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Tumino, Manuela, Benedetta Accordi, Manuela Sciro, et al. "Expression of Annexin 2 in Pediatric B-Acute Lymphoblastic Leukemia: A Marker of Aggressiveness and A Potential Therapeutic Target." Blood 114, no. 22 (2009): 2605. http://dx.doi.org/10.1182/blood.v114.22.2605.2605.
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Abstract Abstract 2605 Poster Board II-581 Background. Annexin II (ANXA2) is a member of a peripheral membrane-binding protein family acting in a calcium-dependent manner, is involved in many cellular mechanisms, as cell proliferation and membrane physiology and is related to cancer progression. The aim of this study was to assess the ANXA2 expression in B cell precursor acute lymphoblastic leukemia (Bcp-ALL), in the attempt to finally evaluate it as a new potential therapeutic target. Materials and Methods. The ANXA2 expression was tested in 77 newly diagnosed pediatric Bcp-ALL diagnosed and treated in our centers, according with LLA-2000 protocol of Associazione Italiana di Ematologia ed Oncologia Pediatrica (AIEOP). Diagnostic samples and 3 B-ALL cell lines (REH, SEM, 697) were studied by reverse phase protein array (RPPA), western blot and real-time PCR (RQ-PCR) analyses. Furthermore, immunofluorescence on bone marrow smears and cytofluorimetric studies were performed, in order to visualize the protein subcellular location. The associations between the ANXA2 expression, molecular features and prognosis were evaluated. For statistical purpose, multivariate analyses with Wilcoxon test and t-Test with conservative Bonferroni corrections and Kaplan-Mayer analysis were performed. Pearson correlation was used to compare mRNA and protein levels. Results. Our analyses demonstrated a positive correlation between mRNA and protein ANXA2 expression (Pearson correlation or index 0.6). Comparing ANX2 expression and molecular features, we found a statistically significant difference between patients with unfavourable [t(9;22), t(4;11)] and favourable translocations [t(12;21)], showing a higher level of ANXA2 in the former group (p-value <0.05). Additionally ANXA2 resulted upregulated at both mRNA and protein levels in 24 out of 77 patients included in the study, and in the group presenting with high ANXA2 expression, 8 (33%) patients relapsed; in contrast, in the group with low ANXA2 expression only 8 out of 53 cases (15%) suffered from a relapse. Interestingly, 5 patients (21%) with high ANXA2 expression died of progressive disease, while with only one case (2%) in the group with low ANXA2 expression. A multivariate analysis also showed that ANXA2 is an independent predictor of disease's aggressiveness. Due to the heterogeneity of response to treatment among our patients, which imply a stratification based on detection of minimal residual disease (MRD), the correlation between high expression level of ANXA2 with prognosis resulted not statistically significant (Kaplan-Mayer p-value >0.05). However, our data strongly suggested a correlation with a worst prognosis in those cases with high ANXA2 expression. Furthermore, immunofluorescence and cytofluorimetric analyses performed on SEM and 697 cell lines showed that ANXA2 is localized on the cellular membrane's surface, where the protein is usually involved in many cell functions. Conclusions. To date, our study reports on ANXA2 expression and location in pediatric ALL. Our findings suggest that ANXA2 expression represents a marker of aggressiveness in Bcp-ALL, confirmed by the correlation with unfavourable molecular rearrangement such as MLL/AF4. Although the prognostic impact of ANXA2 expression needs to be evaluated with a further retrospective study including a larger and selected population, our data already strongly suggest that ANXA2 expression could be considered as a new potential therapeutic target in pediatric Bcp-ALL. Disclosures: No relevant conflicts of interest to declare.
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Yalçın, Koray, Ersin Erhal, Melih Yıldırım, et al. "Pediyatrik Kanser Hastalarında Otolog Kök Hücre Toplama İşlemine Etki Eden Faktörlerin Değerlendirilmesi." LLM Dergi 6, no. 1 (2022): 9–15. http://dx.doi.org/10.5578/llm.20229902.
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Objective: Pediatric cancer patients comprise a fragile patient group regarding age and intensive therapy. It is known that factors like apheresis machine, characteristics of patients, primary disease, and cellular parameters before the process impact the efficacy of stem cell apheresis. In this study, we aim to evaluate the characteristic features of stem cell apheresis and the influencing factors of the process. Patients and Methods: This study involves 42 patients who received a total of 88 aphereses, between August 2012-March 2021in our pediatric stem cell transplantation unit. All of the patients received chemotherapy and GCSF for mobilization. The patients received plerixafor in case of unsuccessful mobilization. Results: For most of the patients (n= 23, 55%), targeted cell numbers could be reached on the second day of apheresis. Especially the patients with neuroblastoma and lymphoma need to have more than one apheresis. Our results indicate that median MNC and CD 34 + cell counts before the apheresis were significantly associated with successful apheresis (p< 0.01 and p= 0.03 respectively). Regarding the influence of primary disease, we showed that successful apheresis was less in neuroblastoma and lymphoma compared to other pediatric cancers (p= 0.01). We reported successful apheresis with plerixafor for six patients who had unsuccessful apheresis before. Conclusion: In this study, it is shown that median MNC counts before apheresis, median CD 34 + cell counts before apheresis, and primary disease are influencing factors for successful apheresis. This study indicates that plerixafor may enhance the apheresis efficacy even in unsuccessful apheresis attempts with standard mobilization protocol. Identifying the influencing factors on apheresis for such a fragile patient population may help the procedure to be more efficient and safe for the children.
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Moreira, Karina Andrade, Ana Lucia Miranda de Carvalho, Marcia Trindade Schramm, Renata Brum Martucci, Leonardo Borges Murad, and Danúbia da Cunha Antunes Saraiva. "Estado Nutricional de Pacientes Pediátricos Recém-Diagnosticados com Leucemia Linfoblástica Aguda em um Instituto de Referência em Oncologia do Rio de Janeiro." Revista Brasileira de Cancerologia 64, no. 3 (2019): 349–55. http://dx.doi.org/10.32635/2176-9745.rbc.2018v64n3.35.
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Introdução: A leucemia linfoblástica aguda (LLA ) constitui a neoplasia mais comum em pediatria e a avaliação nutricional é um instrumento essencial para conhecer as condições de saúde dos pacientes. O presente estudo teve como objetivo avaliar e descrever o estado nutricional de pacientes pediátricos recém-diagnosticados com LLA e verificar a relação do índice de massa corporal para idade (IMC/I) com as demais medidas antropométricas. Método: Estudo observacional, transversal, realizado com pacientes de 1 a 18 anos, recém-diagnosticados com LLA , no período de janeiro/2004 a dezembro/2009. Os dados coletados foram idade, peso corporal, estatura, prega cutânea tricipital (PCT), circunferência do braço (CB) e circunferência muscular do braço (CMB). O IMC foi calculado e a classificação IMC/I utilizada na análise. O teste Qui-quadrado de Pearson e Exato de Fisher foram utilizados para analisar a associação entre os parâmetros antropométricos. Resultados: Foram incluídos no estudo 54 pacientes. A classificação do “estado nutricional adequado” foi a mais frequente em todos os parâmetros antropométricos. Em adição, observou-se que a associação do estado nutricional pela CMB com o IMC/I (p=0,001) demonstra que este último pode ser adequado para classificação dos pacientes pediátricos com LLA ao diagnóstico. E a concordância da CB com a CMB (p=0,01) de 43% (p=0,001) também ratifica a utilização da CB frente à CMB, por ser uma medida mais simples. Conclusão: Na população estudada, o estado nutricional encontrava-se preservado. Assim como a associação da CMB com o IMC/I, a CB demonstrou ser um parâmetro sensível para classificar eutrofia.
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ÜNAL İNCE, Elif, Gül Hatice ERKOL TUNCER, Talia İLERİ, et al. "Impact of ABO Incompatibility on Pediatric Haematopoietic Stem Cell Transplantation." LLM Dergi 2, no. 1 (2018): 9–14. http://dx.doi.org/10.5578/llm.66211.
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TJ, Syntia, Endang Retnowati, Yetti Hernaningsih, I. Dewa Gede Ugrasena, and Soeprapto Ma’at. "COMPARISON OF PERIPHERAL BLOOD ACTIVATED NK CELL PERCENTAGE BEFORE AND AFTER INDUCTION PHASE CHEMOTHERAPY IN PEDIATRIC ACUTE LYMPHOBLASTIC LEUKEMIA (Perbandingan Persentase Sel NK Teraktivasi Darah Tepi Sebelum dan Sesudah Kemoterapi Tahap Induksi di Pasien Leukemia Limfoblastik Akut Anak)." INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY 23, no. 3 (2018): 281. http://dx.doi.org/10.24293/ijcpml.v23i3.1208.
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Leukemia Limfoblastik Akut (LLA) adalah keganasan sel progenitor limfoid yang berasal dari sumsum tulang dan ditandai proliferasileukosit. Kejadian LLA masih tinggi, sehingga perlu diteliti peran sel NK dalam melawan leukemia. Tujuan penelitian adalah untukmengetahui perbedaan persentase sel NK teraktivasi sebelum dan sesudah pengobatan induksi dan hubungan persentase sel NK teraktivasisebelum pengobatan induksi dengan keluaran kemoterapi pasien LLA anak. Penelitian analitik observasional dengan rancang banguncohort prospektif. Subjek penelitian 27 pasien di Ruang Rawat Inap Hemato-Onkologi Anak RSUD Dr. Soetomo Surabaya, antara bulanMaret–Juli 2016. Metode memeriksa flowcytometry menggunakan alat BD FACS CaliburTM reagen Fast Immune CD56FITC/CD69PE/CD45 Per CP No.katalog.5055879. Analisis statistik dengan uji Wilcoxon Signed Rank dan regresi logistik. Terdapat perbedaan bermaknarerata persentase sel NK teraktivasi sebelum pengobatan induksi 0,57% (SB 0,53%) dan sesudahnya 2,01% (SB 1,86%) p=0,000.Menunjukkan peningkatan bermakna sel NK teraktivasi sesudah pengobatan induksi. Kenasaban sel NK teraktivasi sebelum pengobataninduksi dengan keluaran kemoterapi berkurangnya gejala penyakit (remisi) dan meninggal R=0.723 berarti kenasabannya kuat.Peningkatan persentase sel NK teraktivasi sesudah pengobatan induksi disebabkan kerja kemoterapi meningkatkan hasil MICA/B dankerja activating receptors sel NK (NKG2D) yang bersifat sitotoksik yang kuat. Persentase sel NK teraktivasi sebelum pengobatan induksiyang rendah disebabkan mekanisme menghilangnya tumor di LLA. Terdapat perbedaan bermakna persentase sel NK teraktivasi sebelumdan sesudah pengobatan induksi. Hasilnya dapat menjadi peramal keberhasilan pemberian kemoterapi LLA anak. Persentase sel NKteraktivasi sebelum kemoterapi tahap induksi yang tinggi berpengaruh kuat terhadap keluaran kemoterapi berkurangnya gejala penyakitdan sebaliknya bila rendah berpengaruh terhadap kemungkinan yang bersangkutan meninggal. Diperlukan hasil jangka panjang sampaiselesai dalam pengelolaan pemberian pengobatan terkait.
