William A. Cumming

Incidence and description of structural brain abnormalities in newborns exposed to cocaine.

OBJECTIVE This study was undertaken to determine whether an increased incidence of structural brain abnormalities could be demonstrated in newborns exposed to cocaine. STUDY DESIGN This study was part of a prospective, longitudinal study of 154 cocaine users matched to 154 control subjects on prenatal risk level, race, parity, and socioeconomic status. Subjects were enrolled prenatally from a rural public health department population or at delivery. Drug exposure was determined by means of repeated, detailed histories and urine screening for drug metabolites. Ultrasonographic examinations were performed within 4 days of birth by experienced technologists and were read by one experienced radiologist, each blinded to drug use history. RESULTS Cranial ultrasonography results were available for 266 infants (134 cocaine-exposed; 132 control). Only 27 infants had ultrasonography results that were not considered normal, and there were no significant differences between groups (17 cocaine-exposed vs 10 control; p = 0.119). Identified abnormalities included choroid plexus cysts, subependymal cysts, mildly dilated ventricles, and a cyst of the third ventricle. CONCLUSIONS The incidence of abnormal cranial ultrasonography results in our cocaine-exposed group was lower than that previously reported in the literature and not significantly different from the control group. In addition, the identified lesions were less severe than previously reported, despite a wide range of cocaine use in our sample, including heavy use.

An institutional review of the value of computed tomographic angiography in the diagnosis of congenital cardiac malformations.

The ultra-fast, thin-cut computerised tomographic angiogram is an efficient method to diagnose extracardiac lesions associated with congenital cardiac disease. For the purposes of this review, we evaluated various facets of the technique as used in 30 patients who were referred for diagnosis of congenital cardiac disease. The technique had high diagnostic accuracy, with a sensitivity of 93 percent in 15 of these patients referred for either interventional catheterisation or surgery. There were no immediate side-effects associated with the scanning procedure. The scan was also found to be more cost-effective as compared to an alternative noninvasive modality for imaging modality, namely magnetic resonance imaging. The angiographic technique, however, does expose the child to between 2 and 2.5 rems of radiation, despite the short period of scanning, of 10 plus or minus 2 seconds.

SUPRAGLOTTIC AIRWAY INFECTIONS

Supraglottic infections are included among the more serious pediatric infections, although they are less common than other pediatric respiratory infections. Supraglottic infections include epiglottis (supraglottitis), retropharyngeal cellulitis, retropharyngeal abscess, and peritonsillar abscess. A high index of suspicion combined with rapid diagnosis and treatment are crucial to reducing the morbidity and mortality associated with these infections. A review of these infections, including diagnosis and treatment, is presented.

Clinical Fitz-Hugh-Curtis Syndrome in an Adolescent: Ultrasonographic Findings

Correspondence to: Dianne S. Elfenbein, MD, Box J-296, JHMHC, Department of Pediatrics, University of Florida. Gainesville, FL 32160. Received and accepted for publication February 1990. Adolescent female patients infected with Neisseriae gonorrhea or Chlamydia trachomatis are at significantly higher risk of developing pelvic inflammatory disease than are females of any other age group.’ A few of these individuals will develop a syndrome of right upper quad-

Ductus arteriosus aneurysm: an unusual mediastinal mass.

The following is a case report of a ductus arteriosus aneurysm in a newborn. Its various appearance on different imaging modalities, including chest x-ray, computed tomography scan, magnetic resonance imaging, and angiography, are demonstrated. The differential diagnosis of this mediastinal mass, complications related to ductus aneurysms and the appropriate radiographic workup are discussed.

Teleradiology to the intensive care units at Shands Hospital

Abstract not available.

Pisterior hepatodiaphragmatic interposition of the colon complicated by appendicitis

Posterior hepatodiaphragmatic interposition is a rare malposition of the cecum that persists over time but is usually of little or no clinical importance. However, when inflammation occurs in the appendix, the symptoms and signs are those of subphrenic disease rather than abdominal disease and may be misleading to the attending physicians. Radiologists should report the presence of anterior and posterior hepatodiaphragmatic interposition and should differentiate between the two.