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Pediatric Liver

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https://www.readbyqxmd.com/read/28634578/neonatal-venous-thromboembolism
#1
REVIEW
Kristina M Haley
Neonates are the pediatric population at highest risk for development of venous thromboembolism (VTE), and the incidence of VTE in the neonatal population is increasing. This is especially true in the critically ill population. Several large studies indicate that the incidence of neonatal VTE is up almost threefold in the last two decades. Central lines, fluid fluctuations, sepsis, liver dysfunction, and inflammation contribute to the risk profile for VTE development in ill neonates. In addition, the neonatal hemostatic system is different from that of older children and adults...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28632826/-pyogenic-liver-abscess-in-children-clinical-experience-in-a-pediatric-reference-center
#2
Carolina Carballo, Claudia Cazes, Mariana Matsuda, M Laura Praino, Noemí Rivas, Eduardo López
INTRODUCTION: Liver abscess is a serious and an uncommon pediatric disease. OBJECTIVE AND METHOD: Description of 20 pediatric patients with liver abscess admitted in "Ricardo Gutierrez" Children's Hospital, a Tertiary Reference Center of Buenos Aires, between 2009 and 2015. RESULTS: The hospitalization rate was 35/100.000 admissions. Median age was 5 years old, male/female ratio 4/1. Five patients (25%) had predisposing factors. Median days at diagnosis were 12...
April 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28632657/role-of-computed-tomography-in-the-classification-of-pediatric-pelvic-fractures-revisited
#3
Melissa A Bent, William L Hennrikus, Johan E Latorre, Douglas G Armstrong, Brian Shaw, Kerwyn C Jones, Lee S Segal
OBJECTIVES: To determine the need for computerized tomography (CT) scans in the assessment of pediatric pelvic fractures. DESIGN: Retrospective Chart Review. SETTING: Level-1 Pediatric Trauma Center. PATIENTS/PARTICIPANTS: Thirty pediatric trauma patients with pelvic fractures who have obtained both a radiograph and CT scan. MAIN OUTCOME MEASUREMENTS: Fleiss Kappa coefficient to compare interreliability...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28632515/p4-stump-approach-for-intraoperative-portal-vein-stenting-in-pediatric-living-donor-liver-transplantation-an-innovative-technique-for-a-challenging-problem
#4
Chao-Long Chen, Yu-Fan Cheng, Viola Huang, Ting-Lung Lin, Yi-Chia Chan, Hsin-You Ou, Chee-Chien Yong, Shih-Ho Wang, Chih-Che Lin
OBJECTIVE: The aim of this study was to evaluate the utility of the P4 stump stenting approach for treating portal vein (PV) complications in pediatric living donor liver transplantation (LDLT). BACKGROUND: PV complications cause significant morbidity and mortality in pediatric LDLT. Biliary atresia in the backdrop of pathological PV hypoplasia and sclerosis heightens the complexity of PV reconstruction. The authors developed a novel approach for intraoperative PV stenting via the graft segment 4 PV stump (P4 stump) to address this challenge...
June 19, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28631359/management-of-pediatric-hepatocellular-carcinoma-a-multimodal-approach
#5
Mira A Kohorst, Deepti M Warad, Jane M Matsumoto, Julie K Heimbach, Mounif El-Youssef, Carola A S Arndt, Vilmarie Rodriguez, Amulya A Nageswara Rao
HCC is rare in the pediatric population, but is the second most common liver malignancy in children. Survival rates for primary unresectable HCC have been dismal. The objective of this study was to describe our experience with a multimodal approach for the management of unresectable HCC in two adolescent patients and to review the literature. Both patients are currently alive with no recurrence at 51 and 29 months post-transplant. Multimodality treatment involving chemotherapy with doxorubicin, cisplatin, and sorafenib; TACE; timely liver transplantation; and post-transplant therapy with sorafenib and mTOR inhibitors may help improve outcomes and prolong survival in pediatric patients with unresectable HCC...
