Pediatric Investigation最新文献

英文中文

Bilateral globus pallidus internus‐deep brain stimulation in a 5‐year‐old boy with SGCE‐related myoclonus dystonia syndrome 对一名患有 SGCE 相关肌阵挛张力障碍综合征的 5 岁男孩进行双侧苍白球内侧深部脑刺激治疗

IF 2.2 4区医学 Q3 Medicine

Pediatric Investigation

Pub Date : 2024-03-28 DOI: 10.1002/ped4.12421

Xiaojuan Tian, Changhong Ding, Ming Liu, Lifang Dai, Zixing Xie, Tie Fang

引用次数: 0

Instruction for Authors. 作者须知。

IF 2.2 4区医学 Q3 Medicine

Pediatric Investigation

Pub Date : 2024-03-19 eCollection Date: 2024-03-01 DOI: 10.1002/ped4.12423

引用次数: 0

Outcomes of critically ill children with pre‐existing mental health conditions 患有先天性精神疾病的重症儿童的治疗效果

IF 2.2 4区医学 Q3 Medicine

Pediatric Investigation

Pub Date : 2024-03-18 DOI: 10.1002/ped4.12422

C. Krawiec, Morgan Cash, G. Ceneviva, Zizhong Tian, Shouhao Zhou, Neal J. Thomas

Critically ill children with pre‐existing mental health conditions may have an increased risk of poor health outcomes.We aimed to evaluate if pre‐existing mental health conditions in critically ill pediatric patients would be associated with worse clinical outcomes, compared to children with no documented mental health conditions.This retrospective observational cohort study utilized the TriNetX electronic health record database of critically ill subjects aged 12–18 years. Data were analyzed for demographics, pre‐existing conditions, diagnostic, medication, procedural codes, and mortality.From a dataset of 102 027 critically ill children, we analyzed 1999 subjects (284 [14.2%] with a pre‐existing mental health condition and 1715 [85.8%] with no pre‐existing mental health condition). Multivariable analysis demonstrated that death within one year was associated with the presence of pre‐existing mental health conditions (odds ratio 8.97 [3.48–23.15], P < 0.001), even after controlling for the presence of a complex chronic condition.The present study demonstrates that the presence of pre‐existing mental health conditions was associated with higher odds of death within 1 year after receiving critical care. However, the confidence interval was wide and hence, the findings are inconclusive. Future studies with a larger sample size may be necessary to evaluate the true long‐term impact of children with pre‐existing mental health conditions who require critical care services.

这项回顾性观察队列研究利用 TriNetX 电子健康记录数据库对 12-18 岁的重症患者进行了分析。从 102 027 名重症儿童的数据集中，我们分析了 1999 名受试者（284 人 [14.2%]患有既往精神疾病，1715 人 [85.8%] 没有既往精神疾病）。多变量分析表明，即使在控制了是否存在复杂的慢性疾病后，一年内的死亡仍与是否存在既往精神健康状况有关（几率比 8.97 [3.48-23.15]，P < 0.001）。然而，置信区间较宽，因此研究结果并不确定。未来的研究可能需要更大的样本量，以评估需要接受重症监护服务的原有精神健康状况儿童的真正长期影响。

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引用次数: 0

Evaluation of a complex couplet care intervention in a neonatal intensive care unit: A mixed methods study protocol 评估新生儿重症监护室中的复杂对偶护理干预措施：混合方法研究方案

IF 2.2 4区医学 Q3 Medicine

Pediatric Investigation

Pub Date : 2024-03-04 DOI: 10.1002/ped4.12420

Michella Bjerregaard, A. Axelin, Emma Louise Malchau Carlsen, Hans Okkels Birk, Ingrid Poulsen, Patrick Palisz, T. Kallemose, A. Brødsgaard

