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Item Dental care and services of children and young people with cerebral palsy in Australia: A comprehensive survey of oral health‐related quality of life(John Wiley & Sons, Inc., 2025-01-04) Lansdown, Karen; Bulkeley, Kim; McGrath, Margaret; Irving, Michelle; Zagreanu, Claudia; Smithers‐Sheedy, Hayley; International Federation of Dental Hygienists; Cerebral Palsy Alliance Research FoundationAims: To investigate caregiver-reported dental care experiences and oral health-related quality of life (OHRQoL) of children and young people with cerebral palsy (CP). Methods: Between May and August 2023, caregivers of children and young people from three Australian states were invited to complete questionnaires, including the Child Oral Health Impact Profile (COHIP-SF 19). Results: Sixty-eight caregivers participated in the survey. Most children and young people had spastic CP (69.1%) with unilateral spasticity most common (51.1%). The COHIP-SF 19 average score was 51.9% ± 12.4, indicating moderate OHRQoL. Gender, communication, oral health daily routine, participation in dental exams and treatment, special arrangements needed to attend the practice, and urgent dental care due to pain or other problem(s) all significantly impacted OHRQoL (p < 0.05). Conclusion: OHRQoL of children and young people with CP is moderately impacted, as indicated by the COHIP-SF 19 scores. To improve OHRQoL in this population group, it is crucial to prioritize key factors such as upskilling dental professionals and creating more inclusive dental environments.Item Pontocerebellar inflammation and pancytopenia(BMJ Group, 2025-01-07) Dudley, Alex; O'Shea, Derville; Fanning, Noel; Bermingham, Niamh; Sweeney, Brian; Cronin, SimonCase presentation A 19-year-old woman had a 1-week history of gradual onset headache, vomiting, double vision and unsteadiness. She had been previously well. She had no sick contacts and her last foreign travel had been to Nepal over 5 years before. She was febrile at 38.4°C but systemic examination was otherwise normal. She had an ataxic gait, left sixth and seventh cranial nerve palsies, brisk lower limb reflexes and right ankle clonus. Cerebrospinal fluid (CSF) showed lymphocytic pleocytosis with 24 cells/µL (≤5), protein was raised to 1.01 g/L (0.15–0.45) and glucose was 3.0 mmol/L (plasma 5.1). Viral and bacterial tests, including TB stains and culture, were negative. There were no oligoclonal bands. Routine bloods, inflammatory markers, infective serology, vasculitis screen and serum angiotensin-converting enzyme (ACE) were normal. MR scan of brain showed extensive leptomeningeal enhancement; as well as patchy white matter signal abnormality and curvilinear enhancement mainly affecting the pons and cerebellum but also in the right frontal lobe (figure 1). MR scan of spine showed a short segment of right-sided T2 high signal and patchy enhancement in the thoracic cord.Item Embolisation of an acquired uterine arteriovenous malformation(BMJ Publishing Group, 2024-12-15) Coffey, Aidan John; Galvin, Daniel; Power, Stephen; Hayes-Ryan, DeirdreA G5P2+2 woman in her 30s presented to hospital with per vaginum (PV) bleeding, approximately 2 weeks post electric vacuum aspiration (EVA) for retained products of conception. Ultrasound and MRI demonstrated a large vascular myometrial lesion, suggestive of a uterine arteriovenous malformation (UAVM). She underwent digital subtraction angiography (DSA) with interventional radiology and simultaneous uterine artery embolisation (UAE). She represented 2 weeks later with recurrent PV bleeding and anaemia. She underwent repeat DSA, demonstrating persistent UAVM, and a repeat embolisation was performed. Symptoms resolved following the second embolisation, and a repeat MRI performed 12 weeks later demonstrated complete resolution of the UAVM. Although UAVMs are rare lesions, they can cause significant haemorrhage and morbidity. The presence of UAVM should particularly be considered after uterine intervention such as EVA or caesarean section. UAE is a safe and effective therapy, which preserves fertility.Item Radiographers’ knowledge, clinical expertise and application of pain management strategies in the radiology department – results from a qualitative focus group(Elsevier Ltd., 2024-12-24) O’ Regan, Róisín; Rawashdeh, Mohammad; McEntee, Mark F.; Moore, Niamh; Treanor, Ben; Ali, Magdi; England, AndrewBackground: Radiographers are frequently involved in imaging patients in pain thus requiring a heightened awareness and focus on this crucial issue. Purpose: To explore the challenges radiographers encounter when imaging patients in pain and to identify strategies that could be implemented to improve overall patient-centered care. Methods: A qualitative research study with a single focus group (FG) was conducted using six radiographers working within Irish hospitals. The research questions focused on pain management challenges in the radiology department, particularly identifying radiographers' current practices and strategies to address these challenges. The FG was moderated and video-recorded to facilitate comprehensive analysis. The audio obtained from the FG was transcribed and then analyzed thematically. Results: Data from the FG identified four main themes: 1) consequences of pain management, 2) communication, 3) professional experience, and 4) barriers. In addition, the study highlighted the absence of current protocols, policies, and guidelines in practice for the effective management of challenges associated with imaging patients in pain within the radiology department. Conclusion: The primary challenges identified include the stress experienced by both staff and patients, the potential for obtaining suboptimal images, concerns regarding patient safety, and adverse effects on image quality. This study elucidates the manner in which patient discomfort adversely impacts the imaging process and delineates the potential implications for radiographers aiming to achieve optimal image quality. At present, there are no established policies or procedures within the radiology department to direct the imaging of patients in pain.Item Computed tomography morphomics and antifibrotic therapy in idiopathic pulmonary fibrosis(Elsevier Ltd., 2024-11-29) O'Mahony, A. T.; Waldron, M. G.; Henry, P. J.; Shet, Sahil; O'Regan, P. W.; Bennett, D. M.; Ryan, D. J.; Maher, M. M.; Henry, M. T.AIM: Idiopathic pulmonary fibrosis (IPF) is a debilitating and fatal lung disease. Changes in body composition potentially correlate with outcomes in patients with IPF. MATERIALS AND METHODS: Patients with IPF on antifibrotic treatment attending a single institution were identified and retrospectively evaluated (n=84). Three groups were formed based on antifibrotic treatment: pirfenidone group, nintedanib group and pirfenidone-nintedanib switch group. Morphomic analysis of muscle quantity (cross-sectional area in cm2) and quality (density in Hounsfield Units) on thoracic computed tomography (CT) was performed using a web-based morphomic segmentation tool. Bilateral erector spinae and pectoralis muscles were measured at pre-defined vertebral levels. RESULTS: All three treatment groups showed a statistically significant decline in forced vital capacity (FVC), diffusion capacity of the lung for carbon monoxide (DLCO), pectoral muscle cross sectional area (PMA), and erector spinae muscle cross-sectional area (ESMA). Muscle density did not change significantly. Differences existed in analytic morphomics between treatment groups. Patients with a pretreatment body mass index (BMI) below 30 were found to have a significantly greater loss of PMA when treated with nintedanib instead of pirfenidone. FVC and DLCO did not differ between treatment groups. CONCLUSION: There were no direct correlations between pulmonary function and morphomic parameters in our entire group of IPF patients. However, between different treatment groups, the rate of muscle bulk loss differed. This is an important consideration for clinicians when deciding on an antifibrotic agent of choice.
