Haemorrhoidal artery ligation and/or suture mucopexy for haemorrhoidal disease with or without the use of Doppler ultrasonography: a meta-analysis of randomized, controlled trials (2019)

Type of publication:
Conference abstract

Author(s):
*Rehman S.; Miles W.; Sains P.; Sajid M.; Baig M.

Citation:
British Journal of Surgery; Sep 2019; vol. 106, S5; p. 27-28

Abstract:
Aims: The objective of this article is to compare the surgical outcomes following haemorrhoidal artery ligation
and/or suture mucopexy for haemorrhoidal disease with or without the use of Doppler ultrasonography.
Method(s): The data retrieved from the published randomized, controlled trials (RCT) comparing the surgical
outcomes following haemorrhoidal artery ligation and/or suture mucopexy for haemorrhoidal disease with or
without the use of Doppler ultrasonography (DUS) was analysed using the principles of meta-analysis. The
summated outcome of dichotomous variables was expressed in risk ratio (RR) and continuous data was
presented in standardised mean difference (SMD).
Result(s): Four RCTs on 270 patients comparing the surgical outcomes following haemorrhoidal artery ligation
and/or suture mucopexy for haemorrhoidal disease with or without the use of Doppler ultrasonography were
analysed using the statistical software Review Manager 5.3. In the random effects model analysis no-DUS
group had shorter procedure time (SMD, 3.69; 95% CI, 2.73, 4.64; z = 7.56; P = 0.00001), better symptomatic
relief rate (RR, 1.95; 95% CI, 1.07, 3.56; z = 2.19; P = 0.03) and lower risk of short or long term haemorrhoidal
bleed (RR, 2.27; 95% CI, 1.25, 4.11; z = 2.70; P = 0.0007). The recurrence rate (RR, 1.87; 95% CI, 0.66, 5.30; z =
1.18; P = 0.24), post-operative pain score and complication rate were similar in both groups.
Conclusion(s): The use of DUS in haemorrhoidal artery ligation and/or suture mucopexy for haemorrhoidal
disease is not mandatory and better clinical outcomes may be achieved without its use.

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Point-of-care lung ultrasound in patients with COVID-19 – a narrative review (2020)

Type of publication:
Journal article

Author(s):
Smith, M J; Hayward, S A; Innes, S M; *Miller, A S C

Citation:
Anaesthesia; Aug 2020, vol. 75 (no. 8); p. 1096-1104

Abstract:
Ultrasound imaging of the lung and associated tissues may play an important role in the management of patients with COVID-19-associated lung injury. Compared with other monitoring modalities, such as auscultation or radiographic imaging, we argue lung ultrasound has high diagnostic accuracy, is ergonomically favourable and has fewer infection control implications. By informing the initiation, escalation, titration and weaning of respiratory support, lung ultrasound can be integrated into COVID-19 care pathways for patients with respiratory failure. Given the unprecedented pressure on healthcare services currently, supporting and educating clinicians is a key enabler of the wider implementation of lung ultrasound. This narrative review provides a summary of evidence and clinical guidance for the use and interpretation of lung ultrasound for patients with moderate, severe and critical COVID-19-associated lung injury. Mechanisms by which the potential lung ultrasound workforce can be deployed are explored, including a pragmatic approach to training, governance, imaging, interpretation of images and implementation of lung ultrasound into routine clinical practice.

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Physiotherapists utilizing diagnostic ultrasound in shoulder clinics. How useful do patients find immediate feedback from the scan as part of the management of their problem? (2018)

Type of publication:
Journal article

Author(s):
*Lumsden, Gordon; *Lucas-Garner, Kerry; *Sutherland, Sarah; *Dodenhoff, Ron

Citation:
Musculoskeletal care; Mar 2018; vol. 16 (no. 1); p. 209-213

Abstract:
AIMSPhysiotherapists are beginning to utilize diagnostic ultrasound imaging in upper limb/shoulder clinics. The aim of the present study was to receive feedback on the views of the patients concerning the usefulness of the information obtained immediately from the scan in the management of their problem.METHODS A questionnaire was offered to all patients attending a physiotherapist-led upper limb/shoulder clinic who underwent ultrasound imaging as part of a shoulder assessment over a 6-month period. A total of 103 patients completed a questionnaire for analysis.RESULTSPatients rated the ultrasound scan to be of benefit in all aspects. Regarding the ability to understand their shoulder problem better and in feeling reassured about their problem, 97% of patients either strongly agreed or agreed that this was the case. Concerning the capability of managing their problem, 89% of patients strongly agreed or agreed that they felt more able to do this. In total, 96% of patients evaluated the ultrasound scan to be of very high/high value to them.CONCLUSION Patients highly rate the information gained from ultrasound imaging in a physiotherapy-led upper limb/shoulder clinic and felt that it assisted them in the understanding, reassurance and management of their problem.

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Anatomy of the sural nerve and its relation to the achilles tendon by ultrasound examination (2014)

Type of publication:
Journal article

Author(s):
Kammar H., *Carmont M.R., Kots E., Laver L., Mann G., Nyska M., Mei-Dan O.

Citation:
Orthopedics, March 2014, vol./is. 37/3(e298-e301), 0147-7447 (March 2014)

Abstract:
Sural nerve injury is a relatively common complication after surgery on the Achilles tendon. Studies to determine the course of the sural nerve have been performed on cadaveric specimens. The purpose of this cross-sectional study was to use ultrasound to determine the relations of the sural nerve in a healthy population. The authors performed ultrasound examination of the posterior triangle of the ankle and Achilles tendon to determine the course of the sural nerve relative to the Achilles tendon in healthy participants. The mean distance between the nerve and the tendon was 21.48, 11.47, 5.8, and 0.81 mm lateral to the Achilles tendon as measured at the insertion and 4, 8, and 11 cm proximally, respectively. Male participants tended to have a nerve that was initially more lateral to the Achilles insertion compared with women. The distance between the sural nerve and the Achilles tendon was found to be lower in older participants, with the nerve passing significantly closer to the tendon at all levels (P

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