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Pediatric index of suspicion

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https://www.readbyqxmd.com/read/29468064/the-multiple-faces-of-langerhans-cell-histiocytosis-in-childhood-a-gentle-reminder
#1
Maria Papadopoulou, Paraskevi Panagopoulou, Anastasia Papadopoulou, Emmanuel Hatzipantelis, Ioannis Efstratiou, Assimina Galli-Tsinopoulou, Efimia Papadopoulou-Alataki
Langerhans cell histiocytosis (LCH) is a rare hematologic disorder that results from the clonal multiplication and accumulation of immature dendritic Langerhans cells. Its reported incidence rate varies, but is considered to be 2.6-8.9 per million children who are <15 years of age each year. It may affect any system or organ. The present study reported 4 pediatric LCH cases in order to highlight the heterogeneity of the initial presentation, and the pitfalls that may mislead clinicians and delay diagnosis...
March 2018: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29438165/histologic-features-of-gastrointestinal-tract-biopsies-in-iga-vasculitis-henoch-sch%C3%A3-nlein-purpura
#2
Christine Y Louie, Adam J Gomez, Richard K Sibley, Dorsey Bass, Teri A Longacre
Immunoglobulin A (IgA) vasculitis or Henoch-Schönlein purpura (HSP) typically occurs in the pediatric population, although rare cases also occur in adults. Gastrointestinal (GI) involvement is common. The "classic" histologic finding in IgA vasculitis (HSP) is leukocytoclastic vasculitis (LCV); other histologic features in biopsies of IgA vasculitis (HSP) have only been rarely described. The pathology archival files at our institution were searched for GI biopsies from patients with IgA vasculitis (HSP)...
February 12, 2018: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/29395280/pediatric-cochlear-implant-soft-failure
#3
David Ulanovski, Joseph Attias, Meirav Sokolov, Tali Greenstein, Eyal Raveh
PURPOSE: Hard cochlear implant failures are diagnosed by objective tests whereas soft failures are suspected on the basis of clinical signs and symptoms. This study reviews our experience with children in tertiary pediatric medical center who underwent revision cochlear implantation, with emphasis on soft failures. MATERIALS AND METHODS: Children (age<18years) who underwent revision cochlear implantation from 2000 to 2012 were identified by database search. Pre- and post-explantation data were collected...
December 19, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29299687/the-incidence-of-brainstem-primitive-neuroectodermal-tumors-of-childhood-based-on-seer-data
#4
Omar Chamdine, Ghada Ahmad Saad Elhawary, Ahmad Samir Alfaar, Ibrahim Qaddoumi
PURPOSE: Incidence of BS primitive neuroectodermal tumors (BS-PNET) in children is not reported to date. Our main objectives were to estimate the incidence and report the outcome of BS-PNET in children. METHODS: Data were collected using the Surveillance Epidemiology and End Results cancer registry. RESULTS: From 1973 to 2013, we identified 83 pediatric patients (aged 0-21 years). Patients were divided into two age groups (0-3 years and 4-21 years)...
January 3, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29237543/diagnosis-and-management-of-mcfarland-fractures-a-case-report-and-review-of-the-literature
#5
M Birt, B Vopat, P Schroeppel, A Tarakemeh, B Everist, S Mullen
BACKGROUND: McFarland fracture is the eponym for a rare Salter Harris III or IV fracture involving the medial distal tibia. These fractures can be difficult to diagnose without a high index suspicion and appropriate radiographic imaging. These fractures may result in significant growth disturbances to the pediatric patient. When diagnosed and treated acutely, these fractures can be managed with cast immobilization and close follow up. If diagnoses in a delayed fashion they can result in significant morbidity including prolonged casting and possible surgical treatment...
December 9, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29233454/does-radiotherapy-prior-to-surgery-improve-long-term-prognosis-in-pediatric-colorectal-cancer-in-lower-and-upper-middle-income-countries-with-limited-resources-our-experience-and-literature-review
#6
Yacoob Omar Carrim, Luvo Gaxa, Francisca van der Schyff, Nndweleni Meshack Bida, Fareed Omar, Zarina Lockhat
Colorectal carcinoma in children and adolescents is extremely rare, with an annual incidence <0.3 cases per million, most frequently reported in the second decade of life. It accounts for severe morbidity and poor prognosis owing to the low index of suspicion, delayed diagnosis, advanced stage at presentation and the aggressive tumor nature. Patients present with abdominal pain, vomiting, constipation, abdominal distension, rectal tenesmus, iron-deficiency anemia, change in bowel habit and weight loss...
December 2017: Journal of the Egyptian National Cancer Institute
https://www.readbyqxmd.com/read/29225828/cefepime-induced-neurotoxicity-in-a-pediatric-patient-on-chronic-hemodialysis-a-case-report
#7
Monica Guzman-Limon, Subha Amatya, Joshua Samuels, Rita Swinford, Sonal Bhatnagar, Joyce Samuel
Impaired renal function increases the risk for cefepime-induced neurotoxicity. Symptoms include disorientation, myoclonus, status epilepticus, ataxia, gait disturbance, coma, and death. A high index of suspicion and early recognition of symptoms can minimize the risk of progression of symptoms to permanent neurologic impairment or death.
