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1
A, Curry Reva, and Tempkin Betty Bates, eds. Sonography: Introduction to normal structure and function. 2nd ed. St Louis: Saunders, 2004.
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2
Zheng, Yong-Ping, and Yongjin Zhou. Sonomyography: Dynamic and Functional Assessment of Muscle Using Ultrasound Imaging. Springer, 2022.
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3
Zheng, Yong-Ping, and Yongjin Zhou. Sonomyography: Dynamic and Functional Assessment of Muscle Using Ultrasound Imaging. Springer Singapore Pte. Limited, 2021.
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4
Lenzi, Andrea, and Andrea M. Isidori. Ultrasound of the Testis for the Andrologist: Morphological and Functional Atlas. Springer, 2018.
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5
Lenzi, Andrea, and Andrea M. Isidori. Ultrasound of the Testis for the Andrologist: Morphological and Functional Atlas. Springer, 2018.
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6
Gardner, Andrew, Grant L. Iverson, Paul van Donkelaar, Philip N. Ainslie, and Peter Stanwell. Magnetic Resonance Spectroscopy, Diffusion Tensor Imaging, and Transcranial Doppler Ultrasound Following Sport-Related Concussion. Edited by Ruben Echemendia and Grant L. Iverson. Oxford University Press, 2015. http://dx.doi.org/10.1093/oxfordhb/9780199896585.013.12.
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Sport-related concussion has been referred to as a functional rather than a structural injury with neurometabolic and microstructural alterations reported in several studies. Accordingly, conventional neuroimaging techniques, such as computed tomography (CT) and structural magnetic resonance imaging (MRI), have limited value beyond ruling out structural injury such as a contusion or hemorrhage. This chapter presents a review of three neuroimaging techniques that offer insight into the connectivity and neurometabolic consequences of concussion. A number of studies have now been published using magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI)/diffusion-weighted imaging, and transcranial Doppler ultrasound (TCD) with varying findings. The results of these studies will be presented, together with current and possible future application of these techniques within the field of sport-related concussion.
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Nixdorff, Uwe, Stephan Achenbach, Frank Bengel, Pompillio Faggiano, Sara Fernández, Christian Heiss, Thomas Mengden, et al. Imaging in cardiovascular prevention. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656653.003.0006.
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Imaging tools in preventive cardiology can be divided into imaging modalities to assess pre-clinical and clinical atherosclerosis and functional assessments of vascular function or vascular inflammation. To calculate the likelihood of pre-clinical atherosclerosis intima-media thickness as well as coronary calcium scoring are most frequently used. However, beyond these two there are other parameters derived by ultrasound and multi-detector computed tomography as well as magnetic resonance imaging and nuclear/molecular imaging which are discussed in the chapter. Functional tests include flow-mediated dilatation, pulse wave analysis, and the ankle-brachial index. In clinical research other invasive measurements such as intravascular ultrasound/virtual histology/elastography, optical coherence tomography as well as thermography are being used. However, their value in clinical prevention still needs to be established.
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Bunker, Tim D. The clinical evaluation of the shoulder. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.004001.
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♦ History: onset event, radiation, exacerbation, night pain, functional deficit♦ Examination: active and passive movement, impingement signs, instability tests♦ Investigation: x-rays, ultrasound, CT and MR.
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Lancellotti, Patrizio, and Bernard Cosyns. The Standard Transthoracic Echo Examination. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713623.003.0002.
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Functional imaging by modern echocardiography offers a variety of methods to assess regional and global myocardial function beyond classic dimension, volume and ejection fraction measurements. This chapter shows how various modalities of Doppler echocardiography can be used for assessment of valves, haemodynamics, and coronary flow reserve. It also provides information on myocardial function can be extracted from echo images using a tissue Doppler or speckle tracking approach. 3Dechocardiography provides real-time 3D images of the heart in motion. Various types of examination and quantification are also shown. A brief explanation of contrast imaging is included as well as practical considerations such as administration protocols and the safety of ultrasound contrast.
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Cosyns, Bernard, and Bernard Paelinck. Pericardial disease. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199599639.003.0021.
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The ability of ultrasound to elucidate the functional and structural abnormalities of pericardial disease is powerful. Due to multimodality imaging possibilities and to its portability, echocardiography is the technique of choice for the diagnosis of pericardial disease. Although other non-invasive technologies have been developed to provide information about the pericardium, echocardiography remains the first and often only diagnostic method needed to make a definitive diagnosis and guide appropriate treatment in patients with pericardial effusion, cardiac tamponade, or constrictive pericarditis. It allows differential diagnosis with restrictive cardiomyopathy and can easily be performed for guiding pericardiocentesis.
