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Manning GLP, Sharpe E, Calder A, Brierley J. Skeletal surveys in intubated patients: does UK clinical practice match national guidelines? Arch Dis Child 2024; 109:444. [PMID: 38346869 DOI: 10.1136/archdischild-2024-326838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/11/2024] [Indexed: 04/20/2024]
Affiliation(s)
| | - Emma Sharpe
- Paediatric Intensive Care Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Alistair Calder
- Radiology Department, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Joe Brierley
- Paediatric Intensive Care Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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2
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Meshaka R, Müller LSO, Stafrace S, Abella SF, Sofia C, Calder A, Petit P, Perucca G. Intussusception reduction methods in daily practice-a survey by the European Society of Paediatric Radiology Abdominal Imaging Taskforce. Pediatr Radiol 2024; 54:571-584. [PMID: 37993547 DOI: 10.1007/s00247-023-05798-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Image-guided intussusception reduction has been practised internationally for many decades. The use of different modalities, delayed repeat attempts, and sedation/anaesthesia are unknown. OBJECTIVE To survey the practice of image-guided intussusception reduction. MATERIALS AND METHODS A 20-point questionnaire created by the European Society of Paediatric Radiology (ESPR) Abdominal Imaging Taskforce was distributed via the ESPR members' mailing list and shared on social media between 28 March and 1 May 2023. RESULTS There were 69 responses from 65 worldwide institutions, with a mean of 18 intussusception reductions performed per year: 55/69 (80%) from 52 European institutions and 14/69 (20%) from 13 institutions outside of Europe. European centres reported using 19/52 (37%) fluoroscopy, 18/52 (35%) ultrasound, and 15/52 (28%) a mixture of both, with 30/52 (58%) offering a delayed repeat at 15 min to 24 h. Non-European centres reported using 5/13 (39%) fluoroscopy, 6/13 ultrasound (46%), and 2/13 (15%) a mixture of both, with 9/13 (69%) offering a delayed repeat attempt. Sedation or analgesia was used in 35/52 (67%) of European and 2/13 (15%) non-European institutions. CONCLUSION There is wide variation in how image-guided intussusception reduction is performed, and in the use of sedation/anaesthesia.
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Affiliation(s)
- Riwa Meshaka
- Department of Clinical Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1H 3JH, UK.
| | - Lil-Sofie Ording Müller
- Division of Radiology and Nuclear Medicine, Department of Paediatric Radiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Samuel Stafrace
- Department of Diagnostic Imaging, McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada
| | - Stéphanie Franchi Abella
- Department of Pediatric Radiology, Hôpital Bicêtre, Hôpitaux Universitaire Paris-Sud, Assistance Publique Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Carmelo Sofia
- Department of Biomedical Sciences and Morphologic and Functional Imaging, University of Messina, Messina, Italy
| | - Alistair Calder
- Department of Clinical Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1H 3JH, UK
| | - Philippe Petit
- Pediatric and Prenatal Imaging Unit, Aix Marseille University, La Timone-Enfants Hospital, Marseille, France
| | - Giulia Perucca
- Department of Clinical Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC1H 3JH, UK
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3
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Wright J, Cheung M, Siddiqui A, Lucas J, Calder A, Argyropoulou MI, Arthurs OJ, Caro-Dominguez P, Thompson D, Severino M, D'Arco F. Recommendations for neuroradiological examinations in children living with achondroplasia: a European Society of Pediatric Radiology and European Society of Neuroradiology opinion paper. Pediatr Radiol 2023; 53:2323-2344. [PMID: 37674051 DOI: 10.1007/s00247-023-05728-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 09/08/2023]
Abstract
Children living with achondroplasia are at an increased risk of developing neurological complications, which may be associated with acute and life-altering events. To remediate this risk, the timely acquisition of effective neuroimaging that can help to guide clinical management is essential. We propose imaging protocols and follow-up strategies for evaluating the neuroanatomy of these children and to effectively identify potential neurological complications, including compression at the cervicomedullary junction secondary to foramen magnum stenosis, spinal deformity and spinal canal stenosis. When compiling these recommendations, emphasis has been placed on reducing scan times and avoiding unnecessary radiation exposure. Standardized imaging protocols are important to ensure that clinically useful neuroimaging is performed in children living with achondroplasia and to ensure reproducibility in future clinical trials. The members of the European Society of Pediatric Radiology (ESPR) Neuroradiology Taskforce and European Society of Neuroradiology pediatric subcommittee, together with clinicians and surgeons with specific expertise in achondroplasia, wrote this opinion paper. The research committee of the ESPR also endorsed the final draft. The rationale for these recommendations is based on currently available literature, supplemented by best practice opinion from radiologists and clinicians with subject-specific expertise.
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Affiliation(s)
- Jenny Wright
- Department of Radiology, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK.
| | - Moira Cheung
- Department of Paediatric Endocrinology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, UK
| | - Ata Siddiqui
- Department of Neuroradiology, Guy's and Saint Thomas' NHS Foundation Trust, London, UK
| | - Jonathan Lucas
- Paediatric Spinal Surgery, Evelina London Children's Hospital, London, UK
| | - Alistair Calder
- Department of Radiology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
- NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - Maria I Argyropoulou
- Department of Clinical Radiology and Imaging, Medical School, University of Ioannina, Ioannina, Greece
| | - Owen J Arthurs
- Department of Radiology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
- NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - Pablo Caro-Dominguez
- Unidad de Radiologia Pediatrica, Servicio de Radiologia, Hospital Universitario Virgen del Rocio, Seville, Spain
| | - Dominic Thompson
- Department of Paediatric Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, UK
- NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | | | - Felice D'Arco
- Department of Neuroradiology, Guy's and Saint Thomas' NHS Foundation Trust, London, UK
- Department of Radiology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
- NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
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4
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Grimes H, Ansari M, Ashraf T, Cueto-González AM, Calder A, Day M, Fernandez Alvarez P, Foster A, Lahiri N, Repetto GM, Scurr I, Varghese V, Low KJ. PUF60-related developmental disorder: A case series and phenotypic analysis of 10 additional patients with monoallelic PUF60 variants. Am J Med Genet A 2023; 191:2610-2622. [PMID: 37303278 DOI: 10.1002/ajmg.a.63313] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 05/11/2023] [Accepted: 05/18/2023] [Indexed: 06/13/2023]
Abstract
PUF60-related developmental disorder (also referred to as Verheij syndrome), resulting from haploinsufficiency of PUF60, is associated with multiple congenital anomalies affecting a wide range of body systems. These anomalies include ophthalmic coloboma, and congenital anomalies of the heart, kidney, and musculoskeletal system. Behavioral and intellectual difficulties are also observed. While less common than other features associated with PUF60-related developmental disorder, for instance hearing impairment and short stature, identification of specific anomalies such as ophthalmic coloboma can aid with diagnostic identification given the limited spectrum of genes linked with this feature. We describe 10 patients with PUF60 gene variants, bringing the total number reported in the literature, to varying levels of details, to 56 patients. Patients were recruited both via locally based exome sequencing from international sites and from the DDD study in the United Kingdom. Eight of the variants reported were novel PUF60 variants. The addition of a further patient with a reported c449-457del variant to the existing literature highlights this as a recurrent variant. One variant was inherited from an affected parent. This is the first example in the literature of an inherited variant resulting in PUF60-related developmental disorder. Two patients (20%) were reported to have a renal anomaly consistent with 22% of cases in previously reported literature. Two patients received specialist endocrine treatment. More commonly observed were clinical features such as: cardiac anomalies (40%), ocular abnormalities (70%), intellectual disability (60%), and skeletal abnormalities (80%). Facial features did not demonstrate a recognizable gestalt. Of note, but remaining of unclear causality, we describe a single pediatric patient with pineoblastoma. We recommend that stature and pubertal progress should be monitored in PUF60-related developmental disorder with a low threshold for endocrine investigations as hormone therapy may be indicated. Our study reports an inherited case with PUF60-related developmental disorder which has important genetic counseling implications for families.
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Affiliation(s)
- H Grimes
- Department of Clinical Genetics, University Hospitals Bristol and Weston NHS Trust, Bristol, UK
| | - M Ansari
- South East Scotland Genetics Service, Western General Hospital, Edinburgh, UK
| | - T Ashraf
- Department of Clinical Genetics, Great Ormond Street Hospital, London, UK
| | - Anna Mª Cueto-González
- Department of Clinical and Molecular Genetics, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Medicine Genetics Group, Vall Hebron Research Institute (VHIR), Vall d'Hebron Barcelona Hospital Campus, Autonomous University of Barcelona, Barcelona, Spain
| | - A Calder
- Department of Radiology, Great Ormond Street Hospital, London, UK
| | - M Day
- Exeter Genetics Laboratory, Royal Devon and Exeter NHS Trust, Exeter, UK
| | - P Fernandez Alvarez
- Department of Clinical and Molecular Genetics, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - A Foster
- Department of Clinical Genetics, West Midlands Regional Genetics Centre, Birmingham, UK
| | - N Lahiri
- Department of Clinical Genetics, St Georges University Hospital NHS Foundation Trust, London, UK
- Department of Clinical and Molecular Science, St Georges University of London, London, UK
| | - G M Repetto
- Centro de Genética y Genómica, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - I Scurr
- Department of Clinical Genetics, University Hospitals Bristol and Weston NHS Trust, Bristol, UK
| | - V Varghese
- All Wales Medical Genomics Services, University Hospital of Wales, Cardiff, UK
| | - Karen J Low
- Department of Clinical Genetics, University Hospitals Bristol and Weston NHS Trust, Bristol, UK
- Centre for Academic Child Health, University of Bristol, Bristol, UK
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5
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Unger S, Ferreira CR, Mortier GR, Ali H, Bertola DR, Calder A, Cohn DH, Cormier-Daire V, Girisha KM, Hall C, Krakow D, Makitie O, Mundlos S, Nishimura G, Robertson SP, Savarirayan R, Sillence D, Simon M, Sutton VR, Warman ML, Superti-Furga A. Nosology of genetic skeletal disorders: 2023 revision. Am J Med Genet A 2023; 191:1164-1209. [PMID: 36779427 PMCID: PMC10081954 DOI: 10.1002/ajmg.a.63132] [Citation(s) in RCA: 45] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 02/14/2023]
Abstract
The "Nosology of genetic skeletal disorders" has undergone its 11th revision and now contains 771 entries associated with 552 genes reflecting advances in molecular delineation of new disorders thanks to advances in DNA sequencing technology. The most significant change as compared to previous versions is the adoption of the dyadic naming system, systematically associating a phenotypic entity with the gene it arises from. We consider this a significant step forward as dyadic naming is more informative and less prone to errors than the traditional use of list numberings and eponyms. Despite the adoption of dyadic naming, efforts have been made to maintain strong ties to the MIM catalog and its historical data. As with the previous versions, the list of disorders and genes in the Nosology may be useful in considering the differential diagnosis in the clinic, directing bioinformatic analysis of next-generation sequencing results, and providing a basis for novel advances in biology and medicine.
