Pediatric head and neck tumors: an intra-demographic analysis using the SEER* database.

BACKGROUND: The aim of this study was to determine the most frequently presenting tumors exclusive to the head and neck within the pediatric population, and to identify racial disparities within the existing incidence rates. MATERIAL/METHODS: The population-based Surveillance, Epidemiology, and End Results (SEER) registry was utilized to identify the frequency and incidence rates of various tumors found exclusively in the head and neck, diagnosed between 1973 and 2008 in pediatric patients. The tumor categories were based on those defined by the US Department of Health and Human Services National Cancer Institute (NCI). Proportional comparisons were applied to evaluate the intra-demographic incidence rate differences. RESULTS: Among the 11 categories defined, the 5 most prevalent head and neck cancers within the pediatric population were salivary gland tumors (n=319); followed by nasopharyngeal neoplasms (n=311); tumors of the nose, nasal cavity and middle ear (n=208); gum and other mouth tumors (n=134); and glossal tumors (n=61). Proportional comparisons between racial frequency rates indicated that salivary gland tumors were greatest among white pediatric patients (n=246, CI=0.8 to 14.1%, p<.05). Nasopharyngeal cancers were highest among blacks (CI=-26.8 to -12.1%) and other races (CI=-23.6 to -3.4%) relative to the white population. CONCLUSIONS: Salivary gland tumors were the most commonly seen head and neck tumors overall among pediatric patients between 1973 and 2008. Incidence rate differences between white, black, and other racial background pediatric patients revealed that overall, head and neck tumors are most prevalent among pediatric patients within the white ethnic population, while nasopharyngeal tumors showed a strong prevalence in blacks and other ethnic populations.

Acute respiratory failure during routine blood transfusion: a case report and review of the literature.

BACKGROUND: Transfusion medicine is a common practice in the emergency department (ED) and other outpatient settings, and may be complicated by a low rate of potentially fatal transfusion-related reactions. OBJECTIVES: This article presents a case of transfusion-related acute lung injury (TRALI) diagnosed and treated in the ED and reviews the differential diagnosis of acute transfusion reactions. CASE REPORT: A 74-year-old woman presented to the ED from the hospital's transfusion center with fever and respiratory distress immediately after the start of her second unit of red blood cell transfusion. Chest radiograph demonstrated a pattern consistent with acute respiratory distress syndrome (ARDS). After 48 h of respiratory support and antibiotic therapy, the patient's condition improved. CONCLUSION: TRALI is a clinical diagnosis with presentation similar to that of ARDS. Prompt differentiation from other transfusion reactions and initiation of appropriate treatment is crucial in minimizing the morbidity and mortality associated with this syndrome.