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Potentials of Hyperuricemia and Insulin Levels in Predicting Hypertension in Obese Children: A Cross-Sectional Study 高尿酸血症和胰岛素水平预测肥胖儿童高血压的潜力:一项横断面研究
Q3 Medicine Pub Date : 2023-12-15 DOI: 10.5812/jcp-139577
Setila Dalili, Afagh Hassanzadeh Rad, Omid Salkhori, Shayan Dabbaghi, M. Karambin, H. Badeli, Shahin Koohmanaee
Background: Recent studies in humans show that increased uric acid predicts hyperinsulinemia and obesity. Objectives: Our study aimed to investigate whether hyperuricemia and insulin levels predict hypertension in obese children. Methods: This analytical cross-sectional study was conducted on the records of 161 obese children aged 5 to 15 years old based on the defined inclusion criteria. Children's blood pressure, height, weight, FBS (fasting blood sugar), HDL (high-density lipoprotein), LDL (low-density lipoprotein), TG (triglyceride), HbA1c (hemoglobin A1c), urine albumin, creatinine, insulin levels, and uric acid were measured. Data were analyzed by SPSS software. The significance level was considered P < 0.05. Results: According to the data obtained from this study, the mean of SBP (systolic blood pressure) and DBP (diastolic blood pressure) in obese children with hyperuricemia was higher than in obese children without hyperuricemia. The average insulin in obese children and hypertension was higher than in obese children without hypertension, especially in males and the age group of 5 - 10 years. The levels of cholesterol and LDL in hypertensive males were higher than in those with hyperuricemia. HDL was higher in children without hyperuricemia than in children with hyperuricemia. The strongest predictors of uric acid were age (P < 0.001, B = 0.183), HbA1c (P = 0.014, B = 0.255), and cholesterol (P = 0.03, B = -0.007), respectively. Conclusions: Based on this study, there is a relationship between uric acid levels and parameters such as obesity and blood pressure, and the findings showed that increased uric acid predicts hyperinsulinemia and obesity. Therefore, this study indicates that physicians and healthcare workers should consider the level and state of uric acid.
背景:最近的人体研究表明,尿酸升高可预测高胰岛素血症和肥胖症。研究目的我们的研究旨在探讨高尿酸血症和胰岛素水平是否可预测肥胖儿童的高血压。研究方法这项分析性横断面研究根据确定的纳入标准,对 161 名 5-15 岁肥胖儿童的记录进行了分析。测量了儿童的血压、身高、体重、FBS(空腹血糖)、HDL(高密度脂蛋白)、LDL(低密度脂蛋白)、TG(甘油三酯)、HbA1c(血红蛋白 A1c)、尿白蛋白、肌酐、胰岛素水平和尿酸。数据采用 SPSS 软件进行分析。显著性水平为 P <0.05。结果研究数据显示,患有高尿酸血症的肥胖儿童的 SBP(收缩压)和 DBP(舒张压)平均值高于未患有高尿酸血症的肥胖儿童。患有高尿酸血症的肥胖儿童的平均胰岛素高于未患高尿酸血症的肥胖儿童,尤其是男性和 5-10 岁年龄组的肥胖儿童。男性高血压患者的胆固醇和低密度脂蛋白水平高于高尿酸血症患者。无高尿酸血症儿童的高密度脂蛋白高于高尿酸血症儿童。尿酸的最强预测因子分别是年龄(P < 0.001,B = 0.183)、HbA1c(P = 0.014,B = 0.255)和胆固醇(P = 0.03,B = -0.007)。结论:根据这项研究,尿酸水平与肥胖和血压等参数之间存在关系,研究结果表明,尿酸增加可预测高胰岛素血症和肥胖。因此,本研究表明,医生和医护人员应考虑尿酸的水平和状态。
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引用次数: 0
The Relationship Between Perinatal and Postnatal Factors and Cognitive Development of Healthy Toddlers 围产期和产后因素与健康幼儿认知发展之间的关系
Q3 Medicine Pub Date : 2023-11-20 DOI: 10.5812/jcp-140234
R. Behmadi, A. Dehvari, N. Bakhshani, Abdolbaset Vahedi Tabas, Hirad Houjaghani
Background: Cognitive development during childhood has significant implications for an individual's cognitive functioning throughout life. Perinatal and postnatal factors may influence this function. Objectives: In this study, we aimed to investigate the relationship between perinatal and postnatal factors and cognitive development in healthy toddlers aged 18 – 22 months. Methods: In this retrospective cross-sectional study, we examined 50 toddlers born between March 2015 and March 2016 at a teaching hospital in Zahedan, Iran. This study focused on perinatal and neonatal risk factors based on the results of the Bayley-3 test. Data were analyzed using Mann–Whitney U, Kruskal–Wallis, and Pearson correlation coefficient tests. Results: Analysis revealed significant correlations between several perinatal factors and subsequent cognitive performance in toddlers. Greater maternal chronological age at the time of parturition, higher levels of mother's attained education, increased neonatal weight at delivery, augmented body weight in the toddler phase, as well as the documented occurrence of neonatal hyperbilirubinemia within the initial postpartum period, demonstrated meaningful associations with enhanced cognitive functioning as assessed during the toddler stage of development. Conclusions: Based on the results, it is advised that pregnancy commences at a maternal age that circumvents risks of very young childbearing. Offspring growth should be closely tracked, and neonatal jaundice promptly treated, as these perinatal factors impact cognitive performance. Giving priority to these factors improves a child's chances of healthy cognitive development, which is essential for success in life.