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Tempkin, Betty Bates, and Reva Arnez Curry. Sonography: Introduction to Normal Structure and Function. 2nd ed. Saunders, 2004.
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12
Flachskampf, Frank A., Pavlos Myrianthefs, Ruxandra Beyer, and Pavlos M. Myrianthefs. Echocardiography and thoracic ultrasound. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0020.
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For the emergency management of cardiovascular disorders, echocardiography and thoracic ultrasound are indispensable imaging techniques at the bedside. In the intensive care environment, crucial questions, such as left and right ventricular function, valvular heart disease, volume status, aortic disease, cardiac infection, pleural effusion, pulmonary oedema, pneumothorax, and many others, can be sufficiently and reliably answered by using these techniques; in fact, it is almost impossible to manage patients with acute severe haemodynamic impairment reasonably well without a prompt and repeated access to echocardiography. This is confirmed by the prominent place that echocardiography has in the guideline-based diagnosis and treatment of all major cardiovascular emergencies, from acute heart failure to the acute coronary syndrome to pulmonary embolism, etc. Moreover, it is the ideal tool to follow the patient, since repeat examinations pose no risk to the patient and demand relatively little logistics and resources. To benefit from the wealth of information that echocardiography and thoracic ultrasound can provide, modern equipment (including a transoesophageal probe) and systematic training of echocardiographers must be ensured. The availability of prompt and experienced echocardiography and thoracic ultrasound services at all times is fundamental for sound contemporary cardiovascular intensive care.
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Flachskampf, Frank A., Pavlos Myrianthefs, Ruxandra Beyer, and Pavlos M. Myrianthefs. Echocardiography and thoracic ultrasound. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199687039.003.0020_update_001.
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For the emergency management of cardiovascular disorders, echocardiography and thoracic ultrasound are indispensable imaging techniques at the bedside. In the intensive care environment, crucial questions, such as left and right ventricular function, valvular heart disease, volume status, aortic disease, cardiac infection, pleural effusion, pulmonary oedema, pneumothorax, and many others, can be sufficiently and reliably answered by using these techniques; in fact, it is almost impossible to manage patients with acute severe haemodynamic impairment reasonably well without a prompt and repeated access to echocardiography. This is confirmed by the prominent place that echocardiography has in the guideline-based diagnosis and treatment of all major cardiovascular emergencies, from acute heart failure to the acute coronary syndrome to pulmonary embolism, etc. Moreover, it is the ideal tool to follow the patient, since repeat examinations pose no risk to the patient and demand relatively little logistics and resources. To benefit from the wealth of information that echocardiography and thoracic ultrasound can provide, modern equipment (including a transoesophageal probe) and systematic training of echocardiographers must be ensured. The availability of prompt and experienced echocardiography and thoracic ultrasound services at all times is fundamental for sound contemporary cardiovascular intensive care.
14
Bhaskar, Arun. Endoscopic ultrasound-guided coeliac plexus block. Edited by Paul Farquhar-Smith, Pierre Beaulieu, and Sian Jagger. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198834359.003.0064.
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The landmark paper discussed in this chapter is ‘Endosonography-guided celiac plexus neurolysis’, published by Wiersema and Wiersema in 1996. Pain is one of its most distressing complaints of pancreatic cancer, affecting more than 80% of patients with advanced disease. However, the use of opioids and other drugs is often limited by undesirable side effects, which include somnolence, confusion, lethargy, and decreased cognitive function. Intrathecal drug delivery systems, although effective, are often deemed impractical in pancreatic cancer, due to its poor prognosis and the fact that it is often diagnosed late. Tumour infiltration of the coeliac plexus results in pain in the abdomen and back; thus, this area has often been targeted for analgesia via a neurolytic coeliac plexus block. The paper by Wiersema and Wiersema examines the efficacy of an approach that uses ultrasound to guide needle placement in celiac plexus neurolysis, in a study of 30 patients.
15
Sullivan, Mark, John Henderson, Inderbir Gill, and Nilay Patel. Upper urinary tract obstruction. Edited by John Reynard. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0031.
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Obstructive uropathy refers to the clinical sequelae of impairment of free urinary flow in the urological tract. The clinical manifestation of obstructive uropathy depends on the level and duration of obstruction, whether it is partial or complete, and whether infection has supervened. Obstruction may be clinically silent—and incidental radiological, biochemical, or examination findings may suggest the diagnosis. The radiological techniques used to demonstrate obstruction can be divided into anatomical and functional studies. These include ultrasound, urography, cross-sectional imaging, micturating cystourethrography, the Whitaker test, nuclear renography, and urodynamic techniques. Presence of infection with obstruction constitutes a urological emergency and urgent decompression is warranted. The pathophysiological effects of unilateral or bilateral upper tract obstruction differ and have important implications for clinical management of patients. The management of numerous upper urinary tract obstructive conditions is discussed.
