Jornal de pediatria最新文献_第10页

Diagnostic utility, disease activity, and disease phenotype correlation of serum ASCA, pANCA, and PR3-ANCA in pediatric inflammatory bowel disease 儿童炎症性肠病中血清ASCA、pANCA和PR3-ANCA的诊断效用、疾病活动性和疾病表型相关性

IF 3.3 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2024-03-01 DOI: 10.1016/j.jped.2023.10.005

Jeong Min Kim , Young Min Choi , Seung A Jung , Hye Ran Yang

Objective

This study aimed to evaluate the diagnostic utility, disease activity, and phenotypic association of serum anti-Saccharomyces cerevisiae antibody (ASCA), perinuclear anti-neutrophil cytoplasmic antibody (pANCA), PR3-ANCA, and MPO-ANCA in pediatric patients with inflammatory bowel disease (IBD).

Methods

Pediatric patients diagnosed with IBD were recruited and classified as Crohn's disease (CD), ulcerative colitis (UC), and IBD-unclassified (IBD-U) through full investigation. The Paris classification was used to evaluate disease phenotypes of pediatric CD and UC.

Results

In all, 229 pediatric patients with IBD (CD 147, UC 53, IBD-U 29) were included. The ASCA IgG seropositivity significantly differed among the three groups (CD 75.4%, UC 17.5%, and IBD-U 60.0%; p < 0.001). PR3-ANCA positive rates were the highest in UC (24.0%), followed by IBD-U (17.6%), and none in CD (p = 0.002); pANCA-positive rates were higher in IBD-U (33.6%), followed by UC (28.0%) than in CD (1.4%) (p < 0.001). Regarding disease phenotype, perianal disease revealed higher serum ASCA IgG titers (median 36.7 U/mL in P1 vs. 25.2 U/mL in P0, p = 0.019). Serum ASCA IgG and IgA cutoff values to distinguish CD were 32.7 (U/mL) and 11.9 (U/mL), respectively, with a specificity of 80.0%.

Conclusion

Serological biomarkers of ASCA IgG and IgA were effective for differentiating CD in pediatric IBD patients, and serum pANCA and PR3-ANCA, but not MPO-ANCA, were effective in distinguishing UC and IBD-U. Furthermore, measuring serological titers of ASCA IgG and IgA may help differentiate CD and evaluate the disease activity and phenotype of pediatric IBD in practice.

目的:本研究旨在评估血清抗酒酵母抗体(ASCA)、核周抗中性粒细胞胞浆抗体(pANCA)、PR3-ANCA和MPO-ANCA在儿童炎症性肠病(IBD)中的诊断价值、疾病活动性和表型相关性。方法:招募诊断为IBD的儿科患者，通过充分调查将其分为克罗恩病(CD)、溃疡性结肠炎(UC)和IBD未分类(IBD- u)。Paris分类用于评估儿童CD和UC的疾病表型。结果:共纳入229例IBD患儿(CD 147例，UC 53例，IBD- u 29例)。三组患者血清ASCA IgG阳性率差异有统计学意义(CD 75.4%， UC 17.5%， IBD-U 60.0%;结论:血清生物标志物ASCA IgG和IgA可有效鉴别儿科IBD患者的CD，血清pANCA和PR3-ANCA可有效鉴别UC和IBD- u，而MPO-ANCA不能。此外，测定ASCA IgG和IgA的血清学滴度可能有助于区分CD，并在实践中评估儿童IBD的疾病活动性和表型。

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引用次数: 0

Transgenerational transmission of eating habits 饮食习惯的代代相传

IF 3.3 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2024-03-01 DOI: 10.1016/j.jped.2023.11.007

Mauro Fisberg, Nathalia Gioia, Priscila Maximino

Objective

To investigate the relationship between the biopsychosocial environment and eating habits and behaviors that lead to the selection and consumption of certain food from the earliest stages of life. To clarify whether there is an interaction between genetic and epigenetic factors, and how they shape eating habits.

Data source

A narrative review based on research in PubMed and Web of Science electronic databases was carried out over the last 10 years, searching the title and summary fields using the keywords Children OR adolescents Feeding Behavior eating OR Dietary Habits OR Eating Behavior OR Eating Habits OR Children obesity.

Data synthesis

The generational transmission of eating habits is related to the home, community, and school environments, mainly during the first years of life, and can exert the modulation of habits during all stages of life. During childhood, the family's role in consolidating eating habits is very broad and ranges from choosing foods to prioritizing family meals, including the lifestyle.

