Sunday, November 16, 2014

Ultrasound On A Chip?

WHAT?  and how do you propose to have the images interpreted?  What Idiot would fund something like this?  Most people in medical imaging would call radiologists  very professional in looking into the human body.  They get paid to interpret images. Most of them know what they are doing.  Not all.  (giggles).  Go to any medical imaging website and know that medical imaging is a profession.
Here I will give you a partial list:  ASRT, AIUM,SDMS ARDMS just copy and paste in your browser.  People who support this person are just stupid, or have more money than I do. 

Here is a snip.  Thanks Technology Review

A scanner the size of an iPhone that you could hold up to a person’s chest and see a vivid, moving, 3-D image of what’s inside is being developed by entrepreneur Jonathan Rothberg.
Rothberg says he has raised $100 million to create a medical imaging device that’s nearly “as cheap as a stethoscope” and will “make doctors 100 times as effective.” The technology, which according to patent documents relies on a new kind of ultrasound chip, could eventually lead to new ways to destroy cancer cells with heat, or deliver information to brain cells.
Rothberg has a knack for marrying semiconductor technology to problems in biology. He started and sold two DNA-sequencing companies, 454 and Ion Torrent Systems (see “The $2 Million Genome” and “A Semiconductor DNA Sequencer”), for more than $500 million. The profits have allowed Rothberg, who showed up for an interview wearing worn chinos and a tattered sailor’s belt, to ply the ocean on a 130-foot yacht named Gene Machine and to indulge high-concept hobbies like sequencing the DNA of mathematical geniuses.

Gosh with geeks like these, we may not have use of a toilet in the future.

Gizz, with Blessings.

Obama Care Scares Diagnostic Medical Procedures

The image is from Doctor Wolfgang Morodor.

Obama care is hurting health care providers and patients.  We people in health care a trying to do our best with less resources.  I work in a small hospital now that I have retired from teaching, and our department cannot ask the ADMINS for money.  We have no money for upgrades for our imaging equipment.  How can we keep a Toshiba CT  chugging 24 hours a day without a service contract?  How can I keep my GE ultrasound machine going without some help?

Our imaging department is going to grind to dust if we cannot maintain a revenue stream.  Medical imaging is the back bone of any hospital.

Obama care is destroying health care for many reasons:  Number one is confusion.

Most Americans do NOT understand health care insurance.  It is too complex.  I agree.  co-pays etc, and Tier One Versus Tier Two.  They  sound like a Bill Cosby interview about rape.  Goorrroppsteryyerdrop.

Number two:  Health care is Expensive:

When you come to the ED, expect a hefty price.  Regardless of what your ailment is. Remember the first thing you do when you arrive in the ED with a sniffle is fork out your credit card.  Really sick people are just taken in and treated.  But the bill can cause a patients family horrible financial strife.

Number Three:  the Doctor treating you may not be a good doctor.

This is true in many settings.  There is no real good rating system for doctors. Many are slime molds festering under a gurney out to make a buck.  At your expense.  Many are great physicians willing to put a finger in your left ventricle where the bullet went, to keep you alive until the heart surgeon shows up.  ED Doctors are hard to judge, unless you work with them.  Some are morons who call CPS if you deny an expensive procedure, or drug for your child that is not necessary.   I work with one of those.  She is a terror.

Number four:  Medical imaging is expensive

Indeed.  Most hospitals rely on medical imaging to survive.  Ask the doctor why you need a CAT scan, when you fell down after you tripped on a rock.  Ask the doctor why you need an ultrasound when your gall bladder was removed 30 years ago.

Bless you all,  Here is a link for more information on how we all can better take care of our selves.

Health care reform and the shift from the fee-for-service to a value-based payment model will have a negative impact on the diagnostic imaging market in the U.S., according to a new report conducted by Decision Resources Group. Even though the elderly population is increasing and creating a greater need for diagnostic procedures, the market will only grow "modestly" through 2023.

The new payment model is transforming the radiology department from a profit center to a cost center for health care facilities, according to the report. Facilities will be taking a lot more consideration into what imaging procedures are appropriate, which means there will be a reduction in the number they perform.

Thanks Dot Med

http://www.dotmed.com/news/story/24591

Saturday, October 4, 2014

Ebola, And Gil Mobley: Editorial

I know Gil Mobley.  He is a good person.  He is a great physician who does great work.  He has been in the news for donning a TYVEK suit and walking through Atlanta's Harts field airport.  I know him from some work we did together in Guatemala.  I think his comments are correct about the CDC.  His antics are a wake up call.  Gil Mobley is an intelligent doctor, and he spoke his heart.  I work in education, and patient care.  We should all wake up to his clarion call, and realize this virus takes no prisoners.  Gil Mobley was one of my students.  I taught him basic ultrasound skills in Houston Texas.  Gil, God Bless you if you see this post after the media frenzies.   TJW  Here are some links:

PHILADELPHIA (CBS) – Dom Giordano talked with Dr. Gil Mobley, who believes the CDC is lying about the threat posed by Ebola and staged a protest at Atlanta’s Hartsfield-Jackson Airport to expose it.

Thanks CBS and Dom Giorino

Credits:  
http://philadelphia.cbslocal.com/2014/10/03/missouri-doctor-its-just-a-matter-of-time-before-ebola-is-carried-to-every-corner-of-the-world/


 

Cardiologists Who Use An Ultrasound Machine To Examine A Patient?

It is Saturday.  My wife and I are sharing our twentieth wedding anniversary by going out for dinner.  I was cruising through all the doom and gloom of Ebola, and other stuff, and discovered a notable.  A cardiologist using an ultrasound machine to check on a patients heart.  When most patients come to the cardiologists come to the office, they get an ECG (EKG), and the usual vitals by the nurse.

