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https://www.readbyqxmd.com/read/27919760/proton-therapy-present-and-future
#1
REVIEW
Radhe Mohan, David Grosshans
In principle, proton therapy offers a substantial clinical advantage over the conventional photon therapy. This is because of the unique depth-dose characteristics of protons, which can be exploited to achieve significant reductions in normal tissue doses proximal and distal to the target volume. These may, in turn, allow escalation of tumor doses, greater sparing of normal tissues, thus potentially improving local control and survival while at the same time reducing toxicity and improving quality of life. Protons, accelerated to therapeutic energies ranging from 70 to 250MeV, typically with a cyclotron or a synchrotron, are transported to the treatment room where they enter the treatment head mounted on a rotating gantry...
December 2, 2016: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/27918863/ems-providers-beliefs-regarding-spinal-precautions-for-pediatric-trauma-transport
#2
Cindy D Chang, Remle P Crowe, Melissa A Bentley, Alyssa R Janezic, Julie C Leonard
OBJECTIVE: Describe prehospital Emergency Medical Services (EMS) providers' beliefs regarding spinal precautions for pediatric trauma transport. METHODS: We randomly surveyed nationally certified EMS providers. We assessed providers' beliefs about specific precautions, and preferred precautions given a child's age (0-4 or 5-18 years) and presence of specific cervical spine injury (CSI) risk factors. RESULTS: We received 5,400 responses (17%)...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27913912/genetic-counselor-practices-involving-pediatric-patients-with-fap-an-investigation-of-their-self-reported-strategies-for-genetic-testing-and-hepatoblastoma-screening
#3
Caitlin E Lawson, Thomas M Attard, Hongying Dai, Seth Septer
Familial adenomatous polyposis (FAP) is a cancer predisposition syndrome that causes early-onset polyposis and is associated with an increased risk for hepatoblastoma. There is currently a lack of consensus on when to order APC (adenomatous polyposis coli) gene testing or implement surveillance for hepatoblastoma. An online questionnaire was completed by 62 genetic counselors to capture their current practices regarding these questions. Extracolonic findings associated with FAP that were most likely to prompt APC testing in an otherwise asymptomatic 10 year-old child with a negative family history were multiple desmoid tumors, congenital hypertrophy of the retinal pigment epithelium (CHRPE), jaw osteomas, and hepatoblastoma...
December 3, 2016: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/27912976/implications-of-a-negative-abdominal-ct-in-the-management-of-pediatric-blunt-abdominal-trauma
#4
Sarah Braungart, Thomas Beattie, Paula Midgley, Mark Powis
BACKGROUND: No consensus exists on management of children with a negative trauma CT following blunt abdominal trauma (BAT). Asymptomatic children are frequently "admitted for observation" following negative CT owing to concerns about missing an intraabdominal injury (IAI) without evidence for this practice. We aimed to investigate the feasibility of discharge following a negative CT scan in children sustaining blunt abdominal trauma. METHODS: Retrospective audit at a UK paediatric major trauma center and review of the literature...
November 14, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27911246/role-of-follow-up-imaging-after-resection-of-brain-arteriovenous-malformations-in-pediatric-patients-a-systematic-review-of-the-literature
#5
Joaquin E Jimenez, Zachary C Gersey, Jason Wagner, Brian Snelling, Sudheer Ambekar, Eric C Peterson
OBJECTIVE Pediatric patients are at risk for the recurrence of brain arteriovenous malformation (AVM) after resection. While there is general consensus on the importance of follow-up after surgical removal of an AVM, there is a lack of consistency in the duration of that follow-up. The object of this systematic review was to examine the role of follow-up imaging in detecting AVM recurrence early and preventing AVM rupture. METHODS This systematic review was performed using articles obtained through a search of the literature contained in the MeSH database, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
December 2, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27910751/recent-advances-in-pharmacotherapeutic-paradigm-of-mild-to-recalcitrant-atopic-dermatitis
#6
Zahid Hussain, Shariza Sahudin, Hnin Ei Thu, Ahmad Nazrun Shuid, Syed Nasir Abbas Bukhari, Endang Kumolosasi
Atopic dermatitis (AD) is a common, chronic skin inflammatory disorder characterized by perivascular infiltration of immunoglobulin E (IgE), T lymphocytes, and mast cells. The key factors responsible for the pathophysiology of this disease are immunological disorders and defects in epidermal barrier properties. Pruritus, intense itching, psychological stress, deprived physical and mental performance, and sleep disturbance are the hallmark features of this dermatological disorder. Preventive interventions such as educational programs, avoidance of allergens, and exclusive care toward the skin could play a partial role in suppressing the symptoms...
