Pub Date : 2023-05-06DOI: 10.5812/ijpediatr-134112
Cangcang Fu, Bin Wang, Lin Li, Jihua Zhu, Wei Li
Background: The global spread of coronavirus disease 2019 (COVID-19) has reached pandemic proportions. Attempts to control its spread have included a range of early screening and triage measures developed in several nations and areas. Objectives: This study aimed to determine how to prioritize pediatric fever patients to limit the time they had to wait for a consultation and, therefore, the potential of worsening and crises under the burden of COVID-19. Methods: The triage and emergency care process of children in the Fever Clinic of Children’s Hospital of Zhejiang University School of Medicine, Zhejiang, China, within 2019 - 2020 included flow charts, guidance signs, publicity materials, noon and night articulation, and emergency calls. To enhance the management of pre-consultation and triage, the incidence of adverse event injuries was tallied, and satisfaction surveys were conducted. The prevalence of infectious diseases was characterized by demographic and seasonal factors, and the chi-square test was employed to test for differences between groups. Results: From January 2019 to December 2020, four peak periods were observed in each year, namely February, July, September, and December in 2019 and March, June, September, and December in 2020. The peak of common respiratory virus infection was seasonal; however, a significant increase (χ2 = 52.17; P < 0.001) in the case of patients who needed emergency care was observed secondary to fever. The patients within the age range of 1 - 3 years were more in need of emergency care than any other age group (54.70%; 99/181). The most common disease requiring emergency care was febrile convulsions (55.2%). No infectious diseases were missed or underreported during the study period, and no medical personnel was infected. Conclusions: An effective pre-consultation assessment and triage management system and streamlined workflow are of great importance in safeguarding acute patients while preventing infectious diseases.
{"title":"Application of a Pre-examination and Triage of Children in Fever Clinics to Prevent and Control the Epidemic of Infectious Diseases","authors":"Cangcang Fu, Bin Wang, Lin Li, Jihua Zhu, Wei Li","doi":"10.5812/ijpediatr-134112","DOIUrl":"https://doi.org/10.5812/ijpediatr-134112","url":null,"abstract":"Background: The global spread of coronavirus disease 2019 (COVID-19) has reached pandemic proportions. Attempts to control its spread have included a range of early screening and triage measures developed in several nations and areas. Objectives: This study aimed to determine how to prioritize pediatric fever patients to limit the time they had to wait for a consultation and, therefore, the potential of worsening and crises under the burden of COVID-19. Methods: The triage and emergency care process of children in the Fever Clinic of Children’s Hospital of Zhejiang University School of Medicine, Zhejiang, China, within 2019 - 2020 included flow charts, guidance signs, publicity materials, noon and night articulation, and emergency calls. To enhance the management of pre-consultation and triage, the incidence of adverse event injuries was tallied, and satisfaction surveys were conducted. The prevalence of infectious diseases was characterized by demographic and seasonal factors, and the chi-square test was employed to test for differences between groups. Results: From January 2019 to December 2020, four peak periods were observed in each year, namely February, July, September, and December in 2019 and March, June, September, and December in 2020. The peak of common respiratory virus infection was seasonal; however, a significant increase (χ2 = 52.17; P < 0.001) in the case of patients who needed emergency care was observed secondary to fever. The patients within the age range of 1 - 3 years were more in need of emergency care than any other age group (54.70%; 99/181). The most common disease requiring emergency care was febrile convulsions (55.2%). No infectious diseases were missed or underreported during the study period, and no medical personnel was infected. Conclusions: An effective pre-consultation assessment and triage management system and streamlined workflow are of great importance in safeguarding acute patients while preventing infectious diseases.","PeriodicalId":215844,"journal":{"name":"Innovative Journal of Pediatrics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129720073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-16DOI: 10.5812/ijpediatr-130800
U. Ateş, E. Ergun, K. Bahadır, Ozlem Selvi Can, A. Gurbanov, Coskun Ozbicer, M. Çakmak, M. Bingol-Kologlu, G. Gollu
Background: One of the most challenging operations in children for anesthesiologists and surgeons is foreign body aspiration. Bronchospasm and desaturation may lead to bradycardia and even death. Objectives: The study aimed to evaluate the effect of preoperative dexamethasone and β2 agonist (salbutamol) administration on children who had foreign body aspiration during the rigid bronchoscopy on these undesired complications. Methods: Children were divided into two groups via random numbers table, independent of their clinical conditions. β2 agonist (salbutamol) (2.5 mg < 20 kg, 5 mg > 20 kg) and dexamethasone (0.5 mg/kg) were administrated to group 1, 30 minutes before the operation. The same agents were administrated to group 2 during anesthesia induction. The occurrence of bronchospasm, desaturation, and bradycardia was evaluated. Results: There were 27 children in each group. There was no statistically significant difference between the two groups’ time periods between the onset of the symptoms and procedure (P > 0.05). The two groups were similar in clinical aspects. Clinically, periods of spasm and desaturation were shorter, and patients recovered faster in group 1, but the bronchospasm numbers, desaturation, and bradycardia periods were similar in both groups. Conclusions: The results seem statistically similar. Since the periods of spasm and desaturation were shorter, and patients recovered faster in patients with preoperative administration of β2 agonists (salbutamol) and dexamethasone, we may suggest that a larger data set in future studies may lead to more significant results and a better conclusion.
