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  • 1.

    【2hr】The Impact of Ethnicity on Wilms Tumor: Characteristics and Outcome of a South African Cohort

    包量

    机译 种族对威尔姆斯肿瘤的影响：南非队列的特征和结果。
    摘要：Background. Nephroblastoma is the commonest renal tumour seen in children. It has a good prognosis in developed countries with survival rates estimated to be between 80% and 90%, while in Africa it remains low. Method. Retrospective study of patients diagnosed with nephroblastoma who are seen at 4 paediatric oncology units, representing 58.5% of all South African children with nephroblastoma and treated following SIOP protocol between January 2000 and December 2010. Results. A total of 416 patients were seen at the 4 units. Over 80% of our patients were African and almost 10% of mixed ethnicity. The most common stage was stage 4. The median survival was 28 months after diagnosis with the mixed ethnicity patients recording the longest duration (39 months) and the white patients had the shortest median survival. The overall 5-year survival rate was estimated to be 66%. Stage 2 patients did significantly better (85%). Conclusions. Our patients are similar with regard to gender ratio, median age, and age distribution as described in the literature, but in South Africa the more advanced stage disease seen than in other developed countries is translated into low overall survival rate.
  • 2.

    【2hr】Perceptions of Weight and Health Practices in Hispanic Children: A Mixed-Methods Study

    包量

    机译 西班牙裔儿童对体重和健康习惯的认知：混合方法研究
    摘要：Background. Perception of weight by parents of obese children may be associated with willingness to engage in behavior change. The relationship between parents' perception of their child's weight and their health beliefs and practices is poorly understood, especially among the Hispanic population which experiences disparities in childhood obesity. This study sought to explore the relationship between perceptions of weight and health beliefs and practices in a Hispanic population. Methods. A cross-sectional, mixed-methods approach was used with semistructured interviews conducted with parent-child (2–5 years old) dyads in a primarily Hispanic, low-income population. Parents were queried on their perceptions of their child's health, health practices, activities, behaviors, and beliefs. A grounded theory approach was used to analyze participants' discussion of health practices and behaviors. Results. Forty parent-child dyads completed the interview. Most (58%) of the parents of overweight and obese children misclassified their child's weight status. The qualitative analysis showed that accurate perception of weight was associated with internal motivation and more concrete ideas of what healthy meant for their child. Conclusions. The qualitative data suggest there may be populations at different stages of readiness for change among parents of overweight and obese children, incorporating this understanding should be considered for interventions.
  • 3.

    【2hr】A Case Control Study on Risk Factors Associated with Low Birth Weight Babies in Eastern Nepal

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    机译 尼泊尔东部低出生体重儿相关危险因素的病例对照研究
    摘要：Background. This study was done to assess the maternal and sociodemographic factors associated with low birth weight (LBW) babies. Methods. An unmatched case control study was done involving 159 cases (mothers having LBW singleton babies) and 159 controls (mothers having normal birth weight singleton babies). Results. More than 50% of LBW babies were from the mothers with height ≤145 cm while only 9.43% of NBW babies were from the mothers with that height. Finally, after multivariate logistic regression analysis, maternal height, time of first antenatal care (ANC) visit, number of ANC visits, iron supplementation, calcium supplementation, maternal education, any illness during pregnancy, and hypertension were found as the significant predictors of LBW. However, maternal blood group AB, normal maternal Body Mass Index (BMI), mother's age of 30 or more years, and starting ANC visit earlier were found to be protective for LBW. Conclusion. Study findings suggest that selectively targeted interventions such as delay age at first pregnancy, improving maternal education and nutrition, and iron and calcium supplementation can prevent LBW in Nepal.
  • 4.

