D. Botezatu, R. Bohîlțea, B. Mihai, T. Salmen, Vlad Dima
There are many infectious diseases that the newborn can acquire during the passage through the birth canal. Since the evolution of the medical world, the transmission risk during childbirth has declined severely but it’s not non-existent. We included several studies discussing the most important infections that can be transmitted intrapartum and that can have neurological outcomes. These studies have proven a correlation between newborn intrapartum infections and neurological disorders, as well as long-term neurological sequelae in some cases.
{"title":"Aspects in the neurological localization of intrapartum infections","authors":"D. Botezatu, R. Bohîlțea, B. Mihai, T. Salmen, Vlad Dima","doi":"10.37897/rjp.2022.s2.19","DOIUrl":"https://doi.org/10.37897/rjp.2022.s2.19","url":null,"abstract":"There are many infectious diseases that the newborn can acquire during the passage through the birth canal. Since the evolution of the medical world, the transmission risk during childbirth has declined severely but it’s not non-existent. We included several studies discussing the most important infections that can be transmitted intrapartum and that can have neurological outcomes. These studies have proven a correlation between newborn intrapartum infections and neurological disorders, as well as long-term neurological sequelae in some cases.","PeriodicalId":33512,"journal":{"name":"Revista Romana de Pediatrie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42853448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andreea Calomfirescu-Avramescu, Vlad Dima, Mihaela Demetrian, A. Stancu, A. Bălănescu, P. Bălănescu, I. Gherghina
Introduction. Birth asphyxia is a serious condition that causes neurologic sequelae due to decreased blood flow and oxygen to the fetus. We aimed to identify and describe specific macroscopic and microscopic umbilical cord abnormalities in neonates with asphyxia. Materials and methods. We conducted an observational prospective study over a period of 3 years. 80 patients diagnosed with birth asphyxia which had umbilical cord examination performed were enrolled. The control group consisted in 48 newborns that required neonatal intensive care for at least one week, in the same period of time, for any other reason and that also had available umbilical cord exam. Results. We analyzed data gathered from both groups by applying specific statistical tests for each type of variable and hypothesis. Thus, umbilical cord abnormalities were associated with the hypoxic-ischemic encephalopathy in a statistically significant manner when comparing the asphyxia group of newborns with the control one (p = .00). Conclusion. Marginal or velamentous insertion of the umbilical cord was associated with high risk of birth asphyxia.
{"title":"Umbilical cord abnormalities in newborns with birth asphyxia","authors":"Andreea Calomfirescu-Avramescu, Vlad Dima, Mihaela Demetrian, A. Stancu, A. Bălănescu, P. Bălănescu, I. Gherghina","doi":"10.37897/rjp.2022.s2.2","DOIUrl":"https://doi.org/10.37897/rjp.2022.s2.2","url":null,"abstract":"Introduction. Birth asphyxia is a serious condition that causes neurologic sequelae due to decreased blood flow and oxygen to the fetus. We aimed to identify and describe specific macroscopic and microscopic umbilical cord abnormalities in neonates with asphyxia. Materials and methods. We conducted an observational prospective study over a period of 3 years. 80 patients diagnosed with birth asphyxia which had umbilical cord examination performed were enrolled. The control group consisted in 48 newborns that required neonatal intensive care for at least one week, in the same period of time, for any other reason and that also had available umbilical cord exam. Results. We analyzed data gathered from both groups by applying specific statistical tests for each type of variable and hypothesis. Thus, umbilical cord abnormalities were associated with the hypoxic-ischemic encephalopathy in a statistically significant manner when comparing the asphyxia group of newborns with the control one (p = .00). Conclusion. Marginal or velamentous insertion of the umbilical cord was associated with high risk of birth asphyxia.","PeriodicalId":33512,"journal":{"name":"Revista Romana de Pediatrie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44835961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vlad Dima, G. Iancu, R. Bohîlțea, Raluca Mariana Stanescu, Andreea Avramescu-Calomfirescu, V. Varlas, A. Davitoiu
