Myelin oligodendrocyte glycoprotein antibody-associated disease as a novel presentation of central nervous system autoimmunity in a pediatric patient with Wiskott-Aldrich syndrome.

Background: Wiskott-Aldrich syndrome (WAS) is an X-linked primary immunodeficiency caused by mutations in the WAS gene that leads to increased susceptibility to infections, thrombocytopenia, eczema, malignancies, and autoimmunity. Central nervous system (CNS) autoimmune manifestations are uncommon.

Case Presentation: We describe the case of a five-year-old boy with refractory thrombocytopenia and iron deficiency anemia who developed relapsing bilateral optic neuritis.

Pectus Excavatum: Consensus and Controversies in Clinical Practice.

Background: Pectus excavatum is the most common congenital anterior chest wall deformity. Currently, a wide variety of diagnostic protocols and criteria for corrective surgery are being used. Their use is predominantly based on local preferences and experience.

Evaluation and Management of Young Febrile Infants: An Overview of the New AAP Guideline.

The American Academy of Pediatrics released a clinical practice guideline for the management of febrile infants in August 2021 to compile nearly 40 years of research into a cohesive text that would provide a framework for the clinician in safely managing these patients in a variety of settings. (1) This guideline incorporates shared decision-making with the caregiver to guide treatment when appropriate and provides algorithms for 3 age groups: 8 to 21 days, 22 to 28 days, and 29 to 60 days. This guideline applies to previously healthy, well-appearing infants born at 37 weeks' gestation or later who have a temperature of at least 100.

Intramuscular Hematoma as a Manifestation of IgA Vasculitis.

We describe an atypical pediatric case of immunoglobulin A vasculitis (IgAV), also referred to as Henoch-Schönlein purpura, in which formation of spontaneous hematoma of the paraspinal muscles developed. Spontaneous or unprovoked hematomas rarely occur in IgAV. These manifestations have not been described specifically in the pediatric literature as coinciding with IgAV.

Clinical Practice Guideline for the Management of Infantile Hemangiomas.

Infantile hemangiomas (IHs) occur in as many as 5% of infants, making them the most common benign tumor of infancy. Most IHs are small, innocuous, self-resolving, and require no treatment. However, because of their size or location, a significant minority of IHs are potentially problematic.

Dysmorphology of chest wall deformities: frequency distribution of subtypes of typical pectus excavatum and rare subtypes.

Background/purpose: More than forty percent of patients with pectus excavatum have a family history of chest deformity. However, no studies of the frequency of the different phenotypes of pectus excavatum have been published.

Methods: A random sample of 300 non-syndromic pectus excavatum patients, from the chest wall deformities clinic at Children's Hospital of The King's Daughters in Norfolk, Va.

Inflicted skeletal trauma: the relationship of perpetrators to their victims.

Objective: Although inflicted skeletal trauma is a very common presentation of child abuse, little is known about the perpetrators of inflicted skeletal injuries. Studies exist describing perpetrators of inflicted traumatic brain injury, but no study has examined characteristics of perpetrators of inflicted skeletal trauma.

Methods: All cases of suspected child physical abuse evaluated by the child abuse evaluation teams at Vanderbilt University Medical Center (January 1996 to August 2000) and at the Children's Hospital at Denver (January 1996 to December 1999) were reviewed for the presence of fractures.

Classification of the dysmorphology of pectus excavatum.

Background/purpose: To describe the dysmorphology of pectus excavatum, the most common congenital chest wall anomaly.

Methods: A stratified sample of 64 patients, representative of a patient population with pectus excavatum of the Children's Hospital of King's Daughters in Norfolk, VA, was described and classified. The sample was stratified by sex to represent a 4:1 male-to-female ratio.

Serum complement factor I decreases Staphylococcus aureus phagocytosis.

Complement-mediated opsonization of Staphylococcus aureus is a critical host defense in animal models. Specifically, C3b and CD35 play important roles in effective opsonophagocytosis of S. aureus.

Social rejection and ADHD in young adults: an analogue experiment.

Poor outcomes in ADHD may be related to problematic social functioning and consequences of social rejection. This study examines how ADHD symptom expression affects mood and social rejection. Working from findings in depression that describe maintenance through negative interpersonal interactions, the authors seek to examine this theory's applicability to poor outcomes in ADHD.

Child passenger safety and the immunity fallacy: Why what we are doing is not working.