    【2hr】Newborn Care Practices among Mother-Infant Dyads in Urban Uganda

    包量

    机译 乌干达城市母婴中的新生儿护理实践
    摘要：Background. Most information on newborn care practices in Uganda is from rural communities which may not be generalized to urban settings. Methods. A community based cross-sectional descriptive study was conducted in the capital city of Uganda from February to May 2012. Quantitative and qualitative data on the newborn care practices of eligible mothers were collected. Results. Over 99% of the mothers attended antenatal care at least once and the majority delivered in a health facility. Over 50% of the mothers applied various substances to the cord of their babies to quicken the healing. Although most of the mothers did not bathe their babies within the first 24 hours of birth, the majority had no knowledge of skin to skin care as a thermoprotective method. The practice of bathing babies in herbal medicine was common (65%). Most of the mothers breastfed exclusively (93.2%) but only 60.7% initiated breastfeeding within the first hour of life, while a significant number (29%) used prelacteal feeds. Conclusion. The inadequate newborn care practices in this urban community point to the need to intensify the promotion of universal coverage of the newborn care practices irrespective of rural or urban communities and irrespective of health care seeking indicators.
  • 5.

    【2hr】High Risk Infants Follow-Up: A Case Study in Iran

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    机译 高危婴儿随访：伊朗的一个案例研究
    摘要：Background. A follow-up program for high risk infants was initiated in Alzahra Maternity Hospital in Tabriz city, Iran, in 2013. The aim of this paper is to give a brief report of the program. Material and Methods. Two groups of high risk neonates were studied. The first group comprising 509 infants received services in Alzahra Maternity Hospital implemented by the follow-up program. This included a full package for family to look after high risk infant and periodic clinical evaluation at two and four weeks after birth and then two, three, four, five, and six months later again. The second group including 131 infants in Taleqani Maternity Hospital received routine services after birth with no specific follow-up care. Results. Some anthropometric indices showed a significant improvement in the intervention hospital compared to control group. These included the following: head circumference at first and second months; weight in the first, fourth, fifth, and sixth months; and height in sixth month only. Clinical evaluation of infants showed an improvement for some of the medical conditions. Conclusion. Follow-up care program for a minimum of six months after discharge from maternity hospitals may help to avoid adverse and life threatening consequences in high risk infants.
  • 6.

    【2hr】Midline Cervical Cleft: Review of an Uncommon Entity

    包量

    机译 中线颈裂：罕见实体的审查
    • 作者：Liana Puscas
    • 刊名：International Journal of Pediatrics
    • 2015年第期
    摘要：Introduction. Midline cervical cleft is a rare congenital malformation which nonetheless has a classic presentation. This study presents one of the largest single series of new patients with MCC and provides an exhaustive review and catalogue of publications from the international literature. Materials and Methods. Retrospective chart review performed in two academic medical centers and literature review performed with primary verification of all quoted references. Results. Ten patients with MCC were identified (8 boys and 2 girls). All patients presented with the classic findings of this congenital anomaly, and the length of the skin defect correlated with an increase in the patient's age. Surgical excision was complete in all cases. Thorough international literature review yielded only 195 verifiable previously reported cases. Conclusions. This is one of the largest series of new patients with midline cervical cleft presented in the world literature. Although rare (with less than 200 cases published to date) this entity does have a reliable presentation that should lead to rapid and accurate diagnosis. Complete surgical excision at an early age is appropriate since the anomaly increases in length commensurate with the patient's age.
  • 7.

    【2hr】Recent Advances in the Diagnosis and Treatment of Niemann-Pick Disease Type C in Children: A Guide to Early Diagnosis for the General Pediatrician

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    机译 儿童尼曼-匹克病C型诊断和治疗的最新进展：普通儿科医生的早期诊断指南
    • 作者：Hanna Alobaidy
    • 刊名：International Journal of Pediatrics
    • 2015年第期
    摘要：Niemann-Pick disease (NP-C) is a lysosomal storage disease in which impaired intracellular lipid transport leads to accumulation of cholesterol and glycosphingolipids in various neurovisceral tissues. It is an autosomal recessive disorder, caused by mutations in the NPC1 or NPC2 genes. The clinical spectrum is grouped by the age of onset and onset of neurological manifestation: pre/perinatal; early infantile; late infantile; and juvenile periods. The NP-C Suspicion Index (SI) screening tool was developed to identify suspected patients with this disease. It is especially good at recognizing the disease in patients older than four years of age. Biochemical tests involving genetic markers and Filipin staining of skin fibroblast are being employed to assist diagnosis. Therapy is mostly supportive and since 2009, the first specific therapy approved for use was Miglustat (Zavesca) aimed at stabilizing the rate of progression of neurological manifestation. The prognosis correlates with age at onset of neurological signs; patients with early onset form progress faster. The NP-C disease has heterogeneous neurovisceral manifestations. A SI is a screening tool that helps in diagnostic process. Filipin staining test is a specific biomarker diagnostic test. Miglustat is the first disease-specific therapy.
  • 8.

