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Chest pain pediatric

Israel Fernandez-Pineda, Aaron D Seims, Lisa VanHouwelingen, Hafeez Abdelhafeez, Huiyun Wu, Jianrong Wu, Andrew J Murphy, Andrew M Davidoff
BACKGROUND: Uniportal video-assisted thoracic surgery (VATS) is gaining popularity among thoracic surgeons, but the limited space in the thorax of children makes uniportal VATS difficult to perform. The purpose of this study was to evaluate procedural and outcome differences between a modified uniportal VATS (MU-VATS) and three-port VATS (TP-VATS) for peripheral lung nodule biopsy in pediatric cancer patients. MATERIALS AND METHODS: This is an Institutional Review Board-approved retrospective analysis of all consecutive MU-VATS and TP-VATS peripheral lung nodule biopsies performed at a single institution between June 2014 and December 2016...
November 10, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Joana Verdelho Andrade, Joana Magalhães, Catarina Resende, Dora Gomes, Gabriela Laranjo, Joana Campos, Elisabete Santos, Cristina Faria
INTRODUCTION: Pulmonary thromboembolism and deep venous thrombosis occur in pediatric age, with unknown incidence, morbidity and mortality. Our aim is to review the epidemiology, clinical presentation, complementary diagnostic tests and prognosis of patients with pulmonary thromboembolism and deep venous thrombosis. MATERIAL AND METHODS: Retrospective, descriptive and analytical study of pediatric patients admitted to a Level II hospital for pulmonary thromboembolism and deep venous thrombosis, between 2000 and 2014...
September 28, 2018: Acta Médica Portuguesa
Jia-Feng Wu, Chieh Chung, Ping-Huei Tseng, I-Jung Tsai, Yi-Cheng Lin, Chia-Hsiang Yang
OBJECTIVES: We investigated the diagnostic utility of distal contractile integral (DCI) to esophageal impedance integral (EII) ratio (DCIIR) in high-resolution impedance manometry (HRIM) of ineffective esophageal motility (IEM) in children. METHODS: We performed HRIM in 31 children with dysphagia, odynophagia, chronic vomiting, chest pain, or heartburn sensation. Based on the Chicago classification version 3.0, 20 subjects were diagnosed with IEM, and 11 subjects were normal...
October 1, 2018: Pediatric Research
Soham Dasgupta, Megan Stark, Sonal Bhatt, Peter Fischbach, Shriprasad Deshpande
INTRODUCTION: A cardiac cause is an extremely rare etiology of pediatric chest pain. Despite its low sensitivity/specificity, exercise stress testing (EST) is widely used to determine the prognosis in patients with suspected/established coronary disease. We aimed to look at the utility of a combined cardiopulmonary EST in the evaluation of pediatric patients with chest pain. METHODS: After institutional review board approval, a retrospective chart review was performed of all pediatric patients who were referred for an EST for chest pain from January 2014 to 2017...
October 9, 2018: Congenital Heart Disease
Shiv Gandhi, Miranda Lin, Sharon R Smith, Jesse J Sturm
Background: Electrocardiograms (ECGs) are ordered in the pediatric emergency room for a wide variety of chief complaints. Objectives: Criteria are lacking as to when physicians should obtain ECGs. This study uses a large retrospective cohort of 880 pediatric emergency department (ED) patients to highlight objective criteria including significant medical history and specific vital sign abnormalities to guide clinicians as to which patients might have an abnormal ECG...
September 2018: Annals of Pediatric Cardiology
Stephanie Young, Stanley T Lau, Donald B Shaul, Walter D Vazquez, Edward Y Yoo, Roman M Sydorak
BACKGROUND: Reconstruction of complex chest wall deformities is a surgical challenge. A new technique can improve long-term outcomes and result in high patient satisfaction. METHODS: A multicenter study was conducted on pediatric patients undergoing complex chest wall reconstruction between September 2015 and January 2018. The evolution of the technique using open reduction and internal fixation (ORIF) with SternaLock® and RibFix® to repair chest wall deformities is described...
September 10, 2018: Journal of Pediatric Surgery
Alexander K C Leung, Kin Fon Leong, Joseph M Lam
BACKGROUND: Erythema nodosum can be associated with a number of systemic diseases. There is, however, a paucity of information in the pediatric literature on this condition. The purpose of this article is to familiarize pediatricians with the evaluation, diagnosis, and treatment of erythema nodosum. DATA SOURCES: A PubMed search was completed in Clinical Queries using the key terms "erythema nodosum". RESULTS: Clinically, erythema nodosum presents with a sudden onset of painful, erythematous, subcutaneous nodules mainly localized to the pretibial areas...
