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Case of Resistant Epileptic Encephalopathy a Child with Microcephalic Capillary Malformation Syndrome 顽固性癫痫性脑病伴小头毛细血管畸形综合征1例
Pub Date : 2019-04-30 DOI: 10.31031/RPN.2019.03.000564
Sсhugareva Lm, Shumeeva Ag
of presented with the early-onset drug-resistant epilepsy, microcephaly, spastic tetraplegia, profound developmental delay, multiple small capillary hemangiomas in the skin, hypoplasia of fingers. A novel homozygous mutation of STAMBP gene (c188A>G; chr2:74058171rs781694797) in exon 2 was revealed. The same mutation was found in both parents. The antiepileptic drug combination therapy was given.
表现为早发性耐药癫痫、小头畸形、痉挛性四肢瘫痪、严重发育迟缓、皮肤多发小毛细血管瘤、手指发育不全。STAMBP基因纯合突变(c188A>G)Chr2:74058171rs781694797)在外显子2中被发现。在父母双方身上都发现了相同的突变。给予抗癫痫药物联合治疗。
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引用次数: 2
Early Diagnostics of Congenitated Conscious False Hernia Own Diaphragm 先天性有意识膈假疝的早期诊断
Pub Date : 2019-03-17 DOI: 10.31031/RPN.2019.03.000563
Rayanov Nv, Rayanova Rn
Congenital diaphragmatic hernia (EDC) is a malformation of the thoracic-abdominal barrier, in which the abdominal organs are transported into the chest through the natural pathological openings in the diaphragm. The frequency of occurrence in newborns is 1: 2500-1: 5000, which is 8% of all congenital anomalies. Diaphragmatic hernia is divided into three main groups: hernia proper diaphragm (false, true), hiatal hernia (true), hernia of the anterior part of the diaphragm. The article presents a clinical case of early diagnosis of congenital false hernia of the diaphragm itself.
先天性膈疝(EDC)是一种胸腹屏障畸形,腹部器官通过横膈膜的自然病理开口进入胸腔。新生儿发生频率为1:25 00- 1:5 000,占所有先天性异常的8%。膈疝主要分为三大类:膈固有疝(假、真)、膈裂孔疝(真)、膈前部疝。本文报告一例先天性膈肌假疝的早期诊断。
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引用次数: 0
Impact of Kangaroo Mother Care, Music Therapy and Psychological Support to Mothers of VLBW Preterm Newborns on The Breast Milk Production and Neonatal Outcome: Our Experience 袋鼠妈妈护理、音乐治疗和心理支持对VLBW早产儿母亲母乳产量和新生儿结局的影响:我们的经验
Pub Date : 2019-03-15 DOI: 10.31031/RPN.2019.03.000561
P. Betta
Background: Kangaroo mother care (KMC) is a method of care of preterm and low birth weight infants. The method involves infants being carried, usually by the mother, with skin-to-skin contact. Objectives: We evaluated the hypothesis that KMC could have beneficial effects on breast milk (BM) production, neonatal neurological development and onset of ROP. We also evaluated the type of lactation during and after hospitalization and the duration of admission in the two groups. Methods: Our sample was made of 46 mothers of 46 preterm newborns (gestational age <34 weeks, birth weight <1500g) admitted at our NICU. They were divided into 2 groups: Group A, made of 23 mothers who have performed a regular extraction of BM and KMC in a dedicated space with a psychological support; group B, made of 23 mothers who have not performed a regular extraction of BM and KMC in a similar setting. Results: The average amount of BM extracted by mothers in group A was greater than group B. Moreover, the comparative analysis showed that 78% of newborns who performed an efficient KMC had a significantly better neurological outcome (p <0.05). A statistically significant difference (p <0.05) was found in the percentage of mothers who continued breastfeeding after discharge (A 52% versus B 26%). The average length of hospital stay was lower in the group A than group B (p <0.05). On the other hands there were no statistically significant differences between the two groups concerning the onset of ROP. Conclusion: KMC performed in comfortable settings with the help of psychological support figures increases the production of BM, promotes the continuation of breastfeeding at the time of discharge and improves the neurological outcome of preterm infants.
