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Pediatr Pulmonol 2022 Jul 17;57(7):1795-1798. Epub 2022 May 17.

Department of Surgical Sciences, Division of Cardiothoracic Surgery, Stellenbosch University and Tygerberg Hospital, Tygerberg, South Africa.

Foreign body aspiration is rare in children below 6 months of age. Very young children presenting with stridor, atypical croup presentation, and not responding accordingly, subglottic foreign body aspiration should be considered. These may not always be visible with bedside flexible endoscopy and may need investigation under anesthesia. Read More

Pediatr Int 2021 Nov;63(11):1408-1409

Department of Pediatrics, Japanese Red Cross Kitami Hospital, Kitami, Japan.

Animals (Basel) 2021 Oct 15;11(10). Epub 2021 Oct 15.

Department of Animal Nutrition and Feed Management, Wroclaw University of Environmental and Life Sciences, Chelmonskiego 38C, 51-630 Wroclaw, Poland.

Evaluation of body surface temperature change in response to exercise is important for monitoring physiological status. The aim of the study was to assess the influence of high-speed treadmill exercise on body surface temperature using infrared thermography (IRT) in selected body regions of healthy Beagle dogs, taking into account gait and recovery time. Thermographic images of the dogs were taken before exercise (BE), after walk (AW), after trot (AT), after canter (AC), just after second walk (JAE), 5 min after exercise (5 AE), 15 min after exercise (15 AE), 30 min after exercise (30 AE), 45 min after exercise (45 AE), and 120 min after exercise (120 AE). Read More

Pediatr Emerg Care 2022 Jan;38(1):e65-e66

From the Indiana University School of Medicine, Riley Hospital for Children.

Abstract: Stridor is a common presenting symptom for children in emergency departments (EDs) and usually represents an infectious process, such as croup, or aspiration of a foreign body. We present the case of an otherwise healthy 5-year-old girl with episodic increased work of breathing for several months that was initially diagnosed as asthma by her primary care physician. She subsequently presented to the ED with acutely worsening noisy breathing and dyspnea. Read More

Medicine (Baltimore) 2021 Jul;100(28):e26609

Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Hospital and Chonnam National University Medical School, Gwangju, South Korea.

Introduction: Foreign body (FB) aspiration is one of the causes of respiratory distress in infants is an extremely dangerous and potentially life-threatening event. The diagnosis of FB aspiration is difficult because the signs and symptoms vary according to the degree of airway blockage or location of the FB.

Patient Concerns: An 11-month-old female infant visited a hospital because of a sudden onset cough. Read More

Int J Occup Med Environ Health 2020 Oct 14;33(6):829-839. Epub 2020 Oct 14.

University of Ulsan College of Medicine, Ulsan, South Korea (Ulsan University Hospital, Department of Occupational and Environmental Medicine).

Objectives: The purpose of this study was to characterize a new respiratory syndrome associated with exposure to a humidifier disinfectant (HD) in South Korea that is distinct from the well-known HD-related lung injury (HDLI). The authors identified this condition in 24 study subjects who were family members of patients with definite or probable HDLI (referred to as index cases), and were exposed to HD in the same room as the index cases.

Material And Methods: The authors reviewed medical records of 236 family members in 110 families who were exposed to HD in the same rooms and residences as the index cases. Read More

Int J Pediatr Otorhinolaryngol 2020 Nov 1;138:110348. Epub 2020 Sep 1.

Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.

Objective: Post-extubation airway obstruction (PEAO) is common and difficult to predict in children. We hypothesized that Intracricoid Peritubal Free Space (IPFS) obtained by deducting the outer diameter of the endotracheal tube in situ (OD - provided by the manufacturer) from the ultrasonographically measured internal transverse cricoid diameter (ICD) is likely to be inversely proportional to the risk of developing PEAO. This prospective observational study was planned to evaluate this hypothesis. Read More

Respir Med Case Rep 2020 4;31:101182. Epub 2020 Aug 4.

Department of Emergency, Critical Care and Disaster Medicine, Okayama University, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama, 700-8558, Japan.

