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https://www.readbyqxmd.com/read/28069269/clinical-considerations-for-blunt-laryngotracheal-trauma-in-children
#1
REVIEW
Jeffrey Cheng, Matthew Cooper, Elisabeth Tracy
OBJECTIVE: Systematic review of blunt pediatric laryngeal and tracheal trauma and development of proposed evaluation and management strategy. STUDY DESIGN: Systematic review and proposed clinical consideration algorithm. DATA SOURCES: PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. REVIEW METHODS: A medical librarian was utilized. RESULTS: 329 titles and abstracts were identified, and 50 reports were included...
December 30, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28047841/tu-h-207a-04-how-patient-positioning-in-ct-affects-more-than-the-aec-image-noise-uniformity-and-ct-number-changes-as-a-function-of-positioning
#2
T Szczykutowicz, A Duplissis, D Miller
PURPOSE: Studies dealing with patient positioning in CT have mainly dealt with dose and image noise changes. For diagnosis, only dose decreases can negatively affect the diagnostic utility of the exam via an increase in image noise. However, a little studied consequence of poor positioning is CT number and noise uniformity changes. METHODS: An anthropomorphic phantom was imaged in 2 cm vertical steps between the highest and lowest couch positions. CT number and noise were measured using regions of interest (ROI) in the upper-thorax, mid-thorax, and abdomen...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046867/su-f-p-06-moving-from-computed-radiography-to-digital-radiography-a-collaborative-approach-to-improve-image-quality
#3
D Sandoval, D Valenti, T Bateman, V Norris, G Mlady, R Selwyn
PURPOSE: To bring together radiologists, technologists, and physicists to utilize post-processing techniques in digital radiography (DR) in order to optimize image acquisition and improve image quality. METHODS: Sub-optimal images acquired on a new General Electric (GE) DR system were flagged for follow-up by radiologists and reviewed by technologists and medical physicists. Various exam types from adult musculoskeletal (n=35), adult chest (n=4), and pediatric (n=7) were chosen for review...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28024414/defining-service-and-education-in-pediatrics
#4
Debra Boyer, Josh Gagne, Jennifer C Kesselheim
Program directors (PDs) and trainees are often queried regarding the balance of service and education during pediatric residency training. We aimed to use qualitative methods to learn how pediatric residents and PDs define service and education and to identify activities that exemplify these concepts. Focus groups of pediatric residents and PDs were performed and the data qualitatively analyzed. Thematic analysis revealed 4 themes from focus group data: (1) misalignment of the perceived definition of service; (2) agreement about the definition of education; (3) overlapping perceptions of the value of service to training; and (4) additional suggestions for improved integration of education and service...
December 1, 2016: Clinical Pediatrics
https://www.readbyqxmd.com/read/27921127/pre-authorization-processes-have-no-effect-on-patients-undergoing-knee-mri-in-a-pediatric-setting-when-evaluated-by-specialists
#5
Drew Pierce, J Herman Kan, Megan May, George S Bisset
OBJECTIVE: Pre-authorization processes are often used by medical insurance companies to reduce costs by managing the utilization of advanced diagnostic imaging, and their impact on patient care is unclear. The purpose of our study is to determine if a pre-authorization process increases the rate of surgically significant abnormal knee MRI and surgical referrals compared with patients referred from pediatric orthopedic specialists who do not undergo a pre-authorization process. MATERIALS AND METHODS: A retrospective study was performed; 124 patients were identified who were referred for knee MRI by a pediatric orthopedist...
February 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/27914999/dual-therapy-for-refractory-overactive-bladder-in-children-a%C3%A2-prospective-open-label-study
#6
Fannie Morin, Anne-Sophie Blais, Geneviève Nadeau, Katherine Moore, Lucie Genois, Stéphane Bolduc
PURPOSE: Mirabegron (β3 adrenoreceptor agonist) is a new molecule with a mechanism of action distinct from antimuscarinics. Combination therapy with solifenacin was recently studied in an adult population. We evaluated the efficacy and safety of mirabegron as add-on therapy to treat urinary incontinence in children with idiopathic overactive bladder refractory/intolerant to antimuscarinics. MATERIALS AND METHODS: A prospective off-label study using add-on regimens of mirabegron was conducted in pediatric patients presenting with no symptom improvement while undergoing intensive behavioral and medical therapies and/or significant side effects while undergoing antimuscarinic dose escalation...
