L.I. Doctor Offers Sports Injury Option

by Maurice Wingate
NYCHoops.net Publisher

In the competitive world of high school basketball recruiting, sometimes it comes down to the haves versus the have not’s. One sports medicine doctor from Long Island, NY has decided to do his part to level the playing field.

Pradeep Albert, MD
Pradeep Albert, MD

Injuries to the tendons, bone and to muscles are the major reasons why professional athletes are unable to play. Top pro-athletes like Carmelo Anthony (basketball), Tiger Woods (Golf) and MLB star Tanaka Masahiro (as well as basketball publishers like yours truly) have all relied on Platelet-Rich Plasma Therapy (PRP) as a way to accelerate recovery time. Dr. Pradeep Albert, MD, DABR is one of the foremost U.S. authorities on the PRP and explained this groundbreaking procedure for NYCHoops.net. “Your blood is not made up of just red blood cells. It’s made up of white blood cells and it’s made up of platelets,” explained Dr. Albert. “Each of these cells have growth factors.” Albert went on to say that scientists have discovered in Europe, before the advent of it in the United States, that when one’s own platelet-rich plasma is injected into the area of injury, it facilitates healing. Albert said PRP has been used for the last ten years in the United States and probably longer in Europe. “PRP is used ideally for tendon injuries. That’s where it’s shown the most promise,” he said. Albert adds that PRP can also be used for joint injuries (ie. Arthritis). As a successful doctor of sports medicine at Medical Arts Radiology in Huntington, New York, Albert is acutely aware of high performance requirements of athletes. “Everything in life is about timing,” he said. “Just like in professional sports, I think that the average high school athlete has a very very strict time frame meaning that they have to impress somebody in a very short amount of time. Unfortunately, even if you’re excellent or incredible, if you have an injury, it will affect the colleges that you can get into.” Dr. Albert says that PRP can reduce the playing downtime caused by a tendon injury or tear. “Basically it’s the difference in having a completely lost season and being available.” As phenomenal a breakthrough as PRP is, it’s not yet covered by insurance and the procedure is expensive. This has created an uneven playing field off the court between those student-athletes that can afford PRP and those who can’t.

Pradeep Albert, MD ultrasound

As a Queens, NY native and a product of NYC public schools (Brooklyn Tech), Albert says he’s appreciative of what an education has afforded him. “Even though I’m a physician now, I still remember what it was like back in those days when I had to do what I had to do to make it,” Albert exclaimed. “It always seemed like the wealthier kids had an advantage.” Dr. Albert told NYCHoops.net that he wants to do his part to even the playing field while at the same time giving back. “Because I believe in this treatment so much, I’m willing to donate my time and not charge young athletes who are [economically challenged]. That’s something I’m willing to do for the community,” he said. The motivation for helping disadvantaged student-athletes, according to Albert, is the desire to assist them in achieving a higher education. “It would be terrible for them to lose a scholarship or the ability to actually be [college] educated [due to injury],” he said. Understanding the realities that most young athletes will not become professional athletes, Albert said if PRP affords a student-athlete the opportunity for a scholarship and a college education, that would be an accomplishment. “Maybe he will become a doctor one day.” Dr. Albert said he will offer his services based on need as well as on a case-by-case basis. He can be contacted via email at winrad@yahoo.com for details. Albert says that Platelet-Rich Plasma Therapy is a medical procedure and not everyone will qualify.


Reference: NYCHoops; https://nychoops.rivals.com/; L.I. Doctor Offers Sports Injury Option; https://nychoops.rivals.com/content.asp?CID=1678866; Maurice Wingate; September 8, 2014.

Ultrasounds could replace radiography for detecting pneumonia in children

Pediatric UltrasoundUltrasounds could be an equally accurate method for detecting pneumonia in children compared with chest x-rays.

That’s according to a recent study which compared ultrasonography with chest radiography for detecting pneumonia in children.

It suggests that this could mean that more children could be diagnosed, especially in resource-limited settings.

The children would also be exposed to less radiation.

The research was carried out by Dr Lilliam Ambroggio at Cincinnati Children’s Hospital Medical Center, Cincinnati, USA.

Study 

The study enrolled patients aged 3 months to 18 years with a clinically ordered CT or admitted to the hospital with a respiratory condition.

Main exposures were chest ultrasound and x-ray findings read by four radiologists blinded to the clinical diagnosis of the patient.

The authors were able to determine the accuracy of both methods by comparing them to the CT reference standard.

The researchers found that, when compared with chest X-rays, ultrasound may be more sensitive (identifying more true positive results) and less specific (less true negative results) than chest x-rays in detecting consolidations and pleural effusions, both common indicators of pneumonia.

However overall the two techniques were statistically equivalent.

Dr Ambroggio said:

Ultrasound and chest radiography in our study were statistically equivalent, suggesting the potential for chest ultrasonography to replace chest x-rays in detecting pneumonia in children, particularly in outpatient and resource-limited settings.

“The advent of ultrasound technology in the diagnosis of pneumonia in developing countries is potentially easier to establish as the infrastructure needed to perform and interpret a chest ultrasound is much less than what is needed to perform a chest radiograph.”

The research was presented at the annual meeting of the European Society for Pediatric Infectious Diseases in Dublin.

Want to learn more about U/S evaluation of the lung & bowel?  Attend the Pediatric Emergency or Pediatric Ultrasound courses coming up June 25-26.

