Pediatr. Rep., Volume 12, Issue 1 (February 2020) – 8 articles

Sigmoid volvulus in children is a potentially disastrous situation, still remaining rare in terms of occurrence. We hereby present a case report of a 10-year-old male, having admitted in our department complaining about abdominal pain, who finally proved to suffer from sigmoid volvulus. Full article

Acute leukemia is the most common type of cancer in pediatric patients. This type of cancer accounts for a third of all childhood cancer cases. More than half of pediatric acute leukemia patients show signs and symptoms such as hepatomegaly, splenomegaly, pallor, fever and bruising at the time of diagnosis. In early stages of acute lymphoblastic leukemia (ALL), nephromegaly and other renal manifestations such as high blood pressure (HBP) and renal failure are uncommon, although renal infiltration and nephromegaly are common in advanced-stage pediatric patients. This is a retrospective case review with a critical appraisal of the existing evidence from the literature. We present a clinical case of a child with HBP associated with bilateral nephromegaly which resolved after chemotherapy treatment. This patient presented with HBP that required pharmacological treatment, likely owing to nephromegaly. All HBP secondary causes were rejected. Nephromegaly was resolved after chemotherapy treatment, and antihypertensive medication was discontinued. Nephromegaly and HBP are rare manifestations of ALL debut in pediatrics. The present case report illustrates this unusual combination and Suggests clinicians to consider malignancy as its causal factor, especially if the symptoms are accompanied by other suggestive extrarenal manifestations. Full article

The present study focuses on the relation between coping strategies of children with leukemia during treatment and locus of control of their mothers. In particular, the study aims to determine whether maternal locus of control can influence sick children’s coping styles, and if this relation can be used to predict maladjustments. The study analyzed a cohort of 60 pediatric leukemia patients undergoing treatment and a group formed by their mothers. The participants were recruited from two Pediatric Onco- Hematology Units in Italy. The Child Behavioral Style Scale (CBSS) was used to assess children’s coping strategies, whereas the Parental Health Locus of Control Scale (PHLCS) was employed to analyze maternal locus of control. A linear regression model was applied to verify a possible interdependent relationship between children’s coping styles and maternal locus of control. The differences in mean CBSS scores were analyzed by K-S test. Multivariate analysis of variance was performed to assess any potential effect of child’s gender, hospital context and maternal socio-cultural status on children’s coping strategies. Our results show a significant relationship between children’s coping strategies and maternal locus of control. In particular, the scales mass media, fate and healthcare professionals display a predictive effect on children’s monitoring coping style, given the positive correlation observed (F=3.28, P=0.008). In contrast, the same scales negatively correlate with blunting coping style (F=3.5, P=0.005). Our results reveal several interesting resources having a profound impact on the psychological functioning of children with leukemia undergoing treatment as well as their mothers. Furthermore, with regard to the central hypothesis of the study, our findings show both positive and negative correlations between specific scales of maternal locus of control and children’s coping style, which could be used to predict children at risk of emotional maladjustment. Full article

Аcute Myelоid Leukemiа (АML) in children is а serious disease. With a prоper treаtment, а lоng-term survivаl rаte аbоve 50% is typicаl. Befоre 2010, аll the АML pаtients died in оur hоspitаl, аnd аbаndоnment rаte wаs mоre thаn 50%. The аims оf this study аre tо explоre the lоng-term оutcоme оf newly childhood acute myeloid patients treаted аt Hue Centrаl Hоspitаl frоm 2010 tо 2019.A retrоspective study was conducted on 98 children with АML who аdmitted Hue Central Hospital frоm Jаnuаry 2010 tо December 2019. The diаgnоsis wаs cоnfirmed by mоrphоlоgicаl FАB criteriа, cytоchemistry аnd immunоphenоtype. Pаtients were treаted with using mоdified АML 7-3 Regimen. Sоciаl suppоrts were prоvided tо pаtients/fаmilies. А tоtаl оf 98 children with АML were аnаlyzed with meаn аge оf 5.6 yeаrs rаnging frоm 3 mоnths tо 15 yeаrs. The mаle tо femаle rаtiо wаs 1.8:1. The оverаll cоmplete remissiоn rаte after inductiоn were 82.6%. Pаtients аccоunted fоr 46 (46.9%) hаd relаpses which оccurred in during chemоtherаpy n=27 (27,6%), аfter finishing chemоtherаpy n=19(19,4%). Оverаll survivаl аt 3 yeаrs were 23.2%. The event-free survivаl аt 3 yeаrs were 20.2%. Аbаndоnment cаses were 4 (4.1%). During the period study, abаndоnment hаs been reduced successfully with hоlistic strаtegies such аs finаnciаl suppоrt, mаnаging fаmily grоup, prоviding educаtiоn, eаrly fоllоw-up оf pаtients whо missed аppоintments аnd free аccоmmоdаtiоn neаr hоspitаl fоr pаtients/fаmilies. However, with a high rate patient achieved complete remission after induction phase (82.6%), but the overal survival and event-free survival at 3 years were still low in my hospital (23.2 % and 20.2% respectively). It reflected that it was very difficult to treat successfully AML in lowand middle-income countries. We are considering the way how to improve the quality treatment for childhood acute myeloid leukemia in my hospital. Full article

