Effects of decomposition on the recoverability of biological fluid evidence.

The present research assessed how the physical and chemical changes associated with decomposition affect the detection and identification of blood and semen evidence, as well as subsequent DNA analysis. A feeder pig (postmortem interval (PMI) < 3 h) was placed within the Boston University Outdoor Research Facility for a period of 22 days. Human blood and semen were individually dispensed onto multiple areas of two cotton t-shirts; one layer of fabric was placed above and below the pig and a control.

Systemic Bevacizumab for Treatment of Respiratory Papillomatosis: International Consensus Statement.

Objectives/hypothesis: The purpose of this study is to develop consensus on key points that would support the use of systemic bevacizumab for the treatment of recurrent respiratory papillomatosis (RRP), and to provide preliminary guidance surrounding the use of this treatment modality.

Study Design: Delphi method-based survey series.

Methods: A multidisciplinary, multi-institutional panel of physicians with experience using systemic bevacizumab for the treatment of RRP was established.

Analytical approaches to differential extraction for sexual assault evidence.

Many forensic laboratories face growing demands for the processing of DNA evidence from sexual assault investigations. In these cases, evidence collected from the crime scene or from the victim in the form of a Sexual Assault and Evidence Collection Kit (SAECK) typically contains a mixture of cells from at least two donors. Isolation of DNA contributions to link a sample to an alleged offender requires precise chemical treatment of each sample with the goal of separating epithelial cells from non-sperm cells.

Competency-Based Assessment Tool for Pediatric Esophagoscopy: International Modified Delphi Consensus.

Objectives/hypothesis: Create a competency-based assessment tool for pediatric esophagoscopy with foreign body removal.

Study Design: Blinded modified Delphi consensus process.

Setting: Tertiary care center.

Determination of the possible number of genotypes which can contribute to DNA mixtures: Non-computer assisted deconvolution should not be attempted for greater than two person mixtures.

When DNA profiles contain a mixture of contributors (N), the maximum number of alleles observed at any locus is 2 N with the number of alleles varying between 1 and 2 N. The number of possible combinations of the genotypes of the N contributors increases as N increases. The number of possible combinations of genotypes that may occur among the N contributors can be enumerated using the mathematical concept of ordered partitions.

Outcome measures for pediatric laryngotracheal reconstruction: International consensus statement.

Objectives: Develop multidisciplinary and international consensus on patient, disease, procedural, and perioperative factors, as well as key outcome measures and complications, to be reported for pediatric airway reconstruction studies.

Methods: Standard Delphi methods were applied. Participants proposed items in three categories: 1) patient/disease characteristics, 2) procedural/intraoperative/perioperative factors, and 3) outcome measures and complications.

Diagnosis and management of laryngotracheal stenosis.

Laryngotracheal stenosis comprises a broad spectrum of congenital and acquired conditions that commonly cause pediatric airway obstruction. Although the majority of these conditions were historically managed with endoscopic dilations, the introduction of operative procedures such as laryngotracheoplasty, cricotracheal resection, and slide tracheoplasty changed the treatment paradigm. The gradual evolution of endoscopic technology enabled surgeons to perform certain procedures endoscopically that were previously only able to be performed in an open fashion.

Structure and Functions of Pediatric Aerodigestive Programs: A Consensus Statement.

Aerodigestive programs provide coordinated interdisciplinary care to pediatric patients with complex congenital or acquired conditions affecting breathing, swallowing, and growth. Although there has been a proliferation of programs, as well as national meetings, interest groups and early research activity, there is, as of yet, no consensus definition of an aerodigestive patient, standardized structure, and functions of an aerodigestive program or a blueprint for research prioritization. The Delphi method was used by a multidisciplinary and multi-institutional panel of aerodigestive providers to obtain consensus on 4 broad content areas related to aerodigestive care: (1) definition of an aerodigestive patient, (2) essential construct and functions of an aerodigestive program, (3) identification of aerodigestive research priorities, and (4) evaluation and recognition of aerodigestive programs and future directions.

Short- versus Long-term Stenting in Children with Subglottic Stenosis Undergoing Laryngotracheal Reconstruction.

Objectives Suprastomal stents are routinely used in laryngotracheal reconstruction (LTR) to stabilize grafts and provide framework to sites of repair. However, the duration of stenting varies according to patient history and physician preference. We examined outcomes of short- versus long-term stenting in children with subglottic stenosis (SGS) undergoing LTR.

Inverting suprastomal granulomas.

Although suprastomal granulomas are a common complication of tracheotomy, they usually are an incidental finding and do not always require treatment. However, large granulomas may require removal, either to assist with speech production or to make the airway safer in the event of an accidental decannulation. Very large suprastomal granulomas extending up to or even through the vocal cords have been described.

The Management of Cyanotic Spells in Children with Oesophageal Atresia.

