scholarly journals The Rate of Hospitalizations and Intensive Care Admissions in Boston Children Hospital

2020 ◽  
pp. 20-23
Author(s):  
Rajeev Nagpal ◽  
Stanislav Seltser ◽  
Nitender Goyal
Keyword(s):  
Intensive Care ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Age Groups ◽  
Robust Analysis ◽  
Course Of Illness ◽  
Life Threatening Illness ◽  
Life Threatening ◽  
Low Incidence ◽  
Icu Treatment

Much remains unknown about the overall impact of COVID-19 on the pediatric population because of the relative low incidence of symptomatic pediatric cases compared to other age groups. Recent anecdotal reports of rare and unique illnesses related to COVID-19 in this population calls for a more robust analysis. A time series analysis from open source Center for Disease Control (CDC) data on Boston Children’s Hospital over a three-week period from April 21, 2020 thru May 9, 2020 was completed. An overall downward trend of both COVID-19 hospitalizations and patients requiring Intensive Care Unit (ICU) care was found. Moreover, the ratio of patients hospitalized requiring ICU treatment decreased. These findings suggest that pediatric patients were seen earlier in the course of illness as reports emerged linking COVID-19 to symptomatic and life-threatening illness in children. This data is intended to raise this general issue to the broad readership of The Asian Journal of Pediatric Research.

Which diagnostic method should be used in which age interval in the diagnosis of adenoid hypertrophy?

2018 ◽  
Vol 7 (3) ◽  
pp. 50-54
Author(s):  
Kamil Hakan Kaya ◽  
Zeki Tolga Bilece ◽  
Harun Acıpayam ◽  
Hasan Koçak ◽  
Hüseyin Avni Ulusoy ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Pediatric Population ◽  
Age Groups ◽  
Endoscopic Examination ◽  
Adenoid Hypertrophy ◽  
Study Materials ◽  
Adenoid Tissue ◽  
Group 4 ◽  
Group 3 ◽  
Group 2

Aim: This study aims to determine the age interval for which the flexible nasopharyngoscopy (FNP) and lateral nasopharyngeal X-ray radiography (LNX) used in the diagnosis of adenoid hypertrophy more effectively in a pediatric population. Study Design: Prospective Cohort Study. Materials and Methods: 281 pediatric patients (1 to 15 years old) who were admitted to our ENT outpatient clinic with the complaints of nasal obstruction, snoring, sleep apnea through April 2016 and February 2017 and who were examined with FNP with the pre-diagnosis of adenoid hypertrophy were included in our study. All FNP examinations were evaluated by a single physician. The degree of choanal obstruction was recorded as percentage (%) with the help of the adenoid tissue image. The patients were divided into four groups according to the quality of the endoscopic examination performed during FNP examination; optimal assessment (group-1), assisted optimal assessment (group-2), assisted suboptimal assessment (group-3), and inability to assess despite assistance (group-4). LNX was performed for the re-evaluation of adenoid tissue in the patients in Group-3 and 4. Statistical analysis was performed among the groups according to the ages of the patients. Results: Optimal images were obtained with FNP in the patients aged between 1 and 2 years and 8-15 years and the expected images were obtained for choanal obstruction. However, no image could be obtained with FNP for assessment of choanal obstruction in more than 30% of patients between the ages of 3 and 8 years (31.2% and 33.3%, respectively), also in more than 50% of the patients who were 4,5,6 and 7 years old (60.6%, 56.7%, 55.8%, 66 , 6%, respectively). For this reason, their degrees of choanal obstruction were determined with LNX. Conclusion: For the optimal assessment of adenoid hypertrophy, we suggest that using LNX for the pediatric patients who are 4, 5, 6 and 7 years old and using FNP for the other age groups are more appropriate methods respectively in order not to disturb the polyclinic process of physician and for patient compliance.

scholarly journals Intubation Related Laryngeal Injuries in Pediatric Population

2021 ◽  
Vol 9 ◽  
Author(s):  
Karma Lambercy ◽  
Laurence Pincet ◽  
Kishore Sandu
Keyword(s):  
Pediatric Patients ◽  
Pediatric Population ◽  
Laryngeal Edema ◽  
Anatomical Site ◽  
Vocal Cords ◽  
Small Children ◽  
Airway Stenosis ◽  
Wide Range ◽  
Life Threatening ◽  
Retention Cysts

