Pontine tegmental cap dysplasia: the role of diffusion tensor imaging.

Pontine tegmental cap dysplasia (PTCD) is a rare hindbrain malformation syndrome. Recurrent aspiration pneumonia is a major cause of death during a first year of life. We report the case of month-old child with an inability to suck milk since birth and multiple convulsions. PTCD was identified using tractography and MRI. This case report describes the imaging findings, the role of diffusion tensor imaging in PTCD and its differentiating features from Joubert syndrome and related disorders (JSRDs). The constellation of imaging features in PTCD includes a midbrain appearance resembling a molar tooth, a flattened anterior pontine belly, hypoplastic middle cerebellar peduncles and dorsal pontine tegmental cap. 'Tegmental cap' is a transversely oriented abnormal bundle of fibres with absent superior cerebellar peduncle decussation. Accurate diagnosis with MRI and tractography and differentiating PTCD from JSRD would help the clinician for appropriate genetic counselling and prognosis.

Investigating Relationships between Balance Confidence and Balance Ability in Older Adults.

Increasing balance confidence in older individuals is important towards improving their quality of life and reducing activity avoidance. Here, we investigated if balance confidence (perceived ability) and balance performance (ability) in older adults were related to one another and would improve after balance training. The relationship of balance confidence in conjunction with balance performance for varied conditions (such as limiting vision, modifying somatosensory cues, and also base of support) was explored. We sought to determine if balance confidence and ability, as well as their relationship, could change after several weeks of training. Twenty-seven healthy participants were trained for several weeks during standing and walking exercises. In addition, seven participants with a higher risk of imbalance leading to falls (survivors of stroke) were also trained. Prior to and after training, balance ability and confidence were assessed via the Balance Error Scoring System (BESS) and Activities Specific Balance Confidence (ABC) Scale, respectively. Both groups showed improvements in balance abilities (i.e., BESS errors significantly decreased after training). Balance confidence was significantly higher in the healthy group than in the stroke group; however, ABC results reflected that balance confidence did not significantly increase after training for each. The correlations between balance ability and balance confidence were explored. Encouragingly, healthy participants displayed a negative correlation between BESS errors and ABC (i.e., enhancements in balance confidence (increases in ABC Scale results) were related to improvements in balance ability (decreases in BESS errors)). For the stroke participants, despite improvements in balance ability, our results showed that there was no relation to balance confidence (i.e., no correlation between BESS errors and ABC) in this group.

Ultrasonography as a diagnostic aid for a neonate with gingival swelling in a COVID-19 neonatal intensive care unit.

COVID-19 pandemic has impacted all the aspects of life and has emerged as the biggest challenge to the health-care sector. Dental fraternity has also taken its significant impact since the transmission of disease is primarily through aerosol droplets. Management of infants with orofacial anomalies such as natal and neonatal teeth born to COVID-19-positive mothers is another challenge due to unavailability of dental facilities in the isolation wards. In such unforeseen circumstances, out-of-routine approaches such as extraoral mandibular ultrasonography were performed for the management of a congenital intraoral swelling in an infant and are being described in this case report.

Multidirectional Overground Robotic Training Leads to Improvements in Balance in Older Adults.

For the rapidly growing aging demographic worldwide, robotic training methods could be impactful towards improving balance critical for everyday life. Here, we investigated the hypothesis that non-bodyweight supportive (nBWS) overground robotic balance training would lead to improvements in balance performance and balance confidence in older adults. Sixteen healthy older participants (69.7 ± 6.7 years old) were trained while donning a harness from a distinctive NaviGAITor robotic system. A control group of 11 healthy participants (68.7 ± 5.0 years old) underwent the same training but without the robotic system. Training included 6 weeks of standing and walking tasks while modifying: (1) sensory information (i.e., with and without vision (eyes-open/closed), with more and fewer support surface cues (hard or foam surfaces)) and (2) base-of-support (wide, tandem and single-leg standing exercises). Prior to and post-training, balance ability and balance confidence were assessed via the balance error scoring system (BESS) and the Activities specific Balance Confidence (ABC) scale, respectively. Encouragingly, results showed that balance ability improved (i.e., BESS errors significantly decreased), particularly in the nBWS group, across nearly all test conditions. This result serves as an indication that robotic training has an impact on improving balance for healthy aging individuals.

