Quick Search
  Home Journal Information Current Issue Past Issues Services Contact Us  
Vol 12, No 1
Vol 12, No 1 January 2016 ISSN 1708-8569
 
Editorial
Review articles
Meta-analysis
Original articles
Brief report
Case reports
Clinical image
Correspondence
   
Editorial:
Risk stratification and therapeutics of neuroblastoma: the challenges remain
  Hong Mei, Zhen-Yu Lin, Qiang-Song Tong
 
  [Abstract] [Full Text] [PDF]  
Review articles:
Prematurity and the burden of infl uenza and respiratory syncytial virus disease
  Bernhard Resch, Stefan Kurath-Koller, Monika Eibisberger, Werner Zenz
 
Background:
Respiratory morbidity of former preterm infants and especially those with bronchopulmonary dysplasia (BPD) is high during infancy and early childhood.
Data sources:
We performed a review based on a literature search including EMBASE, MEDLINE, and CINAHL databases to identify all relevant papers published in the English and German literature on influenza and respiratory syncytial virus infection associated with preterm infant, prematurity, and BPD between 1980 and 2014.
Results:
Recurrent respiratory symptoms remain common at preschool age, school age and even into young adulthood. Acute viral respiratory tract infections due to different pathogens cause significant morbidity and necessitate rehospitalizations during the fi rst years of life. Infl uenza virus infection plays a minor role compared to respiratory syncytial virus (RSV) associated respiratory tract infection during infancy and early childhood. Nevertheless, particular morbidity to both viruses is high.
Conclusions:
The particular burden of both viral diseases in preterm infants is dominated by RSV and its associated rehospitalizations during the fi rst two years of life. Prophylactic measures include vaccination against influenza virus of family members and caregivers and active immunization starting at the age of 6 months, and monthly injections of palivizumab during the cold season to avoid severe RSV disease and its sequelae.
 
Key words: bronchopulmonary dysplasia; infl uenza; preterm infant; respiratory infectious disease; respiratory syncytial virus
  [Abstract] [Full Text] [PDF]  
Molecular medicine of fragile X syndrome: based on known molecular mechanisms
  Shi-Yu Luo, Ling-Qian Wu, Ran-Hui Duan
 
Background:  
Extensive research on fragile X mental retardation gene knockout mice and mutant Drosophila models has largely expanded our knowledge on mechanism-based treatment of fragile X syndrome (FXS).  In light of these findings, several clinical trials are now underway for therapeutic translation to humans.   
Data sources:  
Electronic literature searches were conducted using the PubMed database and ClinicalTrials.gov. The search terms included "fragile X syndrome", "FXS and medication", "FXS and therapeutics" and "FXS and treatment". Based on the publications identified in this search, we reviewed the neuroanatomical abnormalities in FXS patients and the potential pathogenic mechanisms to monitor the progress of FXS research, from basic studies to clinical trials.   
Results:  
The pathological mechanisms of FXS were categorized on the basis of neuroanatomy, synaptic structure, synaptic transmission and fragile X mental retardation protein (FMRP) loss of function. The neuroanatomical abnormalities in FXS were described to motivate extensive research into the region-specific pathologies in the brain responsible for FXS behavioural manifestations. Mechanism-directed molecular medicines were classified according to their target pathological mechanisms, and the most recent progress in clinical trials was discussed.   
Conclusions:  
Current mechanism-based studies and clinical trials have greatly contributed to the development of FXS pharmacological therapeutics. Research examining the extent to which these treatments provided a rescue effect or FMRP compensation for the developmental impairments in FXS patients may help to improve the effi cacy of treatments.     
 
