Pediatric laryngeal trauma: A case series at a tertiary children's hospital

Abstract Context.—Primary lung neoplasms are rare in children, but they comprise a broad and interesting spectrum of lesions, some of which are familiar from other tissue sites, and some of which are unique to the pediatric lung. Objective.—To determine the relative incidence of primary and metastatic lung tumors in children and adolescents through a single-institution case series, to compare these data to reports in the medical literature, to discuss the clinical and pathologic features of primary tumors of the tracheobronchial tree and lung parenchyma in children, and to provide recommendations for handling pediatric lung cysts and tumors. Data Sources.—A 25-year single institutional experience with pediatric lung tumors, based on surgical biopsies and resections at Texas Children's Hospital from June 1982 to May 2007, an additional 40 lung tumors referred in consultation, and a review of the medical literature. Conclusions.—A total of 204 pediatric lung tumors were diagnosed at our institution, including 20 primary benign lesions (9.8%), 14 primary malignant lesions (6.9%), and 170 secondary lung lesions (83.3%). The ratio of primary benign to primary malignant to secondary malignant neoplasms is 1.4:1:11.6. The common types of lung cancer in adults are exceptional occurrences in the pediatric population. The most common primary lung malignancies in children are pleuropulmonary blastoma and carcinoid tumor. Other primary pediatric lung tumors include congenital peribronchial myofibroblastic tumor and other myofibroblastic lesions, sarcomas, carcinoma, and mesothelioma. Children with primary or acquired immunodeficiency are at risk for Epstein-Barr virus–related smooth muscle tumors, lymphoma, and lymphoproliferative disorders. Metastatic lung tumors are relatively common in children and also comprise a spectrum of neoplasia distinct from the adult population.

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Utilization of Diagnostic Testing for Renal Anomalies and Congenital Heart Disease in Patients with Microtia

Otolaryngology ◽

10.1177/0194599820901351 ◽

2020 ◽

Vol 162 (4) ◽

pp. 554-558

Author(s):

Vaibhav H. Ramprasad ◽

Amber D. Shaffer ◽

Noel Jabbour

Keyword(s):

Congenital Heart ◽

Medical Center ◽

Tertiary Care ◽

Diagnostic Testing ◽

Case Series ◽

Standard Of Care ◽

Renal Ultrasound ◽

Renal Anomalies ◽

Children's Hospital ◽

Children’S Hospital

Objective Congenital ear anomalies are associated with congenital cardiac and renal defects. Renal ultrasounds, electrocardiogram, and echocardiogram can be utilized for diagnosis of these concurrent defects. No standard of care exists for the workup of patients with microtia. The goals of this study were to describe the utilization of diagnostic testing for cardiac and renal anomalies and to identify their prevalence in patients with microtia. Study Design Case series with chart review. Setting Children’s Hospital of Pittsburgh of the University of Pittsburgh Medical Center. Subjects and Methods This study is an Institutional Review Board–approved retrospective review of consecutive patients born between 2002 and 2016 who were diagnosed with microtia and seen in the otolaryngology clinic at a tertiary care children’s hospital. Demographics, sidedness and grade of microtia, comorbid diagnoses, and details of renal and cardiovascular evaluations were recorded. Factors associated with retroperitoneal ultrasound and cardiac testing were assessed with logistic regression. Results Microtia was present in 102 patients, and 98 patients were included as they received follow-up. Microtia was associated with craniofacial syndrome in 34.7% of patients. Renal ultrasound was performed in 64.3% of patients, and 12.9% of patients with ultrasounds had renal aplasia. Cardiac workup (electrocardiogram or echocardiogram) was completed in 60.2% of patients, and of this subset, 54.2% had a congenital heart defect. Conclusion Diagnostic testing revealed renal anomalies and cardiac defects in patients with isolated microtia at a higher rate than in the general population. This suggests the need for further evaluation of the role of routine screening in patients with microtia.

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Collaborating with our adult colleagues: A case series of robotic surgery for suspicious and cancerous lesions in children and young adults performed in a free-standing children's hospital

Journal of Pediatric Urology ◽

10.1016/j.jpurol.2018.01.003 ◽

2018 ◽

Vol 14 (2) ◽

pp. 182.e1-182.e8 ◽

Cited By ~ 5

Author(s):

Briony K. Varda ◽

Patricia Cho ◽

Andrew A. Wagner ◽

Richard S. Lee

Keyword(s):

Young Adults ◽

Robotic Surgery ◽

Case Series ◽

Free Standing ◽

Children's Hospital ◽

Children’S Hospital ◽

Children And Young Adults ◽

Cancerous Lesions

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Nontyphoidal Salmonella Gastroenteritis in a Tertiary Children’s Hospital in Southern China: Characteristics and Dietary Considerations

Gastroenterology Research and Practice ◽

10.1155/2018/3097468 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Lu Ren ◽

Min Yang ◽

Lanlan Geng ◽

Peiyu Chen ◽

Huan Chen ◽

...

