Publications by authors named "Evelyn Y Anthony"

11 Publications

  • Page 1 of 1

Transitional Leadership: Perspectives of a Dean and an Interim Chair on an Increasingly Common Position.

J Pediatr 2021 Jan 18. Epub 2021 Jan 18.

Professor of Vascular and Endovascular Surgery as well as Dean and CEO of Wake Forest School of Medicine, Winston Salem, NC.

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http://dx.doi.org/10.1016/j.jpeds.2021.01.028DOI Listing
January 2021

A Retrospective Evaluation of Airway Anatomy in Young Children and Implications for One-Lung Ventilation.

J Cardiothorac Vasc Anesth 2020 Aug 12. Epub 2020 Aug 12.

Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC.

Objective: One-lung ventilation (OLV) in children remains a niche practice with few studies to guide best practices. The objective of this study was to describe lower airway anatomy relevant to establishment of OLV in young children.

Design: Retrospective, observational study using pre-existing studies in the electronic health record.

Setting: Single institution, academic medical center, tertiary-care hospital.

Participants: Pediatric patients <8 years old.

Interventions: None.

Measurements And Main Results: Chest computed tomographic scans of 111 children 4 days to 8 years of age were reviewed. Measurements were taken from the thyroid isthmus to the carina, carina to first lobar branch on the left and right, diameter of the trachea at the carina, and diameter of the left and right mainstem bronchi. Dimensions were correlated with the outer diameter of endotracheal tubes and bronchial blockers. The left mainstem bronchus is consistently smaller than the right. Lung isolation using a mainstem technique on the left should use an endotracheal tube a half size smaller than would be used for tracheal intubation. The length from the carina to the first lobar branch on the left is consistently 3 times longer than on the right. Further, age-delineated bronchial diameters suggest that the clinician should transition from a 5F to a 7F Arndt bronchial blocker at 3-to-4 years of age.

Conclusion: A more detailed and accurate understanding of pediatric lower airway anatomy may assist the clinician in successfully performing OLV in young children.
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http://dx.doi.org/10.1053/j.jvca.2020.08.015DOI Listing
August 2020

Bright Red Rectal Bleeding: The Bottom Line from Neonates to Older Adults: Gastrointestinal Imaging.

Radiographics 2016 Sep-Oct;36(5):1600-1

From the Department of Radiology, Wake Forest Baptist Medical Center, Medical Center Blvd, Winston-Salem, NC 27157.

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http://dx.doi.org/10.1148/rg.2016160063DOI Listing
September 2017

Imaging of primary pediatric lymphoma of bone.

Pediatr Radiol 2016 Jul 4;46(8):1150-7. Epub 2016 Apr 4.

Department of Radiology, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA.

Background: Primary pediatric bone lymphoma is a rare form of non-Hodgkin lymphoma. Unlike nodal forms of lymphoma, imaging abnormalities in lymphoma of bone do not resolve rapidly in conjunction with treatment and radiologic findings can remain abnormal for years, making it difficult to evaluate treatment response.

Objective: To evaluate the utility of imaging in assessment of patients with primary pediatric bone lymphoma.

Materials And Methods: At our institution between 2004 and 2013, six cases of pathology-proven primary pediatric bone lymphoma were diagnosed. Retrospective chart review was performed to assess imaging utilization. Our data were qualitatively compared with existing literature to construct an algorithm for imaging patients with primary lymphoma of bone.

Results: Imaging evaluation of patients with primary pediatric bone lymphoma was highly variable at our institution. Conventional imaging was routinely used to evaluate response to treatment, despite lack of appreciable osseous change. Imaging in the absence of symptoms did not alter clinical management. Only positron emission tomography CT (PET/CT) proved capable of demonstrating imaging changes from the pretreatment to the post-treatment scans that were consistent with the clinical response to treatment.

Conclusion: Surveillance imaging is likely unnecessary in patients with a known diagnosis of pediatric lymphoma of bone. Pretreatment and post-treatment PET/CT is likely sufficient to assess response. There is little data to support the use of interim and surveillance PET/CT.
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http://dx.doi.org/10.1007/s00247-016-3597-8DOI Listing
July 2016

Adnexal masses in female pediatric patients.

