This study analyzed the neurological manifestation profiles of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across pandemic waves in pediatric patients. The study collected ...data on patients aged between 0 and 18 years, diagnosed with acute SARS-CoV-2 infection, admitted to a pediatric tertiary hospital between 1 March 2020 and 28 February 2023. This study included 1677 patients. Neurological manifestations were noted in 10% (n = 168) of patients with a median age of 3.2 years (interquartile range: 1–11.92). Neurological manifestations were significantly associated with the pandemic waves (p = 0.006) and age groups (p < 0.001). Seizures were noted in 4.2% of cases and reached an increasing frequency over time (p = 0.001), but were not associated with age groups. Febrile seizures accounted for the majority of seizures. Headache was reported in 2.6% of cases and had similar frequencies across the pandemic waves and age groups. Muscular involvement was noted in 2% of cases, reached a decreasing frequency over time (p < 0.001), and showed different frequencies among the age groups. Neurological manifestations of acute SARS-CoV-2 infection exhibit distinct patterns, depending on the pandemic wave and patient age group. The Wuhan and Omicron waves involved the nervous system more often than the other waves.
Most cases of envenomation by common European vipers (Vipera berus) have not been reported to have neurotoxic manifestations. However, these manifestations have been demonstrated in some cases of ...envenomation by subspecies of V. berus, found in the Carpathian Basin region of south-eastern Europe. Here, we report the case of a 5-year-old girl from the south of Romania who presented symptoms of neurotoxicity, as well as other systemic and local symptoms, after being bitten by an adder of the V. berus subspecies. Treatment consisted of monovalent antivenom, a corticosteroid, and prophylactic enoxaparin. Neurotoxic manifestations of envenomation as well as other local and systemic symptoms improved within 5 days of treatment. The presented case shows that venom from V. berus subspecies found in the Carpathian Basin can have neurotoxic effects. This case also confirmed the efficacy of monospecific antivenom treatment in bringing about rapid and complete remission, following envenomation.
Oral antidiabetics have become a common etiology associated with acute poisoning in children. The study shall carry out an analysis of the demographic characteristics, circumstantial characteristics ...and clinical profile associated with oral antidiabetic poisoning. An observational, descriptive and retrospective study was carried out over a period of 4 years including children confirmed with the diagnosis of acute poisoning with oral antidiabetics. In the study group, there is a prevalence of voluntary acute poisoning in female patients in the 15 to 18 year age group. bIn the group study biguanides were the most frequent pharmaceutical dugs involved. The predominant clinical manifestations associated with oral antidiabetic intoxications were gastrointestinal.
Antidiabeticele orale au devenit o etiologie frecvent asociată intoxicaţiilor acute la copil. Studiul realizează o analiză a caracteristicilor demografice, circumstanţiale şi profilului clinic ...asociat intoxicaţiilor cu antidiabetice orale. A fost realizat un studiu observaţional, descriptiv şi retrospectiv, pe o perioadă de 4 ani, în care au fost incluşi copii confirmaţi cu diagnosticul de intoxicaţie acută cu antidiabetice orale. În lotul studiat, se observă o predominanţă a cazurilor de intoxicaţii acute voluntare la pacienţii de sex feminin la grupa de vârstă 15-18 ani. Analiza etiologică a cazurilor de intoxicaţie acută în lotul studiat a identificat o predominanţă a cazurilor de expunere toxică la antidiabetice din clasa biguanide. Manifestările clinice predominante asociate intoxicaţiilor cu antidiabetice orale au fost în sfera digestivă.
Wilson’s disease is a genetic autosomal recessive transmitted pathology, that causes disorders of copper metabolism, leading to its accumulation in target tissues. It is a multisystemic affection and ...has a polymorphic clinical picture. Establishing a positive diagnosis can be difficult, with no single test that confirms or definitely excludes the disease. Diagnostic criteria for the Wilson disease in adult patients were established, then reevaluated for the child. Establishing early diagnosis allows early chelation therapy, which provides a better prognosis, delaying the progression of the disease. This is the reason why the importance of family screening must be emphasized.
