Pub Date : 2023-12-05DOI: 10.12974/2311-8687.2023.11.15
Zi-Qiang Zheng, Chao-Wen Yang, Hong-Xia Liu
Objective: To explore the role of clinical pharmacists in the treatment of clinical diseases by adjusting the treatment of Candida albicans infection in the central nervous system of a premature infant. Methods: Clinical pharmacists participated in the treatment of one premature infant with Candida albicans infection of the central nervous system, and provided drug selection suggestions based on drug safety and pharmacokinetics. Results: The doctor partially adopted the suggestions of clinical pharmacists, revised the medication plan, and the child received reasonable treatment. Conclusion: Clinical pharmacists can make full use of pharmaceutical knowledge to serve the clinic and improve the level of rational drug use.
{"title":"Pharmaceutical Care for Premature Infants with Candida Albicans Infection of the Central Nervous System","authors":"Zi-Qiang Zheng, Chao-Wen Yang, Hong-Xia Liu","doi":"10.12974/2311-8687.2023.11.15","DOIUrl":"https://doi.org/10.12974/2311-8687.2023.11.15","url":null,"abstract":"Objective: To explore the role of clinical pharmacists in the treatment of clinical diseases by adjusting the treatment of Candida albicans infection in the central nervous system of a premature infant. \u0000Methods: Clinical pharmacists participated in the treatment of one premature infant with Candida albicans infection of the central nervous system, and provided drug selection suggestions based on drug safety and pharmacokinetics. \u0000Results: The doctor partially adopted the suggestions of clinical pharmacists, revised the medication plan, and the child received reasonable treatment. \u0000Conclusion: Clinical pharmacists can make full use of pharmaceutical knowledge to serve the clinic and improve the level of rational drug use.","PeriodicalId":91713,"journal":{"name":"International journal of pediatrics and child health","volume":"80 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138597963","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 : 2023-12-02DOI: 10.12974/2311-8687.2023.11.14
A. Mastronuzzi, G. Baldo, A. Carai
Pediatric central nervous system tumors are the primary solid malignancies in children and remain a leading cause of mortality in infancy. Advances in pediatric neuro-oncology, driven by molecular oncology research, emphasize the critical need for high-quality pathological tissue to support advanced molecular investigations. However, the vast heterogeneity of these tumors requires precise discrimination of collection sites, aligning with preoperative imaging data. Surgical resection, a pivotal step in diagnosis and treatment, could result in potential morbidities influencing children's neurological status. This, in turn, affects the feasibility of subsequent oncological treatments, influencing overall prognosis and quality of life. To address these challenges, technological tools enhance neurosurgeon orientation in pre-surgical planning and resection. While stereotactic navigation systems reduce morbidity, limitations persist in providing only two-dimensional anatomical information. Recent developments in 3D surgical simulation and virtual reality revolutionize procedural planning, offering real-time integration with intraoperative navigation systems. Beyond surgery, virtual reality has potential in case discussions, preoperative planning, and operative guidance, aiming to improve care and patient outcomes. The virtual reality experience, coupled with detailed anatomical visualization, facilitates meticulous surgical strategy planning for minimal invasiveness. Despite expanding literature on virtual reality applications in neurosurgery, pediatric neurosurgical oncology experiences remain limited. Scientific evaluation of simulation systems' impact on techniques and outcomes, combined with advances in neuroimaging, offers promise for adapting surgical approaches based on neoplastic brain lesion behavior. In conclusion, incorporating 3D surgical simulation and virtual reality technologies in pediatric neurosurgical oncology holds substantial benefits, offering improved procedural planning, enhanced precision, and patient-specific adaptation. Despite limited reported experiences, the compelling advantages underscore the need for further exploration and consideration in the evolving landscape of pediatric neuro-oncology.