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Cuckow, Peter. Abnormalities of the bladder. Edited by David F. M. Thomas. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0120.
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Anatomical and functional reconstruction of the bladder exstrophy/epispadias complex of anomalies presents paediatric urologists with one of their greatest challenges. Nevertheless, very considerable advances have been made during the last 30 years. Children with classic bladder exstrophy now have an excellent prospect of becoming fully continent—either by primary reconstruction or with a catheterizeable stoma. Achieving continence and normal voiding in children with primary epispadias can be difficult because of the dysplastic nature of their sphincteric and bladder neck tissues. Urachal anomalies may present symptomatically in childhood or incidentally during ultrasound examination of the lower urinary tract. Small bladder diverticula which are secondary to outflow obstruction or bladder dysfunction tend to resolve following treatment of the underlying cause, whereas surgical excision is usually required for larger, symptomatic diverticula.
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Hoskin, Peter, Thankamma Ajithkumar, and Vicky Goh, eds. Imaging for Clinical Oncology. 2nd ed. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198818502.001.0001.
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Imaging is a critical component in the delivery of radiotherapy to patients with malignancy, and this text teaches the principles and practice of imaging specific to radiotherapy. Introductory chapters outline the basic principles of the available imaging modalities, including X-rays, CT, ultrasound, MRI, nuclear medicine, and PET. Site specific chapters then cover the main tumour sites, reviewing optimal imaging techniques for diagnosis, staging, radiotherapy planning, and follow-up for each site. The important areas of radiation protection, exposure justification, and risks are also covered, exploring issues such as balancing radiation exposure with long-term risks of radiation effects, such as second cancer induction. This second edition has been fully revised and updated to reflect current techniques, and includes two brand new chapters on imaging for radiotherapy treatment verification, and the role of specialist MRI techniques and functional imaging for radiotherapy planning.
18
executive, Health and safety. Sensory and Autonomic Function and Ultrasound Nerve Imaging in RSI Patients and Keyboard Workers. Health and Safety Executive (HSE), 2002.
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19
Torres, Río Aguilar, Luigi P. Badano, and Dimitrios Tsiapras. Cardiac transplant patients. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0050.
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Echocardiography has a pivotal role in the care of heart transplant (HT) recipients. This chapter discusses the use of echocardiographic techniques for the assessment of HT patients. In the early post-transplant period, echocardiography has demonstrated its utility to assess the normal and abnormal structural and physiological changes of the transplanted heart, as well as to detect complications such as graft failure. During follow-up, development of acute/chronic graft rejection and cardiac allograft vasculopathy remains the leading causes of mortality in HT recipients and the role of conventional and new echocardiographic techniques in detecting these complications is discussed. Finally, the role of stress echocardiography, which provides additional functional information to the anatomical data obtained with invasive coronary angiography and intravascular ultrasound, is highlighted. The last sections of the chapter are dedicated to the echocardiographic monitoring of endomyocardial biopsies and how to schedule serial echocardiograms during the follow-up of HT recipients.
20
Cañete, Juan D., and Julio Ramírez. Enthesitis. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198737582.003.0011.
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Enthesitis is common in psoriatic arthritis (PsA) occurring in50–60% of patients in clinical trials. Outcome measures for enthesitis have been developed, but its clinical diagnosis may be challenging at sites other than the Achilles and plantar insertions. Power Doppler ultrasound is more sensitive than clinical examination in detecting inflammatory and/or structural changes in asymptomatic patients, which have an unknown significance. Magnetic resonance imaging is useful to evaluate enthesitis and the best technique for osteitis. The concept of synovial–entheseal complex highlights the functional link between the entheseal site and synovium, supporting an important role for biomechanical stress in enthesitis, which is proposed as the primary lesion in PsA. Animal models have improved our understanding of molecular pathways, particularly TNF and IL-23/IL-17 cytokines, and new successful targeted therapies have been developed to treat enthesitis. Prospective studies integrating clinical and image examination will be crucial to better define the clinical implications of enthesitis changes.
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Keshav, Satish, and Palak Trivedi. Investigation in liver disease. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0208.
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This chapter discusses investigations in liver disease, including blood tests (liver chemistry and liver function tests, alpha-fetoprotein, viral serology, antibodies and immunoglobulins), ascetic fluid analysis, imaging (hepatobiliary ultrasound, CT, MRI, endoscopic ultrasound), and liver biopsy.
22
Sonography: Introduction to Normal Structure and Function. Elsevier - Health Sciences Division, 2015.
