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The Effect of the Yeast Probiotic Saccharomyces boulardii on Acute Diarrhea in Children 酵母益生菌布拉酵母对儿童急性腹泻的影响
Q3 Medicine Pub Date : 2021-11-13 DOI: 10.5812/compreped.117391
A. Mahyar, P. Ayazi, Haleh Pashaei, B. Arad, S. Oveisi, S. Esmaeili
Objectives: This study aimed to evaluate the effect of yeast probiotic Saccharomyces boulardii on the frequency and duration of acute diarrhea in children. Methods: Sixty children were randomized to receive yeast probiotic S. boulardii in a daily dose of 250 mg (trial group-30 patients) or placebo (control group-30 patients) for five days. The clinical and demographic characteristics of two groups were recorded before the intervention. After intervention, the two groups were compared in terms of frequency of diarrhea, duration of diarrhea, and hospital stay. Results: The median (interquartile range) of frequency of diarrhea in the trial group was significantly lower than placebo group (4 [2] vs. 5 [2.5]) (P = 0.04). Also, the median (interquartile range) of duration of diarrhea in the trial group was significantly lower than placebo group (3 [2] vs. 4 [2.5]) (P = 0.03). There was no significant difference between groups for hospital stay (P = 0.8). Conclusions: The present study reveals that the use of yeast probiotic S. boulardii can reduce the frequency and duration of acute diarrhea. Therefore, we recommended S. boulardii administration to acute diarrhea in children.
目的:本研究旨在评估酵母益生菌布拉酵母对儿童急性腹泻频率和持续时间的影响。方法:将60名儿童随机分为两组,一组接受酵母益生菌布拉氏酵母菌250mg(试验组30名患者),另一组接受安慰剂(对照组30名病人),为期5天。干预前记录两组患者的临床和人口学特征。干预后,两组在腹泻频率、腹泻持续时间和住院时间方面进行比较。结果:试验组腹泻发生率中位数(四分位间距)显著低于安慰剂组(4[2]vs.5[2.5])(P=0.04),试验组腹泻持续时间的中位数(四分位间距)显著低于安慰剂组(3[2]vs.4[2.5])(P=0.03)。两组住院时间没有显著差异(P=0.8)。结论:本研究表明,使用酵母益生菌布拉氏酵母可以减少急性腹泻的频率和持续时间。因此,我们建议对儿童急性腹泻给予布拉氏酵母菌治疗。
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引用次数: 2
Association Between Overweight and Obesity and Overactive Bladder in Children: A Cross-sectional Study 儿童超重与肥胖及膀胱过度活动的关系:一项横断面研究
Q3 Medicine Pub Date : 2021-11-13 DOI: 10.5812/compreped.111361
F. Saffari, A. Mahyar, Amirhossein Kavian, B. Arad
Background: Overactive bladder (OAB) is a common cause of voiding dysfunction in children and is classified as lower urinary tract dysfunction (LUTD). In recent studies, obesity and overweight are assumed as risk factors for voiding dysfunction and urinary incontinence in children. Objectives: This study was conducted to evaluate the correlation between overweight and obesity with OAB in children. Methods: This cross-sectional study measured BMI in 56 children aged between 3 and 16 years with OAB (case group) and 56 healthy matched children (control group). Overweight and obesity were compared between the two groups. The study also accessed lower urinary tract symptoms and their association with BMI in the OAB children. The data were analyzed using the SPSS software version 18.0 for windows (SPSS Inc., Chicago, IL). Results: The mean age of the OAB patients was 7.71 ± 2.65 years, and 38 (67.8%) of them were female. Frequency and holding maneuvers were the most prevalent complaints. A history of urinary tract infection was detected in 46 (82.1%) of the OAB patients. There were no significant differences in overweight and obesity between the two groups (P = 0.23). Conclusions: No correlation was observed between overweight and obesity with OAB. The reason may be different socioeconomic conditions or malnutrition in these children. Thus, it is recommended to perform a study with a larger sample size in our community to assess malnutrition in the general children population.
