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Croup is a common respiratory illness in children under 5 years, primarily caused by viral infections. Symptoms include inspiratory stridor, barking cough, and hoarseness due to inflamed vocal cords. Diagnosis is based on symptoms difficulty breathing, stridor, chest in-drawing voice changes and head nodding. Severity ranges from mild to severe cases. This study aimed to explore variations in croup and factors contributing to its recurrence in children. This retrospective longitudinal study analyzed health records from the Pediatric Practice "Vitalino" in Veles, North Macedonia, from 2016 to 2022. It included children aged 0-5 years who had croup at least once. The sample was substantial and representative, allowing for a thorough examination of potential correlations and trends in croup occurrence. Among 707 studied children, 254 had croup, with a prevalence of 35.9% over seven years or 5.1% per year. Females had lower odds of recurrent croup, while males had higher odds, but the differences were not statistically significant. Atopic dermatitis and bronchiolitis exposure were significantly associated with croup in both genders. The study provides insights into the prevalence, distribution of croup and associated conditions in young children. The significant associations of atopic dermatitis and bronchiolitis suggest a link between these conditions and recurrent croup. Considering these strong associations, we can conclude that bronchiolitis and croup should be included in the trajectory of the atopic march. [ABSTRACT FROM AUTHOR]

Background/Objectives: With the advent of the field of pediatric emergency medicine, studies on the differences in treatment patterns between pediatricians and emergency medicine (EM) physicians in various pediatric conditions have been accumulating. This study aimed to compare croup (acute laryngotracheobronchitis) management patterns between pediatricians and EM physicians to enhance pediatric emergency care and inform the training of future specialists. Methods: A retrospective review of medical records was conducted for 1676 previously healthy children diagnosed with croup who visited a single pediatric emergency department (PED) of a tertiary university-affiliated hospital in South Korea, from March 2019 to February 2023. Patient characteristics, management patterns, and the impact of physician specialty on emergency care were analyzed. Results: EM physicians used injected dexamethasone monotherapy in 30.54% of the cases, more frequently than the 3.57% among pediatricians. In contrast, pediatricians used a combination of nebulized epinephrine and dexamethasone in 88.29% of the cases, compared with 67.71% for EM physicians. The appropriate use of nebulized epinephrine based on the Westley Croup Score was significantly higher in the EM physician group (77.64% vs. 57.89%, p < 0.001). Pediatricians also prescribed oral antibiotics and corticosteroids more frequently (25.13% vs. 3.13% and 81.54% vs. 22.69%, respectively; p < 0.001 for both). Despite these differences, there were no significant disparities in PED length of stay or 48 h revisit rates. Conclusions: EM physicians adhered more closely to currently accepted management algorithms for croup management. These findings underscore the need for standardized, evidence-based pediatric emergency care and provide valuable insights for training programs in this field. [ABSTRACT FROM AUTHOR]

Copyright of General Practitioner / Lekarz POZ is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Croup is the most common cause of acute, acquired upper airway obstruction in pediatric patients. Severe upper airway obstruction in children can quickly progress to respiratory failure; early and accurate diagnosis and treatment are essential. We examined the characteristics of pediatric patients with croup who visited our emergency department and required hospitalization even after appropriate treatment. We retrospectively studied patients who visited the pediatric emergency department of a tertiary hospital in Gyeonggi-do, Korea, from January 2018 to December 2021. After diagnosis and treatment using a defined protocol, all patients were divided into two groups: those who were hospitalized because they did not meet the criteria for discharge, and those who returned home. A multivariate logistic regression analysis was performed to identify factors associated with hospitalization. We studied 212 patients with an average age of 14 (12-16) months; 68 (32.0%) patients were female and 144 (67.9%) were male. In total, 47 (22.1%) patients were admitted for additional treatment. The multivariate logistic regression analysis revealed that tachycardia, tachypnea, decreased urine output and chest retraction were associated with hospitalization. A nomogram was constructed. Tachycardia, tachypnea, decreased urine volume and chest retraction in pediatric patients with croup showed a relationship with upper airway obstruction that persisted after treatment. If any of the above symptoms are observed in the emergency department, close observation is needed to determine whether respiratory failure is progressing; if so, prompt treatment is required. [ABSTRACT FROM AUTHOR]

