Valeria Vlasceanu Coman, G. Dragan, V. Plaiasu, M. Pavelescu, G. Jugulete, M. Oros
Congenital lung malformations or CLM have resulted in an apparent increase in their frequency with the advances in fetal ultrasound technology and more widely available investigations in prenatal and postnatal periods. The advantage of an early diagnosis came together with the difficulty of the treatment decision, in special in the postnatal management of asymptomatic CLM. In this article, we summarized findings from current literature, with a particular emphasis on the therapeutic strategies. Management of infants for thoracic surgery represents a challenge not only for pediatric surgeon but also for anesthesiologists because of the anatomic and physiologic variations particularities. There are two main important parts that must be obtained: one lung ventilation and specific techniques for optimal pain management, distinguishing pediatric thoracic anesthesia from other pediatric anesthetic disciplines A comprehensive multimodal approach is necessarily followed by a long-term assessment of respiratory function of children who underwent surgery for lung resection.
{"title":"Treatment options and anesthetic considerations for postnatal management of congenital lung malformation","authors":"Valeria Vlasceanu Coman, G. Dragan, V. Plaiasu, M. Pavelescu, G. Jugulete, M. Oros","doi":"10.37897/rjp.2022.3.6","DOIUrl":"https://doi.org/10.37897/rjp.2022.3.6","url":null,"abstract":"Congenital lung malformations or CLM have resulted in an apparent increase in their frequency with the advances in fetal ultrasound technology and more widely available investigations in prenatal and postnatal periods. The advantage of an early diagnosis came together with the difficulty of the treatment decision, in special in the postnatal management of asymptomatic CLM. In this article, we summarized findings from current literature, with a particular emphasis on the therapeutic strategies. Management of infants for thoracic surgery represents a challenge not only for pediatric surgeon but also for anesthesiologists because of the anatomic and physiologic variations particularities. There are two main important parts that must be obtained: one lung ventilation and specific techniques for optimal pain management, distinguishing pediatric thoracic anesthesia from other pediatric anesthetic disciplines A comprehensive multimodal approach is necessarily followed by a long-term assessment of respiratory function of children who underwent surgery for lung resection.","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":"49081087","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}
Introduction. Phenylketonuria (PKU), a genetic disease with autosomal dominant transmission, is the most frequent inborn error in aminoacidic metabolism. The variations in phenylalanine-hydroxylase (PAH) gene lead to a lowered enzymatic activity causing hyperphenylalaninemia. PKU has a mean European prevalence of 1:10,000 newborns, with a large variation in different ethnicities and geographic regions. The large genetic variability (over 1200 genetic variants known) as well as other factors determines a wide spectrum of metabolic phenotypes. Untreated, PKU leads to irreversible intellectual disability, low stature, hypopigmentation, motor deficits, seizures, but the early diagnosis and treatment enables almost normal somatic and mental development. Aim. The aim of this study is the determination of the impact of non-genetic factors over the clinical phenotype of PKU patients in a region of north-west Romania. Material and method. The study group is formed from 44 patients diagnosed with phenylketonuria in the 1981 – 2021 period, found in the database of Bihor Regional Center for Medical Genetics, Emergency Clinical County Hospital, Oradea, Romania. The collected data was referring to the age, sex and domicile of the patients, the age of the diagnosis and the beginning of the treatment, also the metabolic control over the years, the metabolic phenotype of the patients and its impact on the clinical phenotype (IQ, the presence or absence of intellectual disability or the existence of a specific clinical phenotype). Results. The majority of patients (66%) were diagnosticated with phenylketonuria in the first 4 months of life, although there were cases with a late diagnosis, 20.5% of the patients were diagnosticated after the age of 1 year. Based on the pre-treatment plasmatic levels of phenylalanine, the majority of cases (72.7%) had a severe metabolic phenotype (classic PKU - cPKU), 20.5% of cases had a milder form of PKU (mPKU) and 6.8% of patients were found with a mild hyperphenylalaninemia (HPA). In the case of 23 patients, an optimal metabolic control was not obtained. The specific phenotype (blonde hair, light skin, blue eyes) was found in 22.7% of cases, 77.3% not having these features. At 68.2% of cases intellectual disability was found, with different levels of severity: 5 patients (11.5%) had liminal intellect, 9 patients (20.5%) had mild mental retardation, 6 patients (13.6%) had moderate mental retardation, 9 cases (20.5%) were with severe mental retardation and 1 patient (2.3%) had profound mental retardation; 31.8% of cases had normal intellect. The prevalence in Bihor county is 1:7,843 newborns. Discussions. A partial or, in rare cases, total lack of dietetic treatment was observed in all patients over 20 years old (current age). The delay in treatment initiation or an insufficient treatment, with a suboptimal metabolic control, will affect patient’s intellect, regardless of metabolic phenotype. If in 20 years old patients, or older,