I think that it would be great if a cardiologist TRAINED in BASIC echocardiography would use the machine to take a look at the patients heart.  A basic echo would assess cardiac output, wall motion, and other factors like valvular incompetency.  The machine to the left is not an ad.  It is one of several machines used in offices around the globe.  I think the cardiologist should use this tool in a BASIC examination of the patient in the office.  Question: reimbursement.  Oboma care?    We will see how that shakes out.  Here is a link to a useful article.

Cardiologists who used a handheld ultrasound were more likely to make an accurate diagnosis of patients with common cardiovascular abnormalities than colleagues who relied on a physical exam, for an estimated savings of $63 per patient. Handheld ultrasound’s ability to rule out abnormalities also likely would reduce downstream testing, according to a study published online Sept. 17 in the Journal of the American College of Cardiology: Cardiovascular Imaging. 

Thank you Sonoworld and Cardiovascular Business

http://www.cardiovascularbusiness.com/topics/imaging/handheld-ultrasound-trounces-physical-exams-accuracy-cost

 

Sunday, September 7, 2014

Thyroid Ultrasound: Always A Great Option

I do a lot of thyroid U/S.  Many people have thyroid issues.  The go to the doctor because of malaise, or feeling tired.  Perhaps they go to the doctor for a check up and the physician feels a lump in the neck.  Many people blame obesity on a thyroid condition.  I will stay away from that.  I do believe that Fine Needle Aspiration with U/S guidance is a great tool in dealing with thyroid conditions.  Personally, if a nodule is heterogeneous, non-compressible, and icky looking, it needs a FNA.  I had a patient last week who tested positive by ultrasound.  She has follicular cancer.  She will be OK  We caught it in time I hope.  Look at the above picture and remember this is a picture of a nasty cancer.

In the retrospective review, researchers evaluated data of 465 patients with differentiated thyroid cancer (DTC) who underwent surgery at Memorial Sloan Kettering Cancer Center between January 2009 and December 2010. Fifty percent of participants underwent preoperative ultrasound of cervical neck lymph nodes, and 231 were not imaged preoperatively with ultrasound. The median follow-up was 29 months. 

 http://www.healio.com/endocrinology/thyroid/news/online/%7Bb4868556-14b2-4e31-a48a-38169b9ce1f4%7D/preoperative-neck-ultrasound-led-to-better-response-fewer-recurrences-among-dtc-patients

Surgeons View Using HF Ultrasound To Detect Lung Cancer In The Chest Wall

It seems that something new and wonderful happens everyday.  This article I will post a link to is great news on the inventiveness of medical professionals all over the world.  We in the ultrasound community have known that high frequency, high definition medical ultrasound can create great pictures, and inspire inventive solutions to medical dilemmas.  In the case of cancer, it is a wonderful area of research, and development we are doing.  Lung cancer is one of the most nasty and prevalent cancers in the world.  Enjoy reading the link.

http://www.unboundmedicine.com/medline/citation/25038014/Preoperative_Assessment_of_Chest_Wall_Invasion_in_Non_Small_Cell_Lung_Cancer_Using_Surgeon_Performed_Ultrasound_


Preoperative Assessment of Chest Wall Invasion in Non-Small Cell Lung Cancer Using Surgeon-Performed Ultrasound.

Abstract

BACKGROUND
Chest wall invasion in operable lung cancer upgrades the stage and can affect operative planning. Diagnosing chest wall invasion preoperatively is important in patient consent, in the choice of operative incision placement, and can be helpful in choosing an operative approach (open vs thoracoscopic). The objectives of this study were to determine the diagnostic accuracy of preoperative, surgeon-performed ultrasound (US) in assessing tumoral chest wall invasion (T3) in non-small cell lung cancer (NSCLC) patients and to compare its accuracy vs preoperative computed tomography (CT).

Sunday, July 20, 2014

OP ED Number 2

Yes, this is my second OP ED, aside from a recipe post.  I have much to celebrate.  One:  My son will be back in the USA from a missionary trip to Guatemala this afternoon (Yes he is a legal United States Resident).  They helped rebuild some community facilities in a small village there.  I will post the GO-PRO videos on my FB page. The image to the left is a picture of a volcanic lake in Guatemala called Atilan.  I went on a mission with a church 7 years ago to provide medical support there.  I taught a nurse and a physician to do limited and focused sonograms on the village people to triage them and get them to a hospital.  The living conditions are rather horrid by western standards.  The people there are chipper though, always with a grin, and a nice word.  They make do with little to nothing.  I brought an old GE ultrasound machine and taught these wonderful people how to use it for things like ectopic pregnancies, and acute abdominal pains, trauma etc.  It is not like these people here have a med-evac system.  To get to a proper hospital can take hours in a car or truck.  The trip was a great experience for me, and my son is now queuing up at the airport to come home.  This is his third journey.  My wife went on the first.  You can say we are all Guatemalan pros.  Trevor, My Son, I am PROUD.

Second:  I am working at a small hospital, and giving lectures on the side.  I cannot wait to visit the town of Kerrville, TX to present some education to the wonderful sonographers there at a specific large hospital!

 Of note: I have a student where I work.  She is doing very well with the limited education she got at a for profit fly-by-night ultrasound school in Houston.  On Wednesday of last week we had an educational meeting where I outlined what to do when she encounters a ruptured ectopic pregnancy.  Lord Have Mercy!  She was on call that very night and had a bleeder.  The abdominal cavity was filled with blood.  They did a great job and took her by air ambulance to a large hospital, and saved her life.  My sonographer student NAILED the diagnosis.  We are having a party for Logan on Monday morning.  A success like this defines both a teachers role, and a willingness of a student to learn, and act.  Logan, I am PROUD!

Sincerely, TJW