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Sample records for children retrospective analysis

  1. Anemia and growth failure among HIV-infected children in India: a retrospective analysis

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    Shet Anita

    2009-06-01

    Full Text Available Abstract Background Anemia and poor nutrition have been previously described as independent risk factors for death among HIV-infected children. We sought to describe nutritional status, anemia burden and HIV disease correlates among infected children in India. Methods We analyzed retrospective data from 248 HIV-infected children aged 1–12 years attending three outpatient clinics in South India (2004–2006. Standard WHO definitions were used for anemia, HIV staging and growth parameters. Statistical analysis included chi square, t tests, univariate and multivariate logistic regression analyses. Results The overall prevalence of anemia (defined as hemoglobin Conclusion The high prevalence and strong interrelationship of anemia and poor nutrition among HIV-infected children in India, particularly those living in rural areas underscores the need for incorporating targeted nutritional interventions during national scale up of care, support and treatment among HIV-infected children.

  2. Prelinguistic communication development in children with childhood apraxia of speech: a retrospective analysis.

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    Highman, Chantelle; Leitão, Suze; Hennessey, Neville; Piek, Jan

    2012-02-01

    In a retrospective study of prelinguistic communication development, clinically referred preschool children (n = 9) aged 3-4 years, who as infants had failed a community-based screening program, were evaluated for features of childhood apraxia of speech (CAS). Four children showed no features and either delayed or normal language, five had from three-to-seven CAS features and all exhibited delayed language. These children were matched by age with 21 children with typically-developing (TD) speech and language skills. Case-control comparisons of retrospective data from 9 months of age for two participants with more severe features of CAS at preschool age showed a dissociated pattern with low expressive quotients on the Receptive-Expressive Emergent Language Assessment-Second Edition (REEL-2) and records of infrequent babbling, but normal receptive quotients. However, other profiles were observed. Two children with milder CAS features showed poor receptive and expressive development similar to other clinically referred children with no CAS features, and one child with severe CAS features showed poor receptive but normal expressive developmental milestones at 9 months and records of frequent babbling. Results suggest some but not all children with features of suspected CAS have a selective deficit originating within speech motor development.

  3. Prevalence of multidrug resistant pathogens in children with urinary tract infection: a retrospective analysis

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    Srinivasan S, Madhusudhan NS

    2014-11-01

    Full Text Available Urinary tract infection (UTI is one of the commonest medical problems in children. It can distress the child and may cause kidney damage. Prompt diagnosis and effective treatment can prevent complications in the child. But treatment of UTI in children has now become a challenge due to the emergence of multidrug resistant bacteria. Aims & Objectives: To know the bacteriological profile and susceptibility pattern of urinary tract infections in children and to know the prevalence of multidrug resistant uropathogens. Materials & Methods: A retrospective analysis was done on all paediatric urine samples for a period of one year. A total of 1581 samples were included in the study. Antimicrobial susceptibility testing was done on samples showing significant growth by Kirby-Bauer disc diffusion method. Statistical analysis: Prevalence and pattern were analyzed using proportions and percentages. Results: E.coli was the most predominant organism (56% causing UTI in children followed by Klebsiella sp (17%. Fifty three percent of gram negative organisms isolated from children were found to be multidrug resistant. Majority of E. coli isolates were found to be highly resistant to Ampicillin (91% and Cotrimoxazole (82% and highly sensitive to Imipenem (99% and Amikacin (93%. Conclusion: Paediatric UTI was common in children less than 5 years of age. Gram negative bacteria (E. coli and Klebsiella sp were more common than gram positive bacteria. Our study revealed that multidrug resistance was higher in E.coli.

  4. [Tics in children and adolescents: a retrospective analysis of 78 cases].

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    Catarina Prior, A; Tavares, S; Figueiroa, S; Temudo, T

    2007-02-01

    Tics are the most frequent abnormal movement in children. A familial history of tics and a personal and familial history of neurobehavioral disturbances are common in children with this abnormality. Tics may seriously compromise daily activities in affected individuals. To identify the characteristics of tics in children and adolescents followed-up in the Neuropediatric Unit of the Hospital Geral de Santo António. We performed a retrospective analysis of patients with tics based on information collected from medical records. The diagnostic criteria of the DSM IV-TR 2000 of the American Psychiatric Association were used. The medical records of 78 children were analyzed, 84.6 % of whom were boys. More than one third of the patients were aged 4 to 8 years old. In 5.1 % of the patients tics developed before the age of 2 years. A familial history of tics, depression and obsessive disorder traits was found in approximately 30 % of patients. The most frequent comorbidity was attention deficit hyperactivity disorder (67.9 %). The occurrence of pediatric autoimmune neuropsychiatric disorders associated with streptococcus infection (PANDAS) was suggested in five patients. In all patients, motor tics occurred before vocal tics. In more than two thirds of the patients, tics were simple. In 59.0 % of the patients, tics were chronic, and in 45.7 % of these met the criteria for Tourette's syndrome. A total of 43.1 % of the patients with chronic tics received pharmacotherapy, risperidone being the most frequently used drug. In general the results of the present study are in agreement with those of previous studies, underlining the need to consider a diagnosis of tics in young children and highlighting the importance of identification and appropriate treatment of comorbidities.

  5. The prevalence of lumbar spondylolysis in young children: a retrospective analysis using CT.

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    Lemoine, Thibaut; Fournier, Joseph; Odent, Thierry; Sembély-Taveau, Catherine; Merenda, Pauline; Sirinelli, Dominique; Morel, Baptiste

    2017-10-13

    Although lumbar spondylolysis is encountered in general population with an incidence estimated to be 3-10%, limited information is available for children. The aim of the study is to determine the prevalence of spondylolysis according to associated vertebral bony malformation and spinopelvic parameters in children under eight requiring CT evaluation for unrelated lumbar conditions. Seven hundred and seventeen abdominal and pelvic multi-detector CT scans were obtained in patients under 8 years of age were reviewed. Two board certificated radiologists and two resident radiologists retrospectively evaluated CT scans for lumbar spondylolysis and associated malformations. Pelvic incidence and spondylolisthesis were reported. Our analysis included 717 CT scans in 532 children (259 girls and 273 boys). Twenty-five cases of spondylolysis were diagnosed (16 bilateral and 9 unilateral, 64 and 36%, respectively) in 14 boys (56%) and 11 girls (44%), associating with 12 grade I spondylolisthesis. The mean normal pelvic incidence was 45° (median 44°, SD 7°). The prevalence of spondylolysis was 1% in children under age 3 (n = 3 among 292 patients), 3.7% in children under age 6 (n = 17 among 454 patients) and 4.7% among the 532 patients. Unilateral spondylolysis was significantly associated with a spinal malformation (p = 0.04, Fisher's exact test), with normal pelvic incidence. Half of the patients with bilateral spondylolysis had high pelvic incidence. We observed a prevalence peak of unilateral spondylolysis in the context of a specific malformation in young infants under age 4 with normal pelvic incidence, and, then, a progressive increase in the prevalence of bilateral isolated spondylolysis.

  6. Contact sensitization in Dutch children and adolescents with and without atopic dermatitis - a retrospective analysis.

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    Lubbes, Stefanie; Rustemeyer, Thomas; Sillevis Smitt, Johannes H; Schuttelaar, Marie Louise; Middelkamp-Hup, Maritza A

    2017-03-01

    Allergic contact dermatitis is known to occur in children with and without atopic dermatitis, but more data are needed on contact sensitization profiles in these two groups. To identify frequent allergens in children with and without atopic dermatitis suspected of having allergic contact dermatitis. A retrospective analysis of children aged 0-17 years patch tested between 1996 and 2013 was performed. Of all 1012 children tested because of suspected contact dermatitis, 46% developed one or more positive reactions, the proportions for children with (n = 526) and without (n = 395) atopic dermatitis being 48% and 47%, respectively. Children with atopic dermatitis reacted more often to lanolin alcohol (30% pet., p = 0.030), Amerchol L-101 (p = 0.030), and fragrances [fragrance mix I (p = 0.048) and Myroxylon pereirae (p = 0.005)]. Allergens outside the European baseline series that frequently gave positive reactions in these groups included cocamidopropyl betaine and Amerchol L-101. Reactivity to these allergens was significantly more common in atopic dermatitis children. Sensitization prevalences in children with and without atopic dermatitis were similar, but children with atopic dermatitis reacted significantly more often to lanolin alcohol and fragrances. Testing with additional series besides the European baseline series may be necessary, as reactions to, for example, cocamidopropyl betaine and Amerchol L-101 may otherwise be missed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. A retrospective analysis of melioidosis in Cambodian children, 2009-2013.

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    Turner, Paul; Kloprogge, Sabine; Miliya, Thyl; Soeng, Sona; Tan, Pisey; Sar, Poda; Yos, Pagnarith; Moore, Catrin E; Wuthiekanun, Vanaporn; Limmathurotsakul, Direk; Turner, Claudia; Day, Nicholas P J; Dance, David A B

    2016-11-21

    Melioidiosis, infection by Burkholderia pseudomallei, is an important but frequently under-recognised cause of morbidity and mortality in Southeast Asia and elsewhere in the tropics. Data on the epidemiology of paediatric melioidosis in Cambodia are extremely limited. Culture-positive melioidosis cases presenting to Angkor Hospital for Children, a non-governmental paediatric hospital located in Siem Reap, Northern Cambodia, between 1 st January 2009 and 31 st December 2013 were identified by searches of hospital and laboratory databases and logbooks. One hundred seventy-three evaluable cases were identified, presenting from eight provinces. For Siem Reap province, the median commune level incidence was estimated to be 28-35 cases per 100,000 children <15 years per year. Most cases presented during the wet season, May to October. The median age at presentation was 5.7 years (range 8 days-15.9 years). Apart from undernutrition, co-morbidities were rare. Three quarters (131/173) of the children had localised infection, most commonly skin/soft tissue infection (60 cases) or suppurative parotitis (51 cases). There were 39 children with B. pseudomallei bacteraemia: 29 (74.4%) of these had clinical and/or radiological evidence of pneumonia. Overall mortality was 16.8% (29/173) with mortality in bacteraemic cases of 71.8% (28/39). At least seven children did not receive an antimicrobial with activity against B. pseudomallei prior to death. This retrospective study demonstrated a considerable burden of melioidosis in Cambodian children. Given the high mortality associated with bacteraemic infection, there is an urgent need for greater awareness amongst healthcare professionals in Cambodia and other countries where melioidosis is known or suspected to be endemic. Empiric treatment guidelines should ensure suspected cases are treated early with appropriate antimicrobials.

  8. Occipitocervical fusions in children. Retrospective analysis and technical considerations.

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    Rodgers, W B; Coran, D L; Emans, J B; Hresko, M T; Hall, J E

    1999-07-01

    This report presents a retrospective analysis of the authors' experience with occipitocervical fusions in children and adolescents during the last 2 decades. A description of an operative technique devised by the senior author (JEH), and a comparison of the results using this and other methods of fusion are given. Twenty-three patients underwent occipitocervical fusion. Fifteen of the patients were operated on using the authors' technique. To achieve stable fixation of the distal cervical vertebra a threaded Kirschner wire was passed transversely through the spinous process; occipital fixation was achieved by the traditional method of wiring corticocancellous bone graft to the skull through burr holes. The occipital wires then were wrapped around the Kirschner wire and the graft was cradled in the resulting nest. Halo immobilization was used in 10 patients for an average of 12.5 weeks (range, 6-24 weeks). Twenty-two patients achieved successful fusion at an average followup of 5.8 years (range, 1-14.33 years). Several complications, including transient quadriplegia in one patient, pseudarthrosis in two (one of which persists), hardware fixation failure in one, unintended distal extension of the fusion, pneumonia, wound infection, halo pin infection, skin breakdown under the halo vest, hydrocephalus, cerebrospinal fluid leak, and traumatic fusion fracture were encountered. Results using the technique described herein are comparable with or better than the results reported in the previous literature, and the results of the patients in this series in whom the technique was not used.

  9. An audit of the outcome of amblyopia treatment: a retrospective analysis of 322 children.

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    Awan, M; Proudlock, F A; Grosvenor, D; Choudhuri, I; Sarvanananthan, N; Gottlob, I

    2010-08-01

    Little is known about the effectiveness of occlusion therapy in hospital settings. A retrospective analysis was conducted to assess modalities, outcome and hospital costs of children treated for amblyopia with patching in a UK clinic. Notes of 322 children with amblyopia discharged after occlusion treatment were selected consecutively and reviewed. Data collated included age at presentation, amblyopia type, visual acuity (VA; before/after occlusion and at discharge), number of prescribed hours of occlusion, duration of patching treatment, number of glasses prescribed and number of visits attended or failed to attend. Hospital treatment costs were estimated. Mixed amblyopes were prescribed the longest amount of patching (mean 2815 h over 23 months) followed by strabismic (1984 h) and anisometropic (1238 h) amblyopes. 319 amblyopes received glasses and five atropine treatment. The percentage of patients reaching VA of 6/12 was best in the anisometropic and strabismic groups (>75%) and worse in mixed amblyopia (64%). Average hospital costs were estimated at pound1365. Although the mean duration of treatment was long, involving many hospital visits, the visual outcome was variable, unsatisfactory (amblyopia treatment are needed, possibly by using educational/motivational intervention.

  10. A retrospective analysis of melioidosis in Cambodian children, 2009–2013

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    Paul Turner

    2016-11-01

    Full Text Available Abstract Background Melioidiosis, infection by Burkholderia pseudomallei, is an important but frequently under-recognised cause of morbidity and mortality in Southeast Asia and elsewhere in the tropics. Data on the epidemiology of paediatric melioidosis in Cambodia are extremely limited. Methods Culture-positive melioidosis cases presenting to Angkor Hospital for Children, a non-governmental paediatric hospital located in Siem Reap, Northern Cambodia, between 1st January 2009 and 31st December 2013 were identified by searches of hospital and laboratory databases and logbooks. Results One hundred seventy-three evaluable cases were identified, presenting from eight provinces. For Siem Reap province, the median commune level incidence was estimated to be 28-35 cases per 100,000 children <15 years per year. Most cases presented during the wet season, May to October. The median age at presentation was 5.7 years (range 8 days–15.9 years. Apart from undernutrition, co-morbidities were rare. Three quarters (131/173 of the children had localised infection, most commonly skin/soft tissue infection (60 cases or suppurative parotitis (51 cases. There were 39 children with B. pseudomallei bacteraemia: 29 (74.4% of these had clinical and/or radiological evidence of pneumonia. Overall mortality was 16.8% (29/173 with mortality in bacteraemic cases of 71.8% (28/39. At least seven children did not receive an antimicrobial with activity against B. pseudomallei prior to death. Conclusions This retrospective study demonstrated a considerable burden of melioidosis in Cambodian children. Given the high mortality associated with bacteraemic infection, there is an urgent need for greater awareness amongst healthcare professionals in Cambodia and other countries where melioidosis is known or suspected to be endemic. Empiric treatment guidelines should ensure suspected cases are treated early with appropriate antimicrobials.

  11. [Acute ethanol intoxication among children and adolescents. A retrospective analysis of 173 patients admitted to a university children hospital].

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    Schöberl, S; Nickel, P; Schmutzer, G; Siekmeyer, W; Kiess, W

    2008-01-01

    In the last time the alcohol consumption among children and adolescents is a big theme in all kind of media. The ethanol consumption among children and adolescents has risen during the last years, but also new hazardous drinking patterns like "binge-drinking" are increasing. These drinking episodes are responsible for many hospital presentations of children and adolescents with acute ethanol intoxication. This study is a retrospective analysis of 173 patients admitted to the university children hospital of Leipzig due to acute ethanol intoxication during the period 1998-2004. Investigated parameters were: socio-demographic factors, clinical presentation and management as well as quantity and type of alcohol. During the years 1998-2004 the rate of alcohol intoxicated patients in this study increased, from 1998-2003 at about 171.4%. Totally 173 patients with an average age of 14.5 years were admitted to the university children hospital. There were significantly more boys than girls. The mean blood alcohol concentration of these patients was 1.77%. Some of the patients had severe symptoms. 62 were unconscious, 2 were in coma and at least 3 patients had to be ventilated. A difference between socioeconomic groups could be observed by comparing the different school types. 44.8% of the patients went to the middle school. Furthermore 17 patients of this study had mental disorders or psychosocial problems and were therefore in psychological or psychiatric treatment. In this study a significant influence of social classes or psychosocial problems on alcohol consumption such as binge-drinking leading to acute ethanol intoxication could not be found. Alarming is the increasing number of ethanol intoxicated patients, the young age, the high measured blood ethanol concentrations and the severe symptoms of these patients. This is the reason why early and intensive prevention strategies are required.

  12. Tuberculosis of the hip in children: A retrospective analysis of 27 patients.

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    Agarwal, Anil; Suri, Tarun; Verma, Indereshwar; Kumar, Shashi Kant; Gupta, Neeraj; Shaharyar, Abbas

    2014-09-01

    We retrospectively evaluated the pretreatment radiological presentation and the clinicoradiological outcome at the completion of 1 year chemotherapy in osteoarticular tuberculosis of hip in children to prognosticate correlation between them. We retrospectively analyzed the clinical and plain radiographic findings in 27 patients with an age of 12 years or younger in whom hip tuberculosis was diagnosed and treated between 2006 and 2010. The diagnosis was based on histopathology in 14 and clinicoradiological basis in 13 patients. The pre and post treatment plain radiographs were evaluated according to Shanmugasundaram radiological classification and our observations regarding unclassified cases which were not fit in this classification were suggested. The functional outcome at the completion of chemotherapy was assessed using modified Moon's criteria. The male female ratio was 11:16. The left hip was involved more frequently than the right (17:10). The average age was 7.37 years (range, 2-12 years). In the pretreatment radiographs, 9 hips were normal, 6 traveling, 4 dislocating, 1 protrusio acetabuli, 3 atrophic and 4 unclassified types (3 triradiate; 1 pseudarthrosis coxae). There were no Perthes and mortar pestle at the initial presentation. Posttreatment, the types changed to 9 normal, 3 Perthes, 1 protrusio acetabuli, 1 atrophic, 4 mortar pestle and 9 unclassified types (3 triradiate, 3 pseudarthrosis coxae and 3 ankylosed). There were 37% excellent, 18.5% good, 26% fair and 18.5% poor results. The prognosis was best with initial "triradiate" and normal types and worst with posttreatment atrophic and "ankylosed" types. The Shanmugasundaram radiological types accurately predict prognosis only in normal types and "triradiate" pattern. The functional outcome is independent of radiological morphology of the hip in smaller children.

  13. A retrospective study of oral cysts in Nigerian children.

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    Salako, N O; Taiwo, E O

    1995-01-01

    A retrospective analysis of oral cysts that were seen over an 11-year period in children at a dental institution in Nigeria was carried out. In general, oral cysts accounted for only 2.6% of the total biopsied lesions during the period under review. The most common oral cysts were the mucous retention cysts, the gingival cysts of infants and the dentigerous cyst. The commonest sites were the maxilla, the mandible and the floor of the mouth respectively and there was no significant difference in sex preference. Most of the cases were seen in the age group 11-16 years while the least was in the group aged 6-10 years.

  14. Assessing recall in mothers' retrospective reports: concerns over children's speech and language development.

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    Russell, Ginny; Miller, Laura L; Ford, Tamsin; Golding, Jean

    2014-01-01

    Retrospective recall about children's symptoms is used to establish early developmental patterns in clinical practice and is also utilised in child psychopathology research. Some studies have indicated that the accuracy of retrospective recall is influenced by life events. Our hypothesis was that an intervention: speech and language therapy, would adversely affect the accuracy of parent recall of early concerns about their child's speech and language development. Mothers (n = 5,390) reported on their child's speech development (child male to female ratio = 50:50) when their children were aged 18 or 30 months, and also reported on these early concerns retrospectively, 10 years later, when their children were 13 years old. Overall reliability of retrospective recall was good, 86 % of respondents accurately recalling their earlier concerns. As hypothesised, however, the speech and language intervention was strongly associated with inaccurate retrospective recall about concerns in the early years (Relative Risk Ratio = 19.03; 95 % CI:14.78-24.48). Attendance at speech therapy was associated with increased recall of concerns that were not reported at the time. The study suggests caution is required when interpreting retrospective reports of abnormal child development as recall may be influenced by intervening events.

  15. Tuberculosis of the hip in children a retrospective analysis of 27 patients

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    Anil Agarwal

    2014-01-01

    Full Text Available Background: We retrospectively evaluated the pretreatment radiological presentation and the clinicoradiological outcome at the completion of 1 year chemotherapy in osteoarticular tuberculosis of hip in children to prognosticate correlation between them. Materials and Methods: We retrospectively analyzed the clinical and plain radiographic findings in 27 patients with an age of 12 years or younger in whom hip tuberculosis was diagnosed and treated between 2006 and 2010. The diagnosis was based on histopathology in 14 and clinicoradiological basis in 13 patients. The pre and post treatment plain radiographs were evaluated according to Shanmugasundaram radiological classification and our observations regarding unclassified cases which were not fit in this classification were suggested. The functional outcome at the completion of chemotherapy was assessed using modified Moon′s criteria. Results: The male female ratio was 11:16. The left hip was involved more frequently than the right (17:10. The average age was 7.37 years (range, 2-12 years. In the pretreatment radiographs, 9 hips were normal, 6 traveling, 4 dislocating, 1 protrusio acetabuli, 3 atrophic and 4 unclassified types (3 triradiate; 1 pseudarthrosis coxae. There were no Perthes and mortar pestle at the initial presentation. Posttreatment, the types changed to 9 normal, 3 Perthes, 1 protrusio acetabuli, 1 atrophic, 4 mortar pestle and 9 unclassified types (3 triradiate, 3 pseudarthrosis coxae and 3 ankylosed. There were 37% excellent, 18.5% good, 26% fair and 18.5% poor results. The prognosis was best with initial ′"triradiate" and normal types and worst with posttreatment atrophic and "ankylosed" types. Conclusions: The Shanmugasundaram radiological types accurately predict prognosis only in normal types and "triradiate" pattern. The functional outcome is independent of radiological morphology of the hip in smaller children.

  16. Measuring the effect of treatment on gait quality in children with cerebral palsy – a retrospective study

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    Larsen, Anders Holsgaard; Skov Sørensen, Rasmus; Jensen, Carsten

    and subsequently, as a follow-up. Thus, the effect of treatment on gait quality in children with CP may be quantified. Purpose of study: In a retrospective study we investigated the effect of treatment on gait quality (measured by GDI) in children with CP. Materials and Methods: Data from children (...Background: Gait Deviation Index (GDI) describes the overall gait quality and summarizes it into a single score based upon three- dimensional gait analysis (3DGA). In the Region of Southern Denmark, children with cerebral palsy (CP) are referred to 3DGA if surgical intervention is considered......) diagnosed with CP and referred to 3DGA (either as a diagnostic instrument or for the purpose of follow- up) was extracted from a local database for the year 2012. The GDI score was calculated for each child and limb and used for further analysis. Results: 29 children with follow-up analysis were referred...

  17. Therapy with low-dose azacitidine for MDS in children and young adults: a retrospective analysis of the EWOG-MDS study group.

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    Cseh, Annamaria M; Niemeyer, Charlotte M; Yoshimi, Ayami; Catala, Albert; Frühwald, Michael C; Hasle, Henrik; van den Heuvel-Eibrink, Mary M; Lauten, Melchior; De Moerloose, Barbara; Smith, Owen P; Bernig, Toralf; Gruhn, Bernd; Kulozik, Andreas E; Metzler, Markus; Olcay, Lale; Suttorp, Meinolf; Furlan, Ingrid; Strahm, Brigitte; Flotho, Christian

    2016-03-01

    Low-dose azacitidine is efficient and safe in the therapy of malignant myeloid disorders in adults but data in children are lacking. We present a retrospective analysis of 24 children and young adults with myelodysplastic syndrome (MDS) who received azacitidine at the time of first diagnosis or relapse after allotransplant (2 children were treated with azacitidine both initially and for relapse). Diagnoses were refractory cytopenia of childhood (N = 4), advanced primary MDS (N = 9) and secondary MDS (N = 11). The median duration of treatment was four cycles. Azacitidine was well tolerated, but cytopenias led to dose reduction in five cases. Treatment was discontinued in one child because of impaired renal function. Sixteen MDS patients were treated with azacitidine at first diagnosis. One complete clinical remission was observed and one child showed complete marrow remission; six children experienced stable disease with haematological improvement. Ten children received azacitidine for relapsed MDS after transplant: of these, seven experienced stable disease for 2-30 cycles (median 3), including one patient with haematological improvement for seven cycles. In summary, azacitidine is effective in some children with MDS and appears to be a non-toxic option in palliative situations to prolong survival. © 2016 John Wiley & Sons Ltd.

  18. Community-acquired Clostridium difficile infection in children: A retrospective study.

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    Borali, Elena; Ortisi, Giuseppe; Moretti, Chiara; Stacul, Elisabetta Francesca; Lipreri, Rita; Gesu, Giovanni Pietro; De Giacomo, Costantino

    2015-10-01

    Community acquired-Clostridium difficile infection (CDI) has increased also in children in the last years. To determine the incidence of community-acquired CDI and to understand whether Clostridium difficile could be considered a symptom-triggering pathogen in infants. A five-year retrospective analysis (January 2007-December 2011) of faecal specimens from 124 children hospitalized in the Niguarda Ca' Granda Hospital for prolonged or muco-haemorrhagic diarrhoea was carried out. Stool samples were evaluated for common infective causes of diarrhoea and for Clostridium difficile toxins. Patients with and without CDI were compared for clinical characteristics and known risk factors for infection. Twenty-two children with CDI were identified in 5 years. An increased incidence of community-acquired CDI was observed, ranging from 0.75 per 1000 hospitalizations in 2007 to 9.8 per 1000 hospitalizations in 2011. Antimicrobial treatment was successful in all 19 children in whom it was administered; 8/22 CDI-positive children were younger than 2 years. No statistically significant differences in clinical presentation were observed between patients with and without CDI, nor in patients with and without risk factors for CDI. Our study shows that Clostridium difficile infection is increasing and suggests a possible pathogenic role in the first 2 years of life. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  19. Fractures of the distal radius in children: A retrospective evaluation

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    Selma Yazıcı

    2012-06-01

    Full Text Available Objectives: This study designed to evaluate the resultsof treatment, closed reduction and percutaneous wires, ofthe distal radius fractures in children.Materials and methods: A retrospective analysis wascarried out in children aged between 5-15 years who presentedwith a displaced fracture of the distal radius to ourhospital. They were initially treated with closed reductionand cast immobilization. If the fractures redisplaced treatedby percutaneous Kirschner (K- wire with scope undera general anaesthesia.Results: Totally 104 patients, who have distal radius fractureswere treated by closed reduction and immobilizationin a plaster cast. 13 patient who have distal radiusfractures were treated by closed reduction under generalanaesthesia and fixed by percutaneous Kirschner (K-wire. Patients with impaired the alignment of the fracturein late period were usually completely displaced fractures.(n=5, 4,3%, in early period, completely displaced fractures(n=5, 4,3% are superior to partial displaced fractures(n=2, 1,7%.Conclusion: In our study, when children with distal radiusfracture first come, they were treated by closed reductionand immobilization in a plaster cast. We thought that inredisplaced fractures patients were suitable for the closedreduction with percutaneous wire treatment.

  20. Children's vomiting following posterior fossa surgery: A retrospective study

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    Dundon Belinda

    2009-07-01

    Full Text Available Abstract Background Nausea and vomiting is a problem for children after neurosurgery and those requiring posterior fossa procedures appear to have a high incidence. This clinical observation has not been quantified nor have risk factors unique to this group of children been elucidated. Methods A six year retrospective chart audit at two Canadian children's hospitals was conducted. The incidence of nausea and vomiting was extracted. Hierarchical multivariable logistic regression was used to quantify risk and protective factors at 120 hours after surgery and early vs. late vomiting. Results The incidence of vomiting over a ten day postoperative period was 76.7%. Documented vomiting ranged from single events to greater than 20 over the same period. In the final multivariable model: adolescents (age 12 to Conclusion The incidence of vomiting in children after posterior fossa surgery is sufficient to consider all children requiring these procedures to be at high risk for POV. Nausea requires better assessment and documentation.

  1. Adult "termination-of-resuscitation" (TOR)-criteria may not be suitable for children - a retrospective analysis.

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    Rotering, Victoria Maria; Trepels-Kottek, Sonja; Heimann, Konrad; Brokmann, Jörg-Christian; Orlikowsky, Thorsten; Schoberer, Mark

    2016-12-07

    Only a small number of patients survive out-of-hospital-cardiac-arrest (OHCA). The duration of CPR varies considerably and transportation of patients under CPR is often unsuccessful. Termination-of-resuscitation (TOR)-criteria aim to preclude futile resuscitation efforts. Our goal was to find out to which extent existing TOR-criteria can be transferred to paediatric OHCA-patients with special regard to their prognostic value. We performed a retrospective analysis of an eleven-year single centre patient cohort. 43 paediatric patients admitted to our institution after emergency-medical-system (EMS)-confirmed OHCA from 2003 to 2013 were included. Morrison's BLS- and ALS-TOR-rules as well as the Trauma-TOR-criteria by the American Association of EMS Physicians were evaluated for application in children, by calculating sensitivity, specificity, negative and positive predictive value for death-, as well as survival-prediction in our cohort. 26 patients achieved ROSC and 14 were discharged alive (n = 7 PCPC 1/2, n = 7 PCPC 5). Sensitivity for BLS-TOR-criteria predicting death was 48.3%, specificity 92.9%, the PPV 93.3% and the NPV 46.4%. ALS-TOR-criteria for death had a sensitivity of 10.3%, specificity of 100%, a PPV of 100% and an NPV of 35%. Retrospective application of the BLS-TOR-rule in our patient cohort identified the resuscitation of one later survivor as futile. ALS-TOR-criteria did not give false predictions of death. The proportion of CPRs that could have been abandoned is 48.2% for the BLS-TOR and only 10.3% for the ALS-TOR-rule. Both rules therefore appear not to be transferable to a paediatric population.

  2. COMPLICATIONS OF ORAL AND MAXILLOFACIAL SURGERY UNDER GENERAL ANESTHESIA IN TUBE-FED CHILDREN: A RETROSPECTIVE ANALYSIS.

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    Nguyen, Trang D; Freilich, Marshall M; Macpherson, Bruce A

    2016-06-01

    To assess morbidity and mortality associated with oral and maxillofacial surgery procedures requiring general anesthesia among children with aspiration tendency requiring enteral feeding. A retrospective chart review was conducted of children surgically treated under general anesthesia by the oral and maxillofacial surgery service at the Hospital for Sick Children in Toronto, Canada. Medical and dental records over a 9-year period (January 1, 2000 to January 1, 2010) were reviewed. Data were collected on demographics, primary illness, coexisting medical conditions, procedures performed, medications administered, type of airway management used, duration of general anesthesia, American Society of Anesthesiologists' physical status classification and adverse events. During the period reviewed, 28 children underwent 35 oral and maxillofacial surgery procedures under general anesthesia. The mean patient age was 12 years (range 4-17 years). No deaths occurred. Of the 35 surgeries, 10 (29%) were associated with at least 1adverse event. Adverse events included 1incident of respiratory distress, 2incidents of fever, 5incidents of bleeding, 1incident of seizure and 4incidents of oxygen saturation below 90% for more than 30s. Children with a history of aspiration tendency that necessitates enteral feeding, who undergo oral and maxillofacial surgery under general anesthesia, are at increased risk of morbidity. Before initiating treatment, the surgeon and parents or guardians of such children should carefully consider these risks compared with the anticipated benefit of surgery.

  3. Efficacy of Fluoroquinolone/Probiotic Combination Therapy for Recurrent Urinary Tract Infection in Children: A Retrospective Analysis.

    Science.gov (United States)

    Madden-Fuentes, Ramiro J; Arshad, Mehreen; Ross, Sherry S; Seed, Patrick C

    2015-09-01

    Children with normal urinary tract anatomy and function and highly recurrent urinary tract infection (rUTI) may have a lack of alternatives when antibiotic prophylaxis and "watchful waiting" approaches fail. This retrospective review reports the outcomes in children who received a fluoroquinolone/probiotic combination in an attempt to quantify a reduction in rUTI that was perceived by both clinicians and patients' families. Data from all children with rUTIs previously managed with a fluoroquinolone/probiotic combination at the Pediatric Infectious Diseases Clinic at Duke University Medical Center (Durham, North Carolina) were identified and analyzed. Data from 10 children were eligible for inclusion. Compared with before therapy initiation, total UTI episodes were significantly fewer after therapy initiation (57 vs 4; P = 0.0001). Seven (70%) were free of rUTIs during the follow-up period. Of the 8 patients with known compliance, 7 (88%) were free of rUTIs. Given the chronic nature of these patients' symptoms, the significant decrease in UTI after the initiation of therapy, and the increase in the interval without an infection and/or its symptoms, this treatment regimen has the potential to improve overall quality of life, decrease antibiotic courses, and decrease health care costs in children with rUTI. These results will be validated with a larger cohort of patients in a prospective, randomized trial. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

  4. Maxillofacial trauma in Tamil Nadu children and adolescents: A retrospective study

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    Ramraj Jayabalan Arvind

    2013-01-01

    Full Text Available Aim: The aim of this retrospective study is to describe the incidence, aetiology, complexity and surgical indications of maxillofacial injuries in children and adolescents population of Tamil Nadu state of india during period of 4 years. Materials and Methods: A retrospective review was conducted among 500 children and adolescents patients of age group 6 years to 16 years suffered or suffering with maxillofacial and skull fractures presenting to ten Level I trauma centers over a 4 year period.The data collected for this study included age, gender, etiology, associated maxillofacial trauma, anatomic site of fracture and treatment. Results and Conclusion: In our study the most common cause of trauma was traffic 35%, followed by falls 24% and sports 22%. Mandible was commenest bone prone to fracture, followed by maxilla and nasal bone. Mandible fractures accounted for 72% of all maxillofacial fractures.

  5. Retrospective Analysis of Emerging Drugs Use in a Quebec Women's and Children's University Hospital and Perspectives for Safe and Optimal Drug Use.

    Science.gov (United States)

    Corny, Jennifer; Pelletier, Elaine; Lebel, Denis; Bussières, Jean-François

    2017-03-10

    Only few medicines are licensed for children. The use of emerging drugs (unmarketed drug, off-label drug with poorly documented use, and/or costly drugs) might represent an essential alternative for pediatric patients. The objective of the study was to assess emerging drug uses rate and profile in our women's and children's centre to support the implementation of an appropriate policy. We identified retrospectively emerging drugs used between 2013-01-01 and 2014-02-28, using computerized pharmacist software extraction of drugs used. Conventional oncologic drugs were excluded. Retrospective analysis of medical charts for patients who received an emerging drug and literature review for each drug were performed to determine efficacy and safety endpoints. Median delays between first intention and final decision to use the drug and between final decision and first administration were calculated. Proportion of patients who experienced a positive evolution under treatment or a side effect possibly related to the drug was calculated. A total of 26 emerging drugs were identified (89 patients, 99 uses). Median treatment duration was 66 days [1-1435]. Median delay between first evocation and final decision to use the drug was 2 days [0-333] and 0 day [0-404] between final decision and first administration. 52/99 (53%) of patients experienced a positive evolution under treatment and 26/99 (26%) experienced a side effect possibly related to emerging drug use. This study allowed us to describe emerging drug uses in a women and children tertiary hospital. It led to the implementation of a local emerging drug use policy ensuring optimal and safe use of these drugs. There is a significant number of emerging drugs used in pediatric which shows positive improvement in 56% of patients. © 2017 Journal of Population Therapeutics and Clinical Pharmacology. All rights reserved.

  6. Delayed Diagnoses in Children with Constipation: Multicenter Retrospective Cohort Study.

    Science.gov (United States)

    Freedman, Stephen B; Rodean, Jonathan; Hall, Matthew; Alpern, Elizabeth R; Aronson, Paul L; Simon, Harold K; Shah, Samir S; Marin, Jennifer R; Cohen, Eyal; Morse, Rustin B; Katsogridakis, Yiannis; Berry, Jay G; Neuman, Mark I

    2017-07-01

    The use of abdominal radiographs contributes to increased healthcare costs, radiation exposure, and potentially to misdiagnoses. We evaluated the association between abdominal radiograph performance and emergency department (ED) revisits with important alternate diagnosis among children with constipation. Retrospective cohort study of children aged constipation at one of 23 EDs from 2004 to 2015. The primary exposure was abdominal radiograph performance. The primary outcome was a 3-day ED revisit with a clinically important alternate diagnosis. RAND/University of California, Los Angeles methodology was used to define whether the revisit was related to the index visit and due to a clinically important condition other than constipation. Regression analysis was performed to identify exposures independently related to the primary outcome. A total of 65.7% (185 439/282 225) of children with constipation had an index ED visit abdominal radiograph performed. Three-day revisits occurred in 3.7% (10 566/282 225) of children, and 0.28% (784/282 225) returned with a clinically important alternate related diagnosis. Appendicitis was the most common such revisit, accounting for 34.1% of all 3-day clinically important related revisits. Children who had an abdominal radiograph performed were more likely to have a 3-day revisit with a clinically important alternate related diagnosis (0.33% vs 0.17%; difference 0.17%; 95% CI 0.13-0.20). Following adjustment for covariates, abdominal radiograph performance was associated with a 3-day revisit with a clinically important alternate diagnosis (aOR: 1.39; 95% CI 1.15-1.67). Additional characteristics associated with the primary outcome included narcotic (aOR: 2.63) and antiemetic (aOR: 2.35) administration and underlying comorbidities (aOR: 2.52). Among children diagnosed with constipation, abdominal radiograph performance is associated with an increased risk of a revisit with a clinically important alternate related diagnosis

  7. A retrospective analysis of the characteristics, treatment and follow-up of 26 odontomas in Greek children

    International Nuclear Information System (INIS)

    Iatrou, I.; Vardas, E.; Theologie-Lygidakis, N.; Leventis, M.

    2010-01-01

    Odontomas represent the most common type of odontogenic jaw tumors among patients younger than 20 years of age. Clinically, they are often associated with eruption failure of adjacent permanent teeth, and are classified as compound and complex. The aim of the present retrospective study was to present the characteristics, treatment approach and outcome of odontomas in Greek children, over a ten-year period. Twenty six patients, 2 to 14 years of age (mean 9.3 years), with odontomas treated during the years 1999-2008 at the Department of Oral and Maxillofacial Surgery of a Children's Hospital, were included in the study. Data from patients' files were retrieved and they were recalled for review. Odontomas were equally distributed in the maxilla and mandible and 42.3% of them were located in the anterior maxilla. Of the odontomas, 80.7% were related to disturbances in tooth eruption. Bone expansion was observed in 65.3% of the cases. All odontomas were surgically removed, and related impacted permanent teeth were either left to erupt spontaneously, orthodontically guided into occlusion or were removed. Orthodontic intervention appeared to be necessary in older children, while in younger children spontaneous eruption was frequent. In the present study, odontomas were associated with unerupted or impacted teeth. Radiographic examination was essential to verify the presence of the tumor and early removal prevented tooth eruption failure and disturbances in a majority of the cases. (author)

  8. Upper Gastrointestinal Bleeding in Chinese Children: A Multicenter 10-Year Retrospective Study.

    Science.gov (United States)

    Yu, Yi; Wang, Baoxiang; Yuan, Lan; Yang, Hui; Wang, Xinqiong; Xiao, Yuan; Mei, Hong; Xu, Chundi

    2016-08-01

    Objective This study aims to analyze the clinical and endoscopic presentations of upper gastrointestinal bleeding (UGIB) in the Chinese children. Methods A 10-year retrospective study was made on children with UGIB and undertaken esophagogastroduodenoscopy (EGD) from 4 tertiary referral centers in China. Results Of the 1218 children studied, the bleeding source was found in 76.4%. Erosive gastritis was the most common endoscopic finding (33.5%), followed by duodenal ulcer (23.2%). The proportion of erosive gastritis decreased with age (correlation coefficient = -0.787), and duodenal ulcer increased with age (correlation coefficient = 0.958). The bleeding source was more likely to be determined in children having EGDs within 48 hours (80.6% vs 67.9%). Conclusions In Chinese children with UGIB, erosive gastritis and duodenal ulcer were the leading causes, and their proportions varied with age. EGDs performed within 48 hours may improve the possibility of finding the source of bleeding. © The Author(s) 2015.

  9. Growth monitoring in children with low and normal birth weight up to two years: A retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Mina Danaei

    2016-09-01

    Full Text Available Objective: This study was conducted aimed to compare the growth indices in 2 years old children with a history of low birth weight with normal birth weight children.Methods: Current retrospective cohort study on all two-year children with low birth weight and three times the normal weight children covered by health centers of Kahnooj, was conducted in 2015. Cares at birth, 1, 2, 4, 6, 7, 9, 12, 15, 18 and 24 months of age were studied and, child growth indices (weight, height, head circumference, along with some demographic variables were studied. Information were entered SPSS version 20 and the analysis was performed.Results: There were significant differences in children's growth of both groups in all periods of care. Despite the same slope, growth pattern in children showed a significant difference. Young mother, girl sex of baby and preterm birth are predictor factors of low birth weight.Conclusion: Trends and growth patterns of weight, height and head circumference in underweight children have significant difference with normal children and, despite the same slope, these children can not compensate for the backwardness of its growth to the age of two. So you need to plot separate growth curves for these children and, possible preventive measures should be taken to prevent bearing underweight baby.

  10. Serial migration and its implications for the parent-child relationship: a retrospective analysis of the experiences of the children of Caribbean immigrants.

    Science.gov (United States)

    Smith, Andrea; Lalonde, Richard N; Johnson, Simone

    2004-05-01

    This study addressed the potential impact of serial migration for parent-children relationships and for children's psychological well-being. The experience of being separated from their parents during childhood and reunited with them at a later time was retrospectively examined for 48 individuals. A series of measures (e.g., self-esteem, parental identification) associated with appraisals at critical time periods during serial migration (separation, reunion, current) revealed that serial migration can potentially disrupt parent-child bonding and unfavorably affect children's self-esteem and behavior. Time did not appear to be wholly effective in repairing rifts in the parent-child relationship. Risk factors for less successful reunions included lengthy separations and the addition of new members to the family unit in the child's absence. (c) 2004 APA

  11. [Retrospective analysis of 44 childhood drowning accidents].

    Science.gov (United States)

    Brüning, Caroline; Siekmeyer, Werner; Siekmeyer, Manuela; Merkenschlager, Andreas; Kiess, Wieland

    2010-07-01

    Worldwide, drowning is the second leading cause of unintentional death and the leading cause of cardiovascular failure for children [1-3]. The number of near-drownings, where the incident is survived for at least 24 hours, is assumed to be four times as high [5]. In the years 1994 until 2008 there were 44 cases of drowning treated at the children's department of the University of Leipzig. This number shows that even in a medical centre drowning incidents are only occasional incidents. Therefore it is important to know the sequelae and handlings to be able to react in case of an emergency. A total of 44 children suffering a drowning accident within the last 48 hours who were treated during the period of 01.01.1994 through 30.06.2008 at the Children's Centre at the University of Leipzig. A retrospective analysis using a structured questionnaire was done. Social demographic data, accident progress, clinical results and progress as well as outcome of the cases were investigated. During the analysed period in the median three children were treated each year after drowning incidents. Clustering in the summer and winter months and on the weekends was recognizable. The median age was 3.33 years and the group of high risk were children aged 1-3 years, especially boys. Sixty percent of the children came from stable social backgrounds. Half of the children suffered from drowning in created swimming pools or ponds, the rest in natural waters, public pools and sources of water in the household. The median submersion lasted 2 minutes. Correlation of submersions below 1 minute with a good, and submersions above 10 minutes with a negative outcome was shown. A Glasgow Coma Scale (GCS) of 3 points (n = 15) and pupils without light reaction (n = 14) were associated with a lethal outcome or residual neurological deficits. Looking at the laboratory values, correlation between severe acidotic pH-values with a very low base excess, high blood sugar as well as high lactate values and a

  12. Clinical Profile of Acute Accidental Poisoning Among Children- A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Tabassum Khatoon

    2017-12-01

    Full Text Available Acute toxicity is a frequent but avoidable cause of morbidity and mortality in children especially in developing countries, including India. Present study assesses their pattern with relation to different age groupings. This retrospective study was conducted among all hospitalised paediatric victims of acute accidental poisoning at the King George Medical University; Lucknow during 2010 -11. Their history, baseline characteristics, clinical course and outcome was studied. Most children were male of less than three years with 4% overall mortality. Kerosene oil was implicated in most cases. Childhood poisoning is commonest during 1-3 years with a male preponderance. Household poisons; especially kerosene oil was responsible for most cases which was consumed accidentally. Parents must be educated and warned to keep these toxic ingredients safely in suitable containers and out of reach of their beloved children. Keywords: Forensic Science, Paediatric, Acute Poisoning, Kerosene, Outcome.

  13. A retrospective review of pituitary MRI findings in children on growth hormone therapy

    International Nuclear Information System (INIS)

    Tsai, Sarah L.; Lawrence, Sarah; Laffan, Eoghan

    2012-01-01

    Patients with congenital hypopituitarism might have the classic triad of pituitary stalk interruption syndrome, which consists of: (1) an interrupted or thin pituitary stalk, (2) an absent or ectopic posterior pituitary (EPP), and (3) anterior pituitary hypoplasia or aplasia. To examine the relationship between pituitary anatomy and the degree of hormonal dysfunction. This study involved a retrospective review of MRI findings in all children diagnosed with congenital growth hormone deficiency from 1988 to 2010 at a tertiary-level pediatric hospital. Of the 52 MRIs reviewed in 52 children, 26 children had normal pituitary anatomy and 26 had one or more elements of the classic triad. Fourteen of fifteen children with multiple pituitary hormone deficiencies had structural anomalies on MRI. Twelve of 37 children with isolated growth hormone deficiency had an abnormal MRI. Children with multiple pituitary hormone deficiencies were more likely to have the classic triad than children with isolated growth hormone deficiency. A normal MRI was the most common finding in children with isolated growth hormone deficiency. (orig.)

  14. A retrospective review of pituitary MRI findings in children on growth hormone therapy

    Energy Technology Data Exchange (ETDEWEB)

    Tsai, Sarah L.; Lawrence, Sarah [University of Ottawa, Division of Endocrinology, Children' s Hospital of Eastern Ontario, Ottawa (Canada); Laffan, Eoghan [Children' s University Hospital, Pediatric Radiology, Dublin 1 (Ireland)

    2012-07-15

    Patients with congenital hypopituitarism might have the classic triad of pituitary stalk interruption syndrome, which consists of: (1) an interrupted or thin pituitary stalk, (2) an absent or ectopic posterior pituitary (EPP), and (3) anterior pituitary hypoplasia or aplasia. To examine the relationship between pituitary anatomy and the degree of hormonal dysfunction. This study involved a retrospective review of MRI findings in all children diagnosed with congenital growth hormone deficiency from 1988 to 2010 at a tertiary-level pediatric hospital. Of the 52 MRIs reviewed in 52 children, 26 children had normal pituitary anatomy and 26 had one or more elements of the classic triad. Fourteen of fifteen children with multiple pituitary hormone deficiencies had structural anomalies on MRI. Twelve of 37 children with isolated growth hormone deficiency had an abnormal MRI. Children with multiple pituitary hormone deficiencies were more likely to have the classic triad than children with isolated growth hormone deficiency. A normal MRI was the most common finding in children with isolated growth hormone deficiency. (orig.)

  15. Assessment of dental caries predictors in 6-year-old school children - results from 5-year retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Masood Mohd

    2012-11-01

    Full Text Available Abstract Background This was a retrospective cohort study undertaken to assess the rate and pattern of dental caries development in 6-year-old school children followed-up for a period of 5 years, and to identify baseline risk factors that were associated with 5 years caries experience in Malaysian children. Methods This 5-years retrospective cohort study comprised primary school children initially aged 6 years in 2004. Caries experience of each child was recorded annually using World Health Organization criteria. The rates of dental caries were recorded in prevalence and incidence density of carious lesions from baseline to final examination. Risk assessment was done to assess relative risk for caries after 5 years in children with baseline caries status. Simple and multiple logistic regression analysis were performed to identify significant independent risk factors for caries. Results The sample consisted of 1830 school children. All components of DMFT showed significant differences between baseline and final examination. Filled teeth (FT component of the DMFT showed the greatest increases. Results revealed the initial baseline caries level in permanent dentition was a strong predictor for future caries after 5 years (RR=3.78, 95% CI=3.48-4.10, P0.001. Logistic regression analysis showed significant association between caries occurrence and residence (urban/rural (OR=1.80, Pp observed from baseline and after 5 years was 5.80 persons/100 person-year of observation. The rate of new caries-affected tooth (IDt in the period from baseline and after 5-years was 0.76 teeth/100 teeth-year of observation. Conclusion The majority of 12-year-old school children (70% were caries-free and most of the caries were concentrated in only a small proportion (30% of them. We found that the presence of caries in permanent teeth at the age of 6 years was a strong predictor of future caries development in this population. The strong evidence of early permanent teeth

  16. IPRATROPIUM BROMIDE FOR ACUTE ASTHMA IN CHILDREN: A RETROSPECTIVE TRIAL.

    Science.gov (United States)

    Nomura, Osamu; Morikawa, Yoshihiko; Hagiwara, Yusuke; Ihara, Takateru; Inoue, Nobuaki; Sakakibara, Hiroshi; Akasawa, Akira

    Inhaled anticholinergics such as ipratropium bromide (IB), when administered with β2-agonists, are effective in reducing hospital admissions of children presenting to the emergency department with moderate to severe asthma. However, treatment of acute asthma with IB is still uncommon in Japan. The aim of this study was to investigate the effectiveness and safety of IB for the treatment of pediatric acute asthma. We conducted a retrospective study to compare the admission rate of patients who received IB with those who did not. Patients aged 4 years or older with a history of moderate to severe attacks were included. For analysis, propensity score matching was used to adjust the confounding factors related to IB use. Patients received IB by metered-dose inhaler (40μg per dose) with a spacer three times at 20-min intervals. Among 175 patients included in the analysis, 102 patients were treated with IB (IB group) and 73 patients were treated without IB (Non-IB group). A propensity score matching analysis extracted 63 patients from each group. There was no statistical difference between the two groups in terms of admission rate (IB group 12.7% vs Non-IB group 9.5%; p=0.78). One patient (1.0%) treated with IB experienced dryness of the mouth, which resolved spontaneously. The admission rate did not decline with IB use. Several confounding factors could have influenced and limited our results. A prospective study is needed to investigate the effectiveness of IB in Japan.

  17. Identification of Risk Factors for Intravenous Infiltration among Hospitalized Children: A Retrospective Study.

    Directory of Open Access Journals (Sweden)

    Soon Mi Park

    Full Text Available This retrospective study was aimed to identify risk factors of intravenous (IV infiltration for hospitalized children. The participants were 1,174 children admitted to a general hospital, who received peripheral intravenous injection therapy at least once, and had complete records. Data were analyzed with frequency and percentage or mean and standard deviation were calculated, and odds ratio (OR from univariate and multiple logistic regressions. The number and % of infiltrations were 92 and 7.8%, respectively. IV infiltration risk factors were lower limb (OR = 1.72, phenytoin (OR = 11.03, 10% dextrose (OR = 6.55, steroids (OR = 6.21, vancomycin (OR = 4.10, high-concentration electrolytes (OR = 3.49, and ampicillin/sulbactam combination (OR = 3.37. Nurses working at children's hospitals should consider the risk of IV infiltration for children receiving IV infusion therapy and make a preventive effort to identify IV infiltration in high-risk children at an early stage.

  18. Outcome after resuscitation beyond 30 minutes in drowned children with cardiac arrest and hypothermia : Dutch nationwide retrospective cohort study

    NARCIS (Netherlands)

    Kieboom, J. K.; Verkade, H. J.; Burgerhof, J. G.; Bierens, J. J.; van Rheenen, P. F.; Kneyber, M. C.; Albers, M. J.

    2015-01-01

    OBJECTIVES To evaluate the outcome of drowned children with cardiac arrest and hypothermia, and to determine distinct criteria for termination of cardiopulmonary resuscitation in drowned children with hypothermia and absence of spontaneous circulation. DESIGN Nationwide retrospective cohort study.

  19. Severe Sepsis in Severely Malnourished Young Bangladeshi Children with Pneumonia: A Retrospective Case Control Study.

    Directory of Open Access Journals (Sweden)

    Mohammod Jobayer Chisti

    Full Text Available In developing countries, there is no published report on predicting factors of severe sepsis in severely acute malnourished (SAM children having pneumonia and impact of fluid resuscitation in such children. Thus, we aimed to identify predicting factors for severe sepsis and assess the outcome of fluid resuscitation of such children.In this retrospective case-control study SAM children aged 0-59 months, admitted to the Intensive Care Unit (ICU of the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh from April 2011 through July 2012 with history of cough or difficult breathing and radiologic pneumonia, who were assessed for severe sepsis at admission constituted the study population. We compared the pneumonic SAM children with severe sepsis (cases = 50 with those without severe sepsis (controls = 354. Severe sepsis was defined with objective clinical criteria and managed with fluid resuscitation, in addition to antibiotic and other supportive therapy, following the standard hospital guideline, which is very similar to the WHO guideline.The case-fatality-rate was significantly higher among the cases than the controls (40% vs. 4%; p<0.001. In logistic regression analysis after adjusting for potential confounders, lack of BCG vaccination, drowsiness, abdominal distension, acute kidney injury, and metabolic acidosis at admission remained as independent predicting factors for severe sepsis in pneumonic SAM children (p<0.05 for all comparisons.We noted a much higher case fatality among under-five SAM children with pneumonia and severe sepsis who required fluid resuscitation in addition to standard antibiotic and other supportive therapy compared to those without severe sepsis. Independent risk factors and outcome of the management of severe sepsis in our study children highlight the importance for defining optimal fluid resuscitation therapy aiming at reducing the case fatality in such children.

  20. immu ologic ad cli ical outcomes of childre o haart: a retrospective ...

    African Journals Online (AJOL)

    user

    METHOD: A three -year's retrospective cohort analysis was conducted in July 2008 among children ... Health Organization Anthro v2.0.2 software. ... rate and anthropometric changes of HIV infected children on highly active antiretroviral therapy were similar but ..... it was different form the South African pediatric cohorts.

  1. Neuromuscular training based on whole body vibration in children with spina bifida: a retrospective analysis of a new physiotherapy treatment program.

    Science.gov (United States)

    Stark, C; Hoyer-Kuhn, H-K; Semler, O; Hoebing, L; Duran, I; Cremer, R; Schoenau, E

    2015-02-01

    Spina bifida is the most common congenital cause of spinal cord lesions resulting in paralysis and secondary conditions like osteoporosis due to immobilization. Physiotherapy is performed for optimizing muscle function and prevention of secondary conditions. Therefore, training of the musculoskeletal system is one of the major aims in the rehabilitation of children with spinal cord lesions. The neuromuscular physiotherapy treatment program Auf die Beine combines 6 months of home-based whole body vibration (WBV) with interval blocks at the rehabilitation center: 13 days of intensive therapy at the beginning and 6 days after 3 months. Measurements are taken at the beginning (M0), after 6 months of training (M6), and after a 6-month follow-up period (M12). Gait parameters are assessed by ground reaction force and motor function by the Gross Motor Function Measurement (GMFM-66). Sixty children (mean age 8.71 ± 4.7 years) who participated in the program until February 2014 were retrospectively analyzed. Walking velocity improved significantly by 0.11 m/s (p = 0.0026) and mobility (GMFM-66) by 2.54 points (p = 0.001) after the training. All changes at follow-up were not significant, but significant changes were observed after the training period. Decreased contractures were observed with increased muscle function. Significant improvements in motor function were observed after the active training period of the new neuromuscular training concept. This first analysis of the new neuromuscular rehabilitation concept Auf die Beine showed encouraging results for a safe and efficient physiotherapy treatment program which increases motor function in children with spina bifida.

  2. A Retrospective Analysis of Pediatric Patients Admitted to the Pediatric Emergency Service for Carbon Monoxide Intoxication

    OpenAIRE

    Metin Uysalol; Ezgi Paslı Uysalol; Gamze Varol Saraçoğlu; Semra Kayaoğlu

    2011-01-01

    Objective: The aim of the study is to analyze the general aspects of cases with carbon monoxide intoxication in order to improve the approach to future patients. Material and Methods: The hospital records of 84 children (mean age 4.71±2.64 years; 48 male, 36 female) who had been admitted to Paediatric Emergency Department for carbon monoxide intoxication between October 2007 and February 2009, were retrospectively evaluated in a descriptive analysis.Results: The source of carbon monoxide into...

  3. Retrospectively Assessed Early Motor and Current Pragmatic Language Skills in Autistic and Neurotypical Children.

    Science.gov (United States)

    Stevenson, Jennifer L; Lindley, Caitlin E; Murlo, Nicole

    2017-08-01

    Autistic individuals often struggle developmentally, even in areas that are not explicit diagnostic criteria, such as motor skills. This study explored the relation between early motor skills, assessed retrospectively, and current pragmatic language skills. Caregivers of neurotypical and autistic children, matched on gender and age, completed assessments of their child's early motor development and current language abilities. Early motor skills were correlated with later pragmatic language skills, and autistic children exhibited fewer motor skills than neurotypical children. In fact, motor skills were a better predictor of an autism spectrum diagnosis than were scores on a measure of current pragmatic language. These results highlight the important role of motor skills in autism spectrum disorders.

  4. Multicystic dysplastic kidney: a retrospective study.

    Science.gov (United States)

    Sharada, Sathish; Vijayakumar, Mahalingam; Nageswaran, Prahlad; Ekambaram, Sudha; Udani, Amish

    2014-08-01

    To report the renal structural and functional anomalies in children with multicystic dysplastic kidneys. Retrospective descriptive analysis of 47 children with multicystic dysplastic kidney seen in a pediatric nephrology unit over a period of 6 years. Antenatal diagnosis of multicystic dysplastic kidney was made in 34 (72.3%) patients. On follow up of 31 children for more than 12 months, 21 (68%) had involution, 4 [13%] had non-regression, and 4 (13%) were nephrectomized. Vesico-ureteric reflux (n=13; 28%) was the commonest renal abnormality. The serum creatinine values were higher (P=0.006) in children with contralateral reflux. Sub-nephrotic proteinuria was noted in 9 (29%) and was significantly associated with complete involution (P=<0.023). None of the patients developed hypertension and 2 (6.4%) had renal failure. Close nephrological follow-up is needed in children with multicystic dysplasia of kidneys.

  5. Analysis of the factors affecting the occurrence of myopia in children with myopia

    OpenAIRE

    Can Zhao; Qiu-Jie Xue; Xiao-Fen Liu; Wen-Jie Cao; Li-Li Sun

    2017-01-01

    AIM: To analyze the electronic product use time, writing time, playing piano time and outdoor activity time and the distribution of myopia in 586 cases of school age children in our hospital. METHODS: A retrospective analysis of 586 cases of children aged 6 to 12 years old in the outpatient department was established. Personalized files were used to record the uncorrected visual acuity, optometry, slit lamp, fundus mirror and strabismus. The cumulative use time of electronic products(includin...

  6. Acupuncture for treatment of hospital-induced constipation in children: a retrospective case series study.

    Science.gov (United States)

    Anders, Eric Falk; Findeisen, Annette; Nowak, Andreas; Rüdiger, Mario; Usichenko, Taras Ivanovich

    2012-12-01

    Acupuncture is a promising option in the treatment of functional bowel disorders. The aim of this study was to evaluate the feasibility and acceptance of acupuncture for the treatment of hospital-induced constipation (HIC) in children. Bilateral stimulation of acupuncture point LI11 was applied in 10 children with HIC using fixed indwelling acupuncture needles (0.9 mm long) before considering starting conventional local constipation therapy with laxative suppositories. The clinical records were studied retrospectively for feasibility, acceptance and effectiveness of acupuncture. Acupuncture was feasible in all children and application of the indwelling needles was tolerated without fear. Side effects were not observed. After a median of 3 days of HIC, all children defaecated within 2 h after LI11 stimulation. No patient required conventional local constipation therapy. Acupuncture for the treatment of HIC is feasible and acceptable. Its effect should be verified in a randomised controlled trial.

  7. CareTrack Kids—part 3. Adverse events in children's healthcare in Australia: study protocol for a retrospective medical record review

    Science.gov (United States)

    Hibbert, Peter D; Hallahan, Andrew R; Muething, Stephen E; Lachman, Peter; Hooper, Tamara D; Wiles, Louise K; Jaffe, Adam; White, Les; Wheaton, Gavin R; Runciman, William B; Dalton, Sarah; Williams, Helena M; Braithwaite, Jeffrey

    2015-01-01

    Introduction A high-quality health system should deliver care that is free from harm. Few large-scale studies of adverse events have been undertaken in children's healthcare internationally, and none in Australia. The aim of this study is to measure the frequency and types of adverse events encountered in Australian paediatric care in a range of healthcare settings. Methods and analysis A form of retrospective medical record review, the Institute of Healthcare Improvement's Global Trigger Tool, will be modified to collect data. Records of children aged <16 years managed during 2012 and 2013 will be reviewed. We aim to review 6000–8000 records from a sample of healthcare practices (hospitals, general practices and specialists). Ethics and dissemination Human Research Ethics Committee approvals have been received from the Sydney Children's Hospital Network, Children's Health Queensland Hospital and Health Service, and the Women's and Children's Hospital Network in South Australia. An application is under review with the Royal Australian College of General Practitioners. The authors will submit the results of the study to relevant journals and undertake national and international oral presentations to researchers, clinicians and policymakers. PMID:25854978

  8. Dorgan's lateral cross-wiring of supracondylar fractures of the humerus in children: A retrospective review.

    LENUS (Irish Health Repository)

    Queally, Joseph M

    2010-06-01

    The currently accepted treatment for displaced supracondylar humeral fractures in children is closed reduction and fixation with percutaneous Kirschner wires. The purpose of this study was to retrospectively review a novel cross-wiring technique where the cross-wire configuration is achieved solely from the lateral side, thereby reducing the risk of ulnar nerve injury.

  9. Spectrum of ocular firework injuries in children: A 5-year retrospective study during a festive season in Southern India.

    Science.gov (United States)

    John, Deepa; Philip, Swetha Sara; Mittal, Rashmi; John, Sheeja Susan; Paul, Padma

    2015-11-01

    Ocular trauma is a major cause of acquired monocular blindness in children. Firework injuries account for 20% of ocular trauma. The purpose of our study was to document the profile of ocular firework injuries in children during the festive season of Diwali and to determine the prevalence of unilateral blindness in them. A retrospective chart analysis of ocular firework injury in children during the festival of Diwali from 2009 to 2013, conducted in a tertiary care eye center in Tamil Nadu, Southern India. Children below 18 years of age with ocular firework injuries who presented to the emergency department for 3 consecutive days - the day of Diwali, 1 day before, and 1 day after Diwali - were included in this study. Eighty-four children presented with firework-related ocular injuries during the study period. Male to female ratio was 4:1 with mean age 9.48 ± 4 years. Forty-four percentage required hospitalization. The prevalence of unilateral blindness in children due to fireworks was found to be 8% (95% confidence interval - 2-13%). Vision 2020 gives high priority to avoidable blindness, especially in children. In our study, for every 12 children who presented with firecracker injury, one resulted in unilateral blindness. This is an avoidable cause of blindness. Awareness needs to be created, and changes in policy regarding sales and handling of firecrackers including mandatory use of protective eyewear should be considered.

  10. Spectrum of ocular firework injuries in children: A 5-year retrospective study during a festive season in Southern India

    Directory of Open Access Journals (Sweden)

    Deepa John

    2015-01-01

    Full Text Available Purpose: Ocular trauma is a major cause of acquired monocular blindness in children. Firework injuries account for 20% of ocular trauma. The purpose of our study was to document the profile of ocular firework injuries in children during the festive season of Diwali and to determine the prevalence of unilateral blindness in them. Materials and Methods: A retrospective chart analysis of ocular firework injury in children during the festival of Diwali from 2009 to 2013, conducted in a tertiary care eye center in Tamil Nadu, Southern India. Children below 18 years of age with ocular firework injuries who presented to the emergency department for 3 consecutive days - the day of Diwali, 1 day before, and 1 day after Diwali - were included in this study. Results: Eighty-four children presented with firework-related ocular injuries during the study period. Male to female ratio was 4:1 with mean age 9.48 ± 4 years. Forty-four percentage required hospitalization. The prevalence of unilateral blindness in children due to fireworks was found to be 8% (95% confidence interval - 2-13%. Conclusion: Vision 2020 gives high priority to avoidable blindness, especially in children. In our study, for every 12 children who presented with firecracker injury, one resulted in unilateral blindness. This is an avoidable cause of blindness. Awareness needs to be created, and changes in policy regarding sales and handling of firecrackers including mandatory use of  protective eyewear should be considered.

  11. Analysis of morbidity and prevalence of bronchial asthma among children from different age groups and regions in Ukraine

    Directory of Open Access Journals (Sweden)

    Antypkin Yu.G.

    2016-03-01

    Full Text Available Purpose — to present retrospective study of the morbidity and prevalence of bronchial asthma among children from different age groups and regions according to Ukrainian Ministry of Health official government statistics from 2005 to 2014. Patients and methods. Retrospective study of the morbidity and prevalence of bronchial asthma among children in Ukraine from 2005 to 2014. Results. It was established that from 2012 to 2014 there was a tendency towards a decrease of bronchial asthma indicators — rate of sickness 11.9% and 11.4%, maximum reduction of the indicators was observed in the age group of 0–6 years 19.6% and 17% accordingly. The highest rate of bronchial asthma was registered in the age group 7–14 years (0.7–0.64 per 1000 children population, 15–17 years (9.22–8.66 per 1000 children population. Conclusions. Statistical analysis indicates a problem of hypo;diagnostics of bronchial asthma among children from Ukraine.

  12. The clinical characteristics and direct medical cost of influenza in hospitalized children: a five-year retrospective study in Suzhou, China.

    Directory of Open Access Journals (Sweden)

    Tao Zhang

    Full Text Available BACKGROUND: There have been few studies on children hospitalized with influenza published from mainland China. We performed a retrospective review of medical charts to describe the epidemiology, clinical features and direct medical cost of laboratory-proven influenza hospitalized children in Suzhou, China. METHODS: Retrospective study on children with documented influenza infection hospitalized at Suzhou Children Hospital during 2005-2009 was conducted using a structured chart review instrument. RESULTS: A total of 480 children were positive by immuno-fluorescent assay for influenza during 2005-2009. The hospitalizations for influenza occurred in 8-12 months of the year, most commonly in the winter with a second late summer peak (August-September. Influenza A accounted for 86.3%, and of these 286 (59.6% were male, and 87.2% were 60 months old had shorter hospital stay (OR = 0.45; children with oxygen treatment tended to have longer hospital stays than those without oxygen treatment (OR = 2.14. The mean cost of each influenza-related hospitalization was US$ 624 (US$ 1323 for children referred to ICU and US$ 617 for those cared for on the wards. High risk children had higher total cost than low-risk patients. CONCLUSION: Compared to other countries, in Suzhou, children hospitalized with influenza have longer hospital stay and higher percentage of pneumonia. The direct medical cost is high relative to family income. Effective strategies of influenza immunization of young children in China may be beneficial in addressing this disease burden.

  13. Description of 3,180 courses of chelation with dimercaptosuccinic acid in children ≤ 5 y with severe lead poisoning in Zamfara, Northern Nigeria: a retrospective analysis of programme data.

    Directory of Open Access Journals (Sweden)

    Natalie Thurtle

    2014-10-01

    Full Text Available BACKGROUND: In 2010, Médecins Sans Frontières (MSF discovered extensive lead poisoning impacting several thousand children in rural northern Nigeria. An estimated 400 fatalities had occurred over 3 mo. The US Centers for Disease Control and Prevention (CDC confirmed widespread contamination from lead-rich ore being processed for gold, and environmental management was begun. MSF commenced a medical management programme that included treatment with the oral chelating agent 2,3-dimercaptosuccinic acid (DMSA, succimer. Here we describe and evaluate the changes in venous blood lead level (VBLL associated with DMSA treatment in the largest cohort of children ≤ 5 y of age with severe paediatric lead intoxication reported to date to our knowledge. METHODS AND FINDINGS: In a retrospective analysis of programme data, we describe change in VBLL after DMSA treatment courses in a cohort of 1,156 children ≤ 5 y of age who underwent between one and 15 courses of chelation treatment. Courses of DMSA of 19 or 28 d duration administered to children with VBLL ≥ 45 µg/dl were included. Impact of DMSA was calculated as end-course VBLL as a percentage of pre-course VBLL (ECP. Mixed model regression with nested random effects was used to evaluate the relative associations of covariates with ECP. Of 3,180 treatment courses administered, 36% and 6% of courses commenced with VBLL ≥ 80 µg/dl and ≥ 120 µg/dl, respectively. Overall mean ECP was 74.5% (95% CI 69.7%-79.7%; among 159 inpatient courses, ECP was 47.7% (95% CI 39.7%-57.3%. ECP after 19-d courses (n = 2,262 was lower in older children, first-ever courses, courses with a longer interval since a previous course, courses with more directly observed doses, and courses with higher pre-course VBLLs. Low haemoglobin was associated with higher ECP. Twenty children aged ≤ 5 y who commenced chelation died during the period studied, with lead poisoning a primary factor in six deaths. Monitoring of alanine

  14. Dermatophytes and transmission risks to family: a retrospective study of a cohort of 256 adopted children from 1998 to 2012.

    Science.gov (United States)

    Dupont, Damien; Peyron, François; Picot, Stéphane; Wallon, Martine; Bienvenu, Anne-Lise

    2015-01-01

    In this 14-year retrospective study we analyzed samples collected from 101 adopted children originating from developing countries in search of dermatophytosis; a dermatophyte was isolated in 44 children. We demonstrated that dermatophytoses often have a silent clinical presentation (16%) and in approximately 20% of cases cause family member contamination. This study highlights the importance of the clinical examination of children and families as well as systematic sampling of children to avoid dermatophyte transmission to other family members. © 2014 Wiley Periodicals, Inc.

  15. Risk of Nephrotic Syndrome following Enteroviral Infection in Children: A Nationwide Retrospective Cohort Study.

    Science.gov (United States)

    Lin, Jiun-Nong; Lin, Cheng-Li; Yang, Chi-Hui; Lin, Ming-Chia; Lai, Chung-Hsu; Lin, Hsi-Hsun; Kao, Chia-Hung

    2016-01-01

    Nephrotic syndrome is a common chronic illness encountered during childhood. Infections have been identified as a cause of nephrotic syndrome. The aim of this study was to evaluate the association between enteroviral infection and nephrotic syndrome. A nationwide retrospective cohort study was conducted by analyzing data from the National Health Insurance Research Database in Taiwan. Children aged children were randomly selected as the comparison cohort. The primary endpoint was the occurrence of nephrotic syndrome. This study included 280,087 enterovirus-infected children and 280,085 non-enterovirus-infected children. The mean age of the enterovirus-infected children was 2.38 years, and 53.7% of these children were boys. The overall incidence densities of nephrotic syndrome for enterovirus- and non-enterovirus-infected children were 2.65 and 2.21 per 10,000 person-years, respectively. The enterovirus-infected cohort had a higher cumulative incidence of nephrotic syndrome than did the non-enterovirus-infected cohort (log-rank test, p = 0.01). Multivariable analyses revealed that children with enteroviral infection were significantly associated with an increased risk of nephrotic syndrome compared with those without enteroviral infection (adjusted hazard ratio, 1.20; 95% confidence interval, 1.04-1.39; p = 0.01), particularly in children infected with coxsackievirus. Subgroup analyses revealed that enterovirus-infected girls, children of blue-collar workers, and children without allergies had a higher risk of nephrotic syndrome than did children in the non-enterovirus-infected cohort. This study revealed a significant association between enteroviral infection and nephrotic syndrome. Additional studies elucidating the role and pathogenesis of enterovirus in nephrotic syndrome are warranted.

  16. Parents were accurate proxy reporters of urgent pediatric asthma health services: a retrospective agreement analysis.

    Science.gov (United States)

    Ungar, Wendy J; Davidson-Grimwood, Sara R; Cousins, Martha

    2007-11-01

    To assess agreement between parents' proxy reports of children's respiratory-related health service use and administrative data. A retrospective analysis of statistical agreement between clinical and claims data for reports of physician visits, emergency department (ED) visits, and hospitalizations in 545 asthmatic children recruited from sites in the greater Toronto area was conducted. Health services use data were extracted from the Ontario Health Insurance Plan and Canadian Institute for Health Information databases for each child for the interval coinciding with the proxy report for each health service type. Agreement between administrative data and respondent reports (n=545) was substantial for hospitalizations in the past year (kappa=0.80 [0.74, 0.86]), moderate for ED visits in the past year (kappa=0.60 [0.53, 0.67]), and slight for physician visits (kappa=0.13 [0.00, 0.27]) in the past 6 months. Income, parent's education, and child quality-of-life symptom scores did not affect agreement. Agreement for ED visits was significantly higher (Pasthma attack in the past 6 months (kappa=0.61 [0.54, 0.68]) compared to children who did not (kappa=0.25 [0.00, 0.59]). Parents of asthmatic children are reliable reporters of their child's respiratory-related urgent health services utilization.

  17. [Pediatric medulloblastoma: Retrospective series of 52 patients].

    Science.gov (United States)

    Vigneron, C; Antoni, D; Coca, A; Entz-Werlé, N; Lutz, P; Spiegel, A; Jannier, S; Niederst, C; Jarnet, D; Meyer, P; Kehrli, P; Noël, G

    2016-04-01

    Retrospective analysis of the results of 52 children irradiated for a medulloblastoma. Between 1974 and 2012, 52 children with an average age of 6 years and a half (11 months-17 years and a half) were treated with surgery then with radiotherapy at the Comprehensive Cancer Centre of Strasbourg (France). For 44 children, the treatment consisted of a chemotherapy. After a mean follow-up of 106.6 months (7-446 months), 13 relapses and 24 deaths were observed. Overall survival at 5 years and 10 years were 62% and 57%, respectively. Disease-free survival at 5 years and 10 years were 80% and 63%, respectively. Univariate analysis found the following adverse prognostic factors: the existence of a postoperative residue, the positivity of the cerebrospinal fluid, the metastatic status and medulloblastoma of high-risk. Positivity of the cerebrospinal fluid remains a negative factor in multivariate analysis. These results confirm the survival rate obtained by a conventional approach (surgery then irradiation). Insufficiency of results and rarity of medulloblastoma require the establishment of international protocols. Copyright © 2016. Published by Elsevier SAS.

  18. Cochlear implantation outcomes in children with common cavity deformity; a retrospective study.

    Science.gov (United States)

    Zhang, Li; Qiu, Jianxin; Qin, Feifei; Zhong, Mei; Shah, Gyanendra

    2017-09-01

    A common cavity deformity (CCD) is a deformed inner ear in which the cochlea and vestibule are confluent forming a common rudimentary cystic cavity that results in profound hearing loss. There are few studies paying attention to common cavity. Our group is engrossed in observing the improvement of auditory and verbal abilities in children who have received cochlear implantation (CI), and comparing these targets between children with common cavity and normal inner ear structure. A retrospective study was conducted in 12 patients with profound hearing loss that were divided into a common cavity group and a control group, six in each group matched in sex, age and time of implantation, based on inner ear structure. Categories of Auditory Performance (CAP) and speech intelligibility rating (SIR) scores and aided hearing thresholds were collected and compared between the two groups. All patients wore CI for more than 1 year at the Cochlear Center of Anhui Medical University from 2011 to 2015. Postoperative CAP and SIR scores were higher than before operation in both groups (p good as in those without CCD, CI provides benefits in auditory perception and communication skills in these children.

  19. A retrospective analysis of acute organophosphorus poisoning ...

    African Journals Online (AJOL)

    A retrospective analysis of acute organophosphorus poisoning cases admitted to the tertiary care teaching hospital in South India. ... Young adult males were more commonly involved than females (M:F 2.5:1). The mean age of the patients was 28 years (range 2-72 years, SD ± 14.3 years). Mean time to receive treatment ...

  20. Retrospective Study of Rocky Mountain Spotted Fever in Children.

    Science.gov (United States)

    Tull, Rechelle; Ahn, Christine; Daniel, Alyssa; Yosipovitch, Gil; Strowd, Lindsay C

    2017-03-01

    Rocky Mountain spotted fever (RMSF), a lethal tick-borne illness, is prevalent in the south central United States. Children younger than 10 years old have the greatest risk of fatal outcome from RMSF. The objective of the current study was to review pediatric cases of RMSF seen in the dermatology consult service and to evaluate dermatology's role in the diagnosis and management of this disease. A retrospective review was performed of inpatient dermatology consultations at a tertiary care center in North Carolina from 2001 to 2011. Data collected included patient demographic characteristics, symptoms, pre- and postconsultation diagnoses, diagnostic procedures, length of hospital stay, and outcome. A total of 3,912 consultations were conducted in the dermatology service over 10 years. Six patients with RMSF, ranging in age from 22 months to 10 years (mean 5.1 years), were evaluated during April, May, and June. All preconsultation diagnoses included RMSF in the differential diagnosis. All patients underwent skin biopsies, and a culture was obtained in one case. Fifty percent of patients died within 4 days of hospitalization. Variables associated with mortality from RMSF are delayed diagnosis and initiation of antirickettsial therapy. Physicians should consider RMSF in children presenting with fever and rash during the summer months. Dermatology consultation is useful in evaluating patients with suspicious clinical features of RMSF with skin findings. © 2016 Wiley Periodicals, Inc.

  1. 69-74 A Retrospective Analysis of Prescribing Prac

    African Journals Online (AJOL)

    user

    A Retrospective Analysis of Prescribing Practice Based on WHO Prescribing Indicators at Four. Selected Hospitals of West ... Key words: World Health Organization, prescribing indicators, rational drug use. INTRODUCTION. Indicators of ... factors, the risk of irrational prescribing could raise several folds. Irrational use of ...

  2. Breast cancer metastasis to thyroid: a retrospective analysis.

    African Journals Online (AJOL)

    Objective: Retrospective analysis of data from breast cancer patients with thyroid metastasis (TM). Methods: The ... parenchyma with gathering of calcification that reduced in size, revealing the sensitiveness of TM to chemotherapy. Conclusion: US ..... patients.16-18. Most common sites of primary tumors are renal cell car-.

  3. Cephalometric findings among children with velopharyngeal dysfunction following adenoidectomy-A retrospective study.

    Science.gov (United States)

    Kassem, F; Ebner, Y; Nageris, B; Watted, N; DeRowe, A; Nachmani, A

    2017-12-01

    To characterise the craniofacial structure by cephalometry, especially the skull base and nasopharyngeal space, in children who underwent adenoidectomy and developed persistent velopharyngeal dysfunction (VPD). Retrospective study. Speech and swallowing clinic of a single academic hospital. Thirty-nine children with persistent VPD following adenoidectomy (mean age 8.0±3.6 years) and a control group of 80 healthy children. Cephalometric landmarks were chosen; craniofacial linear and angular dimensions were measured and analysed. The linear dimensions of the nasopharyngeal area were shorter in the VPD group, S-Ba (41.6±4.2 mm, P<.05) and S-Ptm (42.4±5.1 mm, P<.05). The anterior skull base, N-S, was similar (68.1 mm±6.8). The velum length, Ptm-P was significantly shorter in the VPD group (27.8±4.3 mm, P<.001). The Ba-S-Ptm angle was significantly larger in the VPD group (63.5±5.6°, P<.001). There was no significant difference in cranial base angle (CBA), Ba-S-N, between the two groups. Cephalometry may provide information regarding persistent postoperative VPD. The nasopharyngeal space angle and velar length appear to be risk factors for persistent VPD after adenoidectomy. © 2017 John Wiley & Sons Ltd.

