scholarly journals Pediatric Portal Hypertension

2021 ◽  
Author(s):  
Reda A. Zbaida
Keyword(s):  
Portal Hypertension ◽  
Variceal Bleeding ◽  
Age Groups ◽  
Primary Prophylaxis ◽  
Secondary Prophylaxis ◽  
Age Group ◽  
Pediatric Age ◽  
Pediatric Age Group ◽  
Rex Shunt ◽  
Hepatic Portal

Portal hypertension is increased intravascular pressure of the portal vein. The prevalence of causes in children is different from adults ones. The commonest cause of pediatric portal hypertension is the extra-hepatic portal hypertension, comparing with an adult where liver cirrhosis is the comments cause. Also, taking into consideration, the fundamental physiological differences between the two age groups. These elements are making the attempt to extrapolate the adult guidelines to the pediatric age group unpractical. On the other hand, the limitation of well-designed studies in the pediatric age group makes reaching a consensus about the safety and efficiency of primary prophylaxis of variceal bleeding difficult. In contrast, there were enough data to recommend the secondary prophylaxis of variceal bleeding and the safety and efficiency of Meso-Rex shunt for portal hypertension have been confirmed. These indicate the necessity of further studies to reach a complete algorithm of guidelines for pediatric portal hypertension.

The Role of Chinese Traditional Medical Practise as a Form of Health Care in Singapore I: Preliminary Study

1980 ◽  
Vol 08 (01n02) ◽  
pp. 26-36 ◽  
Author(s):  
Suzanne Chan Ho ◽  
Kwok Chan Lun ◽  
W. K. Cheng Hin Ng
Keyword(s):  
Age Groups ◽  
Age Group ◽  
Pediatric Age ◽  
Pediatric Age Group ◽  
Prevalent Disease ◽  
Singapore Chinese ◽  
Preliminary Study ◽  
Male To Female ◽  
Group Distribution

A retrospective study of 672 sampled records of patients of a major institutions providing Chinese traditional medicine in Singapore reveals that 97.3% of the patients were Chinese, with a dialect group distribution following closely that of the Singapore Chinese. The male-to-female patient ratio was 1.0:1.13. There were fewer patients of the pediatric age group and more of those from age 30 upwards. Some 43% of the patients sought treatment for ''infective'' and ''internal, emotional and weakness'' diseases. The prevalent disease conditions seen among patients from the different age groups are also analyzed and discussed in this paper.

scholarly journals Management of variceal hemorrhage: current concepts

2014 ◽  
Vol 27 (2) ◽  
pp. 138-144 ◽  
Author(s):  
Fabricio Ferreira COELHO ◽  
Marcos Vinícius PERINI ◽  
Jaime Arthur Pirola KRUGER ◽  
Gilton Marques FONSECA ◽  
Raphael Leonardo Cunha de ARAÚJO ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Surgical Treatment ◽  
Variceal Bleeding ◽  
Endoscopic Therapy ◽  
Beta Blockers ◽  
Primary Prophylaxis ◽  
Underlying Disease ◽  
Secondary Prophylaxis ◽  
Variceal Hemorrhage ◽  
Cirrhotic Patients

INTRODUCTION: The treatment of portal hypertension is complex and the the best strategy depends on the underlying disease (cirrhosis vs. schistosomiasis), patient's clinical condition and time on it is performed (during an acute episode of variceal bleeding or electively, as pre-primary, primary or secondary prophylaxis). With the advent of new pharmacological options and technical development of endoscopy and interventional radiology treatment of portal hypertension has changed in recent decades. AIM: To review the strategies employed in elective and emergency treatment of variceal bleeding in cirrhotic and schistosomotic patients. METHODS: Survey of publications in PubMed, Embase, Lilacs, SciELO and Cochrane databases through June 2013, using the headings: portal hypertension, esophageal and gastric varices, variceal bleeding, liver cirrhosis, schistosomiasis mansoni, surgical treatment, pharmacological treatment, secondary prophylaxis, primary prophylaxis, pre-primary prophylaxis. CONCLUSION: Pre-primary prophylaxis doesn't have specific treatment strategies; the best recommendation is treatment of the underlying disease. Primary prophylaxis should be performed in cirrhotic patients with beta-blockers or endoscopic variceal ligation. There is controversy regarding the effectiveness of primary prophylaxis in patients with schistosomiasis; when indicated, it is done with beta-blockers or endoscopic therapy in high-risk varices. Treatment of acute variceal bleeding is systematized in the literature, combination of vasoconstrictor drugs and endoscopic therapy, provided significant decline in mortality over the last decades. TIPS and surgical treatment are options as rescue therapy. Secondary prophylaxis plays a fundamental role in the reduction of recurrent bleeding, the best option in cirrhotic patients is the combination of pharmacological therapy with beta-blockers and endoscopic band ligation. TIPS or surgical treatment, are options for controlling rebleeding on failure of secondary prophylaxis. Despite the increasing evidence of the effectiveness of pharmacological and endoscopic treatment in schistosomotic patients, surgical therapy still plays an important role in secondary prophylaxis.

