Pediatric airway management in COVID-19 patients: consensus guidelines from the society for pediatric anesthesia's pediatric difficult intubation collaborative and the Canadian Pediatric Anesthesia Society.
Adolescent; Humans; Child; Preschool; Infant; Newborn; Guidelines as Topic; Pneumonia; Intubation; Infection Control; Infectious Disease Transmission; Consensus; Pandemics; Airway Management/ methods; Anesthesia/methods; Anesthesiology/ methods/standards; Coronavirus Infections/ therapy; Pediatrics/ methods/standards; Intratracheal/ methods/standards; Patient-to-Professional/prevention & control; Viral/ therapy
The severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019 [COVID-19]) pandemic has challenged medical systems and clinicians globally to unforeseen levels. Rapid spread of COVID-19 has forced clinicians to care for patients with a highly contagious disease without evidence-based guidelines. Using a virtual modified nominal group technique, the Pediatric Difficult Intubation Collaborative (PeDI-C), which currently includes 35 hospitals from 6 countries, generated consensus guidelines on airway management in pediatric anesthesia based on expert opinion and early data about the disease. PeDI-C identified overarching goals during care, including minimizing aerosolized respiratory secretions, minimizing the number of clinicians in contact with a patient, and recognizing that undiagnosed asymptomatic patients may shed the virus and infect health care workers. Recommendations include administering anxiolytic medications, intravenous anesthetic inductions, tracheal intubation using video laryngoscopes and cuffed tracheal tubes, use of in-line suction catheters, and modifying workflow to recover patients from anesthesia in the operating room. Importantly, PeDI-C recommends that anesthesiologists consider using appropriate personal protective equipment when performing aerosol-generating medical procedures in asymptomatic children, in addition to known or suspected children with COVID-19. Airway procedures should be done in negative pressure rooms when available. Adequate time should be allowed for operating room cleaning and air filtration between surgical cases. Research using rigorous study designs is urgently needed to inform safe practices during the
Matava CT; Kovatsis PG; Lee JK; Castro P; Denning S; Yu J; Park R; Lockman JL; Von Ungern-Sternberg B; Sabato S; Lee LK; Ayad I; Mireles S; Lardner D; Whyte S; Szolnoki J; Jagannathan N; Thompson N; Stein ML; Dalesio N; Greenberg R; McCloskey J; Peyton J; Evans F; Haydar B; Reynolds P; Chiao F; Taicher B; Templeton T; Bhalla T; Raman VT; Garcia-Marcinkiewicz A; Gálvez J; Tan J; Rehman M; Crockett C; Olomu P; Szmuk P; Glover C; Matuszczak M; Galvez I; Hunyady A; Polaner D; Gooden C; Hsu G; Gumaney H; Pérez-Pradilla C; Kiss EE; Theroux MC; Lau J; Asaf S; Ingelmo P; Engelhardt T; Hervías M; Greenwood E; Javia L; Disma N; Yaster M; Fiadjoe JE
Anesthesia and Analgesia
2020
2020-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1213/ANE.0000000000004872" target="_blank" rel="noreferrer noopener">10.1213/ANE.0000000000004872</a>
Pilot Study of Intensive Chemotherapy With Peripheral Hematopoietic Cell Support for Children Less Than 3 Years of Age With Malignant Brain Tumors, the CCG-99703 Phase I/II Study. A Report From the Children's Oncology Group.
