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Cystic fibrosis (CF) is one of the most common genetic disorders among the White population. The disease has a progressive course and leads to a reduction in the quality of life and of life expectancy. Standard diagnostic procedures used in the monitoring of CF patients include methods which expose patients to ionizing radiation. With increasing life expectancy in CF the cumulative dose of ionising radiation increases, prompting clinicians' search for safer imaging studies. Despite its safety and availability lung ultrasound (LUS) is not routinely used in the diagnostic evaluation of CF patients. The aim of the study was to evaluate the diagnostic value of LUS in children with CF compared to a chest X-ray, and to assess the diagnostic value of the recently developed LUS score-CF-USS (Cystic Fibrosis Ultrasound Score). LUS was performed in 48 CF children and adolescents aged from 5 to 18 years (24 girls and 24 boys). LUS consisted of the assessment of the pleura, lung sliding, A-line and B-line artefacts, \"lung rockets\", alveolar consolidations, air bronchogram and pleural effusion. Chest radiography was performed in all patients and analyzed according to the modified Chrispin-Norman score. LUS was analyzed according to CF-USS. The correlation between the CF-USS and the modified Chrispin-Norman scores was moderate (R = 0.52, p = 0.0002) and strong in control studies. In 75% of patients undergoing LUS, small areas of subpleural consolidations were observed, which were not visible on x-rays. At the same time, LUS was not sensitive enough to visualize bronchial pathology, which plays an important role in assessing the progression of the disease. Conclusions: LUS constitutes an invaluable tool for the diagnosis of subpleural consolidations. CF-USS results correlate with the conventional x-ray modified Chrispin-Norman score. LUS should be considered a supplementary radiographic examination in the monitoring of CF patients, and CF-USS may provide clinicians with valuable information concerning the progression of the disease.

Cerebral computed tomography angiography is a widely available imaging technique that helps in the diagnosis of vascular pathologies. Contrast administration is needed to accurately assess the arteries. On non-contrast computed tomography, arteries are hardly distinguishable from the brain tissue, therefore, radiologists do not consider this imaging modality appropriate for the evaluation of vascular pathologies. There are known contraindications to administering iodinated contrast media, and in these cases, the patient has to undergo another examination to visualize cerebral arteries, such as magnetic resonance angiography. Deep learning for image segmentation has proven to perform well on medical data for a variety of tasks. The aim of this research was to apply deep learning methods to segment cerebral arteries on non-contrast computed tomography scans and consequently, generate angiographies without the need for contrast administration. The dataset for this research included 131 patients who underwent brain non-contrast computed tomography directly followed by computed tomography with contrast administration. Then, the segmentations of arteries were generated and aligned with non-contrast computed tomography scans. A deep learning model based on the U-net architecture was trained to perform the segmentation of blood vessels on non-contrast computed tomography. An evaluation was performed on separate test data, as well as using cross-validation, reaching Dice coefficients of 0.638 and 0.673, respectively. This study proves that deep learning methods can be leveraged to quickly solve problems that are difficult and time-consuming for a human observer, therefore providing physicians with additional information on the patient. To encourage the further development of similar tools, all code used for this research is publicly available.

Cystic fibrosis is a progressive disease affecting various organs of the human body, including the respiratory system. While the effect of bacterial infection on cystic fibrosis outcome has been comprehensively described, little is known about the impact of viruses. We collected 49 nasopharyngeal swabs derived from cystic fibrosis paediatric patients during pulmonary exacerbation and tested them for the presence of respiratory viruses to elucidate the influence of the viral infection on their clinical outcome. We found that patients infected with a virus, compared to those in whom molecular testing for viruses was negative, are characterised by a better clinical outcome, as measured by the Shwachman–Kulczycki score (p = 0.006) and have better chest radiographs, as indicated by the Brasfield score (p = 0.002). Moreover, these patients have lower C-reactive protein levels (p = 0.002). We assume this unexpected association of better clinical outcomes during viral infection should be studied further.

