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Fatal cases in pediatric patients after post-exposure prophylaxis for rabies:A report of two cases

Asian Pacific Journal of Tropical Medicine 2024年第1期17卷 39-42页

作者： Hekmatollah Khoubfekr Mohammad Jokar Vahid Rahmanian Hasan Blouch Mohammad Reza Shirzadi Rouzbeh Bashar Department of Public Health Iranshahr University of Medical SciencesIranshahrIran Faculty of Veterinary Medicine Karaj BranchIslamic Azad UniversityKarajIran Department of Public Health Torbat Jam Faculty of Medical SciencesTorbat JamIran Center for Communicable Diseases Control Ministry of Health and Medical EducationTehranIran WHO Collaborating Center for Reference and Research on Rabies Virology DepartmentPasteur Institute of IranTehranIran

Rationale:Rabies is a zoonotic disease with a high mortality,primarily transmitted through the bite of infected mammals,particularly dogs and *** being a well-known disease since ancient times,it continues to cause a significant number of human deaths worldwide,with approximately 65000 fatalities reported *** concerns:We present two fatal cases of rabies in a 12-year-old immigrant boy and a 7-year-old *** first case was subject to a 24-hour delay in receiving appropriate medical attention and rabies preventive measures due to the lack of awareness among emergency hospital staff,leading to the administration of wound dressing *** second case received timely rabies immunoglobulin administration;however,there was a 4-day delay in administering the fourth dose of the rabies vaccine,despite presenting evident symptoms of ***:Postmortem examination of brain samples from both patients confirmed the presence of rabies ***:Post-exposure prophylaxis for ***:Both patients were admitted to the hospital after the manifestation of rabies-related symptoms,with the 12-year-old child seeking medical care 47 days after the animal bite and the 7-year-old child seeking medical care 58 days after the ***,the first patient died after 27 days and the second patient died after 40 days of ***:There is an urgent need for heightened awareness and education among both healthcare professionals and the public regarding the urgency of seeking immediate medical attention after potential rabies *** recognition and initiation of post-exposure prophylaxis are pivotal in preventing the progression of the *** surveillance and reporting systems,coupled with continuous training for healthcare professionals,can contribute to early detection and management of rabies cases.

关键词： Rabies Encephalitis pediatric patients Rabies prophylaxis Public health awareness

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Time to recovery from severe pneumonia and its predictors among pediatric patients admitted in Mizan-Tepi University Teaching Hospital,South West Ethiopia,2022

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Frontiers of Nursing 2024年第3期11卷 343-353页

作者： Belete Fenta Kebede Aynalem Yetwale Hiwot Tsegaw Biyazin Tesfa Yalemtsehay Dagnaw Genie Nigatu Dessalegn Mulu Department of Midwifery College of Medicine and Health SciencesDebre Markos UniversityDebre Markos 269Ethiopia Department of Midwifery Woldiya UniversityWoldiyaEthiopia School of Midwifery Institute of HealthJimma UniversityJimma 378Ethiopia Department of pediatrics and Child Health Nursing Debre Markos UniversityDebre Markos 269Ethiopia Department of pediatrics and Child Health Nursing Injibara UniversityInjibaraEthiopia

Objective:Despite trials and programs for the prevention of childhood mortality due to pneumonia,Ethiopia is among the top five countries with the highest number of deaths due to *** the prevalence of pneumonia has increased in the abovementioned trials,little is known about the recovery time from severe pneumonia and its predictors in the study ***,this study aimed to assess the time to recovery from severe pneumonia and its predictors among pediatric patients admitted to Mizan-Tepi University Teaching Hospital,Ethiopia,in ***:A total of 591 children admitted for severe pneumonia were selected using simple random *** were entered into Epi-data version 4.***.2.1 and expor ted to STATA version 14 for analysis,and the assumptions of Cox propor tional hazard models and goodness of fit were assessed through Shoenfeld residual and Cox-Snell residual,*** and multivariable Cox regression models were used to identify the predictors of mor ***:This study revealed that 91.54%(95%confidence interval[CI]:89.00–93.53)of participants recovered with an incidence rate of 24.10(95%CI:22.15–26.21)per 100 person-day–*** hmedian recovery time of children was 4 days(95%CI:2–6).Children who were not exclusively breastfed(AHR=1.3;95%CI:1.03–1.66),who had a history of inability to suck/feed(AHR=0.81;95%CI:0.65–0.99)were independent predictors of the time to ***:Children with severe pneumonia who had not exclusively breastfed and who had a history of inability to suck/feed were independent predictors of time to ***,all stakeholders and concerned health care providers should focus more on early diagnosis and management and hasten early recovery based on the identified factors.

