19^th World Congress on Clinical Pediatrics April 27-28, 2020 Prague, Czech Republic

Biography:

Dr. Said El deib is a Pediatrician and Neonatologist whose experience in the field spans 15 years, backed by a higher education degree from royal college in UK. He is pioneering as an open and contextual evaluation model based on constructive responses, which has led in the creation of new methods to improve pediatric healthcare, neonatology and pediatric nutrition. He has established this model following his years of experiences in medical practice, research, evaluation, and teaching in hospitals and medical universities in the region, including Egypt, Kuwait and the UAE

Abstract:

Biography:

Flora Selimi is currently working in University Clinical Center, Pediatric Clinic, Pristina, Albania

Abstract:

 Introduction: Lymphoma is the most common blood cancer. The two main forms of lymphoma are Hodgkin lymphoma (HL) and non-Hodgkin Lymphoma

Purpose:Different types of NHL- Patterns of spread in different types of NHL-Initial diagnostics in suspect NHL-Risks associated with different typesof NHL-Possibilites for treatment and potential  outcomes-

Presentation of the case with Burkitt Lymphoma, which treatment in our ward.

Burkitt  lymphoma (BL)  is  an  uncommon form  of non-Hodgkin lymphoma.Burkitt's lymphoma is an aggressive B-cell form of NHL that occurs most often in children and young adults. BL named after British surgeon Denis Burkitt, who first  identified  this  unusual disease in  1956  among  children  in  Africa.The disease may affect the jaw, central nervous system, bone marrow, bowel, kidneys, ovaries or other organs. There are three main types of Burkitt lymphoma: (sporadic, endemic, and immunodeficiency related). Ly  Burkit  affects the third most  common childhood cancer.It occurs most  often in children between the ages of 7 and 11, but can occour at any ages from infancy to adulthood.Its affects males almost three times more often than female.

Burkit  lymphoma may be treated with   chemotherapy, radiation therapy, or autologus  stem cell transpation. Burkitt's lymphoma is potentially curable.  Presentation of the case with Lymphoma  Burkit, which was presented  to Hematology Oncology Unit at Pediatric Clinic  and  has  received chemotherapy treatment..

Materials and methods:  A male child,6 years old ,child comes to our clinic with abdominal pain,loss of apetite, fatigue, nights sweats and fever.After the examinations of: anamnesis, laboratory-hematology analysis, biochemical, RTG chest, USG  and CT  neck,chest, abdomen, pelvic  After  Ct examination  in conclusion :Ct  thorax (is not  represents the mediastinal  and axillar  lymph nodes) and Ct abdominal ( lymhonodes mesenterialis ), we prefer the biopsy and immunochemistry  The obtained results from pathology  proves  Lymphoma Burkitt .

Results.After the diagnosis it was indicated  the treatment protocol of chemotherapy for Burkitt Lymphomas  R-CHOP 21 (Rituximab, VCR, Doxorubicine, Cyclophosphamide, Prednisolon)  for 6 cycles.The  child was admitted in our ward, to  start and continue chemotherapy, the treatment was continued by doctors in our ward.Monitoring of his disease, continuing chemotherapy,laboratory chest, radiological images (CT  neck, chest, abdomen, pelvic),  are made by our ward,institute of University Clinical Center of Kosovo.

Conclusion: The resection of the lymphonodes, application of protocol RCHOP -21, supportive care,,monitoring of chemotherapy  toxicity,  has resulted in absence of minimal residual disease which confirmed by the follow up of his clinical status, laboratory tests, radiology images (PET scan),  that  resulted the absence of secondary deposits.Now  the child is a good health condition, and visits  our  clinic to follow up his condition.

Biography:

Jung Hee Park graduated from Yonsei university college of nursing in 2006 with a master’s degree in clinical nursing and attending a Ph.D. candidate. She is the registered nurse and obtain a certification of clinical advance practice nurse. She is working at the Asan Medical Center, Children’s Hospital inpatient unit, Seoul, Korea. She is currently working in a general ward as a dedicated patient safety nurse

Abstract:

Purpose: The purpose of this study was to compare the effectiveness of heparin and 0.9% normal saline solution flushing for maintaining patency of central venous catheters in pediatrics patients.