{"title":"Preoperative Dexamethasone and β2 Agonist Administration to Children with Airway Foreign Bodies: Effects on Intraoperative Respiratory Complications","authors":"U. Ateş, E. Ergun, K. Bahadır, Ozlem Selvi Can, A. Gurbanov, Coskun Ozbicer, M. Çakmak, M. Bingol-Kologlu, G. Gollu","doi":"10.5812/ijpediatr-130800","DOIUrl":"https://doi.org/10.5812/ijpediatr-130800","url":null,"abstract":"Background: One of the most challenging operations in children for anesthesiologists and surgeons is foreign body aspiration. Bronchospasm and desaturation may lead to bradycardia and even death. Objectives: The study aimed to evaluate the effect of preoperative dexamethasone and β2 agonist (salbutamol) administration on children who had foreign body aspiration during the rigid bronchoscopy on these undesired complications. Methods: Children were divided into two groups via random numbers table, independent of their clinical conditions. β2 agonist (salbutamol) (2.5 mg < 20 kg, 5 mg > 20 kg) and dexamethasone (0.5 mg/kg) were administrated to group 1, 30 minutes before the operation. The same agents were administrated to group 2 during anesthesia induction. The occurrence of bronchospasm, desaturation, and bradycardia was evaluated. Results: There were 27 children in each group. There was no statistically significant difference between the two groups’ time periods between the onset of the symptoms and procedure (P > 0.05). The two groups were similar in clinical aspects. Clinically, periods of spasm and desaturation were shorter, and patients recovered faster in group 1, but the bronchospasm numbers, desaturation, and bradycardia periods were similar in both groups. Conclusions: The results seem statistically similar. Since the periods of spasm and desaturation were shorter, and patients recovered faster in patients with preoperative administration of β2 agonists (salbutamol) and dexamethasone, we may suggest that a larger data set in future studies may lead to more significant results and a better conclusion.","PeriodicalId":215844,"journal":{"name":"Innovative Journal of Pediatrics","volume":"188 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124172202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-13DOI: 10.5812/ijpediatr-129664
Seda Nur Kemer, H. Çelik, Seyda Ozal, N. Kafa
Background: Insufficiencies of gluteus medius and maximus muscles in children with unilateral cerebral palsy (CP) may restrict activity and participation by affecting gait, gross motor functions, and balance. Objectives: The present study aimed to elucidate the effect of Kinesio taping (KT) applied to the gluteus medius and maximus muscles on activity and participation in children with CP. Methods: The study was completed with 20 children with unilateral CP who were randomly divided into 2 groups: The KT group received KT and physiotherapy (n = 11), and the control group received only physiotherapy (n = 9). The KT application was administered for 4 weeks. The activity was evaluated with a BTS G-Walk Spatiotemporal Gait Analysis System, Timed Up and Go test (TUG), Functional Mobility Scale (FMS), Gross Motor Function Measure (GMFM), and Pediatric Balance Scale (PBS); in addition, participation was evaluated using the Canadian Occupational Performance Measure (COPM). Results: The KT group showed significant improvements in the gait parameter (cadence; P = 0.009), pelvic tilt symmetry (P = 0.017), pelvic rotation symmetry (P = 0.018), gait symmetry (P < 0.001), FMS (P = 0.07), TUG, GMFM, PBS, and COPM scores (P < 0.001) in the medium-term compared to the control group. It was also found that gait (cadence; P = 0.004) and functional mobility (P < 0.001) improved in the immediate term than in the KT group. Conclusions: KT combined with conventional physiotherapy can improve cadence and functional mobility in the immediate term, as well as gait and pelvic symmetry, functional mobility, gross motor function, balance, and participation in the medium term in children with unilateral CP. Further randomized controlled studies addressing large samples and long-term effects are warranted.
