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Gestational diabetes mellitus and the hearing of newborns:A nested case-control study in tropical province of China 妊娠期糖尿病与新生儿听力:中国热带省份的巢式病例对照研究。
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-08-03 DOI: 10.1016/j.ijporl.2024.112056
Xiaohua Li , Weizhen Bu , Xiaojing Hu , Tianhong Han , Yan Xuan

Objective

This study aims to determine the association of gestational diabetes mellitus (GDM) and the results of newborn hearing screening(NHS).

Methods

A nested case-control study was conducted in a cohort of newborns who were born between June 2021 to December 2021 and underwent neonatal hearing screening.GDM was diagnosed according to the 75 g 2 h oral glucose tolerance test (OGTT) at 24–28 gestational weeks.A total of 369 pregnant women at the same hospital were individually matched in a 1:2 ratio by maternal age (±2 years), gestational age (±3 days) and sex of newborn.Chi-square test was utilized to evaluate associations between GDM and the results of NHS.

Results

Abnormal NHS results in the GDM group was more frequent than non-GDM group.When comparing the two groups (GDM case and contol), we found significant differences (p < 0.05) between them.Whereas the difference was not statistically significant (p > 0.05) by delivery modes in both case and control groups.

Conclusion

Maternal history of GDM could lead to significantly higher failling rate of NHS.

研究目的本研究旨在确定妊娠期糖尿病(GDM)与新生儿听力筛查(NHS)结果之间的关联:方法:对2021年6月至2021年12月期间出生并接受新生儿听力筛查的新生儿进行了一项巢式病例对照研究。GDM根据孕周24-28周时的75克2小时口服葡萄糖耐量试验(OGTT)进行诊断。同一家医院的 369 名孕妇按产妇年龄(±2 岁)、胎龄(±3 天)和新生儿性别以 1:2 的比例进行了个体匹配:在比较两组(GDM 病例组和对照组)时,我们发现病例组和对照组的分娩方式存在显著差异(P 0.05):结论:有 GDM 病史的产妇会导致 NHS 的死亡率明显升高。
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引用次数: 0
Outcome of kinesio taping in drooling children: A systematic review 流口水儿童的肌动贴效果:系统综述。
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-08-03 DOI: 10.1016/j.ijporl.2024.112057
Jeyasakthy Saniasiaya , Graeme van der Meer , Ed C Toll

Introduction

Drooling is a troublesome condition, especially in children with neuromuscular and intellectual disability. Over the past decade, novel interventions have been trialled to alleviate drooling in the affected children. Kinesio tape (KT) application has shown promising results in controlling drooling in children. We reviewed the literature to determine the outcome of KT application in drooling children.

Methods

A literature search was conducted from January 1, 1990 to March 2024 by searching several databases over a 1-month period (April 2024) according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The primary outcome was defined as the success of the intervention determined by the improvement or resolution of symptoms, and the secondary outcome was determined by adjunct or repeated procedures and the presence of complications.

Results

Overall, 172 children from 10 studies were identified. All studies included are retrospective studies (Level III). This review included 172 children, with a mean age of 8.2 years (Male: 58.7 %). All included children had underlying comorbidities (100 %), with neurological disorders (77 %) being the most prevalent. KT application was performed predominantly over the orbicularis oris in 6 studies, 118 children[68.6 %], suprahyoid region in 3 studies, 45 children (26.2 %) and multiregion over the head and neck in 1 study of children (5.2 %). Drooling was assessed subjectively in all 100 % of children with objective measurement performed in 3 studies. KT was the only intervention in 40.7 % of the included children, whereas KT was performed in combination with oromotor therapy in 48 children, speech therapy in 44 children, and manipulation therapy in 10 children. All included children (100 %) reported improvement in drooling. No studies reported adverse reactions to KT application.

Conclusions

KT application is a safe, effective alternative for drooling children. The effect of KT, however, may be temporary. The quality of the evidence is inadequate to recommend widespread use of the intervention until a better-quality study has been completed. Future randomised controlled studies with a large sample size are warranted to determine the efficacy of this intervention among children.

