Background: It can be challenging for children to cooperate for a magnetic resonance imaging (MRI) exam. General anesthesia is often used to ensure a high-quality image. When determining the need for general anesthesia, many institutions use a simple age cutoff. Decisions on the necessity for anesthesia are often left to schedulers who lack training on determination of patient compliance.
Objective: The study aimed to evaluate whether screening questions administered by certified child life specialists (CCLS) could successfully predict which children could complete an MRI without sedation.
Materials And Methods: This is a retrospective, institutional review board approved study. Data was collected as part of a quality improvement program, where a CCLS screened 4- to 12-year-old children scheduled for MRI scanning using a questionnaire. Parent responses to the screening questions, CCLS's recommendation for scheduling the MRI awake, start and end time for the MRI scan, and scan success were recorded. A predictive model for the CCLS's recommendation was developed using the child's age, estimated scan length, scan difficulty, and the parent's responses to the screening questions. The primary outcome measure was a successfully completed MRI not requiring additional imaging under anesthesia.
Results: Of the 403 screened children, 317 (79%) were recommended to attempt the MRI without anesthesia. The median age of participants was 7 (IQR 4-17) years. Overall, 309 of 317 (97.5%) participants, recommended by the CCLS for the program, met the primary outcome of successful MRI completion on their first attempt. The multivariable regression model which included clinical information about the child's age, estimated scan length, scan difficulty, and four of the six parent screening questions had excellent performance (area under the curve = 0.89).
Conclusion: Information collected by the CCLS via screening along with the child's age, the estimated scan length, and difficulty can help predict which children are likely to successfully complete a non-sedate MRI.
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http://dx.doi.org/10.1007/s00247-024-06040-1 | DOI Listing |
Neuromodulation
January 2025
Department of Anesthesiology, University of Wisconsin, Madison, WI, USA.
Objectives: Past studies have shown the efficacy of spinal targeted drug delivery (TDD) in pain relief, reduction in opioid use, and cost-effectiveness in long-term management of complex chronic pain. We conducted a survey to determine treatment variables associated with patient satisfaction.
Materials And Methods: Patients in a single pain clinic who were implanted with Medtronic pain pumps to relieve intractable pain were identified from our electronic health record.
Lupus Sci Med
January 2025
Division of Rheumatology, Emory University, Atlanta, Georgia, USA.
Objective: Black people in the USA have a higher incidence and severity of SLE and worse outcomes, yet they are significantly under-represented in SLE clinical trials. We assessed racial differences in clinical trial perceptions among a large cohort of predominantly Black people with SLE.
Methods: Georgians Organised Against Lupus (GOAL) is a population-based, prospective cohort of people with a validated diagnosis of SLE living in Atlanta.
Fr J Urol
January 2025
Department of Urology, North Hospital, AP-HM, Marseille, France.
Introduction: A significant proportion of newly diagnosed prostate cancer (PCa) cases are slow growing with a low risk of metastatic progression. There is a lack of data concerning the optimal biopsy regimen for improving diagnosis yield in PI-RADS3 lesions. This study aimed to assess the diagnostic value of current biopsy regimens in PI-RADS 3 lesions and identify clinical predictors to improve clinically significant PCa (csPCa) detection.
View Article and Find Full Text PDFESMO Open
January 2025
AUSL-IRCCS Clinical Cancer Center of Reggio Emilia, Reggio Emilia, Italy.
Background: Non-metastatic pancreatic ductal adenocarcinoma (PDAC) presents a challenging scenario: the rarity of the disease, the limited number of completed prospective trials, and the shortcomings of comparability across series produce several controversial topics and unanswered questions. Guideline recommendations usually include all the different therapeutic options, de facto transferring to the multidisciplinary team the responsibility on the final decision. This secondary analysis of the GARIBALDI study was aimed to explore the correlation of center type, self-declared volume, and commitment with the overall survival (OS) in patients with non-metastatic PDAC.
View Article and Find Full Text PDFRes Dev Disabil
January 2025
Faculty of Medicine, Technion - Israel Institute of Technology, Center for Innovation in Social Work, Tel Hai College, Israel. Electronic address:
Background: Research has not fully elucidated the challenges experienced by the caregivers of children with developmental disabilities (DDs) in different sociocultural contexts. Studies on parents, especially fathers, of children with DDs in the Middle East are especially rare. Similarly, the subject of collaboration between Bedouin fathers and professionals has seen little research.
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