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  1. Article ; Online: AiRDose: Developing and Validating an Augmented Reality Smartphone Application for Weight Estimation and Dosing in Children.

    Waltuch, Temima / Munjal, Kevin / Loo, George T / Lim, Czer Anthoney

    Pediatric emergency care

    2022  Volume 38, Issue 5, Page(s) e1257–e1261

    Abstract: Objectives: Inaccurate weight estimation is a contributing factor to medical error in pediatric emergencies, especially in the prehospital setting. Current American Heart Association guidelines recommend the use of length-based weight estimation tools ... ...

    Abstract Objectives: Inaccurate weight estimation is a contributing factor to medical error in pediatric emergencies, especially in the prehospital setting. Current American Heart Association guidelines recommend the use of length-based weight estimation tools such as the Broselow tape. We developed the AiRDose smartphone application that uses augmented reality to provide length-based weight estimates, as well as medication dosing, defibrillation energy, and equipment sizing recommendations; AiRDose was programmed to use Broselow conversions to obtain these estimates. The primary objective was to compare the length estimated by AiRDose with the actual length obtained by the standard tape measure. The secondary objectives were to compare the estimated weights and critical medication doses from AiRDose with current established methods.
    Methods: In this prospective validation study, lengths and estimated weights were obtained for children presenting to 2 emergency departments using AiRDose, Broselow, and a standard tape measure; actual weight was recorded from the patient chart. Using the AiRDose estimated weights, hypothetical doses of epinephrine and lorazepam were calculated and compared with doses recommended via Broselow and to actual weight-based doses. Spearman rank correlation coefficients were calculated. We defined an acceptable difference of 20% between AiRDose and standard measurements as clinically relevant.
    Results: Five hundred forty-nine children (mean age, 4.8 years; standard deviation [SD], 2.9 years) were recruited. There were 99.6% of AiRDose lengths within a 20% difference of tape-measure lengths. There was a significant correlation between AiRDose and tape-measure length measurements (r = 0.989, P < 0.0001), and between AiRDose and Broselow weights (r = 0.983, P < 0.0001) and AiRDose and actual weights (r = 0.886, P < 0.0001). AiRDose lorazepam and epinephrine doses correlated significantly with Broselow lorazepam (r = 0.963, P < 0.0001) and epinephrine (r = 0.966, P < 0.0001) doses.
    Conclusions: Anthropometric estimates and medication dose recommendations provided by AiRDose strongly correlate with established techniques. Further study will establish the feasibility of using AiRDose to accurately obtain weight estimates and medication doses for pediatric patients in the prehospital setting.
    MeSH term(s) Augmented Reality ; Body Weight ; Child ; Child, Preschool ; Cross-Sectional Studies ; Epinephrine ; Humans ; Lorazepam ; Smartphone ; United States
    Chemical Substances Lorazepam (O26FZP769L) ; Epinephrine (YKH834O4BH)
    Language English
    Publishing date 2022-01-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632588-9
    ISSN 1535-1815 ; 0749-5161
    ISSN (online) 1535-1815
    ISSN 0749-5161
    DOI 10.1097/PEC.0000000000002587
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Features of COVID-19 post-infectious cytokine release syndrome in children presenting to the emergency department.

    Waltuch, Temima / Gill, Prakriti / Zinns, Lauren E / Whitney, Rachel / Tokarski, Julia / Tsung, James W / Sanders, Jennifer E

    The American journal of emergency medicine

    2020  Volume 38, Issue 10, Page(s) 2246.e3–2246.e6

    Abstract: The 2019 coronavirus disease (COVID-19) has not appeared to affect children as severely as adults. However, approximately 1 month after the COVID-19 peak in New York City in April 2020, cases of children with prolonged fevers abruptly developing ... ...

