Fuat Bulut1*, Alev Cumbul2, Basak Ballica3
1*Department of Otorhinolaringology, Private Corlu Reyap Hospital, Rumeli University, Istanbul
2Istanbul Yeditepe University Faculty of Medicine, Istanbul
3Istanbul Bahcesehir University Faculty of Medicine, Istanbul
Introduction: In pediatric patients with a history of recurrent chronic tonsillitis in both their mother and father, they may show an excessive immune response due to genetic inheritance.
Method: Family history in immune defense mechanism predispose to tonsil disorders. Biofilm formation theory explains that the underlying factor of recurrent/ chronic tonsillitis formation is the bacterial biofilm on the surface of the tonsils.
Results: Although recurrent chronic tonsillitis is a clinical diagnosis, patient's symptoms and signs should be monitored carefully. The history of each patient and family members should be taken carefully. Since the clinical presentation of PFAPA (Periodic Fever, Aphthous Stomatitis, Pharyngitis, Adenitis) syndrome can be confused with pediatric patients with a history of recurrent chronic tonsillitis in both parents, must follow a multidisciplinary approach before starting a treatment.
Conclusions: Family history determines the severity of tonsillar damage with immune response in pediatric patients with a history of recurrent chronic tonsillitis in both their mother and father.View / Download Pdf
Zhe Amy Fang1, Meena Nathan2, Sirisha Emani2, Sitaram Emani2, Juan C. Ibla3*
1Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
2Department of Cardiac Surgery, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA
3Division of Cardiac Anesthesia, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
Thromboelastography, a point of care graphical representation of the activation of coagulation and fibrin polymerization process, assists clinicians in making diagnostic and transfusion-related decisions in the perioperative setting. There is growing interest in applying this technology to pediatric cardiac surgery and this article reviews the currently available evidence for the use of thromboelastography (TEG) and thromboelastometry (ROTEM) in this population. A few studies exist on the use of TEG/ROTEM to accurately guide transfusion and positively impacting patient outcomes, indicating a need for additional studies to validate its utility during pediatric cardiac surgery.DOI: 10.29245/2578-2940/2020/2.1158 View / Download Pdf
Darrell O. Ricke1*, Nicole Gherlone2, Philip Fremont-Smith1, Philip Tisdall3, Maurice Fremont-Smith2
1MIT Lincoln Laboratory, USA
2Frank H. Netter MD School of Medicine – Quinnipiac University, USA
3Medical School Companion LLC, USA
Multisystem Inflammatory Syndrome in Children (MIS-C) is appearing in infants, children, and young adults in association with COVID-19 (coronavirus disease 2019) infections of SARS-CoV-2. Kawasaki Disease (KD) is one of the most common vasculitides of childhood. KD presents with similar symptoms to MIS-C especially in severe forms such as Kawasaki Disease Shock Syndrome (KDSS). The observed symptoms for MIS-C and KD are consistent with Mast Cell Activation Syndrome (MCAS) characterized by inflammatory molecules released from activated mast cells. Based on the associations of KD with multiple viral and bacterial pathogens, we put forward the hypothesis that KD and MIS-C result from antibody activation of mast cells by Fc receptor-bound pathogen antibodies causing a hyperinflammatory response upon second pathogen exposure. Within this hypothesis, MIS-C may be atypical KD or a KD-like disease associated with SARS-CoV-2. We extend the mast cell hypothesis that increased histamine levels are inducing contraction of effector cells with impeded blood flow through cardiac capillaries. In some patients, pressure from impeded blood flow, within cardiac capillaries, may result in increased coronary artery blood pressure leading to aneurysms, a well-known complication in KD.DOI: 10.29245/2578-2940/2020/2.1157 View / Download Pdf
View / Download Pdf
María Recuero Pradillo1*, Beatriz Moreno Torres1, Carlos Quimbayo-Arcila1, Esperanza Carabias Lopez1, Laura Sánchez Sánchez2, Ángel Pantoja2, Pedro Rafael Altungy Labrador3, Juan Ruiz Martín1
1Department of Pathology. Hospital Virgen de la Salud, Toledo, Spain
2Department of Pediatrics and Neonatology. Hospital Virgen de la Salud, Toledo, Spain
3Department of Research. Complutense University of Madrid, Spain
Noura Al Hassani1, Abdul-Kader Souid2*
1Department of Pediatrics, Tawam Hospital, Alain, United Arab Emirates (UAE)
2Department of Pediatrics, College of Medicine and Health Sciences - UAE University, Alain, UAE
