ISRN pediatricsPub Date : 2012-01-01Epub Date: 2012-08-05DOI: 10.5402/2012/806920
Ole D Wolthers
{"title":"Component-resolved diagnosis in pediatrics.","authors":"Ole D Wolthers","doi":"10.5402/2012/806920","DOIUrl":"https://doi.org/10.5402/2012/806920","url":null,"abstract":"<p><p>Component resolved diagnosis is a new concept in the investigation of pediatric allergic disease. The aim of the present paper is to review the available data on component resolved diagnosis with respect to implications for investigation of children with allergic disease. In most conditions head-to-head comparisons of component resolved diagnosis with traditional IgE testing have not been performed. Rather than alternatives the molecular methods should be seen as adjuncts to the cheaper traditional specific IgE tests. It may be appropriate to determine IgE antibodies to components as part of the diagnostic work-up in selected cases of peanut and birch pollen allergy and in hymenoptera allergy. However, cost benefit analyses of component resolved diagnosis compared with traditional work-up of allergy are needed. Prospectively planned protocols for assessment of the extent to which component resolved diagnosis may be able to improve the selection of children to immunotherapy and, thus, the efficacy of immunotherapy, are needed. Finally, studies of component resolved diagnosis with microarray technology in screening panels with hundreds of components should be undertaken before it can be determined to which extent such panel screening, if at all, may be helpful in children.</p>","PeriodicalId":73521,"journal":{"name":"ISRN pediatrics","volume":"2012 ","pages":"806920"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/806920","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30856102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ISRN pediatricsPub Date : 2012-01-01Epub Date: 2012-07-01DOI: 10.5402/2012/436046
Oliver Gross, Tim Friede, Reinhard Hilgers, Anke Görlitz, Karsten Gavénis, Raees Ahmed, Ulrike Dürr
{"title":"Safety and Efficacy of the ACE-Inhibitor Ramipril in Alport Syndrome: The Double-Blind, Randomized, Placebo-Controlled, Multicenter Phase III EARLY PRO-TECT Alport Trial in Pediatric Patients.","authors":"Oliver Gross, Tim Friede, Reinhard Hilgers, Anke Görlitz, Karsten Gavénis, Raees Ahmed, Ulrike Dürr","doi":"10.5402/2012/436046","DOIUrl":"https://doi.org/10.5402/2012/436046","url":null,"abstract":"<p><p>Introduction. Retrospective observational data show that ACE-inhibitor therapy delays renal failure and improves life expectancy in Alport patients with proteinuria. The EARLY PRO-TECT Alport trial assesses the safety and efficacy of early therapy onset with ramipril in pediatric Alport patients. Methods and analysis. This double-blind, randomized, placebo-controlled, multicenter phase III trial (NCT01485978; EudraCT-number 2010-024300-10) includes 120 pediatric patients aged 24 months to 18 years with early stages of Alport syndrome (isolated hematuria or microalbuminuria). From March 2012, up to 80 patients will be randomized 1:1 to ramipril or placebo. In the event of disease progression during 3-year treatment, patients are unblinded and ramipril is initiated, if applicable. Approximately 40 patients receive open-label ramipril contributing to the safety database. Primary end-points are \"time to progression to next disease level\" and \"incidence of adverse drug events before disease progression.\" Treatment effect estimates from the randomized comparison and Alport registry data will be combined in supportive analyses to maximize evidence. Conclusion. Without this trial, ACE inhibitors may become standard off-label treatment in Alport syndrome without satisfactory evidence base. The results are expected to be of relevance for therapy of all pediatric patients with kidney disease, and the trial protocol might serve as a model for other rare pediatric glomerulopathies.</p>","PeriodicalId":73521,"journal":{"name":"ISRN pediatrics","volume":"2012 ","pages":"436046"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/436046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30773959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ISRN pediatricsPub Date : 2012-01-01Epub Date: 2012-07-01DOI: 10.5402/2012/375038
Mona M El Ganzoury, Terez B Kamel, Lobna H Khalil, A M Seliem
