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Acta Gastroenterol Belg 2020 Apr-Jun;83(2):315-318

Cystic Fibrosis Centre, Ghent University Hospital.

Most episodes of vomiting, reduced intake and diarrhoea in children can be evaluated and treated without additional tests. However, when the degree of clinical dehydration is not in line with the patient's medical history, other diagnoses should be suspected. In the presence of a hyponatraemic hypochloraemic metabolic alkalosis, cystic fibrosis (CF) should be included in the differential diagnosis, especially if there is failure to thrive even in the absence of respiratory symptoms. Read More

BMC Pediatr 2020 Jun 26;20(1):311. Epub 2020 Jun 26.

Department of Pediatrics, Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond Street, London, ON, N6A5C1, Canada.

Background: Bartter syndrome subtypes are a group of rare renal tubular diseases characterized by impaired salt reabsorption in the tubule, specifically the thick ascending limb of Henle's loop. Clinically, they are characterized by the association of hypokalemic metabolic alkalosis, hypercalciuria, nephrocalcinosis, increased levels of plasma renin and aldosterone, low blood pressure and vascular resistance to angiotensin II. Bartter syndrome type II is caused by mutations in the renal outer medullary potassium channel (ROMK) gene (KCNJ1), can present in the newborn period and typically requires lifelong therapy. Read More

Indian Pediatr 2020 Jun;57(6):519-522

Department of Pediatrics, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi, India. Correspondence to: Dr Raghvendra Singh, Associate Professor, Department of Pediatrics, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi, India.

Objective: To demonstrate the equivalence of Normal Saline (NS) and Ringer Lactate (RL) for change in serum sodium levels during correction of severe dehydration in children with acute diarrhea based on World Health Organization (WHO) plan C.

Design: Equivalence randomized control trial.

Setting: Pediatric diarrhea unit of a tertiary care hospital from May, 2016 to April, 2017. Read More

Pediatr Emerg Care 2020 Jun 11. Epub 2020 Jun 11.

From the Departments of Pediatrics.

Objective: Dehydration is a common concern in children presenting to pediatric emergency departments and other acute care settings. Ultrasound (US) of the inferior vena cava (IVC) may be a fast, noninvasive tool to gauge volume status, but its utility is unclear. Our objectives were to determine the interobserver agreement of IVC collapse and collapse duration, then correlate IVC collapse with the outcome of intravenous (IV) versus oral (PO) rehydration. Read More

Eur J Pediatr 2020 Jun 3. Epub 2020 Jun 3.

Department of Gastroenterology, Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders; Children's Hospital of Chongqing Medical University, Chongqing, P.R China., Chongqing Key Laboratory of Pediatrics, No.136, Zhongshan 2nd Road, Yuzhong District, Chongqing, 400014, China.

In high-income countries. ondansetron is an effective antiemetic in children with gastroenteritis, but data from low- and middle-income countries are sparse. This study aimed to evaluate evidences of the effectiveness of ondansetron in preventing vomiting and reducing the use of intravenous fluids in children with gastroenteritis in developing countries. Read More

Pediatrics 2020 Jul 2;146(1). Epub 2020 Jun 2.

Boston Children's Hospital, Boston, Massachusetts.

Objectives: Management decisions for patients with gastroenteritis affect resource use within pediatric emergency departments (EDs), and algorithmic care using evidence-based guidelines (EBGs) has become widespread. We aimed to determine if the implementation of a dehydration EBG in a pediatric ED resulted in a reduction in intravenous (IV) fluid administration and the cost of care.

Methods: In a single-center quality improvement initiative between 2010 and 2016, investigators aimed to decrease the percentage of patients with gastroenteritis who were rehydrated with IV fluids. Read More

Trials 2020 May 27;21(1):435. Epub 2020 May 27.

Max Rady College of Medicine, Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, and the Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.