背景:膀胱过动症(OAB)是儿童排尿功能障碍的常见原因,被归类为下尿路功能障碍(LUTD)。在最近的研究中,肥胖和超重被认为是儿童排尿障碍和尿失禁的危险因素。目的:本研究旨在评估超重和肥胖与儿童OAB的相关性。方法:本横断面研究测量了56例3 - 16岁OAB儿童(病例组)和56例健康匹配儿童(对照组)的BMI。对两组的超重和肥胖进行比较。该研究还探讨了OAB儿童的下尿路症状及其与BMI的关系。使用SPSS软件18.0 for windows (SPSS Inc., Chicago, IL)分析数据。结果:OAB患者平均年龄为7.71±2.65岁,女性38例(67.8%)。最普遍的抱怨是频繁和保持机动。OAB患者有尿路感染史46例(82.1%)。两组在超重和肥胖方面差异无统计学意义(P = 0.23)。结论:超重、肥胖与OAB无相关性。原因可能是不同的社会经济条件或这些儿童的营养不良。因此,建议在我们的社区进行一项更大样本量的研究,以评估一般儿童人群的营养不良情况。
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引用次数: 0
A Child with Multiple Inflammatory Syndrome in Children, Stroke and Cardiac Insufficiency 儿童多发性炎症综合征、中风和心功能不全
Q3 Medicine Pub Date : 2021-11-12 DOI: 10.5812/compreped.115888
Seyedeh Narjes Ahmadizadeh, Fariba Shirvani, Seyedeh Masumeh Hashemi, Azita Behzad, Zahra Pournasiri, M. Alemzadeh, M. Mohkam
: Multiple inflammatory syndrome in children (MIS-C) is a multisystem inflammatory disease following COVID-19 in children. This disease occurs a few weeks after COVID-19. A child with this condition develops a cytokine release cascade that results in organ damage. The involved organs include the heart, lungs, brain, gastrointestinal tract, and central nervous system. Fever is present in all patients and Kawasaki-like symptoms are one of the common features in these children. In this article, we introduce a child with MIS-C who has skin, gastrointestinal, neurological, and renal symptoms and has been hospitalized in the PICU.
:儿童多发性炎症综合征(MIS-C)是新冠肺炎后儿童的一种多系统炎症性疾病。这种疾病发生在新冠肺炎几周后。患有这种疾病的儿童会产生细胞因子释放级联反应,导致器官损伤。涉及的器官包括心脏、肺、大脑、胃肠道和中枢神经系统。所有患者都有发烧,川崎病样症状是这些儿童的常见症状之一。在这篇文章中,我们介绍了一名患有MIS-C的儿童,他有皮肤、胃肠道、神经和肾脏症状,并在PICU住院。
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引用次数: 1
Effectiveness of Different Educational Methods on Oral Health in 7-13-year-old Visually Impaired Children in Tehran: A Randomized Trial 德黑兰7-13岁视障儿童不同教育方法对口腔健康的影响:一项随机试验
Q3 Medicine Pub Date : 2021-11-02 DOI: 10.5812/compreped.112406
Sheida Masoumi, N. Askarizadeh, M. Ghasemi
Background: Conventional oral health education is not suitable for visually impaired children. Objectives: Considering the importance of oral health, this study aimed to investigate the effectiveness of different educational methods on oral hygiene status. Methods: Following a clinical trial design, 88 visually impaired children, aged 7 to 13 years, living in Tehran were recruited and randomly allocated to four groups of verbal-tactile, verbal-braille, multisensory, and control. Initially, all children were well informed about the importance of oral hygiene; then, the baseline levels of plaque score and gingivitis were recorded by Silness & Loe plaque index and Loe & Silness gingival index, respectively. Experimental groups received oral health education through different methods. The instructions were repeated after one month, and plaque and gingival indices were reevaluated after two months. Data analysis was administered by analysis of variance (ANOVA) and posthoc tests using SPSS 20.0. Results: After receiving the intervention, all groups showed a decrease in plaque and gingival indices, with the most reduction in the multisensory group (with a statistically significant difference (P = 0.0001) between multisensory & control for both plaque & gingival indices). The least change was observed in the verbal-braille group compared to the control (for plaque index and gingival index after two months (P = 0.04) and (P = 0.17), respectively). Conclusions: This study demonstrated that the multisensory method (verbal-tactile-braille) is the best option to educate visually impaired children, with significantly more acceptable results.
