Pub Date : 2019-05-03eCollection Date: 2019-01-01DOI: 10.1177/1179556519846110
Calixte Ida Penda, Francis A Ndongo, Anne-Cécile Z-K Bissek, Mathurin C Téjiokem, Casimir Sofeu, Else C Moukoko Eboumbou, Sandrine Mindjouli, Sophie Desmonde, Louis R Njock
Background: To accelerate access to pediatric HIV care in Cameroon, operational challenges in implementing HIV pediatric care need to be identified. The aim of this study was to assess the knowledge, attitudes, and practices of health care workers regarding pediatric HIV infection in Cameroon.
Methods: A descriptive cross-sectional study was conducted over a 4-month period (April to August 2014) in 12 health facilities in 7 regions of Cameroon selected using systematic random sampling. Data were collected from interviews with health care providers and managers using standardized self-administered questionnaires and stored in the ACCESS software.
Results: In total, 103 health care providers were included in this study, of which 59 (57.3%) were health workers and 44 (42.7%) community agents. Most of the health workers in charge of HIV pediatric care were nurses, requiring effective medical task shifting that was institutionalized in Cameroon. The knowledge of health care providers in relation to pediatric HIV care was acceptable. Indications for prescription of test for early infant diagnosis were known (96.1%), but their attitudes and practices regarding initiating antiretroviral therapy (ART) in infants less than 2 years (5.2%) and first-line ART protocols (25.4%) were insufficient, due to little information about standard procedures.
Conclusion: Capacity building of health care providers and large-scale dissemination of normative national documents are imperative to improve HIV pediatric care in the health care facilities.
{"title":"Practices of Care to HIV-Infected Children: Current Situation in Cameroon.","authors":"Calixte Ida Penda, Francis A Ndongo, Anne-Cécile Z-K Bissek, Mathurin C Téjiokem, Casimir Sofeu, Else C Moukoko Eboumbou, Sandrine Mindjouli, Sophie Desmonde, Louis R Njock","doi":"10.1177/1179556519846110","DOIUrl":"https://doi.org/10.1177/1179556519846110","url":null,"abstract":"<p><strong>Background: </strong>To accelerate access to pediatric HIV care in Cameroon, operational challenges in implementing HIV pediatric care need to be identified. The aim of this study was to assess the knowledge, attitudes, and practices of health care workers regarding pediatric HIV infection in Cameroon.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted over a 4-month period (April to August 2014) in 12 health facilities in 7 regions of Cameroon selected using systematic random sampling. Data were collected from interviews with health care providers and managers using standardized self-administered questionnaires and stored in the ACCESS software.</p><p><strong>Results: </strong>In total, 103 health care providers were included in this study, of which 59 (57.3%) were health workers and 44 (42.7%) community agents. Most of the health workers in charge of HIV pediatric care were nurses, requiring effective medical task shifting that was institutionalized in Cameroon. The knowledge of health care providers in relation to pediatric HIV care was acceptable. Indications for prescription of test for early infant diagnosis were known (96.1%), but their attitudes and practices regarding initiating antiretroviral therapy (ART) in infants less than 2 years (5.2%) and first-line ART protocols (25.4%) were insufficient, due to little information about standard procedures.</p><p><strong>Conclusion: </strong>Capacity building of health care providers and large-scale dissemination of normative national documents are imperative to improve HIV pediatric care in the health care facilities.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2019-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179556519846110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37255454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-29eCollection Date: 2019-01-01DOI: 10.1177/1179556519842816
Jolie Straus, Sarah Coburn, Stephanie Maskell, Jessica Pappagianopoulos, Kathryn Cantrell
Approximately 1 in 59 youth are currently diagnosed with autism spectrum disorder (ASD), a neurodevelopmental disorder. In comparison to typically developing peers, youth with ASD encounter hospitalization at higher rates due to their heightened health care needs. While visiting the hospital is a stressor for youth with neurotypical needs, the experience contains unique challenges for those with ASD. This systematic literature review highlights research that considers the psychosocial impact of the hospital environment on the coping and adjustment of youth with ASD. Specifically, the review focuses on recommendations and interventions that may be used by health care professionals while supporting this population as they encounter the health care system. Ninety-six articles were identified as meeting inclusion and exclusion criteria. The findings suggest that practicing clinicians should implement a wide variety of interventions for youth with ASD including diversion techniques, comfort positions, and picture schedules. Although there are published evidence-based interventions for supporting youth with ASD in the hospital, most clinicians lack ASD-specific training. This article concludes with recommendations for future research.
