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Diagnosis, classification and management of ankyloglossia including its influence on breastfeeding. 强直性粘连的诊断、分类和治疗及其对母乳喂养的影响。
Pub Date : 2019-01-01
Dagna Brzęcka, Małgorzata Garbacz, Marcin Micał, Barbara Zych, Bogumił Lewandowski

Ankyloglossia is defined as a congenital malformation that alters lingual mobility and function. It is listed as one of the possible reasons behind problems with breastfeeding. Due to current WHO recommendations that encourage mothers to breastfeed exclusively up to 6 months of age, quick recognition of any obstacles in the suction mechanism and determining the possible reasons for problems should be a priority. A review of the literature was conducted concerning the diagnosis of ankyloglossia, possible methods of treatment and their efficacy in improving breastfeeding quality. The authors of the research cited claim that any surgical intervention should be performed only in cases of symptomatic ankyloglossia interfering with sucking mechanisms. The most frequent surgical procedure performed in newborns with symptomatic ankyloglossia is frenulotomy. It is a simple procedure with a low risk of complications. The literature gives a great number of studies confirming both the short and long-term efficacy of tongue-tie release in improving breastfeeding quality, with emphasis on decreasing mothers' discomfort, nipple pain and trauma.

强直性咬合症是一种先天性畸形,它会改变舌的活动能力和功能。它被列为母乳喂养问题背后的可能原因之一。由于世卫组织目前的建议是鼓励母亲纯母乳喂养至6个月大,因此应优先迅速识别吸吸机制中的任何障碍并确定问题的可能原因。本文综述了关于强直性咬合的诊断、可能的治疗方法及其对提高母乳喂养质量的效果。该研究的作者引用声称,只有在症状性咬合不全干扰吸吮机制的情况下,才应进行任何手术干预。新生儿症状性强直性咬合最常见的手术是系带切开术。这是一个简单的程序,并发症的风险很低。文献给出了大量的研究,证实了舌结释放在改善母乳喂养质量方面的短期和长期疗效,并强调了减少母亲的不适、乳头疼痛和创伤。
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引用次数: 0
Recent progress in human placental transcriptomics. 人类胎盘转录组学的最新进展。
Pub Date : 2019-01-01
Marcin Jóźwik, Aleksandra Lipka

The placenta serves as a metabolic, respiratory, excretory, and endocrine organ that provides appropriate conditions required for adequate fetal development during pregnancy. The development of particular structures and proper functioning of the placenta are under the influence of sophisticated pathways controlled by the expression of substantial genes that are additionally regulated by long non-coding ribonucleic acids (RNAs). Disruptions to adaptive changes in the placental transcriptome as a response to alterations in the feto-maternal environment may be associated with pregnancy complications and compromised fetal outcomes. The aim of the current paper was to present recent findings in transcriptomics of the human placenta. Different approaches in bioinformatic analyses of the RNA-sequencing results were presented. Novel knowledge about the genes and mechanisms that are crucial for the proper development of the placenta is essential for the understanding what stands behind both the normal and complicated pregnancy.

胎盘作为代谢、呼吸、排泄和内分泌器官,在怀孕期间为胎儿的充分发育提供适当的条件。胎盘特殊结构的发育和正常功能受到复杂途径的影响,这些途径受长链非编码核糖核酸(rna)调节的大量基因表达控制。胎盘转录组的适应性变化作为对胎母环境改变的反应可能与妊娠并发症和胎儿结局受损有关。本文的目的是介绍人类胎盘转录组学的最新发现。介绍了对rna测序结果进行生物信息学分析的不同方法。关于基因和机制的新知识对胎盘的正常发育至关重要,这对于理解正常妊娠和复杂妊娠背后的原因至关重要。
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引用次数: 0
[Food protein-induced enterocolitis syndrome (FPIES) - a rare disease with frequent symptoms - the practitioner's compendium]. [食物蛋白诱导的小肠结肠炎综合征(FPIES)——一种症状频繁的罕见疾病——医生纲要]。
Pub Date : 2019-01-01
Hanna Ludwig, Aneta Krogulska

