Timothy Cain - Academia.edu (original) (raw)

Papers by Timothy Cain

Research paper thumbnail of Pancreatic trauma in children

PurposeTo document the demographics, mechanisms and outcome of traumatic pancreatitis in children... more PurposeTo document the demographics, mechanisms and outcome of traumatic pancreatitis in children at a single large tertiary referral centre in Australia.MethodsWe undertook a 10-year retrospective audit of children admitted to the Royal Children’s Hospital, Melbourne, Australia with a hospital coded diagnosis which included pancreatic injury between 1993 and 2002. Data included patient demographics, source of admission, mechanism of injury, pancreatic complications, associated injuries, intensive care unit admission, results of any operative findings, results of any acute computed tomography and/or ultrasound imaging of pancreas, selected laboratory findings and length of stay.ResultsWe identified two distinct groups of patients in the 91 documented cases of pancreatic trauma (median age 8.0 years, range 0.6–15.8 years; M:F 2.5:1.0): 59 had a history of abdominal trauma and elevated serum lipase but no CT or ultrasound evidence of pancreatic injury (Group A); 32 had a history of ab...

Research paper thumbnail of Another international imaging society—to what end?

Pediatr Radiol (2014) 44:636–638 DOI 10.1007/s00247-014-2939-7 MINISYMPOSIUM Another internationa... more Pediatr Radiol (2014) 44:636–638 DOI 10.1007/s00247-014-2939-7 MINISYMPOSIUM Another international imaging society—to what end? The World Federation of Pediatric Imaging: one voice, a common message, a unified network Amanda Dehaye & Timothy Cain & Maria Ines Boechat Received: 26 November 2013 / Accepted: 13 February 2014 # Springer-Verlag Berlin Heidelberg 2014 The foundations of the World Federation of Pediatric Imaging were laid during the first International Symposium on Pediat- ric Imaging held in Rio de Janeiro in 2009. Pediatric radiolo- gists from all over the world came together to share their knowledge with colleagues. A global movement was born to better integrate the existing international societies of pediatric imaging with regional and local organizations and to unite voices advocating for universal access to appropriate pediatric imaging (Fig. 1). Created in 2011, the World Federation of Pediatric Imaging (WFPI) works to unite pediatric imaging organizations to form o...

Research paper thumbnail of The natural history of asymptomatic central venous catheter-related thrombosis in critically ill children

Asymptomatic central venous catheter (CVC)-related thrombosis in children varies in incidence fro... more Asymptomatic central venous catheter (CVC)-related thrombosis in children varies in incidence from 5% to 69%. The rate of acute and long-term complications, such as postthrombotic syndrome (PTS), from asymptomatic CVC-related thrombosis is unknown. This article reports the outcomes of a prospective study of 189 children in pediatric intensive care that aimed to determine the frequency of asymptomatic CVC-related thrombosis during hospital admission, and the incidence of residual CVC-related thrombosis and clinically significant PTS 2 years later. Risk factors associated with CVC-related thrombosis were also identified. This study is distinct from previous work as children identified to have asymptomatic CVC-related thrombosis were not treated (clinical team kept blinded) and the entire cohort was followed for 2 years to determine the natural history of asymptomatic thrombosis. Ultrasounds of 146 children determined a 21.9% incidence of acute CVC-related thrombosis. Two children were...

Research paper thumbnail of Abstract LB-023: Dynamic real time in vivo CAR T cell tracking: Clinical and preclinical studies using a novel dual PET-MR imaging agent

Bioinformatics, Convergence Science, and Systems Biology

Research paper thumbnail of The clinical utility of fluorodeoxyglucose-positron emission tomography for investigation of fever in immunocompromised children

Journal of Paediatrics and Child Health

Fever in immunocompromised children presents significant challenges. We aimed to determine the cl... more Fever in immunocompromised children presents significant challenges. We aimed to determine the clinical impact of fluorodeoxyglucose‐positron emission tomography (FDG‐PET) in combination with computed tomography (CT) in children with malignancy or following haematopoietic stem cell transplantation with prolonged or recurrent fever.

