Paediatric tracheostomy: a unique situation in a tertiary children’s hospital in Sabah, Malaysia

Background: This paper presents our experience in paediatric tracheostomy in a tertiary children’s hospital and to describe the unique multi-racial and multi-ethnic social demographics involved. Moreover, we would like to highlight an unusual social concern in the state of Sabah, Malaysia and its challenges when treating illegal immigrant children.Methods: A retrospective case note review was conducted for all paediatric patients who underwent tracheostomy between January 2014 to December 2018.Results: Seventy-six patients were recruited. Among them thirteen (17.1%) were illegal immigrant children. The commonest indication for tracheostomy was for prolonged assisted ventilation (60.5%), followed by upper airway obstruction (38.2%) and bronchial toileting (1.3%).Conclusions: This study reflects the current trend in regards to the indication for paediatric tracheostomy. The challenges in treating illegal immigrant children need to be considered on a case by case basis encompassing the family’s economic situation, hospital policies and the child well-being.

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A RETROSPECTIVE CASE SERIES OF NEONATAL SEPTIC ARTHRITIS: EXPERIENCE IN A SINGAPORE TERTIARY CHILDREN’S HOSPITAL

10.26226/morressier.5ad774dcd462b80296ca678d ◽

2018 ◽

Author(s):

Khin Myo Yi

Keyword(s):

Septic Arthritis ◽

Case Series ◽

Retrospective Case ◽

Children's Hospital ◽

Retrospective Case Series ◽

Children’S Hospital

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‘The people in the purple shirts’: Froebelian insights to a Singing Medicine project in a children’s hospital

Journal of Early Childhood Research ◽

10.1177/1476718x20935158 ◽

2020 ◽

Vol 18 (3) ◽

pp. 287-305

Author(s):

Carolyn Blackburn

Keyword(s):

Well Being ◽

Body Awareness ◽

Structured Interviews ◽

Holistic Development ◽

Education Professionals ◽

Children's Hospital ◽

Interpretive Study ◽

The People ◽

Children’S Hospital ◽

Singing Games

Friedrich Wilhelm August Froebel (1782–1852) yearned to promote and foster the harmonious and holistic development of young children through a combination of outdoor activities, songs and games. His Mother Songs, with games and exercises for mothers and their infants, aimed to encourage the use of senses, limbs and body to increase body awareness and promote mental activity. This article reports on a qualitative interpretive study into the role of a Singing Medicine project in a children’s hospital where children on all wards are invited to participate in singing games and activities. An aim was to understand how the application of Froebelian principles can help us to understand and conceptualise children’s rights and well-being in restricted environments such as a Children’s Hospital. Methods included semi-structured interviews with a range of health and education professionals who support children in a children’s hospital in England. In contrast to previous largely quantitative studies relating to the transferable benefits of arts in health projects, the findings from this study suggest that participants value the human connectedness imbued by a Singing Medicine project to children, families and health professionals. Wider benefits for children’s holistic development and empowerment to make choices through participation in singing games were also raised.

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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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Increased Incidence of Severe Breastfeeding Malnutrition and Hypernatremia in a Metropolitan Area

PEDIATRICS ◽

10.1542/peds.96.5.957 ◽

1995 ◽

Vol 96 (5) ◽

pp. 957-960

Author(s):

William O. Cooper ◽

Harry D. Atherton ◽

Madelyn Kahana ◽

Uma R. Kotagal

Keyword(s):

Birth Weight ◽

Parent Education ◽

Metropolitan Area ◽

Tertiary Care ◽

Case Series ◽

Average Weight ◽

Case Review ◽

Retrospective Case ◽

Children's Hospital ◽

Children’S Hospital

Objective: To identify common characteristics among infants with breastfeeding malnutrition in a region with an increasing incidence of breastfeeding malnutrition. Design. Retrospective case series. Setting. A 361-bed regional tertiary care children's hospital in a 1.7 million population metropolitan area. Patients. Case series: five infants with severe breast-feeding malnutrition and hypernatremia admitted to a tertiary care children's hospital over a 5-month period. Retrospective case review: 166 infants admitted between 1990 and 1994 with the diagnosis of dehydration, hypernatremia, or malnutrition. Main Outcome Measures. Maternal characteristics, age at presentation, percent loss from birth weight, serum sodium, average age at birth hospital discharge, neurologic, or cardiovascular complications. Results. Five infants were admitted to a children's hospital over a 5-month period with severe breastfeeding malnutrition and hypernatremia. The average weight loss at time of readmission was 23% (± 8%) from birth weight. The average presenting sodium was 186 ± 19 mmol/L. Three suffered significant complications. From 1990 through 1994, there was a statistically significant (P < .05) annual increase in the number of infants admited with breastfeeding malnutrition and hypernatremia. Conclusions. While breastfeeding malnutrition and hypernatremia is not a new problem, this cluster of infants represents an increase in frequency and severity of the problem and could be a consequence of several factors, including inadequate parent education about breastfeeding problems and inadequate strategies for infant follow-up.

