Introduction: Children’s heart disease is a major public health problem in developing countries and especially in Mali. The purpose of our work was to determine frequency, different types of heart disease and their s...Introduction: Children’s heart disease is a major public health problem in developing countries and especially in Mali. The purpose of our work was to determine frequency, different types of heart disease and their short term evolution in the pediatric department. Methods: We performed a retrospective study among children aged 0 to 15 years, hospitalized in the pediatric department from January to December 2015 and whose diagnosis was confirmed using trans-thoracic echocardiography. Results: We included 103 cases of heart disease out of a total of 8613 admissions in the pediatric department, giving an hospital prevalence of 1.2%. Mean age was 4.1 years (from 1 day to 15 years) and children under 5 years were the most affected with 73.80% of cases. Male predominance was noted (sex ratio = 1.2). Respiratory distress was the most common circumstance of discovery (93.20%). Cardiac murmur and tachycardia were the most common cardiac signs with respectively 88.35% and 83.50%. Congenital heart disease accounted for 70.87% and was dominated by ventricular septal defect (VSD) with 30.13%. Acquired heart disease (29.13% of the sample) was dominated by mitral regurgitation (MR) with 56.67%. Mortality rate was 31.9% for congenital heart disease and 11.1% for acquired heart disease. Conclusion: children’s heart disease is responsible for high mortality. Early detection improves the management of this pathology, which remains frequent.展开更多
<strong>Introduction</strong><span style="font-family:Verdana;"><strong>: </strong></span><span style="font-family:Verdana;">According to Mali’s National ...<strong>Introduction</strong><span style="font-family:Verdana;"><strong>: </strong></span><span style="font-family:Verdana;">According to Mali’s National Immunization Center, the</span><span style="font-family:""> <i><span style="font-family:Verdana;">Hae</span><span style="font-family:Verdana;">mophilus influenzae</span></i><span style="font-family:Verdana;"> b (Hib) vaccine coverage rate was 90% in 2015. Our</span><span style="font-family:Verdana;"> work aimed to study invasive bacterial infections due to </span><i><span style="font-family:Verdana;">Haemophilus influenzae</span></i><span style="font-family:Verdana;"> type b in children aged 0</span></span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">- 15 years hospitalized in the pediatrics department </span><span style="font-family:Verdana;">of the UH-GT</span></span><span style="font-family:Verdana;">. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">We carried out a retrospective descriptive study</span><span style="font-family:""><span style="font-family:Verdana;"> from January 2017 to December 2018 (</span><i><span style="font-family:Verdana;">i</span></i><span style="font-family:Verdana;">.</span><i><span style="font-family:Verdana;">e</span></i><span style="font-family:Verdana;">. 2 years) among children aged 0</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">15 years and hospitalized for </span><i><span style="font-family:Verdana;">Haemophilus influenzae</span></i><span style="font-family:Verdana;"> type b infection confirmed by culture (blood culture, Cerebro-spinal Fluid, and pleural and skin fluid).</span></span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Results</span></b><b><span style="font-family:Verdana;">: </span></b><span style="font-family:""><span style="font-family:Verdana;">Thirty-three cases of Hib infections were collected giving a </span><span style="font-family:Verdana;">frequency of 0.2% and the age group 3 months to 3 years was the most</span><span style="font-family:Verdana;"> affected (72.73%).</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">Children who received no vaccine accounted for 21.21%.</span><span style="font-family:""> </span><span style="font-family:Verdana;">The Cerebro-spinal Fluid culture and other samples (pleural and skin) identified the </span><span style="font-family:Verdana;">bacterium</span><span style="font-family:""> </span><span style="font-family:Verdana;">in 100% of cases, against 72.72% in the blood culture</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">Meningitis </span><span style="font-family:Verdana;">was the most frequent pathology (78.79%) and the lethality was high</span><span style="font-family:Verdana;"> (21.21%).</span></span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Despite the introduction of the Hib vaccine in the routine</span><span style="font-family:Verdana;"> immunization program in Mali, Hib infections remain with a high lethality linked to meningitis</span><span style="font-family:Verdana;">.</span>展开更多
Objective: To study the pulmonary complications of major sickle cell syndromes in children aged 6 months to 15 years followed at the Department of Pediatrics of Gabriel Toure University Hospital. Materials and methods...Objective: To study the pulmonary complications of major sickle cell syndromes in children aged 6 months to 15 years followed at the Department of Pediatrics of Gabriel Toure University Hospital. Materials and methods: This was a retrospective study from January 1<sup>st</sup>, 2017 to February 28, 2018 and a prospective study from March 1, 2018 to December 31, 2019, concerning sickle cell disease children followed at the Gabriel Touré University Hospital. All children with sickle cell disease confirmed by hemoglobin electrophoresis, aged 6 months to 15 years with a pulmonary complication and admitted to pediatrics were included. Were not included: 1) Infants and children with sickle cell disease not presenting a pulmonary complication coming only to their routine follow-up. 2) Sickle cell patients over 16 years of age and those whose parents do not consent. 3) Those who have not done electrophoresis. Results: During the study period, we were able to include 45 sickle cell children with a pulmonary complication. The frequency of pulmonary complications was 13.76%, involving homozygotes in 91.11% of cases. The age group 6 - 10 years predominated with 46.66% and the sex ratio was 0.45. Vaso-occlusive crisis was the most frequent reason for consultation with 35.56%. Respiratory distress (80%), fever (66.67%), crepitus rales (64.44%) and chest pain (60%) were the most frequent clinical signs. The main pulmonary complication was acute chest syndrome with 86.67%. Treatment was based on hydration (91.91%), analgesics (91.91%) and antibiotics (73.33%). Lethality was 4.44%. Conclusion: Pulmonary complications of sickle cell disease are serious and constitute the main cause of mortality in our context.展开更多
Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with H...Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with HIV infection followed up in the pediatric department of the Regional Teaching Hospital of Borgou/Alibori (CHUDB/A) the from 2005 to 2020. Patients and Method: This was a retrospective and descriptive study conducted in the pediatric department of CHUD/B-A in Parakou. All children with HIV infection who died from January 1, 2005 to August 31, 2020 were included. Data collection was carried out in three stages: a phase of medical records processing, a phase of community survey and a phase of death audits. The variables studied were sociodemographic, clinical, biological, therapeutic and evolutionary. Results: Over the study period, the data of 464 infected children were recorded, including 92 deaths, representing a case fatality rate of 19.83%. Severe acute malnutrition (69.23%), gastro-intestinal tract infections (43.58%) and serious opportunistic pulmonary infections (24.36% pulmonary tuberculosis and 19.23% pneumocystis) were the main causes of death. The main dysfunctions found were: the delayed diagnosis of HIV infection (79.35%), the absence or delay in consultation when the child’s clinical condition deteriorates (32.61% and 47.83%), delayed initiation of antiretroviral treatment (42.39%) and non-adherence to treatment (38.04%). Non-adherence to treatment was predominant in adolescents (90.49%). Conclusion: Specific interventions for early detection, adequate nutritional care, psychosocial support for adolescents and mothers of children are necessary to reduce mortality due to HIV among children and adolescents.展开更多
