Pub Date : 2024-05-01DOI: 10.1186/s43054-024-00265-3
Sarah Abdelrashid, Manar Aref
The neonatal intensive care unit (NICU) frequently gets admissions due to respiratory distress (RD). Platelet indices are a beneficial biomarker in order to gauge the severity of neonatal RD. We aimed to assess platelet indices as a potential predictor in neonates with RD. This prospective research involved 120 neonates who had been admitted to the NICU with evidence of RD. On admission and after respiratory support was reduced; a complete blood count (CBC) was performed to determine platelet count (PC), mean platelet volume (MPV), plateletcrit (PCT), platelet distribution width (PDW), platelet mass index (PMI), and platelet large cell ratio (PLCR). MPV and PDW were significantly higher after respiratory support reduction. PC and PMI were significantly higher in neonates exhibiting moderate and severe distress. PC of 276.5*109/L had the highest degree of predictability of RD severity (area under curve (AUC) 0.762, sensitivity 81.5%, specificity 64.3%), 95% confidence interval (0.7–0.9), while PMI of 2473.5 fL/nL was the best cut-off point to predict severity of RD (AUC 0.663, sensitivity 63%, specificity 57.1%) 95% confidence interval (0.6–0.8). There was a significant difference in the average PC between different oxygen modes. Higher PMI and PC are associated with moderate and severe RD and can be used to predict the severity of neonatal RD.
新生儿重症监护室（NICU）经常有因呼吸窘迫（RD）而入院的患者。血小板指数是衡量新生儿呼吸窘迫严重程度的有效生物标志物。我们的目的是评估血小板指数，将其作为患有呼吸窘迫症的新生儿的潜在预测指标。这项前瞻性研究涉及 120 名入住新生儿重症监护室并有 RD 证据的新生儿。在入院时和呼吸支持减少后，进行了全血细胞计数（CBC），以确定血小板计数（PC）、平均血小板体积（MPV）、血小板比容（PCT）、血小板分布宽度（PDW）、血小板质量指数（PMI）和血小板大细胞比率（PLCR）。减少呼吸支持后，MPV 和 PDW 明显升高。中度和重度窘迫新生儿的 PC 和 PMI 明显更高。276.5*109/L的PC对RD严重程度的预测程度最高（曲线下面积（AUC）0.762，灵敏度81.5%，特异度64.3%），95%置信区间（0.7-0.9），而2473.5 fL/nL的PMI是预测RD严重程度的最佳临界点（AUC 0.663，灵敏度63%，特异度57.1%，95%置信区间（0.6-0.8））。不同供氧模式下的平均 PC 存在明显差异。较高的 PMI 和 PC 与中度和重度 RD 相关，可用于预测新生儿 RD 的严重程度。
{"title":"Platelet indices as a predictive marker in neonates with respiratory distress","authors":"Sarah Abdelrashid, Manar Aref","doi":"10.1186/s43054-024-00265-3","DOIUrl":"https://doi.org/10.1186/s43054-024-00265-3","url":null,"abstract":"The neonatal intensive care unit (NICU) frequently gets admissions due to respiratory distress (RD). Platelet indices are a beneficial biomarker in order to gauge the severity of neonatal RD. We aimed to assess platelet indices as a potential predictor in neonates with RD. This prospective research involved 120 neonates who had been admitted to the NICU with evidence of RD. On admission and after respiratory support was reduced; a complete blood count (CBC) was performed to determine platelet count (PC), mean platelet volume (MPV), plateletcrit (PCT), platelet distribution width (PDW), platelet mass index (PMI), and platelet large cell ratio (PLCR). MPV and PDW were significantly higher after respiratory support reduction. PC and PMI were significantly higher in neonates exhibiting moderate and severe distress. PC of 276.5*109/L had the highest degree of predictability of RD severity (area under curve (AUC) 0.762, sensitivity 81.5%, specificity 64.3%), 95% confidence interval (0.7–0.9), while PMI of 2473.5 fL/nL was the best cut-off point to predict severity of RD (AUC 0.663, sensitivity 63%, specificity 57.1%) 95% confidence interval (0.6–0.8). There was a significant difference in the average PC between different oxygen modes. Higher PMI and PC are associated with moderate and severe RD and can be used to predict the severity of neonatal RD.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140841783","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}
Pub Date : 2024-04-30DOI: 10.1186/s43054-024-00272-4
Neng Ren, Ye Gu, Na Song, Wen Qian, Wenhui Gao, Yunfeng Zhang
Kaposiform hemangioendothelioma (KHE) is a rare neoplasm of vascular origin. It may involve skin, bone, connective tissue, and parenchymal organs, and it is difficult to make a definite diagnosis in the early stage because Kasabach-Merritt phenomenon may occur in some cases. On June 12, 2022, a 19-month boy was admitted to our department with the chief complaint of flexion of the right hip joint for over 1 year. An exploratory laparotomy and pelvic lesion resection were conducted and the resection of the iliopsoas muscle mass was performed. The intraoperative resection of the neoplasm confirmed the pathological diagnosis of kaposiform hemangioendothelioma. The vital signs of the child were stable and recovered well after surgery, and the platelet and coagulation indices were normal. KHE is a rare disease in clinics, the number of confirmed cases in the world is still relatively few, and the etiology and mechanism of the disease are still unknown, which could result in misdiagnose and delayed treatment in the disease early stages. It is necessary to continue to collect relevant cases, to unify the standard treatment guidelines as soon as possible, to reduce the mortality rate, and to improve the quality of life of the cases.
