Congenital cystic lesions of the lung.

Congenital cystic lesions of the lung are present in 1 in 10,000-35,000 births and present as a spectrum of anomalies. Majority of these cystic lesions comprise congenital cystic adenomatoid malformations, pulmonary sequestrations, congenital lobar emphysema, and bronchogenic cysts. Most of these lesions are nowadays detected antenatally, however some will present either in the newborn or during later childhood.

Social media for diabetes health education - inclusive or exclusive?

Technological innovations are rising rapidly and are inevitably becoming part of the health care environment. Patients frequently access Social media as a forum for discussion of personal health issues; and healthcare providers are now considering ways of harnessing social media as a source of learning and teaching. This review highlights some of the complex issues of using social media as an opportunity for interaction between public- patient-healthcare staff; considers the impact of self- education and self-management for patients with diabetes, and explores some recent advances in delivering education for staff.

The bid to lose weight: impact of social media on weight perceptions, weight control and diabetes.

Over the last decade the internet has come to permeate every aspect of our lives. With huge leaps in accessibility of the internet via mobile personal devices such as smart cellular phones and tablets, individuals are connected to the internet virtually all the time. It is no surprise therefore that social media now dominates the lives of many people within society.

The experience of being a parent with an acquired brain injury (ABI) as an inpatient at a neuro-rehabilitation centre, 0-2 years post-injury.

Primary Objective: Little research has been conducted exploring the issues surrounding parenting with an acquired brain injury (ABI). This study aimed to explore the experiences and needs of parents who suffered an ABI in the last 2 years from their own perspectives. For individuals with an ABI who have dependent children their ABI has the potential to impact upon their parenting abilities, skills and relationships.

Clinical, biologic, and prognostic differences on the basis of primary tumor site in neuroblastoma: a report from the international neuroblastoma risk group project.

Purpose: Neuroblastoma (NB) is a heterogeneous tumor arising from sympathetic tissues. The impact of primary tumor site in influencing the heterogeneity of NB remains unclear.

Patients And Methods: Children younger than age 21 years diagnosed with NB or ganglioneuroblastoma between 1990 and 2002 and with known primary site were identified from the International Neuroblastoma Risk Group database.

Paediatric neuromyelitis optica: clinical, MRI of the brain and prognostic features.

Background: Neuromyelitis Optica (NMO) is a severe and rare inflammatory condition, where relapses are predictive of disability.

Methods: We describe a national paediatric NMO cohort's clinical, MRI, outcome, and prognostic features in relation to Aquaporin-4 antibody (AQP4-Ab) status, and compared to a non NMO control cohort.

Observations: Twenty NMO cases (females = 90%; AQP4-Ab positive = 60%; median age = 10.

Predictors of parent post-traumatic stress symptoms after child hospitalization on general pediatric wards: a prospective cohort study.

Objective: The aim of this study was to identify predictors of parental post-traumatic stress symptoms following child hospitalization.

Methods: In this prospective cohort study, a sample of 107 parents completed questionnaires during their child's hospitalization on pediatric (non-intensive care) wards and again three months after discharge. Eligible parents had a child expected to be hospitalized for three or more nights.

How can cerebral edema during treatment of diabetic ketoacidosis be avoided?

Cerebral edema during diabetic ketoacidosis (DKA) is a rare complication but it can be devastating, with significant mortality and long-term morbidity. Certain risk factors have been teased out with some large case-control studies, but more research needs to be done to make management guidelines safer. This article will discuss how DKA might be prevented from occurring in the first instance, known risk factors for cerebral edema, fluid and insulin management, the importance of careful monitoring during DKA treatment, and the importance of recognizing and acting on the earliest symptoms to prevent long-term harm.

Age at orchidopexy in the UK: has new evidence changed practice?

Introduction: Research suggesting progressive deterioration in an undescended testis has led to the reduction in the target age for orchidopexy to 6-12 months of age. This age was selected as normal testicular descent is unlikely after 3 months of age and it is timed to prevent early gonadocyte developmental delay as suggested by Hutson and Hasthorpe. This study aims to determine the current age at orchidopexy in one UK training centre and whether changing targets have altered practice.

Analysis of transcription factors key for mouse pancreatic development establishes NKX2-2 and MNX1 mutations as causes of neonatal diabetes in man.

