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Acute Abducens Nerve Paralysis in the Pediatric Emergency Department: Analysis of 14 Patients
Conclusions: Other lesions of primary brain tumors causing increased intracranial pressure constitute 50% of the underlying etiology, followed by Guillain-Barre syndrome (14.2%). However, these patients had neurological symptoms signs, in addition to diplopia or SCN paralysis. Patients admitted to pediatric emergency department with acute SCN paralysis should be examined in detail to disclose the underlying etiology especially if they present with additional clinical signs or symptoms.
Source: Pediatric Emergency Care - May 1, 2016 Category: Emergency Medicine Tags: Original Articles Source Type: research

Partial Nephrogenic Diabetes Insipidus in a Burned Patient Receiving Sevoflurane Sedation With an Anesthetic Conserving Device—A Case Report
Conclusions: Clinicians should be aware of the possibility of sevoflurane-induced diabetes insipidus not only during general anesthesia but also in the intensive care setting of sedation in critically ill patients. This is especially important in patients, such as those with severe burns, in whom preserved renal concentrating ability is important to ensure compensation for extrarenal fluid losses.
Source: Critical Care Medicine - November 19, 2016 Category: Emergency Medicine Tags: Online Case Report Source Type: research

Cardiac Involvement in Sarcoidosis: Evolving Concepts in Diagnosis and Treatment
Semin Respir Crit Care Med 2017; 38: 477-498 DOI: 10.1055/s-0037-1602381Clinically evident sarcoidosis involving the heart has been noted in at least 2 to 7% of patients with sarcoidosis, but occult involvement is much higher (> 20%). Cardiac sarcoidosis is often not recognized antemortem, as sudden death may be the presenting feature. Cardiac involvement may occur at any point during the course of sarcoidosis and may occur in the absence of pulmonary or systemic involvement. Sarcoidosis can involve any part of the heart, with protean manifestations. Prognosis of cardiac sarcoidosis is related to the extent and site(s) ...
Source: Seminars in Respiratory and Critical Care Medicine - July 27, 2017 Category: Respiratory Medicine Authors: Sayah, David M. Bradfield, Jason S. Moriarty, John M. Belperio, John A. Lynch, Joseph P. Tags: Review Article Source Type: research

Reply from Authors of Correlation of LCI with Hyperpolarized (129)Xe Magnetic Resonance Imaging in Pediatric CF Subjects.
Source: Am J Respir Crit Car... - August 11, 2017 Category: Intensive Care Authors: Authors of Correlation of LCI with Hyperpolarized (129)Xe Magnetic Resonance Imaging in Pediatric CF Subjects. Tags: Am J Respir Crit Care Med Source Type: research

Back Pain in a Pediatric Emergency Department: Etiology and Evaluation
Objectives Back pain is an uncommon chief complaint in the pediatric emergency department (ED). However, there are serious underlying conditions requiring prompt diagnosis and treatment. While the etiology is usually benign, variation exists in the evaluation. The study purpose was to describe pediatric patients who presented to the ED with back pain and evaluate for associations with laboratory and radiologic abnormalities indicative of underlying musculoskeletal pathology. Methods A retrospective review was conducted of patients aged birth to 18 years who presented to a pediatric ED with a chief complaint of back pa...
Source: Pediatric Emergency Care - January 1, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Airway Inflammation and Inflammatory Biomarkers
Semin Respir Crit Care Med 2018; 39: 056-063 DOI: 10.1055/s-0037-1606217Severe asthma is a complex disease consisting of different endotypes with different inflammatory and clinicopathological characteristics due to the heterogeneity of immune responses and smooth muscle dysfunction. There is an unmet clinical need to develop and to validate biomarkers that can differentiate between the asthma endotypes and guide clinical management, particularly since the availability of biologicals directed against T2 cytokines. The presence of a “Th2 endotype” is currently assessed in clinical practice using markers, such as eosinop...
Source: Seminars in Respiratory and Critical Care Medicine - February 10, 2018 Category: Respiratory Medicine Authors: Lim, Hui Fang Nair, Parameswaran Tags: Review Article Source Type: research

Emergency and critical care applications for contrast-enhanced ultrasound
Contrast-enhanced ultrasound (CEUS) using intravascular microbubbles has potential to revolutionize point-of-care ultrasonography by expanding the use of ultrasonography into clinical scenarios previously reserved for computed tomography (CT), magnetic resonance imaging, or angiography.
Source: The American Journal of Emergency Medicine - April 21, 2018 Category: Emergency Medicine Authors: Tobias Kummer, Laura Oh, Mary Beth Phelan, Robert D. Huang, Jason T. Nomura, Srikar R. Adhikari Source Type: research

