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Focus sonography

Parisa P Javedani, Gregory S Metzger, Jeremy R Oulton, Srikar Adhikari
Study objectives Although the focused assessment with sonography in trauma (FAST) examination was initially developed for rapid evaluation of trauma patients, the basic skillset required to perform a FAST examination provides valuable information that may alter a non-trauma patient's clinical course. The objective of this study was to determine the utility of the FAST examination in the emergency department management of non-trauma patients. Methods Cases in which the FAST examination was used to direct care in non-trauma patients were retrospectively reviewed...
January 16, 2018: Curēus
Min Huang, Qiyu Zhao, Fen Chen, Qihan You, Tian'an Jiang
To describe the atypical enhancement pattern of hepatic hemangiomas on contrast-enhanced sonography. 22 patients with hepatic hemangiomas that were atypical on contrast-enhanced ultrasound were included in the study, all of them were confirmd by biopsy or surgery pathology. Atypical appearance of hepatic hemangiomas on contrast-enhanced ultrasound were divided into seven subtypes: (i) peripheral nodular enhancement in the arterial phase with centripedal filling, hypoechoic change in the delayed phase; (ii) peripheral circular enhancement; (iii) peripheral nodular enhancement; (iv) none enhancement; (v) septal enhancement; (vi) a central enhancing focus in the arterial phase, followed by a centrifugal enhancement in the portal venous phase, hypoechoic change in the delayed phase; (vii) slowly spoke wheel enhancement...
February 27, 2018: Oncotarget
Robert P Jamplis, Lucas Friedman, Srikar Adhikari
A 28-year-old male was brought to the emergency department by the Emergency medical services (EMS) after being found unconscious and unresponsive. Upon arrival, he was hypotensive, intubated with a Glasgow Coma Scale (GCS) 3T, without the signs of trauma or the evidence of bleeding. A focused assessment with sonography in trauma (FAST), point-of-care ultrasound (POCUS) was performed, obscuring part of the spleen from the distended stomach, which was filled with the heterogeneous contents, with the internal movement being identified...
December 17, 2017: Curēus
Luan Geraldo Ocaña Oliveira, Debora Tagliari, Mariana Juliato Becker, Thiago Adame, José Cruvinel Neto, Fernando Antônio Campelo Spencer Netto
OBJECTIVE: to verify the efficiency and usefulness of basic ultrasound training in trauma (FAST - Focused Assessment with Sonography in Trauma) for emergency physicians in the primary evaluation of abdominal trauma. METHODS: a longitudinal and observational study was carried out from 2015 to 2017, with 11 emergency physicians from Hospital Universitário do Oeste do Paraná, submitted to ultrasound training in emergency and trauma (USET® - SBAIT). FAST results started to be collected two months after the course...
February 19, 2018: Revista do Colégio Brasileiro de Cirurgiões
Nicole Townsend Christian, Clay Cothren Burlew, Ernest E Moore, Andrea E Geddes, Amy E Wagenaar, Charles J Fox, Fredric M Pieracci
BACKGROUND: The Focused Abdominal Sonography for Trauma (FAST) exam has been reported to be unreliable in pelvic fracture patients. Additionally, given the advent of new therapeutic interventions, such as Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), rapid identification of intraabdominal hemorrhage compared to zone III hemorrhage may guide different therapeutic strategies. We hypothesized that FAST is reliable for detecting clinically significant intraabdominal hemorrhage in the face of complex pelvic fractures...
February 14, 2018: Journal of Trauma and Acute Care Surgery
Shou-Wu Lee, Teng-Yu Lee, Sheng-Shun Yang, Chun-Fang Tung, Hong-Zen Yeh, Chi-Sen Chang
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) occurs not only in obese individuals but also in non-obese ones. The aim of this study was to focus on the association between NAFLD and metabolic events in a non-obese or obese Chinese population. METHODS: Data collected from subjects registered at Taichung Veterans General Hospital from January to December 2009 were analyzed. The exclusion criteria were alcoholics, chronic hepatitis B or C. Patients included in analyses were assigned to four groups according to sonography of their liver (normal or NAFLD), and body mass index (BMI) levels (non-obese if BMI < 25 kg/m 2 or obese if BMI ≥ 25 kg/m 2 )...
