Abstract:
:Focused assessment with sonography in trauma (FAST) is a limited ultrasound scan performed in the emergency department to assess patients admitted with blunt abdominal trauma (BAT). It is normally undertaken by emergency physicians in order to identify the presence of free fluid, which may represent haemoperitoneum. This potentially allows prompt referral to further imaging, such as a computed tomography (CT) scan, and/or surgery. FAST has been adopted worldwide, and most major trauma centres now have access to an ultrasound machine. Despite the popularity of FAST, there remains a lack of clarity and evidence around any actual contribution to patient survival. An ability to evaluate the true impact of FAST is complicated by factors such as the operator dependence of ultrasound, the improved access, speed and subsequent use of CT (which has reduced the value of FAST in some centres), a lack of standardisation around education and the most effective methods to ensure competence, and variations in the practice, quality and audit of FAST. Enthusiasm for FAST is undiminished among emergency physicians, and in general, point of care ultrasound is escalating in a range of areas, including the emergency department. Small portable and hand held ultrasound machines improve the accessibility of FAST and its benefits are frequently perceived to be an established and essential part of the emergency department service despite its limitations. Since the introduction of FAST, trauma patients are increasingly managed by non-surgical means if haemodynamically stable, and the presence of intraperitoneal fluid does not necessarily influence this decision. Recent developments in multi-detector CT, and in the use of contrast enhanced ultrasound, have broadened the management options for trauma patients, and can support a faster diagnostic pathway than was previously possible. FAST is a limited triage tool, whose actual value in the diagnostic and treatment pathway of patients with BAT remains questionable, and more data are needed to justify its use in the light of these recent developments.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Smith Jdoi
10.1136/pgmj.2008.076711subject
Has Abstractpub_date
2010-05-01 00:00:00pages
285-91issue
1015eissn
0032-5473issn
1469-0756pii
pgmj.2008.076711journal_volume
86pub_type
杂志文章,评审abstract::Liver transplantation is the accepted treatment for a wide variety of liver diseases in children. Over the past 10 years a number of innovative surgical techniques have been developed to overcome the shortage of size matched donors particularly in children less than 5 years of age. Graft and patient survival at one ye...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2003.018598
更新日期:2004-10-01 00:00:00
abstract::Purtscher's retinopathy presents to the clinician as loss of vision in a patient with a history of a possible precipitating event such as recent major trauma, pancreatitis, childbirth or renal failure. The ophthalmological picture is one of ischaemia at the posterior pole with white patches of oedema and haemorrhages ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.72.849.409
更新日期:1996-07-01 00:00:00
abstract:OBJECTIVE:Since many years, teaching and training in communication skills are cornerstones in the medical education curriculum. Although video recording in a real-time consultation is expected to positively contribute to the learning process, research on this topic is scarce. This study will focus on the feasibility an...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2015-133633
更新日期:2016-08-01 00:00:00
abstract:PURPOSE OF THE STUDY:To look at the association of central and peripheral skinfold thickness with parental history of diabetes in subjects without diabetes. METHODS:Subjects with no parental history of diabetes (n=1132), subjects with one parent with diabetes (n=271) and subjects with both parents with diabetes (n=51)...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2015-133363
更新日期:2016-07-01 00:00:00
abstract::Two patients with nephrotic syndrome developed fatal fulminant hepatitis B following withdrawal of prednisolone or cyclophosphamide. Immunosuppressive therapy probably enhanced hepatitis B virus (HBV) replication and widespread infection of hepatocytes; its withdrawal permitted a return of immune competence resulting ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.64.750.325
更新日期:1988-04-01 00:00:00
abstract::The effect of beta-blockers in improving exercise tolerance in angina pectoris can be accounted for by the reduction in heart rate and arterial pressure than they produce. The failure of a few patients to respond despite reduction in heart rate and the failure of those who do respond to obtain the full expected benefi...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1976-01-01 00:00:00
abstract::It has long been accepted that communication is of central importance in healthcare, and a core aspect of clinical competence. Many educational institutions and Royal Colleges now reflect this and consider communication skills a priority in postgraduate examination. The new examination "Practical Assessment of Clinica...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2004.022129
更新日期:2004-12-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章,meta分析
doi:10.1136/postgradmedj-2019-136396
更新日期:2019-07-01 00:00:00
abstract::Between 1975 and 1982 in 2 centres in Glasgow, 53 previously untreated patients with aggressive non-Hodgkin's lymphomas received chemotherapy consisting of one of the following regimens-CVP, MOPP, CHOP or BACOP. Twenty nine patients (55%) entered complete remission (CR), 20 (38%) had partial remission (PR) and 4 (7%) ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.735.11
更新日期:1987-01-01 00:00:00
abstract::We report the case of a 66 year old woman with clinical manifestations of giant-cell arteritis, positive temporal artery biopsy and excellent response to prednisone, who developed massive cerebral infarcts after 5 days of treatment. Computed tomographic and magnetic resonance imaging scans revealed multiple infarcts i...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.70.821.228
更新日期:1994-03-01 00:00:00
abstract::Paradoxical vocal cord motion disorder (PVCM), also called vocal cord dysfunction, is an important differential diagnosis for asthma. The disorder is often misdiagnosed as asthma leading to unnecessary drug use, very high medical utilisation and occasionally tracheal intubation or tracheostomy. Laryngoscopy is the gol...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2006.052522
更新日期:2007-03-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.65.768.779
更新日期:1989-10-01 00:00:00
