appear similar to conventional stents.”8 Middleton, Teefey and Darcy8 note that the use of PFTE endografts will likely become standard as their performance outweighs the early stent materials used. Color Doppler as well as pulsed Doppler should be used to interrogate the stent and supporting vessels. Velocity measurements are taken using angle correct and spectral waveforms are recorded. Careful examination of the liver vasculature is imperative to verify proper stent function. Specifically, thrombosis or occlusion can be assessed with color and Doppler ultrasound. Velocity parameters may vary from patient to patient and also will change from immediate post procedure velocities to those obtained during long term follow up. Universal Doppler …show more content…
The study hoped to find an acceptable correlation with abnormal or normal Doppler ultrasound and venography. The results were not sufficient to determine that Doppler ultrasound alone was an adequate tool to determine stent malfunction consistently. Future objectives are for non-invasive Doppler testing to be sensitive and reproducible enough to detect early stent malfunction even before symptoms occur.29 Boyer,23 reports that Doppler ultrasound has sensitivity and specificity rates from 70%-100% in cases of stent stenosis, but it is still not ideal. Ultrasound requires a technologist and radiologist with experience and must be conducted with consistent parameters to obtain dependable results. Most of the trials recommend follow up studies including some or all of the following: venography, Doppler ultrasound combined with two-dimensional ultrasound, angiography, magnetic resonance imaging and computerized …show more content…
According to Middleton, Teefey and Darcy,8 TIPS placement is successful in about 90% of patients, but does hold a complication rate of 10-16%. Research has shown that placement of TIPS as a secondary treatment for variceal bleeding has produced encouraging results. In 13 random clinical trials, including over 900 patients, recurrent variceal bleeding rates were 9-40%, which is superior to endoscopic treatments that have recurrent bleeding rates from 20-60%. This success rate has made TIPS procedures more utilized in the setting of variceal bleeding. Additionally, the same clinical trials indicate that ascites reduction after shunting ranges from 38-84%, which is favorable to large volume paracentesis that reported rates of 0-43%. “Compared with large-volume paracentesis, TIPS improved transplant-free survival and the incidence of recurrent ascites in cirrhotic patients with refractory ascites.”26 There is evidence of an increase in the development of HE in patients who undergo TIPS, whereas endoscopic treatment does not show an increase. Furthermore, HE is twice as likely to occur when paracentesis is performed. An important consideration is that the complication rate for hepatic encephalopathy does increase with TIPS usage whereas it doesn’t with endoscopic treatment and it is twice as likely to occur as when paracentesis is performed.28 Presently, TIPS is often used as a temporary solution for patients who are
I want to be part of the Ultrasound program because I realized that where I’m from people don’t consider going into a major like this. I was raised to become a doctor or a nurse it was either of those or your family will be disappointed. I looked at how many doctors and nurses my community has but rarely any ultrasound technicians. I also like to travel to different parts of the world and I would love to have those skills as a ultrasound technician to help those women who are unable to afford to go to a clinic to see if their baby is in good condition. A woman should never have to choose between making a decision about losing her kid, I want to be able to help those women that are struggling daily whether their baby has a health condition or even letting the parents know their baby gender.
Pancreatic duct is dilated in region of the head and neck of the pancreas measuring up to 7 mm, nonspecific. Negative for discreet mass on this noncontrast exam. Negative for parapancreatic inflammation. Unenhanced pancreatic parenchyma otherwise appears unremarkable.
Central venous catheters (CVC) have become the most efficient means to administer long-term, vital medical treatments in hospitalized patients. These catheters are used in almost all types of medical settings for purposes related to, “hemodynamics monitoring, parenteral nutrition, chemotherapy, hemodialysis etc.” (Gorji, Rezaei, Jafari, Cherati, 2015, p.1). Its clinical relevance has become extremely significant in relation to treating patients with all sorts of medical diseases who necessitate the administration of extravasation drugs that can solely be administrated by a CVC. Therefore, CVC have “led to reduction in duration of hospitalization, increment of safety and reduction of hospital charges” (Gorji et al., 2015, p.1). Its benefits
In reviewing Heparin flushes in Central Venous Catheters (CVCs); one must first understand the importance of their placement. To properly investigate central venous catheter (CVC) care; documentation will focus on Heparin flushes as it relates to renal care. The renal dialysis patient undergoes CVC placement as a basis of receiving hemodialysis treatments. It is essentially the first access point placed in preparation of a more permanent access point. Central venous catheters, fistulas, and grafts are considered the lifeline of a dialysis patient. Their function and patency is of the utmost importance to the morbidity and mortality rate of a renal patient. “Venous catheters generally develop a fibrin sheath at the tip, which evolve into a clot due to body’s physiological response to the vein injury and the foreign catheter 1 and subsequent catheter obstruction.” (Journal of Evolution of Medical and Dental Sciences, 2014, pg. 46).
The blood vessel that Dr. Eltahawy was concerned about was thin and looked as though it would collapse in on itself. First, Dr. Eltahawy tried a balloon catheter. At the top of the catheter was a small balloon that could inflate to maintain a shape or structure of a blood vessel. However, because the blood vessel was so thin, the balloon catheter was not very effective. Instead, Dr. Eltahawy installed a stent. A stent is a wire mesh tube. It is placed in a blood vessel permanently to maintain the shape of the vessel and to allow for the free flow of blood. Throughout this entire independent study, I realize that shadowing in the medical field is less about learning about medicine and more about discovering about whether becoming a doctor is the right step. This independent study has been a step in the right
The Life of an Ultrasound Tech Ultrasound technicians, also known as sonographers, play a very important role in the medical field. One must be skillfully trained and strong-willed to pursue such a career. This career can either be extremely rewarding or stressful and troubling, depending upon the workplace you choose to perform in. There are many ups and downs to the job that should be considered before diving into the world of sonography. Before actually becoming a diagnostic medical sonographer, some education and training is required.
