Medical science monitor : international medical journal of experimental and clinical research
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Children with hydrocephalus and increased intracranial pressure are treated with ventricular shunts. Multiple head CT is used to assess shunt malfunction and changes in ventricular size (volume). Because of the naturally high contrast of the head structures in CT imaging, a low-dose protocol for hydrocephalic pediatric patients was proposed. The aim of the study was to assess the implemented protocol in categories of radiation risk to the patients. ⋯ The low-dose protocol for head CT can be recommended for the monitoring of pediatric hydrocephalus patients.
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The aim of this investigation was to evaluate the theoretical framework of regionalized trauma care that places highest expertise at Level I and II Trauma Centers. ⋯ The study raises the question whether regionalization in its current form is the appropriate framework for the organization of trauma care in Texas. Small variation in survival among trauma centers with highest expertise, indicate the need to revisit the entire concept of regionalized trauma care or particular elements of its structure. One solution suggested here is to have multiple centers with similar expertise at the core of the system acting as "Trauma Hospitals" which would connect with all the other hospitals in the region regardless of their expertise in an integrative model.
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Osteomas are relatively common, benign, slow-growing, often asymptomatic neoplasms of the paranasal sinuses occurring mainly in the frontal and ethmoid sinuses. Surgical removal is done if they extend beyond the boundaries of the sinus, continue to enlarge, are localized in the region adjacent to the nasofrontal duct, or if signs of chronic sinusitis are present and, regardless of size, in symptomatic tumors. Progressive headaches and chronic inflammation of the adjacent mucous membrane are the most common symptoms. Surgical approaches are divided into external, endoscopic drill-out, and combined endoscopic and external procedures. ⋯ Resection of small and medium-sized osteomas of the paranasal sinuses can be safely and radically performed using endoscopic techniques. It allows their radical resection and very good cosmetic effects. Giant frontal sinus osteomas can be effectively approached by a combined external and endoscopic procedure. Obliteration of the sinus is not mandatory if the mucous membrane is intact.
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The congenital diaphragm hernia presents most frequently in the neonatal period. In a small group of children his defect can be diagnosed beyond the newborn age, during late infancy or early childhood. The late presenting congenital diaphragm hernia is characterized by a variable clinical picture and represents a considerable diagnostic challenge. The aim of this study was to evaluate the usefulness of imaging methods in diagnosis, monitoring and management of late presenting diaphragmatic hernias. ⋯ The lack of typical clinical presentation in cases of late presenting CDH leads to delayed diagnosis of the defect. This clinical entity should be however taken into account in the differential diagnosis of children with respiratory distress and GI disturbances. The imaging studies are essentials in every case.