Anesthesiology staffs peri-operative care of overweight and obese children

Children are a group of patients that require special knowledge from the anesthesia staff, both general and specific. Theoretical knowledge and practical experience is necessary to adequately care for the child as it anatomically, physiologically and mentally may differ from adult patients. A growing problem in the pediatric population is overweight and obesity. From a stagnation in the early 2000s the prevalence of overweight and obesity among children in the world are again increasing.The purpose of this study was to examine peri-operative care of overweight and obese children. Systematic searches were done in PubMed, CINAHL and Scopus. After the quality audit according to SBU, twelve articles were included for analysis. Results suggest that overweight and obese children have a higher risk of respiratory peri-operative complications. The risk of hospital admission after outpatient surgery was also greater in this group as well as higher costs for health care. Overweight and obese children are complex subjects with more frequent peri-operative risk factors than normal-weight children. This group requires special knowledge of the anesthesia staff. More studies are required to secure evidence in anesthetic care for overweight and obese children

Anesthesiology staffs peri-operative care of overweight and obese children

Children are a group of patients that require special knowledge from the anesthesia staff, both general and specific. Theoretical knowledge and practical experience is necessary to adequately care for the child as it anatomically, physiologically and mentally may differ from adult patients. A growing problem in the pediatric population is overweight and obesity. From a stagnation in the early 2000s the prevalence of overweight and obesity among children in the world are again increasing.The purpose of this study was to examine peri-operative care of overweight and obese children. Systematic searches were done in PubMed, CINAHL and Scopus. After the quality audit according to SBU, twelve articles were included for analysis. Results suggest that overweight and obese children have a higher risk of respiratory peri-operative complications. The risk of hospital admission after outpatient surgery was also greater in this group as well as higher costs for health care. Overweight and obese children are complex subjects with more frequent peri-operative risk factors than normal-weight children. This group requires special knowledge of the anesthesia staff. More studies are required to secure evidence in anesthetic care for overweight and obese children

Submicroscopic genomic imbalances in burkitt lymphomas/leukemias: Association with age and further evidence that 8q24/MYC translocations are not sufficient for leukemogenesis.

Chromosome banding analyses reveal secondary chromosome abnormalities in addition to the MYC translocations t(8;14)(q24;q32), t(8;22)(q24;q11), and t(2;8)(p11;q24) in 60%-80% of Burkitt lymphomas/leukemias (BL). The high incidence of such aberrations indicates that additional changes are important, perhaps necessary, for malignant transformation, i.e., the 8q24/MYC rearrangements may not be sufficient. To investigate this possibility, we performed single nucleotide polymorphism (SNP) array analysis on 20 cases of 8q24/MYC-positive BL. Nineteen (95%) harbored genomic imbalances; the only case without such aberrations displayed secondary changes by chromosome banding analysis. Thus, all BL cases had abnormalities in addition to the 8q24 translocation. The adult cases harbored more changes (median 3; range 1-21) than did the childhood cases (median 1.5; range 0-5) (P = 0.034). Several recurrent aberrations were detected by SNP array analysis, in particular losses of 6q14.1-q22.33, 9p21.3, and 13q14.2-q14.3, gains of 1q23.3-q31.3, chromosome 7, 13q31.3, and partial uniparental isodisomies for 6p12.2-pter, 9p23-pter, and 17p11.2-pter. The molecular genetic consequences of these changes include deletions of the CDKN2A and TP53 genes, and gains/losses of several genes, such as MIR17HG and E2F2K, involved in the MYC pathway. Thus, deregulation of the MYC pathway, both directly through the 8q24/MYC translocation and indirectly through secondary genomic imbalances, may be essential not only for the initiation but also for the progression of BL. © 2012 Wiley Periodicals, Inc

SFPQ-ABL1-positive B-cell precursor acute lymphoblastic leukemias

In recent years, a subgroup of B‐cell precursor acute lymphoblastic leukemia (BCP ALL) without an established abnormality (“B‐other”) has been shown to be characterized by rearrangements of ABL1 , ABL2 , CSF1R , or PDGFRB (a.k.a. ABL‐class genes). Using FISH with probes for these genes, we screened 55 pediatric and 50 adult B‐other cases. Three (6%) of the adult but none of the childhood B‐other cases were positive for ABL‐class aberrations. RT‐PCR and sequencing confirmed a rare SFPQ‐ABL1 fusion in one adult B‐other case with t(1;9)(p34;q34). Only six SFPQ ‐ABL1 ‐positive BCP ALLs have been reported, present case included. A review of these shows that all harbored fusions between exon 9 of SFPQ and exon 4 of ABL1 , that the fusion is typically found in adolescents/younger adults without hyperleukocytosis, and that IKZF1 deletions are recurrent. The few patients not treated with tyrosine kinase inhibitors (TKIs) and/or allogeneic stem cell transplantation relapsed, strengthening the notion that TKI should be added to the therapy of SFPQ ‐ABL1 ‐positive BCP ALL

The hypermethylome of pediatric acute lymphoblastic leukemia

Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy, with high hyperdiploidy [51-67 chromosomes] and the t(12;21)(p13;q22) [ETV6/RUNX1 fusion] representing the most frequent abnormalities. Although these arise in utero, there is long latency before overt ALL, showing that additional changes are needed. Gene dysregulation through hypermethylation may be such an event; however, this has not previously been investigated in a detailed fashion. We performed genome-wide methylation profiling using bacterial artificial chromosome arrays and promoter-specific analyses of high hyperdiploid and ETV6/RUNX1-positive ALLs. In addition, global gene expression analyses were performed to identify associated expression patterns. Unsupervised cluster and principal component analyses of the chromosome-wide methylome profiles could successfully subgroup the two genetic ALL types. Analysis of all currently known promoter-specific CpG islands demonstrated that several B-cell- and neoplasia-associated genes were hypermethylated and underexpressed, indicating that aberrant methylation plays a significant leukemogenic role. Interestingly, methylation hotspots were associated with chromosome bands predicted to harbor imprinted genes and the tri-/tetrasomic chromosomes in the high hyperdiploid ALLs were less methylated than their disomic counterparts. Decreased methylation of gained chromosomes is a previously unknown phenomenon that may have ramifications not only for the pathogenesis of high hyperdiploid ALL but also for other disorders with acquired or constitutional numerical chromosome anomalies

FLT3 mutations in a 10 year consecutive series of 177 childhood acute leukemias and their impact on global gene expression patterns.

Abstract is not availabl