Cartilage Grafting Outcomes in Intermediate and Definitive Cleft Rhinoplasty

Objective: To compare cartilage grafting outcomes in intermediate versus definitive cleft rhinoplasty. Design: A retrospective chart review was conducted. The χ2 and Fisher exact tests were used for statistical analyses. Results were considered statistically significant at P < .05. Participants: All subjects who underwent revision cleft rhinoplasties between July 2011 and June 2019 were included. Subjects with syndromic conditions were excluded. Results: A total of 46 subjects with a cleft nose deformity underwent 65 rhinoplasty procedures. The ages averaged 17 years (range 5-50) with 34 (73.9%) males and 12 (26.1%) females. In the intermediate group, 6 (28.6%) subjects required cartilage grafting as part of 6 cleft rhinoplasties, whereas 15 (71.4%) subjects underwent a total of 26 cleft rhinoplasties that did not require grafting. In the definitive group, 18 (76%) subjects required cartilage grafting over 21 cleft rhinoplasties, whereas 7 (24%) subjects underwent a total of 9 cleft rhinoplasties where cartilage grafting was not required. The difference between the number of subjects requiring cartilage grafting in the intermediate versus the definitive group was statistically significant ( P = .007). Ear concha and nose were the most frequently used cartilage donor sites, with no observed complications. Conclusions: Cartilage grafting was significantly more common in the definitive rhinoplasty group. Intermediate cleft rhinoplasty during the 5- to 13-year age period was effective, with a low-risk profile. In our experience, ear concha and nose were the preferred cartilage donor sites, with effective results and an excellent safety profile.

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Abstract P176: Improving Door to Needle Times With CT Telestroke

Stroke ◽

10.1161/str.52.suppl_1.p176 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Sarah Jamieson ◽

Alexandra C Lesko ◽

Elizabeth Baraban ◽

Lisa R Yanase

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Chart Review ◽

Group Analysis ◽

Retrospective Chart Review ◽

Inclusion Criteria ◽

Night Time ◽

Intention To Treat ◽

The Difference ◽

Treat Analysis

Introduction: Thrombolytic treatment of acute ischemic stroke (AIS) during night-time hours and weekends is associated with prolonged door to needle (DTN) times. A CT suite telestroke unit (CTTU) was installed at two urban stroke centers to expedite treatment for AIS patients. The purpose of this study was to determine whether CTTU evaluation would decrease DTN times on nights and weekends. Methods: A retrospective chart review included patients 18 years and older presenting with AIS to the emergency department and treated with IV alteplase on a week-night (4pm-8am) or weekend (Friday 4pm - Monday 8am) between January 2019- February 2020. The distribution of median DTN times were compared for the following groups: (1) Pre-CTTU installation (January 1, 2019-July 28, 2019) versus post-CTTU installation (July 29, 2019 - February 29, 2020), regardless of telestroke usage (“intention to treat”), (2) Pre-CTTU (using traditional telestroke and excluding bedside evaluations) versus post-CTTU (using CTTU and excluding bedside evaluations) (“per-protocol”) and (3) Post-CTTU period use of traditional telestroke versus CTTU (“post-CTTU group”). Analyses were performed using the Mann-Whitney U test. Results: A total of 111 patients met inclusion criteria with 44 (39.6%) treated in the pre-CTTU period and 67 (60.4%) treated in the post-CTTU period. After installation, CTTU was utilized in 38.8% (n=26) of cases, traditional telestroke in 44.8% (n=30), and the remaining 16.4% (n=11) were evaluated at bedside. The intention-to-treat analysis showed no difference between the pre-CTTU and post-CTTU groups (44.0 minutes vs 44.0 minutes, p=0.909). The per-protocol analysis showed faster DTN times in the Post-CTTU group compared to the Pre-CTTU group (38.5 minutes vs 44.0 minutes, p=0.128), but the difference was not significant. The post-CTTU group analysis showed median DTN times significantly improved using CTTU compared to traditional telestroke (38.5 minutes vs 48.0 minutes, p=0.011). Conclusion: The use of CT telestroke in the evaluation of acute ischemic stroke patients decreased DTN time when a stroke neurologist is not on-site.