AJR Am J Roentgenol 2012 May;198(5):W426-31

Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.

Objective: This article reviews the range of adnexal masses that present in pediatric females. The preferred imaging modalities, the appearance of the normal ovaries, and the epidemiology of ovarian diseases and abnormalities are discussed. The illustrated abnormalities include simple and complex ovarian and paraovarian cysts, neoplasms, ovarian torsion, ectopic pregnancy, and tuboovarian abscess, with attention to the imaging features and vascular flow patterns that help distinguish surgical from nonsurgical cases, malignant from benign lesions, and ovarian abnormalities from mimickers.

Conclusion: The critical clinical questions to the radiologist in the setting of adnexal lesions are the site of origin, benign versus malignant features, and presence of infection or abscess. Pairing clinical presentation and imaging findings will direct appropriate management, whether it is reassurance, follow-up imaging, or surgery.
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http://dx.doi.org/10.2214/AJR.11.7920DOI Listing
May 2012

Occult megarectum--a commonly unrecognized cause of enuresis.

Urology 2012 Feb 14;79(2):421-4. Epub 2011 Dec 14.

Department of Urology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA.

Objective: To determine whether occult megarectum remains a commonly unrecognized cause of enuresis and whether treating it will cure enuresis in most children. A landmark study proved constipation was a commonly unrecognized cause of enuresis in 1986 in which constipation was defined as abnormal rectal distension. However, modern recommendations have focused on signs of functional constipation, such as hard or rare stools.

Methods: A retrospective review of 30 consecutive patients seen in our clinic with a chief complaint of nocturnal enuresis was performed, with an analysis of the results of their plain abdominal radiographs. The results of the studies were determined using a novel method termed the rectal/pelvic outlet ratio and Leech criteria. These results were compared with the reported constipation history according to the International Children's Continence Society guidelines, which recommends asking parents and children whether the child's bowel movements occur less often than every other day and whether the stool consistency is hard. Patients diagnosed with megarectum were treated with laxatives, with the goal of restoring normal rectal tone.

Results: All patients demonstrated rectal distension according to the rectal/pelvic outlet ratio, and 80% were constipated according to the Leech criteria. Only 10% of the patient or families reported clinical symptoms of constipation. All the adolescent patients in our study and 80% of the younger patients were cured of enuresis with laxative therapy.

Conclusion: Occult megarectum remains a commonly undiagnosed cause of nocturnal enuresis. Abdominal radiographs represent a simple, noninvasive method to diagnose megarectum and might improve the treatment of nocturnal enuresis.
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http://dx.doi.org/10.1016/j.urology.2011.10.015DOI Listing
February 2012

Neonatal systemic thromboembolism secondary to ductus arteriosus aneurysm and patent foramen ovale.

Congenit Heart Dis 2013 Jan-Feb;8(1):E5-9. Epub 2011 Jul 31.

Department of Radiology Pediatrics, Wake Forest Baptist Health School of Medicine, Medical Center Blvd, Winston-Salem, NC, USA.

Ductus arteriosus aneurysm (DAA) can be associated with neonatal thromboembolism. We report a neonate with systemic thromboembolism causing acute cerebral infarction with DAA, arterial, and venous thrombosis, discovered on CT angiography. The role of DAA was suspected as a potential etiology of systemic thromboembolism in this case. CT angiography with three-dimensional reconstruction was valuable delineating the adjunctive vascular structures. Screening for presence of DAA may be considered in the neonatal thromboembolism.
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http://dx.doi.org/10.1111/j.1747-0803.2011.00555.xDOI Listing
August 2013

Pediatric occupants, restraint use, and injuries in motor vehicle crashes - biomed 2011.

Biomed Sci Instrum 2011 ;47:94-9

Virginia-Tech - Wake Forest University School of Medicine, Winston Salem, North Carolina.

