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Pediatric ADD

Paige A Culotta, James E Crowe, Quynh-Anh Tran, Jeremy Y Jones, Amy R Mehollin-Ray, H Brandon Tran, Marcella Donaruma-Kwoh, Cristina T Dodge, Elizabeth A Camp, Andrea T Cruz
BACKGROUND: Young children with suspected abusive head trauma often receive skull radiographs to evaluate for fractures as well as computed tomography (CT) of the head to assess for intracranial injury. Using a CT as the primary modality to evaluate both fracture and intracranial injury could reduce exposure to radiation without sacrificing performance. OBJECTIVE: To evaluate the sensitivity of CT head with (3-D) reconstruction compared to skull radiographs to identify skull fractures in children with suspected abusive head trauma...
October 15, 2016: Pediatric Radiology
Tami Rubinek, Shiri Shahmoon, Ayelet Shabtay-Orbach, Michal Ben Ami, Yael Levy-Shraga, Kineret Mazor-Aronovitch, Yonatan Yeshayahu, Ram Doolman, Rina Hemi, Hannah Kanety, Ido Wolf, Dalit Modan-Moses
CONTEXT: Klotho is an aging-modulating protein expressed mainly in the kidneys, which can be cleaved and shed to act as a circulating hormone. Several lines of evidence suggest a tight interaction between klotho and the GH-IGF-I axis. We showed previously that klotho levels are decreased in pediatric patients with growth hormone deficiency (GHD). Our aim now is to investigate the effect of GH therapy on klotho levels in these patients and to elucidate the role of IGF-1 in mediating secretion of klotho...
November 2016: Metabolism: Clinical and Experimental
Javier Otero, Natalie Ben-Yakar, Biruk Alemayehu, Steven D Kozusko, Frank Borao, Thomas S Vates Iii
Background. Polyorchidism, alternatively supernumerary testes (SNT), is a condition where an individual is born with more than two testicles. This congenital anomaly is quite rare and the literature has described various presentations. Questions/Purposes. To our knowledge, this presentation of polyorchidism has yet to be described in the literature. The goal of this case study is to add to the pediatric, general, and urologic surgery's body of knowledge of the subject matter. Case Study. A nine-month-old boy was admitted for an impalpable right testis and phimosis...
2016: Case Reports in Urology
Stacy Stolzman, Marie Hoeger Bement
PURPOSE: Pain relief after exercise, exercise-induced hypoalgesia (EIH), is established across the lifespan. Conditioned pain modulation (CPM: pain inhibits pain) may be a mechanism for EIH. METHODS: In 55 adolescents, pressure pain thresholds were measured before and after exercise (deltoid, quadriceps, and nail bed) and during CPM at the nail bed and deltoid test stimulus sites. The relationship between EIH and CPM was explored. RESULTS: EIH occurred at deltoid and quadriceps; CPM occurred at nail bed and deltoid...
2016: Pediatric Physical Therapy
K Weiss, A Simon
BACKGROUND: Antibiotic stewardship (ABS) and hospital hygiene have both been identified as key components to increase patient safety in hospital inpatients. To set the stage for a new approach in this field, a working group of German Pediatric Infectious Disease (PID) Specialists invented the Paed IC Project in 2012. METHODS: This article summarized the results of a qualitative study using telephone interviews, to which 18 German PID specialists were invited. RESULTS: All local study coordinators and additional PID specialists from the 11 paediatric tertiary care inpatient facilities consented to participate...
September 2016: Klinische Pädiatrie
Frank Haessler, Franziska Gaese, Michael Huss, Christoph Kretschmar, Marc Brinkman, Helmut Peters, Samuel Elstner, Michael Colla, David Pittrow
BACKGROUND: As data on the phenotype, characteristics and management of patients with Fragile X Syndrome (FXS) are limited, we aimed to collect such data in Germany in experienced centres involved in the treatment of such patients. METHODS: EXPLAIN-FXS is a prospective observational (non-interventional) study (registry) performed between April 2013 and January 2016 at 18 sites in Germany. Requirements for patient participation included confirmed diagnosis of FXS by genetic testing (>200 CGG repeats) and written informed consent...
2016: BMC Psychiatry
Berta Almoguera, Lyam Vazquez, Frank Mentch, John Connolly, Jennifer A Pacheco, Agnes S Sundaresan, Peggy L Peissig, James G Linneman, Catherine A McCarty, David Crosslin, David S Carrell, Todd Lingren, Bahram Namjou-Khales, John B Harley, Eric Larson, Gail P Jarvik, Murray Brilliant, Marc S Williams, Iftikhar J Kullo, Erik B Hysinger, Patrick M A Sleiman, Hakon Hakonarson
RATIONALE: Despite significant advances in our knowledge of the genetic architecture of asthma, specific contributors to the variability in the burden between populations remain uncovered. OBJECTIVE: To identify additional genetic susceptibility factors of asthma in European American and African American populations. METHODS: A phenotyping algorithm mining Electronic Medical Records was developed and validated to recruit cases with asthma and controls from the eMERGE (electronic Medical Records and Genomics) network...
