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摘要： Tissue samples may be collected from children in the course of their clinical care, or when they participate in research. Those samples may be stored in research biobanks. However, as the removal of tissue from children in Australia is regulated by State and Territory legislation, clinicians and researchers require an understanding of the regulatory framework. Removal of tissue from children for purposes not authorised under legislation can result in offences being committed. In addition, ethical issues arise from the collection and storage of children's tissue for research purposes. Tissue used for genomic research also brings additional risks to participants. This paper describes the current law, discusses its inadequacies and raises some of the key ethical issues that Australian researchers need to know. This paper focuses on the removal and use of paediatric tissue for research purposes only.

关键词： Parry Romberg syndrome   Progressive facial atrophy   Epilepsy   Seizure   Paediatric  

摘要： Background: Parry-Romberg syndrome (PRS) is a rare disorder characterized by unilateral slow progressive facial atrophy that can be associated with neurologic manifestations, namely seizures. There is scarce data about seizures in paediatric patients with PRS. The aim of our work was to clarify the clinical features of paediatric patients with PRS and seizures. Methods: We performed a literature review based on a literature search using PubMed and EMBASE databases. We included original articles in which the main diagnosis was PRS and the patients were 17 years old or less when the first seizure occurred. Results: We included 40 patients. Most of the patients had previously normal development and had their first seizure in the first decade of life. Neurologic examination was abnormal in 56 % of patients. Seizures are typically focal, frequently with impaired awareness, and became refractory in about 40 % of patients. Few patients have generalized seizures. On electroencephalogram, epileptic discharges are generally focal, on the same side as the facial atrophy, without a predominant cerebral lobe localization. Brain MRI is almost always abnormal, typically with T2 subcortical hyperintensities, and sometimes brain atrophy or calcifications. In addition to the classic antiepileptic drugs, immunosuppressive drugs should be considered as potential epilepsy treatment. Conclusion: To the best of our knowledge, this is the first review dedicated to the characteristics of paediatric patients with PRS and epilepsy. Seizures are usually focal, became refractory in 40 %, and have a significant impact on the quality of life and neurodevelopment of patients.

关键词： Digital radiography   Exposure factors   Paediatric   Radiation dose   Extremities   Bone   Contrast-to-noise ratio   Image quality  

摘要： The proliferation of digital radiography (DR) has led to a re-evaluation of exposure parameters and image quality. Currently, there is a move towards reducing X-ray tube voltage (kVp) in paediatric exposures down to 40 kVp to achieve better images. However, the effect on patient dose of these modifications is uncertain. The main aims of this phantom study were to evaluate the effect of reducing the kVp in paediatric limb DR exposures on contrast-to-noise ratio (CNR) and patient dose. For this purpose, Monte Carlo simulations of radiographic exposures on a paediatric limb phantom were performed. The phantom included muscle tissue and bone segments of five different densities in the range of 1.12 to 1.48 g/cm(3). The overall thickness of the phantom varied between 1 and 12 cm. Dependence of the CNR at constant limb phantom muscle and bone doses and dependence of the CNR per unit of muscle and bone dose at constant detector dose on radiographic exposure factors and limb thickness were calculated. X-ray tube current-time product (mAs) values required to achieve equal detector dose versus limb thickness for different kVp were calculated, as well as muscle and bone doses for the limb phantom of varying thickness. Present work has shown that reducing the kVp in paediatric radiography of the extremities can result in a significant increase in radiation dose, particularly for thicker limbs. Low kVp radiography requires justification for use on the extremities.

关键词： Interventional cardiology   Paediatrics   Diagnostic reference levels   Radiation doses  

摘要： This work presents patient radiation dose data for paediatric interventional cardiology procedures in a large paediatric hospital in Chile. This will contribute to setting national diagnostic reference levels (DRLs) for Chile in the near future. The dosimetric data collection period was from January 2018 to December 2018. The local DRIs were calculated as the 3rd quartile of patient dose data distributions for kerma area-product (P-ka) values. The sample of collected clinical procedures (261) was divided into diagnostic and therapeutic procedures and grouped into five weight bands. The P-ka differences found between diagnostic and therapeutic procedures were not statistically significant when comparing the same weight bands, as a result of which we propose a single DRL value for both types of procedure. The local DRLs were 4.9 Gy cm(2) (< 5 kg), 6.6 Gy cm(2) (5- < 15 kg), 13.7 Gy cm(2) (15- < 30 kg), 30.7 Gy cm(2) (30- < 50 kg) and 29.7 Gy cm(2) (50- < 80 kg), respectively. The conclusion from comparing our results with other existing DRL values is that there is ample scope to continue optimizing by reducing patient dose values. Equipment performance, settings used and examination protocols should be reviewed as corrective actions and adapted to patient weight.

