Manual de diagnóstico ultrasónico / Manual of diagnostic ultrasound

This manual provides guidance on the use of ultrasound in the diagnosis of a wide variety of common conditions at thw primary and first-referral levels of health care. It is intended for use by doctors, sonographers, nurses and midwives with basic training in ultrasound techniques, who are working with a general-purpose scanner, and who do not have ready access to expert advice

The introductory chapters explain how ultrasound works, give advice on choosing a scanner, and describe some misleading artefacts that may occur on ultrasound images. These are followed by 17 chapters dealing with specific organs or systems of the body. Each chapter includes guidance on the indications for ultrasound examination, and describes the preparation of the patient and the techniques that are likely to be successful. Numerous ultrasound scans show both normal and abnormal conditions, and almost every scan is accompanied by a corresponding computer-generated image on which the most significant features are highlighted

Manual of diagnostic ultrasound

This manual provides guidance on the use of ultrasound in the diagnosis of a wide variety of common conditions at thw primary and first-referral levels of health care. It is intended for use by doctors, sonographers, nurses and midwives with basic training in ultrasound techniques, who are working with a general-purpose scanner, and who do not have ready access to expert advice

The introductory chapters explain how ultrasound works, give advice on choosing a scanner, and describe some misleading artefacts that may occur on ultrasound images. These are followed by 17 chapters dealing with specific organs or systems of the body. Each chapter includes guidance on the indications for ultrasound examination, and describes the preparation of the patient and the techniques that are likely to be successful. Numerous ultrasound scans show both normal and abnormal conditions, and almost every scan is accompanied by a corresponding computer-generated image on which the most significant features are highlighted

The value of ultrasonography in the diagnosis of ectopic pregnancy at the Kenyatta National Hospital, Nairobi.

Over a six-month-period, from 1st March 1988 to 30th September 1988, 127 patients suspected of having ectopic gestation at the Kenyatta National Hospital (KNH) were referred for sonographic examination, of whom 100 (78.7%) had enough data for a final diagnosis. During sonography, ectopic pregnancy was diagnosed in 31 (31%) patients, out of whom 15 (48.4%) were confirmed to have ectopic gestation at laparotomy. Of the 69 who were thought to have other gynaecological disorders at sonographic examination, 2 (2.9%) were later found to have other ectopic gestation at surgery. Of the 17 patients who had ectopic gestation finally, extrauterine gestational sac with a demonstrable foetal pole were observed in only 6 (35.3%) cases, thus allowing a confident diagnosis of ectopic pregnancy by sonography. An empty, bulky uterus, demonstrable adnexal mass, pseudo-gestational sac and fluid in the culde-sac, together improved the sonographic positive predictive value to 67.0%. This study has shown that sonography can be used in the diagnosis of ectopic pregnancy at the KNH. However, in order to improve its reliability, further studies are recommended involving a combination of pregnancy test and sonography.

PIP: Between March and September 1988 at the Kenyatta National Hospital in Nairobi, Kenya, clinicians included all patients (127) referred for ultrasonography due to suspected ectopic pregnancy (age range, 18-45 years) in a study to determine whether ultrasonography can be used to accurately diagnose ectopic pregnancy. The researchers examined only the records of 100 patients who had data adequate enough to make a final diagnosis. Based on sonography, clinicians believed 31 women had an ectopic pregnancy, but laparotomy confirmed that just 15 (48.4%) of these women actually had an ectopic pregnancy. Based on sonography, they did not suspect ectopic pregnancy in the other 69 patients, but laparotomy revealed that 2 patients (2.9%) did indeed have an ectopic pregnancy. Thus, the overall ectopic pregnancy rate among the 100 women was 17%. The remaining 83 women had other gynecological conditions. 52.9% of the women with an actual ectopic pregnancy had a pseudogestational sac, which had a positive predictive value of 53% and a negative predictive value of 90%. A pseudogestational sac had a sensitivity of 53% and specificity of 90%. Just 6 ectopic pregnancy cases (35.3%) had an extrauterine gestational sac with a clear fetal pole and a fetal heart beat. An enlarged uterus was more common in women with an ectopic pregnancy than in those with other conditions (82.4% vs. 51.8%; p .05). Every ectopic pregnancy case had a complex adnexal mass compared to just 48.2% of those with other conditions (p .001). When a woman had all these conditions combined--an empty, enlarged uterus; distinct adnexal mass; a pseudogestational sac; and fluid in the cul-de-sac-sonography's positive predictive value increased to 67%. The researchers recommended additional studies using a combination of the urinary pregnancy test and sonography to improve sonography's reliability.

Diverticular disease, carcinoma of the colon and diet in urban and rural Kenya Africans.

20 cases of diverticular disease and 12 cases of carcinoma of the colon have been demonstrated in 183 barium enemas in 1 year. These results, along with a dietary survey, show that diverticular disease can no longer be considered rare in Kenyan Africans and that a low-fibre diet is a contributory but perhaps not the only factor in its aetiology. There is probably an increasing incidence of diverticular disease as well as an increasing recognition of it. The incidence of carcinoma does not appear to be increasing to the same extent.