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Giovanni Volpicelli - One of the best experts on this subject based on the ideXlab platform.
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Specification and guideline for technical aspects and scanning parameter settings of neonatal Lung ultrasound Examination
2021Co-Authors: Jing Liu, Giovanni Volpicelli, Guo Guo, Dalibor Kurepa, Erich Sorantin, Jovan Lovrenski, Almudena Alonso-ojembarrena, Kai-sheng Hsieh, Abhay Lodha, Tsu F. YehAbstract:Lung ultrasound (LUS) is now widely used in the diagnosis and monitor of neonatal Lung diseases. Nevertheless, in the published literatures, the LUS images may display a significant variation in technical execution, while scanning parameters may influence diagnostic accuracy. The inter- and intra-observer reliabilities of ultrasound exam have been extensively studied in general and in LUS. As expected, the reliability declines in the hands of novices when they perform the point-of-care ultrasound (POC US). Consequently, having appropriate guidelines regarding to technical aspects of neonatal LUS exam is very important especially because diagnosis is mainly based on interpretation of artifacts produced by the pleural line and the Lungs. The present work aimed to create an instrument operation specification and parameter setting guidelines for neonatal LUS. Technical aspects and scanning parameter settings that allow for standardization in obtaining LUS images include (1) select a high-end equipment with high-frequency linear array transducer (12–14 MHz). (2) Choose preset suitable for Lung Examination or small organs. (3) Keep the probe perpendicular to the ribs or parallel to the intercostal space. (4) Set the scanning depth at 4–5 cm. (5) Set 1–2 focal zones and adjust them close to the pleural line. (6) Use fundamental frequency with speckle reduction 2–3 or similar techniques. (7) Turn off spatial compounding imaging. (8) Adjust the time-gain compensation to get uniform image from the near-to far-field.
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lsc abstract a combination of the wells score with multiorgan ultrasound to stratify patients with suspected pulmonary embolism
European Respiratory Journal, 2016Co-Authors: Argyro Chatziantoniou, Peiman Nazerian, Simone Vanni, Chiara Gigli, Giuseppe Francesco Sferrazza Papa, Emanuela Gambetta, Mattia Tullio, Stefano Centanni, Giovanni VolpicelliAbstract:Introduction: The pre-test probability of pulmonary embolism (PE) is conventionally estimated by the clinical Wells score (WS). Several studies have considered the role of Lung, heart and peripheral veins ultrasound in the diagnosis of PE. Aims and Objectives: The purpose of this multicenter study was to evaluate whether the combination of the WS with multiorgan ultrasound (MUS) performs better than the conventional criteria based on the sole WS. Methods: In consecutive patients with suspected PE we calculated the WS and performed MUS. We subsequently integrated the WS with the MUS diagnosis of deep venous thrombosis and the probability of an alternative diagnosis based on the Lung Examination. The final diagnosis was confirmed on computerized tomography and/or clinical follow-up at 30 days. Accuracy of WS alone and WS/MUS in the prediction of PE, were statistically compared. Results: We enrolled 249 patients, including 60 (24.1%) with a confirmed diagnosis of PE. The WS was >4 in 106 patients of which 35 (33%) had PE. In 143 patients with Wells score ≤4, 25 patients (17.5%) had EP. The MUS was performed in 7 ± 3 minutes. The WS-MUS was >4 in 62 patients of which 42 (67.7%) with PE, while in 187 patients with WS-MUS ≤4, only 18 cases (9.6%) had PE. A WS-MUS >4 showed sensitivity 70% and specificity 89.4%, significantly higher than the traditional WS (sensitivity 58.3% and specificity 62.4%). The area under the curve of WS-US (88.4%) was significantly superior to WS (62.1%, p Conclusions: The integration of the WS with a bedside MUS Examination improves the accuracy of the conventional WS for the pre-test stratification of PE likelihood.