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Affiliation(s)
- Sheila Unger
- Division of Genetic Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Carlos R Ferreira
- Skeletal Genomics Unit, Metabolic Medicine Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Geert R Mortier
- Center for Human Genetics, University Hospital Leuven and KU Leuven, Leuven, Belgium
| | - Houda Ali
- INSERM, US14-Orphanet, Paris, France
| | - Débora R Bertola
- Unidade de Genética, Instituto da Criança, Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Departamento de Genética e Biologia Evolutiva, Instituto de Biociências, Universidade de São Paulo, São Paulo, Brazil
| | - Alistair Calder
- Radiology Department, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Daniel H Cohn
- Department of Molecular, Cell and Developmental Biology, University of California, Los Angeles, Los Angeles, California, USA
- Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, California, USA
| | - Valerie Cormier-Daire
- Paris Cité University, Reference Center for Skeletal Dysplasia, INSERM UMR 1163, Imagine Institute, Necker Enfants Malades Hospital (AP-HP), Paris, France
| | - Katta M Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Christine Hall
- Emerita Consultant Paediatric Radiologist at Great Ormond Street Childrens' Hospital, London, UK
| | - Deborah Krakow
- Departments of Obstetrics and Gynecology, Orthopaedic Surgery and Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Outi Makitie
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Stefan Mundlos
- Institut für medizinische Genetik und Humangenetik, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Gen Nishimura
- Department of Radiology, Musashino-Yowakai Hospital, Tokyo, Japan
| | - Stephen P Robertson
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Ravi Savarirayan
- Murdoch Children's Research Institute and University of Melbourne, Parkville, Victoria, Australia
| | - David Sillence
- Specialities of Genomic Medicine and Paediatrics and Adolescent Health, Sydney University Clinical School, Children's Hospital, Westmead, NSW, Australia
| | - Marleen Simon
- Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - V Reid Sutton
- Department of Molecular & Human Genetics, Baylor College of Medicine & Texas Children's Hospital, Houston, Texas, USA
| | - Matthew L Warman
- Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Genetics, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrea Superti-Furga
- Division of Genetic Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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6
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Rudrappa SC, Beeman A, Ramaswamy M, Khambadkone S, Derrick G, Kostolny M, Calder A, Muthialu N. Impact of Tracheal Arborization and Lung Hypoplasia in Repair of Pulmonary Artery Sling in Combination With Long-Segment Tracheal Stenosis. World J Pediatr Congenit Heart Surg 2023; 14:134-140. [PMID: 36788380 DOI: 10.1177/21501351221145172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Background: Reimplantation of the left pulmonary artery (LPA) and slide tracheoplasty has been our standard approach of care for patients with pulmonary artery sling (PAS) and tracheal stenosis. We present our experience, with emphasis on tracheal arborization and hypoplastic lungs; and their impact on long-term outcome of children with PAS and tracheal stenosis. Methods: It is a retrospective comparative study. Data were classified and analyzed based on the type of tracheobronchial arborization and normal versus hypoplastic lungs. Results: Seventy-five children operated between January 1994 and December 2019 (67 with normal lungs and 8 with lung hypoplasia/agenesis) were included. Patients with hypoplastic lungs had higher rates of preoperative ventilation (87.5%), postoperative ventilation (10 vs 8 days, P = .621), and mortality (50% vs 9%, P = .009) compared with those with normal lungs. Nineteen patients had tracheal bronchus (TB) variety and 30 patients had congenital long-segment tracheal stenosis (CLSTS) variety of tracheobronchial arborization. Endoscopic intervention was needed in 47.4% of patients with TB type and 60% with CLSTS type. CLSTS patients had higher rates of preoperative ventilation (60% vs 47.4%, P = .386), longer periods of postoperative ventilation (13 vs 6.5 days, P = .006), and ICU stay (15 vs 11 days, P = .714) compared with TB type. Conclusion: Surgical repair of PAS with tracheal stenosis has good long-term outcomes. All variations of tracheal anatomy can be managed with slide tracheoplasty. Persistence of airway problems requires intervention during follow-up as tracheal stenosis continues to be the Achilles heel.
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Affiliation(s)
| | - Arun Beeman
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - Madhavan Ramaswamy
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - Sachin Khambadkone
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - Graham Derrick
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - Martin Kostolny
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - Alistair Calder
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - Nagarajan Muthialu
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
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Hill B, Calder A, Flemming J, Gilmore S, Guo Y, Harshyne L, Linnenbach A, Martinez-Outschoorn U, Curry J, South A, Luginbuhl A, Mahoney M. 089 Desmoglein 2 promotes tumor development through miR-146a/IRAK1/IL-8 signaling axis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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8
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Durkin A, DeVile C, Arundel P, Bull M, Walsh J, Bishop NJ, Hupin E, Parekh S, Nadarajah R, Offiah AC, Calder A, Brock J, Baker D, Balasubramanian M. Expanding the phenotype of SPARC-related osteogenesis imperfecta: clinical findings in two patients with pathogenic variants in SPARC and literature review. J Med Genet 2021; 59:810-816. [PMID: 34462290 DOI: 10.1136/jmedgenet-2021-107942] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/01/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Secreted protein, acidic, cysteine rich (SPARC)-related osteogenesis imperfecta (OI), also referred to as OI type XVII, was first described in 2015, since then there has been only one further report of this form of OI. SPARC is located on chromosome 5 between bands q31 and q33. The encoded protein is necessary for calcification of the collagen in bone, synthesis of extracellular matrix and the promotion of changes to cell shape. METHODS We describe a further two patients with previously unreported homozygous SPARC variants with OI: one splice site; one nonsense pathogenic variant. We present detailed information on the clinical and radiological phenotype and correlate this with their genotype. There are only two previous reports by Mendozo-Londono et al and Hayat et al with clinical descriptions of patients with SPARC variants. RESULTS From the data we have obtained, common clinical features in individuals with OI type XVII caused by SPARC variants include scoliosis (5/5), vertebral compression fractures (5/5), multiple long bone fractures (5/5) and delayed motor development (3/3). Interestingly, 2/4 patients also had abnormal brain MRI, including high subcortical white matter changes, abnormal fluid-attenuated inversion in the para-atrial white matter and a large spinal canal from T10 to L1. Of significance, both patients reported here presented with significant neuromuscular weakness prompting early workup. CONCLUSION Common phenotypic expressions include delayed motor development with neuromuscular weakness, scoliosis and multiple fractures. The data presented here broaden the phenotypic spectrum establishing similar patterns of neuromuscular presentation with a presumed diagnosis of 'myopathy'.
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Affiliation(s)
- Anna Durkin
- The University of Sheffield Medical School, Sheffield, UK
| | - Catherine DeVile
- Highly Specialised OI Service, Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK
| | - Paul Arundel
- Highly Specialised OI Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Mary Bull
- Metabolic Bone Centre, Northern General Hospital, Sheffield, UK
| | - Jennifer Walsh
- Metabolic Bone Centre, Northern General Hospital, Sheffield, UK.,Department of Oncology & Metabolism, The University of Sheffield, Sheffield, UK
| | - Nicholas J Bishop
- Highly Specialised OI Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK.,Department of Oncology & Metabolism, The University of Sheffield, Sheffield, UK
| | - Emilie Hupin
- Highly Specialised OI Service, Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK
| | - Susan Parekh
- Eastman Dental Institute, University College London, London, UK
| | - Ramesh Nadarajah
- Highly Specialised OI Service, Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK
| | - Amaka C Offiah
- Highly Specialised OI Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK.,Department of Oncology & Metabolism, The University of Sheffield, Sheffield, UK
| | - Alistair Calder
- Radiology Department, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Joanna Brock
- Connective Tissue Disorders Service, Sheffield Diagnostic Genetics Service, Sheffield Children's Hospital, Sheffield, UK
| | - Duncan Baker
- Connective Tissue Disorders Service, Sheffield Diagnostic Genetics Service, Sheffield Children's Hospital, Sheffield, UK
| | - Meena Balasubramanian
- Highly Specialised OI Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK .,Department of Oncology & Metabolism, The University of Sheffield, Sheffield, UK.,Sheffield Clinical Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
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9
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Mankad K, Sidpra J, Oates AJ, Calder A, Offiah AC, Choudhary A. Sibling screening in suspected abusive head trauma: a proposed guideline. Pediatr Radiol 2021; 51:872-875. [PMID: 33999232 PMCID: PMC8126595 DOI: 10.1007/s00247-020-04917-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/29/2020] [Accepted: 11/16/2020] [Indexed: 11/15/2022]
Abstract
Abusive head trauma (AHT) is the leading cause of death from child abuse in children younger than 5 years. It is well documented that the infant contacts of children presenting with suspected AHT are at an increased risk of abuse when compared to the general infant population. Despite this association, a paucity of literature stratifies this risk and translates it to the clinic such that this high-risk group is stringently screened for abusive injuries. In this light, the authors propose a standardised screening method for all contact children of the index case and call for further consensus on the subject.
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Affiliation(s)
- Kshitij Mankad
- Department of Radiology, Great Ormond Street Hospital, Great Ormond Street, London, WC1N 3JH, UK.
| | - Jai Sidpra
- grid.83440.3b0000000121901201University College London Medical School, London, UK
| | - Adam J. Oates
- grid.415246.00000 0004 0399 7272Department of Radiology, Birmingham Children’s Hospital, Birmingham, UK
| | - Alistair Calder
- grid.420468.cDepartment of Radiology, Great Ormond Street Hospital, Great Ormond Street, London, WC1N 3JH UK
| | - Amaka C. Offiah
- grid.11835.3e0000 0004 1936 9262Academic Unit of Child Health, University of Sheffield, Western Bank, Sheffield, UK
| | - Arabinda Choudhary
- grid.241054.60000 0004 4687 1637Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR USA
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10
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Davies G, Stanojevic S, Raywood E, Duncan JA, Stocks J, Lum S, Bush A, Viviani L, Wade A, Calder A, Owens CM, Goubau C, Carr SB, Bossley CJ, Pao C, Aurora P. An observational study of the lung clearance index throughout childhood in cystic fibrosis: early years matter. Eur Respir J 2020; 56:13993003.00006-2020. [PMID: 32444409 PMCID: PMC7527650 DOI: 10.1183/13993003.00006-2020] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 04/23/2020] [Indexed: 01/15/2023]
Abstract
The London Cystic Fibrosis Collaboration (LCFC) has prospectively followed a clinically diagnosed cohort of infants with cystic fibrosis (CF) born in South East England since 1999 [1–4]. Over the past 20 years, the LCFC has obtained comprehensive measures of lung function and structure, including measures of ventilation inhomogeneity (lung clearance index (LCI)) and high-resolution computed tomography (HRCT) scans. By pre-school age, 73% of this cohort had LCI above the limits of normal, compared with 7% with abnormal forced expiratory volume in 0.5 seconds (FEV0.5) [1]. Children with elevated LCI during pre-school years also had worse lung function at early school age [2]. The aim of this study was to investigate how LCI changes across childhood to better understand to what extent LCI results at pre-school age are an indicator of lung disease severity in adolescence. Lung clearance index (LCI) in the early years was associated with LCI during adolescence in children with cystic fibrosis. Pre-school LCI may help to identify children in whom treatment could be intensified.https://bit.ly/2yKyMbM
