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Sample records for pediatric neuroradiology paediatrische

  1. Pediatric neuroradiology; Paediatrische Neuroradiologie

    Energy Technology Data Exchange (ETDEWEB)

    Erlt-Wagner, B. [Klinikum Grosshadern, Muenchen (Germany). Inst. fuer klinische Radiologie

    2007-07-01

    The book provides an optimum support for pediatricians wirth respect to the diagnosis of neurosystem diseases. The book covers the embryological development of the brain, congenital disfunctions of the infantile brain, the phakomatosis syndrome, metabolic disturbances, autoimmune and toxically induced diseases, infantile apoplexy and vascular malfunctions, affection-based diseases, hypoxic-ischemic lesions, hydrocephalus, traumatic diseases, infantile brain tumors, congenital disfunctions of the infantile spine, spinal tumors, tumors in the eye.

  2. The Neuroradiological Spectra of Adult and Pediatric Medulloblastoma Differ

    DEFF Research Database (Denmark)

    Beier, Dagmar; Kocakaya, Selin; Hau, Peter

    2018-01-01

    PURPOSE: Current knowledge on the spectrum of the neuroradiological appearance of adult medulloblastoma is sparse. Due to the rarity of the disease, adult patients were generally diagnosed and treated similar to children; however, pediatric and adult medulloblastomas display substantial molecular...... differences that may influence the neuroradiological phenotype. This study therefore aimed at assessment of the neuroradiological spectrum of adult medulloblastoma in comparison to pediatric tumors. METHODS: All available publications on adult medulloblastoma published until June 2013 were screened...... for imaging data on single patients. A total of 109 patients were identified and compared to 118 pediatric patients described in 4 cohorts. RESULTS: The average age of the adult patients was 34.3 years. Most adult medulloblastomas (57.6 %) were localized laterally (vs. 14.4 % in pediatric patients). On T1...

  3. Brain tumors and CT scan in infants and children, (1). The impact on pediatric neuroradiology

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    Ohi, S; Velasco, J M [Northwestern Univ., Chicago, IL (USA). Medical School

    1980-10-01

    The dramatic change in the neuroradiological procedures have been noted after CT scan was introduced in the last several years. Remarkable decreasing numbers of angiographic, pneumoencephalographic and other invasive neuroradiologic studies as well as nuclear brain scan were also found in the pediatric neuroradiology. The authors analyzed the total numbers of these studies performed in the last several years in pediatric neurological/neurosurgical practice in the light of the impact of CT scan especially in the diagnostic procedures and treatments of brain tumor in children. Although the number of these procedures decreased up to 49% in plain skull X-ray, 54% in cerebral angiography, 70% in pneumoencephalography/ventriculography and 79% in nuclear brain scan after CT scan was installed in our results, it is extremely important to renew understanding of those characteristics in each special procedures. Cerebral angiography as well as pneumoencephalography may give the surgeon more precise ideas of the anatomical relationship between the lesion and other normal structures, especially in the posterior fossa tumor in which CT scan occassionally demonstrates only a gross finding. A case with false negative result and another case with a complicated anatomical structure in CT scan were presented. The significance of cerebral angiography and other invasive studies in the diagnosis and follow up of brain tumor in CT scan were discussed.

  4. Update on radiation safety and dose reduction in pediatric neuroradiology

    International Nuclear Information System (INIS)

    Mahesh, Mahadevappa

    2015-01-01

    The number of medical X-ray imaging procedures is growing exponentially across the globe. Even though the overall benefit from medical X-ray imaging procedures far outweighs any associated risks, it is crucial to take all necessary steps to minimize radiation risks to children without jeopardizing image quality. Among the X-ray imaging studies, except for interventional fluoroscopy procedures, CT studies constitute higher dose and therefore draw considerable scrutiny. A number of technological advances have provided ways for better and safer CT imaging. This article provides an update on the radiation safety of patients and staff and discusses dose optimization in medical X-ray imaging within pediatric neuroradiology. (orig.)

  5. Update on radiation safety and dose reduction in pediatric neuroradiology

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    Mahesh, Mahadevappa [Johns Hopkins University School of Medicine, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States)

    2015-09-15

    The number of medical X-ray imaging procedures is growing exponentially across the globe. Even though the overall benefit from medical X-ray imaging procedures far outweighs any associated risks, it is crucial to take all necessary steps to minimize radiation risks to children without jeopardizing image quality. Among the X-ray imaging studies, except for interventional fluoroscopy procedures, CT studies constitute higher dose and therefore draw considerable scrutiny. A number of technological advances have provided ways for better and safer CT imaging. This article provides an update on the radiation safety of patients and staff and discusses dose optimization in medical X-ray imaging within pediatric neuroradiology. (orig.)

  6. Ultrafast MR Imaging in Pediatric Neuroradiology

    International Nuclear Information System (INIS)

    Singh, R.K.; Smith, J.T.; Wilkinson, I.D.; Griffiths, P.D.

    2003-01-01

    Purpose: To compare the diagnostic information obtained from ultrafast MR imaging with standard MR imaging techniques in pediatric neuroradiology. The goal was to judge whether ultrafast methods can be used to replace standard methods and reduce the need for sedation or general anesthesia as a result of the considerably shorter scan times. Material and Methods: Our prospective study involved 125 patients. Routine clinical imaging was performed along with two ultrafast methods. Single shot fast spin echo (SSFSE) was used to give T2-weighted images and an echo planar imaging (EPI) sequence to provide a T1-weighted images. The ultrafast images were presented to an experienced neuro radiologist who was also given the information present on the initial referral card. These reports based on the ultrafast images were then compared with the formal radiologic report made solely on the basis of the standard imaging. Results: The overall sensitivity and specificity for ultrafast imaging when compared to the reference standard were 78% and 98% with positive and negative predictive values of 98% and 76%. Pathologies characterized by small areas of subtle T2 prolongation were difficult or impossible to see on the ultrafast images but otherwise they provided reliable information. Conclusions: This paper demonstrates that ultrafast MR imaging can diagnose many pediatric intracranial abnormalities as well as standard methods. Anatomic resolution limits its capacity to define subtle developmental anomalies and contrast resolution limitations of the ultrafast methods reduce the detection of pathology characterized by subtle T2 prolongation

  7. Sedation for pediatric neuroradiological examinations. Retrospective study of 160 cases

    International Nuclear Information System (INIS)

    Shose, Yoshiteru; Oi, Shizuo

    1995-01-01

    A retrospective study of 160 pediatric neuroradiological examinations was conducted to determine the efficacy and safety of two sedation regimens (figs. 1, 2). For CT purposes, 150 patients (fig. 3) were orally given monosodium trichlorethyl phosphate syrup (100 mg/kg, with repeat 50 mg/kg if necessary), and for cerebral angiography, 15 patients (fig. 4) were intramuscularly administered a modified D.P.T. cocktail (pentazocine, chlorpromadine, promethazine). Failure rate in the oral syrup group was 6%, and in the D.P.T. group 6.7%. Diagnostic-quality images were obtained in 99.3% and 100%, respectively, of the two groups. There were neither mortality nor significant complications (table 3). It was concluded that each method had proved acceptably safe and effective, and that measures can be taken to further decrease complications and sedation failures. (author)

  8. The development of paediatric neuroradiology

    International Nuclear Information System (INIS)

    Harwood-Nash, D.C.

    1978-01-01

    The development of paediatric neuroradiology is a specific persuasion within neuroradiology and has increased in scope and significance throughout the last ten years. The emergence of computed tomography has altered the indications for types of neuroradiological procedures in infants and children. The sophistication, accuracy, and safety of standard neuroradiological procedures have been increased by the accuracy and safety of computed tomography, particularly in the premature infant. There is a growing need for education and instruction in paediatric neuroradiological techniques and paediatric neuroradiological diseases within the neuroradiological fraternity as a whole. (orig.) [de

  9. Pediatric AIDS. Neuroradiologic and neurodevelopmental findings

    Energy Technology Data Exchange (ETDEWEB)

    Price, D.B.; Haller, J.O.; Kramer, J.; Hotson, G.C.; Loh, J.P.; Schlusselberg, D.; Inglese, C.M.; Jacobs, J.; Rose, A.L.; Menez-Bautista, R.

    1988-09-01

    A group of 23 pediatric patients seropositive for HIV antibody were studied by computed tomography and evaluated neurodevelopmentally. Significant neurodevelopmental delays were found in over 95% of the patients studied. CT findings in six patients were normal and thirteen of 23 (57%) had prominence of the CSF spaces. Less frequent findings included calcifications in the basal ganglia and white matter. Cerebral mass lesions included one case of lymphoma and one case of hemorrhage. The CT findings in the pediatric age group differs from the adult population in that that contrast enhancing inflammatory mass lesions are uncommon.

  10. 40{sup th} Annual meeting of the European Society of Neuroradiology. Diagnostic and interventional. 24{sup th} Advanced course in diagnostic neuroradiology and 9{sup th} Advanced course in interventional neuroradiology. ESNR 2017

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    NONE

    2017-09-15

    The volume covers the issues of the 40{sup th} Annual meeting of the European Society of Neuroradiology, the 24{sup th} advanced course in diagnostic neuroradiology and the 9{sup th} advanced course in interventional neuroradiology (ESNR 2017). The main issues of the sessions were the neuroradiological impact in diagnosis and treatment, neurodegenerative diseases, acute stroke - new horizons in diagnosis and treatment, case presentations concerning brain tumors, epilepsy, dementia, trauma.

  11. Deep Learning in Neuroradiology.

    Science.gov (United States)

    Zaharchuk, G; Gong, E; Wintermark, M; Rubin, D; Langlotz, C P

    2018-02-01

    Deep learning is a form of machine learning using a convolutional neural network architecture that shows tremendous promise for imaging applications. It is increasingly being adapted from its original demonstration in computer vision applications to medical imaging. Because of the high volume and wealth of multimodal imaging information acquired in typical studies, neuroradiology is poised to be an early adopter of deep learning. Compelling deep learning research applications have been demonstrated, and their use is likely to grow rapidly. This review article describes the reasons, outlines the basic methods used to train and test deep learning models, and presents a brief overview of current and potential clinical applications with an emphasis on how they are likely to change future neuroradiology practice. Facility with these methods among neuroimaging researchers and clinicians will be important to channel and harness the vast potential of this new method. © 2018 by American Journal of Neuroradiology.

  12. PET imaging in pediatric neuroradiology: current and future applications

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    Kim, Sunhee [Children' s Hospital of Pittsburgh of UPMC, Department of Radiology, Pittsburgh, PA (United States); Salamon, Noriko [UCLA David Geffen School of Medicine at UCLA, Department of Radiology, Ronald Reagan UCLA Medical Center, Los Angeles, CA (United States); Jackson, Hollie A.; Blueml, Stefan [Keck School of Medicine of USC, Department of Radiology, Childrens Hospital Los Angeles, Los Angeles, CA (United States); Panigrahy, Ashok [Children' s Hospital of Pittsburgh of UPMC, Department of Radiology, Pittsburgh, PA (United States); Keck School of Medicine of USC, Department of Radiology, Childrens Hospital Los Angeles, Los Angeles, CA (United States)

    2010-01-15

    Molecular imaging with positron emitting tomography (PET) is widely accepted as an essential part of the diagnosis and evaluation of neoplastic and non-neoplastic disease processes. PET has expanded its role from the research domain into clinical application for oncology, cardiology and neuropsychiatry. More recently, PET is being used as a clinical molecular imaging tool in pediatric neuroimaging. PET is considered an accurate and noninvasive method to study brain activity and to understand pediatric neurological disease processes. In this review, specific examples of the clinical use of PET are given with respect to pediatric neuroimaging. The current use of co-registration of PET with MR imaging is exemplified in regard to pediatric epilepsy. The current use of PET/CT in the evaluation of head and neck lymphoma and pediatric brain tumors is also reviewed. Emerging technologies including PET/MRI and neuroreceptor imaging are discussed. (orig.)

  13. PET imaging in pediatric neuroradiology: current and future applications

    International Nuclear Information System (INIS)

    Kim, Sunhee; Salamon, Noriko; Jackson, Hollie A.; Blueml, Stefan; Panigrahy, Ashok

    2010-01-01

    Molecular imaging with positron emitting tomography (PET) is widely accepted as an essential part of the diagnosis and evaluation of neoplastic and non-neoplastic disease processes. PET has expanded its role from the research domain into clinical application for oncology, cardiology and neuropsychiatry. More recently, PET is being used as a clinical molecular imaging tool in pediatric neuroimaging. PET is considered an accurate and noninvasive method to study brain activity and to understand pediatric neurological disease processes. In this review, specific examples of the clinical use of PET are given with respect to pediatric neuroimaging. The current use of co-registration of PET with MR imaging is exemplified in regard to pediatric epilepsy. The current use of PET/CT in the evaluation of head and neck lymphoma and pediatric brain tumors is also reviewed. Emerging technologies including PET/MRI and neuroreceptor imaging are discussed. (orig.)

  14. Radiation dose and cancer risk among pediatric patients undergoing interventional neuroradiology procedures

    International Nuclear Information System (INIS)

    Thierry-Chef, Isabelle; Simon, Steven L.; Miller, Donald L.

    2006-01-01

    During interventional neuroradiology procedures, patients can be exposed to moderate to high levels of radiation. Special considerations are required to protect children, who are generally more sensitive to the short- and long-term detrimental effects of radiation exposure. Estimates of dose to the skin of children from certain interventional procedures have been published elsewhere, but we are not aware of data on dose to the brain or on the long-term risk of cancer from brain radiation. Our goals were to estimate radiation doses to the brain in 50 pediatric patients who had undergone cerebral embolization and to assess their lifetime risks of developing radiation-related brain cancer. Entrance-peak skin dose and various assumptions on conditions of exposure were used as input for dosimetric calculations to estimate the spatial pattern of dose within the brain and the average dose to the whole brain for each child. The average dose and the age of the child at time of exposure were used to estimate the lifetime risk of developing radiation-related brain cancer. Among the 50 patients, average radiation doses to the brain were estimated to vary from 100 mGy to 1,300 mGy if exposed to non-collimated fields and from 20 mGy to 160 mGy for collimated, moving fields. The lifetime risk of developing brain cancer was estimated to be increased by 2% to 80% as a result of the exposure. Given the very small lifetime background risk of brain tumor, the excess number of cases will be small even though the relative increase might be as high as 80%. ALARA principles of collimation and dose optimization are the most effective means to minimize the risk of future radiation-related cancer. (orig.)

  15. Intraarterial digital subtraction angiography in neuroradiology

    International Nuclear Information System (INIS)

    Zeumer, H.

    1987-01-01

    Neuroradiology always could make best use of subtraction methods, due to the relative immobility and constant shape of the skull. Arterial DSA now has extended the potential uses while reducing the patient's radiation exposure, the contrast medium dosage and osmolarity. The considerable cut-back in time required for invasive examination has reduced the risk of diagnostic and therapeutic measures. The advantages consisting of immediate image display with high contrast resolution in most of the diagnostic tasks counterbalance the disadvantage of low focal resolution of the DSA in neuroradiology. Interventional neuroradiology today cannot do without i.a. DSA. (orig.) [de

  16. Staff exposure in pediatric interventional neuroradiology: focus on the operator's eye lens

    International Nuclear Information System (INIS)

    Bolomey, C.; Fasel, G.; Le Coultre, R.; Ryckx, N.

    2016-01-01

    Previously at 150 mSv year -1 , the ICRP now recommends limiting the equivalent dose to the eye lens to 20 mSv year -1 . For pediatric interventional neuroradiology, the exposure of the operator's eye lens may be increased by the use of a biplane fluoroscopy system and by the proximity of the physician to the patient. In practice, the efficiency of leaded glasses depends on many factors. This study addresses both aspects. First, the eye lens dose of a neuro-radiologist was measured during 12 procedures using 36 TLDs placed on his surgical cap. Secondly, in order to determine the efficiency of leaded glasses, measurements were carried out by reproducing the clinical conditions. A detector was placed on the left eye of a phantom representing the operator. Four pairs of leaded glasses were selected to test various parameters. During the 12 procedures, an individual dose equivalent Hp(0.07) of 45μSv was obtained for the eye lens closest to the tube. This study shows an eye lens dose to DAP ratio 5 times higher than for procedures performed on adult patients. The eye lens dose might be reduced by a factor of approximately 3 with the use of appropriate leaded glasses. The eye wear model with the most coverage reduces the dose by up to 50% more than the model with the least coverage. The addition of lateral protection increases the attenuation by up to 13% compared with the same model without side protection. (authors)

  17. The birth and growth of neuroradiology in the USA

    International Nuclear Information System (INIS)

    Gutierrez, C.; Goettingen Univ. Germany, F.R. Klinik fuer Neurochirurgie)

    1981-01-01

    Neuroradiology in the USA was started by the neurosurgeons Harvey Cushing, who personally made the first X-rays used to treat a patient with a neurological disability, and Walter Dandy, who first performed air ventriculography, ventriculoscopy, air encephalography and air myelography. The father of neuroradiology in the USA was Merrill Sosman, Cushing's associate. Modern neuroradiology was introduced into the USA from Europe by Mannie Schechter who was one of the original team of three Chief Editors of Neuroradiology. (orig.)

  18. Magnetic resonance spectroscopy in pediatric neuroradiology: clinical and research applications

    International Nuclear Information System (INIS)

    Panigrahy, Ashok; Nelson, Marvin D.; Blueml, Stefan

    2010-01-01

    Magnetic resonance spectroscopy (MRS) offers a unique, noninvasive approach to assess pediatric neurological abnormalities at microscopic levels by quantifying cellular metabolites. The most widely available MRS method, proton ( 1 H; hydrogen) spectroscopy, is FDA approved for general use and can be ordered by clinicians for pediatric neuroimaging studies if indicated. There are a multitude of both acquisition and post-processing methods that can be used in the implementation of MR spectroscopy. MRS in pediatric neuroimaging is challenging to interpret because of dramatic normal developmental changes that occur in metabolites, particularly in the first year of life. Still, MRS has been proven to provide additional clinically relevant information for several pediatric neurological disease processes such as brain tumors, infectious processes, white matter disorders, and neonatal injury. MRS can also be used as a powerful quantitative research tool. In this article, specific research applications using MRS will be demonstrated in relation to neonatal brain injury and pediatric brain tumor imaging. (orig.)

  19. Adaptive statistical iterative reconstruction reduces patient radiation dose in neuroradiology CT studies

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    Komlosi, Peter; Zhang, Yanrong; Leiva-Salinas, Carlos; Ornan, David; Grady, Deborah [University of Virginia, Department of Radiology and Medical Imaging, Division of Neuroradiology, PO Box 800170, Charlottesville, VA (United States); Patrie, James T.; Xin, Wenjun [University of Virginia, Department of Public Health Sciences, Charlottesville, VA (United States); Wintermark, Max [University of Virginia, Department of Radiology and Medical Imaging, Division of Neuroradiology, PO Box 800170, Charlottesville, VA (United States); Centre Hospitalier Universitaire Vaudois, Department of Radiology, Lausanne (Switzerland)

    2014-03-15

    Adaptive statistical iterative reconstruction (ASIR) can decrease image noise, thereby generating CT images of comparable diagnostic quality with less radiation. The purpose of this study is to quantify the effect of systematic use of ASIR versus filtered back projection (FBP) for neuroradiology CT protocols on patients' radiation dose and image quality. We evaluated the effect of ASIR on six types of neuroradiologic CT studies: adult and pediatric unenhanced head CT, adult cervical spine CT, adult cervical and intracranial CT angiography, adult soft tissue neck CT with contrast, and adult lumbar spine CT. For each type of CT study, two groups of 100 consecutive studies were retrospectively reviewed: 100 studies performed with FBP and 100 studies performed with ASIR/FBP blending factor of 40 %/60 % with appropriate noise indices. The weighted volume CT dose index (CTDI{sub vol}), dose-length product (DLP) and noise were recorded. Each study was also reviewed for image quality by two reviewers. Continuous and categorical variables were compared by t test and free permutation test, respectively. For adult unenhanced brain CT, CT cervical myelography, cervical and intracranial CT angiography and lumbar spine CT both CTDI{sub vol} and DLP were lowered by up to 10.9 % (p < 0.001), 17.9 % (p = 0.005), 20.9 % (p < 0.001), and 21.7 % (p = 0.001), respectively, by using ASIR compared with FBP alone. Image quality and noise were similar for both FBP and ASIR. We recommend routine use of iterative reconstruction for neuroradiology CT examinations because this approach affords a significant dose reduction while preserving image quality. (orig.)

  20. Adaptive statistical iterative reconstruction reduces patient radiation dose in neuroradiology CT studies

    International Nuclear Information System (INIS)

    Komlosi, Peter; Zhang, Yanrong; Leiva-Salinas, Carlos; Ornan, David; Grady, Deborah; Patrie, James T.; Xin, Wenjun; Wintermark, Max

    2014-01-01

    Adaptive statistical iterative reconstruction (ASIR) can decrease image noise, thereby generating CT images of comparable diagnostic quality with less radiation. The purpose of this study is to quantify the effect of systematic use of ASIR versus filtered back projection (FBP) for neuroradiology CT protocols on patients' radiation dose and image quality. We evaluated the effect of ASIR on six types of neuroradiologic CT studies: adult and pediatric unenhanced head CT, adult cervical spine CT, adult cervical and intracranial CT angiography, adult soft tissue neck CT with contrast, and adult lumbar spine CT. For each type of CT study, two groups of 100 consecutive studies were retrospectively reviewed: 100 studies performed with FBP and 100 studies performed with ASIR/FBP blending factor of 40 %/60 % with appropriate noise indices. The weighted volume CT dose index (CTDI vol ), dose-length product (DLP) and noise were recorded. Each study was also reviewed for image quality by two reviewers. Continuous and categorical variables were compared by t test and free permutation test, respectively. For adult unenhanced brain CT, CT cervical myelography, cervical and intracranial CT angiography and lumbar spine CT both CTDI vol and DLP were lowered by up to 10.9 % (p < 0.001), 17.9 % (p = 0.005), 20.9 % (p < 0.001), and 21.7 % (p = 0.001), respectively, by using ASIR compared with FBP alone. Image quality and noise were similar for both FBP and ASIR. We recommend routine use of iterative reconstruction for neuroradiology CT examinations because this approach affords a significant dose reduction while preserving image quality. (orig.)

  1. 38th European Society of Neuroradiology. Diagnostic and interventional

    International Nuclear Information System (INIS)

    2015-01-01

    The volume contains abstracts of the 38th ESNR annual meeting covering the following topics: advanced tumor imaging, advanced tumor treatment, intracranial aneurisms, spine tumors and metastasis, spondilodiscitis update, interventional neuroradiology, dementia and movement disorders, intracranial vessel evaluation beyond morphology, neuroradiology - diagnostics, aneurysm treatment, publishing a paper and ideas, pain and sleep disturbances, neuroradiological treatment of CF syndrome, diffusion tractography: research advancements and clinical applications.

  2. Signs in neuroradiology - part 1

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    Goncalves, Fabricio Guimaraes, E-mail: goncalves.neuroradio@gmail.co [McGill University Health Centre (MUHC), Montreal, Quebec (Canada). Montreal General Hospital; Barra, Filipe Ramos; Jovem, Cassio Lemos [Hospital Universitario de Brasilia, DF (Brazil). Dept. of Radiology and Imaging Diagnosis; Matos, Valter de Lima [Hospital Santa Luzia, Brasilia, DF (Brazil); Amaral, Lazaro Luis Faria do [MedImagem - Hospital da Beneficencia Portuguesa de Sao Paulo, SP (Brazil). Dept. of Neuroradiology; Carpio-O' Donovan, Raquel del [McGill University Health Centre (MUHC), Montreal, Quebec (Canada)

    2011-03-15

    The use of signs or analogies for interpretation and description of medical images is an old and common practice among radiologists. Comparison of findings with animals, food or objects is not unprecedented and routinely performed. Many signs are quite specific and, in some cases, pathognomonic. Indeed, notwithstanding their degree of specificity, signs may help in the characterization of certain diseases. Several neuroradiological signs have been already described. The authors will present 15 neuroradiology signs in the present essay, approaching their main characteristics, the significance of their role in the clinical practice, as well as their respective imaging findings. (author)

  3. Signs in neuroradiology - part 1

    International Nuclear Information System (INIS)

    Goncalves, Fabricio Guimaraes; Amaral, Lazaro Luis Faria do

    2011-01-01

    The use of signs or analogies for interpretation and description of medical images is an old and common practice among radiologists. Comparison of findings with animals, food or objects is not unprecedented and routinely performed. Many signs are quite specific and, in some cases, pathognomonic. Indeed, notwithstanding their degree of specificity, signs may help in the characterization of certain diseases. Several neuroradiological signs have been already described. The authors will present 15 neuroradiology signs in the present essay, approaching their main characteristics, the significance of their role in the clinical practice, as well as their respective imaging findings. (author)

  4. 38{sup th} European Society of Neuroradiology. Diagnostic and interventional

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-09-15

    The volume contains abstracts of the 38th ESNR annual meeting covering the following topics: advanced tumor imaging, advanced tumor treatment, intracranial aneurisms, spine tumors and metastasis, spondilodiscitis update, interventional neuroradiology, dementia and movement disorders, intracranial vessel evaluation beyond morphology, neuroradiology - diagnostics, aneurysm treatment, publishing a paper and ideas, pain and sleep disturbances, neuroradiological treatment of CF syndrome, diffusion tractography: research advancements and clinical applications.

  5. 31. Congress and 15. Advanced course of the European Society of Neuroradiology. Abstracts

    International Nuclear Information System (INIS)

    Anon.

    2006-01-01

    The European Society of Neuroradiology (ESNR) was founded on September 5, 1969 during a meeting which took place in Colmar, France, upon the initiative of Drs Jean-Paul Braun (Colmar) and Auguste Wackenheim (Strasbourg) and under the guidance and support of Professor George B. Ziedses des Plantes (Amsterdam). The following purposes of the Society were unanimously adopted by the 68 Founding Members: 1. To promote Neuroradiology by appropriate means. 2. To co-ordinate work and documents in Neuroradiology and to assure their diffusion throughout the countries of Europe. 3. To co-ordinate the relationships between General Radiology and the Clinical Neurosciences. 4. To contribute toward unified methods of teaching Neuroradiology and unified standards for training and certification in Neuroradiology. 5. To promote and co-ordinate relationships among the European National Neuroradiological Societies and to promote the foundation of National Neuroradiological Societies. 6. To form European research teams to deal with specific neuroradiological questions. (orig.)

  6. Children with Congenital Hypothyroidism Have Similar Neuroradiological Abnormal Findings as Healthy Ones

    Directory of Open Access Journals (Sweden)

    Marianna Rachmiel

    2013-01-01

    Full Text Available Objective. To assess the neuroradiological findings of children with congenital hypothyroidism (CHT compared to healthy controls (HC. Patients and Methods. Thirty children with CHT, mean age 12.5 ± 1.6 years, 14 (44.8% males, were compared with 38 HC mean age 11.7 ± 1.7 years, 16 (45.7% males. Clinical data were collected from medical charts and questionnaires seeking information on family history, birth and perinatal period events, medications, and overall health history. Neurocognitive function was assessed for global intelligence, visual and verbal memory, and executive functioning using standardized tests. Neuroimaging was performed using 1.5 T magnetic resonance imaging and assessed by two pediatric radiologists. Results. Children with CHT had a similar proportion of incidental findings as did the children in the HC group, at 43.3% and 39.5%, respectively, . Abnormalities of the sellar region were reported in 13.3% of CHT group and 7.9% of HC group, . Other incidental findings included cerebellar ectopia, choroidal fissure and pineal cysts, and multiple increased signal intensity foci. Neuroradiological findings were not associated with clinical and neurocognitive abnormalities. Conclusion. Neuroimaging of children with CHT demonstrated a similar incidence of structural abnormalities as in the healthy population. There is no association between those findings and neurocognitive function.

  7. Influences for Gender Disparity in Academic Neuroradiology.

    Science.gov (United States)

    Ahmadi, M; Khurshid, K; Sanelli, P C; Jalal, S; Chahal, T; Norbash, A; Nicolaou, S; Castillo, M; Khosa, F

    2018-01-01

    There has been extensive interest in promoting gender equality within radiology, a predominately male field. In this study, our aim was to quantify gender representation in neuroradiology faculty rankings and determine any related factors that may contribute to any such disparity. We evaluated the academic and administrative faculty members of neuroradiology divisions for all on-line listed programs in the US and Canada. After excluding programs that did not fulfill our selection criteria, we generated a short list of 85 US and 8 Canadian programs. We found 465 faculty members who met the inclusion criteria for our study. We used Elsevier's SCOPUS for gathering the data pertaining to the publications, H-index, citations, and tenure of the productivity of each faculty member. Gender disparity was insignificant when analyzing academic ranks. There are more men working in neuroimaging relative to women (χ 2 = 0.46; P = .79). However, gender disparity was highly significant for leadership positions in neuroradiology (χ 2 = 6.76; P = .009). The median H-index was higher among male faculty members (17.5) versus female faculty members (9). Female faculty members have odds of 0.84 compared with male faculty members of having a higher H-index, adjusting for publications, citations, academic ranks, leadership ranks, and interaction between gender and publications and gender and citations (9). Neuroradiology faculty members follow the same male predominance seen in many other specialties of medicine. In this study, issues such as mentoring, role models, opportunities to engage in leadership/research activities, funding opportunities, and mindfulness regarding research productivity are explored. © 2018 by American Journal of Neuroradiology.

  8. Clinical utility and limitation of MRI in neuroradiology

    International Nuclear Information System (INIS)

    Aoki, Shigeki; Machida, Tohru; Shirouzu, Ichirou; Ohkubo, Toshiyuki; Sasaki, Yasushi.

    1992-01-01

    Magnetic resonance imaging (MRI) has several advantages over computed tomography in the neuroradiological field: it provids biochemical information, images in any plane without bone artifacts, and superior contrast between gray matter and white matter. It is, however, of limited availability because of longer imaging time, poor spatial resolution, and poor visualization of calcification and the bone. In this review, pathophysiology that shows relatively characteristic signal intensity is described, including hemorrhage, fat, protein-rich cyst, calcification, iron, and posterior pituitary gland. The utility and limitation of MRI are discussed in terms of the following diseases and lesion sites: small tumors in the skull base; demyelination of white matter or degenerative disease; cerebral infarction or cerebral ischemic disease; intramedullary lesion; meningeal lesion; and pediatric diseases such as medullary sheath formation and malformation. Finally, recent advance and future perspectives of MRI are presented, focusing on 3-dimensional imaging, MR angiography, fat-suppression MR imaging, MR spectroscopy, intravoxel incoherent motion imaging, imaging time, and spatial resolution. (N.K.) 82 refs

  9. Pediatric intraspinal neoplasms; Paediatrische intraspinale Neoplasien

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    Mueller, U.; Ahlhelm, F. [Kantonsspital Baden AG, Institut fuer Radiologie, Baden (Switzerland); Ulmer, S. [Medizinisch-Radiologisches Institut, Zuerich (Switzerland); Schlaeger, R. [Universitaetsspital Basel, Neurologische Klinik und Poliklinik, Basel (Switzerland); UCSF, Department of Neurology, San Francisco (United States)

    2014-08-15

    With an overall incidence of 10 % of all central nervous system tumors, spinal tumors are relatively rare in children. The majority of these tumors are astrocytomas and ependymomas (70 %) followed by rare non-glial tumor entities, such as gangliogliomas. They can be differentiated into intramedullary, extramedullary intradural and extramedullary extradural tumors according to their occurrence within the anatomical intraspinal compartments. The clinical presentation is generally unspecific. Longer lasting back pain or a gradually worsening scoliosis are often the first signs of the disease. Neurological deficits, such as gait disturbances and paresis often occur after a time delay. In rare cases increased intracranial pressure has been reported. Knowledge concerning potential organ manifestations, resulting complications and typical radiological presentation, especially in magnetic resonance imaging are mandatory for adequate diagnosis and treatment of affected patients. (orig.) [German] Spinale Tumoren umfassen bei Kindern etwa 10 % aller auftretenden Tumoren des Zentralnervensystems (ZNS) und sind damit relativ selten. Die ueberwiegende Mehrheit dieser Tumoren sind Astrozytome und Ependymome (70 %), gefolgt von selteneren nichtglialen Tumorentitaeten, wie z. B. Gangliogliomen. Differenziert werden koennen sie nach ihrem Auftreten innerhalb der anatomischen intraspinalen Kompartimente in intra- und extramedullaere sowie intra- und extradurale Tumoren. Ihre klinische Praesentation ist haeufig unspezifisch. Laenger bestehende Rueckenschmerzen oder eine progrediente Skoliose sind oft erste Hinweise auf eine Erkrankung. Neurologische Ausfallerscheinungen wie Gangstoerungen und progrediente Laehmungen treten meist zeitlich verzoegert auf. In Einzelfaellen wird ueber Hirndruckzeichen berichtet. Kenntnisse ueber die moegliche Organmanifestation, resultierende Komplikationen und die typischen radiologischen Befunde v. a. in der MRT sind entscheidend fuer die adaequate Diagnose und Behandlung der betroffenen Patienten. (orig.)

  10. 25th annual meeting of the German Society of Neuroradiology. Abstracts

    International Nuclear Information System (INIS)

    Grau, H.C.

    1990-01-01

    The 62 abstracts are precising the individual papers read at the 25th annual meeting of the Germany Society of Neuroradiology, which dealt with the following subjects: The narrowed vertebral canal, congential and acquired spinal compression syndromes (8); neuroradiology of disturbances of perinatal development (7); new horizons in the diagnosis of degenerative and inflammatory disorders of the white matter (14); interventional neuroradiology (12); miscellaneous topics (21). (UHE) [de

  11. Twentieth congress of the European Society of Pediatric Radiology

    International Nuclear Information System (INIS)

    Anon.

    1983-01-01

    91 Abstracts of lectures are presented given at the 20th Congress of the European Society of Pediatric Radiology. The topics of the different sessions were as follows: Urinary tract, musculo-skeletal system, respiratory tract, gastrointestinal tract, skull and neuroradiology, genital tract, new modality imaging and cardiovascular system. (MG)

  12. Scintigraphic examinations in neuroradiology

    Energy Technology Data Exchange (ETDEWEB)

    Emde, H [Universitaet des Saarlandes, Homburg/Saar (Germany, F.R.). Abt. fuer Neuroradiologie

    1979-06-01

    The introduction of CT in neuroradiological diagnostics has clearly lowered the interest in nuclear examinations. Frequently, these are carried only out of a lack of CT capacity. Still, some examples are given to show how useful cerebral, bone, and cerebrospinal fluid scintiscanning can be in every day routine diagnostics.

  13. Health Care Economics: A Study Guide for Neuroradiology Fellows, Part 1.

    Science.gov (United States)

    Weiner, S L; Tu, R; Javan, R; Taheri, M R

    2018-01-01

    Few resources are available in the medical literature for a comprehensive review of current health care economics as it relates to radiologists, specifically framed by topics defined by the Accreditation Council for Graduate Medical Education in the evaluation of neuroradiology fellows. Therefore, we present a comprehensive review article as a study guide for fellows to learn from and gain competence in the Accreditation Council for Graduate Medical Education neuroradiology milestones on health care economics. © 2018 by American Journal of Neuroradiology.

  14. Synovial cysts: clinical and neuroradiological aspects

    International Nuclear Information System (INIS)

    Artico, M.; Cervoni, L.; Carloia, S.; Stevanato, G.; Mastantuono, M.; Nucci, F.

    1997-01-01

    Lumbar and intraneural synovial cysts are uncommon lesions. although their incidence has increased since the introduction of MRI. The authors describe the results of a study comprising 23 patients with synovial cyst (5 lumbar, 19 intraneural). Neuroradiological investigations included CT scan and MRI; however, it was not always possible to diagnose the nature of the lesion. In 18 cases the lesion was removed totally including its capsule; in the other 5 cases it was removed subtotally. Seven of the 23 patients presented a total remission of symptoms/signs, 11 improved and 5 remained unchanged. The importance of treating synovial cysts as radically as possible is discussed together with their most significant clinical and neuroradiological aspects. (author)

  15. Neuroradiologic work-up of brain tumors

    International Nuclear Information System (INIS)

    Fishbein, D.S.

    1988-01-01

    The presence of an intracranial tumor may be suspected or deduced from the clinical history and examination, or it may be discovered incidentally during investigation of another disorder. Once the suggestion is raised, a variety of neuroradiologic techniques are available to define the extent and nature of the lesion. The studies performed may allow a tissue diagnosis to be presumed, may serve as a guide to proposed surgical therapy, or may allow the course of a previously diagnosed lesion to be followed. This chapter discusses the utility of common neuroradiologic techniques and their specific indications in the work-up of intracranial tumors. Emphasis is placed upon tests that are most frequently utilized and have the greatest value

  16. Health Care Economics: A Study Guide for Neuroradiology Fellows, Part 2.

    Science.gov (United States)

    Weiner, S L; Tu, R; Javan, R; Taheri, M R

    2018-01-01

    In this second article, we continue the review of current health care economics as it relates to radiologists, specifically framed by topics defined by the Accreditation Council for Graduate Medical Education in the evaluation of neuroradiology fellows. The discussion in this article is focused on topics pertaining to levels 4 and 5, which are the more advanced levels of competency defined by the Accreditation Council for Graduate Medical Education Neuroradiology Milestones on Health Care Economics and System Based Practice. © 2018 by American Journal of Neuroradiology.

  17. Pediatric central nervous system vascular malformations

    Energy Technology Data Exchange (ETDEWEB)

    Burch, Ezra A. [Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States); Orbach, Darren B. [Boston Children' s Hospital, Neurointerventional Radiology, Boston, MA (United States)

    2015-09-15

    Pediatric central nervous system (CNS) vascular anomalies include lesions found only in the pediatric population and also the full gamut of vascular lesions found in adults. Pediatric-specific lesions discussed here include infantile hemangioma, vein of Galen malformation and dural sinus malformation. Some CNS vascular lesions that occur in adults, such as arteriovenous malformation, have somewhat distinct manifestations in children, and those are also discussed. Additionally, children with CNS vascular malformations often have associated broader vascular conditions, e.g., PHACES (posterior fossa anomalies, hemangioma, arterial anomalies, cardiac anomalies, eye anomalies and sternal anomalies), hereditary hemorrhagic telangiectasia, and capillary malformation-arteriovenous malformation syndrome (related to the RASA1 mutation). The treatment of pediatric CNS vascular malformations has greatly benefited from advances in endovascular therapy, including technical advances in adult interventional neuroradiology. Dramatic advances in therapy are expected to stem from increased understanding of the genetics and vascular biology that underlie pediatric CNS vascular malformations. (orig.)

  18. Pediatric central nervous system vascular malformations

    International Nuclear Information System (INIS)

    Burch, Ezra A.; Orbach, Darren B.

    2015-01-01

    Pediatric central nervous system (CNS) vascular anomalies include lesions found only in the pediatric population and also the full gamut of vascular lesions found in adults. Pediatric-specific lesions discussed here include infantile hemangioma, vein of Galen malformation and dural sinus malformation. Some CNS vascular lesions that occur in adults, such as arteriovenous malformation, have somewhat distinct manifestations in children, and those are also discussed. Additionally, children with CNS vascular malformations often have associated broader vascular conditions, e.g., PHACES (posterior fossa anomalies, hemangioma, arterial anomalies, cardiac anomalies, eye anomalies and sternal anomalies), hereditary hemorrhagic telangiectasia, and capillary malformation-arteriovenous malformation syndrome (related to the RASA1 mutation). The treatment of pediatric CNS vascular malformations has greatly benefited from advances in endovascular therapy, including technical advances in adult interventional neuroradiology. Dramatic advances in therapy are expected to stem from increased understanding of the genetics and vascular biology that underlie pediatric CNS vascular malformations. (orig.)

  19. Neuroradiology

    International Nuclear Information System (INIS)

    Graham, R.N.J.; Perriss, R.W.; Scarsbrook, A.F.

    2005-01-01

    This is the second in a series of short reviews of internet-based radiological educational resources, and will focus on neuroradiology. Most of the sites cater for medical students and trainee or non-specialist radiologists, but may also be of interest to specialists, especially for use in teaching. Hyperlinks are available in the electronic version of this article and were all active at the time of going to press (August 2005). If your computer has high-level internet security settings or does not accept cookies, you may not be able to access all of the sites listed; this may be the case on some hospital-based systems. All websites should be fully accessible from other computers with less stringent security settings, e.g. a PC at home

  20. A glance at live interventional neuroradiology and neurosurgery course 2009

    International Nuclear Information System (INIS)

    Li Qiang; Hong Bo; Liu Jianmin

    2010-01-01

    The annual Live Interventional Neuroradiology and Neurosurgery Course (LINNC) is one of the most important congresses in the neurosurgery and neuroradiology field. LINNC 2009 was held on May 25th this year and lasted for 3 days. In this article, the authors introduced the main points of the congress. The congress mainly discussed some hot topics at present time, including both the clinical and fundamental studies of cerebral arteriovenous malformation, ischemic cerebral disease and intracranial aneurysm, etc. Both neurological and neuroradiological case demonstrations related to the topics, and the main course of the congress were alternately performed. Recent advances in imaging technique and clinical application, such as Dyna-CT and Xper-CT, were also presented on the congress. (authors)

  1. Neuroimaging findings in pediatric Wernicke encephalopathy: a review

    Energy Technology Data Exchange (ETDEWEB)

    Zuccoli, Giulio [Children' s Hospital of Pittsburgh of UPMC, Children' s Hospital of Pittsburgh, Department of Radiology, Pittsburgh, PA (United States); University of Pittsburgh Medical Center, Department of Pediatric Radiology, Children' s Hospital of Pittsburgh, Pittsburgh, PA (United States); Siddiqui, Nasir; Bailey, Ariel; Bartoletti, Stefano C. [Children' s Hospital of Pittsburgh of UPMC, Children' s Hospital of Pittsburgh, Department of Radiology, Pittsburgh, PA (United States)

    2010-06-15

    Wernicke encephalopathy (WE) is an acute neurological disease resulting from dietary thiamine (vitamin B1) deficiency. WE is characterized by changes in consciousness, ocular dysfunction, and ataxia. Neuroradiologic findings usually show symmetric signal intensity alterations in the mammillary bodies, medial thalami, tectal plate, and periaqueductal area. Selective involvement of the cranial nerve nuclei, cerebellum, red nuclei, dentate nuclei, fornix, splenium, cerebral cortex, and basal ganglia characterize nonalcoholic WE patients. Furthermore, symmetric basal ganglia alterations with involvement of the putamen have only been observed in children. The incidence of WE is underestimated in both adult and pediatric patients. Interestingly, the frequency of WE in children appears to be similar to that observed in adults. The prognosis of the disease largely depends on the time from diagnosis to thiamine supplementation. The aim of this pediatric literature review is to provide an update on neuroradiologic findings in children affected by WE in an effort to determine pertinent clinical and imaging findings that can improve the detection and early identification of the disease. A thorough knowledge of the MRI findings of WE will assist in arriving at an early diagnosis, thereby reducing the morbidity and mortality associated with this disease in children. (orig.)

  2. Neuroimaging findings in pediatric Wernicke encephalopathy: a review

    International Nuclear Information System (INIS)

    Zuccoli, Giulio; Siddiqui, Nasir; Bailey, Ariel; Bartoletti, Stefano C.

    2010-01-01

    Wernicke encephalopathy (WE) is an acute neurological disease resulting from dietary thiamine (vitamin B1) deficiency. WE is characterized by changes in consciousness, ocular dysfunction, and ataxia. Neuroradiologic findings usually show symmetric signal intensity alterations in the mammillary bodies, medial thalami, tectal plate, and periaqueductal area. Selective involvement of the cranial nerve nuclei, cerebellum, red nuclei, dentate nuclei, fornix, splenium, cerebral cortex, and basal ganglia characterize nonalcoholic WE patients. Furthermore, symmetric basal ganglia alterations with involvement of the putamen have only been observed in children. The incidence of WE is underestimated in both adult and pediatric patients. Interestingly, the frequency of WE in children appears to be similar to that observed in adults. The prognosis of the disease largely depends on the time from diagnosis to thiamine supplementation. The aim of this pediatric literature review is to provide an update on neuroradiologic findings in children affected by WE in an effort to determine pertinent clinical and imaging findings that can improve the detection and early identification of the disease. A thorough knowledge of the MRI findings of WE will assist in arriving at an early diagnosis, thereby reducing the morbidity and mortality associated with this disease in children. (orig.)

  3. Hot topics in research: Preventive neuroradiology in brain aging and cognitive decline

    NARCIS (Netherlands)

    C.A. Raji; H. Eyre; S.H. Wei; D.E. Bredesen; S. Moylan (Steven); M. Law; G. Small; P.M. Thompson (Paul); R.M. Friedlander; D.H. Silverman; B.T. Baune; T.A. Hoang; N. Salamon; A.W. Toga (Arthur); M.W. Vernooij (Meike)

    2015-01-01

    textabstractPreventive neuroradiology is a new concept supported by growing literature. The main rationale of preventive neuroradiology is the application of multimodal brain imaging toward early and subclinical detection of brain disease and subsequent preventive actions through identification of

  4. Neuroradiology and art. A review and personal contribution

    International Nuclear Information System (INIS)

    Marinkovic, S.; Djordjevic, D.; Stosic-Opincal, T.; Strbac, M.; Tomic, I.; Tomic, O.

    2010-01-01

    Radiology has attracted the world of art with the esthetic value of its images, and as a new medium for the artistic expression. In order to investigate the links between neuroradiology and art, we examined 12,763 artworks presented in corresponding publications and in Google images on the Internet. The selected artworks were created by 1,964 authors. To give our own contribution to this field, we produced several artful radiological images using the X-ray of 4 cerebral hemispheres, one dissected brain, serial sections of one head and brain, the vascular casts of 2 brains, the magnetic resonance imaging (MRI) scans of one volunteer, and various options in Photoshop. Among the examined artworks, neuroradiological images were used in 129 artworks (1.01%) that were created by 31 artists (1.58%). The artists applied different radiological techniques: X-ray, angiography, computed tomography (CT), multislice CT, MRI, functional MRI, positron emission tomography (PET) or single-photon emission computed tomography (SPECT), either alone or in various combinations. They used the original images, id est (i.e.) radiographs or scans, or their electronic modifications in Photoshop or three-dimensional (3D) software. Some artworks presented the skull, yet others the brain, and still others both, either with or without a head image. The neuroradiological artworks were created as paintings, photographs, digital works and sculptures. Their authors were professional artists, designers, amateurs and radiologists. In conclusion, thanks to the esthetics of some radiological images and the valuable creations of certain artists, neuroradiology has become an important field of contemporary art. (author)

  5. Who collects professional fees for neuroradiology interpretation, radiologists or nonradiologists?

    Science.gov (United States)

    Babiarz, Lukasz S; Yousem, David M; Parker, Laurence; Rao, Vijay

    2012-07-01

    An increasing portion of imaging studies are performed by nonradiologists, especially for modalities with the highest relative value units. The aim of this study was to examine the trends in neuroradiologic interpretation among radiologists, neurologists, neurosurgeons, and other specialists within the Medicare population. The number of neuroradiologic studies interpreted by radiologists, neurologists, neurosurgeons, and other specialists in the inpatient, hospital outpatient, and private office settings was determined from the CMS Physician/Supplier Procedure Summary Master Files for 1996 to 2010. Studies billed through professional and global charges were aggregated. Utilization rates and utilization rate compound annual growth rates were computed by specialty and by imaging study. In 1996, radiologists interpreted 4,802,490 (93.7%) CMS neuroradiologic procedures, neurologists 77,312 (1.5%), neurosurgeons 9,825 (0.19%), and other specialists 234,423 (4.6%). In 2010, radiologists interpreted 11,476,376 (93.5%) procedures, neurologists 101,172 (0.8%), neurosurgeons 20,697 (0.17%), and other specialists 680,786 (5.5%). Neurology and neurosurgery lost market share at all sites. Radiology's share increased in the inpatient (from 94.8% to 98.7%) and hospital outpatient (from 95% to 98.7%) settings but decreased in the private office setting (from 88.2% to 73.1%). Lost market share was captured by the other CMS specialty categories, including independent diagnostic testing facilities and multidisciplinary groups, many of which included radiologists. There was marked growth (140%) in neuroradiologic studies between 1996 and 2010 in the Medicare patient population. Radiologists' share of the total neuroradiologic interpretations remained unchanged and constituted 93.5% in 2010. Radiology's market share has shown growth in the inpatient and hospital outpatient sectors but not the private office sector, where independent diagnostic testing facilities, multidisciplinary

  6. Emergency neuroradiology

    International Nuclear Information System (INIS)

    Scarabino, T.; Hospital of Andria; Salvolini, U.; Jinkins, J.R.

    2006-01-01

    The book is directed at emergency radiologists and neuroradiologists. It aims at providing exhaustive information that will help the reader understand the clinical problems in the full range of neurological emergencies and to select the methodological and technical options that will ensure prompt and effective response and correct interpretation of the clinical findings. The various chapters address the most common neuroradiological emergencies, summarize their fundamental physiopathological features, describe the main semiological and differential diagnostic features, and provide operative suggestions for the selection of the appropriate techniques to be applied in a sequential order. The book addresses the application of state-of-the-art techniques and their implications for clinical practice (particularly the contributions of standard and functional MRI and of spiral and multislice CT). The illustrations provide not only training but also reference material for routine clinical work. (orig.)

  7. Primary antiphospholipid antibody syndrome: neuroradiologic findings in 11 patients

    International Nuclear Information System (INIS)

    Kim, Jung Hoon; Choi, Choong Gon; Choi, Soo Jung; Lee, Ho Kyu; Suh, Dae Chul

    2000-01-01

    To describe the neuroradiologic findings of primary antiphospholipid antibody syndrome (PAPS). During a recent two-year period, abnormally elevated antiphospholipid antibodies were detected in a total of 751 patients. In any cases in which risk factors for stroke were detected - hypertension, diabetes mellitus, hyperlipidemia, smoking, and the presence of SLE or other connective tissue diseases - PAPS was not diagnosed. Neuroradiologic studies were performed in 11 of 32 patients with PAPS. We retrospectively reviewed brain CT (n = 7), MR (n = 8), and cerebral angiography (n = 8) in 11 patients with special attention to the presence of brain parenchymal lesions and cerebral arterial or venous abnormalities. CT or MR findings of PAPS included nonspecific multiple hyper-intensity foci in deep white matter on T2-weighted images (5/11), a large infarct in the territory of the middle cerebral artery (4/11), diffuse cortical atrophy (2/11), focal hemorrhage (2/11), and dural sinus thrombosis (1/11). Angiographic findings were normal (5/8) or reflected either occlusion of a large cerebral artery (2/8) or dural sinus thrombosis (1/8). Neuroradiologic findings of PAPS are nonspecific but in young or middle- aged adults who show the above mentioned CT or MR findings, and in whom risk factors for stroke are not present, the condition should be suspected

  8. Primary antiphospholipid antibody syndrome: neuroradiologic findings in 11 patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Hoon; Choi, Choong Gon; Choi, Soo Jung; Lee, Ho Kyu; Suh, Dae Chul [Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2000-03-01

    To describe the neuroradiologic findings of primary antiphospholipid antibody syndrome (PAPS). During a recent two-year period, abnormally elevated antiphospholipid antibodies were detected in a total of 751 patients. In any cases in which risk factors for stroke were detected - hypertension, diabetes mellitus, hyperlipidemia, smoking, and the presence of SLE or other connective tissue diseases - PAPS was not diagnosed. Neuroradiologic studies were performed in 11 of 32 patients with PAPS. We retrospectively reviewed brain CT (n = 7), MR (n = 8), and cerebral angiography (n = 8) in 11 patients with special attention to the presence of brain parenchymal lesions and cerebral arterial or venous abnormalities. CT or MR findings of PAPS included nonspecific multiple hyper-intensity foci in deep white matter on T2-weighted images (5/11), a large infarct in the territory of the middle cerebral artery (4/11), diffuse cortical atrophy (2/11), focal hemorrhage (2/11), and dural sinus thrombosis (1/11). Angiographic findings were normal (5/8) or reflected either occlusion of a large cerebral artery (2/8) or dural sinus thrombosis (1/8). Neuroradiologic findings of PAPS are nonspecific but in young or middle- aged adults who show the above mentioned CT or MR findings, and in whom risk factors for stroke are not present, the condition should be suspected.

  9. New developments in the neuroradiological diagnosis of craniocerebral trauma

    International Nuclear Information System (INIS)

    Parizel, P.M.; Maes, M.; Goethem, J.W. van; Oezsarlak, Oe.; Phillips, C.D.

    2005-01-01

    Accurate radiographic diagnosis is a cornerstone of the clinical management and outcome prediction of the head-injured patient. New technological advances, such as multi-detector computed tomography (MDCT) scanning and diffusion-weighted magnetic resonance imaging (MRI) have influenced imaging strategy. In this article we review the impact of these developments on the neuroradiological diagnosis of acute head injury. In the acute phase, multi-detector CT has supplanted plain X-ray films of the skull as the initial imaging study of choice. MRI, including fluid-attenuated inversion recovery, gradient echo T2* and diffusion-weighted sequences, is useful in determining the severity of acute brain tissue injury and may help to predict outcome. The role of MRI in showing diffuse axonal injuries is emphasized. We review the different patterns of primary and secondary extra-axial and intra-axial traumatic brain lesions and integrate new insights. Assessment of intracranial hypertension and cerebral herniation are of major clinical importance in patient management. We discuss the issue of pediatric brain trauma and stress the importance of MRI in non-accidental injury. In summary, new developments in imaging technology have advanced our understanding of the pathophysiology of brain trauma and contribute to improving the survival of patients with craniocerebral injuries. (orig.)

  10. Pediatric neuroradiology

    International Nuclear Information System (INIS)

    Erlt-Wagner, B.

    2007-01-01

    The book provides an optimum support for pediatricians wirth respect to the diagnosis of neurosystem diseases. The book covers the embryological development of the brain, congenital disfunctions of the infantile brain, the phakomatosis syndrome, metabolic disturbances, autoimmune and toxically induced diseases, infantile apoplexy and vascular malfunctions, affection-based diseases, hypoxic-ischemic lesions, hydrocephalus, traumatic diseases, infantile brain tumors, congenital disfunctions of the infantile spine, spinal tumors, tumors in the eye

  11. Neuroradiological findings in vascular dementia

    Energy Technology Data Exchange (ETDEWEB)

    Guermazi, Ali; Miaux, Yves; Suhy, Joyce; Pauls, Jon; Lopez, Ria [Synarc, Inc., Department of Radiology Services, San Francisco, CA (United States); Rovira-Canellas, Alex [Hospital General Universitari Vall d' Hebron, Unita de Resonancia Magnetica, Barcelona (Spain); Posner, Holly [Eisai, Inc., Teaneck, NJ (United States)

    2007-01-15

    There are multiple diagnostic criteria for vascular dementia (VaD) that may define different populations. Utilizing the criteria of the National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) has provided improved consistency in the diagnosis of VaD. The criteria include a table listing brain imaging lesions associated with VaD. The different neuroradiological aspects of the criteria are reviewed based on the imaging data from an ongoing large-scale clinical trial testing a new treatment for VaD. The NINDS-AIREN criteria were applied by a centralized imaging rater to determine eligibility for enrollment in 1,202 patients using brain CT or MRI. Based on the above data set, the neuroradiological features that are associated with VaD and that can result from cerebral small-vessel disease with extensive leukoencephalopathy or lacunae (basal ganglia or frontal white matter), or may be the consequence of single strategically located infarcts or multiple infarcts in large-vessel territories, are illustrated. These features may also be the consequence of global cerebral hypoperfusion, intracerebral hemorrhage, or other mechanisms such as genetically determined arteriopathies. Neuroimaging confirmation of cerebrovascular disease in VaD provides information about the topography and severity of vascular lesions. Neuroimaging may also assist with the differential diagnosis of dementia associated with normal pressure hydrocephalus, chronic subdural hematoma, arteriovenous malformation or tumoral diseases. (orig.)

  12. A complete image management and communications network for the neuroradiology service at Georgetown University Hospital

    International Nuclear Information System (INIS)

    Horii, S.C.; Muraki, A.; Mun, S.K.; Clark, L.; Schellinger, M.D.; Mallon-Ingeholm, M.L.

    1989-01-01

    A complete image management and communications system has been installed at Georgetown University Hospital (GUH). The network is based on the AT ampersand T CommView System. In the Neuroradiology Division, this network supports a multiscreen workstation with access to multiple imaging modalities such as CT and MRI from both the hospital and a remote imaging center. In addition, the radiologist can access these images from various workstations located throughout the hospital as well as from remote sites such as the home. Among the radiology services supported by the network, neuroradiology has the greatest need for such a system with extensive daily requirements involving the remote imaging center and on-line consultation around the clock. By providing neuroradiology with all available communication links, the radiologist can monitor, diagnose, and consult. The efficiency and effectiveness of the system's capabilities with regard to remote and teleradiology (RVS) operations have been studied for the neuroradiology service. This paper discusses the current clinical acceptance and use, problems in implementation, and ways these difficulties are being surmounted

  13. XXth symposium neuroradiologicum 2014

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2014-09-15

    The volume includes abstracts from lectures and poster presentations during the XXth symposium neuroradiologicum 2014 covering the following issues: Stroke, head and neck, pediatric diagnostic neuroradiology, spine and interventional neuroradiology, adult diagnostic neuroradiology, intravascular interventional neuroradiology.

  14. 25th congress and 9th advanced course of the European Society of Neuroradiology. Final programme and abstracts

    International Nuclear Information System (INIS)

    Schindler, E.

    1999-01-01

    Topics of the conference were mr in neuroradiology, infections and inflammatory diseases of the central nervous system, interventional neuro- radiology, trauma of the central nervous system, history of and preview of neuroradiology and free themes

  15. Feasibility of using the computed tomography dose indices to estimate radiation dose to partially and fully irradiated brains in pediatric neuroradiology examinations

    International Nuclear Information System (INIS)

    Januzis, Natalie; Nguyen, Giao; Yoshizumi, Terry T; Frush, Donald P; Hoang, Jenny K; Lowry, Carolyn

    2015-01-01

    The purpose of this study was two-fold: (a) to measure the dose to the brain using clinical protocols at our institution, and (b) to develop a scanner-independent dosimetry method to estimate brain dose. Radiation dose was measured with a pediatric anthropomorphic phantom and MOSFET detectors. Six current neuroradiology protocols were used: brain, sinuses, facial bones, orbits, temporal bones, and craniofacial areas. Two different CT vendor scanners (scanner A and B) were used. Partial volume correction factors (PVCFs) were determined for the brain to account for differences between point doses measured by the MOSFETs and average organ dose. The CTDI vol and DLP for each protocol were recorded. The dose to the brain (mGy) for scanners A and B was 10.7 and 10.0 for the brain protocol, 7.8 and 3.2 for the sinus, 10.2 and 8.6 for the facial bones, 7.4 and 4.7 for the orbits and 1.6 and 1.9 for the temporal bones, respectively. On scanner A, the craniofacial protocol included a standard and high dose option; the dose measured for these exams was 3.9 and 16.9 mGy, respectively. There was only one craniofacial protocol on scanner B; the brain dose measured on this exam was 4.8 mGy. A linear correlation was found between DLP and brain dose with the conversion factors: 0.049 (R 2 = 0.87), 0.046 (R 2 = 0.89) for scanner A and B, and 0.048 (R 2 = 0.89) for both scanners. The range of dose observed was between 1.8 and 16.9 mGy per scan. This suggests that brain dose estimates may be made from DLP. (paper)

  16. Competitiveness of the match for interventional radiology and neuroradiology fellowships.

    Science.gov (United States)

    Chen, Jim Y; Agarwal, Vikas; Orons, Philip D

    2014-11-01

    Overall resident interest in certain subspecialties changes with time. We sought to investigate the latest 6-year trend in interventional radiology (IR) and neuroradiology fellowship applications and how it has affected competitiveness in obtaining a position. We analyzed statistics published by the National Resident Matching Program in Results and Data: Specialties Matching Service from 2008 to 2013. From these data, we calculated the positions per IR applicant (PPIRA) and positions per neuroradiology applicant (PPNRA) for each year. The number of positions per applicant is one way to assess specialty competitiveness on a supply-and-demand basis. A lower PPIRA or PPNRA indicates a more competitive year. PPIRA has decreased every year, from 1.71 to the present 0.84, and contributed to 52 applicants being unmatched in 2013, up from 9 in 2008. Accordingly, the number of unfilled positions has decreased from 86 in 2008 to 8 in 2013. PPNRA waxed and waned from 2008 to 2010 but stabilized at around 1.15 thereafter. The number of unfilled positions has never dropped below 46. The number of unmatched applicants was consistently in the teens, except in 2011, when it increased to 23. Interest in IR fellowship has increased significantly over the past 6 years, whereas interest in neuroradiology fellowships has plateaued. IR fellowships have become increasingly competitive, leading to many unmatched residents. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  17. Atlas of postsurgical neuroradiology. Imaging of the brain, spine, and neck

    International Nuclear Information System (INIS)

    Ginat, Daniel Thomas; Westesson, Per-Lennart A.

    2012-01-01

    Covers the normal appearances and complications that may be encountered on neuroradiological examinations following surgery to the head, neck, and spine. Contains numerous images and to-the-point case descriptions. Serves as an invaluable and convenient resource for both neuroradiologists and neurosurgeons. The number of surgical procedures performed on the brain, head, neck, and spine has increased markedly in recent decades. As a result, postoperative changes are being encountered more frequently on neuroradiological examinations and constitute an important part of the workflow. However, the imaging correlates of postsurgical changes can be unfamiliar to neuroradiologists and neurosurgeons and are sometimes difficult to interpret. This book is written by experts in the field and contains an abundance of high-quality images and concise descriptions, which should serve as a useful guide to postsurgical neuroradiology. It will familiarize the reader with the various types of surgical procedure, implanted hardware, and complications. Indeed, this work represents the first text dedicated to the realm of postoperative neuroimaging. Topics reviewed include imaging after facial cosmetic surgery; orbital and oculoplastic surgery; sinus surgery; scalp and cranial surgery; brain tumor treatment; psychosurgery, neurodegenerative surgery, and epilepsy surgery; skull base surgery including transsphenoidal pituitary resection; temporal bone surgery including various ossicular prostheses; orthognathic surgery; surgery of the neck including the types of dissection and flap reconstruction; CSF diversion procedures and devices; spine surgery; and vascular and endovascular neurosurgery.

  18. Atlas of postsurgical neuroradiology. Imaging of the brain, spine, and neck

    Energy Technology Data Exchange (ETDEWEB)

    Ginat, Daniel Thomas [Massachusetts General Hospital, Boston, MA (United States). Harvard Medical School; Westesson, Per-Lennart A. [Univ. of Rochester Medical Center, Rochester, NY (United States). Div. of Neuroradiology

    2012-11-01

    Covers the normal appearances and complications that may be encountered on neuroradiological examinations following surgery to the head, neck, and spine. Contains numerous images and to-the-point case descriptions. Serves as an invaluable and convenient resource for both neuroradiologists and neurosurgeons. The number of surgical procedures performed on the brain, head, neck, and spine has increased markedly in recent decades. As a result, postoperative changes are being encountered more frequently on neuroradiological examinations and constitute an important part of the workflow. However, the imaging correlates of postsurgical changes can be unfamiliar to neuroradiologists and neurosurgeons and are sometimes difficult to interpret. This book is written by experts in the field and contains an abundance of high-quality images and concise descriptions, which should serve as a useful guide to postsurgical neuroradiology. It will familiarize the reader with the various types of surgical procedure, implanted hardware, and complications. Indeed, this work represents the first text dedicated to the realm of postoperative neuroimaging. Topics reviewed include imaging after facial cosmetic surgery; orbital and oculoplastic surgery; sinus surgery; scalp and cranial surgery; brain tumor treatment; psychosurgery, neurodegenerative surgery, and epilepsy surgery; skull base surgery including transsphenoidal pituitary resection; temporal bone surgery including various ossicular prostheses; orthognathic surgery; surgery of the neck including the types of dissection and flap reconstruction; CSF diversion procedures and devices; spine surgery; and vascular and endovascular neurosurgery.

  19. CT and MR imaging acquisition performance in a neuroradiology PACS module 1-year clinical experience

    International Nuclear Information System (INIS)

    Lou, S.L.; Loloyan, M.; Weinberg, W.S.; Valentino, D.J.; Lufkin, R.B.; Hanafee, W.N.; Bentson, J.; Jabour, B.A.; Huang, H.K.

    1990-01-01

    This paper analyzes the operational efficiency of our neuroradiology PACS compared with conventional film-based management systems. The authors neuroradiology PACS module has been in clinical evaluation for 6 months. Three SUN microcomputers, two PC/ATs, and an automated optical disk library are connected through Ethernet. Software implemented at the TCP/IP level is used to transfer images from MR imagers and CT scanners to a viewing station. Performance measurements include the time elapsed at each stage of the system

  20. 26th annual meeting of the Japanese Neuroradiological Society. Abstracts

    International Nuclear Information System (INIS)

    Anon.

    1997-01-01

    The annual meeting of neuroradiology in Tokyo gives a good overview of the present topics in radiology. Emphasis is placed on NMR imaging of the brain, the skeleton and the cardiovascular system according to the occurrence of diseases like neoplasms, pathological changes and malformations in these organs. (AJ)

  1. Application of basic physics principles to clinical neuroradiology: differentiating artifacts from true pathology on MRI.

    Science.gov (United States)

    Hakky, Michael; Pandey, Shilpa; Kwak, Ellie; Jara, Hernan; Erbay, Sami H

    2013-08-01

    This article outlines artifactual findings commonly encountered in neuroradiologic MRI studies and offers clues to differentiate them from true pathology on the basis of their physical properties. Basic MR physics concepts are used to shed light on the causes of these artifacts. MRI is one of the most commonly used techniques in neuroradiology. Unfortunately, MRI is prone to image distortion and artifacts that can be difficult to identify. Using the provided case illustrations, practical clues, and relevant physical applications, radiologists may devise algorithms to troubleshoot these artifacts.

