pediatric population
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2022 ◽  
Vol 17 (3) ◽  
pp. 467-472
Author(s):  
Divina D'Auria ◽  
Dolores Ferrara ◽  
Gioconda Argenziano ◽  
Domenico Noviello ◽  
Anna Marcella Giugliano ◽  
...  

2022 ◽  
Vol 19 (1) ◽  
pp. 26-29
Author(s):  
Feeroz Alam Khan ◽  
Prabir Maharjan

Introduction: Undescended testis is one of the commonest presentations in pediatric population. Conventionally, high ligation of the hernia sac was done after vas and vessels were dissected in order to prevent post-operative hernia. However, recent studies have shown that hernia sac ligation was unnecessary. Aims: To evaluate the role of hernia sac ligation during orchidopexy to prevent the development of postoperative hernia and to compare the mean operative time with and without sac ligation. Methods: A prospective comparative study was conducted with a total of 94 patients with undescended testis, age ranging from six months to 16 years were included in the study from November 2018 to May 2021. Cases were randomly divided into two groups. In Group A cases, orchidopexy was carried out with sac ligation, while in Group B, the hernia sac was not ligated. Mean operative time was recorded in each case. All the patients were followed up at one, four and eight weeks post-operatively and examined for postoperative hernia. Results: Of the total 94 cases, there were 18 bilateral and 76 unilateral cases of which 56 were right-sided and 22 left-sided. Most of the patients (45) of the study were between six months and 2 years. None of the patients of either group developed post-operative hernia or any significant complications. The mean operative time for group A and B were 36.72 and 46.96 minutes respectively. Conclusion: It was concluded that ligation of processus vaginalis was unnecessary during orchidopexy and sac ligation consumed more operative time.


Pharmacy ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 16
Author(s):  
Sarah Grace Gunter ◽  
Mary Joyce B. Wingler ◽  
David A. Cretella ◽  
Jamie L. Wagner ◽  
Katie E. Barber ◽  
...  

Limited data are available regarding optimal antimicrobial therapy for Staphylococcus aureus bacteremia (SAB) in pediatric patients. The purpose of this study was to assess clinical characteristics and outcomes associated with intravenous (IV) versus oral step-down treatment of pediatric SAB. This study evaluated patients aged 3 months to 18 years that received at least 72 h of inpatient treatment for SAB. The primary endpoint was 30-day readmission. Secondary endpoints included hospital length of stay and inpatient mortality. One hundred and one patients were included in this study. The median age was 7.9 years. Patients who underwent oral step-down were less likely to be immunocompromised and more likely to have community-acquired SAB from osteomyelitis or skin and soft tissue infection (SSTI). More patients in the IV therapy group had a 30-day readmission (10 (25.6%) vs. 3 (5.3%), p = 0.006). Mortality was low (5 (5%)) and not statistically different between groups. Length of stay was greater in patients receiving IV therapy only (11 vs. 7 days, p = 0.001). In this study, over half of the patients received oral step-down therapy and 30-day readmission was low for this group. Oral therapy appears to be safe and effective for patients with SAB from osteomyelitis or SSTIs.


2022 ◽  
Vol 9 ◽  
Author(s):  
Andrea Accogli ◽  
Ana Filipa Geraldo ◽  
Gianluca Piccolo ◽  
Antonella Riva ◽  
Marcello Scala ◽  
...  

Macrocephaly affects up to 5% of the pediatric population and is defined as an abnormally large head with an occipitofrontal circumference (OFC) >2 standard deviations (SD) above the mean for a given age and sex. Taking into account that about 2–3% of the healthy population has an OFC between 2 and 3 SD, macrocephaly is considered as “clinically relevant” when OFC is above 3 SD. This implies the urgent need for a diagnostic workflow to use in the clinical setting to dissect the several causes of increased OFC, from the benign form of familial macrocephaly and the Benign enlargement of subarachnoid spaces (BESS) to many pathological conditions, including genetic disorders. Moreover, macrocephaly should be differentiated by megalencephaly (MEG), which refers exclusively to brain overgrowth, exceeding twice the SD (3SD—“clinically relevant” megalencephaly). While macrocephaly can be isolated and benign or may be the first indication of an underlying congenital, genetic, or acquired disorder, megalencephaly is most likely due to a genetic cause. Apart from the head size evaluation, a detailed family and personal history, neuroimaging, and a careful clinical evaluation are crucial to reach the correct diagnosis. In this review, we seek to underline the clinical aspects of macrocephaly and megalencephaly, emphasizing the main differential diagnosis with a major focus on common genetic disorders. We thus provide a clinico-radiological algorithm to guide pediatricians in the assessment of children with macrocephaly.