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Affiliation(s)
- Gwyneth Davies
- Infection, Immunity and Inflammation Research and Teaching Dept, UCL Great Ormond Street Institute of Child Health (UCL GOS ICH), London, UK .,Dept of Respiratory Medicine, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,Joint first authors
| | - Sanja Stanojevic
- Translational Medicine, SickKids Research Institute, Toronto, ON, Canada.,Joint first authors
| | - Emma Raywood
- Infection, Immunity and Inflammation Research and Teaching Dept, UCL Great Ormond Street Institute of Child Health (UCL GOS ICH), London, UK
| | - Julie A Duncan
- Infection, Immunity and Inflammation Research and Teaching Dept, UCL Great Ormond Street Institute of Child Health (UCL GOS ICH), London, UK
| | - Janet Stocks
- Infection, Immunity and Inflammation Research and Teaching Dept, UCL Great Ormond Street Institute of Child Health (UCL GOS ICH), London, UK
| | - Sooky Lum
- Infection, Immunity and Inflammation Research and Teaching Dept, UCL Great Ormond Street Institute of Child Health (UCL GOS ICH), London, UK
| | - Andrew Bush
- Dept of Paediatric Respiratory Medicine, Imperial College and Royal Brompton and Harefield Hospital NHS Foundation Trust, London, UK
| | - Laura Viviani
- Infection, Immunity and Inflammation Research and Teaching Dept, UCL Great Ormond Street Institute of Child Health (UCL GOS ICH), London, UK
| | - Angie Wade
- Clinical Epidemiology, Nutrition and Biostatistics Section, UCL GOS ICH, London, UK
| | - Alistair Calder
- Dept of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Catherine M Owens
- Dept of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Christophe Goubau
- Infection, Immunity and Inflammation Research and Teaching Dept, UCL Great Ormond Street Institute of Child Health (UCL GOS ICH), London, UK
| | - Siobhán B Carr
- Dept of Paediatric Respiratory Medicine, Imperial College and Royal Brompton and Harefield Hospital NHS Foundation Trust, London, UK
| | - Cara J Bossley
- Dept of Paediatric Respiratory Medicine, Kings College Hospital, London, UK
| | - Caroline Pao
- Dept of Paediatric Respiratory Medicine, Royal London Hospital, London, UK
| | - Paul Aurora
- Infection, Immunity and Inflammation Research and Teaching Dept, UCL Great Ormond Street Institute of Child Health (UCL GOS ICH), London, UK.,Dept of Respiratory Medicine, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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11
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Polubothu S, Abdin D, Barysch M, Thomas A, Bulstrode N, Evans R, Solman L, Obwegeser J, Hennekam R, Weibel L, Calder A, Di Donato N, Kinsler V. Dermatological signs lead to discovery of mosaic
ACTB
variants in segmental odontomaxillary dysplasia. Br J Dermatol 2020; 183:1128-1130. [DOI: 10.1111/bjd.19339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 11/28/2022]
Affiliation(s)
- S. Polubothu
- Genetics and Genomic Medicine University College London GOS Institute of Child Health LondonWC1N 1EHUK
- Paediatric DermatologyGreat Ormond St Hospital for Children NHS Foundation Trust LondonWC1N 3JHUK
| | - D. Abdin
- Institute for Clinical Genetics Dresden Germany
| | - M. Barysch
- Dermatology Department University Hospital Zurich Zurich Switzerland
| | - A. Thomas
- Genetics and Genomic Medicine University College London GOS Institute of Child Health LondonWC1N 1EHUK
| | - N. Bulstrode
- Plastic SurgeryGreat Ormond St Hospital for Children NHS Foundation Trust LondonWC1N 3JHUK
| | - R. Evans
- Maxillofacial and Dental DepartmentGreat Ormond St Hospital for Children NHS Foundation Trust LondonWC1N 3JHUK
| | - L. Solman
- Paediatric DermatologyGreat Ormond St Hospital for Children NHS Foundation Trust LondonWC1N 3JHUK
| | - J. Obwegeser
- Maxillofacial Surgery University Children’s Hospital Zurich and Limmat Cleft‐ and Craniofacial Center Zurich Switzerland
| | - R.C. Hennekam
- Department of Paediatrics Amsterdam UMC Meibergdreef 9 1105AZ Amsterdam the Netherlands
| | - L. Weibel
- Dermatology Department University Hospital Zurich Zurich Switzerland
| | - A. Calder
- Radiology Great Ormond St Hospital for Children NHS Foundation Trust LondonWC1N 3JHUK
| | | | - V.A. Kinsler
- Genetics and Genomic Medicine University College London GOS Institute of Child Health LondonWC1N 1EHUK
- Paediatric DermatologyGreat Ormond St Hospital for Children NHS Foundation Trust LondonWC1N 3JHUK
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12
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Mestach L, Polubothu S, Calder A, Denayer E, Gholam K, Legius E, Levtchenko E, Van Laethem A, Brems H, Kinsler VA, Morren MA. Keratinocytic epidermal nevi associated with localized fibro-osseous lesions without hypophosphatemia. Pediatr Dermatol 2020; 37:890-895. [PMID: 32662096 DOI: 10.1111/pde.14254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 05/07/2020] [Accepted: 05/30/2020] [Indexed: 11/28/2022]
Abstract
Keratinocytic epidermal nevi (KEN) are characterized clinically by permanent hyperkeratosis in the distribution of Blaschko's lines and histologically by hyperplasia of epidermal keratinocytes. KEN with underlying RAS mutations have been associated with hypophosphatemic rickets and dysplastic bone lesions described as congenital cutaneous skeletal hypophosphatemia syndrome. Here, we describe two patients with keratinocytic epidermal nevi, in one associated with a papular nevus spilus, who presented with distinct localized congenital fibro-osseous lesions in the lower leg, diagnosed on both radiology and histology as osteofibrous dysplasia, in the absence of hypophosphatemia or rickets, or significantly raised FGF23 levels but with distinct mosaic HRAS mutations. This expands the spectrum of cutaneous/skeletal mosaic RASopathies and alerts clinicians to the importance of evaluating for bony disease even in the absence of bone profile abnormalities.
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Affiliation(s)
- Lien Mestach
- Department of Dermatology, University Hospitals of Leuven, Leuven, Belgium
| | - Satyamaanasa Polubothu
- Genetics and Genomic Medicine, UCL GOS Institute of Child Health, London, UK.,Paediatric Dermatology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Alistair Calder
- Paediatric Radiology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Ellen Denayer
- Center for Human Genetics, University Hospital Leuven, Leuven, Belgium
| | - Karolina Gholam
- Paediatric Dermatology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Eric Legius
- Center for Human Genetics, University Hospital Leuven, Leuven, Belgium.,Department of Human Genetics, KU Leuven - University of Leuven, Leuven, Belgium
| | - Elena Levtchenko
- Pediatric Nephrology, University Hospitals of Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - An Van Laethem
- Department of Dermatology, University Hospitals of Leuven, Leuven, Belgium
| | - Hilde Brems
- Center for Human Genetics, University Hospital Leuven, Leuven, Belgium.,Department of Human Genetics, KU Leuven - University of Leuven, Leuven, Belgium
| | - Veronica A Kinsler
- Genetics and Genomic Medicine, UCL GOS Institute of Child Health, London, UK.,Paediatric Dermatology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Marie-Anne Morren
- Department of Dermatology, University Hospitals of Leuven, Leuven, Belgium
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13
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Julies P, Lynn RM, Pall K, Leoni M, Calder A, Mughal Z, Shaw N, McDonnell C, McDevitt H, Blair M. Nutritional rickets under 16 years: UK surveillance results. Arch Dis Child 2020; 105:587-592. [PMID: 31949032 DOI: 10.1136/archdischild-2019-317934] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/06/2019] [Accepted: 12/11/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE The UK national incidence of nutritional rickets is unknown. We aimed to describe the incidence, presentation and clinical management of children under 16 years with nutritional rickets in the UK presenting to secondary care. METHODS Prospective data were collected monthly between March 2015 and March 2017 from 3500 consultant paediatricians using British Paediatric Surveillance Unit methodology. Clinicians completed online clinical questionnaires for cases fitting the surveillance case definition. RESULTS 125 cases met the case definition, an annual incidence of 0.48 (95% CI 0.37 to 0.62) per 100 000 children under 16 years. 116 children were under 5 years (annual incidence of 1.39 (95% CI 1.05 to 1.81) per 100 000. Boys (70%) were significantly more affected than girls (30%) (OR 2.17, 95% CI 1.25 to 3.78). The majority were of Black (43%) or South Asian (38%) ethnicity. 77.6% of children were not taking vitamin D supplements despite being eligible. Complications included delayed gross motor development (26.4%), fractures (9.6%), hypocalcaemic seizures (8%) and dilated cardiomyopathy (3%). Two children died (1.6%). In eight cases, rickets was confirmed radiologically and biochemically [raised serum alkaline phosphatase (ALP) and parathyroid hormone (PTH) levels ] but were excluded from the incidence analysis for not meeting the case definition of 25-hydroxyvitamin D of <25 nmol/L. CONCLUSION The incidence of nutritional rickets in the UK is lower than expected. Serious complications and unexpected deaths, particularly in Black and South Asian children under 5 years, occurred. Both vitamin D deficiency and dietary calcium deficiency are role players in pathogenesis. Uptake of vitamin D supplementation remains low.
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Affiliation(s)
- Priscilla Julies
- Child Health, Royal Free London NHS Foundation Trust, London, UK
| | - Richard M Lynn
- Institute of Child Health, University College London Research Department of Epidemiology and Public Health, London, UK.,BPSU, Royal College of Paedaitrics, London, UK
| | - Karina Pall
- BPSU, Royal College of Paediatrics and Child Health, London, UK
| | - Marina Leoni
- BPSU, Royal College of Paediatrics and Child Health, London, UK
| | - Alistair Calder
- Department of Radiology, Great Ormond Street Hospital, London, UK
| | - Zulf Mughal
- Department of Paediatric Endocrinology, Royal Manchester Children's Hospital, Manchester, UK
| | - Nick Shaw
- Endocrinology and Diabetes, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, West Midlands, UK.,Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, West Midlands, UK
| | - Ciara McDonnell
- Endocrinology Department, Children's University Hospital, Temple Street, Dublin, Ireland
| | - Helen McDevitt
- Paediatric Bone and Endocrinology, Royal Hospital for Children Glasgow, Glasgow, UK.,Neonatology, Royal Hospital for Children Glasgow, Glasgow, UK
| | - Mitch Blair
- Paediatrics, Imperial College London, Harrow, UK
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14
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Davies G, Thia LP, Stocks J, Bush A, Hoo AF, Wade A, Nguyen TTD, Brody AS, Calder A, Klein NJ, Carr SB, Wallis C, Suri R, Pao CS, Ruiz G, Balfour-Lynn IM. Minimal change in structural, functional and inflammatory markers of lung disease in newborn screened infants with cystic fibrosis at one year. J Cyst Fibros 2020; 19:896-901. [PMID: 32044244 DOI: 10.1016/j.jcf.2020.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 01/16/2020] [Accepted: 01/17/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND With the widespread introduction of newborn screening for cystic fibrosis (CF), there has been considerable emphasis on the need to develop objective markers of lung health that can be used during infancy. We hypothesised that in a newborn screened (NBS) UK cohort, evidence of airway inflammation and infection at one year would be associated with adverse structural and functional outcomes at the same age. METHODS Infants underwent lung function testing, chest CT scan and bronchoscopy with bronchoalveolar lavage (BAL) at 1 year of age when clinically well. Microbiology cultures were also available from routine cough swabs. RESULTS 65 infants had lung function, CT and BAL. Mean (SD) lung clearance index and forced expiratory volume in 0.5 s z-scores were 0.9(1.2) and -0.6(1.1) respectively; median Brody II CF-CT air trapping score on chest CT =0 (interquartile range 0-1, maximum possible score 27). Infants isolating any significant pathogen by 1 yr of age had higher LCI z-score (mean difference 0.9; 95%CI:0.4-1.4; p = 0.001) and a trend towards higher air trapping scores on CT (p = 0.06). BAL neutrophil elastase was detectable in 23% (10/43) infants in whom BAL supernatant was available. This did not relate to air trapping score on CT. CONCLUSIONS In this UK NBS cohort at one year of age, lung and airway damage is much milder and associations between inflammation, abnormal physiology and structural changes were at best weak, contrary to our hypothesis and previously published reports. Continued follow-up will clarify longer term implications of these very mild structural, functional and inflammatory changes.