背景:童年时期的认知发展对一个人一生的认知功能有着重要影响。围产期和产后因素可能会影响这一功能。研究目的本研究旨在调查围产期和产后因素与 18-22 个月健康幼儿认知发展之间的关系。研究方法在这项回顾性横断面研究中,我们对 2015 年 3 月至 2016 年 3 月间在伊朗扎黑丹一家教学医院出生的 50 名幼儿进行了调查。本研究根据 Bayley-3 测试结果,重点关注围产期和新生儿风险因素。数据采用 Mann-Whitney U、Kruskal-Wallis 和 Pearson 相关系数检验进行分析。结果显示分析表明,几个围产期因素与幼儿随后的认知表现之间存在明显的相关性。产妇分娩时的实际年龄较大、受教育程度较高、分娩时新生儿体重增加、学步期体重增加,以及产后初期新生儿高胆红素血症的记录,都与学步期认知功能的增强有重要关联。结论根据研究结果,建议孕妇在避免早育风险的年龄开始怀孕。应密切跟踪后代的生长情况,并及时治疗新生儿黄疸,因为这些围产期因素会影响认知能力。优先考虑这些因素可提高儿童认知能力健康发展的机会,这对其一生的成功至关重要。
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引用次数: 0
Assessing the Effectiveness of the Combined Apgar Scoring System in Predicting the Short-Term Outcomes of Newborns 评估联合Apgar评分系统预测新生儿短期预后的有效性
Q3 Medicine Pub Date : 2023-11-11 DOI: 10.5812/jcp-138666
Samira Pournajaf, Zahra Akbarian, Hemmat Gholinia Ahangar, Nesae Bozorgnezhad, Mohsen Haghshenas Mojaveri
Background: Many clinicians have used the Apgar scoring system to evaluate newborn babies at the first minutes of birth. Expanded and combined Apgar have been introduced due to the interventions done for babies in the first minutes of life. This study evaluates the predicting values of combined Apgar scores in short-term neonatal outcomes. Methods: A diagnostic test was conducted on alive preterm and term babies without major anomalies between October 2021 and August 2022. Infants with congenital heart disease, congenital metabolic disorders, and those transferred to another hospital were excluded. Demographic data, feeding volume, conventional, expanded, and combined Apgar scores were assessed at 5 minutes of birth and recorded. The area under the receiver operating characteristic (ROC) curve was used to determine the sensitivity and specificity of the combined Apgar score to predict short-term outcomes (need to admission, duration of hospitalization, and oral feeding progression). Results: Of 599 babies (339 boys and 260 girls) with a mean gestational age of 35.3 ± 3.8 weeks (25 - 42 weeks), 280 (46.7%) babies were admitted. As the average Apgar score decreased, progression to full oral feeding was associated with longer delay. The area under the ROC curve for the Combined Apgar score was 80% and 55% in correlation with the need for admission and duration of hospitalization, respectively. Conclusions: This study showed that the 5th-minute combined Apgar score is a good predictor of the need for admission and oral feeding progression but does not seem suitable for predicting the duration of hospitalization.