  4. Epidemiological and Clinical Characteristics of Children and Adolescents with Leprosy Admitted Over 16 Years at a Rural Hospital in Ethiopia: A Retrospective Analysis.

    Science.gov (United States)

    Ramos, José M; Ortiz-Martínez, Sonia; Lemma, Deriba; Petros, Matheus M; Ortiz-Martínez, Carmen; Tesfamariam, Abraham; Reyes, Francisco; Belinchón, Isabel

    2018-06-01

    To analyse differences in children and adolescents aged ≤18 years admitted to the leprosy ward in a rural Ethiopian hospital >16 years. We retrospectively collected data from leprosy admission registry books on patients with leprosy who were admitted to a referral hospital from September 2000 to September 2016. There were 2129 admissions for leprosy during the study period: 180 (8.4%) patients were s ≤ 18 years old. Of these, 98 (54.4%) were male and 82 (45.6%) were female. The proportion of new diagnoses in children and adolescents was 31.7%, significantly higher than in adults (11.7%; p < 0.001). There were also significant differences in the prevalence of lepromatous ulcers (46.9 vs. 61.7%), leprosy reaction (29.4 vs. 13.0%) and neuritis (16.9 vs.5.3%) between these age groups. There were more new diagnoses, leprosy reactions and neuritis, and fewer lepromatous ulcers, in children and adolescents compared with adults, with younger patients being referred more frequently to reference centres.

  5. Distribution of Microorganisms and Antibiotic Resistance in Children with Urinary Tract Infections, Retrospective Case Series.

    Directory of Open Access Journals (Sweden)

    Didem Kaya

    2017-04-01

    Full Text Available Aim Urinary tract infection is one of the most common serious bacterial infections in children. Due to regional differences and past infections, the use of antibiotics has problems such as variability in microorganisms and antibiotic susceptibility. In this study, we aimed to determine the microorganisms detected in urinary tract infections in children and their antibiotic resistance status.Methods A retrospective observational study was planned. Demographic data, urine microscopy and urine culture results of patients who were hospitalized with urinary tract infection diagnosis in our pediatric clinic at hospital were recorded retrospectively through hospital automation system. The first culture results of the patients were used in the evaluation of the data. Results In the study group of 112 patients, Escherichia coli (E. coli and Klebsiella were the most identified microorganisms in patients with urinary culture. Under 2 years old, Klebsiella was more frequent, and at 2 years of age there was a noticeable increase in the frequency of E-coli. The most common resistance of both microorganisms was found to be ampicillin. Conclusions: Regional infectious agents and antibiotic resistance should be revised at regular intervals, appropriate empiric therapy should be considered. Thus, is predicted that the chance of success in treatment will increase and the speed of resistance development will decrease.

  6. Retrospective study of paracetamol poisoning in children aged zero to six years found no cases of liver injury

    DEFF Research Database (Denmark)

    Dan-Nielsen, S; Bisgaard, A S; Jans, S R

    2018-01-01

    AIM: This study focused on children aged zero to six years with suspected single-dose paracetamol poisoning, which has not been investigated in Denmark. We evaluated the incidence of liver injuries and the use of activated charcoal and N-acetylcysteine treatment. METHODS: Our retrospective study.......67 ± 1.05 years. Activated charcoal treatment was given in 87% of cases, but only 15% of the children received treatment within one hour of the suspected paracetamol poisoning. Although 80% of the children received N-acetylcysteine treatment, only one case (0.5%) had a toxic plasma paracetamol level...... children aged zero to six years with suspected paracetamol poisoning. Vomiting or abdominal pain was associated with elevated plasma paracetamol levels. No liver injuries were reported....

  7. A retrospective analysis of early experience with modified complete primary repair of exstrophy bladder (CPRE in neonates and children

    Directory of Open Access Journals (Sweden)

    Santosh B Kurbet

    2013-01-01

    Full Text Available Objective: To study the problems faced during the surgery and follow-up of modified complete primary repair of exstrophy (CPRE technique. Initial experience with CPRE and its short- and long-term outcomes with respect to continence status and psychosocial impact are reported. Materials and Methods: A retrospective review of the hospital case records from March 2008 to September 2012 was performed. Data of patients with bladder exstrophy managed by a single paediatric surgeon using modified CPRE technique were analysed. Quality of life and psychosocial impact of the surgery were assessed using Pediatric Quality of Life Inventory (PedsQL 4.0 and compared with those of typical peers. Results: Eight children (age 4 days-12 years underwent CPRE using modified Mitchell′s technique. Two patients (25% experienced early postoperative complications, with infection and fistula developing in one each. All the patients were doing well on follow-up, with variable continence rates and good cosmesis. Mean duration of follow-up was 18.5 months (range 6 months-4 years. Five out of seven (71% children were continent or partially continent. One case was lost to follow-up. PedsQL scores were comparable with those of age-matched peers in all domains except the social functioning domain in 8-12 years age group (83.53 ± 9.70 vs. 77.86 ± 10.22, P < 0.05. Conclusion: Our preliminary results with modified CPRE in neonates and children have been encouraging. No major complications were observed. Continence rate was satisfactory and cosmetic results were good. Though the technique is being practiced at several Indian centres, there is a paucity of comprehensive Indian data on CPRE.

  8. A retrospective comparison of dental treatment under general anesthesia on children with and without mental disabilities.

    Science.gov (United States)

    Sari, M E; Ozmen, B; Koyuturk, A E; Tokay, U

    2014-01-01

    The purpose of this study is to determine the properties of the dental procedures performed on children with dental problems under general anesthesia and compared between the patterns of dental treatment provided for intellectual disability and non-cooperate healthy child. In this retrospective study, the records of patients between the ages of 4 and 18 who were treated under general anesthesia were evaluated. Patients were divided into two groups: Those with intellectual disability and healthy patients who had difficulty cooperating. A statistical analysis of the mean standard deviation was conducted with a focus on two factors: Age and dental treatment methods. In this study, it was observed that restorative treatment and tooth extraction was generally higher in intellectual disability children than in their healthy children. When evaluating the health status of teeth, the value of decayed missing and filled teeth (dmf-t) was observed to be close in healthy and intellectual disability individuals in the 4-6 age groups; it was higher in individuals with intellectual disability in the 7-12 age groups. There was no significant difference in terms of periodontal treatment and fissure sealants in the 12-18 age groups. By comparing the different patient groups who received dental treatment under general anesthesia, both the number of teeth extracted and DMF-T indices were higher in the disabled group. Therefore, especially more efforts should be made at encouraging these patients to visit the dentist earlier and receive primary preventive care.

  9. Prevalence of breast tuberculosis: Retrospective analysis of 65 ...

    African Journals Online (AJOL)

    Prevalence of breast tuberculosis: Retrospective analysis of 65 patients attending a tertiary hospital in Durban, South Africa. ... Breast tuberculosis (BTB) is uncommon, but not rare. Knowledge of the ways in which it can ... Fine-needle aspiration cytology had sensitivity of only 28% compared with 94% for histology. Of those ...

  10. retrospective data analysis in the Fertility Centre from 1995 to 2000

    OpenAIRE

    Nahid, Hiwa

    2016-01-01

    Introduction: It is estimated that worldwide seven to nine percent of couples of reproductive age suffer from infertility and more than 6 million children were already born with the support of in vitro fertilization (IVF). Methodology: In the first part of this study, the medical records of 4136 patients in the Fertility Centre Berlin over a period of time from 1995 to 2000 in terms of duration of infertility were evaluated retrospectively. The age of women, the age difference between the ...

  11. Sporotrichosis among children of a hyperendemic area in Peru: an 8-year retrospective study.

    Science.gov (United States)

    Ramírez Soto, Max C

    2017-08-01

    The clinical and epidemiologic characteristics of pediatric sporotrichosis are poorly understood. To describe the incidence and clinical characteristics of cases of sporotrichosis in children 14 years of age and younger reported in Abancay from 2004 to 2011, stratified according to age. We performed a retrospective review of pediatric patients 14 years of age and younger who were diagnosed with sporotrichosis in a referral center at Abancay, a poor area located in the south central highlands of Peru, to estimate the incidence rates (per 100,000 person-years) according to age and sporotrichosis type (lymphocutaneous and fixed), and clinical characteristics of these patients. Of the 240 pediatric cases identified, 131 (54.6%) were male. The median age at baseline was 6 years. The mean incidence rate was 81.4 cases per 100,000 person-years for the period from 2004 to 2011, and was highest among children ranging in age from 5-9 years. The incidence of lymphocutaneous sporotrichosis and fixed sporotrichosis was 55 and 27 cases per 100,000 person-years, respectively, and the face was the most commonly affected anatomic site. Ninety-six of the 240 patients (40%) reported previous contact with cats, and 46 (19.2%) had a clear history of traumatic inoculation with plant material. The therapeutic response to treatment with potassium iodide was satisfactory. In this retrospective study, we described a high incidence of sporotrichosis in children in the south central highlands of Peru, which increased with age. Lymphocutaneous sporotrichosis was the more common type with an incidence rate twice that of the fixed type. The face was the most commonly affected anatomic site, and infection appeared to be acquired predominantly through contact with cats. © 2017 The International Society of Dermatology.

  12. The risk of developing type 2 diabetes mellitus associated with psychotropic drug use in children and adolescents: a retrospective cohort analysis.

    Science.gov (United States)

    Jerrell, Jeanette M; Tripathi, Avnish; Rizvi, Ali A; McIntyre, Roger S

    2012-01-01

    Type 2 diabetes mellitus in children and adolescents has become an important public health concern, in parallel with the "epidemic" of overweight/obesity in this age group and a sharp increase in children being prescribed antidepressant or antipsychotic medications. In children and adolescents, the prevalence of being prescribed antidepressant or antipsychotic medications was examined as well as the association of these medications with developing type 2 diabetes mellitus. A retrospective cohort design evaluating South Carolina Medicaid medical and pharmacy claims between January 1, 1996, and December 31, 2006, was employed to identify 4,070 children and adolescents diagnosed initially with type 2 diabetes mellitus, 39% of whom were later reclassified as type 1 (using ICD-9 criteria). The added risk of developing type 2 diabetes mellitus posed by the use of antidepressants or antipsychotics was investigated in this cohort, controlling for individual risk factors and comorbid cardiometabolic conditions. Use of antidepressants or antipsychotics alone, or the 2 in combination, conferred an increased risk (1.3 to 2 times greater) of having diagnosed type 2 diabetes mellitus and several comorbid cardiometabolic conditions (obesity, dyslipidemia, and hypertension). However, psychiatric illnesses generally developed and were treated after the initial development of diabetes. Depression was diagnosed and treated in 10% to 20% of this cohort. While antidepressants and antipsychotics, alone or in combination, are associated with a diagnosis of type 2 diabetes mellitus and its cardiometabolic comorbidities by adolescence, they do not appear to be an explanatory factor in the early onset of type 2 diabetes mellitus in this age group and do not appear to cloud the initial, overlapping clinical picture between type 1 and type 2 diabetes mellitus.

  13. Hyperhidrosis Substantially Reduces Quality of Life in Children: A Retrospective Study Describing Symptoms, Consequences and Treatment with Botulinum Toxin

    Directory of Open Access Journals (Sweden)

    Sandra Eriksson Mirkovic

    2017-09-01

    Full Text Available Studies on children with hyperhidrosis are sparse. This retrospective study presents clinical data and quality of life, along with treatment effect and safety of botulinum toxin (BTX. Case reports from 366 children were included to capture the medical history of hyperhidrosis. The total median score of the Dermatology Life Quality Index before treatment was 11 for children aged 16–17 years and 12 for children younger than 16 years. The children described physical, psychosocial and consequence-related symptoms. More than 70% had multifocal hyperhidrosis. BTX-A and/or BTX-B were given to 323 children, 193 of whom received repeated treatments. The highest score in a 5-grade scale concerning treatment effect was reported by 176/193 children, i.e. their “sweating disappeared completely”. No severe adverse events occurred. Focal and multifocal hyperhidrosis in children reduces quality of life considerably. Treatment with BTX-A and/or BTX-B has been performed with success.

  14. Hydroxyurea effectiveness in children and adolescents with sickle cell anemia: A large retrospective, population-based cohort.

    Science.gov (United States)

    Quarmyne, Maa-Ohui; Dong, Wei; Theodore, Rodney; Anand, Sonia; Barry, Vaughn; Adisa, Olufolake; Buchanan, Iris D; Bost, James; Brown, Robert C; Joiner, Clinton H; Lane, Peter A

    2017-01-01

    The clinical efficacy of hydroxyurea in patients with sickle cell anemia (SCA) has been well established. However, data about its clinical effectiveness in practice is limited. We evaluated the clinical effectiveness of hydroxyurea in a large pediatric population using a retrospective cohort, pre-post treatment study design to control for disease severity selection bias. The cohort included children with SCA (SS, Sβ 0 thalassemia) who received care at Children's Healthcare of Atlanta (CHOA) and who initiated hydroxyurea in 2009-2011. Children on chronic transfusions, or children with inadequate follow up data and/or children who had taken hydroxyurea in the 3 years prior were excluded. For each patient healthcare utilization, laboratory values, and clinical outcomes for the 2-year period prior to hydroxyurea initiation were compared to those 2 years after initiation. Of 211 children with SCA who initiated hydroxyurea in 2009-2011, 134 met eligibility criteria. After initiation of hydroxyurea, rates of hospitalizations, pain encounters, and emergency department visits were reduced by 47% (Hydroxyurea effectiveness was similar across gender, insurance types and age, although there was a slightly greater reduction in hospitalizations in younger children. Am. J. Hematol. 92:77-81, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  15. Internationally adopted children with cleft lip and/or palate: A retrospective cohort study.

    Science.gov (United States)

    Werker, C L; de Wilde, H; Mink van der Molen, A B; Breugem, C C

    2017-12-01

    The treatment approach for internationally adopted children with cleft lip and/or palate differs from locally born children with cleft lip and/or palate. They are older at initial presentation, may have had treatment abroad of different quality, and are establishing new and still fragile relationships with their adoptive parents. The aim of this study was to describe the characteristics and initial care and treatment of this group. A retrospective cohort study was performed including all internationally adopted children with cleft lip and/or palate presenting to the cleft team outpatient clinic in the Wilhelmina Children's Hospital between January 1994 and December 2014. Medical records of all patients were reviewed; information concerning demographic characteristics, characteristics at initial presentation, and treatment were obtained. A total number of 132 adopted patients were included: 15% had cleft lip, 7% had cleft palate, and 78% had cleft lip and palate. The average age at the time of adoption was 26.5 months. In most cases, China was the country of origin. Seventy-eight percent had surgery in their country of origin, primarily lip repair. Fistulae in need of revision surgery were found in 8% of the patients. Pharyngoplasty was needed in 48% of the patients. No significant differences were found for mean age at adoption, gender, cleft type, and one- or two-stage palatal closure. Internationally adopted children with cleft lip and/or palate are a very diverse group of patients with challenging treatment. These children undergo surgery late and frequently need additional surgery. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  16. [Development and family environment in compulsive neurotic children and adolescents: a retrospective and comparative study].

    Science.gov (United States)

    Ernst, H; Klosinski, G

    1989-09-01

    In a retrospective study the patient histories of 113 children and adolescents who received outpatient (89 cases) or inpatient (24 cases) treatment from 1973 to 1984 in the Department of Child and Adolescent Psychiatry, University of Tübingen with the diagnosis "compulsive neurosis" were examined in terms of the criteria personality development, family structure, frequency of certain forms and contents of compulsory behavior, significance and symbolism of the compulsive behavior within the family dynamics. In addition, a comparison was made with the other patients (n = 8,774) receiving child and adolescent psychiatric treatment during this period. The ratio of boys to girls was 7.3. The average age was 13.8 years in the boys and 12.6 years in the girls. The youngest patient was four years old. Compulsive washing was the predominant compulsive behavior in all age groups. Compulsive fears were most frequently manifested in fears about the mother, followed by poisoning and hypochondriac fears. Compulsive impulses were only found from prepuberty. In the girls they were always directed to killing the mother. The analysis of personality development revealed that there were indications of special features in the anal phase in only three cases. On the other hand, special events of pathoplastic significance were found in half of the patients. In about 33%, anancastic characteristics were present in the parents (eight parents were manifestly subject to compulsive neurosis). Conflict avoidance and ambitious demands on the children concerned were typical in the families. In contrast to the reference population, the compulsively neurotic children and adolescents were of average intelligence, frequently attended higher schools and belonged to a higher social class.

  17. The epidemiologic characteristics of healthcare provider-diagnosed eczema, asthma, allergic rhinitis, and food allergy in children: a retrospective cohort study

    OpenAIRE

    Hill, David A.; Grundmeier, Robert W.; Ram, Gita; Spergel, Jonathan M.

    2016-01-01

    Background The rates of childhood allergic conditions are changing, prompting the need for continued surveillance. Examination of healthcare provider-based diagnosis data is an important and lacking methodology needed to complement existing studies that rely on participant reporting. Methods Utilizing our care network of 1,050,061 urban and sub-urban children, we defined two retrospective cohorts: (1) a closed birth cohort of 29,662 children and (2) a cross-sectional cohort of 333,200 childre...

  18. Retrospective Analysis of Studying Psychological Nature of Creativity

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    N V Artjushkina

    2013-12-01

    Full Text Available The creativity phenomenon analysis in the works of the domestic and foreign scientists is presented in this article. The authors focus their special attention on the factors of creativity manifestation during the various periods of ontogenesis and on the characteristic of the conditions necessary for the formation of a creative personality. On the basis of the retrospective analysis and the synthesis of the conceptual approaches to studying the parameters of creativity, the criteria by which it is possible to determine the level of the development of the creative personality are revealed.

  19. A retrospective analysis of ultrasound-guided large core needle ...

    African Journals Online (AJOL)

    A retrospective analysis of ultrasound-guided large core needle biopsies of breast lesions at a regional public hospital in Durban, KwaZulu-Natal, South Africa. ... Objective: To assess the influence of technical variables on the diagnostic yield of breast specimens obtained by using US-LCNB, and the sensitivity of detecting ...

  20. Intentional and accidental paracetamol poisoning in childhood – a retrospective analysis

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    Katarzyna Kominek

    2015-04-01

    Full Text Available Paracetamol is one of the most commonly used analgesics and antipyretics available without limits as preparations of the OTC group (over the counter drugs. Overdose and poisoning with this drug always brings about the risk of acute hepatic failure. The objective of the study was a retrospective evaluation of patients hospitalized in the Paediatric Clinic during the period 2004–2012 due to poisoning with paracetamol.The analysis covered 44 patients hospitalized in the Paediatric Clinic during 2004–2012 due to poisoning with paracetamol. Patients were divided into three groups: intentional poisonings, accidental poisonings, and drug overdose.During the period of the study, 44 patients aged 2.1–17.1, poisoned with paracetamol, were hospitalized. Among these patients there were 30 (68.2% cases of intentional poisonings, 10 (22.7% of accidental poisonings, and only 4 patients (9.1% were children hospitalized after a paracetamol overdose. The majority of patients in all groups were females (93.3%.Paracetamol intoxication may occur after exceeding a single allowable dose, in the case of intentional poisoning, more rarely after exceeding the daily dose, in the case of intense pain complaints, or in the treatment of persistent fever.Based on the analysis performed, an increase was observed in the frequency of poisoning with paracetamol, especially intentional poisoning. Unlimited access to paracetamol as an OTC drug should be reconsidered.

  1. A retrospective analysis of longitudinal changes in bone mineral content in cystic fibrosis.

    Science.gov (United States)

    Chirita-Emandi, Adela; Shepherd, Sheila; Kyriakou, Andreas; McNeilly, Jane D; Dryden, Carol; Corrigan, Donna; Devenny, Anne; Ahmed, Syed Faisal

    2017-08-28

    We aimed to describe the longitudinal changes in bone mineral content and influencing factors, in children with cystic fibrosis (CF). One hundred children (50 females) had dual X-ray absorptiometry (DXA) performed. Of these, 48 and 24 children had two to three scans, respectively over 10 years of follow-up. DXA data were expressed as lumbar spine bone mineral content standard deviation score (LSBMCSDS) adjusted for age, gender, ethnicity and bone area. Markers of disease, anthropometry and bone biochemistry were collected retrospectively. Baseline LSBMCSDS was >0.5 SDS in 13% children, between -0.5; 0.5 SDS, in 50% and ≤-0.5 in the remainder. Seventy-eight percent of the children who had baseline LSBMCSDS >-0.5, and 35% of the children with poor baseline (LSBMCSDS0.5), showed decreasing values in subsequent assessments. However, mean LS BMC SDS did not show a significant decline in subsequent assessments (-0.51; -0.64; -0.56; p=0.178). Lower forced expiratory volume in 1 s percent (FEV1%) low body mass index standard deviation scores (BMI SDS) and vitamin D were associated with reduction in BMC. Bone mineral content as assessed by DXA is sub-optimal and decreases with time in most children with CF and this study has highlighted parameters that can be addressed to improve bone health.

  2. Retrospective analysis of the Spitak earthquake

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    A. K. Tovmassian

    1995-06-01

    Full Text Available Based on the retrospective analysis of numerous data and studies of the Spitak earthquake the present work at- tempts to shed light on different aspects of that catastrophic seismic event which occurred in Northern Arme- nia on December 7, 1988. The authors follow a chronological order of presentation, namely: changes in geo- sphere, atmosphere, biosphere during the preparation of the Spitak earthquake, foreshocks, main shock, after- shocks, focal mechanisms, historical seismicity; seismotectonic position of the source, strong motion records, site effects; the macroseismic effect, collapse of buildings and structures; rescue activities; earthquake conse- quences; and the lessons of the Spitak earthquake.

  3. Health-Related Quality of Life of Children/Adolescents with Vertigo: Retrospective Study from the German Center of Vertigo and Balance Disorders.

    Science.gov (United States)

    Deissler, Anna; Albers, Lucia; von Kries, Rüdiger; Weinberger, Raphael; Langhagen, Thyra; Gerstl, Lucia; Heinen, Florian; Jahn, Klaus; Schröder, A Sebastian

    2017-04-01

    Purpose  To assess the impact of vertigo on health-related quality of life (HrQoL) of children/adolescents and to assess if the impact on HrQoL varies by age group, gender, and type of vertigo diagnoses. Methods  A retrospective analysis was performed on the clinical and HrQoL data of children and adolescents referred to the German Center of Vertigo and Balance Disorders ( n  = 32; male = 17; female = 15; age range: 8-18 years), using the KIDSCREEN-52 questionnaire. For each scale, means of the Z-scores with 95% confidence intervals of the study and norm sample were compared. By nonparametric Kruskal-Wallis statistics differences between diagnostic groups were assessed. To assess the gender- and age-specific impact of vertigo on quality of life, Wilcoxon signed-rank test was used. Results  The means of the physical well-being, psychological well-being, autonomy scale, and the general HrQoL index of patients were considerably lower than the means of the norm sample. The physical well-being seemed to be most affected by vertigo. The reduction of HrQoL was not related to gender and vertigo types but seemed to be higher in children suffering from vertigo aged 12 to 18 years than children aged 8 to 11 years. Conclusion  These are the first data to demonstrate impaired HrQoL in children with chronic vertigo. Georg Thieme Verlag KG Stuttgart · New York.

  4. Retrospective analysis of paediatric achalasia in India: Single centre experience

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    Sunita Singh

    2012-01-01

    Full Text Available Background: Developing countries at tertiary referral centre. The aim of this study was to share our experience of paediatric achalasia in Indian scenario. Materials and Methods: This was a retrospective analysis of children <16 years, operated for achalasia at our centre, from December 1998 to December 2011. Results: Total 40 patients (mean age 39 ± 4.29 months, including 1 patient of megaesophagus were operated over 13 years of period; 17 patients (associated congenital H-type tracheoesophageal fistula in one patient, non- responders/ lost follow-up for minimum of 3 years in 16 patients were excluded from the study. The response rate of parents in follow-up was 60.0%. Mean symptoms duration was 27.88 ± 2 months. Most common symptoms were regurgitation and failure to thrive (78.2%. Mean symptom scoring in follow-up after 3 year was 1 ± 0.7 compared to 5 ± 0.51 at the time of admission (P < 0.012. One infant expired (mediastenitis, one developed adhesive intestinal obstruction and one needed posterior re-myotomy (for megaesophagus. There were no treatment failures in mean follow-up of 40.2 ± 5.07 months. Conclusions: Cardiomyotomy with partial fundoplication is the best modality of treatment for paediatric achalasia cardia, even from parents′ perspective.

  5. Gandhi and Mao on manual labour in the school: A retrospective analysis

    Science.gov (United States)

    Zachariah, Mathew; Hoffman, Arlene

    1985-12-01

    Mahatma Gandhi's views on relating the world of formal education to the world of work were developed first in his experimental `Tolstoy Farm' in South Africa. On his return to India, Gandhi insisted that a required manual labour component in the curriculum would help regenerate India's village economy, develop in India's children a deeper understanding of India's cultural roots, motivate children to relate `book learning' to life in society, and destroy invidious caste distinctions. The major proposals and suggestions in Gandhi's writing will be discussed in the context of his hopes for using schooling as an agent of progress in India. Mao Ze-Dong's views, on the other hand, were developed in the context of his Yenan experience in the 1930s, i.e. the decision to consolidate a power base in the interior of China before waging a class war against the landlords and capitalists of China. Mao's views were also, to some extent, rooted in the Chinese reality of stagnant, poverty-stricken rural areas. But, Mao's writings indicate that Marxist hopes to relate theory and practice (as understood in dialectical materialism) and to ensure that everyone participated in mental as well as manual labour in a socialist society had led him to formulate his proposals. Both Gandhi's and Mao's views and proposals have been more or less abandoned in India and China respectively. The similar and dissimilar reasons which led to such a fate are examined in this retrospective analysis.

  6. A retrospective analysis of boarding times for adolescents in psychiatric crisis.

    Science.gov (United States)

    Campbell, Michael; Pierce, Jessica

    2018-02-05

    The boarding of children and adolescents with identified psychiatric conditions at medical facilities has numerous negative effects on the patients and the systems that treat them. Efforts to minimize boarding times serves to increase patients' access to appropriate levels of care, redirect medical resources to patients who need them most, and reduce safety risks to people and property. This study explores the role Clinical Social Workers can play in facilitation of care and highlights the advantages of a coordinated data collection process facilitated by the effective use of the Electronic Medical Record. A retrospective chart analysis of 100 patients admitted to the Emergency department at a pediatric hospital in Central Florida was conducted for patients seen between 1 January 2015 and 30 June 2016. The data suggest key correlates that may impact the boarding times of pediatric patients presenting in a psychiatric crisis and the average duration of boarding time in hours (M = 5.11, SD = 2.07) was found to be significantly lower than prior published studies in the adult and pediatric literature. Discussion of these data implications on behavioral health practice is discussed.

  7. Fluid management in children with diarrhea-related hyponatremic-hypernatremic dehydration: a retrospective study of 83 children.

    Science.gov (United States)

    Kocaoglu, Celebi; Selma Solak, Ece; Kilicarslan, Cengizhan; Arslan, Sukru

    2014-02-01

    To investigate serum creatinine and electrolyte status of children with diarrhea-related hyponatremic or hypernatremic dehydration. Medical history of 83 patients admitted to the Pediatric Intensive Care Unit of the Konya Education and Research Hospital, Konya, Turkey with diarrhea, dehydration and electrolyte imbalance was retrospectively evaluated according to the degree of dehydration, serum creatinine, electrolytes, blood gas, approaches to the treatment such as content of given fluid, HCO3- and acute periotenal dialysis. Of 65 patients with hyponatremia, 44 (67.7%) were given fluids at appropriate concentration according to their age, and 21 (32.3%) were given fluids at higher concentration. Of 18 hypernatremic patients, 11 (61.1%) were given fluids at appropriate concentration for age, and seven (38.9%) were given fluids at higher concentration. Mean duration of amelioration of serum sodium levels for those admitted with hyponatremia and given fluids at appropriate concentration for age and at higher concentration were 33.9 ± 28.3 h and 53.7 ± 31.6 h, respectively. Mean duration of amelioration of serum sodium levels for hypernatremics and given fluids at appropriate concentration for age and at higher concentration were 34.7 ± 22.1 h and 46.3 ± 32 h, respectively. Four (4.8%) hyponatremic patients and three (3.6%) with hypernatremia were treated with acute peritoneal dialysis. Mortality rate was 6% (five of all patients). The children with severe diarrhea should be closely followed-up as to clinical examination, serum electrolytes, creatinine and blood gases, and because no single intravenous fluid management is optimal for all children, intravenous fluid therapy should be individualized for each patient.

  8. Characteristics of highly impaired children with severe chronic pain: a 5-year retrospective study on 2249 pediatric pain patients

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    Zernikow Boris

    2012-05-01

    Full Text Available Abstract Background Prevalence of pain as a recurrent symptom in children is known to be high, but little is known about children with high impairment from chronic pain seeking specialized treatment. The purpose of this study was the precise description of children with high impairment from chronic pain referred to the German Paediatric Pain Centre over a 5-year period. Methods Demographic variables, pain characteristics and psychometric measures were assessed at the first evaluation. Subgroup analysis for sex, age and pain location was conducted and multivariate logistic regression applied to identify parameters associated with extremely high impairment. Results The retrospective study consisted of 2249 children assessed at the first evaluation. Tension type headache (48%, migraine (43% and functional abdominal pain (11% were the most common diagnoses with a high rate of co-occurrence; 18% had some form of musculoskeletal pain disease. Irrespective of pain location, chronic pain disorder with somatic and psychological factors was diagnosed frequently (43%. 55% of the children suffered from more than one distinct pain diagnosis. Clinically significant depression and general anxiety scores were expressed by 24% and 19% of the patients, respectively. Girls over the age of 13 were more likely to seek tertiary treatment compared to boys. Nearly half of children suffered from daily or constant pain with a mean pain value of 6/10. Extremely high pain-related impairment, operationalized as a comprehensive measure of pain duration, frequency, intensity, pain-related school absence and disability, was associated with older age, multiple locations of pain, increased depression and prior hospital stays. 43% of the children taking analgesics had no indication for pharmacological treatment. Conclusion Children with chronic pain are a diagnostic and therapeutic challenge as they often have two or more different pain diagnoses, are prone to misuse of

  9. Hypnosis for treatment of insomnia in school-age children: a retrospective chart review

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    Slothower Molly P

    2006-08-01

    Full Text Available Abstract Background The purposes of this study are to document psychosocial stressors and medical conditions associated with development of insomnia in school-age children and to report use of hypnosis for this condition. Methods A retrospective chart review was performed for 84 children and adolescents with insomnia, excluding those with central or obstructive sleep apnea. All patients were offered and accepted instruction in self-hypnosis for treatment of insomnia, and for other symptoms if it was felt that these were amenable to therapy with hypnosis. Seventy-five patients returned for follow-up after the first hypnosis session. Their mean age was 12 years (range, 7–17. When insomnia did not resolve after the first instruction session, patients were offered the opportunity to use hypnosis to gain insight into the cause. Results Younger children were more likely to report that the insomnia was related to fears. Two or fewer hypnosis sessions were provided to 68% of the patients. Of the 70 patients reporting a delay in sleep onset of more than 30 minutes, 90% reported a reduction in sleep onset time following hypnosis. Of the 21 patients reporting nighttime awakenings more than once a week, 52% reported resolution of the awakenings and 38% reported improvement. Somatic complaints amenable to hypnosis were reported by 41%, including chest pain, dyspnea, functional abdominal pain, habit cough, headaches, and vocal cord dysfunction. Among these patients, 87% reported improvement or resolution of the somatic complaints following hypnosis. Conclusion Use of hypnosis appears to facilitate efficient therapy for insomnia in school-age children.

  10. Methadone conversion in infants and children: Retrospective cohort study of 199 pediatric inpatients.

    Science.gov (United States)

    Fife, Alexandra; Postier, Andrea; Flood, Andrew; Friedrichsdorf, Stefan J

    2016-01-01

    Methadone administration has increased in pediatric clinical settings. This review is an attempt to ascertain an equianalgesic dose ratio for methadone in the pediatric population using standard adult dose conversion guidelines. US tertiary children's hospital. Hospitalized pediatric patients, 0-18 years of age. A retrospective chart review was conducted for patients who were converted from their initial opioid therapy regimen (morphine, hydromorphone, and/or fentanyl) to methadone. The primary endpoint was whether or not a dose correction was needed for methadone in the 6 days following conversion using standard dose conversion charts for adults. Documented clinical signs of withdrawal, unrelieved pain, or oversedation were examined. The majority (53.7 percent) of the 199 children were converted to methadone on intensive care units prior extubation or postextubation. The mean conversion ratio was 23.7 mg of oral morphine to 1 mg of oral methadone (median, 18.8 mg:1 mg, SD=25.7). Most patients experienced an adequate conversion (n=115, 57.8 percent), while 83 (41.7 percent) appeared undermedicated, and one child was oversedated. There were no associations found with conversion ratios for initial morphine dose, days to conversion, or effect of withdrawal of concomitant agents with potential for withdrawal. Opioid conversion to methadone is commonly practiced at our institution; however, dosing was significantly lower compared to adult conversion ratios, and more than 40 percent of children were undermedicated. The majority of children in this study received opioids for sedation while intubated and ventilated; therefore, safe and efficacious pediatric methadone conversion rates remain unclear. Prospective studies are needed.

  11. Severe cutaneous drug reactions in Guinean children: a monocentric retrospective study of 35 cases

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    Thierno Mamadou Tounkara

    2018-04-01

    Full Text Available Background: Data on Severe cutaneous drug reactions (CADRs are not common among in sub-Saharan Africa children. The purpose of this study was to document the clinical, etiological and evolutionary aspects of Severe CDRs in children hospitalized at the dermatology department of university hospitals of Conakry. Material and Methods: Retrospective study, conducted from 1 January 2000 to 31 December 2014. Were included all children aged 0-17 years hospitalized for severe CARDs. The data collected were Socio-demographic, clinical, para-clinical and evolution variables. The data was entered and analyzed using the Excel 8.0 software. Results: During a study period, 4437 patients of all ages was hospitalized in dermatology department. 35 patients were included with an average age of 11.3 years and a sex ratio of 1.5. The main clinical patterns were: Stevens Johnson syndrome 37.14% (13/35 Lyell syndrome 25.71 % and generalized bullous fixed eruption 22.85%. The drug was identified as 32 patients (91.42%: Sulfadoxine–Pyriméthamine 40.62%, cotrimoxazole 21.85%, nevirapin 12.5%, ampicillin 6.25%, traditional Pharmacopoeia 6.25% and griseofulin 3.12%. It was taken following self-medication in 14 patients, including a parental initiative in 9 patients. 7 patients had a history of drug allergy and 4 were HIV positive. We recorded 5 deaths. Conclusion: Our study confirms the rarity of severe CADRs in children. The importance of the sulfadoxine-pyrimethamine in the occurrence of severe CADRs in children is the particularity of our series.

  12. Pediatric reduction mammaplasty: A retrospective analysis of the Kids' Inpatient Database (KID).

    Science.gov (United States)

    Soleimani, Tahereh; Evans, Tyler A; Sood, Rajiv; Hadad, Ivan; Socas, Juan; Flores, Roberto L; Tholpady, Sunil S

    2015-09-01

    Pediatric breast reduction mammaplasty is a procedure commonly performed in children suffering from excess breast tissue, back pain, and social anxiety. Minimal information exists regarding demographics, epidemiology, and complications in adolescents. As health care reform progresses, investigating the socioeconomic and patient-related factors affecting cost and operative outcomes is essential. The Kids' Inpatient Database (KID) was used from 2000 to 2009. Patients with an International Classification of Diseases, 9th Revision code of macromastia and procedure code of reduction mammaplasty 20 and less were included. Demographic data, including age, sex, payer mix, and location, were collected. Significant independent variables associated with complications and duration of stay were identified with bivariate and multiple regression analysis. A total of 1,345 patients between the ages 12 and 20 were evaluated. The majority of patients were white (64%), from a zip code with greatest income (36%), and had private insurance (75%). Overall comorbidity and complication rates were 30% and 3.2%, respectively. Duration of stay was associated with race, income quartile, insurance type, having complications, and hospital type. African-American race, Medicaid, lower income, and private-investor owned hospitals were predictive of greater hospital charges. In this large retrospective database analysis, pediatric reduction mammaplasty had a relatively low early complication rate and short duration of stay. Complications, total charges, and duration of stay discrepancies were associated with race, location, and socioeconomic status. Although demonstrably safe, this is the first study demonstrating the negative effect of race and socioeconomic status on a completely elective procedure involving children. These results demonstrate the intricate association between socioeconomic and patient-related factors influencing overall outcomes in the pediatric population. Copyright © 2015

  13. Prognostic Factors for Immune Thrombocytopenia Outcome in Greek Children: A Retrospective Single-Centered Analysis.

    Science.gov (United States)

    Makis, Alexandros; Gkoutsias, Athanasios; Palianopoulos, Theodoros; Pappa, Eleni; Papapetrou, Evangelia; Tsaousi, Christina; Hatzimichael, Eleftheria; Chaliasos, Nikolaos

    2017-01-01

    Immune thrombocytopenia (ITP) in children has a varied course and according to duration is distinguished as newly diagnosed (12) types. Several studies have evaluated the prognostic factors for the progression of the disease, but similar works have yet to be performed in Greece. We aimed to identify prognostic markers for the three forms of the disease in 57 Greek children during a 13-year period. Information regarding age, gender, preceding infection, bleeding type, duration of symptoms and platelets at diagnosis, treatment, disease course, and immunological markers was recorded. 39 children had newly diagnosed, 4 persistent, and 14 chronic disease. Chronic ITP children were more likely to be of age > 10 years ( p = 0.015) and have gradual initiation of the disease ( p = 0.001), platelets > 10 × 10 9 /L ( p = 0.01), and impaired immunological markers ( p < 0.003) compared to newly diagnosed/persistent groups. Recent history of infection was found mainly in the newly diagnosed/persistent group ( p = 0.013). None of the children exhibited severe spontaneous bleeding. Conclusion . Even though ITP in children usually has a self-limited course, with rare serious bleeding complications, the chronic form of the disease is characterized by different predictive parameters, which can be used in clinical practice.

  14. Prognostic Factors for Immune Thrombocytopenia Outcome in Greek Children: A Retrospective Single-Centered Analysis

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    Alexandros Makis

    2017-01-01

    Full Text Available Immune thrombocytopenia (ITP in children has a varied course and according to duration is distinguished as newly diagnosed (12 types. Several studies have evaluated the prognostic factors for the progression of the disease, but similar works have yet to be performed in Greece. We aimed to identify prognostic markers for the three forms of the disease in 57 Greek children during a 13-year period. Information regarding age, gender, preceding infection, bleeding type, duration of symptoms and platelets at diagnosis, treatment, disease course, and immunological markers was recorded. 39 children had newly diagnosed, 4 persistent, and 14 chronic disease. Chronic ITP children were more likely to be of age > 10 years (p=0.015 and have gradual initiation of the disease (p=0.001, platelets > 10 × 109/L (p=0.01, and impaired immunological markers (p<0.003 compared to newly diagnosed/persistent groups. Recent history of infection was found mainly in the newly diagnosed/persistent group (p=0.013. None of the children exhibited severe spontaneous bleeding. Conclusion. Even though ITP in children usually has a self-limited course, with rare serious bleeding complications, the chronic form of the disease is characterized by different predictive parameters, which can be used in clinical practice.

  15. Methylphenidate-risperidone combination in child psychiatry: A retrospective analysis of 44 cases.

    Science.gov (United States)

    Javelot, H; Glay-Ribau, C; Ligier, F; Weiner, L; Didelot, N; Messaoudi, M; Socha, M; Body-Lawson, F; Kabuth, B

    2014-05-01

    Psychotimulant-antipyschotic combinations are frequently used in child psychiatry, but have been rarely described in the literature. We propose here a retrospective study of 44 children who received the combination methylphenidate (MPH)-risperidone (RIS). The sample is composed of children who received either MPH (n=28) or RIS (n=16) as primary treatment. A vast majority of the children had a comorbid attention deficit hyperactivity disorder (ADHD) diagnosis. For over 60% of patients, regardless of their initial monotherapy, bitherapy decreased the symptoms of ADHD and conduct disorder, sleep disorders and anxiety. Concerning the safety of the bitherapy, a compensation effect on weight gain and appetite was respectively observed in 70% and 50% of patients. Even though iatrogenic tachycardia can be encountered with both drugs, it has never been reported when they are associated and we have reported a total of 3 cases in our study. We have also observed a case of dyskinesia resolved with the discontinuation of the treatment. MPH-RIS bitherapy appears to be particularly effective in ADHD with conduct disorder symptoms. Although tolerance may limit its use, the benefit/risk ratio seems favourable for a number of children. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  16. Sertraline May Improve Language Developmental Trajectory in Young Children with Fragile X Syndrome: A Retrospective Chart Review

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    Tri Indah Winarni

    2012-01-01

    Full Text Available Young children with fragile X syndrome (FXS often experience anxiety, irritability, and hyperactivity related to sensory hyperarousal. However, there are no medication recommendations with documented efficacy for children under 5 years old of age with FXS. We examined data through a chart review for 45 children with FXS, 12–50 months old, using the Mullen Scales of Early Learning (MSEL for baseline and longitudinal assessments. All children had clinical level of anxiety, language delays based on MSEL scores, and similar early learning composite (ELC scores at their first visit to our clinic. Incidence of autism spectrum disorder (ASD was similar in both groups. There were 11 children who were treated with sertraline, and these patients were retrospectively compared to 34 children who were not treated with sertraline by chart review. The baseline assessments were done at ages ranging from 18 to 44 months (mean 26.9, SD 7.99 and from 12 to 50 months (mean 29.94, SD 8.64 for treated and not treated groups, respectively. Mean rate of improvement in both expressive and receptive language development was significantly higher in the group who was treated with sertraline (<0.0001 and =0.0071, resp.. This data supports the need for a controlled trial of sertraline treatment in young children with FXS.

  17. Foliar nutrient analysis of sugar maple decline: retrospective vector diagnosis

    Science.gov (United States)

    Victor R. Timmer; Yuanxin Teng

    1999-01-01

    Accuracy of traditional foiiar analysis of nutrient disorders in sugar maple (Acer saccharum Marsh) is limited by lack of validation and confounding by nutrient interactions. Vector nutrient diagnosis is relatively free of these problems. The technique is demonstrated retrospectively on four case studies. Diagnostic interpretations consistently...

  18. Accidental falls in hospitalized children: an analysis of the vulnerabilities linked to the presence of caregivers.

    Science.gov (United States)

    Bagnasco, A; Sobrero, M; Sperlinga, L; Tibaldi, L; Sasso, L

    2010-06-01

    This study stemmed from the data gathered by a research conducted by the coordinator of the Department of Healthcare Services and a group of nurses involved in a research on accidental falls in hospitalized children at the "G. Gaslini" Children's Hospital and Scientific Research Institute in Genoa, Italy. The first retrospective study evaluated the accidental falls in hospitalized children referred to the three-year period 2003-2006, while the second perspective study, referred to the trimester March-May 2007, found that the main cause of falls in children was parent's distraction. The method adopted in the first phase of our study was a proactive risk analysis (The Basics of Healthcare Failure Mode and Effect Analysis), identified in the first place by the VA National Centre for Patient Safety and applied to the "Child and parent hospital admission process". This proactive risk analysis has proven to be very effective in preventing the risk of accidental falls in hospitalized children through effective communication and educational interventions. The second phase of our study consisted of two Focus Groups for accidental traumatic events. The analysis of the results of the study showed how effective communication is instrumental, not only to have a better awareness of the children and their parents during their stay in hospital, but also to implement educational sessions on prevention to reduce the risk of accidental traumatic events. The present study contributes to improve safety and the quality of care by motivating nurses to keep their attention high on falls in hospitalized children, by monitoring and the development of new risk assessment tools.

  19. Shoulder injuries in professional rugby: a retrospective analysis

    OpenAIRE

    Horsley, Ian G; Fowler, Elizabeth M; Rolf, Christer G

    2013-01-01

    Background In the literature, little is known about the level and pattern of rugby injuries. Of the shoulder injuries reported, 51% of these are caused during a tackle, and 65% of all match injuries affected the shoulder. Objective The study aims to describe a sport-specific unique intra-articular shoulder pathology of professional rugby players, who presented with persistent pain and dysfunction despite physiotherapeutic treatment and rest. Method This study is a retrospective analysis set a...

  20. A retrospective analysis of blood gases with two different insulin ...

    African Journals Online (AJOL)

    A retrospective analysis of blood gases with two different insulin infusion protocols in patients undergoing cardiovascular surgery. ... In this study, we aimed to look into the effect of glycemic control on arterial blood gas parameters, serum electrolytes, and hemoglobin (Hb). Materials and Methods: We collected data from ...

  1. Predictive Value of Intraoperative Thromboelastometry for the Risk of Perioperative Excessive Blood Loss in Infants and Children Undergoing Congenital Cardiac Surgery: A Retrospective Analysis.

    Science.gov (United States)

    Kim, Eunhee; Shim, Haeng Seon; Kim, Won Ho; Lee, Sue-Young; Park, Sun-Kyung; Yang, Ji-Hyuk; Jun, Tae-Gook; Kim, Chung Su

    2016-10-01

    Laboratory hemostatic variables and parameters of rotational thromboelastometry (ROTEM) were evaluated for their ability to predict perioperative excessive blood loss (PEBL) after congenital cardiac surgery. Retrospective and observational. Single, large university hospital. The study comprised 119 children younger than 10 years old undergoing congenital cardiac surgery with cardiopulmonary bypass (CPB). Intraoperative excessive blood loss was defined as estimated blood loss≥50% of estimated blood volume (EBV). Postoperative excessive blood loss was defined as measured postoperative chest tube and Jackson-Pratt drainage≥30% of EBV over 12 hours or≥50% of EBV over 24 hours in the intensive care unit. PEBL was defined as either intraoperative or postoperative excessive blood loss. External temogram (EXTEM) and fibrinogen temogram (FIBTEM) were analyzed before and after CPB with ROTEM and laboratory hemostatic variables. Multivariate logistic regression was performed. Incidence of PEBL was 19.3% (n = 23). Independent risk factors for PEBL were CPB time>120 minutes, post-CPB FIBTEM alpha-angle, clot firmness after 10 minutes20%. Laboratory hemostatic variables were not significant in multivariate analysis. The risk prediction model was developed from the results of multivariate analysis. The area under the receiver operating characteristic curve was 0.94 (95% confidence interval: 0.90-0.99). Post-CPB ROTEM may be useful for predicting both intraoperative and postoperative excessive blood loss in congenital cardiac surgery. This study provided an accurate prediction model for PEBL and supported intraoperative transfusion guidance using post-CPB FIBTEM-A10 and EXTEM-A10. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Childhood hospitalisation for otitis media in Western Australia: A 10-year retrospective analysis

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    Nicholas Liu

    2016-04-01

    Full Text Available Background The aim of this study was to assess the prevalence of hospitalisation for otitis media across the different risk indicators for Western Australian children (less than 15 years old over a 10-year period. Method This retrospective population-based study used the deidentified detailed data of children under the age of 15 years, hospitalised for otitis media (OM, as determined by principal diagnosis (ICD-10AM and obtained from the Western Australian (WA Hospital Morbidity Dataset for 10 financial years from 1999–2000 to 2008–2009. Various risk indicators, including age, gender, Indigenous status, insurance status, hospital area, hospital type, and length of stay were also analysed. Results Out of 26,294 cases of in-hospital care, Indigenous children comprised 4.7 per cent (n=1,226, while the non-Indigenous children comprised 95.3 per cent (n=25,068. The majority of the children, nearly 98.8 per cent, were admitted for chronic OM. The children were grouped into three age groups, namely, 0–4 years, 5–9 years, and 10–14 years. Nearly two-thirds of all cases were in the 0–4-year age group. Significantly more non-Indigenous (51 per cent than Indigenous children (2 per cent had private health insurance. The hospitalisation rates were directly proportional between the number of Indigenous children living in the area and the increasing remoteness of the area along with greater socioeconomic disadvantage. There were 24 per cent more cases from very remote areas compared to highly accessible areas, and there were 60 per cent more cases from the most disadvantaged socioeconomic category, compared with the least disadvantaged category, for Indigenous children. Conclusion These data depict the variations in prevalence of otitis media hospitalisations within the community, as affected by various risk indicators.

  3. Predictors of mortality among children on Antiretroviral Therapy at a referral hospital, Northwest Ethiopia: A retrospective follow up study

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    Koye Digsu

    2012-10-01

    Full Text Available Abstract Background An estimated 2.5 million children were living with HIV/AIDS at the end of 2009, 2.3 million (92% in sub-Saharan Africa. Without treatment, a third of children with HIV will die of AIDS before their first birthday, half dying before two years of age. Hence, this study aimed to assess magnitude and predictors of mortality among children on Antiretroviral Therapy (ART at a referral hospital in North-West Ethiopia. Methods Institution based retrospective follow up study was carried out among HIV-positive children from January 1st, 2006 - March 31st, 2011. Information on relevant variables was collected from patients’ charts and registries. Life table was used to estimate the cumulative survival of children. Log rank tests were employed to compare survival between the different categories of the explanatory variables. Multivariate Cox proportional hazards model was fitted to identify predictors of mortality. Results A total of 549 records were included in the analysis. The mean age at initiation of treatment was 6.35 ±3.78 SD years. The median follow up period was 22 months. At the end of the follow up, 41(7.5% were dead and 384(69.9% were alive. Mortality was 4.0 deaths per 100 child-years of follow-up period. The cumulative probabilities of survival at 3, 6, 12, 24, and 60 months of ART were 0.96, 0.94, 0.93, 0.92 and 0.83 respectively. Majority (90.2% of the deaths occurred within the first year of treatment. Absence of cotrimoxazole preventive therapy (adjusted hazard ratio [AHR] = 4.74, 95% CI: 2.17, 10.34, anaemia (haemoglobin level Conclusions There was a high rate of early mortality. Hence, starting ART very early reduces disease progression and early mortality; close follow up of all children of HIV-positive mothers is recommended to make the diagnosis and start treatment at an earlier time before they develop severe immunodeficiency.

  4. GLUCOCORTICOSTEROID THERAPY AND PHYSICAL DEVELOPMENTOF CHILDREN WITH STEROID-SENSITIVE NEPHROTIC SYNDROME: A RETROSPECTIVE STUDY

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    Olga A. Zhdanova

    2017-01-01

    Full Text Available Background. Body weight gain and growth retardation are common side effects of prolonged glucocorticosteroid  therapy in children. Time for the appearance  and elimination of glucocorticosteroid  obesity  as well as growth disorders  require further investigations.Objective.  Our aim was to study the relationship between glucocorticosteroid  therapy and changes in physical development indices of children with steroid-sensitive nephrotic syndrome (SSNS.Methods. We carried out a retrospective study of case records of patients with SSNS hospitalized in 2011–2014.  Treatment of children was carried out in accordance with the Federal Clinical Guidelines. The Z-score (ANTHRO Plus was determined for body length (height, body weight, body mass index and correlation of physical development indices with a cumulative dose and duration of glucocorticosteroid  therapy.Results.  We analyzed data on the treatment of 31 children, 18 of them received glucocorticosteroids  for 6 months (Group 1, 13 of them did not receive glucocorticosteroids       6 months (Group 2. The Z-score  of body weight in children in these groups was 1.64 ± 1.54 and 0.05 ± 1.19 (p = 0.004, Z-score  of body mass index was 1.85 ± 1.64 and -0.54 ± 1.14, respectively (p < 0.001. Excess body weight and obesity were only observed in children of Group 1 (in 6 and 9, respectively.  The Z-score  of the body length of patients in groups 1 and 2 were comparable and did not differ from normal values (0.34 ± 1.08 and 0.52 ± 1.12, respectively, p = 0.655. Correlation of Z-score values of the body length and cumulative doses of glucocorticosteroids was noted (r = -0.87, p < 0.001.Conclusion. Long-term (at least 6 months glucocorticosteroid intake is associated with the development of overweight and obesity in most children with SSNS. In patients who did not use hormonal drugs for 6 months, normal body weight values were recorded. The height of children with SSNS was within

  5. Retrospective analysis of factors affecting the efficacy of surgical treatment of the scar.

    Science.gov (United States)

    Yang, Z; Shi, X; Zhang, Y; Wang, S; Lei, Z; Liu, X; Fan, D

    2014-04-01

    The scar is a major problem in the medical profession. Its timely treatment is very important for the better outcome of the scar treatment and for the improvement of the life quality of the patients. The aim of this study was retrospectively analyzed the epidemiological characteristics affecting the efficacy of the scar surgical treatment of the people in the western part of China. Total 414 scar cases were retrospectively analyzed to clarify the epidemiological characteristics and the factors affecting the scar surgical treatment efficacy. The factors included were sex, age, area distribution, treatment seasons, injury sites, injury causes, and the time from scarring to the surgical treatment. All scar cases were surgically treated with the repairing technology including skin graft, flap and soft tissue dilation. There were 206 males and 208 females with the average age 20.53±12.9 years (age range 1-68 years). The patient proportions in the age groups of 0-20, 21-40 and >40 years were 61.4% (254 cases), 29.2% (121 cases), and 9.4% (39 cases) respectively. The patient's attendance rate reached the highest during the summer and winter. Most patients were from the rural areas with an increasing tendency each year. The burn scars were the most abundant and the injury sites were mostly the head and face. Univariate analysis showed that the time from scarring to the surgical treatment and the injury sites were significantly influenced the scar surgical treatment efficacy. Logistic regression analysis demonstrated that the injured sites of the head and face significantly influenced the scar surgical treatment efficacy. With the development of economy in China, more scar patients especially younger and children visit doctors predominantely from the rural areas. Usually, they get their scars in the exposed area of their bodies (head and face) which seriously affect the patient's appearance and function. Factors influencing the scar surgical treatment efficacy has

  6. [Clinical analysis of two cases of imported children Zika virus infection in China].

    Science.gov (United States)

    Zheng, C G; Xu, Y; Jiang, H Q; Yin, Y X; Zhang, J H; Zhu, W J; Liang, X J; Chen, M X; Ye, J W; Tan, L M; Luo, D; Gong, S T

    2016-05-01

    To analyze the clinical characteristics, outcome and diagnosis of two cases of imported children Zika virus infection in China. A retrospective analysis was performed on clinical characteristics, treatment and outcome of two cases of imported children with Zika virus infection in February 2016 in Enping People's Hospital of Guangdong. Two cases of children with imported Zika virus infection resided in an affected area of Venezuela, 8-year-old girl and her 6 year-old brother. The main findings on physical examination included the following manifestations: fever, rash, and conjunctivitis. The rash was first limited to the abdomen, but extended to the torso, neck and face, and faded after 3-4 d. The total number of white blood cells was not high and liver function was normal. The diagnosis of two cases of Zika virus infection was confirmed by the expert group of Guangdong Provincial Center for Disease Control and Prevention, according to the epidemiological history, clinical manifestations and Zika virus nucleic acid detection results.Treatment of Zika virus infection involves supportive care. Two Zika virus infection children had a relatively benign outcome. At present, Zika virus infection in children is an imported disease in China. No specific therapy is available for this disease. Information on long-term outcomes among infants and children with Zika virus disease is limited, routine pediatric care is advised for these infants and children.

  7. Infant feeding practices among mildly wasted children: a retrospective study on Nias Island, Indonesia

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    Inayati Dyah

    2012-03-01

    Full Text Available Abstract Background This study investigated the infant feeding practices of participating mothers who were recruited into a research project aimed at improving the nutritional status of mildly wasted children (-scores aged ≥ 6 to Methods Cross-sectional, questionnaire-based interview of mothers of the index children (n = 215 who were admitted to the community program for mildly wasted children in the study area. Four focus groups and twenty in-depth interviews were conducted to explore further information on infant feeding practices in the study area. Results Retrospective results indicated that 6% of the mothers never breastfed. Fifty two percent of mothers initiated breastfeeding within six hours of birth, but 17% discarded colostrum. Exclusive breastfeeding until 6 months of age was practiced by 12%. Seventy-four percent of the mothers offered supplementary liquids besides breast milk within the first 7 days of life, and 14% of infants received these supplementary liquids from 7 days onwards until 6 months of age. Moreover, 79% of the infants were given complementary foods (solid, semi-solid, or soft foods before 6 months of age. About 9% of the children were breastfed at least two years. Less than one in five of the mildly wasted children (19% were breastfed on admission to the community program. Qualitative assessments found that inappropriate infant feeding practices were strongly influenced by traditional beliefs of the mothers and paternal grandmothers in the study areas. Conclusion Generally, suboptimal infant feeding was widely practiced among mothers of mildly wasted children in the study area on Nias Island, Indonesia. To promote breastfeeding practices among mothers on Nias Island, appropriate nutrition training for community workers and health-nutrition officers is needed to improve relevant counseling skills. In addition, encouraging public nutrition education that promotes breastfeeding, taking into account social

  8. Iron-Folic Acid Supplementation During Pregnancy Reduces the Risk of Stunting in Children Less Than 2 Years of Age: A Retrospective Cohort Study from Nepal

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    Yasir Bin Nisar

    2016-01-01

    Full Text Available The aim of the study was to investigate the effect of antenatal iron-folic acid (IFA supplementation on child stunting in Nepalese children age <2 years. A retrospective cohort study design was used, in which a pooled cohort of 5235 most recent live births 2 years prior to interview from three Nepal Demographic and Health Surveys (2001, 2006 and 2011 was analysed. The primary outcome was stunting in children age <2 years. The main exposure variable was antenatal IFA supplementation. Multivariate Poisson regression analysis was performed. In our sample, 31% and 10% of Nepalese children age <2 years were stunted and severely stunted, respectively. The adjusted relative risk of being stunted was 14% lower in children whose mothers used IFA supplements compared to those whose mothers did not use (aRR = 0.86, 95% CI = 0.77–0.97. Additionally, the adjusted relative risk of being stunted was significantly reduced by 23% when antenatal IFA supplementation was started ≤6 months with ≥90 IFA supplements used during pregnancy (aRR = 0.77, 95% CI = 0.64–0.92. Antenatal IFA supplementation significantly reduced the risk of stunting in Nepalese children age <2 years. The greatest impact on the risk reduction of child stunting was when IFA supplements were started ≤6 months with ≥90 supplements were used.

  9. Haemorrhoids in Children: A Retrospective Study

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    Afra Karavelioglu

    2015-06-01

    Conclusions: We followed up one of the largest group for haemorrhoids in children. We performed laboratory examinations only for suspected hepatobiliary disorder. Patients did not have progressive illness during follow-up period. We believe that haemorrhoids disease in children can be followed up by routine control examinations, without detailed laboratory examinations. [J Contemp Med 2015; 5(2.000: 106-110

  10. Hospitalizations of Children with Autism Increased from 1999 to 2009

    Science.gov (United States)

    Nayfack, Aaron M.; Huffman, Lynne C.; Feldman, Heidi M.; Chan, Jia; Saynina, Olga; Wise, Paul H.

    2014-01-01

    We performed a retrospective analysis of hospital discharges for children with autism, in comparison to children with cerebral palsy, Down syndrome, mental retardation/intellectual disability, and the general population. Hospitalizations for autism increased nearly threefold over 10 years, especially at the oldest ages, while hospitalizations for…

  11. Patch testing in Israeli children with suspected allergic contact dermatitis: A retrospective study and literature review.

    Science.gov (United States)

    Zafrir, Yaron; Trattner, Akiva; Hodak, Emmillia; Eldar, Oren; Lapidoth, Moshe; Ben Amitai, Dan

    2018-01-01

    Childhood allergic contact dermatitis is recognized as a significant clinical problem. The objective was to evaluate the rate of positive patch tests in Israeli children with clinically suspected allergic contact dermatitis, identify possible sex and age differences, compare results with those in Israeli adults, and review pediatric studies in the literature. The study sample included 343 children and adolescents (197 female, 146 male; 1-18 years of age, mean age 11.8 years) with clinically suspected allergic contact dermatitis who underwent patch testing with a standard pediatric series of 23 allergens at a tertiary medical center from 1999 to 2012. Data on clinical characteristics and test results were collected retrospectively from the medical files. Ninety-eight subjects (28.6%) (75 girls [38.1%], 23 boys [15.8%]) had at least one positive reaction. The most frequent reactions were to nickel sulfate, followed by potassium dichromate and cobalt chloride. Nickel sulfate sensitivity was more common in girls, especially those younger than 3 years and older than 12 years. The prevalence of contact sensitization was similar in subjects with and without atopic dermatitis (50% and 51%, respectively). Nickel is the most common allergen in Israeli children, especially girls. Patch testing should be performed in children with clinically suspected allergic contact dermatitis regardless of atopic background. © 2017 Wiley Periodicals, Inc.

  12. A retrospective study of children and adolescents oral and maxillofacial lesions over a 20-year period in Kerman, Iran

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    Molook Torabi-Parizi

    2017-08-01

    Full Text Available BACKGROUND AND AIM: Oral and maxillofacial lesions vary in different geographic regions based on their clinical features. Until now, few investigations have studied these lesions in children and adolescents in Iran. The aim of this research was to study the clinicopathological manifestations of biopsied oral and maxillofacial lesions among children and adolescents in the south of Iran. METHODS: In this retrospective cross-sectional study, all the cases referred to the Department of Pathology, Kerman faculty of Dentistry, and two treatment centers of Kerman University of Medical Sciences, Kerman, Iran during 1996-2015 were included. All demographic information including age, gender, anatomic location and histopathologic diagnosis of the oral and maxillofacial biopsies in patients under 18 years was extracted from patients’ chart fields. SPSS was used for the data analysis. RESULTS: Of 3196 oral and maxillofacial lesions, 326 cases (10.2% occurred in the age group under 18 years. The most common group was inflammatory/reactive lesions (36.8%. The most common lesions were pyogenic granuloma (9.20%, peripheral giant cell granuloma (8.89%, and dentigerous cyst (8.28%. Gingiva was the main involved area and the female to male ratio was 1.1 to 1. CONCLUSION: Our study revealed that almost 10.2% of oral and maxillofacial lesions occurred in children and adolescents. The majority of lesions were benign, and malignant lesions were rarely observed in the sample. The most prevalent biopsied lesions were inflammatory/reactive lesions. Unlike other studies, lower rates of mucocele were observed in this study. These findings can improve patient’s management among dentists and surgeons.

  13. A retrospective population-based cohort study identifying target areas for prevention of acute lower respiratory infections in children

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    Richmond Peter

    2010-12-01

    Full Text Available Abstract Background Acute lower respiratory infections (ALRI are a major cause of hospitalisation in young children. Many factors can lead to increased risk of ALRI in children and predispose a child to hospitalisation, but population attributable fractions for different risk factors and how these fractions differ between Indigenous and non-Indigenous children is unknown. This study investigates population attributable fractions of known infant and maternal risk factors for ALRI to inform prevention strategies that target high-risk groups or particular risk factors. Methods A retrospective population-based data linkage study of 245,249 singleton births in Western Australia. Population attributable fractions of known maternal and infant risk factors for hospitalisation with ALRI between 1996 and 2005 were calculated using multiple logistic regression. Results The overall ALRI hospitalisation rate was 16.1/1,000 person-years for non-Aboriginal children and 93.0/1,000 for Aboriginal children. Male gender, being born in autumn, gestational age Conclusions The population attributable fractions estimated in this study should help in guiding public health interventions to prevent ALRI. A key risk factor for all children is maternal smoking during pregnancy, and multiple previous pregnancies and autumnal births are important high-risk groups. Specific key target areas are reducing elective caesareans in non-Aboriginal women and reducing teenage pregnancies and improving access to services and living conditions for the Aboriginal population.

  14. Analysis of luminescence from common salt (NaCl) for application to retrospective dosimetry

    International Nuclear Information System (INIS)

    Spooner, N.A.; Smith, B.W.; Williams, O.M.; Creighton, D.F.; McCulloch, I.; Hunter, P.G.; Questiaux, D.G.; Prescott, J.R.

    2011-01-01

    Thermoluminescence (TL), Optically-Stimulated Luminescence (OSL) and Infrared-Stimulated Luminescence (IRSL) emitted from a set of 19 salt (NaCl) samples were studied for potential application to retrospective dosimetry. TL emission spectra revealed intense TL emissions from most samples, centred on 590 nm; UV and blue emissions were also found. Significant thermally-induced sensitivity changes were observed and TL, OSL and IRSL growth curves were measured. Pulse anneal analysis was performed, as was quantitative imaging of the TL, OSL and IRSL to assess sample heterogeneity. Kinetic analysis found lifetimes at 20 °C of the 200 °C and 240 °C TL peaks to be 0.6 ka and 4 ka respectively; sufficient for application to retrospective dosimetry.

  15. Analysis of the value of imaging as part of the follow-up of splenic injury in children

    Energy Technology Data Exchange (ETDEWEB)

    Huebner, S. [Dept. of Radiology, Helath Sciences Centre, Winnipeg, MB (Canada); Reed, M.H. [Pediatric Radiology, Children' s Hospital, Winnipeg, Man. (Canada)

    2001-12-01

    Objective: A recent article suggested that routine follow-up imaging is still frequently used in the conservative management of splenic trauma in children. The purpose of this study was to use decision analysis to assess the value of routine imaging as part of the long-term follow-up of splenic injury in children managed nonoperatively. Methods: A literature review (1970-1999) on the management of blunt splenic trauma in children was performed. Data, including the use of follow-up imaging and the occurrence of delayed splenic rupture and death, on those patients managed nonoperatively were collected. The data were used to construct a decision tree. A Poisson distribution was used to determine the risk of delayed splenic rupture. Results: Information was extracted from 26 cohort studies. Nineteen of these studies were retrospective and six were prospective. One study had both retrospective and prospective arms. The study population consisted of 1,083 children. Of these patients, 920 (85 %) underwent routine follow-up imaging (US, CT, or scintigraphy). Follow-up imaging was either not performed or selectively performed in 163 patients (15 %). No cases of post-discharge splenic rupture or death were encountered in any of these groups. The maximum risk of delayed splenic rupture in the entire group was 0.3 % (0-3.7 cases). Conclusion:. The risk of delayed splenic rupture following blunt injury in children is very low, and is apparently unaffected by imaging protocols. No deaths, even in cases of delayed presentation, were identified in our study. These findings do not support the use of routine follow-up imaging of children with blunt splenic trauma. (orig.)

  16. Analysis of the value of imaging as part of the follow-up of splenic injury in children

    International Nuclear Information System (INIS)

    Huebner, S.; Reed, M.H.

    2001-01-01

    Objective: A recent article suggested that routine follow-up imaging is still frequently used in the conservative management of splenic trauma in children. The purpose of this study was to use decision analysis to assess the value of routine imaging as part of the long-term follow-up of splenic injury in children managed nonoperatively. Methods: A literature review (1970-1999) on the management of blunt splenic trauma in children was performed. Data, including the use of follow-up imaging and the occurrence of delayed splenic rupture and death, on those patients managed nonoperatively were collected. The data were used to construct a decision tree. A Poisson distribution was used to determine the risk of delayed splenic rupture. Results: Information was extracted from 26 cohort studies. Nineteen of these studies were retrospective and six were prospective. One study had both retrospective and prospective arms. The study population consisted of 1,083 children. Of these patients, 920 (85 %) underwent routine follow-up imaging (US, CT, or scintigraphy). Follow-up imaging was either not performed or selectively performed in 163 patients (15 %). No cases of post-discharge splenic rupture or death were encountered in any of these groups. The maximum risk of delayed splenic rupture in the entire group was 0.3 % (0-3.7 cases). Conclusion:. The risk of delayed splenic rupture following blunt injury in children is very low, and is apparently unaffected by imaging protocols. No deaths, even in cases of delayed presentation, were identified in our study. These findings do not support the use of routine follow-up imaging of children with blunt splenic trauma. (orig.)

  17. Wilson's disease: an analysis of 28 Brazilian children

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    Rodolpho Truffa Kleine

    2012-01-01

    Full Text Available OBJECTIVES: Clinical-laboratory and evolutionary analysis of twenty-eight patients with Wilson's disease. METHODS: Twenty-eight children (twelve females and sixteen males with Wilson's disease were evaluated retrospectively between 1987 and 2009, with a follow-up of 72 months (1 - 240 months. The clinical, laboratory, and histologic features at diagnosis were recorded at the end of the study. RESULTS: The median age at diagnosis was 11 years (2 - 18 years. Twelve patients were asymptomatic, seven had hepatitis symptoms, five had raised aminotransferase levels, three had hepatomegaly associated with neurological disorders, one had fulminant hepatitis with hemolytic anemia, and six patients presented with a Kayser-Fleischer ring. A histological analysis revealed that six children had chronic hepatitis, seven had cirrhosis, two had steatosis, one had portal fibrosis, and one had massive necrosis. The treatment consisted of D-penicillamine associated with pyridoxine for 26 patients. Adverse effects were observed in the other two patients: one presented with uncontrollable vomiting and the other demonstrated elastosis perforans serpiginosa. At the end of the study, all 26 treated patients were asymptomatic. Twenty-four of the patients were treated with D-penicillamine and pyridoxine, and two were treated with trientine and zinc sulfate. A liver transplant was performed in one patient with fulminant hepatitis, but the final patient died 48 hours after admission to the intensive care unit. CONCLUSIONS: Family screenings associated with early treatment are important in preventing Wilson's disease symptoms and potentially fatal disease progression. The study suggests that Wilson's disease must be ruled out in children older than two years presenting with abnormal levels of hepatic enzymes because of the heterogeneity of symptoms and the encouraging treatment results obtained so far.

  18. Age trends in 30 day hospital readmissions: US national retrospective analysis

    Science.gov (United States)

    Berry, Jay G; Gay, James C; Joynt Maddox, Karen; Coleman, Eric A; Bucholz, Emily M; O’Neill, Margaret R; Blaine, Kevin; Hall, Matthew

    2018-01-01

    Abstract Objective To assess trends in and risk factors for readmission to hospital across the age continuum. Design Retrospective analysis. Setting and participants 31 729 762 index hospital admissions for all conditions in 2013 from the US Agency for Healthcare Research and Quality Nationwide Readmissions Database. Main outcome measure 30 day, all cause, unplanned hospital readmissions. Odds of readmission were compared by patients’ age in one year epochs with logistic regression, accounting for sex, payer, length of stay, discharge disposition, number of chronic conditions, reason for and severity of admission, and data clustering by hospital. The middle (45 years) of the age range (0-90+ years) was selected as the age reference group. Results The 30 day unplanned readmission rate following all US index admissions was 11.6% (n=3 678 018). Referenced by patients aged 45 years, the adjusted odds ratio for readmission increased between ages 16 and 20 years (from 0.70 (95% confidence interval 0.68 to 0.71) to 1.04 (1.02 to 1.06)), remained elevated between ages 21 and 44 years (range 1.02 (1.00 to 1.03) to 1.12 (1.10 to 1.14)), steadily decreased between ages 46 and 64 years (range 1.02 (1.00 to 1.04) to 0.91 (0.90 to 0.93)), and decreased abruptly at age 65 years (0.78 (0.77 to 0.79)), after which the odds remained relatively constant with advancing age. Across all ages, multiple chronic conditions were associated with the highest adjusted odds of readmission (for example, 3.67 (3.64 to 3.69) for six or more versus no chronic conditions). Among children, young adults, and middle aged adults, mental health was one of the most common reasons for index admissions that had high adjusted readmission rates (≥75th centile). Conclusions The likelihood of readmission was elevated for children transitioning to adulthood, children and younger adults with mental health disorders, and patients of all ages with multiple chronic conditions. Further attention to the

  19. Fluid management of hypernatraemic dehydration to prevent cerebral oedema: a retrospective case control study of 97 children in China.

    Science.gov (United States)

    Fang, Chengqing; Mao, Jianhua; Dai, Yuwen; Xia, Yonghui; Fu, Haidong; Chen, Yifang; Wang, Yaping; Liu, Aimin

    2010-06-01

    To compare the fluid management of hypernatraemic dehydration in acute gastroenteritis in those who developed cerebral oedema (cases) versus those who did not (controls). A retrospective study of 97 cases of hypernatraemic dehydration at a tertiary children's hospital in China over five years, in which rehydration regimes of 49 children who developed cerebral oedema were compared with 48 children who made an uneventful recovery. Risk factors for cerebral oedema (vs. no cerebral oedema) were an initial fluid bolus (29/49 vs. 15/48, P=0.006), the mean rate of bolus infusion (14.7+/-2.2 vs. 10.8+/-1.4 mL/kg/hr, Pdehydration were too rapid a rate of rehydration, an initial fluid bolus to rapidly expand plasma volume and the severity of the hypernatraemia. Thus, we conclude that a uniformly slow rate of rehydration is the best way of preventing cerebral oedema.

  20. Botulinum toxin type A in children and adolescents with severe cerebral palsy: a retrospective chart review.

    Science.gov (United States)

    Mesterman, Ronit; Gorter, Jan Willem; Harvey, Adrienne; Lockhart, Julia; McEwen-Hill, Jenny; Margallo, Karen; Goldie, Nancy

    2014-02-01

    This retrospective cohort study reviewed set goals and their outcomes of children and adolescents with severe cerebral palsy who received botulinum toxin A in 2008 and 2009. Sixty children (36 male, mean age 9 years) were included. They received on average 4 (range 1-7) treatments, with the dosage varying between 20 and 400 units per treatment (3-21 U/kg/body weight). Mild transient side effects were reported in 12 of 242 treatments with botulinum toxin A. Treatment goals were related to lower limb function (82%), range of motion (68%), positioning (33%), upper limb function (33%), and facilitating ease of care in dressing (30%), toileting, and diapering (22%). The treatment goals were reached in 60% to 85% by report of the parent and child dyad. Our findings suggest that botulinum toxin A should be considered as a treatment option in patients with cerebral palsy within Gross Motor Function Classification System levels IV and V.

  1. A 10-year retrospective study of alterative aeroallergens sensitization spectrum in urban children with allergic rhinitis

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    Yang LF

    2018-02-01

    Full Text Available Li-Fen Yang,1,* Liang-Ming Cai,1,* Ming Li,2,* Jin-Tao Liu,3 Zhao-Ni Wang,1 Wei-Hao Wang,4 Qin-tai Yang,4 Zhuang-Gui Chen1,5 1Department of Pediatrics Intensive Care Unit and Respiratory Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China; 2Department of Pulmonary Diseases, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People’s Republic of China; 3Department of Population and Quantitative Health Science, Case Western Reserve University, Cleveland, OH, USA; 4Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China; 5Institution of Respiratory Diseases of Sun Yat-sen University, Guangzhou, People’s Republic of China *These authors contributed equally to this work Objective: To investigate the alterative spectrum and trends of aeroallergens sensitization in children with allergic rhinitis (AR in Guangzhou, China in the past 10 years.Participants and methods: In this retrospective study, 4,111 children with complaints of nasal hyper-reactivity who visited the Pediatric Department and/or Otolaryngology Department from January 2007 to November 2016 were enrolled. Serum specific immunoglobulin E was measured and positive detection was made in 3,328 patients, who were, therefore, diagnosed with AR. Positive rates and trends of different aeroallergens sensitization were assessed. The tendency of positive rates changing over the years, and the difference and trends in positive rate of aeroallergen sensitization that occurred in subgroups of gender, age, and season were determined and analyzed with logistic regression.Results: The percentage of detected common aeroallergens in AR children was (from high to low 81.07%, 34.44%, 14.72%, 11.81%, 6.04%, and 3.70% for house dust mites (HDMs, cat–dog dander, cockroach, mold mixture, tree pollen mixture, and herb pollen mixture

  2. Retrospective North American CFL Experience Curve Analysis and Correlation to Deployment Programs

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Sarah J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wei, Max [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sohn, Michael D. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-07-01

    Retrospective experience curves are a useful tool for understanding historic technology development, and can contribute to investment program analysis and future cost estimation efforts. This work documents our development of an analysis approach for deriving retrospective experience curves with a variable learning rate, and its application to develop an experience curve for compact fluorescent lamps for the global and North American markets over the years 1990-2007. Uncertainties and assumptions involved in interpreting data for our experience curve development are discussed, including the processing and transformation of empirical data, the selection of system boundaries, and the identification of historical changes in the learning rate over the course of 15 years. In the results that follow, we find that that the learning rate has changed at least once from 1990-2007. We also explore if, and to what degree, public deployment programs may have contributed to an increased technology learning rate in North America. We observe correlations between the changes in the learning rate and the initiation of new policies, abrupt technological advances, including improvements to ballast technology, and economic and political events such as trade tariffs and electricity prices. Finally, we discuss how the findings of this work (1) support the use of segmented experience curves for retrospective and prospective analysis and (2) may imply that investments in technological research and development have contributed to a change in market adoption and penetration.

  3. Prognostic Factors for Immune Thrombocytopenia Outcome in Greek Children: A Retrospective Single-Centered Analysis

    OpenAIRE

    Makis, Alexandros; Gkoutsias, Athanasios; Palianopoulos, Theodoros; Pappa, Eleni; Papapetrou, Evangelia; Tsaousi, Christina; Hatzimichael, Eleftheria; Chaliasos, Nikolaos

    2017-01-01

    Immune thrombocytopenia (ITP) in children has a varied course and according to duration is distinguished as newly diagnosed (12) types. Several studies have evaluated the prognostic factors for the progression of the disease, but similar works have yet to be performed in Greece. We aimed to identify prognostic markers for the three forms of the disease in 57 Greek children during a 13-year period. Information regarding age, gender, preceding infection, bleeding type, duration of symptoms and ...

  4. Contact sensitization in Dutch children and adolescents with and without atopic dermatitis - a retrospective analysis

    NARCIS (Netherlands)

    Lubbes, Stefanie; Rustemeyer, Thomas; Smitt, Johannes H. Sillevis; Schuttelaar, Marie-Louise A.; Middelkamp-Hup, Maritza A

    Background. Allergic contact dermatitis is known to occur in children with and without atopic dermatitis, but more data are needed on contact sensitization profiles in these two groups. Objectives. To identify frequent allergens in children with and without atopic dermatitis suspected of having

  5. Isolated traumatic head injury in children: Analysis of 276 observations

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    Bahloul Mabrouk

    2011-01-01

    Full Text Available Background : To determine predictive factors of mortality among children after isolated traumatic brain injury. Materials and Methods : In this retrospective study, we included all consecutive children with isolated traumatic brain injury admitted to the 22-bed intensive care unit (ICU of Habib Bourguiba University Hospital (Sfax, Tunisia. Basic demographic, clinical, biochemical, and radiological data were recorded on admission and during ICU stay. Results : There were 276 patients with 196 boys (71% and 80 girls, with a mean age of 6.7 ± 3.8 years. The main cause of trauma was road traffic accident (58.3%. Mean Glasgow Coma Scale score was 8 ± 2, Mean Injury Severity Score (ISS was 23.3 ± 5.9, Mean Pediatric Trauma Score (PTS was 4.8 ± 2.3, and Mean Pediatric Risk of Mortality (PRISM was 10.8 ± 8. A total of 259 children required mechanical ventilation. Forty-eight children (17.4% died. Multivariate analysis showed that factors associated with a poor prognosis were PRISM > 24 (OR: 10.98, neurovegetative disorder (OR: 7.1, meningeal hemorrhage (OR: 2.74, and lesion type VI according to Marshall tomographic grading (OR: 13.26. Conclusion : In Tunisia, head injury is a frequent cause of hospital admission and is most often due to road traffic injuries. Short-term prognosis is influenced by demographic, clinical, radiological, and biochemical factors. The need to put preventive measures in place is underscored.

