Pub Date : 2024-07-17DOI: 10.15406/jpnc.2024.14.00557
Nilton Carlos Machado, Thabata Koester Weber, Juliana Tedesco Dias, Gabriela Nascimento Hercos, Carine Dias Ferreira de Jesus, Mary de Assis Carvalho
Background: Celiac disease (CD) is chronic small bowel inflammation with villous atrophy, consequently, an immune-mediated disorder triggered by ingesting Gluten in wheat, barley, and rye in genetically susceptible individuals. Aims: Summarize the fundamental principles for managing the diet of patients with CD. This Mini-Review using relevant articles in PubMed's online databases followed the medical keywords Celiac Disease, Gluten, gluten-free diet, nutritional approach, and diet adherence. The institution's Ethics Committee has waived the need to review the ethical aspects of this text. The cornerstone of the treatment is the lifelong adherence to a Gluten-Free Diet (GFD). This dietary regimen, which forms the basis of the patient's treatment, requires eliminating all food components containing Gluten and its derivatives from the diet. However, the treatment approach has changed from focusing on food avoidance to a wide-ranging evaluation of the various factors influencing the dietary choices in the patient's life. The Global Approach to the Follow-up of Celiac Disease is based on 1) control of symptomatology and dietary adherence; 2) improving emotional and social wellness in treating CD patients, with the active involvement of a psychologist; and 3) ensuring successful education of both the child and the family about its management. Indeed, the impact of CD extends beyond the patient and affects the well-being of caregivers and 4) evaluate socioeconomic burden, considering that Gluten-free food products remain significantly more expensive than gluten-containing equivalents with variable availability. So, the GFD is the primary treatment for CD, and difficulties in managing the Disease can lead to impaired Quality of Life. In conclusion, strict adherence to the GFD is imperative, requiring a multidisciplinary team involving physicians, dietitians, and psychologists on a regular visit schedule to assess dietary adherence and avoid long-term complications.
背景：乳糜泻（Celiac disease，CD）是一种慢性小肠炎，伴有绒毛萎缩，因此是一种免疫介导的疾病，由遗传易感人群摄入小麦、大麦和黑麦中的麸质引发。目的：总结 CD 患者饮食管理的基本原则。本微型综述使用 PubMed 在线数据库中的相关文章，以 "乳糜泻"、"麸质"、"无麸质饮食"、"营养方法 "和 "饮食依从性 "为医学关键词。该机构的伦理委员会已免除了对本文伦理方面的审查。治疗的基石是终身坚持无麸质饮食（GFD）。这种饮食疗法是患者治疗的基础，要求从饮食中剔除所有含有麸质及其衍生物的食物成分。然而，治疗方法已从重点避免食物转变为对影响患者生活中饮食选择的各种因素进行广泛评估。乳糜泻全球随访方法的基础是：1）控制症状和坚持饮食；2）在心理学家的积极参与下，改善 CD 患者的情绪和社交健康；3）确保对儿童和家庭进行成功的管理教育。事实上，CD 的影响超出了患者的范围，影响到护理人员的福祉；4）评估社会经济负担，考虑到无麸质食品仍然比含麸质的同类产品昂贵得多，而且供应不稳定。因此，无麸质食品是 CD 的主要治疗方法，而疾病管理方面的困难会导致生活质量下降。总之，严格遵守 GFD 至关重要，需要一个由医生、营养师和心理学家组成的多学科团队定期访问，以评估饮食依从性，避免长期并发症。
{"title":"The primary nutritional approach in pediatric celiac disease: a mini-review","authors":"Nilton Carlos Machado, Thabata Koester Weber, Juliana Tedesco Dias, Gabriela Nascimento Hercos, Carine Dias Ferreira de Jesus, Mary de Assis Carvalho","doi":"10.15406/jpnc.2024.14.00557","DOIUrl":"https://doi.org/10.15406/jpnc.2024.14.00557","url":null,"abstract":"Background: Celiac disease (CD) is chronic small bowel inflammation with villous atrophy, consequently, an immune-mediated disorder triggered by ingesting Gluten in wheat, barley, and rye in genetically susceptible individuals. Aims: Summarize the fundamental principles for managing the diet of patients with CD. This Mini-Review using relevant articles in PubMed's online databases followed the medical keywords Celiac Disease, Gluten, gluten-free diet, nutritional approach, and diet adherence. The institution's Ethics Committee has waived the need to review the ethical aspects of this text. The cornerstone of the treatment is the lifelong adherence to a Gluten-Free Diet (GFD). This dietary regimen, which forms the basis of the patient's treatment, requires eliminating all food components containing Gluten and its derivatives from the diet. However, the treatment approach has changed from focusing on food avoidance to a wide-ranging evaluation of the various factors influencing the dietary choices in the patient's life. The Global Approach to the Follow-up of Celiac Disease is based on 1) control of symptomatology and dietary adherence; 2) improving emotional and social wellness in treating CD patients, with the active involvement of a psychologist; and 3) ensuring successful education of both the child and