Dynamics of childhood obesity in Hong Kong throughout the COVID-19 pandemic before and after the school closures: a 3-year longitudinal study.

OBJECTIVE: This study is to evaluate if there is any difference in the balance between incidence of and remission from overweight/obesity in Hong Kong school-age children before and during the COVID-19 pandemic over three years. METHODS: This is a retrospective longitudinal study that involved children aged 6-16 years from a database of the School Physical Fitness Award Scheme. RESULTS: 2765 students were longitudinally followed up for two years. The prevalence of childhood overweight/obesity was increased between the 2019 and 2021 academic years (P < 0.001). During the COVID-19 pandemic, the rate of obesity remission significantly reduced by 7.9 % (P = 0.003), at a background of a plateau of obesity among children and adolescents. CONCLUSIONS: Our study provides evidence on the impact of school closure and home confinement as a standard infection control measure for the prevention of COVID-19, which are likely to break the balance between incidence of and remission from childhood obesity.

Late relapse of metastatic non-seminomatous testicular germ cell tumours.

Although the majority of men presenting with non-seminomatous germ cell tumours (NSGCT) are cured, late relapse (occurring more than 2 years after obtaining a complete response to treatment) is increasingly recognized. The typical patterns of disease spread have been well-documented, but the findings at late relapse are more variable and less well-described. We discuss the phenomenon of late relapse, the characteristics of teratoma differentiated (TD), and the issue of long-term imaging surveillance of patients with NSGCT. The potential sites of late relapse of NSGCT and the associated spectrum of imaging appearances are illustrated.

Radiological appearances of lymphomas arising from mucosa-associated lymphoid tissue (MALT) in the lung.

We review the radiological findings in 13 patients with histologically proven (n = 10) or clinically diagnosed (n = 3) lymphomas arising in mucosa-associated lymphoid tissue (MALT) of the lung. These rare B-cell lymphomas typically follow an indolent course, and many cases are still being incorrectly described in current radiological literature under the term pseudolymphoma. The patients frequently give a history of autoimmune disease involving the affected organ, and involvement of another mucosal site as part of a disseminated MALT lymphoma, is common. The radiographic patterns of pulmonary parenchymal involvement in lung MALT lymphomas have been reviewed, and correlation made with their clinical behaviour.

Bare area abscess: imaging findings and potential communication with the mediastinum.

The bare area of the liver is not usually visualized by standard cross-sectional imaging techniques except in patients with ascites or subphrenic collections where this area is spared of fluid. We present a case of an abscess in the bare area of the liver with imaging findings and demonstration of a communication with the mediastinum, not previously described.

Multiple cavitating pulmonary lesions in non-Hodgkin's lymphoma.

We report two patients with multiple cavitating lung lesions caused by large cell non-Hodgkin's lymphoma. This pattern of disease has rarely been reported in non-Hodgkin's lymphoma and is more commonly described in Hodgkin's disease. The patterns of pulmonary parenchymal involvement in non-Hodgkin's lymphoma are reviewed with particular reference to cavitary lesions.

Case report: intraperitoneal metastases from testicular germ cell tumour.

We report a patient with intraperitoneal metastases following treatment for seminoma. This is an unusual site of spread and was accompanied by transformation of tumour morphology.

The significance of pulmonary nodules detected on CT staging for lung cancer.

Small pulmonary nodules of soft tissue density are often found during computed tomography for the staging of lung cancer, but CT cannot reliably distinguish benign from malignant uncalcified pulmonary nodules. The purpose of this study was to assess the significance of pulmonary nodules discovered on staging CT. 551 patients with lung cancer who had a staging CT and who were considered operable were studied. Eighty-eight patients (16%) were found to have small non-calcified pulmonary nodules. Adequate follow-up was possible in 25 patients who had a total of 36 nodules. Twenty-five nodules (70%) were subsequently confirmed to be benign, four (11%) were malignant and the nature of seven (19%) could not be determined. The high prevalence of benign nodules in this population should be taken into account when staging lung cancer.

Accuracy of the typical computed tomographic appearances of fibrosing alveolitis.