Outcomes of insulin analogues in pediatric diabetes camps are poorly investigated; no data is available about insulin degludec (IDeg).Our aim was to assess impact of insulin therapy adopted by the participants to a 4-day diabetes camp held in 2017, hypothesizing a possible excess risk of hypoglycemia in patients treated with IDeg. Overall, 40 children with type 1 diabetes (mean age 13.4±3.0 years; 62.5% males) attended the camp (20.0% on continuous subcutaneous insulin infusion and 80.0% on multiple daily injections - MDI). Among children in MDI regimen, 71.9% were treated with IDeg as basal insulin and 28.1% with glargine U100 (IGlar). All patients used Lispro or Aspart as short-acting insulin. Daily plan of the camp included educational sessions, physical exercise, 3 main meals and 2 snacks. At the arrival, IGlar and short-acting insulin doses were revised according to existing guidelines, while IDeg dose was revised based on an empirical individualized approach. At the arrival, insulin doses were reduced in 22 participants (-19.4±10.5%), while doses were increased in 17 children (+17.8±12.7%), based on individual needs. No statistically significant between-group difference emerged in mean blood glucose and glucose variability. No excess risk of hypoglycemia was found in the IDeg group. The study suggests similar effectiveness and safety of different insulin schemes when associated with appropriate diabetes education and management, and flexible dose adjustments. Despite its longer halflife and the lack of a validated algorithm, IDeg was not associated with an excess risk of hypoglycemia. Full article

Seckel syndrome-1 or “bird-headed dwarfism”, Online Mendelian Inheritance in Man number 210600, is a rare genetic disease with an autosomal recessive transmission. We report a female child of 56 months diagnosed with SCKL1 at the Pediatric department of the University Hospital Center Sourou Sanou, Burkina Faso. She showed the typical features including facial dysmorphism, dwarfism, microcephalus and mental retardation. Ophthalmic and dental anomaly and extremities were associated. Without a codified etiological treatment, a psychotherapist support, a genetic counseling, a regular pediatric follow-up, a quarterly odontostomatological and ophthalmological follow- up have been recommended. Full article

Congenital malformations are one of the leading causes of neonates and infants’ mortality and morbidity. The frequency of these congenital malformations varies in different populations. The objective of this study was to find out the prevalence and pattern of congenital malformations in a tertiary teaching hospital in Rabat, Morocco. This four-year retrospective descriptive study was conducted from January 2011 to December 2014. All newborns with congenital malformations diagnosed at birth were included. Mothers and newborn characteristics were analyzed using SPSS 13.0. A total of 706 newborns were noted to have congenital malformation. The prevalence rate was 1.02%. The mean maternal age was 28.8±7.2 years. The mean maternal body mass index was 28.1±6.9 kg/m2. 13.3% of the mothers had a history of abortion. The nervous system was the most affected system (19.4%) followed by the musculoskeletal system (14.2%), the chromosomal abnormalities (12.3%) and the genito-urinary system (10.8%). Males newborns (57.9%) had more congenital malformations than females (40.5%). The rates for live-births, fetal asphyxia and stillbirths were 75.2%, 7.2% and 17.3%, respectively. This retrospective study provides recent and detailed data about congenital malformations in a Moroccan region. The result from this study will contribute to the knowledge of congenital malformations in this particular area and hence the supportive preventive policy. Full article