Testicular yolk sac tumors are rare, and analyses of relevant ultrasound (US) findings are limited. We retrospectively reviewed the US features of 21 pathologically verified cases (patients aged 10–64 months). Neoplasms were unilateral and solitary, occupying part (focal) or all (diffuse) of the testis. Focal lesions (14 cases) were usually solid and ovoid, with a homogeneous echo texture or multiple random anechoic spaces, and hypervascular. Diffuse neoplasms had heterogeneous echo textures; most were hypervascular. On spectral Doppler US imaging, 11 cases had a mean peak systolic velocity of 12.9 cm/s and a mean resistive index of 0.54. Ultrasound is a useful tool for imaging pediatric testes when a yolk sac tumor is suspected. 相似文献
Purpose: To determine reliability of the ABILHAND-Kids, explore sources of variation associated with these measurement results, and generate repeatability coefficients.Method: A reliability study with a repeated measures design was performed in an ambulatory rehabilitation care department from a rehabilitation center, and a center for special education. A physician, an occupational therapist, and parents of 27 children with spastic cerebral palsy independently rated the children’s manual capacity when performing 21 standardized tasks of the ABILHAND-Kids from video recordings twice with a three week time interval (27 first-, and 25?second video recordings available). Parents additionally rated their children’s performance based on their own perception of their child's ability to perform manual activities in everyday life, resulting in eight ratings per child.Results: ABILHAND-Kids ratings were systematically different between observers, sessions, and rating method. Participant?×?observer interaction (66%) and residual variance (20%) contributed the most to error variance (9%). Test–retest reliability was 0.92. Repeatability coefficients (between 0.81 and 1.82 logit points) were largest for the parents’ performance-based ratings.Conclusion: ABILHAND-Kids scores can be reliably used as a performance- and capacity-based rating method across different raters. Parents’ performance-based ratings are less reliable than their capacity-based ratings. Resulting repeatability coefficients can be used to interpret ABILHAND-Kids ratings with more confidence.
Implications for Rehabilitation
The ABILHAND-Kids is a valuable tool to assess a child's unimanual and bimanual upper limb activities.
The reliability of the ABILHANDS-Kids is good across different observers as a performance- and capacity-based rating method.
Parents' performance-based ratings are less reliable than their capacity-based ones.
This study has generated repeatability coefficients for clinical decision making.
Purpose: In this paper, we present our experiences – both successes and challenges – in implementing evidence-based classification tools into clinical practice. We also make recommendations for others wanting to promote the uptake and application of new research-based assessment tools.
Method: We first describe classification systems and the benefits of using them in both research and practice. We then present a theoretical framework from Implementation Science to report strategies we have used to implement two research-based classification tools into practice. We also illustrate some of the challenges we have encountered by reporting results from an online survey investigating 58 Speech-language Pathologists’ knowledge and use of the Communication Function Classification System (CFCS), a new tool to classify children’s functional communication skills.
Result and conclusions: We offer recommendations for researchers wanting to promote the uptake of new tools in clinical practice. Specifically, we identify structural, organizational, innovation, practitioner, and patient-related factors that we recommend researchers address in the design of implementation interventions. Roles and responsibilities of both researchers and clinicians in making implementations science a success are presented.
Implications for rehabilitation
Promoting uptake of new and evidence-based tools into clinical practice is challenging.
Implementation science can help researchers to close the knowledge-to-practice gap.
Using concrete examples, we discuss our experiences in implementing evidence-based classification tools into practice within a theoretical framework.
Recommendations are provided for researchers wanting to implement new tools in clinical practice. Implications for researchers and clinicians are presented.
Ocular trauma is a major cause of acquired monocular blindness in children. Firework injuries account for 20% of ocular trauma. The purpose of our study was to document the profile of ocular firework injuries in children during the festive season of Diwali and to determine the prevalence of unilateral blindness in them.
Materials and Methods:
A retrospective chart analysis of ocular firework injury in children during the festival of Diwali from 2009 to 2013, conducted in a tertiary care eye center in Tamil Nadu, Southern India. Children below 18 years of age with ocular firework injuries who presented to the emergency department for 3 consecutive days - the day of Diwali, 1 day before, and 1 day after Diwali - were included in this study.
Results:
Eighty-four children presented with firework-related ocular injuries during the study period. Male to female ratio was 4:1 with mean age 9.48 ± 4 years. Forty-four percentage required hospitalization. The prevalence of unilateral blindness in children due to fireworks was found to be 8% (95% confidence interval - 2–13%).
Conclusion:
Vision 2020 gives high priority to avoidable blindness, especially in children. In our study, for every 12 children who presented with firecracker injury, one resulted in unilateral blindness. This is an avoidable cause of blindness. Awareness needs to be created, and changes in policy regarding sales and handling of firecrackers including mandatory use of protective eyewear should be considered. 相似文献