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Cohort analysis of pediatric intussusception score to diagnose intussusception

World Journal of Clinical Cases 2023年第21期11卷 5014-5022页

作者： Punwadee Rukwong Nathawit Wangviwat Teerasak Phewplung Palittiya Sintusek Department of pediatrics Phrapokklao HospitalChantaburi 22000MeuangThailand division of Laboratory Medicine King Chulalongkorn Memorial HospitalBangkok 10330Thailand Department of Radiology Chulalongkorn UniversityBangkok 10330Thailand Thai pediatric Gastroenterology Hepatology and Immunology Research UnitDivision of GastroenterologyDepartment of PediatricsKing Chulalongkorn Memorial HospitalChulalongkorn UniversityBangkok 10330Thailand

BACKGROUND Intussusception is a primary cause of intestinal obstruction in young *** diagnosis is associated with increased ***(USG)is the gold standard for diagnosis,but it is operator dependent and often unavailable in limited resource *** To study the clinical characteristics of intussusception including management and evaluation of the diagnostic accuracy of abdominal radiography(AR)and the promising parameters found in the pediatric intussusception score(PIS).METHODS Children with suspected intussusception in our center from 2006 to 2018 were *** manifestations,investigations,and treatment outcomes were *** images were interpreted by a pediatric *** of intussusception was composed of compatible USG and response with *** diagnostic value of the proposed PIS was *** Ninety-seven children were diagnosed with intussusception(2.06±2.67 years,62.9%male),of whom 74%were<2 years old and 37.1%were *** common manifestations of intussusception were irritability or abdominal pain(86.7%)and vomiting(59.2%).Children aged 6 mo to 2 years,pallor,palpable abdominal mass,and positive AR were the parameters that could discriminate intussusception from other mimics(P<0.05).Referral case was the only significant parameter for failure to reduce intussusception(P<0.05).AR to diagnose intussusception had a sensitivity of 59.2%.The proposed PIS,a combination of clinical irritability or abdominal pain,children aged 6 mo to 2 years,and compatible AR,had a sensitivity of 85.7%.CONCLUSION AR alone provides poor screening for *** proposed PIS in combination with common manifestations and AR data was shown to increase the diagnostic sensitivity,leading to timely clinical management.

关键词： Intussusception pediatric Specificity Sensitivity Abdominal radiography Diagnosis

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Fifteen years' review of advanced childhood neuroblastoma from a single institution in Hong Kong

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Chinese Medical Journal 1998年第5期111卷 83-86页

作者： Chan Keywordsong Leung division of pediatric Surgery Department of Surgery University of Hong Kong Queen Mary Hospital Hong Kong China

Objective To assess the progress in the treatment of advanced childhood *** From 1981 to 1996, there were 32 children with neuroblastoma (NB) diagnosed, staged and treated in our institution. There were 4 patients with stage Ⅱ NB (12%), 5 stage Ⅲ (16%), 21 stage Ⅳ (66%) and 2 stage Ⅳs (6%). The NBs were excised if CT scan indicated that the tumors were operable. For advanced NB, stages Ⅲ and Ⅳ, multiple drug chemotherapy was started first and operability was assessed with serial CT scan examinations. Once the X-ray imaging indicated the tumors were operable, surgical interventions were done. The medical records of the advanced NB were *** In the initial period of the study, 9 patients were treated using the VAC protocol [vincristine (vcr), adriamycin(adria) and cyclophosphamide (cyc)]. No patient was convertible to operable and all died with a mean survival of 10 months. OPEC [vcr, cyc, VM26, cisplatin (cis)], Rapid COJEC (carboplatin, VP16, vcr, cis and cyc) and more recently N6 protocol (cyc, adria, vcr, VP16, cis) was used for 17 patients. 80% of them were converted to operable. In 4 patients, surgical specimens showed only necrotic tissue without viable tumor tissue and 6 (35%) tumors were converted to ganglioneuroma or ganglioneuroblastoma. Although 2 (12%) patients died of fungal septicemia and 1 (6%) developed Fanconi's syndrome after chemotherapy, the mean survival period increased to 27 months. In the 10 survivors (60%), 4 had megatherapy with melphalan followed by autologous peripheral blood stem cell (PBSC) transplantation and 2 were waiting for transplantation. Conclusions There is a high percentage of advanced NB on presentation in Hong Kong. With more potent multiple drug chemotherapy for advanced stage NB there are (1) improvement in the survival of these patients, (2) opportunities for more operations for tumor excision and (3) opportunities for autologous PBSC transplantation for better tumor eradication.

