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. Calicheamicin-conjugated humanized anti-CD33 monoclonal antibody (gemtuzumab zogamicin, CMA-676) shows cytocidal effect on CD33-positive leukemia cell lines, but is inactive on P-glycoprotein-expressing sublines.

    PubMed

    Naito, K; Takeshita, A; Shigeno, K; Nakamura, S; Fujisawa, S; Shinjo, K; Yoshida, H; Ohnishi, K; Mori, M; Terakawa, S; Ohno, R

    2000-08-01

    Calicheamicin-conjugated humanized anti-CD33 mouse monoclonal antibody, CMA-676, has recently been introduced to clinics as a promising drug to treat patients with acute myeloid leukemia (AML) in relapse. However, the mechanism of action of CMA-676 has not been well elucidated. The cytotoxic effect of CMA-676 on HL60, NOMO-1, NB4, NKM-1, K562, Daudi, and the multidrug-resistant sublines, NOMO-1/ADR and NB4/MDR, was investigated by cell cycle distribution and morphology. These studies were done by a video-microscopic system, DNA fragmentation, dye exclusion and 3H-thymidine uptake after analysis of CD33, CD34, P-glycoprotein (P-gp), multidrug resistance (MDR)-associated protein and lung-related protein on these cells. A dose-dependent, selective cytotoxic effect of CMA-676 was observed in cell lines that expressed CD33, and was dependent on the amount of CD33 and the proliferative speed of the cells. Sensitive cells were temporally arrested at the G2/M phase before undergoing morphological changes. CMA-676 is not effective on P-gp-expressing multidrug-resistant sublines compared with parental cell lines. MDR modifiers, MS209 and PSC833, restored the cytotoxic effect of CMA-676 in P-gp-expressing sublines. CMA-676 is a promising agent in the treatment of patients with AML that expresses CD33. The combined use of CMA-676 and MDR modifiers may increase the selective cytotoxic effect in multidrug-resistant AML. PMID:10942240

  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. PMID:27417352

  4. EUVE Observations of Epsilon CMa

    NASA Astrophysics Data System (ADS)

    Cassinelli, J. P.

    1993-05-01

    The brightest EUV source in the sky in the long wavelength spectrometer band of EUVE is the B2 II star Epsilon CMa. The star is also detected in the short and medium wavelength spectral bands and several emission lines from Fe and from He II are present. These provide exciting new information regarding the shocked wind of the star. A strong stellar continuum flux is present throughout the long wavelength band from about 400 to 700 Angstroms, with a continuum jump due to the ionization of He I near 504 Angstroms. The jump contains information about the very small interstellar attenuation that is present along the 187 parsecs towards this star, as well as about the confluence of lines just longward of the jump. The observations are used in conjunction with angular diameter and UV data on this star to derive Teff and other fundamental atmospheric parameters. Basic results from fits of the observations to model atmospheres and stellar winds are presented in the talk, and reference is made to the related posters by members of our group of investigators: J. MacFarlane, D. Cohen at U. Wisc; J. Vallerga, B. Welsh, P. Vedder at CEA; and J. Drew and M. Hoare at the U. of Oxford.

  5. Correlation between sperm DNA fragmentation index and CMA3 positive spermatozoa in globozoospermic patients.

    PubMed

    Hosseinifar, H; Yazdanikhah, S; Modarresi, T; Totonchi, M; Sadighi Gilani, M A; Sabbaghian, M

    2015-05-01

    The absence of the acrosome causes the situation which is called globozoospermia. There are a few studies, mostly as case reports, about correlation between levels of sperm DNA damage in patients with total round-headed spermatozoa. We investigated this correlation as well as CMA3 positive spermatozoa in 20 globozoospermic men (with more than 90% round-headed spermatozoa) attending to Royan Institute. Semen samples divided into three parts to semen analysis, to measure DNA fragmentation index (DFI) using sperm chromatin structure assay (SCSA) and to detect CMA3(+) sperm cells by chromomycin A3 staining and fluorescent microscopy. Our results showed that there were significant differences in sperm concentration, total sperm motility, and normal morphology between patients and controls group (p < 0.001). Moreover, the average of DFI and CMA3 positive spermatozoa in patients group significantly increases compared with control group (p < 0.001). A significant correlation between DFI and CMA3(+) in total population was also detected in patients group (r = 0.45, p = 0.046). To our knowledge, this is the largest study about correlation between DNA damage levels and CMA3 positive spermatozoa with round head sperm cells in total globozoospermic men. It seems that the increase in DNA damage may be because of defective sperm DNA compaction, as we detected CMA3 positive sperm cells in these patients.

  6. Task Control Signals in Pediatric Tourette Syndrome Show Evidence of Immature and Anomalous Functional Activity

    PubMed Central

    Church, Jessica A.; Wenger, Kristin K.; Dosenbach, Nico U. F.; Miezin, Francis M.; Petersen, Steven E.; Schlaggar, Bradley L.

    2009-01-01

    Tourette Syndrome (TS) is a pediatric movement disorder that may affect control signaling in the brain. Previous work has proposed a dual-networks architecture of control processing involving a task-maintenance network and an adaptive control network (Dosenbach et al., 2008). A prior resting-state functional connectivity MRI (rs-fcMRI) analysis in TS has revealed functional immaturity in both putative control networks, with “anomalous” correlations (i.e., correlations outside the typical developmental range) limited to the adaptive control network (Church et al., 2009). The present study used functional MRI (fMRI) to study brain activity related to adaptive control (by studying start-cues signals), and to task-maintenance (by studying signals sustained across a task set). Two hypotheses from the previous rs-fcMRI results were tested. First, adaptive control (i.e., start-cue) activity will be altered in TS, including activity inconsistent with typical development (“anomalous”). Second, group differences found in task-maintenance (i.e., sustained) activity will be consistent with functional immaturity in TS. We examined regions found through a direct comparison of adolescents with and without TS, as well as regions derived from a previous investigation that showed differences between unaffected children and adults. The TS group showed decreased start-cue signal magnitude in regions where start-cue activity is unchanged over typical development, consistent with anomalous adaptive control. The TS group also had higher magnitude sustained signals in frontal cortex regions that overlapped with regions showing differences over typical development, consistent with immature task-maintenance in TS. The results demonstrate task-related fMRI signal differences anticipated by the atypical functional connectivity found previously in adolescents with TS, strengthening the evidence for functional immaturity and anomalous signaling in control networks in adolescents with TS

  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. 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.

  9. Medical publishing on the Internet: The CMA goes online

    PubMed Central

    Bolster, Ann; McCullough, Steven L.

    1995-01-01

    The CMA's Publications Department has created an interactive information service on the Internet, CMA Online (http://hpb1.hwc.ca:8400/), to provide physicians with rapid access to up-to-date clinical information and health care news, as well as to facilitate electronic discussion among health care professionals throughout the world and to provide information to patients. The CMA is the first national medical association in the world to do this. The service, part of the Internet's multimedia system known as the World Wide Web, is the first totally electronic product from the CMA. Because anyone with access to the Web can use the service, CMA Online will be an important vehicle for raising the profile of the medical profession in Canada and for disseminating health care information to the computer-literate public. It is tangible evidence of the CMA's commitment to provide strong leadership in the health care field. ImagesFIG. 1FIG. 2

  10. 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.

  11. 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.

  12. 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

  13. 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

  14. 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

    Lee, Jong-Kook; Seo, Chang Ho; Luchian, Tudor; Park, Yoonkyung

    2015-11-09

    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.

  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. Single agent carboplatin for pediatric low-grade glioma: A retrospective analysis shows equivalent efficacy to multiagent chemotherapy.

    PubMed

    Dodgshun, Andrew J; Maixner, Wirginia J; Heath, John A; Sullivan, Michael J; Hansford, Jordan R

    2016-01-15

    Pediatric low-grade gliomas (LGG) that are unresectable often require adjuvant chemotherapy such as carboplatin/vincristine. Small Phase II studies have suggested equivalent efficacy of single agent 4-weekly carboplatin. A single-institution retrospective review captured all patients aged 0 to 18 years diagnosed with LGG between 1996 and 2013 and treated with carboplatin monotherapy. The response and survival according to tumor site was compared to published results for multiagent chemotherapy. Of 268 children diagnosed with LGG diagnosed in this period, 117 received chemotherapy and 104 children received single agent carboplatin as first line chemotherapy. All patients received carboplatin at 560 mg/m(2), four-weekly for a median of 12 courses. The mean age at diagnosis was 5.8 years (range 3m-16y) and 32% had neurofibromatosis type 1. With a mean followup of 54 months, 86% of patients achieved stabilisation or better (SD/PR/CR). 3-year progression free survival (PFS) 66% (95% CI 57-76%), and 5-year PFS was 51% (95% CI 41-63%). 5-year overall survival was 97%. Multivariate analysis showed poorer PFS for those with chiasmatic/hypothalamic tumors. In this retrospective analysis single agent carboplatin shows comparable efficacy to historical multiagent chemotherapy for the treatment of patients with unresectable LGG. Equivalent outcomes are achieved with less chemotherapy, reduced side effects and fewer hospital visits. Further research is required to establish the place of this simplified regimen in the up-front treatment of unresectable LGG.

  17. Calcium magnesium acetate at lower production cost: Production of CMA deicer from biomass. Final report, April 1993--July 1997

    SciTech Connect

    Basu, R.; Breshears, J.S.; Clausen, E.C.; Gaddy, J.L.; Gaines, L.D.

    1999-01-01

    The purpose of this project was to demonstrate the technical and economic feasibility of producing Calcium Magnesium Acetate (CMA) from solid waste by gasification/fermentation. Bench-scale fermentation experiments were conducted with synthesis gases typical of those from gasification of various residues. Fast reaction rates and high yields were obtained, and phase contaminants, such as chlorides, metals, and sulfur gases in concentrations expected in syngas, were not found to affect the fermentation. The production of CMA by reacting lime and magnesium oxide with acetic acid extracted from the fermentation broth was optimized in bench-scale experiments. Procedures for using cheap grades of lime and magnesium oxide were developed. Ice melting and penetration tests, as well as analytical results, showed the laboratory CMA to be comparable (or better) quality to the industry product. Process design and economic projections for a commercial-scale facility were developed.

  18. 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.

  19. 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.

  20. 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

  1. 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

  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.

  3. CoCMA: Energy-Efficient Coverage Control in Cluster-Based Wireless Sensor Networks Using a Memetic Algorithm

    PubMed Central

    Jiang, Joe-Air; Chen, Chia-Pang; Chuang, Cheng-Long; Lin, Tzu-Shiang; Tseng, Chwan-Lu; Yang, En-Cheng; Wang, Yung-Chung

    2009-01-01

    Deployment of wireless sensor networks (WSNs) has drawn much attention in recent years. Given the limited energy for sensor nodes, it is critical to implement WSNs with energy efficiency designs. Sensing coverage in networks, on the other hand, may degrade gradually over time after WSNs are activated. For mission-critical applications, therefore, energy-efficient coverage control should be taken into consideration to support the quality of service (QoS) of WSNs. Usually, coverage-controlling strategies present some challenging problems: (1) resolving the conflicts while determining which nodes should be turned off to conserve energy; (2) designing an optimal wake-up scheme that avoids awakening more nodes than necessary. In this paper, we implement an energy-efficient coverage control in cluster-based WSNs using a Memetic Algorithm (MA)-based approach, entitled CoCMA, to resolve the challenging problems. The CoCMA contains two optimization strategies: a MA-based schedule for sensor nodes and a wake-up scheme, which are responsible to prolong the network lifetime while maintaining coverage preservation. The MA-based schedule is applied to a given WSN to avoid unnecessary energy consumption caused by the redundant nodes. During the network operation, the wake-up scheme awakens sleeping sensor nodes to recover coverage hole caused by dead nodes. The performance evaluation of the proposed CoCMA was conducted on a cluster-based WSN (CWSN) under either a random or a uniform deployment of sensor nodes. Simulation results show that the performance yielded by the combination of MA and wake-up scheme is better than that in some existing approaches. Furthermore, CoCMA is able to activate fewer sensor nodes to monitor the required sensing area. PMID:22408561

  4. CMA conference to look at role research plays when critical policy decisions are being made.

    PubMed

    Wharry, S

    1997-02-01

    Physician leaders will meet in Ottawa Feb. 28 and Mar. 1 for the CMA's 9th Annual Leadership Conference to examine how evidence, research and data influence health policy. For information or to register contact CMA Meetings and Travel Department, 800 663-7336, ext. 2274; fax 613 731-8047.

  5. Two cases of pediatric bone disease (eosinophilic granuloma and Brodie's abscess) showing similar scintigraphic and radiographic findings.

    PubMed

    Yoshikawa, M; Sugawara, Y; Kikuchi, T; Nakata, S; Mochizuki, T; Ikezoe, J; Sakayama, K

    2000-12-01

    Two 9-year-old patients with femoral bone lesions were referred to the authors' institution within a few days of each other. Both showed similar radiographic, magnetic resonance imaging, and scintigraphic findings. The radiographs showed osteolytic lesions in the right femoral diaphyses, and gadolinium-DTPA-enhanced magnetic resonance imaging revealed inhomogeneous enhancement. Tc-99m HMDP showed marked linear accumulation with relatively low central uptake in the right femoral shafts, and TI-201 scintigraphy showed considerable uptake corresponding to the area seen with Tc-99m HMDP. Histologic analysis confirmed eosinophilic granuloma in the first patient and Brodie's abscess in the second. The radiographic and scintigraphic findings in Brodie's abscess may be similar to those in eosinophilic granuloma.

  6. Time Course of Recovery Showing Initial Prefrontal Cortex Changes at 16 weeks, Extended to Subcortical Changes by Three years in Pediatric Bipolar Disorder

    PubMed Central

    Yang, Hongyu; Lu, Lisa H.; Wu, Minjie; Stevens, Michael; Wegbreit, Ezra; Fitzgerald, Jacklynn; Levitan, Bryn; Shankman, Stewart; Pavuluri, Mani N.

    2013-01-01

    Objective Developmental changes at the interface of affective and cognitive systems are examined over a three year period in pediatric bipolar disorder (PBD). Methods Thirteen participants with PBD and 10 healthy controls (HC) matched on demographics and IQ were scanned at baseline, 16 weeks, and after three years. All patients received pharmacotherapy based on a medication algorithm. A pediatric affective color matching paradigm was used to probe cognitive processing under emotional challenge. Results Behavioral data illustrated that patients in PBD group were slower in response time at baseline, but normalized by three years. On fMRI analyses at baseline, in response to emotional vs. neutral words, patients with PBD showed greater activation, relative to HC, in the right dorsal lateral prefrontal cortex (DLPFC) and amygdala, ventral lateral prefrontal cortex (VLPFC), bilateral anterior cingulate cortex (ACC), and ventral striatum. The increased activation in cortical areas in the PBD group normalized with no differences from HC by 16 weeks. By three years, normalization was observed in not only the cortical, but also the subcortical regions such as amygdala and striatum. Limitations These preliminary findings need to be replicated with a larger sample, although it can be challenging to obtain large samples for longitudinal studies. Conclusions Greater activation in fronto-striatal and fronto-limbic circuits were observed in unmedicated patients with PBD. With systematic pharmacotherapy for patients with PBD, the time course of recovery was characterized by initial prefrontal changes at 16 weeks, which extended to subcortical normalization at three years. These preliminary findings illustrated that, following appropriate treatment coupled with normal brain development, patients with PBD showed normalization in brain function. PMID:23517886

  7. Pediatric posttransplant relapsed/refractory B-precursor acute lymphoblastic leukemia shows durable remission by therapy with the T-cell engaging bispecific antibody blinatumomab.

    PubMed

    Schlegel, Patrick; Lang, Peter; Zugmaier, Gerhard; Ebinger, Martin; Kreyenberg, Hermann; Witte, Kai-Erik; Feucht, Judith; Pfeiffer, Matthias; Teltschik, Heiko-Manuel; Kyzirakos, Christina; Feuchtinger, Tobias; Handgretinger, Rupert

    2014-07-01

    We report on posttransplant relapsed pediatric patients with B-precursor acute lymphoblastic leukemia with no further standard of care therapy who were treated with the T-cell engaging CD19/CD3-bispecific single-chain antibody construct blinatumomab on a compassionate use basis. Blast load was assessed prior to, during and after blinatumomab cycle using flow cytometry to detect minimal residual disease, quantitative polymerase chain reaction for rearrangements of the immunoglobulin or T-cell receptor genes, and bcr/abl mutation detection in one patient with Philadelphia chromosome-positive acute lymphoblastic leukemia. Blinatumomab was administered as a 4-week continuous intravenous infusion at a dosage of 5 or 15 μg/m(2)/day. Nine patients received a total of 18 cycles. Four patients achieved complete remission after the first cycle of treatment; 2 patients showed a complete remission from the second cycle after previous reduction of blast load by chemotherapy. Three patients did not respond, of whom one patient proceeded to a second cycle without additional chemotherapy and again did not respond. Four patients were successfully retransplanted in molecular remission from haploidentical donors. After a median follow up of 398 days, the probability of hematologic event-free survival is 30%. Major toxicities were grade 3 seizures in one patient and grade 3 cytokine release syndrome in 2 patients. Blinatumomab can induce molecular remission in pediatric patients with posttransplant relapsed B-precursor acute lymphoblastic leukemia and facilitate subsequent allogeneic hematopoietic stem cell transplantation from haploidentical donor with subsequent long-term leukemia-free survival.

  8. 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

  9. 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.

  10. 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.

  11. The nature of FS CMa stars as revealed by host young clusters

    NASA Astrophysics Data System (ADS)

    de la Fuente, D.; Najarro, F.; Trombley, C.; Davies, B.; Figer, D. F.

    2015-05-01

    The nature and evolutionary state of the diverse objects displaying the B[e] phenomenon are reasonably known, except for a rare subtype named FS CMa stars. These are surrounded by compact disks of warm dust whose origin is unclear. Although the luminosity of these objects corresponds to main-sequence stars, mass loss rates derived from emission lines are 2 orders of magnitude larger than predicted by wind theory. Hitherto, FS CMa stars have been only found in isolation, which hinders the study of their nature. In this contribution, we present the discovery of FS CMa stars in two young Galactic clusters, which host Wolf-Rayet stars and OB supergiants. Membership to these coeval populations allows us to constrain the luminosity, circumstellar extinction and age of FS CMa stars in an unprecedented way. Due to their relatively low brightness when compared with coeval evolved massive stars, a high number of these objects may remain unnoticed in young clusters.

  12. Chromosomal Microarray Analysis (CMA) a Clinical Diagnostic Tool in the Prenatal and Postnatal Settings.

    PubMed

    Batzir, Nurit Assia; Shohat, Mordechai; Maya, Idit

    2015-09-01

    Chromosomal microarray analysis (CMA) is a technology used for the detection of clinically-significant microdeietions or duplications, with a high sensitivity for submicroscopic aberrations. It is able to detect changes as small as 5-10Kb in size - a resolution up to 1000 times higher than that of conventional karyotyping. CMA is used for uncovering copy number variants (CNVs) thought to play an important role in the pathogenesis of a variety of disorders, primarily neurodevelopmental disorders and congenital anomalies. CMA may be applied in the prenatal or postnatal setting, with unique benefits and limitations in each setting. The growing use of CMA makes it essential for practicing physicians to understand the principles of this technology and be aware of its powers and limitations.

  13. 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.

  14. 2D/3D registration with the CMA-ES method

    NASA Astrophysics Data System (ADS)

    Gong, Ren Hui; Abolmaesumi, Purang

    2008-03-01

    In this paper, we propose a new method for 2D/3D registration and report its experimental results. The method employs the Covariance Matrix Adaptation Evolution Strategy (CMA-ES) algorithm to search for an optimal transformation that aligns the 2D and 3D data. The similarity calculation is based on Digitally Reconstructed Radiographs (DRRs), which are dynamically generated from the 3D data using a hardware-accelerated technique - Adaptive Slice Geometry Texture Mapping (ASGTM). Three bone phantoms of different sizes and shapes were used to test our method: a long femur, a large pelvis, and a small scaphoid. A collection of experiments were performed to register CT to fluoroscope and DRRs of these phantoms using the proposed method and two prior work, i.e. our previously proposed Unscented Kalman Filter (UKF) based method and a commonly used simplex-based method. The experimental results showed that: 1) with slightly more computation overhead, the proposed method was significantly more robust to local minima than the simplex-based method; 2) while as robust as the UKF-based method in terms of capture range, the new method was not sensitive to the initial values of its exposed control parameters, and has also no special requirement about the cost function; 3) the proposed method was fast and consistently achieved the best accuracies in all compared methods.

  15. 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.

  16. General Council insists on retaining role as CMA's key policy-making body

    PubMed Central

    Rafuse, Jill

    1996-01-01

    General Council has reaffirmed its role as the CMA's primary policymaking body. Rejecting key elements of a report from the Committee on Structure that would have made General Council advisory to the Board of Directors, delegates at the 129th annual meeting said the current structure serves members well and does not need to be changed. However, there was considerable support for measures that would provide increased representation for young physicians and medical students. Delegates discussed how to make the annual meeting more representative of CMA members, then referred the report to the Board of Directors.

  17. Chromosomal microarray analysis (CMA) detects a large X chromosome deletion including FMR1, FMR2, and IDS in a female patient with mental retardation.

    PubMed

    Probst, Frank J; Roeder, Elizabeth R; Enciso, Victoria B; Ou, Zhishuo; Cooper, M Lance; Eng, Patricia; Li, Jiangzhen; Gu, Yanghong; Stratton, Robert F; Chinault, A Craig; Shaw, Chad A; Sutton, V Reid; Cheung, Sau Wai; Nelson, David L

    2007-06-15

    Chromosomal microarray analysis (CMA) by array-based comparative genomic hybridization (CGH) is a new clinical test for the detection of well-characterized genomic disorders caused by chromosomal deletions and duplications that result in gene copy number variation (CNV). This powerful assay detects an abnormality in approximately 7-9% of patients with various clinical phenotypes, including mental retardation. We report here on the results found in a 6-year-old girl with mildly dysmorphic facies, obesity, and marked developmental delay. CMA was requested and showed a heterozygous loss in copy number with clones derived from the genomic region cytogenetically defined as Xq27.3-Xq28. This loss was not cytogenetically visible but was seen on FISH analysis with clones from the region. Further studies confirmed a loss of one copy each of the FMR1, FMR2, and IDS genes (which are mutated in Fragile X syndrome, FRAXE syndrome, and Hunter syndrome, respectively). Skewed X-inactivation has been previously reported in girls with deletions in this region and can lead to a combined Fragile X/Hunter syndrome phenotype in affected females. X-inactivation and iduronate 2-sulfatase (IDS) enzyme activity were therefore examined. X-inactivation was found to be random in the child's peripheral leukocytes, and IDS enzyme activity was approximately half of the normal value. This case demonstrates the utility of CMA both for detecting a submicroscopic chromosomal deletion and for suggesting further testing that could possibly lead to therapeutic options for patients with developmental delay.

  18. 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] ...

  19. 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) ...

  20. CMA manufacture II: Improved bacterial strain for acetate production: Final report

    SciTech Connect

    Ljungdahl, L.G.; Carreira, L.H.; Garrison, R.J.; Rabek, N.E.; Gunter, L.F.; Wiegel, J.

    1986-06-01

    Three homoacetogenic anaerobic thermophilic bacteria, Clostridium thermoaceticum, Clostridium thermoautotrophicum, and Acetogenium kivui, were evaluated for possible use in an industrial fermentative process to manufacture calcium, magnesium acetate (CMA) from hydrolyzed corn starch and dolime. The hydrolyzed corn starch is fermented by the bacteria with a theoretical yield of about 90%. Improved bacterial strains were obtained from the clostridial bacteria but not from A. kivui. In fermentations with improved bacterial strains using dolime to neutralize the produced acetic acid, up to 150 g/liter of CMA was produced, however, the production rate was only about 12 g/liter per 24 hours. Batch fermentation, continuous fermentation with and without cell-recycling and continuous fermentation with a new type of rotating fermentor were tested. Economic evaluation of the results indicate that CMA can be produced for $0.24/lb. The rotating fermentor device was developed at the end of the contract period. With it a production rate of almost 10 g/liter an hour was obtained, however, the concentration of acetate in the harvested fermentation broth was only 1 percent. Further research should lead to the development of an economic fermentation process for CMA. 38 refs., 10 figs., 34 tabs.

  1. 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.

    1993-04-01

    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. The possibility of introducing two different sorbents sequentially will also be examined. For instance, such a scheme may employ injection of the rather inexpensive calcium carbonate initially, followed by the more costly CMA. The effectiveness of a homemade'' CMA using woody biomass as a low-cost source of acetate will be explored if such a product becomes available during the course of this work. Finally, CMA will be introduced in the matrix of the coal by an ion exchange or a precipitation technique. Upon subsequent combustion, the composition and physical structure of the remaining ash will be examined, as well as the gas phase SO[sub x], concentration. Both techniques (CMA pretreatment and CMA injection) may also be implemented simultaneously to assess their combined effect on sulfur capture.

  2. FY-3C/VIRR SST algorithm and cal/val activities at NSMC/CMA

    NASA Astrophysics Data System (ADS)

    Wang, Sujuan; Cui, Peng; Zhang, Peng; Ran, Maonong; Lu, Feng; Wang, Weihe

    2014-11-01

    The National Satellite Meteorological Center (NSMC)/CMA global sea surface temperature (SST) data are derived from measurements made by the Visible and Infrared Radiometer (VIRR) on board the FY-3 series polar orbiting satellites. Quality controlled in situ data from iQUAM (STAR/NESDIS/NOAA) is used in FY-3B/C VIRR matching procedure. The monthly matchup database (MDB) is created from FY-3C VIRR measurements paired with coincident SST measurements from buoys since November 2013. The satellite sensor's brightness temperature and buoy SST pairs are included in the MDB if they are coincident within 3km in space and 1 hour in time. Least-Square Regression is used for estimating the first-guess coefficient and SST residuals. Outliers are removed using Median±2STD, and the final coefficients of robust regression are estimated. A set of SST regression formalisms are tested base on NOAA- 19/AVHRR 2010 MDB. The test shows that, for daytime split-window nonlinear SST (NLSST) is the best, for nighttime triple-window MCSST (TCSST) is the best, which is agree with STAR/NESDIS's. The same regression analysis method also used on FY-3C/VIRR MDB. Compare with the three daytime SST algorithms and five nighttime SST algorithms, the best algorithm to retrieve FY-3C/VIRR SST for daytime is NLSST and for nighttime is TCSST. Compare with the coefficients of nighttime algorithm TCSST, it shows that for FY-3B/C VIRR SST, the contribution of 3.7μm band is smaller than split-window bands. The performance of 3.7μm band of FY-3C/VIRR is better than FY-3B/VIRR, but worse than NOAA-19/AVHRR.

  3. Pediatric primary central nervous system germ cell tumors of different prognosis groups show characteristic miRNome traits and chromosome copy number variations

    PubMed Central

    2010-01-01

    Background Intracranial pediatric germ cell tumors (GCTs) are rare and heterogeneous neoplasms and vary in histological differentiation, prognosis and clinical behavior. Germinoma and mature teratoma are GCTs that have a good prognosis, while other types of GCTs, termed nongerminomatous malignant germ cell tumors (NGMGCTs), are tumors with an intermediate or poor prognosis. The second group of tumors requires more extensive drug and irradiation treatment regimens. The mechanisms underlying the differences in incidence and prognosis of the various GCT subgroups are unclear. Results We identified a distinct mRNA profile correlating with GCT histological differentiation and prognosis, and also present in this study the first miRNA profile of pediatric primary intracranial GCTs. Most of the differentially expressed miRNAs were downregulated in germinomas, but miR-142-5p and miR-146a were upregulated. Genes responsible for self-renewal (such as POU5F1 (OCT4), NANOG and KLF4) and the immune response were abundant in germinomas, while genes associated with neuron differentiation, Wnt/β-catenin pathway, invasiveness and epithelial-mesenchymal transition (including SNAI2 (SLUG) and TWIST2) were abundant in NGMGCTs. Clear transcriptome segregation based on patient survival was observed, with malignant NGMGCTs being closest to embryonic stem cells. Chromosome copy number variations (CNVs) at cytobands 4q13.3-4q28.3 and 9p11.2-9q13 correlated with GCT malignancy and clinical risk. Six genes (BANK1, CXCL9, CXCL11, DDIT4L, ELOVL6 and HERC5) within 4q13.3-4q28.3 were more abundant in germinomas. Conclusions Our results integrate molecular profiles with clinical observations and provide insights into the underlying mechanisms causing GCT malignancy. The genes, pathways and microRNAs identified have the potential to be novel therapeutic targets. PMID:20178649

  4. Snooping around the Big Dog: VY CMa as Seen with Herschel/HIFI

    NASA Astrophysics Data System (ADS)

    De Beck, E.; Decin, L.; Menten, K. M.; Marston, A.; Teyssier, D.; Hifistars Team

    2011-09-01

    In the framework of the HIFISTARS guaranteed time key programme, we measured more than 70 molecular emission lines with high signal-to-noise ratio towards VY CMa using the high-resolution HIFI spectrometer (de Graauw et al. 2010) on board the Herschel1 satellite. The kinematic information obtained from the measured water lines supports the hypothesis of multiple outflow components. The observed strong maser lines give no indication for polarisation.

  5. 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.

  6. Synthesis, Biodistribution and In vitro Evaluation of Brain Permeable High Affinity Type 2 Cannabinoid Receptor Agonists [11C]MA2 and [18F]MA3

    PubMed Central

    Ahamed, Muneer; van Veghel, Daisy; Ullmer, Christoph; Van Laere, Koen; Verbruggen, Alfons; Bormans, Guy M.

    2016-01-01

    The type 2 cannabinoid receptor (CB2) is a member of the endocannabinoid system and is known for its important role in (neuro)inflammation. A PET-imaging agent that allows in vivo visualization of CB2 expression may thus allow quantification of neuroinflammation. In this paper, we report the synthesis, radiosynthesis, biodistribution and in vitro evaluation of a carbon-11 ([11C]MA2) and a fluorine-18 ([18F]MA3) labeled analog of a highly potent N-arylamide oxadiazole CB2 agonist (EC50 = 0.015 nM). MA2 and MA3 behaved as potent CB2 agonist (EC50: 3 nM and 0.1 nM, respectively) and their in vitro binding affinity for hCB2 was found to be 87 nM and 0.8 nM, respectively. Also MA3 (substituted with a fluoro ethyl group) was found to have higher binding affinity and EC50 values when compared to the originally reported trifluoromethyl analog 12. [11C]MA2 and [18F]MA3 were successfully synthesized with good radiochemical yield, high radiochemical purity and high specific activity. In mice, both tracers were efficiently cleared from blood and all major organs by the hepatobiliary pathway and importantly these compounds showed high brain uptake. In conclusion, [11C]MA2 and [18F]MA3 are shown to be high potent CB2 agonists with good brain uptake, these favorable characteristics makes them potential PET probes for in vivo imaging of brain CB2 receptors. However, in view of its higher affinity and selectivity, further detailed evaluation of MA3 as a PET tracer for CB2 is warranted. PMID:27713686

  7. 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

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. PEDIATRIC PANCREATITIS

    PubMed Central

    Pohl, John F.; Uc, Aliye

    2015-01-01

    Purpose of Review The purpose of this review is to describe recent developments in pediatric pancreatitis and to discuss etiologies and current management. Recent Findings Although recent studies have estimated the annual incidence of pediatric acute pancreatitis approaching that of adults, there are no established guidelines about its diagnosis and treatment in children. Genetic and structural/congenital abnormalities are emerging as the primary risk factors for pediatric acute recurrent and chronic pancreatitis. Specifically, chronic pancreatitis is associated with a significant socioeconomic burden in children. Both medical and surgical therapies are proposed for pediatric chronic pancreatitis, but there is little evidence that they are beneficial. Summary Acute, acute recurrent and chronic pancreatitis create significant health issues in the pediatric population. Medical and surgical therapies exist to potentially treat these conditions, but the pediatric data is limited and the cohorts are small. A multidisciplinary and multicenter approach is necessary to better determine pancreatic disease processes and treatment options in children. PMID:26181572

  13. Pediatric anklebot.

    PubMed

    Krebs, Hermano I; Rossi, Stefano; Kim, Seung-Jae; Artemiadis, Panagiotis K; Williams, Dustin; Castelli, Enrico; Cappa, Paolo

    2011-01-01

    In this paper we present the alpha-prototype of a novel pediatric ankle robot. This lower-extremity robotic therapy module was developed at MIT to aid recovery of ankle function in children with cerebral palsy ages 5 to 8 years old. This lower-extremity robotic module will commence pilot testing with children with cerebral palsy at Blythedale Childrens Hospital (Valhalla, NY), Bambino Gesu Children's Hospital (Rome, Italy), Riley Children's Hospital (Indianapolis, IN). Its design follows the same guidelines as our upper-extremity robots and adult anklebot designs, i.e. it is a low friction, backdriveable device with intrinsically low mechanical impedance. We show the ankle robot characteristics and stability range. We also present pilot data with healthy children to demonstrate the potential of this device. PMID:22275613

  14. 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).

  15. 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.

  16. 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.

  17. Future of health care dominates meeting as CMA urges governments to fix “system in crisis”

    PubMed Central

    Sullivan, Patrick

    1996-01-01

    Despite some media predictions that the CMA would endorse a parallel private health care system for Canadians during its August annual meeting, General Council in fact defeated motions favouring a move to privatized health care delivery. Sixteen resolutions on the future of health and health care were passed at the meeting, and most dealt with ways to improve the existing system.

  18. 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

  19. 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 ...

  20. Virtual Pediatric Hospital

    MedlinePlus

    ... Assistant™ 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 ...

  1. 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.

  2. 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).

  3. 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.

  4. A breast cancer cell microarray (CMA) as a rapid method to characterize candidate biomarkers.

    PubMed

    Wu, Xinyan; Zahari, Muhammad S; Renuse, Santosh; Jacob, Harrys K C; Sakamuri, Sruthi; Singal, Mukul; Gabrielson, Edward; Sukumar, Saraswati; Pandey, Akhilesh

    2014-01-01

    Tissue microarrays (TMAs) have become an invaluable tool in cancer research to evaluate expression and subcellular localization of proteins in cells and tissues. As the catalogs of candidate biomarkers and therapeutic targets become more extensive, there is a need to characterize and validate these targets and biomarkers in cell lines as a primary biological system in research laboratories. Thus, cell microarrays (CMAs) are useful as a high-throughput screening tool. Here, we constructed a CMA containing 32 publicly available immortalized breast cell lines with the goal of creating a method to rapidly screen for antigens of interest in breast cancer research in a relatively easy, rapid and cost-effective manner. As proof of concept, we performed immunocytochemical staining of the HER2 receptor, as the status of this protein is relevant to breast cancer and has previously been reported for these cell lines. We observed a complete concordance of our staining with the published status of HER2 in these cell lines. In addition, we examined the expression of CD44, epithelial markers EpCAM and E-cadherin and tyrosine phosphoproteins. The labeling of these proteins correlates with the known biology of the cell lines. Our results demonstrate the utility of our method to screen for potential biomarkers and therapeutic targets in breast cancer and we suggest that CMAs be used as a general approach in breast cancer research.

  5. A breast cancer cell microarray (CMA) as a rapid method to characterize candidate biomarkers

    PubMed Central

    Wu, Xinyan; Zahari, Muhammad S; Renuse, Santosh; Jacob, Harrys KC; Sakamuri, Sruthi; Singal, Mukul; Gabrielson, Edward; Sukumar, Saraswati; Pandey, Akhilesh

    2014-01-01

    Tissue microarrays (TMAs) have become an invaluable tool in cancer research to evaluate expression and subcellular localization of proteins in cells and tissues. As the catalogs of candidate biomarkers and therapeutic targets become more extensive, there is a need to characterize and validate these targets and biomarkers in cell lines as a primary biological system in research laboratories. Thus, cell microarrays (CMAs) are useful as a high-throughput screening tool. Here, we constructed a CMA containing 32 publicly available immortalized breast cell lines with the goal of creating a method to rapidly screen for antigens of interest in breast cancer research in a relatively easy, rapid and cost-effective manner. As proof of concept, we performed immunocytochemical staining of the HER2 receptor, as the status of this protein is relevant to breast cancer and has previously been reported for these cell lines. We observed a complete concordance of our staining with the published status of HER2 in these cell lines. In addition, we examined the expression of CD44, epithelial markers EpCAM and E-cadherin and tyrosine phosphoproteins. The labeling of these proteins correlates with the known biology of the cell lines. Our results demonstrate the utility of our method to screen for potential biomarkers and therapeutic targets in breast cancer and we suggest that CMAs be used as a general approach in breast cancer research. PMID:25535895

  6. 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

  7. 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.

  8. 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

  9. 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

  10. 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

  11. Pediatric trichotillomania.

    PubMed

    Harrison, J P; Franklin, M E

    2012-06-01

    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

  12. 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 ...

  13. Pediatric Psychotropic Polypharmacy

    PubMed Central

    Zonfrillo, Mark R.; Leonard, Henrietta L.

    2005-01-01

    Study Objective: This study was a literature review designed to assess the rates of psychotropic “polypharmacy” in the pediatric population. Psychotropic polypharmacy was defined as the practice of prescribing two or more medications (e.g. concomitant psychotropic medications) for one or more diagnosed psychiatric conditions and/or behavioral symptoms. Methods: A literature review of relevant articles pertaining to polypharmacy was completed using the Pub Med database from 1994 through April 2004 for pediatric populations under 18 years old. Results: Studies were reviewed from various pediatric settings. While the extent of polypharmacy varied from the different populations, all the studies comparing these rates across time showed an increase in this practice. The use of stimulants with another psychotropic medication was the most frequent combination. Conclusions: There is limited information about the actual rates of psychotropic polypharmacy in the pediatric population. However, the data that are available demonstrate that this practice is on the rise. This is of specific concern due to the increase of adverse events with polypharmacy. The implications of polypharmacy, including efficacy and side effects, are generally unknown and may vary by specific combination. Therefore, these prescribing practices should be conducted with caution, and systematic research is needed. PMID:21152168

  14. CONSTRAINTS ON THE SURFACE MAGNETIC FIELDS AND AGE OF A COOL HYPERGIANT: XMM-NEWTON X-RAY OBSERVATIONS OF VY CMa

    SciTech Connect

    Montez, Rodolfo Jr.; Kastner, Joel H.; Humphreys, Roberta M.; Davidson, Kris; Turok, Rebecca L. E-mail: jhk@cis.rit.edu

    2015-02-10

    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 {sub X,} {sub UL} ≈ 8 × 10{sup –14} erg cm{sup –2} s{sup –1}, corresponding to log L{sub X} /L {sub bol} ≤ –8), we estimate an average surface magnetic field strength fB ≤ 2 × 10{sup –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.

  15. 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

  16. 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

  17. 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.

  18. Sub-0.1'' optical imaging of the Z CMa jets with SPHERE/ZIMPOL

    NASA Astrophysics Data System (ADS)

    Antoniucci, S.; Podio, L.; Nisini, B.; Bacciotti, F.; Lagadec, E.; Sissa, E.; La Camera, A.; Giannini, T.; Schmid, H. M.; Gratton, R.; Turatto, M.; Desidera, S.; Bonnefoy, M.; Chauvin, G.; Dougados, C.; Bazzon, A.; Thalmann, C.; Langlois, M.

    2016-09-01

    Context. Crucial information on the mass accretion-ejection connection in young stars can be obtained from high spatial resolution images of jets in sources with known recurrent accretion outbursts. Aims: Using the VLT/SPHERE ZIMPOL instrument, we observed the young binary Z CMa that is composed of a Herbig Be star and a FUor object, both driving a jet. We aim to analyse the structure of the two jets, their relation with the properties of the driving sources, and their connection with previous accretion events observed in this target. Methods: We obtained optical images in the Hα and [O i] 6300 Å lines at the unprecedented angular resolution of ~0.03 arcsec, on which we have performed both continuum subtraction and deconvolution, thereby deriving results that are consistent with each other. Results: Our images reveal extended emission from both sources: a fairly compact and poorly collimated emission SW of the Herbig component and an extended collimated and precessing jet from the FUor component. The compact emission from the Herbig star is compatible with a wide-angle wind and is possibly connected to the recent outburst events shown by this component. The FUor jet is traced down to 70 mas (80 AU) from the source and is highly collimated with a width of 26-48 AU at distances 100-200 AU, which is similar to the width of jets from T Tauri stars. This strongly suggests that the same magneto-centrifugal jet-launching mechanism also operates in FUors. The observed jet wiggle can be modelled as originating from an orbital motion with a period of 4.2 yr around an unseen companion with mass between 0.48 and 1 M⊙. The jet mass loss rate Ṁjet was derived from the [O i] luminosity and comprises of between 1 × 10-8 and 1 × 10-6M⊙ yr-1. This is the first direct Ṁjet measurement from a jet in a FUor. If we assume previous mass accretion rate estimates obtained through modelling of the accretion disk, the derived range of Ṁjet would imply a very low mass

  19. 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

  20. Karyotype diversity of four species of the incertae sedis group (Characidae) from different hydrographic basins: analysis of AgNORs, CMA3 and 18S rDNA.

    PubMed

    Mendes, M M; da Rosa, R; Giuliano-Caetano, L; Dias, A L

    2011-01-01

    A large number of genera in the tropical fish family Characidae are incertae sedis. Cytogenetic analysis was made of four of these species: Astyanax eigenmanniorum, Deuterodon stigmaturus, Hyphessobrycon luetkenii, and H. anisitsi, collected from various hydrographic basins: hydrographic system from Laguna dos Patos/RS, Tramandaí basin/RS and Tibagi River basin/PR. The first two species were collected in their type locality in the State of Rio Grande do Sul. The 2n = 48 karyotype was observed only in A. eigenmanniorum, while the other species had 2n = 50 chromosomes, with different karyotypic formulas. There was weak heterochromatin staining in the pericentromeric region of A. eigenmanniorum, D. stigmaturus and H. luetkenni chromosomes. In H. anisitsi, heterochromatin appeared to be more abundant and distributed in the pericentromeric and terminal regions of the chromosomes; three pairs showed more evident heterochromatic blocks. There were multiple Ag-NORs in all populations, visualized by FISH with an 18S rDNA probe. While D. stigmaturus and H. luetkenii had conserved AgNOR, CMA3 and 18S rDNA sites, the other two species showed intra- and interindividual variation at these sites. The karyotype variability was high, as is common in this group of fish. Different species arising from isolated hydrographic basins maintain an elevated level of karyotype differentiation, mainly with respect to chromosome structure, heterochromatin distribution and rDNA localization. This is the first report with cytogenetic data for D. stigmaturus and H. luetkenii. PMID:22179995

  1. 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.

  2. Pediatric vitiligo.

    PubMed

    Silverberg, Nanette B

    2014-04-01

    Vitiligo is a disease of pigment loss. Most investigators currently consider vitiligo to be a disorder that occurs as a result of autoimmune destruction of melanocytes, supported by identification of antimelanocyte antibodies in many patients, and the presence of comorbid autoimmune disease in patients with and family members of individuals with vitiligo. One-half of vitiligo cases are of childhood onset. This article presents a current overview of pediatric vitiligo including comorbidities of general health, psychological factors, therapeutic options, and long-term health considerations.

  3. 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

  4. Pediatric rhinitis risk factors

    PubMed Central

    Ji, Yaofeng; Liu, Yin; Yang, Na

    2016-01-01

    Rhinitis is a common global disorder that impacts on the quality of life of the sufferer and caregivers. Treatment for pediatric rhinitis is empirical and does not include a detailed history of the allergy triggers or allergy testing. Thus, allergen avoidance advice is not tailored to the child's sensitivities, which may result in adenoid hypertrophy. However, infant onset rhinitis, especially its relationship with respiratory viruses, remains to be further clarified. Rhinitis basically involves inflammation of the upper nasal lining, presenting typically with symptoms of runny nose (rhinorrhea), nasal blockage, and/or sneezing. While not typically fatal, it does impose significant health, psychological, and monetary burden to its sufferers, and is thus considered a global health problem. Previous findings showed that immunotherapy had significant clinical efficacy in children with allergic rhinitis. The present review article aims to highlight recent perspectives pertaining to the rhinitis risk factors especially in pediatric patients. PMID:27698737

  5. Pediatric rhinitis risk factors

    PubMed Central

    Ji, Yaofeng; Liu, Yin; Yang, Na

    2016-01-01

    Rhinitis is a common global disorder that impacts on the quality of life of the sufferer and caregivers. Treatment for pediatric rhinitis is empirical and does not include a detailed history of the allergy triggers or allergy testing. Thus, allergen avoidance advice is not tailored to the child's sensitivities, which may result in adenoid hypertrophy. However, infant onset rhinitis, especially its relationship with respiratory viruses, remains to be further clarified. Rhinitis basically involves inflammation of the upper nasal lining, presenting typically with symptoms of runny nose (rhinorrhea), nasal blockage, and/or sneezing. While not typically fatal, it does impose significant health, psychological, and monetary burden to its sufferers, and is thus considered a global health problem. Previous findings showed that immunotherapy had significant clinical efficacy in children with allergic rhinitis. The present review article aims to highlight recent perspectives pertaining to the rhinitis risk factors especially in pediatric patients.

