Rhabdomyolysis: a review of clinical presentation, etiology, diagnosis, and management.

Rhabdomyolysis is a condition that results from many underlying etiologies and can present in a myriad of ways to the emergency physician. However, some clinical and laboratory features are almost always present and, if noted, can help in making the diagnosis. This review article will focus on the presenting symptoms, the various etiologies, the underlying mechanisms, and the current management of pediatric rhabdomyolysis.

Developmental anatomy of the tonsil and its implications for intracapsular tonsillectomy.

Objective: To describe the developmental anatomy of the human tonsil from the embryonic period through adulthood and to use this information to define the applicability of intracapsular tonsillectomy in the management of disease.

Design: Descriptive-anatomic.

Subjects: (1) Normal embryos and fetuses from two archival collections, (2) children with adenotonsillar hypertrophy and (3) adult autopsy material.

Intracapsular vs. extracapsular tonsillectomy: a comparison of pain.

Objective: To measure differences in postoperative pain in children undergoing intracapsular tonsillectomy vs. extracapsular tonsillectomy.

Study Design: Prospective clinical trial carried out at a tertiary children's hospital over 1 year.

Lapbelt injuries and the seatbelt syndrome in pediatric spinal cord injury.

Background/objective: Approximately 250,000 patients are presently living with spinal cord injury (SCI) in the United States. Approximately 20% of patients with SCI are less than 20 years old, and 15% are less than 15 years old. The most common cause of pediatric SCI is a motor vehicle collision (MVC; approximately 40%); lapbelt injuries and the seatbelt syndrome are seen more often in children involved in MVCs.

Antegrade and retrograde endoscopic dextranomer/hyaluronic Acid bladder neck bulking for pediatric incontinence.

Purpose: Endoscopic bladder neck bulking techniques offer the potential for a relatively noninvasive cure for a difficult clinical problem. We review our experience using antegrade and retrograde approaches.

Materials And Methods: A total of 34 children (18 boys and 16 girls, mean age 11.

Treatment of cholestatic pruritus in children.

Purpose: The treatment of cholestatic pruritus in children is reviewed.

Summary: Cholestasis is characterized by an accumulation of substances that are normally secreted in the bile. Pruritus is a well-known feature of chronic cholestasis in both adults and children and has been reported as the most incapacitating symptom in children with chronic liver disease.

Transoral "adenoidectomy" excision of juvenile nasopharyngeal angiofibromas.

Objectives: We describe a minimally invasive technique for excision of selected juvenile nasopharyngeal angiofibromas (JNAs) using indirect visualization of the nasopharynx.

Methods: An observational case series with follow-up of 9 months to 3 years was performed. The subjects included 4 teenage boys with early-stage nasopharyngeal angiofibromas.

The use of statins in pediatrics: knowledge base, limitations, and future directions.

The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, or statins, effectively reduce coronary morbidity and mortality in high-risk adults. They are also some of the most widely prescribed medications in the United States. Their use in pediatrics, however, remains circumscribed.

Anti-CD19 immunotoxin enhances the activity of chemotherapy in severe combined immunodeficient mice with human pre-B acute lymphoblastic leukemia.

The anti-CD19 immunotoxin (IT) (HD37-dgRTA) is effective in killing B-lineage leukemia cells and in curing severe combined immunodeficient mice with acute lymphoblastic leukemia. The present study aimed to identify effective combinations of HD37-dgRTA and chemotherapeutic agents. The in-vitro cytotoxicity assays demonstrate that the combination of HD37-dgRTA and either daunorubicin or vincristine is effective.

Thoracoscopic ligation of the thoracic duct in a child with spontaneous chylothorax.

We report a case of a 2-year old girl with a spontaneous chylothorax who presented with respiratory distress. The management of this condition, which included thoracic duct ligation using a thoracoscopic technique, is discussed, and we review the literature on chylothorax.

A historical review of penetrating abdominal trauma.

The course of history changed because of the deaths of these two men. Although the world doesn't remember Chester Allan Arthur (JAG's Vice President), Theodore Roosevelt became one of our most popular presidents. Neither president's injuries were life-threatening, but they died of postoperative complications.

Transient spinal cord injuries in the young athlete.

Spinal cord injuries are be potentially devastating. Despite initial presentation, they may be permanent or transient. A small percentage of spinal cord patients with motor or sensory dysfunction recover rapidly and completely with no neurological sequelae.

The extended use of deflux (dextranomer/hyaluronic acid) in pediatric urology.

The use of injectable bulking agents into the submucosal layer of the pediatric urinary tract continues to grow. Treatment strategies for vesicoureteral reflux and urinary incontinence have changed with the introduction of dextranomer/hyaluronic acid as a minimally invasive option. Socially and medically debilitating conditions requiring major surgical reconstruction and hospitalization in the past have now been replaced by outpatient endoscopic procedures.

The use of levo-carnitine in children with renal disease: a review and a call for future studies.

Carnitine is an amino acid derivative that has a key role in the regulation of fatty acid metabolism and ATP formation. Carnitine deficiency has been described in various conditions, including chronic kidney disease (CKD) and end stage renal disease (ESRD). The deficiency of this micronutrient is postulated to lead to adverse effects across multiple organ systems.

Inside-out complete tonsillectomy: extended intracapsular tonsillectomy for severe sore throat.

Objectives: This consecutive case series is presented to describe inside-out complete tonsillectomy and to assess its effects on postoperative pain and bleeding and its initial effectiveness in controlling recurrent sore throat and peritonsillar abscess formation.

Methods: Bipolar electrosurgical scissors are used for bloodless resection of 90% of the tonsillar mass. During controlled resection, tonsil tissue is intentionally left at the superior and inferior poles and at the deepest part of the tonsillar fossa to provide coverage for nutrient arteries and the tonsillar plexus of veins.

Anesthesia in a patient with chromosome 11;22 translocation: a case report and literature review.

Chromosome 11;22 translocation is a rare genetic condition, which results in characteristic features some of which may present problems when these children require surgery and anesthesia. We describe a child with this chromosomal variant who presented for surgery and anesthesia. The case report and review of the literature is presented here.

Abdominal compartment syndrome in the pediatric patient with blunt trauma.

Abdominal compartment syndrome in the trauma patient is usually associated as a post surgical complication or as a consequence of full thickness burns to the trunk and abdomen. It is not widely recognized in patients who have received massive fluid resuscitation in the absence of abdominal pathology. This paper will present a case study of a pediatric patient who was the victim of a motor vehicle collision.

Digoxin toxicity: pediatric survival after asystolic arrest.

We report the first case of a child with known cardiac disease who presented in full cardiac arrest secondary to digoxin poisoning and was successfully resuscitated. A 12-week-old female presented 1-week status post surgical repair of a congenital heart anomaly in asystolic cardiac arrest. The patient was successfully resuscitated with standard Advanced Pediatric Life Support.

Pediatric intracapsular tonsillectomy with bipolar electrosurgical scissors.

This article describes the benefits of performing intracapsular tonsillectomy with bipolar electrosurgical scissors as an alternative to the powered microdebrider These scissors are used to excise approximately 90% of the tonsillar mass en bloc. The remaining tonsillar tissue is electrodesiccated by monopolar suction cautery, while the anterior and posterior pillars are completely preserved. The procedure leaves a smaller surgical wound than do extracapsular techniques.