1Department of Neonatology, Filantropia Clinical Hospital, Bucharest, Romania 2Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, Bucharest, Romania 3Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania 4National Institute for Mother and Child Health “Alessandrescu-Rusescu”, Bucharest, Romania 5“Victor Gomoiu” Clinical Hospital, Bucharest, Romania Ref: Ro J Pediatr. 2022;71(Suppl2) DOI: 10.37897/RJP.2022.S2.18
{"title":"COVID-19 in pregnancy – a possible risk factor for the poor neurological outcome of the infant","authors":"Vlad Dima, G. Iancu, R. Bohîlțea, Raluca Mariana Stanescu, Andreea Avramescu-Calomfirescu, V. Varlas, A. Davitoiu","doi":"10.37897/rjp.2022.s2.18","DOIUrl":"https://doi.org/10.37897/rjp.2022.s2.18","url":null,"abstract":"1Department of Neonatology, Filantropia Clinical Hospital, Bucharest, Romania 2Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, Bucharest, Romania 3Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania 4National Institute for Mother and Child Health “Alessandrescu-Rusescu”, Bucharest, Romania 5“Victor Gomoiu” Clinical Hospital, Bucharest, Romania Ref: Ro J Pediatr. 2022;71(Suppl2) DOI: 10.37897/RJP.2022.S2.18","PeriodicalId":33512,"journal":{"name":"Revista Romana de Pediatrie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44644415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The article focuses on the clinical recognition of septic shock, the basic investigations and the hierarchical treatment based on recent international therapeutic protocols, being especially useful in services that do not have pediatric intensive care units.
{"title":"Practical guidelines in the treatment of septic shock in children","authors":"S. Buzinschi","doi":"10.37897/rjp.2022.3.3","DOIUrl":"https://doi.org/10.37897/rjp.2022.3.3","url":null,"abstract":"The article focuses on the clinical recognition of septic shock, the basic investigations and the hierarchical treatment based on recent international therapeutic protocols, being especially useful in services that do not have pediatric intensive care units.","PeriodicalId":33512,"journal":{"name":"Revista Romana de Pediatrie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42275132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Plotogea, C. Mehedințu, V. Varlas, Francesca Frîncu, R. Mateescu, A. Edu, Vlad Dima, C. Andreescu, C. Berceanu, Rudolf-Florian Mihai
Cord insertion during pregnancy may take and arise different series of characteristics. Intrapartum fetal assessment depends in a significant matter on the umbilical cord, amniotic fluid and placenta. It is also obvious that the umbilical cord may cause problems that can influence labor and pregnancy altogether. There are many concerns about umbilical cord pathology in the past few years, now more than ever because of high morbidity and mortality in both mother and fetus. This high rate of such concern is because of the fetal hypoxia, neonatal asphyxia and hypoxic-ischemic injury at birth. Modern approach and justified interventions are skills required by any young obstetrician and physician who works in Ob-gyn field. The faster the diagnostic and the proper care are embedded, the quicker and better the outcome of the newborn will be, under the circumstances. Multiple gestation involve some risks and they need to be recognized; preterm birth, growth restriction, fetal demise and perinatal mortality nowadays are associated with unfavorable results and traumatized or touching events. The labor and delivery anomalies which might occur is the only clear objective about studying the umbilical cord pathologies and make sure of improving the perinatal outcomes.
