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1.
Zhonghua Gan Zang Bing Za Zhi ; 29(4): 313-318, 2021 Apr 20.
Article in Chinese | MEDLINE | ID: mdl-33979956

ABSTRACT

The World Health Organization (WHO) has set the goal of eliminating viral hepatitis as a threat to public health by 2030. Blocking mother-to-child transmission (MTCT) of hepatitis B virus (HBV) is the key step for eliminating viral hepatitis, at the same time, it is the hotspot in the field of hepatitis B prevention and control as well. The China Foundation of Hepatitis Prevention and Control (CFHPC) organized a team of specialists to develop an algorithm for preventing MTCT of HBV, based on the most recent hepatitis B guidelines and the latest evidence. The algorithm covers 10 continuous steps from pregnant management to follow-up postpartum. Among the 10 steps, screening, antiviral therapy during pregnancy, and infant's immunization are the core components in the algorithm.


Subject(s)
Hepatitis B , Pregnancy Complications, Infectious , Algorithms , Antiviral Agents/therapeutic use , Child , China , Female , Hepatitis B/drug therapy , Hepatitis B/prevention & control , Hepatitis B Surface Antigens , Hepatitis B e Antigens , Hepatitis B virus , Humans , Infant , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy , Pregnancy Complications, Infectious/drug therapy , Pregnancy Complications, Infectious/prevention & control
2.
J Biol Regul Homeost Agents ; 35(1 Suppl. 2): 33-38, 2021.
Article in English | MEDLINE | ID: mdl-33982536

ABSTRACT

Acute otitis media (AOM) is the most common bacterial infection in children. Some children with AOM tend to be otitis-prone, such as frequent recurrence of AOM (RAOM). Possible RAOM risk factors are widely debated. The current study was performed in a real-life setting, such as an otorhinolaryngologic (ORL) clinic, to identify predictive factors, including clinical data and endoscopic findings, for RAOM in children. In this study, 1,002 children (550 males, 452 females, mean age 5.77 + 1.84 years) complaining of upper airway symptoms were consecutively visited. Detailed clinical history and nasal endoscopy were performed. Throughout the ORL visit, it was possible to define some factors involved in the recurrence of AOM, including female gender, artificial feeding, tonsillar and adenoid hypertrophy. Adenoid and tonsillar hypertrophy, female gender, and artificial are factors significantly associated with RAOM. Therefore, reducing adenoid and tonsil size, also using topical corticosteroids or glycyrrhizin, could be a reasonable strategy to potentially reduce adenoid and tonsil size. The current study suggests that also in a primary care setting, it is possible to achieve meaningful information that is relevant in clinical practice.


Subject(s)
Otitis Media , Acute Disease , Child , Child, Preschool , Chronic Disease , Female , Humans , Infant , Male , Otitis Media/epidemiology , Palatine Tonsil , Recurrence , Risk Factors
3.
Virol J ; 18(1): 89, 2021 04 30.
Article in English | MEDLINE | ID: mdl-33931105

ABSTRACT

BACKGROUND: A novel coronavirus (SARS-CoV-2) emerging has put global public health institutes on high alert. Little is known about the epidemiology and clinical characteristics of human coronaviruses infections in relation to infections with other respiratory viruses. METHODS: From February 2017 to December 2019, 3660 respiratory samples submitted to Zhejiang Children Hospital with acute respiratory symptoms were tested for four human coronaviruses RNA by a novel two-tube multiplex reverse transcription polymerase chain reaction assays. Samples were also screened for the occurrence of SARS-CoV-2 by reverse transcription-PCR analysis. RESULTS: Coronavirus RNAs were detected in 144 (3.93%) specimens: HCoV-HKU1 in 38 specimens, HCoV-NL63 in 62 specimens, HCoV-OC43 in 38 specimens and HCoV-229E in 8 specimens. Genomes for SARS-CoV-2 were absent in all specimens by RT-PCR analysis during the study period. The majority of HCoV infections occurred during fall months. No significant differences in gender, sample type, year were seen across species. 37.5 to 52.6% of coronaviruses detected were in specimens testing positive for other respiratory viruses. Phylogenic analysis identified that Zhejiang coronaviruses belong to multiple lineages of the coronaviruses circulating in other countries and areas. CONCLUSION: Common HCoVs may have annual peaks of circulation in fall months in the Zhejiang province, China. Genetic relatedness to the coronaviruses in other regions suggests further surveillance on human coronaviruses in clinical samples are clearly needed to understand their patterns of activity and role in the emergence of novel coronaviruses.


