PCV27 Survival to Discharge After Cardiac Arrest in a Pediatric Population: Results from the Kids' Inpatient Database, 2003-2009 in the United States

Background: Meniscal allograft transplantation (MAT) is an option to slow the progression of degenerative disease in the setting of substantial meniscal deficiency. This may be especially important in children and adolescents, but there is little literature on MAT in this population. Hypothesis/Purpose: The purpose of this study was to evaluate the epidemiology of MAT in the pediatric population, with specific attention to regional and demographic trends. Methods: The Pediatric Health Information System, a national database consisting of 49 children’s hospitals, was queried for all patients undergoing MAT between 2011 and 2018. Demographic information was collected for each subject as well as data regarding previous and subsequent surgeries. The database was also queried for all meniscus surgeries (including repairs and meniscectomies) performed during the study period. Demographic and geographic data from this control group were compared to that of children undergoing MAT. Univariate analysis was followed by purposeful entry multivariate regression to adjust for confounding factors. Results: A total of 27,168 meniscus surgeries were performed in 47 hospitals, with MAT performed 67 times in 17 hospitals. Twelve patients (18%) underwent a subsequent procedure after transplantation. In multivariate analysis, each year of increasing age resulted in 1.1 times higher odds of having undergone MAT rather than repair or meniscectomy (95% CI 1.03-1.1, p=0.002). Patients that underwent transplantation had 2.0 times higher odds of being female (95% CI 1.2-3.3, p=0.01) and 2.0 times higher odds of being commercially insured (95% CI 1.1-3.6, p=0.02). MAT was performed most frequently in the Northeast (4.9/1000 meniscus surgeries) and least often in the South (1.1/1000 meniscus surgeries, p<0.001). Furthermore, transplantation was more likely to be performed in larger cities. The median pediatric population of cities in which MAT was performed was 983,268 (range 157,253-3,138,870) compared to 662,290 (range 4,420-4,311,500) in cities where it was not (p=0.04). Conclusion: In the United States, patients that underwent MAT were older, more likely to be female, and have commercial insurance than those undergoing meniscus repair or meniscectomy. MAT was only done in 17/47 children’s hospitals that perform meniscus surgery and was most frequently performed in the Northeast and in larger cities. These trends highlight the need for further research, especially regarding differences along the lines of sex and insurance status.

Download Full-text

Malaria in Children in Chicago

PEDIATRICS ◽

10.1542/peds.92.1.83 ◽

1993 ◽

Vol 92 (1) ◽

pp. 83-85

Author(s):

Benjamin Emanuel ◽

Neil Aronson ◽

Stanford Shulman

Keyword(s):

United States ◽

Pediatric Population ◽

The United States ◽

Malaria Endemic Area ◽

Overseas Travel ◽

History Of ◽

Record Review ◽

Recent Immigration ◽

Childhood Malaria ◽

Retrospective Medical Record Review

Objective. To review the experience of a large children's hospital and two community hospitals in Chicago in which malaria was diagnosed in children during a recent 6-year period. Methods. Retrospective medical record review covering the years 1985 to 1990. Results. Twenty cases of childhood malaria were diagnosed, generally in patients hospitalized for fever unresponsive to oral antibiotics also associated with splenomegaly, with presumptive diagnoses of malignancy, typhoid fever, acute appendicitis, or urinary tract infection. History of recent immigration to the United States or travel to a malaria-endemic area was frequently not elicited until several days into hospitalization, thus delaying diagnosis and therapy. Conclusions. Because malaria in the United States pediatric population has increased as a result of foreign immigration and overseas travel, pediatricians must be alert to the possibility of malaria in febrile children, and the importance of antimalarial prophylaxis should be communicated to parents of children traveling to endemic areas.

Download Full-text

Firearm Injuries Affecting the Pediatric Population

PEDIATRICS ◽

10.1542/peds.89.4.788 ◽

1992 ◽

Vol 89 (4) ◽

pp. 788-790

Author(s):

Keyword(s):

United States ◽

Children And Adolescents ◽

Pediatric Population ◽

Age Groups ◽

Unintentional Injury ◽

The United States ◽

Male Adolescents ◽

Firearm Injuries ◽

Group 2 ◽

Developed Nations

In the United States approximately 30 000 people die from firearm injuries each year. Many more are wounded. In the mid 1980s, more than 3000 of the dead were children and adolescents aged 1 to 19 years.1 In 1989 nearly 4000 firearm deaths were among children 1 to 19 years of age, accounting for 12% of all deaths in that age group.2 All of these deaths or injuries affect other children because the victims who are killed or wounded are frequently relatives, neighbors, or friends. Comparison data for childhood age groups demonstrate that in 1987, 203 children aged 1 to 9 years, 484 children aged 10 to 14 years, and 2705 adolescents aged 15 to 19 years died as a result of firearm injuries.1 Firearm deaths include unintentional injuries, homicides, and suicides. Among the 1- to 9-year-olds, half of the deaths were homicides and half were unintentional. Among the 10- to 14-year-olds, one third of the deaths were homicides, one third were suicides, and one third were unintentional. Among the 15- to 19-year-olds, 48% were homicides, 42% were suicides, and 8% were unintentional.1 Firearm homicides are the leading cause of death for some US subpopulations, such as urban black male adolescents and young adults.3 Table 1 indicates how firearms contributed to the deaths of children and adolescents (homicides, suicides, and all causes) in 1987. Table 2 illustrates the unusual scale of firearm violence affecting young people in the United States compared with other developed nations.4 Firearm injuries are the fourth leading cause of unintentional injury deaths to children younger than 15 years of age in the US.5