Comparing the data found in the Palliative Nursing textbook and those found in the articles researched, there are both similarities in description and etiologies identified by the disease but there are variances in the treatment plan for initial management of SVCO. All sources confirmed the use of CT scans as the primary diagnostic tool used to identify SVCO, followed up by the use of MRI. One source identified the use of a portable ultrasound for emergency department patients. Detailed by Birch et al., 2014, those patient were found to have a thrombolytic cause of the obstruction. The ultrasound was used as a primary tool for diagnosis in these cases. In, comparison Coyle et al., 2015 still reports using CT or MRI for screening of thrombolytic causes for SVCO. Older data indicates more frequent use of chemotherapy and radiation therapy but newer data demonstrates a greater use of stent placement as the initial treatment for SVCO. Research data, Leung et al., 2015, detailed that the initial treatment once SVCO is identified should be surgical stenting of the obstruction. This method was recommended because it provided rapid and effective relief of symptoms in patients. According to Leung et al., 2015, it was found that 95% of patients revealed overall symptom relief with stenting as the initial treatment of SVCO. There was only a reoccurrence of SVCO in 11% of patients. Labarca et al, 2014, reaffirms the stance for surgical intervention of stent placement as initial
Decompensated cirrhosis is characterized by the development of a cirrhosis-related complication, including variceal hemorrhage, ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, and/or coagulopathies. For patients with compensated and decompensated cirrhosis, the risk of death is 4.7 and 9.7 times higher than the general population, respectively.4 Survival in patients with decompensated cirrhosis is considerably lower than that of patients with compensated cirrhosis. The median survival times are as low as 2 years in decompensated patients and greater than 12 years in compensated
Unfortunately, “VTE comprised of DVT and/or PE represent a serious public health challenge, affecting up to 600,000 Americans annually. The consequences can be deadly; VTE has been identified as the most common cause of preventable mortality in hospitalized patients, accounting for up to 10% of hospital deaths” (Shermock et al., 2013, p. 1) It is imperative that all patients admitted to the ICU should be assessed for VTE. The assessment should be done frequently. It is important to assess both subjective and objective data. Past medical history is very important. It is essential to find out if the patient has any predisposition to a VTE including any trauma to veins, any varicosities, obesity, COPD, HF. Certain medications can also put a patient at risk for VTE such as oral contraceptives, hormone therapy, tamoxifen, or raloxifene. Also, any recent surgeries such as orthopedic, gynecologic, gastric, or urologic and past surgeries involving veins or a central venous catheter can put a patient at risk. Objective data includes fear, anxiety, and pain. Monitor vital signs frequently. Check the integumentary system for symmetry; taut, shiny, warm skin, erythematous, tender to palpation. Not every patient
Ever since I had been a little girl, I have had a love for people and caring for them. I like to study them to figure out how and what they are feeling. If something is wrong, I enjoy problem solving to find ways to fix the situation or at least make the person feel better. I am also fond of watching people develop and grow, which is why when I bumped into ultrasound sonography, I fell in love.
When I tell a person that I want to pursue a degree in Diagnostic Medical Ultrasound their first thought is babies. Which I don’t blame them because that is the part of ultrasound we are exposed most too. But ultrasound is so much more than just seeing an unborn baby. There are so many amazing things that ultrasounds can do. DMU is an imaging technique used to visualize the tissue structures/internal organs of the body by recording the returning reflections of ultrasonic waves with the purpose of pathology diagnosis. There are two names it goes by, ultrasound and sonography. These two terms are often used interchangeably. Ultrasound uses sound and acoustics to produce images that are then reflected back in real time.
Pregnancy is a very exciting time. The photos, the food, and the announcements are enough to make anyone squeal with joy. One of the most exciting times during your pregnancy is learning the gender of your baby. An ultrasound during your second trimester can reveal whether you are having a boy or girl, which will allow you to continue shopping and planning. If you are going in to have an ultrasound soon to determine the gender of your baby, use these four tips to help the ultrasound technician get a good view of your baby:
Because the spatial resolution of MSCT is lower than that of CCA, detection of stenosis may be more difficult in thickened segments, because the artery lumen is already smaller in a diffuse fashion. Such findings in heart transplant patients should lead to careful analysis before excluding significant narrowing, and in some cases, CCA may be required for confirmation. Eight stenoses were correctly diagnosed by MSCT in 10 evaluable segments, but three were missed in non-evaluable vessels 1.5 mm. In addition, two cases of ISR were missed. Intrastent analysis was not reliable with 16-slice CT, because only three (33%) of nine of the stents could be correctly visualized. Our study clearly indicates that the only reliable tool for detection of ISR
They also use ultrasound to aid in diagnosis of decreased blood flow to the legs and even abnormal liver function (Sanders). The medical profession is using ultrasound in new exciting ways continually. Large research centers are studying ultrasound in many different capacities. Emergency departments are now using bedside ultrasound machines to help aid in the diagnosis of traumatic abdominal and chest injuries. Bedside ultrasound machines provide information rapidly in life-threatening and time-sensitive conditions that is often unavailable in a timely manner (Vieira). Virtually every medical specialty uses ultrasound in their scope of practice. Since there is no radiation exposure, doctors are more comfortable ordering this test on their patients.
Gill, R., 2012. The physics and technology of diagnostic ultrasound: a practitioner's guide. Abbotsford, N.S.W.: High Frequency Publishing.