Research paper thumbnail of Consensus statement on abusive head trauma: additional endorsements

Research paper thumbnail of The natural history of asymptomatic central venous catheter-related thrombosis in critically ill children

Blood, Jan 30, 2018

Asymptomatic central venous catheter (CVC)-related thrombosis in children varies in incidence fro... more Asymptomatic central venous catheter (CVC)-related thrombosis in children varies in incidence from 5-69%. The rate of acute and long-term complications, such as Post Thrombotic Syndrome (PTS), from asymptomatic CVC-related thrombosis is unknown. This paper reports the outcomes of a prospective study of 189 children in paediatric intensive care unit that aimed to determine the frequency of asymptomatic CVC-related thrombosis during hospital admission, and the incidence of residual CVC-related thrombosis and clinically significant PTS two years later. Risk factors associated with CVC-related thrombosis were also identified. This study is distinct from previous work as children identified to have asymptomatic CVC-related thrombosis were not treated (clinical team kept blinded) and the entire cohort was followed for two years to determine the natural history of asymptomatic thrombosis. Ultrasounds of 146 children determined a 21.9% incidence of acute CVC-related thrombosis. Two children...

Research paper thumbnail of Hepatic and renal end-organ damage in the Fontan circulation: A report from the Australian and New Zealand Fontan Registry

International journal of cardiology, Jan 25, 2018

Hepatic and renal dysfunction have been observed in survivors of the Fontan procedure, however th... more Hepatic and renal dysfunction have been observed in survivors of the Fontan procedure, however their incidence and associated factors remain poorly defined. A total of 152 participants from a Registry of 1528 patients underwent abdominal ultrasound, transient elastography (FibroScan), serum fibrosis score (FibroTest), in vivo Tc-99m DTPA measurement of glomerular filtration rate (mGFR), and urine albumin-creatinine ratio (ACR). Mean age and time since Fontan were 19.8 ± 9.3 and 14.1 ± 7.6 years, respectively. Features suggestive of hepatic fibrosis were observed on ultrasound in 87/143 (61%) and no patient was diagnosed with hepatocellular carcinoma. FibroScan median kPa was ≥10 in 117/133 (88%), ≥15 in 75/133 (56%), and ≥20 in 41/133 (31%). Fifty-four patients (54/118, 46%) had a FibroTest score ≥0.49 (equivalent to ≥F2 fibrosis). FibroTest score correlated with FibroScan value (r = 0.24, p = 0.015) and ACR (r = 0.29, p = 0.002), and patients with ultrasound features of hepatic fib...

Research paper thumbnail of Asymptomatic central venous catheter related thrombosis in children: two year follow up

Australian Critical Care, 2017

Research paper thumbnail of Risk factors and clinical features of acute pulmonary embolism in children from the community

Thrombosis Research, 2015

Current clinical decision rules for pulmonary embolism are based on adult populations and have no... more Current clinical decision rules for pulmonary embolism are based on adult populations and have not been validated in children. The objective was to identify and evaluate clinical features for a first lifetime episode of pulmonary embolism in children presenting to the emergency department. We present a case-control study of children (≤18years) presenting to the emergency department of the Royal Children's Hospital, Melbourne between November 2007 and February 2015. Children with radiologically proven pulmonary embolism formed the case group, whilst children in whom there was a clinical suspicion of pulmonary embolism but negative diagnostic imaging formed the control group. Charts, electronic medical and imaging records of both cases and controls were reviewed and analysed. There were a total of 50 patients in this study (11 cases and 39 controls). Current or recent (within three months) use of the oral contraceptive pill was the most significant risk factor in our study (odds ratio 14.667, 95% confidence interval 3.001-71.678, P<0.001). Most other features failed to discriminate between cases and controls, although there was a trend towards increased heart rate in cases. Pulmonary embolism is perhaps the most common presenting spontaneous venous thromboembolism in the community and teenage girls on the oral contraceptive pill are most at-risk amongst children. The clinical signs and symptoms are often non-specific. Additional larger studies are required to determine the significance and magnitude of potential clinical predictors identified in this study. This may lead to derivation of a paediatric-specific pre-test probability tool.

Research paper thumbnail of Assessment and Interpretation of Bone Trauma in Children

Gall/Current Practice in Forensic Medicine, 2011

Research paper thumbnail of What are the greatest challenges or barriers to applying postmortem imaging in paediatric radiology?