One-third of children and adolescents are currently classified as overweight or obese. This epidemic childhood disease is the origin of adult obesity and its associated cardiovascular diseases. Dyslipidemia is also well-recognized risk of cardiovascular disease that often starts in childhood. Breasfeeding lowers the risks of obesity and dyslipidemia later in life and it should be encouraged. Type 1 diabetes (T1D) is an immune-mediated destruction of the pancreatic islets. It is often associated with other autoimmune disorders, such as chronic lymphocytic thyroiditis and celiac disease. Children with T1D require insulin to prevent fatty acid oxidation regardless of their blood glucose level. Exercise can induce hypoglycemia in a child with T1D, as glucose utilization and insulin sensitivity increase. Thus, children with T1D need to check their blood glucose before, during, and after the activity. Type 2 diabetes (T2D) represents an insulin deficiency due to obesity and genetic susceptibility; glucose is overproduced by the liver and underused by the muscles. Thus, healthy diet and regular exercise are the recommended remedies for this condition.DOI: 10.29245/2578-2940/2020/1.1155 View / Download Pdf
Eric W. Reynolds1*, Cynthia S. Bell2, Debbie Grider3
1University of Texas Health Science Center at Houston, McGovern Medical School, Department of Pediatrics, Division of Neonatology Houston, TX
2University of Texas Health Science Center at Houston, McGovern Medical School, Department of Pediatrics, Houston, TX
3University of Kentucky, Department of Pediatrics, Division of Neonatology, Lexington, KY
Introduction: During nonnutritive suck, infants must intermittently swallow. When a swallow occurs, it must interact with respiration in 2 main ways. We have previously labeled HOW the interaction occurs as “swallow-breath interaction” (SwBr), and WHERE in the respiratory cycle the swallow occurs as “phase of respiration incident to swallow” (POR). We have described SwBr and POR in preterm infants with and without bronchopulmonary dysplasia and term infants with neonatal abstinence syndrome.
Objective: The objective of this work is to describe SwBr and POR in term infants (TRM) and compare those findings to our previous study of low-risk preterm (LRP) infants.
Method: Suckle, swallow, nasal airflow and chest movement were recorded during nonnutritive suck in 12 TRM infants, collecting 94 swallows. SwBr and POR for each swallow were characterized by our previously described method. Generalized estimating equations were developed to relate the 3 types of SwBr and 5 types of POR to gender, birth weight, gestational age, postmenstrual age (PMA), and weeks post-first nipple feed. The percentages of SwBr and POR were compared to 16 LRP infants, with 176 swallows over 35 encounters.
Results: TRM infants had more swallows with attenuated respiration (AR) with advancing weeks post-first nipple feed and fewer swallows occurring with obstructive apnea (OA) in males and with increasing birth weight. More swallows occurred at mid-expiration (ME) with increasing gestational age, PMA, and male gender and at mid-inspiration (MI) with increasing weeks post-first nipple feed. Fewer swallows occurred at MI in males. Infants in the LRP group studied before 35 weeks PMA were different from TRM infants but become indistinguishable from TRM infants as PMA approached 40 weeks. SwBr and POR in LRP infants progress towards improved feeding efficiency and safety. These results are similar to studies of nutritive feeding.
Conclusion: SwBr and POR during nonnutritive suck in LRP infants become more like TRM infants with advancing PMA. Because the same brainstem centers are activated in both nutritive and nonnutritive suck, investigation of swallow during nonnutritive suck may provide similar information as nutritive feeding with easier analysis.DOI: 10.29245/2578-2940/2019/4.1150 View / Download Pdf
Tiffanie Bourgeois1, Catie Griffith1, Ema-Chanel Johnson1*, Betty Leblanc1, Brooke Melancon1
1Northwestern State University of Louisiana in Shreveport
This review’s purpose is to identify barriers on adherence of treatment guidelines in the management of pediatric Acute Otitis Media (AOM). The American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP) released revised AOM practice guidelines in 2013. These guidelines address diagnosis and management of AOM in healthy pediatric patients from six months to 12 years of age. AOM is the most common reason children are prescribed antibiotics1. Previous and continued antibiotic overuse presents increasing problems pertaining to antibiotic resistance, overall children’s health, and healthcare costs2. This guideline recommends treatment should be based on presenting signs and symptoms with severity being key in treatment, while conserving antibiotic use. This guideline includes diagnostic criteria, promotes the use of pneumatic otoscopy, and provides appropriate treatment regimens based on findings. Despite this, there is evidence that these guidelines are not being followed in multiple disciplines that provide care to this population.