Thyroid storm is a potentially fatal intensification of thyrotoxicosis normally marked by tachycardia, hyperthermia, impaired mental status, and severe agitation. It can be initiated by numerous causes. Failure to promptly diagnose the condition may lead to high mortality. Read More

Int J Pediatr Otorhinolaryngol 2020 Sep 3;136:110158. Epub 2020 Jun 3.

Albert Einstein School of Medicine, Yeshiva University, Bronx, NY, USA; Montefiore Medical Center, Department of Radiology, Bronx, NY, USA. Electronic address:

Congenital airway malformations can present with respiratory distress, cyanosis, and difficulty feeding in the neonate or infant. Clinical presentation may vary from asymptomatic to fatal airway obstruction. They may exist in isolation or in association with vascular rings and slings, bronchopulmonary malformations, and/or syndromes. Read More

Sci Rep 2019 11 29;9(1):17893. Epub 2019 Nov 29.

Department of Pediatric Emergency Medicine, Children Hospital, China Medical University, Taichung, Taiwan.

Croup is the leading infectious disease resulting in pediatric upper airway obstruction. Our purpose is to analyze diverse features of neck radiographs could be seen as an objective tool to predict outcomes in patients with croup. One hundred and ninety-two patients were prospectively recruited in pediatric emergency department with diagnosis of croup. Read More

Int J Pediatr Otorhinolaryngol 2020 Jan 15;128:109733. Epub 2019 Oct 15.

Airway Surgery Unit, Department of Pediatric Surgery, Bambino Gesù Children's Hospital, Rome, Italy.

Objectives: Laryngopharyngeal reflux (LPR) is a complex problem in pediatric population: diagnosis and clinical presentation are still controversial. Classic white light endoscopy shows some pathognomonic signs of LPR in children, such as thickening of pharyngo-laryngeal mucus, the cobblestoning aspect of pharyngeal mucosa, arytenoid edema/hyperemia, nodular thickening/true vocal cord edema, hypertrophy of the posterior commissure, subglottic edema. The NBI (Narrow Band Imaging) technology, generally used in oncology, allows to study neoangiogenesis and hypervascularization of the mucosa, common aspects in both chronic inflammation and neoplastic transformation. Read More

Ann Emerg Med 2020 02 27;75(2):192-205. Epub 2019 Jun 27.

Department of Emergency Medicine, University of Michigan, Ann Arbor, MI; Department of Pediatrics, University of Michigan, Ann Arbor, MI.

Study Objective: Large-scale quality and performance measurement across unaffiliated hospitals is an important strategy to drive practice change. The Michigan Emergency Department Improvement Collaborative (MEDIC), established in 2015, has baseline performance data to identify practice variation across 15 diverse emergency departments (EDs) on key emergency care quality indicators.

Methods: MEDIC is a unique physician-led partnership supported by a major third-party payer. Read More

Am J Emerg Med 2019 11 3;37(11):2102-2106. Epub 2019 Jun 3.

Department of Emergency Medicine, University of Health Science, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey.

Objective: The purpose of this study was to evaluate the feasibility and diagnostic benefit of point-of-care ultrasound (PoCLUS) in children with non-cardiac respiratory distress or tachypnea.

Methods: In this prospective observational study, children aged between 1 month and 18 years with respiratory distress, tachypnea, or both, at triage were included. Concordance and accuracy of the emergency department (ED) and ultrasound diagnoses, length of stay, and time elapsing until ED and ultrasound diagnoses were calculated. Read More

BMJ Case Rep 2018 Nov 28;11(1). Epub 2018 Nov 28.

University Hospitals Bristol NHS Foundation Trust, Bristol, UK.

Acute lymphoblastic leukaemia (ALL) is one of the the most common malignancies of childhood and can occasionally present as acute airway obstruction. We present the unusual case of a 1-year-old boy who was referred to our Paediatric Otolaryngology (ENT) clinic with a recurrent history of croup. This is the first reported case of localised ALL presenting as a subglottic mass in a paediatric patient. Read More

Pediatr Emerg Care 2018 Aug;34(8):e139-e140

Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Minnesota, Minneapolis, MN.