Pediatric radiology, 2015

Research paper thumbnail of Targeting the Causes of Intractable Chronic Constipation in Children: The Nuclear Transit Study (NTS)

Radioisotopes - Applications in Bio-Medical Science, 2011

Research paper thumbnail of Another international imaging society—to what end?

Pediatric Radiology, 2014

Pediatr Radiol (2014) 44:636–638 DOI 10.1007/s00247-014-2939-7 MINISYMPOSIUM Another internationa... more Pediatr Radiol (2014) 44:636–638 DOI 10.1007/s00247-014-2939-7 MINISYMPOSIUM Another international imaging society—to what end? The World Federation of Pediatric Imaging: one voice, a common message, a unified network Amanda Dehaye & Timothy Cain & Maria Ines Boechat Received: 26 November 2013 / Accepted: 13 February 2014 # Springer-Verlag Berlin Heidelberg 2014 The foundations of the World Federation of Pediatric Imaging were laid during the first International Symposium on Pediat- ric Imaging held in Rio de Janeiro in 2009. Pediatric radiolo- gists from all over the world came together to share their knowledge with colleagues. A global movement was born to better integrate the existing international societies of pediatric imaging with regional and local organizations and to unite voices advocating for universal access to appropriate pediatric imaging (Fig. 1). Created in 2011, the World Federation of Pediatric Imaging (WFPI) works to unite pediatric imaging organizations to form one voice, a common message, and a unified network in addressing the global challenges of pedi- atric imaging. The tremendous disparities in pediatric imaging practices and resources served as an incentive to pool the substantial resources of existing societies. These societies had a common purpose but lacked coordination of efforts to advocate side- by-side for the inclusion of pediatric imaging as a sub- speciality in the care of children worldwide. Diagnostic imag- ing services in modern medical settings have evolved enor- mously, but even state-of-the-art health care can overlook the unique needs of children. Dedicated pediatric imaging training A. Dehaye World Federation of Pediatric Imaging, Reston, VA, USA T. Cain Department of Medical Imaging, The Royal Children’s Hospital, Melbourne, Australia M. I. Boechat (*) Department of Radiology, David Geffen School of Medicine at UCLA, CHS B2-252, 10833 Le Conte Ave., Los Angeles, CA 90095, USA e-mail: iboechat@mednet.ucla.edu is quite simply out of reach for most of the lower-resource nations already confronting multiple health challenges. Al- though such nations’ pediatric populations are huge, appro- priate diagnostic imaging services are rarely integrated into national health plans; yet these services save lives. Deployment of a united platform is encapsulated through our membership reach. Longstanding regional societies (founding members the Asian and Oceanic Society for Paediatric Radiolo- gy [AOSPR], European Society of Paediatric Radiology [ESPR], Latin American Society of Pediatric Radiology [SLARP] and The Society for Pediatric Radiology [SPR]) were rapidly joined by the newly created African Society of Paediatric Imaging at a governance level. At a national level, our numbers include a range of societies well-established in Europe, the Indian Society of Paediatric Radiology and two other groups from Africa, the latest in Nigeria (SPIN), established on the impetus of the WFPI. We will continue to expand our participant base through reaching out to pediatric imaging societies and pediatric interest groups across the world. The goal is to broaden representation and pool available resources, not to replace the activities of the existing societies (Fig. 2). Sealing federation between individual physician members of these societies is commensurate with the rising trajectory of the WFPI. Recent ventures include cross-regional WFPI rep- resentation in World Health Organization meetings on patient safety and international collaboration in education and out- reach projects, as described in subsequent articles in this issue of the journal. Our Web site and newsletters are windows to these efforts, reflecting burgeoning global stewardship as traction is gained. To address the global challenges in pediatric imaging, we will continue to participate in global forums via robust col- laboration with the world’s major health organizations. Our Web site was launched in March 2013 (www.wfpiweb.org),

Research paper thumbnail of Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians

BMJ (Clinical research ed.), Jan 21, 2013

To assess the cancer risk in children and adolescents following exposure to low dose ionising rad... more To assess the cancer risk in children and adolescents following exposure to low dose ionising radiation from diagnostic computed tomography (CT) scans. Population based, cohort, data linkage study in Australia. COHORT MEMBERS: 10.9 million people identified from Australian Medicare records, aged 0-19 years on 1 January 1985 or born between 1 January 1985 and 31 December 2005; all exposures to CT scans funded by Medicare during 1985-2005 were identified for this cohort. Cancers diagnosed in cohort members up to 31 December 2007 were obtained through linkage to national cancer records. Cancer incidence rates in individuals exposed to a CT scan more than one year before any cancer diagnosis, compared with cancer incidence rates in unexposed individuals. 60,674 cancers were recorded, including 3150 in 680,211 people exposed to a CT scan at least one year before any cancer diagnosis. The mean duration of follow-up after exposure was 9.5 years. Overall cancer incidence was 24% greater for...

Research paper thumbnail of A Comparative Study of Three Methods of Nasal Irrigation

The Laryngoscope, 2004

To assess the effectiveness of three methods of nasal irrigation on distributing saline to the na... more To assess the effectiveness of three methods of nasal irrigation on distributing saline to the nasal cavity and paranasal sinuses. : A prospective, cross-over study. Twelve subjects (9 patients with chronic sinusitis after functional endoscopic sinus surgery and 3 healthy controls) underwent nasal irrigation with normal saline containing Technetium 99m sulfur colloid. The distribution of radioactivity was assessed on each subject after three different irrigation techniques: metered nasal spray, nebulization with RinoFlow, and nasal douching while kneeling with the head on the floor. The nasal cavity was well irrigated by all three techniques. Compared with the other two methods, douching was significantly more effective in penetrating the maxillary sinus (P = .036) and frontal recess (P = .003). The sphenoid and frontal sinuses were poorly irrigated by all three techniques. Nasal douches are more effective in distributing irrigation solution to the maxillary sinus and frontal recess. This should be the method of choice for irrigating these areas.

Research paper thumbnail of Dear sir,: re: Nuclear Medicine and Diagnostic Radiologists

Australasian Radiology, 1992

Research paper thumbnail of 2D versus 3D imaging of hip displacement in children with cerebral palsy

Developmental Medicine & Child Neurology, 2011

Research paper thumbnail of To x-ray or not to x-ray? Screening asymptomatic children for pulmonary TB: a retrospective audit

Archives of Disease in Childhood, 2013

Recent studies found that a chest x-ray (CXR) has limited value in the assessment of asymptomatic... more Recent studies found that a chest x-ray (CXR) has limited value in the assessment of asymptomatic adults with tuberculosis (TB) infection. We aimed to determine in asymptomatic children with a positive tuberculin skin test and/or interferon-γ release assay (TST/IGRA) whether a CXR identifies findings suggestive of pulmonary TB. All children with TB infection (defined as TST ≥10 mm and/or positive IGRA) presenting to The Royal Children's Hospital Melbourne during a 54-month period were included. All CXRs were reviewed by a senior radiologist blinded to the clinical details. The medical records of those with radiological abnormalities suggestive of TB were examined to identify those who were asymptomatic when the CXR was done. Demographical data were also collected. CXRs were available for 268 of 330 TB-infected children, of whom 60 had CXR findings suggestive of TB. Of the 57 for whom clinical details were available, 26 were asymptomatic. Of these asymptomatic children with radiological abnormalities suggestive of TB, 6 had CXR findings suggestive of active TB, 14 had CXR findings suggestive of prior TB and 6 had isolated non-calcified hilar lymphadenopathy. The six with findings suggestive of active TB represented 2.6% (95% CI 0.9 to 5.5%) of asymptomatic TST/IGRA-positive children with evaluable CXRs. One child with isolated hilar lymphadenopathy had microbiologically-confirmed TB. In contrast to the results from studies in adults, a CXR identified a small but noteworthy number of children with findings suggestive of pulmonary TB in the absence of clinical symptoms.

Research paper thumbnail of A comparative study of three methods of nasal irrigation

The …, 2004

Materials and Methods: Twelve subjects (9 patients with chronic sinusitis after functional endosc... more Materials and Methods: Twelve subjects (9 patients with chronic sinusitis after functional endoscopic sinus surgery and 3 healthy controls) underwent nasal irrigation with normal saline containing Technetium 99m sulfur colloid. The distribution of radioactivity was assessed on each ...