Subject(s)
/diagnosis , Multiplex Polymerase Chain Reaction/methods , Respiratory Tract Infections/virology , /genetics , Adolescent , Betacoronavirus/genetics , Betacoronavirus/isolation & purification , /genetics , Child , Child, Preschool , China/epidemiology , Coronavirus/genetics , Coronavirus/isolation & purification , Coronavirus 229E, Human/genetics , Coronavirus 229E, Human/isolation & purification , Coronavirus NL63, Human/genetics , Coronavirus NL63, Human/isolation & purification , Coronavirus OC43, Human/genetics , Coronavirus OC43, Human/isolation & purification , Female , Hospitalization , Humans , Infant , Infant, Newborn , Male , Phylogeny , Respiratory Tract Infections/complications , Respiratory Tract Infections/etiology , Spike Glycoprotein, Coronavirus/genetics
4.
J Med Case Rep ; 15(1): 222, 2021 May 01.
Article in English | MEDLINE | ID: mdl-33931116

ABSTRACT

BACKGROUND: Prostatic carcinoma is emerging as the most common male malignancy in Nigeria and the second most common male cancer worldwide. Patients often present with locally advances stages, and common sites of metastasis are the spine, pelvis, chest, and long bones. Metastases to the testes and spermatic cords are reputed to be rare and may be indicative of a worse outcome, when they occur. We recently encountered a clinical case of bilateral testicular, epididymal and spermatic cords prostatic cancer metastases. CASE PRESENTATION: A 71-year-old Nigerian man, who presented at our hospital with 1-month-old complaints of inability to walk together with low back and bilateral thigh pains. This presentation had been preceded by a 5-month history of lower urinary tract symptoms. On examination, the prostate was hard and nodular as were the left testis and spermatic cord. On histological assessment of a needle biopsy, prostatic adenocarcinoma (Gleason score 5 + 5 = 10) was diagnosed. A subsequent therapeutic bilateral total orchidectomy specimen was found to contain metastatic prostatic carcinoma deposits, in the testes, epididymides, and spermatic cords. Although our patient is currently doing well postoperatively on zoledronic acid, ketoconazole, bicalutamide, and tamsulosin, he is being re-evaluated periodically for any feature of recurrence. CONCLUSION: Since it has implications for eventual outcome, every clinically suspicious therapeutic orchidectomy specimen should be subjected to a detailed histopathological examination in order to exclude secondaries from the primary prostatic malignancy.


Subject(s)
Adenocarcinoma , Carcinoma , Prostatic Neoplasms , Spermatic Cord , Testicular Neoplasms , Aged , Humans , Infant , Male , Neoplasm Recurrence, Local , Nigeria , Prostate
5.
BMC Res Notes ; 14(1): 166, 2021 May 01.
Article in English | MEDLINE | ID: mdl-33933159

ABSTRACT

OBJECTIVE: To compare the accuracy of heart rate detection properties of a novel, wireless, dry-electrode electrocardiogram (ECG) device, NeoBeat®, to that of a conventional 3-lead gel-electrode ECG monitor (PropaqM®) in newborns. RESULTS: The study population had a mean gestational age of 39 weeks and 2 days (1.5 weeks) and birth weight 3528 g (668 g). There were 950 heart rate notations from each device, but heart rate was absent from the reference monitor in 14 of these data points, leaving 936 data pairs to compare. The mean (SD) difference when comparing NeoBeat to the reference monitor was -0.25 (9.91) beats per minute (bpm) (p = 0.44). There was a deviation of more than 10 bpm in 7.4% of the data pairs, which primarily (78%) was attributed to ECG signal disturbance, and secondly (22%) due to algorithm differences between the devices. Excluding these outliers, the correlation was equally consistent (r2 = 0.96) in the full range of heart rate captured measurements with a mean difference of - 0.16 (3.09) bpm. The mean difference was less than 1 bpm regardless of whether outliers were included or not.


