scholarly journals Retrospective Review of Pediatric and Adult Autoimmune Hepatitis in Two Quaternary Care Centres in British Columbia: Increased Prevalence Seen in British Columbia’S First Nations Community

2007 ◽  
Vol 21 (9) ◽  
pp. 565-568 ◽  
Author(s):  
Henry V Chung ◽  
Mark Riley ◽  
Jin K Ho ◽  
Benjamin Leung ◽  
Gareth P Jevon ◽  
...  
Keyword(s):  
British Columbia ◽  
Liver Transplant ◽  
Autoimmune Hepatitis ◽  
First Nations ◽  
Adult Patients ◽  
Children's Hospital ◽  
Transplant Program ◽  
Increased Risk ◽  
Children’S Hospital ◽  
Nations Community

BACKGROUND: It has been previously reported that British Columbia’s (BC’s) First Nations (Aboriginal) community has an increased risk of autoimmune diseases, including rheumatological conditions (rheumatoid arthritis, systemic lupus) and primary biliary cirrhosis. The researchers hypothesized that this community may also be at increased risk for autoimmune hepatitis (AIH).METHODS: Independent, retrospective reviews of the databases of two separate tertiary/quaternary British Columbia university-affiliated health care institutions, the Adult Liver Transplant Program of the BC Transplant Society and the Division of Pediatric Gastroenterology, BC Children’s Hospital (Vancouver, BC), were performed. All patients referred with a diagnosis of probable or definite AIH who identified themselves as being of First Nations descent from 1988 to 2004 were reviewed. The liver transplant database records all adult patients in the province referred for transplant assessment. The pediatric database records all children referred to the BC Children’s Hospital.RESULTS: A total of 68 adult patients with a definite or probable diagnosis of AIH were referred to the liver transplant program. Twelve patients (17.6%) were Aboriginal, 11 of which were female. Similarly, a total of 30 children with probable or definite AIH were identified from the pediatric database. Six of these cases (20%) were identified in Aboriginal children.CONCLUSIONS: The findings suggest an increased prevalence of AIH among BC’s First Nations community. A disproportionate First Nations representation was found on independent review of two databases. Future studies are needed to determine the true prevalence of AIH in this community, and to uncover the genetic predisposition and the environmental triggers explaining this phenomenon.

scholarly journals HIV and Liver transplantation: The British Columbia Experience, 2004 to 2013

2014 ◽  
Vol 25 (3) ◽  
pp. 159-162 ◽  
Author(s):  
Clara Tan-Tam ◽  
Pamela Liao ◽  
Julio S Montaner ◽  
Mark W Hull ◽  
Charles H Scudamore ◽  
...  
Keyword(s):  
British Columbia ◽  
Liver Transplantation ◽  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Liver Transplant ◽  
Clinical Outcomes ◽  
Disease Status ◽  
Transplant Program ◽  
End Stage

BACKGROUND: The demand for definitive management of end-stage organ disease in HIV-infected Canadians is growing. Until recently, despite international evidence of good clinical outcomes, HIV-infected Canadians with end-stage liver disease were ineligible for transplantation, except in British Columbia (BC), where the liver transplant program of BC Transplant has accepted these patients for referral, assessment, listing and provision of liver allograft. There is a need to evaluate the experience in BC to determine the issues surrounding liver transplantation in HIV-infected patients.METHODS: The present study was a chart review of 28 HIV-infected patients who were referred to BC Transplant for liver transplantation between 2004 and 2013. Data regarding HIV and liver disease status, initial transplant assessment and clinical outcomes were collected.RESULTS: Most patients were BC residents and were assessed by the multidisciplinary team at the BC clinic. The majority had undetectable HIV viral loads, were receiving antiretroviral treatments and were infected with hepatitis C virus (n=16). The most common comorbidities were anxiety and mood disorders (n=4), and hemophilia (n=4). Of the patients eligible for transplantation, four were transplanted for autoimmune hepatitis (5.67 years post-transplant), nonalcoholic steatohepatitis (2.33 years), hepatitis C virus (2.25 years) and hepatitis B-delta virus coinfection (recent transplant). One patient died from acute renal failure while waiting for transplantation. Ten patients died during preassessment and 10 were unsuitable transplant candidates. The most common reason for unsuitability was stable disease not requiring transplantation (n=4).CONCLUSIONS: To date, interdisciplinary care and careful selection of patients have resulted in successful outcomes including the longest living HIV-infected post-liver transplant recipient in Canada.