Research paper thumbnail of Pancreatic trauma in children

PurposeTo document the demographics, mechanisms and outcome of traumatic pancreatitis in children... more PurposeTo document the demographics, mechanisms and outcome of traumatic pancreatitis in children at a single large tertiary referral centre in Australia.MethodsWe undertook a 10-year retrospective audit of children admitted to the Royal Children’s Hospital, Melbourne, Australia with a hospital coded diagnosis which included pancreatic injury between 1993 and 2002. Data included patient demographics, source of admission, mechanism of injury, pancreatic complications, associated injuries, intensive care unit admission, results of any operative findings, results of any acute computed tomography and/or ultrasound imaging of pancreas, selected laboratory findings and length of stay.ResultsWe identified two distinct groups of patients in the 91 documented cases of pancreatic trauma (median age 8.0 years, range 0.6–15.8 years; M:F 2.5:1.0): 59 had a history of abdominal trauma and elevated serum lipase but no CT or ultrasound evidence of pancreatic injury (Group A); 32 had a history of ab...

Research paper thumbnail of Another international imaging society—to what end?

Pediatr Radiol (2014) 44:636–638 DOI 10.1007/s00247-014-2939-7 MINISYMPOSIUM Another internationa... more Pediatr Radiol (2014) 44:636–638 DOI 10.1007/s00247-014-2939-7 MINISYMPOSIUM Another international imaging society—to what end? The World Federation of Pediatric Imaging: one voice, a common message, a unified network Amanda Dehaye & Timothy Cain & Maria Ines Boechat Received: 26 November 2013 / Accepted: 13 February 2014 # Springer-Verlag Berlin Heidelberg 2014 The foundations of the World Federation of Pediatric Imaging were laid during the first International Symposium on Pediat- ric Imaging held in Rio de Janeiro in 2009. Pediatric radiolo- gists from all over the world came together to share their knowledge with colleagues. A global movement was born to better integrate the existing international societies of pediatric imaging with regional and local organizations and to unite voices advocating for universal access to appropriate pediatric imaging (Fig. 1). Created in 2011, the World Federation of Pediatric Imaging (WFPI) works to unite pediatric imaging organizations to form o...

Research paper thumbnail of The natural history of asymptomatic central venous catheter-related thrombosis in critically ill children

Asymptomatic central venous catheter (CVC)-related thrombosis in children varies in incidence fro... more Asymptomatic central venous catheter (CVC)-related thrombosis in children varies in incidence from 5% to 69%. The rate of acute and long-term complications, such as postthrombotic syndrome (PTS), from asymptomatic CVC-related thrombosis is unknown. This article reports the outcomes of a prospective study of 189 children in pediatric intensive care that aimed to determine the frequency of asymptomatic CVC-related thrombosis during hospital admission, and the incidence of residual CVC-related thrombosis and clinically significant PTS 2 years later. Risk factors associated with CVC-related thrombosis were also identified. This study is distinct from previous work as children identified to have asymptomatic CVC-related thrombosis were not treated (clinical team kept blinded) and the entire cohort was followed for 2 years to determine the natural history of asymptomatic thrombosis. Ultrasounds of 146 children determined a 21.9% incidence of acute CVC-related thrombosis. Two children were...

Research paper thumbnail of Abstract LB-023: Dynamic real time in vivo CAR T cell tracking: Clinical and preclinical studies using a novel dual PET-MR imaging agent

Bioinformatics, Convergence Science, and Systems Biology

Research paper thumbnail of The clinical utility of fluorodeoxyglucose-positron emission tomography for investigation of fever in immunocompromised children

Journal of Paediatrics and Child Health

Fever in immunocompromised children presents significant challenges. We aimed to determine the cl... more Fever in immunocompromised children presents significant challenges. We aimed to determine the clinical impact of fluorodeoxyglucose‐positron emission tomography (FDG‐PET) in combination with computed tomography (CT) in children with malignancy or following haematopoietic stem cell transplantation with prolonged or recurrent fever.