*Hematopoietic Stem Cell Transplantation/adverse effects; Antineoplastic Agents/administration & dosage/adverse effects; Brain Neoplasms/*therapy; Carboplatin/administration & dosage/adverse effects; Child; Children's Oncology Group; Cisplatin/administration & dosage/adverse effects; Combined Modality Therapy/adverse effects/methods; Consolidation Chemotherapy; Cyclophosphamide/administration & dosage/adverse effects/therapeutic use; Etoposide/administration & dosage/adverse effects; Feasibility Studies; Female; high-dose chemotherapy; Humans; Induction Chemotherapy; Infant; infant brain tumor; Male; Pilot Projects; Preschool; stem-cell support; Thiotepa/administration & dosage/adverse effects; Treatment Outcome; Vincristine/adverse effects/therapeutic use
BACKGROUND: The primary goals of the Children's Cancer Group 99703 study were to assess the feasibility and tolerability of-as well as the response rate to-a novel dose-intensive chemotherapy regimen. METHODS: Between March 1998 and October 2004, 92 eligible patients were enrolled. Following biopsy/resection, patients received three identical cycles of Induction chemotherapy (vincristine, cyclophosphamide, etoposide, and cisplatin) administered every 21-28 days. Patients without tumor progression then received three consolidation cycles of marrow-ablative chemotherapy (thiotepa and carboplatin) followed by autologous hematopoietic cell rescue. RESULTS: The maximum tolerated dose of thiotepa was 10 mg/kg/day x 2 days per cycle. The toxic mortality rate was zero during induction and 2.6% during consolidation. Centrally evaluated response rates to induction and consolidation in evaluable patients with residual tumor were 73.3% and 66.7%, respectively. Disease progression rates on induction and consolidation were 4%. Five-year event-free survival and overall survival were 43.9 +/- 5.2% and 63.6 +/- 5% respectively. Gross total resection versus less than gross total resection were the only significant outcome comparisons: 5-year maximum tolerated dose and overall survival of 54.4 +/- 7% versus 28.9 +/- 7% (P = 0.0065) and 75.9 +/- 8% versus 48.7 +/- 8% (P = 0.0034), respectively. The 5-year maximum tolerated dose for localized (M0) versus metastatic (M1+) medulloblastoma was 67.5 +/- 9.5% versus 30 +/- 14.5% (P = 0.007). The 5-year maximum tolerated dose and overall survival for desmoplastic medulloblastoma patients versus other medulloblastoma were 78.6 +/- 11% versus 50.5 +/- 12% (P = 0.038) and 85.7 +/- 9.4% versus 60.6 +/- 11.6% (P = 0.046), respectively. CONCLUSIONS: This phase I dose-escalation study of marrow-ablative thiotepa regimen determined a maximum tolerated dose that had acceptable toxicity. Overall survival data justify this strategy for current Children's Oncology Group studies.
Cohen Bruce H; Geyer J Russell; Miller Douglas C; Curran John G; Zhou Tianni; Holmes Emi; Ingles Sue Ann; Dunkel Ira J; Hilden Joanne; Packer Roger J; Pollack Ian F; Gajjar Amar; Finlay Jonathan L
Pediatric neurology
2015
2015-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.pediatrneurol.2015.03.019" target="_blank" rel="noreferrer noopener">10.1016/j.pediatrneurol.2015.03.019</a>
Plication augmentation of the modified Hummelsheim procedure for treatment of large-angle esotropia due to abducens nerve palsy and type 1 Duane syndrome.
*Ophthalmologic Surgical Procedures; 80 and over; Abducens Nerve Diseases/complications/physiopathology/*surgery; Adolescent; Adult; Aged; Binocular/physiology; Botulinum Toxins; Child; Duane Retraction Syndrome/complications/physiopathology/*surgery; Esotropia/etiology/physiopathology/*surgery; Eye Movements/physiology; Female; Humans; Injections; Intramuscular; Male; Middle Aged; Neuromuscular Agents/administration & dosage; Oculomotor Muscles/drug effects/physiopathology/*surgery; Preschool; Retrospective Studies; Suture Techniques; Tendon Transfer; Type A/administration & dosage; Vision; Young Adult
BACKGROUND: Multiple procedures have been described to treat a large-angle esodeviation with an associated abduction deficit. We report a plication augmentation of the Hummelsheim procedure for the management of esotropia and severe abduction deficit due to abducens nerve palsy or type 1 Duane syndrome. METHODS: The medical records of patients operated on using the plication augmentation Hummelsheim procedure at two tertiary centers were retrospectively reviewed. The surgery involved ipsilateral lateral rectus plication, half muscle transposition of the vertical rectus muscles to the paralytic plicated lateral rectus, Foster augmentation sutures, and ipsilateral medial rectus recession or botulinum toxin injection if it was found to be tight on intraoperative forced duction testing. Pre- and postoperative deviations, ocular motility findings, and complications were noted. RESULTS: A total of 13 patients were included, all of whom had an esotropia with profound abduction deficit (-4 or more). Postoperative deviations ranged from 14(Delta) of esotropia to 14(Delta) of exotropia, with significant improvement of the abductive motion. No patient developed anterior segment ischemia. CONCLUSIONS: The plication augmentation Hummelsheim procedure resulted in correction of even very large esodeviations and improvement of the abduction force. This procedure may also better preserve the blood supply to the anterior segment compared to other surgical approaches.
Kinori Michael; Miller Kyle E; Cochran Megan; Patil Preeti A; El Sahn Mahmoud; Khayali Salma; Robbins Shira L; Hertle Richard W; Granet David B
Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus
2015
2015-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jaapos.2015.05.005" target="_blank" rel="noreferrer noopener">10.1016/j.jaapos.2015.05.005</a>
Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011.
