Amit Singh, Sabyasachi Senapati, I. Panigrahi, P. Khetarpal
{"title":"Novel Compound Heterozygous Mutations of LIG4 Gene in an Indian LIG4 Syndrome Patient with Severe Microcephaly: Case Report, In-silico Analysis and Systematic Review.","authors":"Amit Singh, Sabyasachi Senapati, I. Panigrahi, P. Khetarpal","doi":"10.2174/0115733963285549240328083623","DOIUrl":"https://doi.org/10.2174/0115733963285549240328083623","url":null,"abstract":"BACKGROUND\u0000LIG4 syndrome, characterized by immunodeficiency, sensitivity to ionizing radiations, intrauterine growth retardation, postnatal growth retardation, and microcephaly, is a rare genetic disorder caused by pathogenic variants of the LIG4 gene. Few patients are presented with no immune dysregulation as well.\u0000\u0000\u0000CASE STUDY\u0000We present here a male child of 2 years and 4 months of age with severe microcephaly and short stature. His birth weight was 1.9 Kg, and his current height, weight, and head circumference are 83.2 cm (z score = -2.37), 9.5 Kg (z score = -2.76), and 36 cm (z score = -9.24), respectively. Possible causative pathogenic compound heterozygous variants of the LIG4 gene, which were inherited from the parents, were identified by whole exome sequencing of the DNA of the patient and his parents. A systematic review of the literature is also performed to summarize the patients of LIG4 syndrome reported worldwide and summarize the associated genetic mutations of the LIG4 gene. Compound heterozygous variants (c.597_600delTCAG/ c.342del) of LIG4 gene were identified. The parents were found to be heterozygous carriers of one variant each.\u0000\u0000\u0000CONCLUSION\u0000The in-silico analysis of identified variants explains their effect on the structure and function of the LIG4 protein hence explaining the genotype-phenotype correlation.","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140730005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Transcranial Magnetic Stimulation in the Treatment of Autism Spectrum Disorder: An Approach.","authors":"Cyndi Yacira Meneses Castaño, Paola Penagos","doi":"10.2174/0115733963285951240328051515","DOIUrl":"https://doi.org/10.2174/0115733963285951240328051515","url":null,"abstract":"<jats:sec>\u0000<jats:title />\u0000<jats:p />\u0000</jats:sec>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140750398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna Degtyareva, Alina Dokshukina, Elena Filippova, Jekaterina Shubina, Ekaterina Tolmacheva, Igor Sadelov, Marina Albegova, Dmitriy Degtyarev
{"title":"Newly Described Mutations of the UNC45A Gene in Infants with Jaundice and Pruritus.","authors":"Anna Degtyareva, Alina Dokshukina, Elena Filippova, Jekaterina Shubina, Ekaterina Tolmacheva, Igor Sadelov, Marina Albegova, Dmitriy Degtyarev","doi":"10.2174/0115733963264010231213103328","DOIUrl":"https://doi.org/10.2174/0115733963264010231213103328","url":null,"abstract":"<p><strong>Background: </strong>Cholestatic liver disease is an important cause of morbidity and mortality and a leading indication for liver transplantation in children. These include diseases, such as biliary atresia, Alagille syndrome, progressive familial intrahepatic cholestasis, sclerosing cholangitis, bile acid synthesis defects, and many others.</p><p><strong>Case presentation: </strong>NGS was used as a diagnostic tool to identify the genetic cause in the patient with cholestatic syndrome and to figure out and describe what mutation will be found. In the present observation, the cholestasis syndrome with low GGT activity and intense pruritus was the leading symptom of the patient. The examination also revealed other characteristic features of osteo- oto-hepato-enteric syndrome. The patient had facial features that mimicked Alagille syndrome, which complicated the diagnostic search. Moreover, the genetic test revealed two new pathogenic variants in the UNC45A gene.</p><p><strong>Conclusion: </strong>This clinical observation demonstrates the importance of a multidisciplinary approach in the diagnosis of rare genetic diseases and using WES, which can accelerate the diagnosis compared with outdated gene panels.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karen K Y Leung, Joanna Y L Tung, Yan Tung Kelly Lee, Stephanie Tsang, Kam Lun Hon
