Pub Date : 2024-08-09DOI: 10.1177/00099228241272008
Nora S Alghamdi, Lujain Aletani, Ibrahim Sandokji, Hasan Aljefri, Khalid Alhasan, Mohammad A Shalaby, Jameela A Kari
Multisystemic inflammatory syndrome (Mis-C) has emerged in May 2020 as a serious complication of coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). A total of 6 children presented to tertiary care hospitals with Mis-C, of which 5 (83%) have died during hospitalization. All included patients presented with respiratory symptoms (ranged from mild to severe acute respiratory distress syndrome) and gastrointestinal symptoms. Most of the patients are known to have medical illnesses. Pediatric Risk of Mortality (PRISM) IV score ranged from 3 to 87. All patients developed acidosis and varying stages of acute kidney injury and electrolyte disturbances. All were treated for coagulopathy, thrombocytopenia, bacterial infections as well as antiviral medications (either ritonavir or lopinavir). Most patients had chest X-ray changes either unilateral or bilateral lung changes. Multisystemic inflammatory syndrome is a rare, yet serious complication of SARS-CoV2 infection in children. Multisystem involvement should be anticipated and promptly treated.
多系统炎症综合征(Mis-C)是由严重急性呼吸系统综合征冠状病毒2(SARS-CoV2)引起的冠状病毒病(COVID-19)的一种严重并发症,于2020年5月出现。共有6名儿童在三级医院就诊时感染了Mis-C,其中5人(83%)在住院期间死亡。所有患者均出现呼吸道症状(从轻微到严重的急性呼吸窘迫综合征)和胃肠道症状。大多数患者已知患有内科疾病。所有患者均出现酸中毒、不同程度的急性肾损伤和电解质紊乱。所有患者都接受了凝血病、血小板减少、细菌感染以及抗病毒药物(利托那韦或洛匹那韦)治疗。大多数患者都有胸部 X 光检查结果,要么是单侧肺部病变,要么是双侧肺部病变。多系统炎症综合征是儿童感染 SARS-CoV2 后一种罕见但严重的并发症。应预见到多系统受累并及时治疗。
{"title":"Multisystemic Inflammatory Syndrome in Children (MIS-C) With COVID-19 and Kidney Involvement: Poor Outcomes in a Case Series.","authors":"Nora S Alghamdi, Lujain Aletani, Ibrahim Sandokji, Hasan Aljefri, Khalid Alhasan, Mohammad A Shalaby, Jameela A Kari","doi":"10.1177/00099228241272008","DOIUrl":"https://doi.org/10.1177/00099228241272008","url":null,"abstract":"<p><p>Multisystemic inflammatory syndrome (Mis-C) has emerged in May 2020 as a serious complication of coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). A total of 6 children presented to tertiary care hospitals with Mis-C, of which 5 (83%) have died during hospitalization. All included patients presented with respiratory symptoms (ranged from mild to severe acute respiratory distress syndrome) and gastrointestinal symptoms. Most of the patients are known to have medical illnesses. Pediatric Risk of Mortality (PRISM) IV score ranged from 3 to 87. All patients developed acidosis and varying stages of acute kidney injury and electrolyte disturbances. All were treated for coagulopathy, thrombocytopenia, bacterial infections as well as antiviral medications (either ritonavir or lopinavir). Most patients had chest X-ray changes either unilateral or bilateral lung changes. Multisystemic inflammatory syndrome is a rare, yet serious complication of SARS-CoV2 infection in children. Multisystem involvement should be anticipated and promptly treated.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-09DOI: 10.1177/00099228241271897
Jung Min Park, Jae Hee Seol, Bongsic Yun, Donghwa Yang
We aimed to determine the risk factors for non-responsiveness to intravenous immunoglobulin (IVIG) and coronary ectasia in Korean children with Kawasaki disease (KD) and compare the efficacy of previously published Japanese and Chinese risk scoring systems in the same cohort. We retrospectively reviewed 459 KD cases diagnosed from January 1, 2013, to December 31, 2022. Age (odds ratio [OR]: 0.983; 95% confidence interval [CI]: 0.968-0.999), change in extremities (OR: 3.308; 95% CI: 1.530-7.151), neutrophils (OR: 1.078; 95% CI: 1.049-1.108), and alanine aminotransferase (OR: 1.002; 95% CI: 1.000-1.004) were identified as independent risk factors for IVIG non-responsiveness, and age (OR: 0.945; 95% CI: 0.902-0.989), C-reactive protein (OR: 1.092; 95% CI: 1.004-1.188), and creatinine kinase (OR: 1.004; 95% CI: 1.001-1.006) were identified as independent risk factors for coronary ectasia. Among previously published risk scoring systems, the Egami (area under the receiver operating characteristics curve [AUC]: 0.695; 95% CI: 0.651-0.737) for IVIG non-responsiveness and the Tang score (AUC: 0.726; 95% CI: 0.578-0.874) for coronary ectasia showed the highest predictive value for our study cohort.
