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Competing Interests: Competing interests: None declared.

Newborn infants admitted for neonatal intensive and high dependency care are reliant on intravenous therapy for medications, hydration and nutrition. Adopting a structured approach to gaining neonatal vascular access can improve efficiency and potentially reduce complications. In this article, we discuss an algorithm for decision-making in neonatal vascular access., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.) more...

Competing Interests: Competing interests: None declared.

The World Health Organization (WHO) in Africa and Africa Center Disease Control (Africa CDC) urge the international community and different countries in Africa to ensure sustainable and concrete action to ensure equal and easy access to the COVID-19 vaccines, as different countries in Africa are still struggling to develop a safe and effective strategy to ensure equal vaccine distribution, if available. Africa CDC has called on the international community to come together to help Africa with COVID-19 vaccines to make equal the vaccine distribution among African countries as many cannot afford the vaccine costs due to the level of poverty and other negative factors. The African Union has endorsed the need for Africa to develop a framework to actively engage in easy accessibility to COVID-19 vaccines, which will allow different countries in Africa to take easy steps that will strengthen the local vaccine distribution system, building workforce skills and knowledge, and enrich outreach services in Africa. The article discusses the need for equal access in the distribution of COVID-19 vaccines in Africa, the challenges, and the necessary recommendations that can help to mitigate these challenges., (© 2021 Wiley Periodicals LLC.) more...

Purpose: To compare, in an interventional radiology setting, peak skin doses (PSDs) delivered as calculated using a dedicated software tool and as measured using radiochromic film. To assess the utility of this dose calculation software tool in routine clinical practice., Materials and Methods: First, radiochromic films were positioned on the examination table in the back of an adult anthropomorphic phantom to measure PSD, and X-ray examinations were simulated. Then, films were again positioned in the patient's back for 59 thoracic or abdominopelvic endovascular interventions. The results obtained with the radiochromic films were taken as a reference and were statistically compared with those of the software., Results: With measured PSDs ranging from 100 to 7000 mGy, the median software-film difference was 8.5%. Lin's concordance coefficient was 0.98 [0.97; 0.99] (p < 0.001), meaning that concordance was excellent between the two methods. For the films where PSD exceeded 1000 mGy, the median difference in the measured value was 8.7% [- 1.3; 21.1], with a maximum discrepancy of 34%. Lin's concordance coefficient was 0.98 [0.96; 1] (p < 0.001), meaning that concordance was excellent between the two methods., Conclusion: Comparison between radiochromic films and the software tool showed that the software is a suitable tool for a simple and reliable estimation of PSD. The software seems to be a good alternative to films, whose use remains complex. more...

Objectives: The aim of this work was to compare the performance of a prototype radioprotection cabin in interventional neuroradiology, and to assess its suitability for routine use., Materials and Methods: The radioprotection cabin was a prototype derived from the CATHPAX AF(®) model. Three operators carried out 21 procedures (19 brain arteriographies and 2 embolizations) using the radioprotection cabin and not wearing the usual lead individual protection equipment (IPE), and 17 procedures (16 brain arteriographies and 1 embolization) wearing the standard lead IPE (vest, skirt, thyroid shield and goggles), and not using the radioprotection cabin. In all cases, thermoluminescent dosimeters (TLDs) were positioned at head, trunk, pelvic region, and upper and lower limbs to measure the dose equivalent for Hp(0.07) or Hp(3) that they received, attenuated by either the cabin or the lead IPE. Parallel to these dosimetric measurements, the ergonomics of the protection cabin were appraised by each radiologist after each procedure., Results and Conclusion: The cabin procured an overall reduction of 74% of the dose received on the whole body with Hp(0.07)=0.04 mSv ± 0.01 (CL=95%) against Hp(0.07)=0.12 mSv ± 0.04 (CL=95%) for the IPE. Body protection with the cabin was near complete, and close to 100% for the regions not protected by the usual IPE (e.g. the head). We also showed that design weaknesses noted by the operators that hampered procedures (light reflections, reduced hand mobility, awkward access to radioscopy pedal) could be remedied by maker's improvements to the prototype and minor changes in work habits., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.) more...

Aim: To determine the aetiological associations, neurological sequelae and role of magnetic resonance imaging (MRI) in term newborn infants with seizures., Methods: Cohort study of infants ≥37 weeks' gestation delivered in a tertiary level centre, prospectively identified and followed longitudinally for 18-24 months., Results: An underlying aetiology was found in 95% of the 77 infants identified with seizures (3.0/1000 live births). The most common diagnosis was hypoxic-ischaemic encephalopathy (HIE) (65%), followed by neonatal stroke (12%). Nine infants died, 28 of the 68 survivors developed neurodevelopmental impairment (NDI), and 15 had recurrent seizures in the first 2 years, with both outcomes more likely in those with a diagnosis other than HIE. Abnormal MRI findings were found in 45 of the 70 infants imaged. The absence of major cerebral lesions was highly predictive of a normal neurological outcome., Conclusion: We report the first cohort of term infants with seizures fully investigated by MRI. The universal use of MRI enabled a cause to be identified in 95% of cases. The probability of having NDI or recurrence of seizures was extremely low with absence of major cerebral lesions on MRI. This study demonstrates the added value of MRI for diagnosis of aetiology and the prediction of neurological outcome., (©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.) more...