Introduction: Sleep disruption and sleep disordered breathing have been extensively reported in patients with cerebral palsy (CP) by studies conducted using questionnaires. Polysomnography (PSG) is the gold standard for objectively determining sleep architecture and sleep disorder breathing (SDB) in children and in adults. In this study, we aim to evaluate sleep architecture abnormalities and estimate prevalence of obstructive sleep apnea (OSA) in CP patients using PSG. Methods: All patients (0-18 year) with physician confirmed diagnosis of cerebral palsy who underwent diagnostic PSG study between September 2019 and June 2023 at a tertiary pediatric hospital were included in the study. Clinical and PSG data were retrospectively collected, summarized and reported. Sleep staging and sleep related respiratory events were scored following AASM criteria. OSA diagnosis was considered present if apnea hypopnea index (AHI) was ≥1.5 events per hour of total sleep time. Comparison between patients with OSA and patients with no OSA was also conducted. Student t test or Qui square analysis were used as appropriate. P value >0.05 was considered significant. Results: A total of 65 patients (31 male and 34 females) were included in the study. The mean (range) age was 7.2 (0.9 - 18) years. Majority of patients had quadriplegic CP. Only 12 (18.4%) patients had history of snoring or sleep apnea. Mean (range) sleep efficiency was 69.9% (44%-95%). Mean (range) sleep latency was 52.7 (1-270) minutes. Mean (range) REM latency was 118.8 (2.5-341) minutes. Mean (range) wakefulness after sleep onset was 102.6 (0.5-273.7) minutes. Duration of all sleep stages (REM, N1, N2, N3) expressed as percentages of total sleep time was within normal limits. The mean (range) AHI was 4.2 (0-38) events/hour. The prevalence of OSA was estimated at 54%. However, only 12 patients had documented symptoms related to OSA. The OSA group was younger compared to the non-OSA group and less likely to have seizure disorders. There was no significant difference in the frequency of reported symptoms between both groups. Conclusion: We found normal sleep architecture in patients with CP but decreased sleep efficiency and high prevalence of OSA using PSG. History of sleep related respiratory symptoms was not frequent and did not correlate with PSG detected OSA. Therefore, screening for sleep disruption and OSA using PSG in these patients should be considered.
Introduction: Birth trauma in newborns is the result of difficult deliveries. Despite improvements in pregnancy monitoring and the standardization of delivery care, injuries in neonates during delivery remain a major concern in neonatology. Methodology: Study conducted from January 1, 2014 to December 31, 2018, was a retrospective, cross-sectional, analytical study. The purpose was to determine the frequency of obstetric trauma in newborns at CHU Gabriel TOURE, to analyze the different types of injuries observed and to assess risk factors. All newborns admitted to neonatology for injuries were included. Results: Thirty-nine neonates were included (n=39). The sex ratio was 1.29 (M= 22; F=17). Hospital frequency was 1.9 ‰. The majority of patients were admitted within the first 24h (n=35; 90%). The majority of mothers were aged between 20 and 34, (i.e.76.8 %). Multiparous women represented 38% of the mothers. No pregnancy follow-up had been carried out in 23.1% of mothers. Deliveries by vaginal route accounted for 82.1%. Caesarean section accounted for 18%. Transverse fetal presentation was the most frequent reason for Caesarean section, representing 57%. Instrumental delivery was performed in 23.1% of deliveries. Cupping was utilized in 18%. Perinatal anoxia accounted for 59% of newborns. Trauma in newborns was as follows: Serosanguineous bump (n= 6; 15%), Skull skin injury (n=5; 13%), Brachial plexus nerve palsy (n=13; 33%), Femur fracture (n=12; 31%). Trauma to the skull and face accounted for 25.6%. Twelve patients (31%) received treatment with a posterior splint. Twenty percent of neonates had polytraumatism. Instrumental birth was a significant factor in neonatal craniofacial trauma (p = 0.0001). Macrosomia was a risk factor for brachial plexus palsy (p= 0.03). Breech positioning was a factor in the occurrence of lower leg fractures (p=0.001). The mortality rate was 33.3% (n=13). Perinatal asphyxia was the main cause of death (n= 23; 59%). Conclusion: Newborn birth trauma remains a major concern in neonatology in our country. Enhanced monitoring of pregnancy and delivery will reduce the morbidity and mortality associated with this disorder.
