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https://www.readbyqxmd.com/read/29137905/emergency-department-chest-radiography-for-children-with-asthma-exacerbation-is-infrequently-associated-with-change-of-management
#1
Evan H Allie, Henry E Dingle, William N Johnson, Jeffrey R Birnbaum, Melissa A Hilmes, Sudha P Singh, Donald H Arnold
BACKGROUND: Acute asthma exacerbations (AAE) account for many Pediatric Emergency Department (PED) visits. Chest radiography (CXR) is often performed in these patients to identify practice-changing findings such as pneumonia (PNA). Limited knowledge exists to balance the cost and radiation dose of CXR with expected yield of clinically meaningful information. OBJECTIVE: To determine in children with AAE with CXR, whether patient characteristics are associated with radiographic PNA; and significant practice change by initiation of antibiotic...
October 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29125440/long-term-outcomes-of-primarily-metastatic-juvenile-pilocytic-astrocytoma-in-children
#2
Derek Yecies, Paul Graham Fisher, Samuel Cheshier, Michael Edwards, Gerald Grant
OBJECTIVE Primarily metastatic juvenile pilocytic astrocytoma (JPA) is rare, likely representing 2%-3% of all cases of JPA. Due to the rarity of primarily metastatic JPA, there is currently no standard treatment paradigm and the long-term outcomes are not fully known. The goal of this case series was to add to the current understanding of this disease process. METHODS The authors searched a comprehensive database of pediatric patients with brain and spinal cord tumors treated at Lucile Packard Children's Hospital from 1997 to 2016 and identified 5 patients with primarily metastatic JPA...
November 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29124490/nerve-blocks-in-pediatric-and-adolescent-headache-disorders
#3
REVIEW
Alexander Sasha Dubrovsky
PURPOSE OF REVIEW: Peripheral nerve blocks of the scalp, mainly greater occipital nerve blocks, have received a renewed interest amongst pediatric providers as they offer an alternate option to provide both acute and chronic relief from the suffering of children with difficult to treat headaches. This narrative review will provide an in-depth discussion of the published pediatric-specific studies exploring the utility of nerve blocks for pediatric headache disorders. RECENT FINDINGS: A total of seven pediatric publications have been reported to date and reveal excellent therapeutic effectiveness of bilateral greater occipital nerve blocks on primary chronic headaches and post-traumatic headaches...
November 9, 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29124297/complete-resolution-and-remodeling-of-chronic-recurrent-multifocal-osteomyelitis-on-mri-and-radiographs
#4
Y J Berkowitz, S J Greenwood, G Cribb, K Davies, V N Cassar-Pullicino
Chronic recurrent multifocal osteomyelitis (CRMO) is a rare condition thought to be under-diagnosed, with a true prevalence of more than the 1 in 10,000 estimated. It is a condition that is classically described as polyostotic with a relapsing and remitting course, preferentially affecting the metaphyses of tubular bones in the pediatric population. Lesions have characteristic appearances of cortical hyperostosis and mixed lytic/sclerotic medullary appearances radiographically, with active osteitis and periostitis best seen with fluid-sensitive sequences on magnetic resonance imaging (MRI)...
November 9, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/29119462/syncope-in-pediatric-practice
#5
REVIEW
Pratibha Singhi, Arushi Gahlot Saini
Syncope is defined as a sudden, self-limited loss of consciousness and postural tone followed by spontaneous and complete recovery without any neurological sequelae. It is one of the most common paroxysmal disorders in children and adolescents. The three major causes of syncope in children are neural, cardiovascular and other non-cardiovascular causes. The common unifying mechanism is transient global hypoperfusion of the brain. The diagnosis is primarily clinical and objective laboratory investigations add little to the diagnosis in children especially in neurocardiogenic subtype...
