Chemotherapeutical Nightmares

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Urodynamic abnormality in both conditions is detrusor areflexia; the putative mechanism of it is direct involvement of the pelvic nerves in sacral herpes; and acute spinal shock in MRS. There are few cases with CSF abnormality alone. Although these cases have a benign course, management of the acute urinary retention is necessary to avoid bladder injury due to overdistension.

Clinical features of sacral herpes or MRS differ markedly from those of the original "Elsberg syndrome" cases. Childhood Acute Myeloid Leukaemia. Summary Although acute myeloid leukaemia AML has long been recognized for its morphological and cytogenetic heterogeneity, recent high-resolution genomic profiling has demonstrated a complexity even greater than previously imagined.

This complexity can be seen in the number and diversity of genetic alterations, epigenetic modifications, and characteristics of the leukaemic stem cells. The broad range of abnormalities across different AML subtypes suggests that improvements in clinical outcome will require the development of targeted therapies for each subtype of disease and the design of novel clinical trials to test these strategies.

It is highly unlikely that further gains in long-term survival rates will be possible by mere intensification of conventional chemotherapy. In this review, we summarize recent studies that provide new insight into the genetics and biology of AML, discuss risk stratification and therapy for this disease, and profile some of the therapeutic agents currently under investigation. Clinical Trial Information A clinical trial is a study to answer Pediatric subjects with vertigo or dizziness are rare in Japan, although considerable statistical data accumulated, mostly indicating that orthostatic hypotension is the most frequent clinical symptoms in Japan, as opposed to Benign paroxysmal vertigo of childhood BPVC , reported to be most frequent abroad.

We studied BPVC incidence and clinical features. The predominant diagnosis was BPVC in 8, orthostatic hypotension in 6, labyrinthitis in 2, and delayed endolymphatic hydrops, and conversion disorder in 1 case each. BPVC was most common. All subjects with BPVC had a history or a family history of migraine. Based on BPVC diagnostic criteria, subjects had neither organic nor functional abnormalities. Information is thus required on attack, injury, and personal or family migraine history to determine a final diagnosis. Note that subjects with BPVC have high orthostatic hypotension.

These statistics indicate the importance of diagnostic BPVC criteria in pediatric subjects with dizziness or vertigo. While variation in this percentage among other populations was noted previously, global patterns of childhood APL have not been thoroughly characterized. In this comprehensive review of childhood APL, we examined its geographic pattern and the potential contribution of environmental factors to observed variation.

Future population-based studies examining childhood APL patterns and the potential association with specific environmental exposures and other risk factors are needed. As a result, it can cause problems without spreading to another part of the body. Sometimes, these problems can be serious. The opposite of benign is malignant. Esophageal stenting is a popular of treatment of esophageal strictures in adults.

It has also been described for children with benign strictures who did not respond to standard dilatation therapy.

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The aim of the study was to evaluate weather esophageal stents could be used safely and effectively in the treatment of benign esophageal strictures in children. From to stenting therapy was performed in 12 children with complicated esophageal strictures. Etiologies of the strictures were caustic burns in 9 patients, postoperative strictures due to complicated esophageal atresia in 2 patients and iatrogenic esophageal injury in 1 patient.

Esophageal silicon tubi, covered retrievable expandable nitinol and plastic stents were placed endoscopically. The clinical course and the long term follow up were evaluated retrospectively The stents and tubi were placed in all patients without complications and were later removed successfully. One patient was asymptomatic after therapy, one required further dilatation therapy and the third had esophageal resection. The use of stenting devices in children to treat benign esophageal strictures is safe and efficient.

The self expanding plastic stents had the best long term results but required high compliance of parents and children due to the tendency of stent migration. Self expanding nitinol stents are more traumatic at the extraction procedure and are useful in patients with low compliance. Recurrence of strictures occurred most often after esophageal tubi possibly due to the lack of radial expansion.

Benzene and childhood acute leukemia in Oklahoma. Although childhood cancer is a leading cause of childhood mortality in the US, evidence regarding the etiology is lacking. The goal of this study was to evaluate the association between benzene, a known carcinogen, and childhood acute leukemia. We used conditional logistic regression to evaluate the association between benzene, measured with the National-Scale Air Toxics Assessment NATA at census tract of the birth residence, and childhood acute leukemia. We observed no differences in benzene exposure overall between cases and controls.

However, when stratified by year of birth, cases born from to had a three-fold increased unadjusted odds of elevated exposure compared to controls born in this same time period 4th Quartile OR: Furthermore, the estimates for children with acute myeloid leukemia AML were stronger than those with acute lymphoid leukemia, though not statistically significant. While we did not observe an association between benzene and childhood leukemia overall, our results suggest that acute leukemia is associated with increased benzene exposure among more recent births, and children with AML may have increased benzene exposure at birth.

Using the NATA estimates allowed us to assess a specific pollutant at the census tract level, providing an advantage over monitor or point source data. Our study, however, cannot rule out the possibility that benzene may be a marker of other traffic-related exposures and temporal misclassification may explain the lack of an association among earlier births. Benign vascular proliferation in a lymph node following acute toxoplasmosis. A differential diagnosis from Kaposi's sarcoma.