Subject(s)
Electrocardiography , Electrodes , Gestational Age , Heart Rate , Humans , Infant , Infant, Newborn , Monitoring, Physiologic
6.
J Cosmet Dermatol ; 20 Suppl 1: 14-17, 2021 Apr.
Article in English | MEDLINE | ID: mdl-33934474

ABSTRACT

BACKGROUND: Cradle cap is a benign and self-limiting variant of seborrheic dermatitis (SD) that can be distressing for parents. AIMS: To assess by clinical/laboratory/instrumental evaluation the efficacy/tolerability of a gel cream containing piroctone olamine (antifungal), biosaccharide gum-2 (antifungal), stearyl glycyrrhetinate (anti-inflammatory), and zinc l-pyrrolidone carboxylate (zinc-PCA) (antiseborrheic) in the treatment of mild/ moderate cradle cap. METHODS: In this prospective, open-label trial, 10 infants, with mild/moderate cradle cap enrolled at the Dermatology University Clinic of Catania (Italy) used the tested gel cream twice daily for 30 days. Degree of erythema was evaluated clinically by a 5-point severity scale (from 0=no erythema to 4=severe erythema), at baseline, at 15 and 30 days. Desquamation was rated by dermoscopy evaluation using a 5-point scale (from 0=no desquamation to 4=severe/many large adherent white flakes), at all time points. An Investigator Global Assessment (IGA) using a 6-point scale (from -1=worsening to 4=complete response/clear) was also performed at 30 days. Five subjects, randomly selected, underwent double microbiological evaluation for bacteria and yeasts by cultures of cotton swabs at baseline and at 30 days. Tolerability/acceptability was evaluated on a 4-point scale (from 0=very poor to 3=excellent) at 15 and 30 days. Data were processed using SAS version 9. RESULTS: At baseline, a significant colony-forming unit (CFU) count for Malassezia furfur and Staphylococcus aureus was detected in 4 out of 5 selected patients. After 15 and 30 days, a statically significant reduction from baseline in erythema and desquamation severity was observed, along with a reduction in CFU count for Malassezia furfur and Staphylococcus aureus from baseline. No signs of local side effects were documented. CONCLUSIONS: Our results indicate that the tested gel cream may represent a valid option to treat mild-to-moderate forms of cradle cap and support its antifungal and antibacterial properties.


Subject(s)
Cosmetics , Dermatitis, Seborrheic , Humans , Infant , Laboratories , Prospective Studies , Treatment Outcome
7.
J Cosmet Dermatol ; 20 Suppl 1: 1-4, 2021 Apr.
Article in English | MEDLINE | ID: mdl-33934478

ABSTRACT

BACKGROUND: Diaper dermatitis (DD) is an acute inflammatory reaction, regardless of the cause, of the diaper-covered area. Topical skin barrier repair cosmetic products are the mainstay treatment to cure and/or prevent DD. AIMS: To assess the efficacy/tolerability of a zinc gluconate-taurine/zinc oxide and panthenol/ glycerin/ Butyrospermum parkii butter barrier cream using clinical evaluation. METHODS: In this prospective, open-label trial, 20 patients (10 infants/10 adults), with mild/moderate DD enrolled at the Dermatology University Clinic of Catania (Italy) were instructed to apply the cream twice daily for 30 days. Degree of erythema was performed clinically by a 5-point severity scale (from 0 = no erythema to 4 = severe erythema), at baseline, at 15 and 30 days. An Investigator Global Assessment (IGA) using a 6-point scale (from -1 = worsening to 4 = complete response/clear) along with product tolerability was also performed at 15 and 30 days. Statistical analysis was performed using SAS version 9. RESULTS: At 15 days, a reduction of clinical erythema assessment (CEA) from baseline was observed (mean from 3.2 ± 0.8 to 2.5 ± 0.3; p < 0.06), that although nonsignificant, showed a significant progressive improvement at 30 days (mean from 3.2 ± 0.8 to 1.1 ± 0.9; p < 0.0001) without any age differences. CONCLUSIONS: Our preliminary results indicate that the tested barrier cream may represent a promising approach in DD rash. It may be used in mild-to-moderate forms in monotherapy without significant side effects or, where required, in association with pharmacological agents. Its long-term use is likely safe.


