Hemoglobin Threshold for Blood Transfusion in Young Children Hospitalized with Iron Deficiency Anemia.

Current recommendations advise against blood transfusion in hemodynamically stable children with iron deficiency anemia. In an observational study of 125 children aged 6 through 36 months, hospitalized with iron deficiency anemia, we found that hemoglobin level predicted red blood cell transfusion (area under the curve 0.8862). A hemoglobin of 39 g/L had sensitivity 92% and specificity 72% for transfusion.

HHV6-Associated Hydrocephalus in a Pediatric Hematopoietic Stem Cell Transplant Recipient: An Unusual Presentation.

Human herpesvirus 6 (HHV-6) is a widely spread DNA virus that is ubiquitous and persistent with primary infection occurring in early childhood, with reactivation of the infection a common phenomenon in severely immunocompromised hosts, including hematopoietic stem cell transplant (HSCT) patients, influencing morbidity and mortality. A wide spectrum of clinical presentations is reported in the literature with HHV-6 reactivation including post-transplant limbic encephalitis (PALE). We report the unusual case of a 6-year-old female 107 days postallogenic HSCT due to transfusion dependent beta thalassemia major who developed acute cerebellitis with secondary supratentorial hydrocephalus that required invasive surgical intervention. In addition to accompanying imaging findings, the patient tested positive for HHV-6 by PCR from both serum and CSF samples and demonstrated dramatic improvement with the institution of steroid therapy in addition to ganciclovir treatment. The availability of rapid diagnostic measures in addition to a multidisciplinary approach is crucial to manage HHV-6 encephalitis and associated complications in HSCT patients.

School Attendance Among Pediatric Oncology Patients During the COVID-19 Pandemic in Ontario, Canada.

Supporting schooling for current and past pediatric oncology patients is vital to their quality of life and psychosocial recovery. However, no study has examined the perspectives toward in-person schooling among pediatric oncology families during the COVID-19 pandemic. In this online survey study, we determined the rate of and attitudes toward in-person school attendance among current and past pediatric oncology patients living in Ontario, Canada during the 2020-2021 school year. Of our 31-family cohort, 23 children (74%) did attend and 8 (26%) did not attend any in-person school during this time. Fewer children within 2 years of treatment completion attended in-person school (5/8; 62%) than those more than 2 years from treatment completion (13/15; 87%). Notably, 22 of 29 parents (76%) felt that speaking to their care team had the greatest impact compared to other potential information sources when deciding about school participation, yet 13 (45%) were unaware of their physician's specific recommendation regarding whether their child should attend. This study highlights the range in parental comfort regarding permitting in-person schooling during the COVID-19 pandemic. Pediatric oncologists should continue to address parental concerns around in-person school during times of high transmission of COVID-19 and potentially other communicable diseases in the future.

Successful Systemic Thrombolysis in a Neonatal Occlusive Abdominal Aortic Thrombus Secondary to Hypernatremic Dehydration: A Case Report and Literature Review.

A 6-day-old neonate presented with hypernatremic dehydration and weight loss. Fluids were started for rehydration. He was subsequently found to have signs of reduced lower limb perfusion and investigations revealed an abdominal aortic thrombus and bilateral occlusion of renal arteries. Systemic thrombolysis led to complete resolution of renal artery thrombi with no major complications. A review of similar cases with hypernatremic dehydration and thrombosis is provided.

Oral hygiene status in school adolescents: a study of 20,000 school-age adolescents in 66 public and private schools comparing oral hygiene status by gender and ethnicity.

AIMS: To compare and contrast oral health related data related to Simplified Oral hygiene index (OHI-S) in Dubai school-aged students as a function of the population demographics gender and ethnicity. METHODS: A total of 20,880 subjects were screened in 66 public and private school located in Dubai, United Arab Emirates. The study sample was grouped according to seven geographic regions. The total sample included 9,765 females and 11,115 males. Ages ranged from 9.08 years to 24.4 years with an overall mean age of 14.5 years. Calibrated dentists scored all subjects for Debri, Calculus and Simplified Oral hygiene index (OHI-S). Upon completion, statistical comparison of the study variables by region and gender was applied. RESULTS: Debri, calculus and OHI-S scores were calculated by Middle East and South Asia regions represented by countries with more than 100 subjects per country. OHI-S and debri scores were significantly higher in Middle East (0.90 and 0.78) subjects than South Asia (0.84 and 0.68, p=0.000). In contrast, Calculus score was higher in South Asia subjects compared to Middle East. CONCLUSIONS: • Middle East subjects averaged significantly higher debri and OHI-S scores when compared to South Asia subjects overall. • The highest debri score average was found in Middle East male (Egypt) and female (Palestine) subjects. • The highest calculus score average was found in South Asia male and female (both Bangladesh) subjects. • The highest OHI-S score average was found in South Asia male (Bangladesh) and female (Pakistan) subjects. Debri and OHI-S scores were lowest for Middle East female Iran subjects.