Treatment of pediatric patients with lower extremity deformities using software-assisted Ortho-SUV Frame: analysis of 213 cases

Aim. To retrospectively assess treatment outcomes of long bone deformities of the lower extremities accompanied by shortening in pediatric patients using a software-assisted Ortho-SUV Frame.Materials and methods. The accuracy of deformity correction (AC), period of deformity correction (PDC), external fixation index (EFI), and number of complications in 213 patients were retrospectively analyzed.Results. According to different parameters, AC of femur deformity correction (group 1) varied from 90% to 96%. The average length increase was 47 ± 12 mm. The average distraction duration was 38 ± 14 days. The average PDC was 8 ± 6 days for simple deformities (SDs), 14 ± 7 days for moderate deformities (MDs), and 23 ± 12 days for complex deformities (CDs). EFI was 26 ± 8 days/cm for SDs, 31 ± 6 days/cm for MDs, and 35 ± 12 days/cm for CDs. According to different parameters, AC of the lower leg deformity correction (group 2) varied from 89% to 95%. The average length increase was 52 ± 20 mm. The average distraction duration was 45 ± 18 days. PDC was 11 ± 5 days for SDs, 16 ± 9 days for MDs, and 27 ± 16 days for CDs. EFI was 32 ± 14 days/cm for SDs, 42 ± 12 days/cm for MDs, and 49 ± 8 days/cm for CDs. There were 48 (50.5%) complications in group I with the majority (71%) classified as Caton grade I and 29% as grade II. There were 62 (45%) complications in group 2, where 50% were Caton grade I and 50% were Caton grade II. There were no serious complications (Caton grade III) in either group that influenced the final functional results.Conclusion: Use of a software-assisted Ortho-SUV Frame increased the efficiency of treatment of pediatric patients with long bone deformities because of the great accuracy of deformity correction.

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Analysis of the Incidence and Characteristics of Venoocclusive Disease (VOD) of the Liver in Pediatric Hematopoietic Progenitor Cell Transplant (HPCT) Patients with Heparin Alone Vs. Heparin and Ursodiol Prophylaxis at the Medical College of Wisconsin.

Blood ◽

10.1182/blood.v114.22.4306.4306 ◽

2009 ◽

Vol 114 (22) ◽

pp. 4306-4306

Author(s):

Julie-An Talano ◽

Jessica Brown ◽

Jennifer McArthur ◽

Mollie Mulberry ◽

Daniel Eastwood ◽

...

Keyword(s):