  6. AB024. Chromosome microarray analysis (CMA) for the diagnosis of children with developmental delay and multiple congenital anomalies in Singapore

    PubMed Central

    Law, Hai-Yang; Brett, Maggie; Tan, Ene-Choo; Yong, Min-Hwee; Lai, Angeline

    2015-01-01

    Chromosome microarray analysis (CMA) is a sensitive method to identify submicroscopic changes too small to be detected by conventional karyotyping. Due to its high-sensitivity in identifying regions with structural variation and hence the genes involved, it is recommended to be the first-tier genetic test for children with intellectual disabilities, development delay or multiple congenital anomalies, and is routinely available in USA and many countries in Europe. Our lab has started offering this as a clinical test based on the research experience on screening >400 children with developmental delay and multiple congenital anomalies since February 2014. To date, 271 patients have been screened using the Agilent 4×180K CGH + SNP array. Copy number variants (CNVs) ranging in size from 10 kb to 154 Mb were found in 109 patients (40%). Pathogenic and likely pathogenic CNVs were found in 55 (20%). These included 45 with deletions, 8 with duplications and 2 patients with both deletion and duplication. Recurrent microdeletion and microduplication syndromes including the Angelman/Prader-Willi syndrome [5], 1p36 microdeletion [3], Williams syndrome [2], 22q11.2 distal deletion syndrome [2], 16p13.3 microdeletion syndrome [2], Cat Eye syndrome, Cri du Chat syndrome, Miller Decker syndrome, 3q29 microdeletion, 15q24 microdeletion, and 1q43q44 syndrome were among the variants detected in our patients. CNVs of uncertain clinical significance were detected in 54 (20%) individuals: 32 were duplications, 18 were deletions and one with both deletion and duplication. However, due to the high cost of the test, parental testing was not performed and hence, significance of these variants could not be established conclusively. In conclusion, CMA is a powerful tool in identifying pathogenic chromosomal copy number alternations. However, due to the high cost of the test, parental testing for the cases where variants of uncertain significant are found is often not possible. CMA is useful

  7. 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

  8. 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.

  9. Experimental analysis of singularity-avoidance techniques for CMA equalization in DP-QPSK 112-Gb/s optical systems.

    PubMed

    Rozental, Valery N; Portela, Thiago F; Souto, Diego V; Ferreira, Hugo B; Mello, Darli A A

    2011-09-12

    We experimentally investigate the singularity problem in DP-QPSK 112-Gb/s receivers using the CMA. Three algorithms are compared: Constrained, Two-Stage, and Multi-User. Although these algorithms have been individually evaluated, they have not been compared by extensive experiments. The transmission setup emulates amplifier noise; first-order PMD; and chromatic dispersion. It is shown that all algorithms effectively mitigate singularities. However, under certain conditions, the Multi-User and the Constrained algorithms--both used for system startup--outperformed the Two-Stage, which does not distinguish between system operation and startup. In light of its effectiveness and low computational complexity, we recommend the Constrained algorithm.

  10. 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.

  11. Control of coal combustion SO{sub 2}and NO{sub x} emissions by in- boiler injection of CMA. Second quarterly project status report, 1 January 1993--31 March 1993

    SciTech Connect

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

    1993-04-01

    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. The possibility of introducing two different sorbents sequentially will also be examined. For instance, such a scheme may employ injection of the rather inexpensive calcium carbonate initially, followed by the more costly CMA. The effectiveness of a ``homemade`` CMA using woody biomass as a low-cost source of acetate will be explored if such a product becomes available during the course of this work. Finally, CMA will be introduced in the matrix of the coal by an ion exchange or a precipitation technique. Upon subsequent combustion, the composition and physical structure of the remaining ash will be examined, as well as the gas phase SO{sub x}, concentration. Both techniques (CMA pretreatment and CMA injection) may also be implemented simultaneously to assess their combined effect on sulfur capture.

  12. Find a Pediatric Dentist

    MedlinePlus

    ... Litch's Law Log HIPAA Forms Practice Management and Marketing Newsletter Webinar Materials Member Resources Membership Directory Awards ... Archives Access Pediatric Dentistry Today Practice Management and Marketing Newsletter Pediatric Dentistry Journal Open Access Articles Policies & ...

  13. Nuances in pediatric trauma.

    PubMed

    Kenefake, Mary Ella; Swarm, Matthew; Walthall, Jennifer

    2013-08-01

    Pediatric trauma evaluation mimics adult stabilization in that it is best accomplished with a focused and systematic approach. Attention to developmental differences, anatomic and physiologic nuances, and patterns of injury equip emergency physicians to stabilize and manage pediatric injury.

  14. "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…

  15. 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.

  16. Resources for pediatric drug information.

    PubMed

    Zenk, K E

    1990-10-01

    Finding information on the use of drugs fro infants and children is becoming easier with the publication of excellent resources for pediatric and neonatal drug information. Useful pediatric texts and journals are listed. Texts are graded A and B. Category A books would be useful to include in a basic pharmacy library; Category B books are more comprehensive but expensive, or texts that are not as highly recommended as those in Category A. Some of the resources listed include: (1) Pediatrics--Nelson Textbook of Pediatrics, Rudolph's Pediatrics, Current Pediatric Diagnosis and Treatment, Manual of Pediatric Therapeutics; (2) Dosage Guides--The Pediatric Drug Handbook, Harriet Lane Handbook, Problems in Pediatric Drug THerapy; (3) Intensive Care--Textbook of Pediatric Intensive Care; (4) Infectious Disease--Report of the Committee on Infectious Diseases, Pocketbook of Pediatric Antimicrobial Therapy; (5) Poisoning--Handbook of Poisoning, Medical Toxicology; (6) Parenteral Nutrition--Manual of Pediatric Parenteral Nutrition; (7) Pregnancy and Lactation--Drugs in Pregnancy and Lactation; (8) Compounding--Handbook on Extemporaneous Formulation; (9) IV Administration--Guidelines for Administration of Intravenous Medications to Pediatric Patients; (1) Neonatology--Schaffers Diseases of the Newborn, Neonatology, Basic Management, On-Call Problems, Diseases, Drugs, Drug Therapy in Infants; (11) Pediatric Journals--Pediatrics, Journal of Pediatrics, American Journal of Diseases of Children, Pediatric Infectious Disease Journal, Pediatric Alert, Clinics in Perinatology, Pediatric Clinics of North America, Pediatric Clinical Oncology Journal, and Pediatric Surgery.

  17. Pediatric allergy and immunology in Spain.

    PubMed

    Nieto, Antonio; Mazon, Angel; Martin-Mateos, Maria Anunciacion; Plaza, Ana-Maria; Garde, Jesus; Alonso, Elena; Martorell, Antonio; Boquete, Manuel; Lorente, Felix; Ibero, Marcel; Bone, Javier; Pamies, Rafael; Garcia, Juan Miguel; Echeverria, Luis; Nevot, Santiago; Martinez-Cañavate, Ana; Fernandez-Benitez, Margarita; Garcia-Marcos, Luis

    2011-11-01

    The data of the ISAAC project in Spain show a prevalence of childhood asthma ranging from 7.1% to 15.3%, with regional differences; a higher prevalence, 22.6% to 35.8%, is described for rhinitis, and atopic dermatitis is found in 4.1% to 7.6% of children. The prevalence of food allergy is 3%. All children in Spain have the right to be visited in the National Health System. The medical care at the primary level is provided by pediatricians, who have obtained their titles through a 4-yr medical residency training program. The education on pediatric allergy during that period is not compulsory and thus very variable. There are currently 112 certified European pediatric allergists in Spain, who have obtained the accreditation of the European Union of Medical Specialist for proven skills and experience in pediatric allergy. Future specialists in pediatric allergy should obtain their titles through a specific education program to be developed in one of the four accredited training units on pediatric allergy, after obtaining the title on pediatrics. The Spanish Society of Pediatric Allergy and Clinical Immunology (SEICAP) gathers over 350 pediatric allergists and pediatricians working in this field. SEICAP has a growing activity including yearly congresses, continued education courses, elaboration of technical clinical documents and protocols, education of patients, and collaboration with other scientific societies and associations of patients. The official journal of SEICAP is Allergologia et Immunophatologia, published every 2 months since 1972. The web site of SEICAP, http://www.seicap.es, open since 2004, offers information for professionals and extensive information on pediatric allergic and immunologic disorders for the lay public; the web site is receiving 750 daily visits during 2011. The pediatric allergy units are very active in clinical work, procedures as immunotherapy or induction of oral tolerance in food allergy, contribution to scientific literature, and

  18. Control of coal combustion SO{sub 2} and NO{sub x} emissions by in-boiler injection of CMA. [Third quarterly progress report], 1 July 1994--30 September 1994

    SciTech Connect

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

    1994-11-01

    The principal objectives of this 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. To achieve these goals water solutions of CMA or dry powders of CMA were injected into hot air or gases simulating the furnace exhaust (containing 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 was monitored. The processes of burning the organic acetate as well as the calcination, sintering and sulfation of the remaining solid are studied. The effectiveness of ``homemade`` CMAs containing various amounts of calcium and magnesium was investigated to explore the role of the two chemicals in the NO{sub x} and mainly the SO{sub 2} capture processes. Finally, CMA was introduced in the matrix of coal particles by an ion exchange technique. Upon subsequent combustion, the SO{sub 2}-NO{sub x} emissions were monitored and compared to those from burning untreated coal. The composition and physical structure of the ash residues was examined. Both techniques (CMA pretreatment and CMA injection) may commercially be implemented separate or simultaneously. The work reported herein pertains to introducing dry CMA and other carboxylic salts of calcium: calcium formate (CF), calcium acetate (CA), calcium propanate (CP) and calcium benzoate (CB) in the post-flame region of the furnace and monitoring the SO{sub 2} and NO{sub x}, emissions.

  19. Control of coal combustion SO{sub 2} and NO{sub x} emissions by in-boiler injection of CMA. Seventh quarterly project status report, April 1, 1994--June 30, 1994

    SciTech Connect

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

    1995-02-01

    The principal objectives of this 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. To achieve these goals water solutions of CMA or dry powders of CMA were injected into hot air or gases simulating the furnace exhaust (containing 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 was monitored. The processes of burning the organic acetate as well as the calcination, sintering and sulfation of the remaining solid are studied. The effectiveness of {open_quotes}homemade{close_quotes} CMAs containing various amounts of calcium and magnesium was investigated to explore the role of the two chemicals in the NO{sub x} and mainly the SO{sub 2} capture processes. Finally, CMA was introduced in the matrix of coal particles by an ion exchange technique. Upon subsequent combustion, the SO{sub 2}-NO{sub x} emissions were monitored and compared to those from burning untreated coal. The composition and physical structure of the ash residues was examined. Both techniques (CMA pretreatment and CMA injection) may commercially be implemented separate or simultaneously. The work reported herein pertains to introducing dry or wet CMA in the post-flame region of the furnace and monitoring the SO{sub 2} and NO{sub x} emissions.

  20. 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

  1. A study of the mutational landscape of pediatric-type follicular lymphoma and pediatric nodal marginal zone lymphoma

    PubMed Central

    Ozawa, Michael G; Bhaduri, Aparna; Chisholm, Karen M; Baker, Steven A; Ma, Lisa; Zehnder, James L; Luna-Fineman, Sandra; Link, Michael P; Merker, Jason D; Arber, Daniel A; Ohgami, Robert S

    2016-01-01

    Pediatric-type follicular lymphoma and pediatric marginal zone lymphoma are two of the rarest B-cell lymphomas. These lymphomas occur predominantly in the pediatric population and show features distinct from their more common counterparts in adults: adult-type follicular lymphoma and adult-type nodal marginal zone lymphoma. Here we report a detailed whole-exome deep sequencing analysis of a cohort of pediatric-type follicular lymphomas and pediatric marginal zone lymphomas. This analysis revealed a recurrent somatic variant encoding p.Lys66Arg in the transcription factor interferon regulatory factor 8 (IRF8) in 3 of 6 cases (50%) of pediatric-type follicular lymphoma. This specific point mutation was not detected in pediatric marginal zone lymphoma or in adult-type follicular lymphoma. Additional somatic point mutations in pediatric-type follicular lymphoma were observed in genes involved in transcription, intracellular signaling, and cell proliferation. In pediatric marginal zone lymphoma, no recurrent mutation was identified; however, somatic point mutations were observed in genes involved in cellular adhesion, cytokine regulatory elements, and cellular proliferation. A somatic variant in AMOTL1, a recurrently mutated gene in splenic marginal zone lymphoma, was also identified in a case of pediatric marginal zone lymphoma. The overall non-synonymous mutational burden was low in both pediatric-type follicular lymphoma and pediatric marginal zone lymphoma (4.6 mutations per exome). Altogether, these findings support a distinctive genetic basis for pediatric-type follicular lymphoma and pediatric marginal zone lymphoma when compared with adult subtypes and to one another. Moreover, identification of a recurrent point mutation in IRF8 provides insight into a potential driver mutation in the pathogenesis of pediatric-type follicular lymphoma with implications for novel diagnostic or therapeutic strategies. PMID:27338637

  2. Pediatric en bloc kidney transplantation into pediatric recipients.

    PubMed

    Lau, Keith K; Berg, Gerre M; Schjoneman, Yolanda G; Perez, Richard V; Butani, Lavjay

    2010-02-01

    As a result of the ongoing shortage in organ supply, en bloc renal transplantation from small donors has become more common for adult recipients with ESRD. However, because of concern for higher complication rates and sub-optimal outcomes, it is not being performed in every center, and data describing its use in pediatric recipients are even more limited. We retrospectively studied three patients who have undergone en bloc renal transplantation at our center. Median age at transplantation was 16.7 yr with a median follow-up of 1.2 yr. Donor age ranged from nine to 49 months with weight ranging from 10 to 22 kg. There were no post-operative thrombotic complications. All grafts showed increased renal size at follow-up by ultrasound. There was no clinical or histological rejection at last follow-up. To the best of our knowledge, this is the first report on the outcomes of en bloc kidney transplantation from pediatric donors into pediatric recipients. Based on our experience, albeit very limited, we feel that en bloc renal transplantation from young donors is an acceptable and safe procedure with low complication rates in pediatric recipients and should be given consideration to minimize wait times on the wait list and to improve quality of life.

  3. Pediatric facial nerve rehabilitation.

    PubMed

    Banks, Caroline A; Hadlock, Tessa A

    2014-11-01

    Facial paralysis is a rare but severe condition in the pediatric population. Impaired facial movement has multiple causes and varied presentations, therefore individualized treatment plans are essential for optimal results. Advances in facial reanimation over the past 4 decades have given rise to new treatments designed to restore balance and function in pediatric patients with facial paralysis. This article provides a comprehensive review of pediatric facial rehabilitation and describes a zone-based approach to assessment and treatment of impaired facial movement.

  4. 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

  5. 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.

  6. Pediatric Endocrinology Nurses Society

    MedlinePlus

    ... for PENS Minneapolis 2017! Wednesday, April 26, 2017 ​​​​​​​​​​​​​​​​​​​​​​​​​​​ Journal of Pediatric Nursing The Journal of Pediatric Nursing provides original, peer-reviewed research ...

  7. 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.

  8. 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.

  9. 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.…

  10. [Research in pediatrics].

    PubMed

    Herrera-Márquez, Julia Rocío; González-Cabello, Héctor Jaime

    2015-01-01

    In the interest of encouraging the promotion of research done by physicians of the Instituto Mexicano del Seguro Social, in this supplement we publish articles written by residents of different specialties related to critical themes on pediatrics. These residents are guided by affiliated physicians from the Hospital de Pediatría del Centro Médico Nacional Siglo XXI.

  11. CMA abortion survey.

    PubMed Central

    1983-01-01

    Responses to the question as to whether abortions should be performed at the woman's request during the first trimester of pregnancy were evenly divided. There was support for abortion on socioeconomic grounds, during the first trimester, from 61.5% of the respondents. Termination of pregnancy beyond the first trimester was supported by a majority of the respondents only in cases in which the woman's life is in danger (73.9%) or in which there is evidence of a severe physical abnormality in the fetus (70.6%) or in cases in which the woman's physical health is in danger (55.5%). Those who said they would not support abortion under any circumstances constitute, at most, 5.1% of the respondents. Support for the maintenance or the elimination of therapeutic abortion committees was addressed in two questions and in both cases the respondents were evenly divided. The responses to these two questions were compared and found to be logically consistent. Only physicians should perform abortions, and they should be performed in hospitals with the woman either as an inpatient or, during the first trimester, as an outpatient. The performance of first-trimester abortions in provincially approved abortion clinics was supported by 47.3% of the respondents. Of the 885 respondents who wished to see some amendment to the Criminal Code, 409 stated that the term "health" as used in the Criminal Code relative to the legal grounds for therapeutic abortion should be defined. PMID:6861064

  12. Control of coal combustion SO{sub 2} and NO{sub x} emissions by in-boiler injection of CMA. Sixth quarterly project status report, 1 January 1994--31 March 1994

    SciTech Connect

    Levendis, Y.A.; Wise, D.L.; Steciak, J.; Simons, G.

    1994-06-01

    Conclusions: 1. Impregnation of pulverized coal particles by CMA and CA (and to leser extent MA) was found to increase the combustion temperature of both the volatile and the char phases. Effects of the additives on the burntime of either of the two phases could not be clearly detected. 2. The pretreatment of pulverized (75-90{mu}m) and micronized (3.5{mu}m mean) and beneficiated coals with CMA, CA or MA (at a Ca/S = 2) substantially reduced the emission of SO{sub 2}, at gas temperatures between 1250 to 1450 K, followed by a cool-down zone, in fuel-lean combustion ({phi} = 0.35-0.57). 3. The combustion of CMA-, CA-, or MA-treated pulverized coal in normal air suggested that all three sulfur caption mechanisms, mentioned in the introduction, were evident in the present experiments. 4. The results of experiments in normal air and in atmospheres containing 40% oxygen suggested that the release and subsequent sulfation of CaO and MgO aerosols may be the main mechanism for sulfur removal in the virtually ash-free micronized coal that was treated with CMA. 5. NO{sub x} emissions were increased with higher gas temperatures. Micronized coal produced 25% less NO{sub x} than pulverized coal. This could be due to its lower nitrogen content and slightly more fuel-rich conditions for the micronized coal combustion, as well as localized fuel-rich conditions surrounding the small particles as the volatiles and char burn together. 6. The emissions of NO{sub x} from CMA-treated pulverized coal were similar to those from untreated coal, whereas CMA-treated micronized coal released slightly more NO{sub x} than it did when untreated. The latter event may be caused by the added fuel oxygen associated with the effective penetration of the CMA additive.

  13. 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.

  14. 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

  15. 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

  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 uveitis: An update

    PubMed Central

    Majumder, Parthopratim Dutta; Biswas, Jyotirmay

    2013-01-01

    Because of their varied spectrum of clinical presentation and difficulty in management, pediatric uveitis remains a challenge to the ophthalmologist. Variations in clinical presentation, difficulties in eye examination, extended burden of the inflammation over quality of life, limited treatment modalities, risk of amblyopia are the main challenges in the management of pediatric uveitis. Pediatric uveitis is a cause of significant ocular morbidity and severe vision loss is found in 25-33% of such cases. This article summarizes the common causes of uveitis in children with special approach to the evaluation and diagnosis of each clinical entity. PMID:24379547

  18. [Robotics in pediatric surgery].

    PubMed

    Camps, J I

    2011-10-01

    Despite the extensive use of robotics in the adult population, the use of robotics in pediatrics has not been well accepted. There is still a lack of awareness from pediatric surgeons on how to use the robotic equipment, its advantages and indications. Benefit is still controversial. Dexterity and better visualization of the surgical field are one of the strong values. Conversely, cost and a lack of small instruments prevent the use of robotics in the smaller patients. The aim of this manuscript is to present the controversies about the use of robotics in pediatric surgery.

  19. Genetic pediatric retinal diseases.

    PubMed

    Say, Emil Anthony T

    2014-12-01

    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. PMID:27625880

  20. American Pediatric Surgical Association

    MedlinePlus

    ... Us Login The Hendren Project Resources Research Continuing Education Residents / Fellows Membership About APSA American Pediatric Surgical Association One Parkview Plaza, Suite 800 Oakbrook Terrace, IL 60181 USA Phone: +1-847-686-2237 Fax: +1-847- ...

  1. Pediatric Brain Tumor Foundation

    MedlinePlus

    ... you insights into your child's treatment. LEARN MORE Brain tumors and their treatment can be deadly so ... Cancer Foundation joins the PBTF Read more >> Pediatric Brain Tumor Foundation 302 Ridgefield Court, Asheville, NC 28806 ...

  2. 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

  3. 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 ...

  4. American Academy of Pediatrics

    MedlinePlus

    ... Advocacy Community Pediatrics Grants Database Building Effective Partnerships Obesity Advocacy at the Community Level AAP Health Initiatives Clinical Resources Community Programs Prevention Quality Improvement Media School & Child Care Special Populations shopAAP About the AAP AAP ...

  5. [Complications in pediatric anesthesia].

    PubMed

    Becke, K

    2014-07-01

    As in adult anesthesia, morbidity and mortality could be significantly reduced in pediatric anesthesia in recent decades. This fact cannot conceal the fact that the incidence of anesthetic complications in children is still much more common than in adults and sometimes with a severe outcome. Newborns and infants in particular but also children with emergency interventions and severe comorbidities are at increased risk of potential complications. Typical complications in pediatric anesthesia are respiratory problems, medication errors, difficulties with the intravenous puncture and pulmonal aspiration. In the postoperative setting, nausea and vomiting, pain, and emergence delirium can be mentioned as typical complications. In addition to the systematic prevention of complications in pediatric anesthesia, it is important to quickly recognize disturbances of homeostasis and treat them promptly and appropriately. In addition to the expertise of the performing anesthesia team, the institutional structure in particular can improve quality and safety in pediatric anesthesia. PMID:25004872

  6. 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 ...

  7. 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

  8. 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 © ...

  9. Clinical excellence in pediatrics.

    PubMed

    Mote, Phillip C; Solomon, Barry S; Wright, Scott M; Crocetti, Michael

    2014-08-01

    The 7 core domains of clinical excellence in academic medicine, as defined by the Miller-Coulson Academy of Clinical Excellence at Johns Hopkins, are applicable to the field of pediatrics. The authors use published case reports and teaching models from the pediatric literature to illustrate how thoughtful clinicians have realized distinction in each of the 7 clinical excellence domains, recognizing excellent pediatric patient care serves to strengthen all 3 arms of the tripartite academic mission. Clinicians who feel valued by their institution may be more likely to remain in an academic clinical setting, where they promote the health and well-being of their patients, provide support to families and caregivers, serve as role models for pediatric trainees, and integrate research into their practice with the overall aim of improving patient outcomes.

  10. 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

  11. Liability for pediatric care.

    PubMed

    Classé, J G

    1996-01-01

    Liability claims involving eye care for pediatric patients may constitute as much as 20% of claims against optometrists, with the most common sources of litigation being failure to detect tumors affecting the visual system, improper diagnosis and management of binocular vision disorders, and injuries from shattered spectacle lenses. Claims for pediatric patients tend to allege large damages, partially because of the significant effect exerted by lifelong vision impairment or loss of vision.

  12. Pediatric AIDS: psychosocial impact.

    PubMed

    Mangos, J A; Doran, T; Aranda-Naranjo, B; Rodriguez-Escobar, Y; Scott, A; Setzer, J R

    1990-06-01

    There is no question that the domain of the American family has been invaded by the HIV infection/AIDS epidemic. The disease, and particularly its form affecting children (pediatric AIDS), has had marked psychosocial impact on patients and families (intellectual/cognitive, emotional/behavioral, spiritual, and financial) and on our society in general (adverse or favorable). These impacts of pediatric AIDS are discussed in the present communication. PMID:2371699

  13. Evaluation of pediatric CPR course on knowledge of pediatric residents--before and after ACLS course.

    PubMed

    Soltani, Alireza Ebrahim; Khan, Zahid Hussain; Arbabi, Shahriar; Hossini, Babak; Nahvi, Hedaiatollah; Agamohammadi, Asghar

    2009-02-01

    An evaluation was conducted on the knowledge gained by pediatric residents on CPR, before and after a PALS (Pediatric Advanced Cardiac Life Support) course. Following an examination of all pediatric residents at Tehran University of Medical Sciences, they were divided into two groups: non-trained (Group 1) and a group scheduled to undergone training (Group 2). A course on ACLS was conducted. Examination were performed before and after the ACLS course. The mean of the examination prior to the course in Group 1 and 2 was low, reflecting no significant differences between the Groups. Examination after the ACLS course showed a statistically significant improvement in Group 2 (P < or = 0.05). It is concluded that knowledge of pediatric residents was low before ACLS course and enhanced after the course.

  14. Pediatric oncology in Turkey.

    PubMed

    Kebudi, Rejin

    2012-03-01

    The survival of children with cancer has increased dramatically in the last decades, as a result of advances in diagnosis, treatment and supportive care. Each year in Turkey, 2500-3000 new childhood cancer cases are expected. According to the Turkish Pediatric Oncology Group and Turkish Pediatric Hematology Societies Registry, about 2000 new pediatric cancer cases are reported each year. The population in Turkey is relatively young. One fourth of the population is younger than 15 years of age. According to childhood mortality, cancer is the fourth cause of death (7.2%) after infections, cardiac deaths and accidents. The major cancers in children in Turkey are leukemia (31%), lymphoma (19%), central nervous system (CNS) neoplasms (13%), neuroblastomas (7%), bone tumors (6.1%), soft tissue sarcomas (6%), followed by renal tumors, germ cell tumors, retinoblastoma, carcinomas-epithelial neoplasms, hepatic tumors and others. Lymphomas rank second in frequency as in many developing countries in contrast to West Europe or USA, where CNS neoplasms rank second in frequency. The seven-year survival rate in children with malignancies in Turkey is 65.8%. The history of modern Pediatric Oncology in Turkey dates back to the 1970's. Pediatric Oncology has been accepted as a subspecialty in Turkey since 1983. Pediatric Oncologists are all well trained and dedicated. All costs for the diagnosis and treatment of children with cancer is covered by the government. Education and infrastructure for palliative care needs improvement.

  15. 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.

  16. 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

  17. American Academy of Pediatric Dentistry

    MedlinePlus

    ... Litch's Law Log HIPAA Forms Practice Management and Marketing Newsletter Webinar Materials Member Resources Membership Directory Awards ... Archives Access Pediatric Dentistry Today Practice Management and Marketing Newsletter Pediatric Dentistry Journal Open Access Articles Policies & ...

  18. 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

  19. 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.

  20. 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

  1. Idiopathic thoracic aortic aneurysm at pediatric age.

    PubMed

    Marín-Manzano, E; González-de-Olano, D; Haurie-Girelli, J; Herráiz-Sarachaga, J I; Bermúdez-Cañete, R; Tamariz-Martel, A; Cuesta-Gimeno, C; Pérez-de-León, J

    2009-03-01

    A 6-year-old-boy presented with epigastric pain and vomiting over 1 year. Chest X-ray and esophagogastric transit showed a mediastinal mass. A chest computerized tomography angiogram demonstrated a descending thoracic aortic aneurysm. Analytical determinations carried out were all negative. The aneurysm was surgically repaired using a Dacron patch. The anatomopathological study described atherosclerotic lesions with calcifications, compatible with an atherosclerotic aneurysm wall. Aneurysms are uncommon in the pediatric population. Usually, no pathogenesis can be determined, and thus, such cases are grouped as idiopathic. Direct repair with or without patch is a therapeutic alternative in pediatric aneurysms and can allow the growth of the aortic circumference.

  2. 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.

  3. 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.

  4. [Treatment of pediatric epilepsy].

    PubMed

    Ito, Susumu; Oguni, Hirokazu

    2014-05-01

    Recently, the treatment strategy for pediatric epilepsy has been dramatically changed in Japan, because of the approval of new-generation antiepileptic drugs. Since 2006, a total of 6 new antiepileptic drugs, including gabapentin (GBP; adults/pediatric patients: 2006/2011 [year of approval]), topiramate (TPM; 2007/2013), lamotrigine (LTG; 2008/2008), levetiracetam (LEV; 2010/2013), stiripentol (STP; 2012/2012), and rufinamide (RUF; 2013/2013), have been introduced. Thus far, valproate (VPA) and carbamazepine (CBZ) have been first indicated for "generalized" epilepsy and "focal" epilepsy syndromes/types, respectively, in Japan. However, the approval of these new drugs could allow us to choose more effective and less toxic ones at an early stage of treatment. In this chapter, we describe the latest domestic and foreign guidelines for the treatment of pediatric epilepsy. PMID:24912285

  5. [Treatment of pediatric epilepsy].

    PubMed

    Ito, Susumu; Oguni, Hirokazu

    2014-05-01

    Recently, the treatment strategy for pediatric epilepsy has been dramatically changed in Japan, because of the approval of new-generation antiepileptic drugs. Since 2006, a total of 6 new antiepileptic drugs, including gabapentin (GBP; adults/pediatric patients: 2006/2011 [year of approval]), topiramate (TPM; 2007/2013), lamotrigine (LTG; 2008/2008), levetiracetam (LEV; 2010/2013), stiripentol (STP; 2012/2012), and rufinamide (RUF; 2013/2013), have been introduced. Thus far, valproate (VPA) and carbamazepine (CBZ) have been first indicated for "generalized" epilepsy and "focal" epilepsy syndromes/types, respectively, in Japan. However, the approval of these new drugs could allow us to choose more effective and less toxic ones at an early stage of treatment. In this chapter, we describe the latest domestic and foreign guidelines for the treatment of pediatric epilepsy.

  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. The pediatric Internet.

    PubMed

    Spooner, S A

    1996-12-01

    The Internet is a set of rules for computer communications that has created easy access to electronic mail, electronic mailing lists, and the World Wide Web. The "pediatric Internet" consists of a growing collection of Internet resources that deal specifically with the health care of the young. Locating this information, judging its quality, and determining its appropriate use presents difficulties, but the ubiquity of the Internet makes it imperative for child health professionals to learn the skills necessary to access and provide information via this medium. The Internet will be used increasingly for scientific publishing, the original purpose of the World Wide Web. This article presents basic definitions for the Internet, some characteristics of the pediatric Internet, guidance on how to locate information, and what the future of the pediatric Internet holds. PMID:8951274

  8. Pediatric perspective on pharmacogenomics.

    PubMed

    Stevens, Adam; De Leonibus, Chiara; Hanson, Daniel; Whatmore, Andrew; Murray, Philip; Donn, Rachelle; Meyer, Stefan; Chatelain, Pierre; Clayton, Peter

    2013-11-01

    The advances in high-throughput genomic technologies have improved the understanding of disease pathophysiology and have allowed a better characterization of drug response and toxicity based on individual genetic make up. Pharmacogenomics is being recognized as a valid approach used to identify patients who are more likely to respond to medication, or those in whom there is a high probability of developing severe adverse drug reactions. An increasing number of pharmacogenomic studies are being published, most include only adults. A few studies have shown the impact of pharmacogenomics in pediatrics, highlighting a key difference between children and adults, which is the contribution of developmental changes to therapeutic responses across different age groups. This review focuses on pharmacogenomic research in pediatrics, providing examples from common pediatric conditions and emphasizing their developmental context.

  9. Nelson Textbook of Pediatrics.

    PubMed

    Pomerance, Herbert H

    1997-03-01

    The dedication of this volume states:To the physicians and nurses who care for children in many different circumstances throughout the world and who, by their efforts and commitment, make the world a better place for children.I have used the Nelson Textbook of Pediatrics since its third edition. It remains a source of amazement to me, as I witness the evolution of the book and of the knowledge that dictates its scope. From the days when a textbook was written by 1 or 2 authors, we have progressed to the point where this would be impossible. Three editors preside over this volume; they are also counted among the 212 contributors that lend special expertise to the work, continuing the volume as one of the traditions of pediatrics.The tremendous and rapid explosion in the amount of knowledge in pediatrics made a revision of the total material and even of.

  10. 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.

  11. Contact Dermatitis in Pediatrics.

    PubMed

    Pelletier, Janice L; Perez, Caroline; Jacob, Sharon E

    2016-08-01

    Contact dermatitis is an umbrella term that describes the skin's reaction to contacted noxious or allergenic substances. The two main categories of contact dermatitis are irritant type and allergic type. This review discusses the signs, symptoms, causes, and complications of contact dermatitis. It addresses the testing, treatment, and prevention of contact dermatitis. Proper management of contact dermatitis includes avoidance measures for susceptible children. Implementation of a nickel directive (regulating the use of nickel in jewelry and other products that come into contact with the skin) could further reduce exposure to the most common allergens in the pediatric population. [Pediatr Ann. 2016;45(8):e287-e292.]. PMID:27517356

  12. 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.

  13. Pediatric Orbital Fractures

    PubMed Central

    Oppenheimer, Adam J.; Monson, Laura A.; Buchman, Steven R.

    2013-01-01

    It is wise to recall the dictum “children are not small adults” when managing pediatric orbital fractures. In a child, the craniofacial skeleton undergoes significant changes in size, shape, and proportion as it grows into maturity. Accordingly, the craniomaxillofacial surgeon must select an appropriate treatment strategy that considers both the nature of the injury and the child's stage of growth. The following review will discuss the management of pediatric orbital fractures, with an emphasis on clinically oriented anatomy and development. PMID:24436730

  14. 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.

  15. [Which relationships between civilian-military actions(CMA), civilian and military cooperation (CIMIC)and non-governmental organizations(NGO)?].

    PubMed

    Grünewald, F; de Geoffroy, V

    2002-01-01

    This article questions the existence of "governmental humanitarianism" in opposition to "non-governmental" humanitarianism. The authors report the growing implication of civilian and military actors representing governments in responding to crises and express their concern that this tendency could ultimately lead to use of humanitarian action for diplomatic and economic purposes. They stress that unlike non-governmental organizations, state-run humanitarian agencies are subject to political, economic, and geographic factors. In the context of increasingly frequent application of the CMA doctrine, the authors analyze the role of non-governmental organizations in the field during post-crisis reconstruction. They underline the growing problem of organizing bilateral and multilateral assistance operations. They restate the hope expressed by many humanitarian organizations for a return of the rule of law and conclude on the need to develop complementary activities in the field.

  16. Pseudomonas syringae pv. tomato DC3000 CmaL (PSPTO4723), a DUF1330 family member, is needed to produce L-allo-isoleucine, a precursor for the phytotoxin coronatine

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Pseudomonas syringae pathovar tomato DC3000 produces the phytotoxin coronatine, a major determinant of the leaf chlorosis associated with DC3000 pathogenesis. The DC3000 PSPTO4723 (cmaL) gene is located in a genomic region encoding type III effectors, however it promotes chlorosis in the model plant...

  17. 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…

  18. 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...

  19. 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 ...

  20. 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

  1. Update on pediatric hyperhidrosis.

    PubMed

    Gordon, Jennifer R S; Hill, Samantha E

    2013-01-01

    Hyperhidrosis is a common and under-recognized disease in the pediatric population that has a significant impact on quality of life. Focal and generalized forms of hyperhidrosis exist, which can be idiopathic or secondary to underlying medical conditions or medications. Treatment is tailored to the specific patient needs, characteristics and goals. These include topical preparations, iontophoresis, botulinum toxin and anticholinergic medications. PMID:24552408

  2. Anticoagulant therapy in pediatrics

    PubMed Central

    Dabbous, Mariam K.; Sakr, Fouad R.; Malaeb, Diana N.

    2014-01-01

    Thromboembolic episodes are disorders encountered in both children and adults, but relatively more common in adults. However, the occurrence of venous thromboembolism and use of anticoagulants in pediatrics are increasing. Unfractionated Heparin (UH) is used as a treatment and prevention of thrombosis in adults and critically ill children. Heparin utilization in pediatric is limited by many factors and the most important ones are Heparin Induced Thrombocytopenia (HIT) and anaphylaxis. However, Low Molecular Weight Heparin (LMWH) appears to be an effective and safe alternative treatment. Hence, it is preferred over than UH due to favorable pharmacokinetic and side effect profile. Direct Thrombin Inhibitors (DTI) is a promising class over the other anticoagulants since it offers potential advantages. The aim of this review is to discuss the differences between adult and pediatric thromboembolism and to review the current anticoagulants in terms of pharmacological action, doses, drug reactions, pharmacokinetics, interactions, and parameters. This review also highlights the differences between old and new anticoagulant therapy in pediatrics. PMID:25031496

  3. Update on pediatric hyperhidrosis.

    PubMed

    Gordon, Jennifer R S; Hill, Samantha E

    2013-01-01

    Hyperhidrosis is a common and under-recognized disease in the pediatric population that has a significant impact on quality of life. Focal and generalized forms of hyperhidrosis exist, which can be idiopathic or secondary to underlying medical conditions or medications. Treatment is tailored to the specific patient needs, characteristics and goals. These include topical preparations, iontophoresis, botulinum toxin and anticholinergic medications.

  4. Pediatric brainstem oligodendroglioma

    PubMed Central

    Mohindra, Sandeep; Savardekar, Amey; Bal, Amanjit

    2012-01-01

    The authors present the first report of pediatric brainstem oligodendroglioma, infiltrating midbrain, and medulla oblongata. The report details clinical features, radiological findings, and surgical steps. As this entity is exceedingly uncommon, the overall epidemiology, prognosis, and long-term outcome remain far from established. PMID:22346193

  5. 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

  6. [Management of pediatric status epilepticus].

    PubMed

    Vargas L, Carmen Paz; Varela E, Ximena; Kleinsteuber S, Karin; Cortés Z, Rocío; Avaria B, María de Los Ángeles

    2016-01-01

    Pediatric Status Epilepticus (SE) is an emergency situation with high morbidity and mortality that requires early and aggressive management. The minimum time criterion to define SE was reduced from 30 to 5 minutes, defined as continuous seizure activity or rapidly recurrent seizures without resumption of consciousness for more than 5 minutes. This definition considers that seizures that persist for > 5 minutes are likely to do so for more than 30 min. Those that persist for more than 30 minutes are more difficult to treat. Refractory SE is the condition that extends beyond 60-120 minutes and requires anesthetic management. Super-refractory SE is the state of no response to anesthetic management or relapse during withdrawal of these drugs. The aim of this review is to provide and update on convulsive SE concepts, pathophysiology, etiology, available antiepileptic treatment and propose a rational management scheme. A literature search of articles published between January 1993 and January 2013, focused on pediatric population was performed. The evidence about management in children is limited, mostly corresponds to case series of patients grouped by diagnosis, mainly adults. These publications show treatment alternatives such as immunotherapy, ketogenic diet, surgery and hypothermia. A 35% mortality, 26% of neurological sequelae and 35% of recovery to baseline condition is described on patient’s evolution. PMID:26998986

  7. [Takayasu arteritis in pediatric patients].

    PubMed

    Katsicas, María Martha; Pompozi, Luis; Russo, Ricardo

    2012-01-01

    Takayasu's arteritis is a chronic inflammatory disease that primarily affects the large vessels, such as the aorta and its branches. It represents the third most frequent vasculitis during pediatric age. Our objective was to describe clinical and complementary exams features as well as treatment modalities of a case series of pediatric patients. We present 11 patients (10 girls) with median age at onset of 8 years (range: 2-15). The median diagnosis delay was 16 months (range: 2-96). Clinical presentations were lower limb claudication, arterial hypertension, CNS involvement, presence of murmurs, systemic symptoms, lymphadenopathy, chest pain, abdominal pain and arthritis. Laboratory tests showed: elevated ESR, anemia and trombocytosis. Vascular imaging studies exhibited stenosis, dilatation, occlussion and aneurysms. The outcome of the disease was persistent active condition (1 patient), relapse (4 patients), remission (3 patients), motor sequelae (1 patient) and death (2 patients). All patients were treated with steroids and immunosuppressants. Takayasu 's arteritis is a condition that can potentially be life-threatening. The diagnosis should be suspected in a variety of clinical manifestations during childhood.

  8. 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 ...

  9. 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 ...

  10. 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 ...

  11. Pediatric robotic urologic surgery-2014.

    PubMed

    Kearns, James T; Gundeti, Mohan S

    2014-07-01

    We seek to provide a background of the current state of pediatric urologic surgery including a brief history, procedural outcomes, cost considerations, future directions, and the state of robotic surgery in India. Pediatric robotic urology has been shown to be safe and effective in cases ranging from pyeloplasty to bladder augmentation with continent urinary diversion. Complication rates are in line with other methods of performing the same procedures. The cost of robotic surgery continues to decrease, but setting up pediatric robotic urology programs can be costly in terms of both monetary investment and the training of robotic surgeons. The future directions of robot surgery include instrument and system refinements, augmented reality and haptics, and telesurgery. Given the large number of children in India, there is huge potential for growth of pediatric robotic urology in India. Pediatric robotic urologic surgery has been established as safe and effective, and it will be an important tool in the future of pediatric urologic surgery worldwide. PMID:25197187

  12. 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.

  13. 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

  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. 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

  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 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.

  18. Pediatric Stroke: A Review

    PubMed Central

    Tsze, Daniel S.; Valente, Jonathan H.

    2011-01-01

    Stroke is relatively rare in children, but can lead to significant morbidity and mortality. Understanding that children with strokes present differently than adults and often present with unique risk factors will optimize outcomes in children. Despite an increased incidence of pediatric stroke, there is often a delay in diagnosis, and cases may still remain under- or misdiagnosed. Clinical presentation will vary based on the child's age, and children will have risk factors for stroke that are less common than in adults. Management strategies in children are extrapolated primarily from adult studies, but with different considerations regarding short-term anticoagulation and guarded recommendations regarding thrombolytics. Although most recommendations for management are extrapolated from adult populations, they still remain useful, in conjunction with pediatric-specific considerations. PMID:22254140

  19. 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

  20. Telemedicine: Pediatric Applications.

    PubMed

    Burke, Bryan L; Hall, R W

    2015-07-01

    Telemedicine is a technological tool that is improving the health of children around the world. This report chronicles the use of telemedicine by pediatricians and pediatric medical and surgical specialists to deliver inpatient and outpatient care, educate physicians and patients, and conduct medical research. It also describes the importance of telemedicine in responding to emergencies and disasters and providing access to pediatric care to remote and underserved populations. Barriers to telemedicine expansion are explained, such as legal issues, inadequate payment for services, technology costs and sustainability, and the lack of technology infrastructure on a national scale. Although certain challenges have constrained more widespread implementation, telemedicine's current use bears testimony to its effectiveness and potential. Telemedicine's widespread adoption will be influenced by the implementation of key provisions of the Patient Protection and Affordable Care Act, technological advances, and growing patient demand for virtual visits.

  1. Pediatric hernias and hydroceles.

    PubMed

    Kapur, P; Caty, M G; Glick, P L

    1998-08-01

    Hernias and hydroceles are common conditions of infancy and childhood, and inguinal hernia repair is one of the most frequently performed pediatric surgical operations. As a result of improved neonatal intensive care, more and more premature babies are being delivered, and consequently the incidence of neonatal inguinal hernia is increasing. The most important aspect of the management of neonatal inguinal hernias relate to its risk on incarceration, and emphasis is placed on this point. This article covers the embryology, incidence, clinical presentation, and treatment of groin hernias and hydroceles, as well as dealing with abdominal wall hernias other than umbilical hernias. This article places special emphasis on when a patient with a hernia or hydrocele should be referred to a pediatric surgeon.

  2. Helicobacter pylori in pediatrics.

    PubMed

    Homan, Matjaž; Hojsak, Iva; Kolaček, Sanja

    2012-09-01

    This review summarizes important pediatric studies published from April 2011 up to March 2012. Proteomics profile of ulcerogenic Helicobacter pylori strains was defined in the most interesting study of the last year. The antigen stool test is becoming the "gold standard" in prevalence studies, and according to the last epidemiologic studies, the prevalence of H. pylori infection in childhood is not decreasing any more in the developed world. The resistance rate of H. pylori strains is high in children. Therefore, among other important issues concerning H. pylori in pediatrics, guidelines published by ESPGHAN and NASPGHAN last year also recommended culture and susceptibility testing before first-line treatment in areas with high or unknown antibiotic resistance rates.

  3. [Pediatric advanced life support].

    PubMed

    Muguruma, Takashi

    2011-04-01

    Important changes or points of emphasis in the recommendations for pediatric advanced life support are as follows. In infants and children with no signs of life, healthcare providers should begin CPR unless they can definitely palpate a pulse within 10 seconds. New evidence documents the important role of ventilations in CPR for infants and children. Rescuers should provide conventional CPR for in-hospital and out-of-hospital pediatric cardiac arrests. The initial defibrillation energy dose of 2 to 4J/kg of either monophasic or biphasic waveform. Both cuffed and uncuffed tracheal tubes are acceptable for infants and children undergoing emergency intubation. Monitoring capnography/capnometry is recommended to confirm proper endotracheal tube position.

  4. 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

  5. Pediatric genetic ocular tumors.

    PubMed

    Rouhani, Behnaz; Ramasubramanian, Aparna

    2014-12-01

    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. PMID:27625882

  6. [Ultrasound in pediatric dermatology].

    PubMed

    García-Martínez, F J; Muñoz-Garza, F Z; Hernández-Martín, A

    2015-11-01

    Cutaneous ultrasound is particularly useful in pediatric dermatology to diagnose numerous diseases without the need to use invasive tests. The present articles reviews some frequent dermatological entities in children whose study can be simplified through cutaneous ultrasound. This article also provides practical recommendations reported in the literature that may facilitate ultrasound examination, with special mention of benign tumoural disease, both congenital and acquired, and vascular anomalies.