February 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Caroline Busche, Hans-Jörg Busch, Guido Michels
The use of Point-of-care ultrasonography (POC Ultrasonography) is getting more and more important in the bedside care of patients, especially in emergency- and intensive care units. In addition to the focused sonography of the heart, lungs and abdomen, the POC Ultrasonography recently includes also cases in prehospital care. Increasingly special applications in intensive care, e.g. the assessment of weaning from mechanical ventilation or evaluation of the hemodynamics of a patient by means of sonographic control, gain meaning...
February 2018: Deutsche Medizinische Wochenschrift
John Kleinman, Aaron Strumwasser, David Rosen, Jeremy Hardin, Kenji Inaba, Demetrios Demetriades
Equivocal focused abdominal sonography for trauma (FAST) examinations confound decision-making for trauma surgeons. We sought to determine whether the equivocal FAST (defined as any nonconcordant result) has a deleterious effect on trauma outcomes. A 2-year review (2014-2015) of all trauma activations at our Level I trauma center was performed. Patients were matched at baseline and FAST results were compared. Outcomes included resuscitation time (h), ventilation days (d), hospital length of stay (HLOS-d), ICU length-of-stay, and survival (%)...
October 1, 2017: American Surgeon
Scott Poland, Jennifer A Frey, Ahmad Khobrani, Jason E Ondrejka, Michael U Ruhlin, Richard L George, M David Gothard, Rami A Ahmed
OBJECTIVES: Telepresent education is becoming an important modality in medical education, as it provides a means for instructors to lead education sessions via videoconferencing technologies. This study aimed to compare the effectiveness of telepresent ultrasound training versus traditional in-person ultrasound training. METHODS: Medical student cohorts were educated by either traditional in-person instruction or telementoring on how to perform a focused assessment with sonography for trauma (FAST) examination...
February 1, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Marina Carotti, Vittoria Galeazzi, Francesca Catucci, Marcello Zappia, Francesco Arrigoni, Antonio Barile, Andrea Giovagnoni
With the introduction of new biologics such as anti-TNF-alpha antibodies and other therapies in the treatment of inflammatory arthritis, capable of halting joint destruction and functional disability, there are new pressures on diagnostic and prognostic imaging. Early demonstration of pre-erosive inflammatory features and monitoring of the long-term effects of treatment are becoming increasingly important. Early detection of synovitis offers advantages in terms of allowing early instigation of therapy and may allow the identification of those patients displaying more aggressive disease who might benefit from early intervention with expensive DMARD therapy...
January 19, 2018: Acta Bio-medica: Atenei Parmensis
C E M Pothmann, K Sprengel, H Alkadhi, G Osterhoff, F Allemann, T Jentzsch, G Jukema, H C Pape, H-P Simmen, V Neuhaus
Abdominal injuries are potentially life-threatening and occur in 20-25% of all polytraumatized patients. Blunt trauma is the main mechanism. The liver and spleen are most commonly injured and much less often the intestines. The clinical evaluation proves equivocal in many cases; therefore, the gold standard is computed tomography (CT), which has been increasingly used even in hemodynamically weakly stable or sometimes even unstable patients because it promptly provides precise diagnostic findings, which present the basis for successful therapy...
January 19, 2018: Der Unfallchirurg
Sadaf Sabzevari, Alireza Badirzadeh, Reza Shahkaram, Mohammad Seyyedin
This is the first published case report of an 11-year-old patient with a rupture of a liver hydatid cyst (HC) into the peritoneal cavity after an abdominal trauma in Iran. The disease was diagnosed using focused abdominal sonography for trauma. To date, no cases of traumatic ruptures of liver HCs in children have been reported in Iran. In the endemic regions of the world, where patients suffer from a history of trauma and constant abdominal symptoms or anaphylactic shock, early diagnosis of HC is crucial as it may disseminate to other organs...
November 2017: Revista da Sociedade Brasileira de Medicina Tropical
Hagit Daum, Israela Lerer, Ayala Frumkin, Daniel Rosenak, Nili Yanai, Shay Porat, Simcha Yagel, Vardiella Meiner
OBJECTIVES: Chromosomal microarray analysis is effectively applied prenatally to detect copy number changes. Single nucleotide polymorphism (SNP) probes included in the microarray platform can detect regions of excessive homozygosity and identical-by-descent genomic stretches. The utility of the latter as part of prenatal diagnosis is not well established. Recessive founder mutations are well recognized within distinct ethnic groups. Combining these data with prenatal sonography provides accurate focused molecular diagnoses quickly...