Adolescence; Adolescent; Adult; Aged; Ambulatory Care – Statistics and Numerical Data; Ambulatory Care/*statistics & numerical data; Anti-Bacterial Agents/*therapeutic use; Antibiotics – Therapeutic Use; Child; Female; Health Care Surveys; Human; Humans; Inappropriate Prescribing – Statistics and Numerical Data; Inappropriate Prescribing/*statistics & numerical data; Infant; Male; Middle Age; Middle Aged; Newborn; Otitis Media; Otitis Media – Drug Therapy; Pharyngitis – Drug Therapy; Pharyngitis/drug therapy; Physicians'/*statistics & numerical data; Practice Patterns; Preschool; Prevalence; Respiratory Tract Infections – Drug Therapy; Respiratory Tract Infections/drug therapy; Suppurative/*drug therapy; Surveys; United States
IMPORTANCE: The National Action Plan for Combating Antibiotic-Resistant Bacteria set a goal of reducing inappropriate outpatient antibiotic use by 50% by 2020, but the extent of inappropriate outpatient antibiotic use is unknown. OBJECTIVE: To estimate the rates of outpatient oral antibiotic prescribing by age and diagnosis, and the estimated portions of antibiotic use that may be inappropriate in adults and children in the United States. DESIGN, SETTING, AND PARTICIPANTS: Using the 2010-2011 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, annual numbers and population-adjusted rates with 95% confidence intervals of ambulatory visits with oral antibiotic prescriptions by age, region, and diagnosis in the United States were estimated. EXPOSURES: Ambulatory care visits. MAIN OUTCOMES AND MEASURES: Based on national guidelines and regional variation in prescribing, diagnosis-specific prevalence and rates of total and appropriate antibiotic prescriptions were determined. These rates were combined to calculate an estimate of the appropriate annual rate of antibiotic prescriptions per 1000 population. RESULTS: Of the 184,032 sampled visits, 12.6% of visits (95% CI, 12.0%-13.3%) resulted in antibiotic prescriptions. Sinusitis was the single diagnosis associated with the most antibiotic prescriptions per 1000 population (56 antibiotic prescriptions [95% CI, 48-64]), followed by suppurative otitis media (47 antibiotic prescriptions [95% CI, 41-54]), and pharyngitis (43 antibiotic prescriptions [95% CI, 38-49]). Collectively, acute respiratory conditions per 1000 population led to 221 antibiotic prescriptions (95% CI, 198-245) annually, but only 111 antibiotic prescriptions were estimated to be appropriate for these conditions. Per 1000 population, among all conditions and ages combined in 2010-2011, an estimated 506 antibiotic prescriptions (95% CI, 458-554) were written annually, and, of these, 353 antibiotic prescriptions were estimated to be appropriate antibiotic prescriptions. CONCLUSIONS AND RELEVANCE: In the United States in 2010-2011, there was an estimated annual antibiotic prescription rate per 1000 population of 506, but only an estimated 353 antibiotic prescriptions were likely appropriate, supporting the need for establishing a goal for outpatient antibiotic stewardship.
Fleming-Dutra Katherine E; Hersh Adam L; Shapiro Daniel J; Bartoces Monina; Enns Eva A; File Thomas M Jr; Finkelstein Jonathan A; Gerber Jeffrey S; Hyun David Y; Linder Jeffrey A; Lynfield Ruth; Margolis David J; May Larissa S; Merenstein Daniel; Metlay Joshua P; Newland Jason G; Piccirillo Jay F; Roberts Rebecca M; Sanchez Guillermo V; Suda Katie J; Thomas Ann; Woo Teri Moser; Zetts Rachel M; Hicks Lauri A
JAMA
2016
2016-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1001/jama.2016.4151" target="_blank" rel="noreferrer noopener">10.1001/jama.2016.4151</a>
Recognition of leukemia in skeletal remains: report and comparison of two cases.
Acute/*pathology; Archaeology; Bone and Bones/diagnostic imaging/*pathology; Child; Female; Humans; Leukemia; Male; Middle Aged; Museums; Myeloid; Precursor Cell Lymphoblastic Leukemia-Lymphoma/*pathology; Preschool; Radiography; Skull/diagnostic imaging/pathology; Spine/diagnostic imaging/pathology
Recognition of disease in the archeologic record is facilitated by characterization of the skeletal impact of documented (in life) disease. The present study describes the osteological manifestations of leukemia as identified in the skeletons of two individuals diagnosed during life: a 3-year-old black girl with acute lymphocytic leukemia and a 60-year-old white male with acute myelogenous leukemia in the Hamann-Todd collection. Contrasting with the lack of specificity of radiologic findings, macroscopic skeletal changes appear sufficiently specific to allow distinguishing leukemia from other forms of cancer. While leukemia appears confidently diagnosable, distinguishing among the varieties (e.g., myelogenous and lymphocytic) does not appear possible at this time. Skeletal findings in leukemia are presented in tabular form to facilitate their application to future diagnosis of the disease in the archaeological record.
