Paediatrics and International Child Health最新文献

{"title":"Complications associated with myocardial bridging in four children without underlying cardiac disease: a case series.","authors":"Federica Brancato,&nbsp;Donato Rigante,&nbsp;Marco Piastra,&nbsp;Alessandro Gambacorta,&nbsp;Claudia Aurilia,&nbsp;Gabriella De Rosa","doi":"10.1080/20469047.2021.1891819","DOIUrl":"https://doi.org/10.1080/20469047.2021.1891819","url":null,"abstract":"<p><strong>Background: </strong>Myocardial bridging is largely considered to be a benign, symptomless congenital anomaly of the coronary arteries in which the intramyocardial coronary course is partially 'tunnelled' and leads to vessel compression during ventricular systole. There are few data regarding children.</p><p><strong>Objective: </strong>To report on myocardial bridging observed in children seeking medical help in the paediatric emergency room.</p><p><strong>Case presentation: </strong>A series of four children aged 6-13 years with symptomatic myocardial bridging but no other underlying cardiac abnormalities is reported. They were admitted to the paediatric emergency department during 2013-2016, three with chest pain after physical activity and one with septic shock.</p><p><strong>Results: </strong>Heart computed tomography scan in the first three demonstrated myocardial bridging of the left anterior descendent coronary artery's branches; their 2-year follow-up was uneventful. The fourth patient presented with ventricular fibrillation 24 hours after admission and at autopsy there was an intramyocardial tract 4 cm long on the left anterior descendent coronary artery.</p><p><strong>Conclusions: </strong>This case series demonstrates that myocardial bridging can be symptomatic in children with no underlying cardiac disorders and should be included in the differential diagnosis of exertional chest pain and/or arrhythmias.<b>Abbreviations:</b> CRP, C-reactive protein; CT, computed tomography; D1, diagonal 1 artery; ECG, electrocardiogram; ED, emergency department; KD, Kawasaki disease; LAD, left anterior descending coronary artery; MB, myocardial bridging; RI, ramus intermedius artery; TN, troponin.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":" ","pages":"278-284"},"PeriodicalIF":1.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20469047.2021.1891819","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39082925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and management of vitamin D deficiency in children with newly diagnosed coeliac disease: cohort study.","authors":"Akhshayaa G,&nbsp;Anju Seth,&nbsp;Praveen Kumar,&nbsp;Anju Jain","doi":"10.1080/20469047.2021.1996089","DOIUrl":"https://doi.org/10.1080/20469047.2021.1996089","url":null,"abstract":"<p><strong>Background: </strong>Coeliac disease (CD) causes deficiency of various micronutrients including vitamin D, and there are no specific guidelines for treatment.</p><p><strong>Aims: </strong>To determine the prevalence of vitamin D deficiency in children newly diagnosed with CD and the role of oral high-dose vitamin D in its treatment.</p><p><strong>Methods: </strong>Calcium intake, sun exposure and biochemical and radiological parameters related to vitamin D deficiency were compared between 60 children aged 0-18 years diagnosed with CD and 60 healthy age- and sex-matched controls. The cases with serum 25(OH)D (<20 ng/ml) were given oral vitamin D (60,000 IU/week) and calcium (500 mg/day) for 12 weeks, along with a gluten-free diet (GFD); they were re-evaluated within a week of completion. The primary outcome measure was the serum 25(OH)D level, and secondary measures included serum calcium, phosphorus, alkaline phosphatase, parathormone and clinical and/or radiological rickets.</p><p><strong>Results: </strong>The prevalence of vitamin D deficiency (25(OH)D <20 ng/ml) was significantly greater in the cases (<i>n</i>=38, 63.3%) than in the controls (<i>n</i>=27, 45.0%). Upon treatment, all 38 cases with vitamin D deficiency showed a significant rise in 25(OH)D levels along with normalisation of other biochemical abnormalities. Two children had 25(OH)D levels >100 ng/ml with no other feature suggestive of vitamin D toxicity.</p><p><strong>Conclusions: </strong>Vitamin D deficiency is more prevalent in children with CD. Administration of oral high-dose vitamin D for 12 weeks along with a GFD leads to a robust response, indicating rapid mucosal recovery. The vitamin D dosage recommended for malabsorption states may be excessive in CD.<b>Abbreviations:</b> ALP: alkaline phosphatase; CaBP: calcium-binding proteins; CD: coeliac disease; GFD: gluten-free diet; PTH: parathormone; RU: reproducibility units; 25(OH)D: 25 hydroxy vitamin D.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":" ","pages":"247-252"},"PeriodicalIF":1.