{"title":"Right iliopsoas kaposiform hemangioendothelioma: a case report","authors":"Neng Ren, Ye Gu, Na Song, Wen Qian, Wenhui Gao, Yunfeng Zhang","doi":"10.1186/s43054-024-00272-4","DOIUrl":"https://doi.org/10.1186/s43054-024-00272-4","url":null,"abstract":"Kaposiform hemangioendothelioma (KHE) is a rare neoplasm of vascular origin. It may involve skin, bone, connective tissue, and parenchymal organs, and it is difficult to make a definite diagnosis in the early stage because Kasabach-Merritt phenomenon may occur in some cases. On June 12, 2022, a 19-month boy was admitted to our department with the chief complaint of flexion of the right hip joint for over 1 year. An exploratory laparotomy and pelvic lesion resection were conducted and the resection of the iliopsoas muscle mass was performed. The intraoperative resection of the neoplasm confirmed the pathological diagnosis of kaposiform hemangioendothelioma. The vital signs of the child were stable and recovered well after surgery, and the platelet and coagulation indices were normal. KHE is a rare disease in clinics, the number of confirmed cases in the world is still relatively few, and the etiology and mechanism of the disease are still unknown, which could result in misdiagnose and delayed treatment in the disease early stages. It is necessary to continue to collect relevant cases, to unify the standard treatment guidelines as soon as possible, to reduce the mortality rate, and to improve the quality of life of the cases.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140832154","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}
Pub Date : 2024-04-29DOI: 10.1186/s43054-024-00281-3
Antoine Fakhry AbdelMassih, Waad I. AlHammadi, Hind A. AlHosani, Sara AlHosani, Fatima AlHammadi, Shooq A. AlShehhi
Immersive and non-immersive VR technology has been increasingly employed in training. This has encouraged physicians working in skill development to try using it to improve the learning, emotional recognition, and social skills of various disorders. This study aimed to explore the controlled trials employing VR in autism, ADHD, and dyslexia. A literature review has been conducted, on PubMed, Scopus, and Web of Science. Any controlled trial in the pediatric age group, involving the comparison of VR training with other types of therapies in autism, ADHD, and dyslexia was included. Only 4 controlled trials were identified, comprising a total of 208 patients, with ages ranging from 6 to 16 years. Out of these studies, two involved patients with autism, one with ADHD, and one with dyslexia. VR was successful in improving emotional recognition but not social interaction in autism. All trials did not mention thoroughly possible complications of prolonged use of VR. Despite being a promising technology, there is still a long road to prove the validity of using VR in skills development. Few controlled trials have been tailored to explore VR advantages over conventional training and therapies, most of them have a limited sample size, a short training course, and no mention of possible setbacks, such as ocular effects and social isolation.
