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Ochsner Journal

Jessica Coleman, Ryan Phillips, Rodney Steiner
Background: Hemangiomas of the small bowel are rare tumors that present with melena, hematochezia, or signs of anemia. Because of the rarity of gastrointestinal hemangiomas, they are not commonly considered in the differential diagnosis for pediatric patients with anemia. Case Report: We present a case of small bowel hemangioma in a 2-year-old female with recurrent episodes of severe anemia. After resection of a 4.5 cm × 2 cm benign hemangioma, the patient's hemoglobin level steadily improved...
2018: Ochsner Journal
Abdullah Noor, Eleanor Gradidge
Background: Reye syndrome is a rare and potentially life-threatening disease characterized by liver failure and hepatic encephalopathy. Multiple possible etiologies have been suggested, but only aspirin (acetylsalicylic acid) has been statistically proven to be a causative factor. We describe a case of Reye syndrome secondary to influenza A virus. Case Report: A 2-year-old male with a recent history of influenza-like symptoms presented with neurologic deterioration...
2018: Ochsner Journal
Sarah M Baker, Ashley Kiefer, Dominic S Carollo, Rajasekharan P Warrier
Background: Prekallikrein deficiency is an extremely rare disorder in which functional prekallikrein in the plasma is reduced or absent. Case Report: We present the case of a 15-year-old male with prolonged activated clotting time incidentally noted preoperatively prior to repair of an atrial septal defect. The patient was subsequently found to have prekallikrein (Fletcher factor) deficiency. He successfully underwent open cardiac surgical repair after fresh frozen plasma was administered at a dose of 15 mL/kg 1 hour prior to the start of the procedure...
2018: Ochsner Journal
Hannah Lively-Endicott, Angelina M Dixon, Joyce Varghese
Background: Common neonatal etiologies of acute kidney injury (AKI) include renal vein and inferior vena cava thromboses, maternal use of nonsteroidal antiinflammatory drugs, and congenital renal disease. The incidence of renal vein thrombosis is estimated to be 0.5 per 1,000 neonatal intensive care unit admissions, with approximately half of cases extending to the inferior vena cava and with unilateral disease being significantly more common than bilateral. Data on abdominal venous thromboembolism in pediatric patients are limited, and the clinical presentation of renal vein thrombosis can vary, although most patients have at least one of the three cardinal signs: hematuria, thrombocytopenia, or abdominal mass...
2018: Ochsner Journal
Dmitriy Niyazov, Diego A Lara
Background: Pompe disease is a lysosomal storage disorder that results from an inborn error of metabolism involving abnormal glycogen storage. Infantile-onset Pompe disease is the most severe phenotype, and enzyme replacement therapy with alglucosidase alfa (Lumizyme) improves medical and functional outcomes in patients with infantile-onset Pompe disease. Case Report: We report the case of a patient with infantile-onset Pompe disease who presented with severe hypertrophic cardiomyopathy, systolic and diastolic cardiac dysfunction, and hypotonia...
2018: Ochsner Journal
Hannah Lively-Endicott, Diego A Lara
Background: Heterotaxy is a condition of abnormal lateralization of organs across the body's left-right axis, causing multiple congenital malformations. The anatomic manifestations of heterotaxy syndrome generally follow one of two patterns, referred to as right atrial isomerism (with two similar right atria and duplication of right-sided features of multiple organs) and left atrial isomerism (with two similar left atria and duplication of left-sided features of multiple organs). Cardiac surgical intervention for patients with heterotaxy syndrome depends on ventricular physiology and circulatory balance...
2018: Ochsner Journal
Luke Addesso, David Koenig, Nadia Huq
Background: Ewing sarcoma, a rare cause of cord compression, is predominantly of osseous origin but can also originate in soft tissues. Soft-tissue manifestations account for <15% of all Ewing sarcoma tumors, and even fewer cases of Ewing sarcoma originating in the epidural space have been documented. Case Report: A 19-year-old female presented to the emergency department for worsening low-back pain during the previous 6 months and numbness and weakness in her legs during the prior 2 weeks...
2018: Ochsner Journal
Gonzalo Sumarriva, Brandon Cook, Gustavo Godoy, Sean Waldron
Background: Metacarpophalangeal (MCP) joint dislocations are the result of a hyperextension injury. Complex MCP joint dislocations-those that are irreducible to closed maneuvers and require surgical intervention-are considered uncommon, even in the pediatric population. Although several structures have been identified that contribute to irreducible dislocations, the volar plate is the most significant barrier to reduction through interposition into the MCP joint. Key differences that require consideration for MCP joint dislocations in pediatric patients include ligamentous laxity, the absence of sesamoid bones, the possibility for cartilage fractures, and the possibility of growth arrest...
2018: Ochsner Journal
Kannan Periasamy, Nikhila Radhakrishna, Ashutosh Mukherji, Rajesh Nachiappa Ganesh
Background: Primary gastric adenocarcinoma commonly occurs in the elderly in the sixth to seventh decade of life but is exceedingly rare in children and adolescents, accounting for only 0.05% of pediatric gastrointestinal malignancies. Because of the nonspecific clinical presentation, gastric adenocarcinomas in children and adolescents are often metastatic when they are discovered. Case Report: We describe a case of gastric adenocarcinoma in a 16-year-old female who was diagnosed early and successfully treated with surgery and chemoradiation by volumetric modulated arc technique...
2018: Ochsner Journal
Rajeev Seth, Vijayluxmi Bose, Yawar Qaiyum, Riti Chandrashekhar, Shubhangi Kansal, Indra Taneja, Tulika Seth
Background: Child marriage represents a grave violence against children and deprives them of their rights to health, education, and a livelihood. Because child marriage should be recognized as a social and medical emergency, the social determinants of child marriage in India need to be mapped. The aim of this qualitative case study was to document social determinants of child marriage identified by the authors while providing community mobile health services in rural Mewat District, India...