背景:许多临床医生使用Apgar评分系统来评估新生儿出生后的第一分钟。由于对婴儿生命最初几分钟的干预,已经引入了扩展和联合阿普加。本研究评估综合Apgar评分对新生儿短期预后的预测价值。方法:对2021年10月至2022年8月期间无重大异常的活产早产儿和足月儿进行诊断试验。患有先天性心脏病、先天性代谢紊乱以及转院的婴儿被排除在外。出生5分钟时对人口统计数据、喂养量、常规、扩展和综合Apgar评分进行评估并记录。使用受试者工作特征(ROC)曲线下的面积来确定联合Apgar评分预测短期预后(入院需要、住院时间和口服喂养进展)的敏感性和特异性。结果:599例平均胎龄为35.3±3.8周(25 ~ 42周)的新生儿(男339例,女260例)中,280例(46.7%)入院。随着平均Apgar评分的降低,进展到完全口服喂养的延迟时间越长。综合Apgar评分的ROC曲线下面积与入院需要和住院时间的相关性分别为80%和55%。结论:本研究表明,第5分钟联合Apgar评分可以很好地预测入院需要和口服喂养进展,但似乎不适合预测住院时间。
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引用次数: 0
Comparing the Effectiveness of Computer-Based and Task-Oriented Cognitive Rehabilitation Programs on Epileptic Children’s Attention in Tehran 比较基于计算机和任务导向的认知康复方案对德黑兰癫痫儿童注意力的效果
Q3 Medicine Pub Date : 2023-11-11 DOI: 10.5812/jcp-137309
Asie Khaleghi, Farah Naderi, Reza Joharifard, Mohsen Javadzadeh
Background: There are important cognitive issues in patients with epilepsy, which can be referred to as impairment in executive functions such as attention. Objectives: This research aims to compare the effectiveness of computer-based cognitive rehabilitation programs and task-oriented cognitive rehabilitation programs on attention in children with epilepsy in Tehran. Methods: The present research was a semi-experimental study with a pre-test and post-test design with a control group. The statistical population of the study included all children with epilepsy who were referred to the neurology clinic of Mofid Children's Hospital in 2021. Using the purposeful sampling method, 45 eligible children were included in the study and were randomly divided into 2 experimental groups and 1 control group (15 people in each group). The Integrated Visual and Auditory Continuous Performance Test (IVA2) of Sohlberg and Mateer (2001) was used for data collection. The experimental groups underwent the intervention of the computerized cognitive rehabilitation program of the Cambridge Neuropsychological Test (1980) (12 sessions of 45 minutes) and the task-oriented cognitive rehabilitation program (12 sessions of 45 minutes). The control group did not receive any intervention. SPSS 20 software was used for data analysis. Univariate covariance analysis (ANCOVA) was performed using a significance level of 0.05. Results: The results demonstrated that both computer-based cognitive rehabilitation programs and task-based cognitive rehabilitation were effective in increasing the attention of epileptic children in Tehran (P < 0.001). There was no significant difference between the effectiveness of computer-based cognitive rehabilitation programs and task-based cognitive rehabilitation in increasing the attention of epileptic children (P = 0.67). Conclusions: It can be concluded that computer-based and task-oriented cognitive rehabilitation programs can be used to increase attention and executive functions in children with epilepsy.
背景:癫痫患者存在重要的认知问题,这可以被称为执行功能的损害,如注意力。目的:本研究旨在比较基于计算机的认知康复计划和任务导向的认知康复计划对德黑兰癫痫儿童注意力的效果。方法:本研究为半实验研究,采用前测和后测设计,并设对照组。该研究的统计人群包括2021年转介到Mofid儿童医院神经病学诊所的所有癫痫患儿。采用目的抽样方法,将45名符合条件的儿童纳入研究,随机分为2个实验组和1个对照组,每组15人。采用Sohlberg和Mateer(2001)的综合视觉和听觉连续表现测试(IVA2)进行数据收集。实验组接受剑桥神经心理测试(1980)的计算机化认知康复计划(12次45分钟)和任务导向认知康复计划(12次45分钟)的干预。对照组不接受任何干预。采用SPSS 20软件进行数据分析。采用显著性水平0.05进行单因素协方差分析(ANCOVA)。结果:结果表明,基于计算机的认知康复计划和基于任务的认知康复计划都能有效地提高德黑兰癫痫儿童的注意力(P <0.001)。基于计算机的认知康复方案与基于任务的认知康复方案在提高癫痫儿童注意力方面的效果无显著差异(P = 0.67)。结论:基于计算机和任务导向的认知康复方案可用于提高癫痫患儿的注意力和执行功能。
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引用次数: 0
Evaluating the Frequency and Cause of Persistent Symptoms in Pediatric Patients with Celiac Disease Adhering to a Long-Term Gluten-Free Diet 评估长期坚持无麸质饮食的儿科乳糜泻患者持续症状的频率和原因
Q3 Medicine Pub Date : 2023-10-31 DOI: 10.5812/jcp-138752
Manijeh khalili, Mojgan Sadeghi Zarchi, Alireza Teimouri, Alireza Ansari-Moghaddam, Raheleh Rafaiee
Background: Celiac disease (CD) treatment is based on life-long adherence to a gluten-free diet (GFD). Some patients with CD experience persistent symptoms despite adhering to a GFD. This condition is defined as a nonresponsive CD. Objectives: The present study aimed to investigate the prevalence and cause of persistent symptoms in pediatric patients with CD adhering to a GFD in Sistan and Baluchestan province, southeastern Iran. Methods: This descriptive cross-sectional study was conducted on 112 patients with CD selected from all diagnosed CD patients receiving a GFD for 6 months and newly diagnosed cases studied within one year. Gastrointestinal (GI) and extraintestinal (EI) symptoms were recorded on a questionnaire at the onset and during treatment. Data were analyzed by SPSS16 software, independent t-test, univariate t-test, and analysis of variance (ANOVA). Results: A total of 46.43% of our sample were boys, and 53.57% were girls (mean age = 82 ± 4.43 months). Abdominal pain and constipation symptoms were reported more frequently at the time of diagnosis and following one year of treatment. The most commonly observed EI symptoms at the time of diagnosis and during treatment were weight loss and growth failure, respectively. The percentage of treatment non-response in patients with a positive family history was significantly greater than in those with a negative family history. Conclusions: The results showed that GFD had a significant effect on the reduction of GI and non-GI symptoms, but the effect of this regime on insignificant symptoms, particularly at older ages, is negligible.
