Severe acquired cytomegalovirus infection in a full-term, formula-fed infant: Case Report

<p>Abstract</p> <p>Background</p> <p>Cases of cytomegalovirus colitis are exceptionally reported in immuno-competent infant. The pathogenesis is uncertain but breast-feeding is considered as a main source of postnatal infection.</p> <p>Case Presentation</p> <p>Here we report a full-term, formula-fed infant who developed a severe cytomegalovirus anaemia and colitis when aged 2 months.</p> <p>Conclusion</p> <p>Even if the molecular identity between the cytomegalovirus-isolate of the infant and the maternal virus could not be demonstrated, we confirmed through laboratory investigation that cytomegalovirus infection was acquired postnatally. However, the source of cytomegalovirus infection remained unclear. Alternative modes of cytomegalovirus transmission are discussed.</p

Early Structured Surgical Management Plan for Neonates with Short Bowel Syndrome May Improve Outcomes

Background: In children with short bowel syndrome, maximal adaptation of the bowel after extensive resection is thought to occur during the first 2 years of life. The aim of the present study was to review children with short bowel syndrome from two intestinal rehabilitation centers, comparing those undergoing lengthening procedures &lt;365 days of age (early) versus those whose lengthening procedure was carried out >365 days of age (late). Methods: Retrospective data collection was performed from January 2004 to December 2010 in Manchester, UK, and from December 2006 to December 2010 in Brussels, Belgium. Both medical centers follow a similar intestinal rehabilitation program (IRP). Data collected included population demographics, bowel length preoperatively and postoperatively, age at operation, parenteral nutrition (PN), central access, and complications. Results: Complete data were available for eight children who underwent lengthening surgery at &lt;365 days of age, and six who underwent the procedure at >365 days of age. Diagnoses were similar. Groups were matched for gestation and birthweight, with no statistical difference in preoperative and postoperative bowel lengths. The mean duration of PN postoperatively was 378 days in the early cohort and 589 days in the late cohort. This trended toward statistical significance (p = 0.071). Full enteral autonomy was achieved at 17 months (early) and 59 months (late) (p = 0.01). Patients in the early group required fewer central lines than those operated on later (p = 0.035). Conclusions: Enrolling children into an IRP involving early (&lt;365 days of age) lengthening surgery allows a shorter postoperative time to allow weaning to full enteral nutrition, as well as fewer central lines. Both outcomes provide benefits for the child and family, allowing an earlier return to normal life. © 2013 Société Internationale de Chirurgie

Association of the components of the metabolic syndrome with non- alcoholic fatty liver disease among normal-weight, overweight and obese children and adolescents

<p>Abstract</p> <p>Objectives</p> <p>This study aimed to determine the prevalence of the metabolic syndrome, abnormalities of liver enzymes and sonographic fatty liver, as well as the inter-related associations in normal weight, overweight and obese children and adolescents.</p> <p>Methods</p> <p>This cross-sectional study was conducted among a sample of 1107 students (56.1% girls), aged 6-18 years in Isfahan, Iran. In addition to physical examination, fasting blood glucose, serum lipid profile and liver enzymes were determined. Liver sonography was performed among 931 participants. These variables were compared among participants with different body mass index (BMI) categories.</p> <p>Results</p> <p>From lower to higher BMI category, alanine aminotransferase (ALT), total cholesterol, LDL-cholesterol, triglycerides and systolic blood pressure increased, and HDL-cholesterol decreased significantly. Elevated ALT, aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were documented in respectively 4.1%, 6.6% and 9.8% of normal weight group. The corresponding figure was 9.5%, 9.8% and 9.1% in overweight group, and 16.9%, 14.9% and 10.8% in obese group, respectively. In all BMI categories, ALT increased significantly by increasing the number of the components of the metabolic syndrome. Odds ratio for elevated liver enzymes and sonographic fatty liver increased significantly with higher number of the components of the metabolic syndrome and higher BMI categories before and after adjustment for age.</p> <p>Conclusions</p> <p>Because of the interrelationship of biochemical and sonographic indexes of fatty liver with the components of the metabolic syndrome, and with increase in their number, it is suggested to determine the clinical impact of such association in future longitudinal studies.</p