  6. Retrospective analysis of the treatment of psoriasis of the palms and soles

    NARCIS (Netherlands)

    Spuls, P. I.; Hadi, S.; Rivera, L.; Lebwohl, M.

    2003-01-01

    In this retrospective analysis, the effect of currently used treatments in 26 patients with psoriasis of the palms and soles were analyzed. In general, patients are treated initially with topical medications including superpotent topical corticosteroids in combination with calcipotriene ointment or

  7. Retrospective Evaluation of Milrinone Pharmacokinetics in Children With Kidney Injury.

    Science.gov (United States)

    Gist, Katja M; Mizuno, Tomoyuki; Goldstein, Stuart L; Vinks, Alexander

    2015-12-01

    Milrinone is an inotropic agent with vasodilating properties used in the treatment of ventricular dysfunction. Milrinone is predominantly eliminated by the kidneys and accumulates in the setting of acute kidney injury (AKI). The purpose of this study was to evaluate milrinone pharmacokinetics in children with AKI with or without continuous renal replacement therapy (CRRT). Retrospective collection of milrinone therapeutic drug monitoring data in patients with AKI, including those requiring CRRT, through chart review from January 2008 to March 2014. Pharmacokinetic (PK) data were analyzed by Bayesian estimation using a pediatric population PK model (MW/Pharm). Clearance estimates were allometrically scaled to body weight. Data on 11 patients were available for analysis. Three patients required CRRT. Milrinone concentrations during continuous infusion varied 30-fold and ranged from 44 to 1343 ng/mL. Of the 33 samples obtained in 11 patients, 24 were outside the target range (72.7%), with 16 (48.5%) above and 8 (24.2%) below. Patients with AKI had significantly lower milrinone clearance (4.72 ± 2.26 L/h per 70 kg) compared with published data in patients without AKI. There was large between-patient variability in milrinone clearance (range: 2.91-13.6 L/h per 70 kg). Clearance in patients on CRRT ranged from 2.8 to 7.19 L/h per 70 kg. A significant correlation between milrinone clearance and estimated creatinine clearance was observed (r = 0.70, P = 0.0097). Allometrically scaled milrinone clearance was lower in the youngest patients (younger than 2 years), suggestive of ongoing renal maturation and existing AKI. Pediatric patients with AKI have significantly lower milrinone clearance compared with published data in patients without AKI. Large variability was noted in milrinone concentrations, and they were frequently outside the target range. The large between-patient variability in milrinone concentrations suggests that dosing regimens should be individualized in

  8. A SINGLE CENTRE RETROSPECTIVE 5 YEAR SURVEY OF INFECTIOUS COMPLICATION IN 85 CHILDREN WITH COMBINED IMMUNODEFICIENCY

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    Aghamohammadi

    1996-06-01

    Full Text Available Children with primary Tslymphocyte deficiency arc more ."I/."'clptihfe to infection hy organisms such (15: bacteria, fungi. prolo:o(J lind virus, 1711.' isniatian oj all opponuniuic ory;ani."m or an IImallally severe infection with higher grade pathogens, provide a clue (0 diagnosis of immunodeficiency, To determine the microorganisms causing recurrent or severe infections in children with T•(rmpllOcy!e doflcicncy, we carried out II retrospective case review oj H5 patients with 1'../ympllOC'te deficiency who wuc investigated at the Great Ormond Street Hospital for Children, NHS Trust, OH'r the 5 year period between June I, 1188 and June I, 1193. Tuc /:mllp of patients included 53 mules anti 32 [cmales, among which 23 and 62 were diagnosed to prewnt SClf (/",1 elf subtypes respectively, Among the 174 organisms isolated. these included bacteria (97 isolates], viruses (43 isolates}, funJ:i (25 isolates] and parasites (9 isolates}, 17lC predominant ."ites of infections were mainly the gll. rointe. itwl (60 out of 174 and respiratory tracts (49 out of 174. 171£' most common bacterial infections, were with aerobic gram negative organisms (28 isolatcs, P.H'UdOmOnllS aeruginosa (17 isolates], Enterococcus (/2 isolates, C. difficile (10 isolates], Analysis: of 43 viral infection showed that Homvirus (10 isolates], Adenovirus (9 isolates], Herpes simplex (6 isolates], am!"nC}loml'!:altH'iTlH (6 isalatcs, Wi'rl! prrdominutu pathogens. Candida albicans was IIII' most commonly isolated fungi. Parasitic infections included P. curini and Cryp(o."poridillm, 3 and (j opt of 9 cases. In our }iTOUp of pmients 16 patients' died before hone maTOOW transplantation, due to infectimu complication. Based on this . lldy. we ,wgge.lt thai pronytaxis aJjllin.rt bacterial, viral, Jllngal ami protozoa agents is a necessity to minimize infectious complication." in 7~/ympilOcyte deficient patients, awaiting a hone

  9. Acute epididymitis in Greek children: a 3-year retrospective study.

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    Sakellaris, George S; Charissis, Giorgos C

    2008-07-01

    The aim of the study was to compare historical features, physical examination findings, and testicular color Doppler ultrasound in pediatric patients with epididymitis compared to testicular torsion and torsion of the appendix testes. A retrospective review of the medical records of 66 boys presenting with clinical aspects of acute scrotum over a 3-year period was performed. Sixty-six patients were included in the study (29 with epididymitis, 8 with testicular torsion and 12 with torsion of the appendix testis, 4 with scrotal abscesses, 5 with scrotal swelling, and 1 with inflamed epididymal cyst). The duration of symptoms ranged from 6 h to 4 days with a peak on the second day. Urine cultures and viral testes were negative in all patients. Color Doppler ultrasound was diagnostic for epididymitis in 28 patients (96.6%). Systemic intravenous antibiotics were given in all 29 patients with epididymitis. No patient showed signs of testicular atrophy in the follow-up. The increasing incidence of epididymitis should question the policy of routine exploration of the acute scrotum in children. The history and physical examination cannot reliably identify those boys who can be managed conservatively. Color Doppler ultrasound is a useful adjunct in the evaluation of the acute scrotum when physical findings are equivocal but it can also be misleading.

  10. Correlation analysis of electronic products with myopia in preschool and school aged children

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    Li-Li Sun

    2016-02-01

    Full Text Available AIM: To explore the influence of electronic products on myopia in preschool and school aged children, and the development regularities of myopia, to formulate reasonable guidelines for using eyes healthily, and lay a solid foundation for the prevention and control work. METHODS: This retrospective analysis enrolled 900 3~12 years old children from outpatients department, and all of them were established individualized archives, recording: uncorrected visual acuity, optometry, slit lamp, ophthalmoscopy, strabismus inspection results; recording eye usage condition on TVs, computers, mobile phones, iPad, homework, extra-curricular books. Statistical analyze the refractive status of each age group, the use of electronic products of different age groups and their correlation with refractive status. RESULTS: The number of preschool children with normal uncorrected visual acuity was more than that of early school-age children, and the difference was statistically significant(PP>0.05; the number of children aged 7~12(early school aged childrenwith myopia was more than that of children aged 3~6(preschool childrenand the difference was statistically significant(PCONCLUSION: For preschool children, it is necessary to conduct early screening, health guidance, the establishment of personalized medical records and one-to-one personalized guidance; it is also needed to avoid the arduous learning task with the stacking usage of eyes, to fight for myopia and to control the development of myopia. Therefore, to reduce the use of electronic products has become a topic worthy of further study.

  11. Soy infant formula and seizures in children with autism: a retrospective study.

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    Cara J Westmark

    Full Text Available Seizures are a common phenotype in many neurodevelopmental disorders including fragile X syndrome, Down syndrome and autism. We hypothesized that phytoestrogens in soy-based infant formula were contributing to lower seizure threshold in these disorders. Herein, we evaluated the dependence of seizure incidence on infant formula in a population of autistic children. Medical record data were obtained on 1,949 autistic children from the SFARI Simplex Collection. An autism diagnosis was determined by scores on the ADI-R and ADOS exams. The database included data on infant formula use, seizure incidence, the specific type of seizure exhibited and IQ. Soy-based formula was utilized in 17.5% of the study population. Females comprised 13.4% of the subjects. There was a 2.6-fold higher rate of febrile seizures [4.2% versus 1.6%, OR = 2.6, 95% CI = 1.3-5.3], a 2.1-fold higher rate of epilepsy comorbidity [3.6% versus 1.7%, OR = 2.2, 95% CI = 1.1-4.7] and a 4-fold higher rate of simple partial seizures [1.2% versus 0.3%, OR = 4.8, 95% CI = 1.0-23] in the autistic children fed soy-based formula. No statistically significant associations were found with other outcomes including: IQ, age of seizure onset, infantile spasms and atonic, generalized tonic clonic, absence and complex partial seizures. Limitations of the study included: infant formula and seizure data were based on parental recall, there were significantly less female subjects, and there was lack of data regarding critical confounders such as the reasons the subjects used soy formula, age at which soy formula was initiated and the length of time on soy formula. Despite these limitations, our results suggest that the use of soy-based infant formula may be associated with febrile seizures in both genders and with a diagnosis of epilepsy in males in autistic children. Given the lack of data on critical confounders and the retrospective nature of the study, a prospective study is

  12. Antibiotic resistance of Helicobacter pylori in Chinese children: A multicenter retrospective study over 7 years.

    Science.gov (United States)

    Li, Lan; Ke, Yini; Yu, Chaohui; Li, Guogang; Yang, Ningmin; Zhang, Jianzhong; Li, Youming

    2017-06-01

    To determine the prevalence of resistance to metronidazole, clarithromycin, levofloxacin, amoxicillin, and furazolidone in Helicobacter pylori isolated from Chinese children. This multicenter retrospective study was conducted from January 2009 to December 2015. A total of 1746 isolates of H. pylori were collected from nine areas of Zhejiang province in the southeast coastal region of China. H. pylori strains were examined for antibiotics susceptibility by agar dilution method. The resistance rates were 75.20% for metronidazole, 16.38% for clarithromycin, 6.70% for levofloxacin, 0.06% for amoxicillin, and 0.06% for furazolidone. The pattern of H. pylori antibiotic resistance demonstrated no significant changes in the rates of resistance to clarithromycin, amoxicillin, furazolidone, and metronidazole over 7 years. A significant trend of increasing resistance to metronidazole was observed as children aged, but a downward trend in clarithromycin resistance was observed as children aged. No difference in the resistance to other antibiotics was observed among different age groups. Also, there was no significant difference between male and female subjects in rates of resistance to these five types of antibiotics. The predominant dual resistance to metronidazole and clarithromycin was presented in 10.65% of the isolates. The resistance rates of H. pylori in children from southeast coastal region of China were very high to metronidazole, moderate to clarithromycin and levofloxacin, and low to amoxicillin and furazolidone. It is important to continue monitoring the resistance profiles of H. pylori isolated in this region. © 2017 John Wiley & Sons Ltd.

  13. Unilateral hearing loss in children: a retrospective study and a review of the current literature.

    Science.gov (United States)

    Rohlfs, Anna-Katharina; Friedhoff, Johannes; Bohnert, Andrea; Breitfuss, Achim; Hess, Markus; Müller, Frank; Strauch, Anke; Röhrs, Marianne; Wiesner, Thomas

    2017-04-01

    Despite the introduction of universal newborn hearing screening (UNHS), unilateral hearing loss (UHL) is sometimes recognized late. This diagnostic delay has adverse repercussions, given the importance of binaural hearing for the development of normal auditory processing. It is incorrect to maintain that unilateral hearing is the minimum requirement for adequate speech development and that hearing aid provision is consequently unnecessary. In our retrospective study, hearing aid provision resulted in improved directional and selective hearing (quiet and noisy environments) and, compared with their chronically ill counterparts, the children in our study displayed superior health-related quality of life (HRQoL) scores in all areas. On the basis of the results, the authors conclude that even mild hearing losses (from an auditory threshold of 30 to 40 dB) should have the opportunity for hearing aid provision. A selective literature review was conducted in PubMed and textbooks and with reference to national and international guidelines. Early diagnosis and treatment of UHL have a positive effect on verbal-cognitive, linguistic, communicative, and socio-emotional development, as demonstrated by neurophysiological studies. Among the treatment modalities with differing effects on the quality of binaural hearing, cochlear implants are now used increasingly in children with hearing loss bordering on deafness. Published evidence and clinical experience support early diagnosis and treatment. Wherever feasible, hearing aid provision before or at the end of the first year of life is recommended for children with UHL. What is Known: • Almost 30 years ago, poor academic performance was reported in children with unilateral hearing loss (UHL). • Despite improvements in treatment options, it is traditionally held that unilateral hearing is the minimum requirement for adequate speech development and hearing aid provision is unnecessary. What is New: • Academic and behavioral

  14. Spectral Electroencephalogram Analysis for the Evaluation of Encephalopathy Grade in Children With Acute Liver Failure.

    Science.gov (United States)

    Press, Craig A; Morgan, Lindsey; Mills, Michele; Stack, Cynthia V; Goldstein, Joshua L; Alonso, Estella M; Wainwright, Mark S

    2017-01-01

    Spectral electroencephalogram analysis is a method for automated analysis of electroencephalogram patterns, which can be performed at the bedside. We sought to determine the utility of spectral electroencephalogram for grading hepatic encephalopathy in children with acute liver failure. Retrospective cohort study. Tertiary care pediatric hospital. Patients between 0 and 18 years old who presented with acute liver failure and were admitted to the PICU. None. Electroencephalograms were analyzed by spectral analysis including total power, relative δ, relative θ, relative α, relative β, θ-to-Δ ratio, and α-to-Δ ratio. Normal values and ranges were first derived using normal electroencephalograms from 70 children of 0-18 years old. Age had a significant effect on each variable measured (p liver failure were available for spectral analysis. The median age was 4.3 years, 14 of 33 were male, and the majority had an indeterminate etiology of acute liver failure. Neuroimaging was performed in 26 cases and was normal in 20 cases (77%). The majority (64%) survived, and 82% had a good outcome with a score of 1-3 on the Pediatric Glasgow Outcome Scale-Extended at the time of discharge. Hepatic encephalopathy grade correlated with the qualitative visual electroencephalogram scores assigned by blinded neurophysiologists (rs = 0.493; p encephalopathy was correlated with a total power of less than or equal to 50% of normal for children 0-3 years old, and with a relative θ of less than or equal to 50% normal for children more than 3 years old (p > 0.05). Spectral electroencephalogram classification correlated with outcome (p encephalopathy and correlates with outcome. Spectral electroencephalogram may allow improved quantitative and reproducible assessment of hepatic encephalopathy grade in children with acute liver failure.

  15. Retrospective Analysis of Mosh-Pit-Related Injuries.

    Science.gov (United States)

    Milsten, Andrew M; Tennyson, Joseph; Weisberg, Stacy

    2017-12-01

    . Milsten AM , Tennyson J , Weisberg S , Retrospective analysis of mosh-pit-related injuries. Prehosp Disaster Med. 2017;32(6):636-641.

  16. A Retrospective Study of the Incidence of Missed Opportunities in Identifying, Managing and Referring At-Risk of Overweight and Overweight Children and Adolescents in an Outpatient Primary Care Setting

    National Research Council Canada - National Science Library

    Quirke, Amy

    2004-01-01

    A descriptive study of the incidence of missed opportunities in identifying, managing and referring children and adolescents at-risk of overweight and overweight were conducted using a retrospective...

  17. RESULTS OF ACUTE LYMPHOBLASTIC LEUKEMIA TREATMENT WITH INTENSIVE CHEMOTHERAPY IN CHILDREN IN ST.-PETERSBURG: RETROSPECTIVE EVALUATION OF TWO VERSIONS OF COALL-92 PROTOCOL

    Directory of Open Access Journals (Sweden)

    E.G. Boichenko

    2011-01-01

    Full Text Available Regardless the success gained in treatment of acute lymphoblastic leukaemia, several problems still remain to be solved, such as: overcoming primary drug resistance and minimizing the amount of relapses as well as decreasing of chemotherapy toxicity without detriment to the final outcome of the treatment. Development of an optimal chemotherapeutical strategy still remains a hot issue. Objective: to evaluate an efficacy of two modifications of German protocol COALL-92 in treatment of ALL in children in St.-Petersburg. Methods: the retrospective analysis of results of treatment in patients under 18 years old with ALL was performed. The diagnosis was confirmed according to international criteria. The treatment was performed via protocols PECO-92 and COALL-St.-Petersburg-92. Results: 438 initial patients with ALL were treated in St.-Petersburg clinics during the period from 01.01.1993 to 01.01.2007. At the time of analysis the probability of event-free survival (pEFS was 60% in group of PECO-92 protocol and 70% — in COALL group (plog-rank = 0,048, probability of relapse-free survival (рRFS was 65 and 74% (plog-rank = 0,002, probability of overall survival was (pOS 78 and 70%, correspondingly (plog-rank = 0,079. Conclusion: inclusion of protocol treatment in practice of St.-Petersburg hospitals resulted in significant improvement of treatment results in children with ALL. The problem of both versions of COALL protocol is high rate of postremission mortality due to high toxicity of intensive stage if chemotherapy.Key words: children, acute lymphoblastic leukemia, intensive chemotherapy.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (3: 33–42

  18. Aseptic meningitis in children: analysis of 506 cases.

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    Athanasios G Michos

    Full Text Available BACKGROUND: Non-polio human enteroviruses are the leading cause of aseptic meningitis in children. The role of enterovirus PCR for diagnosis and management of aseptic meningitis has not been fully explored. METHODOLOGY/PRINCIPAL FINDINGS: A retrospective study was conducted to determine the epidemiological, clinical, and laboratory characteristics of aseptic meningitis and to evaluate the role of enterovirus PCR for the diagnosis and management of this clinical entity. The medical records of children who had as discharge diagnosis aseptic or viral meningitis were reviewed. A total of 506 children, median age 5 years, were identified. The annual incidence rate was estimated to be 17/100,000 children less than 14 years of age. Most of the cases occurred during summer (38% and autumn (24%. The dominant clinical symptoms were fever (98%, headache (94% and vomiting (67%. Neck stiffness was noted in 60%, and irritation in 46% of the patients. The median number of CSF cell count was 201/mm(3 with polymorphonuclear predominance (>50% in 58.3% of the cases. Enterovirus RNA was detected in CSF in 47 of 96 (48.9% children tested. Children with positive enterovirus PCR had shorter hospitalization stay as compared to children who had negative PCR or to children who were not tested (P = 0.01. There were no serious complications or deaths. CONCLUSIONS: Enteroviruses accounted for approximately one half of cases of aseptic meningitis. PCR may reduce the length of hospitalization and plays important role in the diagnosis and management of children with aseptic meningitis.

  19. Risk of leukaemia in children infected with enterovirus: a nationwide, retrospective, population-based, Taiwanese-registry, cohort study.

    Science.gov (United States)

    Lin, Jiun-Nong; Lin, Cheng-Li; Lin, Ming-Chia; Lai, Chung-Hsu; Lin, Hsi-Hsun; Yang, Chih-Hui; Sung, Fung-Chang; Kao, Chia-Hung

    2015-10-01

    The association between enterovirus infections in children and risk of leukaemia is unclear. We aimed to assess the risk of leukaemia after enterovirus infection in children. We did a nationwide retrospective cohort study by analysing data from the National Health Insurance Research Database (NHIRD) in Taiwan. Children with enterovirus infections aged younger than 18 years were identified. With use of computer-generated random numbers, children not infected with enterovirus were randomly selected and frequency matched (1:1) with children infected with enterovirus by sex, age, urbanisation level, parental occupation, and index year of enterovirus infection. We only included children with complete baseline data for age and sex and who had at least three clinic visits with the diagnosis of enterovirus infection. The diagnosis date of the first clinic visit for the enterovirus infection was defined as the index date for initiation of follow-up person-year measurement and participants. All study patients were followed up until they developed leukaemia, were lost to follow-up, withdrew from the NHI programme, or until the end of the study without leukaemia (censored). Our primary endpoint was a diagnosis of leukaemia during follow-up. Insurance claims data for 3 054 336 children younger than 18 years were randomly selected from all insured children in the NHIRD. We identified 282 360 children infected with enterovirus and 282 355 children not infected with enterovirus between Jan 1, 2000, and Dec 31, 2007. The incidence density rates of leukaemia were 3·26 per 100 000 person-years for the enterovirus-infected and 5·84 per 100 000 person-years for the non-enterovirus-infected cohorts. The risk of leukaemia was significantly lower in the enterovirus-infected cohort than in the non-enterovirus-infected cohort (adjusted subhazard ratio [SHR] 0·44, 95% CI 0·31-0·60; penterovirus have a reduced risk of both lymphocytic leukaemia (adjusted SHR 0·44, 0·30-0

  20. Clinical validation of free breathing respiratory triggered retrospectively cardiac gated cine balanced steady-state free precession cardiovascular magnetic resonance in sedated children

    OpenAIRE

    Krishnamurthy, Rajesh; Pednekar, Amol; Atweh, Lamya A; Vogelius, Esben; Chu, Zili David; Zhang, Wei; Maskatia, Shiraz; Masand, Prakash; Morris, Shaine A; Krishnamurthy, Ramkumar; Muthupillai, Raja

    2015-01-01

    Background Cine balanced steady-state free precession (SSFP), the preferred sequence for ventricular function, demands uninterrupted radio frequency (RF) excitation to maintain the steady-state during suspended respiration. This is difficult to accomplish in sedated children. In this work, we validate a respiratory triggered (RT) SSFP sequence that drives the magnetization to steady-state before commencing retrospectively cardiac gated cine acquisition in a sedated pediatric population. Metho...

  1. Internal fixation of mandibular angle fractures using one miniplate in Greek children: a 5-year retrospective study.

    Science.gov (United States)

    Iatrou, Ioannis; Theologie-Lygidakis, Nadia; Tzermpos, Fotios; Kamperos, Georgios

    2015-01-01

    Treatment modalities of mandibular angle fractures (MAFs) have been analyzed in several studies mainly referring to adult populations. The aim of this study was to retrospectively present and discuss our experience and literature findings regarding the treatment of MAFs in children. Data were retrieved from the files of the Oral and Maxillofacial department, at the Children's Hospital ''P. & A. Kyriakou'' of Athens, during a 5 years period (2009-2013). Demographic features, treatment methods, outcome and follow-up of all patients with mandibular angle fractures were recorded. 6 boys, 5-14 years old (mean age 10 years), were included in the study. They were all treated intraorally with open reduction and fixation via one monocortical titanium plate osteosynthesis at the external oblique line of the mandible, followed by 1 week of intermaxillary fixation (IMF). Plates were removed 3-12 months post-operatively. Follow-up period ranged from 12 to 18 months (mean 14.7 months). All fractures healed uneventfully and the patients tolerated well both the operation and the post-operative period. Osteosynthesis via intraoral approach combined with short duration IMF is adequate in treating MAFs in children. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  2. A Retrospective Evaluation of Echocardiograms to Establish Normative Inferior Vena Cava and Aortic Measurements for Children Younger Than 6 Years.

    Science.gov (United States)

    Stenson, Erin K; Punn, Rajesh; Ramsi, Musaab; Kache, Saraswati

    2018-02-26

    The ability to plot the inferior vena cava (IVC) size on a normal curve for pediatric patients may prove beneficial. First, in patients with normal cardiac anatomy who present in shock, assessing IVC size may be valuable for evaluating the degree of dehydration. Second, in children with heart disease, understanding how a child's IVC size compares to normal could be particularly beneficial for patients with right heart disease. We sought to create normal curves for the IVC and aorta in children younger than 6 years. Data were gathered from 347 echocardiograms of healthy children younger than 6 years in a retrospective study at a quaternary care children's hospital. From the subcostal long- and short-axis images, maximum diameters in the transverse and longitudinal views were obtained for both the IVC and the aorta. Both IVC and aortic dimensions increased in a linear fashion and had excellent correlations with the body surface area, body mass, and height (IVC, r = 0.78-0.81; P pediatric patient's hydration status or right heart function in patients with congenital heart disease. © 2018 by the American Institute of Ultrasound in Medicine.

  3. The Preschool-Aged and School-Aged Children Present Different Odds of Mortality than Adults in Southern Taiwan: A Cross-Sectional Retrospective Analysis.

    Science.gov (United States)

    Peng, Shu-Hui; Huang, Chun-Ying; Hsu, Shiun-Yuan; Yang, Li-Hui; Hsieh, Ching-Hua

    2018-04-25

    Background : This study aimed to profile the epidemiology of injury among preschool-aged and school-aged children in comparison to those in adults. Methods : According to the Trauma Registry System of a level I trauma center, the medical data were retrieved from 938 preschool-aged children (aged less than seven years), 670 school-aged children (aged 7⁻12 years), and 16,800 adults (aged 20⁻64 years) between 1 January 2009 and 31 December 2016. Two-sided Pearson’s, chi-squared, and Fisher’s exact tests were used to compare categorical data. A one-way analysis of variance (ANOVA) with the Games-Howell post-hoc test was used to assess the differences in continuous variables among different groups of patients. The mortality outcomes of different subgroups were assessed by a multivariable regression model under the adjustment of sex, injury mechanisms, and injury severity. Results : InFsupppjury mechanisms in preschool-aged and school-aged children were remarkably different from that in adults; in preschool-aged children, burns were the most common cause of injury requiring hospitalization (37.4%), followed by falls (35.1%) and being struck by/against objects (11.6%). In school-aged children, injuries were most commonly sustained from falls (47.8%), followed by bicycle accidents (14%) and being struck by/against objects (12.5%). Compared to adults, there was no significant difference of the adjusted mortality of the preschool-aged children (AOR = 0.9; 95% CI 0.38⁻2.12; p = 0.792) but there were lower adjusted odds of mortality of the school-aged children (AOR = 0.4; 95% CI 0.10⁻0.85; p = 0.039). The school-aged children had lower odds of mortality than adults (OR, 0.2; 95% CI, 0.06⁻0.74; p = 0.012), but such lower odds of risk of mortality were not found in preschool-aged children (OR, 0.7; 95% CI, 0.29⁻1.81; p = 0.646). Conclusions : This study suggests that specific types of injuries from different injury mechanisms are predominant among preschool

  4. Pre and post PET-CT impact on oesophageal cancer management: a retrospective analysis.

    Science.gov (United States)

    Azmi, NA; Razak, HRA; Vinjamuri, S.

    2017-05-01

    Assessment of the retrospective cancer incidence, prevalence and crude survival rates of oesophageal cancer to allow comparison between pre and post PET-CT introduction are part of 4 phase cost effectiveness research. It will provide baseline data for to assess PET or PET-CT cost effective potential for staging. A total of 849 patient’s data received from NWCIS databases with various stages of oesophageal cancer between 2001 and 2008. The fundamental activities are retrospective analysis of patient data. In most cases where appropriate, results are presented with 95 percent confidence intervals (CI). Variances between patient groups and variables are assessed using chi-square test. In cases where it deems vital, multiple logistic regression are used to modify for potential confounder such as age and sex. All p-values are two-sided and any value lower than 0.05 were considered to suggest a statistically significant result. Retrospective analysis were categorised into two categories, patients from 2001-2003 considered as pre PET and post PET for 2004-2008. This categorisation allows better comparison of patients’ survival trend to be made between both groups. Rates are presented in percentages and being grouped by tumour characteristics and other variables associated with demographic profile, diagnosis, staging and treatment. Results allowed comparison of oesophageal cancer trends between the pre and post PET-CT introduction such as changes in incidence rate or changes in survival. These data were used to normalise the decision tree model so that cost-effectiveness analysis can be performed across the whole population.

  5. Pre and post PET-CT impact on oesophageal cancer management: a retrospective analysis

    International Nuclear Information System (INIS)

    Azmi, NA; Razak, HRA; Vinjamuri, S

    2017-01-01

    Assessment of the retrospective cancer incidence, prevalence and crude survival rates of oesophageal cancer to allow comparison between pre and post PET-CT introduction are part of 4 phase cost effectiveness research. It will provide baseline data for to assess PET or PET-CT cost effective potential for staging. A total of 849 patient’s data received from NWCIS databases with various stages of oesophageal cancer between 2001 and 2008. The fundamental activities are retrospective analysis of patient data. In most cases where appropriate, results are presented with 95 percent confidence intervals (CI). Variances between patient groups and variables are assessed using chi-square test. In cases where it deems vital, multiple logistic regression are used to modify for potential confounder such as age and sex. All p-values are two-sided and any value lower than 0.05 were considered to suggest a statistically significant result. Retrospective analysis were categorised into two categories, patients from 2001-2003 considered as pre PET and post PET for 2004-2008. This categorisation allows better comparison of patients’ survival trend to be made between both groups. Rates are presented in percentages and being grouped by tumour characteristics and other variables associated with demographic profile, diagnosis, staging and treatment. Results allowed comparison of oesophageal cancer trends between the pre and post PET-CT introduction such as changes in incidence rate or changes in survival. These data were used to normalise the decision tree model so that cost-effectiveness analysis can be performed across the whole population. (paper)

  6. Financial analysis of potential retrospective premium assessments under the Price-Anderson system

    International Nuclear Information System (INIS)

    Wood, R.S.

    1985-04-01

    Ten representative nuclear utilities have been analyzed over the period 1981 to 1983 to evaluate the effects of three levels of retrospective premiums on various financial indicators. This analysis continues and expands on earlier analyses prepared as background for deliberations by the US Congress for possible extension or modification of the Price-Anderson Act

  7. Predictors of nutritional recovery time and survival status among children with severe acute malnutrition who have been managed in therapeutic feeding centers, Southern Ethiopia: retrospective cohort study.

    Science.gov (United States)

    Gebremichael, Delelegn Yilma

    2015-12-21

    Malnutrition remains to be one of the most common causes of morbidity and mortality among children in developing countries. The prevalence of wasting in Ethiopia remained about 10 % for the past ten years. Mortality rate of children with severe acute malnutrition treated in inpatient set ups has remained unacceptably high. A retrospective cohort study was conducted in Southern Ethiopia. The study population were children with severe acute malnutrition aged from 6 to 59 months who have been managed at Karat and Fasha stabilization centers between September 30, 2013, and Sep. 29, 2014. The total sample size was 420 and pretested questionnaire was used. Kaplan Meier analysis was used to estimate time to nutritional recovery and Cox proportional-hazard regression analysis was carried out to determine independent predictors. Nutritional recovery rate was 3.61 per 100 person day observations. Median nutritional recovery time was 22 and 29 days for edematous malnourished and severely wasted children respectively. The independent predictors of nutritional recovery rate were: stabilization center (AHR = 1.4, 95 % CI: 1.1-1.7), malnutrition status (AHR = 1.8, 95 % CI: 1.3-2.4), weight (AHR = 1.5, 95 % CI: 1.2-1.9), mid- upper arm circumference (AHR = 1.4, 95 % CI: 1.1-1.9), inpatient complications (AHR = 2.2, 95 % CI: 1.4-3.5) and did not lose edema within four days of inpatient treatment (AHR = 2.3, 95 % CI: 1.1-4.8). The findings of this study confirm the probability of surviving gets slimmer with inpatient complications and staying longer in stabilization centers. So, to prevent complications and enhance recovery rate due emphasis should be given in improving early detection and treatment of severely malnourished children in Ethiopia.

  8. Epstein-Barr virus (EBV infection in Chinese children: a retrospective study of age-specific prevalence.

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    Geng Xiong

    Full Text Available BACKGROUND: Epstein-Barr Virus (EBV is a globally prevalent herpesvirus associated with infectious mononucleosis and many malignancies. The survey on EBV prevalence appears to be important to study EBV-related diseases and determine when to administer prophylactic vaccine. The purpose of this retrospective study was to collect baseline information about the prevalence of EBV infection in Chinese children. METHODOLOGY/PRINCIPAL FINDING: We collected 1778 serum samples from healthy children aged 0 to 10, who were enrolled in conventional health and nutrition examinations without any EBV-related symptom in 2012 and 2013 in North China (n = 973 and South China (n = 805. We detected four EBV-specific antibodies, i.e., anti-VCA-IgG and IgM, anti-EBNA-IgG and anti-EA-IgG, by ELISA, representing all of the phases of EBV infection. The overall EBV seroprevalence in samples from North and South China were 80.78% and 79.38% respectively. The EBV seropositivity rates dropped slightly at age 2, and then increased gradually with age. The seroprevalence became stabilized at over 90% after age 8. In this study, the seroprevalence trends between North and South China showed no difference (P>0.05, and the trends of average antibody concentrations were similar as well (P>0.05. CONCLUSIONS/SIGNIFICANCE: EBV seroprevalence became more than 50% before age 3 in Chinese children, and exceed 90% after age 8. This study can be helpful to study the relationship between EBV and EBV-associated diseases, and supportive to EBV vaccine development and implementation.

  9. Myopia correction in children: a meta-analysis.

    Science.gov (United States)

    Cui, Yanhui; Li, Li; Wu, Qian; Zhao, Junyang; Chu, Huihui; Yu, Gang; Wei, Wenbin

    2017-06-26

    The purpose of this study was to conduct a meta-analysis comparing rigid gas permeable lenses (RGP) with soft contact lenses (SCL), spectacles and orthokeratology (OK) lenses for myopia control with respect to axial length elongation, spherical equivalent and measures of corneal curvature. Medline, Cochrane, EMBASE, and Google Scholar databases were searched to September 29, 2015 using the following keywords: rigid gas permeable contact lens; refractive error; and refractive abnormalities. Randomized controlled trials, two-arm prospective studies and retrospective studies of children with myopia treated with RGP lenses compared with spectacles, SCL, and OK lenses were included. Outcome measures were changes of axial length, spherical equivalent, flatter meridian, steeper meridian and corneal apical radius. Five studies were included. Three studies reported axial length change after 2-3 years of treatment with RGP lenses and SCL/spectacles and no difference between the groups was noted (pooled mean difference = -0.077, 95% confidence interval [CI]: -0.120 to 0.097, p = 0.840). Two studies reported a change of spherical equivalent after 2-3 years of treatment with RGP lenses and SCL/spectacles, and no difference between the groups was noted (pooled mean difference = 0.275, 95% CI: -0.390 to 0.941, p = 0.417). Two studies compared corneal curvature measures between RGP and OK lenses after 3-6 months of treatment and no differences in any measures of corneal curvature were seen. The effect of RGP lenses and SCL/spectacles on axial length elongation and spherical equivalent and of RGP and OK lenses on corneal curvature in children with myopia was similar.

  10. Analysis of refractive state in 708 children with ametropic amblyopia

    Directory of Open Access Journals (Sweden)

    Ju-Fen Huang

    2016-01-01

    Full Text Available AIM: To analyze the refractive state and explore the epidemiologic feature of children with ametropic amblyopia.METHODS: This study retrospectively analyzed 708 children(1 416 eyeswith amblyopia from January 2012 to December 2013 in Special Department of Strabismus and Amblyopic and Department of Pediatric Ophthalmology in our hospital, who were diagnosed as ametropic amblyopia and accepted centrally comprehensive training. The refractive state were given epidemiologic analyze.RESULTS: In the 708 cases(1 416 eyes, there were 190 eyes with hyperopia(13.42%,612 eyes with hyperopia astigmatism(43.22%,18 eyes with myopia(1.27%,134 eyes with myopia astigmatism(9.46%,462 eyes with mixed astigmatism(32.63%. The distributions of refractive state in children at different age were different, and the difference was statistically significant(PCONCLUSION: Hyperopia ametropia and mixed astigmatism are the main types of refractive errors in amblyopia children. The level of amblyopia is related to refractive state and astigmatism axial.

  11. Retrospective analysis of dengue specific IgM reactive serum samples

    OpenAIRE

    Nemai Bhattacharya; Bhaswati Bandyopadhyay; Indranil Bhattacharjee; Hiranmoy Mukherjee; Srabani Talukdar; Ruby Mondal; Netai Pramanick; Goutam Chandra; Amiya K. Hati

    2013-01-01

    Objective: To conduct a retrospective analysis of dengue cases in Kolkata, on the basis of presence of anti-dengue IgM in their sera and presence or absence of anti-dengue IgG and dengue specific Non structural 1 (NS1) antigen in each of the serum sample. Methods: Sample was tested quantitatively employing ELISA technique, using Biorad test kits, with a view to get a more comprehensive picture of dengue in an urban endemic area and also to evaluate individual cases. Results: Th...

  12. Retrospective analysis of 'gamma distribution' based IMRT QA criteria

    International Nuclear Information System (INIS)

    Wen, C.; Chappell, R.A.

    2010-01-01

    Full text: IMRT has been implemented into clinical practice at Royal Hobart Hospital (RHH) since mid 2006 for treating patients with Head and Neck (H and N) or prostate tumours. A local quality assurance (QA) acceptance criteria based on 'gamma distribution' for approving IMRT plan was developed and implemented in early 2007. A retrospective analysis of such criteria over 194 clinical cases will be presented. The RHH IMRT criteria was established with assumption that gamma distribution obtained through inter-comparison of 2 D dose maps between planned and delivered was governed by a positive-hail' normal distribution. A commercial system-MapCheck was used for 2 D dose map comparison with a built-in gamma analysis tool. Gamma distribution histogram was generated and recorded for all cases. By retrospectively analysing those distributions using curve fitting technique, a statistical gamma distribution can be obtained and evaluated. This analytical result can be used for future IMRT planing and treatment delivery. The analyses indicate that gamma distribution obtained through MapCheckTM is well under the normal distribution, particularly for prostate cases. The applied pass/fail criteria is not overly sensitive to identify 'false fails' but can be further tighten-up for smaller field while for larger field found in both H and N and prostate cases, the criteria was correctly applied. Non-uniform distribution of detectors in MapCheck and experience level of planners are two major factors to variation in gamma distribution among clinical cases. This criteria derived from clinical statistics is superior and more accurate than single-valued criteria for lMRT QA acceptance procedure. (author)

  13. The comparison of grey-scale ultrasonic and clinical features of hepatoblastoma and hepatocellular carcinoma in children: a retrospective study for ten years

    Directory of Open Access Journals (Sweden)

    Luo Yan

    2011-06-01

    Full Text Available Abstract Background Hepatoblastoma (HBL and hepatocellular carcinoma (HCC are respectively the first and the second most common pediatric malignant liver tumors. The purpose of this study was to evaluate the combined use of the ultrasound examination and the assessment of the patients' clinical features for differentiating HBL from HCC in children. Methods Thirty cases of the confirmed HBL and 12 cases of the confirmed HCC in children under the age of 15 years were enrolled into our study. They were divided into the HBL group and the HCC group according to the histological types of the tumors. The ultrasonic features and the clinical manifestations of the two groups were retrospectively analyzed, with an emphasis on the following parameters: onset age, gender (male/female ratio, positive epatitis-B-surface-antigen (HBV, alpha-fetoprotein increase, and echo features including septa, calcification and liquefaction within the tumors. Results Compared with the children with HCC, the children with HBL had a significantly younger onset age (8.2 years vs. 3.9 years, P Conclusion Ultrasonic features combined with clinical manifestations are valuable for differentiating HBL from HCC in children.

  14. Hospital stay as a proxy indicator for severe injury in earthquakes: a retrospective analysis.

    Science.gov (United States)

    Zhao, Lu-Ping; Gerdin, Martin; Westman, Lina; Rodriguez-Llanes, Jose Manuel; Wu, Qi; van den Oever, Barbara; Pan, Liang; Albela, Manuel; Chen, Gao; Zhang, De-Sheng; Guha-Sapir, Debarati; von Schreeb, Johan

    2013-01-01

    Earthquakes are the most violent type of natural disasters and injuries are the dominant medical problem in the early phases after earthquakes. However, likely because of poor data availability, high-quality research on injuries after earthquakes is lacking. Length of hospital stay (LOS) has been validated as a proxy indicator for injury severity in high-income settings and could potentially be used in retrospective research of injuries after earthquakes. In this study, we assessed LOS as an adequate proxy indicator for severe injury in trauma survivors of an earthquake. A retrospective analysis was conducted using a database of 1,878 injured patients from the 2008 Wenchuan earthquake. Our primary outcome was severe injury, defined as a composite measure of serious injury or resource use. Secondary outcomes were serious injury and resource use, analysed separately. Non-parametric receiver operating characteristics (ROC) and area under the curve (AUC) analysis was used to test the discriminatory accuracy of LOS when used to identify severe injury. An 0.7earthquake survivors. However, LOS was found to be a proxy for major nonorthopaedic surgery and blood transfusion. These findings can be useful for retrospective research on earthquake-injured patients when detailed hospital records are not available.

  15. Assessment of hair cortisol as a potential biomarker for possible adrenal suppression due to inhaled corticosteroid use in children with asthma: A retrospective observational study.

    Science.gov (United States)

    Smy, Laura; Shaw, Kaitlyn; Amstutz, Ursula; Staub, Michelle; Chaudhry, Shahnaz; Smith, Anne; Carleton, Bruce; Koren, Gideon

    2018-06-01

    Inhaled corticosteroids (ICS) are the recommended long-term control therapy for asthma in children. However, concern exists regarding potential adrenal suppression with chronic ICS use. Our pilot study reported that hair cortisol in children was 50% lower during ICS therapy than prior to therapy, suggestive of adrenal suppression. To evaluate hair cortisol concentration (HCC) as a potential biomarker for possible adrenal suppression from ICS use in children with asthma. A retrospective observational study was performed at asthma clinics in Vancouver, Winnipeg, and Toronto, Canada. Children (n = 586) were recruited from July 2012 to December 2014 inclusive of those without asthma, with asthma not using ICS, and with asthma using ICS. The most recent three-month HCC was measured by enzyme immunoassay and compared among the groups. Quantile regression analysis was performed to identify factors potentially affecting HCC. The median HCC was not significantly different among the children: No ICS (n = 47, 6.7 ng/g, interquartile range (IQR) 3.7-9.8 ng/g), ICS Treated (n = 360, 6.5 ng/g, IQR 3.8-14.3 ng/g), and Controls (n = 53, 5.8 ng/g, IQR 4.6-16.7 ng/g). 5.6% of the children using ICS had hair cortisol <2.0 ng/g compared to none in the control groups (P < .05, comparing ICS Treated (20/360) to all Controls combined (0/100)) and only half had been exposed to systemic corticosteroids. Age, sex, BMI, and intranasal corticosteroid use were significantly associated with HCC. Results suggest HCC may be a potential biomarker for adrenal suppression as a population of children using ICS with HCC < 2.0 ng/g was identified compared to none in the control groups. Further research is needed to determine if those children have or are at risk of adrenal suppression or insufficiency. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  16. Pediatric Cutaneous Leishmaniasis in an Endemic Region in Turkey: A Retrospective Analysis of 8786 Cases during 1998-2014.

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    Mustafa Aksoy

    2016-07-01

    Full Text Available Cutaneous leishmaniasis (CL is a major public health concern in Turkey and Sanliurfa represents the most endemic city in Turkey. Although children are most commonly affected by CL, detailed studies of pediatric CL in Turkey are lacking.In this report we retrospectively evaluated clinical and epidemiological data of 8786 pediatric CL cases, and how children respond to antimonial therapy. CL was observed most frequently in children between 6-10 years old. Interestingly this group showed shorter duration of disease and smaller lesions compared to 0-5 year and 11-15 year old groups. Females were more affected in all groups. Lesion localization and types varied among groups, with 0-5 year old presenting head/neck and mucosal lesions, and more often suffered from recidivans type, this could be associated to the longest duration of the disease in this group. Eleven-15 year old group showed fewer lesions in the head/neck but more generalized lesions. Evaluation of treatment response revealed that intra-lesional treatment was preferred over intramuscular treatment. However, 0-5 year old received intramuscular treatment more often than the other groups. Furthermore, the majority of 0-5 year old group which received intra-lesional treatment did not received subsequent intra-lesional cycles, as did children in the range of 6-15 years old.We report an increase in pediatric CL patients within the last four years. Analysis of pediatric CL patients by age revealed significant differences in CL progression. The data suggest that children between 0-5 years old responded better than other groups to intralesional treatment, since they received more often a single cycle of IL treatment, although follow up observation is required since they were more prone to develop recidivans. Eleven-15 year old patients comprise the largest percentage of patients receiving two or three cycles of intralesional treatment, suggesting that this group did not respond efficiently to

  17. [A retrospective analysis of 97 drunk driving cases].

    Science.gov (United States)

    Cheng, Xiang-Wei; Chu, Yun; Zong, Xiong-Xin; Wang, Zi-Wei; Chu, Jian-Xin

    2013-04-01

    Based on a retrospective analysis of the drunk driving cases, to explore the drunk drivers' personnel composition, occurrence time and psychology. As a result of punishment of the drunk driving by criminal law for one year from May 1st, 2011 to April 30th, 2012, 91 drunk driving cases were statistically analyzed the easy-happening time of drunk driving, the drunk drivers' age, gender, occupational characteristics, domicile and psychological factors. In 97 drunk driving cases, 26-40 years old, non-local domiciled and non-professional male drivers were prone to drunk driving at night from 22:00 to 5:00. The behavior of drunk driving is relevant to time, age, genders and occupation. The psychological characteristics of most drivers are fluky, making-life-easy, competitive and peacockish.

  18. Hospitalizations for critically ill children with traumatic brain injuries: a longitudinal analysis.

    Science.gov (United States)

    Tilford, John M; Aitken, Mary E; Anand, K J S; Green, Jerril W; Goodman, Allen C; Parker, James G; Killingsworth, Jeffrey B; Fiser, Debra H; Adelson, P David

    2005-09-01

    This study examines the incidence, utilization of procedures, and outcomes for critically ill children hospitalized with traumatic brain injury over the period 1988-1999 to describe the benefits of improved treatment. Retrospective analysis of hospital discharges was conducted using data from the Health Care Cost and Utilization Project Nationwide Inpatient Sample that approximates a 20% sample of U.S. acute care hospitals. Hospital inpatient stays from all types of U.S. community hospitals. The study sample included all children aged 0-21 with a primary or secondary ICD-9-CM diagnosis code for traumatic brain injury and a procedure code for either endotracheal intubation or mechanical ventilation. None. Deaths occurring during hospitalization were used to calculate mortality rates. Use of intracranial pressure monitoring and surgical openings of the skull were investigated as markers for the aggressiveness of treatment. Patients were further classified by insurance status, household income, and hospital characteristics. Over the 12-yr study period, mortality rates decreased 8 percentage points whereas utilization of intracranial pressure monitoring increased by 11 percentage points. The trend toward more aggressive management of traumatic brain injury corresponded with improved hospital outcomes over time. Lack of insurance was associated with vastly worse outcomes. An estimated 6,437 children survived their traumatic brain injury hospitalization because of improved treatment, and 1,418 children died because of increased mortality risk associated with being uninsured. Improved treatment was valued at approximately dollar 17 billion, whereas acute care hospitalization costs increased by dollar 1.5 billion (in constant 2000 dollars). Increased mortality in uninsured children was associated with a dollar 3.76 billion loss in economic benefits. More aggressive management of pediatric traumatic brain injury appears to have contributed to reduced mortality rates over

  19. Retrospective Analysis of Lophodermium seditiosum Epidemics in Estonia

    Directory of Open Access Journals (Sweden)

    HANSO, MÄRT

    2007-01-01

    Full Text Available The needle trace method (NTM, created and developed by the Finnish forest pathologists prof. T. Kurkela, dr. R. Jalkanen and T. Aalto during the last decade of the XX century, has been already used by several researchers of different countries for retrospective analysis of needle diseases (Hypodermella sulcigena, by R. Jalkanen et al. in Finland or herbivorous insect pests of Scots pine (Diprion pini, by T. Kurkela et al. in Finland; Bupalus piniaria, by H. Armour et al. in Scotland, but as well of pests of Sitka spruce (Gilpinia hercyniae, by D.T. Williams et al. in England. Scots pine in forest nurseries and young plantations of Estonia is often but irregularly suffering from the epidemics of the needle cast fungus Lophodermium seditiosum. Current environmental regulations exclude from the regulatory (control measures all the others except of well-argued prophylactic systems, built up on reliable prognoses. The last is inconceivable without the availability of a reliable, as well, and long-lasting retrospective time-series of L. seditiosum epidemics, which, as it is known from the last half of the XX century, are occupying large forest areas, usually not least than a half of (the small Estonia. An appropriate time-series would be useful, as well, for the more basic understanding of the accelerated mortality processes during the stand formation in early pole-age Scots pine plantations. Methodological principles of the use of NTM in an appropriate investigation together with the preliminary results of our research work, looking back for more than a century, are introduced and discussed in this investigation.

  20. Fine motor and self-care milestones for individuals with Down syndrome using a Retrospective Chart Review.

    Science.gov (United States)

    Frank, K; Esbensen, A J

    2015-08-01

    Developmental milestone markers for fine motor and self-care skills among children with Down syndrome (DS) are either minimal, anecdotal or out-of date. Our goal was to produce normative expectations for the development of fine motor and self-care milestones specific to children with DS. A cross-sectional retrospective chart review was completed on 274 children with DS seen at a specialty clinic that ranged in age from 4 months to 18 years. Specific skills were assessed at occupational therapy assessments as either present or absent, including fine motor, handwriting, scissor usage, self-feeding and clothing management. Fine motor milestones describing when 10-30% ('early achievers') and 75-95% ('representative achievement') of children with DS had mastered each skill were developed based upon descriptive review. As the fine motor and self-care skills advanced in complexity, the range of ages for documented skill acquisition was observed to increase. Age ranges for the mastery of fine motor developmental milestones for early and representative achievement were developed based upon descriptive analysis of cross-sectional retrospective clinical chart reviews. That the age range for mastering fine motor and self-care skills broadens as children with DS get older is in agreement with what is identified in the DS behavioural phenotype with regard to variable motor skills overall. These fine motor and self-care developmental milestone markers contribute to the field by informing parents, caregivers and healthcare providers of potential fine motor and self-care outcomes and describing normative development for children with DS. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  1. Late preterm birth is a strong predictor of maternal stress later in life: Retrospective cohort study in school-aged children.

    Science.gov (United States)

    Polic, Branka; Bubic, Andreja; Mestrovic, Julije; Markic, Josko; Kovacevic, Tanja; Juric, Milan; Tesija, Roberta Andrea; Susnjar, Helena; Kolcic, Ivana

    2016-06-01

    The aim of this study was to compare the level of stress in mothers of school-aged children born late preterm and admitted to the intensive care unit (ICU) with the level of maternal stress if a child was born late preterm and not admitted to the ICU as well as if a full-term child was admitted to the ICU. In this retrospective cohort study the data were gathered via telephone interview with mothers. The Parenting Stress Index/Short Form was used to determine the level of stress in mothers. Background demographic characteristics, medically relevant variables, and the level of stress were tested using the chi-square test and Kruskal-Wallis test. Logistic regression was used in order to identify predictors of significant level of stress. Mothers of late preterm born children who were admitted to the ICU, as well as mothers of late preterm children who were not admitted had higher level of stress compared to mothers of full-term children. Namely, mothers of late preterm born children admitted to the ICU had 18-fold increase in risk for significant level of total stress (OR = 18.09; 95% CI 8.55 to 38.26) while 24-fold greater risk was observed in mothers of late preterm children who were not admitted to the ICU (OR = 24.05; 95% CI 10.66 to 54.26) in comparison to mothers of full-term born children. Results indicate that preterm birth and its complications are associated with a higher level of stress in mothers, that persists to school age. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  2. Balloon Eustachian Tuboplasty in children.

    Science.gov (United States)

    Leichtle, A; Hollfelder, D; Wollenberg, B; Bruchhage, K-L

    2017-06-01

    Endonasal ballon dilatation of the Eustachian tube (BET) is a promising treatment for Eustachian tube dysfunction with encouraging results over the last years in adults. In addition, in children, single studies demonstrated promising results, but revealed the necessity for broader and additional studies. Our retrospective analysis presents outcomes with BET in children with chronic obstructive dysfunction of the Eustachian tube, showing resistance to the conventional therapy after adenotomy with paracentesis or grommets (ventilation tubes). The data of 52 children, having undergone BET from April 2011 to April 2016, were retrospectively evaluated. Most children in our study presented middle ear effusion (47%), adhesive (21%), chronic otitis media (13%), or recurrent acute otitis media (11%). In 24 (37%) children, we combined BET with a paracentesis, in 5 (8%) patients with a tympanoplasty type I and in 3 (5%) patients with a type III. All children were assessed using an audiogram, tympanometry, and tubomanometry (50 mbar) before and after BET. In addition, we evaluated the results of the Lübecker questionnaire, which we performed before and after BET. The childrens' ear-related and quality of life-related symptoms, such as pressure equalization, ear pressure, hearing loss, pain and limitation in daily life, and satisfaction pre- and postoperatively, were analyzed. In the majority of patients, we could see an improvement in the ear pressure, hearing loss, limitation in daily life, and satisfaction with recurrent inflammations, underlined by better outcomes in the tubomanometry and the tympanogram. BET in children is a safe, efficient, and promising method to treat chronic tube dysfunction, especially as a second line treatment, when adenotomy, paracentesis, or grommets failed before.

  3. Childhood intussusception in Uzbekistan: Analysis of retrospective surveillance data

    Directory of Open Access Journals (Sweden)

    Flem Elmira

    2011-03-01

    Full Text Available Abstract Background Estimates of baseline incidence of childhood intussusception could help safety monitoring after the introduction of rotavirus vaccines. We studied the incidence of intussusception in Uzbekistan, a GAVI-fund eligible state in Central Asia. Methods We retrospectively reviewed intussusception cases in children Results Over a 5-year study period, 67 confirmed cases were identified, of which 67% were boys. The median age was 12 months, and no seasonal trend in the distribution of cases was observed. The diagnostic methods used included abdominal radiography (87% and ultrasonography (57%. Intussusception reduction by air enema was successful in 33 (49% patients and 34 (50% cases underwent surgery. A total of 4 deaths occurred, including 3 deaths in infants aged 0-6 months. The median length of hospital stay was 7.3 (range 0-37 days. The incidence of intussusception is estimated at 23 (95% CI 13.6-32.4 cases per 100,000 child-years, corresponding to approximately 237 cases annually. Conclusions This is the first study to estimate the incidence of childhood intussusception prior to the introduction of the rotavirus vaccination in Uzbekistan. A prospective surveillance system using a standardized case definition is needed in order to better examine the occurrence of intussusception in developing countries.

  4. Brain tumors in children and teenagers up to 18 in CT

    International Nuclear Information System (INIS)

    Kabula, S.; Trzcinska, I.; Lasek, W.; Goszczynski, W.; Nawrot, M.; Boron, Z.

    1995-01-01

    The results of the CT investigation in children and teenagers up to 18, made in 1990-1994 were exposed to retrospective analysis: 2279 children were examined. The computer research proved the pathological changes in case 1205 people - 52%. In this group 58 children turned out to suffer from brain tumors. The most frequent tumor spatted was: astrocytoma (8), ependymoma (5), oligodendroglioma (3). The brain tumors happen to appear more often in case of boys (34) than in case of girls (22). (author)

  5. Cost per case or total cost? The potential of prevention of hand injuries in young childrenRetrospective and prospective studies

    Directory of Open Access Journals (Sweden)

    Carlsson Katarina

    2008-07-01

    Full Text Available Abstract Background Health-care costs for hand and forearm injuries in young children are poorly documented. We examined costs in 533 children injured years 1996–2003. Methods Health-care costs and costs for lost productivity were retrospectively calculated in children from three catchment areas in Sweden. Seven case categories corresponding to alternative prevention strategies were constructed. Results Over time, diminishing number of ward days reduced the health-care cost per case. Among children, the cost of lost productivity due to parental leave was 14 percent of total cost. Fingertip injuries had low median costs but high total costs due to their frequency. Complex injuries by machine or rifle had high costs per case, and despite a low number of cases, total cost was high. Type of injury, surgery and physiotherapy sessions were associated with variations in health-care cost. Low age and ethnic background had a significant effect on number of ward days. Conclusion The costs per hand injury for children were lower compared to adults due to both lower health-care costs and to the fact that parents had comparatively short periods of absence from work. Frequent simple fingertip injuries and rare complex injuries induce high costs for society. Such costs should be related to costs for prevention of these injuries.

  6. Identification of Design Work Patterns by Retrospective Analysis of Work Sheets

    DEFF Research Database (Denmark)

    Hansen, Claus Thorp

    1999-01-01

    project is carried out where we seek to identify design work patterns by retrospective analysis of documentation created during design projects.An elements to satisfy the wish for an efficient design process could be to identify work patterns applied by engineering designers, evaluate these patterns...... with respect to their efficiency, and reuse the most efficient in future projects. Thus, the objective of this research is to analyse design projects in order to identify the work patterns applied. Based on an evaluation of identified work patterns we expect a recommendation of work patterns supporting...... an efficient design process can be established.In this paper we describe the analysis method, and present observations from analyses of three projects....

  7. Management of pancreatic pseudocysts-A retrospective analysis.

    Directory of Open Access Journals (Sweden)

    Sebastian Rasch

    Full Text Available Pancreatic pseudocysts arise mostly in patients with alcohol induced chronic pancreatitis causing various symptoms and complications. However, data on the optimal management are rare. To address this problem, we analysed patients with pancreatic pseudocysts treated at our clinic retrospectively.We searched our clinical database for the diagnosis pancreatitis from 2004 till 2014, selected patients with pseudocysts larger than 10 mm and entered all relevant information in a database for statistical analysis.In total, 129 patients with pancreatic pseudocysts were treated at our institution during the study period. Most patients suffered from alcohol induced chronic pancreatitis (43.4%; 56/129. Pseudocysts were more frequent in female than in male (2:1 and were mainly located in the pancreatic head (47.3%; 61/129. Local complications like obstructive jaundice were associated with the diameter of the cysts (AUC 0.697 in ROC-curve analysis. However, even cysts up to a diameter of 160 mm can regress spontaneously. Besides a lower re-intervention rate in surgically treated patients, endoscopic, percutaneous and surgical drainage are equally effective. Most treatment related complications occur in large pseudocysts located in the pancreatic head.Conservative management of large pseudocysts is successful in many patients. Therefore, indication for treatment should be made carefully considering the presence and risk of local complications. Endoscopic and surgical drainage are equally effective.

  8. Comparison of immune manifestations between refractory cytopenia of childhood and aplastic anemia in children: A single-center retrospective study.

    Science.gov (United States)

    Wu, Jun; Cheng, Yifei; Zhang, Leping

    2015-12-01

    This retrospective single-center study assessed the incidence and clinical features of immune manifestations of refractory cytopenia of childhood (RCC) and childhood aplastic anemia (AA). We evaluated 72 children with RCC and 123 with AA between February 2008 and March 2013. RCC was associated with autoimmune disease in 4 children, including 1 case each with autoimmune hemolytic anemia, rheumatoid arthritis, systemic lupus erythematosus, and anaphylactoid purpura. No children with AA were diagnosed with autoimmune diseases. Immune abnormalities were common in both RCC and AA; the most significant reductions were in the relative numbers of CD3-CD56+ subsets found in RCC. Despite the many similar immunologic abnormalities in AA and RCC, the rate of autoimmune disease was significantly lower in childhood AA than RCC (p=0.008, χ2=6.976). The relative numbers of natural killer cells were significantly lower in RCC patients than AA patients. By month 6, there was no significant difference in autoimmune manifestations between RCC and AA in relation to the response to immunosuppressive therapy (p=0.907, χ2=0.014). The large overlap of analogous immunologic abnormalities indicates that RCC and childhood AA may share the same pathogenesis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Eczema Is Associated with Childhood Speech Disorder: A Retrospective Analysis from the National Survey of Children's Health and the National Health Interview Survey.

    Science.gov (United States)

    Strom, Mark A; Silverberg, Jonathan I

    2016-01-01

    To determine if eczema is associated with an increased risk of a speech disorder. We analyzed data on 354,416 children and adolescents from 19 US population-based cohorts: the 2003-2004 and 2007-2008 National Survey of Children's Health and 1997-2013 National Health Interview Survey, each prospective, questionnaire-based cohorts. In multivariate survey logistic regression models adjusting for sociodemographics and comorbid allergic disease, eczema was significantly associated with higher odds of speech disorder in 12 of 19 cohorts (P speech disorder in children with eczema was 4.7% (95% CI 4.5%-5.0%) compared with 2.2% (95% CI 2.2%-2.3%) in children without eczema. In pooled multivariate analysis, eczema was associated with increased odds of speech disorder (aOR [95% CI] 1.81 [1.57-2.05], P speech disorder. History of eczema was associated with moderate (2.35 [1.34-4.10], P = .003) and severe (2.28 [1.11-4.72], P = .03) speech disorder. Finally, significant interactions were found, such that children with both eczema and attention deficit disorder with or without hyperactivity or sleep disturbance had vastly increased risk of speech disorders than either by itself. Pediatric eczema may be associated with increased risk of speech disorder. Further, prospective studies are needed to characterize the exact nature of this association. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Traumatic fractures as a result of falls in children and adolescents: A retrospective observational study.

    Science.gov (United States)

    Wang, Hongwei; Yu, Hailong; Zhou, Yue; Li, Changqing; Liu, Jun; Ou, Lan; Zhao, Yiwen; Song, Guoli; Han, Jianda; Chen, Yu; Xiang, Liangbi

    2017-09-01

    The aim of this study is to investigate the incidence and pattern of traumatic fractures (TFs) as a result of falls in a population of children and adolescents (≤18 years old) in China.This was a cross-sectional study. We retrospectively reviewed 1412 patients who were children and adolescents with TFs as a result of falls admitted to our university-affiliated hospitals in China from 2001 to 2010. Etiologies included high fall (height ≥2) and low fall (height fractures in total and 92 patients (6.5%) presented with multiple fractures. The most common fracture sites were upper extremity fractures in 814 patients (57.6%) and lower extremity fractures in 383 patients (27.1%), followed by craniofacial fractures in 233 patients (16.5%). A total of 231 (16.4%) patients suffered a nerve injury. The frequencies of early and late complications/associated injuries were 19.5% (n = 275) and 9.2% (n = 130). The frequencies of emergency admission, nerve injury, spinal fracture, lower extremity fractures, craniofacial fracture, sternum and rib fracture, and early complications/ASOIs were significantly larger in high fall than low fall (all P fractures (P fracture (P = .039), lower extremity fractures (P = .048), and craniofacial fracture (P = .041) were significantly larger in female than the male patients. The frequency of upper extremity fractures (P fracture, and craniofacial fracture were significantly larger in patients with nerve injury than other patients without nerve injury (all P fractures were the most common etiologies and sites, respectively. High fall, spinal fracture and craniofacial fracture were risk factors for nerve injury. Therefore, we should focus on patients who were caused by high fall and presented with spinal and craniofacial fracture to determine the presence of a nerve injury so that we can provide early, timely diagnosis and targeted treatment to children.

  11. [Analysis of individualized primary prophylactic treatment of 19 cases of children with severe hemophilia A].

    Science.gov (United States)

    Liu, G Q; Tang, L; Wu, X Y; Zhen, Y Z; Li, G; Chen, Z P; Wang, Y; Zhang, N N; Zhang, J S; Yu, G X; Wu, R H

    2016-12-02

    Objective: To study the current situation of primary prophylaxis in severe hemophilia A children and to explore rational regimen in order to provide evidence for the development of primary prophylaxis in China. Method: A retrospective clinical data collection and analysis was conducted for 19 severe hemophilia A children who received primary prophylaxis in Beijing Children's Hospital outpatient clinic between February 2011 and September 2015 and evaluated the regimen and efficacy. Result: (1) Primary prophylaxis regimen: the median beginning age 1.8 (range 0.5-2.9) years, the median FⅧ preparation using dosage 16.7 (8.0-23.5) U/(kg·time), the median using frequency was 1.0 (1.0-3.0) time/week. Eight cases among the patients received escalation of treatment intensity because of the poor bleeding control. (2) Efficacy: the median annual bleeding rate (ABR) was 1.9 (0-6.0) times/year, the median annual joint bleeding rate (AJBR) was 0 (0-3.3) times/year, without life threatening bleeding. All of them kept in 4th scale of Beijing Children Hospital daily activity level. The median annual factor consumption was 1 844 (840-5 040) U/kg. Conclusion: Low-dose primary prophylaxis regimen which were in low-dose /low frequencies and adjusted by bleeding frequency could decrease bleeding and joint bleeding frequency significantly, maintained the normal daily activity capacity and saved the factor consumption compared to standard regimen in severe hemophilia A children.

  12. Thermoluminescence properties of irradiated commercial color pencils for accidental retrospective dosimetry

    International Nuclear Information System (INIS)

    Meriç, Niyazi; Şahiner, Eren; Bariş, Aytaç; Polymeris, George S.

    2015-01-01

    Color pencils are widely used mostly in kindergartens, in schools and could be found in all houses with families having young children. Their wide spread use in modern times as well as their chemical composition, consisting mostly of Si and Al, constitute two strong motivations towards exploiting their use as accidental retrospective thermoluminescent dosimeters. The present manuscript reports on the study of colored pencils manufactured by a commercial brand in China which is very common throughout Turkey. The preliminary results discussed in the present work illustrated encouraging characteristics, such as the presence of a trapping level giving rise to natural TL in a temperature range that is sufficiently high. Specific thermoluminescence features of this peak, such as glow peak shape and analysis, anomalous fading, thermal quenching, reproducibility, linearity and recovery ability to low attributed doses were studied. The results suggest that the color pencils could be effectively used in the framework of retrospective thermoluminescent dosimetry with extreme caution, based on multiple aliquot protocols. - Highlights: • Thermoluminescence of the inner part of commercial colored pencils was studied. • The presence of a trapping level giving rise to natural TL at 260 °C was yielded. • Deco analysis, anomalous fading, thermal quenching, reproducibility, linearity and recovery ability of this peak were studied

  13. Colorectal cancer with intestinal perforation - a retrospective analysis of treatment outcomes.

    Science.gov (United States)

    Banaszkiewicz, Zbigniew; Woda, Łukasz; Tojek, Krzysztof; Jarmocik, Paweł; Jawień, Arkadiusz

    2014-01-01

    Colorectal cancer (CRC) is one of the leading cause of death in European population. It progresses without any symptoms in the early stages or those clinical symptoms are very discrete. The aim of this study was a retrospective analysis of treatment outcomes in patients with colorectal cancer complicated with intestinal perforation. A retrospective analysis of patients urgently operated upon in our Division of General Surgery, because of large intestine perforation, from February 1993 to February 2013 has been made. Results were compared with a group of patients undergoing the elective surgery for colorectal cancer in the same time and Division. Intestinal perforation occurred more often in males (6.52% vs. 6.03%), patients with mucous component in histopathological examination (9.09% vs. 6.01%) and with clinicaly advanced CRC. Patients treated because of perforation had a five-fold higher 30 day mortality rate (9.09% vs. 1.83%), however long-term survival did not differ significantly in both groups. After resectional surgery in 874 patients an intestinal anastomosis was made. Anastomotic leakage was present in 23 (2.6%) patients. This complication occurred six-fold more frequently in a group of patients operated upon because of intestinal perforation (12.20% vs. 2.16%). In patients with CRC complicated with perforation of the colon in a 30-day observation significantly higher rate of complications and mortality was shown, whereas there was no difference in distant survival rates.

  14. Comparison of children versus adults undergoing mini-percutaneous nephrolithotomy: large-scale analysis of a single institution.

    Directory of Open Access Journals (Sweden)

    Guohua Zeng

    Full Text Available OBJECTIVE: As almost any version of percutaneous nephrolithotomy (PCNL was safely and efficiently applied for adults as well as children without age being a limiting risk factor, the aim of the study was to compare the different characteristics as well as the efficacy, outcome, and safety of the pediatric and adult patients who had undergone mini-PCNL (MPCNL in a single institution. METHODS: We retrospective reviewed 331 renal units in children and 8537 renal units in adults that had undergone MPCNL for upper urinary tract stones between the years of 2000-2012. The safety, efficacy, and outcome were analyzed and compared. RESULTS: The children had a smaller stone size (2.3 vs. 3.1 cm but had smilar stone distribution (number and locations. The children required fewer percutaneous accesses, smaller nephrostomy tract, shorter operative time and less hemoglobin drop. The children also had higher initial stone free rate (SFR (80.4% vs. 78.6% after single session of MPCNL (p0.05. Both groups had low rate of high grade Clavien complications. There was no grade III, IV, V complications and no angiographic embolization required in pediatric group. One important caveat, children who required multiple percutaneous nephrostomy tracts had significant higher transfusion rate than in adults (18.8% vs. 4.5%, p = 0.007. CONCLUSIONS: This contemporary largest-scale analysis confirms that the stone-free rate in pediatric patients is at least as good as in adults without an increase of complication rates. However, multiple percutaneous nephrostomy tracts should be practiced with caution in children.

  15. Retrospective hospital based surveillance of intussusception in children in a sentinel paediatric hospital: benefits and pitfalls for use in post-marketing surveillance of rotavirus vaccines.

    Science.gov (United States)

    Lloyd-Johnsen, C; Justice, F; Donath, S; Bines, J E

    2012-04-27

    Evaluation of the safety of rotavirus vaccines, particularly with respect to the risk of intussusception, is recommended for countries planning to introduce rotavirus vaccines into the National Immunisation Program. However, as prospective studies are costly, require time to conduct and may be difficult to perform in some settings, retrospective hospital based surveillance at sentinel sites has been suggested as an option for surveillance for intussusception following introduction of rotavirus vaccines. To assess the value of retrospective hospital based surveillance to describe clinical and epidemiological features of intussusception in children aged <24 months and to investigate any temporal association between receipt of a rotavirus vaccine and intussusception. A retrospective chart review of all patients diagnosed with intussusception at Royal Children's Hospital, Melbourne, Australia over an 8-year period including before and after rotavirus vaccine introduction into the National Immunisation Program, was conducted using patients identified by a medical record database (ICD-10-CM 56.1). Patient profile, clinical presentation, treatment and outcome were analysed along with records of immunisation status obtained using the Australian Childhood Immunisation Register. A 9% misclassification rate of discharge diagnosis of intussusception was identified on critical chart review. The incidence rate of intussusception at the Royal Children's Hospital over the study period was 1.91 per 10,000 infants <24 months (95% CI 1.65-2.20). Intestinal resection was required in 6.5% of infants (95% CI 3.6%, 11.0%). Intussusception occurred within 30 days after vaccination in 2 of 27 patients who had received at least 1 dose of a rotavirus vaccine. Valuable data on the incidence, clinical presentation and treatment outcomes of intussusception can be obtained from data retrieved from hospital medical records in a sentinel paediatric hospital using standardised methodology. However

  16. [A retrospective study of orthodontic treatment of children with clefts].

    Science.gov (United States)

    Brin, I; Bar-Abudi, R; Abed, Y; Ben-Bassat, Y; Harari, D; Zilberman, Y

    2003-04-01

    To evaluate the population of cleft patients treated in a Department of Orthodontics and the types of treatment modalities provided. Demographic, cleft related and treatment related data existing in the patients' files were supplemented by questionnaires. Comparisons were conducted among 3 cleft groups: cleft lip (CL), cleft lip and palate (CLP) and cleft palate (CP). The response rate was 36% (n = 152). The distribution of the patients in the 3 cleft groups, the sidedness, the male predominance and association with additional anomalies were similar to the reports in the literature. Most of the patients were the 3rd born (or more) and were of normal birth weight. Consanguity in the cleft families was at least 2.5 times more prevalent than that of the Israeli population and 30% reported on additional cleft in the family. Low birth weight and additional anomalies were found mainly in the CP group. Orthodontic involvement spanned 3 developmental periods: immediate postnatal presurgical treatment, phase I between the ages 6-8 years and full orthodontic treatment at a later age. Up to the age of 5 years only one lip operation was performed for 60% of the lip-affected children and one palate operation for 65% of the palate affected patients. 1. The distribution of the various cleft-related parameters in this retrospective study was similar to the findings in the literature. 2. The high prevalence of additional anomalies found emphasizes the need for a thorough examination of the cleft babies. 3. Orthodontic treatment was rendered in one and two phase protocols in addition to immediate postnatal pre-surgical intervention.

  17. Vertigo in childhood: a retrospective series of 100 children.

    Science.gov (United States)

    Batu, Ezgi Deniz; Anlar, Banu; Topçu, Meral; Turanlı, Güzide; Aysun, Sabiha

    2015-03-01

    Evaluation and management of vertigo in children vary between institutions and medical specialties. The aim of this study is to describe the characteristics of vertigo in children presenting to a pediatric neurology referral center and to investigate the relationship between vertigo and migraine. Patients vertigo to Hacettepe University Ihsan Dogramaci Children's Hospital Neurology Unit between January 1996-January 2012 were included (n = 100). Data were obtained from patient files and phone interviews. Mean age was 7.5 years. The most common etiological groups were benign paroxysmal vertigo of childhood (BPVC) (39%), psychogenic vertigo (21%), epileptic vertigo (15%), and migraine-associated vertigo (MAV) (11%). BPVC was the most common diagnosis in children ≤5 years of age while psychogenic vertigo prevailed in children >5 years. Staring episodes characterized epileptic vertigo patients (p = 0.021) while headache was more often described by MAV patients (p Vertigo attacks >5 min were uncommon in BPVC patients compared to others (p = 0.013). Twenty percent of BPVC patients contacted through phone interviews were experiencing migraine type headaches that started at a median age of 7.5 years. An algorithm for evaluation of children with vertigo was formed based on data obtained from this study and the literature. When this algorithm was applied to 100 cases of this series, 88 (88%) were correctly diagnosed. While most vertigo cases in children can be diagnosed accurately by a detailed medical history, physical and neurological examination, a standard algorithm can help with the correct classification. Copyright © 2014 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  18. Management of neglected lateral condyle fractures of humerus in children: A retrospective study

    Directory of Open Access Journals (Sweden)

    Anil Agarwal

    2012-01-01

    Full Text Available Background: Late presentation of humeral lateral condylar fracture in children is a surgical dilemma. Osteosynthesis of the fracture fragment or correction of elbow deformity with osteotomies and ulnar nerve transposition or sometimes both procedures combined is a controversial topic. We retrospectively evaluated open reduction and fixation cases in late presentation of lateral humeral condyle fracture in pediatric cases with regards to union and functional results. Materials and Methods: Twenty two pediatric (≤12 years patients with fractures of lateral condyle presenting 4 weeks or more post injury between the study period of 2006 and 2010 were included. Multiple K-wires / with or without screws along with bone grafting were used. At final evaluation, union (radiologically and elbow function (Liverpool Elbow Score, LES was assessed. Results: There were 19 boys and 3 girls. Followup averaged 33 months. Pain (n=9, swelling (n=6, restriction of elbow motion (n=6, prominence of lateral condylar region (n=4, valgus deformity (n=4 were the main presenting symptoms. Ulnar nerve function was normal in all patients. There were nine Milch type I and 13 type II fractures. Union occurred in 20 cases. One case had malunion and in another case there was resorption of condyle following postoperative infection and avascular necrosis. Prominent lateral condyles (4/12, fish tail appearance (n=7, premature epiphyseal closure (n=2 were other observations. LES averaged 8.12 (range, 6.66-9.54 at final followup. Conclusions: There is high rate of union and satisfactory elbow function in late presenting lateral condyle fractures in children following osteosynthesis attempt. Our study showed poor correlation between patient′s age, duration of late presentation or Milch type I or II and final elbow function as determined by LES.

  19. Grade repetition and parents' perception of hearing loss: An analysis of data from children in the United States.

    Science.gov (United States)

    Gilani, Sapideh; Roditi, Rachel; Bhattacharyya, Neil

    2017-03-01

    To determine whether parent-perceived hearing problems are associated with grade repetition among children in the United States. Retrospective cohort analysis of a contemporary national database. The National Survey of Children's Health 2011 to 2012 was analyzed. Hearing loss, as perceived and reported by parents, was categorized as: no hearing problem, history of a hearing problem, or current hearing problem. Children never repeating a grade versus repeating one or more grades (kindergarten-high school) were identified. Univariate statistics and multivariate logistic regression analyzed the association of hearing problems with grade repetition. Patients with mental retardation, autism, and attention-deficit/hyperactivity disorder were excluded from the analysis. After adjusting for race, sex, and poverty level, odds ratios for grade repetition were computed. Among 66.1 million (average age, 8.3 years, 49.0% male) children, 97.3% never had a hearing problem, 1.7% had a history of a hearing problem, and 1.0% had a current hearing problem. Overall, 7.1% repeated a grade. Grade repetition was reported in 6.9% of children without a hearing problem versus 9.4% with a history of a hearing problem and 19.3% with a current hearing problem (P hearing problem demonstrated an odds ratio of 1.9 (95% confidence interval 0.82-4.13) for grade repetition, whereas a current hearing problem demonstrated an odds ratio of 3.0 (1.90-4.80). Parents' perception of children's hearing problems is strongly associated with grade repetition. This trend is noticed in elementary school more than in high school. 4. Laryngoscope, 127:741-745, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  20. Complex treatment of localized bone marrow sarcoma in children

    International Nuclear Information System (INIS)

    Kolygin, B.A.; Punanov, Yu.A.; Malinin, A.P.; Safonova, S.A.

    1997-01-01

    The retrospective analysis included the results of the treatment of 67 children suffering from localized sarcomas of bone (Ewing's sarcoma, lymphosarcoma). The advantage was demonstrated in patients, received combination of chemotherapy and radiotherapy on the involved bone. The resection of the primary tumor in combination with radio-chemotherapy improves the 10-year survival

  1. Analysis of failed surgery for patellar instability in children with open growth plates.

    Science.gov (United States)

    Nelitz, Manfred; Theile, Michael; Dornacher, Daniel; Wölfle, Julia; Reichel, Heiko; Lippacher, Sabine

    2012-05-01

    Many surgical procedures have been proposed to treat recurrent patellar dislocation in children. In recent years, a more tailored approach considering the underlying pathology has been advocated. The aim of the study was to analyze a group of patients with recurrent patellofemoral instability after unsuccessful operative stabilization (Roux-Goldthwait procedure, lateral release, medial reefing or in combination) in childhood and adolescence. A total of 37 children and adolescents with recurrent patellofemoral instability despite previous surgery were analyzed retrospectively. Radiographic examination included AP and lateral views to assess patella alta and limb alignment. MRI was performed to evaluate trochlear dysplasia and tibial tubercle-trochlear groove (TTTG) distance. As a control group, 23 age- and sex-matched adolescents that were treated with a favorable outcome after medial reefing alone or combined with a Roux-Goldthwait procedure were analyzed. Severe trochlear dysplasia (type B-D according to Dejour) as detected on MRI scans was found significantly more often in the study group (89%) than in the control group (21%). No statistical difference of patellar height ratio (Insall-Salvati index) and TTTG distance between the two groups could be found. Of the measured parameters, only the incidence of trochlear dysplasia was increased. Trochlear dysplasia therefore seems to be a major risk factor for failure of operative stabilization of recurrent patellofemoral instability in children and adolescents. The results in children are in consensus with the literature in adults that a more tailored operative therapy including reconstruction of the MPFL and trochleaplasty has to be considered. Retrospective study, Level III.

