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Paediatric Cases (paediatric + case)
Selected AbstractsA retrospective study of paediatric oral lesions from ThailandINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 4 2007KITTIPONG DHANUTHAI Aim., To survey the paediatric oral lesions in Thailand. Design., Biopsy records over a 15-year period (1990,2004) were retrieved from the files of the Department of Oral Pathology, Faculty of Dentistry, Chulalongkorn University. Paediatric cases with an age of 16 years or younger were selected. The age of the patients was divided into three groups according to the dentition period. The lesions were classified into three categories: inflammatory/reactive lesions, cystic lesions, and tumour/tumour-like lesions. Results., From a total of 8314 oral biopsies, 1251 cases (15.05%) were in the paediatric population. The greatest number of lesions fell into the cystic category, followed closely by the inflammatory/reactive category and tumour/tumour-like category, respectively. The top ten most frequently encountered lesions in the present study were dentigerous cyst, mucocele, pyogenic granuloma, ameloblastoma, radicular cyst, odontoma, odontogenic keratocyst, irritation fibroma (focal fibrous hyperplasia), fibrous dysplasia, and osteomyelitis. The majority of lesions were found in the mixed dentition period (49.24%). There was no statistical difference in the occurrence between genders in this study. Conclusions., The present study shows an almost similar trend to previous studies except in the ranking among and within categories. These differences may be attributable to the nature of the population studied and because Chulalongkorn University is a major referral centre. [source] Acute inflammatory demyelinating polyradiculoneuropathy associated with perforin-deficient familial haemophagocytic lymphohistiocytosisACTA PAEDIATRICA, Issue 3 2003E Del Giudice This study reports the first paediatric case of acute inflammatory demyelinating polyradiculoneuropathy (AIDP) associated with a fatal haemophagocytic lymphohistiocytosis (HLH). The patient developed progressive weakness of the lower limbs in the context of a picture of infectious mononucleosis and Epstein-Barr virus (EBV) infection. After an apparent improvement, a fulminant hepatic failure and pancytopenia ensued, leading to death. Molecular genetic studies documented a compound heterozygosity for two mutations in the perforin (PRF1) gene as the background defect for a familial haemophagocytic lymphohistiocytosis (FHL). Conclusion: In this patient EBV infection triggered both AIDP and FHL. The latter condition was due to PRF1 deficiency. Two novel mutations in the PRF1 gene were concomitantly present in the patient. The first caused an amino acid change, while the second introduced a stop codon in the sequence which resulted in a truncated protein. [source] Entities and frequency of neonatal diabetes: data from the diabetes documentation and quality management system (DPV)DIABETIC MEDICINE, Issue 6 2010J. Grulich-Henn Diabet. Med. 27, 709,712 (2010) Abstract Aims, The aim of this study was to elucidate the entities and the frequency of neonatal diabetes mellitus (NDM) in a large representative database for paediatric diabetes patients in Germany and Austria. Methods, Based on the continuous diabetes data acquisition system for prospective surveillance (DPV), which includes 51 587 patients with onset of diabetes before the age of 18 years from 299 centres in Germany and Austria, we searched for patients with onset of diabetes mellitus in the first 6 months of life. Results, Ninety patients were identified, comprising 0.17% of all paediatric cases in the DPV registry. This represented an incidence of approximately one case in 89 000 live births in Germany. A monogenic basis for NDM was established in 30 subjects (seven UPD6, 10 KCNJ11, seven ABCC8, two FOXP3, two PDX1, one INS, one EIF2AK3). Pancreatic hypoplasia or agenesis was reported in 10 patients and seven subjects were classified as having Type 1 diabetes by their centres. Transient neonatal diabetes (TNDM) accounted for approximately 10% of all cases with NDM. No aetiology was defined in 41 subjects, which may reflect incomplete genetic testing or novel genetic aetiologies. Conclusion, Based on a large database, we identified a higher rate of NDM in Germany than has been reported previously. Full molecular genetic testing should be performed in all patients diagnosed before 6 months of age. [source] Tension pneumo-orbitus and pneumocephalus induced by a nasal oxygen cannula: Report on two paediatric casesJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 5 2000Bj O'Brien Abstract: The present paper highlights the potential dangers of misplaced nasopharyngeal oxygen cannulae causing secondary pneumo-orbitus and pneumocephalus in two paediatric patients. While this complication is uncommon, early recognition allows prompt and appropriate intervention, with cessation of nasal oxygen, cannula removal, early investigation with computed tomography (CT) head/orbit scan and orbital or cranial decompression, if required. Early CT imaging identifies medial orbital or paranasal sinus fractures, the presence of sinusitis, associated intracranial air and assessment of the degree of orbital or intracranial tension. Antibiotics are not usually required for this type of clean injury unless pre-existing sinusitis is identified. In both cases, direct orbital decompression was performed with excellent results after identification of marked unilateral tense exophthalmos, delayed pupillary reactions to light and ophthalmopegia. [source] Dural haemorrhage in non-traumatic infant deaths: does it explain the bleeding in ,shaken baby syndrome'?NEUROPATHOLOGY & APPLIED NEUROBIOLOGY, Issue 1 2003J. F. Geddes J. F. Geddes, R. C. Tasker, A. K. Hackshaw, C. D. Nickols, G. G. W. Adams, H. L. Whitwell and I. Scheimberg (2003) Neuropathology and Applied Neurobiology 29, 14,22 Dural haemorrhage in non-traumatic infant deaths: does it explain the bleeding in ,shaken baby syndrome'? A histological review of dura mater taken from a post-mortem series of 50 paediatric cases aged up to 5 months revealed fresh bleeding in the dura in 36/50, the bleeding ranging from small perivascular haemorrhages to extensive haemorrhage which had ruptured onto the surface of the dura. Severe hypoxia had been documented clinically in 27 of the 36 cases (75%). In a similar review of three infants presenting with classical ,shaken baby syndrome', intradural haemorrhage was also found, in addition to subdural bleeding, and we believe that our findings may have relevance to the pathogenesis of some infantile subdural haemorrhage. Recent work has shown that, in a proportion of infants with fatal head injury, there is little traumatic brain damage and that the significant finding is craniocervical injury, which causes respiratory abnormalities, severe global hypoxia and brain swelling, with raised intracranial pressure. We propose that, in such infants, a combination of severe hypoxia, brain swelling and raised central venous pressure causes blood to leak from intracranial veins into the subdural space, and that the cause of the subdural bleeding in some cases of infant head injury is therefore not traumatic rupture of bridging veins, but a phenomenon of immaturity. Hypoxia with brain swelling would also account for retinal haemorrhages, and so provide a unified hypothesis for the clinical and neuropathological findings in cases of infant head injury, without impact or considerable force being necessary. [source] Elevated levels of IgG3 and IgG4 subclass in paediatric cases of kala azarPARASITE IMMUNOLOGY, Issue 8 2008N. A. ANSARI SUMMARY Visceral leishmaniasis (VL) or Kala azar (KA) is a systemic disease caused by the parasites of the Leishmania donovani complex. Control measures rely on treatment with antileishmanial agents, however, fraught with problems such as toxicity or drug resistance. The incidence rate is on the rise for children, for reasons yet undefined. Previously we have shown significantly elevated level of IL-10 in children compared to adult KA cases. Here, antileishmanial antibody and C-reactive protein (CRP) levels were investigated in paediatrics and adult patients of KA and post-KA dermal leishmaniasis (PKDL). Level of IgG4 was significantly elevated in PKDL compared to KA, although total IgG and IgG1 were significantly lower. The antileishmania antibody levels of subclass IgG3 and IgG4 were found significantly elevated in paediatrics, however, levels of IgG, IgG1, IgG2 and CRP were comparable in paediatric and adult KA cases. In case of PKDL, levels of IgG and it subclass were similar in the two groups. No significant difference in antileishmanial antibody level was noticed between macular or polymorphic cases of PKDL. The differential antibody intensity in paediatric cases, together with significant level of circulating IL-10, could be considered as a marker of differential disease susceptibility. [source] Postoperative epidural analgesia with bupivacaine and fentanyl: hourly pain assessment in 348 paediatric casesPEDIATRIC ANESTHESIA, Issue 