{"title":"A Narrative Review on Diabetic Ketoacidosis in Children.","authors":"Karen K Y Leung, Joanna Y L Tung, Yan Tung Kelly Lee, Stephanie Tsang, Kam Lun Hon","doi":"10.2174/0115733963276045240123154733","DOIUrl":"https://doi.org/10.2174/0115733963276045240123154733","url":null,"abstract":"<p><strong>Background: </strong>Diabetic ketoacidosis (DKA) is a life-threatening complication in children with diabetes mellitus. There are considerable differences in the management approaches for DKA between different countries. One of the main areas of differences between guidelines is the administration of fluid, with most guidelines adopting a restrictive approach. This is based on the concern over cerebral oedema, a lethal sequela allegedly to be caused by excessive fluid administration. However, in recent years, new clinical studies suggest that there is no causal relationship between intravenous fluid therapy and DKA-related cerebral injury. The British Society of Paediatric Endocrinology updated its guideline in 2020 to adopt a more permissive approach to fluid administration, which has sparked controversy among some paediatricians.</p><p><strong>Objectives: </strong>The purpose of this article is to provide a narrative review on the management of DKA.</p><p><strong>Methods: </strong>A PubMed search was performed with clinical queries using the key term \"diabetic ketoacidosis\". The search strategy included randomized controlled trials, clinical trials, meta-analyses, observational studies, guidelines, and reviews. The search was restricted to English literature and the age range of 18 years and younger. Moreover, we reviewed and compared major guidelines.</p><p><strong>Conclusion: </strong>The management of DKA involves early recognition, accurate diagnosis, meticulous fluid and insulin treatment with close monitoring of blood glucose, ketones, electrolytes, renal function, and neurological status. There is still limited clinical evidence to support either a restrictive or permissive approach in the fluid management of paediatric DKA patients. Clinicians should exercise caution when applying different guidelines in their clinical practice, considering the specific circumstances of individual paediatric patients.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139650449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Iodine Status in Cyprus and Neighboring Countries: A Review Article.","authors":"Nese Akcan, Ismet Zaimagaoglu","doi":"10.2174/0115733963275007231227051736","DOIUrl":"https://doi.org/10.2174/0115733963275007231227051736","url":null,"abstract":"<p><p>Despite the implementation of global iodine supplementation initiatives in the past decade, the problem of iodine deficiency persists as a significant public health concern in numerous countries. Although cretinism is now rare in developed countries, iodine deficiency can still lead to less severe cognitive deficits, which can negatively impact academic achievement, intellectual capacity, and work productivity. There is a scarcity of studies regarding the status of Cyprus, and the global database does not have any information pertaining to the prevalence of iodine deficiency in Cyprus. The geographical setting of the research is of importance as it pertains to the separation of Cyprus into two distinct areas. One region is predominantly inhabited by Greek Cypriots, where the practice of salt iodization is not mandatory. Conversely, the other region is primarily inhabited by Turkish Cypriots, who may potentially experience higher amounts of iodine contact due to their reliance on food imports from Turkey, where salt-iodisation is compulsory. The main objective of this study is to provide an overview of recent research conducted on the prevalence of iodine deficiency in Cyprus and neighboring Mediterranean nations. In this study, we assess the current method and subsequently offer public health recommendations for future research endeavors.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139650450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kam Lun Ellis Hon, Daniel K K Ng, Wa Keung Chiu, Alexander K C Leung
{"title":"Insights from Overviewing Selective International Guidelines for Pediatric Asthma.","authors":"Kam Lun Ellis Hon, Daniel K K Ng, Wa Keung Chiu, Alexander K C Leung","doi":"10.2174/0115733963270829231221062201","DOIUrl":"https://doi.org/10.2174/0115733963270829231221062201","url":null,"abstract":"<p><strong>Background: </strong>Asthma is a chronic atopic and inflammatory bronchial disease characterized by recurring symptoms and, episodic reversible bronchial obstruction and easily triggered bronchospasms. Asthma often begins in childhood. International guidelines are widely accepted and implemented; however, there are similarities and differences in the management approaches. There is no national guideline in many cities in Asia. This review aims to provide a practical perspective on current recommendations in the management of childhood asthma, specifically in the following aspects: diagnosis, classification of severity, treatment options, and asthma control, and to provide physicians with up-to-date information for the management of asthma.