Artisanal model replaces animal use for ultrasound-guided fine needle puncture practice in medical sciences teaching.

Fine needle puncture (FNP) is a widespread technique used to collect cellular samples. Its efficiency can be enhanced by the use of ultrasonography to guide the procedure. Ultrasound-guided FNP is therefore an operator-dependent exam. For this reason, it demands the acquisition of psychomotor skill, ability to recognize structures, and dexterity during the needle puncture. This study describes the development of an artisanal simulator made with gelatin to replace the use of live animals during practical classes in veterinary or medical sciences education. The experimental set consisted of three phases in which the student performed different tasks such as recognition of the target structure with ultrasound and injection of ink (phase 1) or aspiration (phase 2) of its content and evaluation of a parenchymatous organ (liver) and puncture of its surface (phase 3). A survey on the acceptance of the model was carried out, and students filled out a questionnaire elaborated with the visual analog scale system. Participants considered the artisanal model a strong method to teach ultrasound-guided FNP. Other attractive advantages of this simulator are the low manufacturing costs (compared with expensive high-technology devices) and the possibility to replace the use of live animals in practical classes.NEW & NOTEWORTHY This study describes an artisanal simulator made with gelatin to teach ultrasound-guided fine needle puncture during practical classes in veterinary or medical sciences education. A three-phase experimental set allowed the students to practice ultrasound-guided fine needle puncture, aspiration, and injection in three different target structures. This cost-effective simulator may be an alternative to the use of expensive devices or the use of live animals during practical classes.

Value of artisanal simulators to teach ultrasound-guided percutaneous biopsy using a tru-cut needle for veterinary and medical students.

The present study aimed to evaluate the applicability of artisanal simulators to teach veterinary and medical students the ultrasound-guided percutaneous biopsy using a tru-cut needle. The artisanal simulators consisted of bovine liver between two layers of commercially available grape gelatin. Students were paired, with one doing the biopsy and the other the ultrasound guidance. After performing the biopsies, each student answered a questionnaire with close-ended questions using a visual analog scale. The evaluated items were realism of the model, liver scanning, procedure instructions, biopsy feasibility, tru-cut needle handling, technique learning, and confidence to perform in vivo procedures. Items that received a score of 7 or higher were considered strong items; items with a score between 5 and 6.9 were classified as average items; and items with a score of 5 or lower were considered weak items. The answers to all questions had an average score of 7 or higher, suggesting that the simulator was classified as strong for all of the evaluated items. Answers to question 7 suggested that some of the students did not develop confidence to perform a tru-cut biopsy on a patient. Students evaluated the artisanal simulator as a strong method to be used in ultrasound-guided percutaneous biopsy with a tru-cut needle. Additionally, the model presented a low cost of production and was proven accurate to teach biopsy skills in health professional schools dealing with veterinary or human medicine.

Comparative study between radiology and ultrasound in the evaluation of extracardiac thoracic diseases in dogs and cats / Estudo comparativo entre radiologia e ultrassonografia na avaliação de doenças torácicas extracardíacas em cães e gatos

ABSTRACT:This study compared radiographic and B-mode and Doppler ultrasound exams of the thoracic cavity, excluding the heart, in canine and feline species, in which the radiographs revealed the formation of a potential acoustic window. The objectives were to demonstrate the advantages and limitations of each technique and to determine whether the additional information influenced the differential diagnosis as well as the outcome of each case. The advantages of B-mode ultrasonography included: better qualitative and quantitative evaluation of pleural effusions, an improved ability to determine whether a nodule was solid or cystic and easier determination of the location in the pulmonary parenchyma. The Power Doppler ultrasound evaluated the blood supply pattern of the nodules and masses and differentiated between vessels and fluid bronchogram. A limitation of the ultrasound examination was the need to be guided by the previous radiography. The advantages of the radiographic examination included the possibility of localizing pulmonary lesions at any depth in the absence of a pleural effusion and providing a panoramic view of the extent of the thoracic disease. The ultrasound examination influenced the differential diagnosis in 18 (62.06%) cases and influenced the outcome of 8 (27.58%) cases.

RESUMO:Este estudo comparou os exames radiográficos e ultrassonográficos modo-B e Doppler da cavidade torácica, excluindo o coração, em animais da espécie canina e felina, nos casos em que as radiografias torácicas revelaram formação de janela acústica em potencial. O objetivo foi demonstrar as vantagens e limitações de cada técnica e determinar se as informações adicionais influenciaram o diagnóstico diferencial, bem como no desfecho de cada caso. As vantagens do modo B incluíram: melhor avaliação qualitativa e quantitativa de efusão pleural; determinação da natureza sólida ou cística de nódulos, bem como a definição de sua localização no parênquima pulmonar. O ultrassom Doppler de Amplitude permitiu a avaliação do padrão de irrigação sanguínea de nódulos e massas e a diferenciação entre vasos e broncogramas fluidos. Uma limitação do exame de ultrassom foi a necessidade de se guiar pela radiografia prévia. As vantagens do exame radiográfico foram: possibilidade de localização de lesões pulmonares em qualquer profundidade na ausência de efusão pleural e proporcionar uma visão panorâmica do acometimento da cavidade torácica. O exame ultrassonográfico proporcionou impacto no diagnóstico diferencial de 18 (62,06%) dos casos e influiu no desfecho de 8 (27,58%).