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23
Sonography: Introduction to Normal Structure and Function. Elsevier - Health Sciences Division, 2010.
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24
Sonography: Introduction to Normal Structure and Function. Elsevier - Health Sciences Division, 2020.
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25
Galderisi, Maurizio, and Sergio Mondillo. Assessment of diastolic function. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199599639.003.0009.
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Modern assessment of left ventricular (LV) diastolic function should be based on the estimation of degree of LV filling pressure (LVFP), which is the true determinant of symptoms/signs and prognosis in heart failure.In order to achieve this goal, standard Doppler assessment of mitral inflow pattern (E/A ratio, deceleration time, isovolumic relaxation time) should be combined with additional manoeuvres and/or ultrasound tools such as: ◆ Valsalva manoeuvre applied to mitral inflow pattern. ◆ Pulmonary venous flow pattern. ◆ Velocity flow propagation by colour M-mode. ◆ Pulsed wave tissue Doppler of mitral annuls (average of septal and lateral E′ velocity).In intermediate doubtful situations, the two-dimensional determination of left atrial (LA) volume can be diagnostic, since LA enlargement is associated with a chronic increase of LVFP in the absence of mitral valve disease and atrial fibrillation.Some new echocardiographic technologies, such as the speckle tracking-derived LV longitudinal strain and LV torsion, LA strain, and even the three-dimensional determination of LA volumes can be potentially useful to add further information. In particular, the reduction of LV longitudinal strain in patients with LV diastolic dysfunction and normal ejection fraction demonstrates that a subclinical impairment of LV systolic function already exists under these circumstances.
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Garbi, Madalina. The general principles of echocardiography. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199599639.003.0001.
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Knowledge of basic ultrasound principles and current echocardiography technology features is essential for image interpretation and for optimal use of equipment during image acquisition and post-processing.Echocardiography uses ultrasound waves to generate images of cardiovascular structures and to display information regarding the blood flow through these structures.The present chapter starts by presenting the physics of ultrasound and the construction and function of instruments. Image formation, optimization, display, presentation, storage, and communication are explained. Advantages and disadvantages of available imaging modes (M-mode, 2D, 3D) are detailed and imaging artefacts are illustrated. The biological effects of ultrasound and the need for quality assurance are discussed.
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Garbi, Madalina, Jan D’hooge, and Evgeny Shkolnik. General principles of echocardiography. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0001.
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Echocardiography uses ultrasound waves to generate images of cardiovascular structures and to display information regarding the blood flow through these structures. Knowledge of basic ultrasound principles and current technology is essential for image interpretation and for optimal use of equipment during image acquisition and post-processing. This chapter starts by presenting the physics of ultrasound and the construction and function of instruments. Image formation, optimization, display, presentation, storage, and communication are explained. Advantages and disadvantages of available imaging modes (M-mode, two-dimensional, and three-dimensional) are detailed and imaging artefacts are illustrated. The potential biologic effects of ultrasound and the need for quality assurance are discussed.
28
Pedro, Mónica M., and N. Cardim. Vascular imaging. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199599639.003.0027.
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The use of vascular ultrasonography (alone or combined with newer techniques like angio-magnetic resonance or angio-computed tomography) is an essential tool for the diagnosis and the assessment of vascular diseases. It is also useful for the follow-up after surgical or endovascular interventions (avoiding the need to use angiography in any therapeutic decision in most cases). The integration of two-dimensional echocardiography, colour flow imaging and spectral Doppler makes the morphological and functional assessment of vascular disease possible in almost every territory.For a long time, vascular ultrasonography was exclusively performed by non-cardiologists. Nowadays, in modern echo laboratories, vascular echography is frequently performed by cardiologists, often in cooperation with vascular surgeons and radiologists.In this chapter, we review the essential concepts of the use of vascular ultrasound imaging in the study of the territories that are most commonly evaluated: ◆ Cerebrovascular circulation. ◆ Abdominal circulation. ◆ Lower limb circulation (arterial and venous disease).In each of these sections, we describe the technical details of the ultrasonic examination, the normal recordings, the abnormal findings of specific diseases/syndromes affecting each territory, and the postoperative/post-interventional evaluation and follow-up.
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Rudwaleit, Martin. Enthesitis. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0054.
