ABSTRACT
Background: Guillain-Barre syndrome is a polyradiculoneuropathy that has been associated with infectious diseases as triggers. There is currently little medical evidence exploring the relationship between the development of Guillain-Barre syndrome caused by SARS-CoV-2 infection and long Covid. Objective: To synthesize the medical evidence that describes the relationship between post Covid syndrome and Guillain-Barre syndrome in the paediatric population. Methodology: A scoping review was developed using Scopus and PubMed databases, including analytical and/or descriptive experimental and observational studies. Results: The main clinical manifestations presented by paediatric patients were distal and ascending weakness in the lower limbs and myalgia. The diagnostic approach was based on clinical findings, imaging findings on spinal magnetic resonance and electromyography. The therapeutic strategy is based on the use of intravenous human immunoglobulins. Conclusion: Guillain-Barre syndrome is a frequent disease in the paediatric population with active SARS-CoV-2 infection or in survivors, however, it is necessary to encourage further clinical studies that increase the medical literature that describes this association.
Introducción: El síndrome de Guillain-Barré es una polirradiculoneuropatía que se ha asociado con enfermedades infecciosas como desencadenantes. En la actualidad es escasa la evidencia médica que explore la relación entre el desarrollo del síndrome de Guillain-Barré causado por la infección por SARS-CoV-2 y la COVID prolongada. Objetivo: Sintetizar la evidencia médica que describe la relación entre el síndrome pos-COVID y el síndrome de Guillain-Barré en la población pediátrica. Metodología: Se realizó una revisión exploratoria utilizando las bases de datos de Scopus y PubMed, incluyendo estudios experimentales y observacionales analíticos o descriptivos. Resultados: Las principales manifestaciones clínicas presentadas por los pacientes fueron debilidad distal y ascendente en miembros inferiores y mialgias. El enfoque diagnóstico se apoyó en los hallazgos clínicos, hallazgos imagenológicos por resonancia magnética de columna y electromiografía. La estrategia terapéutica se basó en el uso de inmunoglobulinas humanas intravenosas. Conclusión: El síndrome de Guillain-Barré es una enfermedad frecuente en la población pediátrica con infección activa por SARS-CoV-2 o en sobrevivientes, sin embargo, es necesario incentivar el desarrollo de estudios clínicos que incrementen la literatura médica que describe esta asociación.
Subject(s)
Humans , Nervous System Diseases , Polyradiculoneuropathy , Respiratory Tract Infections , Autoimmune Diseases of the Nervous System , Guillain-Barre Syndrome , COVID-19 , InfectionsABSTRACT
Eighty Rh negative women delivering Rh positive babies were screened for red cell antibodies after their routine postnatal dose of 125 micrograms 7S anti D immunoglobulin. In all 80 free antibody could be detected. Distribution of titres by anti-human globulin (indirect Coombs) and ficin techniques were uninfluenced by ABO incompatibility, fetal cell counts, maternal weight or sampling time in the few days after immunoprophylaxis. Quantitations determined by autoanalyser showed some correlation with these variables. It is suggested that screening for free antibody is not the appropriate test to detect large fetomaternal spills which would warrant additional immunoprophylaxis.
Subject(s)
Isoantibodies/isolation & purification , Rh-Hr Blood-Group System/immunology , Coombs Test , Female , Humans , Immunologic Techniques , Infant, Newborn , Postpartum Period , PregnancySubject(s)
Erythroblastosis, Fetal/epidemiology , Isoantibodies/analysis , Rh-Hr Blood-Group System/analysis , Adult , Birth Order , Blood Transfusion, Intrauterine , Erythroblastosis, Fetal/mortality , Erythroblastosis, Fetal/prevention & control , Female , Humans , Immunoglobulin G/therapeutic use , Infant, Newborn , Male , Parity , Pregnancy , Time FactorsSubject(s)
Antibody Formation , Erythroblastosis, Fetal/prevention & control , Immunization , Isoantibodies/analysis , Rh-Hr Blood-Group System , Adolescent , Adult , Anemia/etiology , Anemia/immunology , Blood Transfusion , Coombs Test , Female , Hemoglobins/analysis , Humans , Infant, Newborn , Isoantigens , Medication Errors , New Zealand , Pregnancy , Umbilical CordSubject(s)
Erythroblastosis, Fetal/diagnosis , Erythroblastosis, Fetal/therapy , Amniotic Fluid/analysis , Blood Transfusion, Intrauterine/adverse effects , Catheterization , Erythroblastosis, Fetal/immunology , Female , Fetal Death , Fetus/diagnostic imaging , Humans , Infant, Newborn , Male , Maternal-Fetal Exchange , Methods , Pregnancy , Pregnancy Complications, Hematologic/diagnosis , Radiography , Rh-Hr Blood-Group SystemSubject(s)
Human Experimentation , Biomedical Research , Confidentiality , Databases, Factual , Health , Humans , Informed Consent , Medical Records , Moral Obligations , Nontherapeutic Human Experimentation , Physicians , Public Opinion , Research , Risk , Risk Assessment , Social Responsibility , VolunteersABSTRACT
The effect preoperative paracetamol elixir has on gastric contents is unknown. Children presenting for elective adenotonsillectomy were randomized to receive either paracetamol elixir (40 mg x kg(-1)) 90 min before surgery or paracetamol suppositories (40 mg x kg(-1)) intraoperatively. Following induction of anaesthesia a 16 Fr multiple-oriface orogastric tube was passed into the stomach and measure taken of the residual gastric volume and pH. The children had a mean age of 8.5 years (SD 3.2) with a weight of 35 kg (SD 16.5). Children given elixir (n=41) had a mean residual gastric volume of 0.083 ml x kg(-1) (95% CI; 0.006, 1.24) and a pH of 1.83 (95% CI; 0.75, 4.49), while those given suppositories (n=40) had a mean residual gastric volume of 0.083 ml x kg(-1)(95% CI; 0.008, 0.9) and a pH of 2.07 (95% CI; 0.84, 5.12). There was no significant difference between these two groups. Paracetamol elixir is rapidly absorbed in the gastrointestinal system of children and preoperative administration has no effect on gastric contents. Given paracetamol's slow equilibration rate constant from the central to the effect compartment, children may be given this medication preoperatively for routine surgical procedures.
Subject(s)
Acetaminophen/therapeutic use , Analgesics, Non-Narcotic/therapeutic use , Gastrointestinal Contents/drug effects , Premedication , Stomach/drug effects , Absorption , Acetaminophen/administration & dosage , Acetaminophen/pharmacokinetics , Adenoidectomy , Administration, Oral , Administration, Rectal , Ambulatory Surgical Procedures , Analgesics, Non-Narcotic/administration & dosage , Analgesics, Non-Narcotic/pharmacokinetics , Child , Female , Gastric Mucosa/metabolism , Humans , Hydrogen-Ion Concentration , Intestinal Absorption , Intraoperative Care , Intubation, Gastrointestinal , Male , Stomach/physiology , Suction , Suppositories , TonsillectomyABSTRACT
Using gene mapping, 16.3% of Polynesians were shown to have alpha thalassemia. These results are surprising since malaria is not found in Polynesia. Moreover, triplicated alpha gene rearrangements were identified in a further 7.7%, a frequency not seen in other populations.