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39692478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between distance of referring facilities and haemoglobin change in children in Malawi.","authors":"Elizabeth M Keating,&nbsp;Jeff A Robison,&nbsp;Msandeni Chiume,&nbsp;Marissa Taddie,&nbsp;James A VanDerslice,&nbsp;L Scott Benson,&nbsp;Elizabeth Fitzgerald,&nbsp;Heather L Crouse,&nbsp;Michelle D Eckerle,&nbsp;Emily J Ciccone,&nbsp;Christina A Porucznik","doi":"10.1080/20469047.2022.2044674","DOIUrl":"https://doi.org/10.1080/20469047.2022.2044674","url":null,"abstract":"<p><strong>Background: </strong>Anaemia is a significant cause of mortality in children in sub-Saharan Africa where blood transfusion is often available only at referral hospitals. Understanding the pattern of referrals by health facilities is essential to identify the delays that affect child survival.</p><p><strong>Aim: </strong>To determine if there was a correlation between change in haemoglobin (Hb) level and distance from referring facilities to Kamuzu Central Hospital (KCH) in Malawi, and whether distance affected mortality rates.</p><p><strong>Methods: </strong>This was a retrospective cohort study of 2259 children referred to KCH whose Hb was measured at the referring facility or at KCH. Maps were created using ArcGIS® software. The relationship between distance from KCH and change in Hb was assessed by χ² analysis and multiple linear regression with SAS© software.</p><p><strong>Results: </strong>The majority of children were referred by health facilities in the Lilongwe District. When categorised as Hb <4, 4-6 or >6 g/dL, 87.0% of children remained in the same category during transfer. There was no significant relationship between Hb drop and distance from KCH. Distance from KCH was not a significant predictor of Hb level at KCH or Hb change. However, mortality rates were significantly higher in facilities that were 10-50 km from KCH than in those which were <10 km away.</p><p><strong>Conclusions: </strong>Using distance as a proxy for time, this suggests that referring facilities are transferring children sufficiently quickly to avert significant reductions in Hb. Despite this, there is a need to identify the factors that influence the decision to transfer anaemic children.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"41 4","pages":"253-261"},"PeriodicalIF":1.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9050928/pdf/nihms-1784970.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10093618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic drug monitoring of intravenous anti-tuberculous therapy: management of an 8-month-old child with tuberculous meningitis.","authors":"Lucie Huynh,&nbsp;Cedric Agossah,&nbsp;Véronique Lelong-Boulouard,&nbsp;Julien Marie,&nbsp;David Brossier,&nbsp;Isabelle Goyer","doi":"10.1080/20469047.2020.1855868","DOIUrl":"https://doi.org/10.1080/20469047.2020.1855868","url":null,"abstract":"<p><p>Tuberculous meningitis (TBM) is now uncommon in high-income countries. It is the most severe form of extrapulmonary tuberculosis with high rates of mortality and morbidity if diagnosis and treatment are delayed. An 8-month-old girl with TBM who was treated with high-dose intravenous anti-tuberculous drugs (ATD) is reported. Therapeutic drug monitoring (TDM) of isoniazid and rifampicin was undertaken by measuring serial drug concentrations in serum and cerebrospinal fluid (CSF). There was rapid eradication of <i>Mycobacterium tuberculosis</i> from the CSF with a good clinical outcome and no adverse effects. Using high-dose regimens of intravenous ATD to treat TBM is an important option in order to obtain sufficient CSF diffusion. When available, TDM and a multidisciplinary approach are essential for efficient therapeutic management.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":" ","pages":"285-290"},"PeriodicalIF":1.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20469047.2020.1855868","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25580080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protein-losing enteropathy caused by <i>Yersinia enterocolitica</i> colitis.","authors":"Lara Ferreira,&nbsp;Raquel Amaral,&nbsp;Fernanda Gomes,&nbsp;José Cabral","doi":"10.1080/20469047.2021.1890681","DOIUrl":"https://doi.org/10.1080/20469047.2021.1890681","url":null,"abstract":"<p><p>A 7-month-old boy was admitted with acute gastro-enteritis accompanied by fever and hyponatraemic dehydration. The clinical course was complicated by severe hypokalaemia and hypo-albuminaemia with anasarca. Protein-losing enteropathy (PLE) owing to <i>Yersinia enterocolitica</i> colitis was diagnosed and was complicated by fungal sepsis owing to <i>Kodomaea ohmeri</i>. Colonoscopy demonstrated multiple diffuse ulcers and sub-epithelial haemorrhages extending from the rectum to the hepatic angle. He required prolonged nutritional support comprising partial parenteral feeding for 10 days, followed by a hypo-allergenic diet until 13 months of age when cow milk was tolerated. He was discharged on a normal diet and in good health at 19 months of age.