  7. 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

  8. Pediatric Burn Resuscitation.

    PubMed

    Palmieri, Tina L

    2016-10-01

    Children have unique physiologic, physical, psychological, and social needs compared with adults. Although adhering to the basic tenets of burn resuscitation, resuscitation of the burned child should be modified based on the child's age, physiology, and response to injury. This article outlines the unique characteristics of burned children and describes the fundamental principles of pediatric burn resuscitation in terms of airway, circulatory, neurologic, and cutaneous injury management. PMID:27600126

  9. 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.

  10. 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

  11. Pediatric Obstructive Sleep Apnea

    PubMed Central

    Capdevila, Oscar Sans; Kheirandish-Gozal, Leila; Dayyat, Ehab; Gozal, David

    2008-01-01

    Obstructive sleep apnea (OSA) in children has emerged not only as a relatively prevalent condition but also as a disease that imposes a large array of morbidities, some of which may have long-term implications, well into adulthood. The major consequences of pediatric OSA involve neurobehavioral, cardiovascular, and endocrine and metabolic systems. The underlying pathophysiological mechanisms of OSA-induced end-organ injury are now being unraveled, and clearly involve oxidative and inflammatory pathways. However, the roles of individual susceptibility (as dictated by single-nucleotide polymorphisms), and of environmental and lifestyle conditions (such as diet, physical, and intellectual activity), may account for a substantial component of the variance in phenotype. Moreover, the clinical prototypic pediatric patient of the early 1990s has been insidiously replaced by a different phenotypic presentation that strikingly resembles that of adults afflicted by the disease. As such, analogous to diabetes, the terms type I and type II pediatric OSA have been proposed. The different manifestations of these two entities and their clinical course and approaches to management are reviewed. PMID:18250221

  12. Pediatric ingestion of lamotrigine.

    PubMed

    Zidd, Andrea G; Hack, Jason B

    2004-07-01

    A 3-year-old female presented to the emergency department after ingesting forty-six 25-mg tablets of lamotrigine that resulted in sedation, rash, and transient elevation of liver function tests. Her initial physical examination was significant for marked somnolence and a lacy reticular blanching rash. Laboratory studies were all within normal limits except for mildly elevated liver function tests. Initial plasma lamotrigine level was found to be elevated above adult therapeutic levels (25.3 microg/mL). Treatment consisted of gastric lavage followed by activated charcoal. The patient was subsequently observed in the pediatric intensive care unit where symptoms and laboratory abnormalities promptly resolved, and she was discharged 24 hours later without further complication. This case report describes the largest single ingestion of lamotrigine ever reported in a pediatric patient. The patient exhibited significant somnolence, rash, and liver function test abnormalities with only a slight elevation of serum level of lamotrigine above adult therapeutic levels. More research is required to investigate the toxic profile of lamotrigine in pediatric patients.

  13. 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

  14. 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

  15. [Pediatric neurology in rehabilitation].

    PubMed

    Kurihara, Mana

    2007-07-01

    There are some criteria for administering pediatric rehabilitation, such as (1) plasticity of the child's brain sometimes plays an enormous roles in recovery, (2) on the other hand, break-down of the child's brain is sometimes worse than expected, (3) rehabilitation should be continued with the prospect that child grows and develops everyday, (4) family members should join their child's rehabilitation. The team approach is very effective for pediatric rehabilitation. The pediatric neurologist will be one of the best members of the team because he/she can manage a disabled child and his/her family members well, and is familiar with a normal child's development. Rehabilitation should be performed appropriates, which means that the child is evaluated first, a rehabilitation program is developed and rehabilitation is implemented. The World Health Organization published the International Classification of Functioning, Disability and Health (ICF), which moves away from being a "consequence of disease" classification to "components of health". The concept of disability is changing.

  16. Pediatric Catheterization Protocol.

    PubMed

    Sheikh, N

    2015-07-01

    During the last decade, significant technological progress has taken place in the pediatric cardiac catheterization laboratory. Improved noninvasive diagnostic techniques have narrowed down the indications for diagnostic cardiac catheterization, and these techniques are now increasingly being applied to therapeutic procedures. Recently, concern has been raised about the appropriateness of some these applications in pediatric therapeutic cardiac catheterization because of sheer increase in number of techniques being applied, the increase in the number of persons and centers using these techniques, and the increase in the number of lesion types thought to be amenable to catheter therapy. In comparison to diagnostic cardiac catheterization, therapeutic catheterization require more time and resources, involve higher cost and risk, and demand more technical competence and expertise. Higher level of skill and competency is requirement for the operator who performs the various therapeutic catheterization techniques. These procedures should only be performed in institutions equipped with appropriate facilities, personnel, and programs. These considerations, combined with the rapid increase in the number of laboratories and cardiologists performing therapeutic catheterization procedures, raises concern about the safety of patients and human subjects as well as credentials of hospital and level of training and skill of physician involved. Therapeutic catheterization training programs vary in type, extent, and quality. Due to the complexity and potential risks of these procedures, specific skill and competency benchmark should be developed for personnel undergoing training in therapeutic catheterization as well as for those who continue to perform various procedures. Competency in therapeutic catheterization in children requires specific training. Pediatric cardiology fellows should receive therapeutic catheterization training in one or more centers that specializes in

  17. Drug repurposing in pediatrics and pediatric hematology oncology.

    PubMed

    Blatt, Julie; Corey, Seth J

    2013-01-01

    Drug 'repurposing', that is, using old drugs for new indications, has been proposed as a more efficient strategy for drug development than the current standard of beginning with novel agents. In this review, we explore the scope of drug repurposing in pediatric hematology oncology and in pediatrics in general. Drugs commonly used in children were identified using the Harriet Lane Handbook (HLH) and searched in PubMed for different uses. Additional drugs were identified by searching PubMed and Google.com for 'drug repurposing' or 'drug repositioning'. Almost 10% of drugs with primary uses in pediatrics have been repurposed in pediatric hematology oncology or pediatrics. The observant clinician, pharmacologist and translational bioinformatician, as well as structural targeting, will have a role in discovering new repurposing opportunities.

  18. 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…

  19. 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.

  20. 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,…

  1. A history of pediatric immunology.

    PubMed

    Stiehm, E Richard; Johnston, Richard B

    2005-03-01

    Immunology has played a prominent role in the history of medicine. Pediatric immunologists have focused on immune aberrations in pediatric disorders, particularly those involving host defense mechanisms. These efforts have paid rich dividends in terms of fundamental knowledge of the immune system and major therapeutic advances, including 1) i.v. immunoglobulin therapy, 2) hematopoietic stem cell transplantation, and 3) gene therapy. Pediatric immunology as an organized discipline emerged in the early 1950s, when pediatricians and their basic scientist colleagues began to focus on clinical and basic research related to immunodeficiency. Since then, key organizations and infrastructure have been developed to support this research and the clinical care of immunodeficient patients. We review here the evolution of contemporary pediatric immunology, particularly in North America, from its roots in 19th-century Europe to its current expression as one of the fundamental scientific and clinical disciplines of pediatrics.

  2. 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

  3. Pediatric inflammatory bowel disease.

    PubMed

    King, Robert A

    2003-07-01

    The treatment of children and families affected by pediatric IBD requires an awareness of the diverse psychobiologic effects of the disorder over the course of child, adolescent [53], and adult development [52]. Optimal treatment requires careful coordination of various medical, educational, and rehabilitative services and concerned, empathetic, continuity of care by knowledgeable clinicians [4]. In many cases, this care must also include individual psychotherapeutic work with affected youngsters at crucial junctures to help deal with the social and psychological stresses of IBD, as well supportive casework for parents and siblings. PMID:12910821

  4. 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

  5. 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

  6. Pediatric transplantation: preventing thrombosis.

    PubMed

    Robertson, J D

    2015-06-01

    Due to progressive advances in surgical techniques, immunosuppressive therapies, and supportive care, outcomes from both solid organ transplantation and hematopoietic stem cell transplantation continue to improve. Thrombosis remains a challenging management issue in this context, with implications for both graft survival and long-term quality of life. Unfortunately, there remains a general paucity of pediatric-specific data regarding thrombosis incidence, risk stratification, and the safety or efficacy of preventative strategies with which to guide treatment algorithms. This review summarizes the available evidence and rationale underlying the spectrum of current practices aimed at preventing thrombosis in the transplant recipient, with a particular focus on risk factors, pathophysiology, and described antithrombotic regimens.

  7. Pediatric osteoarticular infection update.

    PubMed

    Montgomery, Nicole I; Rosenfeld, Scott

    2015-01-01

    Musculoskeletal infections are a common cause of morbidity in children. A multitude of studies over the past few years have improved our knowledge and understanding of the etiology, diagnosis, and treatment of pediatric osteomyelitis and septic arthritis. Staphylococcus aureus continues to be the most common pathogen; however, new and innovative organism identification techniques are improving the speed and accuracy of diagnosis and increasing the identification of other less common organisms. Improved capability for patient assessment with a combination of advanced imaging studies and timely laboratory tests allow for a more thorough understanding of the disease process and more efficient patient care.

  8. Pediatric cerebral aneurysms.

    PubMed

    Gemmete, Joseph J; Toma, Ahmed K; Davagnanam, Indran; Robertson, Fergus; Brew, Stefan

    2013-11-01

    Childhood intracranial aneurysms differ from those in the adult population in incidence and gender prevalence, cause, location, and clinical presentation. Endovascular treatment of pediatric aneurysms is the suggested approach because it offers both reconstructive and deconstructive techniques and a better clinical outcome compared with surgery; however, the long-term durability of endovascular treatment is still questionable, therefore long-term clinical and imaging follow-up is necessary. The clinical presentation, diagnosis, and treatment of intracranial aneurysms in children are discussed, and data from endovascular treatments are presented.

  9. Procedural pediatric dermatology.

    PubMed

    Metz, Brandie J

    2013-04-01

    Due to many factors, including parental anxiety, a child's inability to understand the necessity of a procedure and a child's unwillingness to cooperate, it can be much more challenging to perform dermatologic procedures in children. This article reviews pre-procedural preparation of patients and parents, techniques for minimizing injection-related pain and optimal timing of surgical intervention. The risks and benefits of general anesthesia in the setting of pediatric dermatologic procedures are discussed. Additionally, the surgical approach to a few specific types of birthmarks is addressed.

  10. 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

  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. 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

  13. 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

  14. Pediatric heart transplantation.

    PubMed

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

    2015-03-01

    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.

  15. Pediatric spinal trauma.

    PubMed

    Huisman, Thierry A G M; Wagner, Matthias W; Bosemani, Thangamadhan; Tekes, Aylin; Poretti, Andrea

    2015-01-01

    Pediatric spinal trauma is unique. The developing pediatric spinal column and spinal cord deal with direct impact and indirect acceleration/deceleration or shear forces very different compared to adult patients. In addition children are exposed to different kind of traumas. Moreover, each age group has its unique patterns of injury. Familiarity with the normal developing spinal anatomy and kind of traumas is essential to correctly diagnose injury. Various imaging modalities can be used. Ultrasound is limited to the neonatal time period; plain radiography and computer tomography are typically used in the acute work-up and give highly detailed information about the osseous lesions. Magnetic resonance imaging is more sensitive for disco-ligamentous and spinal cord injuries. Depending on the clinical presentation and timing of trauma the various imaging modalities will be employed. In the current review article, a summary of the epidemiology and distribution of posttraumatic lesions is discussed in the context of the normal anatomical variations due to progressing development of the child. PMID:25512255

  16. 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

  17. Abdominal emergencies in pediatrics.

    PubMed

    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E

    2016-05-01

    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition.

  18. 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

  19. Elbow pain in pediatrics.

    PubMed

    Crowther, Marshall

    2009-06-01

    The pediatric and adolescent elbow is subject to both acute and chronic overuse injuries. The practitioner should develop a classification system to evaluate all such injuries, with first focusing on whether the injury represents an acute episode or rather it represents a more chronic problem. In addition, localizing the area of pain as being either medial, lateral, or posterior can better help differentiate the diagnosis. Youth baseball pitchers and throwers are particularly at risk for overuse injuries of the elbow, most of which are related to an injury mechanism termed "valgus extension overload". The most common entity related to this is termed "Little Leaguer's Elbow." Treatment is usually conservative, but for some injuries surgery may be required, especially for displaced medial epicondylar avulsion fractures. Other acute injuries also should be easily recognizable by the general clinician including annular ligament displacement (nursemaid's elbow) which represents one of the most common upper extremity injuries presenting to emergency rooms in youngsters under the age of 6. Most studies seem to indicate a hyperpronation reduction technique may be more successful then the flexion/supination technique. It is also important to have an awareness of some of the common elbow fractures seen in the younger patient, in particularly supracondylar fractures owing to their high propensity for complications. When evaluating the elbow for fractures, it is necessary to have an understanding of the appearance of the ossification centers seen on the pediatric elbow.

  20. [Pediatric retroperitoneal tumors].

    PubMed

    Benicio dos Santos, I; Benicio dos Santos, M

    1980-01-01

    The author has based his work "Retroperitoneals tumors in infancy and childhood" in 65 cases observed at "Hospital Martagao Gesteira", Salvador, Bahia, Brasil. 32 of the retroperitoneals tumors, either intrarenals or extrarenals, observed in infancy and childhood were Wilm's tumor, 22 neuroblastoma, 5 hydronephrosis, 2 multicystic kidney, 1 policystic kidney, 2 pancreatic cyst and 1 biliar cyst. Wilm's tumor had the highest incidence - 32 cases (49,2%); neuroblastoma was in the second place in incidence - 22 (33,8%) of the 65 cases of retroperitoneals tumors studied, were neuroblastoma. As registered by the author in previous paper, the neuroblastoma, on contrary of what is established in the specialized literature, not was: the most frequent abdominal tumors, in infancy and childhood, neither it was also the abdominal pediatric tumor which could match Wilm's tumor in incidence. The plain X ray film of the abdomen, the Excretory Urography, the Cavography and Arteriography, the Radiological Examination of the Stomach and Duodenum, of the Small Intestine and the Colons, contribute in a very important way to establish the topography (retro or intraperitoneal) of the pediatric abdominal tumors. The author emphasizes that the plain X ray film of the abdomen supply important elements for the conclusion concerning the localization of abdominal tumors, from the observation of a simple criterion - the retroperitoneals tumors obliterate the border of kidney, because they are placed in the same plan of the kidney, data which is not pointed out sufficiently by the authors who have studied the subject.

  1. Pediatric allergy and immunology in Brazil.

    PubMed

    Rosario-Filho, Nelson A; Jacob, Cristina M; Sole, Dirceu; Condino-Neto, Antonio; Arruda, Luisa K; Costa-Carvalho, Beatriz; Cocco, Renata R; Camelo-Nunes, Inês; Chong-Neto, Herberto J; Wandalsen, Gustavo F; Castro, Ana P M; Yang, Ariana C; Pastorino, Antonio C; Sarinho, Emanuel S

    2013-06-01

    The subspecialty of pediatric allergy and immunology in Brazil is in its early years and progressing steadily. This review highlights the research developed in the past years aiming to show the characteristics of allergic and immunologic diseases in this vast country. Epidemiologic studies demonstrated the high prevalence of asthma in infants, children, and adolescents. Mortality rates and average annual variation of asthma hospitalization have reduced in all pediatric age groups. Indoor aeroallergen exposure is excessively high and contributes to the high rates of allergy sensitization. Prevalence of food allergy has increased to epidemic levels. Foods (35%), insect stings (30%), and drugs (23%) are the main etiological agents of anaphylaxis in children and adolescents. Molecular diagnosis of primary immunodeficiencies (PID) showed a high incidence of fungal infections including paracoccidioidomycosis in X-linked hyper-IgM syndrome, and the occurrence of BCG adverse reactions or other mycobacterial infections in patients with chronic granulomatous disease. Education in pediatric allergy and immunology is deficient for medical students, but residency programs are effective in training internists and pediatricians for the practice of allergy. The field of PID requires further training. Last, this review is a tribute to Prof. Dr. Charles Naspitz, one of the pioneers of our specialty in Brazil.

  2. 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

  3. 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

  4. Vaccine therapies for pediatric malignancies.

    PubMed

    Rousseau, Raphaël F; Brenner, Malcolm K

    2005-01-01

    Cancer vaccines are examples of active immunotherapy. In pediatric malignancy such active strategies may be particularly problematic because of immune suppression produced by the tumor or its intensive treatment with combined chemotherapy. Nonetheless, the expression of tumor-specific and tumor-associated antigens on a range of pediatric tumors has encouraged investigation of the approach in patients with either bulky or minimal residual disease. Here we describe promising results in neuroblastoma and acute leukemia, suing genetically modified whole cell vaccines, peptides, and dendritic cells. The difficulties of conducting and evaluating such studies in a pediatric population are also described, and a strategy for cancer vaccine development is outlined.

  5. Pediatric neuropsychology: toward subspecialty designation.

    PubMed

    Baron, Ida Sue; Wills, Karen; Rey-Casserly, Celiane; Armstrong, Kira; Westerveld, Michael

    2011-08-01

    Clinical neuropsychology is a rapidly expanding field of study in the psychological sciences whose practitioners are expert in the assessment, treatment, and research of individuals with known or suspected central nervous system disease or disorder. Pediatric neuropsychology has emerged as a distinct subspecialty area with related education, training, and clinical expertise for a growing number of neuropsychologists. This paper details the numerous steps taken by two affiliated organizations, the American Board of Clinical Neuropsychology and its membership organization, the American Academy of Clinical Neuropsychology, in the interest of the larger pediatric neuropsychology community and in pediatric neuropsychology subspecialty development.

  6. Pediatric Cushing's disease: Management Issues.

    PubMed

    Savage, Martin O; Storr, Helen L

    2012-12-01

    Cushing's disease (CD), caused by an ACTH-secreting pituitary corticotroph adenoma, is the commonest cause of Cushing syndrome in children over 5 years of age. It is rare in the pediatric age range and presents difficult diagnostic and therapeutic challenges. Key presenting features include weight gain, growth failure and change in facial appearance. Most pediatric endocrinologists have limited experience managing children or adolescents with CD and thus benefit from close consultation with adult colleagues. We describe a diagnostic protocol which broadly follows the model for adult patients. Treatment strategies are examined and appraised. The management of pediatric CD patients after cure is also discussed. PMID:23565371

  7. 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

  8. What a = 1/298 and C/Ma2 = 0.333 really tell us about the Earth

    USGS Publications Warehouse

    Evernden, J.F.

    1997-01-01

    The discussion in the several versions of The Earth by Jeffreys (third edition, 1952, for example) [1] relative to the ellipticity of the Earth does not demonstrate, as generally believed, that the Earth has the shape of a rotating liquid. His development in conjunction with the work of H. Lamb (1945) [2] shows unequivocally that the Earth is much less oblate than required if it were behaving as a liquid mass. It is not true that the observations of Bouguer in the late 1700's regarding the actual ellipticity of the Earth demonstrated the liquidity of the Earth with mass concentrated towards the center. In fact, proper interpretation of his data would have shown that the Earth's ellipticity results from its great strength, not its weakness. Data available today establish that great strength resides in the lower mantle and has in all probability resided there from the time of the Earth's origin. This strength results in the need for reinterpretation of Earth behavior and operative processes.

  9. Bone Canopies in Pediatric Renal Osteodystrophy.

    PubMed

    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

  10. 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

  11. 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.

  12. Pediatric Posttraumatic Headache.

    PubMed

    Kacperski, Joanne; Hung, Ryan; Blume, Heidi K

    2016-02-01

    Concussion and mild traumatic brain injury are common injuries in pediatrics, and posttraumatic headache is the most common complaint following them. Although most children and teens recover from a simple, isolated concussion without incidents within 1-2 weeks, some develop symptoms that can last for months. It is important to manage both acute and persistent posttraumatic headaches appropriately to speed recovery, minimize disability, and maximize function. In this article, we review the definitions, epidemiology, and current recommendations for the evaluation and treatment of acute and persistent posttraumatic headaches. Although this is still a developing field and there is much that we still need to learn about concussion and the best strategies to prevent and treat these injuries and their sequelae, we hope that this review will help providers to understand the current evidence and treatment recommendations to improve care for children with concussion and mild traumatic brain injury. PMID:27017019

  13. Pediatric Posttraumatic Headache.

    PubMed

    Kacperski, Joanne; Hung, Ryan; Blume, Heidi K

    2016-02-01

    Concussion and mild traumatic brain injury are common injuries in pediatrics, and posttraumatic headache is the most common complaint following them. Although most children and teens recover from a simple, isolated concussion without incidents within 1-2 weeks, some develop symptoms that can last for months. It is important to manage both acute and persistent posttraumatic headaches appropriately to speed recovery, minimize disability, and maximize function. In this article, we review the definitions, epidemiology, and current recommendations for the evaluation and treatment of acute and persistent posttraumatic headaches. Although this is still a developing field and there is much that we still need to learn about concussion and the best strategies to prevent and treat these injuries and their sequelae, we hope that this review will help providers to understand the current evidence and treatment recommendations to improve care for children with concussion and mild traumatic brain injury.

  14. 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

  15. Nutrition for the pediatric athlete.

    PubMed

    Unnithan, Viswanath B; Goulopoulou, Styliani

    2004-08-01

    A paucity of literature exists with regard to research on nutrition for the pediatric athlete. This lack of research makes the development of specific nutritional recommendations for young athletes problematic. This issue is made difficult by the macro- and micronutrient intake required for growth and development in conjunction with that required for sports. Exogenous carbohydrate drinks could be considered for the young athlete engaged in both endurance exercise and high-intensity exercise. Monitoring of the energy intake during resistance training in the pediatric athlete needs to be considered, as there is evidence to suggest that energy deficits may occur. If decrements in exercise performance are noted, then serum ferritin and hemoglobin concentrations should be monitored, as nonanemic iron deficiency is prevalent in the pediatric athlete. The pediatric athlete exercising in the heat is susceptible to voluntary dehydration and evidence exists to suggest that a carbohydrate-electrolyte drink will abolish this phenomenon.

  16. 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.

  17. 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.

  18. 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 ...

  19. 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 ...

  20. 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 ...

  1. 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 ...

  2. Childhood obesity for pediatric gastroenterologists.

    PubMed

    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

    2013-01-01

    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.

  3. 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.

  4. Management of pediatric mandible fractures.

    PubMed

    Goth, Stephen; Sawatari, Yoh; Peleg, Michael

    2012-01-01

    The pediatric mandible fracture is a rare occurrence when compared with the number of mandible fractures that occur within the adult population. Although the clinician who manages facial fractures may never encounter a pediatric mandible fracture, it is a unique injury that warrants a comprehensive discussion. Because of the unique anatomy, dentition, and growth of the pediatric patient, the management of a pediatric mandible fracture requires true diligence with a variance in treatment ranging from soft diet to open reduction and internal fixation. In addition to the variability in treatment, any trauma to the face of a child requires additional management factors including child abuse issues and long-term sequelae involving skeletal growth, which may affect facial symmetry and occlusion. The following is a review of the incidence, relevant anatomy, clinical and radiographic examination, and treatment modalities for specific fracture types of the pediatric mandible based on the clinical experience at the University of Miami/Jackson Memorial Hospital Oral and Maxillofacial Surgery program. In addition, a review of the literature regarding the management of the pediatric mandible fracture was performed to offer a more comprehensive overview of this unique subset of facial fractures. PMID:22337373

  5. [Munchausen syndrome in Spanish pediatrics].

    PubMed

    Jimenez Hernandez, J L; Figuerido-Poulain, J L

    1996-01-01

    The term Munchausen is used to design patients with "expectable clínical histories full of lies and inventions" in a presumable try to find medical attention. In the Munchausen by proxy syndrome the pediatric patients are victims of their parents psychiatric pathology, who, in spite of the normal aspect that many times have, are really sick and urgently needed of psychiatric treatment. In the spanish psychiatric bibliography we have found 25 cases of Munchausen syndrome that hurt to 20 families. 5 cases were Munchausen, and the remain 20 were Munchausen by Proxy. In this group the majority (13 cases: 65%) were non accidental drug intoxications and in the 20 cases the mother was the fraud author. We concluded remarking that statistics shows a casuistic lower than the real one. A study of the Munchausen by proxy syndrome shows that it is a type of child abuse; so that it is essential to stop the abuse as soon as possible, by a multidisciplinary work. PMID:8900975

  6. Pediatric Nasopharyngeal Cancer: Case Report and Review of the Literature

    PubMed Central

    González, Garvin; Bermudéz, Yurany; Maldonado, Maria C; Castañeda, Javier M; Lopéz, David; Cotes-Mestre, Martha

    2016-01-01

    Pediatric nasopharyngeal carcinoma, also referred to as cavum carcinoma, is a rare pediatric disease with an infrequent incidence rate. We present the case of a pediatric patient with nasopharyngeal cancer who received an adult schedule of concomitant chemotherapy and conformal radiotherapy with a brachytherapy boost. Adult protocols with high radiotherapy doses are not commonly used in pediatric patients due to the high comorbidity associated with this practice. In this case, the patient displayed excellent overall survival, a longer disease-free period, and fewer side effects and comorbidities, even in the absence of interferon therapy, which is not easily available in low-income countries. In addition, this case shows that conformal radiotherapy and brachytherapy are options that can be used to escalate the radiotherapy dose and decrease side effects. A 12-year-old female pediatric patient presented to our outpatient clinic with an eight-month history of moderate-to-severe otalgia, intermittent hyaline rhinorrhea, asthenia, adynamia, nasal congestion, epistaxis in the previous months, and local pruritus. Upon physical examination, a 60x60 mm mass was detected at level II of the neck, and a biopsy of the lesion confirmed a histopathological diagnosis of undifferentiated carcinoma compatible with nasopharyngeal carcinoma. The patient was considered to have clinical Stage III cancer, and she received an adult Al-Sarraf protocol with chemoradiotherapy and an intracavitary brachytherapy boost. The patient had a complete response, and she remains without local or distance relapse. Treating pediatric nasopharyngeal carcinoma patients with the Al-Sarraf protocol could be a feasible modality, as observed in this clinical case, despite the elevated cost of using interferon-beta in low-income countries when using more advanced radiotherapy techniques such as conformal radiotherapy and now, modulated intensity radiotherapy. It should be noted that brachytherapy boosts

  7. Television Quiz Show Simulation

    ERIC Educational Resources Information Center

    Hill, Jonnie Lynn

    2007-01-01

    This article explores the simulation of four television quiz shows for students in China studying English as a foreign language (EFL). It discusses the adaptation and implementation of television quiz shows and how the students reacted to them.

  8. Helicobacter pylori Infection in Pediatrics.

    PubMed

    Roma, Eleftheria; Miele, Erasmo

    2015-09-01

    This review includes the main pediatric studies published from April 2014 to March 2015. The host response of Treg cells with increases in FOXP3 and TGF-β1 combined with a reduction in IFN-γ by Teff cells may contribute to Helicobacter pylori susceptibility in children. Genotypic variability in H. pylori strains influences the clinical manifestation of the infection. Helicobacter pylori infection is associated with variables indicative of a crowded environment and poor living conditions, while breast-feeding has a protective effect. Intrafamilial infection, especially from mother to children and from sibling to sibling, is the dominant transmission route. Studies showed conflicting results regarding the association between H. pylori infection and iron deficiency anemia. One study suggests that H. pylori eradication plays a role in the management of chronic immune thrombocytopenic purpura in H. pylori-infected children and adolescents. The prevalence of H. pylori was higher in chronic urticaria patients than in controls and, following H. pylori eradication, urticarial symptoms disappeared. An inverse relationship between H. pylori infection and allergic disease was reported. Antibiotic resistance and insufficient compliance to treatment limit the efficacy of eradication therapy. Sequential therapy had no advantage over standard triple therapy. In countries where H. pylori infection is prevalent, studies focusing on virulence factors and antibiotic susceptibility may provide anticipation of the prognosis and may be helpful to reduce morbidity and mortality.

  9. Helicobacter pylori Infection in Pediatrics.

    PubMed

    Roma, Eleftheria; Miele, Erasmo

    2015-09-01

    This review includes the main pediatric studies published from April 2014 to March 2015. The host response of Treg cells with increases in FOXP3 and TGF-β1 combined with a reduction in IFN-γ by Teff cells may contribute to Helicobacter pylori susceptibility in children. Genotypic variability in H. pylori strains influences the clinical manifestation of the infection. Helicobacter pylori infection is associated with variables indicative of a crowded environment and poor living conditions, while breast-feeding has a protective effect. Intrafamilial infection, especially from mother to children and from sibling to sibling, is the dominant transmission route. Studies showed conflicting results regarding the association between H. pylori infection and iron deficiency anemia. One study suggests that H. pylori eradication plays a role in the management of chronic immune thrombocytopenic purpura in H. pylori-infected children and adolescents. The prevalence of H. pylori was higher in chronic urticaria patients than in controls and, following H. pylori eradication, urticarial symptoms disappeared. An inverse relationship between H. pylori infection and allergic disease was reported. Antibiotic resistance and insufficient compliance to treatment limit the efficacy of eradication therapy. Sequential therapy had no advantage over standard triple therapy. In countries where H. pylori infection is prevalent, studies focusing on virulence factors and antibiotic susceptibility may provide anticipation of the prognosis and may be helpful to reduce morbidity and mortality. PMID:26372825

  10. Evaluation of Physicians’ Awareness of Pediatric Diseases in Iran

    PubMed Central

    Abolhassani, Hassan; Mirminachi, Babak; Daryabeigi, Maedeh; Agharahimi, Zahra; Aghamohammadi, Asghar; Rabbani, Ali; Rezaei, Nima

    2014-01-01

    Objective: Physicians’ awareness about pediatric health problems is very important in health system. This has not been investigated in Iran as yet. Therefore this study was conducted to characterize the knowledge of the Iranian physicians which has direct association with health status of children. Methods: One hundred and four physicians, mainly pediatric specialists (58.6%) working in the state hospitals (45.1%) were enrolled. They filled a valid and reliable questionnaire, containing 26 questions about basic and important pediatric issues before and after an educational pediatric program (EPP). Findings : Thirty nine (37.5%) physicians answered correctly more than 2/3 of all questions (passed the examination) before EPP, which increased to 42.3% after EEP. Subgroup analysis showed that the total scores of general practitioners (P=0.007) was significantly increased after the EPP. Moreover, physicians with shorter practicing time (P=0.006) and those with shorter time past graduation (P=0.01) had a significant improvement in their total scores after the program. The best scores of educational issues were documented in growth and development (16.0%; P=0.04), followed by dermatology (9.2%, P=0.04), urology (9.1%; P=0.04), and asthma and allergy (9.0%, P=0.04). Conclusion: This study revealed that there are gaps in the knowledge of professionals about the pediatric issues. PMID:25793051

  11. Comprehensive training for the future pediatric cardiologist

    PubMed Central

    Subramanyan, Raghavan

    2016-01-01

    India faces a huge burden of pediatric and adult congenital heart diseases (CHDs). Many acquired valvar, myocardial, and vascular diseases also need treatment in childhood and adolescence. The emergence of pediatric cardiology as an independent specialty has been a relatively recent development. A few centers of excellence in pediatric cardiology have developed. However, the requirement of pediatric cardiac care and pediatric cardiologists is far in excess of what is available. There are no guidelines at present in India for uniform training in pediatric cardiology. Many training programs are nonstructured and do not focus on the regional needs. Both core training and advanced training programs are essential to provide adequate numbers of community-level pediatric cardiologists and academic leaders respectively. This article proposes a detailed plan and curriculum for comprehensive training of future pediatric cardiologists in India. PMID:27011684

  12. Cryptosporidiosis in pediatric patients.

    PubMed

    Saredi, N; Bava, J

    1998-01-01

    Cryptosporidium was detected in 21 (3.8%) individual stool samples collected from 553 pediatric patients hospitalized in our center employing a Telemann concentration technique (formalin-ether-centrifugation) and stained with the modified Kinyoun method. The mean age of populations with Cryptosporidiosis (16 boys and 5 girls) was 11 months; 15 months for girls and 6.5 for boys. Ages of 81% of them were less than 19 months. Seventy-six per cent of patients lived on the outskirts of Buenos Aires and 71% lacked pretreated running water at home. In 62% of the cases parasitological diagnoses coincided with warm seasons. At diagnosis mucous (63%) or watery (36%) diarrhea was presented in 90% of the patients with a median of 5 (3-8) bowel movements per day. Fever was presented in 66% of patients while abdominal pain and vomits in 60% and 52%, respectively. The median time from hospitalization up to parasitologic diagnosis was 20 days. Concomitant diseases observed were malnutrition, acute leukemia, bronchiolitis, HIV infection, anemia, celiac disease, myelofibrosis, vitelline sac tumor, neutropenia, osteosarcoma and dehydration. Cryptosporidiosis in our environment seems to occur more frequently in children younger than 18 months of age; who present diarrhea; are immunodeficient; come from a low socioeconomical background; and who live in poor sanitary conditions with no potable running water.

  13. Common pediatric epilepsy syndromes.

    PubMed

    Park, Jun T; Shahid, Asim M; Jammoul, Adham

    2015-02-01

    Benign rolandic epilepsy (BRE), childhood idiopathic occipital epilepsy (CIOE), childhood absence epilepsy (CAE), and juvenile myoclonic epilepsy (JME) are some of the common epilepsy syndromes in the pediatric age group. Among the four, BRE is the most commonly encountered. BRE remits by age 16 years with many children requiring no treatment. Seizures in CAE also remit at the rate of approximately 80%; whereas, JME is considered a lifelong condition even with the use of antiepileptic drugs (AEDs). Neonates and infants may also present with seizures that are self-limited with no associated psychomotor disturbances. Benign familial neonatal convulsions caused by a channelopathy, and inherited in an autosomal dominant manner, have a favorable outcome with spontaneous resolution. Benign idiopathic neonatal seizures, also referred to as "fifth-day fits," are an example of another epilepsy syndrome in infants that carries a good prognosis. BRE, CIOE, benign familial neonatal convulsions, benign idiopathic neonatal seizures, and benign myoclonic epilepsy in infancy are characterized as "benign" idiopathic age-related epilepsies as they have favorable implications, no structural brain abnormality, are sensitive to AEDs, have a high remission rate, and have no associated psychomotor disturbances. However, sometimes selected patients may have associated comorbidities such as cognitive and language delay for which the term "benign" may not be appropriate.

  14. Pediatric guidelines for dyslipidemia.

    PubMed

    Daniels, Stephen R

    2015-01-01

    Clinical guidelines are developed to assist clinicians in complex clinical decision making. Modern guideline development includes a systematic review and grading of relevant literature and then using the evidence review to construct recommendations for clinical care which are also graded regarding the level of evidence supporting them. Pediatric guidelines for dyslipidemia were first published in 1992. There was then a gap during which no formal guidelines were developed. In 2011, the National Heart, Lung, and Blood Institute Integrated Guidelines for Cardiovascular Disease Risk Reduction in Children were published. This included an evidence review and clinical recommendations regarding dyslipidemia. This review process began in 2006. The evidence review ended in 2008, and they were published in 2011 because of an extensive and prolonged review process. These guidelines recommend universal screening for dyslipidemia at age 9 to 11 y with a focus on identifying young individuals with genetic dyslipidemia such as familial hypercholesterolemia. The guidelines also include lifestyle recommendations and recommendations for pharmacologic treatment for children with markedly elevated low-density lipoprotein cholesterol. The guideline process should include review of the implementation of guidelines in practice and should also include ongoing review of the guidelines with respect to a growing evidence base with new research findings.

  15. The pediatric neurotransmitter disorders.

    PubMed

    Pearl, Phillip L; Taylor, Jacob L; Trzcinski, Stacey; Sokohl, Alex

    2007-05-01

    The pediatric neurotransmitter disorders represent an enlarging group of neurological syndromes characterized by abnormalities of neurotransmitter synthesis and breakdown. The disorders of dopamine and serotonin synthesis are aromatic amino acid decarboxylase deficiency, tyrosine hydroxylase deficiency, and disorders of tetrahydrobiopterin synthesis. Amino acid decarboxylase, tyrosine hydroxylase, sepiapterin reductase, and guanosine triphosphate cyclohydrolase (Segawa disease) deficiencies do not feature elevated serum phenylalanine and require cerebrospinal fluid analysis for diagnosis. Segawa disease is characterized by dramatic and lifelong responsiveness to levodopa. Glycine encephalopathy is typically manifested by refractory neonatal seizures secondary to a defect of the glycine degradative pathway. gamma-amino butyric acid (GABA) metabolism is associated with several disorders, including glutamic acid decarboxylase deficiency with nonsyndromic cleft lip/ palate, GABA-transaminase deficiency, and succinic semialdehyde dehydrogenase deficiency. The latter is characterized by elevated gamma-hydroxybutyric acid and includes a wide range of neuropsychiatric symptoms as well as epilepsy. Pyridoxine-dependent seizures have now been associated with deficiency of alpha-aminoadipic semialdehyde dehydrogenase, as well as a new variant requiring therapy with pyridoxal-5-phosphate, the biologically active form of pyridoxine.

  16. Pediatric arterial interventions.

    PubMed

    Marshalleck, Francis

    2010-12-01

    The spectrum of pediatric vascular pathology differs from the adult population and it varies greatly to include congenital and acquired disorders. Although catheter-directed angiography remains the gold standard, most vascular conditions in the child can be adequately diagnosed with magnetic resonance angiography, computed tomographic angiography, or duplex/Doppler ultrasonography with only a few exceptions, such as intrarenal arterial stenosis, small vessel vasculitides, and visceral vascular malformations. The advancement of catheter and wire technology has made it increasingly possible for complex arterial interventions to be performed in children, including embolization, angioplasty with stent insertion, thrombolysis, and endovascular neurological procedures. More angiographic procedures are being performed with the aim of also being therapeutic. Special considerations in children include the use of appropriate equipment and adequate dosing of contrast and of the various medications used during angiography, particularly in patients less than 15 kg in weight. This article will focus on the management of renovascular hypertension, liver transplant hepatic arterial intervention, and the use of carbon dioxide gas as a contrast agent in the child.

  17. Pediatric Eye Screening Instrumentation

    NASA Astrophysics Data System (ADS)

    Chen, Ying-Ling; Lewis, J. W. L.

    2001-11-01

    Computational evaluations are presented for binocular eye screening using the off-axis digital retinascope. The retinascope, such as the iScreen digital screening system, has been employed to perform pediatric binocular screening using a flash lamp and single-shot camera recording. The digital images are transferred electronically to a reading center for analysis. The method has been shown to detect refractive error, amblyopia, anisocoria, and ptosis. This computational work improves the performance of the system and forms the basis for automated data analysis. For this purpose, variouis published eye models are evaluated with simulated retinascope images. Two to ten million rays are traced in each image calculation. The poster will present the simulation results for a range of eye conditions of refractive error of -20 to +20 diopters with 0.5- to-1 diopter resolution, pupil size of 3 to 8 mm diameter (1-mm increment), and staring angle of 2 to 12 degree (2-degree increment). The variation of the results with the system conditions such as the off-axis distance of light source and the shutter size of camera are also evaluated. The quantitative analysis for each eye’s and system’s condition is then performed to obtain parameters for automatic reading. The summary of the system performance is given and performance-enhancement design modifications are presented.

  18. Pediatric cavernous sinus thrombosis

    PubMed Central

    Vossough, Arastoo; Vorona, Gregory A.; Beslow, Lauren A.; Ichord, Rebecca N.; Licht, Daniel J.

    2015-01-01

    Objective: To describe clinical characteristics, imaging findings, morbidity, and mortality in a single-center cohort of 12 pediatric cavernous sinus thrombosis cases and to review all cases available in recent English literature. Methods: Clinical data and radiographic studies on 12 cases from our institution were analyzed retrospectively. A literature search and review was conducted, with additional cases pooled with the new cohort for an aggregate analysis. Results: Twelve cases of cavernous sinus thrombosis in children from the Children's Hospital of Philadelphia between January 1, 2000, and December 31, 2013, were reviewed. All patients survived to discharge; 3 of 12 (25%) experienced neurologic morbidity. Contrast-enhanced MRI and contrast-enhanced head CT were 100% sensitive for detecting cavernous sinus thrombosis, while noncontrast time-of-flight magnetic resonance venography (TOF MRV) and noncontrast head CT were 0% sensitive. Literature review produced an additional 40 cases, and the aggregate mortality rate was 4 of 52 (8%) and morbidity rate was 10 of 40 (25%). Outcomes did not vary by treatment or with unilateral vs bilateral cavernous sinus involvement. There was a trend toward worse outcomes with fungal infections. Conclusion: Our case series demonstrates low morbidity and mortality with early, aggressive surgical, antimicrobial, and anticoagulation therapies. Although anticoagulation and surgery were not associated with significantly different outcomes, more study is needed. PMID:26231260

  19. Debriefing in pediatrics

    PubMed Central

    2015-01-01

    Debriefing is a conversational session that revolves around the sharing and examining of information after a specific event has taken place. Debriefing may follow a simulated or actual experience and provides a forum for the learners to reflect on the experience and learn from their mistakes. Originating from the military and aviation industry, it is used on a daily basis to reflect and improve the performance in other high-risk industries. Expert debriefers may facilitate the reflection by asking open-ended questions to probe into the framework of the learners and apply lessons learned to future situations. Debriefing has been proven to improve clinical outcomes such as the return of spontaneous circulation after cardiac arrest and the teaching of teamwork and communication in pediatrics. Incorporating debriefing into clinical practice would facilitate the cultural change necessary to talk more openly about team performance and learn from near misses, errors, and successes that will improve not only clinical outcome but also patient safety. PMID:25774195

  20. Pediatric cranial computed tomography

    SciTech Connect

    Yamada, H.

    1984-01-01

    The introduction of CT in the investigation of intercranial pathology has revolutionized the approach to clinical neurological and neurosurgical practice. This book applies the advances of cranial CT to the pediatric patient. The test is divided into two sections. The first portion describes the practical methodology, anatomy and normal and abnormal CT scan appearance, including high or low density lesions, cystic lesions and ventricular or subarachnoid space dilation. The characteristic scans for various neurological diseases are presented and discussed. The author has given special attention to the CT diagnosis of congenital malformations and cerebral neoplasms. Partial Contents: Normal Computed Tomographic Anatomy/ High Density Lesions/Low Density Lesions/Cystic Lesions; Supratentorial/Cystic Lesions; Infratentorial/Increased Head Circumference/Increased Ventricular Size/Small Ventricular Size/Cranial Lesions/Spinal Lesions/CT Cisternography/Part II CT in Neonates/Congenital Craniocerebral Malformations/Hydrocephalus/Craniosynostosis/Head Trauma/Cerebrovascular Lesions/Intracranial Lesions/Seizure Disorders/Intracranial and Other Chronic Neurological Disorders.

  1. Pediatric Arm Function Test

    PubMed Central

    Uswatte, Gitendra; Taub, Edward; Griffin, Angi; Rowe, Jan; Vogtle, Laura; Barman, Joydip

    2012-01-01

    Objective Although there are several validated upper-extremity measures in young children with cerebral palsy (CP), none primarily assess capacity to carry out actions and tasks with the more-affected arm. To address this need, we developed the Pediatric Arm Function Test (PAFT), which involves behavioral observation of how children use their more-affected arm during structured play in the laboratory or clinic. This paper evaluates the reliability and validity of the PAFT Functional Ability scale. Design In Study 1, 20 children between 2–8 years with a wide range of upper-extremity hemiparesis due to CP completed the PAFT on two occasions separated by three weeks. In Study 2, 41 children between 2–6 years with similar characteristics completed the PAFT and received a grade reflecting severity of more-affected arm motor impairment. Results In Study 1, the PAFT test-retest reliability correlation coefficient was 0.74. In Study 2, convergent validity was supported by a strong, inverse correlation (r = −0.6, p < .001) between PAFT scores and grade of impairment. Conclusions The PAFT Functional Ability scale is a reliable and valid measure of more-affected arm motor capacity in children with CP between 2–6 years. It can be employed to measure upper-extremity neurorehabilitation outcome. PMID:23103486

  2. A Holographic Road Show.

    ERIC Educational Resources Information Center

    Kirkpatrick, Larry D.; Rugheimer, Mac

    1979-01-01

    Describes the viewing sessions and the holograms of a holographic road show. The traveling exhibits, believed to stimulate interest in physics, include a wide variety of holograms and demonstrate several physical principles. (GA)

  3. Intensity and sulci landmark combined brain atlas construction for Chinese pediatric population.

    PubMed

    Luo, Yishan; Shi, Lin; Weng, Jian; He, Hongjian; Chu, Winnie C W; Chen, Feiyan; Wang, Defeng

    2014-08-01

    Constructing an atlas from a population of brain images is of vital importance to medical image analysis. Especially in neuroscience study, creating a brain atlas is useful for intra- and inter-population comparison. Research on brain atlas construction has attracted great attention in recent years, but the research on pediatric population is still limited, mainly due to the limited availability and the relatively low quality of pediatric magnetic resonance brain images. This article is targeted at creating a high quality representative brain atlas for Chinese pediatric population. To achieve this goal, we have designed a set of preprocessing procedures to improve the image quality and developed an intensity and sulci landmark combined groupwise registration method to align the population of images for atlas construction. As demonstrated in experiments, the newly constructed atlas can better represent the size and shape of brains of Chinese pediatric population, and show better performance in Chinese pediatric brain image analysis compared with other standard atlases.

