荆州里做全身体检好(运城部超声检查) (今日更新中)

Two centuries after its invention, the stethoscope — the very symbol of the medical profession — is facing an uncertain prognosis.It is threatened by hand-held devices that are also pressed against the chest but rely on ultrasound technology, artificial intelligence and smartphone apps instead of doctors’ ears to help detect leaks, murmurs, abnormal rhythms and other problems in the heart, lungs and elsewhere. Some of these instruments can yield images of the beating heart or create electrocardiogram graphs.Dr. Eric Topol, a world-renowned cardiologist, considers the stethoscope obsolete, nothing more than a pair of “rubber tubes.”It “was OK for 200 years,” Topol said. But “we need to go beyond that. We can do better.”In a longstanding tradition, nearly every U.S. medical school presents incoming students with a white coat and stethoscope to launch their careers. It’s more than symbolic — stethoscope skills are still taught, and proficiency is required for doctors to get their licenses.Over the last decade, though, the tech industry has downsized ultrasound scanners into devices resembling TV remotes. It has also created digital stethoscopes that can be paired with smartphones to create moving pictures and readouts.Proponents say these devices are nearly as easy to use as stethoscopes and allow doctors to watch the body in motion and actually see things such as leaky valves. “There’s no reason you would listen to sounds when you can see everything,” Topol said.At many medical schools, it’s the newer devices that really get students’ hearts pumping.“Wow!” ″Whoa!” ″This is awesome,” Indiana University medical students exclaimed in a recent class as they learned how to use a hand-held ultrasound device on a classmate, watching images of his lub-dubbing heart on a tablet screen.The Butterfly iQ device, made by based by Guilford, Connecticut-based Butterfly Network Inc., went on the market last year. An update will include artificial intelligence to help users position the probe and interpret the images.Students at the Indianapolis-based medical school, one of the nation’s largest, learn stethoscope skills but also get training in hand-held ultrasound in a program launched there last year by Dr. Paul Wallach, an executive associate dean. He created a similar program five years ago at the Medical College of Georgia and predicts that within the next decade, hand-held ultrasound devices will become part of the routine physical exam, just like the reflex hammer.The devices advance “our ability to take peek under the skin into the body,” he said. But Wallach added that, unlike some of his colleagues, he isn’t ready to declare the stethoscope dead. He envisions the next generation of physicians wearing “a stethoscope around the neck and an ultrasound in the pocket.”Modern-day stethoscopes bear little resemblance to the first stethoscope, invented in the early 1800s by Frenchman Rene Laennec, but they work essentially the same way.Laennec’s creation was a hollow tube of wood, almost a foot long, that made it easier to hear heart and lung sounds than pressing an ear against the chest. Rubber tubes, earpieces and the often cold metal attachment that is placed against the chest came later, helping to amplify the sounds.When the stethoscope is pressed against the body, sound waves make the diaphragm — the flat metal disc part of the device — and the bell-shaped underside vibrate. That channels the sound waves up through the tubes to the ears. Conventional stethoscopes typically cost under 0, compared with at least a few thousand dollars for some of the high-tech devices.But picking up and interpreting body sounds is subjective and requires a sensitive ear — and a trained one.With medical advances and competing devices over the past few decades, “the old stethoscope is kind of falling on hard times in terms of rigorous training,” said Dr. James Thomas, a cardiologist at Northwestern Medicine in Chicago. “Some recent studies have shown that graduates in internal medicine and emergency medicine may miss as many of half of murmurs using a stethoscope.”Northwestern is involved in testing new technology created by Eko, a Berkeley, California-based maker of smart stethoscopes. To improve detection of heart murmurs, Eko is developing artificial intelligence algorithms for its devices, using recordings of thousands of heartbeats. The devices produce a screen message telling the doctor whether the heart sounds are normal or if murmurs are present.Dennis Callinan, a retired Chicago city employee with heart disease, is among the study participants. At age 70, he has had plenty of stethoscope exams but said he feels no nostalgia for the devices.“If they can get a better reading using the new technology, great,” Callinan said.Chicago pediatrician Dr. Dave Drelicharz has been in practice for just over a decade and knows the allure of newer devices. But until the price comes down, the old stalwart “is still your best tool,” Drelicharz said. Once you learn to use the stethoscope, he said, it “becomes second nature.”“During my work hours in my office, if I don’t have it around my shoulders,” he said, “it’s as though I was feeling almost naked.” 5223

