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Pediatric lower extremity

Jinrong Liu, Baolin Tian, Qi Zeng, Chenghao Chen, Chunju Zhou, Huimin Li, Yuelin Shen, Shunying Zhao
BACKGROUND: Mediastinal teratoma is uncommon in children. It can be very difficult to diagnose especially in early stage. Rarely, teratoma may rupture into adjacent structures and lead to lung lesions or pleuritis. The main rarity of our reported cases was the dynamic imaging findings very similar to the developmental process of tuberculosis in patients 1 and 2, the pachypleuritis in patients 2 and 3, the extremely elevated inflammatory markers very similar to empyema in patient 3, and the extremely atypical tumor shape in all patients...
December 4, 2018: BMC Pediatrics
Keda Wang, Jizong Zhao, Yan Zhang, Yibing Su
BACKGROUND: Intramedullary schwannomas without neurofibromatosis are exceedingly rare. They are rarer in children with only 8 cases reported so far. The association of intramedullary schwannomas with syringomyelia is also rare. Here, we present a case of intramedullary schwannoma with syringomyelia treated surgically in an 9-year-old boy. CASE PRESENTATION: We reviewed the clinical course of a 9-year-old boy, who presented with both lower extremity weakness of 6-month duration...
November 28, 2018: BMC Pediatrics
Evangelia Kalaitzoglou, John L Fowlkes, Iuliana Popescu, Kathryn M Thrailkill
Persons with type 1 or type 2 diabetes (T1D, T2D) have a significantly higher fracture risk than age-matched persons without diabetes, attributed to disease-specific deficits in the microarchitecture and material properties of bone tissue. Therefore, independent effects of diabetes drugs on skeletal integrity are vitally important. Studies of incretin-based therapies have shown divergent effects of different agents on fracture risk, including detrimental, beneficial and neutral effects. The sulfonylurea class of drugs, owing to its hypoglycemic potential, is thought to amplify the risk of fall-related fractures, particularly in the elderly...
November 22, 2018: Diabetes/metabolism Research and Reviews
Jaeyoon Kim, Jong Won Hong, Tai Suk Roh, Won Jai Lee
BACKGROUND: Infantile hemangioma (IH) is a common vascular tumor in pediatric patients, and is commonly treated with propranolol. We describe our experiences with dosage, response to treatment, and side effects in 23 IH patients treated with propranolol. METHODS: For this nonrandomized comparative cohort study, the authors enrolled 23 patients treated with propranolol. Photographs were taken before propranolol administration and at 3, 6, 9, and 12 months after treatment...
November 2018: Archives of Plastic Surgery
Elena Boccuzzi, Valentina A Ferro, Bianca Cinicola, Paolo M Schingo, Luisa Strocchio, Umberto Raucci
Leukemia is the most common childhood malignancy, and it is often characterized by pallor, fatigue, cytopenia, and organomegaly; sometimes musculoskeletal symptoms, mainly characterized by diffuse bone pain in the lower extremities, are the onset clinical characteristics of the disease. In these cases, the disease may initially be misdiagnosed as reactive arthritis, osteomyelitis, or juvenile idiopathic arthritis delaying appropriate diagnosis and management. Even if leukopenia, thrombocytopenia, and a history of nighttime pain are reported to be the most important predictive factors for a pediatric leukemia, blood examinations can sometimes be subtle or within normal limits, and this represents a further diagnostic difficulty...
November 19, 2018: Pediatric Emergency Care
Eli Saleh, Noémi Dahan-Oliel, Kathleen Montpetit, Thierry Benaroch, Rita Yap, Nadia Barakat, M J Mulcahey
Purpose: This pilot study evaluated the outcomes of tendon Achilles lengthening in 12 children (mean age: 11.2 years) with spastic hemiplegia. Methods: Cerebral Palsy Computer Adaptive Tests, the timed up-and-go, the Gross Motor Function Measure, the Gillette Functional Assessment Questionnaire, and the Pediatric Outcomes Data Collection Instrument were administered at baseline and at 6, 12, and 24 months postsurgery. Results: Significant improvement at the latest follow-up (12-24 months following surgery) was seen in all domains of the Cerebral Palsy Computer Adaptive Test: activity ( P = ...
2018: Child Neurology Open
Kevin J Nickel, Aaron C Van Slyke, Aaron D Knox, Kevin Wing, Neil Wells
Background: Tissue expansion in the lower extremity is controversial, with studies reporting complication rates as high as 83%. Few studies have looked at tissue expansion prior to orthopaedic correction of severe foot and ankle deformities, and those available are restricted to clubfoot in the pediatric population. Here, we report the largest case series on the use of tissue expanders for the reconstruction of severe foot and ankle deformity and the only report in adults. Methods: This is a retrospective chart review of the senior author's practice over a 16-year study period...
