Science.gov

Sample records for pediatrics shows cma

  1. CMA Member Survey: Network Management Systems Showing Little Improvement.

    ERIC Educational Resources Information Center

    Lusa, John M.

    1998-01-01

    Discusses results of a survey of 112 network and telecom managers--members of the Communications Managers Association (CMA)--to identify problems relating to the operation of large enterprise networks. Results are presented in a table under categories of: respondent profile; network management systems; carrier management; enterprise management;…

  2. CMA Infobase: clinical practice guidelines.

    PubMed

    Fitzpatrick, Roberta Bronson

    2008-01-01

    The CMA Infobase is a free Web-based resource that contains evidence-based clinical practice guidelines. The database is maintained by the Canadian Medical Association (CMA) and is available on its Web site. The CMA Infobase currently contains 1,200-plus clinical practice guidelines either developed or endorsed by an authoritative health care organization located in Canada. It is an alternative source of free clinical practice guidelines to the National Guideline Clearinghouse. This column will cover the basics of CMA Infobase, including searching, special features, and available resources which complement the database. PMID:19042721

  3. Impact of Pre-Procedure Interventions on No-Show Rate in Pediatric Endoscopy

    PubMed Central

    Mani, Jyoti; Franklin, Linda; Pall, Harpreet

    2015-01-01

    Pediatric endoscopy has evolved into an indispensable tool in the diagnosis and management of gastrointestinal diseases in children. However, there is limited literature focusing on quality improvement initiatives in pediatric endoscopy. The primary goal of this project was to reduce the no-show rate in the pediatric endoscopy unit. Also, we aimed to improve patient and family satisfaction with the procedure by identifying opportunities for improvement. A checklist was designed based on the potential causes of no-show. The endoscopy nurse coordinator reviewed the checklist when scheduling the procedure to identify patients at high risk for non-compliance. Once a risk factor was identified, appropriate actions were taken. She also made a pre-procedure phone call as a reminder and to address any of these risks for non-compliance if present. A patient satisfaction survey was used to identify potential areas for improvement. The no-show rate decreased from an average of 7% in the pre-intervention phase to 2% in the post-intervention phase (p = 0.009). 91% of the patients/family recorded an overall satisfaction of 4 or 5 on a scale of 1–5 (5 being best). Quality improvement strategies decreased the no-show rate in the pediatric endoscopy unit. A patient satisfaction survey helped in identifying areas for improvement.

  4. Pediatric central auditory processing disorder showing elevated threshold on pure tone audiogram.

    PubMed

    Maeda, Yukihide; Nakagawa, Atsuko; Nagayasu, Rie; Sugaya, Akiko; Omichi, Ryotaro; Kariya, Shin; Fukushima, Kunihiro; Nishizaki, Kazunori

    2016-10-01

    Central auditory processing disorder (CAPD) is a condition in which dysfunction in the central auditory system causes difficulty in listening to conversations, particularly under noisy conditions, despite normal peripheral auditory function. Central auditory testing is generally performed in patients with normal hearing on the pure tone audiogram (PTA). This report shows that diagnosis of CAPD is possible even in the presence of an elevated threshold on the PTA, provided that the normal function of the peripheral auditory pathway was verified by distortion product otoacoustic emission (DPOAE), auditory brainstem response (ABR), and auditory steady state response (ASSR). Three pediatric cases (9- and 10-year-old girls and an 8-year-old boy) of CAPD with elevated thresholds on PTAs are presented. The chief complaint was difficulty in listening to conversations. PTA showed elevated thresholds, but the responses and thresholds for DPOAE, ABR, and ASSR were normal, showing that peripheral auditory function was normal. Significant findings of central auditory testing such as dichotic speech tests, time compression of speech signals, and binaural interaction tests confirmed the diagnosis of CAPD. These threshold shifts in PTA may provide a new concept of a clinical symptom due to central auditory dysfunction in CAPD. PMID:26922127

  5. Ethical problems in pediatrics: what does the setting of care and education show us?

    PubMed Central

    2012-01-01

    Background Pediatrics ethics education should enhance medical students' skills to deal with ethical problems that may arise in the different settings of care. This study aimed to analyze the ethical problems experienced by physicians who have medical education and pediatric care responsibilities, and if those problems are associated to their workplace, medical specialty and area of clinical practice. Methods A self-applied semi-structured questionnaire was answered by 88 physicians with teaching and pediatric care responsibilities. Content analysis was performed to analyze the qualitative data. Poisson regression was used to explore the association of the categories of ethical problems reported with workplace and professional specialty and activity. Results 210 ethical problems were reported, grouped into five areas: physician-patient relationship, end-of-life care, health professional conducts, socioeconomic issues and health policies, and pediatric teaching. Doctors who worked in hospitals as well as general and subspecialist pediatricians reported fewer ethical problems related to socioeconomic issues and health policies than those who worked in Basic Health Units and who were family doctors. Conclusions Some ethical problems are specific to certain settings: those related to end-of-life care are more frequent in the hospital settings and those associated with socioeconomic issues and public health policies are more frequent in Basic Health Units. Other problems are present in all the setting of pediatric care and learning and include ethical problems related to physician-patient relationship, health professional conducts and the pediatric education process. These findings should be taken into consideration when planning the teaching of ethics in pediatrics. Trial registration This research article didn't reports the results of a controlled health care intervention. The study project was approved by the Institutional Ethical Review Committee (Report CEP-HIJG 032

  6. A modified CMA for blind equalization and phase recovery in optical coherent receivers

    NASA Astrophysics Data System (ADS)

    Zhu, Hai; Chen, Xue; Zhou, Weiqin; Li, Zhiyu; Zhou, Xian; Zhang, Zhiguo

    2009-11-01

    In order to solve the phase rotating problem for constant modulus algorithm (CMA) in polarization division multiplexing system with optical coherent receivers, a modified constant modulus algorithm based on decomposing cost function into real and imaginary parts is proposed in this paper. Simulation results show that, the proposed algorithm can compensate any angle phase distortion arising from channel, and deal with phase offset caused by intradyne receiver, with better performance comparing the conventional CMA.

  7. Neurocognitive Function in Pediatric Bipolar Disorder: 3-Year Follow-Up Shows Cognitive Development Lagging behind Healthy Youths

    ERIC Educational Resources Information Center

    Pavuluri, Mani N.; West, Amy; Hill, Kristian; Jindal, Kittu; Sweeney, John A.

    2009-01-01

    The comparison of the neurocognitive functioning of people with pediatric bipolar disorder (PBD) with a control group shows that the developmental progress in executive functions and verbal memory of those with PBD was significantly less than those in the control group. The results were seen after comparing data from baseline cognitive tests and a…

  8. 7 CFR 1425.6 - Approved CMA's.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Approved CMA's. 1425.6 Section 1425.6 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS COOPERATIVE MARKETING ASSOCIATIONS § 1425.6 Approved...

  9. Pediatrics

    NASA Technical Reports Server (NTRS)

    Spackman, T. J.

    1978-01-01

    The utilization of the Lixiscope in pediatrics was investigated. The types of images that can presently be obtained are discussed along with the problems encountered. Speculative applications for the Lixiscope are also presented.

  10. Infrared Observations of FS CMa Stars

    NASA Astrophysics Data System (ADS)

    Sitko, Michael L.; Russell, R. W.; Lynch, D. K.; Grady, C. A.; Hammel, H. B.; Beerman, L. C.; Day, A. N.; Huelsman, D.; Rudy, R. J.; Brafford, S. M.; Halbedel, E. M.

    2009-01-01

    A subset of non-supergiant B[e] stars has recently been recognized as forming a fairly unique class of objects with very strong emission lines, infrared excesses, and locations not associated with star formation. The exact evolutionary state of these stars, named for the prototype FS CMa, is uncertain, and they have often been classified as isolated Herbig AeBe stars. We present infrared observations of two of these stars, HD 45677 (FS CMa), HD 50138 (MWC 158), and the candidate FS CMa star HD 190073 (V1295 Aql) that span over a decade in time. All three exhibit an emission band at 10 microns due to amorphous silicates, confirming that much (if not all) of the infrared excess is due to dust. HD 50138 is found to exhibit 20% variability between 3-13 microns that resembles that found in pre-main sequence systems (HD 163296 and HD 31648). HD 45677, despite large changes at visual wavelengths, has remained relatively stable in the infrared. To date, no significant changes have been observed in HD 190073. This work is supported in part by NASA Origins of Solar Systems grant NAG5-9475, NASA Astrophysics Data Program contract NNH05CD30C, and the Independent Research and Development program at The Aerospace Corporation.

  11. Progesterone Treatment Shows Benefit in a Pediatric Model of Moderate to Severe Bilateral Brain Injury

    PubMed Central

    Geddes, Rastafa I.; Sribnick, Eric A.; Sayeed, Iqbal; Stein, Donald G.

    2014-01-01

    Purpose Controlled cortical impact (CCI) models in adult and aged Sprague-Dawley (SD) rats have been used extensively to study medial prefrontal cortex (mPFC) injury and the effects of post-injury progesterone treatment, but the hormone's effects after traumatic brain injury (TBI) in juvenile animals have not been determined. In the present proof-of-concept study we investigated whether progesterone had neuroprotective effects in a pediatric model of moderate to severe bilateral brain injury. Methods Twenty-eight-day old (PND 28) male Sprague Dawley rats received sham (n = 24) or CCI (n = 47) injury and were given progesterone (4, 8, or 16 mg/kg per 100 g body weight) or vehicle injections on post-injury days (PID) 1–7, subjected to behavioral testing from PID 9–27, and analyzed for lesion size at PID 28. Results The 8 and 16 mg/kg doses of progesterone were observed to be most beneficial in reducing the effect of CCI on lesion size and behavior in PND 28 male SD rats. Conclusion Our findings suggest that a midline CCI injury to the frontal cortex will reliably produce a moderate TBI comparable to what is seen in the adult male rat and that progesterone can ameliorate the injury-induced deficits. PMID:24489882

  12. Effects of water and CMA in mitigating industrial road dust resuspension

    NASA Astrophysics Data System (ADS)

    Amato, Fulvio; Escrig, Alberto; Sanfelix, Vicenta; Celades, Irina; Reche, Cristina; Monfort, Eliseo; Querol, Xavier

    2016-04-01

    Water spraying and/or chemical suppressants such as salts and polymers have been suggested to reduce road dust resuspension due to their capability to increase adhesion, and therefore the effective size and weight of particles, but contrasting results have been obtained so further testing are needed. This study presents the first results of street washing and Calcium Magnesium Acetate (CMA) efficiencies at two industrial roads (paved and unpaved) in the Mediterranean region where the high solar radiation, warm climate, and scarce precipitation, may play a key role in determining the efficiency of mitigation techniques Results show that, at both sites, street washing (water only) was more effective than CMA. Street washing made observe 18% (daily basis) and >90% (first hour) reductions of kerbside PM10 concentrations for the paved and unpaved road respectively, while with CMA PM10 decrease was generally lower and with less statistical significance.

  13. Sun signs Valdez Principles; rejoining CMA

    SciTech Connect

    Kirschner, E.

    1993-02-17

    Four year after an investors' group developed the Valdez Principles in response to the Exxon oil spill, Sun Co. (Philadelphia) has become the first major corporation to sign on to the environmental commitment. Sun also says it plans to rejoin the Chemical Manufacturers Association (CMA) in light of new emphasis on its chemical business and to recommit to the Responsible Care program. Sun negotiated the commitment's working with the Coalition for Economically Responsible Economies (CERES; New York), which devised the code of conduct, now called the CERES Principles. It requries goals of reducing environmental impact, as well as annual environmental auditing and public reporting of results. Annual environmental reporting is coming,' says Sun chairman and CEO Robert H. Campbell. CERES' report provides credibility and accountability, he says. Sun's signing is the onset of a stampede,' says New York City Comptroller Elizabeth Holtzman, who advises on investment of the city's $47-billion pension funds. CERES says that between tens of' Fortune 500 companies have shown interest in a negotiated code. The 50 other signers are smaller companies. Du Pont says it is waiting to see Sun's agreement. Campbell says the commitment complements Sun's five-year-old program, which incorporates the American Petroleum Institute program and CMA's Responsible Care initiative. I don't think anything will change that the customer will notice,' he adds.

  14. A Dynamic Tap Allocation for Concurrent CMA-DD Equalizers

    NASA Astrophysics Data System (ADS)

    Trindade, Diego von B. M.; Halmenschlager, Vitor; Ortolan, Leonardo; De Castro, Maria C. F.; De Castro, Fernando C. C.; Ourique, Fabrício

    2010-12-01

    This paper proposes a dynamic tap allocation for the concurrent CMA-DD equalizer as a low complexity solution for the blind channel deconvolution problem. The number of taps is a crucial factor which affects the performance and the complexity of most adaptive equalizers. Generally an equalizer requires a large number of taps in order to cope with long delays in the channel multipath profile. Simulations show that the proposed new blind equalizer is able to solve the blind channel deconvolution problem with a specified and reduced number of active taps. As a result, it minimizes the output excess mean square error due to inactive taps during and after the equalizer convergence and the hardware complexity as well.

  15. Progesterone Treatment Shows Benefit in Female Rats in a Pediatric Model of Controlled Cortical Impact Injury

    PubMed Central

    Geddes, Rastafa I.; Peterson, Bethany L.; Stein, Donald G.; Sayeed, Iqbal

    2016-01-01

    Purpose We recently showed that progesterone treatment can reduce lesion size and behavioral deficits after moderate-to-severe bilateral injury to the medial prefrontal cortex in immature male rats. Whether there are important sex differences in response to injury and progesterone treatment in very young subjects has not been given sufficient attention. Here we investigated progesterone’s effects in the same model of brain injury but with pre-pubescent females. Methods Twenty-eight-day-old female Sprague-Dawley rats received sham (n = 14) or controlled cortical impact (CCI) (n = 21) injury, were given progesterone (8 mg/kg body weight) or vehicle injections on post-injury days (PID) 1–7, and underwent behavioral testing from PID 9–27. Brains were evaluated for lesion size at PID 28. Results Lesion size in vehicle-treated female rats with CCI injury was smaller than that previously reported for similarly treated age-matched male rats. Treatment with progesterone reduced the effect of CCI on extent of damage and behavioral deficits. Conclusion Pre-pubescent female rats with midline CCI injury to the frontal cortex have reduced morphological and functional deficits following progesterone treatment. While gender differences in susceptibility to this injury were observed, progesterone treatment produced beneficial effects in young rats of both sexes following CCI. PMID:26799561

  16. A Pilot Study of Reasons and Risk Factors for "No-Shows" in a Pediatric Neurology Clinic.

    PubMed

    Guzek, Lindsay M; Fadel, William F; Golomb, Meredith R

    2015-09-01

    Missed clinic appointments lead to decreased patient access, worse patient outcomes, and increased healthcare costs. The goal of this pilot study was to identify reasons for and risk factors associated with missed pediatric neurology outpatient appointments ("no-shows"). This was a prospective cohort study of patients scheduled for 1 week of clinic. Data on patient clinical and demographic information were collected by record review; data on reasons for missed appointments were collected by phone interviews. Univariate and multivariate analyses were conducted using chi-square tests and multiple logistic regression to assess risk factors for missed appointments. Fifty-nine (25%) of 236 scheduled patients were no-shows. Scheduling conflicts (25.9%) and forgetting (20.4%) were the most common reasons for missed appointments. When controlling for confounding factors in the logistic regression, Medicaid (odds ratio 2.36), distance from clinic, and time since appointment was scheduled were associated with missed appointments. Further work in this area is needed. PMID:25503257

  17. Antimicrobial Peptide CMA3 Derived from the CA-MA Hybrid Peptide: Antibacterial and Anti-inflammatory Activities with Low Cytotoxicity and Mechanism of Action in Escherichia coli

    PubMed Central

    Lee, Jong-kook; Seo, Chang Ho; Luchian, Tudor

    2015-01-01

    CA-MA is a hybrid antimicrobial peptide (AMP) derived from two naturally occurring AMPs, cecropin A and magainin 2. CA-MA shows strong antimicrobial activity against Gram-negative and Gram-positive bacteria but also exhibits cytotoxicity toward mammalian cells. Our objective was to identify CA-MA analogues with reduced cytotoxicity by systematic replacement of amino acids with positively charged R groups (His and Lys), aliphatic R groups (Leu), or polar R groups (Glu). Among the CA-MA analogues studied (CMA1 to -6), CMA3 showed the strongest antimicrobial activity, including against drug-resistant Escherichia coli and Pseudomonas aeruginosa strains isolated from hospital patients. CMA3 appeared to act by inducing pore formation (toroidal model) in the bacterial membrane. In cytotoxicity assays, CMA3 showed little cytotoxicity toward human red blood cells (hRBCs) or HaCaT cells. Additionally, no fluorescence was released from small or giant unilamellar vesicles exposed to 60 μM CMA3 for 80 s, whereas fluorescence was released within 35 s upon exposure to CA-MA. CMA3 also exerted strong lipopolysaccharide (LPS)-neutralizing activity in RAW 264.7 cells, and BALB/c mice exposed to LPS after infection by Escherichia coli showed improved survival after administration of one 0.5-mg/kg of body weight or 1-mg/kg dose of CMA3. Finally, in a mouse model of septic shock, CMA3 reduced the levels of proinflammatory factors, including both nitric oxide and white blood cells, and correspondingly reduced lung tissue damage. This study suggests that CMA3 is an antimicrobial/antiendotoxin peptide that could serve as the basis for the development of anti-inflammatory and/or antimicrobial agents with low cytotoxicity. PMID:26552969

  18. ALMA Observations of Anisotropic Dust Mass Loss around VY CMa

    NASA Astrophysics Data System (ADS)

    O'Gorman, E.; Vlemmings, W.; Richards, A. M. S.; Baudry, A.; De Beck, E.; Decin, L.; Harper, G. M.; Humphreys, E. M.; Kervella, P.; Khouri, T.; Muller, S.

    2015-12-01

    We present high resolution ALMA Science Verification data of the continuum emission around the highly evolved oxygen-rich red supergiant VY CMa. These data enable us to study the dust in its inner circumstellar environment at a spatial resolution of 129 mas at 321 GHz and 59 mas at 658 GHz, thus allowing us to trace dust on spatial scales down to 11 R⋆ (71 AU). Two prominent dust components are detected and resolved. We find that at least 17% of the dust mass around VY CMa is located in clumps ejected within a more quiescent roughly spherical stellar wind, with a quiescent dust mass loss rate of 5×10-6 M⊙ yr-1. The anisotropic morphology of the dust indicates a continuous, directed mass loss over a few decades, suggesting that this mass loss cannot be driven by large convection cells alone.

  19. Capturing the clinical utility of genomic testing: medical recommendations following pediatric microarray

    PubMed Central

    Hayeems, Robin Z; Hoang, Ny; Chenier, Sebastien; Stavropoulos, Dimitri J; Pu, Shuye; Weksberg, Rosanna; Shuman, Cheryl

    2015-01-01

    Interpretation of pediatric chromosome microarray (CMA) results presents diagnostic and medical management challenges. Understanding management practices triggered by CMA will inform clinical utility and resource planning. Using a retrospective cohort design, we extracted clinical and management-related data from the records of 752 children with congenital anomalies and/or developmental delay who underwent CMA in an academic pediatric genetics clinic (2009–2011). Frequency distributions and relative rates (RR) of post-CMA medical recommendations in children with reportable and benign CMA results were calculated. Medical recommendations were provided for 79.6% of children with reportable results and 62.0% of children with benign results. Overall, recommendations included specialist consultation (40.8%), imaging (32.5%), laboratory investigations (17.2%), surveillance (4.6%), and family investigations (4.9%). Clinically significant variants and variants of uncertain clinical significance were associated with higher and slightly higher rates of management recommendations, respectively, compared with benign/no variants (RR=1.34; 95% CI (1.22–1.47); RR=1.23; 95% CI (1.09–1.38)). Recommendation rates for clinically significant versus uncertain results depended upon how uncertainty was classified (RRbroad=1.09; 95% CI (0.99–1.2); RRnarrow=1.12; 95% CI (1.02–1.24)). Recommendation rates also varied by the child's age and provider type. In conclusion, medical recommendations follow CMA for the majority of children. Compared with benign CMA results, clinically significant CMA variants are a significant driver of pediatric medical recommendations. Variants of uncertain clinical significance drive recommendations, but to a lesser extent. As a broadening range of specialists will need to respond to CMA results, targeted capacity building is warranted. PMID:25491637

  20. THE PAN-PACIFIC PLANET SEARCH. I. A GIANT PLANET ORBITING 7 CMa

    SciTech Connect

    Wittenmyer, Robert A.; Tinney, C. G.; Endl, Michael; Wang Liang; Johnson, John Asher; O'Toole, S. J.

    2011-12-20

    We introduce the Pan-Pacific Planet Search, a survey of 170 metal-rich Southern Hemisphere subgiants using the 3.9 m Anglo-Australian Telescope. We report the first discovery from this program, a giant planet orbiting 7 CMa (HD 47205) with a period of 763 {+-} 17 days, eccentricity e = 0.14 {+-} 0.06, and msin i = 2.6 {+-} 0.6 M{sub Jup}. The host star is a K giant with a mass of 1.5 {+-} 0.3 M{sub Sun} and metallicity [Fe/H] = 0.21 {+-} 0.10. The mass and period of 7 CMa b are typical of planets which have been found to orbit intermediate-mass stars (M{sub *} > 1.3 M{sub Sun }). Hipparcos photometry shows this star to be stable to 0.0004 mag on the radial-velocity period, giving confidence that this signal can be attributed to reflex motion caused by an orbiting planet.

  1. ALMA observations of TiO2 around VY CMa

    NASA Astrophysics Data System (ADS)

    De Beck, Elvire; Vlemmings, Wouter; Muller, Sébastien; Black, John H.; O'Gorman, Eamon; Richards, Anita M. S.; Baudry, Alain; Maercker, Matthias; Decin, Leen; Humphreys, Elizabeth M.

    2016-07-01

    Titanium dioxide, TiO2, is a refractory species that could play a crucial role in the dust-condensation sequence around oxygen-rich evolved stars. We present and discuss the detections of 15 emission lines of TiO2 with ALMA in the complex environment of the red supergiant VY CMa. The observations reveal a highly clumpy, anisotropic outflow in which the TiO2 emission likely traces gas exposed to the stellar radiation field. We find evidence for a roughly east-west oriented, accelerating bipolar-like structure, of which the blue component runs into and breaks up around a solid continuum component. We see a distinct tail to the south-west for some transitions, consistent with features seen in the optical and near-infrared. We find that a significant fraction of TiO2 remains in the gas phase outside the dust-formation zone and suggest that this species might play only a minor role in the dust-condensation process around extreme oxygen-rich evolved stars like VY CMa.

  2. Real-time experimental demonstration of PS-QPSK transmission with manipulated rotating and novel correlated CMA.

    PubMed

    Li, Haibo; Zeng, Tao; Li, Jie; Jiang, Feng; Liu, Ziqing; Hu, Rong; Luo, Ming; Wang, Yuanxiang; Li, Xiang; Yang, Qi; Yu, Shaohua; Huang, Liyan; Cao, Li

    2016-07-25

    In this paper, we propose a novel manipulated rotating polarization switched quadrature phase shift keying (MR-PS-QPSK) technique, and corresponding correlated constant modulus algorithm (CMA) for signal recovery. The latter utilizes the correlation between the PS-QPSK symbols in the two polarizations to lock the phase of output signals. Then the signals in the two polarizations are merged according to the recovered switching bit, which suppresses the noise and simplifies the subsequent process. A field programmable gate array (FPGA) based real-time platform is built for experimental demonstration. The experimental results show that the proposed MR-PS-QPSK modulation format with correlated CMA can provide 3.2 dB optical signal-to-noise ratio (OSNR) improvement over dual-polarization QPSK (DP-QPSK) at back-to-back case and 3.8 dB OSNR improvement after fiber transmission at the same symbol rate, which corresponds to be about 2 dB OSNR improvement at the same bit rate. The resource consumption analysis in FPGA digital signal processing blocks and logic utilizations shows that the MR-PS-QPSK with correlated CMA only requires a small additional computational effort. PMID:27464115

  3. DISTANCE AND KINEMATICS OF THE RED HYPERGIANT VY CMa: VERY LONG BASELINE ARRAY AND VERY LARGE ARRAY ASTROMETRY

    SciTech Connect

    Zhang, B.; Reid, M. J.; Menten, K. M.; Zheng, X. W.

    2012-01-01

    We report astrometric results of phase-referencing very long baseline interferometry observations of 43 GHz SiO maser emission toward the red hypergiant VY Canis Majoris (VY CMa) using the Very Long Baseline Array (VLBA). We measured a trigonometric parallax of 0.83 {+-} 0.08 mas, corresponding to a distance of 1.20{sup +0.13}{sub -0.10} kpc. Compared to previous studies, the spatial distribution of SiO masers has changed dramatically, while its total extent remains similar. The internal motions of the maser spots are up to 1.4 mas yr{sup -1}, corresponding to 8 km s{sup -1}, and show a tendency for expansion. After modeling the expansion of maser spots, we derived an absolute proper motion for the central star of {mu}{sub x} = -2.8 {+-} 0.2 and {mu}{sub y} = 2.6 {+-} 0.2 mas yr{sup -1} eastward and northward, respectively. Based on the maser distribution from the VLBA observations, and the relative position between the radio photosphere and the SiO maser emission at 43 GHz from the complementary Very Large Array observations, we estimate the absolute position of VY CMa at mean epoch 2006.53 to be {alpha}{sub J2000} = 07{sup h}22{sup m}58.{sup s}3259 {+-} 0.{sup s}0007, {delta}{sub J2000} = -25 Degree-Sign 46'03.''063 {+-} 0.''010. The position and proper motion of VY CMa from the VLBA observations differ significantly with values measured by the Hipparcos satellite. These discrepancies are most likely associated with inhomogeneities and dust scattering the optical light in the circumstellar envelope. The absolute proper motion measured with VLBA suggests that VY CMa may be drifting out of the giant molecular cloud to the east of it.

  4. Singularity analysis and elimination of CMA in multistage PMD channel model

    NASA Astrophysics Data System (ADS)

    Nie, Xinhui; Li, Yan; Du, Wentao; Cheng, Haiquan; Wu, Jian; Li, Wei; Lin, Jintong; Lu, Jianxin; Xu, Jian; Zhang, Guoyi; Luo, Huihong

    2015-08-01

    Polarization-division-multiplexed(PDM) optical coherent systems is considered a promising technique for next generation optical networks. With coherent detection, various impairments in the optical transmission system can be compensated by using digital signal processing (DSP) in the electrical domain. Constant modulus algorithm (CMA), due to its simplicity and immunity to phase noise, has been widely used to demultiplex polarizations and compensate received signals. On the other hand, CMA suffers from the singularity problem which results from Polarization- Dependent-Loss (PDL) and the less sensitivity in phase of CMA. Although many people have researched the singularity problem of CMA both in theory and experiments (modify CMA to avoid singularity problem), their theoretical channel model only contains fiber birefringence and does not consider the situation of multistage channel model which is used in long distance transmission system. Then we analyse the performance of CMA in the channel with multistage channel model through simulation. We change the initial tap of the traditional CMA which can achieve correct polarization demultiplexing without singularity in one stage channel model. But it is not very suitable in multistage channel model. We analysed singularity ratio in long distance transmission system. The simulation results play an active role in following research on singularity problem and the performance of CMA.

  5. Testing of CMA-2000 Microwave Landing System (MLS) airborne receiver

    NASA Astrophysics Data System (ADS)

    Labreche, L.; Murfin, A. J.

    1989-09-01

    Microwave landing system (MLS) is a precision approach and landing guidance system which provides position information and various air to ground data. Position information is provided on a wide coverage sector and is determined by an azimuth angle measurement, an elevation angle measurement, and a range measurement. MLS performance standards and testing of the MLS airborne receiver is mainly governed by Technical Standard Order TSO-C104 issued by the Federal Aviation Administration. This TSO defines detailed test procedures for use in determining the required performance under standard and stressed conditions. It also imposes disciplines on software development and testing procedures. Testing performed on the CMA-2000 MLS receiver and methods used in its validation are described. A computer automated test system has been developed to test for compliance with RTCA/DO-177 Minimum Operation Performance Standards. Extensive software verification and traceability tests designed to ensure compliance with RTCA/DO-178 are outlined.

  6. Performance analysis of conventional CMA and RLS in single carrier LTE uplink systems

    NASA Astrophysics Data System (ADS)

    Reddy P, Jaswini; Kotte, Swathi; Gannamaneni, Geetha Chowdary; Talluri, Kalyan Chakravarthy

    2011-10-01

    In wireless communication, channel equalization is one of the most challenging tasks because the broadcast channels are often subjected to multipath fading and several bandwidth limitations. Our project is mainly concerned with the Single Carrier Long Term Evolution (SC-LTE) uplink system model and its performance analysis when Fractionally Spaced Constant Modulus Algorithm (FS-CMA) and Recursive Least Squares Algorithm (RLS) are implemented. FS-CMA (CMA (1, 2) and CMA (2, 2)) and RLS algorithms are used individually to eliminate noise caused by multipath fading and Additive White Gaussian Noise (AWGN) in the stationary channel. The performance of conventional FS-CMA and RLS algorithm are compared using Bit Error Rate (BER) vs. Signal to Noise Ratio (SNR), Convergence, Equalizer output, Peak to Average Power Ratio (PAPR) vs. SNR.

