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Paediatric Ultrasound

Elise Chua, Valerie Udom, Dean Y Huang
We report the case of a 48-year-old man with a right fusiform internal jugular venous aneurysm, presenting as a unilateral painless neck swelling on coughing or laughing. This is a rare condition, more commonly seen in the paediatric population and can be diagnosed using non-invasive modalities such as Doppler ultrasound and contrast-enhanced CT. This anomaly is frequently misdiagnosed or overlooked, and our case highlights the importance of considering venous aneurysm as a differential to prevent invasive imaging and inappropriate management...
March 15, 2018: BMJ Case Reports
Sophie Ovesen, Michala Herskind Sejr, Peter Andersen
A 15-year-old girl was admitted to the paediatric ward due to abdominal pain, vomiting and diarrhoea. Her symptoms could not be explained by the clinical examinations, blood samples or ultrasound, but she had a history of tricho-phagia. A CT-scan showed gastric retention, and an endoscopy revealed a trichobezoar, which was removed by a laparotomy. Furthermore, a smaller bezoar and three perforations were found in the proximal part of the small intestine. The treatment of trichobezoars should include surgery as well as multidisciplinary involvement to prevent future trichophagia...
March 12, 2018: Ugeskrift for Laeger
William Bortcosh, Ashkon Shaahinfar, Sakina Sojar, Jean E Klig
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...
March 9, 2018: Current Opinion in Pediatrics
M Bogdanska, A Morris, J M Hutson, Y Heloury, S R Grover
BACKGROUND: Congenital adrenal hyperplasia (CAH) is an autosomal recessive condition resulting in excess androgen production. Females are typically born with ambiguous genitalia and often undergo feminising genitoplasty in infancy or childhood. Recently, there has been considerable international debate as to whether distressing urinary symptoms in CAH patients are truly present and, if so, whether these urinary problems are a consequence of the feminising genitoplasty. OBJECTIVE: To identify and assess any urinary symptoms in an Australian cohort of adolescent and adult women with CAH who have undergone feminising genitoplasty in infancy, childhood or adolescence as a part of their management...
February 7, 2018: Journal of Pediatric Urology
Elliot Long, Trevor Duke, Ed Oakley, Adam O'Brien, Bennett Sheridan, Franz E Babl
OBJECTIVE: The intent of fluid bolus therapy (FBT) is to increase cardiac output and tissue perfusion, yet only 50% of septic children are fluid responsive. We evaluated respiratory variation of inferior vena cava (IVC) diameter as a predictor of fluid responsiveness. METHODS: A prospective observational study in the ED of The Royal Children's Hospital, Melbourne, Australia. Patients were spontaneously ventilating children treated with FBT for sepsis-induced acute circulatory failure...
March 8, 2018: Emergency Medicine Australasia: EMA
Molinaro Francesco, Cobellis Giovanni, Cerchia Elisa, Ferrara Francesco, Tallarico Rosella, Sica Marina, Noviello Carmine, Martino Ascanio, Angotti Rossella, Messina Mario
Background: The varicocele is the most commonly diagnosed pre-pubertal andrological condition with an incidence of 10%-15% between adolescents. The aim of this study was to evaluate the efficacy of retroperitoneoscopic varicocelectomy (RV) in two Italian centres with particular attention to post-operative testicular volume and semen analysis after 18 years of life. Materials and Methods: From 1999 to 2010, 286 adolescents underwent retroperitoneoscopic left varicocelectomy...
April 2017: African Journal of Paediatric Surgery: AJPS
Saurabh Mittal, Sachidanand Jee Bharati, Sushil K Kabra, Karan Madan
No abstract text is available yet for this article.
February 2018: Indian Journal of Anaesthesia
Michael Narvey, Kenny K Wong, Anne Fournier
Pulse oximetry screening is safe, noninvasive, easy to perform and proven to enhance detection of critical congenital heart disease in newborns. However, this test has yet to be adopted as routine practice in Canada. The present practice point highlights essential details and recommendations for screening, which research has shown to be highly specific, with low false-positive rates. Optimal screening for critical congenital heart disease should include prenatal ultrasound, physical examination and pulse oximetry screening...