June 20, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28629152/the-association-between-pediatric-nafld-and-common-genetic-variants
#6
REVIEW
Giuseppina Rosaria Umano, Mariangela Martino, Nicola Santoro
Non-alcoholic fatty liver disease (NAFLD) is one of the most common complications of obesity. Several studies have shown that genetic predisposition probably plays an important role in its pathogenesis. In fact, in the last few years a large number of genetic studies have provided compelling evidence that some gene variants, especially those in genes encoding proteins regulating lipid metabolism, are associated with intra-hepatic fat accumulation. Here we provide a comprehensive review of the gene variants that have affected the natural history of the disease...
June 18, 2017: Children
https://www.readbyqxmd.com/read/28627016/unique-clinical-conditions-associated-with-different-acinar-regions-of-fibrosis-in-long-term-surviving-pediatric-liver-grafts
#7
Marjolein Baas, Annette S H Gouw, Marius C van den Heuvel, Bouke G Hepkema, Paul M G J Peeters, HenkJan Verkade, René Scheenstra
In the majority of long-term survivors after PLTx, graft fibrosis has been identified. Recently, subtypes of graft fibrosis have been described based on their predominant acinar localization. We aimed to evaluate whether the development of portal, perisinusoidal, and centrilobular distribution of graft fibrosis is related to patient or transplantation-related parameters. We reviewed the histological features in protocol liver biopsies taken at 1 and 5 years after PLTx of 47 children on a tacrolimus-based immunosuppressive regimen...
June 18, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28621023/pediatric-liver-transplantation-for-fulminant-hepatic-failure-secondary-to-intentional-iron-overdose
#8
Joanne Lai, Jaime Chu, Ronen Arnon
Acute iron poisoning may lead to life-threatening hepatotoxicity. We present the cases of two pediatric patients with hepatotoxicity following intentional iron ingestion that progressed rapidly to fulminant hepatic failure despite treatment with deferoxamine. Liver transplantation was lifesaving in both patients. These cases emphasize the need for a high index of suspicion for iron ingestion, close monitoring for liver toxicity, and timely consideration for liver transplantation.
June 15, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28620649/hepatoblastoma-transplant-versus-resection-experience-in-a-latin-american-transplant-center
#9
Luis A Caicedo, Angie Sabogal, Oscar Serrano, Jorge I Villegas, Verónica Botero, María T Agudelo, Viviana Lotero, Diana Dávalos, Eliana Manzi, Ana M Aristizabal, Catalina Gomez, Gabriel J Echeverri
BACKGROUND: Hepatoblastoma is the most common primary malignant liver tumor in children and is usually diagnosed during the first 3 years of life. Overall survival has increased 50% due to chemotherapeutic schemes, expertise surgery centers, and liver transplantation. METHODS: A retrospective collection of data was performed from pediatric patients with diagnosis of hepatoblastoma. Variables included demographic, diagnostic tools and histological classification; chemotherapy and surgical treatment; and outcomes and patient survival...
June 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28620647/the-effect-and-safety-of-prostaglandin-administration-in-pediatric-liver-transplantation
#10
Céline Lironi, Valérie A McLin, Barbara E Wildhaber
BACKGROUND: Prostaglandins are often administered after liver transplantation (LT) to diminish ischemia-reperfusion injury (IRI), to favor liver recovery and to prevent vascular thrombosis. Possible beneficial effects in adult liver recipients are controversial, but the single existing pediatric small case series shows no significant impact of prostaglandin administration after LT. The purpose of this study was to analyze the effect of the prostaglandin dinoprostone in pediatric liver recipients...
June 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28617762/racial-disparities-and-sociodemographic-differences-in-incidence-and-survival-among-pediatric-patients-in-the-united-states-with-primary-liver-cancer-a-surveillance-epidemiology-and-end-results-seer-population-study
#11
Felix Nautsch, Johannes M Ludwig, Minzhi Xing, Kevin M Johnson, Hyun S Kim
BACKGROUND: Primary liver cancer, including Hepatoblastoma (HB) and hepatocellular carcinoma (HCC), in pediatric populations is often fatal. The outcomes are poor despite universal health care access in pediatric patients. AIM: We investigated the sociodemographic factors affecting outcomes in pediatric patients with primary liver cancer. MATERIALS AND METHODS: This is a large population database study of Surveillance, Epidemiology, and End Results cancer registry data from 1973 to 2011...
