Child

摘要： BACKGROUND Hypertrophic neuropathy of the cauda equina(HNCE)is a rare disease,especially in children.It can be caused by different etiological agents such as inflammation,tumor or hereditary factors.Currently,there is no uniform standard for clinical treatment of HNCE.Furthermore,it is unclear whether spinal canal decompression is beneficial for patients with HNCE.CASE SUMMARY We report the case of a 13-year-old boy with enlargement of the cauda equina.The onset of the disease began at the age of 6 years and was initially marked by radiating pain in the buttocks and thighs after leaning over and weakness in the lower limbs when climbing a ladder.The child did not receive any medical treatment.As the disease slowly progressed,the child needed the help of others to walk,and he had a trendelenburg gait.He underwent spinal canal decompression and a nerve biopsy during his hospital stay.A diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy was made based on electrophysiological findings and pathological examination results.Immunoglobulin or hormone therapy was recommended during hospitalization,but his mother refused.After discharge,the boy’s mother helped him carry out postoperative rehabilitation training at home.His lower-limb muscle strength gradually increased,and he could stand upright and take steps.Six mo after surgery,the child was readmitted and began immunoglobulin therapy.Long-term oral steroid treatment was initiated after discharge.The movement and sensation of the lower limbs were further improved,and the boy could walk normally 1 year after surgery.CONCLUSION Spinal canal decompression can improve the clinical symptoms of HNCE caused by inflammation,even in children.When combined with specific etiological interventions,spinal cord decompression can lead to optimal outcomes.

摘要： Introduction: Low birth weight (LBW) is defined as a birth weight 2500 g at birth, regardless of the term of pregnancy. The objective of this study is to evaluate their stature and weight growth from 0 to 9 months of corrected age (CA) in Senegal. Methodology: This is a prospective, descriptive, and analytical cohort follow-up up to 9 months of CA including all live newborns of LBW hospitalized and followed up from 01 August 2019 to 31 May 2020. World Health Organization growth charts were used to assess stature and weight growth. Results: During the study 136 LBW newborns were included. The mean gestational age was 32 weeks of amenorrhea. At discharge, 46 children (33.82%) were exclusively breastfed. At birth, the mean weight was 1487 g (3rd-10th percentile) and the mean height was 41.52 cm (10th-25th percentile). At 9 months of CA, the mean weight was 8119 g (median) and the mean height was 74 cm (median). The children had achieved satisfactory growth in weight (84%) and height (89%). At 9 months of CA, 27% of the children were behind in one of the four areas of psychomotor development. Conclusion: At the end of 9 months of CA, stature and weighted growth was normal.

摘要： Nitrous oxide is one of the most commonly used inhalational anesthetic agents used in practice.It is a cost-effective,pleasant,safe,and versatile anesthetic agent with many desirable properties like good quality analgesia,decreased awareness,accelerated induction and recovery from anesthesia,and reduced utilization of other expensive inhalational agents with potential cost savings.The use of nitrous oxide has been questioned by a lot of studies and case reports perceiving its adverse systemic,hematological,immune,and neurologic adverse effects.However,the literature in the recent past has tried to resolve the controversies related to its use.The concerns over an increase in cardiovascular complications and mortality following nitrous oxide use have been negated by recent data.However,its use in certain vulnerable populations like children with cobalamin and folate deficiency or defects in their metabolic pathways remains a cause of concern for its toxic effects.In this narrative review,we aim to discuss the pharmacological properties of nitrous oxide,the potential advantages and drawbacks of the use of nitrous oxide in children,address the neurodevelopmental and other systemic effects,and throw light on the evidence regarding the safety of nitrous oxide use and its current role in pediatric procedural sedation and anesthesia practice.The literature related to its use in the pediatric population for painful procedures and surgeries has been summarized.

摘要： Tuberculosis infections is a serious illness and can be life threatening for patients with hematologic malignancies. We are reporting the observations of two children aged 7 and 5 years undergoing anticancer treatment for hematological malignancies. The symptoms were, in the first case, cough, purulent sputum and signs of tuberculosis impregnation, for the second case, cervical adenopathies (PDA) with inflammatory signs. The evolution under antituberculosis treatment was favorable for both patients, with a 5-year follow-up for the first patient and one year for the second case. The tuberculosis did not affect chemotherapy. The goal of our work is to specify the etio-pathogenic mechanisms, the clinical, therapeutic and evolutionary particularities of this rare association.