Detection of any disease in the early stage can save a life. There are many medical imaging modalities like MRI, FMRI, ultrasound, CT, and X-ray used in the detection of disease. In the last decades, neural network-based methods are effective in detecting and classifying the disease based on abnormalities present in the medical images. Acute laryngotracheobronchitis (croup) is one of the common diseases seen in children among the 0.5–3 years age group which infects the respiratory system that can cause the larynx, trachea, and bronchi. Prior detection can lower the risk of spreading and can be treated accurately by a pediatrician. Commonly this infection can be diagnosed though physical examination. But due to the similarity of Covid-19 symptoms urges the physicians to get accurate detection of this disease using X-ray and CT images of the infant's chest and throat. The proposed work aims to develop a croup diagnose system (CDS) which identify the Croup infection through post anterior (PA) view of pediatric X-ray using deep learning algorithm. We used the well-known transfer learning algorithm VGG19 and ResNet50. Data augmentation being adapted for reducing the overfitting and to improve the quantity of image samples. We show that the proposed transfer learning based CDS method can be used to classify the X-ray images into two classes namely, croup and normal. The experiment results confirm that VGG19 performs better than ResNet50 with promising classification accuracy (90.91%.). The results show that the proposed CDS models can be used for more pediatric medical image classification problem. [ABSTRACT FROM AUTHOR]

Over-testing and over-treatment are common in children with croup at pediatric emergency departments (PED). The objective of the study was to improve care for children with croup. In this quality improvement (QI) initiative, all pediatric residents starting their rotation in the PED attended an informative presentation about croup and were provided reminders throughout their rotation. The primary outcome of this QI initiative was to reduce nebulized epinephrine (NE) use among children with mild croup by 50% over 7 months. The secondary outcome was to reduce X-rays by 50% over 7 months. Other outcomes included the administration of dexamethasone to all children with croup, reduction of antibiotics, laboratory tests, and revisits, and shortening the duration between physical examination to dexamethasone and NE treatments, and the length of stay (LOS) at the PED. NE administration to patients with mild croup decreased from 80.2% to 36.3% (p < 0.001). The proportion of children with X-rays decreased from 37.4% to 17.1% (p < 0.001). There was a significant increase in dexamethasone administration, and significant decreases in laboratory blood tests, expanded viral PCR panel tests, and antibiotic prescription among all croup cases (p < 0.001). Revisit rates were not significantly different (p > 0.05). Time to dexamethasone and LOS shortened significantly (p < 0.001). With this QI intervention, decreases in the rate of administration of NE to mild croup cases, antibiotic prescription, X-ray, laboratory blood and respiratory PCR panel tests in all croup cases were achieved without an increase in revisits. However, unnecessary NE, antibiotic, and X-ray rates are still high. [ABSTRACT FROM AUTHOR]

Purpose: Supportive anthroposophic therapies are used to treat children with pseudocroup by pediatricians in outpatient and inpatient settings. Anthroposophic treatment comprises forms of creative therapies, external applications as well as remedies, which production is based on the knowledge of the human being, nature and substances. A scientifically based guideline for these therapies is lacking. Due to insufficient study situation, we developed a consensus-based guideline to make therapy decisions more transparent and facilitate clinical routine. Methods: An online Delphi process with 67 anthroposophic pediatricians was conducted. Recommendations were accepted when reaching more than 75 % of expert agreement; otherwise, recommendations were revised and assessed by the experts once again. Results: Recommendations for general interventions and for anthroposophic remedies (Bryonia/Spongia comp.; Larynx/Apis comp.) as well as for external applications (embrocation with lavender oil) were developed. Recommendations have a consensus of 96.4 % or more. Conclusion: The consensus-based guideline provides practical recommendations for the supportive anthroposophic therapies for pseudocroup. The implementation and practicability of this guideline has to be investigated.