scholarly journals Streptococcus pneumoniae serotype specific anti-microbial susceptibility profiles among PCV-10 vaccinated and unvaccinated children attending Gertrude’s Children’s Hospital: a cross-sectional study

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1699
Author(s):  
Michael Walekhwa ◽  
Margaret Muturi ◽  
Eucharia Kenya ◽  
Beatrice Kabera
Keyword(s):  
Streptococcus Pneumoniae ◽  
Pneumococcal Disease ◽  
Agar Plate ◽  
Significant Risk ◽  
Effective Control ◽  
Children's Hospital ◽  
Daycare Centers ◽  
Mueller Hinton ◽  
Increased Risk ◽  
Children’S Hospital

Background: The spread of antimicrobial resistance threatens effective control and treatment of pneumococcal disease worldwide. In Kenya, an estimated one in every five children dies from pneumococcal disease every year. Of these, ≥50% are attributable to antibiotic resistance. Consequently, the WHO has recommended that continuous regional surveillance be done to detect early resistance to available antibiotics and make necessary changes. We therefore investigated antimicrobial susceptibility patterns of Streptococcus pneumoniae among PCV-10 vaccinated and unvaccinated children ≤5 years old at Gertrude's Children’s Hospital. Methods: A 0.5 McFarland standard of freshly subcultured organisms were inoculated on Mueller–Hinton plates with 5% sheep blood agar. A standard disk dispenser was used to dispense various antibiotic disks on the Mueller–Hinton agar plate. Incubation was done overnight (20-24 hours) at 37oC in 5% CO2 and clearance zones read using a Vanier caliber. Antimicrobials tested included vancomycin (30µg, ≥17mm); erythromycin (15µg, ≥21mm); clindamycin (2µg, ≥19mm); oxacillin (1µg, ≥19mm) and ceftriaxone (1µg, ≥30mm). Results: Thirty nine (92.86%) Streptococcus pneumoniae isolates were susceptible to erythromycin; 39 (92.86%) were susceptible to vancomycin; eight (19.86%) Streptococcus pneumoniae isolates were susceptible to oxacillin, while 34 (80.95%) were non-susceptible; 40 (95.24%) isolates were susceptible to clindamycin; and 24 (57.86%) isolates were susceptible to ceftriaxone, while 18 (42.86%) were non-susceptible. Children who attended daycare centers exhibited a four-fold significant risk of being resistant to ceftriaxone. All antibiotics studied were effective against Streptococcus pneumoniae except oxacillin and ceftriaxone, which exhibited high levels of non-susceptibility. Attendance of daycare centers, consumption of antibiotics two weeks prior to collection of sample and subject age were shown to be associated with an increased risk of Streptococcus pneumoniae being resistant to penicillins and ceftriaxone. Conclusions: The law guiding use of antibiotics in Kenya should be meritoriously enforced to curb abuse of the available antibiotics.

Review of Metabolic Screening Program of Children's Hospital, Vancouver, British Columbia. 1971–1977

1979 ◽  
Vol 12 (5) ◽  
pp. 167-172 ◽  
Author(s):  
L.T.K. Wong ◽  
D.F. Hardwick ◽  
D.A. Applegarth ◽  
A.G.F. Davidson
Keyword(s):  
British Columbia ◽  
Screening Program ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Metabolic Screening

scholarly journals Indications for Liver Tranplantation in British Columbia’s Aboriginal Population: A 10-Year Retrospective Analysis

2000 ◽  
Vol 14 (9) ◽  
pp. 775-779 ◽  
Author(s):  
Eric M Yoshida ◽  
Nadine R Caron ◽  
Andrzej K Buczkowski ◽  
Laura T Arbour ◽  
Charles H Scudamore ◽  
...  
Keyword(s):  
British Columbia ◽  
Liver Transplantation ◽  
Liver Transplant ◽  
Autoimmune Hepatitis ◽  
Retrospective Analysis ◽  
Census Data ◽  
Aboriginal People ◽  
Biliary Cirrhosis ◽  
Significant Difference ◽  
Statistics Canada