  2. Neuroradiological findings in multiloculated hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Albanese, V.; Tomasello, F.; Sampaolo, S.; Picozzi, P. (Naples Univ. (Italy). Inst. of Neurosurgery)

    1982-01-01

    The characteristic neuroradiological features of multiloculated hydrocephalus following neonatal meningitis and ventriculitis in five infants are presented. The role of ventriculography and computerized tomography in detecting multiloculated and enlarged ventricles and paraventricular cavities, as well as complete and incomplete septa, is emphasized for early diagnosis and surgical management. CT scan also provides clues indicating the presence of thin but not visualized septa. It is suggested that post-meningitic hydrocephalus should be repeatedly followed-up for detection of multiloculated transformation. Probably this entity occurs less uncommonly than was thought in the past. The CT scan appears the most helpful and safe procedure for the serial evaluation, but ventriculography may be usefully combined with it in order to plan the most suitable operative approach for fenestration of membranes.

  3. Neuroradiological findings in multiloculated hydrocephalus

    International Nuclear Information System (INIS)

    Albanese, V.; Tomasello, F.; Sampaolo, S.; Picozzi, P.

    1982-01-01

    The characteristic neuroradiological features of multiloculated hydrocephalus following neonatal meningitis and ventriculitis in five infants are presented. The role of ventriculography and computerized tomography in detecting multiloculated and enlarged ventricles and paraventricular cavities, as well as complete and incomplete septa, is emphasized for early diagnosis and surgical management. CT scan also provides clues indicating the presence of thin but not visualized septa. It is suggested that post-meningitic hydrocephalus should be repeatedly followed-up for detection of multiloculated transformation. Probably this entity occurs less uncommonly than was thought in the past. The CT scan appears the most helpful and safe procedure for the serial evaluation, but ventriculography may be usefully combined with it in order to plan the most suitable operative approach for fenestration of membranes. (Author)

  4. Neurological, neuropsychological and neuroradiological studies of the posterior cerebral artery occlusion

    International Nuclear Information System (INIS)

    Tagawa, Koichi

    1978-01-01

    Neurological, neuropsychological and neuroradiological studies were performed on 31 cases of the posterior cerebral artery (PCA) occlusion diagnosed by cerebral angiography and/or computed tomography (CT). Neurological examinations revealed visual field defect in 28 cases, contralateral sensory disturbance and hemiparesis in 23 cases and mental syndrome of memory disturbance, disorientation or confusion in 8 cases. CT was done on 17 cases out of 23 cases with contralateral sensory disturbance and hemiparesis. Ten cases of them revealed to have thalamic lesions by CT. In 7 cases which had no evidence of thalamic lesion by CT, 3 cases were highly suspected to have thalamic involvement clinically. The neurological and neuroradiological findings revealed high incidence and its pathomechanism of thalamic lesion in the cases of PCA occlusion. Neuropsychological examinations disclosed pure alexia in 6 cases, cortical blindness in 2 cases and hemispatial agnosia in 2 cases. Four cases with pure alexia were followed their alexic symptoms. Alexic symptoms lasted long in 3 cases. In these cases, collateral flow to the territory of the occlude PCA was hardly visible. One case with a relatively good collateral filling of the occluded PCA, alexic symptoms showed gradual improvement. Two cases with cortical blindness were proven to have bilateral PCA occlusion. In these 2 cases, collateral filling was hardly visible and their symptoms were permanent. The neurological and neuroradiological findings mentioned above suggest that the prognosis of pure alexia and cortical blindness depends largely on the degree of development of collateral circulation to the occluded PCA. Hemispatial agnosia was seen in 2 cases. (author)

  5. Interventional neuroradiology of the head and neck.

    Science.gov (United States)

    Turowski, Bernd; Zanella, Friedhelm E

    2003-08-01

    Vascular interventions are important and helpful for treatment of various pathologies of the head and neck. Interventional neuroradiology of the head and neck includes image-guided biopsies, vessel occlusion, and local chemotherapy. Knowledge of anatomy, functional relationships between intra- and extracranial vessels, and pathology are the basis for therapeutic success. The interventional neuroradiologist is responsible for appropriate selection of patients based on clinical information, indications, and risk assessment. Neuroradiologic imaging, especially CT and MR imaging, and appropriate analysis of angiographic findings help ensure indication for treatment and plan an intervention. Technical equipment, including an angiographic unit, catheters, needles, embolizing materials, and so forth, are important. Knowledge of hemodynamics is relevant to avoid complications and to find the optimal technique for solving the clinical problem. Indications for image-guided biopsies are preverterbal fluid-collections, spinal and paraspinal inflammations and abscesses, deep cervical malignancies, vertebral body, and skull base tumors. Special care should be taken to preserve critical structures in this region, including spinal nerve roots, cervical plexus, main peripheral nerves, and vessels. Indications for vessel occlusion are emergency situations to stop bleeding in vascular lesions (traumatic, malformation, or tumors) by reduction of pressure, preoperative reduction of blood flow to minimize the surgical risk, palliative occlusion of feeding vessels to produce tumor necrosis, or potential curative (or presurgical) occlusion of vascular malformations. Pressure reduction to support normal coagulation, such as epistaxis, in hereditary hemorrhagic telangiectasia can be achieved by proximal vessel occlusion with large particles or platinum coils. Prevention of intraoperative bleeding requires occlusion of the microvascular bed with small particles. Examples of these

  6. 23rd annual meeting of German Society for Neuroradiology

    International Nuclear Information System (INIS)

    Kuehne, D.

    1987-01-01

    Book of abstracts of this annual meeting summarizing the 58 lectures that dealt with the following subjects: Pathologic changes of the cervical vertebral canal and of the cervico-occipital region, as detected by modern imaging techniques (18 papers); diagnostic examination of the urbita and the middle cranial fossa (12 papers); invasive methods of neuroradiology (13 papers); 15 papers on freely chosen subjects. (MG) [de

  7. Quantitative Evaluation of Performance in Interventional Neuroradiology: An Integrated Curriculum Featuring Theoretical and Practical Challenges.

    Directory of Open Access Journals (Sweden)

    Marielle Ernst

    Full Text Available We sought to develop a standardized curriculum capable of assessing key competencies in Interventional Neuroradiology by the use of models and simulators in an objective, quantitative, and efficient way. In this evaluation we analyzed the associations between the practical experience, theoretical knowledge, and the skills lab performance of interventionalists.We evaluated the endovascular skills of 26 participants of the Advanced Course in Endovascular Interventional Neuroradiology of the European Society of Neuroradiology with a set of three tasks (aneurysm coiling and thrombectomy in a virtual simulator and placement of an intra-aneurysmal flow disruptor in a flow model. Practical experience was assessed by a survey. Participants completed a written and oral examination to evaluate theoretical knowledge. Bivariate and multivariate analyses were performed.In multivariate analysis knowledge of materials and techniques in Interventional Neuroradiology was moderately associated with skills in aneurysm coiling and thrombectomy. Experience in mechanical thrombectomy was moderately associated with thrombectomy skills, while age was negatively associated with thrombectomy skills. We found no significant association between age, sex, or work experience and skills in aneurysm coiling.Our study gives an example of how an integrated curriculum for reasonable and cost-effective assessment of key competences of an interventional neuroradiologist could look. In addition to traditional assessment of theoretical knowledge practical skills are measured by the use of endovascular simulators yielding objective, quantitative, and constructive data for the evaluation of the current performance status of participants as well as the evolution of their technical competency over time.

  8. Signs in neuroradiology: A pictorial review

    Energy Technology Data Exchange (ETDEWEB)

    Kizilca, Ozgur; Oztek, Alp; Kesimal, Ugur; Senol, Utku [Dept. of Radiology, Akdeniz University Faculty of Medicine, Antalya (Turkmenistan)

    2017-11-15

    One of the major problems radiologists face in everyday practice is to decide the correct diagnosis, or at least narrow down the list of possibilities. In this context, indicative evidences (signs) are useful to recognize pathologies, and also to narrow the list of differential diagnoses. Despite classically being described for a single disease, or a closely related family of disorders, most indications are not restricted exclusively to their traditional definition. Therefore, using signs for prognosis requires knowledge of the mechanism of their appearance, and which pathologies they are observed in. In this study, we demonstrate some of the more common and useful neuroradiologic signs with relevant images, and discuss their use in differential diagnosis.

  9. XXII congress of the European Society of Neuroradiology. 6th advanced course. Milan, Italy 17-21 September 1996

    International Nuclear Information System (INIS)

    Scotti, G.

    1996-01-01

    The 22nd Congress of the European Society of Neuroradiology, held from 17 -21 September 1996 in Milano, Italy, was dedicated to the neuroradiological aspects of diagnosis and treatment of lesions of the central nervous system. The proceedings issue presents the full Congress programme, the abstracts of the 147 oral presentations as well as the 307 poster presentations. There also is an author index and a list of ESNR members. (Orig./MG) [de

  10. Improvement of Endovascular Stroke Treatment: A 24-Hour Neuroradiological On-Site Service Is Not Enough

    Directory of Open Access Journals (Sweden)

    Omid Nikoubashman

    2018-01-01

    Full Text Available Background and Purpose. With the advent of endovascular stroke treatment (EST with mechanical thrombectomy, stroke treatment has also become more challenging. Purpose of this study was to investigate whether a fulltime neuroradiological on-site service and workflow optimization with a structured documentation of the interdisciplinary stroke workflow resulted in improved procedural times. Material and Methods. Procedural times of 322 consecutive patients, who received EST (1 before (n=96 and (2 after (n=126 establishing a 24-hour neuroradiological on-site service as well as (3 after implementation of a structured interdisciplinary workflow documentation (“Stroke Check” (n=100, were analysed. Results. A fulltime neuroradiological on-site service resulted in a nonsignificant improvement of procedural times during out-of-hours admissions (p≥0.204. Working hours and out-of-hours procedural times improved significantly, if additional workflow optimization was realized (p≤0.026. Conclusions. A 24-hour interventional on-site service is a major prerequisite to adequately provide modern reperfusion therapies in patients with acute ischemic stroke. However, simple measures like standardized and focused documentation that affect the entire interdisciplinary pre- and intrahospital stroke rescue chain seem to be important.

  11. Neuroradiological findings in perinatally HIV-infected children. Neuroradiologische Befunde bei perinatal HIV-infizierten Kindern

    Energy Technology Data Exchange (ETDEWEB)

    Spreer, J [Radiologische Abt., Universitaetsklinik Koeln (Germany); Enenkel-Stoodt, S [Abt. fuer Allgemeine Paediatrie 2, Universitaetsklinik Frankfurt am Main (Germany); Funk, M [Abt. fuer Paediatrische Haematologie und Onkologie, Universitaetsklinik Frankfurt am Main (Germany); Fiedler, A [Abt. fuer Paediatrische Neurologie, Universitaetsklinik Frankfurt am Main (Germany); Simone, A de [Neuroradiologische Abt., Universitaetsklinik Frankfurt am Main (Germany); Hacker, H [Neuroradiologische Abt., Universitaetsklinik Frankfurt am Main (Germany)

    1994-08-01

    The neuroradiological studies (CT, MRI, angiography) in 21 children with perinatal HIV infection were reviewed retrospectively. No patient showed an intracranial mass lesion; after intravenous contrast medium application there was no case with disturbed blood-brain barrier. Common non-specific findings were atrophy and delayed myelination. In 7 cases atrophy was combined with multifocal nearly symmetric white matter lesions, which characteristically spared the U-fibres. Further findings included an intramedullary ring-shaped structure in the cervical cord, an AIDS-associated vasculopathy and symmetric calcifications in the basal ganglia. The spectrum of neuroradiological findings in paediatric AIDS patients differs from that in adults. Knowledge of these age-specific findings is important because the number of HIV-infected children is rising. (orig.)

  12. Entrances skin dose distribution maps for interventional neuroradiological procedures: A preliminary study

    International Nuclear Information System (INIS)

    Rampado, O.; Ropolo, R.

    2005-01-01

    Does estimation in interventional neuroradiology can be useful to limit skin radiation injuries. The purpose of this study was to evaluate the role of entrance skin dose (ESD) maps in planning exposure condition optimisation. Thirteen cerebral angiography and five embolisation procedures were monitored, measuring ESD, dose-area product (DAP) and other operational parameters. A transmission ionisation chamber, simultaneously measuring air kerma and DAP, measured dose-related quantities. Data acquisition software collected dosimetric and geometrical data during the interventional procedure and provided a distribution map of ESD on a standard phantom digital image, with maximum value estimation. Values of 88-1710 mGy for maximum skin dose and 16.7-343 Gy cm 2 for DAP were found. These data confirm the possibility of deterministic effects during therapeutic interventional neuroradiological procedures like cerebral embolisation. ESD maps are useful to retrospectively study the exposure characteristics of a procedure and plan patient exposure optimisation. (authors)

  13. Design considerations for a neuroradiologic picture archival and image processing workstation

    International Nuclear Information System (INIS)

    Fishbein, D.S.

    1986-01-01

    The design and implementation of a small scale image archival and processing workstation for use in the study of digitized neuroradiologic images is described. The system is designed to be easily interfaced to existing equipment (presently PET, NMR and CT), function independent of a central file server, and provide for a versatile image processing environment. (Auth.)

  14. The duty to provide information in the case of neuroradiological examination methods

    International Nuclear Information System (INIS)

    Deutsch, E.

    1987-01-01

    The author gives a survey on the judicial decisions concerning the obligation to give information in the case of neuroradiological examination methods. The scope and content of the medical explanation depends inter alia on the urgency and the necessity of the medical diagnosis and on the understanding of the patient. (WG) [de

  15. ESPR 2015. Abstracts

    International Nuclear Information System (INIS)

    2015-01-01

    The volume includes the abstracts of the ESPR 2015 covering the following topics: PCG (post graduate courses): Radiography; fluoroscopy and general issue; nuclear medicine, interventional radiology and hybrid imaging, pediatric CT, pediatric ultrasound; MRI in childhood. Scientific sessions and task force sessions: International aspects; neuroradiology, neonatal imaging, engineering techniques to simulate injury in child abuse, CT - dose and quality, challenges in the chest, cardiovascular and chest, muscoskeletal, oncology, pediatric uroradiology and abdominal imaging, fetal and postmortem imaging, education and global challenges, neuroradiology - head and neck, gastrointestinal and genitourinary.

  16. ESPR 2015. Abstracts

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-05-10

    The volume includes the abstracts of the ESPR 2015 covering the following topics: PCG (post graduate courses): Radiography; fluoroscopy and general issue; nuclear medicine, interventional radiology and hybrid imaging, pediatric CT, pediatric ultrasound; MRI in childhood. Scientific sessions and task force sessions: International aspects; neuroradiology, neonatal imaging, engineering techniques to simulate injury in child abuse, CT - dose and quality, challenges in the chest, cardiovascular and chest, muscoskeletal, oncology, pediatric uroradiology and abdominal imaging, fetal and postmortem imaging, education and global challenges, neuroradiology - head and neck, gastrointestinal and genitourinary.

  17. Development of neuroradiology. From the visualization of bones to molecular imaging

    International Nuclear Information System (INIS)

    Reith, W.

    2005-01-01

    Since the discovery of X-rays, rapid and significant progress has been and continues to be made in imaging techniques, particularly neuroradiology. Milestones along the way included use of contrast agents, digital subtraction angiography, computed tomography, and magnetic resonance imaging. The most recent achievements are visualization of cerebral activation and fiber systems in the brain parenchyma. Application of new contrast agents seems to make imaging at the ''molecular'' level also possible. (orig.) [de

  18. The role of specialist neuroradiology second opinion reporting: is there added value?

    International Nuclear Information System (INIS)

    Briggs, G.M.; Flynn, P.A.; Worthington, M.; Rennie, I.; McKinstry, C.S.

    2008-01-01

    Aim: To assess the impact on patient management of formal neuroradiology 'second reading' of computed tomography (CT) and magnetic resonance imaging (MRI) images initially interpreted by general radiologists. Materials and methods: Second opinion reports during the calendar year 2004 were compared with the original report and assessed for major or minor discrepancies. A major discrepancy was separated from a minor discrepancy whereby a change in opinion significantly affected patient management. Results: There were 506 second opinions during 2004 given by three consultant neuroradiologists. Incomplete data were found in 141. Forty-one percent were CT images and the remainder MRI. The majority of second opinions were requested by neurologists. Most of the remaining referrals were from neurosurgeons or the primary radiologist. There was a 13% major and a 21% minor discrepancy rate. The remaining 66% were in complete agreement. There was a mixture of overcalls, misinterpretation, and undercalls. There were similar rates of minor and major discrepancies in both CT and MRI. Conclusion: There is a significant major discrepancy rate between specialist neuroradiology second opinion and general radiologists. The benefit of a formal specialist second opinion service is clearly demonstrated; however, it is time-consuming

  19. Neuroradiology computer-assisted instruction using interactive videodisk: Pilot project

    International Nuclear Information System (INIS)

    Andrews, C.L.; Goldsmith, D.G.; Osborn, A.G.; Stensaas, S.S.; Davidson, H.C.; Quigley, A.C.

    1987-01-01

    The availability of microcomputers, high-resolution monitors, high-level authoring languages, and videodisk technology make sophisticated neuroradiology instruction a cost-effective possibility. The authors developed a laser videodisk and interactive software to teach normal and pathologic gross and radiologic anatomy of the sellar/juxtasellar region. A spectrum of lesions is presented with information for differential diagnosis included. The exhibit permits conference participants to review the pilot module and experience the self-paced learning and self-evaluation possible with computer-assisted instruction. They also may choose to peruse a ''visual database'' by instant random access to the videodisk by hand control

  20. Neuroradiological evaluation of dorsal cyst malformations

    International Nuclear Information System (INIS)

    Utsunomiya, Hidetsuna; Hayashi, Takashi; Hashimoto, Takeo; Matsuishi, Toyojiro; Okudera, Toshio.

    1988-01-01

    We discussed six cases with dorsal cyst malformations listing their neuroradiological observations and proposed to differentiate between the holosphere and hemisphere as defined by Yokota (1984). The cases were divided into holospheric and hemispheric groups depending on the continuity of their frontal lobe midlines. Cases 1, 2 and 3 were placed in the holospheric group because of their unseparated frontal lobe sbeneath the partially formed anterior interhemispheric fissures. Cases 4, 5 and 6 were grouped in the hemisphere due to the completion of the interhemispheric fissures. There has been a tendency in recent years for most cases of cerebral malformations having an endogenous dorsal cyst with monoventricular configuration to be diagnosed as holoprosencephaly. However, we believe that only patients who have a dorsal cyst in the holospheric brain should be included, and the others in the hemispheric brain, which is capable of completing hemispheric cleavage, should not. Therefore, we emphasize the importance of correctly identifying the holospheric state in the dorsal cyst malformations for diagnosing holoprosencephaly. (author)

  1. Patient radiation doses from neuroradiology procedures

    Energy Technology Data Exchange (ETDEWEB)

    Garcia-Roman, M J; Abreu-Luis, J; Hernandez-Armas, J [Servicio de Fisica Medica, Hospital Universitario de Canarias, La Laguna, Tenerife (Spain); Prada-Martinez, E [Servicio de Radiodiagnostico, Hospital Universitario de Canarias, La Laguna, Tenerife (Spain)

    2001-03-01

    Following the presentation of radiation-induced deterministic effects by some patients undergoing neuroradiological procedures during successive sessions, such as temporary epilation, in the 'Hospital Universitario de Canarias', measurements were made of dose to patients. The maximum dose-area product measured by ionization chamber during these procedures was 39617 cGy.cm{sup 2} in a diagnostic of aneurysm and the maximum dose to the skin measured by thermoluminescent dosemeters (TLDs) was 462.53 mGy. This can justify certain deterministic effects but it is unlikely that the patients will suffer serious effects from this skin dose. Also, measurements were made of effective dose about two usual procedures, embolisation of tumour und embolisation of aneurysm. These procedures were reproduced with an anthropomorphic phantom Rando and doses were measured with TLDs. Effective doses obtained were 3.79 mSv and 4.11 mSv, respectively. The effective dose valued by the program EFFDOSE was less than values measured with TLDs. (author)

  2. Patient radiation doses from neuroradiology procedures

    International Nuclear Information System (INIS)

    Garcia-Roman, M.J.; Abreu-Luis, J.; Hernandez-Armas, J.; Prada-Martinez, E.

    2001-01-01

    Following the presentation of radiation-induced deterministic effects by some patients undergoing neuroradiological procedures during successive sessions, such as temporary epilation, in the 'Hospital Universitario de Canarias', measurements were made of dose to patients. The maximum dose-area product measured by ionization chamber during these procedures was 39617 cGy.cm 2 in a diagnostic of aneurysm and the maximum dose to the skin measured by thermoluminescent dosemeters (TLDs) was 462.53 mGy. This can justify certain deterministic effects but it is unlikely that the patients will suffer serious effects from this skin dose. Also, measurements were made of effective dose about two usual procedures, embolisation of tumour und embolisation of aneurysm. These procedures were reproduced with an anthropomorphic phantom Rando and doses were measured with TLDs. Effective doses obtained were 3.79 mSv and 4.11 mSv, respectively. The effective dose valued by the program EFFDOSE was less than values measured with TLDs. (author)

  3. Diagnostic relevance of high field MRI in clinical neuroradiology: the advantages and challenges of driving a sports car

    International Nuclear Information System (INIS)

    Wattjes, Mike P.; Barkhof, Frederik

    2012-01-01

    High field MRI operating at 3 T is increasingly being used in the field of neuroradiology on the grounds that higher magnetic field strength should theoretically lead to a higher diagnostic accuracy in the diagnosis of several disease entities. This Editorial discusses the exhaustive review by Wardlaw and colleagues of research comparing 3 T MRI with 1.5 T MRI in the field of neuroradiology. Interestingly, the authors found no convincing evidence of improved image quality, diagnostic accuracy, or reduced total examination times using 3 T MRI instead of 1.5 T MRI. These findings are highly relevant since a new generation of high field MRI systems operating at 7 T has recently been introduced. (orig.)

  4. Simultaneous whole-body PET-MRI in pediatric oncology. More than just reducing radiation?; Simultane Ganzkoerper-PET-MRT in der paediatrischen Onkologie. Mehr als nur Strahlenersparnis

    Energy Technology Data Exchange (ETDEWEB)

    Gatidis, S.; Gueckel, B.; Schaefer, J.F. [Universitaet Tuebingen, Radiologische Klinik, Diagnostische und Interventionelle Radiologie, Tuebingen (Germany); Fougere, C. la [Universitaet Tuebingen, Radiologische Klinik, Nuklearmedizin, Tuebingen (Germany); Schmitt, J. [Universitaet Tuebingen, Abteilung fuer Praeklinische Bildgebung und Radiopharmazie, Werner Siemens Imaging Center, Tuebingen (Germany)

    2016-07-15

    Diagnostic imaging plays an essential role in pediatric oncology with regard to diagnosis, therapy-planning, and the follow-up of solid tumors. The current imaging standard in pediatric oncology includes a variety of radiological and nuclear medicine imaging modalities depending on the specific tumor entity. The introduction of combined simultaneous positron emission tomography (PET) and magnetic resonance imaging (MRI) has opened up new diagnostic options in pediatric oncology. This novel modality combines the excellent anatomical accuracy of MRI with the metabolic information of PET. In initial clinical studies, the technical feasibility and possible diagnostic advantages of combined PET-MRI have been in comparison with alternative imaging techniques. It was shown that a reduction in radiation exposure of up to 70 % is achievable compared with PET-CT. Furthermore, it has been shown that the number of imaging studies necessary can be markedly reduced using combined PET-MRI. Owing to its limited availability, combined PET-MRI is currently not used as a routine procedure. However, this new modality has the potential to become the imaging reference standard in pediatric oncology in the future. This review article summarizes the central aspects of pediatric oncological PET-MRI based on existing literature. Typical pediatric oncological PET-MRI cases are also presented. (orig.) [German] Die bildgebende Diagnostik spielt in der paediatrischen Onkologie eine zentrale Rolle fuer die Diagnose, die Therapieplanung und die Nachsorge solider Tumoren. Der aktuell bildgebende Standard in der paediatrischen Onkologie sieht - abhaengig von der vorliegenden Tumorentitaet - eine Kombination mehrerer radiologischer und nuklearmedizinischer Verfahren vor. Die Einfuehrung der simultanen Positronenemissionstomographie(PET)-Magnetresonanztomographie (MRT) hat neuartige Moeglichkeiten der Diagnostik in der paediatrischen Onkologie eroeffnet. Dabei kombiniert dieses neue Verfahren die

  5. Neuroradiological investigations and findings in spinal vascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Vogelsang, H [Medizinische Hochschule Hannover (Germany, F.R.). Abt. fuer Neuroradiologie

    1980-02-01

    Neuroradiological examinations play a great role today in spinal blood flow disturbances due to spinal vascular disease. This goes for myelography with its new aqueous contrast medium Amipaque as well as for selective spinal arteriography, also with regard to therapeutical approaches (embolisation). Other causes of blood flow disturbances, however - with the exception of growing and displacing processes of the spinal column and spinal canal - cannot be detected by radiological methods or only indirectly; examinations with contrasting agents can only serve for diagnosis by exclusion. The article deals mainly with techniques and findings of examinations for spinal angioma which account for 7 to 11% of growing and displacing processes of the spine. Progress in diagnosis and therapeutical success has been accelerated by technical developments and new contrasting agents as well as by improved surgical techniques.

  6. Dissecting aneurysms of the middle cerebral artery: neuroradiological and clinical features

    International Nuclear Information System (INIS)

    Ohkuma, H.; Suzuki, S.; Shimamura, N.; Nakano, T.

    2003-01-01

    There are few reported cases of nontraumatic dissecting aneurysms of the middle cerebral artery (MCA), and their neuroradiological and clinical features have not been analysed. We looked at these aspects in a collaborative study. We reviewed 13 patients diagnosed as having a dissecting aneurysm of the MCA based on clinical signs and neuroradiological findings in 46 stroke centres between 1995 and 1999. There were four patients who presented with cerebral ischaemia, and nine who presented with bleeding. Of the former group, three were aged less than 15 years. Cerebral angiography showed extensive stenosis and a double lumen of the M1 portion in all four patients. High signal on T1-weighted images around the arterial flow void, due to intramural haematoma, was often seen in the second week. MR angiography showed findings corresponding those of intra-arterial angiography in all four cases. We saw an infarct on CT or MRI in territory of the perforating branches of the M1 segment in all four patients. In the patients presenting with bleeding, pure subarachnoid haemorrhage or a sylvian fissure haematoma was seen on initial CT, and the predominant angiographic finding was dilatation with stenosis, but the site of the lesions was not uniform. A double lumen or intimal flap was seen in about half the cases. Rebleeding occurred within 14 days of the onset in five of the nine patients, with a poor prognosis. (orig.)

  7. A study of the relationship between peak skin dose and cumulative air kerma in interventional neuroradiology and cardiology

    International Nuclear Information System (INIS)

    Neil, S; Padgham, C; Martin, C J

    2010-01-01

    A study of peak skin doses (PSDs) during neuroradiology and cardiology interventional procedures has been carried out using Gafchromic XR-RV2 film. Use of mosaics made from squares held in cling film has allowed doses to the head to be mapped successfully. The displayed cumulative air kerma (CAK) has been calibrated in terms of cumulative entrance surface dose (CESD) and results indicate that this can provide a reliable indicator of the PSD in neuroradiology. Results linking PSD to CESD for interventional cardiology were variable, but CAK is still considered to provide the best option for use as an indicator of potential radiation-induced effects. A CESD exceeding 3 Gy is considered a suitable action level for triggering follow-up of patients in neuroradiology and cardiology for possible skin effects. Application of dose action levels defined in this way would affect 8% of neurological embolisation procedures and 5% of cardiology ablation and multiple stent procedures at the hospitals where the investigations were carried out. A close relationship was observed between CESD and dose-area product (DAP) for particular types of procedure, and DAPs of 200-300 Gy cm 2 could be used as trigger levels where CAK readings were not available. The DAP value would depend on the mean field size and would need to be determined for each application.

  8. What is the relationship between type 2 diabetes mellitus status and the neuroradiological correlates of cerebral small vessel disease in adults? Protocol for a systematic review.

    Science.gov (United States)

    Funnell, Clark; Doyle-Waters, Mary M; Yip, Samuel; Field, Thalia

    2017-01-17

    Cerebral small vessel disease (CSVD) is a common cause of stroke, dementia, and functional decline. In recent years, neuroradiologic correlates of CSVD have been identified. These imaging findings, best characterized on magnetic resonance imaging (MRI), include some combination of white matter hyperintensities, lacunes, cerebral microbleeds, enlarged perivascular spaces, and cerebral atrophy. Though some cohorts have reported that participants with type 2 diabetes mellitus (T2DM), an important risk factor for CSVD, may have a distinct neuroradiologic phenotype, this relationship is not well-characterized. Adults with diabetes mellitus have a two- to threefold higher incidence of ischemic stroke compared to controls and are an increasingly important population given global trends of increasing diabetes prevalence. This study aims to determine if adults with CSVD and T2DM have a distinct neuroradiologic phenotype. A systematic search of the literature will be conducted to find articles that report the MRI features of CSVD in a cohort of participants including those with and without type 2 diabetes mellitus (T2DM). A number of databases will be searched including MEDLINE, Embase, CINAHL, and Web of Science. Proceedings and abstracts from key conferences will also be reviewed and relevant journals hand searched for additional papers. The references from selected papers will be scanned. Screening of potential articles, data extraction, and quality appraisal will be performed in duplicate by independent reviewers. Odds ratios and 95% confidence intervals for the presence versus absence of each neuroradiologic correlate of interest from each included study will be calculated. If sufficient homogeneity exists among studies, a meta-analysis will be performed for each neuroradiologic correlate of CSVD. If heterogeneity of studies precludes data pooling, results will be presented in narrative form. Determining whether a distinct neuroradiologic phenotype of CSVD exists in

  9. Recurrent cerebral thrombosis; With special reference to the neuroradiological study

    Energy Technology Data Exchange (ETDEWEB)

    Iwamoto, Toshihiko; Abe, Shin-e; Kubo, Hideki; Hanyu, Haruo; Takasaki, Masaru (Tokyo Medical Coll. (Japan))

    1992-10-01

    Neuroradiological techniques were used to elucidate pathophysiology of recurrent cerebral thrombosis. Twenty-two patients with cerebral thrombosis who suffered a second attack under stable conditions more than 22 days after the initial stroke were studied. Hypertension, diabetes mellitus, and hypercholesterolemia were also seen in 20, 8, and 12 patients, respectively. The patients were divided into three groups according to their symptoms: (I) symptoms differed between the first and second strokes (n=12); (II) initial symptoms were suddenly deteriorated (n=6); and (III) symptoms occurring in groups I and II were seen (n=4). In group I, contralateral hemiparesis or suprabulbar palsy was often associated with the initial hemiparesis. The time of recurrent stroke varied from 4 months to 9 years. CT and MRI showed not only lacunae in both hemispheres, but also deep white-matter ischemia of the centrum semi-ovale. In group II, hemiparesis or visual field defect was deteriorated early after the initial stroke. In addition, neuroimaging revealed that infarction in the posterior cerebral artery was progressed on the contralateral side, or that white matter lesion in the middle artery was enlarged in spite of small lesion in the left cerebral hemisphere. All patients in group III had deterioration of right hemiparesis associated with aphasia. CT, MRI, SPECT, and angiography indicated deep white-matter ischemia caused by main trunk lesions in the left hemisphere. Group III seemed to be equivalent to group II, except for laterality of the lesion. Neuroradiological assessment of the initial stroke may help to predict the mode of recurrence, although pathophysiology of cerebral thrombosis is complicated and varies from patient to patient. (N.K.).

  10. Neuroradiologic findings in leptomeningeal carcinomatosis: The value interest of gadolinium-enhanced MRI

    International Nuclear Information System (INIS)

    Rodesch, G.; Baleriaux, D.; Bogaert, P. van; Mavroudakis, N.; Hildebrand, J.; Parizel, P.M.; Martin, J.J.; Segebarth, C.; Vyve, M. van

    1990-01-01

    Four patients with leptomeningeal metastases documented by neuroradiological examinations are reported. All had central nervous system or systemic neoplasms and showed clinical signs of carcinomatous meningitis. Gadolinium-enhanced MRI (Gd-MRI) disclosed for each patient pathological foci, allowing delineation of the extent of meningeal disease. Although non-specific, these findings, combined with the clinical context and CSF analysis, may lead to a rapid diagnosis and treatment of carcinomatous meningitis, even when malignant cells are not detected in the cerebrospinal fluid. (orig.)

  11. eLearning in education and advanced training in neuroradiology: introduction of a web-based teaching and learning application

    International Nuclear Information System (INIS)

    Zajaczek, J.E.W.; Goetz, F.; Haubitz, B.; Donnerstag, F.; Becker, H.; Kupka, T.; Behrends, M.; Matthies, H.K.; Rodt, T.; Walter, G.F.

    2006-01-01

    New information technologies offer the possibility of major improvements in the professional education and advanced training of physicians. The web-based, multimedia teaching and learning application Schoolbook has been created and utilized for neuroradiology. Schoolbook is technically based as a content management system and is realized in a LAMP environment. The content is generated with the help of the developed system and stored in a database. The layout is defined by a PHP application, and the webpages are generated from the system. Schoolbook is realized as an authoring tool so that it can be integrated into daily practice. This enables the teacher to autonomously process the content into the web-based application which is used for lectures, seminars and self-study. A multimedia case library is the central building block of Schoolbook for neuroradiology, whereby the learner is provided with original diagnostic and therapeutic data from numerous individual cases. The user can put individual emphasis on key learning points as there are various ways to work with the case histories. Besides the case-based way of teaching and learning, a systematically structured way of dealing with the content is available. eLearning offers various opportunities for teaching and learning in academic and scientific as well as in economic contexts. Web-based applications such as Schoolbook may be beneficial not only for basic university education but also for the realization of international educational programmes such as the European Master of Medical Science with a major in neuroradiology. (orig.)

  12. eLearning in education and advanced training in neuroradiology: introduction of a web-based teaching and learning application.

    Science.gov (United States)

    Zajaczek, J E W; Götz, F; Kupka, T; Behrends, M; Haubitz, B; Donnerstag, F; Rodt, T; Walter, G F; Matthies, H K; Becker, H

    2006-09-01

    New information technologies offer the possibility of major improvements in the professional education and advanced training of physicians. The web-based, multimedia teaching and learning application Schoolbook has been created and utilized for neuroradiology. Schoolbook is technically based as a content management system and is realized in a LAMP environment. The content is generated with the help of the developed system and stored in a database. The layout is defined by a PHP application, and the webpages are generated from the system. Schoolbook is realized as an authoring tool so that it can be integrated into daily practice. This enables the teacher to autonomously process the content into the web-based application which is used for lectures, seminars and self-study. A multimedia case library is the central building block of Schoolbook for neuroradiology, whereby the learner is provided with original diagnostic and therapeutic data from numerous individual cases. The user can put individual emphasis on key learning points as there are various ways to work with the case histories. Besides the case-based way of teaching and learning, a systematically structured way of dealing with the content is available. eLearning offers various opportunities for teaching and learning in academic and scientific as well as in economic contexts. Web-based applications such as Schoolbook may be beneficial not only for basic university education but also for the realization of international educational programmes such as the European Master of Medical Science with a major in neuroradiology.

  13. eLearning in education and advanced training in neuroradiology: introduction of a web-based teaching and learning application

    Energy Technology Data Exchange (ETDEWEB)

    Zajaczek, J.E.W. [Hannover Medical School, Department of Neuroradiology (OE 8210), Hannover (Germany); Hannover Medical School, Department of Medical Informatics, Hannover (Germany); Goetz, F.; Haubitz, B.; Donnerstag, F.; Becker, H. [Hannover Medical School, Department of Neuroradiology (OE 8210), Hannover (Germany); Kupka, T.; Behrends, M.; Matthies, H.K. [Hannover Medical School, Department of Medical Informatics, Hannover (Germany); Rodt, T. [Hannover Medical School, Department of Neurosurgery, Hannover (Germany); Walter, G.F. [Medical University of Graz, Graz (Austria)

    2006-09-15

    New information technologies offer the possibility of major improvements in the professional education and advanced training of physicians. The web-based, multimedia teaching and learning application Schoolbook has been created and utilized for neuroradiology. Schoolbook is technically based as a content management system and is realized in a LAMP environment. The content is generated with the help of the developed system and stored in a database. The layout is defined by a PHP application, and the webpages are generated from the system. Schoolbook is realized as an authoring tool so that it can be integrated into daily practice. This enables the teacher to autonomously process the content into the web-based application which is used for lectures, seminars and self-study. A multimedia case library is the central building block of Schoolbook for neuroradiology, whereby the learner is provided with original diagnostic and therapeutic data from numerous individual cases. The user can put individual emphasis on key learning points as there are various ways to work with the case histories. Besides the case-based way of teaching and learning, a systematically structured way of dealing with the content is available. eLearning offers various opportunities for teaching and learning in academic and scientific as well as in economic contexts. Web-based applications such as Schoolbook may be beneficial not only for basic university education but also for the realization of international educational programmes such as the European Master of Medical Science with a major in neuroradiology. (orig.)

  14. Sella turcica morphology and the pituitary gland--a new contribution to craniofacial diagnostics based on histology and neuroradiology

    DEFF Research Database (Denmark)

    Kjær, Inger

    2012-01-01

    histological analyses of human prenatal material and profile radiographic analyses of human postnatal material, supplemented in a few cases with neuroradiology. Prenatal and postnatal results are compared. Similarities between prenatal and postnatal deviations in sella turcica morphology were demonstrated...

  15. Spinal dysraphism: a review of neuroradiological features with embryological correlations and proposal for a new classification

    International Nuclear Information System (INIS)

    Tortori-Donati, P.; Rossi, A.; Cama, A.

    2000-01-01

    Our purpose was to review the neuroradiological features of spinal dysraphism and to correlate them with clinical findings and up-to-date embryological theory. We also aimed to formulate a working classification which might prove useful in clinical practice. We reviewed series of 986 children referred to our Spina Bifida Centre in the past 24 years. There were 353 children with open spinal (OSD) and 633 with closed (skin-covered) spinal (CSD) dysraphism. By far the most common open abnormality was myelomeningocele, and all patients with OSD had a Chiari II malformation. CSD was categorised clinically, depending on the presence of a subcutaneous mass in the back. CSD with a mass mainly consisted of lipomas with dural defects and meningoceles, and accounted for 18.8 % of CSD. CSD without a mass were simple (tight filum terminale, intradural lipoma) or complex (split cord malformations, caudal regression). Our suggested classification is easy to use and to remember and takes into account clinical and MRI features; we have found it useful and reliable when making a preoperative neuroradiological diagnosis in clinical practice. (orig.)

  16. Technical compliance to standard guidelines for lumbar puncture and myelography: survey of academic neuroradiology attendings and fellows.

    Science.gov (United States)

    Zhang, Yi C; Chandler, Alexander J; Kagetsu, Nolan J

    2014-05-01

    To assess technical compliance among neuroradiology attendings and fellows to standard guidelines for lumbar puncture and myelography to minimize procedural complications such as iatrogenic meningitis and spinal headache. We surveyed academic neuroradiology attendings and fellows in the e-mail directory of the Association of Program Directors in Radiology. We queried use of face masks, use of noncutting needles, and dural puncture practices. All data were collected anonymously. A total of 110 survey responses were received: 75 from neuroradiology attendings and 34 from fellows, which represents a 14% response rate from a total of 239 fellows. Forty-seven out of 101 (47%) neuroradiologists do not always wear a face mask during myelograms, and 50 out of 105(48%) neuroradiologists do not always wear a face mask during lumbar punctures, placing patients at risk for iatrogenic meningitis. Ninety-six out of 106 neuroradiologists (91%) use the Quincke cutting needle by default, compared to only 17 out of 109 neuroradiologists (16%) who have ever used noncutting needles proven to reduce spinal headache. Duration of postprocedure bed rest does not influence incidence of spinal headache and may subject patients to unnecessary monitoring. Only 15 out of 109 (14%) neuroradiologists in our study do not prescribe bed rest. There was no statistically significant difference in practice between attendings and fellows. Iatrogenic meningitis and spinal headache are preventable complications of dural puncture that neuroradiologists can minimize by conforming to procedural guidelines. Wearing face masks and using noncutting spinal needles will reduce patient morbidity and lower hospitalization costs associated with procedural complications. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

  17. Non-traumatic neurological emergencies: emergency neuroradiological interventions

    Energy Technology Data Exchange (ETDEWEB)

    Schroth, Gerhard; Loevblad, Karl-Olof; Ozdoba, Christoph; Remonda, Luca [Department of Neuroradiology, University of Bern, Inselspital (Switzerland)

    2002-07-01

    This article summarizes recent developments in the growing field of interventional neuroradiology for the treatment of acute cerebrovascular disease. We describe the possibilities in endovascular therapy of acute cerebral aneurysms using electrolytically detachable coils combined with trispan neck bridging devices and stent implantation to occlude acute wide neck aneurysms. Techniques and results of local intra-arterial thrombolytic therapy in acute stroke and central retinal artery occlusion are described and we discuss the potential for rapid, large-burden thrombus removal in cases of internal carotid artery thrombosis by rheolytic thrombectomy, percutaneous transluminal angioplasty and stent implantation. Emergency endovascular therapy using the transvenous approach to treat severe intracranial or intraocular hypertension and multifocal haemorrhagic venous infarction due to cerebral sinus thrombosis or dural fistulas is also described. In cases of acute bleeding of head and neck lesions following trauma, tumours after radiotherapy, arteriovenous malformations, epistaxis or from iatrogenic origin, angiography plays a major role in localizing the source of bleeding and occluding the damaged vessel during the same session using the same endovascular approach. (orig.)

  18. Paediatric neuroradiological aspects of Langerhans cell histiocytosis

    Energy Technology Data Exchange (ETDEWEB)

    Demaerel, Philippe [University Hospital K.U.Leuven, Department of Radiology, Leuven (Belgium); Gool, Stefaan van [University Hospital K.U.Leuven, Paediatric Haemato-oncology/Neuro-oncology, Leuven (Belgium)

    2008-01-15

    Langerhans cell histiocytosis, previously known as histiocytosis X, is a complex disease consisting of three entities that are all characterized by a proliferation of the Langerhans cell. The clinical course is variable and ranges from a solitary lytic bone or skin lesion with complete remission to a multisystem disorder with possible lethal outcome. The clinical suspicion can be increased based on radiological findings that are important criteria in defining the extent of the disease involvement. A biopsy is often necessary for establishing the final diagnosis. The lytic craniofacial bone lesions are the most common craniospinal abnormality in Langerhans cell histiocytosis. Abnormalities in the hypothalamic-pituitary region are the most frequent manifestations, often accompanied with diabetes insipidus as the presenting symptom. A range of different central nervous system abnormalities can be recognized. It is important to be able to recognize the extensive spectrum of neuroradiological abnormalities in order to arrive at the diagnosis. Neuroimaging plays an even more important role in assessing the response to treatment or possible relapse. (orig.)

  19. Non-traumatic neurological emergencies: emergency neuroradiological interventions

    International Nuclear Information System (INIS)

    Schroth, Gerhard; Loevblad, Karl-Olof; Ozdoba, Christoph; Remonda, Luca

    2002-01-01

    This article summarizes recent developments in the growing field of interventional neuroradiology for the treatment of acute cerebrovascular disease. We describe the possibilities in endovascular therapy of acute cerebral aneurysms using electrolytically detachable coils combined with trispan neck bridging devices and stent implantation to occlude acute wide neck aneurysms. Techniques and results of local intra-arterial thrombolytic therapy in acute stroke and central retinal artery occlusion are described and we discuss the potential for rapid, large-burden thrombus removal in cases of internal carotid artery thrombosis by rheolytic thrombectomy, percutaneous transluminal angioplasty and stent implantation. Emergency endovascular therapy using the transvenous approach to treat severe intracranial or intraocular hypertension and multifocal haemorrhagic venous infarction due to cerebral sinus thrombosis or dural fistulas is also described. In cases of acute bleeding of head and neck lesions following trauma, tumours after radiotherapy, arteriovenous malformations, epistaxis or from iatrogenic origin, angiography plays a major role in localizing the source of bleeding and occluding the damaged vessel during the same session using the same endovascular approach. (orig.)

  20. CANINE BUTTERFLY GLIOBLASTOMAS: A NEURORADIOLOGICAL REVIEW

    Directory of Open Access Journals (Sweden)

    John Henry Rossmeisl

    2016-05-01

    Full Text Available In humans, high-grade gliomas may infiltrate across the corpus callosum resulting in bihemispheric lesions that may have symmetrical, winged-like appearances. This particular tumor manifestation has been coined a ‘butterfly’ glioma (BG. While canine and human gliomas share many neuroradiological and pathological features, the BG morphology has not been previously reported in dogs. Here we describe the magnetic resonance imaging (MRI characteristics of BG in three dogs, and review the potential differential diagnoses based on neuroimaging findings. All dogs presented with generalized seizures and interictal neurological deficits referable to multifocal or diffuse forebrain disease. MRI examinations revealed asymmetrical (2/3 or symmetrical (1/3, bihemispheric intra-axial mass lesions that predominantly affected the frontoparietal lobes and associated with extensive perilesional edema, and involvement of the corpus callosum. The masses displayed heterogeneous T1, T2, and FLAIR signal intensities, variable contrast enhancement (2/3, and mass effect. All tumors demonstrated classical histopathological features of glioblastoma (GBM including glial cell pseudopalisading, serpentine necrosis, microvascular proliferation, as well as invasion of the corpus callosum by neoplastic astrocytes. Although rare, GBM should be considered a differential diagnosis in dogs with MRI evidence of asymmetric or symmetric bilateral, intra-axial cerebral mass lesions with signal characteristics compatible with glioma.

  1. Serial neuroradiological studies in focal cerebritis

    International Nuclear Information System (INIS)

    Hatta, S.; Mochizuki, H.; Kuru, Y.; Miwa, H.; Kondo, T.; Mori, H.; Mizuno, Y.

    1994-01-01

    We report serial neuroradiological studies in a patient with focal cerebritis in the head of the left caudate nucleus. On the day after the onset of symptoms, CT showed an ill-defined low density lesion. The lack of contrast enhancement appeared to be the most important finding for differentiating focal cerebritis from an encapsulated brain abscess or a tumour. MRI two days later revealed the centre of the lesion to be of slightly low intensity on T1-weighted inversion recovery (IR) images and very low intensity on T2-weighted spin echo images, which appeared to correspond to the early cerebritis stage of experimentally induced cerebritis and brain abscess. Ten days after the onset of symptoms, CT revealed a thin ring of enhancement in the head of the caudate nucleus, and a similar small ring was seen in the hypothalamus 16 days after the onset, corresponding to the late cerebritis stage. MRI nine days later revealed ill-defined high signal lesions within the involved area on the T1-weighted IR images. To our knowledge, this is the first published MRI documentation of the early cerebritis stage developing into an encapsulated brain abscess. The mechanisms underlying of these radiographic changes are discussed. (orig.)

  2. Perfusion magnetic resonance imaging in pediatric brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Dallery, F.; Michel, D.; Constans, J.M.; Gondry-Jouet, C. [University Hospital, Department of Radiology, Amiens (France); Bouzerar, R.; Promelle, V.; Baledent, O. [University Hospital, Department of Imaging and Biophysics, Amiens (France); Attencourt, C. [University Hospital, Departement of Pathology, Amiens (France); Peltier, J. [University Hospital, Departement of Neurosurgery, Amiens (France)

    2017-11-15

    The use of DSC-MR imaging in pediatric neuroradiology is gradually growing. However, the number of studies listed in the literature remains limited. We propose to assess the perfusion and permeability parameters in pediatric brain tumor grading. Thirty children with a brain tumor having benefited from a DSC-MR perfusion sequence have been retrospectively explored. Relative CBF and CBV were computed on the ROI with the largest lesion coverage. Assessment of the lesion's permeability was also performed through the semi-quantitative PSR parameter and the K2 model-based parameter on the whole-lesion ROI and a reduced ROI drawn on the permeability maps. A statistical comparison of high- and low-grade groups (HG, LG) as well as a ROC analysis was performed on the histogram-based parameters. Our results showed a statistically significant difference between LG and HG groups for mean rCBV (p < 10{sup -3}), rCBF (p < 10{sup -3}), and for PSR (p = 0.03) but not for the K2 factor (p = 0.5). However, the ratio K2/PSR was shown to be a strong discriminating factor between the two groups of lesions (p < 10{sup -3}). For rCBV and rCBF indicators, high values of ROC AUC were obtained (> 0.9) and mean value thresholds were observed at 1.07 and 1.03, respectively. For K2/PSR in the reduced area, AUC was also superior to 0.9. The implementation of a dynamic T2* perfusion sequence provided reliable results using an objective whole-lesion ROI. Perfusion parameters as well as a new permeability indicator could efficiently discriminate high-grade from low-grade lesions in the pediatric population. (orig.)

  3. Neuroradiologic Characteristics of Primary Angiitis of the Central Nervous System According to the Affected Vessel Size.

    Science.gov (United States)

    Thaler, Christian; Kaufmann-Bühler, Ann-Katrin; Gansukh, Tserenchunt; Gansukh, Amarjargal; Schuster, Simon; Bachmann, Henrike; Thomalla, Götz; Magnus, Tim; Matschke, Jakob; Fiehler, Jens; Siemonsen, Susanne

    2017-09-05

    Magnetic resonance imaging (MRI) has an important impact in diagnosing primary angiitis of the central nervous system (PACNS). However, neuroradiologic findings may vary immensely, making an easy and definite diagnosis challenging. In this retrospective, single center study, we analyzed neuroradiologic findings of patients with PACNS diagnosed at our hospital between 2009 and 2014. Furthermore, we classified patients according to the affected vessel size and compared imaging characteristics between the subgroups. Thirty-three patients were included (mean age 43 [±15.3] years, 17 females) in this study. Patients with positive angiographic findings were classified as either medium or large vessel PACNS and presented more ischemic lesions (p effect. Twenty-five patients underwent brain biopsy. Patients with medium or large vessel PACNS were less likely to have positive biopsy results. It is essential to differentiate between small and medium/large vessel PACNS since results in MRI, digital subtraction angiography and brain biopsy may differ immensely. Since image quality of MR scanners improves gradually and brain biopsy may often be nonspecific or negative, our results emphasize the importance of MRI/MRA in the diagnosis process of PACNS.

  4. Some methodological issues in neuroradiological research in psychiatry

    International Nuclear Information System (INIS)

    Becker, T.; Retz, W.; Hofmann, E.; Becker, G.; Teichmann, E.; Gsell, W.

    1995-01-01

    An outline is given of some of the methodological issues discussed in neuroradiological research on psychiatric illnesses. The strengths and shortcomings of magnetic resonance imaging (MRI) in depicting and quantifying brain structures are described. Temporal lobe anatomy and pathology are easily accessible to MRI, whereas limits on anatomical delineation hamper approaches to frontal lobe study. White matter hyperintense lesions are sensitively depicted by MRI, but specificity is limited. The distinction of vascular and primary degenerative dementia is considerably improved by CT and MRI analysis. Computed tomography (CT) and MRI have enhanced the understanding of treatable organic psychiatric disorders, e.g., normal pressure hydrocephalus. Subcortical and white matter pathology has been replicated in CT and MRI studies of late onset psychiatric disorders, clinical overlap with cerebrovascular disease or neuro degeneration may be of import. Trans cranial sonography findings of brainstem structural change specific to unipolar depression may contribute to the understanding of affective psychoses. Magnetic resonance spectroscopy and functional MRI are likely to stimulate psychiatric research in the future. (author)

  5. Clinical and neuroradiological studies of eclampsia. Cerebral vasospasm and relation to the brain edema

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Yasuhiro; Niwa, Hisayoshi; Ando, Tetsuo; Yasuda, Takeshi; Yanagi, Tsutomu [Nagoya Daini Red Cross Hospital, Aichi (Japan)

    1995-04-01

    Clinical and neuroradiological studies involving cerebral angiography were conducted in four patients with eclampsia. In three cases (case 1, 2 and 4), neurological focal signs, abnormal low density areas on cranial CT and T{sub 2} high intensity areas on cranial MRI disappeared within a month. But in one case (case 3), cerebral infarction occurred and right hemiparesis and aphasia persisted. Cerebral angiography in the acute phase demonstrated vasospasm in all cases and arterial occlusion in the middle cerebral artery due to vasospasm in case 3. Angiography demonstrated several types of spasms, including diffuse, peripheral and multi local. Furthermore, in some cases, diffuse vasospasms were recognized at the siphon and extracranial portions of the internal carotid artery. In one case (Case 4), segmental vasospasms were detected in the bilateral vertebral arteries. Three to four weeks later, follow-up cerebral angiography was performed in three cases. Cerebral vasospasms had partially or completely recovered. Subarachnoid hemorrhage (SAH) was excluded by lumbar puncture and neuroradiological findings in all cases. We concluded that eclampsia itself causes cerebral vasospasm and that the mechanism of vasospasm is different from that of SAH, since cerebral vasospasm occurred in the extracranial cerebral arteries. We suspected that cerebral vasospasm in eclampsia causes cerebral ischemia, which leads to cytotoxic edema and dysfunction of the blood-brain barrier (BBB) and cerebral autoregulation. With this background, brain edema, especially vasogenic edema, may easily occur and clinical symptoms of eclampsia may appear when the blood pressure rapidly increases. (author).

  6. Clinical and neuroradiological studies of eclampsia. Cerebral vasospasm and relation to the brain edema

    International Nuclear Information System (INIS)

    Ito, Yasuhiro; Niwa, Hisayoshi; Ando, Tetsuo; Yasuda, Takeshi; Yanagi, Tsutomu

    1995-01-01

    Clinical and neuroradiological studies involving cerebral angiography were conducted in four patients with eclampsia. In three cases (case 1, 2 and 4), neurological focal signs, abnormal low density areas on cranial CT and T 2 high intensity areas on cranial MRI disappeared within a month. But in one case (case 3), cerebral infarction occurred and right hemiparesis and aphasia persisted. Cerebral angiography in the acute phase demonstrated vasospasm in all cases and arterial occlusion in the middle cerebral artery due to vasospasm in case 3. Angiography demonstrated several types of spasms, including diffuse, peripheral and multi local. Furthermore, in some cases, diffuse vasospasms were recognized at the siphon and extracranial portions of the internal carotid artery. In one case (Case 4), segmental vasospasms were detected in the bilateral vertebral arteries. Three to four weeks later, follow-up cerebral angiography was performed in three cases. Cerebral vasospasms had partially or completely recovered. Subarachnoid hemorrhage (SAH) was excluded by lumbar puncture and neuroradiological findings in all cases. We concluded that eclampsia itself causes cerebral vasospasm and that the mechanism of vasospasm is different from that of SAH, since cerebral vasospasm occurred in the extracranial cerebral arteries. We suspected that cerebral vasospasm in eclampsia causes cerebral ischemia, which leads to cytotoxic edema and dysfunction of the blood-brain barrier (BBB) and cerebral autoregulation. With this background, brain edema, especially vasogenic edema, may easily occur and clinical symptoms of eclampsia may appear when the blood pressure rapidly increases. (author)

  7. The neuroradiological study of craniopharyngiomas

    International Nuclear Information System (INIS)

    Oikawa, Susumu; Takemae, Toshiki; Kobayashi, Shigeaki

    1992-01-01

    The neuroradiological manifestations of 10 surgically verified craniopharyngiomas are retrospectively studied and compared with those of 8 non-functioning pituitary macroadenomas. The saucer-like appearance of the sella turcica on a craniogram was noted in 2 of the 10 craniopharyngiomas and in 2 of the 8 pituitary adenomas. A ballooning of the sella turcica was observed in one of the 10 craniopharyngiomas and in 5 of the 8 pituitary adenomas. Calcification on CT scan was presented in only 5 craniopharyngiomas. On a plain CT scan, no craniopharyngioma manifested any high-density mass except calcification. Four pituitary adenomas showed a slightly high density, though. A cystic lesion was revealed in all the craniopharyngiomas and in 4 pituitary adenomas. All the craniopharyngiomas except for one intrasellar type and all the pituitary adenomas were enhanced with a contrast medium. The solid portion in one craniopharyngioma and in one pituitary adenoma was high-intensity on T 1 -weighted MRI. The cystic portion in 4 craniopharyngiomas and in 2 pituitary adenomas manifested a high intensity on a T 1 -weighted image. A normal pituitary gland located on the floor of the sella was disclosed in all the craniopharyngiomas on a sagittal T 1 -weighted image; however in all the pituitary adenomas, no normal pituitary gland was found at least not on the floor of the sella. The presence of a normal pituitary gland on the sellar floor on sagittal T 1 -weighted MRI may be a new differential diagnostic point between craniopharyngioma and pituitary macroadenoma. Calcification, cystic formation, and density on a plain CT scan seem to be useful evidence for diagnosis. (author)

  8. Trends in performance indicators of neuroimaging anatomy research publications: a bibliometric study of major neuroradiology journal output over four decades based on web of science database.

    Science.gov (United States)

    Wing, Louise; Massoud, Tarik F

    2015-01-01

    Quantitative, qualitative, and innovative application of bibliometric research performance indicators to anatomy and radiology research and education can enhance cross-fertilization between the two disciplines. We aim to use these indicators to identify long-term trends in dissemination of publications in neuroimaging anatomy (including both productivity and citation rates), which has subjectively waned in prestige during recent years. We examined publications over the last 40 years in two neuroradiological journals, AJNR and Neuroradiology, and selected and categorized all neuroimaging anatomy research articles according to theme and type. We studied trends in their citation activity over time, and mathematically analyzed these trends for 1977, 1987, and 1997 publications. We created a novel metric, "citation half-life at 10 years postpublication" (CHL-10), and used this to examine trends in the skew of citation numbers for anatomy articles each year. We identified 367 anatomy articles amongst a total of 18,110 in these journals: 74.2% were original articles, with study of normal anatomy being the commonest theme (46.7%). We recorded a mean of 18.03 citations for each anatomy article, 35% higher than for general neuroradiology articles. Graphs summarizing the rise (upslope) in citation rates after publication revealed similar trends spanning two decades. CHL-10 trends demonstrated that more recently published anatomy articles were likely to take longer to reach peak citation rate. Bibliometric analysis suggests that anatomical research in neuroradiology is not languishing. This novel analytical approach can be applied to other aspects of neuroimaging research, and within other subspecialties in radiology and anatomy, and also to foster anatomical education. © 2014 Wiley Periodicals, Inc.

  9. Radiology today

    International Nuclear Information System (INIS)

    Donner, M.W.; Heuck, F.H.W.

    1981-01-01

    The book encompasses the proceedings of a postgraduate course held in Salzburg in June 1980. 230 radiologists from 17 countries discussed here the important and practical advances of diagnostic radiology, nuclear medicine and ultrasound as they contribute to gastrointestinal, urologic, skeletal, cardiovascular, pediatric, and neuroradiology. The book contains 55 single contributions of different authors to the following main themes: Cardiovascular, Radiology, pulmonary radiology, gastrointestinal radiology, urinary tract radiology, skeletal radiology, mammography, lymphography, ultrasound, ENT radiology, and neuroradiology. (orig./MG)

  10. Participation in Pre-High School Football and Neurological, Neuroradiological, and Neuropsychological Findings in Later Life: A Study of 45 Retired National Football League Players.

    Science.gov (United States)

    Solomon, Gary S; Kuhn, Andrew W; Zuckerman, Scott L; Casson, Ira R; Viano, David C; Lovell, Mark R; Sills, Allen K

    2016-05-01

    A recent study found that an earlier age of first exposure (AFE) to tackle football was associated with long-term neurocognitive impairment in retired National Football League (NFL) players. To assess the association between years of exposure to pre-high school football (PreYOE) and neuroradiological, neurological, and neuropsychological outcome measures in a different sample of retired NFL players. Cross-sectional study; Level of evidence, 3. Forty-five former NFL players were included in this study. All participants prospectively completed extensive history taking, a neurological examination, brain magnetic resonance imaging, and a comprehensive battery of neuropsychological tests. To measure the associations between PreYOE and these outcome measures, multiple regression models were utilized while controlling for several covariates. After applying a Bonferroni correction for multiple comparisons, none of the neurological, neuroradiological, or neuropsychological outcome measures yielded a significant relationship with PreYOE. A second Bonferroni-corrected analysis of a subset of these athletes with self-reported learning disability yielded no significant relationships on paper-and-pencil neurocognitive tests but did result in a significant association between learning disability and computerized indices of visual motor speed and reaction time. The current study failed to replicate the results of a prior study, which concluded that an earlier AFE to tackle football might result in long-term neurocognitive deficits. In 45 retired NFL athletes, there were no associations between PreYOE and neuroradiological, neurological, and neuropsychological outcome measures. © 2016 The Author(s).

  11. C-arm flat detector computed tomography: the technique and its applications in interventional neuro-radiology

    International Nuclear Information System (INIS)

    Kamran, Mudassar; Nagaraja, Sanjoy; Byrne, James V.

    2010-01-01

    Flat detector computed tomography (FDCT) is an imaging tool that generates three-dimensional (3-D) volumes from data obtained during C-arm rotation using CT-like reconstruction algorithms. The technique is relatively new and, at current levels of performance, lags behind conventional CT in terms of image quality. However, the advantage of its availability in the interventional room has prompted neuro-radiologists to identify clinical settings where its role is uniquely beneficial. We performed a search of the online literature databases to identify studies reporting experience with FDCT in interventional neuro-radiology. The studies were systematically reviewed and their findings grouped according to specific clinical situation addressed. FDCT images allow detection of procedural complications, evaluation of low-radiopacity stents and assessment of endosaccular coil packing in intra-cranial aneurysms. Additional roles are 3-D angiography that provides an accurate depiction of vessel morphology with low concentrations of radiographic contrast media and a potential for perfusion imaging due to its dynamic scanning capability. A single scan combining soft tissue and angiographic examinations reduces radiation dose and examination time. Ongoing developments in flat detector technology and reconstruction algorithms are expected to further enhance its performance and increase this range of applications. FDCT images provide useful information in neuro-interventional setting. If current research confirms its potential for assessing cerebral haemodynamics by perfusion scanning, the combination would redefine it as an invaluable tool for interventional neuro-radiology procedures. This facility and its existing capabilities of parenchymal and angiographic imaging would also extend its use to the triage of acute stroke patients. (orig.)

  12. Neuroradiological evaluation of benign extramedullary tumors in the high cervical region and at the foramen magnum

    Energy Technology Data Exchange (ETDEWEB)

    Nishiura, Iwao; Koyama, Tsunemaro; Tanaka, Kimito; Aii, Heihachirou

    1986-06-01

    Twelve cases of benign extramedullary tumors in the high cervical region and at the foramen magnum were experienced during past five years among eighty all spinal and paraspinal tumors. The diagnosis of masses in this region is very difficult because of the variety of clinical course, symptoms and neurological findings as pointed out by many reporters. Also in our cases, 70 % of the patients complained of the deteriorated motor weakness of the upper or lower extremities on admission, though they had noticed the onset of slight neck or occipital pain a few years ago. Neurological examination on admission clearly showed the symptom of myelopathy except in two cases with a tumor at the foramen magnum and C/sub 1/ level. The percentage of positive findings of plain X-rays was 50 %, that of metrizamide myelography was 92 % and that of IV. e. CT and met. e. CT was 100 %. NMR-CT was performed in 2 cases, and in one of them it was useful in confirming the tumor configuration and extension. Five interesting cases were described mainly from the neuroradiological aspects. Finally the differentiation between meningioma and neurinoma was discussed from the aspects of myelogram, CT and NMR-CT. As already pointed out, it is most important not to forget the existence of tumors in this region when one comes across the confused symptoms, afterwards not to overlook the slight positive neurological and neuroradiological findings.

  13. Flat-detector computed tomography in diagnostic and interventional neuroradiology

    International Nuclear Information System (INIS)

    Struffert, T.; Doerfler, A.

    2009-01-01

    Originally aimed at improving standard radiography by providing higher absorption efficiency and a wider dynamic range than available with film-screen and phosphor luminescence, radiography flat detector technology is now widely accepted for neuroangiographic imaging. Especially flat-detector computed tomography (FD-CT), which uses rotational C-arm mounted flat-panel detector technology, is capable of volumetric imaging with a high spatial resolution. As ''angiographic CT'' FD-CT may be helpful in many diagnostic and neurointerventional procedures, e.g. intracranial stenting for cerebrovascular stenoses, stent-assisted coil embolization of wide-necked cerebral aneurysms and embolization of arteriovenous malformations. By providing morphologic, CT-like images of the brain within the angiography suite FD-CT allows rapid visualization of periprocedural hemorrhaging and may thus improve rapid complication management without the need of patient transfer. In addition, myelography and postmyelographic FD-CT imaging can be carried out using a single modality. Spinal interventions, such as kyphoplasty or vertebroplasty might also benefit from FD-CT. Imaging of the temporal bone may also develop into an important field of FD-CT. This paper briefly reviews the technical principles of FD technology and the potential applications in diagnostic and interventional neuroradiology. (orig.) [de

  14. Early diagnosis of acoustic neuroma by quantitative neurootological and neuroradiological tests

    Energy Technology Data Exchange (ETDEWEB)

    Haid, C T

    1983-02-01

    Every patient with unilateral and sensoneural loss of hearing, independent of vertigo anamnesis or X-rays must be further examined by a vestibular test. Between 1974 and 1980, 80 acoustic neuromas could be diagnosed, including 12 early stage neuromas. This relatively high detection quote of small neuromas is due to a special diagnostical program: All 80 patients with acoustic neuroma had a pathological vestibular result. The positional test turned out to be the most sensitive examination in the early diagnosis of acoustic neuromas and yields a still higher incidence than the caloric test: 95% of the patients with a neurinoma showed a pathological result in the positional test. So every patient suffering from an unidentified unilateral and sensoneural hearing loss combined with a pathological result in the positional test must be further examined by a cisternomeatography or computerized tomography (using air-insufflation). Every fifth of these patients showed unique hints of an acoustic neuroma in the neuroradiological test.