Coccidioidomycosis (CM) is an endemic fungal disease that is prevalent in the Southwestern United States, Mexico, and Central and South America. The majority of cases are asymptomatic. Symptomatic cases primarily present with pneumonic disease, varying in severity from mild to severe. In a minority, extrapulmonary disease is known to occur. These disseminated cases typically manifest as meningitis, osteomyelitis, synovitis, and integumentary. Coccidioidomycosis has been identified in nearly every part of the body, including the soft tissues and cartilaginous tissues of the oropharynx. Disseminated CM to the larynx specifically in the pediatric populations is rarely documented. This is a case of persistent stridor misdiagnosed as viral croup in a 9-month-old male with protracted disease. Herein, diagnosis and treatment of laryngeal mass found to be CM are defined with a salutatory outcome.

Croup syndrome remains one of the most common diseases in children, while being a life-threatening condition for the patient. Materials and methods. The paper presents the clinical and epidemiological features of croup in 79 children aged 0 months. up to 5 years of age hospitalized during the COVID-19 pandemic from January to September 2022. Results. In the age structure of patients, children of the first year of life predominated. The clinical picture of croup against the background of COVID-19 was usually characterized by an acute onset, febrile fever with the addition of symptoms of stenosing laryngotracheitis on the second and third days from the onset of the disease. The appointment of timely and adequate therapy at all stages of care is the key to a favorable outcome of croup in children.

Introduction: As the quality of care for respiratory diseases in pediatric patients in emergency departments (EDs) becomes increasingly important, this systematic review aims to evaluate the current quality indicators (QIs) specifically designed for the ED management of pediatric bronchiolitis and croup. Methods: We conducted searches in four electronic databases (Scopus, Web of Science, CINAHL, and MEDLINE) from their inception up to February 2024. We focused on English-language qualitative and quantitative publications that suggested or described at least one indicator initiative related to ED care for pediatrics with bronchiolitis and croup diseases. These publications were identified by two reviewers, independently. We extracted study characteristics, all relevant QIs reported, and the percentage of compliance with these QIs, where available. All QIs identified from expert panels and observational studies were grouped by definition and categorized by the Institute of Medicine's (IOM) and Donabedian's frameworks for healthcare quality. The percentage of compliance with the identified QIs as reported by observational studies was pooled using a random effect meta-analysis, when appropriate. Results: A total of 17 studies were identified, comprising 5 expert panel studies and 12 observational studies. Altogether, these studies reported 126 QIs for potential use in EDs for pediatric bronchiolitis and croup patients. Of these, 55 QIs were reported by expert panel studies, and 71 by observational studies. Specifically, 81 QIs were related to bronchiolitis, while 45 pertained to croup patients. In terms of the Donabedian domain, most indicators (96.5%) measured the process of care while a smaller fraction (3.5%) addressed care outcomes. In the Institute of Medicine (IOM) domain, most indicators focused on effectiveness and safety. Observational studies reported the percentage of compliance for 35 QIs identified in the expert studies. It was noted that compliance with these QIs varied significantly between studies and health sectors. Conclusions: The findings of this systematic review highlight significant disparities in compliance to the established QIs, which underscores the urgent need for dedicated strategies to enhance the treatment of pediatric bronchiolitis and croup in ED settings.

Objective Since the global outbreak of the novel coronavirus disease 2019 (COVID-19), there have been increasing reports of children developing a croup-like cough associated with concurrent COVID-19 infection. Currently, there is not much information available regarding newborn infants and COVID-19 infection and the incidence of vertical transmission is thought to be rare. This novel case report depicts a term newborn infected at the time of birth with COVID-19 and includes details about the course of their complicated hospitalization. Study Design A term infant, found to be infected at birth with COVID-19, developed respiratory distress resulting in transfer to our neonatal intensive care unit. Due to the increasing respiratory support requirements, endotracheal intubation was required on day of life (DOL) 7. Later, when the infant was extubated, on DOL 21, a croup-like cough developed. Results Despite respiratory treatment with albuterol, budesonide, racemic epinephrine, lidocaine, dornase alfa, and a 10-day course of dexamethasone, the cough persisted. A prolonged hospitalization was required and eventually the infant was discharged home on 0.4 L/minute of oxygen via nasal cannula on DOL 95. Conclusion As the COVID-19 virus mutates over time, there are some seemingly different presentations in both the pediatric and adult populations. The hypervigilance and sharing of new findings among providers are paramount in the treatment of infants with COVID-19 disease. Key Points Term infant with COVID-19 developed a croup-like cough. Usual respiratory treatment not effective with croup-like cough and COVID-19. COVID-19 present at birth later requiring intubation. [ABSTRACT FROM AUTHOR]

