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The appropriate imaging for pediatric patients being evaluated for suspected physical abuse depends on the age of the child, the presence of neurologic signs and symptoms, evidence of thoracic or abdominopelvic injuries, and whether the injuries are discrepant with the clinical history. The clinical presentations reviewed consider these factors and provide evidence-based consensus recommendations by the ACR Appropriateness Criteria((R)) Expert Panel on Pediatric Imaging. [ABSTRACT FROM AUTHOR]

The appropriate imaging for pediatric patients being evaluated for suspected physical abuse depends on the age of the child, the presence of neurologic signs and symptoms, evidence of thoracic or abdominopelvic injuries, and whether the injuries are discrepant with the clinical history. The clinical presentations reviewed consider these factors and provide evidence-based consensus recommendations by the ACR Appropriateness Criteria® Expert Panel on Pediatric Imaging. [ABSTRACT FROM AUTHOR]

The identification of prognostic and predictive biomarkers for high-programmed cell death-ligand 1 (PD-L1) advanced non-small cell lung cancer (aNSCLC) treated with first-line pembrolizumab could support the decision-making about possible combination therapies. To explore the baseline neutrophil-to-lymphocyte ratio (NLR) with the possible addition of PD-L1 tumour proportion score (TPS) level or lactate dehydrogenase (LDH) as possible prognostic biomarkers by a multicenter retrospective exploratory analysis aiming at identifying favourable-risk patients. Baseline NLR was available for all 132 high PD-L1 aNSCLC patients, PD-L1 level and LDH for 81 (61%) and 85 (64%) patients, respectively. NLR, PD-L1 and LDH cut-offs by receiver operating characteristic (ROC) curves were 4.9, 77.5% and 268.5, respectively. Seventy-one patients (54%) had NLR <5; 25 out of 81 NLR <5 (31%) had PD-L1 >80%, 26 out of 85 (31%) NLR <5 and normal LDH (nLDH). Median follow-up was 16.3 months. As compared to NLR >5, significantly better 2-year overall survival (OS) and progression-free survival (PFS) were observed with NLR <5 [62% vs . 41%, P=0.005, hazard ratio (HR) 0.45, and median of 12.0 vs . 5.7 months, P=0.01, HR 0.56, respectively], NLR <5 + PD-L1 >80% (81%, P=0.006, HR 0.20 and median of 14.7, P=0.03, HR 0.44, respectively), and NLR <5 + nLDH (74%, P=0.009, HR 0.25 and median of 14.7, P=0.02, HR 0.40, respectively). NLR <5 and NLR <5 + nLDH significantly associated with PD (P=0.008 and P=0.025, respectively) but not response rate (RR) (P=0.09 and P=0.07, respectively); NLR <5 + PD-L1 >80% both RR (P=0.03) and PD (P=0.02). NLR <5 ± PD-L1 >80% or nLDH could represent easy-to-assess tools to identify high PD-L1 aNSCLC patients with favourable outcome following first-line pembrolizumab monotherapy., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tlcr-19-583). MB reports personal fees from Janssen-Cilag, Boehringer Ingelheim, Roche, non-financial support from Bristol-Myers Squibb, AstraZeneca/MedImmune, Pierre Fabre, Ipsen, outside the submitted work. DS reports personal fees and non-financial support from Astra Zeneca, Bristol Myers Squibb, personal fees from Lilly, non-financial support from Merck Sharp & Dohme, Roche outside the submitted work. Dr. Metro reports personal fees from Boehringher-Ingelheim outside the submitted work and serves as an unpaid editorial board member of Translational Lung Cancer Research from Jul 2019 to Jul 2021. ADT reports other from MSD outside the submitted work. AF reports personal fees from Roche, Pfizer, Astellas and Bristol-Myers Squibb outside the submitted work. MCG reports personal fees and other from Eli Lilly, personal fees from Boehringer Ingelheim, Otsuka Pharma, grants, personal fees and other from Astra Zeneca, Novartis, BMS, Roche, Pfizer, Celgene, personal fees from Incyte, Inivata, Takeda, grants and other from Tiziana Sciences, Clovis, Merck Serono, grants and personal fees from Bayer, grants, personal fees and other from MSD, grants and other from GlaxoSmithKline S.p.A., personal fees from Sanofi-Aventis, grants and other from Spectrum Pharmaceutcials, Blueprint Medicine, personal fees from Seattle Genetics, Daiichi Sankyo outside the submitted work. AA reports personal fees from BMS, Astrazeneca, Roche, Pfizer, MSD, Boehringer outside the submitted work. The other authors have no conflicts of interest to declare., (2020 Translational Lung Cancer Research. All rights reserved.)