    Abstract The 2019 coronavirus disease (COVID-19) has not appeared to affect children as severely as adults. However, approximately 1 month after the COVID-19 peak in New York City in April 2020, cases of children with prolonged fevers abruptly developing inflammatory shock-like states have been reported in Western Europe and the United States. This case series describes four previously healthy children with COVID-19 infection confirmed by serologic antibody testing, but negative by nasopharyngeal RT-PCR swab, presenting to the Pediatric Emergency Department (PED) with prolonged fever (5 or more days) and abrupt onset of hemodynamic instability with elevated serologic inflammatory markers and cytokine levels (IL-6, IL-8 and TNF-α). Emergency physicians must maintain a high clinical suspicion for this COVID-19 associated post-infectious cytokine release syndrome, with features that overlap with Kawasaki Disease (KD) and Toxic Shock Syndrome (TSS) in children with recent or current COVID-19 infection, as patients can decompensate quickly.
    MeSH term(s) Adolescent ; COVID-19/blood ; COVID-19/diagnosis ; COVID-19/physiopathology ; Child ; Child, Preschool ; Female ; Humans ; Male ; SARS-CoV-2 ; Systemic Inflammatory Response Syndrome/blood ; Systemic Inflammatory Response Syndrome/diagnosis ; Systemic Inflammatory Response Syndrome/physiopathology
    Keywords covid19
    Language English
    Publishing date 2020-05-23
    Publishing country United States
    Document type Case Reports
    ZDB-ID 605890-5
    ISSN 1532-8171 ; 0735-6757
    ISSN (online) 1532-8171
    ISSN 0735-6757
    DOI 10.1016/j.ajem.2020.05.058
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Primary hyperoxaluria: spectrum of clinical and imaging findings.

    Strauss, Sara B / Waltuch, Temima / Bivin, William / Kaskel, Frederick / Levin, Terry L

    Pediatric radiology

    2017  Volume 47, Issue 1, Page(s) 96–103

    Abstract: Primary hyperoxaluria is a rare autosomal recessive inborn error of metabolism with three known subtypes. In primary hyperoxaluria type 1, the most common of the subtypes, a deficiency in the hepatic enzymes responsible for the metabolism of glycoxylate ... ...

    Abstract Primary hyperoxaluria is a rare autosomal recessive inborn error of metabolism with three known subtypes. In primary hyperoxaluria type 1, the most common of the subtypes, a deficiency in the hepatic enzymes responsible for the metabolism of glycoxylate to glycine, leads to excessive levels of glyoxylate, which is converted to oxalate. The resultant elevation in serum and urinary oxalate that characterizes primary hyperoxaluria leads to calcium oxalate crystal deposition in multiple organ systems (oxalosis). We review the genetics, pathogenesis, variable clinical presentation and course of this disease as well as its treatment. Emphasis is placed on the characteristic imaging findings before and after definitive treatment with combined liver and renal transplantation.
    MeSH term(s) Adolescent ; Adult ; Age Factors ; Child ; Child, Preschool ; Diagnosis, Differential ; Genotype ; Humans ; Hyperoxaluria, Primary/diagnostic imaging ; Hyperoxaluria, Primary/genetics ; Hyperoxaluria, Primary/surgery ; Infant ; Kidney Transplantation ; Liver Transplantation
    Language English
    Publishing date 2017-01
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 124459-0
    ISSN 1432-1998 ; 0301-0449
    ISSN (online) 1432-1998
    ISSN 0301-0449
    DOI 10.1007/s00247-016-3723-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Features of COVID-19 post-infectious cytokine release syndrome in children presenting to the emergency department

    Waltuch, Temima / Gill, Prakriti / Zinns, Lauren E. / Whitney, Rachel / Tokarski, Julia / Tsung, James W. / Sanders, Jennifer E.

    The American Journal of Emergency Medicine ; ISSN 0735-6757

    2020  

    Keywords Emergency Medicine ; General Medicine ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    DOI 10.1016/j.ajem.2020.05.058
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article: Features of COVID-19 post-infectious cytokine release syndrome in children presenting to the emergency department

    Waltuch, Temima / Gill, Prakriti / Zinns, Lauren E / Whitney, Rachel / Tokarski, Julia / Tsung, James W / Sanders, Jennifer E

    Am. j. emerg. med

    Abstract: The 2019 coronavirus disease (COVID-19) has not appeared to affect children as severely as adults. However, approximately 1 month after the COVID-19 peak in New York City in April 2020, cases of children with prolonged fevers abruptly developing ... ...