{"title":"Revisiting VR training in developmental disorders, is it a friend or foe? A scoping systematic review of randomized controlled trials","authors":"Antoine Fakhry AbdelMassih, Waad I. AlHammadi, Hind A. AlHosani, Sara AlHosani, Fatima AlHammadi, Shooq A. AlShehhi","doi":"10.1186/s43054-024-00281-3","DOIUrl":"https://doi.org/10.1186/s43054-024-00281-3","url":null,"abstract":"Immersive and non-immersive VR technology has been increasingly employed in training. This has encouraged physicians working in skill development to try using it to improve the learning, emotional recognition, and social skills of various disorders. This study aimed to explore the controlled trials employing VR in autism, ADHD, and dyslexia. A literature review has been conducted, on PubMed, Scopus, and Web of Science. Any controlled trial in the pediatric age group, involving the comparison of VR training with other types of therapies in autism, ADHD, and dyslexia was included. Only 4 controlled trials were identified, comprising a total of 208 patients, with ages ranging from 6 to 16 years. Out of these studies, two involved patients with autism, one with ADHD, and one with dyslexia. VR was successful in improving emotional recognition but not social interaction in autism. All trials did not mention thoroughly possible complications of prolonged use of VR. Despite being a promising technology, there is still a long road to prove the validity of using VR in skills development. Few controlled trials have been tailored to explore VR advantages over conventional training and therapies, most of them have a limited sample size, a short training course, and no mention of possible setbacks, such as ocular effects and social isolation.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140811370","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}
{"title":"Proteus syndrome: clinical and radiological findings through a new case report","authors":"Barakizou Hager, Khelifi Azza, Ferjani Maryem, Gargah Tahar","doi":"10.1186/s43054-024-00266-2","DOIUrl":"https://doi.org/10.1186/s43054-024-00266-2","url":null,"abstract":"","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140653535","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}
Pub Date : 2024-04-22DOI: 10.1186/s43054-024-00263-5
Francisco Sotomayor Lugo, Yaíma Zúñiga Rosales, Oliver Pérez Martín, Evelyn Hernández Reyes, Evelyn M. Antiguas Valdés, Hermes Fundora Hernández, Katia Rodríguez Guitiérrez, Yaima Matas González, Imilla Casado Hernández, Carlos Agustín Villegas Valverde, Bárbara Torres Rives, Lázara Minerva Tam Rey, Ihosvany González Díaz, Yaquima Hernández Rego, Ana María Simón Pita, Consuelo Macías Abraham, Beatriz Marcheco Teruel
Recurrent infections in childhood are the main cause of remission to the immunology service. T lymphocytes generated in the thymus are essential for fighting infection, making the thymus area an important predictor of the immune system’s competence. This study aimed to identify the possible relationship of the thymic area with clinical-epidemiological variables and values of subpopulations of T lymphocytes in the peripheral blood of children with recurrent infections. We conducted applied research using a transversal analytical design at the National Medical Genetics Center (Havana, Cuba), from January to August 2022. The study covered 73 children of which we analyzed clinical-epidemiological variables and the size of the thymus through ultrasound. Furthermore, we determined the relative and absolute values of the subpopulations of T cells using flow cytometry. Of the children studied, 65.8% had thymic hypoplasia. The children who breastfed for less than 6 months showed four times the risk of developing moderate-severe thymus hypoplasia (OR = 3.90, 95% CI: 1.21–12.61). A direct relationship was found between the area of the thymus and the child’s size (r = 0.238, p = 0.043) and weight (r = 0.233, p = 0.047). The relative values of CD3+ T lymphocytes decreased in the cases of mild hypoplasia (p = 0.018) and moderate-severe hypoplasia (p = 0.049). The thymus area was associated with the absolute cell count of CD8+ effector memory T cells (rs = −0.263, p = 0.024) and of the central memory T cells (r = −0.283, p = 0.015). Breastfeeding for less than 6 months, as well as the weight and size of the child, are related to their thymus area. The subpopulation values of T lymphocytes detected suggest that patients with thymic hypoplasia develop a contraction of CD3+ T cells, which can make them more vulnerable to infectious processes. This finding was combined with an expansion of the memory compartments of the subpopulations of CD8+ T cells, suggesting a greater susceptibility to intracellular viral and bacterial infections in these cases.
儿童期反复感染是导致免疫学服务缓解的主要原因。胸腺中产生的 T 淋巴细胞对抵抗感染至关重要，因此胸腺面积是预测免疫系统能力的重要指标。本研究旨在确定胸腺面积与临床流行病学变量和反复感染儿童外周血中 T 淋巴细胞亚群值之间可能存在的关系。2022 年 1 月至 8 月，我们在国家医学遗传学中心（古巴哈瓦那）采用横向分析设计进行了应用研究。这项研究涉及 73 名儿童，我们对其中的临床流行病学变量和胸腺大小（通过超声波）进行了分析。此外，我们还使用流式细胞术确定了 T 细胞亚群的相对值和绝对值。在研究的儿童中，65.8%患有胸腺发育不全。母乳喂养不足 6 个月的儿童患中度-重度胸腺发育不良的风险是正常儿童的四倍（OR = 3.90，95% CI：1.21-12.61）。胸腺面积与儿童的体型（r = 0.238，p = 0.043）和体重（r = 0.233，p = 0.047）有直接关系。CD3+T淋巴细胞的相对值在轻度发育不全（p = 0.018）和中重度发育不全（p = 0.049）的病例中有所下降。胸腺面积与 CD8+ 效应记忆 T 细胞的绝对细胞数（rs = -0.263，p = 0.024）和中央记忆 T 细胞的绝对细胞数（r = -0.283，p = 0.015）相关。母乳喂养少于 6 个月以及儿童的体重和体型与胸腺面积有关。检测到的 T 淋巴细胞亚群值表明，胸腺发育不全的患者会出现 CD3+ T 细胞萎缩，从而更容易受到感染过程的影响。这一发现与 CD8+ T 细胞亚群记忆区的扩大相结合，表明这些病例更容易受到细胞内病毒和细菌的感染。
