The Evaluation of Transported Children to Pediatric Intensive Care Unit: Indications, Problems, and Outcomes.

OBJECTIVE: Critically ill children often require transport to tertiary centers where higher levels of care can be provided. In this study, we aimed to evaluate the reasons for transport, complications that occurred during transport, and the clinical outcomes of the patients transferred to our tertiary pediatric intensive care unit (PICU). METHODS: This retrospective study was conducted in a tertiary pediatric hospital with 250 beds and 20 tertiary PICU beds. RESULTS: During the study period, 108 patients were transferred to our PICU. The mean age was 75.0 ± 70.5 months (range, 1-211 months), and 59 were female. Most patients (82.4%) were transported by land; 17.6% were transported by air ambulance. Fourteen patients were referred for liver transplantation, and 7 patients were referred because of a need for extracorporeal membrane oxygenation support and heart transplantation or left ventricular assist device placement. Two patients were transported by air while on extracorporeal membrane oxygenation. Complications occurred in 25% of patients. CONCLUSION: Vital signs were assesed, and certain critical interventions such as intravenous fluids and respiratory support were provided more frequently during air transport, possibly due to the fact that physicians were always present during air transport. Quality improvement of transport teams and multicenter and nationwide studies on PICU transport are needed.

Giant juvenile fibroadenoma of the breast: a clinical case. / Fibroadenoma gigante juvenil de mama: presentación de un caso clínico.

Juvenile giant fibroadenoma is a benign breast tumor and rare variant of the fibroadenomas. Clinical presentation is usually a painless, solitary and unilateral breast mass. It accounts for 0.5%-2% of all fibroadenomas and exact etiology is not known; however, hormonal influences are thought to be contributing factors. We present a case of a 20 cm diameter giant juvenile fibroadenoma of the breast in a 14-year-old girl. The patient was suffering from a painless, progressively enlarging mass for 1 year. Ultrasound revealed fibroadenoma and total surgical excision was performed. The patient is doing well in ten months of follow up.

El fibroadenoma gigante juvenil es un tumor de mama benigno y una variante rara de los fibroadenomas. La presentación clínica suele ser una masa tumoral indolora en la mama, aislada y unilateral. Representa entre el 0,5% y el 2% de todos los fibroadenomas y se desconoce su etiología precisa. Sin embargo, se cree que las hormonas son factores contribuyentes. En este artículo presentamos el caso de un fibroadenoma gigante juvenil de 20 cm de diámetro en la mama de una niña de 14 años. La paciente tenía una masa tumoral indolora, que se había agrandado progresivamente durante 1 año. La ecografía reveló la presencia de un fibroadenoma y se realizó una excisión quirúrgica. Tras diez meses de seguimiento, la paciente se encuentra bien.

Fibroadenoma gigante juvenil de mama: presentación de un caso clínico / Giant juvenile fibroadenoma of the breast: a clinical case

El fibroadenoma gigante juvenil es un tumor de mama benigno y una variante rara de los fibroadenomas. La presentación clínica suele ser una masa tumoral indolora en la mama, aislada y unilateral. Representa entre el 0, 5% y el 2% de todos los fibroadenomas y se desconoce su etiología precisa. Sin embargo, se cree que las hormonas son factores contribuyentes. En este artículo presentamos el caso de un fibroadenoma gigante juvenil de 20 cm de diámetro en la mama de una niña de 14 años. La paciente tenía una masa tumoral indolora, que se había agrandado progresivamente durante 1 año. La ecografía reveló la presencia de un fibroadenoma y se realizó una excisión quirúrgica. Tras diez meses de seguimiento, la paciente se encuentra bien.

Juvenile giant fibroadenoma is a benign breast tumor and rare variant of the fibroadenomas. Clinical presentation is usually a painless, solitary and unilateral breast mass. It accounts for 0.5%-2% of all fibroadenomas and exact etiology is not known; however, hormonal influences are thought to be contributing factors. We present a case of a 20 cm diameter giant juvenile fibroadenoma of the breast in a 14-year-old girl. The patient was suffering from a painless, progressively enlarging mass for 1 year. Ultrasound revealed fibroadenoma and total surgical excision was performed. The patient is doing well in ten months of follow up.