Children with COVID-19 develop moderate symptoms in most cases. Thus, a proportion of children requires hospital admission. The study aimed to assess the history, clinical and laboratory parameters in children with COVID-19 concerning the severity of respiratory symptoms. The study included 332 children (median age 57 months) with COVID-19. History data, clinical findings, laboratory parameters, treatment, and outcome, were evaluated. Children were compared in the groups that varied in the severity of symptoms of respiratory tract involvement. Children who required oxygen therapy represented 8.73%, and intensive care 1.5% of the whole cohort. Comorbidities were present in 126 patients (37.95%). Factors increasing the risk of oxygen therapy included comorbidities (odds ratio (OR) = 92.39; 95% confidence interval (95% CI) = (4.19; 2036.90); p < 0.00001), dyspnea (OR = 45.81; 95% CI (4.05; 518.21); p < 0.00001), auscultation abnormalities (OR = 34.33; 95% CI (2.59; 454.64); p < 0.00001). Lactate dehydrogenase (LDH) > 280 IU/L and creatinine kinase > 192 IU/L were parameters with a good area under the curve (0.804-LDH) and a positive predictive value (42.9%-CK). The clinical course of COVID-19 was mild to moderate in most patients. Children with comorbidities, dyspnea, or abnormalities on auscultation are at risk of oxygen therapy. Laboratory parameters potentially useful in patients evaluated for the severe course are LDH > 200 IU/L and CK > 192 IU/L.

Objective. The aim of the study based on CT images was to assess the age-related changes in maxillary sinus diameters in relation to diameters of the facial skeleton. Materials and Methods. The retrospective analysis of CT images of the head of 170 patients aged 0–18 years (85 females and 85 males) was performed. Specific orientation points (zy, zm, pr, ns, n, and P) were identified in every patient and the following distances were measured: zy-zy, maximum facial width; zm-zm, midfacial width; n-pr, upper facial height; ns-pr, alveolar facial height; and ns-P, distance not indicated in craniometry. Results. The maxillary sinuses of every patient were bilaterally measured in three planes. Three diameters were obtained: maximum transverse (horizontal) diameter called MSW, maximum vertical diameter called MSH, and maximum anteroposterior diameter (length) called MSL. In females, the correlation of MSW, MSH, and MSL and zy-zy, as well as n-pr distances, is very strong. Moreover, the significant correlation was found between all measurements of maxillary sinus and ns-pr as well as ns-P distances in females. The correlation between MSL and all measurements of midface as well as MSH and MSW and all measurements except ns-P is stronger in females than in males. In males, all measurements of maxillary sinus correlate with ns-P distance very strongly. Conclusions. The statistical analysis (correlation and determination coefficient) showed that all measurements of maxillary sinuses correlate with midface dimensions.

Background and Objectives: Conjugated linoleic acid (CLA) can improve bone health in animals, yet the effects on humans have not been consistent. Therefore, this parallel randomised controlled trial aimed to assess the effect of CLA supplementation on bone mineral density (BMD) and content (BMC) in overweight or obese women. Materials and Methods: The study population included 74 women who were divided into the CLA (n = 37) and control (n = 37) groups. The CLA group received six capsules per day containing approximately 3 g of cis-9, trans-11 and trans-10, cis-12 CLA isomers in a 50:50 ratio. The control group received the same number of placebo capsules that contained sunflower oil. BMC and BMD at total body, lumbar spine (L1–L4), and femoral neck were measured before and after a three-month intervention. Results: The comparison of BMC and BMD for the total body, lumbar spine (L1–L4), and femoral neck before and after the intervention showed no differences between the groups. However, a within-group analysis demonstrated a significant increase in BMC (p = 0.0100) and BMD (p = 0.0397) at lumbar spine (L1–L4) in the CLA group. Nevertheless, there were no significant differences between the CLA and placebo groups in changes in all analysed densitometric parameters. Conclusions: Altogether, three-month CLA supplementation in overweight and obese women did not improve bone health, although the short intervention period could have limited our findings, long-term intervention studies are needed. The study protocol was registered in the German Clinical Trials Register database (ID: DRKS00010462, date of registration: 4 May 2016).