November 2018: Plastic Surgery
Omar Z Ahmed, Richard Holubkov, J Michael Dean, Tellen D Bennett, Kathleen L Meert, Robert A Berg, Christopher J L Newth, Joseph Carcillo, Randall S Burd, Murray M Pollack
BACKGROUND: Because pediatric trauma-related mortality continue to decline, metrics assessing morbidity are needed to evaluate the impact of treatment after injury. Based of its value for assessing children with traumatic brain injuries and other critical illnesses, Functional Status Scale (FSS), a tool that measures function in six domains (communication, feeding, mental, motor, sensory and respiratory), was evaluated as an outcome measure for the overall population of injured children...
November 15, 2018: Journal of Trauma and Acute Care Surgery
Ahmed Mousa, Ossama M Zakaria, Ibrahim Hanbal, Tamer A Sultan, Amr M El-Gibaly, Mohamed Y Zakaria, Mohammed A Nasr, Bosat E Bosat, Alaa Sharabi, Mohamed Neinaa, Mohamed Abd El-Hamid, Mohamed Y Daoud, Mahsoub M Amin, Ahmed M Odeh, Omer M Alhaieg, Mohamed A Farhan, Mohamed Bubshait, Abdul Rahman S Al-Mulhim
OBJECTIVES: To evaluates the management and outcome of non-iatrogenic pediatric and adolescence extremity arterial injuries in a resource-challenged setting. METHODS: A retrospective study of the surgical management for non-iatrogenic extremity arterial trauma in pediatric and adolescence during the period from January 2008 to December 2015. This study was performed in two different countries at tertiary referral university and teaching hospitals having a specialized emergency and trauma centers...
November 2, 2018: Asian Journal of Surgery
Peong Gang Park, Eujin Park, Hye-Sun Hyun, Hee Gyung Kang, Il-Soo Ha, Tae-Joon Cho, Jung Min Ko, Hae Il Cheong
Recent molecular genetic studies have revealed that Schimmelpenning-Feuerstein-Mims syndrome (SFMS), which presents as sebaceous nevi, is a mosaic RASopathy caused by postzygotic somatic activating mutations in HRAS , NRAS , or KRAS Some patients with SFMS also have hypophosphatemic rickets, called cutaneous skeletal hypophosphatemia syndrome (CSHS). We here report a pediatric case of biopsy-proven CSHS with mosaic mutation in the HRAS gene. A girl who showed extensive nevus sebaceous since birth had suffered progressive lower extremity deformity since the age of 5 years...
September 2018: Annals of Clinical and Laboratory Science
Vanessa Rustler, Julia Däggelmann, Fiona Streckmann, Wilhelm Bloch, Freerk T Baumann
PURPOSE: Low levels of physical activity often observed in pediatric oncology might be attributed to various functional deficits, especially those of the lower limbs as these affect gait, mobility, and, consequently, physical activity. In the past few years, whole-body vibration (WBV) has emerged as a new therapy modality for improving physical functioning. Although WBV is increasingly applied in children with disabilities, its impact on lower limb function in pediatric cancer patients and survivors has not yet been investigated...
October 27, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Pooya Hosseinzadeh, Mitchel R Obey, Ena Nielsen, Lindsay Andras, Gary M Kiebzak, Megan Mignemi, Jeffrey R Sawyer, Stephen Albanese, John M Flynn
BACKGROUND: The field of orthopaedic surgery has subspecialized over the past decade with an increasing number of graduates of orthopaedic residency programs entering fellowship training. The number of graduates from pediatric orthopaedic fellowships has also increased over the past decade. We hypothesize as the number of pediatric orthopaedic fellowship graduates has increased, the proportion of orthopaedic cases completed by pediatric surgeons in comparison with adult surgeons has also increased...
October 24, 2018: Journal of Pediatric Orthopedics
Sinan Ates, Mahmut Alp Karahan, Nuray Altay, Kazim Akelci, Nagehan Ikiz, Bulent Guzel, Mandeley Wilhelmina Ozer, Haci Durmus Yilmaz
OBJECTIVE: Scorpion stings remain a serious health problem in many parts of the world. There is very limited information regarding the effects of therapies delivered for scorpion stings in pregnant women on the mother and fetus. They can cause acute conditions such as fetal loss, preterm delivery, or placental abnormalities and can also result in other conditions that may have an effect on the baby in the long term. MATERIALS AND METHODS: In this study the medical records of 24 pregnant women who were admitted to the emergency room at Suruç State Hospital due to scorpion stings between January 1, 2013 and January 1, 2014 were retrospectively reviewed...
