With the deepening of education digitization and the construction of new medical disciplines,the limitations of traditional medical education models in resource integration,teaching collaboration,and cross-regional de...With the deepening of education digitization and the construction of new medical disciplines,the limitations of traditional medical education models in resource integration,teaching collaboration,and cross-regional development have become increasingly prominent.This article focuses on the innovation of the medical education system in the information age,taking the construction of a clinical virtual teaching and research office in pediatrics as a practical sample,systematically exploring the construction logic and implementation path of a new type of grass-roots teaching organization.The study points out that the virtual teaching and research office forms a“four-in-one”logical framework by reconstructing its target positioning,organizational structure,and operational guarantee mechanism:taking medical-educational collaboration as the core goal,following the principles of cross-domain linkage and resource sharing,establishing a multi-level collaboration network,and achieving sustainable operation through institutional innovation and technological empowerment.展开更多
Fever is the primary reason for consultation and admission to pediatric emergency departments. The aim of this study was to describe the clinical, etiological and prognostic aspects of acute fever in children aged 0 -...Fever is the primary reason for consultation and admission to pediatric emergency departments. The aim of this study was to describe the clinical, etiological and prognostic aspects of acute fever in children aged 0 - 15 years. Patients and Methods: This was a prospective cross-sectional study from April 1, 2021 to March 31, 2022 and affected all children aged 0 to 15 years old with a temperature of 39˚C or higher (≥), having less than five days and hospitalized in the pediatric department of the Gabriel Touré University Hospital. Results: During the study period, 150 children were included, the sex-ratio was 0.85. Children aged 0 - 5 years represented 71.4% of the sample. References represented more than half of the sample, or 58% of cases. Body temperature was above 40˚C in 18.7% of cases. Functional signs were dominated by respiratory signs in 28% and digestive signs in 18%. Clinical pallor was found in 55.3% of children associated with signs of respiratory struggle in 70% of cases and tachycardia in 40% of patients. Anemia was present in 65.3% of patients. Hyperleucocytosis and leukopenia were found in 45.3% and 43.3% of patients respectively. The C-reactive protein was positive in 44.7% of patients and Cytobacteriological Examination and Chemistry of Cerebrospinal Fluid was positive in 8.7% of cases. The thick drop was positive in 44.7% of patients and blood cultures grew in 6 patients. Etiology was dominated by severe malaria 54 cases (36%), pneumonia (19.3%), meningitis (12.6%), and in those under one month it was bacterial neonatal infection (8.6%). In our study, slightly more than one patient out of three died during hospitalization, 36% (54 cases/150) and among these 70% (38 cases/54) were under 5 years old. The most lethal pathologies were severe malaria (36%), bacterial pneumonia (19.3%), meningitis (12.6%), bacterial neonatal infections (8.6%) and measles complicated by pneumonia (5.3%). Mortality during hospitalization was 36% of deaths (54 out of 150 patients) and 70.3% (38/54) of the deceased patients were under 5 years old. Conclusion: This study shows that fever is a frequent symptom and a sign of serious and very lethal pathologies. The cause of fever can be a diagnostic challenge for health workers. However, early identification of children at risk for serious illness could allow for prompt and appropriate management in appropriate settings.展开更多
Background: One of the most common viral infections occurring in atopic dermatitis (AD) patients is eczema herpeticum (EH): herpes simplex virus (HSV) skin infection. Despite being comparatively uncommon affecting jus...Background: One of the most common viral infections occurring in atopic dermatitis (AD) patients is eczema herpeticum (EH): herpes simplex virus (HSV) skin infection. Despite being comparatively uncommon affecting just 3% of AD patients, EH can progress from a local disease to a potentially fatal systemic infection. Up till now, the pathophysiology of EH is mainly unclear. Case Report: We report the case of a 2-year-old boy who was well-vaccinated and had a history of untreated atopic dermatitis from infancy and presented to the emergency department with increasingly itchy diffuse lesions, red eyes, profuse tearing, chills and malaise. The diagnosis of EH with bilateral ocular involvement was highly suspected. The patient had received intravenous acyclovir with a notable clinical improvement and a complete remission at the two-week follow-up.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
