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Purpose: To characterize delays in diagnosis and treatment of retinal detachments (RDs) in a pediatric population.
Design: Retrospective cohort study using insurance claims data.
Subjects: Pediatric patients with RD who underwent repair in the outpatient setting.
Methods: A retrospective analysis of commercially insured patients from a national cohort (IBM MarketScan Research Databases) aged ≤ 18 years with an incident diagnosis of RD between 2007 and 2016. Patients with preceding eye-related visits, time to diagnosis, and time to repair were calculated and compared between patients with pre-existing ocular diagnosis and those without.
Main Outcome Measures: The time from diagnosis to specialist consultation, time from diagnosis to repair, time from specialist consultation to repair, number of preceding visits, and presence of previous eye-related diagnosis.
Results: Our sample consisted of 826 patients, the majority (77%) of whom were diagnosed with rhegmatogenous RD. Only 40% of patients had at least 1 preceding eye-related visit, and 33% had at least 2 visits before RD diagnosis, with a median time from the last eye-related visit of 32 days (4-197 days) and median time from the second to last visit of 118 days (24-437 days). The median time from RD diagnosis to repair was 2 days (0-9 days). The 323 (37.9%) patients with pre-existing ocular diagnoses more frequently had at least 1 (44% vs. 37%; P = 0.079) or 2 preceding eye-related visits (40% vs. 29%; P = 0.002) compared with those without and also had a shorter time to RD diagnosis (median, 14.5 days vs. 44.5 days; P = 0.011) and repair (1 day vs. 3 days; P = 0.003).
Conclusions: Retinal detachment is an important cause of morbidity in children. This work highlighted how pediatric patients without previous ocular diagnoses and visits with eye care professional may have a delayed diagnosis and repair of their RD.
Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.
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http://dx.doi.org/10.1016/j.oret.2022.08.017 | DOI Listing |
Clin Pediatr (Phila)
September 2025
Department of Medicine (Infectious Disease), University of Connecticut Health Center, Boston University Medical Center, Falmouth Hospital, Falmouth, MA, USA.
A total of 101 patients with a clinical picture of persisting Lyme disease seen at the University of Connecticut Health Center and Boston Medical Center were recruited for the study to determine whether persistent infection is the likely cause. Brain SPECT imaging and responses to antibiotic treatments were recorded. Patients had more than 5 symptoms lasting more than 6 months.
View Article and Find Full Text PDFCirc Arrhythm Electrophysiol
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Department of Congenital Heart Disease, Evelina London Children's Hospital, United Kingdom (S. Chivers, T.V., V.Z., S.M., G.M., W.R., E.R., D.F.A.L., T.G.D., O.I.M., G.K.S., J.M.S.).
Background: Fetal tachycardias can cause adverse fetal outcomes including ventricular dysfunction, hydrops, and fetal demise. Postnatally, ECG is the gold standard, but, in fetal practice, echocardiography is used most frequently to diagnose and monitor fetal arrhythmias. Noninvasive extraction of the fetal ECG (fECG) may provide additional information about the electrophysiological mechanism and monitoring of intermittent arrhythmias.
View Article and Find Full Text PDFSurg Infect (Larchmt)
September 2025
Department of Surgery, Division of Acute Care Surgery, University of Florida College of Medicine, Gainesville, Florida, USA.
Patients with traumatic injuries who develop ventilator-associated pneumonia (VAP) incur a higher risk of developing multi-drug resistance. Shorter duration of antibiotic agents for early VAP at five days may reduce antibiotic agent exposure without worsening patient outcomes. This retrospective cohort study performed at a Level I Trauma Center included adult (≥16 years old) patients with trauma diagnosed with bronchoalveolar lavage (BAL)-proven early (within four days of intubation) bacterial VAP.
View Article and Find Full Text PDFRev Med Liege
September 2025
Service de Chimie clinique, CHU Liège, Belgique.
Chronic kidney disease (CKD), heart failure (HF) and atherosclerotic cardiovascular disease (ASCVD) are pathologies that may remain silent for a long time and thus are largely underdiagnosed in clinical practice. The use of biomarkers may help detect people already suffering from these diseases at an early stage or at increased risk to develop them in a near future. The aim of this article is to discuss the place of the assays of albuminuria, natriuretic peptide (BNP/proBNP) and high-sensitivity troponin as well as lipoprotein(a) to help in the diagnosis and prognosis assessment of individuals at risk of presenting or developing a CKD, HF or ASCVD.
View Article and Find Full Text PDFBr J Psychiatry
September 2025
Neuroscience Research Australia, Randwick, New South Wales, Australia.
Background: Individuals with a family history of bipolar disorder are at increased risk of developing affective psychopathology. Longitudinal imaging studies in young people with familial risk have been limited, and cortical developmental trajectories in the progression towards illness remain obscure.
Aims: To establish high-resolution longitudinal differences in cortical structure that are associated with risk of bipolar disorder.