We performed a prospective, observational, cohort study of children newly diagnosed with children’s interstitial lung disease (ChILD), with structured follow-up at 4, 8, 12 weeks and 6 and 12 months. 127 children, median age 0.9 (IQR 0.3–7.9) years had dyspnoea (68%, 69/102), tachypnoea (75%, 77/103) and low oxygen saturation (SpO₂) median 92% (IQR 88–96). Death (n=20, 16%) was the most common in those <6 months of age with SpO₂<94% and developmental/surfactant disorders. We report for the first time that ChILD survivors improved multiple clinical parameters within 8–12 weeks of diagnosis. These data can inform family discussions and support clinical trial measurements.

Background: Chest radiography is the most frequent X-ray examination performed in the neonatal period. However, commonly used dosimetric entities do not describe the radiation risk sufficiently. Objective: The aim of this study was to investigate selected organ doses and total body dose of chest radiographs in preterm and full-term neonates and infants. Materials and methods: In this retrospective study, we evaluated 1,064 chest radiographs of 136 preterm and 305 full-term babies with respect to field size and centering. We calculated the entrance dose from the dose–area product. Upper and lower field borders referred to the corresponding vertebrae. We calculated individual organ doses of the thyroid, the breast, the liver and active bone marrow for each chest radiograph using the neonatal PCXMC program, a Monte Carlo program for calculating patient doses in medical X-ray examinations. Results: The median field size of chest radiographs ranged from 90 cm² in preterm neonates at birth to 290 cm² in full-term infants at the age of 6 months. Median values of entrance dose varied, depending on age, from 15 μGy to 25 μGy. The median organ doses ranged 1–20 μSv for the thyroid, 3–30 μSv for the breast, 2–20 μSv for the liver and 0.5–3.5 μSv for the bone marrow in preterm and full-term neonates and infants, respectively. Conclusion: The analysis of chest radiographs in preterm and full-term neonates and infants revealed high variability in field size. By contrast, the entrance dose varied to a minor extent. Organ dose calculations using the PCXMC program might be a valuable tool to calculate the individual radiation risk in neonates and infants.

The clinical and technical considerations for successful gallstone dissolution with methyl tert-butyl ether (MTBE) are often underestimated. Patients are selected for MTBE therapy on the basis of a functioning gallbladder without evidence of acute inflammation or calcified stones at plain radiography. A transhepatic route is favored for percutaneous insertion of the cholecystostomy catheter because of the theoretic reduced frequency of bile leakage. MTBE is delivered manually through the catheter in a closed system, with dissolution times of 4-16 hours. After MTBE dissolution, residual debris in the gallbladder is present at follow-up sonography in up to 75% of patients. The high frequency of residual debris, the potential for stone recurrence, and the labor-intensive nature of MTBE therapy make its future uncertain, especially with the advent of laparoscopic cholecystectomy.