  15. Impact of the Journal of Child Neurology: 2002 data.

    Science.gov (United States)

    Brumback, Roger A

    2003-11-01

    The Journal of Child Neurology (JCN) began in 1986 as a quarterly publication focused on child neurology and the related clinical pediatric neuroscience areas of pediatric neurosurgery, child psychiatry, pediatric neuroradiology, and developmental and behavioral pediatrics. As submitted material increased, JCN expanded in publication frequency and now appears monthly. Article quality has always been high and many articles have been frequently cited. Over the years, the ratings produced for the ISI Journal Citation Reports have identified JCN as a high-ranking pediatric journal based upon the impact factor value. Currently (year 2002 figures), JCN (with its impact factor of 1.338) ranks 24th out of 68 pediatric journals.

  16. Metrics and textural features of MRI diffusion to improve classification of pediatric posterior fossa tumors.

    Science.gov (United States)

    Rodriguez Gutierrez, D; Awwad, A; Meijer, L; Manita, M; Jaspan, T; Dineen, R A; Grundy, R G; Auer, D P

    2014-05-01

    Qualitative radiologic MR imaging review affords limited differentiation among types of pediatric posterior fossa brain tumors and cannot detect histologic or molecular subtypes, which could help to stratify treatment. This study aimed to improve current posterior fossa discrimination of histologic tumor type by using support vector machine classifiers on quantitative MR imaging features. This retrospective study included preoperative MRI in 40 children with posterior fossa tumors (17 medulloblastomas, 16 pilocytic astrocytomas, and 7 ependymomas). Shape, histogram, and textural features were computed from contrast-enhanced T2WI and T1WI and diffusivity (ADC) maps. Combinations of features were used to train tumor-type-specific classifiers for medulloblastoma, pilocytic astrocytoma, and ependymoma types in separation and as a joint posterior fossa classifier. A tumor-subtype classifier was also produced for classic medulloblastoma. The performance of different classifiers was assessed and compared by using randomly selected subsets of training and test data. ADC histogram features (25th and 75th percentiles and skewness) yielded the best classification of tumor type (on average >95.8% of medulloblastomas, >96.9% of pilocytic astrocytomas, and >94.3% of ependymomas by using 8 training samples). The resulting joint posterior fossa classifier correctly assigned >91.4% of the posterior fossa tumors. For subtype classification, 89.4% of classic medulloblastomas were correctly classified on the basis of ADC texture features extracted from the Gray-Level Co-Occurence Matrix. Support vector machine-based classifiers using ADC histogram features yielded very good discrimination among pediatric posterior fossa tumor types, and ADC textural features show promise for further subtype discrimination. These findings suggest an added diagnostic value of quantitative feature analysis of diffusion MR imaging in pediatric neuro-oncology. © 2014 by American Journal of Neuroradiology.

  17. Pediatric MS

    Science.gov (United States)

    ... Pediatric MS Share this page Facebook Twitter Email Pediatric MS Pediatric MS Pediatric MS Support Pediatric Providers ... system through the Pediatric MS Support Group . Treating pediatric MS In 2018 the U.S. Food and Drug ...

  18. Structured Reporting in Neuroradiology: Intracranial Tumors

    Directory of Open Access Journals (Sweden)

    Andrea Bink

    2018-02-01

    Full Text Available PurposeThe aim of this pilot study was to assess the clinical feasibility, diagnostic yield, advantages, and disadvantages of structured reporting for routine MRI-reading in patients with primary diagnosis of intracranial tumors as compared to traditional neuroradiological free text reporting.MethodsA structured MRI reporting template was developed covering pathological, anatomical, and functional aspects in an itemized fashion. Retrospectively, 60 consecutive patients with first diagnosis of an intracranial tumor were selected from the radiology information system/PACS system. Structured reporting was performed by a senior neuroradiologist, blinded to clinical and radiological data. Reporting times were measured per patient. The diagnostic content was compared to free text reporting which was independently performed on the same MRI exams by two other neuroradiologists. The comparisons were categorized per item as: “congruent,” “partially congruent,” “incongruent,” or “not mentioned in free-style report.”ResultsTumor-related items: congruent findings were found for all items (17/17 with congruence rates ranging between 98 and 39% per item. Four items achieved congruence rates ≥90%, 5 items >80%, and 9 items ≥70%. Partially congruent findings were found for all items in up to 50% per item. Incongruent findings were present in 7/17 items in up to 5% per item. Free text reports did not mention 12 of 17 items (range 7–43% per item. Non-tumor-related items, including brain atrophy, microangiopathy, vascular pathologies, and various extracranial pathologies, which were not mentioned in free-text reports between 18 and 85% per item. Mean reporting time for structured reporting was 7:49 min (3:12–17:06 min.ConclusionFirst results showed that expert structured reporting ensured reliable detection of all relevant brain pathologies along with reproducible documentation of all predefined diagnostic items, which was not always the

  19. Introduction to neuroimaging

    International Nuclear Information System (INIS)

    Orrison, W.W.

    1989-01-01

    The author focuses on neuroradiology with emphasis on the current imaging modalities. There are chapters on angiography, myelography, nuclear medicine, ultrasonography, computer tomography (CT), and magnetic resonance (MR) imaging. The other chapters are dedicated to the spine, skull, head and neck, and pediatric neuroimaging

  20. IPR 2016. Abstracts

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-05-15

    The volume on the meeting of pediatric radiology includes abstract on the following issues: chest, cardiovascular system, neuroradiology, CT radiation DRs (diagnostic reference levels) and dose reporting guidelines, genitourinary imaging, gastrointestinal radiology, oncology an nuclear medicine, whole body imaging, fetal/neonates imaging, child abuse, oncology and hybrid imaging, value added imaging, muscoskeletal imaging, dose and radiation safety, imaging children - immobilization and distraction techniques, information - education - QI and healthcare policy, ALARA, the knowledge skills and competences for a technologist/radiographer in pediatric radiology, full exploitation of new technological features in pediatric CT, image quality issues in pediatrics, abdominal imaging, interventional radiology, MR contrast agents, tumor - mass imaging, cardiothoracic imaging, ultrasonography.

  1. IPR 2016. Abstracts

    International Nuclear Information System (INIS)

    2016-01-01

    The volume on the meeting of pediatric radiology includes abstract on the following issues: chest, cardiovascular system, neuroradiology, CT radiation DRs (diagnostic reference levels) and dose reporting guidelines, genitourinary imaging, gastrointestinal radiology, oncology an nuclear medicine, whole body imaging, fetal/neonates imaging, child abuse, oncology and hybrid imaging, value added imaging, muscoskeletal imaging, dose and radiation safety, imaging children - immobilization and distraction techniques, information - education - QI and healthcare policy, ALARA, the knowledge skills and competences for a technologist/radiographer in pediatric radiology, full exploitation of new technological features in pediatric CT, image quality issues in pediatrics, abdominal imaging, interventional radiology, MR contrast agents, tumor - mass imaging, cardiothoracic imaging, ultrasonography.

  2. Current radiology. Volume 5

    International Nuclear Information System (INIS)

    Wilson, G.H.; Hanafee, W.N.

    1984-01-01

    This book contains 10 selections. They are: Nuclear Magnetic Resonance Imaging, Interventional Vascular Radiology, Genitourinary Radiology, Skeletal Radiology, Digital Subtraction Angiography, Neuroradiology, Computed Tomographic Evaluation of Degenerative Diseases of the Lumbar Spine, The Lung, Otolaringology and Opthalmology, and Pediatric Radiology: Cranial, Facial, Cervical, Vertebral, and Appendicular

  3. Microcephaly and Zika virus: Neuroradiological aspects, clinical findings and a proposed framework for early evaluation of child development.

    Science.gov (United States)

    Cicuto Ferreira Rocha, Nelci Adriana; de Campos, Ana Carolina; Cicuto Ferreira Rocha, Fellipe; Pereira Dos Santos Silva, Fernanda

    2017-11-01

    As the recent outbreak of microcephaly cases caused by Zika virus has been declared a global health emergency, providing assessment guidelines for multidisciplinary teams providing early developmental screening and stimulation to infants with microcephaly is much needed. Thus, the aim of this manuscript is to provide an overview on what is known about neuroradiological aspects and clinical findings in infants with microcephaly caused by Zika virus and to propose a framework for early evaluation of child development. The keywords "Zika virus" and "microcephaly" were searched in PubMed database for articles published from incept to May 2017. These texts were reviewed, and the ones addressing neuroradiological and clinical findings in infants were selected. Recommendations for early assessment were made based on the International Classification of Functionality Disability and Health (ICF) model. The database search yielded 599 publications and 36 were selected. The studies detected microcephaly with diffuse brain malformations and calcifications, ventriculomegaly, optic nerve hypoplasia, macular atrophy, cataracts, impaired visual and hearing function, arthrogryposis, spasticity, hyperreflexia, irritability, tremors, and seizures, but very little is known about early development. Early assessments were described based on the ICF domains (Body Function and Structures, Activities and Participation and Contextual factors). Studies published showed abnormal brain, optic, neurologic and orthopedic findings, but very little is known about other aspects of functioning in infants with microcephaly caused by Zika virus. The biopsychosocial model based on the ICF paradigm provides an adequate framework to describe the condition of the infant with microcephaly receiving rehabilitative efforts to minimize disability. Efforts towards early identification of developmental delays should be taken within the first six months of life. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Virtual Pediatric Hospital

    Science.gov (United States)

    ... Thoracopaedia - An Imaging Encyclopedia of Pediatric Thoracic Disease Virtual Pediatric Hospital is the Apprentice's Assistant™ Last revised ... pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com Virtual Pediatric Hospital is curated by Donna M. D' ...

  5. Usefulness and limitations of neuroradiological examinations in lumbar canal stenosis

    International Nuclear Information System (INIS)

    Nishi, Shogo; Hanakita, Junya; Suwa, Hideyuki; Ohta, Fumito; Sakaida, Hiroshi

    1989-01-01

    Since 1983, we have performed 434 spinal surgery operations. Among them are included 51 cases of lumbar canal stenosis. For these 51 cases, we performed several neuroradiological examinations, such as lumbar plain X-ray, myelography, metrizamide-CT scan (Met-CT) and magnetic resonance imaging (MRI). On myelography, these 51 patients were divided into three types; a complete block type with 29 patients, soy-beans type with 7 patients and strangulation type with 15 patients. Met CT was performed in 37 cases. In both strangulation type and soy-beans type which had been showed through myelography, Met-CT could clearly demonstrate the subarachnoid space, and several structures around the lumbar spinal canal could be clearly identified. In cases which myelography revealed as complete-block type, we identified two subtypes. In the first type subarachnoid space was clearly demonstrated by Met-CT. The second type was comprised of those cases where Met-CT scan could not demonstrate subarachnoid space at all. MRI was performed on 21 patients. MRI clearly showed the anatomical relationship of disc, subarachnoid space, yellow ligament and hypertrophied bony structure. MRI was thus able to bring useful information about lumbar canal stenosis even in cases where Met-CT gave little information due to the lack of metrizamide penetration of the stenotic subarachnoid space. (J.P.N.)

  6. Pediatric Specialists

    Science.gov (United States)

    ... Healthy Children > Family Life > Medical Home > Pediatric Specialists Pediatric Specialists Article Body ​Your pediatrician may refer your child to a pediatric specialist for further evaluation and treatment. Pediatric specialists ...

  7. Symmetric imaging findings in neuroradiology

    International Nuclear Information System (INIS)

    Zlatareva, D.

    2015-01-01

    Full text: Learning objectives: to make a list of diseases and syndromes which manifest as bilateral symmetric findings on computed tomography and magnetic resonance imaging; to discuss the clinical and radiological differential diagnosis for these diseases; to explain which of these conditions necessitates urgent therapy and when additional studies and laboratory can precise diagnosis. There is symmetry in human body and quite often we compare the affected side to the normal one but in neuroradiology we might have bilateral findings which affected pair structures or corresponding anatomic areas. It is very rare when clinical data prompt diagnosis. Usually clinicians suspect such an involvement but Ct and MRI can reveal symmetric changes and are one of the leading diagnostic tool. The most common location of bilateral findings is basal ganglia and thalamus. There are a number of diseases affecting these structures symmetrically: metabolic and systemic diseases, intoxication, neurodegeneration and vascular conditions, toxoplasmosis, tumors and some infections. Malformations of cortical development and especially bilateral perisylvian polymicrogyria requires not only exact report on the most affected parts but in some cases genetic tests or combination with other clinical symptoms. In the case of herpes simplex encephalitis bilateral temporal involvement is common and this finding very often prompt therapy even before laboratory results. Posterior reversible encephalopathy syndrome (PReS) and some forms of hypoxic ischemic encephalopathy can lead to symmetric changes. In these acute conditions MR plays a crucial role not only in diagnosis but also in monitoring of the therapeutic effect. Patients with neurofibromatosis type 1 or type 2 can demonstrate bilateral optic glioma combined with spinal neurofibroma and bilateral acoustic schwanoma respectively. Mirror-image aneurysm affecting both internal carotid or middle cerebral arteries is an example of symmetry in

  8. Pediatric Patients Demonstrate Progressive T1-Weighted Hyperintensity in the Dentate Nucleus following Multiple Doses of Gadolinium-Based Contrast Agent.

    Science.gov (United States)

    Roberts, D R; Chatterjee, A R; Yazdani, M; Marebwa, B; Brown, T; Collins, H; Bolles, G; Jenrette, J M; Nietert, P J; Zhu, X

    2016-12-01

    the developing brain are unknown. Given this uncertainty, we suggest taking a cautious stance, including the use, in pediatric patients, of higher stability, macrocyclic agents, which in both human and animal studies have been shown to be associated with lower levels of gadolinium deposition, and detailed documentation of dosing. Most important, a patient should not be deprived of a well-indicated contrasted MR examination. © 2016 by American Journal of Neuroradiology.

  9. Social pediatrics: weaving horizontal and vertical threads through pediatric residency.

    Science.gov (United States)

    van den Heuvel, Meta; Martimianakis, Maria Athina Tina; Levy, Rebecca; Atkinson, Adelle; Ford-Jones, Elizabeth; Shouldice, Michelle

    2017-01-13

    Social pediatrics teaches pediatric residents how to understand disease within their patients' social, environmental and political contexts. It's an essential component of pediatric residency training; however there is very little literature that addresses how such a broad-ranging topic can be taught effectively. The aim of this study was to determine and characterize social pediatric education in our pediatric residency training in order to identify strengths and gaps. A social pediatrics curriculum map was developed, attending to 3 different dimensions: (1) the intended curriculum as prescribed by the Objectives of Training for Pediatrics of the Royal College of Physicians and Surgeons of Canada (RCPSC), (2) the formal curriculum defined by rotation-specific learning objectives, and (3) the informal/hidden curriculum as reflected in resident and teacher experiences and perceptions. Forty-one social pediatric learning objectives were extracted from the RCPSC Objectives of Training for Pediatrics, most were listed in the Medical Expert (51%) and Health Advocate competencies (24%). Almost all RCPSC social pediatric learning objectives were identified in more than one rotation and/or seminar. Adolescent Medicine (29.2%), Pediatric Ambulatory Medicine (26.2%) and Developmental Pediatrics (25%) listed the highest proportion of social pediatric learning objectives. Four (10%) RCPSC social pediatric objectives were not explicitly named within learning objectives of the formal curriculum. The informal curriculum revealed that both teachers and residents viewed social pediatrics as integral to all clinical encounters. Perceived barriers to teaching and learning of social pediatrics included time constraints, particularly in a tertiary care environment, and the value of social pediatrics relative to medical expert knowledge. Despite the lack of an explicit thematic presentation of social pediatric learning objectives by the Royal College and residency training program

  10. Sella turcica morphology and the pituitary gland-a new contribution to craniofacial diagnostics based on histology and neuroradiology.

    Science.gov (United States)

    Kjær, Inger

    2015-02-01

    The present review summarizes two decades of published and unpublished studies on normal and pathological development of sella turcica and pituitary gland in humans. The pathological conditions are studied in known genotype deviations, syndromes, and other malformations. The studies include histological analyses of human prenatal material and profile radiographic analyses of human postnatal material, supplemented in a few cases with neuroradiology. Prenatal and postnatal results are compared. Similarities between prenatal and postnatal deviations in sella turcica morphology were demonstrated. Malformations in the pituitary gland were observed in several cases. For diagnostic purposes, the review distinguishes between deviations in the anterior wall and in the posterior wall of the sella turcica. Deviations in the anterior wall seem to be associated with deviations specifically in the frontonasal developmental field, while deviations in the posterior wall are often connected with malformations in the posterior structures, e.g. the cerebellum. In normal cases, minor variations in morphology are observed. In each pathological case, a specific malformation pattern was observed in sella turcica morphology, varying from mild to severe phenotype. The malformation in the sella turcica/pituitary gland can be associated with a malformation within a developmental field that forms the craniofacial region (frontonasal, maxillary, palatal, and mandibular fields), sometimes also involving the brain stem, thymus, thyroid, and heart (velocardiofacial syndrome). Pathological sella turcica morphology can also be associated with malformations in the cerebellum and larynx (Cri-du-Chat syndrome). This review demonstrates the value of combining profile radiographic diagnostics with neuroradiological diagnostics in cases with malformed sella turcicae. © The Author 2012. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For

  11. The Cerefy Neuroradiology Atlas: a Talairach-Tournoux atlas-based tool for analysis of neuroimages available over the internet.

    Science.gov (United States)

    Nowinski, Wieslaw L; Belov, Dmitry

    2003-09-01

    The article introduces an atlas-assisted method and a tool called the Cerefy Neuroradiology Atlas (CNA), available over the Internet for neuroradiology and human brain mapping. The CNA contains an enhanced, extended, and fully segmented and labeled electronic version of the Talairach-Tournoux brain atlas, including parcelated gyri and Brodmann's areas. To our best knowledge, this is the first online, publicly available application with the Talairach-Tournoux atlas. The process of atlas-assisted neuroimage analysis is done in five steps: image data loading, Talairach landmark setting, atlas normalization, image data exploration and analysis, and result saving. Neuroimage analysis is supported by a near-real-time, atlas-to-data warping based on the Talairach transformation. The CNA runs on multiple platforms; is able to process simultaneously multiple anatomical and functional data sets; and provides functions for a rapid atlas-to-data registration, interactive structure labeling and annotating, and mensuration. It is also empowered with several unique features, including interactive atlas warping facilitating fine tuning of atlas-to-data fit, navigation on the triplanar formed by the image data and the atlas, multiple-images-in-one display with interactive atlas-anatomy-function blending, multiple label display, and saving of labeled and annotated image data. The CNA is useful for fast atlas-assisted analysis of neuroimage data sets. It increases accuracy and reduces time in localization analysis of activation regions; facilitates to communicate the information on the interpreted scans from the neuroradiologist to other clinicians and medical students; increases the neuroradiologist's confidence in terms of anatomy and spatial relationships; and serves as a user-friendly, public domain tool for neuroeducation. At present, more than 700 users from five continents have subscribed to the CNA.

  12. SPR 2017. Abstracts

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2017-05-15

    The conference proceedings SPR 2017 include abstracts on the following issues: gastrointestinal radiography - inflammatory bowel diseases, cardiovascular CTA, general muscoskeletal radiology, muscoskeletal congenital development diseases, general pediatric radiology - chest, muscoskeletal imaging - marrow and infectious disorders, state-of-the-art body MR imaging, practical pediatric sonography, quality and professionalism, CT imaging in congenital heart diseases, radiographic courses, body MT techniques, contrast enhanced ultrasound, machine learning, forensic imaging, the radiation dos conundrum - reconciling imaging, imagining and managing, the practice of radiology, interventional radiology, neuroradiology, PET/MR.

  13. Pediatric neurocritical care.

    Science.gov (United States)

    Murphy, Sarah

    2012-01-01

    Pediatric neurocritical care is an emerging multidisciplinary field of medicine and a new frontier in pediatric critical care and pediatric neurology. Central to pediatric neurocritical care is the goal of improving outcomes in critically ill pediatric patients with neurological illness or injury and limiting secondary brain injury through optimal critical care delivery and the support of brain function. There is a pressing need for evidence based guidelines in pediatric neurocritical care, notably in pediatric traumatic brain injury and pediatric stroke. These diseases have distinct clinical and pathophysiological features that distinguish them from their adult counterparts and prevent the direct translation of the adult experience to pediatric patients. Increased attention is also being paid to the broader application of neuromonitoring and neuroprotective strategies in the pediatric intensive care unit, in both primary neurological and primary non-neurological disease states. Although much can be learned from the adult experience, there are important differences in the critically ill pediatric population and in the circumstances that surround the emergence of neurocritical care in pediatrics.

  14. Comparison of gesture and conventional interaction techniques for interventional neuroradiology.

    Science.gov (United States)

    Hettig, Julian; Saalfeld, Patrick; Luz, Maria; Becker, Mathias; Skalej, Martin; Hansen, Christian

    2017-09-01

    Interaction with radiological image data and volume renderings within a sterile environment is a challenging task. Clinically established methods such as joystick control and task delegation can be time-consuming and error-prone and interrupt the workflow. New touchless input modalities may have the potential to overcome these limitations, but their value compared to established methods is unclear. We present a comparative evaluation to analyze the value of two gesture input modalities (Myo Gesture Control Armband and Leap Motion Controller) versus two clinically established methods (task delegation and joystick control). A user study was conducted with ten experienced radiologists by simulating a diagnostic neuroradiological vascular treatment with two frequently used interaction tasks in an experimental operating room. The input modalities were assessed using task completion time, perceived task difficulty, and subjective workload. Overall, the clinically established method of task delegation performed best under the study conditions. In general, gesture control failed to exceed the clinical input approach. However, the Myo Gesture Control Armband showed a potential for simple image selection task. Novel input modalities have the potential to take over single tasks more efficiently than clinically established methods. The results of our user study show the relevance of task characteristics such as task complexity on performance with specific input modalities. Accordingly, future work should consider task characteristics to provide a useful gesture interface for a specific use case instead of an all-in-one solution.

  15. Handbook of radiologic procedures

    International Nuclear Information System (INIS)

    Hedgcock, M.

    1986-01-01

    This book is organized around radiologic procedures with each discussed from the points of view of: indications, contraindications, materials, method of procedures and complications. Covered in this book are: emergency radiology chest radiology, bone radiology, gastrointestinal radiology, GU radiology, pediatric radiology, computerized tomography, neuroradiology, visceral and peripheral angiography, cardiovascular radiology, nuclear medicine, lymphangiography, and mammography

  16. Nephrogenic tumors

    International Nuclear Information System (INIS)

    Wiesbauer, P.

    2008-01-01

    Nephroblastomas are the most common malignant renal tumors in childhood. According to the guidelines of the SIOP (Societe Internationale d'Oncologie Pediatrique) and GPOH (Gesellschaft fuer Paediatrische Onkologie und Haematologie) pre-operative chemotherapy can be started without histological confirmation and thus initial imaging studies, in particular ultrasound, play an outstanding role for diagnostic purposes

  17. Chronicle of pediatric radiology

    International Nuclear Information System (INIS)

    Benz-Bohm, Gabriele; Richter, Ernst

    2012-01-01

    The chronicle of pediatric radiology covers the following issues: Development of pediatric radiology in Germany (BRD, DDR, pediatric radiological accommodations); development of pediatric radiology in the Netherlands (chronology and pediatric radiological accommodations); development of pediatric radiology in Austria (chronology and pediatric radiological accommodations); development of pediatric radiology in Switzerland (chronology and pediatric radiological accommodations).

  18. TBI Endpoints Development

    Science.gov (United States)

    2015-10-01

    therapy , and early mild physical activity, which result in fewer symptoms, lower mean severity of symptoms, less social disability, and fewer days off work...developing more precise TBI diagnostic tools, clinical endpoints, and effective therapies . We designed and executed an interactive program that combined...surgery, neuropsychology, neuroradiology, psychiatry, neurology, sports medicine, pediatrics, geriatrics , health economics, biostatistics, and informatics

  19. Pediatric Asthma

    Science.gov (United States)

    ... Science Education & Training Home Conditions Asthma (Pediatric) Asthma (Pediatric) Make an Appointment Refer a Patient Ask a ... meet the rising demand for asthma care. Our pediatric asthma team brings together physicians, nurses, dietitians, physical ...

  20. Pediatric sleep apnea

    Science.gov (United States)

    Sleep apnea - pediatric; Apnea - pediatric sleep apnea syndrome; Sleep-disordered breathing - pediatric ... Untreated pediatric sleep apnea may lead to: High blood pressure Heart or lung problems Slow growth and development

  1. Pediatric Sinusitis

    Science.gov (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Pediatric Sinusitis Pediatric Sinusitis Patient Health Information News media interested in ... sinuses are present at birth. Unlike in adults, pediatric sinusitis is difficult to diagnose because symptoms of ...

  2. Neuroradiological findings in primary progressive aphasia: CT, MRI and cerebral perfusion SPECT

    International Nuclear Information System (INIS)

    Sinnatamby, R.; Antoun, N.A.; Freer, C.E.L.; Miles, K.A.; Hodges, J.R.

    1996-01-01

    Primary progressive aphasia (PPA) is defined as progressive decline in language for 2 or more years with preservation of activities of daily living and general cognitive functions. Whereas the clinical features of this syndrome have been well documented, the neuroradiological findings have not been studied systematically. We studied 13 patients with PPA retrospectively: 10 underwent CT, 12 MRI and 12 cerebral perfusion studies using 99m Tc-HMPAO SPECT. CT and MR images were scored for focal atrophy by two independent assessors. Initial qualitative assessment of SPECT images was confirmed by quantitative analysis. CY was normal in 5 patients. Focal atrophy, affecting predominantly the left temporal lobe, was seen in 4 of 10 patients on CT, and 10 of 12 on MRI. Atrophy was localised primarily to the superior and middle temporal gyri on MRI. All 12 patients who underwent SPECT had unilateral temporal lobe perfusion defects, in 2 patients of whom MRI was normal. CT is relatively insensitive to focal abnormalities in PPA; MRI and SPECT are the imaging modalities of choice. MRI allows accurate, specific localisation of atrophy with the temporal neocortex. SPECT may reveal a functional decrease in cerebral perfusion prior to establishment of structural change. (orig.)

  3. Neuroradiological findings in primary progressive aphasia: CT, MRI and cerebral perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Sinnatamby, R. [Dept. of Radiology, Addenbrooke`s Hospital NHS Trust, Cambridge (United Kingdom); Antoun, N.A. [Dept. of Radiology, Addenbrooke`s Hospital NHS Trust, Cambridge (United Kingdom); Freer, C.E.L. [Dept. of Radiology, Addenbrooke`s Hospital NHS Trust, Cambridge (United Kingdom); Miles, K.A. [Dept. of Nuclear Medicine, Addenbrooke`s Hospital NHS Trust, Cambridge (United Kingdom); Hodges, J.R. [Dept. of Neurology, Addenbrooke`s Hospital NHS Trust, Cambridge (United Kingdom)

    1996-04-01

    Primary progressive aphasia (PPA) is defined as progressive decline in language for 2 or more years with preservation of activities of daily living and general cognitive functions. Whereas the clinical features of this syndrome have been well documented, the neuroradiological findings have not been studied systematically. We studied 13 patients with PPA retrospectively: 10 underwent CT, 12 MRI and 12 cerebral perfusion studies using {sup 99m}Tc-HMPAO SPECT. CT and MR images were scored for focal atrophy by two independent assessors. Initial qualitative assessment of SPECT images was confirmed by quantitative analysis. CY was normal in 5 patients. Focal atrophy, affecting predominantly the left temporal lobe, was seen in 4 of 10 patients on CT, and 10 of 12 on MRI. Atrophy was localised primarily to the superior and middle temporal gyri on MRI. All 12 patients who underwent SPECT had unilateral temporal lobe perfusion defects, in 2 patients of whom MRI was normal. CT is relatively insensitive to focal abnormalities in PPA; MRI and SPECT are the imaging modalities of choice. MRI allows accurate, specific localisation of atrophy with the temporal neocortex. SPECT may reveal a functional decrease in cerebral perfusion prior to establishment of structural change. (orig.)

  4. Neuroradiologic findings in children with mitochondrial disorder: correlation with mitochondrial respiratory chain defects

    International Nuclear Information System (INIS)

    Kim, Jinna; Lee, Seung-Koo; Kim, Dong Ik; Kim, Eung Yeop; Lee, Young-Mock; Lee, Joon Soo; Kim, Heung Dong

    2008-01-01

    Mitochondrial disorders are a heterogeneous group of disorders affecting energy metabolism that can present at any age with a wide variety of clinical symptoms. We investigated brain magnetic resonance (MR) findings in 40 children with defects of the mitochondrial respiratory chain (MRC) complex and correlated them with the type of MRC defects. Enrolled were 40 children with MRC defects in biochemical enzyme assay of the muscle specimen. Twenty-one children were found to have classical syndromes of mitochondrial disorders and 19 children presented nonspecific mitochondrial encephalomyopathies. Their brain MR imaging findings were retrospectively reviewed and correlated with the biochemical defect in the MRC complex. Children with MRC defects showed various neuroradiologic features on brain MR imaging that resulted from a complex genetic background and a heterogeneous phenotype. Rapid progression of atrophy involving all structures of the brain with variable involvement of deep gray and white matter are the most frequent MR findings in children with MRC defects in both classical syndromes of mitochondrial disorder and nonspecific mitochondrial encephalomyopathies. The type of biochemical defect in the MRC complex enzyme did not correlate with brain MR findings in child patients. (orig.)

  5. Neuroradiologic findings in children with mitochondrial disorder: correlation with mitochondrial respiratory chain defects

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jinna; Lee, Seung-Koo; Kim, Dong Ik [Yonsei University College of Medicine, Department of Radiology, Research Institute of Radiological Science, Seoul (Korea); Kim, Eung Yeop [Yonsei University College of Medicine, Department of Radiology, Research Institute of Radiological Science, Brain Korea 21 Project for Medical Science, Seoul (Korea); Lee, Young-Mock; Lee, Joon Soo [Yonsei University College of Medicine, Department of Pediatrics, Pediatric Epilepsy Clinics, Severance Children' s Hospital, Brain Research Institute, Seoul (Korea); Kim, Heung Dong [Yonsei University College of Medicine, Department of Pediatrics, Pediatric Epilepsy Clinics, Severance Children' s Hospital, Brain Research Institute, Seoul (Korea); Yonsei University College of Medicine, Department of Pediatrics, Seoul (Korea)

    2008-08-15

    Mitochondrial disorders are a heterogeneous group of disorders affecting energy metabolism that can present at any age with a wide variety of clinical symptoms. We investigated brain magnetic resonance (MR) findings in 40 children with defects of the mitochondrial respiratory chain (MRC) complex and correlated them with the type of MRC defects. Enrolled were 40 children with MRC defects in biochemical enzyme assay of the muscle specimen. Twenty-one children were found to have classical syndromes of mitochondrial disorders and 19 children presented nonspecific mitochondrial encephalomyopathies. Their brain MR imaging findings were retrospectively reviewed and correlated with the biochemical defect in the MRC complex. Children with MRC defects showed various neuroradiologic features on brain MR imaging that resulted from a complex genetic background and a heterogeneous phenotype. Rapid progression of atrophy involving all structures of the brain with variable involvement of deep gray and white matter are the most frequent MR findings in children with MRC defects in both classical syndromes of mitochondrial disorder and nonspecific mitochondrial encephalomyopathies. The type of biochemical defect in the MRC complex enzyme did not correlate with brain MR findings in child patients. (orig.)

  6. Pediatric Dentistese

    Directory of Open Access Journals (Sweden)

    Sharath Asokan

    2017-01-01

    Full Text Available Successful practice of pediatric dentistry depends on the establishment of a good relationship between the dentist and the child. Such a relationship is possible only through effective communication. Pediatric dentistry includes both an art and a science component. The focus has been mostly on the technical aspects of our science, and the soft skills we need to develop are often forgotten or neglected. This paper throws light on the communication skills we need to imbibe to be a successful pediatric dentist. A new terminology “Pediatric Dentistese” has been coined similar to motherese, parentese, or baby talk. Since baby talk cannot be applied to all age groups of children, pediatric dentistese has been defined as “the proactive development-based individualized communication between the pediatric dentist and the child which helps to build trust, allay fear, and treat the child effectively and efficiently.”

  7. Long-term side effects of radiotherapy for pediatric localized neuroblastoma. Results from clinical trials NB90 and NB94

    Energy Technology Data Exchange (ETDEWEB)

    Ducassou, Anne [Institut Claudius Regaud, Departement de Radiotherapie, Toulouse (France); Gambart, Marion; Munzer, Caroline; Rubie, Herve [Hopital des Enfants, Departement d' Onco-Hematologie Pediatrique, Toulouse (France); Padovani, Laetitia [Centre Hospitalier et Universitaire, Departement de Radiotherapie, Marseille (France); Carrie, Christian; Claude, Line [Centre Leon Berard, IHOP, Departement de Radiotherapie, Lyon (France); Haas-Kogan, Daphne [University of California, Department of Radiation Oncology, San Francisco (United States); Bernier-Chastagner, Valerie [Centre Alexis Vautrin, Departement de Radiotherapie, Nancy (France); Demoor, Charlotte [Centre Rene Gauducheau, Departement de Radiotherapie, Nantes (France); Helfre, Sylvie [Institut Curie, Departement de Radiotherapie, Paris (France); Bolle, Stephanie [Institut Gustave Roussy, Departement de Radiotherapie, Villejuif (France); Leseur, Julie [Centre Eugene Marquis, Departement de Radiotherapie, Rennes (France); Huchet, Aymeri [Centre Hospitalier et Universitaire, Departement de Radiotherapie, Bordeaux (France); Valteau-Couanet, Dominique [Institut Gustave Roussy, Departement d' Onco-Hematologie Pediatrique, Villejuif (France); Schleiermacher, Gudrun [Institut Curie, Departement d' Onco-Hematologie Pediatrique, Paris (France); Coze, Carole [Aix-Marseille Univ et APHM, Hopital d' Enfants de la Timone, Departement d' hemato-Oncologie Pediatrique, Marseille (France); Defachelles, Anne-Sophie [Centre Oscar Lambret, Departement d' Onco-Hematologie Pediatrique, Lille (France); Marabelle, Aurelien [IHOP, Departement d' Onco-Hematologie Pediatrique, Lyon (France); Ducassou, Stephane [Hopital des Enfants, Departement d' Onco-Hematologie Pediatrique, Bordeaux (France); Devalck, Christine [Hopital des enfants Reine Fabiola, Departement d' Onco-hematologie Pediatrique, Bruxelles (Belgium); Gandemer, Virginie [Centre hospitalier, Departement d' Onco-Hematologie Pediatrique, Rennes (France); Munzer, Martine [Centre hospitalier, Departement d' Onco-hematologie Pediatrique, Reims (France); Laprie, Anne [Institut Claudius Regaud, Departement de Radiotherapie, Toulouse (France); Universite Toulouse III Paul Sabatier, Toulouse (France); INSERM, Toulouse (France); Collaboration: Neuroblastoma study group and radiotherapy group of the French Society of Children with Cancer (SFCE)

    2015-07-15

    Neuroblastoma (NB) is the most frequent indication for extracranial pediatric radiotherapy. As long-term survival of high-risk localized NB has greatly improved, we reviewed treatment-related late toxicities in pediatric patients who received postoperative radiotherapy (RT) for localized NB within two French prospective clinical trials: NB90 and NB94. From 1990-2000, 610 children were enrolled. Among these, 35 were treated with induction chemotherapy, surgery, and RT. The recommended RT dose was 24 Gy at ≤ 2 years, 34 Gy at > 2 years, ± a 5 Gy boost in both age groups. The 22 patients still alive after 5 years were analyzed. The median follow-up time was 14 years (range 5-21 years). Late effects after therapy occurred in 73 % of patients (16/22), within the RT field for 50 % (11/22). The most frequent in-field effects were musculoskeletal abnormalities (n = 7) that occurred only with doses > 31 Gy/1.5 Gy fraction (p = 0.037). Other effects were endocrine in 3 patients and second malignancies in 2 patients. Four patients presented with multiple in-field late effects only with doses > 31 Gy. After a median follow-up of 14 years, late effects with multimodality treatment were frequent. The most frequent effects were musculoskeletal abnormalities and the threshold for their occurrence was 31 Gy. (orig.) [German] Das Neuroblastom (NB) ist die haeufigste Indikation fuer eine extrakranielle paediatrische Strahlentherapie. Da sich beim lokalisierten Hochrisiko-NB das langfristige Ueberleben stark verbessert hat, ueberprueften wir die behandlungsbedingte spaete Toxizitaet bei paediatrischen Patienten, die im Rahmen zweier prospektiver klinischer Studien in Frankreich (NB90 und NB94) eine postoperative Strahlentherapie (RT) bei lokalisiertem NB erhalten hatten. Von 1990-2000 wurden 610 Kinder eingeschlossen. Von diesen wurden 35 mit Chemotherapie, Chirurgie und RT behandelt. Die empfohlene Bestrahlungsdosis war 24 Gy bei ≤ 2 Jahren, 34 Gy bei > 2 Jahren, ± 5-Gy

  8. Characterization of plaque in the internal carotid artery. Comparison neuroradiological findings with pathological findings

    International Nuclear Information System (INIS)

    Nishikawa, Misao; Nishio, Akimasa; Takami, Toshihiro; Goto, Takeo; Ueda, Makiko; Hara, Mitsuhiro

    2006-01-01

    We evaluate the morphology of the carotid plaque using echogram, CT scan and MRI and compare those neuroradiological findings with histological findings of the plaque. We evaluated 14 cases operated with carotid endoarterectomy for carotid stenosis. We estimated the findings of the echogram, enhanced CT scan and black blood MRI (BB MRI), in comparison with the histological findings of the carotid plaque. Echogram, enhanced CT scan and MRI clearly demonstrated the plaque in cervical carotid stenosis. In most cases, echograms could show the plaque, but in some cases could not due to the back shadow caused by plaque calcification. Enhanced CT scan clearly demonstrated the calcification and the neovasculization in plaque. BB MRI clearly showed the carotid plaque. Low-intensity lesions in T1 and T2 weighted images showed hard and fibrous plaque. High-intensity lesions in T1 and T2 weighted images showed soft plaque with lipoprotein and/or hemorrhage. This study demonstrates the potential of a systemic approach to atherosclerotic plaque with enhanced CT scan and BB MRI compared with histological findings of the carotid plaque. These estimations elucidate the growth mechanism of carotid plaque. (author)

  9. Pediatric Academic Productivity: Pediatric Benchmarks for the h- and g-Indices.

    Science.gov (United States)

    Tschudy, Megan M; Rowe, Tashi L; Dover, George J; Cheng, Tina L

    2016-02-01

    To describe h- and g-indices benchmarks in pediatric subspecialties and general academic pediatrics. Academic productivity is measured increasingly through bibliometrics that derive a statistical enumeration of academic output and impact. The h- and g-indices incorporate the number of publications and citations. Benchmarks for pediatrics have not been reported. Thirty programs were selected randomly from pediatric residency programs accredited by the Accreditation Council for Graduate Medical Education. The h- and g-indices of department chairs were calculated. For general academic pediatrics, pediatric gastroenterology, and pediatric nephrology, a random sample of 30 programs with fellowships were selected. Within each program, an MD faculty member from each academic rank was selected randomly. Google Scholar via Harzing's Publish or Perish was used to calculate the h-index, g-index, and total manuscripts. Only peer-reviewed and English language publications were included. For Chairs, calculations from Google Scholar were compared with Scopus. For all specialties, the mean h- and g-indices significantly increased with academic rank (all P calculation using different bibliographic databases only differed by ±1. Mean h-indices increased with academic rank and were not significantly different across the pediatric specialties. Benchmarks for h- and g-indices in pediatrics are provided and may be one measure of academic productivity and impact. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Pediatric portal hypertension

    Science.gov (United States)

    Vogel, Clarissa Barbon

    2017-01-01

    Abstract: Pediatric portal hypertension management is a team approach between the patient, the patient's family, the primary caregiver, and specialty providers. Evidence-based practice guidelines have not been established in pediatrics. This article serves as a review for the primary care NP in the management of pediatric portal hypertension, discussing the etiology, pathophysiology, and clinical presentation of pediatric portal hypertension, diagnostic tests, and treatment and management options. PMID:28406835

  11. MRI usage in a pediatric emergency department: an analysis of usage and usage trends over 5 years

    Energy Technology Data Exchange (ETDEWEB)

    Scheinfeld, Meir H. [Montefiore Medical Center, Albert Einstein College of Medicine, Department of Radiology, Division of Emergency Radiology, Bronx, NY (United States); Moon, Jee-Young; Wang, Dan [Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY (United States); Fagan, Michele J. [Montefiore Medical Center, Albert Einstein College of Medicine, Department of Pediatrics, Division of Emergency Medicine, Bronx, NY (United States); Davoudzadeh, Reubin [Montefiore Medical Center, Department of Radiology, Bronx, NY (United States); Taragin, Benjamin H. [Montefiore Medical Center, Albert Einstein College of Medicine, Department of Radiology, Division of Pediatric Radiology, Bronx, NY (United States)

    2017-03-15

    Magnetic resonance imaging (MRI) usage has anecdotally increased due to the principles of ALARA and the desire to Image Gently. Aside from a single abstract in the emergency medicine literature, pediatric emergency department MRI usage has not been described. Our objective was to determine whether MRI use is indeed increasing at a high-volume urban pediatric emergency department with 24/7 MRI availability. Also, we sought to determine which exams, time periods and demographics influenced the trend. Institutional Review Board exemption was obtained. Emergency department patient visit and exam data were obtained from the hospital database for the 2011-2015 time period. MRI usage data were normalized using emergency department patient visit data to determine usage rates. The z-test was used to compare MRI use by gender. The chi-square test was used to test for trends in MRI usage during the study period and in patient age. MRI usage for each hour and each weekday were tabulated to determine peak and trough usage times. MRI usage rate per emergency department patient visit was 0.36%. Headache, pain and rule-out appendicitis were the most common indications for neuroradiology, musculoskeletal and trunk exams, respectively. Usage in female patients was significantly greater than in males (0.42% vs. 0.29%, respectively, P<0.001). Usage significantly increased during the 5-year period (P<0.001). Use significantly increased from age 3 to 17 (0.011% to 1.1%, respectively, P<0.001). Sixty percent of exams were performed after-hours, the highest volume during the 10 p.m. hour and lowest between 4 a.m. and 9 a.m. MRI use was highest on Thursdays and lowest on Sundays (MRI on 0.45% and 0.22% of patients, respectively). MRI use in children increased during the study period, most notably in females, on weekdays and after-hours. (orig.)

  12. Creating a pediatric digital library for pediatric health care providers and families: using literature and data to define common pediatric problems.

    Science.gov (United States)

    D'Alessandro, Donna; Kingsley, Peggy

    2002-01-01

    The goal of this study was to complete a literature-based needs assessment with regard to common pediatric problems encountered by pediatric health care providers (PHCPs) and families, and to develop a problem-based pediatric digital library to meet those needs. The needs assessment yielded 65 information sources. Common problems were identified and categorized, and the Internet was manually searched for authoritative Web sites. The created pediatric digital library (www.generalpediatrics.com) used a problem-based interface and was deployed in November 1999. From November 1999 to November 2000, the number of hyperlinks and authoritative Web sites increased 51.1 and 32.2 percent, respectively. Over the same time, visitors increased by 57.3 percent and overall usage increased by 255 percent. A pediatric digital library has been created that begins to bring order to general pediatric resources on the Internet. This pediatric digital library provides current, authoritative, easily accessed pediatric information whenever and wherever the PHCPs and families want assistance.

  13. 78 FR 48438 - Pediatric Ethics Subcommittee of the Pediatric Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2013-08-08

    ...] Pediatric Ethics Subcommittee of the Pediatric Advisory Committee; Notice of Meeting AGENCY: Food and Drug... of Subcommittee: Pediatric Ethics Subcommittee of the Pediatric Advisory Committee. General Function... pediatric ethical issues. Date and Time: The meeting will be held on September 9, 2013, from 8 a.m. to 5:30...

  14. Myocarditis - pediatric

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007307.htm Myocarditis - pediatric To use the sharing features on this page, please enable JavaScript. Pediatric myocarditis is inflammation of the heart muscle in ...

  15. CNS manifestations of pediatric AIDS

    International Nuclear Information System (INIS)

    Grattan-Smith, D.; Gerson, L.P.; McCluggage, C.D.; Hanson, C.G.; Singleton, E.B.

    1990-01-01

    This paper assesses the spectrum of neuroradiologic findings in children with symptomatic HIV infection. Cranial CT and MR imaging studies in 31 children with symptomatic HIV infection were retrospectively reviewed. Twenty-eight children were evaluated with CT scanning and 12 with MR imaging. Studies were performed in 17 cases because of abnormal neurologic symptoms and 14 children underwent non-contrast-enhanced CT prior to admission to NIAID research drug trials. The spectrum of findings consisted of abnormalities in the white matter in 14, cerebral atrophic-like changes in 13, abnormal intracranial calcifications in five, cerebral infarction in two, and multifocal cerebral abscesses secondary to disseminated histoplasmosis in one patient

  16. Pediatric oncologic endosurgery.

    Science.gov (United States)

    Boo, Yoon Jung; Goedecke, Jan; Muensterer, Oliver J

    2017-08-01

    Despite increasing popularity of minimal-invasive techniques in the pediatric population, their use in diagnosis and management of pediatric malignancy is still debated. Moreover, there is limited evidence to clarify this controversy due to low incidence of each individual type of pediatric tumor, huge diversity of the disease entity, heterogeneity of surgical technique, and lack of well-designed studies on pediatric oncologic minimal-invasive surgery. However, a rapid development of medical instruments and technologies accelerated the current trend toward less invasive surgery, including oncologic endosurgery. The aim of this article is to review current literatures about the application of the minimal-invasive approach for pediatric tumors and to give an overview of the current status, indications, individual techniques, and future perspectives.

  17. How Do US Pediatric Residency Programs Teach and Evaluate Community Pediatrics and Advocacy Training?

    Science.gov (United States)

    Lichtenstein, Cara; Hoffman, Benjamin D; Moon, Rachel Y

    2017-07-01

    In 2013, the Accreditation Council for Graduate Medical Education updated requirements for training in community pediatrics and advocacy in pediatric residency programs. In light of this update, the aim of this study was to better understand how community pediatrics is being taught and evaluated in pediatric residency programs in the United States. Cross-sectional exploratory study using a Web-based survey of pediatric residency program directors in September 2014. Questions focused on teaching and evaluation of 10 community pediatrics competencies. Of 85 programs (43% response rate), 30% offered a separate training track and/or 6-block individualized curriculum in community pediatrics or advocacy. More than 75% required all residents to learn 7 of 10 competencies queried. Respondents in urban settings were more likely to teach care of special populations (P = .02) and public speaking (P pediatrics and advocacy teaching among responding US pediatric residency programs. Although respondents reported a variety of teaching and evaluation methods, there were few statistically significant differences between programs. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  18. Attention for pediatric interventional radiology

    International Nuclear Information System (INIS)

    Zhu Ming; Cheng Yongde

    2005-01-01

    Radiological interventions possess wide utilization in the diagnosis and treatment for pediatric patients. Pediatric interventional radiology is an important branch of interventional radiology and also an important branch of pediatric radiology. Pediatric interventional radiology has grown substantially over the last 30 years, radiologists closely cooperation with surgeons and other physicians providing a new horizon in the management of pediatric diseases in western countries. It includes pediatric cardiac interventional radiology, pediatric neuro-interventional radiology, pediatric vascular interventional radiology, pediatric nonvascular interventional radiology, pediatric tumor interventional radiology and others. In the United States, every children hospital which owns two hundred beds has to have special trained interventional radiologists in radiologic department installing with advanced digital subtraction angiographic equipment. Interventional therapeutic procedures and diagnostic angiography have been proceeding more and more for the congenital and acquired diseases of children. The promising results give use uprising and interventional therapy as an alternative or a replacement or supplement to surgical operation. Pediatric interventional radiology is rather underdeveloped in China with a few special pediatric interventional radiologist, lack of digital subtraction angiography equipment. Pediatric radiologists have no enough field for interventional procedures such as pediatric neuro-interventional radiology and pediatric vascular interventional radiology. In the contrary adult interventional radiologists do have better interventional jobs in China and Pediatric cardiologists also share the same trend. They perform angiocardiography for congenital heart diseases and treat congenital heart disease with interventional procedures including balloon dilation of valves and vessels, coil embolization of collaterals, patent ducts and other arterial fistulae

  19. Pediatric Stroke

    Science.gov (United States)

    ... and Patient Resources Home » Patients & Families » About Stroke » Pediatric Stroke » Introduction Introduction What is a Stroke? Ischemic Stroke Intracerebral Hemorrhage Subarachnoid Hemorrhage Pediatric Stroke Introduction Types of Stroke Diagnosis and Treatment ...

  20. Sedation in Pediatric Esophagogastroduodenoscopy

    Directory of Open Access Journals (Sweden)

    Seak Hee Oh

    2018-03-01

    Full Text Available Pediatric esophagogastroduodenoscopy (EGD has become an established diagnostic and therapeutic modality in pediatric gastroenterology. Effective sedation strategies have been adopted to improve patient tolerance during pediatric EGD. For children, safety is a fundamental consideration during this procedure as they are at a higher risk of severe adverse events from procedural sedation compared to adults. Therefore, a detailed risk evaluation is required prior to the procedure, and practitioners should be aware of the benefits and risks associated with sedation regimens during pediatric EGD. In addition, pediatric advanced life support by endoscopists or immediate intervention by anesthesiologists should be available in the event that severe adverse events occur during pediatric EGD.

  1. 76. German radiology congress. Book of abstracts and posters

    International Nuclear Information System (INIS)

    Anon.

    1995-01-01

    This issue presents the abstracts and posters of the 76th German radiology congress held from 24-27 May 1995. The session topics are the abdomen, general radiology and interventional radiology, the thorax, cardiovascular system, neck, head, mamma, muscles and skeleton, neuroradiology, pediatrics, nuclear medicine, radiotherapy, computer applications, diagnostic techniques, physics, and radiobiology. Further information given includes videos, a multimedia forum, a historical poster session, and an author index. (VHE) [de

  2. Pediatric heart surgery - discharge

    Science.gov (United States)

    ... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 434. ...

  3. Pediatric maxillary fractures.

    Science.gov (United States)

    Yu, Jack; Dinsmore, Robert; Mar, Philip; Bhatt, Kirit

    2011-07-01

    Pediatric craniofacial structures differ from those of adults in many ways. Because of these differences, management of pediatric craniofacial fractures is not the same as those in adults. The most important differences that have clinical relevance are the mechanical properties, craniofacial anatomy, healing capacity, and dental morphology. This article will review these key differences and the management of pediatric maxillary fractures. From the mechanical properties' perspective, pediatric bones are much more resilient than adult bones; as such, they undergo plastic deformation and ductile failure. From the gross anatomic perspective, the relative proportion of the cranial to facial structures is much larger for the pediatric patients and the sinuses are not yet developed. The differences related to dentition and dental development are more conical crowns, larger interdental spaces, and presence of permanent tooth buds in the pediatric population. The fracture pattern, as a result of all the above, does not follow the classic Le Fort types. The maxillomandibular fixation may require circum-mandibular wires, drop wires, or Ivy loops. Interfragmentary ligatures using absorbable sutures play a much greater role in these patients. The use of plates and screws should take into consideration the future development with respect to growth centers and the location of the permanent tooth buds. Pediatric maxillary fractures are not common, require different treatments, and enjoy better long-term outcomes.

  4. What Is a Pediatric Rheumatologist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Rheumatologist? Page Content Article Body If your child ... a pediatric rheumatologist. What Kind of Training Do Pediatric Rheumatologists Have? Pediatric rheumatologists are medical doctors who ...

  5. Age Limit of Pediatrics.

    Science.gov (United States)

    Hardin, Amy Peykoff; Hackell, Jesse M

    2017-09-01

    Pediatrics is a multifaceted specialty that encompasses children's physical, psychosocial, developmental, and mental health. Pediatric care may begin periconceptionally and continues through gestation, infancy, childhood, adolescence, and young adulthood. Although adolescence and young adulthood are recognizable phases of life, an upper age limit is not easily demarcated and varies depending on the individual patient. The establishment of arbitrary age limits on pediatric care by health care providers should be discouraged. The decision to continue care with a pediatrician or pediatric medical or surgical subspecialist should be made solely by the patient (and family, when appropriate) and the physician and must take into account the physical and psychosocial needs of the patient and the abilities of the pediatric provider to meet these needs. Copyright © 2017 by the American Academy of Pediatrics.

  6. Commentary: Pediatric Epilepsy: A Good Fit for Pediatric Psychologists

    Science.gov (United States)

    Modi, Avani; Smith, Gigi

    2011-01-01

    While there are an abundance of pediatric neuropsychologists working with youth with epilepsy (YWE), other subspecialty psychologists have played minimal roles in clinical and research endeavors in pediatric epilepsy. Thus, the purpose of this commentary was to describe (a) the needs of YWE due to the intermittent nature of seizures and difficulties with disease management, (b) increased risk for psychosocial comorbidities, (c) limited access to care, and (d) provide recommendations for how pediatric psychologists can become involved in the clinical care and research activities for YWE. PMID:21148174

  7. Children's (Pediatric) Nuclear Medicine

    Science.gov (United States)

    ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  8. Pediatric dental chair vs. traditional dental chair: A pediatric dentist′s poll

    Directory of Open Access Journals (Sweden)

    Khushboo Barjatya

    2015-01-01

    Full Text Available Objective: Proper positioning of the child patient, can not only have positive ramifications for the operator′s posture, comfort, and career longevity - it can also lead to better treatment and increased productivity. The aim of the survey questionnaire was to assess the utilization, need, and attitude concerning dental chairs among pediatric dentist while working on and managing the child patient. Study Design: The questions were structured using adobe forms central online software, regarding the user-friendliness of pediatric dental chair vs. traditional adult dental chair available in the market. Results: Our result shows that out of 337 respondents, 79% worked on pediatric dental chair, whereas 21% had no experience of it. Of these 79% pediatric dentist, 48% preferred pediatric dental chair. But pediatric dental problem still has certain disadvantages like higher cost, leg space problem, lower availability, etc. Conclusion: During the research it was found that ergonomics and usability issues were the main problems. Thus, pediatric dental chair is not so popular in the current scenario. This study allowed for general ideas for the improvement of dental chairs and thus improved dental chair would fill the gap in the current scenario.

  9. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  10. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses ... limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of ...

  11. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging ... the limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch ...

  12. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small ... of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical ...

  13. [Etiological, clinical and neuroradiological investigation of deaf children with additional neuropsychiatric disabilities].

    Science.gov (United States)

    Chilosi, A M; Scusa, M F; Comparini, A; Genovese, E; Forli, F; Berrettini, S; Cipriani, P

    2012-04-01

    Sensorineural hearing loss (SNHL) is complicated by additional disabilities in about 30% of cases, but the epidemiology of associated disorders, in terms of type, frequency and aetiology is still not clearly defined. Additional disabilities in a deaf child have important consequences in assessing and choosing a therapeutic treatment, in particular when considering cochlear implantation (CI) or hearing aids (HA). The aim of this paper was to evaluate frequency, type and severity of additional neurodevelopmental disabilities in children with profound bilateral sensorineural hearing loss and to investigate the relationship between disability and the etiology of deafness. Eighty children with profound bilateral sensorineural hearing loss (mean age 5.4 years) were investigated by means of a diagnostic protocol including clinical, neurodevelopmental, and audiological procedures together with genetic and neurometabolic tests and neuroradiological investigation by brain MRI. Fifty-five percent of the sample exhibited one or more disabilities in addition to deafness, with cognitive, behavioural-emotional and motor disorders being the most frequent. The risk of additional disabilities varied according to aetiology, with a higher incidence in hereditary syndromic deafness, in cases due to pre-perinatal pathology (in comparison to unknown and hereditary non syndromic forms) and in the presence of major brain abnormalities at MRI. Our results suggest that the aetiology of deafness may be a significant risk indicator for the presence of neuropsychiatric disorders. A multidimensional evaluation, including aetiological, neurodevelopmental and MRI investigation is needed for formulating prognosis and for planning therapeutic intervention, especially in those children candidated to cochlear implant.

  14. Dehydration treatment practices among pediatrics-trained and non-pediatrics trained emergency physicians.

    Science.gov (United States)

    Nunez, Jeranil; Liu, Deborah R; Nager, Alan L

    2012-04-01

    We sought to survey emergency physicians in the United States regarding the management of pediatric dehydration secondary to acute gastroenteritis. We hypothesized that responses from physicians with dedicated pediatric training (PT), that is, board certification in pediatrics or pediatric emergency medicine, would differ from responses of physicians with no dedicated pediatric training (non-PT). An anonymous survey was mailed to randomly selected members of the American College of Emergency Physicians and sent electronically to enrollees of Brown University pediatric emergency medicine listserv. The survey consisted of 17 multiple-choice questions based on a clinical scenario depicting a 2-year-old with acute gastroenteritis and moderate dehydration. Questions asked related to treatment preferences, practice setting, and training information. One thousand sixty-nine surveys were received: 997 surveys were used for data analysis, including 269 PT physicians and 721 non-PT physicians. Seventy-nine percent of PT physicians correctly classified the scenario patient as moderately dehydrated versus 71% of non-PT physicians (P = 0.063). Among those who correctly classified the patient, 121 PT physicians (58%) and 350 non-PT physicians (68%) would initially hydrate the patient with intravenous fluids. Pediatrics-trained physicians were more likely to initially choose oral or nasogastric hydration compared with non-PT physicians (P = 0.0127). Pediatrics-trained physicians were less likely to perform laboratory testing compared with the non-PT group (n = 92, 45%, vs n = 337, 66%; P dehydrated children, significantly more PT physicians, compared with non-PT physicians, follow established guidelines.

  15. Pediatric vascular access

    International Nuclear Information System (INIS)

    Donaldson, James S.

    2006-01-01

    Pediatric interventional radiologists are ideally suited to provide vascular access services to children because of inherent safety advantages and higher success from using image-guided techniques. The performance of vascular access procedures has become routine at many adult interventional radiology practices, but this service is not as widely developed at pediatric institutions. Although interventional radiologists at some children's hospitals offer full-service vascular access, there is little or none at others. Developing and maintaining a pediatric vascular access service is a challenge. Interventionalists skilled in performing such procedures are limited at pediatric institutions, and institutional support from clerical staff, nursing staff, and technologists might not be sufficiently available to fulfill the needs of such a service. There must also be a strong commitment by all members of the team to support such a demanding service. There is a slippery slope of expected services that becomes steeper and steeper as the vascular access service grows. This review is intended primarily as general education for pediatric radiologists learning vascular access techniques. Additionally, the pediatric or adult interventional radiologist seeking to expand services might find helpful tips. The article also provides education for the diagnostic radiologist who routinely interprets radiographs containing vascular access devices. (orig.)

  16. Nuclear imaging in pediatrics

    International Nuclear Information System (INIS)

    Siddiqui, A.R.

    1985-01-01

    The author's intent is to familiarize practicing radiologists with the technical aspects and interpretation of nuclear medicine procedures in children and to illustrate the indications for nuclear medicine procedures in pediatric problems. Pediatric doses, dosimetry, sedation, and injection techniques, organ systems, oncology and infection, testicular scanning and nuclear crystography, pediatric endocrine and skeletal systems, ventilation and perfusion imaging of both congenital and acquired pediatric disorders, cardiovascular problems, gastrointestinal, hepatobiliary, reticuloendothelial studies, and central nervous system are all topics which are included and discussed

  17. Current use and possible future applications of the magnetization transfer technique in neuroradiology; Aktuelle Anwendungen und moegliche zukuenftige Applikationen der Magnetisierungstransfer-Technik in der Neuroradiologie

    Energy Technology Data Exchange (ETDEWEB)

    Haehnel, S.; Jost, G.; Sartor, K. [Abt. Neuroradiologie, Neurologische Klinik, Universitaetsklinikum Heidelberg (Germany); Knauth, M. [Abt. Neuroradiologie, Universitaetsklinikum Goettingen (Germany)

    2004-02-01

    Magnetization transfer (MT) imaging is a special MR technique used for selective suppression of the MR signal of protons bound on macromolecules. The most important applications in neuroradiology are (1) detection of subtle changes in otherwise normal-appearing cerebral white matter, for instance in multiple sclerosis (MS), Wallerian degeneration, and hydrocephalus, (2) differentiation of white matter lesions with high signal on T{sub 2}-weighted MR-images, like MS plaques, brain infarctions, and brain edema, (3) follow-up of cerebral white matter diseases using volumetric MT techniques, and (4) improvement in delineating of contrast enhancing brain lesions, such as cerebral metastases. We describe the physical rationale of the MT technique and present the most important current and possible future applications of MT imaging to answer clinical and scientific questions in neuroradiology. (orig.) [German] Die Magnetisierungstransfer-(MT)-Technik ist ein spezielles MRT-Verfahren, mit dem selektiv das MR-Signal der an Makromolekuele gebundenen Protonen unterdrueckt werden kann. Die wichtigsten Anwendungen dieser Technik in der Neuroradiologie sind der Nachweis von subtilen Veraenderungen in ansonsten normal erscheinender weisser Hirnsubstanz, wie z.B. bei Multipler Sklerose (MS), Waller'scher Degeneration und Hydrozephalus, die Differenzierung von Laesionen der weissen Substanz, die durchgaengig hohes Signal auf T{sub 2}-gewichteten MRT-Aufnahmen zeigen, wie z.B. MS-Plaques, Hirninfarkte oder Hirnoedem, die Verlaufskontrolle von Erkrankungen der weissen Substanz mit der volumetrischen MT-Technik, und die Verbesserung der Abgrenzbarkeit kontrasmittelaufnehmender Hirnlaesionen wie Hirnmetastasen. Wir beschreiben die MR-physikalischen Grundlagen der MT-Technik und stellen die wesentlichen aktuellen und moeglichen zukuenftigen Anwendungen zur Beantwortung klinischer und wissenschaftlicher Fragestellungen in der Neuroradiologie vor. (orig.)

  18. Estimation of staff lens doses during interventional procedures. Comparing cardiology, neuroradiology and interventional radiology

    International Nuclear Information System (INIS)

    Vano, E.; Sanchez, R.M.; Fernandez, J.M.

    2015-01-01

    The purpose of this article is to estimate lens doses using over apron active personal dosemeters in interventional catheterisation laboratories (cardiology IC, neuroradiology IN and radiology IR) and to investigate correlations between occupational lens doses and patient doses. Active electronic personal dosemeters placed over the lead apron were used on a sample of 204 IC procedures, 274 IN and 220 IR (all performed at the same university hospital). Patient dose values (kerma area product) were also recorded to evaluate correlations with occupational doses. Operators used the ceiling-suspended screen in most cases. The median and third quartile values of equivalent dose Hp(10) per procedure measured over the apron for IC, IN and IR resulted, respectively, in 21/67, 19/44 and 24/54 μSv. Patient dose values (median/third quartile) were 75/128, 83/176 and 61/159 Gy cm 2 , respectively. The median ratios for dosemeters worn over the apron by operators ( protected by the ceiling-suspended screen) and patient doses were 0.36; 0.21 and 0.46 μSv Gy -1 cm -2 , respectively. With the conservative approach used (lens doses estimated from the over apron chest dosemeter) we came to the conclusion that more than 800 procedures y -1 and per operator were necessary to reach the new lens dose limit for the three interventional specialties. (authors)

  19. Pediatric Voiding Cystourethrogram

    Science.gov (United States)

    Scan for mobile link. Children's (Pediatric) Voiding Cystourethrogram A children’s (pediatric) voiding cystourethrogram uses fluoroscopy – a form of real-time x-ray – to examine a child’s bladder ...

  20. Pediatric MATCH Infographic

    Science.gov (United States)

    Infographic explaining NCI-COG Pediatric MATCH, a cancer treatment clinical trial for children and adolescents, from 1 to 21 years of age, that is testing the use of precision medicine for pediatric cancers.

  1. Enhancing the Pediatric Drug Development Framework to Deliver Better Pediatric Therapies Tomorrow.

    Science.gov (United States)

    Bucci-Rechtweg, Christina

    2017-10-01

    Health care professionals involved in the clinical management of children have long appreciated the limited number of therapies suitably evaluated for their optimal use in the pediatric population. In the past century, advances in regulatory policy significantly evolved adult drug evaluation. The scarcity of available patient populations, practical complexities of drug development research, and minimal financial returns have hampered pharmaceutical investment in the study of therapies for children. More recently, pediatric policy and legislation in the United States and Europe have instituted a system of obligations and incentives to stimulate investment in pediatric drug development. These initiatives, in conjunction with a more sophisticated process of drug discovery and development, have led to significant advancements in the labeling of drugs for pediatric use. Facilitated by the emergence of new targets, precision medicine, and innovations in regulatory science, there is now a subtle shift in focus toward drug development research for children rather than simply in children. Although there has been an increase in pediatric studies of investigational agents and labeling of pediatric information for use, there have been unintended consequences of existing policies. As a result, limited progress has been made in certain therapeutic areas and for off-patent therapies. Future policy reform to enhance the availability and accessibility of pediatric medicines should not only reflect an understanding not only of the successes of existing policy and legislative initiatives but also constructively address failures and unintended consequences. Taken together, policy reform, global cooperation, and innovation in regulatory science will more ably deliver better pediatric therapies tomorrow. Copyright © 2017 Elsevier HS Journals, Inc. All rights reserved.

  2. Pediatric Celiac Disease

    Science.gov (United States)

    ... a protein found in wheat, rye, and barley. Pediatric Celiac Disease If your child has celiac disease, ... physician. Established by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) Celiac Disease Eosinophilic ...