Key words: clinical trial; fragile X syndrome; mechanism-based; treatment   
  [Abstract] [Full Text] [PDF]  
New technologies as a strategy to decrease medication errors: how do they affect adults and children differently?
  Margarita Ruano, Elena Villamañn, Ester Prez, Alicia Herrero, Rodolfo Álvarez-Sala
 
Medication error can occur throughout the drug treatment process, with special relevance in children given the risk of adverse effects resulting from a medication error is more prevalent than in adults. The signifi cance of medication error in children is also greater because small error that would be tolerated in adults can cause significant damage in children. Moreover, the likelihood of injury is higher than in adults.
Data sources:
Based on the data published, most medication errors take place in prescribing and administration stages in both populations. Taking in account that child's risk factors are different from those of adults, with some specifi c causes to pediatrics, we have reviewed available data about new technologies as a strategy to reduce pediatric medication errors.
Results:
Even though there is a lack of standardized definitions and terminology that makes studies difficult to compare, we checked that new technologies have proven to be effectives in reducing medication errors, mainly computerized physician order entry (CPOE) and platforms to aid decision-making. However, we also observed that the use of these informatic tools can also generate new errors.
Conclusions:
Implementation of CPOE programs for pediatrics, communication improvement between healthcare professionals taking care of admitted children and the knowledge of these programs should be the mayor priorities for the safety of hospitalized children.
 
Key words: electronic prescribing; new technologies; pediatric medication errors
  [Abstract] [Full Text] [PDF]  
Meta-analysis:
Comparison of different noninvasive diagnostic methods for biliary atresia: a meta-analysis
  Jin-Peng He, Yun Hao, Xiao-Lin Wang, Xiao-Jin Yang, Jing-Fan Shao, Jie-Xiong Feng
 
Background:
This study was undertaken to retrospectively analyze the accuracy of different methods in differentiating biliary atresia from neonatal jaundice.
Methods:
A search was made in MEDLINE, and the Web of Science for relevant original articles published in English; methodological quality of the included studies was also assessed. Two reviewers extracted data independently. Studies were pooled, summary receiver operating characteristics curve and diagnostic odds ratio (DOR) with corresponding confi dence intervals were calculated.
Results:
For diagnosis of biliary atresia, ultrasonography (US), hepatic scintigraphy (HBS), and magnetic resonance cholangiography (MRCP) had a pooled sensitivity of 74.9% (range: 70.4%-79.1%), 93.4% (range: 90.3%- 95.7%) and 89.7% (range: 84.8%-93.4%), a specificity of 93.4% (range: 91.4%-95.1%), 69.2% (range: 65.1%- 73.1%) and 64.7% (range: 58.0%-71.0%), a positive likelihood ratio of 12.16 (range: 6.41-23.08), 3.01 (range: 2.15-4.20) and 3.10 (range: 1.59-6.06), a negative likelihood ratio of 0.23 (range: 0.13-0.38), 0.13 (range: 0.06-0.25) and 0.16 (range: 0.06-0.44), DOR of 72.56 (range: 27.34- 192.58), 29.88 (range: 12.82-69.64) and 32.48 (range: 8.22- 128.29), with an area under the curve of 0.96, 0.91, and 0.92, and Q value of 0.90, 0.85, and 0.85, respectively.
Conclusions:
US, HBS and MRCP can be very useful for the diagnostic work-up of neonatal cholestasis. To improve the sensitivity and specificity, several additional measures can be used.
 
Key words: biliary atresia; diagnostic methods; meta-analysis; noninvasive
  [Abstract] [Full Text] [PDF]  
Original articles:
Predicting eczema severity beyond childhood
  Kam Lun Hon, Yin-Ching K. Tsang, Terence Chuen W. Poon, Nga Hin Pong, Matthew Kwan, Shirley Lau, Yuen-Chun Chiu, Hin-Hei Wong, Ting-Fan Leung
 
Background:
We evaluated factors associated with eczema severity in adolescence.
Methods:
Nottingham Eczema Severity Score (NESS), family and personal history of atopy, skin prick test for common food and aeroallergens, highest serum IgE level and eosinophil count were evaluated. Patients with paired NESSs (childhood-NESS is NESS performed at <10 years of age; adolescence-NESS is NESS performed at age >10 years) were further analyzed.
Results:
Adolescence-NESS (n=383 patients) was associated with eczema onset in infancy, dust mite and food allergen sensitization, dietary avoidance, use of wet wrap, traditional Chinese medicine, immunomodulant (azathioprine or cyclosporine), high IgE level, eosinophil count, but not with family/personal history of atopy. Eighty-two patients had both childhood-NESS and adolescence-NESS (mean follow-up of 6.8 years) showing that adolescence-NESS was associated with childhood- NESS severity grades (P=0.034). Of these patients, 48% remained in the same severity grades, whereas 39% improved, and 13% deteriorated from childhood to adolescence.
Conclusions:
It is not possible to assure parents that their child can outgrow eczema. In eczema prognosis research, long-term follow-up is warranted.
 