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Pedrosa, Francisco, and Mecneide Lins. "Leucemia linfóide aguda: uma doença curável." Revista Brasileira de Saúde Materno Infantil 2, no. 1 (2002): 63–68. http://dx.doi.org/10.1590/s1519-38292002000100010.
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RESUMO: Leucemia linfóide Aguda (LLA), é o tipo mais comum de câncer infantil, constituindo cerca de um terço de todas as neoplasias malignas da criança. A incidência de LLA em crianças nos Estados Unidos é aproximadamente de 3,4 casos por 100.000 crianças menores de 15 anos de idade. Até a metade do século passado, as leucemias eram consideras universalmene, uma doença fatal. O desenvolvimento de combinações terapêuticas, utilizando diversas drogas citotóxicas com ou sem transplante de medula óssea, tem aumentado o percentual de cura da criança portadora de Leucemia linfóide Aguda em mais de 80%. Anualmente cerca de 1.500 crianças com LLA, nos Estados Unidos, estão sendo curadas. Contudo, dos 75.000 novos casos de LLA, que são diagnosticados anualmente em todo o mundo, cerca de 60.000 (80%) não têm acesso a essas modernas formas de tratamento e são, portanto excluídos desse processo de cura. O desafio de tornar a LLA uma doença curável começa a ser vencido com o relato de taxas de sobrevida maior que 50% para crianças tratadas em países com recursos limitados. Em El salvador, Bonilla, conseguiu aumentar a taxa de sobrevida de crianças com LLA de 5% para 50%. No Recife, Pernambuco, Brasil, Pedrosa evoluiu de uma taxa de 29% nos anos 80, para 75% na era atual.
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Nur’Aini, Farida, Endang Retnowati, Yetti Hernaningsih, and Mia Ratwita A. "COMPARISON OF PERCENTAGE PERIPHERAL BLOOD LYMPHOBLAST PROLIFERATION AND APOPTOSIS IN PEDIATRIC ACUTE LYMPHOBLASTIC LEUKEMIA BEFORE AND AFTER CHEMOTHERAPY INDUCTION PHASE (Perbandingan Persentase Proliferasi dan Apoptosis Limfoblas di Darah Tepi di Pasien Leukemia Limfoblastik Akut Anak Sebelum dan Sesudah Kemoterapi Tahap Induksi)." INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY 23, no. 3 (2018): 263. http://dx.doi.org/10.24293/ijcpml.v23i3.1205.
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Leukemia Limfoblastik Akut (LLA) adalah penyakit neoplasma yang dihasilkan dari perpindahan somatik multistep progenitorlimfoid di sumsum tulang, ditandai maturation arrest, proliferasi tidak terkendali seri limfoid serta penumpukan limfoblas di sumsumtulang dan darah tepi. Kelainan terkait aktivitas proliferasi sel berkaitan dengan kendali apoptosis. Penelitian ini bertujuan mengetahuiperbandingan persentase proliferasi dan apoptosis limfoblas di darah tepi pasien LLA anak sebelum dan sesudah kemoterapi tahapinduksi. Subjek penelitian sebesar 12 pasien LLA anak kasus baru yang diperiksa sebelum dan sesudah kemoterapi tahap induksi. Jenispenelitian ini cohort prospektif tanpa pembanding. Pemeriksaan proliferasi limfoblas dilakukan menggunakan spesimen darah tepisedangkan pengecatannya menggunakan reagen PI/RNase. Pemeriksaan apoptosis limfoblas dilakukan menggunakan spesimen darahtepi sedangkan pengecatannya menggunakan reagen FITC Annexin V. Pembacaan proliferasi dan apoptosis limfoblas menggunakan alatBD FACSCallibur dengan metode flow cytometry. Rerata persentase proliferasi dan apoptosis limfoblas sebelum kemoterapi tahap induksi7,84%±7,50 dan 11,50%±8,60 sesudah kemoterapi tahap induksi 3,2%±1,89 dan 13,42%±8,10. Persentase proliferasi limfoblas didarah tepi sesudah pemberian kemoterapi tahap induksi terdapat penurunan bermakna, sedangkan pemeriksaan apoptosis limfoblasdidapatkan peningkatan yang tidak bermakna. Persentase proliferasi limfoblas di darah tepi sesudah kemoterapi tahap induksi terdapatpenurunan bermakna, sehingga dapat dipergunakan sebagai peramal keberhasilan pengobatan pasien LLA anak. Pemeriksaan apoptosislimfoblas tidak terdapat perbedaan bermakna sebelum dan sesudah kemoterapi tahap induksi. Perlu penelitian lebih lanjut untukmenganalisis hasil yang didapat.
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Rusanti, Rahmi, Yetti Hernaningsih, Endang Retnowati, Mia Ratwita Andarsini, and Andy Cahyadi. "CORRELATION OF BLAST PERCENTAGE TO CD34 OF BONE MARROW IN ALL PEDIATRIC PATIENTS." INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY 24, no. 1 (2018): 53. http://dx.doi.org/10.24293/ijcpml.v24i1.1156.
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Leukemia Limfoblastik Akut (LLA) adalah penyakit keganasan sel progenitor limfoid yang berasal dari sumsum tulang. Tanda khasdari diagnosis leukemia akut adalah sel blas. Pemeriksaan mikroskopis dilakukan untuk menentukan persentase sel blas pada diagnosisleukemia akut. Immunophenotyping merupakan metode diagnostik yang dapat membantu menegakkan diagnosis pada keganasanhematologi. CD34 merupakan antigen yang sering digunakan untuk identifikasi sel induk hemopoeisis atau blas. Penelitian ini bertujuanuntuk mengetahui kenasaban antara persentase blas dengan ekspresi CD34 di sumsum tulang di pasien leukemia limfoblastik akut anaksebelum dan sesudah pengobatan kemoterapi fase induksi.
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Salem, Ronza, Jonathan Lorber, and Ron Karmeli. "LEA 25. Pediatric Penetrating Injury of Popliteal Fossa." Journal of Vascular Surgery 70, no. 5 (2019): e124. http://dx.doi.org/10.1016/j.jvs.2019.08.042.
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Rykov, M. Yu, and V. G. Polyakov. "THE HISTORY OF PEDIATRIC ONCOLOGY IN THE USSR-RUSSIA: THE 40TH ANNIVERSARY OF THE INSTITUTE OF PEDIATRIC ONCOLOGY AND HEMATOLOGY OF THE N.N. BLOKHIN RUSSIAN CANCER RESEARCH CENTER AND THE 20TH ANNIVERSARY OF PEDIATRIC ONCOLOGY." Russian Journal of Oncology 22, no. 2 (2017): 107–12. http://dx.doi.org/10.18821/1028-9984-2017-22-1-107-112.
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The article describes the history of the selection of pediatric oncology as a separate specialty, the organization of first oncological departments and the creation of the first in the USSR Research Institute of Pediatric Oncology and Hematology. There is described the role of academician L.A. Durnov as the founder of oncopediatrics in the national health care
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Papp Zsuzsanna, Erzsébet, and Mária-Adriene Horváth. "MANIFESTĂRI CLINICE ÎN PERIOADELE DE APLAZIE SECUNDARĂ CHIMIOTERAPIEI." Romanian Journal of Pediatrics 65, no. 1 (2016): 111–15. http://dx.doi.org/10.37897/rjp.2016.1.23.
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Obiectiv. Evidenţierea semnelor şi simptomelor clinice ale aplaziilor medulare secundare chimioterapiei anticanceroase de atac. Material şi metodă. Lotul de studiu cuprinde 20 copii (9 luni-18 ani) spitalizaţi în compartimentul hemato-oncologie pediatrică al Spitalului Clinic Judeţean Mureş – secţia clinică de Pediatrie, cu următoarele diagnostice: Leucemia acută limfoblastică – LAL, tumoră Wilms – WT, Leucemie acută mieloblastică – LAM, Limfom Hodgkin – LH, Limfom cu celule mari anaplastice non-Hodgkin – LNH, tumoră cu celule mici rotunde desmoplazice – TD, Neuroblastom presacrat tratat şi recidivate – NB. Criteriul de includere în studiu a fost chimioterapia de atac, iar de excludere tratamentul citostatic de întreţinere. S-a alcătuit un protocol de supraveghere clinico-biologică în dinamică, adresat cu precădere reflectării clinice a aplaziilor induse de fiecare bloc citostatic. Aplazia medulară a fost atestată de prezenţa neutropeniei, anemiei şi trombocitopeniei. Rezultate şi discuţii. În studiu s-au încadrat 20 copii (9 fete, 11 băieţi) cu tratament intens citostatic. Patologia majoritară a fost LAL (60%), apoi a urmat WT (3 cazuri) şi câte un caz de LAM, LH, LNH, TD, NB. Vârsta copiilor era cuprinsă între 9 luni şi 18 ani (VM-7.18), distribuţia grupelor de vârstă respectând datele din literatura de specialitate. Toţi pacienţii au fost trataţi conform protocoalelor internaţionale. După fiecare bloc citostatic a urmat o perioadă de aplazie. Patologia aferentă a constat din anemii, trombocitopenii, mucozită, infecţii cu diferite localizări, reactivare zona zoster secundară imunodeprimării. Concluzii. Aplazia medulară postcitostatică a avut durată şi severitatea diferită în funcţie de tipul de cancer. Durata, severitatea complicaţiilor clinice şi rezistenţa la tratament au fost severe în LAL şi leucemia mieloblastică. Complicaţiile infecţioase au evoluat cu nuanţe individualizate generate probabil de particularităţile imunologice.
