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Neonatal Lupus Erythematosus in a 2-Month-Old Girl: A Case Report
Runchao Wang,
Haixia Jing,
Tingting Chen,
Rui Wu,
Wentao Liu
Issue:
Volume 9, Issue 2, June 2023
Pages:
59-62
Received:
17 March 2023
Accepted:
6 April 2023
Published:
15 April 2023
Abstract: Neonatal lupus erythematosus is a rare acquired disease involving the fetus and the newborn. It is caused by autoantibodies (mainly anti-SSA/Ro and anti-SSB/La antibodies) in the mother entering the fetus through the placenta to cause autoimmune reactions, The most common clinical manifestations of neonatal lupus erythematosus include skin involvement and congenital heart block, as well as blood, respiratory, neurological, and digestive system abnormalities. Patients often go to pediatrics or dermatology with rash as the first symptom. Because the rash is atypical, there is often a risk of misdiagnosis or missed diagnosis. We report a case of 2-month-old baby. Physical examination showed that dark red infiltrating macula was scattered on forehead and plantar. ANA positive, anti-SSA/Ro antibody positive, anti-SSB/La antibody positive, no involvement of the heart or other organ systems was found. Her mother was a patient with lupus erythematosus. The diagnosis of neonatal lupus erythematosus was made according to the history and clinical manifestations, symptomatic treatment was given to the rash site, and after 4 months, the rash disappeared at a follow-up visit. ANA, Anti SSA/Ro antibodies and anti SSB/La antibodies all turned negative. The etiology, clinical manifestation, prevention and treatment of neonatal lupus erythematosus were discussed in combination with existing literature. It was emphasized that autoantibody testing should be carried out for women and pregnant women with reproductive requirements in order to detect and prevent neonatal lupus erythematosus in time. For unexplained skin rashes of infants, if the mother has a history of connective tissue disease, the possibility of neonatal lupus erythematosus should be considered.
Abstract: Neonatal lupus erythematosus is a rare acquired disease involving the fetus and the newborn. It is caused by autoantibodies (mainly anti-SSA/Ro and anti-SSB/La antibodies) in the mother entering the fetus through the placenta to cause autoimmune reactions, The most common clinical manifestations of neonatal lupus erythematosus include skin involvem...
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Unusual Presentation of Brain Tumor in a Child: A Case Report
Mahmoud Alhandi Omar Helal,
Mohammed Al-Amri,
Mahmoud Alrifaai,
Shaikha Al-Thani,
Bashir Youssef,
Lujain Loay,
Abdulrahman Siddig,
Hanan Eldesouky Eltomy
Issue:
Volume 9, Issue 2, June 2023
Pages:
63-67
Received:
20 March 2023
Accepted:
17 April 2023
Published:
27 April 2023
Abstract: The most popular type of neurological tumor in childhood is medulloblastoma, which is the most malignant neoplasm of the posterior fossa and cerebellum. Central nervous system neoplasms can cause symptoms and signs due to local invasion, compression of normal structures, and increased intracranial pressure by either a mass effect or obstruction of cerebrospinal fluid flow, resulting in hydrocephalus. Usually, headache is the most common symptom of central nervous system tumors, and the median duration between symptoms beginning and diagnosis of brain tumors in children ranges from 2.5 to 3.5 months. Furthermore, several predisposing factors for brain tumors have been identified such as Epstein–Barr virus infection, exposure to ionizing radiation, and inherited diseases. Recently, the advances in diagnosis and treatment have improved the survival of many children with neurological neoplasms. However, this therapy is associated with long-term complications, and its prognosis remains poor. We present the case of a 4-year-old girl with adequate neuropsychomotor development who presented to the pediatric emergency center with a 14-day history of headache, which was prominent in the morning, neck, back, and bilateral leg pain two days prior to presentation. Brain and Spine Magnetic resonance imaging revealed a cerebellar mass lesion in the posterior fossa. The patient underwent surgery, followed by histopathological and immunohistochemical staining. This case is considered rare and distinctive because the symptoms included only headache for two weeks, no impaired vision, no vomiting, no mental disorders, no abnormal gait, and no ataxia or body imbalance. We report this case to focus on the features of the manifestation and hence increase the chances of timely diagnosis in the future. Consequently, the probability of central nervous system tumors should always be considered in children with headache, and they must be under regular follow-up for early diagnosis and treatment.
Abstract: The most popular type of neurological tumor in childhood is medulloblastoma, which is the most malignant neoplasm of the posterior fossa and cerebellum. Central nervous system neoplasms can cause symptoms and signs due to local invasion, compression of normal structures, and increased intracranial pressure by either a mass effect or obstruction of ...