the family about its management. Indeed, the impact of CD extends beyond the patient and affects the well-being of caregivers and 4) evaluate socioeconomic burden, considering that Gluten-free food products remain significantly more expensive than gluten-containing equivalents with variable availability. So, the GFD is the primary treatment for CD, and difficulties in managing the Disease can lead to impaired Quality of Life. In conclusion, strict adherence to the GFD is imperative, requiring a multidisciplinary team involving physicians, dietitians, and psychologists on a regular visit schedule to assess dietary adherence and avoid long-term complications.","PeriodicalId":388959,"journal":{"name":"Journal of Pediatrics & Neonatal Care","volume":" 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141828088","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 : 2024-04-17DOI: 10.15406/jpnc.2024.14.00547
Melese Tadesse Aredo, A. Habtamu, Mosisa Bekele, Habtamu Legese, Hana Yihdego, Helina Hailu, Hailesilassie Alemnew, Galata Marara
Background: The neonatal period, encompassing the first 28 days of life, is a critical phase for newborn survival. Neonatal mortality refers to the death of newborns within the initial four weeks of life and constitutes a significant portion of child mortality under five years old, accounting for 38% of these deaths in the developing world. The causes of neonatal mortality vary across different regions. Objective: The aim of this study is to assess the prevalence, causes, and associated factors of neonatal mortality among neonates admitted to Asella Referral and Teaching Hospital in Asella, Ethiopia, in 2024. Method: A facility-based retrospective cross-sectional study was conducted among neonates admitted to Asella Referral and Teaching Hospital from July 7, 2020, to July 7, 2023. Participants were selected using a systematic random sampling method. Data collected were entered into Epi Data Version 3.1 and analyzed using SPSS Version 26. Descriptive analysis was performed for all independent variables. Variables with a p-value < 0.25 in bivariable logistic regression analysis were further analyzed using multivariable logistic regression. A significant association between independent variables and the outcome variable was considered at a p-value < 0.05 in the multivariable regression analysis. Results: This study included 194 neonates, with a neonatal mortality prevalence of 13.9%. The leading causes of neonatal mortality were birth asphyxia (22.1%), meconium aspiration syndrome (14.8%), and neonatal sepsis (11.1%). Factors such as obstructed labor [AOR=3.5: 95% CI (1.2–10.7)], instrumentally assisted vaginal delivery [AOR=3.5: 95% CI (1.03–11.9)], pregnancy-induced hypertension [AOR=2.0: 95% CI (1.2–14.5)], and lack of antenatal care follow-up [AOR=3.2: 95% CI (1.1–9.9)] were identified as predictors of neonatal mortalities (p <0.05). Conclusion: The study revealed a high prevalence of neonatal mortalities. Obstructed labor, instrumentally assisted vaginal delivery, pregnancy-induced hypertension, and inadequate antenatal care follow-up were significant predictors of neonatal mortality. Improvements in obstetric care quality, antenatal follow-up, and emergency obstetric services are crucial to reducing neonatal mortality rates in the study setting.
背景：新生儿期包括出生后的头 28 天，是新生儿存活的关键阶段。新生儿死亡是指新生儿在出生后最初四周内的死亡，占五岁以下儿童死亡的很大一部分，在发展中国家占死亡总数的 38%。不同地区的新生儿死亡原因各不相同。研究目的本研究旨在评估 2024 年埃塞俄比亚阿塞拉转诊和教学医院（Asella Referral and Teaching Hospital）收治的新生儿中新生儿死亡的发生率、原因和相关因素。研究方法在 2020 年 7 月 7 日至 2023 年 7 月 7 日期间，对阿塞拉转诊和教学医院收治的新生儿进行了一项基于设施的回顾性横断面研究。研究人员采用系统随机抽样法选出。收集的数据输入 Epi Data 3.1 版，并使用 SPSS 26 版进行分析。对所有自变量进行了描述性分析。在二变量逻辑回归分析中，P 值小于 0.25 的变量将使用多变量逻辑回归进行进一步分析。在多变量回归分析中，如果自变量与结果变量之间的 p 值小于 0.05，则认为自变量与结果变量之间存在明显关联。结果本研究共纳入 194 名新生儿，新生儿死亡率为 13.9%。新生儿死亡的主要原因是出生窒息（22.1%）、胎粪吸入综合征（14.8%）和新生儿败血症（11.1%）。难产[AOR=3.5：95% CI (1.2-10.7)]、器械辅助阴道分娩[AOR=3.5：95% CI (1.03-11.9)]、妊娠高血压[AOR=2.0：95% CI (1.2-14.5)]和缺乏产前护理随访[AOR=3.2：95% CI (1.1-9.9)]等因素被认为是新生儿死亡的预测因素（P <0.05）。结论该研究显示新生儿死亡率较高。难产、器械辅助阴道分娩、妊娠高血压和产前护理随访不足是预测新生儿死亡率的重要因素。改善产科护理质量、产前随访和产科急诊服务对降低研究环境中的新生儿死亡率至关重要。