scholarly journals An Underlooked Cause of Periodic Fever (PFAPA) in an Adult Patient with No Response to Tonsillectomy

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Fiaz Alam ◽  
Mohammed Hammoudeh
Keyword(s):  
Periodic Fever ◽  
Age Groups ◽  
Febrile Illness ◽  
High Dose ◽  
Age Group ◽  
Pediatric Age ◽  
Pediatric Age Group ◽  
Cervical Adenitis ◽  
Aphthous Ulceration ◽  
Febrile Episodes

Periodic fever with aphthous stomatitis, pharyngitis, and adenitis (PFAPA) is an autoinflammatory disease manifested as recurrent febrile episodes associated with one of the following cardinal features: aphthous ulceration, pharyngitis, and cervical adenitis. It was initially described in children and thought to be a disease of pediatric age group. Few adult cases were also reported in the literature. We describe the case of a 39-year-old female affected by PFAPA who presented with a history of febrile episodes associated with aphthous ulceration, stomatitis, and tonsillitis for 4 years. The febrile episodes occurred at a regular interval of 4 weeks and resolved within 5 days. The patient underwent tonsillectomy without any significant improvement. The patient responded only to a single high dose of steroid during the attack. Although PFAPA was initially thought to be a disease of pediatric age group, it should be considered in patients with recurrent febrile illness in all age groups.

scholarly journals Extragonadal Germ Cell Tumors in Children and Adolescents - a 20 Year Study

2020 ◽  
Vol 27 (4) ◽  
pp. 281-287
Author(s):  
Felice FAIZAL ◽  
Alka KALGUTKAR ◽  
Vandana DAHAKE
Keyword(s):  
Germ Cell ◽  
Treatment Options ◽  
Age Groups ◽  
Germ Cell Tumors ◽  
Response To Treatment ◽  
Age Group ◽  
Pediatric Age ◽  
Pediatric Age Group ◽  
Sacrococcygeal Region ◽  
Extragonadal Germ Cell Tumors

Germ cell tumors (GCT) are rare neoplasms which are seen in all age groups and both sexes. Gcts in the pediatric age group show considerable variation from their adult counterparts in relation to site, histological type, clinical and radiological features and response to treatment. Extragonadal gcts are much more common in the pediatric age group with the most common sites being sacrococcygeal region, head and neck, retroperitoneum and mediastinum. Unusual sites like the vagina and urinary bladder have also been reported. Therefore, the varied presentations and different treatment options should be considered.

A Prospective Analysis of Derangement of Coagulation Profile in Adult and Pediatric Age Group in Moderate-to-Severe Traumatic Brain Injury

2018 ◽  
Vol 15 (02/03) ◽  
pp. 087-093
Author(s):  
Swarup Sohan Gandhi ◽  
Manish Mann ◽  
Shashikant Jain ◽  
Ugan Singh Meena ◽  
Virendra Deo Sinha
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Pediatric Patients ◽  
Age Groups ◽  
Age Group ◽  
Pediatric Age ◽  
Coagulation Profile ◽  
Pediatric Age Group ◽  
Severe Tbi

Abstract Background and Aim of Study Coagulopathy is a common occurrence following traumatic brain injury (TBI). Various studies have reported the incidence and risk factors of coagulopathy and their correlation with poor outcome in adult as well as pediatric age group. In our study, we aim to analyze trauma-induced coagulopathy in adult and pediatric patients. Methods Adult (> 18 years) and pediatric (< 18 years) patients of TBI admitted in the intensive care unit of a trauma center of a tertiary care center had been studied from August 2015 to March 2018. Patients were further subdivided into moderate and severe TBI based on Glasgow Coma Scale (GCS) of 9 to 12 and < 9, respectively. Coagulation profile (prothrombin time [PT], activated partial thromboplastin time [APTT], thrombin time, fibrinogen, and D-dimer) and arterial blood gas (ABG) analysis were done on day of admission and on days 3 and 7. Coagulation profiles were analyzed in both the age groups, and risk factors were studied and correlated with the mortality and morbidity based on the Glasgow outcome score. Results Two hundred patients including 143 adults and 57 pediatric patients were included. Mean age among the adult and pediatric population was 31.51 ± 16.83 and 11.5 ± 5.90 years, respectively. In adults, 96 (83.62%) out of 116 in severe TBI group and 20 (74.07%) out of 27 in moderate TBI group developed coagulopathy, and in pediatric age group, 14 (70%) out of 20 in moderate TBI and 30 (81.08%) out of 37 in severe TBI developed coagulopathy. Midline shift was significantly associated with coagulopathy in both the age groups (p value < 0.039). Mortality was not significantly different in patients with coagulopathy between the age groups, but improved status as per the Glasgow outcome score was more in pediatric age group. Conclusion The development of coagulopathy is a frequent complication in patients with moderate to severe TBI in both age groups. Even though it is not closely associated with death in this study, it may be regarded as a marker of injury severity.

