Student perceptions of two simulated learning environments in paediatric audiology.

Objective: To determine audiology student perceptions of two simulated learning environments (SLE) in paediatric audiology.Design: A one-shot case study design.Study sample: Fifteen audiology students who completed questionnaires after participating in two SLEs, one simulating auditory brainstem response (ABR) assessments of neonates in a hospital ward and one simulating visually reinforced orientation audiometry (VROA) assessments of young children in an audiology clinic.Results: The students responded positively to 11/11 areas of audiometric testing and client interaction in both SLEs, to 7/7 aspects of their interactions with the mannequins in both SLEs, and to 8/8 aspects of their interactions with fellow students playing the role of parent in the ABR SLE and 7/8 of these aspects in the VROA SLE. The students reported low levels of anxiety towards both SLEs but rated the ABR SLE more highly than the VROA SLE in areas of preparedness, effectiveness, realism, pre-SLE training, reinforcement of lecture content, and overall usefulness.Conclusions: The participating students responded positively to almost all aspects of both SLEs. Further research is warranted using research designs capable of determining if these SLEs directly improve student abilities as they transition from academic settings to clinical placements in paediatric audiology.

Are Aquaporins the Missing Transmembrane Osmosensors?

Regulation of cell volume is central to homeostasis. It is assumed to begin with the detection of a change in water potential across the bounding membrane, but it is not clear how this is accomplished. While examples of general osmoreceptors (which sense osmotic pressure in one phase) and stretch-activated ion channels (which require swelling of a cell or organelle) are known, effective volume regulation requires true transmembrane osmosensors (TMOs) which directly detect a water potential difference spanning a membrane. At present, no TMO molecule has been unambiguously identified, and clear evidence for mammalian TMOs is notably lacking. In this paper, we set out a theory of TMOs which requires a water channel spanning the membrane that excludes the major osmotic solutes, responds directly without the need for any other process such as swelling, and signals to other molecules associated with the magnitude of changing osmotic differences. The most likely molecules that are fit for this purpose and which are also ubiquitous in eukaryotic cells are aquaporins (AQPs). We review experimental evidence from several systems which indicates that AQPs are essential elements in regulation and may be functioning as TMOs; i.e. the first step in an osmosensing sequence that signals osmotic imbalance in a cell or organelle. We extend this concept to several systems of current interest in which the cellular involvement of AQPs as simple water channels is puzzling or counter-intuitive. We suggest that, apart from regulatory volume changes in cells, AQPs may also be acting as TMOs in red cells, secretory granules and microorganisms.

Risk factors associated with human brucellosis in the country of Georgia: a case-control study.

Human brucellosis occurs when humans ingest or contact Brucella spp. from shedding animals or contaminated environments and food. In Georgia animal and human brucellosis is endemic, but the epidemiology has not been fully characterized. A case-control study was conducted in 2010 to identify risk factors for human brucellosis. Using multivariable logistic regression, the following risk factors were identified: animal-related work [odds ratio (OR) 77·8, 90% confidence interval (CI) 4·7-1278], non-animal-related work (OR 12·7, 90% CI 1·1-149), being unemployed or a pensioner (OR 13·1, 90% CI 1·7, 101), sheep ownership (OR 19·3, 90% CI 5·1-72·6), making dairy products (OR 12·4, 90% CI 1·4-113), living in eastern Georgia (Kakheti) (OR 278·1, 90% CI 9·5-8100), and being aged >44 years (OR 9·3, 90% CI 1·02-84·4). Education of at-risk groups about risk factors and control of disease in sheep may reduce the human disease risk. This is the first study of its kind in Georgia since the collapse of the Soviet Union.

Prewarming effect on adaptation, porosities, and strength of a composite resin.

Warming composite resin before insertion to reduce viscosity is advocated for improving adaptation and reducing voids. This study evaluated how prewarming altered porosities, adaptation, and strength. Twenty composite restorations were placed in 2 increments in typodont teeth with a large Class II preparation. The composite was either at room temperature (control) or prewarmed to 68 °C (n = 10/group). Each increment was light-cured for 20s. After 24h, the restored teeth were sectioned and imaged under a stereomicroscope. Examiners ranked the quality of adaptation to walls and between increments, and the presence of voids on a 0-3 scale. Results were statistically analyzed using Mann-Whitney U Test. Diametral tensile strength of monolithic or incrementally-filled composite cylinders (6 mm diameter × 4 mm height; n = 10/group) made with room temperature or prewarmed composite were tested at 0.5 mm/min. Strength results were analyzed using ANOVA statistics followed by pairwise comparisons. Restorations made with prewarmed composite had significantly fewer large voids and better adaptation to cavity walls and between layers (P < 0.05). Strength of prewarmed composite was higher than room temperature composite, and was significantly higher in monolithic specimens (P < 0.05). It was concluded that prewarming conventional composite can improve its handling, making it handle more like a flowable composite without jeopardizing physical properties. The prewarmed composite was found to have better adaptation and fewer voids, and attained higher strength than composite that was not prewarmed.