  7. To Find a Safe Dose and Show Early Clinical Activity of Weekly Nab-paclitaxel in Pediatric Patients With Recurrent/ Refractory Solid Tumors

    ClinicalTrials.gov

    2016-08-22

    Neuroblastoma;; Rhabdomyosarcoma;; Ewing's Sarcoma;; Ewing's Tumor;; Sarcoma, Ewing's;; Sarcomas, Epitheliod;; Sarcoma, Soft Tissue;; Sarcoma, Spindle Cell;; Melanoma;; Malignant Melanoma;; Clinical Oncology;; Oncology, Medical;; Pediatrics, Osteosarcoma;; Osteogenic Sarcoma;; Osteosarcoma Tumor;; Sarcoma, Osteogenic;; Tumors;; Cancer;; Neoplasia;; Neoplasm;; Histiocytoma;; Fibrosarcoma;; Dermatofibrosarcoma

  8. Furore over language, shortage of women leaders signs of need for change at CMA, committee says.

    PubMed Central

    Rafuse, J

    1995-01-01

    Negative comments made recently about use of the term "chair" instead of "chairman," and the continuing shortage of women at decision-making levels of organized medicine are ample evidence that the work of the CMA's Gender Issues Committee (GIC) is not done, says the committee chair, Dr. May Cohen. At its fall meeting, the GIC said the CMA should actively promote greater representation by women physicians on its political and expert committees; a target of at least 25% membership within the next 2 to 5 years was suggested. The committee discussed other measures the CMA should consider in its attempts to become more representative of Canada's physician population. PMID:7828104

  9. Peculiarities of the accretion flow in the system HL CMa

    NASA Astrophysics Data System (ADS)

    Semena, A. N.; Revnivtsev, M. G.; Buckley, D.; Lutovinov, A. A.; Breitenbach, H.

    2016-06-01

    The properties of the aperiodic luminosity variability for the dwarf novaHLCMa are considered. The variability of the system HL CMa is shown to be suppressed at frequencies above 0.7 × 10-2 Hz. Different variability suppression mechanisms related to the radiation reprocessing time, partial disk evaporation, and characteristic variability formation time are proposed. It has been found that the variability suppression frequency does not change when the system passes from the quiescent state to the outburst one, suggesting that the accretion flow geometry is invariable. It is concluded from the optical and Xray luminosities of the system that the boundary layer on the white dwarf surface is optically thick in both quiescent and outburst states. The latter implies that the optically thick part of the accretion flow (disk) reaches the white dwarf surface. The accretion rate in the system and the accretion flow geometry and temperature have been estimated from the variability power spectra and spectral characteristics in a wide energy range, from the optical to X-ray ones.

  10. SRTC criticality safety technical review of SRT-CMA-930039

    SciTech Connect

    Rathbun, R.

    1993-12-03

    Review of SRT-CMA-930039, ``Nuclear Criticality Safety Evaluation (NCSE): DWPF Melter-Batch 1,`` December 1, 1993, has been performed by the Savannah River Technical Center (SRTC) Applied Physics Group. The NCSE is a criticality assessment of the Melt Cell in the DWPF. Additionally, this pertains only to Batch 1 operation, which differs from batches to follow. Plans for subsequent batch operations call for fissile material in the Salt Cell feed-stream, which necessitates a separate criticality evaluation in the future. The NCSE under review concludes that the process is safe from criticality events, even in the event that all lithium and boron neutron poisons are lost, provided uranium enrichments are less than 40%. Furthermore, if all the lithium and as much as 98% of the boron would be lost, uranium enrichments of 100% would be allowable. After a thorough review of the NCSE, this reviewer agrees with that conclusion. This technical review consisted of: an independent check of the methods and models employed, independent calculations application of ANSI/ANS 8.1, verification of WSRC Nuclear Criticality Safety Manual({sup 2}) procedures.

  11. B fields in OB stars (BOB): on the detection of weak magnetic fields in the two early B-type stars β CMa and ɛ CMa. Possible lack of a "magnetic desert" in massive stars

    NASA Astrophysics Data System (ADS)

    Fossati, L.; Castro, N.; Morel, T.; Langer, N.; Briquet, M.; Carroll, T. A.; Hubrig, S.; Nieva, M. F.; Oskinova, L. M.; Przybilla, N.; Schneider, F. R. N.; Schöller, M.; Simón-Díaz, S.; Ilyin, I.; de Koter, A.; Reisenegger, A.; Sana, H.

    2015-02-01

    Only a small fraction of massive stars seem to host a measurable structured magnetic field, whose origin is still unknown and whose implications for stellar evolution still need to be assessed. Within the context of the "B fields in OB stars (BOB)" collaboration, we used the HARPSpol spectropolarimeter to observe the early B-type stars β CMa (HD 44743; B1 II/III) and ɛ CMa (HD 52089; B1.5II) in December 2013 and April 2014. For both stars, we consistently detected the signature of a weak (<30 G in absolute value) longitudinal magnetic field, approximately constant with time. We determined the physical parameters of both stars and characterise their X-ray spectrum. For the β Cep star β CMa, our mode identification analysis led to determining a rotation period of 13.6 ± 1.2 days and of an inclination angle of the rotation axis of 57.6 ± 1.7°, with respect to the line of sight. On the basis of these measurements and assuming a dipolar field geometry, we derived a best fitting obliquity of about 22° and a dipolar magnetic field strength (Bd) of about 100 G (60 CMa we could only determine a lower limit on the dipolar magnetic field strength of 13 G. For this star, we determine that the rotation period ranges between 1.3 and 24 days. Our results imply that both stars are expected to have a dynamical magnetosphere, so the magnetic field is not able to support a circumstellar disk. We also conclude that both stars are most likely core hydrogen burning and that they have spent more than 2/3 of their main sequence lifetime. Ahistogram of the distribution of the dipolar magnetic field strength for the magnetic massive stars known to date does not show the magnetic field "desert" observed instead for intermediate-mass stars. The biases involved in the detection of (weak) magnetic

  12. Population pharmacokinetic analysis for 10-monohydroxy derivative of oxcarbazepine in pediatric epileptic patients shows no difference between Japanese and other ethnicities.

    PubMed

    Sugiyama, Ikuo; Bouillon, Thomas; Yamaguchi, Masayuki; Suzuki, Hikoe; Hirota, Takashi; Fink, Martin

    2015-04-01

    Oxcarbazepine is an anti-epileptic drug, which is almost completely metabolized by cytosolic enzymes in the liver to the active 10-monohyroxy metabolite (MHD) following oral administration. The pharmacokinetic (PK) profiles of MHD were evaluated in pediatric epileptic patients and a possible ethnic difference in PK of MHD between Japanese and non-Japanese pediatric patients was assessed. A non-linear mixed effect modeling approach was used to determine the PK of MHD. A one-compartment population model with first-order absorption appropriately described the PK of MHD. No clinically relevant differences were found for using body surface area or weight to explain between-patient variability, therefore the final model included the effects of body weight on apparent clearance (CL/F) and apparent volume of distribution (V/F) of MHD, and in addition, the effect of 3 concomitant anti-epileptic drugs (carbamazepine, phenobarbital and phenytoin) on CL/F of MHD. Inclusion of ethnicity as a covariate in the final model, concluded no ethnic difference with respect to CL/F of MHD between Japanese and non-Japanese patients. Hence, oxcarbazepine can be generally applied using the same dosage and administration for the treatment of partial onset seizures in pediatric patients, regardless of ethnicity. PMID:25989891

  13. Pediatric ultrasonography

    SciTech Connect

    Hayden, C.K. Jr.; Swischuk, L.E.

    1987-01-01

    Two leading experts explore the benefits and limitations of pediatric ultrasonography, explaining the latest techniques for optimal imaging of specific body regions: the head, chest, abdomen, pelvis, extremities, and soft tissues. Numerous illustrations emphasize significant points and combine with the text to show specifically what to look for when imaging children.

  14. THE 2008 OUTBURST IN THE YOUNG STELLAR SYSTEM Z CMa: THE FIRST DETECTION OF TWIN JETS

    SciTech Connect

    Whelan, E. T.; Dougados, C.; Bonnefoy, M.; Bouvier, J.; Chauvin, G.; Garcia, P. J. V.; Malbet, F.; Perrin, M. D.; Bains, I.; Redman, M. P.; Ray, T. P.; Bouy, H.; Benisty, M.; Grankvin, K.

    2010-09-01

    The Z CMa binary is understood to undergo both FU Orionis (FUOR) and EX Orionis (EXOR) type outbursts. While the SE component has been spectroscopically classified as an FUOR, the NW component, a Herbig Be star, is the source of the EXOR outbursts. The system has been identified as the source of a large outflow; however, previous studies have failed to identify the driver. Here, we present adaptive optics assisted [Fe II] spectro-images which reveal for the first time the presence of two small-scale jets. Observations made using OSIRIS at the Keck Observatory show the Herbig Be star to be the source of the parsec-scale outflow, which within 2'' of the source shows signs of wiggling and the FUOR to be driving a {approx}0.''4 jet. The wiggling of the Herbig Be star's jet is evidence for an additional companion which could in fact be generating the EXOR outbursts, the last of which began in 2008. Indeed, the dynamical scale of the wiggling corresponds to a timescale of 4-8 years which is in agreement with the timescale of these outbursts. The spectro-images also show a bow-shock-shaped feature and possible associated knots. The origin of this structure is as of yet unclear. Finally, interesting low velocity structure is also observed. One possibility is that it originates in a wide-angle outflow launched from a circumbinary disk.

  15. Pediatric MS

    MedlinePlus

    ... of the oral medications in the pediatric population. Network of Pediatric MS Centers The National MS Society ... MS Study Group (2004) and established a nationwide network of six Pediatric MS Centers of Excellence (2006) ...

  16. Pediatric Injury

    MedlinePlus

    ... common causes, which are 1 , 2 , 3 : Motor vehicle accidents Suffocation (being unable to breathe) Drowning Poisoning ... gov/safechild [top] American Academy of Pediatrics. (2008). Management of pediatric trauma. Pediatrics, 121 , 849–854. [top] ...

  17. Toward Understanding the B[e] Phenomenon. II. New Galactic FS CMa Stars

    NASA Astrophysics Data System (ADS)

    Miroshnichenko, A. S.; Manset, N.; Kusakin, A. V.; Chentsov, E. L.; Klochkova, V. G.; Zharikov, S. V.; Gray, R. O.; Grankin, K. N.; Gandet, T. L.; Bjorkman, K. S.; Rudy, R. J.; Lynch, D. K.; Venturini, C. C.; Mazuk, S.; Puetter, R. C.; Perry, R. B.; Levato, H.; Grosso, M.; Bernabei, S.; Polcaro, V. F.; Viotti, R. F.; Norci, L.; Kuratov, K. S.

    2007-12-01

    FS CMa stars form a group of objects with the B[e] phenomenon that were previously known as unclassified B[e] stars or B[e] stars with warm dust (B[e]WD) until recently. They exhibit strong emission-line spectra and strong IR excesses, most likely due to recently formed circumstellar dust. These properties have been suggested to be due to ongoing or recent rapid mass exchange in binary systems with hot primaries and various types of secondaries. The first paper of this series reported an analysis of the available information about previously known Galactic objects with the B[e] phenomenon, the initial selection of the FS CMa group objects, and a qualitative explanation of their properties. This paper reports the results of our new search for more FS CMa objects in the IRAS Point Source Catalog. We present new photometric criteria for identifying FS CMa stars as well as the first results of our observations of nine new FS CMa group members. With this addition, the FS CMa group has now 40 members, becoming the largest among the dust-forming hot star groups. We also present nine objects with no evidence for the B[e] phenomenon, but with newly discovered spectral line emission and/or strong IR excesses. Partially based on data obtained at the 6 m BTA Telescope of the Russian Academy of Sciences, 3.6 m Canada-France-Hawaii Telescope, 3 m Shane Telescope of the Lick Observatory, 2.7 m Harlan J. Smith and 2.1 m Otto Struve Telescopes of the McDonald Observatory, 2.1 m telescope of the San Pedro Martir Observatory, 1.5 m telescope of the Loiano Observatory, and 0.8 m telescope of the Dark Sky Observatory.

  18. Pediatric Cardiomyopathies

    MedlinePlus

    ... Pressure High Blood Pressure Tools & Resources Stroke More Pediatric Cardiomyopathies Updated:Oct 22,2015 Patient education material ... oxygen or high blood pressure. According to the Pediatric Cardiomyopathy Registry, one in every 100,000 children ...

  19. Myocarditis - pediatric

    MedlinePlus

    Pediatric myocarditis is inflammation of the heart muscle in an infant or young child. ... infections such as Lyme disease. Other causes of pediatric myocarditis include: Allergic reactions to certain medicines Exposure ...

  20. Pediatric Stroke

    PubMed Central

    Jeong, Goun; Lim, Byung Chan

    2015-01-01

    Pediatric stroke is relatively rare but may lead to significant morbidity and mortality. Along with the advance of brain imaging technology and clinical awareness, diagnosis of pediatric stroke is increasing wordwide. Pediatric stroke differs from adults in variable risk factor/etiologies, diverse and nonspecific clinical presentation depending on ages. This review will be discussed pediatric stroke focusing on their clinical presentations, diagnosis and etiologies/risk factors. PMID:26180605

  1. Economics of pediatric burns.

    PubMed

    Bass, Michael J; Phillips, Linda G

    2008-07-01

    Sustaining a burn injury sets in motion a cycle of pain, disfigurement, and a search for survival. In pediatric burns, the injury extends to the parents where fear, ignorance, and helplessness forever change their lives. Pediatric burn injuries are caused by fire, hot liquids, clothing irons, hair curlers, caustic substances like drain cleaner, the grounding of an electrical source, and exposure to radiation. Efficiency in the delivery of pediatric burn care is critical. Maximizing resource utilization means continual self-evaluation and economic analysis of therapeutic modalities. Griffiths et al found that most childhood burns are due to scalds, which can be treated for $1061 per percent burn. Paddock et al reduced the cost of treating superficial pediatric burns and reduced the length of stay in hospital using silver-impregnated gauze over traditional methods. Barrett et al found improved cosmesis of skin grafts using cultured epithelial autografts but at a substantially increased cost. Corpron et al showed that pediatric burn units that treat burns >10% total body surface area and operative treatment of pediatric burns regardless of size generate positive revenue. There is a paucity of evidentiary pediatric burn economic data. More research is needed to address areas of pediatric burn care inefficiency. Improving knowledge of cost in all health care endeavors will create competition and drive down expenditures. PMID:18650705

  2. Pediatric sialadenitis.

    PubMed

    Francis, Carrie L; Larsen, Christopher G

    2014-10-01

    Sialadenitis in the pediatric population accounts for up to 10% of all salivary gland disease. Viral parotitis and juvenile recurrent parotitis are the two most common causes. Multiple factors, independently or in combination, can result in acute, chronic, or recurrent acute salivary gland inflammation. Sialendoscopy has emerged as the leading diagnostic technique and intervention for pediatric sialadenitis. Sialendoscopy is a safe and effective gland-preserving treatment of pediatric sialadenitis. Investigational studies are needed to address the impact of steroid instillation, postoperative stenting, and long-term outcomes of pediatric sialendoscopy. This article presents a comprehensive review of pathophysiology, clinical presentation, diagnosis, and treatment of pediatric sialadenitis. PMID:25128215

  3. Production of low-cost calcium magnesium acetate (CMA) as an environmentally friendly deicer from cheese whey

    SciTech Connect

    Yang, S.T.; Zhu, H.; Li, Y.; Tang, I.C.

    1993-12-31

    About 28 billion lbs of cheese whey are being wasted in the US because of the high biological oxygen demand (BOD) of whey, disposing of surplus whey is a pollution problem. An innovative, wide-scale solution to the whey disposal problem is to use whey as a zero- or low-cost feedstock for the production of an environmentally safe, noncorrosive, road deicer-calcium magnesium acetate (CMA). CMA can be used to replace some of the 10 to 14 million tons road salt used in the North America for deicing. A novel anaerobic fermentation process is developed to produce calcium magnesium acetate (CMA) from whey permeate. A co-culture consisting of homolactic (S. lactis) and homoacetic (C. formicoaceticum) bacteria was used to convert whey lactose to lactate and then to acetate in continuous, immobilized cell bioreactors. The acetate yield from lactose was {approximately}95% (wt/wt), and the final concentration of acetic acid was 4%. The acetic acid present in the fermentation broth can be recovered by solvent-extraction with a tertiary amine and reacted with dolomitic lime (Ca/MgO) to form a concentrated (>25%) CMA solution. About 25 tons CMA can be produced from a plant processing 1 million lbs whey permeate (4.5% lactose) per day. The production costs are estimated at {approximately}$220/ton CMA, which is only about one third of the present market price for CMA deicer. Therefore, about 0.8 million tons/yr CMA deicer can be produced from the currently unused whey. This will partially fulfill market demand for economically and environmentally sound chemicals for roadway deicing. This also will provide a viable solution to the whey disposal problem currently facing many dairies in the North America.

  4. Proposal and Evaluation of Functionally Specialized CMA-ES

    NASA Astrophysics Data System (ADS)

    Akimoto, Youhei; Sakuma, Jun; Ono, Isao; Kobayashi, Shigenobu

    This paper aims the design of efficient and effective optimization algorithms for function optimization. For that purpose we present a new framework of the derandomized evolution strategy with covariance matrix adaptation, which combines the hybrid step size adaptation that is proposed in this paper as a robust alternate to the cumulative step size adaptation and normalization mechanism of covariance matrix. Experiment is conducted on 8 classical unimodal and multimodal test functions and the performance of the proposed strategy is compared with that of the standard strategy. Results show that the proposed strategy beats the standard strategy when the population size becomes larger than the default one, while the performance of proposed strategy is as well or better than that of the standard strategy under the default population size.

  5. Disease-associated pathophysiologic structures in pediatric rheumatic diseases show characteristics of scale-free networks seen in physiologic systems: implications for pathogenesis and treatment

    PubMed Central

    Frank, Mark Barton; Wang, Shirley; Aggarwal, Amita; Knowlton, Nicholas; Jiang, Kaiyu; Chen, Yanmin; McKee, Ryan; Chaser, Brad; McGhee, Timothy; Osban, Jeanette; Jarvis, James N

    2009-01-01

    Background While standard reductionist approaches have provided some insights into specific gene polymorphisms and molecular pathways involved in disease pathogenesis, our understanding of complex traits such as atherosclerosis or type 2 diabetes remains incomplete. Gene expression profiling provides an unprecedented opportunity to understand complex human diseases by providing a global view of the multiple interactions across the genome that are likely to contribute to disease pathogenesis. Thus, the goal of gene expression profiling is not to generate lists of differentially expressed genes, but to identify the physiologic or pathogenic processes and structures represented in the expression profile. Methods RNA was separately extracted from peripheral blood neutrophils and mononuclear leukocytes, labeled, and hybridized to genome level microarrays to generate expression profiles of children with polyarticular juvenile idiopathic arthritis, juvenile dermatomyositis relative to childhood controls. Statistically significantly differentially expressed genes were identified from samples of each disease relative to controls. Functional network analysis identified interactions between products of these differentially expressed genes. Results In silico models of both diseases demonstrated similar features with properties of scale-free networks previously described in physiologic systems. These networks were observable in both cells of the innate immune system (neutrophils) and cells of the adaptive immune system (peripheral blood mononuclear cells). Conclusion Genome-level transcriptional profiling from childhood onset rheumatic diseases suggested complex interactions in two arms of the immune system in both diseases. The disease associated networks showed scale-free network patterns similar to those reported in normal physiology. We postulate that these features have important implications for therapy as such networks are relatively resistant to perturbation. PMID

  6. The effects of calcium magnesium acetate (CMA) deicing material on the water quality of Bear Creek, Clackamas County, Oregon, 1999

    USGS Publications Warehouse

    Tanner, Dwight Q.; Wood, Tamara M.

    2000-01-01

    This report presents the results of a study by the U.S. Geological Survey, done in cooperation with the Oregon Department of Transportation (ODOT), to evaluate the effects of the highway deicing material, calcium magnesium acetate (CMA), on the water quality of Bear Creek, in the Cascade Range of Oregon. ODOT began using CMA (an alternative deicer that has fewer adverse environmental effects than road salt) in the mid-1990s and began this study with the USGS to ensure that there were no unexpected effects on the water quality of Bear Creek. Streamflow, precipitation, dissolved oxygen, pH, specific conductance, and water temperature were measured continuously through the 1998?99 winter. There was no measurable effect of the application of CMA to Highway 26 on the biochemical oxygen demand (BOD), calcium concentration, or magnesium concentration of Bear Creek and its tributaries. BOD was small in all of the water samples, some of which were collected before CMA application, and some of which were collected after application. Five-day BOD values ranged from 0.1 milligrams per liter to 1.5 milligrams per liter, and 20-day BOD values ranged from 0.2 milligrams per liter to 2.0 milligrams per liter. Dissolved copper concentrations in a small tributary ditch on the north side of Highway 26 exceeded the U.S. Environmental Protection Agency aquatic life criteria on three occasions. These exceedances were probably not caused by the application of CMA because (1) one of the samples was a background sample (no recent CMA application), and (2) dissolved copper was not detected in Bear Creek water samples to which CMA was added during laboratory experiments.

  7. Herschel SPIRE and PACS observations of the red supergiant VY CMa: analysis of the molecular line spectra

    NASA Astrophysics Data System (ADS)

    Matsuura, Mikako; Yates, J. A.; Barlow, M. J.; Swinyard, B. M.; Royer, P.; Cernicharo, J.; Decin, L.; Wesson, R.; Polehampton, E. T.; Blommaert, J. A. D. L.; Groenewegen, M. A. T.; Van de Steene, G. C.; van Hoof, P. A. M.

    2014-01-01

    We present an analysis of the far-infrared and submillimetre molecular emission-line spectrum of the luminous M-supergiant VY CMa, observed with the Spectral and Photometric Imaging Receiver (SPIRE) and Photodetector Array Camera and Spectrometer for Herschel spectrometers aboard the Herschel Space Observatory. Over 260 emission lines were detected in the 190-650 μm SPIRE Fourier Transform Spectrometer spectra, with one-third of the observed lines being attributable to H2O. Other detected species include CO, 13CO, H_2^{18}O, SiO, HCN, SO, SO2, CS, H2S and NH3. Our model fits to the observed 12CO and 13CO line intensities yield a 12C/13C ratio of 5.6 ± 1.8, consistent with measurements of this ratio for other M-supergiants, but significantly lower than previously estimated for VY CMa from observations of lower-J lines. The spectral line energy distribution for 20 SiO rotational lines shows two temperature components: a hot component at ˜1000 K, which we attribute to the stellar atmosphere and inner wind, plus a cooler ˜200 K component, which we attribute to an origin in the outer circumstellar envelope. We fit the line fluxes of 12CO, 13CO, H2O and SiO, using the SMMOL non-local thermodynamic equilibrium (LTE) line transfer code, with a mass-loss rate of 1.85 × 10-4 M⊙ yr-1 between 9R* and 350R*. We also fit the observed line fluxes of 12CO, 13CO, H2O and SiO with SMMOL non-LTE line radiative transfer code, along with a mass-loss rate of 1.85 × 10-4 M⊙ yr-1. To fit the high rotational lines of CO and H2O, the model required a rather flat temperature distribution inside the dust condensation radius, attributed to the high H2O opacity. Beyond the dust condensation radius the gas temperature is fitted best by an r-0.5 radial dependence, consistent with the coolant lines becoming optically thin. Our H2O emission-line fits are consistent with an ortho:para ratio of 3 in the outflow.

  8. Searching for Cool Dust in the Mid-to-Far Infrared: The Mass Loss Histories of the Hypergiants mu Cep, VY CMa, IRC +10420, and rho Cas

    NASA Astrophysics Data System (ADS)

    Humphreys, Roberta M.

    2016-01-01

    The most massive cool stars near the empircal upper limit of luminosity on the HR Diagram shed mass during brief, intense periods of enhanced mass loss. Their circumstellar environments show extensive and complex ejecta in scattered light at visual wavelengths. In the infrared, thermal emission from cooler dust in their ejecta can be used as a tracers of their mass loss histories. We combine high-resolution adaptive optics imaging from MMT/MIRAC (8 - 12 µm) with the new capabilities in far-infrared imaging of SOFIA/FORCAST and Herschel/PACS to probe further into the past for evidence of earlier mass loss for four famous objects: the red supergiants mu Cep and VY CMa and the yellow hypergiants IRC +10420 and rho Cas. We find evidence for a variable mass loss rate over several thousand years for mu Cep, while in contrast the lack of extended cold dust beyond VY CMa's visible ejecta indicates that its high mass loss episodes are recent. Despite its history of episodic mass loss, rho Cas has no resolved circumstellar ejecta. The new long wavelength photometry from FORCAST, however, confirms the presence of a slowly expanding dust shell from its 1946 event

  9. KIC 4739791: A New R CMa-type Eclipsing Binary with a Pulsating Component

    NASA Astrophysics Data System (ADS)

    Lee, Jae Woo; Kim, Seung-Lee; Hong, Kyeongsoo; Koo, Jae-Rim; Lee, Chung-Uk; Youn, Jae-Hyuck

    2016-02-01

    The Kepler light curve of KIC 4739791 exhibits partial eclipses, the inverse O’Connell effect, and multiperiodic pulsations. Including a starspot on either of the binary components, the light-curve synthesis indicates that KIC 4739791 is in detached or semi-detached configuration with both a short orbital period and a low mass ratio. Multiple frequency analyses were performed in the light residuals after subtracting the binarity effects from the original Kepler data. We detected 14 frequencies: 6 in the low-frequency region (0.1-2.3 days-1) and 8 in the high-frequency region (18.2-22.0 days-1). Among these, six high frequencies with amplitudes of 0.62-1.97 mmag were almost constant over time for 200 days. Their pulsation periods and pulsation constants are in the ranges of 0.048-0.054 days and 0.025-0.031 days, respectively. In contrast, the other frequencies may arise from the alias effects caused by the orbital frequency or combination frequencies. We propose that KIC 4739791 is a short-period R CMa binary with the lowest mass ratio in the known classical Algols and that its primary component is a δ Sct pulsating star. Only four R CMa stars have been identified, three of which exhibit δ Sct-type oscillations. These findings make KIC 4739791 an attractive target for studies of stellar interior structure and evolution.

  10. "Don't let others design your future", new CMA president tells physicians. Interview by Nancy Robb.

    PubMed Central

    Kazimirski, J

    1996-01-01

    Dr. Judith Kazimirski of Nova Scotia becomes the CMA's 126th president during the association's annual meeting in Sydney, NS, this month. She says her priority for the next year is to help the CMA play a lead role as the debate intensifies about the future of health and health care in Canada. "The time is right for a very public debate about what people want their system to be, what problems they're having, and how reform is moving ahead," she says, "and physicians have a critical leadership role to play." Images p452-a PMID:8801012

  11. Pediatric Terminology

    Cancer.gov

    The National Institute of Child Health and Human Development (NICHD) is working with NCI Enterprise Vocabulary Services (EVS) to provide standardized terminology for coding pediatric clinical trials and other resea

  12. Pediatric Specialists

    MedlinePlus

    ... Life Family Life Family Life Medical Home Family Dynamics Media Work & Play Getting Involved in Your Community ... Life Medical Home Health Insurance Pediatric Specialists Family Dynamics Media Work & Play Getting Involved in Your Community ...

  13. Pediatric sleep apnea

    MedlinePlus

    Sleep apnea - pediatric; Apnea - pediatric sleep apnea syndrome; Sleep-disordered breathing - pediatric ... Untreated pediatric sleep apnea may lead to: High blood pressure Heart or lung problems Slow growth and development

  14. Virtual Pediatric Hospital

    MedlinePlus

    ... Last revised on February 12, 2016 Related Digital Libraries Pediatric GeneralPediatrics.com - the general pediatrician's view of the Internet PediatricEducation.org - a pediatric digital library and learning collaboratory intended to serve as a ...

  15. Pediatric Anthropometry

    NASA Astrophysics Data System (ADS)

    Klinich, Kathleen D.; Reed, Matthew P.

    Anthropometry is the measurement of human size, shape, and physical capabilities. Most pediatric anthropometry data are gathered to describe child growth patterns, but data on body size, mass distribution, range of motion, and posture are used to develop crash test dummies and computational models of child occupants. Pediatric anthropometry data are also used to determine child restraint dimensions, so they will accommodate the applicable population of child occupants.

  16. VizieR Online Data Catalog: VY CMa ALMA NaCl images (Decin+, 2016)

    NASA Astrophysics Data System (ADS)

    Decin, L.; Richards, A. M. S.; Millar, T. J.; Baudry, A.; de, Beck E.; Homan, W.; Smith, N.; van de Sande, M.; Walsh, C.

    2016-07-01

    VY CMa was observed for ALMA Science Verification on 2013 16-19 August using 16-20 12-m antennas on baselines from 0.014-2.7km. The main objective was to map the H2O maser lines at 321 and 325GHz (Band 7) and 658GHz (Band 9), but several thermal lines identified with various rotational transitions of NaCl, TiO2, SO2, and SiO were also present in the spectral setting in addition to the continuum data. Four NaCl lines in the ground or first vibrational state are covered in the ALMA band 7 data. All of them are detected, albeit only two are unblended (see Table 1). (3 data files).

  17. A spectropolarimetric study of the Wolf-Rayet star EZ CMa1

    NASA Astrophysics Data System (ADS)

    de la Chevrotière, Antoine; St-Louis, Nicole; Moffat, Anthony F. J.