简介流口水是一种令人头疼的症状,尤其是神经肌肉和智力残疾儿童。在过去的十年中,人们尝试了一些新的干预措施来缓解患儿流口水的症状。粘贴 Kinesio 胶带 (KT) 在控制儿童流口水方面取得了良好的效果。我们回顾了相关文献,以确定 KT 应用于流口水儿童的效果:根据《系统综述和元分析首选报告项目》(Preferred Reporting Items for Systematic Reviews and Meta-Analyses)指南,我们在 1 个月内(2024 年 4 月)检索了多个数据库,对 1990 年 1 月 1 日至 2024 年 3 月期间的文献进行了检索。主要结果定义为干预的成功与否,由症状的改善或缓解决定,次要结果由辅助或重复程序以及并发症的出现决定:结果:总共确定了 10 项研究中的 172 名儿童。所有纳入的研究均为回顾性研究(III 级)。本综述共纳入 172 名儿童,平均年龄为 8.2 岁(男性:58.7%)。所有纳入研究的儿童都有潜在的合并症(100%),其中神经系统疾病(77%)最为常见。有 6 项研究(118 名儿童[68.6%])主要在眼轮匝肌上使用 KT,有 3 项研究(45 名儿童[26.2%])主要在耳上区使用 KT,有 1 项研究(5.2%)主要在头颈部多区使用 KT。所有 100% 的患儿的流口水情况都是通过主观评估得出的,有 3 项研究进行了客观测量。在 40.7% 的纳入研究的儿童中,KT 是唯一的干预措施,而在 48 名儿童中,KT 与口腔运动疗法、44 名儿童的语言疗法和 10 名儿童的手法疗法结合使用。所有纳入研究的儿童(100%)均报告流口水情况有所改善。没有研究报告称使用 KT 会出现不良反应:结论:应用 KT 是治疗流口水儿童的一种安全、有效的替代方法。然而,KT 的效果可能是暂时的。在完成质量更高的研究之前,建议广泛使用该干预措施的证据不足。未来有必要进行大样本量的随机对照研究,以确定这种干预措施在儿童中的疗效。
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引用次数: 0
Survey of pharyngeal foreign bodies in Japan: An ecological study using the nationwide claims data 日本咽部异物调查:利用全国索赔数据进行生态研究
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-08-02 DOI: 10.1016/j.ijporl.2024.112055
Shintaro Tanaka , Kensuke Uraguchi , Etsuji Suzuki , Naomi Matsumoto , Munechika Tsumura , Shohei Fujimoto , Shotaro Miyamoto , Takashi Yorifuji , Mizuo Ando

Objective

Pharyngeal foreign bodies (PFBs) are a prevalent disease affected by food culture and dietary habits, with fish bones as the leading cause. Most studies were limited to specific regions, and a nationwide survey was not conducted in Japan. In this ecological study, we aimed to conduct a nationwide analysis of outpatient PFB cases in Japan over three years, focusing on seasonal trends, sex- and age-stratified cases, and regional differences.

Methods

We used the National Database of Health Insurance Claims and Specific Health Checkups of Japan open data from April 2019 to March 2022. The case data were analyzed by month, age, sex, and prefecture. Additionally, we calculated the standardized claim ratios (SCRs) for each prefecture and investigated the association between dietary habits, food culture, and SCR of PFBs using a two-level linear regression model.

Results

We analyzed a total of 164,337 outpatient PFB cases in Japan, revealing an average incidence rate of 45.6 per 100,000 persons. The seasonal trend revealed a peak in July each year from 2019 to 2021, confirming seasonality in PFB incidents. Children reported a higher incidence rate. Living west of Japan and expenditure on fish and shellfish had a strongly positive association with the SCR of PFBs.

Conclusion

Our nationwide survey reveals that, even within Japan, there were regional variations influenced by food culture and dietary habits. The data showed that PFB incidence was higher among children, highlighting the need for preventive education.

Level of evidence

Level 3.

目的咽部异物(PFB)是一种受饮食文化和饮食习惯影响的常见疾病,鱼刺是其主要病因。大多数研究仅限于特定地区,日本尚未开展全国性调查。在这项生态研究中,我们旨在对日本三年来的门诊 PFB 病例进行全国性分析,重点关注季节性趋势、按性别和年龄分层的病例以及地区差异。病例数据按月份、年龄、性别和都道府县进行了分析。此外,我们还计算了各都道府县的标准化索赔率(SCR),并使用两级线性回归模型研究了饮食习惯、饮食文化与 PFB SCR 之间的关联。季节性趋势显示,从 2019 年到 2021 年,每年 7 月都会出现发病高峰,这证实了 PFB 发病的季节性。儿童的发病率较高。我们的全国性调查显示,即使在日本国内,也存在受饮食文化和饮食习惯影响的地区差异。数据显示,PFB 在儿童中的发病率较高,这凸显了预防教育的必要性。
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引用次数: 0
The use of a computer-based program focused on the syllabic method to support early literacy in children with cochlear implants 使用以音节法为重点的计算机程序支持人工耳蜗植入儿童的早期识字。
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.ijporl.2024.112048
Marinella Majorano , Michela Santangelo , Irene Redondi , Chiara Barachetti , Elena Florit , Letizia Guerzoni , Domenico Cuda , Rachele Ferrari , Beatrice Bertelli

Background

Children with cochlear implants (CIs) often lag behind children with normal hearing (NH) in early literacy skills. Furthermore, the development of language skills associated with their emergent literacy skills seems to depend on good auditory access. Supporting language acquisition and early literacy in children with CIs may prevent difficulties in primary school. The use of technology may facilitate auditory and speech recovery in children with CIs, but evidence on computer-based early literacy programs is limited.

Objective

This study investigates (a) the effects of a computer-based program focusing on the syllabic method on the literacy skills of children with CIs (CIs group), comparing them with the literacy skills of a group of age-matched NH (normal hearing) peers (NHs group); (b) the associations between language and early literacy skills in the NHs group and between language, auditory and early literacy skills in the CIs group.

