International Journal of Children and Adolescents
Volume:1 Issue: 1, Jul 2015

Cytomegalovirus (CMV) infections are associated with severe morbidity and mortality in patients, especially pediatric renal transplantation patients. The use of immunosuppressive agents places these patients at the risk of viral infections. As cytomegalovirus infection influences the graft outcome, adopting useful strategies for limiting this virus after transplantation seems necessary.
This systematic review evaluates all articles about the prophylactic treatment in pediatric renal graft recipients.
There are several anti-viral agents that are used alone or in combination for preventing CMV infection. The prophylactic agents that are used in pediatric recipients include CMV-Ig, IVIG, acyclovir/valacyclovir, and ganciclovir/valganciclovir. CMV-Ig is an adjective agent and it is less effective if used alone. Although performed studies in children are not sufficient to determine valacyclovir effect in preventing reactivation of cytomegalovirus, valacyclovir is used in moderate risk recipients for CMV infection. It seems that valacyclovir is less effective than valganciclovir.
Nowadays oral valganciclovir is the most appropriate prophylactic agent used in most transplant centers for children and adults. However it appears that valganciclovir prevents cytomegalovirus infection only during prophylaxis period. The incidence of late CMV infection does not reduce by this drug. Some trials in adults and a retrospective study in children recommend that longer duration of prophylaxis with valganciclovir lowers the incidence of CMV infection in late stage.

Non-accidental burns may not be detected unless a complete history of the accident and a detailed physical examination is obtained. Self-inflicted burns are a regular source of admission to burn units.
An 11 year old boy with multiple localized burn injuries was brought to the emergency department of burn hospital by his mother. The lesions were in different symmetrical shapes on the posterior forearms. The grade of burn injury was 2B-3 and the injuries had happened 12 hours ago. The mother claimed that his son decided to punish himself following frequent blame from the family because of lying thus he made knife blade and spoon hot over the stove and put them on his forearms for several times. In further history taking the mother said that his son is a case of attention deficit and hyperactivity disorder (ADHD).
Self-immolation in psychotic children happens with different motivations, thus appropriate history taking, physical examination and psychiatric evaluation can lead us to correct diagnose and take the best decision. Children who suffer from a diagnosable mental illness can benefit from an appropriate treatment and be protected from further injuries.

Vesicoureteral reflux (VUR) is one of the most common urinary tract abnormalities in patients with urinary tract infection. Nowadays noninvasive diagnostic methods are suggested to recognize VUR and its severity.
We measured urinary and serum fibronectin in 51 children with VUR.
The mean serum fibronectin was 318.3±112.1 in children with low grade VUR versus 356.1±189.9 in children with high grade VUR (p>0.05). The mean urinary fibronectin was also 31.5±12.9 in low grade VUR and 25.9±14.2 in high grade VUR (p>0.05). Thus we found no association between the severity of VUR and the amount of fibronectin in serum and urine of patients. We also f found no relationship between dimercaptosuccinic acid (DMSA) changes at the acute phase of unitary tract infection (UTI) and serum and urine fibronectin.
Contrary to some previous studies, we showed the serum and urinary fibronectin cannot preclude the severity and grade of VUR and hence it is not suitable surrogate marker for imaging techniques for VUR diagnosis.

Since there are very few studies on the immunodeficiency state of the Iranian survivors of pediatric acute lymphoblastic leukemia (ALL), we conducted this study to determine the prevalence of humoral defects in children with ALL at least one year after completion of chemotherapy.
In this study, antibody titers for mumps, rubeola, rubella, tetanus and diphtheria toxoids, pertussis and poliovirus were measured in 28 survivor of childhood ALL and 29 normal children. Also, immunoglobulins titers for all participants were evaluated.
In spite of normal serum immunoglobulin levels in all participants, the percentage of children with ALL who had protective titers was markedly lower than that anticipated for immunized controls (p The prevalence of humoral immune defects was high among the survivors of pediatric ALL. It appears that these survivors are at risk of developing these bacterial and viral infections and therefore have to be re-vaccinated as required.

Kidney Transplantation in children is the treatment of choice to treat end stage renal disease. Improvements in immunosuppressive management have dramatically reduced the risk of early acute rejection and graft loss, however the long term results in terms of graft survival and morbidity still require search for new immunosuppressive regimens. Reducing of side effects are the challenges for improving the outcome of pediatric transplantation. This review will discuss the current trends and outcomes of the kidney transplantation in children.

The aim of this study was to analyze our indications, surgical procedures, and clinical outcomes of patients undergoing reoperation after surgical correction of tetralogy of Fallot (TOF).
Thirty seven consecutive patients who underwent reoperation late after intra-cardiac repair of TOF within a period of 10 years were assessed.
The most common indications for correcting TOF was pulmonary valve insufficiency (51.4%) followed by right ventricular outflow tract (RVOT) dilatation (45.9%), residual ventricular septal defect (VSD) (43.2%), pulmonary valve stenosis (32.4%) and pulmonary artery stenosis (32.4%). The most common late complication for primary operation included pulmonary insufficiency (5.4%), followed by ventricular tachycardia (5.4%). Late complication rate following reoperation was 13.5%. There were three operative deaths with a mortality rate of 8.1%. One-year and three-year survival were 96.2% and 91.8%, respectively. Late mortality following reoperation was significantly higher in those with underlying coronary artery anomaly (p= 0.026), those with primary patent ductus arteriosus (PDA) (p= 0.026), and those with pulmonary stenosis (p= 0.028) as indications for repeated operation.
The most common indications of redo surgery following TOF repairing surgery are pulmonary valve insufficiency followed by RVOT dilatation, and residual VSD. Although the redo surgery is associated with serious complications, acceptable long-term survival following this repeated operation is expectable.

Different personality aspects including identity styles, self-efficacy, and cognitive abilities can play a certain role in successful learning result in high educational success. We assessed the value of identity styles, self-efficacy and metacognition beliefs for predicting the level of educational success in female high-school students.
In a cross-sectional study, 380 consecutive female high school students were selected using stratified multi-stage random sampling method.
There were significant associations of educational success rate with informative identity style (r= 0.219, p High levels of informative identity style, commitment, self-efficacy, and cognitive self-consciousness can predict high educational success in students.