Objectives: The main objective was to evaluate antibiotic prescribing in the Department of Pediatrics at Gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from September...Objectives: The main objective was to evaluate antibiotic prescribing in the Department of Pediatrics at Gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from September 1 to November 31, 2018, in the Department of Pediatrics at Gabriel Touré teaching hospital. All children aged 0 to 15 years hospitalized for any pathology during the study period and having received at least one antibiotic had been included. Results: We collected 445 children’s records out of 1032 admissions during the study period, representing a hospital frequency of 43.1%. The sex ratio was 1.3%. The 2 - 5 age group accounted for 48.1%. Fever was the reason for consultation in 45.6% of cases. Patients’ general condition was altered in 60% of cases. The fathers were blue-collar workers in 65.4% and the mothers housewives in 85%, and had no education in 42.9% and 64.5% respectively. Hepatomegaly was present in 18.2%, splenomegaly in 9.6% and peripheral adenopathy in 3.1%. The site of infection was pulmonary in 37.6% and ENT in 9.2%. Bacterial infection was assumed on admission in 54% of cases, and meningitis in 57.7%. The discharge diagnosis was malaria in 54.6%, severe acute malnutrition in 18.6% and meningitis in 6.7%. The death rate was 3.8%. Neutrophilic leukocytosis was present in 47.3% of patients. CRP was positive in 85% of patients. Blood cultures taken in 27.6% of patients were positive in 5. CSF analysis in 30% of patients showed elevated leukocytes in 6.5%. No cultures were positive. Antibiotic prescription was justified by infectious hypotheses in 43.1% of patients. β-lactam antibiotics were prescribed in 98.6%. Antibiotic therapy was not adapted to national/international recommendations in 68.3% of cases, and was not justified in 16.3% of cases on D5 of hospitalization. Conclusion: Antibiotic use was justified in more than half of patients, but remained inadequate in almost two-thirds of cases, in line with national and international recommendations.展开更多
Context: The consequences of non-adherence to antiretroviral therapy (ART) are harmful in terms of morbidity and mortality among HIV-infected adolescents. There is a little data in this population in West Africa, abou...Context: The consequences of non-adherence to antiretroviral therapy (ART) are harmful in terms of morbidity and mortality among HIV-infected adolescents. There is a little data in this population in West Africa, about non-adherence to ART. Objective: To identify factors associated with non-adherence to ART in adolescents at the Pediatric Ambulatory Treatment Center (PATC) of the pediatric department of Yopougon University Hospital. Materials and Methods: A cross-sectional study was conducted from May to July 2017 among adolescents aged 10 to 19 years old at PATC of pediatrics department of Yopougon University Hospital. We have considered that adolescent was not adherent to ART when he affirm that he have not taking ART at least once in the week before the survey. A logistic regression model was used to identify factors associated with non-adherence to ART. Results: Overall 166 adolescents were included. The median age was 15 years old [IQI = 13 - 17 years]. They had a detectable viral load greater than 1000 copies/ml in 41.8% of cases. The rate of non-adherence to ART was 40.4%. The factors associated with non-adherence to ART were male [OR = 2.5 (CI = 1.1 - 10.0)], having parent widowed [OR = 7.8 (CI = 1.6 - 39.3)] or divorced [RC= 3.7 (IC=1.1 - 13.5)], CD4 inclusion rate ≥ 500 cells/ml [OR = 8.5 (CI = 1.6 - 45.5)] and duration on ART ≥ 10 years [OR = 8.9 (CI = 1.6 - 50)]. Conclusion: A rigorous therapeutic education taking into account associated factors in this study is necessary to reduce the rate of non-adherence among adolescents at PATC.展开更多
Introduction: Cancellation of surgical operation is a surgical operation registered in the official schedule the day before or added to the list after and not carried out on the operating day. The purpose of this work...Introduction: Cancellation of surgical operation is a surgical operation registered in the official schedule the day before or added to the list after and not carried out on the operating day. The purpose of this work was to determine the causes of cancellation of elective surgical operations in a major pediatric surgery department in Senegal. Patients and methods: It was a prospective and descriptive study of 278 patients scheduled during a period of 13 weeks. The study took place between April 3<sup>rd</sup>, 2017, and January 31<sup>st</sup>, 2018. Mean age was 2.9 years with extremes of 3 days and 15 years. The age group of 29 days to 30 months was the most represented (62.2%). Sex ratio was 1.41. Causes of cancellation were categorized into administrative and organizational causes, patient-related causes and staff-related causes. Results: Cancellation rate was 29.4%. Patient-related causes were most common (51.2%). Upper Respiratory tract infection (URTI) was commonest reason within this category (57.5%). Organizational causes (28.1%) came second and were mainly represented by the unavailability of the operating room (60.8%) related to breakdowns of anesthesia equipment. Finally, staff-related causes (20.7%) were due for most to the unavailability of the anesthesiologist (12 cases/17). Conclusion: Majority of causes that led to cancellation of elective surgical operations in our Pediatric surgery department are related to intercurrent illnesses affecting the patient, in particular URTI.展开更多
<strong>Introduction:</strong> <span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The harmonious develo...<strong>Introduction:</strong> <span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The harmonious development of the intestinal microbiota</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> during the first 1000 days of life promotes the child</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">’</span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">s immediate and future good health. The objective of the study was to evaluate the knowledge and practices of health personnel on the intestinal microbiota and the first 1000 days of life </span><span style="font-family:Verdana;">for the improvement of child health.</span></span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Methods:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Knowledge, attitudes and</span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> practices (KAP) type survey conducted among health personnel of the pediatric </span><span style="font-family:Verdana;">and gynecology-obstetrics departments of the Bouaké University Hospital</span><span style="font-family:Verdana;"> from </span><span style="font-family:Verdana;">July 1 to 31, 2017. All consenting agents working in the said services and</span><span style="font-family:Verdana;"> present at the time of the study were included. The parameters studied concerned socio-professional characteristics, knowledge of the intestinal microbiota, and knowledge and practice of the first 1000 days. The data analysis was descriptive and analytical with a significance threshold p ≤ 0.05.</span></span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results:</span></b></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> Out of 224 active agents, 76 (30 men, 46 women) participated in the survey, </span><i><span style="font-family:Verdana;">i.e</span></i><span style="font-family:Verdana;">. 