MAYA CITY
##########################
P KZN
Epidural analgesia during labour might increase autism risk
|
RESIGNATION FRUSTRATION AND CONFUSION
########################
Einstein once said, “Reality is an illusion, albeit a persistent one.”
########################
"Being cool is being your own self, not doing something that someone else is telling you to do."
-- Vanessa Hudgens
###############################
p kzn early abx in t21 infants
Effect of antibiotics in preventing hospitalizations from respiratory tract infections in children with Down syndrome
This paper was presented as a poster at the American Thoracic Society Conference 2018.
Abstract
Background
Children with Down syndrome (DS) are at high risk of respiratory tract infections (RTIs) due to anatomical variations, comorbidities, and immune system immaturity. Evidence on interventions to reduce this risk is incomplete. This study aims to quantify the effect of antibiotics prescribed for RTIs in primary care on the subsequent risk of RTI‐related hospitalization for children with DS versus controls.
Methods
We conducted a retrospective cohort study of 992 children with DS and 4874 controls managed by UK National Health Service General Practitioners (GPs) and hospitals as identified in CALIBER (Clinical disease research using LInked Bespoke studies and Electronic health Records), 1997–2010. Univariate and multivariate logistic regression were undertaken.
Results
In children with DS, the prescription of antibiotics following an RTI‐related GP consultation did not significantly reduce the risk of RTI‐related hospitalization in the subsequent 28 days (risk with antibiotics, 1.8%; without, 2.5%; risk ratio, 0.699; 95% confidence interval, 0.471–1.036). Subgroup analyses showed a risk reduction only in infants with DS, after adjustment for covariates. There was no reduction in risk for controls, overall or across subgroups.
Conclusions
In conclusion, while prescription of antibiotics following RTI‐related GP consultations were effective for infants with DS in reducing subsequent RTI‐related hospitalization, this was not the case for older children with DS. We would encourage further high‐quality cohort and randomized controlled trials to interrogate this finding, and to examine the impact of antibiotics on other endpoints, including symptom duration.
#############################
COVID X VITD P KZN
Is vitamin D deficiency a risk factor for COVID‐19 in children?
Abstract
Objective
Coronavirus disease 2019 (COVID‐19) is a global health problem that can result in serious complications. The aim of this study was to investigate the prevalence and clinical importance of vitamin D deficiency in children with COVID‐19.
Material and Methods
This study includes 40 patients who were diagnosed to have COVID‐19 and hospitalized with the real‐time reverse transcription polymerase chain reaction method, 45 healthy matched control subjects with vitamin D levels. The age of admission, clinical and laboratory data, and 25‐hydroxycholecalciferol (25‐OHD) levels were recorded. Those with vitamin D levels which are below 20 ng/ml were determined as Group 1 and those with ≥20 ng/ml as Group 2.
Results
Patients with COVID‐19 had significantly lower vitamin D levels 13.14 μg/L (4.19–69.28) than did the controls 34.81 (3.8–77.42) μg/L (p < .001). Patients with COVID‐19 also had significantly lower serum phosphorus (4.09 ± 0.73 vs. 5.06 ± 0.93 vs. (U/L) (p < .001)) values compared with the controls. The symptom of fever was significantly higher in COVID‐ 19 patients who had deficient and insufficient vitamin D levels than in patients who had sufficient vitamin D levels (p = .038). There was a negative correlation found between fever symptom and vitamin D level (r = −0.358, p = .023).
Conclusion
This is the first to evaluate vitamin D levels and its relationship with clinical findings in pediatric patients with COVID‐19. Our results suggest that vitamin D values may be associated with the occurrence and management of the COVID‐19 disease by modulating the immunological mechanism to the virus in the pediatric population.