Methods: A randomized controlled clinical trial was performed. Sity-two patients were prospectively enrolled and were completed the study. The heparin group consisted of 31 patients given 10u/ml(below 10kg) or 100u/ml diluted heparin flushing and the normal saline group consisted of 31 patients with 0.9% sodium chloride flushing.

Results: There was no significantly difference in occlusion between the heparin group and the normal saline group in central venous catheters’ occlusion. Also there was no difference between these two groups in catheterrelated infections.

Conclusion: Flushing with 0.9% normal saline is as effective as flushing with heparin solution in maintaining the patency of central venous catheters. In this study, however, the duration of central line use was difference and the infection occurrence was little. Further studies are warranted with a larger sample size at multiple centers.

Key words: Central venous catheters, Heparin, Sodium chloride, Catheter, obstruction,Infection

Biography:

Olga Smilevska Spasova is currently working in Institute for Respiratory Disease in children –Kozle, Macedonia

Abstract:

Introduction: Echinococcosis is a parasitic disease a tapeworm of the echinococcus type in people and animals.

Diagnosis: history, physical, labs, x-ray chest, sonogram of chest &abdomen, CT, MRI, serology.

The purpose is to present a case of a 2year old with a complex cystic echinococosis in the right lung, with a successful outcome.

Girl presents 3 weeks with cough, fever, and dyspnea.  Oral antibiotics are started for 25 days, no improvement. In Strumica a chest x-ray is realized and the patient is sent to our institution. 

At the age of one the patient had first hospital stay for a lower respiratory tract infect. After she had a number of lower respiratory tract infections treated ambulatory.

She has a positive family history for echinococcosis.

At admittance is pale, a febrile, with a productive cough, dyspnea, BW below the 3^rd percentile. On auscultation diminished breathing sounds in the middle and lower segment of the right lung and a finding of many inspiratory crackles. CBC-hemoglobin low, elevated wbc with a predomination of granulocytes. CRP-90.4..13.8mg/l, SE-95/110..10/20.  Blood gases, ABS, liver panel, urine, sputum, mantoux test, ehin test-all negative. X-ray of chest –a large substrate with round form, with sharp demarcations in the lower lobe of the right lung, finding suggestive of a cystic formation. Sonogram of thorax and abdomen-on the right side above the diaphragm a large cystic formation filled with fluid. Eosionphils nasal secretions 30%,in sputum 20%. CT of thorax –clearly demarcated cystic formation in right lower lung with dimensions 56X42mm, clearly demarcated capsule.

 I.V antibiotic third generation cephalosporin was administered. The patient was prepared for her operative treatment at the children’s surgery clinic in Skopje.
The post operative check was excellent. 

Conclusion: Early diagnosis and fast and correct treatment is most important in successful outcome.

Key words: child, echinococcosis

Biography:

Ievgeniia Burlaka is currently working in National O.O. Bogomolets Medical University Department of Pediatrics, Kyiv, Ukraine

Abstract:

Background
In diabetes mellitus type I (T1D) progression of cardio-renal disorders, i.e. arterial hypertension and its complications, diabetic nephropathy (DN), is still the most important side-effect. Search of the mechanisms underlying these damages is on priority list. Vitamin D deficiency identified as a common metabolic/endocrine disorder worldwide in health and diseases.  There are data about the role of Vitamin D in T1D in adults. However, this issue remains to be open in pediatric practice.  

Aim of the study: To study the levels of Vitamin D, Endothelin-1 and primary cellular hypoxia markers in children with T1D and DN and to find out the network of these markers inter-relation.

Material and methods: 36 children T1D aged 6 to 17 years hospitalized in Endocrinology unit in Children Clinical Hospital â„–6 (Kyiv, Ukraine) studied. Vitamin D3 levels measured using ELISA assay and commercially available kit (Vitamin D3 (human) ELISA kit (BioVision, USA). Endothelin-1 levels measured using ELISA assay and commercially available Endothelin-1 ELISA kit (Abcam, USA). The O2-Hb dissociation rate studied spectrophotometrically. Results processed using STATISTICA 6.0 and non-parametric statistical  method (Mann-Whitney test).