  2. Clinical risk factors for life-threatening lower respiratory tract infections in children: a retrospective study in an urban city in Malaysia.

    Science.gov (United States)

    Nathan, Anna Marie; Rani, Fairuz; Lee, Rachel Jiun Yi; Zaki, Rafdzah; Westerhout, Caroline; Sam, I-Ching; Lum, Lucy Chai See; de Bruyne, Jessie

    2014-01-01

    Lower respiratory tract infections (LRTIs) are an important cause of morbidity and mortality, especially in low income countries. The aim of this study was to determine risk factors of life-threatening LRTIs in hospitalised children in Malaysia. This retrospective study included children aged less than 18 years admitted for LRTIs over 13 months in a tertiary referral centre in Kuala Lumpur, Malaysia. Neonates, children with asthma and those with either no or a normal chest radiograph were excluded. Life-threatening infection was defined as that needing non-invasive ventilation or admission to the paediatric intensive care unit. Routine blood investigations and nasopharyngeal secretion results (bacterial and viral) were obtained. Chest radiographs were reviewed by a designated radiologist. Environmental data (rainfall, particulate matter ≤ 10 µm [PM10] and air pollution index [API]) was obtained from the respective government departments. Three hundred and ninety-one episodes of LRTIs were included. Viruses were implicated in 48.5% of LRTIs, with respiratory syncytial virus (RSV) being detected in 44% of viral LRTIs. Forty-six (11.8%) children had life-threatening disease and the overall mortality rate was 1.3% (5 children). RSV was detected in 26% of children with life-threatening LRTIs. In multivariate logistic regression, chronic lung disease, presenting history of apnoea and signs of hypoxia, was associated with life threatening LRTIs. Increased LRTI admissions were associated with low rainfall but not PM10 nor API. Of those on follow-up, 39% had persistent respiratory symptoms. One in nine children admitted with LRTI had a life-threatening LRTI. The aetiology was viral in almost half of admitted children. RSV was detected in a quarter of children with life-threatening LRTIs. Children who present with LRTIs and either have chronic lung disease, presenting history of apnoea or signs of hypoxia, should be observed carefully as the risk of deterioration to life

  3. Retrospective analysis of patients clinical manifestations before and after pheochromocytoma surgery.

    Science.gov (United States)

    Balazovjech, I; Davidova, H; Breza, J

    2004-01-01

    A retrospective analysis of presurgical clinical picture and blood pressures of 34 patients with histologically verified pheochromocytoma. Assessment of clinical state, blood pressure and prognosis in the course of patients control hospitalizations from 2001 to 2002. The study was designed as a synoptic one, based on a retrospective analysis of 34 patients records with histologically verified pheochromocytoma (26 women and 8 men). Our assessments of clinical symptomatology, maximum paroxysmal hypertension values, average blood pressure values in patients with persistent arterial hypertension, arterial hypertension grade and circadian index were based on patients records. Patients epinephrectomies were followed during their control hospitalizations to assess their clinical state. Their blood pressures were evaluated by means of their circadian monitoring. From the 34 patients, 21 were diagnosed with solitary pheochromocytomas. The circadian index persistence analysis prior to the surgery was associated with circadian blood pressure monitoring in 21 patients. It was lost in 57% of patients. During their control hospitalization as many as 82% of patients preserved their circadian blood pressure variability with a more than 10% decrease in the night time, 5 patients did not preserve their circadian blood pressure variability. Seven from the original 34 patients died: Three of them died from their primary disease, one 63-year old man died from shock following tumour extirpation. The death of other 3 patients was not associated with their primary disease. Long-lasting survival of patients with pheochromocytoma after surgical treatment--except for those with malignant disease--was demonstrated. Although our assessment of the resulting treatment effects was positive, a long-term follow-up is inevitable because of a difficult pathologic-anatomical verification of the malignant nature of the disease as well as of the risk of tumour relapse assessment. (Tab. 1, Fig. 5, Ref 36.)

  4. Retrospective Morphometric Analysis of the Infraorbital Foramen ...

    African Journals Online (AJOL)

    Objective: The aim of our study is to examine the morphometric characteristics of the infraorbital foramen (IOF) and its anatomic localization by using conebeam computerized tomography (CBCT). Materials and Methods: In our study, the anatomic characteristics of the IOF were identified by studying retrospectively the CBCT ...

  5. Comparison of CATs, CURB-65 and PMEWS as triage tools in pandemic influenza admissions to UK hospitals: case control analysis using retrospective data.

    Directory of Open Access Journals (Sweden)

    Puja R Myles

    Full Text Available Triage tools have an important role in pandemics to identify those most likely to benefit from higher levels of care. We compared Community Assessment Tools (CATs, the CURB-65 score, and the Pandemic Medical Early Warning Score (PMEWS; to predict higher levels of care (high dependency--Level 2 or intensive care--Level 3 and/or death in patients at or shortly after admission to hospital with A/H1N1 2009 pandemic influenza. This was a case-control analysis using retrospectively collected data from the FLU-CIN cohort (1040 adults, 480 children with PCR-confirmed A/H1N1 2009 influenza. Area under receiver operator curves (AUROC, sensitivity, specificity, positive predictive values and negative predictive values were calculated. CATs best predicted Level 2/3 admissions in both adults [AUROC (95% CI: CATs 0.77 (0.73, 0.80; CURB-65 0.68 (0.64, 0.72; PMEWS 0.68 (0.64, 0.73, p<0.001] and children [AUROC: CATs 0.74 (0.68, 0.80; CURB-65 0.52 (0.46, 0.59; PMEWS 0.69 (0.62, 0.75, p<0.001]. CURB-65 and CATs were similar in predicting death in adults with both performing better than PMEWS; and CATs best predicted death in children. CATs were the best predictor of Level 2/3 care and/or death for both adults and children. CATs are potentially useful triage tools for predicting need for higher levels of care and/or mortality in patients of all ages.

  6. Myeloperoxidase mRNA detection for lineage determination of leukemic blasts: retrospective analysis.

    Science.gov (United States)

    Crisan, D; Anstett, M J

    1995-07-01

    Myeloperoxidase (MPO) mRNA is an early myeloid marker; its detection in the morphologically and immunophenotypically primitive blasts of acute undifferentiated leukemia (AUL) establishes myeloid lineage and allows reclassification as acute myelogenous leukemia with minimal differentiation (AML-MO). We have previously reported a procedure for MPO mRNA detection by RT-PCR (reverse transcription-polymerase chain reaction) and an adaptation for use of routine hematology smears. This variant procedure allows retrospective analysis of mRNA and is used in the present study to evaluate the lineage of leukemic blasts in seven cases with morphology and cytochemistry consistent with AUL. All hematology smears used in this study were air-dried, unstained or Wright-stained and stored at room temperature for periods varying between 3 days and 2 years. MPO mRNA was detected in six cases, establishing the myeloid lineage of the blasts and the diagnosis of AML-MO. In the remaining case, the blasts were MPO mRNA negative, confirming the diagnosis of AUL. The RT-PCR procedure for retrospective mRNA analysis is useful in the clinical setting, due to its high specificity and sensitivity, speed (less than 24 h), safety (no radioactivity) and convenient use of routine hematology smears; it is particularly attractive in clinical situations when fresh or frozen specimens are no longer available at the time when the need for molecular diagnostics becomes apparent.

  7. Management of paediatric spontaneous pneumothorax: a multicentre retrospective case series.

    Science.gov (United States)

    Robinson, Paul D; Blackburn, Carol; Babl, Franz E; Gamage, Lalith; Schutz, Jacquie; Nogajski, Rebecca; Dalziel, Stuart; Donald, Colin B; Druda, Dino; Krieser, David; Neutze, Jocelyn; Acworth, Jason; Lee, Mark; Ngo, Peter K

    2015-10-01

    Paediatric guidelines are lacking for management of spontaneous pneumothorax. Adult patient-focused guidelines (British Thoracic Society 2003 and 2010) introduced aspiration as first-line intervention for primary spontaneous pneumothorax (PSP) and small secondary spontaneous pneumothoraces (SSP). Paediatric practice is unclear, and evidence for aspiration success rates is urgently required to develop paediatric-specific recommendations. Retrospective analysis of PSP and SSP management at nine paediatric emergency departments across Australia and New Zealand (2003-2010) to compare PSP and SSP management. 219 episodes of spontaneous pneumothorax occurred in 162 children (median age 15 years, 71% male); 155 PSP episodes in 120 children and 64 SSP episodes in 42 children. Intervention in PSP vs SSP episodes occurred in 55% (95% CI 47% to 62%) vs 70% (60% to 79%), pmanagement, PSP and SSP management did not differ and ICC insertion was the continuing preferred intervention. Overall success of aspiration was lower than reported results for adults, although success was greater for small than for large pneumothoraces. Paediatric prospective studies are urgently required to determine optimal paediatric interventional management strategies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Expert Coaching in Weight Loss: Retrospective Analysis

    Science.gov (United States)

    Kushner, Robert F; Hill, James O; Lindquist, Richard; Brunning, Scott; Margulies, Amy

    2018-01-01

    Background Providing coaches as part of a weight management program is a common practice to increase participant engagement and weight loss success. Understanding coach and participant interactions and how these interactions impact weight loss success needs to be further explored for coaching best practices. Objective The purpose of this study was to analyze the coach and participant interaction in a 6-month weight loss intervention administered by Retrofit, a personalized weight management and Web-based disease prevention solution. The study specifically examined the association between different methods of coach-participant interaction and weight loss and tried to understand the level of coaching impact on weight loss outcome. Methods A retrospective analysis was performed using 1432 participants enrolled from 2011 to 2016 in the Retrofit weight loss program. Participants were males and females aged 18 years or older with a baseline body mass index of ≥25 kg/m², who also provided at least one weight measurement beyond baseline. First, a detailed analysis of different coach-participant interaction was performed using both intent-to-treat and completer populations. Next, a multiple regression analysis was performed using all measures associated with coach-participant interactions involving expert coaching sessions, live weekly expert-led Web-based classes, and electronic messaging and feedback. Finally, 3 significant predictors (Pcoaching session attendance (Pcoaching sessions, attending 60% of live weekly Web-based classes, and receiving a minimum of 1 food log feedback day per week were associated with clinically significant weight loss. Conclusions Participant’s one-on-one expert coaching session attendance, live weekly expert-led interactive Web-based class attendance, and the number of food log feedback days per week from expert coach were significant predictors of weight loss in a 6-month intervention. PMID:29535082

  9. Retrospective analysis of two hundred thirty-five pediatric mandibular fracture cases.

    Science.gov (United States)

    Eskitascioglu, Teoman; Ozyazgan, Irfan; Coruh, Atilla; Gunay, Galip K; Yuksel, Esabil

    2009-11-01

    Maxillofacial fractures are encountered less commonly during childhood period due to anatomic, social, cultural, and environmental factors. Although the incidence of all maxillofacial fractures is 1% to 15% among pediatric and adolescent patients, this rate drops to less than 1% in children below 5 years age. Two hundred thirty-five cases (mandibular fracture were evaluated retrospectively. Patients records were examined in terms of age, gender, cause of fracture, fracture localization, number of fractures, fracture pattern, accompanying injuries, applied treatment methods, and complications. Mean age of cases was 9.2 years and 165 cases were male, 70 were female. Traffic accidents as the most common etiologic cause in all ages. Falls is the second most common cause which particularly affects children above age of 2 years. All cases had 333 fractures and the most common fracture localization was parasymphysis region (34%). The other most common fracture localizations were as follows: condyle (19%), corpus (13%), dentoalveolar region (12%), angulus (11%), symphysis region (9%), and ramus (2%). There was only a single fracture line in 145 cases, 40 cases had unilateral multiple and 50 cases had bilateral fracture lines. We applied symptomatic (conservative) treatment in 20 (8%) of our cases; fracture fixation with interdental wires or closed reduction methods were employed in 122 patients. Internal fixation with open reduction (OR) was performed on 51 (22%) patients. Both closed and OR techniques were carried out in 30 (13%) patients. Pediatric mandibular fractures, which are seen less frequently compared with those of adults, require a specific and different treatment. Although mostly less invasive methods are preferred, we believe that ORs should be considered when required.

  10. A Retrospective Analysis of Neonatal Encephalocele Predisposing Factors and Outcomes.

    Science.gov (United States)

    Yucetas, Seyho Cem; Uçler, Necati

    2017-01-01

    This study evaluates the predisposing factors and outcomes of surgical management of encephaloceles at our institution. A retrospective analysis of 32 occipital encephaloceles managed operatively at the Neurosurgery Department Clinics of the Faculty of Medicine, Adıyaman University, was performed between 2011 and 2015. Among the study population, 19 mothers had been exposed to TORCH infections (toxoplasma, rubella, cytomegalovirus, herpes simplex virus), 18 were in consanguineous marriages, and 3 had regular prenatal screening. Associated congenital anomalies were common. Eight infants required reoperation, and 9 died during follow-up. The study identified key areas for prevention. Knowledge of the intracranial and associated anomalies can guide management. © 2016 S. Karger AG, Basel.

  11. Radiographic evaluation of INBONE total ankle arthroplasty: a retrospective analysis of 30 cases

    International Nuclear Information System (INIS)

    Datir, Abhijit; Xing, Minzhi; Kakarala, Aparna; Terk, Michael R.; Labib, Sameh A.

    2013-01-01

    The objectives of this work were to retrospectively describe the radiographic assessment of INBONE total ankle arthroplasty in 30 patients using validated linear and angular measurements and to correlate these findings with the final surgical outcome over a 2-year follow-up period. Thirty consecutive patients (21 females, nine males; mean age, 64.8 years) underwent INBONE total ankle arthroplasty during 2007-2011. After IRB approval, a retrospective pre- and post-operative radiographic analysis was performed using validated linear and angular measurements. The pre- and post-operative assessment included the tibial angle, talar angle, tibial slope, and coronal deformity. Post-operative measurements also included the talocalcaneal angle, joint space height, talar height, lateral tibial component angle, lateral talar component angle, and anteroposterior tibial component angle. The post-operative bone loss, subluxation, positioning, and subsidence were also assessed. Statistical analysis was performed using two-sample t test and Fisher's exact test. Out of 30 patients, 23 had a successful clinical outcome with intact prosthesis at a 2-year follow-up. The only variables with significant correlation (p < 0.05) to the post-surgical outcome were the lateral talar component angle (p = 0.002) and the mean difference between pre- and post-operative tibial slope (p = 0.001). The coronal deformity had significant mean difference between pre- and post-operative values (p < 0.001); however, it lacked a significant correlation to the final surgical outcome. None of the categorical variables had a significant correlation with post-surgical outcome. In our retrospective study, only the lateral talar component angle and the mean difference between the pre- and post-operative tibial slope had significant correlation with post-surgical outcome in INBONE ankle arthroplasty. These measurements may be helpful in radiographic assessment of the INBONE ankle arthroplasty. (orig.)

  12. Oral mucositis in patients treated with chemotherapy for solid tumors: a retrospective analysis of 150 cases

    NARCIS (Netherlands)

    Raber-Durlacher, J. E.; Weijl, N. I.; Abu Saris, M.; de Koning, B.; Zwinderman, A. H.; Osanto, S.

    2000-01-01

    The incidence and the severity of chemotherapy-associated oral mucositis were determined in a retrospective analysis of 150 patients with various solid tumors. In addition, possible risk factors for the development of mucositis were identified. Patients were treated with chemotherapeutic regimens

  13. Incidence and characteristics of low-speed vehicle run over events in rural and remote children aged 0-14 years in Queensland: an 11 year (1999-2009) retrospective analysis.

    Science.gov (United States)

    Griffin, Bronwyn R; Kimble, Roy M; Watt, Kerrianne; Shields, Linda

    2018-04-01

    The main objective of this study is to describe incidence rates of low-speed vehicle run-over (LSVRO) events among children aged 0-14 years residing in Queensland from 1999 to 2009. A second objective was to describe the associated patterns of injury, with respect to gender, age group, severity, characteristics (host, vehicle and environment), and trends over time in relation to geographical remoteness. Final results are hoped to inform prevention policies. In this statewide, retrospective, population-based study, data were collected on LSVRO events that occurred among children aged 0-14 years in Queensland from 1999 to 2009 from all relevant data sources across the continuum of care, and manually linked to obtain the most comprehensive estimate possible of the magnitude and nature of LSVRO events to date. Crude incidence rates were calculated separately for males and females, for fatal events, non-fatal events (hospital admissions and non-admissions, respectively), and for all LSVRO events, for each area of geographical remoteness (major cities, inner regional, outer regional, remote/very remote). Relative risks and 95% confidence interval were calculated, and trends over time were examined. Data on host, injury and event characteristics were also obtained to investigate whether these characteristics varied between areas of remoteness. Incidence rates were lowest among children (0-14 years) living in major cities (13.8/100 000/annum, with the highest recorded incidence in outer regional areas (incidence rate =42.5/100 000/annum). Incidence rates were higher for children residing outside major cities for both males and females, for every age group, for each of the 11 years of the study, and consequences of LSVRO events were worse. Young children aged 0-4 years were identified as those most at risk for these events, regardless of geographical location. Differences were observed as a function of remoteness category in relation to injury characteristics (eg injury

  14. Prediction of primary vs secondary hypertension in children.

    Science.gov (United States)

    Baracco, Rossana; Kapur, Gaurav; Mattoo, Tej; Jain, Amrish; Valentini, Rudolph; Ahmed, Maheen; Thomas, Ronald

    2012-05-01

    Despite current guidelines, variability exists in the workup of hypertensive children due to physician preferences. The study evaluates primary vs secondary hypertension diagnosis from investigations routinely performed in hypertensive children. This retrospective study included children 5 to 19 years with primary and secondary hypertension. The proportions of abnormal laboratory and imaging tests were compared between primary and secondary hypertension groups. Risk factors for primary vs secondary hypertension were evaluated by logistic regression and likelihood function analysis. Patients with secondary hypertension were younger (5-12 years) and had a higher proportion of abnormal creatinine, renal ultrasound, and echocardiogram findings. There was no significant difference in abnormal results of thyroid function, urine catecholamines, plasma renin, and aldosterone. Abnormal renal ultrasound findings and age were predictors of secondary hypertension by regression and likelihood function analysis. Children aged 5 to 12 years with abnormal renal ultrasound findings and high diastolic blood pressures are at higher risk for secondary hypertension that requires detailed evaluation. © 2012 Wiley Periodicals, Inc.

  15. Bereaved children.

    OpenAIRE

    Schultz, K.

    1999-01-01

    OBJECTIVE: To describe the unique aspects of childhood grief. To provide a framework for family physicians to use in assisting children to grieve. QUALITY OF EVIDENCE: A MEDLINE search from 1966 to 1999 using the key words children, childhood, grief, mourning, and bereavement revealed mainly expert opinion articles, some non-randomized observational studies, and retrospective case-control studies. MAIN MESSAGE: Although children are influenced by similar factors and need to work through the s...

  16. Resource utilization in children with tuberous sclerosis complex and associated seizures: a retrospective chart review study.

    Science.gov (United States)

    Lennert, Barb; Farrelly, Eileen; Sacco, Patricia; Pira, Geraldine; Frost, Michael

    2013-04-01

    Seizures are a hallmark manifestation of tuberous sclerosis complex, yet data characterizing resource utilization are lacking. This retrospective chart review was performed to assess the economic burden of tuberous sclerosis complex with neurologic manifestations. Demographic and resource utilization data were collected for 95 patients for up to 5 years after tuberous sclerosis complex diagnosis. Mean age at diagnosis was 3.1 years, with complex partial and infantile spasms as the most common seizure types. In the first 5 years post-diagnosis, 83.2% required hospitalization, 30.5% underwent surgery, and the majority of patients (90.5%) underwent ≥3 testing procedures. In 79 patients with a full 5 years of data, hospitalizations, intensive care unit stays, diagnostic testing, and rehabilitation services decreased over the 5-year period. Resource utilization is cost-intensive in children with tuberous sclerosis complex and associated seizures during the first few years following diagnosis. Improving seizure control and reducing health care costs in this population remain unmet needs.

  17. A retrospective chart review to identify perinatal factors associated with food allergies.

    Science.gov (United States)

    Dowhower Karpa, Kelly; Paul, Ian M; Leckie, J Alexander; Shung, Sharon; Carkaci-Salli, Nurgul; Vrana, Kent E; Mauger, David; Fausnight, Tracy; Poger, Jennifer

    2012-10-19

    Gut flora are important immunomodulators that may be disrupted in individuals with atopic conditions. Probiotic bacteria have been suggested as therapeutic modalities to mitigate or prevent food allergic manifestations. We wished to investigate whether perinatal factors known to disrupt gut flora increase the risk of IgE-mediated food allergies. Birth records obtained from 192 healthy children and 99 children diagnosed with food allergies were reviewed retrospectively. Data pertaining to delivery method, perinatal antibiotic exposure, neonatal nursery environment, and maternal variables were recorded. Logistic regression analysis was used to assess the association between variables of interest and subsequent food allergy diagnosis. Retrospective investigation did not find perinatal antibiotics, NICU admission, or cesarean section to be associated with increased risk of food allergy diagnosis. However, associations between food allergy diagnosis and male gender (66 vs. 33; p=0.02) were apparent in this cohort. Additionally, increasing maternal age at delivery was significantly associated with food allergy diagnosis during childhood (OR, 1.05; 95% CI, 1.017 to 1.105; p=0.005). Gut flora are potent immunomodulators, but their overall contribution to immune maturation remains to be elucidated. Additional understanding of the interplay between immunologic, genetic, and environmental factors underlying food allergy development need to be clarified before probiotic therapeutic interventions can routinely be recommended for prevention or mitigation of food allergies. Such interventions may be well-suited in male infants and in infants born to older mothers.

  18. Prevalence of oral lichen planus in Iranian children and adolescents: a 12-year retrospective study.

    Science.gov (United States)

    Bakhtiari, S; Taheri, J B; Toossi, P; Azimi, S; Kawosi Nezhad, Sh

    2017-12-01

    To investigate the prevalence of oral lichen planus in patients younger than 18 years, referred to a dermatology centre in Iran during 2002-2014. Lichen planus is a chronic inflammatory, immune-mediated disease that could affect the oral mucosa and is a pre-cancerous condition. The disease usually develops in middle age with female predominance and is rare in children. In this retrospective study, cases with definitive histopathologic diagnosis of lichen planus, over a 12-year period from 2002 to 2014 from a dermatologic hospital archive were evaluated. The prevalence of both cutaneous and oral lichen planus, the male:female ratio and site of involvement were calculated using SPSS version 21. Thirty-six of 564 patients younger than 18 years old diagnosed with lichen planus. Two females (0.4%) had oral lichen planus. One patient had erosive, and one had bullous, oral lichen planus. Oral lichen planus had a very low frequency in Iranian population younger than 18 years old, identifying these patients is recommended for long-term follow-up.

  19. Clinical relevance and cost-effectiveness of HLA genotyping in children with Type 1 diabetes mellitus in screening for coeliac disease in the Netherlands

    NARCIS (Netherlands)

    Elias, J.; Hoorweg-Nijman, J. J. G.; Balemans, W. A.

    2015-01-01

    To investigate the clinical relevance and cost-effectiveness of human leukocyte antigen (HLA)-genotyping in the Netherlands as a screening tool for the development of coeliac disease in children with Type 1 diabetes mellitus. A retrospective analysis was performed in 110 children with Type 1

  20. Cost-analysis of an oral health outreach program for preschool children in a low socioeconomic multicultural area in Sweden

    DEFF Research Database (Denmark)

    Wennhall, Inger; Norlund, Anders; Matsson, Lars

    2010-01-01

    to a comprehensive oral health outreach project for preschool children conducted in a low-socioeconomic multi-cultural urban area. The outcome was compared with historical controls from the same area with conventional dental care. The cost per minute for the various dental professions was added to the cost......The aim was to calculate the total and the net costs per child included in a 3-year caries preventive program for preschool children and to make estimates of expected lowest and highest costs in a sensitivity analysis. The direct costs for prevention and dental care were applied retrospectively...... of materials, rental facilities and equipment based on accounting data. The cost for fillings was extracted from a specified per diem list. Overhead costs were assumed to correspond to 50% of salaries and all costs were calculated as net present value per participating child in the program and expressed...

  1. Colorectal cancer with intestinal perforation – a retrospective analysis of treatment outcomes

    Science.gov (United States)

    Woda, Łukasz; Tojek, Krzysztof; Jarmocik, Paweł; Jawień, Arkadiusz

    2014-01-01

    Aim of the study Colorectal cancer (CRC) is one of the leading cause of death in European population. It progresses without any symptoms in the early stages or those clinical symptoms are very discrete. The aim of this study was a retrospective analysis of treatment outcomes in patients with colorectal cancer complicated with intestinal perforation. Material and methods A retrospective analysis of patients urgently operated upon in our Division of General Surgery, because of large intestine perforation, from February 1993 to February 2013 has been made. Results were compared with a group of patients undergoing the elective surgery for colorectal cancer in the same time and Division. Results Intestinal perforation occurred more often in males (6.52% vs. 6.03%), patients with mucous component in histopathological examination (9.09% vs. 6.01%) and with clinicaly advanced CRC. Patients treated because of perforation had a five-fold higher 30 day mortality rate (9.09% vs. 1.83%), however long-term survival did not differ significantly in both groups. After resectional surgery in 874 patients an intestinal anastomosis was made. Anastomotic leakage was present in 23 (2.6%) patients. This complication occurred six-fold more frequently in a group of patients operated upon because of intestinal perforation (12.20% vs. 2.16%). Conclusions In patients with CRC complicated with perforation of the colon in a 30-day observation significantly higher rate of complications and mortality was shown, whereas there was no difference in distant survival rates. PMID:25784840

  2. Treatment of penetrating hepatic injuries: a retrospective analysis of 50 patients.

    Science.gov (United States)

    Gonullu, D; Koksoy, F N; Ilgun, S; Demiray, O; Yucel, O; Yucel, T

    2009-01-01

    The aim of this study was to determine the possibility of non-operative treatment via retrospective analysis of our patients. Fifty patients with penetrating hepatic injuries were examined retrospectively with respect to trauma scores, associated injuries, complications, and mortality parameters. Thirteen injuries were caused by firearms, whereas 37 injuries were caused by stab wounds. Forty-three patients (86%) underwent laparotomy and 7 patients (14%) were monitored by CT and clinical findings (nonoperative group, NO group). The laparotomies were evaluated as non-therapeutic in 11 patients (22%) (NTL group) and therapeutic in 32 patients (64%) (TL group). The morbidity and mortality rates were 40 and 10%, respectively. RTS and ISS scores of the nonsurviving and the surviving patients were significantly different. The rates of major venous, grade IV-V hepatic injuries, and gunshot wounds were significantly higher in the nonsurviving patients when compared to the surviving patients. Major venous and grade IV-V hepatic injuries were the primary factors determining mortality and these injuries generally occurred as a result of firearm injuries. NTL occurring at a rate of 22% would decrease to 2% if 'RTS <7' criteria was added to the hemodynamic instability and/or peritoneal irritation findings determining surgical candidacy. Copyright 2009 S. Karger AG, Basel.

  3. [Analysis of related factors of recurrent otitis media with effusion in children].

    Science.gov (United States)

    Zhu, Z; Zheng, G X; Li, Q; Shi, Q L; Zhou, H G; Fang, R P

    2017-08-05

    Objective: To investigate the influencing factors of recurrent episodes of otitis media with effusion in children. Method: A retrospective summary of the clinical data of 210 cases of children with otitis media with effusion, 75 cases of recurrence after treatment, 135 cases were recovered, the recurrence of the related factors and after symptomatic treatment effect is analyzed. Result: Logistic regression analysis results found that adenoid hypertrophy (Ⅲ°, Ⅳ°), tonsil hypertrophy (Ⅳ°) and sinusitis (including choanal polyp), a positive allergens, upper respiratory tract infection, the stomach esophagus regurgitation, cleft palate, younger age has significant effect on recurrence of otitis media with effusion, have significant difference ( P gender, passive smoking history and previous medical history of otitis media with effusion has no obvious statistical significance ( P > 0.05). Through the comparison among different age groups, adenoidectomy Ⅲ °, Ⅳ ° hypertrophy tract infections in > 3-6 years old group has significant effect ( P 3-6 years OME recurrence has significant effect ( P different conditions to take symptomatic treatment, 75 cases (123 ears) were cured 96 ears (78.05%), 19 ears were improved (15.45%), the total effective rate was 93.50%, ineffective in 8 ears (6.50%). Conclusion: Adenoid hypertrophy (Ⅲ°, Ⅳ°), tonsil hypertrophy (Ⅳ°), sinusitis, nasal polyps, allergic diseases and upper respiratory tract infection gastroesophageal reflux, cleft palate and younger age may be adverse factors related to recurrent otitis media with effusion in children, the clinical doctors should pay attention to these symptoms, according to different causes, adopt individualized treatment plan, make children get the best treatment as soon as possible. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

  4. A retrospective case report on demographic changes of learners at a school for children with Autism Spectrum Disorder in the Gauteng Province

    Directory of Open Access Journals (Sweden)

    Sumari van Biljon

    2015-09-01

    Full Text Available Limited research has been published about the demographic characteristics of children with Autism Spectrum Disorder (ASD in South Africa. Describing the profiles of learners from a school for children with ASD may contribute to local knowledge in the field. A retrospective comparative design was utilised to compare the demographic characteristics of learners over two time intervals: 1992-2002 (Group 1, n=32 and 2003-2014 (Group 2, n=109. A total of 141 historical admission records in paper-based files were reviewed. Results indicated that there is a large male gender bias (8.4:1 in learners, which increased over the years. The age of the child when parents first became concerned and the age at diagnosis and assessment at school increased over both time periods. There was also an increase in the diversity of home languages after 2002. Parental qualifications decreased, but social class improved in recent years. The low qualification of a mother was associated with an advanced age of the child at school entry. The data serves as a point of reference for future studies about the characteristics of school children with ASD in South Africa.

  5. Analysis of the factors affecting the occurrence of myopia in children with myopia

    Directory of Open Access Journals (Sweden)

    Can Zhao

    2017-10-01

    Full Text Available AIM: To analyze the electronic product use time, writing time, playing piano time and outdoor activity time and the distribution of myopia in 586 cases of school age children in our hospital. METHODS: A retrospective analysis of 586 cases of children aged 6 to 12 years old in the outpatient department was established. Personalized files were used to record the uncorrected visual acuity, optometry, slit lamp, fundus mirror and strabismus. The cumulative use time of electronic products(including computer, mobile phone, iPad, writing time, whether to play the piano and outdoor activities time with the eye situation were recorded. Statistical analysis of the age group of myopia, the cumulative use of electronic age in different age groups, writing time, whether playing piano and outdoor activities and the distribution of myopia occurred.RESULTS:(1With the increasing of age, the distribution of uncorrected eyesight was in children mostly mild myopia, and the proportion of mild myopia was significantly higher than that of moderate and high myopia.(2Electronic products use time distribution: the proportion of playing electronic products(including mobilephone, computers, iPadaccounted for 76.8%, of which 9 years old, 10 years old the cumulative use of electronic products with a long time was higher than other age groups.(3Distribution of writing time: the proportion of write homework ≤1h was significantly lower than the proportion of writing homework> 1h(37.2% vs 62.8%, of which 9 and 10 years old children cumulative write time was higher than other age group.(4Distribution of playing the piano: the proportion of playing piano time less than 1h was significantly higher than the proportion of playing piano time more than 1h(89.1% vs 10.9%.(5Distribution of outdoor activities: the proportion of outdoor activities ≤1h in children at school age was significantly higher than that of outdoor activities > 1h(91.8% vs 8.9%. CONCLUSION: With the age exposure

  6. Clinical Presentation and Treatment Outcome of Sleeping Sickness in Sudanese Pre-School Children.

    OpenAIRE

    Eperon, G; Schmid, C; Loutan, L; Chappuis, F

    2007-01-01

    BACKGROUND: Existing data on human African trypanosomiasis (HAT) due to Trypanosoma brucei gambiense among children are limited. Here, we described the demographic, clinical, diagnostic, treatment and outcome characteristics of HAT in pre-school children from Kajo-Keji County, South Sudan in comparison with older patients. METHODS: We did a retrospective analysis of HAT patients treated at the Kiri Sleeping Sickness Treatment Centre (SSTC), Kajo-Keji County, from June 2000 to December 2002. R...

  7. Variation among cleft centres in the use of secondary surgery for children with cleft palate: a retrospective cohort study

    Science.gov (United States)

    Sitzman, Thomas J; Hossain, Monir; Carle, Adam C; Heaton, Pamela C; Britto, Maria T

    2017-01-01

    Objectives To test whether cleft centres vary in their use of secondary cleft palate surgery, also known as revision palate surgery, and if so to identify modifiable hospital factors and surgeon factors that are associated with use of secondary surgery. Design Retrospective cohort study. Setting Forty-three paediatric hospitals across the USA. Patients Children with cleft lip and palate who underwent primary cleft palate repair from 1999 to 2013. Main outcome measures Time from primary cleft palate repair to secondary palate surgery. Results We identified 4939 children who underwent primary cleft palate repair. At 10 years after primary palate repair, 44% of children had undergone secondary palate surgery. Significant variation existed among hospitals (ppalate repair before 9 months of age was associated with an increased hazard of secondary palate surgery (initial HR 6.74, 95% CI 5.30 to 8.73). Postoperative antibiotics, surgeon procedure volume and hospital procedure volume were not associated with time to secondary surgery (p>0.05). Of the outcome variation attributable to hospitals and surgeons, between-hospital differences accounted for 59% (ppalate surgery exists depending on a child’s age at primary palate repair and the hospital and surgeon performing their repair. Performing primary palate repair before 9 months of age substantially increases the hazard of secondary surgery. Further research is needed to identify other factors contributing to variation in palate surgery outcomes among hospitals and surgeons. PMID:29479567

  8. Cost analysis of substitutive renal therapies in children.

    Science.gov (United States)

    Camargo, Maria Fernanda Carvalho de; Barbosa, Klenio de Souza; Fetter, Seiji Kumon; Bastos, Ana; Feltran, Luciana de Santis; Koch-Nogueira, Paulo Cesar

    End-stage renal disease is a health problem that consumes public and private resources. This study aimed to identify the cost of hemodialysis (either daily or conventional hemodialysis) and transplantation in children and adolescents. This was a retrospective cohort of pediatric patients with End-stage renal disease who underwent hemodialysis followed by kidney transplant. All costs incurred in the treatment were collected and the monthly total cost was calculated per patient and for each renal therapy. Subsequently, a dynamic panel data model was estimated. The study included 30 children who underwent hemodialysis (16 conventional/14 daily hemodialysis) followed by renal transplantation. The mean monthly outlay for hemodialysis was USD 3500 and USD 1900 for transplant. Hemodialysis costs added up to over USD 87,000 in 40 months for conventional dialysis patients and USD 131,000 in 50 months for daily dialysis patients. In turn, transplant costs in 50 months reached USD 48,000 and USD 70,000, for conventional and daily dialysis patients, respectively. For conventional dialysis patients, transplant is less costly when therapy exceeds 16 months, whereas for daily dialysis patients, the threshold is around 13 months. Transplantation is less expensive than dialysis in children, and the estimated thresholds indicate that renal transplant should be the preferred treatment for pediatric patients. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  9. Street children and political violence: a socio-demographic analysis of street children in Rwanda.

    Science.gov (United States)

    Veale, Angela; Donà, Giorgia

    2003-03-01

    The aims were: (1) to examine the profile of African street children and to assess the link between street children in Africa and political violence; (2) to undertake a systematic examination of causal factors of street children in postgenocide Rwanda; and (3) to situate this analysis in the context of the socio-cultural and political impact of the genocide on Rwandan communities. Observational mapping examined the profile and activities of Rwandan street children. Structured interviews were carried out with 290 children in four regional towns to obtain information on socio-demographic, familial, educational background, causal factors surrounding street life involvement, psychological well-being, and relationship to the street. Focus group discussions and key informant interviews examined the relationship between street children and the broader Rwandan society. Street children in Rwanda were predominantly adolescent boys, almost half of whom were homeless (42%), with a high proportion of orphaned children or children who had lost at least one parent. Two variables predicted homelessness: child's guardian and reason for being in street. Qualitative accounts of children conveyed the impact of death of family members, repatriation, imprisonment of parents, and poverty on their lives. The analysis highlighted the need for community based support for children in alternative guardianship care and for policies to support the reintegration of male youths in postconflict welfare strategies as prevention strategies for street migration.

  10. Treatment of convulsive status epilepticus in the UMCG: A retrospective, observational study

    NARCIS (Netherlands)

    Vlaskamp, D.R.M.; Brouwer, O.F.; Callenbach, P.M.C.

    2013-01-01

    Objectives: Little is known about clinical practice with respect to the application of guidelines in the treatment of Convulsive Status Epilepticus (CSE). This retrospective, observational study evaluated treatment of episodes of CSE in children at the University Medical Centre Groningen (UMCG).

  11. ANTI-CYTOKINE THERAPY FOR CHILDREN WITH INFLAMMATORY BOWEL DISEASES

    Directory of Open Access Journals (Sweden)

    A.S. Potapov

    2009-01-01

    Full Text Available The article describes the findings of a pilot research devoted to the estimation of the efficiency of a therapy with TNF α inhibitors for children with inflammatory bowel diseases. Methods: we carried out the retrospective analysis for a therapy with Infliximab in 15 children with a nonspecific ulcerative colitis and Сrohn's disease. Results: 66% of the children with inflammatory bowel diseases react to the first injection of Infliximab, whereas 13% of the children demonstrate a clinical remission of their diseases. After the third injection, a positive response to the used therapy is shown by 60% of the children with inflammatory bowel diseases, and 33% of the children are diagnosed with a clinical remission. Conclusion: The use of Infliximab allowed the children with a refractory course of nonspecific ulcerative colitis and Сrohn's disease to make their inflammation significantly less active and improve the quality of their life.Key words: nonspecific ulcerative colitis, Сrohn's disease, treatment, TNF α inhibitors, children

  12. Familial correlates of social anxiety in children and adolescents.

    Science.gov (United States)

    Bögels, S M; van Oosten, A; Muris, P; Smulders, D

    2001-03-01

    Retrospective studies suggest a relationship between parental rearing practices and social phobia. The present study investigated whether socially anxious children perceive their current parental rearing as rejecting, overprotective, and lacking emotional warmth, and as emphasizing the importance of other's opinion, and de-emphasizing social initiatives and family sociability. Furthermore, we examined whether parents of socially anxious children report to rely on such rearing practices, and suffer themselves from social fears. A regression analysis as well as extreme group comparisons were applied. Little support was found for the presumed role of the assessed family rearing aspects in the development of social anxiety in children. Solely family sociability (children's and mothers' report) and children's perception of overprotection of the mother predicted social anxiety in the regression analysis. Given the influence of the mentioned rearing practices, social anxiety of the mother still significantly predicted social anxiety of the child. In the extreme group comparisons, differences in the expected direction were found between socially anxious and normal children on parental rejection, emotional warmth, and family sociability. However, the lack of differences between socially anxious and clinical control children suggests that these variables do not form a specific pathway to social fears.

  13. The Prospective and Retrospective Memory Questionnaire (PRMQ): latent structure, normative data and discrepancy analysis for proxy-ratings.

    Science.gov (United States)

    Crawford, John R; Henry, Julie D; Ward, Aileen L; Blake, John

    2006-03-01

    To evaluate the proxy-rating version of the Prospective and Retrospective Memory Questionnaire (PRMQ) and provide norms and methods for score interpretation. Cross-sectional and correlational. The PRMQ was administered to a large sample drawn from the general adult population (N=570). Confirmatory factor analysis (CFA) was used to test competing models of its latent structure. Various psychometric methods were applied to provide clinicians with tools for score interpretation. The CFA model with optimal fit specified a general memory factor together with additional prospective and retrospective factors. The reliabilities of the PRMQ were acceptable (.83 to .92), and demographic variables did not influence ratings. Tables are presented for conversion of raw scores on the Total scale and Prospective and Retrospective scales to T scores. In addition, tables are provided to allow users to assess the reliability and abnormality of differences between proxy ratings on the Prospective and Retrospective scales. Finally, tables are also provided to compare proxy-ratings with self-ratings (using data from the present sample and self-rating data from a previous study). The proxy-rating version of the PRMQ provides a useful measure of everyday memory for use in clinical research and practice.

  14. Treatment outcomes of severe acute malnutrition in children treated within Outpatient Therapeutic Program (OTP) at Wolaita Zone, Southern Ethiopia: retrospective cross-sectional study.

    Science.gov (United States)

    Kabalo, Mulugeta Yohannis; Seifu, Canaan Negash

    2017-03-09

    Children in third world countries suffer from severe acute malnutrition (SAM) in an extent of public health important. SAM management protocol available this time brought the approach from facility-based to community-based by Outpatient Therapeutic Program (OTP). But, little was known about the treatment outcomes of the program in Ethiopia. Thus, this study was aimed to assess treatment outcomes of SAM and identify factors associated among children treated at OTP in Wolaita Zone. A retrospective facility-based cross-sectional study was conducted in OTP records of 794 children, treated at 24 health posts retrieved from January to December 2014. Population proportion to size (PPS) was used to allocate sample for each selected district and OTP sites within district. Individual cards of children were selected by systematic random sampling. Data were entered, thoroughly cleaned, and analyzed in SPSS version 20. The recovery rate was revealed as 64.9% at 95% CI (61, 68). Death rate, default rate, weight gain, and length of stay were 1.2%, 2.2%, 4.2 g/kg/day, and 6.8 weeks respectively. Children living in children residing in ≥25 min (AOR = 1.53 at 95% CI (1.11, 2.12)). The likelihood of recovery was 2.6 times higher for children with kwashiorkor than for those with marasmus (AOR = 2.62 at 95% CI (1.77, 3.89)). Likewise, children provided with amoxicillin were 1.52 times more likely to recover compared to their counterparts (AOR = 1.52 at 95% CI (1.09, 2.11)). The recovery rate and weight gain were lower than sphere standard. Distance from OTP, provision of amoxicillin, and type of malnutrition were factors identified as significantly associated with treatment outcome of SAM. Building capacity of OTP service providers and regular monitoring of service provision based on the management protocol were recommended.

  15. Expert Coaching in Weight Loss: Retrospective Analysis.

    Science.gov (United States)

    Painter, Stefanie Lynn; Ahmed, Rezwan; Kushner, Robert F; Hill, James O; Lindquist, Richard; Brunning, Scott; Margulies, Amy

    2018-03-13

    Providing coaches as part of a weight management program is a common practice to increase participant engagement and weight loss success. Understanding coach and participant interactions and how these interactions impact weight loss success needs to be further explored for coaching best practices. The purpose of this study was to analyze the coach and participant interaction in a 6-month weight loss intervention administered by Retrofit, a personalized weight management and Web-based disease prevention solution. The study specifically examined the association between different methods of coach-participant interaction and weight loss and tried to understand the level of coaching impact on weight loss outcome. A retrospective analysis was performed using 1432 participants enrolled from 2011 to 2016 in the Retrofit weight loss program. Participants were males and females aged 18 years or older with a baseline body mass index of ≥25 kg/m², who also provided at least one weight measurement beyond baseline. First, a detailed analysis of different coach-participant interaction was performed using both intent-to-treat and completer populations. Next, a multiple regression analysis was performed using all measures associated with coach-participant interactions involving expert coaching sessions, live weekly expert-led Web-based classes, and electronic messaging and feedback. Finally, 3 significant predictors (Pcoaching session attendance (Pcoaching sessions, attending 60% of live weekly Web-based classes, and receiving a minimum of 1 food log feedback day per week were associated with clinically significant weight loss. Participant's one-on-one expert coaching session attendance, live weekly expert-led interactive Web-based class attendance, and the number of food log feedback days per week from expert coach were significant predictors of weight loss in a 6-month intervention. ©Stefanie Lynn Painter, Rezwan Ahmed, Robert F Kushner, James O Hill, Richard Lindquist, Scott

  16. Imaging in acute renal infection in children

    International Nuclear Information System (INIS)

    Sty, J.R.; Wells, R.G.; Starshak, R.J.; Schroeder, B.A.

    1987-01-01

    Infection is the most common disease of the urinary tract in children, and various imaging techniques have been used to verify its presence and location. On retrospective analysis, 50 consecutive children with documented upper urinary tract infection had abnormal findings on renal cortical scintigraphy with 99mTc-glucoheptonate. The infection involved the renal poles only in 38 and the poles plus other renal cortical areas in eight. Four had abnormalities that spared the poles. Renal sonograms were abnormal in 32 of 50 children. Excretory urograms were abnormal in six of 23 children in whom they were obtained. Vesicoureteral reflux was found in 34 of 40 children in whom voiding cystourethrography was performed. These data show the high sensitivity of renal cortical scintigraphy with 99mTc-glucoheptonate in documenting upper urinary tract infection. The location of the abnormalities detected suggests that renal infections spread via an ascending mode and implies that intrarenal reflux is a major contributing factor

  17. Retrospective Cohort Study of Effectiveness and Safety of Adalimumab Use in Children with Juvenile Idiopathic Arthritis in the Republic of Bashkortostan

    Directory of Open Access Journals (Sweden)

    V. A. Maliyevskiy

    2015-01-01

    Full Text Available Background: Methotrexate is the first-line drug for treating patients with juvenile idiopathic arthritis (JIA. If it is ineffective or intolerable, prescription of genetically engineered biopharmaceuticals is indicated. Objective: The study was aimed at assessing effectiveness and safety of genetically engineered biopharmaceutical adalimumab for treating children with JIA. Methods: A retrospective cohort study was conducted to analyze results of treating patients with JIA aged 2–17 years. Adalimumab would be prescribed biweekly in the dose of 24 mg/m2 (body surface subcutaneously (if body weight is under 30 kg or in the dose of 40 mg/m2 (if body weight is > 30 kg. Effectiveness and safety would be assessed after 4–12–24–48–96 weeks. Results: We analyzed treatment results of 17 patients (15 children with active joint syndrome, 2 — with active uveitis. All patients with active joint syndrome had been receiving adalimumab for 12 weeks, 12 patients — for 24 weeks, 8 — for 48 weeks, 5 — for 96 weeks. 30/50/70% improvement in terms of the ACRpedi criteria was observed in 15/11/4 children after 4 weeks, after 12 weeks — in 15/13/11 patients, after 48 weeks — in 7/6/6 patients. The status of inactive disease was established in 5 patients (33% after 12 weeks, after 24 weeks — in 9 children (75%, after 48 weeks — in 7 children (70%, after 96 weeks — in 4 (80% children. Active uveitis was terminated in all 5 patients with signs of eye damage in the treatment onset. 1 patient suffered from exacerbation of the disease after 48 weeks of therapy; the drug was withdrawn. Tubercular infection without local manifestations was established in 1 patient after 96 weeks (positive Mantoux test, papule — 10 mm. Adalimumab injection was terminated for the period of chemotherapy. Conclusion: Adalimumab has a sufficiently high effectiveness and safety for long-term (up to 2 years treatment of children with JIA. 

  18. [Clinical manifestation of Lyme borreliosis in children with positive and negatiwe western blot results].

    Science.gov (United States)

    Ołdak, Elzbieta; Rozkiewicz, Doroto; Sulik, Artur

    2008-01-01

    In the afforested area of North-Eastern Poland the risk of Borrelia burgdorferi infection seems to be higher compared to the other regions. Because of unspecific clinical manifestation of Lyme borreliosis in children the positive ELISA IgM results should be confirmed with Western blot IgM tests. Retrospective analysis of clinical signs and symptoms of Lyme borreliosis in children with positive ELISA IgM and positive Western blot IgM results and in children with positive ELISA IgM and negative Western blot IgM results. The study included 20 children reactive with ELISA IgM (Bellco Biomedica, Austria), hospitalized in Pediatric Infectious Diseases Clinic in 2007 due to probable diagnosis of Lyme disease. All children were tested with B. burgdorferi Western blot IgM and/or IgG assay (DRG, Diagnostics, Germany) as a second-step diagnosis. In 10 (50% females, 50% males) out of 20 children the results were positive (borreliosis) and in other 10 (80% females, 20% males) the results were negative (controls). In both groups of patients the retrospective analysis of signs and symptoms was done. The most often clinical manifestation of Lyme borreliosis in children was neuroborreliosis. Children presented Lyme meningitis (30%), facial nerve palsy (10%) and chronic or recurrent headaches (40%), associated with vertigo (20%), weakness (30%), fever (40%), and fatigue syndrome (30%). One patient presented Lyme arthritis. Children of control group presented with unspecific symptoms like isolated headaches (40%), arthralgias (70%), myalgias (10%) and abdomen pain (20%) (1) The most frequent clinical presentation of Lyme borreliosis in analyzed children was neuroborreliosis; (2) Isolated arthralgias in children reactive with B. burgdorferi ELISA IgM need to be confirmed with Western blot assay before implementing the antibiotic therapy.

  19. Spinal cord gliomas: A multi-institutional retrospective analysis

    International Nuclear Information System (INIS)

    Abdel-Wahab, May; Etuk, Blessing; Palermo, James; Shirato, Hiroki; Kresl, John; Yapicier, Ozlem; Walker, Gail; Scheithauer, Bernd W.; Shaw, Edward; Lee, Charles; Curran, Walter; Thomas, Terry; Markoe, Arnold

    2006-01-01

    Purpose: To determine the impact of postoperative radiation therapy (POXRT) on outcome in spinal cord gliomas. Patients and Methods: Data from 242 patients were collected retrospectively from six institutions using a standardized data sheet. Pathology specimens, when available, were centrally reviewed. Results: A total of 183 patients were analyzed: 82 received surgery alone as initial treatment, whereas 101 had surgery and POXRT. Demographic, diagnostic, and treatment factors were analyzed for impact on progression-free (PFS) and overall survival (OS). PFS in ependymoma patients was 74%, 60%, and 35% at 5, 10, 15 years, respectively, and was significantly influenced by treatment type, race, age, tumor grade, and type of surgery on univariate analysis, with age being the only significant factor on multivariate analysis (MVA) (p = 0.01). OS of ependymoma patients was 91%, 84%, and 75% at 5, 10, and 15 years, respectively, and was significantly influenced by both complete resection (p = 0.04) and age (p = 0.03) on MVA. In astrocytomas, PFS was 42%, 29%, and 15% at 5, 10, and 15 years, and was significantly influenced by POXRT in low- and intermediate-grade tumors on MVA (p = 0.02). OS at 5, 10, and 15 years was 59%, 53%, and 32%, respectively, and was significantly influenced by grade on MVA (p < 0.01). Conclusion: Postoperative radiation therapy reduced disease progression in low- and moderate-grade astrocytomas. In ependymomas, complete resection significantly influenced OS

  20. Outcome in acromegaly: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Debmalya Sanyal

    2012-01-01

    Full Text Available Introduction: Many of the treatment modalities recommended for acromegaly are either too expensive or not available in large parts of India. There is a dearth of treatment and outcome data in Indian patients. Aims and Objectives: The purpose of this study was to analyze the treatment modalities used and the respective outcomes which include remission, recurrence, hypopituitarism, other complications, and mortality. Materials and Methods: This is a retrospective data analysis of 15 acromegaly patients treated at a tertiary care hospital in eastern India. A remission criteria of nadir growth hormone level <1 μg/dl after Oral Glucose tolerance test (OGTT and normal age related IGF-1 levels was used. Results: All patients (100% had macroadenomas. Surgery could not be done in five (33%; three (19.8% refused, two (13.2% had comorbidities. Transsphenoidal surgery (TSS achieved remission in four out of ten (40%. Conventional radiotherapy (CRT failed in all five patients and caused hypopituitarisn in three (60%. Cabergoline (CAB either alone or following surgery achieved remission in one out of four (25% though symptomatic relief and tolerability were remarkable. One patient (7% had pituitary apoplexy with remission, two patients (14.3% died due to CVA. Conclusions: TSS remains the treatment of choice in acromegaly, though in macroadenomas the success is limited. A sizeable proportion of patients refuse or are unfit for surgery. As most of the recommended options are very costly or unavailable, alternative treatment options generally used are CRT or CAB which have limited efficacy. Incidence of hypopituitarism, following CRT is very high.

  1. Outcome of 132 consecutive reconstructive operations for intestinal fistula--staged operation without primary anastomosis improved outcome in retrospective analysis

    DEFF Research Database (Denmark)

    Runström, B; Hallböök, O; Nyström, P O

    2013-01-01

    AIM: To study factors that influenced healing and survival after attempted closure of enterocutaneous fistula. MATERIAL AND METHODS: Retrospective analysis of prospective data concerning 101 patients operated on 132 instances for 110 enterocutaneous fistulae at two hospitals. RESULTS: In all, 96 ...... is a negative factor that requires careful planning of the operation.......AIM: To study factors that influenced healing and survival after attempted closure of enterocutaneous fistula. MATERIAL AND METHODS: Retrospective analysis of prospective data concerning 101 patients operated on 132 instances for 110 enterocutaneous fistulae at two hospitals. RESULTS: In all, 96...... (87%) of the 110 fistulae healed and 92 (91%) patients survived. A total of 9 patients with unhealed fistula died. Multivariate analysis revealed jaundice as an independent factor for both death and failed closure and operation without anastomosis as an independent positive factor for healing. Failure...

  2. A Retrospective Analysis of Pediatric Patients Admitted to the Pediatric Emergency Service for Carbon Monoxide Intoxication

    Directory of Open Access Journals (Sweden)

    Metin Uysalol

    2011-09-01

    Full Text Available Objective: The aim of the study is to analyze the general aspects of cases with carbon monoxide intoxication in order to improve the approach to future patients. Material and Methods: The hospital records of 84 children (mean age 4.71±2.64 years; 48 male, 36 female who had been admitted to Paediatric Emergency Department for carbon monoxide intoxication between October 2007 and February 2009, were retrospectively evaluated in a descriptive analysis.Results: The source of carbon monoxide intoxication was heaters, waterheaters and fi re in 82.1%, 7.1% and 6% of cases, respectively. There was a statistically signifi cant difference between the carboxyhemoglobin levels of the patients according to the clinical classifi cation (p<0.05. The intoxication caused by heaters was observed signifi cantly in November, December and January (p<0.001, between 16:00-24:00 hours (p<0.001 and among more than one member of a family (p<0.001. A medium level correlation was detected between the treatment approach and clinical classifi cation (r=0.50, p<0.001. Conclusion: Carbon monoxide intoxication, in the presented series, was found to develop accidentally; mostly in the Winter season; during night hours when the family members gathered together. The carboxyhemoglobin levels were appropriate with the developing clinical findings. Carboxyhemoglobin level solely was not enough for achieving the diagnosis and planning the treatment.

  3. A retrospective study on traumatic dental and soft-tissue injuries in preschool children in Zagreb, Croatia.

    Science.gov (United States)

    Vuletić, Marko; Škaričić, Josip; Batinjan, Goran; Trampuš, Zdenko; Čuković Bagić, Ivana; Jurić, Hrvoje

    2014-02-01

    The purpose of this study was to analyze data according to gender, age, cause, number of traumatized teeth, time elapsed before treatment and type of tooth from the records of traumatized children. A retrospective study was conducted in the Department of Paediatric Dentistry at the University Dental Clinic in Zagreb, Croatia using the documentation of 128 patients (61 males and 67 females) aged 1 month to 6 years with injuries of primary teeth between February 2009 and January 2013. Trauma was seen in 217 primary teeth, which implies that the number of injured primary teeth was 1.69 per child. The maxillary central incisors were the most frequently affected teeth (81.1%), they were followed by maxillary lateral incisors, while the least affected were mandibular central incisors. Traumatic dental injuries involved periodontal tissue 2.82 times more frequently than hard dental and pulp tissue. The main cause of teeth injury was fall (67.2%) and the majority of injuries occurred at home (51.6%) (p<0.05). Of 128 patients who received treatment 71 (55.5%) also had soft-tissue injuries. The distribution of soft-tissue injuries by gender (35 males, 36 females) was not statistically significant. Comparing children with soft-tissue injuries and those without them, a statistically significant difference was found in the time of arrival (p<0.01). The results of this study showed the need of informing about preventive measures against falls at home and the methods of providing first aid in dental trauma injuries.

  4. Retrospective mutational analysis of NPHS1, NPHS2, WT1 and LAMB2 in children with steroid-resistant focal segmental glomerulosclerosis – a single-centre experience

    Directory of Open Access Journals (Sweden)

    Agnieszka Bińczak-Kuleta

    2015-05-01

    Full Text Available The aim of our study was to examine NPHS1, NPHS2, WT1 and LAMB2 mutations, previously reported in two thirds of patients with nephrotic syndrome with onset before the age of one year old. Genomic DNA samples from Polish children (n=33 with Steroid-ResistantNephrotic Syndrome (SRNS due to focal segmental glomerulosclerosis (FSGS, manifesting before the age of 13 years old, underwent retrospective analysis of NPHS1, NPHS2, WT1 (exons 8, 9 and adjacent exon/intron boundaries and LAMB2. No pathogenic NPHS1 or LAMB2 mutations were found in our FSGS cohort. SRNS-causing mutations of NPHS2 and WT1 were detected in 7 of 33 patients (21%, including those with nephrotic syndrome manifesting before one year old: five of seven patients. Four patients had homozygous c.413G>A (p.Arg138Gln NPHS2 mutations; one subject was homozygous for c.868G>A (p.Val290Met NPHS2. A phenotypic female had C>T transition at position +4 of the WT1 intron 9 (c.1432+4C>T splice-donor site, and another phenotypic female was heterozygous for G>A transition at position +5 (c.1432+5G>A. Genotyping revealed a female genotypic gender (46, XX for the first subject and male (46, XY for the latter. In addition, one patient was heterozygous for c.104dup (p.Arg36Profs*34 NPHS2; two patients carried a c.686G>A (p.Arg229Gln NPHS2 non-neutral variant. Results indicate possible clustering of causative NPHS2 mutations in FSGS-proven SRNS with onset before age one year old, and provide additional evidence that patients with childhood steroid-resistant nephrotic syndrome due to focal segmentalglomerulosclerosis should first undergo analysis of NPHS2 coding sequence and WT1 exons 8 and 9 and surrounding exon/intron boundary sequences, followed by gender genotyping.

  5. Clinical observations on attention-deficit hyperactivity disorder (ADHD) in children with frontal lobe epilepsy.

    Science.gov (United States)

    Zhang, Dong-Qing; Li, Fu-Hai; Zhu, Xiao-Bo; Sun, Ruo-Peng

    2014-01-01

    The objective was to investigate the prevalence of attention-deficit hyperactivity disorder (ADHD) in children with frontal lobe epilepsy and related factors. The medical records of 190 children diagnosed with frontal lobe epilepsy at Qilu Hospital of Shandong University between 2006 and 2011 were retrospectively collected, and a follow-up analysis of the prevalence of ADHD in these children was conducted. Of the 161 children with an effective follow-up, 59.0% (95/161) with frontal lobe epilepsy suffered from ADHD as well. Analysis of epilepsy and ADHD-related factors indicated that the incidence of ADHD was 89.4% (76/85) in children with abnormal electroencephalogram (EEG) discharges on the most recent EEG, which was significantly higher than the ADHD incidence of 25% (19/76) in children with normal readings on the most recent EEG (P Children with frontal lobe epilepsy have a high incidence of ADHD. Sustained abnormal discharge on the electroencephalogram is associated with increased comorbidity of ADHD with frontal lobe epilepsy.

  6. High risk of loss to follow-up among South African children on ART during transfer, a retrospective cohort analysis with community tracing.

    Science.gov (United States)

    Teasdale, Chloe A; Sogaula, Nonzwakazi; Yuengling, Katharine A; Peters, Zachary J; Mutiti, Anthony; Pepeta, Lungile; Abrams, Elaine J

    2017-06-28

    Decentralization of HIV care for children has been recommended to improve paediatric outcomes by making antiretroviral treatment (ART) more accessible. We documented outcomes of children transferred after initiating ART at a large tertiary hospital in the Eastern Cape of South Africa. Electronic medical records for all children 0-15 years initiating ART at Dora Nginza Hospital (DNH) in Port Elizabeth, South Africa January 2004 to September 2015 were examined. Records for children transferred to primary and community clinics were searched at 16 health facilities to identify children with successful (at least one recorded visit) and unsuccessful transfer (no visits). We identified all children lost to follow-up (LTF) after ART initiation: those LTF at DNH (no visit >6 months), children with unsuccessful transfer, and children LTF after successful transfer (no visit >6 months). Community tracing was conducted to locate caregivers of children LTF and electronic laboratory data were searched to measure reengagement in care, including silent transfers. 1,582 children initiated ART at median age of 4 years [interquartile range (IQR): 1-8] and median CD4+ of 278 cells/mm 3 [IQR: 119-526]. A total of 901 (57.0%) children were transferred, 644 (71.5%) to study facilities; 433 (67.2%) children had successful transfer and 211 (32.8%) had unsuccessful transfer. In total, 399 children were LTF: 105 (26.3%) from DNH, 211 (52.9%) through unsuccessful transfer and 83 (20.8%) following successful transfer. Community tracing was conducted for 120 (30.1%) of 399 children LTF and 66 (55.0%) caregivers were located and interviewed. Four children had died. Among 62 children still alive, 8 (12.9%) were reported to not be in care or taking ART and 18 (29.0%) were also not taking ART. Overall, 65 (16.3%) of 399 children LTF had a laboratory result within 18 months of their last visit indicating silent transfer and 112 (28.1%) had lab results from 2015 to 2016 indicating current care

  7. Retrospective: animal attacks and rabies exposures in Thai children.

    Science.gov (United States)

    Sriaroon, Chakrapol; Sriaroon, Panida; Daviratanasilpa, Svastijaya; Khawplod, Pakamatz; Wilde, Henry

    2006-09-01

    Over 50% of animal bites and potential rabies exposures in Thailand are in children and they also have the more severe injuries due to inexperience, smaller size and less ability to fend off attacks. Potential rabies exposures and animal bites are common in Thailand. Majority of these are in children where the extent of the injuries is also much more severe. The bitten areas correlate to the age of the children and level of the bitten animal head. These are areas noted for a higher risk of infection with rabies virus and shorter incubation periods. The vast majority of bites are due to dogs (86%) of which 74.6% are stray or community-owned animals. The prevalence of dog bites shows no seasonal variation in adults but there are two peaks during school vacation period for children. Extensive educational efforts directed at the Thai public are responsible for the rapid presentation of victims for post-exposure treatment. The dramatic reduction of human rabies deaths in Thailand during the last decades was achieved largely by the provision of expensive WHO standard post-exposure treatment, utilizing modern tissue culture vaccines and immunoglobulins. Canine and feline rabies is nevertheless still endemic and not likely to be controlled or eliminated till sustainable humane methods of dog population control and comprehensive countrywide canine rabies vaccination become possible through government policy.

  8. Retrospective evaluation of tritium fallout by tree-ring analysis

    International Nuclear Information System (INIS)

    Kozak, K.; Biro, T.; Golder, F.; Rank, D.; Rajner, V.; Staudner, F.

    1993-01-01

    Tritium analyses of tree-ring cellulose were made to test its suitability for retrospective evaluation of a local tritium fallout. Several spruce trees were taken from an Austrian alpine area where tritium contamination of May 1974 precipitation had been detected. Wood from the annual growth rings of 1973, 1974 and 1975 was separated and the cellulose extracted. After isotopic equilibration with dead water, cellulose was combusted to yield water, whose tritium concentration was measured by liquid scintillation counting. Rigorous statistical treatment proved the significance of the increased tritium concentration caused by the tritium anomaly, which occurred during the growing season. The long-term trends of local atmospheric tritium, including the 1974 peak, were also well reflected by analysis of a 24-year ring sequence from a single tree in the contaminated area. The tritium data gained by the given method can be used at present qualitatively and a better understanding of the possible sources of contamination is required in order that the quantitative criteria be satisfied. (Author)

  9. Retrospective panoramic radiographic analysis for idiopathic osteosclerosis in Indians

    Directory of Open Access Journals (Sweden)

    Srikanth H Srivathsa

    2016-01-01

    Full Text Available Introduction: Idiopathic osteosclerosis is an area of increased radiodensity observed on panoramic radiographs. The prevalence of this entity is not known, especially in Indians. Aims and Objectives: To determine the prevalence and epidemiological characteristics of idiopathic osteosclerosis. Materials and Methods: Six hundred and forty panoramic radiographs were retrospectively analyzed for the presence of idiopathic osteosclerosis by a single trained oral radiologist. Statistical Analysis: The data obtained were analyzed using Microsoft Excel (Version 2007 for Windows. Results: Idiopathic osteosclerosis was identified in 32 individuals with a prevalence of 5%. There were 21 female (65.7% and 11 male (34.3% participants. There were 31 single, unilateral (96.85% osteosclerotic lesions and 1 (3.15% bilateral lesion. Right side localization was noted in 19 participants (57.57% and left side localization in 14 participants (42.42%. Conclusion: This study illustrates the prevalence of idiopathic osteosclerosis in Indians. Further, it depicts the characteristics of idiopathic osteosclerotic lesions.

  10. Effectiveness of a hepatitis A vaccination program for migrant children in Amsterdam, The Netherlands (1992-2004)

    NARCIS (Netherlands)

    Sonder, G. J. B.; Bovée, L. P. M. J.; Baayen, T. D.; Coutinho, R. A.; van den Hoek, J. A. R.

    2006-01-01

    OBJECTIVE: To evaluate the impact and effectiveness of risk-group vaccination against hepatitis A targeted at migrant children living in a country with low endemicity of hepatitis A. METHODS: Retrospective population based data analysis. Routinely collected data on hepatitis A incidence in migrant

  11. Predictive Factors of In-Stent Restenosis in Renal Artery Stenting: A Retrospective Analysis

    International Nuclear Information System (INIS)

    Vignali, Claudio; Bargellini, Irene; Lazzereschi, Michele; Cioni, Roberto; Petruzzi, Pasquale; Caramella, Davide; Pinto, Stefania; Napoli, Vinicio; Zampa, Virna; Bartolozzi, Carlo

    2005-01-01

    Purpose. To retrospectively evaluate the role of clinical and procedural factors in predicting in-stent restenosis in patients with renovascular disease treated by renal artery stenting. Methods. From 1995 to 2002, 147 patients underwent renal artery stenting for the treatment of significant ostial atherosclerotic stenosis. Patients underwent strict clinical and color-coded duplex ultrasound follow-up. Ninety-nine patients (111 stents), with over 6 months of continuous follow-up (mean 22±12 months, range 6-60 months), were selected and classified according to the presence (group A, 30 patients, 32 lesions) or absence (group B, 69 patients, 79 lesions) of significant in-stent restenosis. A statistical analysis was performed to identify possible preprocedural and procedural predictors of restenosis considering the following data: sex, age, smoking habit, diabetes mellitus, hypertension, serum creatinine, cholesterol and triglyceride levels, renal artery stenosis grade, and stent type, length and diameter. Results. Comparing group A and B patients (χ 2 test), a statistically significant relation was demonstrated between stent diameter and length and restenosis: the risk of in-stent restenosis decreased when the stent was ≥6 mm in diameter and between 15 and 20 mm in length. This finding was confirmed by multiple logistic regression analysis. Stent diameter and length were proved to be significantly related to in-stent restenosis also when evaluating only patients treated by Palmaz stent (71 stents). Conclusion. Although it is based on a retrospective analysis, the present study confirms the importance of correct stent selection in increasing long-term patency, using stents of at least 6 mm in diameter and with a length of approximately 15-20 mm

  12. Agreement between prospective diary data and retrospective questionnaire report of abdominal pain and stooling symptoms in children with irritable bowel syndrome.

    Science.gov (United States)

    Self, M M; Williams, A E; Czyzewski, D I; Weidler, E M; Shulman, R J

    2015-08-01

    In functional gastrointestinal disorders, patient recall of symptoms drives diagnostic decisions and evaluation of treatment response, and research conclusions about potential treatments. In pediatrics, parent report also impacts assessment and care. Hence, identifying methods for accurately capturing patient and parent report of irritable bowel syndrome (IBS) symptoms is important. This study evaluated correspondence between retrospective questionnaire (parent and child report) and prospective diary data for children and adolescents with IBS. Participants included 50 children/adolescents with IBS per Rome III criteria. Children completed a 2-week pain and stool diary. Children and parents subsequently completed a 2-week recall questionnaire, reporting number of pain days, maximum pain, days without bowel movement, and days with diarrhea during the diary interval. Intraclass correlation coefficients and Bland-Altman plots assessed agreement. For pain and days without bowel movement, overall agreement between child recall questionnaire and child diary was strong, although under conditions likely to facilitate agreement and with individual variation observed. Parent recall and child diary were less concordant, and agreement about diarrhea was poor for parent and child. Age did not significantly correlate with agreement. Child questionnaire with short recall interval may be a reasonable approximation for diary data, although this varies by individual and replication/investigation of lengthier recall are needed. Relying on parent questionnaire does not appear a suitable proxy, and recall of stool form by both parent and child appears more problematic. These results combined with existing literature support use of diary data whenever possible. © 2015 John Wiley & Sons Ltd.

  13. Use of positive and negative words in scientific PubMed abstracts between 1974 and 2014 : retrospective analysis

    NARCIS (Netherlands)

    Vinkers, Christiaan H|info:eu-repo/dai/nl/304824755; Tijdink, Joeri K; Otte, Willem M

    2015-01-01

    OBJECTIVE: To investigate whether language used in science abstracts can skew towards the use of strikingly positive and negative words over time. DESIGN: Retrospective analysis of all scientific abstracts in PubMed between 1974 and 2014. METHODS: The yearly frequencies of positive, negative, and

  14. Retrospective questions or a diary method? A two-level multitrait-multimethod analysis

    NARCIS (Netherlands)

    Hox, J.J.; Kleiboer, A.M.

    2007-01-01

    This study describes a comparison between retrospective questions and daily diaries inquiring about positive and negative support in spousal interactions. The design was a multitrait-multimethod matrix with trait factors of positive and negative support, and method factors of retrospective questions

  15. Characteristics and Outcomes of Children With Conversion Disorder Admitted to a Single Inpatient Rehabilitation Unit, A Retrospective Study.

    Science.gov (United States)

    Bolger, Ashlee; Collins, Andrew; Michels, Michelle; Pruitt, David

    2018-03-14

    Conversion disorder (CD) can lead to impaired functioning. Few studies present demographic and outcome data for pediatric patients. Many have had success with rehabilitation; however, further details are not known. To identify characteristics and outcomes of children admitted to a pediatric inpatient rehabilitation program with CD symptoms. Retrospective study. Inpatient rehabilitation unit within a large children's hospital. All patients with diagnosis of CD or functional gait disorder (FGD) during designated time period. Data were obtained from chart review and United Data Systems for Medical Rehabilitation. Descriptive statistics and Wilcoxon signed rank tests were used to analyze data. A P value of conversion disorder symptoms in the 12 months following discharge, and school reentry characteristics. 30 admissions were identified that met criteria. Before diagnosis, duration of symptoms was 58 ± 145 days, physician visits averaged 1.9 ± 2.1, hospital admissions to the same hospital averaged 0.7 ± 0.9, and absence from school was 6 ± 12 weeks. Overall, 83% exhibited mixed symptoms. Length of inpatient rehabilitation stay was 8.4 ± 4.2 days with WeeFIM score change of 30 ± 11.9 (P conversion disorder and leads to sustained functional improvement and return to school after discharge. ?? Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  16. The craniocervical connection: a retrospective analysis of 300 whiplash patients with cervical and temporomandibular disorders.

    Science.gov (United States)

    Friedman, M H; Weisberg, J

    2000-07-01

    Because the concept of whiplash as a causative factor for temporomandibular disorders (TMD) is highly controversial, we decided to do a retrospective analysis of patients treated in our office who had sustained whiplash injuries and were treated for cervical and temporomandibular disorders. The records of 300 patients with TMD preceded by a motor vehicle accident were examined retrospectively. The most common presenting symptoms, in order, were: jaw pain, neck pain, post-traumatic headache, jaw fatigue, and severe temporomandibular joint (TMJ) clicking. The most common TMD diagnoses were: masseter trigger points, closing jaw muscle hyperactivity, TMJ synovitis, opening jaw muscle hyperactivity, and advanced TMJ disk derangement. Based primarily on the physical examination, we concluded that the TMJ and surrounding musculature should be examined similarly to other joints, with no preconceived notion that TMD pathology after whiplash is unlikely.

  17. A Retrospective Analysis of Ruptured Breast Implants

    Directory of Open Access Journals (Sweden)

    Woo Yeol Baek

    2014-11-01

    Full Text Available BackgroundRupture is an important complication of breast implants. Before cohesive gel silicone implants, rupture rates of both saline and silicone breast implants were over 10%. Through an analysis of ruptured implants, we can determine the various factors related to ruptured implants.MethodsWe performed a retrospective review of 72 implants that were removed for implant rupture between 2005 and 2014 at a single institution. The following data were collected: type of implants (saline or silicone, duration of implantation, type of implant shell, degree of capsular contracture, associated symptoms, cause of rupture, diagnostic tools, and management.ResultsForty-five Saline implants and 27 silicone implants were used. Rupture was diagnosed at a mean of 5.6 and 12 years after insertion of saline and silicone implants, respectively. There was no association between shell type and risk of rupture. Spontaneous was the most common reason for the rupture. Rupture management was implant change (39 case, microfat graft (2 case, removal only (14 case, and follow-up loss (17 case.ConclusionsSaline implants have a shorter average duration of rupture, but diagnosis is easier and safer, leading to fewer complications. Previous-generation silicone implants required frequent follow-up observation, and it is recommended that they be changed to a cohesive gel implant before hidden rupture occurs.

  18. A retrospective study of the demographics of sport and exercise injuries in 1143 children presenting to an Irish emergency department over a 6-month period.

    LENUS (Irish Health Repository)

    O'Rourke, Killian Patrick

    2012-02-03

    The purpose of this study was to provide up-to-date data on the nature of sport related injury (SRI) presenting to a large emergency department in Ireland. Data were collected retrospectively on all children under 17 years of age with a SRI, presenting to the emergency department of a major teaching hospital, over a 6-month period, and entered into a Microsoft Access database. A total of 1143 SRIs were identified which had occurred over a 6-month period, from 53 different sports. There was a high proportion of humerus and back SRIs in females, and a higher proportion of falls in females. Males were more frequently involved in collisions. Children with SRI were not using protective equipment in 94% of cases. Advice regarding rest, ice, compression and elevation (RICE)\\/general injury advice was given to 25% of patients and regarding injury preventive measures in less than 0.1% of cases. Of children, 28% had previously attended with a SRI. We also observed a lower rate of analgesia prescription to children under age 4, compared to children of an older age, and rarity of topical analgesic prescription. Overall, 10% of SRIs required admission, with 65% of these cases needing orthopaedic intervention. CONCLUSION: The data provided from this study should raise awareness of the different aspects of sport related injuries affecting children, and may help to provide the impetus for suggesting direction and guidance for reducing such events.

  19. Retrospective analysis of Newcastle disease diagnosed at the ...

    African Journals Online (AJOL)

    Newcastle disease (ND) is a highly contagious viral disease of domestic and wild birds with devastating impact on poultry health and production. Many vaccines and vaccination schedules are in use in controlling the disease but prevention and control are still a problem. A ten-year retrospective study (2002-2011) of ...

  20. Uterine rupture: a retrospective analysis of causes, complications ...

    African Journals Online (AJOL)

    We conducted a retrospective review of case notes (from 2003 to 2009) to determine the incidence, causes, complications and foetal/maternal outcome among women with a diagnosis of ... Out of 72,570 deliveries 163 cases of ruptured uterus were recorded in seven years, making an incidence of 2.25 per 1000 births.

  1. Transcatheter closure, mini-invasive closure and open-heart surgical repair for treatment of perimembranous ventricular septal defects in children: a protocol for a network meta-analysis.

    Science.gov (United States)

    You, Tao; Yi, Kang; Ding, Zhao-Hong; Hou, Xiao-Dong; Liu, Xing-Guang; Wang, Xin-Kuan; Ge, Long; Tian, Jin-Hui

    2017-06-21

    Both transcatheter device closure and surgical repair are effective treatments with excellent midterm outcomes for perimembranous ventricular septal defects (pmVSDs) in children. The mini-invasive periventricular device occlusion technique has become prevalent in research and application, but evidence is limited for the assessment of transcatheter closure, mini-invasive closure and open-heart surgical repair. This study comprehensively compares the efficacy, safety and costs of transcatheter closure, mini-invasive closure and open-heart surgical repair for treatment of pmVSDs in children using Bayesian network meta-analysis. A systematic search will be performed using Chinese Biomedical Literature Database, China National Knowledge Infrastructure, PubMed, EMBASE.com and the Cochrane Central Register of Controlled Trials to include random controlled trials, prospective or retrospective cohort studies comparing the efficacy, safety and costs of transcatheter closure, mini-invasive closure and open-heart surgical repair. The risk of bias for the included prospective or retrospective cohort studies will be evaluated according to the risk of bias in non-randomised studies of interventions (ROBINS-I). For random controlled trials, we will use risk of bias tool from Cochrane Handbook version 5.1.0. A Bayesian network meta-analysis will be conducted using R-3.3.2 software. Ethical approval and patient consent are not required since this study is a network meta-analysis based on published trials. The results of this network meta-analysis will be submitted to a peer-reviewed journal for publication. CRD42016053352. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Suboptimal management of central nervous system infections in children: a multi-centre retrospective study

    Directory of Open Access Journals (Sweden)

    Kelly Christine

    2012-09-01

    Full Text Available Abstract Objective We aimed to audit the regional management of central nervous system (CNS infection in children. Methods The study was undertaken in five district general hospitals and one tertiary paediatric hospital in the Mersey region of the UK. Children admitted to hospital with a suspected CNS infection over a three month period were identified. Children were aged between 4 weeks and 16 years old. Details were recorded from the case notes and electronic records. We measured the appropriateness of management pathways as outlined by national and local guidelines. Results Sixty-five children were identified with a median age of 6 months (range 1 month to 15 years. Ten had a CNS infection: 4 aseptic meningitis, 3 purulent meningitis, 3 encephalitis [2 with herpes simplex virus (HSV type 1]. A lumbar puncture (LP was attempted in 50 (77% cases but only 43 had cerebrospinal fluid (CSF available for analysis. Of these 24 (57% had a complete standard set of tests performed. Fifty eight (89% received a third generation cephalosporin. Seventeen (26% also received aciclovir with no obvious indication in 9 (53%. Only 11 (65% of those receiving aciclovir had CSF herpes virus PCR. Seventeen had cranial imaging and it was the first management step in 14. Treatment lengths of both antibiotics and aciclovir were highly variable: one child with HSV encephalitis was only treated with aciclovir for 7 days. Conclusions The clinical management of children with suspected CNS infections across the Mersey region is heterogeneous and often sub-optimal, particularly for the investigation and treatment of viral encephalitis. National guidelines for the management of viral encephalitis are needed.