Research paper thumbnail of Consensus statement on abusive head trauma: additional endorsements

Research paper thumbnail of The natural history of asymptomatic central venous catheter-related thrombosis in critically ill children

Blood, Jan 30, 2018

Asymptomatic central venous catheter (CVC)-related thrombosis in children varies in incidence fro... more Asymptomatic central venous catheter (CVC)-related thrombosis in children varies in incidence from 5-69%. The rate of acute and long-term complications, such as Post Thrombotic Syndrome (PTS), from asymptomatic CVC-related thrombosis is unknown. This paper reports the outcomes of a prospective study of 189 children in paediatric intensive care unit that aimed to determine the frequency of asymptomatic CVC-related thrombosis during hospital admission, and the incidence of residual CVC-related thrombosis and clinically significant PTS two years later. Risk factors associated with CVC-related thrombosis were also identified. This study is distinct from previous work as children identified to have asymptomatic CVC-related thrombosis were not treated (clinical team kept blinded) and the entire cohort was followed for two years to determine the natural history of asymptomatic thrombosis. Ultrasounds of 146 children determined a 21.9% incidence of acute CVC-related thrombosis. Two children...

Research paper thumbnail of Hepatic and renal end-organ damage in the Fontan circulation: A report from the Australian and New Zealand Fontan Registry

International journal of cardiology, Jan 25, 2018

Hepatic and renal dysfunction have been observed in survivors of the Fontan procedure, however th... more Hepatic and renal dysfunction have been observed in survivors of the Fontan procedure, however their incidence and associated factors remain poorly defined. A total of 152 participants from a Registry of 1528 patients underwent abdominal ultrasound, transient elastography (FibroScan), serum fibrosis score (FibroTest), in vivo Tc-99m DTPA measurement of glomerular filtration rate (mGFR), and urine albumin-creatinine ratio (ACR). Mean age and time since Fontan were 19.8 ± 9.3 and 14.1 ± 7.6 years, respectively. Features suggestive of hepatic fibrosis were observed on ultrasound in 87/143 (61%) and no patient was diagnosed with hepatocellular carcinoma. FibroScan median kPa was ≥10 in 117/133 (88%), ≥15 in 75/133 (56%), and ≥20 in 41/133 (31%). Fifty-four patients (54/118, 46%) had a FibroTest score ≥0.49 (equivalent to ≥F2 fibrosis). FibroTest score correlated with FibroScan value (r = 0.24, p = 0.015) and ACR (r = 0.29, p = 0.002), and patients with ultrasound features of hepatic fib...

Research paper thumbnail of Asymptomatic central venous catheter related thrombosis in children: two year follow up

Australian Critical Care, 2017

Research paper thumbnail of Risk factors and clinical features of acute pulmonary embolism in children from the community

Thrombosis Research, 2015

Current clinical decision rules for pulmonary embolism are based on adult populations and have no... more Current clinical decision rules for pulmonary embolism are based on adult populations and have not been validated in children. The objective was to identify and evaluate clinical features for a first lifetime episode of pulmonary embolism in children presenting to the emergency department. We present a case-control study of children (≤18years) presenting to the emergency department of the Royal Children's Hospital, Melbourne between November 2007 and February 2015. Children with radiologically proven pulmonary embolism formed the case group, whilst children in whom there was a clinical suspicion of pulmonary embolism but negative diagnostic imaging formed the control group. Charts, electronic medical and imaging records of both cases and controls were reviewed and analysed. There were a total of 50 patients in this study (11 cases and 39 controls). Current or recent (within three months) use of the oral contraceptive pill was the most significant risk factor in our study (odds ratio 14.667, 95% confidence interval 3.001-71.678, P<0.001). Most other features failed to discriminate between cases and controls, although there was a trend towards increased heart rate in cases. Pulmonary embolism is perhaps the most common presenting spontaneous venous thromboembolism in the community and teenage girls on the oral contraceptive pill are most at-risk amongst children. The clinical signs and symptoms are often non-specific. Additional larger studies are required to determine the significance and magnitude of potential clinical predictors identified in this study. This may lead to derivation of a paediatric-specific pre-test probability tool.

Research paper thumbnail of Assessment and Interpretation of Bone Trauma in Children

Gall/Current Practice in Forensic Medicine, 2011

Research paper thumbnail of What are the greatest challenges or barriers to applying postmortem imaging in paediatric radiology?