{"title":"Medical Encounters for Youth With Autism Spectrum Disorder: A Comprehensive Review of Environmental Considerations and Interventions.","authors":"Jolie Straus, Sarah Coburn, Stephanie Maskell, Jessica Pappagianopoulos, Kathryn Cantrell","doi":"10.1177/1179556519842816","DOIUrl":"https://doi.org/10.1177/1179556519842816","url":null,"abstract":"<p><p>Approximately 1 in 59 youth are currently diagnosed with autism spectrum disorder (ASD), a neurodevelopmental disorder. In comparison to typically developing peers, youth with ASD encounter hospitalization at higher rates due to their heightened health care needs. While visiting the hospital is a stressor for youth with neurotypical needs, the experience contains unique challenges for those with ASD. This systematic literature review highlights research that considers the psychosocial impact of the hospital environment on the coping and adjustment of youth with ASD. Specifically, the review focuses on recommendations and interventions that may be used by health care professionals while supporting this population as they encounter the health care system. Ninety-six articles were identified as meeting inclusion and exclusion criteria. The findings suggest that practicing clinicians should implement a wide variety of interventions for youth with ASD including diversion techniques, comfort positions, and picture schedules. Although there are published evidence-based interventions for supporting youth with ASD in the hospital, most clinicians lack ASD-specific training. This article concludes with recommendations for future research.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2019-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179556519842816","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37383717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Osteosarcoma (OS) of jaws is a rare entity characterized by malignant osteoid formation and is most commonly seen in third to fourth decade of life. Here, we present a rare and intriguing case of a 14-year-old pediatric patient, who reported with a chief complaint of swelling in the left maxilla, which was rapidly increasing in size. Both cytokeratin AE1/3 and vimentin-positive spindled cells were seen arranged in storiform pattern with minimal areas of osteoid formation on histopathologic examination. The diagnosis of fibroblastic OS was confirmed by fluorescent in situ hybridization after excluding monomorphic synovial sarcoma. The patient underwent segmental resection of left maxilla and is on close follow-up. A PubMed search revealed that only 5 pediatric cases of fibroblastic OS have been published since 1991. Here, we highlight the diagnostic challenges encountered in reaching the histopathologic diagnosis.
{"title":"Pan-Cytokeratin Positive Fibroblastic Osteosarcoma of Jaw: An Extremely Rare Entity in a Pediatric Patient.","authors":"Aadithya B Urs, Priya Kumar, Jeyaseelan Augustine, Pankaj Sharma, Bhaskar Narayan","doi":"10.1177/1179556519842827","DOIUrl":"https://doi.org/10.1177/1179556519842827","url":null,"abstract":"<p><p>Osteosarcoma (OS) of jaws is a rare entity characterized by malignant osteoid formation and is most commonly seen in third to fourth decade of life. Here, we present a rare and intriguing case of a 14-year-old pediatric patient, who reported with a chief complaint of swelling in the left maxilla, which was rapidly increasing in size. Both cytokeratin AE1/3 and vimentin-positive spindled cells were seen arranged in storiform pattern with minimal areas of osteoid formation on histopathologic examination. The diagnosis of fibroblastic OS was confirmed by fluorescent in situ hybridization after excluding monomorphic synovial sarcoma. The patient underwent segmental resection of left maxilla and is on close follow-up. A PubMed search revealed that only 5 pediatric cases of fibroblastic OS have been published since 1991. Here, we highlight the diagnostic challenges encountered in reaching the histopathologic diagnosis.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2019-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179556519842827","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37180428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-08eCollection Date: 2019-01-01DOI: 10.1177/1179556519841876
Ioannis M Stavrakakis, Ioannis I Daskalakis, George E Magarakis, Zacharias Christoforakis, Maria S Katsafarou
Ulnar nerve injury as a result of closed forearm fractures in children is a rare but disastrous complication, affecting significantly the function of the upper extremity. The management of these injuries is still controversial in the literature. This is a review of small case series and case reports, in which an algorithm of treatment is proposed. A brief description of a relative case, which was treated successfully in our department, is presented as well. This case motivated the authors to perform this study.
{"title":"Ulnar Nerve Injuries Post Closed Forearm Fractures in Paediatric Population: A Review of the Literature.","authors":"Ioannis M Stavrakakis, Ioannis I Daskalakis, George E Magarakis, Zacharias Christoforakis, Maria S Katsafarou","doi":"10.1177/1179556519841876","DOIUrl":"https://doi.org/10.1177/1179556519841876","url":null,"abstract":"<p><p>Ulnar nerve injury as a result of closed forearm fractures in children is a rare but disastrous complication, affecting significantly the function of the upper extremity. The management of these injuries is still controversial in the literature. This is a review of small case series and case reports, in which an algorithm of treatment is proposed. A brief description of a relative case, which was treated successfully in our department, is presented as well. This case motivated the authors to perform this study.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2019-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179556519841876","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37166239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-29eCollection Date: 2019-01-01DOI: 10.1177/1179556519839334
Shannon Flahive, Bhakti Chavan, Zelalem T Haile
Background: Maternal feeding practices (MFPs) have been linked to childhood obesity and other eating disorders. However, population-based research examining the association between MFPs and children's emotional well-being is currently lacking.