{"title":"The Effect of Kinesio Taping Over the Gluteal Muscles on Activity and Participation in Children with Unilateral Cerebral Palsy: A Preliminary Randomized Controlled Study","authors":"Seda Nur Kemer, H. Çelik, Seyda Ozal, N. Kafa","doi":"10.5812/ijpediatr-129664","DOIUrl":"https://doi.org/10.5812/ijpediatr-129664","url":null,"abstract":"Background: Insufficiencies of gluteus medius and maximus muscles in children with unilateral cerebral palsy (CP) may restrict activity and participation by affecting gait, gross motor functions, and balance. Objectives: The present study aimed to elucidate the effect of Kinesio taping (KT) applied to the gluteus medius and maximus muscles on activity and participation in children with CP. Methods: The study was completed with 20 children with unilateral CP who were randomly divided into 2 groups: The KT group received KT and physiotherapy (n = 11), and the control group received only physiotherapy (n = 9). The KT application was administered for 4 weeks. The activity was evaluated with a BTS G-Walk Spatiotemporal Gait Analysis System, Timed Up and Go test (TUG), Functional Mobility Scale (FMS), Gross Motor Function Measure (GMFM), and Pediatric Balance Scale (PBS); in addition, participation was evaluated using the Canadian Occupational Performance Measure (COPM). Results: The KT group showed significant improvements in the gait parameter (cadence; P = 0.009), pelvic tilt symmetry (P = 0.017), pelvic rotation symmetry (P = 0.018), gait symmetry (P < 0.001), FMS (P = 0.07), TUG, GMFM, PBS, and COPM scores (P < 0.001) in the medium-term compared to the control group. It was also found that gait (cadence; P = 0.004) and functional mobility (P < 0.001) improved in the immediate term than in the KT group. Conclusions: KT combined with conventional physiotherapy can improve cadence and functional mobility in the immediate term, as well as gait and pelvic symmetry, functional mobility, gross motor function, balance, and participation in the medium term in children with unilateral CP. Further randomized controlled studies addressing large samples and long-term effects are warranted.","PeriodicalId":215844,"journal":{"name":"Innovative Journal of Pediatrics","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115090718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-10DOI: 10.5812/ijpediatr-121793
Jiao Yuan, Dongqing Zhu, Jie Gu, Fu-ying Zhao, Yongming Wang, J. Luo
Background: The placenta, as a link between mother and fetus, is closely related to the development of the fetal nervous system. Histological chorioamnionitis (HCA) is common placental inflammation and an important factor in triggering premature delivery. Anabolic steroid (AS) is an important medication to promote fetal lung maturity. Therefore, this study investigated the relationship between HCA, AS, and brain injury in premature infants. Objectives: This research aimed to explore the correlation of pathological changes in the placental HCA and the prenatal use of AS with brain injury in preterm infants. Methods: In total, 339 premature infants with a gestational age of under 34 weeks were taken as research subjects, and the placenta was examined by pathology after delivery. The samples were divided into HCA+ AS+, HCA+ AS-, HCA- AS+, and HCA- AS- groups based on the pathological results of the placenta and the prenatal use of steroid hormones. The occurrence of brain injury in preterm infants and the level of inflammatory indicators 2 h after birth were compared between the groups. Results: The incidence of brain injury in preterm infants in the HCA+ group was higher than in the HCA- group (χ2 = 5.713, P < 0.05), and the AS- group than in the AS+ group (χ2 = 4.368, P < 0.05); The incidence of brain injury in the HCA+ AS+, HCA+ AS- and HCA- AS-groups was significantly higher than in the HCA- AS+ group (χ2 = 6.105, P = 0.013; χ2 = 9.086, P = 0.003; χ2 = 4.848, P = 0.047, respectively). The incidence of brain injury in preterm infants was the highest in the group (30%). When the procalcitonin level 2 h after birth was 0.213 ng/mL, sensitivity to predict the occurrence of brain injury in preterm infants was 70.7%, and specificity was 80.2%. Conclusions: Brain damage in premature infants is related to HCA in the mother and insufficient AS treatment before delivery. Brain damage is more likely to occur when both factors exist.
背景:胎盘作为连接母体和胎儿的纽带，与胎儿神经系统的发育密切相关。组织学绒毛膜羊膜炎(HCA)是常见的胎盘炎症，是引发早产的重要因素。合成代谢类固醇(AS)是促进胎儿肺成熟的重要药物。因此，本研究探讨HCA、AS与早产儿脑损伤的关系。目的:本研究旨在探讨胎盘HCA病理变化与产前使用AS与早产儿脑损伤的相关性。方法:选取胎龄小于34周的早产儿339例为研究对象，分娩后对胎盘进行病理检查。根据胎盘病理结果及产前类固醇激素使用情况，将样本分为HCA+ AS+、HCA+ AS-、HCA- AS+和HCA- AS-组。比较两组早产儿脑损伤发生率及出生后2 h炎症指标水平。结果:HCA+组早产儿脑损伤发生率高于HCA-组(χ2 = 5.713, P < 0.05)， AS-组早产儿脑损伤发生率高于AS+组(χ2 = 4.368, P < 0.05);HCA+ AS+、HCA+ AS-和HCA- AS组脑损伤发生率均显著高于HCA- AS+组(χ2 = 6.105, P = 0.013;χ2 = 9.086, p = 0.003;χ2 = 4.848, P = 0.047)。早产儿脑损伤发生率最高(30%)。出生后2 h降钙素原水平为0.213 ng/mL时，预测早产儿脑损伤发生的敏感性为70.7%，特异性为80.2%。结论:早产儿脑损伤与母亲HCA及产前AS治疗不足有关。当这两种因素同时存在时，更有可能发生脑损伤。
