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Erratum to: “Cross-cultural adaptation, validity, and reliability of the Child and Adolescent Behavior Inventory (CABI) for use in Brazil” (Jornal de Pediatria 99 (2023) 413–422) 勘误:"在巴西使用的儿童和青少年行为量表(CABI)的跨文化适应性、有效性和可靠性》(Jornal de Pediatria 99 (2023) 413-422)的勘误。
IF 2.8 4区 医学 Q1 PEDIATRICS Pub Date : 2024-06-26 DOI: 10.1016/j.jped.2024.06.001
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引用次数: 0
Instrumental swallowing studies for the prevention of pulmonary morbidity in children and the importance of multi-disciplinary teams 预防儿童肺部疾病的工具性吞咽研究和多学科团队的重要性。
IF 2.8 4区 医学 Q1 PEDIATRICS Pub Date : 2024-05-29 DOI: 10.1016/j.jped.2024.05.002
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引用次数: 0
Risk of autism spectrum disorder in children with infantile epileptic spasms syndrome: a retrospective study in a single center in Brazil 婴幼儿癫痫痉挛综合征患儿患自闭症谱系障碍的风险:巴西一家中心的回顾性研究。
IF 2.8 4区 医学 Q1 PEDIATRICS Pub Date : 2024-05-29 DOI: 10.1016/j.jped.2024.04.006

Objective

This study aimed to investigate the prevalence of autism spectrum disorder and its possible correlations with clinical characteristics in patients with infantile epileptic spasms syndrome in a single center in Brazil.

Methods

This retrospective cross-sectional study examined 53 children with the diagnosis of infantile epileptic spasms syndrome prior to an autism spectrum disorder assessment. Participants were divided into two groups based on the presence or absence of autism spectrum disorder. Available variables (sex, medications, median age at onset of infantile epileptic spasms syndrome, and presence of comorbidities) were compared using Mann–Whitney U or chi-square tests.

Results

Among the included patients, 12 (23 %) were diagnosed with autism spectrum disorder, corresponding to a relative risk of 0.29 (95 % confidence interval 0.174–0.492). The age at the first seizure ranged from 3 to 15 months, with a mean of 6.65 months. This age significantly differed between participants with autism spectrum disorder (10.58 months) and those without (5.43 months), p<0.001.

Conclusion

Children with infantile epileptic spasms syndrome have a higher risk of being diagnosed with autism spectrum disorder. Later age of onset and period of spasm occurrence might be predisposing risk factors.

研究目的本研究旨在调查巴西一个中心的婴儿癫痫痉挛综合征患者中自闭症谱系障碍的患病率及其与临床特征的可能相关性:这项回顾性横断面研究对 53 名诊断为婴儿癫痫性痉挛综合征的儿童进行了自闭症谱系障碍评估。根据是否存在自闭症谱系障碍将参与者分为两组。采用曼-惠特尼U检验或卡方检验对现有变量(性别、药物、婴儿癫痫痉挛综合征发病年龄中位数和是否存在合并症)进行比较:在纳入的患者中,有 12 人(23%)被诊断患有自闭症谱系障碍,相对风险为 0.29(95% 置信区间为 0.174-0.492)。首次癫痫发作的年龄在 3 到 15 个月之间,平均为 6.65 个月。患有自闭症谱系障碍的患者(10.58 个月)与未患有自闭症谱系障碍的患者(5.43 个月)在这一年龄上存在明显差异,P= 结论:患有婴儿癫痫痉挛综合征的儿童被诊断为自闭症谱系障碍的风险较高。较晚的发病年龄和痉挛发生期可能是诱发风险因素。
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引用次数: 0
Patients with genital ambiguity referred without a sex definition: the relationship between clinical picture and defined sex of rearing 未确定性别而转诊的生殖器模糊患者:临床表现与确定的抚养性别之间的关系。
IF 2.8 4区 医学 Q1 PEDIATRICS Pub Date : 2024-05-29 DOI: 10.1016/j.jped.2024.05.001

Objective

It was to verify the association between the definition of sex of rearing and, clinical and cytogenetic features among patients with genital ambiguity referred without a sex assignment.

Methods

The sample consisted of 133 patients with genital ambiguity seen at a single reference service. These patients did not have a defined social sex at the first consultation and their etiological diagnosis was obtained during follow-up.