33.9%. The respondent came from the gynecology-obstetrics (54%) and pediatrics (46%) departments and had professional experience >5 years in 38%. Thirty-eight percent of the respondents had a good knowledge of the intestinal microbiota. Concerning the first 1000 days of life, 64.5% of the respondents had a good knowledge of the first 1000 days overall. They advised exclusive breastfeeding for up to 6 months in 95% of cases. When breastfeeding was not feasible, the main criterion for choosing the infant formula was </span><span style="font-family:Verdana;">the composition (57.1%). They proposed a standard infant formula (43%),</span></span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">enriched with prebiotic (29.4%), enriched with probiotic (21.6%),</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> a symbiotic (6%). Good knowledge of the intestinal microbiota was associated with belonging to the paediatric service (p</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">=</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">0.013), socio-professional category (p</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">=</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">0.031), year of experience >5 years (p</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">=</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">0.032) and the first 1000 days of life to year of experience >5 years (p</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.01). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The health personnel interviewed did not have a good knowledge of the intestinal microbiota and the first 1000 days. Capacity building is needed.</span></span></span></span>展开更多
<strong>Introduction:</strong> <span style="font-family:""><span style="font-family:Verdana;">Respiratory distress (RD) is a major emergency to which infants are partic...<strong>Introduction:</strong> <span style="font-family:""><span style="font-family:Verdana;">Respiratory distress (RD) is a major emergency to which infants are particularly vulnerable. It can lead to neurological sequelae and even death when treatment is not adequate and rapid. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To evaluate the management of RD in infants at the CNHU-HKM in Cotonou. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> The study was of a transversal and analytical nature and took place over a period of 06 months, from 1st January to 30th June 2015. Included in the study were all infants hospitalised for DR. The therapeutic modalities were analysed according to the recommendations of the World Health Organization. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 96 infants were included. The hospital frequency of DR was 38%. The average age was 12 months. One in 3 infants had SaO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> less than 90% on admission, and in 58.3% of cases, the infant showed at least 3 signs of struggle. The initial assessment was as recommended.</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">The systematic use of oxygenrequires a revision of the criteria for oxygentherapy in the unit</span><span style="font-family:""><span style="font-family:Verdana;">. The three main causes were severe pneumonia (31.3%), severe malaria (18.8%) and bronchiolitis (15.6%), and their treatment was correct. However, none of the infants had been able to benefit from ventilatory support. Mortality was high (31.2%) linked to the intensity of DR (p = 0.04) and sepsis (p = 0.006). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The procedures for the diagnosis and treatment of RD in infants at the CNHU are fairly consistent with WHO guidelines. Ventilatory support is necessary for some children with severe RD.</span></span>展开更多
<strong>Introduction:</strong><b><span style="font-family:;" "=""> </span></b><span style="font-family:Verdana;">Scrotoschisis is a very rar...<strong>Introduction:</strong><b><span style="font-family:;" "=""> </span></b><span style="font-family:Verdana;">Scrotoschisis is a very rare congenital defect of the scrotum characterized by the exteriorization of one or two testes. We report a case of right scrotoschisis in a newborn as well as a review of the literature for an approach of probable etiology.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Patient and Observation:</span></b><b><span style="font-family:;" "=""> </span></b><span style="font-family:Verdana;">A newborn baby of 8 hours of life, weighing 3200</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">g was referred to our department for a right scrotal defect with exteriorization of the testis associated with fluid swelling of the left bursa. The 18-year-old mother, primiparous and primigeste followed all the prenatal consultations with eutocic delivery. After clinical investigation the diagnosis of right scrotosisis and left hydrocele was retained. Surgical treatment was carried out by primary closure after orchidopexy and exploration of the contralateral bursa, the content of which was calcified meconium bathed in a yellowish liquid. The post-operative consequences were simple.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><b><span style="font-family:;" "=""> </span></b><span style="font-family:Verdana;">Scrotoschisis is an extremely rare birth defect whose etiology is poorly understood. However, it could be the cause of meconium peritonitis secondary to a scarred f</span><span style="font-family:Verdana;">a</span><span style="font-family:Verdana;">tal intestinal perforation.</span>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
Trauma is a physical injury caused by violence or other forces;in serious trauma, the patient will be at risk of death or loss of function. Trauma is a leading cause of morbidity and mortality among all age groups. Ob...Trauma is a physical injury caused by violence or other forces;in serious trauma, the patient will be at risk of death or loss of function. Trauma is a leading cause of morbidity and mortality among all age groups. Objective: To study the pattern and outcome of upper limbs trauma in children attending the pediatric emergency department. Methodology: This was a retrospective cross-sectional study conducted in the Department of Pediatrics at Security Forces Hospital-Al-Riyadh. Result: Total number of patients seen during the study period was 343 patients, their age range between 6 months and 13 years old with a mean age of 5.473 (±3.8572);also, results showed boys were 187 (54.5%) patients and girls were 156 (45.5%) patients. Based on the site of trauma in the upper limbs, lacerations were in 114 (33.2%), Hand and/or wrist fracture in 67 (19.5%), Nursemaid Elbow in 43 (12.5%), both Radius and Ulnar bones fracture in 33 (9.6%), Radius bone fracture in 29 (8.5%), supracondylar fracture in 22 (6.4%), Clavicle bone fracture in 20 (5.8%), Humorous bone fracture in 7 (2%), Condylar bone fracture 6 (1.7%), and there was 1 (0.3%) patient with Scapulae and Ulna fracture.展开更多
Introduction: The United Nations Sustainable Development Goals (SDGs) aim to decrease the global maternal mortality ratio to below 70 per 100,000 live births and eliminate preventable deaths of newborns and children u...Introduction: The United Nations Sustainable Development Goals (SDGs) aim to decrease the global maternal mortality ratio to below 70 per 100,000 live births and eliminate preventable deaths of newborns and children under the age of five in all countries by 2030. The pediatric department at Spécialisé Mère-Enfant Blanche Gomes Hospital (HSMEBG) is divided into two sectors, one catering to children aged one month to four years and the other dedicated to children aged five to 17 years. According to department records, over the past three years, there has been an average of 1050 hospitalizations per year, with an average duration of five days. Objectives: This study aims to describe the socio-demographic characteristics of children who died while in the pediatrics department of the HSMEBG and analyze the factors associated with their deaths. Methodology: A retrospective analytical cross-sectional study was conducted, collecting data over a three-year period, covering the years 2019, 2020 and 2021. Data were collected from medical records of deceased children using Excel software version 2016, and statistical calculations and logistic regression were performed using Epi info software version 7.2.5.0. Results: During the three years of operation, the pediatric department at HSMEBG recorded 3060 new admissions, of which 271 resulted in death, representing an overall frequency of 8.8%. December and January had the highest mortality rates, accounting for 15.5% and 