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Pediatric bone and joints

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https://www.readbyqxmd.com/read/29761106/current-strategies-and-future-directions-to-optimize-acl-reconstruction-in-adolescent-patients
#1
Dustin Jon Richter, Roger Lyon, Scott Van Valin, Xue-Cheng Liu
The incidence of anterior cruciate ligament (ACL) injuries in the pediatric population has risen in recent years. These injuries have historically presented a management dilemma in skeletally immature patients with open physes and significant growth remaining at time of injury. While those nearing skeletal maturity may be treated with traditional, transphyseal adult techniques, these same procedures risk iatrogenic damage to the growth plates and resultant growth disturbances in younger patients with open physes...
2018: Frontiers in Surgery
https://www.readbyqxmd.com/read/29739471/vitamin-d-in-pediatric-age-consensus-of-the-italian-pediatric-society-and-the-italian-society-of-preventive-and-social-pediatrics-jointly-with-the-italian-federation-of-pediatricians
#2
REVIEW
Giuseppe Saggese, Francesco Vierucci, Flavia Prodam, Fabio Cardinale, Irene Cetin, Elena Chiappini, Gian Luigi De' Angelis, Maddalena Massari, Emanuele Miraglia Del Giudice, Michele Miraglia Del Giudice, Diego Peroni, Luigi Terracciano, Rino Agostiniani, Domenico Careddu, Daniele Giovanni Ghiglioni, Gianni Bona, Giuseppe Di Mauro, Giovanni Corsello
Vitamin D plays a pivotal role in the regulation of calcium-phosphorus metabolism, particularly during pediatric age when nutritional rickets and impaired bone mass acquisition may occur.Besides its historical skeletal functions, in the last years it has been demonstrated that vitamin D directly or indirectly regulates up to 1250 genes, playing so-called extraskeletal actions. Indeed, recent data suggest a possible role of vitamin D in the pathogenesis of several pathological conditions, including infectious, allergic and autoimmune diseases...
May 8, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29727410/improved-diagnosis-and-treatment-of-bone-and-joint-infections-using-an-evidence-based-treatment-guideline
#3
Rachel D Quick, John Williams, Marisol Fernandez, Hilton Gottschalk, Peter Cosgrove, Kyle Kahlden, Kathryn Merkel, Lynn Thoreson, Patrick Boswell, Sarmistha B Hauger
BACKGROUND: Our institution created a multidisciplinary guideline for treatment of acute hematogenous osteomyelitis (AHO) and septic arthritis (SA) in response to updates in evidence-based literature in the field and existing provider variability in treatment. This guideline aims to improve the care of these patients by standardizing diagnosis and treatment and incorporating up to date evidence-based research into practice. The primary objective of this study is to compare cases before versus after the implementation of the guideline to determine concrete effects the guideline has had in the care of patients with AHO and SA...
May 2, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29669821/recognition-of-recurrent-protein-expression-patterns-in-pediatric-acute-myeloid-leukemia-identified-new-therapeutic-targets
#4
Fieke W Hoff, Chenyue W Hu, Yihua Qiu, Andrew Ligeralde, Suk-Young Yoo, Hasan Mahmud, Eveline Sjm De Bont, Amina A Qutub, Terzah M Horton, Steven M Kornblau
Heterogeneity in the genetic landscape of pediatric acute myeloid leukemia (AML) makes personalized medicine challenging. As genetic events are mediated by the expression and function of proteins, recognition of recurrent protein patterns could enable classification of pediatric AML patients and could reveal crucial protein dependencies. This could help to rationally select combinations of therapeutic targets. To determine if protein expression levels could be clustered into functionally relevant groups, custom Reverse Phase Protein Arrays (RPPA) were performed on pediatric AML (n=95) and CD34+ normal bone marrow (n=10) clinical specimens using 194 validated antibodies...
