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Paediatric Radiology

L Alejo, E Corredoira, F Sánchez-Muñoz, C Huerga, Z Aza, R Plaza-Núñez, A Serrada, M Bret-Zurita, M Parrón, C Prieto-Areyano, G Garzón-Moll, R Madero, E Guibelalde
Objective: The new 2013/59 EURATOM Directive (ED) demands dosimetric optimisation procedures without undue delay. The aim of this study was to optimise paediatric conventional radiology exams applying the ED without compromising the clinical diagnosis. METHODS: Automatic dose management software (ADMS) was used to analyse 2678 studies of children from birth to 5 years of age, obtaining local diagnostic reference levels (DRLs) in terms of entrance surface air kerma. Given local DRL for infants and chest exams exceeded the European Commission (EC) DRL, an optimisation was performed decreasing the kVp and applying the automatic control exposure...
March 14, 2018: British Journal of Radiology
Patrick W Hales, Victoria Smith, Deepi Dhanoa-Hayre, Patricia O'Hare, Kshitij Mankad, Felice d'Arco, Jessica Cooper, Ramneek Kaur, Kim Phipps, Richard Bowman, Darren Hargrave, Christopher Clark
Background: Radiological biomarkers which correlate with visual function are needed to improve the clinical management of optic pathway glioma (OPG) patients. Currently, these are not available using conventional magnetic resonance imaging (MRI) sequences. The aim of this study was to determine whether diffusion MRI could be used to delineate the entire optic pathway in OPG patients, and provide imaging biomarkers within this pathway which correlate with a patient's visual acuity (VA)...
2018: NeuroImage: Clinical
S R Sharp, S M Patel, R E Brown, C Landes
AIM: To assess whether the inclusion of skull radiography, as part of the skeletal survey performed in suspected non-accidental injury (NAI), is still justified when volume computed tomography (CT) of the head has also been performed. MATERIALS AND METHODS: This was a retrospective study which included 94 patients aged between 24 days and 23 months who presented to the Emergency Department between August 2014 to July 2016 and had subsequent investigations for suspected NAI...
March 1, 2018: Clinical Radiology
Natalie Hutchings, Wendy Wood, Isabel Reading, Erin Walker, Jane M Blazeby, William Van't Hoff, Bridget Young, Esther M Crawley, Simon Eaton, Maria Chorozoglou, Frances C Sherratt, Lucy Beasant, Harriet Corbett, Michael P Stanton, Simon Grist, Elizabeth Dixon, Nigel J Hall
BACKGROUND: Currently, the routine treatment for acute appendicitis in the United Kingdom is an appendicectomy. However, there is increasing scientific interest and research into non-operative treatment of appendicitis in adults and children. While a number of studies have investigated non-operative treatment of appendicitis in adults, this research cannot be applied to the paediatric population. Ultimately, we aim to perform a UK-based multicentre randomised controlled trial (RCT) to test the clinical and cost effectiveness of non-operative treatment of acute uncomplicated appendicitis in children, as compared with appendicectomy...
March 2, 2018: Trials
Sara C Tho-Calvi, Dominic Thompson, Dawn Saunders, Shakti Agrawal, Anna Basu, Manali Chitre, Gabriel Chow, Frances Gibbon, Anthony Hart, Krishnaraya Kamath Tallur, Fenella Kirkham, Rachel Kneen, Helen McCullagh, Leena Mewasingh, Grace Vassallo, Kayal Vijayakumar, Elizabeth Wraige, Tong Hong Yeo, Vijeya Ganesan
OBJECTIVE: To describe characteristics and course of a large UK cohort of children with moyamoya from multiple centers and examine prognostic predictors. METHODS: Retrospective review of case notes/radiology, with use of logistic regression to explore predictors of outcome. RESULTS: Eighty-eight children (median presentation age 5.1 years) were included. Thirty-six presented with arterial ischemic stroke (AIS) and 29 with TIA. Eighty had bilateral and 8 unilateral carotid circulation disease; 29 patients had posterior circulation involvement...
February 27, 2018: Neurology
Alison Nutter, Garth Meckler, Mimi Truong, Quynh Doan
Background: Constipation is a common condition in children. Little is known about the acute health care utilization of constipated children, including how many present to the paediatric emergency department (ED), the spectrum of presenting complaints, investigations and treatments used. Methods: We conducted a cross-sectional chart review of all 42,875 visits to British Columbia Children's Hospital ED between August 31, 2012 and September 1, 2013. All visits were assessed for a potential diagnosis of constipation and a total of 913 patients were included...
