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https://www.readbyqxmd.com/read/29329689/pediatric-obesity-current-concepts
#1
REVIEW
Donald E Greydanus, Marisha Agana, Manmohan K Kamboj, Saad Shebrain, Neelkamal Soares, Ransome Eke, Dilip R Patel
This discussion reflects on concepts of obesity in children and adolescents in the early 21st century. It includes reflections on its history, definition, epidemiology, diagnostic perspectives, psychosocial considerations, musculoskeletal complications, endocrine complications and principles of management. In addition to emphasis on diet and exercise, research and clinical applications in the second decade of the 21st century emphasize the increasing use of pharmacotherapy and bariatric surgery for adolescent and adult populations with critical problems of overweight and obesity...
January 9, 2018: Disease-a-month: DM
https://www.readbyqxmd.com/read/29329430/increases-in-igf-1-after-anti-tnf-%C3%AE-therapy-are-associated-with-bone-and-muscle-accrual-in-pediatric-crohn-s-disease
#2
Mark D DeBoer, Arthur M Lee, Kirabo Herbert, Jin Long, Meena Thayu, Lindsay M Griffin, Robert N Baldassano, Lee A Denson, Babette S Zemel, Michelle R Denburg, Rita Herskovitz, Mary B Leonard
Context: Low levels of IGF-1 in pediatric and adolescent Crohn's Disease (CD) likely contribute to bone and muscle deficits. Objective: Assess changes in IGF-1 levels and associations with bone and muscle accrual following initiation of anti-TNF-α therapy in pediatric and adolescent CD. Design and Participants: Participants (n=75, age 5-21 years) with CD were enrolled in a prospective cohort study; 63 completed the 12-month visit. Main Outcome Measures: IGF-1 levels at baseline and 10 weeks, and DXA and tibia peripheral quantitative-CT (pQCT) measures of bone and muscle at baseline and 12 months after initiation of anti-TNF-α therapy...
January 10, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29324529/inappropriately-timed-pediatric-orthopaedic-referrals-from-the-emergency-department-result-in-unnecessary-appointments-and-financial-burden-for-patients
#3
Taylor J Jackson, Todd J Blumberg, Apurva S Shah, Wudbhav N Sankar
BACKGROUND: Musculoskeletal injuries are among the most common reasons for emergency department (ED) visits in the pediatric population. Many such injuries can be managed with a single follow-up outpatient visit. However, untimely (ie, premature) referrals by emergency physicians to orthopaedic surgeons are common and may inadvertently create need for a second visit, generating unnecessary expenditures. We sought to elucidate the cost of premature musculoskeletal follow-up visits to the patients, families, and the health care system...
January 10, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29322855/fatigue-in-pediatric-patients-with-familial-mediterranean-fever
#4
Semanur Özdel, Z Birsin Özçakar, Nilgün Cakar, Fatma Aydın, Elif Çelikel, Atilla H Elhan, Fatoş Yalçınkaya
OBJECTIVES: Familial Mediterranean fever (FMF) is characterized by recurrent, self-limited attacks of fever with serositis involving the peritoneum, pleura and joints. Fatigue is a common problem in many pediatric rheumatic diseases; however, has not been evaluated systematically in FMF patients. Accordingly, the aim of this study was to evaluate fatigue and its possible allied factors in patients with FMF. METHODS: Patients with FMF, aged between 10-18 years, were assessed by completed validated fatigue questionnaire (Checklist Individual Strength-20)...
January 11, 2018: Modern Rheumatology
https://www.readbyqxmd.com/read/29317053/fear-of-movement-modulates-the-feedforward-motor-control-of-the-affected-limb-in-complex-regional-pain-syndrome-crps-a-single-case-study
#5
Michihiro Osumi, Masahiko Sumitani, Yuko Otake, Shu Morioka
Pain-related fear can exacerbate physical disability and pathological pain in complex regional pain syndrome (CRPS) patients. We conducted a kinematic analysis of grasping movements with a pediatric patient suffering from CRPS in an upper limb to investigate how pain-related fear affects motor control. Using a three-dimensional measurement system, we recorded the patient's movement while grasping three vertical bars of different diameters (thin, middle, thick) with the affected and intact hands. We analyzed the maximum grasp distance between the thumb and the index finger (MGD), the peak velocity of the grasp movement (PV), and the time required for the finger opening phase (TOP) and closing phase (TCP)...
