Sample records for children retrospective review

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

    LENUS (Irish Health Repository)

    Queally, Joseph M


    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.

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

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    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)


    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.)

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

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    Slothower Molly P


    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.

  4. Resource utilization in children with tuberous sclerosis complex and associated seizures: a retrospective chart review study. (United States)

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


    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.

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

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    Tri Indah Winarni


    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.

  6. Mesenchymal Chondrosarcoma in Children and Young Adults: A Single Institution Retrospective Review

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    Michael W. Bishop


    Full Text Available Background. Mesenchymal chondrosarcoma is an aggressive, uncommon histologic entity arising in bone and soft tissues. We reviewed our institutional experience with this rare diagnosis. Methods. We conducted a retrospective chart review on patients with mesenchymal chondrosarcoma over a 24-year period. Clinicopathologic and radiographic features were reviewed. Results. Twelve patients were identified. Nine were females; median age was 14.5 years (1.2–19.7 years. The most common site was the head/neck (7/12. Disease was localized in 11/12 patients (one with lung nodules. Six with available tissue demonstrated NCOA2 rearrangement by FISH. Six underwent upfront surgical resection, and six received neoadjuvant therapy (2 chemotherapy alone and 4 chemotherapy and radiation. All patients received adjuvant chemotherapy (most commonly ifosfamide/doxorubicin and/or radiation (median dose 59.4 Gy. At a median follow-up of 4.8 years, 5-year disease-free survival and overall survival were 68.2% (95% CI 39.8%, 96.6% and 88.9% (95% CI 66.9%, 100%. Two patients had distant recurrences at 15 and 42 months, respectively. Conclusion. Aggressive surgical resection of mesenchymal chondrosarcoma with chemoradiotherapy yields excellent local control and may reduce likelihood of late recurrence. Characterization of downstream targets of the HEY1-NCOA2 fusion protein, xenograft models, and drug screening are needed to identify novel therapeutic strategies.

  7. Systematic reviews of the evidence on the nature, extent and effects of food marketing to children. A retrospective summary. (United States)

    Cairns, Georgina; Angus, Kathryn; Hastings, Gerard; Caraher, Martin


    A 2009 systematic review of the international evidence on food and beverage marketing to children is the most recent internationally comprehensive review of the evidence base. Its findings are consistent with other independent, rigorous reviews conducted during the period 2003-2012. Food promotions have a direct effect on children's nutrition knowledge, preferences, purchase behaviour, consumption patterns and diet-related health. Current marketing practice predominantly promotes low nutrition foods and beverages. Rebalancing the food marketing landscape' is a recurring policy aim of interventions aimed at constraining food and beverage promotions to children. The collective review evidence on marketing practice indicates little progress towards policy aims has been achieved during the period 2003-2012. There is a gap in the evidence base on how substantive policy implementation can be achieved. We recommend a priority for future policy relevant research is a greater emphasis on translational research. A global framework for co-ordinated intervention to constrain unhealthy food marketing which has received high level support provides valuable insight on some aspects of immediate implementation research priorities.

  8. The retrospective chart review: important methodological considerations

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    Vassar Matt


    Full Text Available In this paper, we review and discuss ten common methodological mistakes found in retrospective chart reviews. The retrospective chart review is a widely applicable research methodology that can be used by healthcare disciplines as a means to direct subsequent prospective investigations. In many cases in this review, we have also provided suggestions or accessible resources that researchers can apply as a “best practices” guide when planning, conducting, or reviewing this investigative method.

  9. Cortisol Levels in Children With Diabetic Ketoacidosis Associated With New-Onset Type 1 Diabetes Mellitus: A Retrospective Review (United States)

    Williams, Kristen M.; Fazzio, Pamela; Oberfield, Sharon E.; Gallagher, Mary P.; Aranoff, Gaya S.


    There is little data documenting cortisol levels in children with diabetic ketoacidosis (DKA), despite the fact that untreated adrenal insufficiency (AI) could worsen the outcome of DKA. In this cross-sectional study, we assessed serum cortisol levels in 28 children with DKA and new onset type 1 diabetes mellitus evaluated at our center over a 5-year period. Average duration of diabetes-related symptoms was positively associated with age (P = .002), and significantly lower hemoglobin A1c levels were observed in the youngest children. The mean cortisol level was 40.9 mg/dL, with a range of 7.8 to 119 mg/dL. Cortisol levels were found to be inversely associated with serum pH (P = .007). There was no difference in the clinical outcome of the 4 patients who had cortisol levels less than 18 mg/dL. Overall, we did not find clinical or laboratory evidence of diminished cortisol reserve; however, the possibility of AI must be kept in mind when treating children with DKA. PMID:28145127

  10. Nursing student medication errors: a retrospective review. (United States)

    Harding, Lorill; Petrick, Teresa


    This article presents the findings of a retrospective review of medication errors made and reported by nursing students in a 4-year baccalaureate program. Data were examined in relation to the semester of the program, kind of error according to the rights of medication administration, and contributing factors. Three categories of contributing factors were identified: rights violations, system factors, and knowledge and understanding. It became apparent that system factors, or the context in which medication administration takes place, are not fully considered when students are taught about medication administration. Teaching strategies need to account for the dynamic complexity of this process and incorporate experiential knowledge. This review raised several important questions about how this information guides our practice as educators in the clinical and classroom settings and how we can work collaboratively with practice partners to influence change and increase patient safety.

  11. Haemorrhoids in Children: A Retrospective Study

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    Afra Karavelioglu


    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

  12. Low-pressure valves in hydrocephalic children : a retrospective analysis

    NARCIS (Netherlands)

    Breimer, G. E.; Sival, Deborah; Hoving, E. W.


    A series of 100 children under 2 years of age treated for hydrocephalus is described. All patients received a standard differential low-pressure (SD low) valve as the first cerebrospinal fluid (CSF) shunt treatment. The performance of this group during follow-up is analysed. A retrospective cohort s

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

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    Dundon Belinda


    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.

  14. A Retrospective Chart Review of Dietary Diversity and Feeding Behavior of Children with Autism Spectrum Disorder before and after Admission to a Day-Treatment Program (United States)

    Sharp, William G.; Jaquess, David L.; Morton, Jane F.; Miles, Aida G.


    The nutritional status and mealtime performance among a group of children with autism spectrum disorders (ASD) were examined before and after admission to an intensive feeding day-treatment program. Treatment involved escape extinction, reinforcement, and stimulus fading procedures. Outcomes focused on dietary diversity and mealtime performance,…

  15. [Retrospective evaluation of carcinoid tumors of the appendix in children]. (United States)

    San Vicente, B; Bardají, C; Rigol, S; Obiols, P; Melo, M; Bella, R


    Carcinoids of the appendix are rare in children. Usually diagnosed incidentally on histologic investigation following appendectomy for acute apendicitis. To investigate the significance of the diagnosis of appendiceal carcinoid tumors in children, we conducted a retrospective study in our institution. Between 1990 and 2007 a total of 1158 appendectomy were done. In four patients the diagnosis was appendiceal carcinoid. We studied treatment, follow-up and prognosis of this patients. Indicacion for appendectomy was acute pain in lower right quadrant. The median tumor diameter was lower than 1 cm and the appropriate treatment was appendectomy. The prognosis was excellent in all the patients.

  16. Biliary Dyskinesia in Children: A Systematic Review. (United States)

    Santucci, Neha R; Hyman, Paul E; Harmon, Carroll M; Schiavo, Julie H; Hussain, Sunny Z


    Cholecystectomy rates for biliary dyskinesia in children are rising in the United States, but not in other countries. Biliary dyskinesia is a validated functional gallbladder disorder in adults, requiring biliary colic in the diagnosis. In contrast, most studies in children require upper abdominal pain, absent gallstones on ultrasound, and an abnormal gallbladder ejection fraction (GBEF) on cholecystokinin-stimulated cholescintigraphy for diagnosis. We aimed to systematically review existing literature in biliary dyskinesia in children, determine the validity and reliability of diagnostic criteria, GBEF, and to assess outcomes following cholecystectomy. We performed a systematic review following the PRISMA checklist and searched 7 databases including PubMed, Scopus, Embase, Ovid, MEDLINE, ProQuest, Web of Science, and the Cochrane library. Bibliographies of articles were screened for additional studies. Our search terms yielded 916 articles of which 28 were included. Three articles were manually added from searched references. We reviewed 31 peer-reviewed publications, all retrospective chart reviews. There was heterogeneity in diagnostic criteria and GBEF values. Outcomes after laparoscopic cholecystectomy varied from 34% to 100% success, and there was no consensus concerning factors influencing outcomes. The observational, retrospective study designs that comprised our review limited interpretation of safety and efficacy of the investigations and treatment in biliary dyskinesia in children. Symptoms of biliary dyskinesia overlapped with functional dyspepsia. There is a need for consensus on symptoms defining biliary dyskinesia, validation of testing required for diagnosis of biliary dyskinesia, and randomized controlled trials comparing medical versus surgical management in children with upper abdominal pain.

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

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    Ramraj Jayabalan Arvind


    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.


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    Full Text Available Myringoplasty is the surgical closure of the perforation of pars tensa of the tympanic membrane. Perforation of the tympanic membrane in children can cause significant disability. It is a simple and effective procedure that results in the success ful closure of the perforation in most cases. This retrospective study was conducted in our hospital, for 06 years. Myringoplasty is a beneficial procedure in the pediatric population in the hands of a skilled and experienced surgeon. This paper will discu ss the success rate of perforation closure, improvement in hearing and complications during surgery and postoperative period in pediatric age group.

  19. Tuberculosis of hip in children: A retrospective analysis

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    Myung-Sang Moon


    Full Text Available Background: Tuberculosis (TB of hip constitutes nearly 15% of all cases of osteoarticular tuberculosis. We report a retrospective study carried out on 43 children with hip TB. Materials and Methods: Forty-three children of TB hip treated between 1971 and 2000 were analysed. Twenty-four children of the early series were treated with streptomycin (S, isoniazid (H and PAS (Pa for 18 months (3HPaS, 15 HPa, while 19 children in the later series were treated with isoniazid (H, rifampicin (R and ethambutol (E or pyrazinamide (Z for 12 months [(12 RHE(Z]. Five out of 18 children with radiologically normal appearing type hip TB were treated with chemotherapy alone and 38 children were subjected to surgery; simple synovectomy alone in 31 hips, joint debridement in six hips, and proximal femoral varisation osteotomy in one. After surgery hips were immobilized in cast for one to three months according to the severity of the disease and patients pain tolerance, and then were mobilized under leg traction in bed gradually till pain subsided completely. Results: TB of hip healed with minimum sequelae in all children. In 18 Type one hip TB, normal hip (synovial form anatomy was maintained, and in 25 patients with advanced lesions some defect in the femoral head and acetabulum was noticed, though painless good hip motion was maintained. Excellent to good results were obtained in 31 children (73.1%, fair in eight (18.6%, and poor in four (9.3%. In four patients with poor results, there was some residual morphological defect in the hip. None developed ankylosis of hip. Conclusion: We achieved good outcome with minimum sequelae in this series. The management goal should be aimed not only to heal the disease but also to maintain a painless mobile hip and anatomical cephalocotyloid relationship until maturity, and retard the development of secondary osteoarthritis.

  20. Herpes Zoster in Healthy Children: A Retrospective Study

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    Birgül Tepe


    Full Text Available Objective: Herpes zoster is an acute dermatomal viral infection caused by the reactivation of varicella zoster virus. While it is commonly seen among elderly and immunocompromised individuals, it is rare in healthy children. The aim of this study was to evaluate the clinical features, treatment and complications of healthy children with herpes zoster. Methods: Thirty one patients aged between 0-16 years who were admitted to our clinic with the diagnosis of herpes zoster, between January 2014 and December 2014, were evaluated retrospectively for age, gender, month of admission, complaint, history of chickenpox infection or varicella vaccination, triggering factors, dermatomal involvement, complications and treatment. Results: Among 31 patients with diagnosis of herpes zoster, 19 were boys (61.3% and 12 were girls (38.7%. The mean of age was 9.12±4.4 years. Twenty patients had thoracic (64.5%, six had lumbar (19.4% and five had cervical involvements (16.2%. The most frequent symptoms were pruritus and pain, respectively. Six patients were administered topical treatment and 25 patients were treated with both systemic and topical treatments. Complication was not observed. Conclusion: Herpes zoster is also being encountered increasingly in healthy children nowadays. It is benign and generally no complications are observed. Incidence can vary because of geographic and socioeconomic differences like vaccination programs.

  1. Dermatologic manifestation of hyperandrogenism: a retrospective chart review. (United States)

    Clark, Charlotte M; Rudolph, Jennifer; Gerber, Donald A; Glick, Sharon; Shalita, Alan R; Lowenstein, Eve J


    Several studies have described a wide spectrum of hyperandrogenism diseases, many of which are difficult to distinguish from each other. In order to better understand diseases of hyperandrogenism, the authors performed a retrospective study of the cutaneous features and metabolic findings in women with hyperandrogenism. A retrospective chart analysis compiled by three dermatologists in both academic and private settings was performed, including patients presenting with > or = 2 manifestations of hyperandrogenism. Relevant dermatologic and associated manifestations and laboratory and imaging study findings were reviewed. Moderate to severe acne was the most common manifestation. Other common manifestations that patients first presented with include hirsutism, acanthosis nigricans, androgenic alopecia, and skin tags. Oligomenorrhea was the most common systemic presenting sign. Statistical analysis of various clinical markers revealed correlations with hyperandrogenemia. Acanthosis nigricans and hirsutism were found to be useful clinical markers for hyperandrogenism, whereas androgenic alopecia was not. This study provides some insights into the presentation and diverse manifestations seen in hyperandrogenism.

  2. A Multicenter Retrospective Case Study of Anaphylaxis Triggers by Age in Korean Children (United States)

    Lee, So-Yeon; Ahn, Kangmo; Kim, Jihyun; Jang, Gwang Cheon; Min, Taek Ki; Yang, Hyeon-Jong; Pyun, Bok Yang; Kwon, Ji-Won; Sohn, Myung Hyun; Kim, Kyung Won; Kim, Kyu-Earn; Yu, Jinho; Hong, Soo-Jong; Kwon, Jung Hyun; Kim, Sung-Won; Song, Tae Won; Kim, Woo Kyung; Kim, Hyung Young; Jeon, You Hoon; Lee, Yong Ju; Lee, Hae Ran; Kim, Hye-Young; Ahn, Youngmin; Yum, Hye Yung; Suh, Dong In; Kim, Hyun Hee; Kim, Jin-Tack; Kim, Jeong Hee; Park, Yong Mean


    Purpose Although anaphylaxis is recognized as an important, life-threatening condition, data are limited regarding its triggers in different age groups. We aimed to identify anaphylaxis triggers by age in Korean children. Methods We performed a retrospective review of medical records for children diagnosed with anaphylaxis between 2009 and 2013 in 23 secondary or tertiary hospitals in South Korea. Results A total of 991 cases (mean age=5.89±5.24) were reported, with 63.9% involving patients younger than 6 years of age and 66% involving male children. Food was the most common anaphylaxis trigger (74.7%), followed by drugs and radiocontrast media (10.7%), idiopathic factors (9.2%), and exercise (3.6%). The most common food allergen was milk (28.4%), followed by egg white (13.6%), walnut (8.0%), wheat (7.2%), buckwheat (6.5%), and peanut (6.2%). Milk and seafood were the most common anaphylaxis triggers in young and older children, respectively. Drug-triggered anaphylaxis was observed more frequently with increasing age, with antibiotics (34.9%) and nonsteroidal anti-inflammatory drugs (17.9%) being the most common causes. Conclusions The most common anaphylaxis trigger in Korean children was food. Data on these triggers show that their relative frequency may vary by age. PMID:27582405

  3. Characterization of tinnitus in different age groups: A retrospective review

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    Jamil Al-Swiahb


    Full Text Available Objectives: The aim of this study was to characterize tinnitus in affected patients. Methods: A retrospective review of medical records from 470 consecutive patients who visited a tertiary care hospital for evaluation of chronic subjective tinnitus between January 2009 and June 2010 was performed. Patients were divided into three subgroups based on age. Clinical, audiological, and psychological characteristics of each subgroup were analyzed. Results: Of the 470 patients evaluated, 85 were less than 40, 217 between 40 and 60, and 168 above 60 years of age. Most patients were men and complained of unilateral, acute high-pitched tinnitus. Most patients above the age of 40 years complained of loud and annoying tinnitus and had worse stress and severity scores. Conclusions: Chronic tinnitus in older adults is subjectively louder, more annoying, and more distressing than that found in younger patients. We recommend considering age in the patient management plan.

  4. Rotavirus-associated immune thrombocytopenic purpura in children: A retrospective study


    Ai, Qi; Yin, Jing; Chen, Sen; Qiao, Lijin; Luo, Na


    Certain studies have previously indicated that an association may exist between rotavirus infection and primary immune thrombocytopenic purpura (ITP). The present retrospective study aimed to investigate whether rotavirus may cause ITP in children. Firstly, the incidence of ITP in children with or without rotavirus diarrhea was compared. A 14.58% incident rate was observed in children with rotavirus diarrhea compared with a 7.22% incident rate in children without rotavirus diarrhea. Subsequen...

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

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    Karpa Kelly


    Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusions 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.

  6. A Retrospective Review of Iatrogenic Skin and Soft Tissue Injuries

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    Tae Geun Lee


    Full Text Available Background Even though the quality of medical and surgical care has improved remarkablyover time, iatrogenic injuries that require surgical treatment including injuries caused by castand elastic bandage pressure, extravasation, and dopamine-induced ischemia still frequentlyoccur. The goal of this study was to estimate the incidence and analyze the distribution ofiatrogenic injuries referred to our department.Methods A retrospective clinical review was performed from April 2006 to November 2010. Intotal, 196 patients (116 females and 80 males were referred to the plastic surgery departmentfor the treatment of iatrogenic injuries. We analyzed the types and anatomic locations ofiatrogenic complications, along with therapeutic results.Results An extravasation injury (65 cases, 37.4% was the most common iatrogeniccomplication in our study sample, followed by splint-induced skin ulceration, dopamineinducednecrosis, prefabricated pneumatic walking brace-related wounds and elasticbandage-induced wounds. Among these, prefabricated pneumatic walking brace-relatedcomplication incidence increased the most during the 5-year study period.Conclusions The awareness of the very common iatrogenic complications and its causes mayallow physicians to reduce their occurrence and allow for earlier detection and referral to aplastic surgeon. We believe this is the first study to analyze iatrogenic complications referredto a plastic surgery department in a hospital unit.


    Seeley, Kathryn E; Clayton, Leigh A; Hadfield, Catherine A; Muth, Dillon; Mankowski, Joseph L; Kelly, Kathleen M


    The giant Pacific octopus (Enteroctopus dofleini) is a popular exhibit species in public display aquaria, but information on health and disease is limited. This retrospective review evaluates time in collection and describes antemortem clinical signs and pathology of giant Pacific octopuses in an aquarium setting. Between March 2004 and December 2013, there were 19 mortalities: eight males, 10 females, and one individual whose sex was not recorded. Average time spent in collection for all octopuses was 375 ± 173 days (males 351 ± 148 days, females 410 ± 196 days). Ten (52.6%) of the octopuses were sexually mature at the time of death, six (31.6%) were not sexually mature, and reproductive status could not be determined in three octopuses (15.8%). Minimal changes were noted on gross necropsy but branchitis was histologically evident in 14 octopuses, often in conjunction with amoeboid or flagellate parasites. Senescence, parasitism, and husbandry were all important contributors to mortality and should be considered when caring for captive octopuses.

  8. Farming tractor fatalities in Virginia: an 11-year retrospective review. (United States)

    Fulcher, James; Noller, Anna; Kay, Deborah


    This retrospective case review examines farm tractor-related deaths in the Commonwealth of Virginia for an 11-year period, from 1997 to 2007. This study compares decedent's demographic information, toxicology results, and medical histories.A vast majority of farm tractor-related deaths were male (98%) and white (91%). The average age was 60 years with most deaths occurring between the ages of 40 and 80 years. Ethanol use was observed in 9% of all cases with 7% of cases being more than 0.08% wt/vol ethanol, which is the legal limit in Virginia to operate a motor vehicle.The more mountainous, Western District Office of the Chief Medical Examiner composed 60% of total cases with 43% of these western cases related to tractor use on a natural slope or incline. The deaths in other districts were all less than 13% natural slope or incline related, reflecting the topography of these areas.These findings confirm much of what observation would suggest; accidents with farming tractors typically involve older white men. Operating a tractor on steep inclines is dangerous as many tractors do not have adequate rollover protection. The use of ethanol is dangerous when using any heavy equipment.This study provides an initial look at tractor-related deaths in Virginia, and more research is needed in this area to improve safety mechanisms on this machinery.

  9. Growth in children with pulmonary arterial hypertension : a longitudinal retrospective multiregistry study

    NARCIS (Netherlands)

    Ploegstra, Mark-Jan; Ivy, D Dunbar; Wheeler, Jeremy G; Brand, Monika; Beghetti, Maurice; Rosenzweig, Erika B; Humpl, Tilman; Iriart, Xavier; Rouzic, Erwan Muros-Le; Bonnet, Damien; Berger, Rolf M F


    BACKGROUND: To enable adequate interpretation of growth measurements in the management of children with pulmonary arterial hypertension (PAH), we assessed growth and its associated determinants in children with PAH. METHODS: We did a retrospective longitudinal study of height and body-mass index in

  10. Children and Divorce: A Review. (United States)

    Wallerstein, Judith S.; Kelly, Joan B.


    Discusses the emotional impact of divorce on children and adolescents and, after reviewing the literature and findings from a five-year longitudinal study, describes the implications of the spiraling divorce rate for practice, research, and social policy. (Author)

  11. Cystosarcoma phyllodes: Pathological enigma: A retrospective review of 162 cases

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    R P Narayanakar


    Full Text Available Purpose: Phyllodes tumor (PT is a rare fibroepithelial neoplasm comprising <1% of all breast tumors. Clinical spectrum ranges from benign (B, borderline (BL, and locally recurrent to malignant (M and metastatic type. The aim of our study was to analyze the clinicopathological factors, compare treatment options, and evaluate outcome in patients with PT. Methods: We retrospectively reviewed 162 women with PT. The surgical intervention varied from simple excision (lumpectomy/wide local excision (WLE in benign cases to simple/modified radical or radical mastectomy (SM/MRM/RM in malignant and recurrent tumors. Results: Out of 162 patients, B, BL, and M were 95 (58.64%, 29 (18%, and 38 (23.45%, respectively. Mean age, duration of lump, and size were 38 ± 8 years, 28 ± 10 months, and 12 ± 5 cm, respectively. Recurrence rate with B, BL, and M was 15.78%, 41.37%, and 55.26%, respectively (P = 0.00001. As compared to WLE (22%, SM (23.8%, and MRM/RM (14.2%, recurrence was higher with lumpectomy (48.9% (P = 0.004. Positive correlation was found between recurrence rate with the size of tumor (P = 0.008 and also number of recurrence with holoprosencephaly (P = 0.047. There was no association between the number of recurrences and size of tumor (P = 0.63. Malignant PT was seen in 38 (24% and distant metastasis was seen in 7 (18%. Mean duration of follow-up was 42 months. Conclusion: WLE with negative margins should be the initial surgery for PT. The role of adjuvant radiotherapy and chemotherapy is uncertain. PT is pathological enigma. Till date, no factors can accurately predict the recurrence and outcome. PT is known for unpredictable behavior and high recurrence rates, hence long-term follow-up is advised.

  12. Outcome of left heart mechanical valve replacement in West African children - A 15-year retrospective study

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    Tamatey Martin


    Full Text Available Abstract Background The West African sub-region has poor health infrastructure. Mechanical valve replacement in children from such regions raises important postoperative concerns; among these, valve-related morbidity and complications of lifelong anticoagulation are foremost. Little is known about the long-term outcome of mechanical valve replacement in West Africa. We sought to determine the outcome of mechanical valve replacement of the left heart in children from this sub-region. Method We conducted a retrospective review of all consecutive left heart valve replacements in children ( Results One hundred and fourteen patients underwent mitral valve replacement (MVR, aortic valve replacement (AVR or mitral and aortic valve replacements (MAVR. Their ages ranged from 6-18 years (13.3 ± 3.1 years. All patients were in NYHA class III or IV. Median follow up was 9.1 years. MVR was performed in 91 (79.8% patients, AVR in 13 (11.4% and MAVR in 10 (8.8% patients. Tricuspid valve repair was performed concomitantly in 45 (39.5% patients. There were 6 (5.3% early deaths and 6 (5.3% late deaths. Preoperative left ventricular dysfunction (ejection fraction Conclusion Mechanical valve replacement in West African children has excellent outcomes in terms of mortality, valve-related events, and reoperation rate. Preoperative left ventricular dysfunction is the primary determinant of mortality within the first 2 years of valve replacement. The risk of valve-related complications is acceptably low. Anticoagulation is well tolerated with a very low risk of bleeding even in this socioeconomic setting.

  13. Dually diagnosed: a retrospective study of the process of diagnosing autism spectrum disorders in children who are deaf and hard of hearing. (United States)

    Szarkowski, Amy; Flynn, Suzanne; Clark, Terrell


    Utilizing a retrospective chart review of 30 children who have been dually diagnosed with hearing loss and autism spectrum disorders (ASDs), this study explores the process of arriving at the diagnosis of ASD in this population. Factors of interest include the age of ASD diagnosis in children who are deaf and hard of hearing, the types of professionals involved in making the diagnosis, and the measures used for assessment. Complications in the diagnostic process are highlighted.

  14. 77 FR 57566 - Announcement of Public Meeting on the Consumer Confidence Report (CCR) Rule Retrospective Review... (United States)


    ... From the Federal Register Online via the Government Publishing Office ENVIRONMENTAL PROTECTION AGENCY Announcement of Public Meeting on the Consumer Confidence Report (CCR) Rule Retrospective Review and Request for Public Comment on Potential Approaches to Electronic Delivery of the CCR;...

  15. 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.


    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. S

  16. Rotavirus-associated immune thrombocytopenic purpura in children: A retrospective study. (United States)

    Ai, Qi; Yin, Jing; Chen, Sen; Qiao, Lijin; Luo, Na


    Certain studies have previously indicated that an association may exist between rotavirus infection and primary immune thrombocytopenic purpura (ITP). The present retrospective study aimed to investigate whether rotavirus may cause ITP in children. Firstly, the incidence of ITP in children with or without rotavirus diarrhea was compared. A 14.58% incident rate was observed in children with rotavirus diarrhea compared with a 7.22% incident rate in children without rotavirus diarrhea. Subsequently, the clinical features of ITP children with or without rotavirus infection were compared. The results indicated that ITP children with rotavirus infection were significantly younger, showed significantly decreased mean platelet volume (MPV) levels and presented a significantly higher frequency of bleeding score of 3 against ITP children without rotavirus infection. In conclusion, these findings suggest that rotavirus serves a causative role in ITP.

  17. Testicular Torsion in Children: A 20-Year Retrospective Study in a Single Institution

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    Chao Yang


    Full Text Available In this paper, we evaluated the historical features and physical examination findings, as well as laboratory tests and ultrasound examinations, in children with testicular torsion (TT, in order to improve diagnosis and treatment in this population. A retrospective review of patients with diagnosis of TT between January 1990 and January 2010 was performed. We included 118 cases in the study, accounting for 9.01% of all cases of acute scrotum. Mean patient age was 9.3 ± 5.6 years. The left side was predominantly affected. The median duration of symptoms up to surgical exploration was 64 h. Absence of cremasteric reflex presented in 94.9% patients. All boys had an ultrasound of the scrotum; decreased or absent blood flow was observed in all orchidectomy patients. Heterogeneous echogenicity presented in all cases of orchidectomy. At surgery, viable testes were present in 46 boys (39% and preserved; in 72 boys with nonviable testes, they were removed. The median duration of symptoms at presentation was 12 h when the testes were successfully conserved and 90 h when they were removed. Testicular salvage depends critically on early surgical intervention. Ultrasound is a useful tool for the clinical assessment of patients with TT, however, sonographic interpretation must be in conjunction with the clinical manifestations. We advocate immediate surgical exploration with suspected TT. Long-term hormonal levels are within the normal range regardless of the fate of the testis. Further follow-up is needed to confirm fertility after TT.

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

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    Shet Anita


    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.

  19. 78 FR 56706 - HHS Retrospective Review 2013 Request for Information (United States)


    ... administration burdens; Achieve better results by modifying, streamlining, expanding, or eliminating rules when the costs or benefits are greater than originally anticipated; Eliminate rules that are outdated... existing regulations HHS should consider reviewing in order to streamline or eliminate...

  20. Five-Year Retrospective Review of Acute Generalized Exanthematous Pustulosis

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    Chitprapassorn Thienvibul


    Full Text Available Background. Acute generalized exanthematous pustulosis (AGEP is an acute pustular eruption characterized by widespread nonfollicular sterile pustules. The aim of this study is to characterize the etiology, clinical features, laboratory findings, management, and outcome of patients with AGEP in Asians. Patient/Methods. A retrospective analysis was performed on patient who presented with AGEP between August 2008 and November 2012 in a tertiary center in Thailand. Results. Nineteen patients with AGEP were included. AGEP was generally distributed in seventeen patients (89.5% and localized in two (10.5%. Fever and neutrophilia occurred in 52.6% and 68.4%, respectively. Hepatitis was found up to 26.3%. The most common etiology was drugs (94.7%, comprising of antibiotics (73.6%, proton pump inhibitors (10.5%, nonsteroidal anti-inflammatory drugs (5.3%, and herbal medicine (5.3%. Beta-lactams were the most common causal drug, particularly carbapenems and cephalosporins. This is the first report of Andrographis paniculata as an offending agent for AGEP. We found no differences between various treatment regimens (topical corticosteroid, systemic corticosteroid, and supportive treatment regarding the time from drug cessation to pustules resolution (P=0.171. Conclusions. We have highlighted the presentation of AGEP among Asians. We found high association with systemic drugs. Carbapenems were one of the leading culprit drugs. Finally, a localized variant was observed.

  1. 75 Years of the International Labour Review: A Retrospective. (United States)

    Thomas, Albert; And Others


    Contains 18 articles published in International Labour Review from 1921-1975 that discuss the International Labour Organisation, international labor movement and law, economics and the labor market, family security, full employment, population growth, industrial welfare, trade policy and employment growth, and income expectations and rural-urban…

  2. Retrospective Review Article: Speaking--The Second Skill. (United States)

    System, 1995


    Reviews four books on speech research: (1) "The Speech Chain: The Physics and Biology of Spoken Language" (Peter B. Denes and Elliot N. Pinson); (2) "Speaking: From Intention to Articulation" (Willem J. M. Levelt); (3) "Talking to Learn: Conversation in Second Language Acquisition" (Richard R. Day); and (4) "Speaking" (Martin Bygate). (eight…

  3. Optimization of machining techniques – A retrospective and literature review

    Indian Academy of Sciences (India)

    Aman Aggarwal; Hari Singh


    In this paper an attempt is made to review the literature on optimizing machining parameters in turning processes. Various conventional techniques employed for machining optimization include geometric programming, geometric plus linear programming, goal programming, sequential unconstrained minimizationtechnique, dynamic programming etc. The latest techniques for optimization include fuzzy logic, scatter search technique, genetic algorithm, Taguchi technique and response surface methodology.

  4. Childhood Learning Disabilities and Atypical Dementia: A Retrospective Chart Review.

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    Alon Seifan

    Full Text Available To further our understanding of the association between self-reported childhood learning disabilities (LDs and atypical dementia phenotypes (Atypical Dementia, including logopenic primary progressive aphasia (L-PPA, Posterior Cortical Atrophy (PCA, and Dysexecutive-type Alzheimer's Disease (AD.This retrospective case series analysis of 678 comprehensive neuropsychological assessments compared rates of self-reported LD between dementia patients diagnosed with Typical AD and those diagnosed with Atypical Dementia. 105 cases with neuroimaging or CSF data available and at least one neurology follow-up were identified as having been diagnosed by the neuropsychologist with any form of neurodegenerative dementia. These cases were subject to a consensus diagnostic process among three dementia experts using validated clinical criteria for AD and PPA. LD was considered Probable if two or more statements consistent with prior LD were documented within the Social & Developmental History of the initial neuropsychological evaluation.85 subjects (Typical AD n=68, Atypical AD n=17 were included in the final analysis. In logistic regression models adjusted for age, gender, handedness, education and symptom duration, patients with Probable LD, compared to patients without Probable LD, were significantly more likely to be diagnosed with Atypical Dementia vs. Typical AD (OR 13.1, 95% CI 1.3-128.4. All three of the L-PPA cases reporting a childhood LD endorsed childhood difficulty with language. By contrast, both PCA cases reporting Probable childhood LD endorsed difficulty with attention and/or math.In people who develop dementia, childhood LD may predispose to atypical phenotypes. Future studies are required to confirm whether atypical neurodevelopment predisposes to regional-specific neuropathology in AD and other dementias.


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    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 , 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

  6. A retrospective review of visual outcome and complications in the treatment of retinoblastoma.

    LENUS (Irish Health Repository)

    O'Doherty, M


    The aim of this study was to look at the visual outcome and treatment complications of children diagnosed with Retinoblastoma during the years 1985-2003 inclusive. A retrospective review of all patients records was performed. Patient characteristics, treatment methods and complications were recorded. Twenty eight children presented to Temple street Hospital between 1985-2003. Six of these infants had bilateral tumours. The mean age at presentation was 23.7 months. Sixty-nine percent presented with Leucocoria, of these 33% also had a squint. The mean duration of symptoms was only known in 58% and this figure was approximately 19.8 months. Enucleation was performed in 24 eyes of 24 patients. Three patients required adjuvant chemotherapy post enucleation. Two eyes was treated with external beam radiation and one eye with plaque radiotherapy. One eye (second eye) was treated with systemic chemotherapy and radiation. Five eyes of three patients were treated with systemic chemotherapy followed by adjuvant Argon laser, cryotherapy and diode laser to each eye.The complications of each treatment group was recorded. The visual outcome in the salvaged eyes was favourable. There were no deaths recorded. Though chemotherapy with adjuvant local treatments provide adequate treatment for early tumours, enucleation still plays a major role in the treatment of Retinoblastoma. The total eye salvage rate in this study was 29% with an enucleation rate of 90% in unilateral cases and 33% in bilateral cases. Sixty-six percent of bilateral eyes affected were salvaged. Seventy-one percent of tumours were diagnosed after a parent noticed a gross abnormality of the eye. This highlights the possible need for screening for retinoblastoma in the infant population.

  7. Bipartite Medial Cuneiform: Case Report and Retrospective Review of 1000 Magnetic Resonance (MR Imaging Studies

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    Geraldine H. Chang


    Full Text Available Objective. To present a unique case report of a Lisfranc fracture in a patient with a bipartite medial cuneiform and to evaluate the prevalence of the bipartite medial cuneiform in a retrospective review of 1000 magnetic resonance (MR imaging studies of the foot. Materials and Methods. Case report followed by a retrospective review of 1000 MR imaging studies of the foot for the presence or absence of a bipartite medial cuneiform. Results. The incidence of the bipartite medial cuneiform is 0.1%. Conclusion. A bipartite medial cuneiform is a rare finding but one with both clinical and surgical implications.

  8. Metamemory prediction accuracy for simple prospective and retrospective memory tasks in 5-year-old children. (United States)

    Kvavilashvili, Lia; Ford, Ruth M


    It is well documented that young children greatly overestimate their performance on tests of retrospective memory (RM), but the current investigation is the first to examine children's prediction accuracy for prospective memory (PM). Three studies were conducted, each testing a different group of 5-year-olds. In Study 1 (N=46), participants were asked to predict their success in a simple event-based PM task (remembering to convey a message to a toy mole if they encountered a particular picture during a picture-naming activity). Before naming the pictures, children listened to either a reminder story or a neutral story. Results showed that children were highly accurate in their PM predictions (78% accuracy) and that the reminder story appeared to benefit PM only in children who predicted they would remember the PM response. In Study 2 (N=80), children showed high PM prediction accuracy (69%) regardless of whether the cue was specific or general and despite typical overoptimism regarding their performance on a 10-item RM task using item-by-item prediction. Study 3 (N=35) showed that children were prone to overestimate RM even when asked about their ability to recall a single item-the mole's unusual name. In light of these findings, we consider possible reasons for children's impressive PM prediction accuracy, including the potential involvement of future thinking in performance predictions and PM.

  9. Diabetic ketoacidosis in children: an 11-year retrospective in Surabaya, Indonesia

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    Nur Rochmah


    Full Text Available Background Diabetic ketoacidosis (DKA is a complication of type I diabetic mellitus (TIDM. Early recognition and prompt treatment can reduce mortality. Objective To evaluate the profiles of patients with diabetic ketoasidosis in Dr. Soetomo Hospital, Surabaya, Indonesia. Methods Retrospective medical records of patients admitted to the pediatric intensive care unit with DKA in Dr. Soetomo Hospital, Surabaya, Indonesia from January 2002 to June 2013 were reviewed. The data collected included clinical parameters, laboratory and imaging results, predisposing factors, complications and outcomes. Results During an 11 years period, there were 58 cases of DKA in children with T1DM. Eighteen subjects (31% were boys. The severity of DKA was classified as follows: mild 13 (22.4%, moderate 23 (39.7%, and severe DKA 22 (37.9%. Recurrent DKA was diagnosed in 24 (41.4% patients. Common clinical profiles recorded were dehydration 46 (79.3%, malaise 37 (63.8%, decreased consciousness 35 (60.3%, dyspnea 27 (46.6%, vomiting 26 (44.8%, fever 25 (43.1%, seizure 13 (22.4%, and decreased body weight 9 (15.5%. Laboratory results observed were as folllows: hyponatremia 19 (32.8%, hyperkalemia 12 (20.7% and acute renal failure 3 (5.2%. Head CT scans showed that 2 (3.4% patients suffered from cerebral edema. Infections, as triggers of DKA, were found in 12 (20.6% patients: 4 caries and periodontitis, 3 urinary tract infections, 2 acute diarrhea, 2 acute pharyngitis, and 1 otitis externa. Four out of 24 patients with recurrent DKA failed to take their insulin dose prior to DKA. The average of length of patient stay in the PICU was 3.26 (SD 3.50 days. No patients died during the study. Conclusion Dehydration is the most common clinical profile of DKA in our study. More than half of the patients suffer from moderate to severe DKA.

  10. Diabetic ketoacidosis in children: an 11-year retrospective in Surabaya, Indonesia

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    Nur Rochmah


    Full Text Available Background Diabetic ketoacidosis (DKA is a complication of type I diabetic mellitus (TIDM. Early recognition and prompt treatment can reduce mortality. Objective To evaluate the profiles of patients with diabetic ketoasidosis in Dr. Soetomo Hospital, Surabaya, Indonesia. Methods Retrospective medical records of patients admitted to the pediatric intensive care unit with DKA in Dr. Soetomo Hospital, Surabaya, Indonesia from January 2002 to June 2013 were reviewed. The data collected included clinical parameters, laboratory and imaging results, predisposing factors, complications and outcomes. Results During an 11 years period, there were 58 cases of DKA in children with T1DM. Eighteen subjects (31% were boys. The severity of DKA was classified as follows: mild 13 (22.4%, moderate 23 (39.7%, and severe DKA 22 (37.9%. Recurrent DKA was diagnosed in 24 (41.4% patients. Common clinical profiles recorded were dehydration 46 (79.3%, malaise 37 (63.8%, decreased consciousness 35 (60.3%, dyspnea 27 (46.6%, vomiting 26 (44.8%, fever 25 (43.1%, seizure 13 (22.4%, and decreased body weight 9 (15.5%. Laboratory results observed were as folllows: hyponatremia 19 (32.8%, hyperkalemia 12 (20.7% and acute renal failure 3 (5.2%. Head CT scans showed that 2 (3.4% patients suffered from cerebral edema. Infections, as triggers of DKA, were found in 12 (20.6% patients: 4 caries and periodontitis, 3 urinary tract infections, 2 acute diarrhea, 2 acute pharyngitis, and 1 otitis externa. Four out of 24 patients with recurrent DKA failed to take their insulin dose prior to DKA. The average of length of patient stay in the PICU was 3.26 (SD 3.50 days. No patients died during the study. Conclusion Dehydration is the most common clinical profile of DKA in our study. More than half of the patients suffer from moderate to severe DKA. [Paediatr Indones. 2015;55:40-3.].

  11. A retrospective analysis of the characteristics, treatment and follow-up of 26 odontomas in Greek children. (United States)

    Iatrou, Ioannis; Vardas, Emmanouil; Theologie-Lygidakis, Nadia; Leventis, Minas


    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 & 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.

  12. 76 FR 66235 - Bar Code Technologies for Drugs and Biological Products; Retrospective Review Under Executive... (United States)


    ... Biological Products; Retrospective Review Under Executive Order 13563; Request for Comments AGENCY: Food and... ] certain human drug products and biological products to have a bar code. Information submitted can help FDA... technologies for the identification, including the unique identification, of drugs and biological products....

  13. Insertion of balloon retained gastrostomy buttons: a 5-year retrospective review of 260 patients.

    LENUS (Irish Health Repository)

    Power, Sarah


    Radiologically inserted gastrostomy (RIG) is an established way of maintaining enteral nutrition in patients who cannot maintain nutrition orally. The purpose of this study was to evaluate the safety and efficacy of primary placement of a wide bore button gastrostomy in a large, varied patient population through retrospective review.

  14. Metastatic Brain Tumors: A Retrospective Review in East Azarbyjan (Tabriz

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    Zinat Miabi


    Full Text Available A set of one hundred and twenty nine patients with known primary malignancy and suspected brain metastasis was reviewed in present study. The patients were selected among patients presented to the MRI section of Imam Khomeini Hospital or a private MRI center in Tabriz (Iran. Primary tumor site, clinical manifestations, number and site of lesions were identified in this patient population. The primary tumor site was breast in 55 patients (42.6%, followed by lung (40.3%, kidney (7.7%, colorectal (4.6%, lymphoma (3.1% and melanoma (1.5%. Most patients were presented with features of increased intracranial pressure (headaches and vomiting, seizures and focal neurologic signs. Single brain metastasis occurred in 16.3% of patients, while multiple lesions accounted for 83.7% of patients. Ninety seven patients had supratentorial metastases (75.2%. Twenty cases (15.5% had metastases in both compartments. Infratentorial lesions were observed only in twelve patients (9.3%.

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

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    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.

  16. Ovarian metastasis in colorectal cancer: retrospective review of 180 cases

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    Omranipour R


    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Routine oophorectomy in women with colorectal cancer is under debate, the aim of this study is to determine incidence, clinicopathologic features and prognostic factors of ovarian involvement in primary colorectal cancer (CRC and to clear the role of prophylactic oophorectomy."n"nMethods: Data from primary CRC women treated between years 1990 and 2004 were retrieved and clinical and pathologic features of those who had undergone oophorectomy during CRC surgery were reviewed."n"nResults: One hundred eighty cases (mean age 47.5 years were included. In 120(66.6%, ovaries were preserved and 60(33.3% cases underwent bilateral oophorectomy in addition to primary CRC resection. Reasons for oophorectomy were prophylactic in 22(36.6%, abnormal morphology in 35(58.3%, and undetermined in 3(5% cases. There were five metastatic carcinomas, eight primary ovarian tumors and 47 normal ovaries in pathologic evaluation. No complication directly related to oophorectomy was noted. Patients with ovarian metastases had higher stages of tumor. Ovarian metastases were not related to menstrual status, CRC location, size, differentiation, and mucin production, as well as abnormal morphology of ovary. The global prevalence of

  17. CFS in Children and Adolescent: Ten Years of Retrospective Clinical Evaluation

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    Irene Elgen


    Full Text Available Aim. To estimate number of children being diagnosed with chronic fatigue syndrome (CFS. Methods. For a period of 10 years (2002–2011 data from children being referred for fatigue symptoms were collected retrospectively. Results. Thirty-seven children were referred. Four were excluded due to incorrect coding. Six (18% patients received other diagnoses at the end of evaluation time. Of the 27 who received the diagnosis G93.3, four had a previous chronic illness, while 23 patients were previously healthy. All patients reported onset of fatigue symptom in relation to an infection, and all tested positive for IgG to either Epstein-Barr virus, cytomegalovirus or borrelia, indicating previous infection. There were 16 (59% boys among the 27 patients. The mean age at the debut of fatigue symptoms was 141 months (SD 30 for boys and 136 months (SD 31 for girls, respectively. Being underweight, defined as BMI < 17.5, was found in 12 (44% patients. Conclusion. An increasing number of children and adolescents are evaluated for CFS. The clinical assessment of children and adolescents with possible CFS need systematically evaluation. Nutritional status, possible eating disorder, and psychosocial issues need to be addressed and evaluated carefully. A multidisciplinary approach is essential when assessing CFS in children and adolescents. There is a need for European guidelines.

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

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    Srinivasan S, Madhusudhan NS


    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.

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

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    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. Diabetic ketoacidosis in children: an 11-year retrospective in Surabaya, Indonesia


    Nur Rochmah; Muhammad Faizi; Netty Harjantien


    Background Diabetic ketoacidosis (DKA) is a complication of type I diabetic mellitus (TIDM). Early recognition and prompt treatment can reduce mortality. Objective To evaluate the profiles of patients with diabetic ketoasidosis in Dr. Soetomo Hospital, Surabaya, Indonesia. Methods Retrospective medical records of patients admitted to the pediatric intensive care unit with DKA in Dr. Soetomo Hospital, Surabaya, Indonesia from January 2002 to June 2013 were reviewed. The data collected ...

  1. Seven-year retrospective analysis of the myopic control effect of orthokeratology in children: a pilot study

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    Alan Kwok-Hei Mok


    Full Text Available Alan Kwok-Hei Mok1,2, Cindy Sin-Ting Chung11Eye’ni, Hong Kong, People’s Republic of China; 2Department of Anatomy, LiKaShing Faculty of Medicine, The University of Hong Kong, Hong Kong, People’s Republic of ChinaObjectives: To investigate retrospectively the difference in myopia progression, over about 7 years, between two groups of Hong Kong Chinese myopic children who wore overnight orthokeratology lenses or single-vision spectacles.Methods: A total of 238 records of children wearing overnight orthokeratology lenses or single-vision spectacles from Eye’ni optical shop (Hong Kong between January 1999 and December 2009 were reviewed. Refractive and central corneal curvature data with 6-year or a longer follow-up period of 70 patients were retrieved: 34 children (15 boys and 19 girls, aged 9.2 ± 1.8 years wore orthokeratology lenses and 36 (20 boys and 16 girls, aged 10.2 ± 2.0 years wore spectacles. Myopic progression was determined as the change of myopia from the baseline to the final visit.Results: No statistically significant differences (P > 0.05 in age, central flat corneal curvatures, baseline refractive error, or follow-up period were observed between the two groups. Average myopic progression of the overnight orthokeratology contact lens cohort (-0.37 ± 0.49 D was significantly less (P < 0.001 than of the single-vision spectacle group (-2.06 ± 0.81 D over about 7 years.Conclusion: Our preliminary 7-year data support the claim that overnight orthokeratology contact lenses may be a feasible clinical method for myopic progression control. Prospective and randomized investigations are warranted to overcome the limitations of this retrospective study.Keywords: myopia, contact lens, orthokeratology, myopia progression

  2. [Non-organic failure to thrive: retrospective study in hospitalized children]. (United States)

    Genero, A; Moretti, C; Fait, P; Guariso, G


    To evaluate incidence, clinical and laboratoristic values of patients with non organic failure to thrive (NOFTT), a retrospective study (January 1987-January 1991) among inpatient children of Department of Pediatrics of University of Padova was made. Thirty-six children (23 females and 13 males) aged 10 days to 22 months were selected. The incidence of NOFTT was 1.15% of total admission for the same age; it was more frequent in females than in males (F:M = 1.8:1) and it was more represented in children 0-3 months and 10-12 months aged. The main data have been: breast-feeding very frequent but early stopped (45% within the first month of life); administration of special formulas (soy milk, hydrolisate, hypoallergenic formulas) in 25% of cases. Specific symptoms in different ages: regurgitation, sucking problems and dysphagia more present in children less than 3 months, and inappetence and/or food refusal more represented in children more than 3 months. Ematologic and other lab values were totally normal.

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

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    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.

  4. Associations between preschool attendance and developmental impairments in pre-school children in a six-year retrospective survey

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    Baune Bernhard T


    Full Text Available Abstract Background Many school-aged children suffer physical and mental impairments which can adversely affect their development and result in significant morbidity. A high proportion of children in western countries attend pre-school, and it is likely that the preschool environment influences the prevalence and severity of these impairments. Currently there is insufficient data available on the prevalence of these impairments and their causal associations. The influence that location of a pre-school and the duration of preschool attendance have on the prevalence of these impairments is not known. Methods In a retrospective survey spanning six years (1997–2002 we reviewed the records of 6,230 preschool children who had undergone routine school entry assessments. These children had been assessed utilising a modified manual of the "Bavarian Model" for school entry examinations. This model outlines specific criteria for impairments of motor, cognitive, behavioural and psychosocial functioning. Prevalence rates for physical and behavioural impairments were based on the results of these assessments. The relationship between the prevalence of impairments and the duration of preschool attendance and the location of the preschool attended was estimated utilizing logistic regression models. Results We found that 20.7% of children met the criteria for at least one type of impairment. Highest prevalence rates (11.5% were seen for speech impairments and lowest (3.5% for arithmetic impairments. Boys were disproportionately over represented, with 25.5% meeting the criteria for impairment, compared to 13.0% for girls. Children who had attended preschool for less than one year demonstrated higher rates of impairment (up to 19.1% for difficulties with memory, concentration or perseverance compared to those who had attended for a longer duration (up to 11.6% for difficulties with pronouncation. Children attending preschool in an urban location had slightly

  5. A Review Of Mediastinal Tumors In Children

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    Ahmadi J


    Full Text Available Background: Mediastinum includes the vital organs like the heart the major respiratory passages and the major vessels due to this vicinity, the masses of this area with malignant or benign etiology or cause systemic diseases such as metastatic malignancies or granulomatous reactions can be potentially fatal. Materials and Methods: According to the priority of the problem, a ten years comprehensive retrospectively study of mediastinal masses in children was conducted In children medical Center (Tehran University from the points of view of incidence, clinical manifestations and diagnostic and treating ways. Results & Conclusion: In our study there were 34 patients from 1992-2002 who were reviewed. No differences between boys and girls with mediastinal masses were observrd. The most prevalence age for mediastinal tumors was form 5-10 years (38%. The most prevalent sign was fever (53% and the most common symptom was coughing (44.4%. Basesd on this research, mediastinal masses have been the most prevalent finding in chest radiography (53.8%. CT-Scan with double contrast was recognized as the most common and easiest ways for diagnosing masses. Anterior masses were the most common finding in our study (41.7%. Most of these masses were removed by surgery and the most common operation in our patients was thoracotomy and removing the masses (61.7%. Lymphoma was the most common masses (35.2% and masses with neural orgins occupy the second grade. According to available documents and with regard to mean follow up of patients in 3.2 years the rate of survival was 54%.

  6. Incidence of platelet dysfunction by thromboelastography-platelet mapping in children supported with ECMO: A Pilot Retrospective Study.

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    Arun eSaini


    Full Text Available Background: Bleeding complications are common and decrease the odds of survival in children supported with extracorporeal membrane oxygenation (ECMO. The role of platelet dysfunction on ECMO-induced coagulopathy and resultant bleeding complications is not well understood. The primary objective of this pilot study was to determine the incidence and magnitude of platelet dysfunction according to thromboelastography (TEG®-platelet mapping (PM testing. Methods: Retrospective chart review of children <18 years old who required ECMO at a tertiary level hospital. We collected TEG®-PM and conventional coagulation tests data. We also collected demographic, medications, blood products administered, and clinical outcome data. We defined severe platelet dysfunction as less than 50 % aggregation in response to an agonist. Results: We identified 24 out of 46 children on ECMO, who had TEG®-PM performed during the study period. We found the incidence of severe bleeding was 42%, and mortality was 54% in our study cohort. In all samples measured, severe qualitative platelet dysfunction was more common for adenosine diphosphate (ADP-mediated aggregation (92% compared to arachidonic acid (AA-mediated aggregation (75%, (p=0.001. Also, ADP-mediated percent of platelet aggregation was significant lower than AA-mediated platelet aggregation (15% [IQR 2.8-48] vs 49% [IQR 22-82.5], p<0.001. There was no difference in kaolin-activated heparinase TEG® parameters between the bleeding group and the non-bleeding group. Only absolute platelet count and TEG®-PM had increased predictive value on receiver operating characteristics analyses for severe bleeding and mortality compared to ACT. Conclusions: We found frequent and severe qualitative platelet dysfunction on TEG®-PM testing in children on ECMO. Larger studies are needed to determine if the assessment of qualitative platelet function by TEG®-PM can improve prediction of bleeding complications for children on ECMO.

  7. Orbital complications secondary to acute sinusitis– A 10 years retrospective review



    Abstract Introduction: Orbital complication may accompany acute sinusitis in all age, commonly preseptal or orbital cellulitis. Aim: To evaluate the clinical presentation, management, and outcome of orbital complications of sinusitis in patients treated at our institution. Methods: A case study of retrospective review of 10 patients with orbital complications secondary to acute sinusitis was conducted in our centre over a 10-years period. The clinical presentation, relevant investigations, m...

  8. A Multicenter Retrospective Survey regarding Diabetic Ketoacidosis Management in Italian Children with Type 1 Diabetes

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    Stefano Zucchini


    Full Text Available We conducted a retrospective survey in pediatric centers belonging to the Italian Society for Pediatric Diabetology and Endocrinology. The following data were collected for all new-onset diabetes patients aged 0–18 years: DKA (pH < 7.30, severe DKA (pH < 7.1, DKA in preschool children, DKA treatment according to ISPAD protocol, type of rehydrating solution used, bicarbonates use, and amount of insulin infused. Records (n=2453 of children with newly diagnosed diabetes were collected from 68/77 centers (87%, 39 of which are tertiary referral centers, the majority of whom (n=1536, 89.4% were diagnosed in the tertiary referral centers. DKA was observed in 38.5% and severe DKA in 10.3%. Considering preschool children, DKA was observed in 72%, and severe DKA in 16.7%. Cerebral edema following DKA treatment was observed in 5 (0.5%. DKA treatment according to ISPAD guidelines was adopted in 68% of the centers. In the first 2 hours, rehydration was started with normal saline in all centers, but with different amount. Bicarbonate was quite never been used. Insulin was infused starting from third hour at the rate of 0.05–0.1 U/kg/h in 72% of centers. Despite prevention campaign, DKA is still observed in Italian children at onset, with significant variability in DKA treatment, underlying the need to share guidelines among centers.

  9. A Multicenter Retrospective Survey regarding Diabetic Ketoacidosis Management in Italian Children with Type 1 Diabetes (United States)

    Zucchini, Stefano; Scaramuzza, Andrea E.; Bonfanti, Riccardo; Buono, Pietro; Cardella, Francesca; Cauvin, Vittoria; Cherubini, Valentino; Chiari, Giovanni; d'Annunzio, Giuseppe; Frongia, Anna Paola; Iafusco, Dario; Maltoni, Giulio; Patera, Ippolita Patrizia; Toni, Sonia; Tumini, Stefano; Rabbone, Ivana; Diabetes Study Group of the Italian Society for Pediatric Endocrinology and Diabetology (ISPED)


    We conducted a retrospective survey in pediatric centers belonging to the Italian Society for Pediatric Diabetology and Endocrinology. The following data were collected for all new-onset diabetes patients aged 0–18 years: DKA (pH < 7.30), severe DKA (pH < 7.1), DKA in preschool children, DKA treatment according to ISPAD protocol, type of rehydrating solution used, bicarbonates use, and amount of insulin infused. Records (n = 2453) of children with newly diagnosed diabetes were collected from 68/77 centers (87%), 39 of which are tertiary referral centers, the majority of whom (n = 1536, 89.4%) were diagnosed in the tertiary referral centers. DKA was observed in 38.5% and severe DKA in 10.3%. Considering preschool children, DKA was observed in 72%, and severe DKA in 16.7%. Cerebral edema following DKA treatment was observed in 5 (0.5%). DKA treatment according to ISPAD guidelines was adopted in 68% of the centers. In the first 2 hours, rehydration was started with normal saline in all centers, but with different amount. Bicarbonate was quite never been used. Insulin was infused starting from third hour at the rate of 0.05–0.1 U/kg/h in 72% of centers. Despite prevention campaign, DKA is still observed in Italian children at onset, with significant variability in DKA treatment, underlying the need to share guidelines among centers. PMID:26649321

  10. Respiratory management of pediatric patients with spinal cord injuries: retrospective review of the duPont experience. (United States)

    Padman, Raj; Alexander, Michael; Thorogood, Christine; Porth, Susan


    Pulmonary complications contribute to morbidity and mortality in spinal cord injuries (SCIs). A retrospective review of 20 years of experience with tracheostomy- and ventilator-dependent SCI children is presented. The authors developed and analyzed a database of 47 children (average age = 11.4 years). Of the patients, 27% had concomitant brain injuries, 6% had prior histories of reactive airway disease, and 2% had thoracic fractures. Injuries were caused by motor vehicle accidents (53%); gunshot wounds (19%); sports-related accidents (19%); and vascular injuries, transverse myelitis, or spinal tumors (8%). Of the injuries, 52% were high level (C1 to C2) and 48% were mid- or low level (C3 to C5). Two groups were analyzed for demographic information. Complications included tracheitis, atelectasis, and pneumonia. Mean tidal volume was 14 cm2/kg (maximum = 22 cm2/kg). Bedside lung function parameters were attempted to assess readiness and the rapidity of weans. T-piece sprints were used to successfully wean 63% of patients. Successfully weaned patients were compared with those not weaned. No deaths or readmissions for late-onset respiratory failure postwean occurred. The authors' clinical impression favors higher tidal volumes and aggressive bronchial hygiene to minimize pulmonary complications and enhance weaning. Successfully weaned patients had fewer complications. A critical pathway for respiratory management of SCI children is presented.

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

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    Inayati Dyah


    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

  12. Psoriasis in Children: A Review. (United States)

    Balato, Anna; Scalvenzi, Massimiliano; Cirillo, Teresa; Gallo, Lucia; Ayala, Fabio; Balato, Nicola


    Psoriasis is a chronic, immune-mediated, inflammatory systemic disease which targets primarily the skin. It presents a genetic basis, affecting 1 to 3% of the white population. Nevertheless, the existence of two psoriasis incidence peaks has been suggested (one in adolescence before 20 years of age and another in adulthood) onset may occur at any age, including childhood and adolescence, in which its prevalence ranges between 0.7% and 1.2%. As for adult psoriasis, pediatric psoriasis has recently been associated with obesity, metabolic syndrome, increased waist circumference percentiles, and metabolic laboratory abnormalities, warranting early monitoring and lifestyle modifications. In addition, due to psoriasis chronic nature and frequently occurring relapses, psoriatic patients tend to have an impaired quality of life, often requiring long-term treatment. Therefore, education of both pediatric patients and their parents is essential to successful and safe disease management. However, systemic treatment of children is challenging as the absence of standardized guidelines and the fact that evidence-based data form randomized controlled trials are very limited. This review shows an overview of the current understanding of the pathogenesis, comorbidities, differential diagnosis, treatment and prevention of pediatric psoriasis, also presenting with an emphasis on the necessity of an integrated treatment approach involving different specialists such as dermatologist, pediatricians, rheumatologists, etc.

  13. Sedation of children for auditory brainstem response using ketamine-midazolam-atropine combination - a retrospective analysis. (United States)

    Bocskai, Tímea; Németh, Adrienne; Bogár, Lajos; Pytel, József


    Authors investigated sedation quality in children for auditory brainstem response testing. Two-hundred and seventy-six sedation procedures were retrospectively analyzed using recorded data focusing on efficacy of sedation and complications. Intramuscular ketamine-midazolam-atropine combination was administered on sedation preceded by narcotic suppository as pre-medication. On using the combination vital parameters remained within normal range, the complication rate was minimal. Pulse rate, arterial blood pressure and pulse oxymetry readings were stable, hypoventilation developed in 4, apnoea in none of the cases, post-sedation agitation occurred in 3 and nausea and/or vomiting in 2 cases. Repeated administration of narcotic agent was necessary in a single case only. Our practice is suitable for the sedation assisting hearing examinations in children. It has no influence on the auditory brainstem testing, the conditions necessary for the test can be met entirely with minimal side-effects. Our practice provides a more lasting sedation time in children during the examination hence there is no need for the repetition of the narcotics.

  14. Promoting Children's Health with Digital Games: A Review of Reviews. (United States)

    Parisod, Heidi; Pakarinen, Anni; Kauhanen, Lotta; Aromaa, Minna; Leppänen, Ville; Liukkonen, Tapani N; Smed, Jouni; Salanterä, Sanna


    Effective, evidence-based, and interesting methods are needed for children's health promotion. Digital games can be such a method, but there is need for a summary of the evidence on the effectiveness of digital games in promoting children's health. The aim of this review of reviews was to evaluate the quality of systematic reviews, to summarize the evidence in systematic reviews and reviews related to the effectiveness of digital games in children's health promotion, and to identify gaps in knowledge. A systematic literature search was conducted in May-August 2013 from relevant databases, and 1178 references were found. In total, 15 systematic reviews and reviews met the inclusion criteria. Most of the systematic reviews were found to be medium quality on the AMSTAR checklist. Most commonly, systematic reviews and reviews evaluated active videogames. According to the results, evidence of the highest level and quality seems to support an increase in physical activity to light to moderate levels and energy expenditure, especially when playing active videogames that require both upper and lower body movements. In addition, sedentary games were shown to have potential in children's health education, especially in supporting changes in asthma- and diabetes-related behavior and in dietary habits. However, there are still several gaps in the knowledge. There is a need for further high-quality systematic reviews and research in the field of health games.

  15. Occipital nerve blocks in postconcussive headaches: a retrospective review and report of ten patients. (United States)

    Hecht, Jeffrey S


    Headaches are common following traumatic brain injuries of all severities. Pain generators may be in the head itself or the neck. Headache assessment is discussed. Diagnosis and treatment of cervical headaches syndromes and, in particular, occipital neuralgia are reviewed. Finally, a retrospective study of 10 postconcussive patients with headaches who were treated with greater occipital nerve blocks is presented. Following the injection(s), 80% had a "good" response and 20% had a "partial" response. Occipital nerve block is a useful diagnostic and treatment modality in the setting of postconcussive headaches.


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    Full Text Available INTRODUCTION: Acute accidental poisoning in children is a big problem anywhere in the world. Studies done elsewhere in India showed a wide range of incidence of the problem. Hence, it was felt important to study its magnitude and associated characteristics as of now. OBJECTIVE: The current study was taken up to know the magnitude among children admitted in JNIMS, Imphal which is a newly established medical institute and also to study the characteristics like age, gender, type of poison, duration of hospital-stay and outcome of the cases. MATERIALS & METHODS: Retrospective data of all acute accidental poisoning cases among children admitted in the Pediatrics Ward, JNIMS, Imphal during the period July 2008 - December 2013 were analyzed by using descriptive statistics. RESULT: Of all the 13,663 children admitted, 148 cases were because of acute accidental poisoning giving an incidence rate of 1.08%. The male is to female ratio was 1.31:1. The last three years of the study period showed a slightly increasing trend in the incidence. Children aged 1-4 years were the most commonly affected (65.54%. Kerosene oil was by far the commonest (42% of all the poisonous substances consumed. Food poisoning, poisoning with organic compounds, poisoning with medicinal drugs and poisoning with corrosives comprised 21%, 12%, 9% and 8% respectively of all the cases. There was no mortality. DISCUSSION: The incidence rate of 1.08% as found out from the current study was on the lower side as compared to reports of previous studies done in other parts of the country. Yet, it was two-fold of the incidence reported from RIMS which is situated in the same State. Parental negligence in storing poisonous substances in the household was implicated. They need to be made aware for keeping harmful poisonous substances in safe places out of the reach of children. CONCLUSION: Community-based studies are recommended for estimating more accurately the magnitude of the problem in the

  17. Monosomy 7 and deletion 7q in children and adolescents with acute myeloid leukemia: an international retrospective study

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    Hasle, Henrik; Alonzo, Todd A; Auvrignon, A


    Monosomy 7 (-7) and deletion 7q \\del(7q)] are rare in childhood acute myeloid leukemia (AML). We retrospectively collected data on 258 children with AML or refractory anemia with excess blasts in transformation (RAEB-T) and -7 or del(7q) with or without other cytogenetic aberrations \\+/- other...