{"title":"Effect of Placental Histological Chorioamnionitis and Prenatal Steroids on the Nervous System of Preterm Infants","authors":"Jiao Yuan, Dongqing Zhu, Jie Gu, Fu-ying Zhao, Yongming Wang, J. Luo","doi":"10.5812/ijpediatr-121793","DOIUrl":"https://doi.org/10.5812/ijpediatr-121793","url":null,"abstract":"Background: The placenta, as a link between mother and fetus, is closely related to the development of the fetal nervous system. Histological chorioamnionitis (HCA) is common placental inflammation and an important factor in triggering premature delivery. Anabolic steroid (AS) is an important medication to promote fetal lung maturity. Therefore, this study investigated the relationship between HCA, AS, and brain injury in premature infants. Objectives: This research aimed to explore the correlation of pathological changes in the placental HCA and the prenatal use of AS with brain injury in preterm infants. Methods: In total, 339 premature infants with a gestational age of under 34 weeks were taken as research subjects, and the placenta was examined by pathology after delivery. The samples were divided into HCA+ AS+, HCA+ AS-, HCA- AS+, and HCA- AS- groups based on the pathological results of the placenta and the prenatal use of steroid hormones. The occurrence of brain injury in preterm infants and the level of inflammatory indicators 2 h after birth were compared between the groups. Results: The incidence of brain injury in preterm infants in the HCA+ group was higher than in the HCA- group (χ2 = 5.713, P < 0.05), and the AS- group than in the AS+ group (χ2 = 4.368, P < 0.05); The incidence of brain injury in the HCA+ AS+, HCA+ AS- and HCA- AS-groups was significantly higher than in the HCA- AS+ group (χ2 = 6.105, P = 0.013; χ2 = 9.086, P = 0.003; χ2 = 4.848, P = 0.047, respectively). The incidence of brain injury in preterm infants was the highest in the group (30%). When the procalcitonin level 2 h after birth was 0.213 ng/mL, sensitivity to predict the occurrence of brain injury in preterm infants was 70.7%, and specificity was 80.2%. Conclusions: Brain damage in premature infants is related to HCA in the mother and insufficient AS treatment before delivery. Brain damage is more likely to occur when both factors exist.","PeriodicalId":215844,"journal":{"name":"Innovative Journal of Pediatrics","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132564718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-10DOI: 10.5812/ijpediatr-126543
M. Mirmohammadkhani, M. Paknazar, Nemat Sodoteh Asl, Fatemeh Paknazar
Background: A considerable percentage of school-age children and adolescents have signs and symptoms of mental health problems. Gender differences can also be important in mental health status. In Iran, talented students are selected through an entrance exam to enter special schools called SAMPAD. Mental health problems in talented school students can also be affected by gender. Objectives: This study was conducted to determine the prevalence of mental health problems of Iranian students studying in SAMPAD junior high schools, aiming to identify gender differences in emotional and behavioral problems. Methods: The study population of this cross-sectional study consisted of male and female students aged 12 - 15 years, in the seventh, eighth, and ninth grades studying in SAMPAD schools of Semnan province, Iran, within the academic year of 2019 - 2020. Sampling was performed by the stratified-cluster random method. The tool used to assess students’ mental health was the standardized Persian version of the Strengths and Difficulties Questionnaire related to adolescence, which is used to screen mental health problems in 11-17-year-old adolescents. Results: A total of 112 (52 boys and 60 girls, mean age: 14.0 ± 0.8 years) and their parents participated in the study. The prevalence of mental health problems was estimated at 19.6% (95% CI: 12.3 - 27.0%) and 14.3% (95% CI: 7.8 - 20.8%) according to the student questionnaire and the parents’ questionnaire, respectively. Based on the questionnaire completed by the students, the lack of prosocial behaviors was higher in female students (25% compared to 7.7%, P = 0.017). Based on the questionnaire completed by the parents, it was still significantly higher in female students than in male students (31.7% compared to 7.7%, P = 0.001). The frequency of conduct problems was higher in boys than in girls, according to the parents’ questionnaire (26.9% compared to 10%, P = 0.026). Conclusions: Girls regarding strengthening prosocial behaviors and boys regarding conduct problems require attention and effective action in SAMPAD junior high schools. Screening programs and holding periodic consultations to timely diagnose the problems mentioned above are recommended to the school officials and parents of students.