################################
Laughing during sleep, or hypnogely, is relatively common and is not usually anything to worry about. In most cases, researchers believe that the cause is laughing at a dream during rapid eye movement sleep, which is entirely harmless.
r/o RBD -REM BHVR DISORDERS
R/O PARKINSON AND HYPOTHALAMIC HAMARTOMA
###########################
P KZN RIME-REACTIVE INFECTIOS MUCOCUTANEOUS ERUPN
Mucocutaneous eruptions associated with respiratory pathogens, specifically Mycoplasma pneumoniae (MP), has recently been described as a MIRM (MP‐induced rash and mucositis). The term reactive infectious mucocutaneous eruption (RIME) has been proposed, since non‐MP pathogens may also cause a similar rash and mucositis. We report two cases with clinical manifestations suggestive of MIRM/RIME, both with documented adenovirus infection.
#######################
Decrease in child abuse notifications during COVID‐19 outbreak:
Adolescent eating disorder with catheter‐related bloodstream infection
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi:10.1111/ped.14511
Abstract
Background
Treatment of adolescent eating disorder requires early improvement of nutritional status. Central venous hyperalimentation is used, but catheter‐related bloodstream infection (CRBSI) is a complication. There have been no reports examining risk factors for CRSBI in eating disorders.
Methods
The subjects were 51 patients who received nutritional therapy with use of a peripherally inserted central catheter (PICC) from January 2012 to December 2019. The courses of weight and white blood cell (WBC) count were examined retrospectively during nutritional therapy. Onset factors for CRBSI were determined and a case‐series of CRBSI caused by Candida parapsilosis is presented.
Results
The day of minimum weight occurred on or before day 7 in 37 of the 51 patients, and this day was preceded by the day with the lowest WBC at a significant rate. The minimum weight day was significantly delayed in CRSBI cases compared to non‐CRBSI cases (P=0.02). In the case‐series of CRBSI caused by Candida parapsilosis, the median WBC count before CRBSI decreased to 2,570 (1,680‐3,270) /µL at a median of day (12‐90) 36. CRBSI developed at a median of day (26‐133) 38. The PICC was immediately removed and an antifungal drug was started, leading to cure with no aftereffects in all subjects.
Conclusion
In patients with eating disorder treated with nutritional therapy using a PICC, prolonged resistance to weight gain became a risk factor for developing CRBSI. WBC counts recover after weight gain, which suggests that there is a risk of developing CRBSI, even with improved appetite and weight gain.
########################
P KZN AIBD
Spectrum of autoimmune bullous diseases among children in Kuwait
Abstract
Background
Autoimmune bullous diseases (AIBD) are rare among children. The data describing the overall spectrum and prognosis of pediatric AIBD (pAIBD) are scarce, and there are no established treatment guidelines.
Objectives
The present study examined the spectrum, clinical characteristics, and long‐term prognosis of pAIBD in a tertiary care pediatric dermatology unit.
Methods
Retrospective records of all pAIBD cases (<18 years) registered over a span of 28 years were analyzed.
Results
Records of 23 cases of pAIBD, including 16 boys and 7 girls, were reviewed. They constituted 8.5% of total AIBD patients from all age groups. Ninety‐one percent of patients were of Arab ethnicity. Linear IgA bullous dermatosis was the most prevalent AIBD followed by bullous pemphigoid, bullous lupus erythematosus, and pemphigus variants (pyostomatitis‐pyodermatitis vegetans and neonatal pemphigus). The mean age of onset and diagnosis was 6.4 and 7.7 years, respectively. Systemic treatments, including systemic corticosteroids and dapsone, were required in most cases. Intravenous immunoglobulin G (IVIG) was also utilized as second‐line therapy. The mean follow‐up period was 76 months with 90% of the patients in complete remission.
Conclusions
AIBD pose a great challenge among children both in diagnosis and treatment. This study highlights the ethnic variability and underscores the need for additional similar, international studies to achieve a better understanding of the burden related to pAIBD and help establish treatment guidelines.
#############################
History began when humans invented gods, and will end when humans become gods.” – Yuval Noah Harari
One hundred thousand years ago, at least six different species of humans inhabited Earth. Yet today there is only one-homo sapiens. What happened to the others? And what may happen to us?
#########################
No comments:
Post a Comment