Introduction: Laryngeal intubation related lesions (LIRL) in pediatric patients cause extreme morbidity in both elective and emergency settings. It has a wide range of presentations from minor laryngeal edema to a life-threatening airway obstruction. We report here our units' experience with LIRL in neonates, infants, and small children.Material and Methods: This is a retrospective monocentric cohort study between January 2013 and April 2019.Results: Thirty-nine patients with intubation lesions were included in the study. We looked at the lesions type, characteristics, management, and outcome. Half the patients were premature and having comorbidities. Main LIRL were subglottic stenosis (31%), ulcers (26%), granulations (18%), retention cysts (18%), posterior glottic stenosis (13%), and vocal cords edema (5%). Unfavorable lesions causing airway stenosis were associated with an intubation duration of over 1 week and were an important factor in causing airway stenosis (p < 0.05). The endoscopic treatment performed for these lesions was lesion and anatomical site-specific. Tracheostomy was needed in five patients, and was avoided in another two. Seven patients (18%) received open surgery prior to their decannulation.Conclusions: LIRL management is challenging and stressful in the pediatric population and optimal treatment could avoid extreme morbidity in them. Intubation duration and associated comorbidities are important factors in deciding the severity of these lesions. Protocols to prevent the formation of these lesions are critical.

scholarly journals Immunocompromised Seroprevalence and Course of Illness of SARS-CoV-2 in One Pediatric Quaternary Care Center

2020 ◽  
Author(s):  
Megan Culler Freeman ◽  
Glenn J Rapsinski ◽  
Megan L Zilla ◽  
Sarah E Wheeler
Keyword(s):  
Pediatric Patients ◽  
Pediatric Population ◽  
Care Center ◽  
Organ Transplant ◽  
Respiratory Illness ◽  
Marrow Transplant ◽  
Solid Organ ◽  
Rt Pcr ◽  
Cross Sectional ◽  
Course Of Illness

Abstract Background The burden of coronavirus disease 2019 (COVID-19) is poorly understood in pediatric patients due to frequent asymptomatic and mild presentations. Additionally, the disease prevalence in pediatric immunocompromised patients remains unknown. Methods This cross-sectional study tested convenience samples from pediatric patients who had clinically indicated lab work collected and an immunocompromising condition, including oncologic diagnoses, solid organ transplant (SOT), bone marrow transplant, primary immunodeficiency, and rheumatologic conditions or inflammatory bowel disease on systemic immunosuppression, for the presence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Results We tested sera from 485 children and observed SARS-CoV-2 seroprevalence of 1.0% (Confidence Interval [CI] 95%: 0.3%–2.4%). Two patients were positive by nasopharyngeal (NP) swab Reverse transcriptase polymerase chain reaction (RT-PCR), but only 1 seroconverted. Patients with oncologic diagnoses or SOT were most likely to be tested for COVID-19 when presenting with respiratory illness as compared with other groups. Conclusions Seroprevalence of antibodies to SARS-CoV-2 in immunocompromised children was similar to that of an immunocompetent pediatric population (0.6%, CI 95%: 0.3%–1.1%), suggesting an adequate antibody response. However, none of the patients who tested positive for antibodies or via NP RT-PCR had more than a mild illness course and 2 patients did not have any reported illness, suggesting that SARS-CoV-2 may not cause a worse clinical outcome in immunosuppressed children, in contrast to immunocompromised adults.