We describe an unusual intranodal vascular proliferation following acute toxoplasmosis in a man. This proliferation is distinct from other benign vasoformative nodal lesions. It could be interpreted as a reactive healing process that might be misdiagnosed as nodal Kaposi's sarcoma. Some criteria to avoid such misdiagnosis are presented. Benign paroxysmal migraine variants of infancy and childhood: Transitions and clinical features. Parents of children with these disorders should be made aware of this phenomenon, which we refer to as "the vestibular march.

Acute scrotal pain in childhood is an emergency. Sudden scrotal pain may be caused by a variety of diseases. Therefore, it is important to carefully consider the specific medical history and possible differential diagnoses in each case for fast and decisive action e. As minors lack the capacity for consent, it is absolutely necessary to obtain consent from their legal guardian.

However, obtaining consent in the available time frame can cause organisational challenges in an acute emergency, which may lead to situations in the daily routine where a therapeutic decision needs to be taken including surgery without legal security based on consent by the guardian. In some cases, the child's consent also needs to be taken into account, depending on its age and development.

For the physician and surgeon in charge, the legal evaluation of the case at hand and therewith the obtainment of legal security are of great significance. Does a normalizing electroencephalogram in benign childhood epilepsy with centrotemporal spikes abort attention deficit hyperactivity disorder?

This retrospective study delineated the efficacy of antiepileptic drugs in preventing the need for methylphenidate in patients with benign childhood epilepsy with centrotemporal spikes and attention deficit hyperactivity disorder. Seventeen patients were identified. Complete normalization was achieved in two patients with sulthiame. Improvement in attention along with the reduction of pathologic electroencephalogram activity was observed in four patients, two with sulthiame, and one each with lamotrigine and levetiracetam which was ceased because of suicidal tendencies.

However, this improvement in attention was either temporary or not significant enough to discontinue methylphenidate. Methylphenidate was eventually prescribed to all patients. To investigate the clinical, neurophysiologic characteristics and therapeutic considerations of epileptic negative myoclonus ENM in atypical benign partial epilepsy of childhood ABPE. Video-EEG monitoring with outstretched arm tests were carried out in 17 patients, and 9 of them were examined with simultaneous electromyography EMG.

Seventeen patients were diagnosed as having benign childhood epilepsy with centrotemporal spikes BECT during the early course of the disease and were treated with AED. During the course of the disease, hand trembling, objects dropping, head nodding and instability during standing might be clues for ENM occurrence.

Stefano Pelloni

The ictal EEG showed that high-amplitude spikes followed by a slow wave over the contralateral motor areas. This was further confirmed by time-locked silent EMG in 9 patients. During ENM occurrence or recurrence, the habitual seizures and interictal discharges were exaggerated.

Atypical absence seizures also occurred in 6 patients. The ENM occurrence was always associated with the frequency increasing of habitual seizures and the aggravation of interictal discharges. VPA, benzodiazepines and corticosteroid with different combination were relatively effective in treatment of ENM. Benign and malignant thyroid neoplasms after childhood irradiation for Tinea capitis. The incidence of all thyroid surgery was studied among 10, persons whose thyroid glands had been exposed in childhood to an average dose of 9 rads of x-radiation during treatment for tinea capitis and among 2 matched control groups.

A statistically significant increased risk for both benign and malignant neoplasms was found in the exposed group. The excess risk was 8. There were no differences in other surgical conditions between the irradiated and nonirradiated groups. Persons irradiated under age 6 years had the highest excess risk for developing carcinomas. Low-dose radiation is instrumental in the development of both benign and malignant thyroid neoplasms.

Epidemiologic study on carcinoma of the breast following irradiation for benign conditions in infancy and childhood. To investigate the relationship of irradiation during infancy and childhood to the subsequent development of carcinoma of the breast, eligible patients were studied at Evanston Hospital, Evanston, Illinois, and Northwestern Memorial Hospital, Chicago. This was a case-control study, with those in the control group being selected from concurrent hospital admissions for nonmalignant surgical conditions. A second group consisting of those with benign biopsy results was also studied.

The type of radiation history included radiotherapy for mastitis or enlarged thymus nine patients , irradiation of the head and neck 69 patients , diagnostic fluoroscopies ten patients and miscellaneous irradiation 52 patients for bursitis, eczema or keloid. Based upon the data obtained from the results of this study and its analysis, we conclude that there is little evidence of increased risk of carcinoma of the breast after irradiation about the head, neck and chest areas for benign conditions in the population being studied herein.

Such a risk, if indeed it exists at all for this population, is estimated to be about 10 per cent. Childhood acute myeloid leukemia and other myeloid malignancies treatment may include chemotherapy, radiation therapy, stem cell transplant, and targeted therapy. Childhood Acute Lymphoblastic Leukemia: Purpose To review the impact of collaborative studies on advances in the biology and treatment of acute lymphoblastic leukemia ALL in children and adolescents.

