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pediatrics sensitivity and specificity study

Madhvi Rajpurkar, Todd A Alonzo, Yi-Cheng Wang, Robert B Gerbing, Alan S Gamis, James H Feusner, John Gregory, Matthew A Kutny
Acute promyelocytic leukemia (APL) is characterized by a heightened risk of coagulopathy with significant morbidity and mortality. Here we report our evaluation of presenting white blood cell (WBC) and the International Society on Thrombosis and Haemostasis (ISTH) disseminated intravascular coagulation (DIC) scoring system as markers for early death and nonlethal coagulopathy in pediatric APL. We evaluated 79 pediatric patients treated on a Children's Oncology Group phase III clinical trial. There were 4 early deaths and 13 nonlethal, clinically significant (grade III to IV) coagulopathy events during induction...
August 8, 2018: Journal of Pediatric Hematology/oncology
Abdullah Bin Zahid, Molly E Hubbard, Julia Lockyer, Olivia Podolak, Vikalpa M Dammavalam, Matthew Grady, Michael Nance, Mitchell Scheiman, Uzma Samadani, Christina L Master
OBJECTIVE: Concussion is the most common type of brain injury in both pediatric and adult populations and can potentially result in persistent postconcussion symptoms. Objective assessment of physiologic "mild" traumatic brain injury in concussion patients remains challenging. This study evaluates an automated eye-tracking algorithm as a biomarker for concussion as defined by its symptoms and the clinical signs of convergence insufficiency and accommodation dysfunction in a pediatric population...
August 8, 2018: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Francesco Saverio Biagiarelli, Simone Piga, Antonino Reale, Pasquale Parisi, Marta Luisa Ciofi Degli Atti, Angelo Gabriele Aulisa, Paolo Schingo, Chiara Ossella, Maria Pia Villa, Umberto Raucci
OBJECTIVE: We aimed to describe characteristics, etiology and health care use in children with low back pain (LBP) presenting to pediatric emergency department (ED) and to develop an algorithm to design a diagnostic approach. METHODS: We conducted a 7-year cohort study of children admitted to ED with a primary complaint of LBP. They were classified into diagnostic groups: visceral LBP; traumatic LBP; non-visceral/non-traumatic LBP. To identify high-risk factors (red flags) associated with severe prognosis conditions (SPCs), we analyzed the non-visceral/non-traumatic group comparing the SPC children with those children without SPCs...
July 21, 2018: American Journal of Emergency Medicine
Anna J Henningsson, Malin Lager, Rebecka Brännström, Ivar Tjernberg, Barbro H Skogman
Anti-Borrelia antibodies in the cerebrospinal fluid (CSF) are required for definite diagnosis of Lyme neuroborreliosis (LNB). However, children often present with early LNB, and antibody production in the CSF may not be demonstrated. Recent studies have suggested the chemokine CXCL13 to be an early marker for LNB. The aim of the study was to evaluate CXCL13 for laboratory diagnosis in pediatric LNB patients and to evaluate the association with pleocytosis in CSF, clinical features, and recovery. CSF samples were collected from LNB patients, classified as definite LNB (n = 44) or possible LNB (n = 22), and controls classified as non-LNB (n = 102) or other specific diagnoses (n = 23)...
August 6, 2018: European Journal of Clinical Microbiology & Infectious Diseases
Victoria J Wright, Jethro A Herberg, Myrsini Kaforou, Chisato Shimizu, Hariklia Eleftherohorinou, Hannah Shailes, Anouk M Barendregt, Stephanie Menikou, Stuart Gormley, Maurice Berk, Long Truong Hoang, Adriana H Tremoulet, John T Kanegaye, Lachlan J M Coin, Mary P Glodé, Martin Hibberd, Taco W Kuijpers, Clive J Hoggart, Jane C Burns, Michael Levin
Importance: To date, there is no diagnostic test for Kawasaki disease (KD). Diagnosis is based on clinical features shared with other febrile conditions, frequently resulting in delayed or missed treatment and an increased risk of coronary artery aneurysms. Objective: To identify a whole-blood gene expression signature that distinguishes children with KD in the first week of illness from other febrile conditions. Design, Setting, and Participants: The case-control study comprised a discovery group that included a training and test set and a validation group of children with KD or comparator febrile illness...
August 6, 2018: JAMA Pediatrics
Paul Stephen Cullis, Emily Mullan, Allan Jackson, Gregor Walker
BACKGROUND: Between 20% and 50% neonates with bilious vomiting are diagnosed with surgical pathology. Distinguishing neonates requiring surgery remains challenging. Our aim was to conduct an audit of term neonates with bilious vomiting referred for assessment to identify characteristics of this cohort and management. Secondary aims were to identify factors predictive of surgical pathology. METHODS: Infants <28 days referred for bilious vomiting from 2011 to 2015 were identified through cross-referencing multiple patient databases...