  3. Annals of Pediatric Surgery

    African Journals Online (AJOL)

    The Annals of Pediatric Surgery is striving to fill an important niche that provides focus to clinical care, technical innovation and clinical research. The Annals of Pediatric Surgery has the responsibility to serve not only pediatric surgeons in the Middle East and North Africa but also should be an important conduit for scientific ...

  4. Cerebral imaging in pediatrics

    Energy Technology Data Exchange (ETDEWEB)

    Gordon, I [London, Great Ormond Street Hospital for Children (United Kingdom)

    1998-06-01

    Radioisotope brain imaging has focused mainly on regional cerebral blood flow (rCBF). However the use of ligand which go to specific receptor sites is being introduced in pediatrics, mainly psychiatry. rCBF is potentially available in many institutions, especially with the availability of multi-headed gamma cameras. The use of this technique in pediatrics requires special attention to detail in the manner of data acquisition and handling the child. The interpretation of the rCBF study in a child requires knowledge of normal brain maturation. The major clinical use in pediatrics is epilepsy because of the advances in surgery and the frequency of complex partial seizures. Other indications in pediatric neurology include brain death, acute neurological loss including stroke, language disorders, cerebral palsy, hypertension due to renovascular disease, traumatic brain injury and migraine. There are pediatric physiological conditions in which rCBF has been undertaken, these include anorexia nervosa, autism, Gilles de la Tourette syndrome (GTS) and attention deficit disorder-hyperactivity (ADHD). Research using different ligands to specific receptor sites will also be reviewed in pediatrics.

  5. Cerebral imaging in pediatrics

    International Nuclear Information System (INIS)

    Gordon, I.

    1998-01-01

    Radioisotope brain imaging has focused mainly on regional cerebral blood flow (rCBF). However the use of ligand which go to specific receptor sites is being introduced in pediatrics, mainly psychiatry. rCBF is potentially available in many institutions, especially with the availability of multi-headed gamma cameras. The use of this technique in pediatrics requires special attention to detail in the manner of data acquisition and handling the child. The interpretation of the rCBF study in a child requires knowledge of normal brain maturation. The major clinical use in pediatrics is epilepsy because of the advances in surgery and the frequency of complex partial seizures. Other indications in pediatric neurology include brain death, acute neurological loss including stroke, language disorders, cerebral palsy, hypertension due to renovascular disease, traumatic brain injury and migraine. There are pediatric physiological conditions in which rCBF has been undertaken, these include anorexia nervosa, autism, Gilles de la Tourette syndrome (GTS) and attention deficit disorder-hyperactivity (ADHD). Research using different ligands to specific receptor sites will also be reviewed in pediatrics

  6. Comparisons between Full-time and Part-time Pediatric Emergency Physicians in Pediatric Emergency Department.

    Science.gov (United States)

    Huang, I-Anne; Tuan, Pao-Lan; Jaing, Tang-Her; Wu, Chang-Teng; Chao, Minston; Wang, Hui-Hsuan; Hsia, Shao-Hsuan; Hsiao, Hsiang-Ju; Chang, Yu-Ching

    2016-10-01

    Pediatric emergency medicine is a young field that has established itself in recent decades. Many unanswered questions remain regarding how to deliver better pediatric emergency care. The implementation of full-time pediatric emergency physicians is a quality improvement strategy for child care in Taiwan. The aim of this study is to evaluate the quality of care under different physician coverage models in the pediatric emergency department (ED). The medical records of 132,398 patients visiting the pediatric ED of a tertiary care university hospital during January 2004 to December 2006 were retrospectively reviewed. Full-time pediatric emergency physicians are the group specializing in the pediatric emergency medicine, and they only work in the pediatric ED. Part-time pediatricians specializing in other subspecialties also can work an extra shift in the pediatric ED, with the majority working in their inpatient and outpatient services. We compared quality performance indicators, including: mortality rate, the 72-hour return visit rate, length of stay, admission rate, and the rate of being kept for observation between full-time and part-time pediatric emergency physicians. An average of 3678 ± 125 [mean ± standard error (SE)] visits per month (with a range of 2487-6646) were observed. The trends in quality of care, observed monthly, indicated that the 72-hour return rate was 2-6% and length of stay in the ED decreased from 11.5 hours to 3.2 hours over the study period. The annual mortality rate within 48 hours of admission to the ED increased from 0.04% to 0.05% and then decreased to 0.02%, and the overall mortality rate dropped from 0.13% to 0.07%. Multivariate analyses indicated that there was no change in the 72-hour return visit rate for full-time pediatric emergency physicians; they were more likely to admit and keep patients for observation [odds ratio = 1.43 and odds ratio = 1.71, respectively], and these results were similar to those of senior

  7. The neuroradiological study of craniopharyngiomas; A comparison with non-functioning pituitary macroadenomas

    Energy Technology Data Exchange (ETDEWEB)

    Oikawa, Susumu; Takemae, Toshiki; Kobayashi, Shigeaki (Shinshu Univ., Matsumoto, Nagano (Japan). Faculty of Medicine)

    1992-06-01

    The neuroradiological manifestations of 10 surgically verified craniopharyngiomas are retrospectively studied and compared with those of 8 non-functioning pituitary macroadenomas. The saucer-like appearance of the sella turcica on a craniogram was noted in 2 of the 10 craniopharyngiomas and in 2 of the 8 pituitary adenomas. A ballooning of the sella turcica was observed in one of the 10 craniopharyngiomas and in 5 of the 8 pituitary adenomas. Calcification on CT scan was presented in only 5 craniopharyngiomas. On a plain CT scan, no craniopharyngioma manifested any high-density mass except calcification. Four pituitary adenomas showed a slightly high density, though. A cystic lesion was revealed in all the craniopharyngiomas and in 4 pituitary adenomas. All the craniopharyngiomas except for one intrasellar type and all the pituitary adenomas were enhanced with a contrast medium. The solid portion in one craniopharyngioma and in one pituitary adenoma was high-intensity on T[sub 1]-weighted MRI. The cystic portion in 4 craniopharyngiomas and in 2 pituitary adenomas manifested a high intensity on a T[sub 1]-weighted image. A normal pituitary gland located on the floor of the sella was disclosed in all the craniopharyngiomas on a sagittal T[sub 1]-weighted image; however in all the pituitary adenomas, no normal pituitary gland was found at least not on the floor of the sella. The presence of a normal pituitary gland on the sellar floor on sagittal T[sub 1]-weighted MRI may be a new differential diagnostic point between craniopharyngioma and pituitary macroadenoma. Calcification, cystic formation, and density on a plain CT scan seem to be useful evidence for diagnosis. (author).

  8. Neuroradiological, neurophysiological and molecular findings in infantile Krabbe disease: two case reports

    Directory of Open Access Journals (Sweden)

    Vargiami E

    2016-06-01

    Full Text Available Krabbe disease is an autosomal recessive neurodegenerative disorder due to a defect of the lysosomal enzyme β-galactocerebrosidase (β-GALC. Depending on the age of onset, the disease is classified into infantile and later-onset forms. We report neuroradiological, neurophysiological and molecular findings in two Greek patients with the infantile form of Krabbe disease. The index patients presented at the age of 3.5 and 6 months, respectively, due to developmental delay. Magnetic resonance imaging (MRI of the first patient’s brain demonstrated signs of leukodystrophy, while nerve conduction velocities (NCVs were significantly decreased. The second patient’s MRI at the age of 4 months was initially normal, but at 18 months demonstrated leukodystrophic alterations as well, whereas NCVs were also significantly delayed. In both patients, a severe decrease in β-GALC, activity supported the diagnosis of Krabbe disease, while the final diagnosis was confirmed by molecular genetic testing. Two homozygous mutations of the GALC gene, the c.411_413delTAA [p.K139del] mutation in the first patient, and the c.749T>C [p.I250T] mutation in the second patient, were identified. At their last follow-up visit at the age of 4 and 6 years, respectively, both patients were bedridden and quadri-plegic, suffering from frequent respiratory tract infections and fed through a gastrostomy. Both mutations found in homozygosity in these two unrelated patients of Greek ancestry, could pinpoint a common origin. Genotyping of patients with Krabbe disease is important, in order to contribute to the creation of a European mutation database and to further study possible genotype-phenotype correlations of the disease.

  9. ASSESSMENT OF KNOWLEDGE & ATTITUDE OF THE PEDIATRIC RESIDENT ABOUT NEONATAL & PEDIATRIC CARDIOPULMONARY RESUSCITATION

    Directory of Open Access Journals (Sweden)

    M KADIAVAR

    2003-09-01

    Full Text Available Introduction: A high leve of skill & knowledge is required in circumstances of cardiopulmonary resucitation which represents the most urgent clinical situations. The difficulties for pediatric residents who are fronted with the most cases of pediatric & neonatal resucitation are due to different causes of cardiorespiratory arrest in camparison to adults. This study aimed to assess the knowledge & their personal attitude toward the neonatal & pediatric cardiopulmonary resuscitatin. Methods: By cross - sectional multicenter study between the pediatric residents who were studied in the teaching hospitals in Tehran (1378-90. Data were gathered among 140 residents by self-completed questionnaires which were included three parts as. demographic information assessment of their attitude by summation of score via ranking list questions and total score from assessment to their knowledge by different scenarios which were formatted in the multiple choice questions. Results: 35.7% of the residents studied in the first year of residency 35.0% in the second year and the remainder (29/3% in the third year More than 90% of them considered their knowledge about neonatal and pediatric cardiopulmonary resuscitation low & less than average. Net only 80% of the residents self - assessed their actual ability about this issue low but also declaired the insufficient education during the medical training. The total score of knowledge assessment was 14.7 + 1_0.54 from 30 without any significant relations among the residents in different hospitals or various levels of pediatric residency. (P value= 0.1 , 0.7 There was not significant correlation between the total score from their attitude & their knowledge. Conclusion: Pediatric residents as the key personnel in the management of cardiopulmonary resuscitation of the neonates and children should have enough knowledge and skills about this topic. This survey demonstrates a low level of the pediatric & neonatal

  10. Pediatric Thyroid Cancer

    Science.gov (United States)

    ... Marketplace Find an ENT Doctor Near You Pediatric Thyroid Cancer Pediatric Thyroid Cancer Patient Health Information News media ... and neck issues, should be consulted. Types of thyroid cancer in children: Papillary : This form of thyroid cancer ...

  11. Radiodiagnosis in pediatrics today

    International Nuclear Information System (INIS)

    Baklanova, V.F.

    1982-01-01

    The fields of radiodiagnosis application in pediatrics are considered. The improvement of roentgenologic methods and application of various contrast proparations enable to study and precisely differentiate congenital and acquired diseases. The scope of roentgenology application in pediatrics extends due to differentiation of pediatric specialities. New methods of investigation with decreasing radiation exposure to minimal are realized [ru

  12. Pediatric Melanoma and Drug Development

    Directory of Open Access Journals (Sweden)

    Klaus Rose

    2018-03-01

    Full Text Available Importance—Pediatric melanoma occurs, albeit rarely. Should patients be treated by today’s medical standards, or be subjected to medically unnecessary clinical studies? Observations—We identified international, industry-sponsored pediatric melanoma studies triggered by regulatory demands in www.clinicaltrials.gov and further pediatric melanoma studies demanded by European Union pediatric investigation plans. We retrieved related regulatory documents from the internet. We analyzed these studies for rationale and medical beneficence on the basis of physiology, pediatric clinical pharmacology and rationale. Regulatory authorities define children by chronological age, not physiologically. Newborns’ organs are immature but they develop and mature rapidly. Separate proof of efficacy in underage patients is justified formally/regulatorily but lacks medical sense. Children—especially post-puberty—and adults vis-a-vis medications are physiologically very similar. Two adolescent melanoma studies were terminated in 2016 because of waning recruitment, while five studies in pediatric melanoma and other solid tumors, triggered by European Union pediatric investigation plans, continue recruiting worldwide. Conclusions and Relevance—Regulatory-demanded pediatric melanoma studies are medically superfluous. Melanoma patients of all ages should be treated with effective combination treatment. Babies need special attention. Children need dose-finding and pharmacokinetic studies but adolescents metabolize and respond to drugs similarly to adults. Institutional Review Boards/ethics committees should suspend ongoing questionable pediatric melanoma studies and reject newly submitted questionable studies.

  13. What Is a Pediatric Gastroenterologist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Gastroenterologist? Page Content Article Body If your child ... children, and teens. What Kind of Training Do Pediatric Gastroenterologists Have? Pediatric gastroenterologists are medical doctors who ...

  14. What Is a Pediatric Endocrinologist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Endocrinologist? Page Content Article Body If your child ... the teen years. What Kind of Training Do Pediatric Endocrinologists Have? Pediatric endocrinologists are medical doctors who ...

  15. What Is a Pediatric Geneticist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Geneticist? Page Content Article Body Fortunately, most children ... with similar problems. What Kind of Training Do Pediatric Geneticists Have? Pediatric geneticists are medical doctors who ...

  16. What Is a Pediatric Urologist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Urologist? Page Content Article Body If your child ... treat your child. What Kind of Training Do Pediatric Urologists Have? Pediatric urologists are medical doctors who ...

  17. Children's (Pediatric) Abdominal Ultrasound Imaging

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen Children’s (pediatric) ultrasound imaging of the ... abdomen using ultrasound. View full size with caption Pediatric Content Some imaging tests and treatments have special ...

  18. The US pediatric nephrology workforce: a report commissioned by the American Academy of Pediatrics.

    Science.gov (United States)

    Primack, William A; Meyers, Kevin E; Kirkwood, Suzanne J; Ruch-Ross, Holly S; Radabaugh, Carrie L; Greenbaum, Larry A

    2015-07-01

    The US pediatric nephrology workforce is poorly characterized. This report describes clinical and nonclinical activities, motivations and disincentives to a career in pediatric nephrology, future workforce needs, trainee recruitment, and possible explanations for personnel shortages. An e-mail survey was sent in 2013 to all identified US-trained or -practicing pediatric nephrologists. Of 504 respondents, 51% are men, 66% are US graduates, and 73% work in an academic setting. About 20% of trained pediatric nephrologists no longer practice pediatric nephrology. Among the 384 respondents practicing pediatric nephrology full or part-time in the United States, the mean work week was 56.1±14.3 hours, with time divided between patient care (59%), administration (13%), teaching (10%), clinical research (9%), basic research (6%), and other medical activities (3%). Most (>85%) care for dialysis and transplantation patients. The median number of weeks annually on call is 16, and 29% work with one or no partner. One-third of US pediatric nephrologists (n=126) plan to reduce or stop clinical nephrology practice in the next 5 years, and 53% plan to fully or partially retire. Almost half the division chiefs (47%) report inadequate physician staffing. Ongoing efforts to monitor and address pediatric nephrology workforce issues are needed. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  19. Seminar Pediatrics. Medical and Technical Applications

    International Nuclear Information System (INIS)

    Montivero, M.; Nespral, D.O.; Alak, Maria del Carmen

    2012-01-01

    The Association of Biology and Nuclear Medicine has organized the 'Seminar Pediatrics - Medical and Technical Applications', held in Buenos Aires in May 2012, in order to collaborate with the scientific growth of nuclear medicine in pediatrics. The main topics covered were: management of pediatric patients and medical application in childhood, dosimetry in pediatric nuclear medicine, scope of radioisotope - studies in nephrourological pathologies, PET in pediatrics, among others.

  20. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is ... a CT scan. View full size with caption Pediatric Content Some imaging tests and treatments have special ...

  1. What is Pediatric Palliative Care?

    Science.gov (United States)

    ... FAQ Handout for Patients and Families What Is Pediatric Palliative Care? Pediatric Palliative care (pronounced pal-lee-uh-tiv) is ... life for both the child and the family. Pediatric palliative care is provided by a team of ...

  2. 96. German Roentgen congress of the DRG. Program with abstracts; 96. Deutscher Roentgenkongress der DRG. Vollstaendiges Program mit Abstracts

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-05-15

    The volume contains the program and the abstracts of the 96th German Roentgen congress of the DRG covering the following issues: profession and environment caused diseases, medical imaging - image processing - software, experimental radiology, whole-body diagnostics, gastro- and abdomen diagnostics, vascular diagnostics, device technology, heart diagnostics, interventional radiology (vascular diseases, oncology, others), pediatric radiology, contrast agents, head- and neck diagnostics, molecular imaging, musco-skeletal diagnostics, neuroradiology, emergency diagnostics - intensive care, oncologic imaging, quality management, radiation protection, thorax diagnostics.

  3. Children's (Pediatric) Magnetic Resonance Imaging

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Children’s (Pediatric) Magnetic Resonance Imaging Children’s magnetic resonance imaging (MRI) ... limitations of Children’s (Pediatric) MRI? What is Children’s (Pediatric) MRI? Magnetic resonance imaging (MRI) is a noninvasive ...

  4. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen Children’s (pediatric) ultrasound imaging of the ... abdomen using ultrasound. View full size with caption Pediatric Content Some imaging tests and treatments have special ...

  5. PET imaging in pediatric oncology

    International Nuclear Information System (INIS)

    Shulkin, B.L.

    2004-01-01

    High-quality PET imaging of pediatric patients is challenging and requires attention to issues commonly encountered in the practice of pediatric nuclear medicine, but uncommon to the imaging of adult patients. These include intravenous access, fasting, sedation, consent, and clearance of activity from the urinary tract. This paper discusses some technical differences involved in pediatric PET to enhance the quality of scans and assure the safety and comfort of pediatric patients. (orig.)

  6. Pediatric Palliative Care at a Glance

    Science.gov (United States)

    ® ™ ® Pediatric Palliative Care at a Glance A child’s serious illness affects the entire family. Pediatric palliative (pal-lee-uh-tiv) care can support ... extra support, palliative care can help. What is pediatric palliative care? Pediatric palliative care is supportive care ...

  7. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children’s (Pediatric) Magnetic Resonance Imaging Children’s magnetic resonance imaging (MRI) ... limitations of Children’s (Pediatric) MRI? What is Children’s (Pediatric) MRI? Magnetic resonance imaging (MRI) is a noninvasive ...

  8. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children’s (Pediatric) Magnetic Resonance Imaging Children’s magnetic resonance imaging ( ... the limitations of Children’s (Pediatric) MRI? What is Children’s (Pediatric) MRI? Magnetic resonance imaging (MRI) is a ...

  9. Pediatric emergence delirium: Canadian Pediatric Anesthesiologists' experience.

    Science.gov (United States)

    Rosen, H David; Mervitz, Deborah; Cravero, Joseph P

    2016-02-01

    Pediatric emergence agitation/delirium (ED) is a cluster of behaviors seen in the early postanesthetic period with negative emotional consequences for families and increased utilization of healthcare resources. Many studies have looked at identifying risk factors for ED and at pharmacologic regimens to prevent ED. There are few published reports on treatment options and efficacy for established ED episodes, and essentially no data concerning current practice in the treatment of ED. We sought to elicit the experience and opinions of Canadian Pediatric Anesthesiologists on the incidence of ED in their practice, definitions and diagnostic criteria, preventative strategies, treatments, and their perceived efficacy. A web-based survey was sent to pediatric anesthesiologists working at academic health science centers across Canada. The participants were selected based on being members of the Canadian Pediatric Anesthesia Society (CPAS), which represents the subspecialty in Canada. All members of CPAS who had e-mail contact information available in the membership database were invited to participate. A total of 209 members out of the total of 211 fulfilled these criteria and were included in the study population. The response rate was 51% (106/209). Of respondents, 42% felt that ED was a significant problem at their institutions, with 45% giving medication before or during anesthesia to prevent the development of ED. Propofol was the most common medication given to prevent ED (68%) and to treat ED (42%). Total intravenous anesthesia (TIVA) was considered by 38% of respondents as a technique used to prevent ED. Medications used for treatment included propofol (42%), midazolam (31%), fentanyl (10%), morphine (7%), and dexmedetomidine (5%), with 87% of respondents rating effectiveness of treatment as 'usually works quickly with one dose'. We present information on current practice patterns with respect to prophylaxis and treatment of ED among a specialized group of pediatric

  10. Kerala Pioneering Pediatric Surgery in India

    Directory of Open Access Journals (Sweden)

    TP Joseph

    2014-04-01

    Full Text Available Pediatric surgeons of Kerala are very proud to have led the development of superspeciality in any branch of medicine in Kerala and also superspeciality of Pediatric surgery in whole of India. Late Prof. Raman Nair returned in 1954 after training under Dr. Everett Koop in US. Same year, in his far-sighted vision for future development of the speciality, he moved to SATH, Medical College, Trivandrum and started Pediatric surgery as a speciality attached to Paediatrics department; this was the beginning of Pediatric surgery in India. He opted for Pediatric surgery as a full time job and did not do any general surgery work in adults. He was the first full time Pediatric surgeon of India; during the next few years, 2 surgeons, one in Calcutta, Prof. UC Chakraboty and Prof. D Anjaneyulu in Hyderabad started working as full time Pediatric surgeons. In Mumbai, Delhi and Chennai, Pediatric surgery developed much later and then all over the country.

  11. Estimation of staff lens doses during interventional procedures. Comparing cardiology, neuroradiology and interventional radiology.

    Science.gov (United States)

    Vano, E; Sanchez, R M; Fernandez, J M

    2015-07-01

    The purpose of this article is to estimate lens doses using over apron active personal dosemeters in interventional catheterisation laboratories (cardiology IC, neuroradiology IN and radiology IR) and to investigate correlations between occupational lens doses and patient doses. Active electronic personal dosemeters placed over the lead apron were used on a sample of 204 IC procedures, 274 IN and 220 IR (all performed at the same university hospital). Patient dose values (kerma area product) were also recorded to evaluate correlations with occupational doses. Operators used the ceiling-suspended screen in most cases. The median and third quartile values of equivalent dose Hp(10) per procedure measured over the apron for IC, IN and IR resulted, respectively, in 21/67, 19/44 and 24/54 µSv. Patient dose values (median/third quartile) were 75/128, 83/176 and 61/159 Gy cm(2), respectively. The median ratios for dosemeters worn over the apron by operators (protected by the ceiling-suspended screen) and patient doses were 0.36; 0.21 and 0.46 µSv Gy(-1) cm(-2), respectively. With the conservative approach used (lens doses estimated from the over apron chest dosemeter) we came to the conclusion that more than 800 procedures y(-1) and per operator were necessary to reach the new lens dose limit for the three interventional specialties. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Pediatric Electrocardiographic Imaging (ECGI) Applications

    Science.gov (United States)

    Silva, Jennifer N. A.

    2014-01-01

    Summary Noninvasive electrocardiographic imaging (ECGI) has been used in pediatric and congenital heart patients to better understand their electrophysiologic substrates. In this article we focus on the 4 subjects related to pediatric ECGI: 1) ECGI in patients with congenital heart disease and Wolff-Parkinson-White syndrome, 2) ECGI in patients with hypertrophic cardiomyopathy and pre-excitation, 3) ECGI in pediatric patients with Wolff-Parkinson-White syndrome, and 4) ECGI for pediatric cardiac resynchronization therapy. PMID:25722754

  13. Pediatric imaging. Rapid fire questions and answers

    International Nuclear Information System (INIS)

    Quattromani, F.; Lampe, R.

    2008-01-01

    The book contains the following contributions: Airway, head, neck; allergy, immunology rheumatology; pediatric cardiac imaging; child abuse; chromosomal abnormalities; conscious sedation; contrast agents and radiation protection; pediatric gastrointestinal imaging; genetic disorders in infants and children; pediatric genitourinary imaging; pediatric hematology, oncology imaging; pediatric intenrventional radiology; metabolic and vitamin disorders; muscoskeletal disorders (osteoradiology); neonatology imaging; pediatric neuroimaging; imaging of the respiratory tract in infants and children; vascular anomalies

  14. Pediatric imaging. Rapid fire questions and answers

    Energy Technology Data Exchange (ETDEWEB)

    Quattromani, F.; Lampe, R. (eds.) [Texas Tech Univ. Health Sciences Center, School of Medicine, Lubbock, TX (United States); Handal, G.A. [Texas Tech Univ. Health Sciences Center, School of Medicine, El Paso, TX (United States)

    2008-07-01

    The book contains the following contributions: Airway, head, neck; allergy, immunology rheumatology; pediatric cardiac imaging; child abuse; chromosomal abnormalities; conscious sedation; contrast agents and radiation protection; pediatric gastrointestinal imaging; genetic disorders in infants and children; pediatric genitourinary imaging; pediatric hematology, oncology imaging; pediatric intenrventional radiology; metabolic and vitamin disorders; muscoskeletal disorders (osteoradiology); neonatology imaging; pediatric neuroimaging; imaging of the respiratory tract in infants and children; vascular anomalies.

  15. Psychological issues in pediatric obesity

    Directory of Open Access Journals (Sweden)

    Gurvinder Kalra

    2012-01-01

    Full Text Available Pediatric obesity is a major health problem and has reached epidemiological proportions today. The present paper reviews major psychological issues in pediatric obesity from a developmental perspective. Research and literature has shown that a number of developmental, family, maternal and child factors are responsible in the genesis of pediatric obesity. Family food habits, early developmental lifestyle of the child, parenting, early family relationships and harmony all contribute towards the growth and development of a child. The present review focuses on the role of developmental psychological factors in the pathogenesis of pediatric obesity and highlights the developmental factors that must be kept in mind when evaluating a case of pediatric obesity.

  16. Find a Pediatric Dentist

    Science.gov (United States)

    ... AAPD AAPD Publications Advertising Brochures Journals & Publications Full Journal Archives Access Pediatric Dentistry Today Practice Management and Marketing Newsletter Pediatric Dentistry Journal Open Access Articles Oral ...

  17. [Gorlin-Goltz syndrome: review of the neuroradiological and maxillofacial features illustrated with two clinical cases].

    Science.gov (United States)

    Safronova, Marta Maia; Arantes, Mavilde; Lima, Iva; Domingues, Sara; Almeida, Marta; Moniz, Pedro

    2010-01-01

    Gorlin-Goltz syndrome or nevoid basal cell carcinoma syndrome is a rare hereditary autosomal-dominant disorder characterized by multiple basal cell carcinomas in young patients, odontogenic keratocysts, palmar or plantar pits, calcification of the falx cerebri and skeletal malformations. This syndrome is due to mutations in PTCH1 (patched homolog 1 da Drosophila), a tumor suppressor gene. Diagnostic criteria were defined by Evans, revised by Kimonis and include major and minor criteria. The authors review in particular the neuroradiological and maxillofacial characteristics of the syndrome. The authors describe the clinical presentation of two children with Gorlin-Goltz syndrome without affected first degree relatives. In both the clinical suspicion of the syndrome is raised by the presence of multiple odontogenic cysts surgically removed. Histopathological exam revealed keratocysts. None of the patients has basal cell carcinomas but both present with skeletal anomalies, namely marked pectus deformity. The absence of major diagnostic criteria like basal cell carcinomas or palmar or plantar pits in young patients delay the early diagnosis and the correct screening for medulloblastoma, basal cell carcinomas and cardiac fibromas. Odontogenic keratocysts are the most consistent clinical finding in Gorlin-Goltz syndrome in the first one or two decades of life. These patients are very sensitive to ionizing radiation, being able to develop basal cell carcinomas and meningiomas. Treatment should accomplish the complete resection of the tumors.

  18. Pediatric vasculitis.

    Science.gov (United States)

    Barut, Kenan; Sahin, Sezgin; Kasapcopur, Ozgur

    2016-01-01

    The aim of this review is to define childhood vasculitis and to highlight new causative factors and treatment modalities under the guidance of recently published studies. Childhood vasculitis is difficult to diagnose because of the wide variation in the symptoms and signs. New nomenclature and classification criteria were proposed for the diagnosis of pediatric vasculitis. Recently, progress has been made toward understanding the genetic susceptibility to pediatric vasculitis as it was in other diseases. Various radiological techniques provide great opportunities in establishing the diagnosis of pediatric vasculitis. Mild central nervous system disease can accompany Henoch-Schonlein purpura and can go unnoticed. Antineutrophilic cytoplasmic antibody-associated vasculitis is rare in children. Increased severity of the disease, subglottic stenosis, and renal disease are described more frequently among children. Biological therapies are used with success in children as in adults. Future studies, whose aims are to evaluate treatment responses, prognosis and to design guidelines for activity, and damage index of vasculitis for children are required. Henoch-Schonlein purpura and Kawasaki disease are the most frequent vasculitides of children. Experience from adult studies for treatment and prognosis are usually used because of low incidence of other vasculitides in children. Multicenter studies of pediatric vasculitis should be conducted to detail treatment responses and prognosis in children.

  19. Pediatric renal transplant practices in India.

    Science.gov (United States)

    Sethi, Sidharth Kumar; Sinha, Rajiv; Rohatgi, Smriti; Kher, Vijay; Iyengar, Arpana; Bagga, Arvind

    2017-05-01

    Limited access to tertiary-level health care, limited trained pediatric nephrologists and transplant physicians, lack of facilities for dialysis, lack of an effective deceased donor program, non-affordability, and non-adherence to immunosuppressant drugs poses a major challenge to universal availability of pediatric transplantation in developing countries. We present the results of a survey which, to the best of our knowledge, is the first such published attempt at understanding the current state of pediatric renal transplantation in India. A designed questionnaire formulated by a group of pediatric nephrologists with the aim of understanding the current practice of pediatric renal transplantation was circulated to all adult and pediatric nephrologists of the country. Of 26 adult nephrologists who responded, 16 (61.5%) were involved in pediatric transplantation, and 10 of 15 (66.6%) pediatric nephrologists were involved in pediatric transplantation. Most of the centers doing transplants were private/trust institution with only three government institutions undertaking it. Induction therapy was varied among pediatric and adult nephrologists. There were only a few centers (n=5) in the country routinely doing >5 transplants per year. Preemptive transplants and protocol biopsies were a rarity. The results demonstrate lower incidence of undertaking pediatric transplants in children below 6 years, paucity of active cadaveric programs and lack of availability of trained pediatric nephrologists and staff. In contrast to these dissimilarities, the immunosuppressant use seems to be quite similar to Western registry data with majority favoring induction agent and triple immunosuppressant (steroid, mycophenolate mofetil and tacrolimus) for maintenance. The survey also identifies major concerns in availability of this service to all regions of India as well as to all economic segments. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Simulation in pediatric anesthesiology.

    Science.gov (United States)

    Fehr, James J; Honkanen, Anita; Murray, David J

    2012-10-01

    Simulation-based training, research and quality initiatives are expanding in pediatric anesthesiology just as in other medical specialties. Various modalities are available, from task trainers to standardized patients, and from computer-based simulations to mannequins. Computer-controlled mannequins can simulate pediatric vital signs with reasonable reliability; however the fidelity of skin temperature and color change, airway reflexes and breath and heart sounds remains rudimentary. Current pediatric mannequins are utilized in simulation centers, throughout hospitals in-situ, at national meetings for continuing medical education and in research into individual and team performance. Ongoing efforts by pediatric anesthesiologists dedicated to using simulation to improve patient care and educational delivery will result in further dissemination of this technology. Health care professionals who provide complex, subspecialty care to children require a curriculum supported by an active learning environment where skills directly relevant to pediatric care can be developed. The approach is not only the most effective method to educate adult learners, but meets calls for education reform and offers the potential to guide efforts toward evaluating competence. Simulation addresses patient safety imperatives by providing a method for trainees to develop skills and experience in various management strategies, without risk to the health and life of a child. A curriculum that provides pediatric anesthesiologists with the range of skills required in clinical practice settings must include a relatively broad range of task-training devises and electromechanical mannequins. Challenges remain in defining the best integration of this modality into training and clinical practice to meet the needs of pediatric patients. © 2012 Blackwell Publishing Ltd.

  1. 20. meeting of the Gesellschaft fuer Paediatrische Radiologie

    International Nuclear Information System (INIS)

    The 54 papers presented at the meeting deal with the methods, reliability and specific problems of paediatric radiology. Sonography is given particular attention. Apart from conventional radiological techniques, also CT and nuclear techniques are reviewed. (MG) [de

  2. New frontiers in pediatric Allo-SCT.

    Science.gov (United States)

    Talano, J M; Pulsipher, M A; Symons, H J; Militano, O; Shereck, E B; Giller, R H; Hancock, L; Morris, E; Cairo, M S

    2014-09-01

    The inaugural meeting of 'New Frontiers in Pediatric Allogeneic Stem Cell Transplantation' organized by the Pediatric Blood and Transplant Consortium (PBMTC) was held at the American Society of Pediatric Hematology and Oncology Annual Meeting. This meeting provided an international platform for physicians and investigators active in the research and utilization of pediatric Allo-SCT in children and adolescents with malignant and non-malignant disease (NMD), to share information and develop future collaborative strategies. The primary objectives of the conference included: (1) to present advances in Allo-SCT in pediatric ALL and novel pre and post-transplant immunotherapy; (2) to highlight new strategies in alternative allogeneic stem cell donor sources for children and adolescents with non-malignant hematological disorders; (3) to discuss timing of immune reconstitution after Allo-SCT and methods of facilitating more rapid recovery of immunity; (4) to identify strategies of utilizing Allo-SCT in pediatric myeloproliferative disorders; (5) to develop diagnostic and therapeutic approaches to hematological complications post pediatric Allo-SCT; (6) to enhance the understanding of new novel cellular therapeutic approaches to pediatric malignant and non-malignant hematological disorders; and (7) to discuss optimizing drug therapy in pediatric recipients of Allo-SCT. This paper will provide a brief overview of the conference.

  3. Simulation-based medical education in pediatrics.

    Science.gov (United States)

    Lopreiato, Joseph O; Sawyer, Taylor

    2015-01-01

    The use of simulation-based medical education (SBME) in pediatrics has grown rapidly over the past 2 decades and is expected to continue to grow. Similar to other instructional formats used in medical education, SBME is an instructional methodology that facilitates learning. Successful use of SBME in pediatrics requires attention to basic educational principles, including the incorporation of clear learning objectives. To facilitate learning during simulation the psychological safety of the participants must be ensured, and when done correctly, SBME is a powerful tool to enhance patient safety in pediatrics. Here we provide an overview of SBME in pediatrics and review key topics in the field. We first review the tools of the trade and examine various types of simulators used in pediatric SBME, including human patient simulators, task trainers, standardized patients, and virtual reality simulation. Then we explore several uses of simulation that have been shown to lead to effective learning, including curriculum integration, feedback and debriefing, deliberate practice, mastery learning, and range of difficulty and clinical variation. Examples of how these practices have been successfully used in pediatrics are provided. Finally, we discuss the future of pediatric SBME. As a community, pediatric simulation educators and researchers have been a leading force in the advancement of simulation in medicine. As the use of SBME in pediatrics expands, we hope this perspective will serve as a guide for those interested in improving the state of pediatric SBME. Published by Elsevier Inc.

  4. Phantom Limb Pain in Pediatric Oncology

    Directory of Open Access Journals (Sweden)

    Patrick DeMoss

    2018-04-01

    Full Text Available Phantom limb pain (PLP is a prevalent problem for children and adolescents undergoing amputation due to cancer treatment. The symptoms are wide ranging from sharp to tingling. PLP in children typically lasts for a few minutes but can be almost constant and can be highly distressing. This focused review describes the characteristics, epidemiology, mechanisms, and evidence-based treatment of PLP in pediatric populations, focusing on pediatric cancer. In pediatric oncology, the administration of chemotherapy is a risk factor that potentially sensitizes the nervous system and predisposes pediatric cancer patients to develop PLP after amputation. Gabapentin, tricyclic antidepressants, opiates, nerve blocks, and epidural catheters have shown mixed success in adults and case reports document potential utility in pediatric patients. Non-pharmacologic treatments, such as mirror therapy, psychotherapy, and acupuncture have also been used in pediatric PLP with success. Prospective controlled trials are necessary to advance care for pediatric patients with PLP.

  5. Toward creating family-friendly work environments in pediatrics: baseline data from pediatric department chairs and pediatric program directors.

    Science.gov (United States)

    McPhillips, Heather A; Burke, Ann E; Sheppard, Kate; Pallant, Adam; Stapleton, F Bruder; Stanton, Bonita

    2007-03-01

    The objective was to determine baseline characteristics of pediatric residency training programs and academic departments in regard to family-friendly work environments as outlined in the Report of the Task Force on Women in Pediatrics. We conducted Web-based anonymous surveys of 147 pediatric department chairs and 203 pediatric program directors. The chair's questionnaire asked about child care, lactation facilities, family leave policies, work-life balance, and tenure and promotion policies. The program director's questionnaire asked about family leave, parenting, work-life balance, and perceptions of "family-friendliness." The response rate was 52% for program directors and 51% for chairs. Nearly 60% of chairs reported some access to child care or provided assistance locating child care; however, in half of these departments, demand almost always exceeded supply. Lactation facilities were available to breastfeeding faculty in 74% of departments, although only 57% provided access to breast pumps. A total of 78% of chairs and 90% of program directors reported written maternity leave policies with slightly fewer reporting paternity leave policies. The majority (83%) of chairs reported availability of part-time employment, whereas only 27% of program directors offered part-time residency options. Most departments offered some flexibility in promotion and tenure. Although progress has been made, change still is needed in many areas in pediatric departments and training programs, including better accessibility to quality child care; improved lactation facilities for breastfeeding mothers; clear, written parental leave policies; and flexible work schedules to accommodate changing demands of family life.

  6. Pediatric Brain Tumor Foundation

    Science.gov (United States)

    ... navigate their brain tumor diagnosis. WATCH AND SHARE Brain tumors and their treatment can be deadly so ... Pediatric Central Nervous System Cancers Read more >> Pediatric Brain Tumor Foundation 302 Ridgefield Court, Asheville, NC 28806 ...

  7. Pediatric advanced life support and sedation of pediatric dental patients.

    Science.gov (United States)

    Kim, Jongbin

    2016-03-01

    Programs provided by the Korea Association of Cardiopulmonary Resuscitation include Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Korean Advanced Life Support (KALS). However, programs pertinent to dental care are lacking. Since 2015, related organizations have been attempting to develop a Dental Advanced Life Support (DALS) program, which can meet the needs of the dental environment. Generally, for initial management of emergency situations, basic life support is most important. However, emergencies in young children mostly involve breathing. Therefore, physicians who treat pediatric dental patients should learn PALS. It is necessary for the physician to regularly renew training every two years to be able to immediately implement professional skills in emergency situations. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is absolutely necessary to be able to immediately implement professional skills in emergency situations.

  8. Pediatric Nephrolithiasis: A Review.

    Science.gov (United States)

    Miah, Tayaba; Kamat, Deepak

    2017-06-01

    The incidence of pediatric nephrolithiasis is on the rise. The composition of kidney stones in children is different than in adults, as most stones in children have a composition of calcium oxalate and calcium phosphate mixed with a small amount of uric acid. The symptoms of pediatric nephrolithiasis are nonspecific. Computed tomography (CT) is the gold standard for diagnosis; however, because of radiation exposure associated with a CT scan, ultrasonography is also an accepted modality for the diagnosis. Extensive metabolic evaluation is important to rule out an underlying metabolic disorder. Urinary decompression, medical expulsion therapy, and surgical interventions such as ureteroscopy and extracorporeal shockwave lithotripsy are some of the options available for treating pediatric nephrolithiasis. [Pediatr Ann. 2017;46(6):e242-e244.]. Copyright 2017, SLACK Incorporated.

  9. Obesity and Pediatric Drug Development.

    Science.gov (United States)

    Vaughns, Janelle D; Conklin, Laurie S; Long, Ying; Zheng, Panli; Faruque, Fahim; Green, Dionna J; van den Anker, John N; Burckart, Gilbert J

    2018-05-01

    There is a lack of dosing guidelines for use in obese children. Moreover, the impact of obesity on drug safety and clinical outcomes is poorly defined. The paucity of information needed for the safe and effective use of drugs in obese patients remains a problem, even after drug approval. To assess the current incorporation of obesity as a covariate in pediatric drug development, the pediatric medical and clinical pharmacology reviews under the Food and Drug Administration (FDA) Amendments Act of 2007 and the FDA Safety and Innovation Act (FDASIA) of 2012 were reviewed for obesity studies. FDA labels were also reviewed for statements addressing obesity in pediatric patients. Forty-five drugs studied in pediatric patients under the FDA Amendments Act were found to have statements and key words in the medical and clinical pharmacology reviews and labels related to obesity. Forty-four products were identified similarly with pediatric studies under FDASIA. Of the 89 product labels identified, none provided dosing information related to obesity. The effect of body mass index on drug pharmacokinetics was mentioned in only 4 labels. We conclude that there is little information presently available to provide guidance related to dosing in obese pediatric patients. Moving forward, regulators, clinicians, and the pharmaceutical industry should consider situations in drug development in which the inclusion of obese patients in pediatric trials is necessary to facilitate the safe and effective use of new drug products in the obese pediatric population. © 2018, The American College of Clinical Pharmacology.

  10. What Is a Pediatric Allergist / Immunologist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Allergist/Immunologist? Page Content Article Body If your ... immune system problems. What Kind of Training Do Pediatric Allergists/Immunologists Have? Pediatric allergists/immunologists are medical ...

  11. What Is a Pediatric Heart Surgeon?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Heart Surgeon? Page Content Article Body If your ... require heart surgery. What Kind of Training Do Pediatric Heart Surgeons Have? Pediatric heart surgeons are medical ...

  12. Pediatric Endocrinology Nurses Society

    Science.gov (United States)

    ... Join Now International Welcome to PENS The Pediatric Endocrinology Nursing Society (PENS) is committed to the development ... nurses in the art and science of pediatric endocrinology nursing. Learn More Text1 2018 PENS Call for ...

  13. Color Perception in Pediatric Patient Room Design: American versus Korean Pediatric Patients.

    Science.gov (United States)

    Phillip Park, Jin Gyu; Park, Changbae

    2013-01-01

    This study simultaneously addresses the issues of the scarcity of information about pediatric patient color preferences, conflicting findings about the impact of culture on color preferences, and limitations of previous research instruments. Effects of culture and gender on color preferences were investigated using American and Korean pediatric patients. Much of the existing research in environmental design has focused on environments for healthy children and adults, but those findings cannot be confidently applied to environments for pediatric patients. In previous studies, the impact of culture on color preferences has been suggested, though the effects appear to vary. Moreover, the results of previous studies were typically based on perceptions of small color chips, which are different from seeing a color on wall surfaces. Previous studies also failed to control for confounding variables such as color attributes and light sources. Instead of using color chips, this study used physical model simulation to investigate environmental color preferences in real contexts. Cultural difference was found in white. Other than white, no significant cultural difference was found. Gender differences were found across both of the groups. Korean pediatric patients showed significantly higher preference scores for white than Americans did. Other than white, both groups reported blue and green as their most preferred colors; white was the least preferred. Both groups reported similar gender effects. Overall, male patients reported significantly lower preference scores for red and purple than female patients did. These results can help healthcare providers and professionals better understand appropriate colors for pediatric populations. Evidence-based design, healing environment, patients, pediatric, satisfaction.

  14. Flat-Panel Computed Tomography (DYNA-CT) in Neuroradiology. From High-Resolution Imaging of Implants to One-Stop-Shopping for Acute Stroke.

    Science.gov (United States)

    Doerfler, A; Gölitz, P; Engelhorn, T; Kloska, S; Struffert, T

    2015-10-01

    Originally aimed at improving standard radiography by providing higher absorption efficiency and a wider dynamic range, flat-panel detector technology has meanwhile got widely accepted in the neuroradiological community. Especially flat-panel detector computed tomography (FD-CT) using rotational C-arm mounted flat-panel detector technology is capable of volumetric imaging with a high spatial resolution. By providing CT-like images of the brain within the angio suite, FD-CT is able to rapidly visualize hemorrhage and may thus improve complication management without the need of patient transfer. As "Angiographic CT" FD-CT may be helpful during many diagnostic and neurointerventional procedures and for noninvasive monitoring and follow-up. In addition, spinal interventions and high-resolution imaging of the temporal bone might also benefit from FD-CT. Finally, using novel dynamic perfusion and angiographic protocols, FD-CT may provide functional information on brain perfusion and vasculature with the potential to replace standard imaging in selected acute stroke patients.

  15. Pediatric melanoma: incidence, treatment, and prognosis

    Directory of Open Access Journals (Sweden)

    Saiyed FK

    2017-04-01

    Full Text Available Faiez K Saiyed,1 Emma C Hamilton,1 Mary T Austin,1,2 1Department of Pediatric Surgery, McGovern Medical School, 2Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Abstract: The purpose of this review is to outline recent advancements in diagnosis, treatment, and prevention of pediatric melanoma. Despite the recent decline in incidence, it continues to be the deadliest form of skin cancer in children and adolescents. Pediatric melanoma presents differently from adult melanoma; thus, the traditional asymmetry, border irregularity, color variegation, diameter >6 mm, and evolution (ABCDE criteria have been modified to include features unique to pediatric melanoma (amelanotic, bleeding/bump, color uniformity, de novo/any diameter, evolution of mole. Surgical and medical management of pediatric melanoma continues to derive guidelines from adult melanoma treatment. However, more drug trials are being conducted to determine the specific impact of drug combinations on pediatric patients. Alongside medical and surgical treatment, prevention is a central component of battling the incidence, as ultraviolet (UV-related mutations play a central role in the vast majority of pediatric melanoma cases. Aggressive prevention measures targeting sun safety and tanning bed usage have shown positive sun-safety behavior trends, as well as the potential to decrease melanomas that manifest later in life. As research into the field of pediatric melanoma continues to expand, a prevention paradigm needs to continue on a community-wide level. Keywords: melanoma, pediatric, adolescent, childhood

  16. American Pediatric Surgical Association

    Science.gov (United States)

    American Pediatric Surgical Association Search for: Login Resources + For Members For Professionals For Training Program Directors For Media For ... Surgical Outcomes Surveys & Results Publications Continuing Education + ExPERT Pediatric Surgery NaT Annual Meeting CME MOC Requirements Residents / ...

  17. National Pediatric Program Update

    International Nuclear Information System (INIS)

    2008-01-01

    The book of the National Pediatric Program Update, issued by the Argentina Society of Pediatrics, describes important issues, including: effective treatment of addictions (drugs); defects of the neural tube; and the use of radiation imaging in diagnosis. [es

  18. Pediatric psoriasis: an update

    Directory of Open Access Journals (Sweden)

    Nanette B Silverberg

    2009-10-01

    Full Text Available Nanette B SilverbergPediatric and Adolescent Dermatology, St. Luke’s-Roosevelt Hospital Center, New York, NY, USAAbstract: Pediatric psoriasis consists broadly of 3 age groups of psoriatic patients: infantile psoriasis, a self-limited disease of infancy, psoriasis with early onset, and pediatric psoriasis with psoriatic arthritis. About one-quarter of psoriasis cases begin before the age of 18 years. A variety of clinical psoriasis types are seen in childhood, including plaque-type, guttate, erythrodermic, napkin, and nail-based disease. Like all forms of auto-immunity, susceptibility is likely genetic, but environmental triggers are required to initiate disease activity. The most common trigger of childhood is an upper respiratory tract infection. Once disease has occurred, treatment is determined based on severity and presence of joint involvement. Topical therapies, including corticosteroids and calcipotriene, are the therapies of choice in the initial care of pediatric patients. Ultraviolet light, acitretin and cyclosporine can clear skin symptoms, while methotrexate and etanercept can clear both cutaneous and joint disease. Concern for psychological development is required when choosing psoriatic therapies. This article reviews current concepts in pediatric psoriasis and a rational approach to therapeutics. Keywords: psoriasis, autoimmunity, Streptococcus, etanercept, calcipotriene, topical corticosteroids

  19. Neonatal and pediatric regionalized systems in pediatric emergency mass critical care.

    Science.gov (United States)

    Barfield, Wanda D; Krug, Steven E; Kanter, Robert K; Gausche-Hill, Marianne; Brantley, Mary D; Chung, Sarita; Kissoon, Niranjan

    2011-11-01

    Improved health outcomes are associated with neonatal and pediatric critical care in well-organized, cohesive, regionalized systems that are prepared to support and rehabilitate critically ill victims of a mass casualty event. However, present systems lack adequate surge capacity for neonatal and pediatric mass critical care. In this document, we outline the present reality and suggest alternative approaches. In May 2008, the Task Force for Mass Critical Care published guidance on provision of mass critical care to adults. Acknowledging that the critical care needs of children during disasters were unaddressed by this effort, a 17-member Steering Committee, assembled by the Oak Ridge Institute for Science and Education with guidance from members of the American Academy of Pediatrics, convened in April 2009 to determine priority topic areas for pediatric emergency mass critical care recommendations.Steering Committee members established subcommittees by topic area and performed literature reviews of MEDLINE and Ovid databases. The Steering Committee produced draft outlines through consensus-based study of the literature and convened October 6-7, 2009, in New York, NY, to review and revise each outline. Eight draft documents were subsequently developed from the revised outlines as well as through searches of MEDLINE updated through March 2010.The Pediatric Emergency Mass Critical Care Task Force, composed of 36 experts from diverse public health, medical, and disaster response fields, convened in Atlanta, GA, on March 29-30, 2010. Feedback on each manuscript was compiled and the Steering Committee revised each document to reflect expert input in addition to the most current medical literature. States and regions (facilitated by federal partners) should review current emergency operations and devise appropriate plans to address the population-based needs of infants and children in large-scale disasters. Action at the state, regional, and federal levels should address

  20. Medical genetic issues in clinical of pediatric neurology practice:a history of pediatrics in Peking University First Hospital.

    Science.gov (United States)

    Wu, Xi-ru

    2006-02-18

    The Department of Pediatrics of Peking University First Hospital has a long term of outstanding history. It was established about 60 years ago. After the division of pediatric neurology (DPN) had been established in 1960s, it had been assigned to cover genetic disorders. During the recent 20 years, efforts have been put on three aspects: (1) Pediatric neurology clinical service and education; (2) research studies of childhood epilepsies and pediatric neurogenetic disorders; and (3) development of a strong DPN team to establish a comprehensive pediatric neurological program. In this paper, we reviewed the history of the pediatric neurology division in our department, our clinical and research work and achievements for neurogenetic diseases.

  1. [Robotics in pediatric surgery].

    Science.gov (United States)

    Camps, J I

    2011-10-01

    Despite the extensive use of robotics in the adult population, the use of robotics in pediatrics has not been well accepted. There is still a lack of awareness from pediatric surgeons on how to use the robotic equipment, its advantages and indications. Benefit is still controversial. Dexterity and better visualization of the surgical field are one of the strong values. Conversely, cost and a lack of small instruments prevent the use of robotics in the smaller patients. The aim of this manuscript is to present the controversies about the use of robotics in pediatric surgery.

  2. What is a pediatric tumor?

    Directory of Open Access Journals (Sweden)

    Mora J

    2012-11-01

    Full Text Available Jaume Mora1,21Department of Oncology, 2Developmental Tumor Biology Laboratory, Hospital Sant Joan de Deu, Fundacio Sant Joan de Deu, Barcelona, SpainAbstract: Working together with medical oncologists, the question of whether a Ewing sarcoma in a 25-year-old is a pediatric tumor comes up repeatedly. Like Ewing's, some tumors present characteristically at ages that cross over what has been set as the definition of pediatrics (15 years, 18 years, or 21 years?. Pediatric oncology textbooks, surprisingly, do not address the subject of defining a pediatric tumor. They all begin with an epidemiology chapter defining the types of tumors appearing at distinct stages of childhood, adolescence, and young adulthood. Describing the epidemiology of tumors in relation to age, it becomes clear that the disease is related to the phenomenon of aging. The question, however, remains: is there a biological definition of what pediatric age is? And if so, will tumors occurring during this period of life have anything to do with such biological definition? With the aim of finding an objective definition, the fundamental concepts of what defines "pediatrics" was reviewed and then the major features of tumors arising during development were analyzed. The tumors were explored from the perspective of a host immersed in the normal process of growth and development. This physiological process, from pluripotential and undifferentiated cells, makes possible the differentiation, maturation, organization, and function of tissues, organs, and apparatus. A biological definition of pediatric tumors and the infancy–childhood–puberty classification of developmental tumors according to the infancy–childhood–puberty model of normal human development are proposed.Keywords: growth and development, pediatric tumor, infant, childhood and adolescence, pubertal tumors

  3. Pediatric dermatology workforce shortage: perspectives from academia.

    Science.gov (United States)

    Craiglow, Brittany G; Resneck, Jack S; Lucky, Anne W; Sidbury, Robert; Yan, Albert C; Resnick, Steven D; Antaya, Richard J

    2008-12-01

    The pediatric dermatology workforce has not been systematically evaluated since recent changes in board certification requirements. To quantify and characterize the workforce of academic pediatric dermatologists and examine issues related to training, hiring, and retention. Dermatology chairpersons and residency directors in the United States and Canada completed a 30-question survey. Eighty of 132 programs (61%) responded to the survey. More than two thirds of programs (56/80) employed a pediatric dermatologist, and 34 programs were recruiting a pediatric dermatologist. The number of residents that pursue careers in pediatric dermatology is significantly associated with the number of pediatric dermatologists on faculty at their institution. Self-reported data, which may have been reflected by recall bias, and 61% response rate. At a majority of academic centers, the current pool of pediatric dermatology faculty is neither adequate to meet academic nor clinical demands. Methods to increase exposure to pediatric dermatology among medical students and residents must be sought.

  4. Specialist training in pediatric anesthesia

    DEFF Research Database (Denmark)

    Hansen, Tom G

    2009-01-01

    There has been a great deal of focus on specialist training in pediatric anesthesia in the last decade or so. Internationally, however, there is still no uniform agreement as to how such a training program should be arranged and organized. Since September 2003, the Scandinavian Society of Anaesth......There has been a great deal of focus on specialist training in pediatric anesthesia in the last decade or so. Internationally, however, there is still no uniform agreement as to how such a training program should be arranged and organized. Since September 2003, the Scandinavian Society...... of Anaesthesiology and Intensive Care Medicine has coordinated an advanced Inter-Nordic educational program in pediatric anesthesia and intensive care. The training program is managed by a Steering Committee. This program is intended for physicians who recently have received their specialist degree in anesthesiology...... and intensive care. The training period is 12 months of which 9 months are dedicated to pediatric anesthesia and 3 months to pediatric intensive care. During the 1-year training period, the candidates are designated a Scandinavian host clinic (at a tertiary pediatric center in Scandinavia approved...

  5. Quality of evidence-based pediatric guidelines

    NARCIS (Netherlands)

    Boluyt, Nicole; Lincke, Carsten R.; Offringa, Martin

    2005-01-01

    Objective. To identify evidence-based pediatric guidelines and to assess their quality. Methods. We searched Medline, Embase, and relevant Web sites of guideline development programs and national pediatric societies to identify evidence-based pediatric guidelines. A list with titles of identified

  6. Pediatric nuclear cardiology

    International Nuclear Information System (INIS)

    Gelfand, M.J.; Hannon, D.W.

    1987-01-01

    Nuclear cardiology methods have had less impact upon pediatric cardiology than upon adult cardiology. Most pediatric heart disease results from congenital malformations of the heart and great vessels, which is usually discovered in infancy, and is most often treated definitively in infancy or early childhood. Unfortunately, nuclear medicine techniques are limited in their spatial resolution - structures that overlie each other are separated with difficulty. As a result, nuclear cardiology is usually of limited value in the anatomic characterization of the congenital heart abnormalities. Nevertheless, it has been useful in the detection and quantification of the pathophysiologic consequences of many congenital cardiac malformations. The authors review application of nuclear medicine in pediatric cardiology, and attempt to assess each in terms of its clinical utility

  7. Child Neurology Education for Pediatric Residents.

    Science.gov (United States)

    Albert, Dara V F; Patel, Anup D; Behnam-Terneus, Maria; Sautu, Beatriz Cunill-De; Verbeck, Nicole; McQueen, Alisa; Fromme, H Barrett; Mahan, John D

    2017-03-01

    The aim of this study was to evaluate whether the current state of child neurology education during pediatric residency provides adequate preparation for pediatric practice. A survey was sent to recent graduates from 3 pediatric residency programs to assess graduate experience, perceived level of competence, and desire for further education in child neurology. Responses from generalists versus subspecialists were compared. The response rate was 32%, half in general pediatric practice. Only 22% feel very confident in approaching patients with neurologic problems. This may represent the best-case scenario as graduates from these programs had required neurology experiences, whereas review of Accreditation Council of Graduate Medical Education-accredited residency curricula revealed that the majority of residencies do not. Pediatric neurologic problems are common, and pediatric residency graduates do encounter such problems in practice. The majority of pediatricians report some degree of confidence; however, some clear areas for improvement are apparent.

  8. [Complications in pediatric anesthesia].

    Science.gov (United States)

    Becke, K

    2014-07-01

    As in adult anesthesia, morbidity and mortality could be significantly reduced in pediatric anesthesia in recent decades. This fact cannot conceal the fact that the incidence of anesthetic complications in children is still much more common than in adults and sometimes with a severe outcome. Newborns and infants in particular but also children with emergency interventions and severe comorbidities are at increased risk of potential complications. Typical complications in pediatric anesthesia are respiratory problems, medication errors, difficulties with the intravenous puncture and pulmonal aspiration. In the postoperative setting, nausea and vomiting, pain, and emergence delirium can be mentioned as typical complications. In addition to the systematic prevention of complications in pediatric anesthesia, it is important to quickly recognize disturbances of homeostasis and treat them promptly and appropriately. In addition to the expertise of the performing anesthesia team, the institutional structure in particular can improve quality and safety in pediatric anesthesia.

  9. GENE-07. MOLECULAR NEUROPATHOLOGY 2.0 - INCREASING DIAGNOSTIC ACCURACY IN PEDIATRIC NEUROONCOLOGY

    Science.gov (United States)

    Sturm, Dominik; Jones, David T.W.; Capper, David; Sahm, Felix; von Deimling, Andreas; Rutkoswki, Stefan; Warmuth-Metz, Monika; Bison, Brigitte; Gessi, Marco; Pietsch, Torsten; Pfister, Stefan M.

    2017-01-01

    Abstract The classification of central nervous system (CNS) tumors into clinically and biologically distinct entities and subgroups is challenging. Children and adolescents can be affected by >100 histological variants with very variable outcomes, some of which are exceedingly rare. The current WHO classification has introduced a number of novel molecular markers to aid routine neuropathological diagnostics, and DNA methylation profiling is emerging as a powerful tool to distinguish CNS tumor classes. The Molecular Neuropathology 2.0 study aims to integrate genome wide (epi-)genetic diagnostics with reference neuropathological assessment for all newly-diagnosed pediatric brain tumors in Germany. To date, >350 patients have been enrolled. A molecular diagnosis is established by epigenetic tumor classification through DNA methylation profiling and targeted panel sequencing of >130 genes to detect diagnostically and/or therapeutically useful DNA mutations, structural alterations, and fusion events. Results are aligned with the reference neuropathological diagnosis, and discrepant findings are discussed in a multi-disciplinary tumor board including reference neuroradiological evaluation. Ten FFPE sections as input material are sufficient to establish a molecular diagnosis in >95% of tumors. Alignment with reference pathology results in four broad categories: a) concordant classification (~77%), b) discrepant classification resolvable by tumor board discussion and/or additional data (~5%), c) discrepant classification without currently available options to resolve (~8%), and d) cases currently unclassifiable by molecular diagnostics (~10%). Discrepancies are enriched in certain histopathological entities, such as histological high grade gliomas with a molecularly low grade profile. Gene panel sequencing reveals predisposing germline events in ~10% of patients. Genome wide (epi-)genetic analyses add a valuable layer of information to routine neuropathological

  10. Teaching Pediatric Nursing Concepts to Non-Pediatric Nurses Using an Advance Organizer

    Science.gov (United States)

    Bell, Julie Ann

    2013-01-01

    Non-pediatric nurses in rural areas often care for children in adult units, emergency departments, and procedural areas. A half-day program about pediatric nursing using constructivist teaching strategies including an advance organizer, case studies, and simulation was offered at a community hospital in Western North Carolina. Nurses reported a…

  11. Validation of a Pediatric Early Warning Score in Hospitalized Pediatric Oncology and Hematopoietic Stem Cell Transplant Patients.

    Science.gov (United States)

    Agulnik, Asya; Forbes, Peter W; Stenquist, Nicole; Rodriguez-Galindo, Carlos; Kleinman, Monica

    2016-04-01

    To evaluate the correlation of a Pediatric Early Warning Score with unplanned transfer to the PICU in hospitalized oncology and hematopoietic stem cell transplant patients. We performed a retrospective matched case-control study, comparing the highest documented Pediatric Early Warning Score within 24 hours prior to unplanned PICU transfers in hospitalized pediatric oncology and hematopoietic stem cell transplant patients between September 2011 and December 2013. Controls were patients who remained on the inpatient unit and were matched 2:1 using age, condition (oncology vs hematopoietic stem cell transplant), and length of hospital stay. Pediatric Early Warning Scores were documented by nursing staff at least every 4 hours as part of routine care. Need for transfer was determined by a PICU physician called to evaluate the patient. A large tertiary/quaternary free-standing academic children's hospital. One hundred ten hospitalized pediatric oncology patients (42 oncology, 68 hematopoietic stem cell transplant) requiring unplanned PICU transfer and 220 matched controls. None. Using the highest score in the 24 hours prior to transfer for cases and a matched time period for controls, the Pediatric Early Warning Score was highly correlated with the need for PICU transfer overall (area under the receiver operating characteristic = 0.96), and in the oncology and hematopoietic stem cell transplant groups individually (area under the receiver operating characteristic = 0.95 and 0.96, respectively). The difference in Pediatric Early Warning Score results between the cases and controls was noted as early as 24 hours prior to PICU admission. Seventeen patients died (15.4%). Patients with higher Pediatric Early Warning Scores prior to transfer had increased PICU mortality (p = 0.028) and length of stay (p = 0.004). We demonstrate that our institution's Pediatric Early Warning Score is highly correlated with the need for unplanned PICU transfer in hospitalized oncology and

  12. Perception of pediatric neurology among non-neurologists.

    Science.gov (United States)

    Jan, Mohammed M S

    2004-01-01

    Pediatric neurology is considered a relatively new and evolving subspecialty. In Saudi Arabia, neurologic disorders in children are common, and the demand for trained pediatric neurologists is strong. The aim was to study the perception of the pediatric neurology specialty among practicing generalists and their referral practices. Attendees of a symposium on pediatric epilepsy comprehensive review for the generalist were included. A structured 25-item questionnaire was designed to examine their demographics, training, practice, and referral patterns. One hundred nineteen participants attended the symposium, and 90 (76%) questionnaires were returned. Attendees' ages were 22 to 70 years (mean 32 years), with 65.5% female physicians. There were 32% consultants, 51% trainees, and 17% students. Most physicians (67%) were practicing general pediatrics. Only 36% received a structured pediatric neurology rotation during training. Children with neurologic complaints constituted 28.5% of those seen in their practice, and they referred 32.5% of them to pediatric neurology. Only 32% were moderately or highly confident in making the diagnosis or providing the appropriate treatment. Those who received a structured pediatric neurology rotation felt more comfortable in their management (P = .03). Many physicians (38.5%) had no direct access to a pediatric neurologist for referrals. To conclude, pediatric neurologic disorders are common in daily practice. Most generalists did not receive a structured neurology rotation during their training and were not highly confident in diagnosing and treating these children. Given the limited number of pediatric neurologists, I highly recommend that generalists receive appropriate neurologic training.

  13. Advances in pediatric dentistry.

    Science.gov (United States)

    Yoon, Richard K; Best, Jed M

    2011-07-01

    This article addresses advances in 4 key areas related to pediatric dentistry: (1) caries detection tools, (2) early interventions to arrest disease progression, (3) caries-risk assessment tools, and (4) trends in pediatric procedures and dental materials. Copyright © 2011 Elsevier Inc. All rights reserved.

  14. Endoscopic Third Ventriculostomy for the Treatment of Hydrocephalus in a Pediatric Population with Myelomeningocele.

    Science.gov (United States)

    Rei, Joana; Pereira, Josué; Reis, Carina; Salvador, Sérgio; Vaz, Rui

    2017-09-01

    Hydrocephalus develops in up to 90% of patients born with myelomeningocele. Although endoscopic third ventriculostomy (ETV) is currently considered the preferred treatment for obstructive hydrocephalus, its results have been inconsistent in patients with myelomeningocele. This study focuses on clinical and radiologic outcomes of ETV in children with hydrocephalus related to myelomeningocele. Medical records of 18 pediatric patients with myelomeningocele treated with ETV from 1998 to 2015 at the Centro Hospitalar São João (Porto, Portugal) were reviewed retrospectively. Patients' caregivers were contacted to evaluate their clinical manifestations before and after surgery regarding signs and symptoms of hydrocephalus and Chiari malformation. Control neuroradiologic imaging of 9 patients was obtained and analyzed. Success of ETV was defined by clinical resolution and radiologic confirmation. ETV was successful in 8 of 18 cases (44.4%). Groups of patients were compared according to age at the time of surgery, with a 40% (2/5) success rate in newborns and a 50% success rate (3/6) in children older than 1 year. Eight patients underwent ETV as a first option, with a 37.5% success rate. Ten patients underwent the procedure after previous ventriculoperitoneal shunt (VPS), 5 for malfunction and 5 for VPS infection with 60% and 40% success rates, respectively. Early postoperative complications occurred in 2 patients. ETV can be performed in patients with myelomeningocele and hydrocephalus with success rates of almost 50%. Prior VPS or VPS malfunction or infection do not contraindicate ETV. If possible, the procedure should be delayed until the patient is at least 1 month old. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Pediatric radiology

    International Nuclear Information System (INIS)

    Benz-Bohm, G.