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a combination of the wells score with multiorgan ultrasound to stratify patients with suspected pulmonary embolism
European Respiratory Journal, 2015Co-Authors: Argyro Chatziantoniou, Peiman Nazerian, Simone Vanni, Chiara Gigli, Giuseppe Francesco Sferrazza Papa, Emanuela Gambetta, Mattia Tullio, Stefano Centanni, Giovanni VolpicelliAbstract:Introduction: The pre-test probability of pulmonary embolism (PE) is conventionally estimated by the clinical Wells score (WS). Several studies have considered the role of Lung, heart and peripheral veins ultrasound in the diagnosis of PE. Aims and Objectives: The purpose of this multicenter study was to evaluate whether the combination of the WS with multiorgan ultrasound (MUS) performs better than the conventional criteria based on the sole WS. Methods: In consecutive patients with suspected PE we calculated the WS and performed MUS. We subsequently integrated the WS with the MUS diagnosis of deep venous thrombosis and the probability of an alternative diagnosis based on the Lung Examination. The final diagnosis was confirmed on computerized tomography and/or clinical follow-up at 30 days. Accuracy of WS alone and WS/MUS in the prediction of PE, were statistically compared. Results: We enrolled 249 patients, including 60 (24.1%) with a confirmed diagnosis of PE. The WS was >4 in 106 patients of which 35 (33%) had PE. In 143 patients with Wells score ≤4, 25 patients (17.5%) had EP. The MUS was performed in 7 ± 3 minutes. The WS-MUS was >4 in 62 patients of which 42 (67.7%) with PE, while in 187 patients with WS-MUS ≤4, only 18 cases (9.6%) had PE. A WS-MUS >4 showed sensitivity 70% and specificity 89.4%, significantly higher than the traditional WS (sensitivity 58.3% and specificity 62.4%). The area under the curve of WS-US (88.4%) was significantly superior to WS (62.1%, p Conclusions: The integration of the WS with a bedside MUS Examination improves the accuracy of the conventional WS for the pre-test stratification of PE likelihood.
Kristie L Foley - One of the best experts on this subject based on the ideXlab platform.
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predictors of enrollment of older smokers in six smoking cessation trials in the Lung cancer screening setting the smoking cessation at Lung Examination scale collaboration
Nicotine & Tobacco Research, 2021Co-Authors: Ellie Eyestone, Randi M Williams, George Luta, Emily Kim, Benjamin A Toll, Alana M Rojewski, Jordan M Neil, Paul M Cinciripini, Marisa Cordon, Kristie L FoleyAbstract:Significance Increased rates of smoking cessation will be essential to maximize the population benefit of low-dose CT screening for Lung cancer. The NCI's Smoking Cessation at Lung Examination (SCALE) Collaboration includes eight randomized trials, each assessing evidence-based interventions among smokers undergoing Lung cancer screening (LCS). We examined predictors of trial enrollment to improve future outreach efforts for cessation interventions offered to older smokers in this and other clinical settings. Methods We included the six SCALE trials that randomized individual participants. We assessed demographics, intervention modalities, LCS site and trial administration characteristics, and reasons for declining. Results Of 6,285 trial- and LCS-eligible individuals, 3,897 (62%) declined and 2,388 (38%) enrolled. In multivariable logistic regression analyses, Blacks had higher enrollment rates (OR 1.5, 95% CI 1.2,1.8) compared to Whites. Compared to 'NRT Only' trials, those approached for 'NRT+prescription medication' trials had higher odds of enrollment (OR 6.1, 95% CI 4.7,7.9). Regarding enrollment methods, trials using 'Phone+In Person' methods had higher odds of enrollment (OR 1.6, 95% CI 1.2,1.9) compared to trials using 'Phone Only' methods. Some of the reasons for declining enrollment included 'too busy' (36.6%), 'not ready to quit' (8.2%), 'not interested in research' (7.7%), and 'not interested in the intervention offered' (6.2%). Conclusion Enrolling smokers in cessation interventions in the LCS setting is a major priority that requires multiple enrollment and intervention modalities. Barriers to enrollment provide insights that can be addressed and applied to future cessation interventions to improve implementation in LCS and other clinical settings with older smokers. Implications We explored enrollment rates and reasons for declining across six smoking cessation trials in the Lung cancer screening setting. Offering multiple accrual methods and pharmacotherapy options predicted increased enrollment across trials. Enrollment rates were also greater among Blacks compared to Whites. The findings offer practical information for the implementation of cessation trials and interventions in the Lung cancer screening context and other clinical settings, regarding intervention modalities that may be most appealing to older, long-term smokers.
