scholarly journals Characteristics of the pediatric patients diagnosed with SARS-CoV-2 infection in a Romanian children’s hospital: a retrospective study

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11560
Author(s):  
Liana-Cătălina Gavriliu ◽  
Carmen Murariu ◽  
Vladimir Potop ◽  
Radu Spătaru
Keyword(s):  
Pediatric Patients ◽  
Age Distribution ◽  
Asymptomatic Group ◽  
Children's Hospital ◽  
Asymptomatic Patients ◽  
Moderate Disease ◽  
Children’S Hospital ◽  
Risk Patients ◽  
Chest X Ray ◽  
Epidemiological Characteristics

Background To date, information on COVID-19 pediatric patients is still sparse. We aimed to highlight the epidemiological and clinical data regarding SARS-CoV-2 infection in children and adolescents to improve the understanding of the disease in this age group and inform physicians during the ongoing COVID-19 pandemic. Methods We conducted a retrospective, observational study in “Marie Curie” Emergency Children’s Hospital from Bucharest, Romania. We analyzed clinical and epidemiological characteristics of the patients confirmed with SARS-CoV-2 infection, between April 1, 2020–October 31, 2020. Results A total of 172 patients aged 0–18 years were included, 79 (45.93%) female and 93 (54.07%) male patients. 28 (16.28%) patients had co-morbidities (more often identified in asymptomatic group; p < 0.0001). 47 (27.32%) had exposure to an identified source. 30 (17.44%) patients were asymptomatic; 142 (85.56%) had mild or moderate disease. The most frequent symptoms were: pyrexia (78.87%), digestive symptoms (50%), cough (40.14%). Chest X-ray was performed in 50 patients and it was abnormal in half of them, all being symptomatic. About 2/3 of the evaluated patients had normal leukocytes. The most common hematological change was lymphopenia; monocytes tended to be higher in symptomatic patients. About 40% of the patients were admitted; none required admission to ICU. No significant differences were found between symptomatic and asymptomatic patients regarding gender, age distribution, and exposure to a source. Conclusions All the patients had asymptomatic, mild or moderate disease. Patients with comorbidities, classically considered high risk patients, presented the same pattern of disease.

scholarly journals Clinical Analysis of Atelectasis Caused by Influenza A in Xiamen Children’s Hospital Between 2017 and 2019

2020 ◽  
Author(s):  
Lin Yuan ◽  
Ding-zhen Bai ◽  
Zhi-qiang Zhuo ◽  
Xing-dong Wu
Keyword(s):  
Influenza A ◽  
Pediatric Patients ◽  
Antiviral Treatment ◽  
Left Lung ◽  
Clinical Manifestations ◽  
Fiberoptic Bronchoscopy ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Tract Infections ◽  
Epidemiological Characteristics

Abstract Background: We aimed to analyze the clinical characteristics of pediatric patients with atelectasis caused by influenza A to provide a reference for reasonable clinical diagnosis and treatment. Methods: We included 79 pediatric patients with atelectasis caused by influenza A diagnosed at Xiamen Children’s Hospital between January 1, 2017 and December 31, 2019. We analyzed their epidemiological characteristics, clinical manifestations, imaging changes, diagnosis, treatment process, and outcomes. Results: Among the 79 included patients (males: 52; females: 27), 70 (88.61%) were > 6 years-old and 54 (68.35%) had atelectasis onset during winter. A majority experienced fever and cough. Among them, 44, 16, 21, 14, and 12 had normal/decreased white blood cells, elevated procalcitonin, abnormal hepatic function, abnormal myocardial enzyme spectrum, Mycoplasma pneumoniae infection, and Streptococcus pneumoniae infection, respectively. Seventy-nine patients presented different atelectasis degrees, including 16 and 29 with atelectasis in the right and left lung, respectively, while 34 had multiple consolidations and atelectasis lesions in both lungs. Fiberoptic bronchoscopy examination of 57 cases revealed mucus plug blockage in 6 cases; among them, 2 cases underwent bronchial cast removal. All patients received oseltamivir or peramivir for antiviral treatment and antibacterial treatment for complicated bacterial infection. All the patients recovered and were eventually discharged. Post-discharge follow-up showed that 77 cases were cured while 2 experienced recurrent respiratory tract infections and post-activity shortness of breath with chest computer tomography showing mosaic perfusion. Conclusion There is a high incidence of atelectasis caused by influenza A during winter among children aged < 6 years. The main manifestations are fever (mostly hyperpyrexia) and cough. Chest imaging shows consolidation and atelectasis occurring in any lung lobe. Some patients present multiple consolidations and atelectasis lesions complicated by mucus plugs or bronchial casts. Timely fiberoptic bronchoscopy and alveolar lavage could shorten the disease course and improve the prognosis.