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S244 – Intraoperative ABR after Myringotomy and Tube Placement

Otolaryngology ◽

10.1016/j.otohns.2008.05.419 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P157-P157

Author(s):

Nanette Sturgill ◽

Joshua G Yorgason ◽

Albert H Park

Keyword(s):

Middle Ear ◽

Chart Review ◽

Medical Center ◽

Hearing Threshold ◽

Retrospective Chart Review ◽

Tube Placement ◽

Threshold Levels ◽

Time Of Surgery ◽

The Difference

Objectives Understand the utility of intraoperative ABR testing after myringotomy and tube placement. Methods We performed a retrospective chart review of 27 patients (mean age 23 months) who underwent intraoperative ABR (ioABR) after myringotomy and tube placement at Primary Childrens Medical Center from 2004 to 2007. Paired t-tests were perfomed to analyze the difference in threshold levels from the ioABR to follow up behavioral audiometry at 1kHz and 4kHz frequencies, accounting for the presence or absence of fluid at the time of surgery. Results 15 patients (29 ears) showed a mean improvement of 10 dB at the 1 kHz frequency (p=0.007), and 16 patients (31 ears) improved by 5 dB at 4kHz (p=0.83). An improvement of at least 15 dB was seen in 45% of patients (13/29 ears) at 1 kHz and in 26% (8/31 ears) at 4 kHz; 5 patients improved by as much as 35–50 dB. Of the patients whose thresholds improved by at least 15 dB, 77% at 1 kHz and 83% at 4 kHz showed evidence of fluid at the time of the ioABR Conclusions Patients who undergo ioABR testing show a significant improvement of dB level on follow-up behavioral audiometry. Many patients whose hearing threshold improved by at least 15 dB had fluid at the time of myringotomy. Therefore, the presence of middle ear pathology may lead to an overestimation of ioABR thresholds. Consequently, ioABR results should be interpreted with caution in isolation, and subsequent audiometric testing should always be performed to validate prior results.

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Abstract WP20: Intra-Arterial Chemotherapy for Retinoblastoma in Infants<10 kg: 74 Treated Eyes With 222 IAC Sessions

Stroke ◽

10.1161/str.51.suppl_1.wp20 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Ahmad Sweid ◽

Batoul Hammoud ◽

Pavlos Texakalidis ◽

Vivian Xu ◽

Kavya Shivashankar ◽

...

Keyword(s):

Multivariate Analysis ◽

Natural History ◽

Safety Profile ◽

Chart Review ◽

Independent Predictor ◽

Retrospective Chart Review ◽

Secondary Treatment ◽

Safety And Efficacy ◽

Eye Enucleation ◽

History Of

Background: Intra-arterial chemotherapy (IAC) for retinoblastoma (Rb) has dramatically altered the natural history of the disease. The spectacular outcomes associated with a high safety profile have pushed the envelope to offer treatment for patients < 10 kg of weight. Objective: We aim to share our findings and experience in a large series of IAC infusions performed in infants < 10 kg. Methods: A retrospective chart review was performed for patients diagnosed with retinoblastoma and managed with IAC as either primary or secondary treatment. Results: There were 207 Rb tumors of 207 eyes in 197 consecutive patients. Of these, patient weight was 10 kg in 69 (35.7%) and >10 kg in 133 (67.5%) patients. Of the 69 patients weighing < 10 kg, 5 patients had bilateral Rb. Thus, a total of 74 eyes of 69 patients weighing < 10 kg were compared to 133 eyes of 133 patients weighing > 10 kg. Comparison ( < 10 kg vs. >10 kg) revealed the total number of IAC cycles was 222 vs. 436. Periprocedural complications occurred in 2 (0.9%) vs. 2 (0.45%) infusions ( p =0.49). Aborted procedure occurred in 12 (5.4%) vs. 7 (1.6%) infusions ( p =0.005). Enucleation following IAC was required in 14 (18.9) vs. 44 (33%) eyes ( p =0.029). On multivariate analysis, weight < 10 kg was not an independent predictor of complications, procedure failure, or eye enucleation. Conclusions: Our results speak for the safety and efficacy of IAC in patients < 10 kg.