    2012-05-01

    We report on the first deep, direct search for a magnetic field via Zeeman splitting in a Wolf-Rayet star. Using the highly-efficient ESPaDOnS (Echelle Spectro-Polarimetric Device for the Observations of Stars) at the Canada-France-Hawaii telescope, we observed at four different rotation phases one of the best WR candidates in the sky expected to harbor a magnetic field, the bright, variable WN4 star EZ CMa = WR6 = HD 50896. We looked for the characteristic circular polarization (Stokes V) pattern in strong emission lines that would arise as a consequence of a global, rotating magnetic field. Based on the work of Gayley and Ignace [1], we investigate the split-monopole scenario as a possible magnetic configuration and obtain an upper limit of ~ 300 G in the formation region of the strongest emission line HeII λ4686A˚.

  18. Control of coal combustion SO[sub 2] and NO[sub x] emissions by in-boiler injection of CMA

    SciTech Connect

    Levendis, Y.A.; Wise, D.L.

    1992-01-01

    The principal objectives of the proposed research are two-fold: (A) To understand the mechanism and assess the effectiveness of sulfur capture by the chemical calcium magnesium acetate (CMA). And (B) To evaluate the NO[sub x] reduction capabilities of CMA by burning the organic constituents of the chemical (the acetate) and reducing NO to stable N[sub 2] The optimum conditions and the location of CMA introduction in the furnace will be identified. To achieve these goals water solutions of CMA or dry powders of CMA will be injected into hot air or gases simulating the furnace exhaust (containing CO[sub 2], SO[sub x] NO[sub x], H[sub 2]O, O[sub 2] etc.) and the composition of gaseous and solid products of the reaction will be monitored. The processes of burning the organic acetate as well as the calcination, sintering and sulfation of the remaining solid will be studied in detail.

  19. SEARCH FOR A MAGNETIC FIELD VIA CIRCULAR POLARIZATION IN THE WOLF-RAYET STAR EZ CMa

    SciTech Connect

    De la Chevrotiere, A.; St-Louis, N.; Moffat, A. F. J.; Collaboration: MiMeS Collaboration

    2013-02-20

    We report on the first deep, direct search for a magnetic field via the circular polarization of Zeeman splitting in a Wolf-Rayet (W-R) star. Using the highly efficient ESPaDOnS spectropolarimeter at the Canada-France-Hawaii Telescope, we observed at three different epochs one of the best W-R candidates in the sky expected to harbor a magnetic field, the bright, highly variable WN4 star EZ CMa = WR6 = HD 50896. We looked for the characteristic circular polarization (Stokes V) pattern in strong emission lines that would arise as a consequence of a global, rotating magnetic field with a split monopole configuration. We also obtained nearly simultaneous linear polarization spectra (Stokes Q and U), which are dominated by electron scattering, most likely from a flattened wind with large-scale corotating structures. As the star rotates with a period of 3.766 days, our view of the wind changes, which in turn affects the value of the linear polarization in lines versus continuum at the {approx}0.2% level. Depending on the epoch of observation, our Stokes V data were affected by significant crosstalk from Stokes Q and U to V. We removed this spurious signal from the circular polarization data and experimented with various levels of spectral binning to increase the signal-to-noise ratio of our data. In the end, no magnetic field is unambiguously detected in EZ CMa. Assuming that the star is intrinsically magnetic and harbors a split monopole configuration, we find an upper limit of B {approx} 100 G for the intensity of its field in the line-forming regions of the stellar wind.

  20. Controversies in Pediatric Perioperative Airways

    PubMed Central

    Klučka, Jozef; Štourač, Petr; Štoudek, Roman; Ťoukálková, Michaela; Harazim, Hana; Kosinová, Martina

    2015-01-01

    Pediatric airway management is a challenge in routine anesthesia practice. Any airway-related complication due to improper procedure can have catastrophic consequences in pediatric patients. The authors reviewed the current relevant literature using the following data bases: Google Scholar, PubMed, Medline (OVID SP), and Dynamed, and the following keywords: Airway/s, Children, Pediatric, Difficult Airways, and Controversies. From a summary of the data, we identified several controversies: difficult airway prediction, difficult airway management, cuffed versus uncuffed endotracheal tubes for securing pediatric airways, rapid sequence induction (RSI), laryngeal mask versus endotracheal tube, and extubation timing. The data show that pediatric anesthesia practice in perioperative airway management is currently lacking the strong evidence-based medicine (EBM) data that is available for adult subpopulations. A number of procedural steps in airway management are derived only from adult populations. However, the objective is the same irrespective of patient age: proper securing of the airway and oxygenation of the patient. PMID:26759809

  1. Pediatric sepsis

    PubMed Central

    Randolph, Adrienne G; McCulloh, Russell J

    2014-01-01

    Sepsis is the leading cause of death in children worldwide. Although the diagnosis and management of sepsis in infants and children is largely influenced by studies done in adults, there are important considerations relevant for pediatrics. This article highlights pediatric-specific issues related to the definition of sepsis and its epidemiology and management. We review how the capacity of the immune system to respond to infection develops over early life. We also bring attention to primary immune deficiencies that should be considered in children recurrently infected with specific types of organisms. The management of pediatric sepsis must be tailored to the child’s age and immune capacity, and to the site, severity, and source of the infection. It is important for clinicians to be aware of infection-related syndromes that primarily affect children. Although children in developed countries are more likely to survive severe infections than adults, many survivors have chronic health impairments. PMID:24225404

  2. Pediatric rosacea.

    PubMed

    Kellen, Roselyn; Silverberg, Nanette B

    2016-07-01

    Because rosacea is uncommon in the pediatric population, care must be taken to exclude other papulopustular disorders. Children can present with vascular, papulopustular, and/or ocular findings. Importantly, ocular symptoms can appear before the cutaneous symptoms of rosacea, leading to misdiagnosis. Rosacea is a clinical diagnosis, but histopathologic examination typically reveals dilated vessels, perivascular lymphohistiocytic infiltrates in the upper dermis, elastosis, and disorganization of the upper dermal connective tissue. Treatment involves avoiding known triggers and utilizing topical and/or systemic therapies. Although treatment can control flares, pediatric rosacea often persists into adulthood. PMID:27529708

  3. Pediatric Sarcomas.

    PubMed

    Williams, Regan F; Fernandez-Pineda, Israel; Gosain, Ankush

    2016-10-01

    Pediatric sarcomas are a heterogeneous group of tumors accounting for approximately 10% of childhood solid tumors. Treatment is focused on multimodality therapy, which has improved the prognosis over the past two decades. Current regimens focus on decreasing treatment for low-risk patients to decrease the long-term side effects while maximizing therapy for patients with metastatic disease to improve survival. Pediatric sarcomas can be divided into soft tissue sarcomas and osseous tumors. Soft tissue sarcomas are further delineated into rhabdomyosarcomas, which affect young children and nonrhabdomyosarcomas, which are most common in adolescents. The most common bone sarcomas are osteosarcomas and Ewing's sarcoma. PMID:27542645

  4. Pediatric intestinal motility disorders.

    PubMed

    Gfroerer, Stefan; Rolle, Udo

    2015-09-01

    Pediatric intestinal motility disorders affect many children and thus not only impose a significant impact on pediatric health care in general but also on the quality of life of the affected patient. Furthermore, some of these conditions might also have implications for adulthood. Pediatric intestinal motility disorders frequently present as chronic constipation in toddler age children. Most of these conditions are functional, meaning that constipation does not have an organic etiology, but in 5% of the cases, an underlying, clearly organic disorder can be identified. Patients with organic causes for intestinal motility disorders usually present in early infancy or even right after birth. The most striking clinical feature of children with severe intestinal motility disorders is the delayed passage of meconium in the newborn period. This sign is highly indicative of the presence of Hirschsprung disease (HD), which is the most frequent congenital disorder of intestinal motility. HD is a rare but important congenital disease and the most significant entity of pediatric intestinal motility disorders. The etiology and pathogenesis of HD have been extensively studied over the last several decades. A defect in neural crest derived cell migration has been proven as an underlying cause of HD, leading to an aganglionic distal end of the gut. Numerous basic science and clinical research related studies have been conducted to better diagnose and treat HD. Resection of the aganglionic bowel remains the gold standard for treatment of HD. Most recent studies show, at least experimentally, the possibility of a stem cell based therapy for HD. This editorial also includes rare causes of pediatric intestinal motility disorders such as hypoganglionosis, dysganglionosis, chronic intestinal pseudo-obstruction and ganglioneuromatosis in multiple endocrine metaplasia. Underlying organic pathologies are rare in pediatric intestinal motility disorders but must be recognized as early as

  5. Pediatric intestinal motility disorders

    PubMed Central

    Gfroerer, Stefan; Rolle, Udo

    2015-01-01

    Pediatric intestinal motility disorders affect many children and thus not only impose a significant impact on pediatric health care in general but also on the quality of life of the affected patient. Furthermore, some of these conditions might also have implications for adulthood. Pediatric intestinal motility disorders frequently present as chronic constipation in toddler age children. Most of these conditions are functional, meaning that constipation does not have an organic etiology, but in 5% of the cases, an underlying, clearly organic disorder can be identified. Patients with organic causes for intestinal motility disorders usually present in early infancy or even right after birth. The most striking clinical feature of children with severe intestinal motility disorders is the delayed passage of meconium in the newborn period. This sign is highly indicative of the presence of Hirschsprung disease (HD), which is the most frequent congenital disorder of intestinal motility. HD is a rare but important congenital disease and the most significant entity of pediatric intestinal motility disorders. The etiology and pathogenesis of HD have been extensively studied over the last several decades. A defect in neural crest derived cell migration has been proven as an underlying cause of HD, leading to an aganglionic distal end of the gut. Numerous basic science and clinical research related studies have been conducted to better diagnose and treat HD. Resection of the aganglionic bowel remains the gold standard for treatment of HD. Most recent studies show, at least experimentally, the possibility of a stem cell based therapy for HD. This editorial also includes rare causes of pediatric intestinal motility disorders such as hypoganglionosis, dysganglionosis, chronic intestinal pseudo-obstruction and ganglioneuromatosis in multiple endocrine metaplasia. Underlying organic pathologies are rare in pediatric intestinal motility disorders but must be recognized as early as

  6. Young eccentric binary KL CMa revisited in the light of spectroscopy

    NASA Astrophysics Data System (ADS)

    Bakış, Volkan

    2015-10-01

    The absolute dimensions of the components of the eccentric eclipsing binary KL CMa have been determined. The solution of light and radial velocity curves of high (Δλ = 0.14 Å) and intermediate (Δλ = 1.1 Å) resolution spectra yielded masses M1 = 3.55 ± 0.27 M⊙, M2 = 2.95 ± 0.24 M⊙ and radii R1 = 2.37 ± 0.09 R⊙, R2 = 1.70 ± 0.1 R⊙ for primary and secondary components, respectively. The system consists of two late B-type components at a distance of 220 ± 20 pc for an estimated reddening of E (B - V) = 0.127 . The present study provides an illustration of spectroscopy's crucial role in the analysis of binary systems in eccentric orbits. The eccentricity of the orbit (e = 0.20) of KL CMa is found to be bigger than the value given in the literature (e = 0.14). The apsidal motion rate of the system has been updated to a new value of w ˙ = 0 ° . 0199 ± 0.0002cycle-1 , which indicates an apsidal motion period of U = 87 ± 1 yrs, two times slower than given in the literature. Using the absolute dimensions of the components yielded a relatively weak relativistic contribution of w˙rel = 0 ° . 0013cycle-1 . The observed internal-structure component (logk2,obs = - 2.22 ± 0.01) is found to be in agreement with its theoretical value (logk2,theo = - 2.23). Both components of the system are found very close to the zero-age main-sequence and theoretical isochrones indicate a young age (τ = 50 Myr) for the system. Analysis of the spectral lines yields a faster rotation (Vrot1,2 = 100 km s-1) for the components than their synchronization velocities (Vrot,syn1 = 68 km s-1, Vrot,syn1 = 49 km s-1).

  7. Pediatric Trichotillomania

    PubMed Central

    Harrison, Julie P.; Franklin, Martin E.

    2012-01-01

    Trichotillomania (TTM) is an impulse control disorder characterized by chronic hair-pulling, distress, and impairment. Although the negative effects of TTM are documented and often readily evident, there remains a paucity of psychopathology and treatment research on this disorder, particularly in pediatric populations. In an effort to improve assessment of pediatric TTM, several TTM-specific instruments for youth have now been developed to reliably identify symptoms and examine related phenomenology. Instrument development has now yielded instruments to evaluate TTM and related symptoms in the context of clinical trials of youth, and the first randomized controlled trial of any treatment for pediatric TTM was recently published. Using the initial pediatric TTM studies as building blocks, future research is now needed to create a stronger body of knowledge about the relative and combined efficacy of potential interventions for TTM in youth, as well as to examine the effects of TTM phenomenology and comorbidity on treatment outcome. Dissemination efforts must also be heightened for this knowledge to best reach these vulnerable populations. PMID:22437627

  8. Adaptive niche radii and niche shapes approaches for niching with the CMA-ES.

    PubMed

    Shir, Ofer M; Emmerich, Michael; Bäck, Thomas

    2010-01-01

    While the motivation and usefulness of niching methods is beyond doubt, the relaxation of assumptions and limitations concerning the hypothetical search landscape is much needed if niching is to be valid in a broader range of applications. Upon the introduction of radii-based niching methods with derandomized evolution strategies (ES), the purpose of this study is to address the so-called niche radius problem. A new concept of an adaptive individual niche radius is applied to niching with the covariance matrix adaptation evolution strategy (CMA-ES). Two approaches are considered. The first approach couples the radius to the step size mechanism, while the second approach employs the Mahalanobis distance metric with the covariance matrix mechanism for the distance calculation, for obtaining niches with more complex geometrical shapes. The proposed approaches are described in detail, and then tested on high-dimensional artificial landscapes at several levels of difficulty. They are shown to be robust and to achieve satisfying results. PMID:20064027

  9. ITC-CMA partnership and data needs for alkylphenols and ethoxylates

    USGS Publications Warehouse

    Rattner, B.A.; Rice, C.P.; Walker, J.D.

    1996-01-01

    The ITC has been an independent advisory committee to the EPA Administrator since enactment of the Toxics Substances Control Act (TSCA) in 1976. The ITC identifies and coordinates U.S. Government data needs for TSCA-regulable chemicals, and makes recommendations to the Administrator for priority testing consideration. Chemicals recommended by the ITC are added to the TSCA Priority Testing List that is revised semi-annually in Reports to the Administrator. In recent Reports, the ITC added alkylphenols (APs) and ethoxylates to the Priority Testing List. About 500 million pounds are produced annually for industrial processing, cleaning and personal care products. APs have been detected in the tissues of fish from the Great Lakes, and one AP (nonylphenol) causes vitellogenin gene expression in trout hepatocytes. Numerous APs and ethoxylates were recommended by the ITC because data are needed on: (1) chemical composition, (2) environmental fate of parent chemicals and impurities, and (3) health and ecological effects (including toxicokinetics and endocrine-modulating effects). In response to the ITC's recommendations, two activities have ensued. First, the EPA promulgated rules requiring manufacturers, importers and processors of APs and ethoxylates to submit production and exposure reports, and unpublished health and safety studies, for review. Second, the Alkylphenols and Ethoxylates Panel of Chemical Manufacturers Association (CMA) and the ITC formed a Dialogue Group to discuss the data needs. Data needs and activities initiated by the Dialogue Group will be presented.

  10. VizieR Online Data Catalog: V352 CMa V-band differential light curve (Kajatkari+, 2015)

    NASA Astrophysics Data System (ADS)

    Kajatkari, P.; Jetsu, L.; Cole, E.; Hackman, T.; Henry, G. W.; Joutsiniemi, S.-L.; Lehtinen, J.; Makela, V.; Porceddu, S.; Ryynanen, K.; Solea, V.

    2015-05-01

    The included files present the numerical data of our analysis of the V352 CMa photometry. The data consists of differential Johnson V-band photometry using the star HD 43879 as the comparison star. The analysis has been performed using our previously published continuous period search (CPS) method, described in detail in Lehtinen et al., 2011A&A...527A.136L, Cat. J/A+A/527/A136. (2 data files).

  11. Pediatric sleep apnea

    MedlinePlus

    Sleep apnea - pediatric; Apnea - pediatric sleep apnea syndrome; Sleep-disordered breathing - pediatric ... During sleep, all of the muscles in the body become more relaxed. This includes the muscles that help keep ...

  12. Pediatric heart surgery - discharge

    MedlinePlus

    ... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Keane JF, Lock JE, Fyler DC, eds. Nadas' Pediatric Cardiology . 2nd ed. St. Louis, MO; WB Saunders; ...

  13. Ecotoxicological evaluation of three deicers (NaCl, NaFo, CMA)-effect on terrestrial organisms.

    PubMed

    Robidoux, P Y; Delisle, C E

    2001-02-01

    The use of chemical deicers such as sodium chloride (NaCl) has increased significantly during the past three decades. Deicers induce metal corrosion and alter the physicochemical properties of soils and water. Environmental damage caused by the use of NaCl has prompted government agencies to find alternative deicers. This article presents a comparative ecotoxicological study of three deicers on soil organisms. Sodium formiate (NaFo) and calcium-magnesium acetate (CMA) are the most interesting commercially available deicers based upon their characteristics and potential toxicity. Organisms used in this study were four species of macrophytes (cress (Lepidium sativum), barley (Ordeum vulgare), red fescue grass (Festuca rubra), Kentucky bluegrass (Poa pratensis)) and an invertebrate (Eisenia fetida). Using standardized and modified methods, the relative toxicity of deicers was CMA < NaFo congruent with NaCl. The results demonstrate that these chemicals could have similar impacts in terrestrial environments since similar quantities of NaFo and greater amounts of CMA are necessary to achieve the same efficiency as NaCl. The toxicity of the tested substances was lower in natural composted soil than in artificial substrate (silica or OECD soil), indicating decreased environmental bioavailability. The response of the organisms changed according to endpoint, species, and soil characteristics (artificial substrate as compared to natural organic soil). The most sensitive endpoint measured was macrophyte growth with Kentucky bluegrass being the most sensitive species. PMID:11161687

  14. Pediatric Virology

    PubMed Central

    Portnoy, Bernard

    1965-01-01

    Pediatric virology is not an isolàted discipline. Rather, the syndromes associated with viral infection are modified by the unique characteristics of infancy and childhood. Fortunately for the pediatrician, and certainly for children, viral infections in childhood are rarely fatal, and are almost never serious. Future efforts of the pediatrician and virologist should be directed toward increased fetal salvage as with rubella and the prevention of severe, viral lower respiratory tract disease. PMID:14298871

  15. Pediatric nutrition.

    PubMed

    Greco, Deborah S

    2014-03-01

    This article discusses pediatric nutrition in puppies and kittens. Supplementation of basic nutrients such as fat, protein, minerals, vitamins, and essential fatty acids of the bitch is essential for the proper growth and development of puppies during the lactation period. Milk replacers are compared for use in puppies and kittens. Supplements such as colostrum and probiotics for promotion of a healthy immune system and prevention or treatment of stress-induced and weaning diarrhea are also discussed. PMID:24580990

  16. Pediatric Neurotrauma

    PubMed Central

    Kannan, Nithya; Ramaiah, Ramesh; Vavilala, Monica S.

    2014-01-01

    Traumatic brain injury (TBI) is the leading cause of death and disability in children over 1 year of age. Knowledge about the age-specific types of injury and how to manage children with neurotrauma is essential to understanding and recognizing the extent and degree of injury and to optimize outcomes. In this article, we review the epidemiology, pathophysiology, and clinical management of pediatric neurotrauma. PMID:25024940

  17. RED SUPERGIANTS AS POTENTIAL TYPE IIn SUPERNOVA PROGENITORS: SPATIALLY RESOLVED 4.6 {mu}m CO EMISSION AROUND VY CMa AND BETELGEUSE

    SciTech Connect

    Smith, Nathan; Hinkle, Kenneth H.; Ryde, Nils E-mail: hinkle@noao.edu

    2009-03-15

    We present high-resolution 4.6 {mu}m CO spectra of the circumstellar environments of two red supergiants (RSGs) that are potential supernova (SN) progenitors: Betelgeuse and VY Canis Majoris (VY CMa). Around Betelgeuse, {sup 12}CO emission within {+-}3'' ({+-}12 km s{sup -1}) follows a mildly clumpy but otherwise spherical shell, smaller than its {approx}55'' shell in K I {lambda}7699. In stark contrast, 4.6 {mu}m CO emission around VY CMa is coincident with bright K I in its clumpy asymmetric reflection nebula, within {+-}5'' ({+-}40 km s{sup -1}) of the star. Our CO data reveal redshifted features not seen in K I spectra of VY CMa, indicating a more isotropic distribution of gas punctuated by randomly distributed asymmetric clumps. The relative CO and K I distribution in Betelgeuse arises from ionization effects within a steady wind, whereas in VY CMa, K I is emitted from skins of CO cloudlets resulting from episodic mass ejections 500-1000 yr ago. In both cases, CO and K I trace potential pre-SN circumstellar matter: we conclude that an extreme RSG like VY CMa might produce a Type IIn event like SN 1988Z if it were to explode in its current state, but Betelgeuse will not. VY CMa demonstrates that luminous blue variables are not necessarily the only progenitors of SNe IIn, but it underscores the requirement that SNe IIn suffer enhanced episodic mass loss shortly before exploding.

  18. History of German pediatric cardiology.

    PubMed

    Heintzen, P

    2002-01-01

    Due to the isolation of German medicine in World War II accompanied by the destruction of many hospitals, German pediatricians did not show any serious interest in the treatment of children with congenital heart diseases, nor did they take notice of the progress achieved by Helen Taussig, Alfred Blalock and other cardiologists and surgeons in the western world. This problem was even worse in East Germany. Only a few German internists and forward-looking surgeons were able and ready to take care of this group of principally operable children in places like Bonn/Düsseldorf, Marburg/Munich, Berlin, and Hamburg. However, in the early 1950s some directors of pediatrics at university hospitals--largely motivated by the cardiac surgeons--allowed or even encouraged younger colleagues to concentrate on pediatric cardiology and to begin application of heart catheterization and angiocardiography. In 1960 a group of colleagues interested in pediatric cardiology met for the first time in Frankfurt and became the nucleus of the future "working group" (1969) and finally the "German Society of Pediatric Cardiology" (1974). By 1972 pediatric cardiology had been approved as an independent (sub)specialty. Colleagues and friends from surrounding countries (Austria, Great Britain, Sweden, Switzerland, and the Netherlands) and also from the US and some eastern countries were either members or regular guests during or between the meetings. Pediatric cardiology is now represented in Germany by specialized practitioners, trainees and assistants who work in both community and university hospitals, and in specialized departments. Due to the foresightedness of the Chief of Pediatrics, Prof. G. Joppich, the first Chair of Pediatric Cardiology was founded in Göttingen in 1960 under the direction of A. Beuren. Another model of interdisciplinary cooperation between pediatric cardiologists, bioengineers, mathematicians and computer scientists was established in Kiel in 1966. In other places

  19. Introduction to pediatric oncology

    SciTech Connect

    McWhirter, W.R.; Masel, J.P.

    1987-01-01

    This book covers the varied and complex aspects of management in pediatric oncology. Emphasis is placed on a team approach and on establishing and maintaining an individualized, humanistic relationships with the patient. Numerous illustrations show modern imaging techniques that are proving most valuable in the investigation of suspected or confirmed childhood cancer. Physical and psychological side effects of short-term and long-term treatment are also discussed.

  20. Pediatric Insomnia.

    PubMed

    Brown, Kelly M; Malow, Beth A

    2016-05-01

    Insomnia in children is complex and frequently multifactorial. This review discusses the major categories of insomnia as well as common causes. The consequences of insomnia, including issues with mood, behavior, and cognition, are discussed. Sleep disorders are much more prevalent in certain pediatric populations, such as children with autism spectrum disorders. The evaluation of insomnia in children includes a focused history and examination and occasionally actigraphy or polysomnography. Behavioral and pharmacological therapies are discussed, as are future directions for research and clinical practice. PMID:26378738

  1. Pediatric radiology

    SciTech Connect

    Silverman, F.N.

    1982-01-01

    A literature review with 186 references of diagnostic pediatric radiology, a speciality restricted to an age group rather than to an organ system or technique of examination, is presented. In the present chapter topics follow the basic organ system divisions with discussions of special techniques within these divisions. The diagnosis of congenital malformations, infectious diseases and neoplasms are a few of the topics discussed for the head and neck region, the vertebrae, the cardiovascular system, the respiratory system, the gastrointestinal tract, the urinary tract, and the skeleton. (KRM)

  2. Pediatric parafalcine empyemas

    PubMed Central

    Niklewski, Franziska; Petridis, Athanasios K.; Al Hourani, Jasmin; Blaeser, Klaus; Ntoulias, Georgios; Bitter, Andrej; Rosenbaum, Thorsten; Scholz, Martin

    2013-01-01

    Subdural intracranial empyemas and brain abscesses are a rare complication of bacterial sinusitis. Pediatric parafalcine abscesses are a rare entity with different treatment compared with other brain abscesses. We present two pediatric cases with falcine abscess as a sinusitis complication and introduce our department’s treatment management. In addition a review of literature is performed. Surgical cases of our department and their management are compared with the current literature. In our cases, both of the children showed a recurrent empyema after the first surgical treatment and antibiotic therapy. A second surgical evacuation was necessary. The antibiotic therapy was given for 3 months. Short-time follow-up imaging is necessary irrespective of infection parameters in blood and patient's clinical condition. Especially in parafalcine abscesses a second look may be an option and surgical treatment with evacuation of pus is the treatment of choice if abscess remnants are visualized. PMID:24964473

  3. Pediatric parafalcine empyemas.

    PubMed

    Niklewski, Franziska; Petridis, Athanasios K; Al Hourani, Jasmin; Blaeser, Klaus; Ntoulias, Georgios; Bitter, Andrej; Rosenbaum, Thorsten; Scholz, Martin

    2013-01-01

    Subdural intracranial empyemas and brain abscesses are a rare complication of bacterial sinusitis. Pediatric parafalcine abscesses are a rare entity with different treatment compared with other brain abscesses. We present two pediatric cases with falcine abscess as a sinusitis complication and introduce our department's treatment management. In addition a review of literature is performed. Surgical cases of our department and their management are compared with the current literature. In our cases, both of the children showed a recurrent empyema after the first surgical treatment and antibiotic therapy. A second surgical evacuation was necessary. The antibiotic therapy was given for 3 months. Short-time follow-up imaging is necessary irrespective of infection parameters in blood and patient's clinical condition. Especially in parafalcine abscesses a second look may be an option and surgical treatment with evacuation of pus is the treatment of choice if abscess remnants are visualized. PMID:24964473

  4. Constraints on the Surface Magnetic Fields and Age of a Cool Hypergiant: XMM-Newton X-Ray Observations of VY CMa

    NASA Astrophysics Data System (ADS)

    Montez, Rodolfo, Jr.; Kastner, Joel H.; Humphreys, Roberta M.; Turok, Rebecca L.; Davidson, Kris

    2015-02-01

    The complex circumstellar ejecta of highly evolved, cool hypergiants are indicative of multiple, asymmetric mass-loss events. To explore whether such episodic, non-isotropic mass loss may be driven by surface magnetic activity, we have observed the archetypical cool hypergiant VY CMa with the XMM-Newton X-ray satellite observatory. The hypergiant itself is not detected in these observations. From the upper limit on the X-ray flux from VY CMa at the time of our observations (F X, UL ≈ 8 × 10-14 erg cm-2 s-1, corresponding to log LX /L bol <= -8), we estimate an average surface magnetic field strength fB <= 2 × 10-3 G (where f is the filling factor of magnetically active surface regions). These X-ray results for VY CMa represent the most stringent constraints to date on the magnetic field strength near the surface of a hypergiant. VY CMa's mass loss is episodic, however, and the hypergiant may have been in a state of low surface magnetic activity during the XMM observations. The XMM observations also yield detections of more than 100 X-ray sources within ~15' of VY CMa, roughly 50 of which have near-infrared counterparts. Analysis of X-ray hardness ratios and IR colors indicates that some of these field sources may be young, late-type stars associated with VY CMa, its adjacent molecular cloud complex, and the young cluster NGC 2362. Further study of the VY CMa field is warranted, given the potential to ascertain the evolutionary timescale of this enigmatic, massive star.

  5. Cytogenetic analyses using C-banding and DAPI/CMA3 staining of four populations of the maize weevil Sitophilus zeamais Motschulsky, 1855 (Coleoptera, Curculionidae)

    PubMed Central

    da Silva, Alexandra A.; Braga, Lucas S.; Guedes, Raul Narciso C.; Tavares, Mara G.

