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Biomedical subjects

Jeffrey Traubici

Publications and source records attributed to Jeffrey Traubici.

13 recordsLinked to original sources
PubMed2007

Pulmonary nodular opacities in children with hereditary hemorrhagic telangiectasia.

BACKGROUND: Hereditary hemorrhagic telangiectasia (HHT) is a rare inherited disorder of vascular endothelium that can result in the formation of pulmonary arteriovenous malformations (pAVMs). We observed that small pulmonary nodules, possibly representing early vascular malformations, are more common in these children than in the general population. OBJECTIVE: To describe and characterize the small pulmonary nodules seen on chest CT examination in the lungs of children with HHT. MATERIALS AND METHODS: We followed 19 children who had undergone chest CT as part of their initial diagnostic evaluation in the HHT clinic of a pediatric hospital. Chest CT scans were reviewed independently by two radiologists blinded to clinical data. Pulmonary nodules were analyzed according to lobar distribution, anatomic position in the lung (outer, mid, inner third), shape (round, linear, V- or Y-shaped, ill-defined), presence of overt AVMs, and nodule size ( 5 mm). We also reviewed a control group of chest CT scans performed on 25 age-matched children. RESULTS: A total of 35 pulmonary nodules were identified on the CT scans in 15 of the 19 children. Multiple nodules were seen in eight children (42%), solitary nodules were seen in seven children (37%) and no nodules were seen in the remaining four children (21%). The nodules were found to be nonspecific with regard to multiple factors other than their anatomic position within the lung. The chest CT scans of 2 of the 25 age-matched controls revealed a total of only four nodules, a significantly lower total (P = 0.0001 vs. children with HHT). CONCLUSION: Nonspecific nodules are commonly seen in children with HHT.

Adolescent↗
PubMed2006

Approach to diagnosis and treatment of pediatric primary tumors of the diaphragm.

BACKGROUND/PURPOSE: Tumors of the diaphragm in the pediatric population are extremely rare. We present 5 cases diagnosed at the Hospital for Sick Children, Toronto, and together with a review of the world literature, provide an approach to the diagnosis and management of these tumors. METHODS: A clinical retrospective review of patients diagnosed as having primary diaphragmatic tumor (PDT) at the Hospital for Sick Children as well as a review of the world literature. RESULTS: Forty-one cases of PDT in the pediatric population have been described from 1868 to 2005 inclusive. There is an equal incidence in boys and girls, they are found with the same frequency on the left as on the right, and 78% are malignant. Rhabdomyosarcoma is the most commonly occurring malignant tumor. The mean age at diagnosis is 10 years. "Chest-associated" symptoms are more common than "abdomen-associated" symptoms. Imaging often fails to identify the site of origin as the diaphragm. Surgery is the cornerstone of therapy for PDT. CONCLUSION: A multidisciplinary team approach is needed for successful treatment and management of PDT.

Abdomen↗
PubMed2006

Safety of power injector use in children as measured by incidence of extravasation.

OBJECTIVE: The purpose of this study was to assess the safety of power injector use in peripheral IV injections for CT examinations of children by measuring the incidence of contrast extravasation and to review the management of extravasation as reported in the literature. SUBJECTS AND METHODS: At a tertiary pediatric center, we prospectively collected data on 557 children undergoing CT with IV contrast injection by power injector through a peripheral venous line. Data collected included age, weight, angiocatheter size, location of venous access, flow rate, total contrast volume, maximum injector pressure, and incidence of extravasation. Adverse effects such as emesis, sensation of warmth, hives, and allergies and anaphylaxis also were recorded. RESULTS: The patients' ages ranged from 13 days to 20 years (mean, 9.8 years). The size of angiocatheter most commonly used was 22 gauge (n = 443). The dorsum of the hand was the most common site of venous access (n = 373). The mean flow rate was 1.48 mL/s. When the patients were divided into groups on the basis of reaction or no reaction, statistical differences between the groups were found with respect to flow rate (p = 0.016) and pressure (p = 0.017) needed for injection. There were two episode of extravasation (0.3%), which were treated conservatively. CONCLUSION: The use of power injectors through 18- to 24-gauge angiocatheters in children is safe when meticulous technique is used and personnel are appropriately trained. Our study showed a similar rate of extravasation as has been reported in other studies.

