Two-Tier Lyme Disease Serology in Children with Previous Lyme Disease.

A history of Lyme disease can complicate the interpretation of Lyme disease serology in acutely symptomatic patients. We prospectively enrolled children undergoing evaluation for Lyme disease in the emergency department of one of eight participating Pedi Lyme Net centers. We selected symptomatic children with a Lyme disease history (definite, probable, or none) as well as an available research biosample.

Positive 2-Tiered Lyme Disease Serology is Uncommon in Asymptomatic Children Living in Endemic Areas of the United States.

Knowing the frequency of positive Lyme disease serology in children without signs of infection facilitates test interpretation. Of 315 asymptomatic children from Lyme disease endemic regions, 32 had positive or equivocal C6 enzyme-linked immunoassays, but only 5 had positive IgG or IgM supplemental immunoblots (1.6%; 95% confidence interval: 0.

Pulmonary artery smooth muscle cell HIF-1α regulates endothelin expression via microRNA-543.

Pulmonary artery smooth muscle cells (PASMCs) express endothelin (ET-1), which modulates the pulmonary vascular response to hypoxia. Although cross-talk between hypoxia-inducible factor-1α (HIF-1α), an O-sensitive transcription factor, and ET-1 is established, the cell-specific relationship between HIF-1α and ET-1 expression remains incompletely understood. We tested the hypotheses that in PASMCs 1) HIF-1α expression constrains ET-1 expression, and 2) a specific microRNA (miRNA) links HIF-1α and ET-1 expression.

Emergency department on-call status for pediatric orthopaedics: a survey of the POSNA membership.

Background: The emergency room on-call status of pediatric orthopaedic surgeons is an important factor affecting their practices and lifestyles and was last evaluated in 2006.

Methods: The entire membership of the Pediatric Orthopaedic Society of North America (POSNA) was surveyed in 2010 for information regarding their emergency room on-call status with 382 surveys returned of over 1000 e-mailed to members of POSNA. Detailed information about on-call coverage, support, and frequency was obtained in answers to 14 different questions.

The National Spina Bifida Patient Registry: profile of a large cohort of participants from the first 10 clinics.

Objective: To use data from the US National Spina Bifida Patient Registry (NSBPR) to describe variations in Contexts of Care, Processes of Care, and Health Outcomes among individuals with spina bifida (SB) receiving care in 10 clinics.

Study Design: Reported here are baseline cross-sectional data representing the first visit of 2172 participants from 10 specialized, multidisciplinary SB clinics participating in the NSBPR. We used descriptive statistics, the Fisher exact test, χ(2) test, and Wilcoxon rank-sum test to examine the data.

Results of Mustard's repair for dextro-transposition of the great arteries.

Dextro-Transposition of Great Arteries (d-TGA) was repaired by Mustard's operation in 69 patients during a 10 year period (1973-1982) in our institution. Ages at the time of surgery ranged from 3 months to 18 years, with a median age of 18 months. Factors that most affected mortality and morbidity were associated cardiac defect, the year of the operation and the age of the patient.

Hypoxemia and pulmonary hyperperfusion due to systemic collateral arteries after total repair of transposition of the great arteries.

Two cases of hypoxemia and pulmonary hyperperfusion due to large bronchial collateral arteries after total repair of simple transposition of the great arteries (TGA) are presented. Pulmonary hyperperfusion was not present before total repair. Hypoxemia and congestive heart failure quickly abated after surgical ligation of these enlarged bronchial collateral arteries.

Bilateral semilunar valvotomies using inflow occlusion in a neonate.

The case of a neonate with critical pulmonary and aortic valve stenosis who underwent successful sequential valvotomies using one period of inflow occlusion is reported. This valvotomy technique performed in critically ill neonates, if carried out expeditiously, can result in the same degree of success as when used for single valvotomies.

Pediatric craniofacial remodeling instrument.

Craniofacial reconstruction in children is technically exacting and requires instruments specifically designed for these procedures. A new pediatric craniofacial remodeling instrument is described here and its applications are discussed. A case study is presented in which the instrument was used when an infant with craniosynostosis of the metopic suture line underwent a bicoronal craniectomy and supraorbital bar advancement and remodeling.

Use of activated clotting time for monitoring anticoagulation during cardiopulmonary bypass in infants and children with congenital heart disease.

The use of a fixed dosage schedule was compared with the use of activated clotting time (ACT) for determining heparin and protamine dosages during and after cardiopulmonary bypass disease. Use of the ACT resulted in a statistically significant increase in heparin dosage and a statistically significant reduction of postoperative blood loss. With ACT use, chest tubes were retained for a shorter period of time, and the incidence of serious postoperative hemorrhage was reduced from 44% to 18%.

USE OF AN EXTRACARDIAC CONDUIT IN THE REPAIR OF l-TRANSPOSITION WITH l-LOOPING ASSOCIATED WITH SEVERE SUBVALVULAR PULMONIC STENOSIS AND A VENTRICULAR SEPTAL DEFECT.

Total correction was performed in a child with l-transposition of the great arteries, severe subpulmonic stenosis, and a ventricular septal defect. The subpulmonic obstruction was bypassed with an extra-cardiac valved conduit. This alternate method of relieving ventricular outflow obstruction should be considered when conventional techniques cannot be employed because of complex intracardiac anatomy.