    2015-01-01

    Abstract Cytogenetic data avalaible for the maize weevil Sitophilus zeamais Motschulsky, 1855 (Coleoptera: Curculionidae), one of the most destructive pests of stored cereal grains, are controversial. Earlier studies focused on single populations and emphasized chromosome number and sex determination system. In this paper, the karyotypes of four populations of Sitophilus zeamais were characterized by conventional staining, C-banding and sequential staining with the fluorochromes chromomycin-A3/4-6-diamidino-2-phenylindole (CMA3/DAPI). The analyses of metaphases obtained from the cerebral ganglia of last instar larvae and the testes of adults showed that the species had 2n = 22 chromosomes, with 10 autosomal pairs and a sex chromosome pair (XX in females and Xyp in males). Chromosome number, however, ranged from 2n = 22 to 26 due to the presence of 0–4 supernumerary chromosomes in individuals from the populations of Viçosa, Unai and Porto Alegre. With the exception of the Y chromosome, which was dot-like, all other chromosomes of this species were metacentric, including the supernumeraries. The heterochromatin was present in the centromeric regions of all autosomes and in the centromere of the X chromosome. The B chromosomes were partially or totally heterochromatic, and the Y chromosome was euchromatic. The heterochromatic regions were labeled with C-banding and DAPI, which showed that they were rich in AT base pairs. PMID:25893077

  6. Pediatric tracheomalacia.

    PubMed

    Fraga, Jose Carlos; Jennings, Russell W; Kim, Peter C W

    2016-06-01

    Tracheomalacia (TM) is defined as an increased collapsibility of the trachea due to structural anomalies of the tracheal cartilage and/or posterior membrane. Tracheomalacia has a wide range of etiologies but is most commonly present in children born with esophageal atresia and tracheal esophageal fistula. Clinical symptoms can range from minor expiratory stridor with typical barking cough to severe respiratory distress episodes to acute life-threatening events (ALTE). Although the majority of children have mild-to-moderate symptoms and will not need surgical intervention, some will need life-changing surgical treatment. This article examines the published pediatric literature on TM, discusses the details of clinical presentation, evaluation, diagnosis, and a variety of treatments. PMID:27301602

  7. Adolescent and Pediatric Brain Tumors

    MedlinePlus

    ... abta.org Donate Now Menu Adolescent & Pediatric Brain Tumors Brain Tumors In Children Pediatric Brain Tumor Diagnosis Family ... or Complete our contact form Adolescent & Pediatric Brain Tumors Brain Tumors In Children Pediatric Brain Tumor Diagnosis Family ...

  8. Karyotype analysis of four jewel-beetle species (Coleoptera, Buprestidae) detected by standard staining, C-banding, AgNOR-banding and CMA3/DAPI staining

    PubMed Central

    Karagyan, Gayane; Lachowska, Dorota; Kalashian, Mark

    2012-01-01

    Abstract The male karyotypes of Acmaeodera pilosellae persica Mannerheim, 1837 with 2n=20 (18+neoXY), Sphenoptera scovitzii Faldermann, 1835 (2n=38–46), Dicerca aenea validiuscula Semenov, 1895 – 2n=20 (18+Xyp) and Sphaerobothris aghababiani Volkovitsh et Kalashian, 1998 – 2n=16 (14+Xyp) were studied using conventional staining and different chromosome banding techniques: C-banding, AgNOR-banding, as well as fluorochrome Chromomycin A3 (CMA3) and DAPI. It is shown that C-positive segments are weakly visible in all four species which indicates a small amount of constitutive heterochromatin (CH). There were no signals after DAPI staining and some positive signals were discovered using CMA3 staining demonstrating absence of AT-rich DNA and presence of GC-rich clusters of CH. Nucleolus organizing regions (NORs) were revealed using Ag-NOR technique; argentophilic material mostly coincides with positive signals obtained using CMA3 staining. PMID:24260661

  9. Pediatric diagnostic imaging

    SciTech Connect

    Gyll, C.; Blake, N.S.

    1986-01-01

    This book treats the practical problems of pediatric radiography and radiological procedures. Written jointly by a radiographer and a radiologist, it covers pediatric positioning and procedures. An extended chapter covers neonatal radiography and radiology.

  10. Pediatric Endocrinology Nurses Society

    MedlinePlus

    ... International Welcome to PENS The Pediatric Endocrinology Nursing Society (PENS) is committed to the development and advancement ... PENS@kellencompany.com • Copyright © 2016 Pediatric Endocrinology Nursing Society • ALL RIGHTS RESERVED • Privacy Policy • Admin

  11. "The Show"

    ERIC Educational Resources Information Center

    Gehring, John

    2004-01-01

    For the past 16 years, the blue-collar city of Huntington, West Virginia, has rolled out the red carpet to welcome young wrestlers and their families as old friends. They have come to town chasing the same dream for a spot in what many of them call "The Show". For three days, under the lights of an arena packed with 5,000 fans, the state's best…

  12. Nuclear imaging in pediatrics

    SciTech Connect

    Siddiqui, A.R.

    1985-01-01

    The author's intent is to familiarize practicing radiologists with the technical aspects and interpretation of nuclear medicine procedures in children and to illustrate the indications for nuclear medicine procedures in pediatric problems. Pediatric doses, dosimetry, sedation, and injection techniques, organ systems, oncology and infection, testicular scanning and nuclear crystography, pediatric endocrine and skeletal systems, ventilation and perfusion imaging of both congenital and acquired pediatric disorders, cardiovascular problems, gastrointestinal, hepatobiliary, reticuloendothelial studies, and central nervous system are all topics which are included and discussed.

  13. FS CMa Type Binaries with the B[e] Phenomenon: Towards Solving a Long-standing Puzzle

    NASA Astrophysics Data System (ADS)

    Miroshnichenko, A. S.; Zharikov, S. V.; Manset, N.; Rossi, C.; Polcaro, V. F.

    The B[e] phenomenon is defined as the simultaneous presence of low-excitation forbidden line emission and strong infrared excess in the spectra of early-type stars. It was discovered in our galaxy nearly 40 years ago and is associated with objects at different evolutionary stages, ranging from the pre-main-sequence to the planetary nebula stage. Nearly half of the originally identified group members remained unclassified until recently. Our studies of the unclassified objects resulted in constraining their properties and fundamental parameters, expansion of the group, discovering binary features in many of its members, and suggesting a new name for the group (FS CMa type objects). Nevertheless, the nature of the secondary components and the evolutionary stage of the systems are still unclear. We review the group properties, present the best studied members, and discuss current understanding of the objects nature.

  14. Molecular characterization of constitutive heterochromatin in three species of Trypoxylon (Hymenoptera: Crabronidae: Trypoxylini) by CMA3/DAPI staining

    PubMed Central

    Menezes, Rodolpho Santos Telles; Carvalho, Antonio Freire; Silva, Janisete Gomes; Costa, Marco Antonio

    2011-01-01

    Abstract Previous cytogenetic analyses in Trypoxylon Latreille, 1796 have been basically restricted to C-banding. In the present study, base-specific CMA3 and DAPI fluorochrome staining were used to characterize the constitutive heterochromatin in three Trypoxylon species. The heterochromatin was GC-rich in all the species studied; however, in Trypoxylon nitidum F. Smith, 1856the molecular composition of the heterochromatinwasdifferent among chromosome pairs. Conversely, the euchromatin was AT-rich in the three species. These results suggest high conservatism in the euchromatic regions as opposed to the heterochromatic regions that have a high rate of changes. In this study, we report the karyotype of Trypoxylon rugifrons F. Smith, 1873which has the lowest chromosome number in the genus and other characteristics of the likely ancestral Trypoxylon karyotype. PMID:24260620

  15. Control of coal combustion SO{sub 2} and NO{sub x} emissions by in-boiler injection of CMA. First quarterly project status report, 1 October 1992--31 December 1992

    SciTech Connect

    Levendis, Y.A.; Wise, D.L.

    1992-12-31

    The principal objectives of the proposed research are two-fold: (A) To understand the mechanism and assess the effectiveness of sulfur capture by the chemical calcium magnesium acetate (CMA). And (B) To evaluate the NO{sub x} reduction capabilities of CMA by burning the organic constituents of the chemical (the acetate) and reducing NO to stable N{sub 2} The optimum conditions and the location of CMA introduction in the furnace will be identified. To achieve these goals water solutions of CMA or dry powders of CMA will be injected into hot air or gases simulating the furnace exhaust (containing CO{sub 2}, SO{sub x} NO{sub x}, H{sub 2}O, O{sub 2} etc.) and the composition of gaseous and solid products of the reaction will be monitored. The processes of burning the organic acetate as well as the calcination, sintering and sulfation of the remaining solid will be studied in detail.

  16. Pediatric lymphomas in Brazil

    PubMed Central

    Gualco, Gabriela; Klumb, Claudete E; Barber, Glen N; Weiss, Lawrence M; Bacchi, Carlos E

    2010-01-01

    OBJECTIVE: This study provides the clinical pathological characteristics of 1301 cases of pediatric/adolescent lymphomas in patients from different geographic regions of Brazil. METHODS: A retrospective analyses of diagnosed pediatric lymphoma cases in a 10‐year period was performed. We believe that it represents the largest series of pediatric lymphomas presented from Brazil. RESULTS: Non‐Hodgkin lymphomas represented 68% of the cases, including those of precursor (36%) and mature (64%) cell origin. Mature cell lymphomas comprised 81% of the B‐cell phenotype and 19% of the T‐cell phenotype. Hodgkin lymphomas represented 32% of all cases, including 87% of the classical type and 13% of nodular lymphocyte predominant type. The geographic distribution showed 38.4% of the cases in the Southeast region, 28.7% in the Northeast, 16.1% in the South, 8.8% in the North, and 8% in the Central‐west region. The distribution by age groups was 15–18 years old, 33%; 11–14 years old, 26%; 6–10 years old, 24%; and 6 years old or younger, 17%. Among mature B‐cell lymphomas, most of the cases were Burkitt lymphomas (65%), followed by diffuse large B‐cell lymphomas (24%). In the mature T‐cell group, anaplastic large cell lymphoma, ALK‐positive was the most prevalent (57%), followed by peripheral T‐cell lymphoma, then not otherwise specified (25%). In the group of classic Hodgkin lymphomas, the main histological subtype was nodular sclerosis (76%). Nodular lymphocyte predominance occurred more frequently than in other series. CONCLUSION: Some of the results found in this study may reflect the heterogeneous socioeconomical status and environmental factors of the Brazilian population in different regions. PMID:21340214

  17. Evaluation of histone 3 lysine 27 trimethylation (H3K27me3) and enhancer of Zest 2 (EZH2) in pediatric glial and glioneuronal tumors shows decreased H3K27me3 in H3F3A K27M mutant glioblastomas.

    PubMed

    Venneti, Sriram; Garimella, Mihir T; Sullivan, Lisa M; Martinez, Daniel; Huse, Jason T; Heguy, Adriana; Santi, Mariarita; Thompson, Craig B; Judkins, Alexander R

    2013-09-01

    H3F3A mutations are seen in ∼30% of pediatric glioblastoma (GBMs) and involve either the lysine residue at position 27 (K27M) or glycine at position 34 (G34R/V). Sixteen genes encode histone H3, each variant differing in only a few amino acids. Therefore, how mutations in a single H3 gene contribute to carcinogenesis is unknown. H3F3A K27M mutations are predicted to alter methylation of H3K27. H3K27me3 is a repressive mark critical to stem cell maintenance and is mediated by EZH2, a member of the polycomb-group (PcG) family. We evaluated H3K27me3 and EZH2 expression using immunohistochemistry in 76 pediatric brain tumors. H3K27me3 was lowered/absent in tumor cells but preserved in endothelial cells and infiltrating lymphocytes in six out of 20 GBMs. H3K27me3 showed strong immunoreactivity in all other tumor subtypes. Sequencing of GBMs showed H3F3A K27M mutations in all six cases with lowered/absent H3K27me3. EZH2 expression was high in GBMs, but absent/focal in other tumors. However, no significant differences in EZH2 expression were observed between H3F3A K27M mutant and wild type GBMs, suggesting that EZH2 mediated trimethylation of H3K27 is inhibited in GBM harboring K27M mutations. Our results indicate that H3F3A K27M mutant GBMs show decreased H3K27me3 that may be of both diagnostic and biological relevance. PMID:23414300

  18. A Search for X-Ray Evidence of a Compact Companion to the Unusual Wolf-Rayet Star HD 50896 (EZ CMa)

    NASA Technical Reports Server (NTRS)

    Skinner, Stephen L.; Itoh, Masayuki; Nagase, Fumiaki

    1998-01-01

    We analyze results of a approx.25 ksec ASCA X-ray observation of the unusual Wolf-Rayet star HD 50896 (= EZ CMa). This WN5 star shows optical and ultraviolet variability at a 3.766 day period, which has been interpreted as a possible signature of a compact companion. Our objective was to search for evidence of hard X-rays (greater than or equal to 5 keV) which could be present if the WN5 wind is accreting onto a compact object. The ASCA spectra are dominated by emission below 5 keV and show no significant emission in the harder 5-10 keV range. Weak emission lines are present, and the X-rays arise in an optically thin plasma which spans a range of temperatures from less than or equal to 0.4 keV up to at least approx. 2 keV. Excess X-ray absorption above the interstellar value is present, but the column density is no larger than N(sub H) approx. 10(exp 22)/sq cm. The absorption-corrected X-ray luminosity L(sub x)(0.5 - 10 keV) = 10(exp 32.85) erg/s gives L(sub x)/ L(sub bol) approx. 10(exp -6), a value that is typical of WN stars. No X-ray variability was detected. Our main conclusion is that the X-ray properties of HD 50896 are inconsistent with the behavior expected for wind accretion onto a neutron star or black hole companion. Alternative models based on wind shocks can explain most aspects of the X-ray behavior, and we argue that the hotter plasma near approx. 2 keV could be due to the WR wind shocking onto a normal (nondegenerate) companion.

  19. [Acquired immunodeficiency syndrome in pediatric patients].

    PubMed

    Molina Moguel, J L; Ruiz Illezcas, R; Forsbach Sánchez, S; Carreño Alvarez, S; Picco Díaz, I

    1990-12-01

    The object of this study was to determine how many of the patients treated at the Pediatric Odontology Clinic, a branch of the Maxillo-Facial Surgery Service at the Veinte de Noviembre Regional Hospital, ISSSTE, are VIH-positive of show serious manifestations of Acquired Immuno-Deficiency Syndrome (AIDS). For such purpose, 100 pediatric patients suffering from different systemic or local diseases were evaluated, the most common being hematological alterations. Results evidenced the presence of VIH in the blood of five of the pediatric subjects, all suffering from Hemophilia. PMID:2132469

  20. Antibody Therapy for Pediatric Leukemia

    PubMed Central

    Vedi, Aditi; Ziegler, David S.

    2014-01-01

    Despite increasing cure rates for pediatric leukemia, relapsed disease still carries a poor prognosis with significant morbidity and mortality. Novel targeted therapies are currently being investigated in an attempt to reduce adverse events and improve survival outcomes. Antibody therapies represent a form of targeted therapy that offers a new treatment paradigm. Monoclonal antibodies are active in pediatric acute lymphoblastic leukemia (ALL) and are currently in Phase III trials. Antibody-drug conjugates (ADCs) are the next generation of antibodies where a highly potent cytotoxic agent is bound to an antibody by a linker, resulting in selective targeting of leukemia cells. ADCs are currently being tested in clinical trials for pediatric acute myeloid leukemia and ALL. Bispecific T cell engager (BiTE) antibodies are a construct whereby each antibody contains two binding sites, with one designed to engage the patient’s own immune system and the other to target malignant cells. BiTE antibodies show great promise as a novel and effective therapy for childhood leukemia. This review will outline recent developments in targeted agents for pediatric leukemia including monoclonal antibodies, ADCs, and BiTE antibodies. PMID:24795859

  1. Declaring pediatric brain death: current practice in a Canadian pediatric critical care unit.

    PubMed Central

    Parker, B L; Frewen, T C; Levin, S D; Ramsay, D A; Young, G B; Reid, R H; Singh, N C; Gillett, J M

    1995-01-01

    OBJECTIVE: To document the criteria used to declare brain death in a pediatric critical care unit (PCCU). DESIGN: Retrospective chart review. SETTING: Regional PCCU in southwestern Ontario. PATIENTS: Sixty patients 16 years of age or less declared brain dead from January 1987 through December 1992. OUTCOME MEASURES: Presence or absence of documentation of irreversible deep coma, nonresponsive cranial nerves, absent brain-stem reflexes, persistent apnea after removal from ventilator, presence or absence of blood flow detected by radioisotope scanning, presence or absence of electroencephalographic evidence of electrocerebral activity. RESULTS: The 60 patients accounted for 1.5% of all PCCU admissions; 17 were under 1 year of age. In 39 cases brain death was diagnosed using clinical criteria ("certified brain death"), which could not be fully applied in the remaining 21 cases ("uncertifiable but suspected brain death"). Electroencephalography and cerebral blood-flow studies with technetium-99m hexamethyl-propyleneamine oxime were used as ancillary tests in 16 patients with certified brain death and in 17 with uncertifiable but suspected brain death who survived long enough to be tested. Electrocerebral silence was demonstrated in all nine patients who underwent electroencephalography. Cerebral blood flow was undetectable in 26 of the 30 patients tested, and an abnormal pattern of blood flow was seen in the remaining 4, all of whom received a diagnosis of certified brain death. CONCLUSIONS: Pediatricians in this large tertiary care referral centre are using clinical criteria based on the 1987 guidelines of the CMA to diagnose brain death in pediatric patients, including neonates. When clinical criteria cannot be fully applied, ancillary methods of investigation are consistently used. Although the soundness of this pattern of practice is established for adults and older children, its applicability to neonates and infants still needs to be validated. PMID:7553492

  2. Pediatric Hand Injuries.

    PubMed

    Sullivan, Matthew A; Cogan, Charles J; Adkinson, Joshua M

    2016-01-01

    Pediatric hand injuries are extremely common. Although many hand injuries are adequately managed in the emergency department, some may need evaluation and treatment by a pediatric hand surgeon to ensure a good functional outcome. This article discusses the diagnosis and management of the most common pediatric hand maladies: fingertip injuries/amputation, tendon injuries, and phalangeal and metacarpal fractures. The plastic surgery nurse should be familiar with hand injuries that require intervention to facilitate efficient management and optimal postoperative care. PMID:27606586

  3. Myocarditis - pediatric

    MedlinePlus

    ... and rashes. A chest x-ray can show enlargement (swelling) of the heart. If the health care ... Enlargement of the heart that leads to reduced heart function (dilated cardiomyopathy) Heart failure Heart rhythm problems

  4. Pediatric Cardiovascular Drug Trials, Lessons Learned

    PubMed Central

    Li, Jennifer S.; Cohen-Wolkowiez, Michael; Pasquali, Sara K.

    2011-01-01

    Few drugs have been labeled for pediatric cardiovascular indications and many children with cardiac disease are prescribed drugs off-label. Recent initiatives have narrowed this gap and as a result there are an increasing number of cardiology trials in the pediatric population. Many studies, however, have either failed to show a dose response in children or have not shown efficacy in children when they have established efficacy in adults. Clinical trials are challenging in children; many factors such as lack of development of a liquid formulation, failure to fully incorporate pharmacokinetic information into trial design, poor dose selection, the lack of clinical equipoise, and the use of difficult surrogate and composite primary endpoints have led to the difficulties and failures observed in several pediatric cardiovascular trials. These lessons learned may help to inform future pediatric clinical trial development. PMID:21242809

  5. Musculoskeletal Ultrasound in Pediatrics.

    PubMed

    Harcke, H. Theodore

    1998-01-01

    Ultrasound is ideally suited to the evaluation of the pediatric musculoskeletal system because of the increased ratio of cartilage to bone in the immature skeleton. The purpose of this article is to review the current uses of musculoskeletal ultrasound in pediatric patients. Hip sonography is widely accepted; other applications are increasing in popularity. PMID:11387111

  6. Pediatric Odontogenic Tumors.

    PubMed

    Abrahams, Joshua M; McClure, Shawn A

    2016-02-01

    Pediatric odontogenic tumors are rare, and are often associated with impacted teeth. Although they can develop anywhere in the jaws, odontogenic tumors mainly occur in the posterior mandible. This article discusses the diagnosis and treatment of the most common pediatric odontogenic tumors, such as ameloblastoma, keratocystic odontogenic tumor, odontoma, and cementoblastoma. PMID:26614700

  7. Teaching Prevention in Pediatrics.

    ERIC Educational Resources Information Center

    Cheng, Tina L.; Greenberg, Larrie; Loeser, Helen; Keller, David

    2000-01-01

    Reviews methods of teaching preventive medicine in pediatrics and highlights innovative programs. Methods of teaching prevention in pediatrics include patient interactions, self-directed learning, case-based learning, small-group learning, standardized patients, computer-assisted instruction, the Internet, student-centered learning, and lectures.…

  8. Pediatric Salivary Gland Malignancies.

    PubMed

    Ord, Robert A; Carlson, Eric R

    2016-02-01

    Pediatric malignant salivary gland tumors are extremely rare. The percentage of malignant tumors is higher than that seen in adults, although the outcomes in terms of survival are better in pediatric patients. The mainstay of treatment is surgical excision with negative margins. This article reviews current concepts in demographics, etiology, management, and outcomes of malignant salivary tumors in children. PMID:26614703

  9. Pediatric Care Online: A Pediatric Point-of-Care Tool.

    PubMed

    Vardell, Emily

    2016-01-01

    Pediatric Care Online is the American Academy of Pediatrics' point-of-care tool designed for health care providers. Pediatric Care Online builds on content from Red Book Online and Pediatric Patient Education and features Quick Reference topic pages for more than 250 pediatric health care topics. The multitude of resources available within Pediatric Care Online will be reviewed in this column, and a sample search will be used to illustrate the type of information available within this point-of-care pediatric resource. PMID:27054536

  10. Approaches to enhancing the quality of drug therapy. A joint statement by the CMA and the Canadian Pharmaceutical Association. Canadian Medical Association.

    PubMed Central

    1996-01-01

    This joint statement was developed by the CMA and the Canadian Pharmaceutical Association, a national association of pharmacists, and includes the goal of drug therapy, strategies for collaboration to optimize drug therapy and physicians' and pharmacists' responsibilities in drug therapy. The statement recognizes the importance of patients, physicians and pharmacists working in close collaboration and partnership to achieve optimal outcomes from drug therapy. PMID:8823225

  11. Primary Immunodeficiency May Be Misdiagnosed as Cow's Milk Allergy: Seven Cases Referred to a Tertiary Pediatric Hospital

    PubMed Central

    Melo, Karina Mescouto; Dantas, Ellen; De Moraes-Pinto, Maria Isabel; Condino-Neto, Antonio; Gonzalez, Isabela G. S.; Mallozi, Marcia C.; Franco, Jackeline M.; Costa-Carvalho, Beatriz T.

    2013-01-01

    Introduction. The presence of eczema and gastrointestinal manifestations are often observed in cow's milk allergy (CMA) and also in some primary immunodeficiency diseases (PID). Objective. To describe 7 patients referred to a tertiary allergy/immunology Center with a proposed diagnosis of CMA, who were ultimately diagnosed with PID. Methods. This was a retrospective study based on clinical and laboratory data from medical records. Results. Seven patients (6 males) aged between 3 mo and 6 y were referred to our clinic with a proposed diagnosis of CMA. They presented with eczema and/or gastrointestinal symptoms. Five were receiving replacement formula. All patients presented with other clinical features, including severe/recurrent infections unrelated to CMA, and two of them had a positive family history of PID. Laboratory tests showed immune system dysfunctions in all patients. Hyper-IgE and Wiskott-Aldrich syndromes, CD40L deficiency, severe combined immunodeficiency, X-linked agammaglobulinemia, transient hypogammaglobulinemia of infancy, and chronic granulomatous disease were diagnosed in these children. In conclusion, allergic diseases and immunodeficiency are a result of a different spectrum of abnormalities in the immune system and may be misdiagnosed. Educational programs on PID among clinical physicians and pediatricians can reduce the occurrence of this misdiagnosis. PMID:24198970

  12. Control of coal combustion SO{sub 2} and NO{sub x} emissions by in-boiler injection of CMA. Second quarterly project status report, 1 April 1993--30 June 1993

    SciTech Connect

    Levendis, Y.A.; Wise, D.L.

    1993-09-01

    Objectives of the proposed research are two-fold: (A) To understand the mechanism and assess the effectiveness of sulfur capture by the chemical calcium magnesium acetate (CMA); and (B) To evaluate the NO{sub x} reduction capabilities of CMA by pyrolyzing the organic constituents of the chemical (the acetate) and reducing NO to stable N{sub 2}. The optimum conditions and the location of CMA introduction in the furnace will be identified. Water solutions of CMA or dry powders of CMA will be injected into hot air or gases simulating the furnace exhaust (containing CO{sub 2}, SO{sub x} NO{sub x} H{sub 2}O, O{sub 2} etc.) and the composition of gaseous and solid products of the reaction will be monitored. The processes of burning the organic acetate as well as the calcination, sintering and sulfation of the remaining solid will be studied. The effectiveness of ``homemade`` CMAs containing various amounts of calcium and magnesium will be investigated to explore the role of the two chemicals in the NO{sub x} and mainly the SO{sub 2} capture processes. CMA will be introduced in the matrix of coal particles by an ion exchange technique. Upon subsequent combustion, the SO{sub 2}-NO{sub x} emissions will be monitored and compared to those from burning untreated coal. The composition and physical structure of the ash residues will also be examined.

  13. Pediatric Multiple Sclerosis.

    PubMed

    Lee, Ji Y; Chitnis, Tanuja

    2016-04-01

    Pediatric multiple sclerosis (MS) is a chronic inflammatory neurologic disease that is challenging to diagnose and treat. Although there are many clinical parallels between pediatric-onset MS and adult-onset MS, there is also accumulating evidence of distinguishing clinical features that may, in part, arise from development-specific, neuroimmune processes governing MS pathogenesis in children. Here the authors describe the clinical features, diagnosis, and treatment of pediatric MS, with a particular focus on describing clinical features and highlighting new developments that promise a better understanding of pediatric MS pathogenesis. An important task that lies ahead for pediatric neurologists is better understanding the early gene-environment interaction that precipitates the first demyelinating event in pediatric MS. This area is of particular importance for understanding the MS etiology and the natural history of pediatric MS. Such understanding should in turn inform new developments in diagnostic tools, long-term therapies, and much-needed biomarkers. Such biomarkers are not only valuable for defining the disease onset, but also for monitoring both the treatment response and a disease evolution that spans multiple decades in children with MS. PMID:27116721

  14. Pediatric ventricular assist devices.

    PubMed

    Adachi, Iki; Burki, Sarah; Zafar, Farhan; Morales, David Luis Simon

    2015-12-01

    The domain of pediatric ventricular assist device (VAD) has recently gained considerable attention. Despite the fact that, historically, the practice of pediatric mechanical circulatory support (MCS) has lagged behind that of adult patients, this gap between the two groups is narrowing. Currently, the Berlin EXCOR VAD is the only pediatric-specific durable VAD approved by the U.S Food and Drug Administration (FDA). The prospective Berlin Heart trial demonstrated a successful outcome, either bridge to transplantation (BTT), or in rare instances, bridge to recovery, in approximately 90% of children. Also noted during the trial was, however, a high incidence of adverse events such as embolic stroke, bleeding and infection. This has incentivized some pediatric centers to utilize adult implantable continuous-flow devices, for instance the HeartMate II and HeartWare HVAD, in children. As a result of this paradigm shift, the outlook of pediatric VAD support has dramatically changed: Treatment options previously unavailable to children, including outpatient management and even destination therapy, have now been becoming a reality. The sustained demand for continued device miniaturization and technological refinements is anticipated to extend the range of options available to children-HeartMate 3 and HeartWare MVAD are two examples of next generation VADs with potential pediatric application, both of which are presently undergoing clinical trials. A pediatric-specific continuous-flow device is also on the horizon: the redesigned Infant Jarvik VAD (Jarvik 2015) is undergoing pre-clinical testing, with a randomized clinical trial anticipated to follow thereafter. The era of pediatric VADs has begun. In this article, we discuss several important aspects of contemporary VAD therapy, with a particular focus on challenges unique to the pediatric population. PMID:26793341

  15. Pediatric ventricular assist devices

    PubMed Central

    Burki, Sarah; Zafar, Farhan; Morales, David Luis Simon

    2015-01-01

    The domain of pediatric ventricular assist device (VAD) has recently gained considerable attention. Despite the fact that, historically, the practice of pediatric mechanical circulatory support (MCS) has lagged behind that of adult patients, this gap between the two groups is narrowing. Currently, the Berlin EXCOR VAD is the only pediatric-specific durable VAD approved by the U.S Food and Drug Administration (FDA). The prospective Berlin Heart trial demonstrated a successful outcome, either bridge to transplantation (BTT), or in rare instances, bridge to recovery, in approximately 90% of children. Also noted during the trial was, however, a high incidence of adverse events such as embolic stroke, bleeding and infection. This has incentivized some pediatric centers to utilize adult implantable continuous-flow devices, for instance the HeartMate II and HeartWare HVAD, in children. As a result of this paradigm shift, the outlook of pediatric VAD support has dramatically changed: Treatment options previously unavailable to children, including outpatient management and even destination therapy, have now been becoming a reality. The sustained demand for continued device miniaturization and technological refinements is anticipated to extend the range of options available to children—HeartMate 3 and HeartWare MVAD are two examples of next generation VADs with potential pediatric application, both of which are presently undergoing clinical trials. A pediatric-specific continuous-flow device is also on the horizon: the redesigned Infant Jarvik VAD (Jarvik 2015) is undergoing pre-clinical testing, with a randomized clinical trial anticipated to follow thereafter. The era of pediatric VADs has begun. In this article, we discuss several important aspects of contemporary VAD therapy, with a particular focus on challenges unique to the pediatric population. PMID:26793341

  16. Genetic pediatric retinal diseases

    PubMed Central

    Say, Emil Anthony T.

    2014-01-01

    Hereditary pediatric retinal diseases are a diverse group of disorders with pathologies affecting different cellular structures or retinal development. Many can mimic typical pediatric retinal disease such as retinopathy of prematurity, vitreous hemorrhage, retinal detachment and cystoid macular edema. Multisystem involvement is frequently seen in hereditary pediatric retinal disease. A thorough history coupled with a good physical examination can oftentimes lead the ophthalmologist or pediatrician to the correct genetic test and correct diagnosis. In some instances, evaluation of parents or siblings may be required to determine familial involvement when the history is inconclusive or insufficient and clinical suspicion is high.

