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Congenital Heart Disease-A Retrospective Study of 156 Cases in Senegal 先天性心脏病——塞内加尔156例回顾性研究
Pub Date : 2020-01-01 DOI: 10.26502/jppch.74050050
I. Basse, Amadou L Fall, A. Sow, Mouhamed C Léye, A. Affangla, Ndiaga Diakhaté, N. Seck, Lamine Thiam, N. Ndiaye, Ali Bido Sibabi, F. Diaby, D. Boiro, Aliou A Ndongo, Ndéye RD Guéye
Results: During the study period, we retained 156 files with a hospital prevalence of 2.4%. The average pulse oxygen saturation of the patients was 89%. Ventricular septal defect (VSD) was the most frequent (45%), followed by atrial septal defect (ASD) (40%), patent ductus arteriosus (PDA) (26%), pulmonary stenosis (16%), atrioventricular septal defect (ASD) (4%) and Tetralogy of Fallot (2%). The sex ratio was 0.89. 93.10% of the patients were aged up to 24 months (n=148) against 6.90% aged over 24 months (n=11). The average pulse oxygen saturation of the patients was 89%. Ventricular septal defect (VIC) was the most frequent (45%), followed by atrial septal defect (ASD) (40%), patent ductus arteriosus (PCA) (26%), pulmonary stenosis (16%), atrioventricular septal defect (VAD) (4%) and Tetralogy of Fallot (2%).The sex ratio was 0.89. Among the patients, 93.10% were aged up to 24 months (n=148) compared to 6.90% aged over 24 months (n=11). The average age of children was 9 months. Conclusion: CHD are a reality in Africa, their frequencies in all reported series are certainly underestimated due to the very limited means of diagnosis.
结果:在研究期间,我们保留了156个病例,医院患病率为2.4%。患者平均脉搏血氧饱和度为89%。室间隔缺损(VSD)最为常见(45%),其次是房间隔缺损(ASD)(40%)、动脉导管未闭(PDA)(26%)、肺动脉狭窄(16%)、房室间隔缺损(ASD)(4%)和法洛四联症(2%)。性别比为0.89。93.10%的患者年龄在24个月以内(n=148), 6.90%的患者年龄在24个月以上(n=11)。患者平均脉搏血氧饱和度为89%。室间隔缺损(VIC)最为常见(45%),其次是房间隔缺损(ASD)(40%)、动脉导管未闭(PCA)(26%)、肺动脉狭窄(16%)、房室间隔缺损(VAD)(4%)和法洛四联症(2%)。性别比为0.89。93.10%的患者年龄在24个月以下(n=148), 6.90%的患者年龄在24个月以上(n=11)。儿童的平均年龄为9个月。结论:冠心病在非洲是一个现实,由于诊断手段非常有限,其在所有报告系列中的发病率肯定被低估了。
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引用次数: 0
Anticipatory Ear Pain Counseling at a 12-15 Month Preventive Care Visit for Low Income Children 对低收入儿童12-15个月预防性保健访视的预期耳痛咨询
Pub Date : 2019-01-01 DOI: 10.26502/jppch.74050025
S. Berman, A. Shriver, Lauren C Mehner, B. Wallace, A. Furniss, Meghan Treitz
Background: Determine the usefulness of ear pain anticipatory counseling for young children with public health plans to reduce visits for acute otitis media (AOM) and shift visits from urgent care/emergency department (UC/ED) settings to primary care clinic (PCC) settings. Methods: We documented the AOM visit distribution and incidence rates by setting according to race/ethnicity from the EPIC electronic medical record system for 12 months following the enrollment of eligible 12-15 month old children in a single blind randomized control trial of ear pain counseling. Results: Among the 310 children enrolled in the study, 30.6% of participants had at least 1 AOM visit and 4.5% had 3 or more AOM visits. The overall incidence was 490 AOM visit episodes per 1000 child years with rates of 232 in PCC and 226 in UC/ED settings. The difference in the proportion of Hispanic children with at least 1 AOM visit (33.5% 52/155) compared to Non-Hispanic children (24% 25/106) approached significance (p=0.08). The counseling intervention did not reduce the proportion of children with at least 1 AOM visit (counseling: 29.0%: 45/155; control: 32.3% 50/155 p=0.54); the proportion of children with 3 or more AOM visits (counseling: 5.8%: 9/155; control: 3.2% 5/155 p=0.41); or the AOM visit incidence rates (counseling: 471; control: 510) and did not shift AOM visits from the UC/ED to PCC setting. Conclusions: Anticipatory ear pain counseling in a hospital based PCC serving children enrolled in public plans does not reduce PCC or UC/ED AOM visit incidence rates.