Subject(s)
Diaper Rash , Zinc Oxide , Adult , Child , Diaper Rash/drug therapy , Emollients , Humans , Infant , Prospective Studies , Skin , Treatment Outcome , Zinc Oxide/therapeutic use
8.
J Pak Med Assoc ; 71(2(B)): 729-733, 2021 Feb.
Article in English | MEDLINE | ID: mdl-33941968

ABSTRACT

Pakistan is one of the countries in which children suffer from malnutrition, and problems of stunting, wasting and under-weight are common among children. The narrative review was planned to examine published research on child malnutrition, factors associated with malnutrition, gender discrimination regarding nutrition and their related outcomes. Studies included were those based on data related to child malnutrition in Pakistan. Total 12 articles from the preceding five years were reviewed to assess the nutritional status prevailing in Pakistan. Most of the studies used the World Health Organisation z-scores for the assessment of stunting and wasting. Majority of the studies had a cross-sectional design. Other studies conducted in South Asian countries were also used to make a comparison and to see if the prevalence of child malnutrition and the factors associated with malnutrition were the same as in Pakistan or not. It was concluded that maternal health and maternal education were the most important factors for enhancing the probability of child malnutrition. No gender difference existed in terms of child malnutrition. Economic conditions and financial status of the family played an important role in child malnutrition.


Subject(s)
Child Nutrition Disorders , Malnutrition , Child , Child Nutrition Disorders/epidemiology , Cross-Sectional Studies , Growth Disorders/epidemiology , Humans , India , Infant , Malnutrition/epidemiology , Nutritional Status , Pakistan/epidemiology , Prevalence , Socioeconomic Factors
9.
J Int Med Res ; 49(5): 3000605211012379, 2021 May.
Article in English | MEDLINE | ID: mdl-33947257

ABSTRACT

OBJECTIVES: To investigate the pathogens and potential risk factors for urinary tract infection (UTI) in patients with retained double-J catheters (DJCs). METHODS: In total, 107 infants and young children with DJCs were included in this retrospective analysis. Patients were included in the infection group (n = 30) or non-infection group (n = 77), according to UTI presence or absence. The species and characteristics of pathogens were investigated, and the clinical features of the patients were recorded for further analysis. RESULTS: Gram-negative bacilli were the most common causative pathogens (69.2%), among which Escherichia coli was most frequent (38.5%). The second most common causative pathogens were Gram-positive cocci (28.2%), among which Enterococcus faecalis was most frequent (10.3%). UTIs among patients in this study were associated with the following factors: catheter retention (long-term) (odds ratio [OR] = 2.514, 95% confidence interval [CI] = 1.176-5.373), sex (male) (OR = 2.966, 95% CI = 1.032-8.529), DJC retention (long-term) (OR = 1.869, 95% CI = 1.194-2.926), and DJC number (unilateral) (OR = 0.309, 95% CI = 0.103-0.922). CONCLUSIONS: Infants and young children with DJCs were likely to experience UTIs, mainly caused by Gram-negative bacilli. Long-term catheter retention or DJC retention, male sex, and bilateral DJC retention were risk factors for UTI.


Subject(s)
Anti-Bacterial Agents , Urinary Tract Infections , Anti-Bacterial Agents/therapeutic use , Catheters , Child , Child, Preschool , Humans , Infant , Male , Retrospective Studies , Risk Factors , Urinary Tract Infections/epidemiology , Urinary Tract Infections/etiology
10.
J Int Med Res ; 49(5): 3000605211012596, 2021 May.
Article in English | MEDLINE | ID: mdl-33947263

ABSTRACT

OBJECTIVES: To describe the clinical, histopathologic, and outcomes data for a cohort of patients with biliary atresia (BA), and to identify the factors affecting survival. METHODS: This was a cross-sectional study of all BA patients diagnosed between 1999 and 2017. Clinical, biochemical, imaging, and histopathologic data were analyzed, and Kaplan-Meier survival rates were compared to identify potential prognostic factors. RESULTS: We evaluated 23 patients. The median age at the Kasai procedure was 77 ± 34 days, and the median overall survival was 12.5 ± 65 months. Thirteen (56%) patients survived with their native livers, 3 (13%) received a transplant, and 6 died (26%) while awaiting a transplant. Cholangitis and the use of ursodeoxycholic acid were associated with longer survival, while impaired synthetic function was associated with shorter survival. CONCLUSIONS: Most patients presented late for the Kasai procedure. The survival rate with the native liver was comparable to other cohorts. Therefore, clinicians are encouraged to refer for the Kasai procedure even with late presentation (between 60 and 90 days), provided there is no hepatic decompensation.


