Sara Ipakchi, N. Zamani, M. Mehdizadeh, N. Pak, F. Zamani
Background: There is anecdotal evidence regarding the simultaneous occurrence of vesicoureteral reflux (VUR) and gastroesophageal reflux disease (GERD), which indicates the probability of pathophysiological commonality. Objectives: In the present study, we evaluated the concurrence of VUR and GERD in children candidates for the voiding cystourethrogram (VCUG) study. Methods: This cross-sectional study was conducted on 62 children between 1 and 14 years old referred to a tertiary referral teaching hospital for VCUG in 2019 - 2020. All subjects underwent ultrasound to assess GERD and VCUG to rule out VUR. Results: According to the ultrasound assessment, 14.5% of subjects were diagnosed with GERD: 8.3% in males and 18.4% in females. VUR was detected in 48.4% of children (50.0% in males and 47.4% in females) using VCUG. Overall, seven (23.3%) had concomitant VUR and GERD: 4.2% in boys and 15.8% in girls, indicating no difference between the two genders (P = 0.125). The prevalence of concurrent GERD and VUR was also independent of age. In the two groups with and without VUR, the prevalence of GERD was 23.3% and 6.2%, respectively, indicating a relative risk of 2 (95% confidence interval [CI]: 1.32 - 3.02, P = 0.001). Conclusions: Regarding the relationship between GERD and VUR, despite the deletion of physiologic GER cases, the pathophysiological overlap between the two phenomena could be considered.
{"title":"Concurrence of Vesicoureteral Reflux and Gastroesophageal Reflux Disease in Children","authors":"Sara Ipakchi, N. Zamani, M. Mehdizadeh, N. Pak, F. Zamani","doi":"10.5812/ijp-130302","DOIUrl":"https://doi.org/10.5812/ijp-130302","url":null,"abstract":"Background: There is anecdotal evidence regarding the simultaneous occurrence of vesicoureteral reflux (VUR) and gastroesophageal reflux disease (GERD), which indicates the probability of pathophysiological commonality. Objectives: In the present study, we evaluated the concurrence of VUR and GERD in children candidates for the voiding cystourethrogram (VCUG) study. Methods: This cross-sectional study was conducted on 62 children between 1 and 14 years old referred to a tertiary referral teaching hospital for VCUG in 2019 - 2020. All subjects underwent ultrasound to assess GERD and VCUG to rule out VUR. Results: According to the ultrasound assessment, 14.5% of subjects were diagnosed with GERD: 8.3% in males and 18.4% in females. VUR was detected in 48.4% of children (50.0% in males and 47.4% in females) using VCUG. Overall, seven (23.3%) had concomitant VUR and GERD: 4.2% in boys and 15.8% in girls, indicating no difference between the two genders (P = 0.125). The prevalence of concurrent GERD and VUR was also independent of age. In the two groups with and without VUR, the prevalence of GERD was 23.3% and 6.2%, respectively, indicating a relative risk of 2 (95% confidence interval [CI]: 1.32 - 3.02, P = 0.001). Conclusions: Regarding the relationship between GERD and VUR, despite the deletion of physiologic GER cases, the pathophysiological overlap between the two phenomena could be considered.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":"17 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78900541","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}
Background: This study aimed to define the normal ranges of echocardiographic parameters that are used to evaluate right ventricular systolic functions. Methods: A total of 607 children within the age range of 0 - 18 years without any cardiac pathology or chronic disorders were included in the study. The study population was categorized into different age groups and underwent transthoracic echocardiography. In this study, tricuspid annular plane systolic excursion (TAPSE), tricuspid annular peak systolic velocity (TAPSV), and right ventricular myocardial performance index (RVMPI) values were measured. Results: There was no statistically significant difference between the mean TAPSE and TAPSV values of male and female subjects. The mean RVMPI was higher in females than in males. The study population was categorized into nine groups according to their age. The TAPSE, TAPSV, and RVMPI values were calculated for each group. Additionally, the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles, and ± 2 standard deviation (SD) and ± 3 SD values of TAPSE measurements were calculated for each age group. The study population was divided into eight groups according to their body surface area (BSA). Moreover, the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles of TAPSE measurements were calculated. There was a strong positive correlation between TAPSE and BSA. The TAPSE was also positively correlated with TAPSV but not with RVMPI. Conclusions: This study determined the normal values for TAPSV and RVMPI. It is important to have knowledge of the normal ranges of these parameters to recognize right ventricular dysfunction early in various cardiac disorders.