2016: Critical Reviews in Therapeutic Drug Carrier Systems
https://www.readbyqxmd.com/read/27909182/2016-update-of-the-north-american-consensus-guidelines-for-pediatric-administered-radiopharmaceutical-activities
#7
S Ted Treves, Michael J Gelfand, Frederic H Fahey, Marguerite T Parisi
No abstract text is available yet for this article.
December 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/27905689/development-of-quality-indicators-for-transition-from-pediatric-to-adult-care-in-sickle-cell-disease-a-modified-delphi-survey-of-adult-providers
#8
Amy E Sobota, Nishita Shah, Jennifer W Mack
BACKGROUND: Transition from pediatric to adult care is a vulnerable time for young adults with sickle cell disease (SCD); however, improvements in transition are limited by a lack of quality indicators. The purpose of this study was to establish quality indicators for transition in SCD and to determine the optimal timing between the final pediatric visit and the first adult provider visit. PROCEDURE: We conducted a modified Delphi survey to reach a consensus on which quality indicators are most important for a successful transition...
December 1, 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27902672/essential-content-for-discharge-instructions-in-pediatric-emergency-care-a-delphi-study
#9
Janet A Curran, Andrea Murphy, Emma Burns, Amy Plint, Monica Taljaard, Shannon MacPhee, Eleanor Fitzpatrick, Andrea Bishop, Jill Chorney, Megan Bourque
OBJECTIVE: The aim of this study was to identify the 5 most essential discharge instruction content elements that should be communicated to all caregivers of children who present to the emergency department (ED) with asthma, vomiting/diarrhea, abdominal pain, fever, minor head injury, or bronchiolitis. METHODS: A discharge information content list was developed for each illness presentation following a review of the literature. Using a modified Delphi technique, 6 lists were distributed to a panel of experts from EDs across Canada using a secure online survey tool with the goal of achieving the 5 most essential discharge instruction elements...
November 29, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27898253/establishing-equipoise-national-survey-of-the-treatment-of-pediatric-para-pneumonic-effusion-and-empyema
#10
Morgan K Richards, Jarod P Mcateer, Todd C Edwards, Lucas R Hoffman, Matthew P Kronman, Dennis W Shaw, Adam B Goldin
BACKGROUND: Despite six randomized trials of various treatments for pediatric para-pneumonic effusion (PPE), management approaches differ. The purpose of this study was to gain insight into opinions on PPE treatment with the goal of designing a definitive trial to generate consensus intervention guidelines. METHODS: To evaluate physician opinions regarding PPE management, we developed a survey based on input from a nationwide, multi-disciplinary advisory group that established content validity...
November 29, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27893084/feasibility-of-clinical-endoscopy-and-stroboscopy-in-children-with-bilateral-vocal-fold-lesions
#11
Stephanie R C Zacharias, Susan Baker Brehm, Barbara Weinrich, Lisa Kelchner, Meredith Tabangin, Alessandro de Alarcon
Purpose: The purpose of this study was to examine the utility of flexible and rigid endoscopy and stroboscopy for the identification of anatomical and physiological features in children with bilateral vocal fold lesions. The secondary purpose was to describe the age distribution of patients who could tolerate use of the different types of endoscopes. Method: This cross-sectional clinic-based study included 38 children (ages 5 to 12 years) diagnosed with bilateral vocal fold lesions via videoendoscopy...
