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Frontiers in Pediatrics

Etienne Javouhey, Pierre-Adrien Bolze, Claire Jamen, Gerard Lina, Cédric Badiou, Claire Poyart, Aurelie Portefaix, Anne Tristan, Frédéric Laurent, Michèle Bes, François Vandenesch, Yves Gilletand, Olivier Dauwalder
Introduction: Toxic shock syndromes (TSS) are severe shocks due to staphylococcal or streptococcal infection that require specific treatments. The early recognition of these shocks is crucial to improve their outcomes. Objectives: The primary objective of this study was to compare characteristics and outcomes of staphylococcal and streptococcal TSS in children, in order to identify putative early clinical diagnostic criteria. Secondary objectives were to determine the toxin gene profiles of associated isolated strains and the relevance of measuring Vβ T-cell signatures to confirm the diagnosis...
2018: Frontiers in Pediatrics
Chris Wincup, Yiannis Ioannou
Antiphospholipid syndrome (APS) is a rare autoimmune disease of unknown etiology that represents a leading cause of acquired thromboembolism and recurrent miscarriage. It is characterized by the persistent elevated presence of pathogenic antiphospholipid auto-antibodies directed against cardiolipin, ß2-glycoprotein-I, and/or a positive lupus anticoagulant test. As with many autoimmune disorders, the pathogenesis of APS is believed to be the result of a complex interaction between environmental triggers and genetic predisposition...
2018: Frontiers in Pediatrics
Claudia K Fox, Aaron S Kelly
There is a gap in treatment modalities for pediatric patients with obesity for whom lifestyle modification therapy, on the one hand, may be insufficient to meaningfully reduce BMI, and bariatric surgery, which on the other hand, may not be indicated, available or desired. Although pharmacotherapy may help fill this treatment void, there is a paucity of FDA-approved medications indicated for pediatric obesity and further, most are single agents with only modest mean treatment effects. In contrast, combination pharmacotherapy, such as phentermine/topiramate, appears to offer greater weight loss efficacy in adults and may prove to be superior to monotherapy for pediatric patients as well...
2018: Frontiers in Pediatrics
Yuanyuan Tong, Jinping Liu, Lihua Zou, Zhengyi Feng, Chun Zhou, Ruoning Lv, Yu Jin
Background: With the widespread application of regional low-flow perfusion (RLFP), development of surgical techniques, and shortened circulatory arrest time, deep hypothermia is indispensable for organ protection. Clinicians have begun to increase the temperature to reduce hypothermia-related adverse outcomes. The aim of this study was to evaluate the safety and efficacy of elevated temperatures during aortic arch surgery with lower body circulatory arrest (LBCA) combined with RLFP. Methods: We retrospectively analyzed data from 207 consecutive pediatric patients who underwent aortic arch repair with LBCA & RLFP between January 2010 and July 2017 and evaluated different hypothermia management strategies...
2018: Frontiers in Pediatrics
Laurence Dillenseger, Claire Langlet, Silvia Iacobelli, Thomas Lavaux, Charline Ratomponirina, Marc Labenne, Dominique Astruc, François Severac, Jean Bernard Gouyon, Pierre Kuhn
Background: Early diagnosis is essential to improve the treatment and prognosis of newborn infants with nosocomial bacterial infections. Although cytokines and procalcitonin (PCT) have been evaluated as early inflammatory markers, their diagnostic properties have rarely been compared. Objectives: This study evaluated and compared the ability of individual inflammatory markers available for clinician (PCT, semi-quantitative determination of IL-8) and of combinations of markers (CRPi plus IL-6 or quantitative or semi-quantitative determination of IL-8) to diagnose bacterial nosocomial infections in neonates...
2018: Frontiers in Pediatrics
Deandra H Luong, Po-Yin Cheung, Megan O'Reilly, Tze-Fun Lee, Georg M Schmolzer
Background: In 2015, the neonatal resuscitation guidelines incorporated the use of electrocardiography (ECG) to monitor heart rate of newborns. However, previous studies have indicated that cardiac arrest with pulseless electrical activity rhythm (PEA) may occur in the delivery room, rendering this method problematic. Objective: To evaluate the accuracy of ECG and auscultation to assess heart rate during PEA. Methods: A total of 45 piglets (age 1-3 days, weight 1.7-2.3 kg) were exposed to 30 min normocapnic alveolar hypoxia followed by asphyxia until asystole, achieved by disconnecting the ventilator and clamping the endotracheal tube...