  4. Intraoperative imaging of pediatric vocal fold lesions using optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Benboujja, Fouzi; Garcia, Jordan A.; Beaudette, Kathy; Strupler, Mathias; Hartnick, Christopher J.; Boudoux, Caroline

    2016-01-01

    Optical coherence tomography (OCT) has been previously identified as a promising tool for exploring laryngeal pathologies in adults. Here, we present an OCT handheld probe dedicated to imaging the unique geometry involved in pediatric laryngoscopy. A vertical cavity surface emitting laser-based wavelength-swept OCT system operating at 60 frames per second was coupled to the probe to acquire three-dimensional (3-D) volumes in vivo. In order to evaluate the performance of the proposed probe and system, we imaged pediatric vocal fold lesions of patients going under direct laryngoscopy. Through this in vivo study, we extracted OCT features characterizing each pediatric vocal fold lesion, which shows a great potential for noninvasive laryngeal lesion discrimination. We believe OCT vocal fold examination in 3-D will result in improved knowledge of the pediatric anatomy and could aid in managing pediatric laryngeal diseases.

  5. Daily Bathing with Chlorhexidine and Its Effects on Nosocomial Infection Rates in Pediatric Oncology Patients.

    PubMed

    Raulji, Chittalsinh M; Clay, Kristin; Velasco, Cruz; Yu, Lolie C

    2015-01-01

    Infections remain a serious complication in pediatric oncology patients. To determine if daily bathing with Chlorhexidine gluconate can decrease the rate of nosocomial infection in pediatric oncology patients, we reviewed rates of infections in pediatric oncology patients over a 14-month span. Intervention group received daily bath with Chlorhexidine, while the control group did not receive daily bath. The results showed that daily bath with antiseptic chlorhexidine as daily prophylactic antiseptic topical wash leads to decreased infection density amongst the pediatric oncology patients, especially in patients older than 12 years of age. Furthermore, daily chlorhexidine bathing significantly reduced the rate of hospital acquired infection in patients older than 12 years of age. The findings of this study suggest that daily bathing with chlorhexidine may be an effective measure of reducing nosocomial infection in pediatric oncology patients.

  6. Daily Bathing with Chlorhexidine and Its Effects on Nosocomial Infection Rates in Pediatric Oncology Patients.

    PubMed

    Raulji, Chittalsinh M; Clay, Kristin; Velasco, Cruz; Yu, Lolie C

    2015-01-01

    Infections remain a serious complication in pediatric oncology patients. To determine if daily bathing with Chlorhexidine gluconate can decrease the rate of nosocomial infection in pediatric oncology patients, we reviewed rates of infections in pediatric oncology patients over a 14-month span. Intervention group received daily bath with Chlorhexidine, while the control group did not receive daily bath. The results showed that daily bath with antiseptic chlorhexidine as daily prophylactic antiseptic topical wash leads to decreased infection density amongst the pediatric oncology patients, especially in patients older than 12 years of age. Furthermore, daily chlorhexidine bathing significantly reduced the rate of hospital acquired infection in patients older than 12 years of age. The findings of this study suggest that daily bathing with chlorhexidine may be an effective measure of reducing nosocomial infection in pediatric oncology patients. PMID:25918820

  7. Advances in Pediatric Intravenous Iron Therapy.

    PubMed

    Mantadakis, Elpis

    2016-01-01

    Iron deficiency anemia (IDA) continues to be very common worldwide. Intravenous (IV) iron is an infrequently used therapeutic option in children with IDA despite numerous studies in adults and several small but notable pediatric studies showing efficacy and safety. Presently, the availability of newer IV iron products allows for replacement of the total iron deficit at a single setting. These products appear safer compared to the high molecular weight iron dextrans of the past. Herein, we review the medical literature and suggest that front line use of IV iron should be strongly considered in diseases associated with IDA in children.

  8. Pediatric scleroderma: systemic or localized forms.

    PubMed

    Torok, Kathryn S

    2012-04-01

    Pediatric scleroderma includes 2 major groups of clinical entities, systemic sclerosis (SSc) and localized scleroderma (LS). Although both share a common pathophysiology, their clinical manifestations differ. LS is typically confined to the skin and underlying subcutis, with up to a quarter of patients showing extracutaneous disease manifestations such as arthritis and uveitis. Vascular, cutaneous, gastrointestinal, pulmonary, and musculoskeletal involvement are most commonly seen in children with SSc. Treatment of both forms targets the active inflammatory stage and halts disease progression; however, progress needs to be made toward the development of more effective antifibrotic therapy to help reverse disease damage.

  9. [Systemic sarcoidosis: a diagnostic challenge in pediatrics. Case report].

    PubMed

    Díaz Angarita, Tomás; Morales Camacho, William; Lozano Neira, Laura; Plata Ortiz, Jessica; Zárate Taborda, Linda

    2016-10-01

    Sarcoidosis is a granulomatous inflammatory disease of unknown etiology, evidenced most often in young adults, which can compromise several organs, mainly lung, lymph nodes, eyes and skin. The presence of the disease in pediatric population is rare. Denomination in pediatrics is made based on age and clinical manifestations of the patient. The aim of this report is to present a case of systemic sarcoidosis in a pediatric patient without lung involvement with severe extrapulmonary manifestations. Fifteen year old patient who debuted with nonspecific symptoms (emesis, weight loss). Radiographic studies without lung involvement but with findings suggestive of Langerhans cell histiocytosis; however, histopathological report (bone and lymph) showed the presence of chronic granulomatous nonnecrotizing disease, sarcoidosis type. Childhood sarcoidosis is a rare and difficult entity to diagnose, mainly by the lack of specific biomarkers for diagnosis. PMID:27606655

  10. Medicalization as professional process: postwar trends in pediatrics.

    PubMed

    Halpern, S A

    1990-03-01

    In the late 1950s American pediatricians began to place increased emphasis on psychosocial and behavioral issues in medical training and research. An intraprofessional movement for psychosocial pediatrics led to alterations in the specialty's stated jurisdiction. One explanation for the movement's origins is that demand for treating sick children was eroding; primary-care providers took up the delivery of behavioral services to avoid extinction. This paper shows that routinization of work, not market decline, preceded psychosocial pediatrics. Academicians rather than community practitioners spearheaded boundary expansion. The movement's major consequence appears to be a new division of labor between pediatricians and other health care professionals rather than increased pediatric treatment of children's psychosocial disorders.

  11. [Systemic sarcoidosis: a diagnostic challenge in pediatrics. Case report].

    PubMed

    Díaz Angarita, Tomás; Morales Camacho, William; Lozano Neira, Laura; Plata Ortiz, Jessica; Zárate Taborda, Linda

    2016-10-01

    Sarcoidosis is a granulomatous inflammatory disease of unknown etiology, evidenced most often in young adults, which can compromise several organs, mainly lung, lymph nodes, eyes and skin. The presence of the disease in pediatric population is rare. Denomination in pediatrics is made based on age and clinical manifestations of the patient. The aim of this report is to present a case of systemic sarcoidosis in a pediatric patient without lung involvement with severe extrapulmonary manifestations. Fifteen year old patient who debuted with nonspecific symptoms (emesis, weight loss). Radiographic studies without lung involvement but with findings suggestive of Langerhans cell histiocytosis; however, histopathological report (bone and lymph) showed the presence of chronic granulomatous nonnecrotizing disease, sarcoidosis type. Childhood sarcoidosis is a rare and difficult entity to diagnose, mainly by the lack of specific biomarkers for diagnosis.

  12. Resuscitation of a Pediatric Drowning in Hypothermic Cardiac Arrest.

    PubMed

    Dragann, Brendan N; Melnychuk, Eric M; Wilson, Christopher J; Lambert, Richard L; Maffei, Frank A

    2016-01-01

    The prognosis of pediatric patients who require prolonged resuscitation after ice water drowning and hypothermic cardiac arrest remains guarded. We report a case of successful prolonged resuscitation of a pediatric patient in hypothermic cardiac arrest who showed severe metabolic derangements and went on to make a rapid and full neurologic recovery without the use of extracoproreal rewarming or mechanical cardiac support. Many ground and air medical emergency medical service programs have policies against interfacility transfer of patients in hypothermic cardiac arrest, calling into question the need to revise current protocols. PMID:27021675

  13. [Hibernoma: brown fat retroperitoneal tumor. Report of a pediatric case].

    PubMed

    Collado, Laura; Sierre, Sergio; Bosalec, Andrea; Lipsich, José

    2011-12-01

    Hibernoma is a rare benign tumor of soft tissue, composed of brown fat. This tissue is predominant in hibernating animals and hence its name. Because of its rarity in Pediatrics and difficult diagnosis, we report a 3 month-old patient with a diagnosis consistent with an abdominal tumor. Ultrasound and computed tomography exams showed an infiltrative retroperitoneal tumor, with hypervascular and lipomatous features. After tumor excision, histopathological exam confirmed the diagnosis of hibernoma or brown fat tumor. This presentation describes the characteristics of this type of tumor, rare in children, and reviews the fatty tumors, according to their frequency in pediatric patients.

  14. Targeted immunotherapy for pediatric solid tumors

    PubMed Central

    Kopp, Lisa M.; Katsanis, Emmanuel

    2016-01-01

    ABSTRACT Metastatic and refractory pediatric solid tumor malignancies continue to have a poor outcome despite the > 80% cure rates appreciated in many pediatric cancers. Targeted immunotherapy is impacting treatment and survival in these aggressive tumors. We review current promising immunotherapeutic approaches in the pediatric oncology solid tumor setting. PMID:27141344

  15. Japanese consensus guidelines for pediatric nuclear medicine. Part 1: Pediatric radiopharmaceutical administered doses (JSNM pediatric dosage card). Part 2: Technical considerations for pediatric nuclear medicine imaging procedures.

    PubMed

    Koizumi, Kiyoshi; Masaki, Hidekazu; Matsuda, Hiroshi; Uchiyama, Mayuki; Okuno, Mitsuo; Oguma, Eiji; Onuma, Hiroshi; Kanegawa, Kimio; Kanaya, Shinichi; Kamiyama, Hiroshi; Karasawa, Kensuke; Kitamura, Masayuki; Kida, Tetsuo; Kono, Tatsuo; Kondo, Chisato; Sasaki, Masayuki; Terada, Hitoshi; Nakanishi, Atsushi; Hashimoto, Teisuke; Hataya, Hiroshi; Hamano, Shin-ichiro; Hirono, Keishi; Fujita, Yukihiko; Hoshino, Ken; Yano, Masayuki; Watanabe, Seiichi

    2014-06-01

    The Japanese Society of Nuclear Medicine has recently published the consensus guidelines for pediatric nuclear medicine. This article is the English version of the guidelines. Part 1 proposes the dose optimization in pediatric nuclear medicine studies. Part 2 comprehensively discusses imaging techniques for the appropriate conduct of pediatric nuclear medicine procedures, considering the characteristics of imaging in children.

  16. The Genetics of Pediatric Obesity.

    PubMed

    Chesi, Alessandra; Grant, Struan F A

    2015-12-01

    Obesity among children and adults has notably escalated over recent decades and represents a global major health problem. We now know that both genetic and environmental factors contribute to its complex etiology. Genome-wide association studies (GWAS) have revealed compelling genetic signals influencing obesity risk in adults. Recent reports for childhood obesity revealed that many adult loci also play a role in the pediatric setting. Childhood GWAS have uncovered novel loci below the detection range in adult studies, suggesting that obesity genes may be more easily uncovered in the pediatric setting. Shedding light on the genetic architecture of childhood obesity will facilitate the prevention and treatment of pediatric cases, and will have fundamental implications for diseases that present later in life.

  17. Antibiotic resistance in pediatric urology

    PubMed Central

    Copp, Hillary L.

    2014-01-01

    Antibiotics are a mainstay in the treatment of bacterial infections, though their use is a primary risk factor for the development of antibiotic resistance. Antibiotic resistance is a growing problem in pediatric urology as demonstrated by increased uropathogen resistance. Lack of urine testing, nonselective use of prophylaxis, and poor empiric prescribing practices exacerbate this problem. This article reviews antibiotic utilization in pediatric urology with emphasis on modifiable practice patterns to potentially help mitigate the growing rates of antibiotic resistance. This includes urine testing to only treat when indicated and tailor broad-spectrum therapy as able; selective application of antibiotic prophylaxis to patients with high-grade vesicoureteral reflux and hydronephrosis with counseling regarding the importance of compliance; and using local antiobiograms, particularly pediatric-specific antiobiograms, with inpatient versus outpatient data. PMID:24688601

  18. Treatment Options for Pediatric Psoriasis.

    PubMed

    Madiraca, Dora; Šitum, Mirna; Prkačin, Ivana; Ožanić Bulić, Suzana

    2016-08-01

    Psoriasis is a multifactorial inflammatory papulosquamous disease affecting 0.5% to 2% of the pediatric population. Pediatric psoriasis, presenting similar to adult psoriasis, significantly reduces patient quality of life, often requiring an individualized treatment approach for each patient. Combination and rotational therapy are helpful in reducing toxicity and maximizing efficacy. Patients with mild and limited disease severity respond well to topical treatment with steroids or vitamin D analogues, unlike moderate and severe psoriasis where sufficient remission is rarely achieved. Therefore phototherapy, systemic immunomodulators, or biologic agents are the next line of treatment to be considered. There is limited data available on the use and long-term safety of biologics in the pediatric population. Biologic agents must be administered by experienced dermatologists, only in patients with moderate-to-severe plaque psoriasis who are intolerant or refractory to other systemic conventional disease-modifying treatment or phototherapy, or if those treatments are contraindicated. PMID:27663917

  19. Pediatric obesity & type 2 diabetes.

    PubMed

    Dea, Tara L

    2011-01-01

    This article focuses on (a) identifying obesity and other risk factors for developing type 2 diabetes, (b) differentiating between pediatric type 1 diabetes and type 2 diabetes, and (c) treating pediatric type 2 diabetes. Obesity has significant implications on a child's health, including an increased risk for insulin resistance and progression to type 2 diabetes. Type 2 diabetes in children, characterized by insulin resistance and relative pancreatic b-cell failure due to the increased demand for insulin production, has now reached epidemic proportions. Longitudinal research on pediatric type 2 diabetes, however, is lacking because this epidemic is relatively new. Treatment of type 2 diabetes in children is focused on lifestyle modification with weight management/increased physical activity, and pharmacological management through oral medication or insulin therapy. Because children with type 2 diabetes are at risk for developing diabetes-related complications earlier in life, they need to be closely monitored for comorbidities.

  20. Complex Cases in Pediatric Cataract.

    PubMed

    Patil-Chhablani, Preeti; Kekunnaya, Ramesh; Nischal, Kanwall Ken

    2016-01-01

    This chapter describes the techniques and pitfalls that the reader may come across when dealing with complex pediatric cataract cases. Each eye in these circumstances is unique, and the examples and general advice shared are intended to help the reader develop a plan for surgery and a road map to avoid potential problems. As in all types of surgery, careful planning is essential. The old saying 'Fail to prepare, then you prepare to fail' is no more true than when dealing with children who have complex cataract. In this chapter, the following circumstances where pediatric cataract may be seen are discussed: retinoblastoma, retinopathy of prematurity, lenticonus, congenital rubella syndrome, trauma, microcornea, pediatric uveitis, Hallermann-Streiff syndrome, Stickler syndrome, Lowe syndrome, subluxated lens, and after previous intraocular surgery (glaucoma, keratoplasty).

  1. Sudden Cardiac Arrest in Pediatrics.

    PubMed

    Scheller, RoseAnn L; Johnson, Laurie; Lorts, Angela; Ryan, Thomas D

    2016-09-01

    Sudden cardiac arrest (SCA) in the pediatric population is a rare and potentially devastating occurrence. An understanding of the differential diagnosis for the etiology of the cardiac arrest allows for the most effective emergency care and provides the patient with the best possible outcome. Pediatric SCA can occur with or without prodromal symptoms and may occur during exercise or rest. The most common cause is arrhythmia secondary to an underlying channelopathy, cardiomyopathy, or myocarditis. After stabilization, evaluation should include electrocardiogram, chest radiograph, and echocardiogram. Management should focus on decreasing the potential for recurring arrhythmia, maintaining cardiac preload, and thoughtful medication use to prevent exacerbation of the underlying condition. The purpose of this review was to provide the emergency physician with a concise and current review of the incidence, differential diagnosis, and management of pediatric patients presenting with SCA. PMID:27585126

  2. The Ozone Show.

    ERIC Educational Resources Information Center

    Mathieu, Aaron

    2000-01-01

    Uses a talk show activity for a final assessment tool for students to debate about the ozone hole. Students are assessed on five areas: (1) cooperative learning; (2) the written component; (3) content; (4) self-evaluation; and (5) peer evaluation. (SAH)

  3. Show What You Know

    ERIC Educational Resources Information Center

    Eccleston, Jeff

    2007-01-01

    Big things come in small packages. This saying came to the mind of the author after he created a simple math review activity for his fourth grade students. Though simple, it has proven to be extremely advantageous in reinforcing math concepts. He uses this activity, which he calls "Show What You Know," often. This activity provides the perfect…

  4. Showing What They Know

    ERIC Educational Resources Information Center

    Cech, Scott J.

    2008-01-01

    Having students show their skills in three dimensions, known as performance-based assessment, dates back at least to Socrates. Individual schools such as Barrington High School--located just outside of Providence--have been requiring students to actively demonstrate their knowledge for years. The Rhode Island's high school graduating class became…

  5. Stage a Water Show

    ERIC Educational Resources Information Center

    Frasier, Debra

    2008-01-01

    In the author's book titled "The Incredible Water Show," the characters from "Miss Alaineus: A Vocabulary Disaster" used an ocean of information to stage an inventive performance about the water cycle. In this article, the author relates how she turned the story into hands-on science teaching for real-life fifth-grade students. The author also…

  6. What Do Maps Show?

    ERIC Educational Resources Information Center

    Geological Survey (Dept. of Interior), Reston, VA.

    This curriculum packet, appropriate for grades 4-8, features a teaching poster which shows different types of maps (different views of Salt Lake City, Utah), as well as three reproducible maps and reproducible activity sheets which complement the maps. The poster provides teacher background, including step-by-step lesson plans for four geography…

  7. Obesity in show cats.

    PubMed

    Corbee, R J

    2014-12-01

    Obesity is an important disease with a high prevalence in cats. Because obesity is related to several other diseases, it is important to identify the population at risk. Several risk factors for obesity have been described in the literature. A higher incidence of obesity in certain cat breeds has been suggested. The aim of this study was to determine whether obesity occurs more often in certain breeds. The second aim was to relate the increased prevalence of obesity in certain breeds to the official standards of that breed. To this end, 268 cats of 22 different breeds investigated by determining their body condition score (BCS) on a nine-point scale by inspection and palpation, at two different cat shows. Overall, 45.5% of the show cats had a BCS > 5, and 4.5% of the show cats had a BCS > 7. There were significant differences between breeds, which could be related to the breed standards. Most overweight and obese cats were in the neutered group. It warrants firm discussions with breeders and cat show judges to come to different interpretations of the standards in order to prevent overweight conditions in certain breeds from being the standard of beauty. Neutering predisposes for obesity and requires early nutritional intervention to prevent obese conditions. PMID:24612018

  8. Show Me the Way

    ERIC Educational Resources Information Center

    Dicks, Matthew J.

    2005-01-01

    Because today's students have grown up steeped in video games and the Internet, most of them expect feedback, and usually gratification, very soon after they expend effort on a task. Teachers can get quick feedback to students by showing them videotapes of their learning performances. The author, a 3rd grade teacher describes how the seemingly…

  9. The Art Show

    ERIC Educational Resources Information Center

    Scolarici, Alicia

    2004-01-01

    This article describes what once was thought to be impossible--a formal art show extravaganza at an elementary school with 1,000 students, a Department of Defense Dependent School (DODDS) located overseas, on RAF Lakenheath, England. The dream of this this event involved the transformation of the school cafeteria into an elegant art show…

  10. Honored Teacher Shows Commitment.

    ERIC Educational Resources Information Center

    Ratte, Kathy

    1987-01-01

    Part of the acceptance speech of the 1985 National Council for the Social Studies Teacher of the Year, this article describes the censorship experience of this honored social studies teacher. The incident involved the showing of a videotape version of the feature film entitled "The Seduction of Joe Tynan." (JDH)

  11. Pediatric transverse myelitis.

    PubMed

    Absoud, Michael; Greenberg, Benjamin M; Lim, Ming; Lotze, Tim; Thomas, Terrence; Deiva, Kumaran

    2016-08-30

    Pediatric acute transverse myelitis (ATM) is an immune-mediated CNS disorder and contributes to 20% of children experiencing a first acquired demyelinating syndrome (ADS). ATM must be differentiated from other presentations of myelopathy and may be the first presentation of relapsing ADS such as neuromyelitis optica (NMO) or multiple sclerosis (MS). The tenets of the diagnostic criteria for ATM established by the Transverse Myelitis Consortium Working Group can generally be applied in children; however, a clear sensory level may not be evident in some. MRI lesions are often centrally located with high T2 signal intensity involving gray and neighboring white matter. Longitudinally extensive ATM occurs in the majority. Asymptomatic lesions on brain MRI are seen in more than one-third and predict MS or NMO. The role of antibodies such as myelin oligodendrocyte glycoprotein in monophasic and relapsing ATM and their significance in therapeutic approaches remain unclear. ATM is a potentially devastating condition with variable outcome and presents significant cumulative demands on health and social care resources. Children generally have a better outcome than adults, with one-half making a complete recovery by 2 years. There is need for standardization of clinical assessment and investigation protocols to enable international collaborative studies to delineate prognostic factors for disability and relapse. There are no robust controlled trials in children or adults to inform optimal treatment of ATM, with one study currently open to recruitment. This review provides an overview of current knowledge of clinical features, investigative workup, pathogenesis, and management of ATM and suggests future directions. PMID:27572861

  12. Psychoneuroimmunology and the pediatric surgeon.

    PubMed

    Tagge, Edward P; Natali, Elizabeth Lee; Lima, Evan; Leek, Dustin; Neece, Cameron L; Randall, Kiti Freier

    2013-08-01

    The mind-body connection is receiving increasing scrutiny in a large number of clinical settings, although research has lagged in the pediatric specialties. Psychoneuroimmunology (PNI) is a novel interdisciplinary scientific field that examines the relationship of the mind to the patient's neurologic, endocrine, and immune systems by examining critical parameters such as the effects of mental stress on wound healing and infection rates. Techniques that modify a patient's emotional and mental responses to illness and surgery have positive effects on their physiology resulting in improved recoveries and higher patient satisfaction rates. In the appropriate clinical settings, an awareness of PNI can enhance outcomes for pediatric surgical patients.

  13. Advances in Pediatric Gastrostomy Placement.

    PubMed

    McSweeney, Maireade E; Smithers, C Jason

    2016-01-01

    Placement of gastrostomy tubes in infants and children has become increasingly commonplace. A historical emphasis on use of open gastrostomy has been replaced by less invasive methods of placement, including percutaneous endoscopic gastrostomy and laparoscopically assisted gastrostomy procedures. Various complications, ranging from minor to the more severe, have been reported with all methods of placement. Many pediatric patients who undergo gastrostomy tube placement will require long-term enteral therapy. Given the prolonged time pediatric patients may remain enterally dependent, further quality improvement and education initiatives are needed to improve long-term care and outcomes of these patients.

  14. Postinfectious Arthritis in Pediatric Practice

    PubMed Central

    PLESCA, Doina Anca; LUMINOS, Monica; SPATARIU, Luminita; STEFANESCU, Mihaela; CINTEZA, Eliza; BALGRADEAN, Mihaela

    2013-01-01

    ABSTRACT Postinfectious arthritis is a relatively often encountered in pediatric practice. The authors present the most important data concerneing this pathology, with up to date informations exemplifying with case presentations. Clinical cases bring to attention the most common forms of postinfectious arthritis (reactive arthritis, postinfectious arthritis bacterial, viral, spirochete, and so on). Although highly studied and commonly found in current pediatric practice, arthritis occurring after infections remains controversial entities, especially regarding terminology. While, according to some authors, postinfectious arthritis belongs to the large group of reactive arthritis, by other authors, these joint events are independent entities. PMID:24371480

  15. Medication Errors in Outpatient Pediatrics.

    PubMed

    Berrier, Kyla

    2016-01-01

    Medication errors may occur during parental administration of prescription and over-the-counter medications in the outpatient pediatric setting. Misinterpretation of medication labels and dosing errors are two types of errors in medication administration. Health literacy may play an important role in parents' ability to safely manage their child's medication regimen. There are several proposed strategies for decreasing these medication administration errors, including using standardized dosing instruments, using strictly metric units for medication dosing, and providing parents and caregivers with picture-based dosing instructions. Pediatric healthcare providers should be aware of these strategies and seek to implement many of them into their practices. PMID:27537086

  16. Psychological complications of pediatric obesity.

    PubMed

    Vander Wal, Jillon S; Mitchell, Elisha R

    2011-12-01

    Psychological complications associated with pediatric obesity include low self-esteem, depression, body dissatisfaction, loss-of-control eating, unhealthy and extreme weight control behaviors, impaired social relationships, obesity stigma, and decreased health-related quality of life. Bioecological models offer a framework for understanding the interaction between pediatric obesity and psychological complications and illustrate system-level approaches for prevention and intervention. As the medical setting is often the first point of contact for families, pediatricians are instrumental in the identification and referral of children with psychological complications. Motivational interviewing, patient talking points, brief screening measures, and referral resources are important tools in this process. PMID:22093858

  17. Shoulder Injuries in Pediatric Athletes.

    PubMed

    Moyer, James E; Brey, Jennifer M

    2016-10-01

    Shoulder injuries in pediatric athletes are typically caused by acute or overuse injuries. The developing structures of the shoulder lead to injury patterns that are distinct from those of adult athletes. Overuse injuries often affect the physeal structures of the proximal humerus and can lead to pain and loss of sports participation. Shoulder instability is common in pediatric athletes, and recurrence is also a concern in this population. Fractures of the proximal humerus and clavicle are typically treated with conservative management, but there is a trend toward surgical intervention. PMID:27637662

  18. Setting up the Pediatric Endoscopy Unit.

    PubMed

    Lerner, Diana G; Pall, Harpreet

    2016-01-01

    As pediatric gastrointestinal endoscopy continues to develop and evolve, pediatric gastroenterologists are more frequently called on to develop and direct a pediatric endoscopy unit. Lack of published literature and focused training in fellowship can render decision making about design, capacity, operation, equipment purchasing, and staffing challenging. To help guide management decisions, we distributed a short survey to 18 pediatric gastroenterology centers throughout the United States and Canada. This article provides practical guidance by summarizing available expert opinions on the topic of setting up a pediatric endoscopy unit. PMID:26616893

  19. Alternative careers in pediatric dentistry: a survey of pediatric dental residents.

    PubMed

    Chinn, Courtney H; Edelstein, Burton L

    2010-10-01

    Pediatric dentistry has enjoyed growing popularity in recent years, yet there remains a need for leadership in academe, research, and public health. In November 2008, the first Maternal and Child Health Bureau-sponsored regional Leadership in Pediatric Dentistry convocation was held at the Columbia University College of Dental Medicine. Seventy-two pediatric dentistry trainees from thirteen programs in the New York City area participated in interactive presentations and exercises. Of the sixty- seven participants who completed a pre-event survey, 93 percent stated they would likely or very likely pursue careers that involved, at least in part, private practice, 55 percent in care of children in Medicaid, 51 percent academics, 36 percent dental public health, and 12 percent research. Barriers related to finances, competence, or work environment/location were perceived by 83 percent for careers involving research, 73 percent for dental public health, 66 percent for providing care to children in Medicaid, 46 percent for academics, and 9 percent for private practice. Results of a pair of pre-event and post-event surveys completed by sixty-three attendees showed no change in reported likelihood to pursue a career alternative except for an increase in the likelihood of working in a practice that accepts Medicaid. The challenge before dental educators is to provide consistent and meaningful opportunities throughout training that encourage residents to consider all career options and to discover how their individual interests mesh with their clinical learning.

  20. Renal function in pediatric liver transplant patients.

    PubMed

    McDiarmid, S V

    1996-01-01

    Actuarial five-year patient survivals after pediatric orthotopic liver transplantation (OLT) of 75 to 80% are now commonplace. However, renal dysfunction after pediatric OLT remains a serious complication and maybe broadly divided into four categories. The first is pre-existing renal disease in association with liver disease. This includes tyrosinemia with Fanconi syndrome, congenital cystic disease of the liver with associated polycystic disease of the kidney, Alagille's syndrome and primary hyperoxaluria. Second is hepatorenal syndrome. Resolution is dependent on successful OLT, although short-term dialysis may be required. Children with renal failure prior to transplantation have a significantly increased mortality. Third is peri- and early post-transplant renal impairment. The four major influences on early renal function after OLT are: (i) pretransplant renal function; (ii) early liver graft function; (iii) induction therapy with cyclosporine and tacrolimus; (iv) use of other nephrotoxic drugs. Fourth is long-term nephrotoxicity of cyclosporine and tacrolimus (FK-506). Both of these essential immunosuppressives carry the risk of long-term irreversible toxicity. In one study children, treated with cyclosporine, surviving > one year after OLT, 73% had a true GFR < 77 ml/min/1.73 m2. Children treated for > or = 24 months had a significantly lower GFR than those treated from 12 to 24 months. Half the children with a GFR < or = 50 ml/min/1.73 m2 had hypertension. Another study showed that 46% of pediatric OLT patients had a > or = 20% decrease in GFR over two to four years. FK-506 nephrotoxicity is comparable to that of cyclosporine. In a randomized control trial comparing FK-506 and cyclosporine, there was a 52% decrease in GFR over the first year in the FK-506 group, which was not significantly different to that of the cyclosporine group. In 60% of patients converted from cyclosporine to FK-506 one study showed a 50% or more drop in GFR. Both FK-506 and

  1. The use of triptans for pediatric migraines.

    PubMed

    Eiland, Lea S; Hunt, Melissa O

    2010-12-01

    Migraine headaches frequently occur in the pediatric population, with a prevalence of 3% in children 2-7 years of age, 4-11% in children 7-11 years of age, and 8-23% in children 11 years of age and older. Migraine without aura is more than twice as common as migraine with aura in children. Headaches are the third leading cause of emergency room referrals and rank in the top five health problems of children. The 2004 American Academy of Neurology's treatment parameter for migraine in children and adolescents recommended that nasal sumatriptan be considered for acute treatment; however, data were lacking to make a decision regarding the available oral triptans at that time. The more recently released European guidelines discuss three different triptans for use in children but no specific triptan was recommended. Currently, six of the seven available triptans have been studied for efficacy and safety in the pediatric population; however, only a few well controlled clinical studies have been conducted. Sumatriptan has the most available data on outcomes in general, with nasal sumatriptan showing the most positive results. Nasal sumatriptan is approved in children older than 12 years of age in Europe. Oral sumatriptan does not show any clinical benefit versus placebo in children. Rizatriptan and zolmitriptan have conflicting efficacy and safety data, with most studies favoring the use of oral rizatriptan and nasal zolmitriptan. Almotriptan is the first triptan to obtain a US FDA indication in adolescents with migraines lasting 4 or more hours. This approval was based upon two studies, one large clinical trial and one very small, open-label, pilot study. At this time, there are insufficient data to recommend naratriptan and eletriptan for first- or second-line use in pediatric patients with migraines. There are currently no efficacy data for frovatriptan in pediatric patients, which limits its use in this population. Adverse effects of triptans and pharmacokinetic data

  2. LEED I/V determination of the structure of a MoO3 monolayer on Au(111): Testing the performance of the CMA-ES evolutionary strategy algorithm, differential evolution, a genetic algorithm and tensor LEED based structural optimization

    NASA Astrophysics Data System (ADS)

    Primorac, E.; Kuhlenbeck, H.; Freund, H.-J.

    2016-07-01

    The structure of a thin MoO3 layer on Au(111) with a c(4 × 2) superstructure was studied with LEED I/V analysis. As proposed previously (Quek et al., Surf. Sci. 577 (2005) L71), the atomic structure of the layer is similar to that of a MoO3 single layer as found in regular α-MoO3. The layer on Au(111) has a glide plane parallel to the short unit vector of the c(4 × 2) unit cell and the molybdenum atoms are bridge-bonded to two surface gold atoms with the structure of the gold surface being slightly distorted. The structural refinement of the structure was performed with the CMA-ES evolutionary strategy algorithm which could reach a Pendry R-factor of ∼ 0.044. In the second part the performance of CMA-ES is compared with that of the differential evolution method, a genetic algorithm and the Powell optimization algorithm employing I/V curves calculated with tensor LEED.

  3. Demand in pediatric dentistry for sedation and general anesthesia by dentist anesthesiologists: a survey of directors of dentist anesthesiologist and pediatric dentistry residencies.

    PubMed

    Hicks, C Gray; Jones, James E; Saxen, Mark A; Maupome, Gerardo; Sanders, Brian J; Walker, Laquia A; Weddell, James A; Tomlin, Angela

    2012-01-01

    This study describes what training programs in pediatric dentistry and dental anesthesiology are doing to meet future needs for deep sedation/general anesthesia services required for pediatric dentistry. Residency directors from 10 dental anesthesiology training programs in North America and 79 directors from pediatric dentistry training programs in North America were asked to answer an 18-item and 22-item online survey, respectively, through an online survey tool. The response rate for the 10 anesthesiology training program directors was 9 of 10 or 90%. The response rate for the 79 pediatric dentistry training program directors was 46 of 79 or 58%. Thirty-seven percent of pediatric dentistry programs use clinic-based deep sedation/general anesthesia for dental treatment in addition to hospital-based deep sedation/general anesthesia. Eighty-eight percent of those programs use dentist anesthesiologists for administration of deep sedation/general anesthesia in a clinic-based setting. Pediatric dentistry residency directors perceive a future change in the need for deep sedation/general anesthesia services provided by dentist anesthesiologists to pediatric dentists: 64% anticipate an increase in need for dentist anesthesiologist services, while 36% anticipate no change. Dental anesthesiology directors compared to 2, 5, and 10 years ago have seen an increase in the requests for dentist anesthesiologist services by pediatric dentists reported by 56% of respondents (past 2 years), 63% of respondents (past 5 years), and 88% of respondents (past 10 years), respectively. Predicting the future need of dentist anesthesiologists is an uncertain task, but these results show pediatric dentistry directors and dental anesthesiology directors are considering the need, and they recognize a trend of increased need for dentist anesthesiologist services over the past decade.

  4. Taking in a Show.

    PubMed

    Boden, Timothy W

    2016-01-01

    Many medical practices have cut back on education and staff development expenses, especially those costs associated with conventions and conferences. But there are hard-to-value returns on your investment in these live events--beyond the obvious benefits of acquired knowledge and skills. Major vendors still exhibit their services and wares at many events, and the exhibit hall is a treasure-house of information and resources for the savvy physician or administrator. Make and stick to a purposeful plan to exploit the trade show. You can compare products, gain new insights and ideas, and even negotiate better deals with representatives anxious to realize returns on their exhibition investments. PMID:27249887

  5. Taking in a Show.

    PubMed

    Boden, Timothy W

    2016-01-01

    Many medical practices have cut back on education and staff development expenses, especially those costs associated with conventions and conferences. But there are hard-to-value returns on your investment in these live events--beyond the obvious benefits of acquired knowledge and skills. Major vendors still exhibit their services and wares at many events, and the exhibit hall is a treasure-house of information and resources for the savvy physician or administrator. Make and stick to a purposeful plan to exploit the trade show. You can compare products, gain new insights and ideas, and even negotiate better deals with representatives anxious to realize returns on their exhibition investments.

  6. A need for phenotyping pediatric asthma in epidemiologic studies.

    PubMed

    Zejda, J

    2014-05-01

    Epidemiological studies on pediatric asthma reveal a substantial variation in the prevalence of the disease. Differing population-specific data on the occurrence of the disease, defined as a physician-diagnosed asthma, are attributed to differences in risk factors, nosologic preferences, availability of diagnostic facilities, socio-economic factors, etc. As a result some findings could be affected by so-called underdiagnosis although in some populations overdiagnosis of pediatric asthma cannot be excluded. Diagnosing pediatric asthma can be difficult even in clinical setting. Among factors hampering that process heterogeneity of the disease plays an important role. Evidence show that asthma is not a single disease but it is a complex syndrome composed of similarly manifested disorders. As a result a significant scientific effort is directed to describe phenotypes of pediatric asthma. Two well known approaches to phenotyping include clinical and etiological assessment. The former approach takes into account the clinical presentation. The latter one involves recognition of the circumstances that precede the symptom manifestation in the disease: 'virus-induced asthma', 'exercise-induced asthma', 'allergen-induced asthma', 'unresolved asthma'. The mentioned approaches do not provide means of complete classification of the disease. A relatively novel and promising research area in the field of phenotyping asthma takes advantage of biomonitoring. Biomarkers of allergy and immunological responses are used in clinical setting (for example: assessment of atopy, eosinophils count, FENO), however many tests need more validation. Of particular interest is availability of non-invasive biomarkers, their repeatability, sensitivity and specificity. Several national and international guidelines and recommendations point to the importance of specific studies addressing the role of biomonitoring in phenotyping asthma. Еpidemiological perspective investigations into biomarkers in

  7. Obesity in show dogs.

    PubMed

    Corbee, R J

    2013-10-01

    Obesity is an important disease with a growing incidence. Because obesity is related to several other diseases, and decreases life span, it is important to identify the population at risk. Several risk factors for obesity have been described in the literature. A higher incidence of obesity in certain breeds is often suggested. The aim of this study was to determine whether obesity occurs more often in certain breeds. The second aim was to relate the increased prevalence of obesity in certain breeds to the official standards of that breed. To this end, we investigated 1379 dogs of 128 different breeds by determining their body condition score (BCS). Overall, 18.6% of the show dogs had a BCS >5, and 1.1% of the show dogs had a BCS>7. There were significant differences between breeds, which could be correlated to the breed standards. It warrants firm discussions with breeders and judges in order to come to different interpretations of the standards to prevent overweight conditions from being the standard of beauty. PMID:22882163

  8. Year in Review 2015: Pediatric ARDS.

    PubMed

    Cheifetz, Ira M

    2016-07-01

    Led by the work of the Pediatric Acute Lung Injury Consensus Conference, much was published on the topic of pediatric ARDS in 2015. Although the availability of definitive data to the pediatric practitioner for the management of infants and children with pediatric ARDS continues to lag behind that for the adult clinician, 2015 augmented the available medical literature with more information than had been seen for years. This article will review key pediatric ARDS publications with a focus on the Pediatric Acute Lung Injury Consensus Conference consensus definition, sedation management, use of high-frequency oscillatory ventilation, diagnosis of delirium, noninvasive respiratory support, lung-protective ventilation, and adjunct management therapies. Despite the recent progress, additional investigation in each of these areas is essential to the continued advancement of our knowledge and, more importantly, improvements in the outcome for pediatric patients with ARDS. PMID:27381701

  9. Not a "reality" show.

    PubMed

    Wrong, Terence; Baumgart, Erica

    2013-01-01

    The authors of the preceding articles raise legitimate questions about patient and staff rights and the unintended consequences of allowing ABC News to film inside teaching hospitals. We explain why we regard their fears as baseless and not supported by what we heard from individuals portrayed in the filming, our decade-long experience making medical documentaries, and the full un-aired context of the scenes shown in the broadcast. The authors don't and can't know what conversations we had, what documents we reviewed, and what protections we put in place in each televised scene. Finally, we hope to correct several misleading examples cited by the authors as well as their offhand mischaracterization of our program as a "reality" show. PMID:23631336

  10. Not a "reality" show.

    PubMed

    Wrong, Terence; Baumgart, Erica

    2013-01-01

    The authors of the preceding articles raise legitimate questions about patient and staff rights and the unintended consequences of allowing ABC News to film inside teaching hospitals. We explain why we regard their fears as baseless and not supported by what we heard from individuals portrayed in the filming, our decade-long experience making medical documentaries, and the full un-aired context of the scenes shown in the broadcast. The authors don't and can't know what conversations we had, what documents we reviewed, and what protections we put in place in each televised scene. Finally, we hope to correct several misleading examples cited by the authors as well as their offhand mischaracterization of our program as a "reality" show.

  11. The Utility of Chromosomal Microarray Analysis in Developmental and Behavioral Pediatrics

    ERIC Educational Resources Information Center

    Beaudet, Arthur L.

    2013-01-01

    Chromosomal microarray analysis (CMA) has emerged as a powerful new tool to identify genomic abnormalities associated with a wide range of developmental disabilities including congenital malformations, cognitive impairment, and behavioral abnormalities. CMA includes array comparative genomic hybridization (CGH) and single nucleotide polymorphism…

  12. Pediatric sexology and hermaphroditism.

    PubMed

    Money, J

    1985-01-01

    Lacking an empirically based theory of erotosexual development and health in childhood, pediatrics too easily falls back on reductionistic hypotheses of the nature versus nurture type. A new, three-term paradigm, namely, nature/critical-period/nurture, is needed to explain, for example, the phenomenology of hermaphroditism, and the differentiation of gender-identity/role (G-I/R) in individual cases. In 30 young women with a history of the early-treated, 46,XX congenital virilizing adrenal hyperplasia (CVAH) syndrome, 37% (N = 11) had a history of bisexual imagery or practice, as compared with 7% in the control patients (chi 2 = 17.7; p less than .001); and 5 of these 11 rated themselves as exclusively or predominantly lesbian. In Kinsey's sample, 15% of females reported homoerotic imagery by age 20, and 2 out of 3 of them also had homoerotic partner contact. The CVAH finding may be a function of prenatal and/or neonatal brain androgenization, but other variables, such as the history of juvenile erotosexual rehearsal play, cannot be ruled out. Among adolescents with a history of hermaphroditism, sex-reassignment applications are honored predominantly if they are made by 46,XY hermaphrodites assigned neonatally as girls and with nonfeminizing hormonal puberty, as medical and folk traditions both favor approval of such applicants more than others. Parthenogenic whiptail lizards that alternately simulate the male and female mating behavior of related diecious species provide an animal model that demonstrates the existence of both male and female sexual schemas in the same brain. In human beings, the irreducible sex differences are that males impregnate, and females menstruate, gestate, and lactate. Otherwise, sexual dimorphism that is programmed into the brain under the influence of prenatal hormones appears to be not sex-irreducible, but sex-shared and threshold-dimorphic. A complete theory of the differentiation of all the constituents of masculinity or femininity of

  13. Assessing Competence in Pediatric Cardiology

    ERIC Educational Resources Information Center

    Johnson, Apul E.; And Others

    1976-01-01

    In response to the need to assure physician competence, a rating scale was developed at the University of Minnesota Medical School for use in evaluating clinical competence in pediatric cardiology. It was tested on first- and second-year specialists. Development and testing procedures are described. (JT)

  14. Promoting innovation in pediatric nutrition.

    PubMed

    Bier, Dennis M

    2010-01-01

    Truly impactful innovation can only be recognized in retrospect. Moreover, almost by definition, developing algorithmic paths on roadmaps for innovation are likely to be unsuccessful because innovators do not generally follow established routes. Nonetheless, environments can be established within Departments of Pediatrics that promote innovating thinking. The environmental factors necessary to do so include: (1) demand that academic Pediatrics Departments function in an aggressively scholarly mode; (2) capture the most fundamental science in postnatal developmental biology; (3) focus education and training on the boundaries of our knowledge, rather than the almost exclusive attention to what we think we already know; (4) devote mentoring, time and resources to only the most compelling unanswered questions in the pediatric sciences, including nutrition; (5) accept only systematic, evidence-based answers to clinical questions; (6) if systematic, evidence-based data are not available, design the proper studies to get them; (7) prize questioning the answers to further move beyond the knowledge limit; (8) support the principle that experiments in children will be required to convincingly answer clinical questions important to children, and (9) establish the multicenter resources in pediatric scientist training, clinical study design and implementation, and laboratory and instrument technologies required to answer today's questions with tomorrow's methods.

  15. Advances in pediatrics. Volume 31

    SciTech Connect

    Barness, L.A.

    1984-01-01

    This book discusses the advances made in pediatrics. The topics discussed are--Molecular biology of thalassemia; genetic mapping of humans; technology of recombinant-DNA; DNA-sequencing and human chromosomes and etiology of hereditary diseases; acne; and T-cell abnormalities.