背景:乳糜泻(CD)的治疗是基于终身坚持无谷蛋白饮食(GFD)。一些乳糜泻患者尽管坚持GFD,但症状仍持续存在。这种情况被定义为无反应性乳糜泻。目的:本研究旨在调查伊朗东南部锡斯坦和俾路支斯坦省坚持GFD的儿科乳糜泻患者持续症状的患病率和原因。方法:对112例CD患者进行了描述性横断面研究,这些患者选自所有接受GFD治疗6个月的确诊CD患者和一年内新诊断的患者。胃肠道(GI)和肠外(EI)症状在发病和治疗期间记录在问卷上。采用SPSS16软件、独立t检验、单因素t检验和方差分析(ANOVA)对数据进行分析。结果:男孩占46.43%,女孩占53.57%,平均年龄为82±4.43个月。腹痛和便秘症状在诊断时和治疗一年后更为常见。在诊断时和治疗期间最常见的EI症状分别是体重减轻和生长衰竭。阳性家族史患者的治疗无反应率显著高于阴性家族史患者。结论:结果显示,GFD对胃肠道和非胃肠道症状的减少有显著作用,但该方案对无关紧要的症状的影响,特别是在老年人,可以忽略不计。
{"title":"Evaluating the Frequency and Cause of Persistent Symptoms in Pediatric Patients with Celiac Disease Adhering to a Long-Term Gluten-Free Diet","authors":"Manijeh khalili, Mojgan Sadeghi Zarchi, Alireza Teimouri, Alireza Ansari-Moghaddam, Raheleh Rafaiee","doi":"10.5812/jcp-138752","DOIUrl":"https://doi.org/10.5812/jcp-138752","url":null,"abstract":"Background: Celiac disease (CD) treatment is based on life-long adherence to a gluten-free diet (GFD). Some patients with CD experience persistent symptoms despite adhering to a GFD. This condition is defined as a nonresponsive CD. Objectives: The present study aimed to investigate the prevalence and cause of persistent symptoms in pediatric patients with CD adhering to a GFD in Sistan and Baluchestan province, southeastern Iran. Methods: This descriptive cross-sectional study was conducted on 112 patients with CD selected from all diagnosed CD patients receiving a GFD for 6 months and newly diagnosed cases studied within one year. Gastrointestinal (GI) and extraintestinal (EI) symptoms were recorded on a questionnaire at the onset and during treatment. Data were analyzed by SPSS16 software, independent t-test, univariate t-test, and analysis of variance (ANOVA). Results: A total of 46.43% of our sample were boys, and 53.57% were girls (mean age = 82 ± 4.43 months). Abdominal pain and constipation symptoms were reported more frequently at the time of diagnosis and following one year of treatment. The most commonly observed EI symptoms at the time of diagnosis and during treatment were weight loss and growth failure, respectively. The percentage of treatment non-response in patients with a positive family history was significantly greater than in those with a negative family history. Conclusions: The results showed that GFD had a significant effect on the reduction of GI and non-GI symptoms, but the effect of this regime on insignificant symptoms, particularly at older ages, is negligible.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135872028","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
Impacted Factors on Death in Children with COVID-19 COVID-19儿童死亡的影响因素
Q3 Medicine Pub Date : 2023-10-22 DOI: 10.5812/jcp-137674
Noor Mohammad Noori, Saeedeh Yaghoubi, Gholamreza Soleimani, Tahereh Boryri, Alireza Teimouri, Sahar Safapour Moghadam, Seyed Hosein Soleimanzadeh Mousavi
Background: The majority of children affected by coronavirus disease 2019 (COVID-19) are thought to be asymptomatic, with a lower mortality rate than adults. Objectives: The aim of this study was to evaluate risk factors associated with mortality in children with COVID-19. Methods: In this study, all patients were under 19 years of age, and their COVID-19 was confirmed by RT-PCR analysis. Primary data were related to underlying diseases, clinical and laboratory information, mortality, or safe discharge. The recorded data were analyzed using SPSS software (version 18), taking into account the significance level of < 0.05. Results: Of the 183 children enrolled in the study, the mortality rate was 13.67%. The major risk factors for death were clinical manifestations involving central nervous system (CNS) diseases (P = 0.006), platelet (PLT) count (P = 0.020), lactate dehydrogenase (LDH) (P < 0.001), alanine transaminase (ALT) (P = 0.033), erythrocyte sedimentation rate (ESR) (P < 0.001), and C-reactive protein (CRP) (P < 0.001) as laboratory measurements, and cardiovascular disease (CVD) was the underlying disease with an odds ratio of 10.94. Conclusions: The study concluded that the factors associated with death were laboratory measures, such as CRP, ESR, hemoglobin, and liver enzymes, and potential diseases, such as cardiovascular and central nervous system diseases.