Approaches for evaluating veterinary epidemiological models: verification, validation and limitations.

The evaluation of models of the spread and control of animal diseases is crucial if these models are to be used to inform decisions about the control or management of such diseases. Two key steps in the evaluation of epidemiological models are model verification and model validation. Verification is the demonstration that a computer-driven model is operating correctly, and conforms to its intended design. Validation refers to the process of determining how well a model corresponds to the system that it is intended to represent. For a veterinary epidemiological model, validation would address such issues as how well the model represents the dynamics of the disease in question in the population to which this model is applied, and how well the model represents the application of different measures for disease control. Just as the development of epidemiological models is a subjective, continuous process, subject to change and refinement, so too is the evaluation of models. The purpose of model evaluation is not to demonstrate that a model is a 'true' or accurate' representation of a system, but to subject it to sufficient scrutiny so that it may be used with an appropriate degree of confidence to aid decision-making. To facilitate model verification and validation, epidemiological modellers should clearly state the purpose, assumptions and limitations of a model; provide a detailed description of the conceptual model; document those steps already taken to test the model; and thoroughly describe the data sources and the process used to produce model input parameters from those data.

Conceptual modeling of postmortem evaluation findings to describe dairy cow deaths.

Dairy cow mortality levels in the United States are excessive and increasing over time. To better define cause and effect and combat rising mortality, clearer definitions of the reasons that cows die need to be acquired through thorough necropsy-based postmortem evaluations. The current study focused on organizing information generated from postmortem evaluations into a monitoring system that is based on the fundamentals of conceptual modeling and that will potentially be translatable into on-farm relational databases. This observational study was conducted on 3 high-producing, commercial dairies in northern Colorado. Throughout the study period a thorough postmortem evaluation was performed by veterinarians on cows that died on each dairy. Postmortem data included necropsy findings, life-history features (e.g., birth date, lactation number, lactational and reproductive status), clinical history and treatments, and pertinent aspects of operational management that were subject to change and considered integral to the poor outcome. During this study, 174 postmortem evaluations were performed. Postmortem evaluation results were conceptually modeled to view each death within the context of the web of factors influencing the dairy and the cow. Categories were formulated describing mortality in terms of functional characteristics potentially amenable to easy performance evaluation, management oversight, and research. In total, 21 death categories with 7 category themes were created. Themes included specific disease processes with variable etiologies, failure of disease recognition or treatment, traumatic events, multifactorial failures linked to transition or negative energy balance issues, problems with feed management, miscellaneous events not amenable to prevention or treatment, and undetermined causes. Although postmortem evaluations provide the relevant information necessary for framing a cow's death, a restructuring of on-farm databases is needed to integrate this level of detail into useful monitoring systems. Individual operations can focus on combating mortality through the use of employee training related to postmortem evaluations, detailed forms for capturing necropsy particulars and other relevant information related to deaths, and standardized nomenclature and categorization schemes. As much as anything, the simple act of recognizing mortality as a problem might be the most fundamental step toward controlling its progression.

A necropsy-based descriptive study of dairy cow deaths on a Colorado dairy.

