Melissa Kimber, Jill McTavish, Michelle Shouldice, Michelle G K Ward, Harriet L MacMillan
Children’s exposure to intimate partner violence (CEIPV) between parents and other caregivers accounts for nearly half of all cases investigated and substantiated by child welfare authorities in Canada. The emotional, physical, and behavioural impairments associated with CEIPV are similar to effects of other forms of child maltreatment. The identification of children and youth who have been exposed to intimate partner violence (IPV) can be challenging due to the non-specific behaviours sometimes associated with such exposure, and the stigma and secrecy that often characterize IPV. Also, responding safely to children and youth with suspected CEIPV can be complicated by the need to consider the safety and well-being of a non-offending caregiver. This position statement presents an evidence-informed approach developed by the Violence, Evidence, Guidance, Action (VEGA) Project for the safe recognition and response to children and youth who are suspected of being exposed to IPV.
{"title":"Recognizing and responding to children with suspected exposure to intimate partner violence between caregivers","authors":"Melissa Kimber, Jill McTavish, Michelle Shouldice, Michelle G K Ward, Harriet L MacMillan","doi":"10.1093/pch/pxad079","DOIUrl":"https://doi.org/10.1093/pch/pxad079","url":null,"abstract":"Children’s exposure to intimate partner violence (CEIPV) between parents and other caregivers accounts for nearly half of all cases investigated and substantiated by child welfare authorities in Canada. The emotional, physical, and behavioural impairments associated with CEIPV are similar to effects of other forms of child maltreatment. The identification of children and youth who have been exposed to intimate partner violence (IPV) can be challenging due to the non-specific behaviours sometimes associated with such exposure, and the stigma and secrecy that often characterize IPV. Also, responding safely to children and youth with suspected CEIPV can be complicated by the need to consider the safety and well-being of a non-offending caregiver. This position statement presents an evidence-informed approach developed by the Violence, Evidence, Guidance, Action (VEGA) Project for the safe recognition and response to children and youth who are suspected of being exposed to IPV.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"27 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141194222","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}
Melissa Kimber, Jill McTavish, Michelle Shouldice, Michelle G K Ward, Harriet L MacMillan
Résumé L’exposition des enfants à la violence entre partenaires intimes (EEVPI), qu’il s’agisse des parents ou d’autres proches, représente près de la moitié de tous les cas qui font l’objet d’une enquête et sont corroborés par les services de protection de l’enfance du Canada. Les atteintes affectives, physiques et comportementales associées à l’EEVPI sont semblables aux effets d’autres formes de maltraitance envers les enfants. Il peut être difficile d’établir quels enfants et adolescents sont exposés à la violence entre partenaires intimes (VPI) en raison des comportements non spécifiques parfois associés à une telle exposition, de même que de la stigmatisation et du secret entourant souvent ce type de violence. Par ailleurs, une intervention en toute sécurité auprès des enfants et des adolescents chez qui on présume une exposition à la VPI peut être compliquée par la nécessité d’également tenir compte de la sécurité et du bien-être d’un proche non contrevenant. Le présent document de principes propose une approche fondée sur des données probantes mise au point par le projet VEGA (Violence, Evidence, Guidance, Action ou violence, données probantes, conseils, action) pour détecter l’exposition des enfants et des adolescents à la VPI et intervenir en toute sécurité auprès d’eux.