Rothschild B M; Hershkovitz I; Dutour O; Latimer B; Rothschild C; Jellema L M
American journal of physical anthropology
1997
1997-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1002/(SICI)1096-8644(199704)102:4%3C481::AID-AJPA5%3E3.0.CO;2-V" target="_blank" rel="noreferrer noopener">10.1002/(SICI)1096-8644(199704)102:4%3C481::AID-AJPA5%3E3.0.CO;2-V</a>
Screen Exposure During Daily Routines and a Young Child's Risk for Having Social-Emotional Delay.
*Child Development; Activities of Daily Living; Affective Disorders; Caregivers; Child; child development; Child Development – Evaluation; Computers/*statistics & numerical data; Cross Sectional Studies; Cross-Sectional Studies; emotions; Female; Human; Humans; Infant; Male; media; New York; Ohio; Preschool; Questionnaires; Race Factors; Risk Factors; screen; Sedentary Behavior; Social Behavior; Surveys and Questionnaires; Television/*statistics & numerical data
This cross-sectional study assessed associations between social-emotional development in young children and their number of daily routines involving an electronic screen. We hypothesized children with poor social-emotional development have a significant portion of daily routines occurring with a screen. Two hundred and ten female caregivers of typically developing children 12 to 36 months old completed the Ages and Stages Questionnaire: Social-Emotional (ASQ: SE) and a media diary. Caregivers completed the diary for 1 day around 10 daily routines (Waking Up, Diapering/Toileting, Dressing, Breakfast, Lunch, Naptime, Playtime, Dinner, Bath, and Bedtime). Median number of daily routines occurring with a screen for children at risk and not at risk for social-emotional delay (as defined by the ASQ: SE) was 7 versus 5. Children at risk for social-emotional delay were 5.8 times more likely to have \textgreater/=5 routines occurring with a screen as compared to children not at risk for delay (chi1(2) = 9.28, N = 210, P = .002; 95% confidence interval = 1.66-20.39).
Raman Sajani; Guerrero-Duby Sara; McCullough Jennifer L; Brown Miraides; Ostrowski-Delahanty Sarah; Langkamp Diane; Duby John C
Clinical pediatrics
2017
2017-11
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/0009922816684600" target="_blank" rel="noreferrer noopener">10.1177/0009922816684600</a>
Streptococcus pneumoniae antimicrobial susceptibility testing.
*Drug Resistance; Anti-Bacterial Agents/*pharmacology; Child; Humans; Infant; Microbial; Microbial Sensitivity Tests/*methods; Preschool; Sensitivity and Specificity; Streptococcus pneumoniae/*drug effects/isolation & purification
Venglarcik J S 3rd
The Pediatric infectious disease journal
2000
2000-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/00006454-200004000-00013" target="_blank" rel="noreferrer noopener">10.1097/00006454-200004000-00013</a>
Technique for preservation of penile skin in genital reconstruction: free graft to the scrotum.
*Free Tissue Flaps; *Skin Transplantation; Adolescence; Adolescent; Child; Epispadias/*surgery; Humans; Hypospadias – Surgery; Hypospadias/*surgery; Infant; Male; Penis – Surgery; Penis/*surgery; Preschool; Reconstructive – Methods; Reconstructive Surgical Procedures/*methods; Reoperation; Scrotum – Surgery; Scrotum/*surgery; Skin; Skin Transplantation; Surgery; Surgical Flaps; Tissue Banks; Urogenital Abnormalities – Surgery; Young Adult
OBJECTIVE: To describe a new technique to preserve the penile epithelium with good cosmetic results when additional surgery is a significant possibility. Complex genital reconstruction can require multiple procedures. METHODS: Seven patients underwent grafting of the penile epithelium to the scrotum during genital reconstruction to bank the tissue for potential future use. The graft size was 8-40 mm in the maximal length. RESULTS: The median age at surgery was 8.1 months. The median interval to the last follow-up examination after surgery was 13.5 months. All 7 patients demonstrated excellent wound healing with good cosmetic results. CONCLUSION: In patients with complex genital anomalies, nonhair-bearing epithelium is a valuable asset. At times, the paucity of available local tissue necessitates autografting with nongenital epithelium. The need for nongenital tissue can be reduced if excess penile skin is banked for potential use at a later date. We describe a technique in which the penile skin is preserved for potential future reconstruction using free grafting to the scrotum.
Massanyi Eric Z; McMahon Daniel R
Urology
2011
2011-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.urology.2011.04.015" target="_blank" rel="noreferrer noopener">10.1016/j.urology.2011.04.015</a>
Temporal artery temperature measurements in healthy infants, children, and adolescents.
