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Febrile Convulsions in Infants at the pediatrics University Hospital Center Charles de Gaulle of Ouagadougou (Burkina Faso)

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Open Journal of pediatrics 2018年第2期8卷 199-206页

作者： A. Kaboré A. Diallo H. Savadogo S. A. P. Ouédraogo K. Nagalo S. Yougbaré D. Yé Service of Médical pediatrics Charles De Gaulle Pediatric University Teaching Hospital Ouagadougou Burkina Faso

Context: Seizures rank high among the commonest emergencies encountered in pediatrics. As far as the etiologies are concerned, the most frequently confronted cause is infectious diseases. Therefore, particularly in the present work context, febrile seizures have been inadequately investigated. The study aimed at assessing the prevalence of febrile convulsions in our pediatrics department. Materials and Methods: This retrospective study was performed in the pediatrics Medical Service Department of the pediatrics University Hospital Charles de Gaulle of Ouagadougou in Burkina Faso (West Africa). Infants from one and thirty months of age, hospitalized between January 1, 2011 and December 31, 2012, were included in this study. Seizures are defined as those who accompany fevers above or equal to 38°C. However, the exclusions from the study included those infants recognized as epileptics;those with abnormal psychomotor development;those afflicted with encephalitis and meningitis;and children with hypoglycemia or dehydration with ionic disorders, as well as those infants who lacked lumbar puncture results. Data were analyzed using the Epi Info software version 3.5.1. Results: While the average age of the patients was 13 months, the average incidence of the febrile seizures was 2.5%. The seizures occurred all through the year, peaking in October (14.1%). The peak frequency (38.7%) was recorded in children from 12 to 24 months. About one-half of the patients (46.2%) registered a temperature from 38.5°C to 39.4°C. In 68.9% of the cases, the tonic convulsions were of the common type of convulsions. The number of convulsions was in the range of >2 episodes/24 h in 83.3% of the children. The pathologies commonly associated with tonic convulsions included acute gastroenteritis (29.4%), malaria (25.8%) and bronchopneumopathies (23.3%). The evolution was favorable in 95.3% of the cases. Conclusion: While this study confirms the benign character of the febrile convulsions, their rec

关键词： Febrile Seizures Infants Associated Pathologies

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Trauma emergencies at University Hospital of Brazzaville, Congo

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Surgical Science 2022年第3期13卷 144-154页

作者： Massamba Miabaou Didace Boukassa Léon Note Madzele Murielle Monka Marius Ondima Irène Moyikoua Armand Massamba Alphonse Digestive Surgery Department University Hospital Brazzaville Congo Polyvalent Surgery Department University Hospital Brazzaville Congo Traumatology-Orthopaedic Department University Hospital Brazzaville Congo Department of pediatric Surgery University Hospital Brazzaville Congo Laboratory of Numerical Analysis Computer Science and Applications Faculty of Sciences and Technology Marien Ngouabi University Brazzaville Congo

Background: Trauma is the main reason for consultation in the emergency unit. They deserve particular attention in the Congo where road accidents and violence of all kinds are increasingly observed. Methods: This study who carried out in the surgical emergencies at the University Hospital of Brazzaville, aims to analyze the epidemiological and etiological aspects, the anatomical lesions encountered;to describe their management, as well as to evaluate the induced mortality while emphasizing their place in all surgical emergencies. The prospective and analytical study included 2127 patients admitted to a traumatic emergency unit from January 1 to June 30, 2018. Medical records served as data sources. The measure of trauma severity was determined using Champion’s Trauma Score. The epidemiological, clinical and therapeutic parameters were studied. Results: The population most affected was adolescents and young adults (mean age, 27.3 years) with a male predominance: 1318 men (i.e. 61.9%) for 809 women (i.e. 38.1%). Road accidents (n = 819, or 38.5%) were the main cause of injuries, followed by violence (n = 702, or 33%) and falls (27.3%). The skull, limbs, thorax and abdomen are the main targets. The most observed lesions were limb fractures (n = 344, i.e. 16.1%), intracranial hematomas and contusions (n = 315, i.e. 14.8%), thoracic and abdominal wounds (n = 28, i.e. 1.3%). Mortality was evaluated at 0.6%, and was correlated with the severity of the lesions and the type of trauma. Conclusion: Trauma is very common in emergency consultations in Congo, with a hospital frequency of 75.1% of all emergencies. Preventive actions are essential to reduce their frequency.