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Affiliation(s)
- Gwyneth Davies
- Respiratory, Critical Care and Anaesthesia section, UCL Great Ormond Street Institute of Child Health (GOS ICH), London, United Kingdom; Department of Respiratory Medicine, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.
| | - Lena P Thia
- Respiratory, Critical Care and Anaesthesia section, UCL Great Ormond Street Institute of Child Health (GOS ICH), London, United Kingdom; Department of Paediatric Respiratory Medicine, Cardiff University and Children's Hospital for Wales, Cardiff, United Kingdom
| | - Janet Stocks
- Respiratory, Critical Care and Anaesthesia section, UCL Great Ormond Street Institute of Child Health (GOS ICH), London, United Kingdom
| | - Andrew Bush
- Department of Paediatric Respiratory Medicine, Imperial College & Royal Brompton & Harefield Hospital NHS Foundation Trust, London, United Kingdom
| | - Ah-Fong Hoo
- Respiratory, Critical Care and Anaesthesia section, UCL Great Ormond Street Institute of Child Health (GOS ICH), London, United Kingdom; Department of Respiratory Medicine, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Angie Wade
- Clinical Epidemiology, Nutrition and Biostatistics Section, UCL GOS ICH, London, United Kingdom
| | - The Thanh Diem Nguyen
- Respiratory, Critical Care and Anaesthesia section, UCL Great Ormond Street Institute of Child Health (GOS ICH), London, United Kingdom; Department of Respiratory Medicine, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Alan S Brody
- University of Cincinnati College of Medicine and Cincinnati Children's Hospital, Cincinnati, OH, United States
| | - Alistair Calder
- Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Nigel J Klein
- Infection, Inflammation and Rheumatology Section, UCL GOS ICH, London, United Kingdom
| | - Siobhán B Carr
- Department of Paediatric Respiratory Medicine, Imperial College & Royal Brompton & Harefield Hospital NHS Foundation Trust, London, United Kingdom
| | - Colin Wallis
- Respiratory, Critical Care and Anaesthesia section, UCL Great Ormond Street Institute of Child Health (GOS ICH), London, United Kingdom; Department of Respiratory Medicine, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Ranjan Suri
- Respiratory, Critical Care and Anaesthesia section, UCL Great Ormond Street Institute of Child Health (GOS ICH), London, United Kingdom; Department of Respiratory Medicine, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Caroline S Pao
- Department of Paediatric Respiratory Medicine, Royal London Hospital, London, United Kingdom
| | - Gary Ruiz
- Department of Paediatric Respiratory Medicine, Kings College Hospital, London, United Kingdom
| | - Ian M Balfour-Lynn
- Department of Paediatric Respiratory Medicine, Imperial College & Royal Brompton & Harefield Hospital NHS Foundation Trust, London, United Kingdom
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15
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Cunningham S, Graham C, MacLean M, Aurora P, Ashworth M, Barbato A, Calder A, Carlens J, Clement A, Hengst M, Kammer B, Kiper N, Krenke K, Kronfeld K, Lange J, Ley-Zaporozhan J, Nicholson AG, Reu S, Wesselak T, Wetzke M, Bush A, Schwerk N, Griese M. One-year outcomes in a multicentre cohort study of incident rare diffuse parenchymal lung disease in children (ChILD). Thorax 2019; 75:172-175. [PMID: 31748256 DOI: 10.1136/thoraxjnl-2019-213217] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 10/22/2019] [Accepted: 10/30/2019] [Indexed: 11/04/2022]
Abstract
We performed a prospective, observational, cohort study of children newly diagnosed with children's interstitial lung disease (ChILD), with structured follow-up at 4, 8, 12 weeks and 6 and 12 months. 127 children, median age 0.9 (IQR 0.3-7.9) years had dyspnoea (68%, 69/102), tachypnoea (75%, 77/103) and low oxygen saturation (SpO2) median 92% (IQR 88-96). Death (n=20, 16%) was the most common in those <6 months of age with SpO2<94% and developmental/surfactant disorders. We report for the first time that ChILD survivors improved multiple clinical parameters within 8-12 weeks of diagnosis. These data can inform family discussions and support clinical trial measurements.
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Affiliation(s)
- Steve Cunningham
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK .,Department of Respiratory and Sleep Medicine, Royal Hospital for Sick Children, Edinburgh, UK
| | - Catriona Graham
- Wellcome Trust Clinical Research Facility, Western General Hospital, Edinburgh, UK
| | - Morag MacLean
- Edinburgh Clinical Trials Unit, University of Edinburgh, Edinburgh, UK
| | - Paul Aurora
- Department of Respiratory Paediatrics, Great Ormond Street Hospital, London, UK
| | - Michael Ashworth
- Department of Paediatric Pathology, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Angelo Barbato
- Department of Women's and Children's Health, University of Padova, Padua, Italy
| | - Alistair Calder
- Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Julia Carlens
- Department of Pediatric Pneumology, Medizinische Hochschule Hannover, Hannover, Germany
| | - Annick Clement
- Paediatric Pulmonary Department, Trousseau Hospital APHP, Sorbonne Universities and Pierre et Marie Curie University, Paris, France
| | - Meike Hengst
- Pediatric Pneumology, Hauner Children's University Hospital, Munich, Germany
| | - Birgit Kammer
- University Children's Hospital at Dr. von Haunersches Kinderspital, LMU Munich, Munich, Germany
| | - Nural Kiper
- Pediatric Pulmonology, Hacettepe University, Ankara, Turkey
| | - Katarzyna Krenke
- Department of Pediatric Pneumology and Allergy, Warszawski Uniwersytet Medyczny, Warszawa, Poland
| | - Kai Kronfeld
- IZKS Mainz, University Medical Center Mainz, Mainz, Germany
| | - Joanna Lange
- Department of Pediatric Pneumology and Allergy, Warszawski Uniwersytet Medyczny, Warszawa, Poland
| | - Julia Ley-Zaporozhan
- Institute for Clinical Radiology, University Hospital of Ludwig Maximilian University, Munich, Germany
| | - Andrew G Nicholson
- Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London, UK
| | - Simone Reu
- Pathology, Ludwig-Maximilians-Universitat Munchen Medizinische Fakultat, Munchen, Germany
| | - Traudl Wesselak
- Pediatric Pneumology, Hauner Children's University Hospital, Munich, Germany
| | - Martin Wetzke
- Department of Pediatric Pulmonology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
| | - Andrew Bush
- Department of Respiratory Paediatrics, Royal Brompton Hospital, London, UK
| | - Nicolaus Schwerk
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
| | - Matthias Griese
- Lung Research Group, Children's Hospital of Ludwig Maximilians University, Munich, Germany
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16
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Swaminathan A, Taylor K, Ramaswamy M, Calder A, McHugh K, Muthialu N, Mok Q. Life-threatening mesenchymal hamartoma of the chest wall in a neonate. BJR Case Rep 2019; 5:20190004. [PMID: 31555474 PMCID: PMC6750625 DOI: 10.1259/bjrcr.20190004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 03/25/2019] [Accepted: 04/23/2019] [Indexed: 11/06/2022] Open
Abstract
Mesenchymal hamartomas of the chest wall are unusual tumours diagnosed in neonates. They mostly resolve spontaneously hence conservative management has been advocated. Some compress vital structures in the thoracic cavity or bleed warranting surgical intervention. We present a neonate with mesenchymal hamartoma of the chest wall presenting as unilateral multifocal lesions with life threatening complications. He responded well to surgical intervention and was successfully discharged.
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Affiliation(s)
- Aravind Swaminathan
- Department of Paediatric and Neonatal Intensive Care, Great Ormond Street Hospital, London
| | - Katherine Taylor
- Department of Paediatric and Neonatal Intensive Care, Great Ormond Street Hospital, London
| | - Madhavan Ramaswamy
- Department of Thoracic and tracheal Surgery, Great Ormond Street Hospital, London
| | - Alistair Calder
- Department of Radiology, Great Ormond Street Hospital, London
| | - Kieran McHugh
- Department of Radiology, Great Ormond Street Hospital, London
| | - Nagarajan Muthialu
- Department of Thoracic and tracheal Surgery, Great Ormond Street Hospital, London
| | - Quen Mok
- Department of Paediatric and Neonatal Intensive Care, Great Ormond Street Hospital, London
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17
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Jacob J, Owens CM, Brody AS, Semple T, Watson TA, Calder A, Garcia-Peña P, Toma P, Devaraj A, Walton H, Moreno-Galdó A, Aurora P, Rice A, Vece TJ, Cunningham S, Altmann A, Wells AU, Nicholson AG, Bush A. Evaluation of inter-observer variation for computed tomography identification of childhood interstitial lung disease. ERJ Open Res 2019; 5:00100-2019. [PMID: 31367634 PMCID: PMC6661316 DOI: 10.1183/23120541.00100-2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 06/06/2019] [Indexed: 11/20/2022] Open
Abstract
Interstitial lung diseases (ILDs) that present in childhood (chILD) are seen far less frequently than ILDs presenting in adults which themselves constitute rare disorders [1]. Histopathological [2, 3] and imaging [4] characterisation of chILD disease subtypes therefore lags behind adult ILDs. The field has also been constrained by comparisons with disease morphology in adults, despite the developmental differences in terms of growth and healing in the paediatric lung, which may alter disease patterns and distributions. The American Thoracic Society [5] and European [1] chILD management guidelines both specify a pivotal role for computed tomography (CT) imaging in the work-up of chILD patients to: 1) determine whether a chILD is present or not; and 2) where possible, to make a specific diagnosis of the underlying cause. For the second aim to be achieved, diagnostic reviews need to be reproducible between experts. Our study uniquely examined agreement between observers of varying experience in the CT evaluation of chILD to inform whether the current status of CT imaging and knowledge can be diagnostic of specific chILDs. We hypothesised that observer agreement for chILD groups and diagnoses would be limited. The study was not designed to relate CT agreement to final diagnosis. As a secondary analysis, we examined how CT interpretation differed between observers in children under and over 2 years of age. Making chILD diagnoses on CT is poorly reproducible, even amongst sub-specialists. CT might best improve diagnostic confidence in a multidisciplinary team setting when augmented with clinical, functional and haematological results.http://bit.ly/327jRCw
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Affiliation(s)
- Joseph Jacob
- Dept of Respiratory Medicine, University College London, London, UK.,Centre for Medical Image Computing, University College London, London, UK
| | | | - Alan S Brody
- Dept of Radiology, University of Cincinnati College of Medicine, and Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - Thomas Semple
- Dept of Radiology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Tom A Watson
- Dept of Radiology, Great Ormond Street Hospital, London, UK
| | | | - Pilar Garcia-Peña
- Dept of Pediatric Radiology, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Paolo Toma
- Dept of Radiology, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Anand Devaraj
- Dept of Radiology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Henry Walton
- Dept of Radiology, Royal Free London NHS Foundation Trust, London, UK
| | - Antonio Moreno-Galdó
- Dept of Paediatric Respiratory Medicine, University Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBERER, Spain
| | - Paul Aurora
- Dept of Paediatric Respiratory Medicine, Great Ormond Street Hospital, London, UK
| | - Alexandra Rice
- Dept of Hisopathology, Royal Brompton and Harefield NHS Foundation Trust and National Heart and Lung Institute, Imperial College, London, UK
| | - Timothy J Vece
- Dept of Pediatrics, Division of Pediatric Pulmonology, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Steve Cunningham
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK
| | - Andre Altmann
- Centre for Medical Image Computing, University College London, London, UK
| | - Athol U Wells
- Interstitial Lung Disease Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Andrew G Nicholson
- Dept of Hisopathology, Royal Brompton and Harefield NHS Foundation Trust and National Heart and Lung Institute, Imperial College, London, UK
| | - Andrew Bush
- Depts of Paediatrics and Paediatric Respiratory Medicine, Imperial College and Royal Brompton Hospital, London, UK
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18
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Bownass L, Abbs S, Armstrong R, Baujat G, Behzadi G, Berentsen RD, Burren C, Calder A, Cormier-Daire V, Newbury-Ecob R, Foulds N, Juliusson PB, Kant SG, Lefroy H, Mehta SG, Merckoll E, Michot C, Monsell F, Offiah AC, Richards A, Rosendahl K, Rustad CF, Shears D, Tveten K, Wellesley D, Wordsworth P, Smithson S. PAPSS2-related brachyolmia: Clinical and radiological phenotype in 18 new cases. Am J Med Genet A 2019; 179:1884-1894. [PMID: 31313512 DOI: 10.1002/ajmg.a.61282] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/07/2019] [Accepted: 06/11/2019] [Indexed: 11/06/2022]
Abstract
Brachyolmia is a skeletal dysplasia characterized by short spine-short stature, platyspondyly, and minor long bone abnormalities. We describe 18 patients, from different ethnic backgrounds and ages ranging from infancy to 19 years, with the autosomal recessive form, associated with PAPSS2. The main clinical features include disproportionate short stature with short spine associated with variable symptoms of pain, stiffness, and spinal deformity. Eight patients presented prenatally with short femora, whereas later in childhood their short-spine phenotype emerged. We observed the same pattern of changing skeletal proportion in other patients. The radiological findings included platyspondyly, irregular end plates of the elongated vertebral bodies, narrow disc spaces and short over-faced pedicles. In the limbs, there was mild shortening of femoral necks and tibiae in some patients, whereas others had minor epiphyseal or metaphyseal changes. In all patients, exome and Sanger sequencing identified homozygous or compound heterozygous PAPSS2 variants, including c.809G>A, common to white European patients. Bi-parental inheritance was established where possible. Low serum DHEAS, but not overt androgen excess was identified. Our study indicates that autosomal recessive brachyolmia occurs across continents and may be under-recognized in infancy. This condition should be considered in the differential diagnosis of short femora presenting in the second trimester.
