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https://www.readbyqxmd.com/read/27811622/therapeutic-endoscopy-for-the-control-of-non-variceal-upper-gastrointestinal-bleeding-in-children-a-case-series
#1
Anna M Banc-Husu, Nuzhat A Ahmad, Vinay Chadrasekhara, Gregory G Ginsberg, David L Jaffe, Michael L Kochman, Michael Rajala, Petar Mamula
INTRODUCTION: Gastrointestinal bleeding is one of the most common indications for urgent endoscopy in the pediatric setting. The majority of these procedures are performed for control of variceal bleeding, with very few performed for non-variceal upper gastrointestinal (NVUGI) bleeding. The data on therapeutic endoscopy for NVUGI are very sparse. The aims of our study were to review our experience with NVUGI bleeding, describe technical aspects and outcomes of therapeutic endoscopy, and determine gastroenterology fellows' training opportunities according to the national training guidelines...
November 2, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27782961/using-the-objective-structured-clinical-exam-osce-to-assess-acgme-competencies-in-pediatric-gastroenterology-fellows
#2
Aliza B Solomon, Rachel Reed, Keith Benkov, Joseph Kingsbery, Sarah S Lusman, Lisa B Malter, Jeremiah Levine, Simon Rabinowitz, Martin Wolff, Sondra Zabar, Elizabeth Weinshel
BACKGROUND: The Accreditation Council for Graduate Medical Education (ACGME) has described six core competencies with which trainees should demonstrate proficiency. Using the Objective Structured Clinical Exam (OSCE), we aimed to assess four of these competencies among Pediatric GI fellows (PG). METHODS: Eight first-year PG's from six medical centers in the New York area participated in a four-station OSCE with trained standardized patient (SP) actors. The cases included an "ED Consult" for lower GI bleeding; "Breaking Bad News" focusing on CF nutritional complications; "Second Opinion" for abdominal pain; "Transition of Care" for inflammatory bowel disease...
October 25, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27110342/a-long-segmental-vascular-malformation-in-the-small-bowel-presenting-with-gastrointestinal-bleeding-in-a-preschool-aged-child
#3
Yeoun Joo Lee, Jae-Yeon Hwang, Yong Hoon Cho, Yong-Woo Kim, Tae Un Kim, Dong Hoon Shin
Gastrointestinal (GI) bleeding in pediatric patients has several causes. Vascular malformation of the small bowel is a rare disease leading to pediatric GI bleeding. To our knowledge, few reports describe ultrasound and computed tomography findings of venous malformations involving the small bowel. We present a case of long-segmental and circumferential vascular malformation that led to GI bleeding in a pre-school aged child, focusing on the radiologic findings. Although vascular malformation including of the GI tract is rare in children, it should be considered when GI bleeding occurs in pediatric patients...
January 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
https://www.readbyqxmd.com/read/27066447/stepwise-endoscopy-based-on-sigmoidoscopy-in-evaluating-pediatric-graft-versus-host-disease
#4
Kyung Jae Lee, Shin Jie Choi, Hye Ran Yang, Ju Yuong Chang, Hyoung Jin Kang, Hee Young Shin, Gyeong Hoon Kang, Jae Sung Ko, Jin Soo Moon
PURPOSE: The aim of our study was to establish a safe and convenient diagnostic method for acute gastrointestinal (GI) graft-versus-host disease (GVHD) in children by determining the sensitivity and negative predictive values of upper and lower endoscopic biopsies for children suspected of GI GVHD. METHODS: Patients suspected of GI GVHD who received endoscopic evaluation within 100 days after stem cell transplantation and endoscopies between January 2012 and March 2014 in Seoul National University Children's Hospital were included in our study...