{"title":"Risk Factors for Intravenous Immunoglobulin Non-responsiveness and Coronary Ectasia in Korean Patients With Kawasaki Disease.","authors":"Jung Min Park, Jae Hee Seol, Bongsic Yun, Donghwa Yang","doi":"10.1177/00099228241271897","DOIUrl":"https://doi.org/10.1177/00099228241271897","url":null,"abstract":"<p><p>We aimed to determine the risk factors for non-responsiveness to intravenous immunoglobulin (IVIG) and coronary ectasia in Korean children with Kawasaki disease (KD) and compare the efficacy of previously published Japanese and Chinese risk scoring systems in the same cohort. We retrospectively reviewed 459 KD cases diagnosed from January 1, 2013, to December 31, 2022. Age (odds ratio [OR]: 0.983; 95% confidence interval [CI]: 0.968-0.999), change in extremities (OR: 3.308; 95% CI: 1.530-7.151), neutrophils (OR: 1.078; 95% CI: 1.049-1.108), and alanine aminotransferase (OR: 1.002; 95% CI: 1.000-1.004) were identified as independent risk factors for IVIG non-responsiveness, and age (OR: 0.945; 95% CI: 0.902-0.989), C-reactive protein (OR: 1.092; 95% CI: 1.004-1.188), and creatinine kinase (OR: 1.004; 95% CI: 1.001-1.006) were identified as independent risk factors for coronary ectasia. Among previously published risk scoring systems, the Egami (area under the receiver operating characteristics curve [AUC]: 0.695; 95% CI: 0.651-0.737) for IVIG non-responsiveness and the Tang score (AUC: 0.726; 95% CI: 0.578-0.874) for coronary ectasia showed the highest predictive value for our study cohort.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-09DOI: 10.1177/00099228241272037
Timothy J Boly, Michell M Lozano-Chinga, Melanie E Reyes-Hernandez, Timothy G Elgin, Zuhair Ballas, Jennifer R Bermick
Neonatal capillary leak syndrome (CLS) is a rare, but life-threatening condition following neonatal sepsis or inflammatory injury. The objective of this study was to describe a standardized treatment approach for CLS that improves mortality and neonatal outcomes. A retrospective cohort study of 10 infants born at 22 to 26 weeks of gestation who developed CLS following a significant inflammatory insult was performed. Time to diagnosis and treatment approaches over 2 epochs were recorded and described. In epoch 2, with increased clinical awareness of CLS and implementation of a standardized treatment approach, there was a non-statistically significant decrease in the time to treatment with a significant decrease in mortality. An early targeted treatment approach for neonatal CLS can decrease mortality rates in this highly morbid condition.
{"title":"Reducing Capillary Leak Syndrome Mortality in Extremely Premature Infants: A Pilot Investigation.","authors":"Timothy J Boly, Michell M Lozano-Chinga, Melanie E Reyes-Hernandez, Timothy G Elgin, Zuhair Ballas, Jennifer R Bermick","doi":"10.1177/00099228241272037","DOIUrl":"https://doi.org/10.1177/00099228241272037","url":null,"abstract":"<p><p>Neonatal capillary leak syndrome (CLS) is a rare, but life-threatening condition following neonatal sepsis or inflammatory injury. The objective of this study was to describe a standardized treatment approach for CLS that improves mortality and neonatal outcomes. A retrospective cohort study of 10 infants born at 22 to 26 weeks of gestation who developed CLS following a significant inflammatory insult was performed. Time to diagnosis and treatment approaches over 2 epochs were recorded and described. In epoch 2, with increased clinical awareness of CLS and implementation of a standardized treatment approach, there was a non-statistically significant decrease in the time to treatment with a significant decrease in mortality. An early targeted treatment approach for neonatal CLS can decrease mortality rates in this highly morbid condition.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-09DOI: 10.1177/00099228241272053
Amanda K Morrow, Cindy Villatoro, Christina Kokorelis, Peter C Rowe, Laura A Malone
Despite there being a wide variety of symptoms reported in pediatric long COVID, one condition that has become increasingly recognized is orthostatic intolerance (OI), which can cause significant morbidity, limiting activities of daily living. This study examines rates of OI in 92 children with long COVID who underwent a bedside passive standing test in a pediatric post-COVID-19 rehabilitation clinic. Seventy-one percent met criteria for an orthostatic condition, including postural orthostatic tachycardia syndrome (POTS), orthostatic tachycardia (OT), classic orthostatic hypotension (OH), delayed OH, and orthostatic hypertension. Our findings suggest that OI is common in pediatric long COVID, necessitating appropriate clinical screening and treatment.