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Boissel, Nicolas, Marie-Françoise Auclerc, Véronique Lhéritier, et al. "Should Adolescents With Acute Lymphoblastic Leukemia Be Treated as Old Children or Young Adults? Comparison of the French FRALLE-93 and LALA-94 Trials." Journal of Clinical Oncology 21, no. 5 (2003): 774–80. http://dx.doi.org/10.1200/jco.2003.02.053.
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Purpose: To compare pediatric and adult therapeutic practices in the treatment of acute lymphoblastic leukemia (ALL) in adolescents. Patients and Methods: From June 1993 to September 1994, 77 and 100 adolescents (15 to 20 years of age) were enrolled in the pediatric FRALLE-93 and adult LALA-94 protocols, respectively. Among the different prognostic factors, we retrospectively analyzed the effect of the trial on achieving complete remission (CR) and event-free survival (EFS). Results: Patients were younger in the FRALLE-93 than in the LALA-94 protocol (median age, 15.9 v 17.9 years, respectively), but other characteristics were similar, including median WBC count (18 × 109 cells/L v 16 × 109 cells/L), B/T-lineage (54 of 23 v 72 of 28 patients), CD10-negative ALL (13% v 15%), and poor-risk cytogenetics (t(9;22), t(4;11), or hypodiploidy less than 45 chromosomes: 6% v 5%). The CR rate depended on WBC count (P = .005) and trial (94% v 83% in FRALLE-93 and LALA-94, respectively; P = .04). Univariate analysis showed that unfavorable prognostic factors for EFS were as follows: the trial (estimated 5-year EFS, 67% v 41% for FRALLE-93 and LALA-94, respectively; P < .0001), an increasing WBC count (P < .0001), poor-risk cytogenetics (P = .005), and T-lineage (P = .01). The trial and WBC count remained significant parameters for EFS in multivariate analysis (P < .0001 and P = .0004). Lineage subgroup analysis showed an advantage for the FRALLE-93 trial for CR achievement (98% v 81%; P = .002) and EFS (P = .0002) in B-lineage ALL and for EFS (P = .05) in T-lineage ALL. Age was not a significant prognostic factor in this population of adolescents. Conclusion: This study’s findings indicate that adolescents should be included in intensive pediatric protocols and that new trials should be designed, inspired by pediatric protocols, for the treatment of young adults with ALL.
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Leite, Edinalva Pereira, Maria Tereza Cartaxo Muniz, Alita da Cunha Andrade Cirne de Azevedo, et al. "Fatores prognósticos em crianças e adolescentes com Leucemia Linfóide Aguda." Revista Brasileira de Saúde Materno Infantil 7, no. 4 (2007): 413–21. http://dx.doi.org/10.1590/s1519-38292007000400009.
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OBJETIVOS: descrever características clínico-laboratoriais, determinar taxas de resposta ao tratamento e identificar fatores de risco que influenciaram na sobrevida de pacientes pediátricos com leucemia linfóide aguda (LLA). MÉTODOS: estudo retrospectivo do tipo série de casos com 108 pacientes de idade até 18 anos, admitidos para tratamento de LLA na Fundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Brasil, de janeiro de 1993 a dezembro de 2001. As variáveis analisadas foram: sexo, idade, principais sintomas e sinais, leucometria, imunofenótipo e grupo de risco ao diagnóstico, taxas de remissão e recaída, óbito e sobrevida global, local de recaída e fatores de risco para a sobrevida. Medidas descritivas foram usadas para a análise estatística. O tempo de sobrevida dos pacientes foi estimado através da função de sobrevida de Kaplan-Meier e Log-Rank. O efeito de fatores de risco no tempo de sobrevida foi avaliado através do Modelo de Regressão de Cox. RESULTADOS: foi encontrada a relação masculino:feminino de 1,7:1, mediana de idade ao diagnóstico de oito anos, freqüência de queixas músculo-esqueléticas (51%), infiltração do sistema nervoso central (8%), LLA-Precursor B (81%) e LLA-T (19%). A distribuição dos grupos correspondeu a Risco Básico Verdadeiro (12%), Risco Básico (21%) e Alto Risco (67%). As principais taxas foram: remissão (86%), óbitos na indução (5,5%), recaída (24%) e sobrevida global (62,5%). CONCLUSÕES: a variável de impacto na sobrevida foi a leucometria. A taxa de sobrevida global foi influenciada pela freqüência elevada de pacientes considerados de alto risco.
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Ovalle B., Pilar, Manuel Azócar M., Carolina Nicklas D., Milena Villarroel C., and Jorge Morales V. "Reacciones de hipersensibilidad asociadas al uso de asparaginasa en niños con leucemia linfoblástica aguda." Andes Pediatrica 92, no. 2 (2021): 182. http://dx.doi.org/10.32641/andespediatr.v92i2.2151.
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El tratamiento de la leucemia linfoblástica aguda (LLA) incluye el uso de asparaginasa (ASP), medicamento asociado a reacciones de hipersensibilidad (RHS) que requieren discontinuar su uso.Objetivo: Determinar la incidencia de RHS asociadas a ASP que requieran discontinuar su uso y describirlas, y verificar si hay asociación entre incidencia de RHS y protocolos o sobrevida.Pacientes y Método: Estudio retrospectivo. Se revisaron los registros clínicos de todos los pacientes (1-15 años) diagnosticados de LLA entre enero de 2010 y diciembre de 2015 en el Hospital Luis Calvo Mackenna. Se determinó incidencia de RHS a ASP, se clasificaron según score de gravedad CTCAE v5.0, se analizó riesgo relativo de RHS con test de Fisher y sobrevida con estimador Kaplan-Meier.Resultados: Se recopilaron 110 pacientes. Durante el primer tratamiento (ALL-IC-BFM), la incidencia de RHS a L-ASP fue 55%, cambiándose a PEG-ASP como segunda línea. De estos, 44% presentó RHS, debiendo discontinuarse ASP definitivamente en 25% de los pacientes. De todas las RHS, 77% fueron anafilácticas (CTCAE 3-5). Los pacientes en protocolo IB aumentado tuvieron mayor riesgo de no completar tratamiento con ASP, RR 3,81 (IC 95%, 1,98-7,31, p = 0,0001). Los pacientes sin RHS en ALL-IC-BFM presentaron menor riesgo de recaer, HR 0,29 (IC 95%, 0,14-0,62, p = 0,0013). Considerando todos los tratamientos (ALL-IC-BFM y recaídas), los que completaron tratamiento con ASP tuvieron mayor sobrevida global, HR 0,20 (IC 95%, 0,07-0,57, p = 0,0026).Conclusiones: Las RHS a ASP que requieren suspensión de tratamiento son frecuentes en niños con LLA, siendo mayormente reacciones anafilácticas graves. Este estudio sugiere mejor pronóstico en pacientes sin RHS a ASP.
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Yustinadewi, Putu Desy, Putu Sanna Yustiantara, and Inna Narayani. "MDR-1 GENE 1199 VARIANT PRIMER DESIGN TECHNIQUES IN PEDIATRIC PATIENT BUFFY COAT SAMPLES WITH LLA." Metamorfosa: Journal of Biological Sciences 5, no. 1 (2018): 105. http://dx.doi.org/10.24843/metamorfosa.2018.v05.i01.p16.
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Single Nucleotide Polymorphism (SNP) 1199 dapat diidentifikasi menggunakan sampel buffy coat dengan metode Polymerase Chain Reaction (PCR). Komponen- komponen yang diperlukan pada proses PCR adalah template DNA; sepasang primer, yaitu suatu oligonukleotida pendek yang mempunyai urutan nukleotida yang komplementer dengan urutan nukleotida DNA templat; dNTPs (Deoxynucleotide triphosphates); buffer PCR; magnesium klorida (MgCl2) dan enzim polimerase DNA (Handoyo dan Rudiretna, 2001). Primer sangat mempengaruhi spesifitas dan sensitivitas reaksi PCR. Rancangan suatu primer merupakan salah satu parameter penentu keberhasilan suatu proses PCR (Ebd-Elsalam, 2003). Primer untuk sekuensing gen MDR-1 variant 1199 berhasil didesain dalam kondisi terbaik. Panjang sekuen primer forward sejumlah 21 oligonukleotida dan reverse sejumlah 20 oligonukleotida dengan fragmen sebesar 225 pb.
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Consuelo-Sánchez, Alejandra, Rodrigo Vázquez-Frías, Alejandra Reyes-De la Rosa, Carlos P. Acosta-Rodríguez-Bueno, María P. Ortal-Vite, and Jorge J. Cebolla. "Mutations Identified in a Cohort of Mexican Patients with Lysosomal Acid Lipase Deficiency." Annals of Hepatology 17, no. 5 (2018): 0–10. http://dx.doi.org/10.5604/01.3001.0012.4899.
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Introduction and aim. Lysosomal acid lipase deficiency (LAL-D) is an autosomal recessive disease caused by mutations in the LIPA gene, located on the long arm of chromosome 10 (10q23.31). Up until now, more than 59 mutations have been described and which are the cause of a very wide clinical spectrum. The goal of this study was to identify the mutations present in Mexican pediatric patients with a diagnosis of LAL-D. Material and methods. A cross-sectional study was carried out which included all the pediatric patients with LAL-D treated in a tertiary hospital in Mexico from January 2000 to June 2017. Results. Sixteen patients with LAL-D were identified with a disease phenotype marked by the accumulation of cholesteryl esters. Eight distinct variants in the LIPA gene sequence were found, four pathogenic variants and four probably pathogenic. In six individuals, the variants were found in the homozygous state and ten were compound heterozygous. The eight variants were inverted, with five found on exon 4 and the others on exons 2, 8 and 10. The variant c.386A>G;p.His129Arg was the most common, being found in six of the 16 individuals (37.5%), making it much more frequent than what had previously been reported in the literature in proportion to the rest of the variants. The mutation known as E8SJM, which has been the mostly frequently found at the international level, was not the most common among this group of Mexican patients. Conclusion. Mexican patients present a different frequency of mutations associated with LAL-D in comparison to European populations.
