By Amber Dulek / Winona Daily News

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Mindy Ward can tell if your baby will be a boy or a girl.

With her ultrasound machine, gel and transducers, the 28-year-old ultrasound technologist can determine if a patient has blood clots or gallstones.

Every day is different.

A lot of people think all we do is fetus scans, but we look for gallstones and use vascular scans looking for blood clots. It’s from outpatient to inpatient to ER patients.

You have to have a poker face a lot of the time because they have to get the results from their physician. … We are the technologist that does the image for the radiologist to read.

The only thing we’re allowed to tell is the baby’s weight and gender. … We don’t actually bring it up until they ask.

Everybody’s generally happy when they find out and can finally shop for the baby. (There are) lots of tears when people find out what their baby will be.

I use an ultrasound machine and different transducers across the abdomen. A water-based gel makes an air-free barrier between the skin. Otherwise we can’t see the image.

You learn the positions and the protocol for each scan. We start down low by the pelvis… do one side and go to the other and the image comes up on the machine.

You have to have schooling to get into the field. Typically, a two-year (diagnostic medical sonography) degree. You have to be certified and pass two boards. Every year, you have to pay dues to keep certified. It’s $60.

Reading people and interacting with patients of all ages is a big part of the job.

You have to be able to multi-task because we get a lot of add-ons and patients who come in and are really sick.

You have to have somebody that’s a go-getter and hard worker. You have a busy schedule. You have to fit patients between times because you can’t put them off.

Rarely do we get a slow day. The hours are 7 a.m. to 4 or 4:30 p.m., but you’re on call basically all the time. We usually make $45,000 to (about $70,000), but it depends on where you work and what kind of facility.

The worst thing to happen (would be) if the machine breaks down and we would have to reschedule everyone.

This story is part of a weekly series called “On the Job,” in which area residents talk about their careers.

Contact reporter Amber Dulek at (507) 453-3513 or amber.dulek@lee.net.

Times of Oman

MUSCAT — Osteoporosis, long regarded as a women-only disease, also affects as many as one in five men. This and other common misconceptions about the bone disease are expected to be addressed with the launch of World Osteoporosis Day on October 20 in Dubai.

Launching World Osteoporosis Day in Dubai will bring this information to the region.

More than 50 international journalists will be present to cover the occasion which has been secured for the destination by the Emirates Osteoporosis Society, according to information received here.

According to doctors, men get osteoporosis, too, although it is often wrongly regarded as exclusive to women. Women naturally have smaller, thinner bones than men, so they are at higher risk, but 20 per cent of those affected by the disease are men.

Over the age of 50, one in every five men and one in every three women will experience an osteoporosis-related fracture in their lifetime.

Osteoporosis cannot be dismissed as a disease of the elderly that should only be of concern to older people as this bone disease is not a natural part of ageing and prevention should begin during youth and young adulthood.

The opportunity to build strong bones begins then, when people should adopt a healthy lifestyle based on a diet rich in calcium and Vitamin D, weight-bearing exercise, no smoking or excessive alcohol intake, and bone density testing and medications for the prevention and treatment of osteoporosis when appropriate.

Although osteoporosis is not age-restricted, age is still a major risk factor, especially for those over 65. Heightened risk characteristics also include: fair skin, small bone structure, early menopause or post-menopausal, family history of osteoporosis, low body weight, low-calcium diet, inactive lifestyle, excessive alcohol intake, tobacco use, eating disorders, and use of certain medications such as steroids or anticonvulsants.

A bone density test provides important information about the bone strength and the risk of future fracture. The bone densitometer uses small amounts of X-ray to measure the amount of bone mineral and this relates directly to bone strength.

World Osteoporosis Day in Dubai is attracting significant support from leading organisations.

by Joan Trombetti, Writer DOTmed

The Food and Drug Administration will soon alert health care workers about the danger of giving drugs used in helping to diagnose heart conditions with ultrasound imaging. The main drugs in question are Definity, (Bristol-Myers Squibb Co.) and Optison (General Electric Co.). The drugs contain microscopic gas-filled spheres and are injected into the veins of patients before the heart is examined with ultrasound. The gas leaves the body after a few minutes. The drugs (called contrast agents) make the pictures of the heart clearer during echocardiography. This helps physicians diagnose heart disease and malfunctions. Unfortunately, the FDA has found through investigations that there have been reports of deaths and serious cardiopulmonary reactions in some patients.

