Pediatric Population
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2021 ◽  
Vol 09 (10) ◽  
pp. E1480-E1490
Salvatore Oliva ◽  
Silvio Veraldi ◽  
Salvatore Cucchiara ◽  
Giusy Russo ◽  
Alessandra Spagnoli ◽  

Abstract Background and study aims Two scores have been implemented to standardize capsule endoscopic (CE) findings in patients with Crohn’s disease (CD): Lewis score (LS) and Capsule Endoscopy Crohnʼs Disease Activity Index (CECDAI). Both have limitations and are not well validated in the pediatric population. The aim of our study was to assess a new score (capsule endoscopy – Crohn’s disease index, CE-CD) in pediatric patients with CD and to compare it to preexisting scores. Patients and methods This was a double-center, retrospective study involving pediatric subjects with CD who underwent CE. Correlation analyses between CE-CD, endoscopy scores and noninvasive markers of disease activities were performed. The ability of different CE scores to predict clinical and endoscopic outcomes was evaluated with regression and survival analyses. Results A total of 312 subjects were analyzed. The CE-CD score showed a moderate (Pearson’s r = 0.581, P < 0.001) and strong (r = 0.909, P < 0.001) association with LS and CECDAI, respectively. CE-CD was a statistically significant predictor of hospitalization (hazard ratio [HR]1.061), treatment escalation (HR 1.062), steroid therapy (HR 1.082), clinical (HR 1.064) and endoscopic (HR 1.060) relapse over the twenty-four months (P < 0.001). Subjects with mucosal inflammation according to CE-CD (CE-CD ≥ 9) had worse outcomes compared to patients without inflammation (CE-CD < 9) (Log rang test < 0.001). Conclusions The CE-CD score is a simple, reliable, reproducible, and predictive score for evaluation of small bowel inflammation in pediatric patients with CD. Prospective validation is needed to confirm the applicability of this new index in clinical practice.

Victoria J.L. Konold ◽  
Palak H. Bhagat ◽  
Jennifer Pisano ◽  
Natasha N. Pettit ◽  
Anish R. Choksi ◽  

2021 ◽  
Vol 15 (1) ◽  
Mohamed Eltayeb Abdelrahman Naiem ◽  
Nassir Alhaboob Arabi

Abstract Background Pancreatic injury presented as isolated injury in the pediatric population is exceptionally rare, with a conveyed incidence of less than 2% of all abdominal trauma injuries cases and a very controversial management approach for grade III injuries. Case presentation A 16-year-old adolescent Sudanese boy was referred to our emergency department with a 5-day history of upper and left hypochondrial pain after blunt abdominal trauma to the epigastric region with a solid object. Grade III pancreatic body trauma with major duct involvement can be successfully treated operatively. The boy was discharged home on day 10 with regular oral intake and diet. A follow-up for 6 months continued by phone, and it was uneventful with no further complications. Conclusions Roux-en-Y pancreatojejunostomy reconstruction can be a safe and valuable surgical option when the surgical approach is considered for grade III pancreatic injury.

2021 ◽  
Vol 11 (18) ◽  
pp. 8522
Luisa Chiapparini ◽  
Marco Moscatelli

In the study of cerebellar degenerative diseases, morphologic imaging (computed tomography, CT and magnetic resonance imaging, MRI) is the most common examination. From the clinical and genetic point of view, cerebellar degenerative diseases include heterogeneous conditions in which MRI may show isolated cerebellar atrophy or cerebellar atrophy associated with other cerebellar or supratentorial abnormalities. Neuroradiological progression is often observed. In congenital disorders of glycosylation (CDG), for example, MRI may be normal, may demonstrate mild cerebellar atrophy or, in the advanced stages of the disease, marked atrophy of the cerebellar hemispheres and vermis associated with the abnormal signal intensity of the cerebellar cortex and white matter and brainstem hypotrophy. In spinal cerebellar ataxias (SCAs), very rare in the pediatric population, MRI may demonstrate isolated cerebellar atrophy or cerebellar and brainstem atrophy. MRI shows characteristic findings in other diseases, strongly suggesting a distinct disorder, such as neuroaxonal dystrophy, ARSACS, ataxia-telangiectasia, or precise mitochondrial diseases. An example of neurodegenerative disorder with prenatal onset is pontocerebellar hypoplasia (PCH). PCH represents a group of neurodegenerative disorders characterized by microcephaly, early cerebellar hypoplasia, and variable atrophy of the cerebellum and ventral pons, genetically divided into several subtypes. Cerebellar hypoplasia visible on MRI is often the first sign that suggests the clinical diagnosis. In most cases, the PCH subtype may demonstrate a characteristic pattern distinguishable at MRI. Selective involvement of the cerebellum, sometimes accompanied by brainstem or supratentorial abnormalities in different combinations, may help restrict the differential diagnosis and may address the specific molecular screening.