November 30, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27903125/outcomes-in-transcranial-microsurgery-versus-extended-endoscopic-endonasal-approach-for-primary-resection-of-adult-craniopharyngiomas
#7
Todd J Wannemuehler, Kolin E Rubel, Benjamin K Hendricks, Jonathan Y Ting, Troy D Payner, Mitesh V Shah, Aaron A Cohen-Gadol
OBJECTIVE Craniopharyngiomas have historically been resected via transcranial microsurgery (TCM). In the last 2 decades, the extended endoscopic endonasal (transtuberculum) approach to these tumors has become more widely accepted, yet there remains controversy over which approach leads to better outcomes. The purpose of this study is to determine whether differences in outcomes were identified between TCM and extended endoscopic endonasal approaches (EEEAs) in adult patients undergoing primary resection of suprasellar craniopharyngiomas at a single institution...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27901408/four-steps-to-eliminate-or-reduce-pain-in-children-caused-by-needles-part-1
#8
Stefan J Friedrichsdorf
Dr Stefan Friedrichsdorf* speaks to Jade Parker, Commissioning Editor: Stefan J Friedrichsdorf, MD, is medical director of the Department of Pain Medicine, Palliative Care and Integrative Medicine at Children's Hospitals and Clinics of Minnesota, Minneapolis/St Paul, MN, USA, home to one of the largest and most comprehensive programs of its kind in the country. The interdisciplinary pain team is devoted to prevent and treat acute, procedural, neuropathic, psycho-social-spiritual, visceral, and chronic/complex pain for all inpatients and outpatients in close collaboration with all pediatric subspecialties at Children's Minnesota...
November 30, 2016: Pain Management
https://www.readbyqxmd.com/read/27895713/coexistence-of-iamp21-and-etv6-runx1-fusion-in-an-adolescent-with-b-cell-acute-lymphoblastic-leukemia-literature-review-of-six-additional-cases
#9
Jun Gu, Alexandra Reynolds, Lianghua Fang, Corrie DeGraffenreid, Kenneth Sterns, Keyur P Patel, L Jeffrey Medeiros, Pei Lin, Xinyan Lu
BACKGROUND: Intrachromosomal amplification of chromosome 21 (iAMP21) results from breakage-fusion-bridge cycles and chromothripsis is a distinct marker of a subgroup of B cell acute lymphoblastic leukemia (B-ALL) cases associated with a poor prognosis. iAMP21 accounts for 2% of pediatric B-ALL and occurs predominantly in older children or adolescents. ETV6-RUNX1 fusion, resulting from t(12;21)(p13;q22), is associated with an excellent outcome in younger children with B-ALL. Coexistence of iAMP21 with ETV6-RUNX1 fusion is extremely rare with limited clinical information available...
2016: Molecular Cytogenetics
https://www.readbyqxmd.com/read/27889021/neuroimaging-of-peptide-based-vaccine-therapy-in-pediatric-brain-tumors-initial-experience
#10
REVIEW
Andre D Furtado, Rafael Ceschin, Stefan Blüml, Gary Mason, Regina I Jakacki, Hideho Okada, Ian F Pollack, Ashok Panigrahy
The potential benefits of peptide-based immunotherapy for pediatric brain tumors are under investigation. Treatment-related heterogeneity has resulted in radiographic challenges, including pseudoprogression. Conventional MR imaging has limitations in assessment of different forms of treatment-related heterogeneity, particularly regarding distinguishing true tumor progression from efficacious treatment responses. Advanced neuroimaging techniques, including diffusion magnetic resonance (MR), perfusion MR, and MR spectroscopy, may add value in the assessment of treatment-related heterogeneity...