Motivating parents to take certain safety precautions when traveling with their children remains an elusive challenge for advocates, as caregiver naiveté contributes to poor parental participation in safety-seat checks, low booster-seat use, poor adherence to rear-seat positioning, and intermittent safety-belt use. Because of inherent human biases and unfortunate characteristics of vehicle travel, it is argued that most caregivers possess an immunity fallacy, or a reduced perception of risk for motor vehicle injury to their children. Consequently, traditionally designed child passenger safety campaigns, which are primarily informational, fail to have an impact on most parents.

Virologic Diagnosis, Viral Monitoring, and Treatment of Epstein-Barr Virus Infectious Mononucleosis.

Epstein-Barr virus (EBV) is the cause of infectious mononucleosis and is associated with severe infections in immunocompromised patients. EBV is also causally linked with several human malignancies. The heterophile antibody test and EBV-specific antibody tests remain the principal means of diagnosis of initial infection in otherwise healthy patients.

The changing picture of hepatitis A in the United States.

Purpose Of Review: Hepatitis A causes approximately half of the cases of viral hepatitis in the United States. Since 1999, routine hepatitis A immunization of children in areas of the United States with high rates of hepatitis A has been recommended.

Recent Findings: There has been an increasing appreciation of the role of young children with asymptomatic or inapparent infection as the community reservoir of hepatitis A virus.

Calicivirus infections in children.

Purpose Of Review: Caliciviruses are a major cause of human illness, and are listed as category B pathogens according to the National Institute of Allergy and Infectious Diseases classification of pathogens important for biodefense. Caliciviruses are commonly encountered in contaminated food and water, and a large variety has been implicated as sources of infection during outbreak investigations.

Recent Findings: New names for two of the four genera of the Caliciviridae were approved in 2002.

Effects of nasal saline spray on human neutrophils.

Background: Nasal saline spray (NSS) used in the treatment of rhinitis and sinusitis often contains the preservative benzalkonium chloride (BKC). Previous studies have shown that corticosteroid nasal sprays and topical decongestants containing BKC damage respiratory mucosa, decrease mucociliary activity, and inhibit neutrophil functions in vitro.

Objective: To evaluate the effects of NSS with BKC on human neutrophils.

Human herpesvirus 8 infection.

Human herpesvirus 8, also known as Kaposi sarcoma-associated herpesvirus, is etiologically associated with Kaposi sarcoma and other rare malignancies. Human herpesvirus 8 infection is common in certain areas of Africa and Italy, but occurs in only 0% to 15% of adult populations in North America and Europe. Reports of human herpesvirus 8 prevalence of 3% to over 50% among children in Central Africa, Brazil, and South Texas suggest that horizontal transmission of human herpesvirus 8 occurs among children.

Fetal rhabdomyoma of the posterior cervical triangle.

Rhabdomyoma is an uncommon benign tumor, with the majority arising from cardiac muscle. Seventy to 90% of extracardiac rhabdomyomas are found in the head and neck region, usually within the upper aerodigestive tract. The case of a 7-month-old boy with an enlarging posterior triangle neck mass found to be fetal rhabdomyoma is presented.

Prevalence and genetic diversity of human caliciviruses (HuCVs) in Mexican children.

Human caliciviruses (HuCVs) contain two genera: "Norwalk-like viruses" (NLVs) and "Sapporo-like viruses" (SLVs). The importance of the two genera as a cause of acute gastroenteritis of infants and children remains unknown. Beginning in 1989, a birth cohort of children in Mexico was enrolled and monitored for acute gastroenteritis.

Pediatric tracheotomies: changing indications and outcomes.

Objective/hypothesis: To study the outcomes and complications associated with pediatric tracheotomy, as well as the changing trend in indications and outcomes since 1970.

Study Design: Retrospective chart review at a major tertiary care children's hospital.

Methods: On children who underwent tracheotomy at Children's Hospital of the King's Daughters (Norfolk, VA) between 1988 and 1998, inpatient and outpatient records were reviewed.

Antiinflammatory effects of human milk on chemically induced colitis in rats.

We examined the effects of a human milk diet on rats with chemical colitis induced with a 4% acetic acid enema. Colonic myeloperoxidase activity was used as a surrogate marker for neutrophil infiltration. Control rats fed rat chow had little colonic myeloperoxidase activity; geometric mean, 0.