背景:袋鼠妈妈护理(KMC)是一种早产儿和低出生体重儿的护理方法。这种方法通常是由母亲抱着婴儿进行皮肤接触。目的:我们评估了KMC可能对母乳产生、新生儿神经发育和ROP发病有有益影响的假设。我们还评估了两组患者在住院期间和住院后的泌乳类型以及住院时间。方法:我们的样本是46位母亲的46个早产儿(胎龄<34周,出生体重<1500g)入住我的NICU。她们被分为两组:A组由23名母亲组成,她们在专门的空间进行常规的BM和KMC提取,并有心理支持;B组,由23名未在类似环境下进行常规BM和KMC提取的母亲组成。结果:A组母亲提取BM的平均量大于b组,并且对比分析显示,78%的新生儿进行有效的KMC后,神经学预后明显改善(p <0.05)。出院后继续母乳喂养的母亲比例(A为52%,B为26%)差异有统计学意义(p <0.05)。A组患者平均住院时间低于B组(p <0.05)。另一方面,两组在ROP发病方面没有统计学上的显著差异。结论:在舒适的环境下,在心理支持数字的帮助下进行KMC,可以增加BM的产生,促进出院时母乳喂养的继续,改善早产儿的神经预后。
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引用次数: 0
Primary Renal Hydatid Cyst in Children: A Case Report 儿童原发性肾包虫病1例报告
Pub Date : 2019-03-09 DOI: 10.31031/RPN.2019.03.000562
A. Jabloun, H. Bouthour, R. Abdallah, F. Trabelsi, Riadh Ben Malek, N. Kaâbar
Echinococcosis is a prevalent zoonosis in endemic region in the world. Although echinococcosis can be present in all parts of the human body, renal echinococcosis is relatively uncommon compared to liver and lung localizations. Its diagnosis is sometimes problematic. There are no specific clinical symptoms or positive result in a routine laboratory analysis that will reliably confirm the diagnosis of renal echinococcus. In this study, a primary right renal hydatic cyst which was found in a 7-year-old girl has been presented. The patient was treated successfully by open surgery in combination with postoperative chemotherapy with albendazole. Physicians should be aware of its clinical presentations and complications.
棘球蚴病是世界流行地区的一种人畜共患病。虽然棘球蚴病可以出现在人体的所有部位,但与肝脏和肺部相比,肾脏棘球蚴病相对罕见。它的诊断有时是有问题的。常规实验室分析没有特定的临床症状或阳性结果,无法可靠地确认肾棘球蚴的诊断。本研究报告一例7岁女童原发性右肾水样囊肿。经开放手术联合术后阿苯达唑化疗,治疗成功。医生应了解其临床表现和并发症。
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引用次数: 0
Dandy-Walker Syndrome – A Case Report 丹迪-沃克综合征1例报告
Pub Date : 2019-02-15 DOI: 10.31031/RPN.2019.03.000560
Halyna Bulak, Dzvenyslava Kopanska
The number of congenital malformations, which are the main cause of early childhood mortality and disability has grown significantly over the past ten years. Congenital anomalies resulting in serious disorders often accompany pathology of the brain. The results of clinical observation of the patient with significant malformation of the central nervous system Dandy-Walker syndrome, have been presented in this paper. Dandy-Walker syndrome occurs in one out of every 25,000 live births but is still not fully understood.