Transjugular intrahepatic portosystemic shunt(TIPS)placement is a standard procedure for the treatment of portal hypertension complications.When this conventional approach is not feasible,alternative procedures for sy...Transjugular intrahepatic portosystemic shunt(TIPS)placement is a standard procedure for the treatment of portal hypertension complications.When this conventional approach is not feasible,alternative procedures for systemic diversion of portal blood have been proposed.A one-step interventional approach,combining minilaparotomy-assisted transmesenteric(MAT)antegrade portal recanalization and TIPS,is described in an adolescent with recurrent esophageal varice bleeding and portal cavernoma(PC).A 16-yearold girl was admitted to our Unit because of repeated bleeding episodes over a short period of time due to esophageal varices in the context of a PC.A portal vein recanalization through an ileocolic vein isolation with the MAT approach followed by TIPS during the same session was performed.In the case of failed portal recanalization,this approach,would also be useful for varice endovascular embolization.Postoperative recovery was uneventful.Treatment consisting of propanolol,enoxaparin and a proton pump inhibitor was prescribed after the procedure.One month post-op,contrast enhanced computed tomography confirmed the patency of the portal and intrahepatic stent grafts.No residual peritoneal fluid was detected nor opacification of the large varices.Endoscopy showed good improvement of the varices.Doppler ultrasound confirmed the accelerated flow in the portal stent and hepatopetal flow inside the intrahepatic portal branches.Three months post-op,TIPS maintained its hourglass shape despite a slight expansion.Portal hypertension and life threatening conditions related to PC would benefit from one-step portal recanalization.MAT-TIPS is feasible and safe for the treatment of PC even in children.This minimally invasive procedure avoids or delays surgical treatment or re-transplantation when necessary in pediatric patients.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
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
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
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
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 sed...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
1 Introduction Kounis syndrome constitutes a coronary hypersensitivity disorder defined by the association of an anaphylactoid,anaphylactic,allergic or hypersensitivity reaction with an acute coronary syndrome,in a ph...1 Introduction Kounis syndrome constitutes a coronary hypersensitivity disorder defined by the association of an anaphylactoid,anaphylactic,allergic or hypersensitivity reaction with an acute coronary syndrome,in a physiopathological context involving various interrelated and interacting inflammatory cells,such as mast-cells,eosinophils and platelets.[1,2]Similar entities to Kounis syndrome might involve cerebral and mesenteric arteries.展开更多
Context: Seizures rank high among the commonest emergencies encountered in Pediatrics. As far as the etiologies are concerned, the most frequently confronted cause is infectious diseases. Therefore, particularly in th...Context: Seizures rank high among the commonest emergencies encountered in Pediatrics. As far as the etiologies are concerned, the most frequently confronted cause is infectious diseases. Therefore, particularly in the present work context, febrile seizures have been inadequately investigated. The study aimed at assessing the prevalence of febrile convulsions in our pediatrics department. Materials and Methods: This retrospective study was performed in the Pediatrics Medical Service Department of the Pediatrics University Hospital Charles de Gaulle of Ouagadougou in Burkina Faso (West Africa). Infants from one and thirty months of age, hospitalized between January 1, 2011 and December 31, 2012, were included in this study. Seizures are defined as those who accompany fevers above or equal to 38°C. However, the exclusions from the study included those infants recognized as epileptics;those with abnormal psychomotor development;those afflicted with encephalitis and meningitis;and children with hypoglycemia or dehydration with ionic disorders, as well as those infants who lacked lumbar puncture results. Data were analyzed using the Epi Info software version 3.5.1. Results: While the average age of the patients was 13 months, the average incidence of the febrile seizures was 2.5%. The seizures occurred all through the year, peaking in October (14.1%). The peak frequency (38.7%) was recorded in children from 12 to 24 months. About one-half of the patients (46.2%) registered a temperature from 38.5°C to 39.4°C. In 68.9% of the cases, the tonic convulsions were of the common type of convulsions. The number of convulsions was in the range of >2 episodes/24 h in 83.3% of the children. The pathologies commonly associated with tonic convulsions included acute gastroenteritis (29.4%), malaria (25.8%) and bronchopneumopathies (23.3%). The evolution was favorable in 95.3% of the cases. Conclusion: While this study confirms the benign character of the febrile convulsions, their recurrent quality necessitates the codification of a prospective study, for clearer identification and closer case monitoring.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
