Neonatal thrombocytopenia: Thrombin generation in presence of reduced platelet counts and effects of rFVIIa in cord blood

Healthy infants exhibit a well-functioning haemostatic system in-vivoand are not prone to easy bruising. The plasmatic coagulation system shows some particularities as many coagulation factors are known to be low at time of birth and adapt to adult levels within the first months of life. As shown by Cvirn et al., low procoagulatory factors are also accompanied by low levels of inhibitory factors, which result in a well-balanced haemostasis1.

Platelets of newborns exhibit impaired platelet function in in-vitroaggregation measurements2. This hypoaggregability is not due to a refractory state caused by preactivation during birth3. Multifactorial impairments in signal transduction have been shown to cause this hypoaggregability, including impaired calcium mobilization, lower numbers of α2-adrenergic receptors and lower GTPase activity in Gq-coupled receptors4,5,6. Despite these impairments, the phospholipid composition of neonatal platelet membranes and the overall phospholipid surface expression upon activation are similar to that of adult platelets.

Clinical Survey and Predictors of Outcomes of Pediatric Out-of-Hospital Cardiac Arrest Admitted to the Emergency Department

Pediatric out-of-hospital cardiac arrest (OHCA) is a rare event associated with poor outcomes.1 The incidence of OHCA varies among countries, ranging from 2.28 to 18.0/100,000 person-years1,2,3,4,5,6,7,8,9,10,11,12. Previously, the survival to hospital discharge (STHD) rate of pediatric OHCA was 2–6%4,5,13,14,15 and with the advance of pediatric emergency medicine, this has improved to 17.6–40.2%16,17,18. For those who survive, only 1–4% of them have good neurological outcomes4,5,13,14,15. Poor outcomes of pediatric OHCA have been related to patient, cardiac event, resuscitation, and post-resuscitation care factors19. Managing pediatric OHCA efficiently is a vital challenge for physicians in the emergency department (ED). Information on factors associated with post-OHCA prognosis can facilitate improvement in pre- and in-ED care; improving survival with good neurological outcomes20. Identification and documentation of aspects other than epidemiological variables of pediatric OHCA are of great importance for developing a treatment plan and determining proper preventive measures. This study assessed the clinical characteristics, prior to and during admission to the ED, associated with clinical outcomes including sustained return of spontaneous circulation (SROSC), STHD, and neurological outcomes of pediatric OHCA in an ED.

Systemic and intrathecal immune activation in association with cerebral and cognitive outcomes in paediatric HIV

Children perinatally infected with human immunodeficiency virus (HIV) show poorer cognitive performance than uninfected peers, even with sustained virological suppression on combination antiretroviral therapy (cART). Widespread neuroimaging abnormalities, including decreased cerebral volume, decreased white matter (WM) integrity, altered neurometabolites, and regional perfusion changes suggest underlying cerebral injury1,2,3,4. While the underlying mechanisms of paediatric central nervous system (CNS) pathology in treated HIV infection remain unclear, increasing evidence suggests that HIV-associated immune and coagulation activation contribute to morbidity of multiple organ systems, including the CNS1,5.


We therefore aimed to characterize systemic and intrathecal markers of immune activation, endothelial function, and coagulation in a cohort of cART-treated perinatally HIV-infected children, and explore their relations to HIV-associated cognitive and cerebral deficits. First, we compared systemic biomarkers of immune activation, inflammation, endothelial function, and coagulation in HIV-infected children to those in matched uninfected controls. Then, we assessed whether systemic biomarker levels corresponded with intrathecal levels within the HIV-infected group. Lastly, we explored potential relationships between selected markers of immune activation, endothelial function, and previously detected cognitive deficits and magnetic resonance imaging (MRI) abnormalities.

How early do most children seeing a pediatric dentist receive their first filling?

Your question makes two assumptions both of which are untrue: (1) most children need to see a pediatric dentist and (2) most children need treatment. Let's start at the beginning. The American Academy of Pediatric Dentistry recommends children receive their first exam before age 1. In reality, this more for the parent(s) than the child. The concern is to make sure the parent is not putting the baby to bed with a bottle. This causes carbohydrates (complex sugars) to lay on the teeth for hours. The result is a condition called "nursing bottle caries," a type of tooth decay that effects almost all the teeth in the mouth with cavities the girdle the tooth at the gumline. This children often have to be hospitalized for treatment. Fortunately, most (medical) pediatricians warn 1st-time mothers about this condition and it is much less common than in the past, even without a formal dental evaluation. Most general dentists advise parents to bring a child between 18-36 months for their first exam. Usually, there is no treatment required.

What attracted you the most towards paediatrics?

I was more inclined to medicine than paediatrics , at first was depressed more due to the workload than the branch, but then when you get used to it, and when you're treating patients on your own, when you get to play with kids, that makes you feel so happy. I had lost 23 kgs in my 1st year of residency, I ended up regaining in 2nd and 3rd years .