    1997-01-01

    Pediatric radiology is an important subsection of diagnostic radiology involving specific difficulties, but unfortunately is quite too often neglected as a subject of further education and training. The book therefore is not intended for specialists in the field, but for radiologists wishing to plunge deeper into the matter of pediatric radiology and to acquire a sound, basic knowledge and information about well-proven modalities, the resulting diagnostic images, and interpretation of results. The book is a compact guide and a helpful source of reference and information required for every-day work, or in special cases. With patients who are babies or children, the challenges are different. The book offers all the information needed, including important experience from pediatric hospital units that may be helpful in diagnostic evaluation, information about specific dissimilarities in anatomy and physiology which affect the imaging results, hints for radiology planning and performance, as well as information about the various techniques and their indication and achievements. The book presents a wide spectrum of informative and annotated images. (orig./CB) [de

  16. Superselective microcoil embolization in severe intractable epistaxis: an analysis of 12 consecutive cases from an otorhinolaryngologic and an interventional neuroradiologic point of view.

    Science.gov (United States)

    Seidel, D U; Remmert, S; Brassel, F; Schlunz-Hendann, M; Meila, D

    2015-11-01

    From 2006 to 2013, 12 patients with severe epistaxis refractory to prior conservative and surgical therapy were treated by superselective embolization of nasal arteries. Supersoft platinum microcoils with smallest diameters were used as the sole embolic agent in all cases. Coils were applied far distally in a stretched position for obtaining ideal target vessel superselectivity. The objective of this study is to evaluate efficacy and complications of superselective coil embolization for treatment of severe intractable epistaxis and to discuss results from an otorhinolaryngologic and an interventional neuroradiologic point of view. Retrospectively, all epistaxis inpatients between 2006 and 2013 were identified and subdivided by form of treatment: conservative, surgical and interventional therapy. Medical records of interventionally treated patients were reviewed for demographics, medical history, risk factors, clinical data, complications and short-term success, and patients were followed up for long-term success. Mean follow-up was 37 months. In 12 patients, 14 embolizations were carried out, with short-term success in 9 patients (75%), while early post-interventional rebleeding occurred in 3 patients (25%). Of 9 patients with short-term success, 1 died during stay, 1 was lost to follow-up and 1 had minor re-bleeding after 30 months. Six patients had short-term and long-term success. Before the first embolization, 3 ± 1 conservative and/or surgical procedures had been undertaken. Length of stay was 12.8 ± 3.6 days. 8 patients (67%) received red cell concentrates. Most frequent complications were mucosal damage and nasal pain, but these were related to repeated packing and surgery. Typical embolic complications as neurological or visual impairment or soft tissue necrosis were not observed in any patient. From the otorhinolaryngologic point of view, surgery is the treatment of choice in severe refractory epistaxis, but in case of repeated failure, superselective

  17. Understanding the pediatric dermatology workforce shortage: mentoring matters.

    Science.gov (United States)

    Admani, Shehla; Caufield, Maura; Kim, Silvia S; Siegfried, Elaine C; Friedlander, Sheila Fallon

    2014-02-01

    To target pediatric dermatologists directly in order to evaluate their current demographics and the most important motivating factors that influenced their career choice. Pediatric dermatology is one of the pediatric subspecialties with an inadequate supply to meet current patient needs. A survey was designed to evaluate the training pathway, employment status, participation in teaching, and clinical practice characteristics of pediatric dermatologists. The survey was administered to attendants of the 2010 Society for Pediatric Dermatology annual meeting. Any remaining board certified pediatric dermatologists who had not previously responded were queried via Survey Monkey. There was a 71% response rate. The majority chose a career in pediatric dermatology early, often prior to starting a dermatology residency. The vast majority of respondents noted mentorship as the most important influence on their decision to pursue a career in pediatric dermatology. The most common obstacles cited by respondents were financial hardship and resistance of some dermatology programs to accept applicants previously trained in pediatrics. Our survey provides evidence to support the importance of early exposure to the field and, most importantly, to committed pediatric dermatologists who can serve as mentors. This information may be helpful in approaching solutions to the workforce shortage in the field of pediatric dermatology. Copyright © 2014 Mosby, Inc. All rights reserved.

  18. The pediatric knee.

    Science.gov (United States)

    Orth, Robert C

    2013-03-01

    Knee pain is a common problem in children and adolescents, and MRI of the knee is the most commonly performed pediatric cross-sectional musculoskeletal imaging exam. The purpose of this pictorial review is to highlight differences between adult and pediatric knee imaging with an emphasis on normal developmental variants, injury and disease patterns unique to children and adolescents, and differences in response and presentation to conditions affecting both adults and children.

  19. Pediatrics

    Science.gov (United States)

    Spackman, T. J.

    1978-01-01

    The utilization of the Lixiscope in pediatrics was investigated. The types of images that can presently be obtained are discussed along with the problems encountered. Speculative applications for the Lixiscope are also presented.

  20. Pediatric allergy and immunology in Spain.

    Science.gov (United States)

    Nieto, Antonio; Mazon, Angel; Martin-Mateos, Maria Anunciacion; Plaza, Ana-Maria; Garde, Jesus; Alonso, Elena; Martorell, Antonio; Boquete, Manuel; Lorente, Felix; Ibero, Marcel; Bone, Javier; Pamies, Rafael; Garcia, Juan Miguel; Echeverria, Luis; Nevot, Santiago; Martinez-Cañavate, Ana; Fernandez-Benitez, Margarita; Garcia-Marcos, Luis

    2011-11-01

    The data of the ISAAC project in Spain show a prevalence of childhood asthma ranging from 7.1% to 15.3%, with regional differences; a higher prevalence, 22.6% to 35.8%, is described for rhinitis, and atopic dermatitis is found in 4.1% to 7.6% of children. The prevalence of food allergy is 3%. All children in Spain have the right to be visited in the National Health System. The medical care at the primary level is provided by pediatricians, who have obtained their titles through a 4-yr medical residency training program. The education on pediatric allergy during that period is not compulsory and thus very variable. There are currently 112 certified European pediatric allergists in Spain, who have obtained the accreditation of the European Union of Medical Specialist for proven skills and experience in pediatric allergy. Future specialists in pediatric allergy should obtain their titles through a specific education program to be developed in one of the four accredited training units on pediatric allergy, after obtaining the title on pediatrics. The Spanish Society of Pediatric Allergy and Clinical Immunology (SEICAP) gathers over 350 pediatric allergists and pediatricians working in this field. SEICAP has a growing activity including yearly congresses, continued education courses, elaboration of technical clinical documents and protocols, education of patients, and collaboration with other scientific societies and associations of patients. The official journal of SEICAP is Allergologia et Immunophatologia, published every 2 months since 1972. The web site of SEICAP, http://www.seicap.es, open since 2004, offers information for professionals and extensive information on pediatric allergic and immunologic disorders for the lay public; the web site is receiving 750 daily visits during 2011. The pediatric allergy units are very active in clinical work, procedures as immunotherapy or induction of oral tolerance in food allergy, contribution to scientific literature, and

  1. Skill qualifications in pediatric minimally invasive surgery.

    Science.gov (United States)

    Iwanaka, Tadashi; Morikawa, Yasuhide; Yamataka, Atsuyuki; Nio, Masaki; Segawa, Osamu; Kawashima, Hiroshi; Sato, Masahito; Terakura, Hirotsugu; Take, Hiroshi; Hirose, Ryuichiro; Yagi, Makoto

    2011-07-01

    In 2006, The Japanese Society of Pediatric Endoscopic Surgeons devised a plan to develop a pediatric endoscopic surgical skill qualification (ESSQ) system. This system is controlled by The Japan Society for Endoscopic Surgery. The standard requirement for skills qualification is the ability of each applicant to complete common types of laparoscopic surgery. The main goal of the system is to decrease complications of laparoscopic surgery by evaluating the surgical skills of each applicant and subsequently certify surgeons with adequate skills to perform laparoscopic operations safely. A committee of pediatric ESSQ created a checklist to assess the applicant's laparoscopic surgical skills. Skills are assessed in a double-blinded fashion by evaluating an unedited video recording of a fundoplication for pediatric gastroesophageal reflux disease. The initial pediatric ESSQ system was started in 2008. In 2008 and 2009, respectively, 9 out of 17 (53%) and 6 out of 12 (50%) applicants were certified as expert pediatric laparoscopic surgeons. Our ultimate goal is to provide safe and appropriate pediatric minimally invasive procedures and to avoid severe complications. To prove the predictive validity of this system, a survey of the outcomes of operations performed by certified pediatric surgeons is required.

  2. Introduction-Pediatric epilepsy surgery techniques.

    Science.gov (United States)

    Rydenhag, Bertil; Cukiert, Arthur

    2017-04-01

    This supplement includes the proceedings from the Pediatric Epilepsy Surgery Techniques Meeting held in Gothenburg (July 4-5, 2014), which focused on presentations and discussions regarding specific surgical technical issues in pediatric epilepsy surgery. Pediatric epilepsy neurosurgeons from all over the world were present and active in very fruitful and live presentations and discussions. These articles represent a synopsis of the areas and subjects dealt with there. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  3. NCI Pediatric Preclinical Testing Consortium

    Science.gov (United States)

    NCI has awarded grants to five research teams to participate in its Pediatric Preclinical Testing Consortium, which is intended to help to prioritize which agents to pursue in pediatric clinical trials.

  4. Pediatric AIDS

    International Nuclear Information System (INIS)

    Price, D.B.; Haller, J.O.; Kramer, J.; Hotson, G.C.; Loh, J.P.; Schlusselberg, D.; Inglese, C.M.; Jacobs, J.; Rose, A.L.; Menez-Bautista, R.; Fikrig, S.

    1988-01-01

    A group of 23 pediatric patients seropositive for HIV antibody were studied by computed tomography and evaluated neurodevelopmentally. Significant neurodevelopmental delays were found in over 95% of the patients studied. CT findings in six patients were normal and thirteen of 23 (57%) had prominence of the CSF spaces. Less frequent findings included calcifications in the basal ganglia and white matter. Cerebral mass lesions included one case of lymphoma and one case of hemorrhage. The CT findings in the pediatric age group differs from the adult population in that that contrast enhancing inflammatory mass lesions are uncommon. (orig.)

  5. Pediatric interventional radiology: vascular interventions

    International Nuclear Information System (INIS)

    Kandasamy, Devasenathipathy; Gamanagatti, Shivanand; Gupta, Arun Kumar

    2016-01-01

    Pediatric interventional radiology (PIR) comprises a range of minimally invasive diagnostic and therapeutic procedures that are performed using image guidance. PIR has emerged as an essential adjunct to various surgical and medical conditions. Over the years, technology has undergone dramatic and continuous evolution, making this speciality grow. In this review, the authors will discuss various vascular interventional procedures undertaken in pediatric patients. It is challenging for the interventional radiologist to accomplish a successful interventional procedure. There are many vascular interventional radiology procedures which are being performed and have changed the way the diseases are managed. Some of the procedures are life saving and have become the treatment of choice in those patients. The future is indeed bright for the practice and practitioners of pediatric vascular and non-vascular interventions. As more and more of the procedures that are currently being performed in adults get gradually adapted for use in the pediatric population, it may be possible to perform safe and successful interventions in many of the pediatric vascular lesions that are otherwise being referred for surgery. (author)

  6. Neuroradiological findings and clinical features of fourth-ventricular meningioma: A study of 10 cases

    International Nuclear Information System (INIS)

    Zhang, B.-Y.; Yin, B.; Li, Y.-X.; Wu, J.-S.; Chen, H.; Wang, X.-Q.; Geng Daoyng

    2012-01-01

    Aim: To present the neuroradiological and clinical findings of fourth-ventricular meningiomas to increase awareness of this entity. Materials and methods: The computed tomography (CT; n = 5), magnetic resonance imaging (MRI; n = 9) features and clinical presentations of 10 patients with pathologically documented fourth-ventricular meningiomas were retrospectively analysed. Results: All tumours appeared as well-demarcated masses in the fourth ventricle at CT and MRI. The tumour shape was round in eight cases (80%) and irregular in two cases (20%). The CT images of five cases showed predominantly isoattenuation in three cases and high attenuation in two cases, with a mean attenuation value of 52 HU. In addition, calcifications were seen in three cases. At MRI, nine masses were isointense (n = 6) or hypointense (n = 3) to grey matter on T1-weighted images and mildly hyperintense (n = 4), isointense (n = 3), hypointense (n = 1), and of mixed signal intensity (n = 1) on T2-weighted and fluid-attenuated inversion recovery (FLAIR) images. Signal voids were visible in two cases. Enhancement after injection of contrast material was marked homogeneous (n = 5) or heterogeneous (n = 5) on CT or T1-weighted images. Three tumours had mild peritumoural oedema. Three tumours were associated with obstructive hydrocephalus. The pathological subtype of the 10 meningiomas was fibromatous (n = 5), atypical (n = 2), and one each of transitional, psammomatous, and clear-cell type. Conclusion: Although fourth-ventricular meningioma is quite rare, it should be considered in differential diagnosis of neoplasms within the fourth ventricle. The relatively typical radiological appearance, combined the age and sex of patients, can suggest the diagnosis of fourth-ventricular meningioma.

  7. Neuroradiological findings and clinical features of fourth-ventricular meningioma: A study of 10 cases

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, B.-Y.; Yin, B.; Li, Y.-X. [Department of Radiology, Huashan Hospital, Fudan University, Shanghai (China); Wu, J.-S. [Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai (China); Chen, H. [Department of Neuropathology, Huashan Hospital, Fudan University, Shanghai (China); Wang, X.-Q., E-mail: wangxq10@126.com [Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai (China); Geng Daoyng, E-mail: fdhsgdy@126.com [Department of Radiology, Huashan Hospital, Fudan University, Shanghai (China)

    2012-05-15

    Aim: To present the neuroradiological and clinical findings of fourth-ventricular meningiomas to increase awareness of this entity. Materials and methods: The computed tomography (CT; n = 5), magnetic resonance imaging (MRI; n = 9) features and clinical presentations of 10 patients with pathologically documented fourth-ventricular meningiomas were retrospectively analysed. Results: All tumours appeared as well-demarcated masses in the fourth ventricle at CT and MRI. The tumour shape was round in eight cases (80%) and irregular in two cases (20%). The CT images of five cases showed predominantly isoattenuation in three cases and high attenuation in two cases, with a mean attenuation value of 52 HU. In addition, calcifications were seen in three cases. At MRI, nine masses were isointense (n = 6) or hypointense (n = 3) to grey matter on T1-weighted images and mildly hyperintense (n = 4), isointense (n = 3), hypointense (n = 1), and of mixed signal intensity (n = 1) on T2-weighted and fluid-attenuated inversion recovery (FLAIR) images. Signal voids were visible in two cases. Enhancement after injection of contrast material was marked homogeneous (n = 5) or heterogeneous (n = 5) on CT or T1-weighted images. Three tumours had mild peritumoural oedema. Three tumours were associated with obstructive hydrocephalus. The pathological subtype of the 10 meningiomas was fibromatous (n = 5), atypical (n = 2), and one each of transitional, psammomatous, and clear-cell type. Conclusion: Although fourth-ventricular meningioma is quite rare, it should be considered in differential diagnosis of neoplasms within the fourth ventricle. The relatively typical radiological appearance, combined the age and sex of patients, can suggest the diagnosis of fourth-ventricular meningioma.

  8. Pediatric hospital medicine core competencies: development and methodology.

    Science.gov (United States)

    Stucky, Erin R; Ottolini, Mary C; Maniscalco, Jennifer

    2010-01-01

    Pediatric hospital medicine is the most rapidly growing site-based pediatric specialty. There are over 2500 unique members in the three core societies in which pediatric hospitalists are members: the American Academy of Pediatrics (AAP), the Academic Pediatric Association (APA) and the Society of Hospital Medicine (SHM). Pediatric hospitalists are fulfilling both clinical and system improvement roles within varied hospital systems. Defined expectations and competencies for pediatric hospitalists are needed. In 2005, SHM's Pediatric Core Curriculum Task Force initiated the project and formed the editorial board. Over the subsequent four years, multiple pediatric hospitalists belonging to the AAP, APA, or SHM contributed to the content of and guided the development of the project. Editors and collaborators created a framework for identifying appropriate competency content areas. Content experts from both within and outside of pediatric hospital medicine participated as contributors. A number of selected national organizations and societies provided valuable feedback on chapters. The final product was validated by formal review from the AAP, APA, and SHM. The Pediatric Hospital Medicine Core Competencies were created. They include 54 chapters divided into four sections: Common Clinical Diagnoses and Conditions, Core Skills, Specialized Clinical Services, and Healthcare Systems: Supporting and Advancing Child Health. Each chapter can be used independently of the others. Chapters follow the knowledge, skills, and attitudes educational curriculum format, and have an additional section on systems organization and improvement to reflect the pediatric hospitalist's responsibility to advance systems of care. These competencies provide a foundation for the creation of pediatric hospital medicine curricula and serve to standardize and improve inpatient training practices. (c) 2010 Society of Hospital Medicine.

  9. What Is a Pediatric Infectious Diseases Specialist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Infectious Diseases Specialist? Page Content Article Body If ... the teen years. What Kind of Training Do Pediatric Infectious Diseases Specialists Have? Pediatric infectious diseases specialists ...

  10. What Is a Pediatric Critical Care Specialist?

    Science.gov (United States)

    ... Text Size Email Print Share What is a Pediatric Critical Care Specialist? Page Content Article Body If ... in the PICU. What Kind of Training Do Pediatric Critical Care Specialists Have? Pediatric critical care specialists ...

  11. Dental traumatology: an orphan in pediatric dentistry?

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Lauridsen, Eva; Daugaard-Jensen, Jette

    2009-01-01

    Traumatic dental injuries are very frequent during childhood and adolescence. In fact, 2 out of 3 children have suffered a traumatic dental injury before adulthood. This fact links dental traumatology to pediatric dentistry. Unfortunately, this is not reflected by active participation by pediatric...... dentists in acute treatment, follow-up, and research. To examine the status of pediatric dentistry in relation to dental trauma, a publication analysis was undertaken in 1980, 1990, 2000, and 2007 about trauma articles published in 4 pediatric journals: journal of Dentistry for Children, Pediatric...... Dentistry, The journal of Pedodontics, and the International journal of Pediatric Dentistry. This study shows an average publication rate of trauma articles of approximately 3 percent of all articles published and with no improvement in later decennia. If only clinical studies are considered (leaving out...

  12. [An analysis of articles published by academic groups in pediatrics in Chinese Journal of Pediatrics and their citations].

    Science.gov (United States)

    Song, Qiurong; Hu, Yanping; Li, Linping

    2014-08-01

    To explore academic significance and guiding function played by subspecialty groups of the Society of Pediatrics, Chinese Medical Association on Chinese pediatric clinical practice through a statistical analysis of the articles published by the subspecialty groups. Bibliometric methods were used to analyze the number of articles, article types, total citations, highly cited articles and the distribution of citing journals. Totally 7 156 articles were published in Chinese Journal of Pediatrics from 1993 (31) to 2012 (51), of which 187 by subspecialty groups of pediatrics (2.6%), with a total citations of 11 985. Among them, 137 articles were cited with a citation rate of 73.3% and average citations for each article was 64.1. Articles classified as clinical guidelines had been totally cited for 10 900 times with average citations of 123.86 per article. The article on Neonatal hypoxic ischemic encephalopathy diagnosis and clinical index was cited 1 791 times ranked in highly cited literatures. All the top three cited literature periodicals were core journals of pediatrics, and 10 periodicals among the top 20 were in pediatrics and the rest in other medical fields. The number of the articles published by the subspecialty groups of pediatrics was increasing year by year though the portion it in the total number of the articles in the journal was not large. However, the citation frequency of the articles by the subspecialty groups of pediatrics was high, making an obvious contribution to the total citations of Chinese Journal of Pediatrics. The total citation rate of clinical guideline articles and their average rate was higher than those of other articles published in this journal, which meant that this type of articles provided academic references with guiding significance for clinical practice of pediatrics and for other medical fields as well.

  13. Antibiotic prophylaxis for children with sickle cell disease: a survey of pediatric dentistry residency program directors and pediatric hematologists.

    Science.gov (United States)

    Tate, Anupama Rao; Norris, Chelita Kaye; Minniti, Caterina P

    2006-01-01

    The purposes of this study were to: (1) investigate the current clinical practice regarding the use of antibiotic prophylaxis by pediatric dentistry residency program directors and pediatric hematologists for children with sickle cell disease (SCD) requiring dental treatment; and (2) evaluate the perceived relative risk of bacteremia following specific dental procedures, as defined by pediatric dentistry residency program directors and pediatric hematologists. A written survey depicting various clinical scenarios of SCD children requiring common dental procedures was mailed to directors of pediatric dental advanced education programs and distributed to pediatric hematologists attending the 2003 Annual Sickle Cell Disease Association of America conference in Washington, DC. Surveys were returned by 60% (N=34/57) of the pediatric dentistry residency program directors. The surveys were obtained from 51% of pediatric hematologists at the meeting (N=72/140). At least 50% of all respondents recommended prophylaxis for the following clinical situations: dental extractions, treatment under general anesthesia, and status post splenectomy. The perceived risk of infectious complication was highest for extractions, followed by restorative treatment and tooth polishing. Dental residency program directors were more likely (71%, N=24/34) to recommend additional antibiotic therapy for patients taking penicillin prophylaxis if they required an invasive oral surgical procedure. Conversely, only 38% (N=25/66) of pediatric hematologists recommended additional antibiotic therapy (P=.001). Eighty-six percent of dental residency program directors (N=25/29) chose amoxicillin for prophylaxis whereas only 62% of pediatric hematologists (N=36/58) recommended amoxicillin. (Pchildren undergoing dental treatments. Further research and risk/benefit assessment is needed to create a unified approach.

  14. Developing competencies for pediatric hospice and palliative medicine.

    Science.gov (United States)

    Klick, Jeffrey C; Friebert, Sarah; Hutton, Nancy; Osenga, Kaci; Pituch, Kenneth J; Vesel, Tamara; Weidner, Norbert; Block, Susan D; Morrison, Laura J

    2014-12-01

    In 2006, hospice and palliative medicine (HPM) became an officially recognized subspecialty. This designation helped initiate the Accreditation Council of Graduate Medical Education Outcomes Project in HPM. As part of this process, a group of expert clinician-educators in HPM defined the initial competency-based outcomes for HPM fellows (General HPM Competencies). Concurrently, these experts recognized and acknowledged that additional expertise in pediatric HPM would ensure that the competencies for pediatric HPM were optimally represented. To fill this gap, a group of pediatric HPM experts used a product development method to define specific Pediatric HPM Competencies. This article describes the development process. With the ongoing evolution of HPM, these competencies will evolve. As part of the Next Accreditation System, the Accreditation Council of Graduate Medical Education uses milestones as a framework to better define competency-based, measurable outcomes for trainees. Currently, there are no milestones specific to HPM, although the field is designing curricular milestones with multispecialty involvement, including pediatrics. These competencies are the conceptual framework for the pediatric content in the HPM milestones. They are specific to the pediatric HPM subspecialist and should be integrated into the training of pediatric HPM subspecialists. They will serve a foundational role in HPM and should inform a wide range of emerging innovations, including the next evolution of HPM Competencies, development of HPM curricular milestones, and training of adult HPM and other pediatric subspecialists. They may also inform pediatric HPM outcome measures, as well as standards of practice and performance for pediatric HPM interdisciplinary teams. Copyright © 2014 by the American Academy of Pediatrics.

  15. Development of a Pediatric Adverse Events Terminology.

    Science.gov (United States)

    Gipson, Debbie S; Kirkendall, Eric S; Gumbs-Petty, Brenda; Quinn, Theresa; Steen, A; Hicks, Amanda; McMahon, Ann; Nicholas, Savian; Zhao-Wong, Anna; Taylor-Zapata, Perdita; Turner, Mark; Herreshoff, Emily; Jones, Charlotte; Davis, Jonathan M; Haber, Margaret; Hirschfeld, Steven

    2017-01-01

    In 2009, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) established the Pediatric Terminology Harmonization Initiative to establish a core library of terms to facilitate the acquisition and sharing of knowledge between pediatric clinical research, practice, and safety reporting. A coalition of partners established a Pediatric Terminology Adverse Event Working Group in 2013 to develop a specific terminology relevant to international pediatric adverse event (AE) reporting. Pediatric specialists with backgrounds in clinical care, research, safety reporting, or informatics, supported by biomedical terminology experts from the National Cancer Institute's Enterprise Vocabulary Services participated. The multinational group developed a working definition of AEs and reviewed concepts (terms, synonyms, and definitions) from 16 pediatric clinical domains. The resulting AE terminology contains >1000 pediatric diseases, disorders, or clinical findings. The terms were tested for proof of concept use in 2 different settings: hospital readmissions and the NICU. The advantages of the AE terminology include ease of adoption due to integration with well-established and internationally accepted biomedical terminologies, a uniquely temporal focus on pediatric health and disease from conception through adolescence, and terms that could be used in both well- and underresourced environments. The AE terminology is available for use without restriction through the National Cancer Institute's Enterprise Vocabulary Services and is fully compatible with, and represented in, the Medical Dictionary for Regulatory Activities. The terminology is intended to mature with use, user feedback, and optimization. Copyright © 2017 by the American Academy of Pediatrics.

  16. Pharmacotherapy in the Management of Pediatric Obesity.

    Science.gov (United States)

    Kelly, Aaron S; Fox, Claudia K

    2017-08-01

    This review provides a rationale for the use of pharmacotherapy in pediatric weight management, summarizes results of some of the key pediatric clinical trials of approved and "off-label" obesity medications, introduces new options in the pediatric pipeline, and offers a glimpse into the future of pediatric obesity medicine. Despite the need for adjunctive treatments to enhance the outcomes of lifestyle modification therapy among youth with obesity, none of the obesity medications evaluated to date have been shown to meaningfully reduce BMI or cardiometabolic risk factors. Promising medications recently approved for the treatment of obesity in adults will soon be tested in pediatric trials, offering hope that new therapeutic options will soon be available. As new medications are approved to treat pediatric obesity, it will be important to evaluate the safety and efficacy of combination pharmacotherapy and investigate predictors of response. Application of precision medicine approaches to the field of pediatric obesity management will improve the long-term outlook for the tens of millions of youth afflicted with this serious and recalcitrant disease.

  17. Imaging in the diagnosis of pediatric urolithiasis

    Energy Technology Data Exchange (ETDEWEB)

    Colleran, Gabrielle C.; Callahan, Michael J.; Paltiel, Harriet J.; Chow, Jeanne S. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Nelson, Caleb P.; Cilento, Bartley G. [Boston Children' s Hospital, Department of Urology, Boston, MA (United States); Baum, Michelle A. [Boston Children' s Hospital, Department of Nephrology, Boston, MA (United States)

    2017-01-15

    Pediatric urolithiasis is an important and increasingly prevalent cause of pediatric morbidity and hospital admission. Ultrasound (US) is the recommended primary imaging modality for suspected urolithiasis in children. There is, however, widespread use of CT as a first-line study for abdominal pain in many institutions involved in pediatric care. The objective of this review is to outline state-of-the-art imaging modalities and methods for diagnosing urolithiasis in children. The pediatric radiologist plays a key role in ensuring that the appropriate imaging modality is performed in the setting of suspected pediatric urolithiasis. Our proposed imaging algorithm starts with US, and describes the optimal technique and indications for the use of CT. We emphasize the importance of improved communication with a greater collaborative approach between pediatric and general radiology departments so children undergo the appropriate imaging evaluation. (orig.)

  18. Imaging in the diagnosis of pediatric urolithiasis

    International Nuclear Information System (INIS)

    Colleran, Gabrielle C.; Callahan, Michael J.; Paltiel, Harriet J.; Chow, Jeanne S.; Nelson, Caleb P.; Cilento, Bartley G.; Baum, Michelle A.

    2017-01-01

    Pediatric urolithiasis is an important and increasingly prevalent cause of pediatric morbidity and hospital admission. Ultrasound (US) is the recommended primary imaging modality for suspected urolithiasis in children. There is, however, widespread use of CT as a first-line study for abdominal pain in many institutions involved in pediatric care. The objective of this review is to outline state-of-the-art imaging modalities and methods for diagnosing urolithiasis in children. The pediatric radiologist plays a key role in ensuring that the appropriate imaging modality is performed in the setting of suspected pediatric urolithiasis. Our proposed imaging algorithm starts with US, and describes the optimal technique and indications for the use of CT. We emphasize the importance of improved communication with a greater collaborative approach between pediatric and general radiology departments so children undergo the appropriate imaging evaluation. (orig.)

  19. Pediatric acquired brain injury.

    Science.gov (United States)

    Bodack, Marie I

    2010-10-01

    Although pediatric patients are sometimes included in studies about visual problems in patients with acquired brain injury (ABI), few studies deal solely with children. Unlike studies dealing with adult patients, in which mechanisms of brain injury are divided into cerebral vascular accident (CVA) and traumatic brain injury (TBI), studies on pediatric patients deal almost exclusively with traumatic brain injury, specifically caused by accidents. Here we report on the vision problems of 4 pediatric patients, ages 3 to 18 years, who were examined in the ophthalmology/optometry clinic at a children's hospital. All patients had an internally caused brain injury and after the initial insult manifested problems in at least one of the following areas: acuity, binocularity, motility (tracking or saccades), accommodation, visual fields, and visual perceptual skills. Pediatric patients can suffer from a variety of oculo-visual problems after the onset of head injury. These patients may or may not be symptomatic and can benefit from optometric intervention. Copyright © 2010 American Optometric Association. Published by Elsevier Inc. All rights reserved.

  20. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... MRI) exam. View full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes child-specific content. Related Articles and Media Catheter Angiography Magnetic Resonance, ...

  1. Sleeping beauties in pediatrics.

    Science.gov (United States)

    Završnik, Jernej; Kokol, Peter

    2016-10-01

    Sleeping beauties (SBs) in science have been known for few decades; however, it seems that only recently have they become popular. An SB is a publication that "sleeps" for a long time and then almost suddenly awakes and becomes highly cited. SBs present interesting findings in science. Pediatrics research literature has not yet been analyzed for their presence, and 5 pediatrics SBs were discovered in this research. Their prevalence was approximately 0.011%. Some environments or periods are more "SB fertile" than others: 3 of 5 SBs were published in the journal Pediatrics, 4 originated from the United States, and 4 were published in the period from 1992 to 1993. No institutions or authors published more than 1 SB.

  2. The Globalization of Pediatric Research: An Analysis of Clinical Trials Completed for Pediatric Exclusivity

    Science.gov (United States)

    Pasquali, Sara K.; Burstein, Danielle S.; Benjamin, Daniel K.; Smith, P. Brian; Li, Jennifer S.

    2010-01-01

    Background Recent studies have examined the globalization of clinical research. These studies focused on adult trials, and the globalization of pediatric research has not been examined to date. We evaluated the setting of published studies conducted under the US Pediatric Exclusivity Program, which provides economic incentives to pharmaceutical companies to conduct drug studies in children. Methods Published studies containing the main results of trials conducted from 1998–2007 under the Pediatric Exclusivity Provision were included. Data were extracted from each study and described, including the therapeutic area of drug studied, number of patients enrolled, number of sites, and location where the study was conducted, if reported. Results Overall, 174 trials were included (sample size 8–27,065 patients); 9% did not report any information regarding the location or number of sites where the study was conducted. Of those that did report this information, 65% were conducted in at least one country outside the US, and 11% did not have any sites in the US. Fifty-four different countries were represented and 38% of trials enrolled patients in at least one site located in a developing/transition country, including more than one third of infectious disease, cardiovascular, and allergy/immunology trials. Conclusions The majority of published pediatric trials conducted under the Pediatric Exclusivity Provision included sites outside of the US, and over a third of trials enrolled patients in developing/transition countries. While there are many potential benefits to the globalization of pediatric research, this trend also raises certain scientific and ethical concerns which require further evaluation. PMID:20732941

  3. Brain tumors in children; Hirntumoren beim Kind

    Energy Technology Data Exchange (ETDEWEB)

    Harting, I.; Seitz, A. [Universitaetsklinikum Heidelberg (Germany). Abt. Neuroradiologie

    2009-06-15

    Brain tumors are common in children; in Germany approximately 400 children are diagnosed every year. In the posterior fossa, cerebellar neoplasms outnumber brainstem gliomas. In contrast to their rarity in adults, brainstem gliomas are not uncommon in children. Supratentorial tumors can be subdivided by location into neoplasms of the cerebral hemispheres, suprasellar and pineal tumors. Astrocytoma is the most common pediatric brain tumor followed by medulloblastoma, ependymoma and craniopharyngeoma. The combination of imaging morphology, tumor localisation and patient age at manifestation form the basis of the neuroradiological differential diagnosis. (orig.)

  4. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... the exam. MRI scanners are air-conditioned and well-lit. Music may be played through the headphones ... full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy ...

  5. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... a risk, depending on their nature and the strength of the MRI magnet. Many implanted devices will ... full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy ...

  6. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... need to be returned to the transducer for analysis. top of page This page was reviewed on ... using ultrasound. View full size with caption Pediatric Content Some imaging tests and treatments have special pediatric ...

  7. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... in CT scans should have no immediate side effects. Risks The risk of serious allergic reaction to ... Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes child-specific ...

  8. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) ... are the limitations of Children's CT? What is Children's CT? Computed tomography, more commonly known as a ...

  9. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... scans, your doctor may ask you to withhold food and drink for several hours before your child's ... full size with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy ...

  10. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... Imaging? Ultrasound waves are disrupted by air or gas; therefore ultrasound is not an ideal imaging technique ... with caption Pediatric Content Some imaging tests and treatments have special pediatric considerations. The teddy bear denotes ...

  11. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... your child. top of page Additional Information and Resources The Alliance for Radiation Safety in Pediatric Imaging's " ... A child being prepared for a CT scan. View full size with caption Pediatric Content Some imaging ...

  12. TRANSFER FROM PEDIATRIC TO ADULT ENDOCRINOLOGY.

    Science.gov (United States)

    Jones, Marybeth R; Robbins, Brett W; Augustine, Marilyn; Doyle, Jackie; Mack-Fogg, Jean; Jones, Heather; White, Patience H

    2017-07-01

    Adult and pediatric endocrinologists share responsibility for the transition of youth with type 1 diabetes from pediatric to adult healthcare. This study aimed to increase successful transfers to adult care in subspecialty practices by establishing a systematic health care transition (HCT) process. Providers from the adult and pediatric endocrinology divisions at the University of Rochester Medical Center met monthly to customize and integrate the Six Core Elements (6CEs) of HCT into clinical workflows. Young adult patients with type 1 diabetes having an outpatient visit during a 34-month pre-post intervention period were eligible (N = 371). Retrospective chart review was performed on patients receiving referrals to adult endocrinology (n = 75) to obtain (1) the proportion of patients explicitly tracked during transfer from the pediatric to adult endocrinology practice, (2) the providers' documentation of the use of the 6CEs, and (3) the patients' diabetes control and healthcare utilization during the transition period. The percent of eligible patients with type 1 diabetes who were explicitly tracked in their transfer more than doubled compared to baseline (11% vs. 27% of eligible patients; P<.01). Pediatric providers started to use transition readiness assessments and create medical summaries, and adult providers increased closed-loop communication with pediatric providers after a patient's first adult visit. Glycemic control and healthcare utilization remained stable. Successful implementation of the 6CEs into pediatric and adult subspecialty practices can result in improvements of planned transfers of pediatric patients with type 1 diabetes to adult subspecialty providers. 6CEs = six core elements; AYA = adolescent and young adult; DKA = diabetic ketoacidosis; ED = emergency department; HbA1c = hemoglobin A1c; HCT = health care transition.

  13. Pediatric fractures – an educational needs assessment of Canadian pediatric emergency medicine residents

    Directory of Open Access Journals (Sweden)

    Dixon AC

    2015-06-01

    Full Text Available Andrew C Dixon Department of Pediatrics, University of Alberta, Edmonton, AB, Canada Objectives: To determine the gaps in knowledge of Canadian pediatric emergency medicine residents with regards to acute fracture identification and management. Due to their predominantly medical prior training, fractures may be an area of weakness requiring a specific curriculum to meet their needs. Methods: A questionnaire was developed examining comfort level and performance on knowledge based questions of trainees in the following areas: interpreting musculoskeletal X-rays; independently managing pediatric fractures, physical examination techniques, applied knowledge of fracture management, and normal development of the bony anatomy. Using modified Dillman technique the instrument was distributed to pediatric emergency medicine residents at seven Canadian sites. Results: Out of 43 potential respondents, 22 (51% responded. Of respondents, mean comfort with X-ray interpretation was 69 (62–76 95% confidence interval [CI] while mean comfort with fracture management was only 53 (45–63 95% CI; mean comfort with physical exam of shoulder 60 (53–68 95% CI and knee 69 (62–76 95% CI was low. Less than half of respondents (47%; 95% CI 26%–69% could accurately identify normal wrist development, correctly manage a supracondylar fracture (39%; 95% CI 20%–61%, or identify a medial epicondyle fracture (44%; 95% CI 24%–66%. Comfort with neurovascular status of the upper (mean 82; 95% CI 75–89 and lower limb (mean 81; 95% CI 74–87 was high. Interpretation: There are significant gaps in knowledge of physical exam techniques, fracture identification and management among pediatric emergency medicine trainees. A change in our current teaching methods is required to meet this need. Keywords: pediatric, fractures, education, radiologic interpretation

  14. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen Children’s (pediatric) ultrasound imaging of ... 30 minutes. top of page What will my child experience during and after the procedure? Ultrasound examinations ...

  15. Society of Pediatric Psychology Workforce Survey: Factors Related to Compensation of Pediatric Psychologists.

    Science.gov (United States)

    Brosig, Cheryl L; Hilliard, Marisa E; Williams, Andre; Armstrong, F Daniel; Christidis, Peggy; Kichler, Jessica; Pendley, Jennifer Shroff; Stamm, Karen E; Wysocki, Tim

    2017-05-01

    To summarize compensation results from the 2015 Society of Pediatric Psychology (SPP) Workforce Survey and identify factors related to compensation of pediatric psychologists. All full members of SPP ( n  = 1,314) received the online Workforce Survey; 404 (32%) were returned with usable data. The survey assessed salary, benefits, and other income sources. The relationship between demographic and employment-related factors and overall compensation was explored.   Academic rank, level of administrative responsibility, and cost of living index of employment location were associated with compensation. Compensation did not vary by gender; however, women were disproportionately represented at the assistant and associate professor level. Compensation of pediatric psychologists is related to multiple factors. Longitudinal administration of the Workforce Survey is needed to determine changes in compensation and career advancement for this profession over time. Strategies to increase the response rate of future Workforce Surveys are discussed. © The Author 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  16. Childhood obesity for pediatric gastroenterologists.

    Science.gov (United States)

    Huang, Jeannie S; Barlow, Sarah E; Quiros-Tejeira, Ruben E; Scheimann, Ann; Skelton, Joseph; Suskind, David; Tsai, Patrika; Uko, Victor; Warolin, Joshua P; Xanthakos, Stavra A

    2013-01-01

    Obesity in childhood is one of the major health issues in pediatric health care today. As expected, the prevalence of obesity-related comorbidities has risen in parallel with that of obesity. Consultation regarding these concomitant diseases and subsequent management by subspecialists, including pediatric gastroenterologists, is now common and has resulted in obesity being recognized as a chronic disease requiring coordination of care. Although medications and even surgery may provide effective, though often temporary, treatments for obesity and its comorbidities, behavioral interventions addressing healthy dietary and physical activity habits remain a mainstay in the obesity treatment paradigm. Therefore, the issue of weight management must be addressed by both general practitioner and subspecialist alike. In this report, we review select aspects of pediatric obesity and obesity-related management issues because it relates in particular to the field of pediatric gastroenterology and hepatology.

  17. Cardiomyopathy in the pediatric patients

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2018-04-01

    Full Text Available Pediatric cardiomyopathies are a group of myocardial diseases with complex taxonomies. Cardiomyopathy can occur in children at any age, and it is a common cause of heart failure and heart transplantation in children. The incidence of pediatric cardiomyopathy is increasing with time. They may be associated with variable comorbidities, which are most often arrhythmia, heart failure, and sudden death. Medical imaging technologies, including echocardiography, cardiac magnetic resonance, and nuclear cardiology, are helpful in reaching a diagnosis of cardiomyopathy. Nevertheless, endomyocardial biopsy is the final diagnostic method of diagnosis. Patients warrant surgical operations, such as palliative operations, bridging operations, ventricular septal maneuvers, and heart transplantation, if pharmaceutical therapies are ineffective. Individual therapeutic regimens due to pediatric characteristics, genetic factors, and pathogenesis may improve the effects of treatment and patients' survival. Key Words: cardiomyopathy, classification, pediatrics

  18. Pediatrics

    NARCIS (Netherlands)

    Rasheed, Shabana; Teo, Harvey James Eu Leong; Littooij, Annemieke Simone

    2015-01-01

    Imaging of pediatric patients involves many diverse modalities, including radiography, ultrasound imaging, computed tomography, magnetic resonance imaging, and scintigraphic and angiographic studies. It is therefore important to be aware of potential pitfalls that may be related to these modalities

  19. Inventory of pediatric neurology "manpower" in Canada.

    Science.gov (United States)

    Keene, Daniel L; Humphreys, Peter

    2005-08-01

    To review the demographics and workload characteristics of pediatric neurology in Canada. A standardized survey questionnaire was mailed out to practicing pediatric neurologists in Canada in 2001. Variables examined were age, gender, hours on call, regular hours worked per week, type of practice and projected changes in practice over next five to ten years. Results were compared to the 1994 Pediatric Neurology Manpower Survey which had used the same survey instrument. Fifty-six (70%) pediatric neurologists practicing in Canada returned the survey. As was the case in 1994, no significant differences in workload were found based on age or gender. The average age of the practicing pediatric neurologist in 2001 was 51 years compared to 45 years in 1994. The proportion of physicians over 55 years in 2001 was 35% compared to 25% in 1994. Pediatric neurology in Canada is an aging specialty needing a significant recruitment of new members

  20. MRI imaging in pediatric appendicitis

    Directory of Open Access Journals (Sweden)

    Robin Riley

    2018-04-01

    Full Text Available An 8-year-old male presents with two days of abdominal pain and emesis. Computed tomography was concerning for obstruction or reactive ileus with an apparent transition point in the right lower quadrant, possibly due to Crohn's. Magnetic resonance imaging was concerning for perforated appendicitis. As demonstrated by this case MRI can be as sensitive as CT in detecting pediatric appendicitis [2]. We recommend using MRI instead of CT to diagnose appendicitis to avoid ionizing radiation and increased cancer risk in the pediatric population. Keywords: Computer tomography, Magnetic resonance imaging, Pediatric appendicitis

  1. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... Site Index A-Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is a fast, painless exam that uses ... of Children's CT? What is Children's CT? Computed tomography, more commonly known as a CT or CAT ...

  2. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... Z Children's (Pediatric) CT (Computed Tomography) Pediatric computed tomography (CT) is a fast, painless exam that uses special ... the limitations of Children's CT? What is Children's CT? Computed tomography, more commonly known as a CT or CAT ...

  3. Pediatric acute respiratory distress syndrome: definition, incidence, and epidemiology: proceedings from the Pediatric Acute Lung Injury Consensus Conference.

    Science.gov (United States)

    Khemani, Robinder G; Smith, Lincoln S; Zimmerman, Jerry J; Erickson, Simon

    2015-06-01

    Although there are similarities in the pathophysiology of acute respiratory distress syndrome in adults and children, pediatric-specific practice patterns, comorbidities, and differences in outcome necessitate a pediatric-specific definition. We sought to create such a definition. A subgroup of pediatric acute respiratory distress syndrome investigators who drafted a pediatric-specific definition of acute respiratory distress syndrome based on consensus opinion and supported by detailed literature review tested elements of the definition with patient data from previously published investigations. International PICUs. Children enrolled in published investigations of pediatric acute respiratory distress syndrome. None. Several aspects of the proposed pediatric acute respiratory distress syndrome definition align with the Berlin Definition of acute respiratory distress syndrome in adults: timing of acute respiratory distress syndrome after a known risk factor, the potential for acute respiratory distress syndrome to coexist with left ventricular dysfunction, and the importance of identifying a group of patients at risk to develop acute respiratory distress syndrome. There are insufficient data to support any specific age for "adult" acute respiratory distress syndrome compared with "pediatric" acute respiratory distress syndrome. However, children with perinatal-related respiratory failure should be excluded from the definition of pediatric acute respiratory distress syndrome. Larger departures from the Berlin Definition surround 1) simplification of chest imaging criteria to eliminate bilateral infiltrates; 2) use of pulse oximetry-based criteria when PaO2 is unavailable; 3) inclusion of oxygenation index and oxygen saturation index instead of PaO2/FIO2 ratio with a minimum positive end-expiratory pressure level for invasively ventilated patients; 4) and specific inclusion of children with preexisting chronic lung disease or cyanotic congenital heart disease. This

  4. Pediatric nuclear medicine

    International Nuclear Information System (INIS)

    1986-01-01

    This symposium presented the latest techniques and approaches to the proper medical application of radionuclides in pediatrics. An expert faculty, comprised of specialists in the field of pediatric nuclear medicine, discussed the major indications as well as the advantages and potential hazards of nuclear medicine procedures compared to other diagnostic modalities. In recent years, newer radiopharmaceuticals labeled with technetium-99m and other short-lived radionuclides with relatively favorable radiation characteristics have permitted a variety of diagnostic studies that are very useful clinically and carry a substantially lower radiation burden then many comparable X-ray studies. This new battery of nuclear medicine procedures is now widely available for diagnosis and management of pediatric patients. Many recent research studies in children have yielded data concerning the effacacy of these procedures, and current recommendations will be presented by those involved in conducting such studies. Individual papers are processed separately for the Energy Data Base

  5. Pediatric nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    1986-01-01

    This symposium presented the latest techniques and approaches to the proper medical application of radionuclides in pediatrics. An expert faculty, comprised of specialists in the field of pediatric nuclear medicine, discussed the major indications as well as the advantages and potential hazards of nuclear medicine procedures compared to other diagnostic modalities. In recent years, newer radiopharmaceuticals labeled with technetium-99m and other short-lived radionuclides with relatively favorable radiation characteristics have permitted a variety of diagnostic studies that are very useful clinically and carry a substantially lower radiation burden then many comparable X-ray studies. This new battery of nuclear medicine procedures is now widely available for diagnosis and management of pediatric patients. Many recent research studies in children have yielded data concerning the effacacy of these procedures, and current recommendations will be presented by those involved in conducting such studies. Individual papers are processed separately for the Energy Data Base.

  6. Pediatric magnetic resonance imaging

    International Nuclear Information System (INIS)

    Cohen, M.D.

    1986-01-01

    This book defines the current clinical potential of magnetic resonance imaging and focuses on direct clinical work with pediatric patients. A section dealing with the physics of magnetic resonance imaging provides an introduction to enable clinicians to utilize the machine and interpret the images. Magnetic resonance imaging is presented as an appropriate imaging modality for pediatric patients utilizing no radiation

  7. Epidemiological Pattern and Management of Pediatric Asthma ...

    African Journals Online (AJOL)

    EL-HAKIM

    Egypt J Pediatr Allergy Immunol 2008; 6(2): 51-56. 51. Epidemiological Pattern and Management of Pediatric Asthma. Review of Ain Shams Pediatric Hospital Chest Clinic Data. Cairo, Egypt 1995-2004. INTRODUCTION. Bronchial asthma is a major worldwide health problem, which has received increased attention in.

  8. Defining Service and Education in Pediatrics.

    Science.gov (United States)

    Boyer, Debra; Gagne, Josh; Kesselheim, Jennifer C

    2017-11-01

    Program directors (PDs) and trainees are often queried regarding the balance of service and education during pediatric residency training. We aimed to use qualitative methods to learn how pediatric residents and PDs define service and education and to identify activities that exemplify these concepts. Focus groups of pediatric residents and PDs were performed and the data qualitatively analyzed. Thematic analysis revealed 4 themes from focus group data: (1) misalignment of the perceived definition of service; (2) agreement about the definition of education; (3) overlapping perceptions of the value of service to training; and (4) additional suggestions for improved integration of education and service. Pediatric residents hold positive definitions of service and believe that service adds value to their education. Importantly, the discovery of heterogeneous definitions of service between pediatric residents and PDs warrants further investigation and may have ramifications for Accreditation Council for Graduate Medical Education and those responsible for residency curricula.

  9. Management of Pediatric Migraine: Current Therapies.

    Science.gov (United States)

    Khrizman, Marina; Pakalnis, Ann

    2018-02-01

    Migraine is one of the most common neurologic conditions in pediatrics. It can be a significant stressor, causing absences from school and interruption of parents' work and family schedules. The mainstay of treatment remains educating patients about healthy lifestyle practices and the influences of sleep, stressors, and hydration on triggering migraine attacks. Psychological therapies such as biofeedback or cognitive-behavioral therapy may be beneficial in some patients, especially those with prominent psychological comorbidities. New advances in the pathophysiology of migraine and additional pediatric approval of abortive therapy with triptans have led to significant advances in the management of migraine in children. Some challenges to preventive therapy were recently noted with the negative results obtained in the Childhood and Adolescent Migraine Prevention Study, which compared prescription drugs to placebo. Inherent differences between adult and pediatric headaches, with shorter duration of pediatric migraine and prominent placebo effect, present recurring challenges for clinicians. [Pediatr Ann. 2018;47(2):e55-e60.]. Copyright 2018, SLACK Incorporated.

  10. Pediatric Hospitalist Comanagement Survey of Clinical and Billing Practices.

    Science.gov (United States)

    O'Connor, Katherine M; Zipes, David G; Schaffzin, Joshua K; Rosenberg, Rebecca

    2017-10-01

    Surgical comanagement is an increasingly common practice in pediatric hospital medicine. Information about the structure and financing of such care is limited. The aim of the researchers for this study was to investigate pediatric hospitalist surgical comanagement models and to assess pediatric hospitalist familiarity with and patterns of billing for surgical patients. We conducted a cross-sectional cohort web-based survey of pediatric hospitalists using the American Academy of Pediatrics' Section on Hospital Medicine listserv. In our study ( N = 133), we found wide variation in our cohort in surgical patient practice management, including program structure, individual billing practices, and knowledge regarding billing practices. Even for pediatric hospitalists with comanagement service agreements between surgeons and pediatric hospitalists, there was no increased awareness or knowledge about reimbursement or billing for surgical patients. This global lack of knowledge in our small but diverse sample suggests that billing resources and training for pediatric hospitalists practicing comanagement of surgical patients are needed. Copyright © 2017 by the American Academy of Pediatrics.

  11. Pediatric uveitis: new and future treatments

    Science.gov (United States)

    Mehta, Preema J.; Alexander, Janet L.; Sen, H. Nida

    2017-01-01

    Purpose of review Pediatric uveitis is relatively uncommon, accounting for only 5–10% of all patients with uveitis. However, owing to high prevalence of complications and devastating outcomes, its lifetime burden can be significant. Recent findings Immunomodulatory therapy has been associated with better outcomes in noninfectious pediatric uveitis. However, effective treatments are limited by medication-related complications, including multiorgan toxicities and systemic side effects. Summary We review the current therapies available to treat pediatric uveitis, discuss novel and future therapies, and provide clinical recommendations utilizing these new agents. The consideration for treatment regimens in noninfectious pediatric uveitis is multifactorial. Understanding past, present, and future technology will aid in treatment of a complex and refractory disease. PMID:23872814

  12. In vivo diagnostic nuclear medicine. Pediatric experience

    International Nuclear Information System (INIS)

    Goetz, W.A.; Hendee, W.R.; Gilday, D.L.

    1983-01-01

    The use of radiopharmaceuticals for diagnostic tests in children is increasing and interest in these is evidenced by the addition of scientific sessions devoted to pediatric medicine at annual meetings of The Society of Nuclear Medicine and by the increase in the literature on pediatric dosimetry. Data presented in this paper describe the actual pediatric nuclear medicine experience from 26 nationally representative U.S. hospitals and provide an overview of the pediatric procedures being performed the types of radiopharmaceuticals being used, and the activity levels being administered

  13. Management of Pediatric Delirium in Pediatric Cardiac Intensive Care Patients: An International Survey of Current Practices.

    Science.gov (United States)

    Staveski, Sandra L; Pickler, Rita H; Lin, Li; Shaw, Richard J; Meinzen-Derr, Jareen; Redington, Andrew; Curley, Martha A Q

    2018-06-01

    The purpose of this study was to describe how pediatric cardiac intensive care clinicians assess and manage delirium in patients following cardiac surgery. Descriptive self-report survey. A web-based survey of pediatric cardiac intensive care clinicians who are members of the Pediatric Cardiac Intensive Care Society. Pediatric cardiac intensive care clinicians (physicians and nurses). None. One-hundred seventy-three clinicians practicing in 71 different institutions located in 13 countries completed the survey. Respondents described their clinical impression of the occurrence of delirium to be approximately 25%. Most respondents (75%) reported that their ICU does not routinely screen for delirium. Over half of the respondents (61%) have never attended a lecture on delirium. The majority of respondents (86%) were not satisfied with current delirium screening, diagnosis, and management practices. Promotion of day/night cycle, exposure to natural light, deintensification of care, sleep hygiene, and reorientation to prevent or manage delirium were among nonpharmacologic interventions reported along with the use of anxiolytic, antipsychotic, and medications for insomnia. Clinicians responding to the survey reported a range of delirium assessment and management practices in postoperative pediatric cardiac surgery patients. Study results highlight the need for improvement in delirium education for pediatric cardiac intensive care clinicians as well as the need for systematic evaluation of current delirium assessment and management practices.

  14. Pediatric health, medicine, and therapeutics

    Directory of Open Access Journals (Sweden)

    Claire E Wainwright

    2011-03-01

    Full Text Available Claire E Wainwright1,21Royal Children’s Hospital, Brisbane and Queensland, Queensland, Australia; 2Queensland Children’s Medical Research Institute, The University of Queensland, Brisbane, AustraliaThe idea of children as small adults with health care needs that can be managed by extrapolation from adult studies has now largely been abandoned. We now recognize that adult health and disease are closely linked to childhood factors and the critical and ethical importance of clinical research in pediatrics is increasingly being recognized.  While funding and output from pediatric clinical research continues to lag behind health research in adults, particularly in the area of therapeutics, the last decade has thankfully seen a dramatic increase in the number of pediatric studies and particularly randomized controlled clinical trials (RCTs. Since the 1997 Food and Drug Administration (FDA Modernization Act in the United States (US and the subsequent changes in drug registration regulatory systems in the US and Europe, there has been a huge increase in the number of pediatric studies sponsored by pharmaceutical companies. In the United Kingdom, the Medicine for Children’s Research Network was established in 2005 to address the lack of clinical studies in pediatrics. Over the first five years they reported an exciting increase in the number of high quality clinical studies and on their website they have a current portfolio of over 200 pediatric studies, half of which are RCTs and half are sponsored by pharmaceutical companies. Other countries particularly across Europe are also establishing similar programs. 

  15. Pediatric neuropsychology: toward subspecialty designation.

    Science.gov (United States)

    Baron, Ida Sue; Wills, Karen; Rey-Casserly, Celiane; Armstrong, Kira; Westerveld, Michael

    2011-08-01

    Clinical neuropsychology is a rapidly expanding field of study in the psychological sciences whose practitioners are expert in the assessment, treatment, and research of individuals with known or suspected central nervous system disease or disorder. Pediatric neuropsychology has emerged as a distinct subspecialty area with related education, training, and clinical expertise for a growing number of neuropsychologists. This paper details the numerous steps taken by two affiliated organizations, the American Board of Clinical Neuropsychology and its membership organization, the American Academy of Clinical Neuropsychology, in the interest of the larger pediatric neuropsychology community and in pediatric neuropsychology subspecialty development.

  16. Environmental pediatrics: an emerging issue.

    Science.gov (United States)

    Valenzuela, Patricia M; Matus, M Soledad; Araya, Gabriela I; Paris, Enrique

    2011-01-01

    To review the most relevant articles regarding environmental pediatrics, its potential effects on health, and especially its advances in prevention. A literature search was conducted using MEDLINE/PubMed and SciELO databases. Articles from 1990 to 2010 were reviewed, in addition to book chapters related to environmental pediatrics. There is a significant variety of factors that make children highly vulnerable to environmental hazard exposure, which are mainly associated with children's comparatively greater consumption of water, food, and air in relation to body weight. According to the World Health Organization, every year more than 3 million children under the age of 5 die because of environment-related conditions. Approximately 30 to 40% of pediatric diseases are related to environmental factors. Children are constantly exposed to various environmental health hazards, among which the following stand out: contaminated water, lack of adequate sanitation facilities, air pollution, disease vectors, chemical hazards, injuries, and accidents. Nowadays, pediatricians are challenged to address environmental pediatrics health care needs. The pediatric health history needs to be more comprehensive by adding pointed questions to help identify potential environmental risks. Awareness and understanding of the noxious effects of various environmental conditions and knowledge of the related prevention measures will result in timely and adequate interventions that will improve our children's health and development.

  17. American Society of Pediatric Hematology/Oncology

    Science.gov (United States)

    ... Learn More Explore career opportunities in pediatric hematology/oncology Visit the ASPHO Career Center. Learn More Join ... Privacy Policy » © The American Society of Pediatric Hematology/Oncology

  18. Pediatric thermal injury: acute care and reconstruction update.

    Science.gov (United States)

    Armour, Alexis D; Billmire, David A

    2009-07-01

    The acute and reconstructive care of each pediatric burn patient presents unique challenges to the plastic surgeon and the burn care team. : The purpose of this review article is to highlight the interdependence between the acute and reconstructive needs of pediatric burn patients as it pertains to each anatomical site. Relevant principles of acute pediatric burn care and burn reconstruction are outlined, based on the authors' experience and review of the literature. The need for late reconstruction in pediatric burn survivors is significantly influenced by the acute surgical and rehabilitative treatments. With their vulnerability to airway swelling, hypothermia, pulmonary edema, and ischemia-reperfusion injury, pediatric patients with large burns require precise, life-saving treatment in the acute phase. Decision-making in pediatric burn reconstruction must take into account the patient's future growth, maturity, and often lack of suitable donor sites. Appropriately selected reconstructive techniques are essential to optimize function, appearance, and quality of life in pediatric burn survivors.

  19. Pediatric dental sedation: challenges and opportunities

    OpenAIRE

    Nelson, Travis; Xu,Zheng

    2015-01-01

    Travis M Nelson, Zheng Xu Department of Pediatric Dentistry, University of Washington, Seattle, WA, USA Abstract: High levels of dental caries, challenging child behavior, and parent expectations support a need for sedation in pediatric dentistry. This paper reviews modern developments in pediatric sedation with a focus on implementing techniques to enhance success and patient safety. In recent years, sedation for dental procedures has been implicated in a disproportionate number of cases th...

  20. Pediatric Gastroenterology in Cuba: Evolution and Challenges.

    Science.gov (United States)

    Castañeda-Guillot, Carlos

    2016-10-01

    INTRODUCTION The professional practice of pediatric gastroenterology arose in Cuba as an expression of the specialty's development internationally and Cuba's new strategies in public health, and in response to national needs for health care expertise in digestive diseases of infants, older children and adolescents. OBJECTIVES Describe the history of pediatric gastroenterology's development in Cuba since its inception at the National Gastroenterology Institute in the early 1970s, its contributions, and efforts to extend it to pediatric hospitals throughout Cuba. EVIDENCE ACQUISITION This is a historical review based on document analysis. Institutional sources from the National Gastroenterology Institute and Ministry of Public Health were reviewed, as well as international and national literature on the history of pediatric gastroenterology and unpublished texts since its emergence in 1972. DEVELOPMENT Although pediatric gastroenterology has not been formally recognized as a medical specialty in Cuba, there have been important achievements in establishing a network of specialized health care services for digestive diseases of children and adolescents. Gastrointestinal endoscopy and other auxiliary diagnostic modalities have been introduced for children and play a major role in clinical trials and research. This article describes the international context that promoted the specialty's development in Cuba. Reference is made to specialized training from its initial stages in 1972, its consolidation as an emerging discipline in Cuban medicine, and its diffusion in Latin American and Caribbean countries. Professional development and specialized training to meet health human resource needs in pediatric hospitals are described, as well as Cuban participation in the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition. National and international milestones, publications, awards and recognitions that indicate advances despite difficulties are also

  1. Pediatric allergy and immunology in Israel.

    Science.gov (United States)

    Geller-Bernstein, Carmi; Etzioni, Amos

    2013-03-01

    After the geographic and sociodemographic settings as well as the health care in Israel are briefly described, the scope of pediatric allergy and immunology in Israel is presented. This includes specific disorders commonly encountered, the environment that induces symptoms, the specialists who treat them, and the common challenges of patients, parents, doctors, and allied health personnel who collaborate to manage the maladies and patient care. Allergies usually affect some overall 15-20% of the pediatric population. The main allergens are inhaled, ingested, or injected (insects stings). Generally, the incidence of the various allergens affecting children in Israel, is similar to other parts of the Western world. Owing to the high consanguinity rate in the Israeli population, the prevalence of the various immunodeficiency conditions (in the adaptive as well as the innate system) is higher than that reported worldwide. Pediatric allergists/immunologists also treat autoimmune disorders affecting the pediatric group. Pediatric allergy and clinical immunology are not separate specialties. The 25 specialists who treat children with allergic/immunologic diseases have undergone a basic training in Pediatrics. They also received an additional 2-yr training in allergy and clinical immunology and then have to pass the board examinations. They work mainly in pediatric allergy units, in several hospitals that are affiliated to the five medical schools in the country. Aside from clinical work, most of the centers are also heavily involved in clinical and basic research in allergy and immunology. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

  2. The Ethics of Vaccination Nudges in Pediatric Practice.

    Science.gov (United States)

    Navin, Mark C

    2017-03-01

    Techniques from behavioral economics-nudges-may help physicians increase pediatric vaccine compliance, but critics have objected that nudges can undermine autonomy. Since autonomy is a centrally important value in healthcare decision-making contexts, it counts against pediatric vaccination nudges if they undermine parental autonomy. Advocates for healthcare nudges have resisted the charge that nudges undermine autonomy, and the recent bioethics literature illustrates the current intractability of this debate. This article rejects a principle to which parties on both sides of this debate sometimes seem committed: that nudges are morally permissible only if they are consistent with autonomy. Instead, I argue that, at least in the case of pediatric vaccination, some autonomy-undermining nudges may be morally justified. This is because parental autonomy in pediatric decision-making is not as morally valuable as the autonomy of adult patients, and because the interests of both the vaccinated child and other members of the community can sometimes be weighty enough to justify autonomy-infringing pediatric vaccination nudges. This article concludes with a set of worries about the effect of pediatric vaccination nudges on parent-physician relationships, and it calls on the American Academy of Pediatrics to draw on scientific and bioethics research to develop guidelines for the use of nudges in pediatric practice and, in particular, for the use of pediatric vaccination nudges.

  3. New Horizons in Pediatric Psychopharmacology.

    Science.gov (United States)

    Khan, Sarah; Rathore, Vijaylaxmi; Khan, Shahida

    2016-12-01

    Preclinical Research Recent advances in pediatric psychopharmacology have been rather uneven. Increased use of psychotropic drugs among the pediatric population has raised concerns regarding their inappropriate use and safety. While clinical trials have been conducted on various pediatric psychopharmacological drugs, there has been an insignificant amount of importance to innovation in holistic treatment. A rational approach toward elucidating the various challenges would be contingent on the convergence of the development of novel efficacious psychotropic drugs with concrete conceptual frameworks and guidelines fostering enhanced outcomes. A research infrastructure concerning the relevance of the clinician's perspective, combining drugs with alternative therapies, the need for pediatric specific formulations and relevance of these in developing countries provides a basis on which innovative treatment/development can be constructed. The current commentary highlights these comprehensive and targeted treatment guidelines as aspects necessary for building the future of the field. Drug Dev Res 77 : 474-478, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  4. Pediatric Obesity and Ear, Nose, and Throat Disorders

    Science.gov (United States)

    ... Marketplace Find an ENT Doctor Near You Pediatric Obesity and Ear, Nose, and Throat Disorders Pediatric Obesity ... self-esteem, and isolation from their peers. Pediatric obesity and otolaryngic problems Otolaryngologists, or ear, nose, and ...

  5. Pediatric Obesity and Ear, Nose, and Throat Disorders

    Science.gov (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Pediatric Obesity and Ear, Nose, and Throat Disorders Pediatric ... of self-esteem, and isolation from their peers. Pediatric obesity and otolaryngic problems Otolaryngologists, or ear, nose, ...

  6. How do pediatric anesthesiologists define intraoperative hypotension?

    Science.gov (United States)

    Nafiu, Olubukola O; Voepel-Lewis, Terri; Morris, Michelle; Chimbira, Wilson T; Malviya, Shobha; Reynolds, Paul I; Tremper, Kevin K

    2009-11-01

    Although blood pressure (BP) monitoring is a recommended standard of care by the ASA, and pediatric anesthesiologists routinely monitor the BP of their patients and when appropriate treat deviations from 'normal', there is no robust definition of hypotension in any of the pediatric anesthesia texts or journals. Consequently, what constitutes hypotension in pediatric anesthesia is currently unknown. We designed a questionnaire-based survey of pediatric anesthesiologists to determine the BP ranges and thresholds used to define intraoperative hypotension (IOH). Members of the Society of Pediatric Anesthesia (SPA) and the Association of Paediatric Anaesthetists (APA) of Great Britain and Ireland were contacted through e-mail to participate in this survey. We asked a few demographic questions and five questions about specific definitions of hypotension for different age groups of patients undergoing inguinal herniorraphy, a common pediatric surgical procedure. The overall response rate was 56% (483/860), of which 76% were SPA members. Majority of the respondents (72%) work in academic institutions, while 8.9% work in institutions with fewer than 1000 annual pediatric surgical caseload. About 76% of respondents indicated that a 20-30% reduction in baseline systolic blood pressure (SBP) indicates significant hypotension in children under anesthesia. Most responders (86.7%) indicated that they use mean arterial pressure or SBP (72%) to define IOH. The mean SBP values for hypotension quoted by SPA members was about 5-7% lower across all pediatric age groups compared to values quoted by APA members (P = 0.001 for all age groups). There is great variability in the BP parameters used and the threshold used for defining and treating IOH among pediatric anesthesiologists. The majority of respondents considered a 20-30% reduction from baseline in SBP as indicative of significant hypotension. Lack of a consensus definition for a common clinical condition like IOH could have

  7. History of pediatric cardiology in India

    OpenAIRE

    Anita Saxena

    2015-01-01

    In India, the discipline of cardiology started in the late 1950s and at that time pediatric cardiology was practiced as a part of cardiology specialty. This article traces the history of pediatric cardiology in India. Dr. S. Padmawati and Dr. Kamala Vytilingam underwent training in pediatric cardiology at international centers in the early 1950s and early 1960s. Dr. N. Gopinath successfully closed a ventricular septal defect using a pump oxygenator at Christian Medical College, Vellore. Open ...