{"title":"Relationship of thymic area with clinical-epidemiological variables and values of T-lymphocyte subpopulations in peripheral blood of children with recurrent infections","authors":"Francisco Sotomayor Lugo, Yaíma Zúñiga Rosales, Oliver Pérez Martín, Evelyn Hernández Reyes, Evelyn M. Antiguas Valdés, Hermes Fundora Hernández, Katia Rodríguez Guitiérrez, Yaima Matas González, Imilla Casado Hernández, Carlos Agustín Villegas Valverde, Bárbara Torres Rives, Lázara Minerva Tam Rey, Ihosvany González Díaz, Yaquima Hernández Rego, Ana María Simón Pita, Consuelo Macías Abraham, Beatriz Marcheco Teruel","doi":"10.1186/s43054-024-00263-5","DOIUrl":"https://doi.org/10.1186/s43054-024-00263-5","url":null,"abstract":"Recurrent infections in childhood are the main cause of remission to the immunology service. T lymphocytes generated in the thymus are essential for fighting infection, making the thymus area an important predictor of the immune system’s competence. This study aimed to identify the possible relationship of the thymic area with clinical-epidemiological variables and values of subpopulations of T lymphocytes in the peripheral blood of children with recurrent infections. We conducted applied research using a transversal analytical design at the National Medical Genetics Center (Havana, Cuba), from January to August 2022. The study covered 73 children of which we analyzed clinical-epidemiological variables and the size of the thymus through ultrasound. Furthermore, we determined the relative and absolute values of the subpopulations of T cells using flow cytometry. Of the children studied, 65.8% had thymic hypoplasia. The children who breastfed for less than 6 months showed four times the risk of developing moderate-severe thymus hypoplasia (OR = 3.90, 95% CI: 1.21–12.61). A direct relationship was found between the area of the thymus and the child’s size (r = 0.238, p = 0.043) and weight (r = 0.233, p = 0.047). The relative values of CD3+ T lymphocytes decreased in the cases of mild hypoplasia (p = 0.018) and moderate-severe hypoplasia (p = 0.049). The thymus area was associated with the absolute cell count of CD8+ effector memory T cells (rs = −0.263, p = 0.024) and of the central memory T cells (r = −0.283, p = 0.015). Breastfeeding for less than 6 months, as well as the weight and size of the child, are related to their thymus area. The subpopulation values of T lymphocytes detected suggest that patients with thymic hypoplasia develop a contraction of CD3+ T cells, which can make them more vulnerable to infectious processes. This finding was combined with an expansion of the memory compartments of the subpopulations of CD8+ T cells, suggesting a greater susceptibility to intracellular viral and bacterial infections in these cases.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140636694","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}
Pub Date : 2024-04-17DOI: 10.1186/s43054-024-00264-4
Mohamed Almalky, Reham M. El Shabrawy, Najeeb Ali Mohammed Gheetah, Hossam Moustafa Elkady, Naglaa S. Osman, Walaa Shoman, Eman Gamal Baz
Hereditary angioedema (HAE) is a hereditary illness represented by repeated bouts of submucosal or subcutaneous edema. Types of HAE includes; HAE with deficient C1-inhibitor (type 1), HAE with dysfunctional C1-inhibitor (type 2), and HAE with normal C1-inhibitor. Data on the epidemiology of HAE in Egypt are limited. Therefore, we aimed to characterize HAE in Egyptian children, identify the morbidity, and clarify HAE's different clinical and laboratory presentations. In this cross-sectional study, we enrolled pediatric patients diagnosed with HAE according to the international hereditary angioedema WAO/EAACI guidelines. We gathered laboratory data on patients' mean serum C1 esterase inhibitor (C1-INH) level and activity, C4, and IgE levels. We included 18 HAE patients (14 females and 4 males). They were between the ages of 6 and 18 years. The mean age upon confirmation of diagnosis was 8.4 ± 2.4 years. The mean time required to correctly diagnose HAE was 3.2 ± 1.8 years. We detected type I in 15 cases and type II in three cases. Eleven patients had a family member with HAE. In terms of previous misdiagnoses, 50% of patients were diagnosed with allergic angioedema. The median annual frequency of episodes was 17. The mean HAE attack time was 2.9 ± 1.5 days. Edema was most typically found in the face and abdomen. Trauma was the main triggering factor. We detected a significant direct relationship between severity of attack and C1-INH activity level. This research adds a considerable clinical information about children with HAE. According to current results, there is a considerable underdiagnosis of HAE in Egypt. The detection and management of HAE can be improved by screening the relatives of HAE patients.
