Jornal de pediatria最新文献

英文中文

Comparing the clinical characteristics and outcomes of septic shock children with and without malignancies: a retrospective cohort study 比较患有和未患有恶性肿瘤的脓毒性休克患儿的临床特征和预后：一项回顾性队列研究。

IF 2.8 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2024-07-03 DOI: 10.1016/j.jped.2024.06.003

Objective

There is an amelioration in mortality rates of septic shock patients with malignancies over time, but it remains uncertain in children. Therefore, the authors endeavored to compare the clinical characteristics, treatment needs, and outcomes of septic shock children with or without malignancies.

Methods

The authors retrospectively analyzed the data of children admitted to the PICU due to septic shock from January 2015 to December 2022 in a tertiary pediatric hospital. The main outcome was in-hospital mortality.

Results

A total of 508 patients were enrolled. The proportion of Gram-negative bacteria and fungal infections in children with malignancies was significantly higher than those without malignancies. Septic shock children with malignancies had a longer length of stay (LOS) in the hospital (21 vs. 11 days, p<0.001). However, there were no statistically significant differences in the LOS of PICU (5 vs. 5 days, p = 0.591), in-hospital mortality (43.0 % vs. 49.4 %, p = 0.276), and 28-day mortality (49.2 % vs. 44.7 %, p = 0.452). The 28-day survival analysis (p = 0.314) also showed no significant differences.

Conclusion

Although there are significant differences in the bacterial spectrum of infections, the septic shock children with or without malignancies showed a similar mortality rate. The septic shock children with malignancies had longer LOS of the hospital.

目的：随着时间的推移，患有恶性肿瘤的脓毒性休克患者的死亡率有所下降，但儿童患者的死亡率仍不确定。因此，作者试图比较有无恶性肿瘤的脓毒性休克患儿的临床特征、治疗需求和预后：作者回顾性分析了一家三级儿科医院2015年1月至2022年12月因脓毒性休克入住PICU的患儿数据。主要结果是院内死亡率：结果：共有508名患者入院。恶性肿瘤患儿的革兰氏阴性菌和真菌感染比例明显高于非恶性肿瘤患儿。患有恶性肿瘤的脓毒症休克患儿的住院时间（LOS）更长（21 天对 11 天，p）：虽然感染的细菌谱存在明显差异，但患有或未患有恶性肿瘤的脓毒性休克患儿的死亡率相似。患有恶性肿瘤的脓毒性休克患儿的住院时间更长。

{"title":"Comparing the clinical characteristics and outcomes of septic shock children with and without malignancies: a retrospective cohort study","authors":"","doi":"10.1016/j.jped.2024.06.003","DOIUrl":"10.1016/j.jped.2024.06.003","url":null,"abstract":"<div><h3>Objective</h3><div>There is an amelioration in mortality rates of septic shock patients with malignancies over time, but it remains uncertain in children. Therefore, the authors endeavored to compare the clinical characteristics, treatment needs, and outcomes of septic shock children with or without malignancies.</div></div><div><h3>Methods</h3><div>The authors retrospectively analyzed the data of children admitted to the PICU due to septic shock from January 2015 to December 2022 in a tertiary pediatric hospital. The main outcome was in-hospital mortality.</div></div><div><h3>Results</h3><div>A total of 508 patients were enrolled. The proportion of Gram-negative bacteria and fungal infections in children with malignancies was significantly higher than those without malignancies. Septic shock children with malignancies had a longer length of stay (LOS) in the hospital (21 vs. 11 days, p<0.001). However, there were no statistically significant differences in the LOS of PICU (5 vs. 5 days, <em>p</em> = 0.591), in-hospital mortality (43.0 % vs. 49.4 %, <em>p</em> = 0.276), and 28-day mortality (49.2 % vs. 44.7 %, <em>p</em> = 0.452). The 28-day survival analysis (<em>p</em> = 0.314) also showed no significant differences.</div></div><div><h3>Conclusion</h3><div>Although there are significant differences in the bacterial spectrum of infections, the septic shock children with or without malignancies showed a similar mortality rate. The septic shock children with malignancies had longer LOS of the hospital.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"100 6","pages":"Pages 633-639"},"PeriodicalIF":2.8,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141537860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Inference of stature using segmental measures in comparison with directly measured height in children and adolescents: an analytical cross-sectional study 使用分段测量法推断儿童和青少年的身高与直接测量身高的比较：一项横断面分析研究。

IF 2.8 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2024-07-02 DOI: 10.1016/j.jped.2024.05.004

Objectives

In the clinical routine of pediatricians, height is the most reliable indicator for assessing growth. However, there are situations where it is not possible to measure this parameter directly, making the estimation of height or length a useful alternative. The main goal of this study is to identify which segmental measure, including upper arm length (UAL), tibial length (TL), and knee-heel length (KHL), provides the stature estimate that most closely approximates directly measured height in the study participants.

