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Ovarian torsion (OT) is an emergency that mandates early detection and surgical detorsion to avoid catastrophic consequences of further adnexal injury. Prompt ultrasound is critical for accurate diagnosis. Traditionally, evaluation of arterial and venous flow was used as a diagnostic tool for OT, but recent radiologic research has indicated that ovarian size and size discrepancy between sides is a better diagnostic criterion. This study seeks to determine whether ovarian size discrepancy or vascular flow to the ovary is more accurate in the diagnosis of OT in the pediatric emergency population and to better describe symptoms that distinguish OT from other abdominal and pelvic pathology.This was a retrospective, cross-sectional study evaluating all female pediatric patients, aged 1 to 18 years, who underwent a pelvic ultrasound to evaluate for OT over a 2-year period in our pediatric emergency department. Patients suitable for inclusion were identified via Nuance mPowerTM, a search engine that provides clinical analytics based on radiology reports generated within our institution.We reviewed the medical records of 193 female patients aged 1 to 18 years, all of whom had a pelvic ultrasound (with or without Doppler) to evaluate for OT during the study period. In comparing ovarian size on ultrasound, patients with OT had a significantly larger magnitude of difference in ovarian volume than patients without torsion (5.57× [interquartile range, 3-12.5] vs 1.56× [interquartile range, 1.24-2.25; P0.001]). Ovarian torsion was associated with a 33-fold increased risk of lack of arterial flow (relative risk, 33.33) and with a 9-fold increased risk of lack of venous flow (relative risk, 9.27), when compared with those patients without OT. Patients with OT were significantly more likely to have emesis and peritoneal signs on examination, as well as previous history of OT (P = 0.01, 0.02, and 0.002, respectively) than those without OT. All patients with OT reported abdominal pain.We found that a large size discrepancy between ovaries is indicative of OT. Our data also suggest that presence of Doppler flow on ultrasound cannot be used to exclude OT but that lack of Doppler flow on ultrasound is a significant diagnostic marker. As previous studies have also found, clinical symptoms of OT are nonspecific and do not offer any certainty in differentiating OT from other pathologies.

Background In hospitalized patients with skin and soft tissue infections (SSTIs), intravenous (IV) empiric antibiotic treatment is initiated. The best time point for switching from IV to oral treatment is unknown. We used an algorithm-based decision tree for the switch from IV to oral antibiotics within 48 hours and aimed to investigate the treatment outcome of this concept. Methods In a nonrandomized trial, we prospectively enrolled 128 patients hospitalized with SSTI from July 2019 to May 2021 at 3 institutions. Clinical and biochemical response data during the first week and at follow-up after 30 days were analyzed. Patients fulfilling criteria for the switch from IV to oral antibiotics were assigned to the intervention group. The primary outcome was a composite definition consisting of the proportion of patients with clinical failure or death of any cause. Results Ninety-seven (75.8%) patients were assigned to the intervention group. All of them showed signs of clinical improvement (ie, absence of fever or reduction of pain) within 48 hours of IV treatment, irrespective of erythema finding or biochemical response. The median total antibiotic treatment duration was 11 (interquartile range [IQR], 9–13) days in the invention group and 15 (IQR, 11–24) days in the nonintervention group (P Conclusions In this pilot trial, the proposed decision algorithm for early switch from IV to oral antibiotics for SSTI treatment was successful in 95% of cases. Clinical Trials Registration. ISRCTN15245496

SIDS stands for sudden infant death syndrome and is one of the leading causes for infant deaths in the United States. It is most common for infants in the age range of newborns to 6 months old. The death occurs suddenly with no symptoms and no predictions based on medical history. Detailed autopsies cannot point out the reasoning behind the death either. There is no known causes for SIDS, however infants are at highest risk when they are sleeping. Our senior design project is intended to provide a modern monitoring system for a sleeping infant. We have designed an ankle strap that can monitor an infant's heart rate and body temperature. The vital signs will be taken and recorded periodically while the strap is worn. In the event that an infant's vital signs are read to be outside of their normal range, the device will send a text message to a care giver. An acceptable response time for an infant in distress is about two to five minutes. Anything above five minutes without oxygen will lead to extreme brain damage and possible death. Our device will detect the onset of an infant losing oxygen and this will allow a care giver to monitor and act promptly to any abnormalities. Once the body starts to lose oxygen, the heart will try to pump more blood throughout the body. This causes the heart rate to increase. The device will be able to detect this increase in heart rate and alert, as the increase in heart rate is usually more drastic than subtle. The device is compact and not harmful to an infant. It uses noninvasive measuring techniques in order to obtain vital sign readings. This device is intended to alert someone of the possible onset of SIDS and allow for a quick response time, in order to help reduce infant fatalities.