September 9, 2016: American Journal of Respiratory and Critical Care Medicine
Juliana Catucci Boza, Natalia Giongo, Priscilla Machado, Roberta Horn, Amanda Fabbrin, Tania Cestari
BACKGROUND: Vitiligo can negatively affect a patient's quality of life (QoL). A specific questionnaire has been developed and validated in the English language: the vitiligo-specific quality-of-life instrument (VitiQoL). The instrument was translated, culturally adapted and validated into Brazilian Portuguese (VitiQoL-PB). OBJECTIVE: The aim of this study was to assess the QoL in adult patients through the VitiQoL and Dermatology Life Quality Index (DLQI) and in pediatric patients through the Children's Dermatology Life Quality Index (CDLQI) in a sample of patients with vitiligo...
September 8, 2016: Dermatology: International Journal for Clinical and Investigative Dermatology
Barbara K Bruce, Chelsea M Ale, Tracy E Harrison, Susan Bee, Connie Luedtke, Jennifer Geske, Karen E Weiss
OBJECTIVE: This study examined key functional outcomes following a 3-week interdisciplinary pediatric pain rehabilitation program for adolescents with chronic pain. Maintenance of gains was evaluated at three-month follow-up. METHODS: Participants included 171 adolescents (12-18 y of age) with chronic pain who completed a hospital-based outpatient pediatric pain rehabilitation program. Participants completed measures of functional disability, depressive symptoms, pain catastrophizing, opioid use, school attendance, and pain severity at admission, discharge, and at 3-month follow-up...
August 31, 2016: Clinical Journal of Pain
Arpita Lakhotia, Alok Sachdeva, Supriya Mahajan, Nancy Bass
Aphasia is an important presenting symptom of acute stroke. With increasing reliance on electronic communication, incoherent texting or "dystextia," which is a subset of aphasia that is reflected in text messages, can be a useful tool for symptom recognition and analysis. It can be a red flag for the family and therefore can help in early identification of an acute neurological deficit. It is also useful for providers to reliably analyze the deficit as well as establish a timeline of evolution of symptoms. There have been case reports where dystextia has been the presenting feature of stroke or complicated migraine and in one case of meningioma...
2016: Case Reports in Neurological Medicine
Joyce T Johnson, Joshua D Robinson, Luciana T Young, Joseph A Camarda
BACKGROUND: Incomplete echocardiographic assessment accounts for approximately 10% of preventable diagnostic errors and may place children at risk for adverse outcomes or increased testing. The aim of this study was to determine if physician review of images improves study completeness. METHODS: A prospective quality improvement (QI) study initiated physician review of first-time echocardiographic studies for completeness before patient discharge. Studies were incomplete if not all anatomic structures were diagnostically demonstrated...
October 2016: Journal of the American Society of Echocardiography
Brett R Harris
Overdose deaths from heroin and prescription opioids have reached epidemic proportions in recent years. Deaths specifically involving heroin have more than tripled since 2011, and for the first time, drug overdose deaths have exceeded deaths resulting from motor vehicle accidents. This epidemic has been receiving attention among policymakers and the media which has resulted in efforts to provide training and education on prescribing practices, increase the use of naloxone, and expand the availability and use of Medication-Assisted Treatment (MAT)...
October 2016: Preventive Medicine
Neval Akbas, Graciela Gonzalez, Gregory J Buffone, David G Grenache, Sridevi Devaraj
OBJECTIVES: α1-Antitrypsin (AAT) deficiency is a hereditary disorder due to defective production of the serine protease inhibitor, AAT, which can cause lung and liver diseases. Severity of disease depends particularly on the phenotypic representation of AAT variants in the patient. METHODS: In this study, we present determination of seven common and nine rare variant phenotypes of AAT using pediatric samples collected in Texas Children's Hospital to address the knowledge gap in the identification of rare variants...