November 9, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29106787/familial-pallister-hall-in-adulthood
#6
(no author information available yet)
Pallister Hall syndrome is autosomal dominant disorder usually diagnosed in infants and children. Current diagnostic criteria include presence of hypothalamic hamartoma, post axial polydactyly and positive family history, but the disease has variable manifestations. Herein we report Pallister Hall syndrome diagnosed in a family where both patients were adults. A 59 year old man developed seizures 4 years prior to our evaluation of him, at which time imaging showed a hypothalamic hamartoma. The seizures were controlled medically...
October 6, 2017: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/29106306/assessing-the-value-of-the-meaningful-use-clinical-summary-for-patients-and-families-with-pediatric-asthma
#7
Karen Colorafi, Lee Moua, Michele Shaw, David Ricker, Julie Postma
Electronic clinical summaries are innovations supported by the Electronic Health Record Incentive Program, known as "Meaningful Use" (MU). The MU clinical summary documents the shared understanding of the plan of care for patients and assists families in managing asthma-related health care. The purpose of this analysis was to identify the communicative value of the summaries to patients and families. Readability measurements, content analysis, and descriptive statistics were employed in a review of twenty clinical summaries and compared with provider encounter notes...
November 6, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29092664/the-perspective-of-the-intensivist-on-inotropes-and-postoperative-care-following-pediatric-heart-surgery-an-international-survey-and-systematic-review-of-the-literature
#8
Peter P Roeleveld, J C A de Klerk
INTRODUCTION: Inotropes are frequently being used in children undergoing heart surgery to prevent or treat low cardiac output syndrome (LCOS). There is only limited evidence that inotropes actually positively influence postoperative outcome. Our aim was to describe the current international practice variation in the use of inotropes following congenital heart surgery. METHODS: We developed an online survey regarding the postoperative use of inotropes. We sent an invitation to all 197 registered members of the Pediatric Cardiac Intensive Care Society (PCICS) to participate in the survey...
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29084001/assessing-the-borderline-ventricle-in-a-term-infant-combining-imaging-and-physiology-to-establish-the-right-course
#9
Meryl S Cohen
PURPOSE OF REVIEW: The purpose of this review is to describe the challenges associated with the diagnosis and treatment of children with borderline ventricles. A borderline ventricle is one in which there is concern that it will not be able to support its circulation. If a biventricular repair is attempted and fails, outcome is often poor. Thus, this early decision is important. RECENT FINDINGS: For the borderline right ventricle, options to add an additional source of pulmonary blood flow make the surgical strategy a bit more flexible than for patients with a borderline left ventricle...
October 27, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29059087/controversies-and-opportunities-in-severe-asthma
#10
Marc Humbert, William Busse, Nicola A Hanania
PURPOSE OF REVIEW: Despite currently available treatments, many asthma patients remain inadequately controlled, but identifying distinct patient populations (phenotypes/endotypes) may optimize their management. This review discusses some of the controversies and opportunities for improved disease control in severe asthma. RECENT FINDINGS: Currently approved anti-immunoglobulin E and anti-interleukin 5 biologics, which target specific pathways instead of using a 'one size fits all' strategy, are efficacious and well tolerated therapies for severe asthma...
October 20, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29054981/immunoadsorption-in-anti-gbm-glomerulonephritis-case-report-in-a-child-and-literature-review
#11
REVIEW
Guillaume Dorval, Mathilde Lion, Sophie Guérin, Saoussen Krid, Louise Galmiche-Rolland, Rémi Salomon, Olivia Boyer
Antiglomerular basement membrane glomerulonephritis (anti-GBM GN) is a rare autoimmune disease that is characterized by rapidly progressive glomerulonephritis that may be associated with pulmonary hemorrhage. Anti-GBM GN is caused by autoantibodies (classically type G immunoglobulin) directed against the α3 subunit of type IV collagen. Without any appropriate treatment, the disease is generally fulminant, and patient and kidney survival is poor. The current guidelines recommend the use of plasma exchanges and immunosuppressive drugs...
