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Table of contents A1 Point-of-care ultrasound examination of cervical spine in emergency department Yahya Acar, Onur Tezel, Necati Salman A2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasound Yahya Acar, Necati Salman, Onur Tezel, Erdem Cevik A3 Pseudoaneurysm of the femoral artery after cannulation of a central venous line. Should we always use ultrasound in these procedures? Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-Bordomás A4 Ultrasound-guided supraclavicular subclavian vein catheterization. A novel approach in emergency department Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-Bordomás A5 Clinical ultrasound in a septic and jaundice patient in the emergency department Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-Bordomás A6 Characterization of the eyes in preoperative cataract Saudi patients by using medical diagnostic ultrasound Mustafa Z. Mahmoud, Abdelmoneim Sulieman A7 High-frequency ultrasound in determining the causes of acute shoulder joint pain Mustafa Z. Mahmoud A8 Teaching WINFOCUS Ultrasound Life Support Basic Level 1 for Providers in resource-limited countries Abbas Ali, Alrayah Mustafa, Ihab Abdelrahman, Mustafa Bahar, Osama Ali, H. Lester Kirchner, Gregor Prosen A9 Changes of arterial stiffness and endothelial function during uncomplicated pregnancy Ajda Anzic, Paul Leeson A10 Cardiovascular haemodynamic properties before, during and after pregnancy Ajda Anzic, Paul Leeson A11 An old man with generalized weakness Maryam Bahreini, Fatemeh Rasooli A12 Ultrasonography for non-specific presentations of abdominal pain Maryam Bahreini, Houman Hosseinnejad A13 Introduction of a new imaging guideline for suspected renal colic in the emergency department: effect on CT Urogram utilisation Gabriel Blecher, Robert Meek, Diana Egerton-Warburton A14 Transabdominal ultrasound screening for pancreatic cancer in Croatian military veterans: a retrospective analysis from the first Croatian veteran’s hospital Edina Ćatić Ćuti, Stanko Belina, Tihomir Vančina, Idriz Kovačević A15 The challenge of AAA: unusual case of obstructive jaundice Edina Ćatić Ćuti, Nadan Rustemović A16 Educational effectiveness of easy-made new simulator model for ultrasound-guided procedures in pediatric patients: vascular access and foreign body management Ikwan Chang, Jin Hee Lee, Young Ho Kwak, Do Kyun Kim A17 Detection of uterine rupture by point-of-care ultrasound at emergency department: a case report Chi-Yung Cheng, Hsiu-Yung Pan, Chia-Te Kung A18 Abdominal probe in the hands of interns as a relevant diagnostic tool in revealing the cause of heart failure Ela Ćurčić, Ena Pritišanac, Ivo Planinc, Marijana Grgić Medić, Radovan Radonić A19 Needs assessment of the potential utility of point-of-care ultrasound within the Zanzibar health system Abiola Fasina, Anthony J. Dean, Nova L. Panebianco, Patricia S. Henwood A20 Ultrasonographic diagnosis of tracheal compression Oliviero Fochi, Moreno Favarato, Ezio Bonanomi A21 The role of ultrasound in the detection of lung infiltrates in critically ill patients: a pilot study Marijana Grgić Medić, Ivan Tomić, Radovan Radonić A22 The SAFER Lasso; a novel approach using point-of-care ultrasound to evaluate patients with abdominal complaints in the emergency department Youngrock Ha, Hongchuen Toh A23 Awareness and use of clinician-performed ultrasound among clinical clerkship faculty Elizabeth Harmon, Wilma Chan, Cameron Baston, Gail Morrison, Frances Shofer, Nova Panebianco, Anthony J. Dean A24 Clinical outcomes in the use of lung ultrasound for the diagnosis of pediatric pneumonias Angela Hua, Sharon Kim, James Tsung A25 Effectiveness of ultrasound in hypotensive patients Isa Gunaydin, Zeynep Kekec, Mehmet Oguzhan Ay A26 Moderate-to-severe left ventricular ejection fraction related to short-term mortality of patients with post-cardiac arrest syndrome after out-of-hospital cardiac arrest Jinjoo Kim, Jinhyun Kim, Gyoosung Choi, Dowon Shim A27 Usefulness of abdominal ultrasound for acute pyelonephritis diagnosis after kidney transplantation Ji-Han Lee A28 Lung ultrasound for assessing fluid tolerance in severe preeclampsia Jana Ambrozic, Katja Prokselj, Miha Lucovnik A29 Optic nerve sheath ultrasound in severe preeclampsia Gabrijela Brzan Simenc, Jana Ambrozic, Miha Lucovnik A30 Focused echocardiography monitoring in the postoperative period for non-cardiac patients Asta Mačiulienė, Almantas Maleckas, Algimantas Kriščiukaitis, Vytautas Mačiulis, Andrius Macas A31 POCUS-guided paediatric upper limb fracture reduction: algorithm, tricks, and tips Sharad Mohite A32 Point-of-care lung ultrasound: a good diagnostic tool for pneumonia in a septic patient Zoltan Narancsik, Hugon Možina A33 A case of undergraduate POCUS (r)evolution Sara Nikolić, Jan Hansel, Rok Petrovčič, Una Mršić, Gregor Prosen A34 The Graz Summer School for ultrasound: from first contact to bedside application: three-and-a-half-day undergraduate ultrasound training: résumé after two years of continuous development Simon Orlob, Markus Lerchbaumer, Niklas Schönegger, Reinhard Kaufmann A35 Usefulness of point-of-care ultrasound in the emergency room in a patient with acute abdominal pain Alberto Oviedo-García, Margarita Algaba-Montes, Mayra Patricio-Bordomás A36 Use of bedside ultrasound in a critically ill patient. A case report Alberto Oviedo-García, Margarita Algaba-Montes, Mayra Patricio-Bordomás A37 Diagnostic yield of clinical echocardiography for the emergency physician Alberto Oviedo-García, Margarita Algaba-Montes, Mayra Patricio-Bordomás A38 Focused cardiac ultrasound in early diagnosis of type A aortic dissection with atypical presentation Chun-I Pan, Hsiu-Yung Pan, Chien-Hung Wu A39 Detection of imperforated hymen by point-of-care ultrasound Hsiu-yung Pan, Chia-Te Kung A40 Developing a point-of-care ultrasound curriculum for pediatric nurse practitioners practicing in the pediatric emergency department Sarah Pasquale, Stephanie J. Doniger, Sharon Yellin, Gerardo Chiricolo A41 Use of transthoracic echocardiography in emergency setting: patient with mitral valve abscess Maja Potisek, Borut Drnovšek, Boštjan Leskovar A42 A young man with syncope Fatemeh Rasooli, Maryam Bahreini A43 Work-related repetitive use injuries in ultrasound fellows Kristine Robinson, Clara Kraft, Benjamin Moser, Stephen Davis, Shelley Layman, Yusef Sayeed, Joseph Minardi A44 Lung ultrasonography in the evaluation of pneumonia in children Irmina Sefic Pasic, Amra Dzananovic, Anes Pasic, Sandra Vegar Zubovic A45 Central venous catheter placement with the ultrasound aid: two years’ experience of the Interventional unit, Division of Intensive Care Medicine, KBC Zagreb Ana Godan Hauptman, Marijana Grgic Medic, Ivan Tomic, Ana Vujaklija Brajkovic, Jaksa Babel, Marina Peklic, Radovan Radonic A46 Duplicitas casui: two patients admitted due to acute liver failure Vedran Radonic, Ivan Tomic, Luka Bielen, Marijana Grgic Medic A47 A pilot survey on an understanding of Bedside Point-of-Care Ultrasound (POCUS) among medical doctors in internal medicine: exposure, perceptions, interest, and barriers to training Peh Wee Ming A48 Unusual case of defecation syncope Nur hafiza Yezid, Fatahul Laham Mohammed A49 A case report of massive pulmonary embolism; a multidisciplinary approach Zainal Abidin Huda, Wan Nasarudin Wan Ismail, W.Yus Haniff W.Isa, Hashairi Fauzi, Praveena Seeva, Mohd Zulfakar Mazlan