  18. Technology-dependency among patients discharged from a children's hospital: a retrospective cohort study

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    Sharp Virginia


    Full Text Available Abstract Background Advances in medical technology may be increasing the population of children who are technology-dependent (TD. We assessed the proportion of children discharged from a children's hospital who are judged to be TD, and determined the most common devices and number of prescription medications at the time of discharge. Methods Chart review of 100 randomly selected patients from all services discharged from a children's hospital during the year 2000. Data were reviewed independently by 4 investigators who classified the cases as TD if the failure or withdrawal of the technology would likely have adverse health consequences sufficient to require hospitalization. Only those cases where 3 or 4 raters agreed were classified as TD. Results Among the 100 randomly sampled patients, the median age was 7 years (range: 1 day to 24 years old, 52% were male, 86% primarily spoke English, and 54% were privately insured. The median length of stay was 3 days (range: 1 to 103 days. No diagnosis accounted for more than 5% of cases. 41% were deemed to be technology dependent, with 20% dependent upon devices, 32% dependent upon medications, and 11% dependent upon both devices and medications. Devices at the time of discharge included gastrostomy and jejeunostomy tubes (10%, central venous catheters (7%, and tracheotomies (1%. The median number of prescription medications was 2 (range: 0–13, with 12% of cases having 5 or more medications. Home care services were planned for 7% of cases. Conclusion Technology-dependency is common among children discharged from a children's hospital.

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

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    Anna Marie Nathan

    Full Text Available AIM: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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

  20. Clozapine Treatment and Cannabis Use in Adolescents with Psychotic Disorders – A Retrospective Cohort Chart Review (United States)

    Tang, Sephora M.; Ansarian, Aylar; Courtney, Darren B.


    Objectives To examine the association between clozapine treatment and frequency of cannabis use in adolescents with co-occurring psychotic and cannabis use disorder in a retrospective cohort chart review. Method We conducted a retrospective cohort chart review of patients diagnosed with a psychotic disorder and concurrent cannabis use disorder admitted to a tertiary care youth inpatient unit from 2010–2012. Longitudinal exposure and outcome data was coded month-by-month. Frequency of cannabis use was measured using a 7-point ordinal scale. Severity of psychosis was measured on a 3-point ordinal scale. Mixed effects regression modeling was used to describe the relationship between exposure and outcome variables. Results Thirteen patients had exposure to clozapine and fourteen had no exposure to clozapine. Cannabis use decreased in patients treated with clozapine, compared to patients treated with other antipsychotics (OR 2.8; 95% CI 0.97–7.9). Compared to no medication, clozapine exposure was associated with significantly less cannabis use (OR 7.1; 95% CI 2.3–22.3). Relative to treatment with other antipsychotics, clozapine exposure was significantly associated with lower severity of psychotic symptoms (OR 3.7; 95% CI 1.2–11.8). Conclusions Clozapine may lead to decreased cannabis use and psychotic symptoms in adolescents with concurrent psychosis and substance use. Clinical trials are warranted. PMID:28331504

  1. Schwannomas in the head and neck: retrospective analysis of 21 patients and review of the literature

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    Erwin Langner

    Full Text Available CONTEXT AND OBJECTIVE: Schwannomas are benign neoplasms of the peripheral nerves originating in the Schwann cells. According to their cellularity, they can be subdivided into Antoni A or Antoni B types. They are rare and usually solitary, with clearly delimited capsules. They occur in the head and neck region in only 25% of the cases, and may be associated with Von Recklinghausen's disease. The present study retrospectively analyzed some data on this disease in the head and neck region and reviewed the literature on the subject. DESIGN AND SETTING: Retrospective study at Head and Neck Service, Universidade Estadual de Campinas. METHODS: Data on 21 patients between 1980 and 2003 were reviewed. The sites of cervical schwannomas and the intraoperative, histopathological and postoperative clinical status of these cases were studied. Diagnostic methods, type of surgery and association with neurofibromatosis were evaluated. RESULTS: The patients' ages ranged from 16 to 72 years. Four patients had a positive past history of type I neurofibromatosis or Von Recklinghausen's disease. The nerves affected included the brachial and cervical plexuses, vagus nerve, sympathetic chain and lingual or recurrent laryngeal nerve. The nerve of origin was not identified in six cases. Tumor enucleation was performed in 16 patients; the other five required more extensive surgery. CONCLUSION: Schwannomas and neurofibromas both derive from Schwann cells, but are different entities. They are solitary lesions, except in Von Recklinghausen's disease. They are generally benign, and rarely recur. The recommended surgical treatment is tumor enucleation.

  2. Craniofacial implants at a single centre 2005-2015: retrospective review of 451 implants. (United States)

    Elledge, R; Chaggar, J; Knapp, N; Martin, T; White, N; Evriviades, D; Edmondson, S; Parmar, S


    Craniofacial endosseous implants are regularly used to support prostheses in the rehabilitation of complex defects, but reported success rates vary. To review our own clinical practice over 10 years, and particularly to examine the impact of radiotherapy and the timing of placement on the survival of implants, we retrospectively audited the records for all patients who had endosseous implants for prosthetic rehabilitation in our unit between 2005 and 2015. We reviewed 167 records, which gave 451 implants, of which, 222 (49%) were auricular, 98 (22%) nasal, and 131 (29%) orbital. Most were placed after ablative operations for cutaneous malignancy (n=103 patients, 62%). The failure rate of implants placed in bone that was irradiated either before or after placement was significantly higher than that of those placed in non-irradiated bone (univariate analysis: 11% compared with 2%, pimplants at the time of ablation. Our findings seem to support this practice regardless of whether or not the patient will later require adjuvant radiotherapy.

  3. Clinical and pathological features of intracranial meningiomas in children: A retrospective analysis

    Institute of Scientific and Technical Information of China (English)

    Kun Yang; Lisheng He; Linsun Dai; Jian Chen; Zhixiong Lin


    BACKGROUND:The attack of meningiomas has sex and age differences.Previous studies indicated that children and adult patients had different clinical and pathological features.Due to the limitation of conditions and technique of diagnosis and treatment,some clinical and pathological features of meningiomas in children should be further recognized.OBJECTIVE:To summarize the clinical and pathological features in 15 children with intracranial meningiomas.DESIGN:A retrospective case analysis.SETTING:The hospitals which the first author had been working in.PARTIClPANTS:Fifteen children with intracranial meningiomas were selected from the hospitals the first author had been working in from June 1996 to June 2006.There were 9 boys and 6 gids,aged 1.8-15 years,with an average of 9.8 years.The duration from attack to diagnosis was 1 month to 2.5 years,with an average of 13months.Inclusive criteria:①Clinically diagnosed,operated and confirmed pathologically;②≤15 years;③The children and their relatives were all informed and agree with the detection.METHODS:The clinical manifestations,imaging data,preoperative diagnosis and misdiagnosis,site and size of tumor,operative treatment and pathological data were retrospectively summarized.Thirteen of 15 children with intracranial meningiomas were followed up by means of reexamination for 1-8 years.and the postoperative recurrence were observed.HAIN OUTCOME MEASURES:Clinical manifestations,imaging data,preoperative diagnosis and misdiagnosis,site and size of tumor,operative treatment,pathological data,recurrence conditions of 1 to 8 years follow-up.RESULTS:Thirteen of the 15 children with intracranial meningiomas were involved in the analysis of results.and 2 lost to the follow-up. ①The main clinical manifestations at diagnosis were headache in 11 cases(73%,11/5),vomiting in 8 cases(53%,8/15),papilledema in 9 cases(60%,9/15),hypopsia in 6 cases (40%,6/15),epilepsy in 5 cases(33%,5,15).hemiplegia in 4 cases(27%,4/15),cranial

  4. Diagnosis and treatment of the Pierre Robin sequence: results of a retrospective clinical study and review of the literature.

    NARCIS (Netherlands)

    Elzen, A. van der; Semmekrot, B.A.; Bongers, M.H.F.; Huygen, P.L.M.; Marres, H.A.M.


    We performed a retrospective study of all children with Pierre Robin sequence (PRS), admitted to our hospital from 1981-1998 in order to evaluate diagnosis, treatment and prognosis. Patients were divided into two categories: isolated PRS (group 1) and PRS plus, i.e. PRS as part of a more complex syn

  5. Oral and maxillofacial tumours in children: a review. (United States)

    Sato, M; Tanaka, N; Sato, T; Amagasa, T


    This retrospective review presents our experience of oral and maxillofacial tumours in children. The subjects were 250 children under the age of 15 years (out of a total of 2747 patients with oral and maxillofacial tumours), who were treated after histopathological confirmation of their diagnoses during the 28 years 1965-92. Diagnosis, incidence, and age at presentation were the main outcome measures and the results showed that 232 patients (93%) had benign tumours and 18 (7%) were malignant. The most common benign tumour was haemangioma (n = 69) and the most common malignant tumour sarcoma (n = 14). The most common odontogenic tumour was odontoma (n = 47) and non-odontogenic tumour ossifying fibroma (n = 5). The most common site of soft tissue tumours was the tongue (n = 65) and of bony tumours the mandible (n = 62). About a third of the tumours developed in patients between the ages of 6 and 11 years. Most of the angiomas developed in patients less than 6 years old, and most of the ameloblastomas in those over 12 years of age. Children accounted for 55% of patients with lymphangoma, 41% of those with odontoma, and 22% of those with haemangioma. It is concluded that most of these lesions were probably developmental malformations rather than neoplasms, and that the definition of oral and maxillofacial tumours in children should be reconsidered.

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

    Directory of Open Access Journals (Sweden)

    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

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

    DEFF Research Database (Denmark)

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

    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......, benefit more from intervention than children with good. Conclusions: Significant improvements in GDI, especially for patients with poor gait quality, were observed. The present study holds promise for future clinical interpretations, involving more patients, and possibly providing a tool...... 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 (

  8. A review of tuberculosis-related referrals among children in Ireland.

    LENUS (Irish Health Repository)

    Iroh Tam, P Y


    BACKGROUND: Immigration has been shown to have an increasingly important effect on the epidemiology of tuberculosis (TB) in developed countries. AIM: To review patterns of TB-related referrals to a paediatric infectious diseases clinic. METHODS: Retrospective chart review of TB-related referrals of children attending the Rainbow Clinic at OLCHC between 2003-2005. RESULTS: Forty-seven children were assessed: 18 referred from public health clinics, 5 from general practitioners, and 24 from paediatricians. Most common reason for referral was history of TB exposure (60%). Eighteen (38%) were female, 29 (62%) were male. Thirteen (28%) had latent TB, and 17 (36%) had active disease. Of children with TB disease, 25 (83%) were Caucasian Irish, and the remainder was African. Twenty-five children completed TB treatment and were discharged, and 2 (7%) were lost to follow-up. CONCLUSION: Our study highlights the problem of TB in children, the majority of whom are native to this country.

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

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    Anil Agarwal


    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.

  10. Methadone for the treatment of Prescription Opioids Dependence. A retrospective chart review. (United States)

    Barrio, Pablo; Ezzeldin, Mohamed; Bruguera, Pol; Pérez, Ana; Mansilla, Sara; Fàbrega, Marina; Lligoña, Anna; Mondón, Sílvia; Balcells, Mercè


    Prescription opioids (PO) addiction is increasing to an epidemic level. Few studies exist regarding its treatment. Although buprenorphine has been the mainstay so far, other treatment options might be considered, such as methadone. We conducted a retrospective assessment of all patients admitted to a psychiatry ward for PO detoxification using methadone between 2010 and 2013. The assessment and description was carried out during a 3-month follow-up period after their discharge. Although this is a retrospective chart review, our exploration included sociodemographic and treatment variables in addition to the abstinence rates for the whole sample. Eleven patients were included, mostly women (81.8%), with a median age of 50 years. The median duration of dependence was 8 years. Dependence on other substances and psychiatric comorbidities were high. Eight patients were monitored during three months. Of these, 7 (87.5%) were abstinent after that period. The results suggest that methadone deserves further exploration as a potentially efficacious treatment option for PO dependence.

  11. Retrospective chart review of duloxetine and pregabalin in the treatment of painful neuropathy. (United States)

    Mittal, Manoj; Pasnoor, Mamatha; Mummaneni, Reddiah B; Khan, Saud; McVey, April; Saperstein, David; Herbelin, Laura; Ridings, Larry; Wang, Yunxia; Dimachkie, Mazen M; Barohn, Richard J


    The primary aims of our study were to compare pregabalin and duloxetine in a neuromuscular clinic for diabetic neuropathic pain (DPN) and to study the effect of these medications in cryptogenic sensory polyneuropathy. We performed a retrospective chart review of 143 patients who were started on pregabalin or duloxetine during a 10-month period in a tertiary neuromuscular outpatient center for neuropathic pain. Duloxetine and pregabalin were started in 103 and 91 patients, respectively. Ninety-two patients tried only one of the two medications while both medications were used at different time periods in 51 patients. Follow-up was available for 87 patients on pregabalin and 89 patients on duloxetine. More patients with neuropathic pain reported an improvement with pregabalin (33%) than duloxetine (21%). Duloxetine (38%) had a higher frequency of side effects compared to pregabalin (30%). However, these differences between pregabalin and duloxetine were not statistically significant. Despite the study's limitations of retrospective design, these findings suggest that both pregabalin and duloxetine are probably effective for neuropathic pain, secondary to diabetes or cryptogenic sensory peripheral neuropathy in a tertiary care academic neuromuscular center. Prospective randomized controlled comparative effectiveness studies are required for both drugs in the treatment of neuropathic pain.

  12. A retrospective analysis of growth of the constructed condyle-ramus in children with hemifacial microsomia. (United States)

    Mulliken, J B; Ferraro, N F; Vento, A R


    A retrospective analysis of changes in costochondral rib grafts used to construct the condyle-ramus in children with hemifacial microsomia (HFM) was made. The mean age at surgical correction was 6.5 years, and the average follow-up was 4.5 years. Direct measurements were made on panoramic radiographs. The condyle-ramus length was expressed as a percentage change comparing the constructed with the normal side. During the first 2 postoperative years, there was either no change or a slight decrease in the length of the rib graft. After 2 years, however, the costochondral graft elongated at a slow, irregular rate. The mode change was 11 percent over the postoperative study period. In four patients who exhibited rapid growth of the normal condyleramus (greater than the mean change of 0.94 cm), the constructed side failed to keep pace. In another group of four patients who exhibited moderate elongation of the normal side, the grafted side grew commensurately or demonstrated greater than normal percentage change in length. There was no correlation between the initial size of the costochondral graft, age at time of operation, or presenting type of mandibular deformity. These findings are discussed in terms of the intrinsic growth and the functional matrix theories of mandibular development.

  13. Metabolic syndrome in children (Review)


    Wu, Yue-E; Zhang, Chong-Lin; Zhen, Qing


    Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors, including central obesity, insulin resistance, glucose intolerance, dyslipidemia and increased blood pressure. The prevalence of MetS is on the increase worldwide owing to the epidemic of overweight and obesity. The risk of prevalence of MetS greatly increases during adulthood for those children exposed to cardiometabolic risk factors in their early lives. MetS has also been associated with liver fat accumulation in child...

  14. Sudden cardiac death while playing Australian Rules football: a retrospective 14 year review. (United States)

    Parsons, Sarah; Lynch, Matthew


    Australian Rules football is a sport which evolved from Gaelic football and which is played by a large number of predominantly male participants in a number of countries. The highest participation rates are in the southern states of Australia. A retrospective review over a period of 14 years identified 14 cases of sudden cardiac death that occurred in individuals while playing the sport. All were male and ranged in age from 13 to 36 years with a mean and median age of 23 years. A spectrum of cardiac causes was identified including coronary artery atherosclerosis, myocarditis, anomalous coronary artery anatomy, arrhythmogenic right ventricular cardiomyopathy, and healed Kawasaki disease. In 5 cases the heart was morphologically normal raising the possibility of a channelopathy. No traumatic deaths were identified. Some of the individuals had experienced symptoms prior to the fatal episode and the role of pre participation screening in reducing mortality is discussed.

  15. Retrospective review of serologic rubella activity in University Hospital Kuala Lumpur. (United States)

    Chua, K B; Lam, S K; Hooi, P S; Chua, B H; Lim, C T


    A retrospective review of rubella serological results carried out in the Virus Diagnostic Unit, University Hospital Kuala Lumpur (UHKL) from January 1993 to September 1999 showed the presence of rubella infection annually which appeared to increase periodically every two to three years. There was no statistical significant difference in the rubella positive rate between male and female population aged 14 to 48 years. Congenital rubella infections (CRI) occurred in babies delivered in UHKL yearly from 1993 to 1998 with an average incidence rate of 48 per 100,000 deliveries. Peaks of rubella cases appeared to be followed by an increase in incidence of CRI cases 6 to 9 months later. The study showed that only 50.8% clinically diagnosed rubella was confirmed by laboratory finding. This study also showed an increase of rubella activity for the months of July, August and September 1999 and this may herald an increase of CRI cases in the coming millennium.

  16. Picosecond pulse duration laser treatment for dermal melanocytosis in Asians : A retrospective review (United States)

    Ohshiro, Toshio; Sasaki, Katsumi; Kishi, Kazuo


    Background and aims: Recently novel picosecond duration lasers (ps-lasers) have been developed for the treatment of multicolored and recalcitrant tattoos, and safety and efficacy have been reported. We therefore hypothesized that the ps-laser could be an alternative treatment for dermal pigmented lesions and performed a retrospective review to evaluate the efficacy and safety of the ps-laser. Subjects and methods: A retrospective photographic review of 10 patients with dermal pigmented lesions was performed (ages from 4 months to 52 yr), 6 nevus of Ota, 3 ectopic Mongolian spots and 1 Mongolian spots. The patients were treated in the Ohshiro Clinic with picosecond 755 nm alexandrite laser (ps-Alex laser) and picosecond 1064 nm Nd:YAG laser (ps-Nd:YAG laser) from April 2014 to December 2015 (ps-Alex laser, 7 patients; ps-Nd:YAG laser, 3 patients, 1 to 3 treatment sessions). Improvement was evaluated as percentage of pigmentation clearance comparing the baseline findings with those at 3 months after the final treatment using a five category grading scale: Poor, 0–24%; Fair, 25–49%; Good, 50–74%; Excellent, 75–94%; and Complete, 95–100% improvement. Adverse events were also assessed. Results: All ten patients obtained clinical improvement ranging from fair to excellent. Treatment with the ps-Alex laser caused transient hyperpigmentation followed by improvement to complete resolution at 3 months follow-up. The ps-Nd:YAG laser caused severe transient erythema and swelling but no post-inflammatory hyperpigmentation. Conclusions: Our results suggest that the 755 nm and 1064 nm ps-lasers are efficacious for the treatment of dermal pigment lesions, with minimum adverse events. PMID:27721561

  17. Picosecond pulse duration laser treatment for dermal melanocytosis in Asians : A retrospective review. (United States)

    Ohshiro, Takafumi; Ohshiro, Toshio; Sasaki, Katsumi; Kishi, Kazuo


    Background and aims: Recently novel picosecond duration lasers (ps-lasers) have been developed for the treatment of multicolored and recalcitrant tattoos, and safety and efficacy have been reported. We therefore hypothesized that the ps-laser could be an alternative treatment for dermal pigmented lesions and performed a retrospective review to evaluate the efficacy and safety of the ps-laser. Subjects and methods: A retrospective photographic review of 10 patients with dermal pigmented lesions was performed (ages from 4 months to 52 yr), 6 nevus of Ota, 3 ectopic Mongolian spots and 1 Mongolian spots. The patients were treated in the Ohshiro Clinic with picosecond 755 nm alexandrite laser (ps-Alex laser) and picosecond 1064 nm Nd:YAG laser (ps-Nd:YAG laser) from April 2014 to December 2015 (ps-Alex laser, 7 patients; ps-Nd:YAG laser, 3 patients, 1 to 3 treatment sessions). Improvement was evaluated as percentage of pigmentation clearance comparing the baseline findings with those at 3 months after the final treatment using a five category grading scale: Poor, 0-24%; Fair, 25-49%; Good, 50-74%; Excellent, 75-94%; and Complete, 95-100% improvement. Adverse events were also assessed. Results: All ten patients obtained clinical improvement ranging from fair to excellent. Treatment with the ps-Alex laser caused transient hyperpigmentation followed by improvement to complete resolution at 3 months follow-up. The ps-Nd:YAG laser caused severe transient erythema and swelling but no post-inflammatory hyperpigmentation. Conclusions: Our results suggest that the 755 nm and 1064 nm ps-lasers are efficacious for the treatment of dermal pigment lesions, with minimum adverse events.

  18. Orbital floor fractures: a retrospective review of 45 cases at a tertiary health care center. (United States)

    Rhim, Chun H; Scholz, Thomas; Salibian, Ara; Evans, Gregory R D


    The purpose of this retrospective study was to investigate treatment options for orbital floor fractures at a Level 1 Trauma Center in Southern California. A review of 45 cases of isolated orbital floor fractures treated at the University of California at Irvine between February 2004 and April 2007 was done. Patients were retrospectively analyzed for gender, age, mechanism of injury, associated facial injuries, presenting symptoms, method of treatment, and postoperative complications. Thirty-six male patients and nine female patients were treated. Motor vehicle collision (26/45) was the most common cause of injury, and the mean age of the patients was 35.5 years (range: 15-81 years). Ecchymosis surrounding the orbital tissue was the most common presentation (38/45). Diplopia was present in 8 of 45 patients, with 1 patient requiring urgent decompression for retrobulbar hematoma. Forty-three patients underwent surgical repair; 40 underwent transconjunctival approach with lateral canthotomy; 17 underwent reconstruction with porous polyethylene Medpor (Porex Surgical, Inc., College Park, GA.); and 26 underwent reconstruction with a titanium mesh plate. Immediate postoperative complications included 12 patients with infraorbital numbness, 3 with diplopia, 1 with cellulitis, and 1 with ectropion with a subcilliary approach. Average timing of surgery of our study was 4.94 days (range, 1-20 days). Orbital floor fracture management has changed significantly over the past few decades with the introduction of new internal fixation methods and new materials for reconstructing orbital floor defects. Recommendations for surgical intervention on orbital floor fractures mostly depend on clinical examination and imaging studies. Consequences of inadequate repair of orbital floor fractures can lead to significant facial asymmetry and visual problems. Both porous polyethylene and titanium plates are effective tools for reconstructing the orbital floor. Our review demonstrates that

  19. Tissue Liquefaction Liposuction for Body Contouring and Autologous Fat Transfer: A Retrospective Review Over 3 Years (United States)

    Godek, Christopher P.


    Objective: Tissue liquefaction lipoplasty is a novel, low-energy method cleared for use in aesthetic body contouring and autologous fat transfer. This is a retrospective review of the clinical effectiveness and safety of a liquefaction lipoplasty system for liposuction and autologous fat transfer. Methods: A retrospective review was done evaluating all liquefaction lipoplasty procedures with or without autologous fat transfer performed by a single surgeon (March 2013 to June 2016). Patient demographics, operative details, and any complications were tabulated from patient charts. A typical case reported is presented with pre-/postoperative photographs. Results: Two hundred fifty-five consecutive liquefaction lipoplasty procedures were performed over 39 months. The average lipoaspirate volume was 1208 ± 991 mL and the average fat graft volume was 322 ± 277 mL. The overall complication rate was 9 of 255 (3.52%). There were 2 episodes of seroma (0.78%) that were aspirated and 2 episodes of cellulitis (0.78%) that responded to oral antibiotics. In the autologous fat transfer cohort, there were 5 of 103 (4.85%) cases of mild to moderate fat necrosis, with 1 patient requiring return to the operating room for removal of an oil cyst. No revisions of donor sites were required. Conclusions: Liquefaction lipoplasty appears safe for liposuction and autologous fat transfer, with a complication profile that is comparable with other widely used forms of suction-assisted liposuction. The liquefaction lipoplasty technology also provides potential time savings in the operating room that can minimize surgeon fatigue when harvesting large volumes of high-quality fat. Liquefaction lipoplasty appears to have advantages for both the patient and the surgeon, and further studies are underway. PMID:28077985

  20. A retrospective review of cases preoperatively diagnosed by radiologic imaging as cavernous venous malformations. (United States)

    Jayaram, Anupam; Cohen, Liza M; Lissner, Gary S; Karagianis, Achilles G


    The purpose of this study is to examine orbital lesions identified on preoperative radiologic imaging as cavernous venous malformations (CVMs), identify their imaging characteristics, and determine if these may help differentiate CVMs from other intraorbital masses. An IRB-approved retrospective chart review over 30 years was undertaken identifying lesions "consistent with cavernous hemangioma" on radiologic studies, which were subsequently surgically resected with a tissue diagnosis. All radiologic images (CT and MRI) obtained preoperatively were re-reviewed by a single masked neuroradiologist. The pattern of contrast enhancement on sequential MRI views was used to determine whether the enhancing characteristics helped identify CVMs compared to other intraorbital masses. Fifty-seven orbital lesions consistent with a CVM were identified on imaging. Fourteen (25%) of them were resected, of which nine (64%) were found to be CVMs on pathologic examination. Five (36%) were found to be a different lesion, most commonly schwannoma (21%). On imaging, CVMs tended to display heterogeneous progressive enhancement, whereas other tumors, in particular schwannomas, enhanced at their maximum level immediately. Based on these characteristics, on re-review, the masked neuroradiologist was able to differentiate a CVM versus other tumors for all 14 imaging cases. This study suggests that examining the pattern of contrast enhancement may help to correctly differentiate a CVM from other isolated, encapsulated orbital lesions on CT/MR imaging.

  1. Parvovirus B19 infection and severe anaemia in Kenyan children: a retrospective case control study

    Directory of Open Access Journals (Sweden)

    Tuju James


    Full Text Available Abstract Background During acute Human parvovirus B19 (B19 infection a transient reduction in blood haemoglobin concentration is induced, due to a 5-7 day cessation of red cell production. This can precipitate severe anaemia in subjects with a range of pre-existing conditions. Of the disease markers that occur during B19 infection, high IgM levels occur closest in time to the maximum reduction in haemoglobin concentration. Previous studies of the contribution of B19 to severe anaemia among young children in Africa have yielded varied results. This retrospective case/control study seeks to ascertain the proportion of severe anaemia cases precipitated by B19 among young children admitted to a Kenyan district hospital. Methods Archival blood samples from 264 children under 6 years with severe anaemia admitted to a Kenyan District Hospital, between 1999 and 2004, and 264 matched controls, were tested for B19 IgM by Enzyme Immunosorbent Assay and 198 of these pairs were tested for B19 DNA by PCR. 536 samples were also tested for the presence of B19 IgG. Results 7 (2.7% cases and 0 (0% controls had high B19 IgM levels (Optical Density > 5 × cut-off value (McNemar's exact test p = 0.01563, indicating a significant association with severe anaemia. The majority of strongly IgM positive cases occurred in 2003. 10/264 (3.7% cases compared to 5/264 (1.9% controls tested positive for B19 IgM. This difference was not statistically significant, odds ratio (OR = 2.00 (CI95 [0.62, 6.06], McNemar's exact test p = 0.3018. There was no significant difference between cases and controls in the B19 IgG (35 (14.8% vs 32 (13.6%, OR = 1.103 (CI95 [0.66, 1.89], McNemar's exact test, p = 0.7982, or the detection of the B19 DNA (6 (3.0% vs 5 (2.5%, OR = 1.2 (CI95 [0.33, 4.01], McNemar's exact test p = 1. Conclusions High B19 IgM levels were significantly associated with severe anaemia, being found only among the cases. This suggests that 7/264 (2.7% of cases of severe

  2. Gay fathers' effects on children: a review. (United States)

    Cameron, Paul


    Extrapolating results from studies of lesbians' children to gays' children and assertions of "no risk to children as a result of growing up in a family with 1 or more gay parents" are questioned. A review of 9 studies gave evidence that gays' children were (a) more apt to adopt homosexual interests and activities, (b) more apt to report sexual confusion, (c) more apt to be socially disturbed, (d) more apt to abuse substances, (e) less apt to get married, (f) more apt to have difficulty in attachment and loving relationships, (g) less religious and more unconventionally religious, (h) more apt to have emotional difficulties, (i) more frequently exposed to parental molestation, and (j) prone to more frequent sexual acting out.

  3. 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


    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.

  4. A retrospective review of the adnexal outcome after detorsion in premenarchal girls

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    Abdullah Yildiz


    Full Text Available Background: The aim of this study was to report our results on premenarchal girls with adnexal torsion who were treated with different approaches. Materials and Methods: Twenty-six adnexal torsions in children were analysed retrospectively. Group 1 included cases of oophorectomy for the twisted adnexa. Group 2 contained the patients with adnexal torsion who untwisted either with a laparoscopic or open approach. Postoperative restoration of ovarian function was evaluated by Doppler ultrasound at the 6 th month. All oophorectomy and biopsy specimens were also evaluated. Results: Group 1 consisted of eleven cases that underwent oophorectomy due to gangrenous change and haemorrhagic infarction. Histology was of a mature teratoma in two cases and haemorrhagic necrosis due to torsion in seven. Group 2 consisted of 15 patients. In 10 out of 15 patients, preoperative biopsy is performed in which their histology revealed haemorrhagic necrosis in eight cases, and simple cyst with a benign nature in two cases. In all of the 10 untwisted adnexas, postoperative radiological imaging showed complete recovery with normal follicular development. No malignancy or increased tumour markers were noted in both groups. Conclusion: Adnexas can be left in place regardless of the preoperative degree of necrosis. Biopsy can be added to the procedure to rule out malignancy.

  5. Effectiveness of screening preschool children for amblyopia: a systematic review

    Directory of Open Access Journals (Sweden)

    Lange Stefan


    Full Text Available Abstract Background Amblyopia and amblyogenic factors like strabismus and refractive errors are the most common vision disorders in children. Although different studies suggest that preschool vision screening is associated with a reduced prevalence rate of amblyopia, the value of these programmes is the subject of a continuing scientific and health policy discussion. Therefore, this systematic review focuses on the question of whether screening for amblyopia in children up to the age of six years leads to better vision outcomes. Methods Ten bibliographic databases were searched for randomised controlled trials, non-randomised controlled trials and cohort studies with no limitations to a specific year of publication and language. The searches were supplemented by handsearching the bibliographies of included studies and reviews to identify articles not captured through our main search strategy. Results Five studies met the inclusion criteria. Of these, three studies suggested that screening is associated with an absolute reduction in the prevalence of amblyopia between 0.9% and 1.6% (relative reduction: between 45% and 62%. However, the studies showed weaknesses, limiting the validity and reliability of their findings. The main limitation was that studies with significant results considered only a proportion of the originally recruited children in their analysis. On the other hand, retrospective sample size calculation indicated that the power based on the cohort size was not sufficient to detect small changes between the groups. Outcome parameters such as quality of life or adverse effects of screening have not been adequately investigated in the literature currently available. Conclusion Population based preschool vision screening programmes cannot be sufficiently assessed by the literature currently available. However, it is most likely that the present systematic review contains the most detailed description of the main limitations in current

  6. Pathology of Haemonchus contortus in New World camelids in the southeastern United States: a retrospective review. (United States)

    Edwards, Erin E; Garner, Bridget C; Williamson, Lisa H; Storey, Bob E; Sakamoto, Kaori


    Most small ruminant farms in tropical climates are plagued by Haemonchus contortus, a hematophagous, abomasal parasite. Heavy burdens of this parasite can cause anemia, hypoproteinemia, weight loss, and mortality in susceptible animals. Haemonchus contortus is becoming a major health concern in New World camelids as well, namely llamas (Llama glama) and alpacas (Vicugna pacos), yet little research has been conducted regarding its prevalence or pathology in these species. Herein, we present a retrospective review of llamas and alpacas that were admitted to The University of Georgia Veterinary Teaching Hospital and Athens Diagnostic Laboratory between the years 2002 and 2013. Antemortem fecal egg count (FEC) estimates performed on 30 alpacas were negatively correlated with hematocrit, hemoglobin, and red blood cell count. Total protein was not significantly correlated with FEC. On postmortem examination, 55 of 198 camelids, including 2 from the aforementioned antemortem review, were infected with H. contortus, with llamas (42.6%) having a significantly higher infection rate than alpacas (22.2%). In 15.7% of the total cases, the parasite was the major cause of death. Common gross lesions included peritoneal, thoracic, and pericardial effusions, visceral pallor, subcutaneous edema, and serous atrophy of fat. Histologic lesions included centrilobular hepatic necrosis, hepatic atrophy, lymphoplasmacytic inflammation of the mucosa of the third gastric compartment (C3), extramedullary hematopoiesis in both the liver and spleen, and the presence of nematodes in C3. Our study emphasizes the importance of H. contortus diagnosis and herd monitoring in New World camelids, particularly llamas.

  7. A 5-Year Retrospective Review of Fungal Keratitis at Hospital Universiti Sains Malaysia

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    Fadzillah Mohd-Tahir


    Full Text Available Background. Corneal blindness from healed infected keratitis is one of the most preventable causes of monocular blindness in developing countries, including Malaysia. Our objectives were to identify the causative fungi, predisposing risk factors, the proportion of correct clinical diagnosis, and visual outcome of patients treated in our hospital. Methods. A retrospective review of medical and microbiology records was conducted for all patients who were treated for fungal keratitis at Hospital Universiti Sains Malaysia from January 2007 until December 2011. Results. Forty-seven patients (47/186, 25.27% were treated for fungal keratitis during the study period. This demonstrated that the incidence of fungal keratitis has increased each year from 2007 to 2011 by 12.50%, 17.65%, 21.21%, 26.83%, and 28.57%, respectively. The most common predisposing factors were injury to the eye followed by use of topical steroid, and preexisting ocular surface disease. Fusarium species were the most common fungal isolated, followed by Candida species. Clinical diagnosis of fungal keratitis was made in 26 of the 41 (63.41% cases of positive isolates. Of these, in eleven cases (23.40% patients required surgical intervention. Clinical outcome of healed scar was achieved in 34 (72.34% cases. Conclusions. The percentage of positive fungal isolated has steadily increased and the trend of common fungal isolated has changed. The latest review regarding fungal keratitis is important for us to improve patients' outcome in the future.

  8. Distal posterior cerebral artery aneurysms: Retrospective review of characteristics and endovascular treatment

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    Baek, Jin Wook [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Jeong, Bae Woong [Dept. of Diagnostic Radiology, Inje University College of Medicine, Busan Paik Hospital, Busan (Korea, Republic of); Seung, Won Bae [Dept. of Neurosurgery, Kosin University College of Medicine, Gospel Hospital, Busan (Korea, Republic of)


    The objective of this study was to review the clinical outcome after treatment of distal posterior cerebral artery (PCA) aneurysms via endovascular approach. Eleven patients with 11 distal PCA aneurysms who were treated via endovascular approach in Inje University Busan Paik Hospital and Kosin University Gospel Hospital from December 2002 to December 2013 were retrospectively reviewed. Among the 11 patients, there were 3 males (27.3%) and 8 females (72.7%). The mean age was 56.6 years (range 44 -72 years) and the mean aneurysm size was 8.45 mm (3 - 30 mm). Four (36.4%) aneurysms were located in the P2 segment, 6 (54.5%) in the P3 segment and 1 (9.1%) in the P1/2 junction. Seven (63.6%) aneurysms were treated with preservation of the parent artery; and the remaining 4 (36.4%) aneurysms were treated with parent artery occlusion. After treatment, the overall complication rate was 27% with the morbidity rate of 9.1% and the mortality rate of 18%. Endovascular treatment of distal PCA aneurysm might be used to minimize neurologic deficit, considering the diverse and rich collaterals of posterior cerebral artery.

  9. Retrospective drug utilization review: impact of pharmacist interventions on physician prescribing

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    Angalakuditi M


    Full Text Available Mallik Angalakuditi1, Joseph Gomes21Georgia State University, Atlanta, GA, USA; 2Baxter Health Care, Deerfield, IL, USAObjectives: To evaluate the impact of retrospective drug utilization review (RDUR, pharmacist’s interventions on physician prescribing, and the level of spillover effect on future prescriptions following the intervention.Methods: A retrospective case–control study was conducted at a pharmacy benefits management company using the available prescription data from April 2004 to August 2005. RDUR conflicts evaluated and intervened by a clinical pharmacist served as a case group, whereas conflicts that were not evaluated and intervened by a clinical pharmacist served as a control group.Results: A total of 40,284 conflicts in cases and 13,044 in controls were identified. For cases, 32,780 interventions were considered nonrepetitive, and 529 were repetitive. There were 22,870 physicians in cases that received intervention letters and 2348 physicians in the control group that would have received intervention letters during the study period. Each physician received on average 1.4 interventions for cases vs 3.0 for controls. Among the case physicians who were intervened during the study period, 2.2% (505 were involved in a repeated intervention vs 18.2% (428 in controls (P < 0.001, which is an eight-fold difference. The most common conflict intervened on in cases was therapeutic appropriateness (8277, 25.3%, and for controls it was drug–drug interactions (1796, 25.4%. The overall interventional spillover effect in cases was 98.4% vs 89.4% in controls (P = 0.01.Conclusion: RDUR is an effective interventional program which results in decreased numbers of interventions per physician and provides a significant impact on future prescribing habits.Keywords: pharmacy management, spillover effect, RDUR, DUR

  10. Retrospective study of dental trauma in children with autism spectrum disorders: a paired study. (United States)

    Andrade, Natália Silva; Dutra, Thaís Torres Barros; Fernandes, Regina Fátima; Moita Neto, José Machado; Mendes, Regina Ferraz; Prado Júnior, Raimundo Rosendo


    The objective was to evaluate the history of traumatic dental injury (TDI) among children with and without autism spectrum disorders (ASD) at the Centro Integrado de Educação Especial (CIES), in Teresina, Brazil. The dental records of 228 children, 114 with ASD (SG = study group) and 114 without ASD (CG = control group), paired by age, gender and socioeconomic characteristics between January 2007 and September 2014 were reviewed. Data were analyzed using chi-square test and multivariate logistic regression (alpha = 5.0%). Dental trauma in SG was lower than in the CG (24.6% and 41.2%, respectively, p = 0.007). The risk of trauma was lower among males in SG (OR: 0.35; 95%CI: 0.18 to 0.67). The likelihood of TDI in SG was 3.17 higher in females than that of males (p = 0.040). The prevalence of TDI was lower in ASD individuals compared to controls. Dental trauma was higher among ASD girls than ASD boys.

  11. Unusual histopathological findings in appendectomy specimens: A retrospective analysis and literature review

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    Sami Akbulut; Mahmut Tas; Nilgun Sogutcu; Zulfu Arikanoglu; Murat Basbug; Abdullah Ulku; Heybet Semur; Yusuf Yagmur


    AIM: To document unusual findings in appendectomy specimens.METHODS: The clinicopathological data of 5262 pa-tients who underwent appendectomies for presumed acute appendicitis from January 2006 to October 2010 were reviewed retrospectively. Appendectomies per-formed as incidental procedures during some other operation were excluded. We focused on 54 patients who had unusual findings in their appendectomy specimens. We conducted a literature review via the PubMed and Google Scholar databases of English lan-guage studies published between 2000 and 2010 on unusual findings in appendectomy specimens.RESULTS: Unusual findings were determined in 54 (1%) cases by histopathology. Thirty were male and 24 were female with ages ranging from 15 to 84 years (median, 32.2 ± 15.1 years). Final pathology revealed 37 cases of enterobiasis, five cases of carcinoids, four mucinous cystadenomas, two eosinophilic infiltra-tions, two mucoceles, two tuberculosis, one goblet-cell carcinoid, and one neurogenic hyperplasia. While 52 patients underwent a standard appendectomy, two pa-tients who were diagnosed with tuberculous appendi-citis underwent a right hemicolectomy. All tumors were located at the distal part of the appendix with a mean diameter of 6.8 mm (range, 4-10 mm). All patients with tumors were alive and disease-free during a mean follow-up of 17.8 mo. A review of 1366 cases reported in the English literature is also discussed.CONCLUSION: Although unusual pathological findings are seldom seen during an appendectomy, all appen-dectomy specimens should be sent for routine histo-pathological examination.

  12. Children who murder: a review. (United States)

    Shumaker, D M; Prinz, R J


    Despite considerable research on juvenile homicide, pre-adolescent homicide offenders have received less attention. This paper reviews the existing literature on preteen murderers in order to characterize the current state of research knowledge about this population, and draws on some of the work on adolescent homicide as well. The analysis of this literature considers historical context, methodological issues, previous attempts to classify youthful homicide offenders, and predictors of preteen homicidal behavior. While there is a high degree of heterogeneity within this population, several developmental similarities emerged across cases that were associated with the perpetration of homicide by preteens. A high percentage of preteen homicide offenders come from homes characterized by physical abuse, domestic violence, poor or absent parenting, and overall instability. Gun availability may have been a facilitating factor. Support for different etiologies of preteen versus adolescent homicide is weak. Recommendations for future research directions are offered.

  13. Chest radiography versus chest CT in the evaluation for pulmonary metastases in patients with Wilms' tumor: a retrospective review

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    Wootton-Gorges, S.L.; Albano, E.A.; Riggs, J.M.; Ihrke, H.; Rumack, C.M.; Strain, J.D. [Colorado Univ., Denver, CO (United States). Dept. of Radiology


    Background. Determination of the presence of pulmonary metastases in children with Wilms' tumor is an important part of staging and treatment. We sought to compare the efficacy of chest radiography (CXR) and chest CT in the evaluation for pulmonary metastases in patients with Wilms' tumor. Materials and methods. This retrospective study included 83 children with Wilms' tumor diagnosed between 1980 and 1993. All patients with pulmonary nodules (n = 12) as well as 14 Wilms' tumor patients without pulmonary metastases (control group) had blinded review of the CXR and chest CTs by three pediatric radiologists. Presence, size, and certainty of metastatic diagnosis were recorded. Medical records were reviewed. The remaining 57 patients had review of their medical and imaging records to confirm the absence of pulmonary metastases. Results. Ten of the 12 with pulmonary masses had imaging available for review. Eight had both positive CXR and chest CT examinations. Two patients had pulmonary nodules seen by CT only: one had a right cardiophrenic angle mass and died as a result of liver metastases. The other had a solitary nodule, which proved to be a plasma-cell granuloma. Overall, the CXR and chest CT data concur in 79/81 (98 %). Conclusion. CXR alone appears adequate for the diagnosis or exclusion of pulmonary metastases in patients with Wilms' tumor. (orig.)

  14. A 25 year retrospective review of the psychological consequences of the Chernobyl accident. (United States)

    Bromet, E J; Havenaar, J M; Guey, L T


    The Chernobyl Forum Report from the 20th anniversary of the Chernobyl nuclear power plant disaster concluded that mental health effects were the most significant public health consequence of the accident. This paper provides an updated review of research on the psychological impact of the accident during the 25 year period since the catastrophe began. First responders and clean-up workers had the greatest exposure to radiation. Recent studies show that their rates of depression and post-traumatic stress disorder remain elevated two decades later. Very young children and those in utero who lived near the plant when it exploded or in severely contaminated areas have been the subject of considerable research, but the findings are inconsistent. Recent studies of prenatally exposed children conducted in Kiev, Norway and Finland point to specific neuropsychological and psychological impairments associated with radiation exposure, whereas other studies found no significant cognitive or mental health effects in exposed children grown up. General population studies report increased rates of poor self-rated health as well as clinical and subclinical depression, anxiety, and post-traumatic stress disorder. Mothers of young children exposed to the disaster remain a high-risk group for these conditions, primarily due to lingering worries about the adverse health effects on their families. Thus, long-term mental health consequences continue to be a concern. The unmet need for mental health care in affected regions remains an important public health challenge 25 years later. Future research is needed that combines physical and mental health outcome measures to complete the clinical picture.


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    Denismar Borges de Miranda


    Full Text Available Objective: to know the scientific literature on head injury in children. Method: this study is an integrative review of published articles in the database SciELO the period 2000-2010. Results: 10 articles were analyzed, from which emerged four categories: causes of traumatic brain child infant prognosis of traumatic brain child, treating children victims of child head injury and complications of therapy used for child victims of traumatic brain injury in children. Conclusions: there is consensus among the authors investigated the factors associated with better prognosis of traumatic brain child, remain vague and uncertain. They add that the success of this customer service related to the control of complications arising from cerebral trauma and mostly are treatable and / or preventable.

  16. Cobalamin deficiency in children: A literature review


    Moen, Synne Helland


    Objective: The aim of this review is to present cobalamin deficiency in children with a specific focus on infants. Background: Cobalamin deficiency is caused by inadequate intake, malabsorption or inborn errors of vitamin B12 metabolism. Cobalamin deficiency in infants is usually caused by deficiency in the mother. There is often a diagnostic delay among infants because the most frequent symptoms are unspecific, e.g., developmental delay, apathy, hypotonia, anorexia and failure to thrive. Chi...

  17. Mercury exposure in children: a review. (United States)

    Counter, S Allen; Buchanan, Leo H


    Exposure to toxic mercury (Hg) is a growing health hazard throughout the world today. Recent studies show that mercury exposure may occur in the environment, and increasingly in occupational and domestic settings. Children are particularly vulnerable to Hg intoxication, which may lead to impairment of the developing central nervous system, as well as pulmonary and nephrotic damage. Several sources of toxic Hg exposure in children have been reported in biomedical literature: (1) methylmercury, the most widespread source of Hg exposure, is most commonly the result of consumption of contaminated foods, primarily fish; (2) ethylmercury, which has been the subject of recent scientific inquiry in relation to the controversial pediatric vaccine preservative thimerosal; (3) elemental Hg vapor exposure through accidents and occupational and ritualistic practices; (4) inorganic Hg through the use of topical Hg-based skin creams and in infant teething powders; (5) metallic Hg in dental amalgams, which release Hg vapors, and Hg2+ in tissues. This review examines recent epidemiological studies of methylmercury exposure in children. Reports of elemental Hg vapor exposure in children through accidents and occupational practices, and the more recent observations of the increasing use of elemental Hg for magico-religious purposes in urban communities are also discussed. Studies of inorganic Hg exposure from the widespread use of topical beauty creams and teething powders, and fetal/neonatal Hg exposure from maternal dental amalgam fillings are reviewed. Considerable attention was given in this review to pediatric methylmercury exposure and neurodevelopment because it is the most thoroughly investigated Hg species. Each source of Hg exposure is reviewed in relation to specific pediatric health effects, particularly subtle neurodevelopmental disorders.

  18. Cerebrospinal fluid cytomorphologic findings in 41 intracranial tumors: a retrospective review

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    Maria José Sá


    Full Text Available The main objective of this retrospective review of clinical and cerebrospinal fluid (CSF data from 41 patients with intracranial tumors diagnosed between 1975 and 1989, is to report the role that the finding of neoplastic cells in CSF plays, specially when cerebral CT-scanning and MRI were not currently done. Another objective is to study the CSF proteic abnormalities in cerebral tumors. CSF cell count, cytomorphologic pictures obtained after sedimentation and protein findings are described. Tumor cells were seen in 12 cases (29%: medulloblastomas - 6, meningeal carcinomatosis - 3, multiforme glioblastoma - 1, ependymoma -1, cerebral metastasis -1; in two cases it was an unexpected finding. We noticed that tumoral localization next to the ventricles favoured cell exfoliation. Although pleocytosis was rare and uncorrelated with the presence of neoplastic cells, pathological cytomorphologic pictures appeared in most of the cases including all "positive" ones. Our results stress that the appearance of neoplastic cells in CSF remains helpful specially when it is an unexpected finding.

  19. Full-tendon nasal transposition of the vertical rectus muscles: a retrospective review. (United States)

    Dawson, Emma L M; Boyle, Natalie J; Lee, John P


    The authors report the results of a retrospective review of patients who underwent nasal transposition of the vertical rectus muscles between 1997 and 2004. Eight patients were identified, 4 males and 4 females. There was an average age at surgery of 37 years, with a range from 8 to 79 years. The aetiologies included 6 patients with trauma to their medial rectus (4 following endoscopic sinus surgery) and 2 patients with paralytic medial rectus muscles secondary to 3rd nerve palsy. All patients underwent whole tendon transposition of the superior and inferior rectus muscles, with resection of both muscles in 7 cases, before reattachment adjacent to the upper and lower borders of the medial rectus, respectively. One patient had a reduced amount of resection and this was combined with inferior oblique disinsertion and traction sutures. All patients had a reduction in deviation in the primary position and in 5 patients there was some improvement in adduction. A consequence of surgery was a degree of limitation of abduction, elevation and depression in some patients. Overall, patients were satisfied with the improvement in their appearance.

  20. Patterns of skin disease in a sample of the federal prison population: a retrospective chart review (United States)

    Gavigan, Geneviève; McEvoy, Alana; Walker, James


    Background: Dermatology in vulnerable populations is under-researched. Our objective was to analyze the most commonly referred skin diseases affecting the Correctional Service Canada inmates in Ontario. Methods: An observational, cross-sectional, retrospective chart review of inmate patients seen from 2008 until 2013 was performed. Two groups of patients were included in the analysis: those assessed in-person, and those evaluated by e-consult. Results: In the in-person patient group, the 3 most common diagnoses were acne, psoriasis and other superficial mycoses. For the e-consult group, the 3 most frequent diagnoses were acne, psoriasis and rosacea. There was a clear bias toward more inmates being seen in-person where the service was provided (Collins Bay Institution) than from other correctional institutions in Eastern Ontario. Interpretation: Most of the skin diseases that affected the incarcerated population studied were common afflictions, similar to those affecting the general population, which is in agreement with other studies. Future studies investigating skin diseases in male and female inmates across Canada would bestow more generalizable data. PMID:27398381

  1. [Neonatal bronchoscopy: a retrospective analysis of 67 cases and a review of their indications]. (United States)

    Oliveira-Santos, J A; Pereira-da-Silva, L; Clington, A; Serelha, M


    The availability of newer, more sophisticated and versatile bronchoscopes has expanded the spectrum and scope of the indications for bronchoscopy in the newborn infant both for diagnostic and therapeutic purposes. The aim of this study was to carry out a retrospective analysis of the bronchoscopies performed on newborn infants, and to review the indications of this procedure in this age group. Sixty-three patients were submitted to 67 bronchoscopies in a period of 13 years, allowing the diagnosis of 45 anomalies and malformations of the tracheo-bronchial tree, and the performance of 24 bronchoalveolar lavages. In six cases, endoscopic removal of secretions helped to resolve resistant atelectasia, while in another case, with esophageal atresia, intra-operative definition of the fistula tract was possible through catheterisation of the fistula with the bronchoscope. The flexible bronchoscope was preferred for diagnosis by direct visualisation, and the rigid bronchoscope for some diagnostic and therapeutic procedures. Stridor, unexplained cyanosis, hemoptysis, persistent or recurrent pulmonary images, difficulties in the intubation or extubation, and persistent disturbances in ventilation are among the main indications for bronchoscopy in the newborn infant. Bronchoscopy also allows the performance of subsidiary techniques, such as bronchoalveolar lavage, biopsy and laser therapy.

  2. Comparing Melanoma Invasiveness in Dermatologist- versus Patient-Detected Lesions: A Retrospective Chart Review

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    Cindy L. Lamerson


    Full Text Available This study examined whether patient-identified melanomas were more advanced than dermatologist-identified tumors at routine clinic visits, and whether a personal or family history of skin cancer was associated with patterns of detection. A retrospective chart review was performed on melanoma patients (N=201 in a private dermatology clinic. Variables included age, gender, pattern of detection (i.e., patient or a board certified dermatologist, personal or family history of skin cancer, skin type, and previous sun exposure, as well as tumor location and severity. Dermatologist-diagnosed melanomas were less invasive (P<0.0005, and more likely present on the chest, back, and legs (P<0.01. Conversely, patient-identified lesions were more likely to occur on the face, neck and scalp, be associated with younger patients, and a family history of melanoma, but not other types of skin cancer (P<0.01. In a post-hoc analysis examining these factors as predictors of tumor invasiveness, only diagnostic source was significant. Specifically, dermatologist-identified tumors were significantly less invasive than patient-identified tumors. Although age, family history, and tumor location played roles in the early detection of melanomas, the most important factor was diagnostic source. Thus, board-certified dermatologists play a key role in the early detection of malignant melanoma.

  3. Cephalosporin Induced Disulfiram-Like Reaction: A Retrospective Review of 78 Cases (United States)

    Ren, Shiyan; Cao, Yuxia; Zhang, Xiuwei; Jiao, Shichen; Qian, Songyi; Liu, Peng


    Concomitant ingestion of alcohol and cephalosporin may cause a disulfiram-like reaction; however its fatal outcomes are not commonly known. We retrospectively reviewed 78 patients who had cephalosporin induced disulfiram-like reaction (CIDLR). The patients who had a negative skin test to cephalosporin prior to intravenous antibiotics were included, and those who were allergic to either alcohol or antibiotics were excluded. The average age of 78 patients was 37.8±12.2 (21–60) years. Of the 78 patients, 93.58% of the patients were males, 70.51% of the patients consumed alcohol after use of antibiotics, and 29.49% patients consumed alcohol initially, followed by intravenous antibiotics; however, no significant difference of morbidity was observed in these two groups. All patients were administered antibiotics intravenously. Five of 78 patients (6.41%) developed severe CIDLR too urgently to be rescued successfully. In conclusion, it is important for clinicians to educate patients that no alcohol should be used if one is taking cephalosporin. Also, clinicians should keep in mind that cephalosporin should not be prescribed for any alcoholics. PMID:24670024

  4. A Retrospective Chart Review of 10 Hz Versus 20 Hz Repetitive Transcranial Magnetic Stimulation for Depression

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    Kristie L. DeBlasio


    Full Text Available We performed a retrospective chart review to examine the progress of patients with depression who received different frequencies of repetitive transcranial magnetic stimulation (rTMS delivered to the left dorsolateral prefrontal cortex (DLPFC. rTMS is a safe and effective alternative treatment for patients with various psychological and medical conditions. During treatment, a coil delivering a time-varying magnetic pulse placed over the scalp penetrates the skull, resulting in clinical improvement. There were 47 patients and three distinct treatment groups found: 10 Hz, 20 Hz, and a separate group who received both frequencies (10/20 Hz. The primary outcome indicator was the difference in Beck Depression Inventory–II (BDI-II scores. Secondary outcomes included categorical indicators of remission, response, and partial response rates as assessed with the BDI-II. In all 3 groups, the majority of patients had depression that remitted, with the highest rate occurring in the 20 Hz group. There were similar response rates in the 10 Hz and 20 Hz groups. There were no patients in the 10/20 Hz group whose depression responded and the highest partial response and nonresponse rates occurred in this group. Although within-group differences were significant from baseline to end of treatment, there were no between-group differences.

  5. Retrospective Study of Castleman's Disease: A Report of Fourteen Cases and Review of the Literature

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    Waiyi Zou; Huixia Lan; Chang Su; Yunxian Chen; Juan Li; Shaokai Luo


    OBJECTIVE To enhance the understanding of Castleman's disease (CD), and to improve its diagnosis and management. METHODS Clinical features and related information on diagnosis and treatment of 14 cases of CD were retrospectively analyzed and the literature reviewed.RESULTS Based on the clinical classification, localized CD was found in 8 of the 14 cases. Both the results of lymph node biopsy and histopathology indicated they were a hyaline-vascular type. The multicentric type CD was detected in 6 cases, among which 4 were plasma cell type and 2 mixed type based on histopathologic examination. There were a variety of clinical situations in the 14 cases, with a lack of specificity. They were previously misdiagnosed as other diseases, and final diagnosis depended on a histopathologic examination. The 8 patients with localized CD underwent excision, without recurrence up to now. The 6 patients with multicentric-type CD were treated with glucocorticoids or combined chemotherapy, and all achieved remission. CONCLUSIONS CD has complicated clinical manifestations and is difficult to diagnose. Lymph node biopsy is important for early diagnosis. An optimal curative effect can be achieved with a suitable therapeutic option, based on histopathology and clinical classification.

  6. Total joint arthroplasty in nonagenarians--a retrospective review of complications and resource use.

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    Baker, Joseph F


    Increased age brings with it the potential for increased surgical risk. Assessment of specific age cohorts is necessary to plan future service provision and this is the case in hip and knee arthroplasty as the demand for these procedures is anticipated to increase. We retrospectively reviewed the outcomes, including complications, length of stay and blood transfusion rate, in a cohort of 35 nonagenarians undergoing primary or revision total hip and knee arthroplasty. All patients were pre-assessed by anaesthetists before being deemed suitable to undergo surgery in the unit. The mean length of hospital stay was 13.7 +\\/- 10 days (range 2-56). Thirty-one percent of patients required a blood transfusion. Patients who underwent primary total hip arthroplasty reported improved joint specific functional scores. In this appropriately selected group of nonagenarians, we found no evidence to suggest surgery be withheld on the basis of age alone. However, patients with multiple medical comorbidities warrant appropriate assessment and surgical intervention in an institution with appropriate support. Future planning needs to take into account the predicted increase in demand for arthroplasty surgery in this age group.

  7. Abdominal ultrasonographic findings associated with feline infectious peritonitis: a retrospective review of 16 cases. (United States)

    Lewis, Kristin M; O'Brien, Robert T


    The feline infectious peritonitis virus (FIPV) is a mutated form of the feline enteric coronavirus (FeCV) that can present with a variety of clinical signs. The purpose of this retrospective study was to analyze abdominal ultrasonographic findings associated with cats with confirmed FIPV infection. Sixteen cases were included in the study from a review of medical records at two academic institutions; inclusion was based either on necropsy lesions (n=13) or a combination of histopathological, cytological, and clinicopathological findings highly suggestive of FIPV infection (n=3). The liver was judged to be normal in echogenicity in 11 (69%) cats, diffusely hypoechoic in three cats, focally hyperechoic in one cat, and focally hypoechoic in one cat. Five cats had a hypoechoic subcapsular rim in one (n=3) or both (n=2) kidneys. Free fluid was present in the peritoneal cavity in seven cats and in the retroperitoneal space in one cat. Abdominal lymphadenopathy was noted in nine cats. The spleen was normal in echogenicity in 14 cats and was hypoechoic in two. One cat had bilateral orchitis with loss of normal testicular architecture. Although none of these ultrasonographic findings are specific for FIPV infection, a combination of these findings should increase the index of suspicion for FIPV infection when considered along with appropriate clinical signs.

  8. Scar endometrioma following obstetric surgical incisions: retrospective study on 33 cases and review of the literature

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    Guilherme Karam Corrêa Leite

    Full Text Available CONTEXT AND OBJECTIVE: The incidence of scar endometrioma ranges from 0.03 to 3.5%. Certain factors relating to knowledge of the clinical history of the disease make correct diagnosis and treatment difficult. The aim here was to identify the clinical pattern of the disease and show surgical results. The literature on this topic was reviewed. DESIGN AND SETTING: Retrospective descriptive study at Hospital Municipal Maternidade - Escola Dr. Mário de Moraes Altenfelder Silva. METHODS: Data from the medical records of patients with preoperative diagnoses of scar endometrioma who underwent operations between 2001 and 2007 were surveyed and reviewed. The postoperative diagnosis came from histopathological analysis. The main information surveyed was age, obstetric antecedents, symptoms, tumor location, size and palpation, duration of complaint, diagnosis and treatment. All patients underwent tumor excision with a safety margin. RESULTS: There were 33 patients, of mean age 30.1 ± 5.0 years (range: 18-41 years. The total incidence was 0.11%: 0.29% in cesarean sections and 0.01% in vaginal deliveries. Twenty-nine tumors (87.9% were located in cesarean scars, two (6.0% in episiotomy scars and two (6.0% in the umbilical region. The main symptom was localized cyclical pain (66.7%, of mean duration 30.5 months (± 23. Surgical treatment was successful in all cases. CONCLUSION: This is an uncommon disease. The most important diagnostic characteristic is coincidence of painful symptoms with menstruation. Patients undergoing cesarean section are at greatest risk: relative risk of 27.37 (P < 0.01. The surgical treatment of choice is excision of the endometrioma with a safety margin.

  9. 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


    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

  10. Cryptococcosis in Colombian children and literature review

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    Jairo Lizarazo


    Full Text Available Cryptococcosis is reported in adults and is often acquired immune deficiency syndrome (AIDS-associated; however, its frequency in children is low. Based on the National Survey on Cryptococcosis conducted in Colombia, an epidemiological and clinical analysis was performed on cases of the disease observed in children less than 16 years old between 1993-2010. We found 41 affected children (2.6% prevalence from the 1,578 surveys received. The country mean annual incidence rate was 0.017 cases/100,000 children under 16 years, while in Norte de Santander the incidence rate was 0.122 cases/100,000 (p < 0.0001. The average age of infected children was 8.4 and 58.5% were male. In 46.3% of cases, a risk factor was not identified, while 24.4% had AIDS. The most frequent clinical manifestations were headache (78.1%, fever (68.8%, nausea and vomiting (65.6%, confusion (50% and meningeal signs (37.5%. Meningitis was the most frequent clinical presentation (87.8%. Amphotericin B was given to 93.5% of patients as an initial treatment. Positive microbiological identification was accomplished by India ink (94.7%, latex in cerebrospinal fluid (100% and culture (89.5%. Out of 34 isolates studied, Cryptococcus neoformans var. grubii (VNI 85.3%, VNII 8.8% was isolated in 94.1% of cases and Cryptococcus gattii (VGII was isolated in 5.9% of cases. These data are complemented by a literature review, which overall suggests that cryptococcosis in children is an unusual event worldwide.

  11. Communication Between Acute Care Hospitals and Skilled Nursing Facilities During Care Transitions: A Retrospective Chart Review. (United States)

    Jusela, Cheryl; Struble, Laura; Gallagher, Nancy Ambrose; Redman, Richard W; Ziemba, Rosemary A


    HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.3 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at To obtain contact hours you must: 1. Read the article, "Communication Between Acute Care Hospitals and Skilled Nursing Facilities During Care Transitions: A Retrospective Chart Review" found on pages 19-28, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until February 29, 2020. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Discuss problematic barriers during care transitions

  12. Bronchoscopic foreign body extraction in a pulmonary medicine department: a retrospective review of egyptian experience. (United States)

    Korraa, Emad; Madkour, Ashraf; Wagieh, Khaled; Nafae, Ahmed


    Foreign body (FB) removal in our hospital was almost exclusively performed by surgeons through a rigid bronchoscope until the pulmonologists started getting involved in FB extraction. This study aimed to retrospectively review the results of 2 years of experience with 120 patients who presented or were referred to the Pulmonary Medicine Department, Ain Shams University Hospital in Cairo, Egypt, with clinical suspicion of FB aspiration during the period between December 2006 and December 2008. FBs were removed by either rigid and/or flexible bronchoscopy using either general or topical anesthesia. There were 54 male and 66 female patients with an age range between 3 months and 70 years and 68.5% of the patients were under the age of 10 years. Ninety patients (75%) presented with a definite history of FB aspiration, with a time interval between aspiration and presentation ranging between less than 6 hours and 12 months. The FB was visible on the chest x-ray in 42 cases. Aspirations were primarily into the right lung (53.2%). Seeds and scarf pins were the most common FB found, and were retrieved in 36 cases. Pulmonologists were successful in extracting 110 out of 111 (99.1%) bronchoscopically visualized FBs, and open thoracotomy was required in only 1 case for FB removal. In another 6 cases, only mucous plug was found to be the endogenous FB, whereas no FB could be found in 3 cases. No mortality or serious complications took place during or after the bronchoscopy. In conclusion, pulmonologists can extract FBs easily and safely either by using rigid and/or flexible bronchoscopes if they have the appropriate experience.

  13. Peripherally inserted central venous catheter safety in burn care: a single-center retrospective cohort review. (United States)

    Austin, Ryan E; Shahrokhi, Shahriar; Bolourani, Siavash; Jeschke, Marc G


    The use of peripherally inserted central catheter (PICC) line for central venous access in thermally injured patients has increased in recent years despite a lack of evidence regarding safety in this patient population. A recent survey of invasive catheter practices among 44 burn centers in the United States found that 37% of burn units use PICC lines as part of their treatment protocol. The goal of this study was to compare PICC-associated complication rates with the existing literature in both the critical care and burn settings. The methodology involved is a single institution retrospective cohort review of patients who received a PICC line during admission to a regional burn unit between 2008 and 2013. Fifty-three patients were identified with a total of seventy-three PICC lines. The primary outcome measurement for this study was indication for PICC line discontinuation. The most common reason for PICC line discontinuation was that the line was no longer indicated (45.2%). Four cases of symptomatic upper extremity deep vein thrombosis (5.5%) and three cases of central line-associated bloodstream infection (4.3%, 2.72 infections per 1000 line days) were identified. PICC lines were in situ an average of 15 days (range 1 to 49 days). We suggest that PICC line-associated complication rates are similar to those published in the critical care literature. Though these rates are higher than those published in the burn literature, they are similar to central venous catheter-associated complication rates. While PICC lines can be a useful resource in the treatment of the thermally injured patient, they are associated with significant and potentially fatal risks.

