scholarly journals TREATMENT OF UNSTABLE THORACOLUMBAR FRACTURES IN PEDIATRIC PATIENTS

2015 ◽  
Vol 14 (3) ◽  
pp. 227-229 ◽  
Author(s):  
Roberto Chapa Sosa ◽  
Edgar Rubén Urrutia Vega
Keyword(s):  
Pediatric Patients ◽  
Pediatric Population ◽  
Cross Sectional Study ◽  
Thoracolumbar Fracture ◽  
Anatomical Site ◽  
Thoracolumbar Fractures ◽  
Sectional Study ◽  
Neurological Damage ◽  
Cross Sectional ◽  
Common Cause

Objective:To analyze the characteristics of unstable thoracolumbar fractures in the pediatric population.Methods:A retrospective cross-sectional study was conducted with pediatric patients (0 to 15 years) who presented with unstable thoracolumbar fracture with or without neurological damage. Twenty-four operated patients were analyzed: 13 male and 11 female.Results:Falls from height are the most common cause, being the thoracolumbar junction the anatomical site most frequently injured.Conclusion:The thoracolumbar fractures are rare in the pediatric population, as well as post-surgical instrumentation structural deformities.

scholarly journals Urate-lowering therapy for gout and asymptomatic hyperuricemia in the pediatric population: a cross-sectional study of a Japanese health insurance database

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masataka Honda ◽  
Hideki Horiuchi ◽  
Tomoko Torii ◽  
Akihiro Nakajima ◽  
Takeshi Iijima ◽  
...  
Keyword(s):  
Uric Acid ◽  
Health Insurance ◽  
Kidney Disease ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Lowering Therapy ◽  
Adult Dose

Abstract Background Our previous research showed that uric acid lowering therapy (ULT) for gout and hyperuricemia is being prescribed for pediatric patients even though these drugs have not been approved for use in children. However, the actual clinical situation has not been clearly elucidated. In this paper, we provide an in-depth look at the details of actual clinical practice. Methods This retrospective cross-sectional study accessed health insurance data for 696,277 children from April 2016 through March 2017 to identify pediatric patients with gout or asymptomatic hyperuricemia, calculate the proportion of patients prescribed ULTs, and analyze population characteristics. Adherence and mean dose for febuxostat and allopurinol, the most commonly prescribed drugs, were also analyzed. Results Among children with gout or asymptomatic hyperuricemia, we found that 35.1% (97/276) were prescribed ULT. This proportion increased with age, especially among males. By comorbidity, ULT was prescribed to 47.9% (46/96) of patients with kidney disease, 41.3% (26/63) for cardiovascular disease, 40.0% (6/15) for Down syndrome, and 27.1% (32/118) for metabolic syndrome. In patients with kidney disease, febuxostat was prescribed more than twice as frequently as allopurinol (28 vs. 12). Median values for the medication possession ratio (MPR) of febuxostat and allopurinol were 70.1 and 76.7%, respectively, and prescriptions were continued for a relatively long period for both drugs. Both drugs were prescribed at about half the adult dose for patients 6–11 years old and about the same as the adult dose for patients 12–18 years old. Conclusions This study showed that the continuous management of serum uric acid is being explored using off-label use of ULT in pediatric patients with gout or asymptomatic hyperuricemia in Japan. Drug selection is based on patient characteristics such as sex, age, and comorbidities, and pediatric dosage is based on usage experience in adults. To develop appropriate pediatric ULT, clinical trials are needed on the efficacy and safety of ULT in the pediatric population. Trial registration UMIN000036029.

scholarly journals Cross-sectional study of the clinical characteristics and outcomes of children hospitalized with COVID-19 in Lima, Peru

Medwave ◽  
2021 ◽  
Vol 21 (01) ◽  
pp. e8107-e8107
Author(s):  
Jesús Domínguez Rojas ◽  
Matilde Estupiñan Vigil ◽  
Raquel Garcés-Ghilardi ◽  
Giancarlo Alvarado-Gamarra ◽  
Olguita del Águila ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Abdomen ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Presenting Symptoms ◽  
Inflammatory Syndrome