关键词： emergencies Trauma Accidents Public Road Violence

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Severe Hyperphosphatemia Resulting in Acute Renal Failure and Ischemic Encephalopathy in a Patient with Infantile Leukemia

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Case Reports in Clinical Medicine 2014年第3期3卷 129-134页

作者： Atsuko Watanabe Atushi Itano Takeshi Koga Ikuma Musha Michio Shimizu Ryuhei Tanaka Department of Diagnostic Pathology International Medical Center Saitama Medical University Hidaka Japan Department of pediatric oncology/Hematology Inter-national medical center Saitama Medical University Hidaka Japan Department of pediatrics Kasumigaura Medical Center Tuchiura Japan Department of pediatric oncology/Hematology Inter-national medical center Saitama Medical University Hidaka Japan Department of pediatrics Saitama Medical University Hospital Moroyama Japan

Tumor lysis syndrome (TLS), hyperleukocytosis, and disseminated intravascular coagulation (DIC) are representative oncological emergencies that overlap mutually at the beginning of therapy for aggressive leukemia. Lately recombinant urate oxidase (rUO) enables to control uric acid level and its crystallization, the most frequent risk factor for clinical TLS;therefore, hyperphosphatemia appears to be the main risk in the rUO era. We here report an infantile leukemia patient who developed severe hyperphosphatemia, resulting in acute renal failure and ischemic encephalopathy. A 9-month-old female baby was adynamic with a bulging anterior fontanel, and was diagnosed as infantile acute lymphoblastic leukemia with a mixed lineage leukemia gene rearrangement. A laboratory examination revealed leukocytosis, bicytopenia, hyperuricemia, a prolonged prothrombin time, activated partial thromboplastin time, and elevated lactate dehydrogenase level. Soon after a reduced dose of prednisolone was administered, she developed hypoxia caused by systemic inflammatory response syndrome and heart failure. Her white blood cell count decreased sharply, leading to acute renal failure due to hyperphosphatemia, which required continuous hemodiafiltration for 48 hours. Although renal function subsequently recovered, severe ischemic encephalopathy remained. She achieved morphological remission once, however, relapsed and passed away soon after. We have to pay attention to the progression of hyperphosphatemia, hyperkakemia and DIC, although hyperuricemia was controlled using rUO. Changes in electrolyte levels must be continuously monitored, and TLS, DIC and/or hyperleukocytosis should be promptly managed especially in patients who are sensitive to therapy.

关键词： Hyperphosphatemia Tumor Lysis Syndrome Hyperleukocytosis Disseminated Intravascular Coagulation Continuous Hemodiafiltration

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pediatric emergency preparedness in Canadian family physician offi ces:A national survey

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World Journal of Emergency Medicine 2021年第3期12卷 225-227页

作者： Dayae Jeong Subhrata Verma Anushka Weeraratne Marina Atalla Mohammed Hassan-Ali April J.Kam Department of pediatrics University of TorontoToronto M5S 1A1Canada Department of pediatrics University of WesternLondon N6A 3K7Canada Department of pediatrics McMaster UniversityHamilton L8S 4K1Canada Department of Health Sciences McMaster UniversityHamilton L8S 4K1Canada Division of pediatric Emergency Medicine McMaster UniversityHamilton L8S 4K1Canada

Dear editor,Family physicians often serve as the primary resource for parents seeking medical treatment for their children,and it is not uncommon for children with medical emergencies to be brought into primary care offices instead of local emergency departments(EDs).Although estimated incidence rates of pediatric emergencies in primary care offices vary based on the definition used,the number of patients seen,and clinic location,[1-3]any healthcare provider who sees pediatric patients should be ready for immediate medical intervention to minimize adverse outcomes.[4,5]Various studies in the USA have shown that outpatient offices are not adequately prepared for pediatric emergencies,whether that is defined as stocking recommended equipment,having policies for the transport of patients to EDs,engaging in mock codes,or being certified in Advanced pediatric Life Support(APLS)or Basic Life Support(BLS).[1-3]This deficit in preparedness exists despite the presence of multiple nation-and state-wide guidelines on the subject,including a policy by the American Academy of pediatrics.[3]Limited information exists on the preparedness of primary care physicians for pediatric emergencies in other nations.

关键词： physician pediatric editor

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