Pub Date : 2023-11-27DOI: 10.29011/2575825x.100297
Anastasia Konidari, Sofia Leka-Emiri, Flora Tzifi, Constantinos Mihas, Aikaterini Evangelopoulou, E. Dikaiakou, M. Kafetzi, E. Vlachopapadopoulou
Background: Pediatric obesity is a public health issue. Elevated alanine transferase (ALT) may co-exist with suboptimal thyroid function in this population. Objectives: The aim of this cross-sectional study was to investigate and compare the association of thyroid function tests, ALT and metabolic profile in Greek children and adolescents with obesity and severe obesity. Methods: 279 children with body mass index (BMI) ≥95 th percentile, were divided in two groups (obese: 95 th ≤ΒΜΙ<99 th percentile and severely obese: ΒΜΙ≥99 th percentile). Insulin resistance was defined as homeostatic model assessment of insulin resistance (HOMA-IR) ≥ 3. Screening markers of suboptimal thyroid and liver function were expressed as 0.7 ng/dl22mg/dl (females) and >26mg/dl (males) respectively. Results: Elevated ALT levels were found in children with FT4<11 ng/dl in comparison to peers with FT4≥1 (53.3% vs 25%, p: 0.024). Children with severe obesity were younger (p: 0.003) and had higher ALT levels (p: 0.001). In multivariate logistic regression, severe obesity status, FT4<1 and HOMA-IR ≥3 were predictive of higher ALT (ORs: 2.23, 3.37, 3.21 with p: 0.029, 0.04, 0.007, respectively). Conclusions: We suggest that children with severe obesity and insulin resistance are routinely screened for FT4 and ALT as surrogate markers of obesity related thyroid and liver dysfunction.
{"title":"Suboptimal Thyroid Function and Elevated ALT in Children and Adolescents with Severe Obesity: A Single Tertiary Center Experience","authors":"Anastasia Konidari, Sofia Leka-Emiri, Flora Tzifi, Constantinos Mihas, Aikaterini Evangelopoulou, E. Dikaiakou, M. Kafetzi, E. Vlachopapadopoulou","doi":"10.29011/2575825x.100297","DOIUrl":"https://doi.org/10.29011/2575825x.100297","url":null,"abstract":"Background: Pediatric obesity is a public health issue. Elevated alanine transferase (ALT) may co-exist with suboptimal thyroid function in this population. Objectives: The aim of this cross-sectional study was to investigate and compare the association of thyroid function tests, ALT and metabolic profile in Greek children and adolescents with obesity and severe obesity. Methods: 279 children with body mass index (BMI) ≥95 th percentile, were divided in two groups (obese: 95 th ≤ΒΜΙ<99 th percentile and severely obese: ΒΜΙ≥99 th percentile). Insulin resistance was defined as homeostatic model assessment of insulin resistance (HOMA-IR) ≥ 3. Screening markers of suboptimal thyroid and liver function were expressed as 0.7 ng/dl<FT4<1ng/dl, ALT>22mg/dl (females) and >26mg/dl (males) respectively. Results: Elevated ALT levels were found in children with FT4<11 ng/dl in comparison to peers with FT4≥1 (53.3% vs 25%, p: 0.024). Children with severe obesity were younger (p: 0.003) and had higher ALT levels (p: 0.001). In multivariate logistic regression, severe obesity status, FT4<1 and HOMA-IR ≥3 were predictive of higher ALT (ORs: 2.23, 3.37, 3.21 with p: 0.029, 0.04, 0.007, respectively). Conclusions: We suggest that children with severe obesity and insulin resistance are routinely screened for FT4 and ALT as surrogate markers of obesity related thyroid and liver dysfunction.","PeriodicalId":8302,"journal":{"name":"Archives of pediatrics","volume":"286 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139234319","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 : 2023-09-08DOI: 10.29011/2575-825x.100285
NI Ezeh, HC Okpara, SO Ochigbo, EC Ezeh, MU Anah
Clinical Insignificance of Procalcitonin as an Acute Phase
降钙素原作为急性期的临床意义不大
{"title":"The Clinical Insignificance of Procalcitonin as an Acute Phase Reactant in Neonatal Sepsis in Nigeria","authors":"NI Ezeh, HC Okpara, SO Ochigbo, EC Ezeh, MU Anah","doi":"10.29011/2575-825x.100285","DOIUrl":"https://doi.org/10.29011/2575-825x.100285","url":null,"abstract":"Clinical Insignificance of Procalcitonin as an Acute Phase","PeriodicalId":8302,"journal":{"name":"Archives of pediatrics","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85795112","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 : 2023-09-01DOI: 10.29011/2575-825x.100284
MC François-Heude, E. Cheuret