Background: There are limited treatment options that clinicians can provide to children presenting to emergency departments with vomiting secondary to acute gastroenteritis. Based on evidence of effectiveness and safety, clinicians now routinely administer ondansetron in the emergency department to promote oral rehydration therapy success. However, clinicians are also increasingly providing multiple doses of ondansetron for home use, creating unquantified cost and health system resource use implications without any evidence to support this expanding practice. Read More

BMC Endocr Disord 2020 May 27;20(1):73. Epub 2020 May 27.

Department of Pediatrics, Gyeongsang National University School of Medicine, 92 Chilam-dong, Jinju, Gyeongnam, 660-751, South Korea.

Background: DAX1 mutations are related to the X-linked form of adrenal hypoplasia congenita (AHC) in infancy and to hypogonadotropic hypogonadism (HH) in puberty. We report a male patient affected by X-linked AHC who presented with central diabetes insipidus and schwannoma in adulthood, which has not been described in association with AHC.

Case Presentation: A 36-day-old male infant who presented with severe dehydration was admitted to the intensive care unit. Read More

Pediatric Health Med Ther 2020 7;11:135-143. Epub 2020 May 7.

Department of Pediatrics and Child Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

Purpose: Irrational antibiotic use is a worldwide problem. One of the main reasons for excessive use of antibiotics is the failure to follow the clinical guidelines. Inappropriate use of antibiotics for infectious diarrhea is associated with the risk of increasing the development of antimicrobial resistance and the cost of health care. Read More

Nutrients 2020 May 17;12(5). Epub 2020 May 17.

Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.

Maintenance with isotonic fluids is recommended in children with gastroenteritis and failure of oral rehydration therapy. However, little is known on the short-term effects of the commonly prescribed intravenous solutions on metabolic balance in children. The aim of this study is to report on our experience with normal saline, dextrose-supplemented saline and lactated Ringer solution. Read More

J Pediatr 2020 May 6. Epub 2020 May 6.

Department of Pediatrics, University of California Davis Health, University of California Davis, School of Medicine. Electronic address:

Objectives: To characterize hemodynamic alterations occurring during diabetic ketoacidosis (DKA) in a large cohort of children and to identify clinical and biochemical factors associated with hypertension.

Study Design: This was a planned secondary analysis of data from the Pediatric Emergency Care Applied Research Network (PECARN) Fluid Therapies Under Investigation in DKA (FLUID) Study, a randomized clinical trial of fluid resuscitation protocols for children in DKA. Hemodynamic data (heart rate, blood pressure) from children with DKA were assessed in comparison with normal values for age and sex. Read More

Medicine (Baltimore) 2020 May;99(19):e20209

Department of Neonatal Surgery Ministry of Education Key Laboratory of Child Development and Disorders National Clinical Research Center for Child Health and Disorders (Chongqing) China International Science and Technology Cooperation base of Child development and Critical Disorders Chongqing Key Laboratory of Pediatrics.

To explore the clinical features and management of post-necrotizing enterocolitis strictures.Clinical data from 158 patients with post-necrotizing enterocolitis strictures were summarized retrospectively in 4 academic pediatric surgical centers between April 2014 and January 2019. All patients were treated conservatively in the internal medicine department. Read More

Eur J Clin Invest 2020 Jun 18;50(6):e13258. Epub 2020 May 18.

Department of Cardiology, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.

J Pediatr Intensive Care 2020 Jun 7;9(2):145-148. Epub 2020 Jan 7.

Department of Pediatrics, Faculty of Medicine, University of Harran, Sanliurfa, Turkey.

Pseudohypoaldosteronism is a rare disease characterized by resistance to aldosterone-targeted organs, hyponatremia, hyperkalemia, metabolic acidosis, and severe salt loss in hyperaldosteronism. Homozygous mutations in , and genes were found to be responsible for the etiology. About 80 cases with molecular basis have been reported to date. Read More

Biomed J 2020 Apr 21. Epub 2020 Apr 21.

Department of Microbiology, University College of Medical Sciences (University of Delhi), Guru Teg Bahadur Hospital, Delhi, 110095, India. Electronic address:

Background: Worldwide around 2 million deaths occur every year due to diarrhoeal illnesses among children less than 5 years of age. Among diarrhoeagenic Escherichia coli, Enteropathogenic E. coli (EPEC) is highly prevalent in both community and hospital settings and is one of the main causes of persistent diarrhea in children in developing countries. Read More

BMC Med Genet 2020 Apr 15;21(1):79. Epub 2020 Apr 15.

The Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.

Background: Congenital chloride diarrhea (CLD; OMIM 214700) is a rare autosomal recessive disorder caused by pathogenic variations in the solute carrier family 26 member A3 (SLC26A3) gene. Without salt substitution, this chronic diarrheal disorder causes severe dehydration and electrolyte disturbances. Homozygous variants in the nearby gene SLC26A4 disrupt anion exchange in the inner ear and the thyroid, causing Pendred syndrome (PDS; OMIM 274600), which is the most frequent form of syndromic deafness. Read More

Minerva Pediatr 2020 Apr 9. Epub 2020 Apr 9.

Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy.

Introduction: Congenital diabetes mellitus is a rare disorder characterized by hyperglycaemia that occurs shortly after birth. We define "Diabetes of Infancy" if hyperglycaemia onset before 6 months of life. From the clinical point of view, we distinguish two main types of Diabetes of Infancy: Transient (TNDM), which remits spontaneously, and permanent (PNDM), which requires lifelong treatment. Read More

J Pediatr Hematol Oncol 2020 Mar 24. Epub 2020 Mar 24.

Department of Pediatrics, Division of Hematology/Oncology, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada.

A 6-day-old neonate presented with hypernatremic dehydration and weight loss. Fluids were started for rehydration. He was subsequently found to have signs of reduced lower limb perfusion and investigations revealed an abdominal aortic thrombus and bilateral occlusion of renal arteries. Read More

Int Breastfeed J 2020 Mar 24;15(1):19. Epub 2020 Mar 24.

Department of Pediatrics, National Hospital Organization Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan.

Background: Excessive weight loss in newborns is associated with neonatal complications such as jaundice and dehydration, which cause renal failure, thrombosis, hypovolemic shock, and seizures. The identification of the risk factors for excessive weight loss will help to discover preventive measures. The aim of this study was to determine the factors associated with excessive weight loss, defined as weight loss of ≥10%, in breastfed full-term newborns in Japan. Read More

Arch Argent Pediatr 2020 04;118(2):89-94

División Promoción y Protección de la Salud, Área de Epidemiología.

Introduction: In pediatrics, fever is a common reason for consultation. The objective was to assess parental knowledge, behaviors, and fears in the management of fever in their children.

Materials And Methods: Observational, analytical, cross-sectional study. Read More

Arch Dis Child 2020 Jul 12;105(7):648-654. Epub 2020 Mar 12.

Health Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.

Background: We explored who actually provides most admission care in hospitals offering supervised experiential training to graduating clinicians in a high mortality setting where practices deviate from guideline recommendations.

Methods: We used a large observational data set from 13 Kenyan county hospitals from November 2015 through November 2018 where patients were linked to admitting clinicians. We explored guideline adherence after creating a cumulative correctness of Paediatric Admission Quality of Care (cPAQC) score on a 5-point scale (0-4) in which points represent correct, sequential progress in providing care perfectly adherent to guidelines comprising admission assessment, diagnosis and treatment. Read More

Pediatrics 2020 04 6;145(4). Epub 2020 Mar 6.

Texas Children's Hospital, Houston, Texas.

A previously healthy 9-year-old immigrant girl from Mexico was evaluated in the emergency department (ED) with one week of fatigue, fevers, rhinorrhea, and cough. She initially presented to her primary pediatrician, where a complete blood count revealed neutropenia, prompting referral to the ED. In the ED, she was found to be influenza A-positive. Read More

PLoS Genet 2020 02 26;16(2):e1008628. Epub 2020 Feb 26.

Department of Pediatrics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.

Skin lesions, cataracts, and congenital anomalies have been frequently associated with inherited deficiencies in enzymes that synthesize cholesterol. Lanosterol synthase (LSS) converts (S)-2,3-epoxysqualene to lanosterol in the cholesterol biosynthesis pathway. Biallelic mutations in LSS have been reported in families with congenital cataracts and, very recently, have been reported in cases of hypotrichosis. Read More

Am J Trop Med Hyg 2020 05;102(5):1001-1008

Department of Medicine, University of Washington, Seattle, Washington.