scholarly journals A Retrospective Review of Hospital-Acquired Venous Thromboembolism at a Large Pediatric Tertiary Care Center

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3471-3471
Author(s):  
Marissa A. Just ◽  
Joanna Robles ◽  
Karan R. Kumar ◽  
Andrew Yazman ◽  
Jennifer A. Rothman ◽  
...  
Keyword(s):  
Retrospective Review ◽  
Research Funding ◽  
Pediatric Patients ◽  
Central Venous ◽  
Vte Prophylaxis ◽  
Children's Hospital ◽  
Congenital Cardiac Disease ◽  
Children’S Hospital ◽  
Icd 10 ◽  
Hospital Acquired

Introduction: The incidence of venous thromboembolism (VTE) in hospitalized pediatric patients is increasing secondary to the growing medical complexity of pediatric patients and the increasing use of central venous catheters. Pediatric patients diagnosed with VTE have up to 2% mortality associated directly with their thromboses. While incidence, risk factor identification and preventive strategies are well established in hospitalized adults, this information is limited in the pediatric population. There are currently no standardized VTE risk screening tools or thromboprophylaxis guidelines for children at Duke Children's Hospital. The incidence of hospital acquired VTE (HA-VTE), as well as their associated risk factors were investigated in a retrospective review. Methods: Medical records of pediatric patients hospitalized at Duke Children's Hospital during June 2018 through November 2018 were reviewed. The EPIC SlicerDicer tool was used to identify patients with ICD-10 diagnoses codes related to thrombosis or treated with anticoagulants. Included patients were diagnosed with HA-VTE during their hospitalization or within 14 days of discharge. Data collected included demographics, thrombosis characteristics, family history, mobility, and acute or chronic co-morbid conditions. The characteristics of the study population were described by median (with 25th and 75th percentiles) for continuous variables and frequencies (with percentages) for binary or categorical variables. Results: Out of 4,176 total pediatric admissions to all units of Duke Children's Hospital (ages 0-18.99 years) during the inclusion timeframe, 33 VTE events were identified. The incidence of VTE events per 1000 patient days was 0.98. The complete patient and VTE event characteristics are listed in Tables 1 and 2. The median age of patients with VTE events was 0.4 years. Of the identified cohort, 73% had an associated central venous line (CVL). Neonates with congenital cardiac disease comprised the majority of the cohort. Other common patient characteristics observed in this cohort included impaired mobility, recent major surgery, and recent mechanical ventilation. Of the 33 VTE diagnoses, 70% received therapeutic anticoagulation with enoxaparin or unfractionated heparin. Only 2 patients (8%) received prophylactic anticoagulation prior to their diagnosis of VTE. Conclusions: The retrospective review of HA-VTE events at Duke Children's Hospital identified that the majority of the events occurred in neonates with congenital cardiac disease and the presence of CVLs. It was also noted that there was no standardization among the use of anticoagulation agents that were initiated for treatment of VTE. Furthermore, few patients received VTE prophylaxis during the hospitalization. A limitation of this review was that it was retrospective and the documentation of family history of thrombosis was inconsistent. It is also possible that several VTE events were missed due to inadequate ICD-10 coding. Based on the results of this review, there is a need to implement a risk stratification tool and develop standardized recommendations of VTE prophylaxis and treatments for pediatric patients admitted to Duke Children's Hospital. There is an additional quality improvement phase of this project and the goal is to implement a risk calculator that is based on information learned from the retrospective review. Ultimately, this risk calculator will help to decrease the incidence of VTE events at Duke Children's Hospital. Disclosures Rothman: Agios: Honoraria, Research Funding; Pfizer: Consultancy, Honoraria, Research Funding; Novartis: Honoraria, Research Funding.