November 2017: Paediatrics & Child Health
Tarsh Pandit, Robin Ray, Sabe Sabesan
The aim of the study was to determine the training needs of doctors managing emergencies in rural and remote Australia. A systematic review of Australian articles was performed using MEDLINE (OVID) and INFORMIT online databases from 1990 to 2016. The search terms included 'Rural Health', 'Emergency Medicine', 'Emergency Medical Services', 'Education, Medical, Continuing' and 'Family Practice'. Only peer-reviewed articles, available in full-text that focussed on the training needs of rural doctors were reviewed...
February 22, 2018: Emergency Medicine Australasia: EMA
Francesco Cenni, Simon-Henri Schless, Lynn Bar-On, Erwin Aertbeliën, Herman Bruyninckx, Britta Hanssen, Kaat Desloovere
BACKGROUND AND OBJECTIVE: 3D freehand Ultrasonography is a medical imaging technique that can be used to measure muscle and tendon morphological and structural properties, including volume, lengths and echo-intensity. These properties are clinically relevant in neurological disorders such as spastic cerebral palsy to monitor disease progression and evaluate the effect of treatment. This study presents a methodology for extracting these parameters along with a clinical reliability analysis for the data acquisition and processing...
March 2018: Computer Methods and Programs in Biomedicine
Margaret G Keane, Mayur Kumar, Natascha Cieplik, Douglas Thorburn, Gavin J Johnson, George J Webster, Michael H Chapman, Keith J Lindley, Stephen P Pereira
BACKGROUND: In adults ERCP and endoscopic ultrasound (EUS) are standard methods of evaluating and treating many hepatopancreaticobiliary (HPB) conditions. HPB disease is being diagnosed with increasing frequency in children but information about role of ERCP and EUS and their outcomes in this population remain limited. Therefore the aims of this study were to describe the paediatric ERCP and EUS experience from a large tertiary referral HPB centre, and to systematically compare outcomes with those of other published series...
February 9, 2018: BMC Pediatrics
Victor Istasy, Drew Thompson, Mirielle Gharib, Rodrick Lim
The focus of this review is to examine the current state of paediatric Point of Care Ultrasound (POCUS) in the injured patient. POCUS has become useful across various medical specialties owing to its ease of use, reproducibility and non-ionizing qualities. Point of care ultrasound has advanced over the past years and has proven to be an extremely useful adjunct in the injured child. Discussion will center around the challenges on when and how to best utilize POCUS. This includes but is not limited to: detection of peritoneal free fluid, pneumothoraces, hemothoraces, pericardial effusions, a wide array of fractures, lung contusions and many other applications...
February 1, 2018: Current Pediatric Reviews
Bruno Donadille, Muriel Houang, Irene Netchine, Jean-Pierre Siffroi, Sophie Christin-Maitre
Human 3 beta-hydroxysteroid dehydrogenase deficiency (3b-HSD) is a very rare form of congenital adrenal hyperplasia resulting from HSD3B2 gene mutations. Its estimated prevalence is less than 1/1,000,000 male neonates. It leads to steroidogenesis impairment in both adrenals and gonads. Few data are available on adult testicular function in such patients. Therefore, we evaluated gonadal axis and testicular function in a 46,XY adult patient, carrying a HSD3B2 mutation. The patient presented at birth with neonatal salt wasting syndrome, a micropenis, perineal hypospadias and intrascrotal testes...
February 2, 2018: Endocrine Connections
Ganna Pogrebna, Andrew J Oswald, David Haig
Using ultrasound scan data from paediatric hospitals, and the exogenous 'shock' of learning the gender of an unborn baby, the paper documents the first causal evidence that offspring gender affects adult risk-aversion. On a standard Holt-Laury criterion, parents of daughters, whether unborn or recently born, become almost twice as risk-averse as parents of sons. The study demonstrates this in longitudinal and cross-sectional data, for fathers and mothers, for babies in the womb and new-born children, and in a West European nation and East European nation...
