RESUMO
Background: The present study aimed to perform a meta-analysis on the performance of Graf's ultrasonography method in the detection of developmental dysplasia of the hip (DDH). Methods: A query was conducted on electronic bibliographic databases until the end of October 2020. The inclusion criteria entailed: 1. the use of Graf method in less than 12 weeks of age, 2. the use of follow-up as reference test, and 3. provision of crude data. Pooled diagnostic performance measures were calculated. Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) checklist was utilized to assess the quality of the included studies. The hierarchical summary receiver-operating characteristic (HROC) curves were also drawn. Results: Six articles (including seven populations, 11,012 patients) were considered eligible. The pooled sensitivity and specificity were obtained at 93% (95% CI: 0.57-0.99) and 97% (95% CI:0.86-0.99), respectively (area under curve= 0.99). The pooled positive and negative likelihood ratio, as well as diagnostic odds ratio, was reported as 28.4, 0.07, and 396, respectively. Conclusion: As evidenced by the obtained results, Graf's method is a useful ultrasonography technique with acceptable accuracy for screening DDH in neonates. However, there are uncertainties about the best population and age for screening. Furthermore, more attention should be paid to the proper training of this method to reduce the number of operator errors.
RESUMO
BACKGROUND: Promptly discovering and counteracting COVID-19 is critical as it could have catastrophic effects. As an asymptomatic group, children are highly susceptible to be misdiagnosed, especially those suffering from underlying diseases. Furthermore, discriminating the direct effects of the virus from those of the underlying diseases can pose a dilemma to physicians. This case series aims to determine the relationship between COVID-19 and various types of congenial heart disease among children. Patients and Methods. Seven patients from three different medical centers were enrolled. Their detailed demographic information, past medical history, symptoms, type of congenital heart diseases, imaging tests, laboratory tests, medications, and outcomes were analyzed. RESULTS: The patients included 4 infants, 1 child, and 2 adolescents, with a median age of 9 months and a majority of boys. All of them had either obstructive lesions (right or left ventricular outflow tracts) or significant pulmonary hypertension. The more common clinical symptoms were cough, dyspnea, and fever. Two patients did not survive the illness. CONCLUSION: Prompt treatment of patients with a combination of COVID-19 and severe obstructive cardiac pathology or pulmonary hypertension is essential due to a risk for serious and/or fatal consequences.