Tạp chí Nhi khoa

DEVELOPMENTAL ORIGINS OF HEALTH AND DISEASE

2025-10-03T03:24:27+00:00

Developmental Origins of Health and Disease (DOHaD) refer to the effects of environmental exposure in developmental periods, while tissues are forming, differention and the epigenome are uniquely sensitive to environment may increase the risk of disease in later life, The developmental periods encompagn fetal life and first few years after birth.

Some references on fetal and first few years development origins of health and disease were presented in the overview. Fetal mal- or over nutrion, low birthweight and stress during fetal life, breastfeeding, high protein intake and high weight gain in the first 2 years of life, hazard environmental exposure during developmental periods were relation to the pathogeny and mortality of various diseases in later life course, as hypertension, coronary heart diseases, stroke, obesity, diabetis, cancer psysophrenia, and various system dysfunction.

Molecular mechanism of pathogeny of diseases originated from developmental periods is epigenetic mechanism, gene expression and phenotype change. Epigenetic changes persist later in life may serve as biomakers of increased disease susceptibility.

Embracing the DOHaD paradigm, risk factors of diseases accumulate from fetal life to life course. Early preventive intervention from the developmental period, can reduce more risk factors of diseases during life course and next generations. Early preventive intervention must start with improved nutrition, reduced stress and no exposure of hazard environment during developmental periods.

ACUTE URTICARIA IN CHILDREN - APPROACH TO DIAGNOSIS AND TREATMENT

2025-10-03T07:11:47+00:00

Acute urticaria in children is a common dermatological condition, primarily characterized by the sudden onset of wheals and intense pruritus, which may be accompanied by angioedema. The condition typically resolves within 24 hours but may persist for up to 6 weeks. Causes of acute urticaria include infections, food or drug allergies, and physical triggers; however, the majority of cases have no identifiable etiology. Diagnosis is based on a detailed medical history and clinical examination, with further testing warranted only when serious underlying causes, such as allergies or systemic diseases, are suspected. Treatment focuses on symptom management, with second-generation H1 antihistamines being the preferred first-line therapy. Corticosteroids are reserved for severe cases or those unresponsive to standard treatment. Patient and family education on avoiding potential triggers is essential for preventing recurrences and improving quality of life.

EFFECTIVENESS OF PREMATURE INFANT ORAL MOTOR INTERVENTION (PIOMI) FOR PRETERM INFFANT WTH SWALLOWING DIFFICULTIES AT NATIONAL CHILDREN’S HOSPITAL

2025-10-03T07:19:06+00:00

Preterm infants are at a 40 - 70% risk of swallowing difficulties due to the immaturity of nervous system and the oral structure are aftected by frenquent non-physiological oral facial stimuli such as endotracheal intubation, continuous positive airway pressure, gavage feeding tube, and adhesive tapes limitingfacial movements. These factors may lead to prolonged hospitalization, aspiration risk, and pneumonia. The Premature Infant Oral Motor Intervention (PIOMI) is a specialized intervention designed to enhance feeding performance and swallowing skills in preterm infants.

Subject and Methods: A prospective study was conducted on 60 preterm infants with feeding and swallowing difficulties. Each infant was evaluated before and after the intervention; there was no control group. Objective: To assess the effectiveness of the PIOMI in improving oral feeding and swallowing abilities in preterm infants.

Results: The mean corrected gestational age at the time of intervention was 34.1 ± 2.1 weeks. On average, full oral feeding was achieved after approximately 5 days of PIOMI, with a statistically significant weight gain observed.

Conclusion: PIOMI is an effective intervention for managing dysphagia in preterm infants.

CLINICAL AND PARACLINICAL CHARACTERISTICS OF CONGENITAL HEART DISEASE IN NEWBORN AT PEDIATRIC CENTER - HUE CENTRAL HOSPITAL

2025-10-03T07:34:59+00:00

Objectives: Congenital heart disease (CHD) occurs in approximately 0,8% of live births. Early recognition of CHD is important for appropriate management and prognosis that need to study. The research results contribute to improving the quality of care, counseling and treatment of congenital heart disease in newborns.

Methods: Cross-sectional study analysis on 131 newborns with congenital heart disease admitted to Pediatric center – Hue Central Hospital from 05/2020-09/2022.