2021 ◽  
pp. 097321792110443
Anita Singh ◽  
Harkirat Kaur ◽  
Girish Gupta ◽  
Kirti Naranje ◽  
Akanksha Verma ◽  

Immunity is protective mechanism of the body against infection, diseases, and cancers. The stronger the immunity is the healthier we are. With increasing environmental change worldwide, increase of new emerging diseases and infection over last few decades, it has become imperative to move toward prevention more than the treatment. The immune mechanism in pediatric population especially neonates and infants is much different than adults and is yet evolving. The development of immunity starts in utero and is dependent on several factors. The various efforts to improve immunity and health should start from antenatal period focusing on overall health and nutrition of mother. Maternal nutrition, antenatal steroids, and delayed cord clamping are helpful in decreasing various neonatal morbidities which include respiratory distress syndrome, sepsis, necrotizing enterocolitis, intraventricular hemorrhage, and mortality. After birth during initial 6 months, exclusive breastfeeding, growth monitoring, primary immunization, developmentally supportive care, and care of infections are of utmost importance. After 6 months of age, a balanced approach toward introduction of complementary feeding, care of micronutrients, optimal environment, and inclusion of immunity enhancing foods in diet may have considerable benefits.

2021 ◽  
Vol Publish Ahead of Print ◽  
Jing Wang ◽  
Wen-Hao Zhou

Cureus ◽  
2021 ◽  
Raphael H Parrado ◽  
Nathan S Rubalcava ◽  
Katherine P Davenport

2021 ◽  
Vol 11 (9) ◽  
pp. 1210
Mariarosaria Caliendo ◽  
Anna Di Sessa ◽  
Elisa D’Alterio ◽  
Alessandro Frolli ◽  
Domenico Verde ◽  

Background: Autism Spectrum Disorder (ASD) is characterized by impairments in social interaction and reciprocal communication. ASD affects about 1% of the general population and is associated with substantial disability and economic loss. A variety of approaches to improve the core deficits and lives of people with ASD have been developed, including behavioral, developmental, educational, and medical interventions. The main objective of this study was to evaluate the efficacy of a neuro-psychomotor approach in children affected by ASD. Methods: The sample consisted of 84 children (66 males, mean age 56.9 ± 15.8 months) affected by ASD assessed between September 2020 to March 2021. The trained therapist was asked to complete the ASD behavior inventory (ASDBI) test at baseline (T0) (September 2020) and after six months (T1) (March 2021) to assess the child’s evolution over the observational period. The study was carried out in southern Italy (Campania Region). Results: ASD children showed a significant improvement for AUTISM composite after 6 months of neuro-psychomotor treatment (T1) compared to baseline (65.4 ± 12.2 vs. 75.8 ± 11.5, p < 0.0001). In particular, significant changes were observed for such domains as the problems of excitability (ECCIT), aggression (AGG), behaviors in social relations (RELSOC), expressive (all p < 0.001), sense/perceptual contact modes (SENS) (p = 0.0007), ritualisms/resistance to changes (RIT) (p = 0.0002), pragmatic/social problems (PPSOC) (p = 0.0009), specific fears (FEARS) (p = 0.01), and learning and memory (AMLR) (p = 0.0007). No differences for the domains Semantic/pragmatic problems (PPSEM) and language (LESP) were found. Conclusions: Our preliminary results suggest the usefulness of the neuro-psychomotor treatment in children with ASD. Although promising, these findings need to be tested further to better understand the long-term effects of this specific type of approach.

Carmela Visalli ◽  
Sergio Lucio Vinci ◽  
Stefania Mondello ◽  
Firas Kobeissy ◽  
Ignazio Salamone ◽  

2021 ◽  
pp. 159101992110418
Pablo Cox ◽  
Rodrigo Riveros ◽  
Francisco Torres ◽  
Alejandro Venegas ◽  
Yuri Carvajal

Transradial access is widely used in cardiological adult interventions and less in pediatrics. In recent years, this access has become more popular in the neuroradiological community in adult patients since it has fewer complications and is more comfortable for the patient after the procedure. We present a single-center case series of 52 transradial access neurointerventions (43 angiographies and 9 therapeutic procedures) in pediatric patients, with a failure of 4 cases (7.7%) in which we could not puncture the artery, crossing over to transfemoral access. Since in five cases we did angiography followed by therapeutic intervention, thus doing only one puncture access for both procedures, then our access failure rate was 10.6%. The 34 successful transradial access solely angiographies had a median radiation exposure of 887 mGy (interquartile range 628–1352), median fluoroscopy time of 9.5 min (interquartile range 7.5–15.3), and median procedure time of 28 min (interquartile range 24–33 min) Therapeutic procedure diagnosis were: one ruptured saccular aneurysm, two juvenile nasopharyngeal angiofibromas, and five arteriovenous malformations. The transradial access neurointerventions for pediatric population older than 11 years is safe and feasible, having previous experience in adults. Younger population should be considered on a case-to-case basis, depending on ultrasound measurement of the arterial diameter and the materials available.

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