  16. Pulse oximetry in pediatric practice.

    PubMed

    Fouzas, Sotirios; Priftis, Kostas N; Anthracopoulos, Michael B

    2011-10-01

    The introduction of pulse oximetry in clinical practice has allowed for simple, noninvasive, and reasonably accurate estimation of arterial oxygen saturation. Pulse oximetry is routinely used in the emergency department, the pediatric ward, and in pediatric intensive and perioperative care. However, clinically relevant principles and inherent limitations of the method are not always well understood by health care professionals caring for children. The calculation of the percentage of arterial oxyhemoglobin is based on the distinct characteristics of light absorption in the red and infrared spectra by oxygenated versus deoxygenated hemoglobin and takes advantage of the variation in light absorption caused by the pulsatility of arterial blood. Computation of oxygen saturation is achieved with the use of calibration algorithms. Safe use of pulse oximetry requires knowledge of its limitations, which include motion artifacts, poor perfusion at the site of measurement, irregular rhythms, ambient light or electromagnetic interference, skin pigmentation, nail polish, calibration assumptions, probe positioning, time lag in detecting hypoxic events, venous pulsation, intravenous dyes, and presence of abnormal hemoglobin molecules. In this review we describe the physiologic principles and limitations of pulse oximetry, discuss normal values, and highlight its importance in common pediatric diseases, in which the principle mechanism of hypoxemia is ventilation/perfusion mismatch (eg, asthma exacerbation, acute bronchiolitis, pneumonia) versus hypoventilation (eg, laryngotracheitis, vocal cord dysfunction, foreign-body aspiration in the larynx or trachea). Additional technologic advancements in pulse oximetry and its incorporation into evidence-based clinical algorithms will improve the efficiency of the method in daily pediatric practice. PMID:21930554

  17. Family Functioning in Pediatric Trichotillomania

    ERIC Educational Resources Information Center

    Moore, Phoebe S.; Franklin, Martin E.; Keuthen, Nancy J.; Flessner, Christopher A.; Woods, Douglas W.; Piacentini, John A.; Stein, Dan J.; Loew, Benjamin

    2009-01-01

    Little is known about how pediatric trichotillomania (TTM), a clinically significant and functionally impairing disorder, is impacted by, and impacts, family functioning. We explored dimensions of family functioning and parental attitudes in a sample of children and adolescents who participated in an Internet-based survey and satisfied…

  18. Pediatric isolated bilateral iliac aneurysm.

    PubMed

    Chithra, R; Sundar, R Ajai; Velladuraichi, B; Sritharan, N; Amalorpavanathan, J; Vidyasagaran, T

    2013-07-01

    Aneurysms are rare in children. Isolated iliac artery aneurysms are very rare, especially bilateral aneurysms. Pediatric aneurysms are usually secondary to connective tissue disorders, arteritis, or mycotic causes. We present a case of a 3-year-old child with bilateral idiopathic common iliac aneurysms that were successfully repaired with autogenous vein grafts.

  19. Precision Medicine for Pediatric Cancer.

    PubMed

    2015-11-01

    In a recent study, whole-exome and transcriptome sequencing identified potentially actionable findings that led to effective treatments for some children with advanced and rare cancers. The findings demonstrate that genomic sequencing data can be effectively integrated into the clinical management of pediatric patients.

  20. Standards for Pediatric Immunization Practices.

    ERIC Educational Resources Information Center

    Centers for Disease Control (DHHS/PHS), Atlanta, GA.

    This booklet outlines 18 national standards for pediatric immunizations. The standards were developed by a 35-member working group drawn from 24 different public and private sector organizations and from numerous state and local health departments and approved by the U.S. Public Health Service. The first three standards state that: immunization…

  1. Current concepts in pediatric endocrinology

    SciTech Connect

    Styne, D.M.; Brook, C.G.D.

    1987-01-01

    This book contains seven chapters. They are: Recombinant DNA Technology; The HLA System in Congenital Adrenal Hyperplasia; Neuroendocrinology; Circadian Rhythms; Basic Aspects and Pediatric Implications; New Treatment Methods in Diabetes Mellitus; The Insulin-Like Growth Factors; and Hypopituitarism: Review of Behavioral Data.

  2. Public medical shows.

    PubMed

    Walusinski, Olivier

    2014-01-01

    In the second half of the 19th century, Jean-Martin Charcot (1825-1893) became famous for the quality of his teaching and his innovative neurological discoveries, bringing many French and foreign students to Paris. A hunger for recognition, together with progressive and anticlerical ideals, led Charcot to invite writers, journalists, and politicians to his lessons, during which he presented the results of his work on hysteria. These events became public performances, for which physicians and patients were transformed into actors. Major newspapers ran accounts of these consultations, more like theatrical shows in some respects. The resultant enthusiasm prompted other physicians in Paris and throughout France to try and imitate them. We will compare the form and substance of Charcot's lessons with those given by Jules-Bernard Luys (1828-1897), Victor Dumontpallier (1826-1899), Ambroise-Auguste Liébault (1823-1904), Hippolyte Bernheim (1840-1919), Joseph Grasset (1849-1918), and Albert Pitres (1848-1928). We will also note their impact on contemporary cinema and theatre. PMID:25273491

  3. The Great Cometary Show

    NASA Astrophysics Data System (ADS)

    2007-01-01

    its high spatial and spectral resolution, it was possible to zoom into the very heart of this very massive star. In this innermost region, the observations are dominated by the extremely dense stellar wind that totally obscures the underlying central star. The AMBER observations show that this dense stellar wind is not spherically symmetric, but exhibits a clearly elongated structure. Overall, the AMBER observations confirm that the extremely high mass loss of Eta Carinae's massive central star is non-spherical and much stronger along the poles than in the equatorial plane. This is in agreement with theoretical models that predict such an enhanced polar mass-loss in the case of rapidly rotating stars. ESO PR Photo 06c/07 ESO PR Photo 06c/07 RS Ophiuchi in Outburst Several papers from this special feature focus on the later stages in a star's life. One looks at the binary system Gamma 2 Velorum, which contains the closest example of a star known as a Wolf-Rayet. A single AMBER observation allowed the astronomers to separate the spectra of the two components, offering new insights in the modeling of Wolf-Rayet stars, but made it also possible to measure the separation between the two stars. This led to a new determination of the distance of the system, showing that previous estimates were incorrect. The observations also revealed information on the region where the winds from the two stars collide. The famous binary system RS Ophiuchi, an example of a recurrent nova, was observed just 5 days after it was discovered to be in outburst on 12 February 2006, an event that has been expected for 21 years. AMBER was able to detect the extension of the expanding nova emission. These observations show a complex geometry and kinematics, far from the simple interpretation of a spherical fireball in extension. AMBER has detected a high velocity jet probably perpendicular to the orbital plane of the binary system, and allowed a precise and careful study of the wind and the shockwave

  4. Psychopharmacology in pediatric critical care.

    PubMed

    Stoddard, Frederick J; Usher, Craigan T; Abrams, Annah N

    2006-07-01

    Psychopharmacologic treatment in pediatric critical care requires a careful child or adolescent psychiatric evaluation, including a thorough review of the history of present illness or injury, any current or pre-existing psychiatric disorder, past history, and laboratory studies. Although there is limited evidence to guide psychopharmacologic practice in this setting, psychopharmacologic treatment is increasing in critical care, with known indications for treatment, benefits, and risks; initial dosing guidelines; and best practices. Treatment is guided by the knowledge bases in pediatric physiology, psycho-pharmacology, and treatment of critically ill adults. Pharmacologic considerations include pharmacokinetic and pharmcodynamic aspects of specific drugs and drug classes, in particular elimination half-life, developmental considerations, drug interactions, and adverse effects. Evaluation and management of pain is a key initial step, as pain may mimic psychiatric symptoms and its effective treatment can ameliorate them. Patient comfort and safety are primary objectives for children who are acutely ill and who will survive and for those who will not. Judicious use of psychopharmacolgic agents in pediatric critical care using the limited but growing evidence base and a clinical best practices collaborative approach can reduce anxiety,sadness, disorientation, and agitation; improve analgesia; and save lives of children who are suicidal or delirious. In addition to pain, other disorders or indications for psychopharmacologic treatment are affective disorders;PTSD; post-suicide attempt patients; disruptive behavior disorders (especially ADHD); and adjustment, developmental, and substance use disorders. Treating children who are critically ill with psychotropic drugs is an integral component of comprehensive pediatric critical care in relieving pain and delirium; reducing inattention or agitation or aggressive behavior;relieving acute stress, anxiety, or depression; and

  5. Pediatric hospitalists and medical education.

    PubMed

    Ottolini, Mary C

    2014-07-01

    Pediatric hospital medicine (PHM) is moving toward becoming an American Board of Pediatrics (ABP) subspecialty, roughly a decade after its formal inception in 2003. Education has played a central role as the field has evolved. Hospitalists are needed to educate trainees, medical students, residents, fellows, and nurse practitioner and physician assistant students in inpatient pediatric practice. Continuous professional development is needed for hospitalists currently in practice to augment clinical skills, such as providing sedation and placing peripherally inserted central catheter lines, and nonclinical skills in areas such as quality improvement methodology, hospital administration, and health service research. To address the educational needs of the current and future state of PHM, additional training is now needed beyond residency training. Fellowship training will be essential to continue to advance the field of PHM as well as to petition the ABP for specialty accreditation. Training in using adult educational theory, curriculum, and assessment design are critical for pediatric hospitalists choosing to advance their careers as clinician-educators. Several venues are available for gaining advanced knowledge and skill as an educator. PHM clinician-educators are advancing the field of pediatric education as well as their own academic careers by virtue of the scholarly approach they have taken to designing and implementing curricula for unique PHM teaching situations. PHM educators are changing the educational paradigm to address challenges to traditional education strategies posed by duty hour restrictions and the increasing drive to shorten the duration of the hospitalization. By embracing learning with technology, such as simulation and e-learning with mobile devices, PHM educators can address these challenges as well as respond to learning preferences of millennial learners. The future for PHM education is bright. PMID:24977677

  6. Stretched View Showing 'Victoria'

    NASA Technical Reports Server (NTRS)

    2006-01-01

    [figure removed for brevity, see original site] Stretched View Showing 'Victoria'

    This pair of images from the panoramic camera on NASA's Mars Exploration Rover Opportunity served as initial confirmation that the two-year-old rover is within sight of 'Victoria Crater,' which it has been approaching for more than a year. Engineers on the rover team were unsure whether Opportunity would make it as far as Victoria, but scientists hoped for the chance to study such a large crater with their roving geologist. Victoria Crater is 800 meters (nearly half a mile) in diameter, about six times wider than 'Endurance Crater,' where Opportunity spent several months in 2004 examining rock layers affected by ancient water.

    When scientists using orbital data calculated that they should be able to detect Victoria's rim in rover images, they scrutinized frames taken in the direction of the crater by the panoramic camera. To positively characterize the subtle horizon profile of the crater and some of the features leading up to it, researchers created a vertically-stretched image (top) from a mosaic of regular frames from the panoramic camera (bottom), taken on Opportunity's 804th Martian day (April 29, 2006).

    The stretched image makes mild nearby dunes look like more threatening peaks, but that is only a result of the exaggerated vertical dimension. This vertical stretch technique was first applied to Viking Lander 2 panoramas by Philip Stooke, of the University of Western Ontario, Canada, to help locate the lander with respect to orbiter images. Vertically stretching the image allows features to be more readily identified by the Mars Exploration Rover science team.

    The bright white dot near the horizon to the right of center (barely visible without labeling or zoom-in) is thought to be a light-toned outcrop on the far wall of the crater, suggesting that the rover can see over the low rim of Victoria. In figure 1, the northeast and southeast rims are labeled

  7. Computer Face Scale for Measuring Pediatric Pain and Mood

    PubMed Central

    Gulur, Padma; Rodi, Scott W.; Washington, Tabitha A.; Cravero, Joseph P.; Fanciullo, Gilbert J.; McHugo, Gregory J.; Baird, John C.

    2009-01-01

    This investigation determined the psychometric properties and acceptability of an animated face scale presented on a hand-held computer as a means to measure pediatric pain and mood. In Study 1, seventy nine hospitalized, pediatric patients indicated their levels of pain by adjusting the expression of an animated cartoon face. The first objective was to determine feasibility, concurrent validity, and acceptability of the method. All patients were tested both with the Computer Face Scale and the poster format of the Wong-Baker Faces Scale. A second objective was to evaluate test-retest reliability of the method. In Study 2, fifty hospitalized, pediatric patients were tested on two occasions, but in this case the patients used the Computer Face Scale to indicate both their pain (how much they hurt) and their mood (how they felt). Children in Study 1 were able to use the Computer Face Scale to express relative amounts of pain/hurt; the method showed concurrent validity with the Wong-Baker Face Scale; and most children expressed a preference for the Computer Face Scale. The method also showed adequate test-retest reliability. In Study 2 adequate test-retest reliability was demonstrated for ratings of both pain and mood. Perspective The Computer Face Scale allows the health provider to obtain reliable and valid measures of pediatric pain and mood. The method can be understood and used by children as young as three years, and is also appropriate for use with adults. PMID:19010740

  8. A right-to-left shunt and prothrombotic disorders in pediatric patients presenting with transient ischemic attack.

    PubMed

    Perkovič-Benedik, Mirjana; Zaletel, Marjan; Pečarič-Meglič, Nuška; Podnar, Tomaž

    2013-02-01

    Arterial ischemic stroke is an important cause of morbidity and mortality in pediatric population. A right-to-left shunt (RLS) across the patent foramen ovale was recently demonstrated as a possible risk factor for pediatric stroke. Prothrombotic disorders are frequently identified in pediatric patients with stroke. Data regarding RLS and prothrombotic disorders in pediatric patients presenting with transient ischemic attack (TIA) are lacking. The aims of the present study were (1) to compare the prevalence and grade of RLS in pediatric patients presenting with TIA vs. controls using contrast transcranial Doppler with Valsalva maneuver and (2) to identify prothrombotic disorders in pediatric patients presenting with TIA. Twenty-three consecutive pediatric patients presenting with TIA were included in the study. Logistic regression analysis showed that RLS was significantly associated with TIA (OR 4.75, 95 % CI 1.39-16.2, p = 0.013). The prevalence of RLS was significantly higher in patients in comparison to controls (p = 0.019). Significantly more microembolic signals (MES) were detected in patients than in controls (p = 0.003). Prothrombotic disorders were identified in 14 of the 23 patients. Both the prevalence of RLS and number of detected MES were significantly higher in pediatric patients presenting with TIA in comparison to controls. Prothrombotic disorders were identified in a high proportion of patients. These findings suggest that paradoxical embolism may be important in pediatric patients presenting with TIA.

  9. Modified functional obturator for the consideration of facial growth in the mucoepidermoid carcinoma pediatric patient.

    PubMed

    Kim, Soung Min; Park, Min Woo; Cho, Young Ah; Myoung, Hoon; Lee, Jong Ho; Lee, Suk Keun

    2015-10-01

    Mucoepidermoid carcinoma (MEC) is a common salivary gland tumor in a adults but is very rare in pediatric patients. The standard treatment of MEC is en bloc resection with wide safety margins and subsequent reconstruction of the jaw, but few surgeons or pediatric specialists have experience with this procedure. An 11-year-old boy received a hemi-maxillectomy with subsequent application of the modified functional obturator (MFO) by the functional matrix concept of Moss. And the patient's face showed normal growth pattern. The purpose of this report is to demonstrate the novel concept of pediatric maxillary reconstruction using MFO for the consideration of facial growth.

  10. Short-Interval Retreatment With Stereotactic Body Radiotherapy (SBRT) for Pediatric Neuroblastoma Resulting in Severe Myositis.

    PubMed

    Taunk, Neil K; Kushner, Brian; Ibanez, Katarzyna; Wolden, Suzanne L

    2016-04-01

    We report a severe and not previously reported toxicity after short-interval retreatment with stereotactic body radiotherapy (SBRT) in a pediatric patient with neuroblastoma. This patient experienced Grade III radiation myositis after treatment with conventional radiation therapy followed by high-dose SBRT for persistent disease a short interval after the initial radiotherapy course. While SBRT shows outstanding rates of local control in adult disease, data in pediatric cancers are extremely limited. In this report, we discuss the rationale of SBRT in this patient's multimodality neuroblastoma treatment, management of the toxicity, and future perspectives on the use of SBRT in pediatric cancer.

  11. [Blood stem cell transplantation in pediatric oncology].

    PubMed

    Mentkevich, G L; Dolgopolov, I S; Popa, A V; Boiarshinov, V K; Ravshanova, R S

    2001-01-01

    Large-dose chemotherapy (LDCT) with auto- and allogenic transplantation of blood stem cells (BSC) in pediatric oncology remains so far the last hope for many patients. The number of such procedures made in Europe increases by 10% every year. At the same time many issues of the place and role of transplantation in pediatric oncology remains unclear. Based on 240 sessions of cytopheresis, the author show that BSC can be sampled from severe pretreated patients despite the drug therapy regimen. The efficacy of G-KSF and GM-KSF used to stimulate BSC secretion is similar. After LDCT with BSC autotransplantation, the relapse-free survival rates in patients with Ewing's sarcoma and acute myeloblast-cell leukemia were 55.4 and 44.4%, respectively (in the first and second remissions). Consolidation as LDCT with BSC autotransplantation without cleansing the material from malignant cells is not a sufficient therapeutical measurement in disseminated neuroblastoma. Whether partial compatible related BSC transplantation can be possible made after non-myeloablative preparation regimens is shown.

  12. Psychosocial treatment of pediatric posttraumatic stress disorder: the neglected field of single-incident trauma.

    PubMed

    Adler-Nevo, Gili; Manassis, Katharina

    2005-01-01

    Despite the prevalence of childhood trauma, studies regarding psychotherapy for children suffering from posttraumatic stress disorder (PTSD) are scarce, especially regarding the treatment for pediatric PTSD following single-incident trauma. Treatment practices for this population rely mainly on the paradigms of therapy for adult PTSD and pediatric PTSD following sexual abuse. This review outlines the studies published in the last 10 years pertaining to the treatment of pediatric PTSD following single-incident trauma. This is done in the context of available literature on the paradigms mentioned above. Of 742 articles dealing with treatment of pediatric trauma, 10 were found relevant to the treatment of pediatric PTSD following single-incident trauma. The modalities of treatment most frequently reported in this context were cognitive-behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR), and play therapy. As a whole, CBT studies were methodologically more rigorous, used manualized, reproducible treatment, and were group, school-based therapies. EMDR treatments were usually short and individual. Most studies showed statistically significant improvement but were still methodologically lacking. We conclude that research on the subject of treatment for pediatric PTSD following single-incident trauma constitutes a neglected part of the study of pediatric PTSD. This stands in contrast to the obvious prevalence of this type of trauma. We encourage future research that will address issues such as clarifying the role of pharmacotherapy, comparing different modes of treatment, dismantling treatment "packages," researching developmentally sensitive treatments, conducting long-term follow-up, and comparing different PTSD populations.

  13. Control of coal combustion SO{sub 2} and NO{sub x} emissions by in-boiler injection of CMA. Final project report, July 1, 1992--December 31, 1994

    SciTech Connect

    Levendis, Y.A.

    1995-04-01

    A study was conducted to determine the efficacy of carboxylic calcium and magnesium salts (e.g., calcium magnesium acetate or CMA, CaMg{sub 2}(CH{sub 2}COOH){sub 6}) for the simultaneous removal of SO{sub 2} and NO{sub x} in oxygen-lean atmospheres. Experiments were performed in a high-temperature furnace that simulated the post-flame environment of a coal-fired boiler by providing similar temperatures and partial pressures of SO{sub 2}, NO{sub x} CO{sub 2} and O{sub 2}. When injected into a hot environment, the salts calcined and formed highly porous {open_quotes}popcorn{close_quotes}-like cenospheres. Residual MgO and/or CaCO{sub 3} and CaO reacted heterogeneously with SO{sub 2} to form MgSO{sub 4} and/or CaCO{sub 4}. The organic components - which can be manufactured from wastes such as sewage sludge - gasified and reduced NO{sub x }to N{sub 2} efficiently if the atmosphere was moderately fuel-rich. Dry-injected CMA particles at a Ca/S ratio of 2, residence time of 1 second and bulk equivalence ratio of 1.3 removed over 90% of SO{sub 2} and NO{sub x} at gas temperatures {>=} 950{degrees}C. When the furnace isothermal zone was {<=} 950{degrees}C, Ca was essentially inert in the furnace quenching zone, while Mg continued to sorb SO{sub 2} as the gas temperature cooled at a rate of -130{degrees}C/sec. Hence, the removal of SO{sub 2} by CMA could continue for nearly the entire residence time of emissions in the exhaust stream of a power plant. Additional research is needed to improve the efficiency and reduce the cost of the relatively expensive carboxylic acid salts as dual SO{sub 2}-NO{sub x} reduction agents. For example, wet injection of the salts could be combined with less expensive hydrocarbons such as lignite or even polymers such as poly(ethylene) that could be extracted from the municipal waste stream.

  14. North American Society for Pediatric Gastroenterology, Hepatology and Nutrition

    MedlinePlus

    North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Skip to Navigation Essential Pediatric GI Review Course ... Fellows Concise Review of Pediatric Gastroenterology, Hepatology and Nutrition (Second Edition) Just released - The NASPGHAN Fellows Concise ...

  15. Cyclic alternating pattern: A window into pediatric sleep.

    PubMed

    Bruni, Oliviero; Novelli, Luana; Miano, Silvia; Parrino, Liborio; Terzano, Mario Giovanni; Ferri, Raffaele

    2010-08-01

    Cyclic alternating pattern (CAP) has now been studied in different age groups of normal infants and children, and it is clear that it shows dramatic changes with age. In this review we first focus on the important age-related changes of CAP from birth to peripubertal age and, subsequently, we describe the numerous studies on CAP in developmental clinical conditions such as pediatric sleep disordered breathing, disorders of arousal (sleep walking and sleep terror), pediatric narcolepsy, learning disabilities with mental retardation (fragile-X syndrome, Down syndrome, autistic spectrum disorder, Prader-Willi syndrome) or without (dyslexia, Asperger syndrome, attention-deficit/hyperactivity disorder). CAP rate is almost always decreased in these conditions with the exception of the disorders of arousal and some cases of sleep apnea. Another constant result is the reduction of A1 subtypes, probably in relationship with the degree of cognitive impairment. The analysis of CAP in pediatric sleep allows a better understanding of the underlying neurophysiological mechanisms of sleep disturbance. CAP can be considered as a window into pediatric sleep, allowing a new vision on how the sleeping brain is influenced by a specific pathology or how sleep protecting mechanisms try to counteract internal or external disturbing events. PMID:20427233

  16. Microscopic examination of grossly unremarkable pediatric dura mater.

    PubMed

    Croft, Philip R; Reichard, R Ross

    2009-03-01

    The histologic characteristics of grossly unremarkable pediatric dura mater obtained at autopsy are not well defined. The microscopic examination of pediatric dura mater is often undertaken to look for evidence of recent, resolving, or remote craniocerebral trauma. Pathologic processes cannot be defined without knowledge of expected histology, however. In this study, we examined grossly unremarkable dura mater from 11 children, utilizing hematoxylin and eosin, iron, CD-34, CD-68, and epithelial membrane antigen stains. Pediatric dura mater is a relatively vascular tissue, particularly on its internal and external surfaces. Several sections contained iron deposits. Almost all of the para-sagittal and many of the lateral dura mater sections contained intradural blood, whereas dura mater attached to bone did not. Intradural blood could arise by several mechanisms, including the act of removing the dura mater from the calvarium during the autopsy. CD-34 staining showed potential as a means to differentiate the internal from the external dural surfaces. Familiarity with the histologic features of pediatric dura mater is crucial for the correct interpretation true dura mater pathology.

  17. Where We Stand—CMA Position Papers: • Abortion • Acupuncture • Chiropractic • Confidentiality • Cost of Care • Drug Abuse • Environmental Health • Health Education for the Public • Health in the United States • Health Quackery • Health Maintenance Organizations and Prepaid Health Plans • Health Manpower • National Health Insurance • Physician's Assistants • Physician Unions • Professional Standards Review Organizations • Quality Medical Care

    PubMed Central

    1973-01-01

    To serve the interests of members and to function in the public interest, the California Medical Association must set policies and take positions on current issues affecting the health care of Californians. These policies then guide the activities of the Association in fulfilling its leadership role and its responsibility to the public. Delegates, elected by the membership of CMA's component medical societies, meet annually to deliberate and determine the policies and courses of action for the Association. Between meetings of these Delegates, the CMA Councilors, elected by their district membership, implement the directives of the Delegates and set interim policies. By this democratic process, the membership governs the CMA. Association members must be informed if they are to participate effectively in the affairs of their medical organizations. To disseminate better understanding of CMA's activities, position papers on current issues have been developed. They are based on House of Delegates resolutions and Council actions. Entitled “Where We Stand on Medical and Health Issues,” these papers represent the current policy positions of CMA. Each paper is annotated to give the reference source of the policy actions. As with any organization, CMA policies are subject to timely revision. When policies are amended or new policies are adopted, new papers will be developed. PMID:4148533

  18. Future of clinical genomics in pediatric oncology.

    PubMed

    Janeway, Katherine A; Place, Andrew E; Kieran, Mark W; Harris, Marian H

    2013-05-20

    The somatic genomic alterations in pediatric cancers to some extent overlap with those seen in adult cancers, but the exact distribution throughout the genome and the types and frequency of alterations differ. The ultimate goal of genomic research in children, as with adults, is translation to the clinic to achieve more accurate diagnosis, more precise risk stratification, and more effective, less toxic therapy. The genomic features of pediatric malignancies and pediatric-specific issues in clinical investigation may make translating genomic discoveries to the clinic more difficult. However, through large-scale molecular profiling of pediatric tumors, continued coordinated efforts to evaluate novel therapies in the pediatric population, thoughtful phase II and III trial design, and continued drug development, genomically based therapies will become more common in the pediatric oncology clinic in the future.

  19. [Risks and dangers in pediatric regional anesthesia].

    PubMed

    Hillmann, R; Kretz, F-J

    2008-02-01

    In recent years peripheral and central regional anesthesia have become increasingly more important in pediatric anesthesia. Unlike adult patients, children typically receive regional anesthesia while under general anesthesia, an approach generally accepted among pediatric anesthesiologists. A well-founded knowledge of the specific anatomical, physiological and pharmacokinetic characteristics of pediatric patients is indispensable for safely practicing pediatric regional anesthesia. If attention is paid to these characteristics, complications are rare. The use of ultrasound when administering regional anesthesia can help reduce the risk of complications even further. Peripheral and central regional anesthesia are safe procedures which pediatric patients should not be deprived of. The present article discusses frequent as well as rare complications of pediatric regional anesthesia.

  20. Pharmacogenetics in clinical pediatrics: challenges and strategies

    PubMed Central

    Van Driest, Sara L; McGregor, Tracy L

    2013-01-01

    The use of genetic information to guide medication decisions holds great promise to improve therapeutic outcomes through increased efficacy and reduced adverse events. As in many areas of medicine, pediatric research and clinical implementation in pharmacogenetics lag behind corresponding adult discovery and clinical applications. In adults, genotype-guided clinical decision support for medications such as clopidogrel, warfarin and simvastatin are in use in some medical centers. However, research conducted in pediatric populations demonstrates that the models and practices developed in adults may be inaccurate in children, and some applications lack any pediatric research to guide clinical decisions. To account for additional factors introduced by developmental considerations in pediatric populations and provide pediatric patients with maximal benefit from genotype-guided therapy, the field will need to develop and employ creative solutions. In this article, we detail some concerns about research and clinical implementation of pharmacogenetics in pediatrics, and present potential mechanisms for addressing them. PMID:24363766

  1. Advances in Pediatric Pharmacology, Therapeutics, and Toxicology

    PubMed Central

    Gonzalez, Daniel; Paul, Ian M.; Benjamin, Daniel K.; Cohen-Wolkowiez, Michael

    2014-01-01

    Significant advancements have been made in pediatric therapeutics and pharmacology over the last two years. In the United States, passage of the Food and Drug Administration Safety and Innovation Act has made the Best Pharmaceuticals for Children Act and Pediatric Research Equity Act permanent, and ensured that studies will be conducted in neonates. In Europe, the Pediatric Regulation, which went into effect in early 2007, has also provided a framework encouraging an expansion of pediatric research. Because of such regulatory involvement, a greater number of studies are being performed, and more pediatric dosing, efficacy, and safety information is being incorporated into product labels. The goal of this publication is to highlight important advancements made in the field of pediatric pharmacology, toxicology, and therapeutics from January 2012 to December 2013. PMID:25037123

  2. A Pediatric Case of Thelaziasis in Korea

    PubMed Central

    Yim, Chung Hyuk; Ko, Jeong Hee; Lee, Jung Hyun; Choi, Yu Mi; Lee, Won Wook; Ahn, Sang Ki; Ahn, Myoung Hee; Choi, Kyong Eun

    2016-01-01

    In the present study, we intended to report a clinical pediatric case of thelaziasis in Korea. In addition, we briefly reviewed the literature on pediatric cases of thelaziasis in Korea. In the present case, 3 whitish, thread-like eye-worms were detected in a 6-year-old-boy living in an urban area and contracted an ocular infection known as thelaziasis incidentally during ecological agritainment. This is the first report of pediatric thelaziasis in Seoul after 1995. PMID:27417087

  3. Pediatric melanoma, moles, and sun safety.

    PubMed

    Hawryluk, Elena B; Liang, Marilyn G

    2014-04-01

    Although pediatric melanoma is a rare disease, diagnosis and management of pigmented lesions in the pediatric population, particularly dysplastic nevi and Spitz nevi, can be challenging. In this article, we provide an overview of pigmented lesions in children, including melanoma and management of melanoma risk factors and melanocytic nevi in the pediatric population. Congenital melanocytic nevi, Spitz nevi, dysplastic and acquired nevi, and changes over time are reviewed. We discuss considerations for excision and management of pigmented lesions in children.

  4. Introduction to pediatric hospital medicine.

    PubMed

    Rauch, Daniel A; Percelay, Jack M; Zipes, David

    2005-08-01

    This article provides a brief summary of the past, present, and future of pediatric hospital medicine. In its short history, it already has made an impact on the way pediatrics is practiced and taught. There is no denying Dr. Menna's prescience when he wrote his opinion in 1990. As the field continues to emerge and mature, the current leadership is cognizant of the obstacles ahead and the need to maintain the goal of the well-being of all children. Maintaining that goal means redoubling efforts to maintain contact with primary care providers for continuity of care in and out of the hospital. Only by promoting patient- and family-centered care, inclusive of all providers, can children's health best be served.

  5. Amenable Treatable Severe Pediatric Epilepsies.

    PubMed

    Pearl, Phillip L

    2016-05-01

    Vitamin-dependent epilepsies and multiple metabolic epilepsies are amenable to treatment that markedly improves the disease course. Knowledge of these amenably treatable severe pediatric epilepsies allows for early identification, testing, and treatment. These disorders present with various phenotypes, including early onset epileptic encephalopathy (refractory neonatal seizures, early myoclonic encephalopathy, and early infantile epileptic encephalopathy), infantile spasms, or mixed generalized seizure types in infancy, childhood, or even adolescence and adulthood. The disorders are presented as vitamin responsive epilepsies such as pyridoxine, pyridoxal-5-phosphate, folinic acid, and biotin; transportopathies like GLUT-1, cerebral folate deficiency, and biotin thiamine responsive disorder; amino and organic acidopathies including serine synthesis defects, creatine synthesis disorders, molybdenum cofactor deficiency, and cobalamin deficiencies; mitochondrial disorders; urea cycle disorders; neurotransmitter defects; and disorders of glucose homeostasis. In each case, targeted intervention directed toward the underlying metabolic pathophysiology affords for the opportunity to significantly effect the outcome and prognosis of an otherwise severe pediatric epilepsy. PMID:27544473

  6. Pediatric brain tumors and epilepsy.

    PubMed

    Wells, Elizabeth M; Gaillard, William D; Packer, Roger J

    2012-03-01

    Seizures are a common complication of pediatric brain tumors and their treatment. This article reviews the epidemiology, evaluation, and treatment of seizures in children with brain tumors. Seizures in known brain tumor patients may signify tumor progression or recurrence, or treatment-related brain damage, as well as other causes, including low drug levels and metabolic disturbances. Careful selection of antiepileptic medications is needed in this population. There are advantages to nonenzyme-inducing antiepileptic drugs including valproic acid, which has potential antitumoral properties as a histone deacetylase inhibitor. Tumor surgery cures many cases of pediatric tumor-associated seizures, and some children are controlled with anti-epileptic medication, however additional epilepsy surgery may be needed for refractory cases.

  7. [Value of simulation in pediatrics].

    PubMed

    Oriot, D; Boureau-Voultoury, A; Ghazali, A; Brèque, C; Scépi, M

    2013-06-01

    The authors present the concepts of simulation and its utilization in pediatrics. Simulation in medicine is a teaching method that has not yet been developed in Europe and has not spread in pediatrics in France. Motivations for simulation are first and foremost ethical: "Never the first time on patients!" Simulation also provides benefits in teaching communication skills and theoretical concepts. It is an essential means to maintain patient safety by limiting the risk of errors. It covers teaching procedures requiring realistic models such as in teaching communication and crisis resource management. Simulation can also be used for teaching disclosure of bad news, using actors. Simulation skills are acquired during debriefing, when the supervisor acts as a facilitator. Evaluation is mandatory in simulation, dependent on the how realistic the models are and on the performance of a procedure or multidisciplinary team management. Performance can be objectively assessed only with validated tools. Simulation will become a mandatory teaching method in medicine.

  8. Gender and Sexuality in Pediatrics.

    PubMed

    Merens, Teri A

    2016-05-01

    The terms gender and sexuality, once rarely discussed in a public forum, are now dominant topics of conversation on social media, in all forms of entertainment, politics, law, and medicine. The pediatric primary care physician, like all people and institutions involved in the delivery of health care, must be diligent about providing compassionate and competent care to patients and families contending with gender issues. The complex variety of obstacles these patients may face require a well-informed, sensitive clinician who can offer sound medical advice and appropriate referral. This article guides pediatricians through some of the challenges related to gender identity so they can assist their patients in navigating through any difficulties. [Pediatr Ann. 2016;45(5):e158-e161.]. PMID:27171801

  9. Physical rehabilitation of pediatric burns

    PubMed Central

    Atiyeh, B.; Janom, H.H.

    2014-01-01

    Summary Significant improvements have been made in the acute treatment of pediatric burn injuries over the past 3 decades which have significantly decreased mortality. Each year, more burned children are necessitating serious medical attention during their convalescence. For children with serious consequences resulting from burns that can persist from childhood through adolescence into adulthood, the value of long-term rehabilitation cannot be over stated. Burn injury management should not focus only on the immediate treatment. Long-term functional outcome and the required rehabilitation that burn victims must go through should be given equal if not more attention. The present is a review of the available modalities utilized for the physical rehabilitation of convalescent pediatric burns in order to overcome the catabolic state, improve muscle power and fitness, reduce disfiguring scars and prevent contractures. PMID:25249846

  10. Beyond the basics: pediatric assessment.

    PubMed

    Krost, William S; Mistovich, Joseph J; Limmer, Daniel D

    2006-05-01

    Some children, regardless of what is done for them, will get sick and die. Fortunately, this is more rare than regular. An EMS provider who appropriately assesses a sick child with a potential to survive will be able to identify life-threatening conditions and manage those conditions. The most common cause of pediatric death is hypoxia. A hypoxic child without proper intervention will ultimately experience cardiovascular collapse and eventually death. Most healthy children have no difficulty in maintaining normal cardiovascular function until and unless they become extremely hypoxic. EMS providers must understand that the most effective management processes require an understanding of why children present in the way they do. If an assessment is not thorough and accurate, a child may continue to deteriorate. Assessment is the key to pediatric management. PMID:16729526

  11. Gender and Sexuality in Pediatrics.

    PubMed

    Merens, Teri A

    2016-05-01

    The terms gender and sexuality, once rarely discussed in a public forum, are now dominant topics of conversation on social media, in all forms of entertainment, politics, law, and medicine. The pediatric primary care physician, like all people and institutions involved in the delivery of health care, must be diligent about providing compassionate and competent care to patients and families contending with gender issues. The complex variety of obstacles these patients may face require a well-informed, sensitive clinician who can offer sound medical advice and appropriate referral. This article guides pediatricians through some of the challenges related to gender identity so they can assist their patients in navigating through any difficulties. [Pediatr Ann. 2016;45(5):e158-e161.].

  12. Pediatric obesity. An introduction ☆

    PubMed Central

    Yanovski, Jack A.

    2015-01-01

    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

  13. Pediatric diseases in Juan Carreño de Miranda's paintings.

    PubMed

    Martínez-Lage, Juan F; Pérez-Espejo, Miguel A; Galarza, Marcelo

    2012-02-01

    Pediatric obesity has become a widespread problem of health in developed countries. Overweight in the pediatric population obeys to a variety of causes. A few of Carreño de Miranda's paintings show pathological conditions occurring in children of his epoch. We briefly illustrate the significance of Carreño's paintings that portray some of these diseases. Two of his best-known works constitute an artistic representation of childhood obesity.

  14. Informed consent in pediatric research.

    PubMed

    Leibson, Tom; Koren, Gideon

    2015-02-01

    Pediatric drug research is gradually becoming more and more accepted as the norm for assessing whether a drug is safe and efficacious for infants and children. The process of informed consent and assent for these trials presents a major challenge. The aim of this review is to map historical, ethical and legal aspects relevant to the challenges of informed consent in the setting of pediatric drug research. The impact of age, level of maturity and life circumstances on the process of obtaining informed consent as well as the relations between consent and assent are discussed. There appears to be a lack of regulatory clarity in the area of pediatric clinical trials; while numerous statements have been made regarding children's rights to autonomy and their ability to care for themselves and for younger ones, the ever changing status of adolescence is still difficult to translate to informed consent. This may delay scientific and clinical advancement for children who are at the very junction of being independent and not needing parental permission. Obtaining consent and assent for pediatric clinical trials is a delicate matter, as both parent and child need to agree to participate. The appropriate transfer of information to guardians and the children, especially concerning potential risks and benefits, is at the heart of informed consent, as it serves to protect both patient and physician. As many adults lack health literacy, one must ensure that guardians receive relevant information at a level and in forms they can understand regarding the trials their children are asked to participate in.

  15. MRI findings in pediatric patients with scurvy.

    PubMed

    Gulko, Edwin; Collins, Lee K; Murphy, Robyn C; Thornhill, Beverly A; Taragin, Benjamin H

    2015-02-01

    In modern times scurvy is a rarely encountered disease caused by ascorbic acid (vitamin C) deficiency. However, sporadic cases of scurvy persist, particularly within the pediatric population. Recent individual case reports highlight an increased incidence of scurvy among patients with autism or developmental delay, with isolated case reports detailing the magnetic resonance imaging (MRI) findings of scurvy in these pediatric populations. We present the MRI findings of scurvy in four patients with autism or developmental delay, and review the literature on MRI findings in pediatric patients with scurvy. Despite its rarity, the radiologist must consider scurvy in a pediatric patient with a restricted diet presenting with arthralgia or myalgia. PMID:25109378

  16. MRI findings in pediatric patients with scurvy.

    PubMed

    Gulko, Edwin; Collins, Lee K; Murphy, Robyn C; Thornhill, Beverly A; Taragin, Benjamin H

    2015-02-01

    In modern times scurvy is a rarely encountered disease caused by ascorbic acid (vitamin C) deficiency. However, sporadic cases of scurvy persist, particularly within the pediatric population. Recent individual case reports highlight an increased incidence of scurvy among patients with autism or developmental delay, with isolated case reports detailing the magnetic resonance imaging (MRI) findings of scurvy in these pediatric populations. We present the MRI findings of scurvy in four patients with autism or developmental delay, and review the literature on MRI findings in pediatric patients with scurvy. Despite its rarity, the radiologist must consider scurvy in a pediatric patient with a restricted diet presenting with arthralgia or myalgia.

  17. Clinical services in environmental pediatrics.

    PubMed

    Paulson, Jerome A; Gordon, Lauren

    2011-01-01

    Pediatric healthcare providers are confronted with environmental health problems frequently: the child with asthma exacerbated by the odor of paint in school or mouse antigen at home, the family who wants to know the risks and benefits of using different types of sunblock, or the community that asks the provider for advice on the potential health impacts of building the new elementary school next to the on-ramp to the interstate highway. Pediatric providers have not been well trained to deal with these questions in medical or nursing schools, residency training, or continuing-education settings. This article provides guidance on history taking, the physical examination, laboratory evaluations of patients and the environment, and making an assessment about and managing environmental health problems. Pediatric Environmental Health Specialty Units are discussed as a source of consultation and referral. The identification and utilization of evidence-based resources are stressed and clinicians are cautioned about non-evidence-based assessments such as clinical ecology and hair analysis and non-evidence-based management strategies such as chelation for autism.

  18. Biomarkers and pediatric environmental health.

    PubMed

    Lubin, B; Lewis, R

    1995-09-01

    It is now possible to identify biochemical and/or cellular changes in humans due to exposure to an environmental toxin. These changes are called biomarkers and are currently used in research studies to identify individuals exposed to specific toxic substances. Advances in the field of biomarker technology may have important implications for the detection, prevention, and treatment of certain diseases in children. This technology may enable physicians to screen children who have no clinically detectable illness for evidence of exposure to specific toxins. Such information could lead to implementation of preventive measures and development of new therapeutic strategies. However, several important issues, including potential adverse consequences resulting from the widespread use of this technology, must be considered prior to its utilization within a clinical setting. Leaders of the pediatric and public health communities should recognize the paucity of scientific data in the pediatric environmental health area, and new approaches to this important aspect of child health should be developed. This article will address several of the issues involved in pediatric environmental health and consider questions that should be answered as the potential for technology transfer becomes a reality. PMID:8549501

  19. Advances in pediatric esthetic dentistry.

    PubMed

    Cannon, Mark L

    2003-08-01

    The introduction of low-shrinkage composite and no-rinse conditioners has created an opportunity for pediatric dentists to change their standard operative regimen. The low-shrink composite solves many of the problems that have discouraged clinicians from routinely providing posterior composites for their patients. The reduction in polymerization shrinkage decreases problems with contraction stresses, sensitivity, microleakage, recurrent caries, and negative pulpal sequelae. No-rinse conditioners simplify the process and shorten the time required for bonding procedures. Liquid polish reduces the tedious finishing previously required with resin-based composites. The combination of the easier bonding and more user-friendly composite could add a new operative technique to the pediatric dentist's armamentarium. A study of low-shrink, resin-based composite restorations was performed to determine the effectiveness of these new materials for pediatric dental practice. The restorations were placed in primary molars to allow for their retrieval when exfoliated. The preparation and restorative techniques were standardized to match a similar study that used the "open-sandwich" method. The modified US Public Health Service ranking was used to evaluate marginal integrity at 6-month intervals for the 40 restorations placed in primary molars as a pilot study. TESCERA ATL restorations and prostheses were also evaluated for clinical effectiveness.

  20. Transitional care in pediatric urology.

    PubMed

    Lambert, Sarah M

    2015-04-01

    The transition from childhood to adolescence and into adulthood occurs as a natural component of human development. As children progress through school and gain independence, health care practitioners must facilitate a parallel transition from pediatric to adult providers. Modern medicine has succeeded in extending the life expectancy for many children with complex conditions, and adult providers are participating in their medical care through adulthood. Transitioning pediatric urology care to adult urology care is unique to every individual and his or her underlying condition, while the transition process is universal. The objectives of all pediatric urologists include preservation of the kidneys and lower urinary tracts, safe urine storage, safe urine drainage, urinary continence, fertility, sexual function, and genital cosmesis. For some children, these objectives can be attained during childhood, while other children require lifelong maintenance and management. Children with posterior urethral valves, exstrophy-epispadias complex, cloaca, vesicoureteral reflux, neurogenic bladder, disorders of sex development, cancer, hypospadias, nephrolithiasis, undescended testes, varicoceles, ureteropelvic junction obstruction, solitary kidney, and upper tract anomalies all require long-term evaluation and management. The obstacles of altering a patient and caregiver paradigm, locating adult urologists with special expertise, coordinating care with other adult specialties such as nephrology, and navigating the adult health care environment can impede the transition process.