12.5%, respectively. Out of the 271 recorded deaths, 143 (52.77%) occurred in children under the age of one, and 230 (84.87%) occurred in children under the age of five. The average age at death was 2.4 years, ranging from one month to 17 years. The sex ratio was 1. More than half of the deaths (51.66%) occurred during the night, and 165 (60.89%) sought medical help more than three days after the onset of symptoms. Weekend deaths accounted for nearly half (45.7%) of the cases. Upon admission, slightly over half of the children (55.72%) had impaired consciousness, 219 (80.81%) presented with respiratory distress, and 194 (71.59%) had a fever. The average time from admission to administering the first medication was 72 minutes. Respiratory infections were the leading cause of death, accounting for 83 (30.26%) cases, followed by severe forms of malaria (anemic and neurological) at 23.25%. Among the 271 recorded deaths, 33 (12.18%) received no treatment before their demise, and 136 (50.18%) died within the first 24 hours of hospitalization. The average duration of hospitalization for patients who spent less than 24 hours was 15 hours, while those who died after the 24th hour had an average hospital stay of five days, ranging from one to 41 days. Children under the age of five who were admitted with impaired consciousness had roughly double the risk of dying compared to those without this condition (p = 0.001). Conclusion: The overall mortality rate in the pediatric department at HSMEBG is 8.8%. Acute respiratory infections are the primary cause of death. Improving this rate necessitates reducing consultation and treatment durations.展开更多
Introduction: Popliteal pterygium syndrome is a rare birth defect, combining craniofacial, genitourinary and musculoskeletal abnormalities. It is an autosomal dominant disease caused by a mutation in the IRF6 gene. We...Introduction: Popliteal pterygium syndrome is a rare birth defect, combining craniofacial, genitourinary and musculoskeletal abnormalities. It is an autosomal dominant disease caused by a mutation in the IRF6 gene. We report in this observation the 1<sup>st</sup> Guinean case corrected by the surgical method as well as a review of the literature for a diagnostic and therapeutic approach. Patient and observation: We present the case of a 7-day old male newborn weighing 2700 g who was received for bilateral cleft lip and palate, lower lip fossa or sinuses, bilateral popliteal pterygium, and triangular skin fold above the hallux. The patient underwent several surgical procedures aimed at correcting these abnormalities. The correction of the pterygium of the lower limbs was ensured by excision of the fibrous band, the tenoplasty in z of the calcaneal tendon on the right side and the skin plasty in z in series then immobilized by plaster splints. The immediate postoperative follow-up was straightforward. Conclusion: Popliteal pterygium syndrome is a rare congenital malformation, the diagnosis is primarily clinical. Early soft tissue lengthening surgery and serial z-skin plasty provide better correction of the knee pterygium. Correct correction of facial abnormalities gives the child a better appearance. The management of this syndrome is multidisciplinary.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
Background: Urinary tract infection (UTI) is one of the most frequent bacterial infections in pediatrics. The aim of our work was to establish the epidemiological and bacteriological profile of UTIs in children and th...Background: Urinary tract infection (UTI) is one of the most frequent bacterial infections in pediatrics. The aim of our work was to establish the epidemiological and bacteriological profile of UTIs in children and then to study the sensitivity of the bacterial strains isolated to antibiotics. Materials and methods: This is a retrospective descriptive study over 3 years (2019-2022), including all cytobacteriological examination of urine (CBEU), performed in children aged 3 months to 14 years, admitted and treated for UTI, in the pediatric emergency department of Mohamed VI University Hospital. Results: A total of 239 children were included in our study. The mean age was 26 months. The sex ratio was 1.08. Escherichia coli was the most isolated bacterial strain in 79% of samples. The tested strains showed a high level of sensitivity to susceptibility rate toward amikacin (91%) and ciprofloxacin (100%) and whereas the level of resistance was high to the most current recommended antibiotics, mainly beta-lactams. Management was based, in severe forms of pyelonephritis, dual antibiotic therapy based on Third-generation cephalosporins combined with gentamycin. Favorable outcome was noted in 94% of children. Conclusion: Awareness-raising on the proper use of antibiotics, issuing national recommendations for the treatment of urinary tract infections in order to standardize therapeutic regimens is strongly recommended. Effective control of these infections requires a global prevention strategy that implies close collaboration between epidemiologists, clinicians, bacteriologists, hygienists and the health care team.展开更多
Objectives: To study the reliability of a transcutaneous bilirubinometer (Bilicheck) to determine bilirubin levels in neonates consulting for jaundice in a Paediatric Emergency Department (ED), and to evaluate its use...Objectives: To study the reliability of a transcutaneous bilirubinometer (Bilicheck) to determine bilirubin levels in neonates consulting for jaundice in a Paediatric Emergency Department (ED), and to evaluate its usefulness as a screening method. Methods: Prospective observational study realized between June of 2005 and December of2005 inneonates consulting at a paediatric emergency department for jaundice, in whom we realized both transcutaneous and total serum bilirubin measurements (TcB and TSB). We collected demographic variables, analytical variables (serum and transcutaneous bilirubin levels), length of stay in the ED, and need for treatment. Results: 66 children were included aged 2 to 31 days (81% of the sample were 2 to 7 days old). There was a close and statistically significant correlation between TcB and TSB (r = 0.81, p < 0.001). The area under the ROC curve was of 0.90, allowing detecting newborns with jaundice susceptible of treatment with TcB levels ≥ 13 mg/dL (sensitivity 92%, specificity 63, 5%, a positive predictive value 39% and a negative predictive value 97%). The number of venous punctures could be reduced in 50%. The medium stay in the ED was of 2 hours when performing serum measurements. Conclusions: A linear correlation exists between TcB-TSB. TcB measurement cannot replace that of TsB, however it could be used as a screening method in an ED to determine which neonates need confirmation by TsB measurement. The use of transcutaneous bilirubinometer would reduce both the number of painful interventions in neonates and the medium length of stay in ED, consequently reducing iatrogenesis.展开更多
This study sought to investigate adverse drug event(ADE)signals associated with eltrombopag use in pediatric patients aged 0–18 years,utilizing data from the U.S.Food and Drug Administration Adverse Event Reporting S...This study sought to investigate adverse drug event(ADE)signals associated with eltrombopag use in pediatric patients aged 0–18 years,utilizing data from the U.S.Food and Drug Administration Adverse Event Reporting System(FAERS).By analyzing this extensive pharmacovigilance database,the study aimed to offer meaningful insights for improving the clinical safety of eltrombopag in children.Data covering eltrombopag-related ADEs from Q12004 to Q42023 were extracted from FAERS,and signal detection was conducted using both the reporting odds ratio(ROR)and proportional reporting ratio(PRR)methods.ADEs were categorized based on the System Organ Class(SOC)classification in MedDRA version 25.0.A total of 582 reports involving pediatric patients receiving eltrombopag were identified,encompassing 21 SOC categories.The analysis revealed that,in addition to the known ADEs listed in the drug label,clinicians should remain vigilant for potential off-label ADE signals.These included abnormal platelet counts,thrombocytosis,antiphospholipid syndrome,myelofibrosis,reduced serum iron levels,myelodysplastic syndrome,hepatic infections,and other related conditions.Given these findings,it is strongly recommended that serum iron and ferritin levels should be routinely monitored in pediatric patients undergoing eltrombopag therapy,particularly during long-term treatment.Such proactive surveillance may help prevent the onset of iron deficiency anemia and enhance overall treatment safety.展开更多