BACKGROUND: Open lung biopsy is often performed to confirm the diagnosis in patients with suspected fibrosing alveolitis. The superior sensitivity and specificity of high resolution computed tomography (CT) over chest radiography in various diffuse lung diseases suggest that the characteristic appearance of fibrosing alveolitis on high resolution CT might render biopsy confirmation unnecessary. METHODS: The chest radiographs and high resolution CT scans of 86 patients (41 with fibrosing alveolitis and 45 with various other diffuse lung diseases) were examined individually and independently by two observers. No clinical information was given and the observers gave a level of confidence when the diagnosis was thought to be fibrosing alveolitis. RESULTS: The observers correctly and confidently discriminated between fibrosing alveolitis and other diffuse lung diseases on high resolution CT with an accuracy of 88% and on chest radiography with an accuracy of 76%. The false negative rate for fibrosing alveolitis diminished from 29% on chest radiography to 11% on high resolution CT. The false positive rate on chest radiography was 19% and on high resolution CT 13%; the false positive diagnoses on CT were the result of a few conditions (extrinsic allergic alveolitis, sarcoidosis, cryptogenic organising pneumonia, and pulmonary eosinophilia) which mimicked some of the CT features of fibrosing alveolitis. The superficial similarity of the CT patterns of these conditions are discussed. CONCLUSIONS: High resolution CT is superior to chest radiography in establishing the diagnosis of fibrosing alveolitis and the typical CT appearances are virtually pathognomonic. The diagnostic advantages of CT over chest radiography should further reduce the need for open lung biopsy in this condition.

Renal biopsy in diffuse renal disease--experience with a 14-gauge automated biopsy gun.

The diagnostic and complication rates of 104 percutaneous renal biopsies performed for diffuse renal disease in native kidneys were retrospectively reviewed. Biopsies were performed by one radiologist using continuous ultrasound guidance and a 14-gauge biopsy needle in an automated gun (Biopty TM, Radiplast TM, Uppsala). 103 of 104 (99%) biopsies resulted in adequate tissue for a definitive histological diagnosis which improves on previously published diagnostic rates. Four patients (3.8%) experienced transient macroscopic haematuria. There were two symptomatic peri-renal haematomas, both of whom required transfusion, and one arteriovenous fistula which was successfully embolized (total 2.9% significant complications). Our results compare favourably with results using more conventional techniques. We suggest that use of real-time ultrasound with the 14-gauge Biopty needle should be the method of choice for percutaneous renal biopsy in adults.

Case report: misdiagnosis of an atypical pericardial cyst presenting in a patient with chest trauma.

We report a patient who presented following major trauma to the chest who had a pericardial cyst in the anterior aspect of the upper mediastinum, the high CT number of which led to a misdiagnosis. The patient underwent surgery when the pericardial cyst was excised.

Neonatal systemic candidiasis diagnosed by ultrasound.

The diagnosis of systemic candidiasis in ill high-risk neonates is often delayed as there are no specific clinical features and the significance of positive cultures for Candida species may be uncertain. Early diagnosis and treatment is essential to reduce mortality and may be aided by ultrasound examination of the commonly involved organs - the brain and kidneys. In this paper we describe 2 cases where the diagnosis was first raised following ultrasound examination, and review the spectrum of abnormalities seen on renal and cranial ultrasound examination. We emphasise the importance of using this imaging technique in the high-risk neonate in initiating earlier diagnosis and treatment, or in establishing the significance or otherwise of positive cultures.

The incidence and sites of medial thigh communicating veins: a phlebographic study.

One hundred saphenograms in 65 patients were reviewed to assess the number and distribution of communicating veins on the medial aspect of the thigh. Sixty-one per cent of the legs had one or more communicating veins in the middle third of the thigh (Hunter's canal), 27% were in the lower third and 1% in the upper third. Eleven per cent of the legs investigated had no evidence of communicating veins. The number of communicating veins ranged from none to three. Because of the range in the number and position of the communicating veins, which are potential sites of venous incompetence, their phelebographic demonstration by varicography is recommended in legs with recurrent varicose veins.

The value of the lateral projection in preoperative assessment of abdominal aortic aneurysms by IV-DSA.

25 consecutive patients with known abdominal aneurysms were examined pre-operatively by IV-DSA. In all patients a lateral view was taken in addition to the standard posteroanterior view. The state of the visceral arteries was best assessed on the lateral projection. In 24% of examinations the renal arteries could not be visualised satisfactorily in the lateral view. In 37% of the 19 patients in which the distance between the renal arteries and the aneurysm neck could be measured there was a greater than 1 cm discrepancy between the two projections indicating that both views are necessary for accurate measurement. It is concluded that both a lateral and a postero-anterior projection should be routinely taken for IV-DSA in pre-operative assessment of abdominal aortic aneurysms.