OBJECTIVES: To study the indications for liver transplantation among British Columbia’s First Nation population.MATERIALS AND METHODS: A retrospective analysis of the British Columbia Transplant Society’s database of Aboriginal and non-Aboriginal liver transplant recipients from 1989 to 1998 was undertaken. For primary biliary cirrhosis (PBC), the transplant assessment database (patients with and without transplants) was analyzed using a binomial distribution and compared with published census data regarding British Columbia’s proportion of Aboriginal people.RESULTS: Between 1989 and 1998, 203 transplantations were performed in 189 recipients. Fifteen recipients were Aboriginal (n=15; 7.9%). Among all recipients, the four most frequent indications for liver transplantation were hepatitis C virus (HCV) infection (n=57; 30.2%), PBC (n=34; 18.0%), alcohol (n=22; 11.6%) and autoimmune hepatitis (n=14; 7.4%). Indications for liver transplantation among Aboriginal people were PBC (n=8; 53.3%; P<0.001 compared with non-Aboriginal people), autoimmune hepatitis (n=4; 26.67%; P=0.017), acute failure (n=2; 13.3%) and HCV (n=1). Among all patients referred for liver transplantation with PBC (n=43), 29 (67.44%) were white and 11 (25.6%) were Aboriginal. A significant difference was found between the proportion of Aboriginal people referred for liver transplantation and the proportion of Aboriginal people in British Columbia (139,655 of 3,698,755 [3.8%]; 1996 Census, Statistics Canada) (P<0.001).CONCLUSIONS: Aboriginal people in British Columbia are more likely to be referred for liver transplantation with a diagnosis of PBC but are less likely to receive a liver transplant because of HCV or alcohol than are non-Aboriginal people.

scholarly journals A Comprehensive System for Identifying Patients With Type 1 Diabetes at Increased Risk for Diabetic Ketoacidosis at Texas Children's Hospital

2021 ◽  
Author(s):  
David D. Schwartz ◽  
Mili Vakharia ◽  
Serife Uysal ◽  
Kristen R. Hendrix ◽  
Kelly Fegan-Bohm ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetes Care ◽  
Care Center ◽  
The United States ◽  
Pediatric Endocrinology ◽  
Children's Hospital ◽  
Pediatric Diabetes ◽  
Increased Risk ◽  
Children’S Hospital

Texas Children’s Hospital, located in Houston, TX, is the largest pediatric hospital in the United States, with 973 inpatient beds and extensive outpatient clinics and services. It is the primary pediatric teaching hospital of Baylor College of Medicine. The Texas Children’s Endocrine and Diabetes Care Center is one of the largest pediatric endocrinology and diabetes centers in the country, with three inpatient facilities and seven ambulatory clinics. The service is staffed by a multidisciplinary team that includes endocrinologists, endocrine fellows, advanced practice providers, certified diabetes care and education specialists (CDCES), dietitians, social workers, and consulting psychologists. Almost 500 youth with newly diagnosed type 1 diabetes are admitted to the hospital each year, with a total pediatric diabetes population of >3,400 patients.

scholarly journals Renal bone disease in pediatric and young adult patients on hemodialysis in a children's hospital.

1993 ◽  
Vol 3 (12) ◽  
pp. 1938-1946
Author(s):  
R Mathias ◽  
I Salusky ◽  
W Harman ◽  
A Paredes ◽  
J Emans ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Calcium ◽  
Bone Disease ◽  
Adult Patients ◽  
Osteitis Fibrosa ◽  
Assay Method ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Renal Bone Disease ◽  
Serum Pth

Renal bone disease has been well defined in adult patients receiving chronic dialysis and in children on peritoneal dialysis/continuous ambulatory peritoneal dialysis. However, little is known about the histologic features in patients undergoing chronic hemodialysis in a children's hospital center. Twenty one patients, aged 17.5 +/- 1.5 yr, on hemodialysis for 35 +/- 6 months underwent iliac crest bone biopsies and deferoxamine infusion tests. Nineteen of 21 patients were receiving oral calcitriol. The 21 patients were classified by histomorphometry as follows: osteitis fibrosa, 5; mild hyperparathyroidism, 3; normal histology, 3; aplastic, 6; and mixed lesions, 4. Four of 21 patients were surface positive for aluminum, and seven other patients stained positive for iron in bone. Serum parathyroid hormone (PTH) levels correlated directly with the bone formation rate (r = 0.84) and with eroded bone perimeter (r = 0.67). Eight of the nine patients with serum PTH levels above 125 pg/mL had marrow fibrosis. All patients with serum calcium levels < 10.0 mg/dL and serum PTH levels > 125 pg/mL had either osteitis fibrosa or mixed bone lesions--a group of patients that might benefit from aggressive vitamin D therapy. In contrast, an examination of patients with serum calcium levels > 10.0 mg/dL and serum PTH levels < 65 pg/mL correctly identified three out of three patients with aluminum-related bone disease. These findings suggest that measurements of serum intact PTH levels by the immunoradiometric assay method may be valuable in distinguishing high-turnover lesions from normal or low-turnover skeletal lesions in this population.

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