Confirming the Presence of Unrecognized Meniscal Injuries on Magnetic Resonance Imaging in Pediatric and Adolescent Patients With Anterior Cruciate Ligament Tears
The objectives of this study were the following: (1) assess the diagnostic ability of MRI in detecting meniscal injuries for pediatric and adolescent patients undergoing arthroscopic ACL reconstruction and (2) characterize the unrecognized meniscal injuries. Methods: The sensitivity, specificity, positive predictive value, and negative predictive value of meniscal tears (medial, lateral, or both) on MRI were calculated for the 107 patients in this cohort. Fisher exact tests were used to compare event frequencies between medial meniscal (MM) and lateral meniscal (LM) tears. One-way analysis of variance tests were perform...
Source: Journal of Pediatric Orthopaedics - September 11, 2019 Category: Orthopaedics Tags: Sports Medicine Source Type: research

Intravenous Thrombolysis at 3.5 Hours From Onset of Pediatric Acute Ischemic Stroke
We report the case of a 14-year-old girl who presented with right-sided weakness and ataxia, loss of sensation, and altered mental status. Magnetic resonance imaging with diffusion-weighted imaging showed an acute lesion in the distribution of the left posterior cerebral artery, and magnetic resonance angiogram demonstrated occlusion of the third branch of the left posterior cerebral artery. With parental consent, clinicians decided to infuse an adult dose of weight-adjusted intravenous alteplase at 3.5 hours from onset of symptoms, with subsequent improvement in National Institutes of Health Stroke Scale score from 11 to ...
Source: Pediatric Emergency Care - January 1, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Outcomes of Operatively Managed Lumbar and Sacral Facet Fractures in Pediatric Athletes: A Case Series
Conclusions: Athletes with localized back pain exacerbated by spine extension may have a facet fracture. As facet fractures are usually not identified with radiographs or MRI, a limited CT scan should be considered in the evaluation of pediatric athletes with localized back pain exacerbated by extension. In this series, surgical excision of facet fracture fragments was safe and provided predictable pain relief.
Source: Journal of Pediatric Orthopaedics - December 15, 2021 Category: Orthopaedics Tags: Sports Medicine Source Type: research

Imaging in Asthma Management
Semin Respir Crit Care Med DOI: 10.1055/s-0042-1743289Asthma is a heterogeneous disease characterized by chronic airway inflammation that affects more than 300 million people worldwide. Clinically, asthma has a widely variable presentation and is defined based on a history of respiratory symptoms alongside airflow limitation. Imaging is not needed to confirm a diagnosis of asthma, and thus the use of imaging in asthma has historically been limited to excluding alternative diagnoses. However, significant advances continue to be made in novel imaging methodologies, which have been increasingly used to better understand respi...
Source: Seminars in Respiratory and Critical Care Medicine - February 24, 2022 Category: Respiratory Medicine Authors: Niedbalski, Peter J. Choi, Jiwoong Hall, Chase S. Castro, Mario Tags: Review Article Source Type: research

Minimizing the Risk of Vascular Injury: Anatomy of the Popliteal Artery in the Pediatric Knee
Conclusions: Understanding the position of the popliteal artery in pediatric patients can help when stabilizing tibial tubercle fractures. Because the artery is close to the posterior cortex, a drill exiting in line with the popliteal artery risks vascular injury. Therefore, we recommend that screws exit within the medial 60% of the tibia. Level of Evidence: IV
Source: Journal of Pediatric Orthopaedics - August 11, 2022 Category: Orthopaedics Tags: Sports Medicine Source Type: research

The Locations of Anterior Cruciate Ligament Tears in Pediatric and Adolescent Patients: A Magnetic Resonance Study
Background: Recently, a resurgence of interest has been noted in anterior cruciate ligament (ACL) preservation in pediatric and adolescent patients. Different tear types, defined by their tear location, require different preservation techniques: proximal and distal avulsion tears can be treated with arthroscopic primary repair, whereas primary repair with biological scaffold has been proposed for midsubstance tears. The goal of this study was to assess the distribution of different tear types in pediatric and adolescent patients, as these are currently unknown. Methods: A retrospective search in an institutional radio...
Source: Journal of Pediatric Orthopaedics - September 11, 2019 Category: Orthopaedics Tags: Sports Medicine Source Type: research