Introduction: Viral laryngotracheobronchitis, or croup, is a common respiratory illness in children that presents with a fever, barking cough, and stridor. The most common viral origin of croup are the parainfluenza viruses.Case Presentation: Here, we present a case of croup in which the viral panel was negative for all commonly tested viral causes of croup, but positive for coronavirus disease 2019 (COVID-19). Conclusion: This case represents a new report of COVID-19 as the viral origin of croup.

Background: Lianhua Qingke (LHQK) is an effective traditional Chinese medicine used for treating acute tracheobronchitis. In this study, we evaluated the effectiveness of LHQK in managing airway mucus hypersecretion in the acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: The AECOPD model was established by subjecting male Wistar rats to 12 weeks of cigarette smoke (CS) exposure (80 cigarettes/day, 5 days/week for 12 weeks) and intratracheal lipopolysaccharide (LPS) exposure (200 μg, on days 1, 14, and 84). The rats were divided into six groups: control (room air exposure), model (CS + LPS exposure), LHQK (LHQK-L, LHQK-M, and LHQK-H), and a positive control group (Ambroxol). H&E staining, and AB-PAS staining were used to evaluate lung tissue pathology, inflammatory responses, and goblet cell hyperplasia. RT-qPCR, immunohistochemistry, immunofluorescence and ELISA were utilized to analyze the transcription, expression and secretion of proteins related to mucus production in vivo and in the human airway epithelial cell line NCI-H292 in vitro. To predict and screen the active ingredients of LHQK, network pharmacology analysis and NF-κB reporter system analysis were employed. Results: LHQK treatment could ameliorate AECOPD-triggered pulmonary structure damage, inflammatory cell infiltration, and pro-inflammatory cytokine production. AB-PAS and immunofluorescence staining with CCSP and Muc5ac antibodies showed that LHQK reduced goblet cell hyperplasia, probably by inhibiting the transdifferentiation of Club cells into goblet cells. RT-qPCR and immunohistochemistry of Muc5ac and APQ5 showed that LHQK modulated mucus homeostasis by suppressing Muc5ac transcription and hypersecretion in vivo and in vitro, and maintaining the balance between Muc5ac and AQP5 expression. Network pharmacology analysis and NF-κB luciferase reporter system analysis provided insights into the active ingredients of LHQK that may help control airway mucus hypersecretion and regulate inflammation. Conclusion: LHQK demonstrated therapeutic effects in AECOPD by reducing inflammation, suppressing goblet cell hyperplasia, preventing Club cell transdifferentiation, reducing Muc5ac hypersecretion, and modulating airway mucus homeostasis. These findings support the clinical use of LHQK as a potential treatment for AECOPD. [ABSTRACT FROM AUTHOR]

The article presents the case study of 6-week-old African American female concerning for laryngomalacia. Topics include past medical history was remarkable for stridor since birth, which was suspected by her Pediatrician to be laryngomalacia; and inspiratory stridor with associated increased work of breathing.

