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Pediatric lower extremity

Juan Carlos Delgado Márquez, Jesus Eloy O Dominguez, Oscar Cervantes, Ana Del Carmen Ibarra López, Juan M Sandoval, Margarita Santiago
Chronic kidney disease is defined as irreversible and progressive damage of the kidney. Chronicity is defined by the presence of renal dysfunction for at least 3 months, and renal dysfunction is defined through combinations of investigation (abnormal radiologic findings, abnormal urine or abnormal biochemistry reflecting renal dysfunction) and/or documentation of glomerular filtration rate below 60 mL/min/1.73 m². The case patient was a girl of 11 years of age, with diagnosis of chronic renal disease, of unknown cause, under renal replacement therapy with peritoneal dialysis, with progressive deterioration of general status and decrease of functional capacity and tolerance to physical activity, presence of fatigue, pulmonary congestion, retention of liquids, and edema in lower extremities, even with adjustment of medical treatment...
January 2019: Experimental and Clinical Transplantation
Marcelo Chávez, Gonzalo Ziegler, José Cotrina, José Galarreta, Miguel de la Cruz, Raúl Mantilla
INTRODUCTION: Soft tissue sarcomas (SFT) are a group of rare and heterogeneous neoplasms (representing less than 1% of cancer in adults and 15% in pediatric patients), for which there is no updated records in the Latin American population. This study aims to describe the current situation of patients treated at a cancer institute in Latin America. METHODS: We obtained records from 250 patients with a diagnosis of SFT, treated at the National Institute of Neoplastic Diseases of Peru (INEN) during the period 2009-2013, with a mean follow-up of 62 months...
February 16, 2019: Cirugía Española
Ghanshyam Das Singhal, Shakti Singhal, Gunjan Agrawal, Deepti Singhal, Vipin Arora
Objective: The objective of this study was to retrospectively study Chiari I malformation patients (<18 years) treated surgically. Materials and Methods: Chiari I malformation patients (<18 years) treated surgically at our institute were retrospectively studied. Results: During the study period between January 1999 and June 2011, fifty patients, aged ≤18 years with Chiari malformation, were treated surgically and formed the basis for this series...
January 2019: Journal of Neurosciences in Rural Practice
Yusuke Takamine, Shun Yamamuro, Koichiro Sumi, Takashi Ohta, Katsunori Shijo, Yoko Nakanishi, Taku Homma, Atsuo Yoshino
Intracranial hemorrhage associated with lower grade glioma is unusual. Furthermore, pleomorphic xanthoastrocytoma (PXA) with intracranial hemorrhage, especially in a children, is extremely rare. We report here a rare case of child PXA with intracranial hemorrhage. An 11-year-old girl was admitted with headache and convulsions. A computed tomography scan demonstrated intracranial hemorrhage in the right temporal lobe. An angiogram revealed no vascular disease including arteriovenous malformation, angioma or aneurysm...
January 2019: NMC Case Report Journal
James S Lin, Julie Balch Samora
Acute compartment syndrome (ACS) is an emergency with potentially devastating consequences. Delayed recognition may be especially concerning for the pediatric population, as children present with a wide variety of etiologies, symptoms, and levels of communication. We sought to determine the average time from injury to diagnosis, most common presentations, the degree to which providers obtained pressure measurements, and outcomes of ACS in the pediatric population. We performed a systematic review of multiple databases to include English-language clinical studies reporting ACS of the extremity in pediatric patients...
January 25, 2019: Journal of Pediatric Orthopedics. Part B
Z-Hye Lee, David A Daar, John T Stranix, Lavinia Anzai, Vishal D Thanik, Pierre B Saadeh, Jamie P Levine
PURPOSE: There is a dearth of literature dedicated to specifically evaluating the use of free flap reconstruction in pediatric lower extremity traumas. This study aims to identify specific risk factors for flap failure in pediatric lower extremity trauma reconstruction. METHODS: Retrospective review of 53 free flaps in our lower extremity database (1979-2017) identified all free flaps performed for traumatic reconstruction in children <18 years of age at our institution...
January 23, 2019: Microsurgery
Jordan B Rapp, Christian A Barrera, Victor M Ho-Fung
BACKGROUND: A closed degloving injury is often referred to as a Morel-Lavellée lesion regardless of location despite traditionally being associated with the hip in adults. It results from a shearing injury that separates the subcutaneous layers from the fascia with fluid filling a potential space. OBJECTIVE: While the most common location and cause have been described in adults, there is limited literature in pediatric patients. We have seen pediatric Morel-Lavellée lesions commonly occurring at the knee after sports...