{"title":"Savoir détecter l’exposition des enfants à la violence entre partenaires intimes, qu’elle soit présumée ou divulguée, et savoir intervenir","authors":"Melissa Kimber, Jill McTavish, Michelle Shouldice, Michelle G K Ward, Harriet L MacMillan","doi":"10.1093/pch/pxad080","DOIUrl":"https://doi.org/10.1093/pch/pxad080","url":null,"abstract":"Résumé L’exposition des enfants à la violence entre partenaires intimes (EEVPI), qu’il s’agisse des parents ou d’autres proches, représente près de la moitié de tous les cas qui font l’objet d’une enquête et sont corroborés par les services de protection de l’enfance du Canada. Les atteintes affectives, physiques et comportementales associées à l’EEVPI sont semblables aux effets d’autres formes de maltraitance envers les enfants. Il peut être difficile d’établir quels enfants et adolescents sont exposés à la violence entre partenaires intimes (VPI) en raison des comportements non spécifiques parfois associés à une telle exposition, de même que de la stigmatisation et du secret entourant souvent ce type de violence. Par ailleurs, une intervention en toute sécurité auprès des enfants et des adolescents chez qui on présume une exposition à la VPI peut être compliquée par la nécessité d’également tenir compte de la sécurité et du bien-être d’un proche non contrevenant. Le présent document de principes propose une approche fondée sur des données probantes mise au point par le projet VEGA (Violence, Evidence, Guidance, Action ou violence, données probantes, conseils, action) pour détecter l’exposition des enfants et des adolescents à la VPI et intervenir en toute sécurité auprès d’eux.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"21 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141193858","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}
Cerebral palsy (CP) is the most common physical disability in Canadian children. The comprehensive care of ambulatory children with CP functioning at Gross Motor Function Classification System (GMFCS) level I and II was covered in a previous practice point. This companion document focuses on the care of children with CP functioning at GMFCS levels III to V. Children functioning at GMFCS level III and IV mobilize using devices such as a walker, canes, or powered mobility, while those functioning at GMFCS level V require assisted mobility, such as a manual wheelchair. An overview of key concepts in early detection, rehabilitation services, and therapeutic options for children with CP at these levels is provided, along with practical resources to assist health surveillance for paediatricians caring for this population.
{"title":"Care for children and youth with cerebral palsy (GMFCS levels III to V)","authors":"Scott McLeod, Amber Makino, Anne Kawamura","doi":"10.1093/pch/pxae003","DOIUrl":"https://doi.org/10.1093/pch/pxae003","url":null,"abstract":"Cerebral palsy (CP) is the most common physical disability in Canadian children. The comprehensive care of ambulatory children with CP functioning at Gross Motor Function Classification System (GMFCS) level I and II was covered in a previous practice point. This companion document focuses on the care of children with CP functioning at GMFCS levels III to V. Children functioning at GMFCS level III and IV mobilize using devices such as a walker, canes, or powered mobility, while those functioning at GMFCS level V require assisted mobility, such as a manual wheelchair. An overview of key concepts in early detection, rehabilitation services, and therapeutic options for children with CP at these levels is provided, along with practical resources to assist health surveillance for paediatricians caring for this population.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"27 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141194167","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}
Résumé La paralysie cérébrale (PC) est l’incapacité physique la plus fréquente chez les enfants canadiens. Les soins complets des enfants ayant la PC, qui sont capables de marcher et qui fonctionnent aux niveaux I et II du système de classification de la fonction motrice globale (GMFCS) sont déjà exposés dans un point de pratique. Le présent document complémentaire traite des soins aux enfants ayant la PC qui fonctionnent aux niveaux III à V du GMFCS. Ceux qui fonctionnent aux niveaux III et IV du GMFCS utilisent des dispositifs d’assistance comme des déambulateurs, des cannes ou des aides à la mobilité motorisées, tandis que ceux qui fonctionnent au niveau V du GMFCS ont besoin d’assistance à la mobilité comme un fauteuil roulant manuel. Le présent document contient un aperçu des principaux concepts relatifs à la détection précoce, aux services de réadaptation et aux possibilités de traitement pour les enfants présentant ces niveaux de PC, conjointement avec des ressources pratiques pour contribuer à la surveillance de la santé assurée par les pédiatres qui s’occupent de cette population.