Introduction: Neonatal testicular torsion (NTT) is a rare but critical condition requiring prompt diagnosis and intervention to prevent testicular loss. Though rare, it accounts for greater than ten percent of testicular torsion cases in the pediatric population. Case Presentation: A 4-day old, ex-36-week gestational age, male infant was admitted to the neonatal intensive care unit (NICU) for hyperbilirubinemia and choking episodes at home. He was the product of a difficult vaginal delivery associated with clavicular fracture. On day two of admission, a firm left testicle and a right hydrocele were noted. There were no signs of distress, tenderness to palpation, nor scrotal color change during the exam. An ultrasound revealed diminished blood flow to the left testicle with morphology suggestive of NTT and a large right hydrocele. The infant was taken to the operating room where left testicular torsion was confirmed; a necrotic left testicle was unsalvageable. Pathology revealed hemorrhagic necrosis without malignancy. Conclusion: Testicular torsion in the newborn period is rare and often difficult to diagnose as there are varying clinical presentations and the infant does not display signs of distress. It has been postulated that fetal stress during pregnancy or delivery is a predisposing factor for NTT; however, little research has been done on whether postpartum stress can contribute to NTT. This case highlights a neonate with testicular torsion discovered following both a stressful delivery and choking event at home. It underscores the importance of considering NTT in neonates with abnormal testicular exam findings, particularly those with stressful deliveries and/or clinical histories.
A 6-months old girl presented with dilated cardiomyopathy (dCMP) with severe left ventricle dysfunction. Surgical pulmonary artery banding was performed, with successful weaning of ventilator despite persistent cardiac dysfunction. Despite the lack of extra-cardiac symptoms at initial presentation, the patient progressively developed marked global developmental delay, stereotypical hand and head movements, and growth retardation, initially thought to be related to the persistent cardiac condition. SNP-array and panel testing for cardiomyopathy and lysosomal storage diseases were noncontributing. Trio exome sequencing revealed a de novo likely pathogenic variant in TCF4 establishing the molecular diagnosis of Pitt-Hopkins Syndrome (PTHS) and explaining the non-cardiac features. As far as we know, this is the first patient described with the association of dCMP and PTHS. We did not detect other known genetic etiologies for dCMP on targeted panel analysis nor in the exome. Systematic unbiased assessment of infantile dCMP patients in the future will therefore be crucial to confirm a possible relationship between TCF4 variants and dCMP. In conclusion, multidisciplinary approach in patients with dCMP contributes to novel insights. With a genetic diagnosis, precision medicine approaches including major therapeutic decisions such as heart transplantation are clearly considered differently. This makes an important difference for the patient, parents, and medical team.
Background: the rising of child psychiatric epidemics during and after the COVID-19 pandemic increased the need of inpatient treatments for adolescents affected with anorexia nervosa (AN). There was also a more frequent and severe comorbid psychopathology as suicide attempts, suicidal ideation, non suicidal self-harming injuries (NSSI) and social withdrawal. Many AN subjects have been treated in pediatric wards and this has raised management and security problems. A deeper knowledge of AN adolescents inpatients with risky behaviors may help their management. Methods: we assessed 85 AN adolescents admitted to inpatient treatment in pediatric wards during the COVID-19 pandemics. The assessment included personality, eating and general psychopathology, attachment, and family functioning self-administered measures. We compared those who displayed risky behaviors with those who did not. Moreover, risky behaviors and psychopathology measures were correlated with treatment length and modality of discharge. Results: AN adolescents who committed suicide attempts displayed higher anticipatory worry, interpersonal distrust, preoccupation with relationships, difficulty in describing feelings, and worse family general functioning. Those with suicidal ideation greater BMI at intake and discharge, higher, lower maternal care, and worse family functioning. Both those with suicidal ideation and social withdrawal displayed higher phobic anxiety, paternal overprotection, tendency towards exploitation. Those with NSSI displayed higher disease for intimacy and worse depression. Conclusions: risky behaviors associated with AN in adolescent inpatients are characterized by specific psychopathology features. The early assessment of these characteristics at intake may help AN adolescents' allocation to prevent management risks.