{"title":"Virtual Reality and 3D Simulation in the Treatment of Pediatric Patients with Central Nervous System Tumors","authors":"A. Mastronuzzi, G. Baldo, A. Carai","doi":"10.12974/2311-8687.2023.11.14","DOIUrl":"https://doi.org/10.12974/2311-8687.2023.11.14","url":null,"abstract":"Pediatric central nervous system tumors are the primary solid malignancies in children and remain a leading cause of mortality in infancy. Advances in pediatric neuro-oncology, driven by molecular oncology research, emphasize the critical need for high-quality pathological tissue to support advanced molecular investigations. However, the vast heterogeneity of these tumors requires precise discrimination of collection sites, aligning with preoperative imaging data. Surgical resection, a pivotal step in diagnosis and treatment, could result in potential morbidities influencing children's neurological status. This, in turn, affects the feasibility of subsequent oncological treatments, influencing overall prognosis and quality of life. To address these challenges, technological tools enhance neurosurgeon orientation in pre-surgical planning and resection. While stereotactic navigation systems reduce morbidity, limitations persist in providing only two-dimensional anatomical information. Recent developments in 3D surgical simulation and virtual reality revolutionize procedural planning, offering real-time integration with intraoperative navigation systems. Beyond surgery, virtual reality has potential in case discussions, preoperative planning, and operative guidance, aiming to improve care and patient outcomes. The virtual reality experience, coupled with detailed anatomical visualization, facilitates meticulous surgical strategy planning for minimal invasiveness. Despite expanding literature on virtual reality applications in neurosurgery, pediatric neurosurgical oncology experiences remain limited. Scientific evaluation of simulation systems' impact on techniques and outcomes, combined with advances in neuroimaging, offers promise for adapting surgical approaches based on neoplastic brain lesion behavior. \u0000In conclusion, incorporating 3D surgical simulation and virtual reality technologies in pediatric neurosurgical oncology holds substantial benefits, offering improved procedural planning, enhanced precision, and patient-specific adaptation. Despite limited reported experiences, the compelling advantages underscore the need for further exploration and consideration in the evolving landscape of pediatric neuro-oncology.","PeriodicalId":91713,"journal":{"name":"International journal of pediatrics and child health","volume":"31 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138606589","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 : 2023-11-16DOI: 10.12974/2311-8687.2023.11.13
Z. Petríková, P. K. Kenderessy, O. P. Petrík, T. A. Adamec
Anaesthetics and their influence on children’s brains have become one of the most discussed problems in paediatric anaesthesiology. The experimental studies on animal models have shown that the anaesthetics used in general anaesthesia should have an influence on neurodegenerative processes, neuroapoptosis and the unregulated death of the neuronal cells in the developing brain. Due to this reality, scientists are trying to discover how to minimize the adverse effects of anaesthesia and revise other alternatives of prevention anaesthesia-induced maladaptive behavioural disorders, especially in children. The paper will present the procedures of preoperative management at a children’s faculty hospital in Banská Bystrica, Slovakia, our working place, and reveal how to minimize the adverse effects of anesthesia presenting in maladaptive behavioural disorders.
{"title":"Pre-Operative Management and Its Influence on Maladaptive Behavioural Disorders in Children","authors":"Z. Petríková, P. K. Kenderessy, O. P. Petrík, T. A. Adamec","doi":"10.12974/2311-8687.2023.11.13","DOIUrl":"https://doi.org/10.12974/2311-8687.2023.11.13","url":null,"abstract":"Anaesthetics and their influence on children’s brains have become one of the most discussed problems in paediatric anaesthesiology. The experimental studies on animal models have shown that the anaesthetics used in general anaesthesia should have an influence on neurodegenerative processes, neuroapoptosis and the unregulated death of the neuronal cells in the developing brain. Due to this reality, scientists are trying to discover how to minimize the adverse effects of anaesthesia and revise other alternatives of prevention anaesthesia-induced maladaptive behavioural disorders, especially in children. The paper will present the procedures of preoperative management at a children’s faculty hospital in Banská Bystrica, Slovakia, our working place, and reveal how to minimize the adverse effects of anesthesia presenting in maladaptive behavioural disorders.","PeriodicalId":91713,"journal":{"name":"International journal of pediatrics and child health","volume":"163 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139266656","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 : 2023-08-22DOI: 10.12974/2311-8687.2023.11.12
Claudia Cammarata, Manuela G Ingrascì, R. Tomasello, Marta Mattana, S. Siragusa, M. Napolitano
We report on an otherwise healthy 11-year-old girl without any past or family history of bleeding, presenting with abnormal menstrual blood losses since menarche which started 4 months back. The patient was evaluated by a gynecologist with evidence of a normal physical examination and pelvic ultrasounds except for the diagnosis of anovulatory cycles. Blood tests including complete blood cells count and first line coagulation assays were normal. She did not respond to oral tranexamic acid treatment suggested by a pediatrician. The patient was later admitted in a reference hospital for investigations and a hematology consult was requested. A second line coagulation assay was normal but platelets aggregation tests were suggestive of Glanzmann’s thrombasthenia which was confirmed by flow cytometry. Treatment recommendations were made and with the additional estro-progestin treatment administration, a good control of excessive menstrual blood losses was achieved and haemoglobin levels remained stable.