Adolescent; Body Temperature/*physiology; Child; Cohort Studies; Confidence Intervals; Female; Humans; Infant; Male; Newborn; Preschool; Reference Values; Sensitivity and Specificity; Skin Temperature/physiology; Temporal Arteries; Thermometers/*standards
A noninvasive temporal artery thermometer that uses arterial heat balance technology has been compared to rectal and ear thermometry and is available in the marketplace. This study was undertaken to establish mean temperatures and temperatures 2 standard deviations above the mean for healthy infants, children, and adolescents. Temperatures were measured in healthy patients 0 to 18 years of age using a noninvasive temporal artery thermometer. Temperatures were measured in 2,346 patients. Mean temperatures and temperatures 2 standard deviations above the mean were: 37.1 degrees C (38.1 degrees C) for 383 infants 0 to 2 months; 36.9 degrees C (37.9 degrees C) for 860 children 3 to 47 months; 36.8 degrees C (37.8 degrees C) for 680 children 4 to 9 years; and 36.7 degrees C (37.8 degrees C) for 423 adolescents 10 to 18 years. There were no significant differences in temperatures in white compared to African-American children, children with or without perspiration on their forehead, or between measurements taken on the left compared to the right side of the forehead. This study provides information about temporal artery temperatures in healthy infants and children that can serve as a basis for interpreting temperature measurements in ill children when the same instrument is used.
Roy Sumita; Powell Keith; Gerson Lowell W
Clinical pediatrics
2003
2003-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/000992280304200508" target="_blank" rel="noreferrer noopener">10.1177/000992280304200508</a>
Temporal artery temperature measurements in healthy infants, children, and adolescents.
Female; Male; Ohio; Child; Infant; Analysis of Variance; Confidence Intervals; Temporal Arteries; Human; Convenience Sample; Descriptive Research; Descriptive Statistics; Funding Source; Data Analysis Software; Adolescence; Blacks; Whites; Preschool; Newborn; Body Temperature Determination – In Adolescence; Body Temperature Determination – In Infancy and Childhood
Roy S; Powell K; Gerson L W
Clinical pediatrics
2003
2003-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/000992280304200508" target="_blank" rel="noreferrer noopener">10.1177/000992280304200508</a>
The consultation and referral process. A report from NEON. Northeastern Ohio Network Research Group.
Adult; Female; Humans; Male; Middle Aged; Ohio; Adolescent; Aged; Child; Cross-Sectional Studies; United States; Prospective Studies; *Medicine; Physicians; *Communication; Interprofessional Relations; *Specialization; Family; *Family Practice/statistics & numerical data; *Referral and Consultation/statistics & numerical data; Ambulatory Care; Preschool
BACKGROUND: Consultation and referral are essential components of the practice of primary care. Despite this, little is known about the factors that contribute to the success of a referral. We examined the short-term outcomes of communication between family physicians and consultants during the referral process. METHODS: The study setting was six family practice centers in northeastern Ohio. All eligible physicians at each center participated in data collection by means of a card study. Data was recorded on any patient who received a referral to a physician or nonphysician provider during the month of July 1994. One year later, referrals were followed up by physician questionnaire. RESULTS: Three hundred nine of 5172 total patients were referred (5.97 referrals per 100 office visits). At follow-up, the family physicians reported that 63% of patients had visited the consultant, 14% had not, and the physician had no knowledge of the actions taken by the other 23%. The referring physician received feedback from the consultant regarding 55% of the patients referred. Receipt of feedback was strongly related to communication by the family physician to the consultant at the time of referral. Physicians who received feedback were the most satisfied with communication from the consultant and the care their patient had received. CONCLUSIONS: Primary care physicians can influence the likelihood of receiving feedback from a consultant by initiating communication with the consultant. A referral wherein the physicians involved do not communicate with one another results in physician dissatisfaction. Primary care physicians must practice strategies to improve the referral process.
Bourguet C C; Gilchrist V; McCord G
The Journal of Family Practice
1998
1998-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
The epidemiology of respiratory tract infections.