Conclusions

Eating habits are transmitted from parents to children in different ways: environmental, emotional, social, and educational. In cases of obesity, a greater association of genetic influence can be observed.

目的研究生物-心理-社会环境与饮食习惯和行为之间的关系，这种关系导致人们从生命的最初阶段就开始选择和食用某些食物。数据来源根据 PubMed 和 Web of Science 电子数据库中过去 10 年的研究结果进行叙述性综述，使用关键词儿童或青少年喂养行为饮食或饮食习惯或饮食行为或饮食习惯或儿童肥胖进行标题和摘要字段搜索。数据综述饮食习惯的代代相传与家庭、社区和学校环境有关，主要发生在生命的最初几年，并能在生命的各个阶段对习惯产生调节作用。在儿童时期，家庭在巩固饮食习惯方面的作用非常广泛，从选择食物到优先安排家庭膳食，包括生活方式。在肥胖症的案例中，可以观察到遗传影响的关联性更大。

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引用次数: 0

Diagnosis and treatment of eating disorders in children and adolescents 儿童和青少年饮食失调症的诊断和治疗

IF 3.3 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2024-03-01 DOI: 10.1016/j.jped.2023.12.001

Ana Paola Robatto , Carla de Magalhães Cunha , Luiza Amélia Cabus Moreira

Objectives

To provide a narrative review of the main eating disorders (ED), specifically focusing on children and adolescents. This review also aims to help the pediatrician identify, diagnose, and refer children and adolescents affected by this medical condition and inform them about the multidisciplinary treatment applied to these disorders.

Data source

The research was conducted in the Scientific Electronic Library Online (SciELO), Medical Literature Analysis and Retrieval System Online (Medline) databases via PubMed and Embase. Consolidated Guidelines and Guidebooks in the area were also included in the review to support the discussion of ED treatment in childhood and adolescence.

Data synthesis

ED are psychiatric condition that usually begins in adolescence or young adulthood but can occur at any time of life, including in childhood, which has been increasingly frequent. Pediatricians are the first professionals to deal with the problem and, therefore, must be well trained in identifying and managing these disorders, which can be severe, and determine physical complications and quality of life of patients and their families.

Conclusion

ED has shown an increase in prevalence, as well as a reduction in the age of diagnosed patients, requiring adequate detection and referral by pediatricians. The treatment requires a specialized multidisciplinary team and is generally long-lasting for adequate recovery of affected individuals.

目的对主要进食障碍（ED）进行叙述性综述，特别关注儿童和青少年。本综述还旨在帮助儿科医生识别、诊断和转诊受这一病症影响的儿童和青少年，并向他们介绍适用于这些疾病的多学科治疗方法。数据来源本研究通过 PubMed 和 Embase 在科学电子图书馆在线（SciELO）、医学文献分析和检索系统在线（Medline）数据库中进行。数据综述ED是一种精神疾病，通常始于青春期或青年期，但也可能发生在生命的任何时期，包括越来越频繁发生的儿童期。儿科医生是最先处理这一问题的专业人员，因此必须在识别和处理这些疾病方面接受良好的培训，这些疾病可能很严重，并决定着患者及其家人的身体并发症和生活质量。ED 的发病率呈上升趋势，确诊患者的年龄也有所下降，这就要求儿科医生进行充分的检测和转诊。治疗需要一个专业的多学科团队，一般需要长期治疗才能使患者充分康复。

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引用次数: 0

Congenital hyperinsulinism and surgical outcome in a single tertiary center in Brazil 巴西一家三级中心的先天性高胰岛素血症和手术结果。

IF 3.3 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2024-03-01 DOI: 10.1016/j.jped.2023.09.005

Raphael Del Roio Liberatore Junior , Isabella Christina Mazzaro Monteiro , Flavio de Oliveira Pileggi , Wellen Cristina Canesin , Lourenço Sbragia

Objective

Congenital hyperinsulinism (CHI) is a heterogeneous genetic disease characterized by increased insulin secretion and causes persistent hypoglycemia in neonates and infants due to dysregulation of insulin secretion by pancreatic β cells. Babies with severe hypoglycemia and for whom medical treatment has been ineffective usually require surgical treatment with near-total pancreatectomy. To evaluate the clinical and surgical aspects affecting survival outcomes in babies diagnosed with CHI in a single tertiary care center.

Methods

Retrospective Cohort study involving a single university tertiary center for the treatment of CHI. The authors study the demographics, clinical, laboratory, and surgical outcomes of this casuistic.