Results

A total of 133 cases were included, 74 of which were reared as males and 59 as females. No correlation was found between the year of birth and the year of the first consultation with the definition of sex of rearing. However, the definition of sex of rearing was associated with age at the first consultation, severity of genital ambiguity, presence of palpable gonad(s), presence of uterus on ultrasound, karyotype, and diagnosis. Palpable gonad(s), more virilized genitalia, absence of a uterus on ultrasound, 46, XY karyotype, or a karyotype with sex chromosome abnormalities emerged as strong predictors for defining male sex. All 77 (58 %) patients over 18 years old had a gender identity in accordance with the sex of rearing; though 9 of 77 (12 %) had homo or bisexual orientation, especially girls with Congenital Adrenal Hyperplasia.

Conclusions

Clinical and cytogenetic data were strongly associated with the definition of the sex of rearing of children with genital ambiguity referred to a DSD center without sex assignment. Management in a specialized center allows the establishment of a gender identity in accordance with the sex of rearing.
目的在转诊的生殖器不明确患者中,验证养育性别的定义与临床和细胞遗传学特征之间的关联:样本包括在一家参考机构就诊的 133 名生殖器发育不全患者。这些患者在初诊时没有明确的社会性别,其病因诊断是在随访过程中获得的:结果:共纳入 133 例患者,其中 74 例为男性,59 例为女性。出生年份和初诊年份与饲养性别定义之间没有相关性。不过,饲养性别的定义与初诊年龄、生殖器模糊的严重程度、是否存在可触及的生殖腺、超声波检查是否存在子宫、核型和诊断结果有关。可触及性腺、生殖器更男性化、超声波检查无子宫、46 XY 染色体核型或有性染色体异常的核型是确定男性性别的重要预测因素。所有 77 名(58%)18 岁以上的患者的性别认同都与抚养性别一致;但 77 名患者中有 9 名(12%)具有同性恋或双性恋倾向,尤其是患有先天性肾上腺皮质增生症的女孩:临床和细胞遗传学数据与生殖器官发育不全中心转诊的生殖器官发育不全儿童的抚养性别定义密切相关。在专科中心接受治疗可以根据抚养性别确定性别身份。
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引用次数: 0
The trajectory of head circumference and neurodevelopment in very preterm newborns during the first two years of life: a cohort study 早产儿头围和神经发育的轨迹:一项队列研究。
IF 2.8 4区 医学 Q1 PEDIATRICS Pub Date : 2024-05-25 DOI: 10.1016/j.jped.2024.04.005

Objective

To evaluate the growth trajectory of head circumference and neurodevelopment, and to correlate head circumference with cognitive, language, and motor outcomes during the first two years.

Method

Prospective cohort study in a tertiary hospital including 95 newborns under 32 weeks or 1500 g. Neonates who developed major neonatal morbidities were excluded. The head circumference was measured at birth, at discharge, and at term-equivalent age, 1, 3, 5, 12, 18, and 24 months of corrected age, and the Bayley Scales (Bayley-III) were applied at 12, 18 and 24 months of corrected age to assess cognitive, language and, motor domains. Scores below 85 were classified as mild/moderate deficits and scores below 70 as severe deficits. The association between head circumference Z score and Bayley scores was assessed using Pearson's correlation. The study considered a significance level of 0.05.

Results

There was a decrease of -0.18 in the head circumference Z score between birth and discharge and the catch-up occurred between discharge and 1 month (an increase of 0.81 in the Z score). There was a positive correlation between head circumference and Bayley scores at 18 months. There was also a positive correlation between head circumference at discharge and at 5 months with the three domains of the Bayley.

Conclusion

Serial measurements of head circumference provide knowledge of the trajectory of growth, with early catch-up between discharge and 1 month, as well as its association with neurodevelopment. Head circumference is therefore a valuable clinical marker for neurodevelopment, especially in very preterm newborns.

目的评估头围的生长轨迹和神经发育情况,并将头围与头两年的认知、语言和运动能力相关联:方法:在一家三级医院进行前瞻性队列研究,包括 95 名不足 32 周或 1500 克的新生儿。排除了患有新生儿重大疾病的新生儿。研究人员在新生儿出生时、出院时、出生后 1 个月、3 个月、5 个月、12 个月、18 个月和 24 个月时测量了新生儿的头围,并在新生儿出生后 12 个月、18 个月和 24 个月时使用 Bayley 量表(Bayley-III)评估新生儿的认知、语言和运动能力。85 分以下为轻度/中度缺陷,70 分以下为重度缺陷。头围 Z 值与 Bayley 评分之间的关系采用皮尔逊相关性进行评估。研究认为显著性水平为 0.05:出生至出院期间,头围 Z 值下降了-0.18,出院至 1 个月期间出现了追赶(Z 值增加了 0.81)。头围与 18 个月时的 Bayley 评分呈正相关。出院时和 5 个月时的头围与 Bayley 三个领域之间也呈正相关:结论:连续测量头围可了解儿童的生长轨迹,包括出院至 1 个月时的早期追赶,以及头围与神经发育的关系。因此,头围是神经发育的重要临床指标,尤其是早产新生儿。
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引用次数: 0
The death risk of pediatric patients with cancer-related sepsis requiring continuous renal replacement therapy: a retrospective cohort study 需要持续肾脏替代治疗的癌症相关败血症儿科患者的死亡风险:一项回顾性队列研究
IF 2.8 4区 医学 Q1 PEDIATRICS Pub Date : 2024-05-24 DOI: 10.1016/j.jped.2024.04.004

