Creatinine-based estimation of glomerular filtration rate in patients with a Fontan circulation.

Background: Patients with a Fontan circulation are at risk of renal dysfunction. We analyzed cross-sectional data in pediatric and adult Fontan patients in order to assess the accuracy of commonly used serum creatinine-based methods in estimating glomerular filtration rate (GFR).

Methods: A total of 124 Fontan patients (58 children, 66 adults) were enrolled across three study centers.

Hepatic and renal end-organ damage in the Fontan circulation: A report from the Australian and New Zealand Fontan Registry.

Background: Hepatic and renal dysfunction have been observed in survivors of the Fontan procedure, however their incidence and associated factors remain poorly defined.

Methods: A total of 152 participants from a Registry of 1528 patients underwent abdominal ultrasound, transient elastography (FibroScan), serum fibrosis score (FibroTest), in vivo Tc-99m DTPA measurement of glomerular filtration rate (mGFR), and urine albumin-creatinine ratio (ACR).

Results: Mean age and time since Fontan were 19.

Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians.

Objective: To assess the cancer risk in children and adolescents following exposure to low dose ionising radiation from diagnostic computed tomography (CT) scans.

Design: Population based, cohort, data linkage study in Australia. COHORT MEMBERS: 10.

How common is colonic elongation in children with slow-transit constipation or anorectal retention?

Purpose: Colonic elongation is reported as a possible cause for slow colonic transit, as it is observed in patients with slow-transit constipation (STC). This study aimed to determine the frequency of colonic elongation in children with STC or anorectal retention using radioimaging. We hypothesized that transverse colon elongation may occur in patients with STC, whereas sigmoid colon elongates in patients with anorectal retention.

Justifying referrals for paediatric CT.

• The system of radiation protection assumes a linear dose-response relationship with no threshold for low doses and dose rate exposures. This is based on epidemiological evidence at higher doses. • Hence there is a small theoretical risk of carcinogenesis attributable to low doses of ionising radiation.

Nuclear transit studies of patients with intractable chronic constipation reveal a subgroup with rapid proximal colonic transit.

Aims/background: Nuclear transit studies (NTS) allow us to follow transit through the stomach and the small and large intestines. We identified children with chronic constipation with rapid proximal colonic transit and characterized their clinical features.

Methods: We reviewed NTS from 1998 to 2009 to identify patients with chronic constipation and rapid proximal colonic transit, defined as greater than 25% of tracer beyond hepatic flexure at 6 hour and/or greater than 25% of tracer beyond end of descending colon at 24 hour.

Paediatric CT imaging trends in Australia.

Introduction: The use of CT has rapidly increased since its introduction. Although an important medical tool for diagnosis and treatment, CT is recognised as being among the highest contributors to population radiation exposure. As the risks associated with exposure are higher for children than for adults, this study assessed the impact of paediatric CT in Australia by analysing imaging trends.

Slow-transit constipation with concurrent upper gastrointestinal dysmotility and its response to transcutaneous electrical stimulation.

Purpose: Transcutaneous electrical stimulation (TES) speeds up colonic transit in children with slow-transit constipation (STC). This study examined if concurrent upper gastrointestinal dysmotility (UGD) affected response to TES.

Methods: Radio-nuclear transit studies (NTS) were performed before and after TES treatment of STC as part of a larger randomised controlled trial.