Hospital for Sick Children

About: Hospital for Sick Children is a healthcare organization based out in Toronto, Ontario, Canada. It is known for research contribution in the topics: Population & Medicine. The organization has 4097 authors who have published 3746 publications receiving 129066 citations. The organization is also known as: Sick Kids Hospital & SickKids.

Pharmacological interventions for recurrent abdominal pain (RAP) in childhood.

Abstract: Background Between 4% and 25% of school age children complain of recurrent abdominal pain (RAP) of sufficient severity to interfere with daily activities. For the majority of such children no organic cause for their pain can be found on physical examination or investigation. Although most children are likely managed by reassurance and simple measures, a large range of interventions has been recommended. Objectives To determine the effectiveness of medication for recurrent abdominal pain in school-age children. Search strategy The Cochrane Library (CENTRAL), MEDLINE, EMBASE, CINAHL, ERIC, PsycLIT, LILACS and JICST were searched using a strategy combining (Recurrent OR synonyms) AND (Abdomen OR synonyms) AND (Pain OR synonyms). Where appropriate search filters were employed. In addition, researchers working in this area were asked to identify relevant studies. Selection criteria Any study in which the majority of participants were school age children fulfilling standard criteria for RAP, and who were allocated by random or quasi-random methods to any drug treatment compared with a placebo or no treatment. Data collection and analysis References identified by the searches were screened against the inclusion criteria by two independent reviewers. Main results Only one trial met the inclusion criteria. This cross-over trial in 14 children who met suggested criteria for "abdominal migraine" compared pizotifen and placebo, each given for one month with no washout period. Participants reported a mean of 8.21 (95% CI 2.93, 13.48) fewer days of pain while taking the active drug. They also reported that the mean difference on an "Index of Severity" was -16.21 (95% CI -26.51, -5.90) and on an "Index of Misery" was -56.07 (95% CI -94.07, -18.07). Reviewer's conclusions There is little evidence to suggest that recommended drugs are effective in the management of RAP. At present there seems little justification for the use of these drugs other than in clinical trials. There is an urgent need for trials of all suggested pharmacologic interventions in children with RAP.

Stimulatory and inhibitory signaling molecules that regulate renal branching morphogenesis.

Abstract: Branching morphogenesis, defined as the growth and branching of epithelial tubules, is a fundamental developmental process involved in the formation of a variety of mammalian tissues, including the kidney. Defective renal branching may result in a number of clinically relevant abnormalities, including renal agenesis, renal dysplasia, multiplex kidneys, and hypertension. In this review we describe the morphological events that generate the characteristic tree-like structure of the mammalian collecting system. We also highlight new knowledge related to both established and novel signaling systems that are important for stimulating and inhibiting branching morphogenesis.

Peripheral nerve tumors.

Abstract: Peripheral nerve tumors (PNTs) are rare soft tissue lesions that can arise anywhere on the body and as a result have a wide differential diagnosis, which is often confirmed to be a PNT only at surgery. PNTs occur both sporadically and within the context of genetically predisposing syndromes; hence, a thorough history of the mass and associated symptoms, with a focused family history for neurofibromatosis (NF) or other known predisposition syndromes, combined with a local plus systemic examination, is crucial. The low frequency of PNTs and incomplete understanding of the molecular etiology and cell of origin of the various subtypes have led to lack of a rigorous classification of PNTs, though one is proposed by the World Health Organization (WHO) [1], as have been several others, such as the one used at our institute (Fig. 58.1). MRI imaging is the preoperative imaging modality of choice of PNTs, though it is not pathognomonic for the diagnosis or differentiation of the various subtypes of PNTs.

Quality improvement in neurology: Child neurology quality measure set: Executive summary

Abstract: Childhood neurologic disorders, as a group, include relatively common conditions such as migraine (prevalence between 3% and 10.6% in children 3–15 years of age1,2), transient tic disorders (TDs) (3%),3 and specifically Tourette syndrome (TS) (0.8%),3 and rarer disorders such as infantile spasms that may occur in only about 1,200 infants each year in the United States. These disorders account for a disproportionately higher number of emergency department visits, intensive care admissions, deaths, and higher costs when compared to other childhood illness.4 Generally, delivery of quality care should improve outcomes and result in decreased unnecessary utilization of health services.4