|
Incidence of brain injuries in premature infants with gestational age ¡Ü34 weeks in ten urban hospitals in China
|
|
Hui-Jin Chen, Ke-Lun Wei, Cong-Le Zhou, Yu-Jia Yao, Yu-Jia Yang, Xiu-Fang Fan, Xi-Rong Gao, Xiao-Hong Liu, Ji-Hong Qian, Ben-Qing Wu, Gao-Qiang Wu, Qing-Mei Zhang, Xiao-Lan Zhang |
|
Incidence of brain injuries in premature infants with gestational age ¡Ü34 weeks in ten urban hospitals in China
Hui-Jin Chen, Ke-Lun Wei, Cong-Le Zhou, Yu-Jia Yao, Yu-Jia Yang, Xiu-Fang Fan, Xi-Rong Gao, Xiao-Hong Liu, Ji-Hong Qian, Ben-Qing Wu, Gao-Qiang Wu, Qing-Mei Zhang, Xiao-Lan Zhang
Shanghai, China
Author Affiliations: Shanghai Institute for Pediatric Research, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China (Chen HJ); The Second Affiliated Hospital of China Medical University, Shenyang 110004, Liaoning Province, China (Wei KL); Peking University First Hospital, Beijing 100034, China (Zhou CL); West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China (Yao YJ); Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China (Yang YJ); Jinan Women & Children Hospital, Jinan 250012, Shandong Province, China (Fan XF); Hunan Children's Hospital, Changsha 410007, Hunan Province, China (Gao XR); Shenzhen Children's Hospital, Shenzhen 518026, Guangdong Province, China (Liu XH); Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China (Qian JH); Shenzhen City People's Hospital, the Second Affiliated Hospital of Jinan University Medical College, Shenzhen 518020, Guangdong Province, China (Wu BQ); Ulumuqi Women & Children Hospital, Ulumuqi 830000, Xinjiang Uyghur Autonomous Region, China (Wu GQ); Shenyang Women Hospital, Shenyang 110014, Liaoning Province, China (Zhang QM); Shenzhen Maternity and Child Healthcare Hospital, Shenzhen 518028, Guangdong Province, China (Zhang XL)
Corresponding Author: Hui-Jin Chen, MD, Professor of Pediatrics, Shanghai Institute for Pediatric Research, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China (Tel: +86-21-65790000-6471; Fax: +86-21-65791316; Email: hjchenk@163.com)
doi: 10.1007/s12519-012-0395-8
Background: There is a large number (1.5 million per year) of premature births in China. It is necessary to obtain the authentic incidences of intraventricular hemorrhage (IVH) and periventricular leukomalacia (PVL), the common brain injuries, in Chinese premature infants. The present multicenter study aimed to investigate the incidence of brain injuries in premature infants in ten urban hospitals in China.
Methods: The research proposal was designed by the Subspecialty Group of Neonatology of Pediatric Society of the Chinese Medical Association. Ten large-scale urban hospitals voluntarily joined the multicenter investigation. All premature infants with a gestational age ¡Ü34 weeks in the ten hospitals were subjected to routine cranial ultrasound within three days after birth, and then to repeated ultrasound every 3-7 days till their discharge from the hospital from January 2005 to August 2006. A uniform data collection sheet was designed to record cases of brain injuries.
Results: The incidences of overall IVH and severe IVH were 19.7% (305/1551) and 4.6% (72/1551), respectively with 18.4% (56/305) for grade 1, 58.0% (177/305) for grade 2, 17.7% (54/305) for grade 3 and 5.9% (18/305) for grade 4 in nine hospitals. The incidences of overall PVL and cystic PVL were 5.0% (89/1792) and 0.8% (14/1792) respectively, with 84.3% (75/89) for grade 1, 13.5% (12/89) for grade 2, and 2.2% (2/89) for grade 3 in the ten hospitals. The statistically significant risk factors that might aggravate the severity of IVH were vaginal delivery (OR=1.883, 95% CI: 1.099-3.228, P=0.020) and mechanical ventilation (OR=4.150, 95% CI: 2.384-7.223, P=0.000). The risk factors that might result in the development of cystic PVL was vaginal delivery (OR=21.094, 95% CI: 2.650-167.895, P=0.000).