Croup caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging disease, and data on the risk factors associated with disease severity are still limited. The Westley croup score (WS) is widely used to assess croup severity. The current study aimed to analyze biomarkers associated with the WS and clinical outcomes in patients with croup and coronavirus disease 2019 in the pediatric emergency department (PED). Patients diagnosed with croup caused by SARS-CoV-2 were admitted at two PEDs. Clinical data including age, WS, length of hospital stay, initial laboratory data, and treatment were analyzed. Clinical parameters were evaluated via multivariate logistic regression analysis. The best cutoff values for predicting croup severity and outcomes were identified using the receiver operating characteristic curve. In total, 250 patients were assessed. Moreover, 128 (51.2%) patients were discharged from the PED, and 122 (48.8%) were admitted to the hospital. Mild, moderate, and severe croup accounted for 63.6% (n = 159), 32% (n = 80), and 4.4% (n = 11) of all cases, respectively. A high mean age (years), neutrophil count (%), neutrophil-to-lymphocyte ratio (NLR), ALT (U/L), procalcitonin (ng/mL), and hemoglobin (g/dL) level, and length of hospital stay (days), and a low lymphocyte count (%) and blood pH were associated with croup severity and need for intensive care. Based on the multivariate logistic regression model, the NLR remained independent factors associated with croup severity and prognosis. Further, NLR was significantly correlated with WS. The area under the receiver operating characteristic curve of NLR for predicting a WS of ≥3 was 0.895 (0.842–0.948, p < 0.001), and that for predicting ICU admission was 0.795 (0.711–0.879, p < 0.001). The best cutoff values for a WS of ≥3 and ICU admission were 1.65 and 2.06, respectively. NLR is correlated with WS and is a reliable, easy-to-use, and cheap biomarker for the early screening and prognosis of croup severity in the PED. A higher NLR may indicate severe croup and the need for further treatment. And the WS score remains reliable for estimating the severity of croup caused by SARS-CoV-2 and the risk of intensive care. [ABSTRACT FROM AUTHOR]

Objectives Subglottic cysts (SGCs) are a rare cause of respiratory distress resulting from upper airway obstruction in infants and young children. Risk factors other than prematurity with a history of endotracheal intubation have not yet been well elucidated. Therefore, we aimed to describe the clinical features and analyze the risk factors of SGCs. Methods We conducted a retrospective review of medical records of pediatric patients who underwent marsupialization for SGCs between January 2017 and March 2022. These records were then compared with those of controls with a history of neonatal intubation, with a case-to-control ratio of 1:3. Results Eleven patients (eight boys and three girls) diagnosed with SGCs and 33 control patients (26 boys and seven girls) were included. All patients had a history of premature birth and neonatal intubation. Symptoms of SGCs appeared at a mean age of 8.2 months (range, 1–14 months) after extubation. The mean duration of intubation was 21.5 days (range, 2–90 days), and the intubation period was longer in patients with SGCs than in controls (21.5±24.8 days vs. 5.3±7.1 days; P

OBJECTIVES: Croup is the most common cause of acute upper airway obstruction in children. The benefits of treating croup with steroids are well established, with an onset of effect 30 minutes after administration. We investigated whether a 30-minute exposure to outdoor cold air might improve mild to moderate croup symptoms before the onset of action of steroids. METHODS: This open-label, single-center, randomized controlled trial, enrolled children aged 3 months to 10 years with croup and a Westley Croup Score (WCS) ≥2 attending a tertiary pediatric emergency department. Participants were randomized (1:1) to either a 30-minute exposure to outdoor cold (<10°C) atmospheric air or to indoor ambient room air immediately after triage and administration of a single-dose oral dexamethasone. The primary endpoint was a decrease in WCS ≥2 points from baseline at 30 minutes. Analyses were intention to treat. RESULTS: A total of 118 participants were randomly assigned to be exposed to outdoor cold air (n = 59) or indoor room temperature (n = 59). Twenty-nine of 59 children (49.2%) in the outdoor group and 14 of 59 (23.7%) in the indoor group showed a decrease in WCS ≥2 points from baseline at 30 minutes after triage (risk difference 25.4% [95% confidence interval 7.0-43.9], P = .007). Patients with moderate croup benefited the most from the intervention at 30 minutes (risk difference 46.1% [20.6-71.5], P < .001). CONCLUSIONS: A 30-minute exposure to outdoor cold air (<10°C), as an adjunct to oral dexamethasone, is beneficial for reducing the intensity of clinical symptoms in children with croup, especially when moderate [ABSTRACT FROM AUTHOR]