Method

Nine prelingually deaf children with CIs (M = 61.11, SD = 6.90) with severe to profound sensorineural hearing loss and nine age-matched NH children participated in the program. Categories of Auditory Performance (CAP) as measures of children's auditory skills were collected. All participants were tested on phonological, morphosyntax (grammatical comprehension and repetition), and early literacy skills (syllable blending and segmentation, syllable and word reading) (T1). Next, all children participated in the computer-based program for 12 weeks. After the program was completed (T2), only early literacy tests were administered to the children.

Results

Although, on average, both groups obtained higher scores in all literacy tasks at T2, the CIs group scored lower than the NHs group. In the CIs group, at T2 we found significant improvements in syllable segmentation (p = 0.042) and word reading (p = 0.035). In the NHs group, at T2 we found significant improvements in syllable segmentation (p = 0.034), syllable blending (p = 0.022), syllable reading (p = 0.008), and word reading (p = 0.009). We also found significant associations in both groups between measures of morphosyntax at T1 and measures of early literacy at T2. In addition, for the CIs group, we found significant associations between children's auditory performance at T1 and measures of morphosyntax at T1 and early literacy at T2.

Conclusion

a computer-based program focused on the syllabic method could support children with CIs in acquiring emergent literacy abilities. The auditory performance of children with CIs seems to influence their morphosyntax and later early literacy skills.

背景:植入人工耳蜗(CI)的儿童在早期识字能力方面往往落后于听力正常(NH)的儿童。此外,与其早期识字能力相关的语言技能的发展似乎取决于良好的听觉接触。支持听力障碍儿童的语言学习和早期识字可以避免他们在小学阶段遇到困难。技术的使用可促进植入式耳机儿童的听觉和语言恢复,但基于计算机的早期识字计划的证据却很有限:本研究调查:(a) 以音节法为重点的计算机程序对 CIs 儿童(CIs 组)识字能力的影响,并将其与一组年龄匹配的 NH(听力正常)同龄人(NHs 组)的识字能力进行比较;(b) NHs 组中语言和早期识字能力之间的关联,以及 CIs 组中语言、听觉和早期识字能力之间的关联:方法:9 名患有重度至极重度感音神经性听力损失的舌前聋儿童(中=61.11,标差=6.90)和 9 名年龄匹配的正常儿童参加了该项目。我们收集了听觉表现类别(CAP),作为衡量儿童听觉技能的标准。所有参与者都接受了语音、语法(语法理解和复述)和早期识字技能(音节混合和分割、音节和单词阅读)测试(T1)。接下来,所有儿童都参加了为期 12 周的电脑课程。课程结束后(T2),只对儿童进行早期识字测试:尽管在 T2 阶段,两组儿童在所有识字任务中的平均得分都较高,但 CIs 组的得分低于 NHs 组。在第二阶段,我们发现 CIs 组在音节分割(p = 0.042)和单词阅读(p = 0.035)方面有显著提高。在 NHs 组中,我们发现在 T2 阶段,音节分段 (p = 0.034)、音节混合 (p = 0.022)、音节阅读 (p = 0.008) 和单词阅读 (p = 0.009) 均有明显改善。我们还发现,在两个组别中,T1 阶段的形态语法测量与 T2 阶段的早期识字测量之间存在着明显的关联。此外,在 CIs 组中,我们还发现儿童在 T1 阶段的听觉表现与 T1 阶段的词法和 T2 阶段的早期识字能力之间存在显著关联。CI儿童的听觉表现似乎会影响他们的语法和日后的早期识字能力。
{"title":"The use of a computer-based program focused on the syllabic method to support early literacy in children with cochlear implants","authors":"Marinella Majorano ,&nbsp;Michela Santangelo ,&nbsp;Irene Redondi ,&nbsp;Chiara Barachetti ,&nbsp;Elena Florit ,&nbsp;Letizia Guerzoni ,&nbsp;Domenico Cuda ,&nbsp;Rachele Ferrari ,&nbsp;Beatrice Bertelli","doi":"10.1016/j.ijporl.2024.112048","DOIUrl":"10.1016/j.ijporl.2024.112048","url":null,"abstract":"<div><h3>Background</h3><p>Children with cochlear implants (CIs) often lag behind children with normal hearing (NH) in early literacy skills. Furthermore, the development of language skills associated with their emergent literacy skills seems to depend on good auditory access. Supporting language acquisition and early literacy in children with CIs may prevent difficulties in primary school. The use of technology may facilitate auditory and speech recovery in children with CIs, but evidence on computer-based early literacy programs is limited.</p></div><div><h3>Objective</h3><p>This study investigates (a) the effects of a computer-based program focusing on the syllabic method on the literacy skills of children with CIs (CIs group), comparing them with the literacy skills of a group of age-matched NH (normal hearing) peers (NHs group); (b) the associations between language and early literacy skills in the NHs group and between language, auditory and early literacy skills in the CIs group.</p></div><div><h3>Method</h3><p>Nine prelingually deaf children with CIs (<em>M</em> = 61.11, <em>SD</em> = 6.90) with severe to profound sensorineural hearing loss and nine age-matched NH children participated in the program. Categories of Auditory Performance (CAP) as measures of children's auditory skills were collected. All participants were tested on phonological, morphosyntax (grammatical comprehension and repetition), and early literacy skills (syllable blending and segmentation, syllable and word reading) (T1). Next, all children participated in the computer-based program for 12 weeks. After the program was completed (T2), only early literacy tests were administered to the children.</p></div><div><h3>Results</h3><p>Although, on average, both groups obtained higher scores in all literacy tasks at T2, the CIs group scored lower than the NHs group. In the CIs group, at T2 we found significant improvements in syllable segmentation (p = 0.042) and word reading (p = 0.035). In the NHs group, at T2 we found significant improvements in syllable segmentation (p = 0.034), syllable blending (p = 0.022), syllable reading (p = 0.008), and word reading (p = 0.009). We also found significant associations in both groups between measures of morphosyntax at T1 and measures of early literacy at T2. In addition, for the CIs group, we found significant associations between children's auditory performance at T1 and measures of morphosyntax at T1 and early literacy at T2.</p></div><div><h3>Conclusion</h3><p>a computer-based program focused on the syllabic method could support children with CIs in acquiring emergent literacy abilities. The auditory performance of children with CIs seems to influence their morphosyntax and later early literacy skills.</p></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The effect of central sleep apnea on sleep architecture in children with obstructive sleep apnea 中枢性睡眠呼吸暂停对阻塞性睡眠呼吸暂停儿童睡眠结构的影响。
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.ijporl.2024.112053
ChenXi Luo , WenBo Chen , Qi Li