Key words: atopic dermatitis; atopy; eczema; Nottingham Eczema Severity Score; prognosis
  [Abstract] [Full Text] [PDF]  
Heat shock protein 70-2 and tumor necrosis factor- gene polymorphisms in Chinese children with Henoch-Schönlein purpura
  Gui-Xia Ding, Chen-Hu Wang, Ruo-Chen Che, Wan-Zhen Guan, Yang-Gang Yuan, Min Su, Ai-Hua Zhang, Song-Ming Huang
 
Background:
Henoch-Schönlein purpura (HSP) or IgAassociated vasculitis is related to immune disturbances. Polymorphisms of the heat shock protein 70-2 gene (HSP70-2) and the tumor necrosis factor- gene (TNF-) are known to be associated with immune diseases. The purpose of this study was to investigate the likely association of HSP70-2 (+1267A/G) and TNF- (+308A/G) gene polymorphisms with HSP in children.
Methods:
The polymerase chain reaction restriction fragment length polymorphism method was used to detect the HSP70-2 and TNF- polymorphisms in 205 cases of children with HSP and 53 controls; and the association of these polymorphisms with HSP and HSP nephritis (HSPN) was analyzed.
Results:
The G/G genotypic frequencies at the +1267A/G position of HSP70-2 in the HSP group (22.9%) were signifi cantly higher than those in the healthy control group (9.4%) (2=4.764, P<0.05). The frequencies of the A/A, A/G and G/G genotypes of HSP70-2 in patients in the nephritis-free group and the HSPN group showed no statistically significant difference. The A/A genotype frequency at the +308G/A position of TNF- in the HSP group was 8.3%, which was higher than that in the control group (2=6.447, P<0.05). The A allele frequency of TNF- in the HSP group was higher than that in the control group, with a statistically significant difference (2=7.241, P<0.05).
Conclusions:
The HSP70-2 (+1267A/G) and TNF- (+308G/A) gene polymorphisms were associated with HSP in children. The G/G homozygosity of HSP70-2 and the A/A homozygosity of TNF- may be genetic predisposing factors for HSP.

Key words: gene polymorphism; heat shock protein 70-2; Henoch-Schönlein purpura; Henoch-Schönlein purpura nephritis; tumor necrosis factor-

  [Abstract] [Full Text] [PDF]  
Outcome in neonates with necrotizing enterocolitis and patent ductus arteriosus
  Ulf Kessler, Franzisca Schulte, Dietmar Cholewa, Mathias Nelle, Stephan C. Schaefer, Peter M. Klimek, Steffen Berger
 
Background:
There is no agreement of the influence of patent ductus arteriosus (PDA) on outcomes in patients with necrotizing enterocolitis (NEC). In this study, we assessed the infl uence of PDA on NEC outcomes.
Methods:
A retrospective study of 131 infants with established NEC was performed. Outcomes (death, disease severity, need for surgery, hospitalization duration), as well as multiple clinical parameters were compared between NEC patients with no congenital heart disease (n=102) and those with isolated PDA (n=29). Univariate, multivariate and stepwise logistic regression analyses were performed.
Results:
Birth weight and gestational age were significantly lower in patients with PDA [median (95% CI): 1120 g (1009-1562 g), 28.4 wk (27.8-30.5 wk)] than in those without PDA [median (95% CI): 1580 g (1593- 1905 g), 32.4 wk (31.8-33.5 wk); P<0.05]. The risk of NEC-attributable fatality was higher in NEC patients with PDA (35%) than in NEC patients without PDA (14%)[univariate odds ratio (OR)=3.3, 95% CI: 1.8- 8.6, P<0.05; multivariate OR=2.4, 95% CI: 0.82-2.39, P=0.111]. Significant independent predictors for nonsurvival within the entire cohort were advanced disease severity stage III (OR=27.9, 95% CI: 7.4-105, P<0.001) and birth weight below 1100 g (OR=5.7, 95% CI: 1.7- 19.4, P<0.01).
Conclusions:
In patients with NEC, the presence of PDA is associated with an increased risk of death. However, when important differences between the two study groups are controlled, only birth weight and disease severity may independently predict mortality.
 
