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  • ISSN: 2373-9312
    Volume 2, Issue 1
    January-March 2014
    Editorial
    Thais Queliz Peña and Angel A. Luciano*
    Nearly 12% of births in the U.S. are preterm, and prematurity is the leading cause of neonatal morbidity and mortality. While advances in medicine have increased the survival of premature infants, the rate of preterm birth in the U.S. has not decreased [1]. As survival has increased, the rates of neonatal systemic complications such as bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC) and sepsis have dramatically increased [2]. Understanding the causes of preterm labor and the pathophysiology of its systemic complications continue to be a challenge. Increasing evidence is demonstrating an association between neonatal inflammation, preterm labor, systemic complications and development of the neonatal immune system [3-8]. Recent findings have demonstrated fetal immunological consequences of intrauterine exposure to inflammation and its possible association with poor clinical outcomes [9-13]. Is it possible to identify preterm infants with a higher risk of developing systemic complications based on their cord blood immune signature? Our group has been asking this question and may have some promising answers.
    Villegas SC1,2*
    What is a fever? A fever is a controlled elevation of the body's temperature above the normal range of 98°F to 98.6°F (36.7°C to 37°C) [1]. According to the American Academy of Pediatrics (AAP), a temperature above 100.4°F (38°C) is what most pediatricians consider to be a sign of a fever [2]. Treatment is typically not required in a healthy child with a temperature below 102.2°F (39°C) [3]. However, parents will often treat a fever to return the child's temperature back to a normal temperature, but the goal of treating the fever should be to help the child's discomfort [4].
    Review Article
    Romy Kursawe*
    Abstract: The ever growing prevalence of childhood obesity is being accompanied by an increase in the pediatric population of diseases once believed to be exclusive of the adulthood such as the metabolic syndrome (MS). The MS has been defined as the link between insulin resistance, hypertension, dyslipidemia, impaired glucose tolerance and other metabolic abnormalities associated with an increased risk of atherosclerotic cardiovascular diseases in adults. In the past years it however became clear that a subgroup of obese patients is metabolically healthy with insulin sensitivity similar to healthy lean individuals, and lower liver fat content than the majority of metabolically ‘unhealthy' obese patients. Recent studies investigating lipid partitioning among specific fat depots revealed that protection against ectopic fat deposition in liver, muscle and heart, as well as protection against adipose tissue dysfunction and inflammation, seem to be contributing to the healthy obese phenotype.
    Mini Review
    Maha Haddad* and Erica Winnicki
    Abstract: Successfully transitioning the care of adolescents with chronic illness to adult providers is an important, yet often challenging, aspect in the care of these patients. In renal transplant recipients in particular, there is concern that the transfer of care of adolescents might increase rejection rates in a population that is already known to have an increased risk of non-adherence to medical therapy. The purpose of this brief review is to provide a definition of transition, to determine some of the potential risks associated with the transfer of care, and lastly to discuss important aspects of a successful transition process.
    Case Report
    Kevin Chang1, Mario Bialostozky1, Joyce Koh2, Eyal Ben-Isaac3*
    Abstract: A seven-year-old previously healthy Hispanic male presented with persistent fevers and a nonproductive cough. After an initial course of outpatient antibiotics, the patient was admitted to the hospital for further management of a right upper lobe consolidation. Initial bronchoscopy revealed a high lipid laden macrophage index. The patient improved after prolonged intravenous antibiotics and was discharged home on further oral antibiotics. Subsequently the fevers recurred and the patient was re-admitted for worsening of his right upper lobe consolidation. A repeat bronchoscopy was positive for rare Burkholderia cepacia group. Given the new finding, further work-up revealed an underlying diagnosis of Chronic Granulomatous Disease.
    Research Article
    Chittalsinh Raulji1, Hope Pritchett1, Matthew Stark2, Kenneth Ward3, Velasco Cruz4 and Jaime Morales1*
    Abstract: Primary malignant bone tumors account for approximately 6% of all childhood malignancies. Osteosarcoma (OS) and Ewing's sarcoma (ES) are the most common and have an annual incidence of 8.7 per million under the age of 20 years. The mean 5-year survival for OS and ES has been 61% and 60% respectively. The survival for OS and ES has not significantly improved for past 20 years.
    We examined the cases of OS and ES, treated at Children's Hospital of New Orleans (CHNOLA) from 1999-2012. Comparison to national survival data from the Survival, Epidemiological and End Results (SEER) study was done. The goal of our study was to demonstrate any difference in survival of our patient population compared to national data.
    Results: Of the 44 patients diagnosed and treated as either OS or ES, 25 (57%) were OS and 19 (43%) were ES. The mean age of diagnoses for OS was 14 years and for ES was 12 years. Overall survival for all cases was 85%, which was superior to the reported SEER 5-year survival of 68.7 % for malignant bone tumors for ages 0-19 years from 2003 to 2009.
    Survival was not affected by patients' age, gender, race or timing of surgery for removal of primary tumor. All non-survivors had metastatic disease at presentation, which was an adverse prognostic factor (p=0.002). Additionally, positive tumor margins at time of surgery (p=0.008) and decreased amount of tumor necrosis post chemotherapy (p=0.001) negatively affected survival.
    Conclusion: Overall survival of pediatric patients with bone tumors was better than SEER data. Presence of metastatic disease and poor response to chemotherapy based on tumor necrosis and positive margins were found to be adverse prognostic factors.
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