abstract::Three women were admitted to the surgical wards with acute gastro-intestinal symptoms and despite good clinical (pigmentation, hypotension) and biochemical (hyponatraemia, acidosis) evidence of Addisonian crisis had unnecessary investigations with delay in the diagnosis and appropriate management of this medical emerg...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.739.367
更新日期:1987-05-01 00:00:00
abstract::Salivary gland lymphoma is associated with Sjögren's syndrome. A case of bilateral submandibular gland and sublingual gland lymphoma, arising in Sjögren's syndrome, is presented. A lymphoma involving more than one salivary gland may occur in Sjögren's syndrome, and there is an increased risk of developing an extrasali...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.736.135
更新日期:1987-02-01 00:00:00
abstract::During one year, out of 1829 faecal specimens examined at the Chelmsford Public Health Laboratory, campylobacters were isolated from 109 (6%), 21 of the positive cultures were from hospital in-patients and 3 were from hospital staff. The remaining 85 isolates were from specimens sent in by general practitioners. The a...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.652.80
更新日期:1980-02-01 00:00:00
abstract::A case of fatal pseudomembranous enterocolitis associated with ampicillin therapy is described and possible mechanisms for its production discussed. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.620.324
更新日期:1977-06-01 00:00:00
abstract::Antiphospholipid syndrome is a disorder of recurrent vascular thrombosis, pregnancy loss and thrombocytopenia associated with persistently elevated levels of antiphospholipid antibodies. It was first described in a group of patients with systemic lupus erythematosus but has since been associated with a wide range of c...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.75.879.45
更新日期:1999-01-01 00:00:00
abstract::Synovial plicae are normal anatomical structures of the knee that may become symptomatic. MRI is an established technique for evaluating the anatomy of the knee, and it is a valuable tool for detecting plicae because of its high resolution resulting in increased tissue characterisation. At MRI, knee plicae appear as l...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2013-132176
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:Cincinnati Children's Hospital Medical Center created the Intermediate Improvement Science Series (I(2)S(2)) training course to develop organisational leaders to do improvement, lead improvement and get results on specific projects. DESIGN METHODS:Each multidisciplinary class consists of 25-30 par...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2012-000890rep
更新日期:2013-02-01 00:00:00
abstract::This is a case report of a 67 year old man who presented with a fluctuating level of consciousness and myoclonic jerks caused in part by hypercalcaemia. The diagnosis of cerebral neoplastic angioendotheleosis was only made later on brain biopsy and is the first report of the occurrence of hypercalcaemia in neoplastic ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.67.788.571
更新日期:1991-06-01 00:00:00
abstract::Intraperitoneal free gas seen radiologically as air under the diaphragm nearly always indicates a perforated abdominal viscus that requires surgical intervention. Rarely, however, the presence of a pneumoperitoneum may not indicate an intra-abdominal perforation and thus may not require laparotomy. Such a situation is...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
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更新日期:1997-09-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.652.121
更新日期:1980-02-01 00:00:00
abstract::A 77-year old woman with pituitary-driven Cushing's disease is described. The condition was completely controlled on long-term treatment with metyrapone. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.62.730.727
更新日期:1986-08-01 00:00:00
abstract::It has long been recognised that intensive efforts are needed to reform medical education in order to meet the future needs of populations worldwide. Pressure for changes to the organisation, content and delivery of both undergraduate and postgraduate medical education has greatly increased in the last two decades. Th...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.71.837.397
更新日期:1995-07-01 00:00:00
abstract::In the Balkan context education in general practice varies greatly and it is in different stages of reorganisation and curriculum development. The postgraduate training in family medicine in Albania started in January 1997 with the goal of providing future family doctors with the proper knowledge, skills, attitudes, a...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
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更新日期:2002-05-01 00:00:00
abstract::A 63 year old woman had been intensively treated for recurrent carcinoma of the neck. Following acute vascular surgery of the carotid artery, she developed the vasodilatory type of the carotid sinus syndrome. The presentation of this type of the syndrome was remarkable, since it is usually associated with primary or m...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.68.800.463
更新日期:1992-06-01 00:00:00
abstract:BACKGROUND:Breast cancer is the most common cause of cancer related deaths among women worldwide. The disease in women occurs at a younger age in Iran than in western communities. OBJECTIVE:To determine the practice of breast self examination (BSE) among 25-54-year-old women in Shiraz, southern Iran. METHODS:Using a ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2008.072678
更新日期:2009-06-01 00:00:00
abstract::Asthma is an inflammatory disease characterized by infiltration of the airways by eosinophils and ensuing bronchial hyperresponsiveness. The activation of eosinophils and their recruitment to the airways are strongly influenced by T-lymphocytes and their products. There is now evidence that successful therapy of asthm...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1991-01-01 00:00:00
abstract::The new formulation of propofol appears to be approximately equipotent to the previous formulation when used as an infusion to supplement nitrous oxide anaesthesia in patients premedicated with morphine. Preliminary haemodynamic studies indicate that the emulsion formulation causes more arterial hypotension than the o...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::We describe two patients with diabetes mellitus and associated neuropathy, who presented with painless foot swelling and no history of trauma. X-Rays revealed recent underlying fractures-in one of a metatarsus, and the other of a proximal phalanx. These were assumed to be 'stress' fractures unassociated with pain beca...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.73.858.241
更新日期:1997-04-01 00:00:00