Brian Coley
Cincinnati Children's Hospital Medical Center, Radiology, Faculty Member
Research Interests:
Vomiting is a commonly reported symptom in infants less than three months of age. There are a multitude of pathologies to consider, both within and outside the gastrointestinal tract. In addition to conducting a thorough history and... more
Vomiting is a commonly reported symptom in infants less than three months of age. There are a multitude of pathologies to consider, both within and outside the gastrointestinal tract. In addition to conducting a thorough history and physical examination, a clinician formulates a reasonable differential diagnosis by consideration of two main factors: the infant's age and the characterization of the vomit as bilious or nonbilious. In this endeavor, the clinician is able to determine if an imaging study is needed and, if so, the urgency of the request. A review of the appropriate imaging evaluation of vomiting infants in the newborn to three-month-old age group is provided by organizing the discussion around the following three clinical scenarios: bilious vomiting, intermittent nonbilious vomiting since birth, and new-onset bilious vomiting. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multi...
Research Interests:
ABSTRACT Background: Lung ultrasonography (LUS) is increasingly being used to detect pneumonia in children. Using chest radiograph as a reference standard, studies have found LUS to have >85% sensitivity and specificity in... more
ABSTRACT Background: Lung ultrasonography (LUS) is increasingly being used to detect pneumonia in children. Using chest radiograph as a reference standard, studies have found LUS to have >85% sensitivity and specificity in detecting pneumonia. However, the interpreting sonologists have rarely been blinded to clinical information. The objective of this study was to determine the inter-rater reliability among pediatric radiologists blinded to the clinical information, with and without a standardized ultrasound protocol. Methods: LUS performed between January 2011-March 2013 on children 3 months-18 years were included. Five pediatric radiologists were trained on LUS interpretation for signs indicative of pneumonia. Two sets of LUS were read. The first set consisted of 40 LUS that were performed for clinical reasons. These LUS were performed without a standardized protocol to ensure coverage of all portions of the lung. The second set consisted of 15 ultrasounds that were performed using a standardized, evidence-based protocol. Inter-rater reliability was calculated using a kappa statistic. Results: The inter-rater reliability for lung consolidation was fair for standardized LUS (0.40) and for unstandardized LUS (0.36). Interstitial disease had slight to poor agreement regardless of protocol. Pleural effusion had fair inter-rater reliability in the unstandardized set (0.29) but almost perfect reliability in the standardized set (0.82) (Table 1). Conclusion: These preliminary data suggest that standardization of sonogram readings leads to higher inter-rater reliability in detecting pleural effusions in children using LUS. However, reliability, while improved, remained low to moderate for other findings of pneumonia. This may indicate a need for clearer definitions in this relatively new application of LUS. Table 1: Inter-rater reliability of lung ultrasounds using unstandardized and standardized ultrasound protocols* Overall Conclusion Unstandardized LUS Standardized LUS Lobar or Patchy Consolidation 0.36 0.40 Interstitial Disease 0.06 0.16 Pleural Effusion 0.29 0.82 * Classification of the strength of agreement: poor (<0.0); slight (0-0.20); fair (0.21-0.40); moderate (0.41-0.60); substantial (0.61-0.80); almost perfect (0.81-1.0)
Objectives To quantify rates and variation in emergency department (ED) cranial computed tomography (CT) utilization in children with ventricular shunts, estimate radiation exposure, and evaluate the association between CT utilization and... more