The manufacturers have also agreed to update their product labeling to carry a "black-box" warning, the sternest cautionary note available, that tells doctors not to use the medicines in patients with unstable angina, acute heart attacks and unstable cardiopulmonary disease. The labels will also instruct physicians to monitor patients' heartbeats for trouble signs with an electrocardiogram, or ECG, for a half-hour after the ultrasound exam is finished.

Newsday

MINNEAPOLIS - Medtronic Inc. is stopping distribution of wires that connect some of its defibrillators to patients' hearts after learning they may have contributed to five deaths.

Medtronic shares dropped more than 12 percent by midday Monday after the disclosure.

A defibrillator monitors a patient's heartbeat; if it senses an abnormal heart rhythm, it delivers an electronic shock to reset the heart to a normal beat. A defibrillation system consists of a device implanted near the shoulder with one or more leads connecting the device to the heart.

Medtronic said it discovered a "small chance of fractures in particular locations" on Sprint Fidelis models 6930, 6931, 6948 and 6949. The company is asking doctors to stop implanting the leads and return unused leads to Medtronic.

A fractured lead "can cause the defibrillator to deliver unnecessary shocks or not operate at all," said Daniel Schultz, director of the Food and Drug Administration's Center for Devices and Radiological Health.

Medtronic did not call its response a "recall," but the FDA did. However, neither the FDA nor Medtronic recommended that patients have their devices removed if no other problems have been detected.

Patients are "are more likely to experience complications from removal," Medtronic said. Instead, the company said doctors can reprogram the device to alert the patient that a fracture may have occurred. Possible indicators could include audible alerts or inappropriate shocks.

"We know it can be frightening for a patient to learn that a product they rely on so much might have a serious defect," Schultz said. "However, patients can be assured that the likelihood of fracture is very low and FDA is committed to ensuring that the risk to patients is minimized."

More than 268,000 of the leads have been implanted. Medtronic and the FDA estimated that fractures have occurred in less than 1 percent of those leads.

When the Spring Fidelis lead was introduced in 2004 it was intended to replace the Sprint Quattro leads in use since 2001. But Medtronic said it noticed that after 2 1/2 years in patients, 99.1 percent of the Quattros were still viable, but only 97.7 percent of the Fidelis leads were still viable. Medtronic said the difference between the two was not statistically significant yet but would have become signifcant as more Fidelis leads were implanted.

In a filing with the Securities and Exchange Commission, Medtronic Chief Financial Officer Gary L. Ellis said the lead problem will likely cause "significant repercussions" to the Japanese market because the company currently has no other leads approved in this market.

In addition, the company will have to account for product returns of its Fidelis lead, which won't be able to be replaced with an alternative until later this year due to a shortage of Sprint Quattro supplies. This will cause a "significant revenue reversal" in the company's fiscal second quarter.

The company said customer bulk purchase orders will either have to be adjusted or in many cases may not be able to be filled due to the limited Sprint Quattro supply.

Medtronic said the lead problems will reduce second-quarter revenue by $150 million to $250 million. Additionally, inventory write-offs will likely total about $15 million to $20 million in the second quarter, and other related costs will be $10 million to $20 million.

Medtronic senior vice president Pat Mackin emphasized that the company's action does not apply to Medtronic pacemakers.

Its shares fell $6.97, or 12.4 percent, to $49.36 in midday trading Monday.

by Barbara Kram, Editor, Dotmed News
MOUNTAIN VIEW, CALIF. - Siemens Medical Solutions is ushering in a new era of medicine with today's launch of the world's smallest and first pocket ultrasound system. The ACUSON P10™ hand held diagnostic ultrasound system is a little larger than a common PDA, weighs only 1.6 pounds, and fits easily into a lab coat pocket. It is intended for complementary initial diagnostic care and triage, particularly in cardiology, emergency care and obstetrics.

"Instead of having to rush the patient to the technology, the P10 system brings the technology to the patient. This can save critical minutes, especially when a patient is in cardiac distress or with trauma patients, who have multiple injuries," said Eyal Herzog, MD, FACC, director of the Cardiac Care Unit at St. Luke's-Roosevelt Hospital Center, in New York, and an ACUSON P10 system beta site user. "The application flexibility and portability of the P10 pocket ultrasound system mark significant changes in the way diagnostic and emergency care are administered, changes that could alter the face of the physical exam and, ultimately, lead to better patient outcomes."

The ACUSON P10 system can be used by physicians and medical personnel in a number of environments including intensive care units, ambulances and medevac helicopters. It can also be used to detect conditions that may be clinically significant, but have previously required expansive or invasive diagnostic testing in asymptomatic patients. The pocket ultrasound device has U.S. Food and Drug Administration 510(k) clearance.