关键词： Mizan-Tepi University Teaching Hospital pediatric patients predictors severe pneumonia Southwest Ethiopia time to recovery

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More common RNAemia in the early stage of severe SARS-CoV-2 BF.7.14 infections in pediatric patients

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Biosafety and Health 2024年第1期6卷 5-11页

作者： Yu Sun Runan Zhu Yang Pan Ri De Shuang Liu Liping Jia Bing Lv Xiaoyun Li Dongmei Chen Yao Yao Dong Qu Daitao Zhang Linqing Zhao Laboratory of Virology Bejing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBejing 100020China Institute for Infectious Disease and Endemic Disease Control Bejing Center for Disease Control and Prevention Beijing 100013China Department of Intensive Care Unit Affiliated Children's Hospital of Capital Institute of PediatricsBeijing 100020China

The risk factors of severe infections in children during the severe acute respiratory syndrome coronavirus 2(SARS‐CoV‐2)outbreak in Beijing remain ***‐CoV‐2‐positive children admitted to the intensive care unit(ICU)with collected plasma specimens were enrolled and screened for common pathogens using capillary electrophoresis‐based multiplex PCR from December 12,2022,to January 24,*** SARS‐CoV‐2 subvariants were identified using next‐generation *** was positive for two(positive;P),one(suspicious;S),or no(negative;N)SARS‐CoV‐2 genes were classified as plasmatic RNA‐positive(RNAemia;P+S)or without RNAemia(N).Clinical and laboratory data of the enrolled cases were then collected and *** 34 enrolled children included 26 males and 24 younger than three *** were negative for other respiratory ***.7.14(18/29)was the predominant *** loads in respiratory specimens,hours from symptom onset to the first respiratory specimen collection(time‐variable),with comorbidities and BF.7.14 and BA.5.2 distributions were significantly different in P vs.N and RNAemia *** RNAemia *** most cases,the T lymphocyte ratios decreased,while the cytokine level and the B lymphocyte ratio *** time variables were 2.22±2.05 and 4.00±2.49 days in BF.7.14 and BA.5.2 infections,*** conclusion,SARS‐CoV‐2 was more likely to cause severe infections among males aged≤3 years old with comorbidities during the SARS‐CoV‐2 outbreak in Beijing,while RNAemia is more common in children at the early stage of severe BF.7.14 infections,and most had high cytokine levels and B‐cell activation.

关键词： Severe SARS‐CoV‐2 infection pediatric patients Risk factor RNAemia BF.7.14

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Comparison of Propofol and Fentanyl for Preventing Emergence Agitation Following Sevoflurane Anesthesia in pediatric patients: A Single-Center Study in Bangladesh

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Pharmacology & Pharmacy 2024年第6期15卷 223-235页

作者： Md. Saiful Islam Khan Md. Abir Tazim Chowdhury Farzana Fardousi Munama Magdum Md. Ahaduzzaman Taneem Mohammad Shamima Akter Suriya Akter Md. Saiful Islam Azad Md. Mozaffer Hossain M. Abdur Rahman Department of Cardiothoracic Anesthesia Evercare Hospital Dhaka Bangladesh Department of Cardiothoracic and Vascular Surgery Evercare Hospital Dhaka Bangladesh Department of Pathology National Institute of Cancer Research & Hospital Dhaka Bangladesh Department of Preventive and Social Medicine National Institute of Preventive and Social Medicine Dhaka Bangladesh Department of Anesthesia Sheikh Sayera Khatun Medical College Gopalgonj Bangladesh Department of Anesthesia Dhaka Medical College Dhaka Bangladesh Department of Anesthesia Combined Military Hospital Dhaka Bangladesh Department of Cardiac Anesthesia National Institute of Cardiovascular Disease Dhaka Bangladesh Department of Anesthesia Bangladesh Medical College Dhaka Bangladesh

