The aim of our study was to investigate the correlation between several clinical parameters and the appearance of atopic manifestations (atopic eczema, food allergy, wheezing bronchitis, allergic ...rhinoconjunctivitis) in the first four years of life.
A total of 139 unselected full-term newborns were included in a prospective follow up from birth to age 4. Cord blood total immunoglobulin E (cIgE) and cord blood absolute eosinophil count (cEo), positive family history of allergy, maternal smoking during pregnancy, mode of delivery, and duration of exclusive and overall breastfeeding were evaluated as predictors for appearance of atopic manifestations.
We found that children with a positive family history of both mother and father are 19.03 times more likely to develop atopic manifestations and those with a positive family history of only mothers are 12.55 times more likely to develop atopy compared with children with a negative family history. Neonates with cord blood eosinophilia had 5.30 times higher chances for developing atopic manifestations. No statistically significant associations were found between cIgE (p = 0.099), mode of delivery (p = 0.379), maternal smoking (p = 0.661), exclusive (p = 0.867) and overall breastfeeding duration (p = 0.675) and the presence of atopic manifestations up to age 4.
A positive medical history, especially of mothers and cEo, seem to be predictive in screening for the onset of allergic diseases.
Neuropsychological development and the impact of postnatal head growth were studied in preschool children with asymmetrical intrauterine growth restriction. Examinees born at term with a birth weight ...below the 10th percentile were matched to the control group according to chronological and gestational age, gender, and maternal education. Fifty children were in each group, with a mean age of 6 years, 4 months. The Touwen neurological examination, the Čuturić developmental test, an imitative hand positions test, and a visual attention test were performed. There were significant differences (P< .03) in motor variables, the developmental quotient, and the imitative hand positions test. Fine motor skills had the most discriminative power. Relative growth of the head in relation to weight gain was positively correlated to neurocognitive outcome. Intrauterine growth–restricted children with a current head circumference ≤10th percentile had poorer outcomes. Conclusively, intrauterine growth restriction has a negative impact on neurocognitive development. Slow postnatal head growth is correlated with a poorer neuropsychological outcome.
Background
Developmental venous anomalies (DVAs) are the most common intracranial vascular malformations of the brain. They are most commonly asymptomatic and often diagnosed incidentally.
...Illustrative case
We present a rare case of a 9-year-old boy with seizures caused by a subcortically located DVA posterior to the postcentral gyrus of the left brain hemisphere. MRI also showed an enlarged, microcystically altered pineal gland and an extracranial cavernous hemangioma. EEG showed left fronto-centro-parietal spikes that corresponded with the location of the DVA. The spikes were occasionally secondary generalized. The boy responded well to oxcarbazepine treatment, and no surgical intervention was required. Control MRI scans showed no progression of the DVA.
Conclusion
Epilepsy may be caused by DVA. The treatment starts with anticonvulsants. The surgical treatment is the therapeutic choice only if seizures are resistant to conservative therapy because surgery might result in serious ischemic or hemorrhagic complications because DVAs are considered to be variations of normal transmedullary veins that are necessary for the drainage of white and gray matter.
Arteriovenous malformations are the most common cause of spontaneous intracerebral hemorrhages in older children. Intracerebral hematoma can cause serious lasting neurologic, cognitive, and language ...deficits, or even possible death. We present the case of a 16-year-old boy who had language impairments after suffering a large hemorrhagic stroke in the left temporoparietal region. All language components, verbal and nonverbal communication, reading, and writing, were found to be affected. These impairments were expected as they are characteristic of the location of the hematoma. After a year of speech language rehabilitation, there was an almost complete recovery of language skills. Quick diagnosis and adequate therapeutic interventions are important to diminish the influence of intracerebral hemorrhage on cognitive and language functions in children.
Tibial tuberosity fractures are rare in childhood, most frequently due to excessive quadriceps muscle contraction. On performing long jump, a 15-year-old boy sustained tibial tuberosity avulsion ...fracture type II according to Watson-Jones. The patient was treated operatively with fragment repositioning and screw fixation. Ten months after the injury and rehabilitation, he resumed his sports activities with full range knee motion.
