PubMed Health⌕ Search

Biomedical subjects

V Martich

Publications and source records attributed to V Martich.

5 recordsLinked to original sources

Sclerosis of the mastoid air cells as an indicator of undiagnosed otitis media in children with Down's syndrome.

We hypothesized that many children with Down's syndrome have undiagnosed otitis media. In a 1989 study of lateral neck radiographs of 22 children with Down's syndrome, we found that 64% had sclerosis of the mastoid air cells, indicating untreated or inadequately treated otitis media. We reviewed the lateral neck radiographs of 53 children with Down's syndrome and interviewed their parents regarding the diagnosis of otitis media. Mastoid air cells were found to be sclerotic in 22 (42%) of study subjects; 32% of these had no known history of otitis media. For the 68% of children diagnosed as having had otitis media, the most common symptoms were fever (61%) and cough or coryza (58%). Sclerosis of the mastoid processes was not associated with a high frequency of otitis media (> 20 episodes) or a higher frequency of hearing loss, but was associated with subsequent myringotomy and insertion of a ventilatory tube (P = .038). Our finding of sclerotic mastoids in 42% of children with Down's syndrome raises the possibility that children with Down's syndrome have unidentified or inadequately treated episodes of otitis media.

Adolescent↗

Anatomic features of reduced-size liver transplant: postsurgical imaging characteristics.

In this retrospective review, the authors evaluated the anatomic and imaging features of 140 reduced-size liver transplants in 120 boys and girls; 100 of these patients (83.3%) were 2 years old or younger. The authors reviewed the surgical reports, plain radiographs, contrast material-enhanced studies of the gastrointestinal tract, duplex Doppler and color Doppler ultrasound (US) scans, and computed tomographic (CT) scans. Understanding the anatomic features associated with transplantation was crucial to understanding the post-surgical imaging characteristics. Changes in visceral anatomic structure caused a variety of imaging appearances, some of them misleading: (a) Some patients had unusual bowel gas patterns on plain radiographs because of a shift in location by bowel loops; (b) gastrointestinal studies showed gastric compression by an oversized left lobe that mimicked mass effect; and (c) displacement or migration of the duodenum, jejunum, or cecum into the right hepatic fossa sometimes mimicked malrotation. Pitfalls were created by fluid and gas collections at the transected edge. US and CT were often used to further assess anatomic structures after surgery; color Doppler was especially helpful in vascular localization.

Adolescent↗

Hypoplastic posterior arch of C-1 in children with Down syndrome: a double jeopardy.

Radiographs of 38 children with Down syndrome (aged 2-3 years) were retrospectively evaluated for hypoplasia of the posterior arch of the C-1 vertebra. The anteroposterior dimensions of the posterior arch of C-1 were measured and compared with those of an age- and sex-matched control group. The posterior arches of C-2 to C-5 were similarly evaluated. Radiographs demonstrated hypoplasia of the posterior arch of C-1 in 26%. This anomaly of C-1 was an isolated event; sagittal diameters of C-2 to C-5 were within normal limits compared with those of the control group and published standards. Because of the known, potentially devastating atlantoaxial dislocation in Down syndrome, the increased prevalence of a second C-1 anomaly causing preexistent narrowing of the vertebral canal is of clinical concern. A hypoplastic posterior arch of C-1 may amplify the risk of spinal cord damage following atlantoaxial subluxation, as the subsequently smaller vertebral canal has less room for dorsal movement of the odontoid process. This potential "double jeopardy" of C-1 vertebral abnormalities should be recognized and assessed on cervical spine screening radiographs in children with Down syndrome.

Cervical Vertebrae↗