{"title":"Glanzmann’s Thrombasthenia in a Young 11-Year-Old Girl Presenting with Menorrhagia: When to Suspect and How to Manage a Rare Disease","authors":"Claudia Cammarata, Manuela G Ingrascì, R. Tomasello, Marta Mattana, S. Siragusa, M. Napolitano","doi":"10.12974/2311-8687.2023.11.12","DOIUrl":"https://doi.org/10.12974/2311-8687.2023.11.12","url":null,"abstract":"We report on an otherwise healthy 11-year-old girl without any past or family history of bleeding, presenting with abnormal menstrual blood losses since menarche which started 4 months back. The patient was evaluated by a gynecologist with evidence of a normal physical examination and pelvic ultrasounds except for the diagnosis of anovulatory cycles. Blood tests including complete blood cells count and first line coagulation assays were normal. She did not respond to oral tranexamic acid treatment suggested by a pediatrician. The patient was later admitted in a reference hospital for investigations and a hematology consult was requested. A second line coagulation assay was normal but platelets aggregation tests were suggestive of Glanzmann’s thrombasthenia which was confirmed by flow cytometry. Treatment recommendations were made and with the additional estro-progestin treatment administration, a good control of excessive menstrual blood losses was achieved and haemoglobin levels remained stable.","PeriodicalId":91713,"journal":{"name":"International journal of pediatrics and child health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46310595","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 : 2023-08-09DOI: 10.12974/2311-8687.2023.11.11
Edward Kuwera, Shreya Hariharakumar
Purpose; To report a case of successfully treated convergence insufficiency type exotropia (CI-XT) in the context of bilateral internuclear ophthalmoplegia (BINO) using only convergence exercises. Observations; A 17-year-old male with a history of a resected posterior fossa pilocytic astrocytoma presented with constant diplopia since the craniotomy. Patient and his parents were adamant in pursuing surgical treatment for his new onset strabismus. With appropriate counseling and management with convergence exercises only, the CI-IXT was successfully treated without surgery over the course of two years. Conclusion and Importance; We present a non-invasive approach to the treatment of CI-IXT in the context of a BINO, also known as wall-eyed BINO (WEBINO). This approach should be considered before any surgical intervention, especially if prism is unable to successfully neutralize diplopia for any extended period of time.
