Pediatrics & Women's Health
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/30293
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Browsing Pediatrics & Women's Health by Author "Bowman, William"
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Item Focal Nodular Hyperplasia in a Pediatric Cancer Survivor(2020) Chor, Holy; Bowman, WilliamBackground: Focal nodular hyperplasia (FNH) are benign hepatic nodules that rarely occur in the pediatric population. Although pathogenesis of FNH is not elucidated, alteration in hepatic blood flow by vascular injury associated with chemotherapy and radiation therapy is thought to play a role. Differential diagnosis of hepatic nodules in the general population is wide and encompasses benign and malignant conditions. Discovery of hepatic nodules at follow-up in patients treated for pediatric malignancy raises a diagnostic dilemma. Case Information: In this case report, we discuss a 21-year-old Caucasian male who presented in 2006 at the age of 8-years with neuropathic leg pain and was diagnosed with embryonal rhabdomyosarcoma of the pelvis. Patient underwent protocol-directed chemotherapy with vincristine, actinomycin D, and cyclophosphamide, and radiation therapy. He completed therapy one year later in 2007 and has remained in continuous complete remission. Follow-up radiological imaging performed from year 2007 through 2020 include 3 computed tomography (CT) scans, 5 abdominal ultrasounds (US), and 2 abdominal magnetic resonance imaging (MRI). The initial diagnosis of FNH was suspected in 2015 by abdominal US and confirmed by MRI. Subsequent MRI and US imaging remained stable and consistent with FNH. No biopsy has been done. Conclusions: The discovery of FNH in follow-up post treatment may pose a diagnostic dilemma in pediatric cancer survivors. A systematic approach to radiological imaging will reduce the exposure of pediatric cancer survivors to unnecessary radiation, adverse effects, and invasive diagnostics.Item Treated prevalence of Austism Spectrum Disorder (ASD), Developmental Coordination Disorder (DCD), and Autism Spectrum Disorder with co-occurring DCD is significantly less than estimated prevalence in Tarrant County(2020) Kata, Karolina; Chang, Shannon; Ganesh, Abhinaya; Mauk, Joyce; Bowman, William; Bailey, Laurie; Hamby, Tyler; Miller, Haylie; Pruitt, BlakeAim: Autism Spectrum Disorder (ASD) and Developmental Coordination Disorder (DCD) commonly co-occur in pediatric patients. However, few studies have assessed the circumstances under which this co-diagnosis is assigned, in order to develop best-practice recommendations. Our multi-center retrospective chart review at Cook Children's Medical Center (CCMC) network, the Child Study Center (CSC), and the University of North Texas Health Science Center (UNTHSC) aims to identify common and differing elements along the diagnostic pathway for individuals with ASD, DCD, and ASD+DCD. Method: Using the electronic medical record of UNTHSC Health, we retrospectively evaluated charts from 2008-present for patients aged 0-21 at first entry. At UNTHSC, the number of patients since 2008 with ASD was 455, DCD was 677, and ASD+DCD was 21. These data were pooled with data previously collected from the other two sites. A maximum of 50 patients per site with ASD+DCD were age- and sex-matched to patients with ASD and patients with DCD. The final sample consisted of 121 non-duplicate ASD+DCD charts, 150 ASD charts, and 150 DCD charts. Results: In-depth analysis of charts is ongoing, and will aid in identifying whether patterns of patient- and provider-based variables differ across sites or diagnostic groups for the final sample Significance: The prevalence of DCD and ASD+DCD was strikingly low across all sites. Notable variability in EMR coding likely contributes to difficulty achieving diagnostic consistency and standardizing care. Undiagnosed or misdiagnosed children are susceptible to reduced access to resources and intervention.