA nadir goal for radiotherapy.

Materials And Methods: From January 1984 through April 1994, 536 stage T1T2NO prostate cancer patients were treated with radioactive iodine 125 (125I) prostate implants followed by external-beam radiation.

Prostate specific antigen-monitored combination radiotherapy for patients with prostate cancer. I-125 implant followed by external-beam radiation.

Background: Because results of retropubic I-125 implantation for prostate cancer have been poor, external beam radiation was added postimplant. Serum prostate specific antigen (PSA) was used to assess this approach of combined irradiation.

Methods: Two hundred and thirty-nine patients with clinical Stage T1 or T2 but surgically node-negative prostate cancer were treated.

Clinical presentation, treatment, and outcome of trilateral retinoblastoma.

In this report, three new cases of trilateral retinoblastoma are presented. The clinical presentation, treatment, and outcome of the patients are described and compared with those of 32 cases that have been previously reported in the literature. A positive family history was obtained in 68% of the patients.