-
Trisomy 18: Anti-Congestive Drug Treatment Combined with Transcatheter Occlusion of an Arterial Duct and Misaligned Perimembranous VSD
Tim Schubert,
Anoosh Esmaeili,
Dietmar Schranz
Issue:
Volume 9, Issue 1, March 2023
Pages:
1-4
Received:
22 November 2022
Accepted:
12 December 2022
Published:
17 January 2023
Abstract: Background Trisomy 18 syndrome, the second most common autosomal numerical chromosomal disorder, is associated with multiple-organ abnormalities. Cardiovascular malformations are just one of those affecting prenatal and postnatal life expectancy. In general, the type and scope of treatment are still controversial and are handled very differently. Palliative care usually focuses on improving quality of life or life-threatening conditions. Objective Based on parental treatment preferences for their child, we report the anticongestive drug treatment and consecutive transcatheter therapy of cardiac shunt lesions in a girl with trisomy 18 who was born small-for-date. Methods Anticongestive drug treatment was switched form diuretic-directed drug treatment to our standard care for chronic heart failure in infants, which consists of a ß1-specific beta-blocker (bisoprolol) in combination with an ACE-inhibitor (lisinopril) and a low-dose mineralocorticoid-blocker (spironolactone). In addition, the strategy and technique of semi-invasive transcatheter treatment of significant cardiovascular shunt lesions is reported. At 3 months of age and weighing 2.4kg, a significant arterial duct was first occluded percutaneously with an MVP-5Q device, followed by transcatheter closure of a slightly misaligned perimembranous VSD six weeks later. Both interventions were performed on a spontaneously breathing only sedated baby. Results The device strategy for treating the hemodynamically significant cardiovascular shunt lesions was technically feasible and effective in combination with medication. However, the medium- or long-term outcome cannot be defined due to the limitations caused by the syndrome. Conclusion As part of a medical risk-benefit assessment, the parents should make the decision as to whether their child should be treated or not; the responsible physicians have individually to offer the best treatment option.
Abstract: Background Trisomy 18 syndrome, the second most common autosomal numerical chromosomal disorder, is associated with multiple-organ abnormalities. Cardiovascular malformations are just one of those affecting prenatal and postnatal life expectancy. In general, the type and scope of treatment are still controversial and are handled very differently. P...
Show More
-
C1q Nephropathy in a 2-Year-Old Boy: A Case Report
Reika Omura,
Hiroshi Tamura,
Keishiro Furuie,
Shohei Kuraoka,
Hitoshi x Kuraoka
Issue:
Volume 9, Issue 1, March 2023
Pages:
15-19
Received:
4 January 2023
Accepted:
27 January 2023
Published:
9 February 2023
Abstract: Background: C1q nephropathy occurs when C1q is significantly deposited in the mesangial region and systemic lupus erythematosus can be excluded as a diagnosis. Clinical Description: A case of a 2-year-old boy who was diagnosed with steroid-resistant C1q nephropathy. As he was initially managed as a case of idiopathic nephrotic syndrome, prednisolone was administered. However, as his condition did not improve with steroid treatment, other causes for nephrotic were considered, including infections. As it was initially refractory to steroid treatment, a cytomegalovirus infection was strongly considered. Based on the histological findings, C1q deposition was noted in the mesangium, which confirmed the diagnosis of C1q nephropathy. Cyclosporine A was initiated, which resulted in complete remission from the disease. When administering high doses of steroids, it is necessary to recognize the risk of infection. Conclusion: C1q nephropathy is considered to be a heterogeneous disease group from the clinicopathological point of view. In order to treat established C1q nephropathy, it is necessary to clarify the pathological significance of C1q deposition in glomeruli. As it was initially refractory to steroid treatment, CMV infection was strongly considered. When administering high doses of steroids, it is necessary to recognize the risk of infection.
Abstract: Background: C1q nephropathy occurs when C1q is significantly deposited in the mesangial region and systemic lupus erythematosus can be excluded as a diagnosis. Clinical Description: A case of a 2-year-old boy who was diagnosed with steroid-resistant C1q nephropathy. As he was initially managed as a case of idiopathic nephrotic syndrome, prednisolon...