80 and over; Adolescent; Adult; Age Factors; Aged; Child; Community-Acquired Infections/epidemiology; Cross Infection/epidemiology; Drug Resistance; Female; Humans; Incidence; Infant; Male; Microbial; Middle Aged; Newborn; Preschool; Respiratory Tract Diseases/*epidemiology/mortality/prevention & control; Risk Factors; United States/epidemiology
Respiratory tract infections (RTIs) are the most common, and potentially most severe, of infections treated by health care practitioners. Lower RTIs along with influenza, are the most common cause of death by infection in the United States. Risk factors for pneumonia and other respiratory tract infections include: extremes of age (very young and elderly), smoking, alcoholism, immunosuppression, and comorbid conditions. The microbial cause of RTIs vary depending on the infection (i.e., pneumonia compared with acute bacterial sinusitis), setting (i.e., community-acquired compared with nosocomial), and other factors. The causative pathogens associated with CAP have changed in prevalence over time. Although Streptococcus pneumoniae remains the most common causative pathogen, a number of newer pathogens, such as Chlamydia pneumoniae and sin nombre virus, have been recognized in recent years. The emerging antimicrobial resistance of respiratory pathogens (most notably S. pneumoniae) has also increased the challenge for appropriate management of RTI. An awareness of the epidemiology and cause of specific respiratory infections should optimize care.
File T M
Seminars in respiratory infections
2000
2000-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1053/srin.2000.18059" target="_blank" rel="noreferrer noopener">10.1053/srin.2000.18059</a>
The natural history of halo nevi: a retrospective case series.
*Skin Pigmentation; Adolescence; Adolescent; Adult; Child; Databases; Disease Progression; Disease Remission; Factual/*statistics & numerical data; Female; Follow-Up Studies; Halo – Pathology; Halo – Surgery; Halo/*pathology/*surgery; Human; Humans; Male; Middle Age; Middle Aged; Nevus; Preschool; Prospective Studies; Questionnaires; Remission; Remission Induction; Resource Databases; Retrospective Design; Retrospective Studies; Skin Pigmentation; Spontaneous; Surveys and Questionnaires; Young Adult
BACKGROUND: The time period between onset of depigmentation around the halo nevus (HN) to complete resolution of the nevus and halo has not been well studied. OBJECTIVE: We sought to better understand the natural history of the HN. METHODS: A retrospective chart review of patients with a clinical diagnosis of HN selected from a private practice database (1994-2010) was performed. In all, 52 patients with 80 HN were identified. The current stage of the HN was determined by a follow-up questionnaire and physical examination of 36 patients with 56 HN. RESULTS: Seven HN were excised. Of the remaining 49 HN, 51% (25) demonstrated no change in the halo or nevus after an average of 4.2 years; 14.3% (7) demonstrated partial nevus regression with persistence of the halo after an average of 6.7 years; 4.1% (2) demonstrated complete involution of the nevus with persistent halo depigmentation after an average of 7.7 years; 8.2% (4) demonstrated complete nevus involution with some repigmentation of the halo after an average of 11.8 years; 22.4% (11) demonstrated complete resolution of the nevus with complete repigmentation of the halo after an average of 7.8 years. LIMITATION: Some subjects were lost to follow-up. The time of initial HN onset was dependent on patient recall. CONCLUSION: These results demonstrate that HN typically persist for a decade or longer. A subgroup may progress through stages of involution with a return to normal-appearing skin, but even these lesions persisted for an average of 7.8 years. Education about the prolonged natural history of HN may reassure patients and avoid unnecessary excision.
Aouthmany Mouhammad; Weinstein Mara; Zirwas Matthew J; Brodell Robert T
Journal of the American Academy of Dermatology
2012
2012-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jaad.2011.11.937" target="_blank" rel="noreferrer noopener">10.1016/j.jaad.2011.11.937</a>
The otolithic organ as a receptor of vestibular hearing revealed by vestibular-evoked myogenic potentials in patients with inner ear anomalies.
Adolescent; Adult; Audiometry; Auditory Threshold; Bone Conduction; Child; Cochlea/abnormalities/diagnostic imaging; Cochlear Diseases/complications/diagnostic imaging/*physiopathology; Deafness/etiology; Evoked Potentials; Female; Hearing/*physiology; Humans; Labyrinth/*physiopathology; Male; Neck Muscles/*physiopathology; Otolithic Membrane/*physiopathology; Preschool; Pure-Tone; Reaction Time; Saccule and Utricle/physiopathology; Tomography; Vestibule; X-Ray Computed
The human vestibule has preserved an ancestral sound sensitivity and it has been suggested that a reflex could originate from this property underlying cervical muscle micro-contractions secondary to strong acoustic stimulation. Previous studies have established that an early component of loud sound-evoked myogenic potentials from the sternocleidomastoid muscle originate in the vestibule. This is based on findings that the response can still be obtained from patients with complete loss of cochlear and vestibular (semi-circular canal) function. Our data confirm, in a more direct way, a saccular origin of this short-latency acoustic response and verifies that a saccular acoustic response persists in the human ear. The contribution of this response to the perception of loud sounds is discussed. It is concluded that vestibular response to sound might be used to assist in the rehabilitation of deafness.