January 8, 2018: Journal of Health Economics
Zondiwe Victor Mwanza, Mignon McCulloch, Mark Drayson, Timothy Plant, David V Milford, Gavin Dreyer
BACKGROUND: There is a paucity of data on paediatric kidney disease in developing countries such as Malawi. Descriptive research on kidney disease is essential to improving patient outcomes. METHODS: We conducted a cross-sectional study at a tertiary hospital in Malawi from 2012 to 2013. Children under 14 years with proteinuric kidney disease were enrolled from paediatric wards and outpatient clinics at Queen Elizabeth Central Hospital (QECH). Demographic, clinical and laboratory data were collected from patients at enrolment and at 3 months review at which point clinical status and disease outcome were ascertained...
January 31, 2018: BMC Nephrology
Kee Yong Wong, Ram Jeeneea, Andrew Healey, Laurence Abernethy, Harriet Corbett, Fiona McAndrew, Paul Losty
INTRODUCTION: To report the management and outcome of paediatric patients sustaining high grade blunt renal trauma. PATIENTS AND METHODS: Medical records were examined for all Grade III to Grade V blunt renal trauma cases admitted to a paediatric trauma centre during the era(s) 2005 to 2015. Data collected and analysed included - demographics, imaging modalities, management, length of hospital stay, complications and follow-up outcome(s). RESULTS: 18 children (12 males, 6 females) with mean age 11 years (4 - 15) were included...
January 23, 2018: BJU International
Brooke T Lawson, Ian A Zealley
PURPOSE: Central venous access in children, in particular small children and infants, is challenging. We have developed a technique employing adult peripherally inserted central venous catheters (PICCs) as tunnelled central venous catheters (TCVCs) in children. The principal advantage of this novel technique is that the removal technique is less complex than that of conventional cuffed TCVCs. The catheter can be removed simply by being pulled out and does not require general anaesthesia...
January 17, 2018: Cardiovascular and Interventional Radiology
Manish Kiran, Saffwan Mohamed, Ashley Newton, Harvey George, Neeraj Garg, Colin Bruce
AIMS: We present the largest series of paediatric pelvic pyomyositis from a temperate country, analyse the factors influencing long term prognosis and suggest a diagnostic protocol. MATERIALS AND METHOD: We included 41 patients diagnosed with primary paediatric pelvic pyomyositis between 1998 and 2016, in this study with a mean age of 7.5 years. Demographic, clinical, radiological and follow-up data were reviewed. Statistical analysis was performed to analyse the influence of early diagnosis and treatment on the final outcome...
December 30, 2017: International Orthopaedics
Giorgia Falanga, Marco Moscatelli, Giana Izzo, Cecilia Parazzini, Chiara Doneda, Andrea Righini
OBJECTIVE: To evaluate single-shot (ss) FLAIR sequence in the detection of intraventricular anomalies in a series of fetuses showing mild-moderate ventriculomegaly at ultrasound. SUBJECTS AND METHODS: Fetuses with mild-moderate isolated ventriculomegaly, which underwent MR imaging between 2003 and 2014 were considered eligible. Fetuses were examined by standard MR protocol and ss-FLAIR sequence, tailored for snapshot imaging. Two paediatric neuroradiologists evaluated MR images...
December 28, 2017: Journal of Computer Assisted Tomography
Gonçalo Nunes, Hélder Coelho, Marta Patita, Rita Barosa, Pedro Pinto Marques, Lídia Roque Ramos, Maria José Brito, Aurora Tomaz, Jorge Fonseca
The authors describe a 31-year-old man admitted due to progressive weight loss, diarrhea and massive hepatomegaly. Laboratory data showed anemia (haemoglobin 11.7 g/dl), abnormal liver tests (total bilirubin 1.4 g/dl, aspartate aminotransferase 70 U/l, alanine aminotransferase 37 U/l and alkaline phosphatase 520 U/l). Abdominal ultrasound (US) displayed a large heterogeneous liver with a segment IV 25 mm nodule. Magnetic resonance revealed a 4 cm pancreatic tail mass and several liver nodules consistent with metastasis...
December 28, 2017: Clinical Journal of Gastroenterology
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