November 2017: Pediatrics
https://www.readbyqxmd.com/read/29050793/anaplasmosis-in-pediatric-patients-case-report-and-review
#12
Vaka K Sigurjonsdottir, Henry M Feder, Gary P Wormser
Human granulocytic anaplasmosis (HGA) is a tick-borne infection, characterized as an acute and sometimes severe febrile illness which may be associated with leukopenia and thrombocytopenia. Most case reports of HGA have been in adults, with only 8 case reports of HGA in children. We add a ninth case of HGA, which occurred in a 5-year-old. The paucity of pediatric HGA case reports maybe because publication bias, or HGA in children is a mild illness and children with HGA are less likely than adults to seek medical care, or the diagnosis of HGA requires a blood draw and adults (versus children) are more likely to get diagnostic testing...
November 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/29036010/the-reasoning-beyond-the-potential-use-of-exclusive-enteral-nutrition-and-other-specified-diets-in-children-with-ulcerative-colitis
#13
Ron Shaoul, Stephanie Brown, Andrew S Day
The incidence of inflammatory bowel disease (IBD) is steadily on the rise in Western as well as in developing countries paralleling the increase of westernized diets, characterized by high protein and fat as well as excessive sugar intake, with less vegetables and fiber. Furthermore, nutrition is involved in several aspects of pediatric inflammatory bowel disease (IBD), ranging from disease etiology to induction and maintenance of remission of disease. Exclusive enteral nutrition (EEN) has been shown to induce remission, including in patients with isolated colonic disease, and leads to mucosal healing in Crohn disease (CD)...
October 13, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28974245/dose-escalation-study-of-intravenous-and-intra-arterial-n-acetylcysteine-for-the-prevention-of-oto-and-nephrotoxicity-of-cisplatin-with-a-contrast-induced-nephropathy-model-in-patients-with-renal-insufficiency
#14
Edit Dósa, Krisztina Heltai, Tamás Radovits, Gabriella Molnár, Judit Kapocsi, Béla Merkely, Rongwei Fu, Nancy D Doolittle, Gerda B Tóth, Zachary Urdang, Edward A Neuwelt
BACKGROUND: Cisplatin neuro-, oto-, and nephrotoxicity are major problems in children with malignant tumors, including medulloblastoma, negatively impacting educational achievement, socioemotional development, and overall quality of life. The blood-labyrinth barrier is somewhat permeable to cisplatin, and sensory hair cells and cochlear supporting cells are highly sensitive to this toxic drug. Several chemoprotective agents such as N-acetylcysteine (NAC) were utilized experimentally to avoid these potentially serious and life-long side effects, although no clinical phase I trial was performed before...
October 3, 2017: Fluids and Barriers of the CNS
https://www.readbyqxmd.com/read/28965959/lower-urinary-tract-terminology-in-daytime-lower-urinary-tract-symptoms-in-children-a-view-of-the-pediatric-urologist
#15
REVIEW
Marleen van den Heijkant, Guy Bogaert
CONTEXT: Epidemiological studies have demonstrated rates of lower urinary tract (LUT) symptoms in school-aged children as high as 20%. Symptoms of LUT may have significant social consequences. The diagnosis of LUT symptoms in children is mainly based on the subjective impression, and it is therefore important to translate the clinical impression into a structured LUT terminology. OBJECTIVE: To have a view, as a pediatric urologist and a urologist, of the LUT terminology proposed by the Standardization Committee of the International Children Continence Society...
April 2017: European Urology Focus
https://www.readbyqxmd.com/read/28945115/advances-in-immunotherapy-for-pediatric-acute-myeloid-leukemia
#16
Challice L Bonifant, Mireya Paulina Velasquez, Stephen Gottschalk
Achieving better disease control in patients diagnosed with acute myeloid leukemia (AML) has proven challenging. Overall survival has been impacted by addressing treatment related mortality with focused supportive care measures. Despite this improvement, it remains difficult to induce durable leukemia remissions despite aggressive chemotherapeutic regimens. The addition of hematopoietic stem cell transplants (HSCT) has allowed further treatment intensification and provided the benefit of graft-versus-leukemia (GVL) effect...