Show More
-
The Use of the Aerophonoscope for Assessing Velo-Pharyngeal Incompetence and Therapeutic Decisions
Gabriel Rousteau,
Jean Claude Talmant
Issue:
Volume 9, Issue 1, March 2023
Pages:
20-42
Received:
24 August 2022
Accepted:
5 December 2022
Published:
15 March 2023
Abstract: Aerophonoscope is an ultra sensitive and original instrument for detecting nasal airflow and analysing the Velo-Pharyngeal Sphincter –VPS - movements. It reveals the aerodynamic function of the VPS, in the usual conditions of speaking and breathing. It has been created for patients with facial cleft, of 4 years old upwards, after primary surgery and during their growth, in a harmless, non-invasive way. There are several sorts of assessments of Velo-Pharyngeal Incompetence (VPI): from an anatomical point of view, a perceptive, acoustic, aerodynamic one. The Aerophonoscope belongs to the latter one. We know the difficulties to treat this pathology in the fields of surgery and speech therapy mostly because of misunderstanding VP physiology and physiopathology, which are complex. Then aerophonoscopy allows us to understand this complexity. So we are able to easily assess excessive Nasal Loss -NL- factors. The NL is linked mainly with a VPS persistent lack of closing, of course. But it varies according to its stiffness, tonicity, and its smaller and slower movements. The latters are according to each phoneme or syllable, and they have more or less speedy succession of the “phonological verbal chain”. So we aim at presenting this instrument that enables an aerodynamic assessment of the VPS precisely. We can analyse many characteristics of its pathological movements with different tests in our protocol (passive, active, effort, successive movements and so on) and show the results of about 652 individuals. These data contribute to guide therapeutic decisions, (choice of type of surgery, targets of rehabilitation), such as to restore the VPS physiology at the very most. Furthermore, it provides a pleasant and efficient means of rehabilitation of the VPS
Abstract: Aerophonoscope is an ultra sensitive and original instrument for detecting nasal airflow and analysing the Velo-Pharyngeal Sphincter –VPS - movements. It reveals the aerodynamic function of the VPS, in the usual conditions of speaking and breathing. It has been created for patients with facial cleft, of 4 years old upwards, after primary surgery an...
Show More
-
Full Immunization Coverage and Related Socio-Demographics Factors in Children Aged 12-23 Months Received in Albert Royer Hospital in Dakar, Senegal
Ba Abou,
Sow Amadou,
Thiongane Aliou,
Diallo Abou,
Keita Younoussa,
Niang Babacar,
Ndiaye Ousmane
Issue:
Volume 9, Issue 1, March 2023
Pages:
43-46
Received:
16 February 2023
Accepted:
4 March 2023
Published:
20 March 2023
Abstract: Introduction: Vaccination is one of the most effective and least costly public health interventions in the world. Methods: This is a cross-sectional, descriptive and analytical study of children aged 12-23 months received in consultation at the Albert Royer Children’s Hospital during the period from November 20, 2019 to January 20, 2020. Results: Boys accounted for 61.8% of children and 70.8% were at least 15 months of age. The average age of mothers was 29.2 years. They were not educated in 22% of cases. Almost all (95.2%) had received vaccination information. Just over half (51%) of mothers did not know how many vaccine contacts their child needs to make. Vaccination records were available in 88.7% of cases. Immunization coverage was complete in 62.9% of children. In multivariate analysis with step-down logistic regression, the only factor significantly associated with complete immunization coverage was the child’s rank in siblings (OR =1; p=0,04). Conclusion: Full immunization coverage for children aged 12-23 months received in pediatric emergency department consultations is low. The vaccination rate according to the specific vaccine is important with good retention for almost all multiple-dose vaccines between the first and third doses.
Abstract: Introduction: Vaccination is one of the most effective and least costly public health interventions in the world. Methods: This is a cross-sectional, descriptive and analytical study of children aged 12-23 months received in consultation at the Albert Royer Children’s Hospital during the period from November 20, 2019 to January 20, 2020. Results: B...