{"title":"Epidemiological aspects in phenylketonuria patients from a region in northwestern Romania","authors":"A. Iuhas, Claudia Jurca, M. Bembea","doi":"10.37897/rjp.2022.2.2","DOIUrl":"https://doi.org/10.37897/rjp.2022.2.2","url":null,"abstract":"Introduction. Phenylketonuria (PKU), a genetic disease with autosomal dominant transmission, is the most frequent inborn error in aminoacidic metabolism. The variations in phenylalanine-hydroxylase (PAH) gene lead to a lowered enzymatic activity causing hyperphenylalaninemia. PKU has a mean European prevalence of 1:10,000 newborns, with a large variation in different ethnicities and geographic regions. The large genetic variability (over 1200 genetic variants known) as well as other factors determines a wide spectrum of metabolic phenotypes. Untreated, PKU leads to irreversible intellectual disability, low stature, hypopigmentation, motor deficits, seizures, but the early diagnosis and treatment enables almost normal somatic and mental development. Aim. The aim of this study is the determination of the impact of non-genetic factors over the clinical phenotype of PKU patients in a region of north-west Romania. Material and method. The study group is formed from 44 patients diagnosed with phenylketonuria in the 1981 – 2021 period, found in the database of Bihor Regional Center for Medical Genetics, Emergency Clinical County Hospital, Oradea, Romania. The collected data was referring to the age, sex and domicile of the patients, the age of the diagnosis and the beginning of the treatment, also the metabolic control over the years, the metabolic phenotype of the patients and its impact on the clinical phenotype (IQ, the presence or absence of intellectual disability or the existence of a specific clinical phenotype). Results. The majority of patients (66%) were diagnosticated with phenylketonuria in the first 4 months of life, although there were cases with a late diagnosis, 20.5% of the patients were diagnosticated after the age of 1 year. Based on the pre-treatment plasmatic levels of phenylalanine, the majority of cases (72.7%) had a severe metabolic phenotype (classic PKU - cPKU), 20.5% of cases had a milder form of PKU (mPKU) and 6.8% of patients were found with a mild hyperphenylalaninemia (HPA). In the case of 23 patients, an optimal metabolic control was not obtained. The specific phenotype (blonde hair, light skin, blue eyes) was found in 22.7% of cases, 77.3% not having these features. At 68.2% of cases intellectual disability was found, with different levels of severity: 5 patients (11.5%) had liminal intellect, 9 patients (20.5%) had mild mental retardation, 6 patients (13.6%) had moderate mental retardation, 9 cases (20.5%) were with severe mental retardation and 1 patient (2.3%) had profound mental retardation; 31.8% of cases had normal intellect. The prevalence in Bihor county is 1:7,843 newborns. Discussions. A partial or, in rare cases, total lack of dietetic treatment was observed in all patients over 20 years old (current age). The delay in treatment initiation or an insufficient treatment, with a suboptimal metabolic control, will affect patient’s intellect, regardless of metabolic phenotype. If in 20 years old patients, or older,","PeriodicalId":33512,"journal":{"name":"Revista Romana de Pediatrie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49451385","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, L. Ceauselu, Vlad Dima, Mihaela Demetrian, A. Bălănescu, P. Bălănescu, I. Gherghina
Objectives. The aim of this study was to present and describe specific macroscopic and microscopic placental findings in patients with hypoxic-ischemic encephalopathy (HIE). Materials and methods. We conducted an observational prospective study which included 84 patients diagnosed with HIE and had available placental histopathological examination. HIE diagnosis was performed according to Sarnat Score. Both macroscopic and microscopic placental lesions were identified. Patients were divided into 2 groups according to the presence of placental lesions. Outcomes. Placental lesions were associated with HIE. Patients with both HIE and placental lesions had lower pH value (p <0.001) and lower Apgar scores (p=0.001). Conclusion. Antenatal placental lesions are present in full-term infants with encephalopathy and seem to define exactly one of the causes of this syndrome.
