Ultrasound-guided introital drainage of pyometrocolpos

Pyometrocolpos can be caused by congenital malformations such as distal vaginal atresia and imperforate hymen. Patients usually present with obstructive urinary tract infections, acute kidney injury, or sepsis. Percutaneous drainage of the infected fluid can help treat the patient; however, recurrence is of concern. In this case report, we present a case of a child with recurrent pyometrocolpos due to distal vaginal atresia despite initial percutaneous drainage. To our knowledge, this is the first report of ultrasound-guided introital drainage of pyometrocolpos with relief of symptoms obviating the need for repeat drainage or immediate surgery. © 201

Detection of iron deficiency in children with Down syndrome

Purpose Current American Academy of Pediatrics guidelines for children with Down syndrome (DS) recommend a complete blood count (CBC) at birth and hemoglobin annually to screen for iron deficiency (ID) and ID anemia (IDA) in low-risk children. We aimed to determine if macrocytosis masks the diagnosis of ID/IDA and to evaluate the utility of biochemical and red blood cell indices for detecting ID/IDA in DS. Methods We reviewed data from 856 individuals from five DS specialty clinics. Data included hemoglobin, mean corpuscular volume, red cell distribution width (RDW), percent transferrin saturation (TS), ferritin, and c-reactive protein. Receiver operating characteristic curves were calculated. Results Macrocytosis was found in 32% of the sample. If hemoglobin alone was used for screening, all individuals with IDA would have been identified, but ID would have been missed in all subjects. RDW had the highest discriminability of any single test for ID/IDA. The combination of RDW with ferritin or TS led to 100% sensitivity, and RDW combined with ferritin showed the highest discriminability for ID/IDA. Conclusion We provide evidence to support that a CBC and ferritin be obtained routinely for children over 1 year old with DS rather than hemoglobin alone for detection of ID

Parental perception of facilitators and barriers to health among young children with down syndrome: a qualitative study

BackgroundDespite high rates of obesity and weight-related conditions observed in children with Down syndrome, little is known about how to prevent these conditions.PurposeThe purpose of this study was to identify parent-perceived facilitators and barriers to health for toddlers (12–36 months old) with Down syndrome.Materials and methodsWe conducted in-depth, semi-structured interviews with the mothers of 25 toddlers with Down syndrome. All interviews were conducted using Zoom Video Technology, audio recorded and transcribed before being coded in NVivo software using a structured protocol. Thematic analysis was used to identify themes in perceived facilitators and barriers to health at the level of the child, family, and community. Data were triangulated using reflective journaling, video review of child meals, and member-checking techniques.ResultsWe identified unique themes for facilitators (on the move and sound sleep) and barriers (co-occurring conditions and eating behaviors) at the level of the child. At the level of the family and community, overarching themes that were viewed as either a facilitator or barrier, depending on the context, were identified (role models matter, time is critical, the importance of place, and social support).ConclusionThese themes can help clinicians and researchers tailor their health promotion interventions to meet the unique needs of children with Down syndrome by using strength-based approaches and providing families with the tools to overcome barriers

The mediamorphosis of Hindustani music: An examination of the role of emergent technologies in the transformation of Northern Indian music

45 p. Examining committee chair: Dr. John FennThe effects of the introduction of new methods to encounter music in the globalized social sphere are difficult to follow as they are continually in the process of change. Humans are recurrently encountering musical traditions through a new lens, forged by their shifting and continually adapting reality. This capstone will address the role of technology as a mediating factor in the transmission of Indian classical music. This research will examine these issues in order to understand technological effects as it specifically pertains to Hindustani music, the classical musical tradition of North India. This study takes a historical approach to explicate the traditional methods of learning Hindustani music through oral transmission and apprenticeship and looks forward into new methods of transmission shaped by the current context of encountering and understanding the music. This research is relevant to the Arts Management field in that it will provide implications of appropriate representation methods for cultural programmers involved in Hindustani music education

Catheter fragment removal from a persistent left superior vena cava in a pediatric patient

Tunneled central venous catheters and ports provide a long-term method of delivering nutrition, hydration, or medications in children. When these devices are no longer needed, it is best practice to remove them entirely. Complications associated with having long-term venous access devices or the process of device removal include site infections, venous thrombosis or occlusion, device fracture, and possible migration of fractured fragments. We present a case of catheter fragmentation that occurred in a pediatric patient during removal of a 3-year-old left chest port that had been placed into a left superior vena cava (SVC)

Tunneled Catheter Placement in a Pediatric Patient: A Novel Approach

© 2017 Association for Vascular Access Establishing venous access can be an important and often complex aspect of care for pediatric patients. When stable central venous access is required for long-term intravenous infusions, several options are available including peripherally inserted central catheters (PICC), tunneled catheters and ports. Both PICC placement and tunneled catheter placement include an exposed external segment of catheter, either in an extremity or on the chest. We present a pediatric patient with complex behavioral history who required long-term intravenous therapy. After careful review, the best option for the patient was determined to be a tunneled catheter that exited the skin in the right upper back, making it difficult to grab and pull out. The catheter was successfully placed and the patient appropriately completed his intravenous antibiotic course. Upon completion, the catheter was removed without complications. This tunneling technique to the scapular region may be useful for patients with psychiatric or neurodegenerative disorders where purposeful dislodgement may be a problem