{"title":"Cochlear Dysfunction in Children following Cardiac Bypass Surgery.","authors":"Mona M El Ganzoury, Terez B Kamel, Lobna H Khalil, A M Seliem","doi":"10.5402/2012/375038","DOIUrl":"https://doi.org/10.5402/2012/375038","url":null,"abstract":"<p><p>Background. Sensorineural hearing loss after procedures including extracorporeal circulation and hypothermia is greater than general population. Mild hypothermia has a protective role on cochlea; however, deep hypothermia may result in cochlear injury. This research aimed at assessing auditory function in children after open heart surgery in relation to different hypothermic techniques. Subjects and Methods. Forty children with acyanotic heart diseases who underwent open heart surgery were included: group I: twenty patients subjected to mild hypothermia (33° to 37°C), group II: twenty patients subjected to moderate hypothermia (28° to 32°C). Audiological assessment included basic evaluation and otoacoustic emissions. Results. Both groups had distortion-product otoacoustic emissions (DPOAEs) amplitude >3 dB SPL at all frequencies. However, group II showed lower amplitude at overall and at high frequencies (4.416-8.837 KHz) than group I. Transient evoked otoacoustic emissions (TEOAEs) showed partial pass in three patients of group I (15%) and in 15 patients of group II (75%). Moreover, group II showed statistical significant reduction in overall TEOAEs amplitude as well as at high frequencies (2-4 KHz). Conclusions. Patients exposed to moderate hypothermic technique had subtle cochlear dysfunction. Otoacoustic emissions should be used for early detection of subtle cochlear dysfunction in operated cardiac children.</p>","PeriodicalId":73521,"journal":{"name":"ISRN pediatrics","volume":"2012 ","pages":"375038"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/375038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30774042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ISRN pediatricsPub Date : 2012-01-01Epub Date: 2012-01-11DOI: 10.5402/2012/121898
Tomoka Kobayashi, Masumi Inagaki, Makiko Kaga
{"title":"Professional Caregiver's View on Mental Health in Parents of Children with Developmental Disabilities: A Nationwide Study of Institutions and Consultation Centers in Japan.","authors":"Tomoka Kobayashi, Masumi Inagaki, Makiko Kaga","doi":"10.5402/2012/121898","DOIUrl":"10.5402/2012/121898","url":null,"abstract":"<p><p>Parents of children with intellectual disabilities and/or physical disabilities are supposed to have an increased risk for parenting stress and psychological distress. We as professional caregivers sometimes experience difficulties in keeping good relations or communicating with the parents. Professional workers in 460 institutions and consultation centers throughout Japan answered a questionnaire on their clinical experiences. About 90% of the facilities experienced \"distressed parents,\" and the parents' condition such as mental health seemed to influence this. Signs of a depressive state were the most common psychiatric disturbances detected, and it was notable in the pervasive developmental disorder group. More welfare support, presence of support groups, support from other family members, and medical treatment of the parents' problems were considered to be helpful and thus requested to be improved. Training more professionals who can properly deal with the parents' mental health needs is an urgent matter that must be tackled.</p>","PeriodicalId":73521,"journal":{"name":"ISRN pediatrics","volume":"2012 ","pages":"121898"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3265212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30506733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ISRN pediatricsPub Date : 2012-01-01Epub Date: 2012-06-14DOI: 10.5402/2012/134541
Pooja L Amatya, Drew H Barzman
{"title":"The Missing Link between Juvenile Delinquency and Pediatric Posttraumatic Stress Disorder: An Attachment Theory Lens.","authors":"Pooja L Amatya, Drew H Barzman","doi":"10.5402/2012/134541","DOIUrl":"https://doi.org/10.5402/2012/134541","url":null,"abstract":"<p><p>The present paper reviews pediatric posttraumatic stress disorder, emphasizing the relational basis of the disorder and highlighting the missing link between juvenile delinquency and trauma. The first part of the paper defines trauma and the diagnostic criteria for PTSD, noting child-specific features. The second part reviews the literature emphasizing the relational and attachment relevant nature of trauma. The third part explores psychological mechanisms for how attachment relations could affect trauma responses. Attachment relations (1) shape core schemas of the world, others, and the self and (2) foster emotional engagement or disengagement, both of which have been associated with traumatic responses. The most empirically supported pediatric trauma treatment, trauma-focused cognitive behavioral therapy (TF-CBT), acknowledges the attachment figure's influence and includes treating and training the parent and conjoint child-parent discussion. The next section reviews the noteworthy link between juvenile delinquency and trauma history. More awareness of trauma and PTSD in children and adolescents is recommended to effectively address juvenile delinquency. The review ends with a few helpful points for practicing pediatricians regarding childhood trauma.</p>","PeriodicalId":73521,"journal":{"name":"ISRN pediatrics","volume":"2012 ","pages":"134541"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/134541","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30750976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ISRN pediatricsPub Date : 2012-01-01Epub Date: 2012-06-14DOI: 10.5402/2012/210632
E E Ekpe, V Ette
