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Ultrasound for pets is often more telling than X-rays

What does an ultrasound show me that X-rays don’t? This is something we are asked almost daily when speaking with clients about diagnostics on their sick pets.

Corgi-pet-ultrasound

X-rays are a great baseline when your pet is ill. We can see the internal organs and their contours, look for changes in the lungs that you may see from heart failure or cancer. We can see bladder or kidney stones and look for signs of intestinal obstructions. We can even look at bone to check for arthritis and growing pains. So why an ultrasound if we can see all that?

An ultrasound lets us look at the actual structure of an organ.

When looking at the heart, we can actually watch it beat and measure how well the heart muscles contract, how efficiently they are working. We can see the heart valves opening and closing, look for any signs of regurgitation, or leaky valves. If there is fluid in the chest or abdomen, we use the ultrasound to help us aspirate a sample for further evaluation, just as we can use it to aspirate or biopsy organs like the liver or kidneys if need be.

Breast cancer detection using sonography in women with mammographically dense breasts

BMC Med Imaging. 2014; 14: 41.
Published online 2014 Dec 30. doi:  10.1186/s12880-014-0041-0

Jimmy Okello, Harriet Kisembo, Sam Bugeza, and Moses Galukande

 BreastSonographyPost

Abstract

Background

Mammography, the gold standard for breast cancer screening misses some cancers, especially in women with dense breasts. Breast ultrasonography as a supplementary imaging tool for further evaluation of symptomatic women with mammographically dense breasts may improve the detection of mass lesions otherwise missed at mammography.

The purpose of this study was to determine the incremental breast cancer detection rate using US scanning in symptomatic women with mammographically dense breasts in a resource poor environment.

Methods

A cross sectional descriptive study. Women referred for mammography underwent bilateral breast ultrasound, and mammography for symptom evaluation. The lesions seen by both modalities were described using sonographic BI-RADS lexicon and categorized. Ultrasound guided core biopsies were performed. IRB approval was obtained and all participants provided informed written consent.

Results

In total 148 women with mammographically dense breasts were recruited over six months. The prevalence of breast cancer in symptomatic women with mammographically dense breasts was 22/148 (15%). Mammography detected 16/22 (73%) of these cases and missed 6/22 (27%). The six breast cancer cases missed were correctly diagnosed on breast ultrasonography. Sonographic features typical of breast malignancy were irregular shape, non-parallel orientation, non circumscribed margin, echogenic halo, and increased lesion vascularity (p values < 0.005). Typical sonofeatures of benign mass lesions were: oval shape, parallel orientation and circumscribed margin (p values <0.005).

Conclusion

Breast ultrasound scan as a supplementary imaging tool detected 27% more malignant mass lesions otherwise missed by mammography among these symptomatic women with mammographically dense breasts. We recommend that ultra sound scanning in routine evaluation of symptomatic women with mammographically dense breasts.

Why Your Heart Disease Risk May Not Be as High as You Think

@aliceparkny | 

Doctors may be overestimating risk for heart problems, which means some people may be prescribed drugs they don’t need

Heart disease is the leading killer of Americans, so predicting who is at highest risk of heart attack or stroke is a top priority. After decades of relying on a checklist of risk factors identified in the 1950s, which included factors like high cholesterol, high blood pressure, excessive weight gain and family history of heart trouble, heart experts decided to update the formula for calculating risk in 2013.

The new formula focused less on specific cholesterol targets and instead created an algorithm of the most significant risk factors, each weighted for how much they might contribute to heart issues. The problem, as many doctors quickly pointed out, was that the new formula seemed to loosen the criteria for putting people on medications, especially ones that lower cholesterol. Simply being older, for example, could push a person into higher risk territory that would warrant a statin prescription, even if this person ate a healthy diet, got plenty of exercise and wasn’t overweight or hypertensive. So this raised serious questions about whether everyone who qualified for treatment under the new guidelines actually needed it.

In a new report published in the Journal of the American College of Cardiology, researchers found that the new recommendations, created by the American Heart Association (AHA) and the American College of Cardiology (ACC), overestimates the risk of heart trouble up to five to six times. That means that five to six times as many people may be prescribed drugs like cholesterol-lowering statins who won’t necessarily benefit from them.

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