Key words: congenital heart disease; necrotizing enterocolitis; neonatal mortality; patent ductus arteriosus
  [Abstract] [Full Text] [PDF]  
Tacrolimus for children with refractory nephrotic syndrome: a one-year prospective, multicenter, and open-label study of Tacrobell®, a generic formula
  Eun Mi Yang, Sang Taek Lee, Hyun Jin Choi, Hee Yeon Cho, Joo Hoon Lee, Hee Gyung Kang, Young Seo Park, Hae Il Cheong, Il-Soo Ha
 
Background:
Cyclosporine A and tacrolimus (TAC) are often used as a second-line treatment for children with refractory nephrotic syndrome (NS). This study was undertaken to investigate the efficacy and safety of Tacrobell®, a locally produced generic form of TAC.
Methods:
This study was a one-year prospective, open-label, single-arm, multicenter trial. Fourty-four children with steroid-dependent NS (SDNS) and 33 children with steroid-resistant NS (SRNS) were enrolled. The primary endpoints were defined as the remission rates, whereas the secondary endpoints were recognized as the duration of remission and adverse effects of TAC.
Results:
After one-year treatment, 34 (77.3%) of the 44 patients with SDNS were in complete remission, and 6 (13.6%) were in partial remission. Nineteen (43.2%) patients did not relapse during the study; for those who did relapse, the mean duration of remission was 4.62.9 months. The number of relapse episodes during the study period (0.90 per patient-year) was significantly lower than that in the preceding year (2.8 per patientyear). After treatment for 3 and 6 months, 12 (36.4%) of the 33 patients with SRNS were in remission, and after treatment for 12 months, the number of patients had increased to 13 (39.4%). The mean time to achieve remission was 4.03.2 months. After remission (duration, 3.72.7 months), 12 (54.5%) of 22 patients relapsed. The fasting blood glucose and blood pressure levels during the therapy were similar to those at the time of study entry.
Conclusions:
Treatment with Tacrobell® was effective and safe for children with refractory NS. The efficacy of this generic form of TAC was better than that of the original TAC formula.
 
Key words: generic drugs; nephrotic syndrome; tacrolimus
  [Abstract] [Full Text] [PDF]  
Feeding methods, sleep arrangement, and infant sleep patterns: a Chinese population-based study
  Xiao-Na Huang, Hui-Shan Wang, Jen-Jen Chang, Lin-Hong Wang, Xi-Cheng Liu, Jing-Xiong Jiang, Lin An
 
Background:
Findings from prior research into the effect of feeding methods on infant sleep are inconsistent. The objectives of this study were to examine infants' sleep patterns by feeding methods and sleep arrangement from birth to eight months old.
Methods:
This longitudinal cohort study enrolled 524 pregnant women at 34-41 weeks of gestation and their infants after delivery in 2006 and followed up until eight months postpartum. The study subjects were recruited from nine women and children hospitals in nine cities in China (Beijing, Chongqing, Wuhan, Changsha, Nanning, Xiamen, Xi'an, Jinan, and Hailin). Participating infants were followed up weekly during the first month and monthly from the second to the eighth month after birth. Twenty-four hour sleep diaries recording infants' sleeping and feeding methods were administered based on caregiver's self-report. Multivariable mixed growth curve models were fi tted to estimate the effects of feeding methods and sleep arrangement on infants' sleep patterns over time, controlling for maternal and paternal age, maternal and paternal education level, household income, supplementation of complementary food, and infant birth weight and length.
Results:
Exclusively formula fed infants had the greatest sleep percentage/24 h, followed by exclusively breast milk fed infants and partially breast milk fed infants (P<0.01). Night waking followed a similar pattern. However, the differences in sleep percentage and night waking frequency between exclusively formula and exclusively breast milk fed infants weakened over time as infants developed. In addition, compared to infants with bed-sharing sleep arrangement, those with room sharing sleep arrangement had greater daytime and 24-hour infant sleep percentage, whereas those with sleeping alone sleep arrangement had greater nighttime sleep percentage.
Conclusions:
Our data based on caregiver's selfreport suggested that partial breastfeeding and bedsharing may be associated with less sleep in infants. Health care professionals need to work with parents of newborns to develop coping strategies that will help prevent early weaning of breastfeeding.
 
