Next generation risk assessment for occupational chemical safety - A real world example with sodium-2-hydroxyethane sulfonate.

Next Generation Risk Assessment (NGRA) is an exposure-led approach to safety assessment that uses New Approach Methodologies (NAMs). Application of NGRA has been largely restricted to assessments of consumer use of cosmetics and is not currently implemented in occupational safety assessments, e.g.

Correlation of Different MRI Scoring Systems with Long-Term Cognitive Outcome in Cooled Asphyxiated Newborns.

(1) Background: Cerebral MRI plays a significant role in assessing the extent of brain injury in neonates with neonatal encephalopathy after perinatal asphyxia. Over the last decades, several MRI scoring systems were developed to enhance the predictive accuracy of MRI. The aim of this study was to validate the correlation of four established MRI scoring systems with cognitive long-term outcomes in cooled asphyxiated newborns.

Multi-centre randomised trial of invasive and less invasive surfactant delivery methods showed similar spirometry results at 5-9 years of age.

Aim: We explored whether subnormal forced expiratory volume within 1 s (FEV ) at 5-9 years of age was lower in children born preterm who received less invasive surfactant administration (LISA) rather than surfactant via an endotracheal tube.

Methods: The multi-centre, randomised Nonintubated Surfactant Application trial enrolled 211 preterm infants born at 23-26 weeks of gestation from 13 level III neonatal intensive care units from April 2009 to March 2012. They received surfactant via LISA (n = 107) or after conventional endotracheal intubation (n = 104).

Vancomycin-induced ototoxicity in very-low-birthweight infants.

Background: Vancomycin is an extensively used anti-infective drug in neonatal ICUs. However, exposure-toxicity relationships have not been clearly defined.

Objectives: To evaluate the risk profile for hearing deficits in vancomycin-exposed very-low-birthweight infants (VLBWI).

causing nosocomial transmission among neonates - an emerging pathogen?

Transmission of Enterobacterales in neonatal intensive care units (NICU) can cause outbreaks of colonization and invasive infections among neonates. Two clusters of nosocomial transmission of identified by MALDI-ToF mass-spectrometry were suspected at two NICUs in July and August 2016. To assess the potential transmission of among neonates.

Aortic Coarctation a Systemic Vessel Disease-Insights from Magnetic Resonance Imaging.

Background:  Even after successful aortic coarctation (CoA) repair, hypertension causes premature morbidity and mortality. The mechanisms are not clear. The aim was to evaluate elastic wall properties and aortic morphology and to correlate these results with severity of restenosis, hypertension, aortic arch geometry, noninvasive pressure gradients, and time and kind of surgical procedure.

Active perinatal care of preterm infants in the German Neonatal Network.

Objective: To determine if survival rates of preterm infants receiving active perinatal care improve over time.

Design: The German Neonatal Network is a cohort study of preterm infants with birth weight <1500 g. All eligible infants receiving active perinatal care are registered.

Assessment of Suspected Vascular Rings and Slings and/or Airway Pathologies Using Magnetic Resonance Imaging Rather Than Computed Tomography.

Background: Congenital cardiovascular malformations (CCVM) may cause infrequently airway pathologies (AP) in children and are of prognostic and therapeutic relevance. While computed tomography (CT) is considered first-line imaging modality in many centres, we started using magnetic resonance imaging (MRI) more and more in the last years to detect CCVM and AP to avoid radiation in this patient group.

Objective: The aim of this retrospective study was to determine and to compare the diagnostic accuracy of CT and MRI when used to detect CCVM and/or AP.

Quantification of myocardial deformation in children by cardiovascular magnetic resonance feature tracking: determination of reference values for left ventricular strain and strain rate.

Background: The objective assessment of global and regional cardiac function in children has shown to be clinically relevant but is challenging to conduct. Cardiovascular magnetic resonance (CMR) has emerged as a valuable diagnostic modality especially in patients with cardiomyopathy or congenital heart disease. However, data on the normal cardiac deformation in children assessed by CMR is lacking at present.

Noninvasive 4D pressure difference mapping derived from 4D flow MRI in patients with repaired aortic coarctation: comparison with young healthy volunteers.

