ABSTRACT
BACKGROUND: An audit of paediatric pelvic radiographs identified deficiencies in gonad shield placement and radiographic technique. OBJECTIVE: A technique using grid-controlled fluoroscopy (GCF), with hard copy images in frame grab and digital spot image (DSI) format was evaluated to optimise gonad shield placement and reduce the dose given to children with Perthes disease and Developmental Hip Dysplasia (DDH) attending for pelvic radiography. MATERIALS AND METHODS: Phantom and patient dose surveys of conventional and fluoroscopic techniques were carried out. Image quality and radiation dose were compared for the frame grab and DSI techniques. Retrospective evaluation was undertaken to compare their clinical acceptability. RESULTS: Both fluoroscopic techniques gave considerably less radiation than conventional non-grid radiography (67-83%, P < 0.05). The frame grab technique gave less radiation than DSI (P < 0.05). There was no significant difference in the clinical acceptability scores of the DSI and frame grab images. CONCLUSION: Fluoroscopy acquired images are now used since the fluoroscopic techniques give much less dose than conventional radiography and provide images of sufficient quality for clinical assessment. Indeed, as there was no significant difference in clinical usefulness between the frame grab and DSI techniques, it is planned to use frame grab alone, thus gaining additional dose saving.
Subject(s)
Fluoroscopy/methods , Hip Dislocation, Congenital/diagnostic imaging , Legg-Calve-Perthes Disease/diagnostic imaging , Pelvis/diagnostic imaging , Adolescent , Child , Child, Preschool , Follow-Up Studies , Humans , Male , Phantoms, Imaging , Radiation Dosage , Radiographic Image Enhancement , Statistics, NonparametricABSTRACT
From an analysis of a database of children who have been prescribed injectable adrenaline we describe our experience of the management of children with severe anaphylactic reactions to food products for the period from March 1994 to August 1999. Notifications to our department increased from 7 in the 1981-83 birth cohort to 48 in the 1990-92 birth cohort. One hundred and forty-four children living in our health district have been prescribed injectable adrenaline for emergency use. A standard protocol agreed with the Local Education Authority to support these pupils in school and to work to provide a safe environment has been in place since April 1995. Almost half the schools in the area covered by our health district have at least one affected child. Community child health staff have played a pivotal role in providing liaison between health and education professionals.
Subject(s)
Anaphylaxis/epidemiology , Community Health Services/organization & administration , Adolescent , Anaphylaxis/drug therapy , Child , Child, Preschool , Databases, Factual , Epinephrine/therapeutic use , Female , Humans , Infant , Infant, Newborn , Male , Medical Records , Registries , Sympathomimetics/therapeutic use , United Kingdom/epidemiologyABSTRACT
BACKGROUND: The UK government has specified that all health authorities are to develop local health improvement programmes. Birthweight and gestational age are important health determinants, and therefore indicators of the health status of children in a community. They also have important resource implications for health and social services. Data regarding birthweight and its relationship to gestational age are not routinely available. This paper describes the results of the measurement of the birthweights and gestational ages of children born to residents in a UK health district, and their relationship with deprivation. METHODS: Routinely collected birthweight and gestational age data for children born to parents resident in the South Tees district during the period 1990-1996 inclusive were downloaded from the community child health department mainframe computer. The data were analysed and compared with national standards. RESULTS: The analysis showed that, despite the high levels of deprivation, birthweights were close to or slightly above average for most gestational ages. However, when compared with the average district in England and Wales, 8 per cent more low-birthweight children, of which 42 per cent were less than 28 weeks gestation, were born in the area. Materially deprived mothers were more likely to give birth to pre-term and light for gestational age infants. CONCLUSIONS: This study has shown that it is now possible to use routine sources of information to monitor local trends in birthweight and gestation, and their relationship with deprivation.