Background: Emergence agitation (EA) is a common phenomenon observed in pediatric patients following general anesthesia. This study aimed to assess the efficacy of propofol and fentanyl in preventing EA and to compare their associated complications or side effects. Methods: This prospective randomized observational comparative study was conducted at Dhaka Medical College Hospital from July 2013 to June 2014. The study aimed to evaluate the effects of propofol and fentanyl on EA in children aged 18 to 72 months undergoing circumcision, herniotomy, and polypectomy operations. Ninety children were included in the study, with 45 in each group. patients with psychological or neurological disorders were excluded. Various parameters including age, sex, weight, American Society of Anesthesiologists (ASA) class, duration of anesthesia, Saturation of Peripheral Oxygen (SPO2), heart rate (HR), respiratory rate (RR), pediatric Anesthesia Emergence Delirium (PAED) score, duration of post-anesthesia care unit (PACU) stay, incidence of laryngospasm, nausea, vomiting, and rescue drug requirement were compared between the two groups. Results: Age, sex, weight, ASA class, and duration of anesthesia were comparable between the two groups. Perioperative SpO2 and HR were similar in both groups. However, the PAED score was significantly higher in the fentanyl group during all follow-ups except at 30 minutes postoperatively. The mean duration of PACU stay was significantly longer in the fentanyl group. Although the incidence of laryngospasm was higher in the fentanyl group, it was not statistically significant. Conversely, nausea or vomiting was significantly higher in the fentanyl group. The requirement for rescue drugs was significantly higher in the fentanyl group compared to the propofol group. Conclusion: Both propofol and fentanyl were effective in preventing emergence agitation in pediatric patients undergoing various surgical procedures under sevoflurane anesthesia. However, propo

关键词： Emergence Agitation (EA) General Anesthesia Propofol Fentanyl pediatric patients pediatric Anesthesia Emergence Delirium (PAED) Score Bangladesh

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Clinical and immunological features of convalescent pediatric patients infected with the SARS-CoV-2 Omicron variant in Tianjin, China

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Virologica Sinica 2022年第6期37卷 850-859页

作者： Jing-Yu Wang Tian-Ning Li Chun-Lei Zhou Jie Zhao Meng Wang Yuan Wang Yan Jiang He-Nan Dong Qian-Ru Qi Hong Mu Department of Clinical Lab Tianjin First Central HospitalTianjin300192China The First Central Clinical College Tianjin Medical UniversityTianjin300192China Department of Clinical Lab Tianjin Children's HospitalTianjin300074China

COVID-19 has spread surprisingly fast worldwide, and new variants continue to emerge. Recently, the World Health Organization acknowledged a new mutant strain “Omicron”, with children were accounting for a growing share of COVID-19 cases compared with other mutant strains. However, the clinical and immunological characteristics of convalescent pediatric patients after Omicron infection were lacking. In this study, we comparatively analyzed the clinical data from pediatric patients with adult patients or healthy children and the effects of SARSCoV-2 vaccine on the clinical and immune characteristics in convalescent pediatric patients. Our results indicated that convalescent pediatric patients had unique clinical and immune characteristics different from those of adult patients or healthy children, and SARS-CoV-2 vaccination significantly affected on the clinical and immune characteristics and the prevention of nucleic acid re-detectable positive(RP) in convalescent patients. Our study further deepens the understanding of the impact of Omicron on the long-term health of pediatric patients and provides a valuable reference for the prevention and treatment of children infected with Omicron.

关键词： COVID-19 SARS-CoV-2 Omicron variant Clinical characteristics pediatric patients SARS-CoV-2 vaccine

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Phakic posterior chamber intraocular lens for unilateral high myopic amblyopia in Chinese pediatric patients

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International Journal of Ophthalmology(English edition) 2016年第12期9卷 1790-1797页

作者： Jing Zhang Jin-Rong Li Zi-Dong Chen Min-Bin Yu Ke-Ming Yu State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat-sen University Guangzhou 510060 Guangdong Province China Depertment of Ophthalmology the East Area of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital Chengdu 610110 Sichuan Province China

AIM： To assess the outcomes of posterior chamber implantable collamer lens （ICL） implantation in Chinese pediatric patients with unilateral high myopic ***： Eleven eyes of 11 amblyopic patients aged 11.02±3.34y underwent ICL （model V4, Staar Surgical Inc.） implantation to treat unilateral anisometropia were studied. Visual acuity, cycloplegic refraction, contrast sensitivity, stereopsis, intraocular pressure （IOP）, vaulting, corneal endothelial cell count and complications were evaluated. patients completed follow-up at 3d, 1, 3mo and the last follow-up time （mean 8.18±2.82mo） after ***： The mean myopic anisometropia was -13.70±3.25 D preoperatively and ＋0.69±2.63 D at 8mo postoperatively. The logMAR corrected distance visual acuity （CDVA） of the amblyopic eye was 1.51±0.72 preoperatively and 0.75±0.40 at 8mo postoperatively. The logMAR CDVA at 3d, 1, 3 and 8mo postoperatively improved by a mean of 0.64, 1.55, 1.82 and 2.64 lines and gained more than 2 lines accounted for 18%, 45%, 45%, 64%, respectively. The contrast sensitivity of 0.5, 1 and 2 cpd in amblyopic eyes was significantly increased after surgery. No patient had near stereopsis recovery. The vaulting at 3 and 8mo was significantly lower than that at 1mo postoperatively. No other intraoperative or postoperative complications were observed, except an acute pupillary block glaucoma happened in a patient at two weeks ***： This short-term results indicate that ICL implantation can be a promising alternative therapy for high myopic anisometropic amblyopia in pediatric patients who have failed with conventional treatments and not suitable to corneal refraction surgery.