{"title":"Normal Values of Echocardiographic Parameters Indicating Right Ventricular Systolic Functions in 607 Healthy Children","authors":"Münevver Yılmaz, M. Çetin, P. Dundar, Ş. Coşkun","doi":"10.5812/ijp-134196","DOIUrl":"https://doi.org/10.5812/ijp-134196","url":null,"abstract":"Background: This study aimed to define the normal ranges of echocardiographic parameters that are used to evaluate right ventricular systolic functions. Methods: A total of 607 children within the age range of 0 - 18 years without any cardiac pathology or chronic disorders were included in the study. The study population was categorized into different age groups and underwent transthoracic echocardiography. In this study, tricuspid annular plane systolic excursion (TAPSE), tricuspid annular peak systolic velocity (TAPSV), and right ventricular myocardial performance index (RVMPI) values were measured. Results: There was no statistically significant difference between the mean TAPSE and TAPSV values of male and female subjects. The mean RVMPI was higher in females than in males. The study population was categorized into nine groups according to their age. The TAPSE, TAPSV, and RVMPI values were calculated for each group. Additionally, the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles, and ± 2 standard deviation (SD) and ± 3 SD values of TAPSE measurements were calculated for each age group. The study population was divided into eight groups according to their body surface area (BSA). Moreover, the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles of TAPSE measurements were calculated. There was a strong positive correlation between TAPSE and BSA. The TAPSE was also positively correlated with TAPSV but not with RVMPI. Conclusions: This study determined the normal values for TAPSV and RVMPI. It is important to have knowledge of the normal ranges of these parameters to recognize right ventricular dysfunction early in various cardiac disorders.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":"07 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86032282","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}
Farshid Kompani, L. Barati, M. Mehrjerdian, M. Vakili, A. Nodehsharifi
Background: Enuresis is one of the most common diseases in children. Although there are several factors involved in the occurrence of this diseases, the root cause of it has remained undetermined. Objectives: Identifying various factors responsible for enuresis may enormously contribute to solving this problem. This study, therefore, aimed to determine the level of vitamin B12 and folic acid in children with enuresis in Gorgan in 2021. Methods: In this case-control study, 43 children with primary enuresis and 99 children without enuresis, as the control group, referring to Taleghani Hospital in 2021 were included. Folic acid and vitamin B12 levels in two groups were measured and analyzed using statistical techniques. Results: Out of all participants, 23 (53.5%) in the case group and 53 (53.5%) in the control group were male. The mean age of children in the case and control groups were 7.60 ± 3.02 and 8.93 ± 3.15, respectively, and the two groups were not significantly different in terms of gender and age. Vitamin B12 and folic acid levels in the case group were significantly lower than those in the control group (P-value = 0.001). There was a significant difference between the case and control groups regarding the mean levels of vitamin B12 and folic acid levels based on sex and gender. Conclusions: In sum, it was found that children with enuresis suffered from deficiency of vitamin B12 and folic acid to some extent, which may have been a factor responsible for delaying the maturation of the central nervous system and, consequently, inducing enuresis in children.
{"title":"Folic Acid and Vitamin B12 Deficiency, Two New Findings in Pediatric Enuresis","authors":"Farshid Kompani, L. Barati, M. Mehrjerdian, M. Vakili, A. Nodehsharifi","doi":"10.5812/ijp-129308","DOIUrl":"https://doi.org/10.5812/ijp-129308","url":null,"abstract":"Background: Enuresis is one of the most common diseases in children. Although there are several factors involved in the occurrence of this diseases, the root cause of it has remained undetermined. Objectives: Identifying various factors responsible for enuresis may enormously contribute to solving this problem. This study, therefore, aimed to determine the level of vitamin B12 and folic acid in children with enuresis in Gorgan in 2021. Methods: In this case-control study, 43 children with primary enuresis and 99 children without enuresis, as the control group, referring to Taleghani Hospital in 2021 were included. Folic acid and vitamin B12 levels in two groups were measured and analyzed using statistical techniques. Results: Out of all participants, 23 (53.5%) in the case group and 53 (53.5%) in the control group were male. The mean age of children in the case and control groups were 7.60 ± 3.02 and 8.93 ± 3.15, respectively, and the two groups were not significantly different in terms of gender and age. Vitamin B12 and folic acid levels in the case group were significantly lower than those in the control group (P-value = 0.001). There was a significant difference between the case and control groups regarding the mean levels of vitamin B12 and folic acid levels based on sex and gender. Conclusions: In sum, it was found that children with enuresis suffered from deficiency of vitamin B12 and folic acid to some extent, which may have been a factor responsible for delaying the maturation of the central nervous system and, consequently, inducing enuresis in children.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75064241","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}
Objectives: The purpose of this study was to evaluate the feasibility and potential effect of a physical exercise package on the motor proficiency of children and adolescents with Down syndrome. Methods: In this research, an experimental design was conducted in two special schools to evaluate the effectiveness of this package and identify its strengths and weaknesses. Forty students with Down syndrome were selected and randomly divided into intervention and control groups. A total of 36 (22 male and 14 female) students out of 50 at two special schools for children with special needs between October 2020 and March 2021 were recruited for the study. Participants were aged 12.888 ± 2.375 (12.954 ± 2.609 for boys and 12.785 ± 2.044 for girls) years. The 18 students in the intervention group participated in the exercise sessions, 2 or 3 sessions per week for 12 weeks. Pre- and post-tests were performed on both groups. The Physical Exercise Package included the principles of exercise, the preferred exercise methods, and the details of exercise planning for Down syndrome individuals (FITT-VP) based on the etiology of Down syndrome and the characteristics of people with this syndrome. Motor proficiency was measured using the Bruininks Oseretsky Test of Motor Proficiency (BOT-2). Results: The results of the study showed that the designed exercise package was adhered to with all the participants attending 93.2% of the sessions, and participants significantly improved their total motor proficiency score, manual dexterity, upper-limb coordination, strength, balance, upper-limb coordination, running speed and agility and fine motor Integration (P < 0.05). However, the exercises did not significantly change the bilateral coordination and fine motor precision (P > 0.05). Conclusions: the current study result shows that developing and implementing the individualized exercise package and observing the principles set out in the program could have significant positive impacts on the motor proficiency of students with Down syndrome.