Subject(s)
Biliary Atresia , Liver Transplantation , Biliary Atresia/surgery , Cross-Sectional Studies , Humans , Infant , Portoenterostomy, Hepatic , Retrospective Studies , Treatment Outcome
11.
World J Gastroenterol ; 27(15): 1655-1663, 2021 Apr 21.
Article in English | MEDLINE | ID: mdl-33958850

ABSTRACT

BACKGROUND: Gastrointestinal cytomegalovirus (CMV) disease occurs commonly in immunocompromised/immunodeficient patients with advanced human immunodeficiency virus infection, neoplasm, solid organ transplantation, hematopoietic stem cell transplantation, or treatment with immunosuppressants, but is rarely reported in association with measles infection. CASE SUMMARY: We describe a case of extensive gastrointestinal CMV disease secondary to measles infection in a 9-mo-old boy who presented with persistent fever and bloody diarrhea. His condition was improved after ganciclovir treatment. Serological analysis of CMV showed negative immunoglobulin (Ig) M and positive IgG. Blood CMV-DNA was 9.26 × 103 copies/mL. The diagnosis of gastrointestinal CMV disease was confirmed by histopathological findings of intranuclear and intracytoplasmic inclusions and Owl's eye inclusion. This case highlights the differential diagnosis and histopathological characteristics of gastrointestinal CMV infection and laboratory tests. CONCLUSION: Extensive gastrointestinal CMV lesions can be induced by the immune suppression secondary to measles infection. Rational, fast, and effective laboratory examinations are essential for suspected patients.


Subject(s)
Cytomegalovirus Infections , Gastrointestinal Diseases , Measles , Cytomegalovirus , Cytomegalovirus Infections/complications , Cytomegalovirus Infections/diagnosis , Cytomegalovirus Infections/drug therapy , Ganciclovir/therapeutic use , Humans , Infant , Measles/complications , Measles/diagnosis
12.
Environ Health Prev Med ; 26(1): 55, 2021 May 03.
Article in English | MEDLINE | ID: mdl-33941073

ABSTRACT

BACKGROUND: An acute upper respiratory tract infection (URI) is the most common disease worldwide, irrespective of age or sex. This study aimed to evaluate the short-term effect of diurnal temperature range (DTR) on emergency room (ER) visits for URI in Seoul, Korea, between 2009 and 2013. METHODS: Daily ER visits for URI were selected from the National Emergency Department Information System, which is a nationwide daily reporting system for ER visits in Korea. URI cases were defined according to International Classification of Diseases, 10th Revision codes J00-J06. The search for DTR effects associated with URI was performed using a semi-parametric generalized additive model approach with log link. RESULTS: There were 529,527 ER visits for URI during the study period, with a daily mean of 290 visits (range, 74-1942 visits). The mean daily DTR was 8.05 °C (range, 1.1-17.6 °C). The cumulative day (lag 02) effect of DTR above 6.57 °C per 1 °C increment was associated with a 1.42% (95% confidence interval [CI] 0.04-2.82) increase in total URI. Children (≤ 5 years of age) were affected by DTR above 6.57 °C per 1 °C, with 1.45% (95% CI 0.32-2.60) at lag 02, adults (19-64 years) with 2.77% (95% CI 0.39-5.20) at lag 07. When the DTR (lag02) was 6.57 °C to 11.03 °C, the relative risk was significant at 6.01% (95% CI 2.45-9.69) for every 1 °C increase in youth subjects aged for 6 to 18 years. CONCLUSIONS: DTR was associated with a higher risk for ER visits for URI. In addition, the results suggested that the lag effects and relative risks of DTR on URI were quite different according to age.


