Long-term psychosocial outcomes reported by children and adolescents with inflammatory bowel disease.

Objectives: The purpose of this study was to compare the self-reported psychosocial functioning of children with inflammatory bowel disease (IBD) to that of healthy children in the areas of behavioral/emotional functioning, social competence, self-esteem, stress coping strategies, and social support.

Methods: Participants were 50 children with IBD diagnosed at least 1 yr before enrollment, and 42 healthy comparison children aged 11-17 yr. They completed a series of well-validated questionnaires assessing psychosocial functioning.

Lessons learned from the development of a new hybrid strategy for the management of hypoplastic left heart syndrome.

Despite improvements in surgical techniques and perioperative management, the overall results of traditional staged palliation for hypoplastic left heart syndrome (HLHS) remain suboptimal. We report the evolution of a hybrid strategy in 34 patients coupling innovative surgical and transcatheter techniques that requires one open-heart procedure to reach a Fontan completion. Experience has led to modifications in technique, timing of procedures, and follow-up.

Characteristics of water skiing-related and wakeboarding-related injuries treated in emergency departments in the United States, 2001-2003.

Background: Water skiing and wakeboarding are popular sports with high potential for injury due to rapid boat acceleration, lack of protective gear, and waterway obstacles. However, trends in water skiing- and wakeboarding-related injuries in the United States have not been described using national data.

Hypothesis: The number of injuries, injury diagnoses, and body regions injured vary by sport.

A case report of malignant hyperthermia in a dental clinic operating room.

A healthy 5-year-old boy presented for arch bar placement under general anesthesia in an operating room in a dental school. The patient had previously undergone general anesthesia without complication, and no family history of anesthetic problems were reported. Halothane mask induction, intravenous catheter placement, and nasal intubation proceeded uneventfully without the aid of a muscle relaxant.

Minority status and the risk of serious childhood injury and death.

Objective: Minority populations have an increased risk for trauma, but little is known about injury rates for minority children. This study compares the causes, rates and outcomes of traumatic injuries between minority and white children in a statewide population sample.

Methods: A cohort study of 5,973 children (age <16) receiving inpatient care for treatment of acute injuries at the pediatric trauma centers in Ohio from 1999--2001.

Pediatric chest ultrasound.

Ultrasound examination of the thorax can be quite rewarding in children, because their unique thoracic anatomy provides many acoustic windows into the chest. With only a modest effort, chest ultrasonography can provide many clinically relevant answers, without the radiation exposure from CT, or the need for sedation sometimes required for CT and MR imaging.

Imaging evolution of airway disorders in children.

This article discusses and illustrates the insights gained from CT imaging of the lungs in infants and young children who do not have respiratory motion and at end-inspiratory and resting end-expiratory lung volumes using noninvasive controlled ventilation CT technique. The potential role of noninvasive controlled ventilation CT in developing quantitative measures of airway disease is highlighted and clinical examples demonstrating the use of the technique are shown.

Pediatric gastric and duodenal disorders.

Purpose Of Review: This review provides a summary of new developments regarding common diseases affecting the stomach and duodenum in children.

Recent Findings: Celiac disease seems to be more prevalent than previously thought in different areas of the world, including the United States. The value of different serologic screening tools and other noninvasive tests has been carefully assessed.

Persistent electrical and morphological atrial abnormalities after early closure of atrial septal defect.

Atrial arrhythmias are associated with enlarged atrial chambers and an increased duration of the P wave. Repair of atrial defects within the oval fossa is expected to normalize atrial size. Few studies, however, have evaluated electrical and morphological atrial features after repair.

Radiofrequency perforation and cutting balloon septoplasty of intact atrial septum in a newborn with hypoplastic left heart syndrome using transesophageal ICE probe guidance.

Newborns with hypoplastic left heart syndrome and intact atrial septum present an emergent and unique challenge to a children's heart center. This case report describes new transcatheter techniques (use of radiofrequency energy to perforate the atrial septum followed by cutting balloon and static balloon septoplasty) and novel use of a transesophageal ICE probe.

Skiing- and snowboarding-related injuries treated in U.S. emergency departments, 2002.

Background: This study aims to describe the characteristics of skiing- and snowboarding-related injuries treated in U.S. emergency departments (EDs).

Physical abuse: Recognition and reporting.

