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Siblings With Abnormal Thyroid Function Tests. 兄弟姐妹甲状腺功能检查异常
IF 1 4区 医学 Q3 PEDIATRICS Pub Date : 2024-12-20 DOI: 10.1177/00099228241304511
Savanna Gornisiewicz, Aleeza Kessler, Kristin Dayton
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引用次数: 0
Resistance to Epoetin-Stimulating Agents in Children Receiving Renal Replacement Therapy. 接受肾脏替代治疗的儿童对催卵素刺激药物的耐药性。
IF 1 4区 医学 Q3 PEDIATRICS Pub Date : 2024-12-17 DOI: 10.1177/00099228241299893
Mehtap Kaya, Neslihan Cicek, Sercin Guven, Harika Alpay, Ibrahim Gokce

The incidence of anemia increases with the stage of chronic kidney disease (CKD). Erythropoietin (EPO) deficiency is a common cause of anemia in CKD. Erythropoietin-stimulating agents (ESAs) are the mainstay of the treatment. Treatment can be challenging due to erythropoietin resistance (ER), which can be assessed using the erythropoietin resistance index (ERI). Our aim was to investigate the factors contributing to high ERI levels in children receiving renal replacement therapy (RRT). Thirty-three children receiving RRT for at least 3 months were included. The mean ERI value was 15.7 IU/kg/w/g/dL. A significant association was observed between serum phosphorus levels and ERI (P = .016, r = 0.41). The mean parathormone (PTH) level was also higher in the high ERI group (599 ± 351 vs 392 ± 320 pg/mL, P = .088). An association, approaching statistical significance, was found between ERI and hypertension (P = .06, r = 0.32). Our study indicated a potential relationship between hyperphosphatemia, possibly secondary hyperparathyroidism, and ERI in children undergoing RRT.

随着慢性肾脏疾病(CKD)的分期,贫血的发生率增加。促红细胞生成素(EPO)缺乏是CKD中贫血的常见原因。促红细胞生成素(ESAs)是主要的治疗方法。由于红细胞生成素耐药(ER),治疗可能具有挑战性,可使用红细胞生成素耐药指数(ERI)进行评估。我们的目的是调查在接受肾脏替代治疗(RRT)的儿童中导致高ERI水平的因素。纳入33名接受RRT治疗至少3个月的儿童。平均ERI值为15.7 IU/kg/w/g/dL。血清磷水平与ERI之间存在显著相关性(P = 0.016, r = 0.41)。高ERI组的平均甲状旁腺激素(PTH)水平也较高(599±351 vs 392±320 pg/mL, P = 0.088)。ERI与高血压之间存在接近统计学意义的关联(P = 0.06, r = 0.32)。我们的研究表明,在接受RRT的儿童中,高磷血症(可能是继发性甲状旁腺功能亢进)与ERI之间存在潜在的关系。
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引用次数: 0
Publicly Insured Hispanic Families' Perspectives on Well-Being and Challenges During the COVID-19 Pandemic. 公共保险西班牙裔家庭对COVID-19大流行期间的福祉和挑战的看法。
IF 1 4区 医学 Q3 PEDIATRICS Pub Date : 2024-12-17 DOI: 10.1177/00099228241306861
Julia Krantz, Ladawna Gievers, Lillya Roldan, Sheevaun Khaki, Tina Burdsall

Previous studies have identified negative impacts of the COVID-19 pandemic on the mental and physical health of children in the United States, including exacerbation of previously existing disparities according to income, race, and ethnicity. However, a knowledge gap exists regarding the experience of minority families who were disproportionately affected by the pandemic. This qualitative study explores publicly insured Hispanic families' experiences with school, physical, and sedentary activities and overall health and well-being during the pandemic and subsequent lifting of stay-at-home orders. Fourteen (7 Spanish-speaking, 7 English-speaking) caregivers participated in semi-structured, language-concordant telephone interviews. Through an iterative coding process, this study identified 3 thematic categories: (1) challenges with virtual learning, (2) changes in children's activity, and (3) resilience and silver linings. Minority populations suffered substantial morbidity and mortality in the United States, and so their experiences are critical as we document the significant impacts of the global pandemic on underserved populations.