January 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29279946/adaptive-statistical-iterative-reconstruction-use-for-radiation-dose-reduction-in-pediatric-lower-extremity-ct-impact-on-diagnostic-image-quality
#6
Amisha Shah, Mitchell Rees, Erica Kar, Kimberly Bolton, Vincent Lee, Ashok Panigrahy
BACKGROUND: For the past several years, increased levels of imaging radiation and cumulative radiation to children has been a significant concern. Although several measures have been taken to reduce radiation dose during computed tomography (CT) scan, the newer dose reduction software adaptive statistical iterative reconstruction (ASIR) has been an effective technique in reducing radiation dose. To our knowledge, no studies are published that assess the effect of ASIR on extremity CT scans in children...
December 26, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/29227372/osteofibrous-dysplasia-of-the-tibia-in-children-outcome-without-resection
#7
Daniel Westacott, Peter Kannu, Jennifer Stimec, Sevan Hopyan, Andrew Howard
BACKGROUND: The proposed association between osteofibrous dysplasia and adamantinoma has led some to advocate resection of the entire lesion, which can require major subsequent reconstruction. However, this link remains unproven and there is some support in more recent literature for a less aggressive approach. This study aims to describe our experience managing pediatric tibial osteofibrous dysplasia with such an approach and to report functional outcomes in children treated thus. METHODS: A total of 28 cases of osteofibrous dysplasia in 25 patients were managed at a referral center for pediatric bone tumors with observation in the first instance, then limited surgical intervention if required to address pain and deformity...
December 8, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29226200/long-term-results-of-osteoarticular-allograft-reconstruction-in-children-with-distal-femoral-bone-tumors
#8
Khodamorad Jamshidi, Mehrdad Bahrabadi, Alireza Mirzaei
Background: There is no consensus regarding the best method of reconstruction in pediatric population following the wide resection of malignant bone tumors. More exploration of the complications of osteoarticular reconstruction leads to less existing controversy of this type of reconstruction, which is the main point of this article. Methods: Long-term outcomes and complications of osteoarticular allograft reconstruction of primary distal femoral bone sarcomas in 22 children with mean age of 10...
September 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/29219854/reconstruction-of-the-scapula-in-pediatric-and-adolescent-patients-after-total-scapulectomy-a-report-of-10-patients-treated-by-extracorporeal-irradiation-and-reimplantation-of-the-scapula
#9
Ahmed M El Ghoneimy, Mohamed S Zaghloul, Iman Zaky, Hala Taha, Ahmed Elgammal, Magdy El Sherbiny, Nehal Kamal
BACKGROUND: Ewing sarcoma of the scapula is uncommon. Restoration of shoulder function after total scapulectomy is challenging. Extracorporeal irradiation and reimplantation is a well-known method of biological reconstruction in orthopaedic oncology; yet very few reports in the literature describe its specific use in tumors of the scapula. PATIENTS AND METHODS: Ten patients with the diagnosis of Ewing sarcoma of the scapula were surgically treated by total scapulectomy and extracorporeal irradiation and reimplantation of the scapula...
December 6, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29202636/range-of-motion-and-ankle-injury-history-association-with-sex-in-pediatric-and-adolescent-athletes
#10
Dai Sugimoto, Ronald E McCartney, Robert L Parisien, Jesse Dashe, Dennis R Borg, William P Meehan
BACKGROUND: Ankle sprain is one of the most common musculoskeletal injuries among young athletes, and there remains a gap in the literature regarding susceptibility to such injuries among physically active youth. OBJECTIVE: The primary purpose of this study was to determine the associations between sex, a history of ankle sprain, and ankle range of motion (ROM) in pediatric and adolescent athletes. METHODS: Athletes under the age of 18 years old who presented to a sports injury prevention center underwent ankle ROM measurements including plantarflexion (PF), inversion (IV), and eversion (EV)...