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Karbalivand, H., A. Iyare, A. Aponte, X. Xianhong, M. Kim, and T. Havranek. "Hypoglycemia screening of asymptomatic newborns on the 2nd day of life." Journal of Neonatal-Perinatal Medicine 15, no. 2 (2022): 311–16. http://dx.doi.org/10.3233/npm-210861.
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BACKGROUND: Neonatal hypoglycemia management in the first 48 hours is guided by the American Academy of Pediatrics (AAP) and Pediatric Endocrine Society (PES) recommendations. Our aim was to determine the incidence of hypoglycemia via point of care test (POCT) on the 2nd day of life (DOL) among healthy, asymptomatic neonates regardless of risk factors. METHODS: In this prospective observational study, preprandial point of care glucose concentration was measured on the 2nd DOL in 150 healthy, asymptomatic neonates in the newborn nursery. We used 50 mg/dl (2.8 mmol/L) as the hypoglycemia threshold based on PES recommendations. RESULTS: The incidence of hypoglycemia on the second DOL was 10% among asymptomatic neonates (no risk factors = 8%; late preterm birth (LPT) + small for gestational age (SGA) = 16%; large for gestational age (LGA) + infant of diabetic mother (IDM) = 6%). SGA + LPT neonates accounted for the majority of the hypoglycemic cases (53.3%) and exhibited a trend towards the lowest glucose concentration (p = 0.09). CONCLUSION: The incidence of hypoglycemia on DOL 2 among asymptomatic neonates is high and of unclear significance in the absence of dedicated neurodevelopmental follow-up.
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Feick, Emma, Peggy-Rae Hamilton, Marlene Luis, et al. "A pilot study examining measures of balance and mobility in children with unilateral lower-limb amputation." Prosthetics and Orthotics International 40, no. 1 (2014): 65–74. http://dx.doi.org/10.1177/0309364614560941.
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Background:Individuals with unilateral lower-limb amputation (LLA) have altered structure and physiology of their lower limbs which impairs their balance, mobility, physical function and participation in physical activities. As part of (re)habilitation, focus is given to improving gait and balance in order to enhance overall mobility, function, self-efficacy, and independence. However, the relationships amongst body impairments and physical activity limitations remain unclear, particularly in the pediatric population.Objective:To provide an examination of the relationships among balance and mobility measures in children with unilateral lower-limb amputation and able-bodied children.Study design:Cross-sectional prospective comparative pilot study.Methods:Spatiotemporal gait parameters and standing postural control were evaluated in children with lower-limb amputation (n = 10) and age-matched able-bodied children (n = 10) in a laboratory-based setting. Clinical tests for mobility and balance consisted of the 10-m walk test, the 6-min walk test, and the Community Balance and Mobility scale. Energy expenditure was estimated during the 6-min walk test using the Physiological Cost Index. Analysis included comparing variables between able-bodied and lower-limb amputation groups, as well as examining the correlations among them.Results:Walking speed, distance, and functional balance (p < 0.05) were significantly diminished in children with lower-limb amputation compared to able-bodied children. For children with lower-limb amputation, reduced energy expenditure was associated with narrower step width and more symmetrical gait; better postural control and balance were associated with faster walking speeds (p < 0.05).Conclusion:A greater clinical understanding of gait and balance deficits in this population may help to improve rehabilitation outcomes and overall functional mobility.Clinical relevanceImproved understanding of deficits in children with lower-limb amputation (LLA) may lead to more targeted interventions and facilitate clinical decision-making in rehabilitation settings for this population. The findings contribute to the limited literature and provide a basis to further examine suitable clinical outcome measures to be used in children with LLA.
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Huguet, Françoise, Emmanuel Raffoux, Xavier Thomas, et al. "Towards a Pediatric Approach in Adults with Acute Lymphoblastic Leukemia (ALL): The GRAALL-2003 Study." Blood 108, no. 11 (2006): 147. http://dx.doi.org/10.1182/blood.v108.11.147.147.
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Abstract Introduction: In a recent French FRALLE versus LALA comparison, we have demonstrated a large benefit in outcome when adolescents and young adults were treated in a pediatric rather than an adult ALL protocol (Boissel JCO 2003). Similar provocative results have been observed in three other pediatric versus adult ALL studies (Stock ASH 2000, de Bont Leukemia 2004, Testi ASH 2004). One explanation may be the larger amounts of steroids, vincristine (VCR), and L-asparaginase (L-aspa) administered in pediatric patients. The GRAALL-2003 study was thus designed to offer a pediatric approach in adults with Ph-negative ALL until 60 years of age. Methods: Treatment included a 5-drug induction, high dose-intensity consolidation blocks, delayed intensification, and 2-year maintenance. The comparison with the former LALA-94 protocol showed a 8.6-fold, 3.7-fold, and 16-fold increase in cumulative doses of prednisone, VCR, and L-aspa, respectively. One difference with childhood ALL therapy remained indication of allogeneic SCT in first CR which was offered to all patients with high-risk factor and a donor. In addition, induction was reinforced with a hyper-cyclophosphamide sequence (HyperC) in case of poor early response (cortico- and/or chemoresistant ALL). In the present report, 212 GRAALL-2003 patients with Philadelphia-negative ALL aged 15–55 years with a median follow-up of 18 months were compared to 712 patients previously treated in the LALA-94 trial. Results: Cohorts were comparable in terms of prognostic factors. CR rate was significantly higher in GRAALL patients (93 vs 88%, P=0.02) due to a reduction in resistant disease (0.5 vs 8%, P<0.001) with comparable induction death (6 vs 5%, P=0.37) rate. When compared to the LALA-94 study, 2-year EFS and overall survival were markedly improved (56 vs 41% and 66 vs 54%; P=0.0002 and 0.02, respectively). Similar differences were observed after censoring SCT patients at transplant time, underlining the role played by chemotherapy modification. Because of a worse tolerance to induction and post-remission therapy, the benefit associated with the GRAALL approach decreased with advanced age, becoming not statistically significant over 40 years of age. Finally, outcome improvement was higher in T- than in B-lineage ALL (2-year overall survival, 75 vs 51% and 61 vs 56%; P=0.016 and 0.25, respectively). Among patients with T-ALL, poor early responders (allocated to HyperC induction) tended to have a better EFS than good early responders, suggesting a major role of HyperC in this ALL subset. Conclusion: In conclusion, a pediatric approach benefits to younger adults with ALL.
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Almira, Isni Dhiyah, and Selvi Nafianti. "Hubungan Pemberian Kortikosteroid terhadap Kenaikan Berat Badan pada Anak Penderita Leukemia Limfoblastik Akut Fase Induksi di RSUP Haji Adam Malik Medan." SCRIPTA SCORE Scientific Medical Journal 2, no. 2 (2021): 76–83. http://dx.doi.org/10.32734/scripta.v2i2.3409.
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Background: Glucocorticoid corticosteroids have vasoconstrictive, anti-proliferation, anti-inflammatory, and immunosuppressant effects through interactions with glucocorticoid receptors which have also been found in one type of leukemia, acute lymphoblastic leukemia (ALL). The most common side effect long-term use of high dose corticosteroids is increase in body weight resulting in obesity. It is one of the main problems in ALL patients, because it leads to persistent leukemia, increase of the risk of recurrence, and poor event-free survival. This has been associated with the use of glucocorticoids namely dexamethasone and prednisone in the induction phase chemotherapy process. Objectives: This study was intended to determine the association of corticosteroid administration to weight gain in children with ALL induction phase. Methods: The study was analytic-cross sectional. A total of 62 medical records of pediatric patients with ALL in Haji Adam Malik General Hospital Medan in 2015-2018. The data obtained were processed using the Wilcoxon statistical test, the Mann-Whitney test, and the Spearman-Correlation Rank test. Results: Wilcoxon test showed the effect of corticosteroid administration on body weight in the sample (p = 0.001). The Mann-Whitney test showed a difference in the influence of the use of prednisone and dexamethasone on sample body weight (p = 0.001), but it was not found regarding the nutritional status of the sample (p = 0.149). The Spearman-correlation test showed that there was no association of weight gain with the total corticosteroid dose given (p = 0.251). Conclusion: There is an association of corticosteroid administration to body weight in children with ALL induction phase. There are differences in the influence of the use of prednisone and dexamethasone on body weight, while there is no such difference on nutritional status in children with ALL induction phase. There is no association of weight gain based on the total corticosteroid dose given during the induction phase in children with ALL. Keywords: acute lymphoblastic leukemia, corticosteroid, induction phase chemotherapy, weight gain Latar Belakang: Kortikosteroid golongan glukokortikoid memiliki efek vasokontriksi, anti-proliferasi, anti-inflamasi, dan imunosupresan melalui interaksinya dengan glucocorticoid receptor yang juga telah ditemukan pada salah satu jenis leukemia yaitu leukemia limfoblastik akut (LLA). Efek samping paling sering dari penggunaan kortikosteroid jangka panjang dengan dosis tinggi adalah peningkatan berat badan berlebih yang berakibat pada obesitas. Hal ini menjadi salah satu masalah utama pada pasien LLA, karena dapat menyebabkan leukemia persisten, meningkatkan risiko kekambuhan, dan event-free survival yang buruk. Hal tersebut telah dikaitkan dengan penggunaan glukokortikoid deksametason dan prednisone dalam proses kemoterapi LLA fase induksi. Tujuan: Penelitian ini dimaksudkan untuk mengetahui hubungan pemberian kortikosteroid terhadap kenaikan berat badan pada anak penderita leukemia limfoblastik akut fase induksi. Metode: Penelitian yang dilakukan bersifat analitik-cross sectional. Dikumpulkan sebanyak 62 rekam medis pasien anak penderita LLA di RSUP Haji Adam Malik Medan tahun 2015-2018. Data yang diperoleh diolah menggunakan uji statistik Wilcoxon, uji Mann-Whitney, dan uji Rank Spearman-Correlation. Hasil: Uji Wilcoxon menunjukkan adanya pengaruh pemberian kortikosteroid terhadap berat badan pada sampel (p = 0,001). Uji Mann-Whitney menunjukkan adanya perbedaan pengaruh penggunaan prednison dan deksametason terhadap berat badan sampel (p = 0,001), tetapi tidak terhadap status gizi sampel (p = 0,149). Uji Rank Spearman-Correlation menunjukkan tidak terdapat hubungan kenaikan berat badan terhadap total dosis kortikosteroid yang diberikan (p = 0,251). Kesimpulan: Terdapat hubungan pemberian kortikosteroid terhadap berat badan anak penderita LLA fase induksi. Terdapat perbedaan pengaruh penggunaan prednison dan deksametason terhadap berat badan anak penderita LLA fase induksi, tetapi tidak terhadap status gizi. Tidak terdapat hubungan kenaikan berat badan berdasarkan total dosis kortikosteroid yang diberikan selama fase induksi pada anak penderita LLA. Kata kunci: kemoterapi fase induksi, kenaikan berat badan, kortikosteroid, leukemia limfoblastik akut
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Kessous, Roy, Eyal Sheiner, Daniella Landau, and Tamar Wainstock. "A History of Large for Gestational Age at Birth and Future Risk for Pediatric Neoplasms: A Population-Based Cohort Study." Journal of Clinical Medicine 9, no. 5 (2020): 1336. http://dx.doi.org/10.3390/jcm9051336.
