Objective: To examine our institutional experiences with ultrasound-guided peripherally inserted central catheter (US-PICC) placement by a dedicated US-PICC team under the umbrella of an existing pediatric sedation service. Methods: Retrospective review quality data examining 968 encounters over 5-year period from 2012 to 2016. Data for each encounter included line indications, success rate, dwelling time, need sedation, and incidence complications including venous thrombosis, infection,...

This is a case of 7-year-old boy with acute lymphoblastic leukemia presenting cholestasis and elevated transaminase levels. Acute the most common malignancy in children can have variable clinical manifestations. However, less commonly encountered pediatric population be diagnostic challenge. We present discovered to levels while undergoing an evaluation for motor tics, which subsequently progressed liver failure secondary leukemia. He demonstrated marked improvement after induction therapy...

BACKGROUND AND OBJECTIVES The 2011 American Academy of Pediatrics guidelines recommended a renal and bladder ultrasound (RBUS) after the first febrile urinary tract infection (UTI) in infants. Abnormal RBUS findings may be due to inflammation from acute UTI or vesicoureteral reflux (VUR), which require voiding cystourethrogram (VCUG) diagnose, increasing health care costs. Our objective was evaluate effect timing imaging relative illness on abnormal dilation VCUG findings. METHODS...

Children with central sleep apnea may require sedation for procedures, including brain imaging as part of the evaluation apnea. However, safety deep without a protected airway is not known in this patient population. In case series, we present 3 children who were sedated propofol non-operating room setting. All did well no complications; those home oxygen requirement on during procedure but none experienced apnea, desaturation, or respiratory distress. While obstructive contraindication to...

A 15-year-old female with no significant past medical history presented to the emergency department 1 day of substernal and pleuritic chest pain, chills, cough, hematuria. She also had swelling face ankles that resolved by presentation. was found have elevated troponin brain natriuretic peptide during initial workup. Electrocardiogram normal, but there were pleural effusions on x-ray. strep positive blood pressure up 150/90, prompting admission for cardiac monitoring cardiology consultation....

A poorly feeding neonate presents the clinician with a diagnostic challenge. Feeding difficulties and irritability may be due to sepsis, congenital heart disease, inborn errors of metabolism, non-accidental head trauma, as well vast variety other pathologies. Teratomas are rare pediatric tumors that can occasionally present in immediate neonatal period manifest infant's central nervous system (CNS) non-specific symptoms poor feeding, lethargy, somnolence. Operative resection remains...

Gadolinium-based compounds are frequently used in contrast-enhanced magnetic resonance imaging studies. Rarely, adverse events have been reported with administration of these compounds, which the most common nausea and vomiting. Although well established adult literature, effects less described pediatric population, who often need sedation to complete In this case series, we present 3 children experienced vomiting shortly after contrast while under propofol, is known antiemetic properties....

The differential diagnosis in a vomiting infant can be extensive, ranging from the benign viral gastroenteritis and gastro esophageal reflux to serious bowel pathologies such as intussusception malrotation.Intussusception occurs when proximal segment becomes trapped distal segment, most commonly ileocecal region, infrequently involve an anatomic lead point intestinal polyps, cancer, inflammatory patches, enteric duplication cysts, or Meckel's diverticulum.We present case of 6-month-old male...

Objective: To examine healthcare providers' screening practices for obstructive sleep apnea (OSA) in children when considering a diagnosis of attention deficit hyperactivity disorder (ADHD).We hypothesized that patients were not being routinely screened OSA risk factors prior to diagnosed with ADHD.Methods: Retrospective chart review examining 113 patient encounters which ADHD was given.Children aged 4 18 years age and evaluated resident staffed, university affiliated community health...

22q11 deletion syndrome (22q11DS), also known as DiGeorge or velocardiofacial syndrome, is the most common human genetic microdeletion. Hypocalcemia secondary to hypoparathyroidism a finding in this condition and may present with seizures. We describe case of an 11-day-old male presenting hypocalcemic seizures positive newborn screen for severe combined immunodeficiency primary manifestations 22q11DS. Given potential wide phenotypic variability, clinicians should maintain high index...

Background Voiding cystourethrography (VCUG) is used to diagnose vesicoureteral reflux (VUR); however, it an invasive procedure and can be psychologically distressing. Procedural sedation occasionally utilized alleviate anxiety during VCUG, some patient populations may get referred more readily for than others. Sedative medications also impact the results of test due their effects on smooth muscle. The goals this study were compare characteristics between those that procedural not VCUG...