To assess spatial and temporal pressure characteristics in patients with repaired aortic coarctation compared to young healthy volunteers using time-resolved velocity-encoded three-dimensional phase-contrast magnetic resonance imaging (4D flow MRI) and derived 4D pressure difference maps. After in vitro validation against invasive catheterization as gold standard, 4D flow MRI of the thoracic aorta was performed at 1.5T in 13 consecutive patients after aortic coarctation repair without recoarctation and 13 healthy volunteers.

Assessment of aortic morphology and compliance in children and adolescents with Ullrich-Turner syndrome (UTS) using magnetic resonance imaging (MRI).

Aim: The aim of this study was to evaluate the morphology and elastic properties of the aorta in children and adolescents with Ullrich-Turner syndrome (UTS) treated with growth hormone, by using magnetic resonance imaging (MRI).

Methods: Thirty-seven conscious UTS patients were examined using a 1.5-T whole-body MRI.

Noninvasive pressure difference mapping derived from 4D flow MRI in patients with unrepaired and repaired aortic coarctation.

Purpose: To develop a method for computing and visualizing pressure differences derived from time-resolved velocity-encoded three-dimensional phase-contrast magnetic resonance imaging (4D flow MRI) and to compare pressure difference maps of patients with unrepaired and repaired aortic coarctation to young healthy volunteers.

Methods: 4D flow MRI data of four patients with aortic coarctation either before or after repair (mean age 17 years, age range 3-28, one female, three males) and four young healthy volunteers without history of cardiovascular disease (mean age 24 years, age range 20-27, one female, three males) was acquired using a 1.5-T clinical MR scanner.

Perioperative management of a child with glutaric aciduria type I undergoing cardiac surgery.

Patients with glutaric aciduria type I are at risk for acute striatal injury precipitated by catabolic stress. Here, we report the successful interdisciplinary anesthetic and perioperative management of a child with glutaric aciduria type I undergoing cardiac surgery with extracorporeal circulation. Given the central focus on prevention of acute striatal injury, our anesthetic strategy emphasized avoiding a high protein load, high-dose inotropics, especially epinephrine (associated with impaired glucose utilization), deliberate hyperventilation, and other interventions associated with systemic inflammatory response.

First description of unilateral lung agenesis and anomalous pulmonary venous connection in a newborn with Goldenhar syndrome.

We present a unique case of unilateral lung agenesis and anomalous pulmonary venous return in a newborn with Goldenhar syndrome.

Usefulness of multidetector CT imaging to assess vascular stents in children with congenital heart disease: an in vivo and in vitro study.

Objective: To evaluate varying CT settings to visualize pediatric vascular stents in comparison to digital angiography (DA).

Background: There is a great clinical interest in substituting noninvasive methods to follow up children with congenital heart disease after interventional treatment.

Materials And Methods: CT studies in small children with transcatheter placed stents were reviewed, retrospectively.

Tissue Doppler derived isovolumic acceleration in patients after atrial repair for dextrotransposition of the great arteries.

Background: Ventricular dysfunction represents one of the major problems in the long-term follow-up of patients after atrial repair for dextrotransposition of the great arteries. We aimed to study the role of tissue Doppler derived isovolumic acceleration (IVA) to detect early myocardial dysfunction in these patients.

Methods: Twenty-four patients with dextrotransposition of the great arteries (D-TGA) that underwent atrial repair (Senning procedure: n = 12; Mustard procedure: n = 12) in infancy were examined at the age of 21 [12-33] years (median [range]) using tissue Doppler analysis of IVA and peak systolic myocardial velocity at rest and during exercise.

CT of pediatric vascular stents used to treat congenital heart disease.

Objective: The purpose of our study was to assess the visibility of lumen narrowing of pediatric vascular stents using various CT dose parameters in an in vitro model.

Materials And Methods: Ten steel stents of varying designs and sizes commonly used in the treatment of congenital heart disease were implanted in polyvinyl chloride (PVC) tubes and three of the 10 stents were partially obstructed with wax by filling 25% (mild) to 60% (moderate) of the lumen with contrast material. On a 64-MDCT scanner, the stents were scanned at tube voltages (kVp) of 80, 100, and 120 and at tube currents (mA) of 40, 80, 120, and 160.