背景:传统的口腔健康教育不适合视障儿童。目的:考虑到口腔卫生的重要性,本研究旨在调查不同教育方法对口腔卫生状况的有效性。方法:根据临床试验设计,88名居住在德黑兰的7至13岁视障儿童被招募,并随机分为四组,即语言触觉组、语言盲文组、多感官组和对照组。起初,所有儿童都充分了解口腔卫生的重要性;然后,分别用Silness&Loe牙菌斑指数和Loe&Silness牙龈指数记录牙菌斑评分和牙龈炎的基线水平。实验组采用不同的方法进行口腔健康教育。一个月后重复使用说明书,两个月后重新评估牙菌斑和牙龈指数。数据分析通过方差分析(ANOVA)和使用SPSS 20.0的事后检验进行。结果:在接受干预后,所有组的牙菌斑和牙龈指数都有所下降,其中多感觉组的降幅最大(在牙菌斑和牙龈指标方面,多感觉组与对照组之间存在统计学显著差异(P=0.0001))。与对照组相比,盲文组的变化最小(两个月后的牙菌斑指数和牙龈指数分别为0.04和0.17)。结论:本研究表明,多感官方法(语言触觉盲文)是教育视障儿童的最佳选择,其结果明显更容易被接受。
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引用次数: 2
Causes of Neonatal Jaundice Requiring Exchange Transfusion 新生儿黄疸需要换血的原因
Q3 Medicine Pub Date : 2021-10-19 DOI: 10.5812/compreped.109539
H. Boskabadi, G. Maamouri, M. Abbasi, E. Heidari
Background: Neonatal jaundice is highly prevalent in Asia and has serious complications, such as kernicterus. Therefore, it is very important to identify the risk factors of jaundice requiring exchange transfusion since it can be helpful in the prevention of the disease and early diagnosis of its complications. Objectives: The present study aimed to identify the causes of neonatal jaundice requiring blood exchange. Methods: The present cross-sectional study was performed on 251 term and preterm neonates. The studied newborns were 2-14 days old (born at ≥ 35 weeks of gestation) with jaundice and bilirubin of more than 17 mg/dL and received exchange transfusion during 2011 - 2020 in Ghaem teaching hospital, Mashhad, Iran. The required data of the study variables, such as hyperbilirubinemia risk factors, laboratory tests, the documented history of the mothers and neonates, and physical examination results, were collected through a questionnaire and the medical records of the patients. Finally, the collected data were analyzed in SPSS software (version 20). Results: Based on the results, the mean value of the total serum bilirubin level in neonates who received exchange transfusion was 27.53 ± 10.05 mg/dL. The blood types of about 40% of mothers and their neonates were O and A/B, respectively. Moreover, 11.4% of mothers were Rh-negative; however, their neonates were Rh-positive. The results also revealed that the causes of exchange transfusion were unknown, ABO incompatibility, Rh incompatibility, glucose-6-phosphate dehydrogenase deficiency (G6PDD), and sepsis in 52.7 %, 24%, 7.1%, 5.3%, and 5.3% of the neonates, respectively. Conclusions: The findings of this study suggest that after unknown causes, the most common causes of exchange transfusion were ABO incompatibility, Rh incompatibility, G6PDD, and sepsis. Therefore, since most of these causes can be recognized, it is recommended to perform related tests and take related measures in the Midwifery Department of the hospital to prevent the occurrence and exacerbation of jaundice. Moreover, it is recommended to perform an early follow-up after the discharge.
