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Cite this page: Hill, M.A. (2021, January 24) Embryology X-ray. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Talk:X-ray
Radiodiagnostic imaging in pregnancy and the risk of childhood malignancy: raising the bar
PLoS Med. 2010 Sep 7;7(9):e1000338.
Franco EL, Turgeon GA. Source Division of Cancer Epidemiology, McGill University, Montreal, Canada. firstname.lastname@example.org Abstract Eduardo Franco and Guy-Anne Turgeon discuss new findings from Joel Ray and colleagues on the cancer risk following prenatal exposure to radiodiagnostic imaging, and where new research needs to be focused.
Comment on PLoS Med. 2010 Sep;7(9):e1000337. PMID 20838652
Newborn screening for cystic fibrosis
Cochrane Database Syst Rev. 2009 Jan 21;(1):CD001402.
Southern KW, Mérelle MM, Dankert-Roelse JE, Nagelkerke AD. Source Institute of Child Health, University of Liverpool, Alder Hey Children's Hospital, Eaton Road, Liverpool, Merseyside, UK, L12 2AP. email@example.com Abstract BACKGROUND: Does newborn screening for cystic fibrosis (CF) improve clinical outcomes, quality of life and survival?
OBJECTIVES: To examine whether newborn screening for CF prevents or reduces irreversible organ damage and improves clinical outcomes, quality of life and survival in people with CF without unacceptable adverse effects.
SEARCH STRATEGY: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register comprising references identified from electronic database searches, handsearches of relevant journals and abstract books of conference proceedings.The Group's Trials Register last searched: June 2008.
SELECTION CRITERIA: Randomised or quasi-randomised controlled trials, published and unpublished, comparing screening to clinical diagnosis in people with CF.
DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial eligibility and quality and independently extracted data. Allocation concealment was unclear in both studies and sequence generation adequate in one.
MAIN RESULTS: Searches identified six trials. Two trials involving 1,124,483 neonates (210 with CF) with a maximum follow up of 17 years were eligible for inclusion. Varying study designs, outcomes reported and summary measures precluded calculation of pooled estimates and only data from one study were analysed. Severe malnutrition was less common among screened participants. Compared with screened participants, the odds ratio of weight below the tenth percentile was 4.12 (95% CI 1.64 to 10.38) and for height was 4.62 (95% CI 1.69 to 12.61) in the control group.At age seven, 88% of screened participants and 75% of controls had lung function parameters within normal limits of at least 89% predicted. At diagnosis chest radiograph scores were significantly better among screened participants; 33% of screened versus 50% of control participants had Wisconsin chest X-ray (WCXR) scores over five (P = 0.097) and 24% of screened versus 45% of control participants had Brasfield chest X-ray (BCXR) scores under 21 (P = 0.042)). Over time, chest radiograph scores were worse in the screened group (WCXR P = 0.017 and BCXR P = 0.041). Results were no longer significant after adjustment for genotype, pancreatic status, and Pseudomonas aeruginosa-culture results. In screened participants colonisation with Pseudomonas aeruginosa occurred earlier. Estimates suggest diagnosis through screening is less expensive.
AUTHORS' CONCLUSIONS: Two randomised controlled trials assessing neonatal screening in CF were identified; data from one study were included. Nutritional benefits are apparent. Screening provides potential for better pulmonary outcomes, but confounding factors influenced long-term pulmonary prognosis of people with CF. Screening seems less expensive than traditional diagnosis.
Update of Cochrane Database Syst Rev. 2001;(3):CD001402. PMID 19160197
Are pre- or postnatal diagnostic X-rays a risk factor for childhood cancer? A systematic review
Radiat Environ Biophys. 2008 Jul;47(3):301-12. Epub 2008 Jun 5.
Schulze-Rath R, Hammer GP, Blettner M. Source Institute for Medical Biostatistics, Epidemiology and Informatics, Johannes-Gutenberg-University Mainz, 55109, Mainz, Germany. firstname.lastname@example.org
The risk of cancer after diagnostic X-rays received as fetus or during early childhood has been investigated in many studies. The results of recent epidemiological studies are summarized in a present systematic review. The strategies for literature search, inclusion criteria, and items for study quality assessment were defined in the study protocol. All epidemiological case control and cohort studies published in English between 1990 and 2006 that reported at least the size of the study population and risk estimates were included. Results were summarized separately for pre- and postnatal exposure and for each cancer site. Nineteen case control studies and six cohort studies matched the inclusion criteria. No association of leukemia with prenatal exposures was observed in nine case control studies. Heterogeneous results were found for postnatal exposures and leukemia in four studies. No significant effect of pre- and postnatal X-ray exposure was observed for other cancer sites (non-Hodgkin lymphomas, solid tumors and brain tumors). Most studies have limitations in study design, study size, or exposure measurement, and involve very low exposures. These results thus do not contradict previous evidence accumulated since 1956 indicating risk increases associated with prenatal X-ray exposure. Computed tomography is not covered in the studies and needs to be investigated in the future.
Comment in Radiat Environ Biophys. 2009 Apr;48(2):237-9; author reply 241.
Maternal effects and cancer risk in the progeny of mice exposed to X-rays before conception
Exp Toxicol Pathol. 2005 Apr;56(6):351-60.
Dasenbrock C, Tillmann T, Ernst H, Behnke W, Kellner R, Hagemann G, Kaever V, Kohler M, Rittinghausen S, Mohr U, Tomatis L. Source Fraunhofer-Institut für Toxikologie und Experimentelle Medizin, Nikolai-Fuchs-Strasse 1, 30625 Hannover, Germany.
To investigate in an animal model whether preconceptual X-ray exposure leads to an altered tumor rate and spectrum in the offspring, a transgeneration carcinogenesis study was carried out. Female mice received X-ray irradiation (2 x 2 Gray) 2 weeks prior to mating with untreated males. After weaning, half of the descendants were exposed for 6 months to the immunomodulating and tumor-promoting compound cyclosporine A (CsA) by diet, the others remained untreated. The animals were maintained for their entire lifespan, terminal sacrifices were carried out after 28 months. Complete autopsy was performed, and three protocol organs (lung, liver and spleen) were examined histologically, together with any suspicious lesions in other organs. Fertility and the lifetime of the maternal mice were reduced by the X-ray irradiation, and their incidence of lung and liver tumors was increased as compared to non-irradiated mice. The descendants of all groups revealed comparable body weights and mortality rates. The incidence of hematopoietic/lymphoreticular tissue tumors increased in the female hybrids by 6 months of CsA-treatment. A higher incidence of lung and liver tumors in the sham-treated male progeny of irradiated mothers was detected, pointing to a possible germ cell-transmitted alteration initiated by the preconceptual maternal X-ray exposure.