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
In order to contribute to reduction of morbidity and mortality due to low acute respiratory infections in pediatrics, the objective of this study was to determine the epidemiological profile and to identify the factor...In order to contribute to reduction of morbidity and mortality due to low acute respiratory infections in pediatrics, the objective of this study was to determine the epidemiological profile and to identify the factors favoring and those associated with the risk of deceased. We reviewed the cases of children aged between 1 and 59 months hospitalized between January and December 2015 in the pediatric intensive care unit of the CHU of Brazzaville and retained those whose diagnosis of discharge was an ALRI. The study variables were: epidemiological, clinical, paraclinic, diagnostic, therapeutic and evolutionary. For 2012 hospitalized children, 400 (19.8%) were hospitalized for an ALRI. There were 235 boys (58.8%) and 165 girls (41.2%) of average age. Infants aged 1 to 11 months were the most affected n = 260 (65%). They were insufficiently immunized with haemophilus influenza B and pneumococcus n = 378 (94.5%);Fully immunized n = 20 (5%), the average delay for consultation after the first symptom was 5.03 ± 3.86 days;Denutrition was rated n = 180 (45%), positive retroviral serology n = 19 cases (4.8%). The main nosological varieties were: bronchiolitis n = 223 (55.7%), pneumonia n = 145 (36.2%). One death was rated n = 65 (16.3%). The mortality determinants were: prematurity, vaccination status and HIV/AIDS infection. The frequency and severity of ALRIs necessitates a strengthened program of integrated management of childhood illnesses, and public health actions targeting the factors that promote and contribute to the risk of death.展开更多
<strong>Introduction:</strong><span style="font-family:""><span style="font-family:Verdana;"> Retinoblastoma is one of the pediatric malignancies and its treatment is s...<strong>Introduction:</strong><span style="font-family:""><span style="font-family:Verdana;"> Retinoblastoma is one of the pediatric malignancies and its treatment is still challenging. The objective of this study was to highlight the sociodemographic, clinical, and therapeutic aspects of retinoblastoma at the Donka Paediatric Haematology/Oncology unit in Donka university hospital, Guinea, and thereby highlight the conditions of this malignancy in this country. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was a retrospective study over 3 years (January 1, 2017 to December 31, 2019). The study population was all retinoblastoma patients who were treated in this unit. Socio-demographic, clinical, and therapeutic data were analyzed. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of 210 pediatric patients followed up for cancer in this unit during the period, retinoblastoma accounted for 46 (22%). The patient age at diagnosis was 35.17 months (range: 3 - 132 months). At admission, metastases were observed in 16 patients (35%): 14 with brain metastases and 2 with lymph node metastases. Preoperative chemotherapy was employed in 38 (83%), tumor resection was performed in 20 patients (43%), and postoperative chemotherapy was performed in 19 patients. As for the prognosis, remission in 9, death in 14, and treatment discontinuation in 15. Only one patient had health insurance (2%). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> In this region of Guinea, retinoblastoma is the most common ocular tumor in children. Its diagnosis is easy: strabismus and leukocoria are the early signs of retinoblastoma. The prognosis depends on how early the diagnosis is made. Physicians, care-givers, and family members should be aware of the nature of this malignancy and social education/message as such is necessary.</span></span>展开更多
Objective: The main objective was to study the disturbances of the Blood Count of children hospitalized in the general pediatric of the Gabriel Touré teaching hospital. Methods: This was a prospective and descrip...Objective: The main objective was to study the disturbances of the Blood Count of children hospitalized in the general pediatric of the Gabriel Touré teaching hospital. Methods: This was a prospective and descriptive study conducted from September 1 to November 30, 2018 in the general pediatrics department of the Gabriel Touré teaching hospital in Bamako. Data were collected on patient records using a survey sheet. Results: We collected 512 files of children out of 1030 admissions during the study period;the rate of completion of the blood count is 50%. The male sex was predominant with a sex ratio of 1.3. The majority of patients were under 5 years old (58%). The majority of fathers (56%) and mothers (64%) of children had no education;they are mainly farmers (61%) and housewives (88%). Pallor was the reason for consultation in 29% of patients and present in 60%. On blood count, anemia was present in 92% of patients, half of whom (50%) had severe anemia with a hemoglobin level below 7 g/dL. The anemia was mainly microcytic (72%) and hypochromic (66%). Hyperleukocytosis (62%), eosinophilia (68%) and basophilia (58%) were the abnormalities observed in the white line. Thrombocytopenia accounted for 40%. Severe malaria (53%) was the main discharge diagnosis and almost all patients (99%) were alive at discharge. Conclusion: The characteristics of anemia require a study of the complete blood count in healthy children with dosage of serum iron and ferritin for a better understanding of the phenomenon.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