2018: Frontiers in Pediatrics
Simone Pratesi, Simona Montano, Stefano Ghirardello, Fabio Mosca, Luca Boni, Lorenzo Tofani, Carlo Dani
Background: Preterm newborns receiving briefly delayed cord clamping or cord milking at birth have better neonatal outcomes. However, the time frame in which both these procedures are performed (< 60 s of life) is too short to explore the possible beneficial effects on early infant postnatal adaptation and outcomes of a prolonged transfusion strategy associated with neonatal respiration. Methods and Design: We have designed a randomized, multicenter, controlled two-phase study: phase 1 to assess the feasibility of carrying out the protocol in a large randomized trial, and phase 2 to assess the efficacy of bedside assistance with intact placental circulation for 3 min in comparison to cord milking to improve outcome in the neonatal period; we present here the feasibility and safety phase of the study...
2018: Frontiers in Pediatrics
Daniel Klotz, Marie Schreiner, Valeria Falcone, Daniel Jonas, Mirjam Kunze, Andrea Weber, Hans Fuchs, Roland Hentschel
Background: Human milk (HM) for preterm infants will often be pasteurized for cytomegalovirus (CMV) inactivation and reduction of its bacterial count. High-temperature short-time (HTST) treatment compared to standard Holder pasteurization (HoP) reduces the impact of heat treatment on bioactive HM proteins while effectively inactivating CMV. No data are available for the efficacy of bacterial count reduction using HTST treatments that are available for clinical use. Objective: To test the antiviral and antibacterial efficacy of HTST treatment protocols in HM using a modified HTST treatment device compared to standard HoP...
2018: Frontiers in Pediatrics
Shilpa Vyas-Read, Lokesh Guglani, Prabhu Shankar, Curtis Travers, Usama Kanaan
Between 4 and 16% of extremely premature infants have late pulmonary hypertension (PH) (onset >30 days of life), and infants with PH have a higher risk of tracheostomy and death. Atrial septal defects (ASD) increase pulmonary blood flow and may promote PH in at-risk infants. The objective of this study was to determine if infants with ASD develop PH sooner than those without ASD. Infants who were born at < 32 weeks' gestation, with an echocardiogram on day of life > 30, and without congenital anomalies were included...
2018: Frontiers in Pediatrics
Kelly L Brown, Joanna M Lubieniecka, Giulia Armaroli, Katharina Kessel, Kristen M Gibson, Jinko Graham, Dongmeng Liu, Robert E W Hancock, Colin J Ross, Susanne M Benseler, Raashid A Luqmani, David A Cabral, Dirk Foell, Christoph Kessel
Objectives: Chronic primary systemic vasculitidies (CPV) are a collection of rare diseases involving inflammation in blood vessels, often in multiple organs. CPV can affect adults and children and may be life- or organ-threatening. Treatments for adult CPV, although effective, have known severe potential toxicities; safety and efficacy of these drugs in pediatric patients is not fully understood. There is an unmet need for biologic measures to assess the level of disease activity and, in turn, inform treatment choices for stopping, starting, or modifying therapy...
2018: Frontiers in Pediatrics
Chiara Rubino, Monica Paci, Massimo Resti, Paolo Lionetti, Sandra Trapani
Henoch-Schönlein purpura is a systemic vasculitis, commonly affecting children. Gastrointestinal manifestations are observed in 50-75% of patients; it is well known they may occur before skin lesions in about 20% of cases during the first vasculitic episode. Relapses occur in about one third of patients, typically within 4 months from the initial presentation and with milder symptoms. We report the case of a 17-year old girl with an atypical relapse of Henoch-Schönlein purpura, presenting with acute abdominal symptoms 5 years after the first episode...
2018: Frontiers in Pediatrics
Hui-Jun Tan, Mei Deng, Jian-Wu Qiu, Jun-Feng Wu, Yuan-Zong Song
Sodium taurocholate cotransporting polypeptide (NTCP) is a carrier protein encoded by the human SLC10A1 gene, acting as the principal transporter of conjugated bile salts from the plasma into hepatocytes. Although NTCP was cloned as early as in 1994 and its function has been studied extensively, clinical description of NTCP deficiency remains rather limited thus far. The patients in this paper were 2 female monozygotic twins, who were referred to our hospital at the age 2 years with the complaint of persistently-raised total bile acids (TBA) for 21 months...
2018: Frontiers in Pediatrics
C Linda M C van Campen, Peter C Rowe, Frans C Visser
Introduction: Conflicting data have been published on the reduction of circulating blood volume in adults with Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The aim of the present study was to compare blood volumes based on the presence or absence of orthostatic symptoms. Methods and results: Twenty consecutive adults with ME/CFS participated in the study. All underwent dual isotope blood volume measurement and were evaluated for a clinical suspicion of orthostatic intolerance (OI). The mean age was 34 (10) years, and median duration of disease was 7...