关键词： birth cohort   child   community   disease burden   infectious diarrhea  

摘要： Estimates of acute gastroenteritis (AGE) burden are difficult to compare between studies because of inconsistent definitions describing this illness. AGE definitions used in prospective, community-based childhood cohort studies were identified by searching databases for studies that collected daily observations of AGE symptoms. Disease definitions and refractory periods were extracted. Data from the Australian community-based Observational Research in Childhood Infectious Diseases birth cohort were used to calculate AGE incidence and duration using identified AGE definitions, and the World Health Organization definition for diarrhoea. Eight distinct AGE definitions were identified. All included loose stools and 7 included vomiting as symptoms. The refractory period separating episodes ranged from 1 to 21 days. When applied to the Observational Research in Childhood Infectious Diseases dataset, AGE incidence ranged from 0.8 to 2.6 episodes per child-year-at-risk, a 3-fold relative difference. Direct comparisons of rates from different cohorts can only be undertaken if a standard definition for AGE is adopted.

关键词： Ultrasound   Liver   Paediatric   Diffuse hepatopathies   Focal liver lesions   Cholestasis  

摘要： Ultrasound scan is a painless and radiation-free imaging modality and, therefore, it is widely considered the first-choice diagnostic tool in the setting of hepatopathies in paediatric patients. This article focuses on the normal ultrasound anatomy of the liver in neonatal and paediatric age and reviews the ultrasound appearance of the most common diffuse and focal liver affections.

关键词： Tonsillectomy   Dissection   Radiofrequency Ablation   Pediatrics   Pain   Hemorrhage  

摘要： Background Cold dissection is the most commonly used tonsillectomy technique, with low post-operative haemorrhage rates. Coblation is an alternative technique that may cause less pain, but could have higher post-operative haemorrhage rates. Objective This study evaluated the peri-operative outcomes in paediatric tonsillectomy patients by comparing coblation and cold dissection techniques. Methods A systematic review was conducted of all comparative studies of paediatric coblation and cold dissection tonsillectomy, up to December 2018. Any studies with adults were excluded. Outcomes such as pain, operative time, and intra-operative, primary and secondary haemorrhages were recorded. Results Seven studies contributed to the summative outcome. Coblation tonsillectomy appeared to result in less pain, less intra-operative blood loss (p < 0.01) and a shorter operative time (p < 0.01). There was no significant difference between the two groups for post-operative haemorrhage (p > 0.05). Conclusion The coblation tonsillectomy technique may offer better peri-operative outcomes when compared to cold dissection, and should therefore be offered in paediatric cases, before cold dissection tonsillectomy.

关键词： abstract   annual meeting   International Associations for Dental Research   paediatric dentistry   publication  

摘要： The International Associations for Dental Research (IADR) annual meeting is one of the most important dental meetings throughout the world, and researches about paediatric dentistry presented in this platform are often used to guide clinical work. To evaluate the publication outcomes of oral and poster paediatric proceedings, which were accepted by the International Associations for Dental Research (IADR), annual meetings from 2010 to 2016 and to analyse the possible factors influencing an abstract's progression to publication. Oral and poster abstracts were retrieved from the official website of IADR (2010-2016). Searching for subsequent publications was conducted in PubMed and Google Scholar (up to March 2019). Two authors independently selected studies, collected, and analysed data. A total of 1396 abstracts were identified, including 275 oral presentations and 1121 poster presentations. Finally, 606 were published in peer-reviewed journals, with a publication rate of 43.41%. s were published earlier if it is from Europe, well funded, presented orally, or with large sample size. The high publication rate of the IADR proceedings supported the impact of IADR annual meetings on paediatric dentistry in the last 10 years.