Treatment of Heat-Related Illnesses

Algorithm for the treatment of heat-related illnesses. (CNS = central nervous system; ABCs = airway, breathing, and circulation; EMS = emergency medical services.)

Neonatal and Pediatric Pharmacology: Therapeutic Principles in Practice

Written by experts at the forefront of current research and clinical practice, this volume provides evidence-based guidelines for safe, effective, and rational drug therapy in newborns, children, and adolescents. Coverage includes specific recommendations for all major drug classes and diseases, a detailed section on drugs and the newborn, and chapters on specific treatment settings such as the pediatric intensive care unit and emergency room. Also included are chapters on adverse effects and interactions and state-of-the-art discussions on pharmacokinetics, pharmacodynamics, pharmacogenetics, drug development, and clinical drug trials in infants and children. Appendices include a neonatal formulary and a pediatric formulary.

Pearl necklace sign

Adenomyomatosis of the gallbladder is a hyperplastic cholesterolosis of the gallbladder wall which is common and benign.
Adenomyomatosis presents usually asymptomatic, however in most cases It is associated with chronic biliary inflammation, most commonly gallstones in 25 - 75% but also seen in cholesterolosis in 33% and pancreatitis.

The pearl necklace sign is seen in patients with adenomyomatosis of the gallbladder, on both oral cholecystograms and MRCP. It represents the contrast / fluid filled intramural mucosal diverticula (Rokitansky-Aschoff sinuses) which line up reminiscent of pearls on a necklace.

MRI images demonstrate adenomyomatosis at the gallbladder fundus This case was donated to Radiopaedia.org by Radswiki.net

It is said to be highly specific (92%) for the diagnosis of adenomyomatosis, however is frequently not seen, only present in ~70% of cases.