  14. Insertion of Balloon Retained Gastrostomy Buttons: A 5-Year Retrospective Review of 260 Patients

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    Power, Sarah, E-mail:; Kavanagh, Liam N.; Shields, Mary C.; Given, Mark F.; Keeling, Aoife N.; McGrath, Frank P.; Lee, Michael J., E-mail: [Beaumont Hospital, Department of Radiology (Ireland)


    Radiologically inserted gastrostomy (RIG) is an established way of maintaining enteral nutrition in patients who cannot maintain nutrition orally. The purpose of this study was to evaluate the safety and efficacy of primary placement of a wide bore button gastrostomy in a large, varied patient population through retrospective review. All patients who underwent gastrostomy placement from January 1, 2004 to January 1, 2009 were identified. 18-Fr gastrostomy buttons (MIC-Key G) were inserted in the majority. Follow-up ranged from 6 months to 4.5 years. A total of 260 patients (M:F 140:120, average age 59.2 years) underwent gastrostomy during the study period. Overall success rate for RIG placement was 99.6 %, with success rate of 95.3 % for primary button insertion. Indications included neurological disorders (70 %), esophageal/head and neck malignancy (21 %), and other indications (9 %). Major and minor complication rates were 1.2 and 12.8 %, respectively. Thirty-day mortality rate was 6.8 %. One third of patients underwent gastrostomy reinsertion during the study period, the main indication for which was inadvertent catheter removal. Patency rate was high at 99.5 %. The maximum number of procedures in any patient was 8 (n = 2), and the average tube dwell time was 125 days. Primary radiological insertion of a wide bore button gastrostomy is a safe technique, with high success rate, high patency rate, and low major complication rate. We believe that it is feasible to attempt button gastrostomy placement in all patients, once tract length is within limits of tube length. If difficulty is encountered, then a standard tube may simply be placed instead.

  15. Cutaneous adverse events of epidermal growth factor receptor inhibitors: A retrospective review of 99 cases

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    Kumutnart Chanprapaph


    Full Text Available Background: Previous reports regarding the cutaneous adverse events of epidermal growth factor receptor inhibitors are mostly limited to small case reports and case series, mainly involving Caucasian patients. Aims: We describe the trends in the clinical presentation of Asian patients who had cutaneous adverse events induced by epidermal growth factor receptor inhibitors and to explore the relationship between skin adverse events and tumor response. Methods: From 2006 to 2010, medical records of Thai patients with non-small cell lung cancer receiving epidermal growth factor receptor inhibitors were retrieved and analyzed. Results: In all, 99 patients were reviewed and analyzed. Erlotinib and gefitinib were commenced in 75 (75.8% and 24 (24.2% patients, respectively. Cutaneous adverse events occurred in 43 (57.3% patients receiving erlotinib and in 15 (62.5% patients receiving gefitinib. The most common adverse event was xerosis (52.5%. Less common adverse events included papulo-pustular eruption (27.3%, erythematous maculopapular rash (11.1%, mucositis (6.7%, paronychia (5.1%, and trichomegaly (2%. Elderly patients had a higher occurrence of xerosis. The presence of cutaneous adverse events was significantly higher in subjects who had a tumor response. Limitations: The limitations of study include its retrospective nature, and the initial screening of cutaneous adverse events was done by non-dermatologists. Conclusions: Cutaneous adverse events due to epidermal growth factor receptor inhibitors are not uncommon in the Asian population. We found a positive correlation between the occurrences of cutaneou adverse events and tumor response supporting the view that they are surrogate markers for therapeutic response.

  16. The incidence of vitamin D deficiency in the obese: a retrospective chart review

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    Deepu Daniel


    Full Text Available Objective: To determine whether the obese population is more likely to be vitamin D deficient compared to healthy and overweight individuals. Patients and methods: A retrospective chart review was performed for patients seen in two ambulatory clinics in South Florida over a 1-year period (n=402. Patients’ vitamin D levels drawn during annual wellness visits were analyzed. Subjects were categorized based on body mass index (BMI as normal (BMI 30.0. Their 25-OH vitamin D status was defined as normal (>30 ng/mL, insufficient (20.0–29.9 ng/mL, and deficient (<20 ng/mL. The study included both men and women of black, white, Hispanic, and Asian races. Other variables in the study included age, history of hypertension, and diabetes. Patients with conditions leading to vitamin D malabsorption (chronic pancreatitis, celiac disease, Crohn's disease, cystic fibrosis, ileocecal resection were excluded. Patients with prior vitamin D supplementation were also excluded. Results: The results of the study indicated a significant association of vitamin D deficiency and obesity (p<0.05. Patients who were obese had a relative risk of 3.36 (95% CI: 1.50–7.54 for vitamin D deficiency compared to subjects with normal BMI. The study also showed a significant association between vitamin D levels and obesity when controlling for age, race, and presence of hypertension (p <0.05, with Asians and blacks more likely to be vitamin D deficient. Conclusion: These results demonstrated that obesity was a risk factor for vitamin D deficiency in all races, especially the Asian and black populations. This suggests that physicians should screen for vitamin D deficiency in the obese populations, especially among Asian and black races.

  17. Hysterectomy at a Canadian tertiary care facility: results of a one year retrospective review

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    Gorwill R Hugh


    Full Text Available Abstract Background The purpose of this study was to investigate the indications for and approach to hysterectomy at Kingston General Hospital (KGH, a teaching hospital affiliated with Queen's University at Kingston, Ontario. In particular, in light of current literature and government standards suggesting the superiority of vaginal versus abdominal approaches and a high number of concurrent oophorectomies, the aim was to examine the circumstances in which concurrent oophorectomies were performed and to compare abdominal and vaginal hysterectomy outcomes. Methods A retrospective chart audit of 372 consecutive hysterectomies performed in 2001 was completed. Data regarding patient characteristics, process of care and outcomes were collected. Data were analyzed using descriptive statistics, t-tests and linear and logistic regression. Results Average age was 48.5 years, mean body mass index (BMI was 28.6, the mean length of stay (LOS was 5.2 days using an abdominal approach and 3.0 days using a vaginal approach without laparoscopy. 14% of hysterectomies were performed vaginally, 5.9% were laparoscopically assisted vaginal hysterectomies and the rest were abdominal hysterectomies. The most common indication was dysfunctional or abnormal uterine bleeding (37%. The average age of those that had an oophorectomy (removal of both ovaries was 50.8 years versus 44.3 years for those that did not (p Conclusions A significant reduction in LOS was found using the vaginal approach. Both the patient and the health care system may benefit from the tendency towards an increased use of vaginal hysterectomies. The audit process demonstrated the usefulness of an on-going review mechanism to examine trends associated with common surgical procedures.

  18. A retrospective chart review: adolescents with borderline personality disorder, borderline personality traits, and controls. (United States)

    Jopling, Ellen N; Khalid-Khan, Sarosh; Chandrakumar, Shivani F; Segal, Shira C


    With an estimated lifetime prevalence as high as 5.9% in the general population, borderline personality disorder (BPD) is a psychiatric disorder characterized by marked impulsivity as well as difficulties in interpersonal relationships, self-image, and affects. The burden on the health care system is immense with BPD patients accounting for 10%-20% of the patients in mental health outpatient facilities and 15%-40% in mental health inpatient facilities. Further, while 75%-80% of BPD patients attempt to commit suicide, 10% succeed; this mortality rate exceeds even that of anorexia nervosa which, with a weighted mortality rate of 5.1%, has often been considered to have the highest mortality rate of any mental disorder. In order to provide treatment and to implement preventative measures, a risk profile as well as clinical features must be identified within the adolescent population. This is presently crucial, as the current criteria for BPD are not developmentally focused, and as a result, criteria initially developed for the adult population are being applied in diagnoses of adolescents. A population of adolescents (n=80) between 16 and 19 years of age meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria either for BPD traits (n=46) or for BPD (n=36) were included in a retrospective chart review; a control group consisting of n=30 mood and anxiety control subjects were included to allow for further comparisons. Complex significant differences were discovered between the three groups in the following areas: history of sexual abuse, suicidal ideation, internalizing/externalizing symptoms, interpersonal difficulties, impulsivity, pre-perinatal stress, bullying, substance abuse, anxiety disorders, disruptive disorders, and finally, learning disorders.

  19. A retrospective chart review of pirfenidone-treated patients in Sweden: the REPRIS study

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    Carl Magnus Sköld


    Full Text Available Background: Idiopathic pulmonary fibrosis (IPF is a chronic, progressive lung disease that usually results in respiratory failure and death. Pirfenidone was approved as the first licensed therapy for IPF in Europe based on phase III trials where patients with a forced vital capacity (FVC >50% of predicted were included. The aim of this study was to characterise patients treated with pirfenidone in Swedish clinical practice and to describe the adherence to the reimbursement restriction since reimbursement was only applied for patients with FVC below 80% of predicted. Methods: This was a retrospective, observational chart review of IPF patients treated with pirfenidone from three Swedish university clinics. Patients initiated on treatment during the period 28 June 2012 to 20 November 2014 were included. Data on patient characteristics, basis of diagnosis, treatment duration, quality of life, and adverse drug reactions (ADRs were collected from medical charts. Results: Forty-four patients were screened and 33 were included in the study. The mean treatment duration from start of pirfenidone until discontinuation or end of study was 38 weeks. At the initiation of pirfenidone treatment, FVC was 62.7% (12.1 [mean (SD], diffusion capacity (DLco was 45.1% (13.8 of predicted, and the ratio of forced expiratory volume on 1 sec (FEV1 to FVC was 0.78 (0.1. The percentage of patients with an FVC between 50 and 80% was 87%. Ten of the patients had ADRs including gastrointestinal and skin-related events, cough and signs of impaired hepatic function, but this led to treatment discontinuation in only two patients. Conclusion: Data from this chart review showed that adherence to the Swedish reimbursement restriction was followed in the majority of patients during the study period. At the start of pirfenidone treatment, lung function, measured as FVC, was lower in the present cohort of Swedish IPF patients compared with other registry and real-life data. About a

  20. A Review of School Reintegration Programs for Children with Cancer. (United States)

    Prevatt, Frances F.; Heffer, Robert W.; Lowe, Patricia A.


    Descriptive articles on school reintegration programs for children with cancer are reviewed to synthesize the information of best practices for program development. Suggestions are given for school psychologists working with chronically ill children. (Author/JDM)

  1. Zinc mono-therapy in pre-symptomatic Chinese children with Wilson disease: a single center, retrospective study.

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    Kuerbanjiang Abuduxikuer

    Full Text Available BACKGROUND: There is no official consensus regarding zinc therapy in pre-symptomatic children with Wilson Disease (WD; more data is needed. OBJECTIVE: To investigate the safety and efficacy of zinc gluconate therapy for Chinese children with pre-symptomatic WD. METHODS: We retrospectively analyzed pre-symptomatic children receiving zinc gluconate in a single Chinese center specialized in pediatric hepatology. Short-term follow-up data on safety and efficacy were presented, and effects of different zinc dosages were compared. RESULTS: 30 children (21 males aged 2.7 to 16.8 years were followed for up to 4.4 years; 26 (87% children had abnormal ALT at baseline. Most patients (73% received higher than the currently recommended dose of elemental zinc. Zinc gluconate significantly reduced mean ALT (p<0.0001, AST (p<0.0001, GGT (p<0.0001 levels after 1 month, and urinary copper excretion after 6 months (p<0.0054. Mean direct bilirubin levels dropped significantly at 1 month (p = 0.0175, 3 months (p = 0.0010, and 6 months (p = 0.0036. Serum zinc levels gradually increased and reached a significantly higher level after 6 months (p<0.0026, reflecting good compliance with the therapy. Complete blood count parameters did not change throughout the analysis period. 8 children experienced mild and transient gastrointestinal side effects. The higher zinc dose did not affect treatment response and was not associated with different or increased side effects when compared to conventional zinc dose. CONCLUSION: In our cohort, zinc gluconate therapy for Chinese children with pre-symptomatic WD was effective, and higher initial dose of elemental zinc had the same level of efficacy as the conventional dose.

  2. Treatment of prolonged convulsive seizures in children; a single centre, retrospective, observational study

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    Vlaskamp, Danique R. M.; Brouwer, Oebele F.; Callenbach, Petra M. C.


    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 child

  3. An Activity-Based Language Intervention Program for Kindergarten Children: A Retrospective Evaluation (United States)

    Cohen-Mimran, Ravit; Reznik-Nevet, Liron; Korona-Gaon, Sharon


    The purpose of the present study was to examine the effect of a small-group intervention based on the naturalistic approach on 220 children from 3-5 years of age. All kindergarten children received weekly sessions delivered by a SLP in collaboration with the kindergarten teacher. These sessions included various book related activities. Two…

  4. Overdiagnosis of asthma in children in primary care : A retrospective analysis

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    Looijmans-Van Den Akker, I.; Van Luijn, K. R S; Verheij, T. J M


    Background Asthma is one of the most common chronic diseases in childhood. According to guidelines, a diagnosis of asthma should be confirmed using lung function testing in children aged >6 years. Previous studies indicate that asthma in children is probably overdiagnosed. However, the extent has no

  5. Symptoms and treatment of Dientamoeba fragilis infection in children, a retrospective study

    NARCIS (Netherlands)

    Schure, Janna M A Ter; de Vries, Marrit; Weel, Jan F L; van Roon, Eric N; Faber, Tina E


    INTRODUCTION: Dientamoeba fragilis infection in children is common, and its incidence has increased since the introduction of more sensitive molecular techniques. There is no consensus on the optimal treatment. Current medical practice in the Netherlands is to treat symptomatic children with clioqui

  6. Children as Subjects in Nutrition Research: A Retrospective Look at Their Perceptions (United States)

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


    Objective: 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. Design: Seven focus group sessions were conducted during March 2008 with research participants from a trial that examined the effects of pre-exercise…

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

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    Masood Mohd


    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

  8. Stingray envenomation: a retrospective review of clinical presentation and treatment in 119 cases. (United States)

    Clark, Richard F; Girard, Robyn Heister; Rao, Daniel; Ly, Binh T; Davis, Daniel P


    Stingray stings are common along coastal regions of this country and the world. The tail of the stingray contains a barbed stinger attached to a venom gland and contained within an integumentary sheath. During a sting, the stinger and sheath can become embedded in the soft tissue of the victim, and venom is injected into the wound. Stingray venom most often causes severe pain on contact, although the exact mechanism of toxicity is not certain. Hot water immersion of the stung extremity has been reported to be effective in relieving pain associated with the envenomation, but large studies of this therapy have not been performed. We retrospectively reviewed stingray stings presenting to our Emergency Department (ED) over an 8-year period. Cases were divided into acute (group 1, within 24 h of the sting) and subacute (group 2, 24 h or more after the sting) presentations. Charts were abstracted for information concerning the victim's history, physical examination, treatment, diagnostic imaging, and outcome, including the effectiveness of hot water immersion as analgesia, and use of antimicrobials. A total of 119 cases were identified and abstracted, 100 in group 1 and 19 in group 2. Of the group 1 patients initially treated with hot water immersion alone, 88% had complete relief of pain within 30 min without administration of any other analgesic. In the patients who initially received a dose of analgesic along with hot water immersion, none required a second dose of analgesics and all had complete pain relief before discharge. There were no adverse effects (such as thermal burns) with this therapy. Analysis of infectious complications in group 1 patients demonstrated a significant number of patients returning to the ED with wound infections when prophylactic antibiotics were not administered at initial presentation. Our findings suggest that hot water immersion was effective in decreasing or eliminating the pain associated with stingray envenomation in our series. Due

  9. Pregnancy-associated deaths: a 15-year retrospective study and overall review of maternal pathophysiology. (United States)

    Christiansen, Lydia R; Collins, Kim A


    Pregnancy-related death is defined by the International Classification of Diseases, Tenth Revision (ICD-10) as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of death. In the year 2000, a collaborative effort involving World Health Organization (WHO), UNICEF, and UNFPA estimated 660 maternal deaths in the United States. This averages 11 maternal deaths per 100,000 live births reported. Many pregnancy-associated deaths are not easily identified as such since the presence of a recent or current pregnancy may not be listed on the death certificate. Thus, the WHO estimates that in the United States, the maternal mortality is approximately 17/100,000 pregnancies. This is significantly higher than the goal set by the US Department of Health and Human Services in Healthy People 2010, which sets the target for maternal mortality at less than 3.3/100,000 live births. The most common causes of maternal death vary somewhat from region to region in the United States. They include pulmonary thromboembolism, amniotic fluid embolism, primary postpartum uterine hemorrhage, infection, and complications of hypertension including preeclampsia and eclampsia. Pulmonary disease, complications of anesthesia, and cardiomyopathy also are significant contributors to maternal mortality in some populations. The death of a pregnant or recently pregnant individual poses a wide scope of challenges to the forensic pathologist and investigator. The pathologist must have a broad knowledge of the physiologic and biochemical changes that occur during pregnancy, as well as the clinical and pathological manifestation of these changes. Conditions that may be "benign" in the nonpregnant individual may be lethal in the puerperal period. In addition, it should be kept in mind that deaths during pregnancy may be due to unnatural causes. Accident, homicide, and suicide must be ruled out in each case. The authors reviewed all forensic cases

  10. Cutaneous Invasive Aspergillosis: Retrospective Multicenter Study of the French Invasive-Aspergillosis Registry and Literature Review. (United States)

    Bernardeschi, Céline; Foulet, Francoise; Ingen-Housz-Oro, Saskia; Ortonne, Nicolas; Sitbon, Karine; Quereux, Gaëlle; Lortholary, Olivier; Chosidow, Olivier; Bretagne, Stéphane


    Invasive aspergillosis (IA) has poor prognosis in immunocompromised patients. Skin manifestations, when present, should contribute to an early diagnosis. The authors aimed to provide prevalence data and a clinical and histologic description of cutaneous manifestations of primary cutaneous IA (PCIA) and secondary CIA (SCIA) in a unique clinical series of IA and present the results of an exhaustive literature review of CIA. Cases of proven and probable IA with cutaneous manifestations were retrospectively extracted from those registered between 2005 and 2010 in a prospective multicenter aspergillosis database held by the National Reference Center for Invasive Mycoses and Antifungals, Pasteur Institute, France. Patients were classified as having PCIA (i.e., CIA without extracutaneous manifestations) or SCIA (i.e., disseminated IA). Among the 1,410 patients with proven or probable IA, 15 had CIA (1.06%), 5 PCIA, and 10 SCIA. Hematological malignancies were the main underlying condition (12/15). Patients with PCIA presented infiltrated and/or suppurative lesions of various localizations not related to a catheter site (4/5), whereas SCIA was mainly characterized by disseminated papules and nodules but sometimes isolated nodules or cellulitis. Histologic data were available for 11 patients, and for 9, similar for PCIA and SCIA, showed a dense dermal polymorphic inflammatory infiltrate, with the epidermis altered in PCIA only. Periodic acid Schiff and Gomori-Grocott methenamine silver nitrate staining for all but 2 biopsies revealed hyphae compatible with Aspergillus. Aspergillus flavus was isolated in all cases of PCIA, with Aspergillus fumigatus being the most frequent species (6/10) in SCIA. Two out 5 PCIA cases were treated surgically. The 3-month survival rate was 100% and 30% for PCIA and SCIA, respectively. Our study is the largest adult series of CIA and provides complete clinical and histologic data for the disease. Primary cutaneous IA should be recognized early

  11. Radiotherapy in stage 1 testicular seminoma: retrospective study and review of literature; Radiotherapie des seminomes testiculaires de stade 1: etude retrospective et revue de la litterature

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    Bauduceau, O.; Le-Moulec, S.; Bernard, O. [Hopital des Armees du Val-de-Grace, Service de Radiotherapie et Oncologie, 75 - Paris (France); Souleau, B. [Hopital des Armees Percy, Service d' Hematologie, 92 - Clamart (France); Houlgatte, A. [Hopital des Armees du Val-de-Grace, Service d' Urologie, 75 - Paris (France)


    Introduction. - Seminoma accounts for about 40% of germ cell tumours of the testicle. In this retrospective analysis, we review literature concerning management of stage I seminoma. Materials and methods. - Between March 1987 and April 2001, 65 patients with stage I pure testicular seminoma received adjuvant radiotherapy with a 25 MV linear accelerator. Results. - Median age was 33 years. Testicular tumour has been found on the right testis in 39 patients and on the left one in 24 patients. Patients have been treated using an anterior-posterior parallel pair and have received 20-25 Gy in 10-14 fractions. The target volume consisted of paraaortic, and paraaortic + homolateral iliac lymph nodes in 17 and 46 patients, respectively. Acute toxicity was mainly digestive, 38% of patients presenting nausea and vomiting. Median follow-up time was 37 months. All patients are alive in complete remission. Discussion. - Because of good radio-sensitivity of seminoma, radiotherapy is regarded as standard adjuvant treatment (5 years relapse rate: 3-5%). Acute toxicity is dominated by moderate gastro-intestinal side effects. Secondary neoplasia represents one of the worst possible long-term complications of therapy. Waiting for ongoing randomized trials, the modern literature for seminoma reflects a trend toward lower radiation doses (20-25 Gy) and smaller treatment volumes (paraaortic field). Adjuvant chemotherapy with two courses of carbo-platin, might be equivalent to radiotherapy but must be investigated in randomized trials. A surveillance policy is one of the other management options less recommended. (author)

  12. Recombinant Human Bone Morphogenetic Protein-2 (rhBMP-2) for the Treatment of Nonunion of the Femur in Children and Adolescents: A Retrospective Analysis (United States)

    Stiel, Norbert; Babin, Kornelia; Rupprecht, Martin; Rueger, Johannes M.; Stuecker, Ralf


    Background. The aim of this study was to examine clinical and radiographic healing after rhBMP-2 application in children and adolescents presenting with nonunion of the femur and to investigate the safety of rhBMP-2 use in these cases. Materials and Methods. We reviewed the medical records of five patients with a mean age of 11 years (5.4 to 16.2) with nonunion of the femur who were treated with rhBMP-2 and internal fixation using a locking plate at a single institution. Particular attention was paid to identify all adverse events that may be due to rhBMP-2 use. Results. Union occurred in four of five patients at a mean of 12.1 months (7.9 to 18.9). The locking plates were removed after a mean of 16 months (11 to 23). One patient had nonunion due to deep infection. After a mean follow-up of 62.5 months (17 to 100), union was still evident in all four patients and they were fully weight-bearing without pain. Discussion. In this retrospective study, rhBMP-2 combined with a locking plate has been used successfully to treat children and adolescents with nonunion of the femur in four of five cases. One major complication was thought to be possibly related to its use.

  13. 76 FR 39343 - Reducing Regulatory Burden; Retrospective Review Under E.O. 13563 (United States)


    ... changes in net benefits, cost- effectiveness ratios, or other financial metrics? With respect specifically... this section. To view Executive Order 13563 go to: on January 21, 2011 (76 FR 3821)), which directs agencies to conduct a retrospective analysis...

  14. Epidemiology and seasonality of respiratory viral infections in hospitalized children in Kuala Lumpur, Malaysia: a retrospective study of 27 years

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    Khor Chee-Sieng


    Full Text Available Abstract Background Viral respiratory tract infections (RTI are relatively understudied in Southeast Asian tropical countries. In temperate countries, seasonal activity of respiratory viruses has been reported, particularly in association with temperature, while inconsistent correlation of respiratory viral activity with humidity and rain is found in tropical countries. A retrospective study was performed from 1982-2008 to investigate the viral etiology of children (≤ 5 years old admitted with RTI in a tertiary hospital in Kuala Lumpur, Malaysia. Methods A total of 10269 respiratory samples from all children ≤ 5 years old received at the hospital's diagnostic virology laboratory between 1982-2008 were included in the study. Immunofluorescence staining (for respiratory syncytial virus (RSV, influenza A and B, parainfluenza types 1-3, and adenovirus and virus isolation were performed. The yearly hospitalization rates and annual patterns of laboratory-confirmed viral RTIs were determined. Univariate ANOVA was used to analyse the demographic parameters of cases. Multiple regression and Spearman's rank correlation were used to analyse the correlation between RSV cases and meteorological parameters. Results A total of 2708 cases were laboratory-confirmed using immunofluorescence assays and viral cultures, with the most commonly detected being RSV (1913, 70.6%, parainfluenza viruses (357, 13.2%, influenza viruses (297, 11.0%, and adenovirus (141, 5.2%. Children infected with RSV were significantly younger, and children infected with influenza viruses were significantly older. The four main viruses caused disease throughout the year, with a seasonal peak observed for RSV in September-December. Monthly RSV cases were directly correlated with rain days, and inversely correlated with relative humidity and temperature. Conclusion Viral RTIs, particularly due to RSV, are commonly detected in respiratory samples from hospitalized children in Kuala Lumpur

  15. Comparison of immune manifestations between refractory cytopenia of childhood and aplastic anemia in children: A single-center retrospective study. (United States)

    Wu, Jun; Cheng, Yifei; Zhang, Leping


    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.

  16. Intellectual Disability in Children; a Systematic Review

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    Dasteh Goli N.*BSc


    Full Text Available Abstract Aims: Intellectual disability is a condition characterised by the inability of a person to undertake normal psychological activities. The purpose of this study was to systematically review the intellectual disability in children and discuss the implications of different environmental and genetic factors, which describe particular categories of intellectual disable cases. Information & Methods: This systematic review was performed in 2014 by searching the existing literature in PubMed database in the scope of “intellectual disability in children”. 38 articles written from 1987 to 2014 were selected and surveyed for review. Findings: The prevalence of ID in the general population is estimated to be approximately 1%. ID disorder is multi-causal, encompassing all factors that interfere with brain development and functioning. Causes usually are classified according to the time of the insult, as prenatal, perinatal, and postnatal or acquired. Some causes, such as environmental toxins or endocrine disorders, may act at multiple times. Others, such as genetic disorders, have different manifestations during postnatal development. The outcome for ID is variable and depends upon the aetiology, associated conditions, and environmental and social factors. The goals of management of ID are to strengthen areas of reduced function, minimize extensive deterioration in mental cognitive and adaptability, and lastly, to promote optimum or normal functioning of the individuals in their community. Conclusion: Prominent features of ID include significant failures in both intellectual functioning and adaptive behaviour, which comprises daily social and practical life skills, commencing earlier in life.

  17. Assessing Proprioception in Children: A Review. (United States)

    Chu, Virginia Way Tong


    Proprioception is the subconscious and conscious awareness of the spatial and mechanical status of the musculoskeletal framework. When working with children with motor delays and sensory integrative dysfunction, occupational therapists routinely assess the client's proprioceptive system. However, currently available assessments for occupational therapists are primarily observer-based and concerns have been raised about the reliability of observer-based assessments of sensation. The author's purpose was to review measures of proprioception currently available to occupational therapists and explore direct measures of proprioception from neuroscience and rehabilitation that can be adapted for pediatric clinical use. Observer-based and direct measurements of proprioception assessments complement each other in meeting clinical needs. A better understanding of both types of evaluation will improve proprioceptive evaluation.

  18. Air pollution and anemia as risk factors for pneumonia in ecuadorian children: a retrospective cohort analysis

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    Harris Aaron M


    Full Text Available Abstract Background Ambient air pollution and malnutrition, particularly anemia, are risk factors for pneumonia, a leading cause of death in children under five. We simultaneously assessed these risk factors in Quito, Ecuador. Methods In 2005, we studied two socioeconomically similar neighborhoods in Quito: Lucha de los Pobres (LP and Jaime Roldos (JR. LP had relatively high levels of air pollution (annual median PM2.5 = 20.4 μg/m3; NO2 = 29.5 μg/m3 compared to JR (annual median PM2.5 = 15.3 μg/m3; NO2 = 16.6 μg/m3. We enrolled 408 children from LP (more polluted and 413 children from JR (less polluted. All subjects were aged 18-42 months. We obtained medical histories of prior physician visits and hospitalizations during the previous year, anthropometric nutrition data, hemoglobin levels, and hemoglobin oxygen saturation via oximetry. Results In anemic children, higher pollution exposure was significantly associated with pneumonia hospitalization (OR = 6.82, 95%CI = 1.45-32.00; P = 0.015. In non-anemic children, no difference in hospitalizations by pollution exposure status was detected (OR = 1.04, NS. Children exposed to higher levels of air pollution had more pneumonia hospitalizations (OR = 3.68, 1.09-12.44; P = 0.036, total respiratory illness (OR = 2.93, 95% CI 1.92-4.47; P Conclusions Ambient air pollution is associated with rates of hospitalization for pneumonia and with physician's consultations for acute respiratory infections. Anemia may interact with air pollution to increase pneumonia hospitalizations. If confirmed in larger studies, improving nutrition-related anemia, as well as decreasing the levels of air pollution in Quito, may reduce pneumonia incidence.

  19. Ocular manifestations of idiopathic aplastic anemia: retrospective study and literature review

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    Mansour AM


    Full Text Available Ahmad M Mansour,1 Jong Wook Lee,2 Seung Ah Yahng,2 Kyu Seop Kim,3 Maha Shahin,4 Nelson Hamerschlak,5 Rubens N Belfort,6 Shree K Kurup71Department of Ophthalmology, American University of Beirut, Rafic Hariri University Hospital, Beirut, Lebanon; 2Division of Hematology, Seoul St Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea; 3Department of Ophthalmology, Seoul St Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea; 4Department of Ophthalmology, Mansoura University, Mansoura City, Egypt; 5Oncology and Hematology Program, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil; 6Vision Institute, Hospital São Paulo, Federal University of São Paulo, Brazil; 7Department of Ophthalmology, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USAAbstract: Aplastic anemia (AA is a rare disease with few reports on its ophthalmic ­manifestations. The ocular findings are described in a retrospective consecutive series of 719 AA Korean patients followed at the Hematology Clinic of The Catholic University of Korea. Out of a total of 719 patients, 269 patients had eye examinations, 156 patients had retinal evaluation, and 37 (23.7% had retinal findings. These 37 patients had unilateral retinal ­hemorrhage in seven and bilateral retinal hemorrhage in 30 with mean hemoglobin of 6.6 g/dL (range 2.7–12.6 g/dL and platelet counts of 18.8×109/L (range 4–157×109/L; central retinal vein occlusion-like picture occurred in nine patients and these had similar rheology to the rest of the subjects; optic disc edema, cotton-wool spots, macular edema, and dry eyes occurred in two, three, five, and three patients, respectively. In this Korean series of 141 subjects with AA, systemic bleeding occurred in 24.8% of subjects, retinal hemorrhage in 37% of subjects, and any bleeding site (eye or elsewhere occurred in 47.5% of subjects with AA. A

  20. Resuscitation after severe burn injury using high-dose ascorbic acid: a retrospective review. (United States)

    Kahn, Steven Alexander; Beers, Ryan J; Lentz, Christopher W


    Resuscitation of burn victims with high-dose ascorbic acid (vitamin C [VC]) was reported in Japan in the year 2000. Benefits of VC include reduction in fluid requirements, resulting in less tissue edema and body weight gain. In turn, these patients suffer less respiratory impairment and reduced requirement for mechanical ventilation. Despite these results, few burn centers resuscitate patients with VC in fear that it may increase the risk of renal failure. A retrospective review of 40 patients with greater than 20% TBSA between 2007 and 2009 was performed. Patients were divided into two groups: one received only lactated Ringer's (LR) solution and another received LR solution plus 66 mg/kg/hr VC. Both groups were resuscitated with the Parkland formula to maintain stable hemodynamics and adequate urine output (>0.5 ml/kg/hr). Patients with >10-hour delay in transfer to the burn center were excluded. Data collected included age, gender, weight, %TBSA, fluid administered in the first 24 hours, urine output in the first 24 hours, and Acute Physiology and Chronic Health Evaluation II score. PaO2 in millimeters mercury:%FIO2 ratio and positive end-expiratory pressure were measured at 12-hour intervals, and hematocrit was measured at 6-hour intervals. Comorbidities, mortality, pneumonia, fasciotomies, and renal failure were also noted. After 7 patients were excluded, 17 patients were included in the VC group and 16 in the LR group. VC and LR were matched for age (42 ± 16 years vs 50 ± 20 years, P = .2), burn size (45 ± 21%TBSA vs 39 ± 15%TBSA, P = .45), Acute Physiology and Chronic Health Evaluation II (17 ± 7 vs 18 ± 8, P = .8), and gender. Fluid requirements in the first 24 hours were 5.3 ± 1 ml/kg/%TBSA for VC and 7.1 ± 1 ml/kg/%TBSA for LR (P < .05). Urine output was 1.5 ± 0.4 ml/kg/hr for VC and 1 ± 0.5 ml/kg/hr for LR (P < .05). Vasopressors were needed in four VC patients and nine LR patients (P = .07). VC patients required vasopressors to maintain mean

  1. Asthma exacerbation in children: a practical review. (United States)

    Fu, Lin-Shien; Tsai, Ming-Chin


    Asthma is the most common chronic lower respiratory tract disease in childhood throughout the world. Despite advances in asthma management, acute exacerbations continue to be a major problem in patients and they result in a considerable burden on direct/indirect health care providers. A severe exacerbation occurring within 1 year is an independent risk factor. Respiratory tract viruses have emerged as the most frequent triggers of exacerbations in children. It is becoming increasingly clear that interactions may exist between viruses and other triggers, increasing the likelihood of an exacerbation. In this study, we provide an overview of current knowledge about asthma exacerbations, including its definition, impact on health care providers, and associated factors. Prevention management in intermittent asthma as well as intermittent wheeze in pre-school children and those with persistent asthma are discussed. Our review findings support the importance of controlling persistent asthma, as indicated in current guidelines. In addition, we found that early episodic intervention appeared to be crucial in preventing severe attacks and future exacerbations. Besides the use of medication, timely education after an exacerbation along with a comprehensive plan in follow up is also vitally important.

  2. Radiological evaluation of facial types in mouth breathing children: a retrospective study. (United States)

    Izuka, E N; Costa, J R; Pereira, S R A; Weckx, L L M; Pignatari, S N; Uema, S F H


    Mouth breathing is a condition often associated with a long face, half-open mouth and increased anterior facial height. We performed conventional lateral and frontal cephalograms of eighty-nine children with nasal and mouth breathing and independently measured Total Facial Height using the analysis technique of Ricketts, and the Morphologic Facial Index employing the technique of Avila. It was concluded that dolicofacial following mesofacial were the most frequent patterns found in mouth-breathing children and this suggests that both analyses can be used independently.

  3. Perioperative fasting and children: A review article

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    Bahareh Imani


    Full Text Available This review provides an overview of the present knowledge on the aspects of preoperative fasting with the assessment of the evidence quality. A systematic research was conducted in electronic databases in order to identify trials published between 1990 and 2014 concerning preoperative fasting, early resumption of oral intake and the effects of oral carbohydrate mixtures on gastric emptying and postoperative recovery. The publications were classified in terms of their evidence level, scientific validity and clinical relevance. The key recommendations are that children be encouraged to drink clear fluids within up to 2 hours before elective surgery (including Caesarean section and all but one member of the guideline groups consider that tea or coffee, with milk added (up to about one fifth of the total volume, are still clear fluids .Furthermore, solid food consumption should be prohibited for up to 6 hours before elective surgery for children. However, patients should not have their operation cancelled or delayed only because they are chewing gums or sucking a boiled sweet immediately prior to the induction of anaesthesia. These recommendations also apply to those patients with obesity, gastro-oesophageal reflux and diabetes. There is insufficient evidence to support the routine use of antacids, metoclopramide or H2-receptor antagonists before elective surgery in non-obstetric patients. Infants should be fed before elective surgery. Breast milk is considered a safe option for up to 4 hours and other kinds of milk for up to 6 hours. The present review takes into account the safety and possible benefits of preoperative carbohydrates while offering advice on the postoperative resumption of oral intake.

  4. Multilevel botulinum toxin type a as a treatment for spasticity in children with cerebral palsy: a retrospective study

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    Ece Unlu


    Full Text Available INTRODUCTION: Cerebral palsy is the most common cause of physical disability in children. Spasticity is a disabling clinical symptom that is prevalent among patients suffering from cerebral palsy. The treatment of spasticity with botulinum toxin type A (BTX-A is a well-established option in the interdisciplinary management of spasticity, providing focal reductions in muscle tone in cerebral palsy patients. OBJECTIVE: The aim of this retrospective study was to describe the effect of multilevel BTX-A injections in the lower extremities, focusing mainly on gross motor function and functional status in cerebral palsy patients. METHODS: Data from 71 cerebral palsy patients (64% male, 36% female, mean age 6.7 ±3.2 years were analyzed retrospectively. We used the Ashworth and Tardieu scales to evaluate the degree of spasticity. Motor function was measured by the Gross Motor Function Measure (GMFM-88, and functional status was classified by the Gross Motor Function Classification System (GMFCS I-V. Multilevel BTX-A injections were applied after sedation and with electrostimulation guidance. The evaluations were repeated every three months, and the patients were followed for six months. RESULTS: We found that the Ashworth and Tardieu scores decreased significantly at the three-month evaluation (p0.05. Although the improvement in spasticity was not maintained at the six-month evaluation, GMFM-88 scores increased significantly at the three- and six-month assessments. GMFSC levels showed no change in the three- and six-month assessments. CONCLUSION: We believe that a single multilevel BTX-A injection reduces spasticity and improves motor function in children with cerebral palsy.

  5. A retrospective study of dento-alveolar injuries of children in Ankara, Turkey. (United States)

    Altay, N; Güngör, H C


    Information concerning age and sex distribution, etiology, types, place and extent of trauma as well as seasonal variations, time difference between traumatic injury and seeking of dental care and number of traumatic injuries was recorded retrospectively from 150 patients. The study comprised 91 boys and 59 girls representing 246 dental injuries and 332 injured teeth (72 primary and 260 permanent teeth). The most common injuries were uncomplicated crown fracture (23.57%), subluxation (15.85%), avulsion (10.16%), lateral luxation (9.75%), complicated crown fracture and intrusion (8.4% and 8.94%, respectively). The occurrence of uncomplicated crown fractures was significantly higher (P<0.05) in the 10-12 years age group than other age groups. Lateral luxation and intrusion were significantly higher in the 1-6 and 7-9 years age groups (P<0.05, respectively).

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

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    Kelly Christine


    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.

  7. [Haemophilus influenzae and parainfluenzae in children. A retrospective study of 52 cases]. (United States)

    Guillot, F; Mory, C; Gire, R; Aït Hamouda, R


    Fifty-two children hospitalized in the Pediatric service of a general hospital between January 1978 and December 1979 were found to be infected with Haemophilus influenzae or para-influenzae (43 with H. influenzae and 9 with para-influenzae). Most of these children (34/52) were less than 4 years of age. The localizations of infections were as follow: 5 meningitis with satisfactory resolution except for 1 who developed slight deafness, 1 epiglotitis, 11 pneumonias or bronchopneumonias, 1 arthritis, 10 otitis medias, 6 conjunctivitis, 3 sinusitis, 10 upper airway infections and 1 neonatal infection. On 8 of these cases the patients were felt to be carriers of H. influenzae or para-influenzae, the signs and symptoms beeing not related to these bacteria. These results are compared with those found in the literature.

  8. 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


    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.

  9. The American Board of Radiology Holman Research Pathway: 10-Year Retrospective Review of the Program and Participant Performance

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    Wallner, Paul E., E-mail: [21st Century Oncology, LLC, Fort Myers, Florida, and American Board of Radiology, Tucson, Arizona (United States); Ang, K. Kian [University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Zietman, Anthony L. [Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts (United States); Harris, Jay R. [Harvard Medical School and Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Ibbott, Geoffrey S. [University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mahoney, Mary C. [University of Cincinnati Medical Center, Cincinnati, Ohio (United States); Mezwa, Duane G. [Oakland University William Beaumont School of Medicine, Royal Oaks, Michigan (United States); Wilson, Lynn D. [Yale University School of Medicine, New Haven, Connecticut (United States); Becker, Gary J. [American Board of Radiology, Tucson, Arizona (United States)


    Introduction: In 1999, the American Board of Radiology (ABR) implemented an innovative training program track in diagnostic radiology (DR) and radiation oncology (RO) designed to stimulate development of a cadre of future academic researchers and educators in the 2 disciplines. The program was designated the Holman Research Pathway (HRP). An in-depth retrospective review of initial certification examination performance, post-training career choices, and academic productivity has not been written. This report represents a 10-year retrospective review of post-training performance of a cohort of trainees who have had sufficient time to complete their training and initial certification process and to enter practice. Methods and Materials: All pertinent proceedings of the ABR and Accreditation Council for Graduate Medical Education (ACGME) Residency Review Committees for DR and RO between 1997 and May 2011 were reviewed. Thirty-four HRP candidates who fulfilled the established evaluation criteria were identified, and their ABR data files were analyzed regarding performance on the qualifying and certifying examinations. All candidates were contacted directly to obtain a current curriculum vitae. Results: Twenty candidates in RO and 14 candidates in DR were identifiable for review. All candidates attained initial certification. At the time of analysis, 23 of 33 (66.6%) candidates were employed in full-time academic practice (1 DR candidate remained in a fellowship and was not evaluated regarding employment status). Fifteen of 20 (75%) RO candidates were in faculty positions compared with 7 of 13 (53.8%) DR trainees. Additional academic productivity metrics are reported. Conclusions: A high percentage of HRP trainees remained in academic practice and demonstrated significant academic productivity as measured by manuscript authorship and research support. Additional time and observation will be needed to determine whether these findings will be sustained by past, current

  10. Clinical course of 63 children with hereditary spherocytosis: a retrospective study

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    Maria Christina Lopes Araujo Oliveira


    Full Text Available BACKGROUND: Hereditary spherocytosis (HS is an inherited hemolytic anemia that is caused by deficiency or dysfunction of erythrocyte cytoskeletal proteins. AIM: The aim of this study was to describe the clinical course of hereditary spherocytosis in patients treated in the Pediatric Hematology Unit, Hospital das Clínicas, Universidade Federal de Minas Gerais. METHODS: Sixty-three under 16-year-old patients with hereditary spherocytosis were retrospectively evaluated between January 1988 and December 2007. Hereditary spherocytosis was diagnosed based on clinical history, physical examination and on a positive osmotic fragility curve. Patients underwent screening for cholelithiasis by ultrasonography. They were classified into three groups: mild, moderate and severe. The events of interest were need for blood transfusion, cholelithiasis, splenic sequestration, aplastic crisis, and splenectomy. Differences between subgroups were evaluated by the two-sided log-rank test. RESULTS: The mean age at diagnosis was 5.2 years and most patients were classified as moderate (54%. Patients with the severe form of the disease were younger (p-value = 0.001 and needed more blood transfusions (p-value = 0.004. Seventeen patients (27% developed cholelithiasis, 14 (22.2% splenic sequestration and three (4.8% aplastic crises. Twenty-two patients (34.9% were splenectomized with the main indication being splenic sequestration in nine patients (41%. CONCLUSIONS: The clinical course of patients with hereditary spherocytosis in this study was relatively benign however cholelithiasis was a common complication.

  11. Retrospective review of thoracic neural damage during lung ablation - what the interventional radiologist needs to know about neural thoracic anatomy

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    Palussiere, Jean, E-mail: [Institut Bergonie, Department of Interventional Radiology (France); Canella, Mathieu [Centre Hospitalier Pau, Department of Radiology (France); Cornelis, Francois; Catena, Vittorio; Descat, Edouard [Institut Bergonie, Department of Interventional Radiology (France); Brouste, Veronique [Institut Bergonie, Clinical and Epidemiological Research Unit (France); Montaudon, Michel [CHU Haut Leveque, Department of Radiology (France)


    Background and Purpose: Radiofrequency ablation (RFA) is associated with low neural morbidity compared with surgery, which commonly causes debilitating long-term pain. The purpose was to review the thoracic neural anatomy relevant to percutaneous RFA and to retrospectively review symptomatic nerve injury after lung RFA at our institution. Materials and Methods: We retrospectively examined all symptomatic nerve injuries occurring after computed tomography (CT)-guided RFA treatment of lung tumors for 462 patients/509 procedures/708 lesions treated at our large tertiary referral centre during 10 years. Results: Eight patients experienced neurological complications after heating during the RFA procedure. These complications occurred in the phrenic (n = 1), brachial (n = 3), left recurrent (n = 1), and intercostal nerves (n = 2) and the stellate ganglion (n = 1). Three were grade 2, four grade 3 and one grade 4 injuries (CTCAE v3). Conclusion: Although rare, neurological complications can occur after RFA, and they can occasionally be severe. To prevent these complications, it is important for the interventional radiologist to be aware of the anatomy of nervous structures and to attempt to identify nerves on CT scans during the RFA procedure. Creating a pneumothorax can be useful to avoid nerve damage and related clinical complications.

  12. The effect of different intervention programs on treatment adherence of HIV-infected children, a retrospective study. (United States)

    van der Plas, Atie; Scherpbier, Henriette; Kuijpers, Taco; Pajkrt, Dasja


    In HIV-infected children, long-term adherence to combination anti-retroviral therapy (cART) is difficult. In this retrospective study, we evaluated the effect of two different treatment adherence programs on treatment adherence (as indicated by cART failures) and the need for additional supportive care measures in a cohort of 31 HIV-infected children between 3 and 18 years of age. In a follow-up period of 6 years, we evaluated the treatment adherence at baseline (before introduction of any treatment adherence program in 2004) and compared this to cART failures during two treatment adherence programs (in respectively 2006 and 2009). The need for additional supportive care measures (the frequency of hospitalizations, daily observed treatment, use of child protection service, attendance of special schools, and placement in foster homes) was also evaluated at these three time points. The first treatment adherence program focused on increasing patient's obedience by imposing negative measures in case of treatment failure, whereas the second program aimed to increase treatment adherence by rewarding optimal medication intake. Prior to start of any treatment adherence intervention program, cART failures were observed in 29% of the pediatric patients. After introduction of the first treatment adherence program, cART failures decreased to 6%. During the second treatment adherence program, the cART failures remained equally low (10%), but the need for some specific additional supportive care measures (the frequency of hospitalizations and placement in foster homes) was importantly reduced. Treatment adherence programs are effective in increasing treatment adherence to cART in HIV-infected children. A novel reward treatment interventional program as an addition to social supportive care programs is a promising new positive enforcement program and can reduce the need for additional supportive care programs. Further prospective studies are needed to evaluate the long

  13. Risk of triple-class virological failure in children with HIV: a retrospective cohort study

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    Castro, Hannah; Judd, Ali; Gibb, Diana M;


    In adults with HIV treated with antiretroviral drug regimens from within the three original drug classes (nucleoside or nucleotide reverse transcriptase inhibitors [NRTIs], non-NRTIs [NNRTIs], and protease inhibitors), virological failure occurs slowly, suggesting that long-term virological...... suppression can be achieved in most people, even in areas where access is restricted to drugs from these classes. It is unclear whether this is the case for children, the group who will need to maintain viral suppression for longest. We aimed to determine the rate and predictors of triple-class virological...

  14. Identification and Referral of Patients at Risk for Post-traumatic Stress Disorder: A Literature Review and Retrospective Analysis. (United States)

    Bolduc, Aaron; Hwang, Brice; Hogan, Christopher; Bhalla, Varun K; Nesmith, Elizabeth; Medeiros, Regina; Alexander, Cassie; Holsten, Steven B


    Post-traumatic stress disorder (PTSD) is a well-established psychological disorder after severe traumatic injury but remains poorly recognized. Recent changes in the "Resources for Optimal Care of the Injured Trauma Patient 2014" stress the need for comprehensive screening and referral for PTSD and depression after injury. Our purpose was to review the current PTSD literature and perform a retrospective chart review to evaluate screening at our institution. We hypothesized a lack of documentation and thus referral of these patients to mental health professionals. We performed a literature review of 43 publications of risk factors for PTSD in the civilian adult population followed by a retrospective review. Records were analyzed for basic demographics, risk factors found in the literature, and referrals to mental health providers. Risk factors included amputation, dissociative symptoms, female gender, history of mental health disorder, and peri-traumatic emotionality. Traumatic amputation status and gender were recorded in all patients. History of mental health disorder was present in 11.5 per cent patients, absent in 80.75 per cent, and not recorded in 7.75 per cent with an overall documentation of 91.75 per cent. Dissociative symptoms and peri-traumatic emotionality were recorded in 0.5 per cent and 1.0 per cent of patients, respectively. Only 13 patients of 400 (3.25%) were referred to mental health professionals. Despite extensive evidence and literature supporting risk factors for the development of PTSD, identification and treatment at our level 1 trauma center is lacking. There is a need for consistent screening among trauma centers to identify PTSD risk factors and protocols for risk reduction and referrals for patients at risk.

  15. Risk factors for central venous catheter-related thrombosis in children: a retrospective analysis. (United States)

    Chen, Kai; Agarwal, Arnav; Tassone, Maria Cristina; Shahjahan, Nadia; Walton, Mark; Chan, Anthony; Mondal, Tapas


    Central venous catheter (CVC) placement is associated with increased risk of thrombosis in the paediatric population, particularly in relation to the type of catheter and the manner of its insertion. Here, we investigate risk factors associated with CVC-related thrombosis in children, with particular emphasis on positioning of the catheter tip. Patients aged 0-18 who underwent at least one CVC placement from 2008 to 2013 at a single centre with a subsequent follow-up echocardiogram were included for a total of 104 patients and 147 lines. Data on clinical and catheter-related risk factors were collected from patient charts. Statistical analysis using Pearson's χ tests, independent samples t-test, and odds ratios were used to assess potential risk factors for thrombosis. Neither insertion site (subclavian vein or otherwise), left- vs. right-sided insertion, nor catheter type were significant risk factors for thrombosis. There were no thrombotic events reported at the superior vena cava (SVC)-right atrium junction and no significant differences in thrombotic risk with initial tip placement in the SVC-right atrium junction vs. the SVC, right atrium, or inferior vena cava. Acute lymphoblastic leukaemia was a major clinical risk factor for thrombosis. Tip movement was common and may have been an important factor in the development of CVC-related thrombi. Prospective studies can yield insight into the role of follow-up imaging in the prevention of catheter-related thrombosis in children.


    Directory of Open Access Journals (Sweden)

    Saif Zil


    Full Text Available BACKGROUND : O rganophosphate pesticides are the most important cause of severe toxicity and death worldwide. Outbreaks of organophosphorus poisoning has increased specially in Bihar and south india after introduction of Mid - day meals schemes . AIM : To study the clinical profile of patients with organophosphorus poisoning outbreak, and efficacy of poison severity score as a triage to predict complications. MATERIALS AND METHODS : Thirty four students referred from primary health care to our tertiary care hospital. Medical History, physical examination and in some cases pseudocholinesterase was done. Medical records were retrospectively analysed and patients were divided into three groups (A, B, C based on poison severity score. Inclusion and exclusion criteria were developed. The Incidence of complications were studied in each group. Patients were also divide into those achieving early atropinisation versus late atropisation and compared . Statistical probability of each group was calculated with CHI SQUARE test. RESULTS : All patients were male children between 12 to 16 years (mean age being13.6 years. Group A, Group B, Group C had 11, 20, 3 patients respectively. Overall vomiting (88%, abdominal pain (79% and depressed mental status (55% were the commonest symptoms . The rate of complication in Group A, Group B ,Group C were 18%,35% and 100%respectively, however a p value calculated(6.84 Vs 9.49 with CHI SQUARE test was not significant. The commonest complications were cardiovascular, followed by respiratory and renal failure. Two patients developed multiple organ dysfunction and has to be referred. Retrospectively a mong 1 8 patients were atropinised early, 3 had complications and among 16 atropinised late, 9 developed complications. By using CHI SQUARE test the p value calculated was significant ( 3.94 >3.84 . CONCLUSION : Poison severity score reliably predicts the incidence of complication and help in triage of patients in outbreaks of

  17. American Children's Literature: An Historiographical Review. (United States)

    Kelly, R. Gordon


    The bibliographic essays which make up this special issue discuss and cite works under the following titles: "Children's Literature as a Field of Study,""Bibliographies of Children's literature,""Previous General Works in the Field," and "Specialized Studies in American Children's Literature." An essay entitled "Suggestions for Further Work"…

  18. Clinical and prognostic features among children with acute encephalitis syndrome in Nepal; a retrospective study

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    Impoinvil Daniel E


    Full Text Available Abstract Background Acute encephalitis syndrome (AES is commonly seen among hospitalized Nepali children. Japanese Encephalitis (JE accounts for approximately one-quarter of cases. Although poor prognostic features for JE have been identified, and guide management, relatively little is reported on the remaining three-quarters of AES cases. Methods Children with AES (n = 225 were identified through admission records from two hospitals in Kathmandu between 2006 and 2008. Patients without available lumbar puncture results (n = 40 or with bacterial or plasmodium infection (n = 40 were analysed separately. The remaining AES patients with suspected viral aetiology were classified, based on positive IgM antibody in serum or cerebral spinal fluid, as JE (n = 42 or AES of unknown viral aetiology (n = 103; this latter group was sub-classified into Non-JE (n = 44 or JE status unknown (n = 59. Bad outcome was defined as death or neurological sequelae at discharge. Results AES patients of suspected viral aetiology more frequently had a bad outcome than those with bacterial or plasmodium infection (31% versus 13%; P = 0.039. JE patients more frequently had a bad outcome than those with AES of unknown viral aetiology (48% versus 24%; P = 0.01. Bad outcome was independently associated in both JE and suspected viral aetiology groups with a longer duration of fever pre-admission (P = 0.007; P = 0.002 respectively and greater impairment of consciousness (P = 0.02; P Conclusions Nepali children with AES of suspected viral aetiology or with JE frequently suffered a bad outcome. Despite no specific treatment, patients who experienced a shorter duration of fever before hospital admission more frequently recovered completely. Prompt referral may allow AES patients to receive potentially life-saving supportive management. Previous studies have indicated supportive management, such as fluid provision, is associated with better outcome in JE. The lower weight and higher

  19. 76 FR 10526 - Reducing Regulatory Burden; Retrospective Review Under E.O. 13563 (United States)


    ..., Department of the Interior, Room 7311, 1849 C Street, NW., Washington, DC 20240. E-mail: . SUPPLEMENTARY INFORMATION: President Obama issued Executive Order 13563, ``Improving... links to the Department's regulations and a link to an e-mail in-box at

  20. Mortality associated with gastrointestinal bleeding in children: A retrospective cohort study (United States)

    Attard, Thomas M; Miller, Mikaela; Pant, Chaitanya; Kumar, Ashwath; Thomson, Mike


    AIM To determine the clinical characteristics of children with gastrointestinal bleeding (GIB) who died during the course of their admission. METHODS We interrogated the Pediatric Hospital Information System database, including International Classification of Diseases, Current Procedural Terminology and Clinical Transaction Classification coding from 47 pediatric tertiary centers extracting the population of patients (1-21 years of age) admitted (inpatient or observation) with acute, upper or indeterminate GIB (1/2007-9/2015). Descriptive statistics, unadjusted univariate and adjusted multivariate analysis of the associations between patient characteristics and treatment course with mortality was performed with mortality as primary and endoscopy a secondary outcome of interest. All analyses were performed using the R statistical package, v.3.2.3. RESULTS The population with GIB was 19528; 54.6% were male, overall mortality was 2.07%; (0.37% in patients with the principal diagnosis of GIB). When considering only the mortalities in which GIB was the principal diagnosis, 48% (12 of 25 principal diagnosis GIB mortalities) died within the first 3 d of admission, whereas 19.8% of secondary diagnosis GIB patients died with 3 d of admission. Patients who died were more likely to have received octreotide (19.8% c.f. 4.04%) but tended to have not received proton pump inhibitor therapy in the first 48 h, and far less likely to have undergone endoscopy during their admission (OR = 0.489, P < 0.0001). Chronic liver disease associated with a greater likelihood of endoscopy. Mortalities were significantly more likely to have multiple complex chronic conditions. CONCLUSION GIB associated mortality in children is highest within 7 d of admission. Multiple comorbidities are a risk factor whereas early endoscopy during the admission is protective. PMID:28321162

  1. Extramedullary Relapse of Acute Myeloid and Lymphoid Leukemia in Children: A Retrospective Analysis

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    Jee Young Kim


    Full Text Available Background Extramedullary relapse (EMR is a recurrence of leukemia in sites other than the bone marrow, and it exhibits a relatively rare presentation of relapse of acute leukemia. However, EMR is an important cause of treatment failure among patients with acute leukemia. Therefore, early detection of these relapses may improve the prognosis. Objectives To describe the disease-related demographic and clinical features and radiologic findings for children diagnosed with EMR in acute leukemia. Patients and Methods The study was based on 22 children (M: F = 14: 8; mean age 7.30 (2.1 - 15.7 years with 8 acute myeloid leukemia (AML and 14 acute lymphoid leukemia (ALL who had experienced an EMR. Age, gender, clinical symptoms, initial extramedullary disease (EMD, French-American-British (FAB morphology, cytogenetics, time to and site of EMR, concurrent bone marrow relapse (BMR, radiologic findings, and outcomes were evaluated. Results No definite relationship was found between initial EMD and EMR. A predilection for AML to relapse in the central nervous system (CNS, except for the CSF and bone, and for ALL to relapse in the CSF and kidney seemed to occur. Patients with EMR had a significantly higher incidence of t(8: 21 cytogenetics and FAB M2 and L1 morphologies. EMR accompanied with concurrent BMR occurred in 31.8% of the patients, who exhibited a relatively grave clinical course. Radiologic findings were nonspecific and had a great variety of structure involved, including bulging enhancing mass in the CT scan, hypoechoic mass in the US, and enhanced mass-like lesion in the MRI. Conclusions Knowledge of the potential sites of EMR, their risk factors, and their clinical and radiologic features may be helpful in the early diagnosis of relapse and planning for therapy.

  2. Peer review comments on drug trials submitted to medical journals differ depending on sponsorship, results and acceptance: a retrospective cohort study

    NARCIS (Netherlands)

    Lent, M. van; Hout, J. in't; Out, H.J.


    OBJECTIVE: During peer review, submitted manuscripts are scrutinised by independent experts to assist journal editors in their decision-making and to help improve the quality of articles. In this retrospective cohort study, peer review comments for drug trials submitted to medical journals were anal

  3. Henoch-Schonlein Purpura in Children: Retrospective evaluation of 53 cases

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    Samet Ozer


    Full Text Available Objective: Henoch-Schonlein Purpura (HSP is the most commonly observed vasculitis during childhood and is a systemic disease which may mainly affect skin, joint, kidney and gastrointestinal system. The aim of the study is to evaluate clinical and laboratory findings of followed patients with HSP diagnosis between the years 2010 and 2015. Materials and Methods: In the study, the reports of 53 patients were retrospectively evaluated who diagnosed with HSP and were treated and followed in the department of pediatrics in Medical Faculty of Tokat Gaziosmanpasa University during the years from 2010 to 2015. The diagnosis was realized provided that at least two criteria of HSP diagnosis, which were created by American College of Rheumatology in 1990, was present. Non-steroid anti-inflammatory and/or corticosteroid was used for the treatment. Results: Of 53 patients, 28 were female and 25 were male. The age range of the patients was 3 to 17 years and median age was 9,8 years. A clinical finding, skin rash was present in all patients. 24 patients (45.3% had arthritis/arthralgia, 33 patients (62.3% had stomachache and 6 patients (11.3% had headache. Proteinuria was observed in 22 patients (41%, hematuria in 9 (17%, occult blood positivity in stool in 20 (37.7%. 25 patients (47% had kidney involvement and 33 patients (62.3% had gastrointestinal system involvement. Steroid treatment was given to 20 patients (37.7% with gastrointestinal system involvement. 6 patients (11% with severe kidney findings were transferred to another health care facility with a child nephrology department. 15 patients (28.3% had recurrent skin rash six months after a complete recovery. Conclusion: HSP is a vasculitis that can involve mostly skin and joints and other organs and systems. It was observed that it has a good short-term prognosis and patients with the case might heal without any sequela. Moreover, the cases with HSP should be closely followed for complications such as

  4. Systematic Review of Invasive Acinetobacter Infections in Children

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    Jia Hu


    Full Text Available INTRODUCTION: Clinicians are generally familiar with Acinetobacter as an etiological agent for serious nosocomial infections in intensive care units. However, there are no previous reviews of the full spectrum of invasive infections in children.

  5. Research Review: The Impact of Domestic Violence on Children


    Devaney, John


    This paper reviews the research on the prevalence and impact of domestic violence on children, and considers how professionals should respond to children’s needs to best provide support and ensure their safety.

  6. Review of Sibling Interventions with Children with Autism (United States)

    Banda, Devender R.


    Fifteen intervention studies were reviewed that included children with autism and their typical siblings. Overall, results across several studies reveal that siblings can have positive impacts on social and communication skills in children with autism. However, methodological variations and mixed results in studies that included siblings as…

  7. Psychological Distress in Refugee Children: A Systematic Review (United States)

    Bronstein, Israel; Montgomery, Paul


    Nearly one-quarter of the refugees worldwide are children. There have been numerous studies reporting their levels of psychological distress. The aim of this paper is to review systematically and synthesize the epidemiological research concerning the mental health of refugee children residing in Western countries. A Cochrane Collaboration style…

  8. Osteoporosis in children: pediatric and pediatric rheumatology perspective: a review


    Zifman Eyal; Uziel Yosef; Hashkes Philip J


    Abstract It is increasingly recognized that osteoporosis affects children as well as adults both as a primary problem and as secondary to various diseases, medications, and lifestyle issues. In this review, we emphasize the correct diagnosis of osteoporosis in children as opposed to adults, etiology, and pharmaceutical and non-pharmaceutical treatments. We especially focus on rheumatologic conditions associated with osteoporosis and management issues.

  9. The New York Court Review of Children in Foster Care (United States)

    Festinger, Trudy Bradley


    Presents a study which investigated three areas: (1) factors related to the court's determination of foster care status or availability of children for adoption; (2) the extent of agreement between agency recommendations and court orders; and (3) the impact of the court review on moving children out of foster care. (SDH)

  10. Family Violence and Violence against Children. Research Review. (United States)

    Ghate, Deborah


    Reviews the research literature on physical violence against children, including disciplinary tactics and abusive violence. Considers the incidence and prevalence of violence against children, key themes in research on causes, correlates and consequences of this violence, and future research needs. (JPB)

  11. Children Who Witness Domestic Violence: A Review of Empirical Literature. (United States)

    Kolbo, Jerome R.; And Others


    Presents a review of the empirical literature examining the initial effects of witnessing domestic violence on children's functioning. Although results are somewhat inconclusive regarding children's social, cognitive, and physical development, findings of recently conducted investigations, when combined and compared with the previously reviewed…

  12. Incidence and risk factors of hospitalization for bronchiolitis in preterm children: a retrospective longitudinal study in Italy

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    Mucchino Eleonora


    Full Text Available Abstract Background Bronchiolitis is a distressing, potentially life-threatening respiratory condition that affects infants. We evaluated the incidence and risk factors of hospitalization for broncholitis in preterm infants (i.e., a gestational age of Methods Retrospective cohort study that linked data from four health administrative databases in the Lazio region (a region of central Italy: the birth register, the hospital discharge register, and two ad-hoc databases that record the doses of Palivizumab administered at two local health units. Results Among 2407 preterm infants, 137 had at least one hospitalization for bronchiolitis in the first 18 months of life, an overall incidence rate of 4.70 per 100 person-years (95%CI: 3.98-5.56; similar incidence rates were observed by calendar year. A multiple Poisson model showed that the following characteristics were associated with higher incidence: younger age of the infant, the period between October-April, male gender, low Apgar score at birth, low birth weight, and low maternal educational level. At least one dose of Palivizumab was administered to 324 (13.5% children; a dramatic increase from 2000 (2.8% to 2006 (19.1% (p Conclusion In Italy the incidence of hospitalization for bronchiolitis, and its associated risk factors, are similar to that found in other countries. Although Palivizumab use is associated with the most important characteristics of severe prematurity, other aspects of its non-use in children with congenital heart disease, the age and the birth country of the mother suggest the need for public health measures that can reduce these health disparities. Finally, the estimated effectiveness of Palivizumab in routine practice, although not significant, confirms the results of previous clinical trials, but its impact on modifying the temporal trend in this population is still negligible.