Conclusions: The investigative report can basically reflect the incidence of brain injuries in premature infants in major big cities of China. Since more than 60% of the Chinese population live in the rural areas of China, it is expected to undertake a further multicenter investigation covering the rural areas in the future.
Key words: incidence; intraventricular hemorrhage; multicenter investigation; periventricular leukomalacia; premature infants
World J Pediatr 2013;9(1):17-24 |
|
[Abstract] [Full Text] [PDF]
|
|
Solid tumors in Turkish children: a multicenter study
|
|
Ayper Kacar, Irem Paker, Zuhal Akcoren, Safak Gucer, Gulsev Kale, Diclehan Orhan, Beril Talim, Aylar Poyraz, Omer Uluoglu, Aylin Okcu Heper, Sema Apaydin, Nilufer Arda, Esin Boduroglu, Aynur Albayrak, Murat Alper, Ata Turker Arikok |
|
Solid tumors in Turkish children: a multicenter study
Ayper Kacar, Irem Paker, Zuhal Akcoren, Safak Gucer, Gulsev Kale, Diclehan Orhan, Beril Talim, Aylar Poyraz, Omer Uluoglu, Aylin Okcu Heper, Sema Apaydin, Nilufer Arda, Esin Boduroglu, Aynur Albayrak, Murat Alper, Ata Turker Arikok
Ankara, Turkey
Author Affiliations: Pathology Department, Ankara Child Diseases Hematology Oncology Research and Training Hospital, Turkey (Kacar A); 2nd Pathology Department, Diskapi Yildirim Beyazit Research and Training Hospital, Turkey (Paker I, Albayrak A, Alper M, Arikok AT); Pediatric Pathology Unit, Child Health and Diseases Department, Faculty of Medicine, Hacettepe University, Turkey (Akcoren Z, Gucer S, Kale G, Orhan D, Talim B); Pathology Department, Faculty of Medicine, Gazi University, Turkey (Poyraz A, Uluoglu O); Pathology Department, Faculty of Medicine, Ankara University, Turkey (Heper AO); Pathology Department, Dr. Sami Ulus Child Diseases Research and Training Hospital, Turkey (Apaydin S, Arda N, Boduroglu E)
Corresponding Author: Ayper Kacar, Ankara Child Diseases Hematology Oncology Research and Training Hospital, Pediatric Pathology Department, Altindag, Ankara, Turkey, Konutkent 2 A2 Blok No: 3 Cayyolu, Yeni Mahalle, Ankara, Turkey (Tel: 0533 655 76 57; Fax: 0312 347 23 30; Email: ayperkacar@yahoo.com)
doi: 10.1007/s12519-011-0323-3
Background: This paper presents a detailed incidence study on childhood solid tumors comprising a histopathology-based documentation of benign and malignant lesions.
Methods: The Ankara Pediatric Pathology Working Group collected databases of pediatric solid tumors from six pediatric reference centers in order to analyze the incidence, distribution and some epidemiologic characteristics of the tumors and to establish a multicenter database for further studies. A five-year retrospective archive search was carried out. Excluding epithelial tumors of the skin, leukemia, lymphoreticular system neoplasias, metastatic tumors, and hamartomas, 1362 solid tumors in 1358 patients were classified according to age, sex, localization, histopathology and clinical behavior.
Results: The male/female ratio was 0.9; 14.8% (201) of the patients belonged to 0-1 year age group, 20.7% (281) to 2-4 years, 25.9% (352) to 5-10 years, 22.2% (301) to 11-14 years, and 16.4% (223) to 15-18 years. Among all tumors, 708 (52.0%) were malignant, 645 (47.4%) benign tumors, 2 (0.1%) borderline tumors, and 2 (0.1%) unknown behavioral tumors. Malignant tumors were found in 50.2% (357) of female patients and in 54.0% (349) of male patients. A balanced distribution between benign and malignant entities among children under 18 years was observed. Comparison between the age groups revealed malignant cases outnumbered benign cases under 4 years of age while benign tumor numbers increased after 10 years of age. The most common entities in the malignant group were of sympathetic nervous system origin, while soft tissue tumors far outnumbered the others in the benign group.
