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https://www.readbyqxmd.com/read/28644187/perioperative-blood-management-in-pediatric-spine-surgery
#1
Matthew E Oetgen, Jody Litrenta
Blood management strategies are integral to successful outcomes in many types of orthopaedic surgery. These strategies minimize blood loss and transfusion requirements, ultimately decreasing complications, improving outcomes, and potentially eliminating risks associated with allogeneic transfusion. Practices to achieve these goals include preoperative evaluation and optimization of hemoglobin, the use of pharmacologic agents or anesthetic methods, intraoperative techniques to improve hemostasis and cell salvage, and the use of predonated autologous blood...
July 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28640778/a-cohort-study-of-blunt-cerebrovascular-injury-screening-in-children-are-they-just-little-adults
#2
Mackenzie R Cook, Cordelie E Witt, Robert H Bonow, Eileen M Bulger, Ken F Linnau, Saman Arbabi, Bryce R H Robinson, Joseph Cuschieri
BACKGROUND: Blunt cerebrovascular injuries (BCVI) are rare with nonspecific predictors, making optimal screening critical. Radiation concerns magnify these issues in children. The Eastern Association for the Surgery of Trauma (EAST) criteria, the Utah score (US) and the Denver criteria (DC) have been advocated for pediatric BCVI screening, though direct comparison is lacking. We hypothesized that current screening guidelines inaccurately identify pediatric BCVI. METHODS: This was a retrospective cohort study of pediatric trauma patients treated from 2005-2015 with radiographically confirmed BCVI...
June 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28640707/response-assessment-in-neuro-oncology-clinical-trials
#3
Patrick Y Wen, Susan M Chang, Martin J Van den Bent, Michael A Vogelbaum, David R Macdonald, Eudocia Q Lee
Development of novel therapies for CNS tumors requires reliable assessment of response and progression. This requirement has been particularly challenging in neuro-oncology for which contrast enhancement serves as an imperfect surrogate for tumor volume and is influenced by agents that affect vascular permeability, such as antiangiogenic therapies. In addition, most tumors have a nonenhancing component that can be difficult to accurately quantify. To improve the response assessment in neuro-oncology and to standardize the criteria that are used for different CNS tumors, the Response Assessment in Neuro-Oncology (RANO) working group was established...
June 22, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28632204/successful-pharmacotherapy-for-the-treatment-of-severe-feeding-aversion-with-mechanistic-insights-from-cross-species-neuronal-remodeling
#4
W G Sharp, A G Allen, K H Stubbs, K K Criado, R Sanders, C E McCracken, R G Parsons, L Scahill, S L Gourley
Pediatric feeding disorders affect up to 5% of children, causing severe food intake problems that can result in serious medical and developmental outcomes. Behavioral intervention (BI) is effective in extinguishing feeding aversions, and also expert-dependent, time/labor-intensive and not well understood at a neurobiological level. Here we first conducted a double-blind, placebo-controlled trial comparing BI with BI plus d-cycloserine (DCS). DCS is a partial N-methyl-d-aspartate (NMDA) receptor agonist shown to augment extinction therapies in multiple anxiety disorders...
June 20, 2017: Translational Psychiatry
https://www.readbyqxmd.com/read/28623416/identifying-intestinal-malrotation-on-magnetic-resonance-examinations-ordered-for-unrelated-indications
#5
Jill S Fay, Victoria Chernyak, Benjamin H Taragin
BACKGROUND: Anatomical imaging findings indicating normal bowel rotation can be identified on cross-sectional imaging, including magnetic resonance imaging (MRI) performed for non-related indications. OBJECTIVE: The goal of our study was to assess whether non-targeted MRI can accurately assess intestinal malrotation. MATERIALS AND METHODS: Four anatomical landmarks were assessed on MRIs of the chest, spine or abdomen performed from January 2006 to June 2014, on patients who also had upper gastrointestinal series (UGI) performed within 10 years of the MRI date: 1) retroperitoneal duodenum, 2) left upper quadrant duodenojejunal junction, 3) superior mesenteric artery to the left of the superior mesenteric vein, and 4) right lower quadrant cecum...