  1. Preventing and managing pediatric obesity

    PubMed Central

    Plourde, Gilles

    2006-01-01

    OBJECTIVE To review the evidence on prevention and management of childhood obesity and to offer suggestions for family physicians. QUALITY OF EVIDENCE Articles were obtained from a PubMed search. Most studies on pediatric obesity provide level II evidence. There are some level I studies on management. MAIN MESSAGE Pediatric obesity is underdiagnosed and undertreated. Prevention should be initiated as early as pregnancy. Prevention and treatment approaches should include patient and family interventions focusing on nutrition, physical activity, reduced television viewing, and behaviour modification. The effectiveness of such interventions by primary care physicians has not been totally demonstrated, but incorporating them into clinical practice routines is likely to be beneficial. CONCLUSION Family physicians have a role in promoting preventive measures and identifying and treating obesity-related comorbidity. Pediatric obesity is not an individual child’s problem, but a problem that involves the whole family and the community. Recommending a healthy diet and increased physical activity and counseling families on behaviour change is the best approach to preventing and managing childhood obesity. PMID:16572577

  2. The Use of Continuous Electrocardiographic Holter Monitoring in Pediatric Cardiology

    PubMed Central

    Begic, Zijo; Begic, Edin; Mesihovic-Dinarevic, Senka; Masic, Izet; Pesto, Senad; Halimic, Mirza; Kadic, Almira; Dobraca, Amra

    2016-01-01

    Objective: To show the place and role of continuous electrocardiographic twenty-four-hour ECG monitoring in daily clinical practice of pediatric cardiologists. Methods: According to protocol, 2753 patients underwent dynamic continuous ECG Holter monitoring (data collected from the “Register of ECG Holter monitoring” of Pediatric Clinic, UCC Sarajevo in period April 2003- April 2015). Results: There were 50,5% boys and 49,5% girls, aged from birth to 19 years (1,63% - neonates and infants, 2,6% - toddlers, 9,95% - preschool children, 35,5% - gradeschoolers and 50,3% children in puberty and adolescence). In 68,1% of patients Holter was performed for the first time. Indications for conducting Holter were: arrhythmias in 42,2% cases, precordial pain in 23,5%, suspicion of pre-excitation and/or pre-excitation in 10%, crisis of consciousness in 8%, uncorrected congenital/acquired heart defects in 4,2%, operated heart defects in 3,7%, hypertension in 3,1% cases, control of the pacemaker in 1,63% and other causes in 3,5% cases. Discharge diagnosis after ECG Holter monitoring were: insignificant arrhythmias in 47,1% cases, wandering pacemaker in 21,3%, pre-excitation in 16,2%, benign ventricular premature beats in 6,3%, atrioventricular block in 3%, sinus pause in 2.2% cases and other arrhythmias in 3,5%. In mentioned period 57 cases of Wolf Parkinson White syndrome were registered, in 4,5% of patients antiarrhythmic therapy was administered. Radiofrequent ablation was performed in 23 cases. Conclusion: The development of pediatric cardiac surgery has initiated development of pediatric arrhythmology as imperative segment of pediatric cardiology. Continuous ECG Holter monitoring has become irreplaceable method in everyday diagnostics and therapy of arrhythmias in children. PMID:27708487

  3. Inflammatory cytokines in pediatric obstructive sleep apnea

    PubMed Central

    Huang, Yu-Shu; Guilleminault, Christian; Hwang, Fang-Ming; Cheng, Chuan; Lin, Cheng-Hui; Li, Hsueh-Yu; Lee, Li-Ang

    2016-01-01

    Abstract Pediatric obstructive sleep apnea (OSA) is associated with chronic systemic inflammation and with cognitive impairments. This study aimed to investigate the status of proinflammatory cytokines, particularly interleukin 17 (IL-17) and interleukin 23 (IL-23) and cognition in pediatric OSA. Controls and OSA children participated in the study. Exclusion criteria were adenotonsillectomy, heart, neurological and severe psychiatric diseases, craniofacial syndromes, and obesity. Polysomnogram was followed by serum testing for inflammatory markers and neurocognitive tests such as continuous performance task (CPT) and Wisconsin card sorting test, questionnaires, analyses of plasma high-sensitivity C-reactive protein (HS-CRP), tumor necrosis factor alpha (TNF-α), interleukin 1 (IL-1), interleukin 6 (IL-6), IL-17, and IL-23. Seventy-nine, 4 to 12-year-old subjects in 2 groups ended the study: 47 nonobese OSA children (mean age = 7.84 ± 0.56 years, body mass index [BMI] = 16.95 ± 0.47 kg/m2, BMI z-score = 0.15 ± 0.21, and mean apnea–hypopnea index [AHI] = 9.13 ± 1.67 events/h) and 32 healthy control children (mean age = 7.02 ± 0.65 years, with BMI = 16.55 ± 0.58 kg/m2, BMI z-score = −0.12 ± 0.27, and mean AHI = 0.41 ± 0.07 event/h) were enrolled. Serum cytokine analyses showed significantly higher levels of HS-CRP, IL-17, and IL-23 in OSA children (P = 0.002, P = 0.024, and P = 0.047). Regression test showed significant influence of HS-CRP, TNF-α, IL-6, IL-17, and specifically IL-23, with the continuous performance test and Wisconsin card sorting test. OSA children have abnormal levels of IL-17, an interleukin related to T helper 17 cells, a T helper cell involved in development of autoimmunity and inflammation. This high expression level may contribute to the complications of pediatric OSA; we also found a significant influence of inflammatory cytokines, particularly IL-23, on abnormal neurocognitive testing. PMID

  4. Theory and Practice of Pediatric Bioethics.

    PubMed

    Ross, Lainie Friedman

    2016-01-01

    This article examines two typical bioethics frameworks: the "Four Principles" by Beauchamp and Childress, and the "Four Boxes" by Jonsen, Siegler, and Winslade. I show how they are inadequate to address the ethical issues raised by pediatrics, in part because they do not pay adequate attention to families. I then consider an alternate framework proposed by Buchanan and Brock that focuses on four questions that must be addressed for the patient who lacks decisional capacity. This model also does not give adequate respect for the family, particularly the intimate family. I then describe my own framework, which provides answers to Buchanan and Brock's four questions in a way that is consistent with the intimate family and its need for protection from state intervention. PMID:27157344

  5. Theory and Practice of Pediatric Bioethics.

    PubMed

    Ross, Lainie Friedman

    2016-01-01

    This article examines two typical bioethics frameworks: the "Four Principles" by Beauchamp and Childress, and the "Four Boxes" by Jonsen, Siegler, and Winslade. I show how they are inadequate to address the ethical issues raised by pediatrics, in part because they do not pay adequate attention to families. I then consider an alternate framework proposed by Buchanan and Brock that focuses on four questions that must be addressed for the patient who lacks decisional capacity. This model also does not give adequate respect for the family, particularly the intimate family. I then describe my own framework, which provides answers to Buchanan and Brock's four questions in a way that is consistent with the intimate family and its need for protection from state intervention.

  6. Concussion evaluation and management in pediatrics.

    PubMed

    Rivera, Robin G; Roberson, Susan P; Whelan, Margaret; Rohan, Annie

    2015-01-01

    Concussions are among the most complex injuries to assess and manage in sports medicine and primary care. Sports concussion in youth has received much attention in recent years because research shows that improperly managed concussion can lead to long-term cognitive deficits and mental health problems. There are several notable risk factors affecting the incidence and severity of concussion in school-age children and adolescents, including a history of a previous concussion. A more conservative approach for return to activities following concussion has been proposed for children and adolescents. Programs of individualized, stepwise increases in physical activity have largely replaced use of algorithms for assigning a grade and activity expectations to concussions. Although validity and reliability testing is ongoing to support use of concussion assessment instruments in pediatric patients, it is practical and appropriate that clinicians incorporate symptom checklists, sideline and balance assessment tools, and neurocognitive assessment instruments into their practice in accordance with evidence-based guidelines.

  7. Attitudes toward Physician-Nurse Collaboration in Pediatric Workers and Undergraduate Medical/Nursing Students.

    PubMed

    Wang, Yong; Liu, Yong-fang; Li, Hao; Li, Tingyu

    2015-01-01

    The purpose of this study was to compare the attitudes of pediatric workers and undergraduate medical/nursing students toward collaboration. Attitude toward collaboration was measured using an adaptation of the Jefferson Scale of Attitude toward Physician-Nurse Collaboration. The 656 questionnaires were gathered from pediatrician, pediatric interns, and medical students (PIS) and pediatric nurses, nursing interns, and nursing students (NIS). Results showed a statistically significant difference in the total mean scores in attitudes towards collaboration with NIS scoring higher. Among the participants of PIS, the pediatricians obtained the highest mean scores, while, among the participants of NIS, the pediatric nurses got higher mean scores than nursing interns. It is desirable that medical and nurse schools should include interprofessional education in their curriculum to increase the understanding of the complementary roles of physicians and nurses and to encourage establishment of an interdependent relationship between them. PMID:26273131

  8. Genome-wide network analysis of Wnt signaling in three pediatric cancers

    NASA Astrophysics Data System (ADS)

    Bao, Ju; Lee, Ho-Jin; Zheng, Jie J.

    2013-10-01

    Genomic structural alteration is common in pediatric cancers, and analysis of data generated by the Pediatric Cancer Genome Project reveals such tumor-related alterations in many Wnt signaling-associated genes. Most pediatric cancers are thought to arise within developing tissues that undergo substantial expansion during early organ formation, growth and maturation, and Wnt signaling plays an important role in this development. We examined three pediatric tumors--medullobastoma, early T-cell precursor acute lymphoblastic leukemia, and retinoblastoma--that show multiple genomic structural variations within Wnt signaling pathways. We mathematically modeled this pathway to investigate the effects of cancer-related structural variations on Wnt signaling. Surprisingly, we found that an outcome measure of canonical Wnt signaling was consistently similar in matched cancer cells and normal cells, even in the context of different cancers, different mutations, and different Wnt-related genes. Our results suggest that the cancer cells maintain a normal level of Wnt signaling by developing multiple mutations.

  9. Screening and Identification in Pediatric Primary Care

    ERIC Educational Resources Information Center

    Simonian, Susan J.

    2006-01-01

    This article reviews issues related to behavioral screening in pediatric primary care settings. Structural-organizational issues affecting the use of pediatric primary care screening are discussed. This study also reviewed selected screening instruments that have utility for use in the primary care setting. Clinical and research issues related to…

  10. Pandemic Influenza Pediatric Office Plan Template

    SciTech Connect

    HCTT CHE

    2010-01-01

    This is a planning tool developed by pediatric stakeholders that is intended to assist pediatric medical offices that have no pandemic influenza plan in place, but may experience an increase in patient calls/visits or workload due to pandemic influenza.

  11. Nursing 436A: Pediatric Oncology for Nurses.

    ERIC Educational Resources Information Center

    Jackman, Cynthia L.

    A description is provided of "Pediatric Oncology for Nurses," the first in a series of three courses offered to fourth-year nursing students in pediatric oncology. The first section provides a course overview, discusses time assignments, and describes the target student population. Next, a glossary of terms, and lists of course goals, long-range…

  12. Audiovisual Instruction in Pediatric Pharmacy Practice.

    ERIC Educational Resources Information Center

    Mutchie, Kelly D.; And Others

    1981-01-01

    A pharmacy practice program added to the core baccalaureate curriculum at the University of Utah College of Pharmacy which includes a practice in pediatrics is described. An audiovisual program in pediatric diseases and drug therapy was developed. This program allows the presentation of more material without reducing clerkship time. (Author/MLW)

  13. Four Cases of Pediatric Photokeratitis Present to the Emergency Department After Watching the Same Theater Show

    PubMed Central

    Mangan, Mehmet Serhat; Arıcı, Ceyhun; Atalay, Eray; Tanyıldız, Burak; Oruçoğlu, Faik

    2015-01-01

    We report four consecutive cases of photokeratitis that presented to the emergency department, interestingly after having watched the same theatre performance in the same school. The patients’ ages (3 male, 1 female) ranged from 9 to 13 years. All patients presented with similar complaints consisting of pain, tearing, foreign body sensation, photophobia and blurred vision in both eyes. Patients reported watching a theatre performance in the same school approximately 4 hours before symptom onset. On slit-lamp examination, conjunctival injection and corneal punctate epithelial erosions were observed in the interpalpebral zone in both eyes. On fundus examination, no pathology was observed in the vitreous, posterior pole or peripheral retina. All cases were treated with topical antibiotics and lubricant eye drops. Corneas were clear two days later in the control visit. In this case report, exposure to ultraviolet light from high-power lamps used in the theatre was proposed as a possible cause of corneal epithelial cell damage and subsequent photokeratitis. PMID:27800238

  14. Pediatric Cancer Recognition Training in Botswana.

    PubMed

    Slone, Jeremy S; Ishigami, Elise; Mehta, Parth S

    2016-01-01

    Delayed presentation of children with cancer is a significant barrier to improving the survival from children's cancer in low- and middle-income countries (LMICs). Botswana, a country of approximately 2 million people in southern Africa, has only 1 pediatric cancer treatment program, based at Princess Marina Hospital (PMH) in the capital of Gaborone. A pediatric cancer recognition training program was developed that reached 50% of the government hospitals in Botswana teaching 362 health care workers how to recognize and refer children with cancer to PMH. Through evaluation of attendees, limitations in pediatric cancer training and general knowledge of pediatric cancer were identified. Attendees demonstrated improvement in their understanding of pediatric cancer and the referral process to PMH following the workshop. PMID:27336006

  15. PEDSnet: a National Pediatric Learning Health System.

    PubMed

    Forrest, Christopher B; Margolis, Peter A; Bailey, L Charles; Marsolo, Keith; Del Beccaro, Mark A; Finkelstein, Jonathan A; Milov, David E; Vieland, Veronica J; Wolf, Bryan A; Yu, Feliciano B; Kahn, Michael G

    2014-01-01

    A learning health system (LHS) integrates research done in routine care settings, structured data capture during every encounter, and quality improvement processes to rapidly implement advances in new knowledge, all with active and meaningful patient participation. While disease-specific pediatric LHSs have shown tremendous impact on improved clinical outcomes, a national digital architecture to rapidly implement LHSs across multiple pediatric conditions does not exist. PEDSnet is a clinical data research network that provides the infrastructure to support a national pediatric LHS. A consortium consisting of PEDSnet, which includes eight academic medical centers, two existing disease-specific pediatric networks, and two national data partners form the initial partners in the National Pediatric Learning Health System (NPLHS). PEDSnet is implementing a flexible dual data architecture that incorporates two widely used data models and national terminology standards to support multi-institutional data integration, cohort discovery, and advanced analytics that enable rapid learning.

  16. PEDSnet: a National Pediatric Learning Health System

    PubMed Central

    Forrest, Christopher B; Margolis, Peter A; Bailey, L Charles; Marsolo, Keith; Del Beccaro, Mark A; Finkelstein, Jonathan A; Milov, David E; Vieland, Veronica J; Wolf, Bryan A; Yu, Feliciano B; Kahn, Michael G

    2014-01-01

    A learning health system (LHS) integrates research done in routine care settings, structured data capture during every encounter, and quality improvement processes to rapidly implement advances in new knowledge, all with active and meaningful patient participation. While disease-specific pediatric LHSs have shown tremendous impact on improved clinical outcomes, a national digital architecture to rapidly implement LHSs across multiple pediatric conditions does not exist. PEDSnet is a clinical data research network that provides the infrastructure to support a national pediatric LHS. A consortium consisting of PEDSnet, which includes eight academic medical centers, two existing disease-specific pediatric networks, and two national data partners form the initial partners in the National Pediatric Learning Health System (NPLHS). PEDSnet is implementing a flexible dual data architecture that incorporates two widely used data models and national terminology standards to support multi-institutional data integration, cohort discovery, and advanced analytics that enable rapid learning. PMID:24821737

  17. Peripheral doses from pediatric IMRT

    SciTech Connect

    Klein, Eric E.; Maserang, Beth; Wood, Roy; Mansur, David

    2006-07-15

    Peripheral dose (PD) data exist for conventional fields ({>=}10 cm) and intensity-modulated radiotherapy (IMRT) delivery to standard adult-sized phantoms. Pediatric peripheral dose reports are limited to conventional therapy and are model based. Our goal was to ascertain whether data acquired from full phantom studies and/or pediatric models, with IMRT treatment times, could predict Organ at Risk (OAR) dose for pediatric IMRT. As monitor units (MUs) are greater for IMRT, it is expected IMRT PD will be higher; potentially compounded by decreased patient size (absorption). Baseline slab phantom peripheral dose measurements were conducted for very small field sizes (from 2 to 10 cm). Data were collected at distances ranging from 5 to 72 cm away from the field edges. Collimation was either with the collimating jaws or the multileaf collimator (MLC) oriented either perpendicular or along the peripheral dose measurement plane. For the clinical tests, five patients with intracranial or base of skull lesions were chosen. IMRT and conventional three-dimensional (3D) plans for the same patient/target/dose (180 cGy), were optimized without limitation to the number of fields or wedge use. Six MV, 120-leaf MLC Varian axial beams were used. A phantom mimicking a 3-year-old was configured per Center for Disease Control data. Micro (0.125 cc) and cylindrical (0.6 cc) ionization chambers were appropriated for the thyroid, breast, ovaries, and testes. The PD was recorded by electrometers set to the 10{sup -10} scale. Each system set was uniquely calibrated. For the slab phantom studies, close peripheral points were found to have a higher dose for low energy and larger field size and when MLC was not deployed. For points more distant from the field edge, the PD was higher for high-energy beams. MLC orientation was found to be inconsequential for the small fields tested. The thyroid dose was lower for IMRT delivery than that predicted for conventional (ratio of IMRT/cnventional ranged

  18. Pediatric malaria in Houston, Texas.

    PubMed

    Rivera-Matos, I R; Atkins, J T; Doerr, C A; White, A C

    1997-11-01

    We retrospectively reviewed the medical records of all infants and children (< 18 years of age) with the discharge diagnosis of malaria who were admitted to the four major pediatric teaching hospitals in Houston, Texas from January 1988 through December 1993. Thirty-four cases of pediatric malaria were identified in three newborns, 22 travelers, and nine recent immigrants. The travel destination was West Africa in 68%, Central America in 14%, India in 14%, and unknown in 4%. The location of the child's and parents' birthplace was available in 77% of the travel-related cases and in all cases the destination of travel was the parents' country of origin. The peak incident of the travel-related cases was late summer and early January corresponding to return from summer or Christmas vacation. Sixteen (75%) of the 22 travel-related cases had received either no prophylaxis (12 of 22) or inadequate (4 of 22) chemoprophylaxis. Half of the patients who were given appropriate chemoprophylaxis admitted to poor compliance. The clinical presentation was usually nonspecific. Fever was the most common symptom (97%) and was paroxysmal in one-third. Splenomegaly was the most common physical finding (68%). The malaria species identified included Plasmodium falciparum (56%), P. vivax (23%), P. malariae (3%), and unidentified (18%). Moderate anemia (hemoglobin level = 7.0-10 g/dL) occurred in 38% and severe anemia (hemoglobin level < 7.0 g/dL) in 29%. Three patients required transfusion. There were no end-organ complications. In summary, pediatric malaria in Houston was primarily seen in immigrants or children of immigrants who returned to their native country. Education and preventive strategies should target these families and should be part of the routine well child care of these children.

  19. Pediatric palliative care and pediatric medical ethics: opportunities and challenges.

    PubMed

    Feudtner, Chris; Nathanson, Pamela G

    2014-02-01

    The fields of pediatric palliative care (PPC) and pediatric medical ethics (PME) overlap substantially, owing to a variety of historical, cultural, and social factors. This entwined relationship provides opportunities for leveraging the strong communication skills of both sets of providers, as well as the potential for resource sharing and research collaboration. At the same time, the personal and professional relationships between PPC and PME present challenges, including potential conflict with colleagues, perceived or actual bias toward a palliative care perspective in resolving ethical problems, potential delay or underuse of PME services, and a potential undervaluing of the medical expertise required for PPC consultation. We recommend that these challenges be managed by: (1) clearly defining and communicating clinical roles of PPC and PME staff, (2) developing questions that may prompt PPC and PME teams to request consultation from the other service, (3) developing explicit recusal criteria for PPC providers who also provide PME consultation, (4) ensuring that PPC and PME services remain organizationally distinct, and (5) developing well-defined and broad scopes of practice. Overall, the rich relationship between PPC and PME offers substantial opportunities to better serve patients and families facing difficult decisions.

  20. [Home parenteral nutrition, question mark in pediatrics].

    PubMed

    Gómez Alvarez, María E; Alaguero Calero, M; Durán Román, C; Olabarri Blanco, A; García Riaño, L; Solís Sánchez, G; Bousoño García, C

    2005-01-01

    Home parenteral nutrition (HPN) is a necessary but under-used therapy in Spain as compared to other European countries. This problem has been studied at the 1st Discussion Forum of the Spanish Society for Parenteral and Enteral Nutrition. One of its recommendations has been "to design studies in order to analyze the problems detected in HPN practice". Our study attempts to assess pediatric professionals knowledge and opinion about this concern, because children are important recipients of this therapy. A multidisciplinary team prepared a questionnaire to be distributed among 136 health professionals (70 physicians and 66 nurses) working in 4 public hospitals (H) and 8 Primary Health Care Centers (PHC) from Asturias and Salamanca (Spain). Answers show that few professionals have appropriated theoretical and practical knowledge about HPN. Most of them have received neither academic training education nor information over the last year on this matter. The ability to solve patient and caregiver doubts in daily management (handling, storage, compatibility and nutrition stability, parenteral infusion equipment problems, etc) is only 10% in PHC and 50% in H. Only 6 physicians (4.4%) from H group know about the existence of NADYA expert group despite its website and handbooks providing a wide information about HPN. The advantage of HPN to improve life quality, its economic efficacy and the need of cooperation to this respect between H and PHC are matters with a high level of agreement. An important number of pediatric professionals does not have enough knowledge about HPN in PHC. The awareness of HPN must be promoted among clinical services dealing with patients able to benefit from this therapy. All available resources must be used to improved this issue. Specific protocols developed by multidisciplinary teams would promote H and PHC collaboration to help patients, who are the aim of our activity.

  1. Timely topics in pediatric psychiatry.

    PubMed

    Dineen Wagner, Karen

    2014-11-01

    This section of Focus on Childhood and Adolescent Mental Health presents findings on an array of topics including inflammation and child and adolescent depression, glutamatergic dysregulation and pediatric psychiatric disorders, predictors of bipolar disorder in children with attention-deficit/hyperactivity disorder (ADHD), and the continuum between obsessive-compulsive personality disorder (OCPD) and obsessive-compulsive disorder (OCD). There is increased interest in the role of inflammation in psychiatric disorders. Kim and colleagues conducted a systematic literature review to examine the relationships between inflammatory processes, inflammation, medical conditions, and depression and suicidality in children and adolescents. PMID:25470084

  2. Psychiatric pharmacogenomics in pediatric psychopharmacology.

    PubMed

    Wall, Christopher A; Croarkin, Paul E; Swintak, Cosima; Koplin, Brett A

    2012-10-01

    This article provides an overview of where psychiatric pharmacogenomic testing stands as an emerging clinical tool in modern psychotropic prescribing practice, specifically in the pediatric population. This practical discussion is organized around the state of psychiatric pharmacogenomics research when choosing psychopharmacologic interventions in the most commonly encountered mental illnesses in youth. As with the rest of the topics on psychopharmacology for children and adolescents in this publication, a clinical vignette is presented, this one highlighting a clinical case of a 16 year old genotyped during hospitalization for recalcitrant depression.

  3. Pediatric genetic disorders of lens.

    PubMed

    Nihalani, Bharti R

    2014-12-01

    Pediatric genetic disorders of lens include various cataractous and non-cataractous anomalies. The purpose of this review is to help determine the genetic cause based on the lens appearance, ocular and systemic associations. Children with bilateral cataracts require a comprehensive history, ophthalmic and systemic examination to guide further genetic evaluation. With advancements in genetics, it is possible to determine the genetic mutations and assess phenotype genotype correlation in different lens disorders. The genetic diagnosis helps the families to better understand the disorder and develop realistic expectations as to the course of their child's disorder. PMID:27625879

  4. Pediatric genetic disorders of lens

    PubMed Central

    Nihalani, Bharti R.

    2014-01-01

    Pediatric genetic disorders of lens include various cataractous and non-cataractous anomalies. The purpose of this review is to help determine the genetic cause based on the lens appearance, ocular and systemic associations. Children with bilateral cataracts require a comprehensive history, ophthalmic and systemic examination to guide further genetic evaluation. With advancements in genetics, it is possible to determine the genetic mutations and assess phenotype genotype correlation in different lens disorders. The genetic diagnosis helps the families to better understand the disorder and develop realistic expectations as to the course of their child's disorder.

  5. Pediatric surgical pathology. Second edition

    SciTech Connect

    Dehner, L.P.

    1987-01-01

    The edition provides view of congenital, hereditary, infectious, and inflammatory neoplastic diseases occurring during the first two decades of life, with special reference to clinical, laboratory, and roentgenographic features. Material includes observations from some of the major national studies on Wilms' tumor and rhabdomyosarcomas, the new classification of pediatric malignant lymphomas, a discussion of the role of immunocytochemistry as it applies to the diagnosis of childhood infections and neoplasms, an examination of graft-versus-host disease in the liver and intestinal tract and more.

  6. [Laser treatments in pediatric dermatology].

    PubMed

    Lévy, J L; Almebayadh, M; Christen-Zaech, S

    2014-04-01

    Lasers in pediatric dermatology were developed as a result of the treatment of port-wine stains. Infantile hemangiomas may benefit, in some cases, from laser treatment as well as venous and lymphatic malformations. For certain pigmented lesions, as well as some hamartomas, laser treatments are a credible alternative to surgical resection. Bum scars are improved by lasers which stimulate collagen remodeling. Furthermore, hair removal of congenital and acquired hypertrichosis can relieve psychosocial discomfort and improve quality of life. The management of pain and fear of children undergoing laser treatment, using either topical or general anesthesia, remains of central importance. PMID:24772810

  7. Radiosurgery for Pediatric Brain Tumors.

    PubMed

    Murphy, Erin S; Chao, Samuel T; Angelov, Lilyana; Vogelbaum, Michael A; Barnett, Gene; Jung, Edward; Recinos, Violette R; Mohammadi, Alireza; Suh, John H

    2016-03-01

    The utility of radiosurgery for pediatric brain tumors is not well known. For children, radiosurgery may have an important role for treating unresectable tumors, residual disease, or tumors in the recurrent setting that have received prior radiotherapy. The available evidence demonstrates utility for some children with primary brain tumors resulting in good local control. Radiosurgery can be considered for limited residual disease or focal recurrences. However, the potential toxicities are unique and not insignificant. Therefore, prospective studies need to be performed to develop guidelines for indications and treatment for children and reduce toxicity in this population. PMID:26536284

  8. 21 CFR 880.5140 - Pediatric hospital bed.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Pediatric hospital bed. 880.5140 Section 880.5140... Devices § 880.5140 Pediatric hospital bed. (a) Identification. A pediatric hospital bed is a device intended for medical purposes that consists of a bed or crib designed for the use of a pediatric...

  9. 21 CFR 880.5140 - Pediatric hospital bed.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Pediatric hospital bed. 880.5140 Section 880.5140... Devices § 880.5140 Pediatric hospital bed. (a) Identification. A pediatric hospital bed is a device intended for medical purposes that consists of a bed or crib designed for the use of a pediatric...

  10. 78 FR 12763 - Pediatric Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-25

    ... HUMAN SERVICES Food and Drug Administration Pediatric Advisory Committee; Notice of Meeting AGENCY: Food... of Committee: Pediatric Advisory Committee. General Function of the Committee: To provide advice and... Thursday, March 14, 2013, the Pediatric Advisory Committee will meet to discuss pediatric-focused...

  11. 21 CFR 880.5140 - Pediatric hospital bed.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Pediatric hospital bed. 880.5140 Section 880.5140... Devices § 880.5140 Pediatric hospital bed. (a) Identification. A pediatric hospital bed is a device intended for medical purposes that consists of a bed or crib designed for the use of a pediatric...

  12. 76 FR 21382 - Pediatric Ethics Subcommittee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-15

    ... HUMAN SERVICES Food and Drug Administration Pediatric Ethics Subcommittee; Notice of Meeting AGENCY... public. Name of Committee: Pediatric Ethics Subcommittee of the Pediatric Advisory Committee. General... public comments to be submitted to the Agency on the issues before the Pediatric Ethics...

  13. The School Psychologist in a Department of Pediatrics.

    ERIC Educational Resources Information Center

    Pfeiffer, Steven I.

    The field of pediatric psychology is a relatively new and emerging specialty, with medical center departments of pediatrics increasingly employing child-oriented psychologists. Since there are no doctoral programs in pediatric psychology, school psychologists with specialized internship training in pediatric psychology are well qualified for these…

  14. Contributions of pediatrics and pediatric pathology to the body of knowledge regarding human disease.

    PubMed

    Nezelof, Christian; Seemayer, Thomas A; Bridge, Julia A

    2010-03-01

    A century or so ago, pediatrics and pediatric pathology did not exist. Then, many fetuses/newborns died in utero or shortly after birth. With time, the issue of sepsis was addressed, and a greater number of newborns survived. Gradually, in this soil, the disciplines of pediatrics and pediatric nursing arose, as some recognized that infants were not merely small adults but were, in fact, quite different. Years later, pediatric pathology developed as a field of exploration. Today, pediatric pathology is a specialty, as witnessed by training programs, societies devoted to research and education, an expanding number of textbooks and innovative research. Pediatric pathology is distinct from adult pathology, as seen by the diversity of malformations and metabolic diseases stemming from mutations, the immaturity of the newborn's immune system, and the types of neoplasms germane to infants and children. Much of the progress in these areas was facilitated by the simultaneous emergence of cytogenetics and molecular biology and their powerful tools of investigation. The latter were applied in a synergistic fashion to a major extent in maternity clinics and children's hospitals by, among others, molecular biologists, clinical geneticists, cytogeneticists, pediatricians, and pediatric pathologists. This article describes a select but small number of the many contributions of pediatrics and pediatric pathology to the current body of medical knowledge.

  15. Clinical applications of retrograde autologous priming in cardiopulmonary bypass in pediatric cardiac surgery

    PubMed Central

    Fu, G.W.; Nie, Y.F.; Jiao, Z.Y.; Zhao, W.Z.

    2016-01-01

    Retrograde autologous priming (RAP) has been routinely applied in cardiac pediatric cardiopulmonary bypass (CPB). However, this technique is performed in pediatric patients weighing more than 20 kg, and research about its application in pediatric patients weighing less than 20 kg is still scarce. This study explored the clinical application of RAP in CPB in pediatric patients undergoing cardiac surgery. Sixty pediatric patients scheduled for cardiac surgery were randomly divided into control and experimental groups. The experimental group was treated with CPB using RAP, while the control group was treated with conventional CPB (priming with suspended red blood cells, plasma and albumin). The hematocrit (Hct) and lactate (Lac) levels at different perioperative time-points, mechanical ventilation time, hospitalization duration, and intraoperative and postoperative blood usage were recorded. Results showed that Hct levels at 15 min after CPB beginning (T2) and at CPB end (T3), and number of intraoperative blood transfusions were significantly lower in the experimental group (P<0.05). There were no significant differences in CPB time, aortic blocking time, T2-Lac value or T3-Lac between the two groups (P>0.05). Postoperatively, there were no significant differences in Hct (2 h after surgery), mechanical ventilation time, intensive care unit time, or postoperative blood transfusion between two groups (P>0.05). RAP can effectively reduce the hemodilution when using less or not using any banked blood, while meeting the intraoperative perfusion conditions, and decreasing the perioperative blood transfusion volume in pediatric patients. PMID:27119427

  16. Clinical applications of retrograde autologous priming in cardiopulmonary bypass in pediatric cardiac surgery.

    PubMed

    Fu, G W; Nie, Y F; Jiao, Z Y; Zhao, W Z

    2016-01-01

    Retrograde autologous priming (RAP) has been routinely applied in cardiac pediatric cardiopulmonary bypass (CPB). However, this technique is performed in pediatric patients weighing more than 20 kg, and research about its application in pediatric patients weighing less than 20 kg is still scarce. This study explored the clinical application of RAP in CPB in pediatric patients undergoing cardiac surgery. Sixty pediatric patients scheduled for cardiac surgery were randomly divided into control and experimental groups. The experimental group was treated with CPB using RAP, while the control group was treated with conventional CPB (priming with suspended red blood cells, plasma and albumin). The hematocrit (Hct) and lactate (Lac) levels at different perioperative time-points, mechanical ventilation time, hospitalization duration, and intraoperative and postoperative blood usage were recorded. Results showed that Hct levels at 15 min after CPB beginning (T2) and at CPB end (T3), and number of intraoperative blood transfusions were significantly lower in the experimental group (P<0.05). There were no significant differences in CPB time, aortic blocking time, T2-Lac value or T3-Lac between the two groups (P>0.05). Postoperatively, there were no significant differences in Hct (2 h after surgery), mechanical ventilation time, intensive care unit time, or postoperative blood transfusion between two groups (P>0.05). RAP can effectively reduce the hemodilution when using less or not using any banked blood, while meeting the intraoperative perfusion conditions, and decreasing the perioperative blood transfusion volume in pediatric patients. PMID:27119427

  17. Pediatric Cardiology in India: Onset of a New Era.

    PubMed

    Kumar, Dinesh; Bagri, Narendra

    2015-07-01

    Pediatric cardiology is outgrowing from the shadows of adult cardiology and cardiac surgery departments in India. It promises to be an attractive and sought-after subspeciality of Pediatrics, dealing with not only congenital cardiac diseases but also metabolic, rheumatic and host of other cardiac diseases. The new government policy shall provide more training avenues for the budding pediatric cardiologists, pediatric cardiac surgeons, pediatric anesthetists, pediatric cardiac intensivists, neonatologists and a host of supportive workforce. The proactive role of Indian Academy of Pediatrics and Pediatric Cardiac Society of India, towards creating a political will at the highest level for framing policies towards building infrastructure, training of workforce and subsidies for pediatric cardiac surgeries and procedures shall fuel the development of multiple tertiary cardiac centers in the country, making pediatric cardiology services accessible to the needy population.

  18. Pediatric patient with Bombay blood group: A rare case report.

    PubMed

    Bhar Kundu, Sudeshna; De, Anisha; Saha, Anindita; Bhattacharyya, Chiranjib

    2015-01-01

    Bombay blood group is a rare blood group in which there is the absence of H antigen and presence of anti-H antibodies. At the time of blood grouping, this blood group mimics O blood group due to the absence of H antigen, but it shows incompatibility with O group blood during cross matching. Serum grouping or reverse grouping are essential for confirmation of the diagnosis. Patients carrying this blood group can receive blood only from a person with this blood group. Reported cases of anesthesia in the pediatric patient with Bombay blood group are relatively rare. Here, we present successful anesthetic management along with intraoperative blood transfusion in a pediatric patient with Bombay blood group posted for ovarian cystectomy.

  19. Pediatric patient with Bombay blood group: A rare case report

    PubMed Central

    Bhar (Kundu), Sudeshna; De, Anisha; Saha, Anindita; Bhattacharyya, Chiranjib

    2015-01-01

    Bombay blood group is a rare blood group in which there is the absence of H antigen and presence of anti-H antibodies. At the time of blood grouping, this blood group mimics O blood group due to the absence of H antigen, but it shows incompatibility with O group blood during cross matching. Serum grouping or reverse grouping are essential for confirmation of the diagnosis. Patients carrying this blood group can receive blood only from a person with this blood group. Reported cases of anesthesia in the pediatric patient with Bombay blood group are relatively rare. Here, we present successful anesthetic management along with intraoperative blood transfusion in a pediatric patient with Bombay blood group posted for ovarian cystectomy. PMID:26240554

  20. Challenges in translating vascular tissue engineering to the pediatric clinic.

    PubMed

    Duncan, Daniel R; Breuer, Christopher K

    2011-01-01

    The development of tissue-engineered vascular grafts for use in cardiovascular surgery holds great promise for improving outcomes in pediatric patients with complex congenital cardiac anomalies. Currently used synthetic grafts have a number of shortcomings in this setting but a tissue engineering approach has emerged in the past decade as a way to address these limitations. The first clinical trial of this technology showed that it is safe and effective but the primary mode of graft failure is stenosis. A variety of murine and large animal models have been developed to study and improve tissue engineering approaches with the hope of translating this technology into routine clinical use, but challenges remain. The purpose of this report is to address the clinical problem and review recent advances in vascular tissue engineering for pediatric applications. A deeper understanding of the mechanisms of neovessel formation and stenosis will enable rational design of improved tissue-engineered vascular grafts. PMID:21999145

  1. Recurrent somatic structural variations contribute to tumorigenesis in pediatric osteosarcoma.

    PubMed

    Chen, Xiang; Bahrami, Armita; Pappo, Alberto; Easton, John; Dalton, James; Hedlund, Erin; Ellison, David; Shurtleff, Sheila; Wu, Gang; Wei, Lei; Parker, Matthew; Rusch, Michael; Nagahawatte, Panduka; Wu, Jianrong; Mao, Shenghua; Boggs, Kristy; Mulder, Heather; Yergeau, Donald; Lu, Charles; Ding, Li; Edmonson, Michael; Qu, Chunxu; Wang, Jianmin; Li, Yongjin; Navid, Fariba; Daw, Najat C; Mardis, Elaine R; Wilson, Richard K; Downing, James R; Zhang, Jinghui; Dyer, Michael A

    2014-04-10

    Pediatric osteosarcoma is characterized by multiple somatic chromosomal lesions, including structural variations (SVs) and copy number alterations (CNAs). To define the landscape of somatic mutations in pediatric osteosarcoma, we performed whole-genome sequencing of DNA from 20 osteosarcoma tumor samples and matched normal tissue in a discovery cohort, as well as 14 samples in a validation cohort. Single-nucleotide variations (SNVs) exhibited a pattern of localized hypermutation called kataegis in 50% of the tumors. We identified p53 pathway lesions in all tumors in the discovery cohort, nine of which were translocations in the first intron of the TP53 gene. Beyond TP53, the RB1, ATRX, and DLG2 genes showed recurrent somatic alterations in 29%-53% of the tumors. These data highlight the power of whole-genome sequencing for identifying recurrent somatic alterations in cancer genomes that may be missed using other methods. PMID:24703847

  2. Pediatric patient with Bombay blood group: A rare case report.

    PubMed

    Bhar Kundu, Sudeshna; De, Anisha; Saha, Anindita; Bhattacharyya, Chiranjib

    2015-01-01

    Bombay blood group is a rare blood group in which there is the absence of H antigen and presence of anti-H antibodies. At the time of blood grouping, this blood group mimics O blood group due to the absence of H antigen, but it shows incompatibility with O group blood during cross matching. Serum grouping or reverse grouping are essential for confirmation of the diagnosis. Patients carrying this blood group can receive blood only from a person with this blood group. Reported cases of anesthesia in the pediatric patient with Bombay blood group are relatively rare. Here, we present successful anesthetic management along with intraoperative blood transfusion in a pediatric patient with Bombay blood group posted for ovarian cystectomy. PMID:26240554

  3. Pediatric obesity epidemic: treatment options.

    PubMed

    Kirk, Shelley; Scott, Barbara J; Daniels, Stephen R

    2005-05-01

    The increasing prevalence of overweight youth in the United States and the associated increase in medical comorbidities has created a growing need for effective weight-management interventions. The recommended treatment for an overweight child to achieve a more healthful weight uses four primary behavioral strategies: (a) reduce energy intake while maintaining optimal nutrient intake to protect growth and development, (b) increase energy expenditure by promoting more physical movement and less sedentary activity, (c) actively engage parents and primary caretakers as agents of change, and (d) facilitate a supportive family environment. Although this approach has the most empirical support, the impact on the pediatric obesity epidemic has been limited, particularly for adolescents with more severe obesity and for African-American, Native-American, and Hispanic children. This has prompted efforts to adapt strategies that have been effective in adult weight management for use in pediatric behavioral intervention programs. These include using motivational interviewing to increase readiness for health behavior changes, modifying the carbohydrate content of children's diets, using culturally appropriate messages and materials, improving cultural competency of health care providers, and using computer-based strategies. Randomized, controlled clinical trials are needed to test the safety and efficacy of these approaches before they can be recommended for clinical practice. Pharmacotherapy and bariatric surgery are more aggressive and historically adult interventions with greater risk that are being considered for severely obese adolescents who have serious obesity-related medical complications and who have failed other more conventional methods. PMID:15867895

  4. Pediatric Sudden Sensorineural Hearing Loss.

    PubMed

    Kizilay, Ahmet; Koca, Çiğdem Firat

    2016-06-01

    Sudden sensorineural hearing loss is defined as sudden unilateral or bilateral sensorineural hearing loss with at least 30 dB decrease in threshold in 3 contiguous test frequencies occurring over 72 hours or less. It is rare among children. The mechanism of the process and prognosis of the disorder remains unclear. The current incidence of sudden sensorineural hearing loss among pediatric population is unknown. The authors carried out a retrospective chart analysis of patients under 15 years of age from 2004 to 2015, who consulted to the Otolaryngology Head and Neck Surgery Department of Inonu University Medical Faculty. Age, sex, number of affected ear and side, audiometric evaluations, medical follow-up, treatment method, duration of treatment recovery, associated complaints; tinnitus and/or vertigo, presence of mumps disease were recorded for each patient. A 4-frequency pure-tone average (500, 1000, 2000, and 4000 Hz) was calculated for each ear. Complete recovery, defined as some hearing level compared with the nonaffected ear, was observed in 3 patients (21.4 %) and there was no partial hearing recovery. The hearing loss of 11 patient remained unchanged after prednisolone treatment. Two of the 11 patients had bilaterally total sensorineural hearing loss and evaluated as appropriate for cochlear implantation. Sex of patient and laterality of hearing loss were not correlated with hearing recovery. Sensorineural hearing loss among pediatrics has been the issue of otolaryngologists. The incidence, etiology, and treatment methods should be more studied.

  5. Pediatric myocardial protection: an overview.

    PubMed

    Allen, B S; Barth, M J; Ilbawi, M N

    2001-01-01

    This article describes the experimental infrastructure and subsequent successful clinical application of a comprehensive bypass and cardioplegic strategy that limits intraoperative injury and improves postoperative outcomes in pediatric patients. The infant heart is at high risk of damage from poor protection because of preoperative hypertrophy, cyanosis, and ischemia. The background factors of vulnerability to damage caused by cyanosis and ischemia are discussed, together with studies of the infrastructure of strategies to use normoxia versus hyperoxia as bypass starts, white blood cell filtration, warm induction and reperfusion with substrate enhancements, multidose blood cardioplegia, and an integrated approach to allow ischemia only when vision is needed in pediatric surgeries. Data on cardioplegic management, including reducing calcium, increasing magnesium, and reducing perfusion pressure are shown, as used during this technique. These principles were applied to a consecutive series of 567 patients at the Heart Institute for Children and University of Illinois hospital over a 2-year period. Included also were 72 patients with hypoplastic left heart over a 4-year period with this myocardial management strategy. Application of these concepts may improve the safety of protection in infant hearts. PMID:11309728

  6. Exercise Rehabilitation in Pediatric Cardiomyopathy

    PubMed Central

    Somarriba, Gabriel; Extein, Jason; Miller, Tracie L.

    2008-01-01

    Children with cardiomyopathy carry significant risk of morbidity and mortality. New research and technology have brought about significant advancements to the diagnosis and clinical management of children with cardiomyopathy. However, currently heart transplantation remains the standard of care for children with symptomatic and progressive cardiomyopathy. Cardiovascular rehabilitation programs have yielded success in improving cardiac function, overall physical activity, and quality of life in adults with congestive heart failure from a variety of conditions. There is encouraging and emerging data on its effects in children with chronic illness and with its proven benefits in other pediatric disorders, the implementation of a program for with cardiomyopathy should be considered. Exercise rehabilitation programs may improve specific endpoints such quality of life, cardiovascular function and fitness, strength, flexibility, and metabolic risk. With the rapid rise in pediatric obesity, children with cardiomyopathy may be at similar risk for developing these modifiable risk factors. However, there are potentially more detrimental effects of inactivity in this population of children. Future research should focus on the physical and social effects of a medically supervised cardiac rehabilitation program with correct determination of the dosage and intensity of exercise for optimal benefits in this special population of children. It is imperative that more detailed recommendations for children with cardiomyopathy be made available with evidence-based research. PMID:18496603

  7. [Cholera in pediatrics].

    PubMed

    Lezama-Basulto, L A; Mota-Hernández, F

    1993-09-01

    Cholerae is a grave and acute bacterial intestine infection which is caused by a bacilo, V. cholerae 01, that produces toxic products. Its clinical symptoms range from abundant liquid diarrhoea combined with vomiting and rapid dehydration. It is highly lethal when right treatment is not applied. There are also cases of cholera where victims do not show any symptoms of it, that is asymptomatic carriers. Any clinical suspicion of cholerae has to be corroborated by epidemiological data and its diagnostic confirmation should be done by isolating the bacteria, V. cholerae. When beginning the treatment, it is not necessary to confirm the diagnostic and this is based on the restitution of the liquids lost through vomiting and facing using any methods that are recommended for any other type of diarrhoea. The antimicrobial treatment is used only for grave cases. This present revision includes recent knowledge about cholerae emphasising on the effective management of cases through an adequate use of right treatment methods and also using the principal prevention measures against dissemination of this disease.

  8. Meeting the Growing Need for Pediatric Rehabilitation Medicine Physicians.

    PubMed

    Houtrow, Amy J; Pruitt, David W

    2016-04-01

    Disability in childhood is on the rise. In light of the national shortage of pediatric rehabilitation medicine physicians to provide care for the growing population of children with disabilities, the field of pediatric rehabilitation medicine should consider allowing pediatric trainees into pediatric rehabilitation medicine fellowships. There are concerns about how best to train these fellows. This commentary discusses the issues and concludes that training opportunities should be developed to allow pediatricians to become pediatric rehabilitation medicine physicians. PMID:26772528

  9. Meeting the Growing Need for Pediatric Rehabilitation Medicine Physicians.

    PubMed

    Houtrow, Amy J; Pruitt, David W

    2016-04-01

    Disability in childhood is on the rise. In light of the national shortage of pediatric rehabilitation medicine physicians to provide care for the growing population of children with disabilities, the field of pediatric rehabilitation medicine should consider allowing pediatric trainees into pediatric rehabilitation medicine fellowships. There are concerns about how best to train these fellows. This commentary discusses the issues and concludes that training opportunities should be developed to allow pediatricians to become pediatric rehabilitation medicine physicians.

  10. Pediatric solid tumor genomics and developmental pliancy

    PubMed Central

    Chen, Xiang; Pappo, Alberto; Dyer, Michael A.