{"title":"Placental changes in a group of full-term newborns with hypoxic-ischemic encephalopathy","authors":"Andreea Calomfirescu-Avramescu, L. Ceauselu, Vlad Dima, Mihaela Demetrian, A. Bălănescu, P. Bălănescu, I. Gherghina","doi":"10.37897/rjp.2022.2.1","DOIUrl":"https://doi.org/10.37897/rjp.2022.2.1","url":null,"abstract":"Objectives. The aim of this study was to present and describe specific macroscopic and microscopic placental findings in patients with hypoxic-ischemic encephalopathy (HIE). Materials and methods. We conducted an observational prospective study which included 84 patients diagnosed with HIE and had available placental histopathological examination. HIE diagnosis was performed according to Sarnat Score. Both macroscopic and microscopic placental lesions were identified. Patients were divided into 2 groups according to the presence of placental lesions. Outcomes. Placental lesions were associated with HIE. Patients with both HIE and placental lesions had lower pH value (p <0.001) and lower Apgar scores (p=0.001). Conclusion. Antenatal placental lesions are present in full-term infants with encephalopathy and seem to define exactly one of the causes of this syndrome.","PeriodicalId":33512,"journal":{"name":"Revista Romana de Pediatrie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45084326","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}
Interrupted aortic arch is a rare ductal-dependent congenital heart malformation, accounting for 1.5% of all MCC, 2 in 100,000 cases of live newborns are diagnosed with IAA. We present the case of a 3-month-old infant who came to our clinic on the recommendation of the family doctor. On clinical examination, he presented an affected general state, peri oronasal cyanosis during moments of agitation, grade III/6 systolic murmur present throughout the precordial area, heart rate = 160 beats/min, respiratory rate = 45 breaths/min, SaO2 = 86 – 91% in atmospheric air, liver 4 cm below the costal rim. Echocardiography revealed a complete ductal-dependent congenital heart malformation, interrupted aortic arch, persistence of ductus arteriosus, wide muscular ventricular septal defect, hypoplasia of the ascending aorta. The angioCT examination confirmed the diagnoses from the echocardiography. During the genetic examination, the suspicion of DiGeorge syndrome was raised, which is why MLPA for microdeletions was required. The first therapeutic act performed was represented by maintaining the patency of the arterial channel. The patient was transferred to a clinic in Italy for the surgical intervention.
