Tracheostomy as a Management Option After Listing for Pediatric Cardiac Transplantation.

Background: Children with end-stage heart failure listed for cardiac transplantation may require mechanical ventilation and/or circulatory support whilst awaiting transplantation. A subgroup of these patients is unable to wean off mechanical ventilator support and undergo tracheostomy to enhance quality of life and allow de-escalation of intensive care. There is limited evidence of the use of tracheostomy associated with pediatric cardiac transplantation.

Unusual bot fly larva removed from the scalp of a returning traveler.

An aberrant bot fly specimen was removed from the scalp of a patient 3 wk after returning from Belize. The specimen showed little resemblance to the typical human bot fly larva, Dermatobia hominis, prompting a molecular identification using cytochrome oxidase I and II (COI and COII, respectively) mitochondrial DNA sequence regions. A BLAST search was subsequently performed, and both our COI and COII amplicon sequences showed 99-100% match with Dermatobia hominis, despite the specimen's clearly aberrant morphology.

Fifteen-minute consultation: Management of raised intracranial pressure in children.

Raised intracranial pressure (ICP) in children can be very challenging to recognise and manage. In order to minimise secondary brain injury, measures to reduce intracranial pressure must be initiated as soon as possible. Initial management is often commenced in District General Hospitals prior to transfer for definitive treatment.