HIV-exposed, uninfected (HEU) children are a growing population at particularly high risk of infection-related death in whom preventing diarrhea may significantly reduce under-5 morbidity and mortality in sub-Saharan Africa. A historic cohort (1999-2002) of Kenyan HEU infants followed from birth to 12 months was used. Maternal and infant morbidity were ascertained at monthly clinic visits and unscheduled sick visits. Read More

J Matern Fetal Neonatal Med 2020 Feb 23:1-6. Epub 2020 Feb 23.

Pediatrics, Neonatology, Thomas Jefferson University/Nemours, Philadelphia, Pennsylvania, USA.

The Baby Friendly Hospital initiative (BFHI) is a global initiative of the World Health Organization developed in 1991 to promote and support successful breastfeeding. It has led to increased rates of exclusive breastfeeding. Exclusive breastfeeding may increase risk for hypoglycemia, hyperbilirubinemia, and dehydration requiring higher level of neonatal care. Read More

J Pediatr Gastroenterol Nutr 2020 May;70(5):694-701

Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (APPSGHAN).

The incidence of gastroenteritis has greatly reduced due to improved hygiene conditions in developing countries and the use of rotavirus vaccine. Still thousands of children, however, die from gastroenteritis, most of them in poor countries. Yet gastroenteritis management is simple, inexpensive, and effective and is largely the same all over the world. Read More

Eur J Pediatr 2020 Jul 11;179(7):1107-1114. Epub 2020 Feb 11.

Division of Pediatric Metabolism, Department of Pediatrics, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey.

Acute metabolic decompensation (AMD) of maple syrup urine disease (MSUD) must be promptly recognized and treated. In this study, we aimed to identify simple variables associated with AMD in children with MSUD for use in emergency settings. Data were collected retrospectively from 115 emergency visits of 29 children with MSUD over a 4-year period in a major referral hospital. Read More

Curr Infect Dis Rep 2020 Jan 28;22(2). Epub 2020 Jan 28.

Department of Pediatrics, University of Antioquia, Medellin, Colombia.

Purpose Of Review: We aimed to summarize the most current evidence on the main aspects of the diarrheal diseases in children. The following key elements were addressed: definitions, etiology, pathogenesis, diagnosis, dietary management, pharmacological treatments, and prevention. We covered the following questions: What are the most important clinical and laboratory features of the disease? What are the best approaches for the dietary management? What is the best way to classify the hydration status, and to prevent and treat the dehydration? What are the most effective and safe interventions for reducing the diarrhea and vomiting?

Recent Findings: Diarrheal diseases are one of the most common diseases in childhood. Read More

Int J Environ Res Public Health 2020 01 18;17(2). Epub 2020 Jan 18.

Department of Pediatrics, Gardi Medical College, Ujjain 456006, India.

Diarrhoea contributes significantly to the under-five childhood morbidity and mortality worldwide. This cross-sectional study was carried out in a tertiary care hospital in Ujjain, India from July 2015 to June 2016. Consecutive children aged 1 month to 12 years having "some dehydration" and "dehydration" according to World Health Organization classification were eligible to be included in the study. Read More

J Matern Fetal Neonatal Med 2020 Jan 14:1-9. Epub 2020 Jan 14.

Orthopedic Research Centre, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

Infantile hypernatremic dehydration (IHD) is a life-threatening disease with potential cerebral adverse effects. This study was conducted to evaluate the prognosis of IHD. Using convenience sampling 183 term infants with IHD (Na > 150 mg/dl) were enrolled in a cohort study with 36 months follow-up during 2007-2017. Read More

Pediatr Emerg Care 2020 Feb;36(2):e96-e98

Division of Clinical Pharmacology and Toxicology, Akron Children's Hospital, Akron.

