Background: Image review on computer-based workstations has made film-basedreview outdated. Despite advances in technology, the lack of portability ofdigital workstations creates an inherent disadvantage. As such, we sought todetermine if the quality of image review on a handheld device is adequatefor routine clinical use. Methods: Six CT/CTA cases and six MR/MRA cases were independently reviewed bythree neuroradiologists in varying environments: high and low ambient lightusing a handheld device and on a traditional imaging workstation in idealconditions. On first review (using a handheld device in high ambient light),a preliminary diagnosis for each case was made. Upon changes in reviewconditions, neuroradiologists were asked if any additional features wereseen that changed their initial diagnoses. Reviewers were also asked tocomment on overall clinical quality and if the handheld display was ofacceptable quality for image review. Results: After the initial CT review in high ambient light, additionalfindings were reported in 2 of 18 instances on subsequent reviews.Similarly, additional findings were identified in 4 of 18 instances afterthe initial MR review in high ambient lighting. Only one of these sixadditional findings contributed to the diagnosis made on the initialpreliminary review. Conclusions: Use of a handheld device for image review is of adequate diagnosticquality based on image contrast, sharpness of structures, visible artefactsand overall display quality. Although reviewers were comfortable with usingthis technology, a handheld device with a larger screen may bediagnostically superior.

Ototoxic drugs are widely used in the developing world, without audiological monitoring. Epidemiological data on ototoxic deafness are lacking for developing countries. The public health aspect of ototoxicity is often overlooked, to the detriment of the individual patient. This paper reviews ototoxic hearing loss, particularly in sub-Saharan Africa, and also assesses the impact of treatments for tuberculosis, cancer and human immunodeficiency virus (the latter including highly active antiretroviral therapy) on ototoxic hearing loss. The paper also discusses obstacles to audiological monitoring for ototoxicity in the developing world, and the potential of audiology screening using applications for mobile devices.