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Dietrich CF, Bulla P, Dudwiesus H, Lo H, Hocke M, Hoffmann B, Horn R, Lehmann B, Morf S, Nuernberg D, Prosch H, Serra A, Spengler J, Blaskova A, Jenssen C. [Perspectives and Challenges of hand-held Ultrasound]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2022. [PMID: 36170860 DOI: 10.1055/a-1901-9394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The use of handheld ultrasound devices from a technical and data protection point of view, device properties, functionality, documentation, indications, delegation of performance, applications by doctors, students and non-medical staff is examined and discussed.
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Affiliation(s)
- Christoph F Dietrich
- Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
| | - Peter Bulla
- Medizinische Klinik I, Klinik für Gastroenterologie, Gastrointestinale Onkologie, Hepatologie, Infektiologie und Geriatrie, Universitätsklinikum Tübingen, Deutschland, Tübingen, Germany
| | | | - Hendra Lo
- Brandenburgisches Institut für Klinischen Ultraschall, Medizinische Hochschule Brandenburg, Neuruppin, Germany
| | - Michael Hocke
- Klinik für Innere Medizin II, HELIOS Klinikum Meiningen, Meiningen, Germany
| | - Beatrice Hoffmann
- Beth Israel Deaconess Medical Center, Boston MA, Boston, United States
| | - Rudolf Horn
- Center da sandà Val Müstair, Sta. Maria, Switzerland
| | - Beat Lehmann
- Universitäres Notfallzentrum, Inselspital Universitätsspital Bern, Bern, Switzerland
| | - Susanne Morf
- Center da sandà Val Müstair, Sta. Maria, Val Müstair, Switzerland
| | - Dieter Nuernberg
- Brandenburgisches Institut für Klinischen Ultraschall und Fakultät Gesundheitswissenschaften, Medizinische Hochschule Brandenburg, Neuruppin, Germany
| | - Helmut Prosch
- Univ. Klinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Wien, Austria
| | | | | | - Andrea Blaskova
- Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
| | - Christian Jenssen
- Brandenburgisches Institut für Klinischen Ultraschall, Medizinische Hochschule Brandenburg, Neuruppin, Germany
- Innere Medizin, Krankenhaus Märkisch Oderland GmbH, Strausberg, Germany
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Ultrasonography in undergraduate medical education: a comprehensive review and the education program implemented at Jichi Medical University. J Med Ultrason (2001) 2022; 49:217-230. [PMID: 35034230 PMCID: PMC8761092 DOI: 10.1007/s10396-021-01178-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/01/2021] [Indexed: 11/03/2022]
Abstract
The concept of point-of-care ultrasound has been widely accepted owing to the development of portable ultrasound systems and growing body of evidence concerning its extensive utility. Thus, it is reasonable to suggest that training to use this modality be included in undergraduate medical education. Training in ultrasonography helps medical students learn basic subjects such as anatomy and physiology, improve their physical examination skills, and acquire diagnostic and procedural skills. Technological advances such as simulators, affordable handheld devices, and tele-ultrasound systems can facilitate undergraduate ultrasound education. Several reports have indicated that some medical schools have integrated ultrasound training into their undergraduate medical curricula. Jichi Medical University in Japan has been providing medical students with ultrasound education to fulfill part of its mission to provide medical care to rural areas. Vertical integration of ultrasound education into a curriculum seems reasonable to ensure skill retention and improvement. However, several issues have hampered the integration of ultrasound into medical education, including a lack of trained faculty, the need to recruit human models, requisition of ultrasound machines for training, and limited curricular space; proposed solutions include peer teaching, students as trained simulated patients, the development of more affordable handheld devices, and a flipped classroom approach with access to an e-learning platform, respectively. A curriculum should be developed through multidisciplinary and bottom-up student-initiated approaches. Formulating national and international consensuses concerning the milestones and curricula can promote the incorporation of ultrasound training into undergraduate medical education at the national level.