Radiopaque densities can be observed on imaging after the ingestion of either foreign bodies or some medications. Our case report discusses an 11-year-old boy with autism spectrum disorder and attention deficient disorder who presented to the emergency department because of concerns for constipation and dehydration. Incidentally, an abdominal x-ray showed numerous radiopaque densities throughout his intestines in addition to his constipation. Read More

Pediatr Emerg Care 2020 Jan 6. Epub 2020 Jan 6.

Hacettepe University Faculty of Medicine, Ihsan Dogramaci Children's Hospital, Department of Pediatrics, Social Pediatrics Unit, Sihhiye, Ankara.

Objective: The most common cause of diarrheal mortality in children is dehydration. In this study, we aimed to assess the validity (sensitivity and specificity) of history and the clinical and laboratory findings in in the diagnosis of dehydration in children younger than 2 years with acute diarrhea.

Methods: One hundred twenty-six 2 to 24-month-old children with acute diarrhea, who were admitted to Hacettepe University Ihsan Dogramaci Children's Hospital's Diarrheal Diseases Treatment and Training Unit, were included. Read More

Genet Med 2020 May 6;22(5):908-916. Epub 2020 Jan 6.

Section of Metabolic Diseases, University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Groningen, The Netherlands.

Purpose: Multiple acyl-CoA dehydrogenase deficiency (MADD) is a life-threatening, ultrarare inborn error of metabolism. Case reports described successful D,L-3-hydroxybutyrate (D,L-3-HB) treatment in severely affected MADD patients, but systematic data on efficacy and safety is lacking.

Methods: A systematic literature review and an international, retrospective cohort study on clinical presentation, D,L-3-HB treatment method, and outcome in MADD(-like) patients. Read More

Neoreviews 2020 01;21(1):e52-e54

Department of Pediatrics, Nassau University Medical Center, East Meadow, NY.

J Infus Nurs 2020 Jan/Feb;43(1):20-22

University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania (Dr Wheaton); St. Christopher's Hospital for Children, Section of Critical Care, Philadelphia, Pennsylvania (Drs Schlichting, Koncicki, and Madhavarapu); and Drexel University College of Medicine, Philadelphia, Pennsylvania (Drs Schlichting, Koncicki, and Madhavarapu). Taylor Wheaton, MD, FAAP, is a cardiac intensive care fellow at the University of Pittsburgh Medical Center Children's Hospital of Pittsburgh. She was previously a pediatric intensive care fellow at St. Christopher's Hospital for Children. Christine Schlichting, MD, is a pediatric critical care attending physician at St. Christopher's Hospital for Children and an associate professor of anesthesia at Drexel University College of Medicine. Swetha Madhavarapu, MD, FAAP, is a pediatric critical care attending physician at St. Christopher's Hospital for Children and assistant professor of pediatrics at Drexel University College of Medicine. She is chairperson of St. Christopher's Code Committee and teaches simulation scenarios for improving clinical care and team communication skills. Monica L. Koncicki, MD, FAAP, is an assistant professor of pediatrics at Drexel University College of Medicine, as well as a pediatric critical care attending physician and associate fellowship program director at St. Christopher's Hospital for Children. She has a special interest in the management of chronically, critically ill children.

Long-term subcutaneous hydration has not been described in pediatrics. A case of a 4-year-old born prematurely with subsequent intestinal failure, large vessel thrombi, and repeated central line-associated bloodstream infections prompting catheter removal is discussed. Chronic dehydration ensued and was managed with long-term subcutaneous fluid infusions with no serious complications. Read More

Emerg Med Australas 2020 Jun 23;32(3):466-472. Epub 2019 Dec 23.

Department of Emergency Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia.

Objective: Fluid bolus therapy (FBT) is recommended as the initial form of acute circulatory support for many disease processes. The epidemiology of its use in the ED is unknown. The aim of this study was to assess indications, use patterns and short-term effects of FBT in a paediatric ED. Read More

J Coll Physicians Surg Pak 2019 Dec;29(12):1179-1182

Department of Paediatrics, Bahria Medical University, Karachi, Pakistan.