December 2018: World Journal of Pediatrics: WJP
Jeremy Mark Steele, Kenneth G Zahka
Pediatric chest pain is a common reason for cardiology referral, and evaluation of exertional chest pain requires proper delineation of coronary anatomy. Congenital coronary anomalies are rare and often benign. However, certain anomalies such as intramural coronary arteries and myocardial bridges have been associated with angina, ventricular arrhythmias, and sudden cardiac death. We present a case of a 10-year-old male with exertional chest pain whose coronary anatomy could not be defined by echocardiography and further evaluation by computed tomography angiography revealed a rare congenital coronary anomaly...
September 28, 2018: Pediatric Cardiology
Chelsea R Majerus, Trevor L Tredway, Nicole K Yun, James M Gerard
OBJECTIVES: Previous studies have not evaluated the utility of obtaining chest radiographs (CXR) in patients with acute asthma exacerbation reporting chest pain. The aims of this study were to evaluate the symptom of chest pain as a predictor for clinicians obtaining a CXR in these patients and to evaluate chest pain as a predictor of a positive CXR finding. METHODS: This was a retrospective chart review of patients, ages 2 to 18 years, presenting for acute asthma exacerbation to the emergency department from August 1, 2014, to March 31, 2016...
September 25, 2018: Pediatric Emergency Care
Shefali Thaker, Elise McKenna, Christine Rader, Meghna V Misra
BACKGROUND: Pectus excavatum is a common chest wall anomaly. Achieving optimal pain control is a priority for adolescents undergoing surgical correction of this condition. Options for pain control include the use of subcutaneous catheters (On-Q® pumps) and epidurals. The objective of this study is to demonstrate the feasibility of using subcutaneous catheters for pain control and to compare them with the use of epidurals during surgical correction of pectus excavatum. MATERIALS AND METHODS: We identified patients who underwent pectus excavatum repair at our institution between January 2010 and August 2016...
September 25, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Chiara Ossella, Floriana DellʼOmo, Elena Zanetti, Isabella Ferdinanda Pestalozza, Pierluigi Galizia, Salvatore Tripodi
BACKGROUND: Belly dancer syndrome is a rare condition consisting of involuntary, repetitive, often rhythmic contractions of the diaphragm, causing undulating movements of the abdomen that recall those of a belly dancer. It is frequently associated with pain or discomfort in the upper abdomen or lower chest, but clinical symptoms are highly variable often resulting in late diagnosis. Very few pediatric cases have been reported, all of which were secondary to other conditions, and to our knowledge, no idiopathic cases of Belly Dancer Syndrome have been reported in children...
August 8, 2018: Pediatric Emergency Care
Gideon Sandler, Andrea Hayes-Jordan
Pediatric chest wall tumors are rare. Malignancies predominate of which sarcomas are the most common. Their resection and the subsequent reconstruction of the chest wall has been a surgical challenge since Dr. Frederick W. Parham published his first comprehensive account on the subject in 1898. Chest wall reconstruction is age, site and pathology dependent, must preserve long term function and cosmesis, must accommodate future growth and development, and must not be a hindrance to adjuvant radiotherapy. Bony reconstruction can be relatively simple or complex involving combinations of synthetic meshes, bioprosthetic materials, steel or titanium constructs, autografts, homografts and porcine or bovine xenografts...
June 2018: Seminars in Pediatric Surgery
C Salvador, A Entenmann, R Salvador, A Niederwanger, R Crazzolara, G Kropshofer
BACKGROUND: Lipemic alterations are commonly seen in pediatric patients with acute lymphoblastic leukemia (ALL) treated with corticosteroids and L-asparaginase. OBJECTIVE: In these children, hypertriglyceridemia rarely causes symptoms and mostly responds well to a low-fat diet. Only few patients demand further therapy, which is not clearly approved in the literature to date. Therefore, it may be important to compile generally accepted standard procedures for lipid-lowering therapy in the pediatric ALL population...