December 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/29217930/symptomatic-cholilithiasis-and-cholecystectomy-for-a-9-month-old-infant-a-case-report
#8
Hailu Wondimu
Background: Symptomatic cholilithiasis is rare in children. Thus, a high degree of suspicion is required for diagnosis. Once a child is diagnosed with symptomatic cholilithiasis, cholecystectomy is required to relieve the symptoms and prevent complication. Case Details: A 9-month-old infant from Addis Ababa presented to the Pediatric Department of ZewdituMemorial Hospital on January 30, 2015 with irritability, abdominal pain. On workup, she was found to have gall stones, and her condition was at last attributed to biliary colic after months of follow-up in the Department of Pediatrics...
May 2017: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/29200147/pediatric-deep-venous-thrombosis-associated-with-staphylococcal-infections-single-institutional-experience
#9
Divyaswathi Citla Sridhar, Ossama M Maher, Nidra I Rodriguez
Deep venous thrombosis (DVT) has been previously reported in children with methicillin-resistant Staphylococcus aureus (MRSA). This study reviews our institutional experience by evaluating characteristics and outcomes of children with DVT and staphylococcal infections. Retrospective clinical data from 16 pediatric patients with DVT and staphylococcal infections over a 5-year period was obtained via medical record abstraction. Sixteen patients with a median age at diagnosis of 8 years were included. The most common infection encountered was osteomyelitis (56%)...
January 4, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29176354/pediatric-avulsion-fractures-of-pelvis-current-concepts
#10
Ismat B Ghanem, Maroun Rizkallah
PURPOSE OF REVIEW: Provide the reader with an evidence-based update on the importance of accurate diagnosis of commonly missed avulsion fractures of pelvis apophyses, the necessary imaging studies, the feared complications and the recent treatment recommendations. RECENT FINDINGS: Accurate diagnosis of avulsion fractures of pelvis apophyses is high yield as misdiagnosis leads to improper treatment. They should be differentiated from muscle strain and apophysitis...
November 15, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29110733/sigmoid-volvulus-in-children-a-case-report
#11
Fayza Haider, Nabeel Al Asheeri, Barrak Ayoub, Eizat Abrar, Jawad Khamis, Hasan Isa, Husain Nasser, Fatima Al Hashimi
BACKGROUND: Sigmoid volvulus is frequently reported in the "volvulus belt" (Middle East, Africa, the Indian subcontinent, Turkey, and South America) and is the third leading cause of large bowel obstruction in North America. It is an uncommon problem in children and adolescents, and is rarely considered a diagnosis in this group. A high index of suspicion is necessary to diagnose sigmoid volvulus in children. CASE PRESENTATION: We present a 13-year-old Arabian girl who came with features suggestive of intestinal obstruction...
November 7, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29098005/foreign-body-aspiration-in-northern-ghana-a-review-of-pediatric-patients
#12
Theophilus Adjeso, Michael Chanalu Damah, James Patrick Murphy, Theophilus Teddy Kojo Anyomih
Background: Foreign body (FB) aspiration requires a high index of suspicion for diagnosis and prompt management to avoid morbidity and mortality. This retrospective study was conducted to review pediatric foreign body aspiration at the Ear, Nose and Throat (ENT) Unit of the Tamale Teaching Hospital (TTH). Materials and Methods: The theater records of children managed for foreign body aspiration from January 2010 to December 2016 at the ENT Unit of TTH were retrieved and data summarized with respect to age, gender, indications for bronchoscopy, nature of foreign body, location of foreign body, and outcome of the bronchoscopy procedure...
2017: International Journal of Otolaryngology
https://www.readbyqxmd.com/read/29097019/secondary-intracranial-hypertension-in-pediatric-patients-with-leukemia
#13
Miguel Ángel Fernández-García, Verónica Cantarín-Extremera, Maitane Andión-Catalán, Anna Duat-Rodríguez, Saioa Jiménez-Echevarría, Ignacio Bermejo-Arnedo, Montesclaros Hortigüela-Saeta, Saray Rekarte-García, Lara Babín-López, David Ruano Domínguez
BACKGROUND: We investigated the clinical characteristics of a pediatric population with hemato-oncological disease and intracranial hypertension, analyze the therapeutic response and outcome, and compare its characteristics with respect to a control group with idiopathic intracranial hypertension. METHODS: We retrospectively analyzed patients with hemato-oncological disease and secondary intracranial hypertension in our center during the past five years. We compared these individuals with a historical cohort with idiopathic intracranial hypertension from our institution (control group)...