Key words: breast feeding; feeding method; infant sleep; sleep arrangement
  [Abstract] [Full Text] [PDF]  
Early term infants are at increased risk of requiring neonatal intensive care
  Pradeep Vittal Mally, Nickolas Theophilos Agathis, Sean Michael Bailey
 
Background:
Increasing evidence is demonstrating that infants born early on during the term period are at increased risk of morbidity compared with infants born closer to a complete 40 week gestational pregnancy. The purpose of this study was to compare early term [gestation age (GA): 37-37 6/7 weeks] neonatal outcomes with those of other full term neonatal intensive care unit (NICU) admissions.
Methods:
Retrospective chart review of all term infants admitted to the NICU at New York University Langone Medical Center over a 17 month period. Subjects were grouped and analyzed according to their GA at birth: 1) early term infants (GA between 37 0/7 to 37 6/7 weeks) and 2) other term infants (38 0/7 weeks and older).
Results:
Early term infants were more likely to require NICU care than other term infants [relative risk: 1.42, 95% confidence interval (CI)=1.07-1.88), P=0.01]. In the NICU, they are more likely to manifest respiratory distress syndrome [odds ratio (OR)=5.7, 95% CI=1.6-19.8, P<0.01] and hypoglycemia (OR=4.6, 95% CI=2.0-10.4, P<0.001). In addition, early term neonates were more likely to be born via elective cesarean section than other term neonates (OR=4.1, 95% CI=2.0-8.5, P<0.001).
Conclusions:
Being born at early term is associated with increased risk of respiratory disease and hypoglycemia requiring neonatal intensive care. Further efforts directed at decreasing early term deliveries may be warranted.
 
Key words: gestational age; hypoglycemia; neonatology; respiratory distress syndrome
  [Abstract] [Full Text] [PDF]  
Violence-related behaviors among adolescents and its association with cognitive emotion regulation strategies
  Peng Bao, Jin Jing, Wen-Han Yang, Xiu-Hong Li, Yu-Sui Cai
 
Background:
Adolescent violence is now regarded as a major public health concern. Despite growing interest in psychographic risk factors for violent behavior, few studies have explored the role of strategies to regulate cognitive emotion in adolescents. This study aimed to investigate the prevalence of adolescent violence behaviors and to identify the relationship between specific strategies to regulate cognitive emotion and forms of violent behavior.
Methods:
We cross-sectionally surveyed 3315 students in grades 7 to 10 using anonymous, self-reporting questionnaires to examine strategies to regulate cognitive emotion and violence-related behaviors in young adolescents. A logistic regression model was used to identify the relationship between specifi c violent behaviors and strategies to regulate cognitive emotion.
Results:
The most commonly reported type of violent behavior was verbal attack (48.6%), while 7.1% of students were involved in fi ghts and 2.4% had been injured in fi ghts. Boys were involved in all forms of violent behavior studied, and did so significantly more often than girls (P<0.05). Logistic regression revealed that six cognitive emotion strategies (self-blame, rumination, planning, reappraisal, catastrophisizing, and blaming others) were associated with violent behaviors, of which catastrophisizing was the most significant factor of all violent behaviors examined that were infl uenced by this strategy.
Conclusions:
Violence-related behaviors, especially verbal attacks, were common among adolescents. Several cognitive emotion regulation strategies were positively associated with specific violent behaviors, but catastrophisizing was strongly related to all forms of violent behavior. Thus, programs targeting adolescent violence must address this and other maladaptive cognitive emotion regulation strategies.
 