{"title":"Les soins aux enfants et aux adolescents ayant la paralysie cérébrale (aux niveaux III à V du GMFCS)","authors":"Scott McLeod, Amber Makino, Anne Kawamura","doi":"10.1093/pch/pxae004","DOIUrl":"https://doi.org/10.1093/pch/pxae004","url":null,"abstract":"Résumé La paralysie cérébrale (PC) est l’incapacité physique la plus fréquente chez les enfants canadiens. Les soins complets des enfants ayant la PC, qui sont capables de marcher et qui fonctionnent aux niveaux I et II du système de classification de la fonction motrice globale (GMFCS) sont déjà exposés dans un point de pratique. Le présent document complémentaire traite des soins aux enfants ayant la PC qui fonctionnent aux niveaux III à V du GMFCS. Ceux qui fonctionnent aux niveaux III et IV du GMFCS utilisent des dispositifs d’assistance comme des déambulateurs, des cannes ou des aides à la mobilité motorisées, tandis que ceux qui fonctionnent au niveau V du GMFCS ont besoin d’assistance à la mobilité comme un fauteuil roulant manuel. Le présent document contient un aperçu des principaux concepts relatifs à la détection précoce, aux services de réadaptation et aux possibilités de traitement pour les enfants présentant ces niveaux de PC, conjointement avec des ressources pratiques pour contribuer à la surveillance de la santé assurée par les pédiatres qui s’occupent de cette population.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"38 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141193862","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}
Katherine N Tom, Alicia M Polack, Natasha D De Silva, Jonathan P Wong, Charles D G Keown-Stoneman, Jonathon L Maguire, Catherine S Birken, Peter D Wong
Objectives To describe clinician management practices for childhood dyslipidemia in the community setting. Methods A descriptive study was conducted for children aged 2 to 10 years with dyslipidemia as defined by the National Cholesterol Education Program Expert Panel on Cholesterol in Children criteria. A convenience sample of participants from the TARGet Kids! cohort study (Toronto, Canada) was used. Trained research assistants reviewed participant medical records to document clinician management practices of abnormal lipid levels. The study outcome was the proportion of clinicians engaging in each management practice. Descriptive statistics were completed, reporting the proportion of clinician engagement in management practices. Results All 768 children were seen by primary paediatric care providers after lipid levels identified dyslipidemia. Medical history regarding lifestyle behaviours and cardiovascular risk factors were frequently obtained (n = 565, 73.6%). Physicians rarely informed families about abnormal lipid levels (n = 11, 1.43%). Management plans for abnormal lipid levels were rarely documented (n = 4, 0.5%). Clinicians did not refer to paediatric lipid specialists or initiate statin therapy. Conclusions Paediatric care providers rarely identified and initiated early management for abnormal lipid levels. Our results may inform the need for improved knowledge translation of the recently published Canadian clinical practice update for the detection and management of childhood dyslipidemia.
{"title":"Childhood dyslipidemia: Clinician management practices in the primary care setting","authors":"Katherine N Tom, Alicia M Polack, Natasha D De Silva, Jonathan P Wong, Charles D G Keown-Stoneman, Jonathon L Maguire, Catherine S Birken, Peter D Wong","doi":"10.1093/pch/pxae018","DOIUrl":"https://doi.org/10.1093/pch/pxae018","url":null,"abstract":"Objectives To describe clinician management practices for childhood dyslipidemia in the community setting. Methods A descriptive study was conducted for children aged 2 to 10 years with dyslipidemia as defined by the National Cholesterol Education Program Expert Panel on Cholesterol in Children criteria. A convenience sample of participants from the TARGet Kids! cohort study (Toronto, Canada) was used. Trained research assistants reviewed participant medical records to document clinician management practices of abnormal lipid levels. The study outcome was the proportion of clinicians engaging in each management practice. Descriptive statistics were completed, reporting the proportion of clinician engagement in management practices. Results All 768 children were seen by primary paediatric care providers after lipid levels identified dyslipidemia. Medical history regarding lifestyle behaviours and cardiovascular risk factors were frequently obtained (n = 565, 73.6%). Physicians rarely informed families about abnormal lipid levels (n = 11, 1.43%). Management plans for abnormal lipid levels were rarely documented (n = 4, 0.5%). Clinicians did not refer to paediatric lipid specialists or initiate statin therapy. Conclusions Paediatric care providers rarely identified and initiated early management for abnormal lipid levels. Our results may inform the need for improved knowledge translation of the recently published Canadian clinical practice update for the detection and management of childhood dyslipidemia.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"24 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141193856","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 Urine cultures are often automatically obtained after urinary catheterization in young children, even in the absence of pyuria, to test for urinary tract infections (UTIs). Although this practice conflicts with some newer guidelines, it is frequently followed in busy emergency departments (EDs) to minimize the need for a repeat invasive procedure. To assess the implications of this longstanding practice, we aimed to describe the frequency and characteristics of children with normal urinalysis (UA) and positive urine culture obtained via catheterization, and to describe their clinical course. Methods A single center, retrospective cohort study was performed for otherwise healthy children aged 6 to 24 months, presenting to a Pediatric ED between January and June 2019 who underwent UTI testing via a urine catheterization. The point-of-care (POC) UA and urine culture results along with any follow-up phone call documentation were reviewed and analyzed using descriptive statistics. Results Of the 818 urine cultures obtained via catheterization during the 6-month study period, 131 (16%) cultures were reported as positive. Of these positive cultures, 14 (10.7%) of the patients meeting inclusion criteria had a normal POC UA. In follow-up phone calls after the ED visit, the majority of these 14 patients were asymptomatic without any antibiotic treatment and 3 (2.3%) patients were still febrile and classified as a potentially missed UTI. Conclusions The routine practice of sending urine cultures from all catheterized urine samples in children 6 to 24 months, regardless of POC UA results, rarely detect missed UTIs. In alignment with more recent practice guidelines, this practice should be reconsidered in low-risk children seen in EDs to improve overall care quality and resource utilization.