Nanomedicine has evolved significantly over the last decades and expanded its applications in pediatric oncology,which represents a special domain with unique patients and distinct requirements.The need for early canc...Nanomedicine has evolved significantly over the last decades and expanded its applications in pediatric oncology,which represents a special domain with unique patients and distinct requirements.The need for early cancer diagnosis andmore effective and targeted therapies aiming to increase the pediatric patients’survival rates andminimize the treatment-related side effects to survivors is profound.Nanoparticles(NPs)come as a beacon of hope to provide sensitive cancer diagnostic tools and assist contrast agents’transport to the malignant tumors.Besides,NPs could be designed to deliver targeted drugs and genes to tumors,minimizing the medicine-related toxicities.Metal and metal oxide NPs could be exploited as sensitizers to enhance chemotherapy and radiotherapy effects.Future research should emphasize pediatric models to gain secure results about NPs’safety and efficiency for pediatric cancer patients.This review presents the recent studies on the use of NPs in pediatric cancer management and highlights their impact on diagnosis,treatment outcomes,and the quality of life of the survivors.The purpose of this study is to investigate the benefits that may arise from the use of NPs in pediatric oncology,address the potential limitations and challenges,and discuss the needs for future research efforts.展开更多
Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was co...Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.展开更多
文摘Introduction: Children’s heart disease is a major public health problem in developing countries and especially in Mali. The purpose of our work was to determine frequency, different types of heart disease and their short term evolution in the pediatric department. Methods: We performed a retrospective study among children aged 0 to 15 years, hospitalized in the pediatric department from January to December 2015 and whose diagnosis was confirmed using trans-thoracic echocardiography. Results: We included 103 cases of heart disease out of a total of 8613 admissions in the pediatric department, giving an hospital prevalence of 1.2%. Mean age was 4.1 years (from 1 day to 15 years) and children under 5 years were the most affected with 73.80% of cases. Male predominance was noted (sex ratio = 1.2). Respiratory distress was the most common circumstance of discovery (93.20%). Cardiac murmur and tachycardia were the most common cardiac signs with respectively 88.35% and 83.50%. Congenital heart disease accounted for 70.87% and was dominated by ventricular septal defect (VSD) with 30.13%. Acquired heart disease (29.13% of the sample) was dominated by mitral regurgitation (MR) with 56.67%. Mortality rate was 31.9% for congenital heart disease and 11.1% for acquired heart disease. Conclusion: children’s heart disease is responsible for high mortality. Early detection improves the management of this pathology, which remains frequent.
文摘<strong>Introduction</strong><span style="font-family:Verdana;"><strong>: </strong></span><span style="font-family:Verdana;">According to Mali’s National Immunization Center, the</span><span style="font-family:""> <i><span style="font-family:Verdana;">Hae</span><span style="font-family:Verdana;">mophilus influenzae</span></i><span style="font-family:Verdana;"> b (Hib) vaccine coverage rate was 90% in 2015. Our</span><span style="font-family:Verdana;"> work aimed to study invasive bacterial infections due to </span><i><span style="font-family:Verdana;">Haemophilus influenzae</span></i><span style="font-family:Verdana;"> type b in children aged 0</span></span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">- 15 years hospitalized in the pediatrics department </span><span style="font-family:Verdana;">of the UH-GT</span></span><span style="font-family:Verdana;">. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">We carried out a retrospective descriptive study</span><span style="font-family:""><span style="font-family:Verdana;"> from January 2017 to December 2018 (</span><i><span style="font-family:Verdana;">i</span></i><span style="font-family:Verdana;">.</span><i><span style="font-family:Verdana;">e</span></i><span style="font-family:Verdana;">. 2 years) among children aged 0</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">15 years and hospitalized for </span><i><span style="font-family:Verdana;">Haemophilus influenzae</span></i><span style="font-family:Verdana;"> type b infection confirmed by culture (blood culture, Cerebro-spinal Fluid, and pleural and skin fluid).</span></span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Results</span></b><b><span style="font-family:Verdana;">: </span></b><span style="font-family:""><span style="font-family:Verdana;">Thirty-three cases of Hib infections were collected giving a </span><span style="font-family:Verdana;">frequency of 0.2% and the age group 3 months to 3 years was the most</span><span style="font-family:Verdana;"> affected (72.73%).</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">Children who received no vaccine accounted for 21.21%.</span><span style="font-family:""> </span><span style="font-family:Verdana;">The Cerebro-spinal Fluid culture and other samples (pleural and skin) identified the </span><span style="font-family:Verdana;">bacterium</span><span style="font-family:""> </span><span style="font-family:Verdana;">in 100% of cases, against 72.72% in the blood culture</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">Meningitis </span><span style="font-family:Verdana;">was the most frequent pathology (78.79%) and the lethality was high</span><span style="font-family:Verdana;"> (21.21%).</span></span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Despite the introduction of the Hib vaccine in the routine</span><span style="font-family:Verdana;"> immunization program in Mali, Hib infections remain with a high lethality linked to meningitis</span><span style="font-family:Verdana;">.</span>
文摘Objective: To study the pulmonary complications of major sickle cell syndromes in children aged 6 months to 15 years followed at the Department of Pediatrics of Gabriel Toure University Hospital. Materials and methods: This was a retrospective study from January 1<sup>st</sup>, 2017 to February 28, 2018 and a prospective study from March 1, 2018 to December 31, 2019, concerning sickle cell disease children followed at the Gabriel Touré University Hospital. All children with sickle cell disease confirmed by hemoglobin electrophoresis, aged 6 months to 15 years with a pulmonary complication and admitted to pediatrics were included. Were not included: 1) Infants and children with sickle cell disease not presenting a pulmonary complication coming only to their routine follow-up. 2) Sickle cell patients over 16 years of age and those whose parents do not consent. 3) Those who have not done electrophoresis. Results: During the study period, we were able to include 45 sickle cell children with a pulmonary complication. The frequency of pulmonary complications was 13.76%, involving homozygotes in 91.11% of cases. The age group 6 - 10 years predominated with 46.66% and the sex ratio was 0.45. Vaso-occlusive crisis was the most frequent reason for consultation with 35.56%. Respiratory distress (80%), fever (66.67%), crepitus rales (64.44%) and chest pain (60%) were the most frequent clinical signs. The main pulmonary complication was acute chest syndrome with 86.67%. Treatment was based on hydration (91.91%), analgesics (91.91%) and antibiotics (73.33%). Lethality was 4.44%. Conclusion: Pulmonary complications of sickle cell disease are serious and constitute the main cause of mortality in our context.