January 17, 2019: Pediatric Radiology
L C Boyd, G A Bond, A Hamidian Jahromi, S D Kozusko, Zinon Kokkalis, P Konofaos
While free tissue transfer has long been established as a reliable microsurgical technique in the adult population, its application in pediatric reconstruction is a relatively recent phenomenon. Despite initial concerns regarding minute vessel diameters, increased propensity for vasospasm, and limited tissue availability, pediatric free tissue transfer is now a widely used technique that has demonstrated an acceptable level of donor and recipient site morbidity in children. Five flaps commonly used in the reconstruction of lower extremity trauma are discussed in this paper: the latissimus dorsi, rectus abdominis, anterolateral thigh, gracilis, and the subscapular and parascapular flaps...
January 16, 2019: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Chae Hoon Chung, Kyung Rae Ko, Joo Hwan Kim, Jong Sup Shim
BACKGROUND: Slipped capital femoral epiphysis (SCFEs) can be idiopathic or atypical (associated with renal failure, radiation therapy, and endocrine disorders). It is important to estimate the likelihood that atypical SCFE shows different clinical and radiographic characteristics and complications with typical SCFEs. METHODS: We retrospectively reviewed 53 patients (66 hips) with SCFEs managed between 1995 and 2016. Sex, age, weight, height, the duration of symptoms the laterality of the slip, and complications were recorded...
January 14, 2019: Journal of Pediatric Orthopedics
Balagangadhar R Totapally, Andre Raszynski, Danyal Khan, Ibrahim Amjad, Jefry Biehler
OBJECTIVES: The purpose of this study was to evaluate the prevalence, demographics, predisposing conditions, therapeutic interventions, and outcomes of extremity arterial thrombosis in hospitalized children. DESIGN: Retrospective cohort study. PATIENTS: National discharge database analysis. MEASUREMENTS AND MAIN RESULTS: Cases of extremity arterial thrombosis in children and neonates were extracted from the Kids' Inpatient Database 2012...
January 11, 2019: Pediatric Critical Care Medicine
Gulcin Otar Yener, Zahide Ekici Tekin, Selcuk Yuksel
BACKGROUND: Diffuse fasciitis with psoriatic arthritis on magnetic resonance imaging (MRI) has not been previously described in childhood. Here we present the first case report of a pediatric patient developing fasciitis, beyond plantar fasciitis, with psoriatic arthritis. CASE SUMMARY: An 11-year-old female was admitted with the complaints of psoriatic rash on the body associated with severe pain in the lower extremities and arthritis in the right knee. Psoriasis was confirmed by skin biopsy, she diagnosed with juvenile psoriatic arthritis...
January 6, 2019: World Journal of Clinical Cases
Glenda M Beaman, Adrian S Woolf, Raimondo M Cervellione, David Keene, Imran Mushtaq, Jill E Urquhart, Helen M Stuart, William G Newman
The bladder exstrophy-epispadias complex (BEEC) comprises of a spectrum of anterior midline defects, all affecting the lower urinary tract, the external genitalia, and the bony pelvis. In extreme cases, the gastrointestinal tract is also affected. The pathogenesis of BEEC is unclear but chromosomal aberrations have been reported. In particular, duplications of 22q11.2 have been identified in eight unrelated individuals with BEEC. The current study aimed to identify chromosomal copy number variants in BEEC. Analyses was performed using the Affymetrix Genome-wide SNP6...
January 9, 2019: American Journal of Medical Genetics. Part A
Henry Bone Ellis, Meagan J Sabatino, Zachary Clarke, Garrett Dennis, Amanda L Fletcher, Charles W Wyatt, Ayesha Zia, Philip L Wilson
INTRODUCTION: Deep vein thrombosis and pulmonary embolism are major complications that can occur in common orthopaedic procedures such as knee arthroscopy. The purpose of this study is to determine the incidence of venous thromboembolism (VTE) risk factors in adolescent patients undergoing elective lower extremity arthroscopy. A second objective is to determine whether a targeted, standardized screening tool is both cost- and clinically effective in the identification of VTE risk factors in adolescents...