{"title":"Gender Differences in Emotional and Behavioral Problems of Adolescents: A Cross-sectional Study on Talented School Students in Iran (2019)","authors":"M. Mirmohammadkhani, M. Paknazar, Nemat Sodoteh Asl, Fatemeh Paknazar","doi":"10.5812/ijpediatr-126543","DOIUrl":"https://doi.org/10.5812/ijpediatr-126543","url":null,"abstract":"Background: A considerable percentage of school-age children and adolescents have signs and symptoms of mental health problems. Gender differences can also be important in mental health status. In Iran, talented students are selected through an entrance exam to enter special schools called SAMPAD. Mental health problems in talented school students can also be affected by gender. Objectives: This study was conducted to determine the prevalence of mental health problems of Iranian students studying in SAMPAD junior high schools, aiming to identify gender differences in emotional and behavioral problems. Methods: The study population of this cross-sectional study consisted of male and female students aged 12 - 15 years, in the seventh, eighth, and ninth grades studying in SAMPAD schools of Semnan province, Iran, within the academic year of 2019 - 2020. Sampling was performed by the stratified-cluster random method. The tool used to assess students’ mental health was the standardized Persian version of the Strengths and Difficulties Questionnaire related to adolescence, which is used to screen mental health problems in 11-17-year-old adolescents. Results: A total of 112 (52 boys and 60 girls, mean age: 14.0 ± 0.8 years) and their parents participated in the study. The prevalence of mental health problems was estimated at 19.6% (95% CI: 12.3 - 27.0%) and 14.3% (95% CI: 7.8 - 20.8%) according to the student questionnaire and the parents’ questionnaire, respectively. Based on the questionnaire completed by the students, the lack of prosocial behaviors was higher in female students (25% compared to 7.7%, P = 0.017). Based on the questionnaire completed by the parents, it was still significantly higher in female students than in male students (31.7% compared to 7.7%, P = 0.001). The frequency of conduct problems was higher in boys than in girls, according to the parents’ questionnaire (26.9% compared to 10%, P = 0.026). Conclusions: Girls regarding strengthening prosocial behaviors and boys regarding conduct problems require attention and effective action in SAMPAD junior high schools. Screening programs and holding periodic consultations to timely diagnose the problems mentioned above are recommended to the school officials and parents of students.","PeriodicalId":215844,"journal":{"name":"Innovative Journal of Pediatrics","volume":"358 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115945255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Early detection, diagnosis, and treatment of children with CHD has been the focus of research attention. Hainan is the southernmost underdeveloped province in China, where the technology of screening, diagnosis, and treatment for children with CHD has not been fully developed. Objectives: This study aimed to introduce and promote an appropriate technology system for screening, diagnosis, and evaluation of neonatal CHD. Methods: Two indicators, namely cardiac auscultation plus pulse oximetry (POX), were used by screening staff to screen live newborns within six to 72 hours after birth at all screening institutions in Hainan province from January 1, 2019, to December 31, 2021. Diagnosis procedure for the screened-positive newborns was performed in 31 certified medical institutions, and evaluation procedure for the newborns confirmed with CHD was performed in six certified medical institutions. Data about screening, diagnosis, evaluation, and treatment were obtained, uploaded, and managed online through a neonatal CHD screening information management net. Results: A total of 321447 live births were included in the CHD screening project, and an overall screening rate of 97.59% (321447/329387) was determined. According to our results, 8032 cases were screened-positive. A total of 1099 cases of CHD were confirmed, suggesting a CHD prevalence of 3.419 per 1000 live births. Atrial septal defect (ASD) was the most common CHD lesion, with a prevalence of 1.313 per 1000 live births. The sensitivity of cardiac auscultation, POX, and two indicators’ combination (i.e., cardiac auscultation plus POX) for CHD detection were 69.15%, 33.49%, and 91.90%, respectively; and the specificity of them were 98.36%, 99.43%, and 97.81%, respectively. The ratio of both positive in two indicators among the children with major (serious and critical) CHD at the initial screening was significantly higher than that of single positive in any indicator (χ2 = 59.455, P < 0.001). All children with CHD were evaluated, out of who 154 children with major CHD were treated promptly. Only 15 cases of children with major CHD died, and the standardized mortality of children aged 0 - 1 years with CHD was 4.67/100,000. Conclusions: It was concluded that the combination of two indicators (i.e., cardiac auscultation plus POX) for CHD screening was reliable as well as non-invasive, simple, and easy to operate so that it was conducive for promotion. It was also found that introducing and promoting an appropriate technology for screening, diagnosis, and evaluation of neonatal CHD were extremely significant since they may have contributed to the timely diagnosing and treating children with CHD, especially those with major CHD.
