A5068401080- Viral Infections and Immunology Research
- Animal Disease Management and Epidemiology
- Viral gastroenteritis research and epidemiology
- SARS-CoV-2 and COVID-19 Research
- Genetics and Neurodevelopmental Disorders
- RNA regulation and disease
- Diphtheria, Corynebacterium, and Tetanus
- T-cell and Retrovirus Studies
- Poverty, Education, and Child Welfare
- Early Childhood Education and Development
- Clinical Nutrition and Gastroenterology
- Cytomegalovirus and herpesvirus research
- Trace Elements in Health
- Infective Endocarditis Diagnosis and Management
- Cardiac Valve Diseases and Treatments
- Neonatal Respiratory Health Research
- RNA and protein synthesis mechanisms
- Connective tissue disorders research
- Neurogenetic and Muscular Disorders Research
- Autoimmune and Inflammatory Disorders Research
- Cardiovascular Effects of Exercise
- Epigenetics and DNA Methylation
- Botulinum Toxin and Related Neurological Disorders
- Intramuscular injections and effects
- Aortic Disease and Treatment Approaches
Evelina London Children's Healthcare
2022
Guy's and St Thomas' NHS Foundation Trust
2022
St Thomas' Hospital
2022
King's College London
2022
Great Ormond Street Hospital
2022
University College London
2022
Oxford University Clinical Research Unit
2012-2021
University of Oxford
2012-2021
Hospital for Tropical Diseases
2012-2019
Cambridge University Hospitals NHS Foundation Trust
2018-2019
We prospectively studied 3,791 children hospitalized during 2011 a large outbreak of enterovirus 71-associated hand, foot, and mouth disease in Vietnam. Formal assessment public health interventions, use intravenous immunoglobulin other therapies, factors predisposing for progression is needed to improve clinical management.
Background Preterm infants are at risk of neurodevelopmental delay, but data on long-term outcomes in low-income and middle-income countries remain scarce. Objectives To examine neurodevelopment using Bayley Scales Infant Toddler Development-3rd edition (Bayley-III) neurological findings 2-year-old preterm infants, to compare with healthy Vietnamese infants. Further, assess factors associated impairment. Design setting Cohort study follow up discharged from a neonatal intensive care unit...
Enterovirus A71 (EV-A71) has emerged as the most important cause of large outbreaks severe and sometimes fatal hand, foot mouth disease (HFMD) across Asia-Pacific region. EV-A71 have been associated with (sub)genogroup switches, accompanied by recombination events. Understanding population dynamics is therefore essential for understanding this emerging infection, may provide pivotal information vaccine development. Despite public health burden EV-A71, relatively few complete-genome sequences...
To describe the clinical presentation, investigations, management, and disease course in pediatric autoimmune limbic encephalitis (LE).In this retrospective observational study, from UK Childhood Neuroinflammatory Disease network, we identified children six tertiary centers with LE <18 years old between 2008 2021. Clinical paraclinical data were retrieved medical records.Twenty-five fulfilling criteria identified, median age of 11 (IQR 8, 14) follow-up 24 months 18, 48). All presented...
We report a 66% reduction in neonatal tetanus mortality after introducing new management bundle integrating antibiotic therapy, muscle relaxation and invasive monitoring. The latter allowed rapid detection of autonomic instability which was treated with magnesium sulphate. This is the first its use tetanus.
Hand foot and mouth disease (HFMD) is a of public health importance across the Asia-Pacific region. The caused by enteroviruses (EVs), in particular enterovirus A71 (EV-A71). In EV-A71-associated HFMD, infection sometimes associated with severe manifestations including neurological involvement fatal outcome. availability robust diagnostic assay to distinguish EV-A71 from other EVs important for patient management outbreak response. We developed validated an internally controlled one-step...
Hand, foot and mouth disease (HFMD) is a common infectious in western Asia area the full range of long-term sequelae HFMD remains poorly described. We conducted retrospective hospital-based cohort study patients with central nervous system (CNS) complications caused by EV-A71 or CV-A16 between 2010 2016. Patients were classified into three groups, including CNS only, autonomic (ANS) dysregulation, cardiorespiratory failure. Neurologic examination, neurodevelopmental assessments, Magnetic...