摘要： Amebiasis is a parasitic infection caused by the protozoa Entamoeba histolytica. It is capable of causing a spectrum of illnesses from asymptomatic infection, to dysentery and invasive extra-intestinal conditions, the most common of which is liver abscess. Here is presented the case of a 14-month old boy presented with Fever of Unknown Origin, which after work-up was diagnosed as amebic liver abscess. Although amebiasis is more prevalent in developing countries the increasing phenomena of migration and tourism has transformed it into a global health issue. It is recommended to maintain a high index of suspicion while valuating a child with Fever of Unknown Origin.

摘要： Background: Febrile seizures are the most frequent neurological disorder in pediatrics. They have multiple etiologies and require urgent management. The aim of this survey was to study febrile seizures in children at the Departmental Teaching Hospital of Ouémé Plateau (DTH/OP). Method: This was a cross-sectional survey, conducted from January 1, 2020, to December 31, 2020, in the pediatric department of the DTH/OP. Children aged 1 month to 18 years, hospitalized for febrile seizures recognized at the anamnesis and/or during the physical examination were included in this study. Results: The frequency of seizures was 17.08% (510/2986). The male to female ratio was equal to 1.4. The mean age was 44.27 ± 40.75 months. The seizure was generalized tonic-clonic in 77.9% of cases and localized in 11.6% of cases. The main etiologies were severe malaria (75.5%), sepsis (21.6%), enteric infections (14.9%) and pneumonia (10.2%). Diazepam was the anticonvulsant treatment used in the first intention (79.7%). Most of the children were hospitalized for 3 to 7 days. The recovery rate was 82.3% and the fatality rate was equal to 17.7%. Eight children presented sequelae. There was a statistically significant link between the children’s clinical outcome and age (p < 0.001);severe malaria (p < 0.001);sepsis (p < 0.001) and enteric infections (p = 0.003). Conclusion: Febrile seizures were frequent in the pediatric emergency department of the DTH/OP. There is a need to intensify sensitization on malaria prevention measures in the community and improve case management at the hospital.

摘要： BACKGROUND Pulmonary lymphomatoid granulomatosis(PLG)is a lymphoproliferative disease associated with Epstein-Barr viral infection occurring mainly in adults and rarely in children.It is characterized by multiple pulmonary nodules.Its diagnosis depends on lung biopsy findings.Most patients are immunodeficient,and it commonly presents in children undergoing chemotherapy for leukemia.We report the case of a child with PLG caused by a mutation in the macrophageexpressed gene 1(MPEG1),suggesting possible PLG occurrence in children undergoing treatment for pulmonary nodular lesions.CASE SUMMARY This study reports a case of PLG without apparent immunodeficiency,suggesting the possibility of this disease occurrence during the treatment of pulmonary nodular lesions in children.Initially,the cause was assumed to be an atypical pathogen.Following conventional anti-infective treatment,chest computed tomography findings revealed that there were still multiple nodules in the lungs.Additionally,the patient was found to be infected with the Epstein-Barr virus.Histopathological examination of the resected lung revealed lymphoproliferative lesions with necrosis.Small lymphocytes,plasma cells,and histiocytes were observed in the background,although Reed-Sternberg cells were absent.Immunohistochemical staining[CD20(+),CD30(+),and CD3(+)]and EBV-encoded small RNA1/2 in situ hybridization of small lymphocytes revealed approximately 200 cells/high-power field.Whole exon sequencing of the patient revealed a mutation in the MPEG1.The patient was eventually diagnosed with PLG and transferred to the Department of Pediatric Oncology for bone marrow transplantation.CONCLUSION As PLG is rare and fatal,it should be suspected in clinical settings when treatment of initial diagnosis is ineffective.

摘要： Introduction: Globally, tuberculosis is the leading cause of death from a single infectious agent ahead of HIV/AIDS. Approximately 10 million people contracted TB in 2017, 10% of whom were children aged 0 - 15 years, or about 1 million with 250,000 deaths in 2016 (including children with HIV-associated TB). The signs of TB in children are not always specific and diagnosis remains difficult unlike in adults. According to a study conducted in 2011 in the paediatric department of the CHU-Gabriel Touré, only seventeen cases of all forms of tuberculosis were found, or approximately 0.2% of hospitalised children. The objective of our study was to investigate the epidemiological and clinical aspects of tuberculosis in children. Materials and Method: This was a prospective, cross-sectional and descriptive study that took place from 24 October 2017 to 23 October 2018, or 12 months in children aged 0-15 years. Data were collected from an individual medical record opened for each patient and an individual survey form established for each child. Results: During the study period, 40,434 children were consulted. Tuberculosis was suspected in 91 children, with a frequency of 0.22%. The age range of 1 to 4 years was 36.3% with a median age of 72 months. The sex ratio was 1.8. Chronic cough with 84.6% and malnutrition with 24.17% were the most frequent symptoms. Chest X-ray revealed bilateral pulmonary lesions in 52.7% and mediastinal adenopathy in 12.1%. TST was positive in 10.9% of patients, microscopy in 26.4%, Gene Xpert in 18.7%, and culture in 16.5%. The biological diagnosis of tuberculosis was retained in 48.4% of the patients, the pulmonary form represented 93.2%. The therapeutic regime (2RHZE/4RH) was used in 81.6% of cases and the evolution was favourable in 65.9% of patients. Conclusion: The diagnosis of tuberculosis in children remains difficult in our context. The clinical signs are not always specific, and further studies are needed to further elucidate this disease.

