Search

Thrombosis is a rare situation in pediatric practice. That makes it impossible to have homogenous series and therefore treatment regimens are difficult to be well defined. In this article the authors present: - neonatal thrombosis (arterial and venous), thrombosis in infants and older children; - treatment regimens (indications regarding the etiology) in neonates, infants, children; - thrombolitic treatment (dosage, duration of treatment, precautions and biologic follow-up); - conclusions. [ABSTRACT FROM AUTHOR]

Rett syndrome, a neurodegenerative disorder, occurs almost exclusively in female children and has an incidence of 1/15.000. Development proceeds normally until 1 year of age when regression of language and motor milestones and acquired microcephaly become apparent. An ataxic gait or fine tremor of hand movements is an early neurologic finding. Most children develop peculiar sighing respirations with intermittent periods of apnea that may be associated with cyanosis. The hallmark of Rett syndrome is repetitive hand-wringing movements and a loss of purposeful and spontaneous use of the hands which may not appear until 2-3 years of age. Autistic behavior is a typical findings in all patients. Generalized tonic-clonic convulsions occur in the majority and are usually well controlled by anticonvulsivants. Feeding disorders and poor weight gain are common. Several studies have shown elevated CSF levels of endorphins in Rett syndrome. Trials of opiate receptorblocking agents (e.g., naltrexone) have improved the apnea and behavior abnormalities in some patients. After the initial period of neurologic regression, the disease process appears to plateau, with a persistence of the autistic behavior. [ABSTRACT FROM AUTHOR]

Crohn's disease is a chronic inflammatory condition that may affect any part of the gastrointestinal system and multiple extraintestinal organs. Although its exact pathogenesis remains unknown, increasing evidence suggest an abnormality in the control of ‟pathologic„ inflammation caused by bacterial and other antigens. Diagnosis starts with a careful history and physical examination, and confirmation rests with radiologic and histologic studies. Newer treatments are more specifically targeting the cascade of cytokine-mediated that perpetuate inflammation. The indications for surgery in Crohn's disease are: failure of medical therapy; obstruction - acute or chronic (gastroduodenal, small bowel, large bowel); hemorrhage; perforation; fistula; growth retardation; carcinoma; obstructive uropathy. Within 10 to 15 years of diagnosis, approximately 50% to 70% of children with Crohn's disease require surgery. With appropiate management, death from Crohn's disease is extremely rare in the pediatric population. [ABSTRACT FROM AUTHOR]

Chronic nonspecific ulcerative colitis remaine a disease of unkown etiology, although much new information continues to be gleaned from basic research and clinical trials. In most instances, ulcerative colitis respond to medical therapy. Selecting appropriate drug therapy for a specific child dependends on the extent and severity of colitis. This article summarized the clinical information, diagnostic studies and approaches to management that should be considered when evaluating a child for ulcerative colitis. [ABSTRACT FROM AUTHOR]

The author presents some surgical abdominal problems in children: • Acute appendicitis • Acute intussusception • Hernia (inguinal, ovary or ovary and fallopian tube) • Torsion of the testis and of the appendages. [ABSTRACT FROM AUTHOR]

The infant with cyanosis is a distressing medical presentation. This article provides an overview of the many causes of cyanosis. Emphasis is placed on the pathophysiology of each disease process: cardiac system - the most commonly involved organ system; pulmonary system; upper airway obstruction; infectious processes in the context of septic shock, meningitis, or pulmonary disease; shock (hypovolemic, distributive, cardiogenic); gastroesophageal reflux; neurologic system; sudden infant death syndrome and near-miss sudden infant death syndrome; trauma; poisoning; metabolic disturbances; methemoglobinemia. A rational approach to diagnosis is outlined. [ABSTRACT FROM AUTHOR]

Therapeutic agents for the treatment of HIV infection in children have incresed rapidly. Four classes of compounds currently are licensed for administration to patients with HIV infection: nucleoside reverstranscriptase inhibitors (NRTIs), non-nucleoside reversetranscirptase inhibitors (NNRTIs), protease inhibitors and most recently, fusion inhibitors. This article describes the clinical utilities, pharmacokinetics and adverse effects of those new drugs to empower practitioners to use them appropriately. Finally the author presents the treatment for HIV infection: 2006 recommendations of the International AIDS Society-USA Panel. [ABSTRACT FROM AUTHOR]

Throughout the last decade we observed an increasing appreciation for the plasticity and complexity of children's pain. Children's perceptions of pain is defined by their age and cognitive level; their previous pain experiences against which they evaluate each new pain; the relevance of the pain or disease causing pain; their expectations for obtaining eventual recovery and pain relief; and their ability to control the pain themselves. Neural plasticity seems an even very important for controlling children's pain. [ABSTRACT FROM AUTHOR]