Team Approach: Pediatric Musculoskeletal Infection.

A team approach is optimal in the evaluation and treatment of musculoskeletal infection in pediatric patients given the complexity and uncertainty with which such infections manifest and progress, particularly among severely ill children. The team approach includes emergency medicine, pediatric intensive care, pediatric hospitalist medicine, infectious disease service, orthopaedic surgery, radiology, anesthesiology, pharmacology, and hematology. These services follow evidence-based clinical practice guidelines with integrated processes of care so that children and their families may benefit from data-driven continuous process improvement.

Breath-hold MR-HIFU hyperthermia: phantom and feasibility.

The use of magnetic resonance imaging-guided high-intensity focused ultrasound (MR-HIFU) to deliver mild hyperthermia requires stable temperature mapping for long durations. This study evaluates the effects of respiratory motion on MR thermometry precision in pediatric subjects and determines the feasibility of circumventing breathing-related motion artifacts by delivering MR thermometry-controlled HIFU mild hyperthermia during repeated forced breath holds. Clinical and preclinical studies were conducted.

Intrathecal Injections in Children With Spinal Muscular Atrophy: Nusinersen Clinical Trial Experience.

Nusinersen (ISIS-SMNRx or ISIS 396443) is an antisense oligonucleotide drug administered intrathecally to treat spinal muscular atrophy. We summarize lumbar puncture experience in children with spinal muscular atrophy during a phase 1 open-label study of nusinersen and its extension. During the studies, 73 lumbar punctures were performed in 28 patients 2 to 14 years of age with type 2/3 spinal muscular atrophy.

The VeinViewer vascular imaging system worsens first-attempt cannulation rate for experienced nurses in infants and children with anticipated difficult intravenous access.

Background: The VeinViewer (Luminetx, Memphis, TN) helps identify veins by projecting an image of subcutaneous vasculature on the skin surface. We tested the primary hypothesis that VeinViewer use improves cannulation success by skilled nurses in pediatric patients with anticipated difficult IV access. A secondary goal was to evaluate the relationship between obesity and cannulation success.

Back pain among long-term survivors of childhood leukemia.

Background: The objectives of this study are to determine the prevalence and relative risk (RR) of back pain and identify possible mechanisms of back pain among childhood acute lymphoblastic leukemia (ALL) survivors.

Methods: Surveys were mailed to 5 + -year survivors of childhood ALL aged 13 to 25 years. Survivors' siblings were also invited to participate in the study.

Intrathecal analgesic drug therapy.

Intrathecal analgesic infusion therapy through an implantable pump system is a sophisticated medical therapy for those who suffer from chronic, severe pain who are unresponsive to traditional medical therapy. This article describes the patient selection and monitoring process and reviews available intrathecal medications and combinations.