遗传性血管性水肿（HAE）是一种遗传性疾病，表现为反复发作的粘膜下或皮下水肿。遗传性血管性水肿的类型包括：缺乏 C1 抑制剂的遗传性血管性水肿（1 型）、C1 抑制剂功能失调的遗传性血管性水肿（2 型）和 C1 抑制剂正常的遗传性血管性水肿。有关埃及 HAE 流行病学的数据十分有限。因此，我们旨在了解埃及儿童 HAE 的特征，确定其发病率，并阐明 HAE 不同的临床和实验室表现。在这项横断面研究中，我们根据国际遗传性血管性水肿 WAO/EAACI 指南招募了被诊断为 HAE 的儿童患者。我们收集了患者平均血清 C1 酯酶抑制剂（C1-INH）水平和活性、C4 和 IgE 水平的实验室数据。我们纳入了 18 名 HAE 患者（14 名女性和 4 名男性）。他们的年龄在 6 至 18 岁之间。确诊时的平均年龄为（8.4 ± 2.4）岁。正确诊断 HAE 所需的平均时间为 3.2 ± 1.8 年。我们在 15 例患者中发现了 I 型，在 3 例患者中发现了 II 型。有11名患者的家庭成员患有HAE。就先前的误诊而言，50%的患者被诊断为过敏性血管性水肿。每年发作频率的中位数为17次。HAE的平均发作时间为2.9 ± 1.5天。水肿最典型的部位是面部和腹部。创伤是主要诱发因素。我们发现，发作的严重程度与 C1-INH 活性水平有明显的直接关系。这项研究为 HAE 儿童提供了大量临床信息。根据目前的结果，埃及对 HAE 的诊断严重不足。通过筛查HAE患者的亲属，可以改善HAE的检测和管理。
{"title":"Clinical and laboratory spectrum of hereditary angioedema in a group of Egyptian children: a cross sectional study","authors":"Mohamed Almalky, Reham M. El Shabrawy, Najeeb Ali Mohammed Gheetah, Hossam Moustafa Elkady, Naglaa S. Osman, Walaa Shoman, Eman Gamal Baz","doi":"10.1186/s43054-024-00264-4","DOIUrl":"https://doi.org/10.1186/s43054-024-00264-4","url":null,"abstract":"Hereditary angioedema (HAE) is a hereditary illness represented by repeated bouts of submucosal or subcutaneous edema. Types of HAE includes; HAE with deficient C1-inhibitor (type 1), HAE with dysfunctional C1-inhibitor (type 2), and HAE with normal C1-inhibitor. Data on the epidemiology of HAE in Egypt are limited. Therefore, we aimed to characterize HAE in Egyptian children, identify the morbidity, and clarify HAE's different clinical and laboratory presentations. In this cross-sectional study, we enrolled pediatric patients diagnosed with HAE according to the international hereditary angioedema WAO/EAACI guidelines. We gathered laboratory data on patients' mean serum C1 esterase inhibitor (C1-INH) level and activity, C4, and IgE levels. We included 18 HAE patients (14 females and 4 males). They were between the ages of 6 and 18 years. The mean age upon confirmation of diagnosis was 8.4 ± 2.4 years. The mean time required to correctly diagnose HAE was 3.2 ± 1.8 years. We detected type I in 15 cases and type II in three cases. Eleven patients had a family member with HAE. In terms of previous misdiagnoses, 50% of patients were diagnosed with allergic angioedema. The median annual frequency of episodes was 17. The mean HAE attack time was 2.9 ± 1.5 days. Edema was most typically found in the face and abdomen. Trauma was the main triggering factor. We detected a significant direct relationship between severity of attack and C1-INH activity level. This research adds a considerable clinical information about children with HAE. According to current results, there is a considerable underdiagnosis of HAE in Egypt. The detection and management of HAE can be improved by screening the relatives of HAE patients.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140613256","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}
Pub Date : 2024-04-12DOI: 10.1186/s43054-023-00244-0
Eman Mahmoud Fouda, Hala Hamdi Shaaban, Mona Mohsen Elattar, Abla Saleh Mostafa, Dina H. Hamed, Aya Samir Mohamed Saleh, Sally Raafat Ishak, Tarek Hamed, Magda Hassab Allah Mohamed, Shahenaz Mohamoud Hussien, Mohamed Mahmoud Rashad, Hala Gouda Elnady, Hoda M. Salah El Din Metwally, Laila Abd Elghaffar, Sherif Reda, Ashraf Abdel Baky, Tarek Omar, Yasser Amer, Dina Tawfeek Sarhan, Amira S. El Refay
We recently adopted a guideline for chronic cough in children in the Egyptian health system. Adapting clinical practice guidelines (CPGs) to the local healthcare setting is a valid alternative to de-novo development that can improve their uptake and implementation without demanding a substantial drain on resources. The objective of this study was to adapt evidence-based recommendations from global high-quality CPGs for children with a chronic cough to suit the Egyptian healthcare context. We followed the Adapted ADAPTE methodological framework for guideline adaptation. This process includes three phases: set-up, adaptation, and finalization. A guideline adaptation group (GAG) and an external review group including clinical content experts and methodologists conducted the process. The GAG adapted 10 sections of recommendations from three original CPG(s) including (i) the American College of Chest Physicians (ACCP) 2006–2020, (ii) the European Respiratory Society (ERS) 2019, (iii) the Korean Academy of Asthma, Allergy and Clinical Immunology (KAAACI) 2018. A set of CPG implementation tools was added to enhance implementability including an algorithm, a slide presentation for clinical diagnosis, investigations and treatment of chronic cough, patient education, and online resources. The adapted CPG provides pediatricians and related healthcare workers with applicable evidence-based recommendations for chronic cough in children in Egypt. The project also highlighted the utility of Adapted ADAPTE and the invaluable collaboration between the clinical and methodological experts for the adaptation of pediatric national guidelines.