{"title":"Different aspects of umbilical cord insertion in twin pregnancies","authors":"M. Plotogea, C. Mehedințu, V. Varlas, Francesca Frîncu, R. Mateescu, A. Edu, Vlad Dima, C. Andreescu, C. Berceanu, Rudolf-Florian Mihai","doi":"10.37897/rjp.2022.3.8","DOIUrl":"https://doi.org/10.37897/rjp.2022.3.8","url":null,"abstract":"Cord insertion during pregnancy may take and arise different series of characteristics. Intrapartum fetal assessment depends in a significant matter on the umbilical cord, amniotic fluid and placenta. It is also obvious that the umbilical cord may cause problems that can influence labor and pregnancy altogether. There are many concerns about umbilical cord pathology in the past few years, now more than ever because of high morbidity and mortality in both mother and fetus. This high rate of such concern is because of the fetal hypoxia, neonatal asphyxia and hypoxic-ischemic injury at birth. Modern approach and justified interventions are skills required by any young obstetrician and physician who works in Ob-gyn field. The faster the diagnostic and the proper care are embedded, the quicker and better the outcome of the newborn will be, under the circumstances. Multiple gestation involve some risks and they need to be recognized; preterm birth, growth restriction, fetal demise and perinatal mortality nowadays are associated with unfavorable results and traumatized or touching events. The labor and delivery anomalies which might occur is the only clear objective about studying the umbilical cord pathologies and make sure of improving the perinatal outcomes.","PeriodicalId":33512,"journal":{"name":"Revista Romana de Pediatrie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45640120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Irina Melinda Baizat, Corina Gabriela Zaharie, M. Hăşmăşanu, M. Matyas, L. Procopciuc
Background. Sepsis continues to be one of the main death causes in the neonate population. The toll-like receptors are molecules that express in the plasma or endosomal membrane and recognize endosomal or microorganism components. While aiming at the identification of new neonatal sepsis biomarkers, the toll-like receptors (TLR) have been considered that some of them overexpress in contact with the bacterial components. Methods. Research in the PubMed database has been made by the following criteria: Inclusion criteria (PubMed database, Period 2005-2022, English & Humans, generated 29, Meta-Analysis - 0, Review - 6, Systematic Review - 0), Exclusion criteria (Studies on animal models, Articles with merely didactical content, Articles regarding only one of the words researched either only neonatal sepsis or TLR in another context than together, Articles that are not directly connected with the topic). Based on the above-mentioned criteria 13 articles were consulted, of which 7 articles included in vivo studies, 6 with in vitro studies. Conclusions. The data of the present review and the current diagnostic method point at the fact that TLRs increase in the conditions of the presence of the inflammatory syndrome. Their dosing during in the neonatal sepsis is possible, but the non-specific overexpression is not a diagnostic.
{"title":"Is it possible to use the Toll-like receptors as biomarkers for neonatal sepsis? Review of the recent literature","authors":"Irina Melinda Baizat, Corina Gabriela Zaharie, M. Hăşmăşanu, M. Matyas, L. Procopciuc","doi":"10.37897/rjp.2022.3.1","DOIUrl":"https://doi.org/10.37897/rjp.2022.3.1","url":null,"abstract":"Background. Sepsis continues to be one of the main death causes in the neonate population. The toll-like receptors are molecules that express in the plasma or endosomal membrane and recognize endosomal or microorganism components. While aiming at the identification of new neonatal sepsis biomarkers, the toll-like receptors (TLR) have been considered that some of them overexpress in contact with the bacterial components. Methods. Research in the PubMed database has been made by the following criteria: Inclusion criteria (PubMed database, Period 2005-2022, English & Humans, generated 29, Meta-Analysis - 0, Review - 6, Systematic Review - 0), Exclusion criteria (Studies on animal models, Articles with merely didactical content, Articles regarding only one of the words researched either only neonatal sepsis or TLR in another context than together, Articles that are not directly connected with the topic). Based on the above-mentioned criteria 13 articles were consulted, of which 7 articles included in vivo studies, 6 with in vitro studies. Conclusions. The data of the present review and the current diagnostic method point at the fact that TLRs increase in the conditions of the presence of the inflammatory syndrome. Their dosing during in the neonatal sepsis is possible, but the non-specific overexpression is not a diagnostic.","PeriodicalId":33512,"journal":{"name":"Revista Romana de Pediatrie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42306733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Pleșca, C. Rădulescu, Alexandra Vilaia, Vlad Pleşca, Anca Cristina Dragnescu
The coronavirus disease 2019 (COVID-19) is profoundly affecting life of the children and adolescents around the globe. The authors present a synthesis of the characteristics of SARS CoV-2 infection in the pediatric population. The role played by children in the transmission of infection as well as the changes related to the clinical picture and the severity of symptoms that changed during the 5 pandemic waves. Another objectives of this review was to describe the diverse facets of the burden of COVID-19 in children and adolescents. The authors presented the direct effects of hospitalization during the acute phase of the disease, multisystem inflammatory syndrome in children, long COVID and the sequelae after infection with the new coronavirus. In addition, the indirect effects of social isolation and interruption in education are discussed. Isolation, contact restrictions and economic shutdown impose a complete change to the psychosocial environment in affected countries. Mental health problems among children and adolescents are increasingly reported amidst the coronavirus disease (COVID-19) pandemic. Anxiety, lack of peer contact and reduced opportunities for stress regulation are main concerns. Another main threat is an increased risk for parental mental illness, domestic violence and child maltreatment. The burden of the COVID-19 pandemic manifested in various ways: there was an increase in poverty, a major crisis arose in education, and new threats concerning children’s health and even survival emerged.