基金Teaching and Research Project on Education and Teaching of Shanxi Medical University(Project No.:XJ2024030)。
文摘With the deepening of education digitization and the construction of new medical disciplines,the limitations of traditional medical education models in resource integration,teaching collaboration,and cross-regional development have become increasingly prominent.This article focuses on the innovation of the medical education system in the information age,taking the construction of a clinical virtual teaching and research office in pediatrics as a practical sample,systematically exploring the construction logic and implementation path of a new type of grass-roots teaching organization.The study points out that the virtual teaching and research office forms a“four-in-one”logical framework by reconstructing its target positioning,organizational structure,and operational guarantee mechanism:taking medical-educational collaboration as the core goal,following the principles of cross-domain linkage and resource sharing,establishing a multi-level collaboration network,and achieving sustainable operation through institutional innovation and technological empowerment.
文摘Fever is the primary reason for consultation and admission to pediatric emergency departments. The aim of this study was to describe the clinical, etiological and prognostic aspects of acute fever in children aged 0 - 15 years. Patients and Methods: This was a prospective cross-sectional study from April 1, 2021 to March 31, 2022 and affected all children aged 0 to 15 years old with a temperature of 39˚C or higher (≥), having less than five days and hospitalized in the pediatric department of the Gabriel Touré University Hospital. Results: During the study period, 150 children were included, the sex-ratio was 0.85. Children aged 0 - 5 years represented 71.4% of the sample. References represented more than half of the sample, or 58% of cases. Body temperature was above 40˚C in 18.7% of cases. Functional signs were dominated by respiratory signs in 28% and digestive signs in 18%. Clinical pallor was found in 55.3% of children associated with signs of respiratory struggle in 70% of cases and tachycardia in 40% of patients. Anemia was present in 65.3% of patients. Hyperleucocytosis and leukopenia were found in 45.3% and 43.3% of patients respectively. The C-reactive protein was positive in 44.7% of patients and Cytobacteriological Examination and Chemistry of Cerebrospinal Fluid was positive in 8.7% of cases. The thick drop was positive in 44.7% of patients and blood cultures grew in 6 patients. Etiology was dominated by severe malaria 54 cases (36%), pneumonia (19.3%), meningitis (12.6%), and in those under one month it was bacterial neonatal infection (8.6%). In our study, slightly more than one patient out of three died during hospitalization, 36% (54 cases/150) and among these 70% (38 cases/54) were under 5 years old. The most lethal pathologies were severe malaria (36%), bacterial pneumonia (19.3%), meningitis (12.6%), bacterial neonatal infections (8.6%) and measles complicated by pneumonia (5.3%). Mortality during hospitalization was 36% of deaths (54 out of 150 patients) and 70.3% (38/54) of the deceased patients were under 5 years old. Conclusion: This study shows that fever is a frequent symptom and a sign of serious and very lethal pathologies. The cause of fever can be a diagnostic challenge for health workers. However, early identification of children at risk for serious illness could allow for prompt and appropriate management in appropriate settings.
文摘Background: One of the most common viral infections occurring in atopic dermatitis (AD) patients is eczema herpeticum (EH): herpes simplex virus (HSV) skin infection. Despite being comparatively uncommon affecting just 3% of AD patients, EH can progress from a local disease to a potentially fatal systemic infection. Up till now, the pathophysiology of EH is mainly unclear. Case Report: We report the case of a 2-year-old boy who was well-vaccinated and had a history of untreated atopic dermatitis from infancy and presented to the emergency department with increasingly itchy diffuse lesions, red eyes, profuse tearing, chills and malaise. The diagnosis of EH with bilateral ocular involvement was highly suspected. The patient had received intravenous acyclovir with a notable clinical improvement and a complete remission at the two-week follow-up.