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Enthesitis is one of the key manifestations of spondyloarthritides (SpA) including ankylosing spondylitis (AS) and psoriatic arthritis. Enthesitis can occur alone or in combination with peripheral arthritis, sacroiliitis, or spondylitis. The inflammatory process is typically located at the insertion of the enthesis or ligament to bone, often resulting in osteitis as well. Because of its anatomical and functional complexity the term 'enthesis organ' has been coined. Biomechanical stress applied to the enthesis seems to play an important role for the occurrence of enthesitis in genetically predisposed individuals. Ultrasound imaging of peripheral entheses reveals enthesis abnormalities including entheseal calcification, bony erosion, or bony proliferation. Power Doppler signals demonstrating increased vascularization of inflamed entheses at the insertional site appear to be the most characteristic finding for enthesitis, yet study results are conflicting. Enthesitis-related osteitis and enthesitis at the spine is best visualized by MRI. Enthesitis may resolve spontaneously or may run a chronic course. Standard treatment includes local steroid injections, non-steroidal anti-inflammatory drugs (NSAIDs), and physical therapy. There is little evidence for the efficacy of disease-modifying anti-rheumatic drugs (DMARDs) in enthesitis. In contrast, anti-TNF agents have proven efficacy, and their use in treatment-resistant enthesitis is recommended in the Assessment of SpondyloArthritis international Society (ASAS)/European League Against Rheumatism (EULAR) recommendations for the management of AS and axial SpA and in the EULAR recommendations for psoriatic arthritis.
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Rudwaleit, Martin. Enthesitis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199642489.003.0054_update_002.
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Enthesitis is one of the key manifestations of spondyloarthritis (SpA) including ankylosing spondylitis (AS) and psoriatic arthritis. Enthesitis can occur alone or in combination with peripheral arthritis, sacroiliitis, or spondylitis. The inflammatory process is typically located at the insertion of the enthesis or ligament to bone, often resulting in osteitis as well. Because of its anatomical and functional complexity the term ’enthesis organ’ has been coined. Biomechanical stress applied to the enthesis seems to play an important role for the occurrence of enthesitis in genetically predisposed individuals. Ultrasound imaging of peripheral entheses reveals enthesis abnormalities including entheseal calcification, bony erosion, or bony proliferation. Power Doppler signals demonstrating increased vascularization of inflamed entheses at the insertional site appear to be the most characteristic finding for enthesitis, yet study results are conflicting. Enthesitis-related osteitis and enthesitis at the spine is best visualized by MRI. Enthesitis may resolve spontaneously or may run a chronic course. Standard treatment includes local steroid injections, non-steroidal anti-inflammatory drugs (NSAIDs), and physical therapy. There is little evidence for the efficacy of disease-modifying antirheumatic drugs (DMARDs) in enthesitis. In contrast, anti-TNF agents have proven efficacy, and their use in treatment-resistant enthesitis is recommended in the Assessment of SpondyloArthritis international Society (ASAS)/European League Against Rheumatism (EULAR) recommendations for the management of AS and axial SpA and in the EULAR recommendations for psoriatic arthritis.
31
Magee, Patrick, and Mark Tooley. Intraoperative monitoring. Edited by Jonathan G. Hardman. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0043.
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Chapter 25 introduced some basic generic principles applicable to many measurement and monitoring techniques. Chapter 43 introduces those principles not covered in Chapter 25 and discusses in detail the clinical applications and limitations of the many monitoring techniques available to the modern clinical anaesthetist. It starts with non-invasive blood pressure measurement, including clinical and automated techniques. This is followed by techniques of direct blood pressure measurement, noting that transducers and calibration have been discussed in Chapter 25. This is followed by electrocardiography. There then follows a section on the different methods of measuring cardiac output, including the pulmonary artery catheter, the application of ultrasound in echocardiography, pulse contour analysis (LiDCO™ and PiCCO™), and transthoracic electrical impedance. Pulse oximetry is then discussed in some detail. Depth of anaesthesia monitoring is then described, starting with the electroencephalogram and its application in BIS™ monitors, the use of evoked potentials, and entropy. There then follow sections on gas pressure measurement in cylinders and in breathing systems, followed by gas volume and flow measurement, including the rotameter, spirometry, and the pneumotachograph, and the measurement of lung dead space and functional residual capacity using body plethysmography and dilution techniques. The final section is on respiratory gas analysis, starting with light refractometry as the standard against which other techniques are compared, infrared spectroscopy, mass spectrometry, and Raman spectroscopy (the principles of these techniques having been introduced in Chapter 25), piezoelectric and paramagnetic analysers, polarography and fuel cells, and blood gas analysis.
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Fye, W. Bruce. Seeing the Heart. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199982356.003.0018.
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During the 1960s and 1970s, new diagnostic technologies were developed that provided unique visual information about the heart’s structure and function. Echocardiography uses ultrasound to create moving images of the heart’s walls and valves. During the 1980s, advances in computer technology contributed to the development of new ultrasound techniques (such as two-dimensional echocardiography) that provided better visualization of the heart. Doppler echocardiography yielded physiological information that had been available previously only by performing cardiac catheterization. Mayo helped pioneer several echocardiography innovations, which it popularized in many publications and lectures. Another so-called noninvasive approach to imaging the heart involved the use of radioisotopes. Nuclear cardiology proved to be especially useful in evaluating patients with known or suspected coronary artery disease. The application of CT and MRI imaging to the heart lagged because it was difficult to apply these technologies to a moving organ.