关键词： review of advanced childhood neuroblastoma from a single institution in Hong Kong Fifteen years

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Overview of screening methods for fatty liver disease in children

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World Journal of Hepatology 2012年第1期4卷 1-4页

作者： Caroline Anitha Devadason Ann O Scheimann division of pediatric Gastroenterology and Nutrition Johns Hopkins University

The prevalence of obesity and obesity related comorbidities including diabetes and nonalcoholic fatty liver disease (NAFLD) has been rising globally. Nonalcoholic fatty liver disease is emerging as a common liver disease among adults which can lead to the eventua development of complications including cirrhosis and hepatocellular carcinoma. With the rise of obesity in children, the development of detection methods for the presence of NAFLD is becoming imperative. Although the gold standard for diagnosis is liver biopsy, practica issues limit pediatric use and warrant development of noninvasive or minimally invasive screening tools for the detection and staging of NAFLD. A variety of diagnostic methods have been studied including use aminotransferases, imaging studies and serologic markers which have some population-based limitations. Additional factors such as gender and ethnicity may also play a role in the screening of NAFLD in pediatric population studies.

关键词： Nonalcoholic fatty liver disease Children Alanine aminotransferase Ethnicity Gender Detection methods

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Splenogonadal fusion-limb deformity syndrome: a rare but important cause of undescended testis

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世界儿科杂志:英文版 2016年第2期12卷 246-248页

作者： Ahmet Celik Sibel Tiryaki Sukran Darcan Orkan Ergun Department of pediatric Surgery Ege University Faculty of MedicineIzmirTurkey Department of pediatrics Division of Pediatric EndocrinologyEge University Faculty of MedicineIzmirTurkey

Background: Splenogonadal fusion is a rare congenitalanomaly which is characterized by fusion formationbetween the spleen and ***: We report a case of a 14-month boy withspleongonadal fusion-limb deformity syndrome focusingon the importance of awareness of this ***: The patient was admitted to our clinic becauseof a left undescended testis, and preoperative diagnosiswas not made. During the operation, "spleen-like" tissueattached to the gonad induced splenogonadal fusion, whichwas confi rmed by laparoscopy. The patient also had a shortright femur, hip dysplasia and a syndromic ***: Splenogonadal fusion anomaly shouldbe considered in the evaluation of undescended testis,especially in patients with facial and limb deformities.

关键词： diagnostic laparoscopy splenogonadal fusion undescended testis

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Diagnostic Yield of Non-Invasive Testing in Patients with Anomalous Aortic Origin of Coronary Arteries:A Multicentric Experience

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Congenital Heart Disease 2022年第4期17卷 375-385页