Methods A review of English literature on childhood ALL focusing on collaborative studies was performed. The resulting article was reviewed and revised by the committee chairs of the major ALL study groups. Many recurrent genetic abnormalities that respond to tyrosine kinase inhibitors and multiple genetic determinants of drug resistance and toxicities have been identified to help develop targeted therapy. Conclusion The information gained from collaborative studies has helped decipher the heterogeneity of ALL to help improve personalized treatment, which will further advance the current high cure rate and the quality of life for children and adolescents with ALL.

To review the impact of collaborative studies on advances in the biology and treatment of acute lymphoblastic leukemia ALL in children and adolescents. A review of English literature on childhood ALL focusing on collaborative studies was performed. The information gained from collaborative studies has helped decipher the heterogeneity of ALL to help improve personalized treatment, which will further advance the current high cure rate and the quality of life for children and adolescents with ALL.

A study on epileptic negative myoclonus in atypical benign partial epilepsy of childhood. To investigate the clinical and neurophysiological characteristics, particularly therapeutic considerations, of epileptic negative myoclonus ENM in atypical benign partial epilepsy ABPE of childhood. ENM manifestations, electrophysiological features, and responses to antiepileptic drugs were analyzed. In all cases, ENM developed after the onset of epilepsy and during antiepileptic drug therapy, and the appearance of ENM were corresponding to EEG findings of high-amplitude spikes followed by a slow wave in the contralateral motor areas with secondary generalization.

This was further confirmed by time-locked silent EMG. During ENM occurrence or recurrence, habitual seizures and interictal discharges were exaggerated. In some patients, the changes in antiepileptic drug regimens in relation to ENM appearance included add-on therapy with carbamazepine, oxcarbazepine, and phenobarbital or withdrawal of valproate.

ENM was controlled in most cases by administration of various combinations of valproate, clonazepam, and corticosteroids. The aggravation of habitual seizures and interictal discharges indicate ENM. Some antiepileptic drugs, such as carbamazepine, oxcarbazepine, and phenobarbital, may be related to ENM occurrence during spontaneous aggravation of ABPE. We investigated the relationship between cognitive performance and altered functional connectivity FC in the resting-state brain networks of BECTS patients. Cognitive performance was assessed using the Korean version of the Wechsler Intelligence Scale for Children-III, in addition to verbal and visuospatial memory tests and executive function tests.

Resting-state functional magnetic resonance imaging was acquired in addition to high-resolution structural data. We selected Rolandic and language-related areas as regions of interest ROIs and analyzed the seed-based FC to voxels throughout the brain. We evaluated the correlations between the neuropsychological test scores and seed-based FC values using the same ROIs.

Benign epilepsy of childhood with centrotemporal spikes BECTS is the most frequent focal epilepsy in children; however, the pattern of affected memory processes remains controversial. Previous studies in BECTS imply deficits in complex working memory tasks, but not in simple modality-specific tasks. We studied working memory processes in children with BECTS by comparing performance in memory binding tasks of different complexities.

We compared 17 children with BECTS aged 6 to 13 years to 17 healthy children matched for age, sex, and intelligence quotient. We measured spatial and verbal memory components separately and jointly on three single-binding tasks binding of what and where; what and when; and where and when and a combined-binding task integration of what, where, and when.

We also evaluated basic visuospatial memory functions with subtests of the Children's Memory Scale, and intellectual abilities with verbal tasks of the Wechsler Intelligence Scale for Children-Fourth Edition and the Raven Progressive Matrices. We found no difference between the BECTS and control groups in single-binding tasks; however, the children with BECTS performed significantly worse on the combined task, which included integration of spatial, verbal, and temporal information.

We found no deficits in their intellectual abilities or basic visuospatial memory functions. Children with BECTS may have intact simple maintenance processes of working memory, but difficulty with high-level functions requiring attentional and executive resources. Our findings imply no specific memory dysfunction in BECTS, but suggest difficulties in integrating information within working memory, and possible frontal lobe disturbances.

Childhood acute lymphoblastic leukemia ALL treatment is usually chemotherapy given in phases and determined by risk group. Radiation therapy, targeted therapy and stem cell transplant are sometimes used. Learn more about newly diagnosed and recurrent ALL in this expert reviewed summary. Management of acute moderate and severe childhood malnutrition. Acute childhood malnutrition affects about a tenth of the world's children under 5 years of age, particularly those living in circumstances of extreme poverty in the developing world.

Malnutrition is typically the result of an inadequate diet and is one of the most common diagnoses in children in he Obesity in patients with acute lymphoblastic leukemia in childhood. Acute lymphoblastic leukemia is the most common malignancy in childhood. Obesity can be considered one of the most important health chronic conditions in the general population, with an increasing incidence in patients treated for childhood cancers and especially in acute lymphoblastic leukemia survivors who are, at the same time, more at risk of experiencing precocious cardiovascular and metabolic co-morbidities.

The hypothalamic-pituitary axis damage secondary to cancer therapies cranial irradiation and chemotherapy or to primary tumor together with lifestyle modifications and genetic factors could affect long-term outcomes. Nevertheless, the etiology of obesity in acute lymphoblastic leukemia is not yet fully understood. The present review has the aim of summarizing the published data and examining the most accepted mechanisms and main predisposing factors related to weight gain in this particular population.