Background: Horner syndrome is caused by a lesion affecting the sympathetic innervation of the lids and pupil. The most common factor producing the preganglionic Horner's syndrome is malignant tumors. Methods: We report here a case of Horner syndrome in young women with the history of breast cancer. The patient underwent extensive neurological examinations, including MRI of head and neck, together with chest radiograph and CT thorax scan. Results: Present radiographic methods revealed one-sided metastatic pleural effusion as a cause of sympathetic lesion. Conclusion: Metastatic breast disease usually affects lungs, bone, liver, adrenals and skin, and it is highly unusual for ocular involvement to be the first sign of its existence. This report presents a rare case of pleural metastatic breast cancer causing Horner's syndrome/Pancoast syndrome without lung involvement.

Determining a patient's prognosis after severe traumatic brain injury remains difficult and complex. The purpose of the present study was following up patients with severe traumatic brain injury by correlating their clinical outcome and sequential computer tomography (CT) findings. We investigated 51 patients who survived the first year following an accident. All patients underwent successive CT examinations within a maximum period of 2 years. The patients' outcomes depended on the underlying brain damage and are presented by the Glasgow Outcome Scale. Based on the investigated data we concluded that the worst outcomes were experienced by patients with initial massive cerebral edema, extensive subdural hematoma and intraventricular hemorrhage, followed by stroke as subacute CT finding and cerebral atrophy as chronic finding visible at follow-up CT scans. The majority of lesions identified by CT scan were found in the frontal lobes, basal ganglia, and temporal lobes. We suggest that CT examination still represents a simple and useful tool in attempting to predict the clinical outcome in patients with severe traumatic brain injury.