Smith Jean - One of the best experts on this subject based on the ideXlab platform.
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respiratory sound energy and its distribution patterns following clinical improvement of congestive heart failure a pilot study
BMC Emergency Medicine, 2010Co-Authors: Zhen Wang, Brigitte M Baumann, Karen Slutsky, Karen N Gruber, Smith JeanAbstract:Although congestive heart failure (CHF) patients typically present with abnormal auscultatory findings on Lung Examination, respiratory sounds are not normally subjected to additional analysis. The aim of this pilot study was to examine respiratory sound patterns of CHF patients using acoustic-based imaging technology. Lung vibration energy was examined during acute exacerbation and after clinical improvement. Respiratory sounds throughout the respiratory cycle were captured using an acoustic-based imaging technique. Twenty-three consecutive CHF patients were imaged at the time of presentation to the emergency department and after clinical improvement. Digital images were created (a larger image represents more homogeneously distributed vibration energy of respiratory sound). Geographical area of the images and respiratory sound patterns were quantitatively analyzed. Data from the CHF patients were also compared to healthy volunteers. The median (interquartile range) geographical areas of the vibration energy image of acute CHF patients without and with radiographically evident pulmonary edema were 66.9 (9.0) and 64.1(9.0) kilo-pixels, respectively (p < 0.05). After clinical improvement, the geographical area of the vibration energy image of CHF patients without and with radiographically evident pulmonary edema were increased by 18 ± 15% (p < 0.05) and 25 ± 16% (p < 0.05), respectively. With clinical improvement of acute CHF exacerbations, there was more homogenous distribution of Lung vibration energy, as demonstrated by the increased geographical area of the vibration energy image.
Argyro Chatziantoniou - One of the best experts on this subject based on the ideXlab platform.
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lsc abstract a combination of the wells score with multiorgan ultrasound to stratify patients with suspected pulmonary embolism
European Respiratory Journal, 2016Co-Authors: Argyro Chatziantoniou, Peiman Nazerian, Simone Vanni, Chiara Gigli, Giuseppe Francesco Sferrazza Papa, Emanuela Gambetta, Mattia Tullio, Stefano Centanni, Giovanni VolpicelliAbstract:Introduction: The pre-test probability of pulmonary embolism (PE) is conventionally estimated by the clinical Wells score (WS). Several studies have considered the role of Lung, heart and peripheral veins ultrasound in the diagnosis of PE. Aims and Objectives: The purpose of this multicenter study was to evaluate whether the combination of the WS with multiorgan ultrasound (MUS) performs better than the conventional criteria based on the sole WS. Methods: In consecutive patients with suspected PE we calculated the WS and performed MUS. We subsequently integrated the WS with the MUS diagnosis of deep venous thrombosis and the probability of an alternative diagnosis based on the Lung Examination. The final diagnosis was confirmed on computerized tomography and/or clinical follow-up at 30 days. Accuracy of WS alone and WS/MUS in the prediction of PE, were statistically compared. Results: We enrolled 249 patients, including 60 (24.1%) with a confirmed diagnosis of PE. The WS was >4 in 106 patients of which 35 (33%) had PE. In 143 patients with Wells score ≤4, 25 patients (17.5%) had EP. The MUS was performed in 7 ± 3 minutes. The WS-MUS was >4 in 62 patients of which 42 (67.7%) with PE, while in 187 patients with WS-MUS ≤4, only 18 cases (9.6%) had PE. A WS-MUS >4 showed sensitivity 70% and specificity 89.4%, significantly higher than the traditional WS (sensitivity 58.3% and specificity 62.4%). The area under the curve of WS-US (88.4%) was significantly superior to WS (62.1%, p Conclusions: The integration of the WS with a bedside MUS Examination improves the accuracy of the conventional WS for the pre-test stratification of PE likelihood.
