From
StayCurrentMD
Journal of Pediatric Surgery Article Review: June 2022, AAP Issue
With Dr. Nicole Chandler & Dr. Todd Ponsky and Biran Modi & Dr. Marcus Malek · hosted by Ellen Incisco and M. Tom Bash
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
NAT was higher after the lockdown, not during the lockdown
During times of public health crises, it's important to maintain systems of protection for children
Management of metastatic hepatoblastoma continues to pose significant treatment challenges
We never had a hepatoblastoma cell line mouse model before
PSORC (Pediatric Surgical Oncology Research Collaborative) is a multi-institutional consortium of North American pediatric surgeons focused on advancing care of children with cancer
There has not been consistency in localization techniques for small pulmonary nodules across North America, with surgeons doing their own thing
Time under anesthesia can be long and quite variable depending on whether institutions use hybrid ORs or have IR on different floors
ICG will become much more popular and more effective for nodule localization in 5 years
Image guided localization techniques varied significantly among institutions but all were wildly successful, showing that experience is probably more important than the actual technique itself
The study focused on patients with pediatric intestinal failure, defined as requirement of parenteral nutrition for 60 days or more at any time, who had the diagnosis before age 8 and were older than 8 at time of study
Puberty is at least partially dependent on having good nutritional stores based on hormonal drivers of puberty
The hypothesis was that chronic pediatric intestinal failure would delay puberty and potentially dull the sharp spike of peak height velocity
Children with intestinal failure might be slightly short statured but are not severely undersized compared to the general population
There is a high incidence of short stature in chronic intestinal failure
The finding that kids with intestinal failure are not missing out on pubertal timing and peak height velocity suggests we need to do a better job at setting them up to go into puberty by working on their height and linear growth
The Midwest Pediatric Surgery Research Consortium (MWPSC) was established by departments of Pediatric Surgery from 11 children's hospitals
The NAT study used historical patterns captured by trauma registries to predict what the volume should have been during the initial COVID time period and compared that to observed rates
Initially non-accidental trauma rates dropped a little bit, but after that the rate increased above what they had expected during the stay at home orders
Patients disproportionately affected were older kids who were older than 5 years who would most commonly be in school, minority children, and lower socioeconomic groups as determined by the social vulnerability index
CDC's Social Vulnerability Index was uniquely created to see neighborhood's vulnerability during times of crises
One has to be careful not to make too strong of conclusions based on ICD 10 codes, no matter how many institutions and how long the evaluation period was
There are very few cell lines available to study hepatoblastoma, and a number of cell lines touted to be hepatoblastoma are actually hepatocellular carcinoma
The researchers labeled hepatoblastoma cells with luciferase, injected them into mouse tail veins where they preferentially went to lungs, harvested and cultured surviving cells, and repeated this process until establishing a reliable metastatic cell line
The new metastatic hepatoblastoma cell line exhibited increased tumorigenicity, invasiveness, and increased resistance to chemotherapy compared to the original human cell line
The most common localization techniques were wire and methylene blue dye, followed by methylene blue dye only
There was no difference in successful IR localization or successful resection of pulmonary nodules among the different localization techniques
Peak height velocity occurred at significantly younger ages for both males and females with intestinal failure
Puberty onset occurred significantly earlier compared to established norms for males, meaning they reached pubertal onset earlier than the CDC 50th percentile