2018: Frontiers in Pediatrics
Anne Morice, Véronique Soupre, Delphine Mitanchez, Francis Renault, Brigitte Fauroux, Sandrine Marlin, Nicolas Leboulanger, Natacha Kadlub, Marie-Paule Vazquez, Arnaud Picard, Véronique Abadie
Pierre Robin sequence (PRS) may lead to life-threatening respiratory and feeding disorders. With the aim to analyse the association of the severities of retrognathia and glossoptosis with those of respiratory and feeding disorders, we retrospectively studied a series of 50 infants with retrognathia, glossoptosis, cleft palate, and airway obstruction. The patients were managed from birth to at least 6 years of age by a single pediatric team at the Armand Trousseau Hospital in Paris within a 12 years period (2000-2012)...
2018: Frontiers in Pediatrics
Liu Yang, Lili Yang, Yuanyuan Zhang, Bo Xi
Background: Subclinical target organ damage (TOD) has been common in hypertensive children, but there is limited data in the Chinese pediatric population. This study aimed to investigate the prevalence of subclinical TOD in the Chinese hypertensive children and adolescents. Methods: A cross-sectional study was performed in children and adolescents from four schools in Jinan, China between September 2012 and September 2014. The hypertensive status was confirmed based on elevated blood pressure across three different occasions...
2018: Frontiers in Pediatrics
Tariq O Abbas, Mansour Ali
Perinatal testicular torsion is a relatively rare event that remains unidentified in many situations and managed only after an avoidable delay of time. Its current management approaches include watchful observation, delayed contralateral orchiopexy, and emergent contralateral orchiopexy. On the other hand, bilateral torsion is now being more frequently reported. However, the assessment of the contralateral testis through physical examination and imaging can be inaccurate in cases of perinatal torsion. We report a case of prenatal testicular torsion with incidentally discovered metachronous contralateral extravaginal testicular torsion...
2018: Frontiers in Pediatrics
Jason A Tye-Din, Heather J Galipeau, Daniel Agardh
Our understanding of celiac disease and how it develops has evolved significantly over the last half century. Although traditionally viewed as a pediatric illness characterized by malabsorption, it is now better seen as an immune illness with systemic manifestations affecting all ages. Population studies reveal this global disease is common and, in many countries, increasing in prevalence. These studies underscore the importance of specific HLA susceptibility genes and gluten consumption in disease development and suggest that other genetic and environmental factors could also play a role...
2018: Frontiers in Pediatrics
Jingjing Gong, Wei Xiao, Hongyan Gao, Wei Wei, Weiwei Zhang, Jing Lv, Lijun Xiao, Lida Duan, Yan Zhang, Hongyun Liu, Yonghua Huang
Background: As the infant's best interests are determined through the perinatal decisions of family members and physicians, it is important to understand the factors that affect such decisions. This paper investigated the separate and combined effects of various factors related to perinatal decision making and sought to determine the best way to convey information in an unbiased manner to family members. Methods: In total, 613 participants were consecutively recruited. Each participant completed a series of surveys...
2018: Frontiers in Pediatrics
Aleksandra Wesolowska, Elena Sinkiewicz-Darol, Olga Barbarska, Kamila Strom, Malgorzata Rutkowska, Katarzyna Karzel, Elzbieta Rosiak, Gabriela Oledzka, Magdalena Orczyk-Pawiłowicz, Sylwester Rzoska, Maria Katarzyna Borszewska-Kornacka
High-pressure processing (HPP) is a non-thermal technology that is being increasingly applied in food industries worldwide. It was proposed that this method could be used as an alternative to holder pasteurization (HoP; 62.5°C, 30 min) in milk banks but its impact on the immunologic, enzymatic and hormonal components of human milk has not yet been evaluated in detail. The aim of our study was to compare the effects of HPP in variants: (1) 600 MPa, 10 min (2) 100 MPa, 10 min, interval 10 min, 600 MPa, 10 min (3) 200 MPa, 10 min, interval 10 min, 400 MPa, 10 min (4) 200 MPa, 10 min, interval 10 min, 600 MPa, 10 min in temperature range 19-21°C and HoP on the leptin, adiponectin, insulin, hepatocyte growth factor (HGF), lactoferrin and IgG contents in human milk...
2018: Frontiers in Pediatrics
Lucila A Barreiros, Gesmar R S Segundo, Anete S Grumach, Pérsio Roxo-Júnior, Troy R Torgerson, Hans D Ochs, Antonio Condino-Neto
[This corrects the article DOI: 10.3389/fped.2018.00230.].
2018: Frontiers in Pediatrics
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