Quick Search
  Home Journal Information Current Issue Past Issues Services Contact Us  
Vol 5, No 1
Vol 5, No 1 February 2009 ISSN 1708-8569
 
Review articles
Original articles
Clinical summary
Clinical images
Case reports
   
Review articles:
Psychological impact of disasters on children: review of assessment and interventions
  Nilamadhab Kar
 

Wolverhampton, United Kingdom

Author Affiliations: Wolverhampton City Primary Care Trust, Wolverhampton, United Kingdom (Kar N)

Corresponding Author: Nilamadhab Kar, MD, DNB, DPM, MRCPsych, Corner House Resource Centre, 300 Dunstall Road, Wolverhampton, WV6 0NZ, UK (Tel: 0044-1902-553798; Fax: 0044-1902-553383; Email: nmadhab@yahoo.com)

Background: There is a wide range of mental and behavioral sequel in children following disasters, which can last long. This review discusses the nature and extent of the psychiatric problems, their management options and process to organize the psychological interventions for affected children.

Data sources: Literatures were searched through PubMed with the words "children, disaster, psychiatry, and mental health" and relevant cross references were included in the review.

Results: Proportions of children having post-traumatic symptoms or syndromal diagnoses vary in different studies depending on various factors like nature and severity of disaster, diagnostic criteria used, cultural issues regarding meaning of trauma, support available, etc. Common psychiatric manifestations among children include acute stress reactions, adjustment disorder, depression, panic disorder, post-traumatic stress disorder, anxiety disorders specific to childhood and psychotic disorders. Comorbidities and sub-clinical syndromes are also common. Most of the post-disaster mental health interventions can be provided in the community by the local disaster workers. Supportive counselling, cognitive behavior therapy, brief trauma/grief-focused psychotherapy, and play therapy are the commonly utilized methods of psychological intervention, which can be given in groups. Information about the efficacy of medications is still emerging, while many are being used and found useful.

Conclusions: Following disaster, systematic screening for psychological problems in children is suggested. An integrated approach using psycho-socio-educational and clinical interventions is expected to be effective.

Key words: assessment; children; disaster; intervention; psychiatric disorders

                World J Pediatr 2009;5(1):5-11

  [Abstract] [Full Text] [PDF]  
Psychopathology and psychological adjustment in children and adolescents with epilepsy
  Soraya Otero
  Santander, Spain

Author Affiliations: Psychiatrist, Child & Adolescent Psychiatry Unit, Psychiatry & Psychology Department, University Hospital Marqu¨¦s de Valdecilla, C/LV de Velasco nº1, 39011 Santander, Cantabria, Spain (Otero S)

Corresponding Author: Soraya Otero, MD, PhD, Child & Adolescent Psychiatry Unit, Psychiatry & Psychology Department, University Hospital Marqu¨¦s de Valdecilla, C/LV de Velasco nº1, 39011 Santander, Cantabria, Spain (Tel: 0034 942330311; Fax: 0034 942344251; Email: sotero@humv.es; sotero@comcantabria.es)

Background: Epilepsy is the most common chronic neurological illness in childhood and adolescence, and this condition may increase the risk of psychopathology at these ages.

Data sources: A literature review, including MEDLINE and PsychLIT database, was made covering the period of 1966-2007. Research studies were included if they were concerned with children suffering from epilepsy and measures of psychopathology.

Results: Studies found a more elevated rate of psychological and psychiatric disorders, both behavioral and emotional, in these samples compared to general population or children with other chronic conditions. The problems presented in children and adolescents with epilepsy are quite similar to those in general population with a slight increase of hyperkinetic and attention problems likely related to both direct brain damage and anticonvulsant treatment. There is no evidence of psychotic disorders and/or specific personality traits associated with epilepsy at these ages.

Conclusions: Family factors, specially those related to psychopathology in other family members and parent-child relationships, appear to have stronger influence on children psychopathology than illness factors themselves. Some guidelines are provided in order to improve future research.