  3. Video content analysis on body-worn cameras for retrospective investigation

    Science.gov (United States)

    Bouma, Henri; Baan, Jan; ter Haar, Frank B.; Eendebak, Pieter T.; den Hollander, Richard J. M.; Burghouts, Gertjan J.; Wijn, Remco; van den Broek, Sebastiaan P.; van Rest, Jeroen H. C.

    2015-10-01

    In the security domain, cameras are important to assess critical situations. Apart from fixed surveillance cameras we observe an increasing number of sensors on mobile platforms, such as drones, vehicles and persons. Mobile cameras allow rapid and local deployment, enabling many novel applications and effects, such as the reduction of violence between police and citizens. However, the increased use of bodycams also creates potential challenges. For example: how can end-users extract information from the abundance of video, how can the information be presented, and how can an officer retrieve information efficiently? Nevertheless, such video gives the opportunity to stimulate the professionals' memory, and support complete and accurate reporting. In this paper, we show how video content analysis (VCA) can address these challenges and seize these opportunities. To this end, we focus on methods for creating a complete summary of the video, which allows quick retrieval of relevant fragments. The content analysis for summarization consists of several components, such as stabilization, scene selection, motion estimation, localization, pedestrian tracking and action recognition in the video from a bodycam. The different components and visual representations of summaries are presented for retrospective investigation.

  4. [Spectrum and drug sensitivity of pathogenic bacteria in children with nephrotic syndrome complicated by urinary tract infection: an analysis of 97 cases].

    Science.gov (United States)

    Song, Shao-Na; Zhang, Bi-Li; Wang, Wen-Hong; Zhang, Xuan

    2012-09-01

    To investigate the spectrum and drug sensitivity of pathogenic bacteria in children with nephrotic syndrome (NS) complicated by urinary tract infection (UTI). A retrospective analysis was performed on the spectrum and drug sensitivity of pathogenic bacteria in 97 children with NS complicated by UTI, who hospitalized from January to December, 2011. The incidence of UTI in children with NS was 36.5%. It was significantly more common in children with recurrent NS than in those with primary NS (44.0% vs 31.9%; Ppathogenic bacteria (50.5%), including Enterococcus faecium (29.4%) and Enterococcus faecalis (21.1%), followed by Gram-negative bacteria, such as Escherichia coli (15.6%) and Klebsiella pneumoniae (14.7%). Enterococcus was highly sensitive to nitrofurantoin, vacomycin and linezolid, but was highly resistant to tetracycline and moxifloxacin. More multi-resistant strains were detected in Enterococcus faecium than in Enterococcus faecalis (72% vs 17%; Pbacteria, 25% produced extended spectrum β-lactamases (ESBLs). ESBLs-producing bacteria had 100% sensitivity to imipenem, amikacin and piperacillin/tazobactam but were highly resistant to ampicillin, cefazolin and ceftriaxone. Children with recurrent NS are more susceptible to UTI than those with primary NS. Enterococcus is becoming major pathogenic bacteria for UTI in children with NS and has relatively high drug resistance, and most strains of Enterococcus faecium are multi-resistant.

  5. The Early Prevention of Obesity in CHildren (EPOCH Collaboration - an Individual Patient Data Prospective Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Simes John

    2010-11-01

    Full Text Available Abstract Background Efforts to prevent the development of overweight and obesity have increasingly focused early in the life course as we recognise that both metabolic and behavioural patterns are often established within the first few years of life. Randomised controlled trials (RCTs of interventions are even more powerful when, with forethought, they are synthesised into an individual patient data (IPD prospective meta-analysis (PMA. An IPD PMA is a unique research design where several trials are identified for inclusion in an analysis before any of the individual trial results become known and the data are provided for each randomised patient. This methodology minimises the publication and selection bias often associated with a retrospective meta-analysis by allowing hypotheses, analysis methods and selection criteria to be specified a priori. Methods/Design The Early Prevention of Obesity in CHildren (EPOCH Collaboration was formed in 2009. The main objective of the EPOCH Collaboration is to determine if early intervention for childhood obesity impacts on body mass index (BMI z scores at age 18-24 months. Additional research questions will focus on whether early intervention has an impact on children's dietary quality, TV viewing time, duration of breastfeeding and parenting styles. This protocol includes the hypotheses, inclusion criteria and outcome measures to be used in the IPD PMA. The sample size of the combined dataset at final outcome assessment (approximately 1800 infants will allow greater precision when exploring differences in the effect of early intervention with respect to pre-specified participant- and intervention-level characteristics. Discussion Finalisation of the data collection procedures and analysis plans will be complete by the end of 2010. Data collection and analysis will occur during 2011-2012 and results should be available by 2013. Trial registration number ACTRN12610000789066

  6. A comparison of the efficacy and tolerability of oxcarbazepine oral suspension between infants and children with epilepsy: a retrospective chart review at a single medical center in Taiwan.

    Science.gov (United States)

    Wei, Shu-Hao; Liu, Cheng-Chao; Fan, Pi-Chuan

    2014-02-01

    Few clinical studies have assessed the efficacy and safety of oxcarbazepine (OXC) oral suspension in Asian pediatric patients and particularly in infants. The aim of this study was to investigate and compare the efficacy, tolerability, and side effects of OXC oral suspension in Taiwanese infants and children with various types of epilepsy. A retrospective review of the efficacy, tolerability, and side effects of OXC oral suspension in a tertiary medical center in Taiwan was conducted and included children (1-9 years old) and infants (effects (30 vs. 21 %, p = 0.525) after OXC oral suspension treatment. The efficacy was significantly correlated with the epilepsy subtype (p effective and well tolerated in both infants and children with partial epilepsy in Taiwan. Treatment efficacy was related to epilepsy subtype and number of combined AEDs before OXC treatment. Monotherapy had an excellent therapeutic response in partial epilepsy but not in multifocal epilepsy.

  7. A retrospective dosimetry method and its uncertainty analysis

    International Nuclear Information System (INIS)

    Zhang, L.; Jia, D.; Dai, G.

    2000-01-01

    The main aim of a radiation epidemiological study is to assess the risk of the population exposed to ionizing radiation. The actual work of the assessment may be very difficult because dose information about the population is often indirect and incomplete. It is very important, therefore, to find a way of estimating reasonable and reliable doses of the population by a retrospective method from limited information. In order to provide reasonable dose information for the cohort study of Chinese medical diagnostic X-ray workers, a retrospective dosimetry method was established. In China, a cohort study of more than 27,000 medical diagnostic X-ray workers, with 25,000 controls, has been carried out for about fifteen years in order to assess the risk to an occupationally exposed population. Obviously, a key to the success of the study is to obtain reliable and reasonable results of dose estimation by the dose reconstruction method. Before 1985, there was a lack of information regarding personal dose measured directly; however, we can obtain other indirect information. Examples are information about working loads from the documents of the hospitals, information about operational conditions of the workers of different statuses by a survey of occupational history, and the exposure levels of various working conditions by some simulation methods. The information for estimating organ dose can also be obtained by simulating experiments with a phantom. Based on the information mentioned above, a mathematical model and computerizing system for dose reconstruction of this occupational population was design and developed. Uncertainty analysis very important for dose reconstruction. The sources of uncertainty of our study are coming from two fields. One is coming from the mode of dose reconstruction. Another is coming from the survey of the occupational history. In the result reported, main results of the uncertainty will be presented. In order to control the uncertainty of the

  8. Sporadic and genetic forms of paediatric somatotropinoma: a retrospective analysis of seven cases and a review of the literature

    Directory of Open Access Journals (Sweden)

    Nozières Cécile

    2011-10-01

    Full Text Available Abstract Background Somatotropinoma, a pituitary adenoma characterised by excessive production of growth hormone (GH, is extremely rare in childhood. A genetic defect is evident in some cases; known genetic changes include: multiple endocrine neoplasia type 1 (MEN1; Carney complex; McCune-Albright syndrome; and, more recently identified, aryl hydrocarbon receptor-interacting protein (AIP. We describe seven children with somatotropinoma with a special focus on the differences between genetic and sporadic forms. Methods Seven children who presented in our regional network between 1992 and 2008 were included in this retrospective analysis. First-type therapy was somatostatin (SMS analogues or transsphenoidal surgery. Control was defined as when insulin-like growth factor-1 (IGF-1 levels were within the normal range for the patient's age at 6 months after therapy, associated with decreasing tumour volume. Results Patients were aged 5-17 years and the majority (n = 6 were male. Four patients had an identified genetic mutation (McCune-Albright syndrome: n = 1; MEN1: n = 1; AIP: n = 2; the remaining three cases were sporadic. Accelerated growth rate was reported as the first clinical sign in four patients. Five patients presented with macroadenoma; invasion was noted in four of them (sporadic: n = 1; genetic: n = 3. Six patients were treated with SMS analogues; normalisation of IGF-1 occurred in one patient who had a sporadic intrasellar macroadenoma. Multiple types of therapy were necessary in all patients with an identified genetic mutation (4 types: n = 1; 3 types: n = 2; 2 types: n = 1, whereas two of the three patients with sporadic somatotropinoma required only one type of therapy. Conclusions This is the first series that analyzes the therapeutic response of somatotropinoma in paediatric patients with identified genetic defects. We found that, in children, genetic somatotropinomas are more invasive than sporadic somatotropinomas. Furthermore

  9. Predictors of outcome in children with status epilepticus during resuscitation in pediatric emergency department: A retrospective observational study

    Directory of Open Access Journals (Sweden)

    Indumathy Santhanam

    2017-01-01

    Full Text Available Objectives: To study the clinical profile and predictors of outcome in children with status epilepticus (SE during resuscitation in pediatric emergency department. Materials and Methods: This retrospective study was carried out in a tertiary care teaching hospital. Admission and resuscitation data of children, aged between 1 month and 12 years, treated for SE, between September 2013 and August 2014, were extracted using a standard data collection form. Our SE management protocol had employed a modified pediatric assessment triangle to recognize and treat acute respiratory failure, cardiovascular dysfunction (CD, and subtle SE until all parameters resolved. Continuous positive airway pressure, fluid boluses based on shock etiology, inotropes, and cardiac safe anticonvulsants were the other modifications. Risk factors predicting mortality during resuscitation were analyzed using univariate and penalized logistic regression. Results: Among 610 who were enrolled, 582 (95.4% survived and 28 (4.6% succumbed. Grunt odds ratio (OR: 3.747 (95% confidence interval [CI]: 1.035−13.560, retractions OR: 2.429 (95% CI: 1.036−5.698, rales OR: 10.145 (95% CI: 4.027−25.560, prolonged capillary refill time OR: 3.352 (95% CI: 1.339−8.388, and shock requiring >60 mL/kg fluids OR: 2.439 (95% CI 1.040−5.721 were associated with 2−3 times rise in mortality. Inappropriate prehospital treatment and CD were the significant predictors of mortality OR: 7.82 (95% CI 2.10−29.06 and 738.71 (95% CI: 97.11−999, respectively. Resolution of CD was associated with improved survival OR: 0.02 (95% CI: 0.003−0.17. Conclusion: Appropriate prehospital management and treatment protocol targeting resolution of CD during resuscitation could reduce mortality in children with SE.

  10. Estimated cumulative radiation dose from PET/CT in children with malignancies: a 5-year retrospective review

    International Nuclear Information System (INIS)

    Chawla, Soni C.; Federman, Noah; Zhang, Di; Nagata, Kristen; Nuthakki, Soujanya; McNitt-Gray, Michael; Boechat, M.I.

    2010-01-01

    The increasing use of serial PET/CT scans in the management of pediatric malignancies raises the important consideration of radiation exposure in children. To estimate the cumulative radiation dose from PET/CT studies to children with malignancy and to compare with the data in literature. Two hundred forty-eight clinical PET/CT studies performed on 78 patients (50 boys/28 girls, 1.3 to 18 years old from December 2002 to October 2007) were retrospectively reviewed under IRB approval. The whole-body effective dose (ED) estimates for each child were obtained by estimating the effective dose from each PET/CT exam performed using the ImPACT Patient Dosimetry Calculator for CT and OLINDA for PET. The average number of PET/CT studies was 3.2 per child (range: 1 to 14 studies). The average ED of an individual CT study was 20.3 mSv (range: 2.7 to 54.2), of PET study was 4.6 mSv (range: 0.4 to 7.7) and of PET/CT study was 24.8 mSv (range: 6.2 to 60.7). The average cumulative radiation dose per patient from CT studies was 64.4 mSv (range: 2.7 to 326), from PET studies was 14.5 mSv (range: 2.8 to 73) and from PET/CT studies was 78.9 mSv (range: 6.2 to 399). The radiation exposure from serial PET/CT studies performed in pediatric malignancies was considerable; however, lower doses can be used for both PET and CT studies. The ALARA principle must be applied without sacrificing diagnostic information. (orig.)

  11. Coroner Autopsy Findings Among Children and Adolescents of ...

    African Journals Online (AJOL)

    year retrospective study of coroner autopsies carried out on children I adolescents aged between 0-19 years, evaluated the pattern, causes and demographic features of childhood deaths in Rivers state, Nigeria. Methods A retrospective remew of ...

  12. A retrospective analysis of oral cholera vaccine use, disease severity and deaths during an outbreak in South Sudan

    NARCIS (Netherlands)

    Bekolo, C.E.; Loenhout, J.A. van; Rodriguez-Llanes, J.M.; Rumunu, J.; Ramadan, O.P.; Guha-Sapir, D.

    2016-01-01

    OBJECTIVE: To determine whether pre-emptive oral cholera vaccination reduces disease severity and mortality in people who develop cholera disease during an outbreak. METHODS: The study involved a retrospective analysis of demographic and clinical data from 41 cholera treatment facilities in South

  13. Dental Caries Scenario Among 5, 12 and 15-Year-old Children in India- A Retrospective Analysis.

    Science.gov (United States)

    Kundu, Hansa; Patthi, Basavaraj; Singla, Ashish; Jankiram, Chandrashekar; Jain, Swati; Singh, Khushboo

    2015-07-01

    Dental caries is the most prevalent dental disease and children are one of the most affected groups. Thus, the present study was conducted to assess the average dental caries prevalence across different WHO index age groups (5, 12 & 15 years) for the past fifteen years. Literature search was performed electronically in various search engines like google scholar, PubMed, Copernicus, etc. using Dental caries and India as MeSH terms. Articles from the past 15 years reporting on dental caries prevalence and experience in India were searched and this online searching strategy collected and listed 781 articles. After evaluating their titles and abstracts, only 30 articles fulfilled the inclusion and exclusion criteria & were finally selected for complete review and data collection. Five articles which were hand searched were also included. Pooled estimates were calculated for different index age groups and different regions (Northern and Southern) separately with a confidence interval of 95% both for prevalence and experience of dental caries. The pooled prevalence of dental caries was found to be highest in 15 year olds followed by 5 and 12 years (62.02%, 48.11% & 43.34% respectively). Weighted mean was also found to be highest for 15 years, followed by 5 and 12 years (2.56±6.508, 2.49±7.78, 1.48±3.292 respectively). Pooled prevalence and weighted mean for the Northernern India region was found to be more in all the index age groups as compared to the Southernern India region. More than 40% of the children in India have shown dental caries in both primary and permanent teeth in the past 15 years. Also, Northernern region was found to be more affected by dental caries than Southern region. Since children are seen as the future of the nation, this data could be helpful in the planning of oral health care services by the concerned authorities in the community.

  14. [Characteristics of growth and development in children from families at social risk].

    Science.gov (United States)

    Stojadinović, A

    2001-01-01

    Body height and weight are important indicators of children's health status. There are many evidences that children from disadvantaged families have lower height and weight than children of the same age from families without social risk. The aim of this study was to investigate characteristics of growth and development of children from economically disadvantaged families. The study was partly retrospective and partly prospective. The retrospective study included 509 children from disadvantaged families hospitalized at the Institute of Child and Adolescent Health Care in Novi Sad, during a five-year period. The prospective study included 90 children from disadvantaged families (experimental group) and 132 children from families without social risk (control group) hospitalized at the Institute during a six month period. Height/length, weight, head circumference, and psychomotor/intellectual development have been examined. In the retrospective study results were compared with theoretically expected values, whereas the prospective study results of experimental and control group were compared. In the retrospective study that included only children from disadvantaged families, 136 (26.7%) children had height/length, 173 (34%) had weight, and 86 (16.9%) children had head circumference below 10th percentile. Delay in psychomotor/intellectual development was established in 177 (34.8%) children. Children from families with social risk have significantly more often height/length, weight, head circumference and developmental delay than theoretically expected. In the prospective study 40 (44.4%) children from experimental group had height/length, 29 (32.2%) had weight, 20 (22.2%) children had head circumference below 10th percentile, and 17 (26.2%) had delay in psychomotor/intellectual development. Children from disadvantaged families (experimental group) significantly more often had delay in growth and development comparing with children from families without social risk

  15. Genomic analysis suggests higher susceptibility of children to air pollution

    DEFF Research Database (Denmark)

    van Leeuwen, Danitsja M; Pedersen, Marie; Hendriksen, Peter J M

    2008-01-01

    modulated gene expressions. In addition, gene expressions in both children and adults were investigated for associations with micronuclei frequencies. Both analysis approaches returned considerably more genes or gene groups and pathways that significantly differed between children from both regions than......Differences in biological responses to exposure to hazardous airborne substances between children and adults have been reported, suggesting children to be more susceptible. Aim of this study was to improve our understanding of differences in susceptibility in cancer risk associated with air...... pollution by comparing genome-wide gene expression profiles in peripheral blood of children and their parents. Gene expression analysis was performed in blood from children and parents living in two different regions in the Czech Republic with different levels of air pollution. Data were analyzed by two...

  16. A descriptive retrospective study on children with newly diagnosed nephrotic syndrome presented to Tripoli Children Hospital during the period between Jan. to Dec. 2014

    Directory of Open Access Journals (Sweden)

    Naziha Ramadan Rhuma

    2016-10-01

    Full Text Available Introduction: Nephrotic syndrome is a clinical picture characterized by severe proteinuria, hypoalbuminemia, edema and hypercholesterolemia. A retrospective study was carried out in order to describe disease pattern in newly diagnosed nephrotic syndrome of children admitted to Tripoli children hospital during the year 2014. Methods: The medical data of 56 patients aged between 1 year and 11 years diagnosed with idiopathic nephrotic syndrome were analysed using SPSS software. The data included gender differences, sensitivity to steroid therapy, relapses during six months of follow up and the effect of variable factors such as family history, hypertension, hematuria, serum urea on the degree of relapse. Results: Out of 56 patients with newly diagnosed nephrotic syndrome (NS, 60.7% were boys and 39.3% were girls, with a mean age 4.2±2.2 years. Age  was related significantly to the response to steroid therapy, where 79.5% of patients aged between 2-8 years (group 1 had steroid sensitive nephrotic syndrome (SSNS compared with only 41.7% of patients aged less than 2 years or more than 8 years (group 2  (P<0.001.  Although girls relapsed more than boys (70.5% versus 57.1% during six months of therapy, this difference was not statistically significant. Similarly, no other factors measured such as family history of NS, hypertension, hematuria, serum complement and urea had any effect on the percentage of relapse in patients with newly diagnosed NS.  Conclusion: NS is one of the commonest reasons for admission to nephrology ward. It is more common in boys than girls. The age at presentation related significantly to the response to steroidal therapy. Regarding relapses, girls seems to relapse more frequent than boys and relapses was seen more in age group 1 than group 2, however, these differences were not significant. Other factors studied seems to have no effect on the relapse rate of children with newly diagnosed NS. Key-words:  Idiopathic

  17. Children with intellectual disability and hospice utilization.

    Science.gov (United States)

    Lindley, Lisa C; Colman, Mari Beth; Meadows, John T

    2017-02-01

    Over 42,000 children die each year in the United States, including those with intellectual disability (ID). Survival is often reduced when children with intellectual disability also suffer from significant motor dysfunction, progressive congenital conditions, and comorbidities. Yet, little is known about hospice care for children with intellectual disability. The purpose of this study was to explore the relationship between intellectual disability and hospice utilization. Additionally, we explored whether intellectual disability combined with motor dysfunction, progressive congenital conditions, and comorbidities influenced pediatric hospice utilization. Using a retrospective cohort design and data from the 2009 to 2010 California Medicaid claims files, we conducted a multivariate analysis of hospice utilization. This study shows that intellectual disability was negatively related to hospice enrollment and length of stay. We also found that when children had both intellectual disability and comorbidities, there was a positive association with enrolling in hospice care. A number of clinical implications can be drawn from the study findings that hospice and palliative care nurses use to improve their clinical practice of caring for children with ID and their families at end of life.

  18. Chloral hydrate sedation in radiology: retrospective audit of reduced dose

    International Nuclear Information System (INIS)

    Bracken, Jennifer; Heaslip, Ingrid; Ryan, Stephanie

    2012-01-01

    Chloral hydrate (CH) is safe and effective for sedation of suitable children. The purpose of this study was to assess whether adequate sedation is achieved with reduced CH doses. We retrospectively recorded outpatient CH sedations over 1 year. We defined standard doses of CH as 50 mg/kg (infants) and 75 mg/kg (children >1 year). A reduced dose was defined as at least 20% lower than the standard dose. In total, 653 children received CH sedation (age, 1 month-3 years 10 months), 42% were given a reduced initial dose. Augmentation dose was required in 10.9% of all children, and in a higher proportion of children >1 year (15.7%) compared to infants (5.7%; P 1 year (95.3%; P = 0.03). A reduced initial dose had no negative effect on outcome (P = 0.19) or time to sedation. No significant complications were seen. We advocate sedation with reduced CH doses (40 mg/kg for infants; 60 mg/kg for children >1 year of age) for outpatient imaging procedures when the child is judged to be quiet or sleepy on arrival. (orig.)

  19. A concept analysis of children's agency within the health literature.

    Science.gov (United States)

    Montreuil, Marjorie; Carnevale, Franco A

    2015-12-14

    The capacity of children to act as agents is being increasingly recognized and has important implications for health research and practice. However, there are various discrepancies in how children's agency is defined in the literature. The aim of this analysis was to examine the concept of children's agency within the health-related literature, using Rodgers evolutionary method. The following questions were addressed: How did the concept of agency become associated with children in the health-related literature? What are the sociocultural and legal contexts that surround the concept of children's agency? What is the meaning of children's agency? Forty-five articles were included in the analysis. An inductive approach was used to identify the attributes of children's agency as well as the temporal, disciplinary, and paradigmatic trends in its conceptualization. The concept of children's agency first appeared in the health literature in the 1980s and was defined as an ability children could gradually develop. Later on, children's agency was used to refer to the capacity of all children to influence their own and others' health-care needs and is now increasingly used to refer to children as active agents who reflect on and construct their social worlds. © The Author(s) 2015.

  20. Toxicity of upfront {sup 131}I-metaiodobenzylguanidine ({sup 131}I-MIBG) therapy in newly diagnosed neuroblastoma patients: a retrospective analysis

    Energy Technology Data Exchange (ETDEWEB)

    Bleeker, Gitta; Schoot, Reineke A.; Caron, Huib N.; Kraker, Jan de; Tytgat, Godelieve A. [Emma Children' s Hospital, Academic Medical Centre (AMC), Department of Paediatric Oncology, PO Box 22700, Amsterdam (Netherlands); Hoefnagel, Cees A. [National Cancer Institute (NKI-AvL), Department of Nuclear Medicine, Amsterdam (Netherlands); Eck, Berthe L. van [Academic Medical Centre (AMC), Department of Nuclear Medicine, Amsterdam (Netherlands)

    2013-10-15

    In the treatment of patients with high-risk neuroblastoma, different doses of {sup 131}I-metaiodobenzylguanidine ({sup 131}I-MIBG) are administered at different time points during treatment. Toxicity, mainly haematological (thrombocytopenia), from {sup 131}I-MIBG therapy is known to occur in extensively chemotherapy pretreated neuroblastoma patients. Up to now, acute toxicity from {sup 131}I-MIBG as initial treatment has never been studied in a large cohort. The aim of this retrospective study was to document acute toxicity related to upfront {sup 131}I-MIBG. All neuroblastoma patients (stages 1-4 and 4S) treated upfront with {sup 131}I-MIBG at the Emma Children's Hospital, Academic Medical Centre (1992 - 2008) were included in this retrospective analysis. The acute toxicity (during therapy) and short-term toxicity (1st month following therapy) of the first two {sup 131}I-MIBG therapies were studied. Of 66 patients (34 boys, 32 girls; median age 2.2 years, range 0.1 - 9.4 years), 49 had stage 4 disease, 5 stage 4S, 6 stage 3, 1 stage 2 and 5 stage 1. The median first dose was 441 MBq/kg (range 157 - 804 MBq/kg). The median second dose was 328 MBq/kg (range 113 - 727 MBq/kg). The most frequently observed symptoms were nausea and vomiting (21 %, maximum grade II). The main toxicity was grade IV haematological, occurring only in stage 4 patients, after the first and second {sup 131}I-MIBG therapies: anaemia (5 % and 4 %, respectively), leucocytopenia (3 % and 4 %) and thrombocytopenia (2 % and 4 %). No stem cell rescue was needed. The main acute toxicity observed was haematological followed by nausea and vomiting. One patient developed posterior reversible encephalopathy syndrome during {sup 131}I-MIBG therapy, possibly related to {sup 131}I-MIBG. We consider {sup 131}I-MIBG therapy to be a safe treatment modality. (orig.)

  1. Pediatric Central Nervous System Tumors in Nepal: Retrospective Analysis and Literature Review of Low- and Middle-Income Countries.

    Science.gov (United States)

    Azad, Tej D; Shrestha, Ram Kumar; Vaca, Silvia; Niyaf, Ali; Pradhananga, Amit; Sedain, Gopal; Sharma, Mohan R; Shilpakar, Sushil K; Grant, Gerald A

    2015-12-01

    Central nervous system (CNS) tumors are the most common cause of cancer-related death in children. Little is known about the demographics and treatment of pediatric brain tumors in low- and middle-income countries (LMICs). We performed a retrospective chart review of all pediatric patients who presented to the neurosurgical service at Tribhuvan University Teaching Hospital in Kathmandu, Nepal from 2009-2014 and collected information on patients tumor. We analyzed age, gender, clinical presentation, extent of surgical resection, histopathology, and length of hospital stay. We also conducted a literature review using specific terminology to capture studies of pediatric neuro-oncologic epidemiology conducted in LMICs. Study location, length of study, sample size, study type, and occurrence of 4 common pediatric brain tumors were extracted. We identified 39 cases of pediatric CNS tumors, with 62.5% observed in male children. We found that male children (median = 13 years) presented later than female children (median = 8 years). The most frequently observed pediatric brain tumor type was ependymoma (17.5%), followed by astrocytoma (15%) and medulloblastoma (15%). Surgical resection was performed for 80% of cases, and gross total resection reported in 62.9% of all surgeries. More than half (54.1%) of patients had symptoms for more than 28 days before seeking treatment. Symptomatic hydrocephalus was noted in 57.1% of children who presented with CNS tumors. The literature review yielded studies from 18 countries. Study length ranged from 2-20 years, and sample sizes varied from 35-1948. Overall, we found more pronounced variation in the relative frequencies of the most common pediatric brain tumors, compared with high-income countries. We present the first operative series of childhood CNS tumors in Nepal. Children often had delayed diagnosis and treatment of a tumor, despite symptoms. More comprehensive data are required to develop improved treatment and management

  2. Family Characteristics of Children with Dyslexia.

    Science.gov (United States)

    Melekian, Badrig A.

    1990-01-01

    A retrospective review of 249 French children (ages 8-15) with severe dyslexia found that families were characterized by low occupational status and educational level for parents and predominance of high-ranking children in large sibships. Parental age and matrimonial status seemed unimportant. (Author/JDD)

  3. Effects of financial support on treatment of adolescents with growth hormone deficiency: a retrospective study in Japan.

    Science.gov (United States)

    Maeda, Eri; Higashi, Takahiro; Hasegawa, Tomonobu; Yokoya, Susumu; Mochizuki, Takahiro; Ishii, Tomohiro; Ito, Junko; Kanzaki, Susumu; Shimatsu, Akira; Takano, Koji; Tajima, Toshihiro; Tanaka, Hiroyuki; Tanahashi, Yusuke; Teramoto, Akira; Nagai, Toshiro; Hanew, Kunihiko; Horikawa, Reiko; Yorifuji, Toru; Wada, Naohiro; Tanaka, Toshiaki

    2016-10-21

    Treatment costs for children with growth hormone (GH) deficiency are subsidized by the government in Japan if the children meet clinical criteria, including height limits (boys: 156.4 cm; girls: 145.4 cm). However, several funding programs, such as a subsidy provided by local governments, can be used by those who exceed the height limits. In this study, we explored the impacts of financial support on GH treatment using this natural allocation. A retrospective analysis of 696 adolescent patients (451 boys and 245 girls) who reached the height limits was conducted. Associations between financial support and continuing treatment were assessed using multiple logistic regression analyses adjusting for age, sex, height, growth velocity, bone age, and adverse effects. Of the 696 children in the analysis, 108 (15.5 %) were still eligible for financial support. The proportion of children who continued GH treatment was higher among those who were eligible for support than among those who were not (75.9 % vs. 52.0 %, P financial support to continuing treatment were 4.04 (95 % confidence interval [CI]: 1.86-8.78) in boys and 1.72 (95 % CI: 0.80-3.70) in girls, after adjusting for demographic characteristics and clinical factors. Financial support affected decisions on treatment continuation for children with GH deficiency. Geographic variations in eligibility for financial support pose an ethical problem that needs policy attention. An appropriate balance between public spending on continuation of therapy and improved quality of life derived from it should be explored.

  4. Children as subjects in nutrition research: a retrospective look at their perceptions.

    Science.gov (United States)

    Kafka, Tamar; Economos, Christina; Folta, Sara; Sacheck, Jennifer

    2011-01-01

    To explore children's motivations for and perceived benefits and barriers to nutrition research participation. To explore children's perspectives on how to improve the research experience. Seven focus group sessions were conducted during March 2008 with research participants from a trial that examined the effects of pre-exercise snacks on physical activity and exercise stress in children. The Health Belief Model for Behavior Change served as the framework for understanding perceived benefits and barriers to research participation and cues to action to help children's readiness for future research participation. Indoor sports center in Acton, Massachusetts. Thirty-five children, 15 males and 20 females, aged 7-10 years. Children's participation in nutrition research. Transcripts were reviewed, coded, and sorted according to recurring trends and patterns using NVIVO software. Participants were overwhelmingly motivated to participate in research because of financial incentives. The biggest barrier to participation was anxiety over finger pricks. Children suggested demonstrating different aspects of data collection during recruitment to reduce trepidation and using distraction techniques to improve the experience during anxiety-provoking data collection. Themes for benefits and barriers to research participation were identified. Data also provide a guide to promote readiness and to improve the research experience for children in future nutrition trials. Copyright © 2011 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

  5. Chloral hydrate sedation in radiology: retrospective audit of reduced dose

    Energy Technology Data Exchange (ETDEWEB)

    Bracken, Jennifer [Children' s University Hospital, Radiology Department, Dublin (Ireland); Royal Children' s Hospital, Department of Medical Imaging, Parkville, Victoria (Australia); Heaslip, Ingrid; Ryan, Stephanie [Children' s University Hospital, Radiology Department, Dublin (Ireland)

    2012-03-15

    Chloral hydrate (CH) is safe and effective for sedation of suitable children. The purpose of this study was to assess whether adequate sedation is achieved with reduced CH doses. We retrospectively recorded outpatient CH sedations over 1 year. We defined standard doses of CH as 50 mg/kg (infants) and 75 mg/kg (children >1 year). A reduced dose was defined as at least 20% lower than the standard dose. In total, 653 children received CH sedation (age, 1 month-3 years 10 months), 42% were given a reduced initial dose. Augmentation dose was required in 10.9% of all children, and in a higher proportion of children >1 year (15.7%) compared to infants (5.7%; P < 0.001). Sedation was successful in 96.7%, and more frequently successful in infants (98.3%) than children >1 year (95.3%; P = 0.03). A reduced initial dose had no negative effect on outcome (P = 0.19) or time to sedation. No significant complications were seen. We advocate sedation with reduced CH doses (40 mg/kg for infants; 60 mg/kg for children >1 year of age) for outpatient imaging procedures when the child is judged to be quiet or sleepy on arrival. (orig.)

  6. Resilience among caregivers of children with chronic conditions: a concept analysis

    Directory of Open Access Journals (Sweden)

    Lin FY

    2013-08-01

    Full Text Available Fang-Yi Lin, Jiin-Ru Rong, Tzu-Ying Lee Department of Nursing, School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, Republic of China Abstract: The purpose of this concept analysis is to uncover the essential elements involved in caregivers' resilience in the context of caring for children with chronic conditions. Walker and Avant's methodology guided the analysis. The study includes a literature review of conceptual definitions of caregiver resilience in caring for children with chronic conditions. The defining attributes and correlates of caregiver resilience are reviewed. Concept analysis findings in a review of the nursing and health-related literature show that caregiver resilience in the context of caring for chronically ill children can be defined within four main dimensions, ie, disposition patterns, situational patterns, relational patterns, and cultural patterns. Empiric measurements of the impact of caregiver resilience applied to caregivers with children with chronic conditions are also reported in the analysis. The findings of this concept analysis could help nurses and health care providers to apply the concept of caregiver resilience in allied health care and be applied to further studies. Keywords: caregiver resilience, children, chronic conditions, concept analysis

  7. Analysis of traffic accidents in children

    Directory of Open Access Journals (Sweden)

    Pavlekić Snežana

    2006-01-01

    Full Text Available Introduction: Violent health damages of different origin (accidents, murders, suicides in children and youth are one of the main causes of death and disabilities in this group of population in most countries. Objective: Objective of our paper was to analyze all related factors of traffic accidents involving children and to propose adequate measures of their prevention. Method: The analysis of fatal traffic accidents of children and youth aged to 18 years on the territory of Belgrade, within the period from 1998 to 2002. Results: In relation to other forms of violent death, the traffic mortality rate in children and youth holds the leading position, accounting for 56.9% with pedestrians as the most frequent category (57.4%. The most frequent age was between 7 and 9 years (46.8% and the boys were more frequently injured than the girls. It was established that the majority of children (51.9% was either running across the street outside the pedestrian/ zebra crossings or they were carelessly running out in the street, especially in April, July, August and September. More than a half of them (55.5%, predominantly school children, were injured by the end of working week, on Thursday and Friday. Conclusion: Results of our research have shown that the traffic education of children in our region is inadequate. Due to the abovementioned, it is primarily necessary to establish long-term and permanent education of this category of population. In addition, some public investments in the City infrastructure will be required in order to reduce the risk of traffic injuries in children.

  8. CAUSES OF RESPIRATORY DISTRESS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    M M Karambin

    2008-11-01

    Full Text Available "nThere is a lack of large, prospective epidemiologic studies concerning acute lung injury (ALI and acute respiratory distress syndrome (ARDS in pediatric population. To determine the different causes of respiratory distress in children, we prepared a retrospective study and included the whole 567 children with respiratory distress referred to 17-Shahrivar Hospital, Rasht, Guilan. Using their medical files, data including age, sex, and causes of respiratory distress were collected. SPSS 13.0 (statistical software applied for statistical analysis. Pneumonia, asthma, and croup were the major causes of ARDS in children with a rate of 38.4, 19.04, and 16.5 percent, respectively. It seems that infectious factors are at the top of the list of ARDS causing factors which can be helpful to approach and manage such patients. We suggest vaccinating these at risk groups against common infectious factors such as H. Influenza and RSV which can cause either pneumonia or inducing asthma.

  9. MEDICAL AND SOCIAL VALUE OF AMETROPIA CORRECTION IN CHILDREN

    Directory of Open Access Journals (Sweden)

    E. Yu. Markova

    2015-01-01

    Full Text Available Aim. To analyze the impact of early ametropia detection on clinical and economic treatment aspects. Patients and methods. Retrospectively, quality of ophthalmological care in 60 children aged 6-8 with ametropia and strabismus was analyzed. All children were divided into three groups depending on age, refractive error and year at which treatment was initiated. In group 1 (30 children, refractive error and strabismus were diagnosed at the first year of life. In group 2 (18 children, refractive error and strabismus were diagnosed at the age of 1-3 years. In group 3 (12 children, glasses were prescribed at the age of 3-7 years. Retrospective analysis of primary medical records of enrolled patients was performed. All diagnostic and treatment methods that were applied as well as treatment results performed at the age of 6-8 were considered. The study of economic aspects considered the rates of ophthalmological examinations and pleoptic and orthoptic treatment courses as well as need in surgery. Direct medical costs were calculated for mediumterm prospects (3-5 years. Results. Early detection of refractive errors prevents amblyopia, binocular vision impairment, and strabismus. Uncorrected refractive errors in children are characterized by high economic and social burden (i.e., the higher is the age at which refractive error was revealed, the higher treatment costs are. Ametropia diagnosis in children requires special skills, hence, dilated eye exam must be performed by pediatric ophthalmologist but not by an orthoptist. Early diagnosis of refractive errors and strabismus provides accurate glass correction and timely therapy thus reducing treatment costs. Conclusions. In terms of clinical and economic efficacy, optimal age of refractive error detection is less than 1 year. Increase in diagnostic costs is compensated by good clinical outcomes and decrease in costs of managing complications and non-medical costs associated with reduced quality of life of

  10. The clinical significance of equivocal findings on spinal MRI in children with medulloblastoma.

    Science.gov (United States)

    Bennett, Julie; Ashmawy, Ramy; Ramaswamy, Vijay; Stephens, Derek; Bouffet, Eric; Laperriere, Normand; Taylor, Michael; Shroff, Manohar; Bartels, Ute

    2017-08-01

    Medulloblastoma (MB) is the most common malignant brain tumor of childhood, with cerebrospinal fluid spread the most common site of metastasis. Currently, children diagnosed with MB and evidence of spinal metastasis are treated with an increased dose of craniospinal radiation (CSI). This report reviewed equivocal abnormalities including nerve root clumping, linear vascular enhancement, nerve root enhancement and/or other vague findings on spinal magnetic resonance imaging (MRI) to elucidate their prognostic significance and aid in risk stratification. This retrospective cohort study identified children (≥3 years) diagnosed with MB between 1988 and 2012. Children treated with upfront CSI were included, and staging spine MRI must have been done preoperatively or within 72 hr of primary tumor resection. Initial MRI of the spine was assessed by two independent reviewers blinded to outcome to evaluate for equivocal findings. Survival analysis was done to determine impact on prognosis. One hundred of 157 patients were eligible for the analysis. Equivocal findings were identified in 48 (48%) patients, with MRI done preoperatively in 45 (94%) patients. Analysis by subgroup identified a higher proportion of equivocal findings in the sonic hedgehog (SHH) subgroup (P = 0.007). Five-year overall survival (OS) in children with equivocal findings compared to those with normal MRI was not different, 80 vs. 84.8% respectively, while OS in M3 patients was worse at 54.7% (P = 0.02). A higher proportion of equivocal findings was identified in the SHH subgroup. This institutional retrospective review demonstrates equivocal findings are common, not associated with decreased OS and should not prompt increased dose of CSI. © 2017 Wiley Periodicals, Inc.

  11. Are diet diaries of value in recording dietary intake of sugars? A retrospective analysis of completion rates and information quality.

    Science.gov (United States)

    Arheiam, A; Albadri, S; Brown, S; Burnside, G; Higham, S; Harris, R

    2016-11-04

    Objectives Current guidance recommends that dental practitioners should routinely give dietary advice to patients, with diet diaries as a tool to help diet assessment. We explored patients' compliance with diet-diaries usage in a paediatric clinic within a teaching hospital setting, where remuneration is not an issue. Objectives were to investigate associated factors affecting diet diaries return rate and the information obtained from returned diaries.Methods A retrospective study of 200 randomly selected clinical records of children aged 5-11 years who had received diet analysis and advice as part of a preventive dental care programme at a dental teaching hospital between 2010 and 2013. Clinical records, with a preventive care pro forma, were included in the study. Data on social and family history, DMFT-dmft, oral hygiene practices, dental attendance and dietary habits were obtained and compared with information given in completed diet-diaries. A deductive content analysis of returned diet-diaries was undertaken using a pre-developed coding scheme.Results Of 174 complete records included in this study, diet diaries were returned in 60 (34.5%) of them. Diet diaries were more likely to be returned by those children who reported that they regularly brushed their teeth (P diet diaries enabled the identification of harmful types of foods and drinks in 100% of diaries. General dietary issues, frequency and between-meals intake of sugars were also all captured in the majority of diaries (95.0%, N = 56). Information on sugar amount (53.0%, N = 32), prolonged-contact with teeth (57.0%, N = 34) and near bedtime intakes (17.0%, N = 28) was reported in fewer diaries.Conclusions The return rate of diet-diaries in this setting was low, and associated with patients' demographic and oral health characteristics. Returned diet-diaries showed a varied range of missing important dietary information, such as sugar amount, which appears to compromise their validity as a diet

  12. Retrospective Review of Pediatric Blunt Renal Trauma: A Single Institution's Five Year Experience.

    Science.gov (United States)

    Richards, Carly R; Clark, Margaret E; Sutherland, Ronald S; Woo, Russell K

    2017-05-01

    Children are at higher risk of renal injury from blunt trauma than adults due to a variety of anatomic factors such as decreased perirenal fat, weaker abdominal muscles, and a less ossified thoracic cage. Non-operative management is gaining in popularity for even major injuries, although there are no universally accepted guidelines. We present a retrospective review of pediatric major blunt renal injuries (grade 3 or higher) at a children's hospital in Hawai'i over a 5-year period. Medical records were examined between January 2009 and September 2014 from Kapi'olani Medical Center for Women and Children in Honolulu, Hawai'i. Inclusion criteria were a diagnosis of renal trauma, or the diagnosis of blunt abdominal trauma with hematuria. Exclusion criteria were grade I or II renal injury or death due to an additional traumatic injury. Mechanism of injury, clinical characteristics on admission, blood product requirements, surgical interventions performed, and hospital length of stay were retrospectively analyzed. Eleven total patient records were examined, nine of which fit inclusion criteria. Uniquely, 33% of patients sustained their renal injury while surfing. No patients required laparotomy or nephrectomy, though 22% of patients received a blood transfusion and 44% of patients underwent ureteral stent placement. Non-operative management of major renal injuries in children is feasible and allows for preservation of renal tissue. A novel mechanism of surfing as a cause of major renal trauma is seen in the state of Hawai'i.

  13. Retrospective Review of Pediatric Blunt Renal Trauma: A Single Institution's Five Year Experience

    Science.gov (United States)

    Clark, Margaret E; Sutherland, Ronald S; Woo, Russell K

    2017-01-01

    Children are at higher risk of renal injury from blunt trauma than adults due to a variety of anatomic factors such as decreased perirenal fat, weaker abdominal muscles, and a less ossified thoracic cage. Non-operative management is gaining in popularity for even major injuries, although there are no universally accepted guidelines. We present a retrospective review of pediatric major blunt renal injuries (grade 3 or higher) at a children's hospital in Hawai‘i over a 5-year period. Medical records were examined between January 2009 and September 2014 from Kapi‘olani Medical Center for Women and Children in Honolulu, Hawai‘i. Inclusion criteria were a diagnosis of renal trauma, or the diagnosis of blunt abdominal trauma with hematuria. Exclusion criteria were grade I or II renal injury or death due to an additional traumatic injury. Mechanism of injury, clinical characteristics on admission, blood product requirements, surgical interventions performed, and hospital length of stay were retrospectively analyzed. Eleven total patient records were examined, nine of which fit inclusion criteria. Uniquely, 33% of patients sustained their renal injury while surfing. No patients required laparotomy or nephrectomy, though 22% of patients received a blood transfusion and 44% of patients underwent ureteral stent placement. Non-operative management of major renal injuries in children is feasible and allows for preservation of renal tissue. A novel mechanism of surfing as a cause of major renal trauma is seen in the state of Hawai‘i. PMID:28484665

  14. Short-term treatment outcomes of children starting antiretroviral ...

    African Journals Online (AJOL)

    Short-term treatment outcomes of children starting antiretroviral therapy in the intensive care unit, general medical wards and outpatient HIV clinics at Red Cross War Memorial Children's Hospital, Cape Town, South Africa: A retrospective cohort study.

  15. A retrospective analysis of health systems in Denmark and Kaiser Permanente

    DEFF Research Database (Denmark)

    Frølich, Anne; Schiøtz, Michaela L; Strandberg-Larsen, Martin

    2008-01-01

    ABSTRACT: BACKGROUND: To inform Danish health care reform efforts, we compared health care system inputs and performance and assessed the usefulness of these comparisons for informing policy. METHODS: Retrospective analysis of secondary data in the Danish Health Care System (DHS) with 5.3 million...... citizens and the Kaiser Permanente integrated delivery system (KP) with 6.1 million members in California. We used secondary data to compare population characteristics, professional staff, delivery structure, utilisation and quality measures, and direct costs. We adjusted the cost data to increase...... comparability. RESULTS: A higher percentage of KP patients had chronic conditions than did patients in the DHS: 6.3% vs. 2.8% (diabetes) and 19% vs. 8.5% (hypertension), respectively. KP had fewer total physicians and staff compared to DHS, with134 physicians/100,000 individuals versus 311 physicians/100...

  16. Comparison of CATs, CURB-65 and PMEWS as triage tools in pandemic influenza admissions to UK hospitals: case control analysis using retrospective data.

    Science.gov (United States)

    Myles, Puja R; Nguyen-Van-Tam, Jonathan S; Lim, Wei Shen; Nicholson, Karl G; Brett, Stephen J; Enstone, Joanne E; McMenamin, James; Openshaw, Peter J M; Read, Robert C; Taylor, Bruce L; Bannister, Barbara; Semple, Malcolm G

    2012-01-01

    Triage tools have an important role in pandemics to identify those most likely to benefit from higher levels of care. We compared Community Assessment Tools (CATs), the CURB-65 score, and the Pandemic Medical Early Warning Score (PMEWS); to predict higher levels of care (high dependency--Level 2 or intensive care--Level 3) and/or death in patients at or shortly after admission to hospital with A/H1N1 2009 pandemic influenza. This was a case-control analysis using retrospectively collected data from the FLU-CIN cohort (1040 adults, 480 children) with PCR-confirmed A/H1N1 2009 influenza. Area under receiver operator curves (AUROC), sensitivity, specificity, positive predictive values and negative predictive values were calculated. CATs best predicted Level 2/3 admissions in both adults [AUROC (95% CI): CATs 0.77 (0.73, 0.80); CURB-65 0.68 (0.64, 0.72); PMEWS 0.68 (0.64, 0.73), ptools for predicting need for higher levels of care and/or mortality in patients of all ages.

  17. Intentional injury against children in Sub-Saharan Africa: A tertiary trauma centre experience.

    Science.gov (United States)

    Gallaher, Jared R; Wildfire, Benjamin; Mabedi, Charles; Cairns, Bruce A; Charles, Anthony G

    2016-04-01

    Intentional injuries are the result of violence. This is an important public health issue, particularly in children, and is an unaddressed problem in sub-Saharan Africa. This study sought to describe the characteristics of intentional injury, particularly physical abuse, in children presenting to our tertiary trauma centre in Lilongwe, Malawi and how they compare to children with unintentional injuries. A retrospective analysis of children (in Lilongwe, Malawi from 2009 to 2013 was performed. Children with intentional and unintentional injuries were compared with bivariate analysis and multivariate logistic regression modelling. 67,672 patients with traumatic injuries presented to KCH of which 24,365 were children. 1976 (8.1%) patients presented with intentional injury. Intentional injury patients had a higher mean age (11.1 ± 5.0 vs. 7.1 ± 4.6, pin intentional injury patients (80.5 vs. 45.4%, pin both groups (89.2 vs 80.9%, pin both groups. Sub-Saharan African tertiary hospitals are uniquely positioned to play a pivotal role in the identification, clinical management, and alleviation of intentional injuries to children by facilitating access to social services and through prevention efforts. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Resilience among caregivers of children with chronic conditions: a concept analysis.

    Science.gov (United States)

    Lin, Fang-Yi; Rong, Jiin-Ru; Lee, Tzu-Ying

    2013-08-29

    The purpose of this concept analysis is to uncover the essential elements involved in caregivers' resilience in the context of caring for children with chronic conditions. Walker and Avant's methodology guided the analysis. The study includes a literature review of conceptual definitions of caregiver resilience in caring for children with chronic conditions. The defining attributes and correlates of caregiver resilience are reviewed. Concept analysis findings in a review of the nursing and health-related literature show that caregiver resilience in the context of caring for chronically ill children can be defined within four main dimensions, ie, disposition patterns, situational patterns, relational patterns, and cultural patterns. Empiric measurements of the impact of caregiver resilience applied to caregivers with children with chronic conditions are also reported in the analysis. The findings of this concept analysis could help nurses and health care providers to apply the concept of caregiver resilience in allied health care and be applied to further studies.

  19. [A retrospective study on nutritional status and growth and development of 37 children with chronic kidney disease stage 3 to 5].

    Science.gov (United States)

    Bao, R; Chen, C Y

    2016-09-01

    To retrospectively analyze the nutritional status and growth and development situation of the children with chronic kidney disease stage 3 to 5 when they were diagnosed at the first visit. After searching for the data of all the hospitalized cases during January 2007 to September 2015 in the Department of Nephrology of Children's Hospital Affiliated to the Capital Institute of Pediatrics from the medical record system, data of 37 cases with complete clinical data were collected; all these cases were diagnosed as chronic kidney disease stage 3 to 5 according to the diagnostic criteria.We recorded these children's age, height, weight, body mass index, albumin, blood lipids and acidosis situation when they were first diagnosed, and then, analyzed and summarized their nutritional status and growth and development situation. In these 37 cases, 24 cases were boys and 13 cases were girls; 23 cases (62%) were shorter than the third percentile of age-sex-specific height; 18 cases (49%) exhibited lower weight than the third percentile of age-sex-specific weight; 5 cases (13.5%) showed lower BMI than the third percentile of height-age BMI, and 5 cases (13.5%) had obesity. The level of albumin was (37.0±8.7) g/L, and no statistically significant difference was observed within each stage. In all of these cases, 10 cases were hypoalbuminemia (27%), and the difference of its frequency between stage 3-4 and stage 5 was not statistically significant. Triglyceride was (2.2±1.1) mmol/L. The mean level was higher than the normal range, but with no statistically significant difference within each stage; 21 cases (62%) were diagnosed as hypertriglyceridemia, which were more frequent compared with the occurrence of the hypercholesterolemia (32%), the high low density lipoprotein (26%) and the low high density lipoprotein(12%). And the occurrence of decompensated metabolic acidosis in stage 5 (69%) was significantly higher than that in stage 3-4 (38%) (P=0.036 6, children with chronic

  20. Retrospective analysis of necropsy reports suggestive of abuse in dogs and cats.

    Science.gov (United States)

    Almeida, Daniel C; Torres, Sheila M F; Wuenschmann, Arno

    2018-02-15

    OBJECTIVE To identify historical and necropsy findings suggestive of neglect or abuse of dogs and cats by retrospective analysis of necropsy reports from a veterinary diagnostic laboratory. DESIGN Retrospective cohort study. SAMPLE 119 necropsy reports of dogs and cats. PROCEDURES Necropsy reports from February 2001 to May 2012 were electronically searched to identify potential animal abuse or neglect cases. Cases were selected and categorized according to a previously proposed method for classification of animal abuse. Inclusion criteria included signs of neglect, nonaccidental injury (NAI; blunt-force or sharp-force trauma, gunshot, burns, drowning, asphyxiation, and suspicious intoxications), and sexual abuse. Poor preservation of cadavers, age abuse cases, determined on the basis of all necropsies performed in the study period, was 73 of 8,417 (0.87%) in dogs and 46 of 4,905 (0.94%) in cats. Neglect and NAI were commonly identified in cats; NAI was most commonly found in dogs. Gunshot and blunt-force trauma were the most common NAIs in dogs and cats, respectively. Pit bull-type dogs (29/73 [40%]) were overrepresented in several abuse categories. Most cats (29/46 [63%]) were domestic shorthair, but no breed association was found. Most (41/71 [58%]) affected animals with age data available were ≤ 2 years old. CONCLUSIONS AND CLINICAL RELEVANCE Approximately 1% of dogs and cats necropsied in the study period had signs suggestive of abuse. Medical findings alone are not necessarily indicative of abuse, but some findings can increase the index of suspicion.

  1. Children with nutritional rickets referred to hospitals in Copenhagen during a 10-year period

    DEFF Research Database (Denmark)

    Pedersen, Pernille; Michaelsen, K F; Mølgaard, C

    2003-01-01

    AIM: To describe the prevalence of nutritional rickets among children admitted to three large paediatric departments in the Copenhagen area during a 10 y period. METHODS: Retrospective analysis of cases identified from the diagnosis registers fulfilling the diagnostic criteria for nutritional...... joints. Two children had generalized convulsions. None of the cases had received vitamin D supplementation. CONCLUSION: Nutritional rickets is still present among immigrants in Denmark, and it is likely that the prevalence of mild cases is high. Prevention through vitamin D supplementation is important......, but requires a dedicated health education effort....

  2. Spatial and temporal analysis of postural control in dyslexic children.

    Science.gov (United States)

    Gouleme, Nathalie; Gerard, Christophe Loic; Bui-Quoc, Emmanuel; Bucci, Maria Pia

    2015-07-01

    The aim of this study is to examine postural control of dyslexic children using both spatial and temporal analysis. Thirty dyslexic (mean age 9.7±0.3years) and thirty non-dyslexic age-matched children participated in the study. Postural stability was evaluated using Multitest Equilibre from Framiral®. Posture was recorded in the following conditions: eyes open fixating a target (EO) and eyes closed (EC) on stable (-S-) and unstable (-U-) platforms. The findings of this study showed poor postural stability in dyslexic children with respect to the non-dyslexic children group, as demonstrated by both spatial and temporal analysis. In both groups of children postural control depends on the condition, and improves when the eyes are open on a stable platform. Dyslexic children have spectral power indices that are higher than in non-dyslexic children and they showed a shorter cancelling time. Poor postural control in dyslexic children could be due to a deficit in using sensory information most likely caused by impairment in cerebellar activity. The reliability of brain activation patterns, namely in using sensory input and cerebellar activity may explain the deficit in postural control in dyslexic children. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  3. Congenital Cytomegalovirus among Children with Cerebral Palsy.

    Science.gov (United States)

    Smithers-Sheedy, Hayley; Raynes-Greenow, Camille; Badawi, Nadia; Fernandez, Marian A; Kesson, Alison; McIntyre, Sarah; Leung, Kin-Chuen; Jones, Cheryl A

    2017-02-01

    To determine the proportion of children with cerebral palsy (CP) and cytomegalovirus (CMV) DNA detected retrospectively in their newborn screening cards (NBSC), to compare the proportion of children with CMV DNA in their NBSC across spastic subtypes of CP, and to compare the sex and other characteristics of children with CP and CMV detected on their NSBC with those in whom CMV DNA was not detected. Retrospective observational study. Data were extracted from patient records on children with CP (birth years 1996-2014) from 2 Australian state CP registers and state-wide paediatric rehabilitation services with consent. NBSCs were retrospectively analyzed for CMV DNA by nested polymerase chain reaction (PCR) using primers against gB. Positive samples were validated using real time PCR for CMV UL83. Of 401 children recruited, 323 (80.5%) had an available NBSC. Of these, 31 (9.6%; 95% CI, 6.8-13.3) tested positive for CMV DNA by nested PCR for CMV gB, of whom 28 (8.7%; 95% CI, 6.1-12.2) also had CMV DNA detected by real-time PCR for CMV UL83. Detection of CMV DNA was significantly associated with epilepsy, but not with clinical or epidemiologic characteristics, including sex and pattern of spasticity. CMV viremia in the newborn period, indicating congenital CMV infection, is highly prevalent among children with CP. Further research is needed to investigate the mechanisms and contribution of congenital CMV to the causal pathways to CP. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. A retrospective case-cohort study comparing treatment outcomes in abacavir versus stavudine containing first line antiretroviral treatment regimens in children <3yrs old, at a paediatric programme based in Soweto, South Africa

    Science.gov (United States)

    Otwombe, Kennedy; Lazarus, Erica; Liberty, Afaaf; Gray, Glenda E.; Greeff, Oppel B. W.; Violari, Avy

    2017-01-01

    Introduction The current World Health Organization guideline for first line antiretroviral therapy (ART) in HIV-infected children recommends the use of abacavir and lamivudine as nucleoside backbones and no longer includes stavudine. We compared treatment outcomes with abacavir (ABC) versus stavudine (d4T) in a cohort of HIV-1 infected children 6 and 12 months after antiretroviral therapy was initiated. Methods This was a retrospective case-cohort study, using programmatic data from children enrolled in the Paediatric Wellness Programme at the Perinatal HIV Research Unit in Soweto, South Africa between 2005 and 2013. Children on abacavir/stavudine who had initiated ART at age 90% for ABC and d4T were similar too (95% in ABC vs. 86% in d4T, p = 0.10). The proportion of children who died over 12 months was 3.5% in the ABC and 7.9% in the d4T group (p = 0.27). Similarly, the anthropometric measures were comparable. Conclusions It is reassuring that in the short term, in this group of patients, the treatment outcomes were similar. PMID:28686654

  5. Childcare use and overweight in Finland: cross-sectional and retrospective associations among 3- and 5-year-old children.

    Science.gov (United States)

    Lehto, R; Mäki, P; Ray, C; Laatikainen, T; Roos, E

    2016-04-01

    Different types of non-parental childcare have been found to associate with childhood overweight in several, but not all studies. Studies on the matter are mainly North American. The objective of our study was to examine associations between childcare use and overweight in Finland. The cross-sectional and partly retrospective data consists of 1683 3- and 5-year-old children participating in the Child Health Monitoring Development project (LATE-project) conducted in 2007-2009 in Finland. Children were measured at health check-ups and information on child's age when entering childcare, the number of childcare places the child has had, current type of childcare (parental, informal, [group] family childcare, childcare centre) and the current amount of childcare (hours) were gathered. Parents' body mass indices, family educational level, family structure, maternal smoking during pregnancy and child's birth weight were treated as covariates. Beginning childcare before age 1 (adjusted model: odds ratio [OR] 2.53, 95% confidence interval [CI] 1.41-4.52) and, for girls only, number of childcare places (adjusted model: OR 1.33, 95% CI 1.11-1.60), were associated with an increased risk of overweight. The current type of childcare or the time currently spent in childcare was not associated with overweight. Beginning childcare before age 1, which is quite rare in Finland, and having attended several childcare places were associated with overweight even when adjusting for family socioeconomic status and other family background variables. The significance of these findings needs to be further studied. © 2015 World Obesity.

  6. Transfusion transmitted infections – A retrospective analysis from the ...

    African Journals Online (AJOL)

    Background: The emergence of transfusion transmitted infection (TTI) especially HIV/AIDS has created a huge obstacle in ensuring blood safety. To assess the situation in Eritrea, we carried out a retrospective study of 29,501 blood donors for the prevalence of TTI's i.e. HIV, HBV, HCV and Syphilis. Methods: The study ...

  7. Evolution of Canadian nursing curricula: a critical retrospective analysis of power and caring.

    Science.gov (United States)

    Anthony, Susan E; Landeen, Janet

    2009-01-01

    The evolution of Canadian nursing curricula has mutually influenced and reflected nursing's historical course: nursing practice and education are inextricably linked. This paper is a critical retrospective analysis of the evolution of nursing curricula in Canada from the 20th century to the present. Falk Rafael's (1996) dialectic exploration of power and caring in nursing guides the analysis. An ordered, assimilated, and empowered curriculum development framework results. Foucault's (1980) work in the sociology of knowledge and Belenky, Clinchy, Goldberger, and Tarule's (1986) epistemological conceptualization of women's knowledge development are incorporated. The intricacies of the relationship between nursing curriculum development and Canadian history, the navigation of societal paradoxes that mutually drive and inform education and practice, and the instrumental need for nursing education research are considered. A fourth and new dialectic layer is suggested that places nursing on the inter-professional team of architects of a co-constructed emancipatory curriculum.

  8. Retrospective Analysis of the Benefits and Impacts of U.S. Renewable Portfolio Standards

    Energy Technology Data Exchange (ETDEWEB)

    Wiser, Ryan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Barbose, Galen [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Heeter, Jenny [National Renewable Energy Lab. (NREL), Golden, CO (United States); Mai, Trieu [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bird, Lori [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bolinger, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Carpenter, Alberta [National Renewable Energy Lab. (NREL), Golden, CO (United States); Heath, Garvin [National Renewable Energy Lab. (NREL), Golden, CO (United States); Keyser, David [National Renewable Energy Lab. (NREL), Golden, CO (United States); Macknick, Jordan [National Renewable Energy Lab. (NREL), Golden, CO (United States); Mills, Andrew [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Millstein, Dev [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2016-01-06

    This analysis is the first-ever comprehensive assessment of the benefits and impacts of state renewable portfolio standards (RPSs). This joint National Renewable Energy Laboratory-Lawrence Berkeley National Laboratory project provides a retrospective analysis of RPS program benefits and impacts, including greenhouse gas emissions reductions, air pollution emission reductions, water use reductions, gross jobs and economic development impacts, wholesale electricity price reduction impacts, and natural gas price reduction impacts. Wherever possible, benefits and impacts are quantified in monetary terms. The paper will inform state policymakers, RPS program administrators, industry, and others about the costs and benefits of state RPS programs. In particular, the work seeks to inform decision-making surrounding ongoing legislative proposals to scale back, freeze, or expand existing RPS programs, as well as future discussions about increasing RPS targets or otherwise increasing renewable energy associated with Clean Power Plan compliance or other emission-reduction goals.

  9. Extrapulmonary Conditions, Concomitant of Bronchopulmonary Dysplasia, in Babies of the First 3 Years of Life: Results of a Retrospective Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    K. A. Kazakova

    2016-01-01

    Full Text Available Background: There are few data on co-occurring with bronchopulmonary dysplasia diseases but there is no single point of view on their mutual effect.Objective: Our aim was to learn the structure and frequency of extrapulmonary disease, concomitant of bronchopulmonary dysplasia, in children aged up to 3 years.Methods. A retrospective analysis of histories of 93 children with bronchopulmonary dysplasia with an analysis of the consequences of perinatal pathology structure was carried out.Results. On average, each patient with bronchopulmonary dysplasia accounted for 5 comorbidities. The most common (89; 96% were perinatal lesions of the nervous system and their consequences. In children with bronchopulmonary dysplasia at the age of 3 years there was a relatively low incidence of hydrocephalus and, on the contrary, high — of infantile cerebral palsy. Violations of the organs of vision were found in 58 (62% children, malnutrition and other violations of physical development — in 58 (62% and 27 (29%, respectively, and the cardiovascular system pathology — in 59 (63%.Conclusion. The most commonly, extrapulmonary pathology, co-occuring with bronchopulmonary dysplasia, includes neurological deficit with psychomotor retardation, violations of organs of vision, pathology of the cardiovascular system, malnutrition/delay in physical development.

  10. Sonographic diagnosis of juvenile polyps in children.

    Science.gov (United States)

    Zhang, Yao; Li, Shi-Xing; Xie, Li-Mei; Shi, Bo; Ju, Hao; Bai, Yu-Zuo; Zhang, Shu-Cheng

    2012-09-01

    The aim of this study was to assess the diagnostic value of ultrasonography for juvenile polyps in children and their sonographic characteristics. A retrospective analysis was performed of the ultrasound findings in 27 children who were diagnosed preoperatively with juvenile polyp within the intestinal tract by ultrasonography and then confirmed by colonoscopy, laparotomy and histopathology. The ultrasonic finding common to all polyps was an isolated intraluminal nodular or massive protrusion, associated with multiple mesh-like fluid areas of different sizes. In 25 children, surrounding pedicle-like low echoes of varying lengths were seen connecting with the polyps to form "mushroom" sign. The color Doppler showed abundant blood flow signals within all polyps and pedicles in a shape of a branch or an umbrella. For seven children with an intussusception, the polyp shadow was detected in the cervical part or interior of the intussusception. Ultrasonography is, thus, considered to be a feasible method for diagnosing intestinal juvenile polyp. Copyright © 2012 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  11. A retrospective neurocognitive study in children with spastic diplegia

    NARCIS (Netherlands)

    Pirila, S; van der Meere, J; Korhonen, P; Ruusu-Niemi, P; Kyntaja, M; Nieminen, P; Korpela, R

    2004-01-01

    The study presents the results on neonatal cranial ultrasonography (US) and later intelligence (Wechsler Intelligence Scale-Third Edition and Wechsler Preschool and Primary Scale of Intelligence-Revised) and Neuropsychological assessments of 15 children with spastic diplegia. The assessments were

  12. Prevalence and risk factors of mortality after surgery for congenital heart disease in Tabriz, Iran: A five year retrospective

    International Nuclear Information System (INIS)

    Sohrab, N.; Alireza, Y.; Ata, M.; Mahmoud, S.; Bahram, Q.; Azad, R.

    2010-01-01

    Objective: The mortality rate after surgeries for congenital heart disorders is the most important factor for determination of the quality of these operations. A study that evaluate the mortality rate of these surgeries has not been done till now in Iran. Therefore, the purpose of this study was to determine the prevalence and risk factors of mortality after surgery for correction of congenital heart disease. Methodology: In a retrospective study, 120 children who expired after cardiac surgery and also 150 children who survived after surgery were evaluated between 2005 and 2009. Personal and Social parameters and some risk factors were analyzed. Analysis of results was performed using SPSS version 14 and descriptive and inferential statistics. Results: It showed that 12.64% of children died after surgery. Important risk factors of death were age, weight, height, body surface, preoperative Blood Urea Nitrogen, preoperative Prothrombin Time, preoperative cyanosis and postoperative bleeding. Conclusion: The results of this study indicate that the death rate of children after heart surgery in cardiovascular center of Tabriz Medical University seems to be high. Because of the lack of studies in this field more trials are advised. (author)

  13. Vesicoureteric reflux in children

    Directory of Open Access Journals (Sweden)

    Jameela A Kari

    2013-01-01

    Full Text Available Aim: This study aimed to identify the differences between primary and secondary vesicoureteric reflux (VUR and the effect of associated bladder abnormalities on kidney function. Patients and Methods: We retrospectively reviewed the medical records of children with VUR who were followed up at King Abdulaziz University Hospital from January 2005 to December 2010. The review included results of radiological investigations and kidney function tests. We used Chi-square test for statistical analysis and paired t-test to compare group means for initial and last creatinine levels. Results: Ninety-nine children were included in this study. Twenty (20.2% had primary VUR, 11 had high-grade VUR, while 9 had low-grade reflux. All children with low-grade VUR had normal dimercaptosuccinic acid (DMSA. Renal scars were present in 72% of the children with high-grade VUR. The mean creatinine levels (initial and last for both groups were normal. Seventy-nine (79.8% children had secondary VUR, which was due to posterior urethral valves (PUV (46.8%, neurogenic bladder caused by meningomyelocele (25.3%, non-neurogenic neurogenic bladder (NNB (21.5%, or neurogenic bladder associated with prune belly syndrome (6.3%. Children with NNB, meningomyelocele and PUV had high creatinine at presentation with no considerable worsening of their kidney functions during the last visit. Renal scars were present in 49.4% of the children with secondary VUR. Conclusion: Children with primary VUR and normal bladder had good-functioning kidneys, while those with secondary VUR associated with abnormal bladder caused by NNB, spina bifida or PUV had abnormal kidney functions. DMSA scans were useful in predicting higher grades of VUR in children with primary reflux.

  14. Medulloblastoma in adults. A retrospective single institution analysis

    Energy Technology Data Exchange (ETDEWEB)

    Hadi, Indrawati; Roengvoraphoj, Olarn; Niyazi, Maximilian; Nachbichler, Silke Birgit [LMU Munich, Department of Radiation Oncology, University Hospital, Munich (Germany); Roeder, Falk [LMU Munich, Department of Radiation Oncology, University Hospital, Munich (Germany); German Cancer Research Center (DKFZ), Molecular Radiation Oncology, Heidelberg (Germany); Schueller, Ulrich [University Medical Center, Institute of Neuropathology, Hamburg-Eppendorf (Germany); Research Institute Children' s Cancer Center, Hamburg (Germany); University Medical Center, Department of Pediatric Hematology and Oncology, Hamburg-Eppendorf (Germany); Belka, Claus [LMU Munich, Department of Radiation Oncology, University Hospital, Munich (Germany); German Cancer Consortium (DKTK), Munich (Germany)

    2018-03-15

    Adult medulloblastoma is a rare disease treated according to the current pediatric treatment guidelines. This retrospective analysis investigated the clinical outcomes and prognostic factors of adult medulloblastoma patients, who received multimodal therapy at our institution. Treatment charts of all patients over the age of 15 years of age with de novo medulloblastoma, who had been treated at our institution between 2001 and 2014, were retrospectively analyzed. Patients' demographic parameters, initial symptoms, treatment modalities, toxicities, and survival outcomes were investigated. In all, 21 patients with a median age of 30.2 years were identified. The most frequent histologies were desmoplastic and classic, and the most common molecular subtype was sonic hedgehog (SHH). After tumor resection, all patients received craniospinal irradiation (median dose 35.2 Gy) and a boost to the posterior fossa (median dose 19.8 Gy). Simultaneous chemotherapy with vincristine was given to 20 patients and sequential chemotherapy to 15 patients. The most common side effects were hematological toxicities. Median overall survival (OS) has not been reached after a median follow-up of 92 months. Estimated 5- and 10-year OS was 89 and 80%, respectively. Estimated 5- and 10-year progression-free survival (PFS) was 89 and 81%, respectively. In univariate analysis, a shorter interval between tumor resection and end of irradiation was significantly associated with improved OS and PFS, anaplastic histology with worse OS and PFS. The combined modality treatment showed a good outcome in adults with medulloblastoma. Treatment time was revealed to be prognostic and should be kept as short as possible. (orig.) [German] Das Medulloblastom des Erwachsenen ist eine seltene Erkrankung, die analog paediatrischer Behandlungsprotokolle therapiert wird. Diese retrospektive Analyse untersuchte die klinischen Ergebnisse und prognostischen Faktoren von erwachsenen Medulloblastompatienten, die eine

  15. Uncovering the problem-solving process: cued retrospective reporting versus concurrent and retrospective reporting.

    Science.gov (United States)

    van Gog, Tamara; Paas, Fred; van Merriënboer, Jeroen J G; Witte, Puk

    2005-12-01

    This study investigated the amounts of problem-solving process information ("action," "why," "how," and "metacognitive") elicited by means of concurrent, retrospective, and cued retrospective reporting. In a within-participants design, 26 participants completed electrical circuit troubleshooting tasks under different reporting conditions. The method of cued retrospective reporting used the original computer-based task and a superimposed record of the participant's eye fixations and mouse-keyboard operations as a cue for retrospection. Cued retrospective reporting (with the exception of why information) and concurrent reporting (with the exception of metacognitive information) resulted in a higher number of codes on the different types of information than did retrospective reporting.

  16. Cancer in human immunodeficiency virus-infected children : A case series from the Children's Cancer Group and the National Cancer Institute

    NARCIS (Netherlands)

    Granovsky, MO; Mueller, BU; Nicholson, HS; Rosenberg, PS; Rabkin, CS

    Purpose: To describe the spectrum of malignancies in human immunodeficiency virus (HIV)-infected children and the clinical outcome of patients with these tumors. Methods: We retrospectively surveyed the Children's Cancer Group (CCG) and the National Cancer institute (NCI) for cases of cancer that

  17. An Analysis of the Last Clinical Encounter before Outpatient Mortality among Children with HIV Infection and Exposure in Lilongwe, Malawi.

    Directory of Open Access Journals (Sweden)

    Chris A Rees

    Full Text Available Human immunodeficiency virus (HIV contributes to nearly 20% of all deaths in children under five years of age in Malawi. Expanded coverage of antiretroviral therapy has allowed children to access treatment on an outpatient basis. Little is known about characteristics of the final outpatient encounter prior to mortality in the outpatient setting.This retrospective cohort study assessed clinical factors associated with mortality among HIV-exposed infants and HIV-infected children less than 18 years of age at the Baylor College of Medicine Abbott Fund Children's Center of Excellence in Lilongwe, Malawi. We compared clinical indicators documented from the final outpatient encounter for patients who died in the outpatient setting versus those who were alive after their penultimate clinical encounter.Of the 8,546 patients who were attended to over a 10-year period at the Baylor Center of Excellence, 851 had died (10%. Of children who died, 392 (46% were directly admitted to the hospital after their last clinical encounter and died as inpatients. Of the remaining 459 who died as outpatients after their last visit, 53.5% had a World Health Organization (WHO stage IV condition at their last visit, and 25% had a WHO stage III condition. Multivariate regression analysis demonstrated that poor nutritional status, female gender, shorter time as a patient, more clinical encounters in the prior month, if last visit was an unscheduled sick visit, and if the patient had lost weight since their prior visit independently predicted increased mortality in the outpatient setting after the final clinical encounter.Clinical indicators may assist in identifying children with HIV who have increased risk of mortality in the outpatient setting. Recognizing these indicators may aid in identifying HIV-infected children who require a higher level of care or closer follow-up.

  18. Usefulness of texture analysis in differentiating transient from persistent part-solid nodules(PSNs: a retrospective study.

    Directory of Open Access Journals (Sweden)

    Sang Hwan Lee

    Full Text Available BACKGROUND: Early discrimination between transient and persistent par-solid ground-glass nodules (PSNs at CT is essential for patient management. The objective of our study was to retrospectively investigate the value of texture analysis in differentiating pulmonary transient and persistent PSNs in addition to clinical and CT features. METHODS: This retrospective study was performed with IRB approval and a waiver of the requirement for patients' informed consent. From January 2007 to October 2009, we identified 77 individuals (39 men and 38 women; mean age, 55 years with 86 PSNs on thin-section chest CT. Thirty-nine PSNs in 31 individuals were transient and 47 PSNs in 46 patients were persistent. The clinical, CT, and texture features of PSNs were evaluated. To investigate the additional value of texture analysis in differentiating transient from persistent PSNs, logistic regression analysis and C-statistics were performed. RESULTS: Between transient and persistent PSNs, there were significant differences in age, gender, smoking history, and eosinophil count among the clinical features. As for thin-section CT features, there were significant differences in lesion size, solid portion size, and lesion multiplicity. In terms of texture features, there were significant differences in mean attenuation, skewness of whole PSN, attenuation ratio of whole PSN to inner solid portion, and 5-, 10-, 25-, 50-percentile CT numbers of whole PSN. Multivariate analysis revealed eosinophilia, lesion size, lesion multiplicity, mean attenuation of whole PSN, skewness of whole PSN, and 5-percentile CT number were significant independent predictors of transient PSNs. (P<0.05 C-statistics revealed that texture analysis incorporating clinical and CT features (AUC, 92.9% showed significantly higher differentiating performance of transient from persistent PSNs compared with the clinical and CT features alone (AUC, 79.0%. (P =  0.004. CONCLUSION: Texture analysis of

  19. Brief Report: Recognition of Autism Spectrum Disorder before One Year of Age: A Retrospective Study Based on Home Videotapes.

    Science.gov (United States)

    Werner, Emily; Dawson, Geraldine; Osterling, Julie; Dinno, Nuhad

    2000-01-01

    This retrospective study compared videotape footage at 8-10 months of 15 children later known to have autism spectrum disorder and videotapes of 15 same-age children with typical development. The strongest finding was that infants with early onset autism were much less likely to orient when their name was called than typically developing infants.…

  20. PREVALENCE OF REFRACTIVE ERROR, STRABISMUS AND AMBLYOPIA AMONG CHILDREN WITH NORMAL DEVELOPMENT OR GLOBAL DEVELOPMENTAL DELAY/INTELLECTUAL DISABILITY ATTENDING OPHTHALMOLOGY OPD AT KLES HOSPITAL, BELAGAVI- A RETROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Smitha K. S

    2017-04-01

    Full Text Available BACKGROUND Global developmental delay/intellectual disability are on a rise in children in the present time. Ocular and visual anomalies are frequently associated with it of which refractive errors are the most frequent. This if goes unnoticed leads to strabismus and amblyopia. MATERIALS AND METHODS This study aims to assess the prevalence of refractive error, strabismus and amblyopia among children with normal development or global developmental delay/intellectual disability attending ophthalmology OPD at KLES Hospital, Belagavi. Case records of all 200 new patients less than or equal to 12 years of age group who attended KLES, Dr. Prabhakar Kore Hospital between January 2015 and December 2015 were retrospectively reviewed. RESULTS The male:female ratio was 1.22:1. Out of the total evaluated 200 cases, 130 cases were with normal development and 70 with GDD/ID. Refractive errors were 85%, whereas the cases of amblyopia was 45.50% and strabismus 39.50%. Amblyopia with refractive error having GDD/ID was stastically significant as compared to amblyopia with refractive error having normal development (p=0.001. CONCLUSION Refractive error was the most common ocular disorder seen. Refractive error with amblyopia is more in children with GDD/ID as compared to normal children. Owing to the high percentage of visual anomalies, ophthalmological referral becomes essential in children with developmental anomalies.

  1. Phono-spectrographic analysis of heart murmur in children

    Directory of Open Access Journals (Sweden)

    Angerla Anna

    2007-06-01

    Full Text Available Abstract Background More than 90% of heart murmurs in children are innocent. Frequently the skills of the first examiner are not adequate to differentiate between innocent and pathological murmurs. Our goal was to evaluate the value of a simple and low-cost phonocardiographic recording and analysis system in determining the characteristic features of heart murmurs in children and in distinguishing innocent systolic murmurs from pathological. Methods The system consisting of an electronic stethoscope and a multimedia laptop computer was used for the recording, monitoring and analysis of auscultation findings. The recorded sounds were examined graphically and numerically using combined phono-spectrograms. The data consisted of heart sound recordings from 807 pediatric patients, including 88 normal cases without any murmur, 447 innocent murmurs and 272 pathological murmurs. The phono-spectrographic features of heart murmurs were examined visually and numerically. From this database, 50 innocent vibratory murmurs, 25 innocent ejection murmurs and 50 easily confusable, mildly pathological systolic murmurs were selected to test whether quantitative phono-spectrographic analysis could be used as an accurate screening tool for systolic heart murmurs in children. Results The phono-spectrograms of the most common innocent and pathological murmurs were presented as examples of the whole data set. Typically, innocent murmurs had lower frequencies (below 200 Hz and a frequency spectrum with a more harmonic structure than pathological cases. Quantitative analysis revealed no significant differences in the duration of S1 and S2 or loudness of systolic murmurs between the pathological and physiological systolic murmurs. However, the pathological murmurs included both lower and higher frequencies than the physiological ones (p Conclusion Phono-spectrographic analysis improves the accuracy of primary heart murmur evaluation and educates inexperienced listener

  2. Use of yoked prisms in patients with acquired brain injury: a retrospective analysis.

    Science.gov (United States)

    Bansal, Surbhi; Han, Esther; Ciuffreda, Kenneth J

    2014-01-01

    The purpose of this retrospective study was to determine the clinical practices for prescribing yoked prisms, as well as to assess related patient responses, in a sample of visually-symptomatic patients having acquired brain injury (ABI). The clinical records of individuals with acquired brain injury (ABI) that were assessed for yoked prisms were reviewed retrospectively. This query resulted in 60 patient records for analysis between January 2011 and December 2012. The following diagnostic groups were analysed: homonymous hemianopsia (HH)/homonymous quadranopsia, abnormal egocentric localization (AEL) and visual neglect. HH/homonymous quadranopsia (58.3%) was the primary indication to prescribe yoked prisms, followed by visual neglect/unilateral spatial inattention (USI) (40.0%) and AEL (11.7%). The most common favourable patient responses were increased awareness of their blind visual field and improved gait, mobility and balance. The magnitude and direction of prisms prescribed were dependent upon the subjective responses in patients manifesting AEL. In contrast, base direction was dependent upon the direction of visual field loss in patients with HH/homonymous quadranopsia and visual neglect. Two-thirds of the present sample population responded favourably to the yoked prisms. The results of the present study should prove useful to clinicians for the successful prescription of yoked prisms as a treatment modality in patients presenting with the above three diagnoses.

