scholarly journals Characteristics of Children and Adolescents Diagnosed With HIV By Targeted and Diagnostic Testing in a Children's Hospital Network

2018 ◽  
Vol 25 (11) ◽  
pp. 1306-1309 ◽  
Author(s):  
Colleen K. Gutman ◽  
Lauren S. Middlebrooks ◽  
April Zmitrovich ◽  
Andres Camacho‐Gonzalez ◽  
Claudia R. Morris
Keyword(s):  
Children And Adolescents ◽  
Diagnostic Testing ◽  
Children's Hospital ◽  
Children’S Hospital

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

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.

scholarly journals The Effect of Rapid Respiratory Viral Diagnostic Testing on Antibiotic Use in a Children's Hospital

2002 ◽  
Vol 156 (12) ◽  
pp. 1230 ◽  
Author(s):  
Carrie L. Byington ◽  
Heidi Castillo ◽  
Kris Gerber ◽  
Judy A. Daly ◽  
Laurie A. Brimley ◽  
...  
Keyword(s):  
Diagnostic Testing ◽  
Antibiotic Use ◽  
Children's Hospital ◽  
Children’S Hospital

Stanford V chemotherapy and involved field radiotherapy for children and adolescents with unfavorable risk Hodgkin lymphoma: Results of a multi-institutional prospective clinical trial.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9502-9502 ◽  
Author(s):  
Monika Metzger ◽  
Amy Billett ◽  
Alison M. Friedmann ◽  
Matthew J. Krasin ◽  
Scott C. Howard ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Children And Adolescents ◽  
Hodgkin Lymphoma ◽  
Low Dose ◽  
Massachusetts General Hospital ◽  
Children's Hospital ◽  
Significant Difference ◽  
Children’S Hospital ◽  
Involved Field ◽  
Involved Field Radiotherapy

9502 Background: To evaluate the efficacy of 12 weeks of Stanford V chemotherapy (prednisone, vinblastine, doxorubicine, nitrogen mustard, etoposide, vincristine, and bleomycin) without routine growth factor support plus response-adapted low-dose, involved-field radiotherapy (IFRT) in children and adolescents with unfavorable risk Hodgkin lymphoma (HL). Methods: Multi-institutional (St. Jude Children’s Research Hospital, Stanford University, Children’s Hospital Boston, Massachusetts General Hospital and Maine Children’s Hospital) clinical trial. One hundred forty-one patients with clinical stages IIB (n=43), IIIB (n=19), IVA (n=27), and IVB (n=52) HL were treated with 12 weeks of Stanford V chemotherapy and low dose IFRT between June 2002 and May 2011. Involved nodal sites in complete remission (CR, defined as > 75% shrinkage of the original tumor and PET negative) after 8 weeks of Stanford V received 15 Gy IFRT; those sites that achieved only partial response received 25.5 Gy IFRT after completion of all 12 weeks of chemotherapy. Results: With a median follow-up of 4.6 years, the 3-year overall and event-free survival (EFS) are 97% (SE=2%) and 79% (SE=4%) respectively. There was no significant difference in EFS by stage (IIB vs. IIIB vs. IV; P=0.84). Ten patients developed progessive disease and 18 relapsed, while 5 have died (1 after relapse in an accident and 4 of refractory disease). Most common toxicities were grade 3 hematologic with 234 episodes of neutropenia in 101 patients (72%) and 85 episodes of anemia in 52 patients (37%); Fever and neutropenia occurred 13 times in 12 patients (9%). Conclusions: Risk-adapted, combined-modality therapy using 12 weeks of Stanford V chemotherapy plus IFRT is well tolerated in this population with manageable acute toxicities. Overall survival is comparable to other more intense chemotherapy regimens. Future high-risk front line therapies may consider a Stanford V backbone with targeted intensification and further tailoring of radiation therapy.

Suicidal Attempts by Ingestion of Various Substances in 2050 Children and Adolescents in Greece

1989 ◽  
Vol 34 (3) ◽  
pp. 205-210 ◽  
Author(s):  
Evangelos Papathomopoulos ◽  
Pavlos Vlachos ◽  
Demetra Kalamara ◽  
Constantinos Papadatos
Keyword(s):  
Children And Adolescents ◽  
Early Recognition ◽  
Poison Control ◽  
Poison Control Center ◽  
Control Center ◽  
Children's Hospital ◽  
Suicidal Attempts ◽  
Children’S Hospital ◽  
Cultural Data

This study investigates suicidal attempts by ingestion of drugs or other chemicals in 2050 children and adolescents (312 boys and 1738 girls) under seventeen years of age as seen over a six year period, 1977–1982, at the Poison Control Center, “P.A. Kyriakou” Children's Hospital, Athens, Greece. Demographic, clinical, psychosocial and cultural data were presented and discussed. It is the authors' opinion that more attention should be paid to the increased incidence of suicidal attempts in younger persons and therefore the urgent need for early recognition and prevention of this event is necessary. This is the first broad study of its kind in Greece which reflects a segment of the psycho-biosocial developments in this country.