WEBBERS FALLS, Oklahoma — Aside from first responders making their rounds, Webbers Falls, Oklahoma was a ghost town after evacuation orders were issued earlier this week.Most people left Wednesday night when the sheriff's department went through the town telling everyone about the barges making their way toward the dam.For those who stayed — they were warned multiple times by police and fire to leave. Almost all residents did evacuate, though.For many, it's something they haven't had to do in 33 years."I'm thinking I can't believe this has gotten like this," said resident Chris Adams. "I mean this is an incredible amount of water we're looking at."The fire department was circling the town with boats, and police were making sure no one sneaks back in.A few firefighters told KJRH television station reporters they had urged people to leave by telling them there was no way to know how the water is going to flood the streets.So while water in the area may not have reached a home on the other side of the street, it could have quickly risen in the area around the house — leaving people inside with nowhere to go. 1139

Unvaccinated people under age 18 are banned from public places in Rockland County, New York, as of midnight Wednesday, according to John Lyon, director of strategic communications for County Executive Ed Day.Day will announce the order Tuesday.The declaration is an effort to contain an outbreak of measles that began in October; 153 cases have been confirmed in the county."We're not punishing the people who are doing the right thing already and following the rules. We just want to encourage everyone to do the right thing so we can stop this outbreak," Lyon said. The step is "extremely unusual. [We] don't believe it's been done anywhere in the country before."Measles is a highly contagious virus that is prevented with the measles, mumps and rubella vaccine. The US Centers for Disease Control and Prevention recommends that the two-dose vaccine be given at 12 to 15 months of age and the second between age 4 and 6.This is the 26th week -- the sixth month -- of the outbreak in Rockland County, according to Lyon, who said it has been the longest outbreak in the United States since before measles was declared eliminated in 2000.Public places include synagogues, churches, schools, restaurants, stores and public buses. Children who are current with the vaccine schedule but not fully vaccinated against measles because they are not old enough are exempt from the order.The order does not apply to people who are older than 18 because "we did not want to prevent anyone from going to work," but unvaccinated adults are also encouraged to get vaccinated. It will be enforced the same way any law is enforced, according to Lyon: During the investigation into when and where an infected individual was exposed, those who are identified as unvaccinated and people in public places will be referred to the district attorney's office."The goal is not to prosecute people. We don't want to fine people. We want to encourage people to get vaccinated," he said.Nearly 17,000 vaccinations have been administered in the county during the outbreak.But Lyon said residents are becoming fatigued, are not returning calls from the health department and are declining to speak with health investigators who visit in person. "We need people to help protect everyone in the community," Lyon said.The outbreak has mainly been isolated in a couple of communities within Rockland County, which is just north of New York City, but the whole community is at risk, he said, noting that there have been complications among patients, including a premature labor and a handful of hospitalizations."Every new confirmed case is a roll of the dice that we'll see more complications. There's a lot that can go wrong with any case."New York City has also been dealing with this measles outbreak, with 181 cases reported since October, according to the city Department of Health. The outbreak began when an unvaccinated resident became infected while visiting Israel and returned with the disease. It has mostly affected observant Jewish neighborhoods. Statewide, there have been at least 345 cases of measles reported since October.This year, 314 cases have been reported nationwide, according to the CDC. 3225

Under a new North Carolina law, a drug dealer who illegally sells a controlled substance that causes someone's death could be charged with second-degree murder.The 175

Two officers in Honolulu have been shot and killed Sunday, Hawai'i Gov. David Ige confirmed. The Honolulu Star-Advertiser reports that officers were responding to an assault call near the base of Diamond Head when they encountered a male with a firearm, who then opened fire, striking two officers. The neighborhood where the shooting occurred is at the far end of the Waikiki Beach between the Honolulu Zoo and the famed Diamond Head State Monument. The area would be packed with tourists and locals, especially on a weekend. A home the suspected gunman was believed to be inside has been engulfed by flames. "As we express our condolences to their families, friends and colleagues, let us also come together to help and support those who have been forever changed by this tragedy," Ige said.Footage from news cameras show that multiple homes were on fire. The Star-Advertiser reported that 12 homes were affected by the fire, five of them destroyed. The Star-Advertiser reported that the sounds of live ammunition exploding from the fire could be heard near the scene.Honolulu's Mayor Kirk Caldwell issued a statement. "I would like to express my deepest condolences to the family and friends of the two officers as well as the entire Honolulu Police Department. This is an unprecedented tragedy for not only the City and County of Honolulu but the entire state of Hawai’i," Caldwell said. "Our office is in communication with the Honolulu Police Department as more details about the circumstances around this horrific event come to light. Our hearts go out to the first responders who are on the scene as this event unfolds." 1640

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