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy with varying degrees of severity. The acute form of the disease is manifested by vomiting, lethargy and pallor, which usually appear within 1-4 hours after food ingestion, and can lead to shock. The most common trigger foods are: cow's milk, soy, rice and oats. Chronic FPIES is typical for infants fed with cow's milk or soy infant formula and is manifested by chronic vomiting, diarrhea and failure to thrive. In the vast majority of patients with FPIES, the analysis of the clinical history is sufficient to diagnose and identify trigger foods. If the history is unclear, use an oral food challenge to help confirm the diagnosis. Long-term management of patients with FPIES involves elimination of the trigger foods, monitoring for FPIES resolution and caregivers' education. The majority of children acquire food tolerance at the age of 3-5.

食物蛋白诱导的小肠结肠炎综合征(FPIES)是一种非ige介导的严重程度不同的食物过敏。该病的急性表现为呕吐、嗜睡和脸色苍白,通常在进食后1-4小时内出现,并可导致休克。最常见的诱发食物是:牛奶、大豆、大米和燕麦。慢性FPIES是用牛奶或大豆婴儿配方奶粉喂养的婴儿的典型症状,表现为慢性呕吐、腹泻和发育不良。在绝大多数FPIES患者中,对临床病史的分析足以诊断和识别触发食物。如果病史不清楚,使用口腔食物检查来帮助确诊。FPIES患者的长期管理包括消除诱发食物,监测FPIES的解决和护理人员的教育。大多数儿童在3-5岁时获得食物耐受性。
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引用次数: 0
Hyperbaric oxygenation in pediatrics: indications in the light of evidence - based medicine. 儿科高压氧合:循证医学的适应症。
Pub Date : 2019-01-01
Jacek Siewiera, Judyta Mews, Katarzyna Królikowska, Bolesław Kalicki, Katarzyna Jobs

Hyperbaric oxygen therapy (HBOT), which is a centuries-old treatment, has now increasingly often been used in the pediatric population. The basic indications for HBOT are well-known disease entities, i.e. carbon monoxide poisoning or decompression sickness. Due to the immunomodulatory properties of hyperbaric oxygen, attempts are made to use HBOT in the treatment of atopic dermatitis or inflammatory bowel diseases. The close cooperation between pediatricians and hyperbaric medicine teams is very important to obtain optimal results. The aim of this article is to present the mechanism of hyperbaric oxygen activity, and its influence on selected disease entities. The paper outlines new perspectives for HBOT in the pediatric population.

高压氧治疗(HBOT)是一种具有数百年历史的治疗方法,现在越来越多地用于儿科人群。HBOT的基本适应症是众所周知的疾病实体,即一氧化碳中毒或减压病。由于高压氧的免疫调节特性,人们尝试使用HBOT治疗特应性皮炎或炎症性肠病。儿科医生与高压氧医学团队的密切合作对获得最佳效果非常重要。本文的目的是介绍高压氧活性的机制,及其对选定疾病实体的影响。本文概述了HBOT在儿科人群中的新前景。
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引用次数: 0
Toward a Romanian version of the Three-Factor Eating Questionnaire-R21 for children and adolescents (CTFEQ-R21): Preliminary psychometric analysis and relation with body composition. 罗马尼亚版儿童和青少年三因素饮食问卷(CTFEQ-R21)的初步心理测量分析及其与身体成分的关系
Pub Date : 2019-01-01
Mirela Steff, Julien Verney, Marius Marinau, Sergiu Perte, Bruno Pereira, Eleonor Bryant, Vicky Drapeau, Jean-Philippe Chaput, Daniel Courteix, David Thivel

Objective: Purpose: The aim of this study was to develop and validate a Romanian version of the Three-Factor Eating Questionnaire-R21 for children and adolescents CTFEQ-R21, and to assess its psychometric properties and factor structure. Associations between the present version of the CTFEQ-R21 and anthropometric measures as well as body composition were also examined.