June 14, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28612751/fighting-mortality-in-the-waiting-list-liver-transplantation-in-north-america-europe-and-asia
#12
Daniel Zamora-Valdes, Pilar Leal-Leyte, Peter T W Kim, Giuliano Testa
Liver disease is a major cause of mortality worldwide. Liver transplantation (LT) is the most effective treatment for end stage liver disease. Available resources and social circumstances have led to different ways of implementing LT around the world. The experience with pediatric LT corroborates the hypothesis that a combination of surgical strategies can be beneficial. The goal of this manuscript is to describe the strategies used by LT centers in North America, Europe and Asia and how these strategies can be applied to reduce waitlist mortality and increase access to LT...
August 1, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28608818/impact-of-parvovirus-b19-viremia-in-liver-transplanted-children-on-anemia-a-retrospective-study
#13
Michael Würdinger, Susanne Modrow, Annelie Plentz
Acute parvovirus B19 (B19V) infection in immunocompromised patients may lead to severe anemia. However, in adult transplant recipients, B19V reactivations without anemia and low-level viremia are common. The impact of B19V in pediatric transplant patients, with high risk of primary infection, is investigated here. In a six-month period, 159 blood samples of 54 pediatric liver transplant recipients were tested for B19V DNA by quantitative real-time PCR. Viremia was correlated with anemia and immunosuppression and compared with rates in adult transplant recipients...
June 13, 2017: Viruses
https://www.readbyqxmd.com/read/28607029/age-dependent-protein-abundance-of-cytosolic-alcohol-and-aldehyde-dehydrogenases-in-human-liver
#14
Deepak Kumar Bhatt, Andrea Gaedigk, Robin E Pearce, J Steven Leeder, Bhagwat Prasad
Hepatic cytosolic alcohol and aldehyde dehydrogenases (ADHs and ALDHs) catalyze the biotransformation of xenobiotics (e.g., cyclophosphamide and ethanol) and vitamin A. Because age-dependent hepatic abundance of these proteins is unknown, we quantified protein expression of ADHs and ALDH1A1 in a large cohort of pediatric and adult human livers by LC-MS/MS proteomics. Purified proteins were used as calibrators. Two to three surrogate peptides per protein were quantified in trypsin digests of liver cytosolic samples and calibrator proteins under optimal conditions of reproducibility...
June 12, 2017: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/28606575/good-adherence-to-the-mediterranean-diet-reduces-the-risk-for-nash-and-diabetes-in-pediatric-patients-with-obesity-the-results-of-an-italian-study
#15
Claudia Della Corte, Antonella Mosca, Andrea Vania, Arianna Alterio, Salvatore Iasevoli, Valerio Nobili
OBJECTIVE: In the last decade, it was demonstrated that the Mediterranean diet (MD) represents an ideal diet for all age groups and has an important role in the prevention of metabolic and cardiovascular diseases, as well as nonalcoholic fatty liver disease (NAFLD). The aim of the present study was to analyze the association between adherence to the MD and NAFLD, with laboratory and histologic evaluation, in a group of children and adolescents with obesity. METHODS: We enrolled 243 patients with obesity referred to our department from March 2014 to November 2015...
July 2017: Nutrition
https://www.readbyqxmd.com/read/28604513/severe-sarcopenia-and-increased-fat-stores-in-pediatric-patients-with-liver-kidney-or-intestine-failure
#16
Richard S Mangus, Weston J Bush, Chandrashekhar A Kubal, Christina Miller
OBJECTIVES: Malnutrition and wasting predict clinical outcomes in children with severe chronic illness. Objectively calculated malnutrition in children with end-stage organ failure has not been well studied. This analysis compares children with kidney, liver or intestine failure to healthy controls to quantitate the disparity in muscle and fat stores. METHODS: Children younger than age 19 with end stage liver, kidney or intestine failure and with pre-transplant computed tomography (CT) imaging were selected from the transplant database...