  3. Odontoid fractures: A retrospective analysis of 53 cases

    Directory of Open Access Journals (Sweden)

    Shetty Arjun

    2009-01-01

    Full Text Available Background: The management of odontoid fracture has evolved but controversy persists as to the best method for Type II odontoid fractures with or without atlantoaxial (AA instability. The anterior odontoid screw fixation can be associated with significant morbidity while delayed odontoid screw fixation has shown to be associated with reasonable good fusion rates. We conducted a retrospective analysis to evaluate the outcome of a trial of conservative management in type II odontoid fractures without atlantoaxial instability (Group A followed by delayed odontoid screw fixation in cases in which fusion was not achieved by conservative treatment. The outcome of type II odontoid fracture with AA subluxation (Group B was also analysed where closed reduction on traction could be achieved and in those atlantoaxial subluxations that were irreducible an intraoperative reduction was done. Materials and Methods: A retrospective evaluation of 53 cases of odontoid fractures treated over a 9-year period is being reported. All odontoid fractures without AA instability (n=29 were initially managed conservatively. Three patients who did not achieve union with conservative management were treated with delayed anterior screw fixation. Twenty-four cases of odontoid fractures were associated with AA instability; 17 of them could be reduced with skeletal traction and were managed with posterior fusion and fixation. Of the seven cases that were irreducible, the initial three cases were treated by odontoid excision followed by posterior fusion and fixation; however, in the later four cases, intra operative reduction was achieved by a manipulation procedure, and posterior fusion and fixation was performed. Results: Twenty-six of 29 cases of odontoid fracture without AA instability achieved fracture union with conservative management whereas the remaining three patients achieved union following delayed anterior odontoid screw fixation. 17 out of 24 odontoid fracture with

  4. Factors affecting compliance to treatment among children with ...

    African Journals Online (AJOL)

    BACKGROUND:This study aimed to determine the factors affecting compliance to treatment among children with epilepsy in Enugu,Nigeria. METHODS: Children with diagnosis of epilepsy were consecutively recruited.Their 6 months retrospective and 1 month prospective data were collected;and analyzed using SPSS ...

  5. The epidemiologic characteristics of healthcare provider-diagnosed eczema, asthma, allergic rhinitis, and food allergy in children: a retrospective cohort study.

    Science.gov (United States)

    Hill, David A; Grundmeier, Robert W; Ram, Gita; Spergel, Jonathan M

    2016-08-20

    The rates of childhood allergic conditions are changing, prompting the need for continued surveillance. Examination of healthcare provider-based diagnosis data is an important and lacking methodology needed to complement existing studies that rely on participant reporting. Utilizing our care network of 1,050,061 urban and sub-urban children, we defined two retrospective cohorts: (1) a closed birth cohort of 29,662 children and (2) a cross-sectional cohort of 333,200 children. These cohorts were utilized to determine the epidemiologic characteristics of the conditions studied. Logistic regression was utilized to determine the extent to which food allergy was associated with respiratory allergy. In our birth cohort, the peak age at diagnosis of eczema, asthma, rhinitis, and food allergy was between 0 and 5 months (7.3 %), 12 and 17 months (8.7 %), 24 and 29 months (2.5 %), and 12 and 17 months (1.9 %), respectively. In our cross-sectional cohort, eczema and rhinitis prevalence rates were 6.7 % and 19.9 %, respectively. Asthma prevalence was 21.8 %, a rate higher than previously reported. Food allergy prevalence was 6.7 %, with the most common allergenic foods being peanut (2.6 %), milk (2.2 %), egg (1.8 %), shellfish (1.5 %), and soy (0.7 %). Food allergy was associated with development of asthma (OR 2.16, 95 % CI 1.94-2.40), and rhinitis (OR 2.72, 95 % CI 2.45-3.03). Compared with previous reports, we measure lower rates of eczema and higher rates of asthma. The distribution of the major allergenic foods diverged from prior figures, and food allergy was associated with the development of respiratory allergy. The utilization of provider-based diagnosis data contributes an important and lacking methodology that complements existing studies.

  6. Retrospective review to determine the utility of follow-up skeletal surveys in child abuse evaluations when the initial skeletal survey is normal

    Directory of Open Access Journals (Sweden)

    Kachelmeyer Andrea

    2011-09-01

    Full Text Available Abstract Objective The AAP recommends that a follow-up skeletal survey be obtained for all children Methods A retrospective review of radiology records from September 1, 1998 - January 31, 2007 was conducted. Suspected victims of child abuse who were Results Forty-seven children had a negative initial skeletal survey and were included for analysis. The mean age was 6.9 months (SD 5.7; the mean number of days between skeletal surveys was 18.7 (SD 10.1 Four children (8.5% had signs of healing bone trauma on a follow-up skeletal survey. Three of these children (75% had healing rib fractures and one child had a healing proximal humerus fracture. The findings on the follow-up skeletal survey yielded forensically important information in all 4 cases and strengthened the diagnosis of non-accidental trauma. Conclusion 8.5 percent of children with negative initial skeletal surveys had forensically important findings on follow-up skeletal survey that increased the certainty of the diagnosis of non-accidental trauma. A follow-up skeletal survey can be useful even when the initial skeletal survey is negative.

  7. del Nido versus St. Thomas Cardioplegia Solutions: A Single-Center Retrospective Analysis of Post Cross-Clamp Defibrillation Rates.

    Science.gov (United States)

    Buel, Shane T; Striker, Carrie Whittaker; O'Brien, James E

    2016-06-01

    There are many cardioplegia solutions currently in use for pediatric cardiopulmonary bypass (CPB). The most common being del Nido solution. Another common cardioplegia solution used for pediatric CPB is St. Thomas. In October 2014, Children's Mercy Kansas City changed from the use of modified St. Thomas to del Nido. This study compared rates of post cross-clamp fibrillation requiring defibrillation between del Nido solution and modified St. Thomas solution stratified by weight at Children's Mercy Kansas City. This retrospective study consisted of 394 patients who underwent cardiac surgery requiring cardioplegia between January 1, 2014 and July 31, 2015. The outcome measured was defibrillation upon cross-clamp removal. Statistical significance was determined using Fishers exact test with a two-sided significance level of .05. Incidence of defibrillation post cross-clamp removal was 4.4% in the del Nido group and 26.8% in the St. Thomas group (p Thomas group (p Thomas group (p Thomas group (p 60-kg category had an incidence of defibrillation of 16.7% in the del Nido group and 63% in the St. Thomas group (p Thomas and del Nido cardioplegia solutions. Analyses of weight stratifications demonstrate a decrease in the rate of defibrillation post cross-clamp removal in all categories within the del Nido group.

  8. [Comparison analysis of muscle enzymes in children with myocarditis and Duchene/Becker muscular dystrophy].

    Science.gov (United States)

    Zhang, Yali; Wang, Hong; Yu, Xuexin; Xing, Yanlin; Wang, Ce; He, Rong

    2016-09-28

    To compare the changes in muscle enzyme between children with myocarditis and Duchene/Becker muscular dystrophy (DMD/BMD), and to seek the explanations for variation.
 The retrospective analysis for 83 myocarditis children (myocarditis group) and 69 DMD/BMD children (DMD/BMD group), who were collected from Department of Pediatric of Shengjing Hospital affiliated to China Medical University since January 2008 to May 2015, was carried out. At the same time, 24 healthy children from the Department of Pediatric Development served as a control group. The examination indexes included creatine kinase (CK), creatine kinase-isoenzyme MB (CK-MB), creatine kinase isoenzyme MB mass (CK-MB mass), cardiac troponin I (cTnI) and high-sensitive-cTnT (hs-cTnT).
 1) In the myocarditis group, the CK increased from 100 to 1 000 U/L, reached a peak after 5 days, which lasted for a week and then dropped to the normal; the CK-MB reached a peak after 5 to 7 days and dropped to the normal a month later; the CK-MB mass reached a peak on the first day and dropped to the normal after 3 weeks; the cTn reached to a peak after 5 days and dropped to the normal after about 17 days; hs-cTnT reached to a peak on the first day and dropped to the normal after about 19 days. 2) In the DMD/BMD group, the CK increased significantly and 27 cases had a CK value of more than 10 000 U/L. After the treatment for 1 to 2 weeks, their enzyme rose again after a slight drop. In terms of cTnI, 6 cases showed a moderate increase, 5 of them couldn't drop to the normal level until more than 3 weeks later; the hs-cTnT increased in the 45 cases, which lasted for more than 3 weeks in the 31 cases of them and showed a tendency of persisting increase.
 The cTnI and hs-cTnT rise significantly and possess wider observation window than CK and CK-MB mass in myocarditis children, with more sensitive and specific changes. The myocardial damage can occur before myasthenia and keep this trend for a long time in the DMD

  9. Incarcerated umbilical hernia in children.

    Science.gov (United States)

    Chirdan, L B; Uba, A F; Kidmas, A T

    2006-02-01

    Umbilical hernia is common in children. Complications from umbilical hernias are thought to be rare and the natural history is spontaneous closure within 5 years. A retrospective analysis was performed of the medical records of a series of 23 children who presented with incarcerated umbilical hernias at our institution over an 8-year period. Fifty-two children with umbilical hernias were seen in the hospital over the period. Twenty-three (44.2%) had incarceration. Seventeen (32.7%) had acute incarceration while 6 (11.5%) had recurrent incarceration. There were 16 girls and 7 boys. The ages of the children with acute incarceration ranged from 3 weeks to 12 years (median 4 years), while the ages of those with recurrent incarceration ranged from 3-15 years (median 8.5 years). Incarceration occurred in hernias of more than 1.5 cm in diameter (in those whose defect size was measured). Twenty-one children (15 with acute and all six with recurrent incarceration) underwent repair of the umbilical hernia using standard methods. The parents of two children with acute incarceration declined surgery after spontaneous reduction of the hernia in one and taxis in the other. One boy had gangrenous bowel containing Meckel's diverticulum inside the sac, for which bowel resection with end-to-end anastomosis was done. Operation led to disappearance of pain in all 6 children with recurrent incarceration. Superficial wound infection occurred in one child. There was no mortality. Incarcerated umbilical hernia is not as uncommon as thought. Active observation of children with umbilical hernia is necessary to prevent morbidity from incarceration.

  10. Multivariate analysis of prognostic factors for idiopathic sudden sensorineural hearing loss in children.

    Science.gov (United States)

    Chung, Jae Ho; Cho, Seok Hyun; Jeong, Jin Hyeok; Park, Chul Won; Lee, Seung Hwan

    2015-09-01

    To evaluate clinical characteristics and possible associated factors of idiopathic sudden sensorineural hearing loss (ISSNHL) in children using univariate and multivariate analyses. A retrospective case series with comparisons. From January 2007 to December 2013, medical records of 37 pediatric ISSNHL patients were reviewed to assess hearing recovery rate and examine factors associated with prognosis (gender; side of hearing loss; opposite side hearing loss; treatment onset; presence of vertigo, tinnitus, and ear fullness; initial hearing threshold), using univariate and multivariate analysis, and compare them with 276 adult ISSNHL patients. Pediatric patients comprised only 6.6% of pediatric/adult cases of ISSNHL, and those below 10 years old were only 0.7%. The overall recovery rates (complete and partial) of the pediatric and adult patients were 57.4% and 47.2%, respectively. The complete recovery rate of the pediatric group (46.6%) was higher than that of the adult group (30.8%, P = .040). According to multivariate analysis, absence of tinnitus, later onset of treatment, and higher hearing threshold at initial presentation were associated with a poor prognosis in pediatric ISSNHL. The recovery rate of ISSNHL in pediatric patients is higher than in adults, and the presence of tinnitus and earlier treatment onset is associated with favorable outcomes. 4. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  11. Hand infections: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Tolga Türker

    2014-09-01

    Full Text Available Purpose. Hand infections are common, usually resulting from an untreated injury. In this retrospective study, we report on hand infection cases needing surgical drainage in order to assess patient demographics, causation of infection, clinical course, and clinical management.Methods. Medical records of patients presenting with hand infections, excluding post-surgical infections, treated with incision and debridement over a one-year period were reviewed. Patient demographics; past medical history; infection site(s and causation; intervals between onset of infection, hospital admission, surgical intervention and days of hospitalization; gram stains and cultures; choice of antibiotics; complications; and outcomes were reviewed.Results. Most infections were caused by laceration and the most common site of infection was the palm or dorsum of the hand. Mean length of hospitalization was 6 days. Methicillin-resistant Staphylococcus aureus, beta-hemolytic Streptococcus and methicillin-susceptible Staphylococcus aureus were the most commonly cultured microorganisms. Cephalosporins, clindamycin, amoxicillin/clavulanate, penicillin, vancomycin, and trimethoprim/sulfamethoxazole were major antibiotic choices. Amputations and contracture were the primary complications.Conclusions. Surgery along with medical management were key to treatment and most soft tissue infections resolved without further complications. With prompt and appropriate care, most hand infection patients can achieve full resolution of their infection.

  12. Cost-analysis of an oral health outreach program for preschool children in a low socioeconomic multicultural area in Sweden.

    Science.gov (United States)

    Wennhall, Inger; Norlund, Anders; Matsson, Lars; Twetman, Svante

    2010-01-01

    The aim was to calculate the total and the net costs per child included in a 3-year caries preventive program for preschool children and to make estimates of expected lowest and highest costs in a sensitivity analysis. The direct costs for prevention and dental care were applied retrospectively to a comprehensive oral health outreach project for preschool children conducted in a low-socioeconomic multi-cultural urban area. The outcome was compared with historical controls from the same area with conventional dental care. The cost per minute for the various dental professions was added to the cost of materials, rental facilities and equipment based on accounting data. The cost for fillings was extracted from a specified per diem list. Overhead costs were assumed to correspond to 50% of salaries and all costs were calculated as net present value per participating child in the program and expressed in Euro. The results revealed an estimated total cost of 310 Euro per included child (net present value) in the 3-year program. Half of the costs were attributed to the first year of the program and the costs of manpower constituted 45% of the total costs. When the total cost was reduced with the cost of conventional care and the revenue of avoided fillings, the net cost was estimated to 30 Euro. A sensitivity analysis displayed that a net gain could be possible with a maximal outcome of the program. In conclusion, the estimated net costs were displayed and available to those considering implementation of a similar population-based preventive program in areas where preschool children are at high caries risk.

  13. Injection therapy for chronic prostatitis: A retrospective analysis of 77 cases

    Directory of Open Access Journals (Sweden)

    Attila Toth

    2018-03-01

    Full Text Available Objective: To compare pre- and post-therapy symptom scores reported on the National Institute of Health Chronic Prostatitis Symptom Index (NIHCPSI after trans-rectal antibiotic injections therapy for men suffering from chronic prostatitis. Materials and methods: Retrospective analysis of NIHCPSI symptom scores obtained from chart reviews of 77 treated males suffering from chronic prostatitis before and after trans rectal injections for the treatment of chronic prostatitis. Results: Most patients reported a 40% to 60% improvement in symptom scores. In subgroups comparing scores in patients with less than 5 injections, the improvement was less than in patients who received 10 or more injections. Patients’ responses after a shorter (3 months follow up showed better pain scores than patient’s scores after longer, over one-year or more, follow- up periods. Conclusion: Our findings show that direct antibiotic injection for chronic prostatitis is a viable addition to standard therapies. Improvements in symptom scores are long lasting. Discomfort is minimal and side effects are rare and avoidable

  14. Long-term outcomes of dental implants placed in elderly patients: a retrospective clinical and radiographic analysis.

    Science.gov (United States)

    Park, Jung-Chul; Baek, Won-Sun; Choi, Seong-Ho; Cho, Kyoo-Sung; Jung, Ui-Won

    2017-02-01

    The aim of this retrospective study was to determine the clinical and the radiographic outcomes of dental implants placed in elderly people older than 65 years. In total, 902 implants in 346 patients (age: 65-89 years) were followed up for 2-17 years following the implant surgery. The survival rate of these implants was recorded and analyzed. Changes in marginal bone levels were also analyzed in serial radiographs, and Cox regression analysis for implant loss was performed. The survival rates were 95.39% and 99.98% in the implant- and patient-based analyses, respectively (involving a total of 29 implant failures), and the marginal bone loss at the implants was 0.17 ± 0.71 mm (mean ± SD). The number of failures was greatest in patients aged 65-69 years. The Cox regression with shared frailty analysis showed that implant loss was significantly greater in those aged 65-69 years than in those aged 70-74 years (P implant systems. Within the limitations of this retrospective study, it was concluded that implant therapy can be successfully provided to elderly patients and that age alone does not seem to affect the implant survival rate. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Gender ratio in a clinical population sample, age of diagnosis and duration of assessment in children and adults with autism spectrum disorder

    OpenAIRE

    Rutherford, Marion; McKenzie, K; Johnson, T; Catchpole, C; OHare, A; McClure, I; Forsyth, Kirsty; McCartney, Deborah; Murray, A

    2016-01-01

    This article reports on gender ratio, age of diagnosis and the duration of assessment procedures in autism spectrum disorder diagnosis in a national study which included all types of clinical services for children and adults. Findings are reported from a retrospective case note analysis undertaken with a representative sample of 150 Scottish children and adults recently diagnosed with autism spectrum disorder. The study reports key findings that the gender ratio in this consecutively referred...

  16. Reviewing Children's Books: A Content Analysis.

    Science.gov (United States)

    Bishop, Kay; Van Orden, Phyllis

    1998-01-01

    An analysis of 599 reviews of children's books from six reviewing journals for 1995-96 was compared to earlier studies, revealing great variation in adequacy of reviews. School Library Journal provided the most complete bibliographic and ordering information but no single journal supplied all the information librarians need for purchasing juvenile…

  17. Effectiveness of Japanese encephalitis SA 14-14-2 live attenuated vaccine among Indian children: Retrospective 1:4 matched case-control study.

    Science.gov (United States)

    Tandale, Babasaheb V; Khan, Siraj A; Kushwaha, Komal P; Rahman, Helina; Gore, Milind M

    2018-04-24

    We estimate the effectiveness of Japanese encephalitis (JE) SA 14-14-2 live-attenuated vaccination single dose campaign among children aged 1-15 years in India during 2006-07. Acute encephalitis syndrome (AES) cases hospitalized following vaccination campaigns during the years 2006-08 were investigated retrospectively. The laboratory-confirmed JE cases were detected from the surveillance laboratories based on anti-JE IgM antibody by ELISA or viral RNA detection by RT-PCR in sera or cerebrospinal fluid. Consent was sought from parents or guardians. Four community controls were chosen randomly per case during house-to-house survey employing individual matching on age, gender and residence during the risk period. Vaccination history was enquired from the child's guardian and verified from vaccination card at home or records at health centre. Conditional logistic regression was conducted on matched case-control sets. We studied 149 cases and matched 596 controls. Vaccination effectiveness was 43.8% (95% CI, 1.9-67.8) based on vaccination card or record. However, effectiveness was 72.2% (95% CI, 56.2-82.4) based on parental history or card/record. Vaccination effectiveness in Assam state was higher than in Uttar Pradesh state. We concluded that the single subcutaneous dose of SA 14-14-2 JE vaccine provided moderate effectiveness in Indian children. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Evaluation of validity of Tanaka-Johnston analysis in Mumbai school children.

    Science.gov (United States)

    Hambire, Chaitali Umesh; Sujan, Sunanda

    2015-01-01

    Estimation of the mesiodistal dimensions of the unerupted canines and premolars in the early mixed dentition is a necessary diagnostic aid in space management. Tanaka-Johnston analysis was developed for North American children. Anthropological study reveals that tooth size varies among different ethnicities. The present study was performed to evaluate the validity of Tanaka-Johnston method of mixed dentition arch analysis in Mumbai school children. (1) To determine the correlation between the sum of the mesiodistal widths of the permanent mandibular incisors and combined mesiodistal widths of the permanent mandibular and maxillary canines and premolar in Mumbai school children. (2) To examine the applicability of Tanaka-Johnston method of prediction. Dental casts of maxillary and mandibular arches of 300 children, 147 boys and 153 girls within the age group of 12-15 years, with permanent dentitions were fabricated. The mesiodistal crown dimensions of teeth were measured with a dial caliper. Tanaka-Johnston method of mixed dentition arch analysis was performed for the study population, and statistical analysis was done. Descriptive statistics including the mean, standard deviation, range, and standard error were calculated and tabulated. Tanaka-Johnston's equation when applied to the data available for Mumbai school children, it was observed that it slightly overestimates the tooth size. (1) There was a positive correlation between the width of mandibular incisors and mandibular and maxillary canines and premolars. (2) The Tanaka-Johnston prediction method was not accurate for a sample of Mumbai school children.

  19. Retrospective analysis of oral and maxillofacial surgery cases in a ...

    African Journals Online (AJOL)

    Method: This was a retrospective study conducted at the Oral Dental Health Centre, Akure, Ondo state, Nigeria covering the period September, 2000 and April, 2004. ... Conclusion: A wide variety of cases were seen but socioeconomic, human resource and infrastructural problems limited the scope of practice. Keywords: ...

  20. Dental treatment and caries prevention preceding treatment under general anaesthesia in healthy children and adolescents: a retrospective cohort study.

    Science.gov (United States)

    Grindefjord, M; Persson, J; Jansson, L; Tsilingaridis, G

    2018-04-01

    This was to examine healthy children and adolescents treated under general anaesthesia (GA) and a matched control group not receiving GA to compare treatment and preventive care received prior to GA treatment. This retrospective cohort study included 71 healthy subjects and 213 age- and gender-matched control subjects. The treatment group had been consecutively referred from the Public Dental Health Service (PDS) in Stockholm to the Department of Paediatric Dentistry, Eastman Institute, Stockholm during 2006-2007. Data was extracted from the patient records at the PDS, including variables such as number of dental visits, treatment/prophylaxis prior to GA, number of missed and cancelled appointments, and number of decayed teeth. On average, the treatment group had significantly more decayed teeth (p general dentists to paediatric specialists had no behaviour management treatment and nearly half, no preventive treatment, despite receiving significantly more operative treatment compared with matched controls. General dentists should target high caries-risk patients for additional behaviour management and preventive care to reduce the need for treatment under GA.

  1. Retrospective dosimetry of Chernobyl liquidators

    International Nuclear Information System (INIS)

    Chumak, V.V.; Bakhanova, E.V.; Sholom, S.V.; Pasalskaya, L.F.; Bouville, A.; Krjuchkov, V.P.

    2000-01-01

    The numerous cohort of Chernobyl liquidators is a very attractive subject for epidemiological follow up due to high levels of exposure, age-gender distribution and availability of patients for medical examination. However, dosimetric information related to this population is incomplete, in many cases the quality of available dose records is doubtful and uncertainties of all dose values are not determined. Naive attempts to evaluate average doses on the basis of such factors as 'distance from the reactor' obviously fail due to large variation of tasks and workplace contamination. Therefore, prior to any sensible consideration of liquidators as a subject of epidemiological study, their doses should be evaluated (reevaluated) using the methods of retrospective dosimetry. Retrospective dosimetry in general got significant development over the last decade. However, most of the retrospective dosimetry techniques are time consuming, expensive and possess sensitivity threshold. Therefore, application of retrospective dosimetry for the needs of epidemiological follow up studies requires development of certain strategy. This strategy depends, of coarse, on the epidemiological design of the study, availability of resources and dosimetric information related to the time of clean up. One of the strategies of application of retrospective dosimetry may be demonstrated on the example of a cohort study with occasional nested case control consideration. In this case, the tools are needed for validation of existing dose records (of not always known quality), screening of the study cohort with express dosimetric method called to determine possible dose ranges, and 'state-of-the-art' assessment of individual doses for selected subjects (cases and controls). Verification of dose records involves analysis of the statistical regularities of dose distributions and detection of possible extraneous admixtures (presumably falsified dose records). This work is performed on impersonified data

  2. Epidemiological aspects of suicide attempts among Moroccan children

    African Journals Online (AJOL)

    Descriptive retrospective study over a period of 3 years (April 2012-April 2015) involving children who visited pediatric medical emergencies of the Children Hospital of Rabat after an autolysis attempt. We observed epidemiological parameters, history, social and family context, the means used, the presumed cause, clinical ...

  3. A Retrospective Analysis of Cyanoacrylate Injection versus Hemoclip Placement for Bleeding Dieulafoy’s Lesion in Duodenum

    Directory of Open Access Journals (Sweden)

    Yu Jiang

    2018-01-01

    Full Text Available Background. Duodenal Dieulafoy’s lesion (DL is a rare disease that may lead to lethal hemorrhage in the upper gastrointestinal tract. The best technique for endoscopic intervention still remains unclear. In the present study, we performed a retrospective analysis of cyanoacrylate injection versus hemoclip placement for treating bleeding DLs. Materials and Methods. We retrospectively analyzed eighteen patients from three medical centers between October 2008 and February 2016; six patients received cyanoacrylate injection, while hemoclips were placed in 12 patients during the upper gastrointestinal endoscopy. Results. All patients received first endoscopic examination and/or endotherapy within 12 hours of admission to hospital. No difference was observed in the primary hemostasis rate or the recurrent hemorrhage rate between the cyanoacrylate injection (CI group and the hemoclip placement (HP group, except that in one patient from the HP group melena was found three days after the first endotherapy. This patient received cyanoacrylate injection once again. Conclusion. Both cyanoacrylate injection and hemoclip placement are effective in treating duodenal DL, and neither of them causes significant side effects.

  4. Use of positive and negative words in scientific PubMed abstracts between 1974 and 2014 : retrospective analysis

    OpenAIRE

    Vinkers, Christiaan H; Tijdink, Joeri K; Otte, Willem M

    2015-01-01

    OBJECTIVE: To investigate whether language used in science abstracts can skew towards the use of strikingly positive and negative words over time. DESIGN: Retrospective analysis of all scientific abstracts in PubMed between 1974 and 2014. METHODS: The yearly frequencies of positive, negative, and neutral words (25 preselected words in each category), plus 100 randomly selected words were normalised for the total number of abstracts. Subanalyses included pattern quantification of individual wo...

  5. Assessment of Oral Status in Pediatric Patients with Special Health Care Needs receiving Dental Rehabilitation Procedures under General Anesthesia: A Retrospective Analysis.

    Science.gov (United States)

    Solanki, Neeraj; Kumar, Anuj; Awasthi, Neha; Kundu, Anjali; Mathur, Suveet; Bidhumadhav, Suresh

    2016-06-01

    Dental problems serve as additional burden on the children with special health care needs (CSHCN) because of additional hospitalization pressure, they face for the treatment of various serious medical problems. These patients have higher incidence of dental caries due to increased quantity of sugar involved in the drug therapies and lower salivary flow in the oral cavity. Such patients are difficult to treat with local anesthesia or inhaled sedatives. Single-sitting dental treatment is possible in these patients with general anesthesia. Therefore, we conducted this retrospective analysis of oral health status of CSHCN receiving various dental treatments in a given population. A total of 200 CSHCN of age 14 years or less reporting in the pediatric wing of the general hospital from 2005 to 2014 that underwent comprehensive dental treatment under general anesthesia were included in the study. Patients with history of any additional systemic illness, any malignancy, any known drug allergy, or previous history of any dental treatment were excluded from the study. Complete mouth rehabilitation was done in these patients under general anesthesia following standard protocols. Data regarding the patient's disability, type, duration, and severity of disability was collected and analyzed. All the results were analyzed by Statistical Package for the Social Sciences (SPSS) software. Chi-square test, Student's t-test, and one-way analysis of variance were used to assess the level of significance. Statistically significant results were obtained while analyzing the subject's decayed missing filled/decayed extracted filled teeth indices divided based on age. Significant difference was observed only in cases where patients underwent complete crown placement even when divided based on type of disability. While analyzing the prevalence, statistically significant results were observed in patients when divided based on their age. In CSHCN, dental pathologies and caries indices are

  6. Fournier's gangrene: A retrospective analysis of 25 patients.

    Science.gov (United States)

    Yücel, Metin; Özpek, Adnan; Başak, Fatih; Kılıç, Ali; Ünal, Ethem; Yüksekdağ, Sema; Acar, Aylin; Baş, Gürhan

    2017-09-01

    Fournier's gangrene is a surgical emergency that progresses rapidly and insidiously and results in high morbidity and mortality rates unless it is immediately diagnosed and managed. Here we analyze the outcomes of patients who were followed up and treated for Fournier's gangrene. We conducted a retrospective analysis of the medical data of 25 patients operated on for Fournier's gangrene between January 2010 and June 2015. The diagnosis of Fournier's gangrene was made by performing a physical examination. Patients who had genital, perineal, and perianal tenderness; induration; cyanosis; gangrene; and subcutaneous crepitation were considered as having Fournier's gangrene. Following resuscitation, aggressive surgical debridement was performed and vacuum-assisted closure (VAC) was conducted in addition to debridement in select patient. Repeat debridements were performed as requirement. This study included 25 patients. Fourteen patients (56%) were females and 11 (44%) were males. The mean age of the patients was 54.3 years (range: 27-82 years). The mean duration of hospital stay was 21.4 days; the mean number of debridements performed was 2.4. Thirteen patients (52%) had perianal abscesses, and 20 (80%) had diabetes mellitus. All patients underwent extensive debridement; 16 patients (64%) underwent VAC in addition to debridement. Patients undergoing VAC had significantly longer durations of hospital stay and a higher mean number of debridements performed (p=0.004 and p=0.048, respectively). An ostomy was made in one patient, and one patient died. In Fournier's gangrene, early diagnosis, effective resuscitation, aggressive debridement, and VAC application in suitable cases may reduce the morbidity and mortality rates and the need for an ostomy.

  7. Speech feature discrimination in deaf children following cochlear implantation

    Science.gov (United States)

    Bergeson, Tonya R.; Pisoni, David B.; Kirk, Karen Iler

    2002-05-01

    Speech feature discrimination is a fundamental perceptual skill that is often assumed to underlie word recognition and sentence comprehension performance. To investigate the development of speech feature discrimination in deaf children with cochlear implants, we conducted a retrospective analysis of results from the Minimal Pairs Test (Robbins et al., 1988) selected from patients enrolled in a longitudinal study of speech perception and language development. The MP test uses a 2AFC procedure in which children hear a word and select one of two pictures (bat-pat). All 43 children were prelingually deafened, received a cochlear implant before 6 years of age or between ages 6 and 9, and used either oral or total communication. Children were tested once every 6 months to 1 year for 7 years; not all children were tested at each interval. By 2 years postimplant, the majority of these children achieved near-ceiling levels of discrimination performance for vowel height, vowel place, and consonant manner. Most of the children also achieved plateaus but did not reach ceiling performance for consonant place and voicing. The relationship between speech feature discrimination, spoken word recognition, and sentence comprehension will be discussed. [Work supported by NIH/NIDCD Research Grant No. R01DC00064 and NIH/NIDCD Training Grant No. T32DC00012.

  8. Dental Caries Experience in Texan Children with Cleft Lip and Palate.

    Science.gov (United States)

    Sunderji, Sabrina; Acharya, Bhavini; Flaitz, Catherine; Chiquet, Brett

    2017-09-15

    The purpose of this study was to assess the caries experience in the primary dentition of children born with cleft lip and palate (CLP). A retrospective chart review was conducted on subjects between two and six years old recruited from a university-based pediatric dentistry residency clinic. The number of dental visits and professional fluoride applications, the plaque index and treatment modality, and the presence/location of caries, white spot lesions, and enamel hypoplastic lesions were compared between CLP patients and healthy age- and gender-matched controls. Descriptive statistics, Student's t test, Mann-Whitney U test, and regression analysis were completed. A total of 183 charts were reviewed. Compared to healthy children, CLP children had increases in number of dental visits (P0.05). Children with cleft lip and palate are at a greater risk of enamel hypoplasia and dental caries. No significant caries experience difference was found between unilateral or bilateral CLP cases.

  9. Systemic meningococcal disease in children: survival analysis, Arkhangelsk region, Northwest Russia, 1991–2011

    Directory of Open Access Journals (Sweden)

    O. V. Samodova

    2012-01-01

    Full Text Available Systemic meningococcal infection requires prompt and adequate medical care. It is considered as unpredictable disease due to extreme severity of a patient’s condition and high risk for fatal outcome. Survival of the children with systemic meningococcal infection was studied. Retrospective cohort includes all cases of systemic meningococcal disease in children arose in Arkhangelsk region in 1991–2011. Rate of fatal outcomes was high (41%. All death cases occurred during first three days of illness. Survival of the patient with correct pre-admission diagnosis was higher in comparison with initially undiagnosed cases. Survival functions were influenced by form of the disease and presence of septic shock. The usage of intramuscular injection of glucocorticoids on pre-admission stage according to the common recommendations did not improve the outcome.

  10. Ambulatory Blood Pressure Monitoring in a Cohort of Children Referred with Suspected Hypertension: Characteristics of Children with and without Attention Deficit Hyperactivity Disorder

    Directory of Open Access Journals (Sweden)

    Silviu Grisaru

    2013-01-01

    Full Text Available Childhood hypertension’s increasing prevalence has generally been linked to the obesity epidemic. We observed that a significant proportion of children referred to our pediatric center with documented office hypertension are nonobese and have a history of attention deficit hyperactivity disorder (ADHD. To define the extent of this anecdotal observation, we performed a retrospective analysis of ambulatory blood pressure monitoring (ABPM tests which in our center are routinely performed in newly referred children suspected of hypertension. Twenty-one percent (48 of 227 new referrals had a history of ADHD, and 81% of them were treated with psychostimulant medications at the time of their ABPM test. Children in this group had a significantly lower average BMI z-score compared with the rest of the children (0.18 versus 0.75 and were significantly more likely to have abnormally elevated wake systolic loads on ABPM (38% versus 4%. The overall proportion of children with any abnormality on ABPM was comparable in both groups (46% versus 40%. Conclusion. A significant proportion of children suspected of hypertension have ADHD which may be related to higher wake systolic BP values. The prevalence of hypertension among children with ADHD will have to be determined in prospective studies.

  11. A Meta-Analysis of Cross Sectional Studies Investigating Language in Maltreated Children

    Science.gov (United States)

    Lum, Jarrad A. G.; Powell, Martine; Timms, Lydia; Snow, Pamela

    2015-01-01

    Purpose: In this review article, meta-analysis was used to summarize research investigating language skills in maltreated children. Method: A systematic search of published studies was undertaken. Studies were included in the meta-analysis if they investigated language skills in groups comprising maltreated and nonmaltreated children. Studies were…

  12. Orthopaedic injuries in children: Federal Medical Centre, Umuahia ...

    African Journals Online (AJOL)

    Background: Worldwide, trauma is a recognized leading cause of childhood morbidity, mortality and disability. Aim: To review the causes and consequences of orthopaedic injuries in children. Methods: A retrospective study of all injuries in children 14 years and below seen at the Federal Medical Centre Umuahia from 1st ...

  13. Retrospective Evaluations of Sequences: Testing the Predictions of a Memory-Based Analysis.

    Science.gov (United States)

    Aldrovandi, Silvio; Poirier, Marie; Kusev, Petko; Ayton, Peter

    2015-01-01

    Retrospective evaluation (RE) of event sequences is known to be biased in various ways. The present paper presents a series of studies that examined the suggestion that the moments that are the most accessible in memory at the point of RE contribute to these biases. As predicted by this memory-based analysis, Experiment 1 showed that pleasantness ratings of word lists were biased by the presentation position of a negative item and by how easy the negative information was to retrieve. Experiment 2 ruled out the hypothesis that these findings were due to the dual nature of the task called upon. Experiment 3 further manipulated the memorability of the negative items--and corresponding changes in RE were as predicted. Finally, Experiment 4 extended the findings to more complex stimuli involving event narratives. Overall, the results suggest that assessments were adjusted based on the retrieval of the most readily available information.

  14. Growth and development profile of Indian children with Down syndrome.

    Science.gov (United States)

    Koshy, Beena; Navamani, Kirubakaran; Oommen, Samuel Philip; Srivastava, Vivi M

    2012-08-01

    In this retrospective study, we describe the profile of 88 children with Down syndrome. The average BMI for children showed a progressive increase with age. Compared to the previously published development profile, there was a significant improvement in the language domain.

  15. Neck pain in children: a retrospective case series.

    Science.gov (United States)

    Cox, Jocelyn; Davidian, Christine; Mior, Silvano

    2016-09-01

    Spinal pain in the paediatric population is a significant health issue, with an increasing prevalence as they age. Paediatric patients attend for chiropractor care for spinal pain, yet, there is a paucity of quality evidence to guide the practitioner with respect to appropriate care planning. A retrospective chart review was used to describe chiropractic management of paediatric neck pain. Two researchers abstracted data from 50 clinical files that met inclusion criteria from a general practice chiropractic office in the Greater Toronto Area, Canada. Data were entered into SPSS 15 and descriptively analyzed. Fifty paediatric neck pain patient files were analysed. Patients' age ranged between 6 and 18 years (mean 13 years). Most (98%) were diagnosed with Grade I-II mechanical neck pain. Treatment frequency averaged 5 visits over 19 days; with spinal manipulative therapy used in 96% of patients. Significant improvement was recorded in 96% of the files. No adverse events were documented. Paediatric mechanical neck pain appears to be successfully managed by chiropractic care. Spinal manipulative therapy appears to benefit paediatric mechanical neck pain resulting from day-today activities with no reported serious adverse events. Results can be used to inform clinical trials assessing effectiveness of manual therapy in managing paediatric mechanical neck pain.

  16. Trends in childhood type 1 diabetes mellitus incidence in Beijing from 1995 to 2010: a retrospective multicenter study based on hospitalization data.

    Science.gov (United States)

    Gong, Chunxiu; Meng, Xi; Jiang, Yuwu; Wang, Xinli; Cui, Hong; Chen, Xiaobo

    2015-03-01

    The incidence of type 1 diabetes mellitus (T1DM) is increasing rapidly worldwide for children of every age group. A retrospective analysis of hospital registration data from five tertiary hospitals in Beijing, China, identified 485 patients (210 boys, 275 girls) younger than 15 years of age with newly diagnosed T1DM between 1995 and 2010. From 1995 to 2010, the incidence of T1DM in patients 1995 to 2010, with rates growing at an accelerated pace since 2006. Based on recent trends, we project continued rapid growth in the number of new childhood T1DM cases in Beijing.

  17. Retrospective Analysis of Communication Events - Understanding the Dynamics of Collaborative Multi-Party Discourse

    Energy Technology Data Exchange (ETDEWEB)

    Cowell, Andrew J.; Haack, Jereme N.; McColgin, Dave W.

    2006-06-08

    This research is aimed at understanding the dynamics of collaborative multi-party discourse across multiple communication modalities. Before we can truly make sig-nificant strides in devising collaborative communication systems, there is a need to understand how typical users utilize com-putationally supported communications mechanisms such as email, instant mes-saging, video conferencing, chat rooms, etc., both singularly and in conjunction with traditional means of communication such as face-to-face meetings, telephone calls and postal mail. Attempting to un-derstand an individual’s communications profile with access to only a single modal-ity is challenging at best and often futile. Here, we discuss the development of RACE – Retrospective Analysis of Com-munications Events – a test-bed prototype to investigate issues relating to multi-modal multi-party discourse.

  18. Differences among children, adolescents and adults with severe leptospirosis: A comparative analysis

    Directory of Open Access Journals (Sweden)

    E F Daher

    2014-01-01

    Full Text Available Leptospirosis is a zoonosis of global importance caused by Leptospira interrogans. The aim of this study was to compare the data between children, adolescents and adults with leptospirosis. This is a retrospective study including a total of 373 consecutive patients with leptospirosis, admitted to tertiary hospitals in Northeast of Brazil, from May 1985 to August 2010. The patients were divided into two groups (age ≤21 years and >21 years. The adults were 304 (81.5% of the population, with a mean ge of 41 ± 13 (range 22-84 years. The pediatric group was 16 ± 3 (range 9-21 years. Signs and symptoms where similar between the groups, excepting arrhythmia, which was more frequent in adults and vomiting, more common in children (16% vs. 0%, P = 0.04 and 65% vs. 79%, P = 0.02, respectively. Adult group presented with higher serum urea (137 vs. 97 mg/dl, P = 0.002 and creatinine (4.3 vs. 3.0 mg/dl, P = 0.007. Acute kidney injury (AKI was observed in 80%, mainly in adults (83% vs. 70% P < 0.005. Adults required renal replacement therapy more frequently than children (38% vs. 11%, P < 0.0001. Mortality was higher in adults (14.8% vs. 2.8%, P = 0.005 and in adults with AKI (93% vs. 7%, P < 0.05. There are important differences between the adults and children with leptospirosis. AKI was more frequent in adults and it was associated with increased mortality.

  19. Sensorineural hearing loss in children.

    LENUS (Irish Health Repository)

    Wormald, R

    2010-02-01

    The objective of the study was to examine the aetiology of sensorineural hearing loss (SNHL) in a paediatric population presenting to the National Centre of Medical Genetics. A retrospective chart review from 1998 to 2006. One hundred and twenty nine children were investigated for SNHL. The average age of diagnosis of hearing loss was 36 months. The degree of hearing loss was mild in 8 children, moderate in 33 children, severe in 31 children and profound in 57 children. Eighty-five children (66%) were diagnosed with a hereditary hearing loss, 11 (8%) children had an acquired hearing loss and no cause found in 33 (26%) children. This is the first report of the causes of hearing loss in Irish children. The mean age of diagnosis in our cohort is high and emphasises the need for a neonatal screening programme. There remains a number of children for whom the cause of hearing loss remains unknown.

  20. SPECTRUM OF CHILDHOOD EYE DISEASES IN A RURAL MEDICAL COLLEGE- A RETROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Vinayaga Murthy K

    2017-05-01

    Full Text Available BACKGROUND Eye disorders in children with different presentations come to Ophthalmology OPD. Early detection and treatment of ocular morbidity is important. This study aimed to detect the prevalence and pattern of common ophthalmic problems in paediatric age group, in a rural based tertiary care hospital. MATERIALS AND METHODS Study design was observational, retrospective review of all children less than 12 yrs. old, who came to the rural based Chengalpattu Government medical college Ophthalmology OPD, between September 2015 and May 2016. Data collection and analysis was based on the age of presentation of both sexes (newborn (0-28 days, infants (1 year, preschool (1-5 years, school going (above 5 years from rural and semi-rural areas and diagnosis were analysed using graph pad prism 5.0. 'P value' less than 0.05 was considered statistically significant. RESULTS During the study period, out of total 2520 OP cases (100%, 230 children (10.95% were evaluated. The male: Female ratio was 1.1:1. The children from school going age constituted the largest group, male (48 .4% & Female (51.5% (p<0.001. Children from semi-rural area constituted (55% and rural area constituted (45%. Defective vision (26% was the common complaint, eye discharge accounts for (20%, and lid swelling accounts for (11.3 %. Common conditions were refractive error (26%, Conjunctivitis (20%, Lid Inflammations (11.3%, and Injuries for (10.3%. Refractive Error was common in females (53.3% and in school going children (60 %. Myopia (85% was the common refractive error. Conjunctivitis was seen more in males (52.17% and less in females (47.8%. In pre-school age group conjunctivitis was common. CONCLUSION The common childhood eye diseases observed in our study is refractive error. This has led to poor scholastic performance in school and absenteeism. Health Education & Environmental Hygiene will help in managing most of these eye disorders.

  1. Blood Transfusion In Surgical Children: The Advantages And Hazards

    African Journals Online (AJOL)

    The increasing opposition to blood transfusion makes the management of surgical children who require blood very challenging. This retrospective study reviews records of blood transfusion so as to determine the advantages and hazards in surgical children. The advantages and hazards of blood transfusion in surgical ...

  2. Acute extradural haematomas in children: A 12-year experience ...

    African Journals Online (AJOL)

    Background: Acute extradural haematomas (AEDHs) occur infrequently in children. This study was undertaken to review our experience with management and outcomes of this condition in children treated in the Neurosurgery Unit at Inkosi Albert Luthuli Central Hospital. Methods: A retrospective review of medical records of ...

  3. Efficacy of Alteplase in a Mouse Model of Acute Ischemic Stroke: A Retrospective Pooled Analysis.

    Science.gov (United States)

    Orset, Cyrille; Haelewyn, Benoit; Allan, Stuart M; Ansar, Saema; Campos, Francesco; Cho, Tae Hee; Durand, Anne; El Amki, Mohamad; Fatar, Marc; Garcia-Yébenes, Isaac; Gauberti, Maxime; Grudzenski, Saskia; Lizasoain, Ignacio; Lo, Eng; Macrez, Richard; Margaill, Isabelle; Maysami, Samaneh; Meairs, Stephen; Nighoghossian, Norbert; Orbe, Josune; Paramo, Jose Antonio; Parienti, Jean-Jacques; Rothwell, Nancy J; Rubio, Marina; Waeber, Christian; Young, Alan R; Touzé, Emmanuel; Vivien, Denis

    2016-05-01

    The debate over the fact that experimental drugs proposed for the treatment of stroke fail in the translation to the clinical situation has attracted considerable attention in the literature. In this context, we present a retrospective pooled analysis of a large data set from preclinical studies, to examine the effects of early versus late administration of intravenous recombinant tissue-type plasminogen activator. We collected data from 26 individual studies from 9 international centers (13 researchers; 716 animals) that compared recombinant tissue-type plasminogen activator with controls, in a unique mouse model of thromboembolic stroke induced by an in situ injection of thrombin into the middle cerebral artery. Studies were classified into early (stroke in mice. The power analysis reveals that a multicenter trial would require 123 animals per group instead of 40 for a single-center trial. © 2016 American Heart Association, Inc.

  4. Time until first dental caries for young children first seen in Federally Qualified Health Centers: a retrospective cohort study.

    Science.gov (United States)

    Kuthy, Raymond A; Jones, Michael; Kavand, Golnaz; Momany, Elizabeth; Askelson, Natoshia; Chi, Donald; Wehby, George; Damiano, Peter

    2014-08-01

    The study assessed the time until first dental caries for young children seen at five Federally Qualified Health Centers (FQHC) in Iowa and the relationship with the frequency and gaps (in months) of dental episodes, the number of topical fluoride treatments, and the number of dentists caring for the subject. Forty children were randomly selected at each FQHC (n = 200). All children were continuously enrolled in the Medicaid program and had their first dental visit prior to age 6. Dental chart findings, claims data for the child and family, and birth certificate information were merged into one dataset. Dental visits were followed for a minimum of 36 months, including dental visits external to the FQHCs. Using time until first caries as the dependent variable, the data were subject to left, interval, and right censoring and were analyzed via Weibull regression. Slightly more than half of the 200 children experienced caries. Regression analysis indicated that the hazard of first dental caries increased by approximately 2% with each additional month that transpired between preventive recall examinations. In addition, children with older siblings who had a dental visit at the same center during the previous year prior to the subject's first visit were more likely to have a longer time until first dental caries. Timing of dental care episodes was associated with caries experience in young children from low income families. Dental professionals should focus on regularity of dental care to prevent or delay caries experience in young children. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Time until first dental caries for young children first seen in Federally Qualified Health Centers: a retrospective cohort study

    Science.gov (United States)

    Kuthy, RA; Jones, M; Kavand, G; Momany, E; Askelson, N; Chi, D; Wehby, G; Damiano, P

    2014-01-01

    Objective The study assessed the time until first dental caries for young children seen at 5 Federally Qualified Health Centers (FQHC) in Iowa and the relationship with the frequency and gaps (in months) of dental episodes, the number of topical fluoride treatments, and the number of dentists caring for the subject. Methods Forty children were randomly selected at each FQHC (n=200). All children were continuously enrolled in the Medicaid program and had their first dental visit prior to age 6. Dental chart findings, claims data for the child and family, and birth certificate information were merged into one dataset. Dental visits were followed for a minimum of 36 months, including dental visits external to the FQHCs. Using time until first caries as the dependent variable, the data were subject to left, interval, and right censoring and were analyzed via Weibull regression. Results Slightly more than half of the 200 children experienced caries. Regression analysis indicated that the hazard rate of first dental caries increased by approximately 2% with each additional month that transpired between preventive recall examinations. In addition, children with older siblings who had a dental visit at the same center during the previous year prior to the subject’s first visit were more likely to have a longer time until first dental caries. Conclusions Timing of dental care episodes was associated with caries experience in young children from low income families. Dental professionals should focus on regularity of dental care in order to prevent or delay caries experience in young children. PMID:24483730

  6. Overweight and Obesity among Children with Developmental Disabilities

    Science.gov (United States)

    De, Sukanya; Small, Jacqueline; Baur, Louise A.

    2008-01-01

    Background: The aim of this study was to determine the prevalence of overweight and obesity in children with developmental disabilities attending a metropolitan Diagnosis and Assessment Service. Method: A retrospective chart review was carried out for 98 children (67 male) aged 2-18 years. Data on age, sex, weight, height, and severity of…

  7. Identification accuracy of children versus adults: a meta-analysis.

    Science.gov (United States)

    Pozzulo, J D; Lindsay, R C

    1998-10-01

    Identification accuracy of children and adults was examined in a meta-analysis. Preschoolers (M = 4 years) were less likely than adults to make correct identifications. Children over the age of 5 did not differ significantly from adults with regard to correct identification rate. Children of all ages examined were less likely than adults to correctly reject a target-absent lineup. Even adolescents (M = 12-13 years) did not reach an adult rate of correct rejection. Compared to simultaneous lineup presentation, sequential lineups increased the child-adult gap for correct rejections. Providing child witnesses with identification practice or training did not increase their correct rejection rates. Suggestions for children's inability to correctly reject target-absent lineups are discussed. Future directions for identification research are presented.

  8. Hoarseness in School-Aged Children and Effectiveness of Voice Therapy in International Classification of Functioning Framework.

    Science.gov (United States)

    Akın Şenkal, Özgül; Özer, Cem

    2015-09-01

    The hoarseness in school-aged children disrupts the educational process because it affects the social progress, communication skills, and self-esteem of children. Besides otorhinolaryngological examination, the first treatment option is voice therapy when hoarseness occurs. The aim of the study was to determine the factors increasing the hoarseness in school-aged children by parental interview and to know preferable voice therapy on school-aged children within the frame of International Classification of Functioning (ICF). Retrospective analysis of data gathered from patient files. A total of 75 children (56 boys and 19 girls) were examined retrospectively. The age range of school-aged children is 7-14 years and average is 10.86 ± 2.51. A detailed history was taken from parents of children involved in this study. Information about vocal habits of children was gathered within the frame of ICF and then the voice therapies of children were started by scheduling appointments by an experienced speech-language pathologist. The differences between before and after voice therapy according to applied voice therapy methods, statistically significant differences were determined between maximum phonation time values and s/z rate. The relationship between voice therapy sessions and s/z rate with middle degree significance was found with physiological voice therapy sessions. According to ICF labels, most of voice complaints are matching with "body functions" and "activity and limitations." The appropriate voice therapy methods for hoarseness in school-aged children must be chosen and applied by speech-language therapists. The detailed history, which is received from family during the examination, within the frame of ICF affects the processes of choosing the voice therapy method and application of them positively. Child's family is very important for a successful management. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  9. Achalasia: Outcome in children.

    Science.gov (United States)

    Meyer, Anell; Catto-Smith, Anthony; Crameri, Joe; Simpson, Di; Alex, George; Hardikar, Winita; Cameron, Donald; Oliver, Mark

    2017-02-01

    Oesophageal achalasia is well-recognized but relatively rare in children, occasionally appearing as the "triple A" syndrome (with adrenal insufficiency and alacrima). Treatment modalities, as in adult practice, are not curative, often needing further interventions and spurring the search for better management. The outcome for syndromic variants is unknown. We sought to define the efficacy of treatments for children with achalasia with and without triple A syndrome. We conducted a retrospective analysis of presentation and outcomes for 42 children with achalasia presenting over three decades to a major pediatric referral center. Long term impact of the diagnosis was assessed by questionnaire. We identified 42 children including six with triple A syndrome. The median overall age at diagnosis was 10.8 years and median follow-up 1593 days. Initial Heller myotomy in 17 required further interventions in 11 (65%), while initial treatment with botulinum toxin (n = 20) was ultimately followed by myotomy in 17 (85%). Ten out of 35 patients who underwent myotomy required a repeat myotomy (29%). Patients with triple A syndrome developed symptoms earlier, but had delayed diagnosis, were more underweight at diagnosis and at last follow up. Questionnaire results suggested a significant long term deleterious impact on the quality of life of children and their families. Many children with achalasia relapse after initial treatment, undergoing multiple, different procedures, despite which symptoms persist and impact on quality of life. Symptoms develop earlier in patients with triple A syndrome, but the diagnosis is delayed and this has substantial nutritional impact. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  10. Mortality rates and causes of death in children with epilepsy prescribed antiepileptic drugs: a retrospective cohort study using the UK General Practice Research Database.

    Science.gov (United States)

    Ackers, Ruth; Besag, Frank M C; Hughes, Elaine; Squier, Waney; Murray, Macey L; Wong, Ian C K

    2011-05-01

    Patients with epilepsy, including children, have an increased risk of mortality compared with the general population. Antiepileptic drugs (AEDs) were the most frequent class of drugs reported in a study looking at fatal suspected adverse drug reactions in children in the UK. The objective of the study was to identify cases and causes of death in a paediatric patient cohort prescribed AEDs with an associated epilepsy diagnosis. This was a retrospective cohort study supplemented with general practitioner-completed questionnaires, post-mortem reports and death certificates. The setting was UK primary care practices contributing to the General Practice Research Database. Participants were children and adolescents aged 0-18 years prescribed AEDs between 1993 and 2005. Causality assessment was undertaken by a consensus panel comprising paediatric specialists in neuropathology, neurology, neuropsychiatry, paediatric epilepsy, pharmacoepidemiology and pharmacy to determine crude mortality rate (CMR) and standardized mortality ratios (SMRs), and the likelihood of an association between AED(s) and the event of death. There were 6190 subjects in the cohort (contributing 26,890 person-years of data), of whom 151 died. Median age at death was 8.0 years. CMR was 56.2 per 10,000 person-years and the SMR was 22.4 (95% CI 18.9, 26.2). The majority of deceased subjects had severe underlying disorders. Death was attributable to epilepsy in 18 subjects; in 9 the cause of death was sudden unexpected death in epilepsy (SUDEP) [3.3 per 10 000 person-years (95% CI 1.5, 6.4)]. AEDs were probably (n = 2) or possibly (n = 3) associated causally with death in five subjects. Two status epilepticus deaths were associated causally with AED withdrawal. Children prescribed AEDs have an increased risk of mortality relative to the general population. Most of the deaths were in children with serious underlying disorders. A small number of SUDEP cases were identified. AEDs are not a major

  11. A Retrospective Analysis of Factors Affecting Early Stoma Complications.

    Science.gov (United States)

    Koc, Umit; Karaman, Kerem; Gomceli, Ismail; Dalgic, Tahsin; Ozer, Ilter; Ulas, Murat; Ercan, Metin; Bostanci, Erdal; Akoglu, Musa

    2017-01-01

    Despite advances in surgical techniques and products for stoma care, stoma-related complications are still common. A retrospective analysis was performed of the medical records of 462 consecutive patients (295 [63.9%] female, 167 [36.1 %] male, mean age 55.5 ± 15.1 years, mean body mass index [BMI] 25.1 ± 5.2) who had undergone stoma creation at the Gastroenterological Surgery Clinic of Turkiye Yuksek İhtisas Teaching and Research Hospital between January 2008 and December 2012 to examine the incidence of early (ie, within 30 days after surgery) stoma complications and identify potential risk factors. Variables abstracted included gender, age, and BMI; existence of malignant disease; comorbidities (diabetes mellitus, hypertension, coronary artery disease, chronic respiratory disease); use of neoadjuvant chemoradiotherapy; permanent or temporary stoma; type of stoma (loop/end stoma); stoma localization; and the use of preoperative marking of the stoma site. Data were entered and analyzed using statistical software. Descriptive statistics, chi-squared, and Mann-Whitney U tests were used to describe and analyze all variables, and logistic regression analysis was used to determine independent risk factors for stoma complications. Ostomy-related complications developed in 131 patients (28.4%) Of these, superficial mucocutaneous separation was the most frequent complication (90 patients, 19.5%), followed by stoma retraction (15 patients, 3.2%). In univariate analysis, malignant disease (P = .025), creation of a colostomy (P = .002), and left lower quadrant stoma location (P toma complication. Only stoma location was an independent risk factor for the development of a stoma complication (P = .044). The rate of stoma complications was not significantly different between patients who underwent nonemergent surgery (30% in patients preoperatively sited versus 28.4% not sited) and patients who underwent emergency surgery (27.1%). Early stoma complication rates were higher

  12. Prevalence of non-febrile seizures in children with idiopathic autism spectrum disorder and their unaffected siblings: a retrospective cohort study.

    Science.gov (United States)

    McCue, Lena M; Flick, Louise H; Twyman, Kimberly A; Xian, Hong; Conturo, Thomas E

    2016-11-28

    Autism spectrum disorder (ASD) is a heterogeneous disorder characterized not only by deficits in communication and social interactions but also a high rate of co-occurring disorders, including metabolic abnormalities, gastrointestinal and sleep disorders, and seizures. Seizures, when present, interfere with cognitive development and are associated with a higher mortality rate in the ASD population. To determine the relative prevalence of non-febrile seizures in children with idiopathic ASD from multiplex and simplex families compared with the unaffected siblings in a cohort of 610 children with idiopathic ASD and their 160 unaffected siblings, participating in the Autism Genetic Resource Exchange project, the secondary analysis was performed comparing the life-time prevalence of non-febrile seizures. Statistical models to account for non-independence of observations, inherent with the data from multiplex families, were used in assessing potential confounding effects of age, gender, and history of febrile seizures on odds of having non-febrile seizures. The life-time prevalence of non-febrile seizures was 8.2% among children with ASD and 2.5% among their unaffected siblings. In a logistic regression analysis that adjusted for familial clustering, children with ASD had 5.27 (95%CI: 1.51-18.35) times higher odds of having non-febrile seizures compared to their unaffected siblings. In this comparison, age, presence of gastrointestinal dysfunction, and history of febrile seizures were significantly associated with the prevalence of non-febrile seizures. Children with idiopathic ASD are significantly more likely to have non-febrile seizures than their unaffected siblings, suggesting that non-febrile seizures may be ASD-specific. Further studies are needed to determine modifiable risk factors for non-febrile seizures in ASD.

  13. Better management of cow's milk allergy using a very low dose food challenge test: a retrospective study.

    Science.gov (United States)

    Okada, Yu; Yanagida, Noriyuki; Sato, Sakura; Ebisawa, Motohiro

    2015-07-01

    Low dose reactive cow's milk (CM) allergic children are at high risk of persistent CM allergy and a positive oral food challenge (OFC). The present study aimed to evaluate if the results of a very low dose (VL) OFC with these children contributes to better management of CM allergy. We retrospectively reviewed subjects with CM allergy who underwent a VL OFC with 3 mL heated CM and had a previous allergic reaction to management of some low dose reactive CM allergic children to change from complete avoidance to partial intake of CM. Copyright © 2015 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

  14. Gender Ratio in a Clinical Population Sample, Age of Diagnosis and Duration of Assessment in Children and Adults with Autism Spectrum Disorder

    Science.gov (United States)

    Rutherford, Marion; McKenzie, Karen; Johnson, Tess; Catchpole, Ciara; O'Hare, Anne; McClure, Iain; Forsyth, Kirsty; McCartney, Deborah; Murray, Aja

    2016-01-01

    This article reports on gender ratio, age of diagnosis and the duration of assessment procedures in autism spectrum disorder diagnosis in a national study which included all types of clinical services for children and adults. Findings are reported from a retrospective case note analysis undertaken with a representative sample of 150 Scottish…

  15. Effects of Radiotherapy in the treatment of multiple myeloma: a retrospective analysis of a Single Institution

    International Nuclear Information System (INIS)

    Matuschek, Christiane; Ochtrop, Thomas A; Bölke, Edwin; Ganswindt, Ute; Fenk, Roland; Gripp, Stephan; Kröpil, Patric; Gerber, Peter Arne; Kammers, Kai; Hamilton, Jackson; Orth, Klaus; Budach, Wilfried

    2015-01-01

    Palliative irradiation of osteolytic lesions is a considerable component in the treatment for patients with multiple myeloma. In this study, we analyzed the efficacy of irradiation in these patients. We retrospectively analyzed 153 patients with multiple myeloma who were admitted to our department between 1989 and 2013. According to the staging system of Durie & Salmon 116 patients were classified as stage III. 107/153 patients were treated with radiotherapy of at least one and up to 6 bony lesions at different times. In order to evaluate the effect of local radiotherapy on pain relief and bone recalcification a uni- and multivariate analysis was performed using a binary logistic regression model to correct for multiple measurements. Complete information on dose, fractionation and volume of radiotherapy was available from 81 patients treated in 136 target volumes for pain relief, and from 69 patients treated in 108 target volumes for recalcification. Total radiation doses varied between 8 Gy to 50 Gy (median dose 25 Gy in 2.5 Gy fractions, 5 times a week). Radiotherapy resulted in complete local pain relief in 31% and partial local pain relief in 54% of the patients. In the univariate analysis, higher total radiation doses (p = 0.023) and higher age (p = 0.014) at the time of radiotherapy were significantly associated with a higher likelihood of pain relief, whereas no significant association was detected for concurrent systemic treatment, type and stage of myeloma and location of bone lesions. The same variables were independent predictors for pain relief in the multivariate analysis. Recalcification was observed in 48% of irradiated bone lesions. In the uni- and multivariate analysis higher radiation doses were significantly associated (p = 0.048) with an increased likelihood of recalcification. Side effects of radiotherapy were generally mild. Higher total biological radiation doses were associated with better pain relief and recalcification in this

  16. How do Dutch general practitioners diagnose children's urinary tract infections?

    NARCIS (Netherlands)

    Harmsen, M.; Wolters, R.J.; Wouden, J.C. van der; Grol, R.P.T.M.; Wensing, M.J.P.

    2009-01-01

    OBJECTIVE: To study which tests general practitioners used to diagnose a urinary tract infection (UTI) in children and which patient characteristics were associated with test choice. DESIGN: Retrospective chart review on the diagnosis of UTIs in children in Dutch general practices who were diagnosed

  17. Fear and Courage in Children: Two Sides of the Same Coin?

    Science.gov (United States)

    Muris, Peter

    2009-01-01

    This study further investigated the construct of courage in children. Children aged 8-13 years (n = 51) were interviewed about the most courageous action that they had ever performed during their life, and to retrospectively rate their level of fear and courage experienced during that event. On a separate occasion, children also completed the…

  18. Nodular gastritis: an endoscopic indicator of Helicobacter pylori infection in children.

    Science.gov (United States)

    Mazigh Mrad, Sonia; Abidi, Kamel; Brini, Ines; Boukthir, Samir; Sammoud, Azza

    2012-11-01

    Helicobacter pylori (Hp) infection is a common and universally distributed bacterial infection. It is predominantly acquired in childhood. To assess the relationship between endoscopic nodular gastritis and Hp infection. A retrospective study was conducted in children who underwent upper gastrointestinal endoscopy for chronic abdominal pain. All children who had five gastric biopsies for histologic analysis, urease test and Hp culture were included in the study. The Sensitivity and sensibility of nodular gastritis were determined and different parameters were studied according the presence or not of nodular gastritis(age, gender, Hp status, gastritis score and lymphoid follicles). 49 children, mean age 6.9 ± 3 years (range 1-12 years) were eligible for the analysis. Hp Infection was diagnosed in 35 out of the 49 children (71.5 %). Nodular gastritis was recorded in 16 out of 49 children and in 14 infected children and 2 out of 14 non infected children (p=0.07), 40% sensitivity, 85.7% specificity, 87.5% positive predictive value, and 36,4% negative predictive value. The parameters associated significantly to the presence of nodular gastritis were older age: (p=0.04), Hp infection: (p=0.01), chronic gastritis: (p=0.05), active gastritis: (p=0.02), follicular gastritis: (p=0.005), higher gastritis score: (p=0.005). Completely normal gastric mucosal histology was never found in infected children with antral nodularity. Among all infected children, the gastritis score was significantly higher when there was a nodular gastritis and follicular gastritis was significantly associated to nodular gastritis. The endoscopic pattern of antral nodularity identifies children with Hp infection, and active chronic follicular gastritis.

  19. Uncovering the Problem-Solving Process: Cued Retrospective Reporting Versus Concurrent and Retrospective Reporting

    OpenAIRE

    Van Gog, Tamara; Paas, Fred; Van Merriënboer, Jeroen; Witte, P.

    2007-01-01

    This study investigated the amounts of problem-solving process information ("action," "why," "how," and "metacognitive") elicited by means of concurrent, retrospective, and cued retrospective reporting. In a within-participants design, 26 participants completed electrical circuit troubleshooting tasks under different reporting conditions. The method of cued retrospective reporting used the original computer-based task and a superimposed record of the participant's eye fixations and mouse-keyb...

  20. Severe ocular injuries in Greek children.

    Science.gov (United States)

    Mela, Ephigenia K; Georgakopoulos, Constantinos D; Georgalis, Athanasios; Koliopoulos, John X; Gartaganis, Sotirios P

    2003-02-01

    To determine the epidemiological characteristics of severe eye injuries in childhood, in a mixed urban and rural Greek setting. Retrospective analysis of 95 cases (103 eyes) of eye injuries in children younger than 17 years of age admitted to the Department of Ophthalmology, University Hospital of Patras, Greece, during a five-year period. The data were analyzed with respect to age, sex, type, cause and mode of injury, method of management, duration of hospitalization and final visual deficit. The average age was 9.8 years and males were involved in 80% of the cases. The most common type of eye injury was mechanical closed-globe injury (71.8%). Mechanical open-globe injuries were found in 21.3% of the eyes, while burns comprised 6.7% of the injuries. Most injuries were agent-related, with blows and falls being responsible most often. Multiple operations were part of the treatment in 11.6% of the eyes; 14.5% of the eyes were blinded and 15.5% had significant final visual acuity loss. These hospital-based data suggest that there is a need for health education of both parents and children, since some injuries in children could easily have been prevented.

  1. The urological and nephrological analysis of children with renal ectopia

    Directory of Open Access Journals (Sweden)

    Sevgi Yavuz

    2014-09-01

    Full Text Available Objective: To assess the morphological and clinical features of children with renal ectopia (RE and assess whether the lateralization of ectopia determines the prognosis. Methods:The clinical, laboratory and radiological data of 61 patients diagnosed as RE in our center between the years of 2004 and 2014 were retrospectively reviewed. Results: There were 32 girls (52.5% and 48 boys (47.5%. The median age was 48 (2-204 months and follow-up time was 60 (2-120 months. RE was right-sided in 33 (54% and left-sided in 26 (46% patients. 52 patients (85.2% had simple RE whereas 9 (14.8% had crossed RE. 27 children (44.3% had additional urinary abnormality, 15 (24.6% had extra-renal disease. The most common urinary tract malformation was vesicoureteral reflux (VUR (21%. Renal scarring (RS was detected in 17 patients (27.9% on DMSA scan. 32 patients (52.5% experienced urinary tract infection (UTI, 5 (8.2% had hypertension, 11 (11% had proteinuria, 5 (8% had chronic renal disease (CKD. No significant difference was found between ectopia sides for evelopment of additional urinary or systemic disease, UTI, proteinuria, hypertension and CKD (p> 0.05. Conclusion: The children with RE should be carefully examined for additional urinary or systemic abnormalities. Voiding cystourethrogram might be recommended in those patients for the increased risk of VUR. The patients with RE should be closely followed-up for avoiding long term complications including proteinuria, hypertension and CKD because of susceptibility to UTI and RS. The lateralization of ectopia might not affect the incidence of additional abnormality or late complications.

  2. Effects of a structured 20-session slow-cortical-potential-based neurofeedback program on attentional performance in children and adolescents with attention-deficit hyperactivity disorder: retrospective analysis of an open-label pilot-approach and 6-month follow-up.

    Science.gov (United States)

    Albrecht, Johanna S; Bubenzer-Busch, Sarah; Gallien, Anne; Knospe, Eva Lotte; Gaber, Tilman J; Zepf, Florian D

    2017-01-01

    The aim of this approach was to conduct a structured electroencephalography-based neurofeedback training program for children and adolescents with attention-deficit hyperactivity disorder (ADHD) using slow cortical potentials with an intensive first (almost daily sessions) and second phase of training (two sessions per week) and to assess aspects of attentional performance. A total of 24 young patients with ADHD participated in the 20-session training program. During phase I of training (2 weeks, 10 sessions), participants were trained on weekdays. During phase II, neurofeedback training occurred twice per week (5 weeks). The patients' inattention problems were measured at three assessment time points before (pre, T0) and after (post, T1) the training and at a 6-month follow-up (T2); the assessments included neuropsychological tests (Alertness and Divided Attention subtests of the Test for Attentional Performance; Sustained Attention Dots and Shifting Attentional Set subtests of the Amsterdam Neuropsychological Test) and questionnaire data (inattention subscales of the so-called Fremdbeurteilungsbogen für Hyperkinetische Störungen and Child Behavior Checklist/4-18 [CBCL/4-18]). All data were analyzed retrospectively. The mean auditive reaction time in a Divided Attention task decreased significantly from T0 to T1 (medium effect), which was persistent over time and also found for a T0-T2 comparison (larger effects). In the Sustained Attention Dots task, the mean reaction time was reduced from T0-T1 and T1-T2 (small effects), whereas in the Shifting Attentional Set task, patients were able to increase the number of trials from T1-T2 and significantly diminished the number of errors (T1-T2 & T0-T2, large effects). First positive but very small effects and preliminary results regarding different parameters of attentional performance were detected in young individuals with ADHD. The limitations of the obtained preliminary data are the rather small sample size, the

  3. Analysis of Virechana karma with Danti avaleha: A retrospective study

    Directory of Open Access Journals (Sweden)

    Sreelakshmi Chaganti

    2015-01-01

    Full Text Available Virechana (therapeutic purgation is a common procedure that is widely practiced among the panchakarma treatments (pentad treatments. Various Virechaka dravyas (purgative drugs have been described for Virechana. Even after critical analysis of Virechaka dravyas in the literature, still there is difficulty in the fixation of dose. Hence, the retrospective analysis of varied outcomes of Virechana with Danti (Baliospermum montanum avaleha (linctus is discussed in this paper. The study included twenty-seven case reports of patients who were administered Virechana with Danti avaleha. These case reports are of patients suffering from various ailments such as irregular menstrual cycles, polycystic ovarian syndrome, primary and secondary infertility, and psoriasis. Danti avaleha was administered at dose of 10 g and 5 g in the Krura (~strong and Madhyama (~moderate/normal Koshta (~GI tract patients, respectively. Among seven Krura koshta patients, three of them resulted with Pravara (excellent Shuddhi and other four resulted with Madhyama (medium Shuddhi. In twenty Madhyama koshta patients, sixteen of them resulted with avara (minimum Shuddhi and remaining four patients resulted with Madhyama shuddhi. Complications like Udara shoola (spasmodic pain of abdomen and Vamana (emesis were observed during Virechana. Majority of the patients suffered with Udara shoola were of Madhyama koshta. Vamana was seen in both Krura and Madhyama koshta patients. Irrespective of the type of Shuddhi and complications, all the patients resulted with Samyak Kaphaantiki Virikta lakshana (signs of perfect purgation with end expulsion of Kapha. The study concluded that the Krura koshta patients were tolerable for dose of 10 g and are expected to attain Pravara Shuddhi. Whereas Madhyama koshta patients were intolerable even to mild dose of 5 g, producing Avara shuddhi.

  4. The use and relevance of gonad protection shields in children during hips radiography

    OpenAIRE

    Silva, C. A.; Silva, P. N.; Ventura, Sandra Rua

    2010-01-01

    Considering that ionizing radiation effects are cumulative and the gonads are particularly sensitive to these effects, and also the clinical importance of pelvic radiographs in children, the excess of radiation exposure to the gonads must be avoided. The purpose of this study is to demonstrate the relevance of the correct use of gonad protection shields and to evaluate their use on the hip radiographs performed in a reference clinical institution, through the retrospective analysis of p...

  5. Language Barriers Impact Access to Services for Children with Autism Spectrum Disorders

    Science.gov (United States)

    St. Amant, Helaine G.; Schrager, Sheree M.; Peña-Ricardo, Carolina; Williams, Marian E.; Vanderbilt, Douglas L.

    2018-01-01

    Racial and ethnic disparities in accessing health care have been described in children with autism spectrum disorder (ASD). In a retrospective chart review of 152 children with ASD, children of parents whose primary language was English were significantly more likely to have both social skills and communication goals within their individualized…

  6. Retention of children under 18 months testing HIV positive in care in ...

    African Journals Online (AJOL)

    Retention of children under 18 months testing HIV positive in care in Swaziland: a retrospective study. ... children within the first two months of life and linking them into care. However, as time progresses the retention of children in care declines. Innovative strategies need to be developed to enhance patient retention.

  7. Differences in bone mineral density between normal-weight children and children with overweight and obesity: a systematic review and meta-analysis.

    Science.gov (United States)

    van Leeuwen, J; Koes, B W; Paulis, W D; van Middelkoop, M

    2017-05-01

    This study examines the differences in bone mineral density between normal-weight children and children with overweight or obesity. A systematic review and meta-analysis of observational studies (published up to 22 June 2016) on the differences in bone mineral density between normal-weight children and overweight and obese children was performed. Results were pooled when possible and mean differences (MDs) were calculated between normal-weight and overweight and normal-weight and obese children for bone content and density measures at different body sites. Twenty-seven studies, with a total of 5,958 children, were included. There was moderate and high quality of evidence that overweight (MD 213 g; 95% confidence interval [CI] 166, 261) and obese children (MD 329 g; 95%CI [229, 430]) have a significantly higher whole body bone mineral content than normal-weight children. Similar results were found for whole body bone mineral density. Sensitivity analysis showed that the association was stronger in girls. Overweight and obese children have a significantly higher bone mineral density compared with normal-weight children. Because there was only one study included with a longitudinal design, the long-term impact of childhood overweight and obesity on bone health at adulthood is not clear. © 2017 World Obesity Federation.

  8. Elevator-related injuries to children in the United States, 1990 through 2004.

    Science.gov (United States)

    O'Neil, Joseph; Steele, Gregory K; Huisingh, Carrie; Smith, Gary A

    2007-09-01

    This study describes the epidemiology of elevator-related injuries among children in the United States from 1990 to 2004. A retrospective cohort analysis was performed using data from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission. Reported cases were used to project national estimates. An estimated 29 030 elevator-related injuries occurred among children in the United States during 1990 to 2004. The mean age was 8.1 years (SD, 6.1 years), with 53.3% of injuries among boys. The overall injury rate was 2.5 injuries per 100,000 population. The injury rate for children aged 0-4 years was 4.2 per 100,000 population, and for children aged 5-19 years the injury rate was 1.9 per 100,000 population. The most frequent cause of injury was the elevator door closing on a body part, the most frequently injured body region was the upper extremity, and soft-tissue injuries were the most frequent type of injury. Children should be closely supervised on or near elevators to reduce the risk of injury.

  9. CHRISTMAS 2015 : THE PUBLICATION GAME Use of positive and negative words in scientific PubMed abstracts between 1974 and 2014: retrospective analysis

    NARCIS (Netherlands)

    Vinkers, Christiaan H.; Tijdink, Joeri K.; Otte, Wim

    2015-01-01

    Objective To investigate whether language used in science abstracts can skew towards the use of strikingly positive and negative words over time. Design Retrospective analysis of all scientific abstracts in PubMed between 1974 and 2014. Methods The yearly frequencies of positive, negative, and

  10. Reflections on Practical Approaches to Involving Children and Young People in the Data Analysis Process

    Science.gov (United States)

    Coad, Jane; Evans, Ruth

    2008-01-01

    This article reflects on key methodological issues emerging from children and young people's involvement in data analysis processes. We outline a pragmatic framework illustrating different approaches to engaging children, using two case studies of children's experiences of participating in data analysis. The article highlights methods of…

  11. Morbidity associated with golf-related injuries among children: findings from a pediatric trauma center.

    Science.gov (United States)

    Vitale, Melissa A; Mertz, Kristen J; Gaines, Barbara; Zuckerbraun, Noel S

    2011-01-01

    To describe injuries due to golf-related activities among pediatric patients requiring hospital admission. We conducted a retrospective analysis of all sports-related injuries from 2000 to 2006 using a level 1 trauma center database. Of 1005 children admitted with sports-related injuries, 60 (6%) had golf-related injuries. The mean injury severity score was significantly higher for golf-related injuries (11.0) than that for all other sports-related injuries (6.8). Most golf-related injuries occurred in children younger than 12 years (80%), at home (48%), and by a strike from a club (57%) and resulted in trauma to the head or neck (68%). Golf-related injuries, although an infrequent cause of sports-related injuries, have the potential to result in severe injuries, especially in younger children. Preventive efforts should target use of golf clubs by younger children in the home setting.

  12. Incidence and risk factors of first-line antiretroviral treatment failure among human immunodeficiency virus-infected children in Amhara regional state, Ethiopia: a retrospective follow-up study.

    Science.gov (United States)

    Sisay, Malede Mequanent; Ayele, Tadesse Awoke; Gelaw, Yalemzewod Assefa; Tsegaye, Adino Tesfahun; Gelaye, Kassahun Alemu; Melak, Melkitu Fentie

    2018-04-05

    This study aimed to assess the incidence and risk factors of treatment failure among HIV/AIDS-infected children who were on antiretroviral therapy (ART) in Amhara National Regional State, Ethiopia. A retrospective follow-up study was conducted from January 2010 to March 2016. A total of 824 children under the age of 15 who had started ART were included in the study. Data were collected from children's medical charts and ART registration logbook using a standard checklist. A Weibull regression model was used to identify the risk factors of treatment failure. Adjusted HRs (AHRs) with 95% CIs were used to declare statistical significance. The mean (±SD) age of the children was 6.4±3.6 years, with a median (IQR) follow-up of 30.5 (14.6-51.4) months. Sixty-three children (7.7%, 95% CI 5.8 to 9.5) developed treatment failure, 17 (27.0%) of whom were immunological and 46 (73.0%) were clinical failures. The incidence rate of treatment failure was 22.1/10 000 person-months. The cumulative probability of failure was 0.4, with 28 562.5 person-month observations. Lack of disclosure (AHR=4. 4, 95% CI 1.8 to 11.3), opportunistic infections during initiation of ART (AHR=2.3, 95% CI 1.3 to 4.1) and prolonged follow-up (AHR=0.06, 95% CI 0.02 to 0.18) were the main predictors of treatment failure. This study revealed that the incidence of treatment failure remains a significant public health concern in Ethiopia. Undisclosed HIV status to children, the presence of opportunistic infections during initiation of ART and prolonged follow-up were found to be the main predictors of treatment failure. Hence, early detection of treatment failure and further studies on viral monitoring need to be considered. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Treatment of prolonged convulsive seizures in children; a single centre, retrospective, observational study

    NARCIS (Netherlands)

    Vlaskamp, Danique R. M.; Brouwer, Oebele F.; Callenbach, Petra M. C.