Wilson’s disease is an autosomal recessive genetic disease with a copper metabolism disorder leading to hepatic, kidney, hematologic and neurologic symptoms. Stroke episodes in this pathology have not been described in the literature. We report a 13-year-old girl with Wilson’s disease discovered on neurological presentation, quickly treated with trihexyphenidyl and trientine. She was heterozygous in the ATP7B gene with two pathogenic variants (c.2128 G>A and c.3188C>T). Three months later, an acute neurological episode with a left capsulolenticular ischemic stroke episode occurred. Brain magnetic resonance imaging revealed a new fluid-attenuated inversion recovery hypersignal in the left internal capsule and striatum. Her neurological deficit regressed completely at six months. Few studies have reported Wilson’s disease patients with stroke-like episodes. No usual cause was found during neurologic explorations. Heart tests and coagulation were normal. Trientine and trihexyphenidyl are not known to generate stroke episodes. We here describe one of the first cases of stroke in Wilson’s disease.
{"title":"Stroke Episode in a Young Patient with Wilson’s Disease","authors":"MC François-Heude, E. Cheuret","doi":"10.29011/2575-825x.100284","DOIUrl":"https://doi.org/10.29011/2575-825x.100284","url":null,"abstract":"Wilson’s disease is an autosomal recessive genetic disease with a copper metabolism disorder leading to hepatic, kidney, hematologic and neurologic symptoms. Stroke episodes in this pathology have not been described in the literature. We report a 13-year-old girl with Wilson’s disease discovered on neurological presentation, quickly treated with trihexyphenidyl and trientine. She was heterozygous in the ATP7B gene with two pathogenic variants (c.2128 G>A and c.3188C>T). Three months later, an acute neurological episode with a left capsulolenticular ischemic stroke episode occurred. Brain magnetic resonance imaging revealed a new fluid-attenuated inversion recovery hypersignal in the left internal capsule and striatum. Her neurological deficit regressed completely at six months. Few studies have reported Wilson’s disease patients with stroke-like episodes. No usual cause was found during neurologic explorations. Heart tests and coagulation were normal. Trientine and trihexyphenidyl are not known to generate stroke episodes. We here describe one of the first cases of stroke in Wilson’s disease.","PeriodicalId":8302,"journal":{"name":"Archives of pediatrics","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79041706","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 : 2023-08-28DOI: 10.29011/2575-825x.100283
Vera M Dantas, Vanessa SL Dantas, Claudia RS Maia, Barbara Mfc Faria, Raissa AS Brandão, PhD Vera Maria Dantas
Objectives: To analyze the clinical, demographic, and epidemiological spectrum and their association with clinical severity and predictors of outcome, in children hospitalized with COVID-19, in a public reference hospital for COVID-19 in a State in Northeastern Brazil, between April 2020 and April 2021. Method: A retrospective cross-sectional study was conducted by analyzing the electronic medical records of children and adolescents. In the statistical analysis, we adopted a significance level of 5% and employed the chi-square test and Fisher’s exact test. Results: Of the 165 patients seen in the emergency room with clinically suspected COVID-19, 117 were admitted and confirmed by rapid serologic test or RT-PCR for SARS-CoV-2. The median age was 3 years 5 months. The weight-for-age in children under 10 years of age was adequate in 64.1% of them. The predominant symptoms were cough, fever, and dyspnea. There was pneumonia diagnosis in 53.8% of patients, and interstitial pulmonary infiltrate was the most frequent alteration (50.4%). There was an association between ethnicity (black or brown) and greater severity of the disease. Asthma was the most prevalent comorbidity, followed by diabetes mellitus, both were statistically associated with disease severity. The favorable outcome of hospital discharge within 14 days was associated with adequate weight. Conclusions: Black and brown ethnicity and the comorbidities of asthma and diabetes mellitus were determinants of severity while age-appropriate weight was a predictor of favorable outcome in COVID-19.