Medical Records ◽

Low Dose ◽

Pediatric Patients ◽

Hematologic Malignancy ◽

Post Transplant ◽

Dose Heparin ◽

Group I ◽

Group 2 ◽

Low Dose Heparin ◽

Group 1

Abstract Abstract 4306 VOD is a serious and potentially life-threatening complication of HPCT as a result of liver injury from the effect of chemotherapy and/or radiation. The reported incidence rate in pediatric HPCT patients varies widely from 5% to 40%. Previous studies have shown the beneficial effects of post-transplant pharmacological therapies such as ursodeoxyholic acid (ursodiol), heparin, and defibrotide at preventing VOD. However, the combined effect of heparin and ursodiol prophylaxis in preventing VOD in pediatric patients has yet to be determined. This study evaluated retrospectively whether there was a benefit of such combined therapy in pediatric HPCT patients. Our center adopted as standard practice for all HPCT patients the initiation of low dose heparin at 4 units/kg/hour with the commencement of conditioning for HPCT until day +28 post transplant. In 2003, we combined ursodiol 10 mg/kg TID to start with HPCT conditioning and to continue until day + 100 post transplant with low dose heparin through day + 28 for all pediatric HPCT patients. We performed a retrospective chart review and compared the characteristics and the incidence of VOD in patients who underwent transplantation from 1996-2002 and received heparin alone compared to 2003-2008 when the patients received the combination of heparin and ursodiol prophylaxis. Patients were identified through medical records with the ICD diagnosis of VOD. The medical records were reviewed and those patients who did not meet the Baltimore criteria for the diagnosis of VOD were excluded. Only patients who developed VOD with their first transplants were included. Group I = Heparin (216) Group II = Heparin + Ursodiol (220) Allogeneic 187 (86.5%) 160 (72.7%) Autologous 29 (13.5%) 60 (27.3%) Median Age 9 yrs 8 yrs Male 123 (57%) 135 (62%) Female 93 (43%) 85 (38%) Non-malignant 34 (15.7%) 50 (22.8%) Hematologic malignancy 143 (66.2%) 109 (49.5%) Non-hematologic malignancy 39 (18.1%) 61 (27.7%) # VOD 13 5 The 100 day incidence of VOD was 0.0605 (SE 0.01618) in group 1 and 0.0227 (SE 0.01002) in group 2. The difference is 0.0377 (SE 0.0190) and based on a standard normal distribution with a p = 0.0473. The estimated risk of VOD for patients receiving Heparin + Ursodiol is 0.94 (risk or hazard ratio) that of the risk with Heparin alone, with a 95% confidence interval of (0.918, 0.960). This represents about a 6% reduction in risk for those receiving Heparin + Ursodiol. The day 100 survival in the VOD patients was 6 out of 13 in group 1 and 3 out of 5 in group 2. In conclusion, low dose heparin and ursodiol prophylaxis appears to be an effective strategy in VOD prevention in pediatric patients. The combination appeared to be more effective than heparin alone. However, this study is limited in that it is retrospective in nature. Disclosures: Off Label Use: heparin and ursodiol as VOD prophylaxis.

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Treatment of congenital long-bone deformities in children using the consequtive application of guided growth and external fixation: preliminary report

Pediatric Traumatology Orthopaedics and Reconstructive Surgery ◽

10.17816/ptors6312-24 ◽

2018 ◽

Vol 6 (3) ◽

pp. 12-24 ◽

Cited By ~ 1

Author(s):

Victor A. Vilensky ◽

Ekaterina A. Zakharjan ◽

Andrej A. Pozdeev ◽

Timur F. Zubairov ◽

Alexander P. Pozdeev

Keyword(s):

External Fixation ◽

Long Bone ◽

Control Group ◽

Guided Growth ◽

Continuous Growth ◽

Minimal Invasiveness ◽

Congenital Deformities ◽

Group 2 ◽

Bone Deformities ◽

Group 1

Aim. This study aimed to estimate the results of congenital long bone deformities using the consecutive application of guided growth and external fixation. Materials and methods. We performed a retrospective analysis of the treatment results of 38 children with congenital deformities of long bones. Group 1 consisted of 17 children who underwent consecutive application of two methods: guided growth and external fixation. Group 2 (control group) consisted of 21 children who underwent isolated lengthening and deformity correction by external fixation. Results. There were 14 complications in group 1 and 25 complications in group 2. Moreover, only seven cases in group 1 had complications requiring surgical treatment, whereas 17 cases in group 2 required operative treatment for complications. There was a relatively low level of refractures: zero cases in group 1 and three cases in group 2. The most common complication was a recurrence of deformity associated with the continuous growth of children: seven cases in group 1 and eight cases in group 2. However, no recurrence of the torsion component of deformity was observed in any group 1 cases, and repeated guided growth could be performed in the six cases of growing children. Conclusion. The consecutive use of external fixation and guided growth to treat congenital deformities of the lower limbs is a promising direction for pediatric orthopedics because it reduces the incidence of complications. The repeated use of guided growth, because of its minimal invasiveness, is the most effective solution for the recurrence of deformity in a growing child.