July 26, 2018: Journal of Pediatric Surgery
Brendan F Judy, Jordan W Swanson, Wuyang Yang, Phillip B Storm, Scott P Bartlett, Jesse A Taylor, Gregory G Heuer, Shih-Shan Lang
OBJECTIVE Evaluation of increased intracranial pressure (ICP) in the pediatric craniosynostosis population based solely on ophthalmological, clinical, and radiographic data is subjective, insensitive, and inconsistent. The aim of this study was to examine the intraoperative ICP before and after craniectomy in this patient population. METHODS The authors measured the ICP before and after craniectomy using a subdural ICP monitor in 45 children. They regulated end-tidal carbon dioxide and the monitoring site under general anesthesia to record consistent ICP readings...
August 3, 2018: Journal of Neurosurgery. Pediatrics
A F Delgado, F De Luca, P Hanagandi, D van Westen, A F Delgado
BACKGROUND: The value of arterial spin-labeling in a pediatric population has not been assessed in a meta-analysis. PURPOSE: Our aim was to assess the diagnostic accuracy of arterial spin-labeling-derived cerebral blood flow to discriminate low- and high-grade tumors. DATA SOURCES: MEDLINE, EMBASE, the Web of Science Core Collection, and the Cochrane Library were used. STUDY SELECTION: Pediatric patients with arterial spin-labeling MR imaging with verified neuropathologic diagnoses were included...
August 2, 2018: AJNR. American Journal of Neuroradiology
Nicholas D Young, Christopher R Takala
OBJECTIVE: This study evaluates sequential screening to improve behavioral health needs detection, reduce unnecessary referrals, and discern adverse impacts (false negatives) for pediatric primary care populations. METHOD: Monte Carlo simulation methodology was used to generate performance data for six sequential screening programs based on known technical properties of three broadband behavioral health measures and general psychopathology base rate estimates in pediatric primary care...
August 2018: Journal of the American Academy of Child and Adolescent Psychiatry
Liu Yang, Yaping Hou, Min Zhao, Pascal Bovet, Bo Xi
OBJECTIVE: In 2017, the American Academy of Pediatrics (AAP) updated its clinical practice guideline for screening and management of high blood pressure (BP) in children. In addition, the AAP guideline also recommended a simplified BP table for screening purposes in children aged 1-12 years, which was based on the fifth height percentile. The aim of this study was to assess the performance of the simplified AAP table and six other simplified tables across different height percentiles in predicting elevated BP in US children...
July 30, 2018: Journal of Hypertension
Ying Tang, Shanliang Zhu, Jun Chen, Lichun Hua
BACKGROUND The aim of this study was to evaluate the feasibility of an R-wave modified tissue Doppler imaging (TDI) myocardial performance index (MPI), or MPI TDI-R, for the assessment of cardiac function in children with congestive heart failure (CHF). MATERIAL AND METHODS Forty children with CHF and 40 normal children were evaluated using the modified pediatric Ross heart failure grading system. TDI recorded the spectrum of diastolic function at the mitral valve annulus to measure the MPI. Twelve-lead electrocardiogram (ECG) measured the R-wave in the QRS complex, resulting in the modified MPI TDI-R...
July 28, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Sharareh Babaie, Azita Behzad, Masoud Mohammadpour, Mohsen Reisi
Background: Hemodynamic monitoring is an essential part in the treatment of critically ill patients. Establishment of intravascular volume and creation of a normal systemic perfusion are the most important part to reduce the risk of organ failure and mortality. This study aimed to determine the correlation between the inferior vena cava (IVC) sonographic indices and the central venous pressure (CVP) to provide a useful guide for noninvasive intravascular volume status assessment in children...
2018: Advanced Biomedical Research
Junmei Yan, Jing Chen, Haiqi Li, Yan Hu
BACKGROUND: This retrospective study was designed in order to compare the usefulness of skin prick tests, serological specific IgE tests and solid phase immunoassays in the diagnosis of infantile allergic diseases. METHODS: Two hundred infants with allergic diseases (120 infants with eczema and 80 infants with asthma), diagnosed in the Pediatric Clinic of our hospital between June of 2011 and June of 2016, were selected to participate in the study. 100 healthy infants were included in a control group...
