The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Gloria Caldito - One of the best experts on this subject based on the ideXlab platform.
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pleural Ultrasonography versus chest radiography for the diagnosis of pneumothorax review of the literature and meta analysis
Critical Care, 2013Co-Authors: Saadah Alrajab, Asser M Youssef, Nuri I Akkus, Gloria CalditoAbstract:Introduction Ultrasonography is being increasingly utilized in acute care settings with expanding applications. Pneumothorax evaluation by Ultrasonography is a fast, safe, easy and inexpensive alternative to chest radiographs. In this review, we provide a comprehensive analysis of the current literature comparing Ultrasonography and chest radiography for the diagnosis of pneumothorax.
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pleural Ultrasonography versus chest radiography for the diagnosis of pneumothorax review of the literature and meta analysis
Critical Care, 2013Co-Authors: Saadah Alrajab, Asser M Youssef, Nuri I Akkus, Gloria CalditoAbstract:Ultrasonography is being increasingly utilized in acute care settings with expanding applications. Pneumothorax evaluation by Ultrasonography is a fast, safe, easy and inexpensive alternative to chest radiographs. In this review, we provide a comprehensive analysis of the current literature comparing Ultrasonography and chest radiography for the diagnosis of pneumothorax. We searched English-language articles in MEDLINE, EMBASE and Cochrane Library dealing with both Ultrasonography and chest radiography for diagnosis of pneumothorax. In eligible studies that met strict inclusion criteria, we conducted a meta-analysis to evaluate the diagnostic accuracy of pleural Ultrasonography in comparison with chest radiography for the diagnosis of pneumothorax. We reviewed 601 articles and selected 25 original research articles for detailed review. Only 13 articles met all of our inclusion criteria and were included in the final analysis. One study used lung sliding sign alone, 12 studies used lung sliding and comet tail signs, and 6 studies searched for lung point in addition to the other two signs. Ultrasonography had a pooled sensitivity of 78.6% (95% CI, 68.1 to 98.1) and a specificity of 98.4% (95% CI, 97.3 to 99.5). Chest radiography had a pooled sensitivity of 39.8% (95% CI, 29.4 to 50.3) and a specificity of 99.3% (95% CI, 98.4 to 100). Our meta-regression and subgroup analyses indicate that consecutive sampling of patients compared to convenience sampling provided higher sensitivity results for both Ultrasonography and chest radiography. Consecutive versus nonconsecutive sampling and trauma versus nontrauma settings were significant sources of heterogeneity. In addition, subgroup analysis showed significant variations related to operator and type of probe used. Our study indicates that Ultrasonography is more accurate than chest radiography for detection of pneumothorax. The results support the previous investigations in this field, add new valuable information obtained from subgroup analysis, and provide accurate estimates for the performance parameters of both bedside Ultrasonography and chest radiography for pneumothorax evaluation.
Meinhard Classen - One of the best experts on this subject based on the ideXlab platform.
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staging of pancreatic and ampullary carcinoma by endoscopic Ultrasonography comparison with conventional sonography computed tomography and angiography
Gastroenterology, 1992Co-Authors: Thomas Rosch, Christine Braig, Thomas Gain, Stefan Feuerbach, J R Siewert, V Schusdziarra, Meinhard ClassenAbstract:In a prospective study, endoscopic Ultrasonography was compared with transabdominal Ultrasonography, computed tomography, and angiography in 60 consecutive patients with pancreatic (n = 46) and ampullary (n = 14) cancer considered to be candidates for surgery. The diagnostic value of these imaging procedures in determining local resectability was assessed. The diagnosis of ampullopancreatic malignancy was made by operation (n = 40) or puncture/biopsy (n = 20). In the 40 patients who underwent surgery, endoscopic Ultrasonography was significantly superior to abdominal Ultrasonography and computed tomography in determining tumor size and extent and lymph node metastases of pancreatic and ampullary cancer. Furthermore, involvement of the portal venous system as judged by histopathology or surgical exploration was correctly assessed by endoscopic Ultrasonography in 95%, whereas angiography (85%), computed tomography (75%) and abdominal Ultrasonography (55%) were less sensitive. Of 11 cases of portal venous infiltration found at surgery, endoscopic Ultrasonography correctly predicted 10, abdominal Ultrasonography only 1, computed tomography 4, and angiography 5 (P less than 0.05 for all three comparisons). Twenty patients did not undergo surgery for different reasons: of those, 9 patients were excluded from operation because of portal venous involvement as shown by angiography. Endoscopic Ultrasonography detected portal venous invasion in all these cases. In contrast to the venous system, arterial encasement was less reliably detected by endoscopic Ultrasonography. In conclusion, endoscopic Ultrasonography is the most effective single imaging procedure for local tumor staging in pancreatic and ampullary cancer. Thus, endoscopic Ultrasonography will improve the assessment of tumor resectability and further decrease the need for explorative laparotomy.