November 1, 2016: American Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/27890687/revisiting-sports-precautions-in-children-with-solitary-kidneys-and-cakut-congenital-anomalies-of-the-kidney-and-urinary-tract
#12
REVIEW
Dimitri Papagiannopoulos, Edward Gong
This review article explores sports and recreational precautions in children with solitary kidneys. In 2001, the American Academy of Pediatrics published recommendations for activity in children with medical conditions. Those with solitary kidneys were graded a "qualified yes": no restriction in non-contact sports, and individual assessment for limited-contact, contact, and collision sports. Recent trauma data suggests that classification according to degree of contact is inaccurate. We propose an updated, data-driven classification of sports/recreation according to risk of high-grade renal trauma or loss of renal unit...
November 24, 2016: Urology
https://www.readbyqxmd.com/read/27889836/clinical-validation-of-synthetic-brain-mri-in-children-initial-experience
#13
Hollie West, James L Leach, Blaise V Jones, Marguerite Care, Rupa Radhakrishnan, Arnold C Merrow, Enrique Alvarado, Suraj D Serai
INTRODUCTION: The purpose of this study was to determine the diagnostic accuracy of synthetic MR sequences generated through post-acquisition processing of a single sequence measuring inherent R1, R2, and PD tissue properties compared with sequences acquired conventionally as part of a routine clinical pediatric brain MR exam. METHODS: Thirty-two patients underwent routine clinical brain MRI with conventional and synthetic sequences acquired (22 abnormal). Synthetic axial T1, T2, and T2 fluid attenuation inversion recovery or proton density-weighted sequences were made to match the comparable clinical sequences...
November 26, 2016: Neuroradiology
https://www.readbyqxmd.com/read/27888014/nonmyeloablative-haploidentical-bone-marrow-transplantation-with-post-transplant-cyclophosphamide-for-pediatric-and-young-adult-patients-with-high-risk-hematologic-malignancies
#14
Orly R Klein, Jessica Buddenbaum, Noah Tucker, Allen R Chen, Christopher J Gamper, David Loeb, Elias Zambidis, Nicolas J Llosa, Jeffrey S Huo, Nancy Robey, Mary Jo Holuba, Yvette L Kasamon, Shannon R McCurdy, Richard Ambinder, Javier Bolaños-Meade, Leo Luznik, Ephraim J Fuchs, Richard J Jones, Kenneth R Cooke, Heather J Symons
Lower intensity conditioning regimens for haploidentical blood or marrow transplantation (BMT) are safe and efficacious for adult patients with hematologic malignancies. We report data for pediatric/young adult patients with high-risk hematologic malignancies (n=40) treated with nonmyeloablative haploidentical BMT with post-transplantation cyclophosphamide (PT/Cy) from 2003-2015. Patients received a preparative regimen of fludarabine, cyclophosphamide, and total body irradiation. Post-transplant immunosuppression consisted of cyclophosphamide, mycophenolate mofetil, and tacrolimus...
November 22, 2016: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/27879381/pediatric-prolonged-mechanical-ventilation-considerations-for-definitional-criteria
#15
REVIEW
Michaël Sauthier, Louise Rose, Philippe Jouvet
A 2005 consensus conference led by the National Association for Medical Direction of Respiratory Care (NAMDRC) defined prolonged mechanical ventilation (PMV) for adults as invasive and/or noninvasive mechanical ventilation (NIV) for ≥21 consecutive days for ≥6 h/d. In children, no such consensus definition exists. This results in substantial variability in definitional criteria, making study of the impact and outcomes of PMV across and within settings problematic. The objective of this work was to identify how PMV for children and neonates is described in the literature and to outline pediatric/neonatal considerations related to PMV, with the goal of proposing a pediatric/neonatal adaptation to the NAMDRC definition...