Focal Dystonia (FD) is a chronic neurological disorder, which causes twisting and repetitive movements and abnormal postures induced by involuntary sustained contractions of agonist and antagonist muscles. Based on the hypothesis that several dystonia-related brain regions, including cerebellum, are implicated in oculomotor disturbances (OCD), a number of studies investigated oculomotor function in patients with dystonia. However, conceptual clarity with respect to the used assessment tools and interpretation of the findings is lacking in the literature. This is the first article to systematically review studies that assessed oculomotor function in patients with FD. In total, 329 publications, published until September 1, 2019, were identified through MEDLINE search. Twenty out of 329 studies, involving 232 subjects in total, met the inclusion criteria. Most of the studies reported oculomotor disturbances in patients with FD. Abnormalities included asymmetry in vestibulo-ocular reflex (VOR), disturbances in saccadic functions, and prolonged latencies of eye motion. Discrepancies in the results could be explained, at least partially, by the long period of time over which the reviewed studies were published, the different methods used for testing the eye movements, and the limited number of patients assessed since the majority of data derived from case reports or small-scale studies. Further prospective studies with larger subject numbers are needed, using advanced tools for the assessment of oculomotor function in focal dystonia.

Focal Dystonia (FD) is a chronic neurological disorder, which causes twisting and repetitive movements and abnormal postures induced by involuntary sustained contractions of agonist and antagonist muscles. Based on the hypothesis that several dystonia-related brain regions, including cerebellum, are implicated in oculomotor disturbances (OCD), a number of studies investigated oculomotor function in patients with dystonia. However, conceptual clarity with respect to the used assessment tools and interpretation of the findings is lacking in the literature. This is the first article to systematically review studies that assessed oculomotor function in patients with FD. In total, 329 publications, published until September 1, 2019, were identified through MEDLINE search. Twenty out of 329 studies, involving 232 subjects in total, met the inclusion criteria. Most of the studies reported oculomotor disturbances in patients with FD. Abnormalities included asymmetry in vestibulo-ocular reflex (VOR), disturbances in saccadic functions, and prolonged latencies of eye motion. Discrepancies in the results could be explained, at least partially, by the long period of time over which the reviewed studies were published, the different methods used for testing the eye movements, and the limited number of patients assessed since the majority of data derived from case reports or small-scale studies. Further prospective studies with larger subject numbers are needed, using advanced tools for the assessment of oculomotor function in focal dystonia.

Although congenital intracranial tumors are very rare, it is important to know the differential diagnosis and distinguishing features of the different disease processes in order to accurately diagnosis and appropriately treat these patients in the neonatal period. We present a case of a rare congenital craniopharyngioma detected in a fetus on prenatal imaging. Teratoma is the most common congenital intracranial tumor. Hence this tumor was initially labelled as a teratoma, which is a pitfall that should be avoided.

Congenital pulmonary artery anomalies are infrequent but given improved prenatal diagnosis and care, and neonatal surgical advances, over the past two decades are not uncommonly encountered by cardiothoracic imagers. An understanding of their etiology, classifications, associated anomalies, and surgical management can be helpful to avoid under or overdiagnosis. Timely diagnosis assisted by familiarity with imaging findings across modalities and recognition of surgical findings allows for medical management and surgical planning for these patients, with more patients reaching adulthood than ever before.

DerTitel dieser Ausfuhrungen ist angesichts der Ge¬ setzesfulle zu Faktoren des Naturhaushaltes reinste Provokation. Durch Provokationen werden Denkund Arbeitsweisen angezweifelt, werden hinter gul¬ tigen Normen Fragezeichen gesetzt. Durch diese Fragezeichen ist es moglich, grundsatzliche Fehler zu erkennen und vielleicht neue Losungsansatze zu entwickeln. In einer Zeit, in der jede Aussage von Experten/-innen zuerst einmal angezweifelt wird, ist eine dauernde und grundsatzliche Auseinander¬ setzung besonders wichtig, hangt doch unsere Glaubwurdigkeit davon ab.

In Switzerland, the shorelands have been put under considerable pressure by exploitation during the last decades. A planning of the shoreland protection is therefore absolutely essential. This confronts us with the difficult problem of formulating the value of protection. We discuss a practicable but integral and yet transparent method.

In Bezug auf praxis-, diskurs- und erzahltheoretische Ansatze zeigt der Beitrag am Beispiel der fur die eidgenossische Initiative „Gegen Masseneinwanderung“ verwendeten Wahlplakate der Schweizerischen Volkspartei (SVP) den Prozess der Sichtbarmachung sozialraumlicher Phanomene. Dabei ist es bedeutsam die diskursiven und visuellen Elemente des Bildes im Hinblick auf ihre konkrete Bildpraxis zu erarbeiten, so dass folgende Frage im Mittelpunkt steht: Wie argumentiert, beweist und erklart ein Bild, so dass Geltung bei den Bildkonsument_innen erzeugt wird? Zudem soll diese Bildpraxis kontextualisiert werden, also einerseits nach den Regeln des Verstehens fragen, die die Durchsetzung der visuellen Bildbotschaft ermoglichen und andererseits die Bildproduzent_innen in den Blick nehmen, um die Bilder in einen politisch-strategischen Kontext setzen zu konnen. Eine solch angelegte Bild¬analyse gibt einen Einblick in die visuelle Wirklichkeitskonstruktion der SVP und verweist auf die Strategien, um dieser Wirklichkeit Akzeptanz zu generieren.