Key words: adolescent; children; epilepsy; psychology; psychopathology

                                                                                                                World J Pediatr 2009;5(1):12-17

  [Abstract] [Full Text] [PDF]  
Prenatal diagnosis and treatment planning of congenital heart defects¡ªpossibilities and limits
  Mathias Nelle, Luigi Raio, Mladen Pavlovic, Thierry Carrel, Daniel Surbek,
  Berne, Switzerland

Author Affiliations: Division of Neonatology (Nelle M), Division of Pediatric Cardiology (Pavlovic M), Department of Cardiac Surgery (Carrel T), and Department of Obstetrics and Gynecology (Raio L, Surbek D, Meyer-Wittkopf M), University Hospital Berne, Switzerland

Corresponding Author: Mathias Nelle, MD, Division of Neonatology, University Children's Hospital Berne, Effingerstr. 102, CH 3010 Berne, Switzerland (Tel: 0041 (0) 31 6321401; Email: mathias.nelle@insel.ch)

Background: Newborns with hypoplastic left heart syndrome (HLHS) or right heart syndrome or other malformations with a single ventricle physiology and associated hypoplasia of the great arteries continue to be a challenge in terms of survival. The vast majority of these forms of congenital heart defects relate to abnormal morphogenesis during early intrauterine development and can be diagnosed accurately by fetal echocardiography. Early knowledge of these conditions not only permits a better understanding of the progression of these malformations but encourages some researchers to explore new minimally invasive therapeutic options with a view to early pre- and postnatal cardiac palliation.

Data sources: PubMed database was searched with terms of "congenital heart defects", "fetal echocardiography" and "neonatal cardiac surgery".

Results: At present, early prenatal detection has been applied for monitoring pregnancy to avoid intrauterine cardiac decompensation. In principle, the majority of congenital heart defects can be diagnosed by prenatal echocardiography and the detection rate is 85%-95% at tertiary perinatal centers. The majority, particularly of complex congenital lesions, show a steadily progressive course including subsequent secondary phenomena such as arrhythmias or myocardial insufficiency. So prenatal treatment of an abnormal fetus is an area of perinatal medicine that is undergoing a very dynamic development. Early postnatal treatment is established for some time, and prenatal intervention or palliation is at its best experimental stage in individual cases.

Conclusion: The upcoming expansion of fetal cardiac intervention to ameliorate critically progressive fetal lesions intensifies the need to address issues about the adequacy of technological assessment and patient selection as well as the morbidity of those who undergo these procedures.

Key words: congenital heart disease; fetal echocardiography; in utero cardiac palliation; postnatal intervention; prenatal diagnosis

                  World J Pediatr 2009;5(1):18-22

  [Abstract] [Full Text] [PDF]  
Original articles:
Metabolic syndrome in fifth grade children with acanthosis nigricans: results from the CARDIAC project
  Christa L Ice, Emily Murphy, Valerie Evans Minor, William A Neal
   

Morgantown, USA

Author Affiliations: Department of Pediatrics, West Virginia University, USA (Ice CL, Murphy E, Neal WA); Department of Nursing,  Alderson-Broaddus College, USA (Minor VE)

Corresponding Author: Christa L Ice, PhD, Department of Pediatrics, WVU Health Sciences, PO Box 9214, Morgantown, WV 26506, USA (Tel: 1-304-293-6515; Fax: 1-304-293-1409; Email: cice@hsc.wvu.edu)

Background: A number of cardiovascular disease (CVD) risk factors have been linked to obesity and associated negative health outcomes in children. However, no consistent definition of metabolic syndrome exists for children. In addition, research is needed to systematically examine the prevalence of metabolic syndrome in high-risk children, including those with insulin resistance. This study explores several definitions of metabolic syndrome and determines the prevalence of metabolic syndrome in a large sample of children with acanthosis nigricans (AN).