P10 in Emergency Medicine In emergency situations, the hand held ACUSON P10 system allows for earlier, faster and more accurate screening and triage decisions. Its emergency applications include FAST (Focused Assessment with Sonography for Trauma) to detect fluid, determining cardiac activity and pericardial effusion as well as detecting abdominal aortic aneurysms and performing pelvic exams.

In addition to cardiac and emergency care, the ACUSON P10 pocket ultrasound system offers applications in other medical specialties, most notably obstetrics where it can be used in labor and delivery. Specifically, the device can determine fetal viability, fetal positioning, and amniotic fluid volume. Additional applications include veterinary medicine.

"In this era of instant access to information - and increased demand for medical mobility - the portable ACUSON P10 system complements existing technologies to fulfill the needs of both practitioners and patients," said Klaus Hambuchen, president, Siemens Medical Solutions, Ultrasound Division. "We like to refer to it as a visual stethoscope that enables substantiated and fast decision-making regarding the subsequent course of treatment for the patient. In addition, the ACUSON P10 pocket ultrasound system is multifunctional and will be used precisely where it is needed - close to the patient."

The ACUSON P10 system will be made available for direct purchase via the Siemens www.pocketultrasound.com Web site. The product may only be purchased and operated by licensed medical professionals.

About Siemens Medical Solutions Siemens Medical Solutions of Siemens AG (NYSE: SI) is one of the world's largest suppliers to the healthcare industry. The company is known for bringing together innovative medical technologies, healthcare information systems, management consulting, and support services, to help customers achieve tangible, sustainable, clinical and financial outcomes. Recent acquisitions in the area of in-vitro diagnostics - such as Diagnostic Products Corporation and Bayer Diagnostics - mark a significant milestone for Siemens as it becomes the first full service diagnostics company. Employing more than 41,000 people worldwide and operating in over 130 countries, Siemens Medical Solutions reported sales of 8.23 billion EUR, orders of 9.33 billion EUR and group profit of 1.06 billion EUR for fiscal 2006 (Sept. 30). Further information can be found by visiting www.siemens.com/medical-pressroom.

The study of 80 women is part of the Penn State Young Women's Health Study, an ongoing
observational study begun in 1990 with the enrollment of 112 healthy female adolescents who are representative of Caucasian females attending public schools in Pennsylvania. The Penn State researchers followed the natural progression of cardiovascular, reproductive and bone health in these women.

For 10 years, researchers tracked a number of factors. Body composition and hip bone measurements were taken yearly with a dual X-ray absorptiometry (DXA) bone densitometer. Although bone mineral density has been widely used as the primary means of determining bone fracture risk, it is not a direct measurement of bone strength, which depends on both the material and structural properties of bone. So, the research team used recently-developed software to calculate specific measures of bone strength and geometric properties from the DXA data.

The team also collected calcium intake information by recording three-day diet records every six months for the first four years of the study and then yearly thereafter. Total average calcium intake in the group was between 618 mg/day and 1498 mg/day.
Oral contraceptive use was recorded, and physical activity was determined using a sports exercise questionnaire that listed 28 activities including school-based activities like soccer and marching band, outside of school activities like dance and aerobic classes, and individual activities like walking and running. A cumulative exercise score was calculated from the 10 years of data.

Study results showed that no significant relationship exists between average daily calcium intake and total bone gain from ages 12 to 22 or in young adult hip bone mineral density. A comparison of the oral contraceptive users and nonusers showed no difference in total body and hip bone mineral density suggesting oral contraceptives have no effected on bone density.
"Our statistical analysis of sport-exercise in adolescence showed that exercise is responsible for between 16 percent and 22 percent of the variation in hip bone mineral density and bending strength," Lloyd said. "Overall, data from the Penn State Young Women's Health Study indicates that daily calcium intake greater than 500 mg/day during adolescence does not result in clinically appreciable increased body bone accrual or increased adult bone mass."
Lloyd said additional, similar longitudinal studies of other ethnic and racial groups are needed to more fully evaluate the importance of the results for American women.

The study team included: Moira Petit, Ph.D., and Hung-Mo Lin, Sc.D., Department of Health Evaluation Science, Penn State College of Medicine, and Thomas J. Beck, Sc.D., Department of Radiology, Johns Hopkins University. The study was funded by the U.S. Department of Health and Human Services and the General Clinical Research Center at Penn State Milton S. Hershey Medical Center.

Contact: Valerie Gliemvgliem@psu.edu814-865-9481Penn State

Original Article Date: 09 Jun 2004 - 9:00 PDT