Accuracy of ultrasound in the diagnosis of classic metaphyseal lesions using radiographs as the gold standard.

Background: Diagnosis of classic metaphyseal lesions (CMLs) in children suspected for child abuse can be challenging. Ultrasound (US) can potentially help diagnose CMLs. However, its accuracy is unknown.

Retroperitoneal and Pelvic Lymph Nodes in Children: What Is Normal?

The purpose of this study was to evaluate size criteria for retroperitoneal and pelvic lymph nodes in healthy children. We identified all trauma patients younger than 18 years old without underlying disease and with CT scans without abnormalities in the abdomen and pelvis during 2014-2015. Two pediatric radiologists reviewed the studies independently and recorded the number of retroperitoneal and pelvic lymph nodes with a long diameter 5 mm or greater and the size (two perpendicular diameters) of the largest lymph node in five anatomic locations.

Effects of Manganese Porphyrins on Cellular Sulfur Metabolism.

Manganese porphyrins (MnPs), MnTE-2-PyP, MnTnHex-2-PyP and MnTnBuOE-2-PyP, are superoxide dismutase (SOD) mimetics and form a redox cycle between O and reductants, including ascorbic acid, ultimately producing hydrogen peroxide (HO). We previously found that MnPs oxidize hydrogen sulfide (HS) to polysulfides (PS; HS, n = 2-6) in buffer. Here, we examine the effects of MnPs for 24 h on HS metabolism and PS production in HEK293, A549, HT29 and bone marrow derived stem cells (BMDSC) using HS (AzMC, MeRho-AZ) and PS (SSP4) fluorophores.

Practice patterns in imaging guidance for ECMO cannulation: A survey of the American Pediatric Surgical Association.

Background: Surgeon-specific variations in pediatric extracorporeal membrane oxygenation (ECMO) cannulation technique are not well characterized. Advances in technology have led to changing techniques with no formal consensus statement for reference.

Methods: A survey was e-mailed to 1301 members of the American Pediatric Surgical Association (APSA).

Isolating red flags to enhance diagnosis (I-RED): An experimental vignette study.

Objective: To investigate effects of a cognitive intervention based on isolation of red flags (I-RED) on diagnostic accuracy of 'do-not-miss diagnoses.'

Design: A 2 × 2 randomized case vignette-based experiment with manipulation of I-RED strategy between subjects and case complexity within subjects.

Setting: Two university-based residency programs.

Frontal Occipital and Frontal Temporal Horn Ratios: Comparison and Validation of Head Ultrasound-Derived Indexes With MRI and Ventricular Volumes in Infantile Ventriculomegaly.

The purpose of our study was to assess whether linear ventricular dimensions-specifically, the frontal occipital horn ratio (FOHR) and frontal temporal horn ratio (FTHR) obtained from ultrasound (US)-are reliable measures of ventriculomegaly in infants. Our hypothesis was that these US measures would show good correlation with linear ventricular indexes and ventricular volumes obtained from MRI. We retrospectively identified 90 infants (age ≤ 6 months corrected gestational age) with ventriculomegaly from 2014 to 2017 who had a total of 100 sets of US and MRI studies performed in a 3-day period.

Ultrasound evaluation of right diaphragmatic eventration and hernia.

Background: A hernia is due to a defect in the diaphragm. An eventration is due to a thinned diaphragm with no central muscle. Distinguishing right diaphragmatic hernia from eventration on chest radiographs can be challenging if no bowel loops are herniated above the diaphragm.

Trends in pediatric-adjusted shock index predict morbidity in children with moderate blunt injuries.

Purpose: Trending the pediatric-adjusted shock index (SIPA) after admission has been described for children suffering severe blunt injuries (i.e., injury severity score (ISS) ≥ 15).

Compliance With Skeletal Surveys for Child Abuse in General Hospitals: A Statewide Quality Improvement Process.

The purpose of this study is to perform a statewide quality improvement process to improve compliance with the American College of Radiology (ACR) guidelines in performing skeletal surveys for suspected child abuse. We prospectively identified all outside hospital skeletal surveys for suspected child abuse in children younger than 3 years referred to our tertiary children's hospital in 2016-2017. We included a 3-month baseline and 21-month intervention period.

The Kawasaki Disease Comparative Effectiveness (KIDCARE) trial: A phase III, randomized trial of second intravenous immunoglobulin versus infliximab for resistant Kawasaki disease.

Background: Although intravenous immunoglobulin (IVIG) is effective therapy for Kawasaki disease (KD), the most common cause of acquired heart disease in children, 10-20% of patients are IVIG-resistant and require additional therapy. This group has an increased risk of coronary artery aneurysms (CAA) and there has been no adequately powered, randomized clinical trial in a multi-ethnic population to determine the optimal therapy for IVIG-resistant patients.

Objectives: The primary outcome is duration of fever in IVIG-resistant patients randomized to treatment with either infliximab or a second IVIG infusion.

The Pediatric Sepsis Biomarker Risk Model (PERSEVERE) Biomarkers Predict Clinical Deterioration and Mortality in Immunocompromised Children Evaluated for Infection.

