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# Mometrix ## Osteosarcoma - Osteosarcoma is the most common skeletal tumor in children, peaking at age 13-14 during periods of rapid growth. - The tumor occurs in the metaphysis of the proximal humerus, proximal tibia, or distal femur. - The cells produced by the tumor do not mature into compac...

# Mometrix ## Osteosarcoma - Osteosarcoma is the most common skeletal tumor in children, peaking at age 13-14 during periods of rapid growth. - The tumor occurs in the metaphysis of the proximal humerus, proximal tibia, or distal femur. - The cells produced by the tumor do not mature into compact bone. - Rates of metastasis are high (20% pulmonary metastasis and metastases to other organs as well, often present on diagnosis). - Prognosis is poor if disease is disseminated. - Diagnosis is per radiographs, CT, MRI, complete blood studies and other examination as indicated to assess for metastasis, arteriography (in preparation for limb-salvage procedures) and tumor biopsy. - Symptoms include: - Pain, sometimes referred to the hip or back, usually progressing over time. - Swelling of affected area. ## Treatment - **Initial**: Chemotherapy (doxorubicin, cisplatin, ifosfamide with mesna, methotrexate with leucovorin rescue) to decrease tumor size and reduce risk of metastasis during surgery. - **Surgery**: Amputation or limb-salvage procedure. - **Last**: Chemotherapy for undetected metastases. ## Parasitic Infections ### Toxoplasma Gondii - *Toxoplasma gondii*, a single-celled parasite, is transmitted from cat feces, poorly-cooked or raw meat. - If a pregnant woman is infected with toxoplasmosis, the infant can develop congenital toxoplasmosis, with transmission rates estimated at 20-50%. - Symptoms in the neonate are most severe if the mother developed the infection in the first trimester. - Congenital abnormalities include hydrocephalus, cerebral calcifications, and chorioretinitis (classic triad of disorders). - Additionally, the child may suffer from seizure disorders, microcephaly, and encephalitis. - There may be other abnormalities as well, including hepatomegaly, splenomegaly, anemia, jaundice, and deafness. - Treatment of the infected mother to prevent transmission to the fetus includes initially spiramycin (Rovamycine®), which reduces risk. - Pyrimethamine (Daraprim®) and sulfonamide are usually given after the 18th week. - Some studies have indicated that treatment does not reduce the rate of mother-infant transmission but does reduce the severity of abnormalities that child manifests. ### Giardia Lamblia - *Giardia lamblia* is a protozoan that infects water supplies and spreads to children through the fecal-oral route. - It is the most common cause on non-bacterial diarrhea in the United States, causing about 20,000 cases of infection each year in all ages. - Children often become infected by swallowing recreational waters (pools, lakes) while swimming or putting contaminated items into the mouth. - Giardia lives and multiplies within the small intestine where cysts develop. - Symptoms occur 7-14.