Asthma in Pediatric Sickle Cell Acute Chest Syndrome: In An Inner City London Hospital

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2481-2481
Author(s):  
Jack L Bartram ◽  
Miriam R Fine-Goulden ◽  
Dido Green ◽  
Rahail Ahmad ◽  
Baba PD Inusa
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Sickle Cell ◽  
Pediatric Population ◽  
Acute Chest Syndrome ◽  
Course Of Illness ◽  
Reactive Protein ◽  
Large Teaching Hospital ◽  
Children With Asthma ◽  
The Uk

Abstract Acute Chest Syndrome (ACS) is the second most common cause of hospitalisation in patients with Sickle Cell Disease (SCD) and up to 25% of those admitted will require intensive care management. ACS is a leading cause of death in SCD. It may also play a role in the development of chronic lung disease in SCD patients and the prevalence of Asthma in SCD patients is high. The pathogenesis of ACS is complex. Previous work has suggested a relationship between asthma and higher risk of ACS in children with SCD. Data in the UK is limited. Our aim therefore was to describe the presentation, course and outcome of ACS in our local SCD pediatric population, compared with those children who had ACS with SCD and physician diagnosed Asthma (Asthma). Methods: The data collection took place at The Evelina Children’s Hospital, which is part of St Thomas’ Hospital, a large teaching hospital in Central London, England. There are over 400 children with SCD registered, and around 30 new SCD births per year. A retrospective analysis of patient hospital electronic and paper records was performed of 63 ACS presentations over a three year period from 2003 to 2006. Inclusion in the study required a new infiltrate on chest radiograph plus acute respiratory symptoms in a patient with SCD under the age of 16 years. The group included 16 (25%) presentations in children with SCD and Asthma. Results: No Known Asthma 47 Presentations; Mean age 6.2 yrs (range 1–15yrs); HbSS 87%, HbSC13%; Previous ACS 26% (n=12); Mean length of stay 5.4 days (range 1–27); Mortality 0; Mean C-Reactive protein (CRP) on admission 70 (normal <5); Mean oxygen saturations on presentation 92% in air (40% of patients presented with saturations <92% in air) Physician Diagnosed Asthma 16 Presentations; Mean age 4.6 (range 1–15yrs); HbSS 94%, HbSC 6%; Previous ACS 63% (n=10); Mean length of stay 5.4 (range 2–14); Mortality 0; Mean CRP on admission 41; Mean oxygen saturations on presentation 92% in air (50% of patients presented with saturations <92% in air) DISCUSSION: Demographics: Comparable in terms of age and haemoglobin genotype. Presentation: Patients with asthma were more likely to have had previous ACS. Children with asthma presented with a lower CRP. Treatment: The treatment in both groups including the use of blood transfusion, and need for transfer to intensive care were comparable. However there was an observed difference in the use of inhaled bronchodilators (non asthma 21% v asthma 50%). Steroids were rarely used (4%) to treat the patients who did not have a pre-existing diagnosis of asthma, however were used to treat most (94%) of those patients with asthma. Outcome: Length of stay was comparable, no deaths in either group. CONCLUSION: Although patients in our study group with asthma had a higher frequency of previous ACS episodes, we did not demonstrate that patients with asthma suffer a more severe course of illness.

scholarly journals Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection

2021 ◽  
Author(s):  
YuV Lobzin ◽  
AN Uskov ◽  
NV Skripchenko ◽  
AA Vilnits ◽  
MK Bekhtereva ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Kawasaki Disease ◽  
Infectious Diseases ◽  
Children And Adolescents ◽  
Pediatric Patients ◽  
Laboratory Data ◽  
Pediatric Research ◽  
Clinical Center ◽  
Low Incidence

Despite the low incidence, low mortality and relatively mild symptoms of COVID-19 in children, there has been a rise in pediatric patients who develop a condition resembling Kawasaki disease after COVID-19 or contact with individuals infected with SARS-CoV-2. This condition is known as the pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection (PIMS-TS). This review introduces the reader to the hypotheses of PIMS-TS pathogenesis, provides information about its diagnosis and treatment, presents clinical and laboratory data and describes treatments strategies used in children and adolescents hospitalized to the intensive care unit of the Pediatric Research and Clinical Center for Infectious Diseases. Besides, the review outlines the main diagnostic and prognostic challenges of PIMS-TS.