A comprehensive review of the literature obtained from several databases, produced 650 articles after inclusion and exclusion criteria was applied. In order to include the highest possible level of research, the articles were individually reviewed, and 19 articles were included in this review. Major barriers identified included factors regarding providers, parents, AOM severity and complications, concerns for follow-up care, and other clinical related factors. This literature review identified and compares these multidisciplinary barriers in hope of understanding reasons for the lack of guideline adherence and possibly help facilitate behavioral changes to improve patients’ wellbeing.DOI: 10.29245/2578-2940/2019/3.1146 View / Download Pdf
Rajesh Parmar1, Hardik Patel2, Sarat K. Dalai1*
1Institute of Science, Nirma University, Ahmedabad, Gujarat, India
2Center for Global Infectious Disease Research, Seattle Children’s Research Institute, Seattle, Washington
Whole sporozoite vaccination (WSV) is considered a gold standard for inducing and providing sterile protection against Plasmodium infection. Multiple doses of immunizations with radiation-attenuated sporozoites (RAS) is essential for establishing complete sterile protection against Plasmodium infection in mice as well as in humans. In our recently published article1, we have shown that the pattern of vaccination with RAS determines the degrees of protection in mice and frequent immunization with RAS in optimum time duration helps in generating minimum threshold liver-stage (LS) specific CD8+ T cell memory responses leading to sterile protection. Further, we have shown that the alterations in successive RAS immunization could possibly affect the induction of sterile protection. In summary, animals receiving four successive doses generated 100% sterile protection. However, three successive doses with the same parasite inoculum as four doses, could induce sterile protection in ∼50% mice. Interestingly, mice immunized with the same 3 doses, but with longer gap, could not survive the challenge.DOI: 10.29245/2578-2940/2019/3.1148 View / Download Pdf
Bridgewater State University
Developmental factors and cyberbullying have not been a major focus in the field; most strikingly, the experiences that young children have with technology have been studied far less, relative to their adolescent peers. Prevalence estimates comparing younger and older children are problematic for several reasons; first, researchers have no consensus definition of cyberbullying, and second, prevalence estimates vary so widely that drawing conclusions is difficult. Access to technology is only another factor among several that likely influences the prevalence of cyberbullying, and it appears to vary with age. Access to cell phones and digital technology in adolescence is related to both victim availability and prevalence of cyberbullying itself. Among younger students, those under 12 years old, one study has found that cell phone ownership increases the risk of being both a cyberbully and a cyberbully/victim significantly. One factor that may mediate the impact of cell phone ownership is education on the appropriate and accurate use of digital technology. This type of education has been neglected in elementary schools, but evidence suggests it may be helpful in reducing cyberbullying.DOI: 10.29245/2578-2940/2019/2.1136 View / Download Pdf
Whitney B. Eldridge
Mednax Incorporated, Sunrise Florida
Kratom is a legal, widely-available herbal supplement with opioid-like properties increasingly used by those with opioid dependence to self-treat opioid withdrawal. Kratom binds to opioid receptors and can induce withdrawal, dependence, and toxicity. Classification of Kratom as an opioid is controversial. The search for non-opioid alternatives for the treatment of opioid dependence has intensified in the current opioid epidemic. Kratom is heavily advertised as one such safe non-opiate alternative and has been used by pregnant women with chronic opioid use resulting in neonatal abstinence syndrome. Kratom cannot be detected on routine toxicology screening. As kratom use becomes more widespread, pediatric populations will likely be impacted and pediatricians should familiarize themselves with its pharmacology and adverse effects to appropriately counsel parents and care for kratom-exposed patients. This article reviews kratom’s pharmacology, uses, potential benefits as a therapeutic, and risks for pediatric patients.DOI: 10.29245/2578-2940/2019/1.1142 View / Download Pdf
Wa Xian1,2*, Marcin Duleba3, Yutao Qi3, Rajasekaran Mahalingam3, Matthew Vincent4, Frank McKeon3
1Institute of Molecular Medicine, McGovern Medical School of University of Texas Health Science Center, Houston, Texas 77030, USA