{"title":"Interrupted aortic arch – case report","authors":"Heidrun Adumitrăchioaiei, A. Luca","doi":"10.37897/rjp.2022.2.5","DOIUrl":"https://doi.org/10.37897/rjp.2022.2.5","url":null,"abstract":"Interrupted aortic arch is a rare ductal-dependent congenital heart malformation, accounting for 1.5% of all MCC, 2 in 100,000 cases of live newborns are diagnosed with IAA. We present the case of a 3-month-old infant who came to our clinic on the recommendation of the family doctor. On clinical examination, he presented an affected general state, peri oronasal cyanosis during moments of agitation, grade III/6 systolic murmur present throughout the precordial area, heart rate = 160 beats/min, respiratory rate = 45 breaths/min, SaO2 = 86 – 91% in atmospheric air, liver 4 cm below the costal rim. Echocardiography revealed a complete ductal-dependent congenital heart malformation, interrupted aortic arch, persistence of ductus arteriosus, wide muscular ventricular septal defect, hypoplasia of the ascending aorta. The angioCT examination confirmed the diagnoses from the echocardiography. During the genetic examination, the suspicion of DiGeorge syndrome was raised, which is why MLPA for microdeletions was required. The first therapeutic act performed was represented by maintaining the patency of the arterial channel. The patient was transferred to a clinic in Italy for the surgical intervention.","PeriodicalId":33512,"journal":{"name":"Revista Romana de Pediatrie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42480712","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, R. Bohîlțea, Raluca Mariana Stanescu, Andreea Avramescu-Calomfirescu, V. Varlas, A. Davitoiu
Background. Alkaline phosphatase (ALP) has been intensively studied and proved to be useful in Neonatology. The first condition studied in correlation with increased ALP values was osteopenia of prematurity. In recent years there was an increase interested in correlations between ALP and bilirubin levels. In this article, we want to review the literature to find other benefits of ALP dosing in neonatal patients. Methods. Clinical trials were searched and analyzed by a single individual (via dedicated search engines such as Google Scholar, PubMed, and Scopus). We have included clinical studies from the last 7 years that present statistically significant results regarding the role of ALP dosing in the screening or diagnosis of other neonatal pathologies (jaundice with hyperbilirubinemia, necrotizing enterocolitis, liver dysfunction, renal failure and oncological diseases). Results. After excluding the clinical trials that did not meet the eligibility criteria, 6 clinical trials remained (n = 859). Following the analysis of these studies, correlations were highlighted between high ALP values in the umbilical cord and the need for phototherapy. It was also shown that all newborns with elevated ALP values required treatment for hyperbilirubinemia, as well as being a good predictor of severe jaundice and helping to predict its onset. Also, evidence about the correlation between high values of ALP and prematurity osteopenia was reaffirmed in recent studies. Conclusions. ALP is an easily dosed biomarker that can be successfully used in Neonatology. The existing studies to date encourage the use of ALP as a biomarker especially for the detection of osteopenia of prematurity and for the early detection of newborns who will develop intense forms of jaundice. There are still differences regarding the serum ALP values considered as cut-offs for the diagnosis of various neonatal conditions, but performing multicenter studies on a large number of cases could establish a valid consensus in order to use the same ALP cut-off values in all Neonatology departments.
{"title":"Why should the neonatologist give a closer look at the alkaline phosphatase?","authors":"Vlad Dima, R. Bohîlțea, Raluca Mariana Stanescu, Andreea Avramescu-Calomfirescu, V. Varlas, A. Davitoiu","doi":"10.37897/rjp.2022.2.7","DOIUrl":"https://doi.org/10.37897/rjp.2022.2.7","url":null,"abstract":"Background. Alkaline phosphatase (ALP) has been intensively studied and proved to be useful in Neonatology. The first condition studied in correlation with increased ALP values was osteopenia of prematurity. In recent years there was an increase interested in correlations between ALP and bilirubin levels. In this article, we want to review the literature to find other benefits of ALP dosing in neonatal patients. Methods. Clinical trials were searched and analyzed by a single individual (via dedicated search engines such as Google Scholar, PubMed, and Scopus). We have included clinical studies from the last 7 years that present statistically significant results regarding the role of ALP dosing in the screening or diagnosis of other neonatal pathologies (jaundice with hyperbilirubinemia, necrotizing enterocolitis, liver dysfunction, renal failure and oncological diseases). Results. After excluding the clinical trials that did not meet the eligibility criteria, 6 clinical trials remained (n = 859). Following the analysis of these studies, correlations were highlighted between high ALP values in the umbilical cord and the need for phototherapy. It was also shown that