Results

61 % were female, 39 % male, Birth weight: 3576 g (±313); Age of onset of symptoms: from the 2nd hour of life to 28 days; Time between diagnosis and surgery ranged between 10 and 60 days; Medical clinical treatment, all patients received glucose solution with a continuous glucose infusion and diazoxide. 81 % of the patients used corticosteroids, 77 %. thiazide, 72 % octreotide, 27 % nifedipine; Neurological sequelae during development and growth: 54 % had some degree of delay in neuropsychomotor development, 27 % obesity. Surgery was performed open in 6 and 12 minimally invasive surgery (MIS). Histopathology: 2 focal and 16 diffuse, Length of stay (days) was lower in MIS (p < 0.05). Survival was 100 %.

Conclusions

CHI is a rare and difficult-to-manage tumor that must be performed in a multidisciplinary and tertiary center. Most surgical results are good and the laparoscopic approach to disease has been the best choice for patients.

目的：先天性高胰岛素血症（CHI）是一种以胰岛素分泌增加为特征的异质性遗传疾病，由于胰腺β细胞对胰岛素分泌的失调，可导致新生儿和婴儿持续低血糖。患有严重低血糖症且药物治疗无效的婴儿通常需要进行近全胰切除术的手术治疗。在一个三级护理中心评估影响被诊断为CHI的婴儿生存结果的临床和外科方面。方法：回顾性队列研究，涉及一所大学三级中心治疗CHI。作者研究了这种诡辩的人口统计学、临床、实验室和手术结果。结果：61%为女性，39%为男性，出生体重3576g（±313）；症状出现的年龄：从生命的第2小时到28天；从诊断到手术的时间在10到60天之间；药物临床治疗，所有患者均接受葡萄糖溶液，并持续输注葡萄糖和二氮氧化物。81%的患者使用皮质类固醇，77%。噻嗪、72%奥曲肽、27%硝苯地平；发育和生长过程中的神经后遗症：54%的人神经运动发育有一定程度的延迟，27%的人肥胖。在6例和12例微创手术（MIS）中进行了开放手术。组织病理学：2例为局灶性，16例为弥漫性，MIS的停留时间（天）较低（p结论：CHI是一种罕见且难以治疗的肿瘤，必须在多学科和三级中心进行。大多数手术结果良好，腹腔镜治疗疾病是患者的最佳选择。

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引用次数: 0

Ultra-processed food consumption and children and adolescents’ health 超加工食品消费与儿童和青少年健康。

IF 3.3 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2024-03-01 DOI: 10.1016/j.jped.2023.09.006

Samantha Bittencourt Mescoloto , Gabriela Pongiluppi , Semíramis Martins Álvares Domene

Objectives

To present observational studies investigating associations between the consumption of ultra-processed foods and health outcomes in childhood and adolescence.

Data source

Observational, cross-sectional, or longitudinal studies were considered, and identified in the Scopus, Web of Science, Pubmed and Scielo databases, without date restrictions.

Data synthesis

The most frequent combinations of risk factors in children and adolescents involved an unhealthy diet, with regular consumption of ultra-processed foods to the detriment of a diet based on fresh or minimally-processed foods and insufficient levels of physical activity; records on alcohol and tobacco use were identified. Combined, these practices contribute to the findings that indicate an increase in the prevalence of obesity in children and adolescents and a sedentary lifestyle, with a decrease in physical activity, in addition to representing a risk for the development of chronic non-communicable diseases, such as cardiovascular diseases and periodontal disease in childhood and adolescence.

Conclusions

The present study maps the current literature on the topic and indicates the direction of the approach for health promotion and prevention of NCDs in children and adolescents. Among the different risk factors that negatively affect the full development of this population, frequently eating breakfast and practicing physical activity is most strongly associated with a lower consumption of ultra-processed foods and should be part of an integrated approach to promoting eating practices that favor the reduction of diseases also in adult life.

目的：进行观察性研究，调查超加工食品的消费与儿童和青少年健康结果之间的关系。数据来源：在Scopus、Web of Science、Pubmed和Scielo数据库中考虑并确定了观察性、横断面或纵向研究，没有日期限制。数据综合：儿童和青少年最常见的风险因素组合包括不健康饮食，经常食用超加工食品，损害了以新鲜或最低加工食品为基础的饮食，以及体育活动水平不足；查明了有关酒精和烟草使用的记录。综合起来，这些做法有助于发现，儿童和青少年肥胖的患病率和久坐的生活方式增加，体育活动减少，此外还代表着儿童和青少年患心血管疾病和牙周病等慢性非传染性疾病的风险。结论：本研究绘制了当前关于该主题的文献，并指出了儿童和青少年非传染性疾病健康促进和预防方法的方向。在对这一人群的全面发展产生负面影响的不同风险因素中，经常吃早餐和进行体育活动与超加工食品的消费量减少密切相关，应该成为促进饮食习惯的综合方法的一部分，有助于减少成年生活中的疾病。

