(Press-News.org) OAK BROOK, Ill. – Computed tomography (CT) utilization in pediatric patients with non-traumatic abdominal pain increased in emergency departments each year between 1999 and 2007, according to a new study published online in the journal Radiology. The study authors found no corresponding increase in ultrasound use during the same period, despite research supporting it as an important diagnostic tool for assessing pediatric abdominal pain.
Non-traumatic abdominal pain is a common source of pediatric visits to the emergency department. Physicians often order CT exams when abdominal pain suggests appendicitis. While CT scans provide rapid, accurate diagnosis, they expose patients to ionizing radiation—an important consideration for children due to their longer life expectancy and increased susceptibility to radiation effects.
"Our findings help give us an overall understanding of places where we can tackle disparities of use and disparities in care," said Anastasia L. Hryhorczuk, M.D., clinical fellow at Children's Hospital Boston. "Ideally, we'd like to see the same standard of care being applied across the country to protect children from unnecessary radiation exposure."
Research has shown that step-by-step evaluations of pediatric patients, beginning with ultrasound and proceeding to CT if ultrasound is negative or uncertain, is the most accurate path for diagnosing appendicitis. Dr. Hryhorczuk and colleagues sought to determine if this strategy had been incorporated into general emergency department practices.
For the study, researchers looked at data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) to evaluate imaging utilization among children with acute abdominal pain in U.S. emergency departments.
From 1999 to 2007, there were 16,900,000 pediatric emergency department visits for acute abdominal pain. The odds of a child receiving a CT scan increased during each year of the study period, despite the fact that there were no statistically significant changes in ultrasound usage, numbers of patients admitted to the hospital, or numbers of patients with acute appendicitis. Only three percent of patients ultimately diagnosed with appendicitis were imaged with both ultrasound and CT.
Children evaluated in pediatric emergency departments were more than 25 percent less likely than those seen at general emergency departments to undergo CT imaging for abdominal pain.
"In a pediatric setting, clinicians may have skills for evaluating patients that favor management without imaging, lowering CT usage," Dr. Hryhorczuk said.
Statistical analysis demonstrated increased odds of CT use in teens, white patients, the Midwest region, urban settings, patients with private insurance, and patients who were admitted or transferred.
Although the study did not investigate reasons for these variations, Dr. Hryhorczuk pointed out that CT scanners are readily available in hospitals, whereas access to ultrasound may be limited based on operator availability in some areas. The local legal climate also may play a factor in obtaining imaging exams, according to the study, as appendicitis diagnoses are a source of lawsuits in the pediatric emergency setting.
The time period of the study predates "Image Gently," a 2008 initiative of the Alliance for Radiation Safety in Pediatric Imaging that promotes radiation safety in the imaging of children. The researchers hope that further investigation of NHAMCS data will provide more information on the success of this and other programs aimed at lowering medical radiation exposure in children.
###
"Pediatric Abdominal Pain: Use of Imaging in the Emergency Department in the United States from 1999 to 2007." Collaborating with Dr. Hryhorczuk were Rebekah C. Mannix, M.D., M.P.H., and George A. Taylor, M.D.
Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc. (http://radiology.rsna.org/)
RSNA is an association of more than 48,000 radiologists, radiation oncologists, medical physicists and related scientists committed to excellence in patient care through education and research. The Society is based in Oak Brook, Ill. (RSNA.org)
For patient-friendly information on pediatric CT, visit RadiologyInfo.org.
END
DURHAM, N.C. -- Children who have experienced violence might really be older than their years. The DNA of 10-year-olds who experienced violence in their young lives has been found to show wear and tear normally associated with aging, a Duke University study has found.
"This is the first time it has been shown that our telomeres can shorten at a faster rate even at a really young age, while kids are still experiencing stress," said Idan Shalev, a post-doctoral researcher in psychology and neuroscience at the Duke Institute for Genome Sciences & Policy.
Telomeres are ...
New research by scientists at the University of Cambridge suggests that chronic cocaine abuse accelerates the process of brain ageing. The study, published today 25 April in Molecular Psychiatry, found that age-related loss of grey matter in the brain is greater in people who are dependent on cocaine than in the healthy population.