  13. Hyponatremic hypertensive syndrome - a retrospective cohort study (United States)

    Mukherjee, Devdeep; Sinha, Rajiv; Akhtar, Md Shakil; Saha, Agni Sekhar


    AIM To ascertain the frequency of hyponatremic hypertensive syndrome (HHS) in a cohort of children with hypertensive emergency in a tertiary pediatric hospital. METHODS A retrospective review was undertaken among children with hypertensive emergency admitted in our tertiary children hospital between June 2014 and December 2015 with an aim to identify any children with HHS. Three children with HHS were identified during this period. RESULTS The 3 patients with HHS presented with hypertensive emergency. They were initially managed with Labetalol infusion and thereafter switched to oral anti-hypertensives (combination of Nifedipine sustained release, Hydralazine and Beta Blocker). All 3 were diagnosed to have unilateral renal artery stenosis. One child was lost to follow up, whereas the other 2 underwent renal angioplasty which was followed with normalization of blood pressure. CONCLUSION Despite activation of renin angiotensin axis secondary to renal artery stenosis, these groups of children have significant hyponatremia. Renal re-vascularisation produces excellent results in most of them. PMID:28101450

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

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    Nozières Cécile


    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

  15. Broncho-vascular fistulas from self-expanding metallic stents: A retrospective case review

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    Chirag Choudhary


    Full Text Available To highlight a potentially fatal complication of broncho-vascular fistula arising from the self expanding metallic stent (SEMS placement. We retrospectively analyzed five patients with benign and malignant airway diseases, who developed tracheo/broncho-vascular fistulas following SEMS placement in our tertiary care setting. All patients received either Wallstent or Ultraflex® stent (Boston Scientific, Natick, MA between 1999 and 2007. All patients had received adjunct therapy such as balloon bronchoplasty, laser therapy or electrocautery. Most patients presented with massive hemoptysis. A total of 483 SEMS were placed during this period. SEMS placement can be complicated by Broncho-vascular fistula formation. True incidence and precise time interval between the insertion of stent and onset of this complication is unknown. Additional therapeutic modalities to maintain stent patency may enhance the risk of fistula formation. SEMS should only be used in a select sub-group of patients, after exhaustive evaluation of other treatment options. These cases provide evidence that broncho-vascular fistulas can develop at any time following SEMS placement, suggesting the need for a more cautious approach, especially while using them for a long term management. In benign airway disease, the stent should be removed as soon as healing has taken place.

  16. Never go to sleep on undrained pus: a retrospective review of surgery for intraparenchymal cerebral abscess. (United States)

    Smith, S J; Ughratdar, I; MacArthur, D C


    Cerebral abscess is an emergency requiring urgent drainage via craniotomy or burrhole aspiration. We examine whether initial method of drainage affects outcome and important characteristics in patients with cerebral abscess. This is a retrospective analysis of 62 patients operated on in our unit with a loculated infected cerebral collection in the years 2003-2007 inclusive. Full statistical analysis was performed using data appropriate tests. Burrhole and craniotomy groups were evenly matched with no difference in any demographic factors. Surgical method made no difference to rate of re-operation (p = 0.276), antibiotic duration (p = 0.648), discharge GCS (p = 0.509), length of stay (p = 0.647) or GOS (p = 0.968). There was a trend to worsened outcome with delay to surgery (p = 0.132) with delayed patients requiring longer hospital stays (p < or = 0.005). Patients requiring a longer antibiotic duration had worse outcomes (p < or = 0.005). Surgical method did not have a significant effect on outcome, so burrhole aspiration with its advantages in terms of speed and scale of surgery should be strongly considered. Delay had an adverse affect, so operation should be as expeditious as possible whenever the differential diagnosis includes abscess, diagnosis of which may be aided by advanced magnetic resonance imaging techniques.

  17. Uterine Carcinosarcoma Confined to the Pelvis: A Retrospective Review and Outcome Analysis

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    Hualei Li


    Full Text Available Objective. We compared the treatments of uterine carcinosarcoma at our institution and evaluated their impact on survival. Methods. A retrospective analysis was performed on 60 eligible patients with carcinosarcoma limited to the pelvis. Subjects were divided into four categories: surgery, surgery plus chemotherapy, surgery plus radiation therapy, and a combination of surgery, chemotherapy, and RT. The most commonly used chemotherapy was cisplatin and/or carboplatin and taxol. Radiotherapy included external beam radiation therapy (EBRT alone or with high dose rate (HDR brachytherapy or HDR brachytherapy alone. Survival probability data were computed using the Kaplan-Meier method. The differences between groups were compared using the log-rank test. Results. The combination of surgery and radiation therapy with or without chemotherapy is seen to improve overall survival (OS compared to surgery alone (P=0.044 and P=0.028, resp.. Brachytherapy involving three HDR vaginal cylinder fractions shows an equally effective reduction in local recurrence compared to EBRT. Conclusion. Our study of a relatively large number of carcinosarcoma patients suggests that adjuvant radiation therapy improves OS compared to surgery alone. Brachytherapy with 3 HDR vaginal cylinder fractions is preferred because of its time-saving, better tolerance, low toxicity and equivalent OS, and local control compared to EBRT.


    Institute of Scientific and Technical Information of China (English)

    陈晋峰; 张力建; 刘静贤


    Objective: To explore the clinical characteristics, diagnosis and treatment of pulmonary sarcoma and blastoma. Methods: Seven cases of pulmonary sarcoma (including 1 case of pulmonary carcinosarcoma, 1 case of pulmonary malignant fibroneuroma, 1 case of pulmonary malignant fibrous tissue tumor and 1 case of pulmonary blastoma from August 1995 to June 2002 in our hospital) were retrospectively summarized the histological characteristics, clinical features, diagnosis and treatment. Results: Pulmonary sarcoma and blastoma both are rare malignant tumors and can be easily misdiagnosed or mistreated. The main symptoms of both diseases are cough and expectoration. X ray or CT shows node or focus in lung. They both are diagnosed by histological pathology. Because the symptoms of these diseases are not typical, it is difficult for patients to be diagnosed without pathology. Conclusion: These two kinds of diseases are often easy to be misdiagnosed. Early diagnosis and treatment are important to improve the efficiency of treatment. Surgical resection is the best method of treatment, and it is important to combine with chemotherapy and radiation treatment.

  19. 76 FR 13526 - Reducing Regulatory Burden; Retrospective Review Under Executive Order 13563 (United States)


    ... individual listed in the FOR FURTHER INFORMATION CONTACT section. Docket: For access to the docket to read... repealed? (2) What factors should the agency consider in selecting and prioritizing rules for review? (3... efficient ways? (8) Are there rules that have been overtaken by technological developments? Can...

  20. 76 FR 40645 - Reducing Regulatory Burden; Retrospective Review Under E.O. 13563 (United States)


    ... FURTHER INFORMATION CONTACT: Mark Lawyer, Office of the Secretary, 202-208-3181, links to the plan, the Department's regulations, and an e-mail in-box at

  1. Review of optically stimulated luminescence (OSL) instrumental developments for retrospective dosimetry

    DEFF Research Database (Denmark)

    Bøtter-Jensen, Lars; Thomsen, Kristina Jørkov; Jain, Mayank


    This review describes 40 years of experience gained at Risø National Laboratory in the development of facilities for irradiation, thermal/optical stimulation and luminescence signal detection. These facilities have mainly been used in luminescence dating and nuclear accident dosimetry. We focus...

  2. 77 FR 59567 - Retrospective Regulatory Review Under E.O. 13563 (United States)


    ... benefits, including consideration of potential economic, environmental, public health, and safety effects... review the U.S. citizenship claims of aliens in expedited removal proceedings. As a result, the... an alien's claim to U.S. citizenship status if DHS places the alien in expedited removal...

  3. Potential brain death organ donors - challenges and prospects: A single center retrospective review

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    Yousef Al-Maslamani


    Full Text Available Organ donation after brain death (BD is a major source for obtaining transplantable organs for patients with end-stage organ disease (ESOD. This retrospective, descriptive study was carried out on all potential BD patients admitted in different intensive care units (ICUs of the Hamad medical Corporation (HMC, Doha, Qatar during a period from January 2011 to April 2012. Our aim was to evaluate various demographic criteria and challenges of organ donation among potential BD organ donors and plan a strategy to improve the rate of organ donation in Qatar. Various aspects of BD patients in the ICUs and their possible effects on organ donation were studied. The time intervals analyzed to determine the possible causes of delay of organ retrieval were: time of diagnosing fixed dilated pupils in the ICU, to performing the first BD test, then to the second BD test, to family approach, to organ retrieval and/or circulatory death (CD without organ retrieval. There were a total of 116 potential BD organ donors of whom 96 (82.75% were males and 20 (17.25% were females. Brain hemorrhage and head injury contributed to 37 (31.9% and 32 (27.6% BD cases, respectively. Time interval between diagnosing fixed dilated pupil and performing the first test of BD was delayed >24 h in 79% of the cases and between the first and second BD tests was >6 h in 70.8% of the cases. This delay is not compatible with the Hamad Medical Corporation (HMC policy for BD diagnosis and resulted in a low number of organs retrieved. BD organ donation, a potential source for organs to save patients with ESOD has several pitfalls and every effort should be made to increase the awareness of the public as well as medical personnel to optimize donation efficacy.

  4. Obesity & hypertension are determinants of poor hemodynamic control during total joint arthroplasty: a retrospective review

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    Nwachukwu Benedict U


    Full Text Available Abstract Background Proper blood pressure control during surgical procedures such as total joint arthroplasty (TJA is considered critical to good outcome. There is poor understanding of the pre-operative risk factors for poor intra-operative hemodynamic control. The purpose of this study is to identify risk factors for poor hemodynamic control during TJA. Methods We performed a retrospective cohort analysis of 118 patients receiving TJA in the Dominican Republic. We collected patient demographic and comorbidity data. We developed an a priori definition for poor hemodynamic control: 1 Mean arterial pressure (MAP 135% of preoperative MAP. We performed bivariate and multivariate analyses to identify risk factors for poor hemodynamic control during TJA. Results Hypertension was relatively common in our study population (76 of 118 patients. Average preoperative mean arterial pressure was 109.0 (corresponding to an average SBP of 149 and DBP of 89. Forty-nine (41.5% patients had intraoperative blood pressure readings consistent with poor hemodynamic control. Based on multi-variable analysis preoperative hypertension of any type (RR 2.9; 95% CI 1.3-6.3 and an increase in BMI (RR 1.2 per 5 unit increase; 95% CI 1.0-1.5 were significant risk factors for poor hemodynamic control. Conclusions Preoperative hypertension and being overweight/obese increase the likelihood of poor blood pressure control during TJA. Hypertensive and/or obese patients warrant further attention and medical optimization prior to TJA. More work is required to elucidate the relationship between these risk factors and overall outcome.

  5. Retrospective study of reverse dorsal metacarpal flap and compound flap: a review of 122 cases

    Institute of Scientific and Technical Information of China (English)

    LU Lai-jin; GONG Xu; LIU Zhi-gang; ZHANG Zhi-xin


    Objective:To evaluate the clinical application and discuss the operative indication of the reverse dorsal metacarpal flap and its compound flap on the skin defects of hand.Methods: From 1990 to 2003, we applied the reverse dorsal metacarpal flap and its compound flap to repair soft tissue defects of fingers in 122 cases, which included 90cases of the reverse metacarpal flap and 32 cases of its compound flaps with tendon grafts, nerve grafts or bone grafts. Based on the follow-up observations, we analyzed the indications of the reverse metacarpal flap and its compound flaps, the postoperative contours, flap colors and textures in comparison to contralateral fingers retrospectively.Results: In the series of 122 cases, flaps survived and the donor site defects were closed directly. The follow-up period ranged from 1-12 years. The postoperative contours,colors and textures of the flaps and its compound flaps were similar to those of normal fingers, although linear scar remained. According to standards of sense recovery(British Medical Research Council, BMRC ), the sense function of the flaps resumed S3 after operation for 1 year.In 10 cases with the tendon defects treated by the flap with tendon grafts, function of flexion-extension of fingers resumed 50%-75% in comparison to the contralateral fingers using the method of measurement of total active motion. In 7 cases with the phalangeal nonunion or bone defects treated by the flap with bone grafts, union occurred after operation for 3 months.Conclusions: To soft tissue defects on fingers with bone or tendon exposure, the reverse metacarpal flap and its compound flap are a better choice for repairing. The range of repairing is up to the distal interphalangeal joint of fingers. The second dorsal metacarpal artery is more consistent and larger as the choice of vascular pedicle, in comparison with other dorsal metacarpal arteries.Postoperative flap color and texture are similar to normal fingers.

  6. A Chart Review of Schizotypal Personality Disorders in Children. (United States)

    Nagy, Joan; Szatmari, Peter


    The literature on the diagnostic validity of schizotypal personality disorders (SPD) in childhood is reviewed, and the results of a chart review of 20 SPD children meeting Diagnostic and Statistical Manual III criteria are presented suggesting that SPD in childhood exists and warrants study. (Author/CB)

  7. Intracranial abscesses: Retrospective analysis of 32 patients and review of literature (United States)

    Udoh, David O.; Ibadin, Emmanuel; Udoh, Mojisola O.


    Background: Intracranial abscess collections, though uncommon, are dreaded complications of head trauma, neurosurgical operations, meningitis, and otogenic, mastoid, and paranasal air sinus infections. Combining surgical evacuation with the appropriate antibiotic therapy is the effective treatment for intracranial abscesses. However, literature on surgical treatment is replete with several procedures which, on their own, may not Objectives: To determine the epidemiology and outcomes (of various treatment modalities) of intracranial abscesses in our institution, a major referral center for neurosurgical conditions in the midwestern region of Nigeria. Materials and Methods: This is a retrospective analysis of demographic data as well as indications, treatment modalities, and outcomes of various surgical procedures for evacuation of intracranial abscesses between September 2006 and December 2011. Results: We carried out 40 procedures in 32 (23 male and 9 female) patients with various intracranial abscesses. These represented approximately 5.6% of all operative neurosurgical procedures in our unit since inception. Most abscesses [16, i.e. 50%] occurred in the second decade. In the first decade, there were 7 (22%), and after the age of 30 years, there were 4 (12.5%). The most susceptible single year of life was infancy with 4 (12.5%) cases of intracranial abscesses. None of the infants had features of congenital heart disease. The predisposing factors were mostly otolaryngologic (9) or posttraumatic (6). Most abscesses (41%) were located in the frontal region, and intraparenchymal (i.e. intracerebral or intracerebellar) (50%) lesions were commoner than extradural, subdural, or intraventricular lesions. The commonest procedure performed (50%) was burr hole evacuation. Four patients (12.5% of cases) died. Prognosis appears to worsen with meningitis as the predisposing infection, ventriculitis, multiple abscesses especially in infants, and immunosuppression. Conclusion

  8. Prevalence of sleep bruxism in children: A systematic review (United States)

    Machado, Eduardo; Dal-Fabbro, Cibele; Cunali, Paulo Afonso; Kaizer, Osvaldo Bazzan


    INTRODUCTION: Prevalence of sleep bruxism (SB) in children is subject to discussions in the literature. OBJECTIVE: This study is a systematic literature review aiming to critically assess the prevalence of SB in children. METHODS: Survey using the following research databases: MEDLINE, Cochrane, EMBASE, PubMed, Lilacs and BBO, from January 2000 to February 2013, focusing on studies specifically assessing the prevalence of SB in children. RESULTS: After applying the inclusion criteria, four studies were retrieved. Among the selected articles, the prevalence rates of SB ranged from 5.9% to 49.6%, and these variations showed possible associations with the diagnostic criteria used for SB. CONCLUSION: There is a small number of studies with the primary objective of assessing SB in children. Additionally, there was a wide variation in the prevalence of SB in children. Thus, further, evidence-based studies with standardized and validated diagnostic criteria are necessary to assess the prevalence of SB in children more accurately. PMID:25628080

  9. Pathology of the appendix in children: an institutional experience and review of the literature

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    Rabah, Raja [Wayne State University, Department of Pathology, Children' s Hospital of Michigan, Detroit, MI (United States)


    The appendix can be affected by a variety of congenital and acquired diseases, but acute appendicitis is the most common pathology found in the pediatric population. This is a retrospective review of all appendectomies performed during a 2-year period at a major children's hospital with a review of the literature regarding the most common pathologic findings. The pathology database was reviewed for appendectomy specimens, and patient medical records were evaluated to determine the age, gender, race and operative diagnosis. All slides were reviewed and the histologic findings were recorded. A total of 392 appendectomies were performed, including 68 incidental appendectomies and 324 performed for clinical suspicion of acute appendicitis. In 247 of the latter, acute appendicitis was confirmed histologically, and of the remainder 14 were interval appendectomies, 2 had findings suspicious for Crohn disease, 1 confirmed diverticulitis and 60 were histologically negative for appendicitis. Acute appendicitis is the most common pathologic cause of appendectomy, but various other pathologic entities are found in children. Examination of the appendix is warranted even when it appears normal on exploration. (orig.)

  10. Clinical features of myasthenia gravis in southern China: a retrospective review of 2,154 cases over 22 years. (United States)

    Huang, X; Liu, W B; Men, L N; Feng, H Y; Li, Y; Luo, C M; Qiu, L


    The objectives of the study are to study the clinical features of myasthenia gravis in southern China. A retrospective study was carried out on all patients who were diagnosed with myasthenia gravis at the First Affiliated Hospital of Sun Yat-sen University during 1987-2009. Of the 2,154 myasthenia gravis patients, the gender ratio (male:female) was 1:1.15. The median age at onset was 18 years. There was a single peak distribution of age at onset, and 44.8 % were children (≤ 14 years) at first onset. 1,766 patients (82.0 %) only had ocular symptoms at onset. 1,451 patients (67.4 %) were classified as Osserman grade I. 250 unselected patients received anti-acetylcholine receptor antibodies test, in which only 51.2 % were positive. Computed tomography scan/magnetic resonance Imaging of chest were done in 1,354 patients, of which 899 patients (66.4 %) had thymic hyperplasia and 201(14.8 %) had thymoma. There were 150 patients (7.0 %) with myasthenia gravis combined with other autoimmune diseases, in which hyperthyroidism was most common (84 %). 189 (8.8 %) patients experienced 267 episodes of crisis. The rate of family myasthenia gravis was 1.6 % (35/2,154). In conclusion, the clinical features and demography of myasthenia gravis patients in this study are significantly different from prior studies on other regions and ethnic groups.

  11. Retrospective Review of Cross Sectional Imaging Findings of Pancreatic Non-functional Islet Cell Tumor (NFICT and its Hepatic Metastases

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    Rashid AL Sukaiti


    Full Text Available AbstractObjectives: Review and correlate the computed tomography (CT imaging features of pancreatic Non Functional Islet Cell Tumors (NFICT and its hepatic metastases.Methods: CT examinations of 28 patients with pathologically proven diagnosis of pancreatic NFICT and no clinical symptoms or signs attributed to hormone overproduction, performed at Mallinkrodt Institute of Radiology, Saint Louis, Missouri, USA between March 2002-July 2006, were retrospectively reviewed by two abdominal radiologists. The imaging findings were analyzed and summarized.Results: Pancreatic NFICT size ranged from 1.2-13 cm. The commonest pattern of enhancement was hypervascular and heterogenous enhancement. The spleen was the commonest invaded nearby local structure. The commonest pattern of enhancement noted in the metastatic liver lesions was hypervascular heterogenous enhancement. 26�0of the liver metastatic lesions were associated with invasion/encasement of nearby vessels.Conclusion: Imaging features of pancreatic NFICT can overlap with other pancreatic neoplasms. Therefore combining the imaging features of pancreatic NFICT and its hepatic metastases helps in narrowing the differential diagnosis.

  12. Visual impairment from uveitis in a reference hospital of Southeast Brazil: a retrospective review over a twenty years period

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    Luci Meire Pereira da Silva


    Full Text Available PURPOSE: To identify the frequency and causes of uveitis leading to visual impairment in patients referred to the Low Vision Service - Department of Ophthalmology - UNIFESP, over a twenty years period. METHODS: In a retrospective study, medical records of 5,461 patients were reviewed. Data from the first clinical evaluation at the Low Vision Service were collected, patient's age, gender and cause of visual impairment were analyzed. Patients with uveitis had their chart reviewed for anatomical classification and clinical diagnosis. RESULTS: The mean age of the patients referred to the Low Vision Service was 42.86 years and the mean age of patients with uveitis diagnosis was 25.51 years. Retinal disorders were the most common cause of visual impairment (N=2,835 patients; 51.9% followed by uveitis (862 patients, 15.7%. Uveitis was posterior in 792 patients (91.9% of uveitis and toxoplasmosis was the most common diagnosis (765 patients, 88.7%. CONCLUSIONS: In our study, uveitis represents the second cause of visual impairment in patients referred for visual rehabilitation and toxoplasmic retinochoroiditis was the most common clinical diagnosis. It affects a young working age population with a relevant social and economic impact, but the early diagnosis and treatment can improve the quality of life of these patients.

  13. Aripiprazole Augmentation in the Treatment of Military-Related PTSD with Major Depression: a retrospective chart review

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    Fikretoglu Deniz


    Full Text Available Abstract Background In this chart review, we attempted to evaluate the benefits of adding aripiprazole in veterans with military-related PTSD and comorbid depression, who had been minimally or partially responsive to their existing medications. Methods A retrospective chart review of patients who received an open-label, flexible-dose, 12- week course of adjunctive aripiprazole was conducted in 27 military veterans meeting DSM-IV criteria for PTSD and comorbid major depression. Concomitant psychiatric medications continued unchanged, except for other antipsychotics which were discontinued prior to initiating aripiprazole. The primary outcome variable was a change from baseline in the PTSD checklist-military version (PCL-M and the Beck Depression Inventory (BDI-II. Results PTSD severity (Total PCL scores decreased from 56.11 at baseline to 46.85 at 12-weeks (p Conclusions The addition of aripiprazole contributed to a reduction in both PTSD and depression symptomatology in a population that has traditionally demonstrated poor pharmacological response. Further investigations, including double-blind, placebo-controlled studies, are essential to confirm and further demonstrate the benefit of aripiprazole augmentation in the treatment of military related PTSD.

  14. Bilateral Breast Reconstruction with Abdominal Free Flaps: A Single Centre, Single Surgeon Retrospective Review of 55 Consecutive Patients

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    Peter McAllister


    Full Text Available Breast reconstruction using free tissue transfer is an increasingly utilised oncoplastic procedure. The aim was to review all bilateral breast reconstructions using abdominal free flaps by a single surgeon over an 11-year period (2003–2014. A retrospective review was performed on all patients who underwent bilateral breast reconstruction using abdominal free flaps between 2003 and 2014 by the senior author (DAM. Data analysed included patient demographics, indication for reconstruction, surgical details, and complications. Fifty-five female patients (mean 48.6 years [24–71 years] had bilateral breast reconstruction. The majority (41, 74.5% underwent immediate reconstruction and DIEP flaps were utilised on 41 (74.5% occasions. Major surgical complications occurred in 6 (10.9% patients, all of which were postoperative vascular compromise of the flap. Failure to salvage the reconstruction occurred on 3 (5.5% occasions resulting in a total flap failure rate of 2.7%. Obesity (>30 kg/m2 and age > 60 years were shown to have a statistically increased risk of developing postoperative complications (P60 years were associated with higher complication rates.

  15. A retrospective review of the metabolic syndrome in women diagnosed with breast cancer and correlation with estrogen receptor. (United States)

    Colonna, Sarah V; Douglas Case, L; Lawrence, Julia A


    Women diagnosed with obesity and breast cancer have an increased risk of recurrence and death (Protani et al., Breast Cancer Res Treat 123:627-635, 1). Obesity is associated with the metabolic syndrome--a pathophysiologically distinct inflammatory process comprised of central obesity, insulin resistance, hypertension, and atherogenic dyslipidemia. The relationship of obesity as a risk factor for breast cancer is complex with a protective effect for younger women in contrast to a risk for older women (Kabat et al., Cancer Epidemiol Biomarkers Prev 18:2046-2053, 2; Ursin et al., Epidemiology 6:137-141, 3). The metabolic syndrome has been associated with the risk of cancer, and pro-inflammatory circulating factors may be associated with risk of more aggressive breast cancer (Capasso et al., Cancer Biol Ther 10:1240-1243, 4; Healy et al., Clin Oncol (R Coll Radiol) 22:281-288, 5; Laukkanen et al., Cancer Epidemiol Biomarkers Prev 13:1646-1650, 6). We conducted a retrospective review of 860 breast cancer patients to determine the relationship between estrogen receptor status and the metabolic syndrome. We collected the relevant metabolic diagnoses, medications, physical findings, and laboratory values and adapted the National Cholesterol Education Program criteria to define the metabolic syndrome retrospectively. No relationship was found between estrogen receptor status and the individual components of the metabolic syndrome. Based on findings in the medical records, 15% of the women with breast cancer had the metabolic syndrome, and 26% of the women were considered obese, 16% hyperglycemic, 54% hypertensive, and 30% dyslipidemic. The metabolic syndrome was associated with advanced age and African-American race (P metabolic syndrome was marginally associated with estrogen receptor-positive tumors (P = 0.054). Our findings do not support the concern that the metabolic syndrome may contribute to more biologically aggressive breast cancer.

  16. Hereditary angioedema and lupus: A French retrospective study and literature review. (United States)

    Gallais Sérézal, Irène; Bouillet, Laurence; Dhôte, Robin; Gayet, Stéphane; Jeandel, Pierre-Yves; Blanchard-Delaunay, Claire; Martin, Ludovic; Mekinian, Arsène; Fain, Olivier


    Hereditary angioedema (HAE) is a rare genetic disorder that is primarily caused by a defect in the C1 inhibitor (C1-INH). The recurrent symptoms are subcutaneous edema and abdominal pain. Laryngeal edema, which can also occur, is life threatening if it goes untreated. HAE can be associated with some inflammatory and autoimmune disorders, particularly lupus. The aim of this study was to describe cases of lupus among HAE patients in France and to perform a literature review of lupus and HAE studies. Case detection and data collection (a standardized form) were performed, thanks to the French Reference Center for Kinin-related angioedema. Data were collected from 6 patients with type 1 HAE and lupus in France; no cases of systemic lupus erythematosus were reported. In the literature review, 32 cases of lupus combined with HAE were identified, including 26 female patients. The median patient age at the time of first reported HAE symptoms and at diagnosis were 17.5 years (range, 9-41 years) and 19 years (range, 9-64 years), respectively for our 6 patients and 14 years (range, 3-30 years) and 17 years (range, 7-48 years), respectively, for the literature review. The clinical manifestations of HAE were mainly abdominal pain (83% in our patients vs 47% in the literature) and edema of the limbs (83% vs 38%). The C4 levels were low (for 100% of our cases vs 93% in the literature). Eighteen patients in the literature demonstrated HAE symptoms prior to the lupus onset vs 5 for our patients. The mean patient age at lupus onset was 20 years (range, 13-76 years) for our patients and 19.5 years (range, 1-78 years) in the literature, respectively. In the literature, 81% of the patients had skin manifestations, 25% had renal involvement and 28% received systemic steroids to treat lupus. Treatment with danazol did not modify the clinical expression of lupus. The association between lupus and HAE is a rare but not unanticipated event. Patients are often symptomatic for HAE before

  17. Pollution status of Pakistan: a retrospective review on heavy metal contamination of water, soil, and vegetables. (United States)

    Waseem, Amir; Arshad, Jahanzaib; Iqbal, Farhat; Sajjad, Ashif; Mehmood, Zahid; Murtaza, Ghulam


    Trace heavy metals, such as arsenic, cadmium, lead, chromium, nickel, and mercury, are important environmental pollutants, particularly in areas with high anthropogenic pressure. In addition to these metals, copper, manganese, iron, and zinc are also important trace micronutrients. The presence of trace heavy metals in the atmosphere, soil, and water can cause serious problems to all organisms, and the ubiquitous bioavailability of these heavy metal can result in bioaccumulation in the food chain which especially can be highly dangerous to human health. This study reviews the heavy metal contamination in several areas of Pakistan over the past few years, particularly to assess the heavy metal contamination in water (ground water, surface water, and waste water), soil, sediments, particulate matter, and vegetables. The listed contaminations affect the drinking water quality, ecological environment, and food chain. Moreover, the toxicity induced by contaminated water, soil, and vegetables poses serious threat to human health.

  18. Pollution Status of Pakistan: A Retrospective Review on Heavy Metal Contamination of Water, Soil, and Vegetables

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    Amir Waseem


    Full Text Available Trace heavy metals, such as arsenic, cadmium, lead, chromium, nickel, and mercury, are important environmental pollutants, particularly in areas with high anthropogenic pressure. In addition to these metals, copper, manganese, iron, and zinc are also important trace micronutrients. The presence of trace heavy metals in the atmosphere, soil, and water can cause serious problems to all organisms, and the ubiquitous bioavailability of these heavy metal can result in bioaccumulation in the food chain which especially can be highly dangerous to human health. This study reviews the heavy metal contamination in several areas of Pakistan over the past few years, particularly to assess the heavy metal contamination in water (ground water, surface water, and waste water, soil, sediments, particulate matter, and vegetables. The listed contaminations affect the drinking water quality, ecological environment, and food chain. Moreover, the toxicity induced by contaminated water, soil, and vegetables poses serious threat to human health.

  19. Septic Arthritis in Infants Younger Than 3 Months: A Retrospective Review. (United States)

    Bono, Kenneth T; Samora, Julie Balch; Klingele, Kevin E


    Septic arthritis in infants is rare and can be difficult to diagnose. This study reviewed a series of patients younger than 3 months to identify factors that may assist in early diagnosis and treatment. A query of records at a large Midwestern pediatric hospital (1994-2010) was performed to identify all patients younger than 3 months at the time of diagnosis. Analysis included birth history, joint involvement, physical examination findings, laboratory results, imaging results, method of treatment, and outcome. In 14 cases (11 boys, 3 girls; mean age at diagnosis, 42.2 days), complete records were available for review. Involved joints included the knee, hip, and shoulder. The most common findings on physical examination were decreased range of motion (100%), tenderness (100%), and swelling (71.4%). Mean temperature was 38.5°C. Mean white blood cell count was 18.5 K/µL, mean erythrocyte sedimentation rate was 48.9 mm/h, and mean C-reactive protein level was 6.1 mg/dL. More than half (57.1%) of joint aspirates grew positive cultures, and 41.7% of blood cultures had positive results. Causative organisms were group B streptococcus, methicillin-sensitive Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae, Salmonella enterica, and Candida albicans. The most common physical examination findings in infants younger than 3 months with septic arthritis include tenderness, decreased range of motion, and swelling. White blood cell count, C-reactive protein level, and erythrocyte sedimentation rate are likely to be elevated, but these findings should be used in combination with findings on physical examination and radiographic studies to aid in diagnosis.

  20. Oral mucosal lesions in a Chilean elderly population: A retrospective study with a systematic review from thirteen countries (United States)

    Droguett, Daniel; Arenas-Márquez, María-Jesús


    Background The oral examination is an essential part of the multidisciplinary medical care in elderly people. Oral mucosal lesions and normal variations of oral anatomy (OMLs) are very common in this people, but few studies have examined the frequency and prevalence of these conditions worldwide and less in Chile. The aim of this research was to evaluate the frequency of OMLs in a Chilean elderly population. Material and Methods It was conducted a retrospective study (Talca, Chile). Two hundred seventy-seven OMLs were classified in groups and anatomical sites. In order to contextualize our numbers, we made a systematic review using Publish or Perish software, Google Scholar and InteractiVenn. Results The most prevalent OMLs groups were soft tissue tumors, epithelial pathology, facial pain and neuromuscular diseases, and dermatologic diseases. The most frequent OMLs included irritation fibroma (30 patients, 10.8%), hemangioma (20, 7.2%), burning mouth syndrome (20 cases, 7.2%), oral lichen planus (12, 4.3%) and epulis fissuratum (12, 4.3%). In the systematic review, 75 OMLs were relevant and the more studied pathologies were traumatic ulcerations (11 of 15 articles), oral lichen planus (10/15), irritation fibroma, melanotic pigmentations, and recurrent aphthous stomatitis (9/10, respectively). Considering all included articles, most frequent OMLs in elderly people included denture-related stomatitis (13.3%), irritation fibroma (8.7%) and fissured tongue (6.3%). Conclusions The results reflect the frequency of OMLs diagnosed in a specialized service in south of Chile and many countries around the world. These numbers will allow the establishment of preventive politics and adequacy of the clinical services. Key words:Oral mucosal lesions, elderly people, Chilean population, frequency, systematic review. PMID:28210449

  1. Transient lingual papillitis: A retrospective study of 11 cases and review of the literature (United States)

    Tosios, Konstantinos I.; Nikitakis, Nikolaos G.; Kamperos, Georgios; Sklavounou, Alexandra


    Background Transient lingual papillitis (TLP) is a common, under-diagnosed, inflammatory hyperplasia of one or multiple fungiform lingual that has an acute onset, and is painful and transient in nature. Material and Methods Eleven cases of TLP were diagnosed based on their clinical features. Information on demographics, clinical characteristics, symptoms, individual or family history of similar lesions, medical history, management and follow-up were extracted from the patients’ records. The English literature was reviewed on TLP differential diagnosis, pathogenesis and management. Results The study group included 8 females and 3 males (age: 10-53 years, mean age 31.7±12.88 years). Seven cases were classified as generalized form of TLP and 4 as localized form. Nine cases were symptomatic. Time to onset ranged from 1 to 14 days. A specific causative factor was not identified in any case and management was symptomatic. Conclusions Although TLP is not considered as a rare entity, available information is limited. Diagnosis is rendered clinically, while biopsy is required in cases with a differential diagnostic dilemma. TLP should be included in the differential diagnosis of acute, painful tongue nodules. Key words:Transient lingual papillitis, fungiform papillary glossitis, tongue, nodules. PMID:28149482

  2. Fournier's gangrene: A retrospective analysis of 26 cases in a Canadian hospital and literature review. (United States)

    McCormack, Michael; Valiquette, Anne Sophie; Ismail, Salima


    We performed a systematic review of all cases of Fournier's Gangrene (FG) at our hospital over a 12-year period. A total of 26 cases were assessed. Our goal was to determine the mortality rate and to identify risk factors associated with FG. We also wanted to examine three potential prognostic factors in relation to patient survival, including the time delay from emergency room admission to surgery, the initial extent of the disease, and the impact of more than one debridement procedure under general anesthesia. The time between emergency room admission and the beginning of surgical debridement was not statistically different between survivors and non-survivors. The extent of surgical debridement was close to the margin of statistical significance (p = 0.07) and can be considered an index of the extent of the disease. FG extending to the thighs or to the abdominal wall carries a worse prognosis. The number of surgical debridement procedures done under anesthesia was statistically different between survivors and non-survivors. Patients were 4.8 times more at risk of dying if they are required to have more than one surgical debridement under general anesthesia. This presumably reflects persistent gangrene following initial surgical debridement, fluid resuscitation, and wide spectrum antibiotic treatment.

  3. A Retrospective Review from 2006 to 2011 of Lower Extremity Injuries in Badminton in New Zealand

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    Joanna Reeves


    Full Text Available Aim: To describe lower extremity injuries for badminton in New Zealand. Methods: Lower limb badminton injuries that resulted in claims accepted by the national insurance company Accident Compensation Corporation (ACC in New Zealand between 2006 and 2011 were reviewed. Results: The estimated national injury incidence for badminton injuries in New Zealand from 2006 to 2011 was 0.66%. There were 1909 lower limb badminton injury claims which cost NZ$2,014,337 (NZ$ value over 2006 to 2011. The age-bands frequently injured were 10–19 (22%, 40–49 (22%, 30–39 (14% and 50–59 (13% years. Sixty five percent of lower limb injuries were knee ligament sprains/tears. Males sustained more cruciate ligament sprains than females (75 vs. 39. Movements involving turning, changing direction, shifting weight, pivoting or twisting were responsible for 34% of lower extremity injuries. Conclusion: The knee was most frequently injured which could be due to multi-planar loading. Turning or cutting movements typically involve motion in the frontal and transverse planes that may place the knee at greater risk of injury than movement in the sagittal plane alone. Further research on badminton specific movements is warranted to better understand the mechanisms of lower extremity injuries in the sport. Sports medicine and support personnel should take into account the susceptibility of the knee to injury when designing training and injury prevention programmes given the large number of change of direction movements during badminton.

  4. A retrospective review of specialist palliative care involvement in motor neurone disease. (United States)

    Ryan, R; Tracey, G; Lawlor, P; O'Siorain, L; Higgins, S


    The provision of specialist palliative care to Irish patients suffering from motor neurone disease has not been described in the literature. The purpose of this study was to characterize the care provided at a Dublin hospice. Consecutive referrals between 1st January 1999 and 31st December 2008 (n=72) were reviewed. At the time of data collection, 61 (84.7%) were deceased, 9 (12.5%) were alive and the status of 2 (2.7%) was unknown. At first assessment, 48 (66%) had bulbar symptoms and 35 (49%) had respiratory symptoms, 50 (70%) were receiving Riluzole, 25 (35%) had a feeding tube and 13 (18%) were using non-invasive positive pressure ventilation (NIPPV). Median survival from the point of referral was 7 months (95% CI 4.5-9.4). Of the 61 deceased patients, 22 (36%) died at home, 22 (36%) died in the inpatient unit, 9 (15%) died in hospital and 8 (13%) died in a nursing home.

  5. Osteoporosis in children: pediatric and pediatric rheumatology perspective: a review

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    Zifman Eyal


    Full Text Available Abstract It is increasingly recognized that osteoporosis affects children as well as adults both as a primary problem and as secondary to various diseases, medications, and lifestyle issues. In this review, we emphasize the correct diagnosis of osteoporosis in children as opposed to adults, etiology, and pharmaceutical and non-pharmaceutical treatments. We especially focus on rheumatologic conditions associated with osteoporosis and management issues.

  6. Review of diffusion tensor imaging and its application in children

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    Vorona, Gregory A. [Children' s Hospital of Richmond at Virginia Commonwealth University, Department of Radiology, Richmond, VA (United States); Berman, Jeffrey I. [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)


    Diffusion MRI is an imaging technique that uses the random motion of water to probe tissue microstructure. Diffusion tensor imaging (DTI) can quantitatively depict the organization and connectivity of white matter. Given the non-invasiveness of the technique, DTI has become a widely used tool for researchers and clinicians to examine the white matter of children. This review covers the basics of diffusion-weighted imaging and diffusion tensor imaging and discusses examples of their clinical application in children. (orig.)

  7. Post-mortem computed tomography findings of the lungs: Retrospective review and comparison with autopsy results of 30 infant cases

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    Kawasumi, Yusuke, E-mail: [Tohoku University Graduate School of Medicine, Department of Clinical Imaging, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Usui, Akihito, E-mail: [Tohoku University Graduate School of Medicine, Department of Diagnostic Image Analysis, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Hosokai, Yoshiyuki, E-mail: [Tohoku University Graduate School of Medicine, Department of Diagnostic Image Analysis, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Igari, Yui, E-mail: [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Hosoya, Tadashi [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Hayashizaki, Yoshie, E-mail: [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Saito, Haruo, E-mail: [Tohoku University Graduate School of Medicine, Department of Diagnostic Image Analysis, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Ishibashi, Tadashi, E-mail: [Tohoku University Graduate School of Medicine, Department of Clinical Imaging, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan); Funayama, Masato, E-mail: [Tohoku University Graduate School of Medicine, Department of Forensic Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 (Japan)


    Highlights: •Infant cases frequently show a diffuse increase in the concentration of lung fields on post-mortem computed tomography (PMCT). •In this study, twenty-two of the thirty sudden infant death cases showed increasing concentration in the entire lung field. •Based on the autopsy results, the lungs simply collapsed and no other abnormal lung findings were identified. •The radiologist should not consider increasing concentration in all lung fields as simply a pulmonary disorder when diagnosing the cause of infant death using PMCT. -- Abstract: Objectives: Infant cases frequently show a diffuse increase in the concentration of lung fields on post-mortem computed tomography (PMCT). However, the lungs often show simply atelectasis at autopsy in the absence of any other abnormal changes. Thus, we retrospectively reviewed the PMCT findings of lungs following sudden infant death and correlated them with the autopsy results. Materials and methods: We retrospectively reviewed infant cases (0 year) who had undergone PMCT and a forensic autopsy at our institution between May 2009 and June 2013. Lung opacities were classified according to their type; consolidation, ground-glass opacity and mixed, as well as distribution; bilateral diffuse and areas of sparing. Statistical analysis was performed to assess the relationships among lung opacities, causes of death and resuscitation attempt. Results: Thirty infant cases were selected, which included 22 sudden and unexplained deaths and 8 other causes of death. Resuscitation was attempted in 22 of 30 cases. Bilateral diffuse opacities were observed in 21 of the 30 cases. Of the 21 cases, 18 were sudden and unexplained deaths. Areas of sparing were observed in 4 sudden and unexplained deaths and 5 other causes of death. Distribution of opacities was not significantly associated with causes of death or resuscitation attempt. The 21 cases with bilateral diffuse opacities included 6 consolidations (4 sudden and unexplained

  8. MRI of early symptomatic metal-on-metal total hip arthroplasty: a retrospective review of radiological findings in 20 hips

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    Toms, A.P. [Department of Radiology, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom)], E-mail:; Marshall, T.J.; Cahir, J. [Department of Radiology, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom); Darrah, C.; Nolan, J. [Department of Orthopaedics, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom); Donell, S.T. [Institute of Health, University of East Anglia, Norwich, Norfolk (United Kingdom); Barker, T. [Department of Pathology, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom); Tucker, J.K. [Department of Orthopaedics, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom)


    Aim: To perform a retrospective review of all the conventional radiographic and magnetic resonance imaging (MRI) studies performed in patients with early postoperative pain following cobalt-chrome metal-on-metal total hip arthroplasty. Methods: A retrospective review of the radiology, surgical findings and histology in nineteen patients who had undergone a total of 20 hip arthroplasties using a cobalt-chromium on cobalt-chromium alloy prosthesis was undertaken. Results: Measures of implant placement on the immediate postoperative radiographs were all within the normal ranges (n = 20). Where more than one postoperative radiograph was available statistical analysis revealed no evidence of progressive change before the MRI examination (14). The median postoperative time to MRI was 35 months (range 11-63 months). Abnormalities were demonstrated using MRI in all symptomatic hips (n = 20). These comprised: periprosthetic fluid collections (20), which were isointense to muscle on T1-weighted images in 19 cases and hyperintense on T2-weighted images in 18 cases, periprosthetic bone marrow oedema (n = 6), muscle oedema (n = 4), avulsion of the gluteus minimus and medius tendons (n = 5), atrophy of piriformis (n = 15) and obturator internus (n = 17), and fracture of the medial calcar (n = 1). Operative findings in patients who had undergone revision surgery (n = 15) included: fluid-filled cavities (n = 11), soft tissue necrosis (n = 8), gluteal tendon avulsion (n = 5), proximal femoral diaphyseal necrosis (n = 4), and pitting and corrosion of the femoral stems (n = 8), which were, in all cases, firmly fixed to the cement mantle. Histology revealed viable tissue in six hips with necrosis (n = 12) and fibrin deposition (n = 15) being the predominate findings. Other findings included a perivascular lymphocytic infiltrate (n = 5), features of active inflammation (n = 4), and metallosis (n = 1). Conclusion: A significant number of patients with metal-on-metal hip replacements

  9. A retrospective monocenter review of simultaneous pancreas-kidney transplantation with bladder drainage in China

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    BI Hai; HOU Xiao-fei; MA Lu-lin; LUO Kang-ping; WANG Guo-liang; ZHAO Lei; LIU Ya-li


    Background Simultaneous pancreas-kidney transplantation (SPKT) frees the diabetic patient with end-stage nephropathy from dialysis and daily insulin injections.Herein,we review consecutive cases of SPKT with bladder drainage performed at our institution over an 8-year period.Methods The study population included 21 patients (16 males and 5 females) who underwent SPKT between September 2001 and September 2009.Seven patients had type-1 diabetes and 14 had type-2 diabetes.Nineteen patients were on dialysis at the time of transplantation.Donation after cardiac death donors were selected for SPKT.The mean human leukocyte antigen match was 2 (range 0-4).SPKT was always performed using bladder drainage and vascular anastomoses to the systemic circulation.Immunosuppressive treatment consisted of anti-lymphocyte globulin induction followed by tacrolimus,mycophenolate mofetil,and prednisone.Results The mean hospital stay was 45.43 days.After a mean follow-up of 39.4 months,survival rates for patient,kidney,and pancreas were 76.2%,76.2%,and 66.7% at 1 year;76.2%,59.3%,and 55.6% at 5 years;and 57.1%,39.5%,and 41.7% at 8 years,respectively.Major complications included anastomotic leaks,reflux pancreatitis,and rejection.Six patients died from septic shock (n=3),duodenal stump leak (1),cardiac arrest (1),or renal failure (1).Eight kidney grafts were lost due to acute rejection (n=2),chronic rejection (3),and death with a functioning graft (3).Pancreatic graft failure (9) was caused by thrombosis (n=1),rejection (2),duodenal stump leak (1),and death with a functioning graft (5).Concluslons SPKT is a valid therapeutic option for uremic diabetics although few hospitals in China can undertake SPKT.


    Directory of Open Access Journals (Sweden)

    P.K. Bharti


    Full Text Available Injection molding has been a challenging process for many manufacturers and researchers to produce products meeting requirements at the lowest cost. Faced with global competition in injection molding industry, using the trialand- error approach to determine the process parameters for injection molding is no longer good enough. Factors that affect the quality of a molded part can be classified into four categories: part design, mold design, machineperformance and processing conditions. The part and mold design are assumed as established and fixed. During production, quality characteristics may deviate due to drifting or shifting of processing conditions caused by machine wear, environmental change or operator fatigue. Determining optimal process parameter settings critically influences productivity, quality, and cost of production in the plastic injection molding (PIM industry. Previously, production engineers used either trial-and-error method or Taguchi’s parameter design method to determine optimal process parameter settings for PIM. However, these methods are unsuitable in present PIM because of the increasing complexity of product design and the requirement of multi-response quality characteristics. This article aims to review the recent research in designing and determining process parameters of injection molding. A number of research works based on various approaches have been performed in the domain of the parameter setting for injection molding. These approaches, including mathematical models, Taguchi method, Artificial Neural Networks (ANN,Fuzzy logic, Case Based Reasoning (CBR, Genetic Algorithms (GA, Finite Element Method(FEM,Non Linear Modeling, Response Surface Methodology, Linear Regression Analysis ,Grey Rational Analysis and Principle Component Analysis (PCA are described in this article. The strength and theweakness of individual approaches are discussed. It is then followed by conclusions and discussions of the potential

  11. A Review on Hematuria in Children


    Sarel Halachmi; David Kakiashvili; Shimon Meretyk


    Asymptomatic hematuria is very common in pediatric and adolescent patients. In contrast to painless hematuria in adults, the differential diagnosis and investigative modalities in the pediatric population is vastly different. This article presents the major diseases that may cause hematuria in children and suggests an evaluation algorithm for the pediatric urologist.

  12. Sensory modulation in preterm children: Theoretical perspective and systematic review (United States)

    Oostrom, Kim J.; Lafeber, Harrie N.; Jansma, Elise P.; Oosterlaan, Jaap


    Background Neurodevelopmental sequelae in preterm born children are generally considered to result from cerebral white matter damage and noxious effects of environmental factors in the neonatal intensive care unit (NICU). Cerebral white matter damage is associated with sensory processing problems in terms of registration, integration and modulation. However, research into sensory processing problems and, in particular, sensory modulation problems, is scarce in preterm children. Aim This review aims to integrate available evidence on sensory modulation problems in preterm infants and children (<37 weeks of gestation) and their association with neurocognitive and behavioral problems. Method Relevant studies were extracted from PubMed, and PsycINFO following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Selection criteria included assessment of sensory modulation in preterm born children (<37 weeks of gestation) or with prematurity as a risk factor. Results Eighteen studies were included. Results of this review support the presence of sensory modulation problems in preterm children. Although prematurity may distort various aspects of sensory modulation, the nature and severity of sensory modulation problems differ widely between studies. Conclusions Sensory modulation problems may play a key role in understanding neurocognitive and behavioral sequelae in preterm children. Some support is found for a dose-response relationship between both white matter brain injury and length of NICU stay and sensory modulation problems. PMID:28182680

  13. Children's reports of past-life memories: a review. (United States)

    Tucker, Jim B


    Researchers have studied young children's reports of past-life memories for the last 45 years. The children usually describe a recent, ordinary life, and many of them have given enough details so that one particular deceased individual has been identified to match the children's statements. These cases occur worldwide, and although they are easiest to find in cultures with a belief in reincarnation, many cases have been found in the West as well. This review explores the facets of this phenomenon and presents several recent American cases.

  14. Exercise Interventions in Children with Cancer: A Review

    Directory of Open Access Journals (Sweden)

    Tseng-Tien Huang


    Full Text Available The purpose of this review is to summarize literature that describes the impact of exercise on health and physical function among children during and after treatment for cancer. Relevant studies were identified by entering the following search terms into Pubmed: aerobic training; resistance training; stretching; pediatric; children; AND cancer. Reference lists in retrieved manuscripts were also reviewed to identify additional trials. We include fifteen intervention trials published between 1993 and 2011 that included children younger than age 21 years with cancer diagnoses. Nine included children with an acute lymphoblastic leukemia (ALL diagnosis, and six children with mixed cancer diagnoses. Generally, interventions tested were either in-hospital supervised exercise training or home based programs designed to promote physical activity. Early evidence from small studies indicates that the effects of exercise include increased cardiopulmonary fitness, improved muscle strength and flexibility, reduced fatigue and improved physical function. Generalizations to the entire childhood cancer and childhood cancer survivor populations are difficult as most of the work has been done in children during treatment for and among survivors of ALL. Additional randomized studies are needed to confirm these benefits in larger populations of children with ALL, and in populations with cancer diagnoses other than ALL.

  15. Classification and clinical features of headache disorders in Pakistan: a retrospective review of clinical data.

    Directory of Open Access Journals (Sweden)

    Muhammed Murtaza

    Full Text Available BACKGROUND: Morbidity associated with primary headache disorders is a major public health problem with an overall prevalence of 46%. Tension-type headache and migraine are the two most prevalent causes. However, headache has not been sufficiently studied as a cause of morbidity in the developing world. Literature on prevalence and classification of these disorders in South Asia is scarce. The aim of this study is to describe the classification and clinical features of headache patients who seek medical advice in Pakistan. METHODS AND RESULTS: Medical records of 255 consecutive patients who presented to a headache clinic at a tertiary care hospital were reviewed. Demographic details, onset and lifetime duration of illness, pattern of headache, associated features and family history were recorded. International Classification of Headache Disorders version 2 was applied. 66% of all patients were women and 81% of them were between 16 and 49 years of age. Migraine was the most common disorder (206 patients followed by tension-type headache (58 patients, medication-overuse headache (6 patients and cluster headache (4 patients. Chronic daily headache was seen in 99 patients. Patients with tension-type headache suffered from more frequent episodes of headache than patients with migraine (p<0.001. Duration of each headache episode was higher in women with menstrually related migraine (p = 0.015. Median age at presentation and at onset was lower in patients with migraine who reported a first-degree family history of the disease (p = 0.003 and p<0.001 respectively. CONCLUSIONS/SIGNIFICANCE: Patients who seek medical advice for headache in Pakistan are usually in their most productive ages. Migraine and tension-type headache are the most common clinical presentations of headache. Onset of migraine is earlier in patients with first-degree family history. Menstrually related migraine affects women with headache episodes of longer duration than other patients

  16. Serial migration and its implications for the parent-child relationship: a retrospective analysis of the experiences of the children of Caribbean immigrants. (United States)

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


    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.

  17. Mucocele of the appendix. Review of 10 cases; Les mucoceles appendiculaires. Etude retrospective a propos de 10 cas

    Energy Technology Data Exchange (ETDEWEB)

    Souei-Mhiri, M.; Tlili-Graies, K.; Ben Cherita, L.; Jeddi, M.; Derbel, F.; Dahmen, Y. [Hopital Sahloul, Sousse (Tunisia); Hmissa, S. [Hopital F Hached, Sousse (Tunisia)


    The purpose of our work was to assess the value of abdominal sonography (US) and computed tomography (CT) in the preoperative diagnosis of appendiceal mucocele. We retrospectively reviewed 10 cases of mucocele of the appendix, 7 cases without pseudo myxoma peritonei, and 3 cases with pseudo-myxoma peritonei. All cases were investigated radiologically by plain film and US, barium enema was performed in 3 cases and CT in 5 cases. Mucoceles of the appendix are rare and their clinical presentation is not specific. US confirms the appendicular involvement, but often poses the differential diagnosis with acute inflammation, abscess or localized appendicular peritonitis. CT appears as a mandatory examination since it allows accurate preoperative diagnosis period. In this series, the diagnosis was made preoperatively in the 5 cases where CT had been performed. US is useful to confirm the abnormal pattern of the appendix but does not allow accurate diagnosis of mucocele. CT is more specific and accurate for diagnosis of mucocele of the appendix. (authors)

  18. A 12-year retrospective review of bullous systemic lupus erythematosus in cutaneous and systemic lupus erythematosus patients. (United States)

    Chanprapaph, K; Sawatwarakul, S; Vachiramon, V


    Objective The aim of this study was to investigate the clinical features, laboratory findings, systemic manifestations, treatment and outcome of patients with bullous systemic lupus erythematosus in a tertiary care center in Thailand. Methods We performed a retrospective review from 2002 to 2014 of all patients who fulfilled the diagnostic criteria for bullous systemic lupus erythematosus to evaluate for the clinical characteristics, extracutaneous involvement, histopathologic features, immunofluorescence pattern, serological abnormalities, internal organ involvement, treatments and outcome. Results Among 5149 patients with cutaneous lupus erythematosus and/or systemic lupus erythematosus, 15 developed vesiculobullous lesions. Ten patients had validation of the diagnosis of bullous systemic lupus erythematosus, accounting for 0.19%. Bullous systemic lupus erythematosus occurred after the diagnosis of systemic lupus erythematosus in six patients with a median onset of 2.5 months (0-89). Four out of 10 patients developed bullous systemic lupus erythematosus simultaneously with systemic lupus erythematosus. Hematologic abnormalities and renal involvement were found in 100% and 90%, respectively. Polyarthritis (40%) and serositis (40%) were less frequently seen. Systemic corticosteroids, immunosuppressants, antimalarials and dapsone offered resolution of cutaneous lesions. Conclusion Bullous systemic lupus erythematosus is an uncommon presentation of systemic lupus erythematosus. Blistering can occur following or simultaneously with established systemic lupus erythematosus. We propose that clinicians should carefully search for systemic involvement, especially hematologic and renal impairment, in patients presenting with bullous systemic lupus erythematosus.

  19. Incidence and Cause of Delirium in Hospitalized Patients between the Ages of 18 and 56: A Retrospective Chart Review

    Directory of Open Access Journals (Sweden)

    Michelle T. Weckmann


    Full Text Available Background. Delirium is a common and devastating condition which has been well characterized in elderly cancer patients, but little is known about delirium in cancer patients under the age of 65. Aim. A pilot study to explore the incidence and potential causes of delirium in hospitalized advanced cancer patients at the age of 18–56 years. Design. A retrospective chart review using validated instruments was used to examine the charts of hematology-oncology admissions in a large academic institution. Data was collected as to the likelihood of delirium and potential precipitants. Results. Delirium incidence was 29% among advanced cancer patients. The associated precipitants of delirium were multifactorial, the most common being medications and infection. Delirium was more common in patients admitted for either acute symptom management or the presence of a lung malignancy. Patients with delirium demonstrated significantly increased total hospital cost and a borderline significant result for increased mortality compared to those without delirium. Conclusions. Delirium is common in hospitalized advanced cancer patients (age 18–56 years and the cause is typically multifactorial. Delirium results in a more complicated hospital course and likely increased mortality. Further research is needed to define strategies to prevent and treat this common and distressing condition.

  20. Allergy to tea tree oil: retrospective review of 41 cases with positive patch tests over 4.5 years. (United States)

    Rutherford, Tim; Nixon, Rosemary; Tam, Mei; Tate, Bruce


    Tea tree oil use is increasing, with considerable interest in it being a 'natural' antimicrobial. It is found in many commercially available skin and hair care products in Australia. We retrospectively reviewed our patch test data at the Skin and Cancer Foundation Victoria over a 4.5-year period and identified 41 cases of positive reactions to oxidized tea tree oil of 2320 people patch-tested, giving a prevalence of 1.8%. The tea tree oil reaction was deemed relevant to the presenting dermatitis in 17 of 41 (41%) patients. Of those with positive reactions, 27 of 41 (66%) recalled prior use of tea tree oil and eight of 41 (20%) specified prior application of neat (100%) tea tree oil. Tea tree oil allergic contact dermatitis is under-reported in the literature but is sufficiently common in Australia to warrant inclusion of tea tree oil, at a concentration of 10% in petrolatum, in standard patch-test series. Given tea tree oil from freshly opened tea tree oil products elicits no or weak reactions, oxidized tea tree oil should be used for patch testing.

  1. A Retrospective Review on Feasibility and Safety of a New Pneumatic Compression Device for Femoral Arteriotomy Hemostasis

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Min Ho [Chungbuk National University Hospital, Cheongju (Korea, Republic of); Shin, Sung Wook [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)


    To report our initial experience on the technical feasibility and safety for hemostasis of a new pneumatic compression device in patients undergoing femoral arteriotomy. This study included 40 consecutive patients in whom hemostasis after transfemoral catheterization was readered by using a pneumatic compression device consisting of an inflatable bulb-containing main body and four pieces of supplementary tape. Medical records were retrospectively reviewed for outcomes and complications of hemostasis. Technical success was defined as achieving immediate hemostasis 10 minutes after applying the device over the arteriotomy sites, and clinical success was defined as the ability to ambulate after 4 hours of bed rest without any complications. Technical and clinical success was achieved in 38 (95%) and 37 (93%) patients, respectively. In two patients, hemostasis was achieved after conversion to manual compression. One patient required sand bag placement after removal of the device to control minimal oozing of blood. No patients had late complications. The new pneumatic compression device provides effective and safe hemostasis after transfemoral catheterization in selected patient populations.

  2. Gait Deviations in Children with Autism Spectrum Disorders: A Review

    Directory of Open Access Journals (Sweden)

    Deirdre Kindregan


    Full Text Available In recent years, it has become clear that children with autism spectrum disorders (ASDs have difficulty with gross motor function and coordination, factors which influence gait. Knowledge of gait abnormalities may be useful for assessment and treatment planning. This paper reviews the literature assessing gait deviations in children with ASD. Five online databases were searched using keywords “gait” and “autism,” and 11 studies were found which examined gait in childhood ASD. Children with ASD tend to augment their walking stability with a reduced stride length, increased step width and therefore wider base of support, and increased time in the stance phase. Children with ASD have reduced range of motion at the ankle and knee during gait, with increased hip flexion. Decreased peak hip flexor and ankle plantar flexor moments in children with ASD may imply weakness around these joints, which is further exhibited by a reduction in ground reaction forces at toe-off in children with ASD. Children with ASD have altered gait patterns to healthy controls, widened base of support, and reduced range of motion. Several studies refer to cerebellar and basal ganglia involvement as the patterns described suggest alterations in those areas of the brain. Further research should compare children with ASD to other clinical groups to improve assessment and treatment planning.

  3. Measuring severe adverse events and medication selection using a “PEER Report” for nonpsychotic patients: a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Hoffman DA


    Full Text Available Daniel A Hoffman,1 Charles DeBattista,2 Rob J Valuck,3 Dan V Iosifescu41Neuro-Therapy Clinic, Inc, Denver, CO, USA; 2Stanford University School of Medicine, Palo Alto, CA, USA; 3University of Colorado, SKAGES School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA; 4Mood and Anxiety Disorders Program, Mount Sinai School of Medicine, New York, NY, USAAbstract: We previously reported on an objective new tool that uses quantitative electroencephalography (QEEG normative- and referenced-electroencephalography sampling databases (currently called Psychiatric EEG Evaluation Registry [PEER], which may assist physicians in determining medication selection for optimal efficacy to overcome trial-and-error prescribing. The PEER test compares drug-free QEEG features for individual patients to a database of patients with similar EEG patterns and known outcomes after pharmacological interventions. Based on specific EEG data elements and historical outcomes, the PEER Report may also serve as a marker of future severe adverse events (eg, agitation, hostility, aggressiveness, suicidality, homicidality, mania, hypomania with specific medications. We used a retrospective chart review to investigate the clinical utility of such a registry in a naturalistic environment.Results: This chart review demonstrated significant improvement on the global assessment scales Clinical Global Impression – Improvement and Quality of Life Enjoyment and Satisfaction – Short Form as well as time to maximum medical improvement and decreased suicidality occurrences. The review also showed that 54.5% of previous medications causing a severe adverse event would have been raised as a caution had the PEER Report been available at the time the drug was prescribed. Finally, due to the significant amount of off-label prescribing of psychotropic medications, additional, objective, evidence-based data aided the prescriber toward better choices.Conclusion: The PEER Report may be

  4. 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


    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.

  5. 257例儿童药物咨询回顾性分析%Retrospective Analysis of 257 Cases of Children's Medication Consultation

    Institute of Scientific and Technical Information of China (English)

    杨智; 张海霞; 蒋志平; 何周康


    Objective To review the children's medicine consultation work for further promotion of drug consultation service and improvementof the quality of pharmaceutical care for children in our hospital. Methods The records of medicine consultation service were collected during January, 2010 to December, 2012 and the the inquisitor's identity, the classification of drugs and advisory content were retrospectively analysed. Results The identities of inquisitors were mainly children's parents. The others were medical staff and pharmacist/medical technologists. Antibiotic agents are the most frequently counseled and secondly the clinical common drugs and digestive agents. The contents of consultation are mainly about usage and dosage of drugs (48.16%), then the adverse reactions and cautions(14.72%), indications(11.37%), drug interaction and incompatibility ( 8 . 03%) . Conclusion Medication consultation plays an important role in the pediatric pharmaceutical service. This work could be an important way to improve the safety and rationality of children's drug use, and can increase the drug use compliance and ensure safety and effectiveness of pediatric medication.%目的:了解我省儿童医院药物咨询工作情况,提高药物咨询服务的质量。方法收集本院2010年1月~2012年12月257例儿科相关药物咨询记录,对咨询者身份、咨询药物类别及咨询内容进行回顾性分析。结果咨询者以患儿家属为主(91.83%),其次为医生、护士、药师和其他医务人员;咨询药物以抗感染药物最多(19.23%),其次为临床各科专用药物和消化系统用药;咨询内容以药品用法用量为主(48.16%),其次为药品不良反应和用药注意事项(14.72%)、药品适应证(11.37%)、药物相互作用和配伍禁忌(8.03%)。结论药物咨询是儿科药学服务的重要内容,是提高儿童用药安全性和合理性的重要途径;提高药物咨询服务水平,有利于提

  6. Correlates of Physical Activity of Children and Adolescents: A Systematic Review of Reviews (United States)

    Sterdt, Elena; Liersch, Sebastian; Walter, Ulla


    Objective: The aim of this study was to identify promoting and inhibiting correlates associated with the physical activity (PA) of children and adolescents (aged 3-18). The intention was to demonstrate the complexity of correlates of PA and to determine possible influencing factors. Design: A systematic review of reviews. Methods: Systematic…

  7. Micronuclei frequency in children exposed to environmental mutagens: a review

    DEFF Research Database (Denmark)

    Neri, Monica; Fucic, Aleksandra; Knudsen, Lisbeth E


    Cytogenetic monitoring has been traditionally used for the surveillance of populations exposed to genotoxic agents. In recent years sensitivity problems emerged in surveys of populations exposed to low levels of mutagens, and therefore alternative approaches have been explored. Biomonitoring......-style, and dietary factors plays a minor role. Among cytogenetic assays, the micronucleus assay (MN) has several advantages and is increasingly used. A review was then carried out to synthesize the published data on the occurrence of MN in children and adolescents (age range 0-18 years), and to assess the impact....... The limited number of published papers indicates that the conduct of properly designed studies on the effect of environmental pollutants in children may be difficult. This review confirmed the usefulness of MN assay in biomonitoring studies conducted in children, revealing that in many circumstances...

  8. The immune system in children with malnutrition - a systematic review

    DEFF Research Database (Denmark)

    Rytter, Maren Johanne Heilskov; Kolte, Lilian; Briend, André;


    BACKGROUND: Malnourished children have increased risk of dying, with most deaths caused by infectious diseases. One mechanism behind this may be impaired immune function. However, this immune deficiency of malnutrition has not previously been systematically reviewed. OBJECTIVES: To review...... the scientific literature about immune function in children with malnutrition. METHODS: A systematic literature search was done in PubMed, and additional articles identified in reference lists and by correspondence with experts in the field. The inclusion criteria were studies investigating immune parameters...... in children aged 1-60 months, in relation to malnutrition, defined as wasting, underweight, stunting, or oedematous malnutrition. RESULTS: The literature search yielded 3402 articles, of which 245 met the inclusion criteria. Most were published between 1970 and 1990, and only 33 after 2003. Malnutrition...

  9. Identifying and characterising cerebral visual impairment in children: a review. (United States)

    Philip, Swetha Sara; Dutton, Gordon N


    Cerebral visual impairment (CVI) comprises visual malfunction due to retro-chiasmal visual and visual association pathway pathology. This can be isolated or accompany anterior visual pathway dysfunction. It is a major cause of low vision in children in the developed and developing world due to increasing survival in paediatric and neonatal care. CVI can present in many combinations and degrees. There are multiple causes and it is common in children with cerebral palsy. CVI can be identified easily, if a structured approach to history-taking is employed. This review describes the features of CVI and describes practical management strategies aimed at helping affected children. A literature review was undertaken using 'Medline' and 'Pubmed'. Search terms included cerebral visual impairment, cortical visual impairment, dorsal stream dysfunction and visual function in cerebral palsy.