{"title":"Current systematic reviews of the burden of COVID-19 pandemic in children and adolescents","authors":"D. Pleșca, C. Rădulescu, Alexandra Vilaia, Vlad Pleşca, Anca Cristina Dragnescu","doi":"10.37897/rjp.2022.3.9","DOIUrl":"https://doi.org/10.37897/rjp.2022.3.9","url":null,"abstract":"The coronavirus disease 2019 (COVID-19) is profoundly affecting life of the children and adolescents around the globe. The authors present a synthesis of the characteristics of SARS CoV-2 infection in the pediatric population. The role played by children in the transmission of infection as well as the changes related to the clinical picture and the severity of symptoms that changed during the 5 pandemic waves. Another objectives of this review was to describe the diverse facets of the burden of COVID-19 in children and adolescents. The authors presented the direct effects of hospitalization during the acute phase of the disease, multisystem inflammatory syndrome in children, long COVID and the sequelae after infection with the new coronavirus. In addition, the indirect effects of social isolation and interruption in education are discussed. Isolation, contact restrictions and economic shutdown impose a complete change to the psychosocial environment in affected countries. Mental health problems among children and adolescents are increasingly reported amidst the coronavirus disease (COVID-19) pandemic. Anxiety, lack of peer contact and reduced opportunities for stress regulation are main concerns. Another main threat is an increased risk for parental mental illness, domestic violence and child maltreatment. The burden of the COVID-19 pandemic manifested in various ways: there was an increase in poverty, a major crisis arose in education, and new threats concerning children’s health and even survival emerged.","PeriodicalId":33512,"journal":{"name":"Revista Romana de Pediatrie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44651726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Revenco, A. Balanuta, Dina Bujor, A. Horodisteanu-Banuh, O. Cirstea
Objective. The present meta-analysis study aimed to evaluate the effectiveness of 13-valent pneumococcal conjugate vaccine (PCV) in reducing the morbidity from pneumonia among children under 5 years old. Material and methods. Cochrane and Medline electronic databases were systematically searched for studies reporting effectiveness of 13-valent pneumococcal conjugate vaccine against pneumonia among children of the foreseen age group. To assess the effect measure, we used the odds ratio (OR) with 95% confidence intervals (95% CI) for dichotomous outcomes. The heterogeneity of the studies was assessed using I2 and Chi2 statistics. Outcomes. The meta-analysis found a non-significant association between vaccinated children and the development of community-acquired pneumonia (OR=0.50; CI 95%: 0.44-0.57; Chi2=6.07; I2=18%). Vaccine effectiveness (VE) of 13-valent PCV was calculated as (1 – Mantel-Haenszel OR in vaccinated children compared to unvaccinated children) x100%. Thus, the VE of PCV 13 valent was estimated to be about 50%, according to the meta-analysis of the included studies. Conclusions. Our study showed that the group of vaccinated children experienced 50% fewer cases of pneumonia than they would have had if they had not been vaccinated. These data bring additional evidence that vaccination is an effective strategy to prevent community acquired pneumonia in young children.
