Enterocolitis following endorectal pull-through procedure in children with Hirschsprung's disease

The enterocolitis following a pull-through in Hirschsprung's disease can be life-threatening and difficult to distinguish clinically from gastroenteritis and post-operative complications. We reviewed retrospectively the abdominal radiographs in our series to identify specific radiographic characteristics of this syndrome in this population. A total of 55 episodes of enterocolitis with an abdominal series at presentation were located in the files of 43 patients following pull-through surgery for Hirschsprung's disease. There were 15 abdominal series with other complications of Hirschsprung's disease and surgery (seven cases of small bowel obstruction, one of fistula, one of abscess, six of severe constipation) and 71 surveillance follow-up studies. Radiographs were evaluated for bowel dilatation, air-fluid levels, intestinal cut-off sign, spiculation, and pneumatosis. The intestinal cut-off sign with two or more air-fluid levels had sensitivity of 68% and specificity of 83%, with a positive predictive value of 0.71 and overall accuracy of 77%. Our review of enterocolitis following pull-through in children with Hirschsprung's disease concludes that the constellation of an intestinal cut-off sign and at least two air-fluid levels on the abdominal series strongly suggests the diagnosis.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46704/1/247_2005_Article_BF02012178.pd

Sonographic Diagnosis of Neonatal Diaphragmatic Inversion

No Abstract.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/38183/1/1870120309_ftp.pd

The role of arthrography in the management of dysplasia epiphysealis hemimelica

Dysplasia epiphysealis hemimelica can be diagnesed on plain radiographs of the affected areas. However, double contrast arthrography in three new cases provided additional information. The cartilaginous portions of the lesion at the articular surface of the bone were precisely demonstrated, aiding the orthopedic surgeon in deciding which patients should have surgery and planning the extent of operation necessary.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46781/1/256_2004_Article_BF00354065.pd

From Flashlight to Searchlight: A Sustainable Information Program for Sex Trafficking Victims in Texas

This project is a product of the Bush School of Government and Public Service Capstone Program. It expands upon a previous project that mapped the legal pathways for domestic minor sex trafficking victims and the resources available to them in the Brazos Valley. It expands victim information and resource models by applying them to broader geographic areas and additional categories of victims for the Human Trafficking and Transnational/Organized Crime Section of the Texas Office of the Attorney General. This project lasted one academic year and involved ten second-year Master students. They have reviewed the literature on trafficking, validated and revised the previous project, created a visual model for the legal pathways of international trafficking victims, mapped the victim resources available in two additional Texas counties, and developed a more comprehensive, bilingual resource model and website that can be updated by community leaders into specific resource guides for any Texas region.Human Trafficking and Transnational/Organized Crime Section within the Office of the Attorney General of Texa

CT appearance of the spleen following conservative management of traumatic injury

Objective: To describe the long-term changes in the traumatized spleen following conservative management in pediatric patients. Methods: Between 1991 and 1997, 92 children were imaged with splenic trauma. The study population includes the 25 boys and 11 girls with follow-up computed tomography (CT) imaging at our institution. The follow-up CT studies were evaluated to determine the evolution of splenic injury. Results: On initial CT there were 6 grade I, 12 grade II, 9 grade III, and 9 grade IV–V splenic injuries. In follow-up 11 spleens were normal (30 %), including at least one in each grade of severity of injury. Splenic abnormalities were identified on follow-up in 25 children. These findings comprised clefts in 8 children, small cysts in 4, and devascularized segments involving less than 1 cm 3 in 6, 1–2 cm 3 in 2, and 2–4 cm 3 in 5 children. Conclusions: All grades of splenic injury can resolve completely on subsequent CT imaging. In this series 30 % of patients had a normal follow-up CT. The most common persistent abnormalities included clefts and devascularized areas less than 4 cm 3 .Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42349/1/10140-6-3-157_90060157.pd

Pulmonary involvement in pediatric lymphoma

The prevalence of pulmonary lymphoma in the pediatric age group is not documented in the literature.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46710/1/247_2003_Article_1080.pd

Cranial Morphology of Protosiren fraasi (Mammalia, Sirenia) from the Middle Eocene of Egypt: A New Study Using Computed Tomography

41-67http://deepblue.lib.umich.edu/bitstream/2027.42/48641/2/ID508.pd

Follow-up imaging of benign pediatric liver tumors

Though surgery has been recommended in the past for the management of benign hepatic tumors, the current emphasis is on medical management. This report of 4 cases with long-term (8–28 months) follow-up emphasizes the natural history of these tumors which serves to indicate the advantages and disadvantages of CT and ultrasound. The lesions typically involute with some calcification. Calcification can technically be a problem in follow-up with sonography.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46688/1/247_2006_Article_BF02386841.pd

Will 'the feeling of abandonment' remain? Persisting impacts of the COVID-19 pandemic on rheumatology patients and clinicians.

OBJECTIVE: To better understand rheumatology patient and clinician pandemic-related experiences, medical relationships and behaviours in order to help identify the persisting impacts of the COVID-19 pandemic and inform efforts to ameliorate the negative impacts and build upon the positive ones. METHODS: Rheumatology patients and clinicians completed surveys (patients n = 1543, clinicians n = 111) and interviews (patients n = 41, clinicians n = 32) between April 2021 and August 2021. A cohort (n = 139) of systemic autoimmune rheumatic disease patients was also followed up from March 2020 to April 2021. Analyses used sequential mixed methods. Pre-specified outcome measures included the Warwick-Edinburgh Mental wellbeing score (WEMWBS), satisfaction with care and healthcare behaviours. RESULTS: We identified multiple ongoing pandemic-induced/increased barriers to receiving care. The percentage of patients agreeing they were medically supported reduced from 74.4% pre-pandemic to 39.7% during-pandemic. Ratings for medical support, medical security and trust were significantly (P <0.001) positively correlated with patient WEMWBS and healthcare behaviours, and decreased during the pandemic. Healthcare-seeking was reduced, potentially long-term, including from patients feeling 'abandoned' by clinicians, and a 'burden' from government messaging to protect the NHS. Blame and distrust were frequent, particularly between primary and secondary care, and towards the UK government, who <10% of clinicians felt had supported clinicians during the pandemic. Clinicians' efforts were reported to be impeded by inefficient administration systems and chronic understaffing, suggestive of the pandemic having exposed and exacerbated existing healthcare system weaknesses. CONCLUSION: Without concerted action-such as rebuilding trust, improved administrative systems and more support for clinicians-barriers to care and negative impacts of the pandemic on trust, medical relationships, medical security and patient help-seeking may persist in the longer term. TRIAL REGISTRATION: This study is part of a pre-registered longitudinal multi-stage trial, the LISTEN study (ISRCTN-14966097), with later COVID-related additions registered in March 2021, including a pre-registered statistical analysis plan

Single sysem ectopic ureters and ureteroceles associated with dysplastic kidney

Eight children forming an uncommon subgroup of renal obstructive dysplasia are presented. Each child had a nonfunctioning dysplastic kidney with a single collecting system with ectopic ureteral insertion and/or ureterocele. Five of the children had classic multicystic dysplastic kidneys, one had they hdyronephrotic type of multicystic dysplasia kidney had two had hypoplastic kidneys. Other significant medical problems in 5 of the 8 children (63%Z) included VACTERL association, congenital heart diseaise and other genitourinary malformations. Unlike some children with unilateral multicystic dysplasia kidney, this subgroup of children ahs an increased risk of infection. The must be correctly identified on imaging so that tailored clinical management decisions can be made and associated anomalies detected.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46698/1/247_2005_Article_BF02012501.pd