Workload Measurement in Subspecialty Placental Pathology in Canada.

Background: Workload measurement is important to help determine optimal staffing and workload distribution for pathology laboratories. The Level 4 Equivalent (L4E) System is the most widely used Anatomical Pathology (AP) workload measurement tool in Canada. However, it was initially not developed with subspecialties in mind.

A Qualitative Evaluation of Program Budgeting and Marginal Analysis in a Canadian Pediatric Tertiary Care Institution.

Background: Hospitals in Canada are being asked by governments to improve efficiency and do more with fewer resources. Healthcare decision makers are thus driven to find better ways to manage budgets and deliver on their mission. Formal processes of priority setting and resource allocation (PSRA) are one means to this end.

Olly Olly Oxen Free (or Ally Ally in Free): Playing Hide and Seek in Allocating Resources for Child and Youth Health.

There are powerful arguments for increased investment in child and youth health. But the extent to which these benefits can be realized is shaped by health institutions' priority setting processes. We asked, "What are the unique features of a pediatric care setting that should influence choice and implementation of a formal priority setting and resource allocation process?" Based on multiple sources of data, we created a "made-for-child-health" lens containing three foci reflective of the distinct features of pediatric care settings: the diversity of child and youth populations, the challenges in measuring outcomes and the complexity of patient and public engagement.

Cranial fasciitis: a rare pediatric non-neoplastic lesion with 14-year follow up.

Cranial fasciitis is a fibroblastic lesion found in the cranium of children three weeks to six years of age. It most commonly manifests as a solitary, rapid growing mass on the scalp with frequent involvement of underlying bone and occasional intracranial expansion. Patients with cranial fasciitis may present with a wide range of associated symptoms.

Novel splice-site mutation in ATP8B1 results in atypical progressive familial intrahepatic cholestasis type 1.

Background And Aim: Our objective was to identify the molecular genetic basis of an Alagille-like condition not linked to JAG1 or NOTCH2 in two related sibships.

Methods: Because of common ancestry, and an autosomal recessive mode of inheritance, it was hypothesized that all affected and no unaffected individuals would be homozygous for the same haplotype in the region of the causative gene. Single nucleotide polymorphism arrays were therefore used to genotype 3 affected individuals from two sibships, their mothers and four unaffected siblings, to identify regions of homozygosity.

Parental views on tissue banking in pediatric oncology patients.

Purpose: Research using banked tissue is key to advancing risk-stratification and treatment of children with cancer. Knowledge of parental attitudes to ethical issues arising in tissue banking is very limited but essential in obtaining respectful consent.

Methods: One hundred parents of consecutively diagnosed children with cancer were offered a validated 34-item questionnaire.

Placental pathology and clinical outcomes in a cohort of infants admitted to a neonatal intensive care unit.

Background: Placental pathology predicts persistent neurological impairment, even in normally grown infants. However, few studies have linked placental pathology with neonatal outcomes in a large population.

Methods: We matched the clinical outcomes of a cohort of neonates admitted to a neonatal intensive care unit (NICU) with placental pathology, where available, and examined (by multivariable logistic regression) the relationship between placental pathologies and these outcomes.

The crucial role of tumour specimen handling in childhood cancer outcomes.

The significant advances achieved in the care of children with cancer have been the result of carefully conducted clinical trials in international cooperative group settings. Specialized biological testing of tumour specimens is now an essential component of risk and treatment assignment for many childhood cancers. Thus, the appropriate collection and handling of tumour specimens is crucial to maintaining and further advancing the excellent outcomes that we have achieved.

Chorioamnionitis with a fetal inflammatory response is associated with higher neonatal mortality, morbidity, and resource use than chorioamnionitis displaying a maternal inflammatory response only.

Objective: This study was undertaken to evaluate whether the proximity of infection of the chorion/amnion and fetal vessels affects neonatal outcomes.

Study Design: We examined all (n=2012) infants admitted to the British Columbia's Children's Hospital Neonatal Intensive Care Unit, from January 1996 to October 1997. We included infants with a placental examination (n=1296), and stratified those with histologic chorioamnionitis into cases displaying a maternal inflammatory response only and cases also displaying a fetal inflammatory response (funisitis and/or fetal surface vessel angiitis).

Ultrasound features of a paratesticular arteriovenous malformation: a case report of an 11-year-old boy.

A paratesticular arteriovenous malformation (AVM) in an 11-year-old boy with a solitary testicle led to a testicle-sparing excision. The radiological features of this rare lesion are reviewed.

Are localized intestinal perforations distinct from necrotizing enterocolitis?

Background/purpose: Localized intestinal perforation (LP) is thought to be a distinct entity when compared with perforation associated with necrotizing enterocolitis (NEC). Studies have indicated that LP is more amenable to percutaneous drainage and associated with a better outcome. We sought to determine whether LP and NEC could be distinguished based on clinical parameters alone.

The association of placental abnormalities with maternal and neonatal clinical findings: a retrospective cohort study.

Objectives: (1) To determine the nature and extent of placental pathologic findings; (2) to associate placental pathologic findings with clinical indicators of infection; (3) to evaluate placental pathology in the context of the guidelines outlined by the College of American Pathologists (CAP).

Methods: A retrospective cohort study, through review of maternal and neonatal charts and placental pathology, of 100 sequential pregnancies in which placentas were submitted to pathology. Data were examined using descriptive statistics, and proportional differences were compared using the chi-square test and Fisher's exact test.