Childhood heart disease is a real public health problem. In our contexts, care remains a major challenge. Doppler echocardiography remains the essential examination for diagnosis. The objective of our study was to des...Childhood heart disease is a real public health problem. In our contexts, care remains a major challenge. Doppler echocardiography remains the essential examination for diagnosis. The objective of our study was to describe the different clinical indications for cardiac ultrasound in children and the main pediatric heart diseases at the Diourbel Heinrich Lübke Regional Hospital. This was a descriptive and analytical retrospective study spanning from 2020 to 2022;covering a series of 140 cases. The study was carried out using patient clinical observation sheets and consultation sheets. We identified 140 ultrasounds. The average age of patients was 35.96 months with extremes of 0.03 months and 192 months. The female sex was predominant, with an M/F sex ratio of 0.72. Ultrasound was systematically requested in 67.14% of the study population. The indications found were mainly: heart murmur, polymalformative syndrome, respiratory failure, bronchiolitis, cardiomegaly, suspicion of heart disease, cardiomegaly, pre-therapeutic and pre-operative assessment. A total of 71 cardiac abnormalities were found in 65 patients, i.e. a prevalence of 46.42%. Congenital heart disease was more frequent (found in 49 patients, a prevalence of 35%) and was dominated by the CIA. There was a female predominance in almost all heart diseases except in the case of endocarditis where codominance is found. Our study has made it possible, through echocardiography, to evaluate the indications for echocardiography in children, to determine the prevalence of heart disease in children and also to assess the relevance of requests for echocardiography.展开更多
Urinary stone disease is a highly prevalent condition affecting approximately 10% of the population,and has increased in incidence significantly over the past 20 years.Along with this,the rate of stone disease among w...Urinary stone disease is a highly prevalent condition affecting approximately 10% of the population,and has increased in incidence significantly over the past 20 years.Along with this,the rate of stone disease among women and children is also on the rise.The management of stone disease in specific populations,such as in children and during pregnancy can present unique challenges to the urologist.In both populations,a multi-disciplinary approach is strongly recommended given the complexities of the patients.Prompt and accurate diagnosis requires a high degree of suspicion and judicious use of diagnostic imaging given the higher risks of radiation exposure.In general,management proceeds from conservative to more invasive approaches and must be individualized to the patient with careful consideration of the potential adverse effects.However,innovations in endourologic equipment and techniques have allowed for the wider application of surgical stone treatment in these patients,and significant advancement in the field.This review covers the history and current advances in the diagnosis and management of stone disease in pregnant and pediatric populations.It is paramount for the urologist to understand the complexities of properly managing stones in these patients in order to maximize treatment efficacy,while minimizing complications and morbidity.展开更多
Omicron,a severe acute respiratory syndrome coronavirus-2 variant,has spread around the globe,causing dramatic increases in infection rates.Viral mutant antigens were responsible for the strong infectivity,fast replic...Omicron,a severe acute respiratory syndrome coronavirus-2 variant,has spread around the globe,causing dramatic increases in infection rates.Viral mutant antigens were responsible for the strong infectivity,fast replication,and high reinfection rates reported from all ages.Omicron causes clinical symptoms mostly related to the upper respiratory tract with minimal symptoms from the lower respiratory tract besides an urgent presentation of cases that resembled a fatal illness,epiglottitis.Not to mention the long coronavirus disease 2019,which rises exponentially in the Omicrons era.Apparently,the disease has a less aggressive course than earlier variants with lower death rates;however,the infection is not trivial.Severe infection was raised among pediatrics,unvaccinated,and the elderly.Complete vaccine protection is urgently needed to protect the most vulnerable community members.Additionally,self-protective strategies such as wearing a mask and safe social distancing cannot be omitted.展开更多
Bowel preparation for colonoscopy in children is a challenging procedure. Wide variety of preparation protocols exist, varying with the hospital. Unlike in adults, there is a lack of uniform bowel preparation protocol...Bowel preparation for colonoscopy in children is a challenging procedure. Wide variety of preparation protocols exist, varying with the hospital. Unlike in adults, there is a lack of uniform bowel preparation protocol in children. Ideally, the bowel preparation agents are assessed by their safety, efficacy and tolerability. Unfortunately, none of the preparations currently available meets all of these criteria. However, since last decade, Polyethylene Glycol-3350 (PEG-3350) is gaining popularity for bowel preparation with reported safety, efficacy, and tolerability. The only major drawback of PEG-3350 without electrolyte was 4 days long preparation time thus raising the question if the duration of preparation time could be minimized and yet have same efficacy, safety, and tolerability of the medicine. Hence, one day PEG-3350 regimen was introduced eventually and is now being studied with increased dosage or combined with other laxatives. This is the first review which compiles the study so far conducted on one day PEG-3350 without electrolyte as colonoscopy bowel preparation in children and tries to summaries if this regimen can be commonly used in children for colonoscopy bowel preparation.展开更多
Hereditary Pancreatitis(HP)has emerged as a significant cause of acute,acute recurrent and chronic pancreatitis in the pediatric population.Given that it presents similarly to other causes of pancreatitis,a positive f...Hereditary Pancreatitis(HP)has emerged as a significant cause of acute,acute recurrent and chronic pancreatitis in the pediatric population.Given that it presents similarly to other causes of pancreatitis,a positive family history and/or isolation of a gene mutation are vital in its designation.Inheritance patterns remain complex,but mutations involving the PRSS1,SPINK1,CFTR and CTRC genes are commonly implicated.Since being first described in 1952,dozens of genetic alterations that modify the action of pancreatic enzymes have been identified.Among children,these variants have been isolated in more than 50%of patients with chronic pancreatitis.Recent research has noted that such mutations in PRSS1,SPINK1 and CFTR genes are also associated with a faster progression from acute pancreatitis to chronic pancreatitis.Patients with HP are at increased risk of developing diabetes mellitus,exocrine pancreatic insufficiency,and pancreatic adenocarcinoma.Management follows a multi-disciplinary approach with avoidance of triggers,surveillance of associated conditions,treatment of pancreatic insufficiency and use of endoscopic and surgical interventions for complications.With significant sequela,morbidity and a progressive nature,a thorough understanding of the etiology,pathophysiologic mechanisms,diagnostic evaluation,current management strategies and future research considerations for this evolving disease entity in pediatrics is warranted.展开更多