Tracheo-oesophageal fistula in a case of button battery ingestion: CT virtual bronchoscopy imaging.

Foreign body ingestion in paediatric population is a very common problem. Usually the foreign bodies pass through the gastrointestinal tract without any complications; however, certain foreign bodies like button batteries might cause severe injuries like tracheo-oesophageal fistula (TOF), oesophago-aortic fistula, perforation and mediastinitis, vocal cord paralysis and stenosis after suspected perforation. In our case, an infant developed a TOF following ingestion of button battery which was diagnosed with the help of CT virtual bronchoscopy. It also contributed to the decision making regarding suitable operative techniques. Thus, CT virtual bronchoscopy can help in the diagnosis and detection of any complications due to foreign body ingestion with the added advantage of being non-invasive.

Sonographic Appearance of Testicular Adrenal Rest Tumour in a Patient with Congenital Adrenal Hyperplasia.

BACKGROUND: Testicular adrenal rest tumours (TARTs) are benign testicular masses that are found in inadequately treated patients with congenital adrenal hyperplasia (CAH). Recognizing this association and identifying characteristic ultrasound features of TARTs is important so as to avoid misdiagnosing them as malignancies, which can lead to unnecessary interventions. CASE REPORT: We describe a case of a 9-year-old boy, with a diagnosis of CAH and precocious puberty, who was referred to our department for an ultrasound evaluation of the abdomen and scrotum. On ultrasound, there were well-defined, heterogeneous, predominantly hypoechoic, round-to-oval masses in both testes. Taking into account the presence of CAH and a typical sonographic appearance of bilateral testicular masses, a diagnosis of testicular adrenal rest tumour was made; biopsy was deferred and hormonal treatment was modified. CONCLUSIONS: Prompt diagnosis of testicular adrenal rest tumours is essential, as it only indicates inadequate hormonal control. Moreover, it can prevent unnecessary biopsies and orchidectomies, and can maintain fertility. TARTs have a typical imaging appearance that every radiologist must be aware of.

Building a more diverse biomedical engineering workforce: Biomedical engineering at the university of the district of Columbia, a historically black college & university.

Biomedical Engineering (BME) is a new, multidisciplinary, and rapidly growing field, however, the BME Workforce suffers from limited ethnic and gender diversity. Despite the demand and growth of this new field due to its public health importance, only 4 out of the 107 Historically Black Colleges and Universities (HBCUs) nationwide offers a Bachelor's of Science (B.S.) in Bio-Engineering related fields. In order to contribute to a growing BME Workforce, HBCUs need to react and offer more degree-programs relevant to BME. At the University of the District of Columbia (UDC), an HBCU and the District's only public institution for higher learning, we have recently established a new, degree program: Bachelor of Science in Biomedical Engineering (B.S. in BME) full-board approved in Fall 2014, with program activities initiated in Fall 2015. The educational goal of this program is to enhance the quality and diversity of the BME Workforce via student professional development, new and relevant BME courses, and BME scholarly activities (e.g., guest lectures and journal club sessions), ultimately to increase the number of ethnic minorities pursuing careers and degrees in BME. Through our program activities, we are aiming to meet the nation's demand to contribute to a diverse BME workforce, directed towards solving problems in human health. A secondary, but related goal, is to increase the diversity of STEM-related fields. This paper summarizes our initial, but encouraging, BME activity-related findings. However, this study will be longitudinal (on a multiple year time period) to observe the true outcomes of our initiative.

Scimitar syndrome.

Scimitar syndrome, a rare anomaly of partial pulmonary venous drainage into the hepatic portion of the inferior vena cava, detected in a ten-day-old neonate who presented clinically with respiratory distress and diagnosed on ultrasound of the thorax is being reported here.