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The volume and localization of fluid in the paediatric gastrointestinal tract is crucial to the design of in vitro and in silico models that predict the absorption of oral drugs administered to children. Previous studies have used magnetic resonance imaging (MRI) to quantify fluid volumes and localization in the intestines of adults; this study is the first to undertake similar analysis of pediatric participants. This study quantified the amount and distribution of fluid in fasted and fluid-fed children using MRI data captured during the routine clinical assessment. Data from 32 fasted children (aged 0-16 years) and 23 fluid-fed children (aged 8-16 years) were evaluated. The gastric volume ranged from 0 to 9 mL in the fasted and 19-423 mL in the fluid-fed state. The small intestinal volume was recorded to be 0-51 mL in the fasted and 6-91 mL in the fluid-fed state with an average number of 7.7 and 22.4 fluid pockets, respectively. The data showed significant differences in gastric volumes and the number of fluid pockets in the small intestine for age-matched fasted and fluid-fed children (p < 0.05). Both the number and the volume of pockets reported in children are much lower than those previously reported in adults. This study is the first to report intestinal volumes and localization in children and provides new information to achieve the design of biorelevant in vitro models and real values to update in silico models. The data available from both fluid-fed and fasted children show the extremes of fluid volumes that are present in the gastro-intestinal tract which is useful to understand the variability associated with drug absorption in children.

Appearance representation and feature extraction of anatomy or anatomical features is a key step for segmentation and classification tasks. We focus on an advanced appearance model in which an object is decomposed into pyramidal complementary channels, and each channel is represented by a part-based model. We apply it to landmark detection and pathology classification on the problem of lumbar spinal stenosis. The performance is evaluated on 200 routine clinical data with varied pathologies. Experimental results show an improvement on both tasks in comparison with other appearance models. We achieve a robust landmark detection performance with average point to boundary distances lower than 2 pixels, and image-level anatomical classification with accuracies around \(85\,\%\).

ObjectiveTo undertake an assessment of preferences as to how, where and by whom ultrasounds (US) should be performed in: (1) patients undergoing surveillance of abdominal aortic aneurysm (AAA) size (AAA group); and (2) patients being scanned for general abdominal conditions (general group).DesignA discrete choice experiment (DCE) questionnaire was administered to patients attending US appointments. Analysis of questionnaire responses used conditional logit models and included validity checks.SettingWest Midlands, England.Participants524 patients (223 in the AAA group and 301 in the general group) were recruited from the US outpatient department at University Hospital Coventry and Warwickshire.Outcome measuresCoefficients for attributes in relation to their reference levels.ResultsThe AAA group preferred to have their US performed in hospital while the general group had a preference for portable US at general practice surgeries. All patients had a strong preference for scanning by specialists, devices with a lower risk of underdiagnosis and receiving their results at the appointment where the scan takes place. The general group had a strong preference for the person performing the scan to know their medical history.ConclusionsPatients being scanned for general abdominal conditions prefer to be scanned in a general practice by practitioners who know their medical history. Patients undergoing surveillance of AAA size prefer to be scanned in a hospital setting. Both groups would prefer to be informed of the scan results as soon as possible. Further research is required to explore the clinical scenarios in which targeted scanning by community practitioners would be of benefit to patients.

A 47-year-old man presented to hospital with a 1 day history of acute left-sided abdominal pain. He was initially treated for renal colic but the pain continued to worsen. Surgical review elicited left iliac fossa tenderness with guarding. Observations were within normal limits but serology revealed a raised C reactive protein. A provisional diagnosis of diverticulitis was made and abdominal CT was performed. …