Recurrent croup is a common clinical entity afflicting the pediatric population, but is not well-characterized in the literature. We describe the largest series of recurrent croup in North America from a single tertiary care academic center, and differentiate subpopulations based on demographic characteristics and clinical presentation. We identified 114 patients for inclusion. Common symptoms included barky cough (86.0%) and inspiratory stridor (60.5%). Many (26.3%) experienced full symptom resolution within a day, and 41.2% reported onset of symptoms at any time of the day. Male patients had a higher number of prior croup episodes at presentation compared with female patients (mean of 9.8 ± 8.0 in males vs 6.6 ± 4.8 in females, P =.03). On multivariate regression, racial/ethnic minority patients were at higher risk for dyspnea (odds ratio [OR]: 58.6; 95% confidence interval [CI]: 7.2-475.4) and upper respiratory infection prodrome (OR: 7.6; 95% CI: 1.6-35.3) compared with non-Hispanic white patients. [ABSTRACT FROM AUTHOR]

The article discusses a large observational cohort study revealing that patients treated by older emergency physicians had a higher 7-day mortality compared to those treated by younger counterparts. Another topic covered is an interview-based study from the University of Washington, highlighting inter-physician conflict between emergency department and general medicine doctors during transitions of care, causing sustained personal and professional harm.

Purpose Croup is a clinical manifestation of coronavirus disease 2019 (COVID-19) in children. The Omicron variant of severe acute respiratory syndrome coronavirus 2 usually causes an upper respiratory tract infection. We investigated the differences between croups caused by COVID-19 and by other respiratory viruses (ORV). Methods We reviewed clinical characteristics, therapeutic measures, and the Westley Croup Score of children with croup who visited the emergency department of Gyeongsang National University Hospital from January 1 through April 7, 2022. According to the laboratory-confirmed viruses, they were divided into 2 groups: COVID-19 and ORV. Between the 2 groups, we compared the abovementioned features. Moderate-to-severe croup was defined by a Westley Croup Score of 3 or higher. Results A total of 20 children were diagnosed with croup caused by COVID-19 (n = 11; median age, 18 months) or by ORV (n = 9; 7 months). Median Westley Croup Score was higher in the COVID-19 group than in the ORV group (5.0 [range, 0-10.0] vs. 2.0 [1.0-5.0]; P = 0.031). Among the components of the scoring system, only stridor showed a significant difference (e.g., “stridor at rest”: COVID-19, 8 of 11 vs. ORV, 2 of 9; P = 0.046). Median C-reactive protein concentration was higher in the COVID-19 group (3.2 vs. 0.4 mg/L; P = 0.007). Severity of the COVID-19 group was marginally higher than that of the ORV group in terms of the median oxygen saturation (95% vs. 98%; P = 0.056) and the proportions of moderate-to-severe croup (9 of 11 vs. 3 of 9; P = 0.065) and application of high-flow nasal cannula (4 of 11 vs. 0 of 9; P = 0.094). Conclusion Croup caused by COVID-19 during the period of dominance of the Omicron variant outbreak might be more severe than croup caused by ORV.

The article discusses the stridor medical condition in children manifested by partial upper airway obstruction that is most commonly caused by viral croup. Topics covered include signs and symptoms of stridor and viral croup, evidence-based assessment criteria and treatments, the use of oral dexamethasone and close observation as first line treatment, and criteria for admission or discharge. Also given is a case study on the diagnosis and treatment of stridor.

To evaluate the effectiveness of coordinated endoscopy with otolaryngology, pulmonology, and gastroenterology in diagnosing and managing recurrent croup in pediatric patients.We reviewed our REDCap Pediatric Aerodigestive Database for patients with recurrent croup who underwent coordinated endoscopy between January 2013 and July 2023. We reviewed patient demographics, comorbidities, surgical findings, treatments, and outcomes.Twenty-five patients were identified with recurrent croup. Their mean (SD) age was 37 (27) months (range = 9-98 months) with half of the patients younger than 25 months. The most common findings noted on combined endoscopies were positive bacterial culture on BAL (n = 10), and tracheomalacia (n = 7), and subglottic stenosis (n = 4). A history of prematurity was significantly associated with the presence of SGS (p = 0.01). Snoring/sleep-disordered breathing (SDB) was associated with a positive bacterial BAL culture (p = 0.03). About half of our cohort (48%) had multiple abnormalities identified by at least 2 different specialists at the time of endoscopy.For patients experiencing frequent or severe recurrent croup episodes, a thorough aerodigestive evaluation and management plan should be pursued. Coordinated endoscopy may be considered for select patients who do not respond to medical treatment. [ABSTRACT FROM AUTHOR]