Addiction is a relation of dependence, more or less alienating for an individual and more or less tolerated, sometimes even totally rejected by the individual's social environment, on a certain ...product, a certain practice or a situation. In young people addiction represents a search for sensations and a remedy for certain depression and/or anxiety symptoms. The pathology of addiction is first and foremost a pathology of sensations. The incriminated products are: tobacco and cannabis; alcohol and energy drinks associated with alcohol; new psychoactive substances (of the type of ethnobotanicals); drugs (withdrawal substances); real drugs (heroin, ecstasy); polydrug use (is quite frequent and currently includes alcohol+tobacco+ethnobotanicals+/- cannabis;). Doctors should not approach these patients alone, but together with the parents, school psychologists, school teachers, and Emergency medicine should evaluate the diagnostic modalities in intoxications with substances of abuse and psychoactive substances by taking into account: the young age of users, polyuse, repeated uses, excessive behaviours (e.g. induced alcoholic comas).
Ethanol intoxications are frequent in children, due to the ubiquitous presence of this substance and can result in serious metabolic phenomena, with important, often irreversible sequelae. Starting ...from the incidence and the severe forms of acute ethyl alcohol intoxication in children, we conducted a trial that focused on voluntary acute ethyl alcohol intoxications associated with drugs in patients hospitalized in a pediatric toxicology centre between 2005 and 2009. The association ethyl alcohol-drugs or psychoactive substances occured in 10% of the severe ethyl alcohol intoxications in teenagers, increasing the severity of intoxication, the depth of the coma and the length of hospitalization.
In children, acute liver failure (ALF) is a severe condition with high mortality. As some patients need liver transplantation (LT), it is essential to predict the fatal evolution and to refer them ...early for LT if needed. Our study aimed to evaluate the prognostic criteria and scores for assessing the outcome in children with ALF.
Data of 161 children with ALF (54.66% female, mean age 7.66 ± 6.18 years) were analyzed based on final evolution (32.91% with fatal evolution or LT) and etiology. We calculated on the first day of hospitalization the PELD score (109 children), MELD, and MELD-Na score (52 children), and King's College Criteria (KCC) for all patients. The Nazer prognostic index and Wilson index for predicting mortality were calculated for nine patients with ALF in Wilson's disease (WD).
PELD, MELD, and MELD-Na scores were significantly higher in patients with fatal evolution (21.04 ± 13.28 vs. 13.99 ± 10.07,
= 0.0023; 36.20 ± 19.51 vs. 20.08 ± 8.57,
< 0.0001; and 33.07 ± 8.29 vs. 20.08 ± 8.47,
< 0.0001, respectively). Moreover, age, bilirubin, albumin, INR, and hemoglobin significantly differed in children with fatal evolution. Function to etiology, PELD, MELD, MELD-Na, and KCC accurately predicted fatal evolution in toxic ALF (25.33 vs. 9.90,
= 0.0032; 37.29 vs. 18.79,
< 0.0001; 34.29 vs. 19.24,
= 0.0002, respectively; with positive predicting value 100%, negative predicting value 88.52%, and accuracy 89.23% for King's College criteria). The Wilson index for predicting mortality had an excellent predictive strength (100% sensibility and specificity), better than the Nazer prognostic index.
Prognostic scores may be used to predict the fatal evolution of ALF in children in correlation with other parameters or criteria. Early estimation of the outcome of ALF is essential, mainly in countries where emergency LT is problematic, as the transfer to a specialized center could be delayed, affecting survival chances.
Background. Acute pediatric poisonings represent an emergency pathology that associates a significant risk of adverse outcome or death. The increased incidence reported by antitoxic centers is a ...public health problem and requires implementing prevention strategies. Material and method. The six-years study targets children diagnosed with acute poisoning complicated by cardiogenic shock in a pediatric toxicology unit, performing a descriptive analysis of the epidemiological characteristics of the group. Aim. To provide statistical data that can represent the basis of preventive measures carried out by health services. Results. The incidence of severe intentional poisonings complicated by cardiogenic shock is almost twice as high as accidental ones. A strong correlation was identified between intentional poisonings and adolescent girls. Conclusions. The detailed epidemiological data allows targeted intervention measures to prevent suicide attempts and decrease the incidence of accidental exposures among the pediatric population.