For the study, the researchers scanned the brains of 120 people with similar age, gender and verbal IQ. Half of the individuals had a dependence on cocaine while the other 60 had no history of substance abuse disorders.
The researchers ...
DETROIT – Robot-assisted surgery is now both more common and far more successful than radical "open" surgery to treat prostate cancer in the United States, according to a new Henry Ford Hospital study published in the current issue of the medical journal European Urology.
The research, led by scientists at Henry Ford Hospital's Vattikuti Urology Institute (VUI), is the first to compare in a nationwide population sample the results of robot-assisted radical prostatectomy (RARP) to the standard surgical procedure, open radical prostatectomy (ORP).
The researchers found, ...
The new release of the linear stock-cutting optimization add-in (1DCutX) for Excel from Optimalon Software got two major improvements. Users can now minimize the number of different cutting layouts generated by 1DCutX and perform the material cutting calculation in a highly customised way using VBA language in Microsoft Excel.
Denis Smirnov, from Optimalon explains: "When 1DCutX calculates how to cut linear stocks with minimal material waste, it generates a list of cutting layouts. Several stocks can be cut simultaneously instead of one by one. The fewer layouts ...
Southwest Solutions Group has been selected as an exclusive field sales and service organization for KardexRemstar products. Services include layout and design, installation, relocations, parts, and routine service and preventative maintenance agreements for KardexRemstar products. Products include Vertical Lift Modules (VLM), Vertical Storage and Retrieval Carousels (VSR), and Lektriever Series 80, 90, 2000 electric filing cabinets throughout the states of Texas, Oklahoma, Arkansas, Louisiana, and Mississippi. "As a full service KardexRemstar Dealer, we are pleased ...
Kai Goulbourne is only eleven years old, but his life could be cut short if a matching bone marrow donor is not found soon.
He was originally diagnosed in December of 2009, when his mom Shelley and Dad noticed, that despite having a healthy appetite, he appeared to be losing weight. Testing and examinations revealed an enlarged spleen, and he was diagnosed as having Chronic Myelogenous Leukemia.
It is largely a genetic disorder where the white blood cells proliferate out of the bone marrow where they are formed to enter into the blood stream.
Kai was treated with ...
The Renaissance Austin Hotel, the centerpiece of the Arboretum at Great Hills, a premier shopping and dining destination, will further enhance the area's stunning landscaped setting with a complete property renovation slated to begin in October. Renaissance Hotels is the signature lifestyle brand within the Marriott International, Inc. family of brands.
Flick-Mars Design has been tapped by the new owners of the hotel, Inland American Lodging Advisors, Inc., to reinvent the space within the AAA four-diamond hotel, including its guest rooms, public spaces, restaurants, ...
Master Life Invest announced today that Ms. Janine Armen has joined the Alternative Investment teams as Senior Client Relations Manager and Product Director. Ms. Janine Armen will be responsible for developing and managing all products, client portfolio strategy and new markets strategy for the Alternatives and Multi-Asset investment products and will report to Mr. Ito Fuyi, Chairman and Chief investment officer for Master Life Invest.
"Increasingly investors are looking for more sophisticated strategies to manage volatility, deliver returns and diversify their portfolios. ...
The New Mexico Gay Men's Chorus is pleased to announce it's Spring 2012 Pride Concerts, "There's Only Us" June 22 and 23 in Albuquerque, NM, and the 24 in Sante Fe, NM. The proceeds of the concerts are used in support of Music and the Arts in New Mexico and within the New Mexico LGBT Community.
The New Mexico Gay Mens Chorus (NMGMC) strives to be an empowering voice for the LGBT and Performing Arts community and aspires to enrich our greater New Mexican community through our choral excellence. We believe that our strength grows as we add voice to voice, and ...
Victoria's Fine Jewelry, a leading diamond engagement ring jeweler located in Rockport, TX today announced that they have begun providing the Iddeal Star diamonds to the Rockport/Corpus Christi, TX area.
The Iddeal Star diamonds from International Diamond Distributors (IDD) are a new twist on an age-old concept of providing "big look for a small price." They are not to be confused with the industry standard "Ideal cut" diamonds - which are cut to a specific measure and specification. These diamond mountings use a smaller mid-stone diamond surrounded ...