Increasing levels of dairy cow mortality pose a challenge to the US dairy industry. The industry's current understanding of dairy cow mortality is reliant upon descriptions largely based on producer or veterinary assumptions regarding cause of death without the benefit of detailed postmortem evaluations. A thorough necropsy is a superior tool for establishing a cause of death, except for cases involving euthanasia for traumatic accidents or severe locomotor disorders. Information provided from a necropsy examination would be most valuable if it were categorized and combined with cow health information in a complete postmortem evaluation designed to guide future management decisions. The objective of this study was to describe dairy cow deaths on a Colorado dairy over a 1-yr period and explore classification systems for necropsy findings that might inform management actions aimed at reducing dairy cow mortality. Throughout the study period a thorough necropsy examination was performed on every cow that died. Based upon this examination each death was characterized by a proximate cause (i.e., the most likely immediate cause of the death). Each proximate cause of death was then categorized using 3 alternate schemes founded on generalized etiologic principles and influenced by previous clinical history and treatments. These schemes included the broad categories commonly used for classifying findings within a review of literature related to dairy cow mortality, a diagnostic scheme used within the problem-oriented veterinary medical record, and an analysis focusing on the primary physiologic system derangement for each death. A total of 2,067 cows were enrolled during the study period of which 1,468 cows freshened, 507 cows were sold, and 94 cows died, resulting in a mortality risk of 6.4 deaths per 100 lactations at risk. The distribution of deaths by parity was significantly different from the herd distribution at the end of study with the largest percentage of death present in parity > or =4. Postmortem findings attributable to a specific cause of death were present for all but 4 of the 94 deaths. Assignment of the proximate causes of death to categories within the 3 alternate schemes provided a means for classifying necropsy findings and causes of death with different levels of detail. Creating categories with more selective groupings may provide a means for capturing specifics related to deaths that can be used to guide management decisions.

Association between hyperglycemia and survival in 228 horses with acute gastrointestinal disease.

BACKGROUND: Glucose homeostasis is dysregulated in critically ill humans resulting in hyperglycemia and decreased survival. Hyperglycemia is common in horses presenting with abdominal crisis, and this might be associated with a worse prognosis for survival. OBJECTIVE: To determine if hyperglycemia in horses with acute abdominal disease is associated with increased odds of failure to survive to hospital discharge. ANIMALS: Two hundred and twenty-eight adult horses with acute gastrointestinal disease. METHODS: Observational retrospective study. Records of horses > 1 year of age presenting for treatment of colic over a 3-year period were reviewed. Data collected included age, duration of colic, glucose, heart rate, PCV, total protein, anion gap, cost of hospitalization, breed, sex, pain at admission, diagnosis, whether surgery was performed, and life status at hospital discharge. Potential risk factors for nonsurvival were screened by univariable logistic regression and the best-fitting univariable model was used as the basis for multivariable regression modeling. RESULTS: Mean blood glucose was 155 mg/dL (8.5 mM) with 45% of the population above the reference range; 16.7% (38 of 228) of horses had severe hyperglycemia (>195 mg/dL; 10.7 mM). Factors associated with increased odds of failure to survive included glucose, severity of pain at admission, heart rate, PCV, anion gap, and diagnosis. The best-fitting multivariable model included glucose and diagnosis, with age included as a confounding variable. The model correctly classified outcome for 92.5% of horses. CONCLUSIONS AND CLINICAL IMPORTANCE: This study has confirmed prior reports that hyperglycemia is common in horses with colic and is associated with a worse prognosis for survival to hospital discharge.

Delayed Photoactivation of Dual-cure Composites: Effect on Cuspal Flexure, Depth-of-cure, and Mechanical Properties.

OBJECTIVES:: This study tested whether delayed photoactivation could reduce shrinkage stresses in dual-cure composites and how it affected the depth-of-cure and mechanical properties. METHODS AND MATERIALS:: Two dual-cure composites (ACTIVA and Bulk EZ) were subjected to two polymerization protocols: photoactivation at 45 seconds (immediate) or 165 seconds (2 minutes delayed) after extrusion. Typodont premolars with standardized preparations were restored with the composites, and cuspal flexure caused by polymerization shrinkage was determined with three-dimensional scanning of the external tooth surfaces before restoration (baseline) and at 10 minutes and one hour after photoactivation. Bond integrity (intact interface) was verified with dye penetration. Depth-of-cure was determined by measuring Vickers hardness through the depth at 1-mm increments. Elastic modulus and maximum stress were determined by four-point bending tests (n=10). Results were analyzed with two- or three-way analysis of variance and pairwise comparisons (Bonferroni; α=0.05). RESULTS:: Delayed photoactivation significantly reduced cuspal flexure for both composites at 10 minutes and one hour ( p≤0.003). Interface was >99% intact in every group. Depth-of-cure, elastic modulus, and flexural strength were not significantly different between the immediate and delayed photoactivation ( p>0.05). The hardness of ACTIVA reduced significantly with depth ( p<0.001), whereas the hardness of Bulk EZ was constant throughout the depth ( p=0.942). CONCLUSIONS:: Delayed photoactivation of dual-cure restorative composites can reduce shrinkage stresses without negatively affecting the degree-of-cure or mechanical properties (elastic modulus and flexural strength).