</p><p><strong>Methods: </strong>We used the PubMed function of Clinical Queries and searched keywords of \"Asthma\", \"Pediatric,\" AND \"Guidelines\" as the search engine. \"Clinical Prediction Guides\", \"Etiology\", \"Diagnosis\", \"Therapy,\" \"Prognosis,\" and \"Narrow\" scope were used as filters. The search was conducted in November 2022. The information retrieved from this search was used in compiling the present article.</p><p><strong>Results: </strong>Diagnosis is clinically based on symptom pattern, response to therapy with bronchodilators and inhaled corticosteroids, and spirometric pulmonary function testing (PFT). Asthma is classified in accordance with symptom frequency, peak expiratory flow rate (PEFR), forced expiratory volume in one second (FEV1), atopic versus nonatopic etiology, where atopy means a predisposition toward a type 1 hypersensitivity reaction. Asthma is also classified as intermittent or persistent (mild to severe). Unfortunately, there is no disease cure for asthma. However, symptoms can be prevented by trigger avoidance and suppressed with inhaled corticosteroids. Antileukotriene agents or long-acting beta-agonists (LABA) may be used together with inhaled corticosteroids if symptoms of asthma are not controlled. Rapidly worsening symptoms are usually treated with an inhaled short-acting beta-2 agonist (SABA, e.g., salbutamol) and oral corticosteroids. Intravenous corticosteroids and hospitalization are required in severe cases of asthma attacks. Some guidelines also provide recommendations on the use of biologics and immunotherapy.</p><p><strong>Conclusion: </strong>Asthma is diagnosed clinically, with supporting laboratory testing. Treatment is based on severity classification, from intermittent to persistent. Inhaled bronchodilator and steroid anti-inflammatory form the main stay of management.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139574990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexander K C Leung, Joseph M Lam, Benjamin Barankin, Alex H C Wong, Kin Fon Leong, Kam Lun Hon
{"title":"Pinworm (Enterobius Vermicularis) Infestation: An Updated Review.","authors":"Alexander K C Leung, Joseph M Lam, Benjamin Barankin, Alex H C Wong, Kin Fon Leong, Kam Lun Hon","doi":"10.2174/0115733963283507240115112552","DOIUrl":"10.2174/0115733963283507240115112552","url":null,"abstract":"<p><strong>Background: </strong>Pinworm infestation is an important public health problem worldwide, especially among children 5 to 10 years of age in developing countries with temperate climates. The problem is often overlooked because of its mild or asymptomatic clinical manifestations.</p><p><strong>Objective: </strong>The purpose of this article was to familiarize pediatricians with the diagnosis and management of pinworm infestation.</p><p><strong>Methods: </strong>A search was conducted in August 2023 in PubMed Clinical Queries using the key terms \"Enterobius vermicularis,\" OR \"enterobiasis,\" OR \"pinworm.\" The search strategy included all clinical trials, observational studies, and reviews published within the past 10 years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of the present article.</p><p><strong>Results: </strong>Enterobiasis is a cosmopolitan parasitosis caused by Enterobius vermicularis. It affects approximately 30% of children worldwide and up to 60% of children in some developing countries. Predisposing factors include poor socioeconomic conditions, inadequate sanitation, poor personal hygiene, and overcrowding. Children aged 5 to 14 years have shown the highest prevalence of enterobiasis.. Egg transmission is mainly by the fecal-oral route. Approximately 30 to 40% of infested patients do not show any clinical symptoms of the disease. For symptomatic patients, the most common presenting symptom is nocturnal pruritus ani. The diagnosis of E. vermicularis infection is best established by the cellophane tape test. The sensitivity of one single test is around 50%; however, the sensitivity increases to approximately 90% with tests performed on three different mornings. If a worm is visualized in the perianal area or the stool, a pathological examination of the worm will yield a definitive diagnosis. As pinworms and eggs are not usually passed in the stool, examination of the stool is not recommended. The drugs of choice for the treatment of pinworm infestation are mebendazole (100 mg), pyrantel pamoate (11 mg/kg, maximum 1 g), and albendazole (400 mg), all of the above-mentioned drugs are given in a single dose and repeated in two weeks. Mebendazole and albendazole are both adulticidal and ovicidal, whereas pyrantel pamoate is only adulticidal. Given their safety and effectiveness, mebendazole and albendazole are currently the best available drugs for the treatment of pinworm infestation. For pregnant women, pyrantel is preferred to mebendazole and albendazole. Treatment of all household members should be considered, especially if there are multiple or repeated symptomatic infections because reinfection is common even when effective medication is given.