Case description: We describe the clinical case of a female newborn, result of a monitored, full-term pregnancy, who presented at birth with an atrophic lesion on the abdominal wall, measuring around 5cm and with visualization of the underlying vasculature. There were no other alterations on objective examination. Aplasia cutis congenita (ACC) was hypothesized and corroborated by dermatology. Abdominal, transfontanellar ultrasound and echocardiogram were requested with no associated anomalies. No family history of similar skin lesions. The approach was conservative with the application of an emollient and there was a favorable evolution, with gradual regression of the lesion. Conclusion: ACC is a rare entity characterized by focal or generalized absence of skin. Since mild cases may not be reported, its incidence may be underestimated. The appropriate approach to this entity depends on its characteristics and severity, and a careful evaluation should be carried out to identify and guide associated malformations at an early stage. Because of the possible implications in terms of counseling, a thorough family history is important. Small, isolated lesions usually resolve spontaneously, and complications are rare.
Background: Currently, the perinatal period is considered to be related to primary adult arterial hypertension. In the intermediate period (which includes childhood and adolescence) between the perinatal and the adult hypertension stage, certain persons present with high blood pressure. In this paper, the relationship between this period and the low birth weight (LBW) found in the medical history of persons with primary adult arterial hypertension is studied. Methods: We carried out a systematic search in Medline for low birth weight, childhood and adolescence high blood pressure, and adult primary hypertension and low birth weight and picked up approximately 50 articles from the hundreds of titles and abstracts, reviewing them in order to find the missing piece of the puzzle: the intermediate stage of childhood and adolescence high blood pressure. Results: The present study points to the continuity of the mechanisms involved in primary/essential HTN, from the perinatal to the adult period. It draws the attention on the interval between the perinatal and the adult period that includes childhood and adolescence. Conclusions: Data in the literature seem to outline an evolution of HTN throughout the whole lifetime of the patient, from the perinatal period (in which intervene genetic, epigenetic, and environmental factors) to adult HTN. The time frame between these two periods appears as an intermediate stage which corresponds with childhood and adolescence.
Background: Acute Lower Respiratory Infections are a heavy burden on the Heath system. The viral cause is the most prevalent in children. The techniques of detection by molecular biology have made it possible to broaden the virological diagnosis and to optimize the therapeutic management. The aim of our work is to describe the epidemiological and virological characteristics of our patients and to specify the factors associated with the severity of the disease by evaluating the need for oxygen and the duration of hospitalization in the patients. Patients and Methods: this is a cross-sectional prospective study carried out from January 1 to February 28, 2021 in the pediatrics department at Cheikh Khalifa Hospital in Casablanca. The epidemiological, clinical and paraclinical data of the patients were collected on an admission form. The virological diagnosis was carried out on nasopharyngeal swabs by the multiplex Polymerase Chain Reaction (PCR) test. Results: A total of 85 cases were included with a median age of 9 months. Children under 12 months of age accounted for 55.3% of cases. The predominant clinical picture was wheezing dyspnea (45.9%). The median length of hospital stay was 5 days [3 - 6]. RSV, rhinovirus, influenza A and H1N1 influenza are detected in 50.8%, 17.5%, 17.5% and 5.2% respectively. Co-infection with 2 viruses is noted in 3 cases. By comparing the patients who required oxygen therapy with those who did not have this need, a statistically significant difference according to age (p <0.001), length of stay (p = 0.019), CRP level (p = 0.02) and whether or not the chest x-ray was pathological (p = 0.005) was found. Conclusion: This study made it possible to determine the virological agents most implicated in ARI during the winter period in our patients. The multiplex PCR detection technique, although expensive, is rapid and efficient. Its routine use should reduce the number of unnecessary paraclinical examinations and the overuse of antibiotics.
High stress in parents may affect parenting and subsequent child socioemotional and behavioral development. Previous evidence suggests that highly stressed parents are more likely to engage in negative parenting, which is less structured and more punitive. However, the effects of life stress versus parent specific stress on parent-child interactions in early childhood has not been well studied, especially in minority and low-income samples. Thus, the current study assessed the relationship between perceived life stress, parenting-related stress, and observed parenting responses to young children during a structured, mildly challenging parent-child task. Predominantly minority and low-income parents and their children (2-5 years old; 54 dyads) completed the Perceived Stress Scale, the Parenting Stress Inventory, and participated in a structured 5-minute interaction task, the Toy-Wait Task (TWT), that was video-taped and coded by blind raters. The coding utilized a standardized system with good reliability assessing 1) Affect (parent and child positive and negative affect, shared positive affect), 2) Positive Parenting Behaviors (warmth, structured good involvement, listening/engagement), and 3) Negative Parenting Behaviors (reactivity, judgment, critical parenting). Significant associations were found between perceived life stress and parenting stress, (r (54) = 0.61, p<.01). Parents with higher perceived life stress scores showed more negative affect (r=0.291, p<.05) and lower involvement with the child (r=-0.367, p<.05), while parenting specific stress did not yield significant effects (p's > 0.05). Findings suggest that interventions that reduce stress in minority and low-income parents of young children may also improve parenting of young children with potential impact on decreasing child psychopathology risk.