3 2001Corinne Lejus MD Background: The objective of this prospective study was the evaluation of the analgesia provided by an epidural infusion of bupivacaine and fentanyl after different types of surgery in children. Methods: Data were collected from 348 epidural analgesia in 87 children below 2 years of age, in 80 children between 2 and 6 years and 181 above 6 years of age, for a median duration of 43 postoperative hours. Bupivacaine (mean concentration 0.185%) and fentanyl (5 ,g·kg,1·day,1) were administered on the surgical ward. Results: Pain control was considered excellent in 86% of the 11 072 pain hourly assessments. Analgesia was found to be better for children older than 2 years, and the overall quality of their night's sleep was better than that of older children. Higher pain scores were noted for Nissen fundoplication surgery and club foot repairs. Early discontinuation rarely occurred, and only because of technical problems with the epidural catheter (4%) or insufficient analgesia (6%). Complications were minor (nausea/vomiting 14%, pruritus 0.6%, urinary retention 17%) and easily reversed. Conclusions: This combination of bupivacaine,fentanyl provides safe analgesia after major surgery in children with frequent clinical monitoring. Regular pain assessments of intensity and duration are useful to improve the quality of postoperative analgesia. [source] Recognition and treatment of genitourinary complications in paediatric Crohn's disease using InfliximabACTA PAEDIATRICA, Issue 7 2010NA Afzal Abstract Although genitourinary complications of Crohn's are well recognized, available information regarding their clinical course and management is sparse especially in the paediatric population. We report a myriad of urological complications in five paediatric cases, our experience from a tertiary paediatric urological and gastroenterological centre. All children with urological complications had severe Crohn's disease which necessitated the use of immuno-suppressants including Infliximab. Three of four children healed and closed their fistulas after treatment, although failed to avoid future surgery, albeit for other reasons. Conclusion:, We suggest Infliximab should be considered as a treatment option but in the absence of a common consensus, treatment be tailored to individual cases. [source] Three-dimensional visualization of renal artery stenosis by 64-channel multiple detector-row computed tomographical angiography: review of two paediatric casesACTA PAEDIATRICA, Issue 3 2010N Ueda Abstract Three-dimensional visualization of renal arteries has recently been established by helical contrast-enhanced multiple detector-row computed tomographical angiography (MDCTA) in adults. So far, no information is available on its use in children. We reported two children with renal artery stenosis detected by 64-channel MDCTA. The first patient probably had fibromuscular dysplasia and the other neurofibromatosis type1. The technique showed a left renal artery stenosis with a small left kidney in the first patient and a right renal artery stenosis in the second. Conclusion:, MDCTA is an accurate and noninvasive imaging technique, easily performed in children, and can be used as an alternative diagnostic modality in children with suspected renovascular hypertension. [source] Nevoid Basal Cell Carcinoma Syndrome in infants: improving diagnosisCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 3 2005L. Pastorino Abstract Background, Diagnosis of Nevoid Basal Cell Carcinoma Syndrome (NBCCS) in infants may pose significant challenges to clinicians owing to its variable expressivity and age-related manifestations. Methods, We report two paediatric cases of NBCCS who presented initially with a non-specific phenotype. Results, In case 1, a diagnosis of NBCCS was possible only after the father was interviewed and found to present with two major criteria for the disease. Subsequent molecular testing confirmed the diagnosis. In case 2, molecular testing of the infant and his father had diagnostic value as neither satisfied fully the current diagnostic criteria for NBCCS. Conclusions, Presence of the few clinical manifestations of NBCCS that appear in infants, typically congenital malformations and skeletal abnormalities, should prompt clinicians to conduct in-person interviews with both parents. In general, paediatricians should refer both parents of infants who are suspected of having an inherited condition to clinical geneticists for expert examination, given the potential unreliability of reported medical history. [source] | ||||||||||