Background: Invasive fungal infections are common opportunistic diseases in patients with AIDS, other conditions related to immunodeficiency and healthy infants. Most publications on this subject are related to indust...Background: Invasive fungal infections are common opportunistic diseases in patients with AIDS, other conditions related to immunodeficiency and healthy infants. Most publications on this subject are related to industrialized countries, and in adult population, with limited data in Latin America (except for Brazil, Colombia, and Argentina), and especially in pediatric population. These patients present a variety of clinical manifestations representing a diagnostic and therapeutic challenge for the health system. Objective: The objective of the study is to describe the epidemiological and laboratory characteristics of children with invasive fungal infections in Guatemala. Methods: A review of the microbiology service database was carried out at Roosevelt Hospital in Guatemala. Positive cultures were taken from children under 15 years of age, in a period of seven years, from 2007 to 2014, with its corresponding medical history. Results: Finally, 23 isolates were documented but only 15 patients were included in the study with complete information;10 Histoplasma capsulatum cases, 4 Cryptococcus neoformans cases and 1 Coccidioidessp case. The average age was 7 years old for Histoplasma and 9 years old for Criptococo, with an age range from 6 months to 14 years. Around 60% of the patients were older than 5 years, of which, more than two-thirds were HIV positive children without antiretroviral therapy, who presented an invasive fungal infection at the time of HIV diagnosis. These infections are endemic in Guatemala, so the distribution was mostly uniform. Around 80% of the patients had some disease related to immunodeficiency and 70% were infected with human immunodeficiency virus (HIV). The microbiological isolation was from blood, bone marrow, lymph nodes, cerebrospinal fluid and urine. The predominant laboratory findings were decrease in hematological series. The most frequent clinical syndromes were fever, adenomegaly, hepatosplenomegaly, respiratory, gastrointestinal, neurological and weight loss. Mortality rate was 53% (from them, 62% were HIV positive). From these patients, an87% did not receive antifungal treatment in time due to late diagnosis of the infection. Conclusions: These infections should be considered when treating pediatric patients from tropical regions, with nonspecific systemic symptoms and signs, lymph node involvement and hematological alterations related to the mononuclear phagocytic system, mainly if they are patients infected by HIV in an advanced stage, infants, or children with a disease that weakens the immune system. When there is a high suspicion of a fungal infection, screening for HIV is mandatory;cultures should be taken early and together with rapid diagnostic tests. An antifungal treatment should be started immediately and then modified accordingly to laboratory results.展开更多
<strong>Ba</strong><span style="font-family:Verdana;"><strong>ckground:</strong></span><span><span><span style="font-family:""><span st...<strong>Ba</strong><span style="font-family:Verdana;"><strong>ckground:</strong></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> Angina is a common </span><span style="font-family:Verdana;">paediatric</span><span style="font-family:Verdana;"> condition. It has certain peculiarities in children, particularly </span><span style="font-family:Verdana;">with regard to</span><span style="font-family:Verdana;"> the frequency of bacterial germs and the use of diagnostic tests. </span><span style="font-family:Verdana;">The aim of this study was</span><span style="font-family:Verdana;"> to determine the place of the rapid diagnostic test in the management of group A beta-hemolytic streptococcal angina in children in the </span><span style="font-family:Verdana;">paediatric</span><span style="font-family:Verdana;"> ward at Donka National Hospital. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was a prospective descriptive study lasting 6 months from 1st February to 31st July 2019 concerning childr</span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">en aged between 3 and 15 years old who were diagnosed with angina. Epidemiological, clinical, para-clinical </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> therapeutic variables were studied. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of 1494 registered children, we collected 116 cases of angina (7.76%). Out of 52 patients who benefited from the rapid diagnostic test, we recorded 13 cases of angina due to group A beta-hemolytic </span><span style="font-family:Verdana;">strptococcus</span><span style="font-family:Verdana;">. The male sex was the most dominant with 31 cases (59.69%) and a G/F sex ratio of 1.47. The age group most affected was between 3 and 5 years old (50%). The average age of our patients was 4.8 years with extremes of 3 and 14 years. Clinical manifestations were dominated by fever and dysphagia (100%) followed by odynophagia (11.79%). We recorded 13 cases of streptococcal angina (25%). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The factors that influence it are multiple, dominated by community life, passive smoking </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> allergies. The use of RDTs in these young children would help in the diagnosis of acute group A </span><span style="font-family:Verdana;">beta hemolytic</span><span style="font-family:Verdana;"> streptococcal angina and rational antibiotic prescription.</span></span></span></span>展开更多
Assessment of entrance skin doses for patients in Digital radiography examinations should be made as a means for the optimization of the radiation protection of the patients. We measured the entrance skin dose (ESD) r...Assessment of entrance skin doses for patients in Digital radiography examinations should be made as a means for the optimization of the radiation protection of the patients. We measured the entrance skin dose (ESD) received by 50 pediatrics undergoing 12 types of diagnostic X-ray examination at Radiology Department of Asser Central Hospital-KSA. The entrance skin dose ESD was determined via measurements parameters: focus to skin distance (FSD), tube current (mAs) and tube voltage (kV) in arithmetical equation. The mean ± SD for ESDs were found to be 0.16 ± 0.03, 0.21 ± 0.01, 0.63 ± 0.26, 0.55 ± 0.09, 0.15 ± 0.05, 0.27 ± 0.06, 0.41 ± 0.19, 0.46 ± 0.18, 0.46 ± 0.12, 0.20 ± 0.02, 0.39 ± 0.01, 0.29 ± 0.03, for PA chest, foot, AP pelvis, PA skull, PA hand, AP arm, ankle, AP shoulder, abdomen, forearm, AP femur, AP elbow consequently. Our study is considered as an attempt to evaluate the ESDs received by digital radiographic x-ray machine for children aged between 2 - 15 years old, taking in our considerations number of other variables. The mean ESD values obtained are found to be within the standard reference. The data obtained may add to the available information in national records for general use. It may provide guidance on where efforts on dose reduction will need to be directed to fulfill the requirements of the optimization process and serve as a reference for future researches.展开更多
Introduction: Medication error (ME) is a common cause of childhood morbidity and mortality reported in developed countries. It has not yet been described in the pediatric services in Cote d’Ivoire. Objective: To eval...Introduction: Medication error (ME) is a common cause of childhood morbidity and mortality reported in developed countries. It has not yet been described in the pediatric services in Cote d’Ivoire. Objective: To evaluate ME in pediatrics for the improvement of professional practice. Materials and Methods: This was a cross-sectional, descriptive and analytical study conducted in the service of pediatrics at the University Teaching Hospital (CHU) of Bouaké from January 11 to February 25, 2016. It involved 204 children hospitalized and treated with drugs. The variables studied were the prescription, dispensing and administration of the drugs. Results: A total of 483 prescriptions notes were recorded for 733 therapeutic lines, i.e. 2.3 prescriptions notes and 3.6 lines per child. The overall prevalence of ME was 31% (prescription 83%, dispensing 0%, administration 11%). The prescription error concerned the illegible writing (20%), the omission of the stamp & signature (47%), the omission of the date (33%), weight (66%), age (25%) and name of the child (9%).The drug name and the dosage were incorrect in 99% and 1% respectively. Regarding the administration error, care was provided by a person without a nursing qualification in 65.5% of cases. On the patient’s care record, the care giver’s name was omitted in 100%, the child’s name in 57% and the date in 47%. The route of administration and the administered dose were each incorrect in 5%. The student nurses and assistant nurse caregivers committed more prescription errors than doctors and nurses and midwives (p= 0,000 X2 = 44.91). Administration error was not significantly related to the service, the socio-professional category, the gender and the age of the patient. Conclusion: EM is common in pediatrics at the University Teaching Hospital (CHU) of Bouaké. To prevent it, it is necessary to strengthen the staff’s capacity to prescribe and administer the drug in children.展开更多