  17. Pediatric autonomic disorders.

    PubMed

    Axelrod, Felicia B; Chelimsky, Gisela G; Weese-Mayer, Debra E

    2006-07-01

    The scope of pediatric autonomic disorders is not well recognized. The goal of this review is to increase awareness of the expanding spectrum of pediatric autonomic disorders by providing an overview of the autonomic nervous system, including the roles of its various components and its pervasive influence, as well as its intimate relationship with sensory function. To illustrate further the breadth and complexities of autonomic dysfunction, some pediatric disorders are described, concentrating on those that present at birth or appear in early childhood. PMID:16818580

  18. Patterns of Pediatric Maxillofacial Injuries.

    PubMed

    Bede, Salwan Yousif Hanna; Ismael, Waleed Khaleel; Al-Assaf, Dhuha

    2016-05-01

    Facial trauma in children and adolescents is reported to range from 1% to 30%. Because of many anatomical, physiological, and psychological characteristics of the pediatric population, maxillofacial injuries in children should be treated with special consideration that is attributable to certain features inherent in facial growth patterns of children. This study evaluated maxillofacial injuries in 726 children in terms of incidence, patterns of injury, causes, and treatment modalities and compared these parameters among 3 pediatric age groups. Intergroup differences were analyzed using Z test for 2 populations' proportion. The results showed that the incidence of pediatric maxillofacial injuries and fractures is higher than that reported elsewhere with male predominance. Soft tissue injuries are more frequently encountered in younger individuals, whereas the incidence of skeletal injuries increases with age. This study also revealed that certain etiologies, namely road traffic accidents, violence, bicycle, missiles, and industrial injures, increase with age; on the other hand, falls and puncture wounds are more common in younger children. PMID:27100637

  19. American Academy of Pediatrics

    MedlinePlus

    ... Bright Futures Medical Home Clinical Support Pediatric Care Online Patient Education Online Bright Futures Medical Home Connected Kids Red Book ... Finding a Job Career Support Professional Education PediaLink/Online Education Maintenance of Certification Professional Education Publications MOC | ...

  20. Imaging Pediatric Vascular Lesions.

    PubMed

    Nguyen, Tuyet A; Krakowski, Andrew C; Naheedy, John H; Kruk, Peter G; Friedlander, Sheila Fallon

    2015-12-01

    Vascular anomalies are commonly encountered in pediatric and dermatology practices. Most of these lesions are benign and easy to diagnose based on history and clinical exam alone. However, in some cases the diagnosis may not be clear. This may be of particular concern given that vascular anomalies may occasionally be associated with an underlying syndrome, congenital disease, or serious, life-threatening condition. Defining the type of vascular lesion early and correctly is particularly important to determine the optimal approach to management and treatment of each patient. The care of pediatric patients often requires collaboration from a multitude of specialties including pediatrics, dermatology, plastic surgery, radiology, ophthalmology, and neurology. Although early characterization of vascular lesions is important, consensus guidelines regarding the evaluation and imaging of vascular anomalies does not exist to date. Here, the authors provide an overview of pediatric vascular lesions, current classification systems for characterizing these lesions, the various imaging modalities available, and recommendations for appropriate imaging evaluation. PMID:26705446

  1. Pediatric oncology in Pakistan.

    PubMed

    Ashraf, Muhammad Shamvil

    2012-03-01

    Pediatric oncology in Pakistan has developed over last decade with substantial increase in the facility for treatment and number of expertise. Though large numbers of children still do not reach treatment center more children have now access to quality cancer treatment. There has been gradual improvement in Pediatric oncology nursing and allied services. Pediatric Palliative care in Pakistan is in initial phase of development. Pediatric Oncology services are largely supported by philanthropists. Children Cancer Hospital a project of Children Cancer Foundation Pakistan Trust is not only providing quality treatment to every child regardless of paying ability but also playing a pivotal role in capacity building and creating awareness about childhood cancer in Pakistan. PMID:22357147

  2. Pediatric Brain Tumor Foundation

    MedlinePlus

    ... you insights into your child's treatment. LEARN MORE Brain tumors and their treatment can be deadly so ... to make progress in “immunogenomics” Read more >> Pediatric Brain Tumor Foundation 302 Ridgefield Court, Asheville, NC 28806 ...

  3. Imaging Pediatric Vascular Lesions

    PubMed Central

    Nguyen, Tuyet A.; Krakowski, Andrew C.; Naheedy, John H.; Kruk, Peter G.

    2015-01-01

    Vascular anomalies are commonly encountered in pediatric and dermatology practices. Most of these lesions are benign and easy to diagnose based on history and clinical exam alone. However, in some cases the diagnosis may not be clear. This may be of particular concern given that vascular anomalies may occasionally be associated with an underlying syndrome, congenital disease, or serious, life-threatening condition. Defining the type of vascular lesion early and correctly is particularly important to determine the optimal approach to management and treatment of each patient. The care of pediatric patients often requires collaboration from a multitude of specialties including pediatrics, dermatology, plastic surgery, radiology, ophthalmology, and neurology. Although early characterization of vascular lesions is important, consensus guidelines regarding the evaluation and imaging of vascular anomalies does not exist to date. Here, the authors provide an overview of pediatric vascular lesions, current classification systems for characterizing these lesions, the various imaging modalities available, and recommendations for appropriate imaging evaluation. PMID:26705446

  4. Pediatric heart surgery - discharge

    MedlinePlus

    ... reduced appetite Alternate Names Congenital heart surgery - discharge; Patent ductus arteriosus ligation - discharge; Hypoplastic left heart repair - ... of the aorta Congenital heart defect - corrective surgery Patent ductus arteriosus Pediatric heart surgery Tetralogy of Fallot ...

  5. Pediatric Celiac Disease

    MedlinePlus

    ... Sprue Association/USA Gluten Intoloerance Group of North America NASPGHAN Foundation Supporters Educational support for the NASPGHAN ... NASPGHAN) Celiac Disease Eosinophilic Esophagitis Pediatric IBD Nutrition & Obesity Reflux & GERD Research & Grants Our Supporters Site Map © ...

  6. Pediatric heart surgery

    MedlinePlus

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... after the baby is born. For others, your child may be able to safely wait for months ...

  7. NIH Pediatric Rheumatology Clinic

    MedlinePlus

    ... patients without discrimination on the basis of race, religion, ethnic group, citizenship, or residence. We can provide ... studies to help understand pediatric rheumatic diseases. Natural history studies, for example, are designed to study how ...

  8. Pediatric liver transplantation

    PubMed Central

    Spada, Marco; Riva, Silvia; Maggiore, Giuseppe; Cintorino, Davide; Gridelli, Bruno

    2009-01-01

    In previous decades, pediatric liver transplantation has become a state-of-the-art operation with excellent success and limited mortality. Graft and patient survival have continued to improve as a result of improvements in medical, surgical and anesthetic management, organ availability, immunosuppression, and identification and treatment of postoperative complications. The utilization of split-liver grafts and living-related donors has provided more organs for pediatric patients. Newer immunosuppression regimens, including induction therapy, have had a significant impact on graft and patient survival. Future developments of pediatric liver transplantation will deal with long-term follow-up, with prevention of immunosuppression-related complications and promotion of as normal growth as possible. This review describes the state-of-the-art in pediatric liver transplantation. PMID:19222089

  9. A correlation analysis of Broselow™ Pediatric Emergency Tape-determined pediatric weight with actual pediatric weight in India

    PubMed Central

    Mishra, Deepak Geetaprasad; Kole, Tamorish; Nagpal, Rahul; Smith, Jeffery Paul

    2016-01-01

    BACKGROUND: The Broselow™ Pediatric Emergency Tape indicates standardized, pre-calculated medication doses, dose delivery volumes, and equipment sizes using color-coded zones based on height-weight correlations. The present study attempted to provide more evidence on the effectiveness of the Broselow™ Pediatric Emergency Tape by comparing the tape-estimated weights with actual weights. We hypothesized that the Broselow™ Pediatric Emergency Tape would overestimate weights in Indian children aged<10 years, leading to inaccurate dosing and equipment sizing in the emergency setting. METHODS: This prospective study of pediatric patients aged <10 years who were divided into three groups based on actual body weight: <10 kg, 10–18 kg, and >18 kg. We calculated the percentage difference between the Broselow-predicted weight and the measured weight as a measure of tape bias. Concordant results were those with a mean percent difference within 3%. Standard deviation was measured to determine precision. Accuracy was determined as color-coded zone prediction and measured weight concordance, including the percentage overestimation by 1–2 zones. RESULTS: The male-to-female ratio of the patients was 1.3:1. Total agreement between color-coding was 63.18% (κ=0.582). The Broselow™ color-coded zone agreement was 74.8% in the <10 kg group, 61.24% in the 10–18 kg group, and 53.42% in the >18 kg group. CONCLUSIONS: The Broselow™ Pediatric Emergency Tape showed good evidence for being more reliable in children of the <10 kg and 10–18 kg groups. However, as pediatric weight increased, predictive reliability decreased. This raises concerns over the use of the Broselow™ Pediatric Emergency Tape in Indian children because body weight was overestimated in those weighing >18 kg. PMID:27006737

  10. Integrative Nutrition for Pediatrics.

    PubMed

    Erlichman, Jessi; Hall, Amanda; Dean, Amy; Godwin, Bridget; Mascarenhas, Maria

    2016-06-01

    Food is essential for life. Yet, poor food choices may cause poor health. Dietary manipulation is frequently integrated into the management of common chronic pediatric conditions. Parents seek dietary information to have more control over child's condition and to avoid side effects of medicine. This article reviews selected diets for a few common pediatric disorders including eczema, attention deficit hyperactivity disorder, headache and migraine, non-celiac gluten sensitivity, and irritable bowel syndrome. PMID:26832886

  11. Pediatric nuclear medicine

    SciTech Connect

    Treves, S.T.

    1985-01-01

    This book discusses the diagnostic techniques of nuclear medicine as applied in pediatric patients. Particular emphasis is placed on the subject of scintigraphy of organ systems for diagnostic purposes. The topics covered are: scintigraphy of skeleton, bone marrow spleen, liver, thyroid, lungs, urinary tract, brain, heart and cerebrospinal fluid. The pathology and scintigraphy of lacrimal glands is also covered. Other diagnostic techniques of radiology in pediatrics are also briefly discussed for comparative evaluation.

  12. Correlative pediatric imaging

    SciTech Connect

    Garty, I.; Delbeke, D.; Sandler, M.P.

    1989-01-01

    Nuclear medicine, ultrasound, and magnetic resonance imaging (MRI) are considered ideal imaging modalities for pediatric patients. The future is even more promising for pediatric imaging with the development of newer and improved radiopharmaceuticals, instrumentation and diagnostic modalities such as positron emission tomography, labeled monoclonal antibodies, and faster dynamic and contrast enhanced MRI methods. However, correlation of more conventional imaging modalities with nuclear medicine, ultrasound and MRI remain essential for optimal patient care. 43 references.

  13. Pediatric Open Fractures.

    PubMed

    Trionfo, Arianna; Cavanaugh, Priscilla K; Herman, Martin J

    2016-07-01

    Open fractures in children are rare and are typically associated with better prognoses compared with their adult equivalents. Regardless, open fractures pose a challenge because of the risk of healing complications and infection, leading to significant morbidity even in the pediatric population. Therefore, the management of pediatric open fractures requires special consideration. This article comprehensively reviews the initial evaluation, classification, treatment, outcomes, and controversies of open fractures in children. PMID:27241379

  14. Pediatric upper gastrointestinal studies.

    PubMed

    Odgren, Mike

    2014-01-01

    Upper gastrointestinal examinations are common procedures in many radiology departments. Performing this examination on pediatric patients requires understanding the formation of the gastrointestinal tract and the various disease processes and anatomical variances that can occur. The examination also requires a thorough patient history. This article discusses embryologic development and anatomy of the small bowel and colon, disease processes and conditions of the upper gastrointestinal tract, and fluoroscopic upper gastrointestinal tract examinations performed on the pediatric and neonatal patient. PMID:24806054

  15. Control of coal combustion SO{sub 2} and NO{sub x} emissions by in-boiler injection of CMA. Fourth quarterly project status report, 1 July 1993--30 September 1993

    SciTech Connect

    Levendis, Y.A.; Wise, D.L.

    1993-12-01

    CMA, has demonstrated exceptional effectiveness in our laboratory as an in-boiler SO{sub 2} removal agent (Levendis, et al., 1993). This is due to the affinity of the calcium component of CMA for sulfur; the reaction results in solid sulfate salts. The current investigation explored the role of the organic component of CMA, as well as that in CA and CB, in removing the NO{sub x} emissions in the post-flame region of pulverized coal or residual oil-fired furnaces. This work was based on high-temperature laboratory-bench experiments under temperatures and oxygen concentrations similar to those found in commercial furnaces. The gas temperatures ranged from 450 to 1450{degrees}C and oxygen concentration varied from 0 to 5%. The residence time was in the order of 4 s. Injection of the CMA reagent at a mass ratio of CMA/NO of 41 (or an equivalent acetate/NO molar ratio of 17) reduced NO by more than 90% (at 0% O{sub 2} and temperatures above 850{degrees}C) to 50% (at 5% O{sub 2} and 650 to 850{degrees}C). At an oxygen concentration of 2%, NO reduction seemed to be most effective between 1000 and 1350{degrees}C with NO reductions of 70 to 80%. The efficacy of calcium acetate (CA) and calcium benzoate (CB) as NO{sub x} reducers was also explored, with CA (CA/NO mass ratio of 41 and acetate/NO molar ratio of 16) being less efficient than CMA with oxygen present but as efficient in 0% oxygen. CB (CB/NO mass ratio of 41 with benzoic acid/NO molar ratio of 9) was a-s efficient as CMA, regardless of O{sub 2} concentration, but at temperatures 300 to 450{degrees}C higher.

  16. Pediatric integrative medicine: pediatrics' newest subspecialty?

    PubMed Central

    2012-01-01

    Background Integrative medicine is defined as relationship-centered care that focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing, including evidence-based complementary and alternative medicine. Pediatric integrative medicine (PIM) develops and promotes this approach within the field of pediatrics. We conducted a survey to identify and describe PIM programs within academic children’s hospitals across North America. Key barriers and opportunities were identified for the growth and development of academic PIM initiatives in the US and Canada. Methods Academic PIM programs were identified by email and eligible for inclusion if they had each of educational, clinical, and research activities. Program directors were interviewed by telephone regarding their clinical, research, educational, and operational aspects. Results Sixteen programs were included. Most (75%) programs provided both inpatient and outpatient services. Seven programs operated with less than 1 FTE clinical personnel. Credentialing of complementary and alternative medicine (CAM) providers varied substantially across the programs and between inpatient and outpatient services. Almost all (94%) programs offered educational opportunities for residents in pediatrics and/or family medicine. One fifth (20%) of the educational programs were mandatory for medical students. Research was conducted in a range of topics, but half of the programs reported lack of research funding and/or time. Thirty-one percent of the programs relied on fee-for-service income. Conclusions Pediatric integrative medicine is emerging as a new subspecialty to better help address 21st century patient concerns. PMID:22894682

  17. Pediatric Electrocardiographic Imaging (ECGI) Applications

    PubMed Central

    Silva, Jennifer N. A.

    2014-01-01

    Summary Noninvasive electrocardiographic imaging (ECGI) has been used in pediatric and congenital heart patients to better understand their electrophysiologic substrates. In this article we focus on the 4 subjects related to pediatric ECGI: 1) ECGI in patients with congenital heart disease and Wolff-Parkinson-White syndrome, 2) ECGI in patients with hypertrophic cardiomyopathy and pre-excitation, 3) ECGI in pediatric patients with Wolff-Parkinson-White syndrome, and 4) ECGI for pediatric cardiac resynchronization therapy. PMID:25722754

  18. Pediatric Euthanasia and Palliative Care Can Work Together.

    PubMed

    Hanson, Stephen S

    2016-06-01

    Since the Netherlands produced the Groningen protocol describing the methods to be used for pediatric euthanasia and Belgium passed laws authorizing euthanasia for children who consent to it, the issue of pediatric euthanasia has become a relevant topic to discuss. Most rejections of pediatric euthanasia fall into 1 or more of 3 categories, each of which has problems. This article shows how several recent arguments against pediatric euthanasia fail to prove that pediatric euthanasia is unacceptable. It does not follow from this that the practice is permissible but rather that if one is to reject such a practice, stronger arguments will need to be made, especially in countries where adult euthanasia or assisted suicide is already permitted. PMID:25667147

  19. Pharmacologic Treatment for Pediatric Gastroparesis: A Review of the Literature.

    PubMed

    Tillman, Emma M; Smetana, Keaton S; Bantu, Likeselam; Buckley, Merrion G

    2016-01-01

    There have been a number of agents that have been tried for treatment of gastroparesis over the past 3 decades, with varying levels of success. Guidelines exist for the management of gastroparesis in adults; however, even though the cause of gastroparesis in children is similar to that in adults, no guidelines exist for treating pediatric gastroparesis as studies on the topic are limited. With what little information we have on pediatric gastroparesis, medications used in children's studies do not seem to demonstrate the same results as in adult patients with gastroparesis; thus, future studies of whether certain medications are effective for treating pediatric gastroparesis and at what dose still need to be conducted. Pharmacological treatment options for pediatric gastroparesis do not show a clear correlation of resolving or even maintaining gastroparesis-associated symptoms or disease state. This article reviews the available studies of drugs that have shown some efficacy, with an emphasis on pediatric studies. PMID:27199619

  20. Pharmacologic Treatment for Pediatric Gastroparesis: A Review of the Literature

    PubMed Central

    Smetana, Keaton S.; Bantu, Likeselam; Buckley, Merrion G.

    2016-01-01

    There have been a number of agents that have been tried for treatment of gastroparesis over the past 3 decades, with varying levels of success. Guidelines exist for the management of gastroparesis in adults; however, even though the cause of gastroparesis in children is similar to that in adults, no guidelines exist for treating pediatric gastroparesis as studies on the topic are limited. With what little information we have on pediatric gastroparesis, medications used in children's studies do not seem to demonstrate the same results as in adult patients with gastroparesis; thus, future studies of whether certain medications are effective for treating pediatric gastroparesis and at what dose still need to be conducted. Pharmacological treatment options for pediatric gastroparesis do not show a clear correlation of resolving or even maintaining gastroparesis-associated symptoms or disease state. This article reviews the available studies of drugs that have shown some efficacy, with an emphasis on pediatric studies. PMID:27199619

  1. Telepractice for pediatric Dysphagia: a case study.

    PubMed

    Malandraki, Georgia A; Roth, Melissa; Sheppard, Justine Joan

    2014-01-01

    A closed-ended intensive pediatric swallowing telepractice program was developed and piloted in one pediatric patient with Opitz BBB/G and Asperger's Syndromes, oropharyngeal dysphagia and aerophagia. The present study is a case report. Outcome variables included behavioral, swallowing and quality of life variables, and were assessed at baseline and at the end of the four-week program. Selective variables were also assessed at a follow-up family interview four weeks post program completion. Over the four-week intervention period, the patient demonstrated substantial improvements in: oral acceptance of eating-related objects and a variety of foods (behavioral variable), timing of voluntary saliva swallows and aerophagia levels (swallowing variables) and quality of life. Follow-up interview analysis showed that most skills were retained or improved one-month post intervention. This intensive telepractice program proved to be feasible and effective for this pediatric patient with dysphagia. PMID:25945217

  2. Telepractice for Pediatric Dysphagia: A Case Study

    PubMed Central

    Malandraki, Georgia A.; Roth, Melissa; Sheppard, Justine Joan

    2014-01-01

    A closed-ended intensive pediatric swallowing telepractice program was developed and piloted in one pediatric patient with Opitz BBB/G and Asperger’s Syndromes, oropharyngeal dysphagia and aerophagia. The present study is a case report. Outcome variables included behavioral, swallowing and quality of life variables, and were assessed at baseline and at the end of the four-week program. Selective variables were also assessed at a follow-up family interview four weeks post program completion. Over the four-week intervention period, the patient demonstrated substantial improvements in: oral acceptance of eating-related objects and a variety of foods (behavioral variable), timing of voluntary saliva swallows and aerophagia levels (swallowing variables) and quality of life. Follow-up interview analysis showed that most skills were retained or improved one-month post intervention. This intensive telepractice program proved to be feasible and effective for this pediatric patient with dysphagia. PMID:25945217

  3. What Is a Pediatric Endocrinologist?

    MedlinePlus

    ... dealing with children and in treating children with endocrine disorders and hormonal problems. If your pediatrician suggests that your child see a pediatric endocrinologist, you can be assured that your child will receive the best possible care. To find a pediatrician or pediatric specialist in ... © Copyright 2016 American Academy of Pediatrics. All rights reserved.

  4. Integrative Pediatrics: Looking Forward

    PubMed Central

    McClafferty, Hilary

    2015-01-01

    Increase in the prevalence of disease and illness has dramatically altered the landscape of pediatrics. As a result, there is a demand for pediatricians with new skills and a sharper focus on preventative health. Patient demand and shifting pediatric illness patterns have accelerated research in the field of pediatric integrative medicine. This emerging field can be defined as healing-oriented medicine that considers the whole child, including all elements of lifestyle and family health. It is informed by evidence and carefully weighs all appropriate treatment options. This Special Issue of Children, containing a collection of articles written by expert clinicians, represents an important educational contribution to the field. The goal of the edition is to raise awareness about integrative topics with robust supporting evidence, and to identify areas where more research is needed.

  5. Ethics in pediatric dermatology.

    PubMed

    Kelly, John B; Makkar, Hanspaul S

    2012-01-01

    The patient-parent-physician relationship is central to studying medical ethics in pediatric dermatology. The rights of children in medical decision making are ambiguous, and parents and physicians will often override the autonomy of a child when a particular treatment is deemed to be in the child's best interest. The use of physical restraint to enforce a treatment should be justified, and a reasonable attempt should be made to ensure the cooperation of the child, if possible. Medical photography is central to the practice of pediatric dermatology in that it allows for serial observation of cutaneous lesions over time. Established guidelines and standards should be followed. Pediatric dermatologists frequently prescribe medications off-label; if following established professional standards, and prescribing with good intention, off-label prescribing can be appropriate and rational. PMID:22902215

  6. Pediatric nuclear medicine

    SciTech Connect

    Not Available

    1986-01-01

    This symposium presented the latest techniques and approaches to the proper medical application of radionuclides in pediatrics. An expert faculty, comprised of specialists in the field of pediatric nuclear medicine, discussed the major indications as well as the advantages and potential hazards of nuclear medicine procedures compared to other diagnostic modalities. In recent years, newer radiopharmaceuticals labeled with technetium-99m and other short-lived radionuclides with relatively favorable radiation characteristics have permitted a variety of diagnostic studies that are very useful clinically and carry a substantially lower radiation burden then many comparable X-ray studies. This new battery of nuclear medicine procedures is now widely available for diagnosis and management of pediatric patients. Many recent research studies in children have yielded data concerning the effacacy of these procedures, and current recommendations will be presented by those involved in conducting such studies. Individual papers are processed separately for the Energy Data Base.

  7. SRTC criticality safety technical review: Phase 1 criticality analysis for the 9972-9975 family of shipping casks: (SRT-CMA-940003)

    SciTech Connect

    Rathbun, R.

    1994-03-02

    Review of SRT-CMA-940003, ``Phase I Criticality Analysis For The 9972-9975 Family Of Shipping Casks (U). (SRT-CMA-940003).`` January 22, 1994, has been performed by the SRTC Applied Physics Group. The NCSE is a criticality assessment of the 9972-9975 family of shipping casks. This work is a follow-on of a previous criticality safety evaluation, with the differences between this and the previous evaluation are that now wall tolerances are modeled and more sophisticated analytical methods are applied. The NCSE under review concludes that, with one exception, the previously specified plutonium and uranium mass limits for 9972-9975 family of shipping casks do ensure that WSRC Nuclear Criticality Safety Manual requirements (ref. 1) are satisfied. The one exception is that the plutonium mass limit for the 9974 cask had to be reduced from 4.4 to 4.3 kg. In contrast, the 7.5 kg uranium mass limit for the 9974 cask was raised to 14.5 kg, making the uranium mass identical for all casks in this family. This technical review consisted of an independent check of the methods and models employed, application of ANSI/ANS 8.1 and 8.15, and verification of WSRC Nuclear Criticality Safety Manual procedures.

  8. Pediatric Extranodal Lymphoma.

    PubMed

    Chung, Ellen M; Pavio, Michael

    2016-07-01

    Lymphoma is the third most common pediatric neoplasm. Non-Hodgkin lymphoma (NHL) accounts for nearly half of cases and commonly involves extranodal sites. Compared with adults, this histologic spectrum of pediatric NHL is very narrow and consists of aggressive tumors. Patients typically present with widespread disease. Generally, NHL occurring in children includes Burkitt lymphoma, lymphoblastic lymphoma, diffuse large B-cell lymphoma, and anaplastic large cell lymphoma. Staging and assessment of therapeutic response are usually based on FDG-PET/CT. Due to the increased susceptibility of young patients to the effects of ionizing radiation, alternative methods of imaging are being explored. PMID:27265605

  9. Pediatric palliative care.

    PubMed

    Moody, Karen; Siegel, Linda; Scharbach, Kathryn; Cunningham, Leslie; Cantor, Rabbi Mollie

    2011-06-01

    Progress in pediatric palliative care has gained momentum, but there remain significant barriers to the appropriate provision of palliative care to ill and dying children, including the lack of properly trained health care professionals, resources to finance such care, and scientific research, as well as a continued cultural denial of death in children. This article reviews the epidemiology of pediatric palliative care, special communication concerns, decision making, ethical and legal considerations, symptom assessment and management, psychosocial issues, provision of care across settings, end-of-life care, and bereavement. Educational and supportive resources for health care practitioners and families, respectively, are included. PMID:21628042

  10. Prediction error and accuracy of intraocular lens power calculation in pediatric patient comparing SRK II and Pediatric IOL Calculator

    PubMed Central

    2010-01-01

    data were analysed to compare the mean prediction error and the accuracy of predictability of intraocular lens power calculation between SRK II and Pediatric IOL Calculator. Results There were 16 eyes in SRK II group and 15 eyes in Pediatric IOL Calculator group. The mean prediction error in the SRK II group was 1.03 D (SD, 0.69 D) while in Pediatric IOL Calculator group was 1.14 D (SD, 1.19 D). The SRK II group showed lower prediction error of 0.11 D compared to Pediatric IOL Calculator group, but this was not statistically significant (p = 0.74). There were 3 eyes (18.75%) in SRK II group achieved acccurate predictability where the refraction postoperatively was within ± 0.5 D from predicted refraction compared to 7 eyes (46.67%) in the Pediatric IOL Calculator group. However the difference of the accuracy of predictability of postoperative refraction between the two formulas was also not statistically significant (p = 0.097). Conclusions The prediction error and the accuracy of predictability of postoperative refraction in pediatric cataract surgery are comparable between SRK II and Pediatric IOL Calculator. The existence of the Pediatric IOL Calculator provides an alternative to the ophthalmologist for intraocular lens calculation in pediatric patients. Relatively small sample size and unequal distribution of patients especially the younger children (less than 3 years) with a short time follow-up (3 months), considering spherical equivalent only. PMID:20738840

  11. Psychological issues in pediatric obesity

    PubMed Central

    Kalra, Gurvinder; De Sousa, Avinash; Sonavane, Sushma; Shah, Nilesh

    2012-01-01

    Pediatric obesity is a major health problem and has reached epidemiological proportions today. The present paper reviews major psychological issues in pediatric obesity from a developmental perspective. Research and literature has shown that a number of developmental, family, maternal and child factors are responsible in the genesis of pediatric obesity. Family food habits, early developmental lifestyle of the child, parenting, early family relationships and harmony all contribute towards the growth and development of a child. The present review focuses on the role of developmental psychological factors in the pathogenesis of pediatric obesity and highlights the developmental factors that must be kept in mind when evaluating a case of pediatric obesity. PMID:23766572

  12. A Study of Hypergiant Mass Loss in the Near-To-Mid Infrared: VY CMa, IRC +10420, mu Cep and rho Cas

    NASA Astrophysics Data System (ADS)

    Shenoy, Dinesh Prabhakar

    2016-01-01

    Stars of initial mass greater than 9 M_sun become red supergiants (RSGs), a short-lived stage during which they experience mass-loss that strongly influences their post-RSG evolution and end state. The highest luminosity RSGs, referred to here as hypergiants, experience episodic mass-loss whose mechanism remains poorly understood and motivates observations to help constrain it. This thesis studies mass loss from hypergiant stars with near-to-mid infrared imaging over a range of angular scales. The recent mass-loss history of the extreme red supergiant VY Canis Majoris and the warm hypergiant star IRC +10420 are studied at the sub-arcsecond scale with adaptive optics imaging and imaging polarimetry from 1 - 5 micron using LMIRCam on the Large Binocular Telescope (LBT) and MMT-Pol at the MMT Observatory. The nebular features of VY CMa are found to be highly polarized at 1.3 and 3.1 micron, with optically thick scattering required to reproduce the observed surface brightness. The flux of VY CMa's peculiar ``Southwest Clump'' is demonstrated to be due almost entirely to optically thick scattering, with little thermal emission, and with a lower limit mass of 5E-03 M_sun in this single feature. The imaging polarimetry of IRC +10420 at 2.2 micron resolves nebular emission with intrinsic polarization of 30%, with a high surface brightness indicating optically thick scattering largely in the plane of the sky. Using the polarimetry to constrain the scattered light emission, it is shown that the nebula's the emission is mostly thermal with a color temperature well above that for typical astrophysical dust. To probe further into hypergiants' history of mass-loss, mid-IR imaging with MMT/ MIRAC and SOFIA/FORCAST is used to study VY CMa, IRC +10420 and two additional hypergiants: the RSG mu Cep and the warm hypergiant rho Cas. Using DUSTY 1-D radiative transfer models, mu Cep's mass-loss rate is found to have declined by about a factor of 5 over a 13,000 history, ranging from 5E

  13. The future of pediatric research.

    PubMed

    Boat, Thomas F

    2007-11-01

    The future of pediatric research will be enhanced by strengthening traditional biomedical approaches and embracing emerging opportunities. Biomedical discovery and translation of new knowledge, concepts, and devices into better diagnostic and therapeutic options will require more pediatric physician-scientists, rapid adoption of enabling technologies, increased funding for research and research training (including the creation of federally funded pediatric translational research centers), and a broader distribution of research activities across the academic pediatric community. Rapid improvement of child health outcomes also will be realized through robust health services research in pediatrics, including the application of rigorous quality improvement science that documents and disseminates successful interventions, leading to better access and effectiveness of care. Improving the value of pediatric care is a realistic goal. Achieving better outcomes through individually tailored (personalized) care for children should be tested experimentally. The future of pediatrics is bright, but will depend on the recognition of and response to a growing array of exciting opportunities. PMID:17950318

  14. A Qualitative Study of Healthcare Providers’ Perspectives on the Implications of Genome-Wide Testing in Pediatric Clinical Practice

    PubMed Central

    Reiff, Marian; Mueller, Rebecca; Mulchandani, Surabhi; Spinner, Nancy B.; Pyeritz, Reed E.; Bernhardt, Barbara A.