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Objective: The aim of this study was to evaluate the association between large for gestational age (LGA) at birth and future risk of childhood neoplasm. Study design: a population-based cohort to compare the long-term risk (up to the age of 18 years) of childhood neoplasms (benign and malignant) in children that were born LGA vs. those that were appropriate for gestational age (AGA), between the years 1991–2014. Childhood neoplasms diagnosis were defined according to international classification of disease 9 (ICD-9) codes recorded medical files. Kaplan–Meier survival curves were used in order to compare cumulative incidence of oncological morbidity over the study period. The Cox proportional hazards model was used to control for confounders. Results: 231,344 infants met the inclusion criteria; out of those 10,369 were diagnosed LGA at birth. Children that were LGA at birth had a higher incidence of leukemia (OR 2.25, 95%CI 1.08–4.65, p = 0.025) as well as kidney tumors (OR = 4.7, 95%CI = 1.02–21.9, p = 0.028). In addition, cumulative incidence over time of childhood malignancies, leukemia, and kidney tumors were significantly higher in LGA children (Log Rank = 0.010, 0.021, and 0.028, respectively). In a Cox regression model controlling for other perinatal confounders, LGA at birth remained independently associated with an increased risk for childhood malignancy (adjusted HR 1.51, 95%CI 1.02–2.23, p = 0.039). Conclusion: LGA at birth is associated with increased long-term risk for childhood malignancy and specifically leukemia and kidney tumors. This possible link may help to improve current knowledge regarding potential exposures that are associated with childhood cancer development.
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Campbell, Elizabeth A., Mitchell G. Maltenfort, Justine Shults, Christopher B. Forrest, and Aaron J. Masino. "Characterizing clinical pediatric obesity subtypes using electronic health record data." PLOS Digital Health 1, no. 8 (2022): e0000073. http://dx.doi.org/10.1371/journal.pdig.0000073.
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In this work, we present a study of electronic health record (EHR) data that aims to identify pediatric obesity clinical subtypes. Specifically, we examine whether certain temporal condition patterns associated with childhood obesity incidence tend to cluster together to characterize subtypes of clinically similar patients. In a previous study, the sequence mining algorithm, SPADE was implemented on EHR data from a large retrospective cohort (n = 49 594 patients) to identify common condition trajectories surrounding pediatric obesity incidence. In this study, we used Latent Class Analysis (LCA) to identify potential subtypes formed by these temporal condition patterns. The demographic characteristics of patients in each subtype are also examined. An LCA model with 8 classes was developed that identified clinically similar patient subtypes. Patients in Class 1 had a high prevalence of respiratory and sleep disorders, patients in Class 2 had high rates of inflammatory skin conditions, patients in Class 3 had a high prevalence of seizure disorders, and patients in Class 4 had a high prevalence of Asthma. Patients in Class 5 lacked a clear characteristic morbidity pattern, and patients in Classes 6, 7, and 8 had a high prevalence of gastrointestinal issues, neurodevelopmental disorders, and physical symptoms respectively. Subjects generally had high membership probability for a single class (>70%), suggesting shared clinical characterization within the individual groups. We identified patient subtypes with temporal condition patterns that are significantly more common among obese pediatric patients using a Latent Class Analysis approach. Our findings may be used to characterize the prevalence of common conditions among newly obese pediatric patients and to identify pediatric obesity subtypes. The identified subtypes align with prior knowledge on comorbidities associated with childhood obesity, including gastro-intestinal, dermatologic, developmental, and sleep disorders, as well as asthma.
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Ben Abdelali, Raouf, Vahid Asnafi, Thibaut Leguay, et al. "Pediatric-inspired intensified therapy of adult T-ALL reveals the favorable outcome of NOTCH1/FBXW7 mutations, but not of low ERG/BAALC expression: a GRAALL study." Blood 118, no. 19 (2011): 5099–107. http://dx.doi.org/10.1182/blood-2011-02-334219.
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Abstract Despite recent progress in the understanding of acute lymphoblastic leukemia (T-ALL) oncogenesis, few markers are sufficiently frequent in large subgroups to allow their use in therapeutic stratification. Low ERG and BAALC expression (E/Blow) and NOTCH1/FBXW7 (N/F) mutations have been proposed as powerful prognostic markers in large cohorts of adult T-ALL. We therefore compared the predictive prognostic value of N/F mutations versus E/Blow in 232 adult T-ALLs enrolled in the LALA-94 and Group for Research on Adult Acute Lymphoblastic Leukemia (GRAALL) protocols. The outcome of T-ALLs treated in the pediatric-inspired GRAALL trials was significantly superior to the LALA-94 trial. Overall, 43% and 69% of adult T-ALL patients were classified as E/Blow and N/F mutated, respectively. Strikingly, the good prognosis of N/F mutated patients was stronger in more intensively treated, pediatric-inspired GRAALL patients. The E/B expression level did not influence the prognosis in any subgroup. N/F mutation status and the GRAALL trial were the only 2 independent factors that correlated with longer overall survival by multivariate analysis. This study demonstrates that the N/F mutational status and treatment protocol are major outcome determinants for adults with T-ALL, the benefit of pediatric inspired protocols being essentially restricted to the N/F mutated subgroup.
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Buczyńska, Anna, and Urszula Grzybowska-Chlebowczyk. "Prognostic Factors of Biologic Therapy in Pediatric IBD." Children 9, no. 10 (2022): 1558. http://dx.doi.org/10.3390/children9101558.
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This was a retrospective cohort study aimed at identifying parameters measured at diagnosis of pediatric IBD to predict subsequent biologic therapy, as an equivalent to an unfavorable clinical course. Identification of predictors of poor outcomes is an important issue in current ECCO guidelines on pIBD. The study population consisted of 119 children with Crohn’s disease and 112 with ulcerative colitis, diagnosed and monitored for at least 1 year from 2009–2019. The population was divided into the study groups separately: 39 children with CD and 14 with UC who received biologics before the age of 18 y compared to 80 with CD and 98 with UC who did not. The combined analysis of 53 biologic therapy recipients vs. 178 non-recipients with IBD was also conducted. Logistic regression tests (OR, RR) and sensitivity, specificity, PPV, and NPV were used. Factors significantly correlated with subsequent biologic therapy were perianal disease, complicated disease behavior, high PCDAI (CD), fatigue, hypoalbuminemia, high PUCAI (UC) and fever, fatigue, hypoalbuminemia, hypoproteinemia, and elevated CRP (IBD). Marginally significant factors were ileocecal disease, elevated serum IgA, anemia, and L4a–L4b coexistence. Apart from parameters already accepted as POPO (B2/3, perianal disease), interesting observations are the significance of IgA, L4a–L4b in CD, and hypoalbuminemia in UC.
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Patni, Maninder, Uday Pratap, Ruchi Sarawgi, and Ruchi Gupta. "Compare the Clinical Profile of Pediatric Patients in either Deep or Awake State underSevoflurane Anaesthesia afterthe Removal of Proseal LMA." Academia Anesthesiologica International 4, no. 2 (2019): 136–41. http://dx.doi.org/10.21276/aan.2019.4.2.32.
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Bravo-Valenzuela, Nathalie Jeanne Magioli, and Guilherme Ricardo Nunes Silva. "Aneurysm of the Left Coronary Artery in Postoperative Bland-White-Garland Syndrome." Case Reports in Cardiology 2015 (2015): 1–4. http://dx.doi.org/10.1155/2015/568014.
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We report a case of anomalous left coronary artery from the pulmonary artery (ALCAPA) or Bland-White-Garland syndrome, present the challenges of performing a differential diagnosis, and discuss the treatment of the syndrome. Although ALCAPA is a rare congenital heart disease, it is one of the most common causes of myocardial ischemia in childhood and presents a diagnostic challenge. A four-year-old girl was referred to a pediatric cardiologist for evaluation of mitral valve regurgitation murmur and heart failure. The transthoracic echocardiogram demonstrated the left coronary artery (LCA) not arising from the aorta, presence of coronary collateral circulation, and moderate mitral valve regurgitation. ALCAPA was confirmed using angiotomography. The LCA was surgically reimplanted into the aorta. After 3 years of postoperative follow-up, the patient developed an LCA aneurysm. Diagnosis of cardiac ischemia in childhood remains a challenge, and careful evaluation of coronary arteries on the echocardiogram is an important tool. In this report, we present a case of ALCAPA with an uncommon postoperative outcome.
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Marinho, Murilo M., Hisashi Ishida, Kanako Harada, Kyoichi Deie, and Mamoru Mitsuishi. "Virtual Fixture Assistance for Suturing in Robot-Aided Pediatric Endoscopic Surgery." IEEE Robotics and Automation Letters 5, no. 2 (2020): 524–31. http://dx.doi.org/10.1109/lra.2019.2963642.