{"title":"Convergence Exercises for Convergence Insufficiency Type Exotropia in Bilateral Internuclear Ophthalmoplegia","authors":"Edward Kuwera, Shreya Hariharakumar","doi":"10.12974/2311-8687.2023.11.11","DOIUrl":"https://doi.org/10.12974/2311-8687.2023.11.11","url":null,"abstract":"Purpose; To report a case of successfully treated convergence insufficiency type exotropia (CI-XT) in the context of bilateral internuclear ophthalmoplegia (BINO) using only convergence exercises. \u0000Observations; A 17-year-old male with a history of a resected posterior fossa pilocytic astrocytoma presented with constant diplopia since the craniotomy. Patient and his parents were adamant in pursuing surgical treatment for his new onset strabismus. With appropriate counseling and management with convergence exercises only, the CI-IXT was successfully treated without surgery over the course of two years. \u0000Conclusion and Importance; We present a non-invasive approach to the treatment of CI-IXT in the context of a BINO, also known as wall-eyed BINO (WEBINO). This approach should be considered before any surgical intervention, especially if prism is unable to successfully neutralize diplopia for any extended period of time.","PeriodicalId":91713,"journal":{"name":"International journal of pediatrics and child health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44900845","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 : 2023-07-14DOI: 10.12974/2311-8687.2023.11.10
Rosario Elizabeth Pacheco Agüero, Franco Exequiel Araya, D. Lomaglio
The growth and development of children are profoundly influenced by dietary habits, lifestyles, and environmental factors, which begin to shape early in ontogeny. In high-altitude populations, geographical stressors, such as permanent hypoxia, add further complexity and cannot be modified by human intervention. This study aimed to describe the nutritional status of preschoolers in a high-altitude area of northwestern Argentina. A cross-sectional and descriptive study was carried out in 59 children aged 4 and 5 years from the towns of El Peñón and Antofagasta de la Sierra (3320 masl), Antofagasta de la Sierra department, Catamarca, Argentina. Anthropometric measurements, including weight (W), height (H), waist circumference, mid-upper arm circumference, and tricipital (T) and subscapular (S) skinfolds. Various indices and indicators, such as body mass index (BMI), waist-to-height ratio (WHtR), subscapular tricipital index (STI), and upper arm fat (UFA) and muscle area (UMA), were calculated. Additionally, the ratios of W/H, H/A (H for age), and BMI/A (BMI for age) were determined. Abdominal obesity was assessed using WHtR, and fat distribution was analyzed using STI. Protein and caloric reserves were estimated based on UMA and UFA, respectively. The study revealed a low prevalence of low weight (3.7%) but a high prevalence of overweight (20.3%) and obesity (3.4%) among the evaluated preschool children. Notably, 30.0% of overweight children and 16.0% of normal weight children exhibited centralized fat distribution. Abdominal obesity was observed in 90.0% of overweight children and 42.2% of normal weight children. Stunting was also observed in 8.5% of the individuals. Additionally, a considerable prevalence of low caloric and protein reserves was identified. These findings confirm the coexistence of deficit and excess malnutrition states, indicating a double burden of malnutrition, among the preschoolers of Antofagasta de la Sierra. Moreover, the study highlights the accumulation and distribution of abdominal and centralized fat as significant concerns in this population.
儿童的生长发育深受饮食习惯、生活方式和环境因素的影响，这些因素在个体发育早期就开始形成。在高海拔人群中，地理压力因素，如永久性缺氧，进一步增加了复杂性，无法通过人为干预来改变。本研究旨在描述阿根廷西北部高海拔地区学龄前儿童的营养状况。对来自阿根廷卡塔马卡Antofagasta de la Sierra省El Peñón镇和Antofagasta de la Sierra镇(3320 masl)的59名4岁和5岁儿童进行了横断面和描述性研究。人体测量，包括体重(W)、身高(H)、腰围、上臂中围、肱三头肌(T)和肩胛下(S)皮肤褶皱。计算体重指数(BMI)、腰高比(WHtR)、肩胛下肱三头指数(STI)、上臂脂肪(UFA)和肌肉面积(UMA)等各项指标。测定W/H、H/A(年龄H)、BMI/A(年龄BMI)比值。采用WHtR评估腹部肥胖，采用STI分析脂肪分布。蛋白质和热量储备分别基于UMA和UFA进行估算。研究发现，受访学龄前儿童体重偏低(3.7%)的患病率较低，但超重(20.3%)和肥胖(3.4%)的患病率较高。值得注意的是，30.0%的超重儿童和16.0%的正常体重儿童呈现集中的脂肪分布。超重儿童腹部肥胖发生率为90.0%，正常体重儿童为42.2%。8.5%的个体发育迟缓。此外，低热量和蛋白质储备相当普遍。这些发现证实了营养不足和过度营养不良状态并存，表明在Antofagasta de la Sierra的学龄前儿童中存在营养不良的双重负担。此外，该研究强调腹部脂肪和集中脂肪的积累和分布是该人群的重要问题。
