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  • ISSN: 2373-9312
    Volume 4, Issue 2
    Research Article
    Yuan Qu, Xin Zhou, Keren Zhang, Huimin Jia* and Weilin Wang
    Abstract
    Introduction: Pediatric patients with abdominal solid malignant tumor may occasionally present with acute abdomen and required emergency surgery because of peritonitis. This report presents four cases of abdominal solid malignant tumor which are associated with rare emergency presentations.
    Methods: This study was carried out on four patients with rare pediatric abdominal malignant tumor who presented to the Pediatric Surgery Unit in an emergency situation. All patients' data, clinical presentations, radiological data, surgical procedures, complications, and survival data were collected, reviewed and analyzed.
    Results: Between December 2010 till September 2014, 4 patients were admitted with different emergency presentations of clinically and radiologically. The tumor was identified separately was solid pseudopapillary tumor (2 cases), gastrointestinal stromal tumors located in the transverse mesocolon and undifferentiated embryonal sarcoma of the liver. The common presenting symptom was acute abdomen with peritonitis suspected of tumor spontaneous rupture and bleeding.
    Conclusions: The emergency surgeon must be acquainted with the malignant tumor, its emergency presentation and principles of surgery in the presence of malignant tumor in children.
    Anne M. De Battista*, Lynne C. Huffman, Bruce Cooper, Abbey Alkon, Christine M. Kennedy and Sandra J. Weiss
    Abstract
    Introduction: Preterm infants are expected to achieve skills consistent with term born peers by age 3. The purpose of this study was to describe trajectories of adaptive behavior for preterm children, examining the influence of gestational age (GA), illness severity, sex, family income, and maternal education.
    Method: 218 children (birth weight < 2500 grams, GA < 37 weeks) were evaluated four times over 36 months with the Vineland Adaptive Behavior Scales. Multilevel modeling was used to assess individual growth trajectories and between-group differences on the adaptive behavior composite score of the Vineland Scales.
    Results: Individual trajectories of children varied. On average, adaptive behavior composite scores declined to the low end of the average range until about 28 months of age when trajectories showed slight improvement (t=6.29, p<.001). Older gestational age was associated with better scores (t=4.68, p<.001). Male sex (t=2.77, p=.005) and poverty (t=-2.73, p=.007) were significant predictors of poorer adaptive behavior as children aged.
    Discussion: Results suggest that a lower threshold for referral to early intervention may be prudent, especially for premature male infants who live in poverty. Research is needed to understand and address the causes of decline in adaptive behavior over time, especially among the large proportion of children born preterm who do not achieve adaptive behavior scores consistent with term peers by age 3 years.
    Case Report
    Murat Sutcu*, Manolya Acar, Hacer Akturk, Muhammet Bulut, Merih Oray, SeldaHancerli Torun, Nuran Salman, IlknurTugal Tutkun, Ali Agacfidan, Ayper Somer
    Abstract
    Introduction: CMVR is the most common opportunistic ocular infection in severely immunocompromised individuals. Herein, we report three immune deficient patients with CMVR.
    First case: A 15-year old girl with the diagnosis of HIV infection and diffuse large B-cell lymphomaadmittedto hospital with the complaint of blurred vision on her left eye. She was then diagnosed as CMVR. She was started on chemotherapy together with antiretroviral treatment. CMVR fully resolved after 6 months of parenteral and intravitreal ganciclovir therapy.
    Second case: A 17-year old boy with the diagnosis of PID (IL-21 receptor deficiency) admitted with the complaint of diminished visual acuity. Absolute CD4 count was 50 cells/mm3 and fundoscopic examination revealed CMVR. Although several antiviral agents were administered, progression of the disease could not be prevented.
    Third case: A4-month old girl with the diagnosis of SCID was diagnosed as bilateral CMVR after fundoscopic examination which had been performed during CMV viremia. She was given systemic ganciclovir and foscarnet treatment. Unfortunately she passed away because of disseminated CMV infection.
    Conclusion: Routine ophthalmologic examinations for CMVR should be performed in immunocompromised patients.
    Henry Ifeanyi Osakwe*, Cristina Dragomir, Cristian Nicolescu and Eugen Sorin Boia
    Abstract
    The problems faced by hospitals in the developing countries and how they handle difficult and complex cases as in short bowel syndrome is usually not discussed in international journals. The aim of this paper is to attract attention to the plight of patients with rare and complex diseases in Eastern Europe. Data's were collected and analyzed from 3 different hospitals in two different countries from November 2013 to 2016. Patient had an emergency surgery for intestinal malrotation (volvulus), as a result of extensive ischemic necrosis, with just 80 cm of the bowel without ileocecal valves after surgery. The resultant short bowel syndrome symptoms forced parents to seek medical help in a bigger regional hospital. But despite intensive care and subsequent surgeries with just 70 cm of the intestine left, patient remained in catabolic state and was transferred to a neighboring western hospital where two more surgeries and intensive care helped patient to finally achieve enteral feeding at the optimal time. The collaboration between our hospitals and the pediatric unit across the border was the last hope that helped save this patient`s life at the last minute. The major problem is the lack of sufficient mucosal surface in order to gain enteral nutrition, as enteral feeding is tolerated TPN was gradually weaned proportionally, it should be noted that fluid and electrolyte imbalance is frequent during this process, so hydration and serum electrolyte level should be closely monitored and corrected promptly
    Clinical Image
    Kathryn Moffett* and Raul Sanchez
    A 19 month old previously healthy toddler had 16 days of fever ranging from 37.8oC to 40.0oC (100 oF -104oF). She had intermittent cough, but no chills, night sweats, rhinorrhea, emesis or diarrhea, lived with her parents and 3 older siblings, and did not attend daycare.
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