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Pediatric In Review

Adrian Caceres, Maria Luisa Avila, Marco Luis Herrera
INTRODUCTION: Invasive mycosis of the central nervous system represent a diverse group of diseases that have gradually emerged as not only opportunistic infections in patients with immune susceptibility due to congenital and acquired deficiency, immunomodulation, solid organ and stem cell transplantation, hematological malignancies, and chronic steroid use but also in selected risk populations such as low weight preterm infants, patients with shunted hydrocephalus and external ventricular drainages, skull base surgery, and head injury...
August 18, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
İlknur Çağlar, İlker Devrim, Halil Özdemir, Zümrüt Şahbudak, Gülsüm Sönmez, Ayse Buyukcam, Belgin Gulhan, Ahu Kara, Deniz F Aygun, Nuri Bayram, Solmaz Celebi, Benhur Çetin, Merve I Nepesov, Ayşe T Yilmaz, Eda Kepenekli, Dilek Yilmaz Çiftdogan, Manolya K Acar, Burcu Cura Yayla, Canan Okumuş, Zafer Ecevit, Nevin Hatipoglu, Necdet Kuyucu, Muhammed Kosker, Semra Sen, Adem Karbuz, Murat Sutcu, Burcu Bursal Duramaz, Metehan Özen, Ergin Çiftçi, Derya Alabaz, Zafer Kurugol, Ateş Kara, Saliha Kanik, Omer Kilic, Selim Oncel, Ayper Somer, Anil Tapisiz, Nursen Belet, Özge Metin Akcan, Özden Türel, Aslinur Ozkaya, Hasan Tezer, Ali Bulent Cengiz, Erdal İnce, Yıldız Camcioglu, Emine Kocabas, Emin S Arisoy, Nuran Salman
INTRODUCTION: The aim of this point prevalence study was to evaluate the consumption, indications and strategies of antifungal therapy within pediatric population in Turkey. MATERIAL-METHODS: A point prevalence study was performed at 25 hospitals. In addition to general data on pediatric units of the institutes, the generic name and indication of antifungal drugs, presence of fungal isolation and susceptibility patterns, presence of galactomannan test and high-resolution computerized tomography (HRCT) scan results were reviewed...
August 16, 2018: Journal of Global Antimicrobial Resistance
Ahmed Mohamed El Ghoneimy, Magdy El Sherbiny, Nehal Kamal
BACKGROUND:  Most reports on skeletal reconstruction using vascularized fibular free flap include patients with varying age groups and anatomic locations. This study has limited the inclusion criteria to pediatric and adolescent patients diagnosed with bone sarcoma of the femoral shaft. METHODS:  Forty-one patients, diagnosed with a malignant bone tumor of the femoral shaft (21 Ewing's sarcomas and 20 osteosarcomas), were locally treated by joint sparing wide resection and reconstruction using a vascularized fibular free flap...
August 18, 2018: Journal of Reconstructive Microsurgery
Yeon Joo Lee, Dionysios Neofytos, Seong Jin Kim, Leslie Cheteyan, Yao-Ting Huang, Esperanza B Papadopoulos, Ann A Jakubowski, Genovefa A Papanicolaou
BACKGROUND: Allogeneic hematopoietic cell transplant (HCT) recipients are at risk for herpes simplex virus (HSV) and varicella-zoster virus (VZV) infections. Routine prophylaxis with acyclovir is recommended during periods of immunosuppression. Brincidofovir (BCV, CMX001), a lipid conjugate of cidofovir, is active in vitro activity against HSV/VZV, but has not been formally studied for HSV/VZV prophylaxis. We report our clinical experience of BCV for HSV/VZV prophylaxis in HCT recipients...
August 18, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Mitchell A Rees, Jonathan R Dillman, Christopher G Anton, Mantosh S Rattan, Ethan A Smith, Alexander J Towbin, Bin Zhang, Andrew T Trout
PURPOSE: To assess inter-radiologist agreement using the Society of Abdominal Radiology-American Gastroenterological Association (SAR-AGA) consensus recommendations for reporting CT/MR enterography exams in pediatric and young adult small bowel Crohn disease (CD). METHODS: Institutional review board approval was obtained for this HIPAA-compliant retrospective investigation; the requirement for informed consent was waived. 25 CT and 25 MR enterography exams performed in children and young adults (age range: 6-23 years) between January 2015 and April 2017 with a distribution of ileal CD severity (phenotype) were identified: normal or chronic CD without active inflammation (40%), active inflammatory CD (20%), stricturing CD (20%), and penetrating CD (20%)...