June 2017: Paediatrics & Child Health
A-L Simon, N Apostolou, C Vidal, E Ferrero, K Mazda, B Ilharreborde
Purpose: Elastic stable intramedullary nailing is increasingly used for surgical treatment of tibial shaft fractures, but frequently requires immobilization and delayed full weight-bearing. Therefore, external fixation remains interesting. The aim was to report clinico-radiological outcomes of monolateral external fixation for displaced and unstable tibial shaft fractures in children. Methods: All tibial fractures consecutively treated by monolateral external fixation between 2008 and 2013 were followed...
February 1, 2018: Journal of Children's Orthopaedics
Thomas Breil, Catherine Lorz, Daniela Choukair, Janna Mittnacht, Ioana Inta, Daniela Klose, Jessica Jesser, Egbert Schulze, Markus Bettendorf
BACKGROUND: Paediatric prolactinomas are rare. The aim of this study was to investigate the clinical features and outcome of paediatric patients with prolactinomas. METHODS: In this single-centre retrospective analysis, clinical, biochemical, and radiological features of all paediatric patients with pituitary adenomas diagnosed between 2000 and 2016 were evaluated. RESULTS: Among 21 patients with pituitary adenomas, 12 patients with prolactinomas (median age 14...
February 16, 2018: Hormone Research in Pædiatrics
S Buratovic, B Stenerlöw, S Sundell-Bergman, A Fredriksson, H Viberg, T Gordh, P Eriksson
BACKGROUND: Radiological methods for screening, diagnostics and therapy are frequently used in healthcare. In infants and children, anaesthesia/sedation is often used in these situations to relieve the patients' perception of stress or pain. Both ionising radiation (IR) and ketamine have been shown to induce developmental neurotoxic effects and this study aimed to identify the combined effects of these in a murine model. METHODS: Male mice were exposed to a single dose of ketamine (7...
March 2018: British Journal of Anaesthesia
Neil Chotai, Sulaiman Alazzawi, Syeda Saman Zehra, Matthew Barry
AIMS: The aim of this retrospective review was to identify all children that presented to our institution with a pelvic or acetabular fracture and to compare these children to a previous cohort of paediatric pelvic fractures that we have reported. PATIENTS: 53 children under the age of 16 were identified over a ten year period. METHODS: We reviewed our trauma database, hospital records and radiological imaging to determine the age, gender, fracture pattern, associated injuries and management of the pelvic fracture...
February 11, 2018: Injury
Trevor William Lambert, Fay Smith, Michael J Goldacre
OBJECTIVE: To report the career specialty choices of UK medical graduates of 2015 one year after graduation and to compare these with the choices made at the same postgraduate stage by previous cohorts. DESIGN: National survey using online and postal questionnaires. SETTING: UK. PARTICIPANTS: UK-trained medical graduates. MAIN OUTCOME MEASURES: Grouped and individual specialty choices. RESULTS: The response rate was 41...
February 12, 2018: Postgraduate Medical Journal
Shilpa Ojha, Julian Gaskin
Spontaneous pneumomediastinum is the presence of free air within the mediastinum that is not associated with trauma. It is a rare, self-limiting condition that can cause widespread subcutaneous surgical emphysema. We present the case of a 12-year-old boy who presented with widespread spontaneous surgical emphysema and pneumomediastinum, with no history of trauma or respiratory tract disease. We discuss our assessment of him and management with our multidisciplinary team (MDT), and whether radiological investigations including CT are helpful in such cases...
February 11, 2018: BMJ Case Reports
Jo-Fen Liu, Robert A Dineen, Shivaram Avula, Tom Chambers, Manali Dutta, Tim Jaspan, Donald C MacArthur, Simon Howarth, Daniele Soria, Philip Quinlan, Srikrishna Harave, Chan Chang Ong, Conor L Mallucci, Ram Kumar, Barry Pizer, David A Walker
BACKGROUND: Despite previous identification of pre-operative clinical and radiological predictors of post-operative paediatric cerebellar mutism syndrome (CMS), a unifying pre-operative risk stratification model for use during surgical consent is currently lacking. The aim of the project is to develop a simple imaging-based pre-operative risk scoring scheme to stratify patients in terms of post-operative CMS risk. METHODS: Pre-operative radiological features were recorded for a retrospectively assembled cohort of 89 posterior fossa tumour patients from two major UK treatment centers (age 2-23yrs; gender 28 M, 61 F; diagnosis: 38 pilocytic astrocytoma, 32 medulloblastoma, 12 ependymoma, 1 high grade glioma, 1 pilomyxoid astrocytoma, 1 atypical teratoid rhabdoid tumour, 1 hemangioma, 1 neurilemmoma, 2 oligodendroglioma)...