Introduction: Acute appendicitis is the most common cause of abdominal pain requiring surgery in children. In most instances the infecting organisms are normal inhabitants of the lumen of appendix. Surgery allows easy...Introduction: Acute appendicitis is the most common cause of abdominal pain requiring surgery in children. In most instances the infecting organisms are normal inhabitants of the lumen of appendix. Surgery allows easy microbiological sampling. Aspiration of fluid or pus in a syringe is preferred. Swabs are less suitable and only to be used when sampling with a syringe is not feasible. Antimicrobial susceptibility testing of the isolated bacteria and particularly of the anaer- obes can be important to adjust therapy in case of the presence of multi resistant bacteria. Objective: The aim of the study was to determine the bacteriological profile of acute appendicitis in children. Materials and Methods: Study design is a prospective descriptive study including children hospitalized for acute appendicitis. Tissue samples (a speci- men of the appendix), peritoneal fluid swab from the appendicial fossa and the peritoneal exudates (if exists) obtained at surgery from 54 children with suspected acute appendicitis operated at the pediatric surgery unit at the Maternity and Child Teaching Hospital in Al-Qadisiya province from the period 1st of June 2007 to the end of May 2011, were exam- ined histologically and by culture for aerobic and anaerobic bacteria. Results: Out of these, 39 boys (72.2%) and 15 (27.7% girls). Their age ranged between (1.8 - 13) years, with a mean of 6.9 years. Of the all patients studied 34 pre- sented with suppurative and phlegmnous appendicitis, 8 with gangrenous appendicitis, 6 with septic complications of appendicitis and 6 had normal appendices. Only 80 of the 108 swabs taken yielded a positive culture (74.07%). Con- clusion: Although in our study no antibiotic regime was changed on the basis of a positive culture swab and the perito- neal culture swabs do not improve immediate postoperative therapy based on surgical impression and rapid histological reporting, however, the routine use of peritoneal culture swabs may be of value in identifying patients requiring outpa- tient follow-up.展开更多
The first issue of the World Journal of Clinical Pediatrics(WJCP),whose preparatory work was initiated on January 10,2011,will be published on June 8,2012.The WJCP editorial board has now been established and consists...The first issue of the World Journal of Clinical Pediatrics(WJCP),whose preparatory work was initiated on January 10,2011,will be published on June 8,2012.The WJCP editorial board has now been established and consists of 100 distinguished experts from 31 countries.Our purpose of launching the WJCP is to publish peer-reviewed,high-quality articles via an open-access online publishing model,thereby acting as a platform for communication between peers and the wider public,and maximizing the benefits to editorial board members,authors and readers.展开更多
I<span><span style="font-family:Verdana;">ntroduction: Acute thoracic syndrome is the appearance of a new pulmonary </span><span style="font-family:Verdana;">infiltrate</...I<span><span style="font-family:Verdana;">ntroduction: Acute thoracic syndrome is the appearance of a new pulmonary </span><span style="font-family:Verdana;">infiltrate</span><span style="font-family:Verdana;"> on radiology associated with fever, desaturation </span><span style="font-family:Verdana;">or</span><span style="font-family:Verdana;"> respiratory signs. It is the second leading cause of hospitalization and</span></span><span style="font-family:Verdana;"> the first cause of death in sickle cell patients. It is an acute pulmonary complication whose pathophysiological mechanisms are still poorly understood. This study aims to</span><span><span style="font-family:Verdana;"> study the epidemiological, clinical, therapeutic </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> evolutionary aspe</span></span><span style="font-family:Verdana;">c</span><span><span style="font-family:Verdana;">ts of Acute Chest Syndrome in children at the Pediatrics Department of Donka National Hospital. Method: This is a prospective study of descriptive type for a period of 6 months from February 19 to August 19, </span><span style="font-family:Verdana;">2019</span><span style="font-family:Verdana;"> on patients with sickle cell disease who developed an ATS in the pediatrics department of Donka National Hospital. Epidemiological, clinical, therapeutic </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> evolutionary data were studied and proportionate data were calculated. Results: The frequency of ATS was 39%. The mean age of our patients was 9.83 years with the extremes of</span></span><span style="font-family:Verdana;"> 4 and 16 years. The age group from 6 to 10 years with a frequ</span><span style="font-family:Verdana;">ency of 66.7% was the most affected. Fever was the main clinical manifestation, followed by hepatome</span><span><span style="font-family:Verdana;">galy. All our patients were homozygous SS and undergoing folic acid prophylaxis. 96% of our patients did not receive any specific vaccine. Antibiotic therapy, hyperhydration </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> analgesics were administered to all our patients. 96% of our patients were transfused with red blood cell concentrate. 96% of our patients were transfused with packed red blood cells. 96% of our patients were transfused with packed red blood cells and 96% of them had a favorable outcome. Conclusion: ATS is an acute co</span></span><span style="font-family:Verdana;">mplication of sickle cell disease responsible for significant mortality and morbidity in the pediatric population. Its treatment is symptomatic and must be started early. Emphasis must be placed on prevention to prevent or limit its occurrence.</span>展开更多
Objective: To investigate the effectiveness of ultrasound-guided central venous catheterization when compared to the conventional procedure. Method: A prospective cohort study was carried out over a 9-month period fro...Objective: To investigate the effectiveness of ultrasound-guided central venous catheterization when compared to the conventional procedure. Method: A prospective cohort study was carried out over a 9-month period from February to October 2016 involving 144 inpatients at PICU of Irmandade da Santa Casa de Sao Paulo Hospital, undergoing central venous catheterization. The patients were matched in pairs of identical patients according to the levels of potentially intervening variables (age, nutritional status, puncture site, professional experience), differing only as to the CVC technique: ultrasound-guided (USG-CVC) or conventional (C-CVC). Discarding data from non-paired patients, the remaining did forming 47 pairs, matched as two related samples: USG-CVC and C-CVC groups. Success parameters: number of puncture attempts;time spent at CVC;success rate and complications. Results: In the USG-CVC group, the number of attempts (mean = 2.04) and the time spent at catheterization (mean = 11.89 minutes) were lower (t = 2.34, df = 46, t 0.95 = 2.02, p t = 3.07, df = 46, t 0.95 = 2.02, p < 0.05), respectively, when compared to the results obtained for the control group (C-GVC), (mean = 3.21) and (mean = 28.26 minutes), respectively. As to success, there was observed a significant difference (F (1, 46) = 16.6;Q (1) = 12.5, p < 005) when considering only one trial (USG -CVC = 27/47;C-CVC = 9/47), but no significant difference (F (1, 46) = 3.76;Q (1) = 3.56, p > 0.05) when considering several attempts. Complications were found less frequently in the USG-CVC group (3/47) than in the CVC-C (13/47), (F (1, 46) = 8.24;Q (1) = 7.14, p < 0.05). Conclusion: USG-CVC was found to be more effective than the conventional technique, especially regarding success at the first puncture attempt.展开更多
Introduction: Violence in hospital is a major Public Health issue. In Cote d’Ivoire, acts of violence against health professionals exist and may sometimes take a dramatic turn. Objective: To research the causes of th...Introduction: Violence in hospital is a major Public Health issue. In Cote d’Ivoire, acts of violence against health professionals exist and may sometimes take a dramatic turn. Objective: To research the causes of this violence for the purpose to prevent them. Materials and Methods: This is a cross-sectional, descriptive study conducted in the Obstetrics & Gynecology and Pediatrics departments at the University Teaching Hospital of Bouaké from 26 January 2016 to 24 February 2016. It included 129 health workers who gave their consent. The data collection was done through individual interviews followed by a focus group according to the socio-professional category. Results: Out of 129 health professionals included, 100 were a victim of violence i.e. a frequency of 77.5%. Most of the violence occurred during “on-call hours” (55.8%) in the emergency units (34.8%). The violence was verbal (52.5%), physical (28.6%), moral and psychological (11.6%), theft (7.3%). The aggression was mainly related to patient’s care (32.1%), visiting hours (26%) and the low level of understanding of the person (16.5%). The victim’s immediate feelings were dominated by frustration (26.7%), discouragement (21.3%) and insecurity (18.3%). The victims received a medical assistance in 9% of cases. To prevent this violence, the staff mainly offered to raise awareness about violence (27.6%) and the respect for hospital staff (25%). Conclusion: Violence against health professionals is common and has negative impacts on staff and hospital activity. Its prevention requires a holistic approach centered on awareness. Keywords: Violence, Hospital, Pediatrics, Staff, Cote d’Ivoire.展开更多
