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Minimal Changes In Pediatric

Savannah Ross, Kristen Eisenman, Kelly W Maloney
Pediatric Burkitt lymphoma has historically been treated with intensive methotrexate-based chemotherapy, which improves patient survival while causing severe toxicities. Young patients typically have better outcomes with intensive therapies, while adults and immunocompromised patients have higher toxicities and worse outcomes. Newer treatment regimens, including etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, rituximab (EPOCH-R), show promise for these patients. However, few studies exist to demonstrate efficacy and improved toxicity profile with EPOCH-R...
August 8, 2018: Journal of Pediatric Hematology/oncology
Danka Pokrajac, Azra Hodzic Kamber, Zinaida Karasalihovic
Background: Nephrotic syndrome (NS) is one of the most frequent glomerular diseases among children. While most of the children with primary NS respond to steroid treatment, 10 to 20% of the patients are steroid-resistant, and the best therapy for such cases has never been defined. Objective: The present study aimed to evaluate steroid-resistant nephrotic syndrome (SRNS) patients. Materials and methods: Our research included 50 children (56% female and 44% male) with NS...
June 2018: Materia Socio-medica
James W Varni, Alan M Delamater, Korey K Hood, Jennifer K Raymond, Nancy T Chang, Kimberly A Driscoll, Jenise C Wong, Joyce P Yi-Frazier, Ellen K Grishman, Melissa A Faith, Sarah D Corathers, Jessica C Kichler, Jennifer L Miller, Elena M Doskey, Robert W Heffer, Don P Wilson
OBJECTIVE: The objective of the study was to report on the measurement properties of the revised and updated Pediatric Quality of Life Inventory (PedsQL) 3.2 Diabetes Module for children, adolescents, and young adults with type 1 diabetes. RESEARCH DESIGN AND METHODS: The 33-item PedsQL 3.2 Diabetes Module and PedsQL Generic Core Scales were completed in a 10-site national field test study by 656 families of patients ages 2-25 years with type 1 diabetes. RESULTS: The 15-item Diabetes Symptoms Summary Score and 18-item Diabetes Management Summary Score were derived from the factor analysis of the items...
July 30, 2018: Diabetes Care
Gabriele Lisi, Maria Teresa Illiceto, Erminia Francesca Romeo, Giuseppe Lauriti, Simona Faraci, Giuliano Lombardi, Luigi DallʼOglio, Pierluigi Lelli Chiesa
OBJECTIVES: Disk battery esophageal retention in children younger than 6 years represents an increasing endoscopic emergency, followed by a relevant risk of life-threatening late complications. Surgical removal after a failed endoscopic approach is rarely reported in the literature. We describe our experience in this scenario. METHODS: Two female asymptomatic patients aged 26 and 29 months presented within 4 hours after a witnessed ingestion of a 2-cm, 3-V lithium battery (CR2032) retained in the cervical esophagus...
July 25, 2018: Pediatric Emergency Care
Oluwadamilola Onwuzuligbo, Allen R Hendricks, Jared Hassler, Kristina Domanski, Collin Goto, Matthias T F Wolf
In adults, membranous nephropathy is the second most common cause of nephrotic syndrome. In contrast, minimal change disease and focal segmental glomerulosclerosis constitute the most common forms of nephrotic syndrome in children, while membranous nephropathy accounts for <5% of cases. In adults, causes of membranous nephropathy include autoantibodies directed against phospholipase A2 receptor and thrombospondin type 1 containing 7A, various infections, environmental toxicities, autoimmune disorders, malignancies, and other secondary forms...
July 21, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Kalyani Uppu, Suzan Sahana, Ghanashyam P Madu, Aron Ak Vasa, Sowjanya Nalluri, Kumar J Raghavendra
Introduction: Saliva is vital for oral health and helps to maintain oral homeostasis. It may show qualitative and quantitative variations owing to any changes in the systemic health. Diabetes mellitus (DM) is a metabolic disease and the individuals may be at higher risk for oral health problems. Objective: The study was aimed to estimate the levels of various salivary components among diabetic and nondiabetic children with similar caries status and also to analyze possible association between caries status and possible caries determinants in the saliva of diabetic children...
March 2018: International Journal of Clinical Pediatric Dentistry
Roberta Fenoglio, Savino Sciascia, Giulietta Beltrame, Paola Mesiano, Michela Ferro, Giacomo Quattrocchio, Elisa Menegatti, Dario Roccatello
Minimal change disease (MCD) accounts for 15% of adult nephrotic syndrome (NS) cases. Adult-MCD patients may have more severe clinical features than pediatric patients. In children, Rituximab (RTX) has been used since 2006 to treat frequently relapsing NS. In adults, data about the efficacy of RTX for MCD are limited. We report our experience on the use of RTX in adult biopsy-proven MCD. Our series includes 6 adult patients (2 males and 4 females), age 45-73 years, treated with RTX (4 weekly doses of 375 mg/m2 )...