June 16, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28609322/thoracic-spine-growth-revisited-how-accurate-is-the-dimeglio-data
#6
Ozgur Dede, Kadir Büyükdoğan, Halil Gökhan Demirkıran, Erhan Akpınar, Muharrem Yazici
STUDY DESIGN: Cross-sectional descriptive study. OBJECTIVE: To describe the normal rate pattern of thoracic spine growth in children without any spinal deformity. SUMMARY OF BACKGROUND DATA: The knowledge of thoracic spine growth and height is important for growing spine treatment and the decision of final fusion. Currently, pediatric spinal deformity is approached as early onset and late onset with an understanding of the fast growth during the first 5 years of life...
June 15, 2017: Spine
https://www.readbyqxmd.com/read/28606403/diaphragmatic-dysfunction-in-sepn1-related-myopathy
#7
Serena Caggiano, Sonia Khirani, Ivana Dabaj, Eliana Cavassa, Alessandro Amaddeo, Jorge Olmo Arroyo, Isabelle Desguerre, Pascale Richard, Renato Cutrera, Ana Ferreiro, Brigitte Estournet, Susana Quijano-Roy, Brigitte Fauroux
SEPN1-related myopathy (SEPN1-RM) is characterized by predominant axial muscle weakness, early scoliosis, rigid spine and severe respiratory insufficiency. The aim of the study was to characterize the mechanisms of respiratory dysfunction in SEPN1-RM patients. Breathing pattern and respiratory muscle strength were measured by means of esophageal (Pes) and gastric (Pgas) pressures. Seven patients aged 7-55 years (1 adult) at first respiratory muscle test were studied. Five patients were treated by nocturnal noninvasive ventilation (NIV)  ≥ 4 months...
April 26, 2017: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/28605734/cervical-spine-aneurysmal-bone-cysts-in-the-pediatric-population-a-systematic-review-of-the-literature
#8
Matthew Protas, Lydia W Jones, Juan Pablo Sardi, Christian Fisahn, Joe Iwanaga, Rod J Oskouian, R Shane Tubbs
Cervical spine aneurysmal bone cysts (ABCs) in pediatric patients have not been thoroughly studied. Using PubMed and Google Scholar, a systematic review of the literature was conducted for publications that included patients aged ≤15 years with a confirmed diagnosis of ABC in the cervical spine. Thirty-five studies with a total of 71 patients met the inclusion criteria. Nearly 80% of patients presented with neck or shoulder pain. The axis was the level most frequently involved (34.28%), followed by C5 (24...
June 13, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28603566/current-concepts-in-pediatric-cervical-spine-trauma
#9
Kunal Shah, Agnivesh Tikoo, Manish K Kothari, Abhay Nene
BACKGROUND: Pediatric spinal trauma is rare and challenging entity. Although cervical spine is commonly affected, it is often missed on routine imaging investigations. Therefore better understanding of growing spine and its patho-physiology is crucial. METHODS: Articles related to pediatric cervical trauma were searched on Pubmed and other online research data banks. We have summarized unique anatomy of pediatric spine, investigations followed by common injury patterns, their diagnostic challenges and management...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28602642/precision-and-accuracy-of-consumer-grade-motion-tracking-system-for-pedicle-screw-placement-in-pediatric-spinal-fusion-surgery
#10
Andrew Chan, Janelle Aguillon, Doug Hill, Edmond Lou
Adolescent idiopathic scoliosis (AIS) is a 3-dimensional spinal deformity involving lateral curvature and axial rotation. Surgical intervention involves insertion of pedicle screws into the spine, requiring accuracies of 1mm and 5° in translation and rotation to prevent neural and vascular complications. While commercial CT-navigation is available, the significant cost, bulk and radiation dose hinders their use in AIS surgery. The objective of this study was to evaluate a commercial-grade Optitrack Prime 13W motion capture cameras to determine if they can achieve adequate accuracy for screw insertion guidance in AIS...