Keyword(s):

Lactose Intolerance ◽

Clinical Presentation ◽

Southern China ◽

Case Series ◽

Infants And Children ◽

Food Allergies ◽

Retrospective Case ◽

Children's Hospital ◽

Children’S Hospital ◽

Bacterial Gastroenteritis

Background. Nontyphoidal Salmonella infection is a common cause for acute bacterial gastroenteritis in children in China. There have been no reports of the prevalence of lactose intolerance or food allergies in children with nontyphoidal Salmonella infection. The aim of this study was to characterize nontyphoidal Salmonella gastroenteritis in a tertiary children’s hospital and evaluate clinical presentation, lactose intolerance, and food allergies in children with prolonged nontyphoidal Salmonella gastroenteritis. Methods. A retrospective case-series analysis was carried out in a tertiary children’s hospital in Guangzhou, China. We included all infants and children who were diagnosed with nontyphoidal Salmonella gastroenteritis between 1 January 2014 and 31 December 2016. Patients’ clinical features, feeding patterns, laboratory tests, and treatment outcomes were reviewed. Results. A total of 142 infants and children were diagnosed with nontyphoidal Salmonella gastroenteritis. 52.1% of cases occurred in infants ≤ 12 months of age and the majority (89.4%) in children younger than 3 years old. The most common symptoms were diarrhea (100%), fever (62%), and vomiting (18.3%). Salmonella Typhimurium was the predominant serotype, accounting for 82.4%. 91.5% of patients were treated with antibiotics. Forty-one (28.9%) and 9 (6.3%) children improved with a lactose-free diet and hypoallergenic formula, respectively, when diarrhea persisted for more than a week. Conclusions. Salmonella Typhimurium was the predominant serotype. Most patients with nontyphoidal Salmonella gastroenteritis were younger than 3 years old. Lactose intolerance occurred frequently in children with nontyphoidal Salmonella gastroenteritis and dietary modification should be considered when diarrhea is persistent and prolonged.

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Pediatric Bacterial Tracheitis—A Variable Entity: Case Series with Literature Review

Otolaryngology ◽

10.1177/0194599818808774 ◽

2018 ◽

Vol 160 (3) ◽

pp. 546-549 ◽

Cited By ~ 1

Author(s):

Geoffrey Casazza ◽

M. Elise Graham ◽

Douglas Nelson ◽

David Chaulk ◽

David Sandweiss ◽

...

Keyword(s):

Literature Review ◽

Case Series ◽

Pediatric Intensive Care ◽

Respiratory Arrest ◽

Prolonged Intubation ◽

Children's Hospital ◽

Presenting Symptoms ◽

Bacterial Tracheitis ◽

Children’S Hospital ◽

Viral Illness

Objective To review the presentation and treatment of children diagnosed with bacterial tracheitis at our institution and to review the available literature focusing on key presenting symptoms and clinical outcomes of children diagnosed with bacterial tracheitis. Study Design Case series with literature review. Setting Tertiary children’s hospital and available literature. Subjects and Methods Case series of children with bacterial tracheitis retrospectively reviewed at a tertiary children’s hospital. Those with a tracheostomy or those who developed bacterial tracheitis as a complication of prolonged intubation were excluded. Results Thirty-six children were identified (mean ± SD age, 6.7 ± 4.5 years). The most common presenting symptom was cough (85%), followed by stridor (77%) and voice changes/hoarseness (67%). A concurrent viral illness was found for 55%, and the most common bacteria cultured was methicillin-sensitive Staphylococcus aureus. Pediatric intensive care admission occurred for 69%, and 43% required intubation. No patient required tracheostomy. One patient (2.7%) died secondary to airway obstruction and subsequent respiratory arrest. Four patients had recurrence of bacterial tracheitis 4 to 12 months following their initial presentation. Conclusion Bacterial tracheitis is an uncommon condition with an atypical presentation and variable clinical course but serious consequences if left unrecognized. Staphylococcus is the most common bacteria identified, and many patients will have a prodromal viral illness. Changes in patient epidemiology and presentation may have occurred over time.