Pediatric spontaneous gastric perforation is a rarely encountered condition with poorly understood causal mechanisms. We present a novel case of a two-month-old female infant from Nepal who previously experienced Croup and subsequently developed severe abdominal distention and vomiting. Abdominal X-ray findings confirmed pneumoperitoneum, prompting immediate laparotomy. Intraoperative examination revealed a substantial perforation along the posterior stomach wall, specifically along the lesser curvature. The surgical intervention involved gastrorrhaphy and omentopexy using 3-0 Vicryl sutures, leading to an uneventful postoperative recovery. This case report highlights the critical importance of early and efficient management of spontaneous gastric perforations in infants, emphasizing the need for timely intervention to achieve favorable outcomes. Pediatric spontaneous gastric perforation remains a rare condition, and reporting such cases contributes to our understanding and management of this unusual pathology. [ABSTRACT FROM AUTHOR]

Copyright of Revista Pediatría de Atención Primaria is the property of LUA Ediciones 3.0 S.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Isolated laryngotracheal amyloidosis is a rare disorder, accounting for only 0.2-1.2% of benign masses of the larynx. In the larynx, the rarest site mentioned in literature for amyloidosis is the subglottis and tracheal wall. Here, we present a case of a 69-year-old male who complained of progressive hoarseness, was diagnosed with subglottis and tracheal wall amyloidosis, and was treated with endoscopic microlaryngeal surgery and excision with coblation. As it is a slowly progressive disease, long-term follow-up is always recommended. [ABSTRACT FROM AUTHOR]

Ear, nose and throat (ENT) emergencies comprise a diverse group of conditions, affecting both upper and lower airways, with the potential for rapid clinical deterioration, airway compromise and death unless managed promptly. Successful patient outcome is dependent upon the individual specialist skills of anaesthetists and ENT surgeons (and others), working in harmony as an effective multidisciplinary team. [ABSTRACT FROM AUTHOR]

The Omicron variant of SARS-CoV-2 has a predilection for the upper airways, causing symptoms such as sore throat, hoarse voice, and stridor. We describe a series of children with COVID-19–associated croup in an urban multicenter hospital system. We conducted a cross-sectional study of children ≤18 years of age presenting to the emergency department during the COVID-19 pandemic. Data were extracted from an institutional data repository comprised of all patients who were tested for SARS-CoV-2. We included patients with a croup diagnosis by International Classification of Diseases, 10th revision code and a positive SARS-CoV-2 test within 3 days of presentation. We compared demographics, clinical characteristics, and outcomes for patients presenting during a pre-Omicron period (March 1, 2020–December 1, 2021) to the Omicron wave (December 2, 2021–February 15, 2022). We identified 67 children with croup, 10 (15%) pre-Omicron and 57 (85%) during the Omicron wave. The prevalence of croup among SARS-CoV-2–positive children increased by a factor of 5.8 (95% confidence interval 3.0–11.4) during the Omicron wave compared to prior. More patients were ≥6 years of age in the Omicron wave than prior (19% vs. 0%). The majority were not hospitalized (77%). More patients ≥6 years of age received epinephrine therapy for croup during the Omicron wave (73% vs. 35%). Most patients ≥6 years of age had no croup history (64%) and only 45% were vaccinated against SARS-CoV-2. Croup was prevalent during the Omicron wave, atypically affecting patients ≥6 years of age. COVID-19–associated croup should be added to the differential diagnosis of children with stridor, regardless of age. © 2022 Elsevier Inc. [ABSTRACT FROM AUTHOR]