Plasma and synovial fluid concentrations and cartilage toxicity of bupivacaine following intra-articular administration of a liposomal formulation to horses.

BACKGROUND: The use of intra-articular (IA) local anaesthetics has proven to be an effective means to treat post-operative pain. The effects of local anaesthetics on equine chondrocytes are mixed with some studies reporting chondrodestruction and others no adverse effects. A liposomal formulation of bupivacaine is used in people and dogs by intra- and peri-articular administration to provide up to 72 h of analgesia. The potential uses, side effects including chondrotoxicity, and likelihood of abuse (long-term analgesic effects) has not been evaluated in horses. OBJECTIVES: Describe bupivacaine concentrations following IA administration and assess biomarkers as indicators of the effects of liposomal bupivacaine on chondrocytes in vivo. STUDY DESIGN: Parallel design. METHODS: Sixteen exercised horses received a single IA administration of 0.12 mg/kg liposomal bupivacaine or 0.9% saline. Blood and urine samples were collected for 96 h post-drug administration. Six horses treated with bupivacaine and those receiving saline, underwent daily arthrocentesis. Six additional bupivacaine treated horses underwent arthrocentesis at 96 h. Drug concentrations were measured using LC-MS/MS and pharmacokinetic analyses performed. Immunoassays were used to measure markers of collagen degradation (C2C, C12C) and cartilage matrix synthesis (CPII, CS846) in synovial fluid. RESULTS: The bupivacaine plasma elimination half-life was 17.8 ± 5.42 and 11.9 ± 5.17 h for horses from which synovial fluid was collected daily and at 96 h respectively. Bupivacaine concentrations in the joint were still detectable at 96 h. Significant increases in C12C and C2C were noted at 96 h in horses undergoing arthrocentesis at 96 h only. CPII was increased at 48 h and CS846 at 24 and 48 h in horses sampled daily. MAIN LIMITATIONS: Limited number of animals and absence of liposome control group. CONCLUSIONS: Sustained concentrations of IA bupivacaine suggest viability of this medication as an intra-articular analgesic. Effects on equine chondrocytes need further study.

The effects of chiropractic, massage and phenylbutazone on spinal mechanical nociceptive thresholds in horses without clinical signs.

REASON FOR PERFORMING STUDY: Common methods used to treat back problems in horses need to be assessed objectively. OBJECTIVES: To measure spinal mechanical nociceptive thresholds (MNTs) and evaluate the effects of chiropractic, massage and phenylbutazone, compared with active and inactive control groups. METHODS: Baseline MNTs at 7 sites within the thoracolumbar and sacral regions were measured in 38 healthy mature horses exhibiting no clinical signs of lumbar pain. Horses were assigned to one of 3 treatment groups: instrument-assisted chiropractic treatment, therapeutic massage and phenylbutazone; or 2 control groups: ridden exercise (active control) or routine paddock turnout with no ridden exercise (inactive control). MNT measurements were repeated at 1, 3 and 7 days post treatment. The percentage change from baseline MNT values was calculated within groups. RESULTS: On Day 7, the median MNT had increased by 27, 12 and 8% in the chiropractic, massage and phenylbutazone groups, respectively. MNT changes of <1% were seen within the active and inactive control groups. CONCLUSIONS: Chiropractic treatment and massage therapy increased spinal MNTs within horses not exhibiting signs of lumbar pain. POTENTIAL RELEVANCE: Pressure algometry provides an objective tool to evaluate the effects of commonly used, but currently unproven treatment modalities on spinal MNTs. Future studies need to evaluate combined treatment effects and longer-term MNT changes in horses with documented back pain.

Mechanical nociceptive thresholds within the pastern region of Tennessee Walking Horses.

REASONS FOR PERFORMING STUDY: 'Soring' is the term used to describe the application of an irritant to the distal forelimbs of gaited horses with the sole intent of inflicting pain and inducing altered gait, illegally practiced in Tennessee Walking Horses. Objective methods for the detection of limb pain due to this practice are, however, lacking. OBJECTIVES: To assess whether Tennessee Walking Horses respond to manual pressures

The role of catastrophic injury or sudden death of the horse in race-day jockey falls and injuries in California, 2007-2012.