Sheykholeslami Kianoush; Kaga Kimitaka
Hearing research
2002
2002-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/s0378-5955(02)00278-2" target="_blank" rel="noreferrer noopener">10.1016/s0378-5955(02)00278-2</a>
Topical corticosteroid-induced acne. Three treatment strategies to break the 'addiction' cycle.
Female; Humans; Child; Anti-Infective Agents; Glucocorticoids; Anti-Inflammatory Agents/*adverse effects; Acne Vulgaris/*chemically induced; Anti-Bacterial Agents/administration & dosage/therapeutic use; Betamethasone/adverse effects; Clindamycin/administration & dosage/therapeutic use; Clotrimazole/adverse effects; Desonide/adverse effects; Erythema/chemically induced; Erythromycin Ethylsuccinate/administration & dosage/therapeutic use; Facial Dermatoses/*chemically induced; Preschool; Administration; Oral; Cutaneous; Local/adverse effects
Brodell R T; O'Brien M J Jr
Postgraduate medicine
1999
1999-11
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.3810/pgm.1999.11.796" target="_blank" rel="noreferrer noopener">10.3810/pgm.1999.11.796</a>
Unexplained fever in infants and young children: how to manage.
Child; Infant; Practice Guidelines; Preschool; Bacterial Infections – Diagnosis – In Infancy and Childhood; Fever – Therapy – In Infancy and Childhood; Primary Health Care – In Infancy and Childhood
If an infant 60 days old or younger who presents with unexplained fever (temperature 38 degrees C [100.4 degrees F] or greater) appears ill, evaluate for sepsis, hospitalize, and give parenteral antibiotics. For well-appearing infants whose temperature is 38 degrees ( (100.4 degrees F) or greater, order a complete blood cell count, urinalysis and, when indicated, stool examination. If the peripheral white blood cell (WBC) count is greater than 15,000/microL or less than 5000/miroL, urine contains more than 10 WBCs per high-power field or a dipstick reagent strip is positive, or fecal analysis shows more than 5 WBCs per high-power field, hospitalize the infant, obtain blood and urine cultures, order lumbar puncture, and administer parenteral antimicrobials. Risk criteria for serious bacterial infection are more flexible for children aged 61 days to 36 months: the cutoff temperature is 39 degrees C (102.2 degrees F) or higher, greater reliance is placed on physical examination findings, and laboratory findings can be interpreted with greater leeway. If the WBC count is less than 15,000/miroL, only follow-up is required; if the count is higher, obtain a blood culture and administer a dose of ceftriaxone.
Bower J R; Powell K R
Consultant (00107069)
2001
2001-04-15
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Unintentional injuries. Risk factors in preschool children.
Female; Humans; Male; Ohio; Chronic Disease; Child; Risk Factors; Body Weight; Educational Status; Birth Order; Family Characteristics; Mothers; Wounds and Injuries/epidemiology/*etiology; Preschool; Accidents; Traffic; Home
Successful strategies for preventing childhood injuries require better understanding of injury epidemiology. A case-control study was designed to identify risk factors for injury among preschool patients of a university-affiliated, community-based family practice center. Thirty-four children who were injured during a 1-year period and 36 age- and sex-matched controls were included. A description of the injury incident and data from each child's medical record and a parent interview were recorded. All injuries were relatively minor. The following were associated with increased injury risk: a history of a chronic medical condition; weight in the lowest 25th percentile of the national distribution; birth order of third or later in the family; maternal education higher than the high school level; and, possibly, a history of previous injury.
Bourguet C C; McArtor R E
American journal of diseases of children (1960)
1989
1989-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1001/archpedi.1989.02150170054021" target="_blank" rel="noreferrer noopener">10.1001/archpedi.1989.02150170054021</a>
Urothelial extension of Wilms tumor presenting as a prolapsing urethral mass.
Child; Female; Humans; Kidney Neoplasms/diagnosis/*pathology; Preschool; Prolapse; Ureter/*abnormalities; Urethral Diseases/etiology; Urethral Neoplasms/complications/*secondary; Wilms Tumor/complications/diagnosis/*secondary
We report a unique case of Wilms tumor presenting as a urethral mass in a patient with bilateral ureteral duplication. The prolapsing urothelial component was contiguous with the intrarenal Wilms tumor and consisted of fetal skeletal muscle free of blastemal or tubular elements.
Stanley K; Khoudary K P; Nasrallah P F
The Journal of urology
1995
1995-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/s0022-5347(01)67384-1" target="_blank" rel="noreferrer noopener">10.1016/s0022-5347(01)67384-1</a>
Use of procalcitonin for the prediction and treatment of acute bacterial infection in children.