Results:
In our study normal level, insufficiency and deficiency of the Vitamin D defined as - ≥ 30 ng/mL, 21-29 ng/mL and ≤ 20 ng/mL, respectively. All patients included into the study during the period September-May. We show that the most prominent Vitamin D3 deficiency detected in the group of patients with diabetic nephropathy (DN). In control group Vitamin D3 was detected at level 35.68 ± 1.56 ng/mL, in patients with T1D – 32.37 ± 5.1 ng/mL, in patients with DN – 19.39 ± 1.76 ng/mL (Ñ€<0.01 as compared to control group). Analysis of the Vitamin D3 levels and the disease course show negative correlation (R=-0,79, Ñ€<0,001).

In all children the  hemoglobin affinity to O2 molecule studied based on Sore peak analysis. Control group show this index at level 3,05 ± 0,23 a.u., children with T1D - 3,61 ± 0,25 a.u. (p <0.05), patients with DN 1,76 ± 0,27 a.u. (p <0.01, compared to control group value). In all children with T1D and DN increased level of ET-1 measured.

Conclusion: Our data show the prominent deficiency of Vitamin D in T1D patients and patients with DN, increased ET-1 level (a potent vasoconstrictor peptide), and reduction of the O2-Hb dissociation rate. We hypothesize that Vitamin D deficiency is a result of toxic effect of glucose. Increased ET-1 in all patients is a sign of early microvascular changes and resistant vessels damage leading to DN progression and arterial hypertension. All mentioned above changes accompanied by reduced O2-Hb dissociation as a result of increased level of HbA1C and may be a reason of cellular hypoxia.    

Key words: T1D, diabetic nephropathy, children, ET-1, cardio-renal complications

Biography:

Ofri has completed her MD at the age of 30 years from TEL AVIV University, Sackler School of Medicine. She is currently in her 3rd year of residency in Pediatric medicine, in Meir medical center, ISRAEL

Abstract:

Abstract:

Backround: the use of Point of care Ultrasound (POCUS) is becoming increasingly widespread In emergency medicine. this is mainly due to its safety, minimal invasiveness, high accuracy, and its ability to provide a binary diagnostic result.Limping or Pain in limb accounts for approximately 1.8/1000 of pediatric ED admissions. This is a very challenging diagnostic entity that often results in extensive and futile diagnostic workup because of its wide differential diagnosis. Therefore, POCUS provides an excellent opportunity to help avoid unnecessary tests and thus significantly shorten ED care duration.

Methods: In this retrospective cohort, performed at pediatric ED in major regional center, 335 cases of limping or pain in limb were included between 2015-2019. The cases were divided to 2 major groups: patients who underwent HIP POCUS (POCUS group), and those that underwent standard accepted workup (CONTROL group). Statistical analysis of the population was conducted (t-test and chi-square comparisons) while primary outcome was care duration in the ED and additional diagnostic workup.

Results: 135 cases underwent HIP POCUS between 2017-2019, and 200 cases underwent standard diagnostic procedure between 2015-2017. The mean age of POCUS group was 6.6 years (SD 3.5), while of CONTROL group 7.5 years (SD 1.5) with no significance difference. The groups didn’t differ significantly in their gender, ethnicity or clinical presentation (fever, prior minor trauma, prior upper respiratory tract infection, and hip joint tenderness on physical examination). Primary outcome significantly differed between the groups with shorter duration in POCUS group (166±90 min. vs 215±105 min. p<0.0001, CI 27.14-71.59). additional tests: blood sampling, orthopedic counseling and formal ultrasound were significantly more abundant in the CONTRROL group (p<0.0001 for each test, chi-square test).   

Conclusions: our results suggest that utilization of POCUS is of high clinical potential to reduce unnecessary tests and shorten duration care in the pediatric ED.

Biography:

A A Koniushevska has graduated from Donetsk National Medical University, Ukraine

Abstract:

Juvenile idiopathic arthritis develops before the age of 16 years. It has chronic severe progressive course and, as a rule, unfavorable prognosis [Geppe et al., 2011; Cassidy et al., 2011; Petty et al., 2015; Berezhnyi et al., 2015; Alekseeva et al., 2015]. Knowledge on the issues of clinical polymorphism of the disease onset and course will permit faster and more accurate identification of this disease, to timely assign adequate therapy, which will lead to earlier stabilization and remission of the disease.