背景:确定耳痛预见性咨询对有公共卫生计划的幼儿的有用性,以减少急性中耳炎(AOM)的就诊,并将就诊从急诊/急诊科(UC/ED)转移到初级保健诊所(PCC)。方法:我们从EPIC电子病历系统中按种族/民族设置了12个月的AOM就诊分布和发病率,并记录了符合条件的12-15个月大的儿童参加了一项耳痛咨询的单盲随机对照试验。结果:在参与研究的310名儿童中,30.6%的参与者至少去了一次AOM, 4.5%的人去了3次或更多的AOM。总发病率为每1000儿童年490次AOM就诊,PCC为232次,UC/ED为226次。西班牙裔儿童至少1次AOM就诊比例(33.5% 52/155)与非西班牙裔儿童(24% 25/106)的差异接近显著性(p=0.08)。咨询干预没有降低至少1次AOM就诊的儿童比例(咨询:29.0%:45/155;对照组:32.3% 50/155 p=0.54);到AOM就诊3次及以上的儿童比例(咨询:5.8%:9/155;对照组:3.2% 5/155 p=0.41);或AOM就诊率(咨询:471;对照:510),并且没有将AOM的访问从UC/ED转移到PCC设置。结论:在以医院为基础的为参加公共计划的儿童提供耳痛预见性咨询的PCC并没有降低PCC或UC/ED AOM的就诊发生率。
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引用次数: 0
Walker-Warburg Syndrome: A Case report of Congenital Muscular Dystrophy with Cerebro-Ocular Malformation, a Rare Syndrome in an African Patient Walker-Warburg综合征:先天性肌营养不良伴脑眼畸形的病例报告,一种罕见的综合征在非洲患者
Pub Date : 2019-01-01 DOI: 10.26502/jppch.74050016
Insiyah A Amiji, Maria N Bulimba, Zawadi E Kalezi, Janeth Fidelis Tarimo, Karim P Manji
Walker-Warburg Syndrome is a genetically heterogeneous disease with autosomal recessive inheritance presenting with congenital muscular dystrophy with cerebro-ocular malformations since birth or infancy. Literature shows a mutation in Protein O-Mannosyltransferase 1 (POMT1) gene, which results in a defect in O-mannosylation of α-dystroglycan, these proteins are central to the pathogenesis of structural and functional brain abnormalities however, the exact pathophysiology of this disorder is not fully understood. The overall incidence still remains unknown and most cases have been reported from the Western hemisphere. In our setting we report a case of 3 weeks old male baby who was delivered by spontaneous vertex delivery at gestation age of 26 weeks with birth weight of 1900 gm referred to our hospital on the 6th day of life, with complaint of bilateral prominent, protruding eyes and inability to close the eyelids. The parents were non-consanguineous and this was the first child. No ante- natal ultrasound was done during the pregnancy. On further examination, he had macrocephaly 33 cm (>97th centile) with no fusion of the sutures, depressed nasal bridge, low set ears, bilateral dental lamina cyst, bilateral cortical thumb, micrognathia, and scoliosis. Systemic examination revealed a normal conscious level with weak cry, normal facial symmetry, generalized hypotonia and primitive reflex were weak to absent and ocular examination revealed bupthalmos, bilateral megalocornea and glaucoma. Creatine kinase was elevated-522 unit/L (0-25 units/L). Cranial Ultrasound revealed Dandy-Walker cyst in the posterior fossa cyst, with third ventricle dilatation (ventriculomegally), the corpus callosum was normal, Interventricular hemorrhage grade 2 and hyper echogenic eyeballs. Echocardiography revealed Double Outlet Right Ventricle. Management was supportive, aimed to improve growth through optimum feeding, eye padding for protection and diuretics for the underlying congenital heart disease.Conclusion: Overall prognosis of this disease is poor, the baby died in 42 days due to aspiration pneumonia and progressive respiratory failure. Genetic counselling was done to the parents, since in families with one affected child, the risk of having another child with the disease is 25%. A high index of suspicion during a routine antenatal ultrasound could prompt further advanced fetal ultrasonography and magnetic resonance imaging, and aid in timely prenatal diagnosis, management, and counseling.