  8. Recommended Curriculum for Training in Pediatric Transplant Infectious Diseases.

    Science.gov (United States)

    Danziger-Isakov, Lara; Allen, Upton; Englund, Janet; Herold, Betsy; Hoffman, Jill; Green, Michael; Gantt, Soren; Kumar, Deepali; Michaels, Marian G

    2015-03-01

    A working group representing the American Society of Transplantation, Pediatric Infectious Diseases Society, and International Pediatric Transplant Association has developed a collaborative effort to identify and develop core knowledge in pediatric transplant infectious diseases. Guidance for patient care environments for training and core competencies is included to help facilitate training directed at improving the experience for pediatric infectious diseases trainees and practitioners in the area of pediatric transplant infectious diseases. © The Author 2013. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  9. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... information about radiation dose. There always is a risk of complications from general anesthesia or sedation. Every measure will be taken to ... in X-Ray and CT Exams Contrast Materials Anesthesia Safety Children and Radiation Safety ... (Pediatric) CT (Computed Tomography) Videos related to Children's (Pediatric) ...

  10. Psychosocial Issues in Pediatric Oncology

    Science.gov (United States)

    Marcus, Joel

    2012-01-01

    Psychosocial oncology, a relatively new discipline, is a multidisciplinary application of the behavioral and social sciences, and pediatric psychosocial oncology is an emerging subspecialty within the domain of psychosocial oncology. This review presents a brief overview of some of the major clinical issues surrounding pediatric psychosocial oncology. PMID:23049457

  11. Automated Processing of Dynamic Contrast-Enhanced MRI: Correlation of Advanced Pharmacokinetic Metrics with Tumor Grade in Pediatric Brain Tumors.

    Science.gov (United States)

    Vajapeyam, S; Stamoulis, C; Ricci, K; Kieran, M; Poussaint, T Young

    2017-01-01

    Pharmacokinetic parameters from dynamic contrast-enhanced MR imaging have proved useful for differentiating brain tumor grades in adults. In this study, we retrospectively reviewed dynamic contrast-enhanced perfusion data from children with newly diagnosed brain tumors and analyzed the pharmacokinetic parameters correlating with tumor grade. Dynamic contrast-enhanced MR imaging data from 38 patients were analyzed by using commercially available software. Subjects were categorized into 2 groups based on pathologic analyses consisting of low-grade (World Health Organization I and II) and high-grade (World Health Organization III and IV) tumors. Pharmacokinetic parameters were compared between the 2 groups by using linear regression models. For parameters that were statistically distinct between the 2 groups, sensitivity and specificity were also estimated. Eighteen tumors were classified as low-grade, and 20, as high-grade. Transfer constant from the blood plasma into the extracellular extravascular space (K trans ), rate constant from extracellular extravascular space back into blood plasma (K ep ), and extracellular extravascular volume fraction (V e ) were all significantly correlated with tumor grade; high-grade tumors showed higher K trans , higher K ep , and lower V e . Although all 3 parameters had high specificity (range, 82%-100%), K ep had the highest specificity for both grades. Optimal sensitivity was achieved for V e , with a combined sensitivity of 76% (compared with 71% for K trans and K ep ). Pharmacokinetic parameters derived from dynamic contrast-enhanced MR imaging can effectively discriminate low- and high-grade pediatric brain tumors. © 2017 by American Journal of Neuroradiology.

  12. The efficacy of the direct clinical intervention for infectious diseases by a pediatric infectious disease specialist in the pediatric ward of a tertiary medical facility without a pediatric antimicrobial stewardship program.

    Science.gov (United States)

    Hoshina, T; Yamamoto, N; Ogawa, M; Nakamoto, T; Kusuhara, K

    2017-08-01

    Antimicrobial stewardship programs (ASPs) have been introduced in most hospital complexes; however, they are not always useful for pediatric patients. The aim of this study is to investigate the efficacy of direct clinical intervention for infectious diseases by a pediatric infectious disease specialist in a tertiary medical facility without pediatric ASP. This retrospective study included 1,821 patients who were hospitalized in the pediatric ward of a large metropolitan hospital from 2010 to 2015. The clinical course, the use of intravenous antimicrobial agents and the results of a microbiological analysis were compared between the period after the beginning of direct intervention by the specialist (post-intervention period) and the previous period (pre-intervention period). In the post-intervention period, the proportion of the patients who received intravenous antimicrobial agents, the number of antimicrobial agents used for each episode, and the proportion of episodes in which an antimicrobial agent was re-administrated were significantly lower (P = 0.006, P = 0.004, P = 0.036, respectively), and the duration of antimicrobial treatment was significantly shorter (P infectious diseases specialist is useful for the treatment of infectious diseases in the pediatric ward of a tertiary medical facility without a pediatric ASP. The creation of a pediatric ASP is recommended in hospital complexes.

  13. Pediatric Terminology

    Science.gov (United States)

    The National Institute of Child Health and Human Development (NICHD) works with NCI Enterprise Vocabulary Services (EVS) to provide standardized terminology for coding pediatric clinical trials and other research activities.

  14. TH-B-207B-00: Pediatric Image Quality Optimization

    International Nuclear Information System (INIS)

    2016-01-01

    This imaging educational program will focus on solutions to common pediatric image quality optimization challenges. The speakers will present collective knowledge on best practices in pediatric imaging from their experience at dedicated children’s hospitals. One of the most commonly encountered pediatric imaging requirements for the non-specialist hospital is pediatric CT in the emergency room setting. Thus, this educational program will begin with optimization of pediatric CT in the emergency department. Though pediatric cardiovascular MRI may be less common in the non-specialist hospitals, low pediatric volumes and unique cardiovascular anatomy make optimization of these techniques difficult. Therefore, our second speaker will review best practices in pediatric cardiovascular MRI based on experiences from a children’s hospital with a large volume of cardiac patients. Learning Objectives: To learn techniques for optimizing radiation dose and image quality for CT of children in the emergency room setting. To learn solutions for consistently high quality cardiovascular MRI of children

  15. TH-B-207B-00: Pediatric Image Quality Optimization

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-06-15

    This imaging educational program will focus on solutions to common pediatric image quality optimization challenges. The speakers will present collective knowledge on best practices in pediatric imaging from their experience at dedicated children’s hospitals. One of the most commonly encountered pediatric imaging requirements for the non-specialist hospital is pediatric CT in the emergency room setting. Thus, this educational program will begin with optimization of pediatric CT in the emergency department. Though pediatric cardiovascular MRI may be less common in the non-specialist hospitals, low pediatric volumes and unique cardiovascular anatomy make optimization of these techniques difficult. Therefore, our second speaker will review best practices in pediatric cardiovascular MRI based on experiences from a children’s hospital with a large volume of cardiac patients. Learning Objectives: To learn techniques for optimizing radiation dose and image quality for CT of children in the emergency room setting. To learn solutions for consistently high quality cardiovascular MRI of children.

  16. Improvement of Pediatric Drug Development: Regulatory and Practical Frameworks.

    Science.gov (United States)

    Tsukamoto, Katusra; Carroll, Kelly A; Onishi, Taku; Matsumaru, Naoki; Brasseur, Daniel; Nakamura, Hidefumi

    2016-03-01

    A dearth in pediatric drug development often leaves pediatricians with no alternative but to prescribe unlicensed or off-label drugs with a resultant increased risk of adverse events. We present the current status of pediatric drug development and, based on our data analysis, clarify the problems in this area. Further action is proposed to improve the drug development that has pediatric therapeutic orphan status. We analyzed all Phase II/III and Phase III trials in ClinicalTrials.gov that only included pediatric participants (Performance index, an indicator of pediatric drug development, was calculated by dividing the annual number of pediatric clinical trials by million pediatric populations acquired from Census.gov. Effects of the 2 Japanese premiums introduced in 2010, for the enhancement of pediatric drug development, were analyzed by comparing mean performance index prepremiums (2006-2009) and postpremiums (2010-2014) among Japan, the European Union, and the United States. The European Union Clinical Trials Register and published reports from the European Medicines Agency were also surveyed to investigate the Paediatric Committee effect on pediatric clinical trials in the European Union. Mean difference of the performance index in prepremiums and postpremiums between Japan and the European Union were 0.296 (P 15% after 2008. Recruitment and ethical obstacles make conducting pediatric clinical trials challenging. An improved operational framework for conducting clinical trials should mirror the ever-improving regulatory framework that incentivizes investment in pediatric clinical trials. Technological approaches, enhancements in electronic medical record systems, and community approaches that actively incorporate input from physicians, researchers, and patients could offer a sustainable solution to recruitment of pediatric study participants. The key therefore is to improve pediatric pharmacotherapy collaboration among industry, government, academia, and

  17. Understanding academic clinicians' intent to treat pediatric obesity.

    Science.gov (United States)

    Frankfurter, Claudia; Cunningham, Charles; Morrison, Katherine M; Rimas, Heather; Bailey, Karen

    2017-02-08

    To examine the extent to which the theory of planned behavior (TPB) predicts academic clinicians' intent to treat pediatric obesity. A multi-disciplinary panel iteratively devised a Likert scale survey based on the constructs of the TPB applied to a set of pediatric obesity themes. A cross-sectional electronic survey was then administered to academic clinicians at tertiary care centers across Canada from January to April 2012. Descriptive statistics were used to summarize demographic and item agreement data. A hierarchical linear regression analysis controlling for demographic variables was conducted to examine the extent to which the TPB subscales predicted intent to treat pediatric obesity. A total of 198 physicians, surgeons, and allied health professionals across Canada (British Columbia, Alberta, Manitoba, Saskatchewan, Nova Scotia, Ontario and Quebec) completed the survey. On step 1, demographic factors accounted for 7.4% of the variance in intent scores. Together in step 2, demographic variables and TPB subscales predicted 56.9% of the variance in a measure of the intent to treat pediatric obesity. Perceived behavioral control, that is, confidence in one's ability to manage pediatric obesity, and subjective norms, congruent with one's context of practice, were the most significant predictors of the intent to treat pediatric obesity. Attitudes and barriers did not predict the intent to treat pediatric obesity in this context. Enhancing self-confidence in the ability to treat pediatric obesity and the existence of supportive treatment environments are important to increase clinician's intent to treat pediatric obesity.

  18. Pediatric rheumatology: An under-recognized subspecialty in India

    Directory of Open Access Journals (Sweden)

    Akhila Kavirayani

    2017-01-01

    Full Text Available Pediatrics in India at the levels of both undergraduate and postgraduate training is often viewed upon as an acute disease specialty with little emphasis on chronic medical musculoskeletal diseases. Pediatric rheumatology is an under-recognized subspecialty of pediatrics which deals specifically with childhood arthritis, noninflammatory joint pains, connective tissue diseases, autoimmune diseases, vasculitis, and other rare inflammatory disorders. This article aims to give a bird's eye view of the repertoire of commonly encountered problems seen by a pediatric rheumatologist, via a classical case vignette for each topic followed by discussion. There is also mention of some rare diseases managed within pediatric rheumatology to give a flavor of the spectrum of diseases encountered. This is to raise awareness of the importance of pediatric rheumatology as a subspecialty within India and to prompt readers to seek specialist advice when encountering challenging cases. Pediatric rheumatologists network and work collaboratively with many other specialties such as ophthalmology, dermatology, neurology, orthopedics, nephrology, infectious diseases, immunology, and gastroenterology for combined care of diverse conditions. There is an unmet need in India to develop a training program for pediatric rheumatology so that shared care pathways with sensitized pediatricians and other specialists can be developed nationwide, to serve these children better to achieve optimal outcomes.

  19. Pediatric allergy and immunology in Italy.

    Science.gov (United States)

    Tozzi, Alberto E; Armenio, Lucio; Bernardini, Roberto; Boner, Attilio; Calvani, Mauro; Cardinale, Fabio; Cavagni, Giovanni; Dondi, Arianna; Duse, Marzia; Fiocchi, Alessandro; Marseglia, Gian L; del Giudice, Michele Miraglia; Muraro, Antonella; Pajno, Giovanni B; Paravati, Francesco; Peroni, Diego; Tripodi, Salvatore; Ugazio, Alberto G; Indinnimeo, Luciana

    2011-05-01

    In Italy, according to the International Study on Asthma and Allergies in Childhood study, the prevalence of current asthma, allergic rhinoconjunctivitis, and atopic eczema in 2006 was 7.9%, 6.5%, and 10.1% among children aged 6-7 and 8.4%, 15.5%, and 7.75% among children aged 13-14 yr. University education in this field is provided by the Postgraduate Schools of Pediatrics and those of Allergology and Clinical Immunology, as well as several annual Master courses. The Italian Society of Pediatric Allergology and Immunology (SIAIP) was founded in 1996 and counts about 1000 members. SIAIP promotes evidence-based management of allergic children and disseminates information to patients and their families through a quite innovative website and the National Journal 'Rivista Italiana di Allergologia Pediatrica'. In the last decade, four major regional, inter-regional, and national web-based networks have been created to link pediatric allergy centers and to share their clinical protocols and epidemiologic data. In addition, National Registers of Primary Immune-deficiencies and on Pediatric HIV link all clinical excellence centers. Research projects in the field of pediatric allergy and immunology are founded by the Italian Ministry of Education, University and Research (MIUR) and by the National Research Council (CNR), but the overall investments in this research area are quite low. Only a handful Italian excellence centers participate in European Projects on Pediatric Allergy and Immunology within the 7th Framework Program. The European Academy of Allergy and Clinical Immunology currently hosts two Italians in its Executive Committee (EC) and one in the EC of the Pediatric Section; moreover, major European Academy of Allergy and Clinical Immunology meetings and courses in the area of pediatrics (e.g., PAAM, Venice, 2009) have been held in Italy in the last 3 yr. Italian hallmarks in the management of allergic diseases in childhood are a quite alive and spread interest in

  20. A description of professional pediatric physical therapy education.

    Science.gov (United States)

    Schreiber, Joe; Goodgold, Shelley; Moerchen, Victoria A; Remec, Nushka; Aaron, Carolanne; Kreger, Alison

    2011-01-01

    The purpose of this work was to reexamine the status of professional pediatric physical therapy education in the United States. A task force designed a 16-item survey and contacted representatives from all professional physical therapy programs. Surveys were gathered from 151 programs for a return rate of 75%. Much variability exists across programs in total number of hours devoted to pediatrics (range, 35-210 hours). In addition, almost 60% of respondents indicated that the individual responsible for delivering the pediatric content will be retiring within the next 15 years. These results describe current pediatric professional education and provide numerous opportunities and challenges for the development of optimal professional pediatric education.

  1. Bridging Adult Experience to Pediatrics in Oncology Drug Development.

    Science.gov (United States)

    Leong, Ruby; Zhao, Hong; Reaman, Gregory; Liu, Qi; Wang, Yaning; Stewart, Clinton F; Burckart, Gilbert

    2017-10-01

    Pediatric drug development in the United States has grown under the current regulations made permanent by the Food and Drug Administration Safety and Innovation Act of 2012. Over 1200 pediatric studies have now been submitted to the US FDA, but there is still a high rate of failure to obtain pediatric labeling for the indication pursued. Pediatric oncology represents special problems in that the disease is most often dissimilar to any cancer found in the adult population. Therefore, the development of drug dosing in pediatric oncology patients represents a special challenge. Potential approaches to pediatric dosing in oncology patients include extrapolation of efficacy from adult studies in those few cases where the disease is similar, inclusion of adolescent patients in adult trials when possible, and bridging the adult dose to the pediatric dose. An analysis of the recommended phase 2 dose for 40 molecularly targeted agents in pediatric patients provides some insight into current practices. Increased knowledge of tumor biology and efforts to identify and validate molecular targets and genetic abnormalities that drive childhood cancers can lead to increased opportunities for precision medicine in the treatment of pediatric cancers. © 2017, The American College of Clinical Pharmacology.

  2. Pediatric GERD (Gastro-Esophageal Reflux Disease)

    Science.gov (United States)

    ... Marketplace Find an ENT Doctor Near You Pediatric GERD (Gastro-Esophageal Reflux Disease) Pediatric GERD (Gastro-Esophageal ... What symptoms are displayed by a child with GERD? While GER and EER in children often cause ...

  3. Researchers? perspectives on pediatric obesity research participant recruitment

    OpenAIRE

    Parikh, Yasha; Mason, Maryann; Williams, Karen

    2016-01-01

    Background Childhood obesity prevalence has tripled over the last three decades. Pediatric obesity has important implications for both adult health as well as the United States economy. In order to combat pediatric obesity, exploratory studies are necessary to create effective interventions. Recruitment is an essential part of any study, and it has been challenging for all studies, especially pediatric obesity studies. The objective of this study was to understand barriers to pediatric obesit...

  4. Practical techniques for pediatric computed tomography

    International Nuclear Information System (INIS)

    Fitz, C.R.; Harwood-Nash, D.C.; Kirks, D.R.; Kaufman, R.A.; Berger, P.E.; Kuhn, J.P.; Siegel, M.J.

    1983-01-01

    Dr. Donald Kirks has assembled this section on Practical Techniques for Pediatric Computed Tomography. The material is based on a presentation in the Special Interest session at the 25th Annual Meeting of the Society for Pediatric Radiology in New Orleans, Louisiana, USA in 1982. Meticulous attention to detail and technique is required to ensure an optimal CT examination. CT techniques specifically applicable to infants and children have not been disseminated in the radiology literature and in this respect it may rightly be observed that ''the child is not a small adult''. What follows is a ''cookbook'' prepared by seven participants and it is printed in Pediatric Radiology, in outline form, as a statement of individual preferences for pediatric CT techniques. This outline gives concise explanation of techniques and permits prompt dissemination of information. (orig.)

  5. Disease phenotype at diagnosis in pediatric Crohn's disease

    DEFF Research Database (Denmark)

    de Bie, Charlotte I; Paerregaard, Anders; Kolacek, Sanja

    2013-01-01

    It has been speculated that pediatric Crohn's disease (CD) is a distinct disease entity, with probably different disease subtypes. We therefore aimed to accurately phenotype newly diagnosed pediatric CD by using the pediatric modification of the Montreal classification, the Paris classification....

  6. Laparoscopic management of pediatric and adolescent patients with ...

    African Journals Online (AJOL)

    role of laparoscopy in the management of intraabdominal complications of VP shunt in ... The length of the postoperative hospital stay ranged from one day in ... Pediatr Surg 14:16–20 c 2018 Annals of Pediatric Surgery. Annals of Pediatric ...

  7. Evolution of the Pediatric Advanced Life Support course: enhanced learning with a new debriefing tool and Web-based module for Pediatric Advanced Life Support instructors.

    Science.gov (United States)

    Cheng, Adam; Rodgers, David L; van der Jagt, Élise; Eppich, Walter; O'Donnell, John

    2012-09-01

    To describe the history of the Pediatric Advanced Life Support course and outline the new developments in instructor training that will impact the way debriefing is conducted during Pediatric Advanced Life Support courses. The Pediatric Advanced Life Support course, first released by the American Heart Association in 1988, has seen substantial growth and change over the past few decades. Over that time, Pediatric Advanced Life Support has become the standard for resuscitation training for pediatric healthcare providers in North America. The incorporation of high-fidelity simulation-based learning into the most recent version of Pediatric Advanced Life Support has helped to enhance the realism of scenarios and cases, but has also placed more emphasis on the importance of post scenario debriefing. We developed two new resources: an online debriefing module designed to introduce a new model of debriefing and a debriefing tool for real-time use during Pediatric Advanced Life Support courses, to enhance and standardize the quality of debriefing by Pediatric Advanced Life Support instructors. In this article, we review the history of Pediatric Advanced Life Support and Pediatric Advanced Life Support instructor training and discuss the development and implementation of the new debriefing module and debriefing tool for Pediatric Advanced Life Support instructors. The incorporation of the debriefing module and debriefing tool into the 2011 Pediatric Advanced Life Support instructor materials will help both new and existing Pediatric Advanced Life Support instructors develop and enhance their debriefing skills with the intention of improving the acquisition of knowledge and skills for Pediatric Advanced Life Support students.

  8. Pediatric dermatology training survey of United States dermatology residency programs.

    Science.gov (United States)

    Nijhawan, Rajiv I; Mazza, Joni M; Silverberg, Nanette B

    2014-01-01

    Variability exists in pediatric dermatology education for dermatology residents. We sought to formally assess the pediatric dermatology curriculum and experience in a dermatology residency program. Three unique surveys were developed for dermatology residents, residency program directors, and pediatric dermatology fellowship program directors. The surveys consisted of questions pertaining to residency program characteristics. Sixty-three graduating third-year residents, 51 residency program directors, and 18 pediatric dermatology fellowship program directors responded. Residents in programs with one or more full-time pediatric dermatologist were more likely to feel very competent treating children and were more likely to be somewhat or extremely satisfied with their pediatric curriculums than residents in programs with no full-time pediatric dermatologist (50.0% vs 5.9%, p = 0.002, and 85.3% vs 52.9%, p dermatology fellowships were much more likely to report being extremely satisfied than residents in programs without a pediatric dermatology fellowship (83.3% vs 21.2%; p dermatology residency programs to continue to strengthen their pediatric dermatology curriculums, especially through the recruitment of full-time pediatric dermatologists. © 2013 Wiley Periodicals, Inc.

  9. Pediatric Donation After Circulatory Determination of Death: A Scoping Review.

    Science.gov (United States)

    Weiss, Matthew J; Hornby, Laura; Witteman, William; Shemie, Sam D

    2016-03-01

    Although pediatric donation after circulatory determination of death is increasing in frequency, there are no national or international donation after circulatory determination of death guidelines specific to pediatrics. This scoping review was performed to map the pediatric donation after circulatory determination of death literature, identify pediatric donation after circulatory determination of death knowledge gaps, and inform the development of national or regional pediatric donation after circulatory determination of death guidelines. Terms related to pediatric donation after circulatory determination of death were searched in Embase and MEDLINE, as well as the non-MEDLINE sources in PubMed from 1980 to May 2014. Seven thousand five hundred ninety-seven references were discovered and 85 retained for analysis. All references addressing pediatric donation after circulatory determination of death were considered. Exclusion criteria were articles that did not address pediatric patients, animal or laboratory studies, surgical techniques, and local pediatric donation after circulatory determination of death protocols. Narrative reviews and opinion articles were the most frequently discovered reference (25/85) and the few discovered studies were observational or qualitative and almost exclusively retrospective. Retained references were divided into themes and analyzed using qualitative methodology. The main discovered themes were 1) studies estimating the number of potential pediatric donation after circulatory determination of death donors and their impact on donation; 2) ethical issues in pediatric donation after circulatory determination of death; 3) physiology of the dying process after withdrawal of life-sustaining therapy; 4) cardiac pediatric donation after circulatory determination of death; and 5) neonatal pediatric donation after circulatory determination of death. Donor estimates suggest that pediatric donation after circulatory determination of death will

  10. Pediatric MRI

    Data.gov (United States)

    U.S. Department of Health & Human Services — The NIH Study of Normal Brain Development is a longitudinal study using anatomical MRI, diffusion tensor imaging (DTI), and MR spectroscopy (MRS) to map pediatric...

  11. Archives: Annals of Pediatric Surgery

    African Journals Online (AJOL)

    Items 1 - 32 of 32 ... Archives: Annals of Pediatric Surgery. Journal Home > Archives: Annals of Pediatric Surgery. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. 1 - 32 of 32 Items ...

  12. Pediatric Palliative Care: A Personal Story

    Medline Plus

    Full Text Available ... thanks 3-months free Find out why Close Pediatric Palliative Care: A Personal Story NINRnews Loading... Unsubscribe ... This vignette shares the story of Rachel—a pediatric neuroblastoma patient—and her family. The story demonstrates ...

  13. Pediatric Palliative Care: A Personal Story

    Medline Plus

    Full Text Available ... Queue Queue __count__/__total__ Find out why Close Pediatric Palliative Care: A Personal Story NINRnews Loading... Unsubscribe ... This vignette shares the story of Rachel—a pediatric neuroblastoma patient—and her family. The story demonstrates ...

  14. Pediatric Mania: The Controversy between Euphoria and Irritability

    Science.gov (United States)

    Serra, Giulia; Uchida, Mai; Battaglia, Claudia; Casini, Maria Pia; De Chiara, Lavinia; Biederman, Joseph; Vicari, Stefano; Wozniak, Janet

    2017-01-01

    Abstract: Pediatric Bipolar Disorder (BD) is a highly morbid pediatric psychiatric disease, consistently associated with family psychiatric history of mood disorders and associated with high levels of morbidity and disability and with a great risk of suicide. While there is a general consensus on the symptomatology of depression in childhood, the phenomenology of pediatric mania is still highly debated and the course and long-term outcome of pediatric BD still need to be clarified. We reviewed the available studies on the phenomenology of pediatric mania with the aim of summarizing the prevalence, demographics, clinical correlates and course of these two types of pediatric mania. Eighteen studies reported the number of subjects presenting with either irritable or elated mood during mania. Irritability has been reported to be the most frequent clinical feature of pediatric mania reaching a sensitivity of 95–100% in several samples. Only half the studies reviewed reported on number of episodes or cycling patterns and the described course was mostly chronic and ultra-rapid whereas the classical episodic presentation was less common. Few long-term outcome studies have reported a diagnostic stability of mania from childhood to young adult age. Future research should focus on the heterogeneity of irritability aiming at differentiating distinct subtypes of pediatric psychiatric disorders with distinct phenomenology, course, outcome and biomarkers. Longitudinal studies of samples attending to mood presentation, irritable versus elated, and course, chronic versus episodic, may help clarify whether these are meaningful distinctions in the course, treatment and outcome of pediatric onset bipolar disorder. PMID:28503110

  15. Pediatric Mania: The Controversy between Euphoria and Irritability.

    Science.gov (United States)

    Serra, Giulia; Uchida, Mai; Battaglia, Claudia; Casini, Maria Pia; De Chiara, Lavinia; Biederman, Joseph; Vicari, Stefano; Wozniak, Janet

    2017-04-01

    Pediatric Bipolar Disorder (BD) is a highly morbid pediatric psychiatric disease, consistently associated with family psychiatric history of mood disorders and associated with high levels of morbidity and disability and with a great risk of suicide. While there is a general consensus on the symptomatology of depression in childhood, the phenomenology of pediatric mania is still highly debated and the course and long-term outcome of pediatric BD still need to be clarified. We reviewed the available studies on the phenomenology of pediatric mania with the aim of summarizing the prevalence, demographics, clinical correlates and course of these two types of pediatric mania. Eighteen studies reported the number of subjects presenting with either irritable or elated mood during mania. Irritability has been reported to be the most frequent clinical feature of pediatric mania reaching a sensitivity of 95-100% in several samples. Only half the studies reviewed reported on number of episodes or cycling patterns and the described course was mostly chronic and ultra-rapid whereas the classical episodic presentation was less common. Few long-term outcome studies have reported a diagnostic stability of mania from childhood to young adult age. Future research should focus on the heterogeneity of irritability aiming at differentiating distinct subtypes of pediatric psychiatric disorders with distinct phenomenology, course, outcome and biomarkers. Longitudinal studies of samples attending to mood presentation, irritable versus elated, and course, chronic versus episodic, may help clarify whether these are meaningful distinctions in the course, treatment and outcome of pediatric onset bipolar disorder.

  16. Practical considerations in radionuclide imaging of pediatric patients

    International Nuclear Information System (INIS)

    Conway, J.J.

    1984-01-01

    A certain proportion of the patients encountered in the practice of nuclear medicine will fall within the pediatric age group. The pediatric age range is usually defined as extending from birth to 18 years. Therefore, the specialist in nuclear medicine may have to deal with pediatric patients weighing as little as 800 g or as much as 300 lb. This encounter may be pleasant or unpleasant, depending upon the physician's knowledge of the techniques required for handling children and obtaining an adequate study and a basic understanding of specific pediatric disorders. Among the issues that must be considered are the equipment, which must be suitable for handling and obtaining optimal images of small children; the development of a basic understanding of the peculiarities of radiopharmaceutical distribution in children, which differs from that in adults; and, importantly, a knowledge of radiation dosimetry as it relates to the pediatric patient. It is beyond the scope of this chapter to present a comprehensive dissertation on the topic of pediatric nuclear medicine. The theme therefore is limited to the general principles and techniques required for nuclear medicine studies on pediatric patients. In addition, studies that exhibit unique characteristics when performed on children are highlighted in an effort to define that essence of pediatric nuclear medicine that differentiates it from the practice of nuclear medicine in adults

  17. Atypical disease phenotypes in pediatric ulcerative colitis

    DEFF Research Database (Denmark)

    Levine, Arie; de Bie, Charlotte I; Turner, Dan

    2013-01-01

    Definitive diagnosis of pediatric ulcerative colitis (UC) may be particularly challenging since isolated colitis with overlapping features is common in pediatric Crohn's disease (CD), while atypical phenotypes of UC are not uncommon. The Paris classification allows more accurate phenotyping...... of atypical inflammatory bowel disease (IBD) patients. Our aim was to identify the prevalence of atypical disease patterns in new-onset pediatric UC using the Paris classification....

  18. Peregrination in the problem pediatric patient. The pediatric Münchhausen syndrome?

    Science.gov (United States)

    Fialkov, M J

    1984-10-01

    Peregrinating pediatric patients are those who go from physician to physician either within hospitals or from clinic to clinic within a community. They are often the symptom bearers of dysfunctional multiproblem families requiring an interdisciplinary approach to diagnosis and management. Because of the obscure nature of the child's pediatric problems, such children are often shunned by the medical profession and other social agencies, setting in motion a sequence of events that can prove detrimental to the child, his family, the community, and the state. This article illustrates the need for an anticipatory, coordinated approach in the management of this complex psychosocial condition.

  19. Establishment of radiation doses for pediatric X-ray examinations in a large pediatric hospital in Turkey

    International Nuclear Information System (INIS)

    Olgar, T.; Sahmaran, T.

    2017-01-01

    Pediatric patients are more sensitive to ionizing radiation when compared with adults. The aim of this study was to evaluate the radiation doses for some common pediatric x-ray examinations performed with various digital radiography systems. Quality control tests of the digital radiography systems were carried out according to international published protocols before the pediatric dose measurements. Radiation dose measurement was performed by using the x-ray tube outputs and thermoluminescent dosimeter dose measurement methods. In the present study, radiation doses were assessed for 247 chest, 230 pelvis, 194 skull and 73 abdomen x-ray examinations and in total 744 pediatric patients doses were measured. Pediatric patients were classified into four age groups 0-1, 1-5, 5-10 and 10-15 years as given by European Commission guidance. Effective doses were determined for each examination using a PCXMC 2.0 Monte Carlo program. The mean measured entrance skin doses for the age interval 1-5 years and AP projection by using tube output measurement methods were 149 μGy for chest, 304 μGy for pelvis, 387 μGy for skull and 199 μGy for abdomen examinations. The radiation dose results obtained in this study were in the range of the published results in the literature. (authors)

  20. Pediatric biobanking

    DEFF Research Database (Denmark)

    Salvaterra, Elena; Giorda, Roberto; Bassi, Maria T

    2012-01-01

    Ethical, legal, and social issues related to the collection, storage, and use of biospecimens and data derived from children raise critical concerns in the international debate. So far, a number of studies have considered a variety of the individual issues crucial to pediatric biobanking such as ......Ethical, legal, and social issues related to the collection, storage, and use of biospecimens and data derived from children raise critical concerns in the international debate. So far, a number of studies have considered a variety of the individual issues crucial to pediatric biobanking...... such as decision making, privacy protection, minor recontact, and research withdrawal by focusing on theoretical or empirical perspectives. Our research attempted to analyze such issues in a comprehensive manner by exploring practices, rules, and researcher opinions regarding proxy consent, minor assent, specimens...

  1. Toward a Child Rights Theory in Pediatric Bioethics.

    Science.gov (United States)

    Goldhagen, Jeffrey; Mercer, Raul; Webb, Elspeth; Nathawad, Rita; Shenoda, Sherry; Lansdown, Gerison

    2016-01-01

    This article offers a child rights theory in pediatric bioethics, applying the principles, standards, and norms of child rights, health equity, and social justice to medical and ethical decision-making. We argue that a child rights theory in pediatric bioethics will help pediatricians and pediatric bioethicists analyze and address the complex interplay of biomedical and social determinants of child health. These core principles, standards and norms, grounded in the U.N. Convention on the Rights of the Child (CRC), provide the foundational elements for the theory and a means for better understanding the complex determinants of children's health and well-being. Rights-based approaches to medical and ethical decision-making provide strategies for applying and translating these elements into the practice of pediatrics and pediatric bioethics by establishing a coherent, consistent, and contextual theory that is relevant to contemporary practice. The proposed child rights theory extends evolving perspectives on the relationship between human rights and bioethics to both child rights and pediatric bioethics.

  2. Is OSCE successful in pediatrics?

    Directory of Open Access Journals (Sweden)

    M Imani

    2009-02-01

    Full Text Available Background: The Faculty of Medical Sciences, University of Zahedan implemented the Objective Structured Clinical Examination (OSCE in the final Examination during the 2003–2004 academic year. Simultaneously, the pediatric department initiated faculty and student training, and instituted the OSCE as an assessment instrument during the pediatric clerkship in year 5. The study set out to explore student acceptance of the OSCE as part of an evaluation of the Pediatric clerkship.Purpose: This study implemented to evaluate a new method of assessment in medical education in pediatrics.Methods: A self-administered questionnaire was completed by successive groups of students immediately after the OSCE at the end of each clerkship rotation. Main outcome measures were student perception of examination attributes, which included the quality of instructions and organization, the quality of performance, authenticity and transparency of the process, and usefulness of the OSCE as an assessment instrument compared to other methods.Results: There was overwhelming acceptance of the OSCE in Pediatric with respect to the comprehensiveness (90%, transparency (87%, fairness (57% and authenticity of the required tasks (58–78%. However, students felt that it was a strong anxiety-producing experience. And concerns were expressed regarding the ambiguity of some questions and inadequacy of time for expected tasks.Conclusion: Student feedback was invaluable in influencing faculty teaching, curriculum direction and appreciation of student opinion. Further psychometric evaluation will strengthen the development of the OSCE.Key words: OSCE, COMPETENCE ASSESSMENT

  3. Pandemic Influenza Pediatric Office Plan Template

    Energy Technology Data Exchange (ETDEWEB)

    HCTT CHE

    2010-01-01

    This is a planning tool developed by pediatric stakeholders that is intended to assist pediatric medical offices that have no pandemic influenza plan in place, but may experience an increase in patient calls/visits or workload due to pandemic influenza.

  4. Retrospective Survey of Biopsied Oral Lesions in Pediatric Patients

    Directory of Open Access Journals (Sweden)

    Yin-Lin Wang

    2009-11-01

    Conclusion: The mucous extravasation phenomenon, odontoma, or dentigerous cyst was the most common inflammatory and reactive, neoplastic, or cystic lesion, respectively, in pediatric patients. The relatively high incidence of inflammatory and reactive lesions in pediatric patients implies the importance of stringent oral hygiene in children. Most oral neoplastic lesions in pediatric patients are benign, and malignant oral tumors rarely occur in pediatric patients.

  5. Citation classics in pediatrics: a bibliometric analysis.

    Science.gov (United States)

    Chhapola, Viswas; Tiwari, Soumya; Deepthi, Bobbity; Kanwal, Sandeep Kumar

    2018-03-06

    Citation analysis provides insights into the history and developmental trajectory of scientific fields. Our objective was to perform an analysis of citation classics in the journals of pediatric specialty and to examine their characteristics. Initially, all the journals listed under the category of pediatrics (n = 120) were identified using Journal Citation Reports. Web of science database was then searched (1950-2016) to select the top-100 cited articles in the above identified pediatric journals. The top-100 cited article were categorized according the study design, sub-specialty, country, institutional affiliation, and language. The top-100 articles were published in 18 different journals, with Pediatrics having the highest numbers (n = 40), followed by The Journal of Pediatrics (n = 17). The majority (n = 62) of classics were published after 1990. The most cited article had citation count of 3516 and the least cited had a citation count of 593. The USA (n = 71) was the most commonly represented country, and 60 institutions contributed to 100 articles. Fifteen authors contributed to more than one classic as first or second author. Observational study (n = 55) was the commonest study design across all decades, followed by reviews (n = 12), scale development studies (n = 11), and guidelines (n = 11). Among the pediatric sub-specialties, growth and development articles were highly cited (n = 24), followed by pediatric psychiatry and behavior (n = 21), endocrinology (n = 15), and neonatology (n = 12). The top-100 cited articles in pediatrics identify the impactful authors, journals, institutes, and countries. Observational study design was predominant-implying that inclusion among citation classics is not related to soundness of study design.

  6. 1987 year book of diagnostic radiology

    International Nuclear Information System (INIS)

    Bragg, D.G.; Keats, T.E.; Kieffer, S.A.; Kirkpatrick, J.A. Jr.; Koehler, P.R.

    1987-01-01

    The book is divided into seven sections, which cover neuroradiology, the thorax, the abdomen, the musculoskeletal system, pediatric radiology, radiation physics, and cardiovascular and interventional radiology. Each of the seven editors was responsible for one section. These editors gleaned what they thought were the most important articles from 78 medical journals worldwide, wrote abstracts, and then commented on their relevance. For each journal article, the heading lists the title of the paper, the authors, the authors' affiliations, and the journal name. If an article contained an important table or figure, it was reproduced for the review

  7. Primary repair for pediatric colonic injury: Are there differences among adult and pediatric trauma centers?

    Science.gov (United States)

    Khan, Muhammad; Jehan, Faisal; O'Keeffe, Terence; Pandit, Viraj; Kulvatunyou, Narong; Tang, Andrew; Gries, Lynn; Joseph, Bellal

    2017-12-01

    Management of colonic injuries (colostomy [CO] versus primary anastomosis [PA]) among pediatric patients remains controversial. The aim of this study was to assess outcomes in pediatric trauma patient with colonic injury undergoing operative intervention. The National Trauma Data Bank (2011-2012) was queried including patients with isolated colonic injury undergoing exploratory laparotomy with PA or CO with age ≤18 y. Missing value analysis was performed. Patients were stratified into two groups: PA and CO. Outcome measures were mortality, in-hospital complications, and hospital length of stay. Multivariate regression analysis was performed. A total of 1151 patients included. Mean ± standard deviation age was 11.61 ± 2.8 y, and median [IQR] Injury Severity Score was 12 [8-16]; 39% (n = 449) of the patients had CO, and 35.6% (n = 410) were managed in pediatric trauma centers (PC). Patients with CO had a higher Injury Severity Score (P trauma centers (AC). Moreover, there was no difference in mortality between the AC and the PC (P = 0.79). Our data demonstrate no difference in mortality in pediatric trauma patients with colonic injury who undergo primary repair or CO. However, adult trauma centers had lower rates of CO performed as compared to a similar cohort of patients managed in pediatric trauma centers. Further assessment of the reasons underlying such differences will help improve patient outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Radiation-induced meningiomas in pediatric patients

    International Nuclear Information System (INIS)

    Moss, S.D.; Rockswold, G.L.; Chou, S.N.; Yock, D.; Berger, M.S.

    1988-01-01

    Radiation-induced meningiomas rarely have latency periods short enough from the time of irradiation to the clinical presentation of the tumor to present in the pediatric patient. Three cases of radiation-induced intracranial meningiomas in pediatric patients are presented. The first involved a meningioma of the right frontal region in a 10-year-old boy 6 years after the resection and irradiation of a 4th ventricular medulloblastoma. Review of our pediatric tumor cases produced a second case of a left temporal fossa meningioma presenting in a 15-year-old boy with a history of irradiation for retinoblastoma at age 3 years and a third case of a right frontoparietal meningioma in a 15-year-old girl after irradiation for acute lymphoblastic leukemia. Only three cases of meningiomas presenting in the pediatric age group after radiation therapy to the head were detected in our review of the literature

  9. Radiology illustrated. Pediatric radiology

    Energy Technology Data Exchange (ETDEWEB)

    Kim, In-One (ed.) [Seoul National Univ. College of Medicine (Korea, Republic of). Dept. of Radiology

    2014-11-01

    Depicts characteristic imaging findings of common and uncommon diseases in the pediatric age group. Will serve as an ideal diagnostic reference in daily practice. Offers an excellent teaching aid, with numerous high-quality illustrations. This case-based atlas presents images depicting the findings typically observed when imaging a variety of common and uncommon diseases in the pediatric age group. The cases are organized according to anatomic region, covering disorders of the brain, spinal cord, head and neck, chest, cardiovascular system, gastrointestinal system, genitourinary system, and musculoskeletal system. Cases are presented in a form resembling teaching files, and the images are accompanied by concise informative text. The goal is to provide a diagnostic reference suitable for use in daily routine by both practicing radiologists and radiology residents or fellows. The atlas will also serve as a teaching aide and a study resource, and will offer pediatricians and surgeons guidance on the clinical applications of pediatric imaging.

  10. Using robotic telecommunications to triage pediatric disaster victims.

    Science.gov (United States)

    Burke, Rita V; Berg, Bridget M; Vee, Paul; Morton, Inge; Nager, Alan; Neches, Robert; Wetzel, Randall; Upperman, Jeffrey S

    2012-01-01

    During a disaster, hospitals may be overwhelmed and have an insufficient number of pediatric specialists available to care for injured children. The aim of this study was to determine the feasibility of remotely providing pediatric expertise via a robot to treat pediatric victims. In 2008, Los Angeles County held 2 drills involving telemedicine. The first was the Tri-Hospital drill in which 3 Los Angeles County hospitals, one being a pediatric hospital, participated. The disaster scenario involved a Metrolink train crash, resulting in a large surge of traumatic injuries. The second drill involved multiple agencies and was called the Great California Shakeout, a simulated earthquake exercise. The telemedicine equipment installed is an InTouch Health, Inc, Santa Barbara, CA robotic telecommunications system. We used mixed-methods to evaluate the use of telemedicine during these drills. Pediatric specialists successfully provided remote triage and treatment consults of victims via the robot. The robot proved to be a useful means to extend resources and provide expert consult if pediatric specialists were unable to physically be at the site. Telemedicine can be used in the delayed treatment areas as well as for training first receivers to collaborate with specialists in remote locations to triage and treat seriously injured pediatric victims. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Pediatric fibromyalgia

    Directory of Open Access Journals (Sweden)

    J. Ablin

    2012-09-01

    Full Text Available Fibromyalgia (FM is currently defined as chronic widespread pain (CWP with allodynia or hyperalgesia to pressure pain. It is classified as one of the large group of soft-tissue pain syndromes. Pain is the cardinal symptom of FM; however, most patients also experience additional symptoms such as debilitating fatigue, disrupted or non-restorative sleep, functional bowel disturbances, and a variety of neuropsychiatric problems, including cognitive dysfunction, anxiety and depressive symptoms. Its pathogenesis is not entirely understood, although it is currently believed to be the result of a central nervous system (CNS malfunction that increases pain transmission and perception. FMS usually involves females, and in these patients it often makes its first appearance during menopause. But it is often diagnosed both in young as well as elderly individuals. Pediatric FMS is a frustrating condition affecting children and adolescents at a crucial stage of their physical and emotional development. Pediatric FMS is an important differential diagnosis to be considered in the evaluation of children suffering from widespread musculoskeletal pain, and must be differentiated from a spectrum of inflammatory joint disorders such as juvenile idiopathic arthritis (JIA, juvenile ankylosing spondylitis, etc. The management of pediatric FMS is centered on the issues of education, behavioral and cognitive change (with a strong emphasis on physical exercise, and a relatively minor role for pharmacological treatment with medications such as muscle relaxants, analgesics and tricyclic agents.

  12. Altered structural brain changes and neurocognitive performance in pediatric HIV

    Directory of Open Access Journals (Sweden)

    Santosh K. Yadav

    2017-01-01

    Full Text Available Pediatric HIV patients often suffer with neurodevelopmental delay and subsequently cognitive impairment. While tissue injury in cortical and subcortical regions in the brain of adult HIV patients has been well reported there is sparse knowledge about these changes in perinatally HIV infected pediatric patients. We analyzed cortical thickness, subcortical volume, structural connectivity, and neurocognitive functions in pediatric HIV patients and compared with those of pediatric healthy controls. With informed consent, 34 perinatally infected pediatric HIV patients and 32 age and gender matched pediatric healthy controls underwent neurocognitive assessment and brain magnetic resonance imaging (MRI on a 3 T clinical scanner. Altered cortical thickness, subcortical volumes, and abnormal neuropsychological test scores were observed in pediatric HIV patients. The structural network connectivity analysis depicted lower connection strengths, lower clustering coefficients, and higher path length in pediatric HIV patients than healthy controls. The network betweenness and network hubs in cortico-limbic regions were distorted in pediatric HIV patients. The findings suggest that altered cortical and subcortical structures and regional brain connectivity in pediatric HIV patients may contribute to deficits in their neurocognitive functions. Further, longitudinal studies are required for better understanding of the effect of HIV pathogenesis on brain structural changes throughout the brain development process under standard ART treatment.

  13. Presentation of suspected pediatric uveitis.

    Science.gov (United States)

    Saeed, Muhammad Usman; Raza, Syed Hamid; Goyal, Sudeshna; Cleary, Gavin; Newman, William David; Chandna, Arvind

    2014-01-01

    Presentation of suspected pediatric uveitis: Pediatric uveitis is usually managed in specialized ophthalmic centers in the UK. Meaningful data acquisition in these clinics may be helpful in clinical governance, and healthcare planning in a specialty that is gradually changing due to changes in treatment choices. Retrospective analysis of prospectively acquired data in the Liverpool pediatric uveitis database was performed. Analysis of our data, based on 147 patients, with a mean age of 10 years, indicated a female to male ratio of 2:1. 99% of patients were Caucasian. Our data indicates 86% of all patients attending the uveitis clinic were diagnosed with juvenile idiopathic arthritis, followed by intermediate uveitis 5% and idiopathic uveitis 4%. 46% of patients required treatment. Systemic treatment included methotrexate (34%), prednisolone (14%), etanercept (6%), ciclosporin (6%), mycophenolate (3%), and infliximab (1%). Severe visual loss (defined by counting fingers or below vision) was seen in 10 eyes despite appropriately treated chronic uveitis. Our data shows uveitis-related ocular morbidity in a predominantly pediatric Caucasian population. Patients with severe and chronic uveitis may experience significant uveitis-related complications and subsequent visual loss despite aggressive treatment.

  14. Increased pediatric sub-specialization is associated with decreased surgical complication rates for inpatient pediatric urology procedures

    Science.gov (United States)

    Tejwani, R.; Wang, H-H. S.; Young, B. J.; Greene, N. H.; Wolf, S.; Wiener, J. S.; Routh, J. C.

    2016-01-01

    Summary Introduction Increased case volumes and training are associated with better surgical outcomes. However, the impact of pediatric urology sub-specialization on perioperative complication rates is unknown. Objectives To determine the presence and magnitude of difference in rates of common postoperative complications for elective pediatric urology procedures between specialization levels of urologic surgeons. The Nationwide Inpatient Sample (NIS), a nationally representative administrative database, was used. Study Design The NIS (1998–2009) was retrospectively reviewed for pediatric (≤18 years) admissions, using ICD-9-CM codes to identify urologic surgeries and National Surgical Quality Improvement Program (NSQIP) inpatient postoperative complications. Degree of pediatric sub-specialization was calculated using a Pediatric Proportion Index (PPI), defined as the ratio of children to total patients operated on by each provider. The providers were grouped into PPI quartiles: Q1, 0–25% specialization; Q2, 25–50%; Q3, 50–75%; Q4, 75–100%. Weighted multivariate analysis was performed to test for associations between PPI and surgical complications. Results A total of 71,479 weighted inpatient admissions were identified. Patient age decreased with increasing specialization: Q1, 7.9 vs Q2, 4.8 vs Q3, 4.8 vs Q4, 4.6 years, PSpecialization was not associated with race (P>0.20), gender (P>0.50), or comorbidity scores (P=0.10). Mortality (1.5% vs 0.2% vs 0.3% vs 0.4%, Pspecialization. Patients treated by more highly specialized surgeons incurred slightly higher costs (Q2, +4%; Q3, +1%; Q4 + 2%) but experienced shorter length of hospital stay (Q2, –5%; Q3, –10%; Q4, –3%) compared with the least specialized providers. A greater proportion of patients treated by Q1 and Q3 specialized urologists had CCS ≥2 than those seen by Q2 or Q4 urologists (12.5% and 12.2%, respectively vs 8.4% and 10.9%, respectively, P=0.04). Adjusting for confounding effects

  15. Pediatric aspects of inpatient health information technology systems.

    Science.gov (United States)

    Lehmann, Christoph U

    2015-03-01

    In the past 3 years, the Health Information Technology for Economic and Clinical Health Act accelerated the adoption of electronic health records (EHRs) with providers and hospitals, who can claim incentive monies related to meaningful use. Despite the increase in adoption of commercial EHRs in pediatric settings, there has been little support for EHR tools and functionalities that promote pediatric quality improvement and patient safety, and children remain at higher risk than adults for medical errors in inpatient environments. Health information technology (HIT) tailored to the needs of pediatric health care providers can improve care by reducing the likelihood of errors through information assurance and minimizing the harm that results from errors. This technical report outlines pediatric-specific concepts, child health needs and their data elements, and required functionalities in inpatient clinical information systems that may be missing in adult-oriented HIT systems with negative consequences for pediatric inpatient care. It is imperative that inpatient (and outpatient) HIT systems be adapted to improve their ability to properly support safe health care delivery for children. Copyright © 2015 by the American Academy of Pediatrics.

  16. The safety of pharmacologic treatment for pediatric obesity.

    Science.gov (United States)

    Chao, Ariana M; Wadden, Thomas A; Berkowitz, Robert I

    2018-04-01

    Pediatric obesity is a serious public health concern. Five medications have been approved by the Food and Drug Administration (FDA) for chronic weight management in adults with obesity, when used as an adjunct to lifestyle modification. Orlistat is the only FDA-approved medication for pediatric patients aged 12 years and above. Areas covered: This paper summarizes safety and efficacy data from clinical trials of weight loss medications conducted among pediatric samples. Relevant studies were identified through searches in PubMed. Expert opinion: Orlistat, as an adjunct to lifestyle modification, results in modest weight losses and may be beneficial for some pediatric patients with obesity. However, gastrointestinal side effects are common and may limit use. In adults taking orlistat, rare but severe adverse events, including liver and renal events, have been reported. Recent pediatric pharmacokinetic studies of liraglutide have demonstrated similar safety and tolerability profiles as found in adults, with gastrointestinal disorders being the most common adverse events. Clinical trials are needed of liraglutide, as well as other medications for obesity, that systematically evaluate their risks and benefits in pediatric patients.

  17. Three-year experience with interventional neuroradiology for management of cerebral aneurysms at a single Australian centre.

    Science.gov (United States)

    McLaughlin, Aden; Rice, Hal; de Viliers, Laetitia; Withers, Teresa; Pearson, David; Arnell, Moira; Walters, Kerin; Czuchwicki, Sarah; Bulmer, Andrew; Winearls, James

    2018-02-01

    Over the last decade interventional neuroradiology (NR) has become the mainstay of managing cerebral aneurysms. The aim of our study was to review our growing experiences with interventional NR and quantify morbidity and mortality associated with these procedures. The electronic medical records of all patients admitted to the Gold Coast (University) Hospital Intensive Care Unit following subarachnoid haemorrhage (SAH) or elective interventional NR management of cerebral aneurysms between January 2012 and December 2014 were retrieved. Primary outcomes of interest were death, thromboembolic and haemorrhagic events during hospital admission. One hundred and fifty-two patients underwent interventional NR procedures for cerebral aneurysms. This consisted of 92 (60.5%) elective cases and 60 (39.5%) emergency cases following SAH. The all-cause mortality rate and the rate of thromboembolic and haemorrhagic events for the entire cohort were 5.9%, 11.2% and 7.2% respectively. Intra-procedural complications occurred in 6.6% of the entire cohort. Median length of follow-up was 448 days, with 91.6% of the entire cohort followed up. At follow-up, 64.1% of patients had no neurological deficits, 29% had mild non-specific deficits and 6.9% had significant disability. Interventional NR represents the primary treatment modality for all patients presenting to our service with cerebral aneurysm. Our results are encouraging and are comparable to published data in the international literature. Reducing the burden of thromboembolism in patients undergoing endovascular treatment of their aneurysmal disease is our main research focus currently, and we aim to improve outcomes for this patient group. © 2017 The Royal Australian and New Zealand College of Radiologists.

  18. Pediatric radiologists: who we are and what we do. Results of a membership survey of the Society for Pediatric Radiology - 1999

    International Nuclear Information System (INIS)

    Goske, M.J.; Lieber, M.; Lebowitz, R.L.; Ablin, D.; Royal, S.

    2000-01-01

    Background. There is a need for reliable monitoring of workforce trends in the field of pediatric radiology by the Society for Pediatric Radiology. In addition, the Society should periodically assess itself as to its mission and relevance to its members via membership surveys. Objective. The Membership Committee of the Society for Pediatric Radiology, 1999, conducted a 54-question survey to determine the makeup of its members, job profiles, satisfaction with services of the Society for Pediatric Radiology, and its official journal, Pediatric Radiology. Materials and methods. Seven hundred fifty surveys were given to active members of the Society for Pediatric Radiology in the United States and Canada. There were 275 surveys returned for an overall response of 37%. Results. Mean age of members is 48 years with 99 % of respondents working. Membership is 34 % female and 66 % male. Women members of the Society are younger (45 vs 49 years, P = 0.0012) and work less hours (47.8 vs 51.0, P = 0.0135) than men. Fifty-seven percent of respondents practice in a freestanding children's hospital, 29 % in a ''children's hospital within a hospital,'' and 14 % are in community hospitals or an office-based practice. Eighty-two percent of the responding pediatric radiologist's time is spent in performing examination on children, with only 18 % spent on adult work or administration. Forty-eight percent work at more than one office. Sixty-one percent worked evenings or weekends, excluding night call. Two hundred twenty-two of 275 respondents had received a Certificate of Added Qualification. The meeting ''for CME credit'' was considered the most important benefit of Society membership. Most respondents read select articles in Pediatric Radiology. There was sentiment to decrease esoteric case reports in favor of review articles. Only 19 % of respondents submitted their articles to Pediatric Radiology initially. Conclusion. Pediatric radiologists are a diverse membership with the common

  19. The role of librarians in teaching evidence-based medicine to pediatric residents: a survey of pediatric residency program directors.

    Science.gov (United States)

    Boykan, Rachel; Jacobson, Robert M

    2017-10-01

    The research sought to identify the general use of medical librarians in pediatric residency training, to define the role of medical librarians in teaching evidence-based medicine (EBM) to pediatric residents, and to describe strategies and curricula for teaching EBM used in pediatric residency training programs. We sent a 13-question web-based survey through the Association of Pediatric Program Directors to 200 pediatric residency program directors between August and December 2015. A total of 91 (46%) pediatric residency program directors responded. Most (76%) programs had formal EBM curricula, and more than 75% of curricula addressed question formation, searching, assessment of validity, generalizability, quantitative importance, statistical significance, and applicability. The venues for teaching EBM that program directors perceived to be most effective included journal clubs (84%), conferences (44%), and morning report (36%). While 80% of programs utilized medical librarians, most of these librarians assisted with scholarly or research projects (74%), addressed clinical questions (62%), and taught on any topic not necessarily EBM (58%). Only 17% of program directors stated that librarians were involved in teaching EBM on a regular basis. The use of a librarian was not associated with having an EBM curriculum but was significantly associated with the size of the program. Smaller programs were more likely to utilize librarians (100%) than were medium (71%) or large programs (75%). While most pediatric residency programs have an EBM curriculum and engage medical librarians in various ways, librarians' expertise in teaching EBM is underutilized. Programs should work to better integrate librarians' expertise, both in the didactic and clinical teaching of EBM.

  20. Burnout Syndrome in Pediatric Practice

    OpenAIRE

    Al-Youbi, Reem A.; Jan, Mohammed M.

    2013-01-01

    Objectives: Burnout is a common work-related syndrome consisting of emotional exhaustion, depersonalization and diminished feelings of personal accomplishment. Burnout influences the performance and efficiency of the healthcare professionals and therefore the quality of the care provided. This study aims to assess the burnout rates and potential determinants in pediatrics.Methods: A cross-sectional, descriptive study involving physicians practicing pediatrics in the Jeddah area of Saudi Arabi...

  1. [Flomoxef in the pediatric surgical field].

    Science.gov (United States)

    Yura, J; Shimizu, Y; Hashimoto, T; Nakamura, T; Otobe, Y; Minami, M

    1991-11-01

    Basic and clinical studies of flomoxef (6315-S, FMOX) were performed in the pediatric surgical field. The results obtained are summarized as follows: 1. FMOX was administered to 7 pediatric patients with biliary atresia (FMOX 20 mg/kg, i.v.d.). Peak biliary levels of FMOX were obtained at 1 hour after finishing administration by drip infusion, and were higher than those in blood 1 hours after finishing administration by drip infusion. 2. Urinary excretion was excellent, and urinary recovery rates were 57.8-97.8%. 3. FMOX was administered to 5 patients in the pediatric surgical field. One case was phlegmon, and other 4 cases were premature babies for postoperative prophylactic use. Clinical results were excellent in 1 case, good in 4 cases, with an overall efficacy rate of 100%. No clinical and laboratory side effects due to the administration FMOX were observed. It was concluded that FMOX was a safe and effective antibiotic in the pediatric surgical field.

  2. Brain Imaging in Pediatric Obsessive-Compulsive Disorder

    Science.gov (United States)

    MacMaster, Frank P.; O'Neill, Joseph; Rosenberg, David R.

    2008-01-01

    Neuroimaging findings support the frontal-striatal-thalamic model of pediatric obsessive-compulsive disorder. Glutamate is also implicated in the pathological finding of the disease. Implications for pediatric OCD treatments are discussed.

  3. Critical Elements for the Pediatric Perioperative Anesthesia Environment.

    Science.gov (United States)

    Polaner, David M; Houck, Constance S

    2015-12-01

    The American Academy of Pediatrics proposes guidance for the pediatric perioperative anesthesia environment. Essential components are identified to optimize the perioperative environment for the anesthetic care of infants and children. Such an environment promotes the safety and well-being of infants and children by reducing the risk of adverse events. Copyright © 2015 by the American Academy of Pediatrics.

  4. Pediatric interventional radiology clinic - how are we doing?

    International Nuclear Information System (INIS)

    Rubenstein, Jonathan; Zettel, Julie C.; Lee, Eric; Cote, Michelle; Aziza, Albert; Connolly, Bairbre L.

    2016-01-01

    Development of a pediatric interventional radiology clinic is a necessary component of providing a pediatric interventional radiology service. Patient satisfaction is important when providing efficient, high-quality care. To analyze the care provided by a pediatric interventional radiology clinic from the perspective of efficiency and parent satisfaction, so as to identify areas for improvement. The prospective study was both quantitative and qualitative. The quantitative component measured clinic efficiency (waiting times, duration of clinic visit, nurse/physician time allocation and assessments performed; n = 91). The qualitative component assessed parental satisfaction with their experience with the pediatric interventional radiology clinic, using a questionnaire (5-point Likert scale) and optional free text section for feedback (n = 80). Questions explored the family's perception of relevance of information provided, consent process and overall satisfaction with their pediatric interventional radiology clinic experience. Families waited a mean of 11 and 10 min to meet the physician and nurse, respectively. Nurses and physicians spent a mean of 28 and 21 min with the families, respectively. The average duration of the pediatric interventional radiology clinic consultation was 56 min. Of 80 survey participants, 83% were satisfied with their experience and 94% said they believed providing consent before the day of the procedure was helpful. Only 5% of respondents were not satisfied with the time-efficiency of the interventional radiology clinic. Results show the majority of patients/parents are very satisfied with the pediatric interventional radiology clinic visit. The efficiency of the pediatric interventional radiology clinic is satisfactory; however, adherence to stricter scheduling can be improved. (orig.)

  5. Pediatric dermatology training during residency: a survey of the 2014 graduating residents.

    Science.gov (United States)

    Akhavan, Alaleh; Murphy-Chutorian, Blair; Friedman, Adam

    2015-01-01

    Knowledge of pediatric dermatology is considered a core competency of dermatology training and should be expected of all practicing dermatologists. While the numbers of both pediatric dermatology fellowships and board certified pediatric dermatologists in the workforce have increased over the years, recent reports suggest that there is a gap in pediatric dermatology education during dermatology residency. The goal of this study is to assess the current state of pediatric education during residency, as well as the clinical experience, satisfaction and expectations of graduating dermatology residents. A 31-question self-report survey was distributed electronically to 294 third-year dermatology residents with questions pertaining to demographics, didactic education, resident experience in pediatric dermatology training, satisfaction with pediatric training and future plans. One hundred and twenty-three residents responded (41.8% response rate) representing approximately 29.1% of the total number of graduating residents. 69 (56.1%) residents reported academic time specifically devoted to pediatric dermatology, the majority (79.7%) of which was led by pediatric dermatologists. 82% of residents reported dedicated pediatric dermatology clinics at their program. 86.8% of respondents felt that their training in pediatric dermatology will allow them to confidently see pediatric dermatology patients in practice. This survey highlights a promising state of pediatric dermatology training among current graduating dermatology residents. The majority of current graduating dermatology residents are satisfied with their pediatric dermatology education, feel confident treating pediatric patients, and plan to see pediatric patients in clinical practice. © 2015 Wiley Periodicals, Inc.

  6. Acitretin in pediatric dermatoses

    Directory of Open Access Journals (Sweden)

    Manjyot Gautam

    2016-01-01

    Full Text Available Acitretin, a synthetic retinoid and the active metabolite of etretinate has been increasingly used over the past two decades. It has proved effective in the treatment of many conditions associated with hyperkeratosis and dyskeratosis. A Google scholar search for the use of acitretin in pediatric dermatoses was done using the words “pediatric dermatoses,” “acitretin,” “etretinate,” “systemic retinoids,” “psoriasis,” “pityriasis rubra pilaris,” “ichthyoses,” “disorders of keratinization,” “Darier's disease,” “palmoplantar keratoderma,” “verrucae,” “lichen planus,” “lupus erythematosus,” and “lichen sclerosus.” All the articles were retrieved and classified into review articles, studies, double-blinded trials, and case reports. The final data were then analyzed and presented in a narrative fashion. It has been found that acitretin is useful in a number of pediatric dermatoses. It is preferred over other drugs in pustular psoriasis. Good results can be obtained in various disorders of keratinization, and it may even prove life-saving in conditions like harlequin ichthyosis. However, long-term maintenance therapy is required and exacerbations are known on discontinuing the drug. It can also be used as alternative therapy for many other pediatric dermatoses where the primary treatment has failed. Acitretin should be used even in children for the proper indications. However, proper clinical and laboratory surveillance has to be maintained in patients on long-term acitretin.

  7. Adderall for All: A Defense of Pediatric Neuroenhancement.

    Science.gov (United States)

    Flanigan, Jessica

    2013-08-20

    I argue that young patients should be able to access neuroenhancing drugs without a diagnosis of ADHD. The current framework of consent for pediatric patients can be adapted to accommodate neuroenhancement. After a brief overview of pediatric neuroenhancement, I develop three arguments in favor of greater acceptance of neuroenhancement for young patients. First, ADHD is not relevantly different from other disadvantages that could be treated with stimulant medication. Second, establishing a legitimate framework for pediatric neuroenhancement would mitigate the bad effects of diversion and improve research on neuroenhancement and ADHD. Third, some pediatric patients have rights to access neuroenhancements. I then consider several objections to pediatric neuroenhancement. I address concerns about addiction, advertising, authentic development, the parent-child relationship and equal opportunity and conclude that these concerns may inform a framework for prescribing neuroenhancement but they do not justify limits on prescribing.