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Affiliation(s)
- Lucy Bownass
- Clinical Genetics, St Michael's Hospital Bristol, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Stephen Abbs
- East Midlands and East of England NHS Genomic Laboratory Hub, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Ruth Armstrong
- East Anglian Medical Genetics Service, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Genevieve Baujat
- Département of Genetics, INSERM UMR1163, Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, AP-HP, Hôpital Necker Enfants Malades, Paris, France
| | - Gry Behzadi
- Department of Radiology, Stavanger University Hospital, Stavanger, Norway
| | | | - Christine Burren
- Department of Paediatric Endocrinology and Diabetes, Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Alistair Calder
- Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Valérie Cormier-Daire
- Département of Genetics, INSERM UMR1163, Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, AP-HP, Hôpital Necker Enfants Malades, Paris, France
| | - Ruth Newbury-Ecob
- Clinical Genetics, St Michael's Hospital Bristol, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Nicola Foulds
- Wessex Clinical Genetics, Princess Anne Hospital, Southampton, UK
| | - Petur B Juliusson
- Department of Health Registries, Norwegian Institute of Public Health, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Paediatrics, Haukeland University Hospital, Bergen, Norway
| | - Sarina G Kant
- Department of Clinical Genetics, Leiden University Medical Centre, Leiden, the Netherlands
| | - Henrietta Lefroy
- Oxford Centre for Genomic Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Sarju G Mehta
- East Anglian Medical Genetics Service, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Else Merckoll
- Department of Radiology, Oslo University Hospital, Oslo, Norway
| | - Caroline Michot
- Département of Genetics, INSERM UMR1163, Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, AP-HP, Hôpital Necker Enfants Malades, Paris, France
| | - Fergal Monsell
- Department of Paediatric Orthopaedics, Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Amaka C Offiah
- University of Sheffield, Academic Unit of Child Health, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Allan Richards
- East Midlands and East of England NHS Genomic Laboratory Hub, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Karen Rosendahl
- Section of Paediatric Radiology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Cecilie F Rustad
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Deborah Shears
- Oxford Centre for Genomic Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Kristian Tveten
- Department of Medical Genetics, Telemark Hospital Trust, Skien, Norway
| | - Diana Wellesley
- Wessex Clinical Genetics, Princess Anne Hospital, Southampton, UK
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- Wellcome Sanger Institute, Cambridge, UK
| | - Sarah Smithson
- Clinical Genetics, St Michael's Hospital Bristol, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
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19
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Griese M, Seidl E, Hengst M, Reu S, Rock H, Anthony G, Kiper N, Emiralioğlu N, Snijders D, Goldbeck L, Leidl R, Ley-Zaporozhan J, Krüger-Stollfuss I, Kammer B, Wesselak T, Eismann C, Schams A, Neuner D, MacLean M, Nicholson AG, Lauren M, Clement A, Epaud R, de Blic J, Ashworth M, Aurora P, Calder A, Wetzke M, Kappler M, Cunningham S, Schwerk N, Bush A. International management platform for children's interstitial lung disease (chILD-EU). Thorax 2017; 73:231-239. [PMID: 29056600 DOI: 10.1136/thoraxjnl-2017-210519] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 08/31/2017] [Accepted: 09/18/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND Children's interstitial lung diseases (chILD) cover many rare entities, frequently not diagnosed or studied in detail. There is a great need for specialised advice and for internationally agreed subclassification of entities collected in a register.Our objective was to implement an international management platform with independent multidisciplinary review of cases at presentation for long-term follow-up and to test if this would allow for more accurate diagnosis. Also, quality and reproducibility of a diagnostic subclassification system were assessed using a collection of 25 complex chILD cases. METHODS A web-based chILD management platform with a registry and biobank was successfully designed and implemented. RESULTS Over a 3-year period, 575 patients were included for observation spanning a wide spectrum of chILD. In 346 patients, multidisciplinary reviews were completed by teams at five international sites (Munich 51%, London 12%, Hannover 31%, Ankara 1% and Paris 5%). In 13%, the diagnosis reached by the referring team was not confirmed by peer review. Among these, the diagnosis initially given was wrong (27%), imprecise (50%) or significant information was added (23%).The ability of nine expert clinicians to subcategorise the final diagnosis into the chILD-EU register classification had an overall exact inter-rater agreement of 59% on first assessment and after training, 64%. Only 10% of the 'wrong' answers resulted in allocation to an incorrect category. Subcategorisation proved useful but training is needed for optimal implementation. CONCLUSIONS We have shown that chILD-EU has generated a platform to help the clinical assessment of chILD. TRIAL REGISTRATION NUMBER Results, NCT02852928.
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Affiliation(s)
- Matthias Griese
- Department of Pediatric Pneumology, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University, German Center for Lung Research, Munich, Germany
| | - Elias Seidl
- Department of Pediatric Pneumology, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University, German Center for Lung Research, Munich, Germany
| | - Meike Hengst
- Department of Pediatric Pneumology, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University, German Center for Lung Research, Munich, Germany
| | - Simone Reu
- Department of Pathology, LMU Munich, Munich, Germany
| | - Hans Rock
- Department of Neurology, University of Marburg, Central Information Office, Marburg, Germany
| | - Gisela Anthony
- Department of Neurology, University of Marburg, Central Information Office, Marburg, Germany
| | - Nural Kiper
- Division of Pediatric Pulmonology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nagehan Emiralioğlu
- Division of Pediatric Pulmonology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | | | - Lutz Goldbeck
- Child and Adolescent Psychiatry, University of Ulm, Clinic for Child and Adolescent Psychiatry/Psychotherapy, Ulm, Germany
| | - Reiner Leidl
- Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt, Munich, Germany
| | - Julia Ley-Zaporozhan
- Department of Pediatric Radiology, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Ingrid Krüger-Stollfuss
- Department of Pediatric Radiology, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Birgit Kammer
- Department of Pediatric Radiology, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Traudl Wesselak
- Department of Pediatric Pneumology, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University, German Center for Lung Research, Munich, Germany
| | - Claudia Eismann
- Department of Pediatric Pneumology, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University, German Center for Lung Research, Munich, Germany
| | - Andrea Schams
- Department of Pediatric Pneumology, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University, German Center for Lung Research, Munich, Germany
| | - Doerthe Neuner
- Department of Pediatric Pneumology, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University, German Center for Lung Research, Munich, Germany
| | - Morag MacLean
- Department of Respiratory and Sleep Medicine, Royal Hospital for Sick Children, Edinburgh, UK
| | | | - McCann Lauren
- Department of Paediatrics, Imperial College London, NHLI, London, UK
| | - Annick Clement
- Department of Paediatrics, University Pierre und Marie Curie, Paris, France
| | - Ralph Epaud
- Department of Paediatrics, University Pierre und Marie Curie, Paris, France
| | - Jacques de Blic
- Department of Paediatrics, University Pierre und Marie Curie, Paris, France
| | - Michael Ashworth
- Department of Paediatrics, Great Ormond Street Hospital For Children NHS Trust, London, UK
| | - Paul Aurora
- Department of Paediatrics, Great Ormond Street Hospital For Children NHS Trust, London, UK
| | - Alistair Calder
- Department of Paediatrics, Great Ormond Street Hospital For Children NHS Trust, London, UK
| | - Martin Wetzke
- Department of Pediatric Pulmonology, Hannover Medical School, Hannover, Germany
| | - Matthias Kappler
- Department of Pediatric Pneumology, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University, German Center for Lung Research, Munich, Germany
| | - Steve Cunningham
- Department of Respiratory and Sleep Medicine, Royal Hospital for Sick Children, Edinburgh, UK
| | - Nicolaus Schwerk
- Department of Pediatric Pulmonology, Hannover Medical School, Hannover, Germany
| | - Andy Bush
- Department of Paediatrics, Royal Brompton Hospital, London, UK.,Department of Paediatrics, Imperial College London, NHLI, London, UK
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20
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Le Quesne Stabej P, James C, Ocaka L, Tekman M, Grunewald S, Clement E, Stanescu HC, Kleta R, Morrogh D, Calder A, Williams HJ, Bitner-Glindzicz M. An example of the utility of genomic analysis for fast and accurate clinical diagnosis of complex rare phenotypes. Orphanet J Rare Dis 2017; 12:24. [PMID: 28173822 PMCID: PMC5297239 DOI: 10.1186/s13023-017-0582-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 01/31/2017] [Indexed: 11/23/2022] Open
Abstract
Background We describe molecular diagnosis in a complex consanguineous family: four offspring presented with combinations of three distinctive phenotypes; non-syndromic hearing loss (NSHL), an unusual skeletal phenotype comprising multiple fractures, cranial abnormalities and diaphyseal expansion, and significant developmental delay with microcephaly. We performed Chromosomal Microarray Analysis on the offspring with either the skeletal or developmental delay phenotypes, and linkage analysis and whole exome sequencing (WES) on all four children, parents and maternal aunt. Results Chromosomal microarray and FISH analysis identified a de novo unbalanced translocation as a cause of the microcephaly and severe developmental delay. WES identified a NSHL-causing splice variant in an autosomal recessive deafness gene PDZD7 which resided in a linkage region and affected three of the children. In the two children diagnosed with an unusual skeletal phenotype, WES eventually disclosed a heterozygous COL1A1 variant which affects C-propetide cleavage site of COL1. The variant was inherited from an apparently unaffected mosaic father in an autosomal dominant fashion. After the discovery of the COL1A1 variant, the skeletal phenotype was diagnosed as a high bone mass form of osteogenesis imperfecta. Conclusions Next generation sequencing offers an unbiased approach to molecular genetic diagnosis in highly heterogeneous and poorly characterised disorders and enables early diagnosis as well as detection of mosaicism. Electronic supplementary material The online version of this article (doi:10.1186/s13023-017-0582-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Polona Le Quesne Stabej
- Genetics and Genomic Medicine, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
| | - Chela James
- Genetics and Genomic Medicine, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
| | - Louise Ocaka
- Genetics and Genomic Medicine, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
| | | | - Stephanie Grunewald
- Department of Paediatric Metabolic Medicine, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Emma Clement
- North East Thames Regional Genetics Service, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | | | | | | | - Alistair Calder
- Radiology Department, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Hywel J Williams
- Genetics and Genomic Medicine, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
| | - Maria Bitner-Glindzicz
- Genetics and Genomic Medicine, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK.
