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Inconsistencies in the definition of clinically unsuspected venous thromboembolism (VTE) in pediatric patients recently led to the recommendation of standardizing this terminology. Clinically unsuspected VTE (cuVTE) is defined as the presence of VTE on diagnostic imaging performed for indications unrelated to VTE in a patient without symptoms or clinical history of VTE. The prevalence of cuVTE in pediatric cancer patients is unclear. Therefore, the main objective of our study was to determine the prevalence of cuVTE in pediatric cancer patients. All patients 0-18 years old, treated at the IWK in Halifax, Nova Scotia, from August 2005 through December 2019 with a known cancer diagnosis and at least one imaging study were eligible (n = 743). All radiology reports available for these patients were reviewed (n = 18,120). The VTE event was labeled a priori as cuVTE event for radiology reports that included descriptive texts indicating a diagnosis of thrombosis including thrombus, central venous catheter-related, thrombosed aneurysm, tumor thrombosis, non-occlusive thrombus, intraluminal filling defect, or small fragment clot for patients without documentation of clinical history and or signs of VTE. A total of 18,120 radiology reports were included in the review. The prevalence of cuVTE was 5.5% (41/743). Echocardiography and computed tomography had the highest rate of cuVTE detection, and the most common terminologies used to diagnose cuVTE were thrombus and non-occlusive thrombus. The diagnosis of cuVTE was not associated with age, sex, and type of cancer. Future efforts should focus on streamlining radiology reports to characterize thrombi. The clinical significance of these cuVTE findings and their application to management, post-thrombotic syndrome, and survival compared to cases with symptomatic VTE and patients without VTE should be further studied., (© 2024 Wiley Periodicals LLC.)

Introduction: Physical activity (PA) decreases morbidity, improves quality of life and elongates life span. PA during pregnancy is safe and decreases complications. Physical inactivity during pregnancy is an independent risk factor for maternal weight gain and complications. Pregnancy is a golden opportunity to promote a healthy lifestyle., Objectives: This article aims to review the latest recommendations regarding PA in pregnancy. In this article we focused on the following: The joint guidelines of the Society of Obstetricians and Gynaecologists of Canada's (SOGC) and the Canadian Society for Exercise Physiology (CSEP), the American College of Obstetricians and Gynecologists (ACOG) committee opinion, and the ACSM's (American College of Sports Medicine) Guidelines for Exercise Testing and Prescription, the 11th Edition published in 2019, 2020 and 2022 respectively., Conclusions: PA during pregnancy is safe and essential. Every pregnant woman without contraindications should perform 150 weekly minutes of aerobic exercise and resistance training., Discussion: A weekly goal of 150 medium intensity aerobic exercise minutes spread over at least 3 separate days combined with resistance training is recommended for every pregnant woman, including women who were inactive prior to the pregnancy, those diagnosed with gestational diabetes and overweight or obese women. Pregnant women with absolute contraindication can continue to perform their daily activities but avoid more intense activities, those with relative contraindications should discuss the advantages and risks of PA with their attending physician. After birth, women can return to PA gradually depending on the mode of delivery and complications encountered.

Objective: The aim of this study was to assess the performance of the Pediatric Canadian Triage and Acuity Scale (PaedCTAS) in adolescent patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection., Methods: A time-series study was conducted in the Emergency Departments (EDs) of 17 public hospitals during the Delta (B.1.617.2) variant spread in Israel. Data were collected prospectively from June 11, 2021 to August 15, 2021. Multivariate regression analyses were performed to identify independent variables associated with hospital admission and with admission to an Intensive Care Unit (ICU)., Results: During the study period, 305 SARS-CoV-2 patients ages 12-18 years presenting to the ED were included, and 267 (87.5%) were unvaccinated. Sixty-seven (22.0%) and 12 (3.9%) patients were admitted to pediatric wards and ICUs, respectively. PaedCTAS level 1-2 and the presence of chronic disease increased the odds of hospital admission (adjusted odds ratio (aOR) 5.74, 95% CI, 2.30-14.35, p < 0.0001), and (aOR 2.9, 95% CI, 1.48-5.67, p < 0.02), respectively. PaedCTAS level 1-2 and respiratory symptoms on presentation to ED increased the odds of ICU admission (aOR 27.79; 95% CI, 3.85-176.91, p < 0.001), and (aOR 26.10; 95% CI, 4.47-172.63, p < 0.0001), respectively. PaedCTAS level 3-5 was found in 217/226 (96%) of the patients who were discharged home from the ED., Conclusions: The findings suggest that PaedCTAS level 1-2 was the strongest factor associated with hospital and ICU admission. Almost all the patients who were discharged home had PaedCTAS level 3-5. Study findings suggest good performance of the PaedCTAS in this cohort., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Introduction: Several echocardiographic scoring systems have been developed to assess the severity of patent ductus arteriosus (PDA) shunting in preterm infants., Objective: The objective of this study was to compare the ability of two different scoring systems to evaluate the hemodynamic significance of the PDA and to predict long-term PDA-associated morbidities., Subjects: El-Khuffash cohort (previously described) was derived from a multicenter, prospective, observational study conducted in tertiary neonatal intensive care units in Ireland, Canada, and Australia., Results: A total of 141 infants with a mean gestational age of 26 ± 1.4 weeks and a mean birth weight of 952 ± 235 g were evaluated on day 2 of life. The two scores were well correlated with each other and both scores positively predicted chronic lung disease/death in this population., Conclusion: There appears to be an overall stepwise progression in the incidence of poor outcome parameters from "closed" to "borderline" to "hemodynamically significant" PDA. Both the El-Khuffash and Shaare Zedek scores are predictive of PDA-associated morbidities., Competing Interests: Conflict of Interest: None., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)