Methods: The study used results from a large-scale screening of fifth-grade students in West Virginia to explore the prevalence of metabolic syndrome among 676 male and female participants who had mild to severe AN.

Results: In this high-risk sample of students who had AN, 49% met the criteria, i.e., three risk factors including insulin resistance, high body-mass index, and elevated blood pressure or dyslipidemia, when tested for metabolic syndrome. Children with AN who were classified as obese or morbidly obese were at significantly increased odds of having metabolic syndrome.

Conclusions: Results are discussed in terms of systematically defining metabolic syndrome for high-risk children, as well as public health and clinical interventions targeting children who are overweight or obese. The presence of AN and morbid obesity might be easily observed markers for metabolic syndrome.

Key words: acanthosis nigricans; children; metabolic syndrome; obesity; risk factors

World J Pediatr 2009;5(1):23-30

  [Abstract] [Full Text] [PDF]  
Melamine-contaminated milk products induced urinary tract calculi in children
  Li Zhang, Ling-Ling Wu, Ya-Ping Wang, Ai-Min Liu, Chao-Chun Zou, Zheng-Yan Zhao
   

Hangzhou, China

Author Affiliations: Department of Children's Health Care (Zhang L, Wu LL, Zou CC, Zhao ZY) and Department of Nephrology (Wang YP, Liu AM), The Children's Hospital of Zhejiang University School of Medicine and  Zhejiang Key Laboratory for Diagnosis and Therapy of Neonatal Diseases, Hangzhou 310003, China

Corresponding Author: Chao-Chun Zou, The Children's Hospital of Zhejiang University School of Medicine, 57 Zhugan Xiang, Hangzhou 310003, China (Tel: +86-15067123060; Fax: +86-571-87033296; Email: zou108cc@yahoo.com)

Background: Melamine is an industrial chemical used primarily as plastics stabilizer and fire retardant. On September 11, 2008, melamine-contaminated milk products were reported to be responsible for urinary tract calculi in infants and children in China. This study aimed to investigate the prevalence, lesions, risk factors, clinical features, and management of children fed with the melamine-contaminated milk products.

Methods: A total of 15 577 infants and children fed with the milk products were screened at our hospital. Ultrasonography was performed in all the infants and children. For those found with urinary tract calculi on ultrasonography, urnalysis was done. Among them, 846 with detailed data screened from September 17 to 25 were enrolled for further analysis in this study. They were divided into calculus group (326 children) and non-calculus group (520 children) according to the results of ultrasonography. They included 429 boys and 417 girls, aged from 1 month to 5 years (median, 18 months). Their clinical and laboratory data, ultrasonograms, and treatment results were analyzed.

Results: Of the 15 577 children screened, 562 (3.61%) had urinary tract calculi. The rate was closely related to the melamine concentration in patients fed with formula. In 846 children with detailed data enrolled in this analysis, weight and head circumference Z scores in the calculus group were lower than those in the non-calculus group (P=0.048, P=0.046). Long duration of formula feeding, high melamine contained formula, and minimal water intake were the risk factors for calculi (P<0.05, respectively). Of 326 children with calculi, 281 had small calculi less than 0.5 cm in diameter, 227 had multiple calculi, and 34 had urinary tract distention. Moreover, diffuse renal lesions, renal failure and ascites were noted in 4, 3 and 2 patients, respectively. After 1-month treatment with sodium bicarbonate and Chinese traditional medicine, calculi disappeared in 49 of 54 outpatients. In 41 inpatients, 5 had calculi removed operatively and 36 had calculi minimized.

Conclusions: Melamine-contaminated milk products induced urinary tract calculi, which have a good response to conservative therapy. Long-term follow-up of infants and children fed with melamine-contaminated milk products is required, and food safety should be supervised increasingly for the health of children.