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Arai, Katsuhiro, Reiko Kunisaki, Fumihiko Kakuta, et al. "Phenotypic characteristics of pediatric inflammatory bowel disease in Japan: results from a multicenter registry." Intestinal Research 18, no. 4 (2020): 412–20. http://dx.doi.org/10.5217/ir.2019.00130.
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Background/Aims: There are few published registry studies from Asia on pediatric inflammatory bowel disease (IBD). Registry network data enable comparisons among ethnic groups. This study examined the characteristics of IBD in Japanese children and compared them with those in European children.Methods: This was a cross-sectional multicenter registry study of newly diagnosed Japanese pediatric IBD patients. The Paris classification was used to categorize IBD features, and results were compared with published EUROKIDS data.Results: A total of 265 pediatric IBD patients were initially registered, with 22 later excluded for having incomplete demographic data. For the analysis, 91 Crohn’s disease (CD), 146 ulcerative colitis (UC), and 6 IBD-unclassified cases were eligible. For age at diagnosis, 20.9% of CD, 21.9% of UC, and 83.3% of IBD-unclassified cases were diagnosed before age 10 years. For CD location, 18.7%, 13.2%, 64.8%, 47.3%, and 20.9% were classified as involving L1 (ileocecum), L2 (colon), L3 (ileocolon), L4a (esophagus/stomach/duodenum), and L4b (jejunum/proximal ileum), respectively. For UC extent, 76% were classified as E4 (pancolitis). For CD behavior, B1 (non-stricturing/non-penetrating), B2 (stricturing), B3 (penetrating), and B2B3 were seen in 83.5%, 11.0%, 3.3%, and 2.2%, respectively. A comparison between Japanese and European children showed less L2 involvement (13.2% vs. 27.3%, <i>P</i>< 0.01) but more L4a (47.3% vs. 29.6%, <i>P</i>< 0.01) and L3 (64.8% vs. 52.7%, <i>P</i>< 0.05) involvement in Japanese CD children. Pediatric perianal CD was more prevalent in Japanese children (34.1% vs. 9.7%, <i>P</i>< 0.01).Conclusions: Upper gastrointestinal and perianal CD lesions are more common in Japanese children than in European children.
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Huguet, Françoise, Thibaut Leguay, Emmanuel Raffoux, et al. "Pediatric-Inspired Therapy in Adults With Philadelphia Chromosome–Negative Acute Lymphoblastic Leukemia: The GRAALL-2003 Study." Journal of Clinical Oncology 27, no. 6 (2009): 911–18. http://dx.doi.org/10.1200/jco.2008.18.6916.
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Purpose Retrospective comparisons have suggested that adolescents or teenagers with acute lymphoblastic leukemia (ALL) benefit from pediatric rather than adult chemotherapy regimens. Thus, the aim of the present phase II study was to test a pediatric-inspired treatment, including intensified doses of nonmyelotoxic drugs, such as prednisone, vincristine, or l-asparaginase, in adult patients with ALL up to the age of 60 years. Patients and Methods Between 2003 and 2005, 225 adult patients (median age, 31 years; range, 15 to 60 years) with Philadelphia chromosome–negative ALL were enrolled onto the Group for Research on Adult Acute Lymphoblastic Leukemia 2003 protocol, which included several pediatric options. Some adult options, such as allogeneic stem-cell transplantation for patients with high-risk ALL, were nevertheless retained. Results were retrospectively compared with the historical France-Belgium Group for Lymphoblastic Acute Leukemia in Adults 94 (LALA-94) trial experience in 712 patients age 15 to 55 years. Results Complete remission rate was 93.5%. At 42 months, event-free survival (EFS) and overall survival (OS) rates were 55% (95% CI, 48% to 52%) and 60% (95% CI, 53% to 66%), respectively. Age remained an important bad prognostic factor, with 45 years of age as best cutoff. In older versus younger patients, there was a higher cumulative incidence of chemotherapy-related deaths (23% v 5%, respectively; P < .001) and deaths in first CR (22% v 5%, respectively; P < .001), whereas the incidence of relapse remained stable (30% v 32%, respectively). Complete remission rate (P = .02), EFS (P < .001), and OS (P < .001) compared favorably with the previous LALA-94 experience. Conclusion These results suggest that pediatric-inspired therapy markedly improves the outcome of adult patients with ALL, at least until the age of 45 years.
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Levitch, Cara, Alice Ann Holland, Jesse Bledsoe, et al. "QOL-11. Comparison of Neuropsychological Functioning in Pediatric Posterior Fossa Tumor Survivors: Medulloblastoma, Low-Grade Astrocytoma, and Healthy Controls." Neuro-Oncology 24, Supplement_1 (2022): i135. http://dx.doi.org/10.1093/neuonc/noac079.494.
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Abstract BACKGROUND: Neuropsychological comparison of medulloblastoma (MB) and cerebellar low-grade astrocytoma (LGA) survivors to controls can clarify treatment-related neurocognitive late effects. While both brain tumor groups undergo surgery to the posterior fossa, children with MB additionally receive craniospinal irradiation with boost and chemotherapy. This study provides an updated comparison of neuropsychological functioning in these two groups and examines effects of demographic risk factors upon outcomes. PROCEDURE: Forty-two children (16 MB, 9 LGA, 17 controls) completed measures of intellectual functioning, verbal learning/memory, visual-motor integration, and fine motor functioning. The effects of age at diagnosis, time since diagnosis, gender, fatigue, and social status on neuropsychological functioning were examined. RESULTS: MB survivors demonstrated the worst neurocognitive late effects, but they were less severe and extensive than in prior studies. LGA survivors’ mean scores were below normative expectations in working memory, processing speed, and fine motor functioning. Additionally, parents of LGA survivors reported the most difficulty with behavior and cognitive regulation compared to healthy controls and medulloblastoma survivors. In this overall sample, processing speed difficulties were independent of fine motor functioning and fatigue. Higher parental education was associated with better intellectual functioning, working memory, delayed recall, and visual-motor integration. Neuropsychological function was not associated with gender, age at diagnosis, or time since diagnosis. CONCLUSION: The results support that contemporary treatment approaches with craniospinal irradiation plus boost and chemotherapy confer the greatest risk for late effects, while surgical resection is associated with subtle but important neurocognitive difficulties. Ultimately, this study furthers our understanding of factors impacting neuropsychological function in pediatric MB and LGA survivors and contributes to empirical support for close monitoring and targeted interventions into survivorship.
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Úriz Monaut, J. J., N. García de Andoin Barandiaran, P. Esparza Paz, et al. "Tratamiento y profilaxis secundaria con voriconazol en un paciente pediátrico con lla y aspergilosis pulmonar." Anales de Pediatría 66, no. 3 (2007): 333–34. http://dx.doi.org/10.1016/s1695-4033(07)70415-0.
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Pombo, M., M. L. Couce, J. M. Couselo, and J. Devesa. "56 NEUROENDOCRINE ALTERATIONS INDUSCED BY CRANIAL IRRADIATION (CR) IN CHILDREN WITH ACUTE LYMPHOBLASTIC LEUKEMIA (LLA)." Pediatric Research 24, no. 4 (1988): 526. http://dx.doi.org/10.1203/00006450-198810000-00077.
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Finnveden, Göran, Rickard Arvidsson, Anna Björklund, Jeroen Guinée, Reinout Heijungs, and Michael Martin. "Six areas of methodological debate on attributional life cycle assessment." E3S Web of Conferences 349 (2022): 03007. http://dx.doi.org/10.1051/e3sconf/202234903007.
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There is a general agreement in the LCA community that there are two types of LCAs: attributional and consequential. There have been numerous discussions about the pros and cons of the two approaches and on differences in methodology, in particular about methods that can be used in consequential LCA. There are, however, methodological aspects of attributional LCA and how it can be used that need further attention. This article discusses six areas of debate and potential misunderstandings concerning attributional LCA. These are: 1) LCA results of all the products in the world should add up to the total environmental impact of the world, sometimes referred to as the 100 % rule. 2) Attributional LCA is less relevant than consequential LCA. 3) System expansion, and/or substitution, cannot be used in attributional LCA. 4) Attributional LCA leads to more truncation errors than consequential LCA does. 5) There is a clear connection between the goal and questions of an LCA and the choice of attributional or consequential LCA. 6) There is a clear boundary between attributional and consequential LCA. In the article, these statements are discussed, and it is argued that they are either misunderstandings or sometimes incorrect.
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Furtado, FM, LA Pinheiro, ER Biojone, et al. "IMPLEMENTAÇÃO DE TRATAMENTO PARA LLA EM PEDIATRIA COM INTENSIDADE AJUSTADA À DRM MEDIDA POR CITOMETRIA DE FLUXO DE NOVA GERAÇÃO." Hematology, Transfusion and Cell Therapy 43 (October 2021): S288. http://dx.doi.org/10.1016/j.htct.2021.10.487.
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Deshpande, Gauri, Mamta Gurav, Omshree Shetty, et al. "MBRS-61. MOLECULAR SUB-GROUPING OF PEDIATRIC MEDULLOBLASTOMA: CORRELATION WITH CLINICAL AND HISTOLOGICAL FEATURES, A SINGLE INSTITUTIONAL STUDY." Neuro-Oncology 22, Supplement_3 (2020): iii408. http://dx.doi.org/10.1093/neuonc/noaa222.565.