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Relationship Between FKBP5 Polymorphisms at Rs1334894, Rs9394309, and Rs6912833 Loci, and Dyslipidemia in Pediatric Nephrotic Syndrome
Shuting Peng,
Fang Yang,
Zhiqiang Guo,
Ding Liu
Issue:
Volume 9, Issue 2, June 2023
Pages:
68-74
Received:
9 April 2023
Accepted:
26 April 2023
Published:
10 May 2023
Abstract: Background: This study aimed to investigate the relationship between rs1334894, rs9394309, and rs6912833 polymorphisms in FKBP5 and hyperlipidemia in nephrotic syndrome (NS). Methods: The case group included 74 children with primary NS, while the control group included 76 healthy children. Polymerase chain reaction and gene sequencing were used to detect polymorphisms at the rs1334894, rs9394309, and rs6912833 loci of FKBP5, in children with NS. Clinical data of total cholesterol (CHOL), triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and plasma albumin were collected. Correlations between FKBP5 polymorphisms and serum lipid levels were analyzed during the active period of the disease. Results: A significant difference in LDL levels between the AA and TA genotypes was observed at the rs6912833 locus of FKBP5 in the case group, but no statistical difference in CHOL, TG, and HDL levels between these genotypes was found. No statistically significant differences in LDL levels between the AA and TA genotypes, and among the steroid-sensitive, -dependent, and -resistant groups were noted. Moreover, no statistically significant differences in the CHOL, TG, HDL, and LDL levels were observed between TT and TC genotypes at the rs1334894 locus. Conclusion: The AA genotype at the rs6912833 locus of FKBP5 may be correlated with plasma lipid levels (LDL) in PNS patients.
Abstract: Background: This study aimed to investigate the relationship between rs1334894, rs9394309, and rs6912833 polymorphisms in FKBP5 and hyperlipidemia in nephrotic syndrome (NS). Methods: The case group included 74 children with primary NS, while the control group included 76 healthy children. Polymerase chain reaction and gene sequencing were used to ...
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Application of Project Improvement in Elevating the Qualified Rate of Retained 24-h Quantitative Urinary Protein Specimens Among Children
Sha Wang,
Shaoxin Lin,
Caiqing Wu,
Xufen Huang
Issue:
Volume 9, Issue 2, June 2023
Pages:
75-78
Received:
17 April 2023
Accepted:
8 May 2023
Published:
22 May 2023
Abstract: Objective To explore the effect of project improvement in elevating the qualified rate of retained 24-h quantitative urinary protein specimens among children in our hospital’s Department of Pediatric Internal Medicine. Methods A project improvement team was set up. The 24-h quantitative urinary protein specimens of 61 pediatric patients collected from January to June 2021 were included in the control group. From the 5 aspects of “people, devices, materials, methods, and environment”, the causes underlying the unqualified 24-h quantitative urinary protein specimens were analyzed, and the major causes were discussed. Accordingly, feasible improvement measures were formulated and implemented by department staff. After that, the 24-h quantitative urinary protein specimens of 51 pediatric patients retained in our department from July to December 2021 were included in the observation group. Finally, a comparison was made between the qualified rates of retained specimens of the two groups. Results Following project improvement, the qualified rate of retained 24-h quantitative urinary protein specimens was obviously lifted from 78.7% to 94.1%. The difference was statistically significant (P < 0.05). Conclusion Nursing project improvement is able to effectively elevate the qualified rate of retained 24-h quantitative urinary protein specimens. With the wisdom of the project improvement team, science-based approaches were adopted to address the clinical nursing issue and enhance the nursing quality. In this way, continuous quality improvement can be achieved, which in turn can make children and their family members feel more satisfied.
Abstract: Objective To explore the effect of project improvement in elevating the qualified rate of retained 24-h quantitative urinary protein specimens among children in our hospital’s Department of Pediatric Internal Medicine. Methods A project improvement team was set up. The 24-h quantitative urinary protein specimens of 61 pediatric patients collected f...