February 12, 2018: British Journal of Neurosurgery
N Ozveren, G Serindere
OBJECTIVES: Dental age (DA) estimation is frequently used in the fields of orthodontics, paediatric dentistry and forensic science. DA estimation methods use radiology, and are reliable and non-destructive according to the literature. The Demirjian method is currently the most frequently used method, but recently, the Willems method was reported to have given results that were more accurate for some regions. The aim of this study was to detect and compare the accuracy of DA estimation methods for children and adolescents from the Thrace region, Turkey...
January 31, 2018: Forensic Science International
Alexander J Towbin, Rebecka L Meyers, Helen Woodley, Osamu Miyazaki, Christopher B Weldon, Bruce Morland, Eiso Hiyama, Piotr Czauderna, Derek J Roebuck, Greg M Tiao
Imaging is crucial in the assessment of children with a primary hepatic malignancy. Since its inception in 1992, the PRETEXT (PRE-Treatment EXTent of tumor) system has become the primary method of risk stratification for hepatoblastoma and pediatric hepatocellular carcinoma in numerous cooperative group trials across the world. The PRETEXT system is made of two components: the PRETEXT group and the annotation factors. The PRETEXT group describes the extent of tumor within the liver while the annotation factors help to describe associated features such as vascular involvement (either portal vein or hepatic vein/inferior vena cava), extrahepatic disease, multifocality, tumor rupture and metastatic disease (to both the lungs and lymph nodes)...
February 9, 2018: Pediatric Radiology
Samit Unadkat, Ashok Adams, Polly Richards, Yogesh Bajaj
Aneurysmal bone cysts (ABCs) are expansile cystic lesions that can affect any bone of the body. Whilst these lesions are histologically benign, the lesions are locally aggressive and can affect the integrity of the affected bone as well as surrounding structures. ABCs arising in the head and neck region, particularly the paranasal sinuses are rare and they are limited to case reports in the literature. Due to the proximity of critical anatomical structures and the visual apparatus, the potential complications can be devastating...
February 2018: Journal of Surgical Case Reports
C Matthew Hawkins, Alexander J Towbin, Derek J Roebuck, Eric J Monroe, Anne E Gill, Avnesh S Thakor, Richard B Towbin, Anne Marie Cahill, Matthew P Lungren
Hepatoblastoma and hepatocellular carcinoma (HCC) are the most common pediatric liver malignancies, with hepatoblastoma occurring more commonly in younger children and HCC occurring more commonly in older children and adolescents. Although surgical resection (including transplant when necessary) and systemic chemotherapy have improved overall survival rate for hepatoblastoma to approximately 80% from 30%, a number of children with this tumor type are not eligible for operative treatment. In contradistinction, pediatric HCC continues to carry a dismal prognosis with an overall 5-year survival rate of 30%...
February 2, 2018: Pediatric Radiology
Tahleesa Cuda, Ronny Gunnarsson, Alan de Costa
BACKGROUND: Acquired Megacolon (AMC) is a condition involving persistent dilatation and lengthening of the colon in the absence of organic disease. Diagnosis depends on subjective radiological, endoscopic or surgical findings in the context of a suggestive clinical presentation. This review sets out to investigate diagnostic criteria of AMC. METHODS: The literature was searched using the databases - PubMed, Medline via OvidSP, ClinicalKey, Informit and the Cochrane Library...
January 31, 2018: BMC Gastroenterology
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
Anna Burford, Alan Mackay, Sergey Popov, Maria Vinci, Diana Carvalho, Matthew Clarke, Elisa Izquierdo, Aimee Avery, Thomas S Jacques, Wendy J Ingram, Andrew S Moore, Kieran Frawley, Timothy E Hassall, Thomas Robertson, Chris Jones
Astroblastomas are rare brain tumours which predominate in children and young adults, and have a controversial claim as a distinct entity, with no established WHO grade. Reports suggest a better outcome than high grade gliomas, though they frequently recur. Recently, they have been described to overlap with a newly-discovered group of tumours described as'high grade neuroepithelial tumour with MN1 alteration' (CNS HGNET-MN1), defined by global methylation patterns and strongly associated with gene fusions targeting MN1...
January 18, 2018: Scientific Reports
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