背景:新生儿黄疸在亚洲非常普遍,并有严重的并发症,如核黄疸。因此,确定需要换血的黄疸的危险因素是非常重要的,因为这有助于疾病的预防和并发症的早期诊断。目的:本研究旨在确定新生儿黄疸需要血液交换的原因。方法:对251例足月和早产新生儿进行横断面研究。研究的新生儿出生2-14天(妊娠≥35周时出生),黄疸和胆红素超过17 mg/dL,2011-2020年在伊朗马什哈德的盖姆教学医院接受了换血。研究变量所需的数据,如高胆红素血症危险因素、实验室检查、母亲和新生儿的记录病史以及体检结果,通过问卷和患者的医疗记录收集。最后,将收集到的数据用SPSS软件(20版)进行分析。结果:换血新生儿血清总胆红素平均值为27.53±10.05mg/dL。约40%的母亲和新生儿的血型分别为O型和A/B型。此外,11.4%的母亲Rh阴性;但新生儿Rh阳性。结果还显示,换血原因不明的新生儿分别为52.7%、24%、7.1%、5.3%和5.3%。结论:本研究结果表明,在不明原因后,最常见的换血原因是ABO血型不合、Rh血型不合,G6PDD和败血症。因此,由于这些原因大多可以识别,建议在医院助产科进行相关检查并采取相关措施,以防止黄疸的发生和恶化。此外,建议在出院后尽早进行随访。
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引用次数: 1
Reasons for Requesting a CT Scan and Amount of Radiation Exposure in Hospitalized Children, the Issue Needs Attention 住院儿童要求CT扫描的原因和辐射暴露量,需要注意的问题
Q3 Medicine Pub Date : 2021-10-14 DOI: 10.5812/compreped.114476
Alireza Kiani, L. Barati, M. Gharib, M. Vakili, Farshid Kompani, Azaleh Khajavi
Background: Computerized Tomographic (CT) scan is a rapid, non-invasive, and common diagnostic modality in radiology. More and faster growth of cells, as well as longer lifespan of a child, may lead to a cumulative effect of radiation and a greater chance of mutation, especially in children who are more vulnerable. Objectives: This study was designed to evaluate the current trend in the use of this modality. Methods: In this descriptive study, all cases of children admitted to Taleghani Hospital who were studied by CT scan during the years 2018 - 2019, entered in survey. Demographic information, anatomical location of the scan, findings from the CT scan report, initial and final diagnosis, number of scans, patient’s complaint that led to his hospitalization and total amount of radiation received by the patient were analyzed. The data were analyzed by SPSS software version 23 with descriptive statistics (frequency, frequency percentage, and mean and standard deviation). Results: In this study, 344 scans of 280 patients were reviewed. Out of 280 patients, 222 patients underwent scan from one, 55 patients from two and four patients from three different anatomical locations. There were 146 male patients (52.1%) with a mean age of 57.7 months and 134 female patients (47.9%) with a mean age of 54.7 months. Out of all scans, the brain was reported with 45%, chest 30%, and other areas 25%. The CT scan was performed at the request of the doctor in charge. Pneumonia (19%) followed by convulsion (17%) and febrile seizures (12%) were the most common complaints. The number of completely normal CT was 151 scans (44.02%), with brain scans having the highest rate of normal scans with 74.19%. Brain scans with an average of 358.66 milliGray.centimeter (mGy.cm) and a maximum of 995.30 mG/cm had the highest average absorbed dose. Conclusions: In this study, the rate of normal CT scans was relatively high and the range of rays available for each modality was significantly wide. Effective interventions must be made in this regard.
背景:计算机断层扫描(CT)是放射学中一种快速、无创和常见的诊断方式。更多更快的细胞生长,以及更长的儿童寿命,可能会导致辐射的累积效应和更大的突变机会,尤其是在更脆弱的儿童中。目的:本研究旨在评估目前使用这种模式的趋势。方法:在这项描述性研究中,将2018年至2019年期间入住Taleghani医院接受CT扫描研究的所有儿童病例纳入调查。分析了人口统计学信息、扫描的解剖位置、CT扫描报告的结果、初步和最终诊断、扫描次数、导致住院的患者投诉以及患者接受的辐射总量。数据采用SPSS软件23版进行分析,并进行描述性统计(频率、频率百分比、平均值和标准差)。结果:在本研究中,对280名患者的344次扫描进行了回顾性分析。在280名患者中,222名患者接受了一名患者的扫描,55名患者接受两名患者的检查,4名患者接受三个不同解剖位置的扫描。有146名男性患者(52.1%)平均年龄为57.7个月,134名女性患者(47.9%)平均年龄54.7个月。在所有扫描中,大脑占45%,胸部占30%,其他区域占25%。CT扫描是应主治医生的要求进行的。肺炎(19%)、惊厥(17%)和高热惊厥(12%)是最常见的主诉。完全正常的CT扫描次数为151次(44.02%),其中脑部扫描的正常扫描率最高,为74.19%。平均358.66毫格雷厘米(mGy.cm)和最大995.30 mG/cm的脑部扫描的平均吸收剂量最高。结论:在本研究中,正常CT扫描的比率相对较高,并且每种模式的可用射线范围都明显较宽。必须在这方面采取有效干预措施。