Conclusions: We conclude that the cancer patterns of children in the Ankara region mostly resemble with those of the western population. This study provides useful information on the diagnosis of solid tumors in children and highlights variations in cancer incidence in different age groups.
Key words: cancer; childhood; epidemiology; incidence; solid tumor
World J Pediatr 2013;9(1):25-31 |
|
[Abstract] [Full Text] [PDF]
|
|
Risk-adapted chemotherapy without procarbazine in treatment of children with Hodgkin lymphoma
|
|
Yi-Jin Gao, Jing-Yan Tang, Ci Pan, Feng-Juan Lu, Hui-Liang Xue, Jing Chen |
|
Risk-adapted chemotherapy without procarbazine in treatment of children with Hodgkin lymphoma
Yi-Jin Gao, Jing-Yan Tang, Ci Pan, Feng-Juan Lu, Hui-Liang Xue, Jing Chen
Shanghai, China
Author Affiliations: Children's Hospital, Shanghai Medical College, Fudan University, Shanghai, China (Gao YJ, Lu FJ); Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (Tang JY, Pan C, Xue HL, Chen J)
Corresponding Author: Jing-Yan Tang, MD, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China (Tel: 86-21-38626161-5471; Fax: 86-21-58756539; Email: yantfk@gmail.com)
doi: 10.1007/s12519-012-0390-0
Background: Because procarbazine is not available in the mainland of China, a risk-adapted chemotherapy without the drug was adopted for children with Hodgkin lymphoma (HL) in two tertiary referral centers for childhood cancer in Shanghai. The objective of the present study was to obtain the results comparable with those of previous studies.
Methods: From January 1998 to December 2009, patients below 18 years with newly diagnosed, untreated HL were enrolled in the study. The patients were stratified into risk groups R1 (early stage), R2 (intermediate stage) and R3 (advanced stage). All the patients who had attained a complete remission were not given involved field radiotherapy.
Results: Fifty-six patients were eligible for the study. The 4-year event-free survival (EFS) rate was 100%, 80.3%¡À7.2%, and 62.5%¡À12.1% for the risk groups R1, R2, and R3, respectively. There was statistically significant difference in EFS between patients with and those without B symptoms (P<0.001). In group R2, the EFS rate was higher for patients treated with chemotherapy combined with radiation (100% vs. 75%¡À8.8%). But no statistical difference was observed (P=0.177). At the time of evaluation (December 31, 2010), secondary malignancy was not observed.
Conclusions: A significant fraction of children with early stage or intermediate stage HL can be cured with a chemotherapy regimen without procarbazine. Complete response to chemotherapy seems not to be a determinant to omit radiotherapy.
Key words: chemotherapy; children; Hodgkin lymphoma; outcome
World J Pediatr 2013;9(1):32-35 |
|
[Abstract] [Full Text] [PDF]
|
|
Effect of proton pump inhibition on acid, weakly acid and weakly alkaline gastro-esophageal reflux in children
|
|
Helena Turk, Bruno Hauser, Jernej Brecelj, Yvan Vandenplas, Rok Orel |
|
Effect of proton pump inhibition on acid, weakly acid and weakly alkaline gastro-esophageal reflux in children
Helena Turk, Bruno Hauser, Jernej Brecelj, Yvan Vandenplas, Rok Orel
Ljubljana, Slovenia; Brussels, Belgium
Author Affiliations: University Children's Hospital, University Medical Centre Ljubljana, Slovenia (Turk H, Brecelj J, Orel R) and UZ Brussel Kinderen, Vrije Universiteit Brussel, Brussels, Belgium (Hauser B, Vandenplas Y)
Corresponding Author: Rok Orel, MD, PhD, University Children's Hospital, University Medical Centre Ljubljana, Slovenia (Tel: +386 1 522 9254; Fax: +386 1 522 9357; Email: rok.orel@kclj.si)
doi: 10.1007/s12519-013-0405-5
Background: The effect of proton pump inhibitors on the characteristics of gastroesophageal reflux (GER) in children and adolescents was evaluated.