July 24, 2018: Minerva Pediatrica
Joshua T Bram, Keith D Baldwin, Todd J Blumberg
BACKGROUND: The diagnosis of pediatric septic arthritis (SA) can be challenging due to wide variability in the presentation of musculoskeletal infection. Synovial fluid Gram stain is routinely obtained and often used as an initial indicator of the presence or absence of pediatric SA. The purpose of this study was to examine the clinical utility of the Gram stain results from a joint aspiration in the diagnosis and management of pediatric SA. METHODS: All patients with suspected SA who underwent arthrocentesis and subsequent surgical irrigation and debridement at an urban tertiary care children's hospital between January 2007 and October 2016 were identified...
July 20, 2018: Journal of Pediatric Orthopedics
Brian C Lau, Toure Vashon, Abhinav Janghala, Nirav K Pandya
BACKGROUND: Discoid lateral meniscus (DLM) is a morphologic variant in which concomitant articular cartilage defects lead to poor outcomes. The purpose of this study was to quantify the prognostic ability of history, physical examination, and magnetic resonance imaging (MRI) to identify arthroscopically confirmed articular cartilage injury in pediatric and adolescent DLM patients. METHODS: An analysis of 34 consecutive patients (mean, 12.5 y) who underwent surgical treatment for DLM...
July 20, 2018: Journal of Pediatric Orthopedics
Mervat Alsous, Imad Hamdan, Mohammad Saleh, James McElnay, Robert Horne, Amira Masri
BACKGROUND: There is a lack of a standardized tool for adherence measurement in patients with epilepsy. Studies in children with epilepsy have reported adherence in 50-96.5%. The primary objective of this study was to identify predictors of nonadherence to antiepileptic drugs (AEDs) using two different methods in Jordanian children and adolescents with epilepsy. METHODS: Participants included 63 children and adolescents with epilepsy and their primary caregivers...
August 2018: Epilepsy & Behavior: E&B
Kelly Klega, Alma Imamovic-Tuco, Gavin Ha, Andrea N Clapp, Stephanie Meyer, Abigail Ward, Catherine Clinton, Anwesha Nag, Eliezer Van Allen, Elizabeth Mullen, Steven G DuBois, Katherine Janeway, Matthew Meyerson, Aaron R Thorner, Brian D Crompton
Objective: Liquid biopsies are being rapidly used in adult cancers as new biomarkers of disease. Circulating tumor DNA (ctDNA) levels have been reported to be proportional to disease burden, correlate with treatment response, and predict relapse. However, little is known about how frequently ctDNA is detectable in pediatric patients with solid tumors. Therefore, we developed a next-generation sequencing approach to detect and quantify ctDNA in the blood of patients with the most common pediatric solid tumors...
2018: JCO Precision Oncology
Shuai Yang, Ruixia Song, Junmei Zhang, Xiaohui Li, Caifeng Li
OBJECTIVE: To construct a predictive tool for the efficacy of intravenous immunoglobulin (IVIG) therapy in children with Kawasaki disease (KD) in Beijing, China. DESIGN: This was a cohort study. Data set (including clinical profiles and laboratory findings) of children with KD diagnosed between 1 January 2010 and 31 December 2015 was used to analyse the risk factors and construct a scoring system. Data set of children with KD diagnosed between 1 January 2016 and 1 December 2016 was used to validate this model...
July 19, 2018: Archives of Disease in Childhood
Meric A Altinoz, Aysel Ozpinar, Ebru Emekli Alturfan, Ilhan Elmaci
Vinorelbine is a very potent chemotherapeutic agent which is used to treat a number of cancers including breast and non-small cell lung tumors. Vinorelbine mainly acts via blocking microtubules and induces a specific type of cell death called 'mitotic catastrophe/apoptosis' subsequent to mitotic slippage, which is the failure of cells to stay in a mitotic arrested state and replicating their DNA without cytokinesis. Glial tumor cells are especially sensitive to mitotic slippage. In recent years, vinorelbine demonstrated potency in pediatric optic and pontine gliomas...
July 20, 2018: Journal of Chemotherapy
Rania Salah El-Zayat, Awny Gamal Shalaby
OBJECTIVES: Myocardial dysfunction is well recognized in severe sepsis and septic shock. Echocardiography provides rapid, noninvasive, and bedside evaluation of cardiac function in patients with hemodynamic instability. Mitral annular plane systolic excursion is an M-mode-derived echocardiographic variable used to assess longitudinal left ventricular systolic function. No data are available about the uses of mitral annular plane systolic excursion in children with septic shock. Therefore, we aimed to assess the prognostic significance of mitral annular plane systolic excursion in children with septic shock and to correlate it with the most commonly used measures of left ventricular systolic function and myocardial injury...
July 17, 2018: Pediatric Critical Care Medicine
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