{"title":"Prevalence and associated factor of neonatal mortality among neonates admitted to Asella referral and teaching hospital, Asella, Ethiopia, 2024","authors":"Melese Tadesse Aredo, A. Habtamu, Mosisa Bekele, Habtamu Legese, Hana Yihdego, Helina Hailu, Hailesilassie Alemnew, Galata Marara","doi":"10.15406/jpnc.2024.14.00547","DOIUrl":"https://doi.org/10.15406/jpnc.2024.14.00547","url":null,"abstract":"Background: The neonatal period, encompassing the first 28 days of life, is a critical phase for newborn survival. Neonatal mortality refers to the death of newborns within the initial four weeks of life and constitutes a significant portion of child mortality under five years old, accounting for 38% of these deaths in the developing world. The causes of neonatal mortality vary across different regions. Objective: The aim of this study is to assess the prevalence, causes, and associated factors of neonatal mortality among neonates admitted to Asella Referral and Teaching Hospital in Asella, Ethiopia, in 2024. Method: A facility-based retrospective cross-sectional study was conducted among neonates admitted to Asella Referral and Teaching Hospital from July 7, 2020, to July 7, 2023. Participants were selected using a systematic random sampling method. Data collected were entered into Epi Data Version 3.1 and analyzed using SPSS Version 26. Descriptive analysis was performed for all independent variables. Variables with a p-value < 0.25 in bivariable logistic regression analysis were further analyzed using multivariable logistic regression. A significant association between independent variables and the outcome variable was considered at a p-value < 0.05 in the multivariable regression analysis. Results: This study included 194 neonates, with a neonatal mortality prevalence of 13.9%. The leading causes of neonatal mortality were birth asphyxia (22.1%), meconium aspiration syndrome (14.8%), and neonatal sepsis (11.1%). Factors such as obstructed labor [AOR=3.5: 95% CI (1.2–10.7)], instrumentally assisted vaginal delivery [AOR=3.5: 95% CI (1.03–11.9)], pregnancy-induced hypertension [AOR=2.0: 95% CI (1.2–14.5)], and lack of antenatal care follow-up [AOR=3.2: 95% CI (1.1–9.9)] were identified as predictors of neonatal mortalities (p <0.05). Conclusion: The study revealed a high prevalence of neonatal mortalities. Obstructed labor, instrumentally assisted vaginal delivery, pregnancy-induced hypertension, and inadequate antenatal care follow-up were significant predictors of neonatal mortality. Improvements in obstetric care quality, antenatal follow-up, and emergency obstetric services are crucial to reducing neonatal mortality rates in the study setting.","PeriodicalId":388959,"journal":{"name":"Journal of Pediatrics & Neonatal Care","volume":" 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140691673","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 : 2024-04-15DOI: 10.15406/jpnc.2024.14.00546
Cynthia Crespo, Amparo Fernández, Alexandra Mascret, Cristina Álvarez, Eva Pacheco, Carme Valls, Florencio Valle, Abdesselam Zhiri
Background: Coughing is crucial for protecting the airways, but associated to unpleasant symptoms that often lead to pediatrician visits. Natural remedies like honey and essentials oils are being increasingly used to effectively relieve symptoms associated with cough. Objectives: Evaluate the efficacy and safety of Pranabb® cough syrup, an organic honey-based natural formulation tailored for pediatric patients, in relieving cough symptoms. Methods: One-week multicenter comparative clinical study of 50 children, 28 in the treatment group and 22 in the control group with supportive measures (increased hydration). Pediatrician appointments were scheduled at the baseline and on day 7, with a progress check call on day 3. Parents kept a daily cough diary. Results: Day 3 results show a significant decrease in daytime cough, night-time cough and global score more pronounced and statistically significant in the study group, although the more severe baseline level in the study group. On day 7, decrease in daytime and overall cough scores was greater in the study group (p<0.05). The frequency of awakenings due to coughing decreased on day 3 only in the study group (p<0.05) and on day 7 for both groups, although it was higher and more significant in the study group (-1.82 p<0.01 vs -1.25 p<0.05). In addition, the safety analysis confirms that the syrup is not toxic to children. Conclusion: Pranabb® Cough Syrup is safe and effective, reducing cough severity and nighttime awakenings in children and improving parents’ ability to sleep. More randomized clinical trials will be interesting to get more homogeneity between the two groups at baseline.
