CT appearances of congential and acquired abnormalities of the superior vena cava.

A wide spectrum of congenital and acquired abnormalities can affect the superior vena cava (SVC). Congenital anomalies can present either as incidental findings or be associated with underlying cardiac abnormalities; these include left-sided or double SVCs and anomalous venous drainages. Acquired conditions involving the SVC, including SVC obstruction syndrome, can be secondary to extrinsic compression or intrinsic occlusion. The CT appearances, the incidence, and associations of these conditions are discussed.

Should GPs have direct access to imaging for children with urinary tract infections? An observational study.

BACKGROUND: All children with urinary tract infections (UTIs) should undergo imaging of the urinary tract. The Royal College of Radiologists currently recommends that such children should be referred to a paediatric specialist prior to imaging. AIM: To investigate whether direct referral of such children by general practitioners (GPs) for imaging offers advantages over the traditional approach. METHOD: Information on 100 children with UTIs, who were referred direct for imaging by GPs according to an agreed protocol, was compared with information on 100 children with UTIs referred initially to paediatric specialists. RESULTS: Protocol-guided direct referral resulted in less delay prior to imaging, no evidence of inappropriate referral (as judged by urinalysis and yield from imaging), greater consistency of follow-up arrangements, and a considerable saving in outpatient department (OPD) appointments. There was no increase in the overall number of referrals for imaging. CONCLUSION: Given agreed protocols, there is no basis for current recommendations that GPs should not refer children with UTIs for imaging without a prior paediatric opinion.

Detection of important abnormalities of the differential count using the Coulter STKR blood counter.

An assessment of the three part differential provided by the Coulter STKR blood counter showed good correlation when compared with an 800 cell manual differential. Satisfactory flagging of eosinophilia, basophilia, and the presence of immature cells was found. The use of variables derived from the STKR in conjunction with interpretive reporting and user-defined flagging enabled this department to reduce considerably the numbers of films requiring manual differential counts.

An evaluation of the Coulter VCS differential counter.

An evaluation of the Coulter VCS (volume, conductivity, light scatter) automated differential counter demonstrated satisfactory correlations with manual 800-cell differential counts for neutrophils, lymphocytes, monocytes and eosinophils. For the detection of abnormal cells, 12.2% of samples gave false-negative results on the VCS, and 13.4% gave false-positive results. However, only 0.8% of the false-negatives would be expected to be picked up by a standard 100-cell manual differential count. Carry-over accorded to manufacturer's specifications and throughput was 60 samples/h. Reference normal ranges have been established and the instrument's precision and performance with leucopenic and neonatal blood samples assessed.