Stridor is a common presenting symptom in young children and is produced by turbulent flow through the upper airway or trachea. In children under 12 months of age, stridor is commonly caused by laryngomalacia, tracheomalacia, croup, airway foreign body, and/or retropharyngeal abscess. In atypical presentations of stridor, soft tissue neck radiographs can be helpful to determine the underlying etiology. Read More

Pediatr Emerg Med Pract 2017 11;14(11):1-24

Associate Professor of Pediatrics and Emergency Medicine; Fellowship Director, Director of Education, Pediatric Emergency Medicine, Yale University School of Medicine, New Haven, CT

Stridor is a result of turbulent air-flow through the trachea from upper airway obstruction, and although in children it is often due to croup, it can also be caused by noninfectious and/or congenital conditions as well as life-threatening etiologies. The history and physical examination guide initial management, which includes reduction of airway inflammation, treatment of bacterial infection, and, less often, imaging, emergent airway stabilization, or surgical management. This issue discusses the most common as well as the life-threatening etiologies of acute and chronic stridor and its management in the emergency department. Read More

BMJ Case Rep 2017 Sep 12;2017. Epub 2017 Sep 12.

Department of Pediatrics, Hospital de Braga, Braga, Portugal.

Pediatr Radiol 2017 Dec 22;47(13):1745-1750. Epub 2017 Aug 22.

Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Background: Human metapneumovirus (HMPV) was identified in 2001 and is a common cause of acute respiratory illness in young children. The radiologic characteristics of laboratory-confirmed HMPV acute respiratory illness in young children have not been systematically assessed.

Objective: We systematically evaluated the radiographic characteristics of acute respiratory illness associated with HMPV in a prospective cohort of pediatric patients. Read More

Pediatrics 2017 Apr 14;139(4). Epub 2017 Mar 14.

Children's Hospital Colorado, Aurora, Colorado.

Background And Objectives: Croup is a clinical diagnosis, and the available evidence suggests that, except in rare cases, ancillary testing, such as radiologic imaging, is not helpful. Given the paucity of inpatient-specific evidence for croup care, we hypothesized that there would be marked variability in the use of not routinely indicated resources (NRIRs). Our primary study objective was to describe the variation and predictors of variation in the use of NRIRs. Read More

Intensive Care Med 2017 04 3;43(4):564-565. Epub 2016 Dec 3.

Department of Emergency Medicine, JR General Hospital, 2-1-3 Yoyogi, Shibuya-Ku, Tokyo, 151-8528, Japan.

Int J Pediatr Otorhinolaryngol 2016 Nov 5;90:86-90. Epub 2016 Sep 5.

Department of Otorhinolaryngology, The University of Oklahoma Health Sciences Center, 920 Stanton L. Young Blvd WP 1290, Oklahoma City, OK, 73104, USA.

Importance: The etiology of recurrent croup is often anatomic. Currently there is no set criteria for determining who should undergo diagnostic bronchoscopy and which patients are at most risk for having a clinically significant finding. Few studies have addressed these questions. Read More

Phlebology 2017 Aug 6;32(7):453-458. Epub 2016 Jul 6.

1 Department of Clinical Sciences, Lund University, Lund, Sweden.

Background High-quality non-invasive imaging of the deep venous system in the thorax is challenging, but nevertheless required for diagnosis of vascular pathology as well as for patient selection and preoperative planning for endovascular procedures. Purpose To compare the diagnostic quality of Gadofosveset-enhanced thoracic magnetic resonance venography, seven consecutive patients with suspected or known disease affecting the central thoracic veins were compared to seven consecutive magnetic resonance venography using conventional gadolinium-based contrast agents. Materials and methods Diagnostic capability, defined as the ability to assess vessel patency and pathologic conditions, for the major thoracic deep venous segments was assessed by two-independent readers. Read More

Mikrobiyol Bul 2016 Jan;50(1):159-64

Bakırköy Dr. Sadi Konuk Training and Research Hospital, Pediatric Intensive Care Unit, Istanbul, Turkey.