June 9, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28587051/evaluating-intensity-modulated-proton-therapy-relative-to-passive-scattering-proton-therapy-for-increased-vertebral-column-sparing-in-craniospinal-irradiation-in-growing-pediatric-patients
#11
Drosoula Giantsoudi, Joao Seco, Bree R Eaton, F Joseph Simeone, Hanne Kooy, Torunn I Yock, Nancy J Tarbell, Thomas F DeLaney, Judith Adams, Harald Paganetti, Shannon M MacDonald
PURPOSE: At present, proton craniospinal irradiation (CSI) for growing children is delivered to the whole vertebral body (WVB) to avoid asymmetric growth. We aimed to demonstrate the feasibility and potential clinical benefit of delivering vertebral body sparing (VBS) versus WVB CSI with passively scattered (PS) and intensity modulated proton therapy (IMPT) in growing children treated for medulloblastoma. METHODS AND MATERIALS: Five plans were generated for medulloblastoma patients, who had been previously treated with CSI PS proton radiation therapy: (1) single posteroanterior (PA) PS field covering the WVB (PS-PA-WVB); (2) single PA PS field that included only the thecal sac in the target volume (PS-PA-VBS); (3) single PA IMPT field covering the WVB (IMPT-PA-WVB); (4) single PA IMPT field, target volume including thecal sac only (IMPT-PA-VBS); and (5) 2 posterior-oblique (-35°, +35°) IMPT fields, with the target volume including the thecal sac only (IMPT2F-VBS)...
May 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28583488/non-invasive-methods-to-maintain-cervical-spine-position-after-pediatric-tracheal-resections
#12
Kahren K Aydinyan, Jonathan D Day, Gina M Troiano, G Paul Digoy
OBJECTIVES: To present our experience with two methods of neck stabilization after pediatric tracheal resection with primary anastomosis as possible alternatives to the traditional chest-chin suture. METHODS: Children undergoing tracheal resection and/or cricotracheal resection with anastomosis under tension were placed in cervical spine flexion postoperatively with either a chest-chin (Grillo) suture, an Aspen cervical collar or Trulife Johnson cervical-thoracic orthosis (CTO)...
July 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28580404/the-associations-of-exposure-to-combined-hormonal-contraceptive-use-on-bone-mineral-content-and-areal-bone-mineral-density-accrual-from-adolescence-to-young-adulthood-a-longitudinal-study
#13
Stefan A Jackowski, Adam D G Baxter-Jones, Ashlee J McLardy, Roger A Pierson, Carol D Rodgers
BACKGROUND: The association of long term combined hormone based contraceptives (CHC) use on bone mineral content (BMC) and areal bone mineral density (aBMD) development remains controversial, as it appears that the relationship may be age-dependent. The purpose of this study was to investigate the long-term associations of CHC exposure on the accrual of bone parameters from adolescence into young-adulthood. METHODS: 110 women (67 exposed to CHC) were drawn from the Pediatric Bone Mineral Accrual Study (PBMAS)...
December 2016: Bone Reports
https://www.readbyqxmd.com/read/28577781/orthobiologics-in-pediatric-orthopedics
#14
REVIEW
Robert F Murphy, James F Mooney
Orthobiologics are biologic devices or products used in orthopedic surgery to augment or enhance bone formation. The use of orthobiologics in pediatric orthopedics is less frequent than in other orthopedic subspecialties, mainly due to the naturally abundant healing potential and bone formation in children compared with adults. However, orthobiologics are used in certain situations in pediatric orthopedics, particularly in spine and foot surgery. Other uses have been reported in conjunction with specific procedures involving the tibia and pelvis...
July 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28554184/vertebral-artery-dissection-in-a-bouncy-castle-injury-case-report-and-literature-review
#15
Valeria Ripa, Timur M Urakov, Sarah C Jernigan
There is an increased rate of injuries associated with activities on bouncy castles. The purpose of this article was to describe the case of a 6-year-old boy who sustained a brain infarct as a consequence of a left posterior inferior cerebellar artery dissection due to improper landing in a bouncy castle and who required a suboccipital craniotomy. The second goal was to outline the literature review regarding cervical trauma related to trampoline or bouncy castle accidents in pediatric populations. Based on the described case and reviewed studies, bouncy castle or any other activity resulting in hyperflexion or hyperextension of the neck should be carefully evaluated for cervical spine fractures and vascular injuries...