Key words: adolescent; anti-social behavior; cognitive emotion regulation; psychographic risk factors; violence
  [Abstract] [Full Text] [PDF]  
Characteristics of respiratory syncytial virus-induced bronchiolitis co-infection with Mycoplasma pneumoniae and add-on therapy with montelukast
  Sheng-Hua Wu, Xiao-Qing Chen, Xia Kong, Pei-Ling Yin, Ling Dong, Pei-Yuan Liao, Jia-Ming Wu
 
Background:
The influence of Mycoplasma pneumoniae (MP) infection on bronchiolitis remains unclear. Additionally, reports on the efficacies of leukotriene receptor antagonists in the treatment of bronchiolitis have been inconclusive.
Methods:
Children with respiratory syncytial virus (RSV)-induced bronchiolitis were divided into two groups: RSV+MP group and RSV group. Each group was randomly divided into two subgroups: one received routine and placebo treatment, while the other received routine and montelukast treatment for 9 months. The cumulative numbers of wheezing episodes and recurrent respiratory tract infections were recorded. Blood parameters were determined.
Results:
Patients in the RSV+MP group exhibited an older average age, fever, more frequent fl aky and patchy shadows in chest X-rays, more frequent extrapulmonary manifestations, and longer hospital stays compared with patients in the RSV group. Additionally, higher baseline blood eosinophil counts, eosinophil cationic protein (ECP), total immunoglobulin E (IgE), interleukin (IL)-4, IL-5, IL-4/interferon- ratios, leukotriene (LT) B4, and LTC4, and lower baseline lipoxin A4 (LXA4)/LTB4 ratios were observed in the RSV+MP group compared with the RSV group. Montelukast treatment decreased the cumulative numbers of recurrent wheezing episodes and recurrent respiratory tract infections at 9 and 12 months. This efficacy may be related to the montelukast-induced reductions in peripheral eosinophil counts, ECP and total IgE, as well as the montelukast-dependent recovery in T helper (Th) 1/Th2 balance and LXA4/LTB4 ratios in children with bronchiolitis.
Conclusions:
RSV bronchiolitis with MP infection was associated with clinical and laboratory features that differed from those of RSV bronchiolitis without MP infection. Add-on therapy with montelukast for 9 months was benefi cial for children with bronchiolitis at 9 and 12 months after the initiation of treatment.
 
Key words: bronchiolitis; leukotrienes; montelukast; Mycoplasma pneumoniae; respiratory syncytial virus
  [Abstract] [Full Text] [PDF]  
Effect of etanercept on refractory systemic-onset juvenile idiopathic arthritis
  Xiao Hu, Fang Yuan, Jian Zhang, Lei Yin, Bi-Ru Li, Yan-Liang Jin
 
Background:
Treatment of systemic-onset juvenile idiopathic arthritis (So-JIA) is challenging, and the effi cacy of injectable recombinant human tumor necrosis factor type 1 receptor-antibody fusion protein (etanercept) on So- JIA has been controversial.
Methods:
We retrospectively studied 12 patients with refractory systemic juvenile arthritis treated with etanercept at our hospital in the past 5 years. The 12 patients were divided into a corticosteroid-dependent group (n=7) and an ineffective group (n=5) on the basis of their responses to treatment before the administration of etanercept. Etanercept was added to the treatment without substantially changing the original regimens in general, and doses, and signs of efficacy including alleviation or resolution of symptoms such as high fever, infl ammatory arthropathy, eruption rash, hydrohymenitis, as well as changes in the levels of laboratory infl ammatory markers such as the white blood cell count, erythrocyte sedimentation rate, levels of C-reactive protein and serum ferritin were recorded.
Results:
Etanercept was withdrawn after the first dose from one patient in the corticosteroid-dependent group because of a systemic allergic rash, and was also withdrawn from one patient in the ineffective group after 2 months of treatment owing to ineffi cacy; the remaining 10 patients completed the entire treatment protocol, at which point etanercept was discontinued. At that time, clinical symptoms and laboratory infl ammatory markers of the remaining patients were within the normal range and the mean dose of prednisone was 0.18 mg/kg per day, an 81% decrease from the mean dose at baseline. At present, the corticosteroid has been discontinued and only methotrexate maintenance treatment is used in 3 patients; the other 7 patients are treated with prednisone and methotrexate maintenance therapy. All of the 10 patients are in a medicated remission with no recurrence.
Conclusions:
In the treatment of patients with refractory So-JIA, the principles of individual therapy and combinations of drugs should be followed. Etanercept is an important and valid candidate for use in such combined treatment strategies.
 