    【2hr】Corrigendum to “Population-Based Placental Weight Ratio Distributions”

    包量

    机译 更正“基于人口的胎盘重量比分布”
    摘要：
  • 9.

    【2hr】Corrigendum to “High Dose Dexmedetomidine: Effective as a Sole Agent Sedation for Children Undergoing MRI”

    包量

    机译 “大剂量右美托咪定：对正在接受MRI的儿童有效的独家镇静剂”勘误
    摘要：
  • 10.

    【2hr】Abnormal Blood Glucose as a Prognostic Factor for Adverse Clinical Outcome in Children Admitted to the Paediatric Emergency Unit at Komfo Anokye Teaching Hospital, Kumasi, Ghana

    包量

    机译 血糖异常是加纳库玛西Komfo Anokye教学医院小儿急诊科收治的儿童不良临床结果的预后因素
    摘要：Dysglycaemia (hyper- or hypoglycaemia) in critically ill children has been associated with poor outcome. We compared the clinical outcomes in children admitted to Pediatric Emergency Unit (PEU) at Komfo Anokye Teaching Hospital (KATH) for acute medical conditions and presenting with euglycaemia or dysglycaemia. This is a prospective case matching cohort study. Eight hundred subjects aged between 3 and 144 months were screened out of whom 430 (215 with euglycaemia and 215 with dysglycaemia) were enrolled. The median age was 24 months (range: 3–144 months). In the dysglycaemia group, 28 (13%) subjects had hypoglycemia and 187 (87%) had hyperglycemia. Overall, there were 128 complications in 116 subjects. The number of subjects with complications was significantly higher in dysglycaemia group (n = 99, 46%) compared to euglycaemia group (n = 17, 8%) (P < 0.001). Forty subjects died out of whom 30 had dysglycaemia (P = 0.001). Subjects with dysglycaemia were 3 times (95% CI: 1.5–6.0) more likely to die and 4.8 times (95% CI: 3.1–7.5) more likely to develop complications (P = 0.001). Dysglycaemia is associated with increased morbidity and mortality in children with acute medical conditions and should lead to intensive management of the underlying condition.
  • 11.

    【2hr】Associated Factors of Acute Chest Syndrome in Children with Sickle Cell Disease in French Guiana

    包量

    机译 法属圭亚那镰状细胞病患儿急性胸综合症的相关因素
    摘要：A matched case-control study was performed in order to identify some associated factors for ACS or to confirm the published data. Controls were children hospitalized during the same period for pain crisis who did not develop an ACS during hospitalization. Between January 2006 and October 2010, there were 24 episodes of ACS distributed among 19 patients (8 girls and 11 boys). The median age was 7.5 years (range: 3 to 17 years) for the cases and 7 years (range: 3–18 years) for the controls. Four cases and 11 controls were treated with hydroxyurea (HU). In 75% of the cases, the ACS had arisen 24–72 hours following admission. The independent factors associated with ACS were average Hb rate <8 g/dL (OR = 4.96, 95% CI = 1.29–27.34, and P = 0.04), annual number of hospitalizations >3 (OR = 5.44, 95% CI = 3.59–8.21, and P = 0.003), average length of hospitalization >7 days (OR = 3.69, 95% CI = 3.59–8.21, and P = 0.003), and a pathological transthoracic echocardiography (TTE) (OR = 13.77, 95% CI = 2.07–91.46, and P = 0.003). Although the retrospective design and small sample size are weaknesses of the present study, these results are consistent with those of previous studies and allowed identifying associated factors such as a pathological TTE.
  • 12.