Objectives To quantify rates and variation in emergency department (ED) cranial computed tomography (CT) utilization in children with ventricular shunts, estimate radiation exposure, and evaluate the association between CT utilization and shunt revision. Study design Retrospective longitudinal cohort study of ED visits from 2003-2013 in children 0-18 years old with initial shunt placement in 2003. Data were examined from 31 hospitals in the Pediatric Health Information System. Main outcomes were cranial CT performed during an ED visit, estimated cumulative effective radiation dose, and shunt revision within 7 days. Multivariable regression modeled the relationship between patient-and hospital-level covariates and CT utilization. Results The 1319 children with initial shunt placed in 2003 experienced 6636 ED visits during the subsequent decade. A cranial CT was obtained in 49.4% of all ED visits; 19.9% of ED visits with CT were associated with a shunt revision. Approximately 6% of patients received $10 CTs, accounting for 37.2% of all ED visits with a CT. The mean number of CTs per patient varied nearly 20-fold across hospitals; the individual hospital accounted for the most variation in CT utilization. The median (IQR) cumulative effective radiation dose was 7.2 millisieverts (3.6-14.0) overall, and 33.4 millisieverts (27.2-43.8) among patients receiving $10 CTs. Conclusions A CT scan was obtained in half of ED visits for children with a ventricular shunt, with wide variability in utilization by hospitals. Strategies are needed to identify children at risk of shunt malfunction to reduce variability in CT utilization and radiation exposure in the ED. (J Pediatr 2015;167:1382-8). A pproximately 150 000 children in the US rely on a cerebrospinal fluid ventricular shunt to treat hydrocephalus. In children , placement of ventriculoperitoneal (VP) shunts, the most common form of cerebrospinal fluid shunt, has doubled over the last 3 decades. 1 Although VP shunts have dramatically improved survival for children with hydrocephalus, they are associated with high rates of complications, such as mechanical failure and infection, which result in cranial imaging and surgical revision. 2 Children are at highest risk for shunt failure within the first year of placement; shunt revision rates are approximately 40% in the first year, and reach as high as 60% within 10 years, with substantial variation in failure rates across hospitals. 3,4 Children with concern for VP shunt-related complications are frequently evaluated in the emergency department (ED), where cranial computed tomog-raphy (CT) is often used to diagnose shunt malfunction and differentiate malfunction from other conditions. 2,5-8 CT use exposes children to ionizing radiation, and greater cumulative radiation exposure might be associated with a greater incidence of malignancy. 7,9,10 Children with VP shunts represent a particularly vulnerable group, as they often undergo multiple CT scans, and may be exposed to large cumulative radiation doses over the course of their lives. 10 Rapid cranial magnetic resonance imaging (MRI) has recently been explored as an alternative to CT to diagnose shunt malfunction. 11,12 To date,
ABSTRACT LEARNING OBJECTIVES Objective: In this course, participants will be able to: (1) Identify basic skills, techniques, and pitfalls of freehand invasive sonography, with specific focus on small parts applications; (2) Discuss and... more
ABSTRACT LEARNING OBJECTIVES Objective: In this course, participants will be able to: (1) Identify basic skills, techniques, and pitfalls of freehand invasive sonography, with specific focus on small parts applications; (2) Discuss and perform basic skills involved in breast, musculoskeletal, and head/neck invasive sonography; (3) Perform specific US-guided procedures to include core biopsy, abscess drainage, thyroid biopsy, cyst aspiration, access for sclerotherapy of lymphatic malformations, soft tissue foreign body removal, and joint injection. ABSTRACT
Research Interests: Radiology, Biomedical Engineering, Humans, Child, Male, and 3 moreClinical Sciences, Scrotum, and Nino
In mechanically ventilated adults, closed multi-use suction systems (CLOSED) have been reported to increase bacterial airway colonization but not the incidence of pneumonia. Comparisons between CLOSED and traditional (OPEN) system in... more
In mechanically ventilated adults, closed multi-use suction systems (CLOSED) have been reported to increase bacterial airway colonization but not the incidence of pneumonia. Comparisons between CLOSED and traditional (OPEN) system in ventilated newborns ...
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OBJECTIVE: We designed this retrospective study to compare radiologic findings in premature infants with bronchopulmonary dysplasia (BPD) in whom gram-positive cocci (GPC), gram-negative bacilli (GNB), or Ureaplasma urealyticum were... more
OBJECTIVE: We designed this retrospective study to compare radiologic findings in premature infants with bronchopulmonary dysplasia (BPD) in whom gram-positive cocci (GPC), gram-negative bacilli (GNB), or Ureaplasma urealyticum were colonized. Another objective was to ...
