Pott's disease: a major issue for an unaccompanied refugee minor

Chest clinic The incidence of TB in children in Germany has been a rise since 2008, especially among foreign-born individuals. With rapidly increasing numbers of refugees from the numerous areas of conflict, this increase in incidence is not expected to halt, neither in Germany in Europe in general. We report a case of insufficient tracking in a 16-year-old unaccompanied refugee minor from Somalia who had a positive interferon. release assay on arrival in Germany. No actions were undertaken, until 6 months later, an X-ray showed prominent hilar enlargement. Nine months later, the patient presented to our hospital with abdominal pain, vomiting and B symptoms. Workup revealed a paravertebral abscess due to Pott's disease, a skeletal manifestation of Mycobacterium tuberculosis disease. The patient made a full recovery after a combination therapy for a total of 9 months

One-year outcomes in a multicentre cohort study of incident rare diffuse parenchymal lung disease in children (ChILD)

We performed a prospective, observational, cohort study of children newly diagnosed with children's interstitial lung disease (ChILD), with structured follow-up at 4, 8, 12 weeks and 6 and 12 months. 127 children, median age 0.9 (IQR 0.3-7.9) years had dyspnoea (68%, 69/102), tachypnoea (75%, 77/103) and low oxygen saturation (SpO(2)) median 92% (IQR 88-96). Death (n=20, 16%) was the most common in those <6 months of age with SpO(2)<94% and developmental/surfactant disorders. We report for the first time that ChILD survivors improved multiple clinical parameters within 8-12 weeks of diagnosis. These data can inform family discussions and support clinical trial measurements

International management platform for children's interstitial lung disease (chILD-EU)

BACKGROUND: Children's interstitial lung diseases (chILD) cover many rare entities, frequently not diagnosed or studied in detail. There is a great need for specialised advice and for internationally agreed subclassification of entities collected in a register.Our objective was to implement an international management platform with independent multidisciplinary review of cases at presentation for long-term follow-up and to test if this would allow for more accurate diagnosis. Also, quality and reproducibility of a diagnostic subclassification system were assessed using a collection of 25 complex chILD cases. METHODS: A web-based chILD management platform with a registry and biobank was successfully designed and implemented. RESULTS: Over a 3-year period, 575 patients were included for observation spanning a wide spectrum of chILD. In 346 patients, multidisciplinary reviews were completed by teams at five international sites (Munich 51%, London 12%, Hannover 31%, Ankara 1% and Paris 5%). In 13%, the diagnosis reached by the referring team was not confirmed by peer review. Among these, the diagnosis initially given was wrong (27%), imprecise (50%) or significant information was added (23%).The ability of nine expert clinicians to subcategorise the final diagnosis into the chILD-EU register classification had an overall exact inter-rater agreement of 59% on first assessment and after training, 64%. Only 10% of the 'wrong' answers resulted in allocation to an incorrect category. Subcategorisation proved useful but training is needed for optimal implementation. CONCLUSIONS: We have shown that chILD-EU has generated a platform to help the clinical assessment of chILD. TRIAL REGISTRATION NUMBER: Results, NCT02852928

Organ doses in preterm and full-term neonates and infants - a retrospective study on 1,064 chest radiographs

Background Chest radiography is the most frequent X-ray examination performed in the neonatal period. However, commonly used dosimetric entities do not describe the radiation risk sufficiently. Objective The aim of this study was to investigate selected organ doses and total body dose of chest radiographs in preterm and full-term neonates and infants. Materials and methods In this retrospective study, we evaluated 1,064 chest radiographs of 136 preterm and 305 full-term babies with respect to field size and centering. We calculated the entrance dose from the dose-area product. Upper and lower field borders referred to the corresponding vertebrae. We calculated individual organ doses of the thyroid, the breast, the liver and active bone marrow for each chest radiograph using the neonatal PCXMC program, a Monte Carlo program for calculating patient doses in medical X-ray examinations. Results The median field size of chest radiographs ranged from 90 cm(2) in preterm neonates at birth to 290 cm(2) in full-term infants at the age of 6 months. Median values of entrance dose varied, depending on age, from 15 mu Gy to 25 mu Gy. The median organ doses ranged 1-20 mu Sv for the thyroid, 3-30 mu Sv for the breast, 2-20 mu Sv for the liver and 0.5-3.5 mu Sv for the bone marrow in preterm and full-term neonates and infants, respectively. Conclusion The analysis of chest radiographs in preterm and full-term neonates and infants revealed high variability in field size. By contrast, the entrance dose varied to a minor extent. Organ dose calculations using the PCXMC program might be a valuable tool to calculate the individual radiation risk in neonates and infants

