Impact of Antimicrobial Stewardship for Pediatric Outpatient Parenteral Antibiotic Therapy.

We developed an outpatient parenteral antibiotic therapy (OPAT) stewardship program in a freestanding children's hospital to improve the appropriateness of OPAT prescribing. Introduction of the program enabled expert review of nearly 90% of the patients being prepared for discharge with OPAT and was associated with a 24% reduction in OPAT use.

Bartonella vinsonii endocarditis in an adolescent with congenital heart disease.

We report the second human case of Bartonella vinsonii subsp. berkhoffii endocarditis in a 19-year-old male with congenital heart disease. Diagnosis was established by Bartonella antibodies detected by immunofluorescence, and polymerase chain reaction amplification and sequencing from blood.

Spectrum of HNF1A and GCK mutations in Canadian families with maturity-onset diabetes of the young (MODY).

Purpose: Maturity-onset diabetes of the young (MODY) is a subtype of type 2 diabetes characterized by autosomal-dominant inheritance and early onset. The pathophysiology of MODY is primarily defective insulin secretion resulting from mutations in at least 6 different genes. Most affected patients harbour mutations in either GCK (encoding glucokinase, also called MODY2) and HNF1A (encoding hepatic nuclear factor-1alpha, also called MODY3).

Optimal management of phenylketonuria: a centralized expert team is more successful than a decentralized model of care.

Objective: To compare phenylketonuria (PKU) management by a centralized, expert team in the Province of Nova Scotia (NS) with the decentralized approach in New Brunswick (NB).

Study Design: Retrospective chart review documented frequency of outpatient visits, phenylalanine (Phe) concentration, and medical formula use. Structured telephone interviews with the 8 regional NB dietitians (NB-D) documented their knowledge and support in PKU management.

Mediastinal polyembryoma associated with Klinefelter syndrome.

A 4.5-year-old boy presented with isosexual precocious puberty and an anterior mediastinal mass. Surgical resection demonstrated a teratoma with foci of malignant mixed germ cell tumor elements of polyembryoma.