Clinical Pediatrics最新文献

The quest for effective treatments for cerebral palsy (CP) remains a significant challenge, crucial for improving outcomes in affected individuals. This study aimed to evaluate the therapeutic effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) on lower limb function in children with hemiplegic cerebral palsy (HCP) through a controlled clinical trial. Forty children with HCP were randomly assigned to either a sham stimulation group or an rTMS treatment group, with 20 participants in each. The rTMS group received low-frequency rTMS in conjunction with conventional rehabilitation, while the sham group received sham stimulation paired with the same rehabilitation. Conventional rehabilitation included physical therapy, occupational therapy, orthopedic shoes, acupuncture, and other training modalities. Treatments were administered 5 days a week for 12 weeks. We assessed gross and fine motor skills, spasticity, and gait parameters before and after treatment using the modified Ashworth scale (MAS), dorsiflexion angle, gross motor function measure 88 (GMFM-88), Gesell developmental scale, and plantar pressure gait analysis. After 12 weeks, both groups exhibited improvements in MAS scores of the affected hamstring muscle, dorsiflexion angles, GMFM-88 D and E zone scores, Gesell developmental scale scores (gross motor), and gait parameters (P < .05). Notably, the rTMS group demonstrated significantly greater improvements (P < .05). Low-frequency rTMS combined with conventional rehabilitation therapy leads to better outcomes in gross and fine motor functions while reducing spasticity and improving gait parameters in children with HCP compared to sham stimulation.

This article reviews otitis media with effusion (OME) in children with cleft palate (CP), the current evidence and recommendations regarding management of OME in cleft palate with a focus on interdisciplinary communication, and the impact this condition has on patients and caregivers. OME is nearly ubiquitous in children with CP due to the anatomical variation of the palatal musculature and resultant Eustachian tube dysfunction. If untreated, OME can negatively affect hearing, speech development, cognitive development, and social integration. Patients with CP have the potential to be negatively impacted by the otologic, cognitive, and psychosocial consequences of untreated chronic OME if not actively managed for this condition. Multidisciplinary management, appropriate intervention, shared decision-making, and appropriate surveillance optimize the wellbeing, cognitive development, and social progression of CP patients with OME.

Acute gastroenteritis is one of the most common diseases causing pediatric hospitalization. We hypothesized that nursing guidance to families could enhance recovery and reduce hospitalization duration. A retrospective study analyzed electronic health records of acute gastroenteritis patients. T-tests and chi-square tests compared age, sex, and rotavirus detection between children hospitalized ≤3 days and >3 days. Data from 94 patients (mean age 4.22; 52.13% male) showed a rotavirus detection rate of 17.02%. The average nursing guidance interventions were 1.36. Guardians of children hospitalized ≤3 days received 1.05 instructions, compared with 1.88 for >3 days. A significant correlation (r = 0.4768, P < .05) was found between hospitalization duration and nursing guidance frequency. Nursing guidance on dietary and nutritional support may promote recovery and shorten hospital stays for pediatric gastroenteritis patients.

Immunoglobulin A vasculitis (IgAV) is a common immune complex-mediated systemic small vessel vasculitis in children. Gastrointestinal (GI) involvement significantly impacts early prognosis and may precede the appearance of purpura, complicating timely diagnosis. We retrospectively analyzed 195 cases of children diagnosed with IgAV from June 2019 to April 2024, among whom 62 cases had GI involvement. Clinical and laboratory data were collected. Children in the IgAV GI involvement group exhibited lower rates of arthritis/arthralgia and significantly higher levels of neutrophil-to-lymphocyte ratio (NLR) (P = .002, OR = 1.455), platelet count (P = .020, OR = 1.005), and uric acid (P = .017, OR = 1.005), with lower immunoglobulin G (IgG) (P = .004, OR = .818) levels. Multivariate analysis identified NLR, platelet count, uric acid, and IgG as independent predictors. The combined model showed good discrimination (area under the curve [AUC] = 0.753) and high specificity (93.2%). Elevated NLR, platelet count, uric acid, and reduced IgG are independent risk factors for GI involvement in pediatric IgAV and may facilitate early risk stratification.

This study evaluated the efficacy of terbutaline combined with Xiao'er Kechuanling in treating pediatric asthma and its effect on airway remodeling indicators. Eighty children were randomized into control (n = 40, terbutaline) and observation (n = 40, terbutaline + Xiao'er Kechuanling) groups, both receiving routine therapy. Clinical efficacy, adverse reactions, symptom relief time, lung function, and airway remodeling indices were compared. The observation group showed higher efficacy (χ² = 4.909, P = .027), higher FVC, FEV1, and FEV1/FVC (t = 2.161, 6.648, 2.980, all P < .05), shorter relief times for dyspnea, wheezing, and cough (t = 9.402, 3.276, 7.133, 4.481, all P < .05), and lower airway remodeling indices (t = 7.715, 5.829, 3.484, 5.023, all P < .001). Adverse reactions showed no difference (χ² = 0.103, P = .749). Terbutaline plus Xiao'er Kechuanling improved efficacy, lung function, and airway remodeling, accelerated symptom relief, and was well tolerated.

Following the COVID-19 pandemic, there has been a significant increase in the frequency and severity of adenoviral respiratory tract infections (RTIs). Differential diagnosis and prediction of their course can provide appropriate management for a favorable outcome. Here, we analyzed the clinical characteristics of children hospitalized with adenoviral RTIs to determine the factors predicting their severity. Of the 53 patients, 38 were included in the bronchopneumonia, 15 in the severe pneumonia group. The duration of fever before hospitalization was statistically shorter in the severe group (P = .034). The leukocyte count was within the normal range in all patients, C-reactive protein was above the normal range in 86.8%, but this had no relation with disease severity. Procalcitonin level was statistically significantly higher in the severe pneumonia group (P = .04). The codetection of Streptococcus pneumoniae and/or Haemophilus influenzae (64.2%) or other viruses (54.7%) in polymerase chain reaction (PCR) testing was not associated with severity of adenovirus RTIs.