Both the interest and actual extent of use of point-of-care ultrasound, PoCUS, among general practitioners or family physicians are increasing and training is also increasingly implemented in residency programs. However, the amount of research within the field is still rather limited compared to what is seen within other specialties in which it has become more established, such as in the specialty of emergency medicine. An assumption is made that what is relevant for emergency medicine physicians and their populations is also relevant to the general practitioner, as both groups are generalists working in unselected populations. This systematic review aims to examine the extent of use and to identify clinical studies on the use of PoCUS by either general practitioners or emergency physicians on indications that are relevant for the former, both in their daily practice and in out-of-hours services. Systematic searches were done in PubMed/MEDLINE using terms related to general practice, emergency medicine, and ultrasound. On the extent of use, we identified 19 articles, as well as 26 meta-analyses and 168 primary studies on the clinical use of PoCUS. We found variable, but generally low, use among general practitioners, while it seems to be thoroughly established in emergency medicine in North America, and increasingly also in the rest of the world. In terms of clinical studies, most were on diagnostic accuracy, and most organ systems were studied; the heart, lungs/thorax, vessels, abdominal and pelvic organs, obstetric ultrasound, the eye, soft tissue, and the musculoskeletal system. The studies found in general either high sensitivity or high specificity for the particular test studied, and in some cases high total accuracy and superiority to other established diagnostic imaging modalities. PoCUS also showed faster time to diagnosis and change in management in some studies. Our review shows that generalists can, given a certain level of pre-test probability, safely use PoCUS in a wide range of clinical settings to aid diagnosis and better the care of their patients.

/pdf/point-of-care-ultrasound-in-primary-care-a-systematic-review-p17l93u8ji.pdf

Point-of-care ultrasound in primary care: a systematic review of generalist performed point-of-care ultrasound in unselected populations

The aim of the present review is to assess the effectiveness of ultrasound (US) in the detection of upper and lower limb bone fractures in adults compared to a diagnostic gold standard available in secondary and tertiary care centres (e.g. radiography, CT scan or MRI). The review followed PRISMA guidelines and used a database-specific search strategy with Medline, EMBASE and The Cochrane Library plus secondary sources (see supplementary material for completed PRISMA checklist). Diagnostic performance of ultrasound was assessed with a qualitative synthesis and a meta-analysis of two data subgroups. Twenty-six studies were included (n = 2360; fracture prevalence =5.3 % to 75.0%); data were organised into anatomical subgroups, two of which were subjected to meta-analysis. Sensitivity and specificity ranged from 42.11 − 100% and 65.0 − 100%, with the highest diagnostic accuracy in fractures of the foot and ankle. The pooled sensitivity and specificity of US was 0.93 and 0.92 for upper limb fractures (I2 = 54.7 % ; 66.3%), and 0.83 and 0.93 for lower limb fractures (I2 = 90.1 % ; 83.5%). Ultrasonography demonstrates good diagnostic accuracy in the detection of upper and lower limb bone fractures in adults, especially in fractures of the foot and ankle. This is supported by pooled analysis of upper and lower limb fracture subgroups. Further research in larger populations is necessary to validate and strengthen the quality of the available evidence prior to recommending US as a first-line imaging modality for prehospital use. The protocol is registered with the PROSPERO International register of systematic reviews: ID = 
 CRD42017053640
 .

https://link.springer.com/content/pdf/10.1186/s12873-019-0226-5.pdf

The effectiveness of ultrasound in the detection of fractures in adults with suspected upper or lower limb injury: a systematic review and subgroup meta-analysis

Since its inception, the Hemoglobin, Albumin, Lymphocyte, Platelet Score (HALP) has gained attention as a new prognostic biomarker to predict several clinical outcomes in a multitude of cancers. In our review, we searched PubMed for articles between the first paper on HALP in 2015 through September 2022, yielding 32 studies in total that evaluated HALP's association with various cancers, including Gastric, Colorectal, Bladder, Prostate, Kidney, Esophageal, Pharyngeal, Lung, Breast, and Cervical cancers, among others. This review highlights the collective association HALP has with demographic factors such as age and sex in addition to TNM staging, grade, and tumor size. Furthermore, this review summarizes HALP's prognostic ability to predict overall survival, progression-free survival, recurrence-free survival, among other outcomes. In some studies, HALP has also been able to predict response to immunotherapy and chemotherapy. This review article also aims to serve as a comprehensive and encyclopedic report on the literature that has evaluated HALP as a biomarker in various cancers, highlighting the heterogeneity surrounding HALP's utilization. Because HALP requires only a complete blood count and albumin - already routinely collected for cancer patients - HALP shows potential as a cost-effective biomarker to aid clinicians in improving outcomes for immuno-nutritionally deficient patients.