{"title":"Automatic urine cultures from catheter-obtained samples—time to implement a practice change to improve value","authors":"Inbal Kestenbom, Neta Cohen, Gidon Test, Aaron Campigotto, Michelle Science, Olivia Ostrow","doi":"10.1093/pch/pxae021","DOIUrl":"https://doi.org/10.1093/pch/pxae021","url":null,"abstract":"Objectives Urine cultures are often automatically obtained after urinary catheterization in young children, even in the absence of pyuria, to test for urinary tract infections (UTIs). Although this practice conflicts with some newer guidelines, it is frequently followed in busy emergency departments (EDs) to minimize the need for a repeat invasive procedure. To assess the implications of this longstanding practice, we aimed to describe the frequency and characteristics of children with normal urinalysis (UA) and positive urine culture obtained via catheterization, and to describe their clinical course. Methods A single center, retrospective cohort study was performed for otherwise healthy children aged 6 to 24 months, presenting to a Pediatric ED between January and June 2019 who underwent UTI testing via a urine catheterization. The point-of-care (POC) UA and urine culture results along with any follow-up phone call documentation were reviewed and analyzed using descriptive statistics. Results Of the 818 urine cultures obtained via catheterization during the 6-month study period, 131 (16%) cultures were reported as positive. Of these positive cultures, 14 (10.7%) of the patients meeting inclusion criteria had a normal POC UA. In follow-up phone calls after the ED visit, the majority of these 14 patients were asymptomatic without any antibiotic treatment and 3 (2.3%) patients were still febrile and classified as a potentially missed UTI. Conclusions The routine practice of sending urine cultures from all catheterized urine samples in children 6 to 24 months, regardless of POC UA results, rarely detect missed UTIs. In alignment with more recent practice guidelines, this practice should be reconsidered in low-risk children seen in EDs to improve overall care quality and resource utilization.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"29 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141193922","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 Virtual reality (VR) glasses have been used in the medical field, as they are perceived to be suitable for distracting children. In this study, we aimed to compare patients who received inhaler treatment with VR glasses with those who received treatment without the aid of any device in terms of treatment compliance. Materials and Methods A prospective, randomized controlled study was conducted on pediatric patients aged 2 to 5 years requiring inhaler treatment (salbutamol), with the informed consent of their families. Participating patients who received standard care were divided into three groups via randomization: roller coaster VR group, wild dolphin VR group, and no additional device group. The patients were observed during their 15-minute inhaler treatment, and the groups were compared in terms of crying times, pre- and post-treatment physician and family questionnaire data (Face, Legs, Activity, Cry, Consolabity Scale [FLACC], Modified Yale Anxiety Scale [MYPAS], Modifiye Parents’ Pain Measure [MPMM], Wong–Baker Faces Pain Rating Scale [WBS]), and respiratory rate (RR), peripheral oxygen saturation, and heart rate value changes to determine any differences between them. Results Post-treatment questionnaire scores, RR, crying duration, and efficacy of treatment exhibited significant differences in Groups 1 and 2 compared to the control group. A significant difference was found in the post-treatment RR between groups 1 and 2, but no difference was observed in the other parameters. Conclusions Utilizing VR glasses during inhaler therapy has the potential to minimize adverse effects, such as pain, and enhance the overall comfort of the treatment environment for patients.
