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Biomedical subjects

T L Slovis

Publications and source records attributed to T L Slovis.

At least 91 records · Page 5Linked to original sources
PubMed1984

Ultrasound in the evaluation of hypoxic-ischemic injury and intracranial hemorrhage in neonates: the state of the art.

The ultrasonic diagnosis of hypoxic-ischemic injury and intracranial hemorrhage in neonates is reviewed. The technical and pertinent anatomical data are presented. The need to diagnose parenchymal lesions is emphasized. A sonographic classification as well as current recommendations for evaluation of intracranial contents in neonates suspected of hypoxic-ischemic injury and/or hemorrhage are presented.

Brain↗
PubMed1984

Trauma to the bones of small infants from passive exercise: a factor in the etiology of child abuse.

Four infants, three premature and one term, developed serious bony injury from parent- or caretaker-administered passive exercises. In the three infants born prematurely, the exercise program was prescribed by neonatal intensive care unit staff before discharge; in the fourth infant, the babysitter initiated the program. In each case the passive exercise was begun to diminish actual or presumed muscle tightness. When these infants were presented to the physician with a serious traumatic injury between the ages of 4 and 10 months, the presumptive diagnosis of child abuse was made after radiologic assessment revealed multiple bone injuries. The several traumatic injuries to bones resulting from the home-administered physical therapy were most impressive. Passive exercise in three of the four infants was a significant factor in the cause of their injuries. Caution must be used in prescribing this form of "therapy" in small infants.

Bone and Bones↗
PubMed1984

Intracranial hemorrhage in the hypoxic-ischemic infant: ultrasound demonstration of unusual complications.

Seven neonates (four preterm and three term) with severe hypoxic-ischemic parenchymal brain changes are presented to illustrate the kinds of parenchymal lesions demonstrable on ultrasound, to show the similarity of parenchymal lesions in preterm and term infants, and to correlate the severe neurologic deficits with the parenchymal changes. The lesions demonstrated are periventricular leukomalacia, large-vessel infarction, isolated parenchymal hemorrhage, multiple cystic encephalomalacia, and parenchymal atrophy. Parenchymal changes should be sought in such infants during any stage of their disease.

Brain↗
PubMed1984

Renal transplant rejection: sonographic evaluation in children.

The ability to detect renal rejection sonographically was studied in 42 pediatric renal transplant patients over a 33-month period. Sonography was not helpful in detecting rejection when the donor was less than five years of age. When the donor was over five years of age, a combination of sonographic findings allowed detection of rejection with a greater specificity than has been reported previously. The combination of three or more of the sonographic findings (increased renal volume 30% over the baseline value; enlarged, broadened, rectangular medullary pyramids [rays]; a reduction or absence of the central sinus echoes, and altered echogenicity in the renal parenchyma) indicated rejection with 97% specificity and 58% sensitivity. Radionuclide imaging with Tc-99m DTPA gave approximately the same sensitivity (60%) but was less specific (88%). By excluding rejection with the absence of the sonographic findings, it was possible to suggest acute tubular necrosis in some patients. It was also possible to detect the complications of renal transplantation, but sonography did not detect small ruptures of the kidney as a part of the rejection phenomenon.

Adolescent↗
PubMed1984

Effect of prophylactic phenobarbital on intraventricular hemorrhage in high-risk infants.

Forty-two premature infants less than 24 hours of age, with normal admission echoencephalograms, were randomly assigned to control or phenobarbital treatment groups. Infants in the treated group received two loading doses of 10 mg/kg of phenobarbital 12 hours apart, followed by a maintenance dose of 2.5 mg/kg every 12 hours for 6 days. Serial echoencephalograms were obtained in both groups. The groups were comparable with regard to birth weight, gestational age, and potential risk factors for subependymal-intraventricular hemorrhage. Ten infants (48%) in each group developed hemorrhage. The hemorrhages in the phenobarbital-treated group were significantly less severe than those in the control group. The phenobarbital-treated infants who bled, however, were also significantly larger and more mature than control infants who bled. The results of this study indicate no effect of phenobarbital on the incidence of subependymal-intraventricular hemorrhage, but a possible beneficial effect on the severity of hemorrhage.