Patients and methods: Material and methods: 153 children and adolescents (68 boys and 95 girls; 10.8±3.5 years) took part in this study (BMI of 17.7±3.1 kg/m²). The participants were first interviewed to ascertain their understanding of the CTFEQ-R21 and were then asked to self-complete the questionnaire. Height and weight were measured and body composition assessed using bio impedance analyzers (Tanita MC 780).

Results: Results: The CTFEQ-R21 showed satisfactory internal consistency (Cronbach's α=0.78). Cronbach's alpha coefficients were 0.55 for CR (cognitive restriction), 0.75 for UE (Uncontrolled Eating), and 0.76 for EE (Emotional Eating) separately. UE and EE were found to be significantly correlated (r=0.54, p<0.05). The three factors explained 43% of the total variance. Correlation between CR, UE and EE with body weight, BMI and FFM were significant but low to moderate, with coefficients ranging from 0.20 to 0.37. The higher the CR, UE and EE tertiles, the higher the weight, fat mass (kg) and fat-free mass values.

Conclusion: Conclusions: According to the psychometric analysis of the questionnaire, the version of the CTFEQ-R21 proposed here is a satisfactory tool to assess eating behaviors in the Romanian child population that remains to be further developed.

目的:本研究的目的是编制和验证罗马尼亚版儿童青少年饮食三因素问卷(CTFEQ-R21),并评估其心理测量特性和因素结构。目前版本的CTFEQ-R21与人体测量测量以及身体成分之间的关系也进行了检查。患者和方法:材料和方法:153名儿童和青少年(男孩68名,女孩95名;(10.8±3.5岁)(BMI为17.7±3.1 kg/m²)。首先对参与者进行访谈,以确定他们对CTFEQ-R21的理解,然后要求他们自行完成问卷。使用生物阻抗分析仪(Tanita MC 780)测量身高和体重,评估身体成分。结果:CTFEQ-R21具有良好的内部一致性(Cronbach’s α=0.78)。CR(认知限制)、UE(失控进食)和EE(情绪进食)的Cronbach’s alpha系数分别为0.55、0.75和0.76。UE和EE显著相关(r=0.54, p)结论:结论:根据问卷的心理测量分析,本文提出的CTFEQ-R21版本是一个令人满意的评估罗马尼亚儿童饮食行为的工具,有待进一步开发。
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引用次数: 0
[What should be changed in Polish neonatal units in order to implement Family-Centered Care?] [为了实施以家庭为中心的护理,波兰新生儿单位应该改变什么?]
Pub Date : 2019-01-01
Magdalena Panek, Judene Mavrikis, Przemko Kwinta

The progress that has been made in neonatology is associated with an increasing number of painful procedures constantly being performed on the neonate. Additionally, prolonged hospitalization of premature neonates in NICUs isolates the family from their child. Parents may state that they do not have any parental feelings and cannot communicate with their newborns. The FCC (Family-Centered Care) initiative responded to emerging reports about the adverse consequences ensuing from the lack of parental access to hospitalized children. The FCC should be understood as care based on partner relations between families and health professionals, which is supposed to lead to health and well-being for both the children and their parents. The FCC should become standard practice in all neonatal intensive care units.

新生儿学取得的进展与不断对新生儿进行的越来越多的痛苦手术有关。此外,新生儿重症监护病房早产儿的长期住院使家庭与孩子隔离。父母可能会说他们没有任何父母的感觉,无法与新生儿沟通。联邦通信委员会(以家庭为中心的护理)倡议回应了关于父母无法接触住院儿童所造成的不利后果的新报告。联邦通信委员会应被理解为基于家庭和保健专业人员之间的伙伴关系的护理,这应该导致儿童及其父母的健康和福祉。FCC应成为所有新生儿重症监护病房的标准做法。
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引用次数: 0
The role of hepcidin in regulating iron homeostasis in selected diseases. hepcidin在特定疾病中调节铁稳态中的作用。
Pub Date : 2019-01-01
Aleksandra Radosz, Anna Obuchowicz

Iron is an element whose content in the human organism remains under strict control not only due to its involvement in many life processes but also because of its potential toxicity. The latest studies in iron metabolism, especially the involvement of hepcidin, which is the main regulator of iron homeostasis, broadened our knowledge in many medical fields (immunology, nephrology, hematology, gastrology). The present paper is a review of the literature devoted to the importance of hepcidin under selected conditions.