Reference: MSN News; http://news.ie.msn.com/ireland/ultrasounds-could-replace-radiography-for-detecting-pneumonia-in-children

Are Stethoscopes Going the Way of the Dodo?

Some experts are saying its time for doctors to toss their stethoscopes in the trash.

Dr. Jagat Narula, associate dean for global affairs at Mount Sinai School of Medicine in New York, and Dr. Bret Nelson, associate professor of emergency medicine at Mount Sinai, wrote in an editorial in the December 2013 issue of Global Heart that they believe doctors in the near future will hang up their stethoscopes in exchange for portable ultrasound devices.

“Now that you can use an ultrasound to look into the chest, why do you need stethoscope?” he asked CBS News.

This is an example of a hand-carried ultrasound unit. (provided by GE)
This is an example of a hand-carried ultrasound unit.
(provided by GE)

Stethoscopes were invented in 1816 in France in order to amplify the sounds the body makes. A disposable version of the tool can cost less than $25.

Ultrasounds, on the other hand, use sound pressure waves to reflect images from inside the body. It does not use radiation and is painless. Typically ultrasounds are used to look at fetuses in pregnant women, but they can be utilized to give doctors a closer look at internal organs without surgery.

Nelson told CBS News that his department uses ultrasounds regularly to diagnose many conditions.

“By looking directly at the lungs, I can see if there’s fluid in those lungs. I can see if the hearts beating properly,” he explained.

Large ultrasound machines that need to be wheeled around cost about $40,000, Popular Mechanics reported. Today, many companies offer hand-held ultrasound devices that can be attached to a smartphone. While these smaller products currently run about $10,000, the authors believe the prices will drop when more products enter the market.

There are some concerns with ultrasounds, however, even if the technology is more advanced. To begin with, doctors would need special training on how to analyze and read ultrasounds.

“It is relatively complex and difficult to interpret in the hands of the average physician, and I think it will be generations before we see the disappearance of the stethescope,” Dr. Sahil A. Parikh, assistant professor of medicine at University Hospitals Case Medical Center in Cleveland, Ohio, said to CBS News.

Dr. Charles Cutler, chairman of the American College of Physicians’ Board of Regents, added to HealthDay that visually looking at organs instead of just listening to them may bring attention to non-troubling areas that might look slightly off-kilter. For example, Culter explained heart valves may look different on ultrasounds, which could lead a doctor to ask for an additional CT scan.

“It may be a false alarm, but now you have ordered the test and you have worried the patient,” he said.

On top of that, many doctors are still simply too attached to their stethoscopes.

“I remain pretty addicted to my stethoscope. It is so much a part of what we do and is very symbolic,” Dr. Michael Dixon, a general practitioner and chairman of the healthcare organization The College of Medicine, said to the Telegraph. “It suggests treatment as well as diagnosis, and a connection. The problem for many is the alienation between doctor and patients that comes from computers. If you start to introduce more machines, it could have a negative effect.”

The authors believe that if this new generation of medical students start using ultrasound devices, it may just become the norm.

“Medical students will train with portable devices during their preclinical years, and witness living anatomy and physiology previously only available through simulation. And as they take on leadership roles themselves they may realize an even broader potential of a technology we are only beginning to fully utilize,” they wrote.

Reference: http://www.cbsnews.com/news/are-stethoscopes-going-the-way-of-the-dodo/, http://www.popularmechanics.com/science/health/med-tech/rip-stethoscope-16414909

Intestinal Ischemia: US-CT findings correlations

Intestinal Ischemia: US-CT findings correlations.

Reginelli A, Genovese E, Cappabianca S, Iacobellis F, Berritto D, Fonio P, Coppolino F, Grassi R.

Second University of Naples, Department of Clinical and Experimental Internistic F, Magrassi – A, Lanzara, Naples, Italy. reginelli@tin.it.

Abstract

BACKGROUND:

Intestinal ischemia is an abdominal emergency that accounts for approximately 2% of gastrointestinal illnesses. It represents a complex of diseases caused by impaired blood perfusion to the small and/or large bowel including acute arterial mesenteric ischemia (AAMI), acute venous mesenteric ischemia (AVMI), non occlusive mesenteric ischemia (NOMI), ischemia/reperfusion injury (I/R), ischemic colitis (IC). In this study different study methods (US, CT) will be correlated in the detection of mesenteric ischemia imaging findings due to various etiologies.

METHODS:

Basing on experience of our institutions, over 200 cases of mesenteric ischemia/infarction investigated with both US and CT were evaluated considering, in particular, the following findings: presence/absence of arterial/venous obstruction, bowel wall thickness and enhancement, presence/absence of spastic reflex ileus, hypotonic reflex ileus or paralitic ileus, mural and/or portal/mesenteric pneumatosis, abdominal free fluid, parenchymal ischemia/infarction (liver, kidney, spleen).

RESULTS:

To make an early diagnosis useful to ensure a correct therapeutic approach, it is very important to differentiate between occlusive (arterial,venous) and nonocclusive causes (NOMI). The typical findings of each forms of mesenteric ischemia are explained in the text.

CONCLUSION:

At present, the reference diagnostic modality for intestinal ischaemia is contrast-enhanced CT. However, there are some disadvantages associated with these techniques, such as radiation exposure, potential nephrotoxicity and the risk of an allergic reaction to the contrast agents. Thus, not all patients with suspected bowel ischaemia can be subjected to these examinations. Despite its limitations, US could constitutes a good imaging method as first examination in acute settings of suspected mesenteric ischemia.

 

References:
See full article at pubmed.gov