April 26, 2017
Volume VIII |  Issue No. 17

Factors associated with thrombotic complications in children with vascular malformations
From a study of 46 children with vascular malformations, half of whom presented with thrombotic complications, it appears that the risk of thrombosis increases with:
  1. Older age.
  2. D-dimer level.
  3. Vascular malformation > 10 cm2
  4. The presence of palpable phleboliths
Journal of Pediatric Surgery

See related video below:
Vascular Anomolies
Vascular Anomalies
Does an edematous and inflamed airway denote gastroesophageal reflux
An elegant prospective study of 77 children with chronic cough who had direct laryngoscopy and bronchoscopy,
esophagogastroduodenoscopy and multichannel intraluminal impedance testing with pH probe (MII-a catheter based method to detect intraluminal bolus movement in the esophagus and with a pH probe allows for detection of acid and non-acid reflux), to correlate airway inflammation with gastroesophageal reflux (GER), indicates that the presence of airway inflammation is a poor predictor of GER and should not be used as a basis for prescribing anti-reflux therapy.

Displaced radial neck fractures - functional outcomes 
Fractures of the radial neck in children frequently occur in 9-10 year olds and make up 1-5% of all pediatric elbow fractures. Management in children is still controversial.

A retrospective study of 51 children (ages 6-15 years) which examined various grades of severity of radial head fractures compared outcomes following closed reduction and casting (under general anesthesia); closed reductions with intramedullary nailing and open reduction with intramedullary nailing.

Using the Mayo Elbow Performance Score (MEPS) to evaluate outcomes from three different techniques to treat displaced radial neck fractures, it appears that there are no significant differences in outcome for the type of technique used. The worse the injury however the poorer the final functional outcome.
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Breast feeding, polyunsaturated fatty acid (PUFA) level in colostrum, and child intelligence Quotient (IQ) at 5-6 years of age.

PUFAs are a class of fatty acids which include the essential fatty acids omega-3, omega-6 and others. A healthy diet contains a balance of both. Omega-3 fatty acids reduce inflammation, play an important part in normal growth and development and are highly concentrated in the brain where they appear to be important for cognitive (memory and performance) and behavioral function. Omega-6s' play a role in stimulating hair and skin growth etc. and promote inflammation.

PUFAs' role as a supplement to enhance brain development in infants and children remains controversial.

A study which examined the relationship between PUFAs in colostrum, duration of breast feeding and subsequent child IQ indicates that both an increased omega-3 level and the duration of breast feeding are associated with an increased IQ level at 5-6 years of age.

Video Feature
PUFAsa nd Brain Health
PUFAs and Brain Health
Prediction of 3- to 5-months outcomes from signs of acute bilirubin toxicity in newborn babies 

The BIND score (bilirubin-induced neurologic dysfunction score) is used to assess bilirubin induced encephalopathy in neonates with severe hyperbilirubinemia. Made up of three parameters with four stages it has been used to identify infants at risk for kernicterus.

A study of 220 severely jaundiced (TSB: 33-38mg/dl) near- and full-term infants assessed and correlated using the BIND score at 6- to 8-hour intervals, neurologic and/or auditory outcomes at 3-5 months.

In severe hyperbilirubinemic full-term infants, a BIND score of 7-9 usually results in death (or significant neurological/auditory impairment). A BIND score of 4-6 results in 62.5% of infants being normal (with moderate encephalopathy and aggressive treatment). Only 4% if infants with BIND score less than 3 will have any residual neurologic and/or auditory dysfunction.

Characteristics of dog bites in children  

A review of 1,616 consecutive dog bites in children (over a four year period) identifies the following:
  1. In-patient admission is rare (9.8%).
  2. Repair of laceration is required in 58% (more likely in the >5 year old).
  3. Infants are 4 times more likely to be bitten by the family dog and 6 times more likely in the head/neck region.
  4. 5.5% of children require an operation, mostly from Pit bull bites with multiple anatomic locations.
Video Feature
Dog Bites in Children
Dog Bites in Children
Comparison of transumbilical multiport (TMLP) and standard laparoscopic pyeloplasty (SLP) in children
A study which compares TMLP (one-5mm and two-3mm ports) to SLP with traditional three-port technique for the repair of congenital ureteropelvic junction obstruction indicates that TMLP is feasible and gives similar outcomes with better cosmetic results.

Nicklaus Children's Hospital Performs the World's First Focused Ultrasound Surgery on Hypothalamic Hamartoma Tumor in Epilepsy Patient

A multidisciplinary clinical team at Nicklaus Children's Hospital used magnetic-resonance guided focused ultrasound to ablate a centrally located brain tumor in a young patient experiencing tumor-associated seizures.

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