The jugular vein catheterism (JVC) is adopted for blood access in patients with acute renal failure, in chronic renal failure and when patients show failure of traditional vascular access. The technique of catheter insertion in the jugular vein is quick and easy. Usually correct catheter positioning, before starting the dialytic procedure, is controlled by chest X-ray or by intra-cavitary electrocardiogram. The aim of this work is to evaluate the feasibility of the real-time ultrasound guidance to control the correct positioning of the catheter instead of the usual chest X-ray control. We have studied 158 patients with JVC insertion before the hemodialytic procedure; 54 patients have undergone both ultrasound and a chest X-ray control while 104 were only submitted to ultrasound control. The ultrasound procedure includes an under xifoid scanning, with a convex 3.5 Mhz drill to evaluate the four heart cavities. When the right atrium is identified a second operator rapidly infuses in the venous catheter 15 ml of physiological solution thus creating a blood turbolence easily observed in real time as a light jet inside the atrium. This turbolence appears to be the main evidence for good catheter positioning and we were able to show the light jet in 156 (98%) patients. All light jet positive patients were submitted to the hemodialytic procedure without any complications during and after dialysis. We concluded that the intraoperative ultrasound control technique is an alternative to the chest X-ray evaluation because it offers the possibility for safe intraoperative immediate control thus reducing the total costs of the procedure.
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http://dx.doi.org/10.1177/112972980000100207 | DOI Listing |
Langenbecks Arch Surg
January 2025
Department of Trauma Surgery, University Hospital Zurich, Rämistrasse 100, CH - 8091, Zurich, Switzerland.
Introduction: Blunt traumatic aortic injury (TAI) is a critical condition and a leading cause of mortality in trauma patients, often resulting from high-speed accidents. Thoracic endovascular aortic repair (TEVAR) has developed into the preferred therapeutic approach due to its minimally invasive nature and promising outcomes. This study evaluates the safety and efficacy of TEVAR for managing TAI over a 10-year period at a Level-1 trauma center.
View Article and Find Full Text PDFBMC Pulm Med
January 2025
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon, 301-721, Republic of Korea.
Background: Behçet's disease (BD) is a multisystem inflammatory disorder that can affect various organs, including the lungs. Pulmonary manifestations are rare and typically present as pulmonary artery aneurysms.
Case Presentation: We report the case of a 56-year-old East Asian male with a 27-year history of BD, who had no respiratory symptoms, such as hemoptysis, cough, or fever.
BMC Pediatr
January 2025
Department of Pulmonology, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Machang compus, 225 Machang Road, Hexi District, Tianjin, 300074, China.
Background: Foreign body inhalation is rare in older children, often leading to underdiagnosis and delayed treatment. Most cases involve a single foreign body, but instances of multiple foreign bodies are exceedingly uncommon. This report presents a case of an elder child who inhaled two pen caps, emphasizing the need for clinical vigilance and thorough medical history collection.
View Article and Find Full Text PDFNEJM AI
October 2024
Google, Mountain View, CA, USA.
Background: Using artificial intelligence (AI) to interpret chest X-rays (CXRs) could support accessible triage tests for active pulmonary tuberculosis (TB) in resource-constrained settings.
Methods: The performance of two cloud-based CXR AI systems - one to detect TB and the other to detect CXR abnormalities - in a population with a high TB and human immunodeficiency virus (HIV) burden was evaluated. We recruited 1978 adults who had TB symptoms, were close contacts of known TB patients, or were newly diagnosed with HIV at three clinical sites.
Radiol Bras
January 2025
Escola de Medicina - Universidade de Passo Fundo (UPF), Passo Fundo, RS, Brazil.
Objective: To identify and analyze the main findings on computed tomography (CT) scans ordered in the emergency department of a tertiary care hospital.
Materials And Methods: This was a cross-sectional observational study conducted through analysis of CT scans of the head, chest, and abdomen of all patients admitted to the emergency department of a tertiary care hospital over a period of four months.
Results: Among a sample of 331 patients, pathological radiological findings were observed in 59.
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