{"title":"Nutritional Assessment of Preschool Children Inhabiting at High Geographical Altitude in the Antofagasta de la Sierra Department, Catamarca, Argentina","authors":"Rosario Elizabeth Pacheco Agüero, Franco Exequiel Araya, D. Lomaglio","doi":"10.12974/2311-8687.2023.11.10","DOIUrl":"https://doi.org/10.12974/2311-8687.2023.11.10","url":null,"abstract":"The growth and development of children are profoundly influenced by dietary habits, lifestyles, and environmental factors, which begin to shape early in ontogeny. In high-altitude populations, geographical stressors, such as permanent hypoxia, add further complexity and cannot be modified by human intervention. This study aimed to describe the nutritional status of preschoolers in a high-altitude area of northwestern Argentina. \u0000A cross-sectional and descriptive study was carried out in 59 children aged 4 and 5 years from the towns of El Peñón and Antofagasta de la Sierra (3320 masl), Antofagasta de la Sierra department, Catamarca, Argentina. Anthropometric measurements, including weight (W), height (H), waist circumference, mid-upper arm circumference, and tricipital (T) and subscapular (S) skinfolds. Various indices and indicators, such as body mass index (BMI), waist-to-height ratio (WHtR), subscapular tricipital index (STI), and upper arm fat (UFA) and muscle area (UMA), were calculated. Additionally, the ratios of W/H, H/A (H for age), and BMI/A (BMI for age) were determined. Abdominal obesity was assessed using WHtR, and fat distribution was analyzed using STI. Protein and caloric reserves were estimated based on UMA and UFA, respectively. \u0000The study revealed a low prevalence of low weight (3.7%) but a high prevalence of overweight (20.3%) and obesity (3.4%) among the evaluated preschool children. Notably, 30.0% of overweight children and 16.0% of normal weight children exhibited centralized fat distribution. Abdominal obesity was observed in 90.0% of overweight children and 42.2% of normal weight children. Stunting was also observed in 8.5% of the individuals. Additionally, a considerable prevalence of low caloric and protein reserves was identified. \u0000These findings confirm the coexistence of deficit and excess malnutrition states, indicating a double burden of malnutrition, among the preschoolers of Antofagasta de la Sierra. Moreover, the study highlights the accumulation and distribution of abdominal and centralized fat as significant concerns in this population.","PeriodicalId":91713,"journal":{"name":"International journal of pediatrics and child health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47722801","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 : 2023-07-07DOI: 10.12974/2311-8687.2023.11.09
Raluca Mihai, Mihaela Mavrodin, Mihalcea Fabrian, A. Dumitrescu, S. Cambrea
Introduction: VZV is a human neurotropic alpha herpes virus, and humans are the only reservoir. Infection can involve any part of the nervous system. The incidence of neurological manifestations associated with VZV is 1-3 per 10,000 cases. The clinical manifestations of varicella-zoster virus (VZV) infections of the central nervous system (CNS) include aseptic meningitis, encephalitis, cerebral infarction associated with granulomatous vasculitis, myelitis, and multiple cranial neuropathies. The aim of this study, by reporting a series of 5 cases of chickenpox hospitalized in the Clinical Infectious Diseases Hospital from Constanta, is to demonstrate some of the neurological complications of varicella zoster virus infection in children, highlighting the importance in early recognition and prompt initiation of specific treatment. Case reports: Two cases of acute post-infectious cerebellitis in children aged 7 and 9 years were hospitalized in our clinic. The clinical picture presented by the 2 patients consisted of fever, headache, altered consciousness with coordination and gait disorders. Other two cases of acute transverse myelitis, a 12-year-old boy, with onset in a febrile state at 9 days post varicella, initially with left knee pain associated with hypo-hyperaesthesia-like tenderness disorders, subsequently decreased lower limb muscle strength and bladder sphincter disorders. In the case of the second patient, the onset was on day 12 of evolution, with gait and balance disorders, with acute urine retention. A fifth case, a 2-year-old child, hospitalized for altered consciousness with drowsiness, listlessness, photophobia and fever with suspicion of encephalitis. Neither of the children didn’t reciveoral acyclovir from de onset of the rash. Conclusion; Clinicians should be aware of the neurologic complications of VZV infection, because early recognition and initiation of acyclovir therapy is necessary for these disorders.
