Subject(s)
Consensus , Disease Management , Hearing Loss/therapy , Australia , Child, Preschool , Congresses as Topic , Electrocardiography , Guidelines as Topic , Health Personnel , Hearing Loss/diagnosis , Hearing Loss/etiology , Hearing Loss/genetics , Humans , Magnetic Resonance Imaging , Ophthalmology , Thyroid Gland/physiologyABSTRACT
We present two cases of tuberculous meningitis in Australian-born children. We review the current literature surrounding management of paediatric tuberculosis and disseminated disease, emphasising the importance of prompt diagnosis and intervention. We discuss the epidemiology of tuberculosis in the Australian paediatric population and highlight the sentinel role of childhood infection in public health surveillance.
Subject(s)
Mycobacterium tuberculosis , Tuberculosis, Meningeal/diagnosis , Tuberculosis, Miliary/diagnosis , Australia/epidemiology , Humans , Infant , Male , Tuberculosis, Meningeal/epidemiology , Tuberculosis, Miliary/epidemiologyABSTRACT
Electrophysiological screening of the hearing of newborn infants has demonstrated that hearing impaired infants can be successfully detected soon after birth.(1) There is much evidence to support the belief that the early fitting of hearing aids when needed (at less than 6 months of age) and guided early language stimulation can result in good outcomes in the language of deaf children.(2,3) The paediatrician and family doctor play key roles in ensuring these outcomes.
Subject(s)
Hearing Loss/rehabilitation , Neonatal Screening/methods , Pediatrics , Physician's Role , Hearing Loss/classification , Hearing Loss/diagnosis , Humans , Infant, Newborn , Language Development , New South WalesSubject(s)
Deafness/diagnosis , Neonatal Screening , Deafness/congenital , False Negative Reactions , Humans , Infant , Infant, NewbornABSTRACT
UNLABELLED: 99mTc-Labeled white cell scintigraphy (WCS) has been used for the investigation of inflammatory bowel disease (IBD) in adults, but data on children are limited. The most common agent used is (99m) Tc-hexamethylpropyleneamine oxime (HMPAO); however, this agent has limitations. In a retrospective study, we assessed the use of (99m)Tc-stannous colloid WCS for the initial evaluation of children with suspected IBD. METHODS: Diagnostic, endoscopic, and contrast radiography results were retrospectively collected from the medical records. Two experienced nuclear physicians unaware of the patient data interpreted the WCS results, with agreement reached by consensus. Statistical analysis was performed on the ability of WCS to detect active disease and localize it topographically and on a comparison of diagnostic methods, using a combination of clinical features and endoscopy as the reference standard. RESULTS: Between 1996 and 1999, 64 patients (35 male and 29 female; mean age, 12.5 y; age range, 2-19 y) had WCS performed, with IBD subsequently diagnosed in 34 patients. (99m)Tc-Stannous colloid WCS had an 88% sensitivity, 90% specificity, and 8.8 likelihood ratio for initial investigation of IBD. Agreement was poor for topographic localization of disease. Small-bowel series had a 75% sensitivity, 50% specificity, and 1.5 likelihood ratio for detecting endoscopic disease of the terminal ileum and proximal colon. CONCLUSION: Our results confirm that WCS is a useful imaging technique for the initial evaluation of patients with suspected IBD. (99m)Tc-Stannous colloid had results at least comparable to those of other WCS agents, and in children, (99m)Tc-stannous colloid WCS should be preferred in view of lower cost, shorter preparation time, and the smaller blood volumes required.
