Implementation of a surgical unit-based safety programme in African hospitals: a multicentre qualitative study.

Background: A Surgical Unit-based Safety Programme (SUSP) has been shown to improve perioperative prevention practices and to reduce surgical site infections (SSI). It is critical to understand the factors influencing the successful implementation of the SUSP approach in low- and middle-income settings. We undertook a qualitative study to assess viability, and understand facilitators and barriers to implementing the SUSP approach in 5 African hospitals.

Implementing infection prevention practices across European hospitals: an in-depth qualitative assessment.

Objective: The Prevention of Hospital Infections by Intervention and Training (PROHIBIT) project included a cluster-randomised, stepped wedge, controlled study to evaluate multiple strategies to prevent catheter-related bloodstream infection. We report an in-depth investigation of the main barriers, facilitators and contextual factors relevant to successfully implementing these strategies in European acute care hospitals.

Methods: Qualitative comparative case study in 6 of the 14 European PROHIBIT hospitals.

Outcome after prenatal diagnosis of congenital anomalies of the kidney and urinary tract.

Unlabelled: Congenital anomalies of the kidney and urinary tract are common findings on fetal ultrasound. The aim of this prospective observational study was to describe outcome and risk factors in 115 patients born 1995-2001. All prenatally diagnosed children were stratified into low- and high-risk group and followed postnatally clinically and by imaging at defined endpoints.

ESPR Uroradiology Taskforce--imaging recommendations in paediatric uroradiology, part VIII: retrograde urethrography, imaging disorder of sexual development and imaging childhood testicular torsion.

Three new consensus-based recommendations of the European Society of Paediatric Radiology Uroradiology Taskforce and the European Society of Urogenital Radiology Paediatric Working Group on paediatric uroradiology are presented. One deals with indications and technique for retrograde urethrography, one with imaging in the work-up for disorders of sexual development and one with imaging workflow in suspected testicular torsion. The latter is subdivided to suggest a distinct algorithm to deal with testicular torsion in neonates.

ESPR uroradiology task force imaging recommendations in paediatric uroradiology, part VII: standardised terminology, impact of existing recommendations, and update on contrast-enhanced ultrasound of the paediatric urogenital tract.

Our purpose is to harmonise and standardise terminology in paediatric uroradiology, to provide and update recommendations for contrast-enhanced US to standardise imaging and encourage further research, and to assess the impact of the existing recommendations in paediatric urogenital imaging. Based on thorough review of literature and variable practice at several centres and after discussion within urogenital imaging groups as well as with other subspecialties, we propose a standardisation of terminology in urogenital imaging. An update with recommendations on paediatric contrast-enhanced US has been issued based on available literature and reports.

ESPR uroradiology task force and ESUR Paediatric Work Group--Imaging recommendations in paediatric uroradiology, part VI: childhood renal biopsy and imaging of neonatal and infant genital tract. Minutes from the task force session at the annual ESPR Meeting 2012 in Athens on childhood renal biopsy and imaging neonatal genitalia.

The European Society of Paediatric Radiology Uroradiology Task Force and the ESUR Paediatric Work Group jointly publish guidelines for paediatric urogenital imaging. Two yet unaddressed topics involving patient safety and imaging load are addressed in this paper: renal biopsy in childhood and imaging of the neonatal genital tract, particularly in girls. Based on our thorough review of literature and variable practice in multiple centers, procedural recommendations are proposed on how to perform renal biopsy in children and how to approach the genital tract in (female) neonates.

ESPR Uroradiology Task Force and ESUR Paediatric Working Group--Imaging recommendations in paediatric uroradiology, part V: childhood cystic kidney disease, childhood renal transplantation and contrast-enhanced ultrasonography in children.

The ESPR Uroradiology Task Force and the ESUR Paediatric Working Group present two new recommendations on imaging in childhood cystic kidney disease and in childhood renal transplantation, and address the presently restricted availability of contrast-enhanced (ce) US in children. New insights into the genetics require an updated classification of paediatric cystic kidney disease along with a new concept of diagnostic imaging. Characteristic imaging features are key to the new classification.

ESPR uroradiology task force and ESUR paediatric working group: imaging recommendations in paediatric uroradiology, part IV: Minutes of the ESPR uroradiology task force mini-symposium on imaging in childhood renal hypertension and imaging of renal trauma in children.

Two new recommendations of the European Society of Radiology task force and the European Society of Uroradiology workgroup on paediatric uroradiology are presented. One deals with diagnostic imaging in children after trauma to the urinary tract-renal trauma, in particular. The other concerns the evaluation of suspected renal hypertension.

ESPR uroradiology task force and ESUR paediatric working group: imaging and procedural recommendations in paediatric uroradiology, part III. Minutes of the ESPR uroradiology task force minisymposium on intravenous urography, uro-CT and MR-urography in childhood.

The ESPR working groups have addressed intravenous urography (IVU), uro-CT and MR-urography (MRU) in childhood as the last in the series of recommendations for paediatric uroradiology. The aim of this process was again to standardise paediatric uroradiologic imaging and to reduce invasiveness and radiation dose. As for the existing recommendations, the new proposals are consensus-based because evidence is lacking, use and indications have changed, or approaches on how to perform the examination in children differ in the literature (MRU).

Retroperitoneoscopically assisted repair of an abdominoscrotal hydrocele.

We present a 2-month-old boy with a primary obstructive megaureter and a giant abdominoscrotal hydrocele (ASH) on the left side. The ASH was initially misdiagnosed as a fornix rupture with infrarenal urinoma, but clinical and radiological examination led to the right diagnosis. Retroperitoneoscopically assisted mobilization combined with the inguinal approach allowed the successful resection of this large ASH.