The aim of this population-based study was to evaluate the characteristics of cerebral palsy (CP) in relation to the predominant pattern of the Magnetic Resonance Imaging Classification System ...(MRICS) that was analogously applied to the neonatal/early infant cranial ultrasound (CUS). The study included children born during the 2004-2007 period from the Croatian part (C28 RCP-HR) of the Surveillance of Cerebral Palsy in Europe (SCPE) CP register. Motor functions, accompanying impairments and brain MRI were evaluated in 227 children, 185 of which also had CUS. Concerning CP types, 56% of children had bilateral spastic, 34% unilateral spastic, 9% dyskinetic and 1% ataxic CP type. Gross Motor Function Classification System (GMFCS) revealed that 62.05% had mild (GMFCS I-III) and 37.85% had severe motor impairment (GMFCS IV-V). CUS showed white matter injury in 60%, gray matter injury in 12%, maldevelopments in 8%, miscellaneous changes in 14%, while 6% were normal; MRI showed significant agreement (κ=0.675, p<0.001). Neuroimaging findings of maldevelopments and predominant gray matter injury were associated with more severe CP, but 7% of children with CP had normal MRI. As we found very good agreement between CUS and MRI findings, CUS is recommended in children at an increased risk of CP if MRI is not available.
Background: The incidence of childhood tuberculosis as well as the number of children being in contact with persons having tuberculosis has increased in the region of Slavonski Brod during the past ...decade (1993–2003). The region is located in east Croatia along the border with Bosnia and close to the besieged and destroyed town of Vukovar. The region was heavily involved in recent military activities and migrations in Croatia and Bosnia (1991–1995). Before the war, the population was reasonably well situated, educated and provided with health services.
Methods: Routine clinical and epidemiological methods for the diagnosis of tuberculosis were used.
Results: A total of 225 cases of tuberculosis were discovered among 271 suspected cases in a total number of 19 623 children below 18 years of age admitted during the last decade to the county hospital (1.38%). The number increased from three patients with tuberculosis in 1993 to 59 in 2003. Discharge diagnoses were: latent infection 40.1%, specific hilar lymphadenopathy 22.1%, primary lung tuberculosis 18.0%, postprimary tuberculosis 3.0%, and contact with infected person but otherwise normal findings 16.9%. The infection was usualy (53.1%) acquired within the family, more often so in younger patients. Bacteriological cultures were positive in 19 of 117 patients with tuberculosis (16.4%). Antituberculosis drug treatment was carried out to completion in all children. Resistance was not encountered.
Conclusion: The authors attribute high incidence of childhood tuberculosis in the region of Slavonski Brod, the second highest incidence in Croatia, to the sequellae of migrations during military activities in Croatia and Bosnia (1991–1995) and to the post‐war recession.
Abstract Background After intrauterine growth retardation, many minor neurodevelopmental disorders may occur, especially in the motor skills domain, language and speech development, and cognitive ...functions. Aim The assessment of language development and impact of postnatal head growth in preschool children born with asymmetrical intrauterine growth retardation. Methods Examinees were born at term with birth weight below the 10th percentile for gestational age, parity and gender. Mean age at the time of study was six years and four months. The control group was matched according to chronological and gestational age, gender and maternal education with mean age six years and five months. There were 50 children with intrauterine growth retardation and 50 controls, 28 girls and 22 boys in each group. For the assessment of language development Reynell Developmental Language Scale, the Naming test and Mottier test were performed. Results There were statistically significant differences ( p < 0.05) in language comprehension, total expressive language (vocabulary, structure, content), naming skills and non-words repetition. Statistically significant positive correlations were found between relative growth of the head (Actual head circumference − head circumference at birth)/(Body weight − birth weight) and language outcome. Children with neonatal complications had lower results ( p < 0.05) in language comprehension and total expressive language. Conclusion Intrauterine growth retardation has a negative impact on language development which is evident in preschool years. Slow postnatal head growth is correlated with poorer language outcome. Neonatal complications were negatively correlated with language comprehension and total expressive language.
Aim. The objective of this study is to compare head circumferences (HCs) measured on the day of delivery and on the third day after delivery. Method. A total of 499 children born in the maternity ...department were recruited for the study. HC was measured in centimeters immediately after birth and on the third day after delivery. Results. There are statistically significant differences between HC at the time of birth and on the third day. Presentation and method of delivery were significantly associated with differences in HC. For presentation, we found that breech newborns more commonly have smaller HC on day 3 measurements (P = .001). For method of delivery, we found that cesarean sections also were more commonly associated with having smaller HC on day 3 measurement (P = .02). Conclusion. Measuring HC on the third day is more clinically valuable because much of the effects of molding and birth injuries will have subsided in most newborns.
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