September 2016: American Journal of Clinical Pathology
Matthew G Fanelli, William L Hennrikus, Jennifer M Slough Hill, Douglas G Armstrong, Steven H King
The mini C-arm has become increasingly popular in the practice of orthopedics. To the authors' knowledge, its use in the pediatric orthopedic outpatient clinic has not been reported. The purpose of this study was to evaluate the practice efficiency and radiation exposure to the patient when the mini C-arm was used in the pediatric orthopedic outpatient clinic. One hundred consecutive midshaft and distal forearm fractures were evaluated by one orthopedic surgeon in follow-up using a mini C-arm. For each case, the radiation physicist calculated the amount of skin exposure in milligray (mGy)...
August 9, 2016: Orthopedics
Daniel J Carroll, James K Byrd, George F Harris
A six-year-old boy who presented with symptoms of obstructive sleep apnea was found to have a midline tongue mass suspicious for lingual thyroglossal duct cyst (TGDC). Surgery was scheduled after workup confirmed the presence of functional, orthotopic thyroid tissue. The surgical robot was used to excise the mass endoscopically without removing any hyoid. He was extubated at the conclusion of the case. The child tolerated a soft diet and was discharged after an uneventful overnight stay in the ICU. Pathology confirmed TGDC...
September 2016: International Journal of Pediatric Otorhinolaryngology
Robert van Haselen, Manuela Thinesse-Mallwitz, Vitaliy Maidannyk, Stephen L Buskin, Stephan Weber, Thomas Keller, Julia Burkart, Petra Klement
We investigated the clinical effectiveness of a homeopathic add-on therapy in a pediatric subpopulation with upper respiratory tract infections (URTI) in a randomized, controlled, multinational clinical trial. Patients received either on-demand symptomatic standard treatment (ST-group) or the same ST plus a homeopathic medication (Influcid; IFC-group) for 7 days. Outcome assessment was based on symptom and fever resolution and the Wisconsin Upper Respiratory Symptom Survey-21 (WURSS-21). A total of 261 pediatric (<12 years) patients (130 IFC-group; 131 ST-group) were recruited in Germany and the Ukraine...
2016: Global Pediatric Health
Oluwatoyosi A Onwuemene, Deneen M Heath, Carol Hartman, Edward C C Wong
Pediatric cardiac transplant patients with antibody-mediated rejection (AMR) often undergo therapeutic plasma exchange (TPE) to remove pathologic donor specific antibodies (DSA). In cases where DSA persist, it is unclear how long TPE should be continued. We report a case of a 17-year-old cardiac transplant patient with AMR where use of a C1q complement fixing antibody assay helped guide TPE cessation. This report adds to the existing literature that highlights the potential clinical significance of C1q antibodies in AMR management...
July 31, 2016: Journal of Clinical Apheresis
A P Skoromets, L M Shchugareva, S V Shumilina, Yu V Gorelik
AIM: To investigate the efficacy of cytoflavin as add-on to moderate controlled hypothermia in the treatment of newborn full-term infants with severe birth asphyxia. MATERIAL AND METHODS: Sixty full-term underweight children diagnosed with severe birth asphyxia (Apgar score 4-5) underwent moderate hypothermia for 72 hours. Depending on the regimen, the children were divided into two equal groups: the basic group received cytoflavin in dose of 2 ml/kg / day and the control group received the traditional scheme of therapy...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Lindsay M Ryerson, Laurence L Lequier
Anticoagulation is an imperfect science and is even more complicated in neonates and young children. The addition of the extracorporeal life support (ECLS) foreign circuit adds an additional layer of complexity. Anticoagulation goals during ECLS are to maintain a clot-free circuit and a hemostatically balanced patient. Unfractionated heparin (UFH) is the default gold standard anticoagulant as no large studies have been performed on any other anticoagulants. This review will focus on the advantages and disadvantages of the various methods to monitor UFH anticoagulation, discuss alternative anticoagulants, and examine bleeding and thrombotic complications during ECLS...
2016: Frontiers in Pediatrics
Giulia Angelino, Maria Debora De Pasquale, Luigi De Sio, Annalisa Serra, Luca Massimi, Rita De Vito, Antonio Marrazzo, Laura Lancella, Andrea Carai, Manila Antonelli, Felice Giangaspero, Marco Gessi, Laura Menchini, Laura Scarciolla, Daniela Longo, Angela Mastronuzzi
BACKGROUND: Primary melanocytic neoplasms are rare in the pediatric age. Among them, the pattern of neoplastic meningitis represents a peculiar diagnostic challenge since neuroradiological features may be subtle and cerebrospinal fluid analysis may not be informative. Clinical misdiagnosis of neoplastic meningitis with tuberculous meningitis has been described in few pediatric cases, leading to a significant delay in appropriate management of patients. We describe the case of a child with primary leptomeningeal melanoma (LMM) that was initially misdiagnosed with tuberculous meningitis...
2016: BMC Cancer
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