Key words: etanercept; juvenile idiopathic arthritis; systemic-onset; therapy
  [Abstract] [Full Text] [PDF]  
Evaluation of carotid intima-media thickness and carotid arterial stiffness in children with adenotonsillar hypertrophy
  Murat Çiftel, Berrin Demir, Gnay Kozan, Osman Yılmaz, Hasan Kahveci, Ömer Kılıç
 
Background:
Adenotonsillar hypertrophy can produce cardiopulmonary disease in children. However, it is unclear whether adenotonsillar hypertrophy causes atherosclerosis. This study evaluated carotid intimamedia thickness and carotid arterial stiffness in children with adenotonsillar hypertrophy.
Methods:
The study included 40 children with adenotonsillar hypertrophy (age: 5-10 years) and 36 healthy children with similar age and body mass index. Systolic blood pressure, diastolic blood pressure, and pulse pressure were measured in all subjects. Carotid intima-media thickness, carotid arterial systolic diameter, and carotid arterial diastolic diameter were measured using a high-resolution ultrasound device. Based on these measurements, carotid arterial strain, carotid artery distensibility, beta stiffness index, and elasticity modulus were calculated.
Results:
Carotid intima-media thickness was greater in children with adenotonsillar hypertrophy (0.360.05 mm vs. 0.340.04 mm, P=0.02) compared to healthy controls. Beta stiffness index (3.011.22 vs. 2.980.98, P=0.85), elasticity modulus (231.3999.23 vs. 226.4683.20, P=0.88), carotid arterial strain (0.170.06 vs. 0.170.04, P=0.95), and carotid artery distensibility (13.143.88 vs. 12.923.84, P=0.75) were similar between children with adenotonsillar hypertrophy and the healthy controls.
Conclusions:
The present study revealed increased carotid intima-media thickness in children with adenotonsillar hypertrophy. The risk of subclinical atherosclerosis may be higher in children with adenotonsillar hypertrophy.
 
Key words: adenotonsillar hypertrophy; carotid artery stiffness; carotid intima media thickness; subclinical atherosclerosis
  [Abstract] [Full Text] [PDF]  
Intravenous iron sucrose for children with iron defi ciency anemia: a single institution study
  Elpis Mantadakis, Emmanouela Tsouvala, Varvara Xanthopoulou, Athanassios Chatzimichael
 
Background:
Intravenous iron sucrose is not recommended by its manufacturers for use in children despite extensive safety and effi cacy data in adults.
Methods:
We reviewed the experience of our department between January, 2011 and February, 2014 with the use of intravenous iron sucrose in children 14 years of age who failed in oral iron therapy for iron defi ciency anemia (IDA).
Results:
Twelve children (6 females) aged 1.2- 14 years (median age 8.9 years) received at least one dose of intravenous iron sucrose. Ten patients had IDA inadequately treated or non-responsive to oral iron therapy. One patient received therapy for blood transfusion avoidance and one for presumed iron refractory iron deficiency anemia (IRIDA). Iron sucrose infusions were given on alternate days up to three times per week. The number of infusions per patient ranged from 2 to 6 (median, 3), the individual doses from 100 mg to 200 mg (median, 200 mg), and the total doses from 200 mg to 1200 mg (median, 400 mg). Iron sucrose was effective in raising the hemoglobin concentration to normal in all patients with IDA, i.e., from 7.62.38 g/dL to 12.40.64 g/dL, within 31-42 days after the fi rst infusion. The single patient with IRIDA demonstrated a 1.8 g/dL rise. Injection site disorders in three cases and transient taste perversion in one case were the only side effects.
Conclusion:
Intravenous iron sucrose appears to be safe and very effective in children with IDA who do not respond or cannot tolerate oral iron therapy.
 