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staging of pancreatic and ampullary carcinoma by endoscopic Ultrasonography comparison with conventional sonography computed tomography and angiography
Gastroenterology, 1992Co-Authors: Thomas Rosch, Christine Braig, Thomas Gain, Stefan Feuerbach, J R Siewert, V Schusdziarra, Meinhard ClassenAbstract:Abstract In a prospective study, endoscopic Ultrasonography was compared with transabdominal Ultrasonography, computed tomography, and angiography in 60 consecutive patients with pancreatic (n = 46) and ampullary (n = 14) cancer considered to be candidates for surgery. The diagnostic value of these imaging procedures in determining local resectability was assessed. The diagnosis of ampullopancreatic malignancy was made by operation (n = 40) or puncture/biopsy (n = 20). In the 40 patients who underwent surgery, endoscopic Ultrasonography was significantly superior to abdominal Ultrasonography and computed tomography in determining tumor size and extent and lymph node metastases of pancreatic and ampullary cancer. Furthermore, involvement of the portal venous system as judged by histopathology or surgical exploration was correctly assessed by endoscopic Ultrasonography in 95%, whereas angiography (85%), computed tomography (75%) and abdominal Ultrasonography (55%) were less sensitive. Of 11 cases of portal venous infiltration found at surgery, endoscopic Ultrasonography correctly predicted 10, abdominal Ultrasonography only 1, computed tomography 4, and angiography 5 ( P
Saadah Alrajab - One of the best experts on this subject based on the ideXlab platform.
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pleural Ultrasonography versus chest radiography for the diagnosis of pneumothorax review of the literature and meta analysis
Critical Care, 2013Co-Authors: Saadah Alrajab, Asser M Youssef, Nuri I Akkus, Gloria CalditoAbstract:Introduction Ultrasonography is being increasingly utilized in acute care settings with expanding applications. Pneumothorax evaluation by Ultrasonography is a fast, safe, easy and inexpensive alternative to chest radiographs. In this review, we provide a comprehensive analysis of the current literature comparing Ultrasonography and chest radiography for the diagnosis of pneumothorax.