January 7, 2019: Journal of the American Academy of Orthopaedic Surgeons
Scott Taylor, Mina Guirguis, Ellen M Raney
BACKGROUND: Patient-reported Outcome Measures (PROMs) quantifying health-related quality of life are widely used to evaluate illness and the impact of health care interventions. The questionnaires must be comprehensible by the persons completing them. Literacy Surveys in the United States reveal nearly half of the US adult population have a literacy level below the 8th grade. Recommendations are that health-related written material directed at adults should be at a reading level of grade 6 or below...
January 2, 2019: Journal of Pediatric Orthopedics
Jessica McQuerry, Lee Gammon, Aaron Carpiaux, Vishwas Talwalkar, Henry Iwinski, Janet Walker, Cale A Jacobs, Ryan Muchow
BACKGROUND: Our aim was to discern whether children with amputations have differences in subjective function based on amputation level. We hypothesized that children with more proximal amputations would report poorer function and quality of life. METHODS: An IRB-approved, retrospective chart review of patients aged 0 to 21 years old with lower extremity amputations was performed. Demographic information, type of amputation, type of prosthesis, and the Pediatric Outcomes Data Collection Instrument (PODCI) was collected from parents and children (above 10 y old)...
January 2, 2019: Journal of Pediatric Orthopedics
Jacob Archer, Alan P Yaacoub, Francisco Angulo-Parker, Gloria Fritsch, Shana Riner, Ann Coon, Sarah K Johnson, Sarah Delima, Andrew Jea, Jeffrey S Raskin
Severe lower limb spasticity can hinder motor tasks and negatively impacts the quality of life in patients with cerebral palsy. Selective dorsal rhizotomy is a well-established neurosurgical intervention aimed at reducing muscle spasticity in patients with such neuromuscular conditions. Long-term outcomes of selective dorsal rhizotomy have been promising among the authors' institutional series of patients. In this case, we demonstrate the use of L1-S1 osteoplastic laminoplasty and L1-S1 selective dorsal rhizotomy in a 5-year-old male patient with cerebral palsy and spastic lower extremity diplegia...
December 27, 2018: Operative Neurosurgery (Hagerstown, Md.)
Goran Djuričić, Zorica Milošević, Tijana Radović, Nataša Milčanović, Predrag Djukić, Marko Radulovic, Jelena Sopta
BACKGROUND: This is the first reported case of a primary intraosseous angioleiomyoma and the second case of a primary leiomyoma of the rib, irrespective of age. Angioleiomyomas mostly occur in patients of advanced age, in any part of the body, particularly the lower extremities and present as painful, slow-growing nodules in the dermis, subcutaneous fat or deep fascia. Other localizations, especially bone, are considered extremely rare, as well as their occurrence in paediatric patients...
December 19, 2018: BMC Medical Imaging
Luke Addesso, David Koenig, Nadia Huq
Background: Ewing sarcoma, a rare cause of cord compression, is predominantly of osseous origin but can also originate in soft tissues. Soft-tissue manifestations account for <15% of all Ewing sarcoma tumors, and even fewer cases of Ewing sarcoma originating in the epidural space have been documented. Case Report: A 19-year-old female presented to the emergency department for worsening low-back pain during the previous 6 months and numbness and weakness in her legs during the prior 2 weeks...
2018: Ochsner Journal
Yasushi Ishigaki, Naoki Kawagishi, Yutaka Hasegawa, Shojiro Sawada, Hideki Katagiri, Susumu Satomi, Shinichi Oikawa
Pharmacological treatments to decrease low-density lipoprotein (LDL) cholesterol (LDL-C) have limited effects on patients with homozygous familial hypercholesterolemia (HoFH). Since LDL receptors are located mainly in the liver, liver transplantation is considered to be the only way to correct the hepatic cholesterol metabolism abnormalities in HoFH. Liver transplantations, including those combined with heart transplantation, for HoFH have been increasing since 1984, making this a globally established therapeutic option for HoFH...
December 15, 2018: Journal of Atherosclerosis and Thrombosis
Zhenhua Luo, Liming Qing, Zhengbing Zhou, Panfeng Wu, Fang Yu, Juyu Tang
BACKGROUND: The closure of massive skin defects remains challenging, particularly in children. In this report, we describe a technique to achieve primary donor site closure using the kiss deep inferior epigastric perforator (DIEP) flap for the reconstruction of large soft tissue defects located in the extremities of children. METHODS: From May 2011 to May 2016, a retrospective analysis was conducted on 10 pediatric patients with extensive soft tissue defects and reconstruction with double-skin paddle DIEP flap...
January 2019: Annals of Plastic Surgery
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