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Transjugular intrahepatic portosystemic shunt(TIPS)placement is a standard procedure for the treatment of portal hypertension complications.When this conventional approach is not feasible,alternative procedures for systemic diversion of portal blood have been proposed.A one-step interventional approach,combining minilaparotomy-assisted transmesenteric(MAT)antegrade portal recanalization and TIPS,is described in an adolescent with recurrent esophageal varice bleeding and portal cavernoma(PC).A 16-yearold girl was admitted to our Unit because of repeated bleeding episodes over a short period of time due to esophageal varices in the context of a PC.A portal vein recanalization through an ileocolic vein isolation with the MAT approach followed by TIPS during the same session was performed.In the case of failed portal recanalization,this approach,would also be useful for varice endovascular embolization.Postoperative recovery was uneventful.Treatment consisting of propanolol,enoxaparin and a proton pump inhibitor was prescribed after the procedure.One month post-op,contrast enhanced computed tomography confirmed the patency of the portal and intrahepatic stent grafts.No residual peritoneal fluid was detected nor opacification of the large varices.Endoscopy showed good improvement of the varices.Doppler ultrasound confirmed the accelerated flow in the portal stent and hepatopetal flow inside the intrahepatic portal branches.Three months post-op,TIPS maintained its hourglass shape despite a slight expansion.Portal hypertension and life threatening conditions related to PC would benefit from one-step portal recanalization.MAT-TIPS is feasible and safe for the treatment of PC even in children.This minimally invasive procedure avoids or delays surgical treatment or re-transplantation when necessary in pediatric patients.
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1 Introduction Kounis syndrome constitutes a coronary hypersensitivity disorder defined by the association of an anaphylactoid,anaphylactic,allergic or hypersensitivity reaction with an acute coronary syndrome,in a physiopathological context involving various interrelated and interacting inflammatory cells,such as mast-cells,eosinophils and platelets.[1,2]Similar entities to Kounis syndrome might involve cerebral and mesenteric arteries.
文摘Context: Seizures rank high among the commonest emergencies encountered in Pediatrics. As far as the etiologies are concerned, the most frequently confronted cause is infectious diseases. Therefore, particularly in the present work context, febrile seizures have been inadequately investigated. The study aimed at assessing the prevalence of febrile convulsions in our pediatrics department. Materials and Methods: This retrospective study was performed in the Pediatrics Medical Service Department of the Pediatrics University Hospital Charles de Gaulle of Ouagadougou in Burkina Faso (West Africa). Infants from one and thirty months of age, hospitalized between January 1, 2011 and December 31, 2012, were included in this study. Seizures are defined as those who accompany fevers above or equal to 38°C. However, the exclusions from the study included those infants recognized as epileptics;those with abnormal psychomotor development;those afflicted with encephalitis and meningitis;and children with hypoglycemia or dehydration with ionic disorders, as well as those infants who lacked lumbar puncture results. Data were analyzed using the Epi Info software version 3.5.1. Results: While the average age of the patients was 13 months, the average incidence of the febrile seizures was 2.5%. The seizures occurred all through the year, peaking in October (14.1%). The peak frequency (38.7%) was recorded in children from 12 to 24 months. About one-half of the patients (46.2%) registered a temperature from 38.5°C to 39.4°C. In 68.9% of the cases, the tonic convulsions were of the common type of convulsions. The number of convulsions was in the range of >2 episodes/24 h in 83.3% of the children. The pathologies commonly associated with tonic convulsions included acute gastroenteritis (29.4%), malaria (25.8%) and bronchopneumopathies (23.3%). The evolution was favorable in 95.3% of the cases. Conclusion: While this study confirms the benign character of the febrile convulsions, their recurrent quality necessitates the codification of a prospective study, for clearer identification and closer case monitoring.
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.