August 17, 2018: Abdominal Radiology
Leman Tekin Orgun, Ebru Arhan, Kürşad Aydın, Tunzale Rzayeva, Tuğba Hırfanoğlu, Ayşe Serdaroğlu
Background/aim: We evaluated the utility of electroencephalography (EEG) in children with neurological conditions and compared the results with those of our previous study on excessive uses of pediatric EEG, which was published in 2003. We also evaluated the possibility of subsequent EEGs and satisfactory duration of EEG recordings according to EEG type and admission status. We also evaluated the yield of varying durations of EEG recordings. Materials and methods: All consecutive pediatric EEG records performed at Gazi University EEG laboratory during a 1-year period were retrospectively reviewed...
August 16, 2018: Turkish Journal of Medical Sciences
Sonja Marie Swenson, Emily R Perito
OBJECTIVE: To identify early predictors of long-term overweight and obesity in pediatric liver transplant recipients. METHODS: Single-center, retrospective review of children who underwent liver transplant before age 6 years. Body Mass Index (BMI), weight, and height percentiles at transplant and post-transplant were calculated. BMI, weight gain trajectories, and failure-to-thrive (FTT) were examined as predictors of overweight/obesity at 3 and 5 years post-transplant...
August 16, 2018: Journal of Pediatric Gastroenterology and Nutrition
Brian D Sumner, Emily A Grimsley, Niall H Cochrane, Ryan R Keane, Alexis B Sandler, Paul C Mullan, Karen J O'Connell
BACKGROUND: The National Association of EMS Physicians emphasizes the importance of high quality communication between emergency medical services (EMS) providers and emergency department (ED) staff for providing safe, effective care. The Joint Commission has identified ineffective handoff communication as a contributing factor in 80% of serious medical errors. The quality of handoff communication from EMS to ED teams for critically ill pediatric patients needs further exploration. OBJECTIVE: This study assessed the quality of handoff communication between EMS and ED staff during pediatric medical resuscitations...
August 17, 2018: Prehospital Emergency Care
Stacey Crane, Joan E Haase, Susan E Hickman
PROBLEM IDENTIFICATION: Pediatric oncology phase 1 clinical trials (P1Ts) are essential to developing new anticancer therapies; however, they raise complex ethical concerns about balancing the need for this research with the well-being of participating children. The purpose of this integrative review was to synthesize and appraise the evidence of how P1T participation, which begins with consent and ends with the transition off the P1T, can affect the well-being (either positively or negatively) of children with cancer...
September 1, 2018: Oncology Nursing Forum
Tanya Holt, Michael Prodanuk, Gregory Hansen
OBJECTIVE: Determining care disposition for pediatric patients during interfacility transport is often challenging. Severity of illness scoring can assist with this process. The purpose of this retrospective study was to compare currently utilized scoring systems and their ability to reliably match pediatric transport patients' severity of illness with the level of care necessary. METHODS: The retrospective transport registry review for our region included 209 patients <18 years, transported between 2015 and 2016 and admitted to tertiary care...
August 17, 2018: Prehospital Emergency Care
Nisha Gadgil, Sandi Lam, Monika Pyarali, Michael Paldino, I-Wen Pan, Robert C Dauser
OBJECTIVE Numerous surgical procedures facilitate revascularization of the ischemic brain in patients with moyamoya disease. Dural inversion is a technique in which flaps of dura mater centered around the middle meningeal artery are inverted, encouraging the formation of a rich collateral blood supply. This procedure has been used in combination with encephaloduroarteriosynangiosis for more than 20 years at the authors' institution for the treatment of pediatric moyamoya disease. The objective of this study was to describe the clinical and radiographic outcomes for a cohort of consecutive pediatric moyamoya patients undergoing dural inversion...
August 17, 2018: Journal of Neurosurgery. Pediatrics
Benjamin M Helm, Mark D Ayers, Adam C Kean
Clinical genetics services continue to expand into diverse medical specialties. An ever-increasing number of non-genetics providers are independently ordering genetic tests, interpreting results, and at times, making diagnoses leading to patient care recommendations. Non-genetics healthcare providers can help increase patient access to these services, but a potential pitfall occurs when these providers either do not have adequate expertise with genetic variant interpretation or do not have access to multi-disciplinary teams including genetic counselors or clinical geneticists for advanced review...
August 16, 2018: Journal of Genetic Counseling
Lyvonne N Tume, Frédéric V Valla
Ensuring optimal nutrition is vital in critically ill children and enteral feeding is the main route of delivery in intensive care. Feeding intolerance is the most commonly cited reason amongst pediatric intensive care unit healthcare professionals for stopping or withholding enteral nutrition, yet the definition for this remains inconsistent, nebulous, and entirely arbitrary. Not only does this pose problems clinically, but research in this field frequently uses feeding intolerance as an endpoint and the heterogeneity in this definition makes the comparison of studies difficult and meta-analysis impossible...