Pediatric occupants are vulnerable in motor vehicle crashes (MVCs), and alternative restraints have been developed for their protection. This study sought to characterize injuries in MVCs for pediatric occupants and to identify scenarios that may benefit from enhanced vehicle safety. Using the NASS-CDS database (2000-2008), pediatric occupants (< 19 yr old) were characterized by their age and injuries to look at national averages in MVCs. There were over 14 million pediatric injuries and non-injured occupants in weighted NASS-CDS (out of over 70 million total). Of these pediatric cases, 60% sustained injuries, which was comparable to the percentage of all occupants injured (65%). Six percent of NASS-CDS pediatric occupants had AIS 2+ injuries, which is the injury inclusion criteria for CIREN pediatric cases. CIREN was used to investigate pediatric occupants and injuries resulting from incorrect positioning and restraints according to NHTSA suggestions. Results indicated that many injured pediatric occupants were not properly restrained, with over 100 in the front row of the vehicle under 13 years of age. There were also over 200 CIREN pediatric occupants under 4’ 9” that were not seated in a child safety seat (CSS). The most frequently injured body region was the face, followed by the head and lower extremity. Eighty-six percent of head injuries and 82% of spinal injuries were AIS 2+. This study supports prior findings that demonstrate a need for enhanced public awareness for proper CSS use to reduce pediatric injuries in the future.
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February 2016

Infantile orbital cellulitis secondary to community-associated methicillin-resistant Staphylococcus aureus.

J AAPOS 2011 Apr 3;15(2):208-10. Epub 2011 Apr 3.

Department of Pediatrics, Wake Forest University School of Medicine and Brenner Children's Hospital, Winston-Salem, North Carolina, USA.

Community-associated methicillin-resistant Staphylococcus aureus (MRSA) is increasingly recognized as a cause of invasive disease in children. Orbital cellulitis typically occurs in older children, but it can occasionally affect infants and neonates. We report 2 infants with sepsis and orbital cellulitis caused by community-associated MRSA and review the relevant literature.
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http://dx.doi.org/10.1016/j.jaapos.2011.01.153DOI Listing
April 2011

Pyomyositis due to Streptococcus pneumoniae.

Am J Emerg Med 2009 Jun;27(5):633.e1-3

Department of Pediatrics, Wake Forest University Health Sciences and Brenner Children's Hospital, Winston-Salem, NC 27157, USA.

Pyomyositis is an unusual but potentially serious disease in children. Staphylococcus aureus is the most commonly implicated pathogen, but pneumococcal pyomyositis is very rare. Clinical diagnosis of pyomyositis can be difficult often mimicking septic arthritis of the hip or appendicitis. We report a 12-year-old male with pyomyositis caused by Streptococcus pneumoniae who presented with fever and severe right hip and abdominal pain. Magnetic resonance imaging of the right hip revealed the diagnosis of pyomyositis. Blood cultures grew Streptococcus pneumoniae, sensitive to penicillin, ceftriaxone, and clindamycin. He was successfully treated with a 3-week course of clindamycin. Early recognition, appropriate antibiotic therapy, and if indicated, drainage of the muscle abscess is critical to reduce morbidity and mortality.
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http://dx.doi.org/10.1016/j.ajem.2008.09.017DOI Listing
June 2009

Common Pediatric Sports Injuries.

Semin Musculoskelet Radiol 1999 ;3(3):247-256

Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.

This article reviews the common acute and overuse injuries encountered in the pediatric athlete. Acute injuries are usually physeal or avulsion fractures relating to a single traumatic event. Overuse injuries are the result of repetitive stress and include the common traction apophysitis, osteochondritis dissecans, and stress fractures. Sports-related injuries most frequently involve the lower extremity with injury patterns and frequencies relative to the athlete's age, size, and type of sport. Indeed, an alternative title for this review might be Òthe adolescent athlete as the changing biomechanics and psychosocial stresses of adolescence are inherent risk factors for sports-related injuries. An estimated seven million adolescents currently play high school sports with an increasing number becoming interested in extreme sports. It is hoped that this review will assist your future encounters with the injured pediatric athlete or Òweekend warrior.
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http://dx.doi.org/10.1055/s-2008-1080070DOI Listing
January 1999