scholarly journals Clinical and epidemiological characteristics of patients with suspected primary immunodeficiency disorders attending Alexandria University Children’s Hospital

2019 ◽  
Vol 6 (5) ◽  
pp. 1872
Author(s):  
Doaa A. Heiba
Keyword(s):  
Primary Immunodeficiency ◽  
Demographic Data ◽  
Positive Family History ◽  
Diagnostic Delay ◽  
Patient Registries ◽  
Primary Immunodeficiency Disorders ◽  
Children's Hospital ◽  
Egyptian Children ◽  
Children’S Hospital ◽  
Epidemiological Characteristics

Background: Current study was conducted to determine the clinical and epidemiological characteristics of patients with suspected primary immunodeficiencies (PID) seen at Alexandria University Children's Hospital.Methods: Eighty one patients with suspected PID were seen at Alexandria University Children's Hospital in one year in the period from September 2016 to October 2017. Demographic data of the patients as well as data related to their disease status were taken and evaluation sheet was developed for all patients.Results: About 61.7% of patients satisfied the criteria of PID based on WHO Scientific Committee. According to modified IUIS classification predominant antibody deficiency was the commonest (34%) followed by other well defined immunodeficiency syndromes (30%), combined immunodeficiencies (16%), phagocytic defects (14%), diseases of immune dysregulation 4% and complement deficiencies (2%). The most frequent disorder was X-linked agammagloulinemia (XLA) (22%). The mean age at diagnosis was 27.4 months. The consanguinity rate was 55.5%. A positive Family history was a strong pointer to diagnosis for PID (46.9%). The commonest clinical presentation was pneumonia (82.7%). 28.4% of patients died from infections. As observed in other patient registries, diagnostic delay remains the major cause of morbidity and mortality.Conclusions: Primary immunodeficiency disorders are not rare in Egyptian children. Creating awareness of PID should be targeted at hospital pediatricians and families with history of PID and this may reveal more cases within the community. The observed high frequency of combined T- and B-cell immunodeficiencies in this cohort made it a health issue in Egypt as in other developing countries.

scholarly journals Molecular epidemiology and antimicrobial resistance of group A streptococcus recovered from patients in Beijing, China

2020 ◽  
Author(s):  
Hongxin Li ◽  
Lin Zhou ◽  
Yong Zhao ◽  
Lijuan Ma ◽  
Xiaoyan Liu ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Group A Streptococcus ◽  
Resistance Rate ◽  
Gene Profiling ◽  
Epidemiological Surveillance ◽  
Erythromycin Resistance ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Group A ◽  
Epidemiological Characteristics

Abstract Background: Group A streptococcus (GAS) is an important human pathogen responsible for a broad range of infections. Epidemiological surveillance has been crucial to detect changes in the geographical and temporal variation of the disease pattern. The objective of this study was to investigate the molecular epidemiological characteristics and antimicrobial resistance of GAS isolates from patients in Children’s Hospital in Beijing. Methods: From 2016 to 2017, pharyngeal swab samples were collected from the outpatients in Children’s Hospital, Capital Institute of Pediatrics, who were diagnosed with scarlet fever. Antimicrobial susceptibility test was performed according to the distribution of conventional antibiotics and Clinical and Laboratory Standards Institute (CLSI) recommendations. The distribution of the macrolide-resistance genes ( ermB, ermA, mefA ), emm (M protein-coding gene) typing, and superantigens (SAg) gene profiling were examined by polymerase chain reaction (PCR). Results: A total of 297 GAS isolates were collected. The susceptibility of the isolates to penicillin, ceftriaxone, and levofloxacin was 100%. The resistance rate to erythromycin and clindamycin was 98.3% and 96.6%, respectively. The dominant emm types were emm12 (65.32%), emm1 (27.61%), emm75 (2.69%), and emm89 (1.35%). Of the 297 isolates, 290 (97.64%) carried the ermB gene, and 5 (1.68%) carried the mefA gene, while none carried the ermA gene. The most common superantigen genes identified from GAS isolates were smeZ (96.97%) , speC (92.59%), speG (91.58%), ssa (85.52%), speI (54.55%), speH (52.19%), and speA (34.34%). Isolates with the genotype emm1 possessed speA , speC , speG , speJ , speM , ssa , and smeZ , while emm12 possessed speC , speG , speH , speI , speM , ssa , and smeZ superantigens. Conclusions: The prevalent strain of GAS isolates in Beijing has a high resistance rate to macrolides; however, penicillin can still be the preferred antibiotic for treatment. Erythromycin resistance was predominantly mediated by ermB. The common emm types were emm12 and emm1. There was a correlation between emm and the superantigen gene. Thus, long-term monitoring and investigation of the emm types and superantigen genes of GAS prevalence are imperative.