Anti-Bacterial Agents/*administration & dosage; Antibiotics – Administration and Dosage; Bacteremia – Blood; Bacteremia – Diagnosis; Bacteremia/blood/diagnosis; Bacterial Infections – Blood; Bacterial Infections – Diagnosis; Bacterial Infections – Drug Therapy; Bacterial Infections/blood/*diagnosis/drug therapy; Biological Markers – Blood; Biomarkers/blood; Calcitonin – Blood; Calcitonin Gene-Related Peptide; Calcitonin/*blood; Child; Humans; Inflammation – Blood; Inflammation – Diagnosis; Inflammation/blood/diagnosis; Predictive Value of Tests; Preschool; Prognosis; Protein Precursors – Blood; Protein Precursors/*blood; Sensitivity and Specificity
PURPOSE OF REVIEW: Procalcitonin (PCT) is increasingly utilized to determine the presence of infection or to guide antibiotic therapy. This review will highlight the diagnostic and prognostic utility of serum PCT in children. RECENT FINDINGS: Recent studies endorse the use of serum PCT to detect invasive infection, to differentiate sepsis from noninfectious systemic inflammatory response syndrome, and to guide antibiotic therapy. Typical values for maximal sensitivity and specificity are less than 0.5 ng/ml for noninfectious inflammation and greater than 2.0 ng/ml for bacterial sepsis. PCT appears to be a reliable indicator of infection. PCT has performed better than C-reactive protein in some settings, though pediatric comparative data are lacking. PCT may aid in diagnosing infection in challenging patient populations such as those with sickle cell disease, congenital heart defects, neutropenia, and indwelling central venous catheters. Antibiotic therapy tailored to serial PCT measurements may shorten the antibiotic exposure without increasing treatment failure. SUMMARY: PCT is a reliable serum marker for determining the presence or absence of invasive bacterial infection and response to antibiotic therapy. Tailoring antibiotics to PCT levels may reduce the duration of therapy without increasing treatment failure, but more research is needed in children.
Pierce Richard; Bigham Michael T; Giuliano John S Jr
Current opinion in pediatrics
2014
2014-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/MOP.0000000000000092" target="_blank" rel="noreferrer noopener">10.1097/MOP.0000000000000092</a>
Vestibular-evoked myogenic potentials in three patients with large vestibular aqueduct.
Adult; Auditory Threshold/*physiology; Auditory/*physiology; Bilateral/diagnosis/etiology; Child; Evoked Potentials; Female; Hearing Loss; Humans; Preschool; Saccule and Utricle/*physiopathology; Sensorineural/diagnosis/etiology; Tomography; Vestibular Aqueduct/*abnormalities/*physiopathology; Vestibular Diseases/complications/congenital/*physiopathology; Vestibular Function Tests; X-Ray Computed
An enlarged vestibular aqueduct (LVA) is a common congenital inner ear anomaly responsible for some unusual vestibular and audiological symptoms. Most of the cases show bilateral early onset and progressive hearing loss in children. The gross appearance on CT scan of the inner ear is generally normal. However, precise measurements of the inner ear components reveal abnormal dimensions, which may account for the accompanying auditory and vestibular dysfunction. Despite extensive studies on hearing and the vestibular apparatus, saccular function is not studied. To our knowledge this is the first report of saccular malfunction in three patients with LVA by means of vestibular evoked myogenic potentials. Conventional audiograms revealed bilateral severe sensorineural hearing loss in two patients and mixed type hearing loss in one patient. Two of the patients complained about vertigo and dizziness but vestibular assessments of the patients showed normal results. The diagnosis had been made by high-resolution CT scans and MR images of the skull that showed LVA in the absence of other anomalies. The VEMP threshold measured from the ear with LVA in two patients with unilateral enlargement of the vestibular aqueduct was 75-80 dB nHL whereas the threshold from normal ears was 95 dB nHL. The third patient with mixed type hearing loss and bilateral LVA had VEMP responses despite a big air-bone gap in the low frequency range. The VEMP in this patient was greater in amplitude and lower in threshold in the operated ear (the patient had a tympanoplasty which did not improve her hearing). These findings and results of other patients with Tullio phenomenon and superior semicircular canal dehiscence, who also showed lower VEMP threshold, confirmed the theory of a 'third window' that allows volume and pressure displacements, and thus larger deflection of the vestibular sensors, which would cause the vestibular organ to be more responsive to sound and pressure changes.
Sheykholeslami Kianoush; Schmerber Sebastien; Habiby Kermany Mohammad; Kaga Kimitaka
Hearing research
2004
2004-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/S0378-5955(04)00018-8" target="_blank" rel="noreferrer noopener">10.1016/S0378-5955(04)00018-8</a>