Families with an infant in need of intensive care most often experience a harmful separation after birth. This is due to a division of medical specialties into neonatal care and maternal care. Therefore, a couplet care intervention is implemented for mother‐infant dyads in a neonatal intensive care unit. This study protocol provides a comprehensive evaluation of the intervention. The aim is to evaluate the effect and implementation of a complex couplet care intervention to promote zero separation between mother and infant.The couplet care intervention is a family‐centered model of care, where treatment‐requiring mother‐infant dyads will be admitted together and receive couplet care by neonatal nurses. The study adheres to the framework of the Medical Research Council and will use a mixed methods embedded design comprising a quasi‐experimental trial and a qualitative process evaluation. Finally, a health economic evaluation will be conducted to assess the cost‐effectiveness of this complex couplet care intervention.Separation of mother‐infant dyads after birth has an adverse impact on family health and well‐being. This study protocol evaluates a complex couplet care intervention. With this study, a first step is taken to help bridge the gap between current practices and a new care model to prevent the separation of mothers and their infants

婴儿出生后，需要重症监护的家庭往往会经历有害的分离。这是由于医疗专业分为新生儿护理和产妇护理。因此，在新生儿重症监护病房中，对母婴二人组实施了对偶护理干预。本研究方案对干预措施进行了全面评估。对偶护理干预是一种以家庭为中心的护理模式，需要治疗的母婴对偶将一起入院，接受新生儿护士的对偶护理。该研究遵循医学研究委员会的框架，将采用混合方法嵌入式设计，包括准实验性试验和定性过程评估。最后，还将进行健康经济评估，以评估这种复合式夫妇护理干预措施的成本效益。本研究方案评估了一种复杂的夫妻护理干预措施。通过这项研究，我们迈出了第一步，帮助弥合当前做法与新护理模式之间的差距，防止母婴分离。

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引用次数: 0

A cross-sectional study of breastfed infants referred for tongue tie assessment and frenotomy in one Canadian health region. 加拿大某卫生区对转诊接受舌系带评估和舌系带切除术的母乳喂养婴儿进行横断面研究。

IF 2.2 4区医学 Q3 Medicine

Pediatric Investigation

Pub Date : 2024-02-28 eCollection Date: 2024-03-01 DOI: 10.1002/ped4.12416

Tiffany A Lee, Jessica Bishop, Anne Drover, William K Midodzi, Laurie K Twells

Importance: Tongue tie (TT) is a condition that can cause infant feeding difficulties due to restricted tongue movement. When TT presents as a significant barrier to breastfeeding, a frenotomy may be recommended. Universally accepted diagnostic criteria for TT are lacking and wide prevalence estimates are reported. New referral processes and a Frenotomy Assessment Tool were implemented in one Canadian health region to connect breastfeeding dyads with a provider for TT evaluation and frenotomy.

Objective: To determine the proportion of babies with TT as well as the frequency of frenotomy.

Methods: This cross-sectional study included infants who initiated breastfeeding at birth and were referred for TT evaluation over a 14-month period. Data were collected retrospectively by chart review and analyzed using SPSS. Factors associated with frenotomy were examined using logistic regression.

Results: Two hundred and forty-one babies were referred. Ninety-two percent (n = 222) were diagnosed with TT and 66.0% (n = 159) underwent frenotomy. In the multivariate model, nipple pain/trauma, inability to latch, inability to elevate tongue, and dimpling of tongue on extension were associated with frenotomy (P < 0.05). Most referrals in our region resulted in a diagnosis of TT; however, the number of referrals was lower than expected, and of these two-thirds underwent frenotomy.

Interpretation: TT is a relatively common finding among breastfed infants. Future research should examine whether a simplified assessment tool containing the four items associated with frenotomy in our multivariate model can identify breastfed infants with TT who require frenotomy.

