Abnormal serum α-fetoprotein (AFP) levels are frequently observed in common disorders such as spina bifida or Down's syndrome in the fetus and cancer in children and adults. The focus of this chapter summarizes on the role of serum α-fetoprotein (AFP) as a useful biomarker in malignant pediatric tumors. The fetal yolk sac and liver generate high levels of AFP during gestation and decline over the next 12 months of infancy, and only trace amounts are detected in childhood. As a result, persistent elevation of AFP correlates with a number of select pediatric malignant conditions. Serum AFP is overexpressed in a considerable fraction of germ cell tumors (GCTs), hepatoblastoma (HB), and hepatocellular carcinoma (HCC). We provide the reader with a review of AFP as a useful specific marker for the diagnosis, management, and followup in select pediatric cancers.
The creation of an intestinal pouch following total gastrectomy is exceedingly rare in infants. We present the case of a term infant who underwent a near-total gastrectomy on day 2 of life for diffuse gastric necrosis with perforation due to severe hypoxemia from an intrapartum nuchal cord. Gastrointestinal continuity was restored at 5 months of age with a Hunt-Lawrence pouch. The child is now 3 years old and has achieved a weight in the 47th percentile despite challenges with micronutrient deficiencies, reduced caloric intake and renal insufficiency requiring 8 months of intermittent haemodialysis.
Clinical practice should be driven by high-quality research that produces evidence to inform best practices. Generation of such evidence is often challenging, particularly for smaller specialties, such as pediatric surgery, that treat many patients with rare diseases. Multi-institutional collaboration is seen as a major strategy to address these challenges. We have recently created the Canadian Consortium for Research in Pediatric Surgery, a national consortium that includes all major pediatric surgical services across Canada. The mission of the Consortium is to improve pediatric surgical care through high-quality collaborative research. In this article, we describe the rationale and methodology for creation of the Canadian Consortium for Research in Pediatric Surgery, demonstrate its achievements to date, and share a number of foundational concepts that are integral to its success. Our aim is to provide a model for creation of such consortia, ultimately leading to improvements in the quality of clinical research and patient care.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.