<b>Abbreviations</b> AVPU scale: A alert, V verbally responsive, P painfully responsive, U unresponsive; CMV: cytomegalovirus; EBV: Epstein-Barr virus; HIV: human immunodeficiency virus; Ig: immunoglobulin; IBD: inflammatory bowel disease; IPEX: immune dysregulation, polyendocrinopathy, enteropathy, X-linked syndrome; PICU: paediatric intensive care unit; PLE: protein-losing enteropathy.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":" ","pages":"291-294"},"PeriodicalIF":1.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39391114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gaps in the tuberculosis preventive therapy care cascade in children in contact with TB.","authors":"E Van Ginderdeuren,&nbsp;J Bassett,&nbsp;C F Hanrahan,&nbsp;L Mutunga,&nbsp;A Van Rie","doi":"10.1080/20469047.2021.1971360","DOIUrl":"https://doi.org/10.1080/20469047.2021.1971360","url":null,"abstract":"<p><strong>Background: </strong>Young children (<5 years) and children living with HIV in contact with an adult with tuberculosis (TB) should receive TB preventive therapy (TPT), but uptake is low.</p><p><strong>Aims: </strong>To determine gaps in the uptake of and adherence to TPT in child TB contacts under routine primary care clinic conditions.</p><p><strong>Methods: </strong>A cohort of child TB contacts (age <5 years or living with HIV <15 years) was followed at a primary care clinic in Johannesburg, South Africa.</p><p><strong>Results: </strong>Of 170 child contacts with 119 adult TB cases, only 45% (77/170) visited the clinic for TPT eligibility screening, two of whom had already initiated TPT at another clinic. Of the 75 other children, 18/75 (24%) commenced TB treatment and 56/75 (75%) started TPT. Health-care workers followed the guidelines, with 96% (64/67) of children screened for symptoms of TB and 97% (36/37) of those symptomatic assessed for TB, but microbiological testing was low (9/36, 25%) and none had microbiologically confirmed tuberculosis. Only half (24/46, 52%) of the children initiating TPT completed the 6-month course. Neither sociodemographic determinants (age, sex) nor clinical factors (HIV status, TB source, time to TPT initiation) was associated with non-adherence to TPT.</p><p><strong>Conclusion: </strong>Most child contacts of an adult TB case do not visit the clinic, and half of those initiating TPT did not adhere to the full 6-month course. These programme failures result in missed opportunities for early diagnosis of active TB and prevention of progression to disease in young and vulnerable children.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":" ","pages":"237-246"},"PeriodicalIF":1.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39424938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sudden-onset haemolacria in an adolescent girl.","authors":"Ayla Akca Caglar,&nbsp;Halise Akca,&nbsp;Funda Kurt,&nbsp;Leman Akcan Yildiz,&nbsp;Pinar Nalcacioglu,&nbsp;Onur Buyukkoc,&nbsp;Emine Dibek Misirlioglu","doi":"10.1080/20469047.2021.1949563","DOIUrl":"https://doi.org/10.1080/20469047.2021.1949563","url":null,"abstract":"<p><p>Haemolacria, also known as bloody tears, is a physical condition in which a person produces tears partially composed of blood. Multiple disorders can cause haemolacria, including trauma, inflammation, vascular lesions, vicarious menstruation, blood disorders, epistaxis, tumours and psychiatric and systemic disorders. Often, no aetiology is identified. It is usually benign, self-limiting, and the treatment depends on the cause. A 14-year-old girl presented to the paediatric emergency department with sudden onset of bloody tears from both eyes and epistaxis for the first time. A detailed history focusing on aetiological factors was unremarkable. Systemic, ocular, nasal and paranasal examination was also unremarkable. Radiological and laboratory investigations were normal, and the patient was diagnosed with idiopathic haemolacria. High-dose oral vitamin C, prophylactic iron therapy and psychological support were provided as conservative treatment. During regular follow-up, there was a spontaneous reduction in the frequency of symptoms.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":" ","pages":"295-299"},"PeriodicalIF":1.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39194569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of tuberculous meningitis in children.","authors":"H Simon Schaaf, James A Seddon","doi":"10.1080/20469047.2021.1952818","DOIUrl":"10.1080/20469047.2021.1952818","url":null,"abstract":"","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":" ","pages":"231-236"},"PeriodicalIF":1.4,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39736970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome in children with newly diagnosed rheumatic heart disease in Indonesia.","authors":"Indah K Murni,&nbsp;Nadya Arafuri,&nbsp;Andrew C Steer,&nbsp;M Taufik Wirawan,&nbsp;Fransisca G W Remi,&nbsp;Noormanto Noormanto,&nbsp;Sasmito Nugroho","doi":"10.1080/20469047.2022.2027324","DOIUrl":"https://doi.org/10.1080/20469047.2022.2027324","url":null,"abstract":"<p><strong>Background: </strong>Rheumatic heart disease (RHD) is associated with high morbidity and mortality, especially in those with severe RHD or progression of valvular disease (VD). Evaluation of the factors that predict valvular progression is important in order to improve clinical outcome.