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Analysis of long-bone deformity correction in adolescents using osteosynthesis by intramedullary interlocking nails: a preliminary report

Pediatric Traumatology Orthopaedics and Reconstructive Surgery ◽

10.17816/ptors435-15 ◽

2016 ◽

Vol 4 (3) ◽

pp. 5-15

Author(s):

Viktor A Vilensky ◽

Edgar V Bukharev ◽

Timur F Zubairov ◽

Andrey A Pozdeev ◽

Aleksander P Pozdeev ◽

...

Keyword(s):

Preliminary Report ◽

Deformity Correction ◽

Functional Results ◽

Lower Leg ◽

Long Bone ◽

Residual Deformity ◽

Bone Deformity ◽

Functional Scale ◽

Fixation Frame ◽

Bone Deformities

Aims. The purpose of this study was to analyze the initial experience with adolescents treated for long-bone deformities of the lower extremities of different etiologies using osteotomies and fixation by interlocking nails.Materials and methods. We analyzed the accuracy of long-bone deformity correction using referent lines and angles, the time of consolidation, number of complications, and functional result.Results. We found that the accuracy of femur deformity correction (dependent on the complicity of the deformity), as estimated by different parameters, varied from 77.8% to 91.7%. Simple deformities and deformities of moderate complicity had the most accurate correction; the group of complex multiplanar deformities of the femur had the least accurate correction. This group included five cases of residual deformity, in which three of these had an angle of residual deformity <10°. The accuracy of leg deformity correction was 90%. Evaluation of the functional results using the Lower Extremity Functional Scale indicated the high functionality of the method used.Conclusions. Correction of long-bone deformities using intramedullary osteosynthesis by interlocking nails is an effective treatment of all types of femur and lower leg deformities. When treating complex deformities of the femur, the path to operative treatment should be complex and in most cases the nailing should be accompanied by intraoperative external fixation frame assistance.

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The results of bone deformity correction using a spider frame with web-based software for lower extremity long bone deformities

SICOT-J ◽

10.1051/sicotj/2016005 ◽

2016 ◽

Vol 2 ◽

pp. 11

Author(s):

Ali Çağrı Tekin ◽

Haluk Çabuk ◽

Süleyman Semih Dedeoğlu ◽

Mehmet Selçuk Saygılı ◽

Müjdat Adaş ◽

...

Keyword(s):

Lower Extremity ◽

Deformity Correction ◽

Long Bone ◽

Bone Deformity ◽

Web Based ◽

Bone Deformities

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Perbandingan Efektivitas Terapi Zink dengan Tanpa Zink Pada Pasien Diare Anak Rawat Inap Di RSD Idaman Kota Banjarbaru

Jurnal Pharmascience ◽

10.20527/jps.v6i1.6076 ◽

2019 ◽

Vol 6 (1) ◽

pp. 64

Author(s):

Helmina Wati ◽

Satrio Wibowo Rahmatullah ◽

Muhamad Hepriatna

Keyword(s):

Standard Therapy ◽

Research Method ◽

Pediatric Patients ◽

Average Length ◽

Public Health Problem ◽

Major Public Health Problem ◽

Cross Sectional ◽

Group I ◽

Group Ii ◽

Zinc Supplements

ABSTRAK Diare merupakan masalah utama kesehatan masyarakat, WHO dan UNICEF merekomendasikan penatalaksanaan diare pada pasien anak dengan penambahan suplemen zink. penelitian ini bertujuan untuk mengetahui perbandingan efektivitas terapi Zink dengan Tanpa zink terhadap pasien anak di rawat inap rumah sakit Idaman Banjarbaru. metode penelitian menggunakan dekriptif cross sectional dengan studi retrospektif. penelitian ini menggunakan 2 kelompok yaitu kelompok I, pasien yang mendapatkan terapi standar tanpa diberikan zink, kelompok II, pasien yang mendapatkan terapi standar dengan pemberian zink. hasil penelitian menunjukkan bahwa rata-rata lama waktu diare pada kelompok I selama 3 hari dibandingkan dengan kelompok II selama 4.4 hari. Hasil Spps menyatakan bahwa terdapat perbedaan yang signifikan antara kelompok I dan kelompok II (p<0,05). Kata kunci : Diare, Zink, tanpa Zink ABSTRACT Diarrhea is a major public health problem, WHO and UNICEF recommend management of diarrhea in pediatric patients with the addition of zinc supplements. This study aims to determine the comparison of the effectiveness of Zink therapy with no zinc on pediatric patients inpatient in Banjarbaru ideal hospital. The research method uses cross sectional descriptive with a retrospective study. This study used 2 groups, group I, patients who received standard therapy without zinc, group II, patients who received standard therapy with zinc. The results showed that the average length of time for diarrhea in group I was 3 days compared to group II for 5 days. The Spps results stated that there were significant differences between group I and group II (p <0.05). Keyword: Diarrea, Zink, Without Zink