{"title":"Morbidity and mortality of caustic ingestion in rural children: experience in a new cardiothoracic surgery unit in Nigeria.","authors":"E E Ekpe, V Ette","doi":"10.5402/2012/210632","DOIUrl":"https://doi.org/10.5402/2012/210632","url":null,"abstract":"<p><p>Background. Inspite of the fact that accidental caustic ingestion is an entirely easily preventable problem, it has however persisted in rural Nigerian communities because the commonly implicated agent which is caustic soda (sodium hydroxide, NaOH) is sold in open markets without restrictive legislations. This study aims to identify the perpetuating factors of paediatric caustic ingestion and recommend preventive measures. Method. Retrospective analysis of clinical records of our paediatric patients who presented following caustic ingestion between November 2006 and November 2010 was made for demography, socioeconomic status of parent(s), caustic substance ingested with amount (where known), circumstance of ingestion, means of oesophageal evaluation, treatment and outcome. Results. There were 16 paediatric cases of caustic ingestion during the study period with age ranging from 1 to 18 years with mode in the 1-3 years group and male : female ratio 4.3 : 1. In 100% of the cases, the caustic ingestion was accidental, while caustic soda was the agent in 93.7%, and 87.5% of the parents were into local soap and detergent production. In all patients, the oesophagus was evaluated with late barium swallow/meal and oesophagoscopy before treatment. Conclusion. Caustic ingestion among rural children in Nigeria can be prevented.</p>","PeriodicalId":73521,"journal":{"name":"ISRN pediatrics","volume":"2012 ","pages":"210632"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/210632","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30750977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ISRN pediatricsPub Date : 2012-01-01Epub Date: 2012-06-26DOI: 10.5402/2012/721295
Christian Mundt, Alexander Sventitskiy, Jeffrey E Cehelsky, Andrea B Patters, Markus Tservistas, Michael C Hahn, Gerd Juhl, John P Devincenzo
{"title":"Assessing Modeled CO(2) Retention and Rebreathing of a Facemask Designed for Efficient Delivery of Aerosols to Infants.","authors":"Christian Mundt, Alexander Sventitskiy, Jeffrey E Cehelsky, Andrea B Patters, Markus Tservistas, Michael C Hahn, Gerd Juhl, John P Devincenzo","doi":"10.5402/2012/721295","DOIUrl":"https://doi.org/10.5402/2012/721295","url":null,"abstract":"<p><p>Background. New aerosol drugs for infants may require more efficient delivery systems, including face masks. Maximizing delivery efficiency requires tight-fitting masks with minimal internal mask volumes, which could cause carbon dioxide (CO(2)) retention. An RNA-interference-based antiviral for treatment of respiratory syncytial virus in populations that may include young children is designed for aerosol administration. CO(2) accumulation within inhalation face masks has not been evaluated. Methods. We simulated airflow and CO(2) concentrations accumulating over time within a new facemask designed for infants and young children (PARI SMARTMASK(®) Baby). A one-dimensional model was first examined, followed by 3-dimensional unsteady computational fluid dynamics analyses. Normal infant breathing patterns and respiratory distress were simulated. Results. The maximum average modeled CO(2) concentration within the mask reached steady state (3.2% and 3% for normal and distressed breathing patterns resp.) after approximately the 5th respiratory cycle. After steady state, the mean CO(2) concentration inspired into the nostril was 2.24% and 2.26% for normal and distressed breathing patterns, respectively. Conclusion. The mask is predicted to cause minimal CO(2) retention and rebreathing. Infants with normal and distressed breathing should tolerate the mask intermittently delivering aerosols over brief time frames.</p>","PeriodicalId":73521,"journal":{"name":"ISRN pediatrics","volume":"2012 ","pages":"721295"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/721295","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30760036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ISRN pediatricsPub Date : 2012-01-01Epub Date: 2012-06-07DOI: 10.5402/2012/763783
Mostafa Abdel-Aziz El-Hodhod, Iman Ali El-Agouza, Hala Abdel-Al, Noha Samir Kabil, Khaled Abd El-Moez Bayomi
