ABSTRACT
Kawasaki syndrome (KS) is a self-limiting childhood disease. Gallbladder hydrops is an uncommon manifestation of this syndrome, found rarely in infants. We report the case of a 7-month-old girl with KS manifesting as gallbladder hydrops, which resolved spontaneously during follow-up. To our knowledge, this represents the youngest such case ever reported. We discuss the clinical characteristics, radiological features, and outcome of gallbladder hydrops in KS during infancy to help understand this rare complication.
Subject(s)
Gallbladder Diseases/etiology , Hydrops Fetalis/etiology , Mucocutaneous Lymph Node Syndrome/complications , Diagnosis, Differential , Female , Follow-Up Studies , Gallbladder Diseases/diagnosis , Humans , Hydrops Fetalis/diagnosis , Infant , Mucocutaneous Lymph Node Syndrome/diagnosis , Remission, SpontaneousABSTRACT
OBJECTIVE: To evaluate the incidence of symptomatic patent ductus arteriosus (PDA) in preterm infants, and the results of the intravenous indomethacine treatment and surgery. METHODS: Among 394 preterm infants (<37 weeks), symptomatic PDA was diagnosed by echocardiography in 51 babies and they were examined retrospectively. All infants were managed conservatively and then IV indomethacine was given to non-responders (n=30). Surgical closure was performed in 12 babies. RESULTS: The incidence of symptomatic PDA in preterm infants was 12.9%: median age: 3 days, mean birth weight: 1434+/-540 g (540-2900g) and mean gestational age (GA) 30.9+/-3.3 weeks (23-37 weeks). With indomethacine, ductal closure was achieved in 70% infants. Early clinical improvement was observed in all cases that underwent surgery and most of them had a low birth weight (<1500 g) and an early gestational age (<32 weeks). None of them died due to operation. CONCLUSION: The incidence of symptomatic PDA is high in preterm infants. Treatment with indomethacine improves ductal closure and is associated with few reversible adverse effects. In the other hand, early clinical improvement and high success rate were achieved after surgery. If indomethacine fails to achieve ductal closure, decision of surgery must be made immediately.
Subject(s)
Cardiovascular Agents/therapeutic use , Ductus Arteriosus, Patent/drug therapy , Ductus Arteriosus, Patent/surgery , Indomethacin/therapeutic use , Infant, Premature , Cardiovascular Agents/adverse effects , Ductus Arteriosus, Patent/epidemiology , Echocardiography, Doppler, Pulsed/methods , Gestational Age , Humans , Incidence , Indomethacin/adverse effects , Infant, Low Birth Weight , Infant, Newborn , Ligation , Retrospective Studies , Treatment OutcomeABSTRACT
Between 1993 and 2002, apical muscular ventricular septal defects were identified in 99 cases by echocardiographic examination. Spontaneous closure time was analyzed in 42 cases followed up at least two years, retrospectively. The ages of 42 cases ranged between 1 day and 13 years old. Initial examination was performed in 22 cases within the newborn period, in 8 cases between 1 and 6 months of age and in 12 cases at more than 6 months of age. Spontaneous closure was seen in 24 of 42 cases (57.1%) between 1 and 36 months of age, and it was most commonly recorded during the first 6 months. It was remarkable that spontaneous closure occurred in 20 of 22 cases (90%) diagnosed in the neonatal period. Closure was seen in 4 of 8 cases (50%) whose initial examination was performed between 1 and 6 months and in none of the patients diagnosed at more than 6 months of age. In conclusion, the frequency of spontaneous closure in cases diagnosed in the neonatal period is higher than previously believed. It is advisable to follow up patients to determine spontaneous closure, especially within the first two years of life.
Subject(s)
Heart Septal Defects, Ventricular/diagnostic imaging , Adolescent , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Male , Remission, Spontaneous , Retrospective Studies , UltrasonographyABSTRACT
BACKGROUND: This study was carried out to determine the true prevalence of bicuspid aortic valve (BAV) in newborns, which has not yet been determined. METHODS: One thousand seventy five live born neonates (567 male neonates, 508 female neonates; gestational ages ranging from 27 to 42 weeks, and birth weights ranging from 720 to 4,780 g) were screened by transthoracic 2-dimensional echocardiography to assess the prevalence of BAV. RESULTS AND CONCLUSION: BAV was identified in a prevalence of 4.6 in 1,000 live births. The prevalence of BAV by sex was 7.1 of 1,000 in male neonates, and 1.9 of 1,000 in female neonates. All newborns with BAV were asymptomatic. Mild aortic regurgitation was found in only 1 neonate with BAV. Because BAV may result in aortic valvular stenosis and/or regurgitation, a recommendation of regular follow-ups and antibiotic prophylaxis for infective endocarditis should be necessary.
Subject(s)
Aortic Valve/abnormalities , Aortic Valve/diagnostic imaging , Heart Defects, Congenital/diagnostic imaging , Heart Defects, Congenital/epidemiology , Female , Humans , Infant, Newborn , Male , Neonatal Screening , Prevalence , UltrasonographyABSTRACT
Hypersensitivity pneumonitis (HP), an extrinsic allergic alveolitis, is a group of immunologically mediated, diffuse inflammatory lung parenchymal diseases. Pigeon breeder's disease (PBD) is one of the most common clinical forms of HP. It is caused by inhalation of various pigeon-derived materials and can present in different clinical forms. The diagnosis is difficult and the best diagnostic tool is correlation of onset of symptoms with time of exposure. Precipitating antibodies against the avian proteins form the characteristic precipitin reactions. The most effective treatment is avoidance of the antigens. Steroids, either systemic or topical (inhalational), can be used to treat HP. We report five children with different clinical forms of PBD in whom the diagnosis was confirmed by positive serum precipitating antibodies to avian proteins. Although the disease is rarely seen in children, it should be considered in any child with recurrent or unexplained respiratory symptoms. Nebulising steroids might be a useful alternative treatment for allergic alveolitis.
Subject(s)
Bird Fancier's Lung/diagnosis , Adolescent , Anti-Infective Agents/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Bird Fancier's Lung/diagnostic imaging , Bird Fancier's Lung/drug therapy , Child , Female , Humans , Lung/diagnostic imaging , Male , Prednisolone/therapeutic use , Radiography , Treatment OutcomeABSTRACT
BACKGROUND: Excessive viewing of television (TV) has been linked to aggressive behavior, violence and childhood obesity. METHODS: A cross-sectional study was conducted among preschool children and primary schoolchildren in Ankara during March and April 1999 to detect the factors that affect TV viewing time and to evaluate their parents' knowledge, attitudes and practices with regard to TV. The parents were asked to fill out a questionnaire about TV habits of their family, the number and location of TVs in the household and the effect of TV on children. Of 400 questionnaires, 350 answered the questions appropriately for this study. Children were divided into two groups, preschool children and primary schoolchildren. Television viewing time was given daily, as a mean of weekday. RESULTS: The mean age for becoming a TV viewer was 2.7 +/- 1.6 years. Of all, 62% of children spent >/= 2h/day watching TV and 8.3% of children spent > 4 h. The TV viewing time of child was significantly and positively correlated with that of siblings, mother and father for both groups. Age and sleeping time of the child, age and the education level of mother, presence of TV in the child's room and the starting age watching TV did not affect the viewing time. One-half of parents reported that the TV programs watched included violence, and one-third thought TV depicts child abuse, especially emotional abuse. CONCLUSIONS: It was found that the TV watching habits of parents had an influence on those of their children. Therefore, pediatricians should take 'TV histories' of children and their parents and educate parents how to become good TV viewers.