Video capsule endoscopy(CE) for evaluation the esophagus(ECE), small bowel(SBCE) and the colon(CCE) is particularly useful in pediatrics, because this imaging modality does not require ionizing radiation, deep sedatio...Video capsule endoscopy(CE) for evaluation the esophagus(ECE), small bowel(SBCE) and the colon(CCE) is particularly useful in pediatrics, because this imaging modality does not require ionizing radiation, deep sedation or general anesthesia. The risk of capsule retention appears to be dependent on indication rather than age and parallels the adult experience by indication, making SBCE a relatively safe procedure with a significant diagnostic yield. The newest indication, assessment of mucosal change, greatly enhances and expands its potential benefit. The diagnostic role of CE extends beyond the SB. The use of ECE also may enhance our knowledge of esophageal disease and assist patient care. Colon CCE is a novel minimally invasive and painless endoscopic technique allowing exploration of the colon without need for sedation, rectal intubation and gas insufflation. The limited data on ECE and CCE in pediatrics does not yet allow the same conclusions regarding efficacy; however, both appear to provide safe methods to assess and monitor mucosal change in their respective areas with little discomfort. Moreover, although experience has been limited, the patency capsule may help lessen the potential of capsule retention; and newly researched protocols for bowel cleaning may further enhance CE's diagnostic yield. However, further research is needed to optimize the use of the various CE procedures in pediatric populations.展开更多
BACKGROUND Extraskeletal Ewing sarcoma(EES)is a member of the Ewing sarcoma family of tumors which is pathologically known as a small,round,blue cell tumor involving bone and soft tissue.The prevalence of EES is only ...BACKGROUND Extraskeletal Ewing sarcoma(EES)is a member of the Ewing sarcoma family of tumors which is pathologically known as a small,round,blue cell tumor involving bone and soft tissue.The prevalence of EES is only 15%-25%of all Ewing sarcoma and EES often occurs in patients aged from 20-mo-old to 30-yearsold resulting in an unfavorable prognosis.CASE SUMMARY The present case report described a 7-year-old patient with a palpable EES mass of 33 mm×27 mm×28 mm in the deep neck with symptoms of persistent dyspnea over the past 5 mo.After laboratory examinations,abnormal physiological and biochemical indicators were not found.Ultrasound images presented the mass to be complex,solid and fluid-filled with circumscribed margins and posterior acoustic enhancement.The mass also presented with partial internal vascularity.The contrast-enhanced magnetic resonance imaging scan illustrated the outstanding enhancement with fast perfusion mode in the early arterial phase. CONCLUSIONOur study suggested that a quick-growing mass in the pediatric patient is possibly a malignanttumor whether the mass has well-defined margins or not.展开更多
Background: Surgical treatment for neuromuscular (NM) hip subluxation or dislocation is undertaken to maintain functionality and decrease pain. Longterm complications are well described;however, the acute complication...Background: Surgical treatment for neuromuscular (NM) hip subluxation or dislocation is undertaken to maintain functionality and decrease pain. Longterm complications are well described;however, the acute complication profile is poorly understood. Questions/Purpose: The aim of this study was to identify the rate of and risk factors for complications following surgical treatment of hip subluxation/dislocation, especially as it relate to NM children. Methods: Hip reconstruction cases in patients with a NM diagnosis and non-NM patients were obtained from the 2015 American College of Surgeons NSQIP-Pediatric database by CPT code. 30-day postoperative complications were classified according to the Clavien-Dindo system as minor (grade 1 or 2) or major (grade 3+). Patient and surgical factors were assessed in univariate and multivariate logistic regression analyses for association with post-operative complications. Results: 1081 cases were identified (median age 7.7, 55% female), of whom 420 (39%) had a NM diagnosis. Overall complication rate was significantly higher in NM patients (33% vs. 19%, p < 0.001). Numerous factors were associated with postoperative complication on univariate analysis. Multivariate analysis identified NM diagnosis (OR 1.5), age > 6 years (OR 1.5), or pelvic osteotomy (OR 1.9) as independent risk factors for complication. Conclusion: In pediatric reconstructive hip surgery requiring pelvic osteotomy, a NM diagnosis is associated with an increased risk of 30-day postoperative complications. Older age and increasing surgical complexity were also independently associated with complications. These findings support special attention for the older patients undergoing concomitant pelvic osteotomies to minimize complication rate.展开更多
Management of hypertension (HTN) largely relies on proper and accurate measurement of blood pressure (BP). Even following the criteria for HTN diagnosis defined in the Fourth report on high BP in children and adolesce...Management of hypertension (HTN) largely relies on proper and accurate measurement of blood pressure (BP). Even following the criteria for HTN diagnosis defined in the Fourth report on high BP in children and adolescents, inaccurate diagnosis and misdiagnosis can occur with white coat effect and masked HTN. The use of Ambulatory Blood Pressure Monitoring (ABPM) has been increasing in pediatrics in the last 20 years. The main use of ABPM is to differentiate between sustained HTN and white coat HTN in patients who have elevated casual BP measurements and to detect masked HTN in high risk patients. ABPM is most useful in patients with casual BP within 20% of the 95th percentile for age, gender, and height. This report will highlight the use of ABPM in the evaluation of elevated BP and management of HTN in pediatrics. The discussion includes a review of various non-invasive BP measuring techniques, a description of ABPM and ABPM-unique data and diagnoses, updated ABPM clinical data more specific to pediatrics, its use in HTN clinical trials, and future outlook and direction of ABPM in pediatrics.展开更多
Aim: To detect the most common musculoskeletal disorders and to explore the common injury and indication of different musculoskeletal systems, and then to obtain the causes of disorders by observing clinical indicatio...Aim: To detect the most common musculoskeletal disorders and to explore the common injury and indication of different musculoskeletal systems, and then to obtain the causes of disorders by observing clinical indications via images. Methodology: The subjects in this project consisted of both genders—males and females and were investigated randomly by collecting data from the PACS unit that exists in the radiology department at KAUH. The participants had a mean age of 7.4 ± 0.3 years, a mean height of 118.2 ± 2.5 cm, a mean mass of 27.8 ± 1.5 kg, and a mean BMI of 19.6 ± 0.8 kg/m2. The author settled the study plan by building a special, appropriate questionnaire to be handed out to the patients and covered mainly the prospective studies of randomly selected patients who came to the emergency unit and the outpatient units from other departments at KAUH in Jeddah. Results: The ratio of injuries in male children (77%) against females (23%) is 3:1, and this ratio is considered significant between age groups for males when compared with females. The injuries existed most in the age groups of 4 to 6 years old and 8 to 10 years old with approximately the same percentage of the total subjects as about 21% for each age group. Trauma injury was significant (81%) compared to other types of causes in all age groups. There was a significant relationship between the causes of injuries and the age groups in pediatrics (p 0.05) between the site of injuries and age groups. The significant site that resulted from trauma was the knee (100%), out of the total traumas’ subject. There was a highly significant relationship between the site of injuries and its causes (p = 0.006, i.e. p < 0.05) that were expected. Conclusion: More awareness and understanding in the society are needed and we should concentrate on increasing the knowledge of such by providing them with more learning courses.展开更多