April 18, 2018: Molecular Cancer Research: MCR
https://www.readbyqxmd.com/read/29661673/the-use-of-pediatric-flexible-intramedullary-nails-for-minimally-invasive-fibular-fracture-fixation
#5
James C Connors, Mark A Hardy, Duane J Ehredt, Michael A Coyer
Fibular fractures in the setting of an unstable ankle joint require surgical fixation; however, several factors contradict open surgical correction. Severe soft tissue compromise can delay adequate fracture reduction and preclude the standard incisional approach. The soft tissue envelope in the setting of obesity, diabetes, and/or peripheral vascular disease further complicates definitive treatment. Poorly timed open fixation can lead to delayed healing of the incision site, with wound breakdown and the potential for hardware failure...
April 13, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29613971/the-impact-of-pediatric-outpatient-parenteral-antibiotic-therapy-implementation-at-a-tertiary-children-s-hospital-in-the-united-kingdom
#6
Sanjay Patel, Valentina Burzio, Helen Green, Sara Rees, Marc Tebruegge, Christine Jones, Saul N Faust
BACKGROUND: Recent advances in outpatient parenteral antibiotic therapy (OPAT) have largely focused on adult practice, and there are few published data on the safety and effectiveness of pediatric OPAT (p-OPAT). METHODS: During a 3-year-period (2012 to 2015), data were prospectively collected on patients managed within the p-OPAT service at Southampton Children's Hospital, a tertiary pediatric hospital in the South of England. RESULTS: A total of 130 p-OPAT episodes were managed during this period...
April 2, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29570590/osteoarticular-infections-following-open-or-penetrating-trauma-in-children-in-the-post-community-acquired-methicillin-resistant-staphylococcus-aureus-era-the-impact-of-enterobacter-cloacae
#7
J Chase McNeil, Jesus G Vallejo, Kristina G Hulten, Sheldon L Kaplan
BACKGROUND: Most cases of pediatric osteoarticular infections (OAI) are hematogenous in nature and caused by Staphylococcus aureus. OAI in children can also occur through direct inoculation of microorganisms secondary to penetrating or open trauma. No studies in the US have evaluated the microbiology or outcomes of trauma-related OAI (TROAI) in children in the era of community-acquired MRSA (CA-MRSA). METHODS: Cases were identified from the inpatient infectious diseases consultation database at Texas Children's Hospital from Jan 2011-Dec 2016...
March 21, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29566735/feasibility-and-reliability-of-the-spondyloarthritis-research-consortium-of-canada-sacroiliac-joint-inflammation-score-in-children
#8
Pamela F Weiss, Walter P Maksymowych, Robert G Lambert, Jacob L Jaremko, David M Biko, Joel Paschke, Timothy G Brandon, Rui Xiao, Nancy A Chauvin
BACKGROUND: Published methods for quantification of magnetic resonance imaging (MRI) evidence of inflammation in the sacroiliac joint lack validation in pediatric populations. We evaluated the reliability and construct validity of the Spondyloarthritis Research Consortium of Canada (SPARCC) sacroiliac joint inflammation score (SIS) in children with suspected or confirmed juvenile spondyloarthritis (JSpA). METHODS: The SPARCC SIS measures the presence, depth, and intensity of bone marrow inflammation on MRI through the cartilaginous part of the joint...
March 22, 2018: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/29515068/-pediatric-acute-lymphoblastic-leukemia-presenting-with-bone-and-joint-pain
#9
Hirohito Kubota, Satoshi Saida, Kagehiro Kouzuki, Takayuki Hamabata, Tomoo Daifu, Itaru Kato, Katsutsugu Umeda, Hidefumi Hiramatsu, Ryuta Nishikomori, Toshio Heike, Takeshi Okamoto, Souichi Adachi
We report on three cases of pediatric acute lymphoblastic leukemia presenting with bone pain and arthralgia as initial symptoms. At the first visit, their primary signs were recurrent bone pain and arthralgia, without significant peripheral blood abnormalities. It took 2-4 months to confirm the diagnosis from the onset of arthralgia due to this atypical presentation of the disease. Definitive diagnosis was obtained by bone marrow examination, and in all cases, complete remission was achieved by chemotherapy...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/29509649/presentation-and-investigation-of-pediatric-bone-and-joint-infections-in-the-pediatric-emergency-department
#10
Olugbenga Akinkugbe, Charles Stewart, Caoimhe McKenna
OBJECTIVE: The objective of this study was to evaluate the presenting features of bone and joint infections with a view to identify distinguishing trends that will be useful for pediatric emergency departments. METHODS: We performed a retrospective review of patient records over a 12-year period in the pediatric emergency department of a large regional pediatric teaching center serving a diverse population. RESULTS: There were 88 cases of osteoarticular infections during the study period...