Subject(s)
Cold Temperature/adverse effects , Emergency Service, Hospital/statistics & numerical data , Hot Temperature/adverse effects , Respiratory Tract Infections/epidemiology , Acute Disease/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Republic of Korea/epidemiology , Respiratory Tract Infections/etiology , Young Adult
13.
Orv Hetil ; 162(19): 760-765, 2021 05 09.
Article in Hungarian | MEDLINE | ID: mdl-33965910

ABSTRACT

Összefoglaló. A cystás fibrosis az egyik leggyakoribb veleszületett genetikai rendellenesség, elofordulása Magyarországon 1:4000. Az érintett szervekben a mirigyek által termelt nyák emelkedett viszkozitása krónikus gyulladáshoz vezet. A progressziót a pulmonalis folyamat határozza meg, súlyos esetben a tüdotranszplantáció az egyetlen megoldás. A betegek instabil állapota és a hosszú várólista miatt a megfelelo elokészítés kihívásokkal teli, a mutét sokszor sikertelen. A szerzok egy eset segítségével ismertetik a személyre szabott, pozitív nyomású légzésterápia szerepét a transzplantációra való elokészítésben cystás fibrosisban. A 13 éves serdülot csecsemokorában történt jobb tüdocsúcs-reszekciót, majd verejtékvizsgálatot és genetikai tipizálást követoen 8 hónapos korától gondoztuk a Heim Pál Országos Gyermekgyógyászati Intézetben cystás fibrosissal. Fokozatosan romló klinikai állapota miatt 11 éves korától otthoni oxigénterápiát igényelt, 13 éves korára tüdotranszplantáció vált szükségessé. A transzplantációig a légzési munka könnyítése érdekében noninvazív lélegeztetést kezdtünk, melyet a beteg nem tolerált. A rapidan romló általános állapot és légzésfunkció, az inhalatív és szisztémás kezelés ellenére is fennálló folyamatos oxigénigény és jelentos nehézlégzés javítása céljából személyre szabott, pozitív nyomású légzésterápia beállítása történt. Ennek eredményeként 4 vízcentiméteres nyomáson 1 liter/perc oxigén adása mellett a teljes alvásido 100%-a 90% fölötti oxigénszaturációval telt. A kezelést a gyermek jól turte, éjszakái nyugodtabban teltek, általános állapota és légzésfunkciója javult, majd sikeres tüdotranszplantáción esett át. A személyre szabott, pozitív nyomású légzésterápia javítja a cystás fibrosisban szenvedo gyermekek általános állapotát és légzésfunkcióját, ezáltal megkönnyíti a beteg tüdotranszplantáció elotti felkészülését, és növeli a mutét sikerességének esélyét. Orv Hetil. 2021; 162(19): 760-765. Summary. Cystic fibrosis is one of the most common hereditary genetic disorders, the appearance rate of which in the Hungarian population is 1:4000. The increased viscosity of mucus leads to chronic inflammation in the affected organs. The pulmonary manifestation defines the progression, in severe cases lung transplantation is needed. Unstable health condition can make the preparation for surgery difficult and unsuccessful. The role of personalised positive airway pressure therapy prior to lung transplantation in cystic fibrosis is presented through a case report. The 13-year-old child was treated at Heim Pál National Pediatric Institute from the age of 8 months with cystic fibrosis after pulmonary lobectomy, followed by sweat chlorid- and genetic testing. The significant impairment of his general condition required oxygen therapy from the age of 11 years and lung transplantation at the age of 13 years. Until lung transplantation, to relieve the respiratory distress, noninvasive ventilation was started, without success. Considering the rapid progression and persistent need for oxygen - despite inhalation and systemic treatment - personalised positive airway pressure therapy was indicated. At the pressure of 4 cmH2O and an oxygen flow rate of 1 l/min, oxygen saturation was higher than 90% during 100% of the total sleep time. Improvement was registered in both general condition and respiratory function, followed by a successful lung transplantation. In patients with cystic fibrosis, personalized positive airway pressure therapy improves respiratory function, general condition and elevates the success rate of lung transplantation. Orv Hetil. 2021; 162(19): 760-765.


