Ultrasound Replaces CT As First Choice

As many of you know I am very much a supporter of ultrasound being the first medical imaging modality utilized when a patient needs medical imaging to establish a diagnosis.  I am on the record as saying medical ultrasound is a great way to start out when a patient presents with symptoms of appendicitis.  As an example, ultrasound is not used to R/O the disease, it is used to "rule in" appendicitis.  The reason is two fold: 1) a CT scan is expensive 2) A CT scan involves ionizing radiation.  Many people are realizing these issues.  Here is part of an article I saw online addressing  this topic.

OREM, UT, June 02, 2011 /24-7PressRelease/ -- Just as insurance carriers are scrutinizing the higher cost of a CT scan versus that of an ultrasound for diagnostic screenings, patients are becoming aware of and concerned about the amount of radiation delivered by a CT scan. This is leading to an increased number of ultrasounds being performed in several medical situations.

http://www.einnews.com/247pr/216724

Hospital Medicine Probes The Use of Ultrasound

A doctor who treats only patients admitted to a hospital is often referred to as a "hospitalist".  I have met a few of these versatile doctors in my job as an ultrasound instructor.  These doctors are charged with dealing with the problems that flare up like wild fires when other physicians are home in bed.  They are trained to deal with many issues, and they are trained to know their limits.  Many of these issues occur in the ICU or CCU and are cardiac, or surgically related.  It is natural for them to be creative with patient care, because they are often working alone without the help of other physicians.  Naturally, hospitalists are discovering the wonderful tool called portable ultrasound.  It makes perfect sense when trying to insert a line in the internal jugular to use ultrasound as a guide.  What about post surgical bleeding? Piece of cake.  Cardiac issues?  Pull out the cardiac probe to scan for a pericardial effusion.  My job is to train the wonderful doctors and give the tools and expertise at making a rapid and accurate diagnosis with portable ultrasound. 

“The ultrasound will be the stethoscope of the 21st century,” says Mark Ault, director of the Division of General Internal Medicine and assistant chairman for clinical affairs of the Department of Medicine at Cedars-Sinai Medical Center in Los Angeles. “And the goal will be to have an ultrasound in the hands of every internist.”

http://www.the-hospitalist.org/details/article/1072699/The_Future_of_Better_Patient_Care.htmlhttp://www.the-hospitalist.org/details/article/1072699/The_Future_of_Better_Patient_Care.html

NASA And Ultrasound

The machine you see to the left is a Philips 5000 modular ultrasound machine which is installed in the ISS. I have good friends that work at Johnson Space Center in Houston and many are physicians.  One of the benefits of the ISS is the medical research that is performed there by the astronauts.  One of the most useful technologies they use is the ultrasound machine.  They study everything from optic nerve diameters to diastolic function of the heart in the weightless environment.  As the medical director of the ISS once said to me: "One of the biggest challenges to the space program is keeping people alive and well in the hostile environment of outer space".  The machine pictured to the left recently died, and a smaller replacement ultrasound machine will be sent up to replace it.

A recent article on Space on MSNBC.com shows astronaut Leroy Chiao performing an eye examination onboard the International Space Station. The exam was performed on Salizhan Sharipov, a cosmonaut who took advantage of NASA’s ultrasound-based “all purpose diagnostic machine”. This ultrasound machine is unique, in that it is directly linked from the Space Station to doctors on Earth. Why use ultrasound machines in space? Like most of the other space-bound experiments, it has a practical application.

http://portableultrasoundmachines.net/nasa-space-inventions-benefit-all-our-lives-on-earth-space-on-msnbc-com/396/

Diastolic CHF

Cardiologists have known for years that a patient may have a systolic ejection of over 55 percent and normal wall motion but still suffer from congestive heart failure.  Yes you heard me right.  Diastolic heart failure is a real entity, and it is not taken seriously by all medical professionals.  Recently, many papers have been published stressing the importance of treating diastolic dysfunction with medications, diet and exercise.  The long term effects of diastolic heart disease are devastating frequently leading up to chronic illnesses that are a challenge to treat from both a medical and an economical standpoint.

http://dmtrk.net/BTE-FS61-3BX0GY-656LN-1/c.aspx

If that link does not work try this one:
http://www.touchcardiology.com/articles/echocardiographic-assessment-diastolic-heart-failure