Objective: To compare the mean number of stools per day in children treated with combination of probiotic (lactobacillus rhamnosus) with ORS and ORS only in acute diarrhea.

Study Design: Randomised control trial.

Place And Duration Of Study: Department of Pediatric Medicine, PNS Shifa Hospital, from February to July, 2017. Read More

Curr Gastroenterol Rep 2019 Dec 7;21(12):67. Epub 2019 Dec 7.

Department of Pediatrics, University of Kentucky College of Medicine/Kentucky Children's Hospital, Lexington, USA.

Purpose Of Review: An understanding of fluid and electrolyte losses from diarrhea and mechanisms of solute cotransport led to development of oral rehydration solution (ORS), representing a watershed in efforts to reduce diarrheal disease morbidity and mortality. This report reviews the scientific rationale and modifications of ORS and barriers to universal application.

Recent Findings: Solutions with osmolality and electrolyte composition different from original ORS for routine and unique pathophysiology such as in malnutrition have met with varying success. Read More

Anaesthesia 2020 03 2;75(3):374-385. Epub 2019 Dec 2.

Department of Anesthesia, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA.

The multidisciplinary International Committee for the Advancement of Procedural Sedation presents the first fasting and aspiration prevention recommendations specific to procedural sedation, based on an extensive review of the literature. These were developed using Delphi methodology and assessment of the robustness of the available evidence. The literature evidence is clear that fasting, as currently practiced, often substantially exceeds recommended time thresholds and has known adverse consequences, for example, irritability, dehydration and hypoglycaemia. Read More

BMJ Qual Saf 2020 Jun 27;29(6):509-516. Epub 2019 Nov 27.

Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia

Objective: To assess quality of care for children presenting with acute abdominal pain using validated indicators.

Design: Audit of care quality for acute abdominal pain according to 21 care quality indicators developed and validated in four stages.

Setting And Participants: Medical records of children aged 1-15 years receiving care in 2012-2013 were sampled from 57 general practitioners, 34 emergency departments (ED) and 28 hospitals across three Australian states; 6689 medical records were screened for visits for acute abdominal pain and audited by trained paediatric nurses. Read More

Cureus 2019 Oct 9;11(10):e5875. Epub 2019 Oct 9.

Pediatrics, Dow University of Health Sciences, Karachi, PAK.

Diphenoxylate-atropine (Lomotil) intoxication incidence was significantly high in the past, but seeing such cases in the present day of modern and advanced medicine, hints about the gaps in the practice of medicine. In our case, a general physician maltreated an infant for diarrhea with an adult dose of diphenoxylate-atropine (Lomotil), a Food and Drug Administration (FDA) unapproved drug, which caused labored breathing and pinpoint pupils. After being maltreated, at the time of presentation to the emergency room (ER), she was being misdiagnosed as a case of dehydration until doctors noticed miosis and reached the diagnosis of diphenoxylate-atropine (Lomotil) toxicity. Read More

J Vis Exp 2019 11 5(153). Epub 2019 Nov 5.

Laboratory of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht University.

In sickle cell disease (SCD), a single point mutation in the gene coding for beta-globin causes the production of abnormal hemoglobin S (HbS). When deoxygenated, HbS can polymerize, forming rigid rods of hemoglobin, resulting in the sickling of red blood cells (RBCs). These sickled RBCs have significantly reduced deformability, causing vaso-occlusion, which leads to numerous SCD-related clinical complications, including pain, stroke, and organ damage. Read More

Indian J Pediatr 2019 12 7;86(12):1142-1145. Epub 2019 Nov 7.

Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.

The objective of the present study was to identify risk factors for mortality at admission in children admitted to the Pediatric Intensive Care Unit (PICU) with acute gastroenteritis (AGE) with severe dehydration and shock. This was a retrospective chart review of all cases of AGE with severe dehydration and shock admitted to the PICU from 2012 to 2017. Children who died during hospital stay were compared with those who survived. Read More

Cureus 2019 Sep 12;11(9):e5639. Epub 2019 Sep 12.

Family Medicine, Dr. Ruth Pfau Hospital, Karachi, PAK.