{"title":"The Effect of a Physical Exercise Package on the Motor Proficiency of Students with Down Syndrome","authors":"A. Kashi, H. Dawes, Maedeh Mansoubi, Z. Sarlak","doi":"10.5812/ijp-120408","DOIUrl":"https://doi.org/10.5812/ijp-120408","url":null,"abstract":"Objectives: The purpose of this study was to evaluate the feasibility and potential effect of a physical exercise package on the motor proficiency of children and adolescents with Down syndrome. Methods: In this research, an experimental design was conducted in two special schools to evaluate the effectiveness of this package and identify its strengths and weaknesses. Forty students with Down syndrome were selected and randomly divided into intervention and control groups. A total of 36 (22 male and 14 female) students out of 50 at two special schools for children with special needs between October 2020 and March 2021 were recruited for the study. Participants were aged 12.888 ± 2.375 (12.954 ± 2.609 for boys and 12.785 ± 2.044 for girls) years. The 18 students in the intervention group participated in the exercise sessions, 2 or 3 sessions per week for 12 weeks. Pre- and post-tests were performed on both groups. The Physical Exercise Package included the principles of exercise, the preferred exercise methods, and the details of exercise planning for Down syndrome individuals (FITT-VP) based on the etiology of Down syndrome and the characteristics of people with this syndrome. Motor proficiency was measured using the Bruininks Oseretsky Test of Motor Proficiency (BOT-2). Results: The results of the study showed that the designed exercise package was adhered to with all the participants attending 93.2% of the sessions, and participants significantly improved their total motor proficiency score, manual dexterity, upper-limb coordination, strength, balance, upper-limb coordination, running speed and agility and fine motor Integration (P < 0.05). However, the exercises did not significantly change the bilateral coordination and fine motor precision (P > 0.05). Conclusions: the current study result shows that developing and implementing the individualized exercise package and observing the principles set out in the program could have significant positive impacts on the motor proficiency of students with Down syndrome.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":"19 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91140176","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}
Xiong Xiaoyu, Ren Jie, Liu Chengjun, Xu Feng, Li Jing
Objectives: This study aimed to compare the efficiencies of the vasoactive-inotropic score (VIS) and left ventricular ejection fraction (LVEF) in predicting the condition and prognosis of children with congenital heart disease (CHD). Methods: We retrospectively reviewed the medical charts of 104 infants aged < 1 year who underwent cardiac surgery with cardiopulmonary bypass. The maximum and mean postoperative VIS in the first and second 24 hours [VIS (24MAX), VIS (24MEA), VIS (48MAX), and VIS (48MEA)] were recorded. Similarly, LVEF within 24 hours following surgery was monitored. Receiver operator curve (ROC), regression analysis, chi-square test, and t-test were used to analyze both heart function monitoring technologies Results: Receiver operating characteristic analysis revealed that VIS was strongly associated with adverse events and death [area under ROC (AUROC) > 0.90, P = 0.00], with the two most representative scores being VIS (24MEA) and VIS (48MAX), with cut-off points of 19.42 (sensitivity = 100%; specificity = 93.90%) and 22 (sensitivity = 100%; specificity = 93.90%), respectively for death, and 18.02 (sensitivity = 91.70%; specificity = 89.10%) and 17.75 (sensitivity = 91.70%; specificity = 90.20%), respectively for adverse events. Infants with higher VIS had significantly higher mortality, higher incidence of clinical adverse events, higher lactic acid value, and longer mechanical ventilation and ICU stay (P < 0.05). However, LVEF within 24 hours following surgery was not associated with death (AUROC = 0.65, P = 0.33) or adverse events (AUROC = 0.53, P = 0.81). Moreover, there was no significant change in the length of ICU stay, duration of mechanical ventilation, and lactate value (P > 0.05). Conclusions: Vasoactive-inotropic score at an early stage following surgery was significantly associated with the condition and prognosis of infants with congenital heart disease; however, the predictive value of LVEF within 24 hours following surgery was lower.
