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Minimal Changes In Pediatric

J W Varni, A M Delamater, K K Hood, J K Raymond, N T Chang, K A Driscoll, J C Wong, J P Yi-Frazier, E K Grishman, M A Faith, S D Corathers, J C Kichler, J L Miller, E M Doskey, V P Aguirre, R W Heffer, D P Wilson
AIM: To test the measurement properties of the revised and updated Pediatric Quality of Life Inventory (PedsQL) 3.2 Diabetes Module originally developed in Type 1 diabetes in youth with Type 2 diabetes. METHODS: The PedsQL 3.2 Diabetes Module and PedsQL Generic Core Scales were administered in a field test study to 100 young people aged 9-25 years with Type 2 diabetes. Factor analysis was conducted to determine the factor structure of the items. RESULTS: The 15-item Diabetes Symptoms Summary Score and 12-item Type 2-specific Diabetes Management Summary Score were empirically derived through factor analysis...
October 21, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Marie R Waterhouse, Phung K Pham, Todd P Chang
OBJECTIVES: Adolescent female patients who are not sexually active and who present to a pediatric emergency department with abdominal pain require a full bladder prior to transabdominal ultrasound. Procedures to fill the bladder are largely institution or provider dependent. We examined adolescent females' attitudes and opinions toward 2 common methods of bladder filling, intravenous fluid administration and transurethral Foley catheter placement, by means of a Q-sort study. METHODS: Two convenience samples of adolescent female patients in the pediatric emergency department at an academic children's hospital participated in the study...
October 17, 2018: Pediatric Emergency Care
Lindsey Hathaway, Jeremy Michael Sen, Michael Keng
Relapsed/refractory (R/R) acute lymphoblastic leukemia (ALL) is associated with a poor prognosis in both children and adults. Traditionally, there were limited options for salvage therapy, which consisted mostly of conventional chemotherapy. However, in the past 5 years, novel agents have changed our treatment strategies in this population. Blinatumomab, a bispecific CD19 directed CD3 T-cell engager, has shown to be effective in both minimal residual disease and R/R B-cell ALL. In R/R B-cell ALL, blinatumomab was associated with an improved median overall survival of 7...
2018: Patient related Outcome Measures
Chang-Hoon Koo, Sun Young Lee, Seung Hyun Chung, Jung-Hee Ryu
The purpose of this study was to compare the incidence of airway complications between extubation under deep anesthesia (deep extubation) and extubation when fully awake (awake extubation) in pediatric patients after general anesthesia. A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) statement standards. The review protocol was registered with the International Prospective Register of Systematic Reviews (registration number: CRD 42018090172)...
October 14, 2018: Journal of Clinical Medicine
Kunj R Sheth, Jason P Van Batavia, Diana K Bowen, Chester J Koh, Arun K Srinivasan
As the frontiers of minimally invasive surgery (MIS) continue to expand, the availability and implementation of new technology in pediatric urology are increasing. MIS is already an integral part of pediatric urology, but there is still much more potential change to come as both recent and upcoming advances in laparoscopic and robotic surgery are surveyed.
November 2018: Urologic Clinics of North America
Joseph A Sujka, Justin Sobrino, Leo A Benedict, Hanna Alemayehu, Shawn St Peter, Richard Hendrickson
INTRODUCTION: Enteric duplication is a congenital anomaly with varied clinical presentation that requires surgical resection for definitive treatment. This had been approached with laparotomy for resection, but has changed with minimally invasive technique. The purpose of our study was to determine the demographics, natural history, operative interventions, and outcomes of pediatric enteric duplication cysts in a contemporary cohort. METHODS: With IRB approval, we performed a retrospective chart review of all patients less than 18 years old treated for enteric duplication between January 2006 and August 2016...
October 13, 2018: Pediatric Surgery International
Ting-Chi Yeh, Der-Cherng Liang, Jen-Yin Hou, Tang-Her Jaing, Dong-Tsamn Lin, Chao-Ping Yang, Ching-Tien Peng, Iou-Jih Hung, Kai-Hsin Lin, Chih-Cheng Hsiao, Shiann-Tarng Jou, Shyh-Shin Chiou, Jiann-Shiuh Chen, Shih-Chung Wang, Te-Kau Chang, Kang-Hsi Wu, Jiunn-Ming Sheen, Hsiu-Ju Yen, Shih-Hsiang Chen, Meng-Yao Lu, Meng-Ju Li, Tai-Tsung Chang, Ting-Huan Huang, Yu-Hsiang Chang, Shu-Huey Chen, Yung-Li Yang, Hsiu-Hao Chang, Bow-Wen Chen, Pei-Chin Lin, Chao-Neng Cheng, Yu-Hua Chao, Shang-Hsien Yang, Yu-Mei Y Chao, Hsi-Che Liu
BACKGROUND: To eliminate cranial irradiation (CrRT)-related sequelae and to minimize the adverse impact of traumatic lumbar puncture (TLP) with blasts, the Taiwan Pediatric Oncology Group (TPOG) introduced a modified central nervous system (CNS)-directed regimen characterized by delayed triple intrathecal therapy (TIT) and the omission of CrRT for all children with newly diagnosed acute lymphoblastic leukemia (ALL). METHODS: This study compared the treatment outcomes of patients overall and patients with a non-CNS-1 status (CNS-2, CNS-3, or TLP with blasts) in 2 treatment eras, one before and another after the revision of the TPOG-ALL-2002 protocol by the introduction of the modification (era 1 [2002-2008] with CrRT and era 2 [2009-2012] with delayed first TIT and no CrRT)...