{"title":"Orthostatic Intolerance in Children With Long COVID Utilizing a 10-Minute Passive Standing Test.","authors":"Amanda K Morrow, Cindy Villatoro, Christina Kokorelis, Peter C Rowe, Laura A Malone","doi":"10.1177/00099228241272053","DOIUrl":"https://doi.org/10.1177/00099228241272053","url":null,"abstract":"<p><p>Despite there being a wide variety of symptoms reported in pediatric long COVID, one condition that has become increasingly recognized is orthostatic intolerance (OI), which can cause significant morbidity, limiting activities of daily living. This study examines rates of OI in 92 children with long COVID who underwent a bedside passive standing test in a pediatric post-COVID-19 rehabilitation clinic. Seventy-one percent met criteria for an orthostatic condition, including postural orthostatic tachycardia syndrome (POTS), orthostatic tachycardia (OT), classic orthostatic hypotension (OH), delayed OH, and orthostatic hypertension. Our findings suggest that OI is common in pediatric long COVID, necessitating appropriate clinical screening and treatment.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.1177/00099228241265172
Damien Ridremont, Emilie Boujut
The aim of our study was to identify burnout profiles among pediatric nurses and physicians, and their specificities concerning sociodemographic characteristics, occupational stress, stress specific to pediatric caregivers, and coping. Conducted on a sample of 195 French pediatric health care professionals, a cluster analysis showed 2 endpoint profiles (Engagement, Burnout) and 3 intermediate profiles (Overextended, Disengaged, Ineffective). The Burnout profile showed the highest median scores on hours worked per week, occupational stress, stress related to working conditions, and relationships with colleagues and superiors. The Overextended profile reported more stress related to working conditions than did other intermediate profiles. The Disengaged profile showed the second lowest median score on stress related to relationships with colleagues and superiors and less social support-seeking than other profiles. The Ineffective profile used less problem-focused coping than the Engagement and intermediate profiles. Intervention for the well-being of these professionals should focus primarily on improving their working conditions.
{"title":"Burnout Profiles Among French Pediatric Health Care Professionals: A Cluster Analysis.","authors":"Damien Ridremont, Emilie Boujut","doi":"10.1177/00099228241265172","DOIUrl":"https://doi.org/10.1177/00099228241265172","url":null,"abstract":"<p><p>The aim of our study was to identify burnout profiles among pediatric nurses and physicians, and their specificities concerning sociodemographic characteristics, occupational stress, stress specific to pediatric caregivers, and coping. Conducted on a sample of 195 French pediatric health care professionals, a cluster analysis showed 2 endpoint profiles (Engagement, Burnout) and 3 intermediate profiles (Overextended, Disengaged, Ineffective). The Burnout profile showed the highest median scores on hours worked per week, occupational stress, stress related to working conditions, and relationships with colleagues and superiors. The Overextended profile reported more stress related to working conditions than did other intermediate profiles. The Disengaged profile showed the second lowest median score on stress related to relationships with colleagues and superiors and less social support-seeking than other profiles. The Ineffective profile used less problem-focused coping than the Engagement and intermediate profiles. Intervention for the well-being of these professionals should focus primarily on improving their working conditions.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.1177/00099228241264359
Ying Shelly Qi, Janice A Espinola, Rebecca E Cash, Ashley F Sullivan, Kohei Hasegawa, Carlos A Camargo
{"title":"Traffic Proximity and Recurrent Wheeze Development by Severe Bronchiolitis Status.","authors":"Ying Shelly Qi, Janice A Espinola, Rebecca E Cash, Ashley F Sullivan, Kohei Hasegawa, Carlos A Camargo","doi":"10.1177/00099228241264359","DOIUrl":"https://doi.org/10.1177/00099228241264359","url":null,"abstract":"","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.1177/00099228241265174
Luke Wohlford, Zola Trotter, Mary Connell, Bikash Bhattarai, Siddharth Pandya
In this study, we describe the role of ultrasound in diagnosing pediatric peritonsillar abscesses (PTAs). A retrospective chart review was conducted on 54 children aged 4 to 17 years who had an ultrasound performed for suspected PTA. Based on ultrasound imaging, the patients were classified into 2 groups: PTA-positive (8, 14.8%) and PTA-negative (46, 85.2 %). Trismus was significantly associated with PTA (50% vs. 13%, P = .03). PTA-positive patients were more likely to be given steroids, be admitted, and have extended hospital stays (P = .04, .004, and .002, respectively). The 2 groups had no significant difference in computed tomography (CT) acquisition, surgical intervention, and return visits (P = .92, .17, and .97, respectively). Larger abscesses trended toward surgical treatment (P = .087). Ultrasound is an efficient diagnostic modality for suspected peritonsillar infections in children, with similar clinical outcomes for PTA-positive and PTA-negative groups.