  8. Enhancing the ED Approach to Pediatric Sexual Assault Care: Implementation of a Pediatric SART Program

    Science.gov (United States)

    Goyal, MK; Mollen, CJ; Hayes, KL; Molnar, J; Christian, CW; Scribano, PV; Lavelle, J

    2013-01-01

    Objective Describe the experience of a novel pediatric Sexual Assault Response Team (SART) program in the first three years of implementation, and compare patient characteristics, evaluation, and treatment among subpopulations of patients. Methods Retrospective chart review of a consecutive sample of patients evaluated at a pediatric ED who met institutional criteria for a SART evaluation. Associations of evaluation and treatment with gender, menarchal status, and presence of injuries were measured using logistic regression. Results One hundred and eighty-four patients met criteria for SART evaluation, of whom 87.5% were female; mean age was 10.1 years (+/− 4.6 years). The majority of patients underwent forensic evidence collection (89.1%), which varied by menarchal status among females (p<0.01), but not by gender. Evidence of acute anogenital injury on physical exam was found in 20.6% of patients. As per the Center for Disease Control and Prevention guidelines for acute sexual assault evaluations in pediatric patients, menarchal females were more likely to undergo testing for sexually transmitted infections (STI) and pregnancy (p<0.01) and to be offered pregnancy, STI, and HIV prophylaxis (p<0.01). Conclusions In an effort to improve quality and consistency of acute sexual assault examinations in a pediatric ED, development of a SART program supported the majority of eligible patients undergoing forensic evidence collection. Furthermore, a substantial number of patients had evidence of injury on exam. These findings underscore the importance of having properly trained personnel to support ED care for pediatric victims of acute sexual assault. PMID:23974714

  9. Problems and preferences in pediatric imaging

    International Nuclear Information System (INIS)

    Thukral, Brij Bhushan

    2015-01-01

    Radiological imaging is extremely valuable as a diagnostic tool in the pediatric population, but it comes with a number of distinct challenges as compared to the imaging of adults. This is because of the following: It requires dedicated imaging protocols to acquire the images, there is need for sedation or general anesthesia for longer procedures such as MRI, specific training is required for the healthcare personnel involved, thorough knowledge and expertise should be applied for evaluating the images, and most importantly, it requires consideration for radiation exposure if ionizing radiation is being used. One of the challenges for clinical care personnel is to gain the child's trust and co-operation before and throughout the duration of an examination, which can prove to be difficult in children who may be ill and have pain. This is important to acquire quality images and prevent repeat examinations. Even with a quality examination, the accurate interpretation of images requires a thorough knowledge of the intricate and dynamic face of anatomy and specific pathological presentations in children. The increased radiation sensitivity of growing organs and children's longer expected life spans make them more susceptible to the harmful effects of radiation. Imaging pediatric patients in a dedicated pediatric imaging department with dedicated pediatric CT technologists may result in greater compliance with pediatric protocols and significantly reduced patient dose. In order to prevent the harmful effects of ionizing radiation, As Low As Reasonably Achievable (ALARA) principle should be strictly followed. This article seeks to draw attention to various challenges of pediatric imaging and the ways to overcome them

  10. Obesity in pediatric ALL survivors: a meta-analysis.

    Science.gov (United States)

    Zhang, Fang Fang; Kelly, Michael J; Saltzman, Edward; Must, Aviva; Roberts, Susan B; Parsons, Susan K

    2014-03-01

    Previous studies of survivors of pediatric acute lymphoblastic leukemia (ALL) have drawn heterogeneous conclusions regarding the prevalence of obesity and risk factors for developing obesity in pediatric ALL survivors. We sought to determine the prevalence of obesity in pediatric ALL survivors and examine risk factors for obesity through a systematic review and meta-analysis. A MEDLINE search was performed from its inception through 2013. Studies met the inclusion criteria if they (1) included at least 10 survivors of pediatric ALL; (2) assessed the prevalence or indicators of obesity; and (3) compared obesity among ALL survivors to a reference population or external control group. Extracted data included patient and treatment characteristics, study design, population used for comparison, and prevalence of obesity. Forty-seven studies met the inclusion criteria. Despite significant heterogeneity among the studies (I(2) = 96%), the mean BMI z score in 1742 pediatric ALL survivors was 0.83 (95% confidence interval: 0.60-1.06), which corresponds to the 80th BMI percentile, indicating a significantly higher BMI in pediatric ALL survivors than the reference population. Subgroup analyses found a high prevalence of obesity in ALL survivors regardless of survivors' receipt of cranial irradiation, gender, or age at diagnosis. Obesity is prevalent in pediatric ALL survivors and is independent of patient- and treatment-related characteristics. Clinicians need to screen for obesity and its associated health conditions early in survivorship.

  11. Pharmacological management of obesity in pediatric patients.

    Science.gov (United States)

    Boland, Cassie L; Harris, John Brock; Harris, Kira B

    2015-02-01

    To review current evidence of pharmacological options for managing pediatric obesity and provide potential areas for future research. A MEDLINE search (1966 to October 2014) was conducted using the following keywords: exenatide, liraglutide, lorcaserin, metformin, obesity, orlistat, pediatric, phentermine, pramlintide, topiramate, weight loss, and zonisamide. Identified articles were evaluated for inclusion, with priority given to randomized controlled trials with orlistat, metformin, glucagon-like peptide-1 agonists, topiramate, and zonisamide in human subjects and articles written in English. References were also reviewed for additional trials. Whereas lifestyle modification is considered first-line therapy for obese pediatric patients, severe obesity may benefit from pharmacotherapy. Orlistat is the only Food and Drug Administration (FDA)-approved medication for pediatric obesity and reduced body mass index (BMI) by 0.5 to 4 kg/m(2), but gastrointestinal (GI) adverse effects may limit use. Metformin has demonstrated BMI reductions of 0.17 to 1.8 kg/m(2), with mild GI adverse effects usually managed with dose titration. Exenatide reduced BMI by 1.1 to 1.7 kg/m(2) and was well-tolerated with mostly transient or mild GI adverse effects. Topiramate and zonisamide reduced weight when used in the treatment of epilepsy. Future studies should examine efficacy and safety of pharmacological agents in addition to lifestyle modifications for pediatric obesity. Lifestyle interventions remain the treatment of choice in pediatric obesity, but concomitant pharmacotherapy may be beneficial in some patients. Orlistat should be considered as second-line therapy for pediatric obesity. Evidence suggests that other diabetes and antiepileptic medications may also provide weight-loss benefits, but safety should be further evaluated. © The Author(s) 2014.

  12. Management of pediatric splenic injuries in Canada.

    Science.gov (United States)

    McDonald, Lindsay A; Yanchar, Natalie L

    2012-03-01

    Nonoperative management (NOM) of blunt splenic injuries has become the standard of care in hemodynamically stable children. This study compares the management of these injuries between pediatric and nonpediatric hospitals in Canada. Data were obtained from the Canadian Institute of Health Information trauma database on all patients aged 2 to 16 years, admitted to a Canadian hospital with a diagnosis of splenic injury between May 2002 and April 2004. Variables included age, sex, associated major injuries, splenic procedures, intensive care unit (ICU) admissions, blood transfusions, and length of stay. Hospitals were coded as pediatric or nonpediatric. Univariate analysis and logistic regression were used to determine associations between hospital type and outcomes. Of 1284 cases, 654 were managed at pediatric hospitals and 630 at nonpediatric centers. Patients at pediatric centers tended to be younger and more likely to have associated major injuries. Controlling for covariates, including associated major injuries, patients managed at pediatric centers were less likely to undergo splenectomy compared with those managed at nonpediatric centers (odds ratio [OR], 0.2; 95% confidence interval, 0.1-0.4). The risk of receiving blood products, admission to the ICU, and staying in hospital for more than 5 days was associated only with having associated major injuries. Even in the presence of other major injuries, successful NOM of blunt splenic injuries occurs more frequently in pediatric hospitals in Canada. This has policy relevance regarding education of adult surgeons about the appropriateness of NOM in children and developing guidelines on appropriate regional triaging of pediatric patients with splenic injury in Canada. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Challenges in pediatric neuroanesthesia: awake craniotomy, intraoperative magnetic resonance imaging, and interventional neuroradiology.

    Science.gov (United States)

    McClain, Craig D; Landrigan-Ossar, Mary

    2014-03-01

    This article gives a review of 3 challenges in caring for children undergoing neurosurgical and neurointerventional procedures. Anesthesiologists may have experience with certain aspects of these situations but may not have extensive experience with each clinical setting. This review addresses issues with awake craniotomy, intraoperative magnetic resonance imaging, and neurointerventional procedures in children with neurologic disease. Familiarization with these complex clinical scenarios and their unique considerations allows the anesthesiologist to deliver optimal care and helps facilitate the best possible outcome for these patients. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Risk in pediatric anesthesia.

    Science.gov (United States)

    Paterson, Neil; Waterhouse, Peter

    2011-08-01

    Risk in pediatric anesthesia can be conveniently classified as minor or major. Major morbidity includes cardiac arrest, brain damage and death. Minor morbidity can be assessed by clinical audits with small patient samples. Major morbidity is rare. It is best assessed by very large clinical studies and by review of closed malpractice claims. Both minor and major morbidity occur most commonly in infants and children under three, especially those with severe co-morbidities. Knowledge of risk profiles in pediatric anesthesia is a starting point for the reduction of risk. © 2010 Blackwell Publishing Ltd.

  15. Validation of a pediatric early warning system for hospitalized pediatric oncology patients in a resource-limited setting.

    Science.gov (United States)

    Agulnik, Asya; Méndez Aceituno, Alejandra; Mora Robles, Lupe Nataly; Forbes, Peter W; Soberanis Vasquez, Dora Judith; Mack, Ricardo; Antillon-Klussmann, Federico; Kleinman, Monica; Rodriguez-Galindo, Carlos

    2017-12-15

    Pediatric oncology patients are at high risk of clinical deterioration, particularly in hospitals with resource limitations. The performance of pediatric early warning systems (PEWS) to identify deterioration has not been assessed in these settings. This study evaluates the validity of PEWS to predict the need for unplanned transfer to the pediatric intensive care unit (PICU) among pediatric oncology patients in a resource-limited hospital. A retrospective case-control study comparing the highest documented and corrected PEWS score before unplanned PICU transfer in pediatric oncology patients (129 cases) with matched controls (those not requiring PICU care) was performed. Documented and corrected PEWS scores were found to be highly correlated with the need for PICU transfer (area under the receiver operating characteristic, 0.940 and 0.930, respectively). PEWS scores increased 24 hours prior to unplanned transfer (P = .0006). In cases, organ dysfunction at the time of PICU admission correlated with maximum PEWS score (correlation coefficient, 0.26; P = .003), patients with PEWS results ≥4 had a higher Pediatric Index of Mortality 2 (PIM2) (P = .028), and PEWS results were higher in patients with septic shock (P = .01). The PICU mortality rate was 17.1%; nonsurvivors had higher mean PEWS scores before PICU transfer (P = .0009). A single-point increase in the PEWS score increased the odds of mechanical ventilation or vasopressors within the first 24 hours and during PICU admission (odds ratio 1.3-1.4). PEWS accurately predicted the need for unplanned PICU transfer in pediatric oncology patients in this resource-limited setting, with abnormal results beginning 24 hours before PICU admission and higher scores predicting the severity of illness at the time of PICU admission, need for PICU interventions, and mortality. These results demonstrate that PEWS aid in the identification of clinical deterioration in this high-risk population, regardless of a hospital

  16. Pediatric Cushing′s disease: Management Issues

    Directory of Open Access Journals (Sweden)

    Martin O Savage

    2012-01-01

    Full Text Available Cushing′s disease (CD, caused by an ACTH-secreting pituitary corticotroph adenoma, is the commonest cause of Cushing syndrome in children over 5 years of age. It is rare in the pediatric age range and presents difficult diagnostic and therapeutic challenges. Key presenting features include weight gain, growth failure and change in facial appearance. Most pediatric endocrinologists have limited experience managing children or adolescents with CD and thus benefit from close consultation with adult colleagues. We describe a diagnostic protocol which broadly follows the model for adult patients. Treatment strategies are examined and appraised. The management of pediatric CD patients after cure is also discussed.

  17. Pediatric AIDS | Khazbak | Egyptian Journal of Pediatric Allergy and ...

    African Journals Online (AJOL)

    Egyptian Journal of Pediatric Allergy and Immunology (The). Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 2, No 1 (2004) >. Log in or Register to get access to full text downloads.

  18. Management of Pediatric Mandibular Fracture Using Orthodontic ...

    African Journals Online (AJOL)

    2017-05-22

    May 22, 2017 ... The pediatric patient is a challenge to manage and ... and osteosynthesis of the pediatric fracture with titanium ... impression material and surgical model prepared with ... circum-mandibular wire were removed under local.

  19. Pediatric Obesity: Etiology and Treatment

    OpenAIRE

    Crocker, Melissa K.; Yanovski, Jack A.

    2009-01-01

    This paper reviews factors that contribute to excessive weight gain in children and outlines current knowledge regarding approaches for treating pediatric obesity. Virtually all of the known genetic causes of obesity primarily increase energy intake. Genes regulating the leptin signaling pathway are particularly important for human energy homeostasis. Obesity is a chronic disorder that requires long-term strategies for management. The foundation for all treatments for pediatric obesity remain...

  20. Pediatric tracheostomy.

    Science.gov (United States)

    Campisi, Paolo; Forte, Vito

    2016-06-01

    Tracheotomy refers to a surgical incision made into a trachea. Tracheostomy, on the other hand, refers to a surgical procedure whereby the tracheal lumen is positioned in close proximity to the skin surface. Tracheostomy is an uncommon procedure in the pediatric population. When required tracheostomy is typically performed as an open surgical procedure under general anesthesia with the patient intubated. However, it may need to be performed under local anesthesia or over a rigid bronchoscope in the patient with a precarious airway. Over the past half century, the primary indication for pediatric tracheostomy has shifted from acute infectious airway compromise to the need for prolonged ventilatory support in neurologically compromised children. The surgical technique, choice of tracheostomy tube, and post-operative care requires a nuanced approach in infants and young children. This article will review these topics in a comprehensive fashion. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Recent advances in pediatric interventional cardiology.

    Science.gov (United States)

    Kim, Seong-Ho

    2017-08-01

    During the last 10 years, there have been major technological achievements in pediatric interventional cardiology. In addition, there have been several advances in cardiac imaging, especially in 3-dimensional imaging of echocardiography, computed tomography, magnetic resonance imaging, and cineangiography. Therefore, more types of congenital heart diseases can be treated in the cardiac catheter laboratory today than ever before. Furthermore, lesions previously considered resistant to interventional therapies can now be managed with high success rates. The hybrid approach has enabled the overcoming of limitations inherent to percutaneous access, expanding the application of endovascular therapies as adjunct to surgical interventions to improve patient outcomes and minimize invasiveness. Percutaneous pulmonary valve implantation has become a successful alternative therapy. However, most of the current recommendations about pediatric cardiac interventions (including class I recommendations) refer to off-label use of devices, because it is difficult to study the safety and efficacy of catheterization and transcatheter therapy in pediatric cardiac patients. This difficulty arises from the challenge of identifying a control population and the relatively small number of pediatric patients with congenital heart disease. Nevertheless, the pediatric interventional cardiology community has continued to develop less invasive solutions for congenital heart defects to minimize the need for open heart surgery and optimize overall outcomes. In this review, various interventional procedures in patients with congenital heart disease are explored.

  2. The Current Landscape of US Pediatric Anesthesiologists: Demographic Characteristics and Geographic Distribution.

    Science.gov (United States)

    Muffly, Matthew K; Muffly, Tyler M; Weterings, Robbie; Singleton, Mark; Honkanen, Anita

    2016-07-01

    There is no comprehensive database of pediatric anesthesiologists, their demographic characteristics, or geographic location in the United States. We endeavored to create a comprehensive database of pediatric anesthesiologists by merging individuals identified as US pediatric anesthesiologists by the American Board of Anesthesiology, National Provider Identifier registry, Healthgrades.com database, and the Society for Pediatric Anesthesia membership list as of November 5, 2015. Professorial rank was accessed via the Association of American Medical Colleges and other online sources. Descriptive statistics characterized pediatric anesthesiologists' demographics. Pediatric anesthesiologists' locations at the city and state level were geocoded and mapped with the use of ArcGIS Desktop 10.1 mapping software (Redlands, CA). We identified 4048 pediatric anesthesiologists in the United States, which is approximately 8.8% of the physician anesthesiology workforce (n = 46,000). The median age of pediatric anesthesiologists was 49 years (interquartile range, 40-57 years), and the majority (56.4%) were men. Approximately two-thirds of identified pediatric anesthesiologists were subspecialty board certified in pediatric anesthesiology, and 33% of pediatric anesthesiologists had an identified academic affiliation. There is substantial heterogeneity in the geographic distribution of pediatric anesthesiologists by state and US Census Division with urban clustering. This description of pediatric anesthesiologists' demographic characteristics and geographic distribution fills an important gap in our understanding of pediatric anesthesia systems of care.

  3. The Simulation-Based Assessment of Pediatric Rapid Response Teams.

    Science.gov (United States)

    Fehr, James J; McBride, Mary E; Boulet, John R; Murray, David J

    2017-09-01

    To create scenarios of simulated decompensating pediatric patients to train pediatric rapid response teams (RRTs) and to determine whether the scenario scores provide a valid assessment of RRT performance with the hypothesis that RRTs led by intensivists-in-training would be better prepared to manage the scenarios than teams led by nurse practitioners. A set of 10 simulated scenarios was designed for the training and assessment of pediatric RRTs. Pediatric RRTs, comprising a pediatric intensive care unit (PICU) registered nurse and respiratory therapist, led by a PICU intensivist-in-training or a pediatric nurse practitioner, managed 7 simulated acutely decompensating patients. Two raters evaluated the scenario performances and psychometric analyses of the scenarios were performed. The teams readily managed scenarios such as supraventricular tachycardia and opioid overdose but had difficulty with more complicated scenarios such as aortic coarctation or head injury. The management of any particular scenario was reasonably predictive of overall team performance. The teams led by the PICU intensivists-in-training outperformed the teams led by the pediatric nurse practitioners. Simulation provides a method for RRTs to develop decision-making skills in managing decompensating pediatric patients. The multiple scenario assessment provided a moderately reliable team score. The greater scores achieved by PICU intensivist-in-training-led teams provides some evidence to support the validity of the assessment. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Aortic Involvement in Pediatric Marfan syndrome: A Review.

    Science.gov (United States)

    Ekhomu, Omonigho; Naheed, Zahra J

    2015-06-01

    Outlining specific protocols for the management of pediatric patients with Marfan syndrome has been challenging. This is mostly due to a dearth of clinical studies performed in pediatric patients. In Marfan syndrome, the major sources of morbidity and mortality relate to the cardiovascular system. In this review, we focus on aortic involvement seen in pediatric patients with Marfan syndrome, ranging from aortic dilatation to aortic rupture and heart failure. We discuss the histological, morphological, and pathogenetic basis of the cardiac manifestations seen in pediatric Marfan syndrome and use a specific case to depict our experienced range of cardiovascular manifestations. The survival for patients with Marfan syndrome may approach the expected survival for non-affected patients, with optimal management. With this potentiality in mind, we explore possible and actual management considerations for pediatric Marfan syndrome, examining both medical and surgical therapy modalities that can make the possibility of improved survival a reality.

  5. The power of stories in Pediatrics and Genetics.

    Science.gov (United States)

    Opitz, John M; Pavone, Lorenzo; Corsello, Giovanni

    2016-04-05

    On the occasion of the opening ceremony of the 43rd Sicilian Congress of Pediatrics, linked with Italian Society of Pediatrics SIP, SIN, SIMEUP, SIAIP and SINP, held in Catania in November 2015, the Organizing Committee dedicated a tribute to Professor John Opitz and invited him to give a Masters Lecture for the attendees at the Congress. The theme expounded was "Storytelling in Pediatrics and Genetics: Lessons from Aesop and from Mendel". The contribution of John Opitz to the understanding of pediatric clinical disorders and genetic anomalies has been extremely relevant. The interests of Professor John Opitz are linked not only to genetic disorders but also extend to historical medicine, history of the literature and to human evolution. Due to his exceptional talent, combined with his specific interest and basal knowledge in the genetic and pediatric fields, he is widely credited to be one of the best pediatricians in the world.

  6. Comparative audit of clinical research in pediatric neurology.

    Science.gov (United States)

    Al-Futaisi, Amna; Shevell, Michael

    2004-11-01

    Clinical research involves direct observation or data collection on human subjects. This study was conducted to evaluate the profile of pediatric neurology clinical research over a decade. Trends in pediatric neurology clinical research were documented through a systematic comparative review of articles published in selected journals. Eleven journals (five pediatric neurology, three general neurology, three general pediatrics) were systematically reviewed for articles involving a majority of human subjects less than 18 years of age for the years 1990 and 2000. Three hundred thirty-five clinical research articles in pediatric neurology were identified in the 11 journals for 1990 and 398 for 2000, a 19% increase. A statistically significant increase in analytic design (21.8% vs 39.5%; P = .01), statistical support (6% vs 16.6%; P neurology over a decade. Trends apparently suggest a more rigorous approach to study design and investigation in this field.

  7. Canadian pediatric gastroenterology workforce: Current status, concerns and future projections

    Science.gov (United States)

    Morinville, Véronique; Drouin, Éric; Lévesque, Dominique; Espinosa, Victor M; Jacobson, Kevan

    2007-01-01

    BACKGROUND: There is concern that the Canadian pediatric gastroenterology workforce is inadequate to meet health care demands of the pediatric population. The Canadian Association of Gastroenterology Pediatric Committee performed a survey to determine characteristics and future plans of the Canadian pediatric gastroenterology workforce and trainees. METHODS: Estimates of total and pediatric populations were obtained from the 2001 Census of Population, Statistics Canada (with estimates to July 1, 2005). Data on Canadian pediatric gastroenterologists, including clinical full-time equivalents, sex, work interests, opinions on workforce adequacy, retirement plans, fellowship training programs and future employment plans of fellows, were gathered through e-mail surveys and telephone correspondence in 2005 and 2006. RESULTS: Canada had an estimated population of 32,270,507 in 2005 (6,967,853 people aged zero to 17 years). The pediatric gastroenterology workforce was estimated at 9.2 specialists per million children. Women accounted for 50% of the workforce. Physician to pediatric population ratios varied, with Alberta demonstrating the highest and Saskatchewan the lowest ratios (1:69,404 versus 1:240,950, respectively). Between 1998 and 2005, Canadian pediatric gastroenterology fellowship programs trained 65 fellows (65% international trainees). Twenty-two fellows (34%) entered the Canadian workforce. CONCLUSIONS: The survey highlights the variable and overall low numbers of pediatric gastroenterologists across Canada, an increasingly female workforce, a greater percentage of part-time physicians and a small cohort of Canadian trainees. In conjunction with high projected retirement rates, greater demands on the work-force and desires to partake in nonclinical activities, there is concern for an increasing shortage of pediatric gastroenterologists in Canada in future years. PMID:17948136

  8. Dexmedetomidine in the pediatric population

    DEFF Research Database (Denmark)

    Plambech, Morten; Afshari, A

    2015-01-01

    Dexmedetomidine, an alpha-2 agonist approved only for sedation in adult intensive care patients, is increasingly used off-label in- and outside Europe in the pediatric setting for various indications such as to prevent agitation, as premedication in the form of intranasal, buccal and oral solution...... of sedation of children. In this paper, we assess 51 minor trials in the form of 44 randomized controlled trials and 7 prospective observational studies in an attempt to update the available evidence on dexmedetomidine use in pediatrics. Furthermore, we discuss its potential indications, benefits and adverse....... Based on the best current evidence dexmedetomidine is found suitable and safe for various indications. However, in order to discover its full potential, indications, dosing and safety profile for various ages and procedures, it should urgently be examined by conducting good quality pediatric trials...

  9. Pediatric procedural sedation and analgesia

    Directory of Open Access Journals (Sweden)

    Meredith James

    2008-01-01

    Full Text Available Procedural sedation and analgesia (PSA is an evolving field in pediatric emergency medicine. As new drugs breach the boundaries of anesthesia in the Pediatric Emergency Department, parents, patients, and physicians are finding new and more satisfactory methods of sedation. Short acting, rapid onset agents with little or no lingering effects and improved safety profiles are replacing archaic regimens. This article discusses the warning signs and areas of a patient′s medical history that are particularly pertinent to procedural sedation and the drugs used. The necessary equipment is detailed to provide the groundwork for implementing safe sedation in children. It is important for practitioners to familiarize themselves with a select few of the PSA drugs, rather than the entire list of sedatives. Those agents most relevant to PSA in the pediatric emergency department are presented.

  10. Obesity in pediatric trauma.

    Science.gov (United States)

    Witt, Cordelie E; Arbabi, Saman; Nathens, Avery B; Vavilala, Monica S; Rivara, Frederick P

    2017-04-01

    The implications of childhood obesity on pediatric trauma outcomes are not clearly established. Anthropomorphic data were recently added to the National Trauma Data Bank (NTDB) Research Datasets, enabling a large, multicenter evaluation of the effect of obesity on pediatric trauma patients. Children ages 2 to 19years who required hospitalization for traumatic injury were identified in the 2013-2014 NTDB Research Datasets. Age and gender-specific body mass indices (BMI) were calculated. Outcomes included injury patterns, operative procedures, complications, and hospital utilization parameters. Data from 149,817 pediatric patients were analyzed; higher BMI percentiles were associated with significantly more extremity injuries, and fewer injuries to the head, abdomen, thorax and spine (p values Obese children also had significantly longer lengths of stay and more frequent ventilator requirement. Among children admitted after trauma, increased BMI percentile is associated with increased risk of death and potentially preventable complications. These findings suggest that obese children may require different management than nonobese counterparts to prevent complications. Level III; prognosis study. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Report of the 10th Biennial conference of Pan African Pediatric ...

    African Journals Online (AJOL)

    Keywords: congress, Egyptian Pediatric Surgical Association, Pan African. Pediatric Surgical Association, report. Department of Surgery, Pediatric surgery unit, Faculty of Medicine, Tanta. University, Tanta, Egypt. Correspondence to Essam Elhalaby, MD, Division of Pediatric Surgery,. Faculty of Medicine, Tanta University, ...

  12. Pediatric Supportive Care (PDQ®)—Patient Version

    Science.gov (United States)

    Pediatric supportive care is an important aspect of cancer care as children and adolescents face unique challenges compared to adult patients. Learn more about supportive care for pediatric patients during and after treatment in this expert-reviewed summary.

  13. Role of ERCP in pediatric blunt abdominal trauma: a case series at a level one pediatric trauma center.

    Science.gov (United States)

    Garvey, Erin M; Haakinson, Danielle J; McOmber, Mark; Notrica, David M

    2015-02-01

    There is no consensus regarding the appropriate use of endoscopic retrograde cholangiopancreatography (ERCP) in pediatric trauma. We report our experience with ERCP for management of pediatric pancreatic and biliary injury following blunt abdominal trauma. A retrospective chart review was performed for pediatric patients with blunt abdominal trauma from July 2008 through December 2012 at our pediatric trauma center. For patients who underwent ERCP, demographics, injury characteristics, diagnostic details, procedures performed, length of stay, total parenteral nutrition use, and complications were reviewed. There were 532 patients identified: 115 hepatic injuries, 25 pancreatic injuries and one gall bladder injury. Nine patients (mean age 7.8 years) underwent ERCP. Seven (78%) had pancreatic injuries, while two (22%) had bilateral hepatic duct injuries. The median time to diagnosis was one day (range, 0-12). Diagnostic ERCP only was performed in three patients, two of which proceeded to distal pancreatectomy. Five patients had stents placed (two biliary and three pancreatic) and four sphincterotomies were performed. Despite pancreatic stenting, one patient required distal pancreatectomy for persistent leak. Median length of stay was 11 days. Pediatric pancreatic and biliary ductal injuries following blunt abdominal trauma are uncommon. ERCP can safely provide definitive treatment for some patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Pediatric burn rehabilitation: Philosophy and strategies

    Directory of Open Access Journals (Sweden)

    Shohei Ohgi

    2013-09-01

    Full Text Available Burn injuries are a huge public health issue for children throughout the world, with the majority occurring in developing countries. Burn injuries can leave a pediatric patient with severely debilitating and deforming contractures, which can lead to significant disability when left untreated. Rehabilitation is an essential and integral part of pediatric burn treatment. The aim of this article was to review the literature on pediatric burn rehabilitation from the Medline, CINAHL, and Web of Science databases. An attempt has been made to present the basic aspects of burn rehabilitation, provide practical information, and discuss the goals and conceptualization of rehabilitation as well as the development of rehabilitation philosophy and strategies.

  15. The role of simulation in teaching pediatric resuscitation: current perspectives

    Directory of Open Access Journals (Sweden)

    Lin Y

    2015-03-01

    Full Text Available Yiqun Lin,1 Adam Cheng2 1KidSIM-ASPIRE Simulation Research Program, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada; 2KidSIM-ASPIRE Research Program, Department of Pediatrics, Division of Emergency Medicine, University of Calgary, Alberta Children's Hospital, Calgary, AB, Canada Abstract: The use of simulation for teaching the knowledge, skills, and behaviors necessary for effective pediatric resuscitation has seen widespread growth and adoption across pediatric institutions. In this paper, we describe the application of simulation in pediatric resuscitation training and review the evidence for the use of simulation in neonatal resuscitation, pediatric advanced life support, procedural skills training, and crisis resource management training. We also highlight studies supporting several key instructional design elements that enhance learning, including the use of high-fidelity simulation, distributed practice, deliberate practice, feedback, and debriefing. Simulation-based training is an effective modality for teaching pediatric resuscitation concepts. Current literature has revealed some research gaps in simulation-based education, which could indicate the direction for the future of pediatric resuscitation research. Keywords: simulation, pediatric resuscitation, medical education, instructional design, crisis resource management, health care

  16. Serum tumor markers in pediatric osteosarcoma: a summary review

    Directory of Open Access Journals (Sweden)

    Savitskaya Yulia A

    2012-03-01

    Full Text Available Abstract Osteosarcoma is the most common primary high-grade bone tumor in both adolescents and children. Early tumor detection is key to ensuring effective treatment. Serum marker discovery and validation for pediatric osteosarcoma has accelerated in recent years, coincident with an evolving understanding of molecules and their complex interactions, and the compelling need for improved pediatric osteosarcoma outcome measures in clinical trials. This review gives a short overview of serological markers for pediatric osteosarcoma, and highlights advances in pediatric osteosarcoma-related marker research within the past year. Studies in the past year involving serum markers in patients with pediatric osteosarcoma can be assigned to one of four categories, i.e., new approaches and new markers, exploratory studies in specialized disease subsets, large cross-sectional validation studies, and longitudinal studies, with and without an intervention. Most of the studies have examined the association of a serum marker with some aspect of the natural history of pediatric osteosarcoma. As illustrated by the many studies reviewed, several serum markers are emerging that show a credible association with disease modification. The expanding pool of informative osteosarcoma-related markers is expected to impact development of therapeutics for pediatric osteosarcoma positively and, it is hoped, ultimately clinical care. Combinations of serum markers of natural immunity, thyroid hormone homeostasis, and bone tumorigenesis may be undertaken together in patients with pediatric osteosarcoma. These serum markers in combination may do better. The potential effect of an intrinsic dynamic balance of tumor angiogenesis residing within a single hormone (tri-iodothyronine is an attractive concept for regulation of vascularization in pediatric osteosarcoma.

  17. Transition from Pediatric to Adult OI Care

    Science.gov (United States)

    Moving from Pediatric to Adult Care Introduction Teen and young adult years are a critical time for major life changes. An ... for youth who have OI is moving from pediatric care into the adult care system. Children’s hospitals ...

  18. Pediatric cardiac emergencies: Children are not small adults

    Directory of Open Access Journals (Sweden)

    Frazier Aisha

    2011-01-01

    Full Text Available Compared with adults, cardiac emergencies are infrequent in children and clinical presentation is often quite variable. In adults, cardiac emergencies are most commonly related to complications of coronary artery disease; however, in pediatric cases, the coronaries are only rarely the underlying problem. Pediatric cardiac emergencies comprise a range of pathology including but not limited to undiagnosed congenital heart disease in the infant; complications of palliated congenital heart disease in children; arrhythmias related to underlying cardiac pathology in the teenager and acquired heart disease. The emergency room physician and pediatric intensivist will usually be the first and second lines of care for pediatric cardiac emergencies and thus it is imperative that they have knowledge of the diverse presentations of cardiac disease in order to increase the likelihood of delivering early appropriate therapy and referral. The objective of this review is to outline cardiac emergencies in the pediatric population and contrast the presentation with adults.

  19. Pediatric radiology for medical-technical radiology assistants/radiologists

    International Nuclear Information System (INIS)

    Oppelt, Birgit

    2010-01-01

    The book on pediatric radiology includes the following chapter: differences between adults and children; psycho-social aspects concerning the patient child in radiology; relevant radiation doses in radiology; help for self-help: simple phantoms for image quality estimation in pediatric radiology; general information; immobilization of the patient; pediatric features for radiological settings; traumatology; contrast agents; biomedical radiography; computerized tomography; NMR imaging; diagnostic ultrasonography; handling of stress practical recommendations; medical displays.

  20. Safe intravenous administration in pediatrics: A 5-year Pediatric Intensive Care Unit experience with smart pumps.

    Science.gov (United States)

    Manrique-Rodríguez, S; Sánchez-Galindo, A C; Fernández-Llamazares, C M; Calvo-Calvo, M M; Carrillo-Álvarez, Á; Sanjurjo-Sáez, M

    2016-10-01

    To estimate the impact of smart pump implementation in a pediatric intensive care unit in terms of number and type of administration errors intercepted. Observational, prospective study carried out from January 2010 to March 2015 with syringe and great volumen infusion pumps available in the hospital. A tertiary level hospital pediatric intensive care unit. Infusions delivered with infusion pumps in all pediatric intensive care unit patients. Design of a drug library with safety limits for all intravenous drugs prescribed. Users' compliance with drug library as well as number and type of errors prevented were analyzed. Two hundred and eighty-three errors were intercepted during 62 months of study. A high risk drug was involved in 58% of prevented errors, such as adrenergic agonists and antagonists, sedatives, analgesics, neuromuscular blockers, opioids, potassium and insulin. Users' average compliance with the safety software was 84%. Smart pumps implementation has proven effective in intercepting high risk drugs programming errors. These results might be exportable to other critical care units, involving pediatric or adult patients. Interdisciplinary colaboration is key to succeed in this process. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  1. New directions in pediatric digital imaging

    International Nuclear Information System (INIS)

    Fletcher, B.D.; Adams, R.B.; Blackham, W.C.

    1985-01-01

    In this chapter the authors describe several simple experiments performed utilizing digital equipment which apply to clinical situations in pediatrics and which suggest future directions for research in digital imaging. They also discuss experimental systems which they believe will overcome certain limitations of current equipment and might be applicable to pediatric digital imaging in the future

  2. Optimization of electronic prescribing in pediatric patients

    NARCIS (Netherlands)

    Maat, B.

    2014-01-01

    Improving pediatric patient safety by preventing medication errors that may result in adverse drug events and consequent healthcare expenditure,is a worldwide challenge to healthcare. In pediatrics, reported medication error rates in general, and prescribing error rates in particular, vary between

  3. Practice Patterns and Projections for the US Pediatric Otolaryngology Workforce.

    Science.gov (United States)

    Bell, Jason R; Ruch-Ross, Holly; Hotaling, Andrew J

    2016-09-01

    This study represents up-to-date information on the current status of and future projections for the pediatric otolaryngology workforce. To provide an update on the practice patterns of and projections for the US pediatric otolaryngology workforce. An online survey was sent to all 172 members of the American Academy of Pediatrics Section on Otolaryngology-Head and Neck Surgery and fielded from May 29, 2014, to September 17, 2014. Current status of and perceived trends in the pediatric otolaryngology workforce. Eighty-four (48.8%) of the 172 members responded to the survey. Not all respondents answered all questions, and so totals and percentages might not reflect a total of 84 for any given response. The demographics and practice characteristics of the responding pediatric otolaryngologists were similar to those noted in a 1997 workforce survey. Fifty-four percent of respondents (n = 38) planned to continue full-time work over the next 5 years, and 47% (n = 31) believed that the number of patients in their practice was increasing. The proportion of those who believed that the need for pediatric otolaryngologists in their community was increasing (31%; n = 21) or decreasing (13%; n = 9) remained relatively constant from the 1997 survey (34% and 12%, respectively). Forty-nine percent (n = 35) reported believing that the number of pediatric otolaryngologists being trained was appropriate and that the need in their community was stable. Eighty-three percent (n = 55) reported believing that employment opportunities for pediatric otolaryngologists in the United States would be plentiful in the near future. The overall state of the pediatric otolaryngology workforce appears stable. The perceived current and future needs for pediatric otolaryngologists appear to be met by the current number of trainees. Employment opportunities appear promising for future pediatric otolaryngologists based on our respondents' opinions. This represents up

  4. Correlates of Pediatric CPAP Adherence

    Science.gov (United States)

    Hawkins, Stephen M.M.; Jensen, Emily L.; Simon, Stacey L.; Friedman, Norman R.

    2016-01-01

    Study Objectives: Obstructive sleep apnea (OSA) is a common pediatric condition characterized by recurrent partial or complete cessation of airflow during sleep, typically due to inadequate upper airway patency. Continuous positive airway pressure (CPAP) is a therapeutic option that reduces morbidity. Despite efforts to promote use, CPAP adherence is poor in both pediatric and adult populations. We sought to determine whether demographics, insurance status, OSA severity, therapeutic pressure, or comorbid conditions were associated with pediatric CPAP adherence. Methods: A retrospective review of adherence download data was performed on all pediatric patients with initiation or adjustment of CPAP treatment over a one-year period with documented in-laboratory CPAP titration. Patients were grouped as CPAP adherent or non-adherent, where adherence was defined as > 70% nightly use and average usage ≥ 4 hours per night. Differences between the groups were analyzed by χ2 test. Results: Overall, nearly half of participants were CPAP adherent (49%, 69/140). Of the demographic data collected (age, ethnicity, sex, insurance status), only female sex was associated with better adherence (60.9% vs 39.5% of males adherent; odds ratio [OR] = 2.41, 95%CI = 1.20–4.85; p = 0.01). Severity of OSA (diagnostic apnea-hypopnea index [AHI] and degree of hypoxemia), therapeutic pressure, and residual AHI did not impact CPAP adherence (p > 0.05). Patients with developmental delay (DD) were more likely to be adherent with CPAP than those without a DD diagnosis (OR = 2.55, 95%CI = 1.27–5.13; p = 0.007). Female patients with trisomy 21 tended to be more adherent, but this did not reach significance or account for the overall increased adherence associated with female sex. Conclusions: Our study demonstrates that adherence to CPAP therapy is poor but suggests that female sex and developmental delay are associated with better adherence. These findings support efforts to understand the

  5. Social Media in Pediatric Orthopaedics.

    Science.gov (United States)

    Lander, Sarah T; Sanders, James O; Cook, Peter C; O'Malley, Natasha T

    Internet searches and social media utilization in health care has exploded over the past 5 years, and patients utilize it to gain information on their health conditions and physicians. Social media has the potential to serve as a means for education, communication, and marketing in all health care specialties. Physicians are sometimes reluctant to engage because of concerns of privacy, litigation, and lack of experience with this modality. Many surgical subspecialties have capitalized on social media but no study to date has examined the specific footprint of pediatric orthopaedic surgeons in this realm. We aim to quantify the utilization of individual social media platforms by pediatric orthopaedic surgeons, and identify any differences between private and hospital-based physicians, but also regional differences. Using the Pediatric Orthopaedic Society of North America Member Directory, each active member's social media presence was reviewed through an Internet search. Members were stratified on the basis of practice model and geographic location. Individual Internet searches, social media sites, and number of publications were reviewed for social media presence. Of 987 Pediatric Orthopaedic Society of North America members, 95% had a professional webpage, 14.8% a professional Facebook page, 2.2% a professional Twitter page, 36.8% a LinkedIn profile, 25.8% a ResearchGate profile, 33% at least 1 YouTube. Hospital-based physicians had a lower mean level of utilization of social media compared with their private practice peers, and a higher incidence of Pubmed publications. Private practice physicians had double the social media utilization. Regional differences reveal that practicing Pediatric Orthopaedists in the Northeast had increased utilization of ResearchGate and LinkedIn and the West had the lowest mean social media utilization levels. The rapid expansion of social media usage by patients and their family members is an undeniable force affecting the health

  6. Demand in pediatric dentistry for sedation and general anesthesia by dentist anesthesiologists: a survey of directors of dentist anesthesiologist and pediatric dentistry residencies.

    Science.gov (United States)

    Hicks, C Gray; Jones, James E; Saxen, Mark A; Maupome, Gerardo; Sanders, Brian J; Walker, Laquia A; Weddell, James A; Tomlin, Angela

    2012-01-01

    This study describes what training programs in pediatric dentistry and dental anesthesiology are doing to meet future needs for deep sedation/general anesthesia services required for pediatric dentistry. Residency directors from 10 dental anesthesiology training programs in North America and 79 directors from pediatric dentistry training programs in North America were asked to answer an 18-item and 22-item online survey, respectively, through an online survey tool. The response rate for the 10 anesthesiology training program directors was 9 of 10 or 90%. The response rate for the 79 pediatric dentistry training program directors was 46 of 79 or 58%. Thirty-seven percent of pediatric dentistry programs use clinic-based deep sedation/general anesthesia for dental treatment in addition to hospital-based deep sedation/general anesthesia. Eighty-eight percent of those programs use dentist anesthesiologists for administration of deep sedation/general anesthesia in a clinic-based setting. Pediatric dentistry residency directors perceive a future change in the need for deep sedation/general anesthesia services provided by dentist anesthesiologists to pediatric dentists: 64% anticipate an increase in need for dentist anesthesiologist services, while 36% anticipate no change. Dental anesthesiology directors compared to 2, 5, and 10 years ago have seen an increase in the requests for dentist anesthesiologist services by pediatric dentists reported by 56% of respondents (past 2 years), 63% of respondents (past 5 years), and 88% of respondents (past 10 years), respectively. Predicting the future need of dentist anesthesiologists is an uncertain task, but these results show pediatric dentistry directors and dental anesthesiology directors are considering the need, and they recognize a trend of increased need for dentist anesthesiologist services over the past decade.

  7. Cognitive dysfunction in pediatric multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Suppiej A

    2014-07-01

    Full Text Available Agnese Suppiej,1 Elisa Cainelli1,2 1Child Neurology and Clinical Neurophysiology, Pediatric University Hospital, Padua, Italy; 2Lifespan Cognitive Neuroscience Laboratory (LCNL, Department of General Psychology, University of Padua, Italy Abstract: Cognitive and neuropsychological impairments are well documented in adult ­multiple sclerosis (MS. Research has only recently focused on cognitive disabilities in pediatric cases, highlighting some differences between pediatric and adult cases. Impairments in several functions have been reported in children, particularly in relation to attention, processing speed, visual–motor skills, and language. Language seems to be particularly vulnerable in pediatric MS, unlike in adults in whom it is usually preserved. Deficits in executive functions, which are considered MS-specific in adults, have been inconsistently reported in children. In children, as compared to adults, the relationship between cognitive dysfunctions and the two other main symptoms of MS, fatigue and psychiatric disorders, was poorly explored. Furthermore, data on the correlations of cognitive impairments with clinical and neuroimaging features are scarce in children, and the results are often incongruent; interestingly, involvement of corpus callosum and reduced thalamic volume differentiated patients identified as having a cognitive impairment from those without a cognitive impairment. Further studies about pediatric MS are needed in order to better understand the impact of the disease on brain development and the resulting effect on cognitive functions, particularly with respect to different therapeutic strategies. Keywords: central nervous system, child, deficit, IQ, inflammatory demyelination, neuropsychological

  8. Leadership trends in academic pediatric departments.

    Science.gov (United States)

    Stapleton, F Bruder; Jones, Douglas; Fiser, Debra H

    2005-08-01

    To examine recent turnover trends among chairs of academic pediatric departments. Membership data for the 150 institutions represented by the Association of Medical School Pediatric Department Chairs in the United States, Canada, and Puerto Rico were reviewed for the time period of 1993-2003. From 1993 to 2003, 278 individuals (250 men and 28 women) held the position of chair. The mean time of service was 5.58 +/- 3.2 years (median: 5 years). Twenty-nine individuals served continuously as chairs during the 11-year period. Seventy-two individuals served as interim chairs. Twenty-eight women were appointed either chairs or interim chairs during the 11 years. The number of female chairs decreased from 13 in 1993 to 11 in 2003. Female chairs were in office 3.42 +/- 2.72 years. A total of 123 departments had a change in leadership, with a mean annual turnover rate of 17% (range: 4.6-24%). Three departments had 5 different leaders as either interim chair or chair and 6 departments had 4 different leaders during this time period. Neonatology was the most common subspecialty represented by recent pediatric chairs, although nephrology was the subspecialty with the greatest proportional representation. Departments of pediatrics have high turnover of leadership. Women, in particular, serve for relatively short periods and appear to be under-represented within the leadership of pediatrics. Efforts should be made to ascertain personal qualities that allow sustained leadership and to attract more women into leadership positions.

  9. Summary of the NICHD-BPCA Pediatric Formulation Initiatives Workshop-Pediatric Biopharmaceutics Classification System (PBCS) Working Group

    OpenAIRE

    Abdel-Rahman, Susan; Amidon, Gordon L.; Kaul, Ajay; Lukacova, Viera; Vinks, Alexander A.; Knipp, Gregory

    2012-01-01

    The Biopharmaceutics Classification System (BCS) allows compounds to be classified based on their in vitro solubility and intestinal permeability. The BCS has found widespread use in the pharmaceutical community as an enabling guide for the rational selection of compounds, formulation for clinical advancement and generic biowaivers. The Pediatric Biopharmaceutics Classification System (PBCS) working group was convened to consider the possibility of developing an analogous pediatric based clas...

  10. Pediatrics in the year 2020 and beyond: preparing for plausible futures.

    Science.gov (United States)

    Starmer, Amy J; Duby, John C; Slaw, Kenneth M; Edwards, Anne; Leslie, Laurel K

    2010-11-01

    Although the future of pediatrics is uncertain, the organizations that lead pediatrics, and the professionals who practice within it, have embraced the notion that the pediatric community must anticipate and lead change to ultimately improve the health of children and adolescents. In an attempt to proactively prepare for a variety of conceivable futures, the board of directors of the American Academy of Pediatrics established the Vision of Pediatrics 2020 Task Force in 2008. This group was charged to think broadly about the future of pediatrics, to gather input on key trends that are influencing the future, to create likely scenarios of the future, and to recommend strategies to best prepare pediatric clinicians and pediatric organizations for a range of potential futures. The work of this task force led to the development of 8 "megatrends" that were identified as highly likely to have a profound influence on the future of pediatrics. A separate list of "wild-card" scenarios was created of trends with the potential to have a substantial influence but are less likely to occur. The process of scenario-planning was used to consider the effects of the 8 megatrends on pediatrics in the year 2020 and beyond. Consideration of these possible scenarios affords the opportunity to determine potential future pediatric needs, to identify potential solutions to address those needs, and, ultimately, to proactively prepare the profession to thrive if these or other future scenarios become realities.

  11. Pediatric obesity & type 2 diabetes.

    Science.gov (United States)

    Dea, Tara L

    2011-01-01

    This article focuses on (a) identifying obesity and other risk factors for developing type 2 diabetes, (b) differentiating between pediatric type 1 diabetes and type 2 diabetes, and (c) treating pediatric type 2 diabetes. Obesity has significant implications on a child's health, including an increased risk for insulin resistance and progression to type 2 diabetes. Type 2 diabetes in children, characterized by insulin resistance and relative pancreatic b-cell failure due to the increased demand for insulin production, has now reached epidemic proportions. Longitudinal research on pediatric type 2 diabetes, however, is lacking because this epidemic is relatively new. Treatment of type 2 diabetes in children is focused on lifestyle modification with weight management/increased physical activity, and pharmacological management through oral medication or insulin therapy. Because children with type 2 diabetes are at risk for developing diabetes-related complications earlier in life, they need to be closely monitored for comorbidities.

  12. Pediatric hospitalists and medical education.

    Science.gov (United States)

    Ottolini, Mary C

    2014-07-01

    Pediatric hospital medicine (PHM) is moving toward becoming an American Board of Pediatrics (ABP) subspecialty, roughly a decade after its formal inception in 2003. Education has played a central role as the field has evolved. Hospitalists are needed to educate trainees, medical students, residents, fellows, and nurse practitioner and physician assistant students in inpatient pediatric practice. Continuous professional development is needed for hospitalists currently in practice to augment clinical skills, such as providing sedation and placing peripherally inserted central catheter lines, and nonclinical skills in areas such as quality improvement methodology, hospital administration, and health service research. To address the educational needs of the current and future state of PHM, additional training is now needed beyond residency training. Fellowship training will be essential to continue to advance the field of PHM as well as to petition the ABP for specialty accreditation. Training in using adult educational theory, curriculum, and assessment design are critical for pediatric hospitalists choosing to advance their careers as clinician-educators. Several venues are available for gaining advanced knowledge and skill as an educator. PHM clinician-educators are advancing the field of pediatric education as well as their own academic careers by virtue of the scholarly approach they have taken to designing and implementing curricula for unique PHM teaching situations. PHM educators are changing the educational paradigm to address challenges to traditional education strategies posed by duty hour restrictions and the increasing drive to shorten the duration of the hospitalization. By embracing learning with technology, such as simulation and e-learning with mobile devices, PHM educators can address these challenges as well as respond to learning preferences of millennial learners. The future for PHM education is bright. Copyright 2014, SLACK Incorporated.

  13. The global pediatric antiretroviral market: analyses of product availability and utilization reveal challenges for development of pediatric formulations and HIV/AIDS treatment in children.

    Science.gov (United States)

    Waning, Brenda; Diedrichsen, Ellen; Jambert, Elodie; Bärnighausen, Till; Li, Yun; Pouw, Mieke; Moon, Suerie

    2010-10-17

    Important advances in the development and production of quality-certified pediatric antiretroviral (ARV) formulations have recently been made despite significant market disincentives for manufacturers. This progress resulted from lobbying and innovative interventions from HIV/AIDS activists, civil society organizations, and international organizations. Research on uptake and dispersion of these improved products across countries and international organizations has not been conducted but is needed to inform next steps towards improving child health. We used information from the World Health Organization Prequalification Programme and the United States Food and Drug Administration to describe trends in quality-certification of pediatric formulations and used 7,989 donor-funded, pediatric ARV purchase transactions from 2002-2009 to measure uptake and dispersion of new pediatric ARV formulations across countries and programs. Prices for new pediatric ARV formulations were compared to alternative dosage forms. Fewer ARV options exist for HIV/AIDS treatment in children than adults. Before 2005, most pediatric ARVs were produced by innovator companies in single-component solid and liquid forms. Five 2-in1 and four 3-in-1 generic pediatric fixed-dose combinations (FDCs) in solid and dispersible forms have been quality-certified since 2005. Most (67%) of these were produced by one quality-certified manufacturer. Uptake of new pediatric FDCs outside of UNITAID is low. UNITAID accounted for 97-100% of 2008-2009 market volume. In total, 33 and 34 countries reported solid or dispersible FDC purchases in 2008 and 2009, respectively, but most purchases were made through UNITAID. Only three Global Fund country recipients reported purchase of these FDCs in 2008. Prices for pediatric FDCs were considerably lower than liquids but typically higher than half of an adult FDC. Pediatric ARV markets are more fragile than adult markets. Ensuring a long-term supply of quality, well

  14. Pediatric Type Follicular Lymphoma: A Rare Entity with Excellent Prognosis

    Science.gov (United States)

    2018-01-19

    YYYY) 12. REPORT TYPE 19/01/2018 Poster 4. TITLE AND SUBTITLE Pediatric -Type Follicular Lymphoma: A Rare Entity with Excellent Prognosis 6. AUTHOR(S...lymphoma is common in older adults but rare in pediatric and young adult patients. Pediatric follicular lymphoma comprises a only 6.5% of childhood... Pediatric follicular lymphoma is defined by a localized high grade appearing lymphoma that lacks these gene rearrangements. Other diagnoses to rule out

  15. Dementia of Alzheimer-type in adult patients with Down's syndrome. Its frequency, neuroradiological findings, and biochemical study of risk factors

    International Nuclear Information System (INIS)

    Sekijima, Yoshiki

    1997-01-01

    We examined the frequency, neuroradiological features, and risk factors of Alzheimer-type dementia (DAT) in 123 Japanese adult patients with Down's syndrome. Among these patients 16 were diagnosed as having DAT. The prevalence of DAT was 0% in the 18- to 39-year-old group, 16% in those aged 40 to 49 years old, and 38% in those over 50 years old. On CT examination, the earliest finding of DAT was atrophy of the temporal lobe. Patients at an advanced stage revealed extensive atrophy of the cerebral hemispheres, frequently associated with calcification of the basal ganglia. 123 I-IMP-SPECT studies showed abnormally decreased isotope uptake in the posterior parietal regions in Down's syndrome patients with DAT, and a similar finding was also seen in Down's syndrome patients who showed severe mental retardation. The frequency of the apolipoprotein E (ApoE) E4 in Down's syndrome patients with DAT was 18.8%, which was higher than that of non-demented Down's syndrome patients (4.5%) and Japanese non-demented controls (6.7%). In particular, the frequency of the ApoE E4 in patients who developed DAT before 50 years of age was significantly high (28.6%). It is very likely that the ApoE E4 is a risk factor for DAT even in Down's syndrome patients with a genetic predisposition to Alzheimer's disease. (author)

  16. Are rates of pediatric bipolar disorder increasing?

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Vradi, Eleni; Andersen, Per Kragh

    2014-01-01

    Studies from the USA suggest that rates of pediatric bipolar disorder have increased since the mid-90s, but no study outside the USA has been published on the rates of pediatric bipolar disorder. Further, it is unclear whether an increase in rates reflects a true increase in the illness or more...... diagnostic attention. Using nationwide registers of all inpatients and outpatients contacts to all psychiatric hospitals in Denmark, we investigated (1) gender-specific rates of incident pediatric mania/bipolar disorder during a period from 1995 to 2012, (2) whether age and other characteristics...... for pediatric mania/bipolar disorder changed during the calendar period (1995 to 2003 versus 2004 to 2012), and (3) whether the diagnosis is more often made at first psychiatric contact in recent time compared to earlier according to gender. Totally, 346 patients got a main diagnosis of a manic episode (F30...

  17. [Evaluation of formal elements of Spanish pediatrics journals].

    Science.gov (United States)

    Aleixandre-Benavent, R; González de Dios, J; Valderrama-Zurián, F J; Bolaños Pizarro, M; Valderrama-Zurián, J C

    2007-03-01

    Standardization of scientific journals is indispensable for accurate transmission of knowledge, since it guarantees the universality and reproducibility of research. The objective of this study was to evaluate the formal elements of Spanish pediatrics journals. In 2005, we studied the characteristics of Spanish biomedical journals with special emphasis on Spanish pediatrics journals. The form used for the selection of journals for inclusion in the database Indice Médico Español (IME) was employed to evaluate 65 distinct characteristics in each journal. The parameters were grouped in the following five categores: journal presentation, presentation of the articles, scientific and editorial committees, content characteristics, and dissemination parameters. The journals with the highest overall scores were Anales de Pediatría (63 points out of a maximum of 82), followed by Pediatría de Atención Primaria (53 points), Acta Pediátrica Española and Cirugía Pediátrica (55 points each), Pediatrika (53 points), and Revista Española de Pediatría (48 points). The score obtained by Anales de Pediatría places this journal in the top 10 Spanish journals included in IME. Spanish pediatrics journals meet most of the formal elements required of biomedical journals, although some aspects could be improved, such as deficiencies in the frequency and regularity of publication, mention of the dates of manuscript receipt and acceptance, the lack of a clear description of the editorial process of manuscript selection and peer review, the absence of committee members' institutional affiliations, and the absence of articles by non-Spanish authors.

  18. Minimum Requirements for Core Competency in Pediatric Pharmacy Practice.

    Science.gov (United States)

    Boucher, Elizabeth A; Burke, Margaret M; Johnson, Peter N; Klein, Kristin C; Miller, Jamie L

    2015-01-01

    Colleges of pharmacy provide varying amounts of didactic and clinical hours in pediatrics resulting in variability in the knowledge, skills, and perceptions of new graduates toward pediatric pharmaceutical care. The Pediatric Pharmacy Advocacy Group (PPAG) endorses the application of a minimum set of core competencies for all pharmacists involved in the care of hospitalized children.

  19. Obesity prevention in pediatrics: A pilot pediatric resident curriculum intervention on nutrition and obesity education and counseling.

    Science.gov (United States)

    Gonzalez, Jose L; Gilmer, Loise

    2006-09-01

    Obesity is a highly burdensome public health issue associated with premature death, multiple comorbid disabilities and staggering healthcare costs. Between 1980-2000, the prevalence of obesity among children and adolescents nearly tripled. Obesity subjects youth to social stigmatization and discrimination. These economic and personal burdens mandate targeted prevention and detection educational programs for all individuals at risk. The most cost-effective method of approaching this obesity epidemic is through education of health professionals. As part of an "Obesity Prevention in Pediatrics" curriculum, postgraduate-year (PGY)-2 residents first observed and then participated in the dietary evaluation and counseling of pediatric patients and their families. Attitudinal questionnaires, multiple-choice knowledge examinations and a pre-established checklist of desired skills and behaviors provided evaluation of the curriculum's effect on the participants' ability and willingness to manage actually obese or at-risk pediatric patients and their families. Attitudinal survey and knowledge test scores from control PGY-3 residents generally confirmed that their knowledge and counseling skills on obesity prevention and management were well below expectation. Following participation in the curriculum, study residents' knowledge tended to improve, as did their level of comfort in counseling obese and at-risk children, adolescents and their parents. Implementation of an "Obesity Prevention in Pediatrics" curriculum appears to improve participants' knowledge base as well as their skills and level of personal comfort in the recognition, evaluation and management, including counseling, of both obese and at-risk pediatric patients and their families.

  20. Gender and generational influences on the pediatric workforce and practice.

    Science.gov (United States)

    Spector, Nancy D; Cull, William; Daniels, Stephen R; Gilhooly, Joseph; Hall, Judith; Horn, Ivor; Marshall, Susan G; Schumacher, Daniel J; Sectish, Theodore C; Stanton, Bonita F

    2014-06-01

    In response to demographic and other trends that may affect the future of the field of pediatrics, the Federation of Pediatric Organizations formed 4 working groups to participate in a year's worth of research and discussion preliminary to a Visioning Summit focusing on pediatric practice, research, and training over the next 2 decades. This article, prepared by members of the Gender and Generations Working Group, summarizes findings relevant to the 2 broad categories of demographic trends represented in the name of the group and explores the interface of these trends with advances in technology and social media and the impact this is likely to have on the field of pediatrics. Available data suggest that the trends in the proportions of men and women entering pediatrics are similar to those over the past few decades and that changes in the overall ratio of men and women will not substantially affect pediatric practice. However, although women may be as likely to succeed in academic medicine and research, fewer women than men enter research, thereby potentially decreasing the number of pediatric researchers as the proportion of women increases. Complex generational differences affect both the workforce and interactions in the workplace. Differences between the 4 generational groups comprising the pediatric workforce are likely to result in an evolution of the role of the pediatrician, particularly as it relates to aspects of work-life balance and the use of technology and social media. Copyright © 2014 by the American Academy of Pediatrics.

  1. Pediatric Dentist Density and Preventive Care Utilization for Medicaid Children.

    Science.gov (United States)

    Heidenreich, James F; Kim, Amy S; Scott, JoAnna M; Chi, Donald L

    2015-01-01

    The purpose of this study was to evaluate county-level pediatric dentist density and dental care utilization for Medicaid-enrolled children. This was a cross-sectional analysis of 604,885 zero- to 17-year-olds enrolled in the Washington State Medicaid Program for 11-12 months in 2012. The relationship between county-level pediatric dentist density, defined as the number of pediatric dentists per 10,000 Medicaid-enrolled children, and preventive dental care utilization was evaluated using linear regression models. In 2012, 179 pediatric dentists practiced in 16 of the 39 counties in Washington. County-level pediatric dentist density varied from zero to 5.98 pediatric dentists per 10,000 Medicaid-enrolled children. County-level preventive dental care utilization ranged from 32 percent to 81 percent, with 62 percent of Medicaid-enrolled children utilizing preventive dental services. County-level density was significantly associated with county-level dental care utilization (Slope equals 1.67, 95 percent confidence interval equals 0.02, 3.32, Pchildren who utilize preventive dental care services. Policies aimed at improving pediatric oral health disparities should include strategies to increase the number of oral health care providers, including pediatric dentists, in geographic areas with large proportions of Medicaid-enrolled children.

  2. Clostridium difficile and pediatric inflammatory bowel disease

    DEFF Research Database (Denmark)

    Martinelli, Massimo; Strisciuglio, Caterina; Veres, Gabor

    2014-01-01

    BACKGROUND: Clostridium difficile infection is associated with pediatric inflammatory bowel disease (IBD) in several ways. We sought to investigate C. difficile infection in pediatric patients with IBD in comparison with a group of children with celiac disease and to evaluate IBD disease course o...

  3. Preface [to: Practical Pediatric Dermatology: Controversies in Diagnosis and Treatment

    NARCIS (Netherlands)

    A.P. Oranje (Arnold); N. Al-Mutairi (Nawaf); T. Shwayder (Tor)

    2016-01-01

    markdownabstractPediatric dermatology is a young field that combines dermatologic and pediatric skills and expertises. Knowledge of dermatology and pediatrics is necessary for optimal care of children with skin diseases. A multidisciplinary approach in which there is cooperation between

  4. State of the practice for pediatric surgery--career satisfaction and concerns. A report from the American Pediatric Surgical Association Task Force on Family Issues.

    Science.gov (United States)

    Katz, Aviva; Mallory, Baird; Gilbert, James C; Bethel, Colin; Hayes-Jordan, Andrea A; Saito, Jacqueline M; Tomita, Sandra S; Walsh, Danielle S; Shin, Cathy E; Wesley, John R; Farmer, Diana

    2010-10-01

    There has been increasing interest and concern raised in the surgical literature regarding changes in the culture of surgical training and practice, and the impact these changes may have on surgeon stress and the appeal of a career in surgery. We surveyed pediatric surgeons and their partners to collect information on career satisfaction and work-family balance. The American Pediatric Surgical Association Task Force on Family Issues developed separate survey instruments for both pediatric surgeons and their partners that requested demographic data and information regarding the impact of surgical training and practice on the surgeon's opportunity to be involved with his/her family. We found that 96% of pediatric surgeons were satisfied with their career choice. Of concern was the lack of balance, with little time available for family, noted by both pediatric surgeons and their partners. The issues of work-family balance and its impact on surgeon stress and burnout should be addressed in both pediatric surgery training and practice. The American Pediatric Surgical Association is positioned to play a leading role in this effort. Copyright © 2010 Elsevier Inc. All rights reserved.

  5. Pediatric blunt splenic trauma: a comprehensive review

    Energy Technology Data Exchange (ETDEWEB)

    Lynn, Karen N.; Werder, Gabriel M.; Callaghan, Rachel M.; Jafri, Zafar H. [William Beaumont Hospital, Department of Diagnostic Radiology, Royal Oak, MI (United States); Sullivan, Ashley N. [St. George' s University School of Medicine, Grenada, West Indies (Grenada); Bloom, David A. [William Beaumont Hospital, Department of Diagnostic Radiology, Royal Oak, MI (United States); William Beaumont Hospital, Section of Pediatric Radiology, Department of Radiology, Royal Oak, MI (United States)

    2009-09-15

    Abdominal trauma is a leading cause of death in children older than 1 year of age. The spleen is the most common organ injured following blunt abdominal trauma. Pediatric trauma patients present unique clinical challenges as compared to adults, including different mechanisms of injury, physiologic responses, and indications for operative versus nonoperative management. Splenic salvage techniques and nonoperative approaches are preferred to splenectomy in order to decrease perioperative risks, transfusion needs, duration/cost of hospitalization, and risk of overwhelming postsplenectomy infection. Early and accurate detection of splenic injury is critical in both adults and children; however, while imaging findings guide management in adults, hemodynamic stability is the primary determinant in pediatric patients. After initial diagnosis, the primary role of imaging in pediatric patients is to determine the level and duration of care. We present a comprehensive literature review regarding the mechanism of injury, imaging, management, and complications of traumatic splenic injury in pediatric patients. Multiple patients are presented with an emphasis on the American Association for the Surgery of Trauma organ injury grading system. Clinical practice guidelines from the American Pediatric Surgical Association are discussed and compared with our experience at a large community hospital, with recommendations for future practice guidelines. (orig.)

  6. Pediatric blunt splenic trauma: a comprehensive review

    International Nuclear Information System (INIS)

    Lynn, Karen N.; Werder, Gabriel M.; Callaghan, Rachel M.; Jafri, Zafar H.; Sullivan, Ashley N.; Bloom, David A.

    2009-01-01

    Abdominal trauma is a leading cause of death in children older than 1 year of age. The spleen is the most common organ injured following blunt abdominal trauma. Pediatric trauma patients present unique clinical challenges as compared to adults, including different mechanisms of injury, physiologic responses, and indications for operative versus nonoperative management. Splenic salvage techniques and nonoperative approaches are preferred to splenectomy in order to decrease perioperative risks, transfusion needs, duration/cost of hospitalization, and risk of overwhelming postsplenectomy infection. Early and accurate detection of splenic injury is critical in both adults and children; however, while imaging findings guide management in adults, hemodynamic stability is the primary determinant in pediatric patients. After initial diagnosis, the primary role of imaging in pediatric patients is to determine the level and duration of care. We present a comprehensive literature review regarding the mechanism of injury, imaging, management, and complications of traumatic splenic injury in pediatric patients. Multiple patients are presented with an emphasis on the American Association for the Surgery of Trauma organ injury grading system. Clinical practice guidelines from the American Pediatric Surgical Association are discussed and compared with our experience at a large community hospital, with recommendations for future practice guidelines. (orig.)

  7. Reexpansion pulmonary edema: review of pediatric cases.

    Science.gov (United States)

    Kira, Shinichiro

    2014-03-01

    Reexpansion pulmonary edema (RPE) is an increased permeability pulmonary edema that usually occurs in the reexpanded lung after several days of lung collapse. This condition is recognized to occur more frequently in patients under the age of 40 years, but there has been no detailed analysis of reported pediatric cases of RPE to date. For this review, PubMed literature searches were performed using the following terms: 're(-)expansion pulmonary (o)edema' AND ('child' OR 'children' OR 'infant' OR 'boy' OR 'girl' OR 'adolescent'). The 22 pediatric cases of RPE identified were included in this review. RPE was reported in almost the entire pediatric age range, and as in adult cases, the severity ranged from subclinical to lethal. No specific treatment for RPE was identified, and treatment was administered according to the clinical features of each patient. Of the 22 reported cases, 10 occurred during the perioperative period, but were not related to any specific surgical procedures or anesthetic techniques, or to the duration of lung collapse. Pediatric anesthesiologists should be aware that pediatric RPE can occur after reexpansion of any collapsed lung and that some invasive therapies can be useful in severe cases. © 2013 John Wiley & Sons Ltd.