Introduction Coronavirus 2019 (SARS-CoV-2) infection in children occurred in Peru as of March 2020, leading to pediatric patients' hospitalization in areas adapted for this purpose at the Edgardo Rebagliati Martins National Hospital. In the beginning, the demand for hospitalization was low, but it increased gradually. Consistent with international reports, the majority of patients presented mild or moderate symptoms. Nonetheless, there were also severe cases, even fatal ones. Objectives To describe the characteristics and clinical outcome of pediatric patients with COVID-19 hospitalized in a referral hospital in Lima, Peru, between March and August 2020. Methods A descriptive and inferential cross-sectional study was carried out. The population includes all hospitalized patients in the Department of Pediatrics, with clinical and surgical diagnoses associated with COVID-19. Results We included 100 patients, with an average age of 83.4 ± 54 months, with a predominance of male patients (55%). Hospitalized patients were grouped into five categories: respiratory failure (17%), multisystemic inflammatory syndrome (MIS-C) (31%), neurological presentation (19%), acute abdomen (20%), and patients with oncological problems (13%). Most of the patients (74%) had comorbidities. Regarding the presenting symptoms, intestinal pain predominated in the appendicitis group (90%, p < 0.001), fever was present in most patients with respiratory failure (64.7%); multisystemic inflammatory syndrome (90.3%), neurological manifestations (15.8%), acute abdomen (50%) and oncological conditions (61.5%) were also present in these patients. Kawasaki symptoms were found in 38.7% of the patients with multisystemic inflammatory syndrome. Mortality was 4%. Respiratory problems (29.4%) and multisystemic inflammatory syndrome (22.6%) required admission to intensive care, more frequently than the other presentations (p = 0.008). Conclusions We conclude that the vulnerability in the pediatric population is the one that has preexisting conditions. We divided our patients according to presentation, diagnosis, and complications, which were predominantly respiratory. We also had oncological patients with COVID-19.

scholarly journals Prevalence of gout and asymptomatic hyperuricemia in the pediatric population: a cross-sectional study of a Japanese health insurance database

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shuichi Ito ◽  
Tomoko Torii ◽  
Akihiro Nakajima ◽  
Takeshi Iijima ◽  
Hiroshi Murano ◽  
...  
Keyword(s):  
Uric Acid ◽  
Health Insurance ◽  
Pediatric Population ◽  
Gouty Arthritis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Insurance Claims ◽  
Cross Sectional ◽  
Total Prevalence ◽  
Health Insurance Claims

Abstract Background Although gout is rare in children, chronic sustained hyperuricemia can lead to monosodium urate deposits progressing to gout, just as in adults. This study assessed prevalence and characteristics of gout and asymptomatic hyperuricemia, and incidence of gouty arthritis in the pediatric population, using data from Japanese health insurance claims. The diagnosis and treatment of pediatric gout and hyperuricemia were analyzed, and specific characteristics of those patients were assessed. Since Japanese guidelines recommend treatment with uric acid lowering drugs for asymptomatic hyperuricemia as well as for gout, these data were also used to investigate the real-world use of uric acid lowering drugs in a pediatric population. Methods This cross-sectional study was based on a 2016–2017 Japanese health insurance claims database, one of the largest epidemiology claims databases available in Japan, which included 356,790 males and 339,487 females 0–18 years of age. Outcomes were measured for prevalence, patient characteristics, treatment with uric acid lowering drugs for gout and asymptomatic hyperuricemia, and prevalence and incidence of gouty arthritis. Because uric acid can be elevated by some forms of chemotherapy, data from patients under treatment for malignancies were excluded from consideration. Results Total prevalence of gout and asymptomatic hyperuricemia in 0–18 year-olds was 0.040% (276/696,277 patients), with gout prevalence at 0.007% (48/696,277) and asymptomatic hyperuricemia at 0.033% (228/696,277). Prevalence of gout and asymptomatic hyperuricemia was highest in adolescent males, at 0.135% (176/130,823). The most common comorbidities for gout and asymptomatic hyperuricemia were metabolic syndrome at 42.8% (118/276) and kidney disease at 34.8% (96/276). Of the patients diagnosed with gout or asymptomatic hyperuricemia, 35.1% (97/276) were treated with uric acid lowering drugs. Gouty arthritis developed in 43.8% (21/48) of gout patients during the study, at an incidence of 0.65 flares/person-year. Conclusions Even the pediatric population could be affected by asymptomatic hyperuricemia, gout, and gouty arthritis, and uric acid lowering drugs are being used in this population even though those drugs have not been approved for pediatric indications. Such off-label use may indicate a potential need for therapeutic agents in this population. Trial registration UMIN000036029.