Objective

This study aimed to investigate how central sleep apnea (CSA) impacts sleep patterns in children with obstructive sleep apnea (OSA).

Methods

Children undergoing polysomnography (PSG) were enrolled and sorted into two groups: those with OSA alone (Group A) and those with both OSA and CSA (CAI <1 nd: children with 10 % CSA or more and less than 50 %, Group B). Statistical analysis was conducted to compare sleep structure and clinical features between Group A and Group B.

Results

Group B exhibited significantly higher respiratory events, apnea hypoventilation index, apnea index and oxygen desaturation index (ODI) compared to Group A (p < 0.05). Group B also showed higher total sleep time and arousal index than Group A (P < 0.05). The proportion of time spent in stage N3 was lower in Group B than in Group A (P < 0.05). Moreover, mean heart rate and minimum heart rate were higher in Group B compared to Group A (P < 0.05).Minimum oxygenation levels (including non-rapid eye movement (NREM) stages) were lowe in Group B than in Group A (P < 0.05). Additionally, the prevalence of positional obstructive sleep apnea (P-OSA) was greater in Group B than in Group A (P < 0.05).

Conclusion

In comparison to those with OSA alone, children with OSA and concurrent CSA exhibited distinct sleep patterns, including reduced N3uration, higher arousal index, longer respiratory events, higher ODI, and lower oxygen saturation, higher heart rate.

研究目的本研究旨在探讨中枢性睡眠呼吸暂停(CSA)如何影响患有阻塞性睡眠呼吸暂停(OSA)的儿童的睡眠模式:方法:将接受多导睡眠图(PSG)检查的儿童分为两组:仅患有 OSA 的儿童(A 组)和同时患有 OSA 和 CSA 的儿童(CAI 结果):与 A 组相比,B 组的呼吸事件、呼吸暂停低通气指数、呼吸暂停指数和血氧饱和度指数(ODI)明显更高(p 结论:与单纯 OSA 患儿相比,CAI 患儿的呼吸事件、呼吸暂停低通气指数、呼吸暂停指数和血氧饱和度指数(ODI)明显更高:与单纯患有 OSA 的儿童相比,患有 OSA 并同时伴有 CSA 的儿童表现出不同的睡眠模式,包括 N3uration 降低、唤醒指数升高、呼吸时间延长、ODI 升高、血氧饱和度降低、心率升高。
{"title":"The effect of central sleep apnea on sleep architecture in children with obstructive sleep apnea","authors":"ChenXi Luo ,&nbsp;WenBo Chen ,&nbsp;Qi Li","doi":"10.1016/j.ijporl.2024.112053","DOIUrl":"10.1016/j.ijporl.2024.112053","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to investigate how central sleep apnea (CSA) impacts sleep patterns in children with obstructive sleep apnea (OSA).</p></div><div><h3>Methods</h3><p>Children undergoing polysomnography (PSG) were enrolled and sorted into two groups: those with OSA alone (Group A) and those with both OSA and CSA (CAI &lt;1 nd: children with 10 % CSA or more and less than 50 %, Group B). Statistical analysis was conducted to compare sleep structure and clinical features between Group A and Group B.</p></div><div><h3>Results</h3><p>Group B exhibited significantly higher respiratory events, apnea hypoventilation index, apnea index and oxygen desaturation index (ODI) compared to Group A (p &lt; 0.05). Group B also showed higher total sleep time and arousal index than Group A (P &lt; 0.05). The proportion of time spent in stage N3 was lower in Group B than in Group A (P &lt; 0.05). Moreover, mean heart rate and minimum heart rate were higher in Group B compared to Group A (P &lt; 0.05).Minimum oxygenation levels (including non-rapid eye movement (NREM) stages) were lowe in Group B than in Group A (P &lt; 0.05). Additionally, the prevalence of positional obstructive sleep apnea (P-OSA) was greater in Group B than in Group A (P &lt; 0.05).</p></div><div><h3>Conclusion</h3><p>In comparison to those with OSA alone, children with OSA and concurrent CSA exhibited distinct sleep patterns, including reduced N3uration, higher arousal index, longer respiratory events, higher ODI, and lower oxygen saturation, higher heart rate.</p></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Regional differences in admissions and surgical management of pediatric nontuberculous mycobacterial cervicofacial lymphadenitis 小儿非结核分枝杆菌宫颈面部淋巴结炎入院和手术治疗的地区差异
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.ijporl.2024.112051
David O'Neil Danis III , Taylor Lynn Jamil , Jessica R. Levi , Andrew R. Scott