March 2016: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/27028942/massive-gastrointestinal-bleed-as-presentation-for-previously-undiagnosed-coarctation-of-aorta
#5
Tara Neubrand, Rakesh Mistry, Roxanna Lefort
BACKGROUND: Coarctation of the aorta is a common congenital heart lesion with a known complication of collateral vessel formation if left untreated. OBJECTIVE: To alert pediatric emergency physicians of a rare and life-threatening presentation of previously undiagnosed congenital heart disease in the adolescent. CASE: We discuss the case of a 15-year-old boy who presented with hypertension and massive upper GI bleed due to aortoenteric fistula formation associated with undiagnosed coarctation of the aorta...
April 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/26678616/gastrointestinal-bleeding-scintigraphy-in-the-early-21st-century
#6
REVIEW
Erin Grady
Gastrointestinal bleeding scintigraphy performed with (99m)Tc-labeled autologous erythrocytes or historically with (99m)Tc-sulfur colloid has been a clinically useful tool since the 1970s. This article reviews the history of the techniques, the different methods of radiolabeling erythrocytes, the procedure, useful indications, diagnostic accuracy, the use of SPECT/CT and CT angiography to evaluate gastrointestinal bleeding, and Meckel diverticulum imaging. The causes of pediatric bleeding are discussed by age...
February 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/26628852/comparison-of-effectiveness-of-manual-orthodontic-powered-and-sonic-toothbrushes-on-oral-hygiene-of-fixed-orthodontic-patients
#7
Ruchi Sharma, Mridula Trehan, Sunil Sharma, Vikas Jharwal, Nidhi Rathore
INTRODUCTION: Maintenance of good oral hygiene is important for patients undergoing fixed orthodontic treatment. AIM: The aim of this study was to evaluate the effectiveness of a manual orthodontic toothbrush, powered toothbrush with oscillating head and sonic toothbrush in controlling plaque, gingivitis and interdental bleeding in patients undergoing fixed orthodontic treatment, and to compare their relative efficacy. MATERIALS AND METHODS: Sixty subjects, who were to receive orthodontic treatment with both upper and lower fixed appliances, were randomly divided into three study groups, with 20 patients in each group...
September 2015: International Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/26380570/current-opinions-on-stress-related-mucosal-disease-prevention-in-canadian-pediatric-intensive-care-units
#8
Jérôme Ouellet, Dennis Bailey, Marie-Ève Samson
OBJECTIVE: To describe current opinions about stress-related mucosal disease (SRMD) prevention in Canadian pediatric intensive care units (PICUs). METHODS: A 22-question survey covering several aspects of SRMD was sent to all identified PICU attendings in Canada. RESULTS: Sixty-eight percent of identified attendings completed the questionnaire. Thirty-eight percent were based in Quebec, 31% in Alberta, and 31% from other provinces. Most attendings (78%) had worked in a PICU for 6 years or more...
July 2015: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/26313771/importance-of-heparin-provocation-and-spect-ct-in-detecting-obscure-gastrointestinal-bleeding-on-99mtc-rbc-scintigraphy-a-case-report
#9
Mahdi Haghighatafshar, Farshid Gheisari, Tahereh Ghaedian
We presented a pediatric case with a history of intermittent melena for 3 years because of angiodyplasia of small intestine. The results of frequent upper gastrointestinal endoscopies and colonoscopies as well as both Tc-red blood cell (RBC) and Meckel's scintigraphies for several times were negative in detection of bleeding site. However, Tc-RBC scintigraphy with single-photon emission computed tomography (SPECT)/computed tomography (CT) after heparin augmentation detected a site of bleeding in the distal ileum which later was confirmed during surgery with final diagnosis of angiodysplasia...
August 2015: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26269699/bezoar-in-a-pediatric-oncology-patient-treated-with-coca-cola
#10
Sara Naramore, Amy Virojanapa, Moshe Bell, Punit N Jhaveri
A bezoar is a mass of indigestible material. Bezoars can present with a gradual onset of non-specific gastrointestinal symptoms including abdominal pain, nausea and vomiting. However, bezoars can result in more serious conditions such as intestinal bleeding or obstruction. Without quick recognition, particularly in susceptible individuals, the diagnosis and treatment can be delayed. Currently resolution is achieved with enzymatic dissolution, endoscopic fragmentation or surgery. We describe, to our knowledge, the first pediatric patient with lymphoma to have had a bezoar treated with Coca-Cola...