Research Interests:
ABSTRACT
Research Interests: Biopsy, Humans, Child, Male, tESTIS, and 2 moreClinical Sciences and Lithiasis(Clinical Sciences and Lithiasis)
(Clinical Sciences and Lithiasis)
To quantify rates and variation in emergency department (ED) cranial computed tomography (CT) utilization in children with ventricular shunts, estimate radiation exposure, and evaluate the association between CT utilization and shunt... more
To quantify rates and variation in emergency department (ED) cranial computed tomography (CT) utilization in children with ventricular shunts, estimate radiation exposure, and evaluate the association between CT utilization and shunt revision. Retrospective longitudinal cohort study of ED visits from 2003-2013 in children 0-18 years old with initial shunt placement in 2003. Data were examined from 31 hospitals in the Pediatric Health Information System. Main outcomes were cranial CT performed during an ED visit, estimated cumulative effective radiation dose, and shunt revision within 7 days. Multivariable regression modeled the relationship between patient- and hospital-level covariates and CT utilization. The 1319 children with initial shunt placed in 2003 experienced 6636 ED visits during the subsequent decade. A cranial CT was obtained in 49.4% of all ED visits; 19.9% of ED visits with CT were associated with a shunt revision. Approximately 6% of patients received ≥10 CTs, accoun...
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The purpose of this study was to describe the imaging and pathologic findings of 2 cases of complex neonatal abdominal masses and to discuss the probable common embryologic etiology of fetus in fetu (FIF) and fetaform teratomas. Two male... more
The purpose of this study was to describe the imaging and pathologic findings of 2 cases of complex neonatal abdominal masses and to discuss the probable common embryologic etiology of fetus in fetu (FIF) and fetaform teratomas. Two male neonates had complex cystic abdominal masses, 1 of which was diagnosed prenatally, and both had abdominal sonography. One patient also had abdominal computed tomography. Both patients subsequently underwent surgical resection, with pathologic and genetic analysis of these masses. One patient had typical imaging, pathologic, and genetic findings of FIF. The second patient had a well-formed mass that was diagnosed pathologically as a teratoma yet had most of the criteria for FIF that have been set forth in recent embryologic literature. Recent concepts regarding the origin of FIF suggest that it is part of a spectrum of monozygotic twinning gone awry, ranging from conjoined twins at one end to fetaform teratomas at the other. The imaging and pathologic features of these 2 cases serve to reinforce this concept.
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ABSTRACT LEARNING OBJECTIVES 1) Identify basic skills, techniques, and pitfalls of freehand invasive sonography, with specific focus on small part applications. 2) Define and discuss technical aspects, rationale, and pitfalls involved in... more
ABSTRACT LEARNING OBJECTIVES 1) Identify basic skills, techniques, and pitfalls of freehand invasive sonography, with specific focus on small part applications. 2) Define and discuss technical aspects, rationale, and pitfalls involved in musculoskeletal, breast, head and neck, and pediatric interventional sonographic care procedures. 3) Successfully perform basic portions of hands-on US-guided procedures in a tissue simulation learning model, to include core biopsy, small abscess coaxial catheter drainage, cyst and ganglion aspiration, lymphatic malformation macrocyst access, soft tissue foreign body removal, and intraarticular steroid injection. 4) Incorporate these component skill sets into further life-long learning for expansion of competency and preparation for more advanced interventional sonographic learning opportunities. ABSTRACT
LEARNING OBJECTIVES 1) Review the imaging features of focal liver lesions. 2) Learn to recognize pediatric hepatic masses and congenital abnormalities. 3) Understand the contributions of different imaging modalities to their evaluation.