Objective

To assess the outcome of patients with cancer-related sepsis requiring continuous renal replacement therapy (CRRT) in a single-center pediatric intensive care unit (PICU).

Method

Children with sepsis who necessitate CRRT from January 2017 to December 2021 were enrolled. The patients with leukemia/lymphoma or solid tumors were defined as underlying cancer. Multivariate logistic regression analysis was performed to identify the death risk factors in patients with cancer-related sepsis.

Results

A total of 146 patients were qualified for inclusion. Forty-six (31.5%) patients with cancer-related sepsis and 100 (68.5%) non-cancer-related sepsis. The overall PICU mortality was 28.1% (41/146), and mortality was significantly higher in cancer-related sepsis patients compared with non-cancer patients (41.3% vs. 22.0%, p = 0.016). Need mechanical ventilation, p-SOFA, acute liver failure, higher fluid overload at CRRT initiation, hypoalbuminemia, and high inotropic support were associated with PICU mortality in cancer-related sepsis patients. Moreover, levels of IL-6, total bilirubin, creatinine, blood urea nitrogen, and international normalized ratio were significantly higher in non-survivors than survivors. In multivariate logistic regression analysis, pediatric sequential organ failure assessment (p-SOFA) score (OR:1.805 [95%CI: 1.047–3.113]) and serum albumin level (OR: 0.758 [95%CI: 0.581 -0.988]) were death risk factors in cancer-related sepsis receiving CRRT, and the AUC of combined index of p-SOFA and albumin was 0.852 (95% CI: 0.730–0.974).

Conclusion

The overall PICU mortality is high in cancer-related sepsis necessitating CRRT. Higher p-SOFA and lower albumin were independent risk factors for PICU mortality.
目的 评估单中心儿科重症监护病房(PICU)中需要进行持续肾脏替代治疗(CRRT)的癌症相关脓毒症患者的预后。方法 纳入 2017 年 1 月至 2021 年 12 月期间需要进行 CRRT 的脓毒症患儿。白血病/淋巴瘤或实体瘤患者被定义为基础癌症。为确定癌症相关脓毒症患者的死亡风险因素,进行了多变量逻辑回归分析。其中46例(31.5%)为癌症相关脓毒症患者,100例(68.5%)为非癌症相关脓毒症患者。PICU 的总死亡率为 28.1%(41/146),与非癌症患者相比,癌症相关脓毒症患者的死亡率明显更高(41.3% 对 22.0%,P = 0.016)。癌症相关脓毒症患者需要机械通气、p-SOFA、急性肝功能衰竭、CRRT 开始时液体超负荷较高、低白蛋白血症和高肌力支持与 PICU 死亡率相关。此外,未存活患者的 IL-6、总胆红素、肌酐、血尿素氮和国际标准化比率水平明显高于存活者。在多变量逻辑回归分析中,儿科序贯器官衰竭评估(p-SOFA)评分(OR:1.805 [95%CI:1.047-3.113])和血清白蛋白水平(OR:0.758 [95%CI:0.581 -0.结论 需要接受CRRT的癌症相关脓毒症患者的PICU总死亡率较高。高 p-SOFA 和低白蛋白是 PICU 死亡率的独立风险因素。
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引用次数: 0
Inflammatory markers in prepubertal children and their associations with abdominal fat 青春期前儿童的炎症指标及其与腹部脂肪的关系。
IF 2.8 4区 医学 Q1 PEDIATRICS Pub Date : 2024-05-08 DOI: 10.1016/j.jped.2024.03.015

Objective

To evaluate the association between inflammatory markers and abdominal fat assessed by ultrasound in prepubertal children with and without excess weight.

Methods

A cross-sectional study involving 241 prepubertal children, 156 with obesity, 37 with overweight, and 48 with normal weight, aged five to ten years, who were followed at a research unit on Childhood Obesity from a teaching hospital belonging to a public health system. The concentration of interleukin-6, tumor necrosis factor-α and C-reactive protein were assessed and regression analyses, considering outcome variables such as abdominal wall and intra-abdominal fat thickness measured by ultrasound, were performed.