Methods: Twenty-one children and adolescents with symptoms suggesting GER disease (GERD) underwent upper endoscopy and a 24-hour multichannel intraluminal impedance/pH (MII-pH) monitoring before and at the end of 2 months of therapy with proton pump inhibitors (PPIs).
Results: Fourteen (67%) patients reported clinically relevant symptom improvement after 2 months of PPIs intake. At the first endoscopy, 8 (38%) patients had macroscopic signs of reflux esophagitis; after two months of therapy, 6/8 (75%) patients had a complete mucosal recovery. There was a significant reduction in the total percentage of mean acid reflux time (from 13.1% to 3.8%), and the De Meester score dropped to normal (from 46.4 to 13.1). The mean number of acid refluxes decreased significantly from 48 to 15 per 24 hours, while inversely, the mean number of weakly acid refluxes increased significantly from 26 to 64 per 24 hours. PPI therapy did not affect the total number of reflux episodes, the number of liquid and mixed refluxes, the duration of esophageal bolus exposure and proximal extent of the reflux.
Conclusions: In children and adolescents with GERD, PPIs do not affect the total number of reflux episodes. PPIs only decrease the acidity of refluxate. Nevertheless, the majority of patients with typical reflux symptoms may report symptom improvement. Esophagitis can be healed after PPI treatment. The treatment of weakly acid and weakly alkaline reflux remains a challenge for physicians in the future.
Key words: acid reflux; gastro-esophageal reflux (disease); multichannel intraluminal impedance; pH monitoring; proton pump inhibitor
World J Pediatr 2013;9(1):36-41 |
|
[Abstract] [Full Text] [PDF]
|
|
Clinical characteristics and mutation analysis of X-linked severe combined immunodeficiency in China
|
|
Cui Zhang, Zhi-Yong Zhang, Jun-Feng Wu, Xue-Mei Tang, Xi-Qiang Yang, Li-Ping Jiang, Xiao-Dong Zhao |
|
Clinical characteristics and mutation analysis of X-linked severe combined immunodeficiency in China
Cui Zhang, Zhi-Yong Zhang, Jun-Feng Wu, Xue-Mei Tang, Xi-Qiang Yang, Li-Ping Jiang, Xiao-Dong Zhao
Chongqing, China
Author Affiliations: Division of Immunology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China (Zhang C, Zhang ZY, Wu JF, Tang XM, Yang XQ, Jiang LP, Zhao XD)
Corresponding Author: Xiao-Dong Zhao, Division of Immunology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China (Tel: +86 23 6362 2554; Fax: +86 23 6360 2136; Email: zhaoxd530@yahoo.com.cn)
doi: 10.1007/s12519-011-0330-4
Background: X-linked severe combined immuno-deficiency (X-SCID) is a rare, life-threatening immune disorder, caused by mutations of the gene for the ¦Ã-chain (¦Ãc) of the interleukin-2 receptor, IL2RG. We analyzed the clinical, immunologic, and molecular characteristics of children with X-SCID, attempting to improve the diagnosis and treatment of X-SCID in China.
Methods: X-SCID was suspected in male infants with recurrent or persistent infections. Eleven male infants from ten unrelated Chinese families were included. The IL2RG gene was amplified and sequenced, followed by mutation analysis in these children and their female relatives. X-linked short tandem repeat (X-STR) typing was done to define the maternal lymphocyte engraftment.
Results: The 11 children exhibited recurrent infections and 10 of them had lymphopenia. B cells were present in all patients, T cells were markedly reduced in 10, and NK cells were markedly reduced in 9. Nine IL2RG gene mutations were identified in the 11 children, with 5 novel mutations. One patient was found to have the maternal lymphocyte engraftment.
Conclusion: The clinical presentations and immunologic characteristics of the X-SCID patients were accordingly quite uniform despite the heterogeneity of mutations locating almost in the entire ¦Ãc gene.