Integrating Genomics into Therapy. Acute lymphoblastic leukemia ALL , the most common malignancy of childhood , is a genetically complex entity that remains a major cause of childhood cancer-related mortality. Major advances in genomic and epigenomic profiling during the past decade have appreciably enhanced knowledge of the biology of de novo and relapsed ALL and have facilitated more precise risk stratification of patients.

These achievements have also provided critical insights regarding potentially targetable lesions for development of new therapeutic approaches in the era of precision medicine. This review delineates the current genetic landscape of childhood ALL with emphasis upon patient outcomes with contemporary treatment regimens, as well as therapeutic implications of newly identified genomic alterations in specific subsets of ALL.

Although, it is commonly occurred in Japanese and Taiwanese population. Nanoparticle targeted therapy against childhood acute lymphoblastic leukemia. The goal of our project is to develop a unique ligand-conjugated nanoparticle NP therapy against childhood acute lymphoblastic leukemia ALL.

LLP2A, discovered by Dr. The Lam lab has developed novel telodendrimer-based nanoparticles NPs which can carry drugs efficiently. LLP2A-conjugated NPs will be evaluated both in vitro and in vivo using primary leukemia cells and this mouse model. NPs will be loaded first with DiD near infra-red dye, and then with the chemotherapeutic agents daunorubicin or vincristine.

Both drugs are mainstays of current chemotherapy for childhood ALL. We expect that LLP2A-conjugated NPs will be preferentially delivered and endocytosed to leukemia cells as an effective targeted therapy. Acute lymphoblastic leukaemia is the most frequent childhood malignancy. The first effective drugs, which provided only short-lived complete remission, started to be used in the s. All the effective drugs currently in use were discovered in the s, when the first multidrug chemotherapy regimens were shown to confer prolonged complete remission, raising the possibility of a cure.

Simultaneously, progress in our knowledge of leukaemic cells, and the identification of prognostic factors such as leukocytosis, age, cytogenetic and molecular abnormalities, and the early therapeutic response of leukaemic cells, led to randomized multicenter national and international trials.

As a result, the chance of cure increased gradually over the last three decades. Non-infectious chemotherapy-associated acute toxicities during childhood acute lymphoblastic leukemia therapy. During chemotherapy for childhood acute lymphoblastic leukemia, all organs can be affected by severe acute side effects, the most common being opportunistic infections, mucositis, central or peripheral neuropathy or both , bone toxicities including osteonecrosis , thromboembolism, sinusoidal obstruction syndrome, endocrinopathies especially steroid-induced adrenal insufficiency and hyperglycemia , high-dose methotrexate-induced nephrotoxicity, asparaginase-associated hypersensitivity, pancreatitis, and hyperlipidemia.

Few of the non-infectious acute toxicities are associated with clinically useful risk factors, and across study groups there has been wide diversity in toxicity definitions, capture strategies, and reporting, thus hampering meaningful comparisons of toxicity incidences for different leukemia protocols. Childhood acute leukemias are frequent in Mexico City: Background Worldwide, acute leukemia is the most common type of childhood cancer.

The objective of this study was to determine the incidence of acute leukemia in children who were diagnosed and treated in public hospitals in Mexico City. Methods Included in this study were those children, under 15 years of age and residents of Mexico City, who were diagnosed in and with leukemia, as determined by using the International Classification of Childhood Cancer. We calculated crude, age- and sex-specific incidence rates and adjusted for age by the direct method with the world population as standard. We determined if there were a correlation between the incidence of acute leukemias in the various boroughs of Mexico City and either the number of agricultural hectares, the average number of persons per household, or the municipal human development index for Mexico used as a reference of socio-economic level.

Results Although a total of new cases of leukemia were registered during , only fit the criteria for inclusion in this study. For cases of ALL, The peak ages for ALL were years and years. More than half the children Worldwide, acute leukemia is the most common type of childhood cancer. Included in this study were those children, under 15 years of age and residents of Mexico City, who were diagnosed in and with leukemia, as determined by using the International Classification of Childhood Cancer.

Although a total of new cases of leukemia were registered during , only fit the criteria for inclusion in this study. There was a positive. Children with benign epilepsy with centrotemporal spikes BECTS have traditionally been considered to have a uniformly good prognosis. However, benign may be a misnomer because BECTS is linked to cognitive deficits, a more severe phenotype with intractable seizures, and the potential for sudden unexpected death in epilepsy SUDEP. The NASR database, which includes medical records, results of electroencephalographic tests, and interviews with family members of patients with epilepsy who died suddenly without other identifiable causes of death, was queried from June 3, , to June 3, , for cases of BECTS.

The patients with epilepsy had died suddenly without other identifiable causes of death eg, drowning, trauma, exposure to toxic substances, or suicide ; SUDEP classification was determined by the consensus of 2 epileptologists. Three boys median age at death, 12 years; range, years who received a diagnosis of BECTS by their pediatric epileptologist or neurologists were identified among cases reported in the NASR.