{"title":"Efficacy and safety of Pranabb® syrup to reduce cough and improve sleep quality in children compared to usual recommended hydration measures","authors":"Cynthia Crespo, Amparo Fernández, Alexandra Mascret, Cristina Álvarez, Eva Pacheco, Carme Valls, Florencio Valle, Abdesselam Zhiri","doi":"10.15406/jpnc.2024.14.00546","DOIUrl":"https://doi.org/10.15406/jpnc.2024.14.00546","url":null,"abstract":"Background: Coughing is crucial for protecting the airways, but associated to unpleasant symptoms that often lead to pediatrician visits. Natural remedies like honey and essentials oils are being increasingly used to effectively relieve symptoms associated with cough. Objectives: Evaluate the efficacy and safety of Pranabb® cough syrup, an organic honey-based natural formulation tailored for pediatric patients, in relieving cough symptoms. Methods: One-week multicenter comparative clinical study of 50 children, 28 in the treatment group and 22 in the control group with supportive measures (increased hydration). Pediatrician appointments were scheduled at the baseline and on day 7, with a progress check call on day 3. Parents kept a daily cough diary. Results: Day 3 results show a significant decrease in daytime cough, night-time cough and global score more pronounced and statistically significant in the study group, although the more severe baseline level in the study group. On day 7, decrease in daytime and overall cough scores was greater in the study group (p<0.05). The frequency of awakenings due to coughing decreased on day 3 only in the study group (p<0.05) and on day 7 for both groups, although it was higher and more significant in the study group (-1.82 p<0.01 vs -1.25 p<0.05). In addition, the safety analysis confirms that the syrup is not toxic to children. Conclusion: Pranabb® Cough Syrup is safe and effective, reducing cough severity and nighttime awakenings in children and improving parents’ ability to sleep. More randomized clinical trials will be interesting to get more homogeneity between the two groups at baseline.","PeriodicalId":388959,"journal":{"name":"Journal of Pediatrics & Neonatal Care","volume":"60 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140701015","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 : 2024-04-10DOI: 10.15406/jpnc.2024.14.00545
Ian Munro Rogers
The author tells two stories. Story one describes the beginnings of his research interest into the cause and effect of neonatal acid secretion. It also explains the new proposal that an insensitivity of the usual negative feed-back in adults between neonatal gastrin and gastric acidity is not functioning at birth and takes some weeks to develop. Because of this, gastrin levels and acidity rise together from birth. This means that when feedback maturity occurs, there will be a temporary peak in both gastrin and gastric acidity before mutual restraint is established. The early gap in acid defense is filled by functional maternal gastrin transfer during labor which produces an external source of acid secretion until the neonatal gastric mucosa has matured. Story two relates the effects of these earlier changes to the baby who has inherited an enhanced parietal cell mass. Such babies develop a critical hyperacidity during developmental peak acidity. Acidity- provoked sphincter contractions; sphincter hypertrophy and gastric outlet obstruction (GOO) may then supervene. All the bewildering clinical features are understandable within the framework of this hypothesis.
{"title":"Neonatal acidity and pyloric stenosis of infancy (PS) - the beginning and the end two stories","authors":"Ian Munro Rogers","doi":"10.15406/jpnc.2024.14.00545","DOIUrl":"https://doi.org/10.15406/jpnc.2024.14.00545","url":null,"abstract":"The author tells two stories. Story one describes the beginnings of his research interest into the cause and effect of neonatal acid secretion. It also explains the new proposal that an insensitivity of the usual negative feed-back in adults between neonatal gastrin and gastric acidity is not functioning at birth and takes some weeks to develop. Because of this, gastrin levels and acidity rise together from birth. This means that when feedback maturity occurs, there will be a temporary peak in both gastrin and gastric acidity before mutual restraint is established. The early gap in acid defense is filled by functional maternal gastrin transfer during labor which produces an external source of acid secretion until the neonatal gastric mucosa has matured. Story two relates the effects of these earlier changes to the baby who has inherited an enhanced parietal cell mass. Such babies develop a critical hyperacidity during developmental peak acidity. Acidity- provoked sphincter contractions; sphincter hypertrophy and gastric outlet obstruction (GOO) may then supervene. All the bewildering clinical features are understandable within the framework of this hypothesis.","PeriodicalId":388959,"journal":{"name":"Journal of Pediatrics & Neonatal Care","volume":"41 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140720184","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 : 2024-03-25DOI: 10.15406/jpnc.2024.14.00542
Prof. Mohamed Nasar, Dr. Tabassum K, Majeeda Begum
Single Eye Baby is a rare presentation of congenital anomalies. We observed a rare case of single eye in the centre of frontal bone of a live baby delivered by LSCS and priory diagnosed by Ultra Sonography.
