Lead Poisoning From Home-Prepared Indian Spices in 3 Families.

Spice consumption, along with other environmental factors, can contribute to pediatric lead poisoning. Although public health efforts have increased awareness of contamination of spices, false assumptions regarding the safety of home-prepared spices have emerged. Here, we present the clinical features, family beliefs, and environmental toxicology of 3 spice-associated pediatric lead poisoning cases.

Identification of hearing loss in pediatric patients with Down syndrome.

OBJECTIVE: To determine the type of hearing loss, incidence of the lost to follow-up rate, and the time to diagnose sensorineural hearing loss (SNHL) in children with Down syndrome (DS) identified from a statewide database. STUDY DESIGN: Case series with chart review. SETTING: Pediatric referral center. SUBJECTS AND METHODS: Three hundred forty-four patients with DS born in Utah between January 2002 and December 2006 were identified using the Utah Department of Health's Newborn Hearing Screening database and birth defects registry. RESULTS: Three hundred thirty-two patients were included in the study. Eighty-seven infants (26.2%) did not pass their newborn hearing screening (NBS). Thirty-three of these children (37.9%) had a conductive hearing loss attributed to serous otitis media. Five infants had SNHL; 3 children were diagnosed with a mixed hearing loss (MHL). The average time to diagnose a sensorineural hearing loss was 485 ± 601 days. One child who passed his NBS was subsequently found to have an SNHL. More than 43% of the newborns with DS who passed their NBS developed a conductive hearing loss requiring insertion of ventilation tubes. Eighty-four percent of newborns with DS who did not undergo NBS did not have any apparent subsequent audiologic testing. CONCLUSION: Patients with DS present with a relatively high incidence of conductive hearing loss, MHL, and SNHL and a higher lost to follow-up rate compared to patients without DS. The authors were not able to diagnose SNHL within the 90-day period recommended by the Joint Committee on Infant Hearing.

Extracorporeal septoplasty: complications and new techniques.

OBJECTIVES: To report our complication rates during extracorporeal septoplasty (ECS) and to describe a new fixation and splinting technique we developed to simplify stable midline fixation of the neocaudal septum. Correction of the caudally deviated septum remains one of the more difficult surgical goals in functional nasal surgery. METHODS: A retrospective medical record review of patients undergoing ECS at our institution. We report our complications and describe a new technique for ECS. RESULTS: Forty-six patients underwent ECS from June 1, 2007, through April 30, 2010. Twenty-six of these patients underwent primary surgical repair, whereas 20 presented for revision surgery from outside facilities. Ten revision cases required an ear cartilage graft, and 5 required a rib graft. The overall complication rate was 9% (4 patients), with 4% (2 patients) each for minor and major complications. CONCLUSIONS: Complication rates of ECS are similar to those of endonasal septoplasty. Stable midline fixation of a reconstructed neocaudal septum is possible with a new technique that relies on novel splinting instead of suture fixation to the midline of the nasal spine.

Correlating matrix metalloproteinase-9 sinus secretion levels with tissue biopsy levels.

BACKGROUND: Collecting mucosal biopsies is invasive and creates additional inflammation, hampering a better understanding of nasal and sinus disease evolution and response to treatment. We examine whether sinus secretion collection can replace tissue biopsy for protein determination. METHODS: Prior to surgical intervention for chronic rhinosinusitis (CRS), a piece of gelatin foam was used to collect secretions from the ethmoid mucosa. A tissue biopsy was then taken from the same location. Matrix metalloproteinase-9 (MMP-9) protein levels were measured in each sample. RESULTS: MMP-9 protein levels in secretions and tissues were significantly correlated (p = 0.0033, r = 0.52, by Pearson correlation). CONCLUSION: Secretion collection can replace tissue biopsy for MMP-9 determinations, reducing morbidity. Furthermore, secretion collection allows sequential sampling from the same location.