May 2015: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/26265893/diagnostic-evaluation-of-our-patients-with-hemophilia-a-17-year-experience
#11
Kamuran Karaman, Sinan Akbayram, Mesut Garipardıç, Ahmet Fayik Öner
AIM: Hemophilia A is a rare inherited bleeding disorder resulting from factor VIII deficiency and is a group of diseases characterized by intra-articular and intramuscular bleeding. In this study, we aimed to retrospectively evaluate the treatment outcomes, demographic and clinical characteristics of our patients who were treated and followed up for last 17 years in our pediatric hematology unit with a diagnosis of Hemophilia A. MATERIAL AND METHODS: The medical records of 83 patients who were diagnosed with Hemophilia A and followed up between 1997 and 2014 in our hospital's pediatric hematology clinic were reviewed retrospectively...
June 2015: Türk Pediatri Arşivi
https://www.readbyqxmd.com/read/26208235/colonic-polyps-and-polyposis-syndromes-in-pediatric-patients
#12
REVIEW
Marsha Kay, Katharine Eng, Robert Wyllie
PURPOSE OF REVIEW: Gastrointestinal polyps are commonly encountered during childhood and are one of the most common causes of rectal bleeding in this age group. Most polyps are benign and located in the colon, with the most frequent type being juvenile polyps. However, in older pediatric patients, if multiple polyps are present, in patients who have a positive family history, or if polyps are located outside of the colon, either adenomatous polyps or polyps associated with genetic abnormalities are more common...
October 2015: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/26150023/histologic-features-of-intestinal-thrombotic-microangiopathy-in-pediatric-and-young-adult-patients-after-hematopoietic-stem-cell-transplantation
#13
Javier El-Bietar, Mikako Warren, Christopher Dandoy, Kasiani C Myers, Adam Lane, Gregory Wallace, Stella M Davies, Sonata Jodele
High-risk transplantation-associated thrombotic microangiopathy (TMA) can present with multisystem involvement and is associated with a poor outcome after hematopoietic stem cell transplantation (HSCT), with < 20% 1-year survival. TMA may involve the intestinal vasculature and can present with bleeding and ischemic colitis. There are no established pathologic criteria for the diagnosis of intestinal TMA (iTMA). The goal of our study was to identify histologic features of iTMA and describe associated clinical features...
November 2015: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/26140101/obtaining-research-biopsies-during-pediatric-colonoscopy-safety-and-adverse-events
#14
Jennifer Mait-Kaufman, Stacie Kahn, Gitit Tomer
AIM: To investigate the safety profile of acquiring additional intestinal biopsies for research purposes in children undergoing a medically indicated colonoscopy. METHODS: A retrospective review of 122 pediatric patients who underwent colonoscopy over a 9 mo time period was completed. 38/122 participants consented to a research study in which 4 additional biopsies were obtained, in addition to routine biopsies. The outcomes after colonoscopy were measured in the research participants, and compared to 84 control participants who did not consent for the study...
June 25, 2015: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/26051270/-eosinophilic-gastroenteritis-and-colitis-in-pediatric-patients-increasingly-frequent-diseases
#15
J Lemale, L Dainese, P Tounian
Eosinophilic gastrointestinal disorders are a heterogeneous group of disorders characterized by no specific digestive symptoms associated with dense eosinophilic inflammation of the gastrointestinal tract in the absence of known causes for such tissue eosinophilia. Among these diseases, eosinophilic gastroenteritis (EGE) and colitis (EC) are less common than esophagitis, but their incidence and prevalence have been increasing over the past decade due in part to increased disease recognition. The exact pathophysiology is not clear: EGE and EC are immune-mediated diseases implicating adaptive T-helper cell type 2 immunity...