{"title":"PATAU SYNDROME- An Unusual Case of Congenital Abnormality","authors":"Prof. Mohamed Nasar, Dr. Tabassum K, Majeeda Begum","doi":"10.15406/jpnc.2024.14.00542","DOIUrl":"https://doi.org/10.15406/jpnc.2024.14.00542","url":null,"abstract":"Single Eye Baby is a rare presentation of congenital anomalies. We observed a rare case of single eye in the centre of frontal bone of a live baby delivered by LSCS and priory diagnosed by Ultra Sonography.","PeriodicalId":388959,"journal":{"name":"Journal of Pediatrics & Neonatal Care","volume":" 37","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140384152","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 : 2024-03-18DOI: 10.15406/jpnc.2024.14.00541
Pichada Saengrat, O. Sirimongkolchaiyakul, Thiraporn Kanjanaphan
This case presents a challenging scenario in a preterm female newborn born at 25 weeks gestation,who developed respiratory distress syndrome, followed by pneumonia, sepsis, subsequent renal complications, and candida albicans infection. Despite initial susceptibility to fluconazole, the emergence of fluconazole-resistant candida albicans led to a shift in antifungal treatment to amphotericin B in an acute kidney injury neonate. This case underscores the growing concern of drug-resistant candida albicans in neonates, highlighting the importance of judicious selection of empirical antifungal therapy and comprehensive management strategies, especially in the context of acute kidney injury.
{"title":"Unveiling the emerging of fluconazole-resistant Candida albicans in preterm with acute kidney injury: a growing challenge at Vajira hospital","authors":"Pichada Saengrat, O. Sirimongkolchaiyakul, Thiraporn Kanjanaphan","doi":"10.15406/jpnc.2024.14.00541","DOIUrl":"https://doi.org/10.15406/jpnc.2024.14.00541","url":null,"abstract":"This case presents a challenging scenario in a preterm female newborn born at 25 weeks gestation,who developed respiratory distress syndrome, followed by pneumonia, sepsis, subsequent renal complications, and candida albicans infection. Despite initial susceptibility to fluconazole, the emergence of fluconazole-resistant candida albicans led to a shift in antifungal treatment to amphotericin B in an acute kidney injury neonate. This case underscores the growing concern of drug-resistant candida albicans in neonates, highlighting the importance of judicious selection of empirical antifungal therapy and comprehensive management strategies, especially in the context of acute kidney injury.","PeriodicalId":388959,"journal":{"name":"Journal of Pediatrics & Neonatal Care","volume":"120 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140233917","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 : 2024-02-15DOI: 10.15406/jpnc.2024.14.00540
Ana Clara Monteiro Laranjeira, Fernanda Cardoso Andrade, Léa Jenifer Souza Cordeiro, Letícia Barros Cardoso, Beatriz Metedeiro Nunes Câmara, Júlia Carvalho de Miranda, Patrícia Fabiane Monteiro Laranjeira
Introduction: Anatomical, physiological, pharmacokinetic, pharmaco dynamic and behavioral particularities relevant to the pediatric population make its sedation challenging for quick and low-complexity procedures. Robust evidence on this subject is still scarce, and the variety of drugs available, with their multiple routes of administration and dosage schemes, makes it difficult for providers to make a decision. Methods: Through research in four databases, we found 170 articles that addressed pediatric sedation and, after applying the exclusion criteria, we selected 32 articles for analysis. Results: In sedation for invasive or painful procedures, Esketamine in monotherapy was effective, despite the significant incidence of adverse effects. Satisfactory responses were also obtained with associations between Esketamine and Propofol and Fentanyl with Propofol or Midazolam. To perform imaging tests, continuous infusions of Propofol or Dexmedetomidine were sufficient, with associations with Esketamine or opioids associated with a higher incidence of adverse effects. Endoscopic procedures have been successfully performed after administration of continuous infusion of Propofol or Dexmedetomidine, associated with Remifentanil infusion or Fentanyl bolus. Esketamine in monotherapy was also effective. Discussion: The drugs studied have an adverse effect profile compatible with safe pediatric sedation, whether administered by a specialist or not. However, alternative administration routes and dosages still need further studies before being routinely applied. Conclusion: Sedation in pediatrics is still an open field for research in our country.