{"title":"Neurological Complications of Primary Varicella Zoster Virus Infection in Children- Case Reports","authors":"Raluca Mihai, Mihaela Mavrodin, Mihalcea Fabrian, A. Dumitrescu, S. Cambrea","doi":"10.12974/2311-8687.2023.11.09","DOIUrl":"https://doi.org/10.12974/2311-8687.2023.11.09","url":null,"abstract":"Introduction: VZV is a human neurotropic alpha herpes virus, and humans are the only reservoir. Infection can involve any part of the nervous system. The incidence of neurological manifestations associated with VZV is 1-3 per 10,000 cases. \u0000The clinical manifestations of varicella-zoster virus (VZV) infections of the central nervous system (CNS) include aseptic meningitis, encephalitis, cerebral infarction associated with granulomatous vasculitis, myelitis, and multiple cranial neuropathies. \u0000The aim of this study, by reporting a series of 5 cases of chickenpox hospitalized in the Clinical Infectious Diseases Hospital from Constanta, is to demonstrate some of the neurological complications of varicella zoster virus infection in children, highlighting the importance in early recognition and prompt initiation of specific treatment. \u0000Case reports: Two cases of acute post-infectious cerebellitis in children aged 7 and 9 years were hospitalized in our clinic. \u0000The clinical picture presented by the 2 patients consisted of fever, headache, altered consciousness with coordination and gait disorders. \u0000Other two cases of acute transverse myelitis, a 12-year-old boy, with onset in a febrile state at 9 days post varicella, initially with left knee pain associated with hypo-hyperaesthesia-like tenderness disorders, subsequently decreased lower limb muscle strength and bladder sphincter disorders. In the case of the second patient, the onset was on day 12 of evolution, with gait and balance disorders, with acute urine retention. \u0000A fifth case, a 2-year-old child, hospitalized for altered consciousness with drowsiness, listlessness, photophobia and fever with suspicion of encephalitis. \u0000Neither of the children didn’t reciveoral acyclovir from de onset of the rash. \u0000Conclusion; Clinicians should be aware of the neurologic complications of VZV infection, because early recognition and initiation of acyclovir therapy is necessary for these disorders.","PeriodicalId":91713,"journal":{"name":"International journal of pediatrics and child health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47982486","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 : 2023-06-22DOI: 10.12974/2311-8687.2023.11.07
A. Mauro, M. A., Maglione M, Savoia F, Calvi M, Amoroso A, Sangerardi M, Tubino B, Piccotti E, Fabi M, Salvadei S, Gadda D, Marchetti F, Midullà F, Buonsenso D, Stanco M, Magrassi S, S. F., Pignataro R, D. F, D. E, B. L., L. R, Tipo V, Rosa M, Gagliardi T, Picciano L, Gagliardi S, O. F., Bellani I, Canzaniga V, M. F., La Torre F, Cardinale F, Tibaldi J, Schiappapietra B, D. M., B. M., G. G, M. S, Nucci A, A. M., Plebani Am, Iacono A, Cairello F, G. C., Rossi N, Schiavone I, Gentile A
Objective: To assess the most frequent clinical features of Multisystem Inflammatory Syndrome in children (MIS-C) at presentation to the Emergency Department (ED) in a large multicenter cohort of patients, in order to define useful tools for a timely diagnosis. Methods: Clinical and laboratory characteristics were retrospectively reviewed for 210 MIS-C patients from 18 Italian pediatric EDs. We assessed correlations between clinical and laboratory parameters and compared features of patients of different age (≤5 years and >5 years). Results: Fever was the main presenting symptom (100%), followed by conjunctivitis (46%), abdominal pain (44%), vomiting (41%) and diarrhea (39%). Forty-nine percent of children presented to the ED in critical or nearly critical condition. A higher prevalence of mucocutaneous involvement was found in younger children (69% versus 47%, p<0.05), whereas gastrointestinal symptoms were more common in children >5 years (62% versus 85%, p<0.05). Higher values of inflammatory markers (C-Reactive Protein, Ferritin, and Fibrinogen), Troponin T and Brain Natriuretic Peptide were related to abnormal echocardiography (p<0.05). No significant differences were detected in laboratory parameters between the two age groups, apart from ferritin, fibrinogen and troponin T, which resulted significantly lower in children ≤5 years. Conclusions: Apart from fever, the most common MIS-C manifestations at presentation to the ED are conjunctivitis, abdominal pain, vomiting and diarrhea. Younger children more frequently present with mucocutaneous involvement, while gastrointestinal manifestations are more common in older patients. These findings should be considered when MIS-C is suspected in the ED, in order to achieve a timely recognition of the condition.