    2013-01-01

    The utilization of genome-wide chromosomal microarray analysis (CMA) in pediatric clinical practice provides an opportunity to consider how genetic diagnostics is evolving, and to prepare for the clinical integration of genome-wide sequencing technologies. We conducted semi-structured interviews with 15 healthcare providers (7 genetic counselors, 4 medical geneticists, and 4 non-genetics providers) to investigate the impact of CMA on clinical practice, and implications for providers, patients and families. Interviews were analyzed qualitatively using content analysis. Most providers reported that genomic testing enhanced their professional experience and was beneficial to patients, primarily due to the improved diagnostic rate compared with earlier chromosomal studies. Other effects on practice included moving towards genotype-first diagnosis and broadening indications for chromosomal testing. Opinions varied concerning informed consent and disclosure of results. The duty to disclose incidental findings (IFs) was noted; however concerns were raised about potential psychosocial harms of disclosing pre-symptomatic findings. Tensions were revealed between the need for comprehensive informed consent for all families and the challenges of communicating time-consuming and potentially anxiety-provoking information regarding uncertain and incidental findings that may be relevant only in rare cases. Genetic counselors can play an important role in liaising with families, health professionals and testing laboratories, providing education and guidance to non-genetics providers, and enabling families to receive adequate pre- and post-test information and follow-up care. PMID:24037030

  15. Pediatric heart surgery

    MedlinePlus

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... There are many kinds of heart defects. Some are minor, and others are more serious. Defects can occur inside the heart or in the large blood vessels ...

  16. Pediatric Traumatic Brain Injury.

    PubMed

    Schaller, Alexandra L; Lakhani, Saquib A; Hsu, Benson S

    2015-10-01

    The purpose of this article is to provide a better understanding of pediatric traumatic brain injury and its management. Within the pediatric age group, ages 1 to 19, injuries are the number one cause of death with traumatic brain injury being involved in almost 50 percent of these cases. This, along with the fact that the medical system spends over $1 billion annually on pediatric traumatic brain injury, makes this issue both timely and relevant to health care providers. Over the course of this article the epidemiology, physiology, pathophysiology, and treatment of pediatric traumatic brain injury will be explored. Emphasis will be placed on the role of the early responder and the immediate interventions that should be considered and/or performed. The management discussed in this article follows the most recent recommendations from the 2012 edition of the Guidelines for the Acute Medical Management of Severe Traumatic Brain Injury in Infants, Children, and Adolescents. Despite the focus of this article, it is important not to lose sight of the fact that an ounce of prevention is worth a pound--or, to be more precise and use the average human's brain measurements, just above three pounds--of cure. PMID:26630835

  17. Pediatric Low Vision

    MedlinePlus

    ... Asked Questions Español Condiciones Chinese Conditions Pediatric Low Vision What is Low Vision? Partial vision loss that cannot be corrected causes ... and play. What are the signs of Low Vision? Some signs of low vision include difficulty recognizing ...

  18. Pediatric Urinary Tract Infection

    MedlinePlus

    SBA National Resource Center: 800-621-3141 Pediatric Urinary Tract Infections and Catheterization in Children with Neurogenic Bladder and ... To protect the kidneys from damage – By preventing urinary tract infections (UTI) – By identifying and treating vesicoureteral remux (VUR). ...

  19. Pediatric functional gastrointestinal disorders

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Functional gastrointestinal disorders continue to be a prevalent set of conditions faced by the healthcare team and have a significant emotional and economic impact. In this review, the authors highlight some of the common functional disorders seen in pediatric patients (functional dyspepsia, irrita...

  20. Pediatric psoriasis: an update

    PubMed Central

    Silverberg, Nanette B

    2009-01-01

    Pediatric psoriasis consists broadly of 3 age groups of psoriatic patients: infantile psoriasis, a self-limited disease of infancy, psoriasis with early onset, and pediatric psoriasis with psoriatic arthritis. About one-quarter of psoriasis cases begin before the age of 18 years. A variety of clinical psoriasis types are seen in childhood, including plaque-type, guttate, erythrodermic, napkin, and nail-based disease. Like all forms of auto-immunity, susceptibility is likely genetic, but environmental triggers are required to initiate disease activity. The most common trigger of childhood is an upper respiratory tract infection. Once disease has occurred, treatment is determined based on severity and presence of joint involvement. Topical therapies, including corticosteroids and calcipotriene, are the therapies of choice in the initial care of pediatric patients. Ultraviolet light, acitretin and cyclosporine can clear skin symptoms, while methotrexate and etanercept can clear both cutaneous and joint disease. Concern for psychological development is required when choosing psoriatic therapies. This article reviews current concepts in pediatric psoriasis and a rational approach to therapeutics. PMID:19898649

  1. Pediatric Glaucoma: Pharmacotherapeutic Options.

    PubMed

    Samant, Monica; Medsinge, Anagha; Nischal, Ken K

    2016-06-01

    Childhood glaucoma is a major therapeutic challenge for pediatric ophthalmologists and glaucoma specialists worldwide. Management depends on the etiology and age at presentation. A variety of drugs are available for the control of intraocular pressure in children; however, none of these drugs have been licensed by the regulatory agencies for use in children. Furthermore, evidence gained from randomized controlled trials in the pediatric population is sparse, and little is known regarding the use of newer anti-glaucoma preparations. This evidence-based review aims to discuss the available pharmacotherapeutic options for glaucoma in children. Topical adrenoceptor blockers, topical and systemic carbonic anhydrase inhibitors, prostaglandin (PG) analogs, adrenoceptor agonists, parasympathomimetics, and combined preparations are available for use in children, but usually as an off-label indication. Therefore, it is important to recognize that serious side effects have been reported, even with topical drops, and measures to reduce systemic absorption should be taken. Most drugs have been shown to have comparable ocular hypotensive effects, with the lowest occurrence of systemic side effects with PG analogs. Whereas a newly introduced prostaglandin analog, tafluprost, and some other preservative-free preparations have shown promising results in adult glaucoma patients, no pediatric reports are available as yet. Future studies may describe their role in treating pediatric glaucoma. This review also shares some suggested treatment pathways for primary congenital glaucoma (PCG), juvenile open angle glaucoma (JOAG), developmental glaucoma, aphakic/pseudophakic glaucoma, and uveitic glaucoma. PMID:27093864

  2. Pharmacotherapy of Pediatric Insomnia

    ERIC Educational Resources Information Center

    Owens, Judith A.

    2009-01-01

    General guidelines for the use of medication to treat pediatric insomnia are presented. It should be noted that medication is not the first treatment choice and should be viewed within the context of a more comprehensive treatment plan. The pharmacological and clinical properties of over the counter medications and FDA-approved insomnia drugs are…

  3. Pediatric head trauma

    PubMed Central

    Alexiou, George A; Sfakianos, George; Prodromou, Neofytos

    2011-01-01

    Head injury in children accounts for a large number of emergency department visits and hospital admissions. Falls are the most common type of injury, followed by motor-vehicle-related accidents. In the present study, we discuss the evaluation, neuroimaging and management of children with head trauma. Furthermore, we present the specific characteristics of each type of pediatric head injury. PMID:21887034

  4. Neurocognitive functions in pediatric renal transplant patients.

    PubMed

    Gulleroglu, K; Baskin, E; Bayrakci, U S; Aydogan, M; Alehan, F; Kantar, A; Karakayali, F; Moray, G; Haberal, M

    2013-01-01

    Neurocognitive dysfunction is one of the major complications of chronic renal failure (CRF). Uremic state during CRF encompasses a wide spectrum of neurobehavioral and neurological disturbances. Recent studies showed that the pathophysiology of neurocognitive dysfunction in CRF is related to plasma levels of uremic solutes. Successful renal transplantation improves renal, metabolic, and endocrine functions and the quality of life. The aim of our study was to determine the state of neurocognitive function in pediatric renal transplant recipients. We prospectively performed a neurological examination and neuropsychological test battery (Bender-Gestalt Test, Cancellation Test, and Visual and Auditory Number Assay Test) in 20 pediatric renal transplant recipients between 6 and 16 years of age. Twenty healthy children and 20 children with CRF were included in the study as the control groups. Mean age of the renal transplant recipients was 13.50 ± 3.40 years old. Mean evaluation time after transplantation was 2.0 ± 0.5 years. Bender-Gestalt Test result was abnormal in 40% of patients. The results of the Cancellation Test and the Visual and Auditory Number Assay Test showed significant decline in pediatric renal transplant patients when compared with the control. We found that neurocognitive dysfunction was frequent in pediatric renal transplantation patients. Awareness of this potential problem may be helpful for early recognition and treatment. Our findings suggest that periodic neurocognitive assessments may be indicated in transplant recipients. PMID:24314945

  5. Pediatric Short Bowel Syndrome

    PubMed Central

    Spencer, Ariel U.; Neaga, Andreea; West, Brady; Safran, Jared; Brown, Pamela; Btaiche, Imad; Kuzma-O'Reilly, Barbara; Teitelbaum, Daniel H.

    2005-01-01

    Objective: To determine predictors of survival and of weaning off parenteral nutrition (PN) in pediatric short bowel syndrome (SBS) patients. Summary Background Data: Pediatric SBS carries extensive morbidity and high mortality, but factors believed to predict survival or weaning from PN have been based on limited studies. This study reviews outcomes of a large number of SBS infants and identifies predictors of success. Methods: Multivariate Cox proportional hazards analysis was conducted on 80 pediatric SBS patients. Primary outcome was survival; secondary outcome was ability to wean off PN. Nonsignificant covariates were eliminated. P < 0.05 was considered significant. Results: Over a mean of 5.1 years of follow-up, survival was 58 of 80 (72.5%) and 51 weaned off PN (63.8%). Cholestasis (conjugated bilirubin ≥2.5 mg/dL) was the strongest predictor of mortality (relative risk [RR] 22.7, P = 0.005). Although absolute small bowel length was only slightly predictive, percentage of normal bowel length (for a given infant's gestational age) was strongly predictive of mortality (if <10% of normal length, RR of death was 5.7, P = 0.003) and of weaning PN (if ≥10% of normal, RR of weaning PN was 11.8, P = 0.001). Presence of the ileocecal valve (ICV) also strongly predicted weaning PN (RR 3.9, P < 0.0005); however, ICV was not predictive of survival. Conclusions: Cholestasis and age-adjusted small bowel length are the major predictors of mortality in pediatric SBS. Age-adjusted small bowel length and ICV are the major predictors of weaning from PN. These data permit better prediction of outcomes of pediatric SBS, which may help to direct future management of these challenging patients. PMID:16135926

  6. The pediatric vaccine stockpiling problem.

    PubMed

    Truong, Van-Anh

    2012-09-21

    The U.S. has experienced many major interruptions of its pediatric vaccine production in the past decade. The Centers for Disease Control and Prevention (CDC) copes with these shortages by building a national stockpile of pediatric vaccines, which it makes accessible to the public in the event of a shortage. The management of this stockpile is difficult due to limited production capacity and long and unpredictable production interruptions. In this paper, we address policies for managing the stockpile. We provide sufficient conditions for the optimal policy to be a modified state-dependent base-stock policy, with the base-stock level decreasing in the pipeline inventory. Since the optimal policy is in general difficult to evaluate, we derive bounds on the optimal decision in each period. We develop an efficient policy that performs on average within 1% of optimality in simulations. We show that stocking the same supply of vaccine of every type can be over-conservative in some cases, and inadequate in others by large factors. We also quantify the substantial reduction in inventory level that can be achieved when there are multiple suppliers in the market. PMID:22874852

  7. Searching for Cool Dust in the Mid-to-far Infrared: The Mass-loss Histories of the Hypergiants μ Cep, VY CMa, IRC+10420, and ρ Cas

    NASA Astrophysics Data System (ADS)

    Shenoy, Dinesh; Humphreys, Roberta M.; Jones, Terry J.; Marengo, Massimo; Gehrz, Robert D.; Helton, L. Andrew; Hoffmann, William F.; Skemer, Andrew J.; Hinz, Philip M.

    2016-03-01

    We present mid- and far-IR imaging of four famous hypergiant stars: the red supergiants μ Cep and VY CMa, and the warm hypergiants IRC +10420 and ρ Cas. Our 11-37 μm SOFIA/FORCAST imaging probes cool dust not detected in visual and near-IR imaging studies. Adaptive optics 8-12 μm imaging of μ Cep and IRC +10420 with MMT/MIRAC reveals extended envelopes that are the likely sources of these stars’ strong silicate emission features. We find μ Cep’s mass-loss rate to have declined by about a factor of five over a 13,000 year history, ranging from 5 × 10-6 down to ˜1× 10-6 M⊙ yr-1. The morphology of VY CMa indicates a cooler dust component coincident with the highly asymmetric reflection nebulae seen in the visual and near-IR. The lack of cold dust at greater distances around VY CMa indicates that its mass-loss history is limited to the last ˜1200 years, with an average rate of 6 × 10-4 M⊙ yr-1. We find two distinct periods in the mass-loss history of IRC +10420 with a high rate of 2 × 10-3 M⊙ yr-1 until approximately 2000 years ago, followed by an order of magnitude decrease in the recent past. We interpret this change as evidence of its evolution beyond the RSG stage. Our new infrared photometry of ρ Cas is consistent with emission from the expanding dust shell ejected in its 1946 eruption, with no evidence of newer dust formation from its more recent events. Based on observations obtained with: (1) the NASA/DLR Stratospheric Observatory for Infrared Astronomy (SOFIA). SOFIA is jointly operated by the Universities Space Research Association, Inc. (USRA), under NASA contract NAS2-97001, and the Deutsches SOFIA Institut (DSI) under DLR contract 50 OK 0901 to the University of Stuttgart; and (2) the MMT Observatory on Mt. Hopkins, AZ, a joint facility of the Smithsonian Institution and the University of Arizona.

  8. What Is a Pediatric Critical Care Specialist?

    MedlinePlus

    ... Email Print Share What is a Pediatric Critical Care Specialist? Page Content Article Body If your child ... PICU. What Kind of Training Do Pediatric Critical Care Specialists Have? Pediatric critical care specialists are medical ...

  9. What Is a Pediatric Infectious Diseases Specialist?

    MedlinePlus

    ... Size Email Print Share What is a Pediatric Infectious Diseases Specialist? Page Content Article Body If your child ... teen years. What Kind of Training Do Pediatric Infectious Diseases Specialists Have? Pediatric infectious diseases specialists are medical ...

  10. What Is a Pediatric Sports Medicine Specialist?

    MedlinePlus

    ... Email Print Share What is a Pediatric Sports Medicine Specialist? Page Content Article Body If your child ... teens. What Kind of Training Do Pediatric Sports Medicine Specialists Have? Pediatric sports medicine specialists are medical ...

  11. Extracorporeal life support in pediatric cardiac dysfunction

    PubMed Central

    2010-01-01

    Background Low cardiac output (LCO) after corrective surgery remains a serious complication in pediatric congenital heart diseases (CHD). In the case of refractory LCO, extra corporeal life support (ECLS) extra corporeal membrane oxygenation (ECMO) or ventricle assist devices (VAD) is the final therapeutic option. In the present study we have reviewed the outcomes of pediatric patients after corrective surgery necessitating ECLS and compared outcomes with pediatric patients necessitating ECLS because of dilatated cardiomyopathy (DCM). Methods A retrospective single-centre cohort study was evaluated in pediatric patients, between 1991 and 2008, that required ECLS. A total of 48 patients received ECLS, of which 23 were male and 25 female. The indications for ECLS included CHD in 32 patients and DCM in 16 patients. Results The mean age was 1.2 ± 3.9 years for CHD patients and 10.4 ± 5.8 years for DCM patients. Twenty-six patients received ECMO and 22 patients received VAD. A total of 15 patients out of 48 survived, 8 were discharged after myocardial recovery and 7 were discharged after successful heart transplantation. The overall mortality in patients with extracorporeal life support was 68%. Conclusion Although the use of ECLS shows a significantly high mortality rate it remains the ultimate chance for children. For better results, ECLS should be initiated in the operating room or shortly thereafter. Bridge to heart transplantation should be considered if there is no improvement in cardiac function to avoid irreversible multiorgan failure (MFO). PMID:21083896

  12. A New Blind 2D-RAKE Receiver Based on CMA Criteria for Spread Spectrum Systems Suitable for Software Defined Radio Architecture

    NASA Astrophysics Data System (ADS)

    Takayama, Kei; Kamiya, Yukihiro; Fujii, Takeo; Suzuki, Yasuo

    Spread Spectrum (SS) has been widely used for various wireless systems such as cellular systems, wireless local area network (LAN) and so on. Using multiple antennas at the receiver, two-dimensional (2D) RAKE is realized over the time- and the space-domain. However, it should be noted that the 2D-RAKE receiver must detect the bit timing prior to the RAKE combining. In case of deep fading, it is often difficult to detect it due to low signal-to-noise power ratio (SNR). To solve this problem, we propose a new blind 2D-RAKE receiver based on the constant modulus algorithm (CMA). Since it does not need a priori bit timing detection, it is possible to compensate frequency selective fading even in very low SNR environments. The proposed method is particularly suitable for the software defined radio (SDR) architecture. The performance of the proposed method is investigated through computer simulations.

  13. Benign Pediatric Salivary Gland Lesions.

    PubMed

    Carlson, Eric R; Ord, Robert A

    2016-02-01

    Salivary gland lesions are rare in pediatric patients. In addition, the types of salivary gland tumors are different in their distribution in specific sites in the major and minor salivary glands in children compared with adults. This article reviews benign neoplastic and nonneoplastic salivary gland disorders in pediatric patients to help clinicians to develop an orderly differential diagnosis that will lead to expedient treatment of pediatric patients with salivary gland lesions. PMID:26614702

  14. Sonography of the Pediatric Chest.

    PubMed

    Goh, Yonggeng; Kapur, Jeevesh

    2016-05-01

    Traditionally, pediatric chest diseases are evaluated with chest radiography. Due to advancements in technology, the use of sonography has broadened. It has now become an established radiation-free imaging tool that may supplement plain-film findings and, in certain cases, the first-line modality for evaluation of the pediatric chest. This pictorial essay will demonstrate the diagnostic potential of sonography, review a spectrum of pediatric chest conditions, and discuss their imaging features and clinical importance. PMID:27009313

  15. Medical Comorbidities in Pediatric Headache.

    PubMed

    Jacobs, Howard; Singhi, Samata; Gladstein, Jack

    2016-02-01

    Comorbid conditions frequently occur in pediatric headaches and may significantly affect their management. Comorbidities that have been associated with pediatric headaches include attention-deficit or hyperactivity disorder, autism, developmental disabilities, depression, anxiety, epilepsy, obesity, infantile colic, atopic disorders, inflammatory bowel disease, and irritable bowel syndrome. The goal of this article is to review these comorbidities associated with pediatric headache, thereby empowering child neurologists to identify common triggers and tailor management strategies that address headache and its comorbidities. PMID:27017024

  16. Pediatric genetic ocular tumors

    PubMed Central

    Rouhani, Behnaz; Ramasubramanian, Aparna

    2014-01-01

    Pediatric genetic ocular tumors include malignancies like retinoblastoma and phakomatosis like neurofibromatosis, tuberous sclerosis, von Hippel-Lindau syndrome, and nevoid basal cell carcinoma syndrome. It is important to screen for ocular tumors both for visual prognosis and also for systemic implications. The phakomatosis comprise of multitude of benign tumors that are aysmptomatic but their detection can aid in the diagnosis of the syndrome. Retinoblastoma is the most common malignant intraocular tumor in childhood and with current treatment modalities, the survival is more than 95%. It is transmitted as an autosomal dominant fashion and hence the offsprings of all patients with the germline retinoblastoma need to be screened from birth. This review discusses the various pediatric genetic ocular tumors discussing the clinical manifestation, diagnosis and treatment.

  17. Pediatric digital chest imaging

    SciTech Connect

    Tarver, R.D.; Cohen, M.; Broderick, N.J.; Conces, D.J. Jr. )

    1990-01-01

    The Philips Computed Radiography system performs well with pediatric portable chest radiographs, handling the throughout of a busy intensive care service 24 hours a day. Images are excellent and routinely provide a conventional (unenhanced) image and an edge-enhanced image. Radiation dose is decreased by the lowered frequency of repeat examinations and the ability of the plates to respond to a much lower dose and still provide an adequate image. The high quality and uniform density of serial PCR portable radiographs greatly enhances diagnostic content of the films. Decreased resolution has not been a problem clinically. Image manipulation and electronic transfer to remote viewing stations appear to be helpful and are currently being evaluated further. The PCR system provides a marked improvement in pediatric portable chest radiology.

  18. Hippocrates on Pediatric Dermatology.

    PubMed

    Sgantzos, Markos; Tsoucalas, Gregory; Karamanou, Marianna; Giatsiou, Styliani; Tsoukalas, Ioannis; Androutsos, George

    2015-01-01

    Hippocrates of Kos is well known in medicine, but his contributions to pediatric dermatology have not previously been examined. A systematic study of Corpus Hippocraticum was undertaken to document references of clinical and historical importance of pediatric dermatology. In Corpus Hippocraticum, a variety of skin diseases are described, along with proposed treatments. Hippocrates rejected the theory of the punishment of the Greek gods and supported the concept that dermatologic diseases resulted from a loss of balance in the body humors. Many of the terms that Hippocrates and his pupils used are still being used today. Moreover, he probably provided one of the first descriptions of skin findings in smallpox, Henoch-Schönlein purpura (also known as anaphylactoid purpura, purpura rheumatica, allergic purpura), and meningococcal septicemia. PMID:26058689

  19. Pediatric epilepsy syndromes.

    PubMed

    Wirrell, Elaine; Nickels, Katherine C

    2010-06-01

    Epilepsy syndromes denote specific constellations of clinical seizure type(s), EEG findings, and other characteristic clinical features. Most syndromes recognized in epilepsy are genetic and developmental disorders that begin in the pediatric years. Epilepsy syndromes are divided into idiopathic (primary) types, in which the presumed etiology is genetic, versus symptomatic (secondary) types, in which there is either an underlying etiology that is known or presumed based on other evidence of brain dysfunction. Epilepsies are also classified by those with generalized seizures and those with localization-related seizures. Identification of a specific syndrome is important to define the best treatment and accurately prognosticate long-term outcome for children with epilepsy. In this chapter, clinical and electrographic features as well as inheritance patterns of common pediatric epilepsy syndromes are discussed. PMID:22810315

  20. Acupuncture for Pediatric Pain

    PubMed Central

    Golianu, Brenda; Yeh, Ann Ming; Brooks, Meredith

    2014-01-01

    Chronic pain is a growing problem in children, with prevalence as high as 30.8%. Acupuncture has been found to be useful in many chronic pain conditions, and may be of clinical value in a multidisciplinary treatment program. The basic principles of acupuncture are reviewed, as well as studies exploring basic mechanisms of acupuncture and clinical efficacy. Conditions commonly treated in the pediatric pain clinic, including headache, abdominal pain, fibromyalgia, juvenile arthritis, complex regional pain syndrome, cancer pain, as well as perioperative pain studies are reviewed and discussed. Areas in need of further research are identified, and procedural aspects of acupuncture practice and safety studies are reviewed. Acupuncture can be an effective adjuvant in the care of pediatric patients with painful conditions, both in a chronic and an acute setting. Further studies, including randomized controlled trials, as well as trials of comparative effectiveness are needed. PMID:27417472

  1. Pediatric obesity. An introduction.

    PubMed

    Yanovski, Jack A

    2015-10-01

    The prevalence of child and adolescent obesity in the United States increased dramatically between 1970 and 2000, and there are few indications that the rates of childhood obesity are decreasing. Obesity is associated with myriad medical, psychological, and neurocognitive abnormalities that impact children's health and quality of life. Genotypic variation is important in determining the susceptibility of individual children to undue gains in adiposity; however, the rapid increase in pediatric obesity prevalence suggests that changes to children's environments and/or to their learned behaviors may dramatically affect body weight regulation. This paper presents an overview of the epidemiology, consequences, and etiopathogenesis of pediatric obesity, serving as a general introduction to the subsequent papers in this Special Issue that address aspects of childhood obesity and cognition in detail. PMID:25836737

  2. Pediatric Biliary Interventions.

    PubMed

    Atchie, Benjamin; Kalva, Sanjeeva; Josephs, Shellie

    2015-12-01

    An interventional radiologist is frequently called to evaluate and treat biliary diseases in children; a tailored approach specific to this population is required. Imaging with an emphasis on minimizing ionizing radiation is used not only in the initial workup but also to guide interventions. The most common form of intervention generally consists of transhepatic biliary drainage to treat either biliary obstruction or bile leakage, a scenario frequently encountered after pediatric liver transplantation. Other pathologies referred for evaluation and management include biliary atresia and, rarely, symptomatic choledochal cysts. Biliary complications caused by an underlying malignancy are not a frequently encountered problem in the pediatric population. The initial evaluation, role of preprocedural imaging, and interventional management with an emphasis on technique are discussed regarding these common biliary pathologies in children. PMID:26615168

  3. Immunotherapy for Pediatric Leukemia

    PubMed Central

    Shah, Nirali N.; Dave, Hema; Wayne, Alan S.

    2013-01-01

    Substantial progress has been made in the treatment of leukemia in childhood. Despite this, leukemia remains a leading cause of pediatric cancer-related mortality and the prognosis is guarded for individuals with relapsed or refractory disease. Standard therapies are associated with a wide array of acute and long-term toxicities and further treatment intensification may not be tolerable or beneficial. The curative potential of allogeneic stem cell transplantation is due in part to the graft-versus-leukemia effect, which provides evidence for the therapeutic capacity of immune-based therapies. In recent years there have been significant advances in the development and application of immunotherapy in the treatment of leukemias, including the demonstration of activity in chemotherapy-resistant cases. This review summarizes immunotherapeutic approaches in the treatment of pediatric leukemia including current results and future directions. PMID:23847759

  4. [Opportunistic mycoses in pediatrics].

    PubMed

    Dupont, B

    1985-12-01

    The two most important pathologic conditions leading to mycotic opportunistic infections in children are impairment of mechanisms of defense due to immunosuppressive drugs and congenital defects of immunity. Other circumstances belong to pediatrics such as prematurity or cystic fibrosis. A few examples are chosen to illustrate these situations: congenital candidiasis, chronic mucocutaneous candidiasis, chronic dermatophytic disease, neonatal candidemia, mycotic infections in chronic granulomatous disease and aspergillosis in cystic fibrosis. PMID:3833106

  5. Psittacine incubation and pediatrics.

    PubMed

    Romagnano, April

    2012-05-01

    Psittacine pediatric medicine and surgery can only continue to be practiced by avian veterinarians if psittacine aviculture (the successful captive breeding of parrot species) is active and thriving. Although beautiful, intelligent parrots are popular as beloved pets and reside in zoo and private collections around the world, private psittacine aviculture is in a transition period recovering from difficult economic times. Many of the larger aviculturists have left and the rise of the small aviculturist has significantly changed the industry. PMID:22640534

  6. Pediatric palliative care

    PubMed Central

    Benini, Franca; Spizzichino, Marco; Trapanotto, Manuela; Ferrante, Anna

    2008-01-01

    The WHO defines pediatric palliative care as the active total care of the child's body, mind and spirit, which also involves giving support to the family. Its purpose is to improve the quality of life of young patients and their families, and in the vast majority of cases the home is the best place to provide such care, but for cultural, affective, educational and organizational reasons, pediatric patients rarely benefit from such an approach. In daily practice, it is clear that pediatric patients experience all the clinical, psychological, ethical and spiritual problems that severe, irreversible disease and death entail. The international literature indicates a prevalence of incurable disease annually affecting 10/10,000 young people from 0 to 19 years old, with an annual mortality rate of 1/10,000 young people from birth to 17 years old. The needs of this category of patients, recorded in investigations conducted in various parts of the world, reveal much the same picture despite geographical, cultural, organizational and social differences, particularly as concerns their wish to be treated at home and the demand for better communications between the professionals involved in their care and a greater availability of support services. Different patient care models have been tested in Italy and abroad, two of institutional type (with children staying in hospitals for treating acute disease or in pediatric hospices) and two based at home (the so-called home-based hospitalization and integrated home-based care programs). Professional expertise, training, research and organization provide the essential foundations for coping with a situation that is all too often underestimated and neglected. PMID:19490656

  7. MR in pediatric neuroimaging

    SciTech Connect

    Wolpert, S.M. ); Barnes, P.; Strand, R. )

    1990-01-01

    The multitude of modern imaging techniques has made pediatric neuroradiology increasingly complex. The practitioner must have a thorough understanding of each possible diagnostic study in order to achieve the best results at the least expense and with minimal risk. In this book, MRI is emphasized; correlative CT, ultrasound, angiographic, and conventional x-ray studies assist in establishing effective diagnostic protocols and reaching accurate diagnoses.