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Safety evaluation of intravenous immunoglobulin in pediatric patients: a retrospective, 1-year observational study

Therapeutic Advances in Drug Safety ◽

10.1177/2042098619876736 ◽

2019 ◽

Vol 10 ◽

pp. 204209861987673

Author(s):

Reem Elajez ◽

Asmaa Ezzeldin ◽

Hossamaldein Gaber

Keyword(s):

Intravenous Immunoglobulin ◽

Safety Profile ◽

Chart Review ◽

Pediatric Patients ◽

Safety Evaluation ◽

Retrospective Chart Review ◽

Risk Category ◽

Good Safety Profile ◽

Review Study ◽

Infusion Protocol

Background: Intravenous immunoglobulin (IVIG) is a pooled human plasma protein that has shown efficacy in treating a variety of disorders. IVIG is generally well tolerated and has a good safety profile. There are various IVIG products available on the market, which results in differences in efficacy and safety profile. The aim of this study was to assess the safety profile of IVIG use in pediatric patients and its association with other predicted factors. Methods: Retrospective chart review study of all pediatric patients who received IVIG as an inpatient at Hamad General Hospital in Qatar during 2014. The occurrence of adverse drug reactions (ADR) was tested for any association with other predicted factors, such as patient age, IVIG dose, brand, and adherence to infusion protocol. Results: A total of 345 IVIG prescriptions were received by pediatric patients during the study period. Most common documented side effects were: fever (5.8%), chills (2.6%), and headache (2%). Renal insufficiency was observed only in six cases, with five of those in ‘Risk’ category according to RIFLE criteria. A hypersensitivity reaction was documented in seven patients, despite being premedicated with paracetamol and/or diphenhydramine and following the infusion protocol. None of the predicted factors were found to be significantly associated with ADR incidence except IVIG brand. Conclusions: IVIG generally has a good safety profile in pediatric patients, with low risk of severe ADR. More studies are needed to evaluate the correlation between ADR and IVIG formulation, taking into account other factors that may affect results.

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Immunohistochemical Staining for Uroguanylin, a Satiety Hormone, is Decreased in Intestinal Tissue Specimens From Female Adolescents With Obesity

Pediatric and Developmental Pathology ◽

10.1177/1093526617722912 ◽

2017 ◽

Vol 21 (3) ◽

pp. 285-295 ◽

Cited By ~ 9

Author(s):

Matthew D Di Guglielmo ◽

Lacey Perdue ◽

Adebowale Adeyemi ◽

Kenneth L van Golen ◽

Diana U Corao

Keyword(s):

Chart Review ◽

Pediatric Patients ◽

Retrospective Chart Review ◽

Staining Intensity ◽

Female Adolescents ◽

Guanylyl Cyclase C ◽

Age Cohort ◽

Satiety Hormone ◽

The Difference ◽

Tissue Specimens

Gastrointestinal tract–secreted satiety hormones play a significant role in one of the largest health-care challenges for children and adults, obesity. Recent studies in mice identified a novel role for uroguanylin, the endogenous intestinal hormone that binds guanylyl cyclase C (GUCY2C), in regulating satiety via a gut-brain signaling pathway. Mice bred without GUCY2C receptors over-ate and developed obesity. We hypothesized that intestinal uroguanylin expression in pediatric patients with obesity would be lower than patients without obesity, and we attempted to examine the difference with immunohistochemistry. Retrospective chart review of gastrointestinal endoscopic procedures at an academic children’s hospital identified patients with normal pathology findings on biopsy. Children aged 8–17 were included in the review; we analyzed biopsy samples from 20 matched pairs that differed only by body mass index (BMI)-for-age (average: 25%–75% vs. high: >95%). Biopsies of the duodenum, terminal ileum, ascending colon, and descending colon were subjected to immunohistochemistry for GUCY2C, uroguanylin, and the endogenous colonic hormone, guanylin. Intensity staining of all specimens was scored by a blinded pathologist. The overall staining intensity for females with high BMI-for-age was less for uroguanylin and guanylin as compared to average BMI-for-age females while GUCY2C staining was equal. Males did not exhibit different staining intensities for uroguanylin or guanylin. More matched female pairs had greater uroguanylin and guanylin staining in the average BMI-for-age cohort. The intestinal expression of uroguanylin, a key satiety hormone, appears to be diminished in female pediatric patients in the setting of obesity.