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Schreuder, Michiel F. Renal hypoplasia. Edited by Adrian Woolf. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0348.
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In true renal hypoplasia, normal nephrons are formed but with a deficit in total numbers. As nephron number estimation is not possible in vivo, renal size is used as a marker. A widely used definition of renal hypoplasia is kidneys with a normal appearance on ultrasound but with a size less than two standard deviations below the mean for gender, age, and body size. A distinct and severe form of renal hypoplasia is called (congenital) oligomeganephronia, which is characterized by small but normal-shaped kidneys with a marked reduction in nephron numbers (to as low as 10–20% of normal), a distinct enlargement of glomeruli, and a reduced renal function. In many cases, the small kidney also shows signs of dysplasia on ultrasound, leading to the diagnosis of renal hypodysplasia. Based on the hyperfiltration hypothesis and clinical studies, glomerular hyperfiltration can be expected, resulting in hypertension, albuminuria, and renal injury, for which long-term follow-up of all patients with renal hypoplasia is desirable.
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Schreuder, Michiel F. Renal dysplasia. Edited by Adrian Woolf. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0347.
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Renal dysplasia refers to abnormal and incomplete development of the kidney, which may be segmental, for instance, in the upper part of a duplex kidney, or affect the entire kidney. Dysplasia is by definition a histological diagnosis, but in most patients diagnosis is made on the basis of evaluation with ultrasound and renography. This typically shows cysts and/or a small kidney with decreased corticomedullary differentiation and a reduced split renal function. The latter can also be found in other conditions, such as hypoplasia, vascular insults, renal post-infectious damage, or polycystic kidney disease, making it difficult to establish the diagnosis and thereby estimate the incidence of renal dysplasia. The clinical consequences of renal dysplasia depend upon the residual renal function and may range from hypertension to chronic kidney disease.
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Evans, Charlotte, Anne Creaton, Marcus Kennedy, and Terry Martin, eds. Equipment and monitoring. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198722168.003.0006.
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The equipment and monitoring chapter in the Oxford Handbook of Retrieval Medicine benchmarks the standard of care delivered by the retrievalist while transiting through the retrieval environment. Continuous physiological monitoring alerts the retrievalist to potential patient deterioration. Core monitor functions are discussed in depth. Standard equipment such as syringe drivers are explained. In addition, a quick but comprehensive guide to ultrasound and blood gas analysis will be a useful refresher for the reader. Echocardiography findings are tabulated. Intraosseous access and recommended insertion sites are detailed. The chapter ends with sound advice regarding packaging of the equipment and the critically ill patient for optimal safe transport.
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Gruenewald, Simon, and Philip Vladica. Renal transplant imaging. Edited by Jeremy R. Chapman. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0282.
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The purpose of imaging of the transplant kidney is to assess integrity, anatomy, and function. Relatively or actually non-invasive technologies can be used to monitor for potential early post-transplant complications such as acute tubular necrosis, acute rejection, haematoma, pyelonephritis, abscess, urinoma, ureteral obstruction, vascular complications, and rarely graft torsion. The technologies also assist in the diagnosis and management of late complications such as those arising from immunosuppression, chronic rejection, lymphocoele, cyst, renal artery stenosis, urinary obstruction, and tumours. This chapter demonstrates the capacity of the various imaging modalities such as ultrasound, computed tomography, and magnetic resonance imaging, to assist in the clinical management of the renal transplant recipient.
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Avni, Fred E., Marie Cassart, Anne Massez, and Michèle Hall. Ante- and postnatal imaging to diagnose human kidney malformations. Edited by Adrian Woolf. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0361.
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Antenatal imaging plays a central role in the detection and management of congenital uropathies. Nowadays, two or three ultrasound examinations are performed in selected countries like Belgium or France while only one mid-trimester examination is performed in others (United Kingdom, Scandinavia). These examinations potentially allow the detection of a wide range of uronephropathies including at one end benign diseases and at the other, life-threatening conditions. Once detected, a full evaluation must be performed in order to confirm the diagnosis and evaluate the prognosis. In selected cases, fetal magnetic resonance imaging will provide additional useful information. After birth, imaging evaluation has been standardized and helps to prevent further deterioration of the renal function.
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Stein, Matthew A. Lymphadenopathy. Edited by Christoph I. Lee, Constance D. Lehman, and Lawrence W. Bassett. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190270261.003.0051.