铁是一种在人体中含量受到严格控制的元素,这不仅是因为它参与许多生命过程,而且还因为它的潜在毒性。铁代谢的最新研究,特别是铁稳态的主要调节因子hepcidin的参与,拓宽了我们在许多医学领域(免疫学、肾脏病学、血液学、胃肠学)的知识。本文是一篇文献综述,致力于在选定条件下hepcidin的重要性。
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引用次数: 0
Impact of early glycemic variability on mortality and neurologic outcome of very low birth weight infants: Data from a continuous glucose monitoring system. 早期血糖变异性对极低出生体重儿死亡率和神经系统预后的影响:来自连续血糖监测系统的数据。
Pub Date : 2019-01-01
Mateusz Jagła, Izabela Szymońska, Katarzyna Starzec, Przemko Kwinta

Objective: Background: Glycemic variability (GV) has been a matter of interest in recent years. However, glycemic variability in preterm infants has not been adequately investigated. Objectives: To evaluate the impact of glycemic variability obtained from continuous glucose monitoring on mortality and neurologic outcomes: grade 3 or 4 intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), and retinopathy of prematurity (ROP) requiring treatment among very low birth weight infants.

Patients and methods: Material and methods:A prospective, single-center, open cohort study enrolled 74 very low birth weight infants with a mean birthweight of 1066 g (+/-267). A continuous glucose monitoring system (CGM) was used to measure glucose during the first week of life. The impact of glycemic variability (standard deviation SD; coefficient of variation CV; and mean amplitude of glucose excursion MAGE) on mortality and neurologic outcomes of infants was evaluated.

Results: Results: Univariate analysis revealed that glycemic variability occurring during the first week of life was not be associated with mortality before term-equivalent age and PVL. Higher GV was associated with grade 3 or 4 IVH (CV p=0.025; MAGE p=0.032) and ROP requiring treatment (SD p=0.019; CV p=0.026; MAGE=0.029). However, logistic regression models did not show a significant association between GV occurring during the first week of life and grade 3 or 4 IVH (MAGE OR 2.64; 95% CI 0.71-9.92) or ROP requiring treatment (MAGE OR 1.74; 95% CI 0.57-5.32).

Conclusion: Conclusions: Further prospective studies are needed to fully investigate the impact of GV on mortality and morbidity in premature infants. The potential benefits of reducing glucose blood fluctuations in VLBW infants need to be addressed.

目的:背景:近年来,血糖变异性(GV)一直是人们感兴趣的问题。然而,早产儿的血糖变异性尚未得到充分的研究。目的:评估从持续血糖监测中获得的血糖变异性对死亡率和神经系统结局的影响:3级或4级脑室内出血(IVH)、脑室周围白质软化(PVL)和需要治疗的极低出生体重婴儿早产儿视网膜病变(ROP)。患者和方法:材料和方法:一项前瞻性、单中心、开放队列研究,纳入74例极低出生体重婴儿,平均出生体重为1066 g(+/-267)。使用连续血糖监测系统(CGM)测量生命第一周的血糖。血糖变异性的影响(标准差SD;变异系数CV;以及平均葡萄糖偏移幅度(MAGE)对婴儿死亡率和神经系统预后的影响。结果:单因素分析显示,出生第一周发生的血糖变异性与足月前的死亡率和PVL无关。较高的GV与3级或4级IVH相关(CV p=0.025;MAGE p=0.032)和ROP需要处理(SD p=0.019;简历p = 0.026;法师= 0.029)。然而,逻辑回归模型并未显示出生第一周发生的GV与3级或4级IVH之间存在显著关联(MAGE or 2.64;95% CI 0.71-9.92)或ROP需要治疗(MAGE or 1.74;95% ci 0.57-5.32)。结论:GV对早产儿死亡率和发病率的影响需要进一步的前瞻性研究来充分研究。降低超低体重婴儿血糖波动的潜在益处需要得到解决。
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引用次数: 0
Fetal alcohol spectrum disorders - diagnostic difficulties in the neonatal period and new diagnostic approaches. 胎儿酒精谱系障碍-在新生儿期诊断困难和新的诊断方法。
Pub Date : 2019-01-01
Iwona Jańczewska, Jolanta Wierzba, Monika Cichoń-Kotek, Alicja Jańczewska