文摘Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with HIV infection followed up in the pediatric department of the Regional Teaching Hospital of Borgou/Alibori (CHUDB/A) the from 2005 to 2020. Patients and Method: This was a retrospective and descriptive study conducted in the pediatric department of CHUD/B-A in Parakou. All children with HIV infection who died from January 1, 2005 to August 31, 2020 were included. Data collection was carried out in three stages: a phase of medical records processing, a phase of community survey and a phase of death audits. The variables studied were sociodemographic, clinical, biological, therapeutic and evolutionary. Results: Over the study period, the data of 464 infected children were recorded, including 92 deaths, representing a case fatality rate of 19.83%. Severe acute malnutrition (69.23%), gastro-intestinal tract infections (43.58%) and serious opportunistic pulmonary infections (24.36% pulmonary tuberculosis and 19.23% pneumocystis) were the main causes of death. The main dysfunctions found were: the delayed diagnosis of HIV infection (79.35%), the absence or delay in consultation when the child’s clinical condition deteriorates (32.61% and 47.83%), delayed initiation of antiretroviral treatment (42.39%) and non-adherence to treatment (38.04%). Non-adherence to treatment was predominant in adolescents (90.49%). Conclusion: Specific interventions for early detection, adequate nutritional care, psychosocial support for adolescents and mothers of children are necessary to reduce mortality due to HIV among children and adolescents.
文摘Objectives: The main objective was to evaluate antibiotic prescribing in the Department of Pediatrics at Gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from September 1 to November 31, 2018, in the Department of Pediatrics at Gabriel Touré teaching hospital. All children aged 0 to 15 years hospitalized for any pathology during the study period and having received at least one antibiotic had been included. Results: We collected 445 children’s records out of 1032 admissions during the study period, representing a hospital frequency of 43.1%. The sex ratio was 1.3%. The 2 - 5 age group accounted for 48.1%. Fever was the reason for consultation in 45.6% of cases. Patients’ general condition was altered in 60% of cases. The fathers were blue-collar workers in 65.4% and the mothers housewives in 85%, and had no education in 42.9% and 64.5% respectively. Hepatomegaly was present in 18.2%, splenomegaly in 9.6% and peripheral adenopathy in 3.1%. The site of infection was pulmonary in 37.6% and ENT in 9.2%. Bacterial infection was assumed on admission in 54% of cases, and meningitis in 57.7%. The discharge diagnosis was malaria in 54.6%, severe acute malnutrition in 18.6% and meningitis in 6.7%. The death rate was 3.8%. Neutrophilic leukocytosis was present in 47.3% of patients. CRP was positive in 85% of patients. Blood cultures taken in 27.6% of patients were positive in 5. CSF analysis in 30% of patients showed elevated leukocytes in 6.5%. No cultures were positive. Antibiotic prescription was justified by infectious hypotheses in 43.1% of patients. β-lactam antibiotics were prescribed in 98.6%. Antibiotic therapy was not adapted to national/international recommendations in 68.3% of cases, and was not justified in 16.3% of cases on D5 of hospitalization. Conclusion: Antibiotic use was justified in more than half of patients, but remained inadequate in almost two-thirds of cases, in line with national and international recommendations.
文摘Context: The consequences of non-adherence to antiretroviral therapy (ART) are harmful in terms of morbidity and mortality among HIV-infected adolescents. There is a little data in this population in West Africa, about non-adherence to ART. Objective: To identify factors associated with non-adherence to ART in adolescents at the Pediatric Ambulatory Treatment Center (PATC) of the pediatric department of Yopougon University Hospital. Materials and Methods: A cross-sectional study was conducted from May to July 2017 among adolescents aged 10 to 19 years old at PATC of pediatrics department of Yopougon University Hospital. We have considered that adolescent was not adherent to ART when he affirm that he have not taking ART at least once in the week before the survey. A logistic regression model was used to identify factors associated with non-adherence to ART. Results: Overall 166 adolescents were included. The median age was 15 years old [IQI = 13 - 17 years]. They had a detectable viral load greater than 1000 copies/ml in 41.8% of cases. The rate of non-adherence to ART was 40.4%. The factors associated with non-adherence to ART were male [OR = 2.5 (CI = 1.1 - 10.0)], having parent widowed [OR = 7.8 (CI = 1.6 - 39.3)] or divorced [RC= 3.7 (IC=1.1 - 13.5)], CD4 inclusion rate ≥ 500 cells/ml [OR = 8.5 (CI = 1.6 - 45.5)] and duration on ART ≥ 10 years [OR = 8.9 (CI = 1.6 - 50)]. Conclusion: A rigorous therapeutic education taking into account associated factors in this study is necessary to reduce the rate of non-adherence among adolescents at PATC.
文摘Introduction: Cancellation of surgical operation is a surgical operation registered in the official schedule the day before or added to the list after and not carried out on the operating day. The purpose of this work was to determine the causes of cancellation of elective surgical operations in a major pediatric surgery department in Senegal. Patients and methods: It was a prospective and descriptive study of 278 patients scheduled during a period of 13 weeks. The study took place between April 3<sup>rd</sup>, 2017, and January 31<sup>st</sup>, 2018. Mean age was 2.9 years with extremes of 3 days and 15 years. The age group of 29 days to 30 months was the most represented (62.2%). Sex ratio was 1.41. Causes of cancellation were categorized into administrative and organizational causes, patient-related causes and staff-related causes. Results: Cancellation rate was 29.4%. Patient-related causes were most common (51.2%). Upper Respiratory tract infection (URTI) was commonest reason within this category (57.5%). Organizational causes (28.1%) came second and were mainly represented by the unavailability of the operating room (60.8%) related to breakdowns of anesthesia equipment. Finally, staff-related causes (20.7%) were due for most to the unavailability of the anesthesiologist (12 cases/17). Conclusion: Majority of causes that led to cancellation of elective surgical operations in our Pediatric surgery department are related to intercurrent illnesses affecting the patient, in particular URTI.