Results: Among 131 children with congenital heart disease (CHD), the male-to-female ratio was 1,5/1. Cyanotic CHD accounted for 59,6%, acyanotic CHD for 36,6%, and 3,8% L-TGA. The most common lesion was ventricular septal defect in the acyanotic group (13%) and Tetralogy of Fallot in the cyanotic group (13%). Critical CHD represented 45.8%, of which 85% were ductal-dependent critical CHD. Common clinical findings included Harzer’s sign (68.7%), tachypnea (64.6%), and heart murmur (56.3%) in the acyanotic group, whereas central cyanosis (100.0%), Harzer’s sign (93.6%), and abnormal S2 sound at the upper left sternal border (75.6%) predominated in the cyanotic group. Associated congenital anomalies were present in 22.9%. The overall mortality rate was 32.1%, higher in the cyanotic (38.5%) and severe CHD groups (56.7%), with the highest rates observed in hypoplastic left heart syndrome (100%), APSI (80%), and single ventricle (62.5%). Factors associated with severe CHD included cyanotic CHD (OR=8.0; 95% CI 2.2–29.1), heart failure complication (OR=6.0; 95% CI 1.8–20.0), and pre-post ductal SpO₂ difference ≥ 4% (OR=64.9; 95% CI 6.0–698.1)

Conclusion: The morbidity and mortality rate of critical congenital heart disease is high especially unless diagnosed early and managed appropriately. It is necessary to propagate the value of prenatal ultrasound and SpO₂ in detecting congenital heart disease, to rational use of PGE1 in treatment CHD.

ASSESSMENT OF RESPONSE TO ANTIBIOTIC THERAPY IN THE TREATMENT OF COMMUNITY PNEUMONIA IN PATIENTS 2 - 59 MONTHS AT THE RESPIRATORY DEPARTMENT OF CHILDREN'S HOSPITAL 1

2025-10-03T07:43:07+00:00

Introduction: Community-acquired pneumonia (CAP) is a leading cause of death in children under five years of age. The appropriate initial selection of antibiotics and timely evaluation of treatment response play a critical role in ensuring therapeutic success and reducing antibiotic resistance.

Objective: To evaluate the response to antibiotic therapy in the treatment of CAP in children aged 2 to 59 months at the Respiratory Department, Children’s Hospital 1, Ho Chi Minh City.

Methods: A cross-sectional descriptive study was conducted on 263 pediatric patients aged 2 to 59 months who were hospitalized with a diagnosis of CAP from November 2022 to July 2023. Treatment response was assessed at 72 hours after initiation of antibiotic therapy and at discharge. Associations between clinical characteristics and treatment response were analyzed using appropriate statistical tests.

Results: The mean age of patients was 21 ± 13.5 months. Among them, 74.1% were diagnosed with severe pneumonia and 7.2% with very severe pneumonia. Ceftriaxone was the most commonly used first-line antibiotic (79.5%). Clinical response at 72 hours was observed in 86.7% of patients, while the response rate to first-line antibiotics was 77.2%. The main reason for antibiotic modification was lack of clinical improvement. Second-line antibiotics were selected based on clinical features and chest X-ray findings (80%), while third-line antibiotics were mainly guided by microbiological results (57.1%). Factors significantly associated with non-response included younger age, history of pneumonia, underlying medical conditions, and malnutrition (p < 0.05).

Conclusion: Ceftriaxone demonstrated high efficacy in the treatment of CAP in children. Monitoring clinical response and individualizing treatment according to risk factors are essential to optimize therapeutic outcomes and minimize antibiotic resistance.

CLINICOPATHOLOGICAL CHARACTERISTICS OF CHILDREN IGA NEPHROPATHY IN VIETNAM NATIONAL CHILDREN’S HOSPITAL

2025-10-03T07:48:58+00:00

Objective: To describe the clinical, laboratory, and histopathological features of IgA nephropathy in children at the National Children’s Hospital, and to assess their correlations.

Methods: A case series was diagnosised IgA neprhopathy with retrospective and prospective longitudinal follow-up was conducted in the Department of Nephrology and Dialysis, Viet Nam National Children’s Hospital, from January 2023 to May 2025.

Results: A total of 64 patients met inclusion criteria. The mean age was 11.4 years (range 4.9–16.6), with 45 males (70.3%). Gross hematuria, edema, and hypertension were present in 70.3%, 57.1%, and 10.9% of patients at presentation, respectively. Nephrotic syndrome was observed in 60.9% and reduced estimated glomerular filtration rate (eGFR) at diagnosis in 23.4%. The most frequent histopathological lesion by the 2016 Oxford classification was segmental glomerulosclerosis. No T2 lesions were observed. Hematuria severity, T1 and C2 lesions were associated with reduced eGFR.