  8. Modelling Pediatric Kinematics

    PubMed Central

    van Ratingen, M.R.; Wismans, J.

    1998-01-01

    In the field of pediatric biomechanics, crash dummy and numerical model development suffers from too limited human subject data to directly establish response and injury values. In order to create child crash dummies and numerical models it is necessary to combine the results from real world accident and reconstruction data, scaled adult data and data from animal testing with limited child volunteer data. This paper presents the functional and biomechanical targets for child crash dummies and numerical models.

  9. Common Pediatric Urological Disorders

    PubMed Central

    Robson, Wm. Lane M.; Leung, Alexander K.C.; Boag, Graham S.

    1991-01-01

    The clinical and radiological presentations of 12 pediatric urological disorders are described. The described disorders include pyelonephritis, vesicoureteral reflux, ureteropelvic obstruction, ureterovesical obstruction, ectopic ureterocele, posterior urethral valves, multicystic dysplastic kidney, polycystic kidney disease, ectopic kidney, staghorn calculi, urethral diverticulum, and urethral meatal stenosis. ImagesFigure 1-2Figure 3Figure 3Figure 4Figure 5Figure 6-7Figure 8-9Figure 10Figure 11-12 PMID:21229068

  10. Acupuncture in Pediatrics.

    PubMed

    Brittner, Mindy; Le Pertel, Noemie; Gold, Melanie A

    2016-06-01

    There has been extensive research on the use of acupuncture in adults with a wide array of conditions. Much less research has been conducted on the use of acupuncture in children. In this article, we review the history and philosophy of acupuncture, and the literature on its effectiveness and safety in children and adolescents, giving special attention to the pediatric and adolescent conditions that have been most studied in high-quality randomized controlled trials (RCTs). PMID:26867822

  11. Moral Dilemmas in Pediatric Orthopedics.

    PubMed

    Mercuri, John J; Vigdorchik, Jonathan M; Otsuka, Norman Y

    2015-12-01

    All orthopedic surgeons face moral dilemmas on a regular basis; however, little has been written about the moral dilemmas that are encountered when providing orthopedic care to pediatric patients and their families. This article aims to provide surgeons with a better understanding of how bioethics and professionalism apply to the care of their pediatric patients. First, several foundational concepts of both bioethics and professionalism are summarized, and definitions are offered for 16 important terms within the disciplines. Next, some of the unique aspects of pediatric orthopedics as a subspecialty are reviewed before engaging in a discussion of 5 common moral dilemmas within the field. Those dilemmas include the following: (1) obtaining informed consent and assent for either surgery or research from pediatric patients and their families; (2) performing cosmetic surgery on pediatric patients; (3) caring for pediatric patients with cognitive or physical impairments; (4) caring for injured pediatric athletes; and (5) meeting the demand for pediatric orthopedic care in the United States. Pertinent considerations are reviewed for each of these 5 moral dilemmas, thereby better preparing surgeons for principled moral decision making in their own practices. Each of these dilemmas is inherently complex with few straightforward answers; however, orthopedic surgeons have an obligation to take the lead and better define these kinds of difficult issues within their field. The lives of pediatric patients and their families will be immeasurably improved as a result. PMID:26652336

  12. [Tracheostomy in pediatrics patients].

    PubMed

    Fantoni, A; Ripamonti, D

    2002-05-01

    This is a case study of 79 children who under-went a tracheostomy with three different techniques, used in succession on three different groups of patients: surgical, percutaneous with progressive probes and translaryngeal technique. The pediatric patient, only under the age of 10, starts showing clear-cut anatomical differences compared to an adult, which gradually become more marked the younger the patient is. The causes of increased difficulties that can normally be found in these patients are obviously due to the reduced diameter of the airway and, above all, the high degree of pliability of the cartilaginous frame. After the discovery that even minimal external pressure can cause the collapse of the tracheal walls, it was decided to adopt the systematic use of a rigid bronchoscope, in order to be able to offer internal support to the anterior wall. The following advantages were obtained in the various techniques: In surgery it permitted the reduction, through the protrusion of the trachea, of the size of the operatory field, of the tracheal opening and consequently of the local trauma. It also caused less bleeding and reduced the risk of lesion to the pleural dome which are very frequent when a bronchoscope is not used. In the percutaneous method the bronchoscope allowed the application of the technique without complications, even in infants of only a few months' old, because it eliminated tracheal squashing, caused by the introduction of the needle, dilators and especially cannula, and the relative danger of lesion to the posterior wall of the trachea. This complication which was always impending in the original technique, which does not involve the use of a rigid bronchoscope, is the main reason which lead to the ban on PDT for patients younger than 16-18. In the translaryngeal method the advantages are of minor importance because they are limited to the initial stage of the procedure, the introduction of the needle and guide wire which are quicker and more

  13. Pediatric suprasellar lesions

    PubMed Central

    Deopujari, C. E.; Kumar, Ashish; Karmarkar, V. S.; Biyani, N. K.; Mhatre, M.; Shah, N. J.

    2011-01-01

    Pediatric brain tumors have always been challenging as well as intriguing in their anatomical, surgical, and postsurgical management-related issues. They are a heterogeneous set of pathologies involving different age groups in childhood and also differ widely from their adult counterparts as far as adjuvant therapies are concerned. Though neurosurgeons across the world are radical in surgery for most of the pediatric tumors, it can often be at the cost of future quality of life in suprasellar tumors. As the time has gone by, the pendulum has swung toward rather conservative and maximal safe surgical resections with adjuvant therapies coming to the forefront. Hence, the aim is to achieve a good quality of life for these children along with a control of tumor growth (rather than cure) and to again tackle the tumors, if required, once these children reach adolescence or adulthood. We have reviewed the literature for different pediatric suprasellar tumors and discussed their current management giving our perspective with illustrative cases. PMID:22069431

  14. Imaging of Pediatric Stroke.

    PubMed

    Bhatia, Aashim; Pruthi, Sumit

    2016-09-01

    Despite being as common as brain tumors in children, lack of awareness of pediatric stroke presents unique challenges, both in terms of diagnosis and management. Due to diverse and overlapping risk factors, as well as variable clinical presentations, the diagnosis can be either missed or frequently delayed. Early recognition and treatment of pediatric stroke is however critical in optimizing long-term functional outcomes, reducing morbidity and mortality, and preventing recurrent stroke. Neuroimaging plays a vital role in achieving this goal. The advancements in imaging over the last two decades have allowed for multiple modality options for suspected stroke with more accurate diagnosis, as well as quicker turnaround time in imaging diagnosis, especially at primary stroke centers. However, with the multiple imaging possibilities, referring physicians can be overwhelmed with the best option for each clinical situation and what the literature recommends. Here the authors review the etiology of pediatric stroke in the settings of arterial ischemia, hemorrhage, and cerebral sinovenous thrombosis (CSVT), with emphasis on the best diagnostic tools available, including advanced imaging techniques. PMID:26920396

  15. Nutrition in Pediatric Cardiomyopathy

    PubMed Central

    Miller, Tracie L.; Neri, Daniela; Extein, Jason; Somarriba, Gabriel; Strickman-Stein, Nancy

    2007-01-01

    Pediatric cardiomyopathies are heterogeneous groups of serious disorders of the heart muscle and are responsible for significant morbidity and mortality among children who have the disease. While enormous improvements have been made in the treatment and survival of children with congenital heart disease, parallel strides have not been made in the outcomes for cardiomyopathies. Thus, ancillary therapies, such as nutrition and nutritional interventions, that may not cure but may potentially improve cardiac function and quality of life, are imperative to consider in children with all types of cardiomyopathy. Growth failure is one of the most significant clinical problems of children with cardiomyopathy with nearly one-third of children with this disorder manifesting some degree of growth failure during the course of their illness. Optimal intake of macronutrients can help improve cardiac function. In addition, several specific nutrients have been shown to correct myocardial abnormalities that often occur with cardiomyopathy and heart failure. In particular, antioxidants that can protect against free radical damage that often occurs in heart failure and nutrients that augment myocardial energy production are important therapies that have been explored more in adults with cardiomyopathy than in the pediatric population. Future research directions should pay particular attention to the effect of overall nutrition and specific nutritional therapies on clinical outcomes and quality of life in children with pediatric cardiomyopathy. PMID:18159216

  16. Trends in pediatric rehabilitation.

    PubMed

    Burkett, K W

    1989-03-01

    The 1980s have been declared the decade of the disabled. Surgeon General Koop has stated that "it is profoundly important for our own society that we tend to these issues of disabled children, that these children not be forgotten or pushed aside, and that we retain our belief in the strength of the American family". The field of pediatric rehabilitation, unheard of as recently as the late 1970s, has become a recognized specialty. The definition of pediatric rehabilitation has expanded to include the care and treatment of children with congenital and acquired disabilities. The pediatric rehabilitation nurse is challenged to keep abreast of new developments in the field while seeking and implementing innovative ways to assist the child and family in their adjustment to the child's disability. A knowledge base of normal growth and development is essential when assessing abnormal patterns in the child with a disability. Complete assessment of the child with a disability includes a parent-child interview and physical assessment, with particular focus on the child's developmental age, movement patterns, and functional activities of daily living. The reaction of the child and family to the disability is all too often viewed as lack of "acceptance" of the child's disability. A continuum of "adjustment" to the disability for both family and child describes normal coping mechanisms for living with and managing the needs of a disabled child. It is important for the pediatric rehabilitation nurse to develop a partnership with parents in which they serve as consultants to families, not as directors of the child's care. Cerebral palsy and spina bifida are the two most common childhood disabilities. With advanced technologic equipment and refined surgical procedures, the child's potential for independence is reaching new heights. Computerized technology has aided the motor-impaired child to progress through normal developmental processes of exploration and discovery. Specialized

  17. Pediatric Nurse Practitioner Program: Theories for Extended Pediatric Nursing Practice.

    ERIC Educational Resources Information Center

    Brady, Margaret A.

    A description is provided of "Theories for Extended Pediatric Nursing Practice," a required course for pediatric and family nurse practitioner students in a California state university program. The course description presents information on the curricular placement of the course, prerequisites, in-class time allotments, and the focus of the course…

  18. Emerging immunotherapy in pediatric lymphoma.

    PubMed

    Erker, Craig; Harker-Murray, Paul; Burke, Michael J

    2016-01-01

    Hodgkin and non-Hodgkin lymphoma collectively are the third most common cancer diagnosed in children each year. For children who relapse or have refractory disease, outcomes remain poor. Immunotherapy has recently emerged as a novel approach to treat hematologic malignancies. The field has been rapidly expanding over the past few years broadening its armamentarium which now includes monoclonal antibodies, antibody-drug conjugates and cellular therapies including bispecific T-cell engagers and chimeric antigen receptor-engineered T cells. Many of these agents are in their infancy stages and only beginning to make their mark on lymphoma treatment while others have begun to show promising efficacy in relapsed disease. In this review, the authors provide an overview of current and emerging immunotherapies in the field of pediatric lymphoma. PMID:26616565

  19. Defective proliferative potential of MSCs from pediatric myelodysplastic syndrome patients is associated with cell senescence

    PubMed Central

    Liu, Qinghua; Zhu, Hongbo; Dong, Jing; Li, Helou; Zhang, Hong

    2015-01-01

    Objectives: Aberrant MSC function was shown to contribute to the pathophysiology of myelodysplastic syndromSe (MDS). In comparison to adult MDS, pediatric MDS displayed different features both in biologically and clinically. The mechanisms for adult MDS may not be applicable in pediatric MDS. However, understanding of the MSCs in pediatric MDS is lacking. In this study, we investigated the proliferation capacity of MSCs from pediatric MDS patients at clone cell level. Material and methods: Clone bone marrow MSCs were isolated from pediatric MDS patients and identified according to the criteria of the International Society for Cellular Therapy for MSCs. The proliferation capacity of pediatric MDS-derived MSCs was compared to healthy controls. Cell cycle was detected by flow cytometry following PI staining, as well as cell senescence was evaluated by β-galactosidase staining and telomere length. Results: Pediatric MDS-derived MSCs displayed similar basic biology characters as MSCs from healthy controls, including differentiation potential and surface markers. However, defective proliferative was displayed by pediatric MDS-derived MSCs. Pediatric MDS-derived MSCs were more prone to cellular senescence than healthy controls, and showed a decrease in the S phase. Conclusion: Pediatric MDS-derived MSCs possess the basic characteristics of normal MSCs, but display defective proliferation, which may be associated with cell senescence. PMID:26722501

  20. MTA applications in pediatric dentistry

    PubMed Central

    MATURO, P.; COSTACURTA, M.; BARTOLINO, M.; DOCIMO, R.

    2010-01-01

    SUMMARY The aim of this paper is to show and asses the clinical applications of the Mineral Trioxide Aggregate (MTA) in pediatric dentistry, either on primary teeth or on immature apex permanent teeth. We have described the primary tooth pulpotomy technique using MTA, that is characterized by a superior biocompatibility and a sealing ability that make it a more suitable compound compared to other materials in terms of result prediction on a long-term basis. We have also reported the direct capping technique using MTA on immature apex teeth; in these particular cases, MTA is undoubtedly preferable to conventional materials, especially in what its sealing characteristics concern. Furthermore, we have explained the apexogenesis clinical procedure, in which after a chamber pulpotomy on incomplete root development teeth, MTA is used in direct contact with the pulpar stump in order to save the root pulp vitality, allowing the apex and relative canal walls physiological maturation to take place. In case of necrotic teeth with immature apex, we describe the possibility of using MTA as an apical barrier making the apexification treatment faster and predictable, taking profit from its biocompatibility quality, its sealing ability and setting characteristic in humid environments. In all described applications, MTA has demonstrated to be a very versatile and extremely trustworthy material. Either literature and results obtained from the present experience, show how the use of MTA in Pediatric Dentistry, compared to commonly used materials, translates into pulp or periapical tissues being less swollen and, thus, guaranteeing a higher prediction of the therapeutic result on a short-term basis and on a long-term one. PMID:23285367

  1. Pediatric maxillary and mandibular tumors.

    PubMed

    Trosman, Samuel J; Krakovitz, Paul R

    2015-02-01

    Pediatric maxillary and mandibular tumors offer considerable challenges to otolaryngologists, oral surgeons, pathologists, and radiologists alike. Because of the close proximity to vital structures, appropriate steps toward a definitive diagnosis and treatment plan are of paramount importance. This article reviews the most common causes of pediatric jaw masses and discusses diagnostic and therapeutic considerations and recommendations. PMID:25442129

  2. Educational Preparation of Pediatric Audiologists

    ERIC Educational Resources Information Center

    Roush, Jackson

    2010-01-01

    Pediatric audiologists play a vital role in detection, diagnosis, and intervention for young children with hearing loss and their families. Preparing the next generation of pediatric audiologists necessitates a creative approach that balances the requirements of a broad curriculum with the special skills needed to serve a unique and varied…

  3. Pediatric imaging for the technologist

    SciTech Connect

    Wilmot, D.M.; Sharko, G.A.

    1987-01-01

    This manual provides an accessible store of information on pediatric imaging procedures, with clearly described techniques and instructions. The aim is to simplify the pediatric examination. Extensively illustrated, this work describes in detail correct positioning, radiation protection, and methods of immobilization. The concluding chapters clarify what is required in the final image for accurate diagnosis.

  4. Intravenous acetaminophen use in pediatrics.

    PubMed

    Shastri, Nirav

    2015-06-01

    Acetaminophen is a commonly used pediatric medication that has recently been approved for intravenous use in the United States. The purpose of this article was to review the pharmacodynamics, indications, contraindications, and precautions for the use of intravenous acetaminophen in pediatrics. PMID:26035501

  5. Group Intervention in Pediatric Rehabilitation

    ERIC Educational Resources Information Center

    LaForme Fiss, Alyssa

    2012-01-01

    Group intervention in pediatric physical and occupational therapy is an alternative to individual intervention allowing the therapist to meet the needs of multiple children at one time. Survey research indicates that approximately 40% to 60% of pediatric physical and occupational therapists use group intervention at least occasionally in practice,…

  6. 78 FR 48438 - Pediatric Ethics Subcommittee of the Pediatric Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-08

    ... HUMAN SERVICES Food and Drug Administration Pediatric Ethics Subcommittee of the Pediatric Advisory... Administration (FDA). The meeting will be open to the public. Name of Subcommittee: Pediatric Ethics Subcommittee... recommendations to the Pediatric Advisory Committee on pediatric ethical issues. Date and Time: The meeting...

  7. Pediatric residency training on tobacco: review and critique of the literature.

    PubMed Central

    Hymowitz, Norman

    2006-01-01

    OBJECTIVE: To review and critique the research literature on training pediatric residents to address tobacco. METHODS: A Medline search was conducted to identify studies that specifically addressed pediatric residency training on tobacco, and Google Scholar was used to identify articles in which the referenced study was cited. RESULTS: Eight studies that specifically addressed training pediatric residents to intervene on tobacco were identified. Most used active as well as passive approaches to training. Baseline data underscored the importance of training future pediatricians to address tobacco. Although the studies differed in size, scope and rigor, they showed that training pediatric residents to address tobacco enhanced residents' ability and likelihood to address tobacco. CONCLUSION: The review documents the importance and value of training pediatric residents to address tobacco, provides suggestions for future research and underscores the need to incorporate training on tobacco into pediatric residency training curriculum. PMID:17019917

  8. Neuroprognostication After Pediatric Cardiac Arrest

    PubMed Central

    Kirschen, Matthew P.; Topjian, Alexis A.; Hammond, Rachel; Illes, Judy; Abend, Nicholas S.

    2014-01-01

    BACKGROUND Management decisions and parental counseling after pediatric cardiac arrest depend on the ability of physicians to make accurate and timely predictions regarding neurological recovery. We evaluated neurologists and intensivists performing neuroprognostication after cardiac arrest to determine prediction agreement, accuracy, and confidence. METHODS Pediatric neurologists (n = 10) and intensivists (n = 9) reviewed 18 cases of children successfully resuscitated from a cardiac arrest and managed in the pediatric intensive care unit. Cases were sequentially presented (after arrest day 1, days 2–4, and days 5–7), with updated examinations, neurophysiologic data, and neuroimaging data. At each time period, physicians predicted outcome by Pediatric Cerebral Performance Category and specified prediction confidence. RESULTS Predicted discharge Pediatric Cerebral Performance Category versus actual hospital discharge Pediatric Cerebral Performance Category outcomes were compared. Exact (Predicted Pediatric Cerebral Performance Category – Actual Pediatric Cerebral Performance Category = 0) and close (Predicted Pediatric Cerebral Performance Category – Actual Pediatric Cerebral Performance Category = ±1) outcome prediction accuracies for all physicians improved over successive periods (P < 0.05). Prediction accuracy did not differ significantly between physician groups at any period or overall. Agreement improved over time among neurologists (day 1 Kappa [κ], 0.28; days 2–4 κ, 0.43; days 5–7 κ, 0.68) and among intensivists (day 1 κ, 0.30; days 2–4 κ, 0.44; days 5–7 κ, 0.57). Prediction confidence increased over time (P < 0.001) and did not differ between physician groups. CONCLUSIONS Inter-rater agreement among neurologists and among intensivists improved over time and reached moderate levels. For all physicians, prediction accuracy and confidence improved over time. Further prospective research is needed to better characterize how physicians

  9. Pediatric Genitourinary Oncology

    PubMed Central

    Dénes, Francisco Tibor; Duarte, Ricardo Jordão; Cristófani, Lílian Maria; Lopes, Roberto Iglesias

    2013-01-01

    Tumors of the kidney, bladder, prostate, testis, and adrenal represent a large part of the adult urologic practice, but are relatively infrequent in children. The natural history and management of these tumors in the pediatric age is different from that of the adults. As result of the successful work of several clinical trial groups in recent decades, there has been a significant improvement in their cure rates. The aim of this article is to review their most significant clinical aspects, as well as to present an update in their management. PMID:24400293

  10. Social pediatric emergencies.

    PubMed

    Jacobs, J

    1978-01-01

    A social pediatric emergency invokes the concept of a crisis situation, which often reflects an acute temporary state, the culmination of problems of long duration. The needs demonstrated in child abuse, neglect and deprivation, sexual abuse, the handling of the crisis of birth, pregnancy and abnormality, death and dying, adoption and learning disabilities are related to the family psychodynamic relationships and the doctor team approach. The social pediatrician can play his role as the physician, advocate, activist and educationalist in the many complex situations revealed within family, community and society. PMID:569270

  11. Epigenetics in pediatrics.

    PubMed

    Puumala, Susan E; Hoyme, H Eugene

    2015-01-01

    Epigenetic mechanisms are external modifications of DNA that cause changes in gene function and are involved in many diseases. Specific examples of pediatric diseases with a known or suspected epigenetic component include Beckwith-Wiedemann syndrome, childhood leukemia, allergies, asthma, fetal alcohol spectrum disorders, childhood obesity, and type 2 diabetes mellitus. Currently, epigenetically active treatments are being used to treat childhood leukemia. Potential epigenetically active treatments and preventive regimens are under study for other diseases. Pediatricians need to be aware of the epigenetic basis of disease to help inform clinical decision making in the future. PMID:25554107

  12. Pediatric environmental health.

    PubMed Central

    Walker, Bailus

    2005-01-01

    The links between environmental agents, environmental conditions, and disease and disability among children are receiving increasing attention. Evidence abounds that children are more susceptible than adults to the damaging effects of environmental agents and conditions. This evidence is illuminated by the much-publicized and expanding research agenda on the prevention, recognition, diagnosis and treatment of environmentally related disease in the pediatric population. Encouragingly, advances in molecular biology and other sciences are providing important tools to aid pediatricians and other healthcare professionals in meeting the environmental health needs of children. PMID:15712790

  13. Pediatric Respiratory Emergencies.

    PubMed

    Richards, Amber M

    2016-02-01

    Respiratory emergencies are 1 of the most common reasons parents seek evaluation for the their children in the emergency department (ED) each year, and respiratory failure is the most common cause of cardiopulmonary arrest in pediatric patients. Whereas many respiratory illnesses are mild and self-limiting, others are life threatening and require prompt diagnosis and management. Therefore, it is imperative that emergency clinicians be able to promptly recognize and manage these illnesses. This article reviews ED diagnosis and management of foreign body aspiration, asthma exacerbation, epiglottitis, bronchiolitis, community-acquired pneumonia, and pertussis. PMID:26614243

  14. 21 CFR 601.27 - Pediatric studies.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 7 2014-04-01 2014-04-01 false Pediatric studies. 601.27 Section 601.27 Food and... LICENSING Biologics Licensing § 601.27 Pediatric studies. (a) Required assessment. Except as provided in... pediatric subpopulations, and to support dosing and administration for each pediatric subpopulation...

  15. 21 CFR 601.27 - Pediatric studies.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 7 2012-04-01 2012-04-01 false Pediatric studies. 601.27 Section 601.27 Food and... LICENSING Biologics Licensing § 601.27 Pediatric studies. (a) Required assessment. Except as provided in... pediatric subpopulations, and to support dosing and administration for each pediatric subpopulation...

  16. 21 CFR 601.27 - Pediatric studies.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 7 2013-04-01 2013-04-01 false Pediatric studies. 601.27 Section 601.27 Food and... LICENSING Biologics Licensing § 601.27 Pediatric studies. (a) Required assessment. Except as provided in... pediatric subpopulations, and to support dosing and administration for each pediatric subpopulation...

  17. A technique for pediatric total skin electron irradiation

    PubMed Central

    2012-01-01

    Background Total skin electron irradiation (TSEI) is a special radiotherapy technique which has generally been used for treating adult patients with mycosis fungoides. Recently, two infants presented with leukemia cutis isolated to the skin requiring TSEI. This work discusses the commissioning and quality assurance (QA) methods for implementing a modified Stanford technique using a rotating harness system to position sedated pediatric patients treated with electrons to the total skin. Methods and Results Commissioning of pediatric TSEI consisted of absolute calibration, measurement of dosimetric parameters, and subsequent verification in a pediatric patient sized cylindrical phantom using radiographic film and optically stimulated luminance (OSL) dosimeters. The depth of dose penetration under TSEI treatment condition was evaluated using radiographic film sandwiched in the phantom and demonstrated a 2 cm penetration depth with the maximum dose located at the phantom surface. Dosimetry measurements on the cylindrical phantom and in-vivo measurements from the patients suggested that, the factor relating the skin and calibration point doses (i.e., the B-factor) was larger for the pediatric TSEI treatments as compared to adult TSEI treatments. Custom made equipment, including a rotating plate and harness, was fabricated and added to a standard total body irradiation stand and tested to facilitate patient setup under sedated condition. A pediatric TSEI QA program, consisting of daily output, energy, flatness, and symmetry measurements as well as in-vivo dosimetry verification for the first cycle was developed. With a long interval between pediatric TSEI cases, absolute dosimetry was also repeated as part of the QA program. In-vivo dosimetry for the first two infants showed that a dose of ± 10% of the prescription dose can be achieved over the entire patient body. Conclusion Though pediatric leukemia cutis and the subsequent need for TSEI are rare, the ability to

  18. [New horizons in pediatrics].

    PubMed

    Grossman, Zachi

    2012-06-01

    The profession of pediatrics is constantLy changing. New morbidities are replacing old ones, as a reflection of the changes in society. Even today, old and rare morbidities, like scurvy or acute urinary retention, can be encountered in special settings and populations such as handicapped and developmentally delayed children. The availability of ever newer genetic tests highlights the duty of pediatricians to constantly update families for carrier detection, but also raises questions on the cLinical significance of asymptomatic mutations. Vaccination is one of the most effective pubLic health measures, but failure of medical staff to follow self vaccination recommendations might jeopardize protecting the children. Anti vaccination movement is rapidly growing due to the Internet. However, we must acknowledge the benefits inherent in Internet forums, for example, adolescents consulting anonymously regarding pubertal issues. A new and most needed aspect of care is treatment of pain in children. Increased staff awareness concerning anaLgesia is needed as well as promoting the use of medical clowns for anxiety and pain provoking procedures. Delivering appropriate healthcare to different societal demographic sectors is a challenge for pediatricians. The approach to fever phobia among ultra orthodox parents and advocacy for safety recommendations in the Arab population are two such exampLes. Finally, we shouLd always strive for innovative approaches in pediatric diseases affecting quality of life, and celiac disease is certainly promising in this direction. PMID:22991856

  19. Pediatric facial burns.

    PubMed

    Kung, Theodore A; Gosain, Arun K

    2008-07-01

    Despite major advances in the area of burn management, burn injury continues to be a leading cause of pediatric mortality and morbidity. Facial burns in particular are devastating to the affected child and result in numerous physical and psychosocial sequelae. Although many of the principles of adult burn management can be applied to a pediatric patient with facial burns, the surgeon must be cognizant of several important differences. Facial burns and subsequent scar formation can drastically affect the growth potential of a child's face. Structures such as the nose and teeth may become deformed due to abnormal external forces caused by contractures. Serious complications such as occlusion amblyopia and microstomia must be anticipated and urgently addressed to avert permanent consequences, whereas other reconstructive procedures can be delayed until scar maturation occurs. Furthermore, because young children are actively developing the concept of self, severe facial burns can alter a child's sense of identity and place the child at high risk for future emotional and psychologic disturbances. Surgical reconstruction of burn wounds should proceed only after thorough planning and may involve a variety of skin graft, flap, and tissue expansion techniques. The most favorable outcome is achieved when facial resurfacing is performed with respect to the aesthetic units of the face. Children with facial burns remain a considerable challenge to their caregivers, and these patients require long-term care by a multidisciplinary team of physicians and therapists to optimize functional, cosmetic, and psychosocial outcomes. PMID:18650717

  20. Pediatric DXA: clinical applications

    PubMed Central

    Sparke, Paul; Henwood, Maria J.