Show More
-
Intervention Strategy for the Development of Specific Competencies in the Care of the Pathological Neonate
Elsa Martínez Sariol,
Lilia Ramírez Córdova,
Rosa Maria Nunez,
Ousman Cham,
Beatrice Nkolika Ezenwa
Issue:
Volume 9, Issue 1, March 2023
Pages:
47-54
Received:
27 February 2023
Accepted:
16 March 2023
Published:
31 March 2023
Abstract: Introduction: Neonatology experts affirm that neonatal complications are closely related to the performance of nurses, in such a sense the factual reasons that motivate the present study denoted a high incidence of complications in neonates assisted at the NICU of the National Hospital "Edward Francis Small Teaching Hospital in The Gambia in the period of julio-december 2021, revealed an increase in complications and the number of neonatal deaths. The solution of this assignment has as objective: Implement an intervention strategy for the development of specific competencies in the care of the pathological newborn that contributes to the prevention of complications and impacts on the quality of life of the child population in The Gambia. The intervention strategy implemented is based on the philosophical, sociological, psychological and epistemological ones that, from their contextualization, improvement the development of competencies in the care of the pathological neonate in 26 nurses who participated in the study. As a result of the implementation, it was possible to verify the level of promotion of the competencies to an average of 4.03, which corresponds to high levels of development and its impact on neonatal morbidity and mortality in the NICU. Conclusions: the intervention Strategy is the theoretical methodological concretion that from the scientific point of view emanates from the work in the training of personnel competencies in the NICU, is in correspondence with the social demands and the requirements of the Health System in the Cuban medical mission. The Gambia.
Abstract: Introduction: Neonatology experts affirm that neonatal complications are closely related to the performance of nurses, in such a sense the factual reasons that motivate the present study denoted a high incidence of complications in neonates assisted at the NICU of the National Hospital "Edward Francis Small Teaching Hospital in The Gambia in the pe...
Show More
-
Congenital Mesoblastic Nephroma in a Newborn: Case Report
Karima Ryouni,
Imane Ain El Hayat,
Mouna Lehlimi,
Amal Badre,
Mounir Chemsi,
Abdelhak Habzi,
Said Benomar,
Asmae El Kebir,
Nisrine Bennani
Issue:
Volume 9, Issue 1, March 2023
Pages:
55-58
Received:
5 February 2023
Accepted:
13 March 2023
Published:
31 March 2023
Abstract: Background: Congenital mesoblastic nephroma (CMN) is a rare mesenchymal renal tumor of the newborn. The objective of this study was to review the clinical particularities, paraclinical and therapeutic characteristics of this tumor. It is about a case report of pediatric patient admitted to a Pediatric Neonatal Reanimation, A. Harouchi Hospital, Ibn Rochd university Hospital centre, Casablanca. Results: We report the observation of a 4-day premature newborn who was hospitalized for exploration of an abdominal mass occupying the right flank since birth. Abdominal ultrasonography revealed a predominantly fleshy right solidocystic renal mass, a site of calcifications laminating the cortex, measuring 57x33x58, with minimal pyelocaliceal dilatation and diffuse infiltration of perrenal fat. The CT scan revealed a kidney increased in size, seat of a voluminous mass rather well limited, of tissue density, heterogeneous, seat of necrosis, realizing a sign of the spur, measuring 40x47x58mm. The diagnosis was confirmed by a kidney biopsy. Conclusion: Mesoblastic nephroma is considered a benign tumor. The diagnosis is discussed on the basis of clinical data, ultrasound and CT scan. Surgery is the primary treatment for NMC and is based on extended nephrectomy. Most patients with NMC have a favorable outcome, the overall prognosis is very good.
Abstract: Background: Congenital mesoblastic nephroma (CMN) is a rare mesenchymal renal tumor of the newborn. The objective of this study was to review the clinical particularities, paraclinical and therapeutic characteristics of this tumor. It is about a case report of pediatric patient admitted to a Pediatric Neonatal Reanimation, A. Harouchi Hospital, Ibn...
Show More