</p><p><strong>Conclusion: </strong>In spite of effective treatment of pinworm infestation, recurrences are common. Recurrences are likely due to repeated cycles of reinfecti","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139575063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexander K C Leung, Joseph M Lam, Benjamin Barankin, Kin Fon Leong
{"title":"Lichen Striatus: An Updated Review.","authors":"Alexander K C Leung, Joseph M Lam, Benjamin Barankin, Kin Fon Leong","doi":"10.2174/0115733963273945240101042423","DOIUrl":"https://doi.org/10.2174/0115733963273945240101042423","url":null,"abstract":"<p><strong>Background: </strong>Lichen striatus is a benign dermatosis that affects mainly children. This condition mimics many other dermatoses.</p><p><strong>Objective: </strong>The purpose of this article is to familiarize pediatricians with the clinical manifestations of lichen striatus to avoid misdiagnosis, unnecessary investigations, unnecessary referrals, and mismanagement of lichen striatus.</p><p><strong>Methods: </strong>A search was conducted in June 2023 in PubMed Clinical Queries using the key term \"Lichen striatus\". The search strategy included all observational studies, clinical trials, and reviews published within the past ten years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of this article.</p><p><strong>Results: </strong>Lichen striatus is a benign self-limited T-cell mediated dermatosis characterized by a linear inflammatory papular eruption seen primarily in children. The onset is usually sudden with minimal or absent symptomatology. The eruption in typical lichen striatus consists of discrete, skin- colored, pink, erythematous, or violaceous, flat-topped, slightly elevated, smooth or scaly papules that coalesce to form a dull red, potentially scaly, interrupted or continuous band over days to weeks. Although any part of the body may be involved, the extremities are the sites of predilection. Typically, the rash is solitary, unilateral, and follows Blaschko lines. In dark-skinned individuals, the skin lesions may be hypopigmented at onset. Nails may be affected alone or, more commonly, along with the skin lesions of lichen striatus. The differential diagnoses of lichen striatus are many and the salient features of other conditions are highlighted in the text.</p><p><strong>Conclusion: </strong>Lichen striatus is a self-limited condition that often resolves within one year without residual scarring but may have transient post-inflammatory hypopigmentation or hyperpigmentation. As such, treatment may not be necessary. For patients who desire treatment for cosmesis or for the symptomatic treatment of pruritus, a low- to mid-potency topical corticosteroid or a topical immunomodulator can be used. A fading cream can be used for post-inflammatory hyperpigmentation.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139566670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Survey on Diagnosis and Prognosis of Prenatal Asphyxia based on Antioxidant Oxidant Balance: Evidence from a Systematic Review and Meta-Analysis.","authors":"Boskabadi Hassan, Amirkhani Samin, Tahereh Loghmani, Zakerihamidi Maryam","doi":"10.2174/0115733963264881231227112345","DOIUrl":"https://doi.org/10.2174/0115733963264881231227112345","url":null,"abstract":"<p><strong>Introduction: </strong>The mechanism of occurrence and complications of asphyxia change in the treatment process and the future prognosis of newborns. One of the discussed mechanisms is the disruption of oxidants to anti-oxidants balance. Therefore, the current study was conducted aiming to systematically review and conduct a meta-analysis on the diagnosis and prognosis of prenatal asphyxia based on oxidant-antioxidant balance.