In recent years, electronic cigarettes (e-cigs) have been falsely advertised as safe alternatives to conventional smoking. We report a case involving a 16-year-old female who presented with fever, nonproductive cough, and shortness of breath after vaping e-cig/tetrahydrocannabinol dab pen. Her symptoms rapidly deteriorated and met diagnostic criteria for pediatric acute respiratory distress syndrome. Chest radiograph revealed extensive patchy airspace disease and computed tomography scan showed bilateral ground glass opacities. Bronchoalveolar lavage fluid revealed increased neutrophils, lymphocytosis, but absent eosinophilia. After the results of a comprehensive workup for infectious etiology returned negative, she was diagnosed with hypersensitivity pneumonitis and started on systemic corticosteroids.
Vertebral artery dissection (VAD) followed by basilar artery occlusion/stroke (BAO/BAS) is a rare but potentially life-threatening complication. We present a case report of a 7-year-old boy with VAD complicated by BAO/BAS 4 days after falling off a scooter. Symptoms included left-sided weakness and facial droop preceded by a 20-minute episode of altered sensorium. Magnetic resonance imaging showed ischemic changes in the left posterior inferior cerebellum and right pons. Computed tomography angiogram confirmed dissection of the left vertebral artery with occlusion/thrombosis of the basilar artery. Heparinization for 96 hours, followed by 6 months of low-molecular weight heparin injection, resulted in improvement of his neurological symptoms.
Adverse childhood experiences (ACEs) refer to a collection of traumatic life events that can derail future development, impact physical/mental health, and affect learning/behavior into adulthood. In the United States, it is estimated that two-thirds of children and teens will experience traumatic ACEs by the age of 16. Schools can represent one domain in a child’s life where trauma-informed approaches (TIAs) could be helpful to curtail effects of ACEs. This systematic review aimed to identify some positive commonalities/facilitators (e.g., drivers of change) among existing TIAs implemented in US schools. The secondary objectives aimed to evaluate the confidence of qualitative data using GRADE-CERQual and to highlight potential challenges/barriers associated with the implementation process of TIAs in schools. This manuscript presents a thorough overview of the current state of trauma-informed practices in US schools and concludes with a forward-thinking discussion on key implications for enhancing the field of education.
The postpartum period is characterized by a myriad of changes—emotional, physical, and spiritual; whilst the psychosocial health of new parents is also at risk. More alarmingly, the majority of pregnancy-related deaths in the U.S. occur during this critical period. The higher maternal mortality rate is further stratified by dramatic racial and ethnic variations: Black, brown, and American Indian/Alaska Native indigenous people have 3–4x higher rates of pregnancy-related deaths and severe morbidity than their White, non-Hispanic, and Asian/Pacific Islander counterparts. This policy brief explores how expanding evidence based home visiting programs (HVPs) and strengthening reimbursement policies that invest in such programs can be pivoted to optimize the scope of care in the postpartum period.
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