Focused Assessment with Sonography for Trauma (FAST) has been widely used and studied in blunt and penetrating trauma for the past 3 decades. Prior to FAST, invasive procedures such as diagnostic peritoneal lavage and exploratory laparotomy were commonly used to diagnose intra-abdominal injuries. Today, the FAST examination has evolved into a more comprehensive study of the abdomen, heart, thorax, inferior vena cava, among others, with many variations in technique, protocols and interpretation. Trauma management strategies such as laparotomy, endoscopy, computed tomography angiography, angiographic intervention, serial imaging and clinical observation have also changed over the years. This technique, at times, has managed to replace computed tomography and peritoneal lavage diagnosis, without producing delays in the surgical procedure. As such, the relationship between the patient’s clinical information and the results of the exam should be guided to guide therapeutic approaches in difficult to access settings such as intensive care units in war zones, rural or remote locations where other imaging methods are not available. This review will discuss the evolution of the FAST exam to its current status and evaluate its evolving role in the acute management of the trauma patient.
In Costa Rica, there is no explicit recommendation from the competent authorities for the use of a specific phantom, so experts must explore what suppliers offer, among which the Normi Mam Digital phantom from PTW stands out. This article presents the results of the dosimetry and image quality control applied to the Normi Mam Digital phantom to validate it as equipment that complies with the recommendations of the Human Health Series No. 17. The results obtained were satisfactory, proving that the equipment complies with the tolerances recommended by international health bodies.
Vascular access in hemodialysis is one of the pillars of success of the program. Therefore, efforts should be directed firstly to achieve the greatest number of vascular accesses of the arteriovenous fistula type, and secondly to reduce complications related to access cannulation in order to functionally preserve the access. Several strategies have been described to improve this last aspect; this article describes the use of ultrasound to improve the probability of successful cannulation in cases considered difficult by the nursing team.
Cardiovascular imaging analysis is a useful tool for the diagnosis, treatment and monitoring of cardiovascular diseases. Imaging techniques allow non-invasive quantitative assessment of cardiac function, providing morphological, functional and dynamic information. Recent technological advances in ultrasound have made it possible to improve the quality of patient treatment, thanks to the use of modern image processing and analysis techniques. However, the acquisition of these dynamic three-dimensional (3D) images leads to the production of large volumes of data to process, from which cardiac structures must be extracted and analyzed during the cardiac cycle. Extraction, three-dimensional visualization, and qualification tools are currently used within the clinical routine, but unfortunately require significant interaction with the physician. These elements justify the development of new efficient and robust algorithms for structure extraction and cardiac motion estimation from three-dimensional images. As a result, making available to clinicians new means to accurately assess cardiac anatomy and function from three-dimensional images represents a definite advance in the investigation of a complete description of the heart from a single examination. The aim of this article is to show what advances have been made in 3D cardiac imaging by ultrasound and additionally to observe which areas have been studied under this imaging modality.
The present work shows an application of the Chan-Vese algorithm for the semi-automatic segmentation of anatomical structures of interest (lungs and lung tumor) in 4DCT images of the thorax, as well as their three-dimensional reconstruction. The segmentation and reconstruction were performed on 10 CT images, which make up an inspiration-expiration cycle. The maximum displacement was calculated for the case of the lung tumor using the reconstructions of the onset of inspiration, the onset of expiration, and the voxel information. The proposed method achieves appropriate segmentation of the studied structures regardless of their size and shape. The three-dimensional reconstruction allows us to visualize the dynamics of the structures of interest throughout the respiratory cycle. In the future, it is expected to have more evidence of the good performance of the proposed method and to have the feedback of the clinical expert, since the knowledge of the characteristics of anatomical structures, such as their dimension and spatial position, helps in the planning of Radiotherapy (RT) treatments, optimizing the radiation dose to cancer cells and minimizing it in healthy organs. Therefore, the information found in this work may be of interest for the planning of RT treatments.
Introduction: In Colombia, the last oral health study showed that about 70% of the population has partial edentulism while 5.2% will have lost all their teeth between the age of 65 and 79. Rehabilitation with implants is an increasingly used option, which requires clinical and radiographic follow-up. Panoramic radiography is a low-cost option, in which it is possible to observe areas of bone loss, mesiodistal angulation of the implant, relationship with anatomical structures and lesions suggestive of peri-implantitis. Reports and analysis of relevant data on radiographic findings associated with dental implants are required to determine the risk factors for their success in patients who use them. Objective: To determine the prevalence and characterize the findings associated with osseointegration implants in panoramic radiographs. Methods: A descriptive cross-sectional observational study was carried out with 10,000 digital panoramic radiographs selected by convenience from radiological centers in the city of Bogota, Colombia, of which 543 corresponded to the sample analyzed for the presence of implants. The following were evaluated for each implant: location, position, angulation and distances to adjacent structures, using the Clínicalview® program (Orthopantomograph OP200D, Instrumentarium, USA). Results: The frequency of radiographs with implants was 5.43% with a total of 1,791 implants, with an average of 3.2 per radiograph. They were found in greater proportion in the upper jaw with a supracrestal location and an angulation of 10.3 degrees. 32% had implant/tooth or implant/implant distances that were less than optimal. 40.9% were restored and 1.2% showed lesions compatible with periimplantitis. Conclusions: A high percentage of the implants reviewed have a risk factor that affects their long-term viability, either due to angulation, supracrestal or crestal position, proximity to teeth or other implants, or because they are not restorable.
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