先天性畸形是幼儿死亡和残疾的主要原因,在过去十年中,先天性畸形的数量显著增加。导致严重疾病的先天性异常常常伴随着脑部病理。本文报道了一名中枢神经系统明显畸形的Dandy-Walker综合征的临床观察结果。Dandy-Walker综合征发生在每25000个活产婴儿中,但仍未完全了解。
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引用次数: 0
A Rare Cause of Cytopenias in Childhood: Paroxysmal Nocturnal Hemoglobinuria 儿童血细胞减少症的罕见病因:阵发性夜间血红蛋白尿
Pub Date : 2018-11-15 DOI: 10.31031/rpn.2019.03.000559
B. Yılmaz
Paroxysmal nocturnal hemoglobinuria (PNH) is a rare hematopoietic stem cell disorder characterized by hemolysis, thrombosis and impaired bone marrow functions. PNH is rarely seen in childhood and usually presents with hypoplastic/aplastic anemia clinic. If the major clinical finding is hemolysis, eculizumab (monoclonal anti-C5 immunoglobulin) can be used for treatment. The other treatment options for PNH are immunosuppressive therapy and stem cell transplantation (SCT). Fluorescent aerolysin (FLAER)-based assay is a high sensitivity test for PNH diagnosis in children. FLAER has become the gold standard for the diagnosis and follow-up of PNH get today. Res Pediatr Neonatol Copyright © Baris Yilmaz 229 How to cite this article: Baris Y. A Rare Cause of Cytopenias in Childhood: Paroxysmal Nocturnal Hemoglobinuria. Res Pediatr Neonatol. 3(2). RPN.000559.2019. DOI: 10.31031/RPN.2019.03.000559 Volume 3 Issue 2 found in radiological examinations. During the follow-up period, the patient had developed diarrhea and microscopic examination of feces contained no leukocytes and no pathological agents. In feces, Clostridium difficile toxins A and B, Adenovirus, Rotavirus, Giardia and Entamoeba histolytica antigens were screened and resulted to be negative. In blood serological tests, Anti Hbs and Anti CMV IgG were positive and all other serological tests were negative. Parvovirus IgM and IgG and Anti HIV1 / 2 + p24 Ag were negative. During the follow-up period, the patient had significant clinical improvement and blood, CSF, urine cultures remained to be negative (no growth is seen), therefore patient was discharged, and a polyclinic follow-up was scheduled for her. One week later, she was diagnosed with acute leukemia, aplastic anemia, hypoplastic myelodysplastic syndrome (MDS) though bone marrow aspiration and biopsy. Microscopic examination of bone marrow aspiration with Giemsa staining revealed severe hypocellular bone marrow, which consisted of cells those exhibit uninterrupted maturation. Bone marrow contained each series of cells but displayed predominantly decreased myeloid series (Myeloid / Erythroid series ratio: 1/3). There were dysmorphic changes in the erythroid series. Plastic cell ratio was <1%. Immunophenotypic analysis of bone marrow aspiration material by flow cytometry revealed lymphocytes in 45% and non-lymphocyte mononuclear cells in 4%. Lymphocytes were predominantly composed of T lymphocytes (29%). 2% of the total cells were monocytes and 2% of all cells were myeloid progenitor cells. In the biopsy report from the pathology, it was learned that the cell / fat ratio was 15/85, there were no ring side oblasts, the dyeable iron level was <1+ and the patient was diagnosed with aplastic anemia. For the differential diagnosis of aplastic anemia, DEB test was performed and resulted as negative, MDS panel (monosomy 5 and 7, trisomy 5 and 8, 5q-, 7q-) resulted as negative; patient’s karyotype was found to be 46XX as expected. By using flow cytom