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A comparative clinical study of ondansetron and dexamethasone for prevention of postoperative vomiting in pediatric patients undergoing intra abdominal surgery

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20170349 ◽

2017 ◽

Vol 6 (2) ◽

pp. 462

Author(s):

Lalit Mohan ◽

Vinit Kumar Thakur ◽

Prakash Kumar Dubey ◽

Harihar Dikshit ◽

Nitish Kumar ◽

...

Keyword(s):

Abdominal Surgery ◽

Pediatric Patients ◽

Postoperative Nausea And Vomiting ◽

Postoperative Vomiting ◽

Complete Control ◽

Group I ◽

Significant Difference ◽

Comparative Clinical Study ◽

Group Ii ◽

Group 2

Background: This study aimed to compare the efficacy of intravenous ondansetron and dexamethasone for prevention of post-operative vomiting in pediatric patients whom underwent intra-abdominal surgery at Indira Gandhi institute of medical sciences, Patna.Methods: A total of 40 eligible patients were included in the study. There were 20 patients in group 1 whom received i.v ondansetron (0.1 mg/kg), and 20 patients in group 2 received i.v Dexamethasone (1mg/kg) one minute prior to the induction of anaesthesia. Episodes of postoperative vomiting within first 24 hours of anaesthesia and thereafter in postoperative ward at different intervals was observed and recorded.Results: Complete control of PONV (no emesis, no rescue treatment for 24 hours after administration of study agent) was achieved in 40% of cases in group I, in 42.25% of cases in group II, mild PONV was achieved in 7.5% of cases in group I, in 5.0% of cases in group II, moderate PONV was achieved in 2.5% of cases in group I, in 2.5% of cases in group II, and severe PONV was not found in any of the two group. There was no statistically significant difference between the groups1and 2 in terms of baseline characteristics and postoperative managements. Frequency of postoperative nausea and vomiting experiences were similar between the groups (p>0.05).Conclusions: Single dose ondansetron 0.1 mg/kg and dexamethasone 0.5 mg/kg, given intravenously are equally effective agents for the control of PONV. Both drugs for the same indication do not seem to increase the antiemetic efficacy.

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Prediction of oligodendroglial tumor subtype and grade using perfusion weighted magnetic resonance imaging

Journal of Neurosurgery ◽

10.3171/jns-07/09/0600 ◽

2007 ◽

Vol 107 (3) ◽

pp. 600-609 ◽

Cited By ~ 50

Author(s):

Robert G. Whitmore ◽

Jaroslaw Krejza ◽

Gurpreet S. Kapoor ◽

Jason Huse ◽

John H. Woo ◽

...