Understanding transcriptional regulation of pancreatic development is required to advance current efforts in developing beta cell replacement therapies for patients with diabetes. Current knowledge of key transcriptional regulators has predominantly come from mouse studies, with rare, naturally occurring mutations establishing their relevance in man. This study used a combination of homozygosity analysis and Sanger sequencing in 37 consanguineous patients with permanent neonatal diabetes to search for homozygous mutations in 29 transcription factor genes important for murine pancreatic development.

Fundoplication versus postoperative medication for gastro-oesophageal reflux in children with neurological impairment undergoing gastrostomy.

Background: Children with neurological impairments frequently experience feeding difficulties, which can lead to malnutrition and growth failure. Gastrostomy feeding is now the preferred method of providing nutritional support to children with neurological impairments who are unable to feed adequately by mouth. Complications may arise as a result of gastrostomy placement, and the development or worsening of gastro-oesophageal reflux (GOR) has been widely reported.

Split mesencephalon: diplomyelia of the basicranium.

We report a novel case of congenitally split mesencephalon, in a 3-year old with hydrocephalus. We speculate that the ontogenetic mechanism is shared with split cord malformations (SCM). Our case adds to the two other cases of basicranial SCM which involved more caudal brainstem.

Button vesicostomy: 13 years of experience.

Introduction: Over recent years the button vesicostomy has become an alternative management option in children with poor bladder emptying, when clean intermittent catheterisation (CIC) cannot be initiated for reasons of age, sensation, or urethral anatomy. This study reviews recent experience of this technique and evaluates its use.

Methods: Retrospective review of patients who had a button vesicostomy to permit bladder drainage between 1998 and 2011.

Opsoclonus-myoclonus syndrome.

Opsoclonus-myoclonus syndrome is a very rare disorder with onset usually in the second year of life, and the clinical features of opsoclonus, myoclonus, ataxia, irritability, sleep disturbance, and, often but by no means invariably, an associated neuroblastoma. There is no diagnostic test; brain imaging is normal and other investigations produce nonspecific results; the diagnosis is clinical and the condition is not infrequently mistaken for acute cerebellar ataxia. The pathophysiology is thought to be immunological on the basis of the paraneoplasticity and the symptomatic (though often incomplete) response to immunomodulatory therapies; a number of autoantibodies have been identified to a variety of antigens and cerebrospinal fluid B-cell numbers found to be increased but no diagnostic immunological marker has yet been identified.

British Thoracic Society Paediatric Pneumonia Audit: a review of 3 years of data.

The British Thoracic Society (BTS) guidelines for the management of community-acquired pneumonia in children are used as the audit standard for the annual BTS Paediatric Pneumonia Audit. This report examines 3 years of data from this national audit, highlighting trends in clinical practice and the impact of the 2011 revisions to the BTS guidelines. The findings suggest an over-reliance on investigations to diagnose pneumonia and underuse of oral antibiotics, particularly amoxicillin.

Parasitic twin within spina bifida.

Spinal dysraphisms in association with accessory limbs are extremely rare congenital anomalies. The potential mechanisms of development and classification of these anomalies remain unclear. We report a unique case of a baby boy with an accessory foot and external genitalia in association with spina bifida.

Care of children with diabetes as inpatients: frequency of admissions, clinical care and patient experience.

Aim: Hospital inpatient care for children with diabetes is frequently mentioned by parents as unsatisfactory. The aim of this study was to examine the reasons for inpatient admission of children with diabetes and to understand patient and carer experience in order to improve services.

Methods: Questionnaires were given to medical teams, parents and children during admissions of children with diabetes under 16 years of age in three regions of England.

Inpatient care for children with diabetes: are standards being met?

Background: Hospital inpatient care is frequently mentioned by parents as unsatisfactory for children with diabetes. Ward staff are now less familiar with diabetes, as admissions are less common and diabetes management is more intensive.

Objective: To compare current practice with Department of Health Children's Diabetes Working Group care standards.

Trilogy of gastrointestinal atresias: a case report and review of the literature.

This is a case report of a child with a rare combination of pyloric and colonic atresias, imperforate anus, hypoganglionosis of the rectum and sigmoid colon, unilateral multicystic dysplastic kidney, bilateral sensorineural deafness, spondyloepimetaphyseal dysplasia, subglottic stenosis, growth failure, and limb anomalies.

British Thoracic Society guidelines for the management of community acquired pneumonia in children: update 2011.

The British Thoracic Society first published management guidelines for community acquired pneumonia in children in 2002 and covered available evidence to early 2000. These updated guidelines represent a review of new evidence since then and consensus clinical opinion where evidence was not found. This document incorporates material from the 2002 guidelines and supersedes the previous guideline document.