Cerebral Hemorrhage↗
PubMed1983

Neonatal kidneys: sonographic anatomic correlation.

The ultrasound appearances of the neonatal and adult kidney contrast dramatically. In the normal kidney of a newborn infant, the echogenicity of the renal cortex equals that of the liver. To determine the morphological reasons for the unique and specific sonographic findings, we performed a quantitative anatomic analysis of the components of the kidney on autopsy specimens from four neonates. Our analysis reveals that the glomeruli occupy proportionally a much greater volume of the renal cortex during the first two months of life (18% as compared with 8.6% in the adult). Other anatomic differences include the greater proportional volume of the cellular component of the glomerular tuft in the neonate, and the location of 20% of the loops of Henle within the neonatal cortex rather than in the medulla. The increased number of anatomical structures, and thus interfaces, undoubtedly accounts for the increased echogenicity. The neonatal kidney often demonstrates prominent and hypoechoic renal pyramids. This may be explained by the larger volume of medulla in the neonatal kidney, which results in a ratio of cortex to medulla of 1.64:1 in the neonate as compared with a ratio of 2.59:1 in the adult. There is also a noted lack of echogenicity in the renal sinus region in neonates. Anatomically this is secondary to the absence of renal sinus adipose tissue in the kidney of the neonate.

Adult↗
PubMed1982

Meconium peritonitis, intraperitoneal calcifications and cystic fibrosis.

Twelve cases of meconium peritonitis were retrospectively reviewed in this study. Five of these patients had cystic fibrosis. Of the patients with cystic fibrosis, intraperitoneal calcifications were present in three (60%) and two (40%) had none. All seven patients (100%) who had meconium peritonitis without cystic fibrosis had abdominal calcifications. These results indicate that the presence of intraperitoneal calcifications does not exclude the diagnosis of cystic fibrosis and that the absence of calcification favors cystic fibrosis. However, a review of the literature indicates the absence of calcification is merely of clue and not definitive as to the etiology of the meconium peritonitis.

Calcinosis↗
PubMed1982

Sonographic classification of intracranial hemorrhage. A prognostic indicator of mortality, morbidity, and short-term neurologic outcome.

Sixty-two neonates diagnosed to have periventricular-intraventricular hemorrhage were classified by sonographic findings as follows: mild, confined to the subependymal region or accompanied by a small amount of blood in the normal-sized lateral ventricle (10); moderate, intermediate amount of blood in the enlarged lateral ventricle (26); and severe, hemorrhage filling the entire ventricle forming a cast (12) or intraventricular hemorrhage with an intracerebral extension (14). Twenty-six of 35 surviving neonates had posthemorrhagic hydrocephalus, and 11 infants required shunt insertion. The survival rate of neonates with periventricular-intraventricular hemorrhage and the incidence of posthemorrhagic hydrocephalus correlated with the severity of the hemorrhage (P less than 0.05). The highest mortality rate was seen in the group with ventricular casts. All surviving neonates with casts developed hydrocephalus. All surviving neonates with intracerebral hemorrhage developed porencephaly. The severity of the hemorrhage correlated with short-term neurologic outcome (P less than 0.05), the group most severely affected being the one with intracerebral extension of hemorrhage. The severity of the hemorrhage also correlated with abnormal ventricular size by sonography on follow-up (P less than 0.05). However, posthemorrhagic hydrocephalus and abnormal ventricular size on follow-up did not correlate with neurologic outcome in the moderate and severe hemorrhage groups.

Cerebral Hemorrhage↗
PubMed1982

Chronic active hepatitis and pregnancy: a report of two cases in adolescence.