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89 The Unintended Consequences and Impact of the COVID-19 Pandemic on Patients, Families and Clinicians in a Children’s Hospital

Paediatrics & Child Health ◽

10.1093/pch/pxab061.071 ◽

2021 ◽

Vol 26 (Supplement_1) ◽

pp. e64-e65

Author(s):

Catherine Diskin ◽

Julia Orkin ◽

Blossom Dharmaraj ◽

Tanvi Agarwal ◽

Arpita Parmar ◽

...

Keyword(s):

Nurse Practitioners ◽

Tertiary Care ◽

Healthcare Providers ◽

Case Series ◽

Unintended Consequences ◽

Pediatric Care ◽

Full Time ◽

Negative Consequences ◽

Children's Hospital ◽

Children’S Hospital

Abstract Primary Subject area Hospital Paediatrics Background The coronavirus (COVID-19) pandemic has broad implications for children and families. Healthcare experience and delivery has changed significantly, and changes will likely continue for some time. Particular attention has been paid to delays in accessing timely pediatric care leading to unintended morbidity. Objectives This study aimed (1) to describe the broader spectrum of unintended negative consequences by describing the courses of care altered by the COVID-19 pandemic from the clinician's perspectives and (2) to identify thematic similarities to inform clinical practice change. Design/Methods All full-time doctors, dentists, and nurse practitioners working at a tertiary care children’s hospital in Canada were surveyed every two weeks throughout the initial phase of the COVID-19 pandemic. We asked them to identify and describe clinical cases in which they perceived a negative outcome associated with hospital or societal changes due to the COVID-19 pandemic. Analysis followed a qualitative case series methodology using a narrative synthesis approach to determine similarities and associated themes. Results Two-hundred and twelve clinicians reported 116 cases. Several broad themes emerged, including (1) timeliness of care, (2) disruption of child and family-centred care, (3) new pressures in the provision of safe and efficient care and (4) inequity in the experience of the COVID-19 pandemic. Within each of these themes, subthemes emerged, highlighting its impact on (1) patients, (2) their families and (3) healthcare providers. Table 1 provides examples of cases within each theme. Conclusion The broad consequences of the COVID-19 pandemic impact patients, families, healthcare providers and the healthcare system. Understanding this breadth is necessary as we strive to deliver safe, high quality, family-centred pediatric care in this new era. As the pandemic continues, we need to consider carefully how to provide elective and ambulatory care, including surgery, in this era of social distancing. Particular attention is needed to understand particular aspects, including vulnerable children and the clinician experience of the COVID-19 pandemic.

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Outcome of acute peritoneal dialysis (APD) in renal failure among children admitted at Children’s Hospital and Institute of Child Health, Multan.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.08.3922 ◽

2020 ◽

Vol 27 (08) ◽

pp. 1560-1564

Author(s):

Shahid Ishaq ◽

Saima Jabeen Joiya ◽

Muhammad Azam Khan

Keyword(s):

Renal Failure ◽

Acute Renal Failure ◽

Peritoneal Dialysis ◽

Child Health ◽

Case Series ◽

Mortality And Morbidity ◽

Children's Hospital ◽

Case Series Study ◽

Children’S Hospital ◽

Series Study

Objectives: Renal failure (RF) is associated with significant mortality and morbidity. its management still remains challenging for treating physicians. Acute peritoneal dialysis (APD) is an option for treatment of renal failure among young children. We aimed to determine the efficacy of peritoneal dialysis (PD) in RF among children admitted. Study Design: Case series study. Setting: Nephrology Department of Children’s Hospital and Institute of Child Health, Multan. Period: February 2018 to July 2018. Material & Methods: A total of 74 children with renal failure were included. All the patients were treated with acute peritoneal dialysis. The outcome of interest was clinical and biochemical improvement. Result: Amongst all there were 46 (62.2%) male and 26 (37.8%) female. Mean age of the children was found to be 57.72 months. Mean weight of children was 12.36 kg with a standard deviation of 6.4 kg. Most of the children, 43 (58.1%) had acute renal failure (ARF) whereas 31 (41.9%) had chronic renal failure (CRF). With PD, mortality was reported in 22 (29.7%) children. Conclusion: Acute peritoneal dialysis showed good rates of improvement in renal function, so, it should be recommending among children with acute renal failure.

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