之前的研究已经确定了COVID-19大流行对美国儿童身心健康的负面影响,包括加剧了先前存在的收入、种族和民族差异。然而,对于受这一流行病影响特别严重的少数民族家庭的经历,存在着知识差距。本定性研究探讨了公共保险西班牙裔家庭在大流行期间和随后解除居家令期间在学校、体育和久坐活动以及整体健康和福祉方面的经历。14名护理人员(7名说西班牙语,7名说英语)参加了半结构化、语言一致的电话访谈。通过迭代编码过程,本研究确定了3个主题类别:(1)虚拟学习的挑战,(2)儿童活动的变化,以及(3)弹性和一线希望。在美国,少数民族人口的发病率和死亡率都很高,因此,他们的经历对于我们记录全球流行病对服务不足人口的重大影响至关重要。
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引用次数: 0
Evaluation of the Impact of Enteral Nutrition Support on Anthropometric Measurements and Micronutrient Levels in Malnourished Children. 评估肠内营养支持对营养不良儿童人体测量和微量营养素水平的影响。
IF 1 4区 医学 Q3 PEDIATRICS Pub Date : 2024-12-11 DOI: 10.1177/00099228241303595
Hanife Ayşegül Arsoy, Günel Aghazada, Zeliha Demirtaş, Alihan Sürsal, Maide Nur Paksoy Korkudur, Fatih Ozdener

Background: Malnutrition is a critical clinical condition that requires early intervention due to its potential for causing preventable fatalities and complications. This study aims to assess the impact of outpatient enteral nutrition support (ENS) as a therapeutic intervention on anthropometric measurements, intolerance, and micronutrient values in malnourished children.

Methods: This observational study included 344 patients in ages 1 to 18 treated with standard enteral nutrition (1.5 kcal/mL energy with fiber). Patient data recorded at admission, in 3 and 6 months, including weight, height, body mass index (BMI), intolerance symptoms, and micronutrient levels. Data were also compared by age groups (1-2, 3-5, 6-12, and 13-18 years of age).

Results: Malnutrition was prevalent in the 1- to 5-year age group (63.6%). Age-based analysis showed significant height and BMI z-score improvement in all age groups (P = .009 and P < .001, for all age groups, respectively), except the 13- to 18-year age group (P = .102 and P = .091, respectively). Micronutrient values remained within healthy ranges with minimal fluctuations. The ENS was well tolerated by 62.5% of patients, and the most common intolerance symptoms were constipation (15.4%), vomiting (8.1%), and nausea (7.3%).

Conclusion: This study demonstrates that outpatient ENS therapy for 6 months significantly improved anthropometric measurements in malnourished children and was well tolerated. The 1 to 2 age group exhibited the most substantial response to treatment, whereas the 1 to 5 age group required at least 6 months of nutritional therapy to prevent stunting. However, the effect of ENS therapy on height and BMI z-scores in the 13 to 18 age group appeared insufficient after 3 months.

背景:营养不良是一种严重的临床状况,由于其可能导致可预防的死亡和并发症,需要早期干预。本研究旨在评估门诊肠内营养支持(ENS)作为一种治疗干预对营养不良儿童人体测量、不耐受和微量营养素值的影响。方法:本观察性研究纳入344例年龄在1至18岁的患者,采用标准肠内营养(1.5 kcal/mL能量和纤维)治疗。入院时、3个月和6个月记录患者数据,包括体重、身高、体重指数(BMI)、不耐受症状和微量营养素水平。数据还按年龄组(1-2岁、3-5岁、6-12岁和13-18岁)进行比较。结果:1 ~ 5岁儿童营养不良发生率为63.6%。基于年龄的分析显示,除13- 18岁年龄组(P = 0.102和P = 0.091)外,所有年龄组的身高和BMI z-score均有显著改善(P = 0.009和P < 0.001,分别为所有年龄组)。微量营养素值保持在健康范围内,波动最小。62.5%的患者对ENS耐受性良好,最常见的不耐受症状是便秘(15.4%)、呕吐(8.1%)和恶心(7.3%)。结论:本研究表明,门诊ENS治疗6个月可显著改善营养不良儿童的人体测量值,且耐受性良好。1至2岁年龄组对治疗反应最明显,而1至5岁年龄组需要至少6个月的营养治疗以防止发育迟缓。然而,3个月后,ENS治疗对13 ~ 18岁年龄组的身高和BMI z评分的影响不足。
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引用次数: 0
Use of Standardized Dosing Sheets in Pediatric Emergency Care: Experience in a Third-Level Hospital. 标准化给药单在儿科急诊护理中的应用:某三甲医院的经验
IF 1 4区 医学 Q3 PEDIATRICS Pub Date : 2024-12-11 DOI: 10.1177/00099228241301842
Júlia Serralabós-Ferré, Fatima Castillo-Gomez, Mireia Sensarrich-Roset, Irene Barceló-Carceller, Xoan Gonzalez-Rioja