The International Neuroblastoma Risk Group Staging System (INRGSS) is based on the age of patients and preoperative imaging, with attention paid to whether the primary tumor is affected by one or more of specific image-defined risk factors (IDRFs). This publication presents a 2.5-year-old boy with neuroblastoma who had an accidental ligation of the celiac trunk during tumor resection. The consequences of this complication were pancreatic and spleen ischemia and necrosis, ischemia, and perforation of the common bile duct, gallbladder, stomach, and duodenum. The aim of this publication was to highlight the great role of the radiologist in determining the indications for neuroblastoma tumor removal, especially with current vascular IDRFs, and to show how the radiologist’s insightful approach can save the patient from irreversible complications.

The aim of the study was a survey-based assessment concerning parents of children undergoing CT examinations and their knowledge of detailed information about procedures involved in imaging diagnostics. A statistical analysis of 108 surveys of parents of children undergoing CT studies in the Department of Pediatric Radiology in Poznań, Poland was done, with the use of Statistica software. In result of the evaluation of all subsections of the substantive question number, the majority of answers were incorrect (68-98%). No correlation between the number of CT examinations conducted for a child and the number of correct answers to substantive questions was observed. No correlation between the number of CT examinations conducted for a child and the fact of noting the examination with the use of ionizing radiation down in a child's health certificate was stated. The statistical analysis showed that children of parents who declared that the aim of the CT examination had been explained to them better underwent more of them. Parents are poorly informed about a radiation dose and risk related to a CT examination procedure. Int J Occup Med Environ Health. 2019;32(1):65-73.

Recurrent bacterial meningitis is a life-threatening infection of the central nervous system that is mostly connected with anatomical abnormalities of the skull, chronic parameningeal infections and immunodeficiencies. It’s rarely seen, but when it occurs an extensive investigation should be carried out to discover the responsible factor, so that further episodes can be prevented. We report on a child with split hand and foot (SHFM), confirmed incorrect karyotype 46, XY, t(7:12)(q21.2;q21.3) and a fourth episode of fulminant meningitis caused by penicillin-resistant Streptococcus pneumoniae . After a broad evaluation of factors predisposing to recurrent meningitis, the undiagnosed malformation of his inner and middle ears - Mondini dysplasia was found. We suggest examining all children with SHFM for hearing impairment before they develop recurrent meningitis. The time when the radiological procedure for searching for inner ear dysplasia should be performed could be a controversial issue: before or after the first episode of meningitis. From the epidemiological point of view, high-resolution computer tomography scanning of the temporal bones should be considered after the diagnosis of deafness in a child with SHFM related to 7q21 deletion.

Hydrocephalus is a common neurological condition that can have traumatic ramifications and can be lethal without treatment. Nowadays, during therapy radiologists have to spend a vast amount of time assessing the volume of cerebrospinal fluid (CSF) by manual segmentation on Computed Tomography (CT) images. Further, some of the segmentations are prone to radiologist bias and high intraobserver variability. To improve this, researchers are exploring methods to automate the process, which would enable faster and more unbiased results. In this study, we propose the application of U-Net convolutional neural network in order to automatically segment CT brain scans for location of CSF. U-Net is a neural network that has proven to be successful for various interdisciplinary segmentation tasks. We optimised training using state of the art methods, including “1cycle” learning rate policy, transfer learning, generalized dice loss function, mixed float precision, self-attention, and data augmentation. Even though the study was performed using a limited amount of data (80 CT images), our experiment has shown near human-level performance. We managed to achieve a 0.917 mean dice score with 0.0352 standard deviation on cross validation across the training data and a 0.9506 mean dice score on a separate test set. To our knowledge, these results are better than any known method for CSF segmentation in hydrocephalic patients, and thus, it is promising for potential practical applications.