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Autoimmune liver disease
ULTRASOUND AS THE PRELIMINARY DIAGNOSTIC TOOL IN CHILDREN WITH CROHN’S DISEASE
Abstract
Abstract Body
Introduction:
Crohn’s disease is classified as chronic inflammatory bowel disease. The incidence in Europe ranges from 1 to almost 11.4 per 100,000 population per year. Ultrasound examination plays an important role in imaging diagnostics of inflammatory bowel lesions. It allows for assessing response to therapy as well as recognizing possible penetrating complications of the disease, i.e. fistula or abscess.
Materials and Methods:
36 children were included in the study: 16 boys and 20 girls with an active phase of Crohn’s disease. Each patient underwent intestinal ultrasound examination with a high frequency 7-12 Mhz linear probe.
Results:
In all patients US examination depicted thickened, hypoechoic ileal wall showing patterns of vascularization. In 8 patients Bauhin’ valve edema was visible. In 16 children, inflammatory infiltration of the periintestinal fat around the affected segment of the intestine was found. In addition, all patients presented mesenteric lymphadenopathy with short-axis diameter of 10-15 mm. 8 patients had penetrating complications of Crohn's disease: 4 small intestine fistulas and 4 abscesses.
Conclusion:
Given its safety profile and diagnostic efficacy, US examination should be considered as the first-line imaging modality for assessing inflammatory bowel disease in children. US proved to be a reliable and easily accessible tool in the diagnosis of enteric inflammatory lesions, evaluating CD activity and assessing potential penetrating complications of the disease.
TRIGGER TOOLS TO IDENTIFY ADVERSE DRUG EVENTS IN HOSPITALISED CHILDREN: A SYSTEMATIC REVIEW
Abstract
Abstract Body
During a hospitalisation, about 10% of the children experience at least one adverse drug event (ADE) with severe events accounting for about 12%. The trigger tool methodology has shown to be the most effective and labor- efficient method to detect ADEs. The aim of this systematic review is to identify all available trigger tools applicable to pediatric population in hospital settings, describe their ability to detect ADE and assess the interest of using of each trigger in a real-time detection model. Material and methods:A systematic literature review was conducted on pubmed until February 2020 and on google scholar until 25 June 2019 to identify relevant studies. Studies have been selected when they used one or more triggerto identify AEs and used data of pediatricinpatient settings.Results: Our search identified 78 studies, 28 met the inclusion criteria. Among included studies, 19 are based on North American populations. 18 studies used chart review and 10 used automated trigger tools. 262 unique triggers were identified in which 173 were included. Among included triggers 67 could be used for prevention ADEs, 76 for verification and 30 for reporting. Only 21 triggers (12%) have an average positive prediction value (PPV) more than 50%, of which 5 triggers have a PPV 100%. Discussion / Conclusion: Triggers are usefull to detect, prevent and report ADEs. The PPVs of most triggers are low, combinations of triggers may have a better PPV. In our future research we intend to concentrate on combining warning triggers with early-detection indicators in automated models in order to prevent ADEs.