Pediatric sepsis and bacterial infection cause significant morbidity and mortality worldwide, with immunocompromised patients being at particularly high risk of rapid deterioration and death. This study evaluated if PERSEVERE, PERSEVERE-II, or the PERSEVERE biomarkers, can reliably estimate the risk of clinical deterioration and 28-day mortality among immunocompromised pediatric patients. This is a single-center prospective cohort study conducted from July 2016 through September 2017 incorporating 400 episodes of suspected bacterial infection from the inpatient units at Cincinnati Children's Hospital Medical Center, a large, tertiary care children's hospital.

Early transplantation into a vesicostomy: a safe approach for managing patients with severe obstructive lesions who are not candidates for bladder augmentation.

Introduction: Management of severe antenatally detected oligohydramnios with and without obstruction is improving with the result that more fetuses are surviving with early renal failure. Significant advances have occurred in all specialties involved in the management of these patients. All these specialties working together have resulted in the survival of more patients born with renal failure.

Leveraging the power of partnerships: spreading the vision for a population health care delivery model in western Kenya.

Background: The Academic Model Providing Access to Healthcare (AMPATH) has been a model academic partnership in global health for nearly three decades, leveraging the power of a public-sector academic medical center and the tripartite academic mission - service, education, and research - to the challenges of delivering health care in a low-income setting. Drawing our mandate from the health needs of the population, we have scaled up service delivery for HIV care, and over the last decade, expanded our focus on non-communicable chronic diseases, health system strengthening, and population health more broadly. Success of such a transformative endeavor requires new partnerships, as well as a unification of vision and alignment of strategy among all partners involved.

Early life growth patterns persist for 12 years and impact pulmonary outcomes in cystic fibrosis.

Background: In children with cystic fibrosis (CF), recovery from growth faltering within 2 years of diagnosis (Responders) is associated with better growth and less lung disease at age 6 years. This study examined whether these benefits are sustained through 12 years of age.

Methods: Longitudinal growth from 76 children with CF enrolled in the Wisconsin CF Neonatal Screening Project was examined and categorized into 5 groups: R, R, and R, representing Responders who maintained growth improvement to age 12, 6, and 2 years, respectively, and I and N representing Non-responders whose growth did and did not improve during ages 2-6 years, respectively.

Mental health care for youth with rheumatologic diseases - bridging the gap.

Youth with rheumatologic diseases have a high prevalence of comorbid mental health disorders. Individuals with comorbid mental health disorders are at increased risk for adverse outcomes related to mental health as well as their underlying rheumatologic disease. Early identification and treatment of mental health disorders has been shown to improve outcomes, but current systems of care fall short in providing adequate mental health services to those in need.

Stem cell therapy in necrotizing enterocolitis: Current state and future directions.

Stem cell therapy is a promising treatment modality for necrotizing enterocolitis. Among the many promising stem cells identified to date, it is likely that mesenchymal stem cells will be the most useful and practical cell-based therapies for this condition. Using acellular components such as exosomes or other paracrine mediators are promising as well.

The Genetic Counselor in the Pediatric Arrhythmia Clinic: Review and Assessment of Services.

There are minimal data on the impact of genetic counselors in subspecialty clinics, including the pediatric arrhythmia clinic. This study aimed to describe the clinical encounters of a genetic counselor integrated into a pediatric arrhythmia clinic. In the 20 months between July 2015 and February 2017, a total of 1914 scheduled patients were screened for indications relevant for assessment by a genetic counselor.

A multi-method study of health behaviours and perceived concerns of sexual minority females in Mumbai, India.

Background: This multi-method study explores the perceived health status and health behaviours of sexual minority (i.e. self-identifying with a sexual identity label other than heterosexual) females (i.

JOURNAL CLUB: Can Coronal STIR Be Used as Screening for Acute Nontraumatic Hip Pain in Children?

Objective: The objective of this study is to evaluate whether coronal STIR MRI can be used as a screening test for nontraumatic acute hip pain in children.

Materials And Methods: From 2008 to 2012, we identified all patients younger than 18 years at our tertiary care facility who underwent pelvic MRI including coronal STIR for the following indications: acute hip pain, limping, or refusal to bear weight. Patients with a history of trauma were excluded.

Corrigendum to "Ophthalmic considerations in patients with pfeiffer syndrome." [Am. J. Ophthalmol. Case Reports (2) 2016 1-3].

[This corrects the article DOI: 10.1016/j.ajoc.

Skin Regeneration Using Dermal Substrates that Contain Autologous Cells and Silver Nanoparticles to Promote Antibacterial Activity: In Vitro Studies.

We hypothesized that the addition of silver nanoparticles (AgNP) to a dermal substrate would impart antibacterial properties without inhibiting the proliferation of contained cells. Our in vitro model was based on the commercial substrate, Integra. The substrate was prepared by simple immersion into 0 to 1% suspension of AgNP (75 or 200 nm diameter) followed by rinsing for 20 minutes and sterilization under an ultraviolet C lamp.