October 11, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28939701/rapid-targeted-genomics-in-critically-ill-newborns
#17
Cleo C van Diemen, Wilhelmina S Kerstjens-Frederikse, Klasien A Bergman, Tom J de Koning, Birgit Sikkema-Raddatz, Joeri K van der Velde, Kristin M Abbott, Johanna C Herkert, Katharina Löhner, Patrick Rump, Martine T Meems-Veldhuis, Pieter B T Neerincx, Jan D H Jongbloed, Conny M van Ravenswaaij-Arts, Morris A Swertz, Richard J Sinke, Irene M van Langen, Cisca Wijmenga
BACKGROUND: Rapid diagnostic whole-genome sequencing has been explored in critically ill newborns, hoping to improve their clinical care and replace time-consuming and/or invasive diagnostic testing. A previous retrospective study in a research setting showed promising results with diagnoses in 57%, but patients were highly selected for known and likely Mendelian disorders. The aim of our prospective study was to assess the speed and yield of rapid targeted genomic diagnostics for clinical application...
October 2017: Pediatrics
https://www.readbyqxmd.com/read/28937639/sleep-disorders-in-childhood-neurological-diseases
#18
REVIEW
Abdullah Tolaymat, Zhao Liu
Sleep problems are frequently addressed as a primary or secondary concern during the visit to the pediatric neurology clinic. Sleep disorders can mimic other neurologic diseases (e.g., epilepsy and movement disorders), and this adds challenges to the diagnostic process. Sleep disorders can significantly affect the quality of life and functionality of children in general and those with comorbid neurological diseases in particular. Understanding the pathophysiology of sleep disorders, recognizing the implications of sleep disorder in children with neurologic diseases and behavioral difficulties, and early intervention continue to evolve resulting in better neurocognitive outcomes...
September 22, 2017: Children
https://www.readbyqxmd.com/read/28936756/clinical-utility-of-mri-brain-in-children-with-non-traumatic-coma
#19
Jatinder Khipal, Naveen Sankhyan, Sunit C Singhi, Pratibha Singhi, Niranjan Khandelwal
OBJECTIVES: To determine characteristics that help identify children with acute encephalopathy who benefit from an MRI (magnetic resonance imaging) of the brain. The secondary objective was to determine the adverse events associated with the MRI procedure. METHODS: In this single center, prospective, observational study. Children (2 mo - 12 y) presenting with impaired consciousness were screened. Those with acute non-traumatic encephalopathy (Glasgow Coma Score of 12 or less) undergoing their first in-patient MRI brain were included...
November 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28928804/efficacy-of-a-leukotriene-receptor-antagonist-for-pediatric-cedar-pollen-allergy-complicated-by-asthma
#20
Shigemi Yoshihara, Yutaka Kikuchi, Mari Saitou, Susumu Yanagawa, Noriko Kanno, Hiroshi Igarashi, Hironobu Fukuda, Akiko Iimura, Toshio Abe, Yumi Yamada, Tamotsu Andou, Osamu Arisaka
Leukotriene receptor antagonists (LTRAs) are identified as a monotherapy for asthma and allergic rhinitis; however, their use in children for treatment of these diseases has not been examined. Accordingly, the present study investigated the efficacy of pranlukast dry syrup for children with both pollinosis and asthma. The subjects were children receiving treatment for asthma who were also diagnosed with cedar pollen allergy. Patients were divided into a group that received continuous treatment with pranlukast (group A; n=20) and a group that commenced add-on treatment for pollinosis following the onset of symptoms (group B; n=20)...
October 2017: Experimental and Therapeutic Medicine
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