{"title":"Early-Stage Vasoactive-Inotropic Score and Left Ventricular Ejection Fraction Following Cardiac Surgery: A Comparison of Two Non-invasive Heart Function Monitoring Technologies in the Prognosis of Infants","authors":"Xiong Xiaoyu, Ren Jie, Liu Chengjun, Xu Feng, Li Jing","doi":"10.5812/ijp-131666","DOIUrl":"https://doi.org/10.5812/ijp-131666","url":null,"abstract":"Objectives: This study aimed to compare the efficiencies of the vasoactive-inotropic score (VIS) and left ventricular ejection fraction (LVEF) in predicting the condition and prognosis of children with congenital heart disease (CHD). Methods: We retrospectively reviewed the medical charts of 104 infants aged < 1 year who underwent cardiac surgery with cardiopulmonary bypass. The maximum and mean postoperative VIS in the first and second 24 hours [VIS (24MAX), VIS (24MEA), VIS (48MAX), and VIS (48MEA)] were recorded. Similarly, LVEF within 24 hours following surgery was monitored. Receiver operator curve (ROC), regression analysis, chi-square test, and t-test were used to analyze both heart function monitoring technologies Results: Receiver operating characteristic analysis revealed that VIS was strongly associated with adverse events and death [area under ROC (AUROC) > 0.90, P = 0.00], with the two most representative scores being VIS (24MEA) and VIS (48MAX), with cut-off points of 19.42 (sensitivity = 100%; specificity = 93.90%) and 22 (sensitivity = 100%; specificity = 93.90%), respectively for death, and 18.02 (sensitivity = 91.70%; specificity = 89.10%) and 17.75 (sensitivity = 91.70%; specificity = 90.20%), respectively for adverse events. Infants with higher VIS had significantly higher mortality, higher incidence of clinical adverse events, higher lactic acid value, and longer mechanical ventilation and ICU stay (P < 0.05). However, LVEF within 24 hours following surgery was not associated with death (AUROC = 0.65, P = 0.33) or adverse events (AUROC = 0.53, P = 0.81). Moreover, there was no significant change in the length of ICU stay, duration of mechanical ventilation, and lactate value (P > 0.05). Conclusions: Vasoactive-inotropic score at an early stage following surgery was significantly associated with the condition and prognosis of infants with congenital heart disease; however, the predictive value of LVEF within 24 hours following surgery was lower.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":"2015 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73550772","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}
Seda Nur Kemer, Halil Ibrahim Celik, Seyda Ozal, Nihan Kafa
Background: Insufficiencies of gluteus medius and maximus muscles in children with unilateral cerebral palsy (CP) may restrict activity and participation by affecting gait, gross motor functions, and balance. Objectives: The present study aimed to elucidate the effect of Kinesio taping (KT) applied to the gluteus medius and maximus muscles on activity and participation in children with CP. Methods: The study was completed with 20 children with unilateral CP who were randomly divided into 2 groups: The KT group received KT and physiotherapy (n = 11), and the control group received only physiotherapy (n = 9). The KT application was administered for 4 weeks. The activity was evaluated with a BTS G-Walk Spatiotemporal Gait Analysis System, Timed Up and Go test (TUG), Functional Mobility Scale (FMS), Gross Motor Function Measure (GMFM), and Pediatric Balance Scale (PBS); in addition, participation was evaluated using the Canadian Occupational Performance Measure (COPM). Results: The KT group showed significant improvements in the gait parameter (cadence; P = 0.009), pelvic tilt symmetry (P = 0.017), pelvic rotation symmetry (P = 0.018), gait symmetry (P < 0.001), FMS (P = 0.07), TUG, GMFM, PBS, and COPM scores (P < 0.001) in the medium-term compared to the control group. It was also found that gait (cadence; P = 0.004) and functional mobility (P < 0.001) improved in the immediate term than in the KT group. Conclusions: KT combined with conventional physiotherapy can improve cadence and functional mobility in the immediate term, as well as gait and pelvic symmetry, functional mobility, gross motor function, balance, and participation in the medium term in children with unilateral CP. Further randomized controlled studies addressing large samples and long-term effects are warranted.
