The hidden costs of CT bioeffects

Pediatric Spinal Cord Injury: A Review

A spinal cord injury (SCI) can be a devastating condition in children, with profound implications for their overall health and quality of life. In this review, we aim to provide a concise overview of the key aspects associated with SCIs in the pediatric population. Firstly, we discuss the etiology and epidemiology of SCIs in children, highlighting the diverse range of causes. We explore the unique anatomical and physiological characteristics of the developing spinal cord that contribute to the specific challenges faced by pediatric patients. Next, we delve into the clinical presentation and diagnostic methods, emphasizing the importance of prompt and accurate diagnosis to facilitate appropriate interventions. Furthermore, we approach the multidisciplinary management of pediatric SCIs, encompassing acute medical care, surgical interventions, and ongoing supportive therapies. Finally, we explore emerging research as well as innovative therapies in the field, and we emphasize the need for continued advancements in understanding and treating SCIs in children to improve their functional independence and overall quality of life.

Follow-Up Computed Tomography Requirement of Pediatric Head Trauma Patients with Abnormal Imaging Findings

OBJECTIVE

We investigated pediatric patients presenting with isolated head trauma to emergency service. Where abnormal findings were detected on brain computed tomography (CT) scan, we evaluated the follow-up scan rate and whether follow-up scans affected the treatment protocol.

METHODS

Pediatric patients who presented to emergency service between 2014 and 2017 with isolated head trauma and were later found to have abnormal findings on CT scan were evaluated. The patients were evaluated in terms of age, sex, pediatric Glasgow Coma Scale score at emergency service, trauma mechanism, and abnormal findings on CT scan. We also documented whether follow-up CT scan altered the treatment decision in patients as to whether they underwent surgery or received conservative treatment.

RESULTS

The 105 head trauma patients with abnormal findings on CT scan consisted of 58 boys (55.2%) and 47 girls (44.8%). After the first brain CT examination, 5 of the patients (4.7%) underwent emergency surgery. For patients with linear fractures, the number of follow-up CT scans was 2.3. For patients with linear fractures, vomiting was found to be a symptom with statistical meaning as a sign of additional cranial pathology compared with headache, drowsiness, and irritability. A total of 280 follow-up CT scans with a mean number of 2.66 per patient were performed.

CONCLUSIONS

Follow-up CT scan for patients with abnormal findings on the initial CT scan after head trauma does not influence the decision to choose clinical observation or surgery except in patients with neurologic deterioration.

Paediatric computed tomography radiation dose: A review of the global dilemma

Computed tomography (CT) has earned a well-deserved role in diagnostic radiology, producing cross-sectional and three-dimensional images which permit enhanced diagnosis of many pathogenic processes. The speed, versatility, accuracy, and non-invasiveness of this procedure have resulted in a rapid increase in its use. CT imaging, however, delivers a substantially higher radiation dose than alternative imaging methodologies, particularly in children due to their smaller body dimensions. In addition, CT use in children produces an increased lifetime risk of cancer, as children's developing organs and tissues are inherently more vulnerable to cellular damage than those of adults. Though individual risks are small, the increasing use of CT scans in children make this an important public health problem. Various organizations have recommended measures to minimize unnecessary exposures to radiation through CT scanning. These include elimination of multiple or medically unnecessary scans, development of patient-specific dosing guidelines, and use of alternative radiographic methodology wherever possible. Another important factor in excessive CT exposures, however, is a documented lack of awareness among medical practitioners of the doses involved in CT usage as well as its significant potential dangers. This review examines the effects of paediatric CT radiation, discusses the level of medical practitioner awareness of these effects, and offers recommendations on alternative diagnostic methods and practitioner education.

Imaging of acute appendicitis in children: EU versus U.S. ... or US versus CT? A North American perspective

The timing, type, and technique of imaging evaluation of suspected appendicitis in children are all debated. This debate is both local and international. The fact is that choices in imaging evaluation will depend on both local and national influences, which are reasonable and to be expected. There still is a responsibility, though, for those involved with evaluation of patients with possible appendicitis to come to agreement about an appropriate diagnostic pathway that considers standards of care and available resources.