{"title":"Clinical Severity and Predictors of Outcome among Children and Adolescents Hospitalized with Covid-19","authors":"Vera M Dantas, Vanessa SL Dantas, Claudia RS Maia, Barbara Mfc Faria, Raissa AS Brandão, PhD Vera Maria Dantas","doi":"10.29011/2575-825x.100283","DOIUrl":"https://doi.org/10.29011/2575-825x.100283","url":null,"abstract":"Objectives: To analyze the clinical, demographic, and epidemiological spectrum and their association with clinical severity and predictors of outcome, in children hospitalized with COVID-19, in a public reference hospital for COVID-19 in a State in Northeastern Brazil, between April 2020 and April 2021. Method: A retrospective cross-sectional study was conducted by analyzing the electronic medical records of children and adolescents. In the statistical analysis, we adopted a significance level of 5% and employed the chi-square test and Fisher’s exact test. Results: Of the 165 patients seen in the emergency room with clinically suspected COVID-19, 117 were admitted and confirmed by rapid serologic test or RT-PCR for SARS-CoV-2. The median age was 3 years 5 months. The weight-for-age in children under 10 years of age was adequate in 64.1% of them. The predominant symptoms were cough, fever, and dyspnea. There was pneumonia diagnosis in 53.8% of patients, and interstitial pulmonary infiltrate was the most frequent alteration (50.4%). There was an association between ethnicity (black or brown) and greater severity of the disease. Asthma was the most prevalent comorbidity, followed by diabetes mellitus, both were statistically associated with disease severity. The favorable outcome of hospital discharge within 14 days was associated with adequate weight. Conclusions: Black and brown ethnicity and the comorbidities of asthma and diabetes mellitus were determinants of severity while age-appropriate weight was a predictor of favorable outcome in COVID-19.","PeriodicalId":8302,"journal":{"name":"Archives of pediatrics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88078235","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 : 2023-08-07DOI: 10.29011/2575-825x.100280
{"title":"Immune Thrombocytopenia in Children with Neurofibromatosis Type 1","authors":"","doi":"10.29011/2575-825x.100280","DOIUrl":"https://doi.org/10.29011/2575-825x.100280","url":null,"abstract":"","PeriodicalId":8302,"journal":{"name":"Archives of pediatrics","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90749023","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 : 2023-07-18DOI: 10.29011/2575-825x.100278
L. Cissé, LO FatyBalla, Pape Alassane, Mbaye, N. Ndoye, D. Guéye, S. Camara, I. Wellé, Ndéye Fatou Séck, SY Fatou, Youssouph Diedhiou, A. Sagna, O. Ndour, G. Ngom
Objective: The aim of our study is to investigate the bacterial ecology of community-acquired infections in the pediatric surgery department of Albert Royer Children’s Hospital, and evaluate the medical and surgical management practices. Methods: Between January 10, 2019
{"title":"Insights into Bacterial Ecology and Management of Community-Acquired Infections in Pediatric Surgery: A Prospective Study in a Developing Country","authors":"L. Cissé, LO FatyBalla, Pape Alassane, Mbaye, N. Ndoye, D. Guéye, S. Camara, I. Wellé, Ndéye Fatou Séck, SY Fatou, Youssouph Diedhiou, A. Sagna, O. Ndour, G. Ngom","doi":"10.29011/2575-825x.100278","DOIUrl":"https://doi.org/10.29011/2575-825x.100278","url":null,"abstract":"Objective: The aim of our study is to investigate the bacterial ecology of community-acquired infections in the pediatric surgery department of Albert Royer Children’s Hospital, and evaluate the medical and surgical management practices. Methods: Between January 10, 2019","PeriodicalId":8302,"journal":{"name":"Archives of pediatrics","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87543627","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 : 2023-07-13DOI: 10.29011/2575-825x.100277