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21
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Tooley M, Lynch D, Bernier F, Parboosingh J, Bhoj E, Zackai E, Calder A, Itasaki N, Wakeling E, Scott R, Lees M, Clayton-Smith J, Blyth M, Morton J, Shears D, Kini U, Homfray T, Clarke A, Barnicoat A, Wallis C, Hewitson R, Offiah A, Saunders M, Langton-Hewer S, Hilliard T, Davis P, Smithson S. Cover Image, Volume 170A, Number 5, May 2016. Am J Med Genet A 2016. [DOI: 10.1002/ajmg.a.37661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Madeleine Tooley
- Department of Clinical Genetics; St. Michael's Hospital; Bristol United Kingdom
| | - Danielle Lynch
- Department of Medical Genetics; University of Calgary; Calgary Canada
| | - Francois Bernier
- Department of Medical Genetics; University of Calgary; Calgary Canada
| | | | - Elizabeth Bhoj
- Department of Clinical Genetics; Children's Hospital of Philadelphia; Philadelphia Pennsylvania
| | - Elaine Zackai
- Department of Clinical Genetics; Children's Hospital of Philadelphia; Philadelphia Pennsylvania
| | - Alistair Calder
- Department of Radiology; Great Ormond Street Children's Hospital; London United Kingdom
| | - Nobue Itasaki
- Centre for Comparative and Clinical Anatomy; University of Bristol; Bristol United Kingdom
| | - Emma Wakeling
- North West Thames Regional Genetic Service; North West London Hospitals NHS Trust; London United Kingdom
| | - Richard Scott
- Department of Clinical Genetics; Great Ormond Street Children's Hospital; London United Kingdom
| | - Melissa Lees
- Department of Clinical Genetics; Great Ormond Street Children's Hospital; London United Kingdom
| | - Jill Clayton-Smith
- Department of Clinical Genetics; St. Mary's Hospital; Manchester United Kingdom
| | - Moira Blyth
- Department of Clinical Genetics; Chapel Allerton Hospital; Leeds United Kingdom
| | - Jenny Morton
- Department of Clinical Genetics; Birmingham Women's Hospital; United Kingdom
| | - Debbie Shears
- Department of Clinical Genetics; Churchill Hospital; Oxford United Kingdom
| | - Usha Kini
- Department of Clinical Genetics; Churchill Hospital; Oxford United Kingdom
| | - Tessa Homfray
- Department of Clinical Genetics; St. George's Hospital; London United Kingdom
| | - Angus Clarke
- Department of Clinical Genetics; University Hospital Wales; Cardiff United Kingdom
| | - Angela Barnicoat
- Department of Clinical Genetics; Great Ormond Street Children's Hospital; London United Kingdom
| | - Colin Wallis
- Department of Paediatric Respiratory Medicine; Great Ormond Street Children's Hospital; London United Kingdom
| | - Rebecca Hewitson
- Department of Paediatric Respiratory Medicine; Great Ormond Street Children's Hospital; London United Kingdom
| | - Amaka Offiah
- Academic Unit of Child Health; Sheffield Children's NHS Foundation Trust; Sheffield United Kingdom
| | - Michael Saunders
- Department of Otolaryngology; St. Michael's Hospital; Bristol United Kingdom
| | - Simon Langton-Hewer
- Department of Paediatric Respiratory Medicine; Bristol Royal Hospital for Children; London United Kingdom
| | - Tom Hilliard
- Department of Paediatric Respiratory Medicine; Bristol Royal Hospital for Children; London United Kingdom
| | - Peter Davis
- Department of Paediatric Intensive Care; Bristol Royal Hospital for Children; Bristol United Kingdom
| | - Sarah Smithson
- Department of Clinical Genetics; St. Michael's Hospital; Bristol United Kingdom
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22
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Tooley M, Lynch D, Bernier F, Parboosingh J, Bhoj E, Zackai E, Calder A, Itasaki N, Wakeling E, Scott R, Lees M, Clayton-Smith J, Blyth M, Morton J, Shears D, Kini U, Homfray T, Clarke A, Barnicoat A, Wallis C, Hewitson R, Offiah A, Saunders M, Langton-Hewer S, Hilliard T, Davis P, Smithson S. Cerebro-costo-mandibular syndrome: Clinical, radiological, and genetic findings. Am J Med Genet A 2016; 170A:1115-26. [PMID: 26971886 DOI: 10.1002/ajmg.a.37587] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/25/2016] [Indexed: 11/07/2022]
Abstract
Cerebro-Costo-Mandibular syndrome (CCMS) is a rare autosomal dominant condition comprising branchial arch-derivative malformations with striking rib-gaps. Affected patients often have respiratory difficulties, associated with upper airway obstruction, reduced thoracic capacity, and scoliosis. We describe a series of 12 sporadic and 4 familial patients including 13 infants/children and 3 adults. Severe micrognathia and reduced numbers of ribs with gaps are consistent findings. Cleft palate, feeding difficulties, respiratory distress, tracheostomy requirement, and scoliosis are common. Additional malformations such as horseshoe kidney, hypospadias, and septal heart defect may occur. Microcephaly and significant developmental delay are present in a small minority of patients. Key radiological findings are of a narrow thorax, multiple posterior rib gaps and abnormal costo-transverse articulation. A novel finding in 2 patients is bilateral accessory ossicles arising from the hyoid bone. Recently, specific mutations in SNRPB, which encodes components of the major spliceosome, have been found to cause CCMS. These mutations cluster in an alternatively spliced regulatory exon and result in altered SNRPB expression. DNA was available from 14 patients and SNRPB mutations were identified in 12 (4 previously reported). Eleven had recurrent mutations previously described in patients with CCMS and one had a novel mutation in the alternative exon. These results confirm the specificity of SNRPB mutations in CCMS and provide further evidence for the role of spliceosomal proteins in craniofacial and thoracic development.
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Affiliation(s)
- Madeleine Tooley
- Department of Clinical Genetics, St. Michael's Hospital, Bristol, United Kingdom
| | - Danielle Lynch
- Department of Medical Genetics, University of Calgary, Calgary, Canada
| | - Francois Bernier
- Department of Medical Genetics, University of Calgary, Calgary, Canada
| | | | - Elizabeth Bhoj
- Department of Clinical Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Elaine Zackai
- Department of Clinical Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Alistair Calder
- Department of Radiology, Great Ormond Street Children's Hospital, London, United Kingdom
| | - Nobue Itasaki
- Centre for Comparative and Clinical Anatomy, University of Bristol, Bristol, United Kingdom
| | - Emma Wakeling
- North West Thames Regional Genetic Service, North West London Hospitals NHS Trust, London, United Kingdom
| | - Richard Scott
- Department of Clinical Genetics, Great Ormond Street Children's Hospital, London, United Kingdom
| | - Melissa Lees
- Department of Clinical Genetics, Great Ormond Street Children's Hospital, London, United Kingdom
| | - Jill Clayton-Smith
- Department of Clinical Genetics, St. Mary's Hospital, Manchester, United Kingdom
| | - Moira Blyth
- Department of Clinical Genetics, Chapel Allerton Hospital, Leeds, United Kingdom
| | - Jenny Morton
- Department of Clinical Genetics, Birmingham Women's Hospital, United Kingdom
| | - Debbie Shears
- Department of Clinical Genetics, Churchill Hospital, Oxford, United Kingdom
| | - Usha Kini
- Department of Clinical Genetics, Churchill Hospital, Oxford, United Kingdom
| | - Tessa Homfray
- Department of Clinical Genetics, St. George's Hospital, London, United Kingdom
| | - Angus Clarke
- Department of Clinical Genetics, University Hospital Wales, Cardiff, United Kingdom
| | - Angela Barnicoat
- Department of Clinical Genetics, Great Ormond Street Children's Hospital, London, United Kingdom
| | - Colin Wallis
- Department of Paediatric Respiratory Medicine, Great Ormond Street Children's Hospital, London, United Kingdom
| | - Rebecca Hewitson
- Department of Paediatric Respiratory Medicine, Great Ormond Street Children's Hospital, London, United Kingdom
| | - Amaka Offiah
- Academic Unit of Child Health, Sheffield Children's NHS Foundation Trust, Sheffield, United Kingdom
| | - Michael Saunders
- Department of Otolaryngology, St. Michael's Hospital, Bristol, United Kingdom
| | - Simon Langton-Hewer
- Department of Paediatric Respiratory Medicine, Bristol Royal Hospital for Children, London, United Kingdom
| | - Tom Hilliard
- Department of Paediatric Respiratory Medicine, Bristol Royal Hospital for Children, London, United Kingdom
| | - Peter Davis
- Department of Paediatric Intensive Care, Bristol Royal Hospital for Children, Bristol, United Kingdom
| | - Sarah Smithson
- Department of Clinical Genetics, St. Michael's Hospital, Bristol, United Kingdom
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23
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Christodoulou L, Pavlidou E, Spyridou C, Eccles S, Calder A, Mankad K, Kinali M. Metaphyseal dysplasia associated with chronic facial nerve palsy. Childs Nerv Syst 2016; 32:1333-6. [PMID: 26847543 PMCID: PMC4947474 DOI: 10.1007/s00381-016-3021-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 01/08/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Metaphyseal dysplasia (Pyle disease) is a rare autosomal recessive disease with impressive and characteristic radiological findings but relatively mild clinical features. It is usually incidentally diagnosed, despite the impressive radiological findings of gross metaphyseal widening and thinning of cortical bone. CASE REPORT Herein, we report an exceptionally unusual case of metaphyseal dysplasia in association with chronic facial nerve palsy. DISCUSSION Chronic facial nerve palsy due to compression of the facial nerve in a patient with Pyle disease represents an unusual novelty. Furthermore, this case delineates the clinical spectrum and phenotype of such a rare clinical entity. To the best of our knowledge, this is the first time that such an association is being described.
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Affiliation(s)
- Loucas Christodoulou
- />Pediatric Neurology Department, Chelsea and Westminister Hospital, 369 Fulham Road, London, SW109NH UK
| | - Efterpi Pavlidou
- />Pediatric Neurology Department, Chelsea and Westminister Hospital, 369 Fulham Road, London, SW109NH UK
| | - Cristina Spyridou
- />Pediatric Neurology Department, Chelsea and Westminister Hospital, 369 Fulham Road, London, SW109NH UK
| | - Simon Eccles
- />Department of Craniofacial Surgery, Chelsea and Westminister Hospital, London, UK
| | - Alistair Calder
- />Department of Radiology, Great Ormond Street Hospital, London, UK
| | - Kshitij Mankad
- />Pediatric Neurology Department, Chelsea and Westminister Hospital, 369 Fulham Road, London, SW109NH UK , />Department of Radiology, Chelsea and Westminister Hospital, London, UK
| | - Maria Kinali
- Pediatric Neurology Department, Chelsea and Westminister Hospital, 369 Fulham Road, London, SW109NH, UK.
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24
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Merrick B, Calder A, Wakeling E. Dysspondyloenchondromatosis (DSC) associated with COL2A1 mutation: Clinical and radiological overlap with spondyloepimetaphyseal dysplasia-Strudwick type (SEMD-S). Am J Med Genet A 2015; 167A:3103-7. [PMID: 26250472 DOI: 10.1002/ajmg.a.37282] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 07/16/2015] [Indexed: 11/11/2022]
Abstract
Dysspondyloenchondromatosis (DSC) is a rare skeletal dysplasia characterized by enchondroma-like lesions and anisospondyly. The former leads to discrepancies in limb length, and the latter, to progressive kyphoscoliosis. Two recent cases have highlighted the genetic heterogeneity of DSC, one demonstrating the presence and, the other, the absence of a COL2A1 mutation. This may have important clinical implications, for example, screening for complications including atlanto-axial instability associated with type II collagenopathies, as well as long-term patient management. We report on a case with radiographic features of DSC with overlap into the type II collagenopathy spondyloepimetaphyseal dysplasia, Strudwick type, who was found to carry a novel heterozygous mutation in the COL2A1 gene. Testing for COL2A1 mutations should be performed in all patients with radiological features of DSC. Further research is needed to identify the underlying molecular cause in cases where no COL2A1 mutation is identified.
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Affiliation(s)
- Blair Merrick
- North West Thames Regional Genetics Service, London North West Healthcare NHS Trust, Harrow, UK
| | - Alistair Calder
- Department of Radiology, Great Ormond Street Hospital, London, UK
| | - Emma Wakeling
- North West Thames Regional Genetics Service, London North West Healthcare NHS Trust, Harrow, UK
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25
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Howes RJ, Calder A, Hollingsworth A, Jones A. The end for the ‘Roman Sandal’: an observational study of methods of securing chest drains in a deployed military setting. ACTA ACUST UNITED AC 2015. [DOI: 10.1136/jrnms-101-42] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AbstractIntroductionThere is ongoing debate regarding the optimal method of securing chest drains in trauma patients. Various courses describe methods for chest drain insertion, but little has been published to identify the best method to secure the drain.AimThis article aims to examine differences in approach to securing chest drains and the security of the methods used.MethodWhilst in a deployed medical treatment facility, 26 clinicians from various specialties and nationalities were asked to secure a pre-placed drain. A 32F drain was placed in a manikin and the clinicians were given a chance to prepare their equipment. They were given a choice of suture and their attempts were observed by one of the researchers. The attempts were timed and photographed. A second researcher, who had not observed the technique, then assessed the security of the drain.Results15/26 clinicians used a ‘Roman Sandal’ technique with 5/26 proving to be insecure. Other techniques used showed no failure. The rate of consultant‐secured failure was 12.5% compared to 40% for registrars and 33% for General Duties Medical Officers.ConclusionsThe type of suture used made no difference, but the traditional ‘Roman Sandal’ method was insecure. Knots tied close to the skin and those that bit into the drain were shown to be most effective.