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Comparing Recurrence and Retreatment of Three Doses of Bevacizumab in Treating Severe Retinopathy of Prematurity

Proceedings of IMPRS ◽

10.18060/25899 ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Jay Chopra ◽

Charline Boente

Keyword(s):

Retinopathy Of Prematurity ◽

Chart Review ◽

Intravitreal Bevacizumab ◽

Retrospective Chart Review ◽

Initial Response ◽

Slight Variation ◽

Demographic Information ◽

Significant Difference ◽

Spss Software ◽

The Difference

Purpose: To determine recurrence and retreatment patterns after treatment of severe retinopathy of Prematurity (ROP) with either 0.5 mg, 0.25 mg, or 0.125 mg of intravitreal bevacizumab for retinopathy of prematurity. Methods: In this retrospective chart review, data was examined for babies who had severe ROP and were treated with intravitreal bevacizumab doses of either 0.500 mg, 0.250 mg, or 0.125 mg at Riley Hospital for Children in Indianapolis from 2014 to 2021. Data collected included demographic information, past medical history, and characteristics of ROP. The data was statistically analyzed using SPSS software. Results: One eye was analyzed for each baby. Out of 85 babies, 79 babies were included in the study. 26 babies were treated with 0.125 mg bevacizumab, 37 with 0.25 mg, and 16 with 0.5 mg. All babies showed initial response to the bevacizumab, with 61 babies (77.2%) receiving retreatment with laser for either recurrence or persistent avascular retina. While the babies treated with lower doses had higher percentages of retreatment (23 babies (88.5%) in the 0.125 mg, 29 babies (78.4%) in the 0.25 mg, and 9 babies (56.3%) in the 0.5 mg group), the difference was not statistically significant (p=0.069). Most of the retreatments were due to recurrence of ROP (0.125 mg: 20 (87.0%), 0.25 mg: 19 (65.5%), 0.50 mg: 8 (88.9%)) (p=0.339). On average, the babies in the 0.125 mg group were retreated with laser at 3.4 weeks earlier gestational age and 4.7 weeks sooner after initial treatment than the higher dosing groups, however, this difference was not statistically significant (p=0.181, p=0.287). Conclusion: The outcomes comparing three doses of intravitreal bevacizumab for severe ROP showed a slight variation in recurrence and retreatment patterns but no statistically significant difference in our study.

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Retrospective Analysis of Pediatric Tracheostomy

Advances in Otolaryngology ◽

10.1155/2014/848262 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Mehmet Akdag ◽

Zeynep Baysal ◽

Ayfer Gozu Pirinccioglu ◽

Aylin Gul ◽

Fazıl Emre Ozkurt ◽

...

Keyword(s):

Airway Obstruction ◽

Patient Population ◽

Chart Review ◽

Genetic Diseases ◽

Upper Airway ◽

Retrospective Chart Review ◽

Upper Airway Obstruction ◽

Prolonged Intubation ◽

Significant Difference ◽

The Difference

Purpose. This paper reviews analyses for tracheostomy within our patient population over the last 6 years. Methods. We conducted a retrospective chart review of consecutive patients undergoing tracheostomy at the tertiary Dicle University Medical hospital, Turkey, from January 2006 to December 2012. Patient age, sex, emergency, planned tracheostomy, indications, complications, and decannulation time were all assessed. Results. Fifty-six (34 male, 22 female) adult Pediatric patients undergoing tracheostomy between 2006 and 2013 were investigated. The most common indication for tracheostomy was upper airway obstruction (66.7%), followed by prolonged intubation (33.3%). Mean decannulation times after tracheostomy ranged between 1 and 131 days, the difference being statistically significant (P=0.040). There was no significant difference in terms of mean age (9.8±6.0; P=0.26). There was also no statistical difference between emergency and planned tracheotomies (P=0.606). Conclusion. In our patient population, there was a significant decline in the number of tracheotomies performed for prolonged intubation and an increasing number of patient tracheostomy for upper airway obstruction. According to the literature, permanent decannulation rates were slightly higher with an increase in genetic diseases such as neuromuscular disease.

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