Local diagnostic reference levels for skeletal surveys in suspected physical child abuse

NoIntroduction: The purpose was to determine if an age based, local diagnostic reference level for paediatric skeletal surveys could be established using retrospective data. Methods: All children below two years of age referred for a primary skeletal survey as a result of suspected physical abuse during 2017 or 2018 (n ¼ 45) were retrospectively included from a large Danish university hospital. The skeletal survey protocol included a total of 33 images. Dose Area Product (DAP) and acquisition parameters for all images were recorded from the Picture Archival and Communication System (PACS) and effective dose was estimated. The 75th percentile for DAP was considered as the diagnostic reference level (DRL). Results: The 75th percentile for DAP was 314 mGy*cm2 , 520 mGy*cm2 and 779 mGy*cm2 for children <1 month, 1e11 months and 12 < 24 months of age respectively. However, only the age group 1e11 months had a sufficient number of children (n ¼ 27) to establish a local DRL. Thus, for the other groups the DAP result must be interpreted with caution. Effective dose was 0.19, 0.26 and 0.18 mSv for children <1, 1e11 months and 12 < 24 months of age respectively. Conclusion: For children between 1 and 11 months of age, a local diagnostic reference level of 520 mGy*cm2 was determined. This may be used as an initial benchmark for primary skeletal surveys as a result of suspected physical abuse for comparison and future discussion. Implications for practice: While the data presented reflects the results of a single department, the suggested diagnostic reference level may be used as a benchmark for other departments when auditing skeletal survey radiation dose

A Comparison of Accuracy between A New Commercial ELISA Test, GenediaTM Test and Other Commercial ELISA Tests for Serological Diagnosis of Helicobacter pylori Infection in Korea

Background/Aims : A new commercial enzyme linked immunosorbent assay (ELISA) test using Korean Helicobacter pylori (H. pylori) as an antigen, GenediaTM test, was compared to other serologic tests for H. pylori infection. Methods: Among two hundred seventy three subjects, H. pylori-positive group was consisted of 132 patients (50 peptic ulcer diseases, 52 chronic gastritis, and 30 gastric cancers) and H. pylori-negative group was consisted of 141 patients (121 adults and 20 pediatric patients). Endoscopic antral biopsy specimens were obtained for microscopy and rapid urease test (CLOTM test). We also performed GenediaTM IgG, IgA ELISA, G.A.P IgG, IgA ELISA, and Cobas-core IgG EIA. H. pylori infection was defermined when H. pylori was detected histologically or the results of CLOTM tests were positive. Results : The sensitivities and specificities of the serologic tests were 96.2% and 46.1% in GenediaTM IgG, 91.7% and 52.5% in GenediaTM IgA, 81.8% and 46.8% in G.A.P IgG, 25.0% and 85.1% in G.A.P IgA, 96.9% and 38.6% in Cobas-core test, respectively. In H. pylori-negative pediatric patients, the specificity of the tests was 80% in GenediaTM IgG, 95% in GenediaTM IgA, 60% in G.A.P. IgG, 100% in G.A.P IgA, and 75% in Cobas-core test. Conclusions: In Korea, GenediaTM test was comparable or superior to general serologic tests used for diagnosing H. pylori infection. However, it is necessary to improve the specificity of the GenediaTM test. (Kor J Gastroenterol 2000;36:20 - 28)ope