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Lymphadenopathy is a pathological or abnormal state of one or more lymph nodes in a nodal basin that occurs in response to pathogens, immunogens, or malignant cells that are detected within the lymph. Malignant lymphadenopathy may be detected by physical exam and/or imaging findings, but it is ultimately confirmed or excluded by histological evaluation. This chapter, appearing in the section on nipple, skin, and lymph nodes, reviews key imaging and clinical features, imaging protocols and pitfalls, differential diagnoses, and management recommendations of lymphadenopathy detected by mammography, tomosynthesis, and ultrasound (US). Topics include the anatomy and physiology of breast lymphatic function, the anatomy and imaging features of lymph nodes, differential diagnosis of lymphadenopathy, and the imaging assessment of the axillary nodal basin in the context of known breast cancer.
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Schreuder, Michiel F. Renal tubular dysgenesis. Edited by Adrian Woolf. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0350.
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Renal tubular dysgenesis involves the absence or incomplete differentiation of proximal tubular nephron segments. Due to the lack of a patent nephron, it is characterized by (fetal) anuria and subsequent oligohydramnios, pulmonary hypoplasia, premature birth with severe and refractory arterial hypotension, and fetal or neonatal death. The main cause for renal tubular dysgenesis is a genetic mutation in the renin–angiotensin system, which has shown an autosomal recessive trait. Maternal use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers during pregnancy can have similar blocking effects on the fetal renin–angiotensin system, which may lead to renal tubular dysgenesis. Even though there is no actual renal function, ultrasound usually shows kidneys of normal size and architecture with an intact corticomedullary differentiation. Most patients with renal tubular dysgenesis do not survive beyond the neonatal period. A few patients have been described to survive with respiratory support, vasopressor treatment, and dialysis.
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Forfar, Colin. Diagnosis and investigation in suspected heart disease. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0087.
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The past 20 years have seen significant changes in both the demographics and natural history of many cardiovascular diseases. Important reductions in case-fatality rates (such as in acute coronary syndromes) have resulted from improved diagnostics and treatment options and better understanding of natural history. For others (such as infective endocarditis), improvements have been limited and disappointing. While advances in therapy and the scientific evidence underpinning treatments have been crucial, the importance of accurate diagnosis has remained a key element for progress. Many of the principles needed for diagnosis are constant: the pre-eminence of a focused, accurate history, complete physical examination, and timely and relevant investigation endures. It is essential to have a secure knowledge of the strengths and limitations of interpretation of a frequently bewildering array of tests. Progress in this field has been rapid; advances in ultrasound, scintigraphy, and cardiac magnetic resonance stand out at the interface between structure and function central to good patient care.
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Jakobsson, Jan. Anaesthesia for day-stay surgery. Edited by Philip M. Hopkins. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0068.
Full textAbstract:
Day-stay surgery is becoming increasingly common the world over. There are several benefits of avoiding in-hospital care. Early ambulation reduces the risk for thromboembolic events, facilitates wound healing, and avoiding admission reduces the risk for hospital-related infection. Additionally, the risk of neurocognitive side-effects can be avoided by returning the elderly patient to their home environment. Day-stay anaesthesia calls for adequate and structured preoperative assessment and patient evaluation, and the potential risk associated with surgery and anaesthesia should be assessed on an individual basis. Need for preoperative testing should be based on functional status of the patient and preoperative medical history but even the surgical procedure should be taken into account. Preoperative fasting should be in accordance with modern guidelines, refraining from food for 6 hours and fluids for 2 hours prior to induction in low-risk patients. Preventive analgesia and prophylaxis of postoperative nausea and vomiting (PONV) should be administered preoperatively. Local anaesthesia should be administered prior to incision, constituting part of multimodal analgesia. The multimodal analgesia strategy should also include paracetamol and a non-steroidal anti-inflammatory drug in order to reduce the noxious stimulus from the surgical field. Third-generation inhaled anaesthetics or a propofol-based maintenance are both feasible alternatives. Titrating depth of anaesthesia by using an EEG-based depth of anaesthesia monitor may facilitate the recovery process. The laryngeal mask airway has become commonly used and has several advantages. Ultrasound-guided peripheral blocks may facilitate the early postoperative course by reducing pain and avoiding the use of opiates. Perineural catheters may be an option for prolongation of the block following painful orthopaedic procedures but a strict protocol and follow-up must be secured. Not only pain but even nausea and vomiting should be prevented, and therefore risk stratification, for example by the Apfel score, and PONV prophylaxis in accordance with the risk score is strongly recommended. Early ambulation should be encouraged postoperatively. Safe discharge should include an escort who also remains at home during the first postoperative night. Analgesics should be provided and be readily available for self-care when the patient comes home. Pain medication should include an opioid; however, the benefit versus risk must be assessed on an individual basis. Patients should also be instructed about a rescue return-to-hospital plan. Quality of care should include follow-up and analysis of clinical practice, and institution of methods to improve quality should be enforced for the benefit of the ambulatory surgical patient.
