Thrombosis in Infants and Children

Hematology ◽  
2006 ◽  
Vol 2006 (1) ◽  
pp. 86-96 ◽  
Author(s):  
Reinhard Schneppenheim ◽  
Jeanette Greiner
Keyword(s):  
Risk Factors ◽  
Clinical Presentation ◽  
Infants And Children ◽  
Therapeutic Interventions ◽  
Older Children ◽  
Thrombotic Risk ◽  
Therapeutic Decisions ◽  
Prophylactic Anticoagulation ◽  
Clinical Conditions ◽  
In Infants And Children

Abstract During the last decade much progress has been made toward better understanding of the underlying reasons causing thromboembolism in children. A considerable number of acquired and hereditary thrombotic risk factors have been identified which may also have an impact on therapeutic decisions and prognosis concerning outcome and the risk of a second event. However, indications for therapeutic interventions, such as thrombolysis and prophylactic anticoagulation with respect to the different clinical conditions and their combination with other risk factors, are not yet well defined. The following article describes the causes, clinical presentation and management of thrombosis in neonates, infants and older children, focusing on the clinically most relevant conditions.

scholarly journals Endoscopic retrograde cholangiopancreatography in infants and children

2021 ◽  
Vol 09 (03) ◽  
pp. E292-E296
Author(s):  
Tone Lise Åvitsland ◽  
Lars Aabakken
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Medical Records ◽  
Pediatric Patients ◽  
Biliary Stricture ◽  
Infants And Children ◽  
University Hospital ◽  
Older Children ◽  
Endoscopic Retrograde ◽  
Procedure Codes ◽  
In Infants And Children

Abstract Background and study aims Previous reports have suggested that endoscopic retrograde cholangiopancreatography (ERCP) in pediatric patients are safe. However, the total number of cases presented in the literature remains small. We present results regarding safety and outcomes in pediatric patients undergoing ERCP at Oslo University Hospital. Patients and methods Patients < 18 years who underwent ERCP between April 1999 and November 2017 were identified using procedure codes. Medical records were examined for age, gender, diagnosis, indications, type of sedation, findings, interventions, and complications. Results A total of 244 procedures were performed in 158 patients. Fifty-six of these were in 53 infants (age ≤ 1 year). Mean age was 8.8 years. The youngest patient was 8 days old. Mean weight was 5.0 kg in infants, the smallest weighing 2.9 kg. Cannulation failed in 19 (7.8 %). The main indication in infants was suspicion of biliary atresia (n = 38). Six of the procedures (10.7 %) were therapeutic. In children the main indications were biliary stricture (n = 64) and investigation of primary sclerosing cholangitis (PSC) (n = 45). 119 (63.2 %) of these procedures were therapeutic.Complications were uncommon in infants; only two episodes of infection were registered. In children (> 1 year) post-ERCP pancreatitis were seen in 10.4 %. Conclusions Our retrospective series of ERCP procedures includes 56 procedures in infants, which is one of the largest series presented. Complications in infants are rare and post-ERCP pancreatitis was not seen. In older children 10.4 % experienced post-ERCP pancreatitis. In expert hands, ERCP was shown to be acceptably feasible and safe in infants and children.

CONTACT-TYPE DELAYED HYPERSENSITIVITY IN INFANTS AND CHILDREN: INDUCTION OF RHUS SENSITIVITY

PEDIATRICS ◽  
1961 ◽  
Vol 27 (1) ◽  
pp. 51-53
Author(s):  
William L. Epstein
Keyword(s):  
Intermediate Position ◽  
Infants And Children ◽  
Delayed Hypersensitivity ◽  
Older Children ◽  
Contact Sensitization ◽  
Contact Type ◽  
Frequency Of Contact ◽  
In Infants And Children

The frequency of contact sensitization to a Rhus allergen, pentadecyl catechol, was determined in 102 infants and children 1 month to 8 years of age. Children between 3 and 8 years were readily sensitized and showed a depth of sensitivity and intensity of reaction comparable to that seen in adults. Infants below the age of 1 year had a markedly depressed ability to react to Rhus allergens. Children between 1 and 3 years old assumed an intermediate position, being more reactive than infants, but less so than older children. Theoretically these observations suggest that the mechanism of delayed hypersensitivity matures more slowly than other processes of immunity and resistance. Clinically the findings mean that lack of exposure is a more important factor than lack of susceptibility in explaining the diminished incidence of clinical Rhus sensitivity in children below the age of 8 years.