Introduction The management of vomiting and antiemetic therapy in young children with acute gastroenteritis (AGE) has not been standardized by any management guidelines. Antiemetic drugs including promethazine, prochlorperazine, metoclopramide, ondansetron, and domperidone are readily used in the emergency departments (EDs). The aim of this study was to compare the efficacy of ondansetron with domperidone in cessation of vomiting in pediatric AGE. Read More

Pediatrics 2019 12 6;144(6). Epub 2019 Nov 6.

Centre of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan.

Background: Ondansetron is an effective antiemetic employed to prevent vomiting in children with gastroenteritis in high-income countries; data from low- and middle-income countries are sparse.

Methods: We conducted a randomized, double-blind, placebo-controlled superiority trial in 2 pediatric emergency departments in Pakistan. Dehydrated children aged 6 to 60 months with ≥1 diarrheal (ie, loose or liquid) stool and ≥1 vomiting episode within the preceding 4 hours were eligible to participate. Read More

Blood Cells Mol Dis 2020 02 22;80:102378. Epub 2019 Oct 22.

Institute of Biochemistry and Biophysics, Polish Academy of Sciences, Poland. Electronic address:

Hereditary xerocytosis (HX) is a rare, autosomal dominant congenital hemolytic anemia (CHA) characterized by erythrocyte dehydration with presentation of various degrees of hemolytic anemia. HX is often misdiagnosed as hereditary spherocytosis or other CHA. Here we report three cases of suspected HX and one case of HX associated with β-thalassemia. Read More

Gastroenterol Clin North Am 2019 12 4;48(4):585-605. Epub 2019 Oct 4.

Pediatrics and Cell Biology, Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Johns Hopkins Children's Center, The Charlotte R. Bloomberg Children's Center, Johns Hopkins University, Suite 7323, 1800 Orleans Street, Baltimore, MD 21287, USA. Electronic address:

Intestinal failure is defined as the inability to maintain fluid, nutrition, energy, and micronutrient balance that leads to the inability to gain or maintain weight, resulting in malnutrition and dehydration. Causes of intestinal failure include short bowel syndrome (ie, the physical loss of intestinal surface area and severe intestinal dysmotility). For patients with intestinal failure who fail to achieve enteral autonomy through intestinal rehabilitation programs, the current treatment options are expensive and associated with severe complications. Read More

Gynecol Endocrinol 2020 Jun 31;36(6):525-529. Epub 2019 Oct 31.

Faculty of Medicine, Department of Psychiatry, Tekirdağ Namık Kemal University, Tekirdağ, Turkey.

Hyperemesis gravidarum (HG) is an extreme form of vomiting during pregnancy and is characterized with excessive vomiting and nausea and ketonuria, electrolyte imbalance, dehydration and severe nurtition deficiency. The etiology of HG is considered as multifactorial. Altough there is a great interest to HG in terms of psychiatric conditions, there have been limited numbers of studies that researched personality traits in patients with HG. Read More

Pediatr Int 2020 Mar 28;62(3):363-370. Epub 2020 Jan 28.

Department of Pediatrics, The University of Tokyo, Tokyo, Japan.

Background: The precise mechanism of hyponatremia in Kawasaki disease (KD) remains elusive because assessment of volume status based on serial changes in body weight is lacking in previous reports.

Methods: Seventeen patients who were diagnosed with KD and hyponatremia (serum sodium levels <135 mmol/L) were analyzed. Volume status was assessed based on serial changes in body weight. Read More

J Clin Neurol 2019 Oct;15(4):496-501

Pediatric Clinical Neuroscience Center, Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.

Background And Purpose: To identify whether serum uric acid levels are significantly higher in patients with benign convulsion associated with mild gastroenteritis (CwG) than in patients with acute gastroenteritis.

Methods: This retrospective study compared the serum levels of uric acid between CwG, acute gastroenteritis, and febrile seizure after correcting for the varying degree of mild dehydration using serum HCO₃- levels. We also compared the serum uric acid levels between patients with CwG and febrile seizures in order to exclude the effect of seizures on uric acid. Read More