{"title":"Appropriate Technology for Screening, Diagnosis, and Evaluation of Neonatal Congenital Heart Disease in the Southernmost Region of China","authors":"Qian Chen, Du-Fei Zhang, Ya-Zhou Wang, Xiang-Yun Zhang","doi":"10.5812/ijpediatr-132589","DOIUrl":"https://doi.org/10.5812/ijpediatr-132589","url":null,"abstract":"Background: Early detection, diagnosis, and treatment of children with CHD has been the focus of research attention. Hainan is the southernmost underdeveloped province in China, where the technology of screening, diagnosis, and treatment for children with CHD has not been fully developed. Objectives: This study aimed to introduce and promote an appropriate technology system for screening, diagnosis, and evaluation of neonatal CHD. Methods: Two indicators, namely cardiac auscultation plus pulse oximetry (POX), were used by screening staff to screen live newborns within six to 72 hours after birth at all screening institutions in Hainan province from January 1, 2019, to December 31, 2021. Diagnosis procedure for the screened-positive newborns was performed in 31 certified medical institutions, and evaluation procedure for the newborns confirmed with CHD was performed in six certified medical institutions. Data about screening, diagnosis, evaluation, and treatment were obtained, uploaded, and managed online through a neonatal CHD screening information management net. Results: A total of 321447 live births were included in the CHD screening project, and an overall screening rate of 97.59% (321447/329387) was determined. According to our results, 8032 cases were screened-positive. A total of 1099 cases of CHD were confirmed, suggesting a CHD prevalence of 3.419 per 1000 live births. Atrial septal defect (ASD) was the most common CHD lesion, with a prevalence of 1.313 per 1000 live births. The sensitivity of cardiac auscultation, POX, and two indicators’ combination (i.e., cardiac auscultation plus POX) for CHD detection were 69.15%, 33.49%, and 91.90%, respectively; and the specificity of them were 98.36%, 99.43%, and 97.81%, respectively. The ratio of both positive in two indicators among the children with major (serious and critical) CHD at the initial screening was significantly higher than that of single positive in any indicator (χ2 = 59.455, P < 0.001). All children with CHD were evaluated, out of who 154 children with major CHD were treated promptly. Only 15 cases of children with major CHD died, and the standardized mortality of children aged 0 - 1 years with CHD was 4.67/100,000. Conclusions: It was concluded that the combination of two indicators (i.e., cardiac auscultation plus POX) for CHD screening was reliable as well as non-invasive, simple, and easy to operate so that it was conducive for promotion. It was also found that introducing and promoting an appropriate technology for screening, diagnosis, and evaluation of neonatal CHD were extremely significant since they may have contributed to the timely diagnosing and treating children with CHD, especially those with major CHD.","PeriodicalId":215844,"journal":{"name":"Innovative Journal of Pediatrics","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125991134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-09DOI: 10.5812/ijpediatr-123152
Bin Yang, Na Guo, Xiao-dan Wang, SuLan Wang
Background: We aimed to analyze contralateral patent processus vaginalis (CPPV) in the laparoscopic high ligation of the vaginal process, treat eligible children surgically, and evaluate the clinical long-term outcomes. Methods: A total of 300 children with unilateral inguinal hernia or unilateral hydrocele treated in our hospital were selected for laparoscopic high ligation of the vaginal process, during which CPPV was analyzed. The 300 children were randomly divided into two groups of 150. In the study group (n = 58), 11 children met the requirements of high ligation and were treated with simultaneous surgery. The 53 children in the control group received simultaneous treatment. The prevalence of CPPV was compared between children with unilateral indirect inguinal hernia and unilateral hydrocele, left and right patent processus vaginalis (PPV), and different ages. After surgery, both groups were followed up for one year. The recurrence rate of contralateral indirect inguinal hernia or hydrocele was compared. Significant differences were assessed between the two groups receiving different treatments. Results: The prevalence of CPPV was 23% in children with unilateral indirect inguinal hernia and 49% in children with unilateral hydrocele. The prevalence of CPPV in children with unilateral hydrocele was significantly higher than that in children with inguinal hernia (P = 0.00). The prevalence of CPPV was 42% in children with left PPV and 33% in children with right PPV, without a statistically significant difference (P = 0.19). The prevalence of CPPV was 63% in children aged 1 - 2 years, which was significantly higher than that in other age groups (χ2 = 7.46, P = 0.01). The prevalence of CPPV was 14% in children aged > 6 years, which was significantly lower than that in other age groups (χ2 = 4.43, P = 0.04). A postoperative one-year follow-up showed that the recurrence rate was 9% in the study group and 1% in the control group, without a statistically significant difference (P = 0.25). Conclusions: The prevalence of CPPV decreases with age. Hydrocele combined with CPPV is more common. For younger children with hydrocele, it is very important to explore the contralateral side during surgery. Moreover, the transformation of CPPV to indirect inguinal hernia or hydrocele occurs rarely, and only eligible children can receive simultaneous treatment during surgery.