The median age of epilepsy onset was 5 years range, years , and the median duration of epilepsy was 4 years range, years. Independent review of clinical and electroencephalographic data supported the diagnosis of BECTS in all 3 patients. None of the patients was prescribed antiseizure drugs, either owing to physician recommendation or mutual decision by the physician and parents. The medical records of 74 children 44 males with neuropsychological examination from a total of children diagnosed with BCECTS at Asan Medical Center were retrospectively reviewed.

Mean T-scores of the continuous performance test were compared across patients grouped according to various epilepsy characteristics. There are 2 intrinsic networks in the human brain: The antagonism between the 2 networks might indicate a dynamic interaction in the brain that is associated with development. Positive functional connectivity FC within the networks and negative FC between the 2 networks were observed in both groups.

The patients exhibited increased FC within both networks, particularly in the frontoparietal nodes such as the left superior frontal cortex, and enhanced antagonism between the 2 networks, suggesting abnormal functional integration of the nodes of the 2 networks in the patients. Granger causality analysis revealed a significant difference in the degree of outflow to inflow in the left superior frontal cortex and the left ventral occipital lobe. The alterations observed in the combined functional and effective connectivity analyses might indicate an association of an abnormal ability to integrate information between the DMN and TPN and the epileptic neuropathology of BECTS and provide preliminary evidence supporting the occurrence of abnormal development in children with BECTS.

Benign childhood epilepsy with centro-temporal spikes: Benign childhood epilepsy with centro-temporal spikes BECTS is a form of focal idiopathic epilepsy, with seizure remission by the age of Recent studies have suggested that some children with BECTS can suffer from deficits of memory, attention and learning ability and in auditory-verbal and performance sub-tests.

On the other hand, alterations in the baseline brain electrical activity determined by using the quantitative electroencephalogram qEEG have been described. Twenty-six 8 to year-old children with BECTS were studied, paired with a control group of healthy children according to age and gender. It was shown that the absolute delta and theta powers were statistically greater in the children with BECTS than in the control group, at almost all the electrodes. In the children with BECTS, a negative correlation Pearson's correlation test was observed at various electrodes between the absolute delta and theta powers and the performance IQ.

These data indicate a possible relationship between maturational disturbance in the brain electrical activity development and the tendency for inferior cognitive performance in children with BECTS. Neuropsychological disorders related to interictal epileptic discharges during sleep in benign epilepsy of childhood with centrotemporal or Rolandic spikes.

Nine children five males, four females; age range 6 years 1 month to 11 years 1 month affected by benign epilepsy of childhood with centrotemporal or Rolandic spikes BECRS with EEG evidence of marked activation of interictal epileptic discharges IEDs during sleep, and nine unaffected control children matched for age, sex, and socioeconomic status, were enrolled in a prospective study. At the time of detection of IED activation during sleep, patients showed a mean Full-Scale IQ score within the normal range, but significantly below that of control participants; neuropsychological assessment revealed disorders in visuospatial short-term memory Corsi's Block Tapping Test , attention, and cognitive flexibility Trail Making Test and Stroop Color-Word Test , picture naming, and fluency Benton's Naming Test and Word Fluency , visuoperceptual skill Ghent-Poppelreuter and Street Gestalt Completion Tests and visuomotor coordination Bender Test.

After detection of IED activation during sleep, children were followed up for 2 years. At the time of IED remission T1 , neuropsychological re-evaluation showed a notable increase in IQ score and a significant improvement t-test: Abstract This multicenter clinical trial was conducted to examine current practice of benign epilepsy with centrotemporal spikes and especially address the question that in what circumstances 1 antiepileptic drug AED should be preferred.

Twenty-five medical centers participate in this clinical trial. The general information, clinical information, and treatment status were collected under the guidance of clinicians and then analyzed. Difference between different treatment groups was compared, and usefulness of the most commonly used AEDs was evaluated.

A total of subjects were collected. The average age of the subject was 8. The average age of onset is 6. Male-to-female ratio is 1. A total of Both age and course of disease of treated rolandic epilepsy RE patients are significantly different from those of untreated patients. Bilateral findings on electroencephalography EEG are less seen in patients with monotherapy compared with patients with multidrug therapy. Age of onset of Chinese RE patients is 6. Bilateral findings on EEG could be a risk factor to require multidrug therapy. The survival rate has increased steadily over the last 40 years.

The patients were followed up until 1. The diagnosis was made in children, 33 new cases per year range 24 to 40 on average. The peak incidence was between 2 and 5 years. Four of 6 infants with acute lymphoblastic leukemia and all 4 with mature B-cell leukemia are alive. Two of the remaining children died before treatment was started. All children achieved remission The data are comparable with the best international results. Milne, Elizabeth; Greenop, Kathryn R. Positive associations have been reported between measures of accelerated fetal growth and risk of childhood acute lymphoblastic leukemia ALL.

We investigated this association by pooling individual-level data from 12 case-control studies participating in the Childhood Leukemia International Consortium. Two measures of fetal growth — weight-for-gestational-age and proportion of optimal birth weight POBW — were analysed. Pooled analyses of all data were also undertaken using multivariable logistic regression. Subgroup analyses were undertaken when possible. Data on weight for gestational age were available for 7, cases and 12, controls from all 12 studies and POBW data were available for 1, cases and 3, controls from three studies.

