Analysis of clinical features of 87 hospitalized children with pertussis / 中国现代医生

Objective To investigate the clinical features of hospitalized children with pertussis.Methods The clinical data of 87 hospitalized children with pertussis admitted to Women and Children's Hospital Affiliated to Xiamen University from January 2019 to December 2022 were retrospectively analyzed.According to the age of the children,they were divided into group A(≤3 months of age,35 cases),group B(4-12 months of age,36 cases)and group C(>12 months of age,16 cases).The clinical features of children at different ages were compared.Results The majority of children with pertussis were<1 year old(81.61%),and August was the month of high incidence.Spastic cough(72.41%)was the main clinical manifestation.Other manifestations included redness or cyanosis,vomiting after coughing,crow echo,etc.There were statistically significant differences in the incidence of spastic cough,redness or cyanosis and the contact history of patients with chronic cough among three groups(P<0.05).There were significant differences in the incidence of pneumonia and the average length of hospital stay among three groups(P<0.05).There was significant difference in C-reactive protein level among three groups(P<0.05).Among 87 children with pertussis,37 cases(42.53%)were infected with other pathogens,among which virus infection was the most common.The treatment is effective with macrolides and compound sulfamethoxazole.Conclusion Pertussis is more common in infants under 1 year of age,and the incidence is high in August.Chronic cough patients with close contact may be the source of infection.Spastic cough is the main clinical symptom of children;the younger,the more common symptoms such as spastic cough,redness and cyanosis,the higher incidence of pneumonia and the longer hospital stay.

Galloway-Mowat Syndrome in an infant caused by OSGEP gene mutation: a case report and literature review / 中国新生儿科杂志

Objective:To summarize the clinical features and pathogenic gene mutation of Galloway-Mowat syndrome (GAMOS).Methods:We retrospectively collected the medical history, physical signs, laboratory findings, imaging, and molecular data of GAMOS in an infant diagnosed at the department of Pediatrics of Women and Children's Hospital, School of Medicine, Xiamen university. Relevant literature up to December 2021, retrieved from PubMed, Embase, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, VIP, Wanfang and the Chinese Medical Journal Full Text database with the terms of "Galloway-Mowat syndrome", "infant", "WDR73", "LAGE3", "OSGEP", "TP53RK" and "TPRKB".Results:The male infant with dysmorphic facial features and microcephaly at birth gradually displayed growth restriction and developmental delay. He was admitted to hospital at 3 months and 1 day due to "tachypnea for a half day", and suffered from severe pneumonia, urinary tract infection, nephrotic syndrome, repetitive convulsion, septic shock, disseminated intravascular coagulation, acute renal damage and multiple organ failure during hospitalization. He died when his family had given up treatment. Whole exome sequencing revealed a homozygous mutation c.740G>A (p.Arg247Gln) in the OSGEP gene and both of his parents were heterozygous variation carriers. In the total 14 publications (13 were in English and only 1 in Chinese) that were retrieved, with 78 patients from 58 pedigrees. Together with the index case, there were 79 patients in total. The main clinical manifestations were craniofacial and skeletal dysmorphism, as well as nervous system, renal and eye impairment. Obstetric problems were detected in 15 cases (19.0%), including intrauterine growth restriction, microcephaly, oligohydramnios and fetal distress in utero. 49 cases (62.0%) died when reported. The genetic cause of GAMOS had been reported in 79 patients: OSGEP in 36 (45.6%), WDR73 in 29 (36.7%), TP53RK in 7(8.9%), LAGE3 in 5 (6.3%), and TPRKB in 2(2.5%).Conclusions:The main clinical manifestations of GAMOS were craniofacial and skeletal dysmorphism, development delay, leukoencephalopathy, myelination defect, proteinuria and nephrotic syndrome, and associated with poor prognosis. Prenatal findings may be useful for an early diagnosis.

Transition of prolonged mechanical ventilation in children from PICU to family and humanistic care / 中国小儿急救医学

With the improvement of pediatric treatment level, the number of children with prolonged mechanical ventilation has increased rapidly.The transition of children from PICU to home mechanical ventilation is a very complex and arduous process that requires multi-faceted support and management.Long-term mechanically ventilated children and their families bear a huge social and psychological burden, and they need psychological support and humanistic care from the society.

Resting energy expenditure in critically ill children on mechanical ventilation / 中华临床营养杂志

ObjectiveTo assess the energy expenditure status in critically ill children on mechanical ventilation.MethodsFifty critically ill children on mechanical ventilation were enrolled in this study.Resting energy expenditure (REE) on days 1,3,5,and 7 were measured.The predictive REE was calculated for each subject using age-appropriate equations (Schofield-HTWT).ResultsREE on day 1 and Schofield-HTWT equation predictive REE were (96.80 ± 42.63 ) and ( 110.67 ± 38.35 ) kJ/d,respectively.REE on days 1,3,5,and 7 were (100.53 ±50.24),(113.80 ±49.19),(117.99 ±50.57),and (115.05±50.18) kJ/d,respectively (F =1.267,P =0.292).The REE of day 1 in children with congenital heart disease (CHD) and without CHD was (75.66 ± 31.23 ) and ( 113.40 ± 28.40) kJ/d,respectively ( F =10.423,P =0.002).ConclusionsThe hypometabolic response is apparent in critically ill children with mechanical ventilation,and the energy expenditure shows no time-specific change within the first week.The energy expenditure in children with CHD is lower than those without CHD.

Progress of resting energy expenditure in critically ill children / 国际儿科学杂志

Resting energy expenditure( REE) , which can better reflect the total energy expenditure of human body, is the common index for researches about energy expenditure. Energy metabolism changes in different physiological or pathological conditions. Especially in critically ill children, energy expenditure is unique, which is the result of stress, trauma, operation and inflammation. Furthermore, the REE of critically ill children is affected by primary diseases, severity of the diseases, time of the mechanical ventilation, mode of ventilation and so on. This review aims to summarize the studies about the REE of critically ill children.