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Naganuma H, Ishida H. One-day seminar for residents for implementing abdominal pocket-sized ultrasound. World J Methodol 2021; 11:208-221. [PMID: 34322370 PMCID: PMC8299907 DOI: 10.5662/wjm.v11.i4.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/10/2021] [Accepted: 06/01/2021] [Indexed: 02/06/2023] Open
Abstract
Despite its proven high utility, integration of pocked-sized portable ultrasound (US) into internal medicine residency training remains inconsistent. For 10 years, we have held a 1-d seminar biannually, consisting of lecture (half-day) and hands-on training (half-day) on pocket-sized US of the abdomen and lungs. The lecture consists of training on US physics and clinical applications of pocket-sized US, followed by a lecture covering the basic anatomy of the abdomen and lungs and introducing the systemic scanning method. Given the simple structure of pocket-sized US devices, understanding the basic physics is sufficient yet necessary to operate the pocket-sized US device. It is important to understand the selection of probes, adjustment of B mode gain, adjustment of color gain, and acoustic impedance. Basic comprehension may have a significant positive impact on the overall utilization of pocket-sized US devices. The easiest and most reliable way to observe the whole abdomen and lungs is a combination of transverse, sagittal, and oblique scanning, pursuing the main vascular system from the center to the periphery of the organ in the abdomen and systemic scanning of the pleura. There is usually a marked change in knowledge and attitudes among the program participants, although skill gaps remain among them. We discuss the limitations and problems to this education system as well.
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Affiliation(s)
- Hiroko Naganuma
- Department of Gastroenterology, Yokote Municipal Hospital, Yokote 0138602, Akita, Japan
| | - Hideaki Ishida
- Department of Gastroenterology, Akita Red Cross Hospital, Akita-City 010-1495, Japan
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Abbasi MA, Kim H, Chinnadayyala SR, Park KD, Cho S. Real-Time Impedance Detection of Intra-Articular Space in a Porcine Model Using a Monopolar Injection Needle. SENSORS 2020; 20:s20164625. [PMID: 32824575 PMCID: PMC7472031 DOI: 10.3390/s20164625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/11/2020] [Accepted: 08/14/2020] [Indexed: 12/20/2022]
Abstract
Rheumatoid arthritis and osteoarthritis can be treated through specific drug injection into the intra-articular space. Several failures during drug injection attempts with conventional fluoroscopy and ultrasonography in a small area of the intra-articular space have been reported. In this work we present an innovative impedance measurement-based method/algorithm for needle tip positioning to enhance image-guided intra-articular vaccination treatment. A novel algorithm for detecting the intra-articular space in the elbow and knee joints of a live porcine model is reported. An impedance measurement system was developed for biological tissue measurement. The electrical impedance in the intra-articular space was monitored and the needle tip was examined by ultrasonography. The contrast dye was vaccinated and checked using fluoroscopy to confirm that the dye was properly inoculated in the cavity. The electrical impedance was estimated for various needle inclusion profundity levels in saline solution, which were broadly used to evaluate the proposed device for in vivo examinations. Good efficiency was observed in the impedance-based measurements using a monopolar injection needle for intra-articular therapy. To enhance the needle tip positioning for intra-articular therapy, the intended impedance measurement device with a monopolar injection needle can be used as a complement to existing modalities.
