Why I’m thankful for my daughter’s MRSA

“What time is surgery today?” Ellie, age 12, croaks. She hasn’t opened her eyes yet, but she knows she’s headed to the operating room … again. It may be the fourth surgery this month, maybe the fifth. We don’t know. What we do know is our routine has changed from soccer carpools and homework battles to twice-weekly trips to the operating room, where the orthopedic surgeon will slice open my baby girl’s thigh and attempt to wash out the deadly bacteria accumulating in her right femur and knee joint. We’re trying to learn the new routine and master a new language. The vocabulary is demanding. There are procedures, medications, devices and acronyms. Most are scary — wound vacuum, PICC (peripherally inserted central catheter), clinical failure of vancomycin, Methicillin-resistant Staphylococcus aureus (MRSA). The only one who seems to have any answers is the pediatric resident. Unfortunately, he’s nearly always wrong. Our trip into this alternate reality started on Ellie’s first day of seventh grade. “My knee hurts,” she says. Probably too much soccer and cross-country running, we think. The next day, her right knee has swelled to the size of a small pumpkin. OK, that’s a little alarming. We visit the local emergency room. They suggest an ACL tear, send her home with a knee brace and order an MRI the next day. When we show up for the MRI, Ellie is definitely not herself. She’s quiet an...
Source: Thrive, Children's Hospital Boston - Category: Pediatrics Authors: Tags: All posts MRSA PICC line Source Type: news

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BACKGROUND: Regular infant carrying might be a contributing factor for the development and progression of low back and pelvic girdle pain in mothers after childbirth. However, the neuromechanical adaptations of the spine due to different sling-based carryi...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Infants and Children Source Type: news
Publication date: Available online 22 October 2018Source: The SurgeonAuthor(s): Fatih Kucukdurmaz, Mohamed Sukeik, Javad ParviziAbstractBackgroundProponents of the direct anterior approach (DAA) for THAs suggest earlier recovery with no increased complications whereas opponents suggest higher complication rates.MethodsWe conducted a meta-analysis of randomized controlled trials (RCTs) to compare the outcomes of the DAA versus other surgical approaches in primary THAs.ResultsWe identified 18 RCTs suitable for detailed extraction of the data. The RCTs included a total of 1661 patients with a mean age of 62 years (range 55&nd...
Source: The Surgeon - Category: Surgery Source Type: research
AbstractTo validate a Spanish language translation of the ASAS Heath-Index (ASAS-HI) testing, its reliability, construct validity, and responsiveness in Colombian patients with spondyloarthritis. Translation was done following a forward-backward procedure. Patients fulfilling the Assessment of Spondyloarthritis international Society (ASAS) criteria for either axial or peripheral spondyloarthritis (SpA) participated. Test-retest reliability was assessed by intra-class correlation coefficient (ICC) in patients without treatment changes. In patients who required a therapeutic intervention, responsiveness was assessed using th...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
AbstractAvailable studies reported contradictory results about serum levels Dickkopf-1 (DKK1), an inhibitor of Wnt signaling in patients with ankylosing spondylitis (AS). In previous studies, we observed in other conditions that parathyroid hormone (PTH) serum levels were an important determinant of DKK1 serum levels. The aim of the present study was to investigate it in patients with AS. We recruited 71 patients diagnosed with AS. Levels of C-reactive protein (CRP), DKK1, PTH, 25OH-vitamin D, and bone turnover markers (intact N-propeptide of type I collagen, P1NP, and C-terminal telopeptide of type I collagen, CTX) were m...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
The objective of the study was to compare the effects of shockwave therapy and laser therapy on pain, neck functionality, and quality of life in patients with myofascial pain syndrome of the trapezius. 61 patients (>  18 years) were randomly allocated to two treatment groups: (1) 31 patients received soft laser therapy once daily in a 3-week period for a total of 15 sessions, (2) 30 patients received shockwave therapy once in a week for 3 weeks, totalling 3 treatments. Resting pain and pain tolerance were as sessed by a 100 mm visual analogue scale; functional status and quality of life were measur...
Source: Rheumatology International - Category: Rheumatology Source Type: research
AbstractComplex Regional Pain Syndrome type 1 (CRPS-1) is a disabling painful disease whose hallmark is pain disproportionate to inciting event. CRPS is also characterized by symptoms and signs, such as vasomotor, sudomotor, trophic and motor changes. Therapeutic approach of CRPS-1 still remains a challenge for clinicians treating a disease with potential heavy consequences on patient prognosis. In the past years, the treatment with bisphosphonates (BPs) has gained some success as confirmed by the results of a number of meta-analyses. The aim of this paper is to point out the pivotal role of bone in CRPS pathogenesis. The ...
Source: Rheumatology International - Category: Rheumatology Source Type: research
AbstractIn patients with a pediatric rheumatic disease (PRD), chronic musculoskeletal pain (CMP) can have a major impact on functioning and social participation. Because CMP is not always alleviated solely by the use of pharmacological approaches, the aim was to systematically review the available evidence regarding non-pharmacological treatment options for reducing CMP in patients with PRD. PubMed, Embase, PsycINFO, and the Cochrane Library were systematically searched for (non-)randomized trials investigating non-pharmacological treatments for CMP in PRD published through October 25, 2017. The GRADE approach was used to ...
Source: Rheumatology International - Category: Rheumatology Source Type: research
AbstractOsteoarthritis (OA) is a chronic disorder associated mainly with pain, limited range of motion, stiffness, low-grade systemic inflammation, and articular cartilage destruction. Recent studies have demonstrated the involvement of chondrocyte differentiation (hypertrophy) as one of the mechanisms in cartilage degradation in OA. This implicates the involvement of principal changes in the regulation of cellular function associated with profound alterations in chondrocyte energy metabolism in the course of cartilage resorption. Therefore, this review describes the major energy-generating pathways and their regulatory mo...
Source: Rheumatology International - Category: Rheumatology Source Type: research
We present a case of tracheal cartilaginous sleeve diagnosed by ultrasound (US) in a patient with Pfeiffer syndrome. The patient developed respiratory failure and was suspected at bronchoscopy to have tracheal cartilaginous sleeve. US performed before tracheostomy placement demonstrated continuous hypoechoic cartilage along the anterior surface of the trachea, confirming the diagnosis. Our report shows that US can make a definitive diagnosis of tracheal cartilaginous sleeve and raises the possibility of using US to screen for the condition in patients with syndromic craniosynostosis without the need for anesthesia or ionizing radiation.
Source: Pediatric Radiology - Category: Radiology Source Type: research
ConclusionAlthough we achieved 100% technical success in intrathecal nusinersen administration, our practices evolved during the course of this study. As a result of our early experience we developed an algorithm to assist in promoting safe and effective nusinersen administration in children with spinal muscular atrophy regardless of SMA type, abnormal spinal anatomy and complex spinal instrumentation.
Source: Pediatric Radiology - Category: Radiology Source Type: research
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