Background: In Congo, there is no pediatric gastroenterology department and the activity of colonoscopy has never been evaluated. The aim of this study is to report the indications and the results of pediatric colonos...Background: In Congo, there is no pediatric gastroenterology department and the activity of colonoscopy has never been evaluated. The aim of this study is to report the indications and the results of pediatric colonoscopy in Brazzaville. Methods: A retrospective study was conducted from January 2016 to August 2017 by analyzing reports of colonoscopy performed in the gastroenterology department in Brazzaville. Sex, prescribers, indications and results of colonoscopy were the variables study. Results: over the 19-month period, 489 colonoscopies have been performed, in which 13 (2.7%) colonoscopies were performed in children under 17 years, with an average age of 9.8 ± 4.6 (8 males and 6 females) and the extreme ranging from 1 - 17 years. The sex ratio (H/F) was 1.6. The prescribers were gastroenterologist (n = 4), pediatrician (n = 4), surgeons (n = 2), general practitioners (n = 2), pediatric students (n = 1). Chronic bowel inflammatory diseases and polypectomy was the most frequent conditions for colonoscopy indication. Seven (7) colonoscopies were normal. 4 cases were recto-polyps, and 2 cases were ulcerative colitis. Conclusion: pediatric colonoscopy is a powerful diagnostic and therapeutic means. The pediatricians should think about it to improve the management of children with digestive symptoms that meet the indications of pediatric colonoscopy.展开更多
文摘Childhood heart disease is a real public health problem. In our contexts, care remains a major challenge. Doppler echocardiography remains the essential examination for diagnosis. The objective of our study was to describe the different clinical indications for cardiac ultrasound in children and the main pediatric heart diseases at the Diourbel Heinrich Lübke Regional Hospital. This was a descriptive and analytical retrospective study spanning from 2020 to 2022;covering a series of 140 cases. The study was carried out using patient clinical observation sheets and consultation sheets. We identified 140 ultrasounds. The average age of patients was 35.96 months with extremes of 0.03 months and 192 months. The female sex was predominant, with an M/F sex ratio of 0.72. Ultrasound was systematically requested in 67.14% of the study population. The indications found were mainly: heart murmur, polymalformative syndrome, respiratory failure, bronchiolitis, cardiomegaly, suspicion of heart disease, cardiomegaly, pre-therapeutic and pre-operative assessment. A total of 71 cardiac abnormalities were found in 65 patients, i.e. a prevalence of 46.42%. Congenital heart disease was more frequent (found in 49 patients, a prevalence of 35%) and was dominated by the CIA. There was a female predominance in almost all heart diseases except in the case of endocarditis where codominance is found. Our study has made it possible, through echocardiography, to evaluate the indications for echocardiography in children, to determine the prevalence of heart disease in children and also to assess the relevance of requests for echocardiography.
文摘Urinary stone disease is a highly prevalent condition affecting approximately 10% of the population,and has increased in incidence significantly over the past 20 years.Along with this,the rate of stone disease among women and children is also on the rise.The management of stone disease in specific populations,such as in children and during pregnancy can present unique challenges to the urologist.In both populations,a multi-disciplinary approach is strongly recommended given the complexities of the patients.Prompt and accurate diagnosis requires a high degree of suspicion and judicious use of diagnostic imaging given the higher risks of radiation exposure.In general,management proceeds from conservative to more invasive approaches and must be individualized to the patient with careful consideration of the potential adverse effects.However,innovations in endourologic equipment and techniques have allowed for the wider application of surgical stone treatment in these patients,and significant advancement in the field.This review covers the history and current advances in the diagnosis and management of stone disease in pregnant and pediatric populations.It is paramount for the urologist to understand the complexities of properly managing stones in these patients in order to maximize treatment efficacy,while minimizing complications and morbidity.
文摘Omicron,a severe acute respiratory syndrome coronavirus-2 variant,has spread around the globe,causing dramatic increases in infection rates.Viral mutant antigens were responsible for the strong infectivity,fast replication,and high reinfection rates reported from all ages.Omicron causes clinical symptoms mostly related to the upper respiratory tract with minimal symptoms from the lower respiratory tract besides an urgent presentation of cases that resembled a fatal illness,epiglottitis.Not to mention the long coronavirus disease 2019,which rises exponentially in the Omicrons era.Apparently,the disease has a less aggressive course than earlier variants with lower death rates;however,the infection is not trivial.Severe infection was raised among pediatrics,unvaccinated,and the elderly.Complete vaccine protection is urgently needed to protect the most vulnerable community members.Additionally,self-protective strategies such as wearing a mask and safe social distancing cannot be omitted.
文摘Bowel preparation for colonoscopy in children is a challenging procedure. Wide variety of preparation protocols exist, varying with the hospital. Unlike in adults, there is a lack of uniform bowel preparation protocol in children. Ideally, the bowel preparation agents are assessed by their safety, efficacy and tolerability. Unfortunately, none of the preparations currently available meets all of these criteria. However, since last decade, Polyethylene Glycol-3350 (PEG-3350) is gaining popularity for bowel preparation with reported safety, efficacy, and tolerability. The only major drawback of PEG-3350 without electrolyte was 4 days long preparation time thus raising the question if the duration of preparation time could be minimized and yet have same efficacy, safety, and tolerability of the medicine. Hence, one day PEG-3350 regimen was introduced eventually and is now being studied with increased dosage or combined with other laxatives. This is the first review which compiles the study so far conducted on one day PEG-3350 without electrolyte as colonoscopy bowel preparation in children and tries to summaries if this regimen can be commonly used in children for colonoscopy bowel preparation.
文摘Hereditary Pancreatitis(HP)has emerged as a significant cause of acute,acute recurrent and chronic pancreatitis in the pediatric population.Given that it presents similarly to other causes of pancreatitis,a positive family history and/or isolation of a gene mutation are vital in its designation.Inheritance patterns remain complex,but mutations involving the PRSS1,SPINK1,CFTR and CTRC genes are commonly implicated.Since being first described in 1952,dozens of genetic alterations that modify the action of pancreatic enzymes have been identified.Among children,these variants have been isolated in more than 50%of patients with chronic pancreatitis.Recent research has noted that such mutations in PRSS1,SPINK1 and CFTR genes are also associated with a faster progression from acute pancreatitis to chronic pancreatitis.Patients with HP are at increased risk of developing diabetes mellitus,exocrine pancreatic insufficiency,and pancreatic adenocarcinoma.Management follows a multi-disciplinary approach with avoidance of triggers,surveillance of associated conditions,treatment of pancreatic insufficiency and use of endoscopic and surgical interventions for complications.With significant sequela,morbidity and a progressive nature,a thorough understanding of the etiology,pathophysiologic mechanisms,diagnostic evaluation,current management strategies and future research considerations for this evolving disease entity in pediatrics is warranted.