    2014-01-01

    Pediatric solid tumors are remarkably diverse in their cellular origins, developmental timing, and clinical features. Over the last 5 years, there have been significant advances in our understanding of the genetic lesions that contribute to the initiation and progression of pediatric solid tumors. To date, over 1,000 pediatric solid tumors have been analyzed by Next-Generation Sequencing. These genomic data provide the foundation to launch new research efforts to address one of the fundamental questions in cancer biology—why are some cells more susceptible to malignant transformation by particular genetic lesions at discrete developmental stages than others? Because of their developmental, molecular, cellular, and genetic diversity, pediatric solid tumors provide an ideal platform to begin to answer this question. In this review, we highlight the diversity of pediatric solid tumors and provide a new framework for studying the cellular and developmental origins of pediatric cancer. We also introduce a new unifying concept called cellular pliancy as a possible explanation for susceptibility to cancer and the developmental origins of pediatric solid tumors. PMID:25639868

  11. Pediatric allergy and immunology in Israel.

    PubMed

    Geller-Bernstein, Carmi; Etzioni, Amos

    2013-03-01

    After the geographic and sociodemographic settings as well as the health care in Israel are briefly described, the scope of pediatric allergy and immunology in Israel is presented. This includes specific disorders commonly encountered, the environment that induces symptoms, the specialists who treat them, and the common challenges of patients, parents, doctors, and allied health personnel who collaborate to manage the maladies and patient care. Allergies usually affect some overall 15-20% of the pediatric population. The main allergens are inhaled, ingested, or injected (insects stings). Generally, the incidence of the various allergens affecting children in Israel, is similar to other parts of the Western world. Owing to the high consanguinity rate in the Israeli population, the prevalence of the various immunodeficiency conditions (in the adaptive as well as the innate system) is higher than that reported worldwide. Pediatric allergists/immunologists also treat autoimmune disorders affecting the pediatric group. Pediatric allergy and clinical immunology are not separate specialties. The 25 specialists who treat children with allergic/immunologic diseases have undergone a basic training in Pediatrics. They also received an additional 2-yr training in allergy and clinical immunology and then have to pass the board examinations. They work mainly in pediatric allergy units, in several hospitals that are affiliated to the five medical schools in the country. Aside from clinical work, most of the centers are also heavily involved in clinical and basic research in allergy and immunology.

  12. Pediatric multiple sclerosis: Clinical features and outcome.

    PubMed

    Waldman, Amy; Ness, Jayne; Pohl, Daniela; Simone, Isabella Laura; Anlar, Banu; Amato, Maria Pia; Ghezzi, Angelo

    2016-08-30

    Multiple sclerosis (MS) in children manifests with a relapsing-remitting MS (RRMS) disease course. Acute relapses consist of new neurologic deficits persisting greater than 24 hours, in the absence of intercurrent illness, and occur with a higher frequency early in the disease as compared to adult-onset RRMS. Most pediatric patients with MS recover well from these early relapses, and cumulative physical disability is rare in the first 10 years of disease. Brainstem attacks, poor recovery from a single attack, and a higher frequency of attacks portend a greater likelihood of future disability. Although prospective pediatric-onset MS cohorts have been established in recent years, there remains very limited prospective data detailing the longer-term clinical outcome of pediatric-onset MS into adulthood. Whether the advent of MS therapies, and the largely off-label access to such therapies in pediatric MS, has improved prognosis is unknown. MS onset during the key formative academic years, concurrent with active cognitive maturation, is an important determinant of long-term outcome, and is discussed in detail in another article in this supplement. Finally, increasing recognition of pediatric MS worldwide, recent launch of phase III trials for new agents in the pediatric MS population, and the clear imperative to more fully appreciate health-related quality of life in pediatric MS through adulthood highlight the need for standardized, validated, and robust outcome measures. PMID:27572865

  13. Novel oncogenic PDGFRA mutations in pediatric high-grade gliomas.

    PubMed

    Paugh, Barbara S; Zhu, Xiaoyan; Qu, Chunxu; Endersby, Raelene; Diaz, Alexander K; Zhang, Junyuan; Bax, Dorine A; Carvalho, Diana; Reis, Rui M; Onar-Thomas, Arzu; Broniscer, Alberto; Wetmore, Cynthia; Zhang, Jinghui; Jones, Chris; Ellison, David W; Baker, Suzanne J

    2013-10-15

    The outcome for children with high-grade gliomas (HGG) remains dismal, with a 2-year survival rate of only 10% to 30%. Diffuse intrinsic pontine glioma (DIPG) comprise a subset of HGG that arise in the brainstem almost exclusively in children. Genome-wide analyses of copy number imbalances previously showed that platelet-derived growth factor receptor α (PDGFRA) is the most frequent target of focal amplification in pediatric HGGs, including DIPGs. To determine whether PDGFRA is also targeted by more subtle mutations missed by copy number analysis, we sequenced all PDGFRA coding exons from a cohort of pediatric HGGs. Somatic-activating mutations were identified in 14.4% (13 of 90) of nonbrainstem pediatric HGGs and 4.7% (2 of 43) of DIPGs, including missense mutations and in-frame deletions and insertions not previously described. Forty percent of tumors with mutation showed concurrent amplification, whereas 60% carried heterozygous mutations. Six different mutations impacting different domains all resulted in ligand-independent receptor activation that was blocked by small molecule inhibitors of PDGFR. Expression of mutants in p53-null primary mouse astrocytes conferred a proliferative advantage in vitro and generated HGGs in vivo with complete penetrance when implanted into brain. The gene expression signatures of these murine HGGs reflected the spectrum of human diffuse HGGs. PDGFRA intragenic deletion of exons 8 and 9 were previously shown in adult HGG, but were not detected in 83 nonbrainstem pediatric HGG and 57 DIPGs. Thus, a distinct spectrum of mutations confers constitutive receptor activation and oncogenic activity to PDGFRα in childhood HGG. PMID:23970477

  14. Current Treatment Strategies in Pediatric Alopecia Areata

    PubMed Central

    Wang, Etienne; Lee, Joyce SS; Tang, Mark

    2012-01-01

    Alopecia areata (AA) is a non-scarring autoimmune disease of the hair follicle that can present at any age. Pediatric cases are commonly seen in a dermatology clinic, and management can potentially be challenging, with a small proportion of cases experiencing a chronic relapsing course marked by distressing hair loss that can bring about significant psychosocial morbidity. We review the established treatments for pediatric alopecia areata, alongside second and third line therapies that have shown to be efficacious. We also offer a treatment algorithm as a guide to the treatment of pediatric AA. PMID:23248364

  15. Extracorporeal Life Support for Pediatric Heart Failure

    PubMed Central

    Burke, Christopher R.; McMullan, D. Michael

    2016-01-01

    Extracorporeal life support (ECLS) represents an essential component in the treatment of the pediatric patient with refractory heart failure. Defined as the use of an extracorporeal system to provide cardiopulmonary support, ECLS provides hemodynamic support to facilitate end-organ recovery and can be used as a salvage therapy during acute cardiorespiratory failure. Support strategies employed in pediatric cardiac patients include bridge to recovery, bridge to therapy, and bridge to transplant. Advances in extracorporeal technology and refinements in patient selection have allowed wider application of this therapy in pediatric heart failure patients. PMID:27812522

  16. Diagnostic Approach to Pediatric Spine Disorders.

    PubMed

    Rossi, Andrea; Martinetti, Carola; Morana, Giovanni; Severino, Mariasavina; Tortora, Domenico

    2016-08-01

    Understanding the developmental features of the pediatric spine and spinal cord, including embryologic steps and subsequent growth of the osteocartilaginous spine and contents is necessary for interpretation of the pathologic events that may affect the pediatric spine. MR imaging plays a crucial role in the diagnostic evaluation of patients suspected of harboring spinal abnormalities, whereas computed tomography and ultrasonography play a more limited, complementary role. This article discusses the embryologic and developmental anatomy features of the spine and spinal cord, together with some technical points and pitfalls, and the most common indications for pediatric spinal MR imaging.

  17. [Pediatric emergencies in the emergency medical service].

    PubMed

    Silbereisen, C; Hoffmann, F

    2015-01-01

    Out-of-hospital pediatric emergencies occur rarely but are feared among medical personnel. The particular characteristics of pediatric cases, especially the unaccustomed anatomy of the child as well as the necessity to adapt the drug doses to the little patient's body weight, produce high cognitive and emotional pressure. In an emergency standardized algorithms can facilitate a structured diagnostic and therapeutic approach. The aim of this article is to provide standardized procedures for the most common pediatric emergencies. In Germany, respiratory problems, seizures and analgesia due to trauma represent the most common emergency responses. This article provides a practical approach concerning the diagnostics and therapy of emergencies involving children.

  18. Surgical Site Infections After Pediatric Spine Surgery.

    PubMed

    Floccari, Lorena V; Milbrandt, Todd A

    2016-04-01

    Surgical site infection (SSI) after spinal deformity surgery is a complication in the pediatric population resulting in high morbidity and cost. Despite modern surgical techniques and preventative strategies, the incidence remains substantial, especially in the neuromuscular population. This review focuses on recent advancements in identification of risk factors, prevention, diagnosis, and treatment strategies for acute and delayed pediatric spine infections. It reviews recent literature, including the best practice guidelines for infection prevention in high-risk patients. Targets of additional research are highlighted to assess efficacy of current practices to further reduce risk of SSI in pediatric patients with spinal deformity. PMID:26772947

  19. Restorative dentistry for the pediatric patient.

    PubMed

    Hackmyer, Steven P; Donly, Kevin J

    2010-11-01

    The American Academy of Pediatric Dentistry sponsored the Pediatric Restorative Dentistry Consensus Conference in 2002. This paper will review the consensus statements that were issued as a result of the conference. Since the conference there have been advances in procedures, materials, and techniques that need to be considered in terms of some of the consensus statements. The introduction of the First Dental Home, interim therapeutic restoration and nanotechnology are examples of some of the materials and techniques that are now part of everyday pediatric dentistry. This paper will discuss the updates as it relates to each of the 2002 consensus statements.

  20. Desmoid Tumors in the Pediatric Population

    PubMed Central

    Honeyman, Joshua N.; La Quaglia, Michael P.

    2012-01-01

    Desmoid tumors are benign soft tissue tumors associated with locally aggressive growth and high rates of morbidity, but they do not metastasize via lymphatic or hematogenous routes. While most of the data on desmoid tumors originates in the adult literature, many of the findings have been applied to the management of pediatric patients. This article discusses the epidemiology, etiology, clinical presentation, pathology, and treatment of this rare tumor in the pediatric population and includes a literature review of the most recent large series of pediatric patients with desmoid tumors. PMID:24213241

  1. OUTCOMES OF THE FIFTH INTERNATIONAL CONFERENCE ON PEDIATRIC MECHANICAL CIRCULATORY SUPPORT SYSTEMS AND PEDIATRIC CARDIOPULMONARY PERFUSION

    PubMed Central

    Ündar, Akif

    2009-01-01

    The overall objective of the Conference was to bring together internationally know clinicians, bioengineers, and basic scientists involved in research on pediatric mechanical cardiac support systems and pediatric cardiopulmonary bypass procedures. The primary focus was to explicitly describe the problems with current pediatric mechanical circulatory support systems, methods, and techniques during acute and chronic support. The organizers were able to bring together respected international scholars from over 25 different countries at past conferences that has already made a significant impact on the treatment of pediatric cardiac patients during the past three years. Over 1,300 participants (250–300 participants each year) from many countries, including Argentina, Australia, Austria, Belgium, Brazil, Canada, China, Finland, France, Germany, Greece, Ireland, Italy, Japan, Kuwait, Netherlands, New Zealand, Poland, South Korea, Saudi Arabia, Scotland, Spain, Switzerland, Taiwan, Turkey, the United Kingdom, and the United States, have participated in the 2005, 2006, 2007, 2008, and 2009 events. To date, The Fifth International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion is the only conference solely dedicated to pediatric cardiac devices used during acute and chronic mechanical circulatory support. There is no other national or international conference to precisely define the problems with pediatric cardiac patients, and to suggest solutions with new methodologies and devices for pediatric patients, but specifically for neonates and infants. PMID:20021466

  2. Extracorporeal shockwave lithotripsy in pediatrics.

    PubMed

    D'Addessi, Alessandro; Bongiovanni, Luca; Sasso, Francesco; Gulino, Gaetano; Falabella, Roberto; Bassi, Pierfrancesco

    2008-01-01

    Since its introduction in 1980, extracorporeal shockwave lithotripsy (SWL) has become the first therapeutic option in most cases of upper-tract urolithiasis, and the technique has been used for pediatric renal stones since the first report of success in 1986. Lithotripter effectiveness depends on the power expressed at the focal point. Closely correlated with the power is the pain produced by the shockwaves. By reducing the dimensions of the focus, it becomes possible to treat the patient without anesthesia or analgesia but at the cost of a higher re-treatment rate. Older children often tolerate SWL under intravenous sedation, and minimal anesthesia is applicable for most patients treated with second- and third-generation lithotripters. Ureteral stenting before SWL has been controversial. Current data suggest that preoperative stent placement should be reserved for a few specific cases. Stone-free rates in pediatric SWL exceed 70% at 3 months, with the rate reaching 100% in many series. Even the low-birth-weight infant can be treated with a stone-free as high as 100%. How can one explain the good results? Possible explanations include the lesser length of the child's ureter, which partially compensates for the narrower lumen. Moreover, the pediatric ureter is more elastic and distensible, which facilitates passage of stone fragments and prevents impaction. Another factor is shockwave reproduction in the body: there is a 10% to 20% damping of shockwave energy as it travels through 6 cm of body tissue, so the small body volume of the child allows the shockwaves to be transmitted with little loss of energy. There are several concerns regarding the possible detrimental effect of shockwaves on growing kidneys. Various renal injures have been documented with all type of lithotripters. On the other hand, several studies have not shown adverse effects. In general, SWL is considered to be the method of choice for managing the majority of urinary stones in children of all

  3. Pediatric diseases and operational deployments.

    PubMed

    Pearn, J

    2000-04-01

    Many nations now export military health as a proactive arm of the nation's contribution to the maintenance of international peace in trouble regions of the world; and all nations are called upon from time to time in emergency and disaster situations to help out in their regions of interest. Children and young teenagers constitute some 50% of war-stricken populations. This paper explores this increasingly important role of military medicine from the point of view of a practicing pediatrician and career doctor-soldier. Many international operational deployments undertaken in the last 5 years have required the insertion of pediatric clinical and preventive health resources. Deployments to Rwanda, the countries of the former Yugoslavia, Somalia, Bougainville (in Papua New Guinea), Irian Jaya (in Indonesia), and the Aitape tsunami disaster response (the Sepik region of Papua New Guinea) have all necessitated major pediatric interventions. In some operational deployments, in excess of one-third of patient and clinical contacts have involved the care of children, including clinical treatments ranging from life-saving resuscitation to the care of children with both tropical and subtropical illnesses. They have also involved mass immunization campaigns (e.g., in Rwanda) to prevent measles and meningococcal septicemia. In developing countries, at any time approximately 1 to 4 teenage and adult women is pregnant; and of these, 1 in 15 is suffering a miscarriage during any 2-week period. The implications of this audit are that service members must be multi-skilled not only in the traditional aspects of military medicine and nursing but also in (a) the developmental aspects of childhood; (b) the prevention of infectious childhood diseases by immunization and other means; (c) the recognition and management of diseases of childhood; and (d) the management of the normal neonate and infant, especially those orphaned in refugee disaster and other emergency situations. Doctor

  4. Plan Showing Cross Bracing Under Upper Stringers, Typical Section Showing ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Plan Showing Cross Bracing Under Upper Stringers, Typical Section Showing End Framing, Plan Showing Cross Bracing Under Lower Stringers, End Elevation - Covered Bridge, Spanning Contoocook River, Hopkinton, Merrimack County, NH

  5. One in Four Questioned Children Faces Problems Regarding Reintegration Into Physical Education at School After Treatment for Pediatric Cancer.

    PubMed

    Kesting, Sabine V; Götte, Miriam; Seidel, Corinna C; Rosenbaum, Dieter; Boos, Joachim

    2016-04-01

    Resumption of physical activity and reintegration into social surroundings after treatment for pediatric cancer is of high importance to recover from the burden of disease and treatment and to positively influence long-term health outcomes. Eighty-three children who had completed intensive treatment for pediatric cancer were surveyed regarding their participation in physical education at school (PES). The results show a concerning low rate of participation, particularly in children treated for pediatric bone tumors, and associated barriers. Reported reasons for quitting PES seem to be conquerable by individual and entity-related support to enable participation according to the children's desire.

  6. The participation of minorities in published pediatric research.

    PubMed Central

    Kelly, Michael L.; Ackerman, Paul D.; Ross, Lainie Friedman

    2005-01-01

    OBJECTIVES: There is extensive documentation that minority adults are underrepresented in medical research, but there are scant data regarding minority children and their parents. DESIGN: All full-length articles published in three general pediatric journals between July 2002 through June 2003 were collected and reviewed. Articles were excluded if they did not include at least one U.S. researcher, all subjects enrolled at U.S. institutions, parents or children as subjects, some prospective data collection, or between eight and 10,000 subjects. Corresponding authors were surveyed to clarify race/ethnicity data, language barriers and how race/ethnicity data were collected. RESULTS: Two-hundred-twenty-eight articles qualified for further analysis. Black children and parents and Asian/Pacific Islander parents were overrepresented, and Hispanic children and parents were underrepresented compared to the Census data. Most researchers collected race/ethnicity data by having subjects self-report. Most studies did not have translation available, although most Hispanic and Asian/Pacific Islander subjects were enrolled in studies in which translation was available. CONCLUSION: Our data show that Hispanic and Asian/Pacific Islander research subjects are more likely to participate in pediatric research when translation is available. If the goal is to ensure access to pediatric research for all ethnic populations, then more research needs to accommodate non-English-speaking participants. PMID:16035575

  7. The role of acute pancreatitis in pediatric burn patients.

    PubMed

    Rivero, Haidy G; Lee, Jong O; Herndon, David N; Mecott, Gabriel A; Kulp, Gabriela A; Kraft, Robert; Brooks, Natasha C; Diblidox-Gonzales, Manuel; Hawkins, Hal K; Jeschke, Marc G

    2011-02-01

    Few publications recognize acute pancreatitis as a complication after large burns, consequently the incidence and outcome acute pancreatitis after burn in children is not well defined. The aim of this study was to determine the incidence, morbidity, and mortality relating to acute pancreatitis in a pediatric burn population and to correlate clinical diagnosis with autopsy findings to determine the incidence of unrecognized pancreatitis. Records of 2699 patients with acute burns were reviewed. Acute pancreatitis was defined as abdominal pain and/or feeding intolerance in addition to a three-fold elevation of amylase and/or lipase. One-hundred twenty-seven burned children served as the control cohort. To assess the presence of autopsy confirmed AP in pediatric burn patients, we evaluated autopsy reports of 78 children who died from burns, looking for reported evidence of pancreatic inflammation, and fat/parenchymal necrosis. Our data show that acute pancreatitis in children has a low incidence after burn. The study included 2699 patients of which 13 were suffering acute pancreatitis (13/2699 = 0.05%). Mortality is significantly higher for the acute pancreatitis group vs. the control group, p < 0.05. Autopsy reports established 11 of 78 patients with evidence of pancreatitis, resulting in an incidence of 0.17% for pancreatitis at autopsy. Although it has low incidence, acute pancreatitis is associated with increased mortality in severely burned pediatric patients, which underlines the importance of increased vigilance in the evaluation and treatment of pancreatitis in burned children.

  8. Graft rejection in pediatric penetrating keratoplasty: Clinical features and outcomes

    PubMed Central

    Kusumesh, Rakhi; Vanathi, Murugesan

    2015-01-01

    Purpose: Early presentation of rejection facilitates early initiation of treatment which can favor a reversible rejection and better outcome. We analyzed the incidence, clinical features including rejection-treatment period and outcomes following graft rejection in our series of pediatric corneal graft. Materials and Methods: Case records of pediatric penetrating keratoplasty (PK) were reviewed retrospectively, and parameters noted demographic profile, indication of surgery, surgery-rejection period, rejection-treatment interval, graft outcome, and complications. Results: PK was performed in 66 eyes of 66 children <12 years, with an average follow-up of 21.12 ± 11.36 months (range 4-48 month). The median age at the time of surgery was 4.0 years (range 2 months to 12 years). Most of the children belonged to rural background. Scarring after keratitis (22, 33.4%) was the most common indication. Graft rejection occurred in eight eyes (12.12%) (acquired nontraumatic - 3, congenital hereditary endothelial dystrophy [CHED] - 2, nonCHED - 1, congenital glaucoma - 1, regraft - 1). The mean surgery-rejection period was 10.5 ± 7.3 months and mean rejection-treatment interval was 10.9 ± 7.02 days. Conclusion: This study showed irreversible graft rejection was the leading cause of graft failure of pediatric PK. Though, the incidence (12.1%) of graft rejection in current study was not high, but the percentage of reversal (25%) was one of the lowest in literature because of delayed presentation and longer interval between corneal graft rejection and treatment. In addition, categorization of the type of graft rejection was very difficult and cumbersome in pediatric patients. PMID:25709272

  9. Applicability of the pediatric evaluation of disability inventory in Slovenia.

    PubMed

    Srsen, Katja Groleger; Vidmar, Gaj; Zupan, Anton

    2005-05-01

    In the process of developmental (re)habilitation, determination of the functional abilities of an individual is an important step. For that we need appropriate measurement instruments. Because we do not have such measurement instruments in Slovenia, we chose the Pediatric Evaluation of Disability Inventory (PEDI), translated it, and applied it in daily practice to assess its usefulness and applicability. The purpose of the study was to find out whether the functional abilities of the population of Slovene children evaluated with the Pediatric Evaluation of Disability Inventory is comparable to the American normative data. We also wanted to assess the possible influence of gender, parent education, community size, and the presence of siblings on children's functional abilities. The Pediatric Evaluation of Disability Inventory was administered in the form of a structured interview to the parents of 147 healthy children in three age groups (0.5-1 year, 3-3.5 years, and 5-5.5 years) in different health care centers in Slovenia. Data analysis showed significant differences in functional skills and caregiver assistance scale scores when comparing the Slovene sample with the American normative data, particularly in the youngest age group. Slovene children were found consistently to be different (scoring either higher or lower) from American children at comparable ages in several functional skills and caregiver assistance scales. The analysis also confirmed the importance of gender and the presence of siblings for gaining higher scores on some of the functional skills and caregiver assistance scales. The level of parent education did not prove to have a significant impact on the results. Our results suggest that the American normative data are not completely appropriate for reference purposes in Slovenia. The results are in agreement with the findings of other studies, demonstrating the importance of ascertaining intercultural differences. We believe that adaptation and

  10. Relationships of Pediatric Anthropometrics for CT Protocol Selection

    PubMed Central

    Phillips, Grace S.; Stanescu, Arta-Luana; Alessio, Adam M.

    2016-01-01

    OBJECTIVE Determining the optimal CT technique to minimize patient radiation exposure while maintaining diagnostic utility requires patient-specific protocols that are based on patient characteristics. This work develops relationships between different anthropometrics and CT image noise to determine appropriate protocol classification schemes. MATERIALS AND METHODS We measured the image noise in 387 CT examinations of pediatric patients (222 boys, 165 girls) of the chest, abdomen, and pelvis and generated mathematic relationships between image noise and patient lateral and anteroposterior dimensions, age, and weight. RESULTS At the chest level, lateral distance (ld) across the body is strongly correlated with weight (ld = 0.23 × weight + 16.77; R2 = 0.93) and is less well correlated with age (ld = 1.10 × age + 17.13; R2 = 0.84). Similar trends were found for anteroposterior dimensions and at the abdomen level. Across all studies, when acquisition-specific parameters are factored out of the noise, the log of image noise was highly correlated with lateral distance (R2 = 0.72) and weight (R2 = 0.72) and was less correlated with age (R2 = 0.62). Following first-order relationships of image noise and scanner technique, plots were formed to show techniques that could achieve matched noise across the pediatric population. CONCLUSION Patient lateral distance and weight are essentially equally effective metrics to base maximum technique settings for pediatric patient–specific protocols. These metrics can also be used to help categorize appropriate reference levels for CT technique and size-specific dose estimates across the pediatric population. PMID:24951232

  11. Pediatric air gun shot injury

    PubMed Central

    Khan, Ubaid U.; Kamal, Naglaa M.; Mirza, Shazia J.; Sherief, Laila M.

    2014-01-01

    Air guns (AGs) use air or another compressed gas to propel a projectile. Different injuries may occur in children due to their body structure, which is less-resistant with thin soft tissue coverage that can be easily penetrated by an AG shot. We present 3 cases of pediatric AG shot injury. The first-case had right lumber deep tissue penetration of AG pallet without internal damage, the second-case had a complex course of pellet into the perineum, and the third-case was shot in the left shoulder. All cases were accidentally shot. The shooters were all children, and relatives of the victims. All patients were generally stable on arrival. Two cases were operated, and one received conservative management. On follow up, no complications were noted. At first sight, AGs and air rifles may appear relatively harmless, but they are potentially lethal and children should not be allowed to play with them. PMID:25491217

  12. Antibiotics, pediatric dysbiosis, and disease.

    PubMed

    Vangay, Pajau; Ward, Tonya; Gerber, Jeffrey S; Knights, Dan

    2015-05-13

    Antibiotics are by far the most common medications prescribed for children. Recent epidemiological data suggests an association between early antibiotic use and disease phenotypes in adulthood. Antibiotic use during infancy induces imbalances in gut microbiota, called dysbiosis. The gut microbiome's responses to antibiotics and its potential link to disease development are especially complex to study in the changing infant gut. Here, we synthesize current knowledge linking antibiotics, dysbiosis, and disease and propose a framework for studying antibiotic-related dysbiosis in children. We recommend future studies into the microbiome-mediated effects of antibiotics focused on four types of dysbiosis: loss of keystone taxa, loss of diversity, shifts in metabolic capacity, and blooms of pathogens. Establishment of a large and diverse baseline cohort to define healthy infant microbiome development is essential to advancing diagnosis, interpretation, and eventual treatment of pediatric dysbiosis. This approach will also help provide evidence-based recommendations for antibiotic usage in infancy.

  13. Surgical strategies for pediatric epilepsy

    PubMed Central

    Guan, Jian; Karsy, Michael; Ducis, Katrina

    2016-01-01

    Pediatric epilepsy is a debilitating condition that impacts millions of patients throughout the world. Approximately 20–30% of children with recurrent seizures have drug-resistant epilepsy (DRE). For these patients, surgery offers the possibility of not just seizure freedom but significantly improved neurocognitive and behavioral outcomes. The spectrum of surgical options is vast, ranging from outpatient procedures such as vagus nerve stimulation to radical interventions including hemispherectomy. The thread connecting all of these interventions is a common goal—seizure freedom, an outcome that can be achieved safely and durably in a large proportion of patients. In this review, we discuss many of the most commonly performed surgical interventions and describe the indications, complications, and outcomes specific to each. PMID:27186522

  14. Potential bacteremia in pediatric practice.

    PubMed

    Hoekelman, R; Lewin, E B; Shapira, M B; Sutherland, S A

    1979-10-01

    The potential consequences of bacteremia are considerable in all infants but particularly in those from 3 to 24 months of age with temperatures of 38.3 degrees C or more. Physicians have been advised to scrutinize these patients carefully with a variety of diagnostic tests and to treat their conditions vigorously if bacteremia is seriously considered or proved. We undertook to determine how often primary care pediatric practitioners encounter such patients "at risk" for bacteremia. Among the practices of nine pediatricians in Monroe County, New York, involving 220 practice days throughout 1977 and 4,151 patient visits, we found 145 instances of potential bacteremia. Depending, then, on the season of the year, practitioners may face this diagnostic and management dilemma as often as once each day. Therefore, laboratory means for determining those infants at highest risk for bacteremia or for rapidly diagnosing bacteremia will need to be readily available to practitioners.

  15. Pediatric Low-Grade Gliomas

    PubMed Central

    Sievert, Angela J.; Fisher, Michael J.

    2010-01-01

    Pediatric low-grade gliomas encompass a heterogeneous set of tumors of different histologies. Cerebellar pilocytic astrocytomas occur most frequently followed by supratentorial diffuse fibrillary astrocytomas. Recent research has implicated activation of the RAS/RAF/MEK pathway in tumorigenesis of these tumors. Surgery is the mainstay of therapy. Overall survival rates for patients whose tumors are completely resected are 90% or greater, 10 years from diagnosis. Conversely, most optic pathway/hypothalamic, deep midline, and brain stem gliomas have minimal potential for resection; these tumors can be difficult to treat and deserve special attention. Combination chemotherapy is currently recommended as front-line adjuvant treatment for progressive or recurrent tumors. Second-line radiotherapy can also improve overall survival but is associated with more frequent and significant neurocognitive, endocrine, and other long-term toxicities. PMID:19841428

  16. Pediatric human immunodeficiency virus infection.

    PubMed Central

    Domachowske, J B

    1996-01-01

    In the past decade, an increase in pediatric human immunodeficiency virus (HIV) infection has had a substantial impact on childhood morbidity and mortality worldwide. The vertical transmission of HIV from mother to infant accounts for the vast majority of these cases. Identification of HIV-infected pregnant women needs to be impoved so that appropriate therapy can be initiated for both mothers and infants. While recent data demonstrate a dramatic decrease in HIV transmission from a subset of women treated with zidovudine during pregnancy, further efforts at reducing transmission are desperately needed. This review focuses on vertically transmitted HIV infection in children, its epidemiology, diagnostic criteria, natural history, and clinical manifestations including infectious and noninfectious complications. An overview of the complex medical management of these children ensues, including the use of antiretroviral therapy. Opportunistic infection prophylaxis is reviewed, along with the important role of other supportive therapies. PMID:8894346

  17. Pediatric air gun shot injury.

    PubMed

    Khan, Ubaid U; Kamal, Naglaa M; Mirza, Shazia J; Sherief, Laila M

    2014-12-01

    Air guns (AGs) use air or another compressed gas to propel a projectile. Different injuries may occur in children due to their body structure, which is less-resistant with thin soft tissue coverage that can be easily penetrated by an AG shot. We present 3 cases of pediatric AG shot injury. The first-case had right lumber deep tissue penetration of AG pallet without internal damage, the second-case had a complex course of pellet into the perineum, and the third-case was shot in the left shoulder. All cases were accidentally shot. The shooters were all children, and relatives of the victims. All patients were generally stable on arrival. Two cases were operated, and one received conservative management. On follow up, no complications were noted.  At first sight, AGs and air rifles may appear relatively harmless, but they are potentially lethal and children should not be allowed to play with them.  PMID:25491217

  18. Intraosseous infusion in pediatric patients.

    PubMed

    Neal, C J; McKinley, D F

    1994-01-01

    In traumatically injured or medically unstable pediatric patients requiring resuscitation, gaining intravenous access often is frustrating for the physician and agonizing for the patient. Even when cardiopulmonary resuscitation is performed by trained professionals, cardiac arrests in children in the prehospital setting have a mortality of 79% to 100%. Immediate vascular access such as that obtained by intraosseous infusion improves survival. The intraosseous infusion technique uses the medullary cavity in the tibia as a "noncollapsible vein" for parenteral infusion. It is indicated in a child in shock or cardiac arrest when two attempts to access peripheral vasculature have failed or when more than 2 minutes have elapsed in the attempt to gain access. Epinephrine, bicarbonate, calcium, lidocaine, and volume expanders can be infused via the intraosseous route. Complications rarely occur. The technique described here is gaining acceptance in both prehospital and emergency department settings. PMID:8169160

  19. Pediatric Neuromodulation Comes of Age.

    PubMed

    Croarkin, Paul E; Rotenberg, Alexander

    2016-09-01

    This special issue surveys recent work and underscores the challenges of psychiatric brain stimulation research with child and adolescent populations. The field of child and adolescent psychopharmacology is replete with examples of potential pitfalls in the assumption that "children are little adults." Arguably, younger age portends more neurobiological and descriptive heterogeneity in research pursuits and clinical practice. For existing brain stimulation modalities, there are a paucity of translational models to design studies for youth and no well-studied dosing schemes. The long-term positive and negative effects of neuromodulation interventions in youth are unknown. Inherent pragmatic and ethical limitations often present barriers for participant recruitment and will necessitate innovative approaches to study design and team efforts. These challenges are not insurmountable, and sustained efforts will advance the growing field of pediatric neuromodulation. PMID:27604043

  20. Imaging of pediatric pituitary endocrinopathies

    PubMed Central

    Chaudhary, Vikas; Bano, Shahina

    2012-01-01

    Accurate investigation of the hypothalamic-pituitary area is required in pediatric patients for diagnosis of endocrine-related disorders. These disorders include hypopituitarism, growth failure, diencephalic syndrome, delayed puberty, precocious puberty, diabetes insipidus, syndrome of inappropriate antidiuretic hormone (SIADH) secretion, and hyperpituitarism. Magnetic resonance imaging (MRI) is the modality of choice to visualize hypothalamic-pituitary axis and associated endocrinopathies. Neuroimaging can be normal or disclose abnormalities related to pituitary-hypothalamic axis like (i) congenital and developmental malformations; (ii) tumors; (iii) cystic lesions; and (iv) infectious and inflammatory conditions. Classical midline anomalies like septo-optic dysplasias or corpus callosum agenesis are commonly associated with pituitary endocrinopathies and also need careful evaluation. In this radiological review, we will discuss neuroendocrine disorders related to hypothalamic pituitary-axis. PMID:23087850

  1. Genetics of pediatric bone strength.

    PubMed

    Mitchell, Jonathan A; Cousminer, Diana L; Zemel, Babette S; Grant, Struan F A; Chesi, Alessandra

    2016-01-01

    Osteoporosis is one of the most common chronic forms of disability in postmenopausal women and represents a major health burden around the world. Bone fragility is affected by bone mineral density (BMD), and, one of the most important factors in preventing osteoporosis is optimizing peak bone mass, which is achieved during growth in childhood and adolescence. BMD is a complex trait resulting from environmental and genetic factors. Genome-wide association studies have discovered robust genetic signals influencing BMD in adults, and similar studies have also been conducted to investigate the genetics of BMD in the pediatric setting. These latter studies have revealed that many adult osteoporosis-related loci also regulate BMD during growth. These investigations have the potential to profoundly impact public health and will allow for the eventual development of effective interventions for the prevention of osteoporosis. PMID:27579163

  2. [Pediatric neurotransmitter disease in Japan].

    PubMed

    Shintaku, Haruo

    2012-09-01

    Pediatric neurotransmitter disease (PND) encompasses a range of rare genetic disorders that affect the metabolism of neurotransmitters in children. While these neurological disorders are often studied independently of each other, they all manifest central nervous system symptoms and require proper diagnosis and intervention at early stages. Since clinical symptoms of PND can be nonspecific, the conditions are often under-diagnosed, leaving patients without a chance to receive effective treatment. Envisioning PND as a whole, a comprehensive research effort is underway for a better understanding of pathophysiology and epidemiology in Japan, and toward the establishment of diagnostic criteria. The early diagnosis and development of new effective therapies are of urgent importance for these rare disorders that are not covered by newborn mass screening. For rarer forms of PND, at the same time, it is important to encourage recognition and understanding of the disease concept among healthcare professionals.

  3. Pediatric Sedation: A Global Challenge

    PubMed Central

    Gozal, David; Mason, Keira P.

    2010-01-01

    Pediatric sedation is a challenge which spans all continents and has grown to encompass specialties outside of anesthesia, radiology and emergency medicine. All sedatives are not universally available and local and national regulations often limit the sedation practice to specific agents and those with specific credentials. Some specialties have established certification and credentials for sedation delivery whereas most have not. Some of the relevant sedation guidelines and recommendations of specialty organizations worldwide will be explored. The challenge facing sedation care providers moving forward in the 21st century will be to determine how to apply the local, regional and national guidelines to the individual sedation practices. A greater challenge, perhaps impossible, will be to determine whether the sedation community can come together worldwide to develop standards, guidelines and recommendations for safe sedation practice. PMID:20981309

  4. Pediatric elbow injuries in athletes.

    PubMed

    Makhni, Eric C; Jegede, Kola A; Ahmad, Christopher S

    2014-09-01

    Elbow injuries in pediatric and adolescent population represent a spectrum of pathology that can range from medial tension injuries to posterior shear injuries. Elbow injuries in this population continue to rise in parallel with the increase in youth participation in sports both throughout the calendar year and across multiple sports. Many of these injuries are noncontact and are attributed to overuse. Evaluation and management of youth and adolescent athletic elbow injuries requires knowledge of developmental anatomy, injury pathophysiology, and established treatment algorithms. Furthermore, risk factors contributing to elbow injuries must be recognized, with education and recommendations for safe play continually advocated. This education--of parents, athletes, and coaches--is paramount in reducing the climbing incidence of elbow injuries in our youth athletes.

  5. The Pediatric Cancer Genome Project

    PubMed Central

    Downing, James R; Wilson, Richard K; Zhang, Jinghui; Mardis, Elaine R; Pui, Ching-Hon; Ding, Li; Ley, Timothy J; Evans, William E

    2013-01-01

    The St. Jude Children’s Research Hospital–Washington University Pediatric Cancer Genome Project (PCGP) is participating in the international effort to identify somatic mutations that drive cancer. These cancer genome sequencing efforts will not only yield an unparalleled view of the altered signaling pathways in cancer but should also identify new targets against which novel therapeutics can be developed. Although these projects are still deep in the phase of generating primary DNA sequence data, important results are emerging and valuable community resources are being generated that should catalyze future cancer research. We describe here the rationale for conducting the PCGP, present some of the early results of this project and discuss the major lessons learned and how these will affect the application of genomic sequencing in the clinic. PMID:22641210

  6. [Digestive interventional endoscopy in pediatrics].

    PubMed

    Bautista Casasnovas, A; Villanueva Jeremías, A; Estévez Martínez, E; Méndez Gallart, R; Taboada Santomil, P; Varela Cives, R

    2006-10-01

    With development and improvement of the endoscope equipment, the paediatric endoscopy is developing from the diagnosis endoscopy to the interventional endoscopy. It is realized under general anaesthesia as a minimal invasive surgery and it is necessary to regularize the legal requirements. The main acts are realized in a current way in paediatrics endoscopy units: extraction of foreign body, dilation of oesophageal strictures, gastrostomy, polipectomy. Other indications are less frequent: injection sclerotherapy, haemostasis of upper GI bleeding or endoscopic achalasia treatment. The biliary and/or pancreatic lesions is rare in children, in these cases, interventional endoscopy is usually done with the collaboration of the adult endoscopists, with a far experience. Interventional endoscopy is a safe and effective technique that can be performed in all the pediatrics endoscopy units.

  7. Pediatric Neuromodulation Comes of Age.

    PubMed

    Croarkin, Paul E; Rotenberg, Alexander

    2016-09-01

    This special issue surveys recent work and underscores the challenges of psychiatric brain stimulation research with child and adolescent populations. The field of child and adolescent psychopharmacology is replete with examples of potential pitfalls in the assumption that "children are little adults." Arguably, younger age portends more neurobiological and descriptive heterogeneity in research pursuits and clinical practice. For existing brain stimulation modalities, there are a paucity of translational models to design studies for youth and no well-studied dosing schemes. The long-term positive and negative effects of neuromodulation interventions in youth are unknown. Inherent pragmatic and ethical limitations often present barriers for participant recruitment and will necessitate innovative approaches to study design and team efforts. These challenges are not insurmountable, and sustained efforts will advance the growing field of pediatric neuromodulation.

  8. Diaphragmatic Hernia After Pediatric Liver Transplant.

    PubMed

    Kirnap, Mahir; Akdur, Aydincan; Ozcay, Figen; Soy, Ebru; Coskun, Mehmet; Moray, Gokhan; Haberal, Mehmet

    2015-10-01

    Diaphragmatic hernia is an unusual complication after pediatric liver transplant. Nearly half of bowel obstruction cases, which require surgical intervention in liver transplant patients, are caused by diaphragmatic hernia. The smaller patients are at risk for higher rates of diaphragmatic complication after pediatric liver transplant, but diaphragmatic hernia has not been reported as a unique occurrence. Here, we report 3 cases of diaphragmatic hernia after liver transplant and discuss the possible contributing factors. Diaphragmatic hernia should nevertheless be added to the list of potential complications after liver transplant in the pediatric population. Pediatric transplant physicians and surgeons should be aware of this complication so that it is recognized promptly in both acute and nonacute settings and appropriate action is taken.

  9. Radiation-induced meningiomas in pediatric patients

    SciTech Connect

    Moss, S.D.; Rockswold, G.L.; Chou, S.N.; Yock, D.; Berger, M.S.

    1988-04-01

    Radiation-induced meningiomas rarely have latency periods short enough from the time of irradiation to the clinical presentation of the tumor to present in the pediatric patient. Three cases of radiation-induced intracranial meningiomas in pediatric patients are presented. The first involved a meningioma of the right frontal region in a 10-year-old boy 6 years after the resection and irradiation of a 4th ventricular medulloblastoma. Review of our pediatric tumor cases produced a second case of a left temporal fossa meningioma presenting in a 15-year-old boy with a history of irradiation for retinoblastoma at age 3 years and a third case of a right frontoparietal meningioma in a 15-year-old girl after irradiation for acute lymphoblastic leukemia. Only three cases of meningiomas presenting in the pediatric age group after radiation therapy to the head were detected in our review of the literature.

  10. Oncolytic virotherapy for pediatric malignancies: future prospects

    PubMed Central

    Waters, Alicia M; Friedman, Gregory K; Ring, Eric K; Beierle, Elizabeth A

    2016-01-01

    Pediatric solid tumors remain a major health concern, with nearly 16,000 children diagnosed each year. Of those, ~2,000 succumb to their disease, and survivors often suffer from lifelong disability secondary to toxic effects of current treatments. Countless multimodality treatment regimens are being explored to make advances against this deadly disease. One targeted treatment approach is oncolytic virotherapy. Conditionally replicating viruses can infect tumor cells while leaving normal cells unharmed. Four viruses have been advanced to pediatric clinical trials, including herpes simplex virus-1, Seneca Valley virus, reovirus, and vaccinia virus. In this review, we discuss the mechanism of action of each virus, pediatric preclinical studies conducted to date, past and ongoing pediatric clinical trials, and potential future direction for these novel viral therapeutics. PMID:27579298

  11. Oncolytic virotherapy for pediatric malignancies: future prospects.

    PubMed

    Waters, Alicia M; Friedman, Gregory K; Ring, Eric K; Beierle, Elizabeth A

    2016-01-01

    Pediatric solid tumors remain a major health concern, with nearly 16,000 children diagnosed each year. Of those, ~2,000 succumb to their disease, and survivors often suffer from lifelong disability secondary to toxic effects of current treatments. Countless multimodality treatment regimens are being explored to make advances against this deadly disease. One targeted treatment approach is oncolytic virotherapy. Conditionally replicating viruses can infect tumor cells while leaving normal cells unharmed. Four viruses have been advanced to pediatric clinical trials, including herpes simplex virus-1, Seneca Valley virus, reovirus, and vaccinia virus. In this review, we discuss the mechanism of action of each virus, pediatric preclinical studies conducted to date, past and ongoing pediatric clinical trials, and potential future direction for these novel viral therapeutics. PMID:27579298

  12. Bedside ultrasound in pediatric emergency medicine.

    PubMed

    Levy, Jason A; Noble, Vicki E

    2008-05-01

    Bedside emergency ultrasound has been used by emergency physicians for >20 years for a variety of conditions. In adult centers, emergency ultrasound is routinely used in the management of victims of blunt abdominal trauma, in patients with abdominal aortic aneurysm and biliary disease, and in women with first-trimester pregnancy complications. Although its use has grown dramatically in the last decade in adult emergency departments, only recently has this tool been embraced by pediatric emergency physicians. As the modality advances and becomes more available, it will be important for primary care pediatricians to understand its uses and limitations and to ensure that pediatric emergency physicians have access to the proper training, equipment, and experience. This article is meant to review the current literature relating to emergency ultrasound in pediatric emergency medicine, as well as to describe potential pediatric applications.

  13. Headaches after Concussion in Pediatrics: a Review.

    PubMed

    Blume, Heidi K

    2015-09-01

    Concussion and mild traumatic brain injury (TBI) are common pediatric injuries. Headaches are one of the most common and disabling complaints following concussion in the acute phase and are pervasive in those who have prolonged symptoms following concussion. The body of evidence regarding the epidemiology of and risk factors for pediatric concussion and post-traumatic headache is growing rapidly, but there still is a distinct lack of strong scientific evidence to support the best treatment strategies for post-traumatic headaches in either children or adults. In this article, we will review the current evidence regarding the epidemiology of acute and chronic headaches following concussion in the pediatric population, as well as current recommendations for the management of acute and chronic pediatric post-traumatic headaches.

  14. Acute kidney injury after pediatric cardiac surgery.

    PubMed

    Singh, Sarvesh Pal

    2016-01-01

    Acute kidney injury is a common complication after pediatric cardiac surgery. The definition, staging, risk factors, biomarkers and management of acute kidney injury in children is detailed in the following review article. PMID:27052074

  15. Eosinophilic Esophagitis in Pediatric and Adolescent Patients

    MedlinePlus

    ... and Adolescent Patients Eosinophilic Esophagitis in Pediatric and Adolescent Patients Basics Overview Eosinophilic esophagitis also known as ( ... children may have vomiting and abdominal pain, and adolescents may complain of the feeling of food getting ...

  16. What Is a Pediatric Allergist / Immunologist?

    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 ...

  17. What Is a Pediatric Heart Surgeon?

    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 ...