scholarly journals S. haematobium as a Common Cause of Genital Morbidity in Girls: A Cross-sectional Study of Children in South Africa

2013 ◽  
Vol 7 (3) ◽  
pp. e2104 ◽  
Author(s):  
Ingrid Elise Amlie Hegertun ◽  
Kristin Marie Sulheim Gundersen ◽  
Elisabeth Kleppa ◽  
Siphosenkosi Gift Zulu ◽  
Svein Gunnar Gundersen ◽  
...  
Keyword(s):  
South Africa ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Common Cause

scholarly journals Microalbuminuria in Ischaemic Stroke and its Relationship with Neurological Defects

2010 ◽  
Vol 15 (Number 2) ◽  
pp. 15-18
Author(s):  
S S Chowdhury ◽  
T Mehdi ◽  
F Alam ◽  
R Ishrat ◽  
S Parveen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischaemic Stroke ◽  
Developed Countries ◽  
Cross Sectional Study ◽  
Neurological Deficits ◽  
Sectional Study ◽  
Cross Sectional ◽  
Common Cause ◽  
Face To Face ◽  
Structured Questionnaire

Stroke is Me third common cause of death in developed countries. Ischaernic stroke accounts for about 83 percent of all cases. For ischaemic stroke, besides modifiable and nononodifiable risk factors. there are some potential nosy risk factors which include mieroalbuminuria. Site objective of this study was to observe the association of microalbuminuria with isehaemic stroke and as well as consequent neurological deficits. This cross sectional study was done among 100 diagnosed patients of ischaeoric stroke of both sexes. A structured questionnaire and checklist was used to collect data through face to face interview. Urinary microalbuminuria was mesured in all study subjects and assessment of necrological defects was done by modified Ranakin scale. The study revealed that the frequency of presence of microallmminteria was significantly high in ischaernic stroke. Higher the level of mieroalburninuria higher was the necrological deficit. So, microalbunrinuria may be a marker for the process to develop the ischamnic stroke.

scholarly journals Characteristics of prescriptions and costs for acute upper respiratory tract infections in Chinese outpatient pediatric patients: a nationwide cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shan Wang ◽  
Lihua Liu ◽  
Jianchao Liu ◽  
Likun Miao ◽  
Qian Zhuang ◽  
...  
Keyword(s):  
Outpatient Care ◽  
Pediatric Patients ◽  
Cross Sectional Study ◽  
Upper Respiratory Tract ◽  
Sectional Study ◽  
Cross Sectional ◽  
Short Supply ◽  
Upper Respiratory ◽  
Tract Infections ◽  
Clinical Records

Abstract Background To understand the characteristics of prescriptions and costs in pediatric patients with acute upper respiratory infections (AURI) is important for the regulation of outpatient care and reimbursement policy. This study aims to provide evidence on these issues that was in short supply. Methods We conducted a retrospective cross-sectional study based on data from National Engineering Laboratory of Application Technology in Medical Big Data. All outpatient pediatric patients aged 0–14 years with an uncomplicated AURI from 1 January 2015 to 31 December 2017 in 138 hospitals across the country were included. We reported characteristics of patients, the average number of medications prescribed per encounter, the categories of medication used and their percentages, the cost per visit and prescription costs of drugs. For these measurements, discrepancies among diverse groups of age, regions, insurance types, and AURI categories were compared. Kruskal-Wallis nonparametric test and Student-Newman-Keuls test were performed to identify differences among subgroups. A multinomial logistic regression was conducted to examine the independent effects of those factors on the prescribing behavior. Results A total of 1,002,687 clinical records with 2,682,118 prescriptions were collected and analyzed. The average number of drugs prescribed per encounter was 2.8. The most frequently prescribed medication was Chinese traditional patent medicines (CTPM) (36.5% of overall prescriptions) followed by antibiotics (18.1%). It showed a preference of CPTM over conventional medicines. The median cost per visit was 17.91 USD. The median drug cost per visit was 13.84 USD. The expenditures of antibiotics and CTPM per visit (6.05 USD and 5.87 USD) were among the three highest categories of drugs. The percentage of out-of-pocket patients reached 65.9%. Disparities were showed among subgroups of different ages, regions, and insurance types. Conclusions The high volume of CPTM usage is the typical feature in outpatient care of AURI pediatric patients in China. The rational and cost-effective use of CPTM and antibiotics still faces challenges. The reimbursement for child AURI cases needs to be enhanced.

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