The purpose of the work was to study the clinical features of the JIA onset and course in the environmentally unfavorable Donetsk region.

Materials and methods. There were 61 children with JIA treated in the Mariupol Territorial Medical Association "Child and Woman Health".

Results. In the environmentally unfavorable Donetsk region, JIA proceeded in the severe form. Thus, two thirds of the patients had activity degrees 2-3 of the process, in one fourth of the patients radiographic stages 2-3 were revealed, in two thirds of the patients - class 2 of functional disorders. A quarter of the patients had an oligoarticular variant of the disease. Almost half of the patients had a polyarticular JIA variant, which is severe and prognostically unfavorable. More than half of the children with JIA need GEBD prescription because they have unfavorable prognostic factors of the disease, such as high activity of the process and lack of the therapy efficacy for 6 months, significant active systemic manifestations for more than 6 months, progressive course of uveitis, damaged hip joints or cervical spine, the presence of erosions and the joint space narrowing during X-ray examination.

Biography:

Abstract:

Introduction:  The diagnostic and therapeuticurgency in front of central nervous system infections makesitnecessary to seek a rapid and precise diagnostic tool.

Materials and methods : This is a retrospective monocentric study conducted between March 2019 and January 2020, carried out at the paediatric emergency department. Weincluded all patients admitted for suspectedmeningitis or meningoencephalitis. Clinical, biological and microbiological data were collected to assess the impact of Multiplex PCR on management.

Results: Seventy-eight patients wereincluded. The medianagewas 34 months [10-84]. Empiricalantibiotictherapywasstarted in all patients and antiviral therapyin 21 patients (27%). In the cerebrospinalfluidstudy, 5 had a positive direct examination and 7 had a positive bacterial culture. The multiplex polymerasechainreaction (PCR) studywasperformedin 48 patients (61.5%), of which 19 (39.5%) were positive (13 bacterial and 6 viral). This allowed the adaptation of treatments, the addition of antiviral for 4 and the cessation of antibiotictherapyin 24 patients (31%) reducingtheirlength of stay in hospital.

Conclusion:  Multiplex PCR canbe a diagnostic toolthatallowstreatment to beadapted more rapidlythanwithconventional techniques.

Biography:

Ofri Hayosh has completed her MD from Sackler School of Medicine, Tel Aviv University, Israel. Currently she is pursuing her residency in Pediatric Medicine, in Meir Medical Center, Israel.

Abstract:

Background: the use of Point of care Ultrasound (POCUS) is becoming increasingly widespread in emergency medicine. This is mainly due to its safety, minimal invasiveness, high accuracy, and its ability to provide a binary diagnostic result. Limping or Pain in limb accounts for approximately 1.8/1000 of pediatric ED admissions. This is a very challenging diagnostic entity that often results in extensive and futile diagnostic workup because of its wide differential diagnosis. Therefore, POCUS provides an excellent opportunity to help avoid unnecessary tests and thus significantly shorten ED care duration.

Methods: In this retrospective cohort, performed at pediatric ED in major regional center, 335 cases of limping or pain in limb were included 2015-2019. The cases were divided to two major groups: patients who underwent HIP POCUS (POCUS group), and those that underwent standard accepted workup (CONTROL group). Statistical analysis of the population was conducted (t-test and chi-square comparisons) while primary outcome was care duration in the ED and additional diagnostic workup.

Results: One hundred and thirty five (135) cases underwent HIP POCUS in 2017-2019, and 200 cases underwent standard diagnostic procedure in 2015-2017. The mean age of POCUS group was 6.6 years (SD 3.5), while of CONTROL group 7.5 years (SD 1.5) with no significance difference. The groups didn’t differ significantly in their gender, ethnicity or clinical presentation (fever, prior minor trauma, prior upper respiratory tract infection, and hip joint tenderness on physical examination). Primary outcome significantly differed between the groups with shorter duration in POCUS group (166±90 min. vs. 215±105 min. p<0.0001, CI 27.14-71.59). Additional tests: blood sampling, orthopedic counseling and formal ultrasound were significantly more abundant in the CONTRROL group (p<0.0001 for each test, chi-square test).   

Conclusions: our results suggest that utilization of POCUS is of high clinical potential to reduce unnecessary tests and shorten duration care in the pediatric ED.