REASONS FOR PERFORMING STUDY: If equine conditions with high likelihood of jockey injury can be determined and subsequently prevented, jockey safety can be enhanced. OBJECTIVES: To identify racehorse injuries or conditions with greatest risk for jockey falls and injuries. STUDY DESIGN: Retrospective correlation of race-day jockey fall and injury data with racehorse fatality data. METHODS: Thoroughbred (TB) and Quarter Horse (QH) racehorse cause of death and jockey fall and injury data for California flat races were reviewed for a 6-year period. Race and jockey race ride population data were used to determine jockey fall and injury incidence rates relative to cause of racehorse death, and were assessed using Poisson regression. Differences in proportions were assessed using Fisher's exact, Pearson's χ(2), and Cochran-Mantel-Haenszel tests. RESULTS: 707 racehorses experienced race-related catastrophic injury or sudden death. 199 jockeys had 601 falls with 325 injuries. Jockeys were 162 times more likely to fall (95% confidence interval 137-192; P<0.001) and 171 times more likely to be injured (95% confidence interval 140-208; P<0.001) when they rode a horse that died in a race. We infer that jockeys were more likely to fall or be injured when riding in QH races than in TB races because of a higher incidence of horse fatalities in QH races. Jockey falls occurred with 24% of TB and 36% of QH race-related horse fatalities, and jockey injury occurred in 64% of falls. Jockey falls were most common with TB fetlock injuries and QH carpal, metacarpal and fetlock injuries; and with axial, bilateral and multiple injuries compared with appendicular, unilateral and singular injuries, respectively. CONCLUSIONS: Prevention of the most common catastrophic injuries and conditions of the racehorse, e.g. fetlock injuries, may be most effective at decreasing rates of falls and injuries to horseracing jockeys during racing.

Prevalence, location and symmetry of noncatastrophic ligamentous suspensory apparatus lesions in California Thoroughbred racehorses, and association of these lesions with catastrophic injuries.

REASONS FOR PERFORMING STUDY: Knowledge of the site distribution of ligamentous injuries facilitates clinical diagnosis of suspensory apparatus conditions. OBJECTIVES: To determine if lesions within the suspensory ligament (SL) and distal ligaments of the proximal sesamoid bones (DSLs) were associated with suspensory apparatus failure or metacarpal lateral condylar fracture in California Thoroughbred racehorses. STUDY DESIGN: Cross-sectional study. METHODS: Suspensory apparatus specimens from 327 deceased Thoroughbred racehorses were sectioned within the SL body and branches, and oblique and straight DSLs. Purple lesions ≥2 mm in width were categorised as moderate and paler or smaller lesions as mild. Associations between moderate lesions and age, sex, racetrack and cause of death were evaluated using multivariable logistic regression. RESULTS: Moderate lesions were evident in 16% and milder lesions in 77% of racehorses. Moderate lesions occurred with similar frequency in SL branches and oblique DSLs. Moderate lesions were more likely to occur in horses that died as a result of suspensory apparatus failure (odds ratio [OR] = 4.60; 95% confidence interval [CI] 1.61-13.13; and P = 0.004) or metacarpal lateral condylar fracture (OR = 5.05; 95% CI 1.42-17.93; and P = 0.012) compared with horses that died from nonmusculoskeletal causes, and in horses aged ≥7 years horses compared with 2-year-old horses (OR = 5.33; 95% CI 1.44-19.75; and P = 0.012). CONCLUSIONS: Moderate lesions are common in the SL branches and oblique DSLs of racehorses, and may be associated with risk for suspensory apparatus failure and metacarpal condylar fracture. Monitoring health of the suspensory apparatus ligamentous structures may be a simple means of assessing fatigue in, and preventing more extensive injuries to, the forelimb suspensory apparatus and metacarpal condyles.

Non-fatal injury occurrence in Southern California Thoroughbred racehorses 2009-2010.

Private-practice racetrack veterinarians in southern California recorded non-fatal injuries meeting defined criteria in Thoroughbreds for 1 year. Injury incidence was 2.29 injury events per 100 horse-months, which was lower than other studies where trainer reported injury data were collected. Of 477 injuries recorded, 344 (72.1%) were acute and 133 (27.9%) were chronic. Fractures were common (47.6% of injuries), with stress fractures accounting for 14% of injuries. Superficial digital flexor tendonitis and suspensory ligament desmitis accounted for 15.3 and 11.5% of injuries, respectively. Agreement between non-fatal injuries recorded in the current study and those recorded via an existing regulatory system (Equine Injury Database) was poor, with neither system capturing all injuries. Non-fatal injuries occurred 17-29 times more often than fatal injuries. Non-fatal musculoskeletal injury remains an ongoing issue for Thoroughbred racehorses, and an accurate, comprehensive system for recording these injuries is needed.

