Concurrent COVID-19 infection in children with acute appendicitis: A report of three cases.

Literature describing patients with concomitant COVID-19 infection with acute appendicitis in pediatric patients is growing, and understanding the clinical picture of such patients is relevant in their treatment. We report 3 male children who were surgically treated for acute appendicitis and had concomitant SARS-CoV-2 infection. Our first patient was a 12-year-old male who presented with symptoms indicative of appendicitis but no respiratory symptoms associated with COVID-19 (eg cough, shortness of breath). Laboratory evaluation revealed leukopenia and an elevated C-reactive protein; imaging was consistent with acute appendicitis and an acute pulmonary viral infection. Though he lacked diffuse peritonitis on physical examination or a leukocytosis, he was found to have perforated appendicitis in the operating room. Our second patient was another 12-year-old male whose suspected appendicitis was confirmed via ultrasound and surgery. He tested positive for COVID-19 1 month prior and he continued to test positive for infection on admission without any associated respiratory symptoms. Our third patient was a 13-year-old patient who also presented with symptomatic acute appendicitis without apparent COVID-19 manifestations. These cases provide further examples of pediatric patients with concomitant acute appendicitis and COVID-19 infection, namely an unusual presentation of perforated appendicitis with asymptomatic COVID-19-related pulmonary infection and the more common acute appendicitis with asymptomatic COVID-19 infection.

Quantitatively and qualitatively augmenting medical student knowledge of oncology and radiation oncology: an update on the impact of the oncology education initiative.

PURPOSE: The Oncology Education Initiative was established in 2007 in an effort to advance oncology and radiation oncology education at the undergraduate level. As a continuation of the initiative, the aim of this study was to determine whether these structured didactics would continue to increase overall medical student knowledge about oncologic topics. METHODS: Preclerkship and postclerkship tests examining concepts in general oncology, radiation oncology, breast cancer, and prostate cancer were administered. The 21-question, multiple-choice examination was administered at the beginning and end of the radiology clerkship, during which a 1.5-hour didactic session was given by an attending radiation oncologist. Changes in individual question responses, student responses, and overall categorical responses were analyzed. All hypothesis tests were two tailed with a significance level of .05. RESULTS: In the 2009-2010 academic year, 155 third-year and fourth-year students had average examination score improvements from 62% to 68.9% (P < .0001). Every topic (100%) showed improvement in scores, with the largest absolute improvement seen in the radiation oncology category, which increased from 56.5% to 71.8% (P < .0001). As the year proceeded, average examination scores increased among third-year students and decreased among fourth-year students. CONCLUSIONS: In the successive years since its inception, the Oncology Education Initiative continues to show a significant improvement in medical students' knowledge of cancer. The initiative has also succeeded in providing radiation oncology education to all graduating medical students at the authors' institution. Dedicated oncology education in the undergraduate medical curriculum provides students with a better understanding of multidisciplinary oncology management.

Teaching evidence-based imaging in the radiology clerkship using the ACR appropriateness criteria.

RATIONALE AND OBJECTIVES: Given escalating health care costs and limited resources, the effective utilization of imaging is essential to permit optimal patient care. Because only 21.4% of medical schools require radiology clerkships, most students do not understand the indications for and clinical effectiveness of most imaging tests. Therefore, the authors introduced two focused sessions on evidence-based imaging during the required radiology core clerkship at their institution. METHODS: From June 2008 to September 2009, 259 students in the radiology core clerkship participated in a didactic session on principles of evidence-based imaging and/or a small-group session and self-directed learning exercise using the American College of Radiology (ACR) Appropriateness Criteria. Students evaluated the exercise on a five-point scale for its effectiveness in teaching imaging strategies and its impact on their future careers. RESULTS: Two hundred twenty-eight of 259 students (88%; 93 third year, 135 fourth year) participated in the two sessions. Two hundred thirteen of 223 (96%) were not aware of the ACR's Web site as a resource prior to this exercise. Two hundred fourteen of 228 (94%) found the ACR Appropriateness Criteria a useful resource. Two hundred two of 228 (89%) stated that they would likely use this resource in other clinical rotations and future practice. Two hundred three of 228 (89%) reported having a solid understanding of the indications for imaging tests following the sessions. Students praised the ACR's Web site for its comprehensive coverage of different modalities and their relative radiation risks. They valued working collaboratively on common clinical scenarios. CONCLUSION: The ACR Appropriateness Criteria are a valuable resource for teaching evidence-based imaging to medical students. A majority of students indicated that they plan to use this resource in the future.

MR imaging of congenital/developmental and acquired disorders of the pediatric hip and pelvis.

This article reviews the MR imaging findings of some of the more common congenital and acquired disorders of the pediatric hip and pelvis,with the intent of increasing the awareness of radiologists and facilitating early and accurate diagnosis and treatment. The importance of MR imaging in the pediatric population is underscored by its ability to evaluate these disorders well and without the use of ionizing radiation.