Objectives

This study aims to determine the overall incidence of medical and surgical admissions related to non-tuberculous mycobacterial cervicofacial lymphadenitis (NTMCL) and determine if rates vary by geographic region in the US. It also aims to assess if the relative frequency of varying treatment modalities for NTMCL differ among geographic regions.

Study design

Population-based inpatient registry analysis.

Setting

Academic medical center.

Methods

The Kids’ Inpatient Database (2016 and 2019) was used to determine NTMCL-related admissions and common head and neck procedures performed during these admissions were identified. Analysis was performed on regional differences in demographic factors and procedures performed during NTMCL-related admissions.

Results

There were 159 weighted admissions (1.31 per 100,000) for NTMCL in 2016 and 2019 in the US, with the Midwest having the highest proportion of NTML-related admissions (1.59:100,000). NTMCL-related admissions were 2.21 times as likely to be elective rather than non-elective in the Midwest when compared to all other geographic regions (p = 0.038). The Midwest was 2.83 times as likely to treat with surgery (p = 0.011), while the Northeast was negatively associated with performing procedures (OR 0.38; p = 0.026). In the Midwest, significantly more excisional surgeries were preformed when compared to other regions, with an OR of 2.98 (p = 0.003).

Conclusion

The Midwest had the highest incidence of pediatric NTMCL-related admissions and was more likely to perform excisional surgery as primary NTMCL treatment. Regions that rarely see pediatric NTMCL have a more inconsistent approach to management.

目的本研究旨在确定与非结核分枝杆菌性颈面部淋巴结炎(NTMCL)相关的内科和外科住院病人的总体发病率,并确定美国不同地理区域的发病率是否存在差异。研究还旨在评估NTMCL不同治疗方式的相对频率在不同地理区域是否存在差异。研究设计基于人群的住院病人登记分析。研究地点学术医疗中心。研究方法使用儿童住院病人数据库(2016年和2019年)确定与NTMCL相关的入院情况,并确定入院期间进行的常见头颈部手术。结果2016年和2019年,美国共有159例NTMCL加权入院(每10万人中有1.31例),其中中西部地区的NTML相关入院比例最高(1.59:100,000)。与所有其他地区相比,中西部地区与 NTMCL 相关的入院患者中,选择性入院的可能性是非选择性的 2.21 倍(p = 0.038)。中西部地区手术治疗的可能性是其他地区的 2.83 倍(p = 0.011),而东北部地区与手术治疗呈负相关(OR 0.38;p = 0.026)。结论中西部地区是小儿NTMCL相关入院率最高的地区,更有可能将切除手术作为主要的NTMCL治疗方法。很少发生小儿NTMCL的地区,其治疗方法更不一致。
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引用次数: 0
Preventing pediatric accidental decannulation events: A quality improvement initiative 预防儿科意外拔管事件:质量改进计划。
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.ijporl.2024.112052
Alexander Cherches MD , Avivah Wang BS , Rolvix H. Patterson MD, MPH , Janet Lee MD , Jeffrey Cheng MD

Objective

To describe a quality improvement (QI) method to decrease pediatric accidental decannulation (AD) in the early postoperative period for children under age 3.

Methods

A retrospective chart review was conducted on children under age 3 who underwent tracheostomy at Duke University Health System from August 1, 2013 to May 1, 2023 (n = 104). A root cause analysis was used to assess factors associated with AD following pediatric tracheostomy. Based on the factors identified by the research team, retrospective data was collected before (8/1/13 - 1/31/22) and after (2/1/22 - 5/1/23) a single practice change was implemented: using twill neck ties, rather than foam neck ties, to secure newly-placed tracheostomy tubes. Twill ties were applied intraoperatively as a visual cue to signal a recent tracheostomy for the interdisciplinary care team. The primary outcome in the pre-intervention and post-intervention period was measured as 30-day incidence of AD per 10 tracheostomy cases.