Results

The findings highlighted an association between abdominal fat and inflammatory markers, even in children at this young age group. Subcutaneous fat showed a stronger association with inflammatory biomarkers compared to intra-abdominal fat when performing logistic regression, with a positive association between tumor necrosis factor-α and abdominal wall thickness equal to or greater than the 75th percentile in adjusted logistic regression (OR: 18.12; CI 95 %: 1.57: 209.55).

Conclusions

Abdominal wall fat, in contrast to what is often observed in adults, appears to have a greater impact on chronic inflammation related to excessive weight in very young children.

目的评估体重超标和未超标的青春期前儿童的炎症标志物与超声波评估的腹部脂肪之间的关系:一项横断面研究涉及 241 名青春期前儿童,其中 156 名肥胖,37 名超重,48 名体重正常,年龄在 5-10 岁之间。研究人员评估了白细胞介素-6、肿瘤坏死因子-α和C反应蛋白的浓度,并根据超声波测量的腹壁和腹内脂肪厚度等结果变量进行了回归分析:结果:研究结果表明,腹部脂肪与炎症标志物之间存在关联,即使是年龄较小的儿童也是如此。在进行逻辑回归时,与腹内脂肪相比,皮下脂肪与炎症生物标志物的关联性更强,在调整后的逻辑回归中,肿瘤坏死因子-α与腹壁厚度等于或大于第75百分位数呈正相关(OR:18.12;CI 95 %:1.57:209.55):腹壁脂肪对体重过重引起的慢性炎症的影响似乎更大,这与在成人身上经常观察到的情况不同。
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引用次数: 0
Sexual violence against children and adolescents in Paraná State: geospatial analysis and main socioeconomic indicators 巴拉那州针对儿童和青少年的性暴力:地理空间分析和主要社会经济指标。
IF 2.8 4区 医学 Q1 PEDIATRICS Pub Date : 2024-05-01 DOI: 10.1016/j.jped.2024.03.014

Objective

Child sexual violence is a multidimensional problem of many contemporary societies, affecting people of all sexes, social stratum and age groups. Offenses involving children and adolescents are more serious, given their total or partial dependence on parents and caregivers. Information on child sexual violence in Brazil is found in raw form and without detail. The objective was to compare the information with social and economic data in the state of Paraná.

Methods

The authors conducted a retrospective study of secondary data from the Notifiable Diseases Information System (SINAN) on cases of sexual violence involving victims aged 0 to 19 years. Results are presented according to notification characteristics. The authors applied exploratory spatial data analysis to assess spatial autocorrelations and investigated relationships by the ordinary least squares regression model.

Results

Between 2017 and 2021, there were 13,403 reports of child sexual violence in Paraná State, Brazil. Most victims (82.8%) were female and aged between 10 and 14 years. The majority of sexual violence cases (67.8%) occurred in the home environment. The highest rates on a population basis were observed in the North Central and Greater Curitiba regions, mainly in cities with higher population density and with higher rates of other types of violence.

Conclusion

The results provide data that can promote a broader understanding of the distribution of sexual violence and the state and associated variations. It is expected to improve the provision of care for victims of child sexual violence and assist in strategic planning to prevent future offenses.

目的:儿童性暴力是当代许多社会的一个多层面问题,影响到所有性别、社会阶层和年龄组的人。由于儿童和青少年完全或部分依赖于父母和照顾者,因此涉及他们的犯罪行为更为严重。在巴西,有关儿童性暴力的信息都是原始的,并不详细。我们的目的是将这些信息与巴拉那州的社会和经济数据进行比较:作者对来自应报告疾病信息系统(SINAN)的二级数据进行了一项回顾性研究,研究对象是涉及 0 至 19 岁受害者的性暴力案件。研究结果根据申报特征进行了阐述。作者运用探索性空间数据分析评估了空间自相关性,并通过普通最小二乘法回归模型研究了相关关系:2017 年至 2021 年间,巴西巴拉那州共收到 13 403 份儿童性暴力报告。大多数受害者(82.8%)为女性,年龄在 10 至 14 岁之间。大多数性暴力案件(67.8%)发生在家庭环境中。按人口计算,中北部和大库里蒂巴地区的性暴力事件发生率最高,主要发生在人口密度较高和其他类型暴力事件发生率较高的城市:研究结果提供的数据可以促进人们更广泛地了解性暴力的分布情况、状态和相关变化。预计这将改善对儿童性暴力受害者的照顾,并有助于制定战略规划,预防未来的犯罪行为。
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引用次数: 0
Acupuncture for pediatric chronic pain: a systematic review 针灸治疗小儿慢性疼痛:系统综述。
IF 2.8 4区 医学 Q1 PEDIATRICS Pub Date : 2024-04-30 DOI: 10.1016/j.jped.2024.03.013

Objectives

To survey, analyze and discuss the scientific evidence supporting the use of acupuncture and related techniques in the management of chronic pain in the pediatric population.

