Linear growth in children with iron deficiency anemia before and after treatment.

We measured growth [length (L) standard deviation score (SDS), growth velocity (GV) SDS and body mass index (BMI)] and hematological (hemoglobin, hematocrit, MCV and MCH) parameters in 40 children (aged 17.2 +/- 12.4 months) with iron deficiency anemia (IDA) before and after iron therapy. Before treatment children with IDA had LSDS = -1.2 +/- 1, GV = 7.5 +/- 2.2, GVSDS = -1.42 +/- 0.6 and BMI = 13.5 +/- 1.2. They were significantly shorter and had reduced growth as compared with age-matched controls. After treatment, their growth parameters significantly increased with LSDS = -0.6 +/- -0.9, GV = 13.2 +/- 4.4 cm year(-1), GVSDS = 1.7 +/- 0.5 and BMI = 14.2 +/- 1.1. Their GV correlated significantly with serum ferritin concentration (r = 0.48, p < 0.001) and BMI (r = 0.32, p < 0.1). In summary, IDA during the first 2 years of life significantly impairs growth.

Effectiveness of palivizumab immunoprophylaxis in preterm infants against respiratory syncytial virus disease in Qatar.

OBJECTIVE: The primary objective of this study was to document the hospitalization rate due to respiratory syncytial virus (RSV) and compliance with palivizumab use in preterm infants receiving palivizumab immunoprophylaxis during 2009-2012 RSV seasons. DESIGN: This is a descriptive single-center cohort study. Infants who were ≤35-week gestational age were eligible for enrollment if they received the first palivizumab dose between November 1 and March 31 (2009-2010, 2010-2011, 2011-2012). Primary endpoint was defined as RSV hospitalization of duration 24 hours or longer. RESULTS: The cumulative RSV hospitalization rate in the registry (2009-2012) was 1.9%. The compliance rate was 85.7%. It showed steady increase across the 3 successive RSV seasons, 2009-2010, 2010-2011, and 2011-2012 (57.7% vs 92.6%, 94.2%, respectively, p<0.05). The RSV hospitalization rate decreased from 3.7% for 2009-2010 to 1.3% for 2010-2011 and 1.7% for 2011-2012 RSV seasons. No deaths and no side effects linked to palivizumab injections were reported for any subjects enrolled. CONCLUSION: Our study provides national data regarding characteristics, compliance rate, and hospitalization outcomes for preterm infants receiving palivizumab in Qatar. Our data is consistent with the previously reported efficacy and safety profile of palivizumab.

Intrapleural hemorrhage due to alteplase use in a 6-year-old boy with pleural effusion.

BACKGROUND: Intrapleural fibrinolytics have been used successfully worldwide for the management of complicated pleural effusions and empyema. Bleeding complications are usually mentioned as rare side effects, but there is no clear information in the literature addressing the alarming outcome that might result following the use of alteplase as a fibrinolytic in the management of complicated parapneumonic effusions. We present a rare, if not unique, case of intrapleural hemorrhage requiring transfusion after alteplase use as a fibrinolytic in a 6-year-old male with complicated parapneumonic effusion. METHODS: A SEARCH OF THE PUBMED DATABASE WAS CARRIED OUT, USING A COMBINATION OF THE FOLLOWING TERMS: alteplase, fibrinolytic, intrapleural hemorrhage, and side effects. RESULTS: The majority of studies found in the search concentrated on the efficacy of intrapleural fibrinolytics in the management of pleural effusion, but very few of the reports addressed the bleeding complications which may be caused by the treatment. CONCLUSION: Although intrapleural and systemic hemorrhage are rare side effects of intrapleural fibrinolytic use, the health care provider must be watchful for these potentially life-threatening complications. Further studies are needed to understand not only the efficacy of fibrinolytics but also their safety, especially in children.

Bilateral congenital lobar emphysema: A rare cause for respiratory distress in infancy.

We report a rare case of bilateral congenital lobar emphysema in a 2-month-old male infant who presented with severe respiratory distress leading to respiratory failure. Plain chest X-ray and later high-resolution CT scan of the chest revealed that both the right middle and the left upper lobes were emphysematous. Surgical excision of the affected lobes has been done successfully in two sequential operations of right middle lobectomy followed by left upper lobectomy which resulted in significant improvement of respiratory status. In this report, the presentation, diagnosis, and surgical management of this rare condition are discussed.