/pdf/what-is-hemoglobin-albumin-lymphocyte-platelet-halp-score-a-1njxlnnf.pdf

What is hemoglobin, albumin, lymphocyte, platelet (HALP) score? A comprehensive literature review of HALP’s prognostic ability in different cancer types

Boxer's fracture is the fifth metacarpal neck fracture resulting from direct trauma to the clenched fist. Worldwide, this type of fracture is the most typical presentation to emergency departments. The management of fifth metacarpal fractures varies from one setting to another. Conservative management is the preferred option for closed, non-angulated, non-malrotated fractures while open fractures, significant angulation, rotational deformity, and intra-articular extension are recognised indications for surgical intervention. The scope of this article covers the results of a literature review examining the management strategies for such fractures.

Management of Fifth Metacarpal Neck Fracture (Boxer's Fracture): A Literature Review.

BACKGROUND Ultrasound imaging can be used to diagnose fractures in patients with acute trauma. Its main advantages over conventional imaging are the absence of radiation exposure and its greater availability. METHODS A systematic search in electronic databases (Medline, Embase, Cochrane CENTRAL) was supplemented by a manual search on the Internet and in the reference lists of pertinent publications. The QUADAS-2 instrument was used to assess the quality of the individual studies retrieved. In the metaanalysis, the sensitivity and specificity of the individual studies were pooled. RESULTS The available information on the diagnostic accuracy of ultrasound in the detection of fractures compared with that of conventional imaging (x-ray, CT, MRI) in patients with acute non-life-threatening trauma is summarized. The database search yielded 2153 hits, among which there were 48 studies that were suitable for inclusion in this review. The pooled sensitivity and specificity were 0.91 (95% confidence interval [0.90; 0.92]) and 0.94 [0.93; 0.95], although the analyzed studies were markedly heterogeneous (I²: sensitivity 74%, specificity 81%). The sensitivity of ultrasound was higher for the detection of fractures of the humerus, the forearm, the ankle, and the long bones in general, as well as fractures in children, and lower for fractures of the short bones of the hands and feet, and in adults. CONCLUSION Strong evidence supports the use of ultrasound imaging for certain indications in the detection of fractures.

The Investigation of Suspected Fracture-a Comparison of Ultrasound With Conventional Imaging.

OBJECTIVE
To investigate the relationship between the HALP score (haemoglobin, albumin, lymphocyte, and platelet), the modified HALP (m-HALP) score, and prognosis in patients presenting to the emergency department (ED) with acute heart failure (AHF).


STUDY DESIGN
A Descriptive study.


PLACE AND DURATION OF STUDY
The Emergency Department of Balikesir University Hospital, Turkey, between January 2019 and September 2021.


METHODOLOGY
Patients diagnosed with AHF were divided into two groups, namely survivors and non-survivors. Both groups were compared in terms of HALP, m-HALP, PLT, NLR and PLR values ROC curve analysis was performed to evaluate their diagnostic performances in discriminating between one-week and three-month mortality. Youden J index was used to obtain the optimal cut-off value.


RESULTS
The mean age of 101 patients included in the study was 73.15±10.19 years, with 51.5% (n=52) females, and 48.5% (n=49) males. The 1-week and 3-month mortality rates were 11.9% and 38.6%, respectively. For 1-week (p=0.018) and 3-month (p=0.006) mortality, platelet was significantly higher in the survivor group than in the non-survivor group. The m-HALP score and the NLR were found to be good predictors for 3-month mortality (p=0.002 and 0.016 respectively). The optimal cut-off values of m-HALP score, the platelet, and the NLR in predicting 3-month mortality were found as ≤1081723.5, ≤217, and >8.4. The area under curve (AUC) values were found as 0.687, 0.663, and 0.643, respectively. The sensitivity of the m-HALP score, the platelet, and the NLR were 76.92, 66.67, and 46.15, and the specificity values were 56.45, 67.74, and 79.03, respectively.


CONCLUSION
The m-HALP score was found to be a potential independent prognostic index for patients with AHF. The classical HALP score was not adequate to predict early and late prognosis. In addition, thrombocytopenia and increased NLR were associated with increased mortality in patients with AHF.


KEY WORDS
Acute heart failure (AHF), HALP score, m-HALP score, Neutrophil lymphocyte ratio (NLR), Platelet lymphocyte ratio (PLR), Platelet (PLT).

/pdf/the-efficiency-of-the-halp-score-and-the-modified-halp-score-1dj9tkmx.pdf

The Efficiency of the HALP Score and the Modified HALP Score in Predicting Mortality in Patients with Acute Heart Failure Presenting to the Emergency Department.