June 20, 2018: Journal of Clinical Lipidology
Craig Friesen, Meenal Singh, Vivekanand Singh, Jennifer V Schurman
Headaches and abdominal pain are among the most common pediatric pain conditions. Mast cells have been implicated in the pathophysiology of migraines, as well as functional dyspepsia (FD) and irritable bowel syndrome (IBS). The primary aims of the current study were to assess headache prevalence in patients with FD and to assess the association between headaches and mucosal mast cells and eosinophils. An additional aim was to explore associations of headache with other symptoms.We conducted a cross-sectional retrospective chart review of 235 consecutive patients with chronic abdominal pain...
July 2018: Medicine (Baltimore)
Jonathan Bourget-Murray, Mathew A Clarke, Sydney Gorzitza, Lisa A Phillips
BACKGROUND: Venous thromboembolism, specifically pulmonary embolism, is a rare complication following elective pediatric orthopedic surgery. Bilateral pulmonary embolism with associated pulmonary hemorrhage/infarct without concomitant deep vein thrombosis has never been reported following routine anterior cruciate ligament reconstruction in an adolescent. CASE PRESENTATION: A 16-year-old white girl presented with acute onset shortness of breath and pleuritic chest pain 6 days following elective anterior cruciate ligament reconstruction...
July 6, 2018: Journal of Medical Case Reports
Peter Kardos, Kai-Michael Beeh, Ulrike Sent, Tobias Mueck, Heidemarie Gräter, Martin C Michel
BACKGROUND: Ambroxol relieves cough symptoms based on its secretagogue, anti-inflammatory, anti-oxidant, anti-bacterial, anti-viral, immunomodulatory and local anesthetic effects. The present study was designed to explore differential patient profiles and efficacy against acute respiratory symptoms of four formulations registered as over-the-counter medicines. METHODS: Nine hundred sixty-five pharmacy customers purchasing one of four branded ambroxol formulations (extended release capsules, adult syrup, pediatric syrup and soft pastilles) filled a questionnaire including a patient-adapted version of the Bronchitis Severity Scale, several questions on degree of impairment by acute cough, time to onset of symptom relief and duration of treatment...
July 4, 2018: BMC Pharmacology & Toxicology
Nicole A Miranda, Jeffrey R Boris, Kristen M Kouvel, Lauren Stiles
BACKGROUND AND PURPOSE: Postural orthostatic tachycardia syndrome (POTS) is increasingly recognized as a complication affecting recovery from concussion. Individuals with POTS demonstrate refractory dizziness, lightheadedness, cognitive dysfunction, fatigue, headache, chronic pain, nausea and gastrointestinal dysmotility, activity and exercise intolerance, syncope, and tachycardia. Subtypes of POTS may include hypovolemia, hyperadrenergic states, autonomic neuropathy, and underlying autoimmunity, which may variably impact response to rehabilitation in varying ways...
July 2018: Journal of Neurologic Physical Therapy: JNPT
Kenneth A Michelson, Todd W Lyons, Joel D Hudgins, Jason A Levy, Michael C Monuteaux, Jonathan A Finkelstein, Richard G Bachur
OBJECTIVES: Differences in emergency care for children exist between general and pediatric emergency departments (EDs). Some pediatric quality measures are available but are not routinely employed nationwide. We sought to create a short list of applied measures that would provide a starting point for EDs to measure pediatric emergency care quality and to compare care between general and pediatric EDs for these measures. METHODS: Previously reported lists comprising 465 pediatric emergency care quality measures were reconciled...
June 2, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Yenisleidy Paez-Perez, Terrance McGovern, Ashley Flannery, Farid Naim
Septic arthritis can be a devastating condition that leads to further morbidity and potential mortality if not identified early in its course. Emergency providers must keep septic arthritis high on their differential of any joint-related pain in the pediatric population. We present a case of an eight-year-old female who initially presented with the chief complaint of chest pain and was subsequently diagnosed with septic arthritis of the left sternoclavicular joint in the emergency department.
November 2017: Clinical practice and cases in emergency medicine
Spencer Corey Greene, John Morgan Carey
A 4-year-old female presented to the emergency department with 2 days of abdominal pain, nausea, and vomiting. She was tachycardic and had abdominal tenderness. Laboratory studies revealed a leukocytosis, hypokalemia, and metabolic acidosis. Her Pediatric Appendicitis Score (MDCalc) was calculated as 6, indicating that appendicitis could not be excluded. She was transferred to our pediatric hospital for further evaluation. Her ultrasound at our facility was normal. Upon reexamination, the patient was noted to have a red mark on her left index finger, and the family reported that the patient may have been stung by a puss caterpillar before the onset of her symptoms...
May 23, 2018: Pediatric Emergency Care
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