  18. Critical Illness Hyperglycemia in Pediatric Cardiac Surgery

    PubMed Central

    Ulate, Kalia P; Raj, Shekhar; Rotta, Alexandre T

    2012-01-01

    Critical illness hyperglycemia (CIH) is common in pediatric and adult intensive care units (ICUs). Children undergoing surgical repair or palliation of congenital cardiac defects are particularly at risk for CIH and its occurrence has been associated with increased morbidity and mortality in this population. Strict glycemic control through the use of intensive insulin therapy (IIT) has been shown to improve outcomes in some adult and pediatric studies, yet these findings have sparked controversy. The practice of strict glycemic control has been slow in extending to pediatric ICUs because of the documented increase in the incidence of hypoglycemia in patients treated with IIT. Protocol driven approaches with more liberal glycemic targets have been successfully validated in general and cardiac critical care pediatric patients with low rates of hypoglycemia. It is unknown whether a therapeutic benefit is obtained by keeping patients in this more liberal glycemic control target. Definitive randomized controlled trials of IIT utilizing these targets in critically ill children are ongoing. PMID:22401320

  19. Pediatric Acid Reflux and GERD in Teens

    MedlinePlus

    ... Print Share Reflux and GERD : Teen GERD Pediatric Acid Reflux and GERD in Teens If you’re ... And here’s the better news: Most kids with acid reflux are able to lead normal, active, healthy ...

  20. Acute Kidney Injury in Pediatric Heart Failure.

    PubMed

    Riley, Alyssa; Gebhard, Daniel J; Akcan-Arikan, Ayse

    2016-01-01

    Acute kidney injury (AKI) is very common in pediatric medical and surgical cardiac patients. Not only is it an independent risk factor for increased morbidity and mortality in the short run, but repeated episodes of AKI lead to chronic kidney disease (CKD) especially in the most vulnerable hosts with multiple risk factors, such as heart transplant recipients. The cardiorenal syndrome, a term coined to emphasize the bidirectional nature of simultaneous or sequential cardiac-renal dysfunction both in acute and chronic settings, has been recently described in adults but scarcely reported in children. Despite the common occurrence and clinical and financial impact, AKI in pediatric heart failure outside of cardiac surgery populations remains poorly studied and there are no large-scale pediatric specific preventive or therapeutic studies to date. This article will review pediatric aspects of the cardiorenal syndrome in terms of pathophysiology, clinical impact and treatment options.

  1. Pediatric fire deaths in Ontario

    PubMed Central

    Chen, Yingming Amy; Bridgman-Acker, Karen; Edwards, Jim; Lauwers, Albert Edward

    2011-01-01

    Abstract Objective To identify the predictors of residential fire deaths in the Ontario pediatric population using systematically collected data from the Office of the Chief Coroner. Design Retrospective cohort study. Setting Ontario. Participants Children younger than 16 years of age who died in accidental residential fires in Ontario between January 1, 2001, and December 31, 2006. Main outcome measures The study retrospectively reviewed the coroner’s case files for 60 subjects who qualified according to the selection criteria. Reviewed documents included the coroner’s investigation statements, autopsy reports, toxicology reports, fire marshal’s reports, police reports, and Children’s Aid Society (CAS) reports. Information on a range of demographic, behavioural, social, and environmental factors was collected. Statistical tests, including relative risk, relative risk confidence intervals, and χ2 tests were performed to determine the correlation between factors of interest and to establish their significance. Results Thirty-nine fire events resulting in 60 deaths occurred between 2001 and 2006. Fire play and electrical failures were the top 2 causes of residential fires. More fires occurred during the night (midnight to 9 am) than during the day (9 am to midnight). Nighttime fires were most commonly due to electrical failures or unattended candles, whereas daytime fires were primarily caused by unsupervised fire play and stove fires. Smoke alarms were present at 32 of 39 fire events (82%), but overall alarm functionality was only 54%. Children from families with a history of CAS involvement were approximately 32 times more likely to die in fires. Conclusion Risk factors for pediatric fire death in Ontario include smoke alarm functionality, fire play, fire escape behaviour, and CAS involvement. Efforts to prevent residential fire deaths should target these populations and risk factors, and primary care physicians should consider education around these

  2. [Harry Dorchy and pediatric diabetology].

    PubMed

    Brink, Stuart J

    2010-01-01

    "Monsieur Le Professor Harry Dorchy is retiring". He has had a brilliant 40 year career since receiving his medical degree from the Free University of Brussels in 1969 and his PhD--entitled " Contribution a l'etude du diabète de l'enfant et de l'adolescent "--in 1981 from the same illustrious university. He had the great fortune to connect with his mentor, Professor Helmut Jean Loeb, and for many years, the two of them cared for young people with diabetes in Brussels and worked closely to establish a remarkable legacy of clinical care, research and innovative thinking about how young children in Belgium--in fact, around the world--, ought to be considered and treated. At the moment of his official retirement, he has an active patient census of 792 patients, 442 under the age of 18 years, at the Queen Fabiola University Children's Hospital in Brussels. As a member of the Hvidoere International Study Group on Childhood Diabetes, Dr Dorchy's patients have the great honor of being the most successful study cohort: those with the lowest (ie. best) levels of hemoglobin A1c. And they do so without excessive hypoglycemia! Dr Dorchy has had 490 publications as an author in his scientific career, 335 as first author. Dr Dorchy's research has complemented his superb work as a clinician : screening for subclinical complications, normal and flexible diet, physical activity, glycemic control and insulin treatment, quality of life, genetics and immunology, specific types of diabetes, etc. Since 1996, with his pediatric diabetologist comrade, Professor Stuart Brink from Boston, he has traveled annually to Romania to help organize, administer and teach at an annual ISPAD-Timisoara Pediatric and Adolescent Diabetes Post-Graduate Course with Professor Viorel Serban.

  3. Pediatric hydrocephalus outcomes: a review

    PubMed Central

    2012-01-01

    The outcome of pediatric hydrocephalus, including surgical complications, neurological sequelae and academic achievement, has been the matter of many studies. However, much uncertainty remains, regarding the very long-term and social outcome, and the determinants of complications and clinical outcome. In this paper, we review the different facets of outcome, including surgical outcome (shunt failure, infection and independence, and complications of endoscopy), clinical outcome (neurological, sensory, cognitive sequels, epilepsy), schooling and social integration. We then provide a brief review of the English-language literature and highlighting selected studies that provide information on the outcome and sequelae of pediatric hydrocephalus, and the impact of predictive variables on outcome. Mortality caused by hydrocephalus and its treatments is between 0 and 3%, depending on the duration of follow-up. Shunt event-free survival (EFS) is about 70% at one year and 40% at ten years. The EFS after endoscopic third ventriculostomy (ETV) appears better but likely benefits from selection bias and long-term figures are not available. Shunt infection affects between 5 and 8% of surgeries, and 15 to 30% of patients according to the duration of follow-up. Shunt independence can be achieved in 3 to 9% of patients, but the definition of this varies. Broad variations in the prevalence of cognitive sequelae, affecting 12 to 50% of children, and difficulties at school, affecting between 20 and 60%, attest of disparities among studies in their clinical evaluation. Epilepsy, affecting 6 to 30% of patients, has a serious impact on outcome. In adulthood, social integration is poor in a substantial number of patients but data are sparse. Few controlled prospective studies exist regarding hydrocephalus outcomes; in their absence, largely retrospective studies must be used to evaluate the long-term consequences of hydrocephalus and its treatments. This review aims to help to establish

  4. Of Mice and Monkeys: Can Animal Models Be Utilized to Study Neurological Consequences of Pediatric HIV-1 Infection?

    PubMed Central

    Carryl, Heather; Swang, Melanie; Lawrence, Jerome; Curtis, Kimberly; Kamboj, Herman; Van Rompay, Koen K. A.; De Paris, Kristina; Burke, Mark W.

    2015-01-01

    Pediatric human immunodeficiency virus (HIV-1) infection remains a global health crisis. Children are much more susceptible to HIV-1 neurological impairments than adults, which can be exacerbated by coinfections. Neurological characteristics of pediatric HIV-1 infection suggest dysfunction in the frontal cortex as well as the hippocampus; limited MRI data indicate global cerebral atrophy, and pathological data suggest accelerated neuronal apoptosis in the cortex. An obstacle to pediatric HIV-1 research is a human representative model system. Host-species specificity of HIV-1 limits the ability to model neurological consequences of pediatric HIV-1 infection in animals. Several models have been proposed including neonatal intracranial injections of HIV-1 viral proteins in rats and perinatal simian immunodeficiency virus (SIV) infection of infant macaques. Nonhuman primate models recapitulate the complexity of pediatric HIV-1, neuropathogenesis while rodent models are able to elucidate the role specific viral proteins exert on neurodevelopment. Nonhuman primate models show similar behavioral and neuropathological characteristics to pediatric HIV-1 infection and offer a stage to investigate early viral mechanisms, latency reservoirs, and therapeutic interventions. Here we review the relative strengths and limitations of pediatric HIV-1 model systems. PMID:26034832

  5. Microcomputer-Based Pediatric Health Maintenance System

    PubMed Central

    Maxwell, Carron M.; Philipsborn, Herbert F.; Napier, Robin; Nigro, Rise

    1983-01-01

    The Pediatric Evaluation, Research and Tracking System (PERTS) is an automated health maintenance and tracking system implemented on a microcomputer. This summary of significant medical information is used to support more effective patient care, operations research, training and program planning for a pediatric group practice in a suburban teaching hospital. The System's programs are designed to be convenient for use by health professionals and clerical staff. The system is implemented on a 64K microcomputer using MBASIC under MP/M and KSAM.

  6. How to approach the pediatric flatfoot

    PubMed Central

    Vulcano, Ettore; Maccario, Camilla; Myerson, Mark S

    2016-01-01

    The most difficult aspect regarding treatment of the pediatric flatfoot is understanding who needs surgery, when it is necessary, and what procedure to be done. A thorough history, clinical examination, and imaging should be performed to guide the surgeon through an often complex treatment path. Surgical technique can be divided in three categories: Soft tissue, bony, and arthroereisis. This paper will describe the joint preserving techniques and their application to treat the pediatric flatfoot deformity. PMID:26807350

  7. New immunosuppressive agents in pediatric transplantation

    PubMed Central

    Nguyen, Christina; Shapiro, Ron

    2014-01-01

    Immunosuppressive therapy in pediatrics continues to evolve. Over the past decade, newer immunosuppressive agents have been introduced into adult and pediatric transplant patients with the goal of improving patient and allograft survival. Unfortunately, large-scale randomized clinical trials are not commonly performed in children. The purpose of this review is to discuss the newer immunosuppressive agents available for induction therapy, maintenance immunosuppression, and the treatment of rejection. PMID:24860853

  8. New immunosuppressive agents in pediatric transplantation.

    PubMed

    Nguyen, Christina; Shapiro, Ron

    2014-01-01

    Immunosuppressive therapy in pediatrics continues to evolve. Over the past decade, newer immunosuppressive agents have been introduced into adult and pediatric transplant patients with the goal of improving patient and allograft survival. Unfortunately, large-scale randomized clinical trials are not commonly performed in children. The purpose of this review is to discuss the newer immunosuppressive agents available for induction therapy, maintenance immunosuppression, and the treatment of rejection.

  9. How to approach the pediatric flatfoot.

    PubMed

    Vulcano, Ettore; Maccario, Camilla; Myerson, Mark S

    2016-01-18

    The most difficult aspect regarding treatment of the pediatric flatfoot is understanding who needs surgery, when it is necessary, and what procedure to be done. A thorough history, clinical examination, and imaging should be performed to guide the surgeon through an often complex treatment path. Surgical technique can be divided in three categories: Soft tissue, bony, and arthroereisis. This paper will describe the joint preserving techniques and their application to treat the pediatric flatfoot deformity. PMID:26807350

  10. Pediatric throwing injuries about the elbow.

    PubMed

    DaSilva, M F; Williams, J S; Fadale, P D; Hulstyn, M J; Ehrlich, M G

    1998-02-01

    Pediatric elbow injuries that result from repetitive throwing-type activities are common. These injuries differ from those seen in adults, because of anatomic differences. The purpose of this paper is twofold: first, to review the anatomy of the elbow and the mechanics of the throwing motion about the elbow, and second, to discuss the diagnosis, treatment, rehabilitation, and prevention of pediatric throwing injuries of the elbow.

  11. Pediatric hernias and hydroceles. The urologist's perspective.

    PubMed

    Skoog, S J; Conlin, M J

    1995-02-01

    Pediatric inguinal hernias and hydroceles are due to incomplete or abnormal obliteration of the processus vaginalis. Surgical correction of these conditions is the most common surgical procedure performed on young children. The embryology, anatomy, evaluation, and management of pediatric inguinal hernias and hydroceles are reviewed. A thorough understanding of these topics will aid with the sometimes difficult decisions encountered in the care of these patients.

  12. Preparing pediatric nurse leaders for practice.

    PubMed

    O'Conner-Von, Susan K; Looman, Wendy S; Lindeke, Linda L; Garwick, Ann; Leonard, Barbara

    2009-01-01

    The growing prevalence of chronic conditions in childhood underscores the urgent need to educate pediatric nurse leaders to address the complex issues these children and families face. This article describes a model of graduate education for preparing pediatric nurse leaders who are equipped to manage and advocate for these children and families. Fifty-one master's prepared graduates completed a Strategic Plan Needs Assessment Survey in 2007 and were asked to indicate specific clinical and leadership competencies that they perceived were essential for pediatric nurse leaders in their areas of practice. Results revealed the highest priority for continuing education and outreach regarding pediatric health to be clinical updates and management of children with special healthcare needs (CSHCN), followed by health promotion for CSHCN and care coordination/case management. The highest priority for continuing education and outreach regarding leadership in pediatrics was evidence-based practice, followed by team care/interdisciplinary practice. The challenge for current nurse leaders is to be cognizant of the urgent need to prepare and retain future pediatric nurse leaders who are experts in the care of CSHCN and their families.

  13. Nanomedicines in the future of pediatric therapy.

    PubMed

    Sosnik, Alejandro; Carcaboso, Angel M

    2014-06-01

    Nanotechnology has become a key tool to overcome the main (bio)pharmaceutical drawbacks of drugs and to enable their passive or active targeting to specific cells and tissues. Pediatric therapies usually rely on the previous clinical experience in adults. However, there exists scientific evidence that drug pharmacokinetics and pharmacodynamics in children differ from those in adults. For example, the interaction of specific drugs with their target receptors undergoes changes over the maturation of the different organs and systems. A similar phenomenon is observed for toxicity and adverse effects. Thus, it is clear that the treatment of disease in children cannot be simplified to the direct adjustment of the dose to the body weight/surface. In this context, the implementation of innovative technologies (e.g., nanotechnology) in the pediatric population becomes extremely challenging. The present article overviews the different attempts to use nanotechnology to treat diseases in the pediatric population. Due to the relevance, though limited available literature on the matter, we initially describe from preliminary in vitro studies to preclinical and clinical trials aiming to treat pediatric infectious diseases and pediatric solid tumors by means of nanotechnology. Then, the perspectives of pediatric nanomedicine are discussed.

  14. The use of bisphosphonates in pediatrics.

    PubMed

    Baroncelli, Giampiero I; Bertelloni, Silvano

    2014-01-01

    Bisphosphonates are widely used for the prevention and treatment of osteoporosis in adulthood. In the last years, bisphosphonates have been increasingly used in pediatric patients for the treatment of a growing number of disorders associated with osteoporosis, resistant hypercalcemia or heterotopic calcifications. The use of bisphosphonates in pediatric patients has been proven safe; however, the risk of potential severe consequences into adulthood should be kept in mind. Well-defined criteria for bisphosphonates treatment in pediatric patients are not specified, therefore an accurate selection of patients who could benefit from bisphosphonates is mandatory. A strict follow-up of pediatric patients receiving long-term bisphosphonate therapy is strongly recommended. The purpose of this mini review is to provide a summary of current knowledge on some main general aspects of the structure, mechanisms of action, pharmacokinetics, and bioavailability of bisphosphonates, and to focus on the latest advances of bisphosphonate treatment in pediatric patients. Particular attention has been paid to the common and potential adverse effects of bisphosphonate treatment, and some suggestions concerning the clinical approach and general measures for bisphosphonate treatment in pediatric patients are reported.

  15. Pediatric AML: From Biology to Clinical Management

    PubMed Central

    de Rooij, Jasmijn D. E.; Zwaan, C. Michel; van den Heuvel-Eibrink, Marry

    2015-01-01

    Pediatric acute myeloid leukemia (AML) represents 15%–20% of all pediatric acute leukemias. Survival rates have increased over the past few decades to ~70%, due to improved supportive care, optimized risk stratification and intensified chemotherapy. In most children, AML presents as a de novo entity, but in a minority, it is a secondary malignancy. The diagnostic classification of pediatric AML includes a combination of morphology, cytochemistry, immunophenotyping and molecular genetics. Outcome is mainly dependent on the initial response to treatment and molecular and cytogenetic aberrations. Treatment consists of a combination of intensive anthracycline- and cytarabine-containing chemotherapy and stem cell transplantation in selected genetic high-risk cases or slow responders. In general, ~30% of all pediatric AML patients will suffer from relapse, whereas 5%–10% of the patients will die due to disease complications or the side-effects of the treatment. Targeted therapy may enhance anti-leukemic efficacy and minimize treatment-related morbidity and mortality, but requires detailed knowledge of the genetic abnormalities and aberrant pathways involved in leukemogenesis. These efforts towards future personalized therapy in a rare disease, such as pediatric AML, require intensive international collaboration in order to enhance the survival rates of pediatric AML, while aiming to reduce long-term toxicity. PMID:26237023

  16. Pioneers in Pediatric Psychology: Integrating Nutrition and Child Development Interventions

    PubMed Central

    2015-01-01

    As part of the Pioneers in Pediatric Psychology series, this article provides a brief personal account of Maureen Black's career as a pediatric psychologist. It traces the transition of the Society of Pediatric Psychology (SPP) from a section of the Division of Clinical Psychology of the American Psychological Association (APA) to an independent division of APA, which occurred during my presidency of SPP. The article addresses three aspects of pediatric psychology that have been central to my career: pediatric nutritional problems, global child development, and the advancement of children's health and development through policy-related strategies. The article concludes with Lessons Learned and Recommendations for the future of pediatric psychology. PMID:25619198

  17. Pioneers in pediatric psychology: integrating nutrition and child development interventions.

    PubMed

    Black, Maureen M

    2015-05-01

    As part of the Pioneers in Pediatric Psychology series, this article provides a brief personal account of Maureen Black's career as a pediatric psychologist. It traces the transition of the Society of Pediatric Psychology (SPP) from a section of the Division of Clinical Psychology of the American Psychological Association (APA) to an independent division of APA, which occurred during my presidency of SPP. The article addresses three aspects of pediatric psychology that have been central to my career: pediatric nutritional problems, global child development, and the advancement of children's health and development through policy-related strategies. The article concludes with Lessons Learned and Recommendations for the future of pediatric psychology.

  18. Evaluating the need for alternative didactic learning options in pediatric dental residency training.

    PubMed

    Keck, Douglas B; Rutkauskas, John S; Clothey, Rebecca A

    2009-06-01

    The need for an alternative means of delivery of a didactic curriculum to pediatric dental residents is described. It is our hope with this project to encourage a much-needed didactic curriculum for programs lacking faculty and to endorse other programs in which academicians exist but cannot cover all the material with which a resident needs to become familiar in the two years of postgraduate residency training. A decrease in faculty number due to retirement, debt burden, or marginal recruitment techniques along with an increase in positions in pediatric dentistry residency programs poses a unique educational dilemma. Using a mixed-method research methodology, we sent a twelve-question survey to 105 pediatric dentistry residency program directors and department chairs, followed by eight telephone interviews. Results from a 55 percent return rate show that the debt burden of most pediatric dental residents is well over $100,000 and that this affects a resident's decision to enter academia, as does the relative lack of positive recruitment techniques and poor faculty remuneration. The survey results affirm the need for improvement in the didactic curriculum of pediatric dentistry residents and show that program directors and department chairs also feel that an alternative delivery method using DVD or online/web-based programs would be welcomed. Despite their extremely heavy workloads, educators are willing to contribute by providing lectures or reading lists in their area of expertise.

  19. Creating a Pediatric Digital Library for Pediatric Health Care Providers and Families

    PubMed Central

    D'Alessandro, Donna; Kingsley, Peggy

    2002-01-01

    The goal of this study was to complete a literature-based needs assessment with regard to common pediatric problems encountered by pediatric health care providers (PHCPs) and families, and to develop a problem-based pediatric digital library to meet those needs. The needs assessment yielded 65 information sources. Common problems were identified and categorized, and the Internet was manually searched for authoritative Web sites. The created pediatric digital library (www.generalpediatrics.com) used a problem-based interface and was deployed in November 1999. From November 1999 to November 2000, the number of hyperlinks and authoritative Web sites increased 51.1 and 32.2 percent, respectively. Over the same time, visitors increased by 57.3 percent and overall usage increased by 255 percent. A pediatric digital library has been created that begins to bring order to general pediatric resources on the Internet. This pediatric digital library provides current, authoritative, easily accessed pediatric information whenever and wherever the PHCPs and families want assistance. PMID:11861631

  20. Teaching Pediatric Nursing Concepts to Non-Pediatric Nurses Using an Advance Organizer

    ERIC Educational Resources Information Center

    Bell, Julie Ann

    2013-01-01

    Non-pediatric nurses in rural areas often care for children in adult units, emergency departments, and procedural areas. A half-day program about pediatric nursing using constructivist teaching strategies including an advance organizer, case studies, and simulation was offered at a community hospital in Western North Carolina. Nurses reported a…

  1. The US pediatric nephrology workforce: a report commissioned by the American Academy of Pediatrics.

    PubMed

    Primack, William A; Meyers, Kevin E; Kirkwood, Suzanne J; Ruch-Ross, Holly S; Radabaugh, Carrie L; Greenbaum, Larry A

    2015-07-01

    The US pediatric nephrology workforce is poorly characterized. This report describes clinical and nonclinical activities, motivations and disincentives to a career in pediatric nephrology, future workforce needs, trainee recruitment, and possible explanations for personnel shortages. An e-mail survey was sent in 2013 to all identified US-trained or -practicing pediatric nephrologists. Of 504 respondents, 51% are men, 66% are US graduates, and 73% work in an academic setting. About 20% of trained pediatric nephrologists no longer practice pediatric nephrology. Among the 384 respondents practicing pediatric nephrology full or part-time in the United States, the mean work week was 56.1±14.3 hours, with time divided between patient care (59%), administration (13%), teaching (10%), clinical research (9%), basic research (6%), and other medical activities (3%). Most (>85%) care for dialysis and transplantation patients. The median number of weeks annually on call is 16, and 29% work with one or no partner. One-third of US pediatric nephrologists (n=126) plan to reduce or stop clinical nephrology practice in the next 5 years, and 53% plan to fully or partially retire. Almost half the division chiefs (47%) report inadequate physician staffing. Ongoing efforts to monitor and address pediatric nephrology workforce issues are needed. PMID:25911315

  2. The US pediatric nephrology workforce: a report commissioned by the American Academy of Pediatrics.

    PubMed

    Primack, William A; Meyers, Kevin E; Kirkwood, Suzanne J; Ruch-Ross, Holly S; Radabaugh, Carrie L; Greenbaum, Larry A

    2015-07-01

    The US pediatric nephrology workforce is poorly characterized. This report describes clinical and nonclinical activities, motivations and disincentives to a career in pediatric nephrology, future workforce needs, trainee recruitment, and possible explanations for personnel shortages. An e-mail survey was sent in 2013 to all identified US-trained or -practicing pediatric nephrologists. Of 504 respondents, 51% are men, 66% are US graduates, and 73% work in an academic setting. About 20% of trained pediatric nephrologists no longer practice pediatric nephrology. Among the 384 respondents practicing pediatric nephrology full or part-time in the United States, the mean work week was 56.1±14.3 hours, with time divided between patient care (59%), administration (13%), teaching (10%), clinical research (9%), basic research (6%), and other medical activities (3%). Most (>85%) care for dialysis and transplantation patients. The median number of weeks annually on call is 16, and 29% work with one or no partner. One-third of US pediatric nephrologists (n=126) plan to reduce or stop clinical nephrology practice in the next 5 years, and 53% plan to fully or partially retire. Almost half the division chiefs (47%) report inadequate physician staffing. Ongoing efforts to monitor and address pediatric nephrology workforce issues are needed.

  3. Ethics consultation in pediatrics: long-term experience from a pediatric oncology center.

    PubMed

    Johnson, Liza-Marie; Church, Christopher L; Metzger, Monika; Baker, Justin N

    2015-01-01

    There is little information about the content of ethics consultations (EC) in pediatrics. We sought to describe the reasons for consultation and ethical principles addressed during EC in pediatrics through retrospective review and directed content analysis of EC records (2000-2011) at St. Jude Children's Research Hospital. Patient-based EC were highly complex and often involved evaluation of parental decision making, particularly consideration of the risks and benefits of a proposed medical intervention, and the physician's fiduciary responsibility to the patient. Nonpatient consultations provided guidance in the development of institutional policies that would broadly affect patients and families. This is one of the few existing reviews of the content of pediatric EC and indicates that the distribution of ethical issues and reasons for moral distress are different than with adults. Pediatric EC often facilitates complex decision making among multiple stakeholders, and further prospective research is needed on the role of ethics consultation in pediatrics.

  4. Ethics consultation in pediatrics: long-term experience from a pediatric oncology center.

    PubMed

    Johnson, Liza-Marie; Church, Christopher L; Metzger, Monika; Baker, Justin N

    2015-01-01

    There is little information about the content of ethics consultations (EC) in pediatrics. We sought to describe the reasons for consultation and ethical principles addressed during EC in pediatrics through retrospective review and directed content analysis of EC records (2000-2011) at St. Jude Children's Research Hospital. Patient-based EC were highly complex and often involved evaluation of parental decision making, particularly consideration of the risks and benefits of a proposed medical intervention, and the physician's fiduciary responsibility to the patient. Nonpatient consultations provided guidance in the development of institutional policies that would broadly affect patients and families. This is one of the few existing reviews of the content of pediatric EC and indicates that the distribution of ethical issues and reasons for moral distress are different than with adults. Pediatric EC often facilitates complex decision making among multiple stakeholders, and further prospective research is needed on the role of ethics consultation in pediatrics. PMID:25970382

  5. Degradation of AF1Q by chaperone-mediated autophagy

    SciTech Connect

    Li, Peng; Ji, Min; Lu, Fei; Zhang, Jingru; Li, Huanjie; Cui, Taixing; Li Wang, Xing; Tang, Dongqi; Ji, Chunyan

    2014-09-10

    AF1Q, a mixed lineage leukemia gene fusion partner, is identified as a poor prognostic biomarker for pediatric acute myeloid leukemia (AML), adult AML with normal cytogenetic and adult myelodysplastic syndrome. AF1Q is highly regulated during hematopoietic progenitor differentiation and development but its regulatory mechanism has not been defined clearly. In the present study, we used pharmacological and genetic approaches to influence chaperone-mediated autophagy (CMA) and explored the degradation mechanism of AF1Q. Pharmacological inhibitors of lysosomal degradation, such as chloroquine, increased AF1Q levels, whereas activators of CMA, including 6-aminonicotinamide and nutrient starvation, decreased AF1Q levels. AF1Q interacts with HSPA8 and LAMP-2A, which are core components of the CMA machinery. Knockdown of HSPA8 or LAMP-2A increased AF1Q protein levels, whereas overexpression showed the opposite effect. Using an amino acid deletion AF1Q mutation plasmid, we identified that AF1Q had a KFERQ-like motif which was recognized by HSPA8 for CMA-dependent proteolysis. In conclusion, we demonstrate for the first time that AF1Q can be degraded in lysosomes by CMA. - Highlights: • Chaperone-mediated autophagy (CMA) is involved in the degradation of AF1Q. • Macroautophagy does not contribute to the AF1Q degradation. • AF1Q has a KFERQ-like motif that is recognized by CMA core components.

  6. The effects of pediatric epilepsy on a language connectome.

    PubMed

    Eddin, Anas Salah; Wang, Jin; Wu, Wensong; Sargolzaei, Saman; Bjornson, Bruce; Jones, Richard A; Gaillard, William D; Adjouadi, Malek

    2014-12-01

    This study introduces a new approach for assessing the effects of pediatric epilepsy on a language connectome. Two novel data-driven network construction approaches are presented. These methods rely on connecting different brain regions using either extent or intensity of language related activations as identified by independent component analysis of fMRI. An auditory word definition decision task paradigm was used to activate the language network for 29 patients and 30 controls. Evaluations illustrated that pediatric epilepsy is associated with a network efficiency reduction. Patients showed a propensity to inefficiently use the whole brain network to perform the language task; whereas, controls seemed to efficiently use smaller segregated network components to achieve the same task. To explain the causes of the decreased efficiency, graph theoretical analysis was performed. The analysis revealed substantial global network feature differences between the patients and controls for the extent of activation network. It also showed that for both subject groups the language network exhibited small-world characteristics; however, the patient's extent of activation network showed a tendency toward randomness. It was also shown that the intensity of activation network displayed ipsilateral hub reorganization on the local level. We finally showed that a clustering scheme was able to fairly separate the subjects into their respective patient or control groups. The clustering was initiated using local and global nodal measurements. Compared to the intensity of activation network, the extent of activation network clustering demonstrated better precision. This ascertained that the network differences presented by the networks were associated with pediatric epilepsy.

  7. Effects of Vibration Therapy in Pediatric Immunizations.

    PubMed

    Benjamin, Arika L; Hendrix, Thomas J; Woody, Jacque L

    2016-01-01

    A randomized clinical trial of 100 children (52 boys, 48 girls) ages 2 months to 7 years was conducted to evaluate the effect of vibration therapy without cold analgesia on pain. A convenience sample was recruited at two sites: a publicly funded, free immunization clinic and a private group pediatric practice. Participants were randomly assigned to receive vibration therapy via a specialized vibrating device or standard care. All children regardless of intervention group were allowed to be distracted and soothed by the parent. Pain was evaluated using the FLACC score, which two nurses assessed at three points in time: prior to, during, and after the injection(s). Data were analyzed using a two-independent samples-paired t-test. Results show that vibration therapy had no effect on pain scores in the younger age groups studied (2 months ≤ 1 year, > 1 year ≤ 4 years). In the oldest age group (> 4 to 7 years of age), a heightened pain reading was found in the period from preinjection to post-injection periods (p = 0.045). These results indicate that the addition of vibration therapy (without cold analgesia) to standard soothing techniques is no more effective in reducing immunization pain than standard soothing techniques alone, and thus, is not indicated for use with immunization pain. Recommendations include further evaluation of interventions. PMID:27468514

  8. The pediatric template of brain perfusion.

    PubMed

    Avants, Brian B; Duda, Jeffrey T; Kilroy, Emily; Krasileva, Kate; Jann, Kay; Kandel, Benjamin T; Tustison, Nicholas J; Yan, Lirong; Jog, Mayank; Smith, Robert; Wang, Yi; Dapretto, Mirella; Wang, Danny J J

    2015-01-01

    Magnetic resonance imaging (MRI) captures the dynamics of brain development with multiple modalities that quantify both structure and function. These measurements may yield valuable insights into the neural patterns that mark healthy maturation or that identify early risk for psychiatric disorder. The Pediatric Template of Brain Perfusion (PTBP) is a free and public neuroimaging resource that will help accelerate the understanding of childhood brain development as seen through the lens of multiple modality neuroimaging and in relation to cognitive and environmental factors. The PTBP uses cross-sectional and longitudinal MRI to quantify cortex, white matter, resting state functional connectivity and brain perfusion, as measured by Arterial Spin Labeling (ASL), in 120 children 7-18 years of age. We describe the PTBP and show, as a demonstration of validity, that global summary measurements capture the trajectories that demarcate critical turning points in brain maturation. This novel resource will allow a more detailed understanding of the network-level, structural and functional landmarks that are obtained during normal adolescent brain development. PMID:25977810

  9. The pediatric template of brain perfusion

    PubMed Central

    Avants, Brian B; Duda, Jeffrey T; Kilroy, Emily; Krasileva, Kate; Jann, Kay; Kandel, Benjamin T; Tustison, Nicholas J; Yan, Lirong; Jog, Mayank; Smith, Robert; Wang, Yi; Dapretto, Mirella; Wang, Danny J J

    2015-01-01

    Magnetic resonance imaging (MRI) captures the dynamics of brain development with multiple modalities that quantify both structure and function. These measurements may yield valuable insights into the neural patterns that mark healthy maturation or that identify early risk for psychiatric disorder. The Pediatric Template of Brain Perfusion (PTBP) is a free and public neuroimaging resource that will help accelerate the understanding of childhood brain development as seen through the lens of multiple modality neuroimaging and in relation to cognitive and environmental factors. The PTBP uses cross-sectional and longitudinal MRI to quantify cortex, white matter, resting state functional connectivity and brain perfusion, as measured by Arterial Spin Labeling (ASL), in 120 children 7–18 years of age. We describe the PTBP and show, as a demonstration of validity, that global summary measurements capture the trajectories that demarcate critical turning points in brain maturation. This novel resource will allow a more detailed understanding of the network-level, structural and functional landmarks that are obtained during normal adolescent brain development. PMID:25977810

  10. Effects of Vibration Therapy in Pediatric Immunizations.

    PubMed

    Benjamin, Arika L; Hendrix, Thomas J; Woody, Jacque L

    2016-01-01

    A randomized clinical trial of 100 children (52 boys, 48 girls) ages 2 months to 7 years was conducted to evaluate the effect of vibration therapy without cold analgesia on pain. A convenience sample was recruited at two sites: a publicly funded, free immunization clinic and a private group pediatric practice. Participants were randomly assigned to receive vibration therapy via a specialized vibrating device or standard care. All children regardless of intervention group were allowed to be distracted and soothed by the parent. Pain was evaluated using the FLACC score, which two nurses assessed at three points in time: prior to, during, and after the injection(s). Data were analyzed using a two-independent samples-paired t-test. Results show that vibration therapy had no effect on pain scores in the younger age groups studied (2 months ≤ 1 year, > 1 year ≤ 4 years). In the oldest age group (> 4 to 7 years of age), a heightened pain reading was found in the period from preinjection to post-injection periods (p = 0.045). These results indicate that the addition of vibration therapy (without cold analgesia) to standard soothing techniques is no more effective in reducing immunization pain than standard soothing techniques alone, and thus, is not indicated for use with immunization pain. Recommendations include further evaluation of interventions.

  11. Overview of Pediatric Testicular Tumors in Korea

    PubMed Central

    Chung, Jae Min

    2014-01-01

    Prepubertal testicular tumors are rare compared with postpubertal testicular tumors. The incidence of prepubertal testicular tumors peaks at 2 years of age, tapers off after 4 years of age, and then begins to rise again at puberty. Prepubertal and postpubertal testicular tumors show many differences, including the typical tumor histology, molecular biological differences, and the malignant potential of tumors at different ages. Pediatric testicular tumors are classified as benign or malignant on the basis of their clinical behavior and histologically are divided into germ cell and gonadal stromal (nongerm cell) tumors. Many histological and biological studies have further confirmed the distinct nature of prepubertal and postpubertal testicular tumors. These differences have led to various management strategies for prepubertal and postpubertal tumors. Because overall about 75% of prepubertal testicular tumors are benign, a testis-sparing approach is becoming more common in children. Orchiectomy and observation with very selective use of chemotherapy has become the standard approach when a malignant tumor is identified. Retroperitoneal lymph node dissection and radiation therapy play very limited roles. PMID:25512812

  12. The diagnosis and treatment of pediatric narcolepsy.

    PubMed

    Nevsimalova, Sona

    2014-08-01

    Narcolepsy in children is a serious disorder marked by a chronic course and lifelong handicap in school performance and choice of employment, by free time activity limitation, and by behavior and personality changes, all of which constitute a major influence on the quality of life. Increased daytime sleepiness may be the only sign at the disease onset, with attacks of sleep becoming longer and lasting up to hours. Also present may be confusional arousals with features of sleep drunkenness. Paradoxically, preschool and young children may show inattentiveness, emotional lability, and hyperactive behavior. Cataplexy may develop after onset of sleepiness and affect mainly muscles of the face. Hypnagogic hallucinations and sleep paralysis are seldom present. Multiple Sleep Latency Test criteria are not available for children younger than 6 years. The haplotype (HLA-DQB1:0602) can be associated with the disorder; however, the best predictor of narcolepsy-cataplexy is hypocretin deficiency. The treatment generally used in adults is regarded as off-label in childhood, which is why the management of pediatric narcolepsy is difficult. PMID:24954623

  13. Pediatric oncology in Morocco: achievements and challenges.

    PubMed

    Hessissen, Laila; Madani, Abdellah

    2012-03-01

    Cancer in children is quickly becoming one of the leading causes of non traumatic death among children. In pediatric oncology, palliative care is a primary component of the cancer control plan. In low income countries also known as emerging nations or developing countries access to adequate care remains a challenge for most pediatric oncology patients. In Morocco the situation has dramatically improved in the last few years as both the government and NGOs have become more aware of the importance and urgency of the issue. The incidence of cancer in patients under 15 years of age in Morocco is estimated to be 1000 new cases per year and the incidence of leukemia to be 100 new cases diagnosed per year. Pediatric cancer patients are mostly managed by public hospitals. Thus they are highly influenced by the Moroccan public health system, which is now considering cancer management a priority. Since health cover is very limited, most chemotherapy drugs were purchased by local parent associations. Recently, a new large Moroccan NGO (ALSC) provides anti-cancer drugs to all government-run oncology units. Despite all the progress, Morocco has witnessed in the pediatric oncology field, the palliative aspect of the care is not yet organized. Pediatric oncology is supported by the work of the National Society of Pediatric Oncolgy. The opioide therapy is available. However its use is strongly limited by the current restrictive and obsolete legislation which represents a major barrier to care. Despite the latest progress, pediatric oncology in Morocco still needs to improve in order to achieve performances comparable to those of the developed world. These improvements include better survival rates, less treatment abandonment, developing new techniques, improving quality of life and creating data collection teams. In order for this action to succeed all the stakeholders (government, NGOs, medical societies, oncology teams) must work together and coordinate their efforts.

  14. 8. Detail showing concrete abutment, showing substructure of bridge, specifically ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. Detail showing concrete abutment, showing substructure of bridge, specifically west side of arch and substructure. - Presumpscot Falls Bridge, Spanning Presumptscot River at Allen Avenue extension, 0.75 mile west of U.S. Interstate 95, Falmouth, Cumberland County, ME

  15. 28. MAP SHOWING LOCATION OF ARVFS FACILITY AS BUILT. SHOWS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    28. MAP SHOWING LOCATION OF ARVFS FACILITY AS BUILT. SHOWS LINCOLN BOULEVARD, BIG LOST RIVER, AND NAVAL REACTORS FACILITY. F.C. TORKELSON DRAWING NUMBER 842-ARVFS-101-2. DATED OCTOBER 12, 1965. INEL INDEX CODE NUMBER: 075 0101 851 151969. - Idaho National Engineering Laboratory, Advanced Reentry Vehicle Fusing System, Scoville, Butte County, ID

  16. Constructing and assessing brain templates from Chinese pediatric MRI data using SPM

    NASA Astrophysics Data System (ADS)

    Yin, Qingjie; Ye, Qing; Yao, Li; Chen, Kewei; Jin, Zhen; Liu, Gang; Wu, Xingchun; Wang, Tingting

    2005-04-01

    Spatial normalization is a very important step in the processing of magnetic resonance imaging (MRI) data. So the quality of brain templates is crucial for the accuracy of MRI analysis. In this paper, using the classical protocol and the optimized protocol plus nonlinear deformation, we constructed the T1 whole brain templates and apriori brain tissue data from 69 Chinese pediatric MRI data (age 7-16 years). Then we proposed a new assessment method to evaluate our templates. 10 pediatric subjects were chosen to do the assessment as the following steps. First, the cerebellum region, the region of interest (ROI), was located on both the pediatric volume and the template volume by an experienced neuroanatomist. Second, the pediatric whole brain was mapped to the template with affine and nonlinear deformation. Third, the parameter, derived from the second step, was used to only normalize the ROI of the child to the ROI of the template. Last, the overlapping ratio, which described the overlapping rate between the ROI of the template and the normalized ROI of the child, was calculated. The mean of overlapping ratio normalized to the classical template was 0.9687, and the mean normalized to the optimized template was 0.9713. The results show that the two Chinese pediatric brain templates are comparable and their accuracy is adequate to our studies.

  17. Early goal-directed therapy in treatment of pediatric septic shock.

    PubMed

    de Oliveira, Cláudio Flauzino

    2010-09-01

    In the whole world, around 29,000 children younger than 5 years die every day, and sepsis is the most common cause of death. Whereas in adult patients vasomotor paralysis represents the predominant cause of mortality, death in pediatric sepsis is associated with severe hypovolemia and low cardiac output. The purpose of this article was to review the recent evidence on early treatment of pediatric severe sepsis and septic shock. Although current American College of Critical Care Medicine-Pediatric Advanced Life Support guidelines represent best practice, stronger evidences are lacking to confirm the components of these recommendations. Retrospective studies showed, at the same time, the positive effects arising from the utilization of American College of Critical Care Medicine-Pediatric Advanced Life Support guidelines and the existing barriers to its implementation. And one randomized control trial paralleled the results observed in adult patients and revealed that early goal-directed therapy in children is one of the few therapeutic interventions that proved to be beneficial in septic shock treatment. Early goal-directed therapy in pediatric septic shock is a successful method to optimize and parameterize treatment, but there is still a long way to turn septic shock resuscitation simpler and more widely spread.

  18. Assessment of the contralesional corticospinal tract in early-onset pediatric hemiplegia: Preliminary findings.

    PubMed

    Hawe, Rachel L; Dewald, Jules P A

    2014-01-01

    While pediatric hemiplegia results from a unilateral lesion, the immature state of the brain at the time of injury increases the likelihood of observing changes in the non-lesioned hemisphere as well. The purpose of this preliminary study was to use diffusion tensor imaging to evaluate the contralesional corticospinal tracts in individuals with early-onset pediatric hemiplegia. Twelve individuals with pediatric hemiplegia and ten age-matched controls underwent diffusion tensor imaging (DTI). Corticospinal projections were reconstructed using probabilistic tractography for both the lesioned and contralesional side in pediatric hemiplegia as well as the dominant and non-dominant sides in control subjects. The contralesional tract was found to have decreased white matter integrity relative to control subjects. Compared to controls, the contralesional tract also showed increased tract volume. The increase in volume suggests the presence of ipsilateral corticospinal projections from the contralesional hemisphere that are maintained during development to control the paretic extremities. Decreases in integrity may be explained by diffuse damage or incomplete maturation. The findings of this study support the notion of bilateral motor involvement in pediatric hemiplegia, and the need to address bilateral neural changes as well as motor deficits in this population. PMID:25571199

  19. Orthodontic treatment and referral patterns: A survey of pediatric dentists, general practitioners, and orthodontists

    PubMed Central

    Aldrees, Abdullah M.; Tashkandi, Nada E.; AlWanis, Areej A.; AlSanouni, Munerah S.; Al-Hamlan, Nasir H.

    2014-01-01

    Objective This study aims to assess the orthodontic diagnostic skills, referral patterns, and the perceptions of orthodontic benefits of pediatric and general dentists in comparison with orthodontists. Materials and methods Two online surveys were e-mailed to pediatric dentists, general dentistry practitioners, and orthodontists registered as members of the Saudi Dental Society and the Saudi Orthodontic Society. The surveys included questions about the type of orthodontic treatment provided, referral trends, and timing; presumed benefits associated with successful orthodontic treatment; and diagnosis and treatment plans of seven cases representing different malocclusions. Results In total, 25 orthodontists, 18 pediatric dentists, and 14 general practitioners completed the survey. Only 38.8% of pediatric dentists and 7.1% of general practitioners reported that they practiced orthodontics clinically. The perceptions of the three groups toward the benefits of orthodontic treatment were comparable in the psychosocial areas. However, the orthodontists perceived significantly lesser effects of orthodontic treatment on the amelioration of temporomandibular disorder (TMD) symptoms. Pediatric dentists tended to rate the need and urgency of treatment higher, while general practitioners tended to rate the need of treatment lower. The selected treatment plans for three early malocclusion cases showed the greatest discrepancies between the orthodontists and the other two groups. Conclusions The orthodontists consistently and significantly downplayed the perceived benefit of orthodontic treatment to reduce TMD symptoms. Also, while there was a similarity in the diagnosis, there were notable differences in the proposed treatment approaches, perceived treatment need, and timing of intervention between the three groups of practitioners. PMID:25544812

  20. Pediatric acute myeloid leukemia as classified using 2008 WHO criteria: a single-center experience.

    PubMed

    Davis, Kara L; Marina, Neyssa; Arber, Daniel A; Ma, Lisa; Cherry, Athena; Dahl, Gary V; Heerema-McKenney, Amy

    2013-06-01

    The classification of acute myeloid leukemia (AML) has evolved to the most recent World Health Organization (WHO) schema, which integrates genetic, morphologic, and prognostic data into a single system. However, this system was devised using adult data and how this system applies to a pediatric cohort is unknown. Performing a retrospective chart review, we examined our single-center experience with AML in 115 children and classified their leukemia using the WHO 2008 schema. We examined patient samples for mutations of FLT3, NPM1, and CEBPA. Overall survival was calculated within categories. In our pediatric population, most cases of AML had recurrent genetic abnormalities of favorable prognosis. More than 10% of patients in our series were categorized as AML, with myelodysplasia-related changes, an entity not well-described in pediatric patients. In addition, a large proportion of patients were categorized with secondary, therapy-related AML. To our knowledge, this is the first application of the WHO 2008 classification to a pediatric cohort. In comparison to adult studies, AML in the pediatric population shows a distinct distribution within the WHO 2008 classification.