Results

Prior to the intervention, a total of 11 ADs occurred in 9 patients across 93 pediatric tracheostomies (1.18 AD per 10 cases). Afterward, 0 ADs occurred across 11 pediatric tracheostomies (0 AD per 10 cases).

Conclusion

This data suggests that the twill tie intervention may prevent AD and the associated morbidity. With the twill tie initiative, we describe 11 ADs and associated risk factors and present a QI intervention that may help prevent AD and improve patient safety in the early postoperative period.

目的描述一种质量改进(QI)方法,以减少 3 岁以下儿童术后早期的小儿意外拔管(AD):对 2013 年 8 月 1 日至 2023 年 5 月 1 日期间在杜克大学医疗系统接受气管切开术的 3 岁以下儿童(n = 104)进行了回顾性病历审查。采用根本原因分析法评估了与小儿气管切开术后急性呼吸衰竭相关的因素。根据研究小组确定的因素,收集了在实施单一实践改变之前(8/1/13 - 1/31/22)和之后(2/1/22 - 5/1/23)的回顾性数据:使用斜纹颈部扎带而非泡沫颈部扎带固定新置入的气管造口管。术中使用斜纹扎带作为视觉提示,向跨学科护理团队表明最近进行了气管切开术。干预前和干预后的主要结果以每10例气管切开术病例30天的AD发生率来衡量:结果:干预前,93 例儿科气管造口术中共有 9 名患者发生了 11 例 AD(每 10 例中有 1.18 例 AD)。干预后,11 例小儿气管造口术中发生了 0 例 AD(每 10 例中发生 0 例 AD):结论:这一数据表明,斜纹扎带干预措施可预防气管插管引起的气管插管不良反应及相关发病率。通过斜纹扎带倡议,我们描述了 11 例 AD 和相关风险因素,并提出了一种 QI 干预方法,可帮助预防 AD 并提高术后早期患者的安全性。
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引用次数: 0
Nasal airway resistance in patients with different degrees of operated unilateral cleft lip: Evaluation of ventilation in 112 patients 不同程度手术单侧唇裂患者的鼻气道阻力:对 112 名患者的通气情况进行评估。
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.ijporl.2024.112049
Yu Wang, Zhilu Zhang, Weiyi Sun, Tao Song, Ningbei Yin, Yongqian Wang

Objective

The aim of this study was to compare the nasal airway resistance between the cleft and non-cleft sides in operated unilateral cleft lip (UCL) patients with varying severities at birth, as well as to assess the differences in nasal airway resistance between UCL patients and healthy individuals.

Methods

This retrospective study was conducted on 112 UCL patients who have undergone primary lip reconstructions but not advanced surgeries as the study group and 20 healthy participants as the control group between February 2023 to March 2024. The study group patients were grouped based on the severity of their cleft lip at birth, divided into occult cleft lip group, incomplete cleft lip group, and complete cleft lip group. The anterior rhinomanometry was used to evaluate nasal resistance, including unilateral effective resistances during inspiration (Reffin), expiration (Reffex), and the entire breath (ReffT), as well as unilateral vertex resistance during inspiration (VRin) and expiration (VRex). The Kolmogorov-Smirnov test was used to assess normality. Paired t-tests were utilized to analyze the differences in nasal resistance between the healthy and affected sides within the same group of patients. Student's t-test was used to analyze the differences in nasal resistance among patients with different degrees of cleft lip. A p-value of <0.05 was considered statistically significant.

Results

The nasal resistances of the occult cleft and incomplete cleft lip groups showed no significant differences between the cleft and non-cleft sides, and were similar to the control group. However, in the complete cleft lip group, the cleft side nasal resistance was significantly higher than the non-cleft side and control group. Among the groups, the complete cleft lip group had significantly higher nasal resistances on the cleft side for Reffin, VRin, and ReffT compared to the occult cleft group.

Conclusion

Understanding the nasal resistance of different degrees of operated UCL patients can benefit clinical diagnosis and treatment. Patients with complete cleft lip have more severe nasal obstruction on the cleft side, with greater impact on inhalation than exhalation. For these patients, treatment by an otolaryngologist is recommended to improve nasal airflow.