Human bocavirus (HBoV), that was first identified in 2005 and classified in Parvoviridae family, is a small, non-enveloped, single-stranded DNA virus, responsible for upper and lower respiratory tract infections, especially in young children. Although HBoV generally causes self-limited influenza-like illness, it may also lead to pneumonia, bronchiolitis, croup and asthma attacks. In this report, a case of acute bronchiolitis complicated with pneumomediastinum and bilateral pneumothorax caused by HBoV has been presented. Read More

Paediatr Anaesth 2016 May 9;26(5):531-8. Epub 2016 Mar 9.

Department of Anesthesiology, University of Minnesota, Minneapolis, MN, USA.

Background: Patients with mucopolysaccharidoses (MPS) are generally considered high risk for anesthesia care, owing to disease-related factors. Sanfilippo syndrome type A (MPS IIIA) is the most frequently occurring MPS. Anesthesia-specific information for MPS IIIA is not readily available in the literature. Read More

Radiographics 2015 Nov-Dec;35(7):2064-79. Epub 2015 Oct 23.

From the Department of Radiology, University of British Columbia, 3350-950 W 10th Ave, Vancouver, BC, Canada V5Z 1M9 (K.E.D., L.K.Y.); Zanvyl Krieger School of Arts and Sciences, Johns Hopkins University, Washington, DC (A.T.R.); and Department of Radiology, British Columbia Children's Hospital, Vancouver, BC, Canada (L.K.Y.).

Acute airway obstruction is much more common in infants and children than in adults because of their unique anatomic and physiologic features. Even in young patients with partial airway occlusion, symptoms can be severe and potentially life-threatening. Factors that predispose children to airway compromise include the orientation of their larynx, the narrow caliber of their trachea, and their weak intercostal muscles. Read More

Adv Emerg Nurs J 2015 Apr-Jun;37(2):79-82

St. Mary Medical Center, Long Beach, California.

Croup, or laryngotracheobronchitis, is a common viral respiratory tract illness seen in the pediatric population (). This article describes the case of a child who presents with croup and the characteristic "steeple sign" seen on the radiograph. The patient received a diagnosis of croup secondary to the parainfluenza virus infection. Read More

Indian J Pediatr 2015 Jul 26;82(7):629-36. Epub 2014 Sep 26.

Department of Pediatric Medicine, S.M.S. Medical College, Jaipur, Rajasthan, 302004, India,

Acute respiratory distress is one of the most common reason for emergency visits in children under 5 y of age. An accurate understanding of the epidemiology of these diseases, identification of risk factors and etiology is critical for successful treatment and prevention of related mortality. The cause of acute respiratory distress varies in etiology, and hence is amenable to different treatment modalities. Read More

Ear Nose Throat J 2014 Apr-May;93(4-5):154, 156

Department of Otolaryngology/Head and Neck Surgery, Division of Pediatric Otolaryngology, University of Tennessee, Memphis, TN, USA.

J Laryngol Otol 2014 Mar 20;128(3):292-5. Epub 2014 Feb 20.

Department of Paediatric Surgery, Queen's Medical Centre, Nottingham, UK.

Objectives: To report a case of misdiagnosis of an impacted oesophageal button battery in a child, and to describe the associated risk factors for impaction and the management of such cases.

Case Report: An 18-month-old, otherwise fit and well child with stridulous respiration was initially treated for croup. Medical treatment over the course of three months failed, and appropriate imaging subsequently demonstrated an impacted button battery in the upper oesophagus. Read More

Med Gas Res 2013 Aug 4;3(1):18. Epub 2013 Aug 4.

Departments of Neurosurgery and Physiology, Loma Linda University, Loma Linda California, USA.

The noble gas helium has many applications owing to its distinct physical and chemical characteristics, namely: its low density, low solubility, and high thermal conductivity. Chiefly, the abundance of studies in medicine relating to helium are concentrated in its possibility of being used as an adjunct therapy in a number of respiratory ailments such as asthma exacerbation, COPD, ARDS, croup, and bronchiolitis. Helium gas, once believed to be biologically inert, has been recently shown to be beneficial in protecting the myocardium from ischemia by various mechanisms. Read More