The term "developmental dysplasia or dislocation of the hip" (DDH) refers to the complete spectrum of abnormalities involving the growing hip, with varied expression from dysplasia to subluxation to dislocation of the hip joint. Unlike the term "congenital dysplasia or dislocation of the hip," DDH is not restricted to congenital problems but also includes developmental problems of the hip. It is important to diagnose these conditions early to improve the results of treat- ment, decrease the risk of complications, and favorably alter the natural history. Careful history taking and physical examination in conjunction with advances in imaging techniques, such as ultrasonography, have increased the ability to diagnose and manage DDH. Use of the Pavlik harness has become the mainstay of initial treatment for the infant who has not yet begun to stand. If stable reduction cannot be obtained after 2 weeks of treatment with the Pavlik harness, alternative treatment, such as examination of the hip under general anesthesia with possible closed reduction, is indicated. If concentric reduction of the hip cannot be obtained, surgical reduction of the dislocated hip is the next step. Toward the end of the first year of life, the toddlerTs ability to stand and bear weight on the lower extremities, as well as the progressive adaptations and soft- tissue contractures associated with the dislocated hip, preclude use of the Pavlik harness.

Care of children with disorders of the cervical spine requires an understanding of the anatomic and biologic features particular to the developing pediatric spine. Congenital and developmental alterations further complicate evaluation and treatment of children. Basic knowledge of pediatric cervical spine disorders in Down syndrome, Klippel-Feil syndrome, osteochondrodysplasias, mucopolysaccharidoses, and post-traumatic instability is essential for all orthopedic surgeons. Thorough patient evaluation and appropriate early management may prevent potentially serious neurologic injury and other complications related to cervical spine pathology.

The young athlete involved in modern sports activity may be subject to considerable problems involving the spine. An appreciation of the differences in spinal anatomy, development, and kinematics facilitates the evaluation of each individual. While a variety of factors are operant that could contribute to difficulty in evaluation and treatment, an organized approach with an emphasis on naturally-occurring variations of the immature spine will allow for appropriate recommendations. While concern exists regarding the individual with congenital, developmental, or hereditary conditions, it is important to respect the individuality of these young athletes and to assess each problem in a comprehensive manner before recommending full or restricted activity. Current research should yield important information that will serve as more absolute guidelines in formulating recommendations for involved adolescent athletes and will establish the natural history of conditions that today remain obscure.

We are reporting the cases of five patients who had occipito-atlantal instability, a rare condition that may be due to either trauma or congenital abnormalities. In three of the patients the instability was secondary to trauma. The clinical and neurological manifestations were varied and included cardiorespiratory arrest, motor weakness, quadriplegia, torticollis, pain in the neck, vertigo, and projectile vomiting. All of the patients underwent posterior arthrodesis of the occiput to the first or second cervical vertebra. In the patients who had trauma-related instability, surgery was performed when immobilization in a cast failed to stabilize the spine; in the patients who had a congenital abnormality, arthrodesis was indicated because of persistent symptoms and the potential for catastrophe with minor trauma. Based on our experience, we recommend surgical stabilization by posterior arthrodesis when this form of instability of the cervical spine is diagnosed.

Fourteen patients with slipped capital femoral epiphysis (SCFE) who had high-resolution and magnification bone scintigraphy during treatment were studied. By demonstrating the vascular status of the femoral head and physiologic condition of the growth plate, scintigraphy was found to assist the clinician in the management of patients with this disorder.