Key words: food contamination; infant; infant formula; melamine; urinary caculi

                   World J Pediatr 2009;5(1):31-35

  [Abstract] [Full Text] [PDF]  
Breast-feeding history and overweight in 11 to 13-year-old children in Iran
  Hossien Fallahzadeh, Motahareh Golestan, Taybeh Rezvanian, Zahra Ghasemian
   

Yazd, Iran

Author Affiliations: Department of Biostatistics and Epidemiology, Yazd Shahid Sadoughi University of Medical Sciences (Fallahzadeh H); Department of Pediatrics, Yazd Shahid Sadoughi University of Medical sciences, Iran (Golestan M, Rezvanian T, Ghasemian Z)

Corresponding Author: Fallahzadeh H, PhD, Department of Biostatistics and Epidemiology, School of health, Yazd Shahid Sadoughi University of Medical sciences, Yazd, Iran (Email: hofaab@yahoo.com)

Background: The relationship between breast-feeding history and risk of overweight in pre-adolescent children was investigated.

Methods: Children's breast-feeding history and demographics were obtained in interviewer-administered questionnaires of a multistage cluster sample survey of 800 parents of children aged 11-13 years living in Yazd, Iran. Height and weight were measured in the children. Overweight was defined as body mass index ¡Ý90th age- and sex-specific percentile of the 2000 Centers for Disease Control reference values.

Results: One hundred and four (13.0%) of 800 children were overweight. A total of 783 (97.9%) of the children had been breast fed. There was a markedly lower overweight prevalence among breast-fed than non breast-fed children. Controlling for age and sex, children breast fed for at least 24 months were substantially less likely to be overweight than children breast fed for less than 12 months (OR 0.56, 95% CI 0.31-0.9). A longer overall duration and duration of exclusive breast-feeding were associated significantly with the decreasing prevalence of overweight.

Conclusion: This sample of Iranian children shows high rates of overweight at young ages but also high rates of breast-feeding. The duration of breast-feeding is inversely related with the prevalence of overweight in pre-adolescent children.

Key words: body mass index; breast-feeding; epidemiology; overweight; pre-adolescent

                                                                                                                     World J Pediatr 2009;5(1):36-41
  [Abstract] [Full Text] [PDF]  
Bilirubin levels predict renal cortical changes in jaundiced neonates with urinary tract infection
  Ioannis Xinias, Vasiliki Demertzidou, Antigoni Mavroudi, Konstantinos Kollios, Panagiotis Kardaras, Fotis Papachristou, Georgios Arsos, Ioannis Tsiouris
  Author Affiliations: 3rd Department of Pediatrics (Xinias I, Demertzidou V, Mavroudi A, Kollios K, Kardaras P, Papachristou F, Tsiouris I); Department of Nuclear Medicine (Arsos G), Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece

Corresponding Author: Ioannis Xinias, 3rd Department of Pediatrics, Hippocration Hospital, Konstantinoupoleos 49, GR 546 42 Thessaloniki, Greece (Tel: +302310-892481; Fax: +302310-992981; Email: xinias@auth.gr)

Background: This study was undertaken to determine the incidence of urinary tract infection (UTI) and the frequency of anatomical abnormalities in newborns with unexplained jaundice and to find out if there is any correlation between bilirubin level and renal damage.

Methods: We studied 462 full-term neonates for UTI. They were aged 3-25 days, with either high (>10 mg/dL) or prolonged (>10 days) hyperbilirubinemia, with or without manifestations such as fever, vomiting, diarrhea, poor feeding, lethargy, and irritability. Neonates positive for UTI were further investigated with ultrasound, cystourethrography, and acute phase renal scintigraphy with technetium-99m dimercaptosuccinate acid (DMSA).