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Affiliation(s)
- Muhammad Aitzaz Abbasi
- Department of Electronics Engineering, Gachon University, 1342 Seongnamdaero, Sujeong-gu, Seongnam-si, Gyeonggi-do 13120, Korea; (M.A.A.); (S.R.C.)
| | - Hwijung Kim
- Department of Rehabilitation Medicine, Gachon University, Gil Medical Center Incheon, Incheon 21565, Korea;
| | - Somasekhar R. Chinnadayyala
- Department of Electronics Engineering, Gachon University, 1342 Seongnamdaero, Sujeong-gu, Seongnam-si, Gyeonggi-do 13120, Korea; (M.A.A.); (S.R.C.)
| | - Ki Deok Park
- Department of Rehabilitation Medicine, Gachon University, Gil Medical Center Incheon, Incheon 21565, Korea;
- Correspondence: (K.D.P.); (S.C.); Tel.: +82-32-460-8374 (K.D.P.); +82-31-750-5321 (S.C.)
| | - Sungbo Cho
- Department of Electronics Engineering, Gachon University, 1342 Seongnamdaero, Sujeong-gu, Seongnam-si, Gyeonggi-do 13120, Korea; (M.A.A.); (S.R.C.)
- Gachon Advanced Institute for Health Science & Technology, Gachon University, Incheon 21999, Korea
- Correspondence: (K.D.P.); (S.C.); Tel.: +82-32-460-8374 (K.D.P.); +82-31-750-5321 (S.C.)
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Jang AY, Ryu J, Oh PC, Moon J, Chung WJ. Feasibility and Applicability of Wireless Handheld Ultrasound Measurement of Carotid Intima-Media Thickness in Patients with Cardiac Symptoms. Yonsei Med J 2020; 61:129-136. [PMID: 31997621 PMCID: PMC6992452 DOI: 10.3349/ymj.2020.61.2.129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 12/28/2019] [Accepted: 12/31/2019] [Indexed: 12/25/2022] Open
Abstract
PURPOSE Routine screening for carotid intima-media thickness (CIMT) and cardiovascular (CV) disease in asymptomatic patients has been criticized for the high costs and large number of patients required for detecting one patient with coronary artery disease (CAD). In order to overcome the low cost-effectiveness thereof, we investigated the feasibility of an economic wireless handheld ultrasound (WHUS) device for CIMT measurement in symptomatic patients. MATERIALS AND METHODS A total of 100 consecutive patients with cardiac symptoms were enrolled. CIMT was measured in all patients. Coronary angiography was performed in 75 patients indicated for the exam. RESULTS The mean of maximal CIMT measured from left/right common carotid artery and bulb (max-CIMT) by the WHUS device showed excellent agreement [intraclass correlation coefficient (ICC)=0.960] with a standard ultrasound device and great interobserver repeatability (ICC>0.9 between all observers). Receiver operating characteristic curve analysis showed that the predictive power for CAD was improved when max-CIMT and plaque information (plaque≥2) was added [area under the curve (AUC): 0.838] to the traditional clinical CV risk factors (AUC: 0.769). The cutoff values for CAD prediction with the standard device and the WHUS device were 1.05 mm (AUC: 0.807, sensitivity: 0.78, specificity: 0.53) and 1.10 mm (AUC: 0.725, sensitivity: 0.98, specificity: 0.27), respectively. CONCLUSION max-CIMT measured by a WHUS device showed excellent agreement and repeatability, compared with standard ultrasound. Combined max-CIMT and plaque information added predictive power to the traditional clinical CV risk factors in detecting high-risk CAD patients.
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Affiliation(s)
- Albert Youngwoo Jang
- Department of Cardiovascular Medicine, Gachon University Gil Medical Center, Incheon, Korea
- Gachon Cardiovascular Research Institute, Gachon University, Incheon, Korea
| | - Jeongwon Ryu
- Gachon Cardiovascular Research Institute, Gachon University, Incheon, Korea
- Department of Medical Engineering, School of Medicine, Gachon University, Incheon, Korea
- Healcerion Co., Ltd., Seoul, Korea
| | - Pyung Chun Oh
- Department of Cardiovascular Medicine, Gachon University Gil Medical Center, Incheon, Korea
- Gachon Cardiovascular Research Institute, Gachon University, Incheon, Korea
| | - Jeonggeun Moon
- Department of Cardiovascular Medicine, Gachon University Gil Medical Center, Incheon, Korea
- Gachon Cardiovascular Research Institute, Gachon University, Incheon, Korea
| | - Wook Jin Chung
- Department of Cardiovascular Medicine, Gachon University Gil Medical Center, Incheon, Korea
- Gachon Cardiovascular Research Institute, Gachon University, Incheon, Korea.