Minimal tools are available to assist with disaster-related mass transport of hospitalized neonates.We describe the validation of a tool to safely transport neonates during a disaster.The Go Sheet was designed to quickly relay information required for patient care on arrival at a new facility.One hundred randomly selected infants from a level IV neonatal intensive care unit were included in the study.The gold standard physician, a resident, nurse, and patient care technician completed Go Sheets.A blinded physician evaluated each, compared it to the gold standard and determined if it was possible to care for the patient.Residents had the greatest percentage of agreement with the gold standard in most categories.There was high agreement with all raters in vital signs and allergies.The greatest variability occurred in reporting of medication dosing and timing.Simulations indicate that the Go Sheet completed by residents could be used to quickly convey information during a disaster.
Introduction: Neonatal sepsis is an important cause of morbidity and mortality in developing countries.Early diagnosis and treatment is necessary in order to mitigate this trend.Procalcitonin is one of the acute phase reactants meant for this purpose.The objective of the study was to determine the usefulness of procalcitonin as an early marker in the diagnosis of neonatal sepsis in University of Calabar Teaching Hospital, Calabar, Nigeria.Methods: This was a prospective case-control hospital-based study conducted from September, 2017 to April, 2018 among 60 neonates with suspected sepsis admitted into the newborn unit as well as healthy 60 age and sex-matched controls.Socio-demographic data, presenting complaints and risk factors for sepsis among others, were obtained using the pre-tested questionnaire.The history suggestive of sepsis included a history of prolonged rupture of membranes, peripartum pyrexia, prolonged labour, fever, fast breathing, convulsions among others.Physical examination was done with focus on signs suggestive of sepsis such as temperature instability, tachypnoea, dyspnoea, seizures, abdominal distension.Samples for procalcitonin test were collected along with samples for routine sepsis workup and blood smear for malaria parasite at presentation.Blood culture was done for anaerobic and aerobic organisms.The serum samples were pooled and analyzed for procalcitonin using quantitative ELISA test.Data was analyzed using SPSS version 20 and p< 0.05 was taken as statistically significant.Result: Out of the 60 subjects, 19 (31.7%) had blood culture positive sepsis, 36 (60.0%) had blood culture negative sepsis and 5 (8.3%) had neonatal malaria.The gram positive organisms accounted for 13 (68.4%) of the 19 bacteria isolated.Of the 36 neonates with blood culture negative sepsis, 31(86.1%)neonates had clinical signs and/or haematological parameters suggestive of sepsis.In addition, 3(8.3%) neonates had bronchopneumonia while 2(5.6%) had ophthalmia neonatorium.The median procalcitonin (PCT) level in the subjects compared with the controls was 0.98ng/ml and 0.40ng/ml respectively (p value = 0.000).The mean PCT level was 5.97±7.36ng/ml in the subjects and 1.58±3.64ng/ml in the controls.Among the subjects, the median PCT was 1.28ng/ml in blood culture negative sepsis and 0.93ng/ml in blood culture positive sepsis (p value = 0.000).In addition, the mean PCT level was also higher in neonates with blood culture negative sepsis (7.46 ± 8.07ng/ml) when compared with blood culture positive sepsis (4.60±5.99ng/ml).Based on the receiver operating characteristics curve, PCT levels ≥ 0.5ng/ml was suggestive of bacterial infection.Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the curve at PCT level of 0.5ng/ml were 68.4%, 29.3%, 30.0%, 66.7% and 0.51 respectively.Conclusion: These findings show that although serum PCT levels were higher in neonates with suspected sepsis when compared to the healthy babies, they were nevertheless lower in culture proven sepsis (septicaemia).PCT was insignificant as an acute phase reactant because of its low specificity and PPV in our environment.