{"title":"The effectiveness of 13-valent pneumococcal vaccine against community acquired pneumonia in young children: a systematic review and meta-analysis","authors":"N. Revenco, A. Balanuta, Dina Bujor, A. Horodisteanu-Banuh, O. Cirstea","doi":"10.37897/rjp.2022.3.5","DOIUrl":"https://doi.org/10.37897/rjp.2022.3.5","url":null,"abstract":"Objective. The present meta-analysis study aimed to evaluate the effectiveness of 13-valent pneumococcal conjugate vaccine (PCV) in reducing the morbidity from pneumonia among children under 5 years old. Material and methods. Cochrane and Medline electronic databases were systematically searched for studies reporting effectiveness of 13-valent pneumococcal conjugate vaccine against pneumonia among children of the foreseen age group. To assess the effect measure, we used the odds ratio (OR) with 95% confidence intervals (95% CI) for dichotomous outcomes. The heterogeneity of the studies was assessed using I2 and Chi2 statistics. Outcomes. The meta-analysis found a non-significant association between vaccinated children and the development of community-acquired pneumonia (OR=0.50; CI 95%: 0.44-0.57; Chi2=6.07; I2=18%). Vaccine effectiveness (VE) of 13-valent PCV was calculated as (1 – Mantel-Haenszel OR in vaccinated children compared to unvaccinated children) x100%. Thus, the VE of PCV 13 valent was estimated to be about 50%, according to the meta-analysis of the included studies. Conclusions. Our study showed that the group of vaccinated children experienced 50% fewer cases of pneumonia than they would have had if they had not been vaccinated. These data bring additional evidence that vaccination is an effective strategy to prevent community acquired pneumonia in young children.","PeriodicalId":33512,"journal":{"name":"Revista Romana de Pediatrie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46758144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Helicobacter pylori (H. pylori) are one of the most common infections during childhood, and if left untreated it might persist lifelong resulting in severe complications such as gastric malignancies. The epidemiology of this infection has wide variations along the continents, countries and sub-regions being related mainly to the socio-economic status, hygiene and sanitary conditions. Nevertheless, a descending trend of H. pylori prevalence was noticed worldwide during the last decades, fact that might decrease in time the incidence of gastric cancer in adults. The diagnosis of this infection remains tricky in children and the selection of the most effective diagnostic tool is essential in order to early diagnose H. pylori associated gastropathies and extraintestinal manifestations. In spite of the lack of symptoms which occurs especially in pediatric subjects, H. pylori infection might result in severe damage to the gastric mucosa and further complications requiring close monitoring after the eradication regimen. Therefore, multiple non-invasive and invasive methods were designed to identify properly the presence of this bacterium within the individual’s stomach and for enabling the clinician to use to most adequate method based on its sensitivity and specificity, but also based on the specific clinical situations. Aside from the well-known standard triple therapy used for the eradication of this infection, multiple other regimens were lately proposed in order to prevent failure of eradication. Moreover, probiotics were recently proved to improve the eradication rate, and at the same time to decrease the side effects of the antibiotics therapy. The proper eradication of H. pylori infection during childhood remains the cornerstone in preventing gastric cancer during adulthood.
{"title":"New insights regarding Helicobacter pylori infection in children","authors":"A. Dincă, L. Meliț, C. Mărginean","doi":"10.37897/rjp.2022.3.2","DOIUrl":"https://doi.org/10.37897/rjp.2022.3.2","url":null,"abstract":"Helicobacter pylori (H. pylori) are one of the most common infections during childhood, and if left untreated it might persist lifelong resulting in severe complications such as gastric malignancies. The epidemiology of this infection has wide variations along the continents, countries and sub-regions being related mainly to the socio-economic status, hygiene and sanitary conditions. Nevertheless, a descending trend of H. pylori prevalence was noticed worldwide during the last decades, fact that might decrease in time the incidence of gastric cancer in adults. The diagnosis of this infection remains tricky in children and the selection of the most effective diagnostic tool is essential in order to early diagnose H. pylori associated gastropathies and extraintestinal manifestations. In spite of the lack of symptoms which occurs especially in pediatric subjects, H. pylori infection might result in severe damage to the gastric mucosa and further complications requiring close monitoring after the eradication regimen. Therefore, multiple non-invasive and invasive methods were designed to identify properly the presence of this bacterium within the individual’s stomach and for enabling the clinician to use to most adequate method based on its sensitivity and