LEARNING OBJECTIVES 1) Learn the basics of doppler waveform analysis. 2) Learn to recognize normal and abnormal sonographic findings in the pediatric central and peripheral vasculature. ABSTRACT
LEARNING OBJECTIVES Objective: In this course participants will be able to (1) Identify basic skills, techniques, and pitfalls of freehand invasive sonography; (2) Discuss and perform basic skills involved in thermal tumor ablation in a... more
LEARNING OBJECTIVES Objective: In this course participants will be able to (1) Identify basic skills, techniques, and pitfalls of freehand invasive sonography; (2) Discuss and perform basic skills involved in thermal tumor ablation in a live learning model; (3) Perform specific US-guided procedures to include core biopsy, abscess drainage, vascular access, cyst aspiration, soft tissue foreign body removal, and radiofrequency tumor ablation. ABSTRACT DISCLOSURE K.H.C.: is a member of the Medical Advisory Board of Philips Medical Systems.
LEARNING OBJECTIVES Participants will: (1) Learn to identify and understand basic skills, techniques, pitfalls of freehand invasive sonography. (2) Practice specific US-guided procedures to include core biopsy, abscess drainage, vascular... more
LEARNING OBJECTIVES Participants will: (1) Learn to identify and understand basic skills, techniques, pitfalls of freehand invasive sonography. (2) Practice specific US-guided procedures to include core biopsy, abscess drainage, vascular access, and cyst aspiration. (3) Learn new US-guided procedures, including US-guided foreign body removal, and radiofrequency tumor ablation. DISCLOSURE J.A.R.: is a stockholder in Boston Scientific.
Vomiting is a commonly reported symptom in infants less than three months of age. There are a multitude of pathologies to consider, both within and outside the gastrointestinal tract. In addition to conducting a thorough history and... more
Vomiting is a commonly reported symptom in infants less than three months of age. There are a multitude of pathologies to consider, both within and outside the gastrointestinal tract. In addition to conducting a thorough history and physical examination, a clinician formulates a reasonable differential diagnosis by consideration of two main factors: the infant's age and the characterization of the vomit as bilious or nonbilious. In this endeavor, the clinician is able to determine if an imaging study is needed and, if so, the urgency of the request. A review of the appropriate imaging evaluation of vomiting infants in the newborn to three-month-old age group is provided by organizing the discussion around the following three clinical scenarios: bilious vomiting, intermittent nonbilious vomiting since birth, and new-onset bilious vomiting. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multi...
Research Interests:
LEARNING OBJECTIVES 1) Identify and correctly diagnose at least three diagnostic challenges in the pediatric head, neck, chest, GI, GU, and musculoskeletal systems. 2) Define three critical elements of radiological diagnostic and... more
LEARNING OBJECTIVES 1) Identify and correctly diagnose at least three diagnostic challenges in the pediatric head, neck, chest, GI, GU, and musculoskeletal systems. 2) Define three critical elements of radiological diagnostic and therapeutic care of children in which, when identified, avoid harm and improve safety of care. 3) Delineate three opportunities for diagnostic and interventional sonography to provide elegant depiction of pathology, reduce radiation exposure to children, and precisely guide interventional sonographic needle access in the care of children.
LEARNING OBJECTIVES 1) Understand the pediatric clinical conditions and imaging findings for which US is often the only necessary imaging test required. ABSTRACT Ultrasound is still the most common cross sectional imaging modality for... more
LEARNING OBJECTIVES 1) Understand the pediatric clinical conditions and imaging findings for which US is often the only necessary imaging test required. ABSTRACT Ultrasound is still the most common cross sectional imaging modality for pediatric abdominal conditions. For many conditions, US can be definitive and obviate the need for further imaging thus leading to efficient and effective patient care. This section will focus on those conditions in which US excels and provides definitive decision points for patient management.