  10. Attribution retraining with sexually abused children: review of techniques. (United States)

    Celano, Marianne; Hazzard, Ann; Campbell, Susan K; Lang, Claudia B


    Clinicians increasingly use empirically based cognitive-behavioral techniques in their treatment of child victims of sexual abuse. Attribution retraining is often a primary component of this work, and it involves various techniques aimed at decreasing abuse-related self-blame and encouraging the child to attribute responsibility for the abuse to the perpetrator This article reviews literature that highlights the complexity of self and other blame for sexually abused children in terms of developmental status, the multifaceted nature and interrelationships of abuse-specific attributions, and the psychological effects of self-blame and perpetrator blame. A review of written attribution retraining techniques developed by diverse authors for use with sexually abused children and their nonoffending parents is provided, including written and verbal techniques and techniques using games and the arts. The relative utility of different approaches with children of various stages of development is discussed, along with the need for empirical research regarding the effectiveness of these techniques.

  11. Bilingualism in children with developmental disorders: A narrative review

    NARCIS (Netherlands)

    Kay-Raining Bird, E.; Genesee, F.; Verhoeven, L.T.W.


    Children with developmental disabilities (DD) often need and sometimes opt to become bilingual. The context for bilingual acquisition varies considerably and can impact outcomes. In this first article of the special issue, we review research on the timing and amount of bilingual exposure and outcome

  12. Tactile Assessment in Children with Cerebral Palsy: A Clinimetric Review (United States)

    Auld, Megan Louise; Boyd, Roslyn Nancy; Moseley, G. Lorimer; Johnston, Leanne Marie


    This review evaluates the clinimetric properties of tactile assessments for children with cerebral palsy. Assessment of registration was reported using Semmes Weinstein Monofilaments (SWMs) or exteroception. Assessment of two-point discrimination was reported using the Disk-Criminator[R] or paperclip methods; Single point localization and double…

  13. Children's Emotionality and Social Status: A Meta-Analytic Review (United States)

    Dougherty, Lea R.


    Over the last 15 years, the role of emotions in children's peer relations has received greater attention. The purpose of the meta-analytic review was to determine the magnitude of the relation between negative emotionality (NE) and positive emotionality (PE) and social status. Based on 54 independent samples, the overall effect size for the…


    BACKGROUND: We performed a systematic review to examine the diagnostic yield (endoscopic and histologic) of esophagogastroduodenoscopy (EGD) for the evaluation of abdominal pain of unclear etiology in children. We also examined the effect of EGD on change in treatment, quality of life, change in abd...

  15. Legibility in Children's Books: A Review of Research. (United States)

    Watts, Lynne; Nisbet, John

    This book reviews the research in the field of typography as it affects children's books and sets it in the context of research on reading. The contents include five chapters: "Problems of Definition and Measurement" discusses the various measures of legibility used in research studies. "The Reading Process" examines three…

  16. Siblings of Handicapped Children: A Review. (United States)

    Lobato, Debra


    Research is critically reviewed and evaluated to determine if the presence of a handicapped child in a family uniquely affects the nonhandicapped siblings and to identify factors mediating the nature and power of those effects. In addition, projects involving sibling therapy, education, and training are described. (Author/CL)

  17. Clinical evaluation and follow-up of body mass and blood pressure in pre-elementary school children: program review. (United States)

    Underwood, Sandra Millon; Averhart, LaCreessha; Dean, Ashante; Ivalis, Ruth; Muluken, Meseret; Robinson, Rebecca; Russ, Jori; Williams, Marcus


    While administrators of pre-elementary school programs throughout the country recognize the importance of screening and monitoring body mass and hypertension in early childhood populations, typically, few efforts are undertaken to systematically, retrospectively, and critically review them. A retrospective cross-sectional analysis of measures, reflective of body mass and blood pressure, collected from a targeted group of 10 urban pre-elementary schools in the Midwestern region of the country, was therefore undertaken. Overweight, obesity, and blood pressure readings suggestive of pre-hypertension and hypertension were found to be more prevalent among both boys and children whose school and residences were located in low-income neighborhoods. More surprising, however, was the lack of documentation of notations in their health records about their BMI status, blood pressure status, and/or need for re-assessment, referral, or follow-up.

  18. Pathophysiology of hypertension in obese children: a systematic review. (United States)

    Wirix, A J G; Kaspers, P J; Nauta, J; Chinapaw, M J M; Kist-van Holthe, J E


    Hypertension is increasingly common in overweight and obese children. The mechanisms behind the development of hypertension in obesity are complex, and evidence is limited. In order to effectively treat obese children for hypertension, it is important to have a deeper understanding of the pathophysiology of hypertension in obese children. The present review summarizes the main factors associated with hypertension in obese children and discusses their potential role in its pathophysiology. Systematic searches were conducted in PubMed and EMBASE for articles published up to October 2014. In total, 60 relevant studies were included. The methodological quality of the included studies ranged from weak to strong. Several factors important in the development of hypertension in obese children have been suggested, including endocrine determinants, such as corticosteroids and adipokines, sympathetic nervous system activity, disturbed sodium homeostasis, as well as oxidative stress, inflammation and endothelial dysfunction. Understanding the pathophysiology of hypertension in overweight and obese children is important and could have implications for its screening and treatment. Based on solely cross-sectional observational studies, it is impossible to infer causality. Longitudinal studies of high methodological quality are needed to gain more insight into the complex mechanisms behind the development of hypertension in obese children.

  19. Thyroid carcinoma in children and young adults: retrospective review of 19 cases. (United States)

    Saraiva, Joana; Ribeiro, Cristina; Melo, Miguel; Gomes, Leonor; Costa, Gracinda; Carrilho, Francisco


    Introdução: O carcinoma da tiróide é raro em crianças e em adultos jovens. A maior parte das orientações clínicas baseia-se em dados obtidos na população adulta. Persistem diversas controvérsias no que se refere à agressividade da apresentação clínica e da abordagem terapêutica.Objectivo: Avaliar todos os doentes com carcinoma da tiróide com menos de 20 anos no momento da apresentação, reflectindo a experiência da nossa unidade relativamente ao diagnóstico, tratamento e seguimento desta entidade.Material e Métodos: Trata-se de um estudo de revisão retrospectiva dos registos clínicos de todas as crianças e adultos jovens seguidos na Consulta de Oncologia do Serviço de Endocrinologia do Centro Hospitalar e Universitário de Coimbra entre 1996 e 2012 .Resultados: Foram estudados 19 doentes, com uma média etária de 16 anos, sendo 13 do sexo feminino. Nenhum dos doentes fora previamente submetido a irradiação da região do pescoço. A queixa de apresentação era a presença de uma massa cervical palpável em 84,6% dos casos. Foi realizada citologia aspirativa em 15 doentes, que foi diagnóstica ou suspeita de neoplasia em 71,4% dos casos. A tiroidectomia total foi levada a cabo em 18 casos (94,7%). Em todos estes foi identificada a presença de um carcinoma papilar. A invasão vascular e multicêntrica ocorreu em 21,1% dos casos. A dimensão tumoral média foi de 2,5 cm. O envolvimento ganglionar cervical foi diagnosticado em 31,6% dos casos e a presença de metástases à distância foi identificada em 5,2% dos casos. Na maior parte dos doentes (18 em 19), o quadro foi classificado como doença em estadio I. Todos os doentes fizeram terapêutica supressora com tiroxina e 84,2% dos doentes foram submetidos a ablação pós-operatória com iodo radioactivo (dose média de 85,7mCi). Durante um seguimento médio de cerca de 6 anos, 16 doentes permaneceram em remissão.Conclusão: Na nossa série, as taxas de metastização ganglionar cervical e à distância foram semelhantes às encontradas na população adulta. O prognóstico foi globalmente muito satisfatório.

  20. Management of acute mastoiditis in children. A retrospective study and literature review

    Directory of Open Access Journals (Sweden)

    Wafa Abid


    Conclusion: Initial management of acute mastoiditis starts with intravenous antibiotics and computerized tomographic scan of the petrous temporal bones. Surgical approach is required in case of complications or failure of medical treatment. Watchful clinical monitoring is essential in all cases.

  1. Alveolar rhabdomyosarcoma in children with histomorphological review

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    S. K. Nema


    Full Text Available Rhabdomyosarcomas (RMS are aggressive malignant neoplasm of mesenchymal origin, related to skeletal muscle lineage. These are the most common soft tissue tumors in children. The diagnosis is made by microscopic analysis and ancillary techniques like immunohistochemistry, electron microscopy, cytogenetics and molecular biology. We encountered a case of a 03 years old child who presented with a tender, reddish, soft swelling over cheek for three weeks. The FNAC was reported as a small round cell tumor, Probably Primitive Neuroectodermal Tumor (PNET. The biopsy of tumor revealed a small round cell tumor with an alveolar pattern. Tumor giant cells were absent and mitotic figures were infrequent. Hence, differentials of alveolar rhabdomyosarcoma and PNET were rendered. Immunohistochemistry (IHC demonstrated desmin positivity. Thus, a final diagnosis of alveolar rhabdomyosarcoma was offered. [Int J Res Med Sci 2014; 2(2.000: 775-778

  2. Fracture of the acetabulum: a retrospective review of ninety-one patients treated at a single institution. (United States)

    Uchida, Kenzo; Kokubo, Yasuo; Yayama, Takafumi; Nakajima, Hideaki; Miyazaki, Tsuyoshi; Negoro, Kohei; Takeno, Kenichi; Sawaguchi, Takeshi; Watanabe, Shuji; Sugita, Daisuke; Takeura, Naoto; Yoshida, Ai; Baba, Hisatoshi


    Acetabular fracture result in fairly good outcome after the anatomic reduction in the displaced fracture fragments and damaged joint structure, but some patients will inevitably suffer from hip joint problems during their courses after the insult. We retrospectively reviewed 91 patients with acetabular fractures to investigate the causes of clinical failure and relationship among the fracture types, selected treatment options and their courses. Ninety-one patients (73 men and 18 women) with an average age of 49 years (range 18-80) at the time of injury were followed up for an average of 8.6 years (range 2-18). Judet-Letournel classification of fracture type and Matta's rating regimen of functional and radiographic patient' assessment were conducted. Conservative treatment was provided in 20 patients, in which 19 attained excellent/good, and one fair clinical results. All achieved excellent/good radiographic outcome. Surgically treated patients (n = 71) with critical dislodgement of the fracture fragment showed that 64 (90%) attained excellent/good and 7 (10%) fair/poor clinical outcomes. Sixty-three (89%) attained excellent/good and 8 (11%) fair/poor postoperative radiographic outcome. Five patients with poor radiographic outcome after surgery subsequently required total hip arthroplasty, due to the development of hip joint osteoarthritis in 3 and femoral head avascular necrosis in 2. We conclude that displacement of the joint surface should be reduced to less than 3 mm in accordance with the selection of the most appropriate surgical approach for open reduction/fixation in each fracture type; however, comminuted fracture and avascular necrosis of the femoral head may be the cause of poor clinical results.

  3. Off-label use of transmucosal ketamine as a rapid-acting antidepressant: a retrospective chart review

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    Nguyen L


    Full Text Available Linda Nguyen,1,2 Patrick J Marshalek,2 Cory B Weaver,1 Kathy J Cramer,2,3 Scott E Pollard,2,4 Rae R Matsumoto1,2,5 1Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University, Morgantown, WV, USA; 2Department of Behavioral Medicine and Psychiatry, School of Medicine, West Virginia University, Morgantown, WV, USA; 3Doctor of Nursing Practice Program, Robert Morris University, Moon Township, PA, USA; 4Department of Behavioral Health, West Park Hospital, Cody, WY, USA; 5College of Pharmacy, Touro University California, Vallejo, CA, USA Objective: This study evaluated the effectiveness and safety of subanesthetic doses of ketamine using an off-label, transmucosal administration route in patients with treatment-resistant depression.Methods: A retrospective chart review was conducted to identify patients who met the inclusion criteria for treatment-resistant major depressive disorder. Seventeen such patients who received subanesthetic doses of ketamine were included. Patient demographics, efficacy (drug refill, clinician notes, side effects, and concurrent medications were assessed.Results: Benefit from low-dose transmucosal ketamine was noted in 76% of subjects (average age 48 years, 88% female, with a dose duration lasting 7–14 days. No notable side effects were noted. The most common classes of concurrent medications to which ketamine was added were serotonin–norepinephrine reuptake inhibitors (59%, stimulants (47%, folate replacement (47%, and benzodiazepines (47%.Conclusion: Our results provide preliminary evidence of the effectiveness and safety of low-dose transmucosal ketamine in treatment-resistant patients. A controlled, prospective pilot study is warranted to validate these findings. Keywords: ketamine, depression, treatment resistance, NMDA receptor, glutamate, mood disorder 

  4. 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


    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.

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

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    Luo Yan


    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.

  6. Community-Acquired Pneumonia in Children: A Multidisciplinary Consensus Review

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    Donald E Low


    Full Text Available Community-acquired pneumonia (CAP is common among children and may have viral, bacterial or, occasionally, other causes. The etiology is complex, with age-related trends, and differs from that in adult CAP, necessitating different management guidelines. There is an absence of current guidelines for the management of pediatric CAP (PCAP that take into account changing etiologies, antimicrobial-resistance issues and the use of newly licensed antimicrobials. The present review does not provide specific guidelines, but it reviews the literature and presents currrent approaches to the treatment of PCAP. To compile the review, an expert panel was convened to provide a consensus. The review discusses the etiology, diagnosis and antimicrobial treatment of PCAP as well as indications for referral to a hospital emergency department. The goal of the review is to provide those involved with treatment of PCAP in the community setting with information that can be used to make effective treatment choices.

  7. Influence of proton pump inhibitors and histamine H2 receptor antagonists on serum phosphorus level control by calcium carbonate in patients undergoing hemodialysis: a retrospective medical chart review


    Tatsuzawa, Masaomi; Ogawa, Ryuichi; OHKUBO, Atsushi; Shimojima, Kazuyo; Maeda, Kunimi; Echizen, Hirotoshi; Miyazaki, Akihisa


    Background Hyperphosphatemia is one of the common complications in patients undergoing hemodialysis. Although calcium carbonate (CaC) is often used to control serum inorganic phosphorus level in dialysis patients, co-administration of gastric acid reducers (ARs) may interfere with the phosphate binding effect of CaC. We performed a retrospective medical chart review to study whether ARs attenuate the hypophosphatemic effect of CaC in patients undergoing hemodialysis. Methods One hundred and e...

  8. Urinary Tract Infection in Children: A Review

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    Farzana Hamid


    Full Text Available Urinary tract infection (UTI is one of the most common paediatric infections. By the time children are 5 years old, about 8% of girls and about 1-2% of boys have had at least one episode of UTI. UTIs are caused mainly by colonic bacteria, such as Escherichia coli, followed by Klebsiella and Proteus. However, any organism that gains access to the urinary tract system may cause infection, including fungi (Candida species and viruses. In some instances, UTI results in recognition of an important underlying structural abnormality of the urinary tract. The febrile infant or child with clinically significant bacteriuria and no other site of infection to explain the fever, even in the absence of systemic symptoms has UTI. Signs and symptoms of UTIs vary depending on the child's age and on which part of the urinary tract is infected. The diagnosis of UTI is based on routine microscopic examination and culture of a properly collected urine specimen. Imaging studies are done in selected patients to identify anatomic abnormalities. Most cases of uncomplicated UTI respond readily to outpatient antibiotic treatment without further sequelae. All patients should have close follow-up to evaluate response to antibiotics and to prevent the development of long term complication.

  9. Prevalence of sleep bruxism in children: A systematic review

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    Eduardo Machado


    Full Text Available INTRODUCTION: Prevalence of sleep bruxism (SB in children is subject to discussions in the literature.OBJECTIVE: This study is a systematic literature review aiming to critically assess the prevalence of SB in children.METHODS: Survey using the following research databases: MEDLINE, Cochrane, EMBASE, PubMed, Lilacs and BBO, from January 2000 to February 2013, focusing on studies specifically assessing the prevalence of SB in children.RESULTS: After applying the inclusion criteria, four studies were retrieved. Among the selected articles, the prevalence rates of SB ranged from 5.9% to 49.6%, and these variations showed possible associations with the diagnostic criteria used for SB.CONCLUSION: There is a small number of studies with the primary objective of assessing SB in children. Additionally, there was a wide variation in the prevalence of SB in children. Thus, further, evidence-based studies with standardized and validated diagnostic criteria are necessary to assess the prevalence of SB in children more accurately.

  10. Experiences of the foster care process in the Republic of Ireland: retrospective accounts from biological children of foster carers


    Williams, David


    This thesis examines the experiences of the biological children of foster carers. In particular it explores their experiences in relation to inclusion, consultation and decision-making. The study also examines the support and training needs of birth children in foster families. Using a qualitative methodology in-depth, semi-structured interviews were conducted with fifteen birth children of foster carers aged between 18 and 30 years. The research findings show that for the majority of birth c...

  11. Acupuncture for Children with Cerebral Palsy: A Systematic Review Protocol (United States)

    Zhang, Qian; Yang, Yejiao; He, Qi; Zhang, Xinghe


    Background Cerebral palsy (CP), a childhood disease of high morbidity and serious harmfulness, has no effective therapies to completely relieve the associated pain. Acupuncture has been used widely in China to alleviate several CP symptoms, such as pain and motion disorders, despite the deficiency of high-quality evidence related to this practice. Objective The aim of this systematic review protocol is to assess the efficacy and safety of acupuncture for the treatment of children with CP. Methods The following electronic databases will be searched: Cochrane Library, Web of Science, EBASE, Springer, World Health Organization International Clinical Trials Registry Platform, China National Knowledge Infrastructure, Wan-fang database, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, and other sources. All published randomized controlled trials from inception to December 2016 will be included. RevMan V.5.3 software will be implemented for the assessment of bias risk, data synthesis, subgroup analysis, and meta-analyses if inclusion conditions are met. Individuals recruited into the trials will include children with all types of CP, and these individuals will be involved as coresearchers to develop and evaluate the efficacy and safety of acupuncture for the treatment of children with CP. Due to language barriers, only English and Chinese articles will be retrieved. Results The systematic review will synthesize the available knowledge surrounding acupuncture for children with CP. The findings will be synthesized to determine the efficacy and safety of acupuncture for children with CP. Conclusions The review has not been completed. This protocol presents a proper method to implement the systematic review, and ensures transparency for the completed review. Findings from the systematic review will be disseminated in a peer-reviewed journal and results will be presented at relevant conferences. The data of individual patients will not be included

  12. Efficacy of Acupuncture for Health Conditions in Children: A Review

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    Jean Libonate


    Full Text Available Acupuncture has been used to treat a variety of childhood problems; however, the efficacy and safety of pediatric acupuncture remains unclear. This article reviews the existing empirical literature relating to the use of acupuncture for medical conditions in children. A systematic search of the literature revealed that acupuncture has been used to treat five main conditions in children, including pain, nocturnal enuresis, postoperative nausea/vomiting, laryngospasm/stridor, and neurological disorders. Despite a number of methodological issues, including limited sample sizes, lack of randomization, and inappropriate control groups, it is concluded that acupuncture represents a promising intervention for a variety of pediatric health conditions. To further address the safety, effectiveness, and acceptability of acupuncture in children, large-scale randomized controlled trials are needed.

  13. Safety and protection for hospitalized children: literature review. (United States)

    Schatkoski, Aline Modelski; Wegner, Wiliam; Algeri, Simone; Pedro, Eva Neri Rubim


    This narrative-descriptive review is about the safety/protection of hospitalized children who, due to their fragility, vulnerability and peculiar growth and development conditions need special attention from health professionals. This study aimed to identify knowledge production on safety, protection and violence to hospitalized children between 1997 and 2007. In total, 15 national and international articles were analyzed, using the key words: hospitalized child, safety, violence and nursing. This qualitative approach enabled the development of four categories: adverse occurrences; medication errors; notification of adverse occurrences; and safety of pediatric patients. Results indicate the need to develop strategies to reduce the probability of these events occurring during children's hospitalization, so that they do not suffer any problem neither violation of their fundamental rights.

  14. Management of Psoriasis in Children: a Narrative Review

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    Zohreh Hajheydari


    Full Text Available Psoriasis is an inherited chronic inflammatory papulosquamous disorder with a variable clinical spectrum affecting about 0.5% to 2% of children and adolescence. In spite of all performed researches around the world for seeking better treatments with fewer adverse effects to control the disease, there is still no cure for psoriasis. Treatment of psoriasis in children is very conservative and many therapies used for adults may not be appropriate for children due to possible long-term or delayed adverse effects. A wide range of therapeutic options are existed including; topical therapy, phototherapy, chemotherapy, systemic therapies and biologic therapies. Here in, because of the lack of data in this specific field of dermatology, we decided to review the current therapies of childhood psoriasis.

  15. Secular trends in blood pressure in children: A systematic review. (United States)

    Roulet, Céline; Bovet, Pascal; Brauchli, Thomas; Simeoni, Umberto; Xi, Bo; Santschi, Valérie; Paradis, Gilles; Chiolero, Arnaud


    Blood pressure (BP) is expected to have increased over time in children in most countries due to the increasing prevalence of childhood obesity worldwide. The authors conducted a systematic review of studies assessing secular trends in BP in children and adolescents. Of 1739 citations screened, the authors identified 18 studies including 2 042 470 participants examined between 1963 and 2012. Thirteen studies were conducted in high-income countries, five in middle-income countries, and none in low-income countries. The prevalence of overweight or obesity increased in 17 studies and decreased in one study. BP decreased over time in 13 studies, increased in four, and did not change in one. These findings suggest that secular trends in BP do not mirror secular trends in overweight. This implies that other factors mitigate the effect of overweight on BP in children and adolescents.

  16. Spinal tuberculosis in children: a retrospective study of 112 cases%少儿脊柱结核的临床特点分析

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    兰汀隆; 董伟杰; 范俊; 唐恺; 秦世炳


    Objectives: To analyze the clinical characteristics of children with spinal tuberculosis (TB),and to provide references for its diagnosis and therapy.Methods: A retrospective analysis of 112 children with spinal TB from January 2006 to December 2012 was carried out,the first complaint,duration,the segments involved,the number of vertebrae involved,the kyphotic Cobb angle and paralysis were reviewed.The correlation between duration,the number of vertebra involved and the kyphotic Cobb angle were analyzed.At the same time,the patients were divided to infant group(0-3 years),preschool children group(4-6 years),school-age children group(7-12 years) and juvenile group(13-17 years).The spine was divided into upper spine(cervical,thoracic and cervicothoracic segment) and lower spine(thoracolumbar,lumbar,lumbosacral and sacral segments).The morbidity of both upper and lower spine was compared.According to the neurological function,the patients were divided into paralysis group and non-paralysis group.The duration,number of vertebra involved and kyphotic Cobb angle of between two groups were compared.According to the kyphotic Cobb angle,the patients were divided into no less than 30° group and less than 30° group.The morbidity of paralysis were compared between two groups.Results: In these patients,pain was the most common first complaint and thoracic segment involved was most common.The average disease duration and number of vertebras involved was 5.3±10.9 months and 2.9±1.0 respectively.The average kyphotic Cobb angle was 15.7°±17.0°.Significant correlations were found for the kyphotic Cobb angle,the number of vertebrae involved and duration (r=0.384-0.666,P<0.05).There was significant difference between paralysis group and non-paralysis group with regard to the kyphotic Cobb angle,the number of vertebrae involved and duration (P<0.05).There was significant difference between the group with the kyphotic Cobb angle of no less than 30° and the group with

  17. Social competence in children with epilepsy--a review. (United States)

    Rantanen, K; Eriksson, K; Nieminen, P


    This systematic review focuses on definitions of social competence and assessment methods and provides an overview of the main findings in childhood epilepsy. A total of 45 studies drawn from MEDLINE and PsycINFO (1998-2010) and their reference lists met the selection criteria. Social competence was not defined in the studies reviewed. The study samples varied and consisted mostly of school-aged children. The majority of the studies focused on social adjustment and addressed problems in this area. Little is known about other aspects of social competence, namely social skills or social performance. A broader perspective on and definition of the assessment of social competence in children with epilepsy are proposed. More studies of the abilities underlying social competence, such as social and socio-cognitive skills, are needed in order to gain insight into the developmental pathways of social competence and protective factors for later development.

  18. Young Children Who Abandon Error Behaviourally Still Have to Free Themselves Mentally: A Retrospective Test for Inhibition in Intuitive Physics (United States)

    Freeman, Norman H.; Hood, Bruce M.; Meehan, Caroline


    When preschoolers overcome persistent error, subsequent patterns of correct choices may identify how the error had been overcome. Children who no longer misrepresented a ball rolling down a bent tube as though it could only fall vertically, were asked sometimes to approach and sometimes to avoid where the ball landed. All children showed requisite…

  19. Brazilian infant and preschool children feeding: literature review

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    Carolina Santos Mello

    Full Text Available Abstract Objective To assess the feeding profile of Brazilian infants and preschool children aged 6 months to 6 years, based on the qualitative and quantitative analysis of food and nutrient intake. Data source This review analyzed studies carried out in Brazil that had food survey data on infants and preschool children. The search was limited to publications from the last 10 years included in the LILACS and MEDLINE electronic databases. Data summary The initial search identified 1480 articles, of which 1411 were excluded after the analysis of abstracts, as they were repeated or did not meet the inclusion criteria. Of the 69 articles assessed in full, 31 articles contained data on food survey and were selected. Only three studies concurrently assessed children from different Brazilian geographical regions. Of the assessed articles, eight had qualitative data, with descriptive analysis of food consumption frequency, and 23 had predominantly quantitative data, with information on energy and nutrient consumption. Conclusions The articles assessed in this review showed very heterogeneous results, making it difficult to compare findings. Overall, the feeding of infants and preschool children is characterized by low consumption of meat, fruits, and vegetables; high consumption of cow's milk and inadequate preparation of bottles; as well as early and high intake of fried foods, candies/sweets, soft drinks, and salt. These results provide aid for the development of strategies that aim to achieve better quality feeding of Brazilian infants and preschoolers.

  20. Pregnancy Outcomes Complicated by Preterm Premature Rupture of Membranes: Retrospective Review of Cases in Three Institutions in Kazakhstan

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    Balkenzhe Imankulova


    Full Text Available Introduction. Pre-term premature rupture of membranes (PPROM is one of the leading causes of perinatal morbidity and mortality. This complication is diagnosed in 3% of pregnant women in Kazakhstan, and it is the leading cause of pre-term deliveries. The aim of this study was to determine the outcomes of pregnancies complicated by PPROM in gestation periods between 24 to 32 weeks among three institutions in Kazakhstan.Methods. This is descriptive analysis of 154 cases with PPROM observed between 24 to 32 weeks of gestation at Perinatal Centers #2 and #3 and the National Research Center for Maternal and Child Health, Astana, Kazakhstan. Cases were selected on the basis of retrospective chart review where PPROM diagnosis occurred in 2013. Descriptive statistics were utilized for data analysis.Results. The most frequent complications associated with PPROM were threat of miscarriage (13.6% of cases and chronic placental insufficiency (7.8%. The mean time between PPROM and onset of spontaneous labor was 12.1 ± 2.3 days.  Spontaneous labor within 3 days after PPROM started in patients with an amniotic fluid index of 3.0 ± 0.2 cm. Complications experienced by PPROM women during delivery and early postpartum period included: precipitous labor (6.4%, weakness of labor activity (16.2%, atonic hemorrhage (1.2%, and chorioamnionitis (3.2%. 37.6% of newborns in this study were admitted to the Intensive Care Unit. Their health complications included pneumonia (7.7%, conjunctivitis (1.3%, omphalitis and infectious-toxic shock (3.8%, intraventricular hemorrhage  (7.8%, and respiratory distress (10.3% .Conclusion. Thus, preterm rupture of membranes is associated with preterm delivery and an increase of neonatal morbidity. Therefore, it is necessary to find ways to effectively manage PPROM, including developing new techniques to restore the amniotic fluid volume in women experiencing PPROM during 24 to 32 weeks of gestation. 

  1. Eating behaviors, diet quality, and gastrointestinal symptoms in children with autism spectrum disorders: a brief review. (United States)

    Kral, Tanja V E; Eriksen, Whitney T; Souders, Margaret C; Pinto-Martin, Jennifer A


    Children with autism spectrum disorders (ASD) and their caregivers face unique challenges in the children's daily eating routines and food intake patterns. The aim of this brief review is to describe eating behaviors of children with ASD, including increased food neophobia and food selectivity, and review findings on children's diet quality, and gastrointestinal (GI) symptoms. Advancing knowledge about the interrelationships between these nutrition-related domains in children with ASD is expected to have important implications for clinical nursing practice and caregiver care.

  2. Review: Ontogeny of oral drug absorption processes in children


    Mooij, Miriam; Koning, De; Huijsman, Mark; de Wildt, Saskia


    textabstractA large proportion of prescribed drugs to children are administered orally. Age-related change in factors affecting oral absorption can have consequences for drug dosing. Areas covered: For each process affecting oral drug absorption, a systematic search has been performed using Medline to identify relevant articles (from inception till February 2012) in humans. This review presents the findings on age-related changes of the following processes affecting oral drug absorption: gast...

  3. Ventilatory Efficiency in Children and Adolescents: A Systematic Review

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    Paloma Lopes Francisco Parazzi


    Full Text Available Introduction. The index of ventilatory efficiency (VE/VCO2 obtained by the progressive exercise test has been considered the gold standard in the prognosis of adults with heart failure, but few studies have evaluated this approach in children. Objective. To verify the scientific evidence about the VE/VCO2 in pediatric and adolescents patients. Methods. A systematic literature review was carried out using the key words VE/VCO2, children, and adolescents using the PEDro and PubMed/MedLine databases. Clinical trials published from 1987 to 2014, including children, adolescents, and young adults up to 25 years, addressing the VE/VCO2 index as a method of evaluation, monitoring, and prognosis were considered. Results. Initially, 95 articles were found; 12 were excluded as the title/abstract did not contain the VE/VCO2 index or because they included patients greater than 25 years of age. From the remaining 83, 58 were repeated between the databases. The final sample consisted of 32 studies including healthy children and children with respiratory and other diseases. Conclusion. There are few studies involving cardiorespiratory assessment by ventilatory efficiency. The studies highlight the fact that high VE/VCO2 values are associated with a worse prognosis of patients due to the relationship with the decrease in pulmonary perfusion and cardiac output.

  4. Rituximab for children with immune thrombocytopenia: a systematic review.

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    Yi Liang

    Full Text Available BACKGROUND: Rituximab has been widely used off-label as a second line treatment for children with immune thrombocytopenia (ITP. However, its role in the management of pediatric ITP requires clarification. To understand and interpret the available evidence, we conducted a systematic review to assess the efficacy and safety of rituximab for children with ITP. METHODOLOGY/PRINCIPAL FINDINGS: We searched MEDLINE, EMBASE, Cochrane Library, CBM, CNKI, abstract databases of American Society of Hematology, American Society of Clinical Oncology and Pediatric Academic Society. Clinical studies published in full text or abstract only in any language that met predefined inclusion criteria were eligible. Efficacy analysis was restricted to studies enrolling 5 or more patients. Safety was evaluated from all studies that reported data of toxicity. 14 studies (323 patients were included for efficacy assessment in children with primary ITP. The pooled complete response (platelet count ≥ 100 × 10(9/L and response (platelet count ≥ 30 × 10(9/L rate after rituximab treatment were 39% (95% CI, 30% to 49% and 68% (95%CI, 58% to 77%, respectively, with median response duration of 12.8 month. 4 studies (29 patients were included for efficacy assessment in children with secondary ITP. 11 (64.7% of 17 patients associated with Evans syndrome achieved response. All 6 patients with systemic lupus erythematosus associated ITP and all 6 patients with autoimmune lymphoproliferative syndrome associated ITP achieved response. 91 patients experienced 108 adverse events associated with rituximab, among that, 91 (84.3% were mild to moderate, and no death was reported. CONCLUSIONS/SIGNIFICANCE: Randomized controlled studies on effect of rituximab for children with ITP are urgently needed, although a series of uncontrolled studies found that rituximab resulted in a good platelet count response both in children with primary and children secondary ITP. Most adverse events

  5. Treatment of hepatitis C in children: a systematic review.

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    Jia Hu

    Full Text Available BACKGROUND: Current guidelines recommend children be treated for hepatitis C virus (HCV using the same principles applied in adults. There are however few published studies which assess the efficacy and safety of HCV therapy in children. METHODOLOGY/PRINCIPAL FINDINGS: A systematic review of the literature was completed for studies of any design that evaluated HCV therapy in children. The primary outcome was sustained virologic response (SVR, with sub-group analysis of response rates by genotype. There were 4 randomized controlled trials (RCTs and 31 non-randomized studies, all involving interferon, pegylated interferon (PEG-IFN, or combinations of these drugs with ribavirin. The SVR rate could not be directly compared as the populations and interventions differed across studies. Genotype was not reported or differed substantially from study to study. The overall SVR rate for PEG-IFN and ribavirin ranged from 30 to 100% which is comparable to the rate in adults. Similar to adults, the SVR rates were significantly higher in children with genotype 2 or 3 compared to genotype 1. Adverse effects were primarily flu-like symptoms and neutropenia. There were insufficient data to assess the applicability of the week 12 stop rule (stopping therapy at week 12 if there is less than a 2 log drop in HCV RNA or the efficacy of shortening therapy to 24 weeks in children with genotype 2 and 3. CONCLUSIONS/SIGNIFICANCE: Current guidelines for the treatment of HCV in children are based on limited data. Further research is needed to define the optimal therapy for HCV in children.

  6. Physical, mental and psychomotor development of children born after multifetal pregnancy reduction: a retrospective case-control study

    Institute of Scientific and Technical Information of China (English)

    Chen Xiao-Qin; Wang Wen-Jun; Li Yu; Li Hong; Ma Yun; Chen Xiang-Hong; Yang Dong-Zi; Zhang Qing-Xue


    Objective: To assess the perinatal and developmental outcomes of assisted reproductive technologies (ART) children born after multifetal pregnancy reduction (MPR).Methods: Twenty-four ART children born after MPR were compared to 9 triplets without MPR, and 24 matched IVF children without MPR and 24 naturally conceived. Mental and psychological development was assessed by Bayley Scales.of Infant. The outcomes compared included perinatal characteristics, body mass index (BMI), mental development index (MDI) and psychomotor development index (PDI).Results: MPR singletons/twins had better neonatal outcomes than non-MPR triplets. Moreover, PDI of the MPR singletons/twins was significantly higher than that of the non-MPR triplets. There were no significantly difference in perinatal characteristics, BMI, MDI and PDI among 24 MPR children, 24 matched IVF children without MPR and 24 matched naturally conceived children.Conclusion: Multifetal pregnancy reduction could improve perinatal outcomes and would not affect physical, mental and psychomotor development for children born after it.

  7. Liver Hydatid Cyst in Children (A 14-year Review

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    Mohsen Rouzrokh


    Full Text Available Objective:Hydatid disease is still an important health hazard in the world. This disease is a parasitic infestation which is endemic in many sheep and cattle raising areas such as in Iran. The aim of this study was to evaluate the clinical appearance, diagnosis, and treatment of liver hydatid cyst in children. Methods:This retrospective study evaluated 100 patients who were referred to Mofid Childrens Hospital with liver hydatid cyst from March 1996 to March 2010. Medical records of 1 to 14 year old patients who had definitive liver hydatid cyst were included and analysis of variables such as age, gender, symptoms, diagnostic investigation, operative technique, hospital stay, mortality, morbidity and outcome of treatment were evaluated. Findings:The patients consisted of 54 boys (54% and 46 (46% girls with an age range of 1-14 years (mean 11.8±4.6. The incidence rate increased by age. The patients had totally 110 cysts, right pulmonary lobe 81 (73% cysts and left side had 29 (27%. Abdominal mass was the most common (50% symptom. Abdominal sonography gave correct diagnosis in 94 (94% patients. Conservative surgical treatment was carried out in 98 children. Two patients were treated medically as the cysts were small and calcified. The most common complication was wound infection in 3 cases. Mean length of hospitalization was 9 days. In 100% of our patients the type of parasite was Echinoccocus granulosus. The morbidity rate was 12%   (prolonging external catheter drainage in 12 patients. There was only one (1% mortality and 2 (2% recurrences. Conclusion:Due to the less invasive and high accuracy of liver sonography in diagnosis of hydatid cyst, we recommend it as the method of choice for the diagnosis in endemic regions. Surgery is the method of choice for treatment.

  8. Review: Interpretation of drug presence in the hair of children. (United States)

    Wang, Xin; Drummer, Olaf H


    Hair analyses for drugs of abuse are being increasingly used in both clinical and forensic toxicology, including cases involving children exposed to a drug using environment. A review was conducted of peer-reviewed publications reporting hair concentrations of drugs in children published in the English language. Fifty-two publications were aggregated into three categories: results published on the newborn where hair was sampled at, or shortly after, birth that reflected in utero exposure and/or short-term exposure from the mother's breast milk, and publications in which children were either believed to have been exposed passively from drugs of abuse through their environment or by active exposure from accidental ingestion or deliberate administration by a caregiver. There was limited data for comparison of all three exposure routes. On average, cocaine, codeine, 6-AM and morphine showed higher concentrations in hair from in utero exposure compared to children exposed passively; however, there was considerable overlap in concentrations. Methamphetamine showed no significant difference between passive and in utero exposure, although there was only one study reporting hair concentrations from in utero exposure. There was no difference in concentrations for those cases exposed passively or actively for codeine and methadone. There was insufficient data for other drugs and other comparisons. Comparison data was confounded by the variability in extraction techniques employed as well as a variety of washing techniques, including studies that did not employ any decontamination technique. These data further illustrate the difficulties in interpreting hair concentrations in isolation of relevant contextual data, particularly in children.

  9. Associations between preschool attendance and developmental impairments in pre-school children in a six-year retrospective survey


    Baune Bernhard T; Stich Heribert L; Caniato Riccardo N; Krämer Alexander


    Abstract Background Many school-aged children suffer physical and mental impairments which can adversely affect their development and result in significant morbidity. A high proportion of children in western countries attend pre-school, and it is likely that the preschool environment influences the prevalence and severity of these impairments. Currently there is insufficient data available on the prevalence of these impairments and their causal associations. The influence that location of a p...

  10. Secular Changes of Adiposity and Motor Development in Czech Preschool Children: Lifestyle Changes in Fifty-Five Year Retrospective Study


    Petr Sedlak; Jana Pařízková; Robert Daniš; Hana Dvořáková; Jana Vignerová


    Secular trends of adiposity and motor development in preschool children since the fifties of the last century up to the beginning of this millennium were analyzed so as to reveal possible changes due to continuously differentiating lifestyle. In preschool children (n = 3678) height, weight, skinfold thickness over triceps, subscapular, and suprailiac were measured by Harpenden caliper in 1957, 1977, 1980, 1985, 1990, and 2012. Simultaneously, motor performance was tested by evaluating the ach...

  11. Are reviewers suggested by authors as good as those chosen by editors? Results of a rater-blinded, retrospective study

    Directory of Open Access Journals (Sweden)

    Parkin Emma C


    Full Text Available Abstract Background BioMed Central (BMC requires authors to suggest four reviewers when making a submission. Editors searching for reviewers use these suggestions as a source. The review process of the medical journals in the BMC series is open – authors and reviewers know each other's identity – although reviewers can make confidential comments to the editor. Reviews are published alongside accepted articles so readers may see the reviewers' names and recommendations. Our objective was to compare the performance of author-nominated reviewers (ANR with that of editor-chosen reviewers (ECR in terms of review quality and recommendations about submissions in an online-only medical journal. Methods Pairs of reviews from 100 consecutive submissions to medical journals in the BMC series (with one author-nominated and one editor-chosen reviewer and a final decision were assessed by two raters, blinded to reviewer type, using a validated review quality instrument (RQI which rates 7 items on 5-point Likert scales. The raters discussed their ratings after the first 20 pairs (keeping reviewer type masked and resolved major discrepancies in scoring and interpretation to improve inter-rater reliability. Reviewers' recommendations were also compared. Results Reviewer source had no impact on review quality (mean RQI score (± SD 2.24 ± 0.55 for ANR, 2.34 ± 0.54 for ECR or tone (mean scores on additional question 2.72 ANR vs 2.82 ECR (maximum score = 5 in both cases. However author-nominated reviewers were significantly more likely to recommend acceptance (47 vs 35 and less likely to recommend rejection (10 vs 23 than editor-chosen reviewers after initial review (p Conclusion Author-nominated reviewers produced reviews of similar quality to editor-chosen reviewers but were more likely to recommend acceptance during the initial stages of peer review.

  12. Systematic literature review of hospital medication administration errors in children

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    Ameer A


    Full Text Available Ahmed Ameer,1 Soraya Dhillon,1 Mark J Peters,2 Maisoon Ghaleb11Department of Pharmacy, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; 2Paediatric Intensive Care Unit, Great Ormond Street Hospital, London, UK Objective: Medication administration is the last step in the medication process. It can act as a safety net to prevent unintended harm to patients if detected. However, medication administration errors (MAEs during this process have been documented and thought to be preventable. In pediatric medicine, doses are usually administered based on the child's weight or body surface area. This in turn increases the risk of drug miscalculations and therefore MAEs. The aim of this review is to report MAEs occurring in pediatric inpatients. Methods: Twelve bibliographic databases were searched for studies published between January 2000 and February 2015 using “medication administration errors”, “hospital”, and “children” related terminologies. Handsearching of relevant publications was also carried out. A second reviewer screened articles for eligibility and quality in accordance with the inclusion/exclusion criteria. Key findings: A total of 44 studies were systematically reviewed. MAEs were generally defined as a deviation of dose given from that prescribed; this included omitted doses and administration at the wrong time. Hospital MAEs in children accounted for a mean of 50% of all reported medication error reports (n=12,588. It was also identified in a mean of 29% of doses observed (n=8,894. The most prevalent type of MAEs related to preparation, infusion rate, dose, and time. This review has identified five types of interventions to reduce hospital MAEs in children: barcode medicine administration, electronic prescribing, education, use of smart pumps, and standard concentration. Conclusion: This review has identified a wide variation in the prevalence of hospital MAEs in children. This is attributed to

  13. Survival status and predictors of mortality among severely acute malnourished children <5 years of age admitted to stabilization centers in Gedeo Zone: a retrospective cohort study (United States)

    Girum, Tadele; Kote, Mesfin; Tariku, Befikadu; Bekele, Henok


    Despite the existence of standard protocol, many stabilization centers (SCs) continue to experience high mortality of children receiving treatment for severe acute malnutrition. Assessing treatment outcomes and identifying predictors may help to overcome this problem. Therefore, a 30-month retrospective cohort study was conducted among 545 randomly selected medical records of children Snell residual plot. During follow-up, 51 (9.3%) children had died, and 414 (76%) and 26 (4.8%) children had recovered and defaulted (missed follow-up for 2 consecutive days), respectively. The survival rates at the end of the first, second and third weeks were 95.3%, 90% and 85%, respectively, and the overall mean survival time was 79.6 days. Age <24 months (adjusted hazard ratio [AHR] =2.841, 95% confidence interval [CI] =1.101–7.329), altered pulse rate (AHR =3.926, 95% CI =1.579–9.763), altered temperature (AHR =7.173, 95% CI =3.05–16.867), shock (AHR =3.805, 95% CI =1.829–7.919), anemia (AHR =2.618, 95% CI =1.148–5.97), nasogastric tube feeding (AHR =3.181, 95% CI =1.18–8.575), hypoglycemia (AHR =2.74, 95% CI =1.279–5.87) and treatment at hospital stabilization center (AHR =4.772, 95% CI =1.638–13.9) were independent predictors of mortality. The treatment outcomes and incidence of death were in the acceptable ranges of national and international standards. Intervention to further reduce deaths has to focus on young children with comorbidities and altered general conditions. PMID:28176953

  14. Small-bowel MRI in children and young adults with Crohn disease: retrospective head-to-head comparison of contrast-enhanced and diffusion-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Neubauer, Henning; Evangelista, Laura; Wirth, Clemens; Beer, Meinrad [University Hospital Wuerzburg, Institute of Radiology, Department of Paediatric Radiology, Wuerzburg (Germany); Pabst, Thomas; Machann, Wolfram; Koestler, Herbert; Hahn, Dietbert [University Hospital Wuerzburg, Institute of Radiology, Wuerzburg (Germany); Dick, Anke [University Hospital Wuerzburg, Department of Paediatrics, Wuerzburg (Germany)


    Small-bowel MRI based on contrast-enhanced T1-weighted sequences has been challenged by diffusion-weighted imaging (DWI) for detection of inflammatory bowel lesions and complications in patients with Crohn disease. To evaluate free-breathing DWI, as compared to contrast-enhanced MRI, in children, adolescents and young adults with Crohn disease. This retrospective study included 33 children and young adults with Crohn disease ages 17 {+-} 3 years (mean {+-} standard deviation) and 27 matched controls who underwent small-bowel MRI with contrast-enhanced T1-weighted sequences and DWI at 1.5 T. The detectability of Crohn manifestations was determined. Concurrent colonoscopy as reference was available in two-thirds of the children with Crohn disease. DWI and contrast-enhanced MRI correctly identified 32 and 31 patients, respectively. All 22 small-bowel lesions and all Crohn complications were detected. False-positive findings (two on DWI, one on contrast-enhanced MRI), compared to colonoscopy, were a result of large-bowel lumen collapse. Inflammatory wall thickening was comparable on DWI and contrast-enhanced MRI. DWI was superior to contrast-enhanced MRI for detection of lesions in 27% of the assessed bowel segments and equal to contrast-enhanced MRI in 71% of segments. DWI facilitates fast, accurate and comprehensive workup in Crohn disease without the need for intravenous administration of contrast medium. Contrast-enhanced MRI is superior in terms of spatial resolution and multiplanar acquisition. (orig.)

  15. Sleep disorders in children with cerebral palsy: An integrative review. (United States)

    Lélis, Ana Luíza P A; Cardoso, Maria Vera L M; Hall, Wendy A


    Sleep disorders are more prevalent in children with cerebral palsy. The review aimed to identify and synthesize information about the nature of sleep disorders and their related factors in children with cerebral palsy. We performed an electronic search by using the search terms sleep/child*, and sleep/cerebral palsy in the following databases: Latin American literature on health sciences, SCOPUS, medical publications, cumulative index to nursing and allied health literature, psycinfo, worldcat, web of science, and the Cochrane library. The selection criteria were studies: available in Portuguese, English or Spanish and published between 2004 and 2014, with results addressing sleep disorders in children (ages 0-18 y) with a diagnosis of cerebral palsy. 36,361 abstracts were identified. Of those, 37 papers were selected, and 25 excluded. Twelve papers were incorporated in the study sample: eight quantitative studies, three reviews, and one case study. Eleven types of sleep disorders were identified, such as difficult morning awakening, insomnia, nightmares, difficulties in initiating and maintaining nighttime sleep (night waking), and sleep anxiety. Twenty-one factors were linked to sleep disorders, which we classified as intrinsic factors associated with common comorbidities accompanying cerebral palsy, and extrinsic aspects, specifically environmental and socio-familial variables, and clinical-surgical and pharmacological interventions.

  16. Review and Discussion of Children's Conceptions of Computers (United States)

    Rücker, Michael T.; Pinkwart, Niels


    Today's children grow up surrounded by computers. They observe them, interact with them and, as a consequence, start forming conceptions of how they work and what they can do. Any constructivist approach to learning requires that we gain an understanding of such preconceived ideas and beliefs in order to use computers as learning tools in an effective and informed manner. In this paper, we present five such conceptions that children reportedly form about computers, based on an interdisciplinary literature review. We then evaluate how persistent these conceptions appear to be over time and in light of new technological developments. Finally, we discuss the relevance and implications of our findings for education in the contexts of conceptual pluralism and conceptual categorisation.

  17. Skeletal Involvement of Brucella melitensis in Children: A Systematic Review

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    Anahita Sanaei Dashti


    Full Text Available Brucellosis is a protean disease and should be excluded in any febrile child with a constellation of symptoms such as fever, malaise, sweating, arthralgia, and joint swelling in endemic areas. Skeletal system involvement is the most common source of complaints in brucellosis. The frequency of skeletal involvement in children is 6.4% to 73.5%. There are some controversies regarding the most common sites of involvement: sacroiliac versus peripheral joints. In the vast majority of cases, peripheral joint involvement in pediatric brucellosis has a monoarticular pattern, although there is no agreement about the most commonly involved peripheral joint. In this systematic review, published articles that describe the bone involvement of Brucella melitensis, as the most prevalent kind of the microorganism in the region, in children are evaluated.

  18. The Impact of the New York Court Review of Children in Foster Care: A Followup Report (United States)

    Festinger, Trudy Bradley


    Examines the data on children studied in a 1974 investigation. Proposes that court review speed movement of children out of foster care, and suggests steps necessary for both court and agencies to make the procedures more effective. (Author/SB)

  19. A Retrospective Review of Imaging and Operative Modalities Performed in Patients with Primary Hyperparathyroidism at a Mid-Volume Surgical Centre in Southeast Asia

    DEFF Research Database (Denmark)

    Tan, Matthew Zw; Ng, Jeremy Cf; Eisman, John A


    in the 1990s. This study aimed to explore what the change has been in preoperative localisation tools compared to the previous study and if the ability of these tools to correctly localise pathologic parathyroid glands has improved. MATERIALS AND METHODS: A retrospective review of patients who had surgery......INTRODUCTION: A paradigm shift appears to have occurred worldwide in surgery for primary hyperparathyroidism with the advent of sensitive preoperative imaging techniques. Preoperative imaging for parathyroid adenoma localisation was not found to be useful in a study conducted in Singapore...

  20. Retrospective reports of parenting received in their families of origin: relationships to adult attachment in adult children of alcoholics. (United States)

    Kelley, Michelle L; Nair, Veena; Rawlings, Tanaya; Cash, Thomas F; Steer, Kate; Fals-Stewart, William


    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.

  1. Acute lymphoblastic leukemia in children with Down syndrome: A retrospective analysis from the Ponte di Legno study group

    NARCIS (Netherlands)

    T.D. Buitenkamp (Trudy); S. Izraeli (Shai); M. Zimmermann (Martin); E. Forestier (Erik); N.A. Heerema (Nyla); M.M. van den Heuvel-Eibrink (Marry); R. Pieters (Rob); C.M. Korbijn (Carin); L.B. Silverman (Lewis); K. Schmiegelow (Kjeld); D.-C. Liang (Der-Cheng); K. Horibe (Keizo); M. Aricò (Maurizio); A. Biondi (Andrea); G. Basso (Giuseppe); K.R. Rabin (Karin); M. Schrappe (Martin); G. Cario (Gunnar); G. Mann (Georg); M. Morak (Maria); R. Panzer-Grümayer (Renate); V. Mondelaers (Veerle); T. Lammens (Tim); H. Cavé (Hèléne); B. Stark (Batia); I. Ganmore (Ithamar); A.V. Moorman (Anthony); A. Vora (Ajay); S.P. Hunger (Stephen); C.H. Pui (Ching-Hon); C.G. Mullighan (Charles); A. Manabe (Atsushi); G. Escherich (Gabriele); J.R. Kowalczyk (Jerzy R.); J.A. Whitlock (James); C.M. Zwaan (Michel)


    textabstractChildren with Down syndrome (DS) have an increased risk of B-cell precursor (BCP) acute lymphoblastic leukemia (ALL). The prognostic factors and outcome of DS-ALL patients treated in contemporary protocols are uncertain. We studied 653 DS-ALL patients enrolled in 16 international trials

  2. Early predictors of long-term cognitive, emotional and behavioural outcome in children with ESES: A retrospective study

    NARCIS (Netherlands)

    Weijenberg, A.; Vlaskamp, D.R.M.; Elting, J.W.; Veenstra, W.S.; Gutter, T.; Geerts, Y.; Brouwer, O.F.; Callenbach, P.M.C.; de Walle, Hermien


    Objectives: Long-term outcome of Electrical Status Epilepticus during Sleep (ESES) is generally unfavourable but hard to predict in individual children. Longer duration of ESES and younger age at onset of ESES have been reported to be predictors of poor outcome, whereas any treatment response is ass

  3. Effect of indoor air quality in the postnatal period on lung function in pre-adolescent children: a retrospective cohort study in Poland

    Energy Technology Data Exchange (ETDEWEB)

    Jedrychowski, W.; Maugeri, U.; Jedrychowska-Bianchi, I.; Flak, E. [Jagiellonian University, Krakow (Poland)


    The purpose of this study was to determine the association between level of lung function in pre-adolescence and indoor air quality in the postnatal period. The retrospective cohort study was carried out in a sample of 1036 pre-adolescent children (9 years of age) attending schools in two residential areas of Krakow, Poland. Measurement of health outcomes considered lung function together with height and weight. Indoor air quality was based on environmental tobacco smoke and type of household heating. In addition, the number of winter months that occurred during the first 6 months of life was included as a key independent variable. Multivariate linear regression of lung function measured by forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC), and postnatal exposure to indoor pollution in the heating season (PEIP score) was adjusted for potential confounders such as maternal smoking during pregnancy and parental education as a proxy of social class. In the total study sample, the adjusted beta coefficient for FEV1 per unit of the PEIP score was -0.06 (P=0.02), while that for FVC was -0.05 (P=0.04). The analysis carried out in the more polluted area found that children living in households heated with gas or coal had a PEIP score that was strongly inversely related to lung function (adjusted beta coefficient for FEV1=-0.13; P=0.03; for FVC=-0.15, P=0.01), whereas regression coefficients were not significant in the group of children living in households with central heating. This study suggests that a lower level of lung function in pre-adolescent children can be related to postnatal exposure to indoor emissions in the winter.

  4. Endothelium-based biomarkers are associated with cerebral malaria in Malawian children: a retrospective case-control study.

    Directory of Open Access Journals (Sweden)

    Andrea L Conroy

    Full Text Available BACKGROUND: Differentiating cerebral malaria (CM from other causes of serious illness in African children is problematic, owing to the non-specific nature of the clinical presentation and the high prevalence of incidental parasitaemia. CM is associated with endothelial activation. In this study we tested the hypothesis that endothelium-derived biomarkers are associated with the pathophysiology of severe malaria and may help identify children with CM. METHODS AND FINDINGS: Plasma samples were tested from children recruited with uncomplicated malaria (UM; n = 32, cerebral malaria with retinopathy (CM-R; n = 38, clinically defined CM without retinopathy (CM-N; n = 29, or non-malaria febrile illness with decreased consciousness (CNS; n = 24. Admission levels of angiopoietin-2 (Ang-2, Ang-1, soluble Tie-2 (sTie-2, von Willebrand factor (VWF, its propeptide (VWFpp, vascular endothelial growth factor (VEGF, soluble ICAM-1 (sICAM-1 and interferon-inducible protein 10 (IP-10 were measured by ELISA. Children with CM-R had significantly higher median levels of Ang-2, Ang-2:Ang-1, sTie-2, VWFpp and sICAM-1 compared to children with CM-N. Children with CM-R had significantly lower median levels of Ang-1 and higher median concentrations of Ang-2:Ang-1, sTie-2, VWF, VWFpp, VEGF and sICAM-1 compared to UM, and significantly lower median levels of Ang-1 and higher median levels of Ang-2, Ang-2:Ang-1, VWF and VWFpp compared to children with fever and altered consciousness due to other causes. Ang-1 was the best discriminator between UM and CM-R and between CNS and CM-R (areas under the ROC curve of 0.96 and 0.93, respectively. A comparison of biomarker levels in CM-R between admission and recovery showed uniform increases in Ang-1 levels, suggesting this biomarker may have utility in monitoring clinical response. CONCLUSIONS: These results suggest that endothelial proteins are informative biomarkers of malarial disease severity. These results

  5. Oral health of children with acute lymphoblastic leukemia: A review

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    Kadalagere Lakshmana Girish Babu


    Full Text Available Leukemia is a malignancy of the bone marrow and blood. It is the most common childhood cancer in India. Advances in the treatment regimens have greatly increased the chances of survival. Both the disease and its treatment change the oral environment. In some cases, oral manifestations are the presenting feature of the disease and it will be the dentist′s responsibility to identify the underlying disorder and guide the diagnosis of the patient. Hence, the aim of present article is to review the literature concerning the oral health of children with acute lymphoblastic leukemia (ALL.

  6. Liver lesions in children post-oncologic therapy: Review of case reports and institutional observation

    Directory of Open Access Journals (Sweden)

    Rebecca Gologorsky


    Full Text Available Purpose: Focal nodular hyperplasia (FNH, a benign hepatic tumor with ill-defined etiology, has been increasingly reported in children treated for extra-hepatic malignancies. Serial imaging or biopsy may be needed when survivors present with liver lesions. This study aims to review the literature, compare them with our institution’s cohort and propose a less invasive diagnostic imaging modality for FNH utilizing Magnetic resonance imaging (MRI with gadoxetate disodium. Methods: We reviewed 13 case reports/series published over the last 20 years and compared them to our retrospective review of 16 childhood cancer survivors (CCS found to have liver lesions on various imaging studies. Several patients underwent biopsy for diagnosis. Results: No specific generalizations could be made in terms of which specific chemotherapeutic agents cause FNH. Seven out of 11 patients underwent radiotherapy and/or hematopoietic stem cell transplant. Additionally, 36% (4/11 had been treated for neuroblastoma. From the literature review, the use of MRI with gadoxetate disodium was difficult to evaluate. Imaging was mainly accomplished using ultrasound, computerized tomography and MRI with gadolinium. The results were often indeterminate and resulted in biopsy in 6 cases in our institution. In contrast, 5 patients underwent initial MRI with gadoxetate disodium, which confirmed the diagnosis of FNH. Conclusion: CCS have an increased risk of developing liver lesions. Consistent with previously published literature, patients exposed to radiotherapy or cytoreductive agents used for hematopoietic stem cell transplants appeared to be at higher risk. A significant proportion (36%, 4/11 of our patients with FNH was previously treated for neuroblastoma. With the introduction of MRI with gadoxetate disodium, imaging may be a viable alternative to biopsy. 

  7. Survival status and predictors of mortality among severely acute malnourished children <5 years of age admitted to stabilization centers in Gedeo Zone: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Girum T


    Full Text Available Tadele Girum,1 Mesfin Kote,2 Befikadu Tariku,2 Henok Bekele3 1Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, 2Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, 3Department of Planning, Adare Hospital, Southern Region Health Bureau, Hawassa, Ethiopia Abstract: Despite the existence of standard protocol, many stabilization centers (SCs continue to experience high mortality of children receiving treatment for severe acute malnutrition. Assessing treatment outcomes and identifying predictors may help to overcome this problem. Therefore, a 30-month retrospective cohort study was conducted among 545 randomly selected medical records of children <5 years of age admitted to SCs in Gedeo Zone. Data was entered by Epi Info version 7 and analyzed by STATA version 11. Cox proportional hazards model was built by forward stepwise procedure and compared by the likelihood ratio test and Harrell’s concordance, and fitness was checked by Cox–Snell residual plot. During follow-up, 51 (9.3% children had died, and 414 (76% and 26 (4.8% children had recovered and defaulted (missed follow-up for 2 consecutive days, respectively. The survival rates at the end of the first, second and third weeks were 95.3%, 90% and 85%, respectively, and the overall mean survival time was 79.6 days. Age <24 months (adjusted hazard ratio [AHR] =2.841, 95% confidence interval [CI] =1.101–7.329, altered pulse rate (AHR =3.926, 95% CI =1.579–9.763, altered temperature (AHR =7.173, 95% CI =3.05–16.867, shock (AHR =3.805, 95% CI =1.829–7.919, anemia (AHR =2.618, 95% CI =1.148–5.97, nasogastric tube feeding (AHR =3.181, 95% CI =1.18–8.575, hypoglycemia (AHR =2.74, 95% CI =1.279–5.87 and treatment at hospital stabilization center (AHR =4.772, 95% CI =1.638–13.9 were independent predictors of mortality. The treatment outcomes and incidence of death

  8. Clinical and Etiological Characteristics of Atypical Hand-Foot-and-Mouth Disease in Children from Chongqing, China: A Retrospective Study

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    Xiang Yan


    Full Text Available Background. Hand-foot-and-mouth disease (HFMD is a disease that had similar manifestations to chickenpox, impetigo, and measles, which is easy to misdiagnose and subsequently causes delayed therapy and subsequent epidemic. To date, no study has been conducted to report the clinical and epidemiological characteristics of atypical HFMD. Methods. 64 children with atypical HFMD out of 887 HFMD children were recruited, stool was collected, and viral VP1 was detected. Results. The atypical HFMD accounted for 7.2% of total HFMD in the same period (64/887 and there were two peaks in its prevalence in nonepidemic seasons. Ten children (15.6% had manifestations of neurologic involvement, of whom 4 (6.3% were diagnosed with severe HFMD and 1 with critically severe HFMD, but all recovered smoothly. Onychomadesis and desquamation were found in 14 patients (21.9% and 15 patients (23.4%, respectively. The most common pathogen was coxsackievirus A6 (CV-A6 which accounted for 67.2%, followed by nontypable enterovirus (26.6%, enterovirus 71 (EV-A71 (4.7%, and coxsackievirus A16 (A16 (1.5%. Conclusions. Atypical HFMD has seasonal prevalence. The manifestations of neurologic involvement in atypical HFMD are mild and usually have a good prognosis. CV-A6 is a major pathogen causing atypical HFMD, but not a major pathogen in Chongqing, China.

  9. Human trichinellosis in children from Timis County, Romania: epidemiological features from a retrospective study conducted between 1990 and 2006

    Directory of Open Access Journals (Sweden)

    Ioan Iacobiciu


    Full Text Available Trichinellosis, a parasitic zoonosis caused by the ingestion of inadequately cooked pork containing Trichinella larvae, has been a serious health problem in Timis, the largest of the Romanian counties. The authors conducted a survey on trichinellosis in children from Timis County, emphasising epidemiological aspects. Medical records from 106 children who were hospitalised at the Victor Babes Infectious Diseases Hospital in Timisoara from 1990 to 2006 were investigated. Children affected by trichinellosis were predominantly in the 10- to 14-year-old age group (34.9%. Most patients (59.43% were inhabitants of urban areas and 59.43% of cases were males. Winter was the season when the number of cases peaked (76.42%. The highest prevalence of disease (18.87% was recorded in 1994. For 38.68% of the patients, eosinophilia ranged between 10% and 20%. The length of hospitalisation ranged from 8 to 14 days in 50.94% of cases. In recent years, human trichinellosis has decreased in Timis County as a result of an improvement in the implementation of hygiene measures. The highest prevalence of the disease recorded in 1994 can be explained by an economic transition period when national pig farms began to close. Winter was the season with the highest prevalence because people eat a lot of pork during the traditional holidays.

  10. Secular Changes of Adiposity and Motor Development in Czech Preschool Children: Lifestyle Changes in Fifty-Five Year Retrospective Study. (United States)

    Sedlak, Petr; Pařízková, Jana; Daniš, Robert; Dvořáková, Hana; Vignerová, Jana


    Secular trends of adiposity and motor development in preschool children since the fifties of the last century up to the beginning of this millennium were analyzed so as to reveal possible changes due to continuously differentiating lifestyle. In preschool children (n = 3678) height, weight, skinfold thickness over triceps, subscapular, and suprailiac were measured by Harpenden caliper in 1957, 1977, 1980, 1985, 1990, and 2012. Simultaneously, motor performance was tested by evaluating the achievements in broad jump and throwing a ball, as a marker of adaptation to changing level of physical activity, free games, and exercise. Along the period of five decades the values of skinfold thickness increased significantly until 2012, mainly on the trunk. Simultaneously, the level of motor performance significantly decreased. Modifications of the way of life during the mentioned five decades characterized by sedentarism and inadequate food intake as related to energy output influenced negatively both adiposity and motor performance already in preschool children. Mostly increased deposition of fat on the trunk which is considered as a marker of possible development of metabolic syndrome was apparent already in preschool age, indicating the importance of early intervention concerning also physical activity and availability for exercise since early life.

  11. Secular Changes of Adiposity and Motor Development in Czech Preschool Children: Lifestyle Changes in Fifty-Five Year Retrospective Study

    Directory of Open Access Journals (Sweden)

    Petr Sedlak


    Full Text Available Secular trends of adiposity and motor development in preschool children since the fifties of the last century up to the beginning of this millennium were analyzed so as to reveal possible changes due to continuously differentiating lifestyle. In preschool children (n=3678 height, weight, skinfold thickness over triceps, subscapular, and suprailiac were measured by Harpenden caliper in 1957, 1977, 1980, 1985, 1990, and 2012. Simultaneously, motor performance was tested by evaluating the achievements in broad jump and throwing a ball, as a marker of adaptation to changing level of physical activity, free games, and exercise. Along the period of five decades the values of skinfold thickness increased significantly until 2012, mainly on the trunk. Simultaneously, the level of motor performance significantly decreased. Modifications of the way of life during the mentioned five decades characterized by sedentarism and inadequate food intake as related to energy output influenced negatively both adiposity and motor performance already in preschool children. Mostly increased deposition of fat on the trunk which is considered as a marker of possible development of metabolic syndrome was apparent already in preschool age, indicating the importance of early intervention concerning also physical activity and availability for exercise since early life.