May 30, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28553386/solitary-plasmacytoma-of-bone-involving-spine-in-a-12-year-old-boy-report-of-a-rare-case-and-review-of-literature
#16
Rahul S Kulkarni, Sonia K Parikh, Asha S Anand, Harsha P Panchal, Apurva A Patel, Priti Trivedi, Kshitij Joshi, Pushpak Chirmade
Solitary plasmacytoma of the bone (SPB) is a rare plasma cell neoplasm representing only about 5% of plasma cell neoplasia. It usually presents as a lytic lesion mainly localized within the axial skeleton. SPB is exceedingly rare in young individuals, and only few cases have been reported so far in patients younger than 20 years of age. In view of rarity of disease, definitive treatment guidelines have not been established. We hereby report a case of SPB involving of lumbar vertebra (L5) in a 12-year-old boy...
January 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28550896/pediatric-near-drowning-events-do-they-warrant-trauma-team-activation
#17
Pranit N Chotai, Lisa Manning, Benjamin Eithun, Joshua C Ross, James W Eubanks, Chad Hamner, Ankush Gosain
BACKGROUND: The purpose of this study was to determine the incidence of traumatic injuries, factors associated with mortality, and need for pediatric trauma surgery involvement for drowning and near-drowning events in children. MATERIALS AND METHODS: An institutional review board-approved, retrospective chart review was performed at three American College of Surgeons-verified Pediatric Trauma Centers (2011-2014). Patients with International Classification of Diseases, Ninth Revision, codes or E-codes for fatal-nonfatal drowning, fall into water, accidental drowning, or submersion were included...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28524790/cognard-type-v-intracranial-dural-arteriovenous-fistula-presenting-in-a-pediatric-patient-with-rapid-progressive-myelopathy
#18
Walter J Jermakowicz, Alexander G Weil, Artyom Vlasenko, Sanjiv Bhatia, Toba N Niazi
Cognard Type V dural arteriovenous fistulas (dAVFs) are a unique type of cranial vascular malformation characterized by congestion of the perimedullary venous system that may lead to devastating spinal cord pathology if left untreated. The authors present the first known case of a pediatric patient diagnosed with a Type V dAVF. A 14-year-old girl presented with a 3-week history of slowly progressive unilateral leg weakness that quickly progressed to bilateral leg paralysis, sphincter dysfunction, and complete sensory loss the day of her presentation...
May 19, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28520681/delayed-dural-leak-following-posterior-spinal-fusion-for-idiopathic-scoliosis-using-all-posterior-pedicle-screw-technique
#19
Lorena V Floccari, A Noelle Larson, Anthony A Stans, Jeremy Fogelson, Iikka Helenius
BACKGROUND: In pediatric patients, pedicle screws are malpositioned 5% to 15% of the time. Complications associated with malpositioned screws are infrequently reported in the literature. We present a series of adolescent idiopathic scoliosis (AIS) patients who presented in a delayed manner with positional headache and chronic dural leak adjacent to the pedicle screw tract. METHODS: Scoliosis databases at 2 centers were reviewed, and cases of delayed positional headaches following posterior spinal fusion for AIS were identified...
May 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28520678/anterior-cruciate-ligament-injury-at-the-time-of-anterior-tibial-spine-fracture-in-young-patients-an-observational-cohort-study
#20
Meredith H Mayo, Justin J Mitchell, Derek P Axibal, Jorge Chahla, Claire Palmer, Armando F Vidal, Jason T Rhodes
BACKGROUND: Anterior tibial spine fractures (ATSF) in the skeletally immature parallel anterior cruciate ligament (ACL) tears in adult patients, yet these injuries are generally regarded as mutually exclusive. Biomechanical analysis suggests that intrinsic ACL damage occurs during ATSF, and long-term clinical studies demonstrate residual anteroposterior knee laxity following ATSF. We aim to describe prevalence, demographics, and characteristics of pediatric patients who sustained ATSF with concomitant ACL injury...
May 17, 2017: Journal of Pediatric Orthopedics
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