Results from a study presented at The International Liver Congress 2015 demonstrate that the use of a pocket-sized ultrasound device (PUD) helps to reduce the need for further testing in both the inpatient and outpatient setting.

The study evaluated the effectiveness of the PUD when testing for the following conditions: biliary-duct dilation, gallstones, ascites, splenomegaly, pleural effusion, pericardial effusion, urinary retention, urinary stones, abdominal mass and aortic aneurysm.

PUDs offer a comparable performance to standard ultrasonography, however the accuracy of a physical examination is often poor meaning that further tests are required. This study assessed whether adding the use of PUD to physical examination could lead to a reduction in the rate of additional tests.

Of the 1,962 patients included in the study:

726 (37%) were inpatients, 510 (26%) were hepatology outpatients and 726 (37%) were recruited from GPs
Gallstones (37%), ascites – excessive accumulation of fluid in the abdominal cavity (17%), pleural effusion (13%), urinary stones (13%) and urinary retention (12%) accounted for more than 90% of the clinical questions, confirmed by PUD in 66% of cases
The overall frequency of further tests needed after PUD was 37%
The rate of agreement between findings of the PUD and additional tests was 89%
This study found that after basic training, the use of a PUD offers a simple and effective way to improve the accuracy of diagnosis and reduce the number of tests a patient needs. EurekAlert

Withholding angiotensin receptor blockers (ARBs) for longer than two days after surgery is associated with a significantly increased risk of postoperative death, according to a study of more than 30,000 patients in the VA health care system by researchers at UC San Francisco and the San Francisco VA Medical Center (SFVAMC).

ARBs are prescribed for high blood pressure, heart disease and kidney disease, explained lead author Susan M. Lee, MD, an SFVAMC anesthesiologist and UCSF clinical instructor.

By age 60, more than 50 percent of men in the United States suffer from benign prostatic hyperplasia (BPH), a condition that leads to annoying changes in urinary flow. While medical therapy is usually the first line of treatment, a new minimally invasive implant can dramatically reduce symptoms for men.

The first definitive summary of the best and safest treatments for kidney disease and diabetes patients has been compiled by Christchurch doctor and researcher Associate Professor Suetonia Palmer.

The University of Otago, Christchurch researcher together with a global team used innovative statistical analysis to compare hundreds of research studies on the effectiveness of blood-pressure-lowering drugs for patients with kidney disease and diabetes. The result: a one-stop-shop, evidence-based guide on which drugs are safe and effective.

Diabetes and high blood pressure are the most common causes of kidney disease around the world, and people often have both. Chronic kidney disease caused by diabetes always affects both kidneys and generally gets worse over time, often leading to kidney failure requiring dialysis treatment or a kidney transplant.

Associate Professor Palmer says this study is important because diabetes and kidney disease are at epidemic proportions in New Zealand. A common treatment for those with diabetes and kidney disease is blood-pressure-lowering drugs. The aim of these drugs is to prevent kidney damage.

However, doctors and patients face a bewildering array of treatment options as there are many drugs available to lower blood pressure, many used in combination. There are also hundreds of research studies done on the effectiveness of drugs or combinations of drugs. It is not possible for people to identify the best available treatments without scientific advances such as this study.

Associate Professor Palmer works as a nephrologist, or kidney specialist, at the Canterbury District Health Board and commonly sees first-hand how confusing the wide range of treatment options can be for patients, and those who treat them.

Her paper is the first to compare all drug options, and combinations of commonly used drugs, against each other.

 

Surgeons could know while their patients are still on the operating table if a tissue is cancerous, according to researchers from the Department of Energy’s Oak Ridge National Laboratory and Brigham and Women