Fetal alcohol spectrum disorders (FASD) is a group of disorders that can occur in children whose mothers consumed alcohol in pregnancy. Diagnosis of fetal alcohol syndrome is based on the appearance of growth deficiency, the presence of the three key features of facial dysmorphism (short palpebral fissures, thin upper lip, smooth or flattend philtrum) and/or disorders in the central nervous system (minimum 3) and prenatal exposure to alcohol (confirmed if possible). Early diagnosis of fetal alcohol syndrome - after birth or in infancy - is very often impossible or very difficult due to the incomplete manifestation of the key dysmorphic features. The latest reports offer the chance of diagnosing children in the neonatal period. The research focuses on the analysis of ethanol metabolites in the biological tissues in pregnant women or newborns. These unique ethanol metabolites include: fatty acid ethyl esters (FAEE) present in the meconium, blood, hair of the mother and the newborn, ethyl glucuronide in the placenta and meconium, urine, nails and hair, and phosphatidylethanol (PEth) found in the infant blood. The presence of fatty acid ethyl esters in the meconium could be a non-invasive and cost-effective method of early detection of disorders associated with prenatal alcohol exposure.

胎儿酒精谱系障碍(FASD)是一组可能发生在母亲在怀孕期间饮酒的儿童身上的疾病。胎儿酒精综合征的诊断是基于生长缺陷的表现、面部畸形的三个关键特征(短睑裂、薄上唇、平滑或平坦中唇)和/或中枢神经系统紊乱(至少3个)和产前酒精暴露(如果可能的话证实)。胎儿酒精综合征的早期诊断——在出生后或婴儿期——往往是不可能或非常困难的,因为关键畸形特征的不完全表现。最新的报告提供了在新生儿期诊断儿童的机会。本研究的重点是孕妇或新生儿生物组织中乙醇代谢物的分析。这些独特的乙醇代谢物包括:存在于胎便、血液、母亲和新生儿头发中的脂肪酸乙酯(FAEE),存在于胎盘和胎便、尿液、指甲和头发中的葡萄糖醛酸乙酯,以及存在于婴儿血液中的磷脂酰乙醇(PEth)。胎便中脂肪酸乙酯的存在可能是一种非侵入性和具有成本效益的方法,可用于早期检测与产前酒精暴露相关的疾病。
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引用次数: 0
Risk factors for premature aging in childhood cancer survivors. 儿童癌症幸存者过早衰老的危险因素。
Pub Date : 2019-01-01
Maryna Krawczuk-Rybak, Eryk Latoch

Over the last decades, the overall survival rate for childhood cancer has increased from 20% to 80%, which is the result of advances in treatment. Nevertheless, most data from the international registers of childhood cancer survivors (CCS) stress that this population of patients is at high risk for late sequelae and their biological aging starts earlier in life. Anticancer therapy (chemotherapy, radiotherapy, surgery, immunotherapy) affects the intracellular processes leading to the chronic deterioration of organ function and premature senescence. The present review focuses on the late effects of anticancer treatment on various human organs that may lead to premature aging.

在过去的几十年里,儿童癌症的总体存活率从20%增加到80%,这是治疗进步的结果。然而,来自国际儿童癌症幸存者登记册(CCS)的大多数数据强调,这类患者患晚期后遗症的风险很高,他们的生物衰老开始得更早。抗癌治疗(化疗、放疗、手术、免疫治疗)影响细胞内过程,导致器官功能的慢性恶化和过早衰老。本文主要综述了抗癌治疗对人体各种器官的后期影响,这些器官可能导致过早衰老。
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引用次数: 0
期刊
Developmental Period Medicine
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