This article provides primary care providers, including pediatric nurse practitioners, with a framework for understanding the dynamics of child abuse, recognizing physical abuse injuries, and reporting concerns of suspected physical abuse to child protective services. Three children die in America every day as a result of child abuse or neglect. Many children who have severe injuries at the time that physical abuse is diagnosed have previously presented with less severe injuries, and physical abuse was overlooked.

Novel adeno-associated virus vector vaccine restricts replication of simian immunodeficiency virus in macaques.

Gene transfer vectors based on recombinant adeno-associated virus (rAAV) are simple, versatile, and safe. While the conventional applications for rAAV vectors have focused on delivery of therapeutic genes, we have developed the system for delivery of vaccine antigens. In particular, we are interested in generating rAAV vectors for use as a prophylactic human immunodeficiency virus type 1 (HIV-1) vaccine.

Sonographically guided aspiration of cerebrospinal fluid pseudocysts in children and adolescents.

Objective: Cerebrospinal fluid (CSF) pseudocyst formation is an uncommon cause of ventriculoperitoneal shunt malfunction in children. Traditional staged treatment consists of shunt externalization, antibiotics, and later shunt revision and internalization. We sought to evaluate whether sonographically guided pseudocyst aspiration to alleviate acute symptoms and to exclude CSF infection could obviate shunt externalization and expedite the care of these patients.

Usefulness of multislice computed tomography angiography to evaluate intravascular stents and transcatheter occlusion devices in patients with d-transposition of the great arteries after mustard repair.

Percutaneous interventions can treat long-term complications after Mustard atrial switch operation in patients with d-transposition of the great arteries (d-TGA), but follow-up for these procedures has not been established. Four patients with d-TGA and previous Mustard operation underwent percutaneous placement of covered stents to relieve superior and inferior vena caval baffle obstructions and leaks. At 6 to 13 months, assessment with 16-slice spiral computed tomography identified stent patency as well as lead placement and visualization of additional devices.

Pharmacokinetics of lidocaine delivered from a transmucosal patch in children.

The DentiPatch lidocaine transoral delivery system (Noven Pharmaceuticals) is indicated for mild topical anesthesia of mucosal membranes in the mouth. The DentiPatch is a mucoadhesive patch containing 46.1 mg of lidocaine (20% concentration).

Pediatric applications of abdominal vascular Doppler: Part II.

Ultrasound is a remarkably powerful and versatile modality for pediatric imaging, without requiring exposure to radiation or sedatives. By providing information on blood flow, Doppler sonography can reveal details about normal physiology and disease processes not discernable from gray-scale anatomic images alone. In part I, the basics of hemodynamics and effects on the Doppler waveform were discussed, along with clinical applications in hepatic disease.

Cerebral saturations trend with mixed venous saturations in patients undergoing extracorporeal life support.

Cerebral saturation (SCO2) monitors are noninvasive tools that continuously measure saturations in the cerebral cortex, a predominately venous bed. The purpose of this study was to see if a trend existed between measurements of SCO2 and mixed venous saturation values (SVO2) for patients on extracorporeal life support (ECLS). Six patients required ECLS for cardiac failure after congenital cardiac surgery, and one patient required ECLS for pulmonary failure.

A snapshot of the U.S. postdoctoral pediatric dentistry faculty workforce, 2002.

This study characterizes the faculty shortage in U.S. postdoctoral pediatric dentistry (PD) education.

Fontan completion without surgery.

An ideal Fontan procedure would minimize complications while maximizing flow dynamics through the circuit. We report our early experience with a new combined surgical/transcatheter approach which enables a nonoperative, transcatheter Fontan completion. The conceptual rationale of this management strategy, as well as surgical and catheterization techniques, are discussed.

Pediatric applications of abdominal vascular Doppler imaging: Part I.

Ultrasound is a remarkably powerful and versatile modality for pediatric imaging, without requiring exposure to radiation or sedatives. By providing information on blood flow, Doppler sonography can reveal details about normal physiology and disease processes not discernable from gray-scale anatomic images alone. However, in routine practice in many institutions Doppler remains underutilized, in part due to uncertainty of the meaning of changes in Doppler waveforms.

Repair of the pectus deformity: results of the Ravitch approach in the current era.

Background: Recent publications have advocated a minimally invasive approach to repair of the pectus deformity. Efforts to evaluate this new approach have been hampered by lack of comparative information regarding outcomes of the standard Ravitch approach. We use a modified Ravitch procedure, and present our series as a basis for comparison.