A. Almawazini, Ali Alsayed Alsharkaway, Ahmed Obaidalla, Alghamdi, Abdulla Abdulaziz Alghamdi, Abdulaziz Saad Alzahrani, F. S. Alsefry, Mohammed I. Alghamdi, Njood Abdulaziz, Reem Abdulrahman Alzahrani, Aghnar T Alzahrani, Nouf Alghamdi, Lara Moaffak Alsakka
Background: Respiratory diseases are common and remain significant causes of emergency in children, especially those less than 5 years old. Objectives: To determine the prevalence, clinical profile, outcome, and common causes of respiratory distress among pediatric patients presenting to the emergency department in King Fahad Hospital, Al-Baha, Saudi Arabia Methods: This was a hospital-based retrospective cohort study carried out at King Fahad Hospital, Al Baha, Saudi Arabia. Children older than 1 month and younger than 14 years who presented to the emergency department with respiratory distress were included in the study. Results:
{"title":"The Spectrum of Pediatric Respiratory Emergencies in King Fahad Hospital Albaha Saudi Arabia","authors":"A. Almawazini, Ali Alsayed Alsharkaway, Ahmed Obaidalla, Alghamdi, Abdulla Abdulaziz Alghamdi, Abdulaziz Saad Alzahrani, F. S. Alsefry, Mohammed I. Alghamdi, Njood Abdulaziz, Reem Abdulrahman Alzahrani, Aghnar T Alzahrani, Nouf Alghamdi, Lara Moaffak Alsakka","doi":"10.29011/2575-825x.100277","DOIUrl":"https://doi.org/10.29011/2575-825x.100277","url":null,"abstract":"Background: Respiratory diseases are common and remain significant causes of emergency in children, especially those less than 5 years old. Objectives: To determine the prevalence, clinical profile, outcome, and common causes of respiratory distress among pediatric patients presenting to the emergency department in King Fahad Hospital, Al-Baha, Saudi Arabia Methods: This was a hospital-based retrospective cohort study carried out at King Fahad Hospital, Al Baha, Saudi Arabia. Children older than 1 month and younger than 14 years who presented to the emergency department with respiratory distress were included in the study. Results:","PeriodicalId":8302,"journal":{"name":"Archives of pediatrics","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85341082","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 : 2023-07-11DOI: 10.29011/2575-825x.100281
Sara Mazzi, Marie-Lou Nussbaum, Christa E Flück
Youth with gender dysphoria are increasing in numbers worldwide. We investigated the cohort of gender dysphoric youth for this trend referred to a Swiss University Children’s Hospital and assessed clinical characteristics and outcome of hormonal treatments at the Division of Pediatric Endocrinology. The retrospective study included 57 pediatric individuals referred between 2012 and 2021. Characteristics of 28 hormonally treated subjects with a diagnosis of transsexualism (ICD-10) were assessed. The number of subjects with gender dysphoria and with a diagnosis of transsexualism increased over the years, but the increase was less pronounced in the latter. A similar trend was found in a nationwide survey for the nine largest pediatric endocrine units in Switzerland. Of the 28 hormonally treated subjects in our center, 78% were trans males and 61% had psychiatric comorbidities. Height and BMI of individuals with transsexualism were normal and did not change under hormonal therapies in the first years. Thus, our study confirms the world-wide trend of increasing numbers of adolescents with gender dysphoria and transsexualism in Switzerland, and the predominance of trans males over trans females. In our cohort, however, numbers of subjects receiving hormonal treatments did not rise proportionally, possibly due to strict diagnosis and psychological assessments before referral. Similar to other studies, we also found an alerting high prevalence of psychiatric comorbidities that needed additional treatment. Therefore, hormonal treatments should only be offered to trans gender youth after careful evaluation by specialized mental health care professionals as recommended in current guidelines.
