Should we abandon landmark-based technique for caudal anesthesia in neonates and infants?

Background: Caudal anesthesia is a landmark-based technique with ultrasound guidance occasionally used in the absence of landmarks. The current surface landmark remains a popular approach due to its desirable success rate. However, incomplete ossification of the posterior vertebral elements can make this procedure for neonatal caudal anesthesia difficult.

Radiographic skeletal survey for non-accidental injury: systematic review and development of a national New Zealand protocol.

Introduction: Clinically occult fractures from non-accidental injury (NAI) are best detected on radiographic skeletal survey. However, there are regional variations regarding the views included in such surveys. We undertook a systematic review of the evidence supporting skeletal survey protocols to design a protocol that could be implemented across New Zealand.

An osteosclerotic form of Robinow syndrome.

Robinow syndrome (RS) is a clinically and genetically heterogenous condition primarily characterized by short stature, mesomelia, genital hypoplasia, oral abnormalities, and a facial gestalt that includes hypertelorism, a short nose, and a broad mouth. The disorder exists in both a dominant and a more severe recessive form. Here two unrelated cases of sporadic RS are described with the additional finding of axial and appendicular osteosclerosis.

Low-lying placenta: who should be recalled for a follow-up scan?

Introduction: The incidence of low-lying placenta or placenta praevia in the second trimester has been reported at 1-5%; however, recent unpublished audits suggest our recall rates are higher. We wanted to assess our recall rates in a large sample size and determine whether we could reduce the placenta-os distance for recalling women with low-lying placenta, while still identifying all cases of placenta praevia at delivery.

Methods: We undertook a retrospective analysis from March 2005 to March 2008 of women attending for 18-20-week obstetric ultrasounds.

Integrating case-based reasoning with an electronic patient record system.

Unlabelled: Electronic patient records (EPRs) contain a wealth of patient-related data and capture clinical problem-solving experiences and decisions. Excelicare is such a system which is also a platform for the national generic clinical system in the UK.

Objective: This paper presents, ExcelicareCBR, a case-based reasoning (CBR) system which has been developed to complement Excelicare.

Using computer aided case based reasoning to support clinical reasoning in community occupational therapy.

Community occupational therapists have long been involved in the provision of environmental control systems. Diverse electronic technologies with the potential to improve the health and quality of life of selected clients have developed rapidly in recent years. Occupational therapists employ clinical reasoning in order to determine the most appropriate technology to meet the needs of individual clients.

Ultrasound appearance of scrotal fat necrosis in prepubertal boys.

Background: Scrotal fat necrosis is a rare cause of scrotal pain in prepubertal boys. Despite its characteristic clinical presentation, it is an under-recognized entity. Specific scrotal US imaging features of this condition have not been previously reported.