2022 ◽  
Vol 23 (2) ◽  
pp. 870
Author(s):  
Anna Kawalec ◽  
Danuta Zwolińska

The microbiome of the urinary tract plays a significant role in maintaining health through the impact on bladder homeostasis. Urobiome is of great importance in maintaining the urothelial integrity and preventing urinary tract infection (UTI), as well as promoting local immune function. Dysbiosis in this area has been linked to an increased risk of UTIs, nephrolithiasis, and dysfunction of the lower urinary tract. However, the number of studies in the pediatric population is limited, thus the characteristic of the urobiome in children, its role in a child’s health, and pediatric urologic diseases are not completely understood. This review aims to characterize the healthy urobiome in children, the role of dysbiosis in urinary tract infection, and to summarize the strategies to modification and reshape disease-prone microbiomes in pediatric patients with recurrent urinary tract infections.


Author(s):  
Ingo Mrosewski ◽  
Tobias Dähn ◽  
Jörg Hehde ◽  
Elena Kalinowski ◽  
Ilona Lindner ◽  
...  

Abstract Objectives Establishing direct reference intervals (RIs) for pediatric patients is a very challenging endeavor. Indirectly determined RIs can address this problem by utilization of existing clinical laboratory databases. In order to provide better laboratory services to the local pediatric population, we established population-specific hematology RIs via data mining. Methods Our laboratory information system (LIS) was searched for pediatric blood counts of patients aged from 0 days to 18 years, performed from 1st of January 2018 until 31st of March 2021. In total, 27,554 blood counts on our SYSMEX XN-9000 were initially identified. After application of pre-defined exclusion criteria, 18,531 sample sets remained. Age- and sex-specific RIs were established in accordance with International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) and Clinical & Laboratory Standards Institute (CLSI) recommendations. Results When compared to pediatric RIs supplied by other authors, the RIs determined specifically for pediatric patients from Berlin and Brandenburg showed several relevant differences, especially with regard to white blood cell counts (WBCs), red blood cell counts (RBCs), red cell distribution widths (RDW) and platelet counts (PLTs) within the distinct age groups. Additionally, alterations to several published age-specific partitions had to be made, while new sex-specific partitions were introduced for WBCs and PLTs. Conclusions Generic RIs from textbooks, manufacturer information and medical publications – even from nationwide or multicenter studies – commonly used in many laboratories might not reflect the specifics of local patient populations properly. RIs should be tailored to the serviced patient population whenever possible. Careful data mining appears to be suitable for this task.


Children ◽  
2022 ◽  
Vol 9 (1) ◽  
pp. 102
Author(s):  
Mirjam Močnik ◽  
Nataša Marčun Varda

Cardiovascular diseases are the leading cause of morbidity and mortality in the modern world. Their common denominator is atherosclerosis, a process beginning in childhood. In pediatrics, the aim of preventive measures is to recognize children and adolescents at risk for accelerated atherosclerosis and possible premature cardiovascular events in adulthood. Several diagnostic procedures and biomarkers are available for cardiovascular risk assessment in adults. However, reliable markers in pediatrics are still insufficiently studied. In this contribution, we discuss five potential biomarkers of particular interest: kidney injury molecule-1, salusin-α and -β, uromodulin, and adropin. Studies regarding the pediatric population are scarce, but they support the evidence from studies in the adult population. These markers might entail both a prognostic and a therapeutic interest.


2022 ◽  
Author(s):  
Stefania Zambrano ◽  
Barbara Parma ◽  
Valeria Morabito ◽  
Silvia Borini ◽  
Roberta Romaniello ◽  
...  

Abstract Background: In recent decades some studies described the frequent co-occurrence of celiac disease autoimmunity and/or overt celiac disease in patients with autism. Therefore, it was suggested that celiac disease could play a possible role in the etiopathogenesis of autism spectrum disorder. However, several other studies have not confirmed this association. The aim of the present study was to elucidate the potential association between autism spectrum disorder and celiac disease.Methods: We prospectively collected data from an Italian cohort of 223 children at the time of their clinical diagnosis of autism spectrum disorder in the 2019-2020 period. A serological celiac disease screening was performed and data were available for 196 patients; male (M):female (F) ratio = 4.4:1; median age = 3.6 years; age range = 1.6–12.8 years. Full-blown celiac disease was established according to the diagnostic algorithm of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) 2012 or 2019 guidelines. Fisher’s exact test was used to compare the celiac disease seroprevalence and prevalence in our autism spectrum disorder cohort and in the Italian healthy pediatric population studied by Gatti et al. to highlight the possible differences between the two groups.Results: A not statistically significant difference between the celiac disease seroprevalence in our autism spectrum disorder cohort (4.08%) and Gatti’s Italian healthy group (2.22%) was found, p = 0.0810; OR = 1.871. A similar result emerged for overt celiac disease prevalences (2.24% versus 1.58%, respectively), p = 0.2862; OR = 1.431.Conclusions: Our data validates a weakness of association between autism spectrum disorder and celiac disease. Regular screening for celiac disease in young patients with autism spectrum disorder is not strongly recommended to a greater extent than in the general population.


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