{"title":"Reasons for Requesting a CT Scan and Amount of Radiation Exposure in Hospitalized Children, the Issue Needs Attention","authors":"Alireza Kiani, L. Barati, M. Gharib, M. Vakili, Farshid Kompani, Azaleh Khajavi","doi":"10.5812/compreped.114476","DOIUrl":"https://doi.org/10.5812/compreped.114476","url":null,"abstract":"Background: Computerized Tomographic (CT) scan is a rapid, non-invasive, and common diagnostic modality in radiology. More and faster growth of cells, as well as longer lifespan of a child, may lead to a cumulative effect of radiation and a greater chance of mutation, especially in children who are more vulnerable. Objectives: This study was designed to evaluate the current trend in the use of this modality. Methods: In this descriptive study, all cases of children admitted to Taleghani Hospital who were studied by CT scan during the years 2018 - 2019, entered in survey. Demographic information, anatomical location of the scan, findings from the CT scan report, initial and final diagnosis, number of scans, patient’s complaint that led to his hospitalization and total amount of radiation received by the patient were analyzed. The data were analyzed by SPSS software version 23 with descriptive statistics (frequency, frequency percentage, and mean and standard deviation). Results: In this study, 344 scans of 280 patients were reviewed. Out of 280 patients, 222 patients underwent scan from one, 55 patients from two and four patients from three different anatomical locations. There were 146 male patients (52.1%) with a mean age of 57.7 months and 134 female patients (47.9%) with a mean age of 54.7 months. Out of all scans, the brain was reported with 45%, chest 30%, and other areas 25%. The CT scan was performed at the request of the doctor in charge. Pneumonia (19%) followed by convulsion (17%) and febrile seizures (12%) were the most common complaints. The number of completely normal CT was 151 scans (44.02%), with brain scans having the highest rate of normal scans with 74.19%. Brain scans with an average of 358.66 milliGray.centimeter (mGy.cm) and a maximum of 995.30 mG/cm had the highest average absorbed dose. Conclusions: In this study, the rate of normal CT scans was relatively high and the range of rays available for each modality was significantly wide. Effective interventions must be made in this regard.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46035815","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}
引用次数: 0
Maternal Attitude Towards Cell Phone Use During Pregnancy; A Potential Harm to the Fetus 母亲对怀孕期间使用手机的态度;胎儿的潜在危害
Q3 Medicine Pub Date : 2021-09-18 DOI: 10.5812/compreped.118566
Gelareh Biazar, Ali Mohammadzadeh Jouryabi, V. Imantalab, Zahra Atrkarroushan, Yasmin Chaibakhsh, Zahra Mirmoazen, H. S. Fayazi, Fazilat Nojumi
Background: Despite the lack of conclusive and proven supporting epidemiologic data about the association between cell phone radiofrequency electromagnetic fields (RF-EMF) and the developing fetus complications, there are frequent discussions about this matter. Methods: A medical student interviewed eligible pregnant women admitted to Al Zahra Hospital, an academic referral hospital in the North of Iran, to fill questionnaires intended to assess maternal demographic data and their attitude towards cell phone use during pregnancy in 2020. Results: A total of 322 pregnant women with the mean age of 30.12 ± 6.81 years enrolled in the survey, in which 3.1% of them were non-cell phone users, and 6.052% of all did not use a cell phone during the first trimester. Also, 38.81% of them mentioned healthcare providers as the main source of obtaining information, while 40.6% did receive any information. The mean years of cell phone use and the daily hours were 8.26 ± 4.1 and 2.66 ± 2.02, respectively. Also, 64.3% believed that cell phone use poses risks to the fetus, while 26.7% had no idea. A positive association was also found concerning maternal awareness from cell phones harmfulness to the fetus and maternal education, residency, and employment (P < 0.0001). Conclusions: In this study, the majority of pregnant women believed that cell phone use during pregnancy could be harmful to the fetus; however, most of them were cell phone users with no special consideration even during the first trimester. It seems that the importance of the issue must be revealed to them by more healthcare providers’ interventions.