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26
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Abstract
Priapism is a rare condition in children and can be classified as high or low flow. We present a case of traumatic high-flow priapism that was successfully managed by selective embolisation of a branch of the internal pudendal artery. The pertinent clinical features are antecedent trauma and prolonged painless partial erection. The investigation of choice is Doppler ultrasound. Management can either be conservative, radiological or surgical. While conservative management can be safely attempted for 6 weeks, given the nature of the condition, early intervention is often required. Radiological embolisation is the first line and is successful in 97% of cases. Surgery carries a higher morbidity and is only reserved in cases where repeated embolisation has failed. This case highlights the importance of a thorough history and careful interpretation of imaging with protocolised follow-up of patients by a paediatric urologist for early and accurate diagnosis of erectile dysfunction and prompt intervention to prevent future complications.
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Affiliation(s)
- Jessica Burns
- Department of Urology, Great Ormond Street Hospital, London, UK
| | - Simon Rajendran
- Department of Urology, Great Ormond Street Hospital, London, UK
| | - Alistair Calder
- Department of Radiology, Great Ormond Street Hospital, London, UK
| | - Derek Roebuck
- Department of Interventional Radiology, Great Ormond Street Hospital, London, UK
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27
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Howes RJ, Calder A, Hollingsworth A, Jones A. The end for the 'Roman Sandal': an observational study of methods of securing chest drains in a deployed military setting. J R Nav Med Serv 2015; 101:42-46. [PMID: 26292392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION There is ongoing debate regarding the optimal method of securing chest drains in trauma patients. Various courses describe methods for chest drain insertion, but little has been published to identify the best method to secure the drain. AIM This article aims to examine differences in approach to securing chest drains and the security of the methods used. METHOD Whilst in a deployed medical treatment facility, 26 clinicians from various specialties and nationalities were asked to secure a pre-placed drain. A 32F drain was placed in a manikin and the clinicians were given a chance to prepare their equipment. They were given a choice of suture and their attempts were observed by one of the researchers. The attempts were timed and photographed. A second researcher, who had not observed the technique, then assessed the security of the drain. RESULTS 15/26 clinicians used a 'Roman Sandal' technique with 5/26 proving to be insecure. Other techniques used showed no failure. The rate of consultant-secured failure was 12.5% compared to 40% for registrars and 33% for General Duties Medical Officers. CONCLUSIONS The type of suture used made no difference, but the traditional 'Roman Sandal' method was insecure. Knots tied close to the skin and those that bit into the drain were shown to be most effective.
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Burton N, Jeffery L, Calder A, Rhodes G. Adaptation to an average expression improves discrimination of facial expressions. J Vis 2014. [DOI: 10.1167/14.10.815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Howes RJ, Wood AM, Calder A, Cowan H, Burrows H. The management of the acutely swollen ankle. J R Nav Med Serv 2014; 100:288-292. [PMID: 25895409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Patients presenting with an acutely swollen ankle are common in both the military and civilian settings. Accurate diagnosis is vital, as there are various potentially serious causes. This article aims to review the common causes of an acutely swollen ankle, as well as the rarer causes, with their significant consequences.
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Sousa SB, Jenkins D, Chanudet E, Tasseva G, Ishida M, Anderson G, Docker J, Ryten M, Sa J, Saraiva JM, Barnicoat A, Scott R, Calder A, Wattanasirichaigoon D, Chrzanowska K, Simandlová M, Van Maldergem L, Stanier P, Beales PL, Vance JE, Moore GE. Gain-of-function mutations in the phosphatidylserine synthase 1 (PTDSS1) gene cause Lenz-Majewski syndrome. Nat Genet 2014; 46:70-6. [PMID: 24241535 DOI: 10.1038/ng.2829] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 10/23/2013] [Indexed: 12/21/2022]
Abstract
Lenz-Majewski syndrome (LMS) is a syndrome of intellectual disability and multiple congenital anomalies that features generalized craniotubular hyperostosis. By using whole-exome sequencing and selecting variants consistent with the predicted dominant de novo etiology of LMS, we identified causative heterozygous missense mutations in PTDSS1, which encodes phosphatidylserine synthase 1 (PSS1). PSS1 is one of two enzymes involved in the production of phosphatidylserine. Phosphatidylserine synthesis was increased in intact fibroblasts from affected individuals, and end-product inhibition of PSS1 by phosphatidylserine was markedly reduced. Therefore, these mutations cause a gain-of-function effect associated with regulatory dysfunction of PSS1. We have identified LMS as the first human disease, to our knowledge, caused by disrupted phosphatidylserine metabolism. Our results point to an unexplored link between phosphatidylserine synthesis and bone metabolism.
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Affiliation(s)
- Sérgio B Sousa
- 1] Clinical and Molecular Genetics Unit, University College London (UCL) Institute of Child Health, London, UK. [2] Serviço de Genética Médica, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Dagan Jenkins
- 1] Molecular Medicine Unit, UCL Institute of Child Health, London, UK. [2]
| | - Estelle Chanudet
- 1] Centre for Translational Genomics-GOSgene, UCL Institute of Child Health, London, UK. [2]
| | - Guergana Tasseva
- 1] Group on the Molecular and Cell Biology of Lipids, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. [2]
| | - Miho Ishida
- Clinical and Molecular Genetics Unit, University College London (UCL) Institute of Child Health, London, UK
| | - Glenn Anderson
- Histopathology Department, Great Ormond Street Hospital for Children, London, UK
| | - James Docker
- Neural Development Unit, UCL Institute of Child Health, London, UK
| | - Mina Ryten
- 1] Reta Lila Weston Institute, UCL Institute of Neurology, London, UK. [2] Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Joaquim Sa
- Serviço de Genética Médica, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Jorge M Saraiva
- 1] Serviço de Genética Médica, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. [2] University Clinic of Pediatrics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Angela Barnicoat
- Clinical Genetics Department, Great Ormond Street Hospital, London, UK
| | - Richard Scott
- Clinical Genetics Department, Great Ormond Street Hospital, London, UK
| | - Alistair Calder
- Radiology Department, Great Ormond Street Hospital, London, UK
| | | | - Krystyna Chrzanowska
- Department of Medical Genetics, Children's Memorial Health Institute, Warsaw, Poland
| | - Martina Simandlová
- Department of Biology and Medical Genetics, University Hospital Motol and Second Faculty of Medicine, Prague, Czech Republic
| | - Lionel Van Maldergem
- 1] Centre de Génétique Humaine, Université de Franche-Comté, Besançon, France. [2] Cutis Laxa Study Group, University of Franche-Comté, Besancon, France
| | - Philip Stanier
- Neural Development Unit, UCL Institute of Child Health, London, UK
| | - Philip L Beales
- 1] Molecular Medicine Unit, UCL Institute of Child Health, London, UK. [2] Centre for Translational Genomics-GOSgene, UCL Institute of Child Health, London, UK
| | - Jean E Vance
- Group on the Molecular and Cell Biology of Lipids, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Gudrun E Moore
- Clinical and Molecular Genetics Unit, University College London (UCL) Institute of Child Health, London, UK
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Affiliation(s)
- Richard H Scott
- North East Thames Regional Genetics Service, Great Ormond Street Hospital Clinical and Molecular Genetics Unit, Institute of Child Health Department of Radiology, Great Ormond Street Hospital, London, UK
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Parry DA, Logan CV, Stegmann APA, Abdelhamed ZA, Calder A, Khan S, Bonthron DT, Clowes V, Sheridan E, Ghali N, Chudley AE, Dobbie A, Stumpel CTRM, Johnson CA. SAMS, a syndrome of short stature, auditory-canal atresia, mandibular hypoplasia, and skeletal abnormalities is a unique neurocristopathy caused by mutations in Goosecoid. Am J Hum Genet 2013; 93:1135-42. [PMID: 24290375 DOI: 10.1016/j.ajhg.2013.10.027] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 10/21/2013] [Accepted: 10/30/2013] [Indexed: 11/17/2022] Open
Abstract
Short stature, auditory canal atresia, mandibular hypoplasia, and skeletal abnormalities (SAMS) has been reported previously to be a rare, autosomal-recessive developmental disorder with other, unique rhizomelic skeletal anomalies. These include bilateral humeral hypoplasia, humeroscapular synostosis, pelvic abnormalities, and proximal defects of the femora. To identify the genetic basis of SAMS, we used molecular karyotyping and whole-exome sequencing (WES) to study small, unrelated families. Filtering of variants from the WES data included segregation analysis followed by comparison of in-house exomes. We identified a homozygous 306 kb microdeletion and homozygous predicted null mutations of GSC, encoding Goosecoid homeobox protein, a paired-like homeodomain transcription factor. This confirms that SAMS is a human malformation syndrome resulting from GSC mutations. Previously, Goosecoid has been shown to be a determinant at the Xenopus gastrula organizer region and a segment-polarity determinant in Drosophila. In the present report, we present data on Goosecoid protein localization in staged mouse embryos. These data and the SAMS clinical phenotype both suggest that Goosecoid is a downstream effector of the regulatory networks that define neural-crest cell-fate specification and subsequent mesoderm cell lineages in mammals, particularly during shoulder and hip formation. Our findings confirm that Goosecoid has an essential role in human craniofacial and joint development and suggest that Goosecoid is an essential regulator of mesodermal patterning in mammals and that it has specific functions in neural crest cell derivatives.
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Affiliation(s)
- David A Parry
- Leeds Institute of Molecular Medicine, University of Leeds, Leeds LS9 7TF, UK
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Thia LP, Calder A, Stocks J, Bush A, Owens CM, Wallis C, Young C, Sullivan Y, Wade A, McEwan A, Brody AS. Is chest CT useful in newborn screened infants with cystic fibrosis at 1 year of age? Thorax 2013; 69:320-7. [PMID: 24132911 PMCID: PMC3963531 DOI: 10.1136/thoraxjnl-2013-204176] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Rationale Sensitive outcome measures applicable in different centres to quantify and track early pulmonary abnormalities in infants with cystic fibrosis (CF) are needed both for clinical care and interventional trials. Chest CT has been advocated as such a measure yet there is no validated scoring system in infants. Objectives The objectives of this study were to standardise CT data collection across multiple sites; ascertain the incidence of bronchial dilatation and air trapping in newborn screened (NBS) infants with CF at 1 year; and assess the reproducibility of Brody-II, the most widely used scoring system in children with CF, during infancy. Methods A multicentre observational study of early pulmonary lung disease in NBS infants with CF at age 1 year using volume-controlled chest CT performed under general anaesthetic. Main results 65 infants with NBS-diagnosed CF had chest CT in three centres. Small insignificant variations in lung recruitment manoeuvres but significant centre differences in radiation exposures were found. Despite experienced scorers and prior training, with the exception of air trapping, inter- and intraobserver agreement on Brody-II score was poor to fair (eg, interobserver total score mean (95% CI) κ coefficient: 0.34 (0.20 to 0.49)). Only 7 (11%) infants had a total CT score ≥12 (ie, ≥5% maximum possible) by either scorer. Conclusions In NBS infants with CF, CT changes were very mild at 1 year, and assessment of air trapping was the only reproducible outcome. CT is thus of questionable value in infants of this age, unless an improved scoring system for use in mild CF disease can be developed.