all newborns with elevated ALP values required treatment for hyperbilirubinemia, as well as being a good predictor of severe jaundice and helping to predict its onset. Also, evidence about the correlation between high values of ALP and prematurity osteopenia was reaffirmed in recent studies. Conclusions. ALP is an easily dosed biomarker that can be successfully used in Neonatology. The existing studies to date encourage the use of ALP as a biomarker especially for the detection of osteopenia of prematurity and for the early detection of newborns who will develop intense forms of jaundice. There are still differences regarding the serum ALP values considered as cut-offs for the diagnosis of various neonatal conditions, but performing multicenter studies on a large number of cases could establish a valid consensus in order to use the same ALP cut-off values in all Neonatology departments.","PeriodicalId":33512,"journal":{"name":"Revista Romana de Pediatrie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49029987","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}
Introduction. Respiratory tract infections (RTIs) represent a growing burden among pediatric populations, as their potential progression towards acute respiratory insufficiency (ARI), which requires hospitalization and can be light-threatening without adequate supportive measures. Several recent studies have tried to investigate the role of non-invasive depictable parameters, such as those easily determined through a complete blood count (CBC), in the prediction of potentially complicated RTIs. The aim of the current study is to assess whether changes in hematological parameters can predict the development of respiratory insufficiency in children with RTIs. Material and methods. A retrospective study was conducted on 80 patients hospitalized for RTIs, divided into two groups based on their complication by ARI: children with RTI and ARI (group 1-30 patients) and children with RTI, uncomplicated with ARI (group 2-50 patients). Patients with a previously known chronic or hematological disorder were excluded from the study. A CBC was carried out in each patient and C-reactive protein (CRP) values were also determined. Moreover, RT-PCR testing for SARS-COV2 infection was carried out in each child. Results. There were no significant differences in most of the hematological parameters analyzed between the two groups, with the exception of mean corpuscular hemoglobin concentration (MCHC), which exhibited lower values in study group 1. Insignificant differences in parameters of CBC were also found when performing a separate analysis on the subgroup of patients infected with SARS-COV2. However, significantly higher CRP values were found in subjects with RTIs complicated by ARI. An important decrease in hemoglobin levels, under 10 mg/dl, was not positively associated with a complicated outcome of RTIs. Conclusion. Hematological parameters, with the exception of MCHC, are not predictive of ARI in children diagnosed with RTIs. A separate analysis on cases diagnosed with SARS-COV2 infection revealed similar, insignificant results. Further studies, conducted on larger populations, could provide more data regarding the role of hematological parameters in the prediction of RTIs’ severity.
{"title":"Prognostic value of hematological parameters in childhood respiratory tract infections","authors":"Katharina Schäfer, M. Săsăran","doi":"10.37897/rjp.2022.2.3","DOIUrl":"https://doi.org/10.37897/rjp.2022.2.3","url":null,"abstract":"Introduction. Respiratory tract infections (RTIs) represent a growing burden among pediatric populations, as their potential progression towards acute respiratory insufficiency (ARI), which requires hospitalization and can be light-threatening without adequate supportive measures. Several recent studies have tried to investigate the role of non-invasive depictable parameters, such as those easily determined through a complete blood count (CBC), in the prediction of potentially complicated RTIs. The aim of the current study is to assess whether changes in hematological parameters can predict the development of respiratory insufficiency in children with RTIs. Material and methods. A retrospective study was conducted on 80 patients hospitalized for RTIs, divided into two groups based on their complication by ARI: children with RTI and ARI (group 1-30 patients) and children with RTI, uncomplicated with ARI (group 2-50 patients). Patients with a previously known chronic or hematological disorder were excluded from the study. A CBC was carried out in each patient and C-reactive protein (CRP) values were also determined. Moreover, RT-PCR testing for SARS-COV2 infection was carried out in each child. Results. There were no significant differences in most of the hematological parameters analyzed between the two groups, with the exception of mean corpuscular hemoglobin concentration (MCHC), which exhibited lower values in study group 1. Insignificant differences in parameters of CBC were also found when performing a separate analysis on the subgroup of patients infected with SARS-COV2. However, significantly higher CRP values were found in subjects with RTIs complicated by ARI. An important decrease in hemoglobin levels, under 10 mg/dl, was not positively associated with a complicated outcome of RTIs. Conclusion. Hematological parameters, with the exception of MCHC, are not predictive of ARI in children diagnosed with RTIs. A separate analysis on cases diagnosed with SARS-COV2 infection revealed similar, insignificant results. Further studies, conducted on larger populations, could provide more data regarding the role of hematological parameters in the prediction of RTIs’ severity.","PeriodicalId":33512,"journal":{"name":"Revista Romana de Pediatrie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46355406","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}