  8. Demand in Pediatric Dentistry for Sedation and General Anesthesia by Dentist Anesthesiologists: A Survey of Directors of Dentist Anesthesiologist and Pediatric Dentistry Residencies

    Science.gov (United States)

    Hicks, C. Gray; Jones, James E.; Saxen, Mark A.; Maupome, Gerardo; Sanders, Brian J.; Walker, LaQuia A.; Weddell, James A.; Tomlin, Angela

    2012-01-01

    This study describes what training programs in pediatric dentistry and dental anesthesiology are doing to meet future needs for deep sedation/general anesthesia services required for pediatric dentistry. Residency directors from 10 dental anesthesiology training programs in North America and 79 directors from pediatric dentistry training programs in North America were asked to answer an 18-item and 22-item online survey, respectively, through an online survey tool. The response rate for the 10 anesthesiology training program directors was 9 of 10 or 90%. The response rate for the 79 pediatric dentistry training program directors was 46 of 79 or 58%. Thirty-seven percent of pediatric dentistry programs use clinic-based deep sedation/general anesthesia for dental treatment in addition to hospital-based deep sedation/general anesthesia. Eighty-eight percent of those programs use dentist anesthesiologists for administration of deep sedation/general anesthesia in a clinic-based setting. Pediatric dentistry residency directors perceive a future change in the need for deep sedation/general anesthesia services provided by dentist anesthesiologists to pediatric dentists: 64% anticipate an increase in need for dentist anesthesiologist services, while 36% anticipate no change. Dental anesthesiology directors compared to 2, 5, and 10 years ago have seen an increase in the requests for dentist anesthesiologist services by pediatric dentists reported by 56% of respondents (past 2 years), 63% of respondents (past 5 years), and 88% of respondents (past 10 years), respectively. Predicting the future need of dentist anesthesiologists is an uncertain task, but these results show pediatric dentistry directors and dental anesthesiology directors are considering the need, and they recognize a trend of increased need for dentist anesthesiologist services over the past decade. PMID:22428968

  9. Job Satisfaction and Relocation Desire among Pediatric Dentists in Puerto Rico.

    Science.gov (United States)

    Arévalo, Oscar; Saman, Daniel M; Tabares, Miguel; Hernández, Ana; Sanders-Ward, Rebecca

    2015-12-01

    To determine the levels of satisfaction, license status, and desire to relocate of pediatric dentists in Puerto Rico. Pediatric dentists in Puerto Rico were surveyed via telephone interviews. Data were collected through a 34-item questionnaire that explored satisfaction as related to income, continuing education, professional goals, and participation in the Mi Salud program. Frequencies, chi-square analysis, and Fisher's exact 2-tailed t-test were utilized to determine the relationships between satisfaction and the demographics of the pediatric dentists. Sixty pediatric dentists participated in our survey-77% of the total number of pediatric dentists practicing in Puerto Rico. Overall, 65% of the participating pediatric dentists expressed dissatisfaction. Male pediatric dentists were more dissatisfied than their female colleagues were. Most pediatric dentists participating in Mi Salud expressed dissatisfaction. When asked about whether or not they had considered migrating to the mainland, those who were dissatisfied were more likely to have considered that idea than were those who were satisfied. Overall, 57% of the pediatric dentists comprising our sample had considered relocating to the continental United States. In general, the pediatric dentists who participated in our study expressed dissatisfaction in most areas except when asked about their ability to reach professional goals. Determining the levels of satisfaction of health care providers is important in the maintaining of an adequate workforce. As current levels of dissatisfaction are high, it is important to determine what variables are related to satisfaction so that corrective measures can be taken to ensure that retention rates improve, thereby maintaining an adequate pediatric dental workforce.

  10. Topical Review: Unique Contributions of Magnetic Resonance Imaging to Pediatric Psychology Research.

    Science.gov (United States)

    Jensen, Chad D; Duraccio, Kara M; Carbine, Kaylie M; Kirwan, C Brock

    2016-03-01

    This review aims to provide a brief introduction of the utility of magnetic resonance imaging (MRI) methods in pediatric psychology research, describe several exemplar studies that highlight the unique benefits of MRI techniques for pediatric psychology research, and detail methods for addressing several challenges inherent to pediatric MRI research. Literature review. Numerous useful applications of MRI research in pediatric psychology have been illustrated in published research. MRI methods yield information that cannot be obtained using neuropsychological or behavioral measures. Using MRI in pediatric psychology research may facilitate examination of neural structures and processes that underlie health behaviors. Challenges inherent to conducting MRI research with pediatric research participants (e.g., head movement) may be addressed using evidence-based strategies. We encourage pediatric psychology researchers to consider adopting MRI techniques to answer research questions relevant to pediatric health and illness. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Recurrence and complications of pediatric inguinal hernia repair ...

    African Journals Online (AJOL)

    complications of inguinal hernia repair in pediatric patients ... surgery. Patients and methods This retrospective study was ... Bilateral inguinal hernia was observed ..... single-blind comparison of laparoscopic versus open repair of pediatric.

  12. 24/7 pediatric radiology attending coverage: times are changing

    Energy Technology Data Exchange (ETDEWEB)

    Donaldson, James S. [Feinberg School of Medicine at Northwestern University, Department of Medical Imaging, Ann and Robert H. Lurie Children' s Hospital of Chicago, IL (United States); Thakrar, Kiran H. [University of Chicago Pritzker School of Medicine, Body Imaging, NorthShore University HealthSystem, Chicago, IL (United States)

    2017-06-15

    The job of the pediatric radiologist long ago ceased to be an 8-to-5 role. Many practices have adopted evening shifts of in-house attending radiologists to cover the busy evening activity. With the ever-increasing role of imaging in clinical decisions and patient management, there is a need - if not a demand - to further extend attending pediatric radiology coverage. In this article, we discuss the needs and justification for extending pediatric radiology coverage at a tertiary-care children's hospital. We also describe the approach we took toward implementing 24/7 attending in-house coverage of pediatric radiology. (orig.)

  13. Comparison between a pediatric health promotion center and a pediatric obesity clinic in detecting metabolic syndrome and non-alcoholic fatty liver disease in children.

    Science.gov (United States)

    Yang, Hye Ran; Yi, Dae Yong; Choi, Hyoung Soo

    2014-12-01

    This study was done to evaluate the efficacy of health check-ups in children in detecting metabolic syndrome and non-alcoholic fatty liver disease (NAFLD) by comparing the pediatric health promotion center with the pediatric obesity clinic. Children who visited a pediatric health promotion center (n=218) or a pediatric obesity clinic (n=178) were included. Anthropometric data, blood pressure, laboratory tests, and abdominal ultrasonography were evaluated. Two different criteria were applied to diagnose metabolic syndrome. The prevalence of metabolic syndrome in the 2 units was 3.2%-3.7% in a pediatric health promotion center and 23%-33.2% in a pediatric obesity clinic. Significant differences were observed in the prevalence of each component of metabolic syndrome between the 2 units including abdominal adiposity, blood pressure, serum triglycerides, and fasting blood glucose (Pobesity clinic targeting obese children than that among patients visiting the health promotion center offering routine check-ups. An obesity-oriented approach is required to prevent obesity-related health problems in children.

  14. Pediatric Cardiopulmonary Arrest in the Postanesthesia Care Unit, Rare but Preventable: Analysis of Data From Wake Up Safe, The Pediatric Anesthesia Quality Improvement Initiative.

    Science.gov (United States)

    Christensen, Robert E; Haydar, Bishr; Voepel-Lewis, Terri D

    2017-04-01

    Nearly 20% of anesthesia-related pediatric cardiac arrests (CAs) occur during emergence or recovery. The aims of this case series were to use the Wake Up Safe database to describe the following: (1) the nature of pediatric postanesthesia care unit (PACU) CA and subsequent outcomes and (2) factors associated with harm after pediatric PACU CA. Pediatric CAs in the PACU were identified from the Wake Up Safe Pediatric Anesthesia Quality Improvement Initiative, a multicenter registry of adverse events in pediatric anesthesia. Demographics, underlying conditions, cause of CA, and outcomes were extracted. Descriptive statistics were used to characterize data and to assess risk of harm in those suffering CA. A total of 26 CA events were included: 67% in children anesthesia care providers until emergence from anesthesia may further reduce the preventable arrest rate. The root cause analyses conducted by individual institutions reporting these data to the Wake Up Safe provided only limited insight, so multicenter collaborative approaches may allow for greater insight into effective CA-prevention strategies.

  15. Qualitative Study of Foster Caregivers’ Views on Adherence to Pediatric Appointments

    Science.gov (United States)

    Schneiderman, Janet U.; Kennedy, Andrea K.; Sayegh, Caitlin S.

    2016-01-01

    The current study is a qualitative investigation of how foster caregivers, primarily Latinos, view adherence to pediatric appointments with the purpose of identifying how the child welfare system, pediatric clinics, and pediatric health providers serving foster children might promote appointment attendance. Participants in the study had a return appointment at an outpatient pediatric clinic that only served children in the child welfare system. Twenty-eight caregivers (13 related and 15 unrelated) participated in telephone interviews after the date of their scheduled pediatric appointment (32% missed their return appointment). Semistructured interview guides included general questions about what promotes attending the pediatric appointment, what makes it difficult to attend the pediatric appointment, and how pediatric care affects the foster child. Analysis of qualitative data using content analysis identified three themes: (a) multiple methods to attend appointments, which included caregivers’ organizational and problem-solving skills; (b) positive health care experiences, which consisted of caregivers’ personal relationships with providers and staff members and clinic organization; and (c) necessity of pediatric care, which included recognition of the need for health care, especially timely immunizations. All caregivers also reported that appointments reminders would be helpful. Unrelated caregivers more often said that appointment attendance was facilitated by clinic organization compared to related caregivers. Nonadherent caregivers mentioned their need to solve problems to attend appointments or reschedule appointments more than attenders. In summary, caregivers said they valued regular pediatric health care to treat their child’s chronic conditions and prevent illnesses, but they acknowledged that their home lives were hectic and attending scheduled appointments was sometimes difficult. Foster caregivers in this study identified the ideal pediatric

  16. Anesthetic considerations for pediatric electroconvulsive therapy.

    Science.gov (United States)

    Franklin, Andrew D; Sobey, Jenna H; Stickles, Eric T

    2017-05-01

    Electroconvulsive therapy is being used more frequently in the treatment of many chronic and acute psychiatric illnesses in children. The most common psychiatric indications for pediatric electroconvulsive therapy are refractory depression, bipolar disorder, schizophrenia, catatonia, and autism. In addition, a relatively new indication is the treatment of pediatric refractory status epilepticus. The anesthesiologist may be called upon to assist in the care of this challenging and vulnerable patient population. Unique factors for pediatric electroconvulsive therapy include the potential need for preoperative anxiolytic and inhalational induction of anesthesia, which must be weighed against the detrimental effects of anesthetic agents on the evoked seizure quality required for a successful treatment. Dexmedetomidine is likely the most appropriate preoperative anxiolytic as oral benzodiazepines are relatively contraindicated. Methohexital, though becoming less available at many institutions, remains the gold standard for induction of anesthesia for pediatric electroconvulsive therapy though ketamine, propofol, and sevoflurane are becoming increasingly viable options. Proper planning and communication between the multidisciplinary teams involved in the care of children presenting for electroconvulsive therapy treatments is vital to mitigating risks and achieving the greatest therapeutic benefit. © 2017 John Wiley & Sons Ltd.

  17. Immersive Virtual Reality for Pediatric Pain.

    Science.gov (United States)

    Won, Andrea Stevenson; Bailey, Jakki; Bailenson, Jeremy; Tataru, Christine; Yoon, Isabel A; Golianu, Brenda

    2017-06-23

    Children must often endure painful procedures as part of their treatment for various medical conditions. Those with chronic pain endure frequent or constant discomfort in their daily lives, sometimes severely limiting their physical capacities. With the advent of affordable consumer-grade equipment, clinicians have access to a promising and engaging intervention for pediatric pain, both acute and chronic. In addition to providing relief from acute and procedural pain, virtual reality (VR) may also help to provide a corrective psychological and physiological environment to facilitate rehabilitation for pediatric patients suffering from chronic pain. The special qualities of VR such as presence, interactivity, customization, social interaction, and embodiment allow it to be accepted by children and adolescents and incorporated successfully into their existing medical therapies. However, the powerful and transformative nature of many VR experiences may also pose some risks and should be utilized with caution. In this paper, we review recent literature in pediatric virtual reality for procedural pain and anxiety, acute and chronic pain, and some rehabilitation applications. We also discuss the practical considerations of using VR in pediatric care, and offer specific suggestions and information for clinicians wishing to adopt these engaging therapies into their daily clinical practice.

  18. Efficacy of carvedilol in pediatric heart failure

    DEFF Research Database (Denmark)

    Christensen, Alex Hørby; Fatkin, Diane

    2013-01-01

    Evaluation of: Huang M, Zhang X, Chen S et al. The effect of carvedilol treatment on chronic heart failure in pediatric patients with dilated cardiomyopathy: a prospective, randomized-controlled study. Pediatr. Cardiol. 34, 680-685 (2013). A role for β-blockers in children with heart failure has...

  19. Pediatric multiple sclerosis in Venezuela

    Directory of Open Access Journals (Sweden)

    Joaquín A. Peña

    2012-04-01

    Full Text Available OBJECTIVE: To describe the epidemiological and clinical characteristics of Venezuelan pediatric patients with multiple sclerosis (MS. METHODS: Database records from the National Program for MS were searched for patients with an established diagnosis of MS whose first symptoms appeared before age 18. RESULTS: The national database held records of 1.710 patients; 3.8% had onset of the first symptoms before age 18. 46.7% were boys, yielding an F:M ratio of 1.13:1. Many children had a disease onset characterized by motor impairment (30.7%, brainstem/cerebellum and spinal cord affectation (27.6%, headache (26%. Less frequent symptoms were sensory symptoms (8% and optic neuritis (7%. DISCUSSION: Pediatric MS patients in Venezuela represent a significant proportion of all MS cases. The clinical pattern is characterized by motor symptoms at onset, and predominantly monosymptomatic presentation with a relapsing-remitting pattern. This is the first systematic attempt to estimate the prevalence of pediatric MS in Venezuela.

  20. Contact Dermatitis in Pediatrics.

    Science.gov (United States)

    Pelletier, Janice L; Perez, Caroline; Jacob, Sharon E

    2016-08-01

    Contact dermatitis is an umbrella term that describes the skin's reaction to contacted noxious or allergenic substances. The two main categories of contact dermatitis are irritant type and allergic type. This review discusses the signs, symptoms, causes, and complications of contact dermatitis. It addresses the testing, treatment, and prevention of contact dermatitis. Proper management of contact dermatitis includes avoidance measures for susceptible children. Implementation of a nickel directive (regulating the use of nickel in jewelry and other products that come into contact with the skin) could further reduce exposure to the most common allergens in the pediatric population. [Pediatr Ann. 2016;45(8):e287-e292.]. Copyright 2016, SLACK Incorporated.

  1. Do pediatric gastroenterology doctors address pediatric obesity?

    OpenAIRE

    Batra, Suruchi; Yee, Caitlin; Diez, Bernadette; Nguyen, Nicholas; Sheridan, Michael J; Tufano, Mark; Sikka, Natalie; Townsend, Stacie; Hourigan, Suchitra

    2017-01-01

    Objectives: To assess how often obesity is acknowledged at pediatric gastroenterology outpatient visits. Methods: A retrospective chart review was performed to identify obese children seen at a gastroenterology subspecialty clinic over a 1-year period of time; 132 children were identified. Demographics, obesity comorbidities, reasons for referral, diagnosis of obesity, and a plan to address obesity were abstracted. Chi-square or Fisher?s exact tests were used to examine statistical associatio...

  2. Pediatric Inpatient Nurses' Perceptions of Child Maltreatment.

    Science.gov (United States)

    Lavigne, Jenifer L; Portwood, Sharon G; Warren-Findlow, Jan; Brunner Huber, Larissa R

    The purpose of this study was to explore the perceptions of child maltreatment among inpatient pediatric nurses. A cross-sectional survey was used to obtain responses to an online survey designed to examine perceptions of child maltreatment from inpatient pediatric nurses. Many nurses surveyed (41.25%) indicated that they had not received adequate training or had never received training on child maltreatment identification and many (40%) also indicated they were not familiar with the applicable reporting laws. Due to the serious immediate and long term effects of child maltreatment, it is imperative that pediatric inpatient nurses have adequate training on how to identify potential abuse and neglect cases, as well as legal reporting requirements, since they are in a unique position to identify potential cases of maltreatment. There is a continuing need for training on child maltreatment identification and reporting laws for inpatient pediatric nurses. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Pediatric sciatic neuropathies due to unusual vascular causes

    NARCIS (Netherlands)

    Srinivasan, Jayashri; Escolar, Diane; Ryan, Monique; Darras, Basil; Jones, H. Royden

    Four cases of pediatric sciatic neuropathies due to unusual vascular mechanisms are reported. Pediatric sciatic neuropathies were seen after umbilical artery catheterization, embolization of arteriovenous malformation, meningococcemia, and hypereosinophilic vasculitis. Electrophysiologic studies

  4. Do systematic reviews on pediatric topics need special methodological considerations?

    Science.gov (United States)

    Farid-Kapadia, Mufiza; Askie, Lisa; Hartling, Lisa; Contopoulos-Ioannidis, Despina; Bhutta, Zulfiqar A; Soll, Roger; Moher, David; Offringa, Martin

    2017-03-06

    Systematic reviews are key tools to enable decision making by healthcare providers and policymakers. Despite the availability of the evidence based Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA-2009 and PRISMA-P 2015) statements that were developed to improve the transparency and quality of reporting of systematic reviews, uncertainty on how to deal with pediatric-specific methodological challenges of systematic reviews impairs decision-making in child health. In this paper, we identify methodological challenges specific to the design, conduct and reporting of pediatric systematic reviews, and propose a process to address these challenges. One fundamental decision at the outset of a systematic review is whether to focus on a pediatric population only, or to include both adult and pediatric populations. Both from the policy and patient care point of view, the appropriateness of interventions and comparators administered to pre-defined pediatric age subgroup is critical. Decisions need to be based on the biological plausibility of differences in treatment effects across the developmental trajectory in children. Synthesis of evidence from different trials is often impaired by the use of outcomes and measurement instruments that differ between trials and are neither relevant nor validated in the pediatric population. Other issues specific to pediatric systematic reviews include lack of pediatric-sensitive search strategies and inconsistent choices of pediatric age subgroups in meta-analyses. In addition to these methodological issues generic to all pediatric systematic reviews, special considerations are required for reviews of health care interventions' safety and efficacy in neonatology, global health, comparative effectiveness interventions and individual participant data meta-analyses. To date, there is no standard approach available to overcome this problem. We propose to develop a consensus-based checklist of essential items which

  5. Statewide Policy Change in Pediatric Dental Care, and the Impact on Pediatric Dental and Physician Visits.

    Science.gov (United States)

    Zlotnick, Cheryl; Tam, Tammy; Ye, Yu

    2017-10-01

    Introduction In 2007, the California signed legislation mandating a dental visit for all children entering kindergarten or first grade; no such mandate was made for physician visits. This study examines the impact of this policy change on the risk factors associated with obtaining pediatric dental and physician health care visits. Methods Every 2 years, California Health Interview Survey conducts a statewide survey on a representative community sample. This cross-sectional study took advantage of these data to conduct a "natural experiment" assessing the impact of this policy change on both pediatric physician and dental care visits in the past year. Samples included surveys of adults and children (ages 5-11) on years 2005 (n = 5096), 2007 (n = 4324) and 2009 (n = 4100). Results Although few changes in risk factors were noted in pediatric physician visits, a gradual decrease in risk factors was found in pediatric dental visits from 2005 to 2009. Report of no dental visit was less likely for: younger children (OR -0.81, CI 0.75-0.88), insured children (OR 0.34, CI 0.22-0.53), and children who had a physician's visit last year (OR 0.37, CI 0.25-0.53) in 2005. By 2007, absence of insurance was the only risk factor related to having no dental visit (OR 0.34, CI 0.19-0.61). By 2009, no a priori measured risk factors were associated with not having a dental visit for children aged 5-11 years. Conclusions A statewide policy mandating pediatric dental visits appears to have reduced disparities. A policy for medical care may contribute to similar benefits.

  6. Pediatric Tuberculosis in Italian Children: Epidemiological and Clinical Data from the Italian Register of Pediatric Tuberculosis

    Directory of Open Access Journals (Sweden)

    Luisa Galli

    2016-06-01

    Full Text Available Tuberculosis (TB is one of the leading causes of death worldwide. Over the last decades, TB has also emerged in the pediatric population. Epidemiologic data of childhood TB are still limited and there is an urgent need of more data on very large cohorts. A multicenter study was conducted in 27 pediatric hospitals, pediatric wards, and public health centers in Italy using a standardized form, covering the period of time between 1 January 2010 and 31 December 2012. Children with active TB, latent TB, and those recently exposed to TB or recently adopted/immigrated from a high TB incidence country were enrolled. Overall, 4234 children were included; 554 (13.1% children had active TB, 594 (14.0% latent TB and 3086 (72.9% were uninfected. Among children with active TB, 481 (86.8% patients had pulmonary TB. The treatment of active TB cases was known for 96.4% (n = 534 of the cases. Overall, 210 (39.3% out of these 534 children were treated with three and 216 (40.4% with four first-line drugs. Second-line drugs where used in 87 (16.3% children with active TB. Drug-resistant strains of Mycobacterium tuberculosis were reported in 39 (7% children. Improving the surveillance of childhood TB is important for public health care workers and pediatricians. A non-negligible proportion of children had drug-resistant TB and was treated with second-line drugs, most of which are off-label in the pediatric age. Future efforts should concentrate on improving active surveillance, diagnostic tools, and the availability of antitubercular pediatric formulations, also in low-endemic countries.

  7. Doses from pediatric CT examinations in Norway: are pediatric scan protocols developed and in daily use?

    International Nuclear Information System (INIS)

    Friberg, Eva G.

    2008-01-01

    Doses to pediatric patients from CT examinations are known to be unnecessarily high if scan protocols developed for adult patients are adopted. This overexposure is most often not recognized by the operating radiographer, due to the digital behavior of the imaging system. Use of optimized size-specific pediatric scan protocols is therefore essential to keep the doses at an appropriate level. The aim of this study was to investigate the doses to pediatric patients from CT examinations and to evaluate the level of optimization of the scan protocols. Patient data, applied scan parameters together with the dose parameters volume computed tomography dose index (CTD vol ) and dose length product (DLP) for examinations of the head, chest and abdomen were collected by means of a questionnaire from five university hospitals. The effective dose was estimated from the total DLP by use of region-specific conversion coefficients (E DLP ). Totally 136, 108 and 82 questionnaires were received for examinations of the head, chest and abdomen, respectively. Large variations in patient doses between the hospitals were observed, addressing the need for optimization of the scan protocols in general. Most of the hospitals applied successive lower mAs with decreasing patient age for all scan areas, while the use of lower tube voltage for small patients and a higher tube voltage for large patients were more rarely. This indicates the presence, to a certain level, of size specific scan protocols at some Norwegian hospitals. Focus on developing size-specific scan protocols for pediatric patients are important to reduce the doses and risks associated with pediatric CT examinations. (author)

  8. Demographics of US pediatric contact dermatitis registry providers.

    Science.gov (United States)

    Goldenberg, Alina; Jacob, Sharon E

    2015-01-01

    Children are as likely as adults to be sensitized and reactive to contact allergens. However, the prevailing data on pediatric allergic contact dermatitis are quantitatively and qualitatively limited because of a narrow geographic localization of data-reporting providers. The aim of the study was to present the first quarter results from the Loma Linda Pediatric Contact Dermatitis Registry focused on registered providers who self-identified as providing care for pediatric allergic contact dermatitis (ACD) within the United States. The US providers were invited to join the registry via completion of an online, secure, 11-question registration survey addressing demographics and clinical practice essentials. The presented results reflect data gathered within the first quarter of registry recruitment; registration is ongoing. Of 169 responders from 48 states, the majority of providers were female (60.4%), academic (55.6%), and dermatologists (76.3%). Based on individual provider averages, the minimum cumulative number of pediatric patch-test evaluations performed each year ranged between 1372 and 3468 children. The Pediatric Contact Dermatitis Registry provides a description of the current leaders in the realm of pediatric ACD and gaps, which are in need of attention. The registry allows for a collaborative effort to exchange information, educate providers, and foster investigative research with the hope of legislation that can reduce the disease burden of ACD in US children.

  9. Considerations for a Pediatric Biopharmaceutics Classification System (BCS): application to five drugs.

    Science.gov (United States)

    Gandhi, Shivani V; Rodriguez, William; Khan, Mansoor; Polli, James E

    2014-06-01

    It has been advocated that biopharmaceutic risk assessment should be conducted early in pediatric product development and synchronized with the adult product development program. However, we are unaware of efforts to classify drugs into a Biopharmaceutics Classification System (BCS) framework for pediatric patients. The objective was to classify five drugs into a potential BCS. These five drugs were selected since both oral and intravenous pharmacokinetic data were available for each drug, and covered the four BCS classes in adults. Literature searches for each drug were conducted using Medline and applied to classify drugs with respect to solubility and permeability in pediatric subpopulations. Four pediatric subpopulations were considered: neonates, infants, children, and adolescents. Regarding solubility, dose numbers were calculated using a volume for each subpopulation based on body surface area (BSA) relative to 250 ml for a 1.73 m(2) adult. Dose numbers spanned a range of values, depending upon the pediatric dose formula and subpopulation. Regarding permeability, pharmacokinetic literature data required assumptions and decisions about data collection. Using a devised pediatric BCS framework, there was agreement in adult and pediatric BCS class for two drugs, azithromycin (class 3) and ciprofloxacin (class 4). There was discordance for the three drugs that have high adult permeability since all pediatric permeabilities were low: dolasetron (class 3 in pediatric), ketoprofen (class 4 in pediatric), and voriconazole (class 4 in pediatric). A main contribution of this work is the identification of critical factors required for a pediatric BCS.

  10. Prophylactic antibiotics in pediatric shunt surgery.

    Science.gov (United States)

    Biyani, N; Grisaru-Soen, G; Steinbok, P; Sgouros, S; Constantini, S

    2006-11-01

    The optimal antibiotic prophylaxis for pediatric shunt-related procedures is not clear. There is much inconsistency among different medical centers. This paper summarizes and analyzes the various prophylactic antibiotic regiments used for shunt-related surgeries at different pediatric neurosurgery centers in the world. A survey questionnaire was distributed through the Pediatric Neurosurgery list-server (an e-mail-based special interest group in pediatric neurosurgery). Forty-five completed questionnaires were received, one per medical center, primarily from pediatric neurosurgeons with the following geographic breakdown: 25 from North America, 13 from Europe, and 7 from Asia and other countries. All centers routinely administered prophylactic antibiotics for shunt-related procedures. The drugs of choice were first-generation cephalosporins (23), second-generation cephalosporins (10), naficillin/oxacillin (4), vancomycin (3), clindamycin (1), amoxicillin (1), and mixed protocols in three centers. The initial drug administration ("first dose") was: in the department before transfer to operating room (5), upon arrival to operating room (11), at induction of anesthesia (13), and at initial skin incision (16). The duration of antibiotic dosage also varied: single dose (13), 24-h administration (26), 48-h administration (2), and longer than 48 h in four centers. Two general tendencies were noted, common to the majority of participating centers. There was a general trend to modify antibiotic treatment protocol in "high-risk" populations. The second common theme noted in more than half of responding centers was the use of long-term antibiotic treatment for externalized devices (such as externalized shunts, external ventricular drains or lumbar drains), usually till the device was in place.

  11. Profile of imatinib in pediatric leukemia

    Directory of Open Access Journals (Sweden)

    Burke MJ

    2014-02-01

    Full Text Available Michael J BurkeDepartment of Pediatrics, Division of Hematology/Oncology/Bone Marrow Transplantation, Medical College of Wisconsin, Milwaukee, WI, USAAbstract: Using targeted therapy for treatment of cancer has become the paradigm to which clinical trials aspire. Imatinib, the BCR-ABL1 tyrosine kinase inhibitor (TKI, was the first of its kind to specifically target and inhibit the underlying Philadelphia chromosome (Ph+ oncogene found to be driving chronic myeloid leukemia in adults, and has since become standard of care for the treatment of chronic myeloid leukemia in children. Imatinib, with its ability to target Ph+ leukemia, has been successfully incorporated into the treatment of not only pediatric chronic myeloid leukemia but also Ph+ acute lymphoblastic leukemia. With the incorporation of imatinib into combination chemotherapy for pediatric Ph+ acute lymphoblastic leukemia, current survival rates are far higher than at any other time for this once dreadful disease. With more children today receiving treatment with imatinib for either chronic myeloid leukemia or Ph+ acute lymphoblastic leukemia, knowledge is accumulating surrounding the short-term and long-term toxicities observed in children, adolescents, and young adults treated with this TKI. In summary, the TKI imatinib has made a historic impact in the treatment of pediatric Ph+ leukemias, transforming what were once very high-risk diseases with considerable morbidity and mortality into ones that are now very treatable but with a new awareness surrounding the long-term toxicities that may come with this price for cure.Keywords: imatinib, leukemia, lymphoblastic leukemia, chronic myeloid leukemia, pediatric

  12. EDUCATION OF DISTRICT PEDIATRICIANS IS THE BASIS OF EFFICIENT OUTPATIENT PEDIATRICS DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    A.G. Gracheva

    2007-01-01

    Full Text Available In the recent decades, the way outpatient pediatrics has lagged behind as opposed to the rapid development of stationary (specialized pediatrics has become especially apparent. One of the ways to eliminate such negative trends, apart from salary raises and advancement of new technologies, is the improvement of post graduate pediatric education. The latter may include both immediate (launch of two curricula for a one year internship and prolonged measures (two year internship, launch of a new major «district pediatrician». This will enhance the priority of national medicine which was the worldwide pioneer in establishing an efficient and cost effective (compared to specialized pediatrics abroad large scale pediatric service in the 20th century through a system of children's clinics and education of doctors at the departments of pediatrics.Key words: pediatric service, post graduate pediatric education.

  13. Cardiomyocyte Hypocontractility and Reduced Myofibril Density in End-Stage Pediatric Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Ilse A. E. Bollen

    2017-12-01

    Full Text Available Dilated cardiomyopathy amongst children (pediatric cardiomyopathy, pediatric CM is associated with a high morbidity and mortality. Because little is known about the pathophysiology of pediatric CM, treatment is largely based on adult heart failure therapy. The reason for high morbidity and mortality is largely unknown as well as data on cellular pathomechanisms is limited. Here, we assessed cardiomyocyte contractility and protein expression to define cellular pathomechanisms in pediatric CM. Explanted heart tissue of 11 pediatric CM patients and 18 controls was studied. Contractility was measured in single membrane-permeabilized cardiomyocytes and protein expression was assessed with gel electrophoresis and western blot analysis. We observed increased Ca2+-sensitivity of myofilaments which was due to hypophosphorylation of cardiac troponin I, a feature commonly observed in adult DCM. We also found a significantly reduced maximal force generating capacity of pediatric CM cardiomyocytes, as well as a reduced passive force development over a range of sarcomere lengths. Myofibril density was reduced in pediatric CM compared to controls. Correction of maximal force and passive force for myofibril density normalized forces in pediatric CM cardiomyocytes to control values. This implies that the hypocontractility was caused by the reduction in myofibril density. Unlike in adult DCM we did not find an increase in compliant titin isoform expression in end-stage pediatric CM. The limited ability of pediatric CM patients to maintain myofibril density might have contributed to their early disease onset and severity.

  14. Cardiomyocyte Hypocontractility and Reduced Myofibril Density in End-Stage Pediatric Cardiomyopathy.

    Science.gov (United States)

    Bollen, Ilse A E; van der Meulen, Marijke; de Goede, Kyra; Kuster, Diederik W D; Dalinghaus, Michiel; van der Velden, Jolanda

    2017-01-01

    Dilated cardiomyopathy amongst children (pediatric cardiomyopathy, pediatric CM) is associated with a high morbidity and mortality. Because little is known about the pathophysiology of pediatric CM, treatment is largely based on adult heart failure therapy. The reason for high morbidity and mortality is largely unknown as well as data on cellular pathomechanisms is limited. Here, we assessed cardiomyocyte contractility and protein expression to define cellular pathomechanisms in pediatric CM. Explanted heart tissue of 11 pediatric CM patients and 18 controls was studied. Contractility was measured in single membrane-permeabilized cardiomyocytes and protein expression was assessed with gel electrophoresis and western blot analysis. We observed increased Ca 2+ -sensitivity of myofilaments which was due to hypophosphorylation of cardiac troponin I, a feature commonly observed in adult DCM. We also found a significantly reduced maximal force generating capacity of pediatric CM cardiomyocytes, as well as a reduced passive force development over a range of sarcomere lengths. Myofibril density was reduced in pediatric CM compared to controls. Correction of maximal force and passive force for myofibril density normalized forces in pediatric CM cardiomyocytes to control values. This implies that the hypocontractility was caused by the reduction in myofibril density. Unlike in adult DCM we did not find an increase in compliant titin isoform expression in end-stage pediatric CM. The limited ability of pediatric CM patients to maintain myofibril density might have contributed to their early disease onset and severity.

  15. The global pediatric antiretroviral market: analyses of product availability and utilization reveal challenges for development of pediatric formulations and HIV/AIDS treatment in children

    Directory of Open Access Journals (Sweden)

    Jambert Elodie

    2010-10-01

    Full Text Available Abstract Background Important advances in the development and production of quality-certified pediatric antiretroviral (ARV formulations have recently been made despite significant market disincentives for manufacturers. This progress resulted from lobbying and innovative interventions from HIV/AIDS activists, civil society organizations, and international organizations. Research on uptake and dispersion of these improved products across countries and international organizations has not been conducted but is needed to inform next steps towards improving child health. Methods We used information from the World Health Organization Prequalification Programme and the United States Food and Drug Administration to describe trends in quality-certification of pediatric formulations and used 7,989 donor-funded, pediatric ARV purchase transactions from 2002-2009 to measure uptake and dispersion of new pediatric ARV formulations across countries and programs. Prices for new pediatric ARV formulations were compared to alternative dosage forms. Results Fewer ARV options exist for HIV/AIDS treatment in children than adults. Before 2005, most pediatric ARVs were produced by innovator companies in single-component solid and liquid forms. Five 2-in1 and four 3-in-1 generic pediatric fixed-dose combinations (FDCs in solid and dispersible forms have been quality-certified since 2005. Most (67% of these were produced by one quality-certified manufacturer. Uptake of new pediatric FDCs outside of UNITAID is low. UNITAID accounted for 97-100% of 2008-2009 market volume. In total, 33 and 34 countries reported solid or dispersible FDC purchases in 2008 and 2009, respectively, but most purchases were made through UNITAID. Only three Global Fund country recipients reported purchase of these FDCs in 2008. Prices for pediatric FDCs were considerably lower than liquids but typically higher than half of an adult FDC. Conclusion Pediatric ARV markets are more fragile than

  16. Pediatric dental sedation: challenges and opportunities

    Directory of Open Access Journals (Sweden)

    Nelson TM

    2015-08-01

    Full Text Available Travis M Nelson, Zheng Xu Department of Pediatric Dentistry, University of Washington, Seattle, WA, USA Abstract: High levels of dental caries, challenging child behavior, and parent expectations support a need for sedation in pediatric dentistry. This paper reviews modern developments in pediatric sedation with a focus on implementing techniques to enhance success and patient safety. In recent years, sedation for dental procedures has been implicated in a disproportionate number of cases that resulted in death or permanent neurologic damage. The youngest children and those with more complicated medical backgrounds appear to be at greatest risk. To reduce complications, practitioners and regulatory bodies have supported a renewed focus on health care quality and safety. Implementation of high fidelity simulation training and improvements in patient monitoring, including end-tidal carbon dioxide, are becoming recognized as a new standard for sedated patients in dental offices and health care facilities. Safe and appropriate case selection and appropriate dosing for overweight children is also paramount. Oral sedation has been the mainstay of pediatric dental sedation; however, today practitioners are administering modern drugs in new ways with high levels of success. Employing contemporary transmucosal administration devices increases patient acceptance and sedation predictability. While recently there have been many positive developments in sedation technology, it is now thought that medications used in sedation and anesthesia may have adverse effects on the developing brain. The evidence for this is not definitive, but we suggest that practitioners recognize this developing area and counsel patients accordingly. Finally, there is a clear trend of increased use of ambulatory anesthesia services for pediatric dentistry. Today, parents and practitioners have become accustomed to children receiving general anesthesia in the outpatient setting. As a

  17. Screening and Identification in Pediatric Primary Care

    Science.gov (United States)

    Simonian, Susan J.

    2006-01-01

    This article reviews issues related to behavioral screening in pediatric primary care settings. Structural-organizational issues affecting the use of pediatric primary care screening are discussed. This study also reviewed selected screening instruments that have utility for use in the primary care setting. Clinical and research issues related to…

  18. Innovation in pediatric surgical education.

    Science.gov (United States)

    Clifton, Matthew S; Wulkan, Mark L

    2015-06-01

    Pediatric surgical training in the United States remained basically unchanged from the model developed by Ladd and Gross in the 1930s until recently. Standardized curriculum and novel evaluation methods are now being implemented. Pediatric Surgical education is currently undergoing a transition to competency-based evaluation and promotion. Unfortunately, there is little data on the efficacy of these changes. This presents an opportunity for further study of how we conduct training, and how we evaluate and promote our trainees. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Evaluating Hospice and Palliative Medicine Education in Pediatric Training Programs.

    Science.gov (United States)

    Singh, Arun L; Klick, Jeffrey C; McCracken, Courtney E; Hebbar, Kiran B

    2017-08-01

    Hospice and Palliative Medicine (HPM) competencies are of growing importance in training general pediatricians and pediatric sub-specialists. The Accreditation Council for Graduate Medical Education (ACGME) emphasized pediatric trainees should understand the "impact of chronic disease, terminal conditions and death on patients and their families." Currently, very little is known regarding pediatric trainee education in HPM. We surveyed all 486 ACGME-accredited pediatric training program directors (PDs) - 200 in general pediatrics (GP), 57 in cardiology (CARD), 64 in critical care medicine (CCM), 69 in hematology-oncology (ONC) and 96 in neonatology (NICU). We collected training program's demographics, PD's attitudes and educational practices regarding HPM. The complete response rate was 30% (148/486). Overall, 45% offer formal HPM curriculum and 39% offer a rotation in HPM for trainees. HPM teaching modalities commonly reported included conferences, consultations and bedside teaching. Eighty-one percent of all respondents felt that HPM curriculum would improve trainees' ability to care for patients. While most groups felt that a HPM rotation would enhance trainees' education [GP (96%), CARD (77%), CCM (82%) and ONC (95%)], NICU PDs were more divided (55%; p training, there remains a paucity of opportunities for pediatric trainees. Passive teaching methods are frequently utilized in HPM curricula with minimal diversity in methods utilized to teach HPM. Opportunities to further emphasize HPM in general pediatric and pediatric sub-specialty training remains.

  20. Rising utilization of inpatient pediatric asthma pathways.

    Science.gov (United States)

    Kaiser, Sunitha V; Rodean, Jonathan; Bekmezian, Arpi; Hall, Matt; Shah, Samir S; Mahant, Sanjay; Parikh, Kavita; Morse, Rustin; Puls, Henry; Cabana, Michael D

    2018-02-01

    Clinical pathways are detailed care plans that operationalize evidence-based guidelines into an accessible format for health providers. Their goal is to link evidence to practice to optimize patient outcomes and delivery efficiency. It is unknown to what extent inpatient pediatric asthma pathways are being utilized nationally. (1) Describe inpatient pediatric asthma pathway design and implementation across a large hospital network. (2) Compare characteristics of hospitals with and without pathways. We conducted a descriptive, cross-sectional, survey study of hospitals in the Pediatric Research in Inpatient Settings Network (75% children's hospitals, 25% community hospitals). Our survey determined if each hospital used a pathway and pathway characteristics (e.g. pathway elements, implementation methods). Hospitals with and without pathways were compared using Chi-square tests (categorical variables) and Student's t-tests (continuous variables). Surveys were distributed to 3-5 potential participants from each hospital and 302 (74%) participants responded, representing 86% (106/123) of surveyed hospitals. From 2005-2015, the proportion of hospitals utilizing inpatient asthma pathways increased from 27% to 86%. We found variation in pathway elements, implementation strategies, electronic medical record integration, and compliance monitoring across hospitals. Hospitals with pathways had larger inpatient pediatric programs [mean 12.1 versus 6.1 full-time equivalents, p = 0.04] and were more commonly free-standing children's hospitals (52% versus 23%, p = 0.05). From 2005-2015, there was a dramatic rise in implementation of inpatient pediatric asthma pathways. We found variation in many aspects of pathway design and implementation. Future studies should determine optimal implementation strategies to better support hospital-level efforts in improving pediatric asthma care and outcomes.

  1. Multidisciplinary Management of Pediatric Sports-Related Concussion.

    Science.gov (United States)

    Ellis, Michael J; Ritchie, Lesley J; McDonald, Patrick J; Cordingley, Dean; Reimer, Karen; Nijjar, Satnam; Koltek, Mark; Hosain, Shahid; Johnston, Janine; Mansouri, Behzad; Sawyer, Scott; Silver, Norm; Girardin, Richard; Larkins, Shannon; Vis, Sara; Selci, Erin; Davidson, Michael; Gregoire, Scott; Sam, Angela; Black, Brian; Bunge, Martin; Essig, Marco; MacDonald, Peter; Leiter, Jeff; Russell, Kelly

    2017-01-01

    To summarize the clinical characteristics and outcomes of pediatric sports-related concussion (SRC) patients who were evaluated and managed at a multidisciplinary pediatric concussion program and examine the healthcare resources and personnel required to meet the needs of this patient population. We conducted a retrospective review of all pediatric SRC patients referred to the Pan Am Concussion Program from September 1st, 2013 to May 25th, 2015. Initial assessments and diagnoses were carried out by a single neurosurgeon. Return-to-Play decision-making was carried out by the multidisciplinary team. 604 patients, including 423 pediatric SRC patients were evaluated at the Pan Am Concussion Program during the study period. The mean age of study patients was 14.30 years (SD: 2.32, range 7-19 years); 252 (59.57%) were males. Hockey (182; 43.03%) and soccer (60; 14.18%) were the most commonly played sports at the time of injury. Overall, 294 (69.50%) of SRC patients met the clinical criteria for concussion recovery, while 75 (17.73%) were lost to follow-up, and 53 (12.53%) remained in active treatment at the end of the study period. The median duration of symptoms among the 261 acute SRC patients with complete follow-up was 23 days (IQR: 15, 36). Overall, 25.30% of pediatric SRC patients underwent at least one diagnostic imaging test and 32.62% received referral to another member of our multidisciplinary clinical team. Comprehensive care of pediatric SRC patients requires access to appropriate diagnostic resources and the multidisciplinary collaboration of experts with national and provincially-recognized training in TBI.

  2. Bone Canopies in Pediatric Renal Osteodystrophy

    DEFF Research Database (Denmark)

    Pereira, Renata C; Levin Andersen, Thomas; Friedman, Peter A

    2016-01-01

    Pediatric renal osteodystrophy (ROD) is characterized by changes in bone turnover, mineralization, and volume that are brought about by alterations in bone resorption and formation. The resorptive and formative surfaces on the cancellous bone are separated from the marrow cavity by canopies...... and their association with biochemical and bone histomorphometric parameters in 106 pediatric chronic kidney disease (CKD) patients (stage 2-5) across the spectrum of ROD. Canopies in CKD patients often appeared as thickened multilayered canopies, similar to previous reports in patients with primary hyperparathyroidism....... This finding contrasts with the thin appearance reported in healthy individuals with normal kidney function. Furthermore, canopies in pediatric CKD patients showed immunoreactivity to the PTH receptor (PTHR1) as well as to the receptor activator of nuclear factor kappa-B ligand (RANKL). The number of surfaces...

  3. Cell therapy for pediatric disorders of glia

    DEFF Research Database (Denmark)

    Albuquerque Osório, Maria Joana; Goldman, Steven A.

    2016-01-01

    The childhood disorders of glia comprise a group of diseases that include the pediatric leukodystrophies and lysosomal storage disorders, cerebral palsies and perinatal hypoxic ischemic encephalopathies, and selected neurodevelopmental disorders of glial origin. Essentially, all of these disorders...... (GPCs) and their derivatives, the glial disorders may be uniquely attractive targets for cell-based therapeutic strategies, and the pediatric disorders especially so. As a result, GPCs, which can distribute throughout the neuraxis and give rise to new astrocytes and myelinogenic oligodendrocytes, have...... become of great interest as candidates for the therapeutic restoration of normal glial architecture and function, as well as new myelin, to the pediatric brain....

  4. Pediatric Supportive Care (PDQ®)—Health Professional Version

    Science.gov (United States)

    Pediatric supportive care includes managing issues from the cancer diagnosis, through treatment, and into adult survivorship. Get detailed information addressing pediatric supportive care including psychologic, family, and end-of-life concerns in this clinician summary.

  5. Environmental Management of Pediatric Asthma: Guidelines for Health Care Providers

    Science.gov (United States)

    Roberts, James R.; McCurdy, Leyla Erk

    2005-01-01

    These guidelines are the product of a new Pediatric Asthma Initiative aimed at integrating environmental management of asthma into pediatric health care. This document outlines competencies in environmental health relevant to pediatric asthma that should be mastered by primary health care providers, and outlines the environmental interventions…

  6. Biomarkers of Pediatric Brain Tumors

    Directory of Open Access Journals (Sweden)

    Mark D Russell

    2013-03-01

    Full Text Available Background and Need for Novel Biomarkers: Brain tumors are the leading cause of death by solid tumors in children. Although improvements have been made in their radiological detection and treatment, our capacity to promptly diagnose pediatric brain tumors in their early stages remains limited. This contrasts several other cancers where serum biomarkers such as CA 19-9 and CA 125 facilitate early diagnosis and treatment. Aim: The aim of this article is to review the latest literature and highlight biomarkers which may be of clinical use in the common types of primary pediatric brain tumor. Methods: A PubMed search was performed to identify studies reporting biomarkers in the bodily fluids of pediatric patients with brain tumors. Details regarding the sample type (serum, cerebrospinal fluid or urine, biomarkers analyzed, methodology, tumor type and statistical significance were recorded. Results: A total of 12 manuscripts reporting 19 biomarkers in 367 patients vs. 397 controls were identified in the literature. Of the 19 biomarkers identified, 12 were isolated from cerebrospinal fluid, 2 from serum, 3 from urine, and 2 from multiple bodily fluids. All but one study reported statistically significant differences in biomarker expression between patient and control groups.Conclusions: This review identifies a panel of novel biomarkers for pediatric brain tumors. It provides a platform for the further studies necessary to validate these biomarkers and, in addition, highlights several techniques through which new biomarkers can be discovered.

  7. [Drug administration to pediatric patients: Evaluation of the nurses' preparation habits in pediatric units].

    Science.gov (United States)

    Ménétré, S; Weber, M; Socha, M; Le Tacon, S; May, I; Schweitzer, C; Demoré, B

    2018-04-01

    In hospitals, the nursing staff is often confronted with the problem of the preparation and administration of drugs for their pediatric patients because of the lack of indication, pediatric dosage, and appropriate galenic form. The goal of this study was to give an overview of the nurses' preparation habits in pediatric units and highlight their daily problems. This single-center prospective study was conducted through an observation of the nursing staff during the drug preparation process in medicine, surgery and intensive care units. We included 91 patients (55 boys and 36 girls), with an average age of 6.3 years (youngest child, 10 days old; oldest child, 18 years old). We observed a mean 2.16 drug preparations per patient [1-5]. We collected 197 observation reports regarding 66 injectable drugs and 131 oral drugs (71 liquid forms and 60 solid forms). The majority of these reports concerned central nervous system drugs (63/197), metabolism and digestive system drugs (50/197), and anti-infective drugs (46/197). The study highlights the nurses' difficulties: modification of the solid galenic forms, lack of knowledge on oral liquid form preservation or reconstitution methods, withdrawal of small volumes, and vague and noncompliant labeling. This study led to the creation of a specific working group for pediatrics. This multidisciplinary team meets on a regular basis to work toward improving the current habits to both simplify and secure drug administration to hospitalized children. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  8. Reversible Cerebral Vasoconstriction Syndrome in Pediatrics: A Case Series and Review.

    Science.gov (United States)

    Coffino, Samantha W; Fryer, Robert H

    2017-06-01

    Reversible cerebral vasoconstriction syndrome is a transient vasculopathy associated with severe headaches and stroke. In most cases of reversible cerebral vasoconstriction syndrome, there is a precipitating event or trigger, such as pregnancy, serotonin agonist treatment or illicit drug use. The authors present 2 pediatric cases of reversible cerebral vasoconstriction syndrome and review the previous 11 pediatric cases in the literature. In many instances, the clinical and radiographic features are similar in both pediatric and adult cases. In the pediatric group, reported potential triggers include trauma (1/13), exercise (2/13), water to the face (3/13), hypertension (3/13), and medication or substance use (4/13). One surprising difference is that 11 out of 13 pediatric patients with reversible cerebral vasoconstriction syndrome are male while most cases in adults are female. Many of the pediatric patients with reversible cerebral vasoconstriction syndrome were treated with a calcium channel blocker and the overall outcome of pediatric reversible cerebral vasoconstriction syndrome was good, with most patients experiencing a full recovery.

  9. Recent advances in delivery mechanisms for aerosol therapy during pediatric respiratory diseases.

    Science.gov (United States)

    Wu, Yue'E; Zhang, Chonglin; Zhen, Qing

    2018-04-01

    The treatment of pediatric surgery diseases via utilization of aerosol delivery mechanisms is in progress for the betterment of pediatric care. Over the years, aerosol therapy has come to play an integral role in the treatment of pediatric respiratory diseases. Inhaled aerosol agents such as bronchodilators, corticosteroids, antibiotics, and mucolytics are commonly delivered to spontaneously breathing pediatric patients with a tracheostomy. Administering therapeutic inhaled aerosols to pediatric patients is challenging. The pediatric population ranges in age, which means patients with different airway sizes, breathing patterns, and cooperation levels. These patient-related factors impact the deposition of aerosol drugs in the lungs. The present review article will discuss the recent advancements in the delivery mechanisms for aerosol therapy in pediatric patients with respiratory diseases.

  10. Summary of the NICHD-BPCA Pediatric Formulation Initiatives Workshop-Pediatric Biopharmaceutics Classification System (PBCS) Working Group

    Science.gov (United States)

    Abdel-Rahman, Susan; Amidon, Gordon L.; Kaul, Ajay; Lukacova, Viera; Vinks, Alexander A.; Knipp, Gregory

    2012-01-01

    The Biopharmaceutics Classification System (BCS) allows compounds to be classified based on their in vitro solubility and intestinal permeability. The BCS has found widespread use in the pharmaceutical community as an enabling guide for the rational selection of compounds, formulation for clinical advancement and generic biowaivers. The Pediatric Biopharmaceutics Classification System (PBCS) working group was convened to consider the possibility of developing an analogous pediatric based classification system. Since there are distinct developmental differences that can alter intestinal contents, volumes, permeability and potentially biorelevant solubilities at the different ages, the PBCS working group focused on identifying age specific issues that would need to be considered in establishing a flexible, yet rigorous PBCS. Objective To summarize the findings of the PBCS working group and provide insights into considerations required for the development of a pediatric based biopharmaceutics classification system. Methods Through several meetings conducted both at The Eunice Kennedy Shriver National Institute of Child Health, Human Development (NICHD)-US Pediatric Formulation Initiative (PFI) workshop (November 2011) and via teleconferences, the PBCS working group considered several high level questions that were raised to frame the classification system. In addition, the PBCS working group identified a number of knowledge gaps that would need to be addressed in order to develop a rigorous PBCS. Results It was determined that for a PBCS to be truly meaningful, it would need to be broken down into several different age groups that would account for developmental changes in intestinal permeability, luminal contents, and gastrointestinal transit. Several critical knowledge gaps where identified including: 1) a lack of fully understanding the ontogeny of drug metabolizing enzymes and transporters along the gastrointestinal (GI) tract, in the liver and in the kidney; 2

  11. Pediatric Contact Dermatitis Registry Inaugural Case Data.

    Science.gov (United States)

    Goldenberg, Alina; Mousdicas, Nico; Silverberg, Nanette; Powell, Douglas; Pelletier, Janice L; Silverberg, Jonathan I; Zippin, Jonathan; Fonacier, Luz; Tosti, Antonella; Lawley, Leslie; Wu Chang, Mary; Scheman, Andrew; Kleiner, Gary; Williams, Judith; Watsky, Kalman; Dunnick, Cory A; Frederickson, Rachel; Matiz, Catalina; Chaney, Keri; Estes, Tracy S; Botto, Nina; Draper, Michelle; Kircik, Leon; Lugo-Somolinos, Aida; Machler, Brian; Jacob, Sharon E

    2016-01-01

    Little is known about the epidemiology of allergic contact dermatitis (ACD) in US children. More widespread diagnostic confirmation through epicutaneous patch testing is needed. The aim was to quantify patch test results from providers evaluating US children. The study is a retrospective analysis of deidentified patch test results of children aged 18 years or younger, entered by participating providers in the Pediatric Contact Dermatitis Registry, during the first year of data collection (2015-2016). One thousand one hundred forty-two cases from 34 US states, entered by 84 providers, were analyzed. Sixty-five percent of cases had one or more positive patch test (PPT), with 48% of cases having 1 or more relevant positive patch test (RPPT). The most common PPT allergens were nickel (22%), fragrance mix I (11%), cobalt (9.1%), balsam of Peru (8.4%), neomycin (7.2%), propylene glycol (6.8%), cocamidopropyl betaine (6.4%), bacitracin (6.2%), formaldehyde (5.7%), and gold (5.7%). This US database provides multidisciplinary information on pediatric ACD, rates of PPT, and relevant RPPT reactions, validating the high rates of pediatric ACD previously reported in the literature. The registry database is the largest comprehensive collection of US-only pediatric patch test cases on which future research can be built. Continued collaboration between patients, health care providers, manufacturers, and policy makers is needed to decrease the most common allergens in pediatric consumer products.

  12. Imaging of primary pediatric lymphoma of bone

    International Nuclear Information System (INIS)

    Milks, Kathryn S.; McLean, Thomas W.; Anthony, Evelyn Y.

    2016-01-01

    Primary pediatric bone lymphoma is a rare form of non-Hodgkin lymphoma. Unlike nodal forms of lymphoma, imaging abnormalities in lymphoma of bone do not resolve rapidly in conjunction with treatment and radiologic findings can remain abnormal for years, making it difficult to evaluate treatment response. To evaluate the utility of imaging in assessment of patients with primary pediatric bone lymphoma. At our institution between 2004 and 2013, six cases of pathology-proven primary pediatric bone lymphoma were diagnosed. Retrospective chart review was performed to assess imaging utilization. Our data were qualitatively compared with existing literature to construct an algorithm for imaging patients with primary lymphoma of bone. Imaging evaluation of patients with primary pediatric bone lymphoma was highly variable at our institution. Conventional imaging was routinely used to evaluate response to treatment, despite lack of appreciable osseous change. Imaging in the absence of symptoms did not alter clinical management. Only positron emission tomography CT (PET/CT) proved capable of demonstrating imaging changes from the pretreatment to the post-treatment scans that were consistent with the clinical response to treatment. Surveillance imaging is likely unnecessary in patients with a known diagnosis of pediatric lymphoma of bone. Pretreatment and post-treatment PET/CT is likely sufficient to assess response. There is little data to support the use of interim and surveillance PET/CT. (orig.)

  13. Radiation dose reduction in pediatric CT

    International Nuclear Information System (INIS)

    Robinson, A.E.; Hill, E.P.; Harpen, M.D.

    1986-01-01

    The relationship between image noise and radiation dose was investigated in computed tomography (CT) images of a pediatric abdomen phantom. A protocol which provided a minimum absorbed dose consistent with acceptable image noise criteria was determined for a fourth generation CT scanner. It was found that pediatric abdominal CT scans could maintain diagnostic quality with at least a 50% reduction in dose from the manufacturers' suggested protocol. (orig.)

  14. Validity of Level of Supervision Scales for Assessing Pediatric Fellows on the Common Pediatric Subspecialty Entrustable Professional Activities.

    Science.gov (United States)

    Mink, Richard B; Schwartz, Alan; Herman, Bruce E; Turner, David A; Curran, Megan L; Myers, Angela; Hsu, Deborah C; Kesselheim, Jennifer C; Carraccio, Carol L

    2018-02-01

    Entrustable professional activities (EPAs) represent the routine and essential activities that physicians perform in practice. Although some level of supervision scales have been proposed, they have not been validated. In this study, the investigators created level of supervision scales for EPAs common to the pediatric subspecialties and then examined their validity in a study conducted by the Subspecialty Pediatrics Investigator Network (SPIN). SPIN Steering Committee members used a modified Delphi process to develop unique scales for six of the seven common EPAs. The investigators sought validity evidence in a multisubspecialty study in which pediatric fellowship program directors and Clinical Competency Committees used the scales to evaluate fellows in fall 2014 and spring 2015. Separate scales for the six EPAs, each with five levels of progressive entrustment, were created. In both fall and spring, more than 300 fellows in each year of training from over 200 programs were assessed. In both periods and for each EPA, there was a progressive increase in entrustment levels, with second-year fellows rated higher than first-year fellows (P < .001) and third-year fellows rated higher than second-year fellows (P < .001). For each EPA, spring ratings were higher (P < .001) than those in the fall. Interrater reliability was high (Janson and Olsson's iota = 0.73). The supervision scales developed for these six common pediatric subspecialty EPAs demonstrated strong validity evidence for use in EPA-based assessment of pediatric fellows. They may also inform the development of scales in other specialties.

  15. [Crisis management in pediatric anesthesia].

    Science.gov (United States)

    Takeuchi, Mamoru; Otsuka, Yoji; Taga, Naoyuki; Sato, Yuki; Iwai, Hidetaka; Okada, Osamu

    2009-05-01

    We describe the risk management of pediatric anesthesia. The most important risk management of pediatric anesthesia is airway and temperature management. Neonates and infants easily become hypoxic due to their insufficient functional residual capacity. Therefore airway management is most important not only during induction of anesthesia but also during maintenance of anesthesia and extubation. The management of patients' temperature, including control of room temperature should be taken into consideration. In addition, careful attention should be paid not to introduce air bubbles in any lines, especially in patients with congenital heart diseases.

  16. Extrapulmonary involvement in pediatric tuberculosis.

    Science.gov (United States)

    Kritsaneepaiboon, Supika; Andres, Mariaem M; Tatco, Vincent R; Lim, Cielo Consuelo Q; Concepcion, Nathan David P

    2017-09-01

    Tuberculosis in childhood is clinically challenging, but it is a preventable and treatable disease. Risk factors depend on age and immunity status. The most common form of pediatric tuberculosis is pulmonary disease, which comprises more than half of the cases. Other forms make up the extrapulmonary tuberculosis that involves infection of the lymph nodes, central nervous system, gastrointestinal system, hepatobiliary tree, and renal and musculoskeletal systems. Knowledge of the imaging characteristics of pediatric tuberculosis provides clues to diagnosis. This article aims to review the imaging characteristics of common sites for extrapulmonary tuberculous involvement in children.

  17. Five-year follow-up of Community Pediatrics Training Initiative.

    Science.gov (United States)

    Minkovitz, Cynthia S; Goldshore, Matt; Solomon, Barry S; Guyer, Bernard; Grason, Holly

    2014-07-01

    To compare community involvement of pediatricians exposed to enhanced residency training as part of the Dyson Community Pediatrics Training Initiative (CPTI) with involvement reported by a national sample of pediatricians. A cross-sectional analyses compared 2008-2010 mailed surveys of CPTI graduates 5 years after residency graduation with comparably aged respondents in a 2010 mailed national American Academy of Pediatrics survey of US pediatricians (CPTI: n = 234, response = 56.0%; national sample: n = 243; response = 59.9%). Respondents reported demographic characteristics, practice characteristics (setting, time spent in general pediatrics), involvement in community child health activities in past 12 months, use of ≥1 strategies to influence community child health (eg, educate legislators), and being moderately/very versus not at all/minimally skilled in 6 such activities (eg, identify community needs). χ(2) statistics assessed differences between groups; logistic regression modeled the independent association of CPTI with community involvement adjusting for personal and practice characteristics and perspectives regarding involvement. Compared with the national sample, more CPTI graduates reported involvement in community pediatrics (43.6% vs 31.1%, P .05). Differences in involvement remained in adjusted analyses with greater involvement by CPTI graduates (adjusted odds ratio 2.4, 95% confidence interval 1.5-3.7). Five years after residency, compared with their peers, more CPTI graduates report having skills and greater community pediatrics involvement. Enhanced residency training in community pediatrics may lead to a more engaged pediatrician workforce. Copyright © 2014 by the American Academy of Pediatrics.

  18. Resident interest and factors involved in entering a pediatric pulmonary fellowship

    Directory of Open Access Journals (Sweden)

    Gershan William M

    2004-07-01

    Full Text Available Abstract Background Relatively little is known about interest in pediatric pulmonology among pediatric residents. The purpose of this study, therefore, was to determine at this institution: 1 the level of pediatric resident interest in pursuing a pulmonary fellowship, 2 potential factors involved in development of such interest, 3 whether the presence of a pulmonary fellowship program affects such interest. Methods A questionnaire was distributed to all 52 pediatric residents at this institution in 1992 and to all 59 pediatric residents and 14 combined internal medicine/pediatrics residents in 2002, following development of a pulmonary fellowship program. Results Response rates were 79% in 1992 and 86% in 2002. Eight of the 43 responders in 1992 (19% had considered doing a pulmonary fellowship compared to 7 of 63 (11% in 2002. The highest ranked factors given by the residents who had considered a fellowship included wanting to continue one's education after residency, enjoying caring for pulmonary patients, and liking pulmonary physiology and the pulmonary faculty. Major factors listed by residents who had not considered a pulmonary fellowship included not enjoying the tracheostomy/ventilator population and chronic pulmonary patients in general, and a desire to enter general pediatrics or another fellowship. Most residents during both survey periods believed that they would be in non-academic or academic general pediatrics in 5 years. Only 1 of the 106 responding residents (~1% anticipated becoming a pediatric pulmonologist. Conclusions Although many pediatric residents consider enrolling in a pulmonary fellowship (~10–20% here, few (~1% here will actually pursue a career in pediatric pulmonology. The presence of a pulmonary fellowship program did not significantly alter resident interest, though other confounding factors may be involved.

  19. Upstairs downstairs: vertical integration of a pediatric service.

    Science.gov (United States)

    Racine, A D; Stein, R E; Belamarich, P F; Levine, E; Okun, A; Porder, K; Rosenfeld, J L; Schechter, M

    1998-07-01

    The combined effects of recent changes in health care financing and training priorities have compelled academic medical centers to develop innovative structures to maintain service commitments yet conform to health care marketplace demands. In 1992, a municipal hospital in the Bronx, New York, affiliated with a major academic medical center reorganized its pediatric service into a vertically integrated system of four interdependent practice teams that provided comprehensive care in the ambulatory as well as inpatient settings. One of the goals of the new system was to conserve inpatient resources. To describe the development of a new vertically integrated pediatric service at an inner-city municipal hospital and to test whether its adoption was associated with the use of fewer inpatient resources. A descriptive analysis of the rationale, goals, implementation strategies, and structure of the vertically integrated pediatric service combined with a before-and-after comparison of in-hospital resource consumption. A before-and-after comparison was conducted for two periods: the period before vertical integration, from January 1989 to December 1991, and the period after the adoption of vertical integration, from July 1992 to December 1994. Four measures of inpatient resource use were compared after adjustment for case mix index: mean certified length of stay per case, mean number of radiologic tests per case, mean number of ancillary tests per case, and mean number of laboratory tests per case. Difference-in-differences-in-differences estimators were used to control for institution-wide trends throughout the time period and regional trends in inpatient pediatric practice occurring across institutions. Results. In 1992, the Department of Pediatrics at the Albert Einstein College of Medicine reorganized the pediatric service at Jacobi Medical Center, one of its principal municipal hospital affiliates, into a vertically integrated pediatric service that combines ambulatory

  20. Quality control of pediatric chest X-rays in diagnostic centers with and without pediatric competence

    International Nuclear Information System (INIS)

    Alt, C.D.; Engelmann, D.; Schenk, J.P.; Troeger, J.

    2006-01-01

    Purpose: Radiation protection in pediatric radiology is very important because of the particular sensitivity of radiosensitive organs in younger patients. Optimized image quality supports radiation protection and should be targeted. In our study we examined the quality of pediatric chest X-rays at diagnostic centers (university hospitals and other large clinics). We then evaluated differences in image quality in departments without pediatric competence (R) and departments with pediatric competence (PR). Materials and Methods: Our study was based on 313 conventional chest X-rays from 207 patients (192 p.a./a.p. and 121 lateral, 43 from R, 258 from PR and 12 neither from R nor KR) and 38 digital chest X-rays from 26 patients (25 p.a./a.p. and 13 lateral, 1 from R and 37 from PR). All patients (age 0 - 18 years) are from Nephroblastoma-Study SIOP-93/01-GPOH. We examined all initial chest X-rays, which were sent to us for evaluation upon request between 4/3/2002 and 6/14/2002. The examined parameters were: exposure, centering of the X-rays/patient positioning, collimation and sharpness. The X-rays were evaluated on a scale from 1 (best result) to 5 (worst result), resulting in an overall score of A = optimum, B = minor problems, C = major problems, or D = unusable. The optical density, the center of the image and the relative field size were also measured. Statistical tests (Mann-Whitney-U and log regression) were carried out on the conventional images. The study was performed retrospectively. The exposure, sharpness and optical density of the digital X-rays were not analyzed. Results: In the case of all conventional X-rays, the quality of the centering of the X-rays/patient positioning and collimation was moderate (average scale value: 2.4 and 2.8), and the quality of the exposure and sharpness was good and very good (average scale value: 1.9 and 1.5). The quality of the chest X-rays in departments with additional pediatric radiological expertise was better mainly in