specificity, but also based on the specific clinical situations. Aside from the well-known standard triple therapy used for the eradication of this infection, multiple other regimens were lately proposed in order to prevent failure of eradication. Moreover, probiotics were recently proved to improve the eradication rate, and at the same time to decrease the side effects of the antibiotics therapy. The proper eradication of H. pylori infection during childhood remains the cornerstone in preventing gastric cancer during adulthood.","PeriodicalId":33512,"journal":{"name":"Revista Romana de Pediatrie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45527352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ioana-Luciana Constantin, E. Rotaru, Delia Stratone, Ioana-Georgia Oglinda, A. Avasilcai, Vlad Dima, A. Tuta, Livica Frăţiman, Irina Franciuc
Objectives. Percutaneously central catheters are typically used in neonatal intensive care units (NICU) to provide parenteral nutrition and drug therapy administration. Their use is associated with specific complications: occlusions, infections, thrombosis, rupture, and migration, including rare life-threatening conditions such as pericardial effusion and cardiac tamponade. Material and methods. We present the case of a patient hospitalized in the Neonatology Department of “Sf. Andrei” County Clinical Emergency Hospital of Constanta, diagnosed with cardiac tamponade at 18 days of life. Outcomes. Premature male newborn, gestational age (GA) of 33 weeks, birth weight (BW) 2380 g, Apgar score 5/7, issuing from pregnancy without prenatal care, admitted in NICU with Continuous Positive Airway Pressure (CPAP) respiratory support. He required intensive care during the neonatal period and presented with sudden cardiac instability 18 days after the insertion of a peripherally inserted central catheter (PIC-Line). The echocardiography demonstrated severe pericardial effusion with evidence of cardiac tamponade. Successful urgent subxiphoid pericardiocentesis was performed. Totally 20 ml of fluid was collected, consistent with the composition of the hyperosmolar solution infused. Conclusions. Despite the fact that it is a rare complication, cardiac tamponade should be considered in any newborn with a PIC-Line who presents with sudden suggestive deterioration (cardiorespiratory instability, bradycardia, cyanosis and metabolic acidosis), which does not respond to resuscitation maneuvers, when lines are considered to be placed correctly. Implementing a modern algorithm, who is easy to learn and quick to perform, with the help of ultrasonography, represents the key of success for detecting urgent neonatal complications leading to sudden deterioration.
{"title":"A successful interdisciplinary collaboration for the management of pneumoperitoneum and pericardial effusion in a premature newborn","authors":"Ioana-Luciana Constantin, E. Rotaru, Delia Stratone, Ioana-Georgia Oglinda, A. Avasilcai, Vlad Dima, A. Tuta, Livica Frăţiman, Irina Franciuc","doi":"10.37897/rjp.2022.3.7","DOIUrl":"https://doi.org/10.37897/rjp.2022.3.7","url":null,"abstract":"Objectives. Percutaneously central catheters are typically used in neonatal intensive care units (NICU) to provide parenteral nutrition and drug therapy administration. Their use is associated with specific complications: occlusions, infections, thrombosis, rupture, and migration, including rare life-threatening conditions such as pericardial effusion and cardiac tamponade. Material and methods. We present the case of a patient hospitalized in the Neonatology Department of “Sf. Andrei” County Clinical Emergency Hospital of Constanta, diagnosed with cardiac tamponade at 18 days of life. Outcomes. Premature male newborn, gestational age (GA) of 33 weeks, birth weight (BW) 2380 g, Apgar score 5/7, issuing from pregnancy without prenatal care, admitted in NICU with Continuous Positive Airway Pressure (CPAP) respiratory support. He required intensive care during the neonatal period and presented with sudden cardiac instability 18 days after the insertion of a peripherally inserted central catheter (PIC-Line). The echocardiography demonstrated severe pericardial effusion with evidence of cardiac tamponade. Successful urgent subxiphoid pericardiocentesis was performed. Totally 20 ml of fluid was collected, consistent with the composition of the hyperosmolar solution infused. Conclusions. Despite the fact that it is a rare complication, cardiac tamponade should be considered in any newborn with a PIC-Line who presents with sudden suggestive deterioration (cardiorespiratory instability, bradycardia, cyanosis and metabolic acidosis), which does not respond to resuscitation maneuvers, when lines are considered to be placed correctly. Implementing a modern algorithm, who is easy to learn and quick to perform, with the help of ultrasonography, represents the key of success for detecting urgent neonatal complications leading to sudden deterioration.","PeriodicalId":33512,"journal":{"name":"Revista Romana de Pediatrie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43454477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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