    2014-01-01

    Objectives: To evaluate treatment of children with Prolonged Convulsive Seizures (PCS) at the University Medical Centre Groningen (UMCG). Material and methods: PCS were identified from an UMCG database of children with epilepsy aged = 10 mm and occurred between January 2000 and October 2012 in

  14. Impact of Obesity on Clinical Outcomes in Urban Children Hospitalized for Status Asthmaticus.

    Science.gov (United States)

    Aragona, Elena; El-Magbri, Eussra; Wang, Justin; Scheckelhoff, Tessa; Scheckelhoff, Trevor; Hyacinthe, Assata; Nair, Suja; Khan, Amina; Nino, Gustavo; Pillai, Dinesh K

    2016-04-01

    The prevalence of both childhood asthma and obesity remain at historically high levels and disproportionately affect urban children. Asthma is a common and costly cause for pediatric hospitalization. Our objective was to determine the effect of obesity on outcomes among urban children hospitalized with status asthmaticus. A retrospective cohort study was performed by using billing system data and chart review to evaluate urban children admitted for asthma. Demographics, asthma severity, reported comorbidities, and outcomes were assessed. Obesity was defined by BMI percentile (leanobese≥95%). Outcomes were length of stay, hospitalization charges, ICU stay, repeat admissions, and subsequent emergency department (ED) visits. Bivariate analysis assessed for differences between overweight/obese and lean children. Multivariable regression assessed the relationship between overweight status and primary outcomes while controlling for other variables. Post hoc age-stratified analysis was also performed. The study included 333 subjects; 38% were overweight/obese. Overweight/obese children admitted with asthma were more likely than lean children to have subsequent ED visits (odds ratio 1.6, 95% confidence interval 1.0-2.6). When stratified by age, overweight/obese preschool-age children (2 times as likely to have repeat ED visits than lean preschool-age children (odds ratio 2.3, 95% confidence interval 1.0-5.6). There were no differences in the other outcomes between overweight/obese and lean individuals within the entire cohort or within other age groups. Copyright © 2016 by the American Academy of Pediatrics.

  15. Factors of poor prognosis of visceral leishmaniasis among children under 12 years of age. A retrospective monocentric study in Belo Horizonte, State of Minas Gerais, Brazil, 2001-2005

    Directory of Open Access Journals (Sweden)

    Alexandre Sérgio da Costa Braga

    2013-01-01

    Full Text Available INTRODUTION: A major concern with the visceral leishmaniasis (VL is its high lethality rate, even with proper treatment. Low age, prior malnutrition, disease duration prior to diagnosis, severe anemia, fever for more than 60 days, diarrhea and jaundice are known poor prognostic factors. The goals of this study are to describe the clinical and laboratory characteristics of VL among children under 12 years of age and to identify the factors associated with VL poor outcome. METHODS: Two hundred and fifty children under 12 years of age with confirmed VL admitted to Hospital João Paulo II (FHEMIG, Belo Horizonte, Brazil, between January 2001 and December 2005 were evaluated retrospectively. The primary outcome was the poor clinical evolution: sepsis, and/or pneumonia, and/or urinary tract infection, and/or of bleeding (expect epistaxis, and/or severe neutropenia (neutrophil < 500 cells/mm3. Odds ratio (crude and adjusted and its 95% confidence interval for each variable were calculated. Values less than 0.05 were considered significant. RESULTS: Average age was 3.3 years (3.6 months-11.6 years, 71.2% were younger than 5 years and 47.2% lived in Metropolitan Area of Belo Horizonte. The mean fatality rate was 3.6%. Sixty-six (26.4% patients presented poor evolution. After a multivariate analysis, age <18 months, abnormal respiratory physical examination on hospital admission, and platelets <85,000/mm3 remained associated with increased chance of poor evolution. CONCLUSIONS: The results suggest that patients aged between 12 and 18 months, with platelet counts bellow 85,000/mm3, and respiratory abnormalities at admission should be considered potentially severe.

  16. [Content analysis of food adverts aimed at children].

    Science.gov (United States)

    Ponce-Blandón, José Antonio; Pabón-Carrasco, Manuel; Lomas-Campos, María de Las Mercedes

    To determine the contents and persuasive techniques used in processed food adverts aimed at children in Andalusia, comparing them with those aimed at adults. Study based on advert content analysis with two phases: a descriptive design phase and an analytical observational design phase. A sample of adverts from 60hours of broadcasting from the two most watched television channels in Andalusia. A total of 416 food and non-alcoholic beverage adverts were obtained, for 91 different products. Approximately 42.9% (n=39) was aimed at children and 53.8% (n=49) were products classified as "unhealthy". Unhealthy foods were more common in adverts for children (p <0.001). Significant differences were found between the ads aimed at adults and those aimed at children. Emotional and irrational persuasive resources such as fantasy (p <0.001), cartoons (p <0.001) or offering gifts with the purchase of the product (p=0.003) were observed more frequently in adverts for children. Food advertising aimed at children in Andalusia is mainly based on offering products with a low nutritional value and using persuasive resources based on fantasy or gifts. The message is focused on the incentive and not the food. More effective measures than the current self-regulatory systems must be put in place to counter these distorted adverts. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. [Clinical analysis of intestinal lymphangiectasia in 47 children].

    Science.gov (United States)

    Guo, S; Song, L; Guan, D X; Mei, T L; Zhou, J; Yu, F H; Wang, G L; Zhang, J; Shen, H Q; Xu, X W

    2017-12-02

    Objective: To analyze the clinical manifestations, diagnosis, treatment and prognosis of intestinal lymphangiectasia (IL) in children in order to improve the skills of diagnosis and treatment of IL. Method: Clinical manifestations, laboratory findings, gastroscopic findings, histopathological examinations and lymphatic radionuclide imaging assessments were analyzed retrospectively among 47 IL patients who were hospitalized in the Gastroenterology Department of Beijing Children's Hospital Affiliated to Capital Medical University from June 2007 to December 2015. All patients were followed up by telephone. According to the various causes, the patients were divided into the primary intestinal lymphangiectasia (PIL) group and secondary IL group, and their clinical manifestations were compared by t test, Rank sum test or Chi-square test. Result: In 47 IL patients, there were 38 children (81%) younger than 3 years old. There were 43 PIL patients (91%) and 4 secondary IL patients (9%). Between PIL and secondary IL, there were statistical differences in serum albumin ( t=- 3.950, P 0.05). Edema (44 cases, 94%), diarrhea (42 cases, 89%), accompanied with infection (35 cases, 74%) and ascites (30 cases, 64%) were the main clinical manifestations. In 47 IL patients, 45 patients were done gastroscopy and histopathological examinations, and there were 31 patients' histopathological examinations(69%) were positive. Forty patients were done lymphatic radionuclide imaging, and there was evidence of protein losing from gut via lymphatic radionuclide imaging in 39 patients(98%). Among 47 patients, 35 patients (74%) were followed up, 32 patients had good prognosis, 2 patient failed to show evidence of improvement, 1 patient died and no patient experienced a relapse till the end of the follow-up. In 35 patients, 28 patients were treated with medium chain triglycerides (MCT) dietary therapy, 26 patients showed improvement in symptoms, and 2 patients had no improvement. Among 35 patients

  18. Characteristics and outcomes of e-cigarette exposure incidents reported to 10 European Poison Centers: a retrospective data analysis

    OpenAIRE

    Vardavas, Constantine I.; Girvalaki, Charis; Filippidis, Filippos T; Oder, Mare; Kastanje, Ruth; de Vries, Irma; Scholtens, Lies; Annas, Anita; Plackova, Silvia; Turk, Rajka; Gruzdyte, Laima; Rato, F?tima; Genser, Dieter; Schiel, Helmut; Bal?zs, Andrea

    2017-01-01

    BACKGROUND: The use of e-cigarettes has increased during the past few years. Exposure to e-cigarette liquids, whether intentional or accidental, may lead to adverse events our aim was to assess factors associated with e-cigarette exposures across European Union Member States (EU MS). METHODS: A retrospective analysis of exposures associated with e-cigarettes reported to national poison centers was performed covering incidents from 2012 to March 2015 from 10 EU MS. De-identified and anonymous ...

  19. Changes in the treatment of abused children: a retrospective review of a practice.

    Science.gov (United States)

    Tsaltas, M O

    1994-01-01

    Using the population of sexually abused children from three periods of my practice, I have described changes in my practice of play therapy over the past 30 years. These changes have come about in part due to the pioneering work of psychiatrists specializing in studies of development in children not designated as emotionally disturbed or mentally ill (Chess and Thomas, 1986; Greenspan, 1981; Winnicott, 1953, 1965, 1971) as well those who have described treatment techniques and theoretical constructs of the experience of traumatized children (Finkelhor and Browne, 1985; Terr, 1991). Because of these convincing works, I have been able to shorten treatment, and shift my goals from direct efforts at unconscious conflict resolution to the more indirect but more effective method of re-establishing maturational tracks through involvement of families, dialogue with children in multiple play techniques as well as words, and to plan ahead for these traumatized children. It remains to be seen what the eventual outcome of this change in treatment will be. Although I always ask families and children to keep in touch even by postcard, only about 20% of them do. Naturally, these are families that are doing well. I am not sure that this necessarily means the other 80% are not doing well but I simply do not know. Because all of these patients are known to one authority or another (police, Rape Centers, courts and Department of Welfare) it should be possible to plan long-term studies of treatment outcome at the time of the initial contact. It seems important enough to me to do this because betrayed trust has a very long lag time before its full effects may be seen in the adults these children become. Because there are so many cases of child abuse, defining the relative effectiveness and efficacy of different kinds of treatment could be useful in managing what is, in effect, a public health problem.

  20. Factors Associated with Klebsiella Bacteremia and Its Outcome in Under-Five Children Admitted with Diarrhea

    Directory of Open Access Journals (Sweden)

    Shamima Akhter

    2016-01-01

    Full Text Available Although Klebsiella bacteremia in children is perceived to be associated with fatal consequences, data are scarce on those children presenting with diarrhea. We evaluated the factors associated with Klebsiella bacteremia in such children. In this retrospective chart analysis, data of all diarrheal children was retrieved from electronic medical record system (named as SHEBA of Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b, from January 1, 2010, to December 31, 2012, who had their blood culture done. This was a study having a case-control design where comparison of clinical and laboratory characteristics was done among children with Klebsiella bacteremia (cases = 30 and those without any bacteraemia (controls = 90. Controls were selected randomly. The cases more often had fatal outcome (p<0.001. In logistic regression analysis, after adjusting for potential confounders such as young age, severe dehydration, severe wasting, abnormal mentation, hypotension, and fast breathing, the cases were independently associated with hospital-acquired infection and positive stool growth (for all, p<0.05. The study highlights the importance of obtaining blood cultures in hospitalized children under five years old with diarrheal illness in the presence of either hospital-acquired infection or positive stool culture to have better outcome.

  1. Ultrasound and PET-CT Correlation in Shoulder Pathology: A 5-Year Retrospective Analysis.

    Science.gov (United States)

    Burke, Christopher J; Walter, William R; Adler, Ronald S; Babb, James S; Sanger, Joseph; Ponzo, Fabio

    2017-10-01

    To correlate shoulder ultrasound and radiography with F-FDG PET-CT to establish FDG uptake and therefore range of metabolic activity, as defined by SUV analysis, in various symptomatic shoulder pathologies. Retrospective database query was performed for shoulder ultrasound and PET-CT scans between January 2012 and January 2017. Patients who had both studies within 1 year were included. Age- and sex-matched control patients with PET-CT scans only were also included. Retrospective image review determined shoulder pathology, and F-FDG SUVmax was measured using regions of interest placed at the glenohumeral joint, rotator cuff/bursa, and bicipital groove. Glenohumeral and acromioclavicular osteoarthrosis was assessed by radiography using the Kellgren-Lawrence classification system. Thirty-three patients had both imaging studies within 1 year. Ten patients (11 cases) were included, ranging in age from 56 to 90 years (mean, 67.9 years). Control subjects were selected among patients receiving PET-CT within 1 week of symptomatic patients. Glenohumeral osteoarthrosis was mild in 3 (27%), moderate in 2 (18%), and severe in 2 (18%). Six full-thickness rotator cuff tears (55%) were identified. SUVmax means were compared between the pathologic and control groups and were significantly higher in the former: glenohumeral joint (1.96 vs 1.32; P = 0.016), rotator cuff/bursa (2.80 vs 2.0; P = 0.005), and bicipital groove (2.19 vs 1.48; P = 0.007). The highest values were seen in full-thickness rotator cuff tear and severe biceps tenosynovitis. Increased metabolic activity about the shoulder is associated with a spectrum of rotator cuff, glenohumeral joint, and other soft tissue pathology that can be correlated with diagnostic ultrasound findings.

  2. Vygotsky's Analysis of Children's Meaning Making Processes

    Science.gov (United States)

    Mahn, Holbrook

    2012-01-01

    Vygotsky's work is extensive and covers many aspects of the development of children's meaning-making processes in social and cultural contexts. However, his main focus is on the examination of the unification of speaking and thinking processes. His investigation centers on the analysis of the entity created by this unification--an internal…

  3. Children in Greenland

    DEFF Research Database (Denmark)

    Kløvgaard, Marius; Nielsen, Nina Odgaard; Sørensen, Thomas Lund

    2016-01-01

    in Nuuk or Ilulissat (n=332). Data on diseases and health care system contacts were extracted. Diagnoses were validated retrospectively. Primary health care contacts were reviewed for a random sample of 1:6. RESULTS: In 311 children with valid social security number, the total number of health care system......, 39.5 versus 34.6 during the study period, p=0.02. The highest annual contact rates for diseases were: hospitalisations/acute respiratory diseases 13.9:1,000; outpatient contacts/otitis media 5.1:1,000; primary care/conjunctivitis or nasopharyngitis 410:1,000 children. Outpatient screening......BACKGROUND: Previous studies of Greenlandic children's disease pattern and contacts to the health care system are sparse and have focused on the primary health care sector. OBJECTIVE: We aimed to identify the disease pattern and use of health care facilities of children aged 0-10 in two Greenlandic...

  4. Patterns of Eye Diseases in Children Visiting a Tertiary Teaching ...

    African Journals Online (AJOL)

    Background: About 19 million children worldwide live with visual impairments resulting from different ocular morbidities. This study aimed to identify the different causes of eye diseases in children visiting a tertiary eye centre at Jimma University Hospital. Methods: We conducted a retrospective review of charts of patients of ...

  5. Mortality in former Olympic athletes: retrospective cohort analysis

    Science.gov (United States)

    Zwiers, R; Zantvoord, F W A; van Bodegom, D; van der Ouderaa, F J G; Westendorp, R G J

    2012-01-01

    Objective To assess the mortality risk in subsequent years (adjusted for year of birth, nationality, and sex) of former Olympic athletes from disciplines with different levels of exercise intensity. Design Retrospective cohort study. Setting Former Olympic athletes. Participants 9889 athletes (with a known age at death) who participated in the Olympic Games between 1896 and 1936, representing 43 types of disciplines with different levels of cardiovascular, static, and dynamic intensity exercise; high or low risk of bodily collision; and different levels of physical contact. Main outcome measure All cause mortality. Results Hazard ratios for mortality among athletes from disciplines with moderate cardiovascular intensity (1.01, 95% confidence interval 0.96 to 1.07) or high cardiovascular intensity (0.98, 0.92 to 1.04) were similar to those in athletes from disciplines with low cardiovascular intensity. The underlying static and dynamic components in exercise intensity showed similar non-significant results. Increased mortality was seen among athletes from disciplines with a high risk of bodily collision (hazard ratio 1.11, 1.06 to 1.15) and with high levels of physical contact (1.16, 1.11 to 1.22). In a multivariate analysis, the effect of high cardiovascular intensity remained similar (hazard ratio 1.05, 0.89 to 1.25); the increased mortality associated with high physical contact persisted (hazard ratio 1.13, 1.06 to 1.21), but that for bodily collision became non-significant (1.03, 0.98 to 1.09) as a consequence of its close relation with physical contact. Conclusions Among former Olympic athletes, engagement in disciplines with high intensity exercise did not bring a survival benefit compared with disciplines with low intensity exercise. Those who engaged in disciplines with high levels of physical contact had higher mortality than other Olympians later in life. PMID:23241269

  6. High dose phenobarbitone coma in pediatric refractory status epilepticus; a retrospective case record analysis, a proposed protocol and review of literature.

    Science.gov (United States)

    Gulati, Sheffali; Sondhi, Vishal; Chakrabarty, Biswaroop; Jauhari, Prashant; Lodha, Rakesh; Sankar, Jhuma

    2018-04-01

    Ongoing refractory status epilepticus is associated with significant morbidity and mortality. Therapeutic coma induction with midazolam, thiopentone, phenobarbitone or propofol is indicated when conventional antiepileptics fail to abort seizure. Of these, the most extensively studied is midazolam. Amongst the remaining three, phenobarbitone has the most favourable pharmacological profile, but has not been studied adequately, more so in the pediatric age group. The current retrospective case records analysis is an attempt to describe use of phenobarbitone coma in pediatric refractory status epilepticus. Case records of patients, admitted with status epilepticus to the pediatric inpatient services of a tertiary care teaching hospital of North India between January 2014 and December 2016 were reviewed. Those with refractory status epilepticus who failed to respond to midaolam infusion and phenobarbitone coma was used were included for analysis. Overall, 108 children presented in status, of which 34 developed refractory status epilepticus. Of these 34, 21 responded to midazolam infusion and in 13 high dose phenobarbitone coma following a standardised protocol was used. Amongst these 13 (8 males and 5 females, median age 6 years, IQR: 2.5-9.5), 12 responded and 1 succumbed. The median time to clinical seizure resolution and desired electroencephalographic changes post phenobarbitone initiation were 16 (IQR: 12-25) and 72 h (IQR: 48-120) respectively. High dose phenobarbitone appears to be an effective therapeutic modality in pediatric refractory status epilepticus. The current study provides a protocol for its use which can be validated in future studies with larger sample size. Copyright © 2018 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  7. Stroke due to mitochondrial disorders in Saudi children

    International Nuclear Information System (INIS)

    Salih, Mustafa A.; Zahraa, Jihad N.; Abdel-Gader, Abdel-Galil M.; Alorainy, Ibrahim A.; Hassan, Hamdy H.; Al-Rayees, Molham; Ruitenbeek, W.; Zeviani, M.

    2006-01-01

    Objective was to report on the clinical and biochemical features of patients who presented with stroke due to mitochondrial disorders amongst a prospective and retrospective cohort of Saudi children. Children, who presented with stroke were evaluated at the Division of Pediatric Neurology, or admitted to King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, during the periods July 1992 to February2001 (retrospective study)and February 2001 to March 2003 (prospective study). Open muscle biopsies were obtained from patients suspected to have mitochondrial disorders, and examined using conventional histological and histochemical techniques. Biochemical, molecular pathological investigations, or both, of muscle could be arranged for only some of the patients. Mitochondrial disorders were the underlying risk factor for stroke in 4 (3.8%) of 104 children (aged one month to 12 years). Three patients (one male and 2 females) had Leigh syndromes (LS) and one had mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS). At the time of stroke, the 3 children with LS were 11 months, 15 months, and 7 years old. They presented with psychomotor regression and seizures. Muscle histology and histochemistry showed mild non-specific changes but no ragged red fibers. Biochemical analysis of muscle (in one patient) revealed deficiency of pyruvate dehydrogenase complex. Analysis of mitochondrial DNA (mtDNA), [the other 2 patients] was negative for the 2 point mutations (T-G and T-C) at nucleotide position 8993, and for two T-C point mutations (at position 8851 and 9176 of the ATPase 6 gene) that have been described in patients with LS. The girl with MELAS syndrome presented with a stroke-like episode at the age of 29 months and had focal brain lesions in the media aspect of the left occipital and temporal lobes, and in the posteromedial aspect of the left thalamus, which resolved within 7 weeks. She had

  8. Survival after Second and Subsequent Recurrences in Osteosarcoma: A Retrospective Multicenter Analysis.

    Science.gov (United States)

    Tirtei, Elisa; Asaftei, Sebastian D; Manicone, Rosaria; Cesari, Marilena; Paioli, Anna; Rocca, Michele; Ferrari, Stefano; Fagioli, Franca

    2017-05-01

    Purpose Osteosarcoma (OS) is the most common primary bone tumor. Despite complete surgical removal and intensive chemotherapeutic treatment, 30%-35% of patients with OS have local or systemic recurrence. Some patients survive multiple recurrences, but overall survival after OS recurrence is poor. This analysis aims to describe and identify factors influencing post-relapse survival (PRS) after a second OS relapse. Methods This is a retrospective analysis of 60 patients with a second relapse of OS of the extremities in 2 Italian centers between 2003 and 2013. Results Treatment for first and subsequent relapses was planned according to institutional guidelines. After complete surgical remission (CSR) following the first recurrence, patients experienced a second OS relapse with a median disease-free interval (DFI) of 6 months. Lung disease was prevalent: 44 patients (76%) had pulmonary metastases. Survival after the second relapse was 22% at 5 years. Lung disease only correlated with better survival at 5 years (33.6%) compared with other sites of recurrence (5%; p = 0.008). Patients with a single pulmonary lesion had a better 5-year second PRS (42%; p = 0.02). Patients who achieved a second CSR had a 5-year second PRS of 33.4%. Chemotherapy (p<0.001) benefited patients without a third CSR. Conclusions This analysis confirms the importance of an aggressive, repeated surgical approach. Lung metastases only, the number of lesions, DFI and CSR influenced survival. It also confirms the importance of chemotherapy in patients in whom surgical treatment is not feasible.

  9. Assessing functional impairment in siblings living with children with disability.

    Science.gov (United States)

    Goudie, Anthony; Havercamp, Susan; Jamieson, Barry; Sahr, Timothy

    2013-08-01

    The purpose of this study was to empirically test if siblings of children with disability had higher levels of parent-reported behavioral and emotional functional impairment compared with a peer group of siblings residing with only typically developing children. This was a retrospective secondary analysis of data from the Medical Expenditure Panel Survey. We included only households with at least 2 children to ensure sibling relationships. Two groups of siblings were formed: 245 siblings resided in households with a child with disability and 6564 siblings resided in households with typically developing children. Parents responded to questions from the Columbia Impairment Scale to identify functional impairment in their children. On the basis of parent reports and after adjusting for sibling demographic characteristics and household background, siblings of children with disability were more likely than siblings residing with typically developing children to have problems with interpersonal relationships, psychopathological functioning, functioning at school, and use of leisure time (P siblings of children with disability classified with significant functional impairment was 16.0% at the first measurement period and 24.2% at the second (P siblings of typically developing children there was a smaller percentage increase from 9.5% to 10.3% (P mental health services and, as such, early assessment and interventions to limit increasing severity and short- to long-term consequences need to be addressed. Health care professionals need to consider a family-based health care approach for families raising children with disability.

  10. Outcomes and indications for intervention in non-operative management of paediatric liver trauma: A 5 year retrospective study

    International Nuclear Information System (INIS)

    Inchingolo, R.; Ljutikov, A.; Deganello, A.; Kane, P.; Karani, J.

    2014-01-01

    Aim: To determine the applicability of accurate computed tomography (CT) evaluation and embolization as non-operative management for liver trauma in a paediatric population. Material and methods: A retrospective observational study of 37 children (mean age 10.5 years) with hepatic trauma (28 blunt, 9 penetrating) admitted to a trauma referral centre over a 5 year period. All patients were evaluated with CT and scored with an Association for the Surgery of Trauma score. Inpatient information was reviewed for demographics, associated injuries, modes of management, efficacy and complications of management, and outcome. Statistical analysis was performed. Results: There were seven contusions, two grade I, two grade II, nine grade III, and 17 grade IV liver lacerations. Only two patients (grade IV, penetrating) underwent surgery for the management of bowel perforation. All children had non-surgical treatment of their liver trauma: three cases (grade IV) had primary angiography due to CT evidence of active bleeding and embolization was performed in two of these. Seven patients (two grade III, five grade IV) had angiography during the follow-up for evidence of a complicating pseudoaneurysm and embolization was performed in six of them. Embolization was successful in all the children; one minor complication occurred (cholecystitis). Endoscopic retrograde cholangiopancreatography (ERCP) plus stenting was performed in two cases for a bile leak. All 37 children had a positive outcome. Conclusion: The present study demonstrates that non-operative management of hepatic trauma is applicable to children and may have a higher success rate than in adults

  11. Analysis and Long-Term Follow-Up of the Surgical Treatment of Children With Craniopharyngioma.

    Science.gov (United States)

    Cheng, Jing; Shao, Qiang; Pan, Zhiyong; You, Jin

    2016-11-01

    To investigate the relationship between the operative approach, clinical pathological factors, and curative effect of the surgical treatment in the patients with craniopharyngioma; to provide a theoretical basis for determining the prognosis and reducing the recurrence rate during the long-term postoperative follow-up in children. This was a retrospective analysis of the clinical data of 92 children who underwent surgical treatment in our department from May 2011 to January 2005. Long-term follow-up was performed from 12 months to 8 years. The pterional approach was used in 49 patients, the interhemispheric approach in 20 patients, the corpus callosum approach in 16 patients, and the butterfly approach in 7 patients. Pathological classification was performed by hematoxylin and eosin stain staining of the pathological tissues and evaluated according to the different surgical approaches, MRI calcification status, calcification type, pathological type, whether radiotherapy was performed, postoperative recurrence, and death. For the pterion approach resection, there was near total resection in 46 patients (93.9%) with the lowest recurrence rate. The operative approach and postoperative recurrence rates were compared; the difference was statistically significant (P 0.05). There was not a significant difference between the MRI classification and postoperative recurrence rate (P >0.05). Comparing the degree of tumor calcification with the recurrence rate after operation and the mortality rate, the difference was statistically significant (P craniopharyngioma and squamous papillary craniopharyngioma in 2 groups following operation were compared, and the differences were statistically significant (P craniopharyngioma relapse rate is higher, which could be because invasion of craniopharyngioma only occurs with adamantimous craniopharyngioma. Postoperative radiotherapy can significantly prolong the recurrence time and reduce the mortality rate of patients with

  12. Birth order and preschool children's cooperative abilities: A within-family analysis.

    Science.gov (United States)

    Prime, Heather; Plamondon, André; Jenkins, Jennifer M

    2017-09-01

    There is evidence for a laterborn sibling advantage in some social skills, although this has not been investigated in children's early capacities for cooperation. Using a within-family design, this study compared firstborn and laterborn (i.e., middle and youngest) siblings on their cooperative abilities when they were aged around 3 years. Further, the study investigated whether the association between children's birth order and cooperative abilities was dependent on the prosocial behaviour of other siblings in the home. The sample included 288 ethnically and sociodemographically diverse children clustered within 144 families. Cooperation was directly assessed using a problem-solving paradigm requiring two simultaneous and complementary actions of the child and adult tester to achieve a joint goal. Parents reported on the prosocial behaviour of up to four siblings in the home. Results of a multilevel analysis indicated that youngest children were more advanced in their cooperative abilities, compared to firstborn children, irrespective of their siblings' prosociality. Middle children, in contrast, were only advantaged over firstborn children if their siblings showed high levels of prosociality. The analysis accounted for a number of potential family-wide confounds, providing evidence that this is a child-specific effect related to birth order. Findings are discussed from a social constructivist perspective with an emphasis on the sibling relationship as a context for cooperative interactions that facilitate sociocognitive development. Statement of contribution What is already known on this subject? There are individual differences in children's early capacities for cooperation. Children's early cooperation has not been considered in relation to birth order and/or sibling interaction quality. What does this study add? Youngest children are advantaged in their cooperation as compared to firstborn children. Middle children are also advantaged, but only if their

  13. Patterns of scald injuries in children--has anything changed?

    LENUS (Irish Health Repository)

    Yates, J

    2011-10-01

    The objective was to study presentation patterns of scald injuries in children and suggest potential countermeasures to reduce these injuries. We retrospectively studied scald injuries in children attending an urban paediatric emergency department between January 1st and December 31st 2008. Data was extracted from our emergency department database using search terms \\'burn\\

  14. Falls from height: A retrospective analysis.

    Science.gov (United States)

    Turgut, Kasim; Sarihan, Mehmet Ediz; Colak, Cemil; Güven, Taner; Gür, Ali; Gürbüz, Sükrü

    2018-01-01

    Emergency services manage trauma patients frequently and falls from height comprise the main cause of emergency service admissions. In this study, we aimed to analyse the demographic characteristics of falls from height and their relationship to the mortality. A total of 460 patients, who admitted to the Emergency Department of Inonu University between November 2011 and November 2014 with a history of fall from height, were examined retrospectively. Demographic parameters, fall characteristics and their effect to mortality were evaluated statistically. The study comprised of 292 (63.5%) men and 168 (36.5%) women patients. The mean age of all patients was 27±24.99 years. Twenty-six (5.6%) patients died and the majority of them were in ≥62 years old group. The highest percentage of falls was at 0-5 years age group (28.3%). People fell mainly from 1.1-4 metres(m) level (46.1%). The causes of falls were ordered as unintentional (92.2%), workplace (8.1%) and suicidal (1.7%). Skin and soft tissue injuries (37.4%) were the main traumatic lesions. Age, fall height, fall place, lineer skull fracture, subarachnoidal hemorrhage, cervical fracture, thoracic vertebra fracture and trauma scores had statistically significant effect on mortality. The casualties died because of subarachnoid hemorrhage mostly.

  15. Duration of tracheostomy dependence and development of tracheocutaneous fistula in children.

    Science.gov (United States)

    Ha, Tu-Anh; Goyal, Meha; Ongkasuwan, Julina

    2017-12-01

    To determine whether the risk of developing a tracheocutaneous fistula (TCF) increases with longer tracheostomy dependence times in children. Retrospective review of medical records. A retrospective chart review was conducted for all children who both underwent tracheotomy and were decannulated between 2002 and 2011 at a tertiary children's hospital. Charts were analyzed for duration of tracheostomy and evidence of TCF up to 12 months. Data for these criteria was available on 164 out of 182 patients. A significant difference in the duration of tracheostomy dependence between children with and without resultant TCF was determined by the Wilcoxon signed rank test (P = 0.0003). The relative risk (RR) of a persistent TCF was significantly increased when the duration of tracheostomy dependence was greater than 24 months (RR = 2.5217, P tracheostomy dependence times for children with and without TCF were 33.1 and 23.4 months, respectively. Overall, 94 children (57.3%) developed a TCF. To our knowledge, this study represents the largest collection of data for children who have been decannulated following tracheostomy placement. These data demonstrate that the risk of developing a TCF increases with longer tracheostomy dependence times in children. 4. Laryngoscope, 127:2709-2712, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  16. The Heidelberg Appendicitis Score Predicts Perforated Appendicitis in Children.

    Science.gov (United States)

    Boettcher, Michael; Günther, Patrick; Breil, Thomas

    2017-10-01

    In the future, surgical management of pediatric appendicitis might become limited to nonperforating appendicitis. Thus, it becomes increasingly important to differentiate advanced from simple appendicitis and to predict perforated appendicitis among a group of children with right-sided abdominal pain, which was the aim of this study. An institutionally approved, single-center retrospective analysis of all patients with appendectomy from January 2009 to December 2010 was conducted. All diagnostic aspects were evaluated to identify predictors and differentiators of perforated appendicitis. In 2 years, 157 children suffered from appendicitis. Perforation occurred in 47 (29.9%) of the patients. C-reactive protein (CRP) levels higher than 20 mg/dL ( P = .037) and free abdominal fluid on ultrasonography ( P = .031) are the most important features to differentiate perforated from simple appendicitis. Moreover, all children with perforation had a positive Heidelberg Appendicitis Score (HAS). A negative HAS excludes perforation in all cases (negative predictive value = 100%). Perforated appendicitis can be ruled out by the HAS. In a cohort with right-sided abdominal pain, perforation should be considered in children with high CRP levels and free fluids or abscess formation on ultrasound.

  17. Efficacy of levamisole in children with frequently relapsing and steroid-dependent nephrotic syndrome.

    Science.gov (United States)

    Ekambaram, Sudha; Mahalingam, Vijayakumar; Nageswaran, Prahlad; Udani, Amish; Geminiganesan, Sangeetha; Priyadarshini, Shweta

    2014-05-01

    To assess the efficacy of levamisole in frequently relapsing nephrotic syndrome and steroid-dependent nephrotic syndrome. Retrospective analysis of hospital case records. Pediatric nephrology department of a tertiary referral pediatric hospital. 62 children with frequently relapsing nephrotic syndrome and 35 children with steroid-dependent nephrotic syndrome. Case records of children who were diagnosed as steroid-dependant or frequently-relapsing nephrotic syndrome from June 2004 to June 2011, were reviewed. Levamisole was given daily (2 mg/kg/d) along with tapering doses of alternate day steroids after remission on daily steroids. Levamisole was effective in 77.3% children with a better (80.6%) efficacy in frequently relapsing nephrotic syndrome. A total of 34 children completed 1 year follow-up post levamisole therapy. The cumulative mean (SD) steroid dose 1-year before therapy was 4109(1154) mg/m2 and 1-year post therapy was 661 (11) mg/m2 (P<0.001). The relapses were also less during the period of post-levamisole therapy. Levamisole is an effective alternative therapy in frequently relapsing and steroid-dependent nephrotic syndrome.

  18. Urinary tract infection in small children: the evolution of renal damage over time.

    Science.gov (United States)

    Swerkersson, Svante; Jodal, Ulf; Sixt, Rune; Stokland, Eira; Hansson, Sverker

    2017-10-01

    Our objective was to analyze the evolution of kidney damage over time in small children with urinary tract infection (UTI) and factors associated with progression of renal damage. From a cohort of 1003 children UTI, a retrospective analysis of 103 children was done. Children were selected because of renal damage at index 99m Tc-dimercaptosuccinic acid (DMSA) scintigraphy at least 3 months after UTI, and a late DMSA scan was performed after at least 2 years. Damage was classified as progression when there was a decline in differential renal function (DRF) by ≥4%, as regression when there was complete or partial resolution of uptake defects. Of 103 children, 20 showed progression, 20 regression, and 63 remained unchanged. There were no differences between groups regarding gender or age. In the progression group, 16/20 (80%) children had vesicoureteral reflux (VUR) grade III-V and 13 (65%) had recurrent UTI. In multivariable regression analysis, both VUR grade III-V and recurrent UTI were associated with progression. In the regression group, 16/20 (80%) had no VUR or grade I-II, and two (10%) had recurrent UTI. Most small children with febrile UTI do not develop renal damage and if they do the majority remain unchanged or regress over time. However, up to one-fifth of children with renal damage diagnosed after UTI are at risk of renal deterioration. These children are characterized by the presence of VUR grades III-V and recurrent febrile UTI and may benefit from follow-up.

  19. Value of pituitary MRI in children with short stat

    OpenAIRE

    Huan ZHOU; Ya-ling NIE; Wei FAN; Cong-ying WANG; An-sheng LI; Hong WANG; Meng-meng WU

    2013-01-01

    Objective To explore the value of pituitary MRI in diagnosis of etiology and prognosis in children with short stature. Methods The MRI data of 130 children with short stature admitted from Jan. to Dec. 2012 were retrospectively analyzed. Of the 130 children, 79 were males and 51 were females, aged 3 to 18 years with mean of 9.8 years. Results Of the 130 children, 82 cases (63.1%) were shown to have normal pituitary morphology and signal manifestation, and in 48 cases (36.9%) pituitary morphol...

  20. Optimised paediatric CT dose at a tertiary children's hospital in Japan: a 4-y single-centre analysis

    International Nuclear Information System (INIS)

    Nakada, Y.; Yamamoto, H.; Nabatame, K.; Obara, S.; Akahane, K.; Blyth, B.J.; Shimada, Y.; Fujiwara, M.; Yokoyama, T.; Shirayama, A.; Date, H.; Hoshioka, A.; Yakami, M.; Miyazaki, O.; Yagi, K.

    2016-01-01

    Since diagnostic reference levels (DRLs) for children are not currently established in Japan, the authors determined local DRLs for the full range of paediatric CT examinations in a single tertiary care children's hospital. A retrospective review of 4801 CT performance records for paediatric patients (<15 y old) who had undergone CT examinations from 2008 to 2011 was conducted. The most frequent examinations were of the head (52 %), followed by cardiac (15 %), temporal bone (9 %), abdomen (7 %), chest (6 %) and others (11 %). Approximately one-third of children received two or more CT scans. The authors' investigation showed that mean CTDI vol and DLP for head, chest and abdomen increased as a function of age. Benchmarking of the results showed that CTDI vol , DLP and effective dose for chest and abdomen examinations in this hospital were below average, whereas those for the head tended to be at or slightly above average of established DRL values from five countries. The results suggest that CT examinations as performed in a tertiary children's hospital in Japan are well optimised. (authors)

  1. [Morbidity and risk behavior regarding street-children in Medellin, Colombia, 2008].

    Science.gov (United States)

    Muñoz-Echeverri, Iván F; Noreña-Herrera, Camilo; Londoño, Beatriz E; Rojas-Arbeláez, Carlos A

    2011-04-01

    Describing the characteristics, morbidity and risk behaviour of street children from Medellin. This was a descriptive, retrospective study. The medical charts of children aged less than 17 who sought medical attention in five protection institutions in Medellin during 2008 were reviewed. The analysis included descriptive statistics and bivariate analysis. Age was categorised into two groups: boys/girls (0- 12 years) and adolescents (13-17 years). The following characteristicswere found after reviewing 483 medical charts: being male (73.1 %), adolescent (73.1 %) and living in the streets (44.7 %). The most common diagnoses were for infectious and parasite illnesses (21.8 %), factors that affected health status and contact with health services (13.7 %), respiratory diseases (11.8 %). A total of 81.0 % of all children were engaged in psychoactive substance abuse,smoking marijuana being the most common (80.0 %);84.0 % reported engaging in sexual activity. Infectious diseases, sexual activity and usingpsychoactive substances placed this population in a high vulnerability category. This situation demands that local health-policy makers guarantee thispopulation's constitutional right to health, through health-promotion programmes and sexual and reproductive health strategies to prevent disease and psychoactive substance abuse.

  2. Risk Factors in Preschool Children for Predicting Asthma During the Preschool Age and the Early School Age: a Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Bao, Yixia; Chen, Zhimin; Liu, Enmei; Xiang, Li; Zhao, Deyu; Hong, Jianguo

    2017-11-18

    The aim of this study was to identify risk factors of asthma among children asthma during the preschool age and early school age (≤ 10 years of age). MEDLINE, Cochrane, EMBASE, and Google Scholar databases were searched until June 30, 2017. Prospective or retrospective cohort and case-control studies were included. Studies had to have evaluated risk factors or a predictive model for developing asthma in children ≤ 6 years of age or persistent asthma in early school age. A total of 17 studies were included in the analysis. Factors associated with developing asthma in children ≤ 10 years of age (both pre-school and early school age) included male gender (pooled OR = 1.70, P asthma (pooled OR = 2.20, P asthma in early school age (pooled OR = 1.51, P = 0.030 and pooled OR = 2.59, P asthma predictive models (e.g., API, PIAMA, PAPS) had relatively low sensitivity (range, 21% to 71.4%) but high specificity (range, 69% to 98%). The study found that male gender, exposure to smoke, atopic dermatitis, family history of asthma, history of wheezing, and serum IgE level ≥ 60 kU/l or having specific IgE were significantly associated with developing asthma by either preschool or early school age. Asthma predictive models can be developed by those risk factors.

  3. Human Metapneumovirus Infection is Associated with Severe Respiratory Disease in Preschool Children with History of Prematurity.

    Science.gov (United States)

    Pancham, Krishna; Sami, Iman; Perez, Geovanny F; Huseni, Shehlanoor; Kurdi, Bassem; Rose, Mary C; Rodriguez-Martinez, Carlos E; Nino, Gustavo

    2016-02-01

    Human metapneumovirus (HMPV) is a recently discovered respiratory pathogen of the family Paramyxoviridae, the same family as that of respiratory syncytial virus (RSV). Premature children are at high risk of severe RSV infections, however, it is unclear whether HMPV infection is more severe in hospitalized children with a history of severe prematurity. We conducted a retrospective analysis of the clinical respiratory presentation of all polymerase chain reaction-confirmed HMPV infections in preschool-age children (≤5 years) with and without history of severe prematurity (prematurity. Preschool children with a history of prematurity had more severe HMPV disease as illustrated by longer hospitalizations, new or increased need for supplemental O2, and higher severity scores independently of age, ethnicity, and history of asthma. Our study suggests that HMPV infection causes significant disease burden among preschool children with a history of prematurity leading to severe respiratory infections and increasing health care resource utilization due to prolonged hospitalizations. Copyright © 2016. Published by Elsevier B.V.

  4. Better management of wheat allergy using a very low-dose food challenge: A retrospective study.

    Science.gov (United States)

    Okada, Yu; Yanagida, Noriyuki; Sato, Sakura; Ebisawa, Motohiro

    2016-01-01

    Low-dose reactive wheat-allergic children are at a high risk of a positive oral food challenge (OFC). The present study aimed to evaluate whether the results of a very low-dose (VL) OFC would contribute to better wheat allergy management in this population. We retrospectively reviewed wheat-allergic subjects who underwent a VL OFC with 2 g of udon noodles (equivalent to 53 mg of wheat protein) and had a previous allergic reaction to management of some low-dose reactive wheat-allergic children from complete avoidance to partial wheat intake. Copyright © 2015 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  5. Clinical Predictors of Progressive Hemorrhagic Injury in Children with Mild Traumatic Brain Injury

    Directory of Open Access Journals (Sweden)

    Guangfu Di

    2017-11-01

    Full Text Available ObjectiveTraumatic brain injury (TBI occurs commonly in children. Repeat computed tomography (CT follow up of TBI patients is often scheduled to identify progressive hemorrhagic injury (PHI. However, the utility of repeated CT scans, especially in children with mild TBI [Glasgow Coma Scale (GCS scores of 13–15], has been debated. The purposes of the present study were to identify clinical predictors of PHI in children with mild TBI and to clarify relevant clinical factors via radiological examination.MethodsFrom 2014 to 2016, we retrospectively enrolled children <15 years of age with mild TBI. We recorded age, sex, GCS scores on admission, causes of head injury, timing of initial CT, any loss of consciousness, vomiting and seizure data, and type of TBI. Based on repeat CT findings, patients were dichotomized into either a PHI group or a non-PHI group. Also, clinical data were comparatively reviewed. Multivariate logistic regression analysis was used to identify clinical predictors of PHI.ResultsOf the 175 enrolled children, 15 (8.6% experienced PHI. Univariate analysis revealed that GCS score on admission, cause of head injury, vomiting, seizure, and TBI type were associated with PHI. Multivariate logistic regression analysis showed that a GCS score of 13 and epidural hemorrhage (EDH were independently associated with PHI (hazard ratio = 0.131, P = 0.018; hazard ratio = 6.612, P = 0.027, respectively.ConclusionA GCS score of 13 and EDH were associated with PHI. These factors should be considered when deciding whether to repeat CT on children with mild TBI.

  6. Cumulative trauma and symptom complexity in children: a path analysis.

    Science.gov (United States)

    Hodges, Monica; Godbout, Natacha; Briere, John; Lanktree, Cheryl; Gilbert, Alicia; Kletzka, Nicole Taylor

    2013-11-01

    Multiple trauma exposures during childhood are associated with a range of psychological symptoms later in life. In this study, we examined whether the total number of different types of trauma experienced by children (cumulative trauma) is associated with the complexity of their subsequent symptomatology, where complexity is defined as the number of different symptom clusters simultaneously elevated into the clinical range. Children's symptoms in six different trauma-related areas (e.g., depression, anger, posttraumatic stress) were reported both by child clients and their caretakers in a clinical sample of 318 children. Path analysis revealed that accumulated exposure to multiple different trauma types predicts symptom complexity as reported by both children and their caretakers. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Paclitaxel-Coated Balloons for the Treatment of Dysfunctional Dialysis Access. Results from a Single-Center, Retrospective Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kitrou, Panagiotis M., E-mail: panoskitrou@gmail.com; Spiliopoulos, Stavros; Papadimatos, Panagiotis; Christeas, Nicolaos; Petsas, Theodoros; Katsanos, Konstantinos; Karnabatidis, Dimitris [Patras University Hospital, Interventional Radiology Department (Greece)

    2017-01-15

    PurposeTo investigate the safety and effectiveness of lutonix paclitaxel-coated balloon (PCB) for the treatment of dysfunctional dialysis access.Materials and MethodsThis was a single-center, single-arm, retrospective analysis of 39 patients (23 male, 59 %) undergoing 61 interventions using 69 PCBs in a 20-month period. There was a balance between arteriovenous fistulae (AVF) and grafts (AVG) (20 AVFs, 19AVGs), and the majority of lesions were restenotic (25/39, 64.1 %). Mean balloon diameter used was 6.6 mm and length 73.4 mm. Primary outcome measure was target lesion primary patency (TLPP) at 6 months, while secondary outcome measures included factors affecting TLPP and major complications. As there were lesions treated more than once with PCB, authors also compared patency results after first and second PCB angioplasty.ResultsTLPP was 72.2 % at 6 months with a median patency of 260 days according to the Kaplan–Meier survival analysis. No major complications occurred. TLPP between AVFs and AVGs (311 vs. 237 days, respectively; p = 0.29) and de novo and restenotic lesions was similar (270.5 vs. 267.5 days, respectively; p = 0.50). In 14 cases, in which lesions were treated with two PCB angioplasties, a statistically significant difference in TLPP after the second treatment was noted (first intervention 179.5 days vs. second intervention 273.5 days; p = 0.032).ConclusionIn this retrospective analysis, Lutonix PCB proved to be safe and effective in treating restenosis in dysfunctional dialysis access with results comparable to the literature available. Larger studies are needed to prove abovementioned results.

  8. Temporomandibular Disorders and Headache: A Retrospective Analysis of 1198 Patients

    OpenAIRE

    Di Paolo, Carlo; D'Urso, Anna; Papi, Piero; Di Sabato, Francesco; Rosella, Daniele; Pompa, Giorgio; Polimeni, Antonella

    2017-01-01

    Aim. Headache is one of the most common diseases associated with Temporomandibular Disorders (TMDs). The aim of this study was to evaluate, retrospectively, if headache influences TMD’s symptoms. Material and Methods. A total sample of 1198 consecutive TMD patients was selected. After a neurological examination, a diagnosis of headache, according to the latest edition of the International Classification of Headache Disorders, was performed in 625 subjects. Patients were divided into two group...

  9. Medical treatment of second-trimester fetal miscarriage; A retrospective analysis

    OpenAIRE

    Niinimaki, Maarit; Mentula, Maarit; Jahangiri, Reetta; Mannisto, Jaana; Haverinen, Annina; Heikinheimo, Oskari

    2017-01-01

    Abstract Objectives: Research on the treatment of second-trimester miscarriages is scarce. We studied the outcomes, and the factors associated with adverse events and need for hospital resources in the medical treatment of second-trimester miscarriage. Materials and methods: In these retrospective analyses we studied women treated for spontaneous fetal miscarriage with misoprostol-only (n = 24) or mifepristone and misoprostol (n = 177) in duration of gestation 12+1–21+6. Primary outcome...

  10. The effects of radiation therapy on height and spine MRI characteristics in children with neuroblastoma

    International Nuclear Information System (INIS)

    Yu, Jeong Il; Lim, Do Hoon; Jung, Sang Hoon; Sung, Ki Woong; Yoo, So-Young; Nam, Heerim

    2015-01-01

    Purpose: To investigate the effect of radiotherapy (RT) on height and spine using magnetic resonance imaging (MRI) analysis in children with neuroblastoma and to identify parameters related to patient height. Methods and materials: We performed a retrospective cohort study of neuroblastoma patients treated between January 1997 and December 2007. Twenty-seven children were enrolled. Whole spine MRI was completed and height percentiles were compared with national growth charts. Results: The median ages were 28, 43, and 126 months at diagnosis, RT, and analysis, respectively. All of the enrolled children received local RT, and 15 patients received total body irradiation (TBI). Median growth percentiles were 67.0, 54.0, and 4.9 at diagnosis, RT, and analysis, respectively. The number of irradiated vertebrae (P = 0.009) and having undergone TBI (P = 0.03) were significantly associated with shorter stature. Among the MRI parameters for irradiated vertebrae, signal intensity was higher (P = 0.05) and more heterogeneous (P = 0.02) in T1-weighted images and roundness was lower (P = 0.03) in T2-weighted images. Conclusions: Height of children with neuroblastoma was significantly affected by RT. The number of irradiated vertebrae and having undergone TBI were significantly associated with lower height. Irradiated spine showed changes in both signal and shape on MRI

  11. Esophageal achalasia: retrospective analysis of treatment during 2000–2010

    Directory of Open Access Journals (Sweden)

    Tomaž Štupnik

    2011-10-01

    Full Text Available BACKGROUND Esophageal achalasia (EA is a primary esophageal motility disorder of unclear aetiology. Standard treatments of EA are: pneumatic balloon dilation (PBD of the lower esophageal sphyncter (LES and surgical cleaving of the muscle by Heller myotomy. Although the treatment effectively cures dysphagia, the symptoms recur in about a half of the patients. Our point of interest was long-term effectiveness of EA treatment at our department. METHODSWe made a retrospective analysis of EA patients treated at our department of thoracic surgery during the 2000–2010 period.RESULTSIn 11 years we performed 187 PBD and 22 laparoscopic myotomies (LM in 148 patients. Three years after the procedure 65 % of patients after PBD and 90 % of patients after LM showed no signs of disease. The risk of recurrence was 3.56-times greater (p = 0.03 after PBD (in comparison to LM, whereas patients older than 50 years bear 0.51-times lower risk (p = 0.02. The most significant complicatios were esophageal perforation in 3 patients (1.6 % after PBD and gastroesophageal reflux in 3 patients (15 % after LM.CONCLUSIONSPBD is a fast, simple, inexpensive and very efficient method of EA treatment, which can be safely performed in almost every patient. LM is far more expensive and a more complicated method that is more suitable for younger patients, in whom PBD is less effective.

  12. Retrospective analysis of dengue specific IgM reactive serum samples

    Directory of Open Access Journals (Sweden)

    Nemai Bhattacharya

    2013-04-01

    Full Text Available Objective: To conduct a retrospective analysis of dengue cases in Kolkata, on the basis of presence of anti-dengue IgM in their sera and presence or absence of anti-dengue IgG and dengue specific Non structural 1 (NS1 antigen in each of the serum sample. Methods: Sample was tested quantitatively employing ELISA technique, using Biorad test kits, with a view to get a more comprehensive picture of dengue in an urban endemic area and also to evaluate individual cases. Results: This reconstructed study revealed that of those 91 dengue cases, 70.3% (64 and 29.7% (27 were suffering from secondary and primary dengue respectively, showing that number of secondary dengue cases were much more than that of primary dengue cases with a possibility of emergence of DHF. A small proportion of cases 18.7% (17 were reactive for NS1. The duration of fever in NS1 antigen positive cases varied between 5 and 7 days. Of 17 NS1 reactive cases, 10 (10.9% and 7 (7.7% were suffering from secondary and primary dengue respectively. Conclusions: Early detection of primary and secondary dengue cases would be facilitated by utilizing all three parameters (NS1 antigen, anti-dengue IgM and IgG helping to evaluate, monitor and treat a dengue case effectively.

  13. Weight patterns in children with higher risk ALL: A report from the Children's Oncology Group (COG) for CCG 1961.

    Science.gov (United States)

    Withycombe, Janice S; Post-White, Janice E; Meza, Jane L; Hawks, Ria G; Smith, Lynette M; Sacks, Nancy; Seibel, Nita L

    2009-12-15

    This retrospective analysis defined and described patterns and predictors of weight change during treatment in children with acute lymphocytic leukemia (ALL) with high-risk features who received treatment on Children's Cancer Group protocol CCG 1961. Patients (1,638) were enrolled in CCG 1961 from November 1996 to May 2002. Weight was measured as BMI percent (%), specific for age and gender, and defined as 100 x ln(BMI/median BMI). By the end of treatment, 23% of children were obese (BMI >or=95%), compared with 14% at diagnosis. Children who received post-induction intensified therapy (arms C, D, SER with Doxorubicin or Idarubicin) had higher gastrointestinal toxicities and lower BMI% from consolidation through interim maintenance 1. BMI% then increased for all arms between delayed intensification and maintenance 1 or 2. Children who were of Black or Hispanic race, obese at diagnosis, or who had grade 3 or 4 pancreatitis/glucose toxicities during induction had higher BMI% throughout treatment. Children were more likely to be obese at the end of the study if they were aged 5-9 years at diagnosis or female gender. Cranial radiation was not a predictor of obesity. Successful treatment of higher risk childhood ALL was associated with obesity, independent of cranial irradiation. The beginning of maintenance therapy may be the best time to intervene with nutritional and behavioral interventions, particularly for children who are obese or aged 5-9 years at diagnosis, female, Black or Hispanic, or those with metabolic toxicities during induction. (c) 2009 Wiley-Liss, Inc.

  14. Pre- and post-operative application of acoustic rhinometry in children with otitis media with effusion and with or without adenoid hypertrophy-a retrospective analysis.

    Science.gov (United States)

    Lai, Dan; Qin, Gang; Pu, Junmei; Liu, Lu; Yang, Yiying

    2017-12-01

    There is no standardized scheme for preoperative evaluation of adenoid hypertrophy or a consensus on surgical indications for adenoidectomy in children with otitis media with effusion (OME), especially for young children intolerant to nasal endoscopic assessment. The aim of this study was to evaluate the efficacy and reliability of acoustic rhinometry (AR) in evaluating benefits from adenoidectomy in children with OME. Children with OME who were scheduled for surgical intervention were reviewed and AR tests performed preoperatively and postoperatively. The patients were divided into two groups based on the surgical strategy (Group I: tympanostomy tube placement alone; Group II: tympanostomy tube placement plus adenoidectomy). Correlation and regression analyses were performed to assess the relationship between findings of AR and nasal endoscopy. AR parameters including minimal nasal cross-sectional area (MCA), and nasopharyngeal volume (NPV), as well as scores of subjective symptoms were obtained to evaluate the utility of AR pre- and post-surgery. Sixty-five children aged 4-10 years who met the inclusion criteria were included. No significant differences in gender or age distribution were observed between Group I and Group II. MCA, as well as NPV significantly decreased in Group II when compared with Group I (p = 0.000). A significant inverse correlation was observed between NPV and choanal obstruction ratio in both groups I (r = -0.625, p children with OME, especially in whom preoperative nasal endoscopic examination is not feasible. Additionally, AR can reveal the changes occurring within the nasopharyngeal passage before and after adenoidectomy. Copyright © 2017. Published by Elsevier B.V.

  15. Uncovering the Problem-Solving Process: Cued Retrospective Reporting Versus Concurrent and Retrospective Reporting

    NARCIS (Netherlands)

    Van Gog, Tamara; Paas, Fred; Van Merriënboer, Jeroen; Witte, P.

    2007-01-01

    This study investigated the amounts of problem-solving process information ("action," "why," "how," and "metacognitive") elicited by means of concurrent, retrospective, and cued retrospective reporting. In a within-participants design, 26 participants completed electrical circuit troubleshooting

  16. Linear IgA Bullous Dermatosis:A Retrospective Study of 23 Patients in Denmark

    OpenAIRE

    Lings, Kristina; Bygum, Anette

    2015-01-01

    Linear IgA bullous dermatosis (LAD) is an autoimmune, chronic bullous disease affecting primarily young children and adults. Studies on LAD are relatively sparse and from Scandinavia we could only find a few case reports. Therefore we decided to conduct a retrospective investigation of patients seen at our department since 1972. The objective is to give a description of the different subgroups of patients with LAD with regard to precipitating factors, demographics, treatments, course of disea...

  17. Retrospective analysis of cytopathology using gray level co-occurrence matrix algorithm for thyroid malignant nodules in the ultrasound imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yeong Ju; Lee, Jin Soo [Dept. of Radiology, Inje University Haeundae Paik Hospital, Busan (Korea, Republic of); Kang, Se Sik; Kim, Chang Soo [Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan, Busan (Korea, Republic of)

    2017-06-15

    This study evaluated the applicability of computer-aided diagnosis by retrospective analysis of GLCM algorithm based on cytopathological diagnosis of normal and malignant nodules in thyroid ultrasound images. In the experiment, the recognition rate and ROC curve of thyroid malignant nodule were analyzed using 6 parameters of GLCM algorithm. Experimental results showed 97% energy, 93% contrast, 92% correlation, 92% homogeneity, 100% entropy and 100% variance. Statistical analysis showed that the area under the curve of each parameter was more than 0.947 (p = 0 .001) in t he ROC curve, which was s ignificant in the recognition of thyroid malignant nodules. In the GLCM, the cut-off value of each parameter can be used to predict the disease through analysis of quantitative computer-aided diagnosis.

  18. Success rates of a skeletal anchorage system in orthodontics: A retrospective analysis.

    Science.gov (United States)

    Lam, Raymond; Goonewardene, Mithran S; Allan, Brent P; Sugawara, Junji

    2018-01-01

    To evaluate the premise that skeletal anchorage with SAS miniplates are highly successful and predictable for a range of complex orthodontic movements. This retrospective cross-sectional analysis consisted of 421 bone plates placed by one clinician in 163 patients (95 female, 68 male, mean age 29.4 years ± 12.02). Simple descriptive statistics were performed for a wide range of malocclusions and desired movements to obtain success, complication, and failure rates. The success rate of skeletal anchorage system miniplates was 98.6%, where approximately 40% of cases experienced mild complications. The most common complication was soft tissue inflammation, which was amenable to focused oral hygiene and antiseptic rinses. Infection occurred in approximately 15% of patients where there was a statistically significant correlation with poor oral hygiene. The most common movements were distalization and intrusion of teeth. More than a third of the cases involved complex movements in more than one plane of space. The success rate of skeletal anchorage system miniplates is high and predictable for a wide range of complex orthodontic movements.

  19. Fishtail deformity - a delayed complication of distal humeral fractures in children

    Energy Technology Data Exchange (ETDEWEB)

    Narayanan, Srikala [Massachusetts General Hospital, Department of Radiology, Division of Pediatric Imaging, Boston, MA (United States); University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, PA (United States); Shailam, Randheer; Nimkin, Katherine [Massachusetts General Hospital, Department of Radiology, Division of Pediatric Imaging, Boston, MA (United States); Grottkau, Brian E. [Massachusetts General Hospital, Department of Orthopaedics, Pediatric Orthopaedics, Boston, MA (United States)

    2015-06-15

    Concavity in the central portion of the distal humerus is referred to as fishtail deformity. This entity is a rare complication of distal humeral fractures in children. The purpose of this study is to describe imaging features of post-traumatic fishtail deformity and discuss the pathophysiology. We conducted a retrospective analysis of seven cases of fishtail deformity after distal humeral fractures. Seven children ages 7-14 years (five boys, two girls) presented with elbow pain and history of distal humeral fracture. Four of the seven children had limited range of motion. Five children had prior grade 3 supracondylar fracture treated with closed reduction and percutaneous pinning. One child had a medial condylar fracture and another had a lateral condylar fracture; both had been treated with conservative casting. All children had radiographs, five had CT and three had MRI. All children had a concave central defect in the distal humerus. Other imaging features included joint space narrowing with osteophytes and subchondral cystic changes in four children, synovitis in one, hypertrophy or subluxation of the radial head in three and proximal migration of the ulna in two. Fishtail deformity of the distal humerus is a rare complication of distal humeral fractures in children. This entity is infrequently reported in the radiology literature. Awareness of the classic imaging features can result in earlier diagnosis and appropriate treatment. (orig.)

  20. Fishtail deformity - a delayed complication of distal humeral fractures in children

    International Nuclear Information System (INIS)

    Narayanan, Srikala; Shailam, Randheer; Nimkin, Katherine; Grottkau, Brian E.

    2015-01-01

    Concavity in the central portion of the distal humerus is referred to as fishtail deformity. This entity is a rare complication of distal humeral fractures in children. The purpose of this study is to describe imaging features of post-traumatic fishtail deformity and discuss the pathophysiology. We conducted a retrospective analysis of seven cases of fishtail deformity after distal humeral fractures. Seven children ages 7-14 years (five boys, two girls) presented with elbow pain and history of distal humeral fracture. Four of the seven children had limited range of motion. Five children had prior grade 3 supracondylar fracture treated with closed reduction and percutaneous pinning. One child had a medial condylar fracture and another had a lateral condylar fracture; both had been treated with conservative casting. All children had radiographs, five had CT and three had MRI. All children had a concave central defect in the distal humerus. Other imaging features included joint space narrowing with osteophytes and subchondral cystic changes in four children, synovitis in one, hypertrophy or subluxation of the radial head in three and proximal migration of the ulna in two. Fishtail deformity of the distal humerus is a rare complication of distal humeral fractures in children. This entity is infrequently reported in the radiology literature. Awareness of the classic imaging features can result in earlier diagnosis and appropriate treatment. (orig.)

  1. Gender Differences in Children's Language: A Meta-Analysis of Slovenian Studies

    Science.gov (United States)

    Marjanovic-Umek, Ljubica; Fekonja-Peklaj, Urška

    2017-01-01

    Child gender has been proved to affect toddlers'/children's language development in several studies, but its effect was not found to be stable across different ages or various aspects of language ability. The effect of gender on toddler's, children's and adolescents' language ability was examined in the present meta-analysis of ten Slovenian…

  2. American Meteorological Society (AMS) - The Modern Era Retrospective-Analysis for Research and Applications (MERRA) Data and Accessibility

    Science.gov (United States)

    daSilva, Arlindo

    2009-01-01

    The AM Short Course on The Modern Era Retrospective-analysis for Research and Applications (MERRA) data and accessibility will be held on January 11, 2009 preceding the 89th Annual Meeting in Phoenix, Arizona. Preliminary programs, registration, hotel, and general information will be posted on the AMS Web site in mid-September 2008. Retrospective-analyses (or reanalyses) have been established as an important tool in weather and climate research over the last decade. As computer power increases, the data assimilation and modeling systems improve and become more advanced, the input data quality increases and so reanalyses become more reliable. In 2008, NASA Global Modeling and Assimilation Office began producing a new reanalysis called the Modem Era Retrospective-analysis for Research and Applications (MERRA). The initial data from the reanalysis has been made available to the community and should be complete through 30 years (1979-present) by Fall of 2009. MERRA has taken advantage of the advancement of computing resources to provide users more data than previously available. The native spatial resolution is nominally 1/2 degrees and the surface two dimensional data are one hourly frequency. In addition to the meteorological analysis data, complete mass, energy and momentum budget data and also stratospheric data are provided. The eventual data holdings will exceed 150Tb. In order to facilitate user accessibility to the data, it will be stored in online hard drives (not tape storage) and available through several portals. Subsetting tools will also be available to allow users to tailor their data requests. The goals of this short course are to provide hands on users of reanalyses instruction on MERRA systems and also interactive experience with the online data and access tools. The course is intended for students and research scientists who will be actively interested in accessing and applying MERRA data in their weather, climate or applications work. The course has

  3. Predicting Future Reading Problems Based on Pre-reading Auditory Measures: A Longitudinal Study of Children with a Familial Risk of Dyslexia.

    Science.gov (United States)

    Law, Jeremy M; Vandermosten, Maaike; Ghesquière, Pol; Wouters, Jan

    2017-01-01

    Purpose: This longitudinal study examines measures of temporal auditory processing in pre-reading children with a family risk of dyslexia. Specifically, it attempts to ascertain whether pre-reading auditory processing, speech perception, and phonological awareness (PA) reliably predict later literacy achievement. Additionally, this study retrospectively examines the presence of pre-reading auditory processing, speech perception, and PA impairments in children later found to be literacy impaired. Method: Forty-four pre-reading children with and without a family risk of dyslexia were assessed at three time points (kindergarten, first, and second grade). Auditory processing measures of rise time (RT) discrimination and frequency modulation (FM) along with speech perception, PA, and various literacy tasks were assessed. Results: Kindergarten RT uniquely contributed to growth in literacy in grades one and two, even after controlling for letter knowledge and PA. Highly significant concurrent and predictive correlations were observed with kindergarten RT significantly predicting first grade PA. Retrospective analysis demonstrated atypical performance in RT and PA at all three time points in children who later developed literacy impairments. Conclusions: Although significant, kindergarten auditory processing contributions to later literacy growth lack the power to be considered as a single-cause predictor; thus results support temporal processing deficits' contribution within a multiple deficit model of dyslexia.

  4. Craniofacial morphology in children with van der Woude syndrome and isolated cleft palate.

    Science.gov (United States)

    Heliövaara, Arja; Karhulahti, Rekina; Rautio, Jorma

    2015-01-01

    To compare cephalometrically 6-year-old children with van der Woude syndrome and cleft palate (VWS) to children with isolated cleft palate alone (CP). A retrospective case-control study. Forty-four children with VWS were compared to 73 children with CP using lateral cephalograms. The mean age of the children with VWS was 6.6 years (range = 5.9-8.2) and that of the children with CP, 6.2 years (range = 5.7-6.7). Palatal closure had been done at a mean age of 1.4 years (range = 0.8-2.2), mostly with the Veau-Wardill-Killner or the Cronin pushback surgical techniques. The data was collected over a 30-year period. Linear and angular measurements were obtained from lateral cephalograms. A Student's t-test was used in the statistical analysis. The craniofacial morphology in children with VWS and CP was similar, but those with VWS had slightly smaller diameters of the lower pharyngeal airway. The maxilla and mandible were well related to each other, although a little retrusive in relation to the cranial base. The soft tissue profile reflected the skeletal relationships, no significant protrusion of the lower lip was noted. Six-year-old children with VWS and CP have similar craniofacial morphology.

  5. Siblings of children with a chronic illness: a meta-analysis.

    Science.gov (United States)

    Sharpe, Donald; Rossiter, Lucille

    2002-12-01

    To review the literature pertaining to the siblings of children with a chronic illness. Fifty-one published studies and 103 effect sizes were identified and examined through meta-analysis. We found (1) a modest, negative effect size statistic existed for siblings of children with a chronic illness relative to comparison participants or normative data; (2) heterogeneity existed for those effect sizes; (3) parent reports were more negative than child self-reports; (4) psychological functioning (i.e., depression, anxiety), peer activities, and cognitive development scores were lower for siblings of children with a chronic illness compared to controls; and (5) a cluster of chronic illnesses with daily treatment regimes was associated with negative effect statistics compared to chronic illnesses that did not affect daily functioning. More methodologically sound studies investigating the psychological functioning of siblings of children with a chronic illness are needed. Clinicians need to know that siblings of children with a chronic illness are at risk for negative psychological effects. Intervention programs for the siblings and families of children with a chronic illness should be developed.

  6. Cerebrospinal fluid lactate level as a diagnostic biomarker for bacterial meningitis in children.

    Science.gov (United States)

    Mekitarian Filho, Eduardo; Horita, Sérgio Massaru; Gilio, Alfredo Elias; Nigrovic, Lise E

    2014-02-27

    Cerebrospinal fluid (CSF) lactate is a potential biomarker for bacterial meningitis in children. To this end, we performed a single-center retrospective cohort study of children from Sao Paulo, Brazil, with CSF pleocytosis to evaluate the ability of CSF lactate to distinguish between children with bacterial and aseptic meningitis. We determined the optimum cutoff point for CSF lactate using receiver-operator curve (ROC) analysis. We identified 451 children of whom 40 (9%) had bacterial meningitis. Children with bacterial meningitis had a higher median CSF lactate level [9.6 mmol/l, interquartile range (IQR) 3.2-38.5 mmol/l bacterial meningitis vs. 2.0 mmol/l, IQR 1.2-2.8 mmol/l aseptic meningitis]. A CSF lactate cutoff point of 3.0 mmol/l had a sensitivity of 95% [95% confidence interval (CI) 83-99%), specificity of 94% (95% CI 90-96%) and negative predictive value of 99.3% (95% CI 97.7-99.9%) for bacterial meningitis. In combination with a validated meningitis clinical prediction rule, the CSF lactate level can be used to distinguish between bacterial and aseptic meningitis in children with CSF pleocytosis.

  7. Talking About Maternal Breast Cancer With Young Children: A Content Analysis of Text in Children's Books.

    Science.gov (United States)

    Huang, Xiaoyan; Lee, Susan; Hu, Yan; Gao, Hongyun; O'Connor, Margaret

    2015-07-01

    Examine the content of children's books and summarize the main issues related to communication with young children about maternal cancer, especially breast cancer. A search of English books discussing early-stage (breast) cancer and written for children aged 3-12 years was conducted on the Amazon.com Web site. Each of 45 identified books was analyzed independently by two of three coders using inductive qualitative content analysis. The main contents of these books included cancer-related knowledge, impacts of maternal cancer, and coping strategies. The concept of (breast) cancer and its treatment was introduced in plain language and some common misunderstandings were clarified. The consequences of maternal cancer were highlighted. These books are beneficial to children and adults. However, impacts on school life, children's concerns about financial burdens, and instructions about age-appropriate use of the books have been neglected. Additional studies should be undertaken to explore the value of these books. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Methadone Poisoning in Children: A Systematic Review and Meta-Analysis in Iran

    Directory of Open Access Journals (Sweden)

    Yasaman Allameh

    2017-05-01

    Full Text Available Context Symptoms of methadone poisoning, as one of the most dangerous types of poisoning, are very serious in children. Objectives The aim of this study was to describe causes and clinical symptoms of methadone poisoning in children admitted to hospitals in Iran. Data Sources Relevant studies published in national and international journals before January 29, 2016 were identified by studying the available databases, including PubMed, Web of Sciences, Google Scholar, Scopus, SID, Iranmedex, MagIran, and Irandoc. Study Selection After excluding duplicate, irrelevant, and low-quality articles, relevant papers were entered into the meta-analysis. The prevalence, mean, and standard deviation of methadone poisoning symptoms in children were statistically analyzed, using Stata version 11, and causes of methadone poisoning were presented in tables. Data Extraction Studies with unknown sample sizes, abstracts without access to full text, articles with quality assessment scores below 15.5, and studies carried out on non-Iranian populations were excluded from the meta-analysis. Results During the initial advanced search, 1594 articles were identified. After quality assessment, 12 papers were found eligible for the final systematic review and meta-analysis, based on the inclusion and exclusion criteria. The reported symptoms included drowsiness, vomiting, apnea, cyanosis, seizure, ataxia, and delirium. In the meta-analysis, prevalence of symptoms in referred patients was estimated at 44% (0.95% confidence interval, 0.288 to 0.609. The causes of poisoning in children included accidental feeding by parents, storage of drugs in inappropriate containers, parental addiction, and low educational level of parents. Conclusions It is important to keep methadone in a suitable container away from children. Also, it is essential to focus on educating parents on health issues of their children.

  9. Long-Term Changes of Subcutaneous Fat Mass in HIV-Infected Children on Antiretroviral Therapy: A Retrospective Analysis of Longitudinal Data from Two Pediatric HIV-Cohorts.

    Science.gov (United States)

    Cohen, Sophie; Innes, Steve; Geelen, Sibyl P M; Wells, Jonathan C K; Smit, Colette; Wolfs, Tom F W; van Eck-Smit, Berthe L F; Kuijpers, Taco W; Reiss, Peter; Scherpbier, Henriette J; Pajkrt, Dasja; Bunders, Madeleine J

    2015-01-01

    Longitudinal studies objectively evaluating changes in regional fat distribution of HIV-infected children assessed by whole body dual energy X-ray absorptiometry (DEXA) are scarce, whilst this long-term effect of HIV and antiretroviral therapy (cART) is an important issue in infected children in need for lifelong treatment. We assessed regional fat distribution over time, measured with sequential DEXA-scans in HIV-infected children on cART in cohorts from South Africa (SA) and the Netherlands (NL), and in healthy controls (SA). Limb and trunk fat Z-scores were calculated with the lambda-mu-sigma (LMS) method. Multivariable linear regression models with mixed effects were used to investigate the effect of cART compounds on body fat distribution over time. In total, 218 children underwent 445 DEXA assessments with a median follow-up of 3.5 years. Fat mass in all limbs was decreased in HIV-infected children compared to controls (arm fat Z-score: coefficient -0.4813; P = 0.006, leg fat Z-score: coefficient -0.4345; P = 0.013). In the HIV-infected group, stavudine treatment was associated with lower subcutaneous fat mass (arm fat Z-score: coefficient -0.5838; P = 0.001), with an additional cumulative exposure effect (arm fat Z-score: coefficient -0.0867; P = 0.003). Our study shows that subcutaneous fat loss is still prevalent in HIV-infected children on cART, and is strongly associated with cumulative stavudine exposure. These results underline the need for early detection of subcutaneous fat loss and alternative treatment options for HIV-infected children globally.

  10. Efficiency of occlusion therapy for management of amblyopia in older children.

    Science.gov (United States)

    Brar, Gagandeep S; Bandyopadhyay, Supratik; Kaushik, Sushmita; Raj, Surishti

    2006-12-01

    To analyse results of full time occlusion therapy for amblyopia in children older than 6 years. This was a retrospective consecutive case series analysis of children treated for amblyopia at a tertiary care center. All children received full time occlusion (FTO) for the dominant eye. Eighty-eight children older than 6 years at the time of initiation of therapy were included. Age at initiation of therapy ranged from 6 to 20 years (9.45 +/- 3.11 years). Forty-two children (47.7%) had strabismic amblyopia, 37 (42.0%) had anisometropic amblyopia and 9 (10.2%) had a combination of strabismic and anisometropic amblyopia. Eighty out of 88 eyes (90.0%) had improvement in visual acuity following FTO. Visual acuity (VA) improved from 0.82 +/- 0.34 at presentation to 0.42 +/- 0.34 (P amblyopia, VA improved from 0.81 +/- 0.42 to 0.42 +/- 0.39 (P amblyopia, visual acuity of the amblyopic eye improved fron 0.82 +/- 0.24 to 0.36 +/- 0.29 (Pocclusion was 8.37 +/- 1.78 months. Occlusion therapy yields favorable results in strabismic and/or anisometropic amblyopia, even when initiated for the first time after 6 years of age. After 12 years of age, some children may still respond to occlusion of the dominant eye.

  11. Correlation of EEG with neuropsychological status in children with epilepsy.

    Science.gov (United States)

    Hsu, David A; Rayer, Katherine; Jackson, Daren C; Stafstrom, Carl E; Hsu, Murielle; Ferrazzano, Peter A; Dabbs, Kevin; Worrell, Gregory A; Jones, Jana E; Hermann, Bruce P

    2016-02-01

    To determine correlations of the EEG frequency spectrum with neuropsychological status in children with idiopathic epilepsy. Forty-six children ages 8-18 years old with idiopathic epilepsy were retrospectively identified and analyzed for correlations between EEG spectra and neuropsychological status using multivariate linear regression. In addition, the theta/beta ratio, which has been suggested as a clinically useful EEG marker of attention-deficit hyperactivity disorder (ADHD), and an EEG spike count were calculated for each subject. Neuropsychological status was highly correlated with posterior alpha (8-15 Hz) EEG activity in a complex way, with both positive and negative correlations at lower and higher alpha frequency sub-bands for each cognitive task in a pattern that depends on the specific cognitive task. In addition, the theta/beta ratio was a specific but insensitive indicator of ADHD status in children with epilepsy; most children both with and without epilepsy have normal theta/beta ratios. The spike count showed no correlations with neuropsychological status. (1) The alpha rhythm may have at least two sub-bands which serve different purposes. (2) The theta/beta ratio is not a sensitive indicator of ADHD status in children with epilepsy. (3) The EEG frequency spectrum correlates more robustly with neuropsychological status than spike count analysis in children with idiopathic epilepsy. (1) The role of posterior alpha rhythms in cognition is complex and can be overlooked if EEG spectral resolution is too coarse or if neuropsychological status is assessed too narrowly. (2) ADHD in children with idiopathic epilepsy may involve different mechanisms from those in children without epilepsy. (3) Reliable correlations with neuropsychological status require longer EEG samples when using spike count analysis than when using frequency spectra. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights

  12. Analysis of the Emotion of Fear in Gifted Children and its Use in Teaching Practice

    OpenAIRE

    Machů, Eva; Morysová, Dominika

    2016-01-01

    This article presents an analysis of fear in gifted children of younger school age in comparison with the control group of children. The tool used for the research was a questionnaire with statements about fear, with the intensity of selected types of fear evaluated. The questionnaire was subject to a factor analysis, which resulted in 5 areas of fear. At the level of the individual factors we determined that fear in gifted children is less intense than fear in children from the normal popula...

  13. Hearing loss in children with primary ciliary dyskinesia.

    Science.gov (United States)

    Kreicher, Kathryn L; Schopper, Heather K; Naik, Akash N; Hatch, Jonathan L; Meyer, Ted A

    2018-01-01

    To evaluate the type and severity of hearing impairment in pediatric patients with primary ciliary dyskinesia (PCD) and relate these measures to patient demographics, treatment options, and other otologic factors. A retrospective analysis of children with a diagnosis of PCD, Kartagener's syndrome, or situs inversus in the AudGen Database was conducted. Audiograms were analyzed for type of hearing loss (HL), severity, laterality, and progression. Medical charts were reviewed to identify factors that influence severity and progression of hearing loss. 56 patients met inclusion criteria and 42 patients had HL. 66.6% had bilateral and 33.3% had unilateral loss (70 total ears with HL). Conductive hearing loss (CHL) was the most common type of HL, though 30% of children had some sensorineural component to their hearing loss. 92.9% of children with HL received at least one diagnosis of otitis media, but HL did not improve in the majority (77.8%) of ears in our study regardless of ear tube placement. Slight to mild CHL and all types of otitis media are prevalent among patients with PCD, and some of these children have sensorineural hearing loss (SNHL). All patients diagnosed with situs inversus at birth should be evaluated by an otolaryngologist. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Long-Term Use of Aldosterone-Receptor Antagonists in Uncontrolled Hypertension: A Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    Pieter M. Jansen

    2011-01-01

    Full Text Available Background. The long-term efficacy of aldosterone-receptor antagonists (ARAs as add-on treatment in uncontrolled hypertension has not yet been reported. Methods. Data from 123 patients (21 with primary aldosteronism, 102 with essential hypertension with difficult-to-treat hypertension who received an ARA between May 2005 and September 2009 were analyzed retrospectively for their blood pressure (BP and biochemical response at first followup after start with ARA and the last follow-up available. Results. Systolic BP decreased by 22±20 and diastolic BP by 9.4±12 mmHg after a median treatment duration of 25 months. In patients that received treatment >5 years, SBP was 33±20 and DBP was 16 ± 13 mmHg lower than at baseline. Multivariate analysis revealed that baseline BP and follow-up duration were positively correlated with BP response. Conclusion. Add-on ARA treatment in difficult-to-treat hypertension results in a profound and sustained BP reduction.