Results: Thirty neonates (6.5%) were found to have UTI. Twenty-eight of them had indirect hyperbilirubinemia and two had direct hyperbilirubinemia, with total bilirubin levels of 11.8-20.1 mg/dL. None of the neonates was found to have jaundice because of other reasons such as infection. Vesicoureteral reflux was found in 5 neonates and one of them was combined with hydronephrosis. Renal scintigraphy with technetium-99m DMSA showed renal cortex changes in 14 (46.7%) of the 30 neonates with UTI. These 14 neonates also had increased levels of bilirubin in comparison to those with normal findings of DMSA.

Conclusions: The incidence of UTI in uncomplicated neonatal jaundice is relatively high. Anatomical abnormalities of the urinary tract are not rare in infected children. Increased bilirubin levels are related to pathological findings in renal scintigraphy.

Key words: hyperbilirubinemia; neonates; urinary tract infection

                World J Pediatr 2009;5(1):42-45

  [Abstract] [Full Text] [PDF]  
A practical screening model for hearing loss in Iranian school-aged children
  Mozafar Sarafraz, Khashayar Ahmadi
   

Ahwaz, Iran

Author Affiliations: Department of Otorhinolaryngology and Head and Neck Surgery, Ahwaz University of Medical Sciences, Ahwaz, Iran (Sarafraz M, Ahmadi K)

Corresponding Author:  Khashayar Ahmadi, MD, Flat 1, No 51, Siami Alley, Sattarkhan Avenue, Tehran, Iran (Tel: +982166919206; Fax:+9821 66423304; Email: dr.khashayar.ahmadi@gmail.com)

Background: Hearing loss is a common and considerable disability that harms educational performance of school children in developing countries like Iran. Lack of a simple and practical screening protocol often deters routine and systematic hearing screening at school entry.

Methods: This study was to establish a practical screening model for hearing loss in school-aged children based on a community-based, retrospective case-control study in Ilam, the capital of Ilam province in Iran. Results from the audiologic and non-audiologic examination of 785 children in primary schools were selected and examined. The non-audiologic evaluation consisted of medical history, general physical examination, while the audiologic assessment consisted of otoscopy, audiometry and tympanometry.

Results: Univariate analysis of non-audiologic variables showed an association between hearing loss and male gender (P<0.05) and the grade of study (P<0.05). The frequency of impaired hearing in the first grade of primary schools was significantly higher than the children in the second grade (P<0.05). In audiologic factors related to impaired hearing, otitis media with effusion (OME) was diagnosed significantly (P<0.05).

Conclusion: Routine screening based on the identification of OME will facilitate the detection of a major amount of hearing impaired school-aged children.

Key words: hearing loss; otitis media; screening; students

                   World J Pediatr 2009;5(1):46-50

  [Abstract] [Full Text] [PDF]  
Why we are still doing so many exchange blood transfusion for neonatal jaundice in Nigeria
  Joshua Aderinsola Owa, Titus A Ogunlesi
  Ilesa, Nigeria

Author Affiliations: Department of Paediatrics and Child Health, Obafemi Awolowo University,  Ile-Ife, Nigeria (Owa  JA); Department of Paediatrics, Adebisi Onabanjo University Teaching Hospital, Sagamu, Nigeria (Ogunlesi  TA)

Corresponding Author: Joshua Aderinsola Owa, Obafemi Awolowo University, PO Box 617, Ile-Ife, 220005, Nigeria (Email: jowa@oauife.edu.ng; jaowa2001@yahoo.co.uk)

Background: Since exchange blood transfusion (EBT) is associated with serious complications, phototherapy has been made more powerful to reduce the need for EBT in the developed world. This study was undertaken to determine the indications for EBT in neonatal jaundice (NNJ) at our unit and what proportion of EBTs was possibly avoidable.

Methods: All the babies who had EBT for hyperbilirubinemia over a three-year period were included. Age, sex, weight, place of delivery, blood group of baby and mother, other investigations, management, and the outcome of the babies were recorded.