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引用次数: 0

Marketing and child feeding 营销和儿童营养。

IF 3.3 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2024-03-01 DOI: 10.1016/j.jped.2023.09.013

Kátia Galeão Brandt , Giselia Alves Pontes da Silva

Objective

To carry out a narrative review on the use of marketing strategies in child nutrition, as well as potential implications for health professionals and children.

Data source

Searches were carried out on the PubMed, SciELO, and Google platforms, using the terms “child nutrition” or “industrialized baby food” or “infant formula” or “breast milk” or “breastfeeding” and “marketing”, with original articles, review articles, institutional reports, institutional position documents and websites considered relevant to the topic being analyzed.

Data synthesis

Children's food marketing started with the industrialization of food and the resulting actions aimed at increasing sales and meeting commercial interests. Since its inception to the present, infant formulas have been the most widely used products, which has impacted breastfeeding practices. International and national institutions, that care for children's health, are searching for strategies to limit the abusive marketing of industrialized children's foods. Marketing strategies interfere with medical knowledge and actions, potentially influencing the guidance provided by pediatricians to families, and finally, compromising healthy eating practices at a critical period in life, with possible long-term effects.

Conclusions

Health professionals, especially pediatricians, must provide the best care for children and families, and need to maintain the search for quality scientific information, not influenced by conflicts of interest. Updated and critical knowledge on the part of healthcare professionals can curb marketing strategies that aim to influence their actions.

目的：对儿童营养营销策略的使用进行叙述性综述，以及对卫生专业人员和儿童的潜在影响。数据来源：在PubMed、SciELO和谷歌平台上进行了搜索，使用术语“儿童营养”或“工业化婴儿食品”或“婴儿配方奶粉”或“母乳喂养”或“营销”，并分析了被认为与该主题相关的原创文章、综述文章、机构报告、机构立场文件和网站。数据综合：儿童食品营销始于食品的工业化，以及由此产生的旨在增加销售额和满足商业利益的行动。自诞生至今，婴儿配方奶粉一直是使用最广泛的产品，这对母乳喂养实践产生了影响。关心儿童健康的国际和国家机构正在寻找战略，以限制工业化儿童食品的滥用营销。营销策略干扰了医学知识和行动，可能影响儿科医生为家庭提供的指导，最终影响生命关键时期的健康饮食习惯，并可能产生长期影响。结论：卫生专业人员，尤其是儿科医生，必须为儿童和家庭提供最好的护理，并需要保持对高质量科学信息的搜索，不受利益冲突的影响。医疗保健专业人员更新的关键知识可以遏制旨在影响其行动的营销策略。

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引用次数: 0

What causes obesity in children and adolescents? 是什么导致儿童和青少年肥胖？

IF 3.3 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2024-03-01 DOI: 10.1016/j.jped.2023.09.011

Carlos Alberto Nogueira-de-Almeida , Virginia Resende Silva Weffort , Fábio da V. Ued , Ivan S. Ferraz , Andrea A. Contini , Edson Zangiacomi Martinez , Luiz A. Del Ciampo

Objective

To present the different aspects that may be involved in the genesis and maintenance of obesity in children and adolescents.

Data source

Narrative review of articles published in the PubMed, Scielo, Lilacs, Scopus and Google Scholar databases, using the search terms: overweight, obesity, pre-conception, prenatal, infants, schoolchildren, children, and adolescents. The search was conducted in studies written in Portuguese, English and Spanish, including narrative, integrative or systematic reviews, meta-analyses, cross-sectional, case-control and cohort studies, published between 2003 and 2023.

Data synthesis

A total of 598 studies were initially screened and 60 of them, which showed the main biopsychosocial aspects related to greater risks of excessive adiposity in the pediatric age, were included in the review. The data were presented taking into account the incidence of risk factors and their consequences in six periods: pre-conception, pre-natal, infant, preschool, school age, and adolescence.

Conclusions

The causal factors described in the scientific literature that have been shown to be related to obesity in childhood and adolescence are presented.

