What do we really know about infants who attend Accident and Emergency departments?

Aims: Accident and Emergency attendances continue to rise. Infants are disproportionately represented. This study examines the clinical reasons infants attend UK Accident and Emergency departments.

Clinical features of sarcoid rhinosinusitis.

Objective: We asked if certain clinical features were useful predictors of sarcoid rhinosinusitis in general populations of patients with chronic rhinosinusitis.

Methods: Our patients with sarcoid rhinosinusitis and those from the literature formed the study group. A group of 21 randomly selected patients from The University of Mississippi Medical Center Allergy Clinic with chronic rhinosinusitis composed the control group.

Intermittent diaphragmatic hernia of Bochdalek: report of a case and literature review.

Congenital diaphragmatic hernias appearing in late infancy or childhood are entities distinct from the more common newborn disorder. "Delayed" diaphragmatic hernias are associated with prior normal chest roentgenograms. Symptomatic intermittent herniation of abdominal viscera through a congenital posterolateral defect has not been previously reported in 17 cases of late-onset diaphragmatic herniation and may explain the latency period seen in older children.

Evaluation of the inferior vena cava by sonography and venography in children with renal and hepatic tumors.

Ultrasonography was used to examine 81 children with intra-abdominal or retroperitoneal malignancies for tumor extension into the inferior vena cava (IVC). In seven of the 18 patients with Wilms tumors and three of the seven patients with hepatic tumors, the IVC ws sonographically abnormal. Venography was also performed in five patients with Wilms tumors.

Intrathoracic kidney.

Five cases of intrathoracic kidney are presented, and the literature is reviewed. The diagnosis was made incidentally in 3 patients who had chest radiographs because of upper respiratory tract infections and in 1 infant on a follow-up radiograph after recovery from hyaline membrane disease. The fifth patient had an abdominal mass.

Hemophilus influenzae type b pneumonia in 43 children.

Using positive blood, lung, or pleural fluid cultures as definitive criteria for bacterial infection, 43 examples of Hemophilus influenzae type b pneumonia were identified in a 43-month period. The mean age of the patients was 26 months; 12% were older than 5 years of age. Associated infections were found in 34 patients and included upper respiratory infections, otitis media, epiglottitis, and meningitis.

Wilms' tumor to the heart: clinical and radiographic evaluation.

The clinical and radiographic appearances of four children with cardiac extension of Wilms' tumor and four cases from the literature are described. Four of the eight children were seen for "cardiac problems" and four for "routine" Wilms' tumor. In those "routine" cases, there were no clinical suggestions of inferior vena cava or cardiac extension.

Diagnostic features of tumors of the lower thoracic sympathetic chain.

Four cases of sympathetic neural tumors of the most inferior portion of the thoracic sympathetic chain are presented. The location of each tumor was such that a primary adrenal tumor might have been considered. However, each tumor was associated with erosion of the ipsilateral lower ribs or vertebral pedicles.

Bilateral interstitial pneumonia in acute lymphoblastic leukemia.

Of 148 children with acute lymphoblastic leukemia (ALL) 34 had bilateral interstitial pneumonia (BIP). Their records were reviewed retrospectively to evaluate the incidence of this pneumonia and delineate the various etiologic factors involved. All but 1 were in remission; 82% of the episodes occurred within the first 6 months, the majority of these occurring during the first 3 months of diagnosis of ALL; 16 were receiving methotrexate (MTX), and 14 were receiving combination chemotherapy with vincristine, prednisone and 6-mercaptopurine (6-Mp) and 4 were on no systemic therapy.

Neonatal small left colon syndrome: intramural not intraluminal obstruction.

We have described a characteristic syndrome of intestinal dysfunction in infants of diabetic mothers. This finding appears to result from a transient intramural dysfunction. Many respond to rectal irrigations alone.