The summary ORs from the meta-analyses were 1. The pooled analyses produced similar results. The summary and pooled ORs for small-for-gestational-age children were 0. Results were consistent across subgroups defined by sex, ethnicity and immunophenotype, and when the analysis was restricted to children who did not have high birth weight. The evidence that accelerated fetal growth is associated with a modest increased risk of childhood ALL is strong and consistent with known biological mechanisms involving insulin like growth factors.

The associations between childhood acute lymphoblastic leukemia ALL and several proxies of early stimulation of the immune system, that is, day-care center attendance, birth order, maternally reported common infections in infancy, and breastfeeding, were investigated by using data from 11 case-control studies participating in the Childhood Leukemia International Consortium enrollment period: The sample included 7, ALL cases and 11, controls aged 2—14 years.

The data were collected by questionnaires administered to the parents. Joint hypermobility syndrome in childhood. A not so benign multisystem disorder? The average age at onset of symptoms was 6.

Mean age at first walking was Forty-three per cent described a history of easy bruising. JHS is poorly recognized in children with a long delay in the time to diagnosis. Although there is a referral bias towards joint symptoms, a surprisingly large proportion is associated with significant neuromuscular and motor development problems. The delay in diagnosis results in poor control of pain and disruption of normal home life, schooling and physical activities. Knowledge of the diagnosis and simple interventions are likely to be highly effective in reducing the morbidity and cost to the health and social services.

To investigate the diagnostic value of vestibular test and high stimulus rate auditory brainstem response ABR test and the possible mechanism responsible for benign paroxysmal vertigo of childhood BPVC. Data of 56 patients with BPVC in vertigo clinic of our hospital from May to September were retrospectively analyzed in this study. The results of the hearing and vestibular function test were compared and analyzed.

There were 56 patients with BPVC, including 32 men, 24 women, aged years old, with an average of 6. Among 56 cases of BPVC patients, the results of pure tone audiometry were all normal. High stimulus rate ABR was abnormal in Bithermal caloric test was abnormal in The abnormal rate of VEMP was much higher than that of caloric test. The inferior vestibular pathway is much more impaired than the superior vestibular pathway in BPVC.

Aberrant EPHB4 gene methylation and childhood acute lymphoblastic leukemia. The present study aimed to investigate the association between aberrant DNA methylation of the promoter region of the ephrin type-B receptor 4 EPHB4 gene and the development of childhood acute lymphoblastic leukemia ALL. Bisulfite sequencing polymerase chain reaction BSP was performed to determine the methylation density of cytosine-guanine pair islands in the promoter region of EPHB4, in bone marrow samples from 40 children with ALL. The mRNA and protein expression levels of EPHB4 were detected using reverse transcription-quantitative polymerase chain reaction and western blot analysis.

A total of 10 children with idiopathic thrombocytopenic purpura ITP were recruited as controls. Acute presentation of a benign cystadenofibroma of the fallopian tube: Introduction Cystadenofibromas are rare benign tumors of the fallopian tube with only 15 reported cases worldwide. They are usually asymptomatic and are found incidentally. This case is presented on account of its rarity and to the best of our knowledge, is the first reported case of cystadenofibroma of the fallopian tube discovered during an appendicectomy.

Case presentation We report a rare case of cystadenofibroma of the fallopian tube in a year-old Caucasian woman who presented with sudden onset of right iliac fossa pain. A clinical diagnosis of appendicitis was made and she was taken to the operating theater for an appendicectomy. Intraoperatively, the appendix appeared normal. However, the 8 cm cyst contained within the right ovary and the blood in the pelvis warranted a salpingo-oopherectomy.

Our patient made an uneventful recovery and was discharged after four days. Histology revealed a benign cystadenofibroma of the fallopian tube. There was no evidence of recurrence in the follow-up period of 12 months. Conclusion Cystadenofibromas are benign tumors that may macroscopically and ultrasonographically appear malignant. We recommend that the diagnosis of cystadenofibroma is considered prior to performing radical surgery that may affect the fecundity of these patients.

Cystadenofibromas confined to the fallopian tube can be treated curatively with unilateral salpingo-oophorectomy, without the need for any further treatment. However, long-term follow-up of more cases is required to draw more definitive conclusions. Childhood Acute Bacterial Meningitis: Clinical Spectrum, Bacteriological Profile and Outcome. To determine the disease pattern, etiological agents and outcome of childhood acute bacterial meningitis.

Atotal of children between the ages of 1 month and 5 years, admitted with the diagnosis of meningitis on the basis of clinical findings and positive cerebrospinal fluid CSF , were included. Data was analysed using SPSS version Out of children, F ratio of 1. Mean age was Maximum numbers of children were Acute bacterial meningitis mostly affected children under the age of 1 year.

CSF culture revealed both Grampositive and Gram-negative bacteria. The most common pathogen in children who died was streptococcus pneumoniae. Predicting relapse risk in childhood acute lymphoblastic leukaemia. Intensive multi-agent chemotherapy regimens and the introduction of risk-stratified therapy have substantially improved cure rates for children with acute lymphoblastic leukaemia ALL. Current risk allocation schemas are imperfect, as some children are classified as lower-risk and treated with less intensive therapy relapse, while others deemed higher-risk are probably over-treated.