{"title":"Pediatric Transgender Care: Experience of a Swiss Tertiary Center Over the Past Decade","authors":"Sara Mazzi, Marie-Lou Nussbaum, Christa E Flück","doi":"10.29011/2575-825x.100281","DOIUrl":"https://doi.org/10.29011/2575-825x.100281","url":null,"abstract":"Youth with gender dysphoria are increasing in numbers worldwide. We investigated the cohort of gender dysphoric youth for this trend referred to a Swiss University Children’s Hospital and assessed clinical characteristics and outcome of hormonal treatments at the Division of Pediatric Endocrinology. The retrospective study included 57 pediatric individuals referred between 2012 and 2021. Characteristics of 28 hormonally treated subjects with a diagnosis of transsexualism (ICD-10) were assessed. The number of subjects with gender dysphoria and with a diagnosis of transsexualism increased over the years, but the increase was less pronounced in the latter. A similar trend was found in a nationwide survey for the nine largest pediatric endocrine units in Switzerland. Of the 28 hormonally treated subjects in our center, 78% were trans males and 61% had psychiatric comorbidities. Height and BMI of individuals with transsexualism were normal and did not change under hormonal therapies in the first years. Thus, our study confirms the world-wide trend of increasing numbers of adolescents with gender dysphoria and transsexualism in Switzerland, and the predominance of trans males over trans females. In our cohort, however, numbers of subjects receiving hormonal treatments did not rise proportionally, possibly due to strict diagnosis and psychological assessments before referral. Similar to other studies, we also found an alerting high prevalence of psychiatric comorbidities that needed additional treatment. Therefore, hormonal treatments should only be offered to trans gender youth after careful evaluation by specialized mental health care professionals as recommended in current guidelines.","PeriodicalId":8302,"journal":{"name":"Archives of pediatrics","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139360310","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 : 2023-07-08DOI: 10.29011/2575-825x.100276
J. Lawson
Nursing intuition is rapidly growing as an acceptable form of clinical nursing knowledge. This manuscript follows the journey of a nurse’s intuition in caring for a neonate in the Emergency Department after a brief, resolved, unexplained, event. The nurse’s intuition and persistence helped advocate for the patient and the appropriate definitive care. Ultimately the nurse’s intuition was correct, thus validating the important role intuition plays in clinical knowledge. Have you ever had a nurse tell you they don’t know what is wrong, but they just have this feeling that something bad is about to happen? Or better yet, call the doctor because something just isn’t right, but has no findings or data to back it up? Nursing intuition over the past decade has gained increasing acceptance and has become a legitimate form of clinical nursing knowledge [1]. But what is nursing intuition? Many people have heard the phrase used across the field of nursing, but unless you have experienced it, it can be hard to define or understand. A systematic review of eight quantitative studies and over 300 abstracts offered these common themes, “Sensing an unconscious and conscious thought process” and “A sudden emotional awareness and reflection, and arousal of conscious thought process.” Additionally, they identified a sub theme of the willingness to act, based on one’s personal, social and clinical experiences [1].