Determining a patient’s prognosis after severe traumatic brain injury remains difficult and complex. The purpose of the present study was following up patients with severe traumatic brain injury by correlating their clinical outcome and sequential computer tomography (CT) findings. We investigated 51 patients who survived the first year following an accident. All patients underwent successive CT examinations within a maximum period of 2 years. The patients’ outcomes depended on the underlying brain damage and are presented by the Glasgow Outcome Scale. Based on the investigated data we concluded that the worst outcomes were experienced by patients with initial massive cerebral edema, extensive subdural hematoma and intraventricular hemorrhage, followed by stroke as subacute CT finding and cerebral atrophy as chronic finding visible at follow-up CT scans. The majority of lesions identified by CT scan were found in the frontal lobes, basal ganglia, and temporal lobes. We suggest that CT examination still represents a simple and useful tool in attempting to predict the clinical outcome in patients with severe traumatic brain injury.

Elektroničkim pretraživanjem putem interneta na adresi: http://www.ncbi.nlm.nih.gov/pubmed/ izdvojene su randomizirane studije s kontrolnom skupinom na placebu radi ispitivanja učinkovitosti djelovanja alfa-blokatora na kronični prostatitis tipa III s tegobama definiranim s pomoću simptomskog skora NIH-CPSI. Od 13 odabranih studija tri su isključene zato što nisu rabile NIH-CPSI, tri zato što su bile na kineskom jeziku i dvije zato što su bile u formi kongresnog sažetka. Analizirano je pet studija s ukupno 563 bolesnika, a metodološka kvaliteta studija po Jadadu iznosila je četiri ili pet jedinica. Uporijebljeni alfa-blokatori bili su alfuzosin, terazosin, tamsulozin i doksazosin u trajanju od 6 tjedana do 6 mjeseci. Učinak liječenja alfa-blokatorima bio je izraženiji u bolesnika s kroničnim prostatitisom tipa III s visokim vrijednostima NIH-CPSI i izraženijim tegobama mokrenja, koji su manje selektivne alfa-blokatore alfuzosin, terazosin i doksazosin primali 3–6 mjeseci., Studies were identified on internet by searching on address: http://www.ncbi.nlm.nih.gov/pubmed/ with criteria that studies should be placebo-controlled and randomized in trials of alpha-blockers in chronic category III prostatitis evaluated by symptom-score NIH-CPSI. From 13 clinical studies three were excluded because of not using NIH-CPSI, three were in Chinese language and two were congress abstracts. Analysed were five studies with four or five Jadad scale including 563 patients. Alpha-blockers alfuzosin, terazosin, tamsulosin and doxazosin have been used through 6 weeks and 6 months. Better results were accomplished by less selective alpha-blockers alfuzosin, terazosin and doxazosin through 3–6 months in patients having higher NIH-CPSI score and higher voiding score.

The contribution deals vith application of virtual reality technology and computer assisted surgery in rhinology

Cilj je ovoga rada prikazati raspodjelu i zastupljenost patomorfoloških promjena ramenog zgloba otkrivenih ultrazvučnim pregledom bolesnika s radnom dijagnozom humeroskapularnog periartritisa (PHS). Retrospektivno su analizirani ultrazvučni nalazi 141 bolesnika, odnosno 147 simptomatskih ramena kod bolesnika s uputnom dijagnozom PHS. Nalazi su podijeljeni u skupine prema anatomskoj lokalizaciji i ultrazvučno otkrivenoj patomorfologiji te po dobnim skupinama. Podaci su analizirani deskriptivno. Ukupno je nađeno 87 (59,2%) pozitivnih i 60 (40,8%) urednih ultrazvučnih nalaza. Najčešće su promjene na tetivi supraspinatusa (55,3%), potom tenosinovitis duge glave bicepsa (15,2%), burzitisi (12,6%), tendinitis supskapularisa (10,6%) i tendinitis infraspinatusa (0,7%). Najveći broj patomorfoloških promjena, a ujedno i urednih nalaza, nađen je u dobnoj skupini od 40 do 65 godina. Najmanji je broj urednih nalaza u skupini starijih od 65 godina gdje je otkriveno najviše kompletnih ruptura supraspinatusa. Ultrazvuk je zbog svoje visoke specifičnosti i osjetljivosti za otkrivanje promjena rotatorne manšete, subakromijalo-subdeltoidne burze i tetive duge glave bicepsa, a s druge strane dostupnosti, neinvazivnosti i relativno niske cijene, metoda izbora za procjenu mekotkivnih struktura kod bolnog ramena. Ciljana anamneza i klinički pregled smanjit će broj neadekvatno indiciranih pretraga, The aim of this study was to present the distribution and representation of shoulder ultrasonographic (US) examination findings in patients with diagnosis of humeroscapular periarthritis. US examination findings in 141 patients, that is 147 symptomatic shoulders with diagnosis of humeroscapular periarthritis, were evaluated retrospectively. Outcomes of ultrasonography were distributed in groups by anatomical location, US examination finding and age. Descriptive statistics were used to analyze the data. Out of 147 analyzed shoulders, 87 (59.2%) were positive and 60 (40.8%) were negative upon US examination. The most frequent US abnormalities were detected in a supraspinatus tendon (55.3%), followed by long head of the biceps tendon (15.2%), bursitis (12.6%), subscapularis tendinitis (10.6%) and infraspinatus tendinitis (0.7%). The highest number of US abnormalities, as well as negative ultrasonographies, were detected at the age 40 to 65. The least negative US examination findings were at age over 65, where also the highest number of supraspinatus tears were detected. Due to high specificity and sensitivity in the evaluation of the rotator cuff, subacromial bursa and long head of the biceps tendon changes, ultrasound is a reliable method for evaluation of patients with painful shoulder. Its availability, noninvasivity and relatively low cost make it a method of choice for inital evaluation of such patients. Detailed history and clinical examination are going to lessen inadequate medical requests for ultrasonography