2Department of Biochemistry and Molecular Biology, University of Texas McGovern Medical School, Houston, Texas 77030, USA
3Department of Biology and Biochemistry, University of Houston, Houston, Texas 77204, USA
4Tract Pharmaceuticals, Inc., Marlborough, Massachusetts 01752, USA
A robust and reliable culture system of adult stem cells is essential for applying the cutting-edge technologies of drug screening, gene editing, and genomics to stem cell research necessary for breakthroughs in this field. In addition, personalized regenerative medicine based on autologous transplantation requires our ability to clone and expand the numbers of these stem cells in vitro. In comparison to the 3D "organoid" culture system that shows limited ability to propagate stem cells as the majority of cells are differentiated or transit amplifying cells, ground-state stem cell culture system is a novel technology that permits long-lived adult stem cells to maintain immaturity, self-renewal capacity, multi-potency and genomic stability despite long-term culturing in a 2D system. The robustness, reliability and easy-to-use features of this new technology bypass the deficiencies of 3D organoid culture systems and provided unlimited stem cell sources for research, therapeutic use, and drug discovery.DOI: 10.29245/2578-2940/2018/6.1140 View / Download Pdf
Sania Amr1,2 and Christopher A. Loffredo3
1Department of Epidemiology and Public Health, University of Maryland School of Medicine
2Marlene and Stuart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland
3Lombardi Comprehensive Cancer Center, Georgetown University, Washington DC
Hepatocellular carcinoma (HCC) is on the rise worldwide and in the US, and despite emerging treatment modalities, its overall prognosis remains poor; therefore, there is a need for preventing its development globally. The major factors contributing to HCC development, namely, infections with hepatitis B and hepatitis C viruses, alcoholic cirrhosis, aflatoxin-contaminated food, non-alcoholic fatty liver disease, metabolic syndrome, and smoking are modifiable; and prevention intervention can start in childhood.
Vaccination for hepatitis B, screening for and treatment of hepatitis C and intravenous drug users, education to avoid fatty liver, alcoholism, and substance use were shown to be effective ways to curb HCC incidence. A focus on reducing early childhood adversity and training young children to make healthy decisions has been strongly recommended as a prevention strategy to reduce most of HCC risk factors.DOI: 10.29245/2578-2940/2018/6.1139 View / Download Pdf
DOI: 10.29245/2578-2940/2018/5.1133 View / Download Pdf
Lilly Bayouth1*, Shannon W. Longshore2
1Department of Surgery, Brody School of Medicine at East Carolina University, 600 Moye Blvd, Greenville, NC, USA
2Division of Pediatric Surgery, Brody School of Medicine at East Carolina University, 600 Moye Blvd MA, 207, Greenville, NC, USA
DOI: 10.29245/2578-2940/2018/4.1134 View / Download Pdf
Hannelore Ehrenreich1,2*, Luise Poustka3#
1Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
2Cluster of Excellence and DFG Research Center for Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Göttingen, Germany
3Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Göttingen, Germany
Vugar Nabi Nabyev1, Hakan Seneran2, Mehmet Cemalettin Aksoy3*
1Acibadem Ankara Hospital, Department of Orthopedics, Ankara, Turkey
2Selcuk University Faculty of Medicine, Department of Orthopedics, Selcuklu/Konya, Turkey
3Hacettepe University, Faculty of Medicine, Department of Orthopedics, Ankara, Turkey
The congenital insensitivity to pain with anhidrosis (CIPA) is a rare autosomal recessive disease caused by mutations in NTRK1 gene (neurotrophic tyrosine kinase receptor 1) located in chromosome 1q21-22, encoding the tyrosinase domain receptor high affinity nerve growth factor. It is characterized by anhidrosis, insensitivity to painful stimuli and mental retardation. Given their low prevalence and the few reported cases, it is important to know its main features to be considered in the differential diagnosis in pediatric practice. The therapeutic approach of CIPA remains unclear. The preventive approach remains the only possible treatment of CIPA. Early surgical treatment for long bone fractures to prevent pseudo arthrosis and to allow early weightbearing decreasing the risk of further osteopenia. The choice of appropriate antibiotics and surgical debridement in cases of infection might prevent further destruction of joints.DOI: 10.29245/2578-2940/2018/4.1126 View / Download Pdf
Lawrence M. Benedict1, Deeksha Sarma1, Achintya Moulick1,2, Randy Stevens1,2, Vicki Mahan*