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Penicillin-Resistant Systemic Pneumococcal Infections in Children: A Retrospective Case-Control Study

PEDIATRICS ◽

10.1542/peds.92.6.761 ◽

1993 ◽

Vol 92 (6) ◽

pp. 761-767 ◽

Cited By ~ 1

Author(s):

Tina Q. Tan ◽

Edward O. Mason ◽

Sheldon L. Kaplan

Keyword(s):

Minimum Inhibitory Concentration ◽

Inhibitory Concentration ◽

Case Control Study ◽

Case Control ◽

Pneumococcal Infections ◽

Retrospective Case ◽

Children's Hospital ◽

Children’S Hospital ◽

Minimum Inhibitory Concentration Range ◽

Control Study

Objective. To determine whether there are any risk factors that differentiate children with systemic infections due to Streptococcus pneumoniae relatively or fully resistant (minimum inhibitory concentration >0.1 µg/mL) to penicillin from those children with infections due to S pneumoniae susceptible to penicillin. Design. Retrospective case-control study. Setting. A large children's hospital. Participants. Forty-three children with systemic penicillin-resistant S pneumoniae infections identified at Texas Children's Hospital over the 51-month period from January 1989 through March 1993. Each case had one or two controls matched only for age and date of S. pneumoniae infection. Sixty-six controls were selected from a group of 341 children with susceptible isolates. Outcome measures. Variables compared included gender, race, diagnosis, underlying conditions, past hospitalization, geographic area of residence, antibiotic use in past month, amoxicillin-clavulanic acid use in past month, and outcome. Results. Thirty-seven patients (86%) had relatively resistant isolates (minimum inhibitory concentration range 0.125 to 1.0 µg/mL) and six patients (15%) had fully resistant isolates (minimum inhibitory concentration range 2.0 to 8.0 µg/mL). Thirty-three percent of the cases vs 36% of the controls had underlying conditions. Seventy-one percent of the cases vs 39% of the controls had received antibiotics in the previous month. Compared with their matched controls, the patients with penicillin-resistant systemic pneumococcal infections were more likely (P = .02) to have received a course of antibiotics within the month prior to their infection. Conclusion. The only identified associated risk factor in children who developed a systemic penicillin-resistant pneumococcal infection appears to have been the use of antibiotics within the month prior to their infection.

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Passy-Muir Speaking Valve Use in a Children's Hospital: An Interdisciplinary Approach

Perspectives on Voice and Voice Disorders ◽

10.1044/vvd18.2.76 ◽

2008 ◽

Vol 18 (2) ◽

pp. 76-86 ◽

Cited By ~ 2

Author(s):

Lauren Hofmann ◽

Joseph Bolton ◽

Susan Ferry

Keyword(s):

Tracheostomy Tube ◽

Pediatric Population ◽

Interdisciplinary Approach ◽

Extended Period ◽

Speech Development ◽

Tube Placement ◽

Background Information ◽

Speaking Valve ◽

Children's Hospital ◽

Children’S Hospital

Abstract At The Children's Hospital of Philadelphia (CHOP) we treat many children requiring tracheostomy tube placement. With potential for a tracheostomy tube to be in place for an extended period of time, these children may be at risk for long-term disruption to normal speech development. As such, speaking valves that restore more normal phonation are often key tools in the effort to restore speech and promote more typical language development in this population. However, successful use of speaking valves is frequently more challenging with infant and pediatric patients than with adult patients. The purpose of this article is to review background information related to speaking valves, the indications for one-way valve use, criteria for candidacy, and the benefits of using speaking valves in the pediatric population. This review will emphasize the importance of interdisciplinary collaboration from the perspectives of speech-language pathology and respiratory therapy. Along with the background information, we will present current practices and a case study to illustrate a safe and systematic approach to speaking valve implementation based upon our experiences.

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