    2007-01-01

    Normal bone mineral accrual requires adequate dietary intake of calcium, vitamin D and other nutrients; hepatic and renal activation of vitamin D; normal hormone levels (thyroid, parathyroid, reproductive and growth hormones); and neuromuscular functioning with sufficient stress upon the skeleton to induce bone deposition. The presence of genetic or acquired diseases and the therapies that are used to treat them can also impact bone health. Since the introduction of clinical DXA in pediatrics in the early 1990s, there has been considerable investigation into the causes of low bone mineral density (BMD) in children. Pediatricians have also become aware of the role adequate bone mass accrual in childhood has in preventing osteoporotic fractures in late adulthood. Additionally, the availability of medications to improve BMD has increased with the development of bisphosphonates. These factors have led to the increased utilization of DXA in pediatrics. This review summarizes much of the previous research regarding BMD in children and is meant to assist radiologists and clinicians with DXA utilization and interpretation. PMID:17431606

  1. Immunotherapy for pediatric cancer.

    PubMed

    Grupp, Stephan A; Verneris, Michael; Sondel, Paul M; Cooper, Laurence J N

    2008-01-01

    Improvements in adult cancer survivorship can be achieved from behavioral changes and adopting screening programs. Yet, these approaches cannot be readily applied to lower the morbidity and mortality from childhood cancers. Rather, pediatric oncologists must rely on procedures and therapies to treat, rather than prevent malignancies. The systematic application of chemotherapy, radiation therapy, and surgery has led to remarkable advances in survival but these improvements have come at a cost. Children routinely receive chemotherapy agents that were designed decades ago, and these drugs have predictable side effects that result in the loss of potential for long-term survivors. The advent of targeted applications of immune-based therapies offers children with cancer a new class of oncolytic therapies that may be used to treat disease refractory to conventional approaches and lessen the toxicity of current treatment regimens without compromising remission. This review explores how 3 components of the immune system--T cells, natural killer (NK) cells, and antibodies--can be used for therapy of pediatric malignancies. PMID:18162219

  2. Updates in pediatric nutrition.

    PubMed

    Oken, E; Lightdale, J R

    2001-06-01

    Ongoing research in several areas of pediatric nutrition has new practical applications for community-based pediatricians. For example, a fresh understanding of risk factors for rickets persuades pediatricians to recognize and treat this disease, which was thought to be nearly extinct in the modern industrialized world. Similarly, an expanded awareness of the antibacterial components of breast milk encourages a more complete dialogue between pediatricians and new mothers about the potential benefits of breast-feeding. For those infants with feeding intolerance, new data help to refine the indications for hypoallergenic formulas, which are increasingly recommended for children with a variety of symptoms. The past year also has seen breakthroughs in our understanding of supplemental nutrition for children. Vitamin A may provide direct benefits for the most vulnerable of children, namely premature infants at high risk for lung disease. At the other end of the pediatric spectrum, adolescent athletes seeking to enhance their performance are consuming poorly studied sports supplements that may not be beneficial and may even be toxic. Finally, a greater appreciation for the epidemic of obesity that is sweeping the United States and other countries suggests that children at high risk may represent a far more diverse population than had been recognized previously. PMID:11389365

  3. Pediatric contact dermatitis.

    PubMed

    Sharma, Vinod K; Asati, Dinesh P

    2010-01-01

    Allergic contact dermatitis (ACD) in children, until recently, was considered rare. ACD was considered as a disorder of the adult population and children were thought to be spared due to a lack of exposure to potential allergens and an immature immune system. Prevalence of ACD to even the most common allergens in children, like poison ivy and parthenium, is relatively rare as compared to adults. However, there is now growing evidence of contact sensitization of the pediatric population, and it begins right from early childhood, including 1-week-old neonates. Vaccinations, piercing, topical medicaments and cosmetics in younger patients are potential exposures for sensitization. Nickel is the most common sensitizer in almost all studies pertaining to pediatric contact dermatitis. Other common allergens reported are cobalt, fragrance mix, rubber, lanolin, thiomersol, neomycin, gold, mercapto mix, balsum of Peru and colophony. Different factors like age, sex, atopy, social and cultural practices, habit of parents and caregivers and geographic changes affect the patterns of ACD and their variable clinical presentation. Patch testing should be considered not only in children with lesions of a morphology suggestive of ACD, but in any child with dermatitis that is difficult to control. PMID:20826990

  4. Pediatric optic neuritis.

    PubMed

    Yeh, E Ann; Graves, Jennifer S; Benson, Leslie A; Wassmer, Evangeline; Waldman, Amy

    2016-08-30

    Optic neuritis (ON) is a common presenting symptom in pediatric CNS demyelinating disorders and may be associated with dramatic visual loss. Knowledge regarding clinical presentation, associated diseases, therapy, and outcomes in ON in children has grown over the past decade. These studies have shown that younger children (<10 years of age) are more likely to present with bilateral ON and older children with unilateral ON. Furthermore, studies focusing on visual recovery have shown excellent recovery of high-contrast visual acuity in the majority of children, but functional and structural studies have shown evidence of irreversible injury and functional decline after ON in children. Although randomized controlled treatment trials have not been performed in children and adolescents with ON, standard of care suggests that the use of high-dose pulse steroids is safe and likely effective. This article reviews current knowledge about the clinical presentation and management of pediatric ON, with attention to associated syndromes and evaluative tools that may inform diagnosis and interventions. PMID:27572862

  5. Pediatric heart transplantation

    PubMed Central

    Stiasny, Brian; Dave, Hitendu; Cavigelli-Brunner, Anna; Balmer, Christian; Kretschmar, Oliver; Bürki, Christoph; Klauwer, Dietrich; Hübler, Michael

    2015-01-01

    Pediatric heart transplantation (pHTx) represents a small (14%) but very important and particular part in the field of cardiac transplantation. This treatment has lifelong impact on children. To achieve the best short and especially long-term survival with adequate quality of life, which is of crucial importance for this young patient population, one has to realize and understand the differences with adult HTx. Indication for transplantation, waitlist management including ABO incompatible (ABOi) transplantation and immunosuppression differ. Although young transplant recipients are ultimately likely to be considered for re-transplantation. One has to distinguish between myopathy and complex congenital heart disease (CHD). The differences in anatomy and physiology make the surgical procedure much more complex and create unique challenges. These recipients need a well-organized and educated team with pediatric cardiologists and intensivists, including a high skilled surgeon, which is dedicated to pHTx. Therefore, these types of transplants are best concentrated in specialized centers to achieve promising outcome. PMID:25922739

  6. PROMIS® Pediatric Self Report Scales Distinguish Subgroups of Children Within and Across Six Common Pediatric Chronic Health Conditions

    PubMed Central

    DeWalt, Darren A.; Gross, Heather E.; Gipson, Debbie S.; Selewski, David T.; DeWitt, Esi Morgan; Dampier, Carlton D.; Hinds, Pamela S.; Huang, I-Chan; Thissen, David; Varni, James W.

    2015-01-01

    Purpose To conduct a comparative analysis of eight pediatric self-report scales for ages 8-17 years from the National Institutes of Health (NIH) Patient Reported Outcomes Measurement Information System (PROMIS®) in six pediatric chronic health conditions, using indicators of disease severity. Methods Pediatric patients (N = 1,454) with asthma, cancer, chronic kidney disease, obesity, rheumatic disease, and sickle cell disease completed items from the PROMIS pediatric mobility, upper extremity functioning, depressive symptoms, anxiety, anger, peer relationships, pain interference, and fatigue self-report scales. Comparisons within the six pediatric chronic health conditions were conducted by examining differences in groups based on disease severity using markers of severity that were specific to characteristics of each disease. A comparison was also made across diseases between children who had been recently hospitalized and those who had not. Results In general, there were differences in self-reported health outcomes within each chronic health condition, with patients who had higher disease severity showing worse outcomes. Across health conditions, when children with recent hospitalizations were compared with those who had not been hospitalized in the past six months, we found significant differences in the expected directions for all PROMIS domains, except anger. Conclusions PROMIS measures discriminate between different clinically meaningful subgroups within several chronic illnesses. Further research is needed to determine the responsiveness of the PROMIS pediatric scales to change over time. PMID:25715946

  7. CHIEF PEDIATRIC RESIDENTS TRAINING - A TRAINING PROGRAM OF THE AMERICAN ACADEMY OF PEDIATRICS

    EPA Science Inventory

    The American Academy of Pediatrics will convene workshops at four meetings of the Pediatric Academic Societies for incoming pediatric chief residents. The residents receive an overview of childen's environmental health issues, will create a powerpoint presentation on a specific ...

  8. Imaging in pediatric liver transplantation.

    PubMed

    Monti, L; Soglia, G; Tomà, P

    2016-05-01

    Liver transplantation has become an established curative treatment in adult patients with acute or chronic end-stage liver diseases. In pediatric cases the number of cadaveric donor livers is not sufficient and to overcome the shortage of appropriate-sized whole liver grafts, technical variants of liver transplantation have been practiced. Reduced-size cadaveric and split cadaveric allografts have become an important therapeutic option, expanding the availability of size-appropriate organs for pediatric recipients with terminal liver disease. The number of pediatric deaths awaiting liver transplantation has been reduced by the introduction of living-related liver transplantation, developed to overcome the shortage of suitable grafts for children. It is important for radiologists to know that children have distinct imaging of liver transplantation that distinguish them from adults. A multidisciplinary pediatric liver transplantation team should be skilled in pediatric conditions and in associated processes, risks and complications. Radiologists should know the common pediatric liver diseases that lead to liver transplantation, the anastomotic techniques and the expected postoperative imaging findings. The aim of this study is to illustrate the role of non-invasive imaging such us ultrasonography, color Doppler ultrasonography, multidetector computed tomography and magnetic resonance imaging in the evaluation of pediatric liver transplantation and in potential liver donors. PMID:26909515

  9. Pediatric drug development: formulation considerations.

    PubMed

    Ali, Areeg Anwer; Charoo, Naseem Ahmad; Abdallah, Daud Baraka

    2014-10-01

    Absence of safe, effective and appropriate treatment is one of the main causes of high mortality and morbidity rates among the pediatric group. This review provides an overview of pharmacokinetic differences between pediatric and adult population and their implications in pharmaceutical development. Different pediatric dosage forms, their merits and demerits are discussed. Food and Drug Administration Act of 1997 and the Best Pharmaceuticals for Children Act 2002 added 6 months patent extension and exclusivity incentives to pharmaceutical companies for evaluation of medicinal products in children. Prescription Drug User Fee Act and Food and Drug Administration Amendments Act of 2007 made it mandatory for pharmaceutical companies to perform pediatric clinical studies on new drug products. Drug development program should include additional clinical bridge studies to evaluate differences in pharmacokinetics and pharmacodynamics of drugs in adult and child populations. Additionally, pharmaceutical development should consider ease of administration, palatability, appropriate excipients, stability and therapeutic equivalency of pediatric dosage forms. Pediatric population is diverse with individual preferences and demand for custom made dosage formulations. Practically it is not feasible to have different pharmaceutical dosage forms for each group. Hence, an appropriate dosage form that can be administered across pediatric population is warranted. PMID:24483293

  10. Radiation Safety in Pediatric Orthopaedics.

    PubMed

    Caird, Michelle S

    2015-01-01

    Patients, surgeons, and staff are exposed to ionizing radiation in pediatric orthopaedic surgery from diagnostic studies and imaging associated with procedures. Estimating radiation dose to pediatric patients is based on complex algorithms and dose to surgeons and staff is based on dosimeter monitoring. Surgeons can decrease radiation exposure to patients with careful and thoughtful ordering of diagnostic studies and by minimizing exposure intraoperatively. Surgeon and staff radiation exposure can be minimized with educational programs, proper shielding and positioning intraoperatively, and prudent use of intraoperative imaging. Overall, better awareness among pediatric orthopaedic surgeons of our role in radiation exposure can lead to improvements in radiation safety. PMID:26049299

  11. Pediatric facial transplantation: Ethical considerations

    PubMed Central

    Flynn, Jennifer; Shaul, Randi Zlotnik; Hanson, Mark D; Borschel, Gregory H; Zuker, Ronald

    2014-01-01

    Facial transplantation is becoming increasingly accepted as a method of reconstructing otherwise unreconstructable adult faces. As this modality is made more available, we must turn our attention to pediatric patients who may benefit from facial transplantation. In the current article, the authors present and briefly examine the most pressing ethical challenges posed by the possibility of performing facial transplantation on pediatric patients. Furthermore, they issue a call for a policy statement on pediatric facial transplantation. The present article may serve as a first step in that direction, highlighting ethical issues that would need to be considered in the creation of such a statement. PMID:25114614

  12. Septorhinoplasty in the Pediatric Patient.

    PubMed

    Bhuskute, Aditi; Sumiyoshi, Mika; Senders, Craig

    2016-08-01

    Pediatric septorhinoplasty has been an area of controversy because early surgical intervention can prevent normal growth. There are certain conditions where early correction of the nose is indicated, such as in cleft lip nasal deformities, severe traumatic deformities, and congenital nasal lesions. Animal and clinical studies have been helpful in elucidating certain areas of the nose that are potential growth zones that should be left undisturbed when performing nasal surgeries on pediatric patients. We discuss the timing, indications, and surgical technique in pediatric septorhinoplasty. PMID:27400839

  13. Clinicopathological Implications of Mitochondrial Genome Alterations in Pediatric Acute Myeloid Leukemia

    PubMed Central

    Kang, Min-Gu; Kim, Yu-Na; Lee, Jun Hyung; Szardenings, Michael; Baek, Hee-Jo; Kook, Hoon

    2016-01-01

    Background To the best of our knowledge, the association between pediatric AML and mitochondrial aberrations has not been studied. We investigated various mitochondrial aberrations in pediatric AML and evaluated their impact on clinical outcomes. Methods Sequencing, mitochondrial DNA (mtDNA) copy number determination, mtDNA 4,977-bp large deletion assessments, and gene scan analyses were performed on the bone marrow mononuclear cells of 55 pediatric AML patients and on the peripheral blood mononuclear cells of 55 normal controls. Changes in the mitochondrial mass, mitochondrial membrane potential, and intracellular reactive oxygen species (ROS) levels were also examined. Results mtDNA copy numbers were about two-fold higher in pediatric AML cells than in controls (P<0.0001). Furthermore, a close relationship was found between mtDNA copy number tertiles and the risk of pediatric AML. Intracellular ROS levels, mitochondrial mass, and mitochondrial membrane potentials were all elevated in pediatric AML. The frequency of the mtDNA 4,977-bp large deletion was significantly higher (P< 0.01) in pediatric AML cells, and pediatric AML patients harboring high amount of mtDNA 4,977-bp deletions showed shorter overall survival and event-free survival rates, albeit without statistical significance. Conclusions The present findings demonstrate an association between mitochondrial genome alterations and the risk of pediatric AML. PMID:26709256

  14. The human mast cell chymase gene (CMA1): Mapping to the cathepsin G/granzyme gene cluster and lineage-restricted expression

    SciTech Connect

    Caughey, G.H.; Schaumberg, T.H.; Zerweck, E.H. ); Butterfield, J.H. ); Hanson, R.D.; Ley, T.J. ); Silverman, G.A. )

    1993-03-01

    Genes encoding T-cell receptor [alpha]/[delta] chains, neutrophil cathepsin G, and lymphocyte CGL/granzymes are closely linked on chromosomal band 14q11.2. The current work identifies the human mast cell chymase gene (CMA1) as the fourth protease in this cluster and maps the gene to within 150 kb of the cathepsin G gene. The gene order is centromere-T cell receptor [alpha]/[delta]-CGL-1/granzyme B-CGL-2/granzyme H-cathepsin G-chymase. Chymase and cathepsin G genes are shown to be cotranscribed in the human mast cell line HMC-1 and in U-937 cells. Other cells transcribe cathepsin G or CGL/granzyme genes, but not chymase genes, suggesting a capacity for independent regulation. Comparison of the 5[prime] flank of the chymase gene with those of cathepsin G and CGL/granzymes reveals little overall homology. Only short regions of the 5[prime] flanks of the human and murine chymase genes sequenced to date are similar, suggesting that they are more distantly related than human and rodent CGL-1/granzyme B, the flanks of which are highly homologous. The expression patterns and clustering of genes provide possible clues to the presence of locus control regions that orchestrate lineage-restricted expression of leukocyte and mast cell proteases. 30 refs., 4 figs., 1 tab.

  15. Electrographic seizures in pediatric ICU patients

    PubMed Central

    Arndt, Daniel H.; Carpenter, Jessica L.; Chapman, Kevin E.; Cornett, Karen M.; Gallentine, William B.; Giza, Christopher C.; Goldstein, Joshua L.; Hahn, Cecil D.; Lerner, Jason T.; Loddenkemper, Tobias; Matsumoto, Joyce H.; McBain, Kristin; Nash, Kendall B.; Payne, Eric; Sánchez, Sarah M.; Fernández, Iván Sánchez; Shults, Justine; Williams, Korwyn; Yang, Amy; Dlugos, Dennis J.

    2013-01-01

    Objectives: We aimed to determine the incidence of electrographic seizures in children in the pediatric intensive care unit who underwent EEG monitoring, risk factors for electrographic seizures, and whether electrographic seizures were associated with increased odds of mortality. Methods: Eleven sites in North America retrospectively reviewed a total of 550 consecutive children in pediatric intensive care units who underwent EEG monitoring. We collected data on demographics, diagnoses, clinical seizures, mental status at EEG onset, EEG background, interictal epileptiform discharges, electrographic seizures, intensive care unit length of stay, and in-hospital mortality. Results: Electrographic seizures occurred in 162 of 550 subjects (30%), of which 61 subjects (38%) had electrographic status epilepticus. Electrographic seizures were exclusively subclinical in 59 of 162 subjects (36%). A multivariable logistic regression model showed that independent risk factors for electrographic seizures included younger age, clinical seizures prior to EEG monitoring, an abnormal initial EEG background, interictal epileptiform discharges, and a diagnosis of epilepsy. Subjects with electrographic status epilepticus had greater odds of in-hospital death, even after adjusting for EEG background and neurologic diagnosis category. Conclusions: Electrographic seizures are common among children in the pediatric intensive care unit, particularly those with specific risk factors. Electrographic status epilepticus occurs in more than one-third of children with electrographic seizures and is associated with higher in-hospital mortality. PMID:23794680

  16. Bone Canopies in Pediatric Renal Osteodystrophy

    PubMed Central

    Pereira, Renata C.; Andersen, Thomas L.; Friedman, Peter A.; Tumber, Navdeep; Salusky, Isidro B.; Wesseling-Perry, Katherine

    2016-01-01

    Pediatric renal osteodystrophy (ROD) is characterized by changes in bone turnover, mineralization, and volume that are brought about by alterations in bone resorption and formation. The resorptive and formative surfaces on the cancellous bone are separated from the marrow cavity by canopies consisting of a layer of flat osteoblastic cells. These canopies have been suggested to play a key role in the recruitment of osteoprogenitors during the process of bone remodeling. This study was performed to address the characteristics of the canopies above bone formation and resorption sites and their association with biochemical and bone histomorphometric parameters in 106 pediatric chronic kidney disease (CKD) patients (stage 2–5) across the spectrum of ROD. Canopies in CKD patients often appeared as thickened multilayered canopies, similar to previous reports in patients with primary hyperparathyroidism. This finding contrasts with the thin appearance reported in healthy individuals with normal kidney function. Furthermore, canopies in pediatric CKD patients showed immunoreactivity to the PTH receptor (PTHR1) as well as to the receptor activator of nuclear factor kappa-B ligand (RANKL). The number of surfaces with visible canopy coverage was associated with plasma parathyroid hormone (PTH) levels, bone formation rate, and the extent of remodeling surfaces. Collectively, these data support the conclusion that canopies respond to the elevated PTH levels in CKD and that they possess the molecular machinery necessary to respond to PTH signaling. PMID:27045269

  17. Permanent cardiac pacing in pediatric patients.

    PubMed

    Lotfy, Wael; Hegazy, Ranya; AbdElAziz, Osama; Sobhy, Rodina; Hasanein, Hossam; Shaltout, Fawzan

    2013-02-01

    Pediatric pacemaker (PM) implants comprise less than 1 % of all PM implants. This study aimed to investigate permanent cardiac pacing among the pediatric population, identifying different indications and complications of pediatric cardiac pacing, especially focusing on the effect of the pacing sites, the PM lead type, and the indications for pacing. The current work is a cross-sectional study of 103 procedures for permanent PM insertion in pediatric patients between January 2001 and December 2010. The patients were followed up 1, 3, and 6 months after implantation, then every 6 months or as needed. Evaluation included routine clinical examination, electrocardiography, chest X-ray, echocardiography, and a full analysis of the pacing system measurements. The ages of the patients ranged from 0.09 to 12 years (median, 2.3 years). The most common indication for pacing was postoperative complete heart bock, noted in 54 patients (52.4 %). Transvenous endocardial PM insertion was performed in 92 procedures (89.3 %), whereas transthoracic epicardial insertion was performed in 11 procedures (10.7 %). The most common site of pacing was the right ventricular apex (n = 64, 62 %), followed by the right ventricular outflow tract (n = 25, 24.3 %). Transthoracic epicardial PM insertion was associated with a significantly higher percentage and greater severity of complications. In this study, 65 % of the patients with left ventricle (LV) dilation before pacing showed a significant improvement in LV dimensions and function after pacing. This was noted only in those with endocardially inserted PM leads in both the congenital and the postoperative groups regardless of the pacing site. Endocardial PM insertion in children is a safe procedure with fewer complications and a lower ventricular threshold than the epicardial route. Permanent single-chamber right ventricle pacing is safe and can lead to significant improvement in LV function and dimensions. However, long-term follow

  18. Evaluation of the efficiency of tumor and tissue delivery of carrier-mediated agents (CMA) and small molecule (SM) agents in mice using a novel pharmacokinetic (PK) metric: relative distribution index over time (RDI-OT)

    PubMed Central

    Madden, Andrew J.; Rawal, Sumit; Sandison, Katie; Schell, Ryan; Schorzman, Allison; Deal, Allison; Feng, Lan; Ma, Ping; Mumper, Russell; DeSimone, Joseph; Zamboni, William C.

    2015-01-01

    The pharmacokinetics (PK) of carrier-mediated agents (CMA) is dependent upon the carrier system. As a result, CMA PK differs greatly from the PK of small molecule (SM) drugs. Advantages of CMAs over SMs include prolonged circulation time in plasma, increased delivery to tumors, increased antitumor response, and decreased toxicity. In theory, CMAs provide greater tumor drug delivery than SMs due to their prolonged plasma circulation time. We sought to create a novel PK metric to evaluate the efficiency of tumor and tissue delivery of CMAs and SMs. We conducted a study evaluating the plasma, tumor, liver, and spleen PK of CMAs and SMs in mice bearing subcutaneous flank tumors using standard PK parameters and a novel PK metric entitled relative distribution over time (RDI-OT), which measures efficiency of delivery. RDI-OT is defined as the ratio of tissue drug concentration to plasma drug concentration at each time point. The standard concentration versus time area under the curve values (AUC) of CMAs were higher in all tissues and plasma compared with SMs. However, 8 of 17 SMs had greater tumor RDI-OT AUC0–last values than their CMA comparators and all SMs had greater tumor RDI-OT AUC0–6 h values than their CMA comparators. Our results indicate that in mice bearing flank tumor xenografts, SMs distribute into tumor more efficiently than CMAs. Further research in additional tumor models that may more closely resemble tumors seen in patients is needed to determine if our results are consistent in different model systems. PMID:26392803

  19. Pediatric Antifungal Agents

    PubMed Central

    Cohen-Wolkowiez, Michael; Moran, Cassandra; Benjamin, Daniel K.; Smith, P Brian

    2009-01-01

    Purpose of review In immunocompromised hosts, invasive fungal infections are common and fatal. In the past decade, the antifungal armamentarium against invasive mycoses has expanded greatly. The purpose of this report is to review the most recent literature addressing the use of antifungal agents in children. Recent findings Most studies evaluating the safety and efficacy of antifungal agents are limited to adults. However, important progress has been made in describing the pharmacokinetics and safety of newer antifungal agents in children, including the echinocandins. Summary Dosage guidelines for newer antifungal agents are currently based on adult and limited pediatric data. Because important developmental pharmacology changes occur throughout childhood impacting the pharmacokinetics of these agents, antifungal studies specifically designed for children are necessary. PMID:19741525

  20. Moral Hazard in Pediatrics.

    PubMed

    Brunnquell, Donald; Michaelson, Christopher M

    2016-07-01

    "Moral hazard" is a term familiar in economics and business ethics that illuminates why rational parties sometimes choose decisions with bad moral outcomes without necessarily intending to behave selfishly or immorally. The term is not generally used in medical ethics. Decision makers such as parents and physicians generally do not use the concept or the word in evaluating ethical dilemmas. They may not even be aware of the precise nature of the moral hazard problem they are experiencing, beyond a general concern for the patient's seemingly excessive burden. This article brings the language and logic of moral hazard to pediatrics. The concept reminds us that decision makers in this context are often not the primary party affected by their decisions. It appraises the full scope of risk at issue when decision makers decide on behalf of others and leads us to separate, respect, and prioritize the interests of affected parties. PMID:27292845

  1. Pediatric radiation oncology

    SciTech Connect

    Halperin, E.C.; Kun, L.E.; Constine, L.S.; Tarbell, N.J.

    1989-01-01

    This text covers all aspects of radiation therapy for treatment of pediatric cancer. The book describes the proper use of irradiation in each of the malignancies of childhood, including tumors that are rarely encountered in adult practice. These include acute leukemia; supratentorial brain tumors; tumors of the posterior fossa of the brain and spinal canal; retinoblastoma and optic nerve glioma; neuroblastoma; Hodgkin's disease; malignant lymphoma; Ewing's sarcoma; osteosarcoma; rhabdomyosarcoma; Desmoid tumor; Wilms' tumor; liver and biliary tumors; germ cell and stromal cell tumors of the gonads; endocrine, aerodigestive tract, and breast tumors; Langerhans' cell histiocytosis; and skin cancer and hemangiomas. For each type of malignancy, the authors describe the epidemiology, common presenting signs and symptoms, staging, and proper diagnostic workup. Particular attention is given to the indications for radiation therapy and the planning of a course of radiotherapy, including the optimal radiation dose, field size, and technique.

  2. Pediatric Ingestions: Emergency Department Management.

    PubMed

    Tarango Md, Stacy M; Liu Md, Deborah R

    2016-04-01

    Pediatric ingestions present a common challenge for emergency clinicians. Each year, more than 50,000 children aged less than 5 years present to emergency departments with concern for unintentional medication exposure, and nearly half of all calls to poison centers are for children aged less than 6 years. Ingestion of magnetic objects and button batteries has also become an increasing source of morbidity and mortality. Although fatal pediatric ingestions are rare, the prescription medications most responsible for injury and fatality in children include opioids, sedative/hypnotics, and cardiovascular drugs. Evidence regarding the evaluation and management of common pediatric ingestions is comprised largely of case reports and retrospective studies. This issue provides a review of these studies as well as consensus guidelines addressing the initial resuscitation, diagnosis, and treatment of common pediatric ingestions. Also discussed are current recommendations for decontamination, administration of antidotes for specific toxins, and management of ingested foreign bodies. PMID:27104813

  3. Advances in pediatrics. Volume 32

    SciTech Connect

    Barness, L.A.

    1985-01-01

    These proceedings collect papers on pediatrics. Topics include: the biological role and clinical implications of taurine; human milk nonprotein nitrogen; monoclonal antibodies in the diagnosis and treatment of childhood diseases; and human immune responses to polysaccharide antigens.

  4. What Is a Pediatric Gastroenterologist?

    MedlinePlus

    ... Life Family Life Family Life Medical Home Family Dynamics Media Work & Play Getting Involved in Your Community ... Life Medical Home Health Insurance Pediatric Specialists Family Dynamics Media Work & Play Getting Involved in Your Community ...

  5. What Is a Pediatric Rheumatologist?

    MedlinePlus

    ... Life Family Life Family Life Medical Home Family Dynamics Media Work & Play Getting Involved in Your Community ... Life Medical Home Health Insurance Pediatric Specialists Family Dynamics Media Work & Play Getting Involved in Your Community ...

  6. What Is a Pediatric Geneticist?

    MedlinePlus

    ... Life Family Life Family Life Medical Home Family Dynamics Media Work & Play Getting Involved in Your Community ... Life Medical Home Health Insurance Pediatric Specialists Family Dynamics Media Work & Play Getting Involved in Your Community ...

  7. What Is a Pediatric Urologist?

    MedlinePlus

    ... Life Family Life Family Life Medical Home Family Dynamics Media Work & Play Getting Involved in Your Community ... Life Medical Home Health Insurance Pediatric Specialists Family Dynamics Media Work & Play Getting Involved in Your Community ...

  8. Childhood Obesity for Pediatric Gastroenterologists

    PubMed Central

    Huang, Jeannie S.; Barlow, Sarah E.; Quiros-Tejeira, Ruben E.; Scheimann, Ann; Skelton, Joseph; Suskind, David; Tsai, Patrika; Uko, Victor; Warolin, Joshua P.; Xanthakos, Stavra A.

    2014-01-01

    Obesity in childhood is one of the major health issues in pediatric health care today. As expected, the prevalence of obesity-related comorbidities has risen in parallel with that of obesity. Consultation regarding these concomitant diseases and subsequent management by subspecialists, including pediatric gastroenterologists, is now common and has resulted in obesity being recognized as a chronic disease requiring coordination of care. Although medications and even surgery may provide effective, though often temporary, treatments for obesity and its comorbidities, behavioral interventions addressing healthy dietary and physical activity habits remain a mainstay in the obesity treatment paradigm. Therefore, the issue of weight management must be addressed by both general practitioner and subspecialist alike. In this report, we review select aspects of pediatric obesity and obesity-related management issues because it relates in particular to the field of pediatric gastroenterology and hepatology. PMID:23282941

  9. Neonatal and pediatric respiratory care

    SciTech Connect

    Koff, P.B. ); Eitzman, D.V.; Nev, J. )

    1988-01-01

    This book contains 23 chapters. Some of the titles are: Radiographic evaluations; Neonatal parenchymal diseases: physiologic development; Oxygen therapy; Pediatric parenchymal diseases; and Care of the neurologically injured child.

  10. Innovation in pediatric surgical education.

    PubMed

    Clifton, Matthew S; Wulkan, Mark L

    2015-06-01

    Pediatric surgical training in the United States remained basically unchanged from the model developed by Ladd and Gross in the 1930s until recently. Standardized curriculum and novel evaluation methods are now being implemented. Pediatric Surgical education is currently undergoing a transition to competency-based evaluation and promotion. Unfortunately, there is little data on the efficacy of these changes. This presents an opportunity for further study of how we conduct training, and how we evaluate and promote our trainees. PMID:25976147