Publications by authors named "Shaahinfar A"

Objectives: We evaluated the completeness of real-world Focused Assessment with Sonography for Trauma (FAST) in children after blunt abdominal trauma by benchmarking against established expert guidelines.

Methods: We conducted a retrospective cohort study, analyzing a random sample of FASTs from two urban pediatric emergency departments. Two experts reviewed and labeled all FASTs for completeness using a predefined guideline of 5 anatomic views and 30 landmarks.

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Article Synopsis
  • In 2020, firearm injuries became the leading cause of death for children in the US, surpassing car accidents, prompting a need for effective public health interventions.
  • A study analyzed firearm injury data from 2003 to 2018 for patients under 19, focusing on demographics, injury intent, and outcomes across four pediatric hospitals in different regions.
  • Results showed a significant rise in firearm injuries, particularly in the South, emphasizing variations in injury causes and implications for developing targeted prevention strategies based on regional data.
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Background: Daycare and school closures prompted by shelter-in-place orders may have increased opportunities for unintentional ingestions among young children.

Objectives: We examined emergency department (ED) presentations for toxic exposures among young children during the COVID-19 pandemic in the San Francisco Bay Area, which had some of the strictest and most prolonged shelter-in-place policies in the United States.

Methods: We performed a retrospective cross-sectional study of children 0 to 5 years of age who presented with an ED International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnosis code of toxic exposure within a tertiary care hospital system between March 16, 2016 and March 15, 2021.

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Importance: The wide variation in the accuracy and reliability of the Focused Assessment With Sonography for Trauma (FAST) and the extended FAST (E-FAST) for children after blunt abdominal trauma reflects user expertise. FAST and E-FAST that are performed by experts tend to be more complete, better quality, and more often clinically valuable.

Objective: To develop definitions of a complete, high-quality, and accurate interpretation for the FAST and E-FAST in children with injury using an expert, consensus-based modified Delphi technique.

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Background: Point-of-care ultrasound (POCUS) is a noninvasive bedside tool with many pediatric applications but is not currently a formal part of pediatric training and practice. Formal surveys of general pediatricians regarding POCUS training are lacking. We aimed to quantify the baseline ultrasound experience and training needs of general pediatricians and pediatric residents across different practice settings.

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Article Synopsis
  • Point-of-care ultrasound can enhance the effectiveness and safety of various pediatric procedures in the emergency department.
  • The article discusses how ultrasound guidance can aid in soft tissue treatments, musculoskeletal and neurologic procedures, vascular access, and critical care interventions.
  • By using ultrasound, emergency physicians can improve their skills and confidence while ensuring better outcomes for pediatric patients.
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Anomalous left coronary artery from the pulmonary artery is a rare cause of dilated cardiomyopathy. We present the first reported case of anomalous left coronary artery from the pulmonary artery diagnosed by point-of-care ultrasound, leading to expedited management, stabilization, and eventual treatment.

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Point-of-care ultrasound can be used to screen for malrotation with and without volvulus in the newborn with bilious vomiting, as well as children with unexplained intermittent abdominal pain. We discuss cases where infants and children presenting to pediatric emergency departments with bilious vomiting and/or intermittent abdominal pain were initially screened for small bowel pathology with point-of-care ultrasound. Bedside findings suggestive of midgut volvulus were confirmed with radiology-performed ultrasound or upper gastrointestinal fluoroscopy.

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Objectives: The objective was to determine whether children surviving to hospital discharge after firearm assault (FA) and nonfirearm assault (NFA) are at increased risk of mortality relative to survivors of unintentional trauma (UT). Secondarily, the objective was to elucidate the factors associated with long-term mortality after pediatric trauma.

Methods: This was a multicenter, retrospective cohort study of pediatric patients aged 0 to 16 years who presented to the three trauma centers in San Francisco and Alameda counties, California, between January 2000 and December 2009 after 1) FA, 2) NFA, and 3) UT.

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Purpose Of Review: The diagnostic capability, efficiency and versatility of point-of-care ultrasound (POCUS) have enabled its use in paediatric emergency medicine (PEM) and paediatric critical care (PICU). This review highlights the current applications of POCUS for the critically ill child across PEM and PICU to identify areas of progress and standardized practice and to elucidate areas for future research.

Recent Findings: POCUS technology continues to evolve and advance bedside clinical care for critically ill children, with ongoing research extending its use for an array of clinical scenarios, including respiratory distress, trauma and dehydration.

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Purposes Of Review: This article provides an update on abusive head trauma (AHT), focusing on new developments most salient to the emergency medicine clinician, including epidemiology, clinical recognition, diagnostic work-up, management of neurologic injury, and public health implications.

Recent Findings: The recent literature has focused on honing the clinician's ability to recognize AHT and its immediate sequelae, to more accurately distinguish between abusive and accidental head injuries by patterns of neuroimaging and retinal hemorrhages, and to appreciate the long-term impacts. Specifically, both a clinical prediction rule and biomarker show promise, and new research advocates for the early identification of subclinical seizures as well as cervical spine injuries.

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Background: Many of India's estimated 40 million migrant workers in the construction industry migrate with their children. Though India is undergoing rapid economic growth, numerous child protection issues remain. Migrant workers and their children face serious threats to their health, safety, and well-being.

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We have created a bioimpedance probe designed to detect subtle changes in human cervical tissue composition in vivo, and thereby detect the onset of cervical remodeling in a noninvasive manner sooner than existing clinical methods allow. Our cervical bioimpedance measurement device, which can be used during a routine pelvic examination, is composed of a contoured probe with disposable tip and, within the probe's handle, a bioimpedance sensor equipped with an integrated chip capable of generating sinusoidal voltage of varying frequencies. A constant force spring assures consistent measurements through a range of contact forces applied.

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