文摘<strong>Introduction:</strong> <span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The harmonious development of the intestinal microbiota</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> during the first 1000 days of life promotes the child</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">’</span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">s immediate and future good health. The objective of the study was to evaluate the knowledge and practices of health personnel on the intestinal microbiota and the first 1000 days of life </span><span style="font-family:Verdana;">for the improvement of child health.</span></span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Methods:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Knowledge, attitudes and</span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> practices (KAP) type survey conducted among health personnel of the pediatric </span><span style="font-family:Verdana;">and gynecology-obstetrics departments of the Bouaké University Hospital</span><span style="font-family:Verdana;"> from </span><span style="font-family:Verdana;">July 1 to 31, 2017. All consenting agents working in the said services and</span><span style="font-family:Verdana;"> present at the time of the study were included. The parameters studied concerned socio-professional characteristics, knowledge of the intestinal microbiota, and knowledge and practice of the first 1000 days. The data analysis was descriptive and analytical with a significance threshold p ≤ 0.05.</span></span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results:</span></b></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> Out of 224 active agents, 76 (30 men, 46 women) participated in the survey, </span><i><span style="font-family:Verdana;">i.e</span></i><span style="font-family:Verdana;">. 33.9%. The respondent came from the gynecology-obstetrics (54%) and pediatrics (46%) departments and had professional experience >5 years in 38%. Thirty-eight percent of the respondents had a good knowledge of the intestinal microbiota. Concerning the first 1000 days of life, 64.5% of the respondents had a good knowledge of the first 1000 days overall. They advised exclusive breastfeeding for up to 6 months in 95% of cases. When breastfeeding was not feasible, the main criterion for choosing the infant formula was </span><span style="font-family:Verdana;">the composition (57.1%). They proposed a standard infant formula (43%),</span></span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">enriched with prebiotic (29.4%), enriched with probiotic (21.6%),</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> a symbiotic (6%). Good knowledge of the intestinal microbiota was associated with belonging to the paediatric service (p</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">=</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">0.013), socio-professional category (p</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">=</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">0.031), year of experience >5 years (p</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">=</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">0.032) and the first 1000 days of life to year of experience >5 years (p</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.01). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The health personnel interviewed did not have a good knowledge of the intestinal microbiota and the first 1000 days. Capacity building is needed.</span></span></span></span>
文摘<strong>Introduction:</strong> <span style="font-family:""><span style="font-family:Verdana;">Respiratory distress (RD) is a major emergency to which infants are particularly vulnerable. It can lead to neurological sequelae and even death when treatment is not adequate and rapid. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To evaluate the management of RD in infants at the CNHU-HKM in Cotonou. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> The study was of a transversal and analytical nature and took place over a period of 06 months, from 1st January to 30th June 2015. Included in the study were all infants hospitalised for DR. The therapeutic modalities were analysed according to the recommendations of the World Health Organization. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 96 infants were included. The hospital frequency of DR was 38%. The average age was 12 months. One in 3 infants had SaO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> less than 90% on admission, and in 58.3% of cases, the infant showed at least 3 signs of struggle. The initial assessment was as recommended.</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">The systematic use of oxygenrequires a revision of the criteria for oxygentherapy in the unit</span><span style="font-family:""><span style="font-family:Verdana;">. The three main causes were severe pneumonia (31.3%), severe malaria (18.8%) and bronchiolitis (15.6%), and their treatment was correct. However, none of the infants had been able to benefit from ventilatory support. Mortality was high (31.2%) linked to the intensity of DR (p = 0.04) and sepsis (p = 0.006). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The procedures for the diagnosis and treatment of RD in infants at the CNHU are fairly consistent with WHO guidelines. Ventilatory support is necessary for some children with severe RD.</span></span>
文摘<strong>Introduction:</strong><b><span style="font-family:;" "=""> </span></b><span style="font-family:Verdana;">Scrotoschisis is a very rare congenital defect of the scrotum characterized by the exteriorization of one or two testes. We report a case of right scrotoschisis in a newborn as well as a review of the literature for an approach of probable etiology.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Patient and Observation:</span></b><b><span style="font-family:;" "=""> </span></b><span style="font-family:Verdana;">A newborn baby of 8 hours of life, weighing 3200</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">g was referred to our department for a right scrotal defect with exteriorization of the testis associated with fluid swelling of the left bursa. The 18-year-old mother, primiparous and primigeste followed all the prenatal consultations with eutocic delivery. After clinical investigation the diagnosis of right scrotosisis and left hydrocele was retained. Surgical treatment was carried out by primary closure after orchidopexy and exploration of the contralateral bursa, the content of which was calcified meconium bathed in a yellowish liquid. The post-operative consequences were simple.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><b><span style="font-family:;" "=""> </span></b><span style="font-family:Verdana;">Scrotoschisis is an extremely rare birth defect whose etiology is poorly understood. However, it could be the cause of meconium peritonitis secondary to a scarred f</span><span style="font-family:Verdana;">a</span><span style="font-family:Verdana;">tal intestinal perforation.</span>
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Trauma is a physical injury caused by violence or other forces;in serious trauma, the patient will be at risk of death or loss of function. Trauma is a leading cause of morbidity and mortality among all age groups. Objective: To study the pattern and outcome of upper limbs trauma in children attending the pediatric emergency department. Methodology: This was a retrospective cross-sectional study conducted in the Department of Pediatrics at Security Forces Hospital-Al-Riyadh. Result: Total number of patients seen during the study period was 343 patients, their age range between 6 months and 13 years old with a mean age of 5.473 (±3.8572);also, results showed boys were 187 (54.5%) patients and girls were 156 (45.5%) patients. Based on the site of trauma in the upper limbs, lacerations were in 114 (33.2%), Hand and/or wrist fracture in 67 (19.5%), Nursemaid Elbow in 43 (12.5%), both Radius and Ulnar bones fracture in 33 (9.6%), Radius bone fracture in 29 (8.5%), supracondylar fracture in 22 (6.4%), Clavicle bone fracture in 20 (5.8%), Humorous bone fracture in 7 (2%), Condylar bone fracture 6 (1.7%), and there was 1 (0.3%) patient with Scapulae and Ulna fracture.
文摘Introduction: The United Nations Sustainable Development Goals (SDGs) aim to decrease the global maternal mortality ratio to below 70 per 100,000 live births and eliminate preventable deaths of newborns and children under the age of five in all countries by 2030. The pediatric department at Spécialisé Mère-Enfant Blanche Gomes Hospital (HSMEBG) is divided into two sectors, one catering to children aged one month to four years and the other dedicated to children aged five to 17 years. According to department records, over the past three years, there has been an average of 1050 hospitalizations per year, with an average duration of five days. Objectives: This study aims to describe the socio-demographic characteristics of children who died while in the pediatrics department of the HSMEBG and analyze the factors associated with their deaths. Methodology: A retrospective analytical cross-sectional study was conducted, collecting data over a three-year period, covering the years 2019, 2020 and 2021. Data were collected from medical records of deceased children using Excel software version 2016, and statistical calculations and logistic regression were performed using Epi info software version 7.2.5.0. Results: During the three years of operation, the pediatric department at HSMEBG recorded 3060 new admissions, of which 271 resulted in death, representing an overall frequency of 8.8%. December and January had the highest mortality rates, accounting for 15.5% and 12.5%, respectively. Out of the 271 recorded deaths, 143 (52.77%) occurred in children under the age of one, and 230 (84.87%) occurred in children under the age of five. The average age at death was 2.4 years, ranging from one month to 17 years. The sex ratio was 1. More than half of the deaths (51.66%) occurred during the night, and 165 (60.89%) sought medical help more than three days after the onset of symptoms. Weekend deaths accounted for nearly half (45.7%) of the cases. Upon admission, slightly over half of the children (55.72%) had impaired consciousness, 219 (80.81%) presented with respiratory distress, and 194 (71.59%) had a fever. The average time from admission to administering the first medication was 72 minutes. Respiratory infections were the leading cause of death, accounting for 83 (30.26%) cases, followed by severe forms of malaria (anemic and neurological) at 23.25%. Among the 271 recorded deaths, 33 (12.18%) received no treatment before their demise, and 136 (50.18%) died within the first 24 hours of hospitalization. The average duration of hospitalization for patients who spent less than 24 hours was 15 hours, while those who died after the 24th hour had an average hospital stay of five days, ranging from one to 41 days. Children under the age of five who were admitted with impaired consciousness had roughly double the risk of dying compared to those without this condition (p = 0.001). Conclusion: The overall mortality rate in the pediatric department at HSMEBG is 8.8%. Acute respiratory infections are the primary cause of death. Improving this rate necessitates reducing consultation and treatment durations.