{"title":"The Effect of Kinesio Taping Over the Gluteal Muscles on Activity and Participation in Children with Unilateral Cerebral Palsy: A Preliminary Randomized Controlled Study","authors":"Seda Nur Kemer, Halil Ibrahim Celik, Seyda Ozal, Nihan Kafa","doi":"10.5812/ijp-129664","DOIUrl":"https://doi.org/10.5812/ijp-129664","url":null,"abstract":"Background: Insufficiencies of gluteus medius and maximus muscles in children with unilateral cerebral palsy (CP) may restrict activity and participation by affecting gait, gross motor functions, and balance. Objectives: The present study aimed to elucidate the effect of Kinesio taping (KT) applied to the gluteus medius and maximus muscles on activity and participation in children with CP. Methods: The study was completed with 20 children with unilateral CP who were randomly divided into 2 groups: The KT group received KT and physiotherapy (n = 11), and the control group received only physiotherapy (n = 9). The KT application was administered for 4 weeks. The activity was evaluated with a BTS G-Walk Spatiotemporal Gait Analysis System, Timed Up and Go test (TUG), Functional Mobility Scale (FMS), Gross Motor Function Measure (GMFM), and Pediatric Balance Scale (PBS); in addition, participation was evaluated using the Canadian Occupational Performance Measure (COPM). Results: The KT group showed significant improvements in the gait parameter (cadence; P = 0.009), pelvic tilt symmetry (P = 0.017), pelvic rotation symmetry (P = 0.018), gait symmetry (P < 0.001), FMS (P = 0.07), TUG, GMFM, PBS, and COPM scores (P < 0.001) in the medium-term compared to the control group. It was also found that gait (cadence; P = 0.004) and functional mobility (P < 0.001) improved in the immediate term than in the KT group. Conclusions: KT combined with conventional physiotherapy can improve cadence and functional mobility in the immediate term, as well as gait and pelvic symmetry, functional mobility, gross motor function, balance, and participation in the medium term in children with unilateral CP. Further randomized controlled studies addressing large samples and long-term effects are warranted.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":"269 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135901836","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}
Context: In recent decades, the growing number of factories and vehicles has accelerated the release of environmental contaminants such as heavy metals. These inhalable pollutants often cause respiratory diseases and can endanger human health. Some heavy metals (e.g., zinc), on the other hand, are beneficial micronutrients, playing critical roles in the body. Objectives: This systemic review and meta-analysis study aimed to examine the role of lead (Pb) and zinc (Zn) in asthma. Methods: MeSH keywords, including lead, asthma, and zinc, along with their Persian equivalents were searched in the PubMed, Google, Web of Sciences, Google Scholar, and SID databases. The articles published between 2000 and 2018 were included. For assessing heterogeneity, the Q and I2 statistics were applied. STATA version 14 was used for data analysis. The review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. Results: The frequency of asthma was 12% (95% CI: 11 - 13%, P < 0.001). The frequencies of high blood lead levels (BLL) in controls and patients with asthma were 2% (95% CI: 0 - 2.03, P < 0.001) and 3% (95% CI: 0 - 3.04, P < 0.001), respectively. The ratios of BLL of < 5, 5 - 10, and > 10 µg/dL were found to be 8% (95% CI: 0 - 9.7, P < 0.001), 10% (95% CI: 0.8 - 11, P < 0.001), and 9% (95% CI: 0.08 - 11, P < 0.001), respectively. The forced expiratory volume (FEV) was significantly correlated with zinc level. The results from meta-regression analysis suggested an increasing trend in asthma occurrence from 2000 to 2018. Conclusions: While zinc may have been protective against asthma, lead was a risk factor for respiratory diseases and asthma. Educating children and their parents about lead poisoning may have prevented or reduced lead intoxication and asthma in children.
近几十年来，越来越多的工厂和车辆加速了重金属等环境污染物的排放。这些可吸入污染物常引起呼吸道疾病，危害人体健康。另一方面，一些重金属(如锌)是有益的微量营养素，在人体中起着至关重要的作用。目的:本系统评价和荟萃分析研究旨在探讨铅(Pb)和锌(Zn)在哮喘中的作用。方法:在PubMed、Google、Web of Sciences、Google Scholar和SID数据库中检索MeSH关键词，包括lead、asthma和zinc，以及它们在波斯语中的对应词。收录了2000年至2018年间发表的文章。为了评估异质性，采用Q和I2统计量。使用STATA version 14进行数据分析。按照系统评价和荟萃分析的首选报告项目(PRISMA)声明进行评价。结果:哮喘发生率为12% (95% CI: 11 ~ 13%， P < 0.001)。对照组和哮喘患者的高血铅(BLL)发生率分别为2% (95% CI: 0 ~ 2.03, P < 0.001)和3% (95% CI: 0 ~ 3.04, P < 0.001)。BLL < 5、5 ~ 10和> 10µg/dL的比例分别为8% (95% CI: 0 ~ 9.7, P < 0.001)、10% (95% CI: 0.8 ~ 11, P < 0.001)和9% (95% CI: 0.08 ~ 11, P < 0.001)。用力呼气量(FEV)与锌水平显著相关。meta回归分析结果显示，2000 - 2018年哮喘发病率呈上升趋势。结论:虽然锌可能对哮喘有保护作用，但铅是呼吸系统疾病和哮喘的危险因素。教育儿童及其父母有关铅中毒的知识可能预防或减少儿童铅中毒和哮喘。
