The miniaturization of ultrasound equipment in the form of tablet- or smartphone-sized ultrasound equipment is a result of the rapid evolution of technology and handheld ultrasound devices (HHUSD). This position paper of the European Federation of Societies in Ultrasound and Medicine (EFSUMB) assesses the current status of HHUSD in abdominal ultrasound, pediatric ultrasound, targeted echocardiography and heart ultrasound, and we will report position comments on the most common clinical applications. Also included is a SWOT (Strength – Weaknesses – Opportunities – Threats) analysis, the use for handheld devices for medical students, educational & training aspects, documentation, storage and safety considerations.

Glomerular filtration rate (GFR) was evaluated in 32 Wilms’ tumour survivors (WTs) in a cross-sectional study using 99 Tc-diethylene triamine pentaacetic acid (99 Tc-DTPA) clearance, the Schwartz formula, the new Schwartz equation for chronic kidney disease (CKD), cystatin C serum concentration and the Filler formula. Kidney damage was established by beta-2-microglobulin (B-2-M) and albumin urine excretion, urine sediment and ultrasound examination. Blood pressure was measured. No differences were found between the mean GFR in 99 Tc-DTPA and the new Schwartz equation for CKD (91.8 ± 11.3 vs. 94.3 ± 10.2 ml/min/1.73 m2 [p = 0.55] respectively). No differences were observed between estimated glomerular filtration rate (eGFR) using the Schwartz formula and the Filler formula either (122.3 ± 19.9 vs. 129.8 ± 23.9 ml/min/1.73 m2 [p = 0.28] respectively). Increased urine albumin and B-2-M excretion, which are signs of kidney damage, were found in 7 (22%) and 3 (9.4%) WTs respectively. Ultrasound signs of kidney damage were found in 14 patients (43%). Five patients (15.6%) had more than one sign of kidney damage. Eighteen individuals (56.25%) had CKD stage I (10 with signs of kidney damage; 8 without). Fourteen individuals (43.75%) had CKD stage II (6 with signs of kidney damage; 8 without). The new Schwartz equation for CKD better estimated GFR in comparison to the Schwartz formula and the Filler formula. Furthermore, the WT survivors had signs of kidney damage despite the fact that GFR was not decreased below 90 ml/min/1.73 m2 with 99 Tc- DTPA.

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Bedside chest ultrasound examination is especially useful in children with high risk of PTE and in critical general condition. In newborns in severe general condition ultrasound examination of chest should be first imaging test for PTE. It is significant to set on a multicenter study to evaluate the diagnostic value of chest ultrasound in diagnosis of PTE in children.

Licence: This open access article is licensed under Creative Commons Attribution 4.0 International (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Users are allowed to share (copy and redistribute the material in any medium or format) and adapt (remix, transform, and build upon the material for any purpose, even commercially), as long as the authors and the publisher are explicitly identified and properly acknowledged as the original source. AbstractCurrently, the treatment of Wilms tumour (WT) is successful in approximately 90% of cases, and consists of chemotherapy, nephrectomy, and, in some cases, radiation therapy. All treatments have potential long-term influence on the function of solitary kidneys in WT survivors (WTS). Severe reduction in glomerular filtration rate occurs after nephrectomy. All patients who underwent surgical treatment for WT could be considered to have 132a risk of chronic kidney disease (CKD) because they lack a kidney. End-stage renal disease is rare (1.8% of National Wilms Tumour Study patients). Recent studies have revealed that patients with CKD have a greater risk of cardiovascular events and death. Most of the WTS have lower stages or no CKD. Regular biochemical studies and ultrasound examination at follow-up visits should be considered as indispensible elements of long-term care in uninephrectomized WTS. The evaluation of a single kidney function should be frequent, consisting of the assessment of estimated glomerular filtration rate (eGFR), assessment of albumin urine excretion, urine sediment analysis to detect abnormalities, ultrasound examination and measurements of blood pressure. According to Kidney Disease Improving Global Outcomes (KDIGO) recommendation and suggestions, GFR should be assessed using GFR-estimating equations that include serum creatinine and cystatin C concentrations. Cystatin C can be a more sensitive marker of kidney filtration function than creatinine, especially in diseases characterized by a mild decrease in glomerular filtration. This will facilitate the detection of early kidney impairment and assessment of the progression of CKD in WTS.

CysC levels may be elevated in people with normal GFR. Hypertrophy of a single kidney increases with deteriorating kidney function. PT/KL should be verified in future studies as a sonographic marker of kidney impairment.

Background/Aims: This study presents an analysis of the sonographic and laboratory parameters of solitary kidney in Wilms tumour survivors (TWs) and compares these parameters with those of healthy individuals. Methods: Fifty-three TWs who completed treatment for Wilms tumour and 44 healthy individuals were enrolled. The study protocol consisted of completing a medical history, sonographic examination of the solitary kidney, estimation of glomerular filtration rate (eGFR) by the Schwartz or MDRD formulas, albumin urine excretion and BP measurement. Results: Sonographic signs of kidney damage were observed in 22 (41,5%) TWs. The most frequently detected abnormalities are hyperechoic rings around renal pyramids (28,3% TWs). Hypertrophy of the solitary kidney occurred in 71,7% of cases. The mean volume of the solitary kidney was 77% of the sum of the two kidney volumes in the control group. The median eGFR in the TWs group was 117 with 25Q-105,5, 75Q-130 ml/min/1,73 m² vs 131,8 with 25Q-124, 75Q-140 ml/min/1,73 m² in the control group (p=0,000). Six TWs (11,3%) had a value of eGFR below 90 ml/min/1,73 m². Increased urine albumin excretion (> 30 mg/g) was observed in 7 TWs (13,2%) and in 3 (6,8%) individuals in the control group. Conclusion: Ultrasonographic abnormalities in solitary kidney of TWs are frequent. The most frequently detected abnormalities are hyperechoic rings around renal pyramids. Sonographic examination of TWs ought to be performed not only to detect tumour recurrence but also to assess the signs of kidney damage and their progression.

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