{"title":"Screening for celiac disease in children with dental enamel defects.","authors":"Mostafa Abdel-Aziz El-Hodhod, Iman Ali El-Agouza, Hala Abdel-Al, Noha Samir Kabil, Khaled Abd El-Moez Bayomi","doi":"10.5402/2012/763783","DOIUrl":"https://doi.org/10.5402/2012/763783","url":null,"abstract":"<p><p>Background. Dental enamel defects (DEDs) are seen in celiac disease (CD). Aim was to detect frequency of CD among such patients. Methods. This study included 140 children with DED. They were tested for CD. Gluten-free diet (GFD) was instituted for CD patients. A cohort of 720, age and sex-matched, normal children represented a control group. Both groups were evaluated clinically. Serum calcium, phosphorus, alkaline phosphatase, serum IgA, and tissue transglutaminase (tTG) IgG and IgA types were measured. Results. CD was more diagnosed in patients with DEDs (17.86%) compared to controls (0.97%) (P < 0.0001). Majority of nonceliac patients showed grade 1 DED compared to grades 1, 2, and 3 DED in CD. Five children had DED of deciduous teeth and remaining in permanent ones. After 1 year on GFD, DED improved better in CD compared to nonceliac patients. Gastrointestinal symptoms did not vary between celiac and nonceliac DED patients. Lower serum calcium significantly predicted CD in this cohort. Conclusion. CD is more prevalent among children with DED than in the general population. These DEDs might be the only manifestation of CD; therefore, screening for CD is highly recommended among those patients especially in presence of underweight and hypocalcemia.</p>","PeriodicalId":73521,"journal":{"name":"ISRN pediatrics","volume":"2012 ","pages":"763783"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/763783","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30707041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ISRN pediatricsPub Date : 2012-01-01Epub Date: 2012-11-06DOI: 10.5402/2012/619107
Omneya I Youssef, Samar M Farid
{"title":"QTc and QTd in Children with Type 1 Diabetes Mellitus during Diabetic Ketoacidosis.","authors":"Omneya I Youssef, Samar M Farid","doi":"10.5402/2012/619107","DOIUrl":"https://doi.org/10.5402/2012/619107","url":null,"abstract":"<p><p>Cardiac arrest has been described in children with diabetic ketoacidosis (DKA). Aim. To evaluate QTc and QTd in type 1 diabetic children with DKA. Methods. Twelve-lead ECG was done to 30 type 1 diabetic children with DKA at presentation and recovery. Corrected QT interval and QT dispersion (QTd) were assessed. Results. QTc and QTd mean values were significantly decreased in patients after than before DKA recovery (P < 0.01). Procedure. Sixteen patients (53, 3%) had prolonged QTc during DKA (range 451-538 ms) that dropped to one patient after recovery, his QTc (453 ms) returned to normal 5 days after hospital discharge. Nineteen patients (63.3%) had prolonged QTd (>50 ms) that dropped to three after recovery. The fact that three patients had normal QTc but prolonged QTd increases the privilege of QTd over QTc as a better marker for cardiac risk in those patients. Anion gap was significantly associated with QTc and QTd prolongation (P < 0.0001). Patients had no electrolyte abnormalities or hypoglycemia to account for QTc or QTd prolongation. Conclusion. Prolonged QTc and QTd frequently occur in DKA positively correlated to ketosis. Cardiac monitoring for patients with DKA is mandatory.</p>","PeriodicalId":73521,"journal":{"name":"ISRN pediatrics","volume":"2012 ","pages":"619107"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/619107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31094666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ISRN pediatricsPub Date : 2012-01-01Epub Date: 2012-03-29DOI: 10.5402/2012/976206
Parvaneh Karimzadeh, Mohammad Reza Alaee, Hadi Zarafshan
{"title":"The Association between EEG Abnormality and Behavioral Disorder: Developmental Delay in Phenylketonuria.","authors":"Parvaneh Karimzadeh, Mohammad Reza Alaee, Hadi Zarafshan","doi":"10.5402/2012/976206","DOIUrl":"https://doi.org/10.5402/2012/976206","url":null,"abstract":"<p><p>Background. Brain defect leading to developmental delay is one of the clinical manifestations of phenylketonuria. The aim of this study was to evaluate the association between EEG abnormality and developmental delay/behavioral disorders in phenylketonuria. Patients and Methods. 105 phenylketonuria patients, who were diagnosed through newborn screening tests or during follow-up evaluation, were enrolled. Patients who were seizure-free for at least six months before the study were included. The developmental score were evaluated by the ASQ questionnaire (age-stage questionnaire) and the test of child symptom inventory-4 (CSI-4), respectively. Results. 55 patients had a history of seizure more than 6 months before the study. Seventy had abnormal EEG (cases) and 35 had normal EEG (controls). There was no significant difference between mean phenylalanine levels in the abnormal and normal EEG groups at the time of diagnosis, after six months and at our evaluation. Distribution of DQ level in the abnormal and normal EEG groups revealed a significant difference. An abnormal EEG was associated with a higher percentage of low DQ levels. Conclusion. Paroxysmal epileptic discharges in PKU patients are important. Treatment of these EEG abnormalities may affect developmental scores or may lead to correction of some behavioral disorders in patients.</p>","PeriodicalId":73521,"journal":{"name":"ISRN pediatrics","volume":"2012 ","pages":"976206"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2012/976206","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30588105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}