October 10, 2018: Cancer
Rohit S Loomba, Seth B Gray, Saul Flores
INTRODUCTION: Ketamine is a drug often used for procedural sedation or as adjunct agent for general sedation in children with congenital heart disease. In the clinical realm, there is often confusion regarding the effects of ketamine on hemodynamics, particularly pulmonary vascular resistance and systemic vascular resistance. We performed a meta-analysis of studies investigating the effects of ketamine on hemodynamics. METHODS: A systematic review was conducted to identify studies characterizing the hemodynamic effects of ketamine in children with congenital heart disease...
September 27, 2018: Congenital Heart Disease
Micaela Gal, Nina Gobat, Nicholas A Francis, Kerenza Hood, Christopher C Butler, Julia Bielicki, Pieter L Fraaij, Mike Sharland, Jessica Jarvis, Annemarie M C van Rossum, Terho Heikkinen, Federico Martinon-Torres, Jethro Herberg, Angela Watkins, Steve A R Webb, Ronnie Moore, Prasanth Sukumar, Alistair Nichol
BACKGROUND: Infectious disease pandemics (IDP) pose a considerable global threat and can disproportionately affect vulnerable populations including children. Pediatric clinical research in pandemics is essential to improve children's healthcare and minimize risks of harm by interventions that lack an adequate evidence base for this population. The unique features of IDPs require consideration of special processes to facilitate clinical research. We aimed to obtain consensus on pediatric clinician-researchers' perceptions of the priorities to feasibly conduct clinical pediatric pandemic research in Europe...
September 25, 2018: Pediatric Infectious Disease Journal
Peng Hu, Jian Liu, Juanjuan Zhao, Benjamin J Wilkins, Katherine Lupino, Hao Wu, Liming Pei
A fundamental challenge in understanding cardiac biology and disease is that the remarkable heterogeneity in cell type composition and functional states have not been well characterized at single-cell resolution in maturing and diseased mammalian hearts. Massively parallel single-nucleus RNA sequencing (snRNA-seq) has emerged as a powerful tool to address these questions by interrogating the transcriptome of tens of thousands of nuclei isolated from fresh or frozen tissues. snRNA-seq overcomes the technical challenge of isolating intact single cells from complex tissues, including the maturing mammalian hearts; reduces biased recovery of easily dissociated cell types; and minimizes aberrant gene expression during the whole-cell dissociation...
October 1, 2018: Genes & Development
Isadora Olenscki Gilli, Andrei Fernandes Joaquim, Helder Tedeschi, Simone Dos Santos Aguiar, Andre Moreno Morcillo, Enrico Ghizoni
PURPOSE: Understand the variables that could interfere with diagnosis and prompt treatment in CNS childhood cancer in Brazil, a developing country with continental dimensions. METHODS: From 2005 to 2010, we retrospectively evaluated factors, which could represent a negative influence on the time period elapsing from the onset of symptoms until the diagnosis of the central nervous system (CNS) neoplasia in children and adolescents attended in our service. RESULTS: Two hundred seventeen records were analyzed retrospectively...
September 24, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Barbara Ameer, Michael A Weintraub
Obesity is an ongoing global health concern and has only recently been recognized as a chronic disease of energy homeostasis and fuel partitioning. Obesity afflicts 17% of U.S. children and adolescents. Severe obesity (≥120% of the 95th percentile of body mass index (BMI) for age, or a BMI ≥ 35 kg/m2 ) is the fastest-growing subgroup and now approaches 6% of all U.S. youth. Health consequences (eg, type 2 diabetes, coronary heart disease) are related in a dose-dependent manner to severity of obesity. Because therapeutic interventions are less effective in severe obesity, prevention is a high priority...
October 2018: Journal of Clinical Pharmacology
Chris I Wong, Amy L Billett, Shicheng Weng, Kelly Eng, Usha Thakrar, Kimberly J Davies
Introduction: Influenza vaccination of pediatric oncology and stem cell transplant (SCT) patients is crucial due to high risk of complications. Achieving high vaccination rates to prevent illness is often limited by competing demands and intensive treatment. A quality improvement (QI) initiative beginning influenza season 2012-2013 aimed to achieve and sustain high vaccination rates in active patients > 6 months of age, receiving cancer therapy or SCT within 6 months before or at any time during the season, and > 100 days after allogeneic SCT...