July 2015: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/26020374/endoscopy-following-pediatric-intestinal-transplant
#16
Joanna Yeh, Khiet D Ngo, Laura J Wozniak, Jorge H Vargas, Elizabeth A Marcus, Sue V McDiarmid, Douglas G Farmer, Robert S Venick
OBJECTIVES: Biopsies remain the criterion standard in the diagnosis of intestinal transplant (ITx) rejection, and gastrointestinal endoscopy plays a pivotal role in patient management. Herein, we describe a single-center 23-year endoscopic experience in pediatric ITx recipients. METHODS: A retrospective review of endoscopy and pathology reports of all ITx recipients <18 years old transplanted between 1991 and 2013 was performed with the aim of describing the procedural indications, findings, and complications...
December 2015: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/26011216/success-of-minimally-invasive-transumbilical-single-incision-laparoscopic-surgery-t-sils-plus-double-balloon-endoscopy-dbe-for-pediatric-intestinal-angiodysplasia-a-case-report
#17
Koichiro Mori, Yuhki Koike, Mikihiro Inoue, Kohei Ohtake, Koji Tanaka, Keichi Uchida, Yasuhiko Mohri, Masato Kusunoki
We describe here a child with angiodysplasia of the small intestine, diagnosed by double-balloon endoscopy (DBE), who was treated with transumbilical single-incision laparoscopic surgery (T-SILS). A 9-year-old boy presented to another hospital with intermittent fresh melena of a duration of 5 months and 4 days. Anoscopy and gastric mucosal membrane scintigraphy were unsuccessful diagnostically, and he was referred to our hospital for further examination and treatment. Under general anesthesia, we performed DBE by an anal route, with the ileum assessed for a distance of about 150 cm from the ileocecal valve...
May 2015: International Surgery
https://www.readbyqxmd.com/read/25968047/safety-of-octreotide-in-hospitalized-infants
#18
Daniela Testoni, Christoph P Hornik, Megan L Neely, Qinghong Yang, Ann W McMahon, Reese H Clark, P Brian Smith
BACKGROUND: Octreotide is used off-label in infants for treatment of chylothorax, congenital hyperinsulinism, and gastrointestinal bleeding. The safety profile of octreotide in hospitalized infants has not been described; we sought to fill this information gap. METHODS: We identified all infants exposed to at least 1 dose of octreotide from a cohort of 887,855 infants discharged from 333 neonatal intensive care units managed by the Pediatrix Medical Group between 1997 and 2012...
July 2015: Early Human Development
https://www.readbyqxmd.com/read/25888151/red-blood-cell-transfusion-decision-making-in-critically-ill-children
#19
REVIEW
Jacques Lacroix, Marisa Tucci, Geneviève Du Pont-Thibodeau
PURPOSE OF REVIEW: To discuss the tradeoff between permissive anemia and administering red blood cell transfusion to children in pediatric ICUs. RECENT FINDINGS: Postsurgical mortality in adults increases abruptly if their nadir hemoglobin level falls below 5 g/dl. Patients with sepsis, even those in septic shock, and patients with upper gastrointestinal bleeding do not require red blood cell (RBC) transfusion if their hemoglobin level is above 7 g/dl. SUMMARY: Anemia is common in critically ill children and is well tolerated most of the time...
June 2015: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/25850637/characteristics-and-diagnostic-yield-of-pediatric-colonoscopy-in-taiwan
#20
Chien-Ting Wu, Chih-An Chen, Yao-Jong Yang
BACKGROUND: Colonoscopy of the lower gastrointestinal tract has diagnostic and therapeutic value. This retrospective study aimed to investigate the indications, complications, and diagnostic yield of diagnostic colonoscopy among Taiwanese children. METHODS: The application of colonoscopy performed on children aged < 18 years between 1998 and 2010 in a referral tertiary center in Southern Taiwan was reviewed. Data on age, gender, indications, complications, and colonoscopic and final diagnoses were collected and analyzed...
October 2015: Pediatrics and Neonatology
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