February 2017: Neuroimaging Clinics of North America
https://www.readbyqxmd.com/read/27872179/anti-n-methyl-d-aspartate-nmda-receptor-encephalitis-a-survey-of-treatment-progress-and-prospects-from-pediatric-neurologists
#11
Ilana Kahn, Guy Helman, Adeline Vanderver, Elizabeth Wells
Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis has been shown to be a treatable form of autoimmune encephalitis, but there remains no standardized approach to immunotherapy. We designed an anonymous survey sent to members of the Child Neurology Society to identify the current practices among child neurologists. A total of 151 pediatric neurologists responded to the survey. With these responses we were able to highlight areas of practice uniformity, including first-line treatment with intravenous immunoglobulin and intravenous methylprednisone and initiation of disease-modifying therapy with rituximab alone...
November 21, 2016: Journal of Child Neurology
https://www.readbyqxmd.com/read/27867960/is-a-short-anesthetic-exposure-in-children-safe-time-will-tell-a-focused-commentary-of-the-gas-and-panda-trials
#12
COMMENT
Gregory A Chinn, Jennifer M Sasaki Russell, Jeffrey W Sall
Early life exposure to general anesthesia in preclinical studies has consistently led to permanent cognitive deficits later in life. However, the extent to which this finding is translatable to humans is the subject of much debate as the results from clinical studies have been mixed. Recently two well-designed clinical trials have attempted to add clarity to our murky understanding. The General Anesthesia compared to Spinal anesthesia (GAS) trial, was an international, prospective, randomized, multicenter, equivalence trial comparing infants undergoing herniorrhaphy receiving general anesthesia vs...
October 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27858385/third-ventricle-floor-variations-and-abnormalities-in-myelomeningocele-associated-hydrocephalus-an-experience-in-455-endoscopic-third-ventriculostomy-procedures
#13
Volkan Etus, Tugba Morali Guler, Hakan Karabagli
AIM: This multicenter study aims to evaluate the incidence of anatomical variations and abnormalities of the third ventricle floor encountered during endoscopic third ventriculostomy (ETV) procedure in myelomeningocele associated hydrocephalus (MAH) cases. MATERIAL AND METHODS: A retrospective analysis was performed on 455 pediatric MAH cases that have been treated with ETV. This case series consisted of the patients who were initially treated with ETV and those who were treated with ETV for the management of cerebrospinal fluid shunt dysfunction as well...
September 21, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27857781/delayed-hemorrhage-after-surgery-and-radiation-in-suprasellar-pilocytic-astrocytomas
#14
REVIEW
Mazda K Turel, Tim-Rasmus Kiehl, Fred Gentili
Delayed intracranial hemorrhage is a rare complication of treatment for central nervous system tumors. This may be secondary to malignant transformation of the tumor or vasculopathy related to radiation therapy (RT). While most reports on radiation-induced vasculopathy in children with optic pathway gliomas are associated with ischemic complications, there are only two reports of hemorrhagic complications in these patients. In both cases, the hemorrhage was asymptomatic and remote from the site of the original tumor but within the field of irradiation...
July 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/27846057/disseminated-fusariosis-in-immunocompromised-children-analysis-of-recent-cases-identified-in-the-global-fungiscope-registry
#15
Angela Hassler, Adrian Lieb, Danila Seidel, Simone Cesaro, Johann Greil, Nikolay Klimko, Sofya Khostelidi, Galina Solopova, Dilara Ogunc, Luisa Durán Graeff, Oliver A Cornely, Maria J G T Vehreschild, Thomas Lehrnbecher
Disseminated fusariosis is a rare disease, and data are scant in pediatric patients. In the FungiScope registry we identified 10 children with disseminated fusariosis between 2006 and 2015. Our analysis of the largest pediatric case series reported to date adds pediatric-specific experience to the management of this opportunistic infection in children.