Key words: clinical characteristics; IL2RG gene; mutation; severe combined immunodeficiency; X-linked trait
World J Pediatr 2013;9(1):42-47 |
|
[Abstract] [Full Text] [PDF]
|
|
Common WU polyomavirus infection in a Beijing population indicated by surveillance for serum IgG antibody against capsid protein VP2
|
|
Ni-Na Zhang, Lin-Qing Zhao, Yuan Qian, Ru-Nan Zhu, Jie Deng, Fang Wang, Yu Sun, Li-Ying Liu |
|
Common WU polyomavirus infection in a Beijing population indicated by surveillance for serum IgG antibody against capsid protein VP2
Ni-Na Zhang, Lin-Qing Zhao, Yuan Qian, Ru-Nan Zhu, Jie Deng, Fang Wang, Yu Sun, Li-Ying Liu
Beijing, China
Author Affiliations: Laboratory of Virology, Capital Institute of Pediatrics, 2 Yabao Road, Beijing 100020, China (Zhang NN, Zhao LQ, Qian Y, Zhu RN, Deng J, Wang F, Sun Y, Liu LY)
Corresponding Author: Yuan Qian, MD, Director of the Laboratory of Virology, Capital Institute of Pediatrics, 2 Yabao Road, Beijing 100020, China (Tel: 86-10-85610550; Fax: 86-10-85610550; Email: yqianbjc@263.net)
doi: 10.1007/s12519-013-0397-1
Background: WU polyomavirus (WU virus) was identified as a novel polyomavirus in 2007 from specimens of pediatric patients with acute respiratory infection (ARI). A lack of permissive cell lines has limited investigations into WU virus pathogenesis and prevalence.
Methods: The encoding region of the capsid protein VP2 gene was amplified from a WU virus DNA-positive clinical specimen and expressed as a recombinant His-tagged protein in Escherichia coli BL21 (DE3). The expressed VP2 was identified by expected molecular weight and immunoreactivity with anti-His monoclonal antibody in Western blotting assay. Serum samples collected from 455 individuals of all ages in Beijing without symptoms of ARI were tested for IgG antibodies against the affinity-purified recombinant VP2 protein by Western blotting to investigate the prevalence of natural WU virus infection. In addition, serum samples from four ARI pediatric patients, whose nasopharyngeal aspirates were positive for WU virus DNA and negative for all other respiratory-related viruses, were tested for IgM antibody against the recombinant VP2.
Results: Of the 455 serum samples, 238 reacted with the recombinant VP2, yielding an overall positive rate of 52.3% for IgG against VP2 of WU virus. The positive rate was the highest in serum samples from infants and children between 1 to 4 years of age. One of four ARI pediatric patients was positive for IgM against WU virus VP2, implicating WU virus as the causative disease agent.
Conclusions: The high prevalence of IgG against WU polyomavirus in Beijing-based study population indicates that WU virus infection is common in Beijing. WU virus may be responsible for some pediatric ARI cases, and primary infection of this virus may occur mostly in childhood.
Key words: antibody; infection; virus; WU polyomavirus
World J Pediatr 2013;9(1):48-52 |
|
[Abstract] [Full Text] [PDF]
|
|
Novel OCRL mutations in Chinese children with Lowe syndrome
|
|
Yan-Qin Zhang, Fang Wang, Jie Ding, Hui Yan, Yan-Ling Yang |
|
Novel OCRL mutations in Chinese children with Lowe syndrome
Yan-Qin Zhang, Fang Wang, Jie Ding, Hui Yan, Yan-Ling Yang
Beijing, China
Author Affiliations: Department of Pediatrics, Peking University First Hospital, Beijing, China (Zhang YQ, Wang F, Ding J, Yan H, Yang YL)
Corresponding Author: Ding J, MD, PhD, Department of Pediatrics, Peking University First Hospital, 100034 Beijing, China (Tel: 86-010 -83572168; Fax: 86-010-66530532; Email: djnc_5855@126.com)
doi: 10.1007/s12519-013-0406-4
Background: Lowe syndrome is a rare X-linked recessive hereditary disease caused by mutations of the OCRL gene, which encodes an inositol polyphosphate-5-phosphatase. The disease is clinically characterized by congenital cataracts, psychomotor retardation, and proximal tubulopathy.
Methods: We retrospectively reviewed three unrelated Chinese patients with Lowe syndrome, clinically diagnosed by the abnormalities of eyes, nervous system, and kidneys. Genetic analysis of the OCRL gene was done for the three patients as well as their family members.