Clara Dima, B. Mitoiu, R. Nartea, Vlad Dima, A. Mirea
Posture, hyper-kyphosis or “the postural round back”, and balance are topics that have been extensively studied, although with some conflicting findings. Body position is representative of physical and mental health. Bad posture can lead to spinal complications (affects the muscular system, deforms the skeletal bone, and causes abnormal development) and the same can be said the other way around. As the standard of living increases, there is an increase in consumerism for technological devices, especially among teenagers. Identified as a public health problem, postural changes among children and adolescents have a high prevalence, emphasizing the need for prevention, diagnosis, and early initiation of treatment, especially from the growth and development phase of the body, because during this period teenagers are most vulnerable to live changes. Taking these elements into consideration, we conducted an extensive literature review of the subject, considering adolescence a key element for early diagnosticating and the institution of a complex rehabilitation program, with full functional restoration. Efforts to reduce the prevalence of bad posture will improve not only body posture but will also reduce the prevalence and the severity of spine deformities.
{"title":"Hyperkyphotic posture among adolescents – still a public health problem","authors":"Clara Dima, B. Mitoiu, R. Nartea, Vlad Dima, A. Mirea","doi":"10.37897/rjp.2022.2.6","DOIUrl":"https://doi.org/10.37897/rjp.2022.2.6","url":null,"abstract":"Posture, hyper-kyphosis or “the postural round back”, and balance are topics that have been extensively studied, although with some conflicting findings. Body position is representative of physical and mental health. Bad posture can lead to spinal complications (affects the muscular system, deforms the skeletal bone, and causes abnormal development) and the same can be said the other way around. As the standard of living increases, there is an increase in consumerism for technological devices, especially among teenagers. Identified as a public health problem, postural changes among children and adolescents have a high prevalence, emphasizing the need for prevention, diagnosis, and early initiation of treatment, especially from the growth and development phase of the body, because during this period teenagers are most vulnerable to live changes. Taking these elements into consideration, we conducted an extensive literature review of the subject, considering adolescence a key element for early diagnosticating and the institution of a complex rehabilitation program, with full functional restoration. Efforts to reduce the prevalence of bad posture will improve not only body posture but will also reduce the prevalence and the severity of spine deformities.","PeriodicalId":33512,"journal":{"name":"Revista Romana de Pediatrie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46019068","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}
Rodica Demenciuc, L. Meliț, Tudor Fleșeriu, C. Mărginean
Pediatric population associates multiple peculiarities in terms of SARS-CoV-2 regarding the differences of symptoms in comparison to adults, but also the higher incidence of asymptomatic cases. The aim of these case reports is to underline the importance of SARS-CoV-2 testing in pediatric patients. The first case describes the case of a 2-year and nine-month-old child admitted to the Pediatrics Clinic I Targu Mures for involuntary ingestion of toxic substance. The clinical exam pointed out a mild hyperemia of pharynx and small lymph nodes under the mandibula, on the side area of the neck and above the clavicula; and the laboratory tests pointed out leukocytosis, thrombocytosis and one of the liver transaminases above the normal limit. In spite of the presentation concerns, the patient was tested for SARS-CoV-2 infection, with positive result. The evolution was favorable during the admission. The second case describes a 3-year and 8-month-old male patient brought in the emergency department with the suspicion of foreign body aspiration, but the bronchoscopy revealed only purulent secretion in the trachea and bronchia. The RTPCR test for SARS-CoV-2 infection was negative on the admission day, but due to the slowly favorable evolution, the patient was retested on the 5th day of admission, with positive result. The testing of pediatric patients independently of the symptoms and the clinical setting might carry a higher importance in limiting the viral transmission.