研究目的本研究旨在比较出生时不同严重程度的单侧唇裂(UCL)患者手术后唇裂侧与非唇裂侧的鼻气道阻力,并评估 UCL 患者与健康人之间鼻气道阻力的差异:这项回顾性研究以 2023 年 2 月至 2024 年 3 月期间接受过初级唇部重建但未接受过高级手术的 112 名 UCL 患者为研究组,以 20 名健康参与者为对照组。研究组患者根据出生时唇裂的严重程度进行分组,分为隐性唇裂组、不完全唇裂组和完全唇裂组。采用前鼻阻力测量法评估鼻阻力,包括吸气时(Reffin)、呼气时(Reffex)和整个呼吸过程(ReffT)的单侧有效阻力,以及吸气时(VRin)和呼气时(VRex)的单侧顶点阻力。采用 Kolmogorov-Smirnov 检验评估正态性。利用配对 t 检验分析同组患者健侧和患侧鼻阻力的差异。采用学生 t 检验分析不同唇裂程度患者鼻阻力的差异。结果的 p 值:隐性唇裂组和不完全唇裂组唇裂侧和非唇裂侧的鼻阻力无明显差异,与对照组相似。然而,在完全唇裂组中,裂侧鼻阻力明显高于非裂侧和对照组。与隐性唇裂组相比,完全唇裂组唇裂侧的 Reffin、VRin 和 ReffT 的鼻阻力明显更高:结论:了解不同程度手术后 UCL 患者的鼻阻力有助于临床诊断和治疗。完全唇裂患者的裂侧鼻腔阻塞更为严重,对吸气的影响大于呼气。对于这些患者,建议由耳鼻喉科医生进行治疗,以改善鼻腔气流。
{"title":"Nasal airway resistance in patients with different degrees of operated unilateral cleft lip: Evaluation of ventilation in 112 patients","authors":"Yu Wang,&nbsp;Zhilu Zhang,&nbsp;Weiyi Sun,&nbsp;Tao Song,&nbsp;Ningbei Yin,&nbsp;Yongqian Wang","doi":"10.1016/j.ijporl.2024.112049","DOIUrl":"10.1016/j.ijporl.2024.112049","url":null,"abstract":"<div><h3>Objective</h3><p>The aim of this study was to compare the nasal airway resistance between the cleft and non-cleft sides in operated unilateral cleft lip (UCL) patients with varying severities at birth, as well as to assess the differences in nasal airway resistance between UCL patients and healthy individuals.</p></div><div><h3>Methods</h3><p>This retrospective study was conducted on 112 UCL patients who have undergone primary lip reconstructions but not advanced surgeries as the study group and 20 healthy participants as the control group between February 2023 to March 2024. The study group patients were grouped based on the severity of their cleft lip at birth, divided into occult cleft lip group, incomplete cleft lip group, and complete cleft lip group. The anterior rhinomanometry was used to evaluate nasal resistance, including unilateral effective resistances during inspiration (Reffin), expiration (Reffex), and the entire breath (ReffT), as well as unilateral vertex resistance during inspiration (VRin) and expiration (VRex). The Kolmogorov-Smirnov test was used to assess normality. Paired t-tests were utilized to analyze the differences in nasal resistance between the healthy and affected sides within the same group of patients. Student's t-test was used to analyze the differences in nasal resistance among patients with different degrees of cleft lip. A p-value of &lt;0.05 was considered statistically significant.</p></div><div><h3>Results</h3><p>The nasal resistances of the occult cleft and incomplete cleft lip groups showed no significant differences between the cleft and non-cleft sides, and were similar to the control group. However, in the complete cleft lip group, the cleft side nasal resistance was significantly higher than the non-cleft side and control group. Among the groups, the complete cleft lip group had significantly higher nasal resistances on the cleft side for Reffin, VRin, and ReffT compared to the occult cleft group.</p></div><div><h3>Conclusion</h3><p>Understanding the nasal resistance of different degrees of operated UCL patients can benefit clinical diagnosis and treatment. Patients with complete cleft lip have more severe nasal obstruction on the cleft side, with greater impact on inhalation than exhalation. For these patients, treatment by an otolaryngologist is recommended to improve nasal airflow.</p></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Application of bidirectional telemedicine in home CPAP for children with obstructive sleep apnea syndrome 双向远程医疗在阻塞性睡眠呼吸暂停综合征患儿家庭 CPAP 中的应用。
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.ijporl.2024.112047
Liqiang Yang, Dabo Liu, Jianwen Zhong, Jinhong Huang, Shuyao Qiu

Background

Traditional telemedicine follow-up proves unsuitable for home continuous positive airway pressure (CPAP) therapy in children with obstructive sleep apnea syndrome (OSAS). Accompanying advancements in mobile internet, this study explores the feasibility and effectiveness of a mobile communication and remote monitoring system as a novel bidirectional telemedicine approach to enhance adherence to home CPAP in children with OSAS.

Methods

A prospective cohort utilizing bidirectional telemedicine follow-up from January to December 2022 (TM) was compared with a retrospective cohort receiving conventional phone follow-up from August 2018 to December 2021 (CP). Participants in TM group were subdivided into two groups based on the number of inquiries in the first week: a high-question group and a low-question group. The main endpoints included successful CPAP adaption and adherence at 2 months of follow-up.

