Reza Assadsangabi

Bio: Reza Assadsangabi is an academic researcher from University of Pennsylvania. The author has contributed to research in topics: Medicine & Neuroradiology. The author has an hindex of 7, co-authored 14 publications receiving 219 citations. Previous affiliations of Reza Assadsangabi include Children's Hospital of Philadelphia & Shiraz University of Medical Sciences.

Sonographic measurement of the inferior vena cava as a predictor of shock in trauma patients.

Abstract: Detecting and monitoring blood loss is always a challenging dilemma in emergency settings. The diameter of the inferior vena cava (IVC) in trauma patients may be useful in this way. This has been classically done with computed tomography (CT); however, doing it with ultrasound as a bedside easily available modality is a relatively novel approach. Between January 2006 and March 2006, 88 injured patients referred to our center were investigated. The patients were divided in to two groups: a shock group (n = 11, 12.5%) and a control group (n = 77, 87.5%) who were trauma patients with normal blood pressure. The maximum anteroposteroir diameter of IVC was measured ultrasonographically both in inspiration (i) and expiration (e) by M-mode in the subxyphoid area. The difference between the diameters of IVCe and IVCi was regarded as collapsibility, and collapsibility index was defined as IVCe − IVCi/IVCe. Statistical analysis included Mann–Whitney U test and correlation analysis. The average diameters of IVCe and IVCi in the shock group at arrival were significantly smaller than in the control group (5.6 ± 0.8 mm, 4.0 ± 0.7 mm versus 11.9 ± 2.2 mm, 9.6 ± 2.0 mm; P < 0.0001). The maximum diameter of IVC in the shock group was in a 30-year-old male patient with an IVCe and IVCi of 7.0 and 5.3 mm, respectively. Correlation analysis revealed a negative correlation between the diameter of IVCe (r = 0.72) and IVCi (r = 0.73) and the presence of shock. Regarding the collapsibility index, the mean collapsibility index of IVC was significantly higher in the shock group compared to patients in the control group (27% versus 20%; P < 0.001). The diameter of IVC was found to correlate with shock in trauma patients. The measurement of the IVC may be an important addition to the ultrasonographic evaluation of trauma and other potentially volume-depleted patients and can be added to the focused assessment with sonography for trauma (FAST) of the trauma patient with minimum additional time.

Neuroimaging in Central Nervous System Lymphoma.

Abstract: Primary central nervous system lymphoma (PCNSL) is a rare aggressive high-grade type of extranodal lymphoma. PCNSL can have a variable imaging appearance and can mimic other brain disorders such as encephalitis, demyelination, and stroke. In addition to PCNSL, the CNS can be secondarily involved by systemic lymphoma. Computed tomography and conventional MRI are the initial imaging modalities to evaluate these lesions. Recently, however, advanced MRI techniques are more often used in an effort to narrow the differential diagnosis and potentially inform diagnostic and therapeutic decisions.

An Imager's Guide to Perineural Tumor Spread in Head and Neck Cancers: Radiologic Footprints on 18F-FDG PET, with CT and MRI Correlates.

Abstract: Perineural spread (PNS) refers to tumor growth along large nerves, a macroscopic analog of microscopic perineural invasion. This phenomenon most commonly occurs in the head and neck, but its incidence varies with histologic tumor subtype. PNS results from a complex molecular interplay between tumor cells, nerves, and connective stroma. PNS is clinically underdiagnosed despite its impact on patients' prognosis and management. The role of 18F-FDG PET in assessment of PNS in head and neck cancer remains to be explored, in contrast to MRI as the established gold standard. In patients with PNS, 18F-FDG PET shows both abnormality along the course of the involved nerve and muscular changes secondary to denervation. Assessment of PNS on 18F-FDG PET requires knowledge of relevant neural pathways and can be improved by correlation with anatomic imaging, additional processing of images, and review of clinical context.

Evolution of Obstructive Sleep Apnea in Infants with Cleft Palate and Micrognathia.

Abstract: Study Objectives:Children with craniofacial anomalies are a heterogeneous group at high risk for obstructive sleep apnea (OSA). However, the prevalence and structural predictors of OSA in this popu...

International Evidence-Based Recommendations for Focused Cardiac Ultrasound

Abstract: Background Focused cardiac ultrasound (FoCUS) is a simplified, clinician-performed application of echocardiography that is rapidly expanding in use, especially in emergency and critical care medicine. Performed by appropriately trained clinicians, typically not cardiologists, FoCUS ascertains the essential information needed in critical scenarios for time-sensitive clinical decision making. A need exists for quality evidence-based review and clinical recommendations on its use. Methods The World Interactive Network Focused on Critical UltraSound conducted an international, multispecialty, evidence-based, methodologically rigorous consensus process on FoCUS. Thirty-three experts from 16 countries were involved. A systematic multiple-database, double-track literature search (January 1980 to September 2013) was performed. The Grading of Recommendation, Assessment, Development and Evaluation method was used to determine the quality of available evidence and subsequent development of the recommendations. Evidence-based panel judgment and consensus was collected and analyzed by means of the RAND appropriateness method. Results During four conferences (in New Delhi, Milan, Boston, and Barcelona), 108 statements were elaborated and discussed. Face-to-face debates were held in two rounds using the modified Delphi technique. Disagreement occurred for 10 statements. Weak or conditional recommendations were made for two statements and strong or very strong recommendations for 96. These recommendations delineate the nature, applications, technique, potential benefits, clinical integration, education, and certification principles for FoCUS, both for adults and pediatric patients. Conclusions This document presents the results of the first International Conference on FoCUS. For the first time, evidence-based clinical recommendations comprehensively address this branch of point-of-care ultrasound, providing a framework for FoCUS to standardize its application in different clinical settings around the world.

Review article: Use of ultrasound in the developing world.

Abstract: As portability and durability improve, bedside, clinician-performed ultrasound is seeing increasing use in rural, underdeveloped parts of the world. Physicians, nurses and medical officers have demonstrated the ability to perform and interpret a large variety of ultrasound exams, and a growing body of literature supports the use of point-of-care ultrasound in developing nations. We review, by region, the existing literature in support of ultrasound use in the developing world and training guidelines currently in use, and highlight indications for emergency ultrasound in the developing world. We suggest future directions for bedside ultrasound use and research to improve diagnostic capacity and patient care in the most remote areas of the globe.

Measurement of Blood Loss: Review of the Literature

Abstract: It is important to recognize excessive blood loss during childbirth, which is a significant cause of morbidity and mortality. This article reviews methods to measure blood loss that could be used during childbirth.