{"title":"Pediatric sedation for emergency, imaging and endoscopic procedures: a worldwide review from the last five years","authors":"Ana Clara Monteiro Laranjeira, Fernanda Cardoso Andrade, Léa Jenifer Souza Cordeiro, Letícia Barros Cardoso, Beatriz Metedeiro Nunes Câmara, Júlia Carvalho de Miranda, Patrícia Fabiane Monteiro Laranjeira","doi":"10.15406/jpnc.2024.14.00540","DOIUrl":"https://doi.org/10.15406/jpnc.2024.14.00540","url":null,"abstract":"Introduction: Anatomical, physiological, pharmacokinetic, pharmaco dynamic and behavioral particularities relevant to the pediatric population make its sedation challenging for quick and low-complexity procedures. Robust evidence on this subject is still scarce, and the variety of drugs available, with their multiple routes of administration and dosage schemes, makes it difficult for providers to make a decision. Methods: Through research in four databases, we found 170 articles that addressed pediatric sedation and, after applying the exclusion criteria, we selected 32 articles for analysis. Results: In sedation for invasive or painful procedures, Esketamine in monotherapy was effective, despite the significant incidence of adverse effects. Satisfactory responses were also obtained with associations between Esketamine and Propofol and Fentanyl with Propofol or Midazolam. To perform imaging tests, continuous infusions of Propofol or Dexmedetomidine were sufficient, with associations with Esketamine or opioids associated with a higher incidence of adverse effects. Endoscopic procedures have been successfully performed after administration of continuous infusion of Propofol or Dexmedetomidine, associated with Remifentanil infusion or Fentanyl bolus. Esketamine in monotherapy was also effective. Discussion: The drugs studied have an adverse effect profile compatible with safe pediatric sedation, whether administered by a specialist or not. However, alternative administration routes and dosages still need further studies before being routinely applied. Conclusion: Sedation in pediatrics is still an open field for research in our country.","PeriodicalId":388959,"journal":{"name":"Journal of Pediatrics & Neonatal Care","volume":"196 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140455662","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 : 2024-02-14DOI: 10.15406/jpnc.2024.14.00539
Husen Zakir Abasimel, Befekadu Tesfaye Oyato, Adugna Alemu Desta, Tadele Kinati, Hana Israel Gesisa, Mukemil Awol
Introduction: Reducing under-five mortality to less than 25 per 1000 live births by 2030 is one of the Sustainable Development Goals introduced in 2016. However, several countries are still falling short of their targets. In Ethiopia, one out of every 19 children dies before reaching the age of five. Thus, this study aims to identify the time to death and its predictors among under-five children in Ethiopia. Methods: The data were retrieved from the 2019 Ethiopian Mini Demographic and Health Survey data set. Descriptive statistics and survival curves were applied. Shared frailty survival analysis was employed to determine the predictors of under-five mortality. Statistical significance was declared at p-value <0.05. Result: The under-five mortality rate was found to be 59 deaths per 1000 live births with an estimated mean survival time of 57.6 months (95%CI: 57.38, 57.85). A child born into a family of seven or more had an 85% lowered risk of dying (AHR = 0.15, 95% CI: 0.05, 0.44). The risk of mortality among children born in the birth order of five or above was 3 times higher (AHR = 3.00, 95%CI: 1.70, 5.21) compared to those born in the birth order of one to four. The estimated risk of death among under-five children born less than 24 months interval was 2.68 times higher (AHR=2.68, 95%CI: 1.71, 4.21). Never breastfed was also a significant predictor of under-five child death (AHR = 2.76, 95%CI: 1.46, 5.23). Conclusion: Birth order, family size, preceding birth interval, and never breastfed history were significant predictors of under-five child mortality. Health policies should focus on keeping the spirit of a continuum of care to improve the health of the child and the health of the family as a whole. Health care providers should intervene in the community to maximize optimal infant and young child feeding practices.
{"title":"Time to death and its predictors among Ethiopian under-five children: cluster-level shared frailty survival analysis using the 2019 Ethiopian mini demographic health survey","authors":"Husen Zakir Abasimel, Befekadu Tesfaye Oyato, Adugna Alemu Desta, Tadele Kinati, Hana Israel Gesisa, Mukemil Awol","doi":"10.15406/jpnc.2024.14.00539","DOIUrl":"https://doi.org/10.15406/jpnc.2024.14.00539","url":null,"abstract":"Introduction: Reducing under-five mortality to less than 25 per 1000 live births by 2030 is one of the Sustainable Development Goals introduced in 2016. However, several countries are still falling short of their targets. In Ethiopia, one out of every 19 children dies before reaching the age of five. Thus, this study aims to identify the time to death and its predictors among under-five children in Ethiopia. Methods: The data were retrieved from the 2019 Ethiopian Mini Demographic and Health Survey data set. Descriptive statistics and survival curves were applied. Shared frailty survival analysis was employed to determine the predictors of under-five mortality. Statistical significance was declared at p-value <0.05. Result: The under-five mortality rate was found to be 59 deaths per 1000 live births with an estimated mean survival time of 57.6 months (95%CI: 57.38, 57.85). A