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Validity Study Comparing Polar Ignite’s® Estimated VO2max to Traditional Cardiopulmonary Exercise Testing in Normal Cardiac Anatomy & Fontan Pediatric Patients
Brian Hernandez,
Bayley Roberts,
Erica Jamro-Comer,
Anusha Kodidhi,
Lisa Roelle,
Nathan Miller,
Lauren Littell,
Aecha Ybarra,
Jonathan Silva,
Jennifer Silva,
William Orr
Issue:
Volume 9, Issue 2, June 2023
Pages:
79-84
Received:
19 April 2023
Accepted:
17 May 2023
Published:
29 May 2023
Abstract: Cardiorespiratory fitness as represented by maximum oxygen uptake, VO2max, is considered the best indicator for overall cardiovascular health. Fitness technology such as wrist worn devices, now allows for an easy method to monitor an individual’s VO2max. This study sought to compare the estimated VO2max measurements from the Polar Ignite (Polar Electro Oy, Kempele, Finland) fitness watch (Polar Ignite) against the gold standard, cardiopulmonary exercise testing (CPET) in normal cardiac anatomy and Fontan pediatric patients. This single-center, prospective study enrolled patients with normal cardiac anatomy and single ventricle patients with Fontan palliation (Fontan) between 13-21 years. The Polar Ignite was fastened on the patient’s right or left wrist while supine and estimated VO2max was generated based on a non-exercise test (Polar Fitness Test). A maximal voluntary CPET using the standard Bruce Treadmill Protocol was then completed. Measurements from the two tests were compared using the intraclass correlation coefficient (ICC), Pearson correlation coefficient and Bland-Altman method. Forty-seven patients were enrolled, including n=36 (77%) normal cardiac patients and n=11 (23%) Fontan patients. The majority of participants were white (n=41, 87%) and female (n=36, 66%). Patients were 15.3±1.9 years old, weighed 65.7±16.6 kg, and were 168.0±10.4 cm tall on average. The mean estimated Polar Ignite VO2max and peak CPET VO2 was 43.9±6.1 ml/kg/min vs 37.7±8.2 ml/kg/min, respectively in the normal cardiac group, and 42.6±3.9 ml/kg/min vs 22.6±5.6 ml/kg/min, respectively in the Fontan group. We found poor validity (ICC=0.21) and a weak correlation (r=0.31, p=0.07) between VO2max measured by the Polar Ignite and CPET in the normal cardiac group and poor validity (ICC=0.08) and strong correlation (r=0.84, p=0.001) in the Fontan group. In Bland-Altman analyses, the mean bias between VO2max as measured by the Polar Ignite and CPET was 6.85 ml/kg/min among the normal cardiac group and 20.05 ml/kg/min among the Fontan group. The Polar Ignite overestimated VO2max compared to CPET in both the normal cardiac and Fontan groups and cannot replace formal testing.
Abstract: Cardiorespiratory fitness as represented by maximum oxygen uptake, VO2max, is considered the best indicator for overall cardiovascular health. Fitness technology such as wrist worn devices, now allows for an easy method to monitor an individual’s VO2max. This study sought to compare the estimated VO2max measurements from the Polar Ignite (Polar Ele...
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Silent Lung Abscess in a Newborn: A Case Report
Mahmoud Alhandi Omar Helal,
Shaikha Nasser Al-Thani,
Dhabiya Al-kubaisi,
Wadha Al-Shafi,
Farah Falah Kadhim Al Khawaja,
Amal Alnajjad,
Hafez Alsliman,
Mohamed Alaido,
Mohammad Qusad,
Loma Abdulla Al Enzi,
Mona Altemimi
Issue:
Volume 9, Issue 2, June 2023
Pages:
85-91
Received:
17 May 2023
Accepted:
1 June 2023
Published:
10 June 2023
Abstract: Background: Lung abscesses are rare in childhood and very rare in early infancy and neonates. With a predicted incidence of 7 per 1000,000 admissions per year. Furthermore, Neonatal lung abscesses are usually of multi-bacterial etiology. In addition, Risk factors in neonates include prematurity, ventilation, congenital lung malformation, and aspiration. Here, we are reporting a 21 day- old baby, full term, normal vaginal delivery, no history of NICU admission, no resuscitation at birth, group B streptococcus screening is negative, breast feeding, and no respiratory distress at birth, who presented with unusual picture of mild cough and flu without fever or other symptoms, and was diagnosed as a lung abscess, which is probably one of the few cases reported in the literature in neonates. Case presentation: A 3-week-old boy presented with unusual symptoms of cough, flu, without fever, or other manifestations. The Diagnosis of lung abscess was based on chest CT scan. Empirically treated with intravenous antibiotics was started. Then, patient was discharged from the hospital with an outpatient follow-up. At the time of discharge, he had reassuring vital signs and a normal physical examination. At the follow-up visit after one week, no clinical symptoms were reported and the physical examination was normal. Conclusion: unexpected case of lung abscess in neonates is very rare and distinctive condition, so our recommendations for pediatricians are to be vigilant about the silent presentation of infection in neonates.