背景:大多数感染2019冠状病毒病(COVID-19)的儿童被认为是无症状的,死亡率低于成人。目的:本研究的目的是评估与COVID-19儿童死亡率相关的危险因素。方法:本研究中所有患者年龄均在19岁以下,采用RT-PCR方法确诊。主要数据与基础疾病、临床和实验室信息、死亡率或安全出院有关。记录的数据采用SPSS (version 18)软件进行分析,考虑<0.05. 结果:纳入研究的183名儿童死亡率为13.67%。死亡的主要危险因素为临床表现包括中枢神经系统疾病(P = 0.006)、血小板(PLT)计数(P = 0.020)、乳酸脱氢酶(LDH) (P <0.001)、丙氨酸转氨酶(ALT) (P = 0.033)、红细胞沉降率(ESR) (P <0.001), c反应蛋白(CRP) (P <0.001)作为实验室测量,心血管疾病(CVD)是潜在疾病,优势比为10.94。结论:研究得出与死亡相关的因素是实验室测量,如CRP、ESR、血红蛋白和肝酶,以及潜在疾病,如心血管和中枢神经系统疾病。
{"title":"Impacted Factors on Death in Children with COVID-19","authors":"Noor Mohammad Noori, Saeedeh Yaghoubi, Gholamreza Soleimani, Tahereh Boryri, Alireza Teimouri, Sahar Safapour Moghadam, Seyed Hosein Soleimanzadeh Mousavi","doi":"10.5812/jcp-137674","DOIUrl":"https://doi.org/10.5812/jcp-137674","url":null,"abstract":"Background: The majority of children affected by coronavirus disease 2019 (COVID-19) are thought to be asymptomatic, with a lower mortality rate than adults. Objectives: The aim of this study was to evaluate risk factors associated with mortality in children with COVID-19. Methods: In this study, all patients were under 19 years of age, and their COVID-19 was confirmed by RT-PCR analysis. Primary data were related to underlying diseases, clinical and laboratory information, mortality, or safe discharge. The recorded data were analyzed using SPSS software (version 18), taking into account the significance level of < 0.05. Results: Of the 183 children enrolled in the study, the mortality rate was 13.67%. The major risk factors for death were clinical manifestations involving central nervous system (CNS) diseases (P = 0.006), platelet (PLT) count (P = 0.020), lactate dehydrogenase (LDH) (P < 0.001), alanine transaminase (ALT) (P = 0.033), erythrocyte sedimentation rate (ESR) (P < 0.001), and C-reactive protein (CRP) (P < 0.001) as laboratory measurements, and cardiovascular disease (CVD) was the underlying disease with an odds ratio of 10.94. Conclusions: The study concluded that the factors associated with death were laboratory measures, such as CRP, ESR, hemoglobin, and liver enzymes, and potential diseases, such as cardiovascular and central nervous system diseases.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135462926","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
Local Validation of NutricheQ, a Study in Jordan NutricheQ在约旦的本地验证研究
Q3 Medicine Pub Date : 2023-10-09 DOI: 10.5812/jcp-137522
Mofeed Abdelqader, Sameer Abdo, Maisa Jallad, Maha Muhtaseb, Shawqi Amerah, Qais Azar, Nabeel Fararjeh, Bashar Khasawneh, Furat Kreshan, Ayman Obeid, Mohammad Rawashdeh, Manar Shawbkeh, Suleimman Al-Sweedan
Background: Toddlers are consuming more energy-dense, nutrient-poor foodstuffs in discordance with international dietary guidelines. Limited data are available on the dietary habits of children in Jordan. Objectives: This study aimed primarily at assessing the local validity of the NutricheQ tool in reflecting the nutritional risk status of 12- to 36-month-old toddlers in Jordan. Methods: This national, multicentre, observational validation study analyzed the data of healthy 12- to 36-month-old toddlers who were identified and prospectively enrolled during a routine clinic visit. After providing written informed consent, the parents or legal guardians of toddlers were asked to (a) complete a food intake diary form (FIDF) over three days (two weekdays and one weekend day); and (b) to answer the NutricheQ questionnaire completed by the physician during a single outpatient visit, as part of the case report form (CRF). Results: Out of 213 Jordanian toddlers, 31 (14.6%) were at low nutritional risk; 145 (68.1%) (95% confidential interval (CI): 61.5 - 74.0) were at moderate nutritional risk, and 37 (17.4%) (95% CI: 12.8 - 23.1) were at an increased nutritional risk. The average nutritional intake of the toddlers did not meet the daily intake of the main nutrients recommended across all food categories, with a default daily intake of vitamin A, vitamin D, fiber, and iodine and an excess daily intake of protein and iron. NutricheQ-predicted risk categories significantly correlated with meat intake and the number of weekly servings of fruits and cooked vegetables. Conclusions: NutricheQ is a valid tool to predict nutritional risk among toddlers in Jordan.
