Articles Related to Pediatric

This study is an attempt to emphasize the prevalence of severe anemia in pediatric age group and characterize different clinical and Hematological findings among them. Anemia is a major global health problem, especially in developing countries like India, despite the fact that this problem is largely preventable & easily treatable. It leads to morbidity and mortality in children and establish a public health problem of substantial importance.

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Cystic fibrosis (CF) is an inherited disorder caused by genetic mutations encoding the cystic fibrosis transmembrane conductance regulator (CFTR) protein. Elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) is a CFTR modulator shown to improve lung function in certain patients with CF. We undertook this study to determine its effects on glycemic outcomes in pediatric patients with cystic fibrosis-related diabetes (CFRD). We reviewed the medical records and identified two subjects, referred to as subject A and subject B, with CFRD on insulin therapy at Duke University Hospital between 2019-2020 who were on treatment with ELX/TEZ/IVA for at least one year. The mean hgbA1C pre- and post- treatment was 5.65% (5.6-5.7) and 5.05% (5.0-5.1) respectively with a mean reduction of 0.6% (p value 0.01). Improvement in hgbA1C occurred in the absence of increased insulin requirements, subject B remained on a similar insulin regimen whereas subject A was able to come off insulin completely. In addition, improvements in BMI z-score were seen in both groups with a mean BMI z-score of -0.30 pre-treatment (-0.71-0.11) and z-score of +0.28 post-treatment (0.11-0.45).

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Introduction: Studies from several countries have shown that there is a lack of knowledge related to child protection among dentists and their teams. So far, there are no data available about the situation in Germany. Aim of this study is to describe the perception of the role of German dentists in terms of child abuse and neglect. Material and Methods: A questionnaire previously used by other studies regarding the role of dentists in child protection was adapted to German terminology and provided online. The internet address has been shown in different German dentists’ association journals addressing dentists only. The participation was voluntary. Results: A total of 251 (79.68%) dentists completed the questionnaire with valid data, 62.5% reported to have had a sus- picion of child abuse or neglect. Of these, 21,7% had reported their suspicion to the social services. Dentists specialized in pediatric dentistry reported their suspicion more often. Most frequently reported barriers towards contacting social services were uncertainty about diagnosis, fear of violence towards the child and the lack of knowledge in terms of referral procedures. Most of the participants expressed a need for further education. Conclusion: Dentists in Germany are not able to fill their role in child protection matters sufficiently and show a need for undergraduate and continuing postgraduate training.

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Pediatric cancer overall survival has increased due to improvements in treatment. However, long-term adverse effects are a challenge for this population. Secondary myeloid neoplasm (MN) is one of the complications of solid tumor treatment. Therapy-related myeloid neoplasms (t-MN), therapy-related acute myeloid leukemia (t-AML), and therapy-related myelodysplastic syndrome (t-MDS) are the most common events. The aim of this study was to report a large pediatric sample and the relevance of t-MN after pediatric solid tumor therapy. We conducted a retrospective study between 2000-2016 in a cohort of pediatric patients treated for solid tumors who developed a secondary MN by medical records review and analysis. Seven from 2178 pediatric patients who were previously treated for solid tumors, were diagnosed with t-MN in a reference cancer center in Brazil. The median age at primary tumor diagnosis was 12.8 years old. Osteosarcoma, atypical primitive neuroectodermal tumor (PNET), Ewing sarcoma, and retinoblastoma were the most frequent solid tumors associated with t-MN. Three patients had a story of familiar cancer, and one patient with osteosarcoma had Li-Fraumeni syndrome confirmed. The median latency period to secondary MN was ten months and the prevalence rate was 0.32%. Two patients developed t-MDS and five, t-AML. All these patients received cytotoxic agents’ high doses that may have been associated with t-MN development. t-MN initial control, as well as unfavorable cytogenetic abnormalities, may have contributed to the poor outcome. We described the rarity of t-MN related to previous solid tumor therapy in a large pediatric sample in a Brazilian Cancer Center and their poor prognosis.