Adolescent↗
PubMed2004

Primary germ cell tumor of the diaphragm.

The authors present a case of a 2-year-old boy with an abdominal mass, which was later found to be a yolk sac tumor arising from the diaphragm. To the authors' knowledge there has been only 1 previous report of a germ cell tumor arising from the diaphragm. This case illustrates the imaging findings in this rare tumor and how it could be confused with a primary liver neoplasm.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2003

Intravascular linear thrombus after catheter removal: sonographic appearance mimicking retained catheter fragment.

BACKGROUND: A common complication of central catheters is vascular thrombosis. We have observed that the remaining thrombus can sonographically simulate the appearance of the catheter itself, suggesting that the catheter may have broken. OBJECTIVE: To describe the difference in the sonographic appearance of an intravascular linear thrombus and a retained catheter. PATIENTS AND METHODS: The study comprised 11 infants who were born between 1 January 2000 and 31 December 2001 and had at least one sonographic examination after removal of a central venous or arterial catheter, in whom a residual thrombus had a sonographic appearance simulating the appearance of the catheter itself. RESULTS: In all of our cases the thrombus appeared as two parallel hyperechoic lines. In comparison to the sonographic appearance of a true catheter, these lines were less sharply demarcated, not quite geometrically parallel, less echogenic, and did not shadow or have reverberation artifacts. CONCLUSIONS: Although the sonographic appearance of a residual linear thrombus may closely resemble the sonographic appearance of a retained catheter fragment, appreciation of the subtle differences between the two is important, and could obviate the necessity for more invasive procedures.

Catheterization, Central Venous↗
PubMed2003

Vesicoureteral reflux in infants with isolated antenatal hydronephrosis.

Standardized evaluation of all newborns with antenatally recognized hydronephrosis (ANH) at The Hospital for Sick Children (HSC) has included voiding cystourethrography (VCUG). This paper reviews this protocol to determine: (1) the prevalence of vesicoureteral reflux (VUR) in isolated ANH and (2) the value of performing VCUG in cases of mild hydronephrosis, defined as renal pelvis dilatation <10 mm on postnatal ultrasonography (US). A retrospective chart review was performed on infants referred with ANH. The inclusion criterion was isolated ANH. Exclusion criteria were (1) presence of additional genitourinary abnormalities and (2) no VCUG. Pelviectasis was categorized according to the anteroposterior diameter of the renal pelvis. There were 111 infants with isolated ANH. All except 3 underwent VCUG. There were 68 children (63%) with normal postnatal US or mild pelviectasis (<10 mm). VUR was detected in 16 patients, of whom 10 had mild or absent pelvic dilatation. There was no correlation between the degree of pelviectasis on postnatal US and the presence or severity of VUR ( P=0.567 and P=0.802). VUR was detected in 15% of children with isolated ANH, many of whom had normal postnatal US or mild postnatal pelviectasis. VCUG is the only reliable test for detecting postnatal VUR.

Adult↗
PubMed2003

Original report. Testicular torsion in neonates and infants: sonographic features in 30 patients.

OBJECTIVE: The purpose of this study was to illustrate the spectrum of sonographic findings in testicular torsion in a large series of neonates and infants. These patterns and their evolution have, to our knowledge, not been described previously. CONCLUSION: The sonographic appearance of testicular torsion in neonates and infants can be divided into three types. We believe that the findings represent different stages in the evolution of testicular torsion.

Blood Flow Velocity↗
PubMed2002

CT diagnosis of traumatic bronchial rupture in children.