    【2hr】Lipid Profile and Correlation to Cardiac Risk Factors and Cardiovascular Function in Type 1 Adolescent Diabetics from a Developing Country

    包量

    机译 发展中国家1型青少年糖尿病患者的血脂谱及其与心脏危险因素和心血管功能的相关性
    摘要：Objective. The adverse role of dyslipidemia in predicting cardiovascular outcomes has not been elucidated extensively among type 1 diabetics in the literature. Methods. We assessed dyslipidemia and its correlation to other cardiac risk factors in adolescents with type 1 diabetes. Total thirty type 1 adolescent diabetics were evaluated for their metabolic profile, including serum lipids and echocardiography was performed. Results. The average age of the cohort was 14.3 ± 3.09 yr with disease duration of 5.35 ± 2.94 yr. The mean HbA1C was 8.01%. The mean serum cholesterol, LDL, HDL, and triglyceride were normal. Serum cholesterol was high in patients with longer disease duration (P = 0.011, r = 0.41), high systolic blood pressure (P = 0.04, r = 0.32), and elevated HbA1C > 8% (P = 0.038, r = 0.33). Higher lipid values were associated with poorer carotid artery distensibility (P > 0.05) and higher carotid artery intimomedial thickness (cIMT) (P < 0.05 for cholesterol and LDL). Hyperglycemia adversely affected ejection fractions, though serum lipids did not show any significant effect on left ventricular parameters. Conclusions. Dyslipidemia and hyperglycemia can serve as biomarkers for cardiovascular dysfunction in at-risk adolescents with type 1 diabetes. Carotid artery parameters are adjunctive tools which may be affected early in the course of macrovascular disease.
  • 13.

    【2hr】Hearing and Neurological Impairment in Children with History of Exchange Transfusion for Neonatal Hyperbilirubinemia

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    机译 新生儿高胆红素血症换血病史患儿的听力和神经功能障碍
    摘要：The objective was to determine frequency of sensorineural hearing loss (SNHL), identified by abnormal threshold in evoked potentials, absence of otoacoustic emissions and behavioral responses, auditory neuropathy (AN) (absence of evoked potentials, with preservation of otoacoustic emissions), and neurological comorbidity in infants with hyperbilirubinemia (HB) treated with exchange-transfusion (ET). From a total of 7,219 infants, ET was performed on 336 (4.6%). Inclusion criteria were fulfilled in 102; 234 children did not meet criteria (182 outside of the study period, 34 did not have complete audiological evaluation, and 18 rejected the followup). Thirty-five children (34%) were born at-term and 67 (66%) were preterm. Children had a mean age of 5.5 ± 3.9 years. Main causes of ET were Rh isoimmunization in 48 (47%), ABO incompatibility in 28 (27.5%), and multifactorial causes in 26 (25.5%). Fifteen (15%) children presented with SNHL. Preterm newborns presented more often with SNHL. Indirect bilirubin level was higher in children with SNHL (22.2 versus 18.7 mg/dL, P = 0.02). No cases of AN were documented. An increased risk of neurologic sequelae was observed in children with SNHL. In conclusion, we disclosed a high frequency of SNHL in children with neonatal HB and ET and neurological alterations. No cases of AN were observed.
  • 14.

    【2hr】Neonatal Thrombocytopenia after Perinatal Asphyxia Treated with Hypothermia: A Retrospective Case Control Study

    包量

    机译 低温治疗围产期窒息后新生儿血小板减少症：回顾性病例对照研究
    摘要：Our objective was to estimate the effect of therapeutic hypothermia on platelet count in neonates after perinatal asphyxia. We performed a retrospective case control study of all (near-) term neonates with perinatal asphyxia admitted between 2004 and 2012 to our neonatal intensive care unit. All neonates treated with therapeutic hypothermia were included in this study (hypothermia group) and compared with a historic control group of neonates with perinatal asphyxia treated before introduction of therapeutic hypothermia (2008). Primary outcome was thrombocytopenia during the first week after birth. Thrombocytopenia was found significantly more often in the hypothermia group than in the control group, 80% (43/54) versus 59% (27/46) (P = .02). The lowest mean platelet count in the hypothermia group and control group was 97 × 109/L and 125 × 109/L (P = .06), respectively, and was reached at a mean age of 4.1 days in the hypothermia group and 2.9 days in the control group (P < .001). The incidence of moderate/severe cerebral hemorrhage was 6% (3/47) in the hypothermia group versus 9% (3/35) in the control group (P = .64). In conclusion, neonates with perinatal asphyxia treated with therapeutic hypothermia are at increased risk of thrombocytopenia, without increased risk of cerebral hemorrhage.
  • 15.