November 11, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27832341/non-accidental-trauma-the-role-of-radiology
#16
Cory M Pfeifer, Matthew R Hammer, Kate L Mangona, Timothy N Booth
Non-accidental trauma is a significant source of morbidity and mortality in the pediatric population. Given the vulnerable state of the child, the radiologist can often provide valuable diagnostic information in the setting of suspected abuse. This review focuses on common findings of abusive trauma and serves as a guide to aid in clinical decision-making for providers of emergency medicine and pediatrics. Amid this discussion is an assessment of modern controversies regarding reported mimicking pathologies, recapitulation of the current state of evidence with respect to radiologic findings of abuse, and examination of the contribution that spine imaging may add to the diagnosis of possible abusive head trauma in the acutely injured child...
November 10, 2016: Emergency Radiology
https://www.readbyqxmd.com/read/27826962/asthma-severity-and-the-controller-prescription-in-children-at-12-tertiary-hospitals
#17
Dong In Suh, Hyeon Jong Yang, Bong Seong Kim, Youn Ho Shin, So Yeon Lee, Geunhwa Park, Woo Kyung Kim, Hyo Bin Kim, Heysung Baek, Ja Kyoung Kim, Jin Tack Kim, Dae Hyun Lim
PURPOSE: Guidelines need to be tailored to where they are applied. We aimed to describe the distinctive asthma severity profile and the pattern of controller prescription in Korean children. METHODS: Twelve pediatric allergists from tertiary medical centers reviewed medical records of all asthmatic children who visited their clinics between September 1 and November 30 of 2013. Controller prescriptions were re-classified into 4 categories, then the prevalence of each asthma severity category and the controller prescription patterns according to asthma severity assessed by a Western (Global Initiative for Asthma, GINA) and an Asia-Pacific (Japanese Pediatric GuideLine, JPGL) guideline were evaluated...
January 2017: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/27820122/tumor-induced-osteomalacia-in-a-3-year-old-with-unresectable-central-giant-cell-lesions
#18
Stephanie S Crossen, Eduardo Zambrano, Beverley Newman, Jonathan A Bernstein, Anna H Messner, Laura K Bachrach, Clare J Twist
Tumor-induced osteomalacia (TIO) is a rare cause of hypophosphatemia involving overproduction of fibroblast growth factor 23. TIO has been described largely in adults with small mesenchymal tumors. We report a case of TIO in a child who presented with knee pain and radiographic findings concerning for rickets, and was found to have maxillomandibular giant cell lesions. The patient was treated with oral phosphorus and calcitriol, surgical debulking, and intralesional corticosteroids, which resulted in tumor regression and normalization of serum fibroblast growth factor 23 and phosphorus...
January 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/27799938/ppar-gamma-in-neuroblastoma-the-translational-perspectives-of-hypoglycemic-drugs
#19
REVIEW
Serena Vella, Pier Giulio Conaldi, Tullio Florio, Aldo Pagano
Neuroblastoma (NB) is the most common and aggressive pediatric cancer, characterized by a remarkable phenotypic diversity and high malignancy. The heterogeneous clinical behavior, ranging from spontaneous remission to fatal metastatic disease, is attributable to NB biology and genetics. Despite major advances in therapies, NB is still associated with a high morbidity and mortality. Thus, novel diagnostic, prognostic, and therapeutic approaches are required, mainly to improve treatment outcomes of high-risk NB patients...
2016: PPAR Research
https://www.readbyqxmd.com/read/27783092/development-of-monofixation-syndrome-after-extraction-of-dense-cataracts
#20
H Sprague Eustis, Adam Janot, Chirag Jhaveri
PURPOSE: If the interruption of macular fusion for an extended period of time is the key event that results in the development of monofixation syndrome, then the decreased macular input caused by dense cataracts may cause monofixation syndrome in adults. This study was designed to test this hypothesis. METHODS: The study design was a retrospective chart review that identified patients with unilateral cataracts at two southern Louisiana medical centers. Patients were assigned to the dense cataract group if a unilateral cataract had been present for at least 3 months and led to a visual acuity of worse than 20/200...
October 25, 2016: Journal of Pediatric Ophthalmology and Strabismus
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