作者： Alberto Cipriani Pietro Bernardo Dall’Aglio Laura Mazzotta Domenico Sirico George Sarris Mark Hazekamp Thierry Carrel Alessandro Frigiola Vladimir Sojak Mauro Lo Rito Jurgen Horer Regine Roussin Julie Cleuziou Bart Meyns Jose Fragata Helena Telles Anastasios C.Polimenakos Katrien Francois Altin Veshti Jukka Salminen Alvaro Gonzalez Rocafort Matej Nosal Eleftherios Protopapas Roberto Tumbarello Patrizio Sarto Cinzia Pegoraro Raffaella Motta Giovanni Di Salvo Domenico Corrado Vladimiro LVida Massimo A.Padalino Department of Cardio-Thoracic Vascular Sciences and Public HealthUniversity of PadovaPadovaItaly Department of Woman and Child’s Health Pediatric CardiologyUniversity of PadovaPadovaItaly Athens Heart Surgery Institute and Iaso Children’s Hospital AthensGreece Department for Cardiovascular Surgery University Medical CenterLeidenThe Netherlands Department for Cardiovascular Surgery University Hospital BernBernSwitzerland Department of Congenital Cardiac Surgery IRCCS Policlinico San DonatoSan Donato MilaneseItaly Department of pediatric Cardiology and Congenital Heart Disease Hôpital Marie LannelongueUniversitéParis-SudLe Plessis-RobinsonFrance Deutsch Herz Zentrum MunichGermany Katholieke Universiteit Leuven LeuvenBelgium Cardiothoracic Surgery Hospital de Santa Marta Rua LisbonPortugal Department of pediatric Cardiothoracic Surgery Children’s Hospital of GeorgiaGeorgiaUSA Department of Cardiac Surgery University Hospital GhentGhentBelgium division of Cardiac Surgery University Hospital Center of TiranaTiranaAlbania Department of pediatric Cardiac Surgery Hospital for Children and AdolescentsUniversity of HelsinkiHelsinkiFinland Congenital Cardiac Surgery Department Hospital Universitario La PazMadridSpain Department of pediatric Cardiac Surgery National Institute of Cardio-Vascular Diseases-Children’s Heart CenterBratislavaSlovakia division of pediatric Cardiology Ospedale BrotzuCagliariItaly division of Sport Medicine Ospedale Ca’FoncelloTrevisoItaly Department of Medicine Radiology ClinicUniversity of Padua Medical SchoolPadovaItaly

Background:Anomalous aortic origin of a coronary artery(AAOCA)is a congenital heart disease with a 0.3%−0.5%*** is challenging due to nonspecific clinical *** stratification and treatment are currently based on expert consensus and single-center case ***:Demographical and clinical data of AAOCA patients from 17 tertiary-care centers were *** imaging studies(Bidimensional echocardiography,coronary computed tomography angiography[CCTA]were *** correlations with anomalous coronary course and origin were ***:Data from 239 patients(42%males,mean age 15 y)affected by AAOCA were collected;154 had AAOCA involving the right coronary artery(AAORCA),62 the left(AAOLCA),23 other anomalies.211(88%)presented with an inter-arterial *** electrocardiogram(ECG)was abnormal in 37(16%).AAOCA was detected by transthoracic echocardiography and CCTA in 53%and 92%of patients,*** of the patients reported cardiac symptoms(119/239;50%),mostly during exercise in 121/178(68%).An ischemic response was demonstrated in 37/106(35%)and 16/31(52%)of patients undergoing ECG stress test and stress-rest single positron emission cardiac *** with AAORCA,patients with AAOLCA presented more frequently with syncope(18%vs.5%,P=0.002),in particular when associated with inter-arterial course(22%vs.5%,P<0.001).Conclusion:Diagnosis of AAOCA is a clinical challenge due to nonspecific clinical presentations and low sensitivity of first-line cardiac screening *** seems to be strictly correlated to AAOLCA with inter-arterial course.

关键词： Anomalous coronary arteries congenital echocardiography coronary computed tomography angiography

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Commentary on"Spongiosum-combined glanuloplasty reduces glans complications after proximal hypospadias repair"

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Asian Journal of Andrology 2022年第6期24卷 675-675页

作者： Sachit Anand HiseyinÖzbey Department of pediatric Surgery Kokilaben Dhirubhai Ambani HospitalMumbaiMaharashtra 400053India Department of pediatric Surgery Division of Pediatric Urology and AndrologyI.M.Sechenov First Moscow State Medical UniversityMoscow 119435Russia

Dear Editor,We read the recent article by Lyu et al.^(1)with great interest and appreciate their efforts in describing a new technique for glansplasty in children with proximal *** this article,the images that locate the diverted corpus spongiosum are almost the same as those described using the glanular-frenular collar(GFC)technique.^(2)We would therefore like to thank the authors for adopting the GFC technique as a model for their reconstructive technique.