    【2hr】The Effect of Probiotics on Childhood Constipation: A Randomized Controlled Double Blind Clinical Trial

    包量

    机译 益生菌对儿童便秘的影响：一项随机对照双盲临床试验
    摘要：Background. Inconsistent data exist about the role of probiotics in the treatment of constipated children. The aim of this study was to investigate the effectiveness of probiotics in childhood constipation. Materials and Methods. In this placebo controlled trial, fifty-six children aged 4–12 years with constipation received randomly lactulose plus Protexin or lactulose plus placebo daily for four weeks. Stool frequency and consistency, abdominal pain, fecal incontinence, and weight gain were studied at the beginning, after the first week, and at the end of the 4th week in both groups. Results. Forty-eight patients completed the study. At the end of the fourth week, the frequency and consistency of defecation improved significantly (P = 0.042 and P = 0.049, resp.). At the end of the first week, fecal incontinence and abdominal pain improved significantly in intervention group (P = 0.030 and P = 0.017, resp.) but, at the end of the fourth week, this difference was not significant (P = 0.125 and P = 0.161, resp.). A significant weight gain was observed at the end of the 1st week in the treatment group. Conclusion. This study showed that probiotics had a positive role in increasing the frequency and improving the consistency at the end of 4th week.
  • 16.

    【2hr】IVIG Effects on Erythrocyte Sedimentation Rate in Children

    包量

    机译 IVIG对儿童红细胞沉降率的影响
    摘要：Background. Erythrocyte sedimentation rate (ESR) is a valuable laboratory tool in evaluation of infectious, inflammatory, and malignant diseases. Red blood cells in outside from the body precipitate due to their higher density than the plasma. In this study we discuss the IVIG effect on ESR in different diseases and different ages. Methods and Materials. Fifty patients under 12 years old who had indication to receive IVIG enrolled in this study. Total dose of IVIG was 2 gr/kg (400 mg/kg in five days or 2 gr/kg in single dose). ESR before infusion of IVIG and within 24 hours after administration of the last dose of IVIG was checked. Results. 23 (46%) patients were males and 27 (54%) were females. The mean of ESR before IVIG was 31.8 ± 29.04 and after IVIG it was 47.2 ± 36.9; this difference was meaningful (P = 0.05). Results of ESR changes in different age groups, 6 patients less than 28 days, 13 patients from 1 month to 1 year, 20 patients from 1 to 6 years old, and 11 patients from 6 to 12 years have been meaningful (P = 0.001, P = 0.025, and P = 0.006, resp.). Conclusion. In patients who are receiving IVIG as a therapy, ESR increased falsely (noninflammatory rising); therefore use of ESR for monitoring of response to treatment may be unreliable. Although these results do not apply to neonatal group, we suggest that, in patients who received IVIG, interpretation of ESR should be used cautiously on followup.
  • 17.

    【2hr】Prevalence of Nocturnal Enuresis and Its Associated Factors in Primary School and Preschool Children of Khorramabad in 2013

    包量

    机译 2013年霍拉马巴德小学和学龄前儿童的夜间遗尿症患病率及其相关因素
    摘要：Background. Nocturnal enuresis refers to an inability to control urination during sleep. This study aimed to determine the prevalence of nocturnal enuresis and its associated factors in children in the city of Khorramabad. Materials and Methods. In this descriptive-analytic, cross-sectional study, 710 male and female children were divided into two groups with equal numbers. The samples were selected from the schools of Khorramabad using the multistage cluster and stratified random sampling methods based on the diagnostic criteria of DSM-IV. The data was analyzed using the logistic regression. Results. The results showed that 8% of the children had nocturnal enuresis, including 5.2% of primary nocturnal enuresis and 2.8% of secondary nocturnal enuresis. The prevalence of nocturnal enuresis in the boys (10.7%) was higher compared with that in the girls (5.4%) (P = 0.009). There were statistically significant relationships between nocturnal enuresis and history of nocturnal enuresis in siblings (P = 0.023), respiratory infections (P = 0.036), deep sleep (P = 0.007), corporal punishment at school (P = 0.036), anal itching (P = 0.043), and history of seizures (P = 0.043). Conclusion. This study showed that the prevalence of nocturnal enuresis in the boys was higher compared with that in the girls.
  • 18.