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Wakefield RJ, Weerasinghe A, Tung P, Smith L, Pickering J, Msimanga T, Arora M, Flood K, Gupta P, Bickerdike S, McLaughlan J, Uttley A, Wilson J, Evans T, Wolstenhulme S, Roberts TE. The development of a pragmatic, clinically driven ultrasound curriculum in a UK medical school. MEDICAL TEACHER 2018; 40:600-606. [PMID: 29490531 DOI: 10.1080/0142159x.2018.1439579] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Whether ultrasound (US) should be incorporated into a medical undergraduate curriculum remains a matter of debate within the medical education arena. There are clear potential benefits to its early introduction particularly with respect to the study of living anatomy and physiology in addition to the learning of clinical skills and procedures required for the graduate clinical practice. However, this needs to be balanced against what is perceived as an added value in addition to financial and time constraints which may potentially lead to the sacrifice of other aspects of the curriculum. Several medical schools have already reported their experiences of teaching US either as a standalone course or as a fully integrated vertical curriculum. This article describes and discusses the initial experience of a UK medical school that has taken the steps to develop its own pragmatic vertical US curriculum based on clinical endpoints with the intent of using US to enhance the learning experience of students and equipping them with the skills required for the safe practice as a junior doctor.
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Affiliation(s)
- Richard J Wakefield
- a Department of Rheumatology, Leeds Institute of Rheumatic and Musculoskeletal Medicine , University of Leeds , Leeds , UK
| | - Asoka Weerasinghe
- b Department of Emergency Medicine , Dewsbury and District Hospital, Mid Yorkshire Hospitals NHS Trust , Wakefield , UK
| | - Patrick Tung
- b Department of Emergency Medicine , Dewsbury and District Hospital, Mid Yorkshire Hospitals NHS Trust , Wakefield , UK
| | - Laura Smith
- c Department of Clinical Skills Education, Leeds Institute of Medical Education , University of Leeds , Leeds , UK
| | - James Pickering
- d Division of Anatomy, Leeds Institute of Medical Education , University of Leeds , Leeds , UK
| | - Tendekayi Msimanga
- e Department of Acute and General Medicine , Mid Yorkshire NHS Trust, University of Leeds , Leeds , UK
| | - Mohit Arora
- f Department of Emergency Medicine , Leeds Teaching Hospitals NHS Trust , Leeds , UK
| | - Karen Flood
- g Department of Vascular Interventional Radiology , Leeds Teaching Hospitals NHS Trust , Leeds , UK
| | - Pawan Gupta
- h Department of Anaesthesia , Leeds Teaching Hospitals NHS Trust , Leeds , UK
| | - Suzanne Bickerdike
- i Leeds Institute of Medical Education , University of Leeds , Leeds , UK
| | - James McLaughlan
- j School of Electronic and Electrical Engineering/Leeds Institute of Cancer and Pathology , University of Leeds , Leeds , UK
| | - Ashley Uttley
- k Radiology Department , Leeds Teaching Hospitals NHS Trust , Leeds , UK
| | - Jean Wilson
- l School of Medicine , University of Leeds , Leeds , UK
| | - Tony Evans
- m Leeds Institute of Cardiovascular and Metabolic Medicine , University of Leeds , Leeds , UK
| | - Stephen Wolstenhulme
- k Radiology Department , Leeds Teaching Hospitals NHS Trust , Leeds , UK
- n Faculty of Health Sciences , University of Malta , Msida , Malta
| | - Trudie E Roberts
- i Leeds Institute of Medical Education , University of Leeds , Leeds , UK
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