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pleural Ultrasonography versus chest radiography for the diagnosis of pneumothorax review of the literature and meta analysis
Critical Care, 2013Co-Authors: Saadah Alrajab, Asser M Youssef, Nuri I Akkus, Gloria CalditoAbstract:Ultrasonography is being increasingly utilized in acute care settings with expanding applications. Pneumothorax evaluation by Ultrasonography is a fast, safe, easy and inexpensive alternative to chest radiographs. In this review, we provide a comprehensive analysis of the current literature comparing Ultrasonography and chest radiography for the diagnosis of pneumothorax. We searched English-language articles in MEDLINE, EMBASE and Cochrane Library dealing with both Ultrasonography and chest radiography for diagnosis of pneumothorax. In eligible studies that met strict inclusion criteria, we conducted a meta-analysis to evaluate the diagnostic accuracy of pleural Ultrasonography in comparison with chest radiography for the diagnosis of pneumothorax. We reviewed 601 articles and selected 25 original research articles for detailed review. Only 13 articles met all of our inclusion criteria and were included in the final analysis. One study used lung sliding sign alone, 12 studies used lung sliding and comet tail signs, and 6 studies searched for lung point in addition to the other two signs. Ultrasonography had a pooled sensitivity of 78.6% (95% CI, 68.1 to 98.1) and a specificity of 98.4% (95% CI, 97.3 to 99.5). Chest radiography had a pooled sensitivity of 39.8% (95% CI, 29.4 to 50.3) and a specificity of 99.3% (95% CI, 98.4 to 100). Our meta-regression and subgroup analyses indicate that consecutive sampling of patients compared to convenience sampling provided higher sensitivity results for both Ultrasonography and chest radiography. Consecutive versus nonconsecutive sampling and trauma versus nontrauma settings were significant sources of heterogeneity. In addition, subgroup analysis showed significant variations related to operator and type of probe used. Our study indicates that Ultrasonography is more accurate than chest radiography for detection of pneumothorax. The results support the previous investigations in this field, add new valuable information obtained from subgroup analysis, and provide accurate estimates for the performance parameters of both bedside Ultrasonography and chest radiography for pneumothorax evaluation.
Jung Hwan Baek - One of the best experts on this subject based on the ideXlab platform.
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comparison of fine needle aspiration and core needle biopsy under ultrasonographic guidance for detecting malignancy and for the tissue specific diagnosis of salivary gland tumors
American Journal of Neuroradiology, 2015Co-Authors: H J Eom, J H Lee, Y J Choi, Ra Gyoung Yoon, K J Cho, Soon Yuhl Nam, Jung Hwan BaekAbstract:BACKGROUND AND PURPOSE: Diagnostic test accuracy studies for Ultrasonography-guided fine-needle aspiration and Ultrasonography-guided core needle biopsy have shown inconclusive results due to their heterogenous study designs. Our aim was to compare the diagnostic accuracy of Ultrasonography-guided fine-needle aspiration versus Ultrasonography-guided core needle biopsy for detecting malignant tumors of the salivary gland and for the tissue-specific diagnosis of salivary gland tumors in a single tertiary hospital. MATERIALS AND METHODS: This retrospective study was approved by our institutional review board and informed consent was waived. Four hundred twelve patients who underwent Ultrasonography-guided fine-needle aspiration (n = 155) or Ultrasonography-guided core needle biopsy (n = 257) with subsequent surgical confirmation or clinical follow-up were enrolled. We compared the diagnostic accuracy of Ultrasonography-guided fine-needle aspiration and Ultrasonography-guided core needle biopsy regarding malignant salivary gland tumors and the correct tissue-specific diagnosis of benign and malignant tumors. We also tested the difference between these procedures according to the operator9s experience and lesion characteristics. RESULTS: The inconclusive rates of Ultrasonography-guided fine-needle aspiration and Ultrasonography-guided core needle biopsy were 19% and 4%, respectively (P CONCLUSIONS: Ultrasonography-guided core needle biopsy is superior to Ultrasonography-guided fine-needle aspiration in detecting and characterizing malignant tumors of the salivary gland and could emerge as the diagnostic method of choice for patients presenting with a salivary gland mass.
Martin H Prins - One of the best experts on this subject based on the ideXlab platform.