    【2hr】Bacterial Pathogens and Antimicrobial Resistance Patterns in Pediatric Urinary Tract Infections: A Four-Year Surveillance Study (2009–2012)

    包量

    机译 小儿尿路感染中的细菌病原体和抗菌素耐药性模式：四年监测研究（2009-2012年）
    摘要：The aims of this study were to assess the common bacterial microorganisms causing UTI and their antimicrobial resistance patterns in Bandar Abbas (Southern Iran) during a four-year period. In this retrospective study, samples with a colony count of ≥105 CFU/mL bacteria were considered positive; for these samples, the bacteria were identified, and the profile of antibiotic susceptibility was characterized. From the 19223 samples analyzed, 1513 (7.87%) were positive for bacterial infection. UTI was more frequent in male (54.9%). E. coli was reported the most common etiological agent of UTI (65.2%), followed by Klebsiella spp. (26%), Pseudomonas aeruginosa (3.6%), and Staphylococcus coagulase positive (3.7%). Results of antimicrobial susceptibility analysis for E. coli to commonly used antibiotics are as follows: Amikacin (79.7%), Ofloxacin (78.3%), Gentamicin (71.6%), Ceftriaxone (41.8), Cefotaxime (41.4%), and Cefixime (27.8%). Empirical antibiotic selection should be based on awareness of the local prevalence of bacterial organisms and antibiotic sensitivities rather than on universal or even national guidelines. In this study, Amikacin and Gentamicin were shown to be the most appropriate antibiotics for empiric therapy of pyelonephritis, but empirical therapy should only be done by specialist physicians in cases where it is necessary while considering sex and age of children.
  • 19.

    【2hr】2-Year BMI Changes of Children Referred for Multidisciplinary Weight Management

    包量

    机译 多学科体重管理的儿童两年BMI变化
    摘要：Objective. To examine body mass index (BMI) changes among pediatric multidisciplinary weight management participants and nonparticipants. Design. In this retrospective database analysis, we used multivariable mixed effect models to compare 2-year BMI z-score trajectories among 583 eligible overweight or obese children referred to the One Step Ahead program at the Boston Children's Primary Care Center between 2003 and 2009. Results. Of the referred children, 338 (58%) attended the program; 245 (42%) did not participate and were instead followed by their primary care providers within the group practice. The mean BMI z-score of program participants decreased modestly over a 2-year period and was lower than that of nonparticipants. The group-level difference in the rate of change in BMI z-score between participants and nonparticipants was statistically significant for 0–6 months (P = 0.001) and 19–24 months (P = 0.008); it was marginally significant for 13–18 months (P = 0.051) after referral. Younger participants (<5 years) had better outcomes across all time periods examined. Conclusion. Children attending a multidisciplinary program experienced greater BMI z-score reductions compared with usual primary care in a real world practice; younger participants had significantly better outcomes. Future research should consider early intervention and cost-effectiveness analyses.
  • 20.

    【2hr】Do Maternal Quality of Life and Breastfeeding Difficulties Influence the Continuation of Exclusive Breastfeeding?

    包量

    机译 孕产妇的生活质量和母乳喂养困难是否会影响纯母乳喂养的持续性？
    摘要：Objectives. This study was conducted to determine whether maternal quality of life (QOL) and breastfeeding difficulties influence the continuation of exclusive breastfeeding (EBF). Methods. In a survey, 358 consecutive pregnant women filled out a quality of life questionnaire in the third trimester of pregnancy and the breastfeeding experience scale at 4 weeks postpartum. We assessed breastfeeding practices every month up to 6 months postpartum. Results. Only 11.8% of women continued EBF at six months. Mothers who continued EBF at 2 and 4 months postpartum had better QOL in late pregnancy than mothers who discontinued it (P < 0.05). There were no significant differences between the two groups in QOL scores at 6 months postpartum. Mothers who continued EBF at 2 months postpartum experienced less breastfeeding difficultties during one month postpartum than mothers who discontinued it (P < 0.05). Conclusion. In attempts to promote EBF, mothers with poor QOL or breastfeeding difficulties in early postpartum should be identified and helped.
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