Introduction: Waardenburg Syndrome (WS) is a rare, genetically and phenotypically heterogeneous disorder caused by abnormal migration or differentiation of neural crest cells during embryonic development.WS is classified into four types: WS Type 1 (WS1), WS2, WS3, and WS4.WS4 is characterized by the association of intestinal aganglionosis, pigmentation abnormalities and sensorineural hearing loss.Variability in the severity of the phenotypes has been reported among patients and different animal models.WS4 is typically characterized by aganglionosis, however hypoganglionosis can clinically mimic aganglionosis in Hirschsprung disease (HSCR), most cases of which are limited to the distal colon and treated by surgical resection, with a pullthrough operation.The most severe form, total colonic aganglionosis, is treated with total colectomy.Congenital myenteric hypoganglionosis (CMH) typically involves both small and large bowel and cannot be cured surgically.Thus accurate histopathologic diagnosis is key to distinguishing hypoganglionosis from aganglionosis seen in HSCR in patients with WS4.Aim: We describe clinical features and intestinal histology in three patients with WS4.Conclusion: Waardenburg syndrome type 4 is a rare genetic disease that presents with a more severe phenotype than types 1-3.Diagnosis is often suspected after a water-soluble contrast enema followed by a rectal suction biopsy.It is ultimately confirmed by a thorough physical examination that is often aided by family history and genetic testing.It remains critical to distinguish these two conditions (aganglionosis and hypoganglionosis) in patients with WS4 in order to avoid unnecessary resections and it seems that enteral autonomy maybe possible to occur over time in those with hypoganglionosis.
Background: Respiratory diseases are common and remain significant causes of emergency in children, especially those less than 5 years old.Objectives: To determine the prevalence, clinical profile, outcome, and common causes of respiratory distress among pediatric patients presenting to the emergency department in King Fahad Hospital, Al-Baha, Saudi Arabia Methods: This was a hospital-based retrospective cohort study carried out at King Fahad Hospital, Al Baha, Saudi Arabia.Children older than 1 month and younger than 14 years who presented to the emergency department with respiratory distress were included in the study.Results: Files of 210 children with respiratory distress were reviewed in this study.The prevalence of respiratory diseases in children was 24%.Hyperactive airway disease was the most common causes of respiratory distress, diagnosed in 48 pts (22.85%), followed by bronchial asthma 45 pts, bronchopneumonia 45 pts (21.41%) each, P< 0.009.No mortality was register in this study.Age group less than 5 years was the most common presenting with respiratory distress, and male were affected more with male to female ratio was 1/1.8, (P<0.007).Tachypnea was the most common sign seen in 87.74% followed by cough in 79.90%.Conclusion: Respiratory diseases were found to be significant cause childhood illnesses and emergency admissions in our hospital.The common respiratory signs were tachypnea, cough, fever, nasal flaring and subcostal retractions.No mortality was documented in this study.
Background: Infection is an important cause of morbidity and mortality especially in the respiratory system. Human metapneumovirus (HMPV) belongs to the paramyxovirus family of viruses, and can cause a simple upper respiratory tract infection (URTI) or severe lower respiratory tract infection LRTI which needs intensive care. Methods: This is a retrospective, descriptive review of the electronic medical record, for a five-year period between January 2017 until December 2021 which was done for all children aged between 0–14 years old, who were admitted to a tertiary PICU in King Fahad Medical City (KFMC) in Riyadh, Saudi Arabia, with a HMPV infection, which was laboratory-confirmed by polymerase chain reaction on specimens obtained via nasopharyngeal swab. Results: 41 patients included in the study period. The age ranged between 3 months to 14 years. The majority of cases 31 [76%] were admitted between November and March. A total of 35(85.4%) children required respiratory support, 7 [17.1%] patients needed vasopressors, 14 [34.1%] patients received blood transfusions and 2 [4.9%] patients needed renal replacement therapy. Conclusion: The majority of HMPV cases admitted to PICU were between November to March and had a previous admission to PICU due to other co morbidities. Viral co-infection was present in 21.9% of subjects. We found that the majority of the patients needed respiratory support. One quarter of the patients had acute kidney injury initially, and most of them had improved hemodynamics. However two patients did need renal replacement therapy.
Many children require placement of a subdural peritoneal shunt for congenital or acquired hydrocephalus, certain cystic malformations, or subdural hematomas.The device may be placed temporarily or permanently.As many complications have been reported, the indications for placement are limited.We report the case of a male child who required a subdural peritoneal shunt because of a subdural hematoma as a complication of abusive head trauma in early childhood.For technical reasons, the intracranial portion could not be extracted.The child's development was marked by residual hemiparesis and balanced epilepsy.Eleven years later, the epilepsy had worsened, and a left frontal nodular formation in contact with the intracranial portion of the drain was identified, surrounded by perilesional edema.Surgical excision was performed.The histopathological examination revealed a chronic inflammatory infiltrate with superinfection by multisensitive Staphylococcus epidermidis.Antibiotic therapy was associated for 8 weeks.The control cerebral MRI at 8 weeks revealed a scarred cavity with a marked reduction in the left frontal perilesional edema, along with improvement in his epilepsy.Few similar cases have been reported in the literature.Maintaining exogenous material in the intracranial space carries a risk, even many years later, which suggests it should be systematically removed when no longer indicated or functional.