scholarly journals Improving Pediatric Adverse Drug Event Reporting through Clinical Pharmacy Services

2011 ◽  
Vol 16 (4) ◽  
pp. 285-290
Author(s):  
David M. Crowther ◽  
Marcia L. Buck ◽  
Michelle W. McCarthy ◽  
Virginia W. Barton
Keyword(s):  
Causative Agent ◽  
Adverse Drug Event ◽  
Pediatric Patients ◽  
Drug Event ◽  
University Of Virginia ◽  
Children's Hospital ◽  
Therapeutic Class ◽  
Children’S Hospital ◽  
The University

OBJECTIVES The purpose of this study was to summarize adverse drug event (ADE) reporting and to characterize the type of healthcare practitioners involved in reporting over a 10-year period at a 120-bed university-affiliated children's hospital. METHODS The University of Virginia Children's Hospital ADE database was analyzed for records involving pediatric patients. Data from patients &lt;18 years of age who were admitted to the University of Virginia Children's Hospital between January 1, 2000, and December 31, 2009, were analyzed. Data collected included drug name and therapeutic class of the suspected causative agent, description of the event, severity, causality, outcome, and the type of healthcare practitioner reporting the event. RESULTS A total of 863 ADEs were reported over the 10-year period. The 5 most common types reported were extravasation injury (10%), rash (8%), hypotension (5%), pruritus (5%), and renal failure (3%). A total of 196 (21%) cases were categorized as mild, 436 (47%) cases as moderate, and 296 (32%) cases as severe. Further characterization of extravasations was performed to identify trends relating to potential causes. In 45 (57%) reports, parenteral nutrition was identified as the causative agent. Full recovery was documented in 21 (47%) extravasations. Of the total events reported, 83% were reported by pharmacists, 16% by nurses, and &lt;1% by other healthcare practitioners. CONCLUSIONS Results of this study are consistent with those of previous studies involving ADE reporting in children's hospitals. This consistency is due in part to system design and use of unit-based pharmacists as the primary reporters.

A Survey of Nosocomial Respiratory Viral Infections in a Children's Hospital: Occult Respiratory Infection in Patients Admitted During an Epidemic Season

1991 ◽  
Vol 12 (4) ◽  
pp. 231-238 ◽  
Author(s):  
Paul N. Goldwater ◽  
A. James Martin ◽  
Brownwyn Ryan ◽  
Sylvia Morris ◽  
Jill Thompson ◽  
...  
Keyword(s):  
Respiratory Infection ◽  
Respiratory Symptoms ◽  
Respiratory Virus ◽  
Pediatric Hospital ◽  
Children's Hospital ◽  
Asymptomatic Patients ◽  
Number Of Patients ◽  
Epidemic Period ◽  
Children’S Hospital ◽  
Hospital Acquired