{"title":"Chronic cough in children: an evidence-based clinical practice guideline adapted for the use in Egypt using ‘Adapted ADAPTE’","authors":"Eman Mahmoud Fouda, Hala Hamdi Shaaban, Mona Mohsen Elattar, Abla Saleh Mostafa, Dina H. Hamed, Aya Samir Mohamed Saleh, Sally Raafat Ishak, Tarek Hamed, Magda Hassab Allah Mohamed, Shahenaz Mohamoud Hussien, Mohamed Mahmoud Rashad, Hala Gouda Elnady, Hoda M. Salah El Din Metwally, Laila Abd Elghaffar, Sherif Reda, Ashraf Abdel Baky, Tarek Omar, Yasser Amer, Dina Tawfeek Sarhan, Amira S. El Refay","doi":"10.1186/s43054-023-00244-0","DOIUrl":"https://doi.org/10.1186/s43054-023-00244-0","url":null,"abstract":"We recently adopted a guideline for chronic cough in children in the Egyptian health system. Adapting clinical practice guidelines (CPGs) to the local healthcare setting is a valid alternative to de-novo development that can improve their uptake and implementation without demanding a substantial drain on resources. The objective of this study was to adapt evidence-based recommendations from global high-quality CPGs for children with a chronic cough to suit the Egyptian healthcare context. We followed the Adapted ADAPTE methodological framework for guideline adaptation. This process includes three phases: set-up, adaptation, and finalization. A guideline adaptation group (GAG) and an external review group including clinical content experts and methodologists conducted the process. The GAG adapted 10 sections of recommendations from three original CPG(s) including (i) the American College of Chest Physicians (ACCP) 2006–2020, (ii) the European Respiratory Society (ERS) 2019, (iii) the Korean Academy of Asthma, Allergy and Clinical Immunology (KAAACI) 2018. A set of CPG implementation tools was added to enhance implementability including an algorithm, a slide presentation for clinical diagnosis, investigations and treatment of chronic cough, patient education, and online resources. The adapted CPG provides pediatricians and related healthcare workers with applicable evidence-based recommendations for chronic cough in children in Egypt. The project also highlighted the utility of Adapted ADAPTE and the invaluable collaboration between the clinical and methodological experts for the adaptation of pediatric national guidelines.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140594135","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}
Pub Date : 2024-04-08DOI: 10.1186/s43054-024-00260-8
Soha M. Hamdy, Yomna A. Othman, Omayma O. Abdelaleem, Rehab G. Abd El-Hamid, Doaa Y. Ali
Neonatal sepsis is one of the life-threatening diseases. MicroRNAs are non-coding RNAs that play vital roles in various diseases. This study included 50 neonates with sepsis and 60 healthy controls. RNA extraction and assessment of mir-182-5p and miR-590-3p using real-time PCR were done. Significant downregulation of mir-182-5p and miR-590-3p in neonates with sepsis compared with healthy neonates was observed. Positive correlations were confirmed between the expression levels of miR-182-5p and birth weight (R = 0.355, P = 0.012), RDW (R = 0.476, p = < 0.0001), I/T Neutrophil (R = 0.362, P = 0.012), and a negative correlations were demonstrated between miR-182-5p and each of lyomphocyte count (R = − 0.399, P = 0.004), HCO3 (R = − 0.396, P = 0.004), as well as snap score (R = − 0.321, P = 0.023). Moreover, positive correlations were verified between the expression level of miR-590-3p and I/T Neutrophil (R = 0.420, P = 0.003), RDW (R = 0.359, p = 0.010), CRP (R = 0.285, P = 0.45), and negative correlations were established between the expression level of miR-590-3p and platelets (R = − 0.495, P = < 0.0001), lymphocyte count (R = − 0.365, P = 0.009), and snap score (R = − 0.568, P = < 0.0001). mir-182-5p and miR-590-3p may be used as new biomarkers for neonatal sepsis suggesting that they could be used in the treatment of neonatal sepsis. Also, a significant negative correlation was noted between expression levels of mir-182-5p and miR-590-3p and snap score.