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Abstract INTRODUCTION Molecular subgroups of pediatric medulloblastomas are distinctive in infantile and non-infantile age-groups. METHODS Real-time quantitative PCR based GEP of customized 12 protein-coding genes was performed on 206 FFPE childhood medulloblastoma samples. FISH for MYC amplification, monosomy 6 and sequencing for CTNNB1 exon 3 mutation were done in relevant cases. H&E and reticulin-stained slides were used for histological subtyping. p53-protein immunoreactivity pattern was noted. RESULTS Infantile (n=33) comprised 57.6% SHH-activated (desmoplastic: 73.7%; MBEN: 15.8% and classic: 10.5%), 21.2% group 3 (large cell/anaplastic [LCA]: 28.6% and none were desmoplastic) and 12% group 4. 40% of group 3 patients died of disease and 21% of the SHH-activated (all desmoplastic) had subsequent local recurrence. Non-infantile (n=173) comprised 19.4% WNT-activated, 12.9% SHH-activated (15% classic, 30% desmoplastic, 10% paucinodular), 19.4% group 3 (63.3% classic & 26.7% LCA), 48.4% group 4 (73.3% classic, 5.3% desmoplastic, 10.7% paucinodular & 1.4% LCA), and non-WNT/non-SHH (NWNS), NOS (n=14,9%) and unclassified (n=4,2.6%). None of WNT-activated were desmoplastic/LCA histology. Non-infantile WNT-activated and group 3 MBs showed 90% monosomy 6 & CTNNB1 mutation, and 16.7% MYC-amplification respectively. 17.4% (13% spinal, 4.4% local) WNT-activated, 31% (12.5% local, 18.5% distant [spinal: 12.5%, intracranial:6%]) SHH-activated, 27% (18% both spinal and local, 9% spinal) group 3 and 31.5% (7.4% local, 5.5% intracranial, 11.2% spinal, 7.4% both spinal and local) group 4 showed metastases during follow up. CONCLUSIONS SHH-activated and group 3 are the common infantile subgroups but group 4 is not non-existent in infantile age. No desmoplastic (including paucinodular) histological subtype is of WNT- activated and group 3.
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Khan, Junaid, and Salam Al-Jubouri. "Normoblasts in LGA infants." Early Human Development 84 (November 2008): S137. http://dx.doi.org/10.1016/j.earlhumdev.2008.09.357.
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Mandell, Jason G., Abhaya V. Kulkarni, Benjamin C. Warf, and Steven J. Schiff. "Volumetric brain analysis in neurosurgery: Part 2. Brain and CSF volumes discriminate neurocognitive outcomes in hydrocephalus." Journal of Neurosurgery: Pediatrics 15, no. 2 (2015): 125–32. http://dx.doi.org/10.3171/2014.9.peds12427.
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OBJECT The evaluation of hydrocephalus remains focused on ventricular size, yet the goal of treatment is to allow for healthy brain development. It is likely that brain volume is more related to cognitive development than is fluid volume in children with hydrocephalus. This study tests this hypothesis by comparing brain and fluid volumes with neurocognitive outcome in pediatric patients with hydrocephalus. METHODS Warf and colleagues previously acquired CT scans for pediatric patients in Uganda with myelomeningocele, measured frontal–occipital horn ratio (FOHR), and administered the modified Bayley Scales of Infant Development, third edition (BSID-III) to measure neurocognitive outcome that did not correlate with FOHR. In this present study, brain and fluid volumes were measured in 33 of these patients, 26 of whom required surgical treatment for hydrocephalus. Linear discrimination analysis (LDA) was used to test whether age-normalized brain and fluid volumes can discriminate neurocognitive outcome. RESULTS Hydrocephalic patients show normal to small brain volumes and substantially larger fluid volumes compared with normal values. FOHR correlates highly with fluid volume (r = 0.84, p < 0.001) and substantially less with brain volume (r = −0.37, p = 0.03), while brain and fluid volumes do not correlate with each other (p = 0.99). Brain and CSF volumes correlated best with fine motor (p = 0.03, p = 0.01), cognitive (p = 0.05, p = 0.09), and expressive communication (p = 0.08, p = 0.08) scores. A combination of these 3 scores was used as a multivariate measure of neurocognitive outcome. Brain volume alone, unlike fluid volume, could discriminate high from low cognitive outcome (by t-test and ANOVA). It was shown that a combination of age-normalized brain and fluid volumes can discriminate neurocognitive outcome by 2-way LDA (p < 0.01) and 3-way LDA (p < 0.01). The multivariate LDA demonstrated the contribution of large fluid volume to a decrement in cognition. CONCLUSIONS Hydrocephalus is treated by normalizing CSF, but normal brain development depends on brain growth. A combination of brain and CSF volumes appears to be significantly more powerful at predicting good versus poor neurocognitive outcomes in patients with hydrocephalus than either volume alone.
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Suhag, Alisha, Amaraporn Rerkasem, Kanokwan Kulprachakarn, et al. "Long-Term Health Associated with Small and Large for Gestational Age Births among Young Thai Adults." Children 9, no. 6 (2022): 779. http://dx.doi.org/10.3390/children9060779.
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We examined the long-term health outcomes associated with being born small for gestational age (SGA) or large for gestational age (LGA). A total of 632 young adults aged ≈20.6 years were recruited from a longitudinal study (Chiang Mai, Thailand) in 2010: 473 born appropriate for gestational age (AGA), 142 SGA, and 17 LGA. The clinical assessments included anthropometry, blood pressure (BP), lipid profile, and an oral glucose tolerance test (OGTT). Young adults born SGA were 1.8 and 3.2 cm shorter than AGA (p = 0.0006) and LGA (p = 0.019) participants, respectively. The incidence of short stature was 8% among SGA compared with 3% in AGA and no cases among LGA participants, with the adjusted relative risk (aRR) of short stature among SGA 2.70 times higher than that of AGA counterparts (p = 0.013). SGA participants also had a 2 h glucose 7% higher than that of the AGA group (105 vs. 99 mg/dL; p = 0.006). Young adults born LGA had a BMI greater by 2.42 kg/m2 (p = 0.025) and 2.11 kg/m2 (p = 0.040) than those of SGA and AGA, respectively. Thus, the rate of overweight/obesity was 35% in the LGA group compared with 14.2% and 16.6% of SGA and AGA groups, respectively, with corresponding aRR of overweight/obesity of 2.95 (p = 0.011) and 2.50 (p = 0.017), respectively. LGA participants had markedly higher rates of BP abnormalities (prehypertension and/or hypertension) with an aRR of systolic BP abnormalities of 2.30 (p = 0.023) and 2.79 (p = 0.003) compared with SGA and AGA groups, respectively. Thai young adults born SGA had an increased risk of short stature and displayed some impairment in glucose metabolism. In contrast, those born LGA were at an increased risk of overweight/obesity and elevated blood pressure. The long-term follow-up of this cohort is important to ascertain whether these early abnormalities accentuate over time, leading to overt cardiometabolic conditions.
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Fadiloglu, Erdem, Atakan Tanacan, Canan Unal, Duygu Aydin Hakli, and Mehmet Sinan Beksac. "Clinical importance of the 75-g glucose tolerance test (GTT) in the prediction of large for gestational age (LGA) fetuses in non-diabetic pregnancies." Journal of Perinatal Medicine 47, no. 5 (2019): 534–38. http://dx.doi.org/10.1515/jpm-2018-0373.
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Abstract Objective To demonstrate clinical importance of the 75-g glucose tolerance test (GTT) in the prediction of large for gestational age (LGA) fetuses in non-diabetic pregnancies. Methods We retrospectively evaluated 75-g GTT screening results of 356 pregnancies without prompt diagnosis of gestational diabetes mellitus (GDM) between January 2013 and December 2017. Newborns with a birthweight greater than the 90th percentile were evaluated as LGA. Pregnancies with LGA and non-LGA fetuses were compared by demographic and historical factors – maternal age, gravidity, parity, birthweight, birthweek, GTT results and birthweight percentiles – via Student’s t-test. Multiple linear regression using the backward elimination method was performed to define the correlation between parameters and LGA (P-value of <0.20 was identified as the threshold). Receiver operator characteristics (ROC) curve analysis was performed for further analysis. Results The cohort was consisted of 45 (12.6%) and 311 (87.4%) pregnancies with LGA and non-LGA fetuses, respectively. Maternal age and 2nd-h GTT results were found to be significantly higher in patients with LGA newborns (P<0.001 and P=0.016, respectively). Fasting glucose levels and GTT 1st-h results were also higher (P=0.112, P=0.065). The coefficient of multiple determination (R2) was 0.055 by multiple linear regression analysis. Accordingly, GTT 2nd-h result and maternal age were statistically significant and contributed to the explanation of LGA, although the R2 value was not that much higher (P=0.016; P=0.001). Maternal age and GTT 2nd-h results were found to be associated with LGA fetuses with area under the curve (AUC) values of 0.662 and 0.608 according to ROC curve analysis. Conclusion Maternal age and 75-g GTT 2nd-h results were significantly higher in gestations with LGA newborns without GDM.
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Brzheskiy, Vladimir Vsevolodovich, and O. V. Konikova. "THE SELECTED PAGES OF THE HISTORY OF PEDIATRIC OPHTHALMOLOGY IN SAINT PETERSBURG." Russian Pediatric Ophthalmology 12, no. 2 (2017): 62–72. http://dx.doi.org/10.18821/1993-1859-2017-12-2-62-72.
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The history of pediatric ophthalmology in Saint Petersburg dates back to the opening of the city children’s hospital “in memory of the sacred coronation of their Imperil Majesties” under the patronage of Nikolas II, Emperor of Russia, in 1905. Based at this facility, the Russia’s first department of pediatric ophthalmology was founded in 1935 to be affiliated with Leningrad Pediatric Medical Institute. The department was successively headed by professors V.V. Chirkovsky, L.A. Dymshits, V.I. Grigor’eva, A.I. Gorban’, and E.E. Somov. The present head of the department is professor V.V. Brzheskiy. One more department of pediatric ophthalmology was opened in 1983 based at the Leningrad Institute of Advanced Medical Training. It was successively headed by the associate professor V.V. Kolotov, professors S.S. Saporovsky and R.L. Troyanovsky, E.I. Saidasheva, d-r med. sci. At present, an extensive network of children’s clinics and specialized kindergartens for the children suffering from visual impairment successfully operates in Saint-Petersburg, besides two schools for the blind and visually impaired children, the eye diagnostic centre for the children and adults, and three pediatric ophthalmological hospitals. The city pediatric ophthalmology service is headed by R.V. Ershova. N.N. Sadovnikova is in charge of the Ophthalmological Department of the Clinic of Saint Petersburg State Pediatric Medical University. The Ophthalmological Department of K.A. Raukhfus municipal city hospital No 19 is headed by A.V. Baranov, PhD, and the Department of Eye Microsurgery at the Leningrad regional Children’s Clinical Hospital by O.V. Diskalenko. The present-day clinical, scientific, and educational potential of the Saint-Petersburg pediatric ophthalmological community formed at the base of many-year experience of the preceding generations of physicians continues to further increase which creates conditions for the formulation and successful achievement of the new ambitious goals.