Methods: We examined 1241 participants from Year 6 Follow-Up of the Infant Feeding Practices Study II, conducted from March to June 2012 in the United States.
Results: Approximately 57.5% and 47.8% of participants reported at least one symptom of childhood anxiety and depression, respectively. After adjusting for potential confounders, mothers who responded "yes" to "If I did not guide or regulate my child's eating, he or she would eat too much of his or her favorite food" had higher odds of having a child who has symptoms of depression and anxiety compared with mothers who responded "no" (odds ratio [OR], 95% confidence interval [CI]) (2.02; 1.47-2.78, P < .001) and (1.41, 1.05-1.91, P = .024), respectively. The odds of having a child who has symptoms of depression were lower among mothers who responded "yes" to "I make sure that my child does not eat too many sweets or junk foods" compared with mothers who responded "no" (0.49; 0.26-0.91, P = .020). Mothers who responded "yes" to "I encourage my 6 year-old to eat all of the food on his or her plate" had higher odds of having a child who has symptoms of anxiety compared with mothers who responded "no" (1.43; 1.01-2.05, P = .049).
Conclusions: Controlling MFPs may influence a child's emotional well-being. Further research is needed to address the complex relationships between MFPs and psychosocial well-being in children.
背景:母亲喂养方式(mfp)与儿童肥胖和其他饮食失调有关。然而,目前还缺乏以人群为基础的研究来检验mfp与儿童情绪健康之间的关系。方法:我们从2012年3月至6月在美国进行的婴儿喂养实践研究II的第6年随访中检查了1241名参与者。结果:大约57.5%和47.8%的参与者分别报告了至少一种儿童焦虑和抑郁症状。在调整了潜在的混杂因素后,对“如果我不指导或调节孩子的饮食,他或她就会吃太多他或她喜欢的食物”回答“是”的母亲比回答“不是”的母亲有更高的几率生下有抑郁和焦虑症状的孩子(优势比[or], 95%置信区间[CI]) (2.02;1.47-2.78, P = 0.024)。对“我确保我的孩子不吃太多糖果或垃圾食品”回答“是”的母亲与回答“不是”的母亲相比,孩子出现抑郁症状的几率更低(0.49;0.26-0.91, p = 0.020)。对“我鼓励我6岁的孩子把盘子里所有的食物都吃完”回答“是”的母亲,与回答“不是”的母亲相比,孩子出现焦虑症状的几率更高(1.43;1.01-2.05, p = 0.049)。结论:控制mfp可能会影响儿童的情绪健康。需要进一步的研究来解决mfp与儿童心理社会健康之间的复杂关系。
{"title":"Association Between Maternal Feeding Practices and Symptoms of Anxiety and Depression Among 6-Year-Old Children.","authors":"Shannon Flahive, Bhakti Chavan, Zelalem T Haile","doi":"10.1177/1179556519839334","DOIUrl":"https://doi.org/10.1177/1179556519839334","url":null,"abstract":"<p><strong>Background: </strong>Maternal feeding practices (MFPs) have been linked to childhood obesity and other eating disorders. However, population-based research examining the association between MFPs and children's emotional well-being is currently lacking.</p><p><strong>Methods: </strong>We examined 1241 participants from Year 6 Follow-Up of the Infant Feeding Practices Study II, conducted from March to June 2012 in the United States.</p><p><strong>Results: </strong>Approximately 57.5% and 47.8% of participants reported at least one symptom of childhood anxiety and depression, respectively. After adjusting for potential confounders, mothers who responded \"yes\" to \"If I did not guide or regulate my child's eating, he or she would eat too much of his or her favorite food\" had higher odds of having a child who has symptoms of depression and anxiety compared with mothers who responded \"no\" (odds ratio [OR], 95% confidence interval [CI]) (2.02; 1.47-2.78, <i>P</i> < .001) and (1.41, 1.05-1.91, <i>P</i> = .024), respectively. The odds of having a child who has symptoms of depression were lower among mothers who responded \"yes\" to \"I make sure that my child does not eat too many sweets or junk foods\" compared with mothers who responded \"no\" (0.49; 0.26-0.91, <i>P</i> = .020). Mothers who responded \"yes\" to \"I encourage my 6 year-old to eat all of the food on his or her plate\" had higher odds of having a child who has symptoms of anxiety compared with mothers who responded \"no\" (1.43; 1.01-2.05, <i>P</i> = .049).</p><p><strong>Conclusions: </strong>Controlling MFPs may influence a child's emotional well-being. Further research is needed to address the complex relationships between MFPs and psychosocial well-being in children.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2019-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179556519839334","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37291240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Lead is considered a neurotoxic agent. We aimed to evaluate the blood lead level (BLL) in young population and determine probable risk factors of lead exposure in Iran.