阵发性夜间血红蛋白尿(PNH)是一种罕见的造血干细胞疾病,以溶血、血栓形成和骨髓功能受损为特征。PNH在儿童期罕见,临床表现为发育不良/再生障碍性贫血。如果主要临床表现为溶血,可以使用eculizumab(单克隆抗c5免疫球蛋白)进行治疗。PNH的其他治疗选择是免疫抑制治疗和干细胞移植(SCT)。基于荧光气溶素(fler)的检测是诊断儿童PNH的高灵敏度试验。目前,FLAER已成为PNH诊断和随访的金标准。版权所有©Baris Yilmaz 229如何引用这篇文章:Baris Y.一个罕见的儿童血细胞减少的原因:阵发性夜间血红蛋白尿。[儿科学]. 3(2)。RPN.000559.2019。DOI: 10.31031/RPN.2019.03.000559第3卷第2期在放射检查中发现。随访期间,患者出现腹泻,镜检粪便无白细胞,无病理因子。在粪便中筛选艰难梭菌毒素A、B、腺病毒、轮状病毒、贾第鞭毛虫和溶组织内阿米巴抗原均为阴性。血清学检测中,抗Hbs和抗CMV IgG阳性,其他血清学检测均为阴性。细小病毒IgM、IgG及抗hiv / 2 + p24 Ag阴性。随访期间,患者临床好转明显,血、CSF、尿培养均为阴性(未见生长),因此出院,并安排对其进行综合门诊随访。一周后,经骨髓穿刺活检诊断为急性白血病、再生障碍性贫血、骨髓增生不良综合征(MDS)。用吉姆萨染色法对骨髓穿刺进行显微镜检查,发现骨髓细胞严重减少,由不间断成熟的细胞组成。骨髓中包含了所有系列的细胞,但髓系细胞明显减少(髓系/红系细胞比例:1/3)。红系有畸形改变。塑料电池比<1%。骨髓抽吸材料流式细胞术免疫表型分析显示淋巴细胞占45%,非淋巴细胞单核细胞占4%。淋巴细胞以T淋巴细胞为主(29%)。2%的细胞为单核细胞,2%的细胞为髓系祖细胞。病理活检报告,细胞/脂肪比15/85,无环侧母细胞,可染铁水平<1+,诊断为再生障碍性贫血。鉴别诊断再生障碍性贫血时,行DEB试验结果为阴性,MDS组(5、7、5、8、5q-、7q-)结果为阴性;患者核型如预期为46XX。通过流式细胞术检测红细胞中CD59的表达,通过fler检测巨噬细胞和粒细胞的表达,我们的患者检测到PNH克隆(表1)。表1:诊断时的PNH克隆。
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引用次数: 0
Presentation and Management of HHV6 Infection in a 32 Days Old Baby 32天大婴儿HHV6感染的表现和处理
Pub Date : 2018-11-13 DOI: 10.31031/RPN.2018.03.000557
El Ahmar Malak, Srour Sara, Hanna pielly, Beih Farah, Sacy Robert, I. Nada
Background: Human herpesvirus 6 (HHV-6), commonly known to cause the childhood disease roseola and nonspecific viral illness, has been known to cause serious neurological complications including fever induced seizures and encephalitis with possible long-term sequelae especially in immunocompromised patients. Purposes: To report a rare case of HHV-6 meningitis in a 32-day old male infant and the challenging therapeutic approach required to treat and manage this condition. Case summary: A 32-day old male infant presented with one episode of high-grade fever and bulging anterior fontanel in the absence of skin rashes. Blood tests were normal but lumbar puncture done at admission revealed lymphocytic pleocytosis secondary to acute HHV-6 confirmed by CSF PCR. Data indicating appropriate treatment in this age group is limited. In this case, the patient received Ganciclovir IV for 14 days and showed clinical improvement. Conclusion: Treatment of HHV-6 meningitis with ganciclovir is recommended for immunocompromised patients, including immune deficient patients, and those receiving chemotherapy or prolonged course of steroid. However, literature does not support any specific treatment for immunocompetent children. No data or clear recommendations are currently available for the treatment of neonates with HHV-6 meningitis. Should neonates be thought of as immunocompromised hosts and be treated with Ganciclovir or should they only receive supportive treatment? More studies are required to have an evidence based antiviral treatment in this age group.
背景:人类疱疹病毒6 (HHV-6),通常被认为是引起儿童疾病玫瑰疹和非特异性病毒性疾病,已经被认为是引起严重的神经系统并发症,包括发热引起的癫痫和脑炎,特别是免疫功能低下的患者可能有长期的后遗症。目的:报告一例罕见的32天大男婴HHV-6脑膜炎病例,以及治疗和管理这种疾病所需的具有挑战性的治疗方法。病例总结:一个32天大的男婴,在没有皮疹的情况下,表现为一次高热和前囟门隆起。血液检查正常,但入院时腰椎穿刺显示继发于急性HHV-6的淋巴细胞增多症,经CSF PCR证实。数据表明该年龄组的适当治疗是有限的。本例患者接受更昔洛韦治疗14天,临床有所改善。结论:更昔洛韦治疗HHV-6脑膜炎推荐用于免疫功能低下患者,包括免疫缺陷患者,接受化疗或延长类固醇疗程的患者。然而,文献不支持对免疫功能正常的儿童进行任何特异性治疗。目前尚无治疗新生儿HHV-6型脑膜炎的数据或明确建议。新生儿是否应该被认为是免疫功能低下的宿主,应该用更昔洛韦治疗,还是应该只接受支持性治疗?需要更多的研究来为这一年龄组提供基于证据的抗病毒治疗。
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引用次数: 0
Acute Pneumonia: What Infection We’re Treating? 急性肺炎:我们在治疗什么感染?