January 2018: Pediatric Quality & Safety
Sho Kohyama, Takeshi Ogawa, Naotaka Mamizuka, Yuki Hara, Masashi Yamazaki
Background: Evaluations of the stability of osteochondritis dissecans (OCD) lesions of the elbow using magnetic resonance imaging (MRI) have resulted in reports with variable accuracy. Therefore, the International Cartilage Repair Society (ICRS) classification remains the gold standard to determine OCD lesion stability. Because OCD commonly occurs in pediatric patients, a noninvasive method comparable with the ICRS classification is desired. Hypothesis/Purpose: Based on the previous literature, the capitellum of unstable OCD lesions has an irregular outline on MRI because of displacement or dislocation of the lesion via synovial fluid inflow...
September 2018: Orthopaedic Journal of Sports Medicine
Xiaoyang Li, Nicole A Seebacher, Francis J Hornicek, Tao Xiao, Zhenfeng Duan
Bone and soft tissue sarcomas account for approximately 1% of adult solid malignancies and 20% of pediatric solid malignancies. Sarcomas are divided into more than 50 subtypes. Each subtype is highly heterogeneous and characterized by significant morphological and phenotypic variability. Currently, sarcoma characterization is based on tissue biopsies. However, primary and invasive tissue biopsies may not accurately reflect the current disease condition following treatment as is may cause marked changes to the tumor cells...
September 14, 2018: Cancer Letters
Diane Armao, Terry S Hartman, Christopher M Shea, Laurence Katz, Tracey Thurnes, J Keith Smith
"I am not young enough to know everything."Oscar Wilde. Background: There is insufficient knowledge among providers and patients/caregivers of ionizing radiation exposure from medical imaging examinations. This study used a brief, interactive educational intervention targeting the topics of best imaging practices and radiation safety early in health professions students' training. The authors hypothesized that public health, medical, and physician assistant students who receive early education for imaging appropriateness and radiation safety will undergo a change in attitude and have increased awareness and knowledge of these topics...
January 2018: Journal of Medical Education and Curricular Development
Gina M Whitney, James J Thomas, Thomas M Austin, Jemel Fanfan, Myron Yaster
BACKGROUND: Pediatric anesthesiologists are exposed to ionizing radiation from x-rays on an almost daily basis. Our goal was to determine the culture of safety in which they work and how they adhere to preventative strategies that minimize exposure risk in their daily practice. METHODS: After Institutional Review Board waiver and approval of the Society for Pediatric Anesthesia's research and quality and safety committees, an electronic e-mail questionnaire was sent to the Society's physician, nontrainee members and consisted of questions specific to provider use of protective lead shielding, the routine use of dosimeters, and demographic information...
September 6, 2018: Anesthesia and Analgesia
H Y Geng, L N Ji, C Y Chen, J Tu, H R Li, R Bao, Y Lin
Objective: To compare the efficacy and safety of mycophenolate mofetil versus cyclosporine A in treating children with primary refractory nephrotic syndrome. Methods: Conducted a prospective randomized controlled clinical trial in 62 pediatric patients (including 44 boys and 18 girls), age ranged from 2.1 to 17.0 years; 32 cases presented with frequently relapsing nephrotic syndrome (FRNS) and 30 cases presented with steroid-resistant nephrotic syndrome (SRNS), who were admitted to department of Nephrology, Children's Hospital Affiliated to Capital Institute of Pediatrics from October 2013 to October 2015...
September 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Britta Höcker, Lutz T Weber, Ulrike John, Jens Drube, Henry Fehrenbach, Günter Klaus, Martin Pohl, Tomáš Seeman, Alexander Fichtner, Elke Wühl, Burkhard Tönshoff
BACKGROUND: Variable effects of steroid minimization strategies on blood pressure in pediatric renal transplant recipients have been reported, but data on the effect of steroid withdrawal on ambulatory blood pressure and circadian blood pressure rhythm have not been published so far. METHODS: In a prospective, randomized, multicenter study on steroid withdrawal in pediatric renal transplant recipients (n = 42) on cyclosporine, mycophenolate mofetil, and methylprednisolone, we performed a substudy in 28 patients, aged 11...
September 4, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Lauren M Baumann, Kibileri Williams, Hassan Ghomrawi, Fizan Abdullah
BACKGROUND: Postoperative activity restrictions are designed to prevent undue stress on a recent repair and minimize the risk of surgical complication, however, there is little evidence to support certain restrictions in clinical practice. For the pediatric population, there is a paucity of formal evaluations of postoperative activity restrictions, and little is known about current practice patterns among pediatric surgeons. This study aimed to describe national practice patterns of pediatric surgeons for postoperative activity recommendations following three common general surgical procedures...
June 26, 2018: Journal of Pediatric Surgery
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