AbstractObjective:To define the extent of shedding of respiratory viruses and Mycoplasma pneumoniae among a population of pediatric patients admitted to the hospital during a winter epidemic period and to identify nosocomial infections within this population.Design:An open, prospective survey of patients admitted to three wards (General Medical, Respiratory Infectious, and Infectious Diseases) of a pediatric hospital during a defined three-month period.Patients:All patients with medical, respiratory, and infectious conditions admitted to three wards of the Adelaide Children's Hospital had nasopharyngeal aspirations performed at the time of admission with the purpose of documenting viral and M pneumoniae shedding. Patients were monitored daily for the development of symptoms of respiratory infection or new symptoms of respiratory disease. Such patients underwent a further nasopharyngeal aspiration for the purpose of diagnosing hospital-acquired infection.Results:Nasopharyngeal aspirations were obtained from 601 patients. Forty-seven percent of asymptomatic patients were positive for a respiratory virus orMpneumoniae, and 61% of patients with respiratory symptoms were also positive. Gastroenteritis patients shed viruses in 66% of cases. Respiratory symptoms were initially overlooked by admitting physicians but subsequently identified in 110 cases, and 46% of these were found to be positive for a respiratory virus or M pneumoniae. There were 18 possible hospital acquired infections among the 293 initially virus-negative patients. Multiple isolates were obtained from a substantial number of patients, especially those with respiratory symptoms.Conclusions:A substantial proportion of all patients admitted to a pediatric hospital during winter represent a potential source of infection, and strict infection control measures should be enacted to limit the spread of these infections.

scholarly journals MENISCUS REPAIR VERSUS DEBRIDEMENT FOR MENISCAL TEARS IN PEDIATRIC PATIENTS – PREDICTORS FOR TREATMENT BASED ON DEMOGRAPHICS

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0016
Author(s):  
Lauren Agatstein ◽  
Alton W. Skaggs ◽  
Matthew J. Brown ◽  
Nicole Friel ◽  
Brian Haus
Keyword(s):  
Pediatric Patients ◽  
Private Insurance ◽  
Meniscal Repair ◽  
Meniscus Repair ◽  
Meniscus Tear ◽  
Children's Hospitals ◽  
Children's Hospital ◽  
Children’S Hospitals ◽  
Meniscus Tears ◽  
Children’S Hospital

BACKGROUND: Pediatric and adolescent patients with meniscus tears have a relatively high rate of healing after meniscus repair – up to greater than 80% in the literature. Despite this fact, many patients undergo meniscus debridement for treatment of their meniscus tears. In this study, we investigated the demographic factors predictive of whether a pediatric patient would receive a meniscal repair or a meniscal debridement for their meniscal tear. METHODS: The California statewide ambulatory surgery database (OSHPD) was queried for all patients under 18 years old who underwent meniscus debridement or meniscus repair from 2008-2016. The effect of age, hospital setting (adult versus pediatric hospital), injury chronicity, gender, insurance type, race, and year of service was assessed using logistic regression. RESULTS: A total of 13,906 pediatric patients had meniscal surgery during the timeframe. 83% (11,561/13,906) underwent meniscal debridement and 17% (2,345/13,906) underwent meniscal repair. Age, hospital type, nature of injury, gender, private insurance, being Hispanic, and year of service were statistically significant in predicting the odds of having meniscus repair versus meniscus debridement. Surgery at a children’s hospital increases the odds of having meniscus repair (p < 0.001). Of the 82.6% of pediatric patients (11,491/13,906) treated at non-children’s hospitals, 16% (1839) had repair and 84% underwent debridement (9,652). Of the 17.4% (2,415) treated at children’s hospitals, 21% (506) had repair and 79% (1,909) underwent debridement. As patients age, the odds of receiving a meniscus repair decrease (p < 0.001). Acute meniscus injury (p < 0.001) or private insurance (p < 0.05) increase the odds of having meniscus repair. However, females (p < 0.05) and Hispanics (p < 0.01) had decreased odds of having meniscus repair. As time between injury and surgery progressed, the odds of having meniscus repair versus meniscus debridement increased (p < 0.001). CONCLUSIONS: There is increasing evidence that pediatric patients have successful outcomes after meniscal repair surgery. The results of this study demonstrate that the majority of pediatric patients with meniscus tears undergo a meniscal debridement rather than a repair. Treatment at a children’s hospital, private insurance, and a short time frame between injury and surgery were positive predictors of meniscus repair over debridement. The results of the study may help inform patients, families, and referring physicians about what type of treatment a patient may receive for a meniscus tear, based on their demographic profile.

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