摘要： Introduction: The most frequent glomerular pathology in children, nephrotic syndrome (NS) is a cosmopolitan affection. It is an immunological disease and certain environmental factors, in particular viral infections and allergens, influence its occurrence. The climatic and environmental differences coupled with the frequency of infectious pathologies signing the African particularity and the absence of data in Mali on this affection, motivated us to carry out this work. Objective: To study the epidemiological aspects of nephrotic syndrome in hospitalized children aged 0 - 15 years. Patients and Methods: This was a descriptive prospective study from January 1 to December 31, 2021 in the Pediatrics Department of the University Teaching Hospital (UTH) Gabriel Touré, anational pediatric reference service in Mali. Diagnostic confirmation was provided by biology. Results: In one year, 120 children were hospitalized for nephrotic syndrome with a sex ratio of 2.75. Male exclusivity was observed at the ages of one year, eight years and 14 years and a reversal at 13 years (sex-ratio = 0.33). The median age was 6 years for an average age of 6.4 years ± 2.4 years with extremes ranging from one year to 14 years. The first attack of nephrotic syndrome occurred outside the classic age (>10 years) in 16.67%. Nephrotic syndrome is observed throughout the year with two peaks in summer (July to September) and winter (December to February). Many ethnic groups were affected by this condition with a high frequency among ethnic groups where endogamy is common. All patients were melanoderms. No cases of NS were recorded in Caucasian children from Northern Mali. The patients came from Bamako in 47.5% of cases. Two brothers from the same siblings had had their first attack of nephrotic syndrome the same year, ten months apart. Conclusion: Nephrotic syndrome in pediatric hospitals of Bamako occurs at a median age of six years all along the year with a summer and winter peaks. It is more observed in ethnic groups where the practice of endogamy is common and concerns melanoderm children.

摘要： Introduction: This study aims to describe the outcome of adrenocortical cancer in children through observation. Observation: A 10-year-old girl with no previous pathological history. She presented headaches and severe hypertension with clinical and biological signs of hyperandrogenism for 6 months. An abdominal CT scan showed an encapsulated left adrenal mass without local or regional invasion or secondary location. A pheochromocytoma or adrenal neuroblastoma was first suspected. The blood pressure was stable at 130/65 mmHg under antihypertensive drugs. She underwent a complete tumor resection without any intraoperative incident. The pathologic study confirmed the adrenocortical carcinoma scored Weiss 7. The severe high blood pressure reappeared 2-year later despite antihypertensive drugs. The thoracic abdominal and pelvic CT scan showed a locally advanced tumor recurrence in the left adrenal gland with parenchymal nodes in the lungs and liver. The outcome was fatal despite medical and surgical management. Conclusion: Adrenocortical cancer is a rare tumor. It is important to hormonal testing in the presence of Cushing’s syndrome in children. It can give a strong indication of the diagnostic possibilities. Histology confirms the diagnosis. The evolution is covered by complications, in particular recurrence with life-threatening metastases.

摘要： 本发明公开了一种删除Child SA的方法和设备，该方法包括：当设备需要删除Child SA时，所述设备将待删除Child SA对应的出方向Child SA设置为不可用，并向对端设备发送携带该待删除Child SA的安全参数索引SPI和安全协议的删除消息；当所述设备接收到所述对端设备返回的删除响应消息时，所述设备删除所述待删除Child SA以及该待删除Child SA对应的出方向Child SA。在本发明中，降低了错误删除Child SA的可能性。

摘要： 本发明公开了一种删除Child SA的方法和设备，该方法包括：当设备需要删除Child SA时，所述设备将待删除Child SA对应的出方向Child SA设置为不可用，并向对端设备发送携带该待删除Child SA的安全参数索引SPI和安全协议的删除消息；当所述设备接收到所述对端设备返回的删除响应消息时，所述设备删除所述待删除Child SA以及该待删除Child SA对应的出方向Child SA。在本发明中，降低了错误删除Child SA的可能性。