Bronchial rupture is a rare and serious complication of blunt chest trauma in children. The diagnosis of this injury is challenging and requires a high degree of clinical suspicion. It is frequently associated with other severe injuries that may draw the focus of attention away from this potentially catastrophic but treatable injury. The radiographic findings of bronchial rupture have been reported in very few series. We report the findings in two children with bronchial rupture diagnosed by CT, in whom CT resulted in a significant change in patient management.

Accidents, Traffic↗
PubMed2002

Mesenteric lymphatic malformation associated with small-bowel volvulus - two cases and a review of the literature.

Cystic mesenteric lymphatic malformations are uncommon abdominal masses, which can cause abdominal signs and symptoms for a wide variety of reasons. Symptoms owing to volvulus are uncommon and have not been illustrated previously in the radiology literature. We present two cases to illustrate volvulus as a complication of mesenteric lymphatic malformations and how imaging can aid in the diagnosis of this complication. While uncommon, volvulus should be considered in any child with sonographic findings of an abdominal lymphatic malformation and acute abdominal pain.

Abnormalities, Multiple↗
PubMed2002

Reliability of contrast enhanced sonography with harmonic imaging for detecting early renal scarring in experimental pyelonephritis in a porcine model: preliminary results.

PURPOSE: Contrast medium enhanced harmonic ultrasound is a recently developed ultrasound technique that improves the assessment of renal parenchymal vascularity. We performed a preliminary study to define the ability of contrast enhanced ultrasound with harmonic imaging to detect and localize renal scars in a porcine model of experimentally induced pyelonephritis. MATERIALS AND METHODS: Vesicoureteral reflux was surgically induced in 10 pigs weighing 10 kg. with the contralateral kidney serving as a control. Approximately 4 weeks after the creation of vesicoureteral reflux cystography confirmed reflux. Infection was induced by placing a suspension of paraffin broth impregnated with Escherichia coli in the bladder of each pig. At 4 to 8 weeks (mean 6.5) after the induction of infection a radiologist blinded to the side of the previous procedure performed conventional gray scale ultrasound, color Doppler ultrasound and contrast enhanced ultrasound with harmonic power imaging. The animals were sacrificed; the kidneys were inspected and tissues from the upper, mid and lower poles were sent for culture and histological examination. Histology results were compared with the findings of the 3 ultrasound modalities. RESULTS: All 10 pigs survived the surgical procedures with no complications. Post-contrast harmonic ultrasound images were available in 9 pigs (18 renal units). Harmonic ultrasound revealed decreased blood flow in 11 renal units, including the upper pole in 7, lower pole in 3, and upper and lower poles in 2. Renal tissue cultures were positive in 11 renal units (6 refluxing units). Histological findings revealed fibrosis in 10 renal units (8 refluxing units). Harmonic ultrasound findings in these 10 renal units showed 9 with changes consistent with inflammation or scars. Using histological results as the gold standard for renal injury harmonic ultrasound was more sensitive than gray scale ultrasound for detecting renal injury with 90% sensitivity, 75% specificity, 81% positive predictive value and 85% negative predictive value. CONCLUSIONS: Preliminary results indicate that contrast enhanced ultrasound with harmonic imaging is a sensitive method for determining renal scarring without the need for radiation exposure. It may be prove to be a useful adjunct for evaluating children who present with urinary tract infection.

Animals↗
PubMedDate not supplied

Mercury intoxication: it still exists.

A3-year-old boy presented to the Hospital for Sick Children with systemic symptoms and oropharyngeal and peripheral extremity changes suggestive of Kawasaki disease. He was found to have severe hypertension. Investigation for a catecholamine-secreting tumor was negative. Toxins were considered when the patient's 20-month-old brother presented with similar symptoms, and the boys were subsequently diagnosed with elemental mercury poisoning. We review the literature on mercury intoxication and discuss the historical context, clinical syndrome (acrodynia), treatment, and radiologic findings of this unusual diagnosis.

Acrodynia↗