October 2018: Taiwanese Journal of Obstetrics & Gynecology
L C Wang, A G Mittal, K Puttmann, N Janzen, L S Palmer, E B Yerkes, S L Ryan, E T Gonzales, D R Roth, C J Koh
INTRODUCTION: Women are entering the subspecialty of pediatric urology at an accelerated rate. Gender differences affecting fellowship and job selection have been identified in other fields of medicine. OBJECTIVE: The objective of this study was to understand gender differences in pediatric urology fellowship and job selection and how they may affect the workforce. STUDY DESIGN: A 47-question electronic survey consisting of questions regarding demographics, residency training, and factors influencing fellowship and job selection was distributed to current fellows and recent graduates in pediatric urology in May 2017...
September 19, 2018: Journal of Pediatric Urology
Amanda Nicole Fletcher, Richard M Schwend, Mitchell Solano, Christopher Wester, Dale E Jarka
BACKGROUND: Unintentional injuries are the leading cause of morbidity and mortality among children 0 to 18 years of age in the U.S. An estimated 9,400 to 17,000 pediatric lawn-mower injuries occur each year. The aims of this study were to better define the epidemiology of lawn-mower injuries and to identify predictors of severe lawn-mower injuries to optimize public education and injury prevention. METHODS: All patients 0 to 18 years of age who presented to Children's Mercy Hospital (CMH), Kansas City, Missouri, during the period of 1995 to 2015 after sustaining a lawn-mower injury were identified using International Classification of Diseases, 9th Revision (ICD-9) codes...
October 17, 2018: Journal of Bone and Joint Surgery. American Volume
Abdulrahman Hamad Al-Abdulwahhab, Abdulaziz Mohammad Al-Sharydah, Sari Saleh Al-Suhibani, Saeed Ahmad Al-Jubran, Ali Khalaf Al-Haidey, Abdulkhaliq Ibrahim Al-Hifzi, Wissam Al-Issawi
Background: Spinal myelitis is an infrequent manifestation of spinal cord infection. It is caused by the Schistosoma species, which are endemic in South America, part of the Middle East, and Africa. Case presentation: We report the case of a 13-year-old male adolescent complaining of progressive lower back pain and weakness of the lower extremities for 3 days. Initial magnetic resonance imaging revealed typical transverse myelitis. Subsequently, parasite serology showed a markedly elevated level of Schistosoma antibody titers, and cerebrospinal fluid analysis yielded normal results...
2018: Patient Safety in Surgery
A Andreacchio, F Alberghina, L Marengo, F Canavese
The main objective of this paper is to review the current literature on treatment of tibial and femur fractures in children and adolescents guided by body weight in patients weighing 50 kg (110 lb) or more. A secondary aim of this mini-review was to determine, as per literature review, whether weight  > 50 kg (110 lb) is an identifiable factor associated with increased complication rate. A search of the PubMed/MEDLINE, EMBASE and Cochrane Database of Systematic Reviews databases from 1954 to September 2017 was performed to identify papers related to pediatric tibia and femur fractures in children weighing more than 50 kg (110 lb)...
October 11, 2018: Musculoskeletal Surgery
Juhee Shin, Dong Hyun Lee, Nani Jung, Hee Joung Choi, Ye Jee Shim
Background: Reactive thrombocytosis (RT) is a common condition among children, although no studies have examined the etiology or clinical characteristics of RT among Korean children. Methods: This retrospective study evaluated children with RT at a single Korean tertiary center during a 10-year period. Results: RT accounted for 13.5% of children who were admitted to the pediatric ward (4,113/30,355): mild RT, 82.7%; moderate RT, 14.1%; severe RT, 1...
September 2018: Blood Research
Jun Ah Lee, Hea Lin Oh, Dong Ho Kim, Jung Sub Lim
Purpose: We aimed to determine the prognostic significance of lymphocyte counts and lymphocyte-monocyte ratio (LMR) in pediatric patients with osteosarcoma. Methods: We retrospectively reviewed the medical records of 27 pediatric patients with localized extremity osteosarcoma treated at Korea Cancer Center Hospital between May 2002 and March 2016. Pretreatment and day 14 of first cisplatin-doxorubicin chemotherapy leukocyte counts and LMR (LMR14) were evaluated...
October 1, 2018: Korean Journal of Pediatrics
Min Jeng Cho, Jihoon Kim, Sung Jeep Kim, Kyu Hyouck Kyoung, Min Ae Keum, Sung Kyun Park
Purpose: Several published policy statements have warned for risk of trampoline and have recommended safety guideline. However, few studies have focused on trampoline-related injuries in Korea. The aim of this study was to assess the incidence and characteristics of pediatric trampoline-related injuries presenting to our hospital. Methods: We retrospectively reviewed the medical record of children <16 years old with trampoline-related injuries who visited our emergency department from 2008 to 2017...
October 4, 2018: Korean Journal of Pediatrics
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