March 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29494352/tenosynovial-giant-cell-tumors-in-children-a-similar-entity-compared-with-adults
#11
Monique J L Mastboom, Floortje G M Verspoor, Daniël Uittenbogaard, Gerard R Schaap, Paul C Jutte, H W Bart Schreuder, Michiel A J van de Sande
BACKGROUND: Tenosynovial giant cell tumor (TGCT) is a rare, benign, monoarticular entity. Many case-series in adults are described, whereas TGCT is only incidentally reported in children. Therefore, its incidence rate and natural history in children are unknown. QUESTIONS/PURPOSES: (1) How many cases have been reported of this condition, and what were their characteristics? (2) What is the standardized pediatric incidence rate for TGCT? (3) Is there a clinical difference in TGCT between children and adults? (4) What is the risk of recurrence after open resection in children compared with adults? METHODS: Data were derived from three sources: (1) a systematic review on TGCT in children, seeking sources published between 1990 and 2016, included 17 heterogeneous, small case-series; (2) the nationwide TGCT incidence study: the Dutch pediatric incidence rate was extracted from this nationwide study by including patients younger than 18 years of age...
February 8, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29442252/survey-of-staphylococcus-aureus-in-a-general-pediatric-population-and-focus-on-isolates-with-three-clinically-relevant-toxin-encoding-genes
#12
Anne Filleron, Sarah Beauregard-Birba, Thibault Mura, Fabien Aujoulat, Anne Laure Michon, Michel Rodière, Tu Anh Tran, Eric Jeziorski, Hélène Marchandin
BACKGROUND: In children, surveys on Staphylococcus aureus have focused on specific infections, situations or strains but no study has so far given an overview on S. aureus isolation without any selection. Here, we describe the overall bacteriological and clinical characteristics of S. aureus isolation in children, with a special focus on isolates harbouring tst, sea, and/or luk-PV genes, respectively, encoding the three clinically relevant toxins: toxic shock syndrome toxin-1, enterotoxin A and Panton-Valentine leukocidin...
February 2018: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/29418008/double-barrel-vascularized-dual-fibula-transfer-with-epiphyseal-growth-plate-for-hip-reconstruction-a-case-report
#13
Fabio Santanelli di Pompeo, Gennaro Selvaggi, Benedetto Longo, Rosaria Laporta, Vittoria Amorosi, Michail Sorotos
We present a case report of a 10-year-old girl diagnosed with Ewing sarcoma treated with intra-articular wide resection of the right femur and reconstruction with a series-connected double-barrel bilateral vascularized fibula graft (db-BVFG), including fibular head for articulation with the acetabulum of the pelvic bone and preservation of the epiphyseal growth plates for eventual limb growth. No postoperative complications were observed and bone union was achieved with fibular graft hypertrophy, allowing for full weight bearing...