Characterization of the live salmonid movement network in Ireland: Implications for disease prevention and control.

Live fish movement is considered as having an important role in the transmission of infectious diseases. For that reason, interventions for cost-effective disease prevention and control rely on a sound understanding of the patterns of live fish movements in a region or country. Here, we characterize the network of live fish movements in the Irish salmonid farming industry during 2013, using social network analysis and spatial epidemiology methods, and identify interventions to limit the risk of disease introduction and spread. In the network there were 62 sites sending and/or receiving fish, with a total of 130 shipments (84 arcs) comprising approx. 17.2 million fish during the year. Atlantic salmon shipments covered longer distances than trout shipments, with some traversing the entire country. The average shipment of Atlantic salmon was 146,186 (SD 194,344) fish, compared to 77,928 (127,009) for trout, however, variability was high. There were 3 periods where shipments peaked (February-April, June-September, and November), which were related to specific stages of fish. The network was disconnected and had two major weak components, the first one with 39 nodes (mostly Atlantic salmon sites), and the second one with 10 nodes (exclusively trout sites). Correlation between in and out-degree at each site and assortativity coefficient were slightly low and non-significant: -0.08 (95% CI: -0.22, 0.06) and -0.13 (95% CI: -0.36, 0.08), respectively, indicating random mixing with regard to node degree. Although competing models also produced a good fit to degree distribution, it is likely that the network possesses both small-world and scale-free topology. This would facilitate the spread and persistence of infection in the salmon production system, but would also facilitate the design of risk-based surveillance strategies by targeting hubs, bridges or cut-points. Using Infomap community detection algorithms, 2 major communities were identified within the giant weak component, which were linked by only 4 nodes. Communities found had no correspondence with geographical zones within the country, which could potentially hinder the implementation of zoning strategies for disease control and eradication. Three significant spatial clusters of node centrality measures were detected, two in county Donegal (betweenness and outcloseness) and one in county Galway (incloseness), highlighting the importance of these locations as hot spots of highly central sites with a higher potential for both introduction and spread of infection. These results will assist in the design and implementation of measures to reduce the sanitary risks emerging from live fish trade within Ireland.

Facio-cardio-renal (Eastman-Bixler) syndrome.

We report on a 5-year-old boy with moderate mental retardation, horseshoe kidneys, tricuspid valve prolapse, and a characteristic face with broad nasal root, prominent ears, and a cleft palate. These manifestations suggested the diagnosis of the Eastman-Bixler syndrome. Our patient also had an isolated growth hormone deficiency which responded successfully to treatment.

Survey of restriction-modification systems and transformation in Mannheimia haemolytica and Pasteurella trehalosi.

A significant obstacle to molecular studies of Mannheimia (Pasteurella) haemolytica, has been its resistance to genetic transformation. The lack of competence of many M. haemolytica strains has been attributed to the presence of restriction modification systems. In this study, representative strains of 12 M. haemolytica serotypes and four Pasteurella trehalosi serotypes were successfully transformed by electroporation using a recombinant vector derived from the native M. haemolytica A1 serotype plasmid pNSF2176. Transformation was achieved despite PCR-based evidence for the presence of genes encoding a type I restriction enzyme, phaI, and a type II restriction enzyme hsdM, in each of the M. haemolytica strains.

Cranial computed tomography in the under twos.

One hundred consecutive cranial computed tomographic scans were reviewed in children aged 0-2 years, presenting to the Royal Belfast Hospital for Sick Children. The mean age at scanning was 8.3 months and 73% of the scans were abnormal. The majority of scans were performed electively (78%). The commonest indication for a scan was seizures (31) and the diagnostic yield was highest where they were associated with other neuro-developmental symptoms. The usefulness of the CT scan was not limited to the abnormal studies but contributed to management in children with normal scans by excluding important intracranial pathology. Developmental CNS malformation (16 scans) and cerebral atrophy (15 scans) were the most frequent CT abnormalities encountered.