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Rashaan Z.M.,Leiden University | Rashaan Z.M.,Red Cross | Krijnen P.,Leiden University | Allema J.H.,Haga Teaching Hospital Juliana Childrens Hospital | And 5 more authors.
European Journal of Trauma and Emergency Surgery

Purpose: Evaluation of usability and effectiveness of Suprathel® in the treatment of partial thickness burns in children. Methods: A prospective, observational study to evaluate adherence of Suprathel® to the wound bed, reepithelialization time, grafting, wound colonization and infection, pain, dressing changes, length of hospital stay (LOS) and scar formation. Results: Twenty-one children (median age 2.4 years, range 5 months–14 years) with a median total body surface area (TBSA) of 4 % (range 1–18) were included. Median LOS was 10 days (range 3–20). Median outer layer dressing changes was 3 (range 1–14). Suprathel® was only adherent in wounds debrided with Versajet®. Median reepithelialization time was 13 days (range 7–29). Three patients needed a split skin graft. There were 7 (33 %) patients with wound colonization before application of Suprathel®. This increased to 12 (57 %) patients during treatment. One patient developed a wound infection. Median visual analog scale (VAS) scores for background and procedural pain in patients >7 years were 3.2 (range 2–5) and 3.5 (range 2–5), respectively. In younger patients, median background and procedural COMFORT-B scores were 13.8 (range 10–23) and 14.8 (range 13–23, p = 0.03), respectively. Patient and Observer Scar Assessment Scale (POSAS) scores were favorable after 3 and 6 months post burn. Conclusions: Suprathel® provides potential advantages regarding pain and scar formation, but extensive wound debridement is needed to achieve adequate adherence. © 2016 The Author(s) Source

Houwing M.E.,Erasmus MC Sophia Childrens Hospital | Koopman-Coenen E.A.,Erasmus MC Sophia Childrens Hospital | Kersseboom R.,Erasmus University Rotterdam | Gooskens S.,Erasmus MC Sophia Childrens Hospital | And 14 more authors.
International Journal of Hematology

We report, for the first time, a non-syndromic infant with a reversible myeloproliferative disease that harbors a germline hereditary thrombopoietin (THPO) gene mutation, a condition that is known to induce familial thrombocytosis at increasing age. In order to investigate whether somatic THPO gene mutations play a role in sporadic pediatric myeloproliferative diseases, we performed a mutation screening of a large representative cohort of pediatric acute myeloid leukemia, myeloid leukemia of Down syndrome, and juvenile myelomonocytic leukemia samples and show that gain-of-function THPO mutations are extremely rare in sporadic pediatric myeloproliferative diseases. © 2015, The Japanese Society of Hematology. Source

Nuijsink M.,Haga Teaching Hospital Juliana Childrens Hospital | Vaessen-Verberne A.A.P.H.,Amphia Hospital | Hop W.C.J.,Erasmus Medical Center | Sterk P.J.,University of Amsterdam | And 2 more authors.
Respiratory Medicine

Introduction Children with persistent asthma may have diminished lung function in early adulthood. In our previous study ('CATO') we showed preservation of lung function in asthmatic children, during 2 years of treatment that was guided by airway hyperresponsiveness (AHR). The aim of the present prospective follow up study was to investigate whether the positive effect of the AHR strategy on lung function had persisted beyond the duration of the intervention study, after several years of usual care by paediatrician and general practitioner. Methods With a mean interval of 4.4 y after the last visit, 137 subjects (67% of the original CATO population) participated in this follow-up study. Evaluation consisted of spirometry (n = 137), a methacholine challenge test (n = 83), data on inhaled steroid treatment and asthma exacerbations (n = 137), and an asthma symptom diary during 6 weeks (n = 90). Results At follow-up, lung function, % symptom-free days and exacerbation rates of both treatment strategy groups was similar. The mean dose of inhaled corticosteroids had diminished from 550 μg/day at the end of CATO to 235 μg/day at follow-up. The decrease in AHR measured at the end of CATO was maintained at follow-up for both treatment strategy groups. Conclusion The beneficial effect on lung function of 2 years treatment guided by AHR was lost after 3-7 years of usual care. This suggests that an AHR-guided treatment strategy may need to be sustained in order to preserve lung function.© 2013 Elsevier Ltd. All rights reserved. Source

Bomer J.,Haga Teaching Hospital Juliana Childrens Hospital | Wiersma-Deijl L.,Haga Teaching Hospital Juliana Childrens Hospital | Holscher H.C.,Haga Teaching Hospital Juliana Childrens Hospital
Insights into Imaging

In digital radiography we are now able to electronically collimate images after acquisition. This may seem convenient in paediatric imaging, but we have to be aware that electronic collimation has two major downsides. Electronic collimation implicates that the original field size should have been smaller and the child has been exposed to unnecessary radiation. Also, by use of electronic collimation, potentially important information may be lost. The "silver lining", denoting the X-ray beam collimation, can serve as a useful radiation protection instrument to check for proper field size and detect unnecessary exposure. Furthermore, the silver lining confirms all exposed anatomy is shown in the final image, and thus may also serve as a quality assurance instrument as the patient has the right to all acquired information. Teaching Points • The ability to electronically collimate an image after acquisition may serve to enhance contrast in the region of interest. • The ability to electronically collimate an image after acquisition carries the risk of overexposure. • The ability to electronically collimate an image after acquisition carries the risk of losing important information. • The silver lining can serve as a quality control instrument for proper collimation. • The patient has the right to all information obtained during an X-ray examination. © 2013 The Author(s). Source

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