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Affiliation(s)
- Lena P Thia
- Portex Unit: Respiratory Physiology and Medicine, UCL Institute of Child Health, , London, UK
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Mareschal I, Calder A, Clifford C. A prior for direct gaze. J Vis 2013. [DOI: 10.1167/13.9.402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Calder A, Seach N, Fletcher A, Hammett M, Boyd R, Chidgey A. Androgen reduction and mesenchymal stem cell therapies improve kinetics of thymic epithelial cell recovery following chemotherapy. Placenta 2011. [DOI: 10.1016/j.placenta.2011.07.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Ewbank M, Henson R, Rowe J, Calder A. Different neural mechanisms underlie repetition suppression to facial identity for same-size and different-size faces in the occipitotemporal lobe. J Vis 2011. [DOI: 10.1167/11.11.640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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37
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Chong K, Barnacle A, Biassoni L, Calder A, Chippington S, Easty M, Gunny R, Hiorns M, McHugh K, Persaud T, Roebuck D, Saunders D. Radiology service at Great Ormond Street Hospital. Lancet 2011; 378:224. [PMID: 21737132 DOI: 10.1016/s0140-6736(11)61065-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Owens CM, Aurora P, Stanojevic S, Bush A, Wade A, Oliver C, Calder A, Price J, Carr SB, Shankar A, Stocks J. Lung Clearance Index and HRCT are complementary markers of lung abnormalities in young children with CF. Thorax 2011; 66:481-8. [PMID: 21422040 DOI: 10.1136/thx.2010.150375] [Citation(s) in RCA: 146] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
RATIONALE High resolution computed tomography (HRCT) is a more sensitive tool for detecting early cystic fibrosis (CF) lung disease than either spirometry or plain radiography, but its relationship to other measures of lung function has not been established in young children. OBJECTIVES (1) To assess whether the lung clearance index (LCI) derived from multiple breath inert-gas washout (MBW) is as effective as HRCT in identifying pulmonary abnormalities; and (2) explore the relationships between abnormalities detected by HRCT and by spirometry, plethysmography and MBW (collectively, LFTs) in young children with CF. METHODS Children with CF underwent LFTs and volumetric HRCT on the same day. Healthy age-matched controls underwent identical LFTs without HRCT. Scans were anonymised, and scored using the Brody-II CT scoring system, to assess for presence and extent of bronchiectasis, airway wall thickening, mucus plugging, and parenchymal opacities. RESULTS Assessments were undertaken in 60 children with CF (mean (SD) 7.8 (1.3 years) and 54 healthy controls (7.9 (1.2) y). Among children with CF, 84% (47/56) had abnormal LCI, 58% (27/47) abnormal plethysmographic lung volumes (FRC(pleth) or RV), 35% (21/60) abnormal sRaw and 47% (28/60) abnormal spirometry (FEV1 or FEF(25-75)); whereas HRCT scans were abnormal in 85% (51/60): median total Brody-II score: 9.5% (range 0-51%). Total CT score correlated more strongly with LCI (Spearman correlation = 0.77) than with spirometry (R = -0.43) or any other marker of lung function. Of the nine children with normal LCI, five had abnormalities on HRCT, whereas five children with normal HRCT had raised LCI. CONCLUSIONS These results suggest that while LCI and HRCT have similar sensitivity to detect CF lung disease, complimentary information may be gained in individual patients.
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Affiliation(s)
- C M Owens
- Department of Paediatric Radiology, Great Ormond Street Hospital for Children NHS Trust, London, UK
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McKeown A, Strachan L, Keeley P, Booth MG, Calder A, Panicker A. Unsuitable for ICU: what happens next? Crit Care 2010. [PMCID: PMC2934394 DOI: 10.1186/cc8647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Leung RS, Calder A, Roebuck D. Embryonal rhabdomyosarcoma of the omentum: two cases occurring in children. Pediatr Radiol 2009; 39:865-8. [PMID: 19387628 DOI: 10.1007/s00247-009-1275-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2009] [Revised: 03/25/2009] [Accepted: 03/29/2009] [Indexed: 10/20/2022]
Abstract
Rhabdomyosarcoma is a soft-tissue malignancy that represents approximately 4-8% of all solid tumours in children and commonly arises from the head and neck and genitourinary system. Intraperitoneal rhabdomyosarcoma, in particular with omental involvement, has been rarely reported in the literature. Furthermore, reports of omental rhabdomyosarcoma of embryonal origin do not exist, to our knowledge. We report two cases of omental embryonal rhabdomyosarcoma affecting children and illustrate the imaging characteristics of this rare tumour.
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Affiliation(s)
- Rebecca S Leung
- Radiology Department, Great Ormond Street Hospital for Children, London, UK.
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Haidopoulou K, Calder A, Jones A, Jaffe A, Sonnappa S. Bronchiectasis secondary to primary immunodeficiency in children: longitudinal changes in structure and function. Pediatr Pulmonol 2009; 44:669-75. [PMID: 19514055 DOI: 10.1002/ppul.21036] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Primary immunodeficiency is a common cause of bronchiectasis in children. The term bronchiectasis suggests an irreversible process; however, disease progression following treatment is controversial. The aim of this study was to evaluate the progression of bronchiectasis in children with primary immunodeficiency after institution of treatment. METHODS A retrospective review of case notes of children with primary immunodeficiency was undertaken to identify patients with confirmed bronchiectasis. Children who had two high-resolution computed tomography scans of the chest (HRCT chest) with an interval of at least 2 years were identified. The HRCT-chest scans at diagnosis and follow up were scored using a Bhalla score. Spirometry results (FEV1, FVC, and FEV1:FVC ratios) were related to HRCT-chest scores, where available. Statistical analysis was by Wilcoxon signed rank test and Spearman's rank order correlation. RESULTS Eighteen subjects were studied. The diagnosis of primary immunodeficiency was established at median (range) age 3.4 (1-13) years, and bronchiectasis at 9.3 (3.1-13.8) years. There was no significant difference between baseline and follow-up median (range) HRCT-chest scores (6 [1-13] and 7.5 [0-15], P = 0.21) respectively. The follow-up FEV1 and FVC percent predicted median (range) were significantly higher than baseline (86% [49-124%] vs. 75% [36-93%], P < 0.005, and 86% [47-112%] vs. 78% [31-96%], P < 0.05), respectively; there was no significant difference between baseline and follow-up FEV(1):FVC ratios. There was no significant correlation between HRCT-chest score changes and FEV1 or FVC changes. CONCLUSIONS Bronchiectasis secondary to primary immunodeficiency in childhood is not always a progressive condition, suggesting a potential to slow or prevent disease progression with appropriate treatment.
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Affiliation(s)
- Katerina Haidopoulou
- Fourth Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Calder A, Owens CM. Imaging of parapneumonic pleural effusions and empyema in children. Pediatr Radiol 2009; 39:527-37. [PMID: 19198826 DOI: 10.1007/s00247-008-1133-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2008] [Revised: 12/10/2008] [Accepted: 12/11/2008] [Indexed: 12/01/2022]
Abstract
Pleural empyema in children is increasing in incidence. The British Thoracic Society published guidelines for the management of empyema in children in 2005, including recommendations regarding imaging. In this article we review the pathophysiology, treatment options and imaging findings of complicated parapneumonic effusion and empyema in children. We also review the published evidence that supports the roles imaging is called upon to play in the management of these conditions. Imaging in the form of chest radiography and US is recommended to identify and guide drainage of complicated parapneumonic effusions. CT is recommended in special circumstances only. Imaging techniques have not been shown to accurately stage empyema, predict outcome or guide decisions regarding surgical versus medical management.
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Affiliation(s)
- Alistair Calder
- Radiology Department, Great Ormond Street Hospital for Children, London, UK.
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Calder A. Building the address register for the 2011 Census. Popul Trends 2009; 138:22-26. [PMID: 20120248 DOI: 10.1057/pt.2009.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A high quality, comprehensive list of addresses is fundamental to planning for the 2011 Census. The address list will provide the key to accurate delivery, collection and follow-up of questionnaires, as well as playing a central role in fieldwork and estimation. This article provides a short summary of current thinking on developing the register, which will involve the address data suppliers, all local authorities, and many other stakeholders.
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Leães R, Cambraia R, Bacim F, Dalmarco G, Calder A, De Azevedo DFG, Pinho M, Russomano T. Development of walking pattern evaluation system for hypogravity simulation. Conf Proc IEEE Eng Med Biol Soc 2007; 2006:6285-8. [PMID: 17947187 DOI: 10.1109/iembs.2006.260726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study aimed to develop a Walking Pattern Evaluation System during Hypogravity Simulation (SAMSH), which included the adaptation of a body suspension device, the instrumentation of a treadmill and the development of a virtual environment. SAMSH was developed using one subject. Kinematic analyses were performed whilst one individual was walking on the treadmill during body weight reduction simulating the gravitational forces of the Moon (reduction of 60%) and Mars (reduction of 30%) with and without virtual reality glasses (Head Mounted Display, HMD). The walking pattern was evaluated by means of knee and ankle electrogoniometers, foot switches placed on the front and back part of the plantar region, and five video cameras. Results showed that the body weight reduction during Moon simulation alter the walking pattern, including the increase in step time, contact time, step length and aerial time, and the decrease of walking cadence time (steps per minute). The findings of this study also suggested that hypogravity simulation reduces walking effort. The utilization of the HMD allowed the evaluation of the head position three-dimensionally during hypogravity simulation. The virtual environment reduced postural balance, due to the absence of visual input, which was evidenced by a protective extension reaction.
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Affiliation(s)
- R Leães
- Microgravity Lab., Pontifical Catholic Univ., Porto Alegre, RS, Brazil
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Calder A, Dursi J, Fryxell B, Plewa T, Weirs G, Dupont T, Robey H, Kane J, Drake P, Remington B, Dimonte G, Hayes J, Stone J, Ricker P, Timmes F, Zingale M, Olson K. Validating astrophysical simulation codes. Comput Sci Eng 2004. [DOI: 10.1109/mcse.2004.44] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Calder A, Forrester AR, James PG, Luckhurst GR. Nitroxide radicals. V. N,N'-Di-tert-butyl-m-phenylenebinitroxide, a stable triplet. J Am Chem Soc 2002. [DOI: 10.1021/ja01042a006] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kane JO, Robey HF, Remington BA, Drake RP, Knauer J, Ryutov DD, Louis H, Teyssier R, Hurricane O, Arnett D, Rosner R, Calder A. Interface imprinting by a rippled shock using an intense laser. Phys Rev E Stat Nonlin Soft Matter Phys 2001; 63:055401. [PMID: 11414953 DOI: 10.1103/physreve.63.055401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2000] [Indexed: 05/23/2023]
Abstract
Perturbation imprinting at a flat interface by a rippled shock has been observed in a laser hydrodynamics experiment. A strong shock was driven through a three-layer target, with the first interface rippled, and the second flat. The chosen thickness of the second layer gave instability growth with opposite phases at the two interfaces, consistent with two-dimensional simulations and rippled shock theory.
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Affiliation(s)
- J O Kane
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
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Penney G, Calder A. The Scottish Programme for Clinical Effectiveness in Reproductive Health (SPCERH): lessons from a three-year programme. Health Bull (Edinb) 2000; 58:261-6. [PMID: 12813805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
OBJECTIVE To describe the work of the Scottish Programme for Clinical Effectiveness in Reproductive Health (SPCERH) in order to draw lessons applicable to other clinical effectiveness programmes. DESIGN Overview of an integrated clinical effectiveness programme relating to reproductive health. SETTING Scotland. SUBJECTS The programme is designed to reach all professionals who share responsibility for reproductive healthcare--including obstetrician/gynaecologists, midwives, general practitioners, family planning doctors, commissioners of services and NHS managers. RESULTS During its first three-year Workplan, SPCERH has conducted an integrated programme of audit, guideline and educational activities. Findings have been disseminated using multi-faceted approaches including publications, presentations and interactive meetings. Evidence from surveys undertaken within the Programme indicates that clinicians have changed or reconsidered their practice in several key areas in response to audit and guideline recommendations made by the Programme. CONCLUSIONS As a way of funding and organising clinical effectiveness activities, the integrated Programme has many advantages over the stand-alone Project. These advantages include: enabling the linkage of national audits to national guidelines and other forms of NHS guidance; enabling the re-audit of topics after a time interval sufficient to allow for the implementation of change; the building of expertise within a dedicated team and the use of that expertise across a range of linked projects; the availability of an experienced team which can respond to new priority issues at short notice.
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Affiliation(s)
- G Penney
- Dugald Baird Centre, Aberdeen Maternity Hospital, Cornhill Road, Aberdeen
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