{"title":"Expression of serum microRNAs, mir-182-5p, and miR-590-3p and its clinical significance in neonatal sepsis","authors":"Soha M. Hamdy, Yomna A. Othman, Omayma O. Abdelaleem, Rehab G. Abd El-Hamid, Doaa Y. Ali","doi":"10.1186/s43054-024-00260-8","DOIUrl":"https://doi.org/10.1186/s43054-024-00260-8","url":null,"abstract":"Neonatal sepsis is one of the life-threatening diseases. MicroRNAs are non-coding RNAs that play vital roles in various diseases. This study included 50 neonates with sepsis and 60 healthy controls. RNA extraction and assessment of mir-182-5p and miR-590-3p using real-time PCR were done. Significant downregulation of mir-182-5p and miR-590-3p in neonates with sepsis compared with healthy neonates was observed. Positive correlations were confirmed between the expression levels of miR-182-5p and birth weight (R = 0.355, P = 0.012), RDW (R = 0.476, p = < 0.0001), I/T Neutrophil (R = 0.362, P = 0.012), and a negative correlations were demonstrated between miR-182-5p and each of lyomphocyte count (R = − 0.399, P = 0.004), HCO3 (R = − 0.396, P = 0.004), as well as snap score (R = − 0.321, P = 0.023). Moreover, positive correlations were verified between the expression level of miR-590-3p and I/T Neutrophil (R = 0.420, P = 0.003), RDW (R = 0.359, p = 0.010), CRP (R = 0.285, P = 0.45), and negative correlations were established between the expression level of miR-590-3p and platelets (R = − 0.495, P = < 0.0001), lymphocyte count (R = − 0.365, P = 0.009), and snap score (R = − 0.568, P = < 0.0001). mir-182-5p and miR-590-3p may be used as new biomarkers for neonatal sepsis suggesting that they could be used in the treatment of neonatal sepsis. Also, a significant negative correlation was noted between expression levels of mir-182-5p and miR-590-3p and snap score.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140594094","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}
Pub Date : 2024-04-05DOI: 10.1186/s43054-024-00273-3
Bahram Aminmansour, Samaneh Fatehi, Ali Mokhtari, Ali Riazi, Donya Sheibani Tehrani
Functional and structural complexities associated with craniosynostosis present challenges for families of affected individuals. Additionally, these patients undergo childhood surgeries that significantly impact the role of the family/caregiver. Consequently, multiple therapeutic teams have provided various guidelines, with the most recent version in 2023 introducing the patient/family guide. The objective of this study was to evaluate the level of awareness among the patient’s family/caregiver regarding the treatment plan. The descriptive-analytical study sample consisted of 117 caregivers (parents) of children diagnosed with craniosynostosis between 2013 and 2023, who were conveniently selected for participation. The self-designed questionnaire was based on the 2023 guidelines and underwent reliability and validity testing. It comprised 14 chapters derived from the literature, with a total of 55 yes/no questions. Based on the results obtained from this study, the total correct response rate is 62.3%. The highest level of respondent awareness was associated with Chapter 12, with a correct response rate of 69%. The lowest level of awareness, at 41.8%, was related to Chapter 10. It is better to use appropriate educational aids such as educational podcasts based on the latest guidelines for craniosynostosis to educate parents.