{"title":"Investigating the effect of virtual reality glasses during inhaler therapy use in children: A randomized clinical trial","authors":"Berker Okay, Zeynep Üze Okay","doi":"10.1093/pch/pxae020","DOIUrl":"https://doi.org/10.1093/pch/pxae020","url":null,"abstract":"Objectives Virtual reality (VR) glasses have been used in the medical field, as they are perceived to be suitable for distracting children. In this study, we aimed to compare patients who received inhaler treatment with VR glasses with those who received treatment without the aid of any device in terms of treatment compliance. Materials and Methods A prospective, randomized controlled study was conducted on pediatric patients aged 2 to 5 years requiring inhaler treatment (salbutamol), with the informed consent of their families. Participating patients who received standard care were divided into three groups via randomization: roller coaster VR group, wild dolphin VR group, and no additional device group. The patients were observed during their 15-minute inhaler treatment, and the groups were compared in terms of crying times, pre- and post-treatment physician and family questionnaire data (Face, Legs, Activity, Cry, Consolabity Scale [FLACC], Modified Yale Anxiety Scale [MYPAS], Modifiye Parents’ Pain Measure [MPMM], Wong–Baker Faces Pain Rating Scale [WBS]), and respiratory rate (RR), peripheral oxygen saturation, and heart rate value changes to determine any differences between them. Results Post-treatment questionnaire scores, RR, crying duration, and efficacy of treatment exhibited significant differences in Groups 1 and 2 compared to the control group. A significant difference was found in the post-treatment RR between groups 1 and 2, but no difference was observed in the other parameters. Conclusions Utilizing VR glasses during inhaler therapy has the potential to minimize adverse effects, such as pain, and enhance the overall comfort of the treatment environment for patients.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"36 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141194249","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: To construct reference growth curves for the preterm population from North India and compare it with global charts.
Methods: This prospective study enrolled preterm neonates (23 to 36 weeks) from July 2018 to August 2019 after excluding stillbirths and those with congenital malformations. Anthropometry was performed within 18 hours of birth. Gestation age was assessed by the best estimate of a combination of the last menstrual period, antenatal first-trimester ultrasound, and Expanded New Ballard Score (ENBS). Centile curves were constructed for both genders for twins and singleton neonates separately using the GAMLSS method using R software.
Results: During the study period, of the 14,908 births, 3253 (21.8%) were born preterm. After excluding malformations and stillbirths, 2976 preterm neonates were eligible, out of which anthropometry within 18 hours was done for 2719 neonates. Data was analyzed for 2290 singleton and 414 twin preterm neonates. Smoothed reference growth curves were constructed for all anthropometric parameters for both genders for singleton as well as twin neonates. Indian preterm infants were smaller compared to international standards. The proportion of small for gestational age (SGA) neonates was 23.1% (Fenton's charts) but only 10.9% when the data from the newly constructed chart was used. The concordance with international standards was better for very preterm neonates <32 weeks than moderate and late preterm neonates (32 to 36 weeks).
Conclusions: The reference charts derived from the present study can be used for the North Indian preterm population. The use of western growth charts tends to overestimate the incidence of SGA.