January 11, 2018: Prenatal Diagnosis
Angel Augusto Perez-Calatayud, Raul Carrillo-Esper, Eduardo Daniel Anica-Malagon, Jesus Carlos Briones-Garduño, Emilio Arch-Tirado, Robert Wise, Manu L N G Malbrain
PURPOSE: There is currently a lack of universally accepted criteria for gastrointestinal (GI) failure or dysfunction in critical care. Also, the clinical assessment of intestinal function is notoriously difficult and thus often goes unrecognized, contributing to poor outcomes. A recent grading system has been proposed to define acute gastrointestinal injury (AGI) in conjunction with other organ function scores (e.g., SOFA). Ultrasonography has become widely accepted as a diagnostic tool for GI problems and pathology...
January 5, 2018: Anaesthesiology Intensive Therapy
Anna Lehrberg, Bilal Kharbutli
BACKGROUND: Adrenal gland trauma is a rare condition that typically stems from blunt force trauma, and is associated with multiple organ injuries. Alternatively, isolated adrenal gland trauma is extremely rare, accounting for only 1.5 to 4% of all adrenal trauma cases. While isolated adrenal trauma is a mostly self-limiting condition, it is potentially life-threatening, representing a significant cause of bleeding, and/or hypotension due to adrenal insufficiency and adrenal crisis. Due to its rare occurrence, there are no reported guidelines for monitoring and observing isolated adrenal trauma...
December 26, 2017: Journal of Medical Case Reports
Christopher Dang, Eitan Dickman, Mark O Tessaro, Pranjal Patel, Maxim Dzeba, Antonios Likourezos, Illya Pushkar, Peter Homel, Lawrence E Haines
OBJECTIVE: Emergency Department patients with abdominal pain may require both an ultrasound (US) and computed tomography (CT) for an accurate diagnosis. Patients are often asked to drink oral radiocontrast while awaiting ultrasound, in order to better expedite a CT in the case of a non-diagnostic US. The impact of oral radiocontrast on US image quality has not been studied. We compared the quality of US images obtained before and after the ingestion of oral radiocontrast in healthy adult volunteers...
November 20, 2017: American Journal of Emergency Medicine
Adel Hamed Elbaih, Sameh T Abu-Elela
PURPOSE: The emergency physicians face significant clinical uncertainty when multiple trauma patients arrive in the emergency department (ED). The priorities for assessment and treatment of polytrauma patients are established in the primary survey. Focused assessment with sonography for trauma (FAST) is very essential clinical skill during trauma resuscitation. Use of point of care ultrasound among the trauma team working in the primary survey in emergency care settings is lacking in Suez Canal University Hospitals even ultrasound machine not available in ED...
December 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Lieselore Vandermeulen, Ann Cornelis, Christina Kjaergaard Rasmussen, Dirk Timmerman, Thierry Van den Bosch
Objective: To compare ultrasonographic features of uterine lesions with the findings at macroscopy and microscopy. Methods: Case series of ten consecutive women undergoing a hysterectomy for uterine pathology. A preoperative transvaginal ultrasound examination was performed. After hysterectomy, the uterus was re-evaluated by 3D in vitro ultrasonography and in vitro gel instillation sonography (iGIS). The lesion of interest was pinpointed by inserting an intramuscular injection needle using a free-hand 2D-ultrasound guided technique to focus the macroscopic and the microscopic examination by the pathologist...
June 2017: Facts, Views & Vision in ObGyn
Jacob Pace, Robert Arntfield
The use of point-of-care ultrasound in trauma provides diagnostic clarity and routinely influences management. A scanning protocol known as the Focused Assessment with Sonography in Trauma (FAST) has been widely adopted by trauma providers of all specialties. The FAST exam addresses a broad array of pathologic conditions capable of causing instability, including hemoperitoneum, hemopericardium, hemothorax, and pneumothorax. The exam is an integral component to the primary assessment of injured patients and an iconic application of point-of-care ultrasound...
December 4, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Abdulrahman M Alzahem, Soundappan S V Soundappan, Daniel T Cass
OBJECTIVES: Abdominal computed tomography (ACT) use in the initial evaluation of pediatric abdominal trauma is liberal in most instances. The aim of this study was to identify the predictors for a positive yield ACT scan in this population. METHODS: A prospective, cohort, single-center observational study was conducted at Children's Hospital at Westmead, New South Wales, from January 2008 to June 2015 on 240 pediatric abdominal trauma patients who had abdominal computed tomography...
December 1, 2017: Pediatric Emergency Care
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