Keyword(s):

Magnetic Resonance ◽

Mr Imaging ◽

Blood Volume ◽

Tumor Grade ◽

Grade Ii ◽

Cytogenetic Profile ◽

Group 2 ◽

Oligodendroglial Neoplasms ◽

Grade Iii ◽

Group 1

Object Treatment of patients with oligodendrogliomas relies on histopathological grade and characteristic cytogenetic deletions of 1p and 19q, shown to predict radio- and chemosensitivity and prolonged survival. Perfusion weighted magnetic resonance (MR) imaging allows for noninvasive determination of relative tumor blood volume (rTBV) and has been used to predict the grade of astrocytic neoplasms. The aim of this study was to use perfusion weighted MR imaging to predict tumor grade and cytogenetic profile in oligodendroglial neoplasms. Methods Thirty patients with oligodendroglial neoplasms who underwent preoperative perfusion MR imaging were retrospectively identified. Tumors were classified by histopathological grade and stratified into two cytogenetic groups: 1p or 1p and 19q loss of heterozygosity (LOH) (Group 1), and 19q LOH only on intact alleles (Group 2). Tumor blood volume was calculated in relation to contralateral white matter. Multivariate logistic regression analysis was used to develop predictive models of cytogenetic profile and tumor grade. Results In World Health Organization Grade II neoplasms, the rTBV was significantly greater (p < 0.05) in Group 1 (mean 2.44, range 0.96–3.28; seven patients) compared with Group 2 (mean 1.69, range 1.27–2.08; seven patients). In Grade III neoplasms, the differences between Group 1 (mean 3.38, range 1.59–6.26; four patients) and Group 2 (mean 2.83, range 1.81–3.76; 12 patients) were not significant. The rTBV was significantly greater (p < 0.05) in Grade III neoplasms (mean 2.97, range 1.59–6.26; 16 patients) compared with Grade II neoplasms (mean 2.07, range 0.96–3.28; 14 patients). The models integrating rTBV with cytogenetic profile and grade showed prediction accuracies of 68 and 73%, respectively. Conclusions Oligodendroglial classification models derived from advanced imaging will improve the accuracy of tumor grading, provide prognostic information, and have potential to influence treatment decisions.

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Biocompatiblibility analysis of the decellularized bovine pericardium

Cell and Organ Transplantology ◽

10.22494/cot.v8i2.110 ◽

2020 ◽

Vol 8 (2) ◽

Author(s):

A. Sokol ◽

◽

D. Grekov ◽

G. Yemets ◽

O. Galkin ◽

...

Keyword(s):

Tissue Engineering ◽

Sodium Dodecyl ◽

Bovine Pericardium ◽

Surrounding Tissue ◽

Tissue Samples ◽

Group I ◽

Alternative Material ◽

Decellularized Scaffolds ◽

Group 2 ◽

Potential Use

The decellularized bovine pericardium and its potential use as a natural scaffold is a promising approach in the field of tissue engineering and regenerative medicine. The reaction of the host toward decellularized scaffolds depends on their biocompatibility, which should be satisfied being before applied in clinical use. Purpose: to evaluate the biocompatibility of the extracellular matrices, which were decellularized by trypsin enzyme and anionic sodium dodecyl sulfate (SDS) detergent. Material and methods. Pericardial sacs were acquired from 12-18 months’ age bulls. Tissue decellularization was performed by using 0.25 % Trypsin solution and 1 % ionic SDS for group I and 0.1 % SDS for group II samples. The implantation was performed on Wistar rats. The tissue samples were stained with hematoxylin & eosin, Congo red and Masson's Trichrome for histological analysis. Results. In group 1 in 3 months after subcutaneous implantation in rats we noticed the inflammation in surrounding tissue and degradation of the implant. Under the same conditions in animals of group 2 implant replacement with growing immature connective tissue was noted. Bio-implant of this group did not degrade, moreover it's integrated to the tissues of experimental rats. Conclusion. Our results showed that decellularized bovine pericardium by 0.1 % SDS can become an alternative material for tissue engineering and has the potential for further use in human surgery.

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Association between cervical disc disease and lesions of multiple sclerosis

The Neuroradiology Journal ◽

10.1177/1971400920983565 ◽

2021 ◽

pp. 197140092098356

Author(s):

Marwan Alkrenawi ◽

Michael Osherov ◽

Azaria Simonovich ◽

Jonathan Droujin ◽

Ron Milo ◽

...