Results: Of the 1686 babies admitted to the neonatal unit, 90 (5.3%) had EBT. Fourteen (15.6%) were inborn while 76 (84.4%) were out-born babies. Fifty-six (62.2%) babies were admitted primarily for NNJ while 34 (37.8%) developed NNJ during admission. Thirty-six (40.0%) of the babies had phototherapy for more than 24 hours prior to EBT either because they were of very low birthweight or NNJ was detected very early and therapy was so commenced. Sixty-eight (75.6%) babies had single EBT while the remaining 22 (24.4%) had two sessions of EBT. Factors associated with severe NNJ in babies requiring EBT included low birthweight (<2500 g, 44.4%), ABO incompatibility (30.0%), glucose-6-phosphate dehydrogenase deficiency (34.4%) and septicemia (26.1%). Twenty-seven (30.0%) of the neonates developed features of kernicterus: 26 before admission while 1 during admission; all except one were delivered outside the hospital.

Conclusions: The EBT rate in our center was high. With more effective phototherapy, EBT could be avoided in most of the babies who initially had phototherapy for more than 24 hours before EBT and repeated EBT sessions. Health education of the population at risk, especially pregnant women, and early referral at the primary health care level will reduce the burden of severe NNJ.

Key words: exchange blood transfusion; hyperbilirubinemia; neonatal jaundice; phototherapy

                   World J Pediatr 2009;5(1):51-55

  [Abstract] [Full Text] [PDF]  
Diagnosis and management of esophageal achalasia in children: analysis of 13 cases
  Yin Zhang, Chun-Di Xu, Abdehaman Zaouche, Wei Cai
  Shanghai, China

Author Affiliations: Department of Pediatrics, Shanghai Ruijin Hospital Affiliated to School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China (Zhang Y, Xu CD); Digestive Functional Exploration Department, Necker Children's Hospital, Paris, France (Zaouche A); Department of Pediatric Surgery, Shanghai Xinhua Hospital Affiliated to School of Medicine, Shanghai Jiaotong University, Shanghai, China (Cai W)

Corresponding Author: Chun-Di Xu, Department of Pediatrics, Shanghai Ruijin Hospital Affiliated to School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China (Tel: +86-21-64370045; Email: chundixu@hotmail.com)

Background: Esophageal achalasia is a rare disease and there have been very few reports about it, especially in children. We reviewed our experience in dealing with esophageal achalasia in 13 children.

Methods: Thirteen children (6 boys and 7 girls), who had been diagnosed with achalasia over a 12-year period between May 1993 and October 2005, were analysed with regard to clinical manifestations, esophageal manometry, endoscopic findings, and treatment. Their age ranged from 3 years to 14 years and 5 months (average 10.3 years) at the time of diagnosis.

Results: In the 13 children, 3 had a family history of esophageal achalasia, 2 of them were sisters. All the 3 children suffered from achalasia/alacrimia/ACTH deficiency. Dysphagia was the most common symptom in the affected children. Vomiting/regurgitation, retrosternal pain, retarded growth, and respiratory symptoms were also observed in some patients. Heller's esophagocardiomyotomy was performed in 9 (69.23%) children, among whom 3 had an antireflux operation at the same time. In the remaining 4 children, 3 received a pneumatic dilatation and 1 received regular administration of nifedipine. Twelve patients were followed up: 8 patients by surgery were cured and have been in perfect condition until now, 3 patients recovered fairly, and 1 patient showed improvement.

Conclusions: Esophageal manometry combined with X-ray examination proves to be an effective diagnostic method for achalasia. It is also effective in evaluating the result of treatment. Heller's esophagocardiomyotomy is a treatment of choice for children with achalasia because of its safety and long-term effective results after surgery.