Abstract: Background: Lung abscesses are rare in childhood and very rare in early infancy and neonates. With a predicted incidence of 7 per 1000,000 admissions per year. Furthermore, Neonatal lung abscesses are usually of multi-bacterial etiology. In addition, Risk factors in neonates include prematurity, ventilation, congenital lung malformation, and aspira...
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Feeding Practices and Nutritional Status of Children Aged 6-59 Months in Kolda; Southern Senegal
Ba Abou,
Thiongane Aliou,
Niang Babacar,
Keïta Younoussa,
Ly Fatou,
Deme Ly Indou,
Ndongo Aliou Abdoulaye,
Boiro Djibril,
N’diaye Ousmane
Issue:
Volume 9, Issue 2, June 2023
Pages:
92-97
Received:
16 May 2023
Accepted:
2 June 2023
Published:
15 June 2023
Abstract: Introduction: Infant and young child feeding is a critical area for improving child survival and promoting healthy growth and development. The objective of this study was to evaluate the feeding practices and nutritional status of children seen in the pediatric department of the regional hospital of Kolda. Method: This was a descriptive and analytical cross-sectional study conducted from July 12 to August 11, 2022. Children aged 6 to 59 months were included. Feeding practices were assessed according to the infant and young child feeding indicators (ANJE). Children's nutritional status was determined using WHO growth standards. Results: A total of 203 children were included. Breastfeeding was practiced by 97.46% of mothers. Breastfeeding was exclusive for up to 6 months in 19.7% of children. The minimum acceptable dietary intake was met in 47.76% of children. Acute malnutrition, stunting and underweight were found in 26.4%, 18.81% and 23.77% respectively. After univariate and multivariate analysis, the most predictive factors of malnutrition were the lack of education of the father (AOR =2.37; CI [1.14-4.92]; p= 0. 021) and of the mother (AOR =2.45; CI [1.04-5.78]; p=0.04), low birth weight (AOR =3.29; CI [1.3-8.33]; p=0.012), age range 25 - 36 months (AOR =3.56; CI [1-12.66]; p=0.005) and lack of minimum acceptable dietary intake (AOR =2.25; CI [1.1-4.61]; p=0.026). Conclusion: Children's feeding practices are suboptimal. Malnutrition remains frequent among children seen at the Regional Hospital, Kolda.
Abstract: Introduction: Infant and young child feeding is a critical area for improving child survival and promoting healthy growth and development. The objective of this study was to evaluate the feeding practices and nutritional status of children seen in the pediatric department of the regional hospital of Kolda. Method: This was a descriptive and analyti...
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Atypical Appendicitis in Children: Clinical Presentation, Imaging Features, and Management Plan
Gihad Alsaeed,
Ali Alassiri,
Tamer Rizk,
Anas Alshamali,
Suhib Alsaeed,
Mohamed Aslaeed,
Lama Bakri
Issue:
Volume 9, Issue 2, June 2023
Pages:
98-103
Received:
26 May 2023
Accepted:
12 June 2023
Published:
21 June 2023
Abstract: Atypical appendicitis is not uncommon in pediatrics. Factors that are usually seen in such presentations include: Age less than five years, developmental delay, ectopic anatomic location of the appendix, subacute or chronic appendicitis, and symptomatic treatment in addition to early inconclusive investigations. Children with Autistic spectrum disorder often suffer from communication problems, which might affect their ability to deliver their complaints effectively. It is usually parent’s interpretation that physicians will rely on as they are the best to delineate minor changes of their children’s behavior and body language signs, so that a correct diagnosis may be reached. Atypical appendicitis is usually a delayed diagnosis with increased morbidity and mortality. In this paper we illustrate the possible causes of atypical appendicitis in childhood, and review its clinical presentation, radiologic findings, and management plan as mentioned in medical literature. We also present a rare case of subacute appendicitis in a 5 years old autistic girl with atypical presentation, misleading imaging features, and re-admission after successful laparoscopy. Our aim is to present the importance of clinical assessment and suggest an approach to improve practice regarding childhood appendicitis which can be an endless trap for both patients and practitioners.
Abstract: Atypical appendicitis is not uncommon in pediatrics. Factors that are usually seen in such presentations include: Age less than five years, developmental delay, ectopic anatomic location of the appendix, subacute or chronic appendicitis, and symptomatic treatment in addition to early inconclusive investigations. Children with Autistic spectrum diso...
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