December 4, 2017: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/29199542/medication-use-among-pediatric-patients-with-chronic-musculoskeletal-pain-syndromes-at-initial-pain-clinic-evaluation
#11
Jessica W Guite, David D Sherry, Esther W Jarvis, Margaret O Lewen, Sarosh Khan, Francis Wickham Kraemer
AIM: To characterize medication use by adolescents with chronic musculoskeletal pain syndromes before an initial multidisciplinary clinic visit. PATIENTS & METHODS: A cross-sectional sample of 120 adolescents and parents reported on standardized assessment measures, with medication use data extracted from the medical chart and categorized. RESULTS: On average, 3.2 medications were reported; 70% used more than one pain-specific medication including opioids (17%), nonopioids (31%), psychotropics/neuropathics (45%) and other medications (13%)...
December 4, 2017: Pain Management
https://www.readbyqxmd.com/read/29192742/biliary-tract-rhabdomyosarcoma-a-report-from-the-soft-tissue-sarcoma-committee-of-the-associazione-italiana-ematologia-oncologia-pediatrica
#12
Katia Perruccio, Valerio Cecinati, Angela Scagnellato, Massimo Provenzi, Giuseppe Maria Milano, Eleonora Basso, Carla Manzitti, Giovanni Cecchetto, Rita Alaggio, Martina Di Martino, Amalia Schiavetti, Fraia Melchionda, Maria Carmen Affinita, Stefano Chiaravalli, Lucia Miglionico, Rita Balter, Angela Tamburini, Gianni Bisogno, Andrea Ferrari
INTRODUCTION: Rhabdomyosarcoma is a soft tissue malignant musculoskeletal tumor frequent in children. Biliary duct localization is extremely rare, but it is the most common cause of malignant obstructive jaundice in pediatric patients. METHODS: This report describes a series of 10 patients under 18 years of age with biliary tract rhabdomyosarcoma who were enrolled, from 1979 to 2004, in 3 consecutive Italian pediatric cooperative protocols that had been drawn up by the Soft Tissue Sarcoma Committee of the Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP)...
December 1, 2017: Tumori
https://www.readbyqxmd.com/read/29189342/the-diagnostic-accuracy-of-ultrasound-in-detecting-distal-radius-fractures-in-a-pediatric-population
#13
Chae Ko, Matthew Baird, Matthew Close, Kyle J Cassas
OBJECTIVE: Sports ultrasound (US) is becoming popular in diagnosing musculoskeletal injuries. This study, also called the Pediatric Distal Radius Ultrasound Study (PeDRUS), compared the diagnostic accuracy of sports US with plain radiographs in possible distal radius buckle fractures in pediatric population. METHODS: In this prospective observational study, patients (2-15 years) presenting to an outpatient orthopedic injury clinic with distal forearm injuries without deformity were recruited...
November 15, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29167076/the-convergence-of-two-epidemics-vitamin-d-deficiency-in-obese-school-aged-children
#14
REVIEW
Linda Cheng
PROBLEM: Vitamin D deficiency (VDD) and obesity are two interrelated global epidemics that affect school-aged children. This article will review the relationship between VDD and obesity in school-aged children and implications it has for the pediatric nurse (PN). ELIGIBILITY CRITERIA: Original articles of studies, review articles and meta-analyses were selected from the past 5years and pooled for review. These included obese school-aged children who had vitamin D insufficiency...
