The outcomes of juvenile idiopathic arthritis in children managed with contemporary treatments: results from the ReACCh-Out cohort.

Objective: To describe clinical outcomes of juvenile idiopathic arthritis (JIA) in a prospective inception cohort of children managed with contemporary treatments.

Methods: Children newly diagnosed with JIA at 16 Canadian paediatric rheumatology centres from 2005 to 2010 were included. Kaplan-Meier survival curves for each JIA category were used to estimate probability of ever attaining an active joint count of 0, inactive disease (no active joints, no extraarticular manifestations and a physician global assessment of disease activity <10 mm), disease remission (inactive disease >12 months after discontinuing treatment) and of receiving specific treatments.

Multimodal monitoring for hemodynamic categorization and management of pediatric septic shock: a pilot observational study*.

Objectives: To evaluate the cardiovascular aberrations using multimodal monitoring in fluid refractory pediatric septic shock and describe the clinical characteristics of septic myocardial dysfunction.

Design: Prospective observational study of patients with unresolved septic shock after infusion of 40 mL/kg fluid in the first hour.

Setting: Two tertiary care referral Indian PICUs.

Echo-Doppler assessment of arterial stiffness in pediatric patients with Kawasaki disease.

Background: There is growing evidence to suggest increased arterial stiffness in patients with a history of Kawasaki disease (KD). Pulse-wave velocity (PWV) is the most validated measure of arterial stiffness. The aim of this study was to determine if aortic PWV is increased in children with KD.

Postnatal outcome in patients with fetal tachycardia.

The diagnosis and management of prenatal tachyarrhythmias is well established; however, the postnatal course and outcomes are not. The purpose of our study was to review the natural history of patients with fetal tachycardia, determine the incidence of postnatal arrhythmias, and determine whether there are factors to predict which fetuses will develop postnatal arrhythmias. A retrospective chart review of patients with fetal tachyarrhythmias investigated at British Columbia Children's and Women's Hospitals between 1983 and 2010 was conducted.

Postexertional supraventricular tachycardia in children with catecholaminergic polymorphic ventricular tachycardia.

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a severe arrhythmia associated with sudden death in the young. It is caused by defective calcium handling in ventricular myocytes. The association of supraventricular tachycardia (SVT) with CPVT is described in the literature, occurring in the lead-up to ventricular tachycardia during exercise testing.

Imaging of a carotid aneurysm in two patients following extracorporeal membrane oxygenation therapy.

Following extracorporeal membrane oxygenation (ECMO), two patients subsequently developed carotid aneurysms at the site of cannulation. Given the invasive nature of ECMO, vascular ultrasound and/or computerized tomographic imaging should be considered to rule out cannulation-site complications post-ECMO.

Epilepsy surgery in the first 3 years of life: a Canadian survey.

Objective: To determine the clinical characteristics, surgical challenges, and outcome in children younger than 3 years of age undergoing epilepsy surgery in Canada.

Methods: Retrospective data on patients younger than age 3 years who underwent epilepsy surgery at multiple centers across Canada from January 1987 to September 2005 were collected and analyzed.

Results: There were 116 patients from eight centers.

Long-term bowel function and quality of life in children with Hirschsprung's disease.

Background/purpose: Little is known about the quality of life (QOL) of children with Hirschsprung's disease (HD) as they grow older. The purpose of this study was to measure the QOL and bowel function of these children as they mature.

Methods: All children who were surgically treated for HD at British Columbia Children's Hospital, Vancouver, British Columbia, Canada between 1986 and 2003 were invited to participate.

Anti-basal ganglia antibodies and acute movement disorder following herpes zoster and streptococcal infections.

Anti-basal ganglia antibodies (ABGA) have been associated with poststreptococcal encephalitis similar to encephalitis lethargica (EL). We report two children with parainfectious encephalitis of similar phenotype and IgG ABGA. However, the associated pathogens in the two cases differed; beta-hemolytic streptococcus and herpes zoster.

Echocardiographic Doppler assessment of the biophysical properties of the aorta in pediatric patients with the Marfan syndrome.

In the Marfan syndrome (MS), aortic root involvement is usually clinically monitored according to the aortic sinus of Valsalva dilation. Using an echocardiographic Doppler method in this cross-sectional study, abnormal biophysical properties of the ascending aorta were found in pediatric patients with MS compared with healthy controls but not consistently in association with the aortic sinus of Valsalva dilation.

Laparoscopic vs percutaneous endoscopic gastrostomy tube insertion: a new pediatric gold standard?

Background/purpose: Gastrostomy tube insertion is frequently performed in children. Percutaneous endoscopic gastrostomy (PEG) insertion, considered by many to be the "gold standard," is unavoidably associated with a risk of intestinal perforation and frequently requires a second anesthetic for its replacement with a low-profile "button." We hypothesized that a laparoscopic technique with low-pressure insufflation would yield comparable outcomes, a lower procedural complication rate, and require fewer anesthetics per patient.

Say goodbye and say hello: the transition from pediatric to adult gastroenterology.

Pediatric and adult gastroenterologists have identified an important issue to be addressed which entails the process of transition of care for youth affected by chronic gastrointestinal disorders. The adolescent years are a time of change and development, and may be significantly affected by conditions such as Crohn's disease or ulcerative colitis. Health care providers need to advocate and provide comprehensive, developmentally appropriate care for youth and families to facilitate the transition from the pediatric to the adult setting.