Objectives Vertigo is a relatively common complaint in children with 5.3% of pediatric patients complaining of this symptom. Although the causes of vertigo have been well established in adults, the diagnoses in children have not been well described. The aims of this systematic review are to discover the current information regarding etiologies of vertigo in children and to determine the most common diagnoses that present with vertigo in pediatric patients. Methods PubMed, Scopus, and Embase were searched using the PRISMA guidelines. The inclusion and exclusion criteria were established a priori. All results were analyzed using a Bayesian methodology for point estimation and credible interval calculation. Results From the database searches, 1419 titles were reviewed. Twenty-two studies met inclusion criteria. From these studies, a total of 2726 children aged 2 months to 19 years were reported. The top 4 diagnoses associated with childhood vertigo include vestibular migraine (23.8%; credible interval, 22.3%–25.5%), benign paroxysmal vertigo of childhood (13.7%; credible interval, 12.4%–15%), idiopathic or no identified association (11.7%; credible interval, 10.5%–12.9%), and labyrinthitis/vestibular neuronitis (8.47%, credible interval, 7.46%–9.55%) accounting for approximately 57% of cases. Less common diagnoses included Meniere disease and central nervous system tumors. Conclusions Although the most common causes of pediatric vertigo include vestibular migraine and benign paroxysmal vertigo of childhood, the etiologies are myriad. Rates and credible intervals are provided to permit a probabilistic diagnostic approach to these children.

Occupational exposure to trichloroethylene (TCE) has been associated with alterations in B‐cell activation factors and an increased risk of non‐Hodgkin's lymphoma (NHL). Here, we aimed to examine the biological processes influenced by TCE exposure to understand the underlying molecular mechanisms. This cross‐sectional molecular epidemiology study included data of 1317 targeted proteins in the serum from 42 TCE exposed and 34 unexposed factory workers in Guangdong, China. We used multivariable linear regressions to identify proteins associated with TCE exposure and examined their exposure‐response relationship across categories of TCE exposure (unexposed, low exposed: <10 ppm, high exposed: ≥10 ppm). We further examined pathway enrichment of TCE‐related proteins to understand their biological response. Occupational exposure to TCE was associated with lower levels of tumor necrosis factor receptor superfamily member 17 (TNFRSF17; β = −.08; p‐value = .0003) and kynureninase (KYNU; β = −.10, p‐value = .002). These proteins also showed a significant exposure‐response relation across the unexposed, low exposed, and high exposed workers (all p‐trends < .001, false discovery rate [FDR] < 0.20). Pathway analysis of TCE‐related proteins showed significant enrichment (FDR < 0.05) for several inflammatory and immune pathways. TCE exposure was associated with TNFRSF17, a key B‐cell maturation antigen that mediates B‐cell survival and KYNU, an enzyme that plays a role in T‐cell mediated immune response. Given that altered immunity is an established risk factor for NHL, our findings support the biological plausibility of linking TCE exposure with NHL.

Purpose: Diffuse large B-cell lymphoma (DLBCL) is the most common form of non-Hodgkin’s lymphoma, and patients are sometimes asymptomatic until the presentation of an oncological emergency, such as end organ complications, tumor lysis syndrome, or spinal cord compression. We aimed to investigate demographic and clinical factors associated with time from initial symptom onset until diagnosis of DLBCL. Methods: We performed a retrospective cohort study of 1076 patients with DLBCL diagnosed in the Montefiore Health System from 2005 to 2022. Logistic regression models, adjusted for race and preferred language, estimated the associations between demographic factors and increased time to diagnosis (TTD), defined as a time to diagnosis greater than the median for non-Hispanic White patients (58.5 days). Results: Within our cohort, 24.7% of patients were non-Hispanic White, 26.5% were non-Hispanic Black, and 39.86% were Hispanic. Median TTD was highest for Hispanic patients at 63 days (IQR 22–224) followed by non-Hispanic Whites at 58.5 (IQR 22–331) and 58 for non-Hispanic Black patients (IQR 17–237) (p = 0.03). Patients who had a preferred language of Spanish had increased odds of prolonged TTD in the multivariable model (adjusted OR = 2.06, 95% CI = 1.05–4.01, p = 0.03) compared to English speakers, as did patients with a preferred language of “other” (adjusted OR = 3.11, 95% CI = 1.01–9.59, p = 0.05.) Conclusions: Non-English-speaking patients experienced longer TTD of DLBCL compared to English speaking patients. Our results suggest that interventions increasing the availability of interpreter services, patient literature on preventative screenings in non-English languages, and increasing the number of healthcare workers with competency in common foreign languages, may potentially reduce TTD in non English speaking patients.

Background: Ethnic and racial disparities have recently been observed both in treatment-related toxicities and rates of long-lasting cure in acute lymphoblastic leukemia (ALL) and acute lymphoblastic lymphoma (ALLy), the most common pediatric malignancy. Despite significant improvements in overall survival in the recent past, a large number of children die from aggressive disease. Methods:We performed a retrospective cohort analysis of 274 pediatric ALL/ ALLy patients within Montefiore Health System from 2004 to 2021 to determine differences in all-cause mortality within the Pediatric Hematologic Malignancies Cohort using Cox Proportional Hazard regression modeling, adjusted for age at diagnosis, race/ethnicity, administration of intensive chemotherapy, preferred language, maximum glucose, and hypertension.Results: Among our 274 patients, 132 were Hispanic, 54 Non-Hispanic Black, and 25 Non-Hispanic White, with 25 identified as "Non-Hispanic Other," including Asian, Arabic, and Other. Hispanic patients were 78% less likely to die (HR 0.22; 95% CI 0.07, 0.73) when compared with Non-Hispanic Black individuals. Spanish speakers were 2.91 times more likely to die compared with those who spoke English (HR 2.91; 95% CI 1.08, 7.82). Among those English speakers, the diagnosis of hypertension and Hispanic ethnicity significantly impacted the risk of death, while these factors did not impact survival in Spanish speakers. Highrisk cytogenetics did not impact survival.Conclusions: Hispanic children with ALL/ALLy have improved survival outcomes compared with Non-Hispanic Blacks. Additionally, Spanish language preference was strongly associated with poorer survival, a novel finding that should be validated in future studies.