1Drexel University College of Medicine, PA, USA
2Department of Pediatric Cardiothoracic Surgery, St. Christopher’s Hospital for Children, Philadelphia, PA, USA
Cardiac risk factors in childhood are often overlooked in clinical practice, however cardiac risk factors can start before the child is even born. Maternal factors including diet, genetics, and smoking during gestation can all impact the long-term cardiac health of the offspring. Atherosclerosis starts as early as fetal life and can continue to develop in children with risks including high cholesterol. Current guidelines for screening of cholesterol in children, while improving in recent years, still allows years of damage to accumulate before identifying those at risk. Additionally, intervention for cholesterol and other known risks in children and adolescents are often avoided or started later than necessary for optimal cardiac health. Non-pharmacological approaches like diet and exercise for cholesterol and health management can be implemented very early in life, while many pharmacological options are approved for use in certain conditions as early as ages 8 to 10. Combating cardiac disease reaching endemic levels in the developed world will take an aggressive approach in management starting with identification early in life and utilizing the appropriate tools available, both medical and lifestyle.DOI: 10.29245/2578-2940/2018/4.1131 View / Download Pdf
Sudha Rathna Prabhu*
The Tamil Nadu Dr MGR Medical University, Chennai, Tamil Nadu, India
Congenital hypothyroidism (CH) is one of the most common preventable and treatable cause of intellectual impairment in children. Among known etiologies dysgenesis due to abnormal anatomical development and dyshormonogenesis as a result of deranged physiological functioning of fetal thyroid gland. account for at least 90 % of causes of CH. While review of literature report thyroid dysgenesis as the most common etiology of CH currently focus is on iodine status adequacy in women before and during pregnancy and after delivery and lactation. Worldwide reports of previously iodine sufficient countries declared presently as iodine insufficient and recent publications of several Indian states consuming lesser amounts of iodized salt seem to indicate that iodine related pathophysiological factors are emerging as predominant etiologies of CH. The most vulnerable pregnant women and newborns are prone to be affected with iodine imbalances leading to pregnancy and perinatal related complications. Analysis of demographic, biochemical, clinical and statistical data by Indian Council of Medical Research (ICMR) in a multi-centric pilot study on congenital hypothyroidism has clearly shown that dyshormonogenesis is a leading cause of CH in neonates born in India. The need of the hour is to consider mandatory newborn screening for CH in all live newborns and further conduct country wise ethnic and culture oriented research studies with special emphasis on iodine status, genetic predispositions and lifestyle changes impact on all vulnerable populations and design effective early therapeutic strategies for management of CH to prevent intellectual impairment.DOI: 10.29245/2578-2940/2018/4.1130 View / Download Pdf
DOI: 10.29245/2578-2940/2018/3.1127 View / Download Pdf
Juan R Malagelada1*, Carolina Malagelada1
1Digestive System Research Unit, University Hospital Vall d’Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
Paolo Indolfi1*, Serena Picazio2, Silverio Perrotta1, Francesca Rossi1, Andrea Pession3, Martina Di Martino1, Elvira Pota1, Daniela Di Pinto1, Roberto Rondelli3, Cristiana Indolfi1, Fiorina Casale1
1*UOSD Hemato-Oncology, Department of Woman and Children, and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
2AIL, Section “Valentina Picazio”, Caserta, Italy
3Pediatric Hemato-Oncology Unit, University of Bologna, Italy
Introduction: Childhood cancer is relatively uncommon and the European age-standardized rate was 164 new case per million per year among 0 to 15 years old children (95% CI 158-170). We analyzed data collected in the Mod. 1.01 of the AIEOP (Association Italian Pediatric Hematology-Oncology) over 25 years (1990-2014) about patients with malignant disease diagnosed in 90 towns of the “Ground of fires” (56 in Napoli and 34 in Caserta province).
Methods: Thanks to the wide monitored population we defined 5 time trends: 1990-94; 1995-99; 2000-04; 2005-09; and 2010-14. We calculated the ratio between observed cases (O) and expected (E) numbers of cases among the children from “Terra dei fuochi”.
Results: 2037 cancer patients (0-15 years) were registered in the AIEOP database: 1144 males (56.1%) and 893 females (43.8%).