Methods

Analytical cross-sectional study of the anthropometric and segmental measures of 248 participants, aged 0 to 14 years old, using Stevenson's and Kihara's equations to estimate indirectly measured height.

Results

The segmental measure that provided a measurement that deviated the least from the actual height was the KHL, followed by TL, both calculated using Stevenson's equations.

Conclusion

The use of segmental measures to infer a child's stature is valuable in clinical practice, particularly in bedridden and incapacitated patients. Based on the present findings, the KHL and TL segments yielded more accurate results than the UAL

目的：在儿科医生的临床日常工作中，身高是评估生长情况的最可靠指标。然而，在某些情况下无法直接测量这一参数，因此身高或身长的估算成为一种有用的替代方法。本研究的主要目的是确定上臂长度（UAL）、胫骨长度（TL）和膝跟长度（KHL）等哪种分段测量方法能提供最接近直接测量身高的身材估计值：对 248 名 0 至 14 岁参与者的人体测量和节段测量进行分析性横断面研究，使用史蒂文森和木原方程估算间接测量的身高：结果：测量结果与实际身高偏差最小的节段测量值是 KHL，其次是 TL，两者均使用史蒂文森方程计算：结论：使用节段测量法推断儿童的身材在临床实践中很有价值，尤其是对于卧床不起和丧失劳动能力的患者。根据目前的研究结果，KHL和TL节段比UAL得出的结果更准确。

{"title":"Inference of stature using segmental measures in comparison with directly measured height in children and adolescents: an analytical cross-sectional study","authors":"","doi":"10.1016/j.jped.2024.05.004","DOIUrl":"10.1016/j.jped.2024.05.004","url":null,"abstract":"<div><h3>Objectives</h3><div>In the clinical routine of pediatricians, height is the most reliable indicator for assessing growth. However, there are situations where it is not possible to measure this parameter directly, making the estimation of height or length a useful alternative. The main goal of this study is to identify which segmental measure, including upper arm length (UAL), tibial length (TL), and knee-heel length (KHL), provides the stature estimate that most closely approximates directly measured height in the study participants<strong>.</strong></div></div><div><h3>Methods</h3><div>Analytical cross-sectional study of the anthropometric and segmental measures of 248 participants, aged 0 to 14 years old, using Stevenson's and Kihara's equations to estimate indirectly measured height.</div></div><div><h3>Results</h3><div>The segmental measure that provided a measurement that deviated the least from the actual height was the KHL, followed by TL, both calculated using Stevenson's equations.</div></div><div><h3>Conclusion</h3><div>The use of segmental measures to infer a child's stature is valuable in clinical practice, particularly in bedridden and incapacitated patients. Based on the present findings, the KHL and TL segments yielded more accurate results than the UAL</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"100 6","pages":"Pages 622-626"},"PeriodicalIF":2.8,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141537862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Corrigendum to 对......的更正

IF 2.8 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2024-07-02 DOI: 10.1016/j.jped.2024.06.004

引用次数: 0

Validation of entrustable professional activities for use in neonatal care residency programs 验证新生儿护理住院医师培训计划中使用的可委托专业活动。

IF 2.8 4区医学 Q1 PEDIATRICS

Jornal de pediatria

Pub Date : 2024-06-29 DOI: 10.1016/j.jped.2024.05.003

Objective

Define and develop a set of entrustable professional activities (EPAs) to link clinical training and assessment of the hospital components of neonatal care in neonatology medical residency programs.

Methods

An exploratory study was conducted in two phases using a modified Delphi approach. In the first phase, a committee of five neonatology residency program coordinators drafted an initial set of EPAs based on the national matrix of competencies and on EPAs defined by international organizations. In the second phase, a group of neonatal care physicians and medical residents rated the indispensability and clarity of the EPAs and provided comments and suggestions.

Results

Seven EPAs were drafted by the coordinators´ committee (n = 5) and used in the content validation process with a group (n = 37) of neonatal care physicians and medical residents. In the first Delphi round, all EPAs reached a content validity index (CVI) above 0.8. The coordinators´ committee analyzed comments and suggestions and revised the EPAs. A second Delphi round with the revised EPAs was conducted to validate and all items maintained a CVI above 0.8 for indispensability and clarity.

Conclusion

Seven entrustable professional activities were developed to assess residents in the hospital components of neonatal care medicine. These EPAs might contribute to implementing competency-based neonatology medical residency programs grounded in core professional activities.

