Evaluation of Cerebral Ventricles by Computed Tomography in the First Year of Life

CONTEXT AND OBJECTIVE: High-resolution computed tomography (HRCT) is considered to be the best method for detailed pulmonary evaluation. The aim here was to describe a scoring system based on abnormalities identified on HRCT among premature infants, and measure the predictive validity of the score in relation to respiratory morbidity during the first year of life. DESIGN AND SETTING: Prospective cohort study in Instituto Fernandes Figueira, Fundação Oswaldo Cruz. METHODS: Scoring system based on HRCT abnormalities among premature newborns. The affected lung area was quantified according to the number of compromised lobes, in addition to bilateral pulmonary involvement. Two radiologists applied the score to 86 HRCT scans. Intraobserver and interobserver agreement were analyzed. The score properties were calculated in relation to predictions of respiratory morbidity during the first year of life. RESULTS: Most of the patients (85%) presented abnormalities on HRCT, and among these, 56.2% presented respiratory morbidity during the first year of life. Scores ranged from zero to 12. There was good agreement between observers (intraclass correlation coefficient, ICC = 0.86, confidence interval, CI: 0.64-0.83). The predictive scores were as follows: positive predictive value 81.8%, negative predictive value 56.3%, sensitivity 39.1%, and specificity 90.0%. CONCLUSION: The scoring system is reproducible, easy to apply and allows HRCT comparisons among premature infants, by identifying patients with greater likelihood of respiratory morbidity during the first year of life. Its use will enable HRCT comparisons among premature infants with different risk factors for respiratory morbidity.

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355 Incomplete Intestinal Rotation with Appendicular Abscess Causing Diagnostic Dilemma in An Adult Patient

British Journal of Surgery ◽

10.1093/bjs/znab134.263 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

I Almafreji ◽

N Nur

Keyword(s):

Computed Tomography ◽

Abdominal Pain ◽

Literature Review ◽

First Year ◽

Inflammatory Mass ◽

Diagnostic Dilemma ◽

Abdominal Symptoms ◽

History Of ◽

First Year Of Life ◽

Intestinal Rotation

Abstract Intestinal malrotation presents as an emergency in the neonate and within the first year of life. Incomplete intestinal rotation may remain asymptomatic and undiagnosed. Adult patients are usually diagnosed incidentally while being investigated for nonspecific abdominal symptoms. We report a case of a 43-year-old female who presented with a 10-day history of paraumbilical abdominal pain. Computed tomography demonstrated features of incomplete intestinal rotation and a centrally located inflammatory mass related to the appendix. She underwent a laparotomy and appendectomy. Upon a brief literature review of similar cases, there seems to be a conflict of views regarding the management of incidentally diagnosed adult incomplete intestinal rotation.

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Craniofacial Skeletal Measurements Based on Computed Tomography: Part II. Normal Values and Growth Trends

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1992_029_0118_csmboc_2.3.co_2 ◽

1992 ◽

Vol 29 (2) ◽

pp. 118-128 ◽

Cited By ~ 74

Author(s):

Ariel A. Waitzman ◽

Jeffrey C. Posnick ◽

Derek C. Armstrong ◽

Gaylene E. Pron

Keyword(s):

Computed Tomography ◽

Normal Values ◽

Age Groups ◽

Normal Subjects ◽

Growth Patterns ◽

Cranial Vault ◽

First Year ◽

Adult Size ◽

Differential Growth ◽

First Year Of Life

Current diagnosis and surgical correction of craniofacial anomalies would benefit from accurate quantitative and standardized points of reference. A retrospective study was undertaken to define normal values for a series of craniofacial measurements and to evaluate the growth patterns of the craniofacial complex through axial computed tomography (CT). Fifteen measurements were taken from 542 CT scan series of skeletally normal subjects. The measurement values were then divided into 1 -year age categories from 1 to 17 years, and into four age groups for those under 1 year of age. The normal range and growth pattern of measurement values for the cranial vault, orbital region, and upper midface are presented. The overall size of the cranio-orbito-zygomatic skeleton reaches more than 85 percent of adult size by age 5 years. The cranial vault grows rapidly in the first year of life but growth levels off early. The upper midface grows at a slower rate in infancy, but continues to grow later in childhood and early adolescence. Knowledge of the differential growth patterns and normal measurement values in the craniofacial region will help improve diagnostic accuracy, staging of reconstruction, precision of corrective surgery, and follow-up of patients.

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The Development of Swallowing Respiratory Coordination

Perspectives on Swallowing and Swallowing Disorders (Dysphagia) ◽

10.1044/sasd18.1.19 ◽

2009 ◽

Vol 18 (1) ◽

pp. 19-24

Author(s):

Maggie-Lee Huckabee

Keyword(s):

Cortical Activation ◽

First Year ◽

Healthy Children ◽

Nasal Airflow ◽

Single Session ◽

Primary Finding ◽

Patterns Of Behavior ◽

Cortical Modulation ◽

First Year Of Life ◽

Swallowing Apnea

Abstract Research exists that evaluates the mechanics of swallowing respiratory coordination in healthy children and adults as well and individuals with swallowing impairment. The research program summarized in this article represents a systematic examination of swallowing respiratory coordination across the lifespan as a means of behaviorally investigating mechanisms of cortical modulation. Using time-locked recordings of submental surface electromyography, nasal airflow, and thyroid acoustics, three conditions of swallowing were evaluated in 20 adults in a single session and 10 infants in 10 sessions across the first year of life. The three swallowing conditions were selected to represent a continuum of volitional through nonvolitional swallowing control on the basis of a decreasing level of cortical activation. Our primary finding is that, across the lifespan, brainstem control strongly dictates the duration of swallowing apnea and is heavily involved in organizing the integration of swallowing and respiration, even in very early infancy. However, there is evidence that cortical modulation increases across the first 12 months of life to approximate more adult-like patterns of behavior. This modulation influences primarily conditions of volitional swallowing; sleep and naïve swallows appear to not be easily adapted by cortical regulation. Thus, it is attention, not arousal that engages cortical mechanisms.

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