June 9, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28603862/graft-reduction-using-a-powered-stapler-in-pediatric-living-donor-liver-transplantation
#17
Koichiro Yoshimaru, Toshiharu Matsuura, Yoshiaki Kinoshita, Makoto Hayashida, Yoshiaki Takahashi, Yusuke Yanagi, Norifumi Harimoto, Toru Ikegami, Hideaki Uchiyama, Tomoharu Yoshizumi, Yoshihiko Maehara, Tomoaki Taguchi
Large-for-size syndrome is defined by inadequate tissue oxygenation, which results in vascular complications and graft compression after abdominal closure in living donor liver transplantation recipients. An accurate graft reduction that matches the optimal liver volume for the recipient is essential. We herein initially present the feasibility and safety of graft reduction using a powered stapler to obtain an optimal graft size. From October 1996 to October 2015, a total of eight graft reductions were performed using a powered stapler (group A; n=4) or by the conventional method using a cavitron ultrasonic surgical aspirator and portal triad suturing (group B; n=4)...
June 11, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28601178/pediatric-hepatobiliary-neoplasms-an-overview-and-update
#18
REVIEW
Ali Yikilmaz, Michael George, Edward Y Lee
Recent developments regarding the treatment of pediatric liver tumors have significantly improved patient care. Stimulated by collaboration between international pediatric groups, advances have been made in surgical techniques, transplantation options, and chemotherapy schemas. In light of this progress, clear understanding of the state-of-the-art imaging evaluation of hepatobiliary tumors has become even more integral to the effective management of children with hepatic neoplasms. The unique imaging features of hepatic neoplasms in the pediatric population, when coupled with supportive demographic data and laboratory findings, can lead to accurate diagnosis and proper treatment of hepatobiliary tumors...
July 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/28600116/features-of-nonalcoholic-steatohepatitis-in-severely-obese-children-and-adolescents-undergoing-sleeve-gastrectomy
#19
Aayed Alqahtani, Mohamed Elahmedi, Khalid Alswat, Maha Arafah, Mosa Fagih, Jaehoon Lee
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is an underrecognized co-morbidity of obesity. The characteristic features and severity of NAFLD in severe childhood obesity remain unknown. OBJECTIVES: To investigate features of NAFLD in obese children and identify predictors of significant disease. SETTING: Academic center with a standardized pathway for pediatric bariatric surgery and a dedicated multidisciplinary team. DESIGN: This is a baseline cross-sectional analysis for a data set obtained from a prospective clinical outcome study that included severely obese children (≤14 yr of age) and adolescents (14-21 yr of age) who underwent laparoscopic sleeve gastrectomy between March 2008 and March 2015...
April 7, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28598585/epithelioid-hemangioendotheliomas-of-the-liver-and-lung-in-children-and-adolescents
#20
REVIEW
Simone Hettmer, Geoffroy Andrieux, Jochen Hochrein, Philipp Kurz, Jochen Rössler, Silke Lassmann, Martin Werner, Nikolas von Bubnoff, Christoph Peters, Ewa Koscielniak, Monika Sparber-Sauer, Charlotte Niemeyer, Thomas Mentzel, Hauke Busch, Melanie Boerries
Epithelioid hemangioendothelioma (EHE) is a rare, vascular sarcoma. Visceral forms arise in the liver/ lungs. We review the clinical and molecular phenotype of pediatric visceral EHE based on the case of a 9-year-old male child with EHE of the liver/lungs. His tumor expressed the EHE-specific fusion oncogene WWTR1-CAMTA1. Molecular characterization revealed a low somatic mutation rate and activated interferon signaling, angiogenesis regulation, and blood vessel remodeling. After polychemotherapy and resection of lung tumors, residual disease remained stable on oral lenalidomide...
June 9, 2017: Pediatric Blood & Cancer
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