背景:与国际膳食指南不符的是,幼儿正在消耗更多高能量、低营养的食物。关于约旦儿童饮食习惯的数据有限。目的:本研究主要旨在评估NutricheQ工具在反映约旦12至36个月幼儿营养风险状况方面的本地有效性。方法:这项全国性、多中心、观察性验证研究分析了在常规门诊就诊期间确定并前瞻性纳入的12至36个月健康幼儿的数据。在提供书面知情同意后,幼儿的父母或法定监护人被要求(a)在三天内(两个工作日和一个周末)完成一份食物摄入日记表(FIDF);(b)回答由医生在单次门诊期间完成的NutricheQ问卷,作为病例报告表(CRF)的一部分。结果:在213名约旦幼儿中,31名(14.6%)处于低营养风险;145人(68.1%)(95%可信区间(CI): 61.5 ~ 74.0)处于中等营养风险,37人(17.4%)(95% CI: 12.8 ~ 23.1)处于营养风险增加。幼儿的平均营养摄入量没有达到所有食物类别中推荐的主要营养素的每日摄入量,默认的每日摄入量是维生素a、维生素D、纤维和碘,而过量的每日摄入量是蛋白质和铁。nutricheq预测的风险类别与肉类摄入量和每周食用水果和煮熟蔬菜的数量显著相关。结论:NutricheQ是预测约旦幼儿营养风险的有效工具。
{"title":"Local Validation of NutricheQ, a Study in Jordan","authors":"Mofeed Abdelqader, Sameer Abdo, Maisa Jallad, Maha Muhtaseb, Shawqi Amerah, Qais Azar, Nabeel Fararjeh, Bashar Khasawneh, Furat Kreshan, Ayman Obeid, Mohammad Rawashdeh, Manar Shawbkeh, Suleimman Al-Sweedan","doi":"10.5812/jcp-137522","DOIUrl":"https://doi.org/10.5812/jcp-137522","url":null,"abstract":"Background: Toddlers are consuming more energy-dense, nutrient-poor foodstuffs in discordance with international dietary guidelines. Limited data are available on the dietary habits of children in Jordan. Objectives: This study aimed primarily at assessing the local validity of the NutricheQ tool in reflecting the nutritional risk status of 12- to 36-month-old toddlers in Jordan. Methods: This national, multicentre, observational validation study analyzed the data of healthy 12- to 36-month-old toddlers who were identified and prospectively enrolled during a routine clinic visit. After providing written informed consent, the parents or legal guardians of toddlers were asked to (a) complete a food intake diary form (FIDF) over three days (two weekdays and one weekend day); and (b) to answer the NutricheQ questionnaire completed by the physician during a single outpatient visit, as part of the case report form (CRF). Results: Out of 213 Jordanian toddlers, 31 (14.6%) were at low nutritional risk; 145 (68.1%) (95% confidential interval (CI): 61.5 - 74.0) were at moderate nutritional risk, and 37 (17.4%) (95% CI: 12.8 - 23.1) were at an increased nutritional risk. The average nutritional intake of the toddlers did not meet the daily intake of the main nutrients recommended across all food categories, with a default daily intake of vitamin A, vitamin D, fiber, and iodine and an excess daily intake of protein and iron. NutricheQ-predicted risk categories significantly correlated with meat intake and the number of weekly servings of fruits and cooked vegetables. Conclusions: NutricheQ is a valid tool to predict nutritional risk among toddlers in Jordan.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146463","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
Endothelial Injury in Paediatric Sepsis-associated Acute Kidney Injury 儿童败血症相关急性肾损伤的内皮损伤
Q3 Medicine Pub Date : 2023-09-07 DOI: 10.5812/jcp-137916
Dadang Hudaya Somasetia, F. Meilyana, A. Widiasta, D. Rachmadi
Background: Sepsis-associated acute kidney injury (SA-AKI) is an acute kidney injury in the presence of sepsis without other significant contributing factors explaining acute kidney injury (AKI). Circulating syndecan-1, angiopoietin-2, and urinary neutrophil gelatinase-associated lipocalin levels can potentially cause neglected AKI to become acute kidney disease (AKD) and even chronic kidney disease (CKD). Therefore, studying its levels in the early phase of AKI is important, especially in SAAKI. Objectives: This study aims to analyze the levels of syndecan-1, angiopoietin-2, and urine neutrophil gelatinase-associated lipocalin (uNGAL) as other modalities that might detect AKI earlier in children with SAAKI. Methods: This study enrolled 23 children between one month and 18 years with sepsis. Blood samples were collected from all patients at the baseline, 12, 24, and 48 hours after admission to assess serum creatinine, syndecan-1, angiopoietin-2, and a urine sample was collected to measure uNGAL levels. We used the Wilcoxon signed-rank test to compare each biomarker with the time of measurement and the Mann-Whitney test to compare the levels of biomarkers with the incidence of SA-AKI. Results: The highest median value for uNGAL was 78.30 (3.20 - 24098.40) in the 12th-hour measurement; for syndecan was 2.92 (0.06 - 83.00) in the baseline measurement, slightly decreased and continued to increase up to 48 hours, and for Ang-2 was 4159.60 (17.60 - 226428.00) in the 12th-hour measurement. The incidence of SA-AKI based on the pediatric risk-injury-failure-loss-end stage (pRIFLE) criteria were that five children (21.7%) had AKI in the risk/injury phase at baseline, 24-hour, 48-hour observations, and also six children (26.1%) at 12-hour observation. Conclusion: There was an increase in levels of syndecan-1 and ang-2 in children with severe sepsis, especially in the first 24 hours.