{"title":"Analysis of Contralateral Patent Processus Vaginalis in Laparoscopic High Ligation of the Vaginal Process and Clinical Long-term Effect of Individualized Treatment","authors":"Bin Yang, Na Guo, Xiao-dan Wang, SuLan Wang","doi":"10.5812/ijpediatr-123152","DOIUrl":"https://doi.org/10.5812/ijpediatr-123152","url":null,"abstract":"Background: We aimed to analyze contralateral patent processus vaginalis (CPPV) in the laparoscopic high ligation of the vaginal process, treat eligible children surgically, and evaluate the clinical long-term outcomes. Methods: A total of 300 children with unilateral inguinal hernia or unilateral hydrocele treated in our hospital were selected for laparoscopic high ligation of the vaginal process, during which CPPV was analyzed. The 300 children were randomly divided into two groups of 150. In the study group (n = 58), 11 children met the requirements of high ligation and were treated with simultaneous surgery. The 53 children in the control group received simultaneous treatment. The prevalence of CPPV was compared between children with unilateral indirect inguinal hernia and unilateral hydrocele, left and right patent processus vaginalis (PPV), and different ages. After surgery, both groups were followed up for one year. The recurrence rate of contralateral indirect inguinal hernia or hydrocele was compared. Significant differences were assessed between the two groups receiving different treatments. Results: The prevalence of CPPV was 23% in children with unilateral indirect inguinal hernia and 49% in children with unilateral hydrocele. The prevalence of CPPV in children with unilateral hydrocele was significantly higher than that in children with inguinal hernia (P = 0.00). The prevalence of CPPV was 42% in children with left PPV and 33% in children with right PPV, without a statistically significant difference (P = 0.19). The prevalence of CPPV was 63% in children aged 1 - 2 years, which was significantly higher than that in other age groups (χ2 = 7.46, P = 0.01). The prevalence of CPPV was 14% in children aged > 6 years, which was significantly lower than that in other age groups (χ2 = 4.43, P = 0.04). A postoperative one-year follow-up showed that the recurrence rate was 9% in the study group and 1% in the control group, without a statistically significant difference (P = 0.25). Conclusions: The prevalence of CPPV decreases with age. Hydrocele combined with CPPV is more common. For younger children with hydrocele, it is very important to explore the contralateral side during surgery. Moreover, the transformation of CPPV to indirect inguinal hernia or hydrocele occurs rarely, and only eligible children can receive simultaneous treatment during surgery.","PeriodicalId":215844,"journal":{"name":"Innovative Journal of Pediatrics","volume":"114 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114552038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Peripherally inserted central catheter (PICC) is an alternative to central venous cannulation. This study aimed to identify factors associated with first-attempt success rate in children undergoing PICC insertion. Methods: This retrospective study included pediatric patients who underwent PICC placement at the Children’s Hospital of Zhejiang (1/2020-12/2020). The successful puncture was defined as smooth blood return and insertion of the guide wire. Clinical data were collected, and factors associated with first-attempt success were identified by logistic regression analyses. Results: The final analysis included 640 children (360 males, 56.2%). Successful puncture at the first attempt was achieved in 380 (59.4%) patients. Multivariate logistic regression revealed that being uncooperative after sedation (OR = 2.745, 95%CI: 1.028 - 7.331, P = 0.044), being cooperative after sedation (OR = 0.318, 95%CI: 0.128–0.791, P = 0.014), target vein depth (0.5 - 1 vs. ≤ 0.5: OR = 1.715, 95%CI: 1.081–2.720, P = 0.022; 1.1-1.5 vs. ≤ 0.5: OR = 3.036, 95%CI: 1.166 - 7.903, P = 0.023; > 1.5 vs. ≤ 0.5: OR = 10.453, 95%CI: 2.366 - 46.139, P = 0.002), target vein diameter (2.0 - 2.9 vs. ≤ 2: OR = 0.313, 95%CI: 0.180 - 0.545, P < 0.001; ≥ 3 vs. ≤ 2: OR = 0.122, 95%CI: 0.055 - 0.272, P < 0.001), and 3F catheter specification (vs. 1.9F: OR = 2.057, 95%CI: 1.069 - 3.958, P = 0.031) were independently associated with puncture failure at the first attempt. Conclusions: The degree of cooperation, target vein diameter and depth, and catheter specification were independently associated with the first-attempt success rate.
背景:外周置管中心导管(PICC)是一种替代中心静脉插管的方法。本研究旨在确定与儿童PICC置入首次成功率相关的因素。方法:本回顾性研究纳入了在浙江省儿童医院(2020年1月- 2020年12月)接受PICC安置的儿童患者。穿刺成功的定义是血液顺利回流并插入导丝。收集临床资料，并通过逻辑回归分析确定与首次尝试成功相关的因素。结果:最终纳入儿童640例，其中男性360例，占56.2%。首次穿刺成功380例(59.4%)。多因素logistic回归分析显示:镇静后不配合(OR = 2.745, 95%CI: 1.028 ~ 7.331, P = 0.044)、镇静后配合(OR = 0.318, 95%CI: 0.128 ~ 0.791, P = 0.014)、目标静脉深度(0.5 ~ 1 vs.≤0.5:OR = 1.715, 95%CI: 1.081 ~ 2.720, P = 0.022;1.1 ~ 1.5 vs.≤0.5:OR = 3.036, 95%CI: 1.166 ~ 7.903, P = 0.023;> 1.5 vs.≤0.5:OR = 10.453, 95%CI: 2.366 ~ 46.139, P = 0.002)，靶静脉直径(2.0 ~ 2.9 vs.≤2:OR = 0.313, 95%CI: 0.180 ~ 0.545, P < 0.001;≥3 vs≤2:OR = 0.122, 95%CI: 0.055 ~ 0.272, P < 0.001)、3F导管规格(vs. 1.9F: OR = 2.057, 95%CI: 1.069 ~ 3.958, P = 0.031)与首次穿刺失败独立相关。结论:配合程度、靶静脉直径和深度、导管规格与首次尝试成功率独立相关。
