Clinical Pediatrics最新文献

Excess screen time is an emerging hazard to physical and mental well-being of children. This observational cross-sectional study aimed to assess and compare knowledge regarding screen exposure guidelines among 100 mothers and 150 primigravida antenatal women (AW) using a questionnaire framed based on the Indian Academy of Paediatrics parental guidelines. Only 16% of mothers and none among the AW exhibited good knowledge while 48% of mothers and 79.3% of AW demonstrated poor knowledge (p = .01). Mothers showed higher awareness regarding the minimum permissible age to introduce social media platforms, whereas AW exhibited a higher knowledge regarding ill effects of excess screen use on mental health and physical ill effects like obesity. Women from both groups were unaware of the minimal permissible age to introduce screens and the signs of mobile phone addiction. This emphasizes the need for targeted educational intervention for mothers and AW to promote healthy screen habits among children.

Lysosomal dysfunction in Gaucher disease (GD) leads to inflammation, impaired cellular homeostasis, and disrupted autophagy. The alteration in immune system and the pro-inflammatory state in GD involves in the pathogenesis of the disease with increased levels of cytokines and chemokines. In this study, we aimed to analyze immunological abnormalities and association with HLA alleles in GD patients. Whole blood count, lyso-Gb3 levels, and immunological status were evaluated. A total of 13 patients confirmed to have GD were enrolled in our study. The most common positive antibody was anti-CCP and ANA. Only one patient's HLA profile was predisposing to autoimmune disease but had no clinical findings. None of the patients had symptoms of any related diseases with detected immunological markers. In our study, clinical status of GD or HLA alleles were not associated with positive markers of autoimmune diseases. Further studies are needed to elucidate inflammatory mechanism in GD.

Commercial blenderized formula for children dependent on feeding tubes is becoming increasingly popular. We aimed to determine if these formula provide complete nutrition for children. We compared the nutrient composition of popular commercial blenderized tube feeds to the Dietary Reference Intake (DRI) for age. We analyzed 3 brands: Compleat Pediatric, Real Food Blends, and Nourish. For children consuming a standard volume, all blenderized tube feeds met macronutrient requirements. None met all the fiber and micronutrient requirements with important deficiencies in vitamin D, calcium, B vitamins, and iron. Deficiencies were common in nonfortified feeds like Real Food Blends. There were micronutrients above the tolerable upper limits, especially in young children, in fortified feeds like Compleat and Nourish. No currently available commercial blenderized tube feeds provide complete nutrition for children compared to DRI for age. Physicians should be aware of possible deficiencies and/or toxicities associated with their long-term use.

Growing pains (GPs) are non-inflammatory pain syndromes affecting children aged 4 to 14 years. This case-control study aims to investigate the role of vitamin D deficiency in GP development. The study was conducted for 6 months. Healthy children without a history of GP were recruited as control subjects. Serum concentrations of calcium, phosphate, and alkaline phosphatase were measured. Vitamin D3 supplementation was administered to those identified with deficient or insufficient 25-hydroxyvitamin D (25-OHD). A total of 95.6% of the GP group and 93.3% of the control group had insufficient or deficient 25-OHD levels. No significant correlations for serum calcium, serum phosphate, and alkaline phosphatase with 25-OHD level in either group. Children with sufficient 25-OHD also experienced similar reduction in pain as those who received supplementation. The study found no significant difference in vitamin D levels between children with GP and those without.

This study aimed to investigate the clinical features of Escherichia coli (E coli)-induced pediatric pyogenic meningitis and analyze the risk factors for imaging abnormalities. These findings provide evidence for early diagnosis and treatment to improve patient prognosis. A multicenter retrospective study was conducted, which included 321 confirmed cases of E coli meningitis. A total of 98.8% (317/321) of the patients had an age at onset of 1 year or younger. Imaging abnormalities were observed in 63.5% (202/318) of the patients and primarily included subdural effusion and/or abscess (28.9%), hydrocephalus or ventricular dilation (21.4%), and intracranial hemorrhage (18.9%). Multivariate logistic regression analysis revealed that initial cerebrospinal fluid (CSF) glucose concentration (odds ratio [OR] = 0.758, 95% confidence interval [CI] = 0.601-0.956, P = .019) and neurological symptom duration exceeding 1 week were independent risk factors for imaging abnormalities. Cerebrospinal fluid glucose levels and the duration of neurological symptoms are crucial indicators for assessing disease severity.

This study aimed to assess the factors affecting the daily subcutaneous insulin dose in children with newly diagnosed T1D. A retrospective file review of 85 children (≤18 years old) admitted to the hospital between 2020 and 2023 due to new onset T1D. Whereas total daily subcutaneous insulin dose (TDD) on the first day 1.3 ± 0.16 u/kg/day, it was 0.81 ± 0.28 u/kg/day on the last day. Total daily subcutaneous insulin dose on the first day was significantly higher in patients presenting with diabetic ketoacidosis (DKA) than in those presenting with ketosis and hyperglycemia (1.41 ± 0.14 u/kg/day and 1.19 ± 0.18 u/kg/day respectively). The three groups had similar TDD on the last day. The multiple linear regression analysis identified pH at admission and body weight as parameters affecting TDD. Our results support the high insulin requirement that continues after switching to subcutaneous treatment with the severity of acidosis. Therefore, subcutaneous insulin dose should be adjusted according to presentation characteristics.

This study aimed to determine the mental health needs of mothers of children with Down syndrome, identify their access to mental health support along with the barriers. The study included 64 mothers of children diagnosed with Down syndrome, aged 0 to 42 months. State-Trait Anxiety Scale 1 (STAI-1), Trait Anxiety Scale 2 (STAI-2), and Epidemiologic Studies Depression Scale (CES-D) were administered. According to the STAI-1, 82.8% of mothers exhibited elevated levels of anxiety, while the STAI-2 revealed that 76.6% experienced elevated anxiety. The CES-D indicated that 37.5% of mothers exhibited symptoms of depression. Among the participants, 43.8% expressed the greatest need for support when receiving their child's diagnosis. Additionally, 57.8% of the mothers preferred meeting with families facing similar challenges as the most suitable approach. It was found that 82.8% of the mothers cited acceptance of the disease according to their religious beliefs as the most common barrier to accessing support.

37 cases of Mycoplasma pneumoniae pneumonia were diagnosed in children in North Dakota, over 3.5 months (35 by PCR); 44% harbored macrolide-resistance. Children with macrolide-resistant M. pneumoniae had a longer period of coughing prior to diagnosis (+ 3.9 days, p=0.048), a longer duration of illness (+ 5.4 days, p=0.011) and earlier resolution of fever after initiation of doxycycline (- 0.92 days, p=0.025) compared to those without macrolide resistant M. pneumoniae.

Psychosocial screening is inconsistently administered in pediatric primary care and rarely includes older children. This cross-sectional study compares screening outcomes from and interventions related to expanded use of the safe environment for every kid (SEEK) approach in children aged 0 to 17 versus the usual application to families with children under 5. Caregivers (N = 450) of children aged 0 to 17 years completed screening between April and December 2021. Screening results were compared across 3 age categories (0-5, 6-11, and 12-17) using the exact binomial method and Fisher's exact test. The prevalence of problems was similar across all age groups except for stress (P < .001) and substance misuse (P = .002). Publicly insured families had higher rates of identified problems versus privately insured families for stress (P = .035) and partner violence (P = .031). Interventions for positive screens were offered for 61% of participants. Expanded SEEK screening enables increased detection of social needs and offerings of resources for all ages and insurance types.