[Respiratory complications in early elective caesarean section].

Two neonates were born via elective caesarean section, after 38 2/7 and 38 0/7 weeks of gestation, respectively. They developed serious respiratory complications: a pneumothorax and respiratory insufficiency, respectively, for which they were transferred to a neonatal intensive care unit and were mechanically ventilated. If a caesarean section is performed before 39 0/7 weeks of gestation, the risk of respiratory complications, such as idiopathic respiratory distress syndrome or wet lung disease, is increased.

Growth of analytical thinking skills over time as measured with the MATCH test.

Context: Ber's Comprehensive Integrative Puzzle aims to assess analytical clinical thinking in medical students. We developed a paediatric version, the MATCH test, in which we added two irrelevant options to each question in order to reduce guessing behaviour. We tested its construct validity and studied the development of integrative skills over time.

Practical implementation of a multiplex PCR for acute respiratory tract infections in children.

Molecular testing for acute respiratory infections (ARIs) has documented value but limited implementation due to questions that typically slow the acceptance of new tests. This study sought to address these questions and achieve implementation. Rhinovirus was added to a nested multiplex PCR (M-PCR), increasing its diagnostic yield.

[Family with malaria: from the asymptomatic to life-threatening].

Five members of a Dutch family of Nigerian origin (three girls aged 1, 6 and 8 years and their parents, mother aged 32 and father aged 41 years), had been infected with Plasmodium falciparum during a visit to Nigeria. The mildest infection could be treated at home with oral medication. The severest case had to be admitted to the paediatric intensive care unit for respiratory support and exchange transfusions.

[Six-month old girl with an anaphylactic reaction to rice flour, a rare food allergy].

A 6-month-old girl had been admitted three times due to the sudden onset of respiratory and gastrointestinal symptoms, paleness and a reduced level of consciousness. Various laboratory tests (including allergy tests) as well as microbiological and radiological investigations did not establish the cause. Only when it was noticed that the incidents followed a change of diet, did it became obvious that a reaction to food components was the underlying cause.

Life-threatening heart failure in meningococcal septic shock in children: non-invasive measurement of cardiac parameters is of important prognostic value.

Unlabelled: Heart failure is a life-threatening complication of fulminant meningococcal septic shock (MSS). Depression of left ventricular function, in particular, is thought to be due to circulating meningococcal endotoxin. Myocardial failure leads to ventricular dilation expressed by an increased left-ventricle end-diastolic diameter (LVED).

[Drowning and near-drowning in children].

Drowning and near-drowning are major causes of death and neurological damage, respectively, in children. The pathophysiological substrate consists of hypoxia, ischaemia, respiratory and metabolic acidosis and sometimes, hypothermia. Most cases involve aspiration of liquid; this leads to a persistent impairment of the gas exchange.

Activation of the intrinsic pathway of coagulation in children with meningococcal septic shock.

Meningococcal septic shock (MSS) is complicated by activation of coagulation, fibrinolytic, and complement systems. We studied the contact system of the intrinsic pathway of coagulation in thirteen children with MSS. Activation was assessed upon admittance to the intensive care unit and 48 h thereafter, based on the measurement of factor XII- (FXII), prekallikrein- and factor XI (FXI) antigen levels, as well as on the detection of FXIa-FXIa inhibitor, FXIIa-C1-inhibitor, and kallikrein-C1-inhibitor complexes, respectively.

[Erroneously prepared oral rehydration solution life-threatening].

Two male infants, 6 and 2 months old, children of immigrant parents, were hospitalised because of somnolence and diarrhoea. Both had severe hypernatraemia. The first died during venous cannulation, the second had convulsions with multiple cerebral haemorrhages and severe neurologic damage.