Key words: adverse effects; iron defi ciency; iron sucrose; parenteral iron
  [Abstract] [Full Text] [PDF]  
Brief report:
Tonsillitis in children: unnecessary laboratory studies and antibiotic use
  Antti Kunnamo, Matti Korppi, Merja Helminen
 
Background:
The Finnish Current Care Guidelines on diagnostics and treatment of sore throat recommend the treatment of only group A streptococcus (GAS) positive cases with penicillin. The aim of the study was to evaluate how these guidelines are followed in the pediatric emergency unit.
Methods:
We analyzed retrospectively the data on microbiological studies and blood tests done, and data on prescribing of antibiotics, of 200 children admitted for febrile exudative tonsillitis.
Results:
After the clinical diagnosis of exudative tonsillitis, antigen test and/or culture for GAS identifi cation was done in >95% of cases. All the 32 (16%) children with GAS infection, but also 52 (38%) of the 137 children without any evidence of bacterial infection received antibiotics. Additional laboratory studies were done in 96% of children. Serum C-reactive concentrations or white blood cell counts were not able to separate streptococcal from non-streptococcal tonsillitis. No serious bacterial infection was diagnosed.
Conclusions:
The Finnish Current Care Guidelines lead to over-treatment with antibiotics. None of the 200 children returned after discharge, suggesting that undertreatment did not happen.
 
Key words: exudative tonsillitis; streptococcal antigen test; streptococcal culture
  [Abstract] [Full Text] [PDF]  
Case reports:
Focal seizure associated with human parvovirus B19 infection in a non-encephalopathic child
  Debopam Samanta, Erin Willis
 
Background:
The incidence of acute symptomatic (at the time of documented brain insult) seizures and single unprovoked seizures are 29-39 and 23-61 per 100 000 per year, respectively. After stabilization of the patient, fi nding the etiology of the seizure is of paramount importance. A careful history and physical examination may allow a diagnosis without need for further evaluation.
Methods:
In the literature, severe central nervous system involvement has been reported from human parvovirus B19 infection. We reported a previously healthy 7-year-old girl who presented after an episode of focal seizure. She was afebrile and didn't have any focal neurological abnormalities. She had erythematous malar rash along with reticulating pattern of rash over her both upper extremities.
Results:
Parvovirus infection was suspected due to the characteristic erythematous malar rash. Serum human parvovirus B19 DNA polymerase chain reaction was positive which was consistent with acute parvovirus infection. Further confirmation of current infection was done with Sandwich enzyme immunoassays showing positive anti-B19 IgM Index (>1.1). IgG index was equivocal (0.9-1.1). Conclusions:
We report an extremely rare presentation of non-febrile seizure from acute parvovirus infection in a child without encephalopathy who had an excellent recovery. Timely diagnosis can provide counselling regarding future seizure recurrence risk, curtail expenditure from expensive diagnostic work up and provide additional recommendations about potential risks to a pregnant caregiver.
 
Key words: erythema infectiosum; human parvovirus B19; nonfebrile seizure
  [Abstract] [Full Text] [PDF]  
Clinical image:
Interlabial mass in a neonate with paraurethral cyst
  Min-Hua Tseng, Shih-Hua Lin
 
  [Abstract] [Full Text] [PDF]  
Correspondence:
Parenteral iron therapy in children with iron
  Jelena Roganovic
 
  [Abstract] [Full Text] [PDF]  
Correspondence: Parenteral iron therapy in children with iron
  Elpis Mantadakis
 
  [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