文摘Background: Invasive fungal infections are common opportunistic diseases in patients with AIDS, other conditions related to immunodeficiency and healthy infants. Most publications on this subject are related to industrialized countries, and in adult population, with limited data in Latin America (except for Brazil, Colombia, and Argentina), and especially in pediatric population. These patients present a variety of clinical manifestations representing a diagnostic and therapeutic challenge for the health system. Objective: The objective of the study is to describe the epidemiological and laboratory characteristics of children with invasive fungal infections in Guatemala. Methods: A review of the microbiology service database was carried out at Roosevelt Hospital in Guatemala. Positive cultures were taken from children under 15 years of age, in a period of seven years, from 2007 to 2014, with its corresponding medical history. Results: Finally, 23 isolates were documented but only 15 patients were included in the study with complete information;10 Histoplasma capsulatum cases, 4 Cryptococcus neoformans cases and 1 Coccidioidessp case. The average age was 7 years old for Histoplasma and 9 years old for Criptococo, with an age range from 6 months to 14 years. Around 60% of the patients were older than 5 years, of which, more than two-thirds were HIV positive children without antiretroviral therapy, who presented an invasive fungal infection at the time of HIV diagnosis. These infections are endemic in Guatemala, so the distribution was mostly uniform. Around 80% of the patients had some disease related to immunodeficiency and 70% were infected with human immunodeficiency virus (HIV). The microbiological isolation was from blood, bone marrow, lymph nodes, cerebrospinal fluid and urine. The predominant laboratory findings were decrease in hematological series. The most frequent clinical syndromes were fever, adenomegaly, hepatosplenomegaly, respiratory, gastrointestinal, neurological and weight loss. Mortality rate was 53% (from them, 62% were HIV positive). From these patients, an87% did not receive antifungal treatment in time due to late diagnosis of the infection. Conclusions: These infections should be considered when treating pediatric patients from tropical regions, with nonspecific systemic symptoms and signs, lymph node involvement and hematological alterations related to the mononuclear phagocytic system, mainly if they are patients infected by HIV in an advanced stage, infants, or children with a disease that weakens the immune system. When there is a high suspicion of a fungal infection, screening for HIV is mandatory;cultures should be taken early and together with rapid diagnostic tests. An antifungal treatment should be started immediately and then modified accordingly to laboratory results.
文摘<strong>Ba</strong><span style="font-family:Verdana;"><strong>ckground:</strong></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> Angina is a common </span><span style="font-family:Verdana;">paediatric</span><span style="font-family:Verdana;"> condition. It has certain peculiarities in children, particularly </span><span style="font-family:Verdana;">with regard to</span><span style="font-family:Verdana;"> the frequency of bacterial germs and the use of diagnostic tests. </span><span style="font-family:Verdana;">The aim of this study was</span><span style="font-family:Verdana;"> to determine the place of the rapid diagnostic test in the management of group A beta-hemolytic streptococcal angina in children in the </span><span style="font-family:Verdana;">paediatric</span><span style="font-family:Verdana;"> ward at Donka National Hospital. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was a prospective descriptive study lasting 6 months from 1st February to 31st July 2019 concerning childr</span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">en aged between 3 and 15 years old who were diagnosed with angina. Epidemiological, clinical, para-clinical </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> therapeutic variables were studied. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of 1494 registered children, we collected 116 cases of angina (7.76%). Out of 52 patients who benefited from the rapid diagnostic test, we recorded 13 cases of angina due to group A beta-hemolytic </span><span style="font-family:Verdana;">strptococcus</span><span style="font-family:Verdana;">. The male sex was the most dominant with 31 cases (59.69%) and a G/F sex ratio of 1.47. The age group most affected was between 3 and 5 years old (50%). The average age of our patients was 4.8 years with extremes of 3 and 14 years. Clinical manifestations were dominated by fever and dysphagia (100%) followed by odynophagia (11.79%). We recorded 13 cases of streptococcal angina (25%). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The factors that influence it are multiple, dominated by community life, passive smoking </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> allergies. The use of RDTs in these young children would help in the diagnosis of acute group A </span><span style="font-family:Verdana;">beta hemolytic</span><span style="font-family:Verdana;"> streptococcal angina and rational antibiotic prescription.</span></span></span></span>
文摘Assessment of entrance skin doses for patients in Digital radiography examinations should be made as a means for the optimization of the radiation protection of the patients. We measured the entrance skin dose (ESD) received by 50 pediatrics undergoing 12 types of diagnostic X-ray examination at Radiology Department of Asser Central Hospital-KSA. The entrance skin dose ESD was determined via measurements parameters: focus to skin distance (FSD), tube current (mAs) and tube voltage (kV) in arithmetical equation. The mean ± SD for ESDs were found to be 0.16 ± 0.03, 0.21 ± 0.01, 0.63 ± 0.26, 0.55 ± 0.09, 0.15 ± 0.05, 0.27 ± 0.06, 0.41 ± 0.19, 0.46 ± 0.18, 0.46 ± 0.12, 0.20 ± 0.02, 0.39 ± 0.01, 0.29 ± 0.03, for PA chest, foot, AP pelvis, PA skull, PA hand, AP arm, ankle, AP shoulder, abdomen, forearm, AP femur, AP elbow consequently. Our study is considered as an attempt to evaluate the ESDs received by digital radiographic x-ray machine for children aged between 2 - 15 years old, taking in our considerations number of other variables. The mean ESD values obtained are found to be within the standard reference. The data obtained may add to the available information in national records for general use. It may provide guidance on where efforts on dose reduction will need to be directed to fulfill the requirements of the optimization process and serve as a reference for future researches.
文摘Introduction: Medication error (ME) is a common cause of childhood morbidity and mortality reported in developed countries. It has not yet been described in the pediatric services in Cote d’Ivoire. Objective: To evaluate ME in pediatrics for the improvement of professional practice. Materials and Methods: This was a cross-sectional, descriptive and analytical study conducted in the service of pediatrics at the University Teaching Hospital (CHU) of Bouaké from January 11 to February 25, 2016. It involved 204 children hospitalized and treated with drugs. The variables studied were the prescription, dispensing and administration of the drugs. Results: A total of 483 prescriptions notes were recorded for 733 therapeutic lines, i.e. 2.3 prescriptions notes and 3.6 lines per child. The overall prevalence of ME was 31% (prescription 83%, dispensing 0%, administration 11%). The prescription error concerned the illegible writing (20%), the omission of the stamp & signature (47%), the omission of the date (33%), weight (66%), age (25%) and name of the child (9%).The drug name and the dosage were incorrect in 99% and 1% respectively. Regarding the administration error, care was provided by a person without a nursing qualification in 65.5% of cases. On the patient’s care record, the care giver’s name was omitted in 100%, the child’s name in 57% and the date in 47%. The route of administration and the administered dose were each incorrect in 5%. The student nurses and assistant nurse caregivers committed more prescription errors than doctors and nurses and midwives (p= 0,000 X2 = 44.91). Administration error was not significantly related to the service, the socio-professional category, the gender and the age of the patient. Conclusion: EM is common in pediatrics at the University Teaching Hospital (CHU) of Bouaké. To prevent it, it is necessary to strengthen the staff’s capacity to prescribe and administer the drug in children.