背景:尽管缺乏关于手机射频电磁场(RF-EMF)与胎儿并发症之间关系的结论性和经证实的支持性流行病学数据,但关于这一问题的讨论却很频繁。方法:一名医学生采访了伊朗北部学术转诊医院Al-Zahra医院的合格孕妇,填写问卷,以评估2020年孕妇的人口统计数据及其对怀孕期间使用手机的态度。结果:共有322名孕妇参加了调查,平均年龄为30.12±6.81岁,其中3.1%的孕妇是非手机用户,6.052%的孕妇在怀孕前三个月没有使用手机。此外,38.81%的人提到医疗保健提供者是获得信息的主要来源,而40.6%的人确实收到了任何信息。平均手机使用年限和日工作时间分别为8.26±4.1和2.66±2.02。此外,64.3%的人认为使用手机会对胎儿造成风险,26.7%的人对此一无所知。母亲对手机对胎儿的危害意识与母亲的教育、居住和就业呈正相关(P<0.0001)。结论:在本研究中,大多数孕妇认为怀孕期间使用手机可能对胎儿有害;然而,他们中的大多数人都是手机用户,即使在怀孕前三个月也没有特别考虑。似乎必须通过更多的医疗保健提供者的干预来向他们揭示这个问题的重要性。
{"title":"Maternal Attitude Towards Cell Phone Use During Pregnancy; A Potential Harm to the Fetus","authors":"Gelareh Biazar, Ali Mohammadzadeh Jouryabi, V. Imantalab, Zahra Atrkarroushan, Yasmin Chaibakhsh, Zahra Mirmoazen, H. S. Fayazi, Fazilat Nojumi","doi":"10.5812/compreped.118566","DOIUrl":"https://doi.org/10.5812/compreped.118566","url":null,"abstract":"Background: Despite the lack of conclusive and proven supporting epidemiologic data about the association between cell phone radiofrequency electromagnetic fields (RF-EMF) and the developing fetus complications, there are frequent discussions about this matter. Methods: A medical student interviewed eligible pregnant women admitted to Al Zahra Hospital, an academic referral hospital in the North of Iran, to fill questionnaires intended to assess maternal demographic data and their attitude towards cell phone use during pregnancy in 2020. Results: A total of 322 pregnant women with the mean age of 30.12 ± 6.81 years enrolled in the survey, in which 3.1% of them were non-cell phone users, and 6.052% of all did not use a cell phone during the first trimester. Also, 38.81% of them mentioned healthcare providers as the main source of obtaining information, while 40.6% did receive any information. The mean years of cell phone use and the daily hours were 8.26 ± 4.1 and 2.66 ± 2.02, respectively. Also, 64.3% believed that cell phone use poses risks to the fetus, while 26.7% had no idea. A positive association was also found concerning maternal awareness from cell phones harmfulness to the fetus and maternal education, residency, and employment (P < 0.0001). Conclusions: In this study, the majority of pregnant women believed that cell phone use during pregnancy could be harmful to the fetus; however, most of them were cell phone users with no special consideration even during the first trimester. It seems that the importance of the issue must be revealed to them by more healthcare providers’ interventions.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49280450","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}
引用次数: 0
Effect of High-Flow Nasal Oxygen on Respiratory Parameters and Pulmonary Complications After Early Extubation Following Pediatric Heart Surgery 高流量鼻吸氧对小儿心脏手术后早期拔管后呼吸参数及肺部并发症的影响
Q3 Medicine Pub Date : 2021-08-31 DOI: 10.5812/compreped.116104
Farzaneh Enayati, S. Amini, Mohammad Gholizadeh Gerdrodbari, L. Jarahi, M. Ansari
Objectives: The aim of this study was to evaluate the effect of high-flow nasal cannula (HFNC) after early extubation on children undergoing cardiac surgery. Methods: This randomized controlled clinical trial was performed among 92 children aged 1 to 24 months undergoing cardiac surgery from March 5 to August 30, 2020, in a pediatric post-cardiac surgery intensive care unit (ICU). The patients were randomized to receive either HFNC or conventional oxygen therapy after extubation. Arterial blood samples were collected after anesthesia induction, after the end of the surgery, at the time of entering the ICU while they were intubated, 6 hours after entering the ICU, before removing the endotracheal tube, immediately after extubation, as well as 1, 6, 12, 24, and 36 hours after extubation. The patients were compared regarding PaCO2, PaO2/FiO2 ratios, respiratory failure, need for reintubation, development of atelectasis, pneumothorax, pleural effusion, and length of ICU stay. Results: The patients were similar regarding demographic characteristics, the duration of surgery, and mechanical ventilation (P > 0.05). On the first and second days after the surgery, the mean modified radiologic atelectasis score (m-RAS) was lower in the HFNC group compared to the conventional oxygen therapy group (P < 0.05). The frequency of respiratory failure did not differ in the groups before and after the surgery (P > 0.05). PaCO2 was lower in the HFNC group than in the control group after extubation (P < 0.001). PaO2/FIO2 ratio was significantly higher in the HFNC group one hour after extubation and afterward in comparison to the control group (P < 0.001). The need for re-intubation (P < 0.013) and the length of ICU stay (P < 0.001) were significantly lower in the HFNC group compared to the control group. Conclusions: It was found that HFNC could improve the respiratory parameters and reduce postoperative pulmonary complications in infants following a congenital heart surgery.