Most cooperative groups previously used morphological clearance of blasts in blood and marrow during the initial phases of chemotherapy as a primary factor for risk group allocation; however, this has largely been replaced by the detection of minimal residual disease MRD. Other than age and white blood cell count WBC at presentation, many clinical variables previously used for risk group allocation are no longer prognostic, as MRD and the presence of sentinel genetic lesions are more reliable at predicting outcome.

Currently, a number of sentinel genetic lesions are used by most cooperative groups for risk stratification; however, in the near future patients will probably be risk-stratified using genomic signatures and clustering algorithms, rather than individual genetic alterations. This review will describe the clinical, biological, and response-based features known to predict relapse risk in childhood ALL, including those currently used and those likely to be used in the near future to risk-stratify therapy.

Treatment for childhood acute lymphoblastic leukaemia: Research on parental adaptation to a child's chronic illness is still scant, and this is particularly so in relation to the experience of treatment for paediatric Acute Lymphoblastic Leukaemia ALL. The work that does exist on parental reactions tends to conflate maternal responses with paternal responses, as fathers are usually seen as having a secondary role. Consequently, little is known about how fathers cope with treatment for childhood ALL. The present discussion seeks to make a contribution to this area by presenting findings on the paternal experience of treatment for paediatric ALL from a longitudinal study conducted at Royal Children's Hospital in Brisbane, Queensland.

The findings from this research clearly indicate the emotional pain that fathers face in their struggle to accept the diagnosis of a serious, life-threatening illness such as ALL in their child. The findings challenge the notion of the make stereotype by showing that the shock of diagnosis, the emotional pain of coping with the illness, the expression of pain through tears, the desire to be with the child, the struggle to cope with the medical interventions, and concerns about other family members are not gender specific, but are rather issues common to both parents.

Other myeloid malignancies include transient abnormal myelopoiesis and myelodysplastic syndrome. Get detailed information about the classification, clinical presentation, diagnostic and molecular evaluation, prognosis, and treatment of newly diagnosed and recurrent disease in this summary for clinicians. Patients and Methods We analyzed data on risk factors and outcomes of children with SMNs occurring after treatment for ALL from 18 collaborative study groups between and Five-year survival estimates for AML were DNMT3A mutations were detected in 4 out of 1.

Furthermore, there was 1 intronic mutation c. One patient gave up treatment due to remission induction failure in day Only 1 patient achieved continuous complete remission. The mutation positions were different from the hotspots reported in adult AML. Benign course after acute high dose levothyroxine intoxication in a 3-year-old boy.

Acute ingestion of thyroid hormone preparations is a common intoxication, with cases in children acute intoxication with high dose levothyroxine 0. We describe the proper management of levothyroxine intoxication in children. His vital-signs were normal and the only symptom during admission was a tachycardia the following day. He was treated prophylactically and therapeutically with activated charcoal and propranolol. Despite very high levels, his clinical symptoms were relatively mild. After clinical follow-up for 3 d he was discharged.

Aim To explore associations between acute otitis media in early childhood and prenatal and postnatal tobacco smoke exposure. Methods Subjects were 32, children born — in the Norwegian Mother and Child Study with questionnaire data on tobacco smoke exposure and acute otitis media up to 18 months of age. Multivariate regression models were used to obtain adjusted relative risks for acute otitis media. Results Acute otitis media was slightly more common in children exposed to parental smoking. The incidence from 0—6 months was 4. After adjusting for postnatal exposure and covariates, the relative risk for acute otitis media 0—6 months when exposed to maternal smoking in pregnancy was 1.

Maternal smoking in pregnancy was associated with acute otitis media up to 12 months of age. Compared to non-exposed children, there was a slightly increased risk of recurrent acute otitis media for children exposed both pre- and postnatally with a relative risk of 1. Conclusion Even in a cohort with relatively low exposure levels of parental smoking, maternal smoking in pregnancy was associated with an increased risk of acute otitis media in early childhood. Birth weight and risk of childhood acute leukaemia. Studies of risk factors for acute leukaemia are inconclusive. This case-control study was done in West Azerbaijan province, Islamic Republic of Iran, to determine the relationship between birth weight and acute leukaemia in children aged under 15 years.

For every patient 2 age- and sex-matched controls were selected from hospital and community populations. Of cases diagnosed over the period , Significantly more of them were male than female In a multivariate logistic regression model variables significantly associated with acute leukaemia were: The risk of acute leukaemia increased significantly with increasing birth weight in the total group and among girls, but not among boys.

Rates of prostate surgery and acute urinary retention for benign prostatic hyperplasia in men treated with dutasteride or finasteride. Previous studies have suggested a greater benefit for various outcomes in men diagnosed with benign prostatic hyperplasia BPH who are treated with dutasteride than for men treated with finasteride. This study investigates whether the rates of BPH-related prostate surgery and acute urinary retention AUR differ between dutasteride and finasteride users in the Netherlands.