Endothelin-1 and asymmetric dimethylarginine in children with left-to-right shunt after intracardiac repair.

Background: Endothelin-1 (ET-1) is an endogenous vasoconstrictive peptide hormone and asymmetric dimethylarginine (ADMA) acts as an endogenous inhibitor of nitric oxide synthase. We hypothesized that both could contribute to pulmonary hypertension in patients with left-to-right shunt after intracardiac repair.

Patients And Methods: We prospectively analyzed ET-1 and ADMA plasma levels in 31 patients (m = 16; f = 15) at an age of 0.

Visualization of coronary arteries in patients after childhood Kawasaki syndrome: value of multidetector CT and MR imaging in comparison to conventional coronary catheterization.

Background: After childhood Kawasaki syndrome (KS) the coronary arteries undergo a lifelong dynamic pathological change, and follow-up coronary artery imaging is essential. At present, conventional coronary catheterization (CCC) and angiography is still regarded as the gold standard. Less-invasive methods such as multidetector CT angiography (MDCT-A) and MRI have been used sporadically.

Evaluation of aortic regurgitation in congenital heart disease: value of MR imaging in comparison to echocardiography.

Background: Evaluation of the severity and the follow-up of aortic insufficiency (AI) are important tasks in paediatric cardiology. Assessment is based on clinical and echocardiographic (ECHO) findings such as the configuration of the valve and the regurgitation fraction (RF).

Objective: The goal of this study was to evaluate MRI compared to ECHO for determination of clinical severity, valve morphology and RF.

Exercise tissue Doppler echocardiography with strain rate imaging in healthy young individuals: feasibility, normal values and reproducibility.

Purpose Of The Study: The study was done to determine the clinical feasibility and reproducibility of tissue Doppler echocardiography (TDE) with strain rate imaging (SRI) at rest and under physical exercise in healthy young individuals and to report normal values for parameters of regional myocardial function under exercise.

Methods: Forty-five young volunteers (age 9-29 years) underwent echocardiography with TDE/SRI at rest and during a bicycle exercise test (2 W/kg body weight).

Results: Velocities could be obtained in 93% of segments, whereas strain rate was measurable at least in 80% of segments.

Preoperative assessment and follow-up of congenital abnormalities of the pulmonary arteries using CT and MRI.

Congenital heart disease (CHD), including complex anomalies of the pulmonary arteries, are now earlier diagnosed and treated. Due to improvements in interventional and surgical therapy, the number of patients with the need for follow-up examinations is increasing. Pre- and postinterventional imaging should be done as gently as possible, avoiding invasive techniques if possible.

Assessment of in-stent stenosis in small children with congenital heart disease using multi-detector computed tomography: a validation study.

Objectives: Our purpose was to investigate the diagnostic reliability of multi-detector computed tomography (MDCT) in assessing in-stent stenosis compared to digital angiography (DA) in small children.

Background: Little is known about the feasibility of using MDCT to assess stents placed to treat children with congenital heart disease (CHD).

Methods: Twenty-two children (median age [range], 2(3/4) [(1/2) to 12] years) with 42 transcatheter placed stents (median diameter: 7.

Multislice computed tomography as an adjunct to the management of an in-stent stenosis in an infant with congenital heart disease: imaging for the future.

The case report demonstrates the value of multslice computed tomography for stent imaging and detection of an in-stent stenosis in an infant with pulmonary atresia and ventricular septal defect after stent placement in the right pulmonary artery after biventricular repair.

Magnetic resonance blood flow measurements in the follow-up of pediatric patients with aortic coarctation - a re-evaluation.

Background: Previous studies have suggested the feasibility of a non-invasive quantification of vascular trans-stenotic pressure gradients (DeltaP) by phase-contrast MR imaging (PC-MRI). Our purpose was to assess the value of MRI estimated pressure gradients as a screening tool for assessing hemodynamically significant (re-)coarctation of the aorta (CoA) in pediatric patients.

Methods: Forty-three patients (median age (range), 16 (5-25) years) with CoA (38 postoperative and 5 native) and clinically suspected hemodynamically significant stenosis underwent quantitative and semi-quantitative PC-MRI blood flow measurements and 3D MR-angiography, Doppler ultrasound (US) and conventional catheter angiography (CCA, n=20).