scholarly journals Comparison of Timing to Develop Anti-Drug Antibodies to Infliximab and Adalimumab Between Adult and Pediatric Age Groups, Males and Females

2021 ◽  
Vol 27 (1) ◽  
pp. 63-71
Author(s):  
Maria Consiglia Trotta ◽  
Roberto Alfano ◽  
Giovanna Cuomo ◽  
Ciro Romano ◽  
Antonietta Gerarda Gravina ◽  
...  
Keyword(s):  
Age Groups ◽  
Therapeutic Drug ◽  
Female Group ◽  
Age Group ◽  
Pediatric Age ◽  
Adult Age ◽  
Pediatric Age Group ◽  
Drug Concentrations ◽  
Combining Data ◽  
Males And Females

OBJECTIVE To compare the timing of serum anti-drug antibodies in adult and pediatric age groups, males and females, treated for inflammatory bowel disease or arthritis with adalimumab or infliximab by retrospectively combining data collected during a 2-year therapeutic drug monitoring period. METHODS Four hundred thirty sera were divided in groups collected at 0, 3, 6, 12, and 24 months (T0, T3, T6, T12, and T24) after initiation of therapy and assayed for drug and relative anti-drug antibodies levels. At each time point, the percentage of sera presenting anti-drug antibodies, as well as the drug concentrations, were calculated and correlated with patient age and sex. RESULTS Anti-drug antibodies were present in 31.5% of sera and were significantly higher in the pediatric age group than in the adult age group, through all time points. The percentages of sera showing anti-drug antibodies were significantly different as early as 3 months and were sera from pediatric female group. The percentages of sera showing anti-drug antibodies reached the highest value at 6 months in the pediatric age group and at 12 months in the adult age group. CONCLUSIONS Sera from pediatric had an earlier presence of anti-drug antibodies than adults. In particular, pediatric females sera showed the fastest anti-drug antibodies development.

scholarly journals Diabetes Technology and Therapy in the Pediatric Age Group

2016 ◽  
Vol 12 (01) ◽  
pp. 22
Author(s):  
Gregory P Forlenza ◽  
David Maahs ◽  
◽  
Keyword(s):  
Type 1 Diabetes ◽  
Artificial Pancreas ◽  
Age Groups ◽  
Age Group ◽  
Pediatric Age ◽  
Ongoing Research ◽  
Pediatric Age Group ◽  
Diabetes Technology ◽  
The Status

Recent data from the Type 1 Diabetes Exchange has highlighted the urgent need for better glycemic control in the pediatric age group. Fortunately, ongoing research on insulin pumps, continuous glucose monitors, and artificial pancreas systems continues to improve our ability to manage type 1 diabetes in all age groups, while reducing the burden of care at the same time. Here we discuss the status of diabetes technology research as well as future directions and goals of these projects.

scholarly journals Multisystem inflammatory syndrome in infant temporally associated with SARS-CoV-2 infection

2021 ◽  
Vol 8 (9) ◽  
pp. 1590
Author(s):  
Ananya Roy ◽  
Dhiraj Chandra Biswas
Keyword(s):  
Virus Disease ◽  
Case Reports ◽  
Age Groups ◽  
Severe Case ◽  
Systemic Review ◽  
Age Group ◽  
Pediatric Age ◽  
Pediatric Age Group ◽  
New Type ◽  
Inflammatory Syndrome

Since the end of December 2019, corona virus disease (COVID-19) has spread globally. Though the majority of COVID-19 cases in pediatric age group have not been critical, a novel disease named as multisystem inflammatory syndrome in children (MIS-C) have been emerging as the pandemic progresses. A systemic review of the literature was performed in the principle medical databases including Pubmed, Embase and Google Scholar between December 2019 and March 2021. A total of 40 articles were identified in the described database. Altogether 12 articles met the inclusion criteria and were eligible. The critical and severe case were more in infant age group, also the number of hospitalization was more in infant age group than other pediatric age groups. A number of case reports reflected that infants with COVID-19 positive may present with shock and sepsis. The mean age of MIS-C COVID-19 positive children was 1.1 year emphasizing the vulnerability of infant age group to this novel disease MIS-C. MIS-C is a new type of presentation of COVID-19 infection. Special emphasis should be given in infant age group with COVID-19 who are vulnerable to develop MIS-C. 

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