Acute plastic bowing deformity: a review of the literature

An acute plastic bowing deformity (APBD) represents a subtle form of an acute fracture. This entity was not formally recognized until recently when Borden demonstrated the almost imperceptible deformity radiographically. While found in both the adult and pediatric populations, the biomechanical properties of children's bones make them more prone to this injury. In either population, the lack of an obvious cortical defect lends this injury to misdiagnosis, mismanagement, and subsequent complications.     

Cutaneous hyperpigmentation due to chronic quinine ingestion

Striking hyperpigmentation developed on the arms of a 66-year-old man following protracted oral ingestion of quinine. Although this phenomenon is well described in conjunction with other similar drugs, including quinidine, it has not been well documented following exposure to quinine. This adverse event is cosmetic in nature and is not associated with functional impairment.     

Diarrhea in children under 5 years of age from Ifakara, Tanzania: a case-control study

A matched case-control study was conducted in the Maternal and Child Health Clinic (MCH) in Ifakara, Tanzania, during the rainy season in order to elucidate the risk factors for and etiology of diarrheal diseases in children under 5 years of age. Cases (103) and controls (206) were matched for sex and age group. Precoded questionnaires with demographic details, clinical history, and physical signs were completed. Stools samples were collected for bacterial, parasitological, and viral studies. A high number of siblings (odds ratio [OR], 0.86; P = 0.027), the number of siblings surviving (OR, 0.82; P = 0.007), the birth order (OR, 0.85; P = 0.018) and the distance from the house to the water source (OR, 0.33; P = 0.011) were associated with the risk of diarrhea. There were high rates of enteropathogen isolates in stool samples from children without diarrhea (52.23%). Shigella species were the only enteropathogen statistically related with diarrhea (OR, 2.90; P < 0.029). Enterotoxigenic, enteropathogenic, and enteroaggregative strains of Escherichia coli were not related with diarrhea, and neither were Giardia lamblia or Salmonella species.     

Entomological characteristics of malaria transmission in Manhiça, a rural area in southern Mozambique

From October 1997 to September 1998, an entomological survey was carried out in Manhi?a, Mozambique, to describe the anopheline population and intensity of malaria transmission. Ten different huts were randomly selected for entomological surveillance throughout the year. CDC light trap collections were conducted during three nights each month. Additional knockdown spraying catches were carried out in the morning, after the last catch. A total of 17,245 Culicinae and 1,251 Anophelinae were collected during the study. There was substantial house to house variation and seasonality in the distribution of Anophelinae population, with a peak in April towards the end of the warm and rainy season. Four species of genus Anopheles (Diptera: Culicidae) were described: Anopheles funestus Giles, Anopheles tenebrosus D?nitz, Anopheles arabiensis Patton, and Anopheles merus D?nitz. An. funestus constitutes 72.3% of the anopheline population. The estimated sporozoite rate was 1.2% and the average entomological inoculation rate for the area was 15 infective bites per person per year.     

The role of local inflammation in complications associated with intubation in pediatric patients: A narrative review

Although the most important primary local inflammatory response factor to intubation is not yet clear, it is known that it may be directly attributed to the presence of trauma during intubation or the response of oral bacterial flora present in the trachea. It is known that prolonged intubation is associated with worse outcomes, but other underlying systemic issues, such as sepsis and trauma, are also associated with this result. Likewise, patients who require advanced airway management and excessive manipulation are more likely to experience complications. There are various inflammatory mediators that are generated during orotracheal intubation, many of which can be considered targets for therapies to help reduce inflammation caused by intubation. However, there is little evidence on the management of the inflammatory response induced by orotracheal intubation in pediatric patients. Therefore, the aim of this narrative review is to highlight the intubation associated complications that can arise from poorly controlled inflammation in intubated pediatric patients, review the proposed pathophysiology behind this, and discuss the current treatments that exist. Finally, taking into account the discussion on pathophysiology, we describe the current therapies being developed and future directions that can be taken in order to create more treatment options within this patient population.