{"title":"The importance of SARS-CoV-2 testing in pediatric population","authors":"Rodica Demenciuc, L. Meliț, Tudor Fleșeriu, C. Mărginean","doi":"10.37897/rjp.2022.2.4","DOIUrl":"https://doi.org/10.37897/rjp.2022.2.4","url":null,"abstract":"Pediatric population associates multiple peculiarities in terms of SARS-CoV-2 regarding the differences of symptoms in comparison to adults, but also the higher incidence of asymptomatic cases. The aim of these case reports is to underline the importance of SARS-CoV-2 testing in pediatric patients. The first case describes the case of a 2-year and nine-month-old child admitted to the Pediatrics Clinic I Targu Mures for involuntary ingestion of toxic substance. The clinical exam pointed out a mild hyperemia of pharynx and small lymph nodes under the mandibula, on the side area of the neck and above the clavicula; and the laboratory tests pointed out leukocytosis, thrombocytosis and one of the liver transaminases above the normal limit. In spite of the presentation concerns, the patient was tested for SARS-CoV-2 infection, with positive result. The evolution was favorable during the admission. The second case describes a 3-year and 8-month-old male patient brought in the emergency department with the suspicion of foreign body aspiration, but the bronchoscopy revealed only purulent secretion in the trachea and bronchia. The RTPCR test for SARS-CoV-2 infection was negative on the admission day, but due to the slowly favorable evolution, the patient was retested on the 5th day of admission, with positive result. The testing of pediatric patients independently of the symptoms and the clinical setting might carry a higher importance in limiting the viral transmission.","PeriodicalId":33512,"journal":{"name":"Revista Romana de Pediatrie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45268142","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, R. Bohîlțea, Raluca Mariana Stanescu, A. Toma, V. Varlas, A. Davitoiu
Background. Studies to date support the beneficial effect that therapeutic hypothermia (TH) has on neonates with hypoxic-ischemic encephalopathy. TH can be delivered in two ways: selective head cooling (SHC) or therapeutic whole-body cooling (WBC). The purpose of this review is to examine the literature to expose the advantages and disadvantages of the two methods of performing TH in neonates diagnosed with moderate or severe HIE and to investigate whether one method is superior to the other. Methods. We started from the data from the Cochrane review published in 2013 [1] and we want to bring new information from recent clinical studies comparing the two TH methods (SHC vs WBC). Clinical studies were searched and analyzed by a single individual (through dedicated search engines such as Google Scholar, PubMed, and Scopus). We have included clinical studies from the last 7 years comparing the two ways of performing TH (SHC vs. WBC). We selected only the articles that compared the two methods and excluded the articles describing only one method. Results. After excluding the clinical trials that did not meet the eligibility criteria, 5 clinical trials remained (n = 256 neonates). Analysis of these studies supports the idea that both modalities of therapeutic hypothermia cool central nervous system (CNS) structures and have a similar neurodevelopmental prognosis among surviving neonates. Also, there are no significant differences in terms of short-term neurological prognosis, as well as the adverse effects that may occur in neonates with moderate or severe HIE (hypoxic-ischemic encephalopathy) treated with SHC or WBC; although some studies note the presence of more severe, statistically significant lesions among patients treated with SHC compared to those treated with WBC. Conclusions. Prospective, randomized studies on a much larger scale are needed to track the adverse effects that the two HT methods may have on patients, as well as long-term neurological and cognitive prognosis. Until now, there is no clear evidence that one of these two methods is definitely safer or more reliable than the other.