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simplification of the diagnostic management of suspected deep vein thrombosis
JAMA Internal Medicine, 2002Co-Authors: Roderik A Kraaijenhagen, Franco Piovella, Enrico Bernardi, F Verlato, Erik A M Beckers, Maria M W Koopman, Marisa Barone, Giuseppe Camporese, Bert Jan Potter Van Loon, Martin H PrinsAbstract:Background: The standard diagnostic approach in patients with suspected deep vein thrombosis is to repeat the compression Ultrasonography after 1 week in all patients with an initial normal result. We hypothesized that a normal finding of a D-dimer assay safely obviates the need for repeated Ultrasonography. In addition, we evaluated the potential value of a pretest probability assessment for this purpose. Methods: At presentation, consecutive outpatients with suspected thrombosis underwent independent assessment by means of Ultrasonography of the proximal veins, a wholeblood D-dimer assay, and a pretest clinical model. Patients with normal ultrasonographic findings and an abnormal D-dimer assay result were scheduled for repeated Ultrasonography. We evaluated the incidence of symptomatic venous thromboembolic complications during a 3-month follow-up, and the value of clinical pretest probability with Ultrasonography or D-dimer assay in scenario analyses. Results: Westudied1756patientswithprevalenceofthrombosis of 22%. At entry, results of the D-dimer assay and Ultrasonography were normal in 828 patients (47%). Of these, 6 returned with confirmed symptomatic venous thromboembolism (complication rate, 0.7%; 95% confidence interval[CI],0.3%-1.6%).RepeatedUltrasonographywasavoided in 61% of the patients with an initial normal test result. Scenario analyses disclosed that the complication rate was 1.6% (95% CI, 0.8%-2.6%) in those with a low clinical pretest probability and a normal result of Ultrasonography at referral, whereas this figure was 1.8% (95% CI, 0.9%-3.3%) in patients with a low clinical probability result and a normal result of the D-dimer assay at referral. Conclusions: It is safe to withhold repeated Ultrasonography in patients with suspected deep vein thrombosis who have normal results of ultrasonograpy and the SimpliRED D-dimer assay at presentation. The combination of a low clinical pretest probability with a normal result of compression Ultrasonography or the Ddimer assay appears to be equally safe in refuting the diagnosis of deep vein thrombosis. Arch Intern Med. 2002;162:907-911
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simplification of the diagnostic management of suspected deep vein thrombosis
JAMA Internal Medicine, 2002Co-Authors: Roderik A Kraaijenhagen, Franco Piovella, Enrico Bernardi, F Verlato, Erik A M Beckers, Maria M W Koopman, Marisa Barone, Giuseppe Camporese, Bert Jan Potter Van Loon, Martin H PrinsAbstract:Background: The standard diagnostic approach in patients with suspected deep vein thrombosis is to repeat the compression Ultrasonography after 1 week in all patients with an initial normal result. We hypothesized that a normal finding of a D-dimer assay safely obviates the need for repeated Ultrasonography. In addition, we evaluated the potential value of a pretest probability assessment for this purpose. Methods: At presentation, consecutive outpatients with suspected thrombosis underwent independent assessment by means of Ultrasonography of the proximal veins, a wholeblood D-dimer assay, and a pretest clinical model. Patients with normal ultrasonographic findings and an abnormal D-dimer assay result were scheduled for repeated Ultrasonography. We evaluated the incidence of symptomatic venous thromboembolic complications during a 3-month follow-up, and the value of clinical pretest probability with Ultrasonography or D-dimer assay in scenario analyses. Results: Westudied1756patientswithprevalenceofthrombosis of 22%. At entry, results of the D-dimer assay and Ultrasonography were normal in 828 patients (47%). Of these, 6 returned with confirmed symptomatic venous thromboembolism (complication rate, 0.7%; 95% confidence interval[CI],0.3%-1.6%).RepeatedUltrasonographywasavoided in 61% of the patients with an initial normal test result. Scenario analyses disclosed that the complication rate was 1.6% (95% CI, 0.8%-2.6%) in those with a low clinical pretest probability and a normal result of Ultrasonography at referral, whereas this figure was 1.8% (95% CI, 0.9%-3.3%) in patients with a low clinical probability result and a normal result of the D-dimer assay at referral. Conclusions: It is safe to withhold repeated Ultrasonography in patients with suspected deep vein thrombosis who have normal results of ultrasonograpy and the SimpliRED D-dimer assay at presentation. The combination of a low clinical pretest probability with a normal result of compression Ultrasonography or the Ddimer assay appears to be equally safe in refuting the diagnosis of deep vein thrombosis. Arch Intern Med. 2002;162:907-911