重要性：舌系带（TT）是一种因舌头活动受限而导致婴儿喂养困难的疾病。当 TT 严重阻碍母乳喂养时，建议进行舌系带切除术。目前还缺乏普遍接受的 TT 诊断标准，而且据报道，TT 的发病率也很高。在加拿大的一个卫生地区实施了新的转诊流程和 "婴儿齿槽切除术评估工具"，以便将母乳喂养二人组与医疗服务提供者联系起来，进行 TT 评估和齿槽切除术：目的：确定患有 TT 的婴儿比例以及实施肾网膜切除术的频率：这项横断面研究包括出生时开始母乳喂养并在 14 个月内转诊接受 TT 评估的婴儿。通过病历回顾收集数据，并使用 SPSS 进行分析。使用逻辑回归分析了与脐带切开术相关的因素：结果：共有 241 名婴儿被转诊。92%（n = 222）的婴儿被诊断为 TT，66.0%（n = 159）的婴儿接受了乳晕切除术。在多变量模型中，乳头疼痛/外伤、无法吮吸、无法抬高舌头和伸舌时舌头凹陷与肾盂切开术有关（P < 0.05）。我们所在地区的大多数转诊患者都被诊断为 TT；然而，转诊人数低于预期，其中三分之二的患者接受了泪腺切除术：TT在母乳喂养的婴儿中较为常见。未来的研究应探讨一种简化的评估工具（包含我们的多变量模型中与肾网切开术相关的四个项目）能否识别出需要进行肾网切开术的 TT 母乳喂养婴儿。

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引用次数: 0

Digital interventions for autism spectrum disorders: A systematic review and meta‐analysis 自闭症谱系障碍的数字化干预：系统回顾和荟萃分析

IF 2.2 4区医学 Q3 Medicine

Pediatric Investigation

Pub Date : 2024-02-25 DOI: 10.1002/ped4.12417

Tianqi Wang, Yu Ma, X. Du, Chunpei Li, Zhongbi Peng, Yi Wang, Hao Zhou

Digital technology is now widely available for the interventions of autism, but its validity and feasibility remain to be proved.This study aimed to investigate the effectiveness of digital health interventions (DHIs) in improving core symptoms or intelligence quotient in patients with autism spectrum disorder (ASD).Three databases including PubMed, Cochrane, and Scopus, were searched on November 15, 2022. Randomized clinical trials that enrolled patients with ASD who received DHIs and a control group without DHI treatment were included. Cochrane risk of bias tool (RoB 2) was applied to assess the risk of bias.A total of 33 studies, involving 1285 participants (658 [51.2%] in DHI groups and 627 [48.8%] in control groups), were analyzed to investigate the differences between DHI groups and control groups. Significantly greater improvements in the overall performance of ASD were observed in the DHI groups compared to the control groups (including active, waitlist, treatment‐as‐usual, and no treatment) with an effect size of 1.89 (Cohen's d 95% confidence interval [CI]: 1.26–2.52). Studies with treatment‐as‐usual, waitlist, and no treatment control demonstrated large effect sizes of Cohen's d 3.41 (95% CI: 0.84–5.97), Cohen's d 4.27 (95% CI: 1.95–6.59), and Cohen's d 4.52 (95% CI: 2.98–6.06) respectively. In contrast, studies with active control revealed insignificant effect sizes (Cohen's d 0.73, 95% CI: 0.12–1.33).This meta‐analysis found significantly greater improvements in core symptoms or intelligence quotient in ASD patients receiving DHIs compared to those in control conditions. ASD patients may benefit from the DHIs and reduce the economic burden.