scholarly journals The need for tumor surveillance of children and adolescents with cancer predisposition syndromes: a retrospective cohort study in a tertiary-care children’s hospital

2021 ◽  
Author(s):  
Simon Huber ◽  
Mareike Schimmel ◽  
Désirée Dunstheimer ◽  
Karolina Nemes ◽  
Markus Richter ◽  
...  
Keyword(s):  
Cancer Risk ◽  
Children And Adolescents ◽  
Current Practice ◽  
Tertiary Care ◽  
Cancer Predisposition ◽  
Tumor Surveillance ◽  
Children's Hospital ◽  
Consensus Recommendations ◽  
Children’S Hospital ◽  
Expert Recommendations

AbstractExpert recommendations for the management of tumor surveillance in children with a variety of cancer predisposition syndromes (CPS) are available. We aimed (1) at identifying and characterizing children who are affected by a CPS and (2) at comparing current practice and consensus recommendations of the American Association for Cancer Research workshop in 2016. We performed a database search in the hospital information system of the University Children’s Hospital for CPS in children, adolescents, and young adults and complemented this by review of electronic patients’ charts. Between January 1, 2017, and December 3, 2019, 272 patients with 41 different CPS entities were identified in 20 departments (144 [52.9%] male, 128 [47.1%] female, median age 9.1 years, range, 0.4–27.8). Three (1.1%) patients died of non-malignancy-associated complications of the CPS; 49 (18.0%) patients were diagnosed with malignancy and received regular follow-up. For 209 (95.0%) of the remaining 220 patients, surveillance recommendations were available: 30/220 (13.6%) patients received CPS consultations according to existing consensus recommendations, 22/220 (10.0%) institutional surveillance approaches were not complying with recommendations, 84/220 (38.2%) patients were seen for other reasons, and 84/220 (38.2%) were not routinely cared for. Adherence to recommendations differed extensively among CPS entities.Conclusion: The spectrum of CPS patients at our tertiary-care children’s hospital is manifold. For most patients, awareness of cancer risk has to be enhanced and current practice needs to be adapted to consensus recommendations. Offering specialized CPS consultations and establishing education programs for patients, relatives, and physicians may increase adherence to recommendations. What is Known: • A wide spectrum of rare syndromes manifesting in childhood is associated with an increased cancer risk. • For many of these syndromes, expert recommendations for management and tumor surveillance are available, although based on limited evidence. What is New: • Evaluating current practice, our data attest significant shortcomings in tumor surveillance of children and adolescents with CPS even in a tertiary-care children’s hospital. • We clearly advocate a systematic and consistent integration of tumor surveillance into daily practice.

scholarly journals Clinical Impact of Malaria Rapid Diagnostic Testing at a US Children’s Hospital

2019 ◽  
Vol 9 (3) ◽  
pp. 298-304
Author(s):  
Leslie A Enane ◽  
Kaede V Sullivan ◽  
Evangelos Spyridakis ◽  
Kristen A Feemster
Keyword(s):  
Diagnostic Testing ◽  
Clinical Signs ◽  
Length Of Hospital Stay ◽  
Clinical Impact ◽  
Rapid Diagnostic Testing ◽  
Children's Hospital ◽  
Antimalarial Therapy ◽  
Children’S Hospital ◽  
The Mean ◽  
Mean Time

Abstract Background Children who develop malaria after returning to a setting in which the disease is not endemic are at high risk for critical delays in diagnosis and initiation of antimalarial therapy. We assessed the clinical impact of the implementation of malaria rapid diagnostic testing (RDT) on the management of children with malaria at an urban US children’s hospital that serves a large immigrant population. Methods This was a retrospective cohort study of all children diagnosed with laboratory-confirmed malaria at the Children’s Hospital of Philadelphia (CHOP) between 2000 and 2014. RDT using a US Food and Drug Administration–approved immunochromatographic assay was introduced at CHOP on August 1, 2007. We compared clinical management and outcomes of patients with malaria diagnosed before and after RDT introduction. Results We analyzed 82 pediatric malaria cases (32 before and 50 after RDT implementation). The majority of these patients had traveled to West Africa (91.5%) and were infected with Plasmodium falciparum (80.5%). The mean time to a positive result decreased from 10.4 to 0.9 hours (P < .001) after the introduction of RDT for patients with P falciparum. The mean time to antimalarial therapy decreased from 13.1 to 6.9 hours (P =; .023) in hospitalized patients. We found no significant reduction in the mean number of clinical signs of severe malaria between 0 and 48 hours of hospitalization and no difference in the need for exchange transfusion, time to resolution of parasitemia, or length of hospital stay. Conclusions Implementation of RDT for malaria was associated with shorter times to malaria diagnosis and initiation of antimalarial therapy. The results of this study support RDT in the optimal management of patients with malaria who present in settings in which the disease is not endemic.

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