目的:本研究旨在评估早期拔管后使用高流量鼻插管(HFNC)对接受心脏手术的儿童的影响。方法:这项随机对照临床试验于2020年3月5日至8月30日在儿科心脏手术后重症监护室(ICU)对92名1至24个月的儿童进行心脏手术。患者在拔管后随机接受HFNC或常规氧气治疗。在麻醉诱导后、手术结束后、插管时进入ICU时、进入ICU后6小时、拔出气管导管前、拔管后立即以及拔管后1、6、12、24和36小时采集动脉血样。比较了患者的PaCO2、PaO2/FiO2比率、呼吸衰竭、需要再次插管、肺不张的发展、肺气肿、胸腔积液和ICU住院时间。结果:两组患者在人口学特征、手术时间和机械通气方面相似(P>0.05),HFNC组的平均改良放射学肺不张评分(m-RAS)低于常规氧疗组(P<0.05)。术前和术后呼吸衰竭的发生率没有差异(P>0.05)。拔管后HFNC组PaCO2低于对照组(P<0.001)HFNC组拔管后1小时和拔管后的ICU住院时间(P<0.001)明显低于对照组(P<0.01)。结论:HFNC可以改善先天性心脏手术后婴儿的呼吸参数,减少术后肺部并发症。
{"title":"Effect of High-Flow Nasal Oxygen on Respiratory Parameters and Pulmonary Complications After Early Extubation Following Pediatric Heart Surgery","authors":"Farzaneh Enayati, S. Amini, Mohammad Gholizadeh Gerdrodbari, L. Jarahi, M. Ansari","doi":"10.5812/compreped.116104","DOIUrl":"https://doi.org/10.5812/compreped.116104","url":null,"abstract":"Objectives: The aim of this study was to evaluate the effect of high-flow nasal cannula (HFNC) after early extubation on children undergoing cardiac surgery. Methods: This randomized controlled clinical trial was performed among 92 children aged 1 to 24 months undergoing cardiac surgery from March 5 to August 30, 2020, in a pediatric post-cardiac surgery intensive care unit (ICU). The patients were randomized to receive either HFNC or conventional oxygen therapy after extubation. Arterial blood samples were collected after anesthesia induction, after the end of the surgery, at the time of entering the ICU while they were intubated, 6 hours after entering the ICU, before removing the endotracheal tube, immediately after extubation, as well as 1, 6, 12, 24, and 36 hours after extubation. The patients were compared regarding PaCO2, PaO2/FiO2 ratios, respiratory failure, need for reintubation, development of atelectasis, pneumothorax, pleural effusion, and length of ICU stay. Results: The patients were similar regarding demographic characteristics, the duration of surgery, and mechanical ventilation (P > 0.05). On the first and second days after the surgery, the mean modified radiologic atelectasis score (m-RAS) was lower in the HFNC group compared to the conventional oxygen therapy group (P < 0.05). The frequency of respiratory failure did not differ in the groups before and after the surgery (P > 0.05). PaCO2 was lower in the HFNC group than in the control group after extubation (P < 0.001). PaO2/FIO2 ratio was significantly higher in the HFNC group one hour after extubation and afterward in comparison to the control group (P < 0.001). The need for re-intubation (P < 0.013) and the length of ICU stay (P < 0.001) were significantly lower in the HFNC group compared to the control group. Conclusions: It was found that HFNC could improve the respiratory parameters and reduce postoperative pulmonary complications in infants following a congenital heart surgery.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43873172","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}
引用次数: 2
Successful Management of an Atrioventricular Nodal Re-entrant Tachycardia in a Neonate: A Case Report 一例新生儿房室结折返性心动过速的成功治疗
Q3 Medicine Pub Date : 2021-08-31 DOI: 10.5812/compreped.112484
M. Hosseini, Hamid Khederlou, Samieh Ahadi
: The most common tachyarrhythmias in fetal cases is supraventricular tachycardia (SVT); atrioventricular nodal re-entrant tachycardia (AVNRT) type. Premature delivery, neonatal complications, and mortality following fetal SVT are high, and therefore, require proper management. Hereby, we introduce an AVNRT that was diagnosed in the fetus and adenosine infusion, and propranolol tablets were initially administered, but arrhythmia was not controlled; eventually, the tachycardia was controlled with flecainide tablets. She was discharged with the prescription of propranolol and flecainide tablets. She is currently 18 months old and under follow-up.
