A case of base rate bias, or are adolescents at a higher risk of developing complications after catheterizable urinary channel surgery?

Objective: Adolescents are considered to be at high risk of developing complications after lower genitourinary tract reconstruction. This perception may be due to base rate bias, where clinicians favor specific information (adolescents with complications), while ignoring more general information (number of total adolescents being followed). The goal of this study was to assess whether age was a true risk factor for subfascial and stomal revisions after continent catheterizable urinary (CCU) channel procedures.

Mobility, hydrocephalus and quality of erections in men with spina bifida.

Introduction: Little is known about erectile dysfunction (ED) among men with spina bifida (SB). The goal of this study was to determine quality of erections and possible factors affecting erections in this population. It was hypothesized that men who ambulate and do not have a ventriculoperitoneal shunt (VPS) are more likely to have erections sufficient for intercourse.

Validated cost comparison of open vs. robotic pyeloplasty in American children's hospitals.

The objective of this study is to determine the cost and charge differences between patients undergoing open vs. robotic pyeloplasty. This is a retrospective analysis of the Pediatric Health Information System (PHIS) database in patients undergoing pyeloplasty between 2004 and 2013 conducted in large pediatric children's hospitals in the United States which contribute to PHIS.

Cardiac defects, nuchal edema and abnormal lymphatic development are not associated with morphological changes in the ductus venosus.

Background: In human fetuses with cardiac defects and increased nuchal translucency, abnormal ductus venosus flow velocity waveforms are observed. It is unknown whether abnormal ductus venosus flow velocity waveforms in fetuses with increased nuchal translucency are a reflection of altered cardiac function or are caused by local morphological alterations in the ductus venosus.

Aim: The aim of this study was to investigate if the observed increased nuchal translucency, cardiac defects and abnormal lymphatic development in the examined mouse models are associated with local changes in ductus venosus morphology.

Ophthalmic considerations in patients with Pfeiffer syndrome.

Purpose: We report here a newborn male infant with striking features consistent with severe Pfeiffer syndrome type II, including cloverleaf skull deformity with pansynostosis, extreme proptosis, upper extremity contractures, broad big toes and thumbs with varus deviation and genetic mutation in the FGFR2 gene. The authors review the ophthalmic complications in Pfeiffer syndrome and discuss the unique surgical strategies used for obtaining adequate corneal coverage in these unique patients.

Observations: Ophthalmic considerations in Type 2 Pfeiffer Syndrome include vision loss secondary to increased intracranial pressure, and extreme proptosis as a result of orbitostenosis and midfacial retrusion.

Bladder stones after bladder augmentation are not what they seem.

Introduction: Bladder and renal calculi after bladder augmentation are thought to be primarily infectious, yet few studies have reported stone composition.

Objective: The primary aim was to assess bladder stone composition after augmentation, and renal stone composition in those with subsequent nephrolithiasis. The exploratory secondary aim was to screen for possible risk factors for developing infectious stones.

QUAlity of Life Assessment in Spina bifida for Adults (QUALAS-A): development and international validation of a novel health-related quality of life instrument.

Purpose: Health-related quality of life (HRQOL) is important in spina bifida (SB) management. No clinically useful, comprehensive instrument incorporating bladder/bowel domains exists. We aimed to develop and validate a self-reported QUAlity of Life Assessment in Spina bifida for Adults (QUALAS-A).

Controversies in nutritional support for critically ill children.

Nutritional support for critically ill infants and children is of paramount importance and can greatly affect the outcome of these patients. The energy requirement of children is unique to their size, gestational age, and physiologic stress, and the treatment algorithms developed in adult intensive care units cannot easily be applied to pediatric patients. This article reviews some of the ongoing controversial topics of fluid, electrolyte, and nutritional support for critically ill pediatric patients focusing on glycemic control and dysnatremia.

Distal humeral epiphyseal separation in young children: an often-missed fracture-radiographic signs and ultrasound confirmatory diagnosis.

OBJECTIVE. Distal humeral epiphyseal separation is rare and often misdiagnosed. The purpose of this study was to summarize an experience with radiography and ultrasound of distal humeral epiphyseal separation.

Is the new ACR-SPR practice guideline for addition of oblique views of the ribs to the skeletal survey for child abuse justified?

Objective: The purpose of our study was to determine whether adding oblique bilateral rib radiography to the skeletal survey for child abuse significantly increases detection of the number of rib fractures.

Materials And Methods: We identified all patients under 2 years old who underwent a skeletal survey for suspected child abuse from January 2003 through July 2011 and who had at least one rib fracture. These patients were age-matched with control subjects without fractures.

Testicular microlithiasis in children and associated testicular cancer.

Purpose: To evaluate the prevalence of testicular microlithiasis (TM) in children who have undergone scrotal ultrasonography (US) and their association with testicular tumors.

Materials And Methods: This HIPAA-compliant study with waiver of informed consent was approved by the institutional review board. From 2003 to 2012, all patients with scrotal US and report mentioning calcifications or microlithiasis and all patients with testicular tumors from pathology database were identified.

The placenta findings from an XYY abortus: a case report.

Introduction: The placenta morphology from an XYY pregnancy abortus has not been reported in the medical literature. This case report consists of the first detailed documentation. The reported case is also highly unusual because the mother had two prior pregnancies with fetuses being confirmed to have Zellweger syndrome and one prior molar pregnancy.

Removal of comfort pads underneath babies: a method of reducing radiation exposure to neonates.

Rationale And Objectives: The recent increasing utilization of imaging has increased the population exposure to ionizing radiation. With increasing knowledge of the potential harm of radiation exposure, efforts should be made to minimize patient radiation whenever possible, especially in young children. The purpose of this study was to use the exposure index (EI) standard to assess the potential for reducing radiation dose to babies by removing a soft comfort pad, often placed underneath the baby.

Pediatric nonalcoholic fatty liver disease.

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the pediatric population. Increased recognition of this form of liver disease parallels the dramatic rise in childhood and adolescent obesity over the past 2 decades. Like adults, most children with NAFLD are obese, and comorbidities include insulin resistance, hypertension, and dyslipidemia.

Ultrasound evaluation of costochondral abnormalities in children presenting with anterior chest wall mass.

Objective: The purpose of this article is to summarize our experience with the use of ultrasound for evaluation of costochondral cartilage deformity in patients presenting with an anterior chest wall mass.

Materials And Methods: From 2007 to 2012, we identified all patients at our tertiary care children's hospital younger than 18 years old who underwent ultrasound for a clinical indication of anterior chest wall mass of unknown cause. A pediatric radiologist reviewed all ultrasound examinations and other pertinent radiology examinations as well as prior and follow-up clinical history and determined the final clinical cause of the mass.