LEARNING OBJECTIVES Participants will: (1) Learn to identify and understand basic skills, techniques, and pitfalls of freehand invasive sonography. (2) Practice specific US-guided procedures to include core biopsy, abscess drainage,... more
LEARNING OBJECTIVES Participants will: (1) Learn to identify and understand basic skills, techniques, and pitfalls of freehand invasive sonography. (2) Practice specific US-guided procedures to include core biopsy, abscess drainage, vascular access, and cyst aspiration. (3) Learn new US-guided procedures, including US-guided foreign body removal and radiofrequency tumor ablation. URL's
LEARNING OBJECTIVES In this course participants will be able to: (1) Identify basic skills, techniques, and pitfalls of freehand invasive sonography. (2) Discuss and perform basic skills involved in thermal tumor ablation in a live... more
LEARNING OBJECTIVES In this course participants will be able to: (1) Identify basic skills, techniques, and pitfalls of freehand invasive sonography. (2) Discuss and perform basic skills involved in thermal tumor ablation in a live learning model. (3) Perform specific US-guided procedures to include core biopsy, abscess drainage, vascular access, cyst aspiration, soft tissue foreign body removal, and radiofrequency tumor ablation. ABSTRACT URL's www.cc.nih.gov/drd/rfa
Purpose: Advances in medicine and multidisciplinary care have resulted in increased life expectancy and improved quality of life for patients with chronic congenital urological conditions (CUC). Current survival into adulthood approaches... more
Purpose: Advances in medicine and multidisciplinary care have resulted in increased life expectancy and improved quality of life for patients with chronic congenital urological conditions (CUC). Current survival into adulthood approaches 80%. These patients are often followed with multiple serial radiographic studies to monitor their health and improve clinical outcomes. We created an inter-disciplinary improvement program to optimize the utilization of diagnostic imaging (DI) for patients with CUC, i.e. patients with Spina Bifida (SB) and Posterior Urethral Valves (PUV). In this study we present the baseline data on cost and dosimetry associated with DI in this patient population during their care in a Pediatric Hospital. Methods: A collaborative study was undertaken to review DI practices to determine utilization of DI resources, patient dosimetry, and cost to the healthcare system. IRB approval was obtained. A cohort of patients with CUC treated from birth to age 21 years was ide...
PURPOSE To evaluate the efficacy and clinical impact of image-guided foreign body removal (IGFBR) for treatment of self-inflicted soft tissue foreign bodies (STFBs). METHOD AND MATERIALS Four hundred patients underwent IGFBR with... more
PURPOSE To evaluate the efficacy and clinical impact of image-guided foreign body removal (IGFBR) for treatment of self-inflicted soft tissue foreign bodies (STFBs). METHOD AND MATERIALS Four hundred patients underwent IGFBR with sonographic and/or fluoroscopic guidance. Self-mutilation was seen in 5 adolescent female patients (1.2%), representing 7 patient care encounters; 2 patients presented with self-inflicted STFBs on 2 separate occasions. Mean age 16.8 yr; (range 15-17 yr). Foreign body number, location, type and size as well as incision size, intraoperative imaging modality, type of surrounding reaction, and success or failure of removal were documented prospectively. RESULTS Twenty-five foreign bodies were inserted into the forearm or upper arm of the five patients. Referring services included Pediatric Surgery, Emergency Department, and Psychiatry. Number of STFBs per case ranged from 1-9; median=2. Foreign body types included metal (13), wood (5), graphite (3), plastic (2)...
ABSTRACT
... Arch Pediatr Adolesc Med 2008; 162:526531. Abstract/FREE Full Text. Rallison ML, Dobyns BM, Keating FR, Rall JE, Tyler FH. ... Schäffler A, Palitzsch KD, Seiffarth C, et al. Coexistent thyroiditis is associated with lower tumour... more
... Arch Pediatr Adolesc Med 2008; 162:526531. Abstract/FREE Full Text. Rallison ML, Dobyns BM, Keating FR, Rall JE, Tyler FH. ... Schäffler A, Palitzsch KD, Seiffarth C, et al. Coexistent thyroiditis is associated with lower tumour stage in thyroid carcinoma. ...