December 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/29051906/intra-articular-physeal-fractures-of-the-distal-femur-a-frequently-missed-diagnosis-in-adolescent-athletes
#14
Andrew T Pennock, Henry B Ellis, Samuel C Willimon, Charles Wyatt, Samuel E Broida, M Morgan Dennis, Tracey Bastrom
BACKGROUND: Intra-articular physeal fractures of the distal femur are an uncommon injury pattern, with only a few small case series reported in the literature. PURPOSE: To pool patients from 3 high-volume pediatric centers to better understand this injury pattern, to determine outcomes of surgical treatment, and to assess risk factors for complications. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A multicenter retrospective review of all patients presenting with an intra-articular physeal fracture between 2006 and 2016 was performed...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29040243/toxic-shock-syndrome-still-a-timely-diagnosis
#15
Kira L Gossack-Keenan, April J Kam
BACKGROUND: Toxic shock syndrome (TSS) is an acute, severe, toxin-mediated disease, characterized by fever, hypotension, and multiorgan system involvement. Toxic shock syndrome has made headlines because of its high associated morbidity and mortality rate in previously healthy young females. Incidence peaked in the early 1980s owing to increased usage of ultra-absorbent tampons. After improved patient education and tampon labeling, the incidence of menstrual TSS has declined. CASE: A previously healthy 14-year-old girl presented to an urgent care center with a 2-day history of fever, erythematous maculopapular rash, vomiting, diarrhea, and malaise...
October 16, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28991343/endophthalmitis-following-pediatric-cataract-surgery-an-international-pediatric-ophthalmology-and-strabismus-council-global-perspective
#16
Almutez M Gharaibeh, Eedy Mezer, Luis H Ospina, Tamara Wygnanski-Jaffe
PURPOSE: To compile international data on the risk factors, diagnosis, and treatment of endophthalmitis following pediatric cataract surgery. METHODS: An e-mail containing a link to an online survey was sent to all members of the American Association for Pediatric Ophthalmology and Strabismus. The questionnaire examined the incidence, risk factors, treatment, outcomes, and prophylaxis of endophthalmitis following pediatric cataract surgery around the world. RESULTS: Two hundred thirty-seven ophthalmologists answered the questionnaire...
October 9, 2017: Journal of Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/28964279/pediatric-primary-sj%C3%A3-gren-syndrome-presenting-with-bilateral-ranulas-a-case-report-and-systematic-review-of-the-literature
#17
REVIEW
Casey Means, Mark A Aldape, Ericka King
CONTEXT: Primary Sjögren syndrome is uncommon in children, and the standard clinical criteria used in diagnosis of adult Sjögren syndrome will miss many children with the disease. Floor of mouth ranulas have not been described in Sjögren syndrome. OBJECTIVE: This study aims to describe a novel presentation of juvenile primary Sjögren syndrome, and to present a comprehensive systematic review of the literature regarding the presentation and diagnosis of Sjögren syndrome in children...
October 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28959231/demographic-clinical-and-immunologic-features-of-389-children-with-opsoclonus-myoclonus-syndrome-a-cross-sectional-study
#18
Michael R Pranzatelli, Elizabeth D Tate, Nathan R McGee
Pediatric-onset opsoclonus-myoclonus syndrome (OMS) is a devastating neuroinflammatory, often paraneoplastic, disorder. The objective was to characterize demographic, clinical, and immunologic aspects in the largest cohort reported to date. Cross-sectional data were collected on 389 children in an IRB-approved, observational study at the National Pediatric Myoclonus Center. Non-parametric statistical analysis was used. OMS manifested in major racial/ethnic groups, paralleling US population densities. Median onset age was 1...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28956182/combined-avulsion-fracture-of-the-tibial-tubercle-and-patellar-tendon-rupture-in-pediatric-population-case-series-and-review-of-literature
#19
Mohamed Abdelhamid Ali Yousef
Simultaneous occurrence of tibial tubercle fracture and patellar tendon avulsion with double-hit injury of the knee extensor mechanism is an extremely rare condition. However, they become more frequent due to increased participation in sports and high-energy recreational activities at younger age. It represents a frequently missed diagnosis; therefore, high index of suspicion is required for the diagnosis of such injuries to avoid delays in the treatment which would lead to possible suboptimal functional outcome...
September 27, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28938329/mandibular-osteomyelitis-and-cervical-lymphadenitis-due-to-mycobacterium-abscessus-surgical-management-of-a-pediatric-cohort-with-a-shared-epidemiologic-exposure
#20
Peter W Thompson, Joseph K Williams
BACKGROUND: Mycobacterium abscessus has been implicated as the cause of various infections in the setting of healthcare-related "outbreaks." Mandibular osteomyelitis caused by M abscessus is exceedingly rare, with only 1 patient reported in the literature. The authors describe the surgical management of 12 pediatric patients with M abscessus-related mandibular osteomyelitis and cervical lymphadenitis caused by exposure to contaminated water at a regional dental clinic. METHODS: Following institutional review board approval, new suspected patients were reviewed and followed prospectively...
November 2017: Journal of Craniofacial Surgery
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