  12. Incidence, risk factors, and treatment outcome of symptomatic osteonecrosis in Taiwanese children with acute lymphoblastic leukemia: a retrospective cohort study of 245 patients in a single institution. (United States)

    Chen, Shih-Hsiang; Chang, Tsung-Yen; Jaing, Tang-Her; Lee, Mel S; Wang, Chao-Jan; Hung, Iou-Jih; Yang, Chao-Ping


    Osteonecrosis (ON) is a potentially disabling complication encountered in children who receive chemotherapy for acute lymphoblastic leukemia (ALL). Considering the possible effect of ethnic difference on the clinical features of symptomatic ON in pediatric ALL, we retrospectively evaluated 245 children with ALL who were treated at Chang Gung Memorial Hospital, Linkou, between 2002 and 2011. Six (2.4 %) patients developed symptomatic ON in a total of 17 sites during the follow-up period. Diagnosis of ON was confirmed by X-ray in seven, magnetic resonance imaging in two, and bone scan in three patients. The estimated cumulative incidence of symptomatic ON in newly diagnosed ALL was 3.4 % at 8 years. Four patients received ON-directed surgical interventions, including total hip replacement in three and arthroplasty in one. The incidence of ON was significantly higher among girls (P = 0.03), patients >10 years old (P = 2.2 × 10(-4)), and patients who had received more intensive chemotherapy regimen (P = 0.02). These results indicate that the incidence and risk factors in our institute were similar to those observed in Western countries. Future studies surveying the impact on the quality of life of childhood ALL survivors in Taiwan are warranted.

  13. Correlation between dento-skeletal characteristics and craniomandibular disorders in growing children and adolescent orthodontic patients: retrospective case-control study (United States)



    SUMMARY Purpose The aim of this retrospective case-control study was to identify, in a group of growing children and adolescents affected by malocclusion, specific dento-skeletal characteristics which could be correlated to the onset, in the above-mentioned subjects, of craniomandibular disorders (CMD). Materials and methods Among the patients treated at the Paedodontics and Orthodontics department of Bari Dental School, we recruited a group of patients with malocclusion and symptoms of temporomandibular disorders, as an experimental group. We considered as controls those patients who, match-paired to their skeletal class depending on the ANB angle, did not show any CMD sign or symptom. Results Of the 128 examined patients, 15 showed signs and/or symptoms of CMD (11.7%). When compared to 15 patients non-affected by CMD, we could not detect statistically significant differences in both skeletal and occlusal characteristics. It is still interesting to notice how in CMD patients, characteristics of skeletal hyperdivergence are often to be found. Conclusions The present study seems to confirm that in growing children and adolescents, the presence of signs and/or symptoms of CMD is not associable to a specific vertical skeletal growth pattern or to other specific occlusal characteristics. PMID:28042446

  14. Solitary rectal ulcer syndrome in children: A literature review

    Institute of Scientific and Technical Information of China (English)

    Seyed Mohsen Dehghani; Abdorrasoul Malekpour; Mahmood Haghighat


    Solitary rectal ulcer syndrome (SRUS) is a benign and chronic disorder well known in young adults and less in children.It is often related to prolonged excessive straining or abnormal defecation and clinically presents as rectal bleeding,copious mucus discharge,feeling of incomplete defecation,and rarely rectal prolapse.SRUS is diagnosed based on clinical symptoms and endoscopic and histological findings.The current treatments are suboptimal,and despite correct diagnosis,outcomes can be unsatisfactory.Some treatment protocols for SRUS include conservative management such as family reassurance,regulation of toilet habits,avoidance of straining,encouragement of a high-fiber diet,topical treatments with salicylate,sulfasalazine,steroids and sucralfate,and surgery.In children,SRUS is relatively uncommon but troublesome and easily misdiagnosed with other common diseases,however,it is being reported more than in the past.This condition in children is benign; however,morbidity is an important problem as reflected by persistence of symptoms,especially rectal bleeding.In this review,we discuss current diagnosis and treatment for SRUS.


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    Praburam P. M


    Full Text Available Introduction: The survival of a newborn or a child presenting with ambiguous genitalia depends upon the timely diagnosis and institution of appropriate medical care. We undertook this study with the aim to determine if appropriate clinical and confirmatory diagnosis was arrived on time and if the treatment instituted was relevant and satisfactory. Methods: All children who were evaluated for ambiguous genitalia under the Department of Pediatric Endocrinology over the preceding 18 years were invited for a review. Data including time taken to make a clinical diagnosis, time taken to confirm the diagnosis, reasons for delay if any, and appropriateness of the sex assigned for rearing and treatment instituted were collected from the charts. Patients were evaluated for adequacy of response to treatment, compliance, problems encountered if any and subjective parental satisfaction. Results: A total of 165 children were diagnosed to have conditions with ambiguous genitalia and were called for a review. 33 children attended the review. 15 were being raised as boys and 18 as girls. 12 children had virilising congenital adrenal hyperplasia (CAH, 6 had cryptorchidism, 6 had hypospadias, 3 had complete and 1 had partial testicular feminisation, 2 had mixed gonadal dysgenesis (MGD, 2 had hypogonadism and 1 was a true hermaphrodite. An appropriate clinical diagnosis was made in 30childrenon the day one and a final confirmatory diagnosis was made within a month in 23. Conclusion: In most conditions presenting with ambiguous genitalia, a clinical and confirmatory diagnosis can be made in a short duration. Initiation of appropriate treatment results in favourable outcomes in terms of growth sexual identity and adaptation.

  16. Osseointegrated dental implants in growing children: a literature review. (United States)

    Mankani, Nivedita; Chowdhary, Ramesh; Patil, Brijesh A; Nagaraj, E; Madalli, Poornima


    Edentulism is usually associated with the aging patient. However, total or partial tooth loss also affects young individuals, mainly as a result of trauma, decay, anodontia, or congenital and acquired jaw defects involving the alveolar processes. For elderly patients, the use of oral implants has become an accepted treatment modality for edentulism, and most of today's knowledge regarding implants is based on such practice. There has been hesitation to perform implant therapy for growing children; hence, few children to date have been provided with implant-supported construction. Consequently, little is known about the outcome of the osseointegration procedure in young patients, and until now, only a limited number of case presentations have been reported. This article reviews the current literature to discuss the use of dental implants in growing patients and the influence of maxillary and mandibular skeletal and dental growth on the stability of those implants. The literature review was performed through Science Direct, Wileys Blackwell Synergy, PubMed, Google, Embase, Medknow publications, and Springer for references published from 1963 to 2011. It is recommended to wait for the completion of dental and skeletal growth, except for severe cases of ectodermal dysplasia.

  17. Leptospirosis in children: A review for family physicians

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    Tullu Milind


    Full Text Available Leptospirosis is an important cause of acute febrile illness in the monsoon season in India. It is a zoonotic disease that is spread primarily by rodents. There exist two clinical types: anicteric and icteric leptospirosis. Both have an initial septicemic phase followed by an immune phase. The clinical manifestations vary and the disease manifestations may range from a nonspecific febrile illness to one with severe multiorgan failure. Weil′s disease is the severe form of the infection; which occurs in less than 10% of the patients and is associated with high mortality. The methods available for diagnosis and treatment of leptospirosis are discussed in this review. Crystalline penicillin is the drug of choice for treatment of leptospirosis in children. Avoidance of contact with flood waters and rodent control are vital for prevention of the disease. We also discuss the differences between childhood leptospirosis and adult disease. We used two methods to garner the information presented in this article: i we searched the PubMed database ( using the keywords ′leptospirosis′ and ′children,′ with special emphasis given to articles from the Indian literature; and ii we reviewed the chapters on leptospirosis in the standard textbooks of pediatric and infectious diseases.

  18. Oral alterations in children with cancer. Literature review.

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    Juan Cortes-Ramírez


    Full Text Available For dentists, there is little information on malignant tumors and complications both because their natural evolution is secondary to treatment, despite cancer in children represents 3% of all cancer cases. The goal is to make a brief review of the most common neoplasm in children, to identify them and find out the oral alterations with highest incidence both as secondary to the pathology and as a side effect of treatment. This review analyses various types of malignant neoplasms which may occur in this stage of life. They are divided into haematological: leukemias, lymphomas and solid tumors. The most common leukemia is acute lymphoblastic (ALL followed by acute myeloid and granulocytic. Lymphomas develop from the lymphatic system and are divided into Hodgkin’s and non-Hodgkin’s. Cancer has become a chronic disease favoring a new group of patients who achieve survival but suffer side effects due to therapies, drugs, doses and the child’s characteristics. Oral complications appear in 40% of cases and the most frequent are mucositis, opportunistic infection, xerostomia, bleeding, periodontal disease and disorders in the development of teeth and jaw. Although cancer is located outside of the maxillofacial area, chemotherapy is aggressive for a developing organism. The side effects of radiation therapy affect the general and specific area to radiate as well as the surrounding organs and tissues. Recently, advances in diagnosis and treatment have increased survival from 20% to 80%, with long-term treatment.

  19. Does Kapandji wiring help in older patients? A retrospective comparative review of displaced intra-articular distal radial fractures in patients over 55 years. (United States)

    Board, T; Kocialkowski, A; Andrew, G


    Forty-six patients aged 55-90 with intra-articular displaced fractures of the distal radius were reviewed retrospectively. All patients were treated with either manipulation and plaster of Paris or Kapandji wiring. Radiographic and functional review was performed by an independent observer a mean of 17 months after the fracture. The results showed superior anatomical and functional results in the group treated with Kapandji wiring. The mean dorsal angle was significantly better in the wired group, and the improvement in dorsal angle, radial angle and radial length from presentation to final result was also significantly better. Functional results were excellent or good in 19/23 of the wired group, compared with 12/23 of the plaster group. There was a strong correlation between functional outcome and both dorsal angle and radial length at union. These results support the use of this method of wire fixation in older patients, as the technique is simple and complications were few.

  20. Disaccharidase activity in children undergoing esophagogastroduodenoscopy: A systematic review

    Institute of Scientific and Technical Information of China (English)

    Taylor Daileda; Peter Baek; Morgan E Sutter; Kalpesh Thakkar


    AIM:To investigate the utility of intestinal disaccharide analysis during esophagogastroduodenoscopy(EGD)in children,we performed a systematic review of studies examining disaccharide activity.METHODS:All full-length articles published in English during 1966-2014 were included if:(1)participants had small intestinal biopsy evaluation of disaccharide activity;(2)levels of lactase,sucrase,maltase or palatinase were reported;and(3)age of participants was under 18 years.RESULTS:Thirty articles examining 34753 disaccharide assays fulfilled the specific search,inclusion,and exclusion criteria.All of the studies were observational in design and 57%(17)were prospective.Sixteen studies were conducted in the United States and 9European studies were identified.The biggest study enrolled about 30,314 procedures and 13 studies investigated fewer than 50 procedures.Eleven studies examined Caucasian subjects,3 studies examined Asian subjects,and 6 examined African subjects.Only one Hispanic subject was included.In studies reporting disaccharide deficiency,the overall proportion of lactase deficiency was 39.2%,sucrase deficiency was9.0%,maltase deficiency was 12.6%and palatinase deficiency was 9.1%.The prevalence of duodenal inflammatory changes ranged from 6%to 24%for nonspecific histological lesions(e.g.,duodenitis).Sixteen studies examined the association of histologic findings with disaccharide activities,and 12 studies reported an inverse association between degree of histologic inflammation and disaccharide levels.CONCLUSION:We reviewed 30 studies including34753 biopsy specimens with disaccharide analysis from children undergoing EGD.Our findings advocate a large study is to further illuminate the importance of EGDwith disaccharide analysis in children.

  1. Sedentary behavior in Brazilian children and adolescents: a systematic review (United States)

    Guerra, Paulo Henrique; de Farias, José Cazuza; Florindo, Alex Antonio


    ABSTRACT OBJECTIVE To describe the methodological characteristics of the studies selected and assess variables associated with sedentary behavior in Brazilian children and adolescents. METHODS For this systematic review, we searched four electronic databases: PubMed, Web of Knowledge, LILACS, SciELO. Also, electronic searches were applied in Google Scholar. A supplementary search was conducted in the references lists of the included articles and in non-indexed journals. We included observational studies with children and adolescents aged from three to 19 years developed in Brazil, presenting analyses of associations based on regression methods and published until September 30, 2014. RESULTS Of the 255 potential references retrieved by the searches, 49 met the inclusion criteria and composed the descriptive synthesis. In this set, we identified a great number of cross-sectional studies (n = 43; 88.0%) and high methodological variability on the types of sedentary behavior assessed, measurement tools and cut-off points used. The variables most often associated with sedentary behavior were “high levels of body weight” (in 15 out of 27 studies; 55.0%) and “lower level of physical activity” (in eight out of 16 studies; 50.0%). CONCLUSIONS The findings of this review raise the following demands to the Brazilian agenda of sedentary behavior research geared to children and adolescents: development of longitudinal studies, validation of measuring tools, establishment of risk cut-offs, measurement of sedentary behavior beyond screen time and use of objective measures in addition to questionnaires. In the articles available, the associations between sedentary behavior with “high levels of body weight” and “low levels of physical activity” were observed in different regions of Brazil. PMID:27007685

  2. Recombinant tissue plasminogen activator as a novel treatment option for infective endocarditis: a retrospective clinical study in 32 children. (United States)

    Levitas, Aviva; Krymko, Hanna; Richardson, Justin; Zalzstein, Eli; Ioffe, Viktoriya


    Infective endocarditis is a life-threatening infectious syndrome, with high morbidity and mortality. Current treatments for infective endocarditis include intravenous antibiotics, surgery, and involve a lengthy hospital stay. We hypothesised that adjunctive recombinant tissue plasminogen activator treatment for infective endocarditis may facilitate faster resolution of vegetations and clearance of positive blood cultures, and therefore decrease morbidity and mortality. This retrospective study included follow-up of patients, from 1997 through 2014, including clinical presentation, causative organism, length of treatment, morbidity, and mortality. We identified 32 patients, all of whom were diagnosed with endocarditis and were treated by recombinant tissue plasminogen activator. Among all, 27 patients (93%) had positive blood cultures, with the most frequent organisms being Staphylococcus epidermis (nine patients), Staphylococcus aureus (six patients), and Candida (nine patients). Upon treatment, in 31 patients (97%), resolution of vegetations and clearance of blood cultures occurred within hours to few days. Out of 32 patients, one patient (3%) died and three patients (9%) suffered embolic or haemorrhagic events, possibly related to the recombinant tissue plasminogen activator. None of the patients required surgical intervention to assist vegetation resolution. In conclusion, it appears that recombinant tissue plasminogen activator may become an adjunctive treatment for infective endocarditis and may decrease morbidity as compared with current guidelines. Prospective multi-centre studies are required to validate our findings.

  3. Antibiotic prophylaxis in children with relapsing urinary tract infections: review. (United States)

    Mangiarotti, P; Pizzini, C; Fanos, V


    Recurrent urinary tract infections (UTIs) are observed in 30-50% of children after the first UTI. Of these, approximately 90% occur within 3 months of the initial episode. The basic aim of antibiotic prophylaxis in children with malformative uropathy and/or recurrent UTIs, is to reduce the frequency of UTIs. The bacteria most frequently responsible for UTI are gram-negative organisms, with Escherichia coli accounting for 80% of urinary tract pathogens. In children with recurrent UTIs and in those treated with antibiotic prophylaxis there is a greater incidence of UTI due to Proteus spp., Klebsiella spp. and Enterobacter spp., whereas Pseudomonas spp., Serratia spp. and Candida spp. are more frequent in children with urogenital abnormalities and/or undergoing invasive instrumental investigations. Several factors are involved in the pathogenesis of UTI, the main ones being circumcision, periurethral flora, micturition disorders, bowel disorders, local factors and hygienic measures. Several factors facilitate UTI relapse: malformative uropathies, particularly of the obstructive type; vesico-ureteric reflux (VUR); previous repeated episodes of cystitis and/or pyelonephritis (3 or more episodes a year), even in the absence of urinary tract abnormalities; a frequently catheterized neurogenic bladder; kidney transplant. The precise mechanism of action of low-dose antibiotics is not yet fully known. The characteristics of the ideal prophylactic agent are presented in this review, as well as indications, dosages, side effects, clinical data of all molecules. While inappropriate use of antibiotic prophylaxis encourages the emergence of microbial resistance, its proper use may be of great value in clinical practice, by reducing the frequency and clinical expression of UTIs and, in some cases such as VUR, significantly helping to resolve the underlying pathology.

  4. Incidence and risk factors for Malaria, pneumonia and diarrhea in children under 5 in UNHCR refugee camps: A retrospective study

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    Hershey Christine L


    Full Text Available Abstract Background United Nations High Commissioner for Refugees (UNHCR refugee camps are located predominantly in rural areas of Africa and Asia in protracted or post-emergency contexts. Recognizing the importance of malaria, pneumonia and diarrheal diseases as major causes of child morbidity and mortality in refugee camps, we analyzed data from the UNHCR Health Information System (HIS to estimate incidence and risk factors for these diseases in refugee children younger than five years of age. Methods Data from 90 UNHCR camps in 16 countries, including morbidity, mortality, health services and refugee health status, were obtained from the UNHCR HIS for the period January 2006 to February 2010. Monthly camp-level data were aggregated to yearly estimates for analysis and stratified by location in Africa (including Yemen or Asia. Poisson regression models with random effects were constructed to identify factors associated with malaria, pneumonia and diarrheal diseases. Spatial patterns in the incidence of malaria, pneumonia and diarrheal diseases were mapped to identify regional heterogeneities. Results Malaria and pneumonia were the two most common causes of mortality, with confirmed malaria and pneumonia each accounting for 20% of child deaths. Suspected and confirmed malaria accounted for 23% of child morbidity and pneumonia accounted for 17% of child morbidity. Diarrheal diseases were the cause of 7% of deaths and 10% of morbidity in children under five. Mean under-five incidence rates across all refugee camps by region were: malaria [Africa 84.7 cases/1000 U5 population/month (95% CI 67.5-102.0, Asia 2.2/1000/month (95% CI 1.4-3.0]; pneumonia [Africa 59.2/1000/month (95% CI 49.8-68.7, Asia 254.5/1000/month (95% CI 207.1-301.8]; and diarrheal disease [Africa 35.5/1000/month (95% CI 28.7-42.4, Asia 69.2/1000/month (95% CI 61.0-77.5]. Measles was infrequent and accounted for a small proportion of child morbidity (503 cases, Conclusions As in

  5. Hip arthrodesis in children: A review of 28 patients

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    Banskota Ashok


    Full Text Available Background: The best method of treating intractable hip pain in an unsalvageable hip joint in a child is still a subject open to debate. We believe that hip arthrodesis in such patients provides a painless and stable hip for most activities of daily living in our challenging rural terrain. Therefore, we conducted this study to assess the functional ability of children with painful hip arthrosis treated by arthrodesis of the hip. Materials and Methods: A retrospective evaluation of 28 children (out of 35 who had an arthrodesis of the hip performed between 1994 and 2008 was carried out. The average age was 14 years, with 12 males and 16 females. There was involvement of the right hip in 13 and left in 15 cases. The average duration of follow-up was 4.87 years. The preferred position of the hip for arthrodesis was 20-30° of flexion, neutral abduction-adduction, and neutral rotation, irrespective of the method of fixation. Results: The average duration of clinical and radiological arthrodesis was found to be 4 months (2-6 months. At the last follow-up, all patients were painfree and had good ambulatory capacity. The average Modified Harris Hip Score increased from 53 to 84 and the average post-surgical limb length discrepancy was 1.3 cm, which was well tolerated in all cases. Patients, however, had difficulty in squatting and had to modify their posture for foot care, putting on shoes, etc. Also, some patients complained of ipsilateral knee, contralateral hip, or low back pain with prolonged activity, but this was not severe enough to restrict activity except in one case that was known to have juvenile rheumatoid arthritis and needed ambulatory aid. Conclusion: In an environment where pathology generally presents very late and often in a dramatic manner, where the patient′s socioeconomic status, understanding, compliance, and the logistics of follow-up are consistently a challenge in management, hip arthrodesis has been an important procedure for

  6. Retrospective Analysis on Treatment of Children with Purulent Meningitis in Our Hospital in 2010%2010年我院化脓性脑膜炎患儿治疗回顾

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    目的 总结化脓性脑膜炎惠儿的药物治疗经验,为临床提供参考.方法 对2010年1月至12月收治的化脓性脑膜炎病例进行回顾性调查,分析其药物治疗情况和预后.结果 73例患儿都使用了抗菌药物,使用频次最高的依次为阿莫西林克拉维酸钾、美罗培南、拉氧头孢.绝大多数患儿病情好转出院.结论 合理使用抗茵药物是治疗化脓性脑膜炎的关键.%Objective To summarize the treatment experiences of children purulent meningitis in our hospital to provide reference for clinic. Methods In this retrospective study, the medical records of pediatric patients with purulent meningitis admitted to our hospital from Jan. 2010 to Dec. 2010 were analyzed regarding the medication and prognosis. Results Of all the cases reviewed, 73 cases all used antibiotics; the three antibiotics of amoxicillin alavulanate, meropenem, latamoxef were used most frequently. The majority took a favorable turn and were discharged from hospital. Conclusion Rational use of antimicrobial agents is the key to cure purulent meningitis.

  7. Let the Children Have their Say: Children with Special Educational Needs and their Experiences of Physical Education--A Review (United States)

    Coates, Janine; Vickerman, Philip


    This paper reviews literature examining the perspectives of children with special educational needs related to their experiences of Physical Education (PE). The extent to which literature addresses inclusion in PE was determined and emerging themes arising from consultation with children with special educational needs regarding PE were examined.…

  8. [A retrospective study on HBsAg clearance rate after antiviral therapy in children with HBeAg-positive chronic hepatitis B aged 1-7 years]. (United States)

    Zhu, S S; Dong, Y; Xu, Z Q; Wang, L M; Chen, D W; Gan, Y; Wang, F C; Yan, J G; Cao, L L; Wang, P; Zhang, H F


    Objective: To investigate the HBsAg clearance rate after antiviral therapy in children with HBeAg-positive chronic hepatitis B (CHB) aged 1-7 years. Methods: A retrospective analysis was performed for the HBsAg clearance rate in 293 children who were hospitalized in 302 Hospital of PLA from June 2006 to December 2013, met the inclusion criteria, received antiviral therapy, and were followed up for at least 6 months after the withdrawal of antiviral therapy. The t-test or the rank sum test was applied according to the distribution of continuous data, and the chi-square test was used for comparison of categorical data. Results: The HBsAg positive rate of children's mothers was 91.1%. In the age groups of >1-≤2 years, >2-≤3 years, >3-≤4 years, >4-≤5 years, >5-≤6 years, and >6-≤7 years, the HBsAg clearance rates were 66.1%, 65.5%, 45.7%, 41.3%, 20.6%, and 27.6%, respectively. There were significant differences in HBsAg clearance rate between the age groups of >1-≤3 years and >3-≤5 years, >1-≤3 years and >5-≤7 years, and >3-≤5 years and >5-≤7 years (P = 0.001, 0.000, and 0.008). Of all children, 64.8% were boys, among whom 41.1% achieved HBsAg clearance, and 35.2% were girls, among whom 61.2% achieved HBsAg clearance; there was a significant difference in HBsAg clearance rate between boys and girls (P = 0.001). The children with pretreatment alanine aminotransferase (ALT) levels of ≤80 IU/L, > 80 IU/L, ≤200 IU/L, and > 200 IU/L had HBsAg clearance rates of 40.7%, 51.2%, 47.6%, and 49.4%, respectively; there were no significant differences in HBsAg clearance rate between the ALT ≤80 IU/L and ALT > 80 IU/L groups and the ALT ≤200 IU/L and ALT > 200 IU/L groups (P = 0.101 and 0.778). There was no significant difference in HBsAg clearance rate between the pretreatment HBV DNA load clearance rate of 57.1%, and 85% had genotype C and an HBsAg clearance rate of 39.5%; there was no significant difference in HBsAg clearance rate between the

  9. Sensory-Based Intervention for Children with Behavioral Problems: A Systematic Review (United States)

    Wan Yunus, Farahiyah; Liu, Karen P.; Bissett, Michelle; Penkala, Stefania


    Sensory-based intervention is a common approach used to address behavioral problems in children. Types of sensory-based intervention for children and details of the intervention effectiveness have not been systematically examined. This review examined the effectiveness and ideal types of sensory-based interventions for children with behavioral…

  10. Voluntary peer review as innovative tool for quality improvement in the intensive care unit – a retrospective descriptive cohort study in German intensive care units (United States)

    Kumpf, Oliver; Bloos, Frank; Bause, Hanswerner; Brinkmann, Alexander; Deja, Maria; Marx, Gernot; Kaltwasser, Arnold; Dubb, Rolf; Muhl, Elke; Greim, Clemens-A.; Weiler, Norbert; Chop, Ines; Jonitz, Günther; Schaefer, Henning; Felsenstein, Matthias; Liebeskind, Ursula; Leffmann, Carsten; Jungbluth, Annemarie; Waydhas, Christian; Pronovost, Peter; Spies, Claudia; Braun, Jan-Peter


    Introduction: Quality improvement and safety in intensive care are rapidly evolving topics. However, there is no gold standard for assessing quality improvement in intensive care medicine yet. In 2007 a pilot project in German intensive care units (ICUs) started using voluntary peer reviews as an innovative tool for quality assessment and improvement. We describe the method of voluntary peer review and assessed its feasibility by evaluating anonymized peer review reports and analysed the thematic clusters highlighted in these reports. Methods: Retrospective data analysis from 22 anonymous reports of peer reviews. All ICUs – representing over 300 patient beds – had undergone voluntary peer review. Data were retrieved from reports of peers of the review teams and representatives of visited ICUs. Data were analysed with regard to number of topics addressed and results of assessment questionnaires. Reports of strengths, weaknesses, opportunities and threats (SWOT reports) of these ICUs are presented. Results: External assessment of structure, process and outcome indicators revealed high percentages of adherence to predefined quality goals. In the SWOT reports 11 main thematic clusters were identified representative for common ICUs. 58.1% of mentioned topics covered personnel issues, team and communication issues as well as organisation and treatment standards. The most mentioned weaknesses were observed in the issues documentation/reporting, hygiene and ethics. We identified several unique patterns regarding quality in the ICU of which long-term personnel problems und lack of good reporting methods were most interesting Conclusion: Voluntary peer review could be established as a feasible and valuable tool for quality improvement. Peer reports addressed common areas of interest in intensive care medicine in more detail compared to other methods like measurement of quality indicators. PMID:25587245

  11. Voluntary peer review as innovative tool for quality improvement in the intensive care unit – a retrospective descriptive cohort study in German intensive care units

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    Kumpf, Oliver


    Full Text Available [english] Introduction: Quality improvement and safety in intensive care are rapidly evolving topics. However, there is no gold standard for assessing quality improvement in intensive care medicine yet. In 2007 a pilot project in German intensive care units (ICUs started using voluntary peer reviews as an innovative tool for quality assessment and improvement. We describe the method of voluntary peer review and assessed its feasibility by evaluating anonymized peer review reports and analysed the thematic clusters highlighted in these reports.Methods: Retrospective data analysis from 22 anonymous reports of peer reviews. All ICUs – representing over 300 patient beds – had undergone voluntary peer review. Data were retrieved from reports of peers of the review teams and representatives of visited ICUs. Data were analysed with regard to number of topics addressed and results of assessment questionnaires. Reports of strengths, weaknesses, opportunities and threats (SWOT reports of these ICUs are presented. Results: External assessment of structure, process and outcome indicators revealed high percentages of adherence to predefined quality goals. In the SWOT reports 11 main thematic clusters were identified representative for common ICUs. 58.1% of mentioned topics covered personnel issues, team and communication issues as well as organisation and treatment standards. The most mentioned weaknesses were observed in the issues documentation/reporting, hygiene and ethics. We identified several unique patterns regarding quality in the ICU of which long-term personnel problems und lack of good reporting methods were most interestingConclusion: Voluntary peer review could be established as a feasible and valuable tool for quality improvement. Peer reports addressed common areas of interest in intensive care medicine in more detail compared to other methods like measurement of quality indicators.

  12. Risk Factors for Acute Kidney Injury after Congenital Cardiac Surgery in Infants and Children: A Retrospective Observational Study (United States)

    Kim, Eunhee; Park, Jung Bo; Kim, Youngwon; Yang, Ji-Hyuk; Jun, Tae-Gook; Kim, Chung Su


    Acute kidney injury (AKI) after pediatric cardiac surgery is associated with high morbidity and mortality. Modifiable risk factors for postoperative AKI including perioperative anesthesia-related parameters were assessed. The authors conducted a single-center, retrospective cohort study of 220 patients (aged 10 days to 19 years) who underwent congenital cardiac surgery between January and December 2012. The incidence of AKI within 7 days postoperatively was determined using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Ninety-two patients (41.8%) developed AKI and 18 (8.2%) required renal replacement therapy within the first postoperative week. Among patients who developed AKI, 57 patients (25.9%) were KDIGO stage 1, 27 patients (12.3%) were KDIGO stage 2, and eight patients (3.6%) were KDIGO stage 3. RACHS-1 (Risk-Adjusted classification for Congenital Heart Surgery) category, perioperative transfusion and fluid administration as well as fluid overload were compared between patients with and without AKI. Multivariable logistic regression analyses determined the risk factors for AKI. AKI was associated with longer hospital stay or ICU stay, and frequent sternal wound infections. Younger age (CPB) time (OR, 2.45; 95% CI, 1.24–4.84), and low preoperative hemoglobin (OR, 2.40; 95% CI, 1.07–5.40) were independent risk factors for AKI. Fluid overload was not a significant predictor for AKI. When a variable of hemoglobin concentration increase (>3 g/dl) from preoperative level on POD1 was entered into the multivariable analysis, it was independently associated with postoperative AKI (OR, 6.51; 95% CI, 2.23–19.03 compared with no increase). This association was significant after adjustment with patient demographics, medication history and RACHS-1 category (hemoglobin increase >3g/dl vs. no increase: adjusted OR, 6.94; 95% CI, 2.33–20.69), regardless of different age groups and cyanotic or non-cyanotic heart disease. Prospective trials are

  13. Dexamethasone As Prophylaxis! is it Effective in Reducing Postoperative Extubation Blues in Paediatric Age Group? A RetrospectiveReview of 331 Patients

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    Pramod Patra


    Full Text Available Use of steroids for different airway morbidities is common. This retrospective analysis was aimed at justifying the use of dexamethasone in preventing postoperative airway morbidities during extubation in paediatric age group. Recorded data of all paediatric surgeries in a particular institute was analyzed for incidences of post extubation airway problems in patients who received dexamethasone and compared with those who did not receive any steroid perioperatively. Three hundred and thirty one patients were considered out of which 226 received intravenous dex-amethasone preoperatively, and 105 did not receive any steroids peri-operatively. Out of 52 children (15.7% who had post-extubation airway problems, only 14 (6.1% belonged to the dexamethasone group while 38 (36.1% be-longed to the non-dexa group. The difference noted in the incidence between the two groups was statistically signifi-cant (p< 0.05.There was no significant incidence of any systemic adverse effects while a large number of children developed severe perianal and vulval pruritus immediately after the bolus dexamethasone injection. There was no significant difference in the incidence of subglottic or supraglottic airway morbidities when compared between both the groups. In conclusion, a single bolus preoperative intravenous dose of dexamethasone, in paediatric patients, is of immense help in reducing the airway morbidities faced at the time of extubation in the post operative period.

  14. Ten-year Etiologic Review of Chinese Children Hospitalized for Pediatric Cataracts

    Institute of Scientific and Technical Information of China (English)

    Zixun Song; Daixin Zhao; Cancan Lv; Wei Pu; Wei Xiao


    Purpose:.Our aim was to obtain a better understanding of the etiologies and characteristics of pediatric cataracts treated at a single facility in China.Methods:.Medical records accrued over a 10-year period (from August, 2003 to July, 2013) at Shengjing Hospital of China Medical University were reviewed retrospectively , ide ntifying all patients treated for various subtypes of pediatric cataract..A database with 367 subjects under 14 years of age (598, including second-round surgeries) was generated.Results:.Of this cohort (n =367; males: 232, 63.2% ; fe-males: 135, 36.8%), 200 patients (54.5%) had bilateral cataracts, and 258 (70.3%) were under 3 years of age. In all age groups and in all subtypes of pediatric cataract,.males were most commonly affected..Congenital cataract was the most prevalent subtype, accounting for 296 patients (80.7%). Most congeni-tal cataracts were associated with other ocular or systemic ab-normalities;.and in 48 patients (16.22%),.they were heredi-tary..Traumatic cataract was the most common subtype (85.92%) of acquired cataract. The few instances of cataracts due to steroids (n=3) or to metabolic disorders (n=2) occurred in males and involved both eyes.Conclusion: The majority of pediatric cataracts in this patient population were congenital in nature. A significant lag in oph-thalmologic evaluation of Chinese infants was evident and should be addressed by educating both children and parents on risk factors for cataract development. Regular assessments are especially important in children subjected to long-term sys-temic steroid treatments. (Eye Science 2014; 29:138-142)

  15. Alcohol consumption and interpersonal injury in a pediatric oral and maxillofacial trauma population: a retrospective review of 1,192 trauma patients. (United States)

    McAllister, Peter; Laverick, Sean; Makubate, Boikanyo; Jones, David Carl


    The social, financial, and health implications of adult alcohol-related oral and maxillofacial trauma have been recognized for several years. Affordability and widespread accessibility of alcohol and issues of misuse in the pediatric trauma population have fostered concerns alcohol may be similarly implicated in young patients with orofacial trauma. The aim of this study was to review data of pediatric facial injuries at a regional maxillofacial unit, assess the prevalence of alcohol use, and review data of patients sustaining injury secondary to interpersonal violence. This study is a retrospective, 3-year review of a Regional Maxillofacial Unit (RMU) trauma database. Inclusion criterion was consecutive facial trauma patients under 16 years of age, referred to RMU for further assessment and/or management. Alcohol use and injuries sustained were reviewed. Of 1,192 pediatric facial trauma patients, 35 (2.9%) were associated with alcohol intake. A total of 145 (12.2%) alleged assault as the mechanism of injury, with older (12-15 years) (n = 129; 88.9%), male (n = 124; 85.5%) (p role of alcohol in the pediatric trauma population is essential.

  16. Peer-Mediated Pivotal Response Treatment for Young Children with Autism Spectrum Disorders: A Systematic Review (United States)

    Boudreau, Ainsley M.; Corkum, Penny; Meko, Katelyn; Smith, Isabel M.


    This review examined the effectiveness of peer-mediated pivotal response treatment (PM-PRT) to increase social-communication skills for children with autism spectrum disorders (ASD). A systematic review was conducted of all published studies examining PM-PRT in school-aged children with ASD, based on an established rubric. Five PM-PRT studies…

  17. Systematic Review of Early Intensive Behavioral Interventions for Children with Autism (United States)

    Howlin, Patricia; Magiati, Iliana; Charman, Tony


    Recent reviews highlight limitations in the evidence base for early interventions for children with autism. We conducted a systematic review of controlled studies of early intensive behavioral interventions (EIBI) for young children with autism. Eleven studies met inclusion criteria (including two randomized controlled trials). At group level,…

  18. Foster Family Characteristics and Behavioral and Emotional Problems of Foster Children: A Narrative Review. (United States)

    Orme, John G.; Buehler, Cheryl


    Reviews the literature on the foster family characteristics that are thought to contribute to the behavioral and emotional problems of foster children. The review is shaped by an understanding of the personal and familial factors associated with children's problem behaviors. Factors include parenting, family home environment, family functioning,…

  19. A Literature Review of Afterschool Mentoring Programs for Children at Risk (United States)

    McDaniel, Sara; Yarbrough, Anna-Margaret


    Afterschool programs such as tutoring and school-based or community-based programs have effectively functioned as prevention and intervention programs for children at risk. This literature review focuses on afterschool mentoring programs for children at risk. The purpose of reviewing the literature was to (a) determine the breadth and scope of the…

  20. Amphetamines, the pregnant woman and her children: a review. (United States)

    Oei, J L; Kingsbury, A; Dhawan, A; Burns, L; Feller, J M; Clews, S; Falconer, J; Abdel-Latif, M E


    The objective of this study is to review and summarize available evidence regarding the impact of amphetamines on pregnancy, the newborn infant and the child. Amphetamines are neurostimulants and neurotoxins that are some of the most widely abused illicit drugs in the world. Users are at high risk of psychiatric co-morbidities, and evidence suggests that perinatal amphetamine exposure is associated with poor pregnancy outcomes, but data is confounded by other adverse factors associated with drug-dependency. Data sources are Government data, published articles, conference abstracts and book chapters. The global incidence of perinatal amphetamine exposure is most likely severely underestimated but acknowledged to be increasing rapidly, whereas exposure to other drugs, for example, heroin, is decreasing. Mothers known to be using amphetamines are at high risk of psychiatric co-morbidity and poorer obstetric outcomes, but their infants may escape detection, because the signs of withdrawal are usually less pronounced than opiate-exposed infants. There is little evidence of amphetamine-induced neurotoxicity and long-term neurodevelopmental impact, as data is scarce and difficult to extricate from the influence of other factors associated with children living in households where one or more parent uses drugs in terms of poverty and neglect. Perinatal amphetamine-exposure is an increasing worldwide concern, but robust research, especially for childhood outcomes, remains scarce. We suggest that exposed children may be at risk of ongoing developmental and behavioral impediment, and recommend that efforts be made to improve early detection of perinatal exposure and to increase provision of early-intervention services for affected children and their families.

  1. Leprosy among children under 15 years of age: literature review. (United States)

    Oliveira, Marcela Bahia Barretto de; Diniz, Lucia Martins


    Leprosy is a chronic infectious disease caused by Mycobacterium leprae, representing a public health issue in some countries. Though more prevalent in adults, the detection of new cases in children under 15 years of age reveals an active circulation of bacillus, continued transmission and lack of disease control by the health system, as well as aiding in the monitoring of the endemic. Among patients under 15 years of age, the most affected age group is children between 10 and 14 years of age, although cases of patients of younger than 1 year of age have also been reported. Household contacts are the primary source of infection, given that caretakers, such as babysitters and others, must be considered in this scenario. Paucibacillary forms of the disease prevailed, especially borderline-tuberculoid leprosy, with a single lesion in exposed areas of the body representing the main clinical manifestation. Reactional states: Lepra reactions are rare, although some authors have reported high frequencies of this phenomenon, the most frequent of which is Type 1 Lepra Reaction. Peripheral nerve involvement has been described at alarming rates in some studies, which increases the chance of deformities, a serious problem, especially if one considers the age of these patients. The protective effect of BCG vaccination was found in some studies, but no consensus has been reached among different authors. Children must receive the same multidrug therapy regimen and the doses should, ideally, be calculated based on the child´s weight. Adverse reactions to this therapy are rare within this age group. This article aims to review epidemiological, clinical, and therapeutic aspects of leprosy in patients under 15 years of age.

  2. Leprosy among children under 15 years of age: literature review* (United States)

    de Oliveira, Marcela Bahia Barretto; Diniz, Lucia Martins


    Leprosy is a chronic infectious disease caused by Mycobacterium leprae, representing a public health issue in some countries. Though more prevalent in adults, the detection of new cases in children under 15 years of age reveals an active circulation of bacillus, continued transmission and lack of disease control by the health system, as well as aiding in the monitoring of the endemic. Among patients under 15 years of age, the most affected age group is children between 10 and 14 years of age, although cases of patients of younger than 1 year of age have also been reported. Household contacts are the primary source of infection, given that caretakers, such as babysitters and others, must be considered in this scenario. Paucibacillary forms of the disease prevailed, especially borderline-tuberculoid leprosy, with a single lesion in exposed areas of the body representing the main clinical manifestation. Reactional states: Lepra reactions are rare, although some authors have reported high frequencies of this phenomenon, the most frequent of which is Type 1 Lepra Reaction. Peripheral nerve involvement has been described at alarming rates in some studies, which increases the chance of deformities, a serious problem, especially if one considers the age of these patients. The protective effect of BCG vaccination was found in some studies, but no consensus has been reached among different authors. Children must receive the same multidrug therapy regimen and the doses should, ideally, be calculated based on the child´s weight. Adverse reactions to this therapy are rare within this age group. This article aims to review epidemiological, clinical, and therapeutic aspects of leprosy in patients under 15 years of age. PMID:27192519

  3. Plunging ranula in children: case report and literature review

    Directory of Open Access Journals (Sweden)

    Veronica Carlini


    Full Text Available Few cases of plunging ranulas (PRs occur during childhood and the lesions are frequently misdiagnosed. Here, a PR in a child is reported along with a literature review. A seven-year-old female complaining of swelling in the midline neck, left-submandibular region, was evaluated. No oral cavity or major salivary glands abnormalities were detected. On palpation, a soft, painless, and fluid-containing mass was observed. The suspicion PR was performed by ultrasound. The diagnosis was confirmed with a histopathological examination. The lesion was removed with a cervical approach, without recurrence. PR is an uncommon condition in children under 10 years of age. Differential diagnosis depends on clinical examination and ultrasonography. A computed tomography-scan and magnetic resonance imaging can be performed if the diagnosis remains uncertain. In pediatrics, the key to success of the treatment may rely on the radical excision of the cyst and sublingual gland, via an intraoral or submandibular approach.

  4. Plunging Ranula in Children: Case Report and Literature Review. (United States)

    Carlini, Veronica; Calcaterra, Valeria; Pasqua, Noemi; Guazzotti, Marinella; Fusillo, Mario; Pelizzo, Gloria


    Few cases of plunging ranulas (PRs) occur during childhood and the lesions are frequently misdiagnosed. Here, a PR in a child is reported along with a literature review. A seven-year-old female complaining of swelling in the midline neck, left-submandibular region, was evaluated. No oral cavity or major salivary glands abnormalities were detected. On palpation, a soft, painless, and fluid-containing mass was observed. The suspicion PR was performed by ultrasound. The diagnosis was confirmed with a histopathological examination. The lesion was removed with a cervical approach, without recurrence. PR is an uncommon condition in children under 10 years of age. Differential diagnosis depends on clinical examination and ultrasonography. A computed tomography-scan and magnetic resonance imaging can be performed if the diagnosis remains uncertain. In pediatrics, the key to success of the treatment may rely on the radical excision of the cyst and sublingual gland, via an intraoral or submandibular approach.

  5. Retrospective analysis of 195 cases of acute exacerbation of bronchial asthma in children%不同年龄儿童支气管哮喘急性发作的对比分析

    Institute of Scientific and Technical Information of China (English)

    朱赟; 王亚亭


    目的 探讨不同年龄组哮喘急性发作儿童的临床特点.方法 回顾性分析2006年1月至2010年12月住院195例哮喘急性发作患儿的临床资料,比较5岁前和5岁后2个年龄组患儿的临床特点.结果 2组比较,<5岁组患儿具有血小板计数高、住院时间长、合并肺炎及支原体感染率高,过去1年喘息发作的次数多,哮喘及时诊断和治疗率低的特点(P<0.05).结论 <5岁组患儿在哮喘急性发作时表现较重,更易并发肺炎和支原体感染,哮喘及时诊断率较低,治疗依从性较差.%Objective To explore the clinical features of different age groups ( <5 years old and ≥5 years old ) of children with a-cute exacerbation of asthma. Methods The clinical data concerning 195 cases of hospitalization children with acute exacerbation of asthma between Jan. 2006 to Dec. 2010 were retrospectively reviewed, and their clinical features were comparied. Results Comparing with ≥5 years old groups, <5 years of age group of children have higher platelet count, longer hospital stay, higher pneumonia , mycoplasma infection rate, more times of wheezing in the past year, low diagnosis rate of asthma and low treatment (P <0. 05 ). Conclusion <5 years of age group of children,who have stronger inflammatory response, are easy to suffer from pneumonia and mycoplasma infection, and very few of them can be diagnosed timely and treated with poor adherence.

  6. Academic Attainment Findings in Children with Sickle Cell Disease (United States)

    Epping, Amanda S.; Myrvik, Matthew P.; Newby, Robert F.; Panepinto, Julie A.; Brandow, Amanda M.; Scott, J. Paul


    Background: Children with sickle cell disease (SCD) demonstrate deficits in cognitive and academic functioning. This study compared the academic attainment of children with SCD relative to national, state, and local school district rates for African American students. Methods: A retrospective chart review of children with SCD was completed and…

  7. Summer camps for children with burn injuries: a literature review. (United States)

    Maslow, Gary R; Lobato, Debra


    The first summer camps for children with burn injuries started over 25 years ago, and as of 2008, there were 60 camps worldwide. This review examines the literature on summer pediatric burn camps. The authors describe common characteristics of burn camp structure, activities, and staffing and then examine the scientific evidence regarding the effect of burn camp programs on campers and camp staff volunteers. A search of Pubmed and Psychinfo databases from 1970 to 2008 for articles related to pediatric burn summer camps identified 17 articles, of which 13 fit the inclusion criteria. Existing literature consists primarily of qualitative studies, suggesting that burn camp can decrease camper isolation, improve self-esteem, and promote coping and social skills. Studies examining volunteer staff at burn camp have consistently found that there are both personal and professional benefits. Quantitative studies of self-esteem have yielded equivocal results. No studies have examined safety or the effect of burn camp on medical or rehabilitation outcomes. For the past 25 years, pediatric summer camps for children with burn injuries have played an important rehabilitation role and provided a strong community that benefits both campers and staff. Future research using more rigorous research methods and examining a broader range of outcomes (eg, safety and medical/rehabilitation outcomes) is recommended.

  8. Assessing Caudal Block Concentrations of Bupivacaine With and Without the Addition of Intravenous Fentanyl on Postoperative Outcomes in Pediatric Patients: A Retrospective Review. (United States)

    Karkera, Megha M; Harrison, Dale R; Aunspaugh, Jennifer P; Martin, Timothy W


    Caudal blocks are a significant and efficacious aspect of pediatric anesthesia, especially in urologic and many general surgery cases. This type of regional anesthesia is common because it has a high success rate and provides between 6 and 8 hours of postoperative pain control. The aim of this study was to determine whether the concentration of bupivacaine or the addition of intravascular (i.v.) fentanyl affected the postanesthesia care unit (PACU) discharge time. A retrospective cohort study comparing the outcomes in pediatric patients who have received varying caudal concentrations with and without the addition of i.v. fentanyl was performed. A total of 849 consecutive patients undergoing hypospadias repairs or circumcisions were reviewed and placed in one of the following 3 groups: 0.125% bupivacaine (group 1), 0.25% bupivacaine (group 2), or one of these concentrations of bupivacaine + i.v. fentanyl intraoperatively (group 3). Total PACU time for each group was 46.1 minutes (group 1), 48.9 minutes (group 2), and 49.7 minutes (group 3). Our results revealed that there is no statistically significant difference between concentrations of bupivacaine administered in a caudal block with or without i.v. fentanyl with regard to the outcome of PACU duration (P = 0.16). Overall, based on the retrospective cohort design, there is no difference in primary and secondary outcomes based on the concentration of bupivacaine, when administered at a volume of 1 mL/kg.

  9. Effectiveness of physiotherapy and conductive education interventions in children with cerebral palsy: a focused review

    DEFF Research Database (Denmark)

    Anttila, Heidi; Suoranta, Jutta; Malmivaara, Antti


    We conducted a criteria-based appraisal of systematic reviews on the effectiveness of physiotherapy and conductive education interventions in children with cerebral palsy (CP). Computerized bibliographic databases were searched without language restriction up to August 2007. Reviews on trials...... physiotherapy and occupational therapy interventions. Conclusions in the other reviews should be interpreted cautiously, although, because of the poor quality of the primary studies, most reviews drew no conclusions on the effectiveness of the reviewed interventions. Reviews on complex interventions...

  10. Radiation therapy of thymoma. A multicentric retrospective review of 149 cases; Radiotherapie des thymomes. Etude de la litterature a propos d`une serie retrospective et multicentrique de 149 cas

    Energy Technology Data Exchange (ETDEWEB)

    Resbeut, M.; Mornex, F.; Richaud, P.; Bachelot, T.; Jung, G.; Mirabel, X.; Marchal, C.; Lagrange, J.P.; Rambert, P.; Chaplain, G.; N`Guyen, T.D.; Gastaut, J.A. [Federation Nationale des Centres de Lutte contre le Cancer, 75 - Paris (France)


    Thymomas is a rare disease. Staging systems and surgical adjuvant treatments remain controversial. We reviewed the outcome and the prognostic factors in a series of 149 patients with non metastatic thymomas treated in ten French cancer centers between 1979 and 1990. Patients were staged according to the ``GETT`` classification derived from that of Masaoka. There were 13 stage I patients, 46 stage II, 58 stage III and 32 stage IV. Surgery consisted of complete resection in 63 patients, partial resection in 31 patients and biopsy alone in 55 patients. All patients received postoperative radiation therapy and 74 were given postoperative chemotherapy. Median follow-up was 7,7 years. Local control was obtained in 117 patients (78,5%) and was influenced by the extent of surgery (p < 0,0001). Metastases occurred in 26 patients. Seven patients developed grade 3-4 pulmonary and heart complications. One patient developed a malignant lymphoma after 24 cycles of chemotherapy. Disease-free survival (DFS) rates were of five years 92%, 75%, 60%, 39% and 48% in stage I, II, IIA, IIIB and IVA patients, respectively. After complete resection, partial resection and biopsy alone, these rates were 74%, 60% and 38%, respectively. With a multivariate analysis, DFS rates were influenced by the extent of surgery (p < 0,001) and by chemotherapy (p < 0,001). Three other factors could predict a worse DFS: young age (p < 0,006), stages III-IV (p < 0,04) and mediastinal symptoms (p < 0,001). ``GETT`` staging correlated well with local control and survival. After complete resection, a 50 Gy postoperative radiation therapy can be recommended in patients with invasive thymomas. Despite a 65% local control rate after partial resection or biopsy alone in this series, a higher dose of radiation (> 60 Gy) must be evaluated. Despite the benefit of the chemotherapy in this retrospective and multicentric study, the role of this treatment remains to be assessed. 43 refs., 5 figs., 7 tabs.

  11. The correlation and level of agreement between end-tidal and blood gas pCO2 in children with respiratory distress: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Alexander Jamin L


    Full Text Available Abstract Background To investigate the correlation and level of agreement between end-tidal carbon dioxide (EtCO2 and blood gas pCO2 in non-intubated children with moderate to severe respiratory distress. Methods Retrospective study of patients admitted to an intermediate care unit (InCU at a tertiary care center over a 20-month period with moderate to severe respiratory distress secondary to asthma, bronchiolitis, or pneumonia. Patients with venous pCO2 (vpCO2 and EtCO2 measurements within 10 minutes of each other were eligible for inclusion. Patients with cardiac disease, chronic pulmonary disease, poor tissue perfusion, or metabolic abnormalities were excluded. Results Eighty EtCO2-vpCO2 paired values were available from 62 patients. The mean ± SD for EtCO2 and vpCO2 was 35.7 ± 10.1 mmHg and 39.4 ± 10.9 mmHg respectively. EtCO2 and vpCO2 values were highly correlated (r = 0.90, p SD between EtCO2 and vpCO2 was -3.68 ± 4.70 mmHg. The 95% level of agreement ranged from -12.88 to +5.53 mmHg. EtCO2 was found to be more accurate when vpCO2 was 35 mmHg or lower. Conclusion EtCO2 is correlated highly with vpCO2 in non-intubated pediatric patients with moderate to severe respiratory distress across respiratory illnesses. Although the level of agreement between the two methods precludes the overall replacement of blood gas evaluation, EtCO2 monitoring remains a useful, continuous, non-invasive measure in the management of non-intubated children with moderate to severe respiratory distress.

  12. 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.

  13. Mortality and Disease in Wild Turkeys ( Meleagris gallopavo silvestris) in Ontario, Canada, from 1992 to 2014: A Retrospective Review. (United States)

    MacDonald, Amanda M; Jardine, Claire M; Campbell, G Douglas; Nemeth, Nicole M


    Wild turkeys ( Meleagris gallopavo silvestris) were extirpated from Ontario, Canada, in the early 1900s due to unregulated over-hunting and habitat loss. Despite a successful reintroduction program and strong population numbers, information regarding the health of wild turkeys in Ontario is scarce. A 22-yr (1992-2014) retrospective study was performed to evaluate diagnostic data, including the cause(s) and contributors to death, in wild turkeys submitted to the Ontario-Nunavut node of the Canadian Wildlife Health Cooperative (n = 56). Noninfectious diagnostic findings (39/56; 69.6%) were more common than infectious, with emaciation recognized most frequently (n = 19; 33.9%) followed by trauma (n = 11, 19.6%). The majority of deaths due to emaciation occurred in winter and spring (17/18; 94.4%), which is consistent with lack of access to or availability of food resources. Morbidity and mortality due to infectious diseases was diagnosed in 16 (28.6%) wild turkeys. Avian poxvirus was the most common infectious cause of disease (n = 7; 12.5%), followed by bacterial infections (n = 5; 8.9%), the most common of which was Pasteurella multocida . Zinc phosphide toxicosis (n = 7; 12.5%) occurred in two incidents involving multiple birds. This study aims to provide baseline data that can be used for reference and comparison in future wild turkey disease surveillance and population monitoring studies.

  14. A retrospective outcomes review of patients with idiopathic normal pressure hydrocephalus treated with a low flow valve system

    Directory of Open Access Journals (Sweden)

    Phillip G. St. Louis, MD, FACS


    Full Text Available Accepted treatment of patients with Idiopathic Normal Pressure Hydrocephalus (INPH dictates the placement of a Ventriculoperitoneal (VP shunt. Selection of a valve regulated system for implantation is usually determined by the treating surgeon. Data regarding the efficacy of a Low Flow Valve (LFV are sparse. The use of this type of system may be of benefit in patients with INPH. Data from fourteen patients in the Florida Hospital NPH Program Registry with placement of a Low Flow Valve were retrospectively examined. All patients completed baselines studies to quantify gait disturbance, cognitive dysfunction, and ventriculomegaly (Evan's Ratio. Studies were repeated post three day external lumbar drain, as well as 6, 12, and 24 months post shunt placement. Significant improvement was noted in gait (Berg Balance Score at six months and one year post shunt placement. Patients improved from a "medium" fall risk to a "low" fall risk. Significant improvement in NAB was noted at 2 years of follow up, improving from "mildly impaired" to "average". Evan's ratio was stable throughout the study. There were no instances of over drainage or shunt infection. One shunt obstruction which necessitated surgical intervention was observed. Objective improvement in BERG and NAB appears to provide conclusive evidence of efficacy in this small group of patients with INPH treated with placement of an LFV and followed for two years. The absence of over-drainage as a related complication in this small group is encouraging.

  15. A Retrospective Review of the Presentation and Treatment of Stingray Stings Reported to a Poison Control System. (United States)

    Clark, Alexander T; Clark, Richard F; Cantrell, F Lee

    We studied stingray stings reported to our poison system to identify associated complications and treatments. We undertook a 14-year retrospective observational analysis of stingray stings reported to our poison system. Extracted data included caller age and gender, outcome, management site, symptoms, treatments, and geographical location of the sting. We examined suspected infection rate, hot water treatment efficacy, and possible presence of foreign bodies in the wound. Suspected infection rate was defined as "possible infection" or "likely infection." Hot water treatment efficacy was defined as cases that encoded hot water as a treatment and noted pain relief within 1 hour of treatment in the free-text record, before documentation of other analgesic administration. A total of 576 envenomations were reported. The majority were men (76%), with an average age of 24 years (range, 6-78 years). Symptoms were reported in 485 cases. A total of 9% recorded a foreign body or debris at the wound site. Symptoms included pain (79%), puncture wound (65%), and edema (25%). Infections were reported in 9% of cases. Hot/warm water immersion appeared effective for pain relief in 69% of cases where outcome was documented. The most common geographical location of stingray envenomations was Southern California. Stingray stings are common in California. Hot/warm water seemed to be effective in pain management in our series, whereas foreign bodies or retained spines and infections were other identified complications.

  16. Efficacy and safety of superficial cryotherapy for alopecia areata: A retrospective, comprehensive review of 353 cases over 22 years. (United States)

    Jun, Myungsoo; Lee, Noo Ri; Lee, Won-Soo


    Alopecia areata (AA) affects anagen hair follicles, resulting in non-scarring hair loss. Since introduced by Huang et al., superficial cryotherapy has been accepted as a considerable primary therapeutic modality for AA. The aim of this study was to objectively clarify the therapeutic efficacy and safety of superficial hypothermic cryotherapy for treatment of AA. Medical records of 353 patients from 1993 to 2014 were retrospectively analyzed. According to the response to the superficial cryotherapy, patients were categorized into four groups: "marked", "partial", "poor" and "no recovery". The marked and partial recovery groups were considered as responders. The proportions of the responders among patient subgroups which were defined by various patients, disease, and treatment factors were compared. Of the patients, 60.9% were classified as responders after 3 months of superficial hypothermic cryotherapy. The proportion of the responders were higher when the treatment interval was 2 weeks or less and in the incipient disease stage, with statistical significance. No severe side-effects other than mild pain and pruritus were reported. In conclusion, superficial cryotherapy is an effective and safe therapeutic modality for AA. Especially when the treatment interval is 2 weeks or less and in the first occurrence of the disease, the therapeutic outcome is superior.

  17. Pronuclear morphology evaluation in in vitro fertilization (IVF / intracytoplasmic sperm injection (ICSI cycles: a retrospective clinical review

    Directory of Open Access Journals (Sweden)

    Nicoli Alessia


    Full Text Available Abstract Background The assessment of the embryo quality is crucial to maintain an high pregnancy rate and to reduce the risk of multiple pregnancy. The evaluation of the pronuclear and nucleolar characteristics of human zygote have been proposed as an indicator of embryo development and chromosomal complement. The aim of the current study was to assess the role of pronuclear morphology evaluation in vitro fertilization (IVF / intracytoplasmic sperm injection (ICSI cycles. Methods Retrospective clinical analysis on 755 non-elective transfers of only one embryo (ET. Embryo assessment was performed in days 1 and 2. Clinical and biological data were recorded and analyzed according to embryo and/or pronuclear morphology. Results Both pronuclear and embryo morphology were significantly related to clinical pregnancy and live-birth rates. No significant difference in clinical pregnancy and live-birth rates was detected when the pronuclear and embryo morphology assessments were combined. Embryo morphology and maternal age were the only independent predictors of favorable outcome by logistic regression analysis. Conclusions Pronuclear evaluation is effective to select the best zygotes if ET is performed at day 1, whereas it did not improve the clinical outcomes when combined with embryo morphology evaluation in day 2.

  18. Antipsychotic poisoning in young children: a systematic review. (United States)

    Isbister, Geoffrey K; Balit, Corrine R; Kilham, Henry A


    The aim of this review was to determine the spectrum and severity of effects of unintentional antipsychotic poisoning in children. A computerised literature search of MEDLINE (1966 to February 2005) and EMBASE (1980 to February 2005) was undertaken. The Internet was searched using URL: The proceedings of the North American Congress of Clinical Toxicology (NACCT) and the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT) were hand searched. All cases of unintentional antipsychotic (all classes) poisoning in children aged 0-6 years were included. The data extracted included the age, weight, antipsychotic, dose, clinical effects, treatment and outcomes. The toxic dose was estimated as the lowest dose causing objective adverse effects.Sixty-eight reports were identified. Few contained all of the required information. Most of the case series included multiple antipsychotics with limited information on individual drugs or all ages with limited paediatric information. For most antipsychotics the ingestion of one tablet caused symptoms that were sometimes severe and usually lasted from 1 to 3 days. Extrapyramidal symptoms (EPS) were often delayed for up to 12-24 hours. Chlorpromazine caused CNS depression, hypotension and miosis; EPS and cardiac effects were rare, and the toxic dose was estimated to be 15 mg/kg. Haloperidol caused drowsiness (rarely coma) and over one-half of patients had neuromuscular effects (mainly EPS), with a toxic dose estimated at 0.15 mg/kg. Thioridazine caused CNS depression and potentially cardiac effects, with a toxic dose of 1.4 mg/kg. Atypical antipsychotics caused significant CNS depression (except risperidone); EPS were less common. Toxic doses were clozapine 2.5 mg/kg, olanzapine 0.5 mg/kg and aripiprazole 3 mg/kg. EPS responded to anticholinergic drug treatment. In summary, unintentional antipsychotic ingestion in children can cause severe effects that last 1-3 days, often with one tablet. Children

  19. Safety and toxicity of intrathecal liposomal cytarabine (Depocyte) in children and adolescents with recurrent or refractory brain tumors: a multi-institutional retrospective study. (United States)

    Benesch, Martin; Siegler, Nele; Hoff, Katja von; Lassay, Lisa; Kropshofer, Gabriele; Müller, Hermann; Sommer, Constanze; Rutkowski, Stefan; Fleischhack, Gudrun; Urban, Christian


    This retrospective study aimed to evaluate the safety and toxicity of intrathecal liposomal cytarabine (Depocyte) in children and adolescents with refractory or recurrent brain tumors. Nineteen heavily pretreated patients (males, n = 14; females, n = 5; median age at diagnosis 8.5 years; range, 1.4-22 years) were given intrathecal liposomal cytarabine on a compassionate use basis for recurrent refractory medulloblastoma (n = 12), mixed germ cell tumor (n = 2), central nervous system primitive neuroectodermal tumors of the pons (n = 1), anaplastic ependymoma (n = 1), anaplastic oligodendroglioma (n = 1), atypical teratoid rhabdoid tumor (n = 1), or rhabdoid papillary meningioma (n = 1). Eighteen patients received concomitant systemic radiochemotherapy. A total of 88 intrathecal injections of liposomal cytarabine (dose range, 20-50 mg) were administered with concomitant dexamethasone prophylaxis. The median number of doses per patient was four (range, 1-10). Duration of treatment ranged from (1/2) to 10 months. Eleven patients (57.9%) did not show any side effects, whereas eight patients (42.1%) developed side effects related to either chemical arachnoiditis (n = 4) or neurological progression (n = 2). Less typical treatment-related symptoms (e.g. lethargy, ataxia, and slurred speech) were observed in two patients. Treatment with intrathecal liposomal cytarabine was discontinued twice because of side effects. In conclusion, although intrathecal liposomal cytarabine was generally well tolerated, it should be used cautiously and only with dexamethasone prophylaxis in extensively pretreated patients with recurrent brain tumors. Proof of efficacy requires a prospective single-agent phase II study.

  20. Dietary determinants of subclinical inflammation, dyslipidemia and components of the metabolic syndrome in overweight children: a review

    NARCIS (Netherlands)

    Zimmermann, M.B.; Aeberli, I.