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Ultrasound of the thorax is particularly rewarding in children, because their unique thoracic anatomy provides many available acoustic windows into the chest. Newer ultrasound techniques can allow better understanding of lung disease.... more
Ultrasound of the thorax is particularly rewarding in children, because their unique thoracic anatomy provides many available acoustic windows into the chest. Newer ultrasound techniques can allow better understanding of lung disease. With minimum effort and creativity, chest ultrasound can provide important clinical information without radiation exposure or sedation sometimes required for computed tomography and magnetic resonance imaging.
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The purpose of this study was to describe a series of cases of hydrocolpos that proved to be due to vesicovaginal reflux. Cases with a diagnosis of hydrocolpos or a fluid-filled vagina identified from our ultrasound database were... more
The purpose of this study was to describe a series of cases of hydrocolpos that proved to be due to vesicovaginal reflux. Cases with a diagnosis of hydrocolpos or a fluid-filled vagina identified from our ultrasound database were retrospectively reviewed. The results from sonographic and fluoroscopic studies were reviewed, along with demographic and clinical data. Four patients had sonographic findings mimicking obstructive hydrocolpos that resolved after voiding. Fluoroscopic studies showed abnormal urethral morphologic characteristics in all 4, diminished bladder capacity in 3, and vesicovaginal reflux in 3. No anatomic abnormalities were identified. Vesicovaginal reflux can produce vaginal distension that is sonographically identical to obstructive hydrocolpos. This may be due to dysfunctional voiding issues. Postvoid sonography allows proper diagnosis.
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To assess the efficacy of ultrasound-guided compression repair (UGCR) in postcatheterization femoral artery pseudoaneurysms. One hundred thirty-three patients with pseudoaneurysms were considered for UGCR. Patients underwent compression... more
To assess the efficacy of ultrasound-guided compression repair (UGCR) in postcatheterization femoral artery pseudoaneurysms. One hundred thirty-three patients with pseudoaneurysms were considered for UGCR. Patients underwent compression with duplex and color Doppler ultrasound. Immediate and long-term successes were evaluated. Seven patients were not candidates for UGCR. UGCR was technically possible in 117 of the 126 patients who were candidates. UGCR was successful in 109 patients. The failure rate was significantly higher in patients who were receiving anticoagulant medication (P < .001). Pseudoaneurysm size, age, and structure (simple vs multiloculated) had no bearing on success or failure. The time required for successful compression was not related to treatment with anticoagulants but was related to pseudoaneurysm structure. Complications included one case of a distal embolus and two episodes of hypotension. UGCR is a simple and expedient method for the treatment of postcat...
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The subtalar joint is commonly affected in children with juvenile idiopathic arthritis and is challenging to treat percutaneously. To describe the technique for treating the subtalar joint with US-guided corticosteroid injections in... more
The subtalar joint is commonly affected in children with juvenile idiopathic arthritis and is challenging to treat percutaneously. To describe the technique for treating the subtalar joint with US-guided corticosteroid injections in children and young adults with juvenile idiopathic arthritis and to evaluate the safety of the treatment. We retrospectively analyzed 122 patients (age 15 months-29 years) with juvenile idiopathic arthritis who were referred by a pediatric rheumatologist for corticosteroid injection therapy for symptoms related to the hindfoot or ankle. In these patients the diseased subtalar joint was targeted for therapy, often in conjunction with adjacent affected joints or tendon sheaths of the ankle. We used a protocol based on age, weight and joint for triamcinolone hexacetonide or triamcinolone acetonide dose prescription. We describe the technique for successful treatment of the subtalar joint. A total of 241 subtalar joint corticosteroid injections were performed under US guidance, including 68 repeat injections for recurrent symptoms in 26 of the 122 children and young adults. The average time interval between repeat injections was 24.8 months (range 2.2-130.7 months, median 14.2 months). Subcutaneous tissue atrophy and skin hypopigmentation were the primary complications observed. These complications occurred in 3.9% of the injections. With appropriate training and practice, the subtalar joint can be reliably and safely targeted with US-guided corticosteroid injection to treat symptoms related to juvenile idiopathic arthritis.