Randomised trial of oral versus sequential intravenous/oral cephalosporins in children with pyelonephritis.

The hypothesis was tested that oral antibiotic treatment in children with acute pyelonephritis and scintigraphy-documented lesions is equally as efficacious as sequential intravenous/oral therapy with respect to the incidence of renal scarring. A randomised multi-centre trial was conducted in 365 children aged 6 months to 16 years with bacterial growth in cultures from urine collected by catheter. The children were assigned to receive either oral ceftibuten (9 mg/kg once daily) for 14 days or intravenous ceftriaxone (50 mg/kg once daily) for 3 days followed by oral ceftibuten for 11 days.

Imaging recommendations in paediatric uroradiology: minutes of the ESPR workgroup session on urinary tract infection, fetal hydronephrosis, urinary tract ultrasonography and voiding cystourethrography, Barcelona, Spain, June 2007.

We present here a few basic proposals for algorithms and procedures for imaging the paediatric genitourinary tract based on initial discussion at a paediatric uroradiology symposium and proposals of the ESUR Paediatric Uroradiologic Guidelines Subcommittee. These recommendations were developed in the light of new knowledge that might influence existing guidelines. Regional, individual and local flexibility and variability should be preserved in order to make these recommendations applicable throughout Europe.

Pre- and postnatal imaging of a girl with a cloacal variant.

We describe the prenatal MR findings in a 29-week fetus with a cloacal variant (urogenital sinus and anterior placed anus) in combination with an enlarged clitoris and urethral duplication and correlate them with postnatal imaging. Fetal MR imaging permits the diagnosis and characterization of cloacal and urogenital sinus malformations in utero. This information may guide pre-, peri- and postnatal management.

Middle ear dynamics in response to seismic stimuli in the Cape golden mole (Chrysochloris asiatica).

The hypertrophied malleus in the middle ear of some golden moles has been assumed to be an adaptation for sensing substrate vibrations by inertial bone conduction, but this has never been conclusively demonstrated. The Cape golden mole (Chrysochloris asiatica) exhibits this anatomical specialization, and the dynamic properties of its middle ear response to vibrations were the subjects of this study. Detailed three-dimensional middle ear anatomy was obtained by x-ray microcomputed tomography (muCT) at a resolution of 12 microm.

Ossicular differentiation of airborne and seismic stimuli in the Cape golden mole (Chrysochloris asiatica).

Comparison between the middle ear anatomy of the Cape golden mole (Chrysochloris asiatica), which exhibits a club-shaped malleus head, and the Desert golden mole (Eremitalpa granti), with a ball-shaped malleus head, suggests differences in sensitivity to airborne sound. Scanning laser Doppler vibrometric measurements of the ossicular behavior in response to both vibration and airborne sound were made in C. asiatica.

Tension gastrothorax.

Background: Tension gastrothorax develops when the stomach herniated through a congenital diaphragmatic defect into the thorax is massively distended by trapped air. The authors present 5 cases and discuss the diagnostic and therapeutic management.

Case Reports: Four children, aged 3, 4, 6, and 13 months, presented with progressive respiratory distress.

Magnetic resonance imaging of the feto-placentar unit after fetoscopic laser coagulation for twin-to-twin transfusion syndrome.

Twin-to-twin transfusion syndrome (TTTS) is a severe complication in monochorionic twin pregnancies that results from a hemodynamical imbalance of placentar vascular anstomoses that connect the circulation of both fetuses. In TTTS, a poly/oligohydramnios sequence with high fetal morbidity and mortality rates occurs. Fetoscopic laser coagulation of the placentar anastomoses can limit or prevent fetal injury.

Outcome of fetal renal pelvic dilatation diagnosed during the third trimester.

Objectives: The aim of this study was to evaluate renal function and the need for postnatal treatment--antibiotic therapy and/or surgery--in relation to the grade of fetal renal pelvic dilatation (RPD) found on third-trimester ultrasound examination.

Methods: The retrospective study included 78 children, born between 1995 and 2000, with 115 dilated fetal renal pelvic units. The children were allocated to three groups based on pelvic anteroposterior diameter (APD) detected on third-trimester ultrasound: APDs of 7-9.

Radiographic and MRI features of deferiprone-related arthropathy of the knees in patients with beta-thalassemia.

Objective: This study was undertaken to describe the radiographic and MRI appearances of arthropathy of the knees in 14 patients with beta-thalassemia major undergoing chelation therapy with deferiprone (L1).

Materials And Methods: All available radiographs and MRI studies of the knees in 14 beta-thalassemia major patients (mean age, 16.3 years; age range, 7-33 years) undergoing chelation therapy with L1 were retrospectively assessed for changes in the synovium, cartilage, and bone.

Solitary infantile choriocarcinoma of the liver: MRI findings.

Infantile hepatic choriocarcinoma is a rare, highly malignant germ-cell tumour believed to result from a choriocarcinoma of the placenta that spreads to the child. Most infants present with a characteristic clinical picture of anaemia, hepatomegaly and precocious puberty. Imaging findings, including conventional MRI, may be non-specific.

Medial clavicular epiphysiolysis in children: the so-called sterno-clavicular dislocation.

We retrospectively reviewed six pediatric cases of medial clavicular injury, i.e., epiphyseal separation (Salter/Harris type I or II injury), diagnosed between 1993 and 1997.

Renal dimensions measured by ultrasonography in children: variations as a function of the imaging plane and patient position.

The purpose of this study was to determine the effect of patient positioning on sonographic renal measurements and to test if the patient position alters the three-dimensional shape of the kidneys. The maximum longitudinal renal length and transverse renal width and depth were measured in the supine and prone position in 100 children (200 kidneys). Age ranged from 6 months to 16 years (mean age 5 years).