{"title":"The Effects of Lead and Zinc on Asthma: A Systematic Review and Meta-Analysis","authors":"B. Darabi, G. Kalvandi, R. Najafi, H. Tavan","doi":"10.5812/ijp-121732","DOIUrl":"https://doi.org/10.5812/ijp-121732","url":null,"abstract":"Context: In recent decades, the growing number of factories and vehicles has accelerated the release of environmental contaminants such as heavy metals. These inhalable pollutants often cause respiratory diseases and can endanger human health. Some heavy metals (e.g., zinc), on the other hand, are beneficial micronutrients, playing critical roles in the body. Objectives: This systemic review and meta-analysis study aimed to examine the role of lead (Pb) and zinc (Zn) in asthma. Methods: MeSH keywords, including lead, asthma, and zinc, along with their Persian equivalents were searched in the PubMed, Google, Web of Sciences, Google Scholar, and SID databases. The articles published between 2000 and 2018 were included. For assessing heterogeneity, the Q and I2 statistics were applied. STATA version 14 was used for data analysis. The review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. Results: The frequency of asthma was 12% (95% CI: 11 - 13%, P < 0.001). The frequencies of high blood lead levels (BLL) in controls and patients with asthma were 2% (95% CI: 0 - 2.03, P < 0.001) and 3% (95% CI: 0 - 3.04, P < 0.001), respectively. The ratios of BLL of < 5, 5 - 10, and > 10 µg/dL were found to be 8% (95% CI: 0 - 9.7, P < 0.001), 10% (95% CI: 0.8 - 11, P < 0.001), and 9% (95% CI: 0.08 - 11, P < 0.001), respectively. The forced expiratory volume (FEV) was significantly correlated with zinc level. The results from meta-regression analysis suggested an increasing trend in asthma occurrence from 2000 to 2018. Conclusions: While zinc may have been protective against asthma, lead was a risk factor for respiratory diseases and asthma. Educating children and their parents about lead poisoning may have prevented or reduced lead intoxication and asthma in children.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":"34 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90383985","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}
Jiao Yuan, Dongqing Zhu, Jie Gu, Fuying Zhao, Yongming Wang, Jingxia Luo
Background: The placenta, as a link between mother and fetus, is closely related to the development of the fetal nervous system. Histological chorioamnionitis (HCA) is common placental inflammation and an important factor in triggering premature delivery. Anabolic steroid (AS) is an important medication to promote fetal lung maturity. Therefore, this study investigated the relationship between HCA, AS, and brain injury in premature infants. Objectives: This research aimed to explore the correlation of pathological changes in the placental HCA and the prenatal use of AS with brain injury in preterm infants. Methods: In total, 339 premature infants with a gestational age of under 34 weeks were taken as research subjects, and the placenta was examined by pathology after delivery. The samples were divided into HCA+ AS+, HCA+ AS-, HCA- AS+, and HCA- AS- groups based on the pathological results of the placenta and the prenatal use of steroid hormones. The occurrence of brain injury in preterm infants and the level of inflammatory indicators 2 h after birth were compared between the groups. Results: The incidence of brain injury in preterm infants in the HCA+ group was higher than in the HCA- group (χ2 = 5.713, P < 0.05), and the AS- group than in the AS+ group (χ2 = 4.368, P < 0.05); The incidence of brain injury in the HCA+ AS+, HCA+ AS- and HCA- AS-groups was significantly higher than in the HCA- AS+ group (χ2 = 6.105, P = 0.013; χ2 = 9.086, P = 0.003; χ2 = 4.848, P = 0.047, respectively). The incidence of brain injury in preterm infants was the highest in the group (30%). When the procalcitonin level 2 h after birth was 0.213 ng/mL, sensitivity to predict the occurrence of brain injury in preterm infants was 70.7%, and specificity was 80.2%. Conclusions: Brain damage in premature infants is related to HCA in the mother and insufficient AS treatment before delivery. Brain damage is more likely to occur when both factors exist.