{"title":"Factors Associated with Successful First-attempt Puncture in Pediatric Patients Undergoing Ultrasound-guided Peripherally Inserted Central Catheter","authors":"Midan Zhang, Xiaofei Chen, Hong-Yuan Zhou, Meifang Xu","doi":"10.5812/ijpediatr-130372","DOIUrl":"https://doi.org/10.5812/ijpediatr-130372","url":null,"abstract":"Background: Peripherally inserted central catheter (PICC) is an alternative to central venous cannulation. This study aimed to identify factors associated with first-attempt success rate in children undergoing PICC insertion. Methods: This retrospective study included pediatric patients who underwent PICC placement at the Children’s Hospital of Zhejiang (1/2020-12/2020). The successful puncture was defined as smooth blood return and insertion of the guide wire. Clinical data were collected, and factors associated with first-attempt success were identified by logistic regression analyses. Results: The final analysis included 640 children (360 males, 56.2%). Successful puncture at the first attempt was achieved in 380 (59.4%) patients. Multivariate logistic regression revealed that being uncooperative after sedation (OR = 2.745, 95%CI: 1.028 - 7.331, P = 0.044), being cooperative after sedation (OR = 0.318, 95%CI: 0.128–0.791, P = 0.014), target vein depth (0.5 - 1 vs. ≤ 0.5: OR = 1.715, 95%CI: 1.081–2.720, P = 0.022; 1.1-1.5 vs. ≤ 0.5: OR = 3.036, 95%CI: 1.166 - 7.903, P = 0.023; > 1.5 vs. ≤ 0.5: OR = 10.453, 95%CI: 2.366 - 46.139, P = 0.002), target vein diameter (2.0 - 2.9 vs. ≤ 2: OR = 0.313, 95%CI: 0.180 - 0.545, P < 0.001; ≥ 3 vs. ≤ 2: OR = 0.122, 95%CI: 0.055 - 0.272, P < 0.001), and 3F catheter specification (vs. 1.9F: OR = 2.057, 95%CI: 1.069 - 3.958, P = 0.031) were independently associated with puncture failure at the first attempt. Conclusions: The degree of cooperation, target vein diameter and depth, and catheter specification were independently associated with the first-attempt success rate.","PeriodicalId":215844,"journal":{"name":"Innovative Journal of Pediatrics","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130487635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-08DOI: 10.5812/ijpediatr-132681
B. Yaşa, N. Karabulut, S. Uslu, S. Memur, Dilek Yavuzcan Ozturk, O. Bagci, Halime Sema Can Buker, I. Polat, M. Çetinkaya
Background: The outbreak of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) created unexpected impacts worldwide. Objectives: This study aimed to examine the association of SARS-CoV-2 viral load in pregnant women with maternal disease severity and neonatal outcomes. Methods: In this retrospective cohort study, 55 pregnant women infected with SARS-CoV-2 and their newborn infants were included. The association between maternal viral load (tested by cycle threshold) and maternal disease severity/neonatal outcomes was examined. Results: Infants had a median gestational age of 38 (29 - 41) weeks and birth weight of 3200 (630 - 4570) grams. The median Ct value of pregnant women was 30 (20 - 37). No significant difference was detected among mild, moderate or severely ill pregnant women in terms of median Ct values (30, 28.5, and 30, respectively; P > 0.05). The median Ct value of pregnant women who gave preterm delivery was similar to those who had term delivery [30 (21 - 36) vs. 30 (25 - 35); P > 0.05]. The median Ct values were similar among pregnant women who died or survived [32.5 (30 - 34) vs. 30 (21 - 36); P > 0.05]. Preterm delivery rates and overall mortality were not associated with SARS-CoV-2 RT-qPCR Ct values, (r = 0.04, P > 0.05). No correlation was found between maternal SARS-CoV-2 viral load and maternal disease severity/neonatal outcomes. Conclusions: To the best of our knowledge, this study was the first one examining the association between maternal SARS-CoV-2 viral load and maternal/neonatal outcomes. It was suggested that viral load may not have been used for predicting the severity of maternal disease and maternal/neonatal outcomes.
{"title":"SARS-CoV-2 Viral Load in Pregnant Women and Association with Maternal Disease Severity and Neonatal Outcomes","authors":"B. Yaşa, N. Karabulut, S. Uslu, S. Memur, Dilek Yavuzcan Ozturk, O. Bagci, Halime Sema Can Buker, I. Polat, M. Çetinkaya","doi":"10.5812/ijpediatr-132681","DOIUrl":"https://doi.org/10.5812/ijpediatr-132681","url":null,"abstract":"Background: The outbreak of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) created unexpected impacts worldwide. Objectives: This study aimed to examine the association of SARS-CoV-2 viral load in pregnant women with maternal disease severity and neonatal outcomes. Methods: In this retrospective cohort study, 55 pregnant women infected with SARS-CoV-2 and their newborn infants were included. The association between maternal viral load (tested by cycle threshold) and maternal disease severity/neonatal outcomes was examined. Results: Infants had a median gestational age of 38 (29 - 41) weeks and birth weight of 3200 (630 - 4570) grams. The median Ct value of pregnant women was 30 (20 - 37). No significant difference was detected among mild, moderate or severely ill pregnant women in terms of median Ct values (30, 28.5, and 30, respectively; P > 0.05). The median Ct value of pregnant women who gave preterm delivery was similar to those who had term delivery [30 (21 - 36) vs. 30 (25 - 35); P > 0.05]. The median Ct values were similar among pregnant women who died or survived [32.5 (30 - 34) vs. 30 (21 - 36); P > 0.05]. Preterm delivery rates and overall mortality were not associated with SARS-CoV-2 RT-qPCR Ct values, (r = 0.04, P > 0.05). No correlation was found between maternal SARS-CoV-2 viral load and maternal disease severity/neonatal outcomes. Conclusions: To the best of our knowledge, this study was the first one examining the association between maternal SARS-CoV-2 viral load and maternal/neonatal outcomes. It was suggested that viral load may not have been used for predicting the severity of maternal disease and maternal/neonatal outcomes.","PeriodicalId":215844,"journal":{"name":"Innovative Journal of Pediatrics","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114894455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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