背景:脓毒症相关急性肾损伤(SA-AKI)是一种存在脓毒症的急性肾损伤,没有其他重要的因素可以解释急性肾损伤。循环综合征-1、血管生成素-2和尿中性粒细胞明胶酶相关的脂质运载蛋白水平可能导致被忽视的AKI成为急性肾脏疾病(AKD),甚至慢性肾脏疾病(CKD)。因此,研究其在AKI早期阶段的水平很重要,尤其是在SAAKI中。目的:本研究旨在分析syndecan-1、血管生成素-2和尿液中性粒细胞明胶酶相关脂质运载蛋白(uNGAL)的水平,作为可能早期检测SAAKI儿童AKI的其他方式。方法:本研究招募了23名1个月至18岁的败血症儿童。在基线、入院后12、24和48小时采集所有患者的血样,以评估血清肌酸酐、syndecan-1、血管生成素-2,并采集尿样以测量uNGAL水平。我们使用Wilcoxon符号秩检验将每个生物标志物与测量时间进行比较,并使用Mann-Whitney检验将生物标志物水平与SA-AKI的发生率进行比较。结果:在第12小时的测量中,uNGAL的最高中位值为78.30(3.20-24098.40);syndecan在基线测量中为2.92(0.06-83.00),略有下降并持续增加至48小时,Ang-2在第12小时测量中为4159.60(17.60-226428.00)。根据儿科风险-损伤-失败-丢失终末期(pRIFLE)标准,SA-AKI的发生率为:在基线、24小时、48小时观察时,5名儿童(21.7%)处于风险/损伤阶段,在12小时观察时有6名儿童(26.1%)患有AKI。结论:严重脓毒症患儿血清syndecan-1和ang-2水平升高,尤其是在发病前24小时。
{"title":"Endothelial Injury in Paediatric Sepsis-associated Acute Kidney Injury","authors":"Dadang Hudaya Somasetia, F. Meilyana, A. Widiasta, D. Rachmadi","doi":"10.5812/jcp-137916","DOIUrl":"https://doi.org/10.5812/jcp-137916","url":null,"abstract":"Background: Sepsis-associated acute kidney injury (SA-AKI) is an acute kidney injury in the presence of sepsis without other significant contributing factors explaining acute kidney injury (AKI). Circulating syndecan-1, angiopoietin-2, and urinary neutrophil gelatinase-associated lipocalin levels can potentially cause neglected AKI to become acute kidney disease (AKD) and even chronic kidney disease (CKD). Therefore, studying its levels in the early phase of AKI is important, especially in SAAKI. Objectives: This study aims to analyze the levels of syndecan-1, angiopoietin-2, and urine neutrophil gelatinase-associated lipocalin (uNGAL) as other modalities that might detect AKI earlier in children with SAAKI. Methods: This study enrolled 23 children between one month and 18 years with sepsis. Blood samples were collected from all patients at the baseline, 12, 24, and 48 hours after admission to assess serum creatinine, syndecan-1, angiopoietin-2, and a urine sample was collected to measure uNGAL levels. We used the Wilcoxon signed-rank test to compare each biomarker with the time of measurement and the Mann-Whitney test to compare the levels of biomarkers with the incidence of SA-AKI. Results: The highest median value for uNGAL was 78.30 (3.20 - 24098.40) in the 12th-hour measurement; for syndecan was 2.92 (0.06 - 83.00) in the baseline measurement, slightly decreased and continued to increase up to 48 hours, and for Ang-2 was 4159.60 (17.60 - 226428.00) in the 12th-hour measurement. The incidence of SA-AKI based on the pediatric risk-injury-failure-loss-end stage (pRIFLE) criteria were that five children (21.7%) had AKI in the risk/injury phase at baseline, 24-hour, 48-hour observations, and also six children (26.1%) at 12-hour observation. Conclusion: There was an increase in levels of syndecan-1 and ang-2 in children with severe sepsis, especially in the first 24 hours.","PeriodicalId":37929,"journal":{"name":"Journal of Comprehensive Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44192750","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
Diagnosis and Management of Congenital Hypothyroidism: An Updated Overview 先天性甲状腺功能减退症的诊断和治疗:最新综述
Q3 Medicine Pub Date : 2023-09-01 DOI: 10.5812/jcp-138532
Shahin Koohmanaee, Arash Bakhshi, Shayan Pourkazem, B. Motamed
Context: Hypothyroidism describes an endocrine disorder that occurs when the thyroid gland cannot secrete adequate thyroid hormones. Congenital hypothyroidism refers to a lack of thyroid hormone among newborns. Evidence Acquisition: The ISI Web of Sciences, Scopus, PubMed, and Google Scholar databases were reviewed for relevant articles published from 2000 to 2022. Results: Congenital hypothyroidism, occurring in approximately one in 2,000 to one in 4,000 newborns, ranks among the most frequent causes of intellectual disability that can be prevented. The screening of newborns, confirmation assessments, interpretation of thyroid function tests accurately, prompt and therapeutic treatment, and regular follow-up contribute to a very good neurocognitive outcome later in life. Since the timely diagnosis of congenital hypothyroidism is critical in preventing mental retardation, clinicians must be kept abreast of this disorder and educate nursing and medical students regarding accurate interpretations of diagnostic testing and the recognition of associated symptoms. Most newborns with congenital hypothyroidism present no symptoms, even though their TSH or T4 levels are likely to have fluctuated significantly. As a result, congenital hypothyroidism was rarely detected in newborns before the introduction of neonatal screenings. Conclusions: We provide an overview of the etiology, epidemiology, manifestation, diagnosis, and treatment of congenital hypothyroidism based on the latest studies.