{"title":"The awareness of treatment plans of craniosynostosis: guideline for patient and family version","authors":"Bahram Aminmansour, Samaneh Fatehi, Ali Mokhtari, Ali Riazi, Donya Sheibani Tehrani","doi":"10.1186/s43054-024-00273-3","DOIUrl":"https://doi.org/10.1186/s43054-024-00273-3","url":null,"abstract":"Functional and structural complexities associated with craniosynostosis present challenges for families of affected individuals. Additionally, these patients undergo childhood surgeries that significantly impact the role of the family/caregiver. Consequently, multiple therapeutic teams have provided various guidelines, with the most recent version in 2023 introducing the patient/family guide. The objective of this study was to evaluate the level of awareness among the patient’s family/caregiver regarding the treatment plan. The descriptive-analytical study sample consisted of 117 caregivers (parents) of children diagnosed with craniosynostosis between 2013 and 2023, who were conveniently selected for participation. The self-designed questionnaire was based on the 2023 guidelines and underwent reliability and validity testing. It comprised 14 chapters derived from the literature, with a total of 55 yes/no questions. Based on the results obtained from this study, the total correct response rate is 62.3%. The highest level of respondent awareness was associated with Chapter 12, with a correct response rate of 69%. The lowest level of awareness, at 41.8%, was related to Chapter 10. It is better to use appropriate educational aids such as educational podcasts based on the latest guidelines for craniosynostosis to educate parents.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140594098","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}
Pub Date : 2024-04-05DOI: 10.1186/s43054-024-00279-x
Maria Klimeczek Chrapusta, Maciej Preinl, Zofia Łubniewska, Filip Procháska, Maria Gruba, Wojciech Górecki
This study explores the effectiveness of ultrasonography (USG)-guided saline enema reduction for ileocecal intussusception. It investigates factors, ascertainable through physical examination, ultrasound, and medical history, that impact the success of the procedure and the likelihood of recurrence. Conducted at a tertiary referral center, the study included 323 pediatric cases diagnosed with intussusception between 2017 and 2023. Patient data, symptoms, signs, and outcomes were collected. Hydrostatic saline enema, performed under USG guidance, served as the primary non-operative treatment. Logistic regression models assessed the impact of clinical factors on success and recurrence rates. Out of 323 patients examined for eligibility, 184 met inclusion criteria and were analyzed. Successful reduction with saline enema was achieved in 86.7%. In-hospital recurrence occurred in 17.1%, notably higher for intussusceptions extending into the rectum (p < 0.03). Pathologic lead point was identified in 33.3% of operated cases. The study revealed a correlation between the increasing number of symptoms (p < 0.001) and reduced success rates in enema reduction, with vomiting (p < 0.02), diarrhea (p < 0.05), and peritoneal fluid (p < 0.008) negatively affecting outcomes. Symptom duration of 1–9 h (p < 0.001) and 10–24 (p < 0.01) correlated with higher success rates, but prolonged symptom duration of > 24 (p = 0.4) and 48–72 (p = 0.2) hours did not decrease chances for successful reduction. Prolonged symptom duration of over 24 and 48–72 h should not be a definitive contraindication for non-operative treatment. Cumulation of symptoms typical for intussusception might reduce the chances of success. These findings contribute valuable insights into optimizing non-operative strategies for managing pediatric intussusception.
{"title":"Predictive factors for failure of nonsurgical management of intussusception and its in-hospital recurrence in pediatric patients: a large retrospective single-center study","authors":"Maria Klimeczek Chrapusta, Maciej Preinl, Zofia Łubniewska, Filip Procháska, Maria Gruba, Wojciech Górecki","doi":"10.1186/s43054-024-00279-x","DOIUrl":"https://doi.org/10.1186/s43054-024-00279-x","url":null,"abstract":"This study explores the effectiveness of ultrasonography (USG)-guided saline enema reduction for ileocecal intussusception. It investigates factors, ascertainable through physical examination, ultrasound, and medical history, that impact the success of the procedure and the likelihood of recurrence. Conducted at a tertiary referral center, the study included 323 pediatric cases diagnosed with intussusception between 2017 and 2023. Patient data, symptoms, signs, and outcomes were collected. Hydrostatic saline enema, performed under USG guidance, served as the primary non-operative treatment. Logistic regression models assessed the impact of clinical factors on success and recurrence rates. Out of 323 patients examined for eligibility, 184 met inclusion criteria and were analyzed. Successful reduction with saline enema was achieved in 86.7%. In-hospital recurrence occurred in 17.1%, notably higher for intussusceptions extending into the rectum (p < 0.03). Pathologic lead point was identified in 33.3% of operated cases. The study revealed a correlation between the increasing number of symptoms (p < 0.001) and reduced success rates in enema reduction, with vomiting (p < 0.02), diarrhea (p < 0.05), and peritoneal fluid (p < 0.008) negatively affecting outcomes. Symptom duration of 1–9 h (p < 0.001) and 10–24 (p < 0.01) correlated with higher success rates, but prolonged symptom duration of > 24 (p = 0.4) and 48–72 (p = 0.2) hours did not decrease chances for successful reduction. Prolonged symptom duration of over 24 and 48–72 h should not be a definitive contraindication for non-operative treatment. Cumulation of symptoms typical for intussusception might reduce the chances of success. These findings contribute valuable insights into optimizing non-operative strategies for managing pediatric intussusception.","PeriodicalId":43064,"journal":{"name":"Egyptian Pediatric Association Gazette","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140594106","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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