Pediatric radiology, 2015

Research paper thumbnail of Targeting the Causes of Intractable Chronic Constipation in Children: The Nuclear Transit Study (NTS)

Radioisotopes - Applications in Bio-Medical Science, 2011

Research paper thumbnail of Another international imaging society—to what end?

Pediatric Radiology, 2014

Pediatr Radiol (2014) 44:636–638 DOI 10.1007/s00247-014-2939-7 MINISYMPOSIUM Another internationa... more Pediatr Radiol (2014) 44:636–638 DOI 10.1007/s00247-014-2939-7 MINISYMPOSIUM Another international imaging society—to what end? The World Federation of Pediatric Imaging: one voice, a common message, a unified network Amanda Dehaye & Timothy Cain & Maria Ines Boechat Received: 26 November 2013 / Accepted: 13 February 2014 # Springer-Verlag Berlin Heidelberg 2014 The foundations of the World Federation of Pediatric Imaging were laid during the first International Symposium on Pediat- ric Imaging held in Rio de Janeiro in 2009. Pediatric radiolo- gists from all over the world came together to share their knowledge with colleagues. A global movement was born to better integrate the existing international societies of pediatric imaging with regional and local organizations and to unite voices advocating for universal access to appropriate pediatric imaging (Fig. 1). Created in 2011, the World Federation of Pediatric Imaging (WFPI) works to unite pediatric imaging organizations to form one voice, a common message, and a unified network in addressing the global challenges of pedi- atric imaging. The tremendous disparities in pediatric imaging practices and resources served as an incentive to pool the substantial resources of existing societies. These societies had a common purpose but lacked coordination of efforts to advocate side- by-side for the inclusion of pediatric imaging as a sub- speciality in the care of children worldwide. Diagnostic imag- ing services in modern medical settings have evolved enor- mously, but even state-of-the-art health care can overlook the unique needs of children. Dedicated pediatric imaging training A. Dehaye World Federation of Pediatric Imaging, Reston, VA, USA T. Cain Department of Medical Imaging, The Royal Children’s Hospital, Melbourne, Australia M. I. Boechat (*) Department of Radiology, David Geffen School of Medicine at UCLA, CHS B2-252, 10833 Le Conte Ave., Los Angeles, CA 90095, USA e-mail: iboechat@mednet.ucla.edu is quite simply out of reach for most of the lower-resource nations already confronting multiple health challenges. Al- though such nations’ pediatric populations are huge, appro- priate diagnostic imaging services are rarely integrated into national health plans; yet these services save lives. Deployment of a united platform is encapsulated through our membership reach. Longstanding regional societies (founding members the Asian and Oceanic Society for Paediatric Radiolo- gy [AOSPR], European Society of Paediatric Radiology [ESPR], Latin American Society of Pediatric Radiology [SLARP] and The Society for Pediatric Radiology [SPR]) were rapidly joined by the newly created African Society of Paediatric Imaging at a governance level. At a national level, our numbers include a range of societies well-established in Europe, the Indian Society of Paediatric Radiology and two other groups from Africa, the latest in Nigeria (SPIN), established on the impetus of the WFPI. We will continue to expand our participant base through reaching out to pediatric imaging societies and pediatric interest groups across the world. The goal is to broaden representation and pool available resources, not to replace the activities of the existing societies (Fig. 2). Sealing federation between individual physician members of these societies is commensurate with the rising trajectory of the WFPI. Recent ventures include cross-regional WFPI rep- resentation in World Health Organization meetings on patient safety and international collaboration in education and out- reach projects, as described in subsequent articles in this issue of the journal. Our Web site and newsletters are windows to these efforts, reflecting burgeoning global stewardship as traction is gained. To address the global challenges in pediatric imaging, we will continue to participate in global forums via robust col- laboration with the world’s major health organizations. Our Web site was launched in March 2013 (www.wfpiweb.org),

Research paper thumbnail of Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians

BMJ (Clinical research ed.), Jan 21, 2013

To assess the cancer risk in children and adolescents following exposure to low dose ionising rad... more To assess the cancer risk in children and adolescents following exposure to low dose ionising radiation from diagnostic computed tomography (CT) scans. Population based, cohort, data linkage study in Australia. COHORT MEMBERS: 10.9 million people identified from Australian Medicare records, aged 0-19 years on 1 January 1985 or born between 1 January 1985 and 31 December 2005; all exposures to CT scans funded by Medicare during 1985-2005 were identified for this cohort. Cancers diagnosed in cohort members up to 31 December 2007 were obtained through linkage to national cancer records. Cancer incidence rates in individuals exposed to a CT scan more than one year before any cancer diagnosis, compared with cancer incidence rates in unexposed individuals. 60,674 cancers were recorded, including 3150 in 680,211 people exposed to a CT scan at least one year before any cancer diagnosis. The mean duration of follow-up after exposure was 9.5 years. Overall cancer incidence was 24% greater for...

Research paper thumbnail of A Comparative Study of Three Methods of Nasal Irrigation

The Laryngoscope, 2004

To assess the effectiveness of three methods of nasal irrigation on distributing saline to the na... more To assess the effectiveness of three methods of nasal irrigation on distributing saline to the nasal cavity and paranasal sinuses. : A prospective, cross-over study. Twelve subjects (9 patients with chronic sinusitis after functional endoscopic sinus surgery and 3 healthy controls) underwent nasal irrigation with normal saline containing Technetium 99m sulfur colloid. The distribution of radioactivity was assessed on each subject after three different irrigation techniques: metered nasal spray, nebulization with RinoFlow, and nasal douching while kneeling with the head on the floor. The nasal cavity was well irrigated by all three techniques. Compared with the other two methods, douching was significantly more effective in penetrating the maxillary sinus (P = .036) and frontal recess (P = .003). The sphenoid and frontal sinuses were poorly irrigated by all three techniques. Nasal douches are more effective in distributing irrigation solution to the maxillary sinus and frontal recess. This should be the method of choice for irrigating these areas.

Research paper thumbnail of Dear sir,: re: Nuclear Medicine and Diagnostic Radiologists

Australasian Radiology, 1992

Research paper thumbnail of 2D versus 3D imaging of hip displacement in children with cerebral palsy

Developmental Medicine & Child Neurology, 2011

Research paper thumbnail of To x-ray or not to x-ray? Screening asymptomatic children for pulmonary TB: a retrospective audit

Archives of Disease in Childhood, 2013

Recent studies found that a chest x-ray (CXR) has limited value in the assessment of asymptomatic... more Recent studies found that a chest x-ray (CXR) has limited value in the assessment of asymptomatic adults with tuberculosis (TB) infection. We aimed to determine in asymptomatic children with a positive tuberculin skin test and/or interferon-γ release assay (TST/IGRA) whether a CXR identifies findings suggestive of pulmonary TB. All children with TB infection (defined as TST ≥10 mm and/or positive IGRA) presenting to The Royal Children's Hospital Melbourne during a 54-month period were included. All CXRs were reviewed by a senior radiologist blinded to the clinical details. The medical records of those with radiological abnormalities suggestive of TB were examined to identify those who were asymptomatic when the CXR was done. Demographical data were also collected. CXRs were available for 268 of 330 TB-infected children, of whom 60 had CXR findings suggestive of TB. Of the 57 for whom clinical details were available, 26 were asymptomatic. Of these asymptomatic children with radiological abnormalities suggestive of TB, 6 had CXR findings suggestive of active TB, 14 had CXR findings suggestive of prior TB and 6 had isolated non-calcified hilar lymphadenopathy. The six with findings suggestive of active TB represented 2.6% (95% CI 0.9 to 5.5%) of asymptomatic TST/IGRA-positive children with evaluable CXRs. One child with isolated hilar lymphadenopathy had microbiologically-confirmed TB. In contrast to the results from studies in adults, a CXR identified a small but noteworthy number of children with findings suggestive of pulmonary TB in the absence of clinical symptoms.

Research paper thumbnail of A comparative study of three methods of nasal irrigation

The …, 2004

Materials and Methods: Twelve subjects (9 patients with chronic sinusitis after functional endosc... more Materials and Methods: Twelve subjects (9 patients with chronic sinusitis after functional endoscopic sinus surgery and 3 healthy controls) underwent nasal irrigation with normal saline containing Technetium 99m sulfur colloid. The distribution of radioactivity was assessed on each ...