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Age at presentation of common pediatric surgical conditions: Reexamining dogma.
[hirschsprung disease]
The
commonly
cited
ages
at
presentation
of
many
pediatric
conditions
have
been
based
largely
on
single
center
or
outdated
epidemiologic
evidence
.
Thus
,
we
sought
to
examine
the
ages
at
presentation
of
common
pediatric
surgical
conditions
using
cases
from
large
national
databases
.
A
retrospective
analysis
was
performed
on
Healthcare
Cost
and
Utilization
Project
databases
from
1988
to
2009
.
Pediatric
discharges
were
selected
using
matched
ICD
9
diagnosis
and
procedure
codes
for
malrotation
,
intussusception
,
hypertrophic
pyloric
stenosis
(
HPS
)
,
incarcerated
inguinal
hernia
(
IH
)
,
and
Hirschsprung
disease
(
HD
)
.
Descriptive
statistics
were
computed
.
A
total
of
63
,
750
discharges
were
identified
,
comprising
2744
cases
of
malrotation
,
5831
of
intussusception
,
36
,
499
of
HPS
,
8564
of
IH
,
and
10
,
112
of
HD
.
About
58
.
2
%
of
malrotation
cases
presented
before
age
1
.
Moreover
,
92
.
8
%
of
HPS
presented
between
3
and
10
weeks
.
For
intussusception
,
50
.
3
%
and
91
.
4
%
presented
prior
to
ages
1
and
4
years
,
respectively
.
Also
,
55
.
8
%
of
IHD
cases
presented
before
their
first
birthday
.
For
HD
,
6
.
5
%
of
cases
presented
within
the
neonatal
period
and
45
.
9
%
prior
to
age
1
year
.
Our
findings
support
generally
cited
presenting
ages
for
HPS
and
intussusception
.
However
,
the
ages
at
presentation
for
HD
,
malrotation
,
and
IH
differ
from
commonly
cited
texts
.
Diseases
Validation
Diseases presenting
"neonatal period"
symptom
alexander disease
alpha-thalassemia
benign recurrent intrahepatic cholestasis
congenital adrenal hyperplasia
congenital diaphragmatic hernia
congenital toxoplasmosis
cutaneous mastocytosis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
harlequin ichthyosis
hirschsprung disease
homocystinuria without methylmalonic aciduria
junctional epidermolysis bullosa
kabuki syndrome
kallmann syndrome
kindler syndrome
lamellar ichthyosis
megacystis-microcolon-intestinal hypoperistalsis syndrome
monosomy 21
neonatal adrenoleukodystrophy
neuralgic amyotrophy
pyruvate dehydrogenase deficiency
zellweger syndrome
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