  15. A Componential Analysis of Visual Attention in Children With ADHD.

    Science.gov (United States)

    McAvinue, Laura P; Vangkilde, Signe; Johnson, Katherine A; Habekost, Thomas; Kyllingsbæk, Søren; Bundesen, Claus; Robertson, Ian H

    2015-10-01

    Inattentive behaviour is a defining characteristic of ADHD. Researchers have wondered about the nature of the attentional deficit underlying these symptoms. The primary purpose of the current study was to examine this attentional deficit using a novel paradigm based upon the Theory of Visual Attention (TVA). The TVA paradigm enabled a componential analysis of visual attention through the use of a mathematical model to estimate parameters relating to attentional selectivity and capacity. Children's ability to sustain attention was also assessed using the Sustained Attention to Response Task. The sample included a comparison between 25 children with ADHD and 25 control children aged 9-13. Children with ADHD had significantly impaired sustained attention and visual processing speed but intact attentional selectivity, perceptual threshold and visual short-term memory capacity. The results of this study lend support to the notion of differential impairment of attentional functions in children with ADHD. © 2012 SAGE Publications.

  16. Are scabies and impetigo "normalised"? A cross-sectional comparative study of hospitalised children in northern Australia assessing clinical recognition and treatment of skin infections.

    Directory of Open Access Journals (Sweden)

    Daniel K Yeoh

    2017-07-01

    Full Text Available Complications of scabies and impetigo such as glomerulonephritis and invasive bacterial infection in Australian Aboriginal children remain significant problems and the overall global burden of disease attributable to these skin infections remains high despite the availability of effective treatment. We hypothesised that one factor contributing to this high burden is that skin infection is under-recognised and hence under-treated, in settings where prevalence is high.We conducted a prospective, cross-sectional study to assess the burden of scabies, impetigo, tinea and pediculosis in children admitted to two regional Australian hospitals from October 2015 to January 2016. A retrospective chart review of patients admitted in November 2014 (mid-point of the prospective data collection in the preceding year was performed. Prevalence of documented skin infection was compared in the prospective and retrospective population to assess clinician recognition and treatment of skin infections.158 patients with median age 3.6 years, 74% Aboriginal, were prospectively recruited. 77 patient records were retrospectively reviewed. Scabies (8.2% vs 0.0%, OR N/A, p = 0.006 and impetigo (49.4% vs 19.5%, OR 4.0 (95% confidence interval [CI 2.1-7.7 were more prevalent in the prospective analysis. Skin examination was only documented in 45.5% of cases in the retrospective review. Patients in the prospective analysis were more likely to be prescribed specific treatment for skin infection compared with those in the retrospective review (31.6% vs 5.2%, OR 8.5 (95% CI 2.9-24.4.Scabies and impetigo infections are under-recognised and hence under-treated by clinicians. Improving the recognition and treatment of skin infections by clinicians is a priority to reduce the high burden of skin infection and subsequent sequelae in paediatric populations where scabies and impetigo are endemic.

  17. Are scabies and impetigo "normalised"? A cross-sectional comparative study of hospitalised children in northern Australia assessing clinical recognition and treatment of skin infections.

    Science.gov (United States)

    Yeoh, Daniel K; Anderson, Aleisha; Cleland, Gavin; Bowen, Asha C

    2017-07-01

    Complications of scabies and impetigo such as glomerulonephritis and invasive bacterial infection in Australian Aboriginal children remain significant problems and the overall global burden of disease attributable to these skin infections remains high despite the availability of effective treatment. We hypothesised that one factor contributing to this high burden is that skin infection is under-recognised and hence under-treated, in settings where prevalence is high. We conducted a prospective, cross-sectional study to assess the burden of scabies, impetigo, tinea and pediculosis in children admitted to two regional Australian hospitals from October 2015 to January 2016. A retrospective chart review of patients admitted in November 2014 (mid-point of the prospective data collection in the preceding year) was performed. Prevalence of documented skin infection was compared in the prospective and retrospective population to assess clinician recognition and treatment of skin infections. 158 patients with median age 3.6 years, 74% Aboriginal, were prospectively recruited. 77 patient records were retrospectively reviewed. Scabies (8.2% vs 0.0%, OR N/A, p = 0.006) and impetigo (49.4% vs 19.5%, OR 4.0 (95% confidence interval [CI 2.1-7.7) were more prevalent in the prospective analysis. Skin examination was only documented in 45.5% of cases in the retrospective review. Patients in the prospective analysis were more likely to be prescribed specific treatment for skin infection compared with those in the retrospective review (31.6% vs 5.2%, OR 8.5 (95% CI 2.9-24.4). Scabies and impetigo infections are under-recognised and hence under-treated by clinicians. Improving the recognition and treatment of skin infections by clinicians is a priority to reduce the high burden of skin infection and subsequent sequelae in paediatric populations where scabies and impetigo are endemic.

  18. Online marketing of food and beverages to children: a content analysis.

    Science.gov (United States)

    Brady, Jennifer; Mendelson, Rena; Farrell, Amber; Wong, Sharon

    2010-01-01

    The goal was to assess websites sponsored by food and beverage manufacturers that have pledged to market branded food and beverage products to children responsibly, by ratifying the Children's Food and Beverage Advertising Initiative (CFBAI). A content analysis was conducted of 24 purposively sampled websites sponsored by 10 companies that promote food and beverage products to children. All are participant members of the CFBAI. Of the 24 websites analyzed, the majority targeted children below age 12 (83%). An array of innovative online marketing techniques, most notably free website membership (63%), leader boards (50%), adver-games (79%), and branded downloadable content (76%), were used to encourage children's engagement with branded food and beverage promotions. Food and beverage manufacturers are engaging children with dynamic online marketing techniques that challenge regulatory codes governing broadcast media. These techniques may contradict the spirit of the CFBAI. Innovative regulatory guidelines are needed to address modern marketing media.

  19. Children with Disabilities Are Often Misdiagnosed Initially and Children with Neuropsychiatric Disorders Are Referred to Adequate Resources 30 Months Later than Children with Other Disabilities

    Science.gov (United States)

    Tuominen-Eriksson, Alli-Marie; Svensson, Yvonne; Gunnarsson, Ronny K.

    2013-01-01

    Disabilities in a child may lead to low self-esteem and social problems. The lives of parents and siblings are also affected. Early intervention may decrease these consequences. To promote early intervention early referral to adequate resources is essential. In a longitudinal retrospective observational study it was found that children with…

  20. Intellectual development in preschool children with early treated congenital hypothyroidism.

    Science.gov (United States)

    Seo, Min Kyoung; Yoon, Jong Seo; So, Chul Hwan; Lee, Hae Sang; Hwang, Jin Soon

    2017-06-01

    Delayed treatment of congenital hypothyroidism (CH) is a common cause of mental retardation. The aim of the present study was to evaluate intellectual outcomes in preschool children with treated CH. We retrospectively reviewed the clinical records of 43 children (age range: 13 to 60 days of life; 22 girls and 21 boys) diagnosed with CH. Children aged 5 to 7 years were examined using the Korean Wechsler Intelligence Scale for Children or the Korean Wechsler Preschool and Primary Scale of Intelligence. The patients started treatment between 13 and 60 days of age. The mean intelligence quotient (IQ) of patients tested at age 5 to 7 years was 103.14±11.68 (IQ range: 76-126). None had intellectual disability (defined as an IQ scale IQ (FSIQ), verbal IQ (VIQ), and performance IQ (PIQ) scores between the 2 groups. FSIQ, PIQ, and VIQ scores were not significantly correlated with initial dose of L-T4, initial fT4, age at treatment in multivariate analysis. IQ scores of subjects with early treated CH diagnosed through a neonatal screening test were within normal range, regardless of etiology, thyroid function, initial dose of levothyroxine, and age at start of treatment.

  1. Prolonged methylprednisolone therapy after the pulse treatment for patients with moderate-to-severe paraquat poisoning: A retrospective analysis.

    Science.gov (United States)

    Gao, Jie; Feng, ShunYi; Wang, Jian; Yang, SiYuan; Li, Yong

    2017-06-01

    This retrospective study aims to evaluate the effect of prolonged methylprednisolone (MP) therapy on the mortality of patients with moderate-to-severe paraquat (PQ) poisoning after the pulse treatment.We performed a retrospective analysis of patients with acute moderate-to-severe PQ poisoning that were admitted to the emergency department from May 2012 to August 2016. Out of 138 patients, 60 were treated with pulse treatment (15 mg kg day MP for 3 days) and 78 were treated with prolonged MP therapy after pulse treatment (15 mg kg day MP for 3 days; afterward, the dosage was reduced in half every 2 days, and the MP therapy was terminated until 0.47 mg kg day). Kaplan-Meier method was used to compare the mortality between the 2 groups. Cox proportional hazard models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI).The mortality of the prolonged MP therapy after pulse treatment group was lower than that of the pulse group (47.4% vs 63.3%; log-rank tests, P  =  .003). According to the multivariate Cox analysis, the prolonged MP therapy after pulse treatment was significantly associated with a lower mortality risk (HR: 0.31, 95% CI: 0.19-0.52, P treatment caused more incidences of leucopenia than the pulse treatment alone (25.6% vs 11.7%, P  =  .04).The prolonged MP therapy after pulse treatment can reduce the mortality of moderate-to-severe PQ poisoning patients.

  2. Hypercholesterolemia is associated with the apolipoprotein C-III (APOC3 genotype in children receiving HAART: an eight-year retrospective study.

    Directory of Open Access Journals (Sweden)

    Carlos A Rocco

    Full Text Available Polymorphisms in apolipoprotein genes have shown to be predictors of plasma lipid levels in adult cohorts receiving highly active antiretroviral therapy (HAART. Our objective was to confirm the association between the APOC3 genotype and plasma lipid levels in an HIV-1-infected pediatric cohort exposed to HAART. A total of 130 HIV-1-infected children/adolescents that attended a reference center in Argentina were selected for an 8-year longitudinal study with retrospective data collection. Longitudinal measurements of plasma triglycerides, total cholesterol, HDL-C and LDL-C were analyzed under linear or generalized linear mixed models. The contribution of the APOC3 genotype at sites -482, -455 and 3238 to plasma lipid levels prediction was tested after adjusting for potential confounders. Four major APOC3 haplotypes were observed for sites -482/-455/3238, with estimated frequencies of 0.60 (C/T/C, 0.14 (T/C/C, 0.11 (C/C/C, and 0.11 (T/C/G. The APOC3 genotype showed a significant effect only for the prediction of total cholesterol levels (p<0.0001. However, the magnitude of the differences observed was dependent on the drug combination (p = 0.0007 and the drug exposure duration at the time of the plasma lipid measurement (p = 0.0002. A lower risk of hypercholesterolemia was predicted for double and triple heterozygous individuals, mainly at the first few months after the initiation of Ritonavir-boosted protease inhibitor-based regimens. We report for the first time a significant contribution of the genotype to total cholesterol levels in a pediatric cohort under HAART. The genetic determination of APOC3 might have an impact on a large portion of HIV-1-infected children at the time of choosing the treatment regimens or on the counter-measures against the adverse effects of drugs.

  3. Changes in refractive characteristics in Japanese children with Down syndrome.

    Science.gov (United States)

    Horio, Junna; Kaneko, Hiroki; Takayama, Kei; Tuzuki, Kinichi; Kakihara, Hiroko; Iwami, Miou; Kawase, Yoshikatsu; Tsunekawa, Taichi; Yamaguchi, Naoko; Nonobe, Norie; Terasaki, Hiroko

    2018-03-01

    To investigate the refractive characteristics of Japanese children with Down syndrome. Retrospective study. The clinical records of refractive errors and ocular manifestations in children with Down syndrome who visited the Aichi Children's Health and Medical Center between November 2001 and January 2016 were retrospectively reviewed. The children were divided into the 3 following groups depending on their age: group 1 (≤ 6 years), group 2 (7-12 years), and group 3 (13-19 years). The collection of refractive error data was performed only for the right eyes and only once for each child, when the children were last examined with their pupils dilated. The study included 416 children (224 boys, 192 girls; average age, 6.1 ± 4.1 years). Group 3 had significantly stronger myopia than did groups 1 and 2. The mean cylindrical power in all the children was - 2.1 ± 1.2 diopters (D), and cylindrical power ≤ - 1.0 D (stronger than - 1.0 D) was seen in 366 eyes (88%). No significant difference in cylindrical power was found among the 3 groups. The spherical equivalent refraction showed an age-dependent myopic shift. Given that the amount of astigmatism did not show age-dependent differences, the age-dependent myopic shift could be due mainly to the change in spherical power.

  4. FIACH: A biophysical model for automatic retrospective noise control in fMRI.

    Science.gov (United States)

    Tierney, Tim M; Weiss-Croft, Louise J; Centeno, Maria; Shamshiri, Elhum A; Perani, Suejen; Baldeweg, Torsten; Clark, Christopher A; Carmichael, David W

    2016-01-01

    Different noise sources in fMRI acquisition can lead to spurious false positives and reduced sensitivity. We have developed a biophysically-based model (named FIACH: Functional Image Artefact Correction Heuristic) which extends current retrospective noise control methods in fMRI. FIACH can be applied to both General Linear Model (GLM) and resting state functional connectivity MRI (rs-fcMRI) studies. FIACH is a two-step procedure involving the identification and correction of non-physiological large amplitude temporal signal changes and spatial regions of high temporal instability. We have demonstrated its efficacy in a sample of 42 healthy children while performing language tasks that include overt speech with known activations. We demonstrate large improvements in sensitivity when FIACH is compared with current methods of retrospective correction. FIACH reduces the confounding effects of noise and increases the study's power by explaining significant variance that is not contained within the commonly used motion parameters. The method is particularly useful in detecting activations in inferior temporal regions which have proven problematic for fMRI. We have shown greater reproducibility and robustness of fMRI responses using FIACH in the context of task induced motion. In a clinical setting this will translate to increasing the reliability and sensitivity of fMRI used for the identification of language lateralisation and eloquent cortex. FIACH can benefit studies of cognitive development in young children, patient populations and older adults. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  5. Family-centred care of children in hospital - a concept analysis

    DEFF Research Database (Denmark)

    Mikkelsen, Gitte; Frederiksen, Kirsten

    2011-01-01

    from 1951 to 2009 resulted in a sample of 25 research articles. Review methods.  A theoretical concept analysis influenced by Risjord's distinction between theoretical and colloquial analyses and based on the principles developed by Morse, Hupcey and Penrod was used to examine the structure...... of professionals and families, mostly represented by mothers. Few attempts have been made to operationalize the concept. Conclusion.  Family-centred care is a partially mature and highly abstract concept. Developing a theory of family-centred care could position the concept in a theoretical context and should also......mikkelsen g. & frederiksen k. (2011) Family-centred care of children in hospital - a concept analysis. Journal of Advanced Nursing67(5), 1152-1162. ABSTRACT: Aim.  This paper reports a concept analysis of family-centred nursing care of hospitalized children. Background.  Family-centred care...

  6. Nonnatural deaths of children under the age of 5 years in Ontario, Canada: A retrospective autopsy analysis of 10 years (2006-2015

    Directory of Open Access Journals (Sweden)

    Syeda Sakina Rizvi

    2017-01-01

    Full Text Available The goal of this study is to unravel the common patterns observed among nonnatural deaths of children under 5 years and suggest ways to prevent such unnecessary deaths. The study was confined to the province of Ontario to allow the identification of regional specific patterns. The database at the Office of the Chief Coroner of Ontario was searched for all pediatric deaths from the years 2006-2015. All nonnatural deaths for children under the age of 5 years, including sudden infant death syndrome, were selected for the study. Manner and cause of death along with the corresponding year were recorded in tables. In the 10-year period, 940 nonnatural deaths were identified in Ontario through autopsy records which are equal to approximately 36.7% of the total childhood deaths. There were 295 accidental cases (11.6% and 71 homicides (2.8%. The leading causes of nonnatural childhood deaths in Ontario were drowning, traffic accidents, blunt trauma, and asphyxia. Nonnatural deaths are preventable through education and training of parents. Implementation of educational interventions can significantly reduce nonnatural deaths of children in Ontario.

  7. [Fever and petechial exanthema in children].

    Science.gov (United States)

    Soult Rubio, J A; Navarro González, J; Olano Claret, P

    1992-11-01

    In an attempt to determine clinical and analytical predictive parameters of a possible grave disease, we have carried out a retrospective study of 172 children admitted to our hospital with fever and petechiae as initial symptoms. The ages ranged between 1 month and 10 years. Even though we have not found a clinical symptom or analysis sufficiently sensitive as to predict all grave diseases, the general clinical state of the child associated with either a high or low white cell count and an abnormal coagulation study should be alert signals for a serious infectious disease. On the contrary, if the clinical and analytical parameters are within normal limits the risk of a grave disease is low. We emphasize the high incidence of meningococcal disease (26%).

  8. [Etiological analysis of 264 cases with chronic kidney disease stage 2 to 5 in children].

    Science.gov (United States)

    Miao, Qianfan; Shen, Qian; Xu, Hong; Sun, Li; Tang, Xiaoshan; Fang, Xiaoyan; Liu, Haimei; Zhai, Yihui; Bi, Yunli; Wang, Xiang; Chen, Hong

    2015-09-01

    To study and summarize the etiology of children patients with chronic kidney disease (CKD) stage 2 to 5 seen in Children's Hospital of Fudan University from Jan. 2004 to Dec. 2013. By complying with the NKF-K/DOQI guidelines, we collected data of 264 cases of children patients with CKD stage 2-5 from Jan. 2004 to Dec. 2013 in the medical record system of Children's Hospital of Fudan University. And we retrospectively analyzed their age and CKD stage at first diagnosis, primary diseases, complications, etc. In the collected 264 cases, 52 cases (19.7%) were diagnosed at stage 2, 67 (25.4%) at stage 3, 52 (19.7%) at stage 4 and 93 (35.2%) at stage 5. For disease causes, 116 cases (43.9%) had congenital anomalies of the kidney and urinary tract (CAKUT), 61 cases (23.1%) had glomerular disease, 15 (5.7%) had hereditary kidney disease, 14 (5.3%) had other diseases and in 58 cases (22.0%) the causes of disease were unknown. In the group with age between 0 and 3.0 and 3.1 and 6.0 years, 57.1% (24 cases) and 60.0% (30 cases) had primary disease with CAKUT. In the group with age older than 10 years, 49.2% (30 cases) had primary disease with glomerular disease and 32.0% (32 cases) with unknown causes. The major cause of CKD stage 2-5 in children in our hospital during the last ten years was CAKUT (43.9%), followed by glomerular disease (23.1%). The primary diseases of CKD were significantly different between the 2 age groups. CAKUT was more common in infants and preschool children while for adolescents, glomerular disease was the major cause.

  9. A RETROSPECTIVE ANALYSIS OF ARTHROSCOPIC ACL RECONSTRUCTION WITH HAMSTRING TENDON GRAFT

    Directory of Open Access Journals (Sweden)

    Ashish R. Agarwal

    2017-08-01

    Full Text Available BACKGROUND ACL reconstruction is one of the commonest knee surgeries done. Young adults are the commonest patients; thus, this injury has a large impact on socioeconomic status of the family. The aim of the study is to study the outcome of arthroscopic ACL reconstruction with hamstring tendon graft. MATERIALS AND METHODS 50 patients following up in the OPD who had undergone ACL reconstruction with hamstring tendon graft are evaluated. Patients who had other lesions, such meniscal injuries or collateral injuries were discarded. These patients were evaluated by using Tegner and Lysholm score of 6 months, 12 months and 24 months. Settings- It is a retrospective analysis of the data collected from the patients who were opiated at Nair Hospital. RESULTS 90% of patients in the study were males. Mean age of the study population is 30.7 years. All the patients in the study had instability as a symptom, while 80% of them also had pain. Six months after surgery, according to Tegner and Lysholm score, 52% patients had good outcome, while 48% had fair outcome. At 2 years, 98% of study population had excellent outcome. CONCLUSION Arthroscopic ACL reconstruction with hamstring graft is an effective way of treating ACL tear.

  10. Retrospective reports of parenting received in their families of origin: relationships to adult attachment in adult children of alcoholics.

    Science.gov (United States)

    Kelley, Michelle L; Nair, Veena; Rawlings, Tanaya; Cash, Thomas F; Steer, Kate; Fals-Stewart, William

    2005-09-01

    The present study examined general and romantic attachment and parenting students received in their families of origin among 401 college students who resided with an alcohol-abusing parent prior to age 16 years as compared to those who did not reside with alcohol-abusing parents. Participants completed the Children's Report of Parent Behavior Instrument [Schludermann, E. and Schludermann, S. (1970). Children's Report of Parent Behavior Inventory (CRPBI). Canada: University of Manitoba], Experiences in Close Relationships--Revised [Fraley, R. C., Waller, N. G., and Brennan, K. G. (2000). An item response theory analysis of self-report measures of adult attachment. Journal of Personality and Social Psychology, 78, 350-365], Relationship Scale Questionnaire [Griffin, D. W. and Bartholomew, K. (1994). Models of the self and other: Fundamental dimensions underlying measures of adult attachment. Journal of Personality and Social Psychology, 67, 430-445], and the Children of Alcoholics Screening Test [Jones, J. W. (1983). The Children of Alcoholics Screening Test: Test manual. Chicago: Camelot]. Young adults who met criteria for ACOAs reported more anxious and avoidant behavior in romantic relationships and a more fearful style of general adult attachment. Parenting behavior in one's family of origin predicted anxious behavior in romantic relationships and a fearful overall style of attachment, whereas being an ACOA and parenting in one's family of origin predicted avoidant behavior in romantic relationships.

  11. Can the Methotrexate Therapy Prevent the Development of Uveitis in Patients with Juvenile Idiopathic Arthritis: Results of a Retrospective Study

    OpenAIRE

    M. M. Kostik; E. V. Gaydar; M. F. Dubko; V. V. Masalova; L. S. Snegireva; I. A. Chikova; E. A. Isupova; T. N. Nikitina; E. D. Serogodskaya; O. V. Kalashnikova; A. Ravelli; V. G. Chasnyk

    2015-01-01

    Background: Uveitis is one of the most common extra-articular manifestations of juvenile idiopathic arthritis (JIA). Currently, the possibility of reducing the risk of uveitis in children with JIA by using methotrexate has been studied.Objective: Our aim was to analyze the results of treatment of children with JIA by studying the relation between the use of methotrexate and the risk of uveitis.Methods: A retrospective uncontrolled study. The case histories of patients with JIA who were treate...

  12. Nerve Decompression and Restless Legs Syndrome: A Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    James C. Anderson

    2017-07-01

    Full Text Available IntroductionRestless legs syndrome (RLS is a prevalent sleep disorder affecting quality of life and is often comorbid with other neurological diseases, including peripheral neuropathy. The mechanisms related to RLS symptoms remain unclear, and treatment options are often aimed at symptom relief rather than etiology. RLS may present in distinct phenotypes often described as “primary” vs. “secondary” RLS. Secondary RLS is often associated with peripheral neuropathy. Nerve decompression surgery of the common and superficial fibular nerves is used to treat peripheral neuropathy. Anecdotally, surgeons sometimes report improved RLS symptoms following nerve decompression for peripheral neuropathy. The purpose of this retrospective analysis was to quantify the change in symptoms commonly associated with RLS using visual analog scales (VAS.MethodsForty-two patients completed VAS scales (0–10 for pain, burning, numbness, tingling, weakness, balance, tightness, aching, pulling, cramping, twitchy/jumpy, uneasy, creepy/crawly, and throbbing, both before and 15 weeks after surgical decompression.ResultsSubjects reported significant improvement among all VAS categories, except for “pulling” (P = 0.14. The change in VAS following surgery was negatively correlated with the pre-surgery VAS for both the summed VAS (r = −0.58, P < 0.001 and the individual VAS scores (all P < 0.01, such that patients who reported the worst symptoms before surgery exhibited relatively greater reductions in symptoms after surgery.ConclusionThis is the first study to suggest improvement in RLS symptoms following surgical decompression of the common and superficial fibular nerves. Further investigation is needed to quantify improvement using RLS-specific metrics and sleep quality assessments.

  13. Children's experiences and responses towards an intervention for psychological preparation for radiotherapy.

    Science.gov (United States)

    Engvall, Gunn; Lindh, Viveca; Mullaney, Tara; Nyholm, Tufve; Lindh, Jack; Ångström-Brännström, Charlotte

    2018-01-22

    Children can experience distress when undergoing radiotherapy as a reaction to being scared of and unfamiliar with the procedure. The aim was to evaluate children's experiences and responses towards an intervention for psychological preparation for radiotherapy. A case control design with qualitative content analysis of semi-structured interviews and statistical analysis of anxiety ratings were used for evaluating a strategy for psychological preparation and distraction. Fifty-seven children aged 2 to 18 years and their parents participated - 30 children in the baseline group and 27 in the intervention group. Child interviews were performed and the child and their parents rated the child's anxiety. The intervention was most appropriate for the younger children, who enjoyed the digital story, the stuffed animal and training with their parents. There were some technical problems and the digital story was not detailed enough to fit exactly with various cancer diagnoses. Children described suggestions for improvement of the intervention. The ratings of the child's anxiety during radiation treatment showed no differences between the baseline group and the intervention group. The children of all the age groups experienced their interventions as positive. The strength of the intervention was that it encouraged interaction within the family and provided an opportunity for siblings and peers to take part in what the child was going through. Future research on children's experiences to interventions should be encouraged. The intervention and the technical solutions could improve by further development. The study design was structured as an un-matched case-control study, baseline group vs. intervention group. ClinicalTrials.gov NCT02993978 , Protocol Record 2012-113-31 M. Retrospectively registered - 21 November 2016.

  14. SU-F-T-135: A Retrospective Analysis of the Impact of Range Uncertainty in Brain Patients

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    Grantham, K; Santanam, L; Goddu, S; Sun, B; Zhang, T; Mutic, S; Robinson, C; Huang, J; Perkins, S; Tsien, C; Bradley, J; Zhao, T [Washington University School of Medicine, Saint Louis, MO (United States)

    2016-06-15

    Purpose: We retrospectively evaluate the dosimetric impact of a 3.5% range uncertainty on CTV coverage and normal organ toxicity for a cohort of brain patients. Methods: Twenty treatment plans involving 20 brain cancer patients treated with Mevions S250 were reviewed. Forty uncertain plans were made by changing the ranges in original plans by ±3.5% while keeping all devices unchanged. Fidelity to the original plans was evaluated with gamma index. Changes in generalized equivalent uniform dose (gEUD) were reported for the following structures: CTV coverage, brainstem, optic chiasm, and optic nerves. Comparisons were made by plotting the relevant endpoints from the uncertain plans as a function of the same endpoints from the original clinical plan. Results: Gamma-index analysis resulted in a 50% pass rate of the uncertain plans using a 90% passing rate and 3%/3mm criterion. A 9.5% decrease in the slope of gEUD plot for the CTV was observed for the 3.5% downward range shift. However, the change in slope did not result in a gEUD change greater than 1.1% for the CTV. The slopes of the gEUD plots for normal structures increased by 3.1% 3.9% 2.4% and 0.2% for the chiasm, brainstem, left optic nerve and right optic nerve respectively. The maximum deviation from the gEUD of the clinical plan for normal structures was: 64% in the chiasm, 31% for the brainstem, and 19% for both optic nerves. Conclusion: A retrospective review shows moderate radiobiological impact of range uncertainty in passively scattered proton therapy with sporadic catastrophe. The linear regression analysis on the statistical data indicates a systematic deviation of gEUD from treatment planning in the light of range uncertainty.

  15. Long-term follow-up of young children with brain tumors after irradiation

    International Nuclear Information System (INIS)

    Syndikus, I.; Tait, D.; Ashley, S.

    1994-01-01

    Young children with brain tumors are at high risk of developing late sequelae after curative radiotherapy. A retrospective study was undertaken to determine the frequency and severity of neurological deficits, endocrine dysfunction, and intellectual disabilities. One hundred and fifty-six children age ≥ 3 years were treated between 1952 and 1986 with radiotherapy. Of the 57 survivors, 47 had surgery, 12 chemotherapy and 24 children received cranio-spinal radiotherapy. Late radiation side effects were assessed with a clinical examination, blood tests and an interview. The median follow-up was 13 years and the actuarial survival at 5 and 10 years was 49% and 44%, respectively. No, or only a mild, handicap was noted in 24 patients, while 21 had moderately severe and 16 severe disabilities. Children with supratentorial tumors had more abnormal neurological findings compared to those with infratentorial malignancies (p<0.001). Eighty percent of children had endocrine abnormalities, which were more marked in children with parasellar tumors (p<0.001). Twenty-one children were mentally retarded. In a multivariate analysis epilepsy emerged as the only significant variable independently associated with poor cognitive function. Long-term morbidity was found to be disabling in 58% of the surviving children. These findings encourage the development of treatment strategies designed to reduce toxity. 34 refs., 3 figs., 5 tabs

  16. Asthma and Environmental Factors in Children

    Directory of Open Access Journals (Sweden)

    Mirzadeh M.

    2016-10-01

    Full Text Available Asthma is one of the most prevalent atopic diseases in childhood. It is characterized by inflammation of conductive airways and bronchial hyperresponsiveness. Environmental factors introduced to child in early years of life may have a protective or harmful role in developing atopic diseases. To evaluate the influence of some environmental factors such as cat or dog ownership, smoking of mother or father and environmental pollution on prevalence of wheezing in children. Subjects and methods: This was a cross sectional retrospective study. A questionnaire was designed based on International Study of Asthma and Allergies in Childhood (ISAAC. Parents of the subjects were asked to fill in the questionnaires. Children’s wheezing association with keeping cats and dogs, smoking mother and father and frequency of truck passing in place of residence was investigated. 545 children were recruited in our study. Prevalence of wheezing was 9%. Keeping cats in first year of life and last year was associated with less wheezing. But the latter association was not statistically significant. Keeping dogs was so scarce in area of our study, so we could not perform a rightful analysis. Frequency of truck passing was significantly higher in those with wheezing. Keeping cats in first year of life was a significant protective factor, whereas residence in an area with frequent truck passing increased wheezing in children. Results of our study can emphasize the need to keep children away from polluted areas. Further studies are needed to investigate whether keeping a pet in household can benefit children regarding all possible concerns and benefits.

  17. [Retrospective analysis of 24 recurrent glioblastoma after chemoradiation and treated with nitrosoureas or irinotecan and bevacizumab].

    Science.gov (United States)

    Vauleon, Elodie; Mesbah, Habiba; Gedouin, Daniel; Lecouillard, Isabelle; Louvel, Guillaume; Hamlat, Abderrahmane; Riffaud, Laurent; Carsin, Béatrice; Quillien, Véronique; Audrain, Odile; Lesimple, Thierry

    2012-02-01

    Despite progress in the initial management of glioblastoma (GB), the vast majority of patients will experience recurrence within 2-3 years. The medical treatment of these recurrences is being modified by the use of antiangiogenic therapies. Twenty-four patients, who relapsed from GB after chemoradiation followed by adjuvant temozolomide in Rennes, were treated by conventional chemotherapy (nitrosourea) or by the combination of irinotecan and bevacizumab. In this retrospective analysis, overall survival from diagnosis of recurrence was significantly longer in patients treated with the combination of bevacizumab and irinotecan than with nitrosourea (5 months versus 11.5 months). The combination of irinotecan and bevacizumab appeared to provide clinical benefit to patients with recurrent GB.

  18. Otitis Media and Related Complications among Children with Autism Spectrum Disorders

    Science.gov (United States)

    Adams, Daniel J.; Susi, Apryl; Erdie-Lalena, Christine R.; Gorman, Gregory; Hisle-Gorman, Elizabeth; Rajnik, Michael; Elrod, Marilisa; Nylund, Cade M.

    2016-01-01

    Acute otitis media (AOM) symptoms can be masked by communication deficits, common to children with autism spectrum disorders (ASD). We sought to evaluate the association between ASD and otitis media. Using ICD-9-CM diagnostic codes, we performed a retrospective case-cohort study comparing AOM, and otitis-related diagnoses among children with and…

  19. Shoulder injuries in professional rugby: a retrospective analysis.

    Science.gov (United States)

    Horsley, Ian G; Fowler, Elizabeth M; Rolf, Christer G

    2013-04-26

    In the literature, little is known about the level and pattern of rugby injuries. Of the shoulder injuries reported, 51% of these are caused during a tackle, and 65% of all match injuries affected the shoulder. The study aims to describe a sport-specific unique intra-articular shoulder pathology of professional rugby players, who presented with persistent pain and dysfunction despite physiotherapeutic treatment and rest. This study is a retrospective analysis set at a university sports medicine clinic. Eighty-seven professional rugby players, referred by their professional medical team since they could no longer play, underwent shoulder arthroscopy between June 2001 and October 2007 due to persistent shoulder pain and dysfunction. All were full-time professional male rugby union and rugby league players. They all had failed conservative treatment for their complaint, and the diagnosis was unclear. Arthroscopic findings were used as a measure of main outcome. The primary mechanism of injury was reported as direct tackling (56%; n = 49) followed in succession by falling onto the arm (10%; n = 8). However, in 30% of the cases, no definite injury could be recalled. The main operative finding was that most patients exhibited multiple shoulder pathologies, with 75% of cases presenting with two or more pathologies. A superior labrum anterior to posterior (SLAP) lesion was evident at arthroscopy in 72 of the 87 cases (83%), while rotator cuff tears were evident in 43% of cases (n = 37). One-third of all cases had a Bankart tear (n = 29), despite none of them reporting previous dislocations, while other labral tears, excluding SLAP tears, to the inferior or posterior labrum were present in 34% (n = 30) of the cohort. Repeated tackling, which is clearly rugby specific, is most likely to be responsible for most of these shoulder injuries, which upon arthroscopic examination, showed signs of mixed pathology. We suggest that an early arthroscopic investigation is valuable in

  20. Incorporating Colour Information for Computer-Aided Diagnosis of Melanoma from Dermoscopy Images: A Retrospective Survey and Critical Analysis

    Directory of Open Access Journals (Sweden)

    Ali Madooei

    2016-01-01

    Full Text Available Cutaneous melanoma is the most life-threatening form of skin cancer. Although advanced melanoma is often considered as incurable, if detected and excised early, the prognosis is promising. Today, clinicians use computer vision in an increasing number of applications to aid early detection of melanoma through dermatological image analysis (dermoscopy images, in particular. Colour assessment is essential for the clinical diagnosis of skin cancers. Due to this diagnostic importance, many studies have either focused on or employed colour features as a constituent part of their skin lesion analysis systems. These studies range from using low-level colour features, such as simple statistical measures of colours occurring in the lesion, to availing themselves of high-level semantic features such as the presence of blue-white veil, globules, or colour variegation in the lesion. This paper provides a retrospective survey and critical analysis of contributions in this research direction.

  1. [Idiopathic facial paralysis in children].

    Science.gov (United States)

    Achour, I; Chakroun, A; Ayedi, S; Ben Rhaiem, Z; Mnejja, M; Charfeddine, I; Hammami, B; Ghorbel, A

    2015-05-01

    Idiopathic facial palsy is the most common cause of facial nerve palsy in children. Controversy exists regarding treatment options. The objectives of this study were to review the epidemiological and clinical characteristics as well as the outcome of idiopathic facial palsy in children to suggest appropriate treatment. A retrospective study was conducted on children with a diagnosis of idiopathic facial palsy from 2007 to 2012. A total of 37 cases (13 males, 24 females) with a mean age of 13.9 years were included in this analysis. The mean duration between onset of Bell's palsy and consultation was 3 days. Of these patients, 78.3% had moderately severe (grade IV) or severe paralysis (grade V on the House and Brackmann grading). Twenty-seven patients were treated in an outpatient context, three patients were hospitalized, and seven patients were treated as outpatients and subsequently hospitalized. All patients received corticosteroids. Eight of them also received antiviral treatment. The complete recovery rate was 94.6% (35/37). The duration of complete recovery was 7.4 weeks. Children with idiopathic facial palsy have a very good prognosis. The complete recovery rate exceeds 90%. However, controversy exists regarding treatment options. High-quality studies have been conducted on adult populations. Medical treatment based on corticosteroids alone or combined with antiviral treatment is certainly effective in improving facial function outcomes in adults. In children, the recommendation for prescription of steroids and antiviral drugs based on adult treatment appears to be justified. Randomized controlled trials in the pediatric population are recommended to define a strategy for management of idiopathic facial paralysis. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  2. Kinetic therapy reduces complications and shortens hospital stay in patients with cardiogenic shock - a retrospective analysis.

    Science.gov (United States)

    Simonis, Gregor; Flemming, Kerstin; Ziegs, Enrico; Haacke, Katrin; Rauwolf, Thomas; Strasser, Ruth H

    2007-03-01

    Kinetic therapy (KT) has been shown to reduce complications and to shorten hospital stay in trauma patients. Data in non-surgical patients are inconclusive, and kinetic therapy has not been tested in patients with cardiogenic shock. The present analysis compares KT with standard care in patients with cardiogenic shock. A retrospective analysis of 133 patients with cardiogenic shock admitted to 1 academic heart center was performed. Patients with standard care (SC, turning every 2 h by the staff) were compared with kinetic therapy (KT, using oscillating air-flotation beds). 68 patients with KT were compared with 65 patients with SC. Length of ventilator therapy was 11 days in KT and 18 days in SC (p=0.048). The mortality was comparable in both groups. Pneumonia occurred in 14 patients in KT and 39 patients in SC (ppatients treated with kinetic therapy. The use of KT shortens hospital stay and reduces rates of pneumonia and pressure ulcers as compared to SC.

  3. Communicative abilities in toddlers and in early school age children with cleft palate

    NARCIS (Netherlands)

    Ruiter, Jolien S.; Korsten-Meijer, Astrid G. W.; Goorhuis-Brouwer, Siena M.

    Objectives: Evaluation of improvement in communicative abilities in children with nonsyndromic cleft palate. Methods: Longitudinal retrospective case history Study. Out of 117 children with cleft lip and/or cleft palate born in 1998, 1999 and 2000 and enrolled in the cleft palate team of the

  4. Semiotic Approach to the Analysis of Children's Drawings

    Science.gov (United States)

    Turkcan, Burcin

    2013-01-01

    Semiotics, which is used for the analysis of a number of communication languages, helps describe the specific operational rules by determining the sub-systems included in the field it examines. Considering that art is a communication language, this approach could be used in analyzing children's products in art education. The present study aiming…

  5. Muscle synergy analysis in children with cerebral palsy

    Science.gov (United States)

    Tang, Lu; Li, Fei; Cao, Shuai; Zhang, Xu; Wu, De; Chen, Xiang

    2015-08-01

    Objective. To explore the mechanism of lower extremity dysfunction of cerebral palsy (CP) children through muscle synergy analysis. Approach. Twelve CP children were involved in this study, ten adults (AD) and eight typically developed (TD) children were recruited as a control group. Surface electromyographic (sEMG) signals were collected bilaterally from eight lower limb muscles of the subjects during forward walking at a comfortable speed. A nonnegative matrix factorization algorithm was used to extract muscle synergies. In view of muscle synergy differences in number, structure and symmetry, a model named synergy comprehensive assessment (SCA) was proposed to quantify the abnormality of muscle synergies. Main results. There existed larger variations between the muscle synergies of the CP group and the AD group in contrast with the TD group. Fewer mature synergies were recruited in the CP group, and many abnormal synergies specific to the CP group appeared. Specifically, CP children were found to recruit muscle synergies with a larger difference in structure and symmetry between two legs of one subject and different subjects. The proposed SCA scale demonstrated its great potential to quantitatively assess the lower-limb motor dysfunction of CP children. SCA scores of the CP group (57.00 ± 16.78) were found to be significantly less (p < 0.01) than that of the control group (AD group: 95.74 ± 2.04; TD group: 84.19 ± 11.76). Significance. The innovative quantitative results of this study can help us to better understand muscle synergy abnormality in CP children, which is related to their motor dysfunction and even the physiological change in their nervous system.

  6. Attributes of advanced practice registered nurse care coordination for children with medical complexity.

    Science.gov (United States)

    Cady, Rhonda G; Kelly, Anne M; Finkelstein, Stanley M; Looman, Wendy S; Garwick, Ann W

    2014-01-01

    Care coordination is an essential component of the pediatric health care home. This study investigated the attributes of relationship-based advanced practice registered nurse care coordination for children with medical complexity enrolled in a tertiary hospital-based health care home. Retrospective review of 2,628 care coordination episodes conducted by telehealth over a consecutive 3-year time period for 27 children indicated that parents initiated the majority of episodes and the most frequent reason was acute and chronic condition management. During this period, care coordination episodes tripled, with a significant increase (p < .001) between years 1 and 2. The increased episodes could explain previously reported reductions in hospitalizations for this group of children. Descriptive analysis of a program-specific survey showed that parents valued having a single place to call and assistance in managing their child's complex needs. The advanced practice registered nurse care coordination model has potential for changing the health management processes for children with medical complexity. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

  7. [Dysphonia in children: Retrospective and comparative study between the late 1980s and today].

    Science.gov (United States)

    Ruiz, Y; Orive, D; Coulombeau, B; Perouse, R

    Child dysphonia is a frequent pathological situation which concerns 6 to 38 percent of a school attending population. Thus it demands a specific and adapted treatment. Because of its direct consequences on social, family and school lives, parents often seek advice from a speech specialist. This study focuses on the specificities of those individuals having diagnosed child dysphonia, as well as the treatment which can be given to them. Our work covers a period of twenty years of comparative studies. We have read through dr Coulombeau's files, from 2005 to 2011, and we have made up a series of questions addressed to the speech therapists having speech impaired children in their practice. We have cross-examined these data with those of Dr Cornut's, covering a period of seven years (1985-1991). The qualitative and quantitative studies which have been carried out enabled us to highlight the fact there has been a constant background of child dysphonia and an evolution in the offered treatments. Indeed, we have realised that the number of individuals having diagnosed child dysphonia are less and less operated on. In the same time people tend to ignore the offered treatments. Though the follow-ups to a prior visit at a speech therapist have decreased for twenty years, it still remains the most common treatment. Our analysis does not focus on the effects of the given treatments on a long term basis. It thus appears that a study consisting in analysing the development of these children through adulthood would be greatly accurate.

  8. Retrospective Analysis of T and B Cells Flow-Cross Matches in Renal Transplant Recipients

    Directory of Open Access Journals (Sweden)

    Lakshmi Kiran C

    2008-01-01

    Full Text Available Complement-mediated cytotoxic antibodies in conventional cross match, often result in misappropriation of true positives and borderline positives which are detrimental to allograft survival. Flow cross matches (FCXM are sensitive to capture even non comple-ment fixing cytotoxic antibodies. This retrospective study evaluates the utility of FCXM in effectively predicting acute allograft rejection. A total of 17 cases were processed for FCXM (T and B cell of whom seven had no rejection episodes, while the remaining 11 had acute rejection despite negative cross match and panel reacting antibodies being ne-gative (less than 20%. The sensitivity and specificity of the FCXM outcome demons-trated that positive B-cell FCXM has potential to be a good tool in pre-transplant scree-ning. The current analysis proposes the possible utility of B-cell positive FCXM as a more sensitive parameter in predicting acute allograft rejection prior to transplantation.

  9. Shifting the Focus: Children's Image-Making Practices and Their Implications for Analysis

    Science.gov (United States)

    Lomax, Helen Jayne

    2012-01-01

    This paper provides analytic focus on the productive and editorial contexts of children and young people's image-making, making visible its implications for the analysis of photographs. Drawing on participatory research in which children and young people worked alongside researchers to create a visual narrative of their lived experiences of…

  10. Factors associated with growth disturbance at celiac disease diagnosis in children: a retrospective cohort study.

    Science.gov (United States)

    Nurminen, Samuli; Kivelä, Laura; Taavela, Juha; Huhtala, Heini; Mäki, Markku; Kaukinen, Katri; Kurppa, Kalle

    2015-10-06

    Impaired growth is a well-known complication in celiac disease, but factors associated with it are poorly known. We investigated this issue in a large cohort of children. 530 children with biopsy-proven celiac disease were included. The participants were divided into two groups on the basis of the presence (n = 182) or absence (n = 348) of growth disturbance at diagnosis. Histological, serological and clinical characteristics were compared between children with growth failure and those with normal growth. Further, patients with growth failure as the sole clinical presentation were compared to those with poor growth and concomitant other symptoms. Children with growth failure were younger (p celiac antibody (p symptoms (OR 3.4 (1.8-6.7) vs mild symptoms) and vomiting (OR 3.1 (1.5-6.3). The presence of abdominal pain reduced the risk (OR 0.5 (0.3-0.7)), while there was no effect of gender, diarrhea, constipation, other chronic diseases and celiac disease in the family. Children evincing poor growth as the sole clinical presentation were older (p symptoms. In particular young age and severe clinical and histological presentation were associated with growth disturbance at celiac disease diagnosis. Children with only poor growth are markedly different from those with other concomitant symptoms, suggesting different pathogenic mechanisms.

  11. Long-Term Changes of Subcutaneous Fat Mass in HIV-Infected Children on Antiretroviral Therapy: A Retrospective Analysis of Longitudinal Data from Two Pediatric HIV-Cohorts

    NARCIS (Netherlands)

    Cohen, Sophie; Innes, Steve; Geelen, Sibyl P. M.; Wells, Jonathan C. K.; Smit, Colette; Wolfs, Tom F. W.; van Eck-Smit, Berthe L. F.; Kuijpers, Taco W.; Reiss, Peter; Scherpbier, Henriette J.; Pajkrt, Dasja; Bunders, Madeleine J.

    2015-01-01

    Longitudinal studies objectively evaluating changes in regional fat distribution of HIV-infected children assessed by whole body dual energy X-ray absorptiometry (DEXA) are scarce, whilst this long-term effect of HIV and antiretroviral therapy (cART) is an important issue in infected children in

  12. [Medical negligence in surgery: 112 cases retrospective analysis].

    Science.gov (United States)

    Xiang, Jian; Chang, Lin; Wang, Xu; Zhang, Feng-Qin

    2013-06-01

    To explore the general characteristics of medical negligence in surgery in order to provide the reference for forensic practices. One hundred and twelve cases of medical negligence in surgical department were retrospectively analyzed in Fada Institute of Forensic Medicine and Science from 2008 to 2010. The common types of medical negligence cases in the surgery were improper operation procedure (28.57%), failure of consent (26.79%), and inadequate monitoring (22.32%). The results of complications included disability or functional impairment (61.61%), death (31.25%) and transient impairment with no obvious adverse reactions (7.14%). The most common roles played by the medical negligence cases were minor role (26.79%), equal role (19.64%), and slight role (14.29%). Significant attention should be paid to the operation procedure, consent, and monitoring. It should be cautious to not make assessment on involvement degree of medical negligence.

  13. Asthma Controller Medications for Children in Japan

    Directory of Open Access Journals (Sweden)

    Shota Hamada DrPH

    2015-04-01

    Full Text Available Background. Treatment and management strategies for asthma in children are generally consistent internationally, but prescription of antiasthma drugs differs among countries. The objective of this study was to examine the prescribing patterns of antiasthma drugs, particularly controller medications, in children. Methods. A retrospective cohort study was performed in children with asthma using an administrative claims database in Japan. Results. A total of 1149 preschool-age and 3226 school-age children were identified. Leukotriene receptor antagonists were prescribed for about 80% of the children. Long-acting β-agonists were prescribed for 87.6% and 59.6% of preschool-age and school-age children, respectively, whereas prescriptions of inhaled corticosteroids had lower rates of 8.2% and 16.5%, respectively. In an examination of prescriptions at 1-month intervals, a relatively high number of children were prescribed bronchodilators without anti-inflammatory agents. Conclusion. Our findings suggest that asthma care for children in Japan can be improved through changes in drug prescriptions.

  14. UNCERTAINTY ON RADIATION DOSES ESTIMATED BY BIOLOGICAL AND RETROSPECTIVE PHYSICAL METHODS.

    Science.gov (United States)

    Ainsbury, Elizabeth A; Samaga, Daniel; Della Monaca, Sara; Marrale, Maurizio; Bassinet, Celine; Burbidge, Christopher I; Correcher, Virgilio; Discher, Michael; Eakins, Jon; Fattibene, Paola; Güçlü, Inci; Higueras, Manuel; Lund, Eva; Maltar-Strmecki, Nadica; McKeever, Stephen; Rääf, Christopher L; Sholom, Sergey; Veronese, Ivan; Wieser, Albrecht; Woda, Clemens; Trompier, Francois

    2018-03-01

    Biological and physical retrospective dosimetry are recognised as key techniques to provide individual estimates of dose following unplanned exposures to ionising radiation. Whilst there has been a relatively large amount of recent development in the biological and physical procedures, development of statistical analysis techniques has failed to keep pace. The aim of this paper is to review the current state of the art in uncertainty analysis techniques across the 'EURADOS Working Group 10-Retrospective dosimetry' members, to give concrete examples of implementation of the techniques recommended in the international standards, and to further promote the use of Monte Carlo techniques to support characterisation of uncertainties. It is concluded that sufficient techniques are available and in use by most laboratories for acute, whole body exposures to highly penetrating radiation, but further work will be required to ensure that statistical analysis is always wholly sufficient for the more complex exposure scenarios.

  15. Retrospective analysis of bottlenose dolphin foraging: a legacy of anthropogenic ecosystem disturbance

    Science.gov (United States)

    Rossman, Sam; Barros, Nélio B.; Ostrom, Peggy H.; Stricker, Craig A.; Hohn, Aleta A.; Gandhi, Hasand; Wells, Randall S.

    2013-01-01

    We used stable isotope analysis to investigate the foraging ecology of coastal bottlenose dolphins (Tursiops truncatus) in relation to a series of anthropogenic disturbances. We first demonstrated that stable isotopes are a faithful indicator of habitat use by comparing muscle isotope values to behavioral foraging data from the same individuals. δ13C values increased, while δ34S and δ15N values decreased with the percentage of feeding observations in seagrass habitat. We then utilized stable isotope values of muscle to assess temporal variation in foraging habitat from 1991 to 2010 and collagen from tooth crown tips to assess the time period 1944 to 2007. From 1991 to 2010, δ13C values of muscle decreased while δ34S values increased indicating reduced utilization of seagrass habitat. From 1944 to 1989 δ13C values of the crown tip declined significantly, likely due to a reduction in the coverage of seagrass habitat and δ15N values significantly increased, a trend we attribute to nutrient loading from a rapidly increasing human population. Our results demonstrate the utility of using marine mammal foraging habits to retrospectively assess the extent to which anthropogenic disturbance impacts coastal food webs.

  16. Children treated for lawn mower-related injuries in US emergency departments, 1990-2014.

    Science.gov (United States)

    Ren, Karen S; Chounthirath, Thiphalak; Yang, Jingzhen; Friedenberg, Laura; Smith, Gary A

    2017-06-01

    Investigate the epidemiology of lawn mower-related injuries to children in the US. A retrospective analysis was conducted of children younger than 18years of age treated in US emergency departments for a lawn mower-related injury from 1990 through 2014 using data from the National Electronic Injury Surveillance System. An estimated 212,258 children lawn mower-related injuries from 1990 through 2014, equaling an average annual rate of 11.9 injuries per 100,000 US children. The annual injury rate decreased by 59.9% during the 25-year study period. The leading diagnosis was a laceration (38.5%) and the most common body region injured was the hand/finger (30.7%). Struck by (21.2%), cut by (19.9%), and contact with a hot surface (14.1%) were the leading mechanisms of injury. Patients Lawn mower-related injuries continue to be a cause of serious morbidity among children. Although the annual injury rate decreased significantly over the study period, the number of injuries is still substantial, indicating the need for additional prevention efforts. In addition to educational approaches, opportunities exist for improvements in mower design and lawn mower safety standards. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. The utility of anaerobic blood culture in detecting facultative anaerobic bacteremia in children.

    Science.gov (United States)

    Shoji, Kensuke; Komuro, Hisako; Watanabe, Yasushi; Miyairi, Isao

    2013-08-01

    Routine anaerobic blood culture is not recommended in children because obligate anaerobic bacteremia is rare in the pediatric population. However, a number of facultative anaerobic bacteria can cause community and hospital acquired infections in children and the utility of anaerobic blood culture for detection of these organisms is still unclear. We conducted a retrospective analysis of all blood culture samples (n = 24,356) at a children's hospital in Japan from October 2009 to June 2012. Among the samples that had paired aerobic and anaerobic blood cultures, 717 samples were considered clinically significant with 418 (58%) organisms detected from both aerobic and anaerobic cultures, 167 (23%) detected only from aerobic culture and 132 (18%) detected only from anaerobic culture. While most facultative anaerobes were detectable by aerobic culture, over 25% of Enterobacteriaceae and 15% of Staphylococcus sp. were detected from anaerobic cultures bottles only, suggesting its potential role in selected settings. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Fungal peritonitis in children on peritoneal dialysis.

    NARCIS (Netherlands)

    Raaijmakers, R.; Schroder, C.; Monnens, L.A.H.; Cornelissen, E.A.M.; Warris, A.

    2007-01-01

    Fungal peritonitis is a rare but serious complication in children on peritoneal dialysis (PD). In this study, risk factors were evaluated, and therapeutic measures were reviewed. A retrospective, multi-centre study was performed in 159 Dutch paediatric PD patients, between 1980 and 2005 (3,573

  19. Effects of a structured 20-session slow-cortical-potential-based neurofeedback program on attentional performance in children and adolescents with attention-deficit hyperactivity disorder: retrospective analysis of an open-label pilot-approach and 6-month follow-up

    Directory of Open Access Journals (Sweden)

    Albrecht JS

    2017-03-01

    (inattention subscales of the so-called Fremdbeurteilungsbogen für Hyperkinetische Störungen and Child Behavior Checklist/4–18 [CBCL/4–18]. All data were analyzed retrospectively. Results: The mean auditive reaction time in a Divided Attention task decreased significantly from T0 to T1 (medium effect, which was persistent over time and also found for a T0–T2 comparison (larger effects. In the Sustained Attention Dots task, the mean reaction time was reduced from T0–T1 and T1–T2 (small effects, whereas in the Shifting Attentional Set task, patients were able to increase the number of trials from T1–T2 and significantly diminished the number of errors (T1–T2 & T0–T2, large effects. Conclusion: First positive but very small effects and preliminary results regarding different parameters of attentional performance were detected in young individuals with ADHD. The limitations of the obtained preliminary data are the rather small sample size, the lack of a control group/a placebo condition and the open-label approach because of the clinical setting and retrospective analysis. The value of the current approach lies in providing pilot data for future studies involving larger samples. Keywords: SCP, neurofeedback, ADHD, children, adolescents, attention

  20. Uroradiographic manifestations of Burkitt's lymphoma in children

    International Nuclear Information System (INIS)

    Fernbach, S.K.; Glass, R.B.

    1986-01-01

    The radiological studies of 18 children with biopsy proved Burkitt's lymphoma were analyzed retrospectively. Before therapy the genitourinary tract was evaluated in 15 children by excretory urography, sonography, computerized tomography and/or gallium citrate scintigraphy. Genitourinary abnormalities were detected in 9 children. Changes due to tumor included renal or ureteral displacement in 4 children, hydronephrosis in 3 and intraparenchymal masses in 4. Extrinsic compression of the bladder causing no compromise of function was seen in only 2 children. Gonadal involvement occurred in 2 boys and 1 girl. The modality of choice for evaluating the genitourinary tract in patients with Burkitt's lymphoma has been excretory urography. Since ultrasound and computerized tomography provide more direct information about tumor deposits within the kidney and retroperitoneum, either should be performed in this population before initiation of chemotherapy

  1. Health needs of regional Australian children in out-of-home care.

    Science.gov (United States)

    Arora, Nitin; Kaltner, Melissa; Williams, Judy

    2014-10-01

    This study aims to identify the health needs of children placed in out-of-home care in regional Queensland and to compare them with the needs of similar children in metropolitan Queensland. Retrospective chart review and subsequent analysis of data from the first assessments of the children placed in care from January 2005 to April 2011. Health needs based on assessment recommendations were then compared with needs and recommendations from a similar clinic in metropolitan Brisbane. Two hundred thirty-nine first assessments were reviewed. The average number of health referrals arising out of each assessment was 2. 72% children were between 2 and 12 years of age and accounted for 76% of the health referrals made. The 10-13% of the children needed referrals for medical and surgical specialties, audiology, speech pathology, dental, and ophthalmology/optometry, each. A percentage of 30 needed ongoing paediatric care. The 15% needed immunisation catch up, 35% counselling and behaviour management, and 15% formal mental health referrals. These were comparable to the health needs identified in out-of-home care children residing in metropolitan Queensland. Children in care who live in a regional setting have similar health-care needs compared with urban children. Given restricted health services in regional settings, there is difficulty in accessing services to meet these needs. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  2. Prevalence and outcomes of heart transplantation in children with intellectual disability.

    Science.gov (United States)

    Wightman, Aaron; Bartlett, Heather L; Zhao, Qianqian; Smith, Jodi M

    2017-03-01

    Heart transplantation in children with intellectual disability is a controversial issue. We sought to describe the prevalence and outcomes of heart transplantation in children with intellectual disability and hypothesized that recipients with intellectual disability have comparable short-term outcomes compared to recipients without intellectual disability. We performed a retrospective cohort analysis of children receiving a first heart-alone transplant in the UNOS STAR database from 2008 to 2013. Recipients with intellectual disability were compared to those without using chi-square tests. Kaplan-Meier curves were constructed for patient and graft survival. Cox proportional hazard models were used to estimate the association between intellectual disability and graft failure and patient survival. Over the study period, 107 children with intellectual disability underwent initial heart transplantation, accounting for 8.9% of first pediatric heart transplants (total=1204). There was no difference in the incidence of acute rejection between groups in the first year after transplant. Mean functional status scores at follow-up improved in both groups after transplantation, but tended to be lower among children with intellectual disability than children without. Log-rank tests did not suggest significant differences in graft survival between those with and without intellectual disability during the first 4 years following transplantation. Children with intellectual disability constitute a significant portion of total heart transplants with short-term outcomes comparable to children without intellectual disability. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. THE ORGANIZATION OF REABILITATION DEPARTMENTS FOR CHILDREN — CONVALESCENT INFECTIOUS DISEASES

    Directory of Open Access Journals (Sweden)

    E. V. Pronina

    2014-01-01

    Full Text Available Recently the actual direction is development of programs of rehabilitation of the second stage of recovering of infectious diseases children. The purpose of this work is justification of need of the organization of offices of rehabilitation in a children's infectious hospital according to Order of the organization of medical rehabilitation. The retrospective analysis of clinical records of the patients who have arrived on treatment in clinical divisions of Federal State Budgetary Institution of Research of Children's Infections of Russia in 2011—2012 is carried out. It is established, that among surveyed 14 363 for 2 years of patients (in a year on the average more than 7000 children — about 40% (2800 patients a year children for whom rehabilitation actions of the second stage in the conditions of a hospital, including carrying out a diet therapy, physiotherapy exercises, physical therapy and pharmacotherapy are necessary. On a profile of infectious patients for rendering the rehabilitation help it is expedient to organize 2 offices on 30 beds: for treatment of children with consequences of neuroinfections and children with somatic pathology. The organization of two offices for carrying out medical rehabilitation of the second stage to recovering infectious diseases children taking into account recommended standards on equipment, according to the Order of the organization of medical rehabilitation, will allow to give high-tech help to patients and to prevent development of complications.

  4. Effective Interventions in Overweight or Obese Young Children: Systematic Review and Meta-Analysis

    NARCIS (Netherlands)

    Hoek, van E.; Feskens, E.J.M.; Bouwman, L.I.; Janse, A.J.

    2014-01-01

    Abstract Background: Treatment programs for overweight and obese young children are of variable effectiveness, and the characteristics of effective programs are unknown. In this systematic review with meta-analysis, the effectiveness of treatment programs for these children is summarized. Methods:

  5. Effects of a Gluten-Free Diet on Rate of Learning in Autistic Children in an Applied Behavioral Analysis Program: Summary Analysis.

    Science.gov (United States)

    Pontino, Jamie Lyn; Schaal, Kelly; Chambliss, Catherine

    This summary analysis discusses a series of studies that used both between-subjects and within-subjects analyses to examine the effects of a gluten-free diet on the academic achievement of children with autism. In the first study, the between-subjects analysis included data from eight children with autism (ages 5-7), with four on a gluten-free…

  6. A retrospective outcomes study examining the effect of interactive metronome on hand function.

    Science.gov (United States)

    Shank, Tracy M; Harron, Wendy

    2015-01-01

    Interactive Metronome (IM, The Interactive Metronome Company, Sunrise, Florida, USA) is a computer-based modality marketed to rehabilitation professionals who want to improve outcomes in areas of coordination, motor skills, self-regulation behaviors, and cognitive skills. This retrospective study examined the efficacy of IM training on improving timing skills, hand function, and parental report of self-regulatory behaviors. Forty eight children with mixed motor and cognitive diagnoses completed an average of 14 one-hour training sessions over an average of 8.5 weeks in an outpatient setting. Each child was assessed before and after training with the Interactive Metronome Long Form Assessment, the Jebsen Taylor Test of Hand Function, and a parent questionnaire. All three measures improved with statistical significance despite participants having no direct skill training. These results suggest an intimate relationship between cognition and motor skills that has potential therapeutic value. Level 4, Retrospective Case Series. Copyright © 2015 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  7. Meta-analysis of fluid intelligence tests of children from the Chinese mainland with learning difficulties.

    Science.gov (United States)

    Tong, Fang; Fu, Tong

    2013-01-01

    To evaluate the differences in fluid intelligence tests between normal children and children with learning difficulties in China. PubMed, MD Consult, and other Chinese Journal Database were searched from their establishment to November 2012. After finding comparative studies of Raven measurements of normal children and children with learning difficulties, full Intelligent Quotation (FIQ) values and the original values of the sub-measurement were extracted. The corresponding effect model was selected based on the results of heterogeneity and parallel sub-group analysis was performed. Twelve documents were included in the meta-analysis, and the studies were all performed in mainland of China. Among these, two studies were performed at child health clinics, the other ten sites were schools and control children were schoolmates or classmates. FIQ was evaluated using a random effects model. WMD was -13.18 (95% CI: -16.50- -9.85). Children with learning difficulties showed significantly lower FIQ scores than controls (Pintelligence of children with learning difficulties was lower than that of normal children. Delayed development in sub-items of C, D, and E was more obvious.

  8. Number of Black Children in Extreme Poverty Hits Record High. Analysis Background.

    Science.gov (United States)

    Children's Defense Fund, Washington, DC.

    To examine the experiences of black children and poverty, researchers conducted a computer analysis of data from the U.S. Census Bureau's Current Population Survey, the source of official government poverty statistics. The data are through 2001. Results indicated that nearly 1 million black children were living in extreme poverty, with after-tax…

  9. Pleural space infections after image-guided percutaneous drainage of infected intraabdominal fluid collections: a retrospective single institution analysis.

    Science.gov (United States)

    Avella, Diego M; Toth, Jennifer W; Reed, Michael F; Gusani, Niraj J; Kimchi, Eric T; Mahraj, Rickeshvar P; Staveley-O'Carroll, Kevin F; Kaifi, Jussuf T

    2015-04-11

    Percutaneous drainage of infected intraabdominal fluid collections is preferred over surgical drainage due to lower morbidity and costs. However, it can be a challenging procedure and catheter insertion carries the potential to contaminate the pleural space from the abdomen. This retrospective analysis demonstrates the clinical and radiographic correlation between percutaneous drainage of infected intraabdominal collections and the development of iatrogenic pleural space infections. A retrospective single institution analysis of 550 consecutive percutaneous drainage procedures for intraabdominal fluid collections was performed over 24 months. Patient charts and imaging were reviewed with regard to pleural space infections that were attributed to percutaneous drain placements. Institutional review board approval was obtained for conduct of the study. 6/550 (1.1%) patients developed iatrogenic pleural space infections after percutaneous drainage of intraabdominal fluid collections. All 6 patients presented with respiratory symptoms and required pleural space drainage (either by needle aspiration or chest tube placement), 2 received intrapleural fibrinolytic therapy and 1 patient had to undergo surgical drainage. Pleural effusion cultures revealed same bacteria in both intraabdominal and pleural fluid in 3 (50%) cases. A video with a dynamic radiographic sequence demonstrating the contamination of the pleural space from percutaneous drainage of an infected intraabdominal collection is included. Iatrogenic pleural space infections after percutaneous drainage of intraabdominal fluid collections occur at a low incidence, but the pleural empyema can be progressive requiring prompt chest tube drainage, intrapleural fibrinolytic therapy or even surgery. Expertise in intraabdominal drain placements, awareness and early recognition of this complication is critical to minimize incidence, morbidity and mortality in these patients.

  10. Appropriateness of clinical severity classification of new WHO childhood pneumonia guidance: a multi-hospital, retrospective, cohort study.

    Science.gov (United States)

    Agweyu, Ambrose; Lilford, Richard J; English, Mike

    2018-01-01

    Management of pneumonia in many low-income and middle-income countries is based on WHO guidelines that classify children according to clinical signs that define thresholds of risk. We aimed to establish whether some children categorised as eligible for outpatient treatment might have a risk of death warranting their treatment in hospital. We did a retrospective cohort study of children aged 2-59 months admitted to one of 14 hospitals in Kenya with pneumonia between March 1, 2014, and Feb 29, 2016, before revised WHO pneumonia guidelines were adopted in the country. We modelled associations with inpatient mortality using logistic regression and calculated absolute risks of mortality for presenting clinical features among children who would, as part of revised WHO pneumonia guidelines, be eligible for outpatient treatment (non-severe pneumonia). We assessed 16 162 children who were admitted to hospital in this period. 832 (5%) of 16 031 children died. Among groups defined according to new WHO guidelines, 321 (3%) of 11 788 patients with non-severe pneumonia died compared with 488 (14%) of 3434 patients with severe pneumonia. Three characteristics were strongly associated with death of children retrospectively classified as having non-severe pneumonia: severe pallor (adjusted risk ratio 5·9, 95% CI 5·1-6·8), mild to moderate pallor (3·4, 3·0-3·8), and weight-for-age Z score (WAZ) less than -3 SD (3·8, 3·4-4·3). Additional factors that were independently associated with death were: WAZ less than -2 to -3 SD, age younger than 12 months, lower chest wall indrawing, respiratory rate of 70 breaths per min or more, female sex, admission to hospital in a malaria endemic region, moderate dehydration, and an axillary temperature of 39°C or more. In settings of high mortality, WAZ less than -3 SD or any degree of pallor among children with non-severe pneumonia was associated with a clinically important risk of death. Our data suggest that admission to hospital

  11. Infantile Hypertrophic pyloric stenosis: A retrospective study from a ...

    African Journals Online (AJOL)

    Methods: In this retrospective analysis, medical records of patients admitted to TAH, Addis Ababa, Ethiopia, with a diagnosis of IHPS in the years 2011 and 2012 were revised; information on age, sex, birth order, clinical presentation, treatment and outcomes of treatment were collected and analyzed. Results: Sixty one ...

  12. Planning for Retrospective Conversion: A Simulation of the OCLC TAPECON Service.

    Science.gov (United States)

    Hanson, Heidi; Pronevitz, Gregory

    1989-01-01

    Describes a simulation of OCLC's TAPECON retrospective conversion service and its impact on an online catalog in a large university research library. The analysis includes results of Library of Congress Card Numbers, author/title, and title searches, and hit rates based on an analysis of OCLC and locally generated reports. (three references)…

  13. Radiologic signs of detrusor instability in children

    International Nuclear Information System (INIS)

    Hidalgo Teran, D.G.; Podesta, M.; Mendel, R.

    2004-01-01

    Purpose: To revalue radiologic signs of detrusor instability in children. Material and Methods: Retrospective analysis of videourodynamic studies performed in 85 children consulting for urinary incontinence and/or infection. Patients were free from neuropathic diseases, alterations of the urinary tract, previous surgery or anticholinergic treatment. Images of the bladder coinciding to the peaks of unstable detrusor contractions in patients with unstable bladders, and those at the end of filling in stable bladders were analyzed. Results: Bladder outlets were open in 38 patients and close in 47. Detrusor instability was found in 97 % of those with an open bladder outlet and in 36 % when close. Bladder outlets were open in all cases with contractions stronger than 60 cm.water. All 'spinning-top' urethras were associated to contractions stronger than 70 cm.water. Most false negatives (close bladder outlet in unstable bladders) corresponded to contractions lower than 30 cm.water. Different shapes of the bladder were found irrespective of detrusor instability. Conclusions: 1) An open bladder outlet observed during bladder filling is a reliable sign of significant detrusor instability in children without neuropathy; 2) It is highly specific of instability; 3) Most false negatives coincide with low amplitude contractions; 4) 'Spinning-top' images indicate strong contractions. (author)

  14. Duplex investigations in children: Are clinical signs in children with venous disorders relevant?

    Science.gov (United States)

    Birgitte Maessen-Visch, M; Smeets, L; van Vleuten, C

    2015-12-01

    Ultra sound colored duplex sonography is the preferred method in diagnosing chronic venous disease. Data in children on incidence, indications, and results are lacking. From the total of 9180 duplex investigations performed in our hospital from 2009 to 2012, data on indication and results of the investigation as well as patient characteristics were evaluated retrospectively for the proportion of pediatric patients. Duplex investigations were performed 49 times in 38 children (6-18 years), with an average of 1.3 times (1-6 times) per child. Forty percent showed abnormalities: 17 times deep venous thrombosis was suspected; deep venous thrombosis was objectified in 18%. In the 21 investigations performed for varicosis-related complaints, varicose veins or venous malformations were objectified in 57%. Edema was never a symptom of chronic venous disease. Duplex investigation is not often performed in children. In children with established deep venous thrombosis, a family history with deep venous thrombosis is common. In general, edema was not seen in children with varicose veins and, therefore, does not seem a reliable clinical sign at young age. © The Author(s) 2014.

  15. Invasive pulmonary aspergillosis in immune-compromised children

    International Nuclear Information System (INIS)

    Kramer, S.S.; Jakaki, R.I.

    1991-01-01

    Invasive pulmonary aspergillosis (IPA) is a potentially lethal complication of prolonged neutropenia occurring most commonly in patients with leukemia or aplastic anemia. Early diagnosis is important for prompt therapy but may prove difficult. This paper assesses the role of CT in the early diagnosis and follow-up of IPA in children. Nine proved cases and 2 cases clinically consistent with IPA were the group for both retrospective and prospective analysis. Medical records, chest radiographs, and CT scans were reviewed. Eight children had acute leukemia, and 3 had aplastic anemia. five patients died; 2 underwent lobectomy. Typical CT findings included multiple found parenchymal nodules, larger confluent masslike infiltrates, and peripheral pleural-based nodules/infiltrates resembling infarcts. No adenopathy or pleural effusions occurred. Some lesions later cavitated or developed an air crescent. CT clearly depicted several unusual complications, including involvement of bronchus (resulting in luminal narrowing, unilateral pulmonary overinflation, and air leak) and mycotic thrombosis or aneurysim of the pulmonary artery. Resolution of lesions with therapy was also documented by CT

  16. Image, measure, figure: a critical discourse analysis of nursing practices that develop children.

    Science.gov (United States)

    Einboden, Rochelle; Rudge, Trudy; Varcoe, Colleen

    2013-07-01

    Motivated by discourses that link early child development and health, nurses engage in seemingly benign surveillance of children. These practices are based on knowledge claims and technologies of developmental science, which remain anchored in assumptions of the child body as an incomplete form with a universal developmental trajectory and inherent potentiality. This paper engages in a critical discursive analysis, drawing on Donna Haraway's conceptualizations of technoscience and figuration. Using a contemporary developmental screening tool from nursing practice, this analysis traces the effects of this tool through production, transformation, distribution, and consumption. It reveals how the techniques of imaging, abstraction, and measurement collide to fix the open, transformative child body in a figuration of the developing child. This analysis also demonstrates how technobiopower infuses nurses' understandings of children and structures developmentally appropriate expectations for children, parents, and nurses. Furthermore, it describes how practices that claim to facilitate healthy child development may inversely deprive children of agency and foster the production of normal or ideal children. An alternative ontological perspective is offered as a challenge to the individualism of developmental models and other dominant ideologies of development, as well as practices associated with these ideologies. In summary, this analysis argues that nurses must pay closer attention to how technobiopower infuses practices that monitor and promote child development. Fostering a critical understanding of the harmful implications of these practices is warranted and offers the space to conceive of human development in alternate and exciting ways. © 2013 John Wiley & Sons Ltd.

  17. Ultrasound and MRI features of pyomyositis in children

    Energy Technology Data Exchange (ETDEWEB)

    Trusen, Andreas; Beissert, Matthias; Schultz, Georg; Darge, Kassa [Department of Pediatric Radiology, Institute of Radiodiagnostics, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg (Germany); Chittka, Bernd [University Children' s Hospital, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg (Germany)

    2003-05-01

    Pyomyositis (PM) is an infectious disease of the skeletal muscle with a wide range of symptoms such as pain, fever or swelling, and is predominantly found in the tropics. In recent years PM has increasingly been diagnosed in Europe and in the U.S. Our objective is to describe the ultrasound and MRI features of PM in children. A retrospective analysis of 12 children with PM (2 girls and 10 boys; age range 1-13 years) admitted to our hospital between 1998 and 2002 was carried out. All children had a US exam and 8 children underwent MRI. Children with osteomyelitis and accompanying myositis were excluded from this study. In all patients who had MRI (n=8) the infected muscles were found to have the following features: hyperintensity on the T2-weighted images, diffuse borders and contrast enhancement. In the pelvis (n=4), only one PM could be detected with US, in the other 3 cases only US of the hip joint was performed based on the clinical symptoms. In the extremities (n=8) US always revealed an altered echogenicity of the affected muscles as well as fluid collection in 5 cases. Both US and MRI reveal characteristic changes of the PM. Ultrasound should be the first imaging modality in the extremities. In the pelvis MRI is the imaging modality of choice. The MRI is needed to differentiate pyomyositis from osteomyelitis. (orig.)

  18. Meta-analysis of the comorbidity rate of allergic rhinitis and asthma in Chinese children.

    Science.gov (United States)

    Kou, Wei; Li, Xuelei; Yao, Hongbing; Wei, Ping

    2018-04-01

    Allergic rhinitis (AR) and asthma often occur concomitantly and are the two most common inflammatory conditions of the airways in children. Large-scale studies investigating the comorbidity of asthma and AR in children are rare. So, we performed a meta-analysis to describe the comorbidity rate of asthma and AR in Chinese children. We retrieved related studies from Pubmed, Science, Springer, Elsevier, Embase, BMJ, and four Chinese biomedical databases, including Wanfang Data, VIP, CBM, and CNKI. From these individual studies, the comorbidity rate of asthma and AR in Chinese children was extracted and pooled to generate summary effect estimates in R version 3.2.3. The meta-analysis included 25 cross-sectional studies. The results indicated that in China, the incidence of asthma in children with AR is 35.01% (95% CI: 32.32%-37.70%) and the incidence of AR in children with asthma is 54.93% (95% CI: 53.05%-56.80%). The comorbidity of AR and asthma is high in Chinese children. Statistically, the prevalence of AR was higher in children with asthma, as opposed to the prevalence of asthma in children with AR. The comorbidity rate of AR and asthma signifies the importance of improving the recognition and treatment under both conditions by respiratory physicians and otolaryngologists. Copyright © 2018. Published by Elsevier B.V.

  19. Factor H autoantibody is associated with atypical hemolytic uremic syndrome in children in the United Kingdom and Ireland.

    Science.gov (United States)

    Brocklebank, Vicky; Johnson, Sally; Sheerin, Thomas P; Marks, Stephen D; Gilbert, Rodney D; Tyerman, Kay; Kinoshita, Meredith; Awan, Atif; Kaur, Amrit; Webb, Nicholas; Hegde, Shivaram; Finlay, Eric; Fitzpatrick, Maggie; Walsh, Patrick R; Wong, Edwin K S; Booth, Caroline; Kerecuk, Larissa; Salama, Alan D; Almond, Mike; Inward, Carol; Goodship, Timothy H; Sheerin, Neil S; Marchbank, Kevin J; Kavanagh, David

    2017-11-01

    Factor H autoantibodies can impair complement regulation, resulting in atypical hemolytic uremic syndrome, predominantly in childhood. There are no trials investigating treatment, and clinical practice is only informed by retrospective cohort analysis. Here we examined 175 children presenting with atypical hemolytic uremic syndrome in the United Kingdom and Ireland for factor H autoantibodies that included 17 children with titers above the international standard. Of the 17, seven had a concomitant rare genetic variant in a gene encoding a complement pathway component or regulator. Two children received supportive treatment; both developed established renal failure. Plasma exchange was associated with a poor rate of renal recovery in seven of 11 treated. Six patients treated with eculizumab recovered renal function. Contrary to global practice, immunosuppressive therapy to prevent relapse in plasma exchange-treated patients was not adopted due to concerns over treatment-associated complications. Without immunosuppression, the relapse rate was high (five of seven). However, reintroduction of treatment resulted in recovery of renal function. All patients treated with eculizumab achieved sustained remission. Five patients received renal transplants without specific factor H autoantibody-targeted treatment with recurrence in one who also had a functionally significant CFI mutation. Thus, our current practice is to initiate eculizumab therapy for treatment of factor H autoantibody-mediated atypical hemolytic uremic syndrome rather than plasma exchange with or without immunosuppression. Based on this retrospective analysis we see no suggestion of inferior treatment, albeit the strength of our conclusions is limited by the small sample size. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  20. Pamidronate Affects the Mandibular Cortex of Children with Osteogenesis Imperfecta

    Science.gov (United States)

    Apolinário, A.C.; Figueiredo, P.T.; Guimarães, A.T.; Acevedo, A.C.; Castro, L.C.; Paula, A.P.; Paula, L.M.; Melo, N.S.; Leite, A.F.

    2015-01-01

    We hypothesized that mandibular cortical width (MCW) is smaller in children with osteogenesis imperfecta (OI) than in healthy children and that pamidronate can improve the cortical mandibular thickness. The aim of this study was to assess changes in the MCW on dental panoramic radiographs (DPRs) of children with normal bone mineral density (BMD) and with OI. We also compared the MCW of children with different types of OI regarding the number of pamidronate cycles and age at the beginning of treatment. MCW measurements were retrospectively obtained from 197 DPRs of 66 children with OI types I, III, and IV who were in treatment with a comparable dosage of cyclical intravenous pamidronate between 2007 and 2013. The control group had 92 DPRs from normal BMD children. Factorial analysis of variance was used to compare MCW measurements among different age groups and between sexes and also to compare MCW measurements of children with different types of OI among different pamidronate cycles and age at the beginning of treatment. No significant differences in results were found between male and female subjects in both OI and healthy children, so they were evaluated altogether (P > 0.05). There was an increase of MCW values related to aging in all normal BMD and OI children but on a smaller scale in children with OI types I and III. Children with OI presented lower mean MCW values than did children with normal BMD at the beginning of treatment (P < 0.05). A linear model estimated the number of pamidronate cycles necessary to achieve mean MCW values equivalent to those of healthy children. The thinning of the mandibular cortex depended on the number of pamidronate cycles, the type of OI, and the age at the beginning of treatment. DPRs could thus provide a way to identify cyclic pamidronate treatment outcomes in patients with OI. PMID:25608973