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Magee, Patrick, and Mark Tooley. Physics in anaesthesia. Edited by Antony R. Wilkes and Jonathan G. Hardman. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0023.
Full textAbstract:
This chapter covers the basic science of physics relevant to anaesthetic practice. Equipment and measurement devices are covered elsewhere. Starting with fundamentals, atomic structure is introduced, followed by dimensions and units as used in science. Basic mechanics are then discussed, focusing on mass and density, force, pressure, energy, and power. The concept of linearity, hysteresis, and frequency response in physical systems is then introduced, using relevant examples, which are easy to understand. Laminar and turbulent fluid flow is then described, using flow measurement devices as applications of this theory. The concept of pressure and its measurement is then discussed in some detail, including partial pressure. Starting with the kinetic theory of gases, heat and temperature are described, along with the gas laws, critical temperature, sublimation, latent heat, vapour pressure and vaporization illustrated by the function of anaesthetic vaporizers, humidity, solubility, diffusion, osmosis, and osmotic pressure. Ultrasound and its medical applications are discussed in some detail, including Doppler and its use to measure flow. This is followed by an introduction to lasers and their medical uses. The final subject covered is electricity, starting with concepts of charge and current, voltage, energy, and power, and the role of magnetism. This is followed by a discussion of electrical circuits and the rules governing them, and bridge circuits used in measurement. The function of capacitors and inductors is then introduced, and alternating current and transformers are described.
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Leeson, Paul, Cristiana Monteiro, Daniel Augustine, and Harald Becher, eds. Echocardiography. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198804161.001.0001.
Full textAbstract:
Fully updated for its third edition, Echocardiography provides all of the essential information you need on echo acquisition, interpretation, and reporting in an easily readable and concise format. Featuring over 400 full colour images, this resource also comes with online access to 155 video clips to clarify complex issues, making it an invaluable guide for both the experienced and trainee cardiologist who performs echocardiography as part of their practice. Designed to align to international guidelines and help trainees undergoing accreditation or certification, including the BSE, EACVI, and ASE requirements, this handbook bridges the gap between entry-level texts and large textbooks, and is compact enough to carry around in clinical settings. It covers all echocardiography modalities, from acute echocardiography to transoesophageal and stress imaging. The third edition includes a simplified approach to the physics of ultrasound, a brand new chapter on interventional echocardiography, and a streamlined navigation between basic and advanced techniques. The sections on diastolic function, heart failure, and congenital heart disease have been expanded, and over 100 new illustrations, images, and schematic diagrams have been added to simplify images and anatomy for the reader.
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Sidebotham, David, Alan Forbes Merry, Malcolm E. Legget, and I. Gavin Wright, eds. Practical Perioperative Transoesophageal Echocardiography. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198759089.001.0001.
Full textAbstract:
Practical Perioperative Transoesophageal Echocardiography, 3rd edition, is a concise guide to the use of transoesophageal echocardiography (TOE) for patients undergoing cardiac surgical and interventional cardiological procedures. The text is aimed at anaesthetists and cardiologists, particularly those in training and those preparing for examinations. Three-dimensional imaging is integrated throughout the text. New to the third edition are chapters on mitral valve repair, aortic valve repair, TOE in the interventional catheter laboratory, and TOE assessment of pericardial disease. The first three chapters address the fundamentals of ultrasound imaging: physical principles, artefacts, image optimization, and quantitative echocardiography. Chapters 4 and 5 cover standard views, anatomical variants, and cardiac masses. Chapters 6 and 7 address left ventricular systolic and diastolic function, respectively. The subsequent eight chapters form the core of the book and deal with the cardiac valves and the thoracic aorta. Emphasis is placed on those aspects relevant to cardiac surgery; therefore, the mitral and aortic valves are afforded particular prominence. The role of three-dimensional imaging for the mitral valve is highlighted. Chapter 17 covers the emerging role of TOE for patients undergoing procedures in the catheter laboratory and covers topics such as transcatheter aortic valve replacement and edge-to-edge mitral valve repair. Chapter 18 provides an overview of the common congenital abnormalities encountered in adults. Two chapters address the important subjects of thoracic transplantation and mechanical cardiorespiratory support. Finally, Chapter 21 brings many threads from previous chapters together to describe the role of TOE in assessing haemodynamic instability.