2018: Ochsner Journal
Renée V Gardner
Background: Sickle cell disease causes significant morbidity and mortality and affects the economic and healthcare status of many countries. Yet historically, the disease has not had commensurate outlays of funds that have been aimed at research and development of drugs and treatment procedures for other diseases. Methods: This review examines several treatment modalities and new drugs developed since the late 1990s that have been used to improve outcomes for patients with sickle cell disease...
2018: Ochsner Journal
Tanvir F Kabir, Aman Chauhan, Lowell Anthony, Gerhard C Hildebrandt
Background: Checkpoint inhibitors have transformed the treatment of cancer in adults. This class of drugs has demonstrated encouraging results in various malignancies such as metastatic melanoma, bladder cancer, renal cancer, and non-small cell lung carcinoma. However, researchers have only begun investigating the effectiveness and tolerability of checkpoint inhibitors in pediatric patients. Methods: We conducted a review of PubMed indexed literature and clinicaltrials...
2018: Ochsner Journal
Bethany Holt, Nayereh Kaviani, Mehul Sheth, Mieke van Driel
Background: One of the greatest challenges in healthcare today is dealing with a growing burden of multimorbid chronic diseases in an aging population. Awareness is growing that a healthy start in life plays a critical role in reversing this trend, especially for young women, pregnant mothers, and children in their first 2 years of life. Methods: We reviewed the international literature on early childhood nutrition and development, based on the landmark Lancet series on maternal and child nutrition and child development, and World Health Organization reports...
2018: Ochsner Journal
Lauren Narcisse, Edward A Walton, Lewis L Hsu
Background: Children with sickle cell disease (SCD) face unique problems that attendance at a camp with their peers is well suited to address. However, because the staff members at ordinary summer camps are not accustomed to accommodating children with chronic diseases, the potential for significant health consequences exists. Methods: We searched the literature in PubMed and CINAHL using the keywords summer camp, camp, sickle, and anemia to identify the unique characteristics of camps for children with SCD and the recommendations for care and/or lessons learned...
2018: Ochsner Journal
Priyanshi Ritwik
Background: Childhood cancer is the second most common cause of death in children in the United States. Treatments for childhood cancers usually incorporate chemotherapy, radiation therapy, immunotherapy, and/or surgery. This review of contemporary literature highlights the necessity for interprofessional care to achieve the best dental outcomes for this patient population during cancer treatment, as well as for children who are long-term cancer survivors. Methods: A literature search at PubMed identified research and review articles about oral and dental complications in children diagnosed with cancer...
2018: Ochsner Journal
Priyanshi Ritwik, Kimberly K Patterson
Background: Tooth agenesis, the congenital absence of one or more teeth, can be diagnosed in children in the first decade of life. Tooth agenesis is a phenotypic feature of conditions such as ectodermal dysplasia, cleft lip, cleft palate, Down syndrome, and Van der Woude syndrome. Tooth agenesis can also be nonsyndromic. Studies have shown an association between the genetic determinants of nonsyndromic tooth agenesis and neoplasms in adulthood. Methods: This review of the implications of tooth agenesis as a risk indicator for neoplasms in adulthood is based on a search of PubMed to identify published case series, case reports, and review articles...
2018: Ochsner Journal
Melinda B Clark, David A Clark
Background: The mouth is integral in the development of feeding, the initiation of digestion, and for speech and socialization. Signs of systemic disease and nutritional deficiencies often manifest in the mouth, and poor oral health can exacerbate many systemic conditions. Methods: This review addresses the fetal development of the mouth, major anomalies, common minor physical findings, and pathologic conditions and their management. Results: Pediatric practitioners have historically been poorly trained in diagnosis and management of oral conditions, so this article provides an overview of oral embryology and pathology, with a focus on hard and soft tissue disease identification, triage, and management...
2018: Ochsner Journal
Nicholas J Fustino, Margo Wohlfeil, Hayden L Smith
Background: Patient perception of care is positively associated with better medical outcomes, clinician job satisfaction, and fewer malpractice claims and also has significant downstream economic impact for healthcare organizations. A sparse amount of data exists regarding provider and practice characteristics driving high levels of patient experience in the pediatric hematology-oncology (PHO) ambulatory setting. The aims of this study were to determine key drivers of high care provider ratings and of the likelihood of recommending our ambulatory PHO practice...
2018: Ochsner Journal
Mary Vetter, Katharine Thomas, Alaa Mohammed, Fernando Urrego
Background: Louisiana has one of the highest rates of smoking in the country, putting its children at high risk of secondhand and third-hand smoke exposure and subsequent morbidity. Pediatricians have an important role to play by including smoking cessation promotion (SCP) in their discussions with patient caregivers. The purpose of this study was to examine SCP trends at Ochsner Health System and to determine if pediatricians are less likely to express confidence in and performance of SCP activities than physicians in other specialties...
2018: Ochsner Journal
Rachel Bernard, Rebecca Hammarlund, Mikki Bouquet, Taiwo Ojewole, Diane Kirby, Joseph Grizzaffi, Pamela McMahon
Background: Food insecurity-the inability to provide adequate food for at least one household member sometime during the year-is linked to negative physical and mental health outcomes. Child reports of experiences in other domains of life are only moderately related to parental proxy reports of the same experiences. The goal of our study was to assess the convergence of parent and child reports of food insecurity and several specific mental health symptoms. Methods: Dyads of parents and children attending medical appointments were surveyed...
2018: Ochsner Journal
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