本研究旨在调查数字健康干预（DHIs）在改善自闭症谱系障碍（ASD）患者核心症状或智商方面的有效性。研究人员于2022年11月15日检索了PubMed、Cochrane和Scopus等三个数据库。纳入的随机临床试验包括接受 DHIs 治疗的 ASD 患者和未接受 DHI 治疗的对照组。共分析了33项研究，涉及1285名参与者（658名[51.2%]在DHI组，627名[48.8%]在对照组），以调查DHI组与对照组之间的差异。与对照组（包括积极治疗组、候补治疗组、照常治疗组和不治疗组）相比，DHI 组在 ASD 整体表现方面有显著改善，效应大小为 1.89（Cohen's d 95% 置信区间 [CI]：1.26-2.52）。采用 "照常治疗"、"候补治疗 "和 "无治疗 "对照的研究显示了较大的效应量，分别为 Cohen's d 3.41 (95% CI: 0.84-5.97)、Cohen's d 4.27 (95% CI: 1.95-6.59)和 Cohen's d 4.52 (95% CI: 2.98-6.06)。这项荟萃分析发现，与对照组相比，接受 DHIs 治疗的 ASD 患者的核心症状或智商有明显改善。自闭症患者可从定向行走引导器中获益，并减轻经济负担。

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引用次数: 0

Current situation and prospect for the diagnosis and treatment of pediatric critical rare diseases in China. 中国儿科危重罕见病诊治现状与展望。

IF 2.2 4区医学 Q3 Medicine

Pediatric Investigation

Pub Date : 2024-02-21 eCollection Date: 2024-03-01 DOI: 10.1002/ped4.12419

Yingchao Liu, Suyun Qian

The onset of critical rare diseases (RDs) in children is rapid and dangerous, accompanied by a high mortality rate, which brings a heavy burden to both families and society. Multiple malformations, neuromuscular diseases, metabolic diseases, and heart diseases are the most common types of RDs in children of China, often manifesting with multiple organ dysfunction. At present, the diagnosis and treatment of critical RDs in children face challenges such as prolonged diagnosis time, a high misdiagnosis rate, limited treatment modalities, and a significant disease burden. However, with the progress in genetic testing technology, the establishment of multidisciplinary diagnosis and treatment platforms, and the implementation of relevant RD policies in China, children with critical RDs will received enhanced medical services, experience improved prognoses, and reintegrate into social life.

儿童危重罕见病（RDs）发病急、危害大、死亡率高，给家庭和社会带来沉重负担。多发性畸形、神经肌肉疾病、代谢性疾病和心脏病是我国儿童最常见的罕见病类型，常表现为多器官功能障碍。目前，儿童危重症 RD 的诊断和治疗面临着诊断时间长、误诊率高、治疗手段有限、疾病负担重等挑战。然而，随着我国基因检测技术的进步、多学科诊疗平台的建立以及相关 RD 政策的实施，危重 RD 患儿将获得更好的医疗服务、预后得到改善，并重新融入社会生活。

引用次数: 0

Machine learning enables update to pediatric neurorehabilitation 机器学习实现了儿科神经康复的更新

IF 2.2 4区医学 Q3 Medicine

Pediatric Investigation

Pub Date : 2024-02-12 DOI: 10.1002/ped4.12418

Yunfang He, Simian Cai, Tingting Peng, Yan Qiao, NaiQi Wu, Kaishou Xu

引用次数: 0

Machine learning enables update to pediatric neurorehabilitation 机器学习实现了儿科神经康复的更新

IF 2.2 4区医学 Q3 Medicine

Pediatric Investigation

Pub Date : 2024-02-12 DOI: 10.1002/ped4.12418

Yunfang He, Simian Cai, Tingting Peng, Yan Qiao, NaiQi Wu, Kaishou Xu

引用次数: 0

Novel variants and phenotypes of ROBO3 gene associated with horizontal gaze palsy with progressive scoliosis 与水平凝视麻痹伴进行性脊柱侧凸相关的 ROBO3 基因新变体和表型

IF 2.2 4区医学 Q3 Medicine

Pediatric Investigation

Pub Date : 2024-02-01 DOI: 10.1002/ped4.12414

Yan Xie, Lijuan Huang, Yunyu Zhou, Jin Wu, Ningdong Li

引用次数: 0

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Pediatric Investigation

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