关键词： phakic intraocular lens myopic anisometropic amblyopia pediatric patients refractive surgery

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Pharmacokinetic variability of factor VIII concentrates in Chinese pediatric patients with moderate or severe hemophilia A

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pediatric Investigation 2021年第1期5卷 38-45页

作者： Zhenping Chen Kun Huang Gang Li Yingzi Zhen Xinyi Wu DiAi Guoqing Liu Zekun Li Iorio Alfonso Runhui Wu Beijing Key Laboratory of pediatric Hematology Oncology National Key Discipline of PediatricsMinistry of EducationHematology Oncology CenterBeijing Children's HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina Clinical Epidemiology and Biostatistics McMaster UniversityHamiltonONCanada

Importance:The use of factor VIII(FVIII)concentrates under pharmacokinetic(PK)guidance has become the main approach for treatment of ***,limited PK research has been conducted in Chinese pediatric ***:To investigate the PK parameters of various FVIII concentrates in Chinese pediatric ***:Seventy-nine patients were enrolled(28 treated with Kogenate FS^(®),23 treated with Advate^(®),and 28 treated with GreenMono^(™)).All enrolled patients participated in single-dose PK analysis after at least a 3-day washout *** samples were collected predose,as well as at 1 h,9 h,24 h,and 48 h after infusion;FVIII levels were measured using a one-stage clotting assay,von Willebrand Factor Antigen(VWF:Ag)levels and blood types were also *** parameters were evaluated by ***:Mean values of terminal elimination half-life time(t_(1/2))for the Kogenate FS^(®),Advate^(®),and GreenMono^(™)FVIII groups were 12.24 h,10.18 h,and 9.62 h;median clearance values were 4.16,6.23,and 5.11 mL kg^(-1)h^(-1);and median in vivo recovery values were 1.97,1.55,and 1.61 IU/dL per IU/*** t_(1/2),higher in vivo recovery,and lower clearance were observed in patients with higher VWF:Ag level who were treated with recombinant ***:Chinese pediatric patients with hemophilia had FVIII PK characteristics similar to those previously observed in non-Chinese children,including large variation among ***:Ag level and FVIII brand were associated with differences in FVIII ***,PK-guided dosing should be used to optimize individualized therapy in Chinese children.

关键词： Hemophilia A Pharmacokinetics pediatric patients FVin concentrates

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Evaluation of Predictors of Suicidal Re-Attempt in pediatric patients in the Emergency Department

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Open Journal of pediatrics 2017年第4期7卷 309-319页

作者： Ali Kemal Erenler Turker Yardan Fuat Kulaksiz Cem Kocak Department of Emergency Medicine Hitit University Corum Training and Research HospitalCorumTurkey Department of Emergency Medicine Faculty of MedicineOndokuzmayis UniversitySamsunTurkey Department of Statistics Hitit University Corum Training and Research HospitalCorumTurkey

Background: Suicidal attempt in children is a serious public health problem. A proper identification of features of suicide-related behavior may help physicians to develop an accurate approach. The aim of this study was to clarify the characteristics of children with poisoning due to suicidal attempt and to determine the risk factors of suicidal re-attempt in the Emergency Department (ED) via a simple questionnaire. Methods: We collected medical data of patients under 18 years who were admitted to our ED with intoxication due to suicidal attempt, retrospectively. General characteristics of patients were evaluated. patients were divided into 2 groups as 1) High risk: patients with repetitive suicide attempt;2) Low risk: patients with first time suicidal attempt. Results: A total of 57 patients were included in this study. The mean age was 15.91 ± 0.97. Majority of the patients were female (73.7%). Analgesics were the most frequent abused drugs with a ratio of 51.1%. It is determined that the most important variables affecting the risk of suicidal re-attempt are “idea about the suicide” and “purpose”. It was determined that patients with an idea of repetitive suicide (I will try again) and whose purpose was to die (I wish I have died) were in the most risky group with a history of previous suicidal attempt. Conclusion: This study suggests that answers of the pediatric patients to some question have a potential to predict the high risk patients. The risk of suicidal re-attempt may be predicted by the answers given to these questions: 1) What is your idea about suicide? 2) What was your purpose?