{"title":"Reference gender-specific neonatal size at birth growth curves for singleton and twin neonates from North India.","authors":"Ambalakkuthan Murugesan, Sushma Nangia, Arvind Saili","doi":"10.1093/pch/pxae011","DOIUrl":"10.1093/pch/pxae011","url":null,"abstract":"<p><strong>Objectives: </strong>To construct reference growth curves for the preterm population from North India and compare it with global charts.</p><p><strong>Methods: </strong>This prospective study enrolled preterm neonates (23 to 36 weeks) from July 2018 to August 2019 after excluding stillbirths and those with congenital malformations. Anthropometry was performed within 18 hours of birth. Gestation age was assessed by the best estimate of a combination of the last menstrual period, antenatal first-trimester ultrasound, and Expanded New Ballard Score (ENBS). Centile curves were constructed for both genders for twins and singleton neonates separately using the GAMLSS method using R software.</p><p><strong>Results: </strong>During the study period, of the 14,908 births, 3253 (21.8%) were born preterm. After excluding malformations and stillbirths, 2976 preterm neonates were eligible, out of which anthropometry within 18 hours was done for 2719 neonates. Data was analyzed for 2290 singleton and 414 twin preterm neonates. Smoothed reference growth curves were constructed for all anthropometric parameters for both genders for singleton as well as twin neonates. Indian preterm infants were smaller compared to international standards. The proportion of small for gestational age (SGA) neonates was 23.1% (Fenton's charts) but only 10.9% when the data from the newly constructed chart was used. The concordance with international standards was better for very preterm neonates <32 weeks than moderate and late preterm neonates (32 to 36 weeks).</p><p><strong>Conclusions: </strong>The reference charts derived from the present study can be used for the North Indian preterm population. The use of western growth charts tends to overestimate the incidence of SGA.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"29 6","pages":"367-373"},"PeriodicalIF":1.8,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625638","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}
Connie L Yang, Zofia Zysman-Colman, Estelle Chétrit, Anne Hicks, Joseph Reisman, Amy Glicksman
This practice point summarizes recommendations from the Canadian Thoracic Society’s 2021 “Guideline update: Diagnosis and management of asthma in preschoolers, children, and adults.” New recommendations include: a decrease in the frequency of daytime symptoms and reliever use to ≤2 per week in the asthma control criteria; assessing for risk of asthma exacerbation; not using as-needed short-acting beta-agonists alone in patients at higher risk for exacerbation; and the option of as-needed budesonide/formoterol (bud/form) in those ≥12 years old if they are unable to take daily inhaled corticosteroids despite extensive asthma education and support. The preference for daily inhaled corticosteroids to manage mild asthma in children, and the recommendation against intermittent short courses of inhaled corticosteroids, are unchanged.
{"title":"The management of very mild and mild asthma in preschoolers, children, and adolescents","authors":"Connie L Yang, Zofia Zysman-Colman, Estelle Chétrit, Anne Hicks, Joseph Reisman, Amy Glicksman","doi":"10.1093/pch/pxae006","DOIUrl":"https://doi.org/10.1093/pch/pxae006","url":null,"abstract":"This practice point summarizes recommendations from the Canadian Thoracic Society’s 2021 “Guideline update: Diagnosis and management of asthma in preschoolers, children, and adults.” New recommendations include: a decrease in the frequency of daytime symptoms and reliever use to ≤2 per week in the asthma control criteria; assessing for risk of asthma exacerbation; not using as-needed short-acting beta-agonists alone in patients at higher risk for exacerbation; and the option of as-needed budesonide/formoterol (bud/form) in those ≥12 years old if they are unable to take daily inhaled corticosteroids despite extensive asthma education and support. The preference for daily inhaled corticosteroids to manage mild asthma in children, and the recommendation against intermittent short courses of inhaled corticosteroids, are unchanged.","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"92 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140582223","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}
Connie L Yang, Zofia Zysman-Colman, Estelle Chétrit, Anne Hicks, Joseph Reisman, Amy Glicksman
Résumé Le présent point de pratique résume la mise à jour des lignes directrices de la Société canadienne de thoracologie publiée en 2021 sur le diagnostic et la prise en charge de l’asthme chez les enfants d’âge préscolaire, les enfants et les adultes. Ces nouvelles recommandations incluent, parmi les critères de contrôle de l’asthme, une diminution de la fréquence des symptômes diurnes et de l’utilisation de médicaments pour soulager l’asthme à un maximum de deux fois par semaine. Elles comprennent également l’évaluation du risque d’exacerbation de l’asthme, la non-utilisation de bêta-agonistes à courte durée d’action seuls au besoin chez les patients à plus fort risque d’exacerbation et la possibilité d’administrer du budésonide-formotérol au besoin aux jeunes de 12 ans ou plus qui sont incapables de prendre des corticostéroïdes inhalés au quotidien malgré une éducation sur l’asthme et un soutien importants. La préférence pour la prise quotidienne de corticostéroïdes inhalés afin de traiter l’asthme léger chez les enfants et la recommandation d’éviter les courts traitements intermittents de corticostéroïdes inhalés ne changent pas.
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