Objectives: Medication errors are one of the main causes of avoidable injuries in health care. With the aim of reducing them, a set of sheets with precalculated doses (by weight intervals) and preparation guidelines of the most common drugs in emergencies (Farmacards) was implemented in a Pediatric Emergency Department, replacing the previous manual calculation system. The aim of the study is to assess the staff's perception of safety and usefulness of the new dosing system.

Study design: Pre-post intervention comparative analysis was performed by distributing an opinion questionnaire to pediatric emergency department staff in 2017 (manual calculation in situ) and 2023 (Farmacards). We obtained 60 and 55 responses, respectively, and analyzed the characteristics of the sample and the perception of the new method.

Results: Five years after its introduction, 88.5% were aware of its existence, 86.9% knew where to find it, and 76% used it "always or almost always" for critically ill patients. Greater use was observed among personnel with more years of work experience (Spearman, P = .057) and among nurses (Mann-Whitney, P < .001). The new method improved the level of perceived safety, especially for nurses (Mann-Whitney, P = .008).

Conclusions: Standardized medication dosing systems in emergency situations aim to reduce medical errors and minimize iatrogenesis, participating in safety culture. According to the results of our study, the implementation of Farmacards shows a good acceptance by the staff and in the perception of patient safety, which is a good starting point to further optimize the quality of care. specialties: emergency medicine, general pediatrics, toxicology, and critical care.

目的:用药错误是卫生保健中可避免伤害的主要原因之一。为了减少这种情况,在儿科急诊科实施了一套预先计算剂量(按重量间隔)和紧急情况下最常用药物制备指南的表格(Farmacards),取代了以前的人工计算系统。这项研究的目的是评估工作人员对新给药系统的安全性和实用性的看法。研究设计:2017年(现场人工计算)和2023年(Farmacards)分别向儿科急诊科工作人员发放意见问卷,进行干预前后对比分析。我们分别获得了60和55个回复,并分析了样本的特征和对新方法的感知。结果:引入五年后,88.5%的人知道它的存在,86.9%的人知道在哪里可以找到它,76%的人“总是或几乎总是”使用它来治疗危重病人。在工作经验较长的人员(Spearman, P = 0.057)和护士(Mann-Whitney, P < 0.001)中观察到更多的使用。新方法提高了感知安全水平,特别是对护士而言(Mann-Whitney, P = 0.008)。结论:在紧急情况下,标准化的给药系统旨在减少医疗差错,最大限度地减少医源性,参与安全文化。根据我们的研究结果,Farmacards的实施显示出良好的员工接受度和患者对安全的感知,这是进一步优化护理质量的良好起点。专长:急诊医学、普通儿科、毒理学、重症监护。
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引用次数: 0
Enterovirus and Paraechovirus Meningitis in Neonates: Which Is the Difference? 新生儿肠道病毒和副粘病毒脑膜炎:二者有何区别?
IF 1 4区 医学 Q3 PEDIATRICS Pub Date : 2024-12-01 Epub Date: 2024-03-04 DOI: 10.1177/00099228241235448
Simonetta Picone, Vito Mondì, Federico Di Palma, Maria Beatrice Valli, Martina Rueca, Manuela Bedetta, Piermichele Paolillo

Enterovirus (EV) and parechovirus (HPeV) are common viruses in the neonatal period, with similar seasonality and symptomatology. They also are the main causes of aseptic meningitis in newborns and children under 1 year of age. We compared the clinical signs, laboratory data, brain, and neurodevelopmental outcome of 10 infants with HPeV and 8 with EV meningitis. In patients with EV meningitis, serum C-reactive protein (CRP) values were significantly higher than those of patients with HPeV infection. Procalcitonin values were low in both groups. White blood cell (WBC) and lymphocyte values were significantly higher in EV patients. None of the infants had a brain lesion on cerebral ultrasound neither negative neurological outcome. Based solely on symptoms, it is not possible to distinguish HPeV from EV infection. C-reactive protein, WBC, and lymphocyte values might allow the physician to assume EV infection. The gold standard test for diagnosis remains real-time polymerase chain reaction on cerebral spinal fluid.