Results: Three OCRL gene mutations were detected in our study. Two of the mutations, g.1897delT in exon 18 (patient 1) and g.1470delG in exon 15 (patient 2), were novel. A missense mutation (p.Y513C) in exon 15, which had been reported previously, was found in patient 3. The mothers of all patients were heterozygous carriers of the respective mutations.
Conclusions: Three Chinese children were diagnosed with Lowe syndrome through clinical and genetic analyses. And two novel mutations in the OCRL gene were identified.
Key words: cataract; Dent disease 2; Lowe syndrome; mutations; OCRL
World J Pediatr 2013;9(1):53-57 |
|
[Abstract] [Full Text] [PDF]
|
|
Assessment of nutrient intakes of picky-eating Chinese preschoolers using a modified food frequency questionnaire
|
|
Flora Yin-Ying Kwok, Yvonne Yi-Fong Ho, Chung-Mo Chow, Christabella Yat-Nam So, Ting-Fan Leung |
|
Assessment of nutrient intakes of picky-eating Chinese preschoolers using a modified food frequency questionnaire
Flora Yin-Ying Kwok, Yvonne Yi-Fong Ho, Chung-Mo Chow, Christabella Yat-Nam So, Ting-Fan Leung
Hong Kong, China
Author Affiliations: Department of Pediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong (Kwok FY, Ho YY, Chow CM, Leung TF); University of Western Ontario, London, Ontario, Canada (So CY)
Corresponding Author: Ting Fan Leung, MD, Department of Pediatrics, 6/F, Clinical Sciences Building, Prince of Wales Hospital, Shatin, N.T., Hong Kong (Tel: 852-2632 2981; Fax: 852-2636 0020; Email: tfleung@cuhk.edu.hk))
doi: 10.1007/s12519-012-0386-9
Background: Dietary assessment is crucial for monitoring nutritional status of young children. This study applied a modified Chinese food frequency questionnaire (FFQ) to assess nutrient intakes of young picky-eating Hong Kong children.
Methods: Nutrient intakes were obtained by FFQ and 3-day food record (3DFR) in 29 picky-eating children aged 44.8¡À9.2 months who participated in a randomised controlled trial of a new milk formula.
Results: When compared with 3DFR, FFQ over-reported energy intake by 283 kcal (26.5%) at baseline and 237 kcal (21.4%) at end-of-study, and also over-estimated intakes of carbohydrates, proteins and fats. At baseline, FFQ and 3DFR classified 34.4%-65.5% of subjects into the same tertiles for most nutrients. These methods showed weak-to-moderate agreement in measuring most nutrients, with 3DFR showing a trend towards a systematic increase in the differences with increasing nutrient intake.
Conclusion: Our FFQ shows promising results for assessing nutrient intakes in picky-eating Chinese preschoolers.
Key words: Chinese; food frequency questionnaire; nutrition; preschooler
World J Pediatr 2013;9(1):58-63 |
|
[Abstract] [Full Text] [PDF]
|
|
Asthma management by medical practitioners: the situation in a developing country
|
|
Osarogiagbon Wilson Osaretin, Nwaneri Damian Uchechukwu, Oviawe Osawaru |
|
Asthma management by medical practitioners: the situation in a developing country
Osarogiagbon Wilson Osaretin, Nwaneri Damian Uchechukwu, Oviawe Osawaru
Benin City, Nigeria
Author Affiliations: Department of Child Health, University of Benin Teaching Hospital, PMB 1111, Benin City, Nigeria (Osarogiagbon WO, Nwaneri DU, Oviawe O)
Corresponding Author: Oviawe O, Department of Child Health, University of Benin Teaching Hospital, PMB 1111, Benin City, Edo State, Nigeria (Tel: +2348037275398; Email: sonofeto@yahoo.com).
doi: 10.1007/s12519-012-0389-6
Background: Asthma is a common chronic disease worldwide and is responsible for considerable morbidity, socioeconomic burden, and depletion of health resources. Clinically, diagnosis of asthma is based on information obtained from symptom questionnaires, physical examination and demonstration of variable airflow obstruction. Proper diagnosis of asthma is mandatory in clinical practice in order to avoid undue use of potentially toxic asthma medications and prevent unwarranted social stigmatization. This study aimed to determine how medical practitioners in Nigeria diagnose asthma and use asthma medications during asthma exacerbation and the follow-up period.