child born into a family of seven or more had an 85% lowered risk of dying (AHR = 0.15, 95% CI: 0.05, 0.44). The risk of mortality among children born in the birth order of five or above was 3 times higher (AHR = 3.00, 95%CI: 1.70, 5.21) compared to those born in the birth order of one to four. The estimated risk of death among under-five children born less than 24 months interval was 2.68 times higher (AHR=2.68, 95%CI: 1.71, 4.21). Never breastfed was also a significant predictor of under-five child death (AHR = 2.76, 95%CI: 1.46, 5.23). Conclusion: Birth order, family size, preceding birth interval, and never breastfed history were significant predictors of under-five child mortality. Health policies should focus on keeping the spirit of a continuum of care to improve the health of the child and the health of the family as a whole. Health care providers should intervene in the community to maximize optimal infant and young child feeding practices.","PeriodicalId":388959,"journal":{"name":"Journal of Pediatrics & Neonatal Care","volume":"38 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139779162","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 : 2024-02-14DOI: 10.15406/jpnc.2024.14.00539
Husen Zakir Abasimel, Befekadu Tesfaye Oyato, Adugna Alemu Desta, Tadele Kinati, Hana Israel Gesisa, Mukemil Awol
Introduction: Reducing under-five mortality to less than 25 per 1000 live births by 2030 is one of the Sustainable Development Goals introduced in 2016. However, several countries are still falling short of their targets. In Ethiopia, one out of every 19 children dies before reaching the age of five. Thus, this study aims to identify the time to death and its predictors among under-five children in Ethiopia. Methods: The data were retrieved from the 2019 Ethiopian Mini Demographic and Health Survey data set. Descriptive statistics and survival curves were applied. Shared frailty survival analysis was employed to determine the predictors of under-five mortality. Statistical significance was declared at p-value <0.05. Result: The under-five mortality rate was found to be 59 deaths per 1000 live births with an estimated mean survival time of 57.6 months (95%CI: 57.38, 57.85). A child born into a family of seven or more had an 85% lowered risk of dying (AHR = 0.15, 95% CI: 0.05, 0.44). The risk of mortality among children born in the birth order of five or above was 3 times higher (AHR = 3.00, 95%CI: 1.70, 5.21) compared to those born in the birth order of one to four. The estimated risk of death among under-five children born less than 24 months interval was 2.68 times higher (AHR=2.68, 95%CI: 1.71, 4.21). Never breastfed was also a significant predictor of under-five child death (AHR = 2.76, 95%CI: 1.46, 5.23). Conclusion: Birth order, family size, preceding birth interval, and never breastfed history were significant predictors of under-five child mortality. Health policies should focus on keeping the spirit of a continuum of care to improve the health of the child and the health of the family as a whole. Health care providers should intervene in the community to maximize optimal infant and young child feeding practices.
{"title":"Time to death and its predictors among Ethiopian under-five children: cluster-level shared frailty survival analysis using the 2019 Ethiopian mini demographic health survey","authors":"Husen Zakir Abasimel, Befekadu Tesfaye Oyato, Adugna Alemu Desta, Tadele Kinati, Hana Israel Gesisa, Mukemil Awol","doi":"10.15406/jpnc.2024.14.00539","DOIUrl":"https://doi.org/10.15406/jpnc.2024.14.00539","url":null,"abstract":"Introduction: Reducing under-five mortality to less than 25 per 1000 live births by 2030 is one of the Sustainable Development Goals introduced in 2016. However, several countries are still falling short of their targets. In Ethiopia, one out of every 19 children dies before reaching the age of five. Thus, this study aims to identify the time to death and its predictors among under-five children in Ethiopia. Methods: The data were retrieved from the 2019 Ethiopian Mini Demographic and Health Survey data set. Descriptive statistics and survival curves were applied. Shared frailty survival analysis was employed to determine the predictors of under-five mortality. Statistical significance was declared at p-value <0.05. Result: The under-five mortality rate was found to be 59 deaths per 1000 live births with an estimated mean survival time of 57.6 months (95%CI: 57.38, 57.85). A child born into a family of seven or more had an 85% lowered risk of dying (AHR = 0.15, 95% CI: 0.05, 0.44). The risk of mortality among children born in the birth order of five or above was 3 times higher (AHR = 3.00, 95%CI: 1.70, 5.21) compared to those born in the birth order of one to four. The estimated risk of death among under-five children born less than 24 months interval was 2.68 times higher (AHR=2.68, 95%CI: 1.71, 4.21). Never breastfed was also a significant predictor of under-five child death (AHR = 2.76, 95%CI: 1.46, 5.23). Conclusion: Birth order, family size, preceding birth interval, and never breastfed history were significant predictors of under-five child mortality. Health policies should focus on keeping the spirit of a continuum of care to improve the health of the child and the health of the family as a whole. Health care providers should intervene in the community to maximize optimal infant and young child feeding practices.","PeriodicalId":388959,"journal":{"name":"Journal of Pediatrics & Neonatal Care","volume":"554 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139838915","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: Breastfeeding technique is defined as the positioning of the mother and baby, the baby's attachment to the breast, and suckling during nursing, all of which are crucial for successful breastfeeding. Appropriate and longer breastfeeding practices have numerous benefits for both mothers and babies. Moreover, ineffective breastfeeding techniques are a cause of death for thousands of newborns every year. In Ethiopia, the practice of effective breastfeeding techniques remained low. Therefore, this study aimed to assess the practice of effective breastfeeding techniques and associated factors among breastfeeding mother-infant pairs in Dugda district, Central Ethiopia, 2023. Methods: A community-based cross-sectional study was conducted from June 20 to August 20, 2023, in Dugda district on a total of 620 breastfeeding mother-infant pairs who were selected using a multistage sampling technique. Ethical clearance and approval were secured from the Ethical Review Board of Salale University with reference number SLU-IRB/53/23. The WHO's breastfeeding observational checklist and a face-to-face interview were used to collect the data. Bi-variable and multivariable binary logistic regression analyses were employed. An adjusted odds ratio coupled with a 95% CI was used to determine a significant association. Bi-variable and multivariable binary logistic regression analyses were employed. An adjusted odds ratio coupled with a 95% CI was used to determine a significant association. Results: The prevalence of effective breastfeeding techniques in this study was 43.4% (95% CI: 39.1%, 47.4%). Having antenatal care follow-up (AOR: 2.24; 95% CI: 1.21, 4.14), having prior information about breast feeding techniques (AOR: 5.78; 95% CI: 3.95, 8.46), being multipara (AOR: 2.21; 95% CI: 1.47, 3.33), and having educational levels of primary education (AOR: 2.42; 95% CI: 1.44, 4.06) and secondary education and above (AOR: 2.85; 95% CI: 1.73, 4.69) were significantly associated with effective breastfeeding techniques. Conclusion: The prevalence of effective breastfeeding techniques in the study area was relatively low. Therefore, empowering women in education, promoting utilisation of ANC follow-up and disseminating information about breastfeeding techniques could be the key implication for effective breastfeeding techniques. Special emphasis should be given to primipara mothers because they are new for nursing their infants.
{"title":"Effective breast feeding techniques and associated factors among lactating mothers: a community-based cross-sectional study in Dugda district, central Ethiopia","authors":"Befekadu Tesfaye Oyato, Beyene Golo Gutema, Mulugeta Feyisa, Tariku Regea, Adugna Alemu, Husen Zakir Abasimel, Andualem Gezahagn, Ifa Dereje, Hawi Abayneh, Henok Abebayehu Delelegn","doi":"10.15406/jpnc.2024.14.00538","DOIUrl":"https://doi.org/10.15406/jpnc.2024.14.00538","url":null,"abstract":"Background: Breastfeeding technique is defined as the positioning of the mother and baby, the baby's attachment to the breast, and suckling during nursing, all of which are crucial for successful breastfeeding. Appropriate and longer breastfeeding practices have numerous benefits for both mothers and babies. Moreover, ineffective breastfeeding techniques are a cause of death for thousands of newborns every year. In Ethiopia, the practice of effective breastfeeding techniques remained low. Therefore, this study aimed to assess the practice of effective breastfeeding techniques and associated factors among breastfeeding mother-infant pairs in Dugda district, Central Ethiopia, 2023. Methods: A community-based cross-sectional study was conducted from June 20 to August 20, 2023, in Dugda district on a total of 620 breastfeeding mother-infant pairs who were selected using a multistage sampling technique. Ethical clearance and approval were secured from the Ethical Review Board of Salale University with reference number SLU-IRB/53/23. The WHO's breastfeeding observational checklist and a face-to-face interview were used to collect the data. Bi-variable and multivariable binary logistic regression analyses were employed. An adjusted odds ratio coupled with a 95% CI was used to determine a significant association. Bi-variable and multivariable binary logistic regression analyses were employed. An adjusted odds ratio coupled with a 95% CI was used to determine a significant association. Results: The prevalence of effective breastfeeding techniques in this study was 43.4% (95% CI: 39.1%, 47.4%). Having antenatal care follow-up (AOR: 2.24; 95% CI: 1.21, 4.14), having prior information about breast feeding techniques (AOR: 5.78; 95% CI: 3.95, 8.46), being multipara (AOR: 2.21; 95% CI: 1.47, 3.33), and having educational levels of primary education (AOR: 2.42; 95% CI: 1.44, 4.06) and secondary education and above (AOR: 2.85; 95% CI: 1.73, 4.69) were significantly associated with effective breastfeeding techniques. Conclusion: The prevalence of effective breastfeeding techniques in the study area was relatively low. Therefore, empowering women in education, promoting utilisation of ANC follow-up and disseminating information about breastfeeding techniques could be the key implication for effective breastfeeding techniques. Special emphasis should be given to primipara mothers because they are new for nursing their infants.","PeriodicalId":388959,"journal":{"name":"Journal of Pediatrics & Neonatal Care","volume":"21 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139783464","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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