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引用次数: 0
Healthcare Disparities in the Treatment of Pediatric Distal Radius-Ulna Fractures: A Single-Institution Perspective 儿童桡骨-尺骨远端骨折治疗的医疗差异:单一机构视角
Pub Date : 2019-01-01 DOI: 10.26502/jppch.74050020
Andrew S. Moon, Thomas E Niemeier, Charles C. Pitts, G. McGwin, J. Khoury
Background: This study sought to identify variables associated with socioeconomic disparities in the treatment of distal forearm fractures in children. Methods: A single-institution retrospective cohort study of patients less than 18 years of age with isolated fractures of the distal radius and ulna. Patient included underwent a closed reduction and casting under sedation by an orthopedic resident with outpatient, clinical follow up within two weeks of injury. Demographic data were collected. Primary outcomes evaluated were the final fracture alignment and rate of surgical treatment. Results: 177 children included in this study, including 105 with private insurance and 72 with Medicaid or no insurance, 129 were white and 48 were minorities, and 51 were female while 126 were male. There were no statistically significant differences between patient groups when assessed for treatment outcome, mean fracture displacement, time to first clinic appointment, and duration of follow-up. Rates of surgical treatment between all groups tested were non-significant. Of patients that met institutional operative criteria, a lower percentage of non-white (p=0.03), male (p=0.07), and non-private insurance patients (p=0.08) received surgery when surgery was indicated compared to white female patients with insurance. Conclusions: At a single institution, no clear disparities in the overall care and outcomes of children with distal radius and ulna fractures were identified. When surgery was indicated by institutional standards, a significantly greater percentage of white patients underwent surgery when compared to non-whites, but no significant difference in the percentage of good, fair, and poor outcomes between these groups was seen.
背景:本研究旨在确定儿童前臂远端骨折治疗中与社会经济差异相关的变量。方法:对年龄小于18岁的孤立性桡骨和尺骨远端骨折患者进行单机构回顾性队列研究。患者在镇静下接受骨科住院医师的闭合复位和铸造,并在受伤后两周内进行门诊和临床随访。收集了人口统计数据。评估的主要结果是最终骨折对齐和手术治疗率。结果:本研究共纳入177名儿童,其中有私人保险105名,有医疗补助或无医疗保险72名,白人129名,少数民族48名,女性51名,男性126名。在评估治疗结果、平均骨折移位、首次门诊预约时间和随访时间时,两组患者之间无统计学差异。两组间的手术治疗率无显著性差异。在符合机构手术标准的患者中,非白人(p=0.03)、男性(p=0.07)和非私人保险患者(p=0.08)在需要手术时接受手术的比例低于白人女性保险患者。结论:在单一机构中,桡骨和尺骨远端骨折患儿的整体护理和预后没有明显差异。当手术符合制度标准时,与非白人患者相比,白人患者接受手术的比例明显更高,但两组患者在良好、一般和不良结果的百分比上没有显著差异。
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引用次数: 3
Report of a Case of Thrombocitopenic Syndrome with Radius Aplasia with a 16 Year Follow up in Celaya, Mexico, and Review of Literature 墨西哥塞拉亚1例伴桡骨发育不全的血小板减少综合征16年随访报告及文献复习
Pub Date : 2019-01-01 DOI: 10.26502/jppch.74050013
R. Puente, P. Rogelio, Daniela Rico Medina, V. Guarner-Lans, O. Grimaldo
There are numerous published works on thrombocytopenic syndrome with radius aplasia. Most of them refer to cases or families with several affected individuals without giving them follow-up. Here we report the follow up of a patient with the syndrome. The clinical manifestations found in the patient are not classical since thrombocytopenic syndrome with Radius Aplasia does not usually have bilateral agenesis of radius and ulna at birth as is shown in this case. In addition, the musculoskeletal manifestations in this patient were present 16 years afterwards. Therefore, the phenotypic expression of this syndrome in the present case is of great interest.