    Objective: To review and summarize the dietary determinants of the metabolic syndrome, subclinical inflammation and dyslipidemia in overweight children. Design: Review of the current literature, focusing on pediatric studies. Participants: Normal weight, overweight, or obese children and adolescents

  1. Retrospective analysis of 25 children with Takayasu's arteritis%儿童多发性大动脉炎25例回顾性分析

    Institute of Scientific and Technical Information of China (English)

    李亚男; 李善玉; 刘丽


    Objective To explore the clinical feature of children with Takayasn's arteritis (TA), and to analyze the relevant treatment methods and prognosis. Methods Retrospective analysis was performed on the clinical manifestations of 25 children with TA, and the process of treatment and prognosis. Results In this study, the ratio of male to female was 8 : 17, and the average onset age was ( 10.8 ± 3.0) years old. The most common TA type was 1 (56.0%), and the initial symptoms included headache, convulsions, fatigue, protcinuria, etc. All children had high blood pressure and 19 cases had lo (Tubercle bacillus) injection, 22 cases received cortjcosterojcis, and/or eveiophos-pharnide treatment All patient's condition relieved, but 16 patients had recurrence. Three cases received interventional therapy, no stenosis happened again. Conclusions For children, especially adolescent children with headache and high blood pressure as the main clinical manifestation, the diagnosis of TA should be kept in mind, TA in children is often caused by tuberculosis infection, therefore, early diagnosis and treatment of tuberculosis infection can effectively prevent the occurrence of TA. Drug treatment have a higher recurrence rate, interventional therapy can effectively improve ischemic symptoms.%目的 探讨儿童多发性大动脉炎(TA)的临床特征,分析相关治疗方法和转归.方法回顾性分析25例儿童多发性大动脉炎患儿的临床表现、治疗过程及预后.结果 患儿发病年龄为(10.8±3.0)岁,男女比为8:17.TA临床分型中以Ⅲ型最多(56.0%),常以头痛、抽搐、乏力、蛋白尿等为首发症状,25例患儿均有高血压,其中19例有结核感染.22例患儿接受糖皮质激素和(或)环磷酰胺治疗后病情缓解,其中16例出现复发;3例患儿接受血管内介入治疗,效果良好,未再出现狭窄.结论 儿童尤其是青春期以头痛、高血压为主要表现时需注意多发性大动脉炎可能.儿童多发性大动脉

  2. Short-term outcome of propionic aciduria treated at presentation with N-carbamylglutamate: a retrospective review of four patients. (United States)

    Lévesque, Sébastien; Lambert, Marie; Karalis, Aspasia; Melancon, Serge; Russell, Laura; Braverman, Nancy


    N-carbamylglutamate (NCG) has been reported to decrease ammonia levels in patients with propionic aciduria (PA) and methylmalonic aciduria (MMA), but reports on clinical outcomes remain scant. Here, we report a retrospective series of four patients with neonatal PA treated with NCG at presentation. Patients presented between 2 and 9 days of age and peak plasma ammonia ranged from 524 to 1,572 μM. Patients received bolus (30-200 mg/kg) and sustaining (115-300 mg/kg per day) doses of NCG in addition to a standard treatment regimen that included ammonia scavenger drugs. Ammonia levels decreased significantly in three of the four cases within 2 h after administration of NCG and fell below 100 μM in all within 12-29 h. Two patients received NCG (bolus 200 mg/kg) while ammonia was above 500 μM (740 and 1,572) and their levels fell below 500 μM by 4 and 8 h post-treatment, respectively. Outcomes of these NGC-treated patients were not improved over previously reported PA patients who did not receive NCG: two died during the initial episode and one after his third metabolic decompensation at 46 days. The survivor is now 3 years old and has a well-controlled seizure disorder and a mild developmental delay mostly in language. We conclude that despite a trial of NCG and a rapid fall in plasma ammonia, the short-term outcome of these patients was not improved.

  3. FDG PET/CT imaging in primary osseous and soft tissue sarcomas: a retrospective review of 212 cases

    Energy Technology Data Exchange (ETDEWEB)

    Charest, Mathieu [Lakeshore General Hospital, Service of Nuclear Medicine, Pointe-Claire (Canada); Hickeson, Marc; Lisbona, Robert; Novales-Diaz, Javier A.; Derbekyan, Vilma [McGill University Health Center, Department of Nuclear Medicine, Montreal (Canada); Turcotte, Robert E. [McGill University Health Center, Department of Orthopedic Surgery, Montreal (Canada)


    The aims of this study are to evaluate the sensitivity of FDG PET/CT for detection of soft tissue and osseous sarcomas on the basis of FDG avidity. We retrospectively evaluated 212 consecutive patients with known soft tissue or osseous sarcoma who had undergone a FDG PET/CT study for the initial staging or assessment of recurrence of disease. The maximum standardized uptake value (SUV{sub max}) of each primary and/or most intense metastatic lesion was measured and compared with the histological data provided in the final pathological reports. An SUV{sub max} of 2.5 or greater was considered positive for our analysis. Sufficient histopathological data were available for 160 soft tissue sarcomas and 52 osseous sarcomas. FDG PET/CT detected 93.9% of all sarcomas with a sensitivity of 93.7% for soft tissue sarcomas and 94.6% for osseous sarcomas. The sensitivities of the most common sarcoma histologies were 100% for leiomyosarcomas, 94.7% for osteosarcomas, 100% for Ewing's sarcomas, 88.9% for liposarcomas, 80.0% for synovial sarcomas, 100% for gastrointestinal stromal tumors, 87.5% for malignant peripheral nerve sheath tumors, 100% for fibroblastic and myoblastic sarcomas, and 100% for malignant fibrohistiocytic tumors. The receiver-operating characteristic curve revealed an area under the curve of 94% for the discrimination of low-grade and high-grade sarcomas imaged for initial staging by FDG PET/CT. The combined metabolic and morphological information of FDG PET/CT imaging allows high sensitivity for the detection of various sarcomas and accurate discrimination between newly diagnosed low-grade and high-grade sarcomas. (orig.)

  4. 30 Years Retrospective Review of Tuberculosis Cases in a Tuberculosis Dispensary in Bursa/Nilufer, Turkey (1985-2014

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    Kayıhan PALA


    Full Text Available Abstract Objective: The aim of this study was to evaluate tuberculosis control programmes of patients who applied to the Bursa Nilufer Tuberculosis Dispensary and by investigating the changes in the variables over 3 decades. Method: In this retrospective descriptive study, the records of all tuberculosis cases (1662 people treated in the last 30 years (1985-2014 at the Bursa Nilufer Tuberculosis Dispensary were examined. In the analysis, the chi-square test, the trend chi-square test and Fisher's exact test were used. Results: Males comprised 65.2% of the patients. The ages of the patients ranged from 1 to 87 years, and the mean age was 37.4 (95% CI:36.6-38.2. Among the cases, 86.7% were new and 74.1% were pulmonary tuberculosis. In the last decade, the proportion of women, the education level, the proportion of patients who had received a BCG vaccination and the proportion of active employees among women increased by a statistically significant amount, while the proportion of employees among men decreased. Clinical symptoms, such as weakness, anorexia, weight loss, and cough, decreased to a statistically significant degree. In the last decade, the mortality rate was 3.6%, a statistically significant increase compared with previous decades. Mortality was statistically significant higher among patients who were elderly, male, did not have a BCG scar or had a chronic disease. Conclusion: This study reveals the need for studies that determine the risk factors associated with tuberculosis mortality and examine the effectiveness of tuberculosis control programmes. Direct measures to address mortality risk factors can reduce the number of deaths from tuberculosis.

  5. Inflammatory arthritis in patients with myelodysplastic syndromes: a multicenter retrospective study and literature review of 68 cases. (United States)

    Mekinian, Arsène; Braun, Thorsten; Decaux, Olivier; Falgarone, Géraldine; Toussirot, Eric; Raffray, Loic; Omouri, Mohamed; Gombert, Bruno; De Wazieres, Benoit; Buchdaul, Anne-Laure; Ziza, Jean-Marc; Launay, David; Denis, Guillaume; Madaule, Serge; Rose, Christian; Grignano, Eric; Fenaux, Pierre; Fain, Olivier


    We describe the characteristics and outcome of inflammatory arthritis in patients with myelodysplastic syndrome (MDS) in a French multicenter retrospective study. Twenty-two patients with MDS (median age, 77.5 yr [interquartile range, 69-81]; 10 women) were included. Inflammatory arthritis presented as polyarthritis in 17 cases (77%) and with symmetric involvement in 15 cases (68%). At diagnosis, the median disease activity score 28 based on C-reactive protein (DAS28-CRP) was 4.5 [2-6.5]. Two patients had anti-citrullinated protein antibodies (ACPAs), and 1 had radiologic erosions. The median time between the diagnoses of arthritis and MDS was 10 months [6-42], with a median articular symptom duration of 3 months [2-8]. The diagnosis of both diseases was concomitant in 6 cases (27%); arthritis preceded MDS in 12 cases (55%), and occurred after MDS in 4 (18%). While the number of swollen and tender joints significantly decreased during follow-up, as did the median DAS28-CRP (from 4.3 [3.8-4.6] at baseline to 2.9 [1.75-3.3]; p 20 mg/L) in 8 patients (42%). Nevertheless, radiographic progression and new ACPA positivity were not observed during a median follow-up of 29 months [9-76]. While most of the patients were treated with steroids (n = 16) for arthritis, additional treatment was administered in only 4 patients (hydroxychloroquine, n = 2; sulfasalazine [Salazopyrin] and etanercept, n = 1, respectively). Eleven patients died during follow-up from acute myeloid leukemia (n = 5); infections (n = 3); or cerebral bleeding, cardiorespiratory failure, or undetermined cause (n = 1, respectively). Inflammatory arthritis associated with MDS can have various presentations and is often seronegative and nonerosive. Steroids alone are the most common treatment in MDS-associated arthritis, but that treatment is insufficient to control arthritis. Steroid-sparing strategies need to be identified.

  6. Children in Greenland

    DEFF Research Database (Denmark)

    Kløvgaard, Marius; Nielsen, Nina Odgaard; Sørensen, Thomas Lund


    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......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...... cohorts. METHODS AND DESIGN: In a retrospective, descriptive follow-up of the Ivaaq (The Greenland Child Cohort) and the CLEAR (climate changes, environmental contaminants and reproductive health) birth cohorts (total n=1,000), we reviewed medical records of children aged 6-10 in 2012 with residence...

  7. Interruptions of antiretroviral therapy in children and adolescents with HIV infection in clinical practice: a retrospective cohort study in the USA

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    Natella Rakhmanina


    Full Text Available Introduction: Changes in combination antiretroviral therapy (cART throughout childhood challenge the continuity of paediatric HIV treatment. This study aimed to evaluate the prevalence of treatment interruption (TI, including lamivudine (3TC monotherapy, and the relationship of TI to virologic and immunologic parameters in HIV-infected paediatric patients. Methods: Nested within a prospective observational study of a city-wide cohort of HIV-infected persons in the District of Columbia, this sub-study collected retrospective data on antiretroviral therapy, enrolment (endpoint and historic (lifelong CD4 counts and HIV RNA viral load (VL of the paediatric cohort. TI was defined as interruption of cART ≥4 consecutive weeks. Data on TI, including 3TC monotherapy TI (MTI, were collected. Descriptive statistics and univariate testing were used to compare children with TI and MTI to children on continuous treatment (CT. Results: Thirty-eight (28% out of 136 enrolled children (median age=12.9 years experienced TI, with 14 (37% of those placed on 3TC MTI. Significantly lower endpoint median CD4 counts (598 cells/mm3 vs. 815 cells/mm3; p=0.003 and CD4% (27.5% vs. 33%; p=0.006 were observed in the TI cohort as compared to the CT cohort. The median endpoint VL in the overall TI cohort was ~4 times higher than among the CT cohort (1427 copies/mL vs. 5581 copies/mL; p<0.0001. After a median TI duration of one year, a majority (n=31; 82% of patients with TI restarted cART, including 100% of those with total TI and 53% of those on MTI, respectively. Conclusions: In our study, we observed high frequency of the TI in HIV in paediatric HIV clinical practice. All TIs, including 3TC MTI, were associated with significantly lower endpoint median CD4 counts and higher median VLs, as compared to CT in paediatric patients. The high frequency of TI and associated poor outcomes suggest a need for a better strategy in managing the course of the paediatric and adolescent cART.

  8. Retrospective review of bone mineral metabolism management in end-stage renal disease patients wait-listed for renal transplant

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    Chavlovski A


    Full Text Available Anna Chavlovski,1 Greg A Knoll,1–3 Timothy Ramsay,4 Swapnil Hiremath,1–3 Deborah L Zimmerman1–31University of Ottawa, 2Ottawa Hospital, 3Kidney Research Centre, Ottawa Hospital Research Institute, 4Ottawa Methods Centre, Ottawa, ON, CanadaBackground: In patients with end-stage renal disease, use of vitamin D and calcium-based phosphate binders have been associated with progression of vascular calcification that might have an impact on renal transplant candidacy. Our objective was to examine management of mineral metabolism in patients wait-listed for renal transplant and to determine the impact on cardiac perfusion imaging.Methods: Data was collected retrospectively on patients wait-listed for a renal transplant (n = 105, being either active (n = 73 and on hold (n = 32. Demographic data, medications, serum concentrations of calcium, phosphate, parathyroid hormone, and cardiac perfusion imaging studies were collected from the electronic health record. Chi-square and Student’s t-tests were used to compare active and on-hold patients as appropriate. Logistic regression was used to examine variables associated with worsening cardiac imaging studies.Results: The wait-listed patients were of mean age 56 ± 14 years and had been on dialysis for 1329 ± 867 days. On-hold patients had received a significantly greater total dose of calcium (2.35 ± .94 kg versus 1.49 ± 1.52 kg; P = 0.02 and were more likely to have developed worsening cardiovascular imaging studies (P = 0.03. Total doses of calcium and calcitriol were associated with worsening cardiovascular imaging studies (P = 0.05.Conclusion: Patients on hold on the renal transplant waiting list received higher total doses of calcium. A higher total dose of calcium and calcitriol was also associated with worsening cardiovascular imaging. Time on dialysis before transplant has been associated with worse post-transplant outcomes, and it is possible that the total calcium and calcitriol dose

  9. Skin cancers among Albinos at a University teaching hospital in Northwestern Tanzania: a retrospective review of 64 cases

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    Mabula Joseph B


    Full Text Available Abstract Background Skin cancers are a major risk associated with albinism and are thought to be a major cause of death in African albinos. The challenges associated with the care of these patients are numerous and need to be addressed. The aim of this study was to outline the pattern and treatment outcome of skin cancers among albinos treated at our centre and to highlight challenges associated with the care of these patients and proffer solutions for improved outcome. Methods This was a retrospective study of all albinos with a histopathological diagnosis of skin cancer seen at Bugando Medical Centre from March 2001 to February 2010. Data collected were analyzed using descriptive statistics. Results A total of 64 patients were studied. The male to female ratio was 1.5:1. The median age of patients was 30 years. The median duration of illness at presentation was 24 months. The commonest reason for late presentation was financial problem. Head and the neck was the most frequent site afflicted in 46(71.8% patients. Squamous cell carcinoma was the most common histopathological type in 75% of cases. Surgical operation was the commonest modality of treatment in 60 (93.8% patients. Radiotherapy was given in 24(37.5% patients. Twenty-seven (42.2% of the patients did not complete their treatment due to lack of funds. Local recurrence following surgical treatment was recorded in 6 (30.0% patients. Only thirty-seven (61.7% patients were available for follow-up at 6–12 months and the remaining patients were lost to follow-up. Conclusions Skin cancers are the most common cancers among albinos in our environment. Albinism and exposure to ultraviolet light appears to be the most important risk factor in the development of these cancers. Late presentation and failure to complete treatment due to financial difficulties and lack of radiotherapy services at our centre are major challenges in the care of these patients. Early institution of preventive

  10. Contact allergy and allergic contact dermatitis in children - a review of current data

    DEFF Research Database (Denmark)

    Simonsen, Anne Birgitte; Deleuran, Mette; Johansen, Jeanne Duus


    of ACD in children seems to be increasing. In 1999, a review of the literature reported prevalence rates of 14.5-70% in selected paediatric populations. The current paper reviews the studies on the prevalence of positive patch test reactions and ACD in the paediatric population during the past decade...... reactions. Children with atopic dermatitis are as frequently sensitized as children with no history of atopic dermatitis, and there are no differences associated with sex. Children and adults can be tested with equal concentrations of patch test allergens. Our findings may support the notion...

  11. Outcome of hyperleukocytic adult acute myeloid leukaemia: a single-center retrospective study and review of literature. (United States)

    Marbello, Laura; Ricci, Francesca; Nosari, Anna Maria; Turrini, Mauro; Nador, Guido; Nichelatti, Michele; Tedeschi, Alessandra; Vismara, Eleonora; Morra, Enrica


    Hyperleukocytic acute myeloid leukaemia is considered to have a poor prognosis due to high early death rate secondary to leukostasis. Supportive treatments do not seem to have reduced early exitus in this subset of patients. Prognostic impact of hyperleukocytosis on outcome has been the object of few studies. Clinical characteristics and outcome of 45 consecutive adult patients with newly diagnosed acute myeloid leukaemia presenting to our institution with a white cell count (WBC) above 100 x 10(9)L(-1) were reviewed. The outcome of this subset of patients was compared with 200 patients with a leukocyte count lower than 100 x 10(9)L(-1) similarly treated in the same period. Eight hyperleukocytic patients (17%) died of intracranial haemorrhage or pulmonary failure due to leukostasis within the first 7 days of treatment. A significant association was found between complete response (CR) and absence of hyperleukocytosis, but if early deaths were removed from analysis the difference was no longer significant. Hyperleukocytosis also significantly reduces the overall survival (OS) but does not significantly influence the disease-free survival (DFS). We reviewed in literature studies in which the outcome of series of at least 10 patients with hyperleukocytosis were compared with that of patients with a leukocyte count lower than 100 x 10(9)L(-1). Our data were consistent with those of the literature regarding the rate of early mortality and causes of death. In most of the reviewed series hyperleukocytosis does not seem to influence the outcome of patients. Avoiding early death seems to be an important step in this subset of patients. New data about pathophysiology of leukostasis are needed.

  12. Microwaves in the cold war: the Moscow embassy study and its interpretation. Review of a retrospective cohort study

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    Elwood J


    Full Text Available Abstract Background From 1953 to 1976, beams of microwaves of 2.5 to 4.0 GHz were aimed at the US embassy building in Moscow. An extensive study investigated the health of embassy staff and their families, comparing Moscow embassy staff with staff in other Eastern European US embassies. The resulting large report has never been published in peer reviewed literature. Methods The original report and other published comments or extracts from the report were reviewed. Results The extensive study reports on mortality and morbidity, recorded on medical records and by regular examinations, and on self-reported symptoms. Exposure levels were low, but similar or greater than present-day exposures to radiofrequencies sources such as cell phone base stations. The conclusions were that no adverse health effects of the radiation were shown. The study validity depends on the assumption that staff at the other embassies were not exposed to similar radiofrequencies. This has been questioned, and other interpretations of the data have been presented. Conclusions The conclusions of the original report are supported. Contrary conclusions given in some other reports are due to misinterpretation of the results.

  13. Primary pancreatic lymphoma – pancreatic tumours that are potentially curable without resection, a retrospective review of four cases

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    Chin Melvin T


    Full Text Available Abstract Background Primary pancreatic lymphomas (PPL are rare tumours of the pancreas. Symptoms, imaging and tumour markers can mimic pancreatic adenocarcinoma, but they are much more amenable to treatment. Treatment for PPL remains controversial, particularly the role of surgical resection. Methods Four cases of primary pancreatic lymphoma were identified at Prince of Wales Hospital, Sydney, Australia. A literature review of cases of PPL reported between 1985 and 2005 was conducted, and outcomes were contrasted. Results All four patients presented with upper abdominal symptoms associated with weight loss. One case was diagnosed without surgery. No patients underwent pancreatectomy. All patients were treated with chemotherapy and radiotherapy, and two of four patients received rituximab. One patient died at 32 months. Three patients are disease free at 15, 25 and 64 months, one after successful retreatment. Literature review identified a further 103 patients in 11 case series. Outcomes in our series and other series of chemotherapy and radiotherapy compared favourably to surgical series. Conclusion Biopsy of all pancreatic masses is essential, to exclude potentially curable conditions such as PPL, and can be performed without laparotomy. Combined multimodality treatment, utilising chemotherapy and radiotherapy, without surgical resection is advocated but a cooperative prospective study would lead to further improvement in treatment outcomes.

  14. Children with intellectual disabilities and pain perception: a review and suggestions for future assessment protocols

    NARCIS (Netherlands)

    van Dijk, M.; Valkenburg, A.; Boerlage, A.A.; Tibboel, D.; Veerkamp, J.S.


    AIM: This was to review what is known about pain assessment in children with intellectual disabilities and to translate findings into clinical dental practice. Methods: Literature review. Review: The association between anxiety and pain as reported in the literature was explored. The specific pain e

  15. Sublingual immunotherapy in children with allergic rhinitis : quality of systematic reviews

    NARCIS (Netherlands)

    de Bot, Cindy M. A.; Moed, Heleen; Berger, Marjolein Y.; Roeder, Esther; van Wijk, Roy G.; van der Wouden, Johannes C.


    Systematic reviews have gained popularity as a way to combine the increasing amount of research information. This study assessed the quality of systematic reviews and meta-analyses of sublingual immunotherapy (SLIT) for allergic rhinitis in children, published since 2000. Eligible reviews were ident

  16. Food intolerance and food allergy in children: a review of 68 cases. (United States)

    Minford, A M; MacDonald, A; Littlewood, J M


    The clinical and laboratory features of 68 children with food intolerance or food allergy are reviewed. Young children were affected the most with 79% first experiencing symptoms before age 1 year. Forty-eight (70%) children presented with gastrointestinal symptoms (vomiting, diarrhoea, colic, abdominal pain, failure to thrive), 16 (24%) children with skin manifestations (eczema, urticaria, angioneurotic oedema, other rashes), and 4 (6%) children with wheeze. Twenty-one children had failed to thrive before diagnosis. A single food (most commonly cows' milk) was concerned in 28 (41%) cases. Forty (59%) children had multiple food intolerance or allergy; eggs, cows' milk, and wheat were the most common. Diagnosis was based on observing the effect of food withdrawal and of subsequent rechallenge. In many children food withdrawal will mean the use of an elimination diet which requires careful supervision by a dietician. Laboratory investigations were often unhelpful in suggesting or confirming the diagnosis.

  17. Workplace violence in a large correctional health service in New South Wales, Australia: a retrospective review of incident management records

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    Cashmore Aaron W


    Full Text Available Abstract Background Little is known about workplace violence among correctional health professionals. This study aimed to describe the patterns, severity and outcomes of incidents of workplace violence among employees of a large correctional health service, and to explore the help-seeking behaviours of staff following an incident. Methods The study setting was Justice Health, a statutory health corporation established to provide health care to people who come into contact with the criminal justice system in New South Wales, Australia. We reviewed incident management records describing workplace violence among Justice Health staff. The three-year study period was 1/7/2007-30/6/2010. Results During the period under review, 208 incidents of workplace violence were recorded. Verbal abuse (71% was more common than physical abuse (29%. The most (44% incidents of workplace violence (including both verbal and physical abuse occurred in adult male prisons, although the most (50% incidents of physical abuse occurred in a forensic hospital. Most (90% of the victims were nurses and two-thirds were females. Younger employees and males were most likely to be a victim of physical abuse. Preparing or dispensing medication and attempting to calm and/or restrain an aggressive patient were identified as ‘high risk’ work duties for verbal abuse and physical abuse, respectively. Most (93% of the incidents of workplace violence were initiated by a prisoner/patient. Almost all of the incidents received either a medium (46% or low (52% Severity Assessment Code. Few victims of workplace violence incurred a serious physical injury – there were no workplace deaths during the study period. However, mental stress was common, especially among the victims of verbal abuse (85%. Few (6% victims of verbal abuse sought help from a health professional. Conclusions Among employees of a large correctional health service, verbal abuse in the workplace was substantially more

  18. Feeding Problems in Children with Autism Spectrum Disorders: A Review (United States)

    Ledford, Jennifer R.; Gast, David L.


    Many parents of children with autism spectrum disorders (ASD) report that their children have feeding problems. A body of literature targeted toward parents of children with ASD includes information about possible interventions for this problem. Most intervention suggestions within this literature have been only anecdotally reported to be…

  19. Cost-minimization analysis in the treatment of spasticity in children with cerebral palsy with botulinum toxin type A: an observational, longitudinal, retrospective study

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    Gloria Tapias


    Full Text Available Objective: Cost-minimization analysis of onabotulinumtoxinA and abobotulinumtoxinA, taking into account the real dose administered to children with spasticity associated with dynamic equinus foot deformity due to cerebral palsy. Method: A single centre, observational, longitudinal, and retrospective study which included spastic paediatric patients aged 2-to-18-years and treated with onabotulinumtoxinA or abobotulinumtoxinA from December 1995 to October 2012, in the Paediatric Neurology Unit of a first-level Spanish hospital. A longitudinal analysis of spasticity severity was made to confirm the similar efficacy of both treatments. Cost minimization was analyzed using the dose administered and the direct costs (pharmacological and medical visits costs from the perspective of the National Health System (in euros from 2016. Results: We analyzed 895 patients with paediatric spasticity: 543 were treated only with onabotulinumtoxinA, 292 only with abobotulinumtoxinA, and 60 with both treatments. The mean doses administered were 5.44 U/kg (SD = 2.17 for onabotulinumtoxinA, and 14.73 U/kg (5.26 for abobotulinumto xinA. The total annual direct cost (pharmacological and medical visits was € 839.56 for onabotulinumtoxinA and € 631.23 for abobotulinumtoxinA, which represents a difference of € 208.34 per year in favour of treatment with abobotulinumtoxinA Conclusions: It has been demonstrated that in real clinical practice, the cost per patient and year for treatment of paediatric spasticity was lower when abobotulinumtoxinA was used.

  20. The Retrospective Examination of the Reports for the Children with Disabilities Prepared by the Disability Board of Ege University Medical School

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    Ahsen Kaya


    Full Text Available Introduction: To have a child with a disability, whatever the disability is, brings many challenges. In this study, in the light of the related legislation for the determination of the rate of disability, it was aimed to create awareness for the causes of childhood disability and about the problems faced in reporting. Materials and Methods: Reports of subjects under the age of 18 prepared by The Disability Health Board of Ege University between January 1, 2011 and June 30, 2013 regarding age, gender, type and causes of application (personal-formal, disability, disability cause and rates, the reported date and the validity periods of the reports were evaluated retrospectively. The obtained data were analyzed with statistical software. Results: Of 8104 reports, 2839 belonged to children. Of the patients, 978 were females and 1861 were males. The mean age was 7.0±4.6 years. Of the applications, 99.2% were personal applications and the most common reason for application was to have special education (81.6%. 61.4% of the subjects had only one disability. The disability rate of 17.3% was below 40%. Conclusions: Among the countries’ development indicators, the quality of life of the disabled population and the quality of services offered to disabled people occupy an important place. In both national and international platforms, it is necessary to make regulations for prevention of disability, for solution of disabled people’s problems related to health, education, rehabilitation, employment and social security and also for ensuring their participation in society.

  1. A 7-year follow-up retrospective, international, multicenter study of insulin pump therapy in children and adolescents with type 1 diabetes. (United States)

    Mameli, Chiara; Scaramuzza, Andrea E; Ho, Josephine; Cardona-Hernandez, Roque; Suarez-Ortega, Larisa; Zuccotti, Gian Vincenzo


    We evaluated the long-term glycemic control in children with type 1 diabetes, using continuous subcutaneous insulin infusion (CSII) for at least 5 years in three diabetes centers from three different countries: Canada, Italy and Spain. This was an observational retrospective multicenter cohort study. Subjects were included if they were followed at one of the participating centers, had type 1 diabetes, age 5-20 years at time of data collection and used CSII for more than 5 years. Data collected included gender, age, disease duration, age at CSII initiation, body mass index (BMI), hemoglobin A1c (HbA1c), insulin requirement and serious adverse events (SAE) at baseline and every 12 months during follow-up. One hundred fifteen patients were included in the study (55% males), aged 5-20 years (mean: 13.5 ± 3.8 years), with mean diabetes duration of 6.3 ± 3.4 years, using CSII for mean of 6.9 ± 1.2 years (range 5-12 years.). HbA1c significantly improved after 1 year of CSII treatment and during follow-up (p = 0.02). When HbA1c was compared between countries, a difference was observed, with slightly lower values in Italy than in Canada and Spain (p = 0.04). When evaluated by gender, HbA1c was similar at baseline, but significantly improved only in males during all follow-up (p = 0.004). No significant differences were observed for BMI, insulin requirement or SAE. Insulin pump therapy is safe and effective in the pediatric population, although in this study, the major benefit in HbA1c was seen in males. The use of advanced pump features was associated with greater improvement in HbA1c.

  2. 30例儿童隐球菌性脑膜炎的临床分析%Cryptococcal meningitis in children: a retrospective study of 30 cases

    Institute of Scientific and Technical Information of China (English)

    何粒立; 黄延风


    Objective To explore the characteristics of cryptococcal meningitis in children to improve diagnosis and treatment. Methods A retrospective study was performed on the clinical data of 30 children with cryptococcal meningitis.Results Twenty-one males and 9 females were enrolled in this study with mean age of (7.25±3.75) years. The main clinical manifestations included fever (96.67%), vomiting (86.67%), headache (76.67%) and neck rigidity (73.33%). All cases underwent lumbar puncture and the positive rates of India ink smear and culture were 90.00% and 76.67% respectively. Ten cases underwent drug sensitivity tests. Three of 10 showed amphotericin B resistance and 8 of 9 showed fluconazole resistance. Twenty-one cases were treated with amphotericin B or amphotericin B liposome over 7 days. Data analysis showed that the total d osage of amphotericin B or amphotericin B liposome, the average dose and course of treatment during the period of 2007 to 2011 were higher than those of 2001 to 2006 (P 7 d,2007年至2011年收治患儿的两性霉素B或锋克松总用量、平均用量和疗程明显高于2001年至2006年,差异有统计学意义 (P <0.05).结论 儿童隐球菌性脑膜炎多见于学龄前和学龄期儿童,男性多见,以发热、头痛、呕吐、颈项强直为常见临床表现,墨汁染色涂片及真菌培养阳性率高.近年隐球菌性脑膜炎治疗较前困难,可能是因隐球菌对氟康唑耐药现象严重,而且对两性霉素B也有耐药株产生.

  3. Sensorineural hearing loss in children.

    LENUS (Irish Health Repository)

    Wormald, R


    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.

  4. Does pre-ordering tests enhance the value of the periodic examination? Study Design - Process implementation with retrospective chart review

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    Stroebel Robert J


    Full Text Available Abstract Background To evaluate the value of a pre-ordering process for the pro-active scheduling and completion of appropriate preventive and chronic disease monitoring tests prior to a periodic health examination (PHE. Methods A standardized template was developed and used by our nursing staff to identify and schedule appropriate tests prior to the patients PHE. Chart reviews were completed on all 602 PHE visits for a 3-month interval in a primary care setting. A patient satisfaction survey was administered to a convenience sample of the PHE patients. Results Of all the patients with tests pre-ordered, 87.8% completed the tests. All providers in the division used the process, but some evolved from one template to another over time. Most patients (61% preferred to get their tests done prior to their PHE appointment. Many of our patients had abnormal test results. With this process, patients were able to benefit from face-to-face discussion of these results directly with their provider. Conclusions A pre-order process was successfully implemented to improve the value of the PHE visit in an internal medicine primary care practice using a standardized approach that allowed for provider autonomy. The process was accepted by patients and providers and resulted in improved office efficiency through reduced message handling. Completion of routine tests before the PHE office visit can help facilitate face-to-face discussions about abnormal results and subsequent management that otherwise may only occur by telephone.

  5. Pulmonary lymphangitic carcinomatosis from squamous cell carcinoma of the cervix:A retrospective study with review of literature

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    Mamta Singla


    Full Text Available Background: Pulmonary lymphangitic carcinomatosis (LC secondary to cervical squamous cell carcinoma (SCC is an uncommon cause of diffuse infiltrative lung disease. Its reported incidence is quiet low. Materials and Methods: Fifty cases of cervical carcinoma were studied from 2005 to 2014. There was only one case of squamous cell carcinoma cervix that developed pulmonary lymphangitic carcinomatosis subsequently. Clinical manifestations of LC such as dyspnea and non-productive cough can mimic with clinical picture of pneumonia, pneumonitis, pulmonary embolism, congestive heart failure, asthma, and sarcoidosis and thus can be a diagnostic dilemma for treating physician. A review of world literature was also done to examine all the reported cases of cervical carcinoma which presented as pulmonary lymphangitic carcinomatosis. A few cases have been reported so far. Concussion: Pulmonary lymphangitic carcinomatosis is a rare manifestation of metastatic Squamous Cell Carcinoma (SCC of the cervix and is associated with a poor prognosis. Increased clinical alertness of such patterns of metastases in cervical cancer along with accurate pathological diagnosis is compulsory to guide proper therapy in these patients.

  6. Intrarticular Sodium Hyaluronate for the Treatment of Osteoarthritis of the Knee. A Retrospective Review of 45 Patients

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    Yoga R


    Full Text Available Intrarticular Hyaluronic Acid was administered to 45 patients with various grades of osteoarthritis in the knee. Following 3 fortnightly injections, these patients were reviewed at 6 weeks and 3 months with regard to their knee pain. We found that most patients (84.4% had decreased knee pain following these injections. Patients who had severe grade osteoarthritis based on knee radiographs before the injections were less likely to have pain reduction compared to those with milder grade osteoarthritis. Only 4 (8.9% patients showed no improvement and were subsequently considered for surgery. Many patients did not require any further treatment (24.4% and the remaining were given analgesia (64.4% to aid in their pain. One patient required another course of this injection. There were no complications recorded in this study. We concluded that intrarticular Hyaluronic Acid is an easy and safe method to treat osteoarthritis. The short-term outcome with regard to knee pain is good in patients with milder grades of osteoarthritis.

  7. [Epidemiological retrospective survey intestinal parasitism in the Provincial Hospital Center (Kenitra, Morocco): review of 10 years (1996-2005)]. (United States)

    El Guamri, Y; Belghyti, D; Achicha, A; Tiabi, M; Aujjar, N; Barkia, A; El Kharrim, K; Barkia, H; El-Fellaki, E; Mousahel, R; Bouachra, H; Lakhal, A


    The survey drew up the epidemiological situation of intestinal parasitism in the center of health El Idrissi (Kenitra, Morocco). The number of reviews has decreased between 1996 and 2005. A correlation between the number of examinations and years of the study period was observed (p parasited by one or several species, say an infestation index of 14.15%. Amoeba were frequently observed (47.04%) with prevalence of Entamoeba histolytica (23.74%), followed by Flagella (28.79%) represented by: Giardia intestinalis (22.71%), Trichomonas intestinalis (5.49%) and Chilomastix mesnilii (0.60%). Helminthes were less found. Ascaris lumbricoides was frequent among helminthes (11.87%), followed by Trichuris trichiura (5.64%), Hymenolepis nana (2.68%), Enterobius vermicularis (2.08%), Taenia saginata (0.75%) and Stronyloides stercoralis (0.45%). The clinical symptoms were observed in 110 subjects with parasites (110/606 or 18.15%) characterized by abdominal pain (75 cases) and association diarrhea more abdominal pain (35 cases). The relationship between the infestation index calculed, sex, age, the annual and seasonal changes, polyparasitism and intestinal parasitic infection is discussed.

  8. Technology transfer in human vaccinology: a retrospective review on public sector contributions in a privatizing science field. (United States)

    Hendriks, Jan


    As health intervention, vaccination has had a tremendous impact on reducing mortality and morbidity caused by infectious diseases. Traditionally vaccines were developed and made in the western, industrialised world and from there on gradually and with considerable delay became available for developing countries. Today that is beginning to change. Most vaccine doses are now produced in emerging economies, although industrialised countries still have a lead in vaccine development and in manufacturing innovative vaccines. Technology transfer has been an important mechanism for this increase in production capacity in emerging economies. This review looks back on various technology transfer initiatives and outlines the role of WHO and other public and private partners. It goes into a more detailed description of the role of the National Institute of Public Health and the Environment (RIVM) in Bilthoven, the Netherlands. For many decades RIVM has been providing access to vaccine technology by capacity building and technology transfer initiatives not only through multilateral frameworks, but also on a bilateral basis including a major project in China in the 90 s of the previous century. Looking forward it is expected that, in a globalizing world, the ambition of BRICS countries to play a role in global health will lead to an increase of south-south technology transfers. Further, it is argued that push approaches including technology transfer from the public domain, connecting innovative enabling platforms with competent developing country vaccine manufacturers (DCVM), will be critical to ensure a sustainable supply of affordable and quality vaccines to national immunization programmes in developing countries.

  9. PERSIST: Physician's Evaluation of Restasis® Satisfaction in Second Trial of topical cyclosporine ophthalmic emulsion 0.05% for dry eye: a retrospective review

    Directory of Open Access Journals (Sweden)

    Mah F


    Full Text Available Francis Mah,1 Mark Milner,2 Samuel Yiu,3 Eric Donnenfeld,4 Taryn M Conway,5 David A Hollander51University of Pittsburgh, Pittsburgh, PA, 2The Eye Center, Hamden, CT, 3University of Southern California, Los Angeles, CA, 4Ophthalmic Consultants of Long Island and Connecticut, Rockville Centre, New York, NY, 5Allergan Inc, Irvine, CA, USABackground: Chronic dry eye disease often requires long-term therapy. Tear film alterations in the setting of dry eye may include reduced tear volume as well as an increase in inflammatory cytokines and osmolarity. Topical cyclosporine ophthalmic emulsion 0.05% (Restasis®; Allergan Inc, Irvine, CA is indicated to increase tear production in patients with dry eye and reduced tear production presumed to be due to ocular inflammation. This study was designed to evaluate the efficacy of a second trial of topical cyclosporine in patients with dry eye who were previously considered treatment failures.Materials and methods: This multicenter (three cornea practices retrospective chart review evaluated clinical outcomes in patients with dry eye who received a second trial of cyclosporine after a prior treatment failure, defined as prior discontinuation of topical cyclosporine after less than 12 weeks.Results: Thirty-five patients, most of whom were female (71.4% and Caucasian (62.9%, were identified. Prior discontinuation was most commonly due to burning/stinging (60%. The median duration of second treatment was 10 months (range 1 week to 45 months. Physician education was provided in the second trial in 97.1% of cases. At initiation of the second trial of cyclosporine, 10 (28.6% patients received courses of topical corticosteroids. Physicians reported on a questionnaire that 80% of patients achieved clinical benefit with a second trial of cyclosporine.Conclusion: A repeat trial with topical cyclosporine can achieve clinical success. Direct patient education via the physician and staff may be key to success. Proper patient

  10. Urotherapy in children: quantitative measurements of daytime urinary incontinence before and after treatment according to the new definitions of the International Children's Continence Society

    NARCIS (Netherlands)

    Mulders, M.M.; Cobussen-Boekhorst, H.; Gier, R.P. de; Feitz, W.F.J.; Kortmann, B.B.M.


    OBJECTIVE: To assess the effectiveness of urotherapy in children with lower urinary tract dysfunction, according to the new definitions of the International Children's Continence Society. MATERIAL AND METHODS: We performed a retrospective review of 122 children (aged 8.8 +/- 2.0 years) treated in an

  11. Nutritional Status of Children with Autism Spectrum Disorders, Cerebral Palsy and Down Syndrome: A Scoping Review

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    Noor Safiza Mohamad Nor


    Full Text Available Introduction: Autism Spectrum Disorders (ASD, Down Syndrome (DS and Cerebral Palsy (CP are the most common disabilities among children. Nutritional status assessment is important as these children are at risk of underweight, overweight or obesity. Therefore, the objectives of this review were to identify evidence on the prevalence of nutritional status of children with DS, CP and ASD, and to determine tools and indicators to measure the nutritional status of these children. Methods: This scoping review was conducted using a framework suggested by Arksey and O'Maley. A comprehensive search was performed to identify published and unpublished works, reviews, grey literature and reports. Inclusion criteria for the search were articles in English published from 1990 to 2014 and related to children with ASD, DS and CP. Titles, abstract, and keywords for eligibility were examined independently by the researchers. Results: A total of 305,268 titles were extracted from electronic databases and other resources. Based on the inclusion criteria, 21 articles were selected for review. The prevalence of overweight or obese children with DS ranged from 33.5% to 43.5%. The prevalence of underweight children with CP was 22.2% to 78.2%. Children with ASD at a younger age were more likely to be overweight or obese compared with normal developing children. The common nutritional indicators used were z-scores for weight-for-age, height-for-age, body mass index-for-age, and head circumference-for-age. Conclusions: Overall, there is emerging evidence on the nutritional status of children with ASD, DS and CP although this is still very limited in developing countries including Malaysia. The evidence shows that children with CP were at risk of being underweight, while children with DS and ASD were at risk of being overweight or obese.

  12. The caries-preventive effect of chlorhexidine varnish in children and adolescents: a systematic review.

    LENUS (Irish Health Repository)

    James, Patrice


    Our purpose was to systematically review the literature on the effectiveness of chlorhexidine varnish for preventing dental caries in children and adolescents and to determine its effectiveness compared to fluoride varnish.

  13. Aid to Families with Dependent Children Quality Control Review Panel Decisions (United States)

    U.S. Department of Health & Human Services — Decisions issued by the Aid to Families with Dependent Children (AFDC) Quality Control Review Panel of the Departmental Appeals Board concerning the AFDC program...

  14. Multiple micronutrient supplementation for improving cognitive performance in children: systematic review of randomized controlled trials

    NARCIS (Netherlands)

    Eilander, A.; Gera, T.; Sachdev, H.S.; Transler, C.; Knaap, van der H.; Kok, F.J.; Osendarp, S.J.M.


    Background: Although multiple micronutrient interventions have been shown to benefit children's intellectual development, a thorough evaluation of the totality of evidence is currently lacking to direct public health policy. Objective: This study aimed to systematically review the present literature

  15. Paraneoplastic Neurologic Syndromes in Children: A Review Article

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    Samin ALAVI


    Full Text Available How to Cite This Article: Alavi S. Paraneoplastic Neurologic Syndromes in Children: A Review Article. Iran J Child Neurol. 2013Summer; 7(3: 6- 14.ObjectiveParaneoplastic neurological syndromes (PNS were initially defined as neurological syndromes with unknown etiology that often associate with cancer. This broad definition may lead to misconception that any neurological syndrome, which coincides with a cancer might be considered as PNS. In the last two decades it has been suggested that PNSs are mainly immune-mediated. The detection of onconeural antibodies has been very helpful in indicating the existence of a tumor and defining a given neurological syndrome as paraneoplastic. However, PNS may occur without onconeural antibodies, and the antibodies can occur with no neurological syndrome; thus, their presence should not be the only condition to define a neurological syndrome as paraneoplastic. Diagnosis of paraneoplastic syndromes in children may result in early detection and treatment of the pediatric cancer and can reduce the neurological damage that is the major source of morbidity in children with successfully treated tumors. This study reviews the presenting symptoms, immunology, and management options for paraneoplastic syndromes, focusing on those most commonly reported in children.References1. Darnell RB, Posner JB. Paraneoplastic syndromes involving the nervous system. N Engl J Med 200316; 349(16:1543-54.2. Siu LL, Chapman W, Moore MJ. Use of the somatostatinanalogue octreotide acetate in the treatment of encephalopathy associated with carcinoid tumor. Case report. Am J Clin Oncol 1997; 20(6: 558-61.3. Bataller L, Dalmau JO. Paraneoplastic disorders of the central nervous system: update on diagnostic criteria and treatment.Semin Neurol 2004 Dec; 24(4: 461-71.4. Graus F, Keime-Guibert F, Reñe R, Benyahia B, RibaltaT, Ascaso C, et al. Anti-Hu-associated paraneoplastic encephalomyelitis: analysis of 200 patients. Brain 2001;124(Pt 6

  16. Young Children's Learning in Art Museums: A Review of New Zealand and International Literature (United States)

    Terreni, Lisa


    In order to examine the existing literature in relation to the benefits of art museum education for the young, as well as to emphasise the literature gap in early childhood education research pertaining to access to and use of art museums by young children, a review of literature that discussed museum education for young children was undertaken. A…

  17. Fibromatoses and related tumors of the hand in children. A clinicopathologic review. (United States)

    Chinyama, C N; Roblin, P; Watson, S J; Evans, D M


    Benign and malignant tumors of the hand are rare in children. This article reviews some of the common tumors that affect the hand in children, with an emphasis on clinico-pathologic correlations. Illustrated case histories on some rare tumors are also included.

  18. Measuring Physical Activity in Children and Youth Living with Intellectual Disabilities: A Systematic Review (United States)

    Hinckson, Erica Aneke; Curtis, Amy


    Accurate assessment of physical activity is necessary in determining levels of physical activity in children living with intellectual disability (ID) and assessing effectiveness of intervention programmes. A systematic review of measures of physical activity in children with ID was undertaken using the PRISMA guidelines. MEDLINE-PubMed, Scopus,…

  19. The Effects of Physical Activity on Children Diagnosed with Attention Deficit Hyperactivity Disorder: A Review (United States)

    Reeves, Matthew Jonathan; Bailey, Richard P.


    Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental psychiatric disorder among children. Despite the noted positive aspects of the disorder, it is often associated with a range of negative outcomes for that are detrimental to children's education and wider well-being. This comprehensive scoping review examined…

  20. The impact of parental cancer on children and the family : a review of the literature

    NARCIS (Netherlands)

    Visser, A; Huizinga, GA; van der Graaf, WTA; Hoekstra, HJ; Hoekstra-Weebers, JEHM


    Objective. Children of cancer patients may go through a distressing time. The aim of this review was to survey present knowledge on the impact of parental cancer on children and the family. Design. Studies published between January 1980 and March 2004 addressing emotional, social, behavioural, cogni

  1. The value of (pre)school playgrounds for children's physical activity level: A systematic review

    NARCIS (Netherlands)

    Broekhuizen, K.; Scholten, A.M.; Vries, S.I. de


    The (pre)school environment is an important setting to improve children's health. Especially, the (pre)school playground provides a major opportunity to intervene. This review presents an overview of the existing evidence on the value of both school and preschool playgrounds on children's health in

  2. 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.


    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: P

  3. Preschool Children's Fundamental Motor Skills: A Review of Significant Determinants (United States)

    Iivonen, S.; Sääkslahti, A. K.


    Fundamental motor skills (FMS) affect children's physical, social, and cognitive development. To plan successful interventions when promoting the development of children's FMS, the underlying positive determinants for the acquisition of FMS competence during preschool years need to be identified. The purpose of this systematic review was…

  4. Communication Partners Supporting Children with Complex Communication Needs Who Use AAC: A Systematic Review (United States)

    Shire, Stephanie Y.; Jones, Nancy


    Communication partners who efficiently use augmentative and alternative communication (AAC) are essential interaction partners for children learning to communicate using AAC. This systematic review examines studies targeting interventions designed to help communication partners support children with complex communication needs who use AAC.…

  5. Cost effectiveness of guideline advice for children with asthma : a literature review

    NARCIS (Netherlands)

    Feenstra, Talitha L; Rutten-Van Mölken, Maureen P M H; Jager, Johannes C; Van Essen-Zandvliet, Liesbeth E M


    Asthma is an important chronic disease among children. This study reviews the cost effectiveness of interventions in the long-term care of asthmatic children and compares these results with treatment advice in four current guidelines. Cost-effectiveness studies were searched for in Medline, Embase,

  6. Measures of Self-Care Independence for Children with Osteochondrodysplasia: A Clinimetric Review (United States)

    Ireland, Penelope; Johnston, Leanne M.


    This systematic review evaluates the validity, reliability, and clinical utility of outcome measures used to assess self-care skills among children with congenital musculoskeletal conditions and assesses the applicability of these measures for children with osteochondrodysplasia aged 0-12 years. Electronic databases were searched to identify…

  7. Strategies for Implementing School-Located Influenza Vaccination of Children: A Systematic Literature Review (United States)

    Cawley, John; Hull, Harry F.; Rousculp, Matthew D.


    Background: The Advisory Committee on Immunization Practices (ACIP) recommends influenza vaccinations for all children 6 months to 18 years of age, which includes school-aged children. Influenza immunization programs may benefit schools by reducing absenteeism. Methods: A systematic literature review of PubMed, PsychLit, and Dissertation Abstracts…

  8. Assessment of Postural Control in Children with Cerebral Palsy: A Review (United States)

    Pavao, Silvia Leticia; dos Santos, Adriana Neves; Woollacott, Marjorie Hines; Rocha, Nelci Adriana Cicuto Ferreira


    This paper aimed to review studies that assessed postural control (PC) in children with cerebral palsy (CP) and describe the methods used to investigate postural control in this population. It also intended to describe the performance of children with CP in postural control. An extensive database search was performed using the keywords: postural…

  9. Children with Cochlear Implants: A Review of Demographics and Communication Outcomes (United States)

    Belzner, Kate A.; Seal, Brenda C.


    Children with severe to profound hearing loss in the United States are diverse in their racial-ethnic backgrounds, comorbid disabilities, socioeconomic levels, and communication modalities. The present article addresses demographic variables and communication outcomes of children with cochlear implants by means of a review of longitudinal studies…

  10. Nasopharyngeal Carcinoma in Children A report of three cases with review of literature

    Directory of Open Access Journals (Sweden)

    Rauf Ahmad, A. Ahad, M. Latif, Rafiq Ahmad, Sajad M. Qazi, *Reyaz A. Tasleem


    Full Text Available Nasopharyngeal carcinoma is rare in children and adolescents. Nevertheless, it is considered to beIhe only tumour of surface epithelium afflicting children and young adults. Three such cases seenom a period of eight years (1990-1997 are reported with a review of relevant literature.

  11. Pain Assessment in Children with Special Needs: A Review of the Literature (United States)

    Quinn, Brenna L.; Seibold, Esther; Hayman, Laura


    Challenges in assessing the pain of children with special needs are created by the differing abilities of these students to self-report pain presence and intensity. This article reports the results of a literature review examining methods of pain assessment for children with special needs. The authors note the need to foster partnerships with…

  12. Violence against children in humanitarian settings: A literature review of population-based approaches. (United States)

    Stark, Lindsay; Landis, Debbie


    Children in humanitarian settings are thought to experience increased exposure to violence, which can impair their physical, emotional, and social development. Violence against children has important economic and social consequences for nations as a whole. The purpose of this review is to examine population-based approaches measuring violence against children in humanitarian settings. The authors reviewed prevalence studies of violence against children in humanitarian contexts appearing in peer-reviewed journals within the past twenty years. A Boolean search procedure was conducted in October 2014 of the electronic databases PubMed/Medline and PsychInfo. If abstracts contained evidence of the study's four primary themes--violence, children, humanitarian contexts and population-based measurement--a full document review was undertaken to confirm relevance. Out of 2634 identified articles, 22 met the final inclusion criteria. Across studies, there was varying quality and no standardization in measurement approach. Nine out of 22 studies demonstrated a relationship between conflict exposure and adverse health or mental health outcomes. Among studies that compared rates of violence between boys and girls, boys reported higher rates of physical violence, while girls reported higher rates of sexual violence. Children in infancy and early childhood were found to be among the most under-researched. Ultimately, the body of evidence in this review offers an incomplete picture regarding the prevalence, nature and impact of violence against children in emergencies, demonstrating a weak evidence base for some of the basic assumptions underpinning humanitarian practice. The development of standardized approaches to more rigorously measure violence against children is urgently needed in order to understand trends of violence against children in humanitarian contexts, and to promote children's healthy development and well-being.

  13. Endoscopic stenting for hilar cholangiocarcinoma: efficacy of unilateral and bilateral placement of plastic and metal stents in a retrospective review of 480 patients

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    Liberato Manuel José


    Full Text Available Abstract Background Endoscopic biliary drainage of hilar cholangiocarcinoma is controversial with respect to the optimal types of stents and the extent of drainage. This study evaluated endoscopic palliation in patients with hilar cholangiocarcinoma using self-expandable metallic stents (SEMS and plastic stents (PS.We also compared unilateral and bilateral stent placement according to the Bismuth classification. Methods Data on 480 patients receiving endoscopic biliary drainage for hilar cholangiocarcinoma between September 1995 and December 2010 were retrospectively reviewed to evaluate the following outcome parameters: technical success (TS, functional success (FS, early and late complications, stent patency and survival. Patients were followed from stent insertion until death or stent occlusion. Patients were divided into 3 groups according to the Bismuth classification (Group 1, type I; Group 2, type II; Group 3, type > III. Results The initial stent insertion was successful in 450 (93.8% patients. TS was achieved in 204 (88.3% patients treated with PS and in 246 (98.8% patients palliated with SEMS (p P P  Conclusions SEMS insertion for the palliation of hilar cholangiocarcinoma offers higher technical and clinical success rates in the ITT analysis as well as lower complication rates and a superior cumulative stent patency when compared with PS placement in all Bismuth classifications. The cumulative patency of bilateral SEMS or PS stents was significantly higher than that of unilateral SEMS or PS stents, with lower occlusion rates in Bismuth II patients.

  14. Variations in chemoprophylaxis for meningococcal disease: a retrospective case note review, analysis of routine prescribing data and questionnaire of general practitioners

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    Neal Keith R


    Full Text Available Abstract Background Invasive meningococcal disease is a significant cause of mortality and morbidity in the UK. Administration of chemoprophylaxis to close contacts reduces the risk of a secondary case. However, unnecessary chemoprophylaxis may be associated with adverse reactions, increased antibiotic resistance and removal of organisms, such as Neisseria lactamica, which help to protect against meningococcal disease. Limited evidence exists to suggest that overuse of chemoprophylaxis may occur. This study aimed to evaluate prescribing of chemoprophylaxis for contacts of meningococcal disease by general practitioners and hospital staff. Methods Retrospective case note review of cases of meningococcal disease was conducted in one health district from 1st September 1997 to 31st August 1999. Routine hospital and general practitioner prescribing data was searched for chemoprophylactic prescriptions of rifampicin and ciprofloxacin. A questionnaire of general practitioners was undertaken to obtain more detailed information. Results Prescribing by hospital doctors was in line with recommendations by the Consultant for Communicable Disease Control. General practitioners prescribed 118% more chemoprophylaxis than was recommended. Size of practice and training status did not affect the level of additional prescribing, but there were significant differences by geographical area. The highest levels of prescribing occurred in areas with high disease rates and associated publicity. However, some true close contacts did not appear to receive prophylaxis. Conclusions Receipt of chemoprophylaxis is affected by a series of patient, doctor and community interactions. High publicity appears to increase demand for prophylaxis. Some true contacts do not receive appropriate chemoprophylaxis and are left at an unnecessarily increased risk.

  15. Predictors of circumferential resection margin involvement in surgically resected rectal cancer: A retrospective review of 23,464 patients in the US National Cancer Database (United States)

    Al-Sukhni, Eisar; Attwood, Kristopher; Gabriel, Emmanuel; Nurkin, Steven J.


    Introduction The circumferential resection margin (CRM) is a key prognostic factor after rectal cancer resection. We sought to identify factors associated with CRM involvement (CRM+). Methods A retrospective review was performed of the National Cancer Database, 2004–2011. Patients with rectal cancer who underwent radical resection and had a recorded CRM were included. Multivariable analysis of the association between clinicopathologic characteristics and CRM was performed. Tumor patients, 13.3% were CRM+. Factors associated with CRM+ were diagnosis later in the study period, lack of insurance, advanced stage, higher grade, undergoing APR, and receiving radiation. Nearly half of CRM+ patients did not receive neoadjuvant therapy. CRM+ patients who did not receive neoadjuvant therapy were more likely to be female, older, with more comorbidities, smaller tumors, earlier clinical stage, advanced pathologic stage, and CEA-negative disease compared to those who received it. Conclusions Factors associated with CRM+ include features of advanced disease, undergoing APR, and lack of health insurance. Half of CRM+ patients did not receive neoadjuvant treatment. These represent cases where CRM status may be modifiable with appropriate pre-operative selection and multidisciplinary management. PMID:26906328

  16. Estimating the Incidence of Suspected Epidural Hematoma and the Hidden Imaging Cost of Epidural Catheterization: A Retrospective Review of 43,200 Cases (United States)

    Henneman, Justin P.; Sandberg, Warren S.


    Introduction Hematoma associated with epidural catheterization is rare, but the diagnosis might be suspected relatively frequently. We sought to estimate the incidence of suspected epidural hematoma after epidural catheterization, and to determine the associated cost of excluding or diagnosing an epidural hematoma through radiologic imaging. Methods We conducted an electronic retrospective chart review of 43,200 patient charts using 4 distinct search strategies and cost analysis, all from a single academic institution from 2001 through 2009. Charts were reviewed for use of radiological imaging studies to identify patients with suspected and confirmed epidural hematomas. Costs for imaging to exclude or confirm the diagnosis were related to the entire cohort. Results In our analysis, over a 9-year period that included 43,200 epidural catheterizations, 102 patients (1:430) underwent further imaging studies to exclude or confirm the presence of an epidural hematoma—revealing 6 confirmed cases and an overall incidence (per 10,000 epidural blocks) of epidural hematoma of 1.38 (95% CI 0, 0.002). Among our patients, 207 imaging studies, primarily lumbar spine MRI, were performed. Integrating Medicare cost expenditure data, the estimated additional cost over a 9-year period for imaging and hospital charges related to identifying epidural hematomas nets to approximately $232,000 or an additional $5.37 per epidural. Discussion About 1 in 430 epidural catheterization patients will be suspected to have an epidural hematoma. The cost of excluding the diagnosis, when suspected, is relatively low when allocated across all epidural catheterization patients. PMID:23924685

  17. Language and Verbal Short-Term Memory Skills in Children with Down Syndrome: A Meta-Analytic Review (United States)

    Naess, Kari-Anne B.; Lyster, Solveig-Alma Halaas; Hulme, Charles; Melby-Lervag, Monica


    This study presents a meta-analytic review of language and verbal short-term memory skills in children with Down syndrome. The study examines the profile of strengths and weaknesses in children with Down syndrome compared to typically developing children matched for nonverbal mental age. The findings show that children with Down syndrome have…

  18. Reviewing the process of preparing children for MRI

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    Hallowell, Leanne M.; Stewart, Shari E. [Royal Children' s Hospital, Department of Educational Play Therapy, Melbourne, Victoria (Australia); Amorim e.Silva, Cicero T. de [Royal Children' s Hospital, Department of Medical Imaging, Melbourne (Australia); King Faisal Specialist Hospital and Research Centre, Pediatric Radiology Section, Radiology Department, Riyadh (Saudi Arabia); Ditchfield, Michael R. [Royal Children' s Hospital, Department of Medical Imaging, Melbourne (Australia)


    MRI is a common medical imaging investigation. Patients, including young children, can be required to keep still for up to 60 min for the study to be completed successfully. Children often find the confined space, noise, need to lie still and possibility of intravenous administration of contrast agent anxiety-provoking and sometimes so distressing that they are unable to cope and require general anaesthesia. A practice MRI intervention was introduced at the Royal Children's Hospital in Melbourne, Australia. The program is conducted by educational play therapists in conjunction with the Department of Medical Imaging. This study explored the effectiveness of this intervention. The intervention was conducted in a practice MRI unit devoid of magnets. Data were collected as a clinical audit with respect to age, gender, times of scans, position in bore, diagnostic scans and movement artefact. Epidata and Stata were used to analyze the data. A total of 291 children were included; their ages ranged from 3 years 7 months to 17 years (mean 7.9 years), and 48.8% were male. Of the 291 children, 218 (74.9%) were considered a pass at practice, 35 (12 %) were considered borderline pass, and diagnostic images were obtained from 218 (96%) of those children who went onto a clinical MRI. We conclude that practice MRI intervention facilitated by educational play therapists is a useful intervention in supporting children to cope with MRI without general anaesthesia. (orig.)

  19. Dentistry to the rescue of missing children: A review

    Directory of Open Access Journals (Sweden)

    Nitika Vij


    Full Text Available Today's society is becoming increasingly unsafe for children: we frequently hear about new incidents of missing children, which lead to emotional trauma for the loved ones and expose systemic failures of law and order. Parents can take extra precautions to ensure the safety of their children by educating them about ways to protect themselves and keep important records of the child such as updated color photographs, fingerprints, deoxyribonucleic acid (DNA samples, etc., handy. However, in spite of all efforts, the problem of missing children still remains. Developments in the field of dentistry have empowered dentists with various tools and techniques to play a pivotal role in tracing a missing child. One such tool is Toothprints, a patented arch-shaped thermoplastic dental impression wafer developed by Dr. David Tesini, a paediatric dentist from Massachusetts. Toothprints enables a unique identification of the missing children not only through the bite impression but also through salivary DNA. Besides the use of Toothprints, a dentist can assist investigating agencies in identifying the missing children in multiple ways, including postmortem dental profiling, labeled dental fixtures, DNA extraction from teeth, and serial number engraving on the children's teeth. More importantly, all these tools cause minimal inconvenience to the individual, making a dentist's role in tracking a missing child even more significant. Thus, the simple discipline of maintaining timely dental records with the help of their dentists can save potential hassles for the parents in the future.

  20. Prevalence of sleep bruxism in children: a systematic review of the literature

    NARCIS (Netherlands)

    Manfredini, D.; Restrepo, C.; Diaz-Serrano, K.; Winocur, E.; Lobbezoo, F.


    The aim of the present investigation was to perform a systematic review of the literature dealing with the issue of sleep bruxism prevalence in children at the general population level. Quality assessment of the reviewed papers was performed to identify flaws in the external and internal validity. C

  1. Factors associated with physical activity in children and adolescents with a physical disability : a systematic review

    NARCIS (Netherlands)

    Bloemen, Manon A T; Backx, FJG; Takken, Tim; Wittink, H; Benner, Joyce; Mollema, Jurgen; de Groot, Janke F.


    AimThe aim of this review was to summarize the important factors associated with participation in physical activity in children and adolescents with physical disabilities. MethodA systematic mixed-studies review was conducted using the databases Academic Search Elite, CINAHL, The Cochrane Library, E

  2. A Review of Literature Pertinent to a Needs Assessment of Children Five to Twelve Years Old. (United States)

    Balk, David

    Literature relevant to the needs assessment of children 5 to 12 years of age is reviewed and variables demonstrated to be factors in healthy or deviant behavior are identified. Problems addressed in the review of literature range from school maladjustment through social deviancy to schizophrenia. Five categories of studies are considered: (1)…

  3. Activities and Participation in Children with Developmental Coordination Disorder: A Systematic Review (United States)

    Magalhaes, L. C.; Cardoso, A. A.; Missiuna, C.


    Purpose: To systematically review all literature published in peer reviewed journals from January 1995 to July 2008 in order to summarize and describe the activity limitations and participation restrictions of children with developmental coordination disorder (DCD). Methods: Multiple databases were systematically searched for articles related to…

  4. Methods for Assessing Sleep in Children with Autism Spectrum Disorders: A Review (United States)

    Hodge, Danelle; Parnell, Andrea M. N.; Hoffman, Charles D.; Sweeney, Dwight P.


    A literature review completed by Bauer and Blunden (2008) determined that compared to objective measures, subjective assessments of sleep for typically developing children (e.g., parental reports) were of limited utility. No comparable literature review has been undertaken to determine whether subjective measures are appropriate for assessing…

  5. Adult Children of Divorce and Intimate Relationships: A Review of the Literature. (United States)

    Christensen, Teresa M.; Brooks, Morgan C.


    Reviews research specific to the effects of parental divorce on adults in terms of relationship issues. Specific purposes of this review are to (a) explore research specific to intimacy and marital attitudes in adult children of divorce, (b) inform couple and family counselors of effects of parental divorce, and (c) relay implications for…

  6. Risk and Protective Factors in Young Children's Adjustment to Parental Divorce: A Review of the Research. (United States)

    Leon, Kim


    Reviews the literature on parental divorce and early childhood development, using developmental psychopathology as an organizing framework. Because this review is unique in its focus on divorce-related issues specific to young children, limitations of existing research are noted and directions for future research are suggested. (Contains 63…

  7. Hereditary spherocytosis and partial splenectomy in children: review of surgical technique and the role of imaging

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    Hollingsworth, Caroline L. [Duke University Medical Center, Department of Radiology, Box 3808, Durham, NC (United States); Rice, Henry E. [Duke University Medical Center, Department of Surgery, Durham, NC (United States)


    The risks associated with total splenectomy, including overwhelming postsplenectomy infection, have led to an interest in the use of partial splenectomy as an alternative surgical option for children with congenital hemolytic anemias and hypersplenism. Partial splenectomy, a procedure designed to remove enough spleen to improve anemia and avoid complications of splenic sequestration while preserving splenic function, has shown promise in children. Radiologic imaging is essential for the preoperative evaluation and postoperative care for children undergoing partial splenectomy and offers a broad range of critical clinical information essential for care of these complex children. It is imperative for radiologists involved in the care of these children to be familiar with the surgical technique and imaging options for these procedures. This article reviews the surgical technique as well as the current status of various diagnostic imaging options used for children undergoing partial splenectomy, highlighting technical aspects and specific clinical information obtained by each modality. (orig.)

  8. Adverse drug reactions associated with asthma medications in children: systematic review of clinical trials

    DEFF Research Database (Denmark)

    Aagaard, Lise; Hansen, Ebba Holme


    Background Respiratory medications are frequently prescribed for use in children. Several studies have reported information on the safety of asthma medications in clinical studies in adults, but information about safety in children is scarce. Objective To review published clinical trials......, age and gender, type and seriousness of ADRs, design, setting, observation period, type of assessors, and funding sources was extracted from the articles. Results Literature searches resulted in 162 potential relevant articles. However only 12 of these studies were included in this review...... on the occurrence and characteristics of adverse drug reactions (ADRs) in children, reported for asthma medications licensed for paediatric use. Methods We systematically reviewed the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. PubMed, Embase...

  9. [Contact dermatitis in children - a review of current opinions]. (United States)

    Castanedo-Tardan, M P; Matiz, C; Jacob, S E


    In the not so distant past, in the United States contact dermatitis was considered to be a condition that affected mainly adults. The diagnosis was certainly less often rendered in pediatrics, mainly because it was believed that a child's immune system was immature and that children were generally exposed to fewer allergens. With this in mind, we can attribute the low prevalence formerly reported for this disease partly to the fact that most affected children were not (and are still not) evaluated using appropriate skin tests. Patch testing in children requires certain modifications, but the international literature of the last decade and US data published in the past year indicate that contact dermatitis is a common condition in the pediatric population and that the prevalence is similar in children and adults.