Pub Date : 2018-11-13 DOI: 10.31031/RPN.2018.03.000558
I. Klepikov
Dear colleagues, the assessment of the events and phenomena taking place around us, as well as the nature of the reaction to them are determined by the existing ideas and views on the essence of what is happening. As the old postulate of philosophy says: “Ideas rule the world”. This Maxim is relevant for all spheres and branches of our life, including medicine. In the latter case, conceptual ideas about the nature of the disease determine the direction and nature of medical care. It is no secret that the deeper and more specific our knowledge about the causes and mechanisms of the development of the painful process, the higher the chances of achieving maximum success in its treatment. In this context, the modern understanding of the nature of acute pneumonia (АР) raises many questions, to which there are actually no reasoned answers in the available literature.
亲爱的同事们,对我们周围发生的事件和现象的评价,以及对这些事件和现象的反应的性质,是由对正在发生的事情的本质的现有想法和观点决定的。正如古老的哲学公理所说:“思想统治世界”。这句格言适用于我们生活的各个领域和分支,包括医学。在后一种情况下,关于疾病性质的概念观念决定了医疗保健的方向和性质。众所周知,我们对疼痛过程发展的原因和机制的了解越深入和具体,在治疗中取得最大成功的机会就越高。在这种情况下,对急性肺炎本质的现代理解(АР)提出了许多问题,在现有文献中实际上没有合理的答案。
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引用次数: 2
Relevance of Single Step Gastric Aspirate Shake Test in Management of Respiratory Distress Syndrome in Preterm Babies and Neonatal Mortality in Rural Setup 单步吸胃震动试验与农村地区早产儿呼吸窘迫综合征及新生儿死亡率的相关性
Pub Date : 2018-10-05 DOI: 10.31031/RPN.2018.03.000555
R. Jaswal, Shikha Verma
This study was conducted Abstract The morbidity and mortality due to preterm births is significant, one of the handicaps of preterm delivery is respiratory distress syndrome (hyaline membrane disease). The timely recognition and referral of these babies from peripheral institutions to tertiary care centers of utmost importance for further management. This study was conducted to highlight the application of this forgotten simple, cheap and sensitive single step gastric aspirate shake test.
摘要早产的发病率和死亡率显著,早产的障碍之一是呼吸窘迫综合征(透明膜病)。及时识别和转介这些婴儿从外围机构到三级护理中心是最重要的进一步管理。本研究旨在强调这种被遗忘的简单、廉价、灵敏的单步吸胃震动试验的应用。
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引用次数: 0
Early Interventions for Infants with Clinical Signs of Cerebral Palsy 有脑瘫临床症状婴儿的早期干预
Pub Date : 2018-09-18 DOI: 10.31031/RPN.2018.03.000553
Puneet Wadhwa
In a bid to construct an all-encompassing definition of the multi-faceted condition that is cerebral palsy (CP), The Study of Cerebral Palsy in Europe (SCPE) and the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) have attempted a unifying definition, as follows: “Cerebral palsy describes a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing foetal or infant brain. The motor disorders are often accompanied by disturbances of sensation, perception, cognition, communication and behavior; by epilepsy and by secondary musculoskeletal problems” [1].
为了给脑瘫(CP)这一多方面的疾病建立一个全面的定义,欧洲脑瘫研究(SCPE)和美国脑瘫与发育医学学会(AACPDM)尝试了一个统一的定义,如下:脑瘫描述的是一组永久性的运动和姿势发育障碍,导致活动受限,这是由于胎儿或婴儿大脑发育中发生的非进行性障碍造成的。运动障碍常伴有感觉、知觉、认知、交流和行为障碍;癫痫和继发性肌肉骨骼问题"[1]。
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引用次数: 0
期刊
Research in Pediatrics & Neonatology
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