Purpose: This analysis provides a cross-sectional examination of adolescent mental health and substance use, to explore whether COVID-19 related stressors had an impact on substance use.Methods: This analysis examines data from 249 adolescents (aged 12-17 years) gathered between April 2020-April 2021.Adolescents completed a one-time survey assessing COVID-19-related stressors (CDC COVID-19 question bank), anxiety (GAD-7), depression (PHQ-9), and substance use (ASSIST).COVID-19-related items were categorized to create five indices of the Pandemic Response Index (PRI): Positive Actions, Negative Actions, Antisocial Behavior, Family Conflict, and Family Stress.Four logistic regression analyses were conducted for each substance use dependent variable (tobacco/alcohol/marijuana/any substance), with predictor variables including: 5 covariates (state, age, sex, race, and ethnicity) and 7 explanatory variables (PHQ-9 and GAD-7 scores, and the 5 Pandemic Response Indices scores).Results: Overall rates of anxiety and depression were high in the sample.For the PRI, Negative Actions (aOR=1.67[1.06, 2.61]) and Antisocial Behavior (aOR=1.31[1.06, 1.63]) indices were significantly associated with alcohol use, while Family Stress was associated with tobacco use (aOR=2.08 [1.31, 3.30]) and any substance use (aOR=1.58 [1.08, 2.29]).Across each of the models, the only significant preventive relationship from the PRI was Positive Action (aOR=0.63[0.34, 0.89]), which was associated with decreased likelihood of tobacco use.Conclusion: This study found an association between some COVID-19 stressors and adolescent substance use behaviors.Self-reported anxiety and depression in this sample are concerning, but were not independently associated with substance use.
Objectives: To determine patient characteristics and clinical outcomes during and after orchiopexy in syndromic children with either developmental delay, genetic syndromes, or congenital anomalies compared to age matched controls.Study Design: This is a retrospective cohort study of patients ≤ 18 years old who underwent orchiopexy at UCSF Benioff Children's Hospitals between 2012-2020 and were identified as syndromic patients with either developmental delay, molecular testing-confirmed genetic syndromes or known congenital anomalies, compared to an age-matched non syndromic control group.Intra-operative covariates including procedure staging, surgical approach, undescended testes location, estimated blood loss, intra-operative complication occurrence, orchiopexy laterality and post-operative covariates including complication occurrence were gathered through electronic chart review.Differences in continuous and categorical variables were assessed using Mann-Whitney and Chi-squared tests, respectively.Results: Our study yielded 825 total patients undergoing orchiopexy, of which 16% were defined as syndromic.67 patients had developmental delay, 38 patients had a defined genetic syndrome, and 25 patients had an associated congenital anomaly.These patients were compared to 60 age matched non-syndromic control patients undergoing orchiopexy.Patients with unspecified developmental delay more often underwent bilateral orchiopexy compared to the control group (43% v. 23%, p=0.02).Patients with a genetic syndrome were less likely to have a single stage procedure (92% v. 100%, p=0.03) and more likely to undergo bilateral orchiopexy (45% v. 23%, p=0.03) compared to the control group.There were no differences in rate of bilateral orchiopexy and single stage procedures between patients with a congenital anomaly and the control group.There was no difference in intraoperative or post-operative complications or clinical outcomes between the three syndromic groups and control group.Conclusions: Clinical outcomes were no different between patients with syndromes undergoing orchiopexy compared to non-syndromic children.Patients with non-specific developmental delay or a genetic syndrome more often had bilateral orchiopexies.Patients with a genetic syndrome were also less likely to have a single stage procedure.Orchiopexy in syndromic patients undergoing orchiopexy is safe with comparable outcomes to non-syndromic patients.
Congenital scoliosis is a complex spinal deformity that arises during fetal development. It is often associated with other congenital anomalies, such as those found in VACTERL syndrome, which includes vertebral anomalies, anal atresia, cardiac defects, tracheoesophageal fistula, renal anomalies, and limb abnormalities. This case report presents a unique case of congenital scoliosis associated with VACTERL syndrome and explores the impact of substance use during pregnancy