August 17, 2018: European Journal of Pediatrics
Irina V Kholodenko, Daniel V Kalinovsky, Igor I Doronin, Sergey M Deyev, Roman V Kholodenko
Neuroblastoma is a pediatric solid cancer of heterogeneous clinical behavior. The unique features of this type of cancer frequently hamper the process of determining clinical presentation and predicting therapy effectiveness. The tumor can spontaneously regress without treatment or actively develop and give rise to metastases despite aggressive multimodal therapy. In recent years, immunotherapy has become one of the most promising approaches to the treatment of neuroblastoma. Still, only one drug for targeted immunotherapy of neuroblastoma, chimeric monoclonal GD2-specific antibodies, is used in the clinic today, and its application has significant limitations...
2018: Journal of Immunology Research
Eldad Fisher, Liora Lazar, Shlomit Shalitin, Michal Yackobovitch-Gavan, Liat de Vries, Tal Oron, Ariel Tenenbaum, Moshe Phillip, Yael Lebenthal
Aims: The transition of emerging adults with type 1 diabetes (T1D) from pediatric diabetes clinics to adult clinics between 18 and 21 years of age could result in decreased clinic attendance and thus worsen glycemic control. Our institutional policy offering surveillance till age 30 enabled us to evaluate clinic attendance without the confounding effect of transition. Our aim was to determine the association between glycemic control (HbA1c) and attendance rate. Methods: The medical records of 261 (54% males) young adult T1D patients (median age 22...
2018: Journal of Diabetes Research
Christina L Nelms
Growth in pediatric Chronic Kidney Disease is important for long-term outcomes including final adult height and cognitive function. However, there are many barriers for children with chronic kidney disease to achieve adequate nutritional intake to optimize growth. This review highlights these unique concerns, including route of nutrition, dialysis contributions and biochemical indices. Fitting the enteral feeding to the patients' needs involves choosing an appropriate product or products, limiting harmful nutrients in excess, notably aluminum, and altering for electrolyte and micronutrient needs...
2018: Frontiers in Pediatrics
Zafar Nazir, Muhammad Arif Mateen Khan, Javaria Qamar
BACKGROUND: Congenital Prepubic Sinus (CPS) is an uncommon urogenital anomaly characterized by a blind tract between the skin over the pubis to anterior of the urinary bladder, Urethra or umbilicus. We report four such cases to emphasize varied clinical presentation and embryological conundrum. METHODS: Following Ethical Review Committee (ERC) approval, medical records of pediatric patients (<16 years) presenting with CPS (identified through operating room records and Hospital Information Management System (HIMS) between 1994 and 2018 were reviewed for demographics, clinical presentation, investigations including histopathology, management and outcome...
July 25, 2018: Journal of Pediatric Surgery
Kazuhiro Uda, Chitose Koyama-Wakai, Kensuke Shoji, Noriyasu Iwase, Daisuke Motooka, Shota Nakamura, Isao Miyairi
BACKGROUND: WU polyomavirus (WUPyV) is a relatively new virus associated with respiratory infections. However, its role is unclear in children with severe respiratory failure. OBJECTIVES: We aimed to evaluate the characteristics of severe respiratory failure associated with WUPyV infection in children. STUDY DESIGN: We retrospectively reviewed cases of respiratory tract infection at a tertiary children's hospital in Japan and performed real-time polymerase chain reaction (PCR) for WUPyV using residual extracted nucleic acid samples taken from respiratory tract samples of pediatric patients primarily with respiratory failure...
August 9, 2018: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
Amir Taher, Benjamin Zhu, Sophia Ma, Albert Shun, Anne M Durkan
BACKGROUND: The incidence and types of intraabdominal complications following pediatric transplantation are not well established and specific risk groups have not been clearly identified. METHODS: A retrospective chart review of all pediatric transplant recipients, between 1995 and 2016 was undertaken. Intraabdominal complications were grouped into 4 categories: fluid collections, gastrointestinal, vascular and urogenital. Donor, recipient, and transplant characteristics were evaluated using univariate and multivariate logistic regression...
August 15, 2018: Transplantation
Angeliki Makri, Srivandana Akshintala, Claudia Derse-Anthony, Jaydira Del Rivero, Brigitte Widemann, Constantine A Stratakis, John Glod, Maya Lodish
Background: Multiple endocrine neoplasia type 2B (MEN2B) is characterized by early-onset medullary thyroid cancer (MTC) in virtually all cases and a 50% lifetime risk of pheochromocytoma (PHEO) development. The literature on PHEO in patients with MEN2B is limited with most data being reported from adult studies that primarily address MEN2A. Aim: The aim of the current study is to describe PHEO development in a cohort of pediatric patients with MEN2B. Design: Retrospective chart review of patients with MEN2B evaluated at the NIH in the period between July 2007 and February 2018...
August 2, 2018: Journal of Clinical Endocrinology and Metabolism
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