有许多关于血小板减少综合征伴桡骨发育不全的出版物。其中大多数涉及病例或有几个受影响个人的家庭,而没有对他们进行后续调查。在此,我们报告一位患者的随访。该患者的临床表现并不典型,因为伴桡骨发育不全的血小板减少综合征在出生时通常没有双侧桡骨和尺骨发育不全,如本病例所示。此外,该患者的肌肉骨骼表现在16年后出现。因此,本病例中该综合征的表型表达是非常有趣的。
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引用次数: 0
Home Respiratory Polygraphy-An Alternative for the Diagnosis of Pediatric Obstructive Sleep Apnea Syndrome 家庭呼吸测谎——儿童阻塞性睡眠呼吸暂停综合征的另一种诊断方法
Pub Date : 2019-01-01 DOI: 10.26502/jppch.74050027
Cristina Nicoleta Tiboc, S. Man, V. Sas, G. A. Filip
Obstructive sleep apnea syndrome is one of the most common types of sleep-disordered breathing in children and is characterized by partial or complete obstruction of the upper airways during sleep with repeated episodes of airflow cessation, reduction in blood oxygen saturation and sleep disruption to restore patency of the upper airways. Because polysomnography, the gold-standard test for the diagnosis of obstructive sleep apnea, is a costly procedure with technical difficulties, home respiratory polygraphy is used as an alternative diagnostic method. This review seeks to summarize the utility of home respiratory polygraphy in detecting obstructive sleep apnea syndrome and to show if it can be used as a substitute for polysomnography in children.
阻塞性睡眠呼吸暂停综合征是儿童最常见的睡眠呼吸障碍类型之一,其特征是睡眠时上呼吸道部分或完全阻塞,反复发作气流停止,血氧饱和度降低和睡眠中断,以恢复上呼吸道通畅。由于多导睡眠描记术是诊断阻塞性睡眠呼吸暂停的金标准测试,是一项昂贵且技术困难的程序,因此家庭呼吸测谎术被用作替代诊断方法。本综述旨在总结家庭呼吸测谎仪在检测阻塞性睡眠呼吸暂停综合征中的应用,并表明它是否可以作为儿童多导睡眠图的替代品。
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引用次数: 0
Knowledge of Diabetic Patients towards Diabetes Mellitus in a Sample of Patients Attending Diabetes and Endocrine Center 在糖尿病与内分泌中心就诊的糖尿病患者对糖尿病认知的调查
Pub Date : 2019-01-01 DOI: 10.26502/jppch.7405009
Khalida Saad
Background: Diabetes is a chronic disease that affects people and requires the continuation of medical treatment and follow-up, which is a widespread disease at all the time and places in the world. Aims: To assess the knowledge level of participants towards diabetic mellitus and found any relation between variables. Methods: A cross-sectional descriptive study was conducted in Diabetes and endocrine center in Baghdad for a period started from February 2018 up to July 2018. In this study (150) diabetic patients from different age categories, both males and females, were included in the study. The data analysis through descriptive and chi- square statistical analysis by using soft STATA version 13. Results: The mean age of participants were 40.8 and SD 0.94 with 95% CI [39.0155-42.7310]. 52 (34.7%) in the age groups (40-49) years old, 86 (57.3%) were males, live in urban area were 128 (85.3%), employed 45 (30%), married 105 (70%), 38 (25.3%) were elementary school. Not statistically significant has been found between the type of diabetic and gender with the knowledge level toward diabetic. Conclusions: Most participants had type II diabetes mellitus and family history; the participants had a moderate Knowledge levels towards diabetes. Significant association has been found between the knowledge level of diabetic with the age groups and type of therapy. Assist patient to determine amount of food, drink, or glucose tablets; also, education and guidance are provided to patients to identify risks for hypoglycemia and hyperglycemia and appropriately treat hypoglycemia to avoid unnecessary caloric intake and weight gain.
