Although dexamethasone is highly effective in the treatment of pediatric acute lymphoblastic leukemia (ALL), it can cause serious metabolic side effects. Because studies regarding the effects of dexamethasone are limited by their small scale, we prospectively studied the direct effects of treating pediatric ALL with dexamethasone administration with respect to activation of components of metabo...

Since the modern era of cancer chemotherapy that began in the mid-1940s, survival rates for children afflicted with cancer have steadily improved from 10% to current rates that approach 80% (60). Unfortunately, many long-term survivors of pediatric cancer develop chemotherapy-related health effects; 25% are afflicted with a severe or life-threatening medical condition, with cardiovascular disea...

Substantial variation exists with respect to the management of traumatic brain injuries (TBI) in children. Centers that practice aggressive treatment of TBI may improve survival, but it is not clear that the outcomes can be justified using cost-effectiveness criteria. This study illustrates the use of cost-effectiveness analysis to assess interventions for improving outcomes in children by asse...

BACKGROUND Trauma in pediatric patients is a major cause of death. This study investigated differences between decedents and survivors. Furthermore, an analysis of preventable and potential preventable trauma deaths was conducted and errors in the acute trauma care were investigated. METHODS All patients aged less than 16 years with an Injury Severity Score (ISS) ≥ 16 upon primary admission t...

BACKGROUND To determine the B-type natriuretic peptide (BNP) level in pediatric septic patients, and to investigate its association with cardiovascular dysfunction and clinical outcome. METHODS Pediatric patients with sepsis or septic shock were prospectively enrolled in our pediatric intensive care unit (PICU). On day 1 of admission, plasma BNP levels were measured at the time-point of echoc...

We examined clinical, morphologic, and cytogenetic features and ALL-1 (MLL, Htrxl, HRX) gene rearrangements in 17 cases of secondary leukemia that occurred 11 months to 9 years from diagnoses of primary cancers in children who received topoisomerase II inhibitors or developed secondary leukemias typical of those associated with this therapy. Primary diagnoses included nine solid tumors and eigh...

Total antioxidant status (TAS), and the influence of treatment and correlation between TAS and parameters involved in metabolic syndrome (MS) in pediatric cancer survivors were evaluated. One hundred children and adolescents were studied. Twenty-five survivors received radiotherapy, 12 were obese or overweight.Additionally, we analyzed TAS in eight children with acute lymphoblastic leukemia (AL...

Treatments for mucopolysaccharidoses (MPSs) have increased longevity, but cardiovascular disease causes mortality in a significant percentage of survivors. Markers must be developed to predict MPS cardiac risk and monitor efficacy of investigational therapies.MPS patients underwent carotid artery ultrasonography from which carotid intima-media thickness (cIMT) and three measures of arterial sti...

We conducted this study to evaluate the outcome of 203 patients admitted to PICU, using PRISM score. Overall mortality was 16.7%. The mean PRISM score was 6.5+/-3.6 and 15.5+/-7 for survivors and non survivors, respectively (OR: 1.36; 95% CI=1.24 -1.5; P<0.001). PRISM score also correlated well with length of hospital stay and the number of organ failures (P<0.001). A cut off score of 15 was as...

INTRODUCTION Limited data exist on the outcome of Dandy-Walker malformation (DWM), Dandy-Walker variant (DWV) and mega-cisterna magna (MCM). We report the first population-based study of posterior fossa anomalies from the northern region of England. METHODS Cases were identified from the Northern Congenital Abnormality Survey (NorCAS) and regional Fetal Medicine Unit databases for the period ...