</p><p><strong>Methods: </strong>A comprehensive electronic search was conducted using PubMed, Cochrane Library, Scopus, and Web of Science databases, up to February 2023 to identify relevant studies examining the association between Prooxidant anti-oxidant balance (PAB) and Malondialdehyde 1 levels with the risk of prenatal asphyxia. Only English studies were incorporated. The search terms used included Asphyxia, Diagnosis, Prognosis, Newborns, Prenatal, Oxidant antioxidant balance, and oxidative stress. A total of 13 studies were retrieved. Data regarding the standard mean difference (SMD) were collected, and a pooled SMD with 95%CI was calculated using a random-effect model to determine the strength of the relationship. Furthermore, the risk of publication bias was assessed through funnel plot and Egger's linear regression tests. Inclusion criteria was 1) The studies conducted on neonates, diagnosis and outcomes of prenatal asphyxia, oxidants and antioxidants were included. Research conducted on adults or on animals or review articles, and articles in which only their abstracts were available were excluded. The quality of the reported studies was also assessed.</p><p><strong>Results: </strong>Out of 980 searched articles, 13 articles (10 prospective articles and 3 cross-sectional articles) were studied. An increase in antioxidant enzymes (Glutathione peroxidase (GSH-Px), catalase (CAT) and Plasma superoxide dismutase (SOD)) cannot be dealt with excessive oxidants produced in the body (Plasma and cerebrospinal fluid levels of Malondialdehyde (MDA), free radical products (F8-isoprostane and MDA), saturated fatty acids and % CoQ-10). Prooxidant anti-oxidant balance (PAB) levels among neonates who had asphyxia were announced to be two times higher than normal newborns. PAB values in neonates with asphyxia, who had adverse prognosis, were about three times higher than those with favorable prognosis. The sensitivity of PAB in predicting the prognosis of neonates with asphyxia was reported 83- 89% and its specificity was 71- 92%. The pooled SMD analysis revealed a significant association between PAB and MDA levels with the risk of prenatal asphyxia both overall (SMD = 1.447, 95%CI: 0.961-1.934, P < 0.001), as well as separately in subgroups of PAB (SMD = 1.134, 95%CI: 0.623-1.644, P < 0.001) and MDA (SMD = 1.910, 95%CI: 0.916-2.903, P < 0.001).</p><p><strong>Conclusion: </strong>Our meta-analysis findings revealed the potential of evaluating antioxidant enzymes and oxidant agents, as well as assessing the balance bet","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139566590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karen K Y Leung, Pak Leung Ho, Sally C Y Wong, Wilson Y K Chan, Kam Lun Ellis Hon
{"title":"Prevalence and Outcomes of Infections in Critically-ill Paediatric Oncology Patients: A Retrospective Observation Study.","authors":"Karen K Y Leung, Pak Leung Ho, Sally C Y Wong, Wilson Y K Chan, Kam Lun Ellis Hon","doi":"10.2174/0115733963264717231208114248","DOIUrl":"https://doi.org/10.2174/0115733963264717231208114248","url":null,"abstract":"<p><strong>Purpose: </strong>The survival of paediatric oncology patients has improved substantially in the past decades due to advances in the field of oncology. Modern cancer treatments often come with life-threatening complications, of which infection is one of the most common causes in this patient population. This study aims to investigate the prevalence and outcomes of common infections in haemato-oncology patients during their stay in paediatric intensive care unit (PICU) and to identify any factors associated with these infections.</p><p><strong>Methods: </strong>A retrospective observational study was conducted on all children with a haemato-oncology diagnosis or who underwent haematopoietic stem cell transplantation (HSCT) and who were admitted to the Hong Kong Children's Hospital PICU over a one-year period. Infection characteristics and patient outcomes were evaluated and compared between different sub-groups. Univariable and multi-variable analyses were employed to identify risk factors associated with the development of active infection.</p><p><strong>Results: </strong>Forty-five (36.3%) of 124 critically ill haemato-oncology admissions to PICU were associated with infections, of which 31 (25%) admissions involved bacterial infections, 26 (20.9%) involved viral infections and 6 (4.8%) involved fungal infections. Bloodstream infection was the most common type of infection. More than half (61.3%) of the bacterial infections were due to an antibiotic-resistant strain. After adjusting for confounding variables, post-HSCT status and neutropenia were significantly associated with active infections.</p><p><strong>Conclusion: </strong>Infections in critically-ill haemato-oncological patients are associated with post haematopoietic stem cell transplant status and neutropenia. Further study is warranted to review effective strategies that may mitigate the likelihood of infection in this patient population.</p>","PeriodicalId":11175,"journal":{"name":"Current Pediatric Reviews","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139563103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}