Methods: A semi-structured self-administered questionnaire on asthma management was distributed to medical practitioners attending the annual scientific meeting/update course in August, 2009. Forty-nine practice centers in the 6 geopolitical zones in Nigeria were included in this survey.
Results: Totally 131 medical practitioners (80 males, 51 females) completed the questionnaire. Post National Youth Service Corp practice (mean ¡À SD) was 9.95¡À7.78 years, ranging from 2 to 39 years. The practice centers of respondents included university teaching hospitals (65.6%), state specialist hospitals (17.6%), private hospitals (10.7%), and missionary hospitals (6.l%). Respondents' assessment of burden of asthma was high (30.5%), moderate (63.4%) and low (6.1%). Asthma diagnosis was made by various methods including: symptoms only (35.9%), health personnels (32.3%), mother/self evaluation (20.3%), and use of spirometry/peak expiratory flow rate (11.5%). Thus inappropriate asthma diagnosis could have been practiced by 116 (88.5%) medical practitioners.
Conclusion: The study revealed inadequate knowledge of asthma diagnosis and drug management of asthma by medical practitioners in Nigeria.
Key words: airflow obstruction; asthma; medical practitioner; peak expiratory flow rate
World J Pediatr 2013;9(1):64-67 |
|
[Abstract] [Full Text] [PDF]
|
|
Liver steatosis in Polish children assessed by medico-legal autopsies
|
|
Marta Rorat, Tomasz Jurek, Ernest Kuchar, Leszek Szenborn, Wojciech Golema, Agnieszka Halon |
|
Liver steatosis in Polish children assessed by medico-legal autopsies
Marta Rorat, Tomasz Jurek, Ernest Kuchar, Leszek Szenborn, Wojciech Golema, Agnieszka Halon
Wroclaw, Poland
Author Affiliations: Department of Forensic Medicine (Rorat M, Jurek T, Golema W), Department of Pediatrics and Infectious Diseases (Kuchar E, Szenborn L), Department of Pathological Anatomy (Halon A), Wroclaw Medical University, Poland
Corresponding Author: Marta Rorat, Department of Forensic Medicine, Medical University of Wroclaw, Mikulicza Radeckiego 4, Wroclaw 50-368, Poland (Tel: +48-71-784-14-74; Fax: + 48-71-784-00-95; Email: marta.rorat@gmail.com)
doi: 10.1007/s12519-012-0387-8
Background: Cases of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are increasing in the pediatric population. Their growing prevalence coincides with the obesity epidemic. Assessment of the incidence requires liver biopsies on a representative population sample, which are hampered by the absence of indications for invasive examination on children without clinical symptoms. The aim of the current study was to assess the incidence of liver steatosis in the population of children up to 18 years old from Lower Silesia.
Methods: We retrospectively reviewed 342 medico-legal autopsy reports from 2000 to 2009. We separated a group of 256 children whose death was caused by trauma. Liver steatosis was diagnosed according to the results of histopathological examinations and typical macroscopic imaging.
Results: In the 265 children who died from trauma, liver steatosis was reported in 11 (4.2%) children (6 boys) aged between 6 months and 18 years old. Six of the 11 children (54.5%) were found to be overweight. In all 342 children, steatosis was found in 18 (5.3%) children (13 boys), while NASH was diagnosed in 1 (0.3%). Excess body weight was observed in 55.6% (10/18) of children with steatosis.
Conclusions: Liver steatosis can occur at any age, even in infancy. Being overweight is a very important risk factor. Gross examination of the liver is insufficient for the diagnosis of steatosis because of its lower sensitivity and specificity. Verification of liver steatosis requires reference histopathological examination.
Key words: autopsy; liver steotosis; non-alcoholic fatty liver disease; obesity
World J Pediatr 2013;9(1):68-72 |
|
[Abstract] [Full Text] [PDF]
|
|