Key words: dysphagia; esophageal achalasia; esophageal manometry;  Heller's esophagocardiomyotomy; pneumatic dilatation

                   World J Pediatr 2009;5(1):56-59

  [Abstract] [Full Text] [PDF]  
Clinical summary:
Serum total and free carnitine levels in children with asthma
  Suna Asilsoy, Özlem Bekem, Özkan Karaman, Nevin Uzuner, Salih Kavukçu
   

Izmir, Turkey

Author Affiliations: Department of Pediatrics, Dokuz Eyl¨¹l University Medical Faculty, Izmir, Turkey (Asilsoy S, Bekem Ö, Karaman Ö, Uzuner N, Kavukçu S)

Corresponding Author: Özlem Bekem, MD, Çamlıçay Mah. 5182 Sok. No:12/A, Urla 35315, Izmir, Turkey (Email: obekem@yahoo.com)

Background: Serum carnitine is decreased in recurrent pulmonary infections. We aimed to evaluate serum carnitine levels in asthmatic children.

Methods: Study group consisted of children with stable asthma and those with acute asthma attacks, while control group included healthy children. Attack severity was determined by the pulmonary score system. Total and free carnitine levels were studied in one blood sample from the control group and stable asthmatics and in two samples from children with acute asthma exacerbation during and after the attack.

Results: All the 40 patients in the study group had moderate asthma including 30 with acute attack (13 mild and 17 moderate) and 10 with stable asthma. Carnitine levels were significantly lower in acute attack asthmatics than in the stable asthmatics and controls, while there was no significant difference between the latter two groups. Carnitine levels were not different between asthmatics with mild and moderate attack, and were similar during and after an acute attack.

Conclusions: Serum carnitine levels decrease in children with moderate asthma during exacerbation of asthma and shortly thereafter. Further studies are needed to evaluate the effect of carnitine treatment on serum carnitine level.

Key words: asthma; carnitine; children

                   World J Pediatr 2009;5(1):60-62

  [Abstract] [Full Text] [PDF]  
Clinical images:
Neuroimages of persistent falcine sinus in children
  Chun-Quan Cai, Qing-Jiang Zhang, Wei-Dong Yang, Chun-Xiang Wang, Chang-Hong Shen
  Tianjin, China

Author Affiliations: Department of Pediatric Neurosurgery, General Hospital of Tianjin Medical University, Tianjin 300052, China (Cai CQ, Yang WD, Shen CH); Department of Neurosurgery, Tianjin Children's Hospital, Tianjin 300074, China (Cai CQ, Zhang QJ); Department of Radiology, Tianjin Children's Hospital, Tianjin 300074, China (Wang CX)

Corresponding Author: Prof. Chang-Hong Shen, MD, Department of Pediatric Neurosurgery, General Hospital of Tianjin Medical University, No. 54 Anshan Road, Heping District, Tianjin 300052, China (Tel: +86-22-23519459-86403; Email: tjpns@126.com)

  [Abstract] [Full Text] [PDF]  
Case reports:
Is there a correlation between venlafaxine therapy during pregnancy and a higher incidence of necrotizing enterocolitis?
  Markus Treichel, Katharina Schwendener Scholl, Ulf Kessler, Alexander Joeris, Mathias Nelle
   

Berne, Switzerland

Author Affiliations: Department of Neonatology (Treichel M, Schwendener Scholl K, Nelle M) and Department of Surgical Pediatrics (Kessler U, Joeris A), Children's Hospital, University of Berne, Berne, Switzerland

Corresponding Author: Ulf Kessler, Department of Surgical Pediatrics, Inselspital, 3010 Berne, Switzerland (Tel: +41 31 6329223; Fax: +41 31 6329292; Email: ulf.kessler@insel.ch)

Background: Novel antidepressant drugs are increasingly used by women of child bearing age. However, potentially harmful effects on fetus and newborn remain unknown.

Methods: Case report and literature review.

Results: We present preterm twins whose mother was treated with venlafaxine, a nonselective serotonin reuptake inhibitor, throughout pregnancy until delivery. The twins developed neonatal necrotizing enterocolitis.