文摘Introduction: Acute appendicitis is the most common cause of abdominal pain requiring surgery in children. In most instances the infecting organisms are normal inhabitants of the lumen of appendix. Surgery allows easy microbiological sampling. Aspiration of fluid or pus in a syringe is preferred. Swabs are less suitable and only to be used when sampling with a syringe is not feasible. Antimicrobial susceptibility testing of the isolated bacteria and particularly of the anaer- obes can be important to adjust therapy in case of the presence of multi resistant bacteria. Objective: The aim of the study was to determine the bacteriological profile of acute appendicitis in children. Materials and Methods: Study design is a prospective descriptive study including children hospitalized for acute appendicitis. Tissue samples (a speci- men of the appendix), peritoneal fluid swab from the appendicial fossa and the peritoneal exudates (if exists) obtained at surgery from 54 children with suspected acute appendicitis operated at the pediatric surgery unit at the Maternity and Child Teaching Hospital in Al-Qadisiya province from the period 1st of June 2007 to the end of May 2011, were exam- ined histologically and by culture for aerobic and anaerobic bacteria. Results: Out of these, 39 boys (72.2%) and 15 (27.7% girls). Their age ranged between (1.8 - 13) years, with a mean of 6.9 years. Of the all patients studied 34 pre- sented with suppurative and phlegmnous appendicitis, 8 with gangrenous appendicitis, 6 with septic complications of appendicitis and 6 had normal appendices. Only 80 of the 108 swabs taken yielded a positive culture (74.07%). Con- clusion: Although in our study no antibiotic regime was changed on the basis of a positive culture swab and the perito- neal culture swabs do not improve immediate postoperative therapy based on surgical impression and rapid histological reporting, however, the routine use of peritoneal culture swabs may be of value in identifying patients requiring outpa- tient follow-up.
文摘The first issue of the World Journal of Clinical Pediatrics(WJCP),whose preparatory work was initiated on January 10,2011,will be published on June 8,2012.The WJCP editorial board has now been established and consists of 100 distinguished experts from 31 countries.Our purpose of launching the WJCP is to publish peer-reviewed,high-quality articles via an open-access online publishing model,thereby acting as a platform for communication between peers and the wider public,and maximizing the benefits to editorial board members,authors and readers.
文摘I<span><span style="font-family:Verdana;">ntroduction: Acute thoracic syndrome is the appearance of a new pulmonary </span><span style="font-family:Verdana;">infiltrate</span><span style="font-family:Verdana;"> on radiology associated with fever, desaturation </span><span style="font-family:Verdana;">or</span><span style="font-family:Verdana;"> respiratory signs. It is the second leading cause of hospitalization and</span></span><span style="font-family:Verdana;"> the first cause of death in sickle cell patients. It is an acute pulmonary complication whose pathophysiological mechanisms are still poorly understood. This study aims to</span><span><span style="font-family:Verdana;"> study the epidemiological, clinical, therapeutic </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> evolutionary aspe</span></span><span style="font-family:Verdana;">c</span><span><span style="font-family:Verdana;">ts of Acute Chest Syndrome in children at the Pediatrics Department of Donka National Hospital. Method: This is a prospective study of descriptive type for a period of 6 months from February 19 to August 19, </span><span style="font-family:Verdana;">2019</span><span style="font-family:Verdana;"> on patients with sickle cell disease who developed an ATS in the pediatrics department of Donka National Hospital. Epidemiological, clinical, therapeutic </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> evolutionary data were studied and proportionate data were calculated. Results: The frequency of ATS was 39%. The mean age of our patients was 9.83 years with the extremes of</span></span><span style="font-family:Verdana;"> 4 and 16 years. The age group from 6 to 10 years with a frequ</span><span style="font-family:Verdana;">ency of 66.7% was the most affected. Fever was the main clinical manifestation, followed by hepatome</span><span><span style="font-family:Verdana;">galy. All our patients were homozygous SS and undergoing folic acid prophylaxis. 96% of our patients did not receive any specific vaccine. Antibiotic therapy, hyperhydration </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> analgesics were administered to all our patients. 96% of our patients were transfused with red blood cell concentrate. 96% of our patients were transfused with packed red blood cells. 96% of our patients were transfused with packed red blood cells and 96% of them had a favorable outcome. Conclusion: ATS is an acute co</span></span><span style="font-family:Verdana;">mplication of sickle cell disease responsible for significant mortality and morbidity in the pediatric population. Its treatment is symptomatic and must be started early. Emphasis must be placed on prevention to prevent or limit its occurrence.</span>
文摘Objective: To investigate the effectiveness of ultrasound-guided central venous catheterization when compared to the conventional procedure. Method: A prospective cohort study was carried out over a 9-month period from February to October 2016 involving 144 inpatients at PICU of Irmandade da Santa Casa de Sao Paulo Hospital, undergoing central venous catheterization. The patients were matched in pairs of identical patients according to the levels of potentially intervening variables (age, nutritional status, puncture site, professional experience), differing only as to the CVC technique: ultrasound-guided (USG-CVC) or conventional (C-CVC). Discarding data from non-paired patients, the remaining did forming 47 pairs, matched as two related samples: USG-CVC and C-CVC groups. Success parameters: number of puncture attempts;time spent at CVC;success rate and complications. Results: In the USG-CVC group, the number of attempts (mean = 2.04) and the time spent at catheterization (mean = 11.89 minutes) were lower (t = 2.34, df = 46, t 0.95 = 2.02, p t = 3.07, df = 46, t 0.95 = 2.02, p < 0.05), respectively, when compared to the results obtained for the control group (C-GVC), (mean = 3.21) and (mean = 28.26 minutes), respectively. As to success, there was observed a significant difference (F (1, 46) = 16.6;Q (1) = 12.5, p < 005) when considering only one trial (USG -CVC = 27/47;C-CVC = 9/47), but no significant difference (F (1, 46) = 3.76;Q (1) = 3.56, p > 0.05) when considering several attempts. Complications were found less frequently in the USG-CVC group (3/47) than in the CVC-C (13/47), (F (1, 46) = 8.24;Q (1) = 7.14, p < 0.05). Conclusion: USG-CVC was found to be more effective than the conventional technique, especially regarding success at the first puncture attempt.
文摘Introduction: Violence in hospital is a major Public Health issue. In Cote d’Ivoire, acts of violence against health professionals exist and may sometimes take a dramatic turn. Objective: To research the causes of this violence for the purpose to prevent them. Materials and Methods: This is a cross-sectional, descriptive study conducted in the Obstetrics & Gynecology and Pediatrics departments at the University Teaching Hospital of Bouaké from 26 January 2016 to 24 February 2016. It included 129 health workers who gave their consent. The data collection was done through individual interviews followed by a focus group according to the socio-professional category. Results: Out of 129 health professionals included, 100 were a victim of violence i.e. a frequency of 77.5%. Most of the violence occurred during “on-call hours” (55.8%) in the emergency units (34.8%). The violence was verbal (52.5%), physical (28.6%), moral and psychological (11.6%), theft (7.3%). The aggression was mainly related to patient’s care (32.1%), visiting hours (26%) and the low level of understanding of the person (16.5%). The victim’s immediate feelings were dominated by frustration (26.7%), discouragement (21.3%) and insecurity (18.3%). The victims received a medical assistance in 9% of cases. To prevent this violence, the staff mainly offered to raise awareness about violence (27.6%) and the respect for hospital staff (25%). Conclusion: Violence against health professionals is common and has negative impacts on staff and hospital activity. Its prevention requires a holistic approach centered on awareness. Keywords: Violence, Hospital, Pediatrics, Staff, Cote d’Ivoire.