背景:胎盘作为连接母体和胎儿的纽带，与胎儿神经系统的发育密切相关。组织学绒毛膜羊膜炎(HCA)是常见的胎盘炎症，是引发早产的重要因素。合成代谢类固醇(AS)是促进胎儿肺成熟的重要药物。因此，本研究探讨HCA、AS与早产儿脑损伤的关系。目的:本研究旨在探讨胎盘HCA病理变化与产前使用AS与早产儿脑损伤的相关性。方法:选取胎龄小于34周的早产儿339例为研究对象，分娩后对胎盘进行病理检查。根据胎盘病理结果及产前类固醇激素使用情况，将样本分为HCA+ AS+、HCA+ AS-、HCA- AS+和HCA- AS-组。比较两组早产儿脑损伤发生率及出生后2 h炎症指标水平。结果:HCA+组早产儿脑损伤发生率高于HCA-组(χ2 = 5.713, P <P < 0.05)， AS-组明显高于AS+组(χ2 = 4.368, P <0.05);HCA+ AS+、HCA+ AS-和HCA- AS组脑损伤发生率均显著高于HCA- AS+组(χ2 = 6.105, P = 0.013;χ2 = 9.086, p = 0.003;χ2 = 4.848, P = 0.047)。早产儿脑损伤发生率最高(30%)。出生后2 h降钙素原水平为0.213 ng/mL时，预测早产儿脑损伤发生的敏感性为70.7%，特异性为80.2%。结论:早产儿脑损伤与母亲HCA及产前AS治疗不足有关。当这两种因素同时存在时，更有可能发生脑损伤。
{"title":"Effect of Placental Histological Chorioamnionitis and Prenatal Steroids on the Nervous System of Preterm Infants","authors":"Jiao Yuan, Dongqing Zhu, Jie Gu, Fuying Zhao, Yongming Wang, Jingxia Luo","doi":"10.5812/ijp-121793","DOIUrl":"https://doi.org/10.5812/ijp-121793","url":null,"abstract":"Background: The placenta, as a link between mother and fetus, is closely related to the development of the fetal nervous system. Histological chorioamnionitis (HCA) is common placental inflammation and an important factor in triggering premature delivery. Anabolic steroid (AS) is an important medication to promote fetal lung maturity. Therefore, this study investigated the relationship between HCA, AS, and brain injury in premature infants. Objectives: This research aimed to explore the correlation of pathological changes in the placental HCA and the prenatal use of AS with brain injury in preterm infants. Methods: In total, 339 premature infants with a gestational age of under 34 weeks were taken as research subjects, and the placenta was examined by pathology after delivery. The samples were divided into HCA+ AS+, HCA+ AS-, HCA- AS+, and HCA- AS- groups based on the pathological results of the placenta and the prenatal use of steroid hormones. The occurrence of brain injury in preterm infants and the level of inflammatory indicators 2 h after birth were compared between the groups. Results: The incidence of brain injury in preterm infants in the HCA+ group was higher than in the HCA- group (χ2 = 5.713, P < 0.05), and the AS- group than in the AS+ group (χ2 = 4.368, P < 0.05); The incidence of brain injury in the HCA+ AS+, HCA+ AS- and HCA- AS-groups was significantly higher than in the HCA- AS+ group (χ2 = 6.105, P = 0.013; χ2 = 9.086, P = 0.003; χ2 = 4.848, P = 0.047, respectively). The incidence of brain injury in preterm infants was the highest in the group (30%). When the procalcitonin level 2 h after birth was 0.213 ng/mL, sensitivity to predict the occurrence of brain injury in preterm infants was 70.7%, and specificity was 80.2%. Conclusions: Brain damage in premature infants is related to HCA in the mother and insufficient AS treatment before delivery. Brain damage is more likely to occur when both factors exist.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136131706","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}
U. Şenel, Halil İbrahim Tanrıverdi, S. Tanrıverdi, Hilal Irmak Sapmaz, Ali Akbaş, F. Gevrek, M. Uysal, U. Taş
Background: Necrotizing enterocolitis (NEC) is a serious intestinal illness in newborns. Objectives: We aimed to investigate the potential protective effects of hesperidin (Hsd) and diosmin on NEC. Methods: Thirty newborn rats were divided into 3 groups: The control group (n = 10), the NEC group (n = 10), and the treatment group (n = 10). The treatment group was given 100 mg/kg of the flavonoid by oral gavage twice daily. On day 5 of the study, animals were sacrificed under anesthesia. After laparotomy, the tissue samples were obtained from the stomach, cecum, and ileum. NEC scoring was performed histopathologically. Apoptotic changes were evaluated by TUNEL (terminal deoxynucleotidyl transferase–mediated biotin–deoxyuridine triphosphate nick-end labeling) staining. Furthermore, levels of oxidants and antioxidants were determined by biochemical analyzes of the tissues. Results: Glutathione peroxidase (GSH-Px) activity and malondialdehyde (MDA) levels were significantly higher in the NEC group than in the control group in all gastrointestinal tract regions examined. Similar to the control group, GSH-Px and MDA were found to be low only in the cecum in the group treated with flavonoids. NEC damage score and apoptotic index in all 3 regions examined were significantly higher in the NEC group than in the control and treatment groups. The apoptotic index values in the treatment group were similar in the stomach and cecum, and the NEC damage score was similar to those in the control group only in the cecum. Conclusions: Hsd and diosmin treatment significantly reduces the severity of NEC-induced damage and apoptotic cell death, especially in the cecum.