背景:糖尿病是一种影响人的慢性疾病,需要持续的药物治疗和随访,是世界上任何时间和地方普遍存在的疾病。目的:了解被试对糖尿病的认知程度,并探讨变量间的关系。方法:2018年2月至2018年7月,在巴格达糖尿病和内分泌中心进行了一项横断面描述性研究。本研究共纳入150例不同年龄段的糖尿病患者,包括男性和女性。数据分析采用描述性和卡方统计分析,采用STATA软件进行统计分析。结果:参与者的平均年龄为40.8岁,SD为0.94,95% CI[39.0155-42.7310]。40-49岁年龄组52人(34.7%),男性86人(57.3%),城区居住128人(85.3%),在职45人(30%),已婚105人(70%),小学38人(25.3%)。糖尿病类型、性别与糖尿病知识水平之间无统计学差异。结论:大多数参与者有2型糖尿病和家族史;参与者对糖尿病有中等程度的了解。糖尿病知识水平与年龄、治疗方式有显著相关性。协助患者确定食物、饮料或葡萄糖片的用量;同时对患者进行教育和指导,识别低血糖和高血糖的风险,适当治疗低血糖,避免不必要的热量摄入和体重增加。
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引用次数: 0
Factors Affecting Mortality in the Transfusion of Concentrate of Hemacies in Pediatric Patients: A Systematic Review 影响儿科患者输血血精死亡率的因素:一项系统综述
Pub Date : 2019-01-01 DOI: 10.26502/jppch.74050030
Eduardo Manoel Pereira, Woryk de Souza Schröder Nowak, Caciano Vinicius Krenchinski, Lucas Renato Rocha
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引用次数: 0
Embolic Stroke and Carotid Artery Occlusion in an Infant with Dilated Cardiomyopathy Secondary to Acute Myocarditis 急性心肌炎继发扩张型心肌病婴儿的栓塞性卒中和颈动脉闭塞
Pub Date : 2019-01-01 DOI: 10.26502/jppch.74050017
W. Al-Twaijri, Fahad Al-Bassam, Tala Al-Bassri
We are reporting on an 11-month-old infant girl with two interesting findings. The first is dilated cardiomyopathy following an acute clinical course, which on presentation suggested acute myocarditis; two-dimensional echocardiographic findings showed severely-dilated left atrial and ventricular chambers as well as severe ventricular dysfunction. The second is the occurrence of right-sided middle cerebral artery stroke, with clinical manifestations of sudden onset left-sided hemiparalysis, secondary to right carotid artery occlusion. To the best of our knowledge, there is no previous report in the literature of this condition within a similar age group.
我们正在报道一个11个月大的女婴,有两个有趣的发现。第一种是急性临床病程后的扩张型心肌病,表现为急性心肌炎;二维超声心动图显示左房室和心室严重扩张以及严重的心室功能障碍。二是发生右侧大脑中动脉卒中,临床表现为突发性左侧偏瘫,继发于右侧颈动脉闭塞。据我们所知,以前的文献中没有类似年龄组的这种情况的报道。
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引用次数: 0
Klippel-Feil Syndrome with Meningiocele and Chiari malformation-A Case Report Klippel-Feil综合征合并脑膜膨出和Chiari畸形1例报告
Pub Date : 2019-01-01 DOI: 10.26502/jppch.74050012
N. Zwn, Al-Gburi Sm, Al-Azzawe Hs
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引用次数: 0
期刊
Journal of pediatrics, perinatology and child health
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