{"title":"Selective head cooling or whole body cooling? That is the question","authors":"Vlad Dima, R. Bohîlțea, Raluca Mariana Stanescu, A. Toma, V. Varlas, A. Davitoiu","doi":"10.37897/rjp.2022.2.8","DOIUrl":"https://doi.org/10.37897/rjp.2022.2.8","url":null,"abstract":"Background. Studies to date support the beneficial effect that therapeutic hypothermia (TH) has on neonates with hypoxic-ischemic encephalopathy. TH can be delivered in two ways: selective head cooling (SHC) or therapeutic whole-body cooling (WBC). The purpose of this review is to examine the literature to expose the advantages and disadvantages of the two methods of performing TH in neonates diagnosed with moderate or severe HIE and to investigate whether one method is superior to the other. Methods. We started from the data from the Cochrane review published in 2013 [1] and we want to bring new information from recent clinical studies comparing the two TH methods (SHC vs WBC). Clinical studies were searched and analyzed by a single individual (through dedicated search engines such as Google Scholar, PubMed, and Scopus). We have included clinical studies from the last 7 years comparing the two ways of performing TH (SHC vs. WBC). We selected only the articles that compared the two methods and excluded the articles describing only one method. Results. After excluding the clinical trials that did not meet the eligibility criteria, 5 clinical trials remained (n = 256 neonates). Analysis of these studies supports the idea that both modalities of therapeutic hypothermia cool central nervous system (CNS) structures and have a similar neurodevelopmental prognosis among surviving neonates. Also, there are no significant differences in terms of short-term neurological prognosis, as well as the adverse effects that may occur in neonates with moderate or severe HIE (hypoxic-ischemic encephalopathy) treated with SHC or WBC; although some studies note the presence of more severe, statistically significant lesions among patients treated with SHC compared to those treated with WBC. Conclusions. Prospective, randomized studies on a much larger scale are needed to track the adverse effects that the two HT methods may have on patients, as well as long-term neurological and cognitive prognosis. Until now, there is no clear evidence that one of these two methods is definitely safer or more reliable than the other.","PeriodicalId":33512,"journal":{"name":"Revista Romana de Pediatrie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47111277","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}
Cutis laxa syndromes is a rare, multisystem disorder, which primary involves the skin, caused by various mutations in genes that code structural or functional components of the elastic fiber, resulting in heterogenous manifestations. Diagnosis is primarily based on the physical examination, but supported by molecular tests, and guides treatment and monitoring of the patients. Endocrinological complications are sparsely described, with short stature, osteoporosis and fractures being the most frequent. The precise mechanisms are not elucidated and reports about condition-specific treatments are rare. This review provides an overview of the endocrinological disturbances reported in association with cutis laxa syndromes.
{"title":"Endocrinological disorders in children with cutis-laxa syndromes","authors":"M. Iancu, A. Albu, R. Vlad, D. Albu","doi":"10.37897/rjp.2022.1.4","DOIUrl":"https://doi.org/10.37897/rjp.2022.1.4","url":null,"abstract":"Cutis laxa syndromes is a rare, multisystem disorder, which primary involves the skin, caused by various mutations in genes that code structural or functional components of the elastic fiber, resulting in heterogenous manifestations. Diagnosis is primarily based on the physical examination, but supported by molecular tests, and guides treatment and monitoring of the patients. Endocrinological complications are sparsely described, with short stature, osteoporosis and fractures being the most frequent. The precise mechanisms are not elucidated and reports about condition-specific treatments are rare. This review provides an overview of the endocrinological disturbances reported in association with cutis laxa syndromes.","PeriodicalId":33512,"journal":{"name":"Revista Romana de Pediatrie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42351551","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：