Conclusions: It is note-worthy to underline that our cases needed to be integrated with the Hospital Informative System and Register of births, marriage and deaths to have a better collection of observed cases. This is a limit of our study. The data analysis do not show significant differences in number of observed cases and type of diseases respect to our previous epidemiological study on cancer cases registered in Campania.DOI: 10.29245/2578-2940/2018/3.1124 View / Download Pdf
Marta Cristaldi1, Rodolfo Mauceri1, Laura Tomasello2, Giuseppe Pizzolanti2, Giovanni Zito5, Riccardo Alessandro3,4, Carla Giordano2*, Giuseppina Campisi1
1Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
2Biomedical Department of Internal and Specialist Medicine (DIBIMIS), Laboratory of Regenerative Medicine, Section of Endocrinology, Diabetology and Metabolism, University of Palermo, Palermo, Italy
3Department of Biopathology and Medical Biotechnology, Section of Biology and Genetics, University of Palermo, Palermo, Italy
4Institute of Biomedicine and Molecular Immunology (IBIM), National Research Council, Palermo, Italy
5Advanced Technologies Network (ATeN) Center, University of Palermo, Palermo, Italy
In the last three decades, the constantly increasing need for therapies, efficiently preventing and/or treating human diseases, has raised the interest in Regenerative Medicine (RM). RM is based on employing mesenchymal stem cells (MSCs), that showed to have great proliferation, self-renewal and multi-lineage differentiation potential, in vitro as well as in vivo. The opportunity of an accessible, painless and low-cost reservoir of MSCs constitutes the first important step of a successful regenerative therapy to include in the current clinical practice. Oral cavity has recently demonstrated to contain different MSCs niches: dental pulp from permanent and deciduous teeth, periodontal ligament, dental follicle, apical papilla and mucosa. MSCs from dental pulp of deciduous teeth, naturally lost in pediatric age, and the oral mucosa have shown to be easily harvested and to have a promising regenerative potential. Thus, the aim of the paper is to review the potentialities of human exfoliated deciduous teeth stem cells (SHEDs) and oral mucosa stem cells (OMSCs) in RM, with the purpose of their use as accessible source of MSCs for the future of pediatric patient.DOI: 10.29245/2578-2940/2018/3.1120 View / Download Pdf
Fousseyni Traore1*, Belco Maiga1, Konimba Diabaté2, Yacaria Coulibaly3, Hawa Diall1, Pierre Togo1, Oumar Coulibaly1, Issa Amadou3, Karamoko Sacko1, Abdoul Karim Doumbia1, Abdoul Aziz Diakite1, Bakary Kamaté4, Fatoumata Dicko-Traoré1, Mariam Sylla1, Boubacar Togo1
1Gabriel Toure hospital, department of pediatrics, Bamako-Mali
2National hospital of Mali, Radiation therapy service, Bamako-Mali
3Gabriel Toure hospital, pediatric surgery service, Bamako-Mali
4Hospital of Point G, department of histopathology, Bamako-Mali
Purpose: Congenital mesoblastic nephroma (CMN) is a mesenchymal renal tumor of the newborn and young infant. This tumor is generally non-aggressive and amenable to surgical removal. Few studies are available in Africa about the treatment of CMN. The aim of this retrospective study was to evaluate the treatment of CMN in the pediatric oncology unit of teaching hospital Gabriel Toure in Bamako-Mali.
Patients and method: The study was performed retrospectively from 01 January 2005 to 31 December 2016 (duration 11 years), in the pediatric-oncology unit of Gabriel Touré Teaching Hospital. Were included, patients with histologically proven CMN. The uretero-nephrectomy was indicated for all included patients. Patients with significant tumor volume at abdominal CT-scan and those with no staging at surgery with imprecise histologic stage, received neoadjuvant and adjuvant chemotherapy, respectively.
Result:From 2005/01/01 to 2016/12/31 eight cases of CMN were included in the study. CMN accounted for 3% of renal tumors. The median age of patient was 4.5 months (1 month-6 months) with a sex ratio of 0.33 (M = 2, F = 6). Abdominal mass was the most common physical sign (n = 7; 87%). The CT scan was performed in five patients (62%). There was no difference in laterality (right kidney, n = 4, left kidney, n = 4).
Three patients received neoadjuvant chemotherapy (37%). Seventy-two percent of patients received initial nephro-ureterectomy. The histology confirmed CMN in all patients (n = 8, 100%). All patients had the classic histological form (n = 8; 100%). Stage 1 (n = 4; 50%), stage 2 (n = 2; 25%), unspecified (n = 2; 25%). Two patients received adjuvant chemotherapy (25%). Overall survival was 100% with a median follow-up of 8 years (6 -10 years).
Conclusion: Multidisciplinary collaboration is the key of therapeutic success of CMN.DOI: 10.29245/2578-2940/2018/3.1128 View / Download Pdf