文摘Video capsule endoscopy(CE) for evaluation the esophagus(ECE), small bowel(SBCE) and the colon(CCE) is particularly useful in pediatrics, because this imaging modality does not require ionizing radiation, deep sedation or general anesthesia. The risk of capsule retention appears to be dependent on indication rather than age and parallels the adult experience by indication, making SBCE a relatively safe procedure with a significant diagnostic yield. The newest indication, assessment of mucosal change, greatly enhances and expands its potential benefit. The diagnostic role of CE extends beyond the SB. The use of ECE also may enhance our knowledge of esophageal disease and assist patient care. Colon CCE is a novel minimally invasive and painless endoscopic technique allowing exploration of the colon without need for sedation, rectal intubation and gas insufflation. The limited data on ECE and CCE in pediatrics does not yet allow the same conclusions regarding efficacy; however, both appear to provide safe methods to assess and monitor mucosal change in their respective areas with little discomfort. Moreover, although experience has been limited, the patency capsule may help lessen the potential of capsule retention; and newly researched protocols for bowel cleaning may further enhance CE's diagnostic yield. However, further research is needed to optimize the use of the various CE procedures in pediatric populations.
文摘BACKGROUND Extraskeletal Ewing sarcoma(EES)is a member of the Ewing sarcoma family of tumors which is pathologically known as a small,round,blue cell tumor involving bone and soft tissue.The prevalence of EES is only 15%-25%of all Ewing sarcoma and EES often occurs in patients aged from 20-mo-old to 30-yearsold resulting in an unfavorable prognosis.CASE SUMMARY The present case report described a 7-year-old patient with a palpable EES mass of 33 mm×27 mm×28 mm in the deep neck with symptoms of persistent dyspnea over the past 5 mo.After laboratory examinations,abnormal physiological and biochemical indicators were not found.Ultrasound images presented the mass to be complex,solid and fluid-filled with circumscribed margins and posterior acoustic enhancement.The mass also presented with partial internal vascularity.The contrast-enhanced magnetic resonance imaging scan illustrated the outstanding enhancement with fast perfusion mode in the early arterial phase. CONCLUSIONOur study suggested that a quick-growing mass in the pediatric patient is possibly a malignanttumor whether the mass has well-defined margins or not.
文摘Background: Surgical treatment for neuromuscular (NM) hip subluxation or dislocation is undertaken to maintain functionality and decrease pain. Longterm complications are well described;however, the acute complication profile is poorly understood. Questions/Purpose: The aim of this study was to identify the rate of and risk factors for complications following surgical treatment of hip subluxation/dislocation, especially as it relate to NM children. Methods: Hip reconstruction cases in patients with a NM diagnosis and non-NM patients were obtained from the 2015 American College of Surgeons NSQIP-Pediatric database by CPT code. 30-day postoperative complications were classified according to the Clavien-Dindo system as minor (grade 1 or 2) or major (grade 3+). Patient and surgical factors were assessed in univariate and multivariate logistic regression analyses for association with post-operative complications. Results: 1081 cases were identified (median age 7.7, 55% female), of whom 420 (39%) had a NM diagnosis. Overall complication rate was significantly higher in NM patients (33% vs. 19%, p < 0.001). Numerous factors were associated with postoperative complication on univariate analysis. Multivariate analysis identified NM diagnosis (OR 1.5), age > 6 years (OR 1.5), or pelvic osteotomy (OR 1.9) as independent risk factors for complication. Conclusion: In pediatric reconstructive hip surgery requiring pelvic osteotomy, a NM diagnosis is associated with an increased risk of 30-day postoperative complications. Older age and increasing surgical complexity were also independently associated with complications. These findings support special attention for the older patients undergoing concomitant pelvic osteotomies to minimize complication rate.
文摘Management of hypertension (HTN) largely relies on proper and accurate measurement of blood pressure (BP). Even following the criteria for HTN diagnosis defined in the Fourth report on high BP in children and adolescents, inaccurate diagnosis and misdiagnosis can occur with white coat effect and masked HTN. The use of Ambulatory Blood Pressure Monitoring (ABPM) has been increasing in pediatrics in the last 20 years. The main use of ABPM is to differentiate between sustained HTN and white coat HTN in patients who have elevated casual BP measurements and to detect masked HTN in high risk patients. ABPM is most useful in patients with casual BP within 20% of the 95th percentile for age, gender, and height. This report will highlight the use of ABPM in the evaluation of elevated BP and management of HTN in pediatrics. The discussion includes a review of various non-invasive BP measuring techniques, a description of ABPM and ABPM-unique data and diagnoses, updated ABPM clinical data more specific to pediatrics, its use in HTN clinical trials, and future outlook and direction of ABPM in pediatrics.
文摘Aim: To detect the most common musculoskeletal disorders and to explore the common injury and indication of different musculoskeletal systems, and then to obtain the causes of disorders by observing clinical indications via images. Methodology: The subjects in this project consisted of both genders—males and females and were investigated randomly by collecting data from the PACS unit that exists in the radiology department at KAUH. The participants had a mean age of 7.4 ± 0.3 years, a mean height of 118.2 ± 2.5 cm, a mean mass of 27.8 ± 1.5 kg, and a mean BMI of 19.6 ± 0.8 kg/m2. The author settled the study plan by building a special, appropriate questionnaire to be handed out to the patients and covered mainly the prospective studies of randomly selected patients who came to the emergency unit and the outpatient units from other departments at KAUH in Jeddah. Results: The ratio of injuries in male children (77%) against females (23%) is 3:1, and this ratio is considered significant between age groups for males when compared with females. The injuries existed most in the age groups of 4 to 6 years old and 8 to 10 years old with approximately the same percentage of the total subjects as about 21% for each age group. Trauma injury was significant (81%) compared to other types of causes in all age groups. There was a significant relationship between the causes of injuries and the age groups in pediatrics (p 0.05) between the site of injuries and age groups. The significant site that resulted from trauma was the knee (100%), out of the total traumas’ subject. There was a highly significant relationship between the site of injuries and its causes (p = 0.006, i.e. p < 0.05) that were expected. Conclusion: More awareness and understanding in the society are needed and we should concentrate on increasing the knowledge of such by providing them with more learning courses.
文摘Background: In Congo, there is no pediatric gastroenterology department and the activity of colonoscopy has never been evaluated. The aim of this study is to report the indications and the results of pediatric colonoscopy in Brazzaville. Methods: A retrospective study was conducted from January 2016 to August 2017 by analyzing reports of colonoscopy performed in the gastroenterology department in Brazzaville. Sex, prescribers, indications and results of colonoscopy were the variables study. Results: over the 19-month period, 489 colonoscopies have been performed, in which 13 (2.7%) colonoscopies were performed in children under 17 years, with an average age of 9.8 ± 4.6 (8 males and 6 females) and the extreme ranging from 1 - 17 years. The sex ratio (H/F) was 1.6. The prescribers were gastroenterologist (n = 4), pediatrician (n = 4), surgeons (n = 2), general practitioners (n = 2), pediatric students (n = 1). Chronic bowel inflammatory diseases and polypectomy was the most frequent conditions for colonoscopy indication. Seven (7) colonoscopies were normal. 4 cases were recto-polyps, and 2 cases were ulcerative colitis. Conclusion: pediatric colonoscopy is a powerful diagnostic and therapeutic means. The pediatricians should think about it to improve the management of children with digestive symptoms that meet the indications of pediatric colonoscopy.