{"title":"The Role of Ultrasound in Pediatric Peritonsillar Infection: A Descriptive Analysis.","authors":"Luke Wohlford, Zola Trotter, Mary Connell, Bikash Bhattarai, Siddharth Pandya","doi":"10.1177/00099228241265174","DOIUrl":"https://doi.org/10.1177/00099228241265174","url":null,"abstract":"<p><p>In this study, we describe the role of ultrasound in diagnosing pediatric peritonsillar abscesses (PTAs). A retrospective chart review was conducted on 54 children aged 4 to 17 years who had an ultrasound performed for suspected PTA. Based on ultrasound imaging, the patients were classified into 2 groups: PTA-positive (8, 14.8%) and PTA-negative (46, 85.2 %). Trismus was significantly associated with PTA (50% vs. 13%, <i>P</i> = .03). PTA-positive patients were more likely to be given steroids, be admitted, and have extended hospital stays (<i>P</i> = .04, .004, and .002, respectively). The 2 groups had no significant difference in computed tomography (CT) acquisition, surgical intervention, and return visits (<i>P</i> = .92, .17, and .97, respectively). Larger abscesses trended toward surgical treatment (<i>P</i> = .087). Ultrasound is an efficient diagnostic modality for suspected peritonsillar infections in children, with similar clinical outcomes for PTA-positive and PTA-negative groups.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.1177/00099228241263778
Rachel Reoli, Hallie Lenker
It is known that rehabilitation provides beneficial outcomes postburns. However, the frequency of therapy interventions is inconsistent, especially in the hospital setting. Our objective is to identify the frequency of rehabilitation interventions for pediatric patients with burns in acute care. Manuscripts were included if they addressed rehabilitation burn interventions for the pediatric population and reported intervention frequencies. Studies were excluded if they included adults and/or were beyond the acute care setting. We searched 6 databases for published literature, in the English language, from 2010 to April 2023. A total of 140 articles were found; however, only 8 met the inclusion criteria. Five studies met criteria for high-quality evidence, 3 for low quality. Frequency of rehabilitative therapy in the acute care setting was found to be variable, ranging from 1 day per week to 2 times per day. More research is needed to support optimum frequency.
{"title":"Rehabilitation Frequency for Pediatric Patients With Burns in Acute Care.","authors":"Rachel Reoli, Hallie Lenker","doi":"10.1177/00099228241263778","DOIUrl":"https://doi.org/10.1177/00099228241263778","url":null,"abstract":"<p><p>It is known that rehabilitation provides beneficial outcomes postburns. However, the frequency of therapy interventions is inconsistent, especially in the hospital setting. Our objective is to identify the frequency of rehabilitation interventions for pediatric patients with burns in acute care. Manuscripts were included if they addressed rehabilitation burn interventions for the pediatric population and reported intervention frequencies. Studies were excluded if they included adults and/or were beyond the acute care setting. We searched 6 databases for published literature, in the English language, from 2010 to April 2023. A total of 140 articles were found; however, only 8 met the inclusion criteria. Five studies met criteria for high-quality evidence, 3 for low quality. Frequency of rehabilitative therapy in the acute care setting was found to be variable, ranging from 1 day per week to 2 times per day. More research is needed to support optimum frequency.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}