{"title":"Multisystem Inflammatory Syndrome in Children: Tools for a Timely Diagnosis in the Emergency Department from an Italian Multicenter Survey","authors":"A. Mauro, M. A., Maglione M, Savoia F, Calvi M, Amoroso A, Sangerardi M, Tubino B, Piccotti E, Fabi M, Salvadei S, Gadda D, Marchetti F, Midullà F, Buonsenso D, Stanco M, Magrassi S, S. F., Pignataro R, D. F, D. E, B. L., L. R, Tipo V, Rosa M, Gagliardi T, Picciano L, Gagliardi S, O. F., Bellani I, Canzaniga V, M. F., La Torre F, Cardinale F, Tibaldi J, Schiappapietra B, D. M., B. M., G. G, M. S, Nucci A, A. M., Plebani Am, Iacono A, Cairello F, G. C., Rossi N, Schiavone I, Gentile A","doi":"10.12974/2311-8687.2023.11.07","DOIUrl":"https://doi.org/10.12974/2311-8687.2023.11.07","url":null,"abstract":"Objective: To assess the most frequent clinical features of Multisystem Inflammatory Syndrome in children (MIS-C) at presentation to the Emergency Department (ED) in a large multicenter cohort of patients, in order to define useful tools for a timely diagnosis. Methods: Clinical and laboratory characteristics were retrospectively reviewed for 210 MIS-C patients from 18 Italian pediatric EDs. We assessed correlations between clinical and laboratory parameters and compared features of patients of different age (≤5 years and >5 years). Results: Fever was the main presenting symptom (100%), followed by conjunctivitis (46%), abdominal pain (44%), vomiting (41%) and diarrhea (39%). Forty-nine percent of children presented to the ED in critical or nearly critical condition. A higher prevalence of mucocutaneous involvement was found in younger children (69% versus 47%, p<0.05), whereas gastrointestinal symptoms were more common in children >5 years (62% versus 85%, p<0.05). Higher values of inflammatory markers (C-Reactive Protein, Ferritin, and Fibrinogen), Troponin T and Brain Natriuretic Peptide were related to abnormal echocardiography (p<0.05). No significant differences were detected in laboratory parameters between the two age groups, apart from ferritin, fibrinogen and troponin T, which resulted significantly lower in children ≤5 years. Conclusions: Apart from fever, the most common MIS-C manifestations at presentation to the ED are conjunctivitis, abdominal pain, vomiting and diarrhea. Younger children more frequently present with mucocutaneous involvement, while gastrointestinal manifestations are more common in older patients. These findings should be considered when MIS-C is suspected in the ED, in order to achieve a timely recognition of the condition.","PeriodicalId":91713,"journal":{"name":"International journal of pediatrics and child health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42890114","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 : 2023-06-22DOI: 10.12974/2311-8687.2023.11.08
F. D'Amico, A. L. Pomi, D. Busceti, G. Zirilli, G. Salzano, U. Cucinotta, C. Cassone, G. Vazzana, M. Valenzise
Hyponatremia and dehydration in children represent a medical emergency due to a variety of underlying illness. Other than an evidence of gastroenteritis with diarrhea and vomiting (which is the major cause of hypoosmolar hyponatremia in pediatric age), other causes should be considered, especially if there is evidence of hyperkalemia and high sodium fraction excretion (FENa), like iatrogenic causes (diuretic excess), transient or genetic abnormalities of the renal mineralocorticoid pathway, syndrome of inappropriate anti-diuretic hormone secretion (SIADH), acute renal failure, congenital adrenal hyperplasia (CAH). Here we present a case of transient pseudohypoaldosteronism in a 2 months old baby secondary to urinary tract infection, who presented with a history of poor sucking, fever and dehydration.