Conclusion: The question whether there might be a correlation between maternal serotonin reuptake inhibitor therapy and neonatal necrotizing enterocolitis is discussed.

Key words: antidepressive agents; necrotizing enterocolitis; nonselective serotonin reuptake inhibitor; pregnancy; venlafaxine

                World J Pediatr 2009;5(1):65-67

  [Abstract] [Full Text] [PDF]  
Congenital pulmonary lymphangiectasis
  Zuo-Yuan Xiao, Yu Tao, Xin-Yi Tang, Guo-Juan Chen, Lei Guo
   

Guangzhou, China

Author Affiliations: Department of General Pediatrics, The Third Affiliated Hospital of Sun Yat-sen University (Xiao ZY, Tang XY, Chen GJ, Guo L); Department of Pathology, The First Affiliated Hospital of Sun Yat-sen University (Tao Y), Guangzhou, China

Corresponding Author: Zuo-Yuan Xiao, Department of General Pediatrics, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China (Tel: 86-20-85253098; Email: xiaozy2@126.com)

Background: Congenital pulmonary lymphangiectasis (CPL) characterized by dilatation of pulmonary lymphatic vessels occurs as a congenital anomaly. With poor prognosis, neonatal presentation of bilateral CPL is associated with the severe compromise of pulmonary gas exchange and high mortality.

Methods: A male infant born at 39 weeks of gestation was found to have CPL. Cyanosis and cardiac arrest occurred a few minutes after birth, and the symptoms remained after artificial ventilation. The infant died of hypoxemic cardiac failure 45 minutes after birth. Autopsy showed neither pleural effusion nor valvular abnormalities.

Results: Microscopically dilated vessels with lymphatics were seen in the lung of the infant. Atelectasis, CPL, inhalation of amniotic fluid, partial hydropic degeneration of hepatic cells, and scrotal edema were diagnosed.

Conclusion: With regard to treatment and prognosis, CPL must be distinguished from interstitial emphysema and other diseases.

Key words: congenital disease; neonate; pulmonary lymphangiectasis

                   World J Pediatr 2009;5(1):68-70

  [Abstract] [Full Text] [PDF]  
Intracranial solitary juvenile xanthogranuloma in an infant
  Lian-Ping Sun, Hui-Ming Jin, Bo Yang, Xiang-Ru Wu
   

Shanghai, China

Author Affiliations: Department of Pediatric Neurosurgery (Sun LP, Jin HM, Yang B); Department of Pathology (Wu XR), Xin Hua Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200092, China

Corresponding Author: Lian-Ping Sun, MD, Department of Pediatric Neurosurgery, Xin Hua Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200092, China (Tel: 86-21-65790000 ext 8285; Email: slp1128@126.com)

Background: Juvenile xanthogranuloma (JXG) is a disorder of histiocyte proliferation. Most cases present with a solitary cutaneous lesion. JXG with systemic involvement is rare with significant morbidity. Intracranial solitary JXG may be misdiagnosed before operation.

Methods: A 5-month-old boy showed an elevated anterior fontanel but no other abnormalities on admission. Brain MRI showed a large mass in the right parietal region.

Results: The tumor was removed with the encroached meninges. A JXG in the right parietal region was diagnosed pathologically.

Conclusion: Total excision of the tumor may be curative with a prerequisite of ensuring normal vital signs and nervous function.

Key words: infant; intracranial; juvenile xanthogranuloma; surgery

                 World J Pediatr 2009;5(1):71-73

  [Abstract] [Full Text] [PDF]  
   
 
 
 
World Journal of Pediatric Surgery
roger vivier bags 美女 美女

Home  |  Journal Information  |  Current Issue  |  Past Issues  |  Journal Information  |  Contact Us
Children's Hospital, Zhejiang University School of Medicine, China
Copyright 2007  www.wjpch.com  All Rights Reserved Designed by eb