Neonatal tetanus continues to occur in many resource-limited settings but there are few data regarding long-term neurological outcome from the disease, especially with critical care facilities. We assessed following neonatal infants treated a pediatric intensive unit southern Vietnam. Neurological and neurodevelopmental testing was performed 17 survivors of 18 control children same communities using tools previously validated Vietnamese children. The median age 36 months. Eight 9 community...
<ns4:p><ns4:bold>Background:</ns4:bold> There are limited psychometric reports of construct validity following adaptation the Bayley Scales Infant and Toddler Development 3<ns4:sup>rd</ns4:sup> edition (Bayley III). This paper aims to demonstrate a process assessing reliability, validity, gender equivalence adapted tool for Vietnamese children.</ns4:p><ns4:p> <ns4:bold>Methods:</ns4:bold> We evaluated cognitive, fine motor, gross expressive communication receptive subtests in 267 healthy...
Over the last 15 years, hand, foot, and mouth disease (HFMD) has emerged as a major public health burden across Asia-Pacific region. A small proportion of HFMD patients, typically those infected with enterovirus 71 (EV71), develop brainstem encephalitis autonomic nervous system (ANS) dysregulation may progress rapidly to cardiopulmonary failure death. Although milrinone been reported control hypertension support myocardial function in two studies, practice, number children still deteriorate...
Brainstem encephalitis is a serious complication of hand foot and mouth disease (HFMD) in children. Autonomic nervous system (ANS) dysregulation hypertension may occur, sometimes progressing to cardiopulmonary failure death. Vietnamese national guidelines recommend use milrinone if ANS with Stage 2 develops. We wished investigate whether magnesium sulfate (MgSO4) improved outcomes children HFMD used earlier the evolution (Stage 1 hypertension). During regional epidemic we conducted...
Abstract Purpose of Review This review presents an appraisal current therapeutic options for the treatment central nervous system haemophagocytic lymphohistiocytosis (CNS-HLH) in context systemic disease, as well when CNS features occur isolation. We present reader with a diagnostic approach to CNS-HLH and commonly used protocols. discuss evaluate newer treatments on horizon. Recent Findings Mortality is high patients who do not undergo HSCT, while larger studies are required establish...
A previously well 15-year-old boy presented to the emergency department with sudden-onset severe back pain and inability weight bear. Preceding this event, he stretched out in bed felt a click his back. On examination, was alert interactive normal vital signs. Neurological examination of lower limbs demonstrated bilateral hypotonia reduced power 2/5 proximally distally, absent reflexes, sensory level at L2 paraesthesia (pins needles) dysaesthesia bilaterally. Upper limbs, cranial nerves...
The "epilepsy-dyskinesia" spectrum is increasingly recognized in neurogenetic and neurometabolic conditions. It can be challenging to diagnose because of clinical genetic heterogeneity, atypical or nonspecific presentations, the rarity each diagnostic entity. This further complicated by lack sensitive specific biomarkers for most nonenzymatic Nevertheless, awareness timely diagnosis are paramount facilitate appropriate prognostication, counseling, management.This report describes a case...
Background: Enterovirus 71 has emerged as a frequent cause of hand, foot and mouth disease (HFMD) outbreaks in Asia, is associated with neurologic cardiopulmonary complications, especially children under 4 years age. In 2011, large outbreak HFMD hit southern Vietnam from March onward: 110,897 cases 166 deaths were reported across 63 provinces. A grading system based on clinical symptoms used to guide interventions. Children no neurological involvement are classified grade 1 usually not...
Abstract Hand, Foot, and Mouth Disease (HFMD) is a major public health issue in the Asia-Pacific region. Our research program aims to address unanswered questions about clinical, epidemiology, pathogen evolution, cost of illness, host-genetic makers associated with severe HFMD Vietnam. A multi-hospital-based observational study has been conducted at three referral hospitals Ho Chi Minh City, Vietnam since 2013. Demographic, clinical data, illness were collected alongside specimens. Multiplex...