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This article outlines a practical approach to the investigation of the jaundiced child and reviews the imaging modalities and findings that can establish a diagnosis or narrow the differential. A systematic approach to the work-up of the jaundiced child prevents unnecessary tests and facilitates prompt treatment. Imaging of the jaundiced neonate and infant is reviewed separately to that of the older child and adolescent owing to different aetiologies in the two age groups. There are wide and varied differential diagnoses for the cause of jaundice in a child, which are broadly classified as pre-hepatic, hepatic and post-hepatic. Imaging does not play a significant role in elucidating the cause of pre-hepatic (unconjugated hyperbilirubinaemia); the underlying causes include physiological jaundice, breast milk jaundice, haemolysis and sepsis. Imaging does, however, play an important role in the investigation of conjugated hyperbilirubinaemia, which nearly always reflects hepatic dysfunction. One of the major roles of imaging is to differentiate intrahepatic from extrahepatic causes of jaundice although the underlying diagnosis is often ultimately established by a combination of clinical presentation and findings, laboratory tests, imaging and histology. Initial laboratory tests include liver function tests (including conjugated bilirubin fraction), hepatitis screening, TORCH (Toxoplasmosis, Other (syphilis, hepatitis, zoster), Rubella, Cytomegalovirus and Herpes) titres, a sepsis screen (blood, urine and cerebrospinal fluid (CSF)), metabolic screen (e.g. alpha1-antitrypsin phenotype testing) and sweat test, and in older children a toxic screen and autoantibodies. These results help to determine the most appropriate imaging. [ABSTRACT FROM AUTHOR]

Objective To determine clinical response, dosing and adverse events associated with quetiapine treatment in early psychosis. Method 40 Patients (33 men; 7 women; mean age 23.75) with schizophrenia spectrum disorders and less than 6 months previous exposure to antipsychotic treatment, entered an open label, 2 years, flexible dose trial and were assessed with PANSS, CGI, GAF, SOFAS, ESRS, BMI and ocular exams at baseline and 6 month intervals thereafter. Results Among 30 patients who enrolled >1 years ago, 19 (63%) completed 1-year assessment. Dropouts were due to insufficient clinical response (13%), nonadherence (13%) and personal choice (10%). At 1 year, significant improvement was observed on the PANSS, CGI, GAF and SOFAS. Mean dose was 559 (±207) mg/day. No drug induced EPS was noted and EPS present at baseline was reduced. Mean change in BMI was 17% (±22). No ocular changes were observed. Conclusions Quetiapine was well tolerated. Clinical response was similar to that achieved with other second generation antipsychotic agents in the same early psychosis programme. [ABSTRACT FROM AUTHOR]