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a combination of the wells score with multiorgan ultrasound to stratify patients with suspected pulmonary embolism
European Respiratory Journal, 2015Co-Authors: Argyro Chatziantoniou, Peiman Nazerian, Simone Vanni, Chiara Gigli, Giuseppe Francesco Sferrazza Papa, Emanuela Gambetta, Mattia Tullio, Stefano Centanni, Giovanni VolpicelliAbstract:Introduction: The pre-test probability of pulmonary embolism (PE) is conventionally estimated by the clinical Wells score (WS). Several studies have considered the role of Lung, heart and peripheral veins ultrasound in the diagnosis of PE. Aims and Objectives: The purpose of this multicenter study was to evaluate whether the combination of the WS with multiorgan ultrasound (MUS) performs better than the conventional criteria based on the sole WS. Methods: In consecutive patients with suspected PE we calculated the WS and performed MUS. We subsequently integrated the WS with the MUS diagnosis of deep venous thrombosis and the probability of an alternative diagnosis based on the Lung Examination. The final diagnosis was confirmed on computerized tomography and/or clinical follow-up at 30 days. Accuracy of WS alone and WS/MUS in the prediction of PE, were statistically compared. Results: We enrolled 249 patients, including 60 (24.1%) with a confirmed diagnosis of PE. The WS was >4 in 106 patients of which 35 (33%) had PE. In 143 patients with Wells score ≤4, 25 patients (17.5%) had EP. The MUS was performed in 7 ± 3 minutes. The WS-MUS was >4 in 62 patients of which 42 (67.7%) with PE, while in 187 patients with WS-MUS ≤4, only 18 cases (9.6%) had PE. A WS-MUS >4 showed sensitivity 70% and specificity 89.4%, significantly higher than the traditional WS (sensitivity 58.3% and specificity 62.4%). The area under the curve of WS-US (88.4%) was significantly superior to WS (62.1%, p Conclusions: The integration of the WS with a bedside MUS Examination improves the accuracy of the conventional WS for the pre-test stratification of PE likelihood.
Ellie Eyestone - One of the best experts on this subject based on the ideXlab platform.
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predictors of enrollment of older smokers in six smoking cessation trials in the Lung cancer screening setting the smoking cessation at Lung Examination scale collaboration
Nicotine & Tobacco Research, 2021Co-Authors: Ellie Eyestone, Randi M Williams, George Luta, Emily Kim, Benjamin A Toll, Alana M Rojewski, Jordan M Neil, Paul M Cinciripini, Marisa Cordon, Kristie L FoleyAbstract:Significance Increased rates of smoking cessation will be essential to maximize the population benefit of low-dose CT screening for Lung cancer. The NCI's Smoking Cessation at Lung Examination (SCALE) Collaboration includes eight randomized trials, each assessing evidence-based interventions among smokers undergoing Lung cancer screening (LCS). We examined predictors of trial enrollment to improve future outreach efforts for cessation interventions offered to older smokers in this and other clinical settings. Methods We included the six SCALE trials that randomized individual participants. We assessed demographics, intervention modalities, LCS site and trial administration characteristics, and reasons for declining. Results Of 6,285 trial- and LCS-eligible individuals, 3,897 (62%) declined and 2,388 (38%) enrolled. In multivariable logistic regression analyses, Blacks had higher enrollment rates (OR 1.5, 95% CI 1.2,1.8) compared to Whites. Compared to 'NRT Only' trials, those approached for 'NRT+prescription medication' trials had higher odds of enrollment (OR 6.1, 95% CI 4.7,7.9). Regarding enrollment methods, trials using 'Phone+In Person' methods had higher odds of enrollment (OR 1.6, 95% CI 1.2,1.9) compared to trials using 'Phone Only' methods. Some of the reasons for declining enrollment included 'too busy' (36.6%), 'not ready to quit' (8.2%), 'not interested in research' (7.7%), and 'not interested in the intervention offered' (6.2%). Conclusion Enrolling smokers in cessation interventions in the LCS setting is a major priority that requires multiple enrollment and intervention modalities. Barriers to enrollment provide insights that can be addressed and applied to future cessation interventions to improve implementation in LCS and other clinical settings with older smokers. Implications We explored enrollment rates and reasons for declining across six smoking cessation trials in the Lung cancer screening setting. Offering multiple accrual methods and pharmacotherapy options predicted increased enrollment across trials. Enrollment rates were also greater among Blacks compared to Whites. The findings offer practical information for the implementation of cessation trials and interventions in the Lung cancer screening context and other clinical settings, regarding intervention modalities that may be most appealing to older, long-term smokers.