June 22, 2018: Oncotarget
Jonathan H Pelletier, Karan R Kumar, Rachel Engen, Adam Bensimhon, Jennifer D Varner, Michelle N Rheault, Tarak Srivastava, Caroline Straatmann, Cynthia Silva, T Keefe Davis, Scott E Wenderfer, Keisha Gibson, David Selewski, John Barcia, Patricia Weng, Christoph Licht, Natasha Jawa, Mahmoud Kallash, John W Foreman, Delbert R Wigfall, Annabelle N Chua, Eileen Chambers, Christoph P Hornik, Eileen D Brewer, Shashi K Nagaraj, Larry A Greenbaum, Rasheed A Gbadegesin
BACKGROUND AND OBJECTIVES: Steroid-resistant nephrotic syndrome (SRNS) due to focal segmental glomerulosclerosis (FSGS) and minimal change disease (MCD) is a leading cause of end-stage kidney disease in children. Recurrence of primary disease following transplantation is a major cause of allograft loss. The clinical determinants of disease recurrence are not completely known. Our objectives were to determine risk factors for recurrence of FSGS/MCD following kidney transplantation and factors that predict response to immunosuppression following recurrence...
July 7, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Mehrdad Hefazi, Mark R Litzow
PURPOSE OF REVIEW: This article provides an overview of the current knowledge regarding the biology and treatment of T cell acute lymphoblastic leukemia (T-ALL) and highlights the most recent findings in this field over the past 5 years. RECENT FINDINGS: Remarkable progress has been made in the genomic landscape of T-ALL over the past few years. The discovery of activating mutations of NOTCH1 and FBXW7 in a majority of patients has been a seminal observation, with several early phase clinical trials currently exploring these as potential therapeutic targets...
June 15, 2018: Current Hematologic Malignancy Reports
Alexander R Cortez, Gianna D Katsaros, Vikrom K Dhar, F Thurston Drake, Timothy A Pritts, Jeffrey J Sussman, Michael J Edwards, R Cutler Quillin
BACKGROUND: Although overall operative volume has remained stable since the implementation of duty hours, more detailed analyses suggest shifts in the resident operative experience. Understanding these differences allows educators to better appreciate the impact of the current training environment on resident preparation for practice. METHODS: National Accreditation Council for Graduate Medical Education case logs from 1990 to 2016 were reviewed. Statistical analysis was performed using analysis of variance and linear regression analysis...
June 18, 2018: Surgery
Jerome H Taylor, Ewgeni Jakubovski, Daniel Gabriel, Michael H Bloch
BACKGROUND: Antipsychotic-related weight gain is a common clinically relevant side effect when treating psychotic disorders in pediatric populations, yet few predictors and no moderators of antipsychotic-related weight gain are known. METHODS: The Treatment of Early-Onset Schizophrenia Spectrum Disorders (TEOSS) study randomized 119 youths (age 8-19 years) with schizophrenia or schizoaffective disorder to 8 weeks of antipsychotic treatment with molindone, risperidone, or olanzapine and assessed treatment response and side effects...
June 19, 2018: Journal of Child and Adolescent Psychopharmacology
Daniel C Bland, Andrew T Pennock, Vidyadhar V Upasani, Eric W Edmonds
BACKGROUND: Lateral condyle fractures of the distal humerus are the second most common pediatric elbow fracture. A difference of 1 or 2 mm in fracture displacement measurement may change the operative or nonoperative management of a minimally displaced fracture. The goal of this study was to determine the interobserver and intraobserver agreement in the measurements of displacement of lateral condyle fractures of the humerus. METHODS: A retrospective radiographic review of 60 patients was performed by 3 reviewers...
June 18, 2018: Journal of Pediatric Orthopedics
Sheng Nie, Wenjuan He, Ting Huang, Diankun Liu, Guobao Wang, Jian Geng, Nan Chen, Gang Xu, Ping Zhang, Yang Luo, Jing Nie, Xin Xu, Fan Fan Hou
BACKGROUND AND OBJECTIVES: High-quality epidemiologic data on the spectrum of biopsy-proven glomerular diseases among children are limited. This study aimed to determine the profile of and temporal change in biopsy-proven pediatric glomerular diseases in China. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We previously conducted a nationwide kidney biopsy survey including 71,151 patients over an 11-year period from January 2004 to December 2014. A total of 7962 children younger than 18 years old from 115 hospitals across China with biopsy-proven glomerular diseases were included in this study...