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In order to contribute to reduction of morbidity and mortality due to low acute respiratory infections in pediatrics, the objective of this study was to determine the epidemiological profile and to identify the factors favoring and those associated with the risk of deceased. We reviewed the cases of children aged between 1 and 59 months hospitalized between January and December 2015 in the pediatric intensive care unit of the CHU of Brazzaville and retained those whose diagnosis of discharge was an ALRI. The study variables were: epidemiological, clinical, paraclinic, diagnostic, therapeutic and evolutionary. For 2012 hospitalized children, 400 (19.8%) were hospitalized for an ALRI. There were 235 boys (58.8%) and 165 girls (41.2%) of average age. Infants aged 1 to 11 months were the most affected n = 260 (65%). They were insufficiently immunized with haemophilus influenza B and pneumococcus n = 378 (94.5%);Fully immunized n = 20 (5%), the average delay for consultation after the first symptom was 5.03 ± 3.86 days;Denutrition was rated n = 180 (45%), positive retroviral serology n = 19 cases (4.8%). The main nosological varieties were: bronchiolitis n = 223 (55.7%), pneumonia n = 145 (36.2%). One death was rated n = 65 (16.3%). The mortality determinants were: prematurity, vaccination status and HIV/AIDS infection. The frequency and severity of ALRIs necessitates a strengthened program of integrated management of childhood illnesses, and public health actions targeting the factors that promote and contribute to the risk of death.
文摘<strong>Introduction:</strong><span style="font-family:""><span style="font-family:Verdana;"> Retinoblastoma is one of the pediatric malignancies and its treatment is still challenging. The objective of this study was to highlight the sociodemographic, clinical, and therapeutic aspects of retinoblastoma at the Donka Paediatric Haematology/Oncology unit in Donka university hospital, Guinea, and thereby highlight the conditions of this malignancy in this country. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was a retrospective study over 3 years (January 1, 2017 to December 31, 2019). The study population was all retinoblastoma patients who were treated in this unit. Socio-demographic, clinical, and therapeutic data were analyzed. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of 210 pediatric patients followed up for cancer in this unit during the period, retinoblastoma accounted for 46 (22%). The patient age at diagnosis was 35.17 months (range: 3 - 132 months). At admission, metastases were observed in 16 patients (35%): 14 with brain metastases and 2 with lymph node metastases. Preoperative chemotherapy was employed in 38 (83%), tumor resection was performed in 20 patients (43%), and postoperative chemotherapy was performed in 19 patients. As for the prognosis, remission in 9, death in 14, and treatment discontinuation in 15. Only one patient had health insurance (2%). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> In this region of Guinea, retinoblastoma is the most common ocular tumor in children. Its diagnosis is easy: strabismus and leukocoria are the early signs of retinoblastoma. The prognosis depends on how early the diagnosis is made. Physicians, care-givers, and family members should be aware of the nature of this malignancy and social education/message as such is necessary.</span></span>
文摘Objective: The main objective was to study the disturbances of the Blood Count of children hospitalized in the general pediatric of the Gabriel Touré teaching hospital. Methods: This was a prospective and descriptive study conducted from September 1 to November 30, 2018 in the general pediatrics department of the Gabriel Touré teaching hospital in Bamako. Data were collected on patient records using a survey sheet. Results: We collected 512 files of children out of 1030 admissions during the study period;the rate of completion of the blood count is 50%. The male sex was predominant with a sex ratio of 1.3. The majority of patients were under 5 years old (58%). The majority of fathers (56%) and mothers (64%) of children had no education;they are mainly farmers (61%) and housewives (88%). Pallor was the reason for consultation in 29% of patients and present in 60%. On blood count, anemia was present in 92% of patients, half of whom (50%) had severe anemia with a hemoglobin level below 7 g/dL. The anemia was mainly microcytic (72%) and hypochromic (66%). Hyperleukocytosis (62%), eosinophilia (68%) and basophilia (58%) were the abnormalities observed in the white line. Thrombocytopenia accounted for 40%. Severe malaria (53%) was the main discharge diagnosis and almost all patients (99%) were alive at discharge. Conclusion: The characteristics of anemia require a study of the complete blood count in healthy children with dosage of serum iron and ferritin for a better understanding of the phenomenon.
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.