{"title":"Nursing Intuition: Finding Your Inner Spidy-sense","authors":"J. Lawson","doi":"10.29011/2575-825x.100276","DOIUrl":"https://doi.org/10.29011/2575-825x.100276","url":null,"abstract":"Nursing intuition is rapidly growing as an acceptable form of clinical nursing knowledge. This manuscript follows the journey of a nurse’s intuition in caring for a neonate in the Emergency Department after a brief, resolved, unexplained, event. The nurse’s intuition and persistence helped advocate for the patient and the appropriate definitive care. Ultimately the nurse’s intuition was correct, thus validating the important role intuition plays in clinical knowledge. Have you ever had a nurse tell you they don’t know what is wrong, but they just have this feeling that something bad is about to happen? Or better yet, call the doctor because something just isn’t right, but has no findings or data to back it up? Nursing intuition over the past decade has gained increasing acceptance and has become a legitimate form of clinical nursing knowledge [1]. But what is nursing intuition? Many people have heard the phrase used across the field of nursing, but unless you have experienced it, it can be hard to define or understand. A systematic review of eight quantitative studies and over 300 abstracts offered these common themes, “Sensing an unconscious and conscious thought process” and “A sudden emotional awareness and reflection, and arousal of conscious thought process.” Additionally, they identified a sub theme of the willingness to act, based on one’s personal, social and clinical experiences [1].","PeriodicalId":8302,"journal":{"name":"Archives of pediatrics","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85165344","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 : 2023-07-03DOI: 10.29011/2575-825x.100275
Many children require placement of a subdural peritoneal shunt for congenital or acquired hydrocephalus, certain cystic malformations, or subdural hematomas. The device may be placed temporarily or permanently. As many complications have been reported, the indications for placement are limited. We report the case of a male child who required a subdural peritoneal shunt because of a subdural hematoma as a complication of abusive head trauma in early childhood. For technical reasons, the intracranial portion could not be extracted. The child’s development was marked by residual hemiparesis and balanced epilepsy. Eleven years later, the epilepsy had worsened, and a left frontal nodular formation in contact with the intracranial portion of the drain was identified, surrounded by perilesional edema. Surgical excision was performed. The histopathological examination revealed a chronic inflammatory infiltrate with superinfection by multisensitive Staphylococcus epidermidis. Antibiotic therapy was associated for 8 weeks. The control cerebral MRI at 8 weeks revealed a scarred cavity with a marked reduction in the left frontal perilesional edema, along with improvement in his epilepsy. Few similar cases have been reported in the literature. Maintaining exogenous material in the intracranial space carries a risk, even many years later, which suggests it should be systematically removed when no longer indicated or functional.
{"title":"Intracranial Granuloma and Unbalanced Epilepsy as Complications of a Subdural Peritoneal Shunt","authors":"","doi":"10.29011/2575-825x.100275","DOIUrl":"https://doi.org/10.29011/2575-825x.100275","url":null,"abstract":"Many children require placement of a subdural peritoneal shunt for congenital or acquired hydrocephalus, certain cystic malformations, or subdural hematomas. The device may be placed temporarily or permanently. As many complications have been reported, the indications for placement are limited. We report the case of a male child who required a subdural peritoneal shunt because of a subdural hematoma as a complication of abusive head trauma in early childhood. For technical reasons, the intracranial portion could not be extracted. The child’s development was marked by residual hemiparesis and balanced epilepsy. Eleven years later, the epilepsy had worsened, and a left frontal nodular formation in contact with the intracranial portion of the drain was identified, surrounded by perilesional edema. Surgical excision was performed. The histopathological examination revealed a chronic inflammatory infiltrate with superinfection by multisensitive Staphylococcus epidermidis. Antibiotic therapy was associated for 8 weeks. The control cerebral MRI at 8 weeks revealed a scarred cavity with a marked reduction in the left frontal perilesional edema, along with improvement in his epilepsy. Few similar cases have been reported in the literature. Maintaining exogenous material in the intracranial space carries a risk, even many years later, which suggests it should be systematically removed when no longer indicated or functional.","PeriodicalId":8302,"journal":{"name":"Archives of pediatrics","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90285582","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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