{"title":"Transient Pseudohypoaldosteronism: A Rare Cause of Severe Hyponatremia in a Baby","authors":"F. D'Amico, A. L. Pomi, D. Busceti, G. Zirilli, G. Salzano, U. Cucinotta, C. Cassone, G. Vazzana, M. Valenzise","doi":"10.12974/2311-8687.2023.11.08","DOIUrl":"https://doi.org/10.12974/2311-8687.2023.11.08","url":null,"abstract":"Hyponatremia and dehydration in children represent a medical emergency due to a variety of underlying illness. Other than an evidence of gastroenteritis with diarrhea and vomiting (which is the major cause of hypoosmolar hyponatremia in pediatric age), other causes should be considered, especially if there is evidence of hyperkalemia and high sodium fraction excretion (FENa), like iatrogenic causes (diuretic excess), transient or genetic abnormalities of the renal mineralocorticoid pathway, syndrome of inappropriate anti-diuretic hormone secretion (SIADH), acute renal failure, congenital adrenal hyperplasia (CAH). \u0000Here we present a case of transient pseudohypoaldosteronism in a 2 months old baby secondary to urinary tract infection, who presented with a history of poor sucking, fever and dehydration.","PeriodicalId":91713,"journal":{"name":"International journal of pediatrics and child health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41543869","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 : 2023-06-14DOI: 10.12974/2311-8687.2023.11.06
L. Ricotta, Carmen D'Amore, L. Ravà, M. Raponi, Marta Luisa Ciofi degli Atti
Healthcare workers hands are the most common vehicle for the transmission of healthcare-associated infections. Hand hygiene is considered the most effective measure for preventing microbial pathogen cross-transmission, and reducing healthcare-associated infections; thus, it’s key to maintain high healthcare workers compliance with this practice. We calculated trends of compliance to hand hygiene and healthcare-associated infections (HAIs) point prevalence in a tertiary care children hospital, in years 2016–2022. We observed a significantly increased hand hygiene compliance from 89.5% (95% CI: 89.1-89.9) in 2016 to 92.1% (95% CI: 91.7-92.4; p<0.001) in 2022. Hand hygiene compliance significantly increased for four out of five moments for hand hygiene, and for most of the professional categories observed. We observed a stable trend of HAIs point prevalence which was 1.8% (95% CI: 0.7-3.6) in 2016, and 2.0% (95% CI:1.0-3.7; p=0.6) in 2022. No significant trends were observed over time stratifying by type of HAIs. Our results document the increased adherence to hand hygiene in the context of pandemic emergency response, associated to maintenance of low prevalence of HAIs.
{"title":"Hand Hygiene Compliance and Healthcare Associated Infections Trends in a Tertiary Care Children Hospital, in Years 2016-2022","authors":"L. Ricotta, Carmen D'Amore, L. Ravà, M. Raponi, Marta Luisa Ciofi degli Atti","doi":"10.12974/2311-8687.2023.11.06","DOIUrl":"https://doi.org/10.12974/2311-8687.2023.11.06","url":null,"abstract":"Healthcare workers hands are the most common vehicle for the transmission of healthcare-associated infections. Hand hygiene is considered the most effective measure for preventing microbial pathogen cross-transmission, and reducing healthcare-associated infections; thus, it’s key to maintain high healthcare workers compliance with this practice. \u0000We calculated trends of compliance to hand hygiene and healthcare-associated infections (HAIs) point prevalence in a tertiary care children hospital, in years 2016–2022. We observed a significantly increased hand hygiene compliance from 89.5% (95% CI: 89.1-89.9) in 2016 to 92.1% (95% CI: 91.7-92.4; p<0.001) in 2022. Hand hygiene compliance significantly increased for four out of five moments for hand hygiene, and for most of the professional categories observed. We observed a stable trend of HAIs point prevalence which was 1.8% (95% CI: 0.7-3.6) in 2016, and 2.0% (95% CI:1.0-3.7; p=0.6) in 2022. No significant trends were observed over time stratifying by type of HAIs. \u0000Our results document the increased adherence to hand hygiene in the context of pandemic emergency response, associated to maintenance of low prevalence of HAIs.","PeriodicalId":91713,"journal":{"name":"International journal of pediatrics and child health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43882901","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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