胎儿最常见的心动过速是室上性心动过速(SVT);房室结型再入性心动过速(AVNRT)。早产、新生儿并发症和胎儿上室心动后的死亡率很高,因此需要适当的处理。在此,我们介绍一例胎儿确诊的AVNRT,并输注腺苷,初期给予心得安片,但心律失常未得到控制;最后,使用氟氯胺片控制心动过速。她开了心得安和氟氯胺片出院。她目前18个月大,正在接受随访。
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引用次数: 0
COVID-19 in Children: Do They Have a Lower Risk of Severe Infection Than Adults? 儿童新冠肺炎:他们严重感染的风险比成年人低吗?
Q3 Medicine Pub Date : 2021-08-31 DOI: 10.5812/COMPREPED.109345
M. Amiri
: The novel coronavirus disease 2019 (COVID-19), which was first identified in Wuhan, China, in late 2019, has now spread around the world. It significantly affects the lower respiratory tract, and pneumonia is always present in patients with the severe form of the disease. Many studies have shown that the severity of COVID-19 is lower in pediatric populations. It is important to determine why infants and young children are not severely affected by COVID-19. By increasing our awareness of this disease, we can prioritize our limited health resources. Several theories have been proposed to explain such significant differences between the pediatric and adult populations with COVID-19. Some of them are: (1) the role of angiotensin-converting enzyme 2 (ACE2); (2) cross-immunity with other severe acute respiratory syndrome (SARS)-like viruses; (3) obtunded systemic inflammatory response in children; (4) more efficient T cells in them; (5) interactions of SARS-Coronavirus-2 (SARS-CoV-2) with other viruses in the mucosa of the lungs and airways; and (6) a hypothesis that COVID-19 proteins onslaught the heme on the β-1 chain of hemoglobin. The important thing to keep in mind is that the asymptomatic and mildly symptomatic pediatrics are crucial in the spread of COVID-19.
:2019年新型冠状病毒疾病(新冠肺炎)于2019年末在中国武汉首次被发现,目前已在世界各地传播。它严重影响下呼吸道,肺炎总是出现在重症患者中。许多研究表明,新冠肺炎在儿科人群中的严重程度较低。重要的是要确定为什么婴儿和幼儿没有受到新冠肺炎的严重影响。通过提高我们对这种疾病的认识,我们可以优先考虑我们有限的卫生资源。有人提出了几种理论来解释新冠肺炎儿科和成年人群之间的显著差异。其中包括:(1)血管紧张素转换酶2(ACE2)的作用;(2) 与其他严重急性呼吸系统综合征(SARS)样病毒的交叉免疫;(3) 儿童闭塞性全身炎症反应;(4) 它们中更有效的T细胞;(5) 严重急性呼吸系统综合征冠状病毒2型与肺粘膜和气道中其他病毒的相互作用;以及(6)新冠肺炎蛋白攻击血红蛋白β-1链上的血红素的假说。需要记住的重要一点是,无症状和轻度症状的儿科在新冠肺炎的传播中至关重要。
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引用次数: 0
期刊
Journal of Comprehensive Pediatrics
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