背景:甲状腺功能减退症是指当甲状腺不能分泌足够的甲状腺激素时发生的内分泌紊乱。先天性甲状腺功能减退是指新生儿甲状腺激素缺乏。证据获取:审查了ISI科学网、Scopus、PubMed和谷歌学者数据库中2000年至2022年发表的相关文章。结果:先天性甲状腺功能减退症约发生在2000至4000名新生儿中的一人,是可预防的智力残疾最常见的原因之一。新生儿筛查、确认评估、准确解释甲状腺功能测试、及时治疗和定期随访有助于在以后的生活中获得非常好的神经认知结果。由于及时诊断先天性甲状腺功能减退症对预防智力迟钝至关重要,临床医生必须及时了解这种疾病,并教育护理和医学生正确解读诊断测试和识别相关症状。大多数患有先天性甲状腺功能减退症的新生儿没有任何症状,尽管他们的TSH或T4水平可能有显著波动。因此,在新生儿筛查之前,新生儿很少发现先天性甲状腺功能减退症。结论:根据最新研究,我们对先天性甲状腺功能减退症的病因、流行病学、表现、诊断和治疗进行了综述。
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引用次数: 0
Efficacy of Vitamin D as Adjuvant Therapy for Treatment of Hospitalized Children with COVID-19: A Randomized Clinical Trial 维生素D辅助治疗住院儿童COVID-19的疗效:一项随机临床试验
Q3 Medicine Pub Date : 2023-08-23 DOI: 10.5812/jcp-138083
H. Hashemian, Rasool Poorjamal, M. Asgharzadeh, Saeid Sadatmansouri, M. Shahrokhi
Background: Vitamin D is a multifunctional hormone essential in the immune system. Vitamin D deficiency may increase the disease burden in patients with COVID-19. Objectives: We investigated the effect of vitamin D administration as an adjunctive therapy on treating children with COVID-19. Methods: Children with confirmed or probable COVID-19 who were admitted to 17th Shahrivar Hospital in Rasht from October 2022 to April 2023 were selected by random sampling method. They were divided into two groups by random blocks: the intervention group with vitamin D administration and the placebo-controlled group. The patient data were recorded and analyzed, including age, sex, and the required clinical and laboratory information, including the time required to recover from fever and respiratory distress and the length of hospitalization. Results: In this study, 60 patients (30 in each group) were evaluated. At the beginning of hospitalization, fever was significantly more observed in the intervention group (90% vs. 53.3%, P = 0.002). The average time required to recover from fever and respiratory distress was less in the intervention group, although this difference was not significant between the two groups (P = 0.591 and P = 0.192, respectively). The hospitalization duration was also similar in both groups, and no complications or death were observed in the two groups. Conclusions: Administering vitamin D at a dose of 1000 IU daily showed no significant efficacy for recovering children with COVID-19. Further studies are suggested to investigate the high dose of vitamin D supplementation in treating children with COVID-19.
背景:维生素D是免疫系统中必需的一种多功能激素。维生素D缺乏可能会增加新冠肺炎患者的疾病负担。目的:研究维生素D辅助治疗新冠肺炎患儿的疗效。方法:采用随机抽样方法选择2022年10月至2023年4月入住拉什特第17沙赫里瓦尔医院的确诊或疑似新冠肺炎儿童。他们被随机分为两组:维生素D干预组和安慰剂对照组。记录和分析患者数据,包括年龄、性别、所需的临床和实验室信息,包括从发烧和呼吸窘迫中恢复所需的时间以及住院时间。结果:在本研究中,对60名患者(每组30名)进行了评估。在住院初期,干预组的发烧症状明显增多(90%对53.3%,P=0.002)。干预组从发烧和呼吸窘迫中恢复所需的平均时间较少,尽管两组之间的差异并不显著(分别为P=0.591和P=0.192)。两组的住院时间也相似,两组均未观察到并发症或死亡。结论:每天1000国际单位剂量的维生素D对新冠肺炎患儿的康复没有显著疗效。建议进一步研究高剂量补充维生素D治疗新冠肺炎儿童的情况。
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引用次数: 0
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Journal of Comprehensive Pediatrics
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