肠道病毒(EV)和细小病毒(HPeV)是新生儿期常见的病毒,具有相似的季节性和症状。它们也是新生儿和 1 岁以下儿童无菌性脑膜炎的主要病因。我们比较了 10 例 HPeV 婴儿和 8 例 EV 脑膜炎婴儿的临床症状、实验室数据、大脑和神经发育结果。在EV脑膜炎患者中,血清C反应蛋白(CRP)值明显高于HPeV感染患者。两组患者的降钙素原值均较低。EV患者的白细胞(WBC)和淋巴细胞值明显较高。没有一名婴儿在脑部超声波检查中发现脑部病变,神经系统结果也不乐观。仅凭症状无法区分 HPeV 和 EV 感染。C反应蛋白、白细胞和淋巴细胞的数值可能会让医生认为是 EV 感染。诊断的金标准检测仍然是脑脊液实时聚合酶链反应。
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引用次数: 0
Acute Abdominal Pain: Not Always So Obvious. 急性腹痛:并不总是那么明显。
IF 1 4区 医学 Q3 PEDIATRICS Pub Date : 2024-12-01 Epub Date: 2024-03-16 DOI: 10.1177/00099228241235447
Inês Alexandra Azevedo, Rosa Cardoso, Pedro Portugal, Cláudia Almeida, Catarina Matos de Figueiredo, Magalys Pereira
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引用次数: 0
A Case of Respiratory Distress in a Newborn. 一例新生儿呼吸窘迫病例
IF 1 4区 医学 Q3 PEDIATRICS Pub Date : 2024-12-01 Epub Date: 2024-03-21 DOI: 10.1177/00099228241240194
Eleanor J Scalone, Andrea D Triplett
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引用次数: 0
The Impact of Environmental Externalities on Pediatric Dermatologic Conditions. 环境外部因素对儿科皮肤病的影响。
IF 1 4区 医学 Q3 PEDIATRICS Pub Date : 2024-12-01 Epub Date: 2024-03-30 DOI: 10.1177/00099228241241385
Alexandra Ola Baczynski, Wendy E Kim
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引用次数: 0
The Gap Between What Parents Need and How Pediatric Primary Care Providers Can Help Families of Children With Special Education Needs. 家长需求与儿科初级保健提供者如何帮助有特殊教育需求儿童的家庭之间的差距。
IF 1 4区 医学 Q3 PEDIATRICS Pub Date : 2024-12-01 Epub Date: 2024-02-29 DOI: 10.1177/00099228241234702
Michelle L Stransky, Alexandra van Waes, Ivys Fernandez-Pastrañ A, Hilana Scott, Soukaina Adolphe

We describe the gap between parents' special education needs and pediatric primary care providers' (PCPs) ability to address those needs from a mixed-methods study at a safety-net hospital. We conducted qualitative interviews with English- and Spanish-speaking parents (n = 25) and PCPs (n = 11) about special education knowledge and experience and interactions with a primary care-embedded special education clinic. PCPs also answered survey questions on these topics. Parents reported four challenges: (1) knowing where to start and how to advocate for their youth, (2) being heard or having a say, (3) using the "right" language, and (4) gathering information on special education resources. Primary care providers disclosed three barriers: (1) training, (2) knowledge to assess the appropriateness of supports, and (3) time to address concerns. The gap between PCPs and parents was bridged by the special education clinic. Systematic interventions can ensure that PCPs help parents address the special education needs of their patients.

我们通过在一家安全网医院进行的一项混合方法研究,描述了家长的特殊教育需求与儿科初级保健提供者(PCPs)满足这些需求的能力之间的差距。我们对讲英语和西班牙语的家长(25 人)和初级保健医生(11 人)进行了定性访谈,内容涉及特殊教育知识和经验以及与初级保健嵌入式特殊教育诊所的互动。初级保健医生也回答了有关这些主题的调查问题。家长们报告了四项挑战:(1)知道从哪里开始以及如何为他们的孩子争取权益;(2)被倾听或有发言权;(3)使用 "正确的 "语言;(4)收集特殊教育资源信息。初级保健提供者指出了三个障碍:(1) 培训,(2) 评估支持是否适当的知识,(3) 解决问题的时间。特殊教育诊所弥补了初级保健医生和家长之间的差距。系统性干预措施可确保初级保健医生帮助家长解决病人的特殊教育需求。
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引用次数: 0
期刊
Clinical Pediatrics
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