    Abstract The 2019 coronavirus disease (COVID-19) has not appeared to affect children as severely as adults. However, approximately 1 month after the COVID-19 peak in New York City in April 2020, cases of children with prolonged fevers abruptly developing inflammatory shock-like states have been reported in Western Europe and the United States. This case series describes four previously healthy children with COVID-19 infection confirmed by serologic antibody testing, but negative by nasopharyngeal RT-PCR swab, presenting to the Pediatric Emergency Department (PED) with prolonged fever (5 or more days) and abrupt onset of hemodynamic instability with elevated serologic inflammatory markers and cytokine levels (IL-6, IL-8 and TNF-α). Emergency physicians must maintain a high clinical suspicion for this COVID-19 associated post-infectious cytokine release syndrome, with features that overlap with Kawasaki Disease (KD) and Toxic Shock Syndrome (TSS) in children with recent or current COVID-19 infection, as patients can decompensate quickly.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #342742
    Database COVID19

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  6. Article ; Online: Sleep and Breathing the First Night After Adenotonsillectomy in Obese Children With Obstructive Sleep Apnea.

    De, Aliva / Waltuch, Temima / Gonik, Nathan J / Nguyen-Famulare, Ngoc / Muzumdar, Hiren / Bent, John P / Isasi, Carmen R / Sin, Sanghun / Arens, Raanan

    Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

    2017  Volume 13, Issue 6, Page(s) 805–811

    Abstract: Study objectives: There are few studies measuring postoperative respiratory complications in obese children with obstructive sleep apnea (OSA) undergoing adenotonsillectomy (AT). These complications are further compounded by perioperative medications. ... ...

    Abstract Study objectives: There are few studies measuring postoperative respiratory complications in obese children with obstructive sleep apnea (OSA) undergoing adenotonsillectomy (AT). These complications are further compounded by perioperative medications. Our objective was to study obese children with OSA for their respiratory characteristics and sleep architecture on the night of AT.
    Methods: This was a prospective study at a tertiary pediatric hospital between January 2009-February 2012. Twenty obese children between 8-17 years of age with OSA and adenotonsillar hypertrophy were recruited. Patients underwent baseline polysomnography (PSG) and AT with or without additional debulking procedures, followed by a second PSG on the night of surgery. Demographic and clinical variables, surgical details, perioperative anesthetics and analgesics, and PSG respiratory and sleep architecture parameters were recorded. Statistical tests included Pearson correlation coefficient for correlation between continuous variables and chi-square and Wilcoxon rank-sum tests for differences between groups.
    Results: Baseline PSG showed OSA with mean obstructive apnea-hypopnea index (oAHI) 27.1 ± 22.9, SpO
    Conclusions: Obese children undergoing AT for OSA are at increased risk for residual OSA on the night of surgery. Special considerations should be taken for postoperative monitoring and treatment of these children.
    Commentary: A commentary on this article appears in this issue on page 775.
    MeSH term(s) Adenoidectomy ; Adolescent ; Child ; Female ; Humans ; Male ; Obesity/complications ; Obesity/physiopathology ; Polysomnography ; Postoperative Complications/physiopathology ; Postoperative Period ; Prospective Studies ; Risk Factors ; Severity of Illness Index ; Sleep Apnea, Obstructive/complications ; Sleep Apnea, Obstructive/physiopathology ; Sleep Apnea, Obstructive/surgery ; Tonsillectomy
    Language English
    Publishing date 2017-06-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2397213-0
    ISSN 1550-9397 ; 1550-9389
    ISSN (online) 1550-9397
    ISSN 1550-9389
    DOI 10.5664/jcsm.6620
    Database MEDical Literature Analysis and Retrieval System OnLINE

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