Download Full-text

Emergency Department inter-hospital transfer for post-cardiac arrest care: Initial experience with implementation of a regional cardiac resuscitation center in the United States

Resuscitation ◽

10.1016/j.resuscitation.2012.09.018 ◽

2013 ◽

Vol 84 (5) ◽

pp. 596-601 ◽

Cited By ~ 12

Author(s):

Brian W. Roberts ◽

J. Hope Kilgannon ◽

Jessica A. Mitchell ◽

Neil Mittal ◽

Janah Aji ◽

...

Keyword(s):

United States ◽

Emergency Department ◽

Cardiac Arrest ◽

The United States ◽

Initial Experience ◽

Cardiac Resuscitation ◽

Hospital Transfer

Download Full-text

Association of HIV infection with age and symptomatic carotid atherosclerotic disease at the time of carotid intervention in the United States

Vascular Medicine ◽

10.1177/1358863x18789783 ◽

2018 ◽

Vol 23 (5) ◽

pp. 467-475 ◽

Cited By ~ 3

Author(s):

Timothy C Lin ◽

Brittany N Burton ◽

Andrew Barleben ◽

Martin Hoenigl ◽

Rodney A Gabriel

Keyword(s):

United States ◽

Hiv Infection ◽

The United States ◽

Atherosclerotic Disease ◽

Symptomatic Carotid ◽

Patient Demographics ◽

Younger Age ◽

Male Sex ◽

Nationally Representative ◽

Inpatient Database

The primary objectives of this work were: (1) to describe trends in HIV prevalence among those undergoing carotid intervention (carotid endarterectomy or carotid artery stenting) in the United States; and (2) to determine if HIV infection is independently associated with symptomatic carotid atherosclerotic disease or age at the time of carotid intervention. In a nationally representative inpatient database from 2004 to 2014, HIV infection was associated with younger age at the time of carotid intervention (59 years [SE 0.2] vs 71 years [SE 0.01], p < 0.001), male sex (83% vs 58%, p < 0.001), black race (21% vs 4%, p < 0.001), and symptomatic carotid atherosclerotic disease (18.8% vs 11.0%, p < 0.001). Among those undergoing carotid intervention, there was a significant increase in the prevalence of HIV from 0.08% in 2004 to 0.17% in 2014 ( p < 0.001). After adjustment for patient demographics, comorbidities and other covariates, HIV infection remained significantly associated with younger age (–8.9 years; 95% CI: –9.7 to −8.1; p < 0.001) at the time of carotid intervention, but HIV infection was not independently associated with symptomatic carotid atherosclerotic disease.

Download Full-text

Lung mass and neurogenic hyperventilation as a presentation of disseminated tuberculosis

10.22541/au.161499390.05635040/v1 ◽

2021 ◽

Author(s):

Deena Yousif ◽

Sindhu Mohandas ◽

Sally Ward ◽

Ronen Zipkin

Keyword(s):

United States ◽

Pulmonary Tuberculosis ◽

Pediatric Population ◽

Respiratory Alkalosis ◽

The United States ◽

Lung Mass ◽

Disseminated Tuberculosis ◽

Pediatric Presentation

Disseminated tuberculosis (TB) in the pediatric population is relatively rare in the United States with variable nonspecific presentations. In this letter we discuss the case of 2-year-old child with a lung mass and central neurogenic hyperventilation with primary respiratory alkalosis as a rare pediatric presentation of disseminated tuberculosis with TB meningitis and pulmonary tuberculosis.

Download Full-text

Emergence of SARS-CoV-2 variants of concern in the pediatric population of the United States

10.1101/2021.05.22.21257660 ◽

2021 ◽

Author(s):

Jennifer Dien Bard ◽

Moiz Bootwalla ◽

Amy Leber ◽

Paul Planet ◽

Ahmed Moustafa ◽

...

Keyword(s):

United States ◽

Young Children ◽

Pediatric Population ◽

The United States ◽

Surveillance Program ◽

Children's Hospitals ◽

Prevalence Data ◽

Children’S Hospitals ◽

Report Data

The evolution of SARS-CoV2 virus has led to the emergence of variants of concern (VOC). Children, particularly <12 years old not yet eligible for vaccines, continue to be important reservoirs of SARS-CoV-2 yet VOC prevalence data in this population is lacking. We report data from a genomic surveillance program that includes 9 U.S. children's hospitals. Analysis of SARS-CoV-2 genome from 2119 patients <19 years old between 03/20 to 04/21 identified 252 VOCs and 560 VOC signature mutations, most from 10/20 onwards. From 02/21 to 04/21, B.1.1.7 prevalence increased from 3.85% to 72.22% corresponding with the decline of B.1.429/B.1.427 from 51.82% to 16.67% at one institution. 71.74% of the VOC signature mutations detected were in children <12 years old, including 33 cases of B.1.1.7 and 119 of B.1.429/B.1.427. There continues to be a need for ongoing genomic surveillance, particularly among young children who will be the last groups to be vaccinated.

Download Full-text