Frontal sinus fractures (FSF) are commonly caused by traffic accidents, assaults, industrial accidents and gunshot wounds. Classical roentgenography has high proportion of false negative findings in cases of FSF and is not particularly useful in examining the severity of damage to the frontal sinus posterior table and the nasofrontal duct region. High resolution computed tomography was inavoidable during the management of such patients but it may produce large quantity of 2D images. Postprocessing of datasets acquired by high resolution computer tomography from patients with severe head trauma may offer a valuable additional help in diagnostics and surgery planning. We performed virtual endoscopy (VE) and 3D volume rendering (3DVR) on high resolution CT data acquired from a 54-year-old man with with both anterior and posterior frontal sinus wall fracture in order to demonstrate advantages and disadvantages of these methods. Data acquisition was done by Siemens Somatom Emotion scanner and postprocessing was performed with Syngo 2006G software. VE and 3DVR were performed in a man who suffered blunt trauma to his forehead and nose in an traffic accident. Left frontal sinus anterior wall fracture without dislocation and fracture of tabula interna with dislocation were found. 3D position and orientation of fracture lines were shown in by 3D rendering software. We concluded that VE and 3DVR can clearly display the anatomic structure of the paranasal sinuses and nasopharyngeal cavity, revealing damage to the sinus wall caused by a fracture and its relationship to surrounding anatomical structures.

The main goal of our work was to evaluate advantages and disadvantages of virtual endoscopy (VE) techniques in routinely diagnostic and preoperative management of patients with various sinus diseases or head traumas in our practice. Fly-through algorithm was performed using an Xeon based workstation on data sets created from axial CT images acquired from 320 patients with various paranasal sinus disorders. Images were created using Siemens Somatom Emotion 16 continiously rotating helical CT scanner and archived in DICOM format. In comparison with real endoscopy, the VE has several advantages. It is completely non-invasive. It is possible to repeat the same procedure several times, therefore it may be a valuable tool for training. Interactive control of all virtual camera parameters, including the field- -of-view is possible. Endoscopic viewing as opposed to real endoscopy is not restricted to the spaces defined by inner surfaces. The viewer may penetrate the walls and see the extent of lesions within and beyond the wall as well as the adjacent anatomic structures. Virtual endoscopy also has a potential to stage tumors by determining the location and the extent of transmural extension.

Multislice helical CT generated virtual bronchoscopy (VB) represents one of the most recent developments in three-dimensional computer aided visualisation techniques. VB allows non-invasive and relatively accurate 3D evaluation of tracheobronchal tree. We performed virtual bronchoscopy and in-space 3D volume analysis on CT-data set acquired from sixty-four-year old male with bronchial cancer in order to demonstrate advantages and disadvantages of these methods in diagnostics and preoperative management of metastatic bronchial cancer. Siemens Somatom Emotion 16 helical CT scanner was used for data acquisition. Data post-processing was done with 3D Syngo 2006G software package from Siemens medical systems. CT scanning of the thorax was performed in heavy smoker with an expansive T4N1M1 malignant process in a superior lobe of the right lung accompanied with large metastatic lesion attached on the right lateral chest wall. Metastatic lesions were also found in vertebral column. In-space 3D analysis followed with virtual bronchoscopy had revealed obstruction of apical branch of superior lobe segmental bronchus. External compression done by tumor to the superior segmental and right main bronchus was found. We concluded that multi-slice CT in connection with VB became a possible non-invasive alternative to bronchoscopy, if tissue samples are not required.