关键词： technique. thank proximal

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Physical activity and nutrition attitudes in obese Hispanic children with non-alcoholic steatohepatitis

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World Journal of Gastroenterology 2011年第39期17卷 4396-4403页

作者： Lana N Hattar Theresa A Wilson Leanel A Tabotabo E O'Brian Smith Stephanie H Abrams division of pediatric Gastroenterology Hepatologyand NutritionBaylor College of Medicine Stephanie H Abrams Department of PediatricsBaylor College of Medicine

AIM:To assess nutrition,physical activity and health-ful knowledge in obese children with biopsy-proven nonalcoholic steatohepatitis(NASH or NA)compared to children without liver ***:Children with biopsy-proven NASH comprised the NASH ***,sex and ethnicity matched control groups consisted of obese(OB)and lean(CO) children with no liver *** were adminis-tered the School Physical Activity and Nutrition Survey and one blood draw was ***:Fifty-seven patients were enrolled with a mean age of 12.1±2.1 years,and all were *** though the OB and NA had a similar increased body mass index(%),35%of the NA group always read nutrition labels compared to none in the OB(P2 compared to only 63.6%of those with grade 1 or no fibrosis(P<0.05).CONCLUSION:Children with NASH had increased sedentary behavior,decreased activity,and fruit *** studies may determine the benefit of changing these behaviors as treatment for NASH.

关键词：营养调查西班牙酒精性儿童体育锻炼肥胖肝炎脂肪

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Assessment of pathogens and risk factors associated with bloodstream infection in the year after pediatric liver transplantation

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World Journal of Gastroenterology 2022年第11期28卷 1159-1171页

作者： Yeong Eun Kim Ho Jung Choi Hye-Jin Lee Hyun Ju Oh Mi Kyoung Ahn Seak Hee Oh Jung-Man Namgoong Dae Yeon Kim Won Kyoung Jhang Seong Jong Park Dong-Hwan Jung Deok Bog Moon Gi-Won Song Gil-Chun Park Tae-Yong Ha Chul-Soo Ahn Ki-Hun Kim Shin Hwang Sung Gyu Lee Kyung Mo Kim Department of pediatrics Asan Medical Center Children's HospitalUniversity of Ulsan College of MedicineSeoul 05505South Korea division of pediatric Surgery Department of SurgeryAsan Medical Center Children's HospitalUniversity of Ulsan College of MedicineSeoul 05505South Korea division of Hepatobiliary Surgery and Liver Transplantation Department of SurgeryAsan Medical CenterUniversity of Ulsan College of MedicineSeoul 05505South Korea

BACKGROUND Bloodstream infection(BSI)is one of the most significantly adverse events that can occur after liver transplantation(LT)in *** To analyze the profile of BSI according to the postoperative periods and assess the risk factors after pediatric *** Clinical data,collected from medical charts of children(n=378)who underwent primary LT,were retrospectively *** primary outcome considered was BSI in the first year after *** and multivariate analyses were performed to identify risk factors for BSI and respective odds ratios(ORs).RESULTS Of the examined patients,106(28%)experienced 162 episodes of pathogen-confirmed BSI during the first year after *** were 1.53±0.95 episodes per children(mean±SD)among BSIcomplicated patients with a median onset of 0.4 mo *** most common pathogenic organisms identified were Coagulase-negative staphylococci,followed by Enterococcus *** Streptococcus *** half(53%)of the BSIs were of unknown *** analysis demonstrated that young age(≤1.3 year;OR=2.1,P=0.011),growth failure(OR=2.1,P=0.045),liver support system(OR=4.2,P=0.008),and hospital stay of>44 d(OR=2.3,P=0.002)were independently associated with BSI in the year after *** BSI was frequently observed in patients after pediatric LT,affecting survival *** profile of BSI may inform clinical treatment and management in high-risk children after LT.