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To determine if percutaneous nephrostomy can be performed safely as an outpatient procedure in children and adolescents. Percutaneous nephrostomy was performed in 102 kidneys in 87 patients at 93 separate encounters. Patients were... more
To determine if percutaneous nephrostomy can be performed safely as an outpatient procedure in children and adolescents. Percutaneous nephrostomy was performed in 102 kidneys in 87 patients at 93 separate encounters. Patients were excluded from outpatient treatment if they presented with signs of infection, were hospitalized for other reasons, were undergoing additional endourologic stone procedures, had solitary kidneys or poor renal function, had social problems precluding outpatient care, or had a procedural complication. Follow-up was performed by means of direct communication and/or chart review. Successful outpatient percutaneous nephrostomy was performed in 39 (42%) of the 93 encounters. Reasons for exclusion included infection (n = 23), concomitant problems requiring hospitalization (n = 11), stone therapy (n = 7), solitary kidney with renal failure (n = 3), and social reasons (n = 10). No procedure-related complication occurred. No patient required readmission within 3 weeks for a tube- or procedure-related problem. Outpatient percutaneous nephrostomy can be safely performed in a selected group of patients.
Research Interests: Radiology, Adolescent, Safety, Humans, Child, and 5 moreInfant, Follow-up studies, Newborn Infant, Ambulatory Care, and Nino
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Background: Traditionally, orogastric tube (OGt) length of insertion is determined by nose-earlobe-xyphoid (NEX) measurement. Although radiography is the gold standard for verification of placement, scarce data are available for extremely... more
Background: Traditionally, orogastric tube (OGt) length of insertion is determined by nose-earlobe-xyphoid (NEX) measurement. Although radiography is the gold standard for verification of placement, scarce data are available for extremely low birth weight (ELBW) ...
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Ultrasound examination of the thorax can be quite rewarding in children, because their unique thoracic anatomy provides many acoustic windows into the chest. With only a modest effort, chest ultrasonography can provide many clinically... more
Ultrasound examination of the thorax can be quite rewarding in children, because their unique thoracic anatomy provides many acoustic windows into the chest. With only a modest effort, chest ultrasonography can provide many clinically relevant answers, without the radiation exposure from CT, or the need for sedation sometimes required for CT and MR imaging.
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The Radiation Protection in Medicine conference, reviewed in this journal supplement, outlined nine strategies to promote radiation protection for patients. The Alliance for Radiation Safety in Pediatric Imaging has focused its work on... more
The Radiation Protection in Medicine conference, reviewed in this journal supplement, outlined nine strategies to promote radiation protection for patients. The Alliance for Radiation Safety in Pediatric Imaging has focused its work on three of those areas: creating awareness of the need and opportunities for radiation protection for children; developing open-source educational materials for medical professionals and parents on this critical topic for improved patient safety and communication; and lastly, advocating on behalf of children with industry, government and regulatory bodies to improve equipment design and safety features, standardisation of nomenclature and displays of dose reports across vendor platforms that reflect the special considerations of children.
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In mechanically ventilated adults, closed multi-use suction systems (CLOSED) have been reported to increase bacterial airway colonization but not the incidence of pneumonia. Comparisons between CLOSED and traditional (OPEN) system in... more
In mechanically ventilated adults, closed multi-use suction systems (CLOSED) have been reported to increase bacterial airway colonization but not the incidence of pneumonia. Comparisons between CLOSED and traditional (OPEN) system in ventilated newborns ...
Research Interests:
Conclusion: xRay signs of severe BPD (combined scores≥ 4) are visible at 2 w of VENT in 87% of the cases. Neither U, GNB nor GPC airway colonization is associated with a particular xRay pattern at any time. GNB colonized infants... more
Conclusion: xRay signs of severe BPD (combined scores≥ 4) are visible at 2 w of VENT in 87% of the cases. Neither U, GNB nor GPC airway colonization is associated with a particular xRay pattern at any time. GNB colonized infants experienced the most severe ...