Human Growth Hormone - Utility of Extended FAST in Blunt Chest Trauma: Is it the Time

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Human Growth Hormone – Utility of Extended FAST in Blunt Chest Trauma: Is it the Time

Related Articles Utility of Extended FAST in Blunt Chest Trauma: Is it the Time to be Used in the ATLS Algorithm?

World J Surg. 2014 Sep 10;

Authors: Abdulrahman Y, Musthafa S, Hakim SY, Nabir S, Qanbar A, Mahmood I, Siddiqui T, Hussein WA, Ali HH, Afifi I, El-Menyar A, Al-Thani H

Abstract
INTRODUCTION: The clinical significance of extended Focused Assessment with Sonography for Trauma (EFAST) for diagnosis of pneumothorax is not well defined.
OBJECTIVES: To investigate the utility of EFAST in blunt chest trauma (BCT) patients.
STUDY DESIGN: A single blinded, prospective study. Participants: All patients admitted with BCT (2011-2013).
SETTINGS: Level 1 trauma center in Qatar.
PROCEDURES AND OUTCOME MEASURES: Patients were screened by EFAST and results were compared to the clinical examination (CE) and chest X-ray (CXR). Chest-computed tomography (CT) scoring system was used to confirm and measure the pneumothorax. Diagnostic accuracy of diagnostic modalities of pneumothorax was measured using sensitivity, specificity, predictive values (PVs), and likelihood ratio.
RESULTS: A total of 305 BCT patients were included with median age of 34 (18-75). Chest CT was positive for pneumothorax in 75 (24.6.%) cases; of which 11.% had bilateral pneumothorax. Chest CT confirmed the diagnosis of pneumothorax in 43, 41, and 11.% of those who were initially diagnosed by EFAST, CE, and CXR, respectively. EFAST was positive in 42 hemithoraces and its sensitivity (43.%) was higher in comparison to CXR (11.%). Positive and negative PVs of EFAST were 76 and 92.%, respectively. The frequency of missed cases by CXR was higher in comparison to EFAST and CE. The lowest median score of missed pneumothorax was observed by EFAST.
CONCLUSION: EFAST can be used as an efficient triaging tool in BCT patients to rule out pneumothorax. Based on our analysis, we would recommend EFAST as an adjunct in ATLS algorithm.

PMID: 25205343 [PubMed - as supplied by publisher]

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Human Growth Hormone - Utility of Extended FAST in Blunt Chest Trauma: Is it the Time

IGF - The utility of the IGF-I generation test in children with chronic kidney diseas

New Exercise and Fitness Review

IGF – The utility of the IGF-I generation test in children with chronic kidney diseas

Related Articles The utility of the IGF-I generation test in children with chronic kidney disease.

Pediatr Nephrol. 2013 Dec;28(12):2323-33

Authors: Al-Uzri A, Swinford RD, Nguyen T, Jenkins R, Gunsul A, Kachan-Liu SS, Rosenfeld R

Abstract
BACKGROUND: To determine if the insulin-like-growth factor (IGF-I) generation test is a marker for growth hormone (GH) sensitivity in children with chronic kidney disease (CKD).
METHODS: This was a randomized cross-over study in which children with CKD received low-dose (0.025 mg/kg/day) and high-dose (0.05 mg/kg/day) GH therapy in the framework of a 7-day IGF-I generation test. Blood samples were collected on day 1 (D1; pre-dose) and on day 8 (D8; post 7 doses) of GH therapy. All subjects received GH for 12 months at 0.05 mg/kg/day. Serum IGF-I was measured by radioimmunometric assay. Normative historic data from healthy children and those with idiopathic short stature were used for comparison.
RESULTS: Sixteen subjects (age 2-13 years) with creatinine clearances of between 25 and 75 ml/min/1.73 m(2) were enrolled. Annualized height velocity for all subjects was 10.3 ± 1.1 cm/year (mean ± standard deviation), with an annual change in height Z score of 0.7 ± 1.0. No correlation was found between the generated serum IGF-I levels (D8 – D1) and creatinine clearances, and with changes in height Z scores. Serum IGF-I levels on D1 and D8 in CKD subjects were lower than normative data, but with adequate IGF-I generation on D8.
CONCLUSIONS: Children with CKD were able to respond to GH therapy with both growth and an increase in serum IGF-I levels, but the IGF-I generation test was not a good predictor of growth response in this cohort.

PMID: 24013497 [PubMed - indexed for MEDLINE]

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Insulin like growth factors
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IGF - The utility of the IGF-I generation test in children with chronic kidney diseas