July 6, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Ivana Rabbone, Nicola Minuto, Sonia Toni, Fortunato Lombardo, Dario Iafusco, Marco Marigliano, Riccardo Schiaffini, Giulio Maltoni, Anna P Frongia, Marco Scardapane, Antonio Nicolucci, Valentino Cherubini, Riccardo Bonfanti, Andrea E Scaramuzza
AIM: To evaluate the incidence of insulin pump and infusion set failures in a cohort of children and adolescents with type 1 diabetes during a 1-year follow-up. MATERIALS AND METHODS: Insulin pump breakdown and infusion set failures were prospectively registered in a cohort of 1046 children and adolescents from 25 tertiary pediatric diabetes centres (50% male, mean age 12.2 ± 4.1 years), with type 1 diabetes from the age of 6.7 ± 3.6 years, and using an insulin pump from the age of 3...
June 12, 2018: Diabetes, Obesity & Metabolism
Amanda I Rodriguez, Megan L A Thomas, Kristen L Janky
OBJECTIVES: Pediatric vestibular evaluations incorporate cervical and ocular vestibular evoked myogenic potential (c- and oVEMP, respectively) testing; however, in children, c- and oVEMP thresholds have been minimally investigated and frequency tuning is unknown. Children are also at risk for unsafe sound exposure secondary to VEMP. While it is unknown if VEMP threshold testing leads to cochlear changes, it is possible that this risk increases due to the increased number of trials needed to obtain a threshold...
June 2, 2018: Ear and Hearing
Irshad Ali Bajeer, Sabeeta Khatri, Veena Tresa, Seema Hashmi, Mohammed Mubarak, Ali Asghar Lanewala
OBJECTIVE: To determine the short-term outcome of cyclophosphamide (CPO) course in children with relapsing steroid sensitive nephrotic syndrome (SSNS) with different histopathological lesions. STUDY DESIGN: Descriptive, observational study. PLACE AND DURATION OF STUDY: Pediatric Nephrology Department, Sindh Institute of Urology and Transplantation, Karachi, from January 2012 to December 2014. METHODOLOGY: All children with relapsing steroid-sensitive nephrotic syndrome, who underwent renal biopsy and received cyclophosphamide therapy, were included and followed up for 2 years...
June 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Xiaoming Shi, Mary J Edwards, Jordan Guice, Richard Strilka, Brandon Propper
BACKGROUND: The pediatric patient's response to hemorrhage as a function of young age is not well understood. As a result, there is no consensus on optimal resuscitation strategies for hemorrhagic shock in pediatric patients, or on the identification of clinical triggers to prompt implementation. The study objective was to develop a model of pediatric hemorrhage using young pigs to simulate school-aged children, and determine clinical and laboratory indicators for significant hemorrhage...
July 2018: Pediatric Surgery International
Melissa Pielech, Dustin P Wallace, Megan Fitzgerald, Cara M Hoffart
Targeting parents' responses to their child's pain during intensive interdisciplinary pain treatment (IIPT) could influence child functioning. This longitudinal, observational study investigated changes in these responses and concurrent relationships between parent responses and changes in levels of child functioning and pain. Parents of youths 10 to 19years of age (mean = 15years, SD = 1.98 years) participated in twice weekly, parent-only groups while their teens were enrolled in IIPT (mean length of treatment = 3...
May 17, 2018: Journal of Pain: Official Journal of the American Pain Society
Pierre-Henri Heitz, Jean-François Aubin-Fournier, Éric Parent, Carole Fortin
BACKGROUND CONTEXT: Posture changes are a major consequence of idiopathic scoliosis (IS). Posture changes can lead to psychosocial and physical impairments in adolescents with IS. Therefore, it is important to assess posture, but the test-retest reliability of posture measurements still remains unknown in this population. PURPOSE: The primary objective of the present study was to determine the test-retest reliability of 25 head and trunk posture indices using the Clinical Photographic Postural Assessment Tool (CPPAT) in adolescents with IS...
May 7, 2018: Spine Journal: Official Journal of the North American Spine Society
Keewon Kim, Charles Cho, Moon-Suk Bang, Hyung-Ik Shin, Ji-Hoon Phi, Seung-Ki Kim
Intraoperative monitoring (IOM) utilizes electrophysiological techniques as a surrogate test and evaluation of nervous function while a patient is under general anesthesia. They are increasingly used for procedures, both surgical and endovascular, to avoid injury during an operation, examine neurological tissue to guide the surgery, or to test electrophysiological function to allow for more complete resection or corrections. The application of IOM during pediatric brain tumor resections encompasses a unique set of technical issues...
May 2018: Journal of Korean Neurosurgical Society
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