Digitalisierte historische Bauzeitschriften auf dem Digitalen Repositorium (OPUS)

Die Universitätsbibliothek der BTU Cottbus-Senftenberg digitalisiert seit 2005 historische Bauzeitschriften, um häufig nachgefragte Titel digital verfügbar zu machen. Diese Maßnahme dient nebenbei auch dem Bestandsschutz. Um Überschneidungen zu vermeiden, wird zunächst überprüft, ob bereits durch andere Einrichtungen wie z.B. der Zentral- und Landesbibliothek Berlin, beziehungsweise Projekte (z.B. ANNO, ZDB) digitalisiert wird. Der Workflow des Digitalisierungsprojekts verläuft folgendermaßen: Nach dem Scannen werden die Dokumente mittels OCR (Optical Character Recognition) in maschinenlesbare PDF-Dateien umgewandelt. Anschließend erfolgt der Upload in Opus und die Vergabe der Metadaten für die inhaltliche und formale Beschreibung. Diese dienen der Such– und Auffindbarkeit der Bauzeitschriften auch außerhalb von OPUS. Die Digitalisate werden auf dem Digitalen Repositorium der BTU Cottbus-Senftenberg archiviert und sind frei zugänglich. Die digitalisierten Zeitschriften werden in der Zeitschriftendatenbank und der Elektronischen Zeitschriftenbibliothek nachgewiesen. Bei der Digitalisierung wurde darauf geachtet, dass die Bestände möglichst vollständig abgebildet sind und es wurde ein Zeitschnitt bei 1920 gemacht. Dieser Service wird von den Mitarbeitern der BTU, anderen Einrichtungen und externen Nutzern sehr gut angenommen

Facilitating access to emotions: neural signature of EMDR stimulation.

Eye Movement Desensitisation and Reprocessing (EMDR) is a method in psychotherapy effective in treating symptoms of posttraumatic stress disorder. The client attends to alternating bilateral visual, auditory or sensory stimulation while confronted with emotionally disturbing material. It is thought that the bilateral stimulation as a specific element of EMDR facilitates accessing and processing of negative material while presumably creating new associative links. We hypothesized that the putatively facilitated access should be reflected in increased activation of the amygdala upon bilateral EMDR stimulation even in healthy subjects.We investigated 22 healthy female university students (mean 23.5 years) with fMRI. Subjects were scanned while confronted with blocks of disgusting and neutral picture stimuli. One third of the blocks was presented without any additional stimulation, one third with bilateral simultaneous auditory stimulation, and one third with bilateral alternating auditory stimulation as used in EMDR.Contrasting disgusting vs. neutral picture stimuli confirmed the expected robust effect of amygdala activation for all auditory stimulation conditions. The interaction analysis with the type of auditory stimulation revealed a specific increase in activation of the right amygdala for the bilateral alternating auditory stimulation. Activation of the left dorsolateral prefrontal cortex showed the opposite effect with decreased activation.We demonstrate first time evidence for a putative neurobiological basis of the bilateral alternating stimulation as used in the EMDR method. The increase in limbic processing along with decreased frontal activation is in line with theoretical models of how bilateral alternating stimulation could help with therapeutic reintegration of information, and present findings may pave the way for future research on EMDR in the context of posttraumatic stress disorder

Advanced diagnostic imaging in children and adolescents with solid tumors Staging, risk stratification, and response assessment

Background The spectrum of solid tumors in children and adolescents as well as the concepts of treatment (e.g., bone marrow transplants in solid tumors) differ from those in adults. Almost all children with cancer are included in studies of national and international oncological societies and treated in pediatric oncological centers. Pediatric radiology takes on essential tasks, especially in therapeutic risk stratification and therapy control. Materials and methods Based on a selective literature search in the PubMed database, recent guidelines, and study protocols of the national and international pediatric oncology societies, the imaging standards and the latest developments for selected solid tumor entities were described. The authors who work in pediatric oncology centers discuss embryonic tumors, lymphomas, brain tumors, and tumor predisposition syndromes. Conclusion Both performing and reading of imaging in children with solid tumors are already relatively standardized. Experienced radiologists in certified centers should primarily be involved in this task. In particular, further functional imaging innovations suggest that imaging biomarkers may be used as target parameters in future treatment studies