The course and outcome of pregnancy in two adolescents with chronic active hepatitis is described. Pregnancy was uneventful in both patients apart from mild biochemical deterioration in one patient. Both infants are entirely normal. One mother died 4 1/2 months after delivery from primary pulmonary hypertension, an extrahepatic manifestation of her chronic active hepatitis. The second patient is asymptomatic but has evidence of ongoing liver disease 26 months postdelivery.

Adolescent↗
PubMed1981

Evaluation of the inferior vena cava by sonography and venography in children with renal and hepatic tumors.

Ultrasonography was used to examine 81 children with intra-abdominal or retroperitoneal malignancies for tumor extension into the inferior vena cava (IVC). In seven of the 18 patients with Wilms tumors and three of the seven patients with hepatic tumors, the IVC ws sonographically abnormal. Venography was also performed in five patients with Wilms tumors. However, percutaneous transfemoral venacavography did not always allow differentiation between extrinsic compression and intracaval tumor. It is suggested that venacavography, when necessary, should be performed via the brachial vein route and that the catheter be advanced into the right atrium. If an injection in this chamber does not result in enough reflux into the retrohepatic IVC for adequate evaluation, the catheter should be advanced into the IVC and a second injection made. However, ultrasonography is the preferred modality for evaluation of the IVC in children because it is the most accurate method and is noninvasive. Real-time ultrasonography makes it possible to distinguish between tumor extension into the lumen of the IVC and extrinsic compression of the vessel.

Child↗
PubMed1981

Real-time sonography of the brain through the anterior fontanelle.

Noninvasive, rapid evaluation of the neonate and young infants with reproducible results is feasible with real-time cranial sonography through the anterior fontanelle. Cerebral anatomy in coronal and sagittal planes is visualized, and the entire ventricular system and adjacent brain parenchyma are identified. This rapid (5-10 min) procedure can be done at/in the incubator making transport of sick neonates unnecessary, thus preserving their thermal stability. Images are recorded on videotape and "hard copy" is obtained afterward. Ventricular size, intracranial hemorrhage (both intraventricular and parenchymal), abnormalities of the the ventricular system, subdural effusion, and fluid-filled lesions are recognized by the usual sonographic criteria. In addition, "solid" parenchymal lesions such as diffuse hemangiomas and brain tumors are depicted as changes in sonographic parenchymal architecture.

Brain↗
PubMed1980

Incidence of cholelithiasis in sickle cell anemia using the ultrasonic gray-scale technique.

Gray-scale ultrasound examination of the gallbladder was successfully performed in 226 patients with sickle cell hemoglobinopathy from 2 to 18 years of age. Sixty-three (27%) demonstrated the presence of gallstones; 14 additional patients had "sludge." The incidence of gallstones increased significantly with age, from 12% in the 2- to 4-year age group to 42% in the 15- to 18-year-old group. The proportion of females with gallstones increased significantly in adolescence. Patients with gallstones had higher mean bilirubin levels, but their mean hemoglobin values and reticulocyte counts were not significantly different from those in patients without gallstones. Ultrasound examination of the gallbladder is a simple, noninvasive technique for evaluating the biliary system. The incidence of gallstones in patients below the age of 10 is higher than expected and raises management questions that must be resolved.

Adolescent↗
PubMed1980

The sonographic evaluation and management of simple renal cysts in children.

Although simple cysts of the kidney are common in adults such lesions are seldom reported in children. The wider application of improving pediatric uroradiology and the increasing diagnostic accuracy of ultrasound allow more frequent recognition and better definition of these lesions. We evaluated the results of non-operative management of simple renal cysts in 7 children between 7 and 13 yars old, seen at this hospital during the last 3 years. A review of the world literature indicates that management of simple renal cysts is predominantly surgical. A non-operative form of diagnosis and followup evaluation of simple renal cysts, using specific ultrasonographic techniques and criteria, are offered as the method of choice for this condition.

Adolescent↗