October 18, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29164166/juvenile-osteochondritis-dissecans-of-the-knee-does-magnetic-resonance-imaging-instability-correlate-with-the-need-for-surgical-intervention
#15
Simon Haeri Hendy, Darren de Sa, Kelly Ainsworth, Olufemi R Ayeni, Nicole Simunovic, Devin Peterson
Background: Several magnetic resonance imaging (MRI) classification systems have been developed to determine the degree of instability of juvenile osteochondritis dissecans (JOCD) lesions. Our current practice involves correlating the patients' symptoms with their MRI findings, but there are many cases in which this correlation is poor and results in incorrect classification of the stability of a JOCD lesion. Purpose: To determine whether certain MRI findings of JOCD instability are associated with the necessity for arthroscopic intervention to assess lesion stability...
November 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29162121/the-involvement-of-musculoskeletal-system-and-its-influence-on-postural-stability-in-children-and-young-adults-with-cystic-fibrosis
#16
Ozge Kenis-Coskun, Evrim Karadag-Saygi, Yeliz Bahar-Ozdemir, Yasemin Gokdemir, Bulent Karadag, Onder Kayhan
BACKGROUND: Cystic fibrosis (CF) affects the musculoskeletal system via a multifactorial pathway that includes vitamin D deficiency and involvement of respiratory muscles such as intercostals due to recurrent upper and lower respiratory tract infections. Eventual result is the deterioration of musculoskeletal health and posture in CF patients. Postural stability is directly affected by posture and can be compromised in every musculoskeletal problem. The aim of this study is to evaluate musculoskeletal system and postural stability in patients with CF...
November 21, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29153236/nonsurgical-management-of-pediatric-temporomandibular-joint-dysfunction
#17
REVIEW
Steven John Scrivani, Shehryar Nasir Khawaja, Paula Furlan Bavia
Temporomandibular disorders (TMD) are a subgroup of craniofacial pain problems involving the temporomandibular joint (TMJ), masticatory muscles, and associated head and neck musculoskeletal structures. These disorders are subclassified into TMJ articular disorders and masticatory muscle disorders. Patients with TMD most commonly present with pain, restricted or asymmetric mandibular motion, and TMJ sounds during mandibular movements. The prevalence tends to increase with age. Management of TMJ articular disorders consists of a combination of patient education, home-care plan, biobehavioral therapy, physical therapy, orthotic jaw appliance therapy, pharmacotherapy, and/or surgery...
February 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29144253/pediatric-orthopedic-hoverboard-injuries-a-prospectively-enrolled-cohort
#18
COMPARATIVE STUDY
Andrew D Sobel, Daniel B Reid, Travis D Blood, Alan H Daniels, Aristides I Cruz
Hoverboards pose a significant risk of musculoskeletal injury to pediatric riders. A prospectively enrolled cohort yielded 9 pediatric patients injured while riding hoverboards in 2016. Eight of the injuries involved the upper extremity, and one involved the lower extremity. No riders wore any safety equipment and injury patterns modeled those seen in skateboard riders.
November 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29137632/descriptive-study-of-interprofessional-collaboration-between-physicians-and-osteopaths-for-the-pediatric-population-in-quebec-canada
#19
Chantal Morin, Johanne Desrosiers, Isabelle Gaboury
BACKGROUND: Osteopathy is an increasingly popular healthcare approach that uses a wide variety of therapeutic manual techniques to address pain and somatic dysfunction. In Quebec, Canada, osteopathy is the complementary medicine most often recommended by family physicians. However, factors fostering the development of interprofessional collaboration (IPC) between physicians and osteopaths are unknown. This study aimed to describe the current situation in terms of IPC among practitioners working with pediatric patients...
November 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29126579/chest-pain-as-a-manifestation-of-hypokalemia-in-a-pediatric-patient
#20
Jonathan S Schiffman
Patients presenting to the emergency department with chest pain are common and a cause of significant concern to patients and families and physicians alike. The causes of chest pain are myriad. These causes span diverse categories including cardiovascular, respiratory, abdominal and gastrointestinal, musculoskeletal, psychiatric, hematologic and oncologic, and neurologic Thull-Freedman (2010) [1]. These diverse etiologies present a diagnostic and management challenge to the ER physician who is tasked to minimize unnecessary diagnostics while not missing any significant disease...
November 7, 2017: American Journal of Emergency Medicine
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