Introduction The aim of this study was to evaluate the efficiency of ultrasonography (USG) in identifying metacarpal bone fractures in patients admitted to the emergency department (ED) with hand injury. Materials and methods Patients who were admitted to a training and research hospital's ED during the study period with hand trauma and had suspected metacarpal fractures were included in the study. They were examined for metacarpal fracture by USG and x-ray. Hand radiographs reviewed by an emergency physician were considered to be the criterion standard diagnostic tool. Ultrasonography results were compared to x-ray results. Results Ninety-eight ultrasound examinations were performed on 96 adult patients who were enrolled in the study. The mean age of the patients was 30.1 ± 11.8 years; 79.2% of the patients were male. Right hand injury was observed in 69.4% of the cases. Forty metacarpal fractures were detected in 38 patients on x-ray. We found a sensitivity of 92.5% (95% confidence interval [CI], 78.5-98), a specificity of 98.28% (95% CI, 89.5-99.9), a positive predictive value of 97.37% (95% CI, 84.5-99.8), and a negative predictive value of 95% (95% CI, 85-98) for USG to detect metacarpal fractures when compared to x-ray imaging. Conclusions Under the light of these results, we suggest that USG may be an option for detecting metacarpal fractures and prevent unnecessary x-ray imaging examinations in patients presenting to the ED with hand trauma.

The role of ultrasonography in the diagnosis of metacarpal fractures

Background:Community-acquired pneumonia is an important cause of mortality and morbidity in all age groups. Oxidant and antioxidant mechanisms play an important role in the pathogenesis and mortali...

https://journals.sagepub.com/doi/pdf/10.1177/1024907918802956

Evaluation of dynamic thiol/disulfide homeostasis in adult patients with community-acquired pneumonia:

Objectives This study aimed to make a comparison between classical shock index (SI), modified shock index (MSI), and age shock index (age SI) for predicting critical patients presenting to the emergency department (ED) with gastrointestinal bleeding (GIS). Methods The study, which was planned retrospectively, consisted of patients diagnosed with GIS bleeding at the ED admission. Triage time vital signs were used to calculate SI, MSI, and age SI. These results were compared with intensive care admission, endoscopic/colonoscopic (E/C) intervention, blood transfusion, and mortality criteria, which we define as adverse outcomes. Results The study included 151 patients. Seventy-nine (52.32%) of the patients had at least one adverse outcome. Of the 151 patients, 19 (12.58%) had ICU admission, 27 (17.88%) underwent endoscopic/colonoscopic (E/C) intervention, 68 (45.03%) received a blood transfusion, and 6 (3.97%) died. There was a significant difference between patients who had no adverse outcome and those who had at least one adverse outcome in terms of SI, age SI, and MSI. We performed ROC curve analyses to evaluate the diagnostic performances of all indices for predicting adverse outcomes. AUC (area under the curve) values for age SI was the highest (age SI AUC = 0.711, p Conclusions In patients with GIS bleeding, age SI, which can be easily calculated in triage, is more significant than SI and MSI for predicting the critical patient.

Use of age shock index in determining severity of illness in patients presenting to the emergency department with gastrointestinal bleeding.

OBJECTIVE
To determine whether lactate dehydrogenase (LDH), platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and lymphocyte-monocyte ratio (LMR) values can be used as a prediction for their relationship with stroke volume (SV) and for in-hospital mortality in stroke patients in Emergency Department (ED).


STUDY DESIGN
Analytical study.


PLACE AND DURATION OF STUDY
Balikesir University, Turkey from 24/03/2021 to 30/06/2021.


METHODOLOGY
Patients aged 18 years or older, diagnosed with stroke in ED, were included in the study. Stroke volumes were calculated from diffusion-weighted images (DWi) with 3D slicer software using image-based semi-automatic and manual segmentation methods.


RESULTS
Of the 265 patients, 128 (48.3%) were males. SV was significantly higher in the non-survivor group than in the survivor group (p=0.007). NLR was significantly higher in the non-survivor group than in the survivor group (p=0.018).


CONCLUSION
The ratios of NLR and SV stand out as practical parameters for the estimation of mortality, prognosis, and management of patients diagnosed with acute stroke. Taking into account, these parameters in the diagnosis process and prognosis management in EDs will provide convenience. Key Words: Ischemia, NLR, Stroke volume, Cerebrovasular accident, Prognosis.

/pdf/the-relationship-of-ldh-and-hematological-parameters-with-2ypoaqcq.pdf

The Relationship of LDH and Hematological Parameters with Ischemic Volume and Prognosis in Cerebrovascular Disease.

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Salih Kocaoğlu

Author Tools

Chat about Author