关键词： Suicide pediatric patients Emergency Department

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Comparison of Clinical Characteristics and Outcomes of pediatric and Adult patients with Coronavirus Disease 2019 in Shenzhen,China

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Biomedical and Environmental Sciences 2020年第12期33卷 906-915页

作者： WANG Fang LAI Chang Xiang HUANG Peng Yu LIU Jia Ming WANG Xian Feng TANG Qi Yuan ZHOU Xuan XIAN Wen Jie CHEN Rui Kun LI Xuan LI Zhi Yu LIAO Li Qun HE Qing LIU Lei National Clinical Research Center for Infectious Disease Shenzhen Third People's HospitalDepartment of HepatologySecond Hospital Affiliated to Southern University of Science and TechnologyShenzhen 518112GuangdongChina Fujian Provincial Reproductive Medicine Center Fujian Maternity and Children's Hospital Affiliated to Fujian Medical UniversityFuzhou 350001FujianChina Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Department of Hepatopancreatobiliary Surgery IPeking University Cancer Hospital&InstituteBeijing 100142China

Objective Here we aimed to investigate the difference in clinical characteristics and outcomes between pediatric and adult patients with *** A total of 333 consecutive patients with laboratory-confirmed SARS-CoV-2 infection treated in the departments of Internal medicine of Shenzhen Third People’s Hospital from January 11 th to February 10 th,2020 were *** data were obtained from electronic medical *** epidemiological data,clinical characteristics,length of hospital stays,and outcomes of pediatric and adult patients were *** Compared with adult patients,pediatric patients had a shorter time of symptom onset to hospitalization than adults[median time,1(IQR,1.0-1.0)d vs.3(IQR,2.0-6.0)d,Ppatients had been discharged from *** 2(0.7%)adult patients died,with an overall case mortality of 0.6%.The median length of hospital stay of pediatric patients was shorter than that of adult patients[19(95%CI:16.6-21.4)d vs.21(95%CI:19.9-22.1)d,P=0.024].Conclusion pediatric patients with COVID-19 had milder or less clinical symptoms,less evident pulmonary imaging changes,better prognosis,and shorter length of hospital stay.

关键词： Coronavirus disease 2019 Severe acute respiratory syndrome coronavirus 2 Clinical characteristics pediatric patients

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Clinical Characteristics, Imaging Findings and Surgical Outcomes of Chiari Malformation Type I in pediatric and Adult patients

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Current Medical Science 2018年第2期38卷 289-295页

作者： Zhuo-wei LEI Shi-qiang WU Zhuo ZHANG Yang HAN Jun-wen WANG Feng LI Kai SHU Department of Orthopedics Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 China Department of Neurosurgery Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 China

A growing number of children and adolescents are being diagnosed as Chiari malformation type I （CM- I ） for behavioral disorders, developmental delay, seizures, or abnormal orpharyngeal function. The aim of this study was to compare the clinical characteristics, imaging findings and surgical outcomes of CM- I in pediatric and adult patients. Between January 2014 and June 2017, 84 patients with CM- I underwent surgical treatment in our department. We divided the patients into two groups： pediatric group （n=l 1, age 〈18 years） and adult group （n=73, age 〉18 years）. Data on clinical characteristics, imaging findings, surgical outcomes, and prognosis were retrospectively reviewed and compared between these two groups. For clinical presentation, scoliosis （36.4%） and developmental delay （36.4%） were more common in pediatric patients, whereas, sensory disturbance （58.9%） and motor weakness （41. 1%） were more common in adult patients. Imaging findings showed that the incidence of hydrocephalus and craniovertebral junctional abnormalities was significantly higher in pediatric group than in adult group （P〈0.05）. Compared to adult group, pediatric group showed a better improvement or resolution of syrinx and tonsillar herniation after surgical treatments （P〈0.05）. The total Chicago Chiari Outcome Scale （CCOS） score in pediatric patients at the last follow- up was significantly higher than that in adult patients （P=0.002）. In conclusion, the clinical characteristics and imaging findings appeared to be different in pediatric and adult patients with CM- I. The surgical outcomes of pediatric patients were shown to be significantly better than those of adult patients.

关键词： Chiari malformation type I adult patients pediatric patients clinical manifestations surgical outcome

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