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Laryngotracheal stenosis is one of the important causes of pediatric airway obstruction, and the etiology can be classified as congenital and acquired. With the widespread use of tracheal intubation and tracheotomy in pediatric emergency, iatrogenic laryngotracheal stenosis is gradually replacing trauma and infection as the major cause of acquired laryngotracheal stenosis [1]. Nowadays, open surgery is the first choice for severe laryngotracheal stenosis cases [1,2]. Here, we describe a case of childhood iatrogenic severe laryngotracheal stenosis, and the reflection on the current treatment methods of children with laryngotracheal stenosis.

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A 9 year old boy refered to the hospital with abdominal pain insisting for 2 weeks. In his history there was any clinic symptom before. A giant opasification was detected in the distal part of the right ureter on plain abdominal film. Hematuria, hyperuricosuria, hyperoxaluria and hypocitraturia in his urinary analysis. Only a small right kidney (right kidney: 62x25mm; left kidney: 100x35mm) has found in the abdominal ultarsonography and an approximately a stone 42x17mm in seizes has detected in the magnetic resonance urography.

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An eight-year-old boy with Kabuki Syndrome (KS) and an enlarging CNS mass is presented. The ‘tumor’ was discovered incidentally during MR imaging for a behavioral disorder and was located within the left globus pallidus. Retrospective review of previous MRIs showed no abnormality in the basal ganglia seven years earlier but a small region (a few pixels) of increased in T2 signal intensity three years earlier.

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It is essential for practitioners to recognize the pathophysiology of commonly presenting infectious diseases and their mode of transmission. This allows healthcare workers to provide a safe perioperative experience for the patient as well as engage in appropriate infection control practices. There are a number of noteworthy pediatric respiratory infections, such as the novel coronavirus, known as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and pulmonary tuberculosis.

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Tooth decay is a progressive disease caused by acid fermentation of carbohydrates by pathogenic microorganisms in the mouth, leading to demineralization of teeth.

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Chest x-rays (CXR) are frequently used in the diagnosis of pneumonia in pediatrics patient. The lateral projection produces more than double the effective patient dose than the frontal (anterior-posterior (AP)/ posterior-anterior (PA)) projection in CXR series, with potentially little assistance in diagnosing disease.

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Stridor in children is not uncommon reason to visit emergency department and usually due to croup but inhalation of toxic substance may cause severe stridor which is uncommon

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Congenital malformations can go unnoticed and have an impact on morbidity and mortality in early stages of life being a cause of infant death in some countries [1]. Malformations of the gastrointestinal tract occupy the second place among congenital abnormalities [2]. Along with them, the enteric duplication cyst is an infrequent anomaly difficult to diagnose specially for a non-specialist physician that is not use to attend this kind of pathologies or in hospitals where patients with this entities are infrequent. We present the case of a 5-month-old patient who underwent intestinal resection due to enteric duplication cyst.

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Celiac disease (CD) is a systemic chronic immune-mediated disorder that is associated with weight loss, diarrhea, and laboratory abnormalities. Celiac disease (CD) is a disease in which the mucosal lining of the small intestine is damaged in response to the ingestion of gluten and similar proteins, which are found in wheat, oats, rye, barley and other grains. Children with CD are very common [1].

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Patients under two years of age who were admitted Emergency Department (ED) within three months due to MHT and who underwent cranial CT scan were included in the study. Trauma mechanisms, Glasgow Coma Scale (GCS) scores, symptoms (crying/unrest, vomiting, to refuse eating, drowsiness, loss of consciousness) and clinical signs (hyperemia/ecchymosis, abrasion, skin laceration, cephalohematoma, fontanel bulging) were retrospectively screened.

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Antibiotics are one of the most widely used groups of drugs. The development of antimicrobial drugs represents one of the most important advances in therapeutics. Irrational and uncontrolled use of these agents both in developing and developed countries has resulted in an evolution of resistant strains in addition to a poor health outcome. Despite this fact, antimicrobial agents are vastly over-prescribed in the inpatient setting and the availability of antimicrobial agents without prescription in many developing countries. The use antimicrobial agents in Infants and children have become a routine practice for the treatment of pediatric illness and it needs study to show the status and pattern of antimicrobial in this age group is critical hence they are most vulnerable population groups to counteract illness

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