Conclusion: In children, the mean age at onset of IgA nephropathy was 11 years, predominantly in males. Chronic histopathological lesions were less common in pediatric patients. Severe hematuria, tubular atrophy/interstitial fibrosis, and cellular crescents were associated with reduced eGFR.

CLINICAL EPIDEMIOLOGICAL CHARACTERISTICS AND RISK FACTORS FOR GLUCOCORTICOID-INDUCED CUSHING SYNDROME IN CHILDREN WITH IDIOPATHIC NEPHROTIC SYNDROME

2025-10-03T07:58:00+00:00

Objective: To describe the clinical epidemiological characteristics and risk factors of glucocorticoid-induced Cushing syndrome in children with idiopathic nephrotic syndrome.

Subjects: 98 pediatric patients with idiopathic nephrotic syndrome treated at Hai Phong Children's Hospital from August 1, 2023 to July 31, 2024.

Methods: Cross-sectional descriptive study.

Results: The prevalence of Cushing syndrome was 41/98 (41.84%), with a male-to-female ratio of 3.6:1. Regarding clinical features, 41/41 (100%) had a round face, 40/41 (97.56%) had central obesity, 37/41 (90.24%) had weight gain, 35/41 (85.37%) had hirsutism, 35/41 (85.37%) had peptic ulcer disease, 20/41 (48.78%) had infections and 3/41 (7.32%) had acute adrenal insufficiency. Regarding investigations, the percentage of decreased ACTH and serum cortisol were 28/41 (68.29%) and 25/41 (60.98%), respectively, while total cholesterol increased in 35/41 (85.37%). Glucocorticoid use ≥ 24 months and non-compliance with treatment increased the risk of Cushing syndrome by 2.3 times and 4.94 times, respectively, in children with idiopathic nephrotic syndrome.

Conclusion: The prevalence of Cushing syndrome was quite high at 41.84%, and it was more common in boys. Most patients had decreased ACTH and serum cortisol levels measured at 8 am. Prolonged glucocorticoid use and non-compliance with treatment increased the risk of Cushing syndrome.

PATTERN OF RENAL DISEASES IN THAI BINH PEDIATRIC HOSPITAL IN 5 YEARS (2019 - 2023)

2025-10-03T08:10:12+00:00

Objective: This study aimed to identify the pattern of renal diseases in Thai Binh Pediatric Hospital in 5 years from 01/01/2019 to 31/12/2023.

Subject: 139,601 pediatric patients at Thai Binh Children's Hospital.

Method: Descriptive cross-sectional study.

Results: 1,855 (1.33%) patients with renal diseases hospitalized in the total of 139,601 patients admitted. The male/female ratio was 1,3/1, and the average age was 5,24± 3,15 years. The most common age group affected by renal diseases was under 5 years old with 950/1,855 (34.4%), while the least common age group was over 10 years old with 275/1,855 (14,8%). The patients were distributed in all regions of Thai Binh province, found in both urban, rural areas and also from other provinces. The highest number of patients was recorded in October and November. The common diseases were Urinary tract infection in 918/1,855 (49.5%) of cases, Nephrotic syndrome in 229/1,855 (12.3%) of cases, Lupus nephritis in 146/1.855 (7.9%) of cases, Acute nephritic syndrome in 117/1,855 (6.3%) of cases. 109 cases (5.8%) were referred to National Children Hospital, mainly with Urinary tract malformations, Steroid-resistant nephrotic syndrome, Acute kidney injury, Lupus nephritis.

Conclusion: Renal diseases account for a fairly high proportion, the common diseases were Urinary tract infection, Nephrotic syndrome, Acute nephritic syndrome, and Urinary tract malformations.

CASE REPORT: A CHILD WITH OMENTAL INFARCTION

2025-10-03T08:22:18+00:00

Omental Infarction (OI) is a rare cause of acute abdominal pain in children, with more than 85% of cases reported in adults [1,2]. Clinical signs are nonspecific, and the initial diagnosis is frequently mistaken for acute appendicitis, which can lead to an early unnecessary surgical.

A 10-year-old girl without significant previous medical history presented with 20-hour history of right lower quadrant abdominal (RLQ) pain, fever and focal tenderness in the RLQ.The diagnosis of OI was made, using abdominal ultrasound and enhanced CT scan findings. She received conservative management with antibiotics including ceftriaxone, metronidazole and analgesia. Her condition gradually resolved, and The child was discharged five days hospitalisation. She was rechecked after 1 month with the symptoms-free.