Analysis of Unplanned Intensive Care Unit Admissions in Postoperative Pediatric Patients

2016 ◽  
Vol 32 (3) ◽  
pp. 204-211 ◽  
Author(s):  
Elizabeth K. Landry ◽  
Rodney A. Gabriel ◽  
Sascha Beutler ◽  
Richard P. Dutton ◽  
Richard D. Urman
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Multivariate Logistic Regression Analysis ◽  
Data Set ◽  
Icu Admission ◽  
Increased Risk ◽  
Wide Range

Background: Currently, there are only a few retrospective, single-institution studies that have addressed the prevalence and risk factors associated with unplanned admissions to the pediatric intensive care unit (ICU) after surgery. Based on the limited amount of studies, it appears that airway and respiratory complications put a child at increased risk for unplanned ICU admission. A more extensive and diverse analysis of unplanned postoperative admissions to the ICU is needed to address risk factors that have yet to be revealed by the current literature. Aim: To establish a rate of unplanned postoperative ICU admissions in pediatric patients using a large, multi-institution data set and to further characterize the associated risk factors. Methods: Data from the National Anesthesia Clinical Outcomes Registry were analyzed. We recorded the overall risk of unplanned postoperative ICU admission in patients younger than 18 years and performed univariate and multivariate logistic regression analysis to identify the associated patient, surgical, and anesthetic-related characteristics. Results: Of the 324 818 cases analyzed, 211 reported an unexpected ICU admission. There was an increased likelihood of unplanned postoperative ICU in infants (age <1 year) and children who were classified as American Society of Anesthesiologists physical status classification of III or IV. Likewise, longer case duration and cases requiring general anesthesia were also associated with unplanned ICU admissions. Conclusion: This study establishes a rate of unplanned ICU admission following surgery in the heterogeneous pediatric population. This is the first study to utilize such a large data set encompassing a wide range of practice environments to identify risk factors leading to unplanned postoperative ICU admissions. Our study revealed that patient, surgical, and anesthetic complexity each contributed to an increased number of unplanned ICU admissions in the pediatric population.

Prevalence of Unique Pediatric Pathologies Encountered by Paramedic Students Across Age Groups

2016 ◽  
Vol 31 (4) ◽  
pp. 386-391 ◽  
Author(s):  
Eric V. Ernest ◽  
Tom B. Brazelton ◽  
Elliot D. Carhart ◽  
Jonathan R. Studnek ◽  
Patricia L. Tritt ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Saint Paul ◽  
Age Groups ◽  
Age Group ◽  
Pediatric Age ◽  
Provider Education ◽  
Publication Type ◽  
One Year

AbstractIntroductionTraditionally, Emergency Medical Services (EMS) educators have divided the pediatric population into age groups to assist in targeting their clinical and didactic curriculum. Currently, the accrediting body for paramedic training programs requires student exposure to pediatric patients based entirely on age without specifying exposure to specific pathologies within each age stratification. Identifying which pathologies are most common within the different pediatric age groups would allow educators to design curriculum targeting the most prevalent pathologies in each age group and incorporating the physiologic and psychological developmental milestones commonly seen at that age.HypothesisIt was hypothesized that there are unique clusterings of pathologies, represented by paramedic student primary impressions, that are found in different age groups which can be used to target provider education.MethodsThis is a retrospective review of prospectively collected data documented by paramedic students in the Fisdap (Field Internship Student Data Acquisition Project; Saint Paul, Minnesota USA) database over a one-year period. For the purposes of this study, pediatric patients were defined arbitrarily as those between the ages of 0-16 years. All paramedic student primary impressions recorded in Fisdap for patients aged 0-16 years were abstracted. Primary impression by age was calculated and graphed. The frequency of primary impression was then assessed for significance of trend by age with an alpha ≤.05 considered significant.ResultsThe following primary impressions showed clinically and statistically significant variability in prevalence among different pediatric age groups: respiratory distress, medical-other, abdominal pain, seizure, overdose/poisoning, behavioral, and cardiac. In patients less than 13 years old, respiratory and other-medical were the most common two primary impressions and both decreased with age. In patients 5-16 years old, the prevalence of abdominal pain and behavioral/psych increased. Bimodal distributions for overdose were seen with one spike in the toddler and another in the adolescent population. Seizures were most common in the age group associated with febrile seizure. Sepsis was seen most often in the youngest patients and its prevalence decreased with age.ConclusionThere are statistically significant variations in the frequency of paramedic student primary impressions as a function of age in the pediatric population. Emphasizing paramedic student exposure to the most common pathologies encountered in each age group, in the context of the psychological and physiological milestones of each age, may improve paramedic student pediatric practice.ErnestEV, BrazeltonTB, CarhartED, StudnekJR, TrittPL, PhilipGA, BurnettAM. Prevalence of unique pediatric pathologies encountered by paramedic students across age groups. Prehosp Disaster Med. 2016; 31(4):386–391.