文摘Introduction: Popliteal pterygium syndrome is a rare birth defect, combining craniofacial, genitourinary and musculoskeletal abnormalities. It is an autosomal dominant disease caused by a mutation in the IRF6 gene. We report in this observation the 1<sup>st</sup> Guinean case corrected by the surgical method as well as a review of the literature for a diagnostic and therapeutic approach. Patient and observation: We present the case of a 7-day old male newborn weighing 2700 g who was received for bilateral cleft lip and palate, lower lip fossa or sinuses, bilateral popliteal pterygium, and triangular skin fold above the hallux. The patient underwent several surgical procedures aimed at correcting these abnormalities. The correction of the pterygium of the lower limbs was ensured by excision of the fibrous band, the tenoplasty in z of the calcaneal tendon on the right side and the skin plasty in z in series then immobilized by plaster splints. The immediate postoperative follow-up was straightforward. Conclusion: Popliteal pterygium syndrome is a rare congenital malformation, the diagnosis is primarily clinical. Early soft tissue lengthening surgery and serial z-skin plasty provide better correction of the knee pterygium. Correct correction of facial abnormalities gives the child a better appearance. The management of this syndrome is multidisciplinary.
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Background: Urinary tract infection (UTI) is one of the most frequent bacterial infections in pediatrics. The aim of our work was to establish the epidemiological and bacteriological profile of UTIs in children and then to study the sensitivity of the bacterial strains isolated to antibiotics. Materials and methods: This is a retrospective descriptive study over 3 years (2019-2022), including all cytobacteriological examination of urine (CBEU), performed in children aged 3 months to 14 years, admitted and treated for UTI, in the pediatric emergency department of Mohamed VI University Hospital. Results: A total of 239 children were included in our study. The mean age was 26 months. The sex ratio was 1.08. Escherichia coli was the most isolated bacterial strain in 79% of samples. The tested strains showed a high level of sensitivity to susceptibility rate toward amikacin (91%) and ciprofloxacin (100%) and whereas the level of resistance was high to the most current recommended antibiotics, mainly beta-lactams. Management was based, in severe forms of pyelonephritis, dual antibiotic therapy based on Third-generation cephalosporins combined with gentamycin. Favorable outcome was noted in 94% of children. Conclusion: Awareness-raising on the proper use of antibiotics, issuing national recommendations for the treatment of urinary tract infections in order to standardize therapeutic regimens is strongly recommended. Effective control of these infections requires a global prevention strategy that implies close collaboration between epidemiologists, clinicians, bacteriologists, hygienists and the health care team.
文摘Objectives: To study the reliability of a transcutaneous bilirubinometer (Bilicheck) to determine bilirubin levels in neonates consulting for jaundice in a Paediatric Emergency Department (ED), and to evaluate its usefulness as a screening method. Methods: Prospective observational study realized between June of 2005 and December of2005 inneonates consulting at a paediatric emergency department for jaundice, in whom we realized both transcutaneous and total serum bilirubin measurements (TcB and TSB). We collected demographic variables, analytical variables (serum and transcutaneous bilirubin levels), length of stay in the ED, and need for treatment. Results: 66 children were included aged 2 to 31 days (81% of the sample were 2 to 7 days old). There was a close and statistically significant correlation between TcB and TSB (r = 0.81, p < 0.001). The area under the ROC curve was of 0.90, allowing detecting newborns with jaundice susceptible of treatment with TcB levels ≥ 13 mg/dL (sensitivity 92%, specificity 63, 5%, a positive predictive value 39% and a negative predictive value 97%). The number of venous punctures could be reduced in 50%. The medium stay in the ED was of 2 hours when performing serum measurements. Conclusions: A linear correlation exists between TcB-TSB. TcB measurement cannot replace that of TsB, however it could be used as a screening method in an ED to determine which neonates need confirmation by TsB measurement. The use of transcutaneous bilirubinometer would reduce both the number of painful interventions in neonates and the medium length of stay in ED, consequently reducing iatrogenesis.
文摘This study sought to investigate adverse drug event(ADE)signals associated with eltrombopag use in pediatric patients aged 0–18 years,utilizing data from the U.S.Food and Drug Administration Adverse Event Reporting System(FAERS).By analyzing this extensive pharmacovigilance database,the study aimed to offer meaningful insights for improving the clinical safety of eltrombopag in children.Data covering eltrombopag-related ADEs from Q12004 to Q42023 were extracted from FAERS,and signal detection was conducted using both the reporting odds ratio(ROR)and proportional reporting ratio(PRR)methods.ADEs were categorized based on the System Organ Class(SOC)classification in MedDRA version 25.0.A total of 582 reports involving pediatric patients receiving eltrombopag were identified,encompassing 21 SOC categories.The analysis revealed that,in addition to the known ADEs listed in the drug label,clinicians should remain vigilant for potential off-label ADE signals.These included abnormal platelet counts,thrombocytosis,antiphospholipid syndrome,myelofibrosis,reduced serum iron levels,myelodysplastic syndrome,hepatic infections,and other related conditions.Given these findings,it is strongly recommended that serum iron and ferritin levels should be routinely monitored in pediatric patients undergoing eltrombopag therapy,particularly during long-term treatment.Such proactive surveillance may help prevent the onset of iron deficiency anemia and enhance overall treatment safety.
文摘Nanomedicine has evolved significantly over the last decades and expanded its applications in pediatric oncology,which represents a special domain with unique patients and distinct requirements.The need for early cancer diagnosis andmore effective and targeted therapies aiming to increase the pediatric patients’survival rates andminimize the treatment-related side effects to survivors is profound.Nanoparticles(NPs)come as a beacon of hope to provide sensitive cancer diagnostic tools and assist contrast agents’transport to the malignant tumors.Besides,NPs could be designed to deliver targeted drugs and genes to tumors,minimizing the medicine-related toxicities.Metal and metal oxide NPs could be exploited as sensitizers to enhance chemotherapy and radiotherapy effects.Future research should emphasize pediatric models to gain secure results about NPs’safety and efficiency for pediatric cancer patients.This review presents the recent studies on the use of NPs in pediatric cancer management and highlights their impact on diagnosis,treatment outcomes,and the quality of life of the survivors.The purpose of this study is to investigate the benefits that may arise from the use of NPs in pediatric oncology,address the potential limitations and challenges,and discuss the needs for future research efforts.
文摘Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.