Cyanotic spells, also known as blue spells, dying spells, or apparent life-threatening events, refer to a bluish tone visible in the mucosal membranes and skin caused by an oxygen decrease in the peripheral circulation. Although this decrease may be transient and benign, it may also be indicative of a severe underlying problem that requires immediate intervention. Children with oesophageal atresia (OA) are at risk for a number of coexisting conditions that may trigger cyanotic spells.

Laryngotracheal Cleft Repair in Children With Complex Airway Anomalies.

Importance: This study provides clinicians with relevant information regarding the surgical outcomes of patients with laryngotracheal cleft in the context of additional airway anomalies.

Objectives: To determine the rates of surgical success in patients who underwent laryngotracheal cleft repair in the context of additional airway anomalies, determine the revision rate for cleft repair, characterize the time to revision among patients who underwent cleft repair, and assess the functional swallowing outcomes after cleft repair.

Design, Setting, And Participants: A retrospective study was conducted at a quaternary pediatric center of 81 children diagnosed as having laryngotracheal cleft with or without concomitant airway anomalies who underwent laryngotracheal cleft repair between February 1, 2000, and February 28, 2013.

Review: Properties of sperm and seminal fluid, informed by research on reproduction and contraception.

Forensic DNA testing is grounded in molecular biology and population genetics. The technologies that were the basis of restriction length polymorphism testing (RFLP) have given way to PCR based technologies. While PCR has been the pillar of short tandem repeat (STR) methods and will continue to be used as DNA sequencing and analysis of single nucleotide polymorphisms (SNPs) are introduced into human identification, the molecular biology techniques in use today represent significant advances since the introduction of STR testing.

Swallowing function after laryngeal cleft repair: more than just fixing the cleft.

Objectives/hypothesis: To evaluate and describe the swallowing function in children after laryngeal cleft repair.

Study Design: Ten-year (2002-2012) retrospective chart review.

Setting: Academic tertiary care pediatric otolaryngology practice.

High-dose sublesional bevacizumab (avastin) for pediatric recurrent respiratory papillomatosis.

Objectives: We review and report the use of high-dose bevacizumab for the treatment of recurrent respiratory papillomatosis (RRP) in pediatric patients.

Methods: We included all patients with pediatric-onset RRP who underwent bevacizumab (25 mg/mL) injections by a single practitioner. A series of 5 consecutive subepithelial injections were administered at 4- to 6-week intervals with concomitant 532 nm KTP laser ablation.

Tracheocutaneous fistula closure in the pediatric population: should secondary closure be the standard of care?

Objective: Tracheocutaneous fistula (TCF) closure is achieved by excision followed either by primary closure or healing by secondary intention. Although primary closure provides immediate resolution of the fistula, it is associated with more severe potential complications. Healing by secondary intention minimizes these potential complications; however, it is inconvenient for the patient and may be more likely to require revision surgery.

The effects of differential extraction conditions on the premature lysis of spermatozoa.

The purpose of this study was to determine the effect Proteinase K, sodium dodecyl sulfate (SDS), incubation times, and temperatures had on differential extraction efficiencies and the premature lysis of spermatozoa. The effect was measured using Quantifiler® Duo and Identifiler™ PCR Amplification kits, where the resultant male and female DNA concentrations and their ratios within the nonsperm- and sperm fractions (SFs) were determined. Comparisons between expected and observed ratios illustrate the quantity of female DNA in the SF increased when Proteinase K was absent during the initial incubation.

Analytical thresholds and sensitivity: establishing RFU thresholds for forensic DNA analysis.

Determining appropriate analytical thresholds (ATs) for forensic DNA analysis is critical to maximize allele detection. In this study, six methods to determine ATs for forensic DNA purposes were examined and compared. Four of the methods rely on analysis of the baseline noise of a number of negatives, while two utilize the relationship between relative fluorescence unit signal and DNA input in the polymerase chain reaction (PCR) derived from a dilution series ranging from 1 to 0.

Pediatric tracheal reconstruction using cadaveric homograft.

Objective: To examine the indications, risks, and surgical outcomes after tracheal reconstruction using cadaveric homograft in children.

Design: Retrospective medical record review.

Setting: Tertiary referral center.

Oropharyngeal stenosis: a complication of multilevel, single-stage upper airway surgery in children.

Objectives: To describe oropharyngeal stenosis (OPS), a potential complication of multilevel, single-stage upper airway surgery involving lingual tonsillectomy in children, and to discuss the manner in which OPS may be managed successfully.

Design: Case series with an average follow-up of 12 months.

Setting: Tertiary care children's hospital.

Investigation of reproducibility and error associated with qPCR methods using Quantifiler® Duo DNA quantification kit.

Reproducibility of quantitative PCR results is dependent on the generation of consistent calibration curves via accurate volume transfers and instrument performance. A review of 14 standard curves, using two different QuantDuo® standard DNA lots, showed variability of cycle threshold values between assays were larger than those of the Internal PCR Control (IPC). This prompted a set of experiments designed to determine the source of variability.