Subject(s)
Cystic Fibrosis , Adolescent , Child , Cystic Fibrosis/therapy , Humans , Hungary , Infant , Positive-Pressure Respiration
14.
BMC Surg ; 21(1): 240, 2021 May 11.
Article in English | MEDLINE | ID: mdl-33975594

ABSTRACT

BACKGROUND: We aimed to evaluate the impact of COVID-19 pandemic on pediatric transplant outcomes and determine whether to continue pediatric transplant activity or not, and how policies intended our center has been effective in preventing COVID-19 among organ transplant recipients. METHODS: We conducted a single-center, retrospective, cohort study of hospitalized pediatrics after organ transplantation at Shiraz transplant center since March to August 2020. All liver and kidney transplanted children were included the study and their laboratory and clinical related COVID-19 characteristics were followed up till 3 months after transplantation during hospitalization period and then weekly by the transplant committee. RESULTS: Fifty-one patients underwent transplantation including 11 kidney and 40 liver recipients. The mean age of the pediatric cases was 6.72 ± 5.47 years. A total of 11 patients died due to post-transplant complications, while none of the patients presented any sign or symptoms in favor of COVID-19 in the hospital course after transplantation. Six transplants including 2 kidney and 4 liver were canceled when positive PCR tests were detected in their donors before the surgery. In the 3 months of follow up, two patients presented with symptoms including high grade fever, malaise, rhinorrhea, and GI symptoms. Both patients had two negative PCR, and no radiologic or laboratory results regarding COVID-19 were also detected. One had positive influenza PCR, while the second one had a positive serologic test for EBV; CT, computed tomography CONCLUSION: Transplant programs could continue their activities during the COVID-19 pandemic with specific case selection, accurate screening methods and following protective protocols.


Subject(s)
Kidney Transplantation , Pediatrics , Child , Child, Preschool , Cohort Studies , Follow-Up Studies , Humans , Infant , Iran/epidemiology , Liver , Pandemics , Retrospective Studies , Tertiary Care Centers
15.
Anticancer Res ; 41(5): 2591-2596, 2021 May.
Article in English | MEDLINE | ID: mdl-33952488

ABSTRACT

BACKGROUND/AIM: Tacrolimus is an essential immunosuppressant for successful allogeneic haematopoietic stem cell transplantation (Allo-HSCT). This study aimed to examine the change in the blood concentration of tacrolimus during switching from intravenous to oral administration in allo-HSCT for paediatric cancer to predict the optimal dosage. PATIENTS AND METHODS: We retrospectively examined the medical records of 63 patients who received allo-HSCT and were administered tacrolimus. To compare bioavailability among different dose ranges, the blood concentration was divided by the dose (C/D). RESULTS: Thirty-nine patients (age range=children 1-15 years, adults 17-67 years) were switched to oral administration of tacrolimus. The C/D after switching was significantly lower in children than in adults (p=0.039). There was a strong positive correlation between age and C/D in children, whereas no correlation was observed in adults. CONCLUSION: In paediatric cancer patients, switching tacrolimus administration route may result in reduced blood concentrations. This tendency is more prominent in younger children.


Subject(s)
Administration, Intravenous/methods , Administration, Oral , Neoplasms/drug therapy , Tacrolimus/administration & dosage , Adolescent , Adult , Aged , Blood Physiological Phenomena/drug effects , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Neoplasms/blood , Neoplasms/pathology , Pediatrics , Tacrolimus/adverse effects , Young Adult
17.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 38(5): 465-468, 2021 May 10.
Article in Chinese | MEDLINE | ID: mdl-33974257

ABSTRACT

OBJECTIVE: To summarize the clinical phenotype and genotype of a Chinese child affected with Mowat-Wilson syndrome (MWS). METHODS: Clinical data of the patient were collected. The patient was analyzed by whole-exome sequencing (WES) as well as Sanger sequencing. RESULTS: The patient was a male infant with recurrent fever and slow growth. He also had characteristic facies, recurrent spasm, and growth retardation. WES revealed that he has carried a heterozygous nonsense c.2609C>G (p.Ser870X) variant of the ZEB2 gene (30% mosaicism). Based on the American College of Medical Genetics and Genomics standards and guidelines, the variant was predicted to be pathogenic (PVS1+PS1+PS2+PM2). CONCLUSION: The c.2609C>G variant of the ZEB2 gene probably underlay the MWS in this child. The mosaicism of the variant may explain his mild symptoms.


