19 research outputs found
World Federation of Pediatric Imaging (WFPI) volunteer outreach through tele-reading: the pilot project in South Africa
BackgroundShortages in radiology services are estimated to affect 3.5-4.7 billion people worldwide. Teleradiology is a potential means of alleviating this shortage.ObjectiveThis paper examines the practicality and sustainability of a pilot pediatric teleradiology project at the Khayelitsha District Hospital in sub-Saharan Africa. We analyze how this World Federation of Pediatric Imaging (WFPI) program fares against the global challenges described in the current literature facing these practice types.Materials and methodsA teleradiology pilot was developed to provide coverage to the Khayelitsha District Hospital after the district pediatrician requested assistance in interpreting radiographs. This program utilized a network of WFPI volunteer pediatric radiologists, direct JPEG conversion of digital radiographic images, and an e-mail delivery system of images, referral requests and teleradiology opinion. Data were collected retrospectively from referral cards and JPEG images of radiographs, as well as from the volunteer officer database.ResultsA total of 555 referral cards and 1,106 radiographs were submitted for teleradiology opinion during the course of this pilot program; 74.6% of requests for image interpretation were chest radiographs and 14.2% of those were for the evaluation of tuberculosis. There were 40 volunteer teleradiologists from 17 countries; all spoke English, and 14 were bilingual (8 fluent in Spanish, 5 in Portuguese, and 1 in Italian).ConclusionTeleradiology is a viable option to alleviate radiologist shortages in underserved areas, but there are many challenges to designing an adequate teleradiology system. The WFPI pilot teleradiology program can be considered a successful one
Cough Frequency During Treatment Associated With Baseline Cavitary Volume and Proximity to the Airway in Pulmonary TB.
BACKGROUND: Cough frequency, and its duration, is a biomarker that can be used in low-resource settings without the need of laboratory culture and has been associated with transmission and treatment response. Radiologic characteristics associated with increased cough frequency may be important in understanding transmission. The relationship between cough frequency and cavitary lung disease has not been studied. METHODS: We analyzed data in 41 adults who were HIV negative and had culture-confirmed, drug-susceptible pulmonary TB throughout treatment. Cough recordings were based on the Cayetano Cough Monitor, and sputum samples were evaluated using microscopic observation drug susceptibility broth culture; among culture-positive samples, bacillary burden was assessed by means of time to positivity. CT scans were analyzed by a US-board-certified radiologist and a computer-automated algorithm. The algorithm evaluated cavity volume and cavitary proximity to the airway. CT scans were obtained within 1 month of treatment initiation. We compared small cavities (≤ 7 mL) and large cavities (> 7 mL) and cavities located closer to (≤ 10 mm) and farther from (> 10 mm) the airway to cough frequency and cough cessation until treatment day 60. RESULTS: Cough frequency during treatment was twofold higher in participants with large cavity volumes (rate ratio [RR], 1.98; P = .01) and cavities located closer to the airway (RR, 2.44; P = .001). Comparably, cough ceased three times faster in participants with smaller cavities (adjusted hazard ratio [HR], 2.89; P = .06) and those farther from the airway (adjusted HR, 3.61;, P = .02). Similar results were found for bacillary burden and culture conversion during treatment. CONCLUSIONS: Cough frequency during treatment is greater and lasts longer in patients with larger cavities, especially those closer to the airway
Education in Global Health Radiology
Radiologists and radiology professionals have noted the gaps in diagnostic and interventional imaging access worldwide as documented by the World Health Organization. Since global health focuses on issues that transcend national boundaries, emphasizes solutions that often require global cooperation, and is multidisciplinary, then the concept of radiology education in global health should consider this broader context of international partnership and collaboration. There are several models in place for education in the global health setting with emphasis on radiology. This chapter discusses faculty exchanges, scholarly collaboration, partnership, formal education, online education as a tool, integration of global health concepts into radiology curricula, and socially responsible collaboration. Regardless of the type of model used, educational goals and objectives should be based on initial assessment data and address the appropriate needs. Curricula should be established in partnership with all stakeholders and with consideration for ethical best practices, continuous evaluation and improvement of the program, and open communication among stakeholders
Immunohistochemical localisation of TRA-1-60, TRA-1-81, GCTM-2 and podocalyxin in the developing baboon kidney
The baboon is an ideal animal model to study
human kidney development. The aim of the current study
was to use immunohistochemistry to localise the antigens
TRA-1-60, TRA-1-81, GCTM-2 and podocalyxin in the
developing baboon kidney where nephrogenesis was still
on-going and in kidneys where nephrogenesis was complete.
Fixed kidney sections from baboons delivered at 125,
140, 175 and 185 days gestation (term = 185 days) were
immuno-labelled with antibodies directed against TRA-
1-60, TRA-1-81, GCTM-2 and podocalyxin. In kidneys
with on-going nephrogenesis (125 and 140 days gestation),
TRA-1-60, TRA-1-81 and GCTM-2 were speciWcally
localised to the apical plasma membrane of the epithelium
of the ureteric ampullae and the collecting ducts, while
podocalyxin immunostaining was not detected. In kidneys
where nephrogenesis was complete (175 and 185 days gestation)
localisation of these markers was again very speciWcally
localised to the collecting ducts. In conclusion,
although further experimentation is required to conWrm the
identity of the speciWc cell types marked by these antibodies, this study provides new insight into the distribution of commonly utilised stem cell antibodies in the developing baboon kidney