{"title":"Effects of Hesperidin and Diosmin on Necrotizing Enterocolitis: An Experimental Study","authors":"U. Şenel, Halil İbrahim Tanrıverdi, S. Tanrıverdi, Hilal Irmak Sapmaz, Ali Akbaş, F. Gevrek, M. Uysal, U. Taş","doi":"10.5812/ijp-127271","DOIUrl":"https://doi.org/10.5812/ijp-127271","url":null,"abstract":"Background: Necrotizing enterocolitis (NEC) is a serious intestinal illness in newborns. Objectives: We aimed to investigate the potential protective effects of hesperidin (Hsd) and diosmin on NEC. Methods: Thirty newborn rats were divided into 3 groups: The control group (n = 10), the NEC group (n = 10), and the treatment group (n = 10). The treatment group was given 100 mg/kg of the flavonoid by oral gavage twice daily. On day 5 of the study, animals were sacrificed under anesthesia. After laparotomy, the tissue samples were obtained from the stomach, cecum, and ileum. NEC scoring was performed histopathologically. Apoptotic changes were evaluated by TUNEL (terminal deoxynucleotidyl transferase–mediated biotin–deoxyuridine triphosphate nick-end labeling) staining. Furthermore, levels of oxidants and antioxidants were determined by biochemical analyzes of the tissues. Results: Glutathione peroxidase (GSH-Px) activity and malondialdehyde (MDA) levels were significantly higher in the NEC group than in the control group in all gastrointestinal tract regions examined. Similar to the control group, GSH-Px and MDA were found to be low only in the cecum in the group treated with flavonoids. NEC damage score and apoptotic index in all 3 regions examined were significantly higher in the NEC group than in the control and treatment groups. The apoptotic index values in the treatment group were similar in the stomach and cecum, and the NEC damage score was similar to those in the control group only in the cecum. Conclusions: Hsd and diosmin treatment significantly reduces the severity of NEC-induced damage and apoptotic cell death, especially in the cecum.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":"96 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77917183","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}
M. Nasehi, P. Ahmadi, Z. Khalili, Maryam Rahmannia, Zahra Ahmadi, Mahmoud Reza Zitatzadeh, E. Pourbakhtyaran
Background: Guillain-Barré syndrome (GBS) is a post-infectious immune-mediated peripheral neuropathy, progressing bilaterally and often symmetrically and affecting sensory and motor function. Most cases completely recover, but around 20% of cases may lead to complications, incomplete recovery, or even death. Objectives: This study aims to assess the prognosis of GBS in pediatric patients and possible associated conditions regarding recovery or prognosis. Methods: We investigated 71 cases of GBS admitted to Mofid Pediatric Hospital from March 2014 to March 2017. Demographic, clinical, and laboratory data were retrospectively recorded and analyzed. Two follow-up visits were performed after 1 to 3 and 5 to 8 years from onset, according to the GBS Disability Scale, and recovery of motor function was assessed during patients’ visits to the clinic. Results: We found 35 male and 36 female subjects with an average age of 6.17 ± 3.82 (range 0.9 up to 15 years old); cases were mostly presented with myalgia and weakness (78.9%) followed by headache, found in 5 patients (7%). Around 84.5% of patients had an upper respiratory infection as their antecedent infection. Fifteen cases of autonomic dysfunction were observed, and 15 patients had cranial nerve involvement. Most cases had the acute inflammatory demyelinating polyradiculoneuropathy (AIDP) form of GBS on electrophysiologic tests. Analysis showed only axonal involvement was significantly correlated with poor prognosis (P-value
{"title":"A Retrospective Single-center Study of Presentation and Prognosis of Guillain-Barré Syndrome in Pediatric Patients","authors":"M. Nasehi, P. Ahmadi, Z. Khalili, Maryam Rahmannia, Zahra Ahmadi, Mahmoud Reza Zitatzadeh, E. Pourbakhtyaran","doi":"10.5812/ijp-128852","DOIUrl":"https://doi.org/10.5812/ijp-128852","url":null,"abstract":"Background: Guillain-Barré syndrome (GBS) is a post-infectious immune-mediated peripheral neuropathy, progressing bilaterally and often symmetrically and affecting sensory and motor function. Most cases completely recover, but around 20% of cases may lead to complications, incomplete recovery, or even death. Objectives: This study aims to assess the prognosis of GBS in pediatric patients and possible associated conditions regarding recovery or prognosis. Methods: We investigated 71 cases of GBS admitted to Mofid Pediatric Hospital from March 2014 to March 2017. Demographic, clinical, and laboratory data were retrospectively recorded and analyzed. Two follow-up visits were performed after 1 to 3 and 5 to 8 years from onset, according to the GBS Disability Scale, and recovery of motor function was assessed during patients’ visits to the clinic. Results: We found 35 male and 36 female subjects with an average age of 6.17 ± 3.82 (range 0.9 up to 15 years old); cases were mostly presented with myalgia and weakness (78.9%) followed by headache, found in 5 patients (7%). Around 84.5% of patients had an upper respiratory infection as their antecedent infection. Fifteen cases of autonomic dysfunction were observed, and 15 patients had cranial nerve involvement. Most cases had the acute inflammatory demyelinating polyradiculoneuropathy (AIDP) form of GBS on electrophysiologic tests. Analysis showed only axonal involvement was significantly correlated with poor prognosis (P-value","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":"96 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2023-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90635176","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}
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