</p><p><strong>Aim: </strong>To evaluate outcome and clinical predictors of valvular progression in children with newly diagnosed RHD.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted in children with newly diagnosed RHD at Dr Sardjito Hospital, Yogyakarta, Indonesia during 2013-2020. Clinical and echocardiography data at the time of diagnosis were collected and patients were followed up for 1 year. Echocardiography evaluations were undertaken to determine the progression of VD. Independent predictors of valvular progression were identified by Cox regression analysis.</p><p><strong>Results: </strong>A total of 77 patients were recruited, 36 (46.7%) of whom were male, and the median age (range) was 12.3 years (5.9-17.8). Thirty-three (42.8%) had progression of VD in the year after diagnosis. By multivariable analysis, an age at diagnosis of >10 years and high C-reactive protein (CRP) were independently associated with an increased risk of valvular progression with an adjusted hazard ratio (95% CI) of 3.23 (1.09-9.60) and 3.69 (1.45-9.67), respectively.</p><p><strong>Conclusion: </strong>After only 1 year of follow-up, approximately four in 10 children with newly diagnosed RHD developed progression of VD. An increased risk of valvular progression was associated with being over 10 years of age and a high level of CRP.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":" ","pages":"262-267"},"PeriodicalIF":1.8,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39850189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal depression and infant social withdrawal as predictors of behaviour and development in vertically HIV-infected children at 3.5 years","authors":"J. Nöthling, B. Laughton, S. Seedat","doi":"10.1080/20469047.2021.2023436","DOIUrl":"https://doi.org/10.1080/20469047.2021.2023436","url":null,"abstract":"ABSTRACT Background In low- and middle-income countries, there is a high prevalence of post-partum depression and it is often associated with HIV status. Maternal depression negatively affects mothering and can lead to social withdrawal in infants. Maternal depression and infant social withdrawal can have deleterious long-term effects on children’s behaviour and neurodevelopmental trajectories. Aim To investigate whether maternal depression and infant social withdrawal at 10–12 months post-partum were significant predictors of child behaviour and development at 42 months. Method Seventy-four mother–infant dyads living with HIV were followed in a prospective, longitudinal design. Mothers were assessed for depression using the Center for Epidemiologic Studies Depression scale (CES-D). Infant social withdrawal was assessed by the modified Alarm Distress Baby Scale (m-ADBB), and development and behaviour were evaluated by the Griffiths Mental Development Scales (GMDS) and the Child Behavior Checklist (CBCL), respectively. Results Maternal depression explained 4.8% of the variance in child behaviour (β = 0.98, t = 2.05, p < 0.05) and 10.3% of the variance in development (β = −0.30, t = −2.66, p < 0.05). Infant social withdrawal was not a significant predictor of behaviour (β = 3.27, t = 1.36, p = 0.18), but it did uniquely explain 7% of the variance in development (β = −1.32, t = −2.48, p < 0.05). Conclusion In the context of HIV, screening for maternal depression and the quality of mother–infant interactions are important (especially in the 1st year post-partum), given the significant long-term impact they have on behaviour and neurodevelopment. Abbreviations ANOVA: analysis of variance; ART: antiretroviral therapy; CBCL: Child Behavioral Checklist; CES-D: Center for Epidemiologic Studies Depression Scale; CHEI: children HIV-exposed and infected; CHER: Children with HIV Early Antiretroviral Treatment Trial; CHEU: children HIV-exposed and uninfected; CHUU: children HIV-unexposed and -uninfected; GMDS: Griffiths Mental Development Scales; HIV: human immunodeficiency virus; LMIC: low- and middle-income countries; m-ADBB: modified Alarm Distress Baby Scale; NRF: National Research Foundation; SAMRC: South African Medical Research Council; WHO: World Health Organization","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"41 1","pages":"268 - 277"},"PeriodicalIF":1.8,"publicationDate":"2021-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44388009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}