scholarly journals Differential Diagnosis and Treatment of Itching in Children and Adolescents

Biomedicines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 919
Author(s):  
Seok-Young Kang ◽  
Ji-Young Um ◽  
Bo-Young Chung ◽  
Jin-Cheol Kim ◽  
Chun-Wook Park ◽  
...  
Keyword(s):  
Primary Care Physicians ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Objective Assessment ◽  
Age Groups ◽  
Treatment Modalities ◽  
Systemic Diseases ◽  
Skin Disorders ◽  
Pharmacokinetics And Pharmacodynamics

Itching is prevalent in children with skin disorders and associated with effects on their mood, quality of life, and social functioning. Surprisingly, there are no data on childhood prevalence of pruritus in the general population. The aim of this article is to explore the epidemiology, clinical manifestation, and treatment for itch (pruritus) in the pediatric population (from infancy to adolescence), and to be helpful to primary care physicians who assess and diagnose pediatric patients with itching. In this study, we searched for specific keywords using PubMed and MEDLINE (Ovid) and, then, refined the retrieved searches for each cause and treatment. As a result of reviewing the literature, atopic dermatitis was shown to be the most common cause of itching, especially during infancy and through preschool. Not only skin disorders but also systemic diseases, drugs, and postburn states can predispose an individual to itching in childhood. There are traditional and newly developed treatment modalities for itching in pediatric patients. However, because the pharmacokinetics and pharmacodynamics of childhood are different from those of adults, the medications for itching have to be applied carefully for these age groups. There are many areas to be elucidated regarding the prevalence and objective assessment of pruritus in pediatric patients. Moreover, the safety profiles of medications in the pediatric population need to be better understood. Further studies to investigate itching in childhood are warranted.

scholarly journals Evaluation of Different Methods Used to Calculate Ideal Body Weight in the Pediatric Population

2019 ◽  
Vol 24 (5) ◽  
pp. 421-430
Author(s):  
Kai Kang ◽  
Randy Absher ◽  
Elizabeth Farrington ◽  
Renee Ackley ◽  
Tsz-Yin So
Keyword(s):  
Body Weight ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Accurate Determination ◽  
Age Groups ◽  
Ideal Body Weight ◽  
Mean Difference ◽  
Ideal Body

OBJECTIVES Accurate determination of ideal body weight (IBW) in pediatric patients is important for the proper dosing of many medications and the classification of nutritional status. There is no consensus on the best method to calculate IBW. The purpose of this study is to evaluate and compare 7 different methods used to calculate IBW in the pediatric population. METHODS This was a retrospective observational study. All subjects were pediatric inpatients at a 536-bed community teaching hospital between January 1, 2016, and June 30, 2017. Subjects were divided into 2 cohorts: cohort 1 was aged 12 months and 0 day to 35 months and 30 days, and cohort 2 was aged 36 months and 0 day to 17 years and 364 days. The McLaren method was used as the reference to compare with 6 other methods: Moore method, Devine method, American Dietetic Association (ADA) method, body mass index (BMI) method, Traub equation, and simplified Traub equation. RESULTS For cohort 1 (n = 347), the Moore method was not statistically different from the McLaren method with a mean difference of −0.07 kg (95% CI: −0.14 to 0.01, p = 0.07). For cohort 2 (n = 1095), the BMI method was not statistically different from the McLaren method with a mean difference of 0.17 kg (95% CI: −0.07 to 0.40, p = 0.17). CONCLUSIONS In both cohorts, the majority of methods used to calculate IBW in pediatric patients leads to statistically different results when compared with the McLaren method. For certain methods, these differences become pronounced at high and low height percentiles and in older age groups.

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