November 22, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27878111/increasing-the-reliability-of-the-grading-system-for-voiding-cystourethrograms-using-ultrasonography-an-inter-rater-comparison
#16
Seyithan Ozaydin, Suleyman Celebi, Ismail Caymaz, Cemile Besik, Birgul Karaaslan, Ozgur Kuzdan, Serdar Sander
BACKGROUND: To assess the effectiveness of the current vesicoureteral reflux (VUR) grading system according to the international classification of VUR (ICVUR) and to evaluate whether VUR grading accuracy could be improved by renal ultrasonography (RU) according to the Society for Fetal Urology (SFU) grading system. OBJECTIVES: Therefore, this study assessed the accuracy of the current VCUG staging system by assessing inter-rater reliability among pediatric radiologists and urologists; it also evaluated whether accuracy is increased by RU without consensus (with respect to VCUG grading)...
September 2016: Nephro-urology Monthly
https://www.readbyqxmd.com/read/27874494/pediatric-multiple-sclerosis-updates-in-epidemiology-clinical-features-and-management
#17
Sona Narula
Consensus definitions for acute demyelinating syndromes in children have led to increased recognition of pediatric multiple sclerosis and improved our understanding of its pathogenesis, epidemiology and treatment. An estimated 2-10% of MS patients experience their first clinical symptom in childhood. Multiple genetic and environmental risk factors have been identified in the pathogenesis of pediatric MS, although further research to determine their interplay is required. Clinical trials of emerging disease-modifying therapies in children are nearing completion...
December 2016: Neurodegenerative Disease Management
https://www.readbyqxmd.com/read/27871597/variability-in-anesthesiologists-approach-to-the-preoperative-management-of-asthmatic-children
#18
Keren Armoni Domany, Guy Gut, Bat-El Yakir, Yakov Sivan
OBJECTIVE: No consensus guidelines exist for the preoperative treatment of asthmatic children referred for elective surgery. We investigated the attitude of pediatric anesthesiologists to this issue. DESIGN: A questionnaire survey was conducted. SETTING: National survey. SUBJECTS: Certified Israeli pediatric anesthesiologists from all 24 general hospitals in Israel. MEASUREMENT: Twenty-one questions regarding the approach to preoperative management of asthmatic children including 6 case scenarios with a variety of clinical situations and treatments of asthmatic children...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27861376/risk-factor-analysis-of-autoimmune-hemolytic-anemia-after-allogeneic-hematopoietic-stem-cell-transplantation-in-children
#19
Tsung-Yen Chang, Tang-Her Jaing, Yu-Chuan Wen, I-Anne Huang, Shih-Hsiang Chen, Pei-Kwei Tsay
Autoimmune hemolytic anemia (AIHA) is a clinically relevant complication after allogeneic hematopoietic stem cell transplantation (HSCT). Currently, there is no established consensus regarding the optimal therapeutic approach. Whether AIHA contributes to increased mortality is still somewhat controversial.We investigated the incidence, risk factors, and outcome of post-transplant AIHA in 265 consecutive pediatric patients undergoing allo-HSCT over a 17-year period. Onset of AIHA was calculated from the first documented detection of AIHA by either clinical symptoms or positive direct agglutinin test...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27857797/recurrent-acute-disseminated-encephalomyelitis-a-favorable-outcome-among-recurrent-brain-diseases-in-pediatric-patient
#20
Anirban Chatterjee, Supratim Datta
Acute disseminated encephalomyelitis (ADEM) is an idiopathic inflammatory demyelinating disease of the central nervous system (CNS) and considered mostly a monophasic course. Recurrence of ADEM is rare entity, posing diagnostic dilemma with multiple sclerosis (MS). There were no definite diagnostic criteria or established treatment for ADEM. International Pediatric MS Study Group laid down first consensus definition. We report a boy presented with recurrent episodes of fever, paraparesis, seizure, and unconsciousness...
July 2016: Journal of Pediatric Neurosciences
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