  10. Evaluation Of Methadone Poisoning in Hospitalized Children: A Short Review

    Directory of Open Access Journals (Sweden)

    Gholamali Maamouri


    Full Text Available Upload poisoning is one of the most dangerous and common poisoning in Iranian children. Depression of the respiratory and central nervous systems may lead to significant toxicity. Even low doses of uploads are dangerous in pediatrics under 6 years old. Methadone is the most toxic of the uploads; small doses as low as a single tablet can lead to death. According to this information we decided to evaluate methadone poisoning in Hospitalized Children

  11. Predictors of children's secondhand smoke exposure at home: a systematic review and narrative synthesis of the evidence


    Sophie Orton; Jones, Laura L; Sue Cooper; Sarah Lewis; Tim Coleman


    BACKGROUND: Children's exposure to secondhand smoke (SHS) has been causally linked to a number of childhood morbidities and mortalities. Over 50% of UK children whose parents are smokers are regularly exposed to SHS at home. No previous review has identified the factors associated with children's SHS exposure in the home. AIM: To identify by systematic review, the factors which are associated with children's SHS exposure in the home, determined by parent or child reports and/or biochemic...

  12. The impact of heat waves on children's health: a systematic review (United States)

    Xu, Zhiwei; Sheffield, Perry E.; Su, Hong; Wang, Xiaoyu; Bi, Yan; Tong, Shilu


    Young children are thought to be particularly sensitive to heat waves, but relatively less research attention has been paid to this field to date. A systematic review was conducted to elucidate the relationship between heat waves and children's health. Literature published up to August 2012 were identified using the following MeSH terms and keywords: "heatwave", "heat wave", "child health", "morbidity", "hospital admission", "emergency department visit", "family practice", "primary health care", "death" and "mortality". Of the 628 publications identified, 12 met the selection criteria. The existing literature does not consistently suggest that mortality among children increases significantly during heat waves, even though infants were associated with more heat-related deaths. Exposure to heat waves in the perinatal period may pose a threat to children's health. Pediatric diseases or conditions associated with heat waves include renal disease, respiratory disease, electrolyte imbalance and fever. Future research should focus on how to develop a consistent definition of a heat wave from a children's health perspective, identifying the best measure of children's exposure to heat waves, exploring sensitive outcome measures to quantify the impact of heat waves on children, evaluating the possible impacts of heat waves on children's birth outcomes, and understanding the differences in vulnerability to heat waves among children of different ages and from different income countries. Projection of the children's disease burden caused by heat waves under climate change scenarios, and development of effective heat wave mitigation and adaptation strategies that incorporate other child protective health measures, are also strongly recommended.

  13. Social competence in children with brain disorders: a meta-analytic review. (United States)

    Kok, Tessa B; Post, Wendy J; Tucha, Oliver; de Bont, Eveline S J M; Kamps, Willem A; Kingma, Annette


    Social competence, i.e. appropriate or effective social functioning, is an important determinant of quality of life. Social competence consists of social skills, social performance and social adjustment. The current paper reviews social skills, in particular emotion recognition performance and its relationship with social adjustment in children with brain disorders. In this review, normal development and the neuro-anatomical correlates of emotion recognition in both healthy children and adults and in various groups of children with brain disorders, will be discussed. A systematic literature search conducted on PubMed, yielded nine papers. Emotion recognition tasks were categorized on the basis of task design and emotional categories to ensure optimal comparison across studies before an explorative meta-analysis was conducted. This meta-analytic review suggests that children with brain disorders show impaired emotion recognition, with the recognition of sad and fearful expressions being most impaired. Performance did not seem to be related to derivative measures of social adjustment. Despite the limited number of studies on a variety of brain disorders and control groups, outcomes were quite consistent across analyses and corresponded largely with the existing literature on development of emotion recognition in typically developing children. More longitudinal prospective studies on emotion recognition are needed to gain insight into recovery and subsequent development of children with distinct brain disorders. This will aid development, selection and implementation of interventions for improvement of social competence and quality of life in children with a brain disorder.

  14. Clinical significance of coryneform Gram-positive rods from blood identified by MALDI-TOF mass spectrometry and their susceptibility profiles - a retrospective chart review. (United States)

    Mushtaq, Ammara; Chen, Derrick J; Strand, Gregory J; Dylla, Brenda L; Cole, Nicolynn C; Mandrekar, Jayawant; Patel, Robin


    With the advent of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), most Gram-positive rods (GPRs) are readily identified; however, their clinical relevance in blood cultures remains unclear. Herein, we assessed the clinical significance of GPRs isolated from blood and identified in the era of MALDI-TOF MS. A retrospective chart review of patients presenting to the Mayo Clinic, Rochester, MN, from January 1, 2013, to October 13, 2015, was performed. Any episode of a positive blood culture for a GPR was included. We assessed the number of bottles positive for a given isolate, time to positivity of blood cultures, patient age, medical history, interpretation of culture results by the healthcare team and whether infectious diseases consultation was obtained. We also evaluated the susceptibility profiles of a larger collection of GPRs tested in the clinical microbiology laboratory of the Mayo Clinic, Rochester, MN from January 1, 2013, to October 31, 2015. There were a total of 246 GPRs isolated from the blood of 181 patients during the study period. 56% (n = 101) were deemed contaminants by the healthcare team and were not treated; 33% (n = 59) were clinically determined to represent true bacteremia and were treated; and 8% (n = 14) were considered of uncertain significance, with patients prescribed treatment regardless. Patient characteristics associated with an isolate being treated on univariate analysis included younger age (P = 0.02), identification to the species level (P = 0.02), higher number of positive blood culture sets (P blood culture sets (P = 0.0005) and lower time to positivity (P = 0.03) were associated with an isolate being treated. 100, 83, 48 and 34% of GPRs were susceptible to vancomycin, meropenem, penicillin and ceftriaxone, respectively.

  15. Long-lasting effects of anti-VEGF/photodynamic combination therapy in the treatment of exudative age-related macular degeneration: a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Silva-Garcia R


    Full Text Available Rosemary Silva-Garcia, Colleen McLellan, Fadi S Shaya, Kent W Small Macula and Retina Institute, Molecular Insight Research Foundation, Cedars-Sinai Medical Towers, Glendale, CA, USA Purpose: To examine the potential long-term benefit of an anti-VEGF/photodynamic therapy (PDT combination on patients treated for wet age-related macular degeneration (AMD.Methods: A retrospective chart review was conducted on 29 eyes (subjects from 26 patients (eight male and 18 female that showed sustained, positive response to combination therapy for exudative AMD for a minimum of 1 year. Collected data included: visual acuity, central retinal thickness, intraocular pressure and history of glaucoma, wet AMD onset and treatment history, concomitant use of anticoagulants and past history or development of cerebrovascular or cardiovascular disease while receiving combination therapy. Results: Subjects underwent an average of five injections and two PDT treatments in total over 16 months before the choroidal neovascular membrane (CNVM stabilized and became inactive for at least 1 year. Prior to the effective anti-VEGF/PDT combination therapy the median Snellen visual acuity ranged from 20/200 to 20/250 and presented at no worse than 20/200 at 1 year after treatment. Some subjects were followed for up to 5 years and remained inactive.Conclusion: Combination therapy can cause long-lasting closure of the CNVM, even with advanced disease resistant to anti-VEGF monotherapy. Keywords: anti-vascular endothelial growth factor, photodynamic therapy, age-related macular degeneration, bevacizumab, visual acuity, intraocular pressure

  16. Overweight and Obesity among Children with Developmental Disabilities (United States)

    De, Sukanya; Small, Jacqueline; Baur, Louise A.


    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…

  17. Pulmonary tuberculosis in severely-malnourished or HIV-infected children with pneumonia: a review. (United States)

    Chisti, Mohammod Jobayer; Ahmed, Tahmeed; Pietroni, Mark A C; Faruque, Abu S G; Ashraf, Hasan; Bardhan, Pradip K; Hossain, Iqbal; Das, Sumon Kumar; Salam, Mohammed Abdus


    Presentation of pulmonary tuberculosis (PTB) as acute pneumonia in severely-malnourished and HIV-positive children has received very little attention, although this is very important in the management of pneumonia in children living in communities where TB is highly endemic. Our aim was to identify confirmed TB in children with acute pneumonia and HIV infection and/or severe acute malnutrition (SAM) (weight-for-length/height or weight-for-age z score nutritional oedema). We conducted a literature search, using PubMed and Web of Science in April 2013 for the period from January 1974 through April 2013. We included only those studies that reported confirmed TB identified by acid fast bacilli (AFB) through smear microscopy, or by culture-positive specimens from children with acute pneumonia and SAM and/or HIV infection. The specimens were collected either from induced sputum (IS), or gastric lavage (GL), or broncho-alveolar lavage (BAL), or percutaneous lung aspirates (LA). Pneumonia was defined as the radiological evidence of lobar or patchy consolidation and/or clinical evidence of severe/ very severe pneumonia according to the WHO criteria of acute respiratory infection. A total of 17 studies met our search criteria but 6 were relevant for our review. Eleven studies were excluded as those did not assess the HIV status of the children or specify the nutritional status of the children with acute pneumonia and TB. We identified only 747 under-five children from the six relevant studies that determined a tubercular aetiology of acute pneumonia in children with SAM and/or positive HIV status. Three studies were reported from South Africa and one each from the Gambia, Ethiopia, and Thailand where 610, 90, 35, and 12 children were enrolled and 64 (10%), 23 (26%), 5 (14%), and 1 (8%) children were identified with active TB respectively, with a total of 93 (12%) children with active TB. Among 610 HIV-infected children in three studies from South Africa and 137 SAM children

  18. Bacterial Interstitial Nephritis in Children


    Bobadilla Chang, Fernando; Departamento de Ciencias Dinámicas Facultad de Medicina Universidad Nacional Mayor de San Marcos Lima, Perú; Villanueva, Dolores; Departamento de Ciencias Dinámicas Facultad de Medicina Universidad Nacional Mayor de San Marcos Lima, Perú


    OBJECTIVE: To assess the diagnosis approach to urinary tract infections in children. MATERIAL AND METHODS: Medical records from 103 children with diagnosis of interstitial bacterial nephritis were retrospectively reviewed. Diagnosis was supported by the dramatic involvement of renal parenquima, which is not addressed as "urinary tract infection". RESULTS: From all 103 patients, 49 were 2-years-old or younger, 33 were between 2 and 5-years-old, and 21 were between 6 to 10. Clinical picture inc...

  19. Parental factors associated with obesity in children with disability: a systematic review. (United States)

    McGillivray, J; McVilly, K; Skouteris, H; Boganin, C


    The current literature on obesity in typically developing children shows that the family context, and specifically the way parents parent their children are major determinants of childhood obesity. The influence of these factors on obesity in children with disability, however, remains unclear. A systematic review of the literature was undertaken to identify the parental and parenting risk factors associated with obesity in children and adolescents with disability. Articles were identified through Medline, Academic Search Complete, PsycINFO, ProQuest, ISI, CINAHL, Cochrane and Scopus databases. There was no restriction on publication dates. The inclusion criteria were empirical papers that tested associations between parental and parenting risk factors and obesity in children and adolescents with intellectual and other developmental disabilities. Only 11 studies met the selection criteria and subsequently included in this review. Results suggest that obesity in children and adolescents with disability may be associated with socioeconomic status; parents' body mass index, perception and attitude towards their children's weight and physical activity; and levels of activity in both parents and children. Firm conclusions about these associations cannot be reached, however, due to mixed findings and methodological limitations of the studies. Recommendations for future research are provided.

  20. Oral protein-energy supplements for children with chronic disease: systematic review. (United States)

    Poustie, Vanessa J; Watling, Ruth M; Smyth, Rosalind L


    Growth failure and poor nutritional status are features of children with chronic disease. Oral protein-energy supplements are one of a number of interventions provided with the aim of improving nutritional status in these children. The present paper describes a Cochrane systematic review assessing the efficacy of these products in children with chronic disease. The objective was to examine the evidence that in children with chronic disease oral protein-energy supplements alter nutrient intake, nutritional indices, survival and quality of life. All randomised controlled trials of the use of oral protein-energy supplements in children with chronic disease were identified through searching electronic databases and hand searching the abstract books of nutrition conferences. Studies identified were independently assessed for eligibility and methodological quality, and data on outcomes of interest were combined in a meta-analysis where possible. Two trials were eligible for inclusion in the review, both of which were undertaken with children with cystic fibrosis. No statistical differences could be found between treatment and control groups when data from both studies were combined. Oral protein-energy supplements are widely used to improve the nutritional status of children with chronic disease. No conclusions can be drawn on the efficacy of these products based on the limited data available. Further randomised controlled trials are required to investigate the use of these products in children with chronic disease. Until further data are available, these products should be used with caution.

  1. Overweight, physical activity and high blood pressure in children: a review of the literature. (United States)

    Torrance, Brian; McGuire, K Ashlee; Lewanczuk, Richard; McGavock, Jonathan


    Obesity is a growing problem in developed countries and is likely a major cause of the increased prevalence of high blood pressure in children. The aim of this review is to provide clinicians and clinical scientists with an overview of the current state of the literature describing the negative influence of obesity on blood pressure and it's determinants in children. In short, we discuss the array of vascular abnormalities seen in overweight children and adolescents, including endothelial dysfunction, arterial stiffening and insulin resistance. We also discuss the potential role of an increased activation of the sympathetic nervous system in the development of high blood pressure and vascular dysfunction associated with obesity. As there is little consensus regarding the methods to prevent or treat high blood pressure in children, we also provide a summary of the evidence supporting relationship between physical activity and blood pressure in children and adolescents. After reviewing a number of physical activity intervention studies performed in children, it appears as though 40 minutes of moderate to vigorous aerobic-based physical activity 3-5 days/week is required to improve vascular function and reduce blood pressure in obese children. Future studies should focus on describing the influence of physical activity on blood pressure control in overweight children.

  2. Current clinical evidence on the effect of general anesthesia on neurodevelopment in children: an updated systematic review with meta-regression.

    Directory of Open Access Journals (Sweden)

    Xin Wang

    Full Text Available BACKGROUND: Several epidemiological studies have been conducted to address the later effect of anesthesia on neurodevelopment in children. However, the results are still inconclusive. METHODS: We here conducted a systematic review and meta-analysis to summarize the currently available clinical and epidemiologic evidence on the association of anesthesia/surgery with neurodevelopmental outcomes in children by searching PubMed, EMBASE, and Web of Science database (from January-1 2000 to February-1, 2013. The evaluation of neurodevelopment includes language and learning disabilities, cognition, behavioral development, and academic performance. Both retrospective and prospective studies were included. Data were abstracted from seven eligible studies. We estimated the synthesized hazard ratios (HR and 95% confidence interval (CI according to inter-study heterogeneity. RESULTS: The pooled HR for the association of anesthesia/surgery with an adverse behavioral or developmental outcome was 1.25 (95% CI, 1.13-1.38, P<0.001; random-effects model in children undergoing the first anesthesia before the age of 4-year. Then we analyzed the factors for this association using meta-regression method. It showed that it was the number of times of exposure (HR = 1.75, 95% CI 1.31-2.33; P<0.001 rather than the time at exposure before 4-year (HR = 1.08, 95% CI 0.87-1.34 for the effect of per 1-year early exposure; P = 0.47 is a risk factor for neurodevelopmental impairment. CONCLUSION: The current clinical evidence suggests modestly elevated risk of adverse neurodevelopmental outcomes in children who were exposed to anesthesia/surgery during early childhood, especially for those with multiple times of exposure. Due to limitation of retrospective studies, prospective investigations are needed to determine whether anesthesia/surgery is causative.

  3. Brazilian indigenous children: Review of studies about nutritional status

    Directory of Open Access Journals (Sweden)

    Dixis Figueroa Pedraza


    Full Text Available Objective: To systematize studies on the anthropometric nutritional status of Brazilian indigenous children in order to examine the ability to address the totality of biological, anthropological, and ecological aspects, as well as to characterize the main analytical results of the determinants of nutritional status of Brazilian indigenous children. Methods: MedLine and Lilacs were searched using the intersection of "South American Indians" and "nutritional status" descriptors (the search in MedLine also included the descriptor "Brazil". Results: Overall, 65 studies were identified, and 23 were considered relevant to this study. The systematization of these studies highlights the concentration of studies in the midwestern and northern regions of Brazil, as well as the lack of cultural, biochemical, and food consumption approaches. Regarding nutritional status, we found: 1 greater vulnerability of younger children, especially in relation to stunting; 2 absence of differences in nutritional status according to sex; 3 socioeconomic determination of nutritional status; 4 differences in nutritional status between children from different villages. Conclusion: The nutritional status of Brazilian indigenous children is associated with age, socioeconomic status, and ethnic characteristics. Efforts are needed to understand the ethnic and cultural influence on nutritional status and on its causal network, as well as of various factors minimally discussed.

  4. Safety and efficacy of flumazenil for reversal of iatrogenic benzodiazepine-associated delirium toxicity during treatment of alcohol withdrawal, a retrospective review at one center. (United States)

    Moore, Philip W; Donovan, J Ward; Burkhart, Keith K; Waskin, Jeffrey A; Hieger, Michelle A; Adkins, Audrey R; Wert, Yijin; Haggerty, David A; Rasimas, J J


    Both alcohol withdrawal syndrome (AWS) and benzodiazepines can cause delirium. Benzodiazepine-associated delirium can complicate AWS and prolong hospitalization. Benzodiazepine delirium can be diagnosed with flumazenil, a GABA-A receptor antagonist. By reversing the effects of benzodiazepines, flumazenil is theorized to exacerbate symptoms of AWS and precludes its use. For patients being treated for alcohol withdrawal, flumazenil can diagnose and treat benzodiazepine delirium without precipitating serious or life-threatening adverse events. Hospital admission records were retrospectively reviewed for patients with the diagnosis of AWS who received both benzodiazepines and flumazenil from December 2006 to June 2012 at a university-affiliated inpatient toxicology center. The day of last alcohol consumption was estimated from available blood alcohol content or subjective history. Corresponding benzodiazepine, flumazenil, and adjunctive sedative pharmacy records were reviewed, as were demographic, clinical course, and outcome data. Eighty-five patients were identified (average age 50.3 years). Alcohol concentrations were detectable for 42 patients with average 261 mg/dL (10-530 mg/dL). Eighty patients were treated with adjunctive agents for alcohol withdrawal including antipsychotics (n = 57), opioids (n = 27), clonidine (n = 35), and phenobarbital (n = 23). Average time of flumazenil administration was 4.7 days (1-11 days) after abstinence, and average dose was 0.5 mg (0.2-1 mg). At the time of flumazenil administration, delirium was described as hypoactive (n = 21), hyperactive (n = 15), mixed (n = 41), or not specified (n = 8). Response was not documented in 11 cases. Sixty-two (72.9 %) patients had significant objective improvement after receiving flumazenil. Fifty-six patients required more than one dose (average 5.6 doses). There were no major adverse events and minor adverse effects included transiently increased anxiety

  5. In search of quality evidence for lifestyle management and glycemic control in children and adolescents with type 2 diabetes: A systematic review

    Directory of Open Access Journals (Sweden)

    Jetha Mary M


    Full Text Available Abstract Background Our purpose was to evaluate the impact of lifestyle behavior modification on glycemic control among children and youth with clinically defined Type 2 Diabetes (T2D. Methods We conducted a systematic review of studies (randomized trials, quasi-experimental studies evaluating lifestyle (diet and/or physical activity modification and glycemic control (HbA1c. Our data sources included bibliographic databases (EMBASE, CINAHL®, Cochrane Library, Medline®, PASCAL, PsycINFO®, and Sociological Abstracts, manual reference search, and contact with study authors. Two reviewers independently selected studies that included any intervention targeting diet and/or physical activity alone or in combination as a means to reduce HbA1c in children and youth under the age of 18 with T2D. Results Our search strategy generated 4,572 citations. The majority of citations were not relevant to the study objective. One study met inclusion criteria. In this retrospective study, morbidly obese youth with T2D were treated with a very low carbohydrate diet. This single study received a quality index score of Conclusions There is no high quality evidence to suggest lifestyle modification improves either short- or long-term glycemic control in children and youth with T2D. Additional research is clearly warranted to define optimal lifestyle behaviour strategies for young people with T2D.

  6. Book review: 'Four Decades of Marine Geosciences in India - A Retrospect, National Seminar organised in connection with 150 th year celebration of Geological Survey of India. Mangalore 14-16, March 2001'

    Digital Repository Service at National Institute of Oceanography (India)

    Rao, V.P.

    , Geological Survey of India, 27 Jawaharlal Nehru Road, Kolkata - 700 016. 325p, Price INR: 575/-, US$: 32/-, UK?: 20/- Marine Geology is a relatively young branch of Geology. It was initiated in India at the Andhra University, Waltair in the late 40's... REVIEW PROCEEDINGS VOLUME OF THE NATIONAL SEMINAR FOUR DECADES OF MARINE GEOSCIENCES IN INDIA - A RETROSPECT', commemorating 150th year celebration of Geological Survey of India (GSI), Special Publication No.74, Published by the Director General...

  7. Patch-test results in children and adolescents: systematic review of a 15-year period. (United States)

    Rodrigues, Dulcilea Ferraz; Goulart, Eugênio Marcos Andrade


    The number of studies on patch-test results in children and adolescents has gradually increased in recent years, thus stimulating reviews. This paper is a systematic review of a 15-year period devoted to studying the issue. Variations pertaining to the number and age groups of tested children and/or adolescents, the number of subjects with atopy/atopic dermatitis history, the quantity, type and concentrations of the tested substances, the test technique and type of data regarding clinical relevance, must all be considered in evaluating these studies, as they make it harder to formulate conclusions. The most common allergens in children were nickel, thimerosal, cobalt, fragrance, lanolin and neomycin. In adolescents, they were nickel, thimerosal, cobalt, fragrance, potassium dichromate, and Myroxylon pereirae. Knowledge of this matter aids health professionals in planning preventive programs aimed at improving children's quality of life and ensuring that their future prospects are not undermined.

  8. The constraints of connecting children with nature--A research literature review (United States)

    Ponds, Phadrea D.; Schuster, Rudy M.


    Reports or research investigations studying children in nature are rapidly expanding and increasingly diverse. This document reports a review of a particular part of this field-studies of constraints to recreation and participation in environmental and outdoor recreation programs. The findings result from a review of more than 125 journal articles, books, and reports that were published between 1980 and 2009. This report discusses how the current information concerning constraints to participation can be understood in terms of four concentrations or foci of work generated in this particular field of study. These foci, which are all well established in the literature, are (1) intrapersonal, interpersonal, and structural constraints, (2) significant life experiences, (3) environmental attitudes, values and beliefs, and (4) environmental behaviors. The recent research associated with each of these research areas is discussed in successive sections of the review. Overall, this review found that the research on constraints that inhibit children's connection to nature is less diverse in terms of methodological and theoretical approaches than is the research into the broader outdoor recreation research field within which it is situated. This review focused on the issue of connecting children with nature, but examples from studies using adults to understand childhood experiences and recreation preferences were used because there are relatively few peer-reviewed articles showing the theoretical or empirical connection of children and nature. In some cases, broader empirical studies were used to connect with larger themes (that is, environmental attitudes, beliefs, and values).

  9. Post-traumatic Stress Disorder (PTSD) in Children of Conflict Region of Kashmir (India): A Review. (United States)

    Mushtaq, Raheel; Shah, Tabindah; Mushtaq, Sahil


    Post-traumatic stress disorder (PTSD) occurs due to traumatic events. The last two decades have seen various traumatic events in Kashmiri population, which has led to psychological impact on all population, especially children. PTSD is one of the psychiatric disorders occurring after witnessing of traumatic events. A review of literature regarding PTSD in children of Kashmir (India) has been done to assess the prevalence, causes, neurobiology, risk factors and psychiatric co morbidity associated with it.

  10. Modern conceptions about mechanisms of progression process of hip dysplasia in children (review

    Directory of Open Access Journals (Sweden)

    Sertakova А.V.


    Full Text Available In the literature review of modern data concerning mechanisms of formation and progression process of hip dysplasia in children is represented. The questions concerning classification, processes of morphological and functional (biochemical change of osteocartilaginous components of hip in children with connective tissue dysplasia, changes of content of remodeling and skeletal system degradation markers, angiogenesis in the process of progression of pathological changes in joint are taken up

  11. Tufted Angioma in Children: Report of Two Cases and a Review of the Literature

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    Alessandra Dutra da Silva


    Full Text Available Tufted angioma (TA is a benign vascular tumor with endothelial origin. It is extremely rare in oral mucosa; only seven cases have been reported in the literature so far. Here, we describe two cases of tufted angioma observed in children and we also present a review of the literature about this pathology, concerning the differential diagnosis and management of this lesion in children.

  12. Road Traffic Injuries Among Iranian Children and Adolescents: An Epidemiological Review


    Salar Behzadnia; Soheila Shahmohammadi


    Context: Road traffic injuries (RTIs) are the leading cause of death and globally kill 1.2 million people every year and leave 20 - 50 million people injured and disabled. In Iran, traffic related fatalities are the leading cause of death among all inadvertent fatal injuries imposed on children under five. Herein, authors review the epidemiological studies performed on vehicle accidents among Iranian children and adolescents to improve the knowledge about these preventable events...

  13. Distraction methods for pain relief of cancer children submitted to painful procedures: systematic review


    Ferreira, Elaine Barros; Cruz,Flávia Oliveira de Almeida Marques da; Silveira,Renata Cristina de Campos Pereira; Reis,Paula Elaine Diniz dos


    ABSTRACT BACKGROUND AND OBJECTIVES: Pain is one of the most persistent cancer symptoms. Non-pharmacological therapies are potential sources for cancer children care and should be considered alternatives for handling cancer signs and symptoms. This study aimed at identifying effective distraction interventions for pain relief and control of cancer children submitted to invasive procedures. CONTENTS: This is a systematic review carried out in electronic databases LILACS, CINAHL, CENTRAL Cochran...

  14. Prevention programmes for children of problem drinkers: a review

    NARCIS (Netherlands)

    Cuijpers, P.


    It is well established that children of problem drinkers have an increased risk of developing mental health problems, including drinking and drug misuse problems, depression, eating disorders, conduct disorders, and delinquency. However, compared to the hundreds of studies that have examined the eff

  15. Review: Ontogeny of oral drug absorption processes in children

    NARCIS (Netherlands)

    M.G. Mooij (Miriam); B.A.E. Koning, de (Barbara); M.L. Huijsman (Mark); S.N. de Wildt (Saskia)


    textabstractA large proportion of prescribed drugs to children are administered orally. Age-related change in factors affecting oral absorption can have consequences for drug dosing. Areas covered: For each process affecting oral drug absorption, a systematic search has been performed using Medline

  16. Annual research review : conceptualising functional impairment in children and adolescents

    NARCIS (Netherlands)

    Rapee, R.M.; Bogels, S.M.; van der Sluis, Cathy .M.; Craske, M.G.; Ollendick, T.


    Functional impairment is a key factor in the clinical importance of mental health problems in children. Yet, the nature of impairment and criteria for defining and assessing impairment in childhood disorders has been surprisingly overlooked in much of the literature. The current article examines the

  17. Behavioral treatments for children and adults who stutter: a review

    Directory of Open Access Journals (Sweden)

    Blomgren M


    Full Text Available Michael Blomgren Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, UT, USA Abstract: This paper provides a brief overview of stuttering followed by a synopsis of current approaches to treat stuttering in children and adults. Treatment is discussed in terms of multifactorial, operant, speech restructuring, and anxiolytic approaches. Multifactorial and operant treatments are designed for young children who stutter. Both of these approaches involve parent training and differ primarily in their focus on reducing demands on the child (multifactorial or in their use of response contingent stimulation (operant conditioning. Speech restructuring and anxiolytic approaches are used with adults who stutter. Speech restructuring approaches focus on the mechanics of speech production, and anxiolytic treatments tend to focus on the symptoms and social and vocational challenges of stuttering. The evidence base for these different approaches is outlined. Response contingent therapy (for children and speech restructuring therapy (for adults have the most robust empirical evidence base. Multifactorial treatments for children and stuttering management approaches for adults are popular but are based on theoretical models of stuttering; the evidence base is not robust and tends to be inferred from work in areas such as cognitive behavior therapy and desensitization. Comprehensive, or holistic, approaches to treating stuttering are also discussed. Comprehensive approaches for treating stuttering in adults address both improved speech fluency and stuttering management. Keywords: stuttering, treatment, stuttering management, speech restructuring, cognitive restructuring

  18. The Sexual Exploitation of Missing Children: A Research Review. (United States)

    Hotaling, Gerald T.; Finkelhor, David

    This paper evaluates current knowledge about the prevalence, dynamics, and short- and long-term effects of sexual exploitation among missing children. It is based upon empirical research findings from books, papers presented at professional meetings, doctoral dissertations, works in progress, and more than 75 articles in professional journals.…

  19. Sexual abuse of children in residential care : an international review

    NARCIS (Netherlands)

    Timmerman, Margaretha; Schreuder, Pauline


    This paper reports the results of an international review of academic literature on sexual abuse in residential child and youth care, 1945-2011. The review focusses on questions related to the nature and scope of sexual abuse, on personal and institutional factors providing either protection or risk

  20. How to Review a Manuscript for "TEACHING Exceptional Children" (United States)

    Ludlow, Barbara L.; Dieker, Lisa A.; Powell, Selma


    Professional journals are an integral component of information dissemination and professional development in the field of special education. Peer review of manuscripts submitted for consideration for publication in journals is the cornerstone of the professional review process, providing editors with advice about the value of the information…

  1. Surgical treatment of equinus foot deformity in children with cerebral palsy (review

    Directory of Open Access Journals (Sweden)

    Krasnov A.S.


    Full Text Available The review presents data about etiology and pathogenesis of cerebral palsy in children and its clinical manifestations. The effectiveness analysis of main surgical methods to correct equinus foot deformity in children with cerebral palsy has been conducted. The article comes to conclusion that at present surgical methods eliminating all pathologic deformity units are incompletely presented. In this connection high recurrence frequency after using traditional treatment methods is registered. Development of surgical intervention adequate to pathologic foot state in children with cerebral palsy is a perspective direction in treatment of given category of patients

  2. Metacognition and reading in children who are deaf: a review of the research. (United States)

    Strassman, B


    The purpose of this article is to review and synthesize the literature linking metacognition and reading in children who are deaf. Although this body of research is sparse, three issues emerge. First, the research implies that current instructional practices used to teach reading to deaf children might actually hinder their development of mature metacognitive knowledge and control. Second, the studies suggest that the low-level reading material typically given to deaf children might not provide the opportunity for them to develop, practice, or use metacognitive strategies. And third, the research shows that deaf students can benefit from metacognitive strategy instruction.

  3. Primary intracranial soft tissue sarcomas in children, adolescents, and young adults: single institution experience and review of the literature. (United States)

    Maher, Ossama M; Khatua, Soumen; Mukherjee, Devashis; Olar, Adriana; Lazar, Alexander; Luthra, Raja; Liu, Diane; Wu, Jimin; Ketonen, Leena; Zaky, Wafik


    There is a paucity of literature reporting the outcome of intracranial sarcomas (IS) in children, adolescents, and young adults (CAYA). A multimodal therapeutic approach is commonly used, with no well-established treatment consensus. We conducted a retrospective review of CAYA with IS, treated at our institution, to determine their clinical findings, treatments, and outcomes. Immunohistochemistry (PDGFRA and EGFR) and DNA sequencing were performed on 5 tumor samples. A literature review of IS was also conducted. We reviewed 13 patients (median age, 7 years) with a primary diagnosis of IS between 1990 and 2015. Diagnoses included unclassified sarcoma (n = 9), chondrosarcoma (n = 2), and rhabdomyosarcoma (n = 2). Five patients underwent upfront gross total resection (GTR) of the tumor. The 5-drug regimen (vincristine, doxorubicin, cyclophosphamide, etoposide, and ifosfamide) was the most common treatment used. Nine patients died due to progression or recurrence (n = 8) or secondary malignancy (n = 1). The median follow-up period of the 4 surviving patients was 1.69 years (range 1.44-5.17 years). The 5-year progression-free survival and overall survival rates were 21 and 44 %, respectively. BRAF, TP53, KRAS, KIT, ERBB2, MET, RET, ATM, and EGFR mutations were detected in 4 of the 5 tissue samples. All 5 samples were immunopositive for PDGFRA, and only 2 were positive for EGFR. IS remain a therapeutic challenge due to high progression and recurrence rates. Collaborative multi-institutional studies are warranted to delineate a treatment consensus and investigate tumor biology to improve the disease outcome.

  4. A review of "music and movement" therapies for children with autism: embodied interventions for multisystem development. (United States)

    Srinivasan, Sudha M; Bhat, Anjana N


    The rising incidence of Autism Spectrum Disorders (ASDs) has led to a surge in the number of children needing autism interventions. This paper is a call to clinicians to diversify autism interventions and to promote the use of embodied music-based approaches to facilitate multisystem development. Approximately 12% of all autism interventions and 45% of all alternative treatment strategies in schools involve music-based activities. Musical training impacts various forms of development including communication, social-emotional, and motor development in children with ASDs and other developmental disorders as well as typically developing children. In this review, we will highlight the multisystem impairments of ASDs, explain why music and movement therapies are a powerful clinical tool, as well as describe mechanisms and offer evidence in support of music therapies for children with ASDs. We will support our claims by reviewing results from brain imaging studies reporting on music therapy effects in children with autism. We will also discuss the critical elements and the different types of music therapy approaches commonly used in pediatric neurological populations including autism. We provide strong arguments for the use of music and movement interventions as a multisystem treatment tool for children with ASDs. Finally, we also make recommendations for assessment and treatment of children with ASDs, and provide directions for future research.

  5. Use of mefloquine in children - a review of dosage, pharmacokinetics and tolerability data

    Directory of Open Access Journals (Sweden)

    Schaerer Martin T


    Full Text Available Abstract Background Use of anti-malarial medication in children is hampered by a paucity of dosage, pharmacokinetic and tolerability data. Methods Data on the use of mefloquine in children, particularly in young children weighing less than 20 kg, were reviewed using PubMed literature and reports on file. Results Chemoprophylaxis data: Two studies with a total of 170 children were found. A simulated mefloquine plasma profile showed that doses to achieve protective chemoprophylaxis blood concentration of mefloquine of approximately 620 ng/mL (or 1.67 μmol/L in children should be at least 5 mg/kg. This simulated plasma profile in children corresponds to that seen in adult travellers using a weekly prophylaxis dose of 250 mg. This reinforces current practice of using weight-based dosage for children. Clearance per body weight is higher in older children. For children who travel to malaria risk areas tablets can be broken and crushed as required. It is necessary to disguise the bitter taste of the drug. Treatment data: Mefloquine treatment (alone or in combination data are available for more than 6000 children of all age and weight categories. The stereoselectivity and pharmacokinetic profile of mefloquine in children is similar to that observed in adults. There is higher clearance in older children (aged 5-12 years compared to younger children (aged 6-24 months. Mefloquine treatment is well tolerated in infants (5-12 kg but vomiting is a problem at high doses. This led to the use of a "split dose" regimen with 15 mg/kg initially, followed 12 hours later by 10 mg/kg. Mefloquine 125 mg has been used as intermittent preventive treatment (IPT and was found to be efficacious in reducing episodes of malaria in a moderate-transmission setting but vomiting was a problem in 8% of children aged 2-11 months. Mefloquine is also used as a component of artemisinin combination therapy (ACT in small children. The combination artesunate plus mefloquine is a WHO

  6. Emergence of Socially Assistive Robotics in Rehabilitation for Children with Cerebral Palsy: A Review

    Directory of Open Access Journals (Sweden)

    Norjasween Abdul Malik


    Full Text Available Robotic assistive technology is today widely used in rehabilitation. Social assistive robotics (SAR is one of the developing areas of research with potential advantages for areas involving elderly care, people with cognitive impairment, rehabilitation for people with physical disabilities and for educational purposes. Cerebral palsy (CP is a common neurological disorder among children that impairs motor function and may involve cognitive function. The use of social assistive robotic technology serves as a potential approach for CP rehabilitation. The objective of this paper is to review published articles regarding SAR in rehabilitation for children with CP. Twelve published studies have been identified and will be discussed in this review paper.

  7. Safety of Acupuncture and Pharmacopuncture in 80,523 Musculoskeletal Disorder Patients: A Retrospective Review of Internal Safety Inspection and Electronic Medical Records. (United States)

    Kim, Me-Riong; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Ahn, Yong-Jun; Park, Ki Byung; Lee, Hwa Dong; Lee, Yoonmi; Kim, Sung Geun; Ha, In-Hyuk


    We investigated the range and frequency of significant adverse events (AEs) in use of pharmacopuncture and acupuncture using large-scale, single-center safety data as evidence supporting safety of acupuncture with pharmacopuncture, used extensively in Asia, is scarce. Status reports (nurse records in ambulatory and inpatient care units, and administrative event records) as a part of an internal audit at a Korean Medicine hospital specializing in the treatment of musculoskeletal disorders, patient complaints filed through the hospital website, and medical records of patients visiting from December, 2010 (inception of internal audit) to October, 2014 were retrospectively reviewed. A total 80,523 patients (5966 inpatients and 74,557 outpatients) visited during this period. Inpatients received an average 31.9 ± 20.7 acupuncture, 23.0 ± 15.6 pharmacopuncture, and 15.4 ± 11.3 bee venom pharmacopuncture sessions, and outpatients were administered 8.2 ± 12.2 acupuncture, 7.8 ± 11.5 pharmacopuncture, and 10.0 ± 12.3 bee venom sessions, respectively. AEs associated with acupuncture/pharmacopuncture were forgotten needle (n = 47), hypersensitivity to bee venom (n = 37), presyncopic episode (n = 4), pneumothorax (n = 4), and infection (n = 2). Most cases were mild requiring little or no additional intervention and leaving no sequelae. Although serious AEs including infection (n = 2) and anaphylaxis associated with bee venom treatment (n = 3) were also reported, incidence was rare at 0.002% in infection and 0.019% in anaphylaxis. Incidence of AEs associated with acupuncture/pharmacopuncture treatment was low, and most cases were not serious. Still, however rare, avoidable AEs can and should be prevented through education and corrective action. Further prospective studies on the effect of error reduction strategies on incidence of adverse effects are warranted.

  8. Influence of friends on children's physical activity: a review. (United States)

    Maturo, Claire C; Cunningham, Solveig A


    We examined evidence for friendship influences on children's physical activity (PA) through systematic searches of online databases in May 2012. We identified 106 studies (25 qualitative) published in English since 2000 that analyzed indicators of friendship influences (e.g., communication about PA, friends' PA, and PA with friends) among persons younger than 19 years. Children's PA was positively associated with encouragement from friends (43 of 55 studies indicating a positive relationship), friends' own PA (30/35), and engagement with friends in PA (9/10). These findings are consistent with friends influencing PA, but most studies did not isolate influence from other factors that could explain similarity. Understanding friendship influences in childhood can facilitate the promotion of lifelong healthy habits. PA with friends should be considered in health promotion programs.

  9. Allergic contact dermatitis in children: review of the past decade. (United States)

    Admani, Shehla; Jacob, Sharon E


    Allergic contact dermatitis (ACD) is a type IV delayed hypersensitivity reaction. During the last decade, there has been a heightened awareness of this disease in the pediatric population. The gold standard for diagnosis is patch testing. The prevalence of positive patch tests in referred children with suspected ACD ranges from 27 to 95.6 %. The most common allergens in children in North America are nickel, neomycin, cobalt, fragrance, Myroxylon pereirae, gold, formaldehyde, lanolin/wool alcohols, thimerosal, and potassium dichromate. The relationship between ACD and atopic dermatitis (AD) is complicated with conflicting reports of prevalence in the literature; however, in a patient with dermatitis not responding to traditional therapies, or with new areas of involvement, ACD should be considered as part of the work-up.

  10. Solitary rectal ulcer syndrome in children: A literature review


    Dehghani, Seyed Mohsen; Malekpour, Abdorrasoul; HAGHIGHAT, MAHMOOD


    Solitary rectal ulcer syndrome (SRUS) is a benign and chronic disorder well known in young adults and less in children. It is often related to prolonged excessive straining or abnormal defecation and clinically presents as rectal bleeding, copious mucus discharge, feeling of incomplete defecation, and rarely rectal prolapse. SRUS is diagnosed based on clinical symptoms and endoscopic and histological findings. The current treatments are suboptimal, and despite correct diagnosis, outcomes can ...

  11. Road Traffic Injuries Among Iranian Children and Adolescents: An Epidemiological Review

    Directory of Open Access Journals (Sweden)

    Salar Behzadnia


    Full Text Available Context: Road traffic injuries (RTIs are the leading cause of death and globally kill 1.2 million people every year and leave 20 - 50 million people injured and disabled. In Iran, traffic related fatalities are the leading cause of death among all inadvertent fatal injuries imposed on children under five. Herein, authors review the epidemiological studies performed on vehicle accidents among Iranian children and adolescents to improve the knowledge about these preventable events. Evidence Acquisition: International databases including PubMed, Google scholar, science direct Cochrane library, and national data bases such as scientific information database (SID were searched for terms; children, motor vehicle accident, road traffic injuries, Iran 2000 - 2015. Publication in Persian or English language related to the subject including Iranian children and adolescent's age groups were included. Among the 312 articles, 11 (two abstracts and nine full texts were selected. Nine full texts were reviewed. Results: From 22865 victims, about 3578 children and adolescents under 19 years old were identified. Males were more affected than females. Pedestrian injury with 43.66% was the most common case of road traffic injuries. Head trauma was the most common cause of injuries reported by eight of the reviewed articles. Most of the accidents occurred between 1:00 - 6:00 PM. Most of RTIs occurred in summer. Care by emergency medical services (EMS (29.14% was reported by five out of the nine reviewed article. Conclusions: Most of the road traffic injuries among Iranian children and adolescents are preventable using appropriate preventive strategies such as safety facilities, safe vehicles, and safe traffic behavior, and establishing comprehensive public education programs for older children and their parents.

  12. Involving disabled children and young people as partners in research: a systematic review. (United States)

    Bailey, S; Boddy, K; Briscoe, S; Morris, C


    Children and young people can be valuable partners in research, giving their unique perspectives on what and how research should be done. However, disabled children are less commonly involved in research than their non-disabled peers. This review investigated how disabled children have been involved as research partners; specifically how they have been recruited, the practicalities and challenges of involvement and how these have been overcome, and impacts of involvement for research, and disabled children and young people. The INVOLVE definition of involvement and the Equality and Human Rights Commission definition of disability were used. Relevant bibliographic databases were searched. Websites were searched for grey literature. Included studies had involved disabled children and young people aged 5-25 years in any study design. Reviews, guidelines, reports and other documents from the grey literature were eligible for inclusion. Twenty-two papers were included: seven reviews, eight original research papers, three reports, three guidelines and one webpage. Nine examples of involvement were identified. Recommendations included developing effective communication techniques, using flexible methods that can be adapted to needs and preferences, and ensuring that sufficient support and funding is available for researchers undertaking involvement. Positive impacts of involvement for disabled children included increased confidence, self-esteem and independence. Positive impacts for research were identified. Involving disabled children in research can present challenges; many of these can be overcome with sufficient time, planning and resources. More needs to be done to find ways to involve those with non-verbal communication. Generally, few details were reported about disabled children and young people's involvement in studies, and the quality of evidence was low. Although a range of positive impacts were identified, the majority of these were authors' opinions rather

  13. Consensus Review of Best Practice of Transanal Irrigation in Children. (United States)

    Mosiello, Giovanni; Marshall, David; Rolle, Udo; Crétolle, Célia; Santacruz, Bruno G; Frischer, Jason; Benninga, Marc A


    Pediatric patients with either functional or organic bowel dysfunction may suffer from constipation and fecal incontinence and represent a complex group in whom management is often difficult. Many noninvasive and invasive treatments have been proposed, with variable efficacy and adverse effects. Transanal irrigation (TAI) is now an accepted alternative, in both children and adults, for bowel dysfunction that has not responded to conservative and medical therapies. There is, however, still some uncertainty about the use of TAI in pediatric populations. Hence, a group of specialists from different nations and pediatric disciplines, all with long-standing experience of bowel management in children, performed a literature search and had round table discussions to determine the best-practice use of TAI in the pediatric patient population. Based on these findings, this article provides best-practice recommendations on indications, patient selection, important considerations before treatment, patient and family training, treatment regimens, troubleshooting, and practical aspects of TAI. We conclude that careful patient selection, a tailored approach, directly supervised training, and sustained follow-up are key to optimize outcomes with TAI in children with functional or organic bowel dysfunction.

  14. Self-Esteem within Children, Adolescents, and Adults Diagnosed with Attention-Deficit Hyperactivity Disorder: A Review of the Literature. (United States)

    Vine, Frances Louise

    This literature review addresses the question of whether or not children, adolescents, and adults with Attention Deficit Hyperactivity Disorder (ADHD) and the parents of those with ADHD have lowered self-esteem when compared to children, adolescents, and adults without ADHD and the parents of children without ADHD. The research is inconclusive on…

  15. Parental Influences on the Diets of 2-5-Year-Old Children: Systematic Review of Interventions (United States)

    Peters, Jacqueline; Sinn, Natalie; Campbell, Karen; Lynch, John


    During the early years, parents have a major influence on their children's diets, food choices and development of eating habits. However, research concerning the influence of parental feeding practices on young children's diets is limited. This paper presents a systematic review of intervention studies with parents of preschool children. The aim…

  16. Research on the Effects of Television Advertising on Children; A Review of the Literature and Recommendations for Future Research. (United States)

    Adler, Richard P.; And Others

    This report summarizes the present state of knowledge about the effects of television advertising on children. After a discussion of children's television viewing patterns, the report reviews the existing research relevant to such issues as children's ability to distinguish commercials from program material; the influence of format and audiovisual…

  17. Physical Examination Findings Among Children and Adolescents With Obesity: An Evidence-Based Review. (United States)

    Armstrong, Sarah; Lazorick, Suzanne; Hampl, Sarah; Skelton, Joseph A; Wood, Charles; Collier, David; Perrin, Eliana M


    Overweight and obesity affects 1 in 3 US children and adolescents. Clinical recommendations have largely focused on screening guidelines and counseling strategies. However, the physical examination of the child or adolescent with obesity can provide the clinician with additional information to guide management decisions. This expert-based review focuses on physical examination findings specific to children and adolescents with obesity. For each physical examination element, the authors define the finding and its prevalence among pediatric patients with obesity, discuss the importance and relevance of the finding, describe known techniques to assess severity, and review evidence regarding the need for additional evaluation. The recommendations presented represent a comprehensive review of current evidence as well as expert opinion. The goal of this review is to highlight the importance of conducting a targeted physical examination during pediatric weight management visits.

  18. Obesity and overweight in Bangladeshi children and adolescents: a scoping review


    Rahman, Sholeh; Islam, Md Tauhidul; Alam, Dewan S.


    Background Obesity and overweight in children and adolescents is an emerging public health concern alongside under-nutrition in low and middle income countries. Our aim was to conduct a scoping review of literature to ascertain what is known about childhood and adolescent overweight and/or obesity in Bangladesh. Method Using the scoping review based on York methodology, a comprehensive search of published academic articles, conference proceedings and grey literature was carried out through Pu...

  19. School-Based Interventions Targeting Challenging Behaviors Exhibited by Young Children with Autism Spectrum Disorder: A Systematic Literature Review (United States)

    Martinez, Jose R.; Werch, Brittany L.; Conroy, Maureen A.


    The purpose of this review was to critically examine and summarize the impact of school-based interventions designed to decrease challenging behaviors in young children with Autism Spectrum Disorder (ASD). Reviewed studies employed a single-case experimental design, targeted challenging behaviors, included children 3-8 years old with ASD, and took…

  20. A Systematic Review of Cross-Linguistic and Multilingual Speech and Language Outcomes for Children with Hearing Loss (United States)

    Crowe, Kathryn; McLeod, Sharynne


    The purpose of this study was to systematically review the factors affecting the language, speech intelligibility, speech production, and lexical tone development of children with hearing loss who use spoken languages other than English. Relevant studies of children with hearing loss published between 2000 and 2011 were reviewed with reference to…

  1. Therapeutic Effects of Horseback Riding Therapy on Gross Motor Function in Children with Cerebral Palsy: A Systematic Review (United States)

    Whalen, Cara N.; Case-Smith, Jane


    Purpose: This systematic review examined the efficacy of hippotherapy or therapeutic horseback riding (THR) on motor outcomes in children with cerebral palsy (CP). Methods: Databases were searched for clinical trials of hippotherapy or THR for children with CP. Results: Nine articles were included in this review. Although the current level of…

  2. Retrospective Analysis of Food Allergy in Children%儿童食物过敏现状及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    王丽; 程茜


    Objective The study was designed to estimate the status and influential factors of food allergy in order to prevent the disease and provide guidance for paediatric clinic.Methods 403 children with food allergy skin prick test (SPT) strongly positive(++ and +++) from 2004 to 2006 were reviewed.Results The strongly positive rates for SPT in 2004,2005,2006 were 3.35%,3.82%,3.58% respectively.The age of all children who were diagnosed of strongly positive was 6.10 months.Among the 403 samples,54 weren′t introduced complementary food when they were diagnosed,55 were introduced before 4 months,254 beween 4 and 6 months(63.3%),40 after 6 months (9.93%).Of these,344 were sensitized to eggs (85.36%),180 of milk allergy (44.67%),followed by peanut,fish and shrimp.237(58.51%) were sensitized to single food allergen,the rest were sensitized to multitude food allergens (41.19%).The number of children with at least one first-degree relative (parent or sibling) atopic diseases is 121(24.32%),256 weren′t have family history of atopic diseases (63.52%).98 mothers took food of high protein during pregnant and lactation,especially eggs and milk.Conclusion In recent years,there has no significant rise of the strongly positive rates for SPT in Chongqing.The main food allergen is egg ,followed by cow′s milk.The most susceptible age of food allergy was 4~6 months;two-thirds of children weren′t have family history of atopic diseases;a quarter of mothers took food of high protein during pregnant and lactation.%目的 探讨儿童食物过敏的现状及其影响因素,以期为食物过敏的预防及儿科临床工作提供一定的指导.方法 对403例食物过敏皮肤点刺试验(SPT)强阳性(++和+++)患儿进行回顾性分析.结果 2004、2005、2006年儿童食物过敏SPT强阳性率分别为3.55%、3.82%、3.58%,各年的SPT强阳性率比较差异无统计学意义(P>0.05).403例患儿诊断食物过敏的平均月龄为6.10个月.在403例SPT强

  3. The psychological and social impact of camp for children with chronic illnesses: a systematic review update. (United States)

    Moola, F J; Faulkner, G E J; White, L; Kirsh, J A


    Advances in medicine have reduced mortality among children with complex medical conditions, resulting in a growing number of young patients living with chronic illnesses. Despite an improved prognosis, these children experience significant psychosocial morbidity, such as depression and anxiety. Therapeutic summer recreation camps have been proposed as an intervention to enhance quality of life among these children. The purpose of this systematic review was to assess the psychosocial impact of camp for children with chronic illnesses. A systematic review of central databases was undertaken using key words, and a rating tool – the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies – was employed to rate methodological quality. 21 studies were included in this systematic review. Although overall methodological quality was weak, camp participation appeared to offer short-term psychosocial benefits on some parameters in children with a variety of chronic illnesses. There was some consistency in improved social outcomes, such as social interaction and acceptance. Based on the available evidence, it is premature to make robust claims regarding the psychosocial impact of camp as a therapeutic intervention. Theoretically informed camp programs, long-term follow-up, and incorporating camp-based messaging into routine hospital care,may enhance the utility of camp as a potential psychosocial intervention in paediatrics.

  4. Delivering healthcare services to children with cerebral palsy and their families: a narrative review. (United States)

    Hayles, Emily; Jones, Anne; Harvey, Desley; Plummer, David; Ruston, Sally


    Children with cerebral palsy have complex healthcare needs and often require complex multidisciplinary care. It is important for clinicians to understand which approaches to healthcare service delivery for this population are supported in the literature and how these should be applied in clinical practice. This narrative review aims to identify and review the evidence for current approaches to healthcare service delivery for children with cerebral palsy. Databases were searched using key terms to identify relevant research articles and grey literature from December 2011 to September 2013. Search results were screened and sorted according to inclusion and exclusion criteria. Thirty-two documents were included for evaluation and their content was analysed thematically. Three current approaches to healthcare service delivery for children with cerebral palsy identified in this narrative review were family-centred care, the World Health Organisation's International Classification of Functioning, Disability and Health, and collaborative community-based primary care. However, healthcare services for children with cerebral palsy and their families are inconsistently delivered according to these approaches and the identified guidelines or standards of care for children with cerebral palsy have limited incorporation of these approaches. Future research is required to investigate how these approaches to healthcare service delivery can be integrated into clinical practices to enable clinicians to improve services for this population.

  5. Are antidepressants effective in quality of life improvement among children and adolescents? A systematic review. (United States)

    Stevanovic, Dejan; Tadic, Ivana; Knez, Rajna


    There is some evidence indicating that psychotropic medications might lead to health-related quality of life (QOL) improvements among children and adolescents with psychiatric disorders. The aim of this systematic review is to assess evidence regarding whether antidepressant treatment improves QOL among children and adolescents with depressive or anxiety disorders. A comprehensive search resulted in 5 clinical trials to be included in this review: 4 trials with major depressive disorder (MDD) and 1 trial with social anxiety disorder (SAD). In one MDD trial, fluoxetine combined with cognitive behavior therapy (CBT) significantly improved QOL compared to fluoxetine or CBT alone (effect sizes were 0.53 and 0.69, respectively). In 2 combined trials, sertraline alone significantly improved QOL among adolescents with MDD (effect size was 0.29), but not among children with MDD. Essentially, it was observed that antidepressants in these trials had minor positive effects on QOL improvement, which were lower than their potential to improve depressive symptoms. Although fluoxetine with CBT or sertraline monotherapy were shown to have some potential to improve QOL, this systematic review found inconclusive evidence that antidepressant treatments improve QOL among children and adolescents with depressive or anxiety disorders. More research is required, considering that QOL is currently under-evaluated in clinical trials with antidepressants among children and adolescents and available trials have limited methodological quality when reporting QOL data.

  6. The prevalence of urinary tract infection in children with severe acute malnutrition: a narrative review

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    Uwaezuoke SN


    Full Text Available Samuel N Uwaezuoke Department of Pediatrics, Pediatric Nephrology Firm, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria Abstract: This article aims to review the current evidence which shows that the prevalence of urinary tract infection (UTI has been increasing in children with severe acute malnutrition (SAM. UTI remains one of the most common causes of febrile illness in pediatric practice. Most studies conducted among hospitalized children with complicated SAM have reported high prevalence rates of UTI. Clearly, the knowledge of baseline risk of UTI can help clinicians to make informed diagnostic and therapeutic decisions in these children. From the global reports reviewed in this article, UTI prevalence rates range from as low as 6% to as high as 37% in developing countries, while the most common bacterial isolates from urine cultures are Gram-negative coliform organisms such as Escherichia coli and Klebsiella species. These findings form the basis for the current diagnostic and therapeutic guidelines for clinicians managing children with complicated SAM. With the reported high prevalence of UTI among these children and concerns over antibiotic resistance, more extensive data are required using standardized microbiological methods. Thus, the assessment of the performance of urine dipsticks and microscopy against the gold standard urine culture is an important step toward strengthening the evidence for the therapeutic guidelines for UTI in children with SAM. Keywords: protein energy malnutrition, bacterial infection, urinary tract, therapeutic guidelines

  7. Manual function outcome measures in children with developmental coordination disorder (DCD): Systematic review. (United States)

    Bieber, Eleonora; Smits-Engelsman, Bouwien C M; Sgandurra, Giuseppina; Cioni, Giovanni; Feys, Hilde; Guzzetta, Andrea; Klingels, Katrijn


    This study systematically reviewed the clinical and psychometric properties of manual function outcome measures for children with developmental coordination disorder (DCD) aged 3-18 years. Three electronic databases were searched to identify manual function tools at the ICF-CY body function, activity and participation level used in children with DCD. Study selection and data extraction was conducted by two blind assessors according to the CanChild Outcome Measures Rating Form. Nineteen clinical tests (seven fine hand use tools and 12 handwriting measures), three naturalistic observations and six questionnaires were identified. The fine-motor subdomain of the Movement Assessment Battery for Children, the Bruininks-Oseretsky Test of Motor Proficiency-2 and the Functional Strength Measurement, with adequate reliability and validity properties, might be useful for manual function capacity assessment. The Systematic Detection of Writing Problems (SOS) and the Detailed Assessment of Speed of Handwriting (DASH) could be adopted for handwriting assessment, respectively from 6 and 9 years old. Naturalistic observations and questionnaires, whose psychometric properties have been investigated into limited extent, offer an assessment of the daily performances. This review shows that a combination of different tools is needed for a comprehensive assessment of manual function in children with DCD including the three levels of the ICF-CY. Further investigation of psychometric properties of those tools in children with DCD is warranted. Tests validated in other populations should be explored for their applicability for assessing manual function in children with DCD.

  8. A review of music and movement therapies for children with autism: Embodied interventions for multisystem development

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    Anjana Narayan Bhat


    Full Text Available The rising incidence of Autism Spectrum Disorders (ASDs has led to a surge in the number of children needing autism interventions. This paper is a call to clinicians to diversify autism interventions and to promote the use of embodied music-based approaches to facilitate multisystem development. Approximately 12% of all autism interventions and 45% of all alternative treatment strategies in schools involve music-based activities. Evidence suggests that musical training significantly impacts various forms of development including communication, social-emotional, motor, and behavioral development, in children with ASDs, typically developing individuals, and children with other neurological disabilities such as dyslexia and intellectual disabilities. In this review, we first highlight mechanisms and evidence for how music and movement interventions can enhance communication, social-emotional, behavioral, and motor skills in individuals with autism. We will support our claims by reviewing results from brain imaging studies in children with autism that provide neuroanatomical evidence for the effects of music therapies in autism. We will also discuss the critical elements and the different types of music therapy approaches commonly used in pediatric neurological populations including autism. We provide strong arguments for the use of music and movement interventions as a multisystem treatment tool for children with ASDs. Finally, we also make recommendations for assessment and treatment of children with ASDs, and provide directions for future research.

  9. Early mortality and primary causes of death in mothers of children with intellectual disability or autism spectrum disorder: a retrospective cohort study.

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    Jenny Fairthorne

    Full Text Available INTRODUCTION: Mothers of children with intellectual disability or autism spectrum disorder (ASD have poorer health than other mothers. Yet no research has explored whether this poorer health is reflected in mortality rates or whether certain causes of death are more likely. We aimed to calculate the hazard ratios for death and for the primary causes of death in mothers of children with intellectual disability or ASD compared to other mothers. METHODS: The study population comprised all mothers of live-born children in Western Australia from 1983-2005. We accessed state-wide databases which enabled us to link socio-demographic details, birth dates, diagnoses of intellectual disability or ASD in the children and dates and causes of death for all mothers who had died prior to 2011. Using Cox Regression with death by any cause and death by each of the three primary causes as the event of interest, we calculated hazard ratios for death for mothers of children intellectual disability or ASD compared to other mothers. RESULTS AND DISCUSSION: During the study period, mothers of children with intellectual disability or ASD had more than twice the risk of death. Mothers of children with intellectual disability were 40% more likely to die of cancer; 150% more likely to die of cardiovascular disease and nearly 200% more likely to die from misadventure than other mothers. Due to small numbers, only hazard ratios for cancer were calculated for mothers of children with ASD. These mothers were about 50% more likely to die from cancer than other mothers. Possible causes and implications of our results are discussed. CONCLUSION: Similar studies, pooling data from registries elsewhere, would improve our understanding of factors increasing the mortality of mothers of children with intellectual disability or ASD. This would allow the implementation of informed services and interventions to improve these mothers' longevity.

  10. Analysis of Studies on Social Support and Children of Depressed Mothers: A Systematic Review

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    Sonia Regina Loureiro


    Full Text Available Recognizing the conditions that minimize the impact of maternal depression on children has clinical relevance. The present review aimed to analyze recent empirical studies that have investigated the associations between maternal depression and different social support conditions for school-aged children. We systematically reviewed empirical articles indexed from 2007 to 2014 in the following databases: MEDLINE, PubMed, PsycINFO, Web of Science, LILACS and SciELO. Three keywords were used: maternal depression, social support and child behavior. Twenty-seven articles were included and analyzed. These studies included a broad range of contextual risk factors and social support conditions, and in their predictive models, it was found that less contextual risk and greater parental resources and social support were predictors of fewer problems for the children. The identification of social support sources that attenuate the effect of maternal depression on child outcomes has implications for the development of prevention and intervention programs.

  11. [Chronic diseases in children and adolescents: a review of the literature]. (United States)

    Moreira, Martha Cristina Nunes; Gomes, Romeu; Calheiros de Sá, Miriam Ribeiro


    The scope of this article is to analyze papers published between 2003 and 2011 that focus on discussions regarding chronic conditions or chronic diseases in children and adolescents. It combines a methodological review of the literature and thematic analysis of content in order to identify the elements that characterize chronic diseases in children and adolescents and the specificities generated by these chronic conditions. The review of the literature resulted in a description of the series of articles identified by year of publication, country of origin, type of study, population and the chronic condition addressed. Thematic content analysis generated two core themes: Definition of chronic disease and Ways of handling chronic disease in children and teenagers. The main conclusion reached is that the age transitions when a disease is diagnosed and treated since childhood involve transformations that include changes in health facilities, discharge processes, decision making and networking that include family, hospital, school and institutions that guarantee the child's rights.

  12. Common and Uncommon Conditions of Breast Disease in Children and Adolescents: A Pictorial Review

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    Cho, Hyoun; Kim, Kyu Soon; Kim, Da Mi [Dept. of f Radiology, Eulji University Hospital, Daejeon (Korea, Republic of); Kim, You Me [Dept. of Radiology, Dankook University Hospital, Cheonan (Korea, Republic of); Kim, Hak Hee [Dept. of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)


    The purpose of this study is to review various breast diseases in children and adolescents and to illustrate the sonographic findings. We reviewed the cases at our institution in order to identify breast disease in children and adolescent patients who underwent sonography and mammography. Breast disease in children and adolescents included developmental disturbance, infection, benign tumors and inherent defects. In contrast to adults, the radiologic findings of malignant breast conditions in pediatric populations have rarely been reported; however, we show ductal carcinoma in situ with juvenile fibroadenoma and rhabdomyosarcoma. During childhood and adolescence, the recognition and correct identification of physiologic breast development and specific lesions in breast entities on radiologic findings is most helpful in identifying and characterizing abnormalities and in guiding further investigation.

  13. A systematic review of the effect of breakfast on the cognitive performance of children and adolescents. (United States)

    Hoyland, Alexa; Dye, Louise; Lawton, Clare L


    Breakfast is recommended as part of a healthy diet because it is associated with healthier macro- and micronutrient intakes, BMI and lifestyle. Breakfast is also widely promoted to improve cognitive function and academic performance, leading to the provision of breakfast initiatives by public health bodies. Despite this positive and intuitive perception of cognitive benefits, there has been no systematic review of the evidence. Systematic review methodology was employed to evaluate the effects of breakfast on cognitive performance in well-nourished children and nutritionally at-risk or stunted children. Acute experimental studies, school feeding programmes and studies of habitual breakfast intake are reviewed. Comparisons of breakfast v. no breakfast and breakfasts differing in energy and macronutrient composition are discussed. Included are forty-five studies described in forty-one papers published between 1950 and 2008. The evidence indicates that breakfast consumption is more beneficial than skipping breakfast, but this effect is more apparent in children whose nutritional status is compromised. There is a lack of research comparing breakfast type, precluding recommendations for the size and composition of an optimal breakfast for children's cognitive function. Few studies examined adolescents. Studies of school breakfast programmes suggest that such interventions can have positive effects on academic performance, but this may be in part explained by the increased school attendance that programmes encourage. The present systematic review considers methodological issues in this field and makes recommendations for future research design and policy priorities.

  14. Everybody's Business? A Research Review of the Informal Safeguarding of Other People's Children in the UK (United States)

    Holland, Sally; Tannock, Stuart; Collicott, Hayley


    The paper reviews public discourses and research on the safeguarding of other people's children by adults at the neighbourhood level. There is much empirical evidence pointing to the existence of thriving informal communities of support and informal childcare for parents across the social classes. There appears to be less empirical evidence…

  15. Exposure to Metal Pollutants and Behavioral Disorders in Children: A Review of the Evidence.