Risk Factors for Hypotension after Intra-Operative Protamine Administration in Infants and Children

2002 ◽  
Vol 96 (Sup 2) ◽  
pp. A1287
Author(s):  
Harry A. Seifert ◽  
David R. Jobes ◽  
Thomas Ten Have ◽  
Stephen E. Kimmel ◽  
Brian L. Strom
Keyword(s):  
Risk Factors ◽  
Infants And Children ◽  
In Infants And Children ◽  
Protamine Administration

scholarly journals Ischemic Stroke in Infants and Children: Practical Management in Emergency

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Sara Ciccone ◽  
Michela Cappella ◽  
Caterina Borgna-Pignatti
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Rare Disease ◽  
Clinical Picture ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Signs And Symptoms ◽  
The Subject ◽  
Underlying Diseases ◽  
In Infants And Children

Stroke is a rare disease in children, with an estimated incidence 13/100000 and a significant impact on morbidity and mortality. Clinical presentation and risk factors, present in almost half of pediatric patients, are not the same as in adults. The diagnosis of stroke in children is often delayed because signs and symptoms can be subtle and nonspecific. History and clinical examination should exclude underlying diseases or predisposing factors. Neuroimaging is crucial in defining diagnosis. Other tests might be necessary, according to the clinical picture. We present here the most recent practical directions on how to diagnose and manage arterial stroke in children, according to different international guidelines on the subject.

Perianal Abscesses and Fistulas in Infants and Children

2020 ◽  
Vol 30 (05) ◽  
pp. 386-390
Author(s):  
Jan-Hendrik Gosemann ◽  
Martin Lacher
Keyword(s):  
Pediatric Patients ◽  
Clinical Presentation ◽  
Perianal Abscess ◽  
Current Evidence ◽  
Surgical Approaches ◽  
Older Children ◽  
Fistula In Ano ◽  
Inflammatory Bowel ◽  
In Infants And Children ◽  
Rule Out

AbstractPerianal abscess (PA) and fistula-in-ano (FIA) are common entities in infancy. Although several hypotheses have been suggested, the pathogenesis of PA/FIA remains elusive. The natural course of these diseases in infancy is self-limiting in the majority of cases whereas older children show similarities to PA/FIA in adults. It is important to rule out rare differential diagnoses of PA/FIA such as inflammatory bowel disease (IBD), surgical complications after colorectal surgery, and immunodeficiencies. Treatment remains empiric, comprises conservative, as well as surgical approaches, and is dependent on the age of the patient. This review summarizes anatomical aspects, current evidence on disease pathogenesis, clinical presentation, and management of pediatric patients with PA and FIA.

Pediatric Pain

2019 ◽  
pp. 773-782
Author(s):  
Juliana H. O’Brien ◽  
Maggie C. Root
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Developmental Stages ◽  
Developmentally Appropriate ◽  
Infants And Children ◽  
Psychological Consequences ◽  
Older Children ◽  
Nonverbal Children ◽  
In Infants And Children ◽  
Experience Pain

Children and infants experience pain as a serious complication of disease and injury, but only recently have clinicians come to understand how children experience pain. Exposure to painful injury is associated with psychological consequences in infants and children, including posttraumatic stress symptoms, neurodevelopmental issues, increased anxiety, and cortical dysfunction in childhood. In seriously ill infants, pain may be associated with increased morbidity and mortality; in older children, untreated pain can lead to decreased functioning, social isolation, sleep disorders, and mood changes. Prevention and relief of pain for this vulnerable population is essential. Pain assessment and management in infants and children require that palliative care nurses understand the developmental stages of childhood. This chapter provides a recommended approach to pain assessment and pain management in children. It outlines age-specific and developmentally appropriate pain assessment tools. It describes commonly observed pain behaviors in verbal and nonverbal children. It highlights the management differences between acute pain, neuropathic pain, and chronic pain. It details a combined nonpharmacologic and pharmacologic (including weight-based dosing) approach for pain management.

scholarly journals National registry for sudden unexpected deaths of infants and children in England: why do we need one and do families want one?

2019 ◽  
Vol 104 (10) ◽  
pp. 989-993 ◽  
Author(s):  
Emma Matthews ◽  
Peter Blair ◽  
Sanjay Sisodiya ◽  
Stuart Jones ◽  
Neil Sebire ◽  
...  
Keyword(s):  
Risk Factors ◽  
Public Health Problem ◽  
Epidemiological Data ◽  
National Registry ◽  
Infants And Children ◽  
Older Children ◽  
Unexpected Death ◽  
Infant Deaths ◽  
Unknown Risk ◽  
Infancy And Childhood

The sudden and unexpected death of an infant or child is devastating. An inability to explain why an infant or child died is difficult to accept for both families and professionals. No reliable national dataset exists to estimate precisely how many infants and children die unexpectedly each year in England. This lack of accurate epidemiological data belies the scale of this public health problem. Detailed controlled observational studies of infant deaths identifying risk factors and providing evidence-based advice for parents has seen a dramatic reduction in incidence over the last 30 years by almost 80% but greater knowledge is needed if future deaths of infants and older children are to be prevented and families optimally supported. We propose that a national registry of sudden unexpected deaths in infancy and childhood would accurately determine incidence, identify unknown risk factors and highlight good care practices, ensuring these can be standardised nationally. For such a project to be successful, however, parents must be at the heart of it. We held a consultation day between families, professionals and supporting charities (The Lullaby Trust, Child Bereavement UK, SUDC UK and CRY) to seek opinion on the desire for a registry and how best to ensure families are engaged. Here, we summarise our rationale for a registry and the feedback we received from attendees regarding their views of the proposal and the practical aspects of administering it.

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