Keyword(s):

Spinal Cord ◽

Cervical Disc ◽

Cervical Disc Disease ◽

Disc Disease ◽

Group 4 ◽

Demyelinating Lesions ◽

Grade Ii ◽

Group 3 ◽

Group 2 ◽

Group 1

Background Cervical discopathy and demyelinating lesions often co-exist in patients with multiple sclerosis (MS). Our study examines the possible association between these two pathologies. Methods Medical records and cervical magnetic resonance imaging scans of MS patients with cervical discopathy who were seen at our MS clinic during 2018 were retrospectively reviewed. The severity of the disc disease was classified as grade I (no compression), grade II (compression of the dural sac) and grade III (cord compression). The spinal cord in each scan was divided into six segments corresponding to the intervertebral space of the spine (C1–C6). Each segment was defined as containing demyelinating lesion and disc pathology (group 1), demyelinating lesion without disc pathology (group 2), disc pathology without demyelinating lesion (group 3) and no demyelinating lesion or disc pathology (group 4). Fisher’s exact test was used to test the association between demyelinating lesions and disc pathology. Results Thirty-four MS patients with cervical discopathy were included in the study (26 females; average age 42.9 ± 13.7 years; average disease duration 8.4 ± 5.4 years). A total of 204 spinal cord segments were evaluated. Twenty-four segments were classified as group 1, 27 segments as group 2, 52 segments as group 3 and 101 segments as group 4. There was no association between demyelinating lesions and the grade of disc disease ( p = 0.1 for grade I, p = 0.3 for grade II and p = 1 for grade III disc disease). Conclusion Our study did not find any association between cervical disc disease and demyelinating spinal cord lesion.

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Evaluation of Recurrent Pediatric Syncope: Role of Tilt Table Testing

PEDIATRICS ◽

10.1542/peds.93.4.660 ◽

1994 ◽

Vol 93 (4) ◽

pp. 660-662

Author(s):

Margaret J. Strieper ◽

Debbie O. Auld ◽

J. Edward Hulse ◽

Robert M. Campbell

Keyword(s):

Pediatric Patients ◽

Neurocardiogenic Syncope ◽

Tilt Table ◽

Conversion Reaction ◽

Cell Counts ◽

Group I ◽

Tilt Table Testing ◽

Group Ii ◽

Made In

Objective. To determine the current practice and effectiveness of evaluating recurrent syncope in pediatric patients, and to establish the role of tilt table testing in the evaluation. Design. Retrospective analysis of 54 pediatric patients with the history of syncope referred to cardiologists. Group I consisted of 27 patients examined without tilt table testing group II consisted of 27 patients whose examination included tilt table testing. Results. Group I had an average of 5.4 studies and group II, 6.6 studies performed per patient. Studies included chest radiograph (16 vs 13), electrocardiogram (24 vs 27), echocardiography (21 vs 27), 24-hour electrocardiogram (14 vs 16), transtelephonic monitor (7 vs 8), electrophysiology study (1 vs 3), complete blood cell counts (11 vs 12), chemistries (10 vs 11), thyroid function test (3 vs 3), neurology consult (12 vs 6), electroencephalogram (12 vs 5), and head computed tomographic scan (5 vs 3). Of the 298 non-tilt studies, the results of only 5 (1.6%) were abnormal. Diagnoses were made in 5 (18.5%) of 27 group I patients (Wolff-Parkinson-White syndrome, 1; conversion reaction, 2; hyperventilation, 1; migraines, 1), whereas diagnosis was made in 27 (100%) of 27 group II patients (neurocardiogenic syncope, 25; conversion reaction, 2). Conclusion. An extensive workup is not routinely indicated in syncopal patients with a history consistent with neurocardiogenic syncope. Tilt table testing performed early in the evaluation will increase the probability of a diagnosis, and will often prevent the need for further extensive, expensive anxiety-producing tests.

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