Sources

A survey of databases (MEDLINE, Scopus and Scielo) was carried out with search strategies, following the PRISMA statement, without limits on publication dates and languages. Clinical studies (clinical trials, single-arm, and case series) were accepted for review if they included participants aged up to 22 years. Study quality was assessed by MMAT, and the randomized clinical trial was analyzed under the STRICTA criteria.

Summary of the findings

2369 articles were retrieved. After excluding repetitions, 1335 underwent the initial selection. Only 16 articles were selected for full reading, of which 5 were included in the review, being two case series, two single-arm studies, and one randomized clinical trial. The articles were considered of good quality by the adopted criteria.

Conclusion

The analyzed studies showed important clinical results such as the reduction of pain intensity, and improvement in school attendance and social life. However, there are many limitations in study design and sample size. Therefore, there is weak evidence to support the use of acupuncture in the context of pediatric chronic pain, but the positive results reinforce the need for further investigation of the topic with the conduct of larger and well-designed studies, to obtain more data and greater scientific conviction of the findings.
目的调查、分析并讨论支持使用针灸及相关技术治疗儿科慢性疼痛的科学证据:根据 PRISMA 声明,采用检索策略对数据库(MEDLINE、Scopus 和 Scielo)进行了调查,不限制发表日期和语言。如果临床研究(临床试验、单臂研究和病例系列研究)的参与者年龄不超过 22 岁,则接受该研究的审查。研究质量由 MMAT 评估,随机临床试验则根据 STRICTA 标准进行分析。在排除重复文章后,1335 篇文章通过了初选。只有 16 篇文章被选中进行全文阅读,其中 5 篇被纳入综述,包括 2 篇病例系列、2 篇单臂研究和 1 篇随机临床试验。根据采用的标准,这些文章被认为质量良好:所分析的研究显示了重要的临床结果,如减轻了疼痛强度,改善了就学和社交生活。然而,在研究设计和样本量方面存在很多局限性。因此,支持在小儿慢性疼痛中使用针灸的证据不足,但积极的结果加强了进一步调查该主题的必要性,即进行更大规模和设计良好的研究,以获得更多数据和更科学的研究结果。
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引用次数: 0
Inhaled magnesium versus inhaled salbutamol in rescue treatment for moderate and severe asthma exacerbations in pediatric patients 吸入镁与吸入沙丁胺醇在儿童患者中度和重度哮喘加重的抢救治疗中的比较
IF 2.8 4区 医学 Q1 PEDIATRICS Pub Date : 2024-04-30 DOI: 10.1016/j.jped.2024.03.012

Objective

To compare the effectiveness of inhaled Magnesium Sulfate associated with Salbutamol versus Inhaled Salbutamol alone in patients with moderate and severe asthma exacerbations.

Method

Clinical, prospective and randomized study with patients between 3 and 14 years of age divided into two groups: one to receive inhaled salbutamol associated with magnesium sulfate (GSM), the other to receive inhaled salbutamol alone (GS). The sample consisted of 40 patients, 20 patients in each group. Severity was classified using the modified Wood-Downes score, with values between 4 and 7 classified as moderate and 8 or more classified as severe.

Results

Post-inhalation scores decreased both in patients who received salbutamol and magnesium and in those who received salbutamol alone, with no statistically significant difference between the groups.

Conclusions

Despite the benefits when administered intravenously, inhalation of the drug alone or in combination did not reduce the severity of the exacerbation.

比较吸入硫酸镁联合舒喘宁与单独吸入舒喘宁对中度和重度哮喘加重患者的疗效。该临床前瞻性随机研究将 3 至 14 岁的患者分为两组:一组接受吸入舒喘宁联合硫酸镁(GSM),另一组接受单独吸入舒喘宁(GS)。样本包括 40 名患者,每组 20 人。严重程度采用改良的伍德-多恩斯评分法进行分类,评分值在 4 到 7 之间的为中度,评分值在 8 或以上的为重度。吸入沙丁胺醇和镁的患者以及仅吸入沙丁胺醇的患者吸入后的评分均有所下降,但两组之间的差异在统计学上并无显著性。尽管静脉给药有好处,但单独或联合吸入药物并不能减轻病情恶化的严重程度。
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引用次数: 0
期刊
Jornal de pediatria
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