目的定义并制定一套可委托的专业活动（EPAs），将新生儿科住院医师培训项目中新生儿护理的临床培训和医院部分的评估联系起来：采用改良德尔菲法，分两个阶段进行探索性研究。在第一阶段，由五名新生儿科住院医师培训项目协调员组成的委员会根据国家能力矩阵和国际组织定义的 EPA，起草了一套初步的 EPA。在第二阶段，一组新生儿护理医师和住院医师对 EPA 的不可或缺性和清晰度进行了评分，并提出了意见和建议：结果：协调员委员会（n = 5）起草了七份 EPA，并与一组（n = 37）新生儿护理医师和住院医师进行了内容验证。在第一轮德尔菲讨论中，所有 EPA 的内容效度指数 (CVI) 均高于 0.8。协调员委员会分析了意见和建议，并对 EPA 进行了修订。对修订后的 EPA 进行了第二轮德尔菲验证，所有项目的不可或缺性和清晰度的 CVI 均保持在 0.8 以上：结论：制定了七项可委托的专业活动，用于评估住院医师在新生儿护理医学中的医院部分。这些EPAs可能有助于实施以核心专业活动为基础的能力本位新生儿科住院医师培训项目。

{"title":"Validation of entrustable professional activities for use in neonatal care residency programs","authors":"","doi":"10.1016/j.jped.2024.05.003","DOIUrl":"10.1016/j.jped.2024.05.003","url":null,"abstract":"<div><h3>Objective</h3><div>Define and develop a set of entrustable professional activities (EPAs) to link clinical training and assessment of the hospital components of neonatal care in neonatology medical residency programs.</div></div><div><h3>Methods</h3><div>An exploratory study was conducted in two phases using a modified Delphi approach. In the first phase, a committee of five neonatology residency program coordinators drafted an initial set of EPAs based on the national matrix of competencies and on EPAs defined by international organizations. In the second phase, a group of neonatal care physicians and medical residents rated the indispensability and clarity of the EPAs and provided comments and suggestions.</div></div><div><h3>Results</h3><div>Seven EPAs were drafted by the coordinators´ committee (<em>n</em> = 5) and used in the content validation process with a group (<em>n</em> = 37) of neonatal care physicians and medical residents. In the first Delphi round, all EPAs reached a content validity index (CVI) above 0.8. The coordinators´ committee analyzed comments and suggestions and revised the EPAs. A second Delphi round with the revised EPAs was conducted to validate and all items maintained a CVI above 0.8 for indispensability and clarity.</div></div><div><h3>Conclusion</h3><div>Seven entrustable professional activities were developed to assess residents in the hospital components of neonatal care medicine. These EPAs might contribute to implementing competency-based neonatology medical residency programs grounded in core professional activities.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"100 6","pages":"Pages 627-632"},"PeriodicalIF":2.8,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141492084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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

Jornal de pediatria

Pub Date : 2024-06-26 DOI: 10.1016/j.jped.2024.06.001

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

Jornal de pediatria

Pub Date : 2024-05-29 DOI: 10.1016/j.jped.2024.05.002

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

Jornal de pediatria

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。

{"title":"Risk of autism spectrum disorder in children with infantile epileptic spasms syndrome: a retrospective study in a single center in Brazil","authors":"","doi":"10.1016/j.jped.2024.04.006","DOIUrl":"10.1016/j.jped.2024.04.006","url":null,"abstract":"<div><h3>Objective</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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), <em>p</em><0.001.</p></div><div><h3>Conclusion</h3><p>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.</p></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"100 5","pages":"Pages 552-556"},"PeriodicalIF":2.8,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021755724000688/pdfft?md5=e9958f9112a525471d638ccaa644e577&pid=1-s2.0-S0021755724000688-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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

Jornal de pediatria

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。

{"title":"Patients with genital ambiguity referred without a sex definition: the relationship between clinical picture and defined sex of rearing","authors":"","doi":"10.1016/j.jped.2024.05.001","DOIUrl":"10.1016/j.jped.2024.05.001","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"100 6","pages":"Pages 609-613"},"PeriodicalIF":2.8,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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

Jornal de pediatria

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。

{"title":"The trajectory of head circumference and neurodevelopment in very preterm newborns during the first two years of life: a cohort study","authors":"","doi":"10.1016/j.jped.2024.04.005","DOIUrl":"10.1016/j.jped.2024.04.005","url":null,"abstract":"<div><h3>Objective</h3><p>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.</p></div><div><h3>Method</h3><p>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.</p></div><div><h3>Results</h3><p>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.</p></div><div><h3>Conclusion</h3><p>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.</p></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"100 5","pages":"Pages 483-490"},"PeriodicalIF":2.8,"publicationDate":"2024-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021755724000676/pdfft?md5=21d54f3cb6f420f0cd34e4e9de714205&pid=1-s2.0-S0021755724000676-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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

Jornal de pediatria

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。

{"title":"The death risk of pediatric patients with cancer-related sepsis requiring continuous renal replacement therapy: a retrospective cohort study","authors":"","doi":"10.1016/j.jped.2024.04.004","DOIUrl":"10.1016/j.jped.2024.04.004","url":null,"abstract":"<div><h3>Objective</h3><div>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).</div></div><div><h3>Method</h3><div>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.</div></div><div><h3>Results</h3><div>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% <em>vs</em>. 22.0%, <em>p</em> = 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).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"100 6","pages":"Pages 614-621"},"PeriodicalIF":2.8,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141140008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Jornal de pediatria

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