关键词： Bloodstream infection Liver transplantation Children Pathogens

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Evaluation of Clinician Training in Autism Screening, Care Management, and Patient Education

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Open Journal of pediatrics 2024年第3期14卷 488-513页

作者： Belinda O’Hagan Julie White Ilana Hardesty Rachel Amgott Candice Bangham Xinyang Liu Alyson Codner Amy Ursitti Alana Chandler Sarah Foster Marilyn Augustyn Jacey Greece division of Developmental and Behavioral pediatrics Department of Pediatrics Boston Medical Center Boston United States of America Boston University Chobanian & Avedisian School of Medicine Boston United States of America Department of Community Health Sciences Boston University School of Public Health Boston United States of America

Objective: The demand for pediatric developmental evaluations has far exceeded the workforce available to perform them, which creates long significant wait times for services. A year-long clinician training using the Extension for Community Healthcare Outcomes (ECHO®) model with monthly meetings was conducted and evaluated for its impact on primary care clinicians’ self-reported self-efficacy, ability to administer autism screening and counsel families, professional fulfillment, and burnout. Methods: Participants represented six community health centers and a hospital-based practice. Data collection was informed by participant feedback and the Normalization Process Theory via online surveys and focus groups/interviews. Twelve virtual monthly trainings were delivered between November 2020 and October 2021. Results: 30 clinicians participated in data collection. Matched analyses (n = 9) indicated statistically significant increase in self-rated ability to counsel families about autism (Pre-test Mean = 3.00, Post-test Mean = 3.89, p = 0.0313), manage autistic patients’ care (Pre-test Mean = 2.56, Post-test Mean = 4.11, p = 0.0078), empathy toward patients (Pre-test Mean = 2.11, Post-test Mean = 1.22, p = 0.0156) and colleagues (Pre-test Mean = 2.33, Post-test Mean = 1.22, respectively, p = 0.0391). Unmatched analysis revealed increases in participants confident about educating patients about autism (70.59%, post-test n = 12 vs. 3.33%, pre-test n = 1, p = 0.0019). Focus groups found increased confidence in using the term “autism”. Conclusion: Participants reported increases in ability and confidence to care for autistic patients, as well as empathy toward patients and colleagues. Future research should explore long-term outcomes in participants’ knowledge retention, confidence in practice, and improvements to autism evaluations and care.

关键词： Autism Spectrum Disorder Program Evaluation Case-Based Training Provider Burnout Continuing Medical Education

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Immune checkpoint inhibitor resistance in soft tissue sarcoma

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Cancer Drug Resistance 2022年第2期5卷 328-338页

作者： Vanessa Eulo Brian A.Van Tine division of Medical Oncology University of Alabama at BirminghamBirminghamAL35233USA. division of Medical Oncology Washington University in St.LouisSt.LouisMO63110USA. division of pediatric Hematology/Oncology Washington University in St.LouisSt.LouisMO63110USA. Siteman Cancer Center St.LouisMO 63110USA.

The emergence of immunotherapy as a cancer therapy has dramatically changed the treatment paradigm of systemic cancer *** have been several trials evaluating immune checkpoint blockade(ICI)in soft tissue *** there is generally a limited response in sarcoma,a subset of patients has durable responses to *** is attributable to a variety of factors including histologic subtype,tumor-infiltrating lymphocytes,and the tumor microenvironment among *** is ongoing translational and clinical research evaluating ICI resistance in sarcoma and identifying therapeutic strategies to overcome this ***,we provide a review of the current data,proposed mechanisms of resistance,and potential approaches to overcome this resistance.

关键词： Sarcoma soft tissue sarcoma checkpoint inhibitor immunotherapy resistance

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