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Zudeh, Giulia, Raffaella Franca, Marianna Lucafò, et al. "PACSIN2as a modulator of autophagy and mercaptopurine cytotoxicity: mechanisms in lymphoid and intestinal cells." Life Science Alliance 6, no. 3 (2023): e202201610. http://dx.doi.org/10.26508/lsa.202201610.
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PACSIN2 variants are associated with gastrointestinal effects of thiopurines and thiopurine methyltransferase activity through an uncharacterized mechanism that is postulated to involve autophagy. This study aims to clarify the role of PACSIN2 in autophagy and in thiopurine cytotoxicity in leukemic and intestinal models. Higher autophagy and lower PACSIN2 levels were observed in inflamed compared with non-inflamed colon biopsies of inflammatory bowel disease pediatric patients at diagnosis. PACSIN2 was identified as an inhibitor of autophagy, putatively through inhibition of autophagosome formation by a protein–protein interaction with LC3-II, mediated by a LIR motif. Moreover, PACSIN2 resulted a modulator of mercaptopurine-induced cytotoxicity in intestinal cells, suggesting that PACSIN2-regulated autophagy levels might influence thiopurine sensitivity. However, PACSIN2 modulates cellular thiopurine methyltransferase activity via mechanisms distinct from its modulation of autophagy.
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Ťoukálková, Lenka. "The rare case of boy with diagnosis LAL-D." Pediatrie pro praxi 18, no. 1 (2017): 56–58. http://dx.doi.org/10.36290/ped.2017.011.
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Fraschetti, Emily C., Lauren E. Skelly, Mavra Ahmed, Emma C. Biancaniello, Panagiota Klentrou, and Andrea R. Josse. "The Influence of Increased Dairy Product Consumption, as Part of a Lifestyle Modification Intervention, on Diet Quality and Eating Patterns in Female Adolescents with Overweight/Obesity." Children 9, no. 11 (2022): 1703. http://dx.doi.org/10.3390/children9111703.
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Our study examined how increased dairy consumption versus habitually low dairy consumption, against a background of healthy eating (and exercise), influenced diet quality, nutrient intake, and snacking in Canadian female adolescents (14.8 ± 2.2 years) with overweight/obesity (OW/OB). We also explored dairy consumption patterns in the group consuming dairy products. Participants were randomized into two groups: higher/recommended dairy (RDa; 4 svg/d; n = 24) or low dairy (LDa; 0–2 svg/d; n = 23). Both groups participated in a 12-week, eucaloric, lifestyle modification intervention consisting of exercise training and nutritional counseling. The intervention increased the total Canadian Healthy Eating Index score (p < 0.001) with no differences between groups. The “other food” sub-score improved more in RDa than LDa (p = 0.02), and the “saturated fat” sub-score increased more in LDa than RDa (p = 0.02). The intervention significantly increased the consumption of dairy-related nutrients more in RDa than LDa (p < 0.05). The intervention also decreased snack size in both groups (p = 0.01) and improved percentage of healthy snack energy intake more in RDa than LDa (p = 0.04). More servings of dairy products were consumed as snacks than at breakfast, lunch, or dinner (p < 0.05). Thus, our study improved diet quality, and dairy product consumption improved intakes of key related nutrients and snack consumption in adolescents with OW/OB.
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Yeh, EA, B. Weinstock-Guttman, N. Lincoff, et al. "Retinal nerve fiber thickness in inflammatory demyelinating diseases of childhood onset." Multiple Sclerosis Journal 15, no. 7 (2009): 802–10. http://dx.doi.org/10.1177/1352458509104586.
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Purpose To evaluate retinal nerve fiber layer thickness (RNFLT) using optical coherence tomography (OCT) in children with acquired demyelinating diseases. Methods This is a cross-sectional study of patients seen between 2006–2008 at the Pediatric MS Center of the Jacobs Neurological Institute. Consensus definitions for pediatric demyelinating disease were followed. All children received OCT testing and assessment of visual acuity (VA) using Snellen and low contrast letter acuity (LCLA) charts. Results Thirty-eight children diagnosed with acquired demyelinating disease, 15 healthy controls, and five children with other neurological disorders (OND) were included. Average RNFLT in healthy controls was 107 ± 12 μm( n = 30) versus 108 ± 5 μm ( n = 10) in OND controls. In children with multiple sclerosis, average RNFLT ± SD was 99 ± 14 μm in unaffected ( n = 24) versus 83 ± 12 μmin eyes affected by optic neuritis (“affected eyes”) ( n = 10). Average RNFLT in children with acute disseminated encephalomyelitis and transverse myelitis was 102 ± 15 μm in unaffected ( n = 18) versus 67 ± 17 μm in affected eyes ( n = 6). In children with optic neuritis (ON), average RNFLT ± SD was 97 ± 13 μm in unaffected ( n = 5) versus 89 ± 12 μm in affected eyes ( n = 9). Differences between children with demyelinating disease and controls and between ON and nonON eyes were statistically significant ( P < 0.001). Bivariate correlations of RNFLT with LCLA ( P = 0.002) and VA ( P < 0.001) were significant. Conclusions OCT may be a valuable tool for the assessment and monitoring of anterior optic pathway dysfunction in children with demyelinating diseases.
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Yulia, Dian Estu, Yulinda Arty Laksmita, Julie Dewi Barliana, Laura Agnestasia Djunaedi, Lia Amanda, and Hartono Gunardi. "Visual acuity assessment of preschool children in the inner city area in Jakarta." Paediatrica Indonesiana 62, no. 1 (2021): 1–6. http://dx.doi.org/10.14238/pi62.1.2022.1-6.
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Background Visual acuity (VA) assessment is an important ocular examination to identify children with vision problems. Such early identification allows for early intervention to prevent childhood blindness.
 Objective To describe and compare visual acuity measurements in preschool children using two different visual acuity charts.
 Methods This cross-sectional study in children aged 36-60 months was done in a low-income area in the Central Jakarta District as a collaboration between Department of Ophthalmology and Department of Child Health, Universitas Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta. All children underwent visual acuity examinations using Lea symbols and Tumbling E charts. The VA results from two charts were analyzed with Bland-Altman plot for limits of agreement. Statistical analyses were performed to determine the differences between vision charts.
 Results A total of 113 children enrolled, but only 38 children completed the examinations. The mean age of subjects was 50.5 (SD 6.4) months. Overall, subjects’ mean VA was 0.29 (SD 0.18) for Lea symbols and 0.37 (SD 0.14) for Tumbling E. The mean difference of VA between Lea symbols and Tumbling E was 0.07 (SD 0.22) logMAR units, with upper and lower limits of agreement at 0.36 and 0.51, respectively. There was no statistical difference in VA score using Lea symbols and Tumbling-E based on gender and age.
 Conclusion Most preschool children in our study have normal visual acuity. Lea symbols and Tumbling E chart are comparable and can be used to efficiently measure VA in preschool children.
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Hanna, Leila Maués Oliveira, Rodolfo José Gomes De Araújo, Maria Teresa Botti Rodrigues Santos, and Gelson Gomes De Andrade Filho. "Pediatric cancer: epidemiologic profile of attended children in a reference center in the state of Para." Journal of Research in Dentistry 4, no. 3 (2017): 100. http://dx.doi.org/10.19177/jrd.v4e32016100-107.
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Aim: To describe the epidemiological findings of children diagnosed with cancer in a referral center.Material and Methods: Daily at Ophir Loyola Hospital visits were made - Belém / PA, in clinical pediatric oncology sector, from December 2013 to June 2014. The sample comprised 46 children 2-12 years, diagnosed with cancer, which was already or would begin anticancer treatment. A questionnaire containing questions about family, socioeconomic and environmental aspects was applied..Results: The most frequent neoplasia LLA was followed by nephroblastoma, neuroblastoma, Hodgkin lymphoma, and osteosarcoma. The genre most affected by childhood cancer was male. The age group with the predominant prevalence were children aged 8-12 years. By observing the religious belief that it was possible to detect most practiced Catholicism. The practice of sports is not part of the daily lives of these children. The origin of these families had dominated for deriving from the state. As the rating distribution of households according to the Economic Classification Criterion Brazil, the two classes were most frequently C2 and D. Conclusions: We sought, in this article, to demonstrate the epidemiological profile of children seen at a referral center in the state of Para. Research like this, identifying population groups at highest risk or with more unfavorable prognosis, provide health authorities and researchers in the area of cancer with an important instrument in the definition of health necessary for proper control and prevention of the disease.
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Galera, A., M. Bermúdez, M. aJ Ortega, et al. "Experiencia con mesilato de imatinib (STI) en el tratamiento de la leucemia linfoblástica aguda Philadelphia positiva (LLA-Phi+) en niños." Anales de Pediatría 66, no. 4 (2007): 439. http://dx.doi.org/10.1016/s1695-4033(07)70458-7.
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Eiden, Toseph, E. Richard Moxon, and Robert Yolken. "531 PREDICTIVE VALUE OF C-REACTIVE PROTEIN (C-RP) AND LIMULUS LYSATE ASSAY (LLA) IN EVALUATION OF CHILDHOOD BACTERIAL MENINGITIS." Pediatric Research 19, no. 4 (1985): 199A. http://dx.doi.org/10.1203/00006450-198504000-00561.
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Bryand, A., J. Isnard, M. P. Quere, B. Dupas, J. M. Rogez, and A. Hamel. "ANAT-WS-S Etude radio-anatomique de l’insertion femorale du LCA en pediatrie." Journal de Radiologie 89, no. 10 (2008): 1530. http://dx.doi.org/10.1016/s0221-0363(08)76697-6.
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Cox, A. D. "The Psychological Aspects of Pediatrics. By Dane G. Prugh. Philadelphia: Lea and Febiger. 1983. $71.50." British Journal of Psychiatry 146, no. 1 (1985): 113. http://dx.doi.org/10.1017/s0007125000120409.
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