Subject(s)
Hirschsprung Disease , Intellectual Disability , Microcephaly , Child , Facies , Hirschsprung Disease/genetics , Humans , Infant , Intellectual Disability/genetics , Male , Microcephaly/genetics , Mutation
18.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 38(5): 469-471, 2021 May 10.
Article in Chinese | MEDLINE | ID: mdl-33974258

ABSTRACT

OBJECTIVE: To explore the clinical and genetic characteristics of a child with X-linked hypohidrotic ectodermal dysplasia (XLHED). METHODS: Clinical data of the child was collected. Peripheral blood samples were taken from the child and his parents with informed consent and subjected to copy number variation (CNV) analysis and whole exome sequencing (WES). RESULTS: The male infant manifested sparse hair, anhidrosis, anuresis due to polycystic kidney dysplasia, external genital malformation and anal atresia. WES has revealed a 406 bp hemizygous deletion at Xq13 (68 836 147-68 836 553) in the proband, which encompassed exon 1 of the EDA gene. A heterozygous deletion at the same site was detected in the mother, while no deletion or duplication of the site was detected in the father. CONCLUSION: The hemizygous deletion of EDA gene exon 1 probably underlay the ectodermal dysplasia in the proband. Above result has provided a basis for genetic counseling and prenatal diagnosis for the family.


Subject(s)
Ectodermal Dysplasia 1, Anhidrotic , Ectodermal Dysplasia , Child , DNA Copy Number Variations , Ectodermal Dysplasia/genetics , Ectodermal Dysplasia 1, Anhidrotic/genetics , Ectodysplasins/genetics , Genetic Testing , Humans , Infant , Male , Pedigree
19.
Kyobu Geka ; 74(2): 121-124, 2021 Feb.
Article in Japanese | MEDLINE | ID: mdl-33976017

ABSTRACT

We herein report two cases of pediatric poststernotomy mediastinitis treated by traction-assisted negative pressure wound therapy (NPWT) with Zip Surgical Skin Closure (Zip), which is a non-invasive skin closure device. We used this device with NPWT in cases of pediatric poststernotomy mediastinitis to stabilize the sternum and reduce the natural retractive forces of the skin. The patients were two boys (two and three months old), with an onset of infection at 13 and eight postoperative days, respectively. The culture examination detected methicillin-susceptible Staphylococcus aureus in both cases. Traction-assisted NPWT with Zip was performed at-75 mmHg for 16 and 33 days, and the wounds healed completely. In conclusion, this modification was successfully applied to treat pediatric poststernotomy mediastinitis and may help reduce the duration of treatment.


Subject(s)
Mediastinitis , Negative-Pressure Wound Therapy , Child , Humans , Infant , Male , Mediastinitis/surgery , Sternum , Surgical Wound Infection/therapy , Traction , Treatment Outcome
20.
Codas ; 33(1): e20190070, 2021.
Article in Portuguese, English | MEDLINE | ID: mdl-33978058

ABSTRACT

PURPOSE: To investigate the association between oral-motor disorder and feeding difficulty during the process of introducing complementary feeding in preterm infants. METHODS: This is a cross-sectional, observational, and quantitative study. Preterm infants who had already begun complementary feeding and were up to 24 months corrected gestational age, were followed up at an outpatient clinic for high-risk newborns. The feeding difficulty was assessed using the mother's perception of the presence of defensive behaviors in their child. The measurement of the oral motor skills performance was obtained through the application of an adaptation of the Clinical evaluation protocol of pediatric dysphagia (PAD-PED). RESULTS: The sample consisted of 62 dyads of children with a mean corrected gestational age (CGA) of 13.5 months. Complementary feeding was introduced at the sixth month CGA by almost half of the mothers and most of them reported some sort of difficulty with this activity. Extreme prematurity revealed an association with defensive feeding behavior (p = 0.005), as well as with the initial introduction of food with liquid consistency (p = 0.001), the extended period of time using enteral tube feeding (p = 0.044), the continuous positive airway pressure (CPAP) (p = 0.013) and parenteral nutrition (p = 0.039). CONCLUSION: There was no significant association between oral motor disorder and feeding difficulty.


Subject(s)
Breast Feeding , Infant, Premature , Child , Cross-Sectional Studies , Feeding Behavior , Female , Humans , Infant , Infant Nutritional Physiological Phenomena , Infant, Newborn , Mothers
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