Results

The TM group exhibited a significantly lower termination rate within 2 months compared to the CP group (1/24 vs. 6/22, p = 0.037). In the first week of home CPAP, the high-question group reported shorter average nightly usage and fewer days with usage of ≥4 h compared to the low-question group (5 h per night vs. 8.5 h per night, 4.5 days vs. 7 days, both p < 0.001). However, the high-question group showed significant improvement in adherence from the second week onward for the remainder of the study period.

Conclusions

Bidirectional telemedicine represents an effective and feasible method to improve adherence to home CPAP therapy in children with OSAS. Considering the costs, researchers recommend applying bidirectional telemedicine for at least 1 week to better enhance long-term adherence.

背景:传统的远程医疗跟踪被证明不适合阻塞性睡眠呼吸暂停综合征(OSAS)患儿的家庭持续气道正压(CPAP)治疗。随着移动互联网的发展,本研究探讨了移动通信和远程监控系统作为一种新型双向远程医疗方法的可行性和有效性,以提高阻塞性睡眠呼吸暂停综合征患儿对家用 CPAP 的依从性:方法: 将 2022 年 1 月至 12 月采用双向远程医疗随访的前瞻性队列(TM)与 2018 年 8 月至 2021 年 12 月接受传统电话随访的回顾性队列(CP)进行比较。根据第一周的咨询次数,TM 组的参与者被细分为两组:高问题组和低问题组。主要终点包括成功适应 CPAP 和随访 2 个月后的依从性:结果:与 CP 组相比,TM 组在 2 个月内的终止率明显较低(1/24 对 6/22,P = 0.037)。在使用家用 CPAP 的第一周,高问题组与低问题组相比,平均每晚使用时间更短,使用时间≥4 小时的天数更少(每晚 5 小时 vs. 每晚 8.5 小时,4.5 天 vs. 7 天,均为 p 结论:在使用 CPAP 的第一周,高问题组与低问题组相比,平均每晚使用时间更短,使用时间≥4 小时的天数更少:双向远程医疗是一种有效且可行的方法,可提高 OSAS 患儿对家庭 CPAP 治疗的依从性。考虑到费用问题,研究人员建议双向远程医疗至少应用一周,以更好地提高长期依从性。
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引用次数: 0
Ankyloglossia in Australia: Experiences and perspectives of parents and caregivers 澳大利亚的强直性口吃:家长和照顾者的经历和观点。
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.ijporl.2024.112046
Donna Akbari , Hans Bogaardt , Kimberley Docking

Objectives

To investigate the perspectives and experiences of parents of infants with ankyloglossia in Australia.

Method

Two hundred and sixty-seven parents across Australia responded to an online survey including their experiences of having a child with ankyloglossia. Descriptive statistics were used to analyse quantitative data.

Results

Participants were from all Australian states and territories, with the majority residing in New South Wales and Victoria. Ankyloglossia diagnoses typically occurred within the first two weeks of life, driven mainly by difficulties with feeding. Lactation consultants played a prominent role in diagnosis, particularly in rural areas. Surgical interventions were common, with frenotomy using scissors or scalpel being the primary treatment. Aftercare recommendations, including stretching the frenotomy wound, were prevalent. Most parents received education about ankyloglossia, primarily through verbal and written information. Parents generally reported high satisfaction with the effectiveness of treatments, favouring surgical interventions. However, satisfaction with health professionals' support did not consistently correlate with the likelihood of consenting to the treatment again, and those who conducted their own research on ankyloglossia expressed lower satisfaction with health professionals’ support.

Conclusions

The experiences of Australian parents in their infant's diagnosis, management and education of ankyloglossia varied greatly. Clinical guidelines for all relevant health professionals are needed to ensure standardised diagnosis and management processes. In future, this will help guide evidence-based diagnosis and intervention for infants with ankyloglossia.

目的调查澳大利亚患有强口齿症婴儿的父母的观点和经历:方法: 澳大利亚有 267 名家长参与了一项在线调查,调查内容包括他们养育强直性口吃患儿的经历。调查采用描述性统计方法对定量数据进行分析:参与者来自澳大利亚各州和地区,其中大多数居住在新南威尔士州和维多利亚州。患儿通常在出生后两周内被诊断为会说话,主要是因为喂养困难。哺乳顾问在诊断中发挥着重要作用,尤其是在农村地区。手术干预很常见,使用剪刀或手术刀进行咬肌腱切除术是主要的治疗方法。术后护理建议也很普遍,包括拉伸韧带切除术的伤口。大多数家长都接受过有关强直性舌炎的教育,主要是通过口头和书面信息。家长对治疗效果的满意度普遍较高,并倾向于手术治疗。然而,对医护人员支持的满意度与再次同意接受治疗的可能性并不一致,而那些自己对强直性口吃进行研究的家长对医护人员支持的满意度较低:澳大利亚父母在婴儿强直性口吃的诊断、管理和教育方面的经验差异很大。需要为所有相关医疗专业人员制定临床指南,以确保诊断和管理流程的标准化。今后,这将有助于指导对患有强口齿症的婴儿进行循证诊断和干预。
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引用次数: 0
期刊
International journal of pediatric otorhinolaryngology
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