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  • Journal article
    Thayyil S, 2011,

    Less invasive autopsy: an evidenced based approach

    , ARCHIVES OF DISEASE IN CHILDHOOD, Vol: 96, Pages: 681-687, ISSN: 0003-9888
  • Journal article
    Thayyil S, 2011,

    Brain cooling in babies: Are we ready for clinical trials in developing countries?

    , INDIAN PEDIATRICS, Vol: 48, Pages: 441-442, ISSN: 0019-6061
  • Journal article
    Wilkinson DJ, Thayyil S, Robertson NJ, 2011,

    Ethical and practical issues relating to the global use of therapeutic hypothermia for perinatal asphyxial encephalopathy

  • Book chapter
    Robertson NJ, Thayyil S, 2011,

    Hypothermic neural rescue for neonatal encephalopathy in mid- and low-resource settings

    , Neonatal Neural Rescue: A Clinical Guide, Pages: 128-141, ISBN: 9781107681606

    © Cambridge University Press 2013. The most significant burden of neonatal encephalopathy (NE) occurs in low- and mid-resource settings [1]. The WHO World Health Report 2005 estimated that an annual 1 million survivors of “birth asphyxia” may develop cerebral palsy, learning difficulties or other disabilities [2]. Globally, perinatal asphyxia is responsible for 42 million disability life adjusted years – this is double that due to diabetes and three quarters of that due to HIV/AIDS [1]. Almost one quarter of the world’s 4 million annual neonatal deaths are caused by perinatal asphyxia (Figures 12.1, 12.2) [3]: 99% of these deaths occur in low- and mid-resource settings especially those countries with higher neonatal mortality rates (Figures 12.1, 12.2). The potential benefits of therapeutic hypothermia (were it to be safe and effective in every setting) are potentially greater in low- and mid-resource settings where birth asphyxia is at least 10-fold higher than in the developed world. However, all the positive evidence about the safety and efficacy of cooling relates to high-income countries. Furthermore, there is a theoretical risk that problems such as immune suppression by hypothermia may be deleterious in a different setting; one pilot study in a low-resource setting [4] reported more deaths in the cooled group and the expensive high tech cooling devices used in the developed world are not appropriate for global use in low- and mid-resource settings.

  • Journal article
    Thayyil S, Robertson NJ, Sebire NJ, Taylor AMet al., 2010,

    Post-mortem MR and CT imaging in fetuses, newborns and children: an evidenced based approach

    , Diagnostic Histopathology, Vol: 16, Pages: 565-572, ISSN: 1756-2317

    There is insufficient evidence in the published literature to support the use of post-mortem MR imaging (MRI) as an alternative for conventional non-forensic autopsy in fetuses, newborns and children. Large prospective studies evaluating the accuracy of post-mortem MR imaging in a rigorous and blinded way are now nearing completion and the results are expected in 2011. Less-invasive autopsies by post-mortem MR imaging may have major effect in resurrecting consented autopsy rates; however an evidenced based and systematic approach towards less-invasive autopsy process is mandatory to ensure that the post-mortem data remains accurate and credible. Here we summarize the current evidence, ongoing research and future directions for less-invasive autopsy process in the United Kingdom. A joint effort between clinicians, radiologists, pathologists, parent groups and funding bodies is essential for successful implementation of less-invasive autopsy, in the UK. © 2010 Elsevier Ltd.

  • Journal article
    Robertson NJ, Kendall GS, Thayyil S, 2010,

    Techniques for therapeutic hypothermia during transport and in hospital for perinatal asphyxial encephalopathy

    , SEMINARS IN FETAL & NEONATAL MEDICINE, Vol: 15, Pages: 276-286, ISSN: 1744-165X
  • Journal article
    Schievano S, Sebire NJ, Robertson NJ, Taylor AM, Thayyil Set al., 2010,

    Reconstruction of fetal and infant anatomy using rapid prototyping of post-mortem MR images.

    , Insights Imaging, Vol: 1, Pages: 281-286, ISSN: 1869-4101

    OBJECTIVES: The recent decline in autopsy rates and lack of human anatomical material donated for research and training has resulted in issues for medical training in the United Kingdom. This study aims to examine the feasibility of making accurate three-dimensional (3D) models of the human body and visceral organs using post-mortem magnetic resonance (MR) imaging and rapid prototyping. METHODS: We performed post-mortem MR imaging using a 3D T2-weighted sequence in 11 fetuses and infants, before autopsy, using either a 1.5-T or 9.4-T MR scanner. Internal organs were reconstructed in silico and 3D models were created by rapid prototyping. RESULTS: The median gestation of fetuses was 20 (range 19-30) weeks and the median age of infants was 12 (range 8-16) weeks. Models created by rapid prototyping accurately depicted structural abnormalities and allowed clear visualisation of 3D relationships. CONCLUSIONS: Accurate 3D modelling of anatomical features from post-mortem imaging in fetuses and infants is feasible. These models could have a large number of medical applications, including improved parental counselling, invaluable teaching resources and significant medico-legal applications to demonstrate disease or injury, without the need to show actual autopsy photographs.

  • Journal article
    Thayyil S, Chitty LS, Robertson NJ, Taylor AM, Sebire NJet al., 2010,

    Minimally invasive fetal postmortem examination using magnetic resonance imaging and computerised tomography: current evidence and practical issues

    , PRENATAL DIAGNOSIS, Vol: 30, Pages: 713-718, ISSN: 0197-3851
  • Journal article
    Thayyil S, Chandrasekaran M, Chitty LS, Wade A, Skordis-Worrall J, Bennett-Britton I, Cohen M, Withby E, Sebire NJ, Robertson NJ, Taylor AMet al., 2010,

    Diagnostic accuracy of post-mortem magnetic resonance imaging in fetuses, children and adults: A systematic review

    , EUROPEAN JOURNAL OF RADIOLOGY, Vol: 75, Pages: E142-E148, ISSN: 0720-048X
  • Journal article
    Thayyil S, Bhutta ZA, Ramji S, Costello AM, Robertson NJet al., 2010,

    Global application of therapeutic hypothermia to treat perinatal asphyxial encephalopathy

    , INTERNATIONAL HEALTH, Vol: 2, Pages: 79-81, ISSN: 1876-3413

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