目的：介绍儿童和青少年肥胖的发生和维持可能涉及的不同方面。数据来源：PubMed、Scielo、Lilacs、Scopus和Google Scholar数据库中发表的文章的叙述性综述，使用搜索词：超重、肥胖、怀孕前、产前、婴儿、学童、儿童和青少年。这项搜索是在2003年至2023年间发表的葡萄牙语、英语和西班牙语研究中进行的，包括叙述性、综合性或系统性综述、荟萃分析、横断面、病例对照和队列研究。数据综合：最初共筛选了598项研究，其中60项，该综述显示了与儿童年龄过度肥胖风险更大相关的主要生物心理社会方面。这些数据考虑了六个时期的风险因素发生率及其后果：受孕前、出生前、婴儿、学前、学龄和青春期。结论：介绍了科学文献中描述的与儿童和青少年肥胖有关的因果因素。

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引用次数: 0

Public health implications of replacing screen time with physical activity and sleep in Brazilian children 巴西儿童以体育活动和睡眠取代屏幕时间对公共卫生的影响。

IF 3.3 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2024-03-01 DOI: 10.1016/j.jped.2023.11.004

Ryan D. Burns

引用次数: 0

Child feeding and nutrition: a contemporary view 儿童喂养与营养：当代视角

IF 3.3 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2024-03-01 DOI: 10.1016/j.jped.2024.01.001

Crésio de Aragão Dantas Alves , Giselia Alves Pontes da Silva

引用次数: 0

Bone and joint infection complicated with sepsis in neonates and infants under three months of age 新生儿和三个月以下婴儿的骨关节感染并发败血症。

IF 3.3 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2024-03-01 DOI: 10.1016/j.jped.2023.09.003

Yao Liu , Kai Zhao , Ya Liu , Yu-Han Sun , Meng-Xia Li , Min Yu , Lun-Qing Zhu , Xiao-Dong Wang

Objective

Studies focusing on bone and joint infections (BJIs) in young infants are rare. Some cases of BJI are accompanied by sepsis. This study aimed to identify the clinical and bacteriological features of sepsis in neonates and young infants with BJIs.

Methods

Neonates and infants younger than 3 months diagnosed with BJI in the present institution from 2014 to 2021 were retrospectively reviewed. Patient characteristics, clinical data, and outcomes were documented and compared between those with and without sepsis.

Results

Twenty-five patients with a mean age of 34.8 days were included. Nine BJI cases had concomitant sepsis (group A), and 16 had BJI without sepsis (group B). Within group A, staphylococcus aureus was the major pathogenic germ (5 cases, of which 4 were of the methicillin-resistant staphylococcus aureus (MRSA) type). There was no statistical difference in male-to-female ratio, age, history of hospitalization, anemia, birth asphyxia, peripheral leukocyte counts, C-reactive protein on admission, and sequelae between groups. Univariate analyses indicated a significant difference in the incidence of septic arthritis (SA) combined with osteomyelitis (OM) (88.9% vs 37.5%), congenital deformities (44.4% vs 0%), and mean duration of symptoms (2.83 days vs 9.21 days) in comparisons between groups A and B.

Conclusion

Staphylococcus aureus is the main pathogenic bacteria in BJI cases complicated with sepsis in neonates and young infants. Among infants younger than 3 months diagnosed with BJI, those with concurrent SA and OM, MRSA infection, or congenital deformities are more likely to develop sepsis.

目的：对婴幼儿骨关节感染的研究很少。一些BJI病例伴有败血症。本研究旨在确定患有BJI的新生儿和婴幼儿败血症的临床和细菌学特征。方法：回顾性回顾2014年至2021年在本机构诊断为BJI的3个月以下新生儿和婴儿。记录患者特征、临床数据和结果，并在有败血症和无败血症的患者之间进行比较。结果：纳入25例患者，平均年龄34.8天。9例BJI伴有败血症（A组），16例BJI无败血症（B组）。A组主要病原菌为金黄色葡萄球菌（5例，其中耐甲氧西林金黄色葡萄菌（MRSA）型4例）。两组之间在男女比例、年龄、住院史、贫血、出生窒息、外周血白细胞计数、入院时C反应蛋白和后遗症方面没有统计学差异。单因素分析显示感染性关节炎（SA）合并骨髓炎（OM）（88.9%vs 37.5%）、先天性畸形（44.4%vs 0%）和先天性关节炎的发生率存在显著差异，A组和B组的平均症状持续时间（2.83天vs 9.21天）。结论：金黄色葡萄球菌是新生儿和婴幼儿BJI并发败血症的主要病原菌。在被诊断为BJI的3个月以下婴儿中，同时患有SA和OM、MRSA感染或先天畸形的婴儿更有可能患败血症。

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引用次数: 0