The incidence of BPH-related prostate surgery and AUR was determined during dutasteride or finasteride treatment and stratified by type of initial BPH-treatment 5-ARI monotherapy or combination with alpha-blocker and prescriber general practitioner GP or urologist. Comparison of the incidence of BPH-related prostate surgery and AUR between the treatment groups was done by Cox proportional hazard regression. Most users started treatment in combination with an alpha-blocker.

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Overall, dutasteride users had a lower risk of BPH-related prostate surgery was lower among dutasteride users than finasteride users HR: This lower risk among dutasteride users was also seen when stratifying by monotherapy or combination therapy HR: However, the association was only present among men treated by urologists. For AUR the rates were low and no statistical significant difference was observed between dutasteride and finasteride users. The risk of undergoing BPH-related prostate surgery was lower among men using dutasteride compared to men using finasteride.

The association was observed for monotherapy as well as combination therapy, however, only among men who received their prescription from a. Uroflowmetric assessment of acute effects of sildenafil on the voiding of men with erectile dysfunction and symptomatic benign prostatic hyperplasia. To evaluate the acute effects of sildenafil 50 mg on the micturation of men with erectile dysfunction ED and concomitant benign prostatic hyperplasia BPH with lower urinary tract symptoms LUTS using uroflowmetric parameters.

A total of 68 male patients randomized into two groups 36 treatment, 32 control groups with International Prostate Symptom Score IPSS greater than 7 and International Index of Erectile Dysfunction-erectile function domain score lower than 26 were enrolled in the study.

Patients in the treatment group received a single dose of 50 mg of oral sildenafil. Patients in the control group received no treatment. Prevoiding urine volumes determined ultrasonographically and voided urine volumes were also recorded.

Mean ages were similar between treatment and control groups In the treatment group the maximum and average flow rates increased significantly Q max from In this paper we demonstrate applying time series models on medical research. The Hungarian mortality rates were analysed by autoregressive integrated moving average models and seasonal time series models examined the data of acute childhood lymphoid leukaemia.

The mortality data may be analysed by time series methods such as autoregressive integrated moving average ARIMA modelling. This method is demonstrated by two examples: Mathematical expressions are given for the results of analysis. Calculations of confidence intervals for autoregressive parameters by tree methods: Analysing the confidence intervals of the first order autoregressive parameters we may conclude that the confidence intervals were much smaller than other estimations by applying the continuous time estimation model.

We present a new approach to analysing the occurrence of acute childhood lymphoid leukaemia. We decompose time series into components.

The periodicity of acute childhood lymphoid leukaemia in Hungary was examined using seasonal decomposition time series method. The cyclic trend of the dates of diagnosis revealed that a higher percent of the peaks fell within the winter months than in the other seasons. This proves the seasonal occurrence of the childhood leukaemia in Hungary. Therefore, we aimed to investigate BIRC6 gene expression in childhood acute leukemia in relation to clinicopathological characteristics at presentation, therapeutic response, and prognosis.

BIRC6 expression level was assessed in 75 children with acute leukemia; 30 patients with acute myeloblastic leukemia AML and 45 patients with acute lymphoblastic leukemia ALL using real-time quantitative reverse transcriptase-polymerase chain reaction. BIRC6 gene expression was higher in patients with unfavorable response to therapy at day 14, those who developed relapse or died in both leukemic groups. The best cutoff value of BIRC6 to predict therapeutic response and disease outcome was determined.

Our results suggested that BIRC6 gene expression could be considered as an adverse risk factor in childhood acute leukemia and, hence, could be used to guide therapeutic regimens. Acute epidural hematoma is a critical emergency all around the world, and its aggressive diagnosis and treatment are of vital importance. Emergent surgical evacuation of the hematoma is known as standard management; however, conservative procedures are also used for small ones. Spontaneous rapid resolution of these hematomas has also been reported in eight pediatric cases. Various theories have been proposed to explain the underlying pathophysiology of this resolution.

Herein, we are reporting a new pediatric case with spontaneously resolving acute epidural hematoma 12 hours after admission to the emergency room. Of a series of children suffering from acute purulent meningitis at the Children's Hospital, Winnipeg, in the years , 12 9. Fortyone of the survivors were re-studied 2. Five children exhibited psychiatric evidence of organic brain damage; seven, neurological abnormality; 11, electroencephalographic abnormality.

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Three had defective intelligence and nine psychological test evidence of organic brain damage. There was a positive correlation between the severity of the acute illness and the presence of neuropsychiatric sequelae; also between neuropsychiatric sequelae, defective intelligence and psychological evidence of brain damage. No correlation existed between the electroencephalographic abnormality and neuropsychiatric defect.

Does childhood misfortune raise the risk of acute myocardial infarction in adulthood? Whereas most research on acute myocardial infarction AMI has focused on more proximal influences, such as adult health behaviors, the present study examines the early origins of AMI.

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A series of event history analyses modeling age of first AMI investigated the direct effects of accumulated and separate domains of childhood misfortune as well as the mediating effects of adult health lifestyle and psychosocial factors. Try the Kindle edition and experience these great reading features: Share your thoughts with other customers. Write a customer review. Amazon Giveaway allows you to run promotional giveaways in order to create buzz, reward your audience, and attract new followers and customers.

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