February 8, 2018: Microsurgery
https://www.readbyqxmd.com/read/29337456/-pediatrics-perthes-disease-current-knowledges-and-treatment
#14
Sophie Merckaert, Pierre-Yves Zambelli
Perthes's disease corresponds to an interruption of the vascularization of the epiphyseal nucleus of the femoral head followed by avascular necrosis. This necrosis weakens the bone and subchondral fractures associated with a deformation of the femoral head is seen. It is important not to miss an extrusion of the femoral head, which makes surgical treatment unavoidable. The loss of joint congruence causes functional limitations and represents an increased risk for early hip osteoarthritis. Non weight bearing limits the subchondral fractures, but requires an important adaptation from the patient and his entourage...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29290233/antibiotic-therapy-of-bone-and-joint-infections-in-children-proposals-of-the-french-pediatric-infectious-disease-group
#15
M Lorrot, Y Gillet, C Gras Le Guen, E Launay, R Cohen, E Grimprel
Acute hematogenous bone and joint infections (osteomyelitis, septic arthritis, osteoarthritis, and spondylodiscitis) affect more frequently children younger than 5 years of age. Early diagnosis and prompt treatment are needed to limit the risk of complications. Children with suspected bone and joint infections (BJI) should be hospitalized at the beginning of treatment. Surgical drainage is indicated in patients with septic arthritis and in those with periosteal abscess. Staphylococcus aureus is involved in BJIs in children at all ages; Kingella kingae is a very common causative pathogen in children under 4 years of age...
December 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29246347/temporal-association-between-rhinovirus-activity-and-kingella-kingae-osteoarticular-infections
#16
Nina Droz, Vincent Enouf, Philippe Bidet, Damir Mohamed, Sylvie Behillil, Anne-Laure Simon, Manon Bachy, Marion Caseris, Stéphane Bonacorsi, Romain Basmaci
OBJECTIVE: To determine whether the seasonal distribution of Kingella kingae osteoarticular infections is similar to that of common respiratory viruses. STUDY DESIGN: Between October 2009 and September 2016, we extracted the results of K kingae-specific real-time polymerase chain reaction analyses performed for bone or joint specimens in patients from 2 pediatric tertiary care centers in Paris. We used data of respiratory virus detection from the Réseau National des Laboratoires network with coordination with the National Influenza Center of France...
January 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29242803/as-a-definitive-choice-of-treatment-joint-and-defect-spanning-multiplanar-tubular-external-fixation-in-the-management-of-pediatric-open-defective-supracondylar-humerus-fracture-a-case-report
#17
Mehmet Demirel, Onur Tunali, Ismail Turkmen, Yavuz Saglam
Introduction: Although supracondylar fractures of the humerus are common in children, open fractures of are extremely rare injuries. Gustilo- Anderson Type-III fractures in the upper extremity are primarily associated with considerable bone loss resulting from high energy trauma. In this study, a case of open pediatric supracondylar humerus fracture treated by a joint and defect spanning multiplanar tubular external fixation is presented. Case Report: A boy aged 3 years suffered from a Gustilo-Anderson Type-IIIA supracondylar humerus fractures...
September 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29226200/long-term-results-of-osteoarticular-allograft-reconstruction-in-children-with-distal-femoral-bone-tumors
#18
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/29204196/delineate-yet-not-dread-anomalous-vertebral-artery-in-pediatric-congenital-atlantoaxial-dislocation-and-basilar-invagination
#19
Pravin Salunke
Introduction: The deformed joints seen in congenital atlantoaxial dislocation (CAAD) are often associated with vascular anomalies. It is important to identify these vascular anomalies and address them appropriately without compromising the manipulation and fusion of C1-C2 joints. The small bones in pediatric age group pose an additional challenge. Materials and Methods: Data of fifty-six children with CAAD operated in the last 4 years was analyzed. A computed tomography angiogram was obtained preoperatively to assess for the course of the third segment of vertebral artery (VA)...
July 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/29153237/trauma-to-the-pediatric-temporomandibular-joint
#20
REVIEW
Sam S Bae, Sharon Aronovich
Management of pediatric condylar fractures presents a unique challenge because the developing mandible provides limited available bone for fixation and primary teeth preclude the use of typical closed reduction techniques. The available literature is reviewed with regard to closed and open treatment approaches.
February 2018: Oral and Maxillofacial Surgery Clinics of North America
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