Methods: In a cross-sectional study, a total of 100 children were entered and their BLLs were checked.
Results: In all, 25 and 8 patients had BLLs above 5 and 10 µg/dL, respectively. There was a significant univariate correlation between BLL and place of living, water pipe type, using dairy products, and stature in both cut-offs of 5 and 10 µg/dL. Binary regression analysis showed that pipe type was associated with high BLLs at cut-offs of 5 and 10 µg/dL, respectively. Also, there was an association between 50th percentile of stature for age and cut-off of 5 µg/dL.
Conclusions: Higher BLLs may be seen in short stature pediatric population. Polyvinyl chloride (PVC) and polypropylene water pipes may even cause more release of lead and result in higher absorption of this metal in the pediatric population.
{"title":"Factors Associated With High Blood Lead Levels in a Sample of 100 Children in Tehran.","authors":"Nasim Zamani, Narges Gholami, Hossein Hassanian-Moghaddam, Fariba Farnaghi, Latif Gachkar","doi":"10.1177/1179556518825451","DOIUrl":"https://doi.org/10.1177/1179556518825451","url":null,"abstract":"<p><strong>Background: </strong>Lead is considered a neurotoxic agent. We aimed to evaluate the blood lead level (BLL) in young population and determine probable risk factors of lead exposure in Iran.</p><p><strong>Methods: </strong>In a cross-sectional study, a total of 100 children were entered and their BLLs were checked.</p><p><strong>Results: </strong>In all, 25 and 8 patients had BLLs above 5 and 10 µg/dL, respectively. There was a significant univariate correlation between BLL and place of living, water pipe type, using dairy products, and stature in both cut-offs of 5 and 10 µg/dL. Binary regression analysis showed that pipe type was associated with high BLLs at cut-offs of 5 and 10 µg/dL, respectively. Also, there was an association between 50th percentile of stature for age and cut-off of 5 µg/dL.</p><p><strong>Conclusions: </strong>Higher BLLs may be seen in short stature pediatric population. Polyvinyl chloride (PVC) and polypropylene water pipes may even cause more release of lead and result in higher absorption of this metal in the pediatric population.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2019-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179556518825451","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37110663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-19eCollection Date: 2019-01-01DOI: 10.1177/1179556519835833
Tsunenori Isa, Ryuichi Sawa, Kohtaroh Torizawa, Shunsuke Murata, Takashi Saito, Aoi Ebina, Yuki Kondo, Yamato Tsuboi, Akimasa Fukuta, Shogo Misu, Rei Ono
Objectives: This study aimed to examine the reliability and validity of the Japanese version of the Physical Activity Questionnaire for Older Children (PAQ-C) in Japanese children aged 9 to 12 years.
Methods: A total of 210 children aged between 9 and 12 years participated. Internal consistency and test-retest reliability were evaluated using Cronbach alpha coefficient and intraclass correlation coefficient (ICC), respectively. Validity was evaluated using athletic competence (AC), self-efficacy (SE), body mass index (BMI), body fat percentage (%BF), cardiovascular fitness (CVF), and World Health Organization Health Behavior in School-aged Children (WHO HBSC) physical activity questionnaire.
Results: Internal consistency was acceptable (alpha = 0.80) and test-retest reliability showed excellent agreement (ICC = 0.83). The PAQ-C score was significantly correlated with AC (r = 0.41), SE (r = 0.65), %BF (r = 0.19), and CVF (r = -0.32). The PAQ-C score of the active group classified by the WHO HBSC physical activity questionnaire (mean score ± standard deviation [SD] = 3.03 ± 0.57) was significantly higher than that of the inactive group (mean score ± SD = 2.27 ± 0.63, P < .01).
Conclusions: The PAQ-C had acceptable reliability and validity. The PAQ-C is a useful instrument to evaluate physical activity for Japanese children aged 9 to 12 years.
{"title":"Reliability and Validity of the Japanese Version of the Physical Activity Questionnaire for Older Children.","authors":"Tsunenori Isa, Ryuichi Sawa, Kohtaroh Torizawa, Shunsuke Murata, Takashi Saito, Aoi Ebina, Yuki Kondo, Yamato Tsuboi, Akimasa Fukuta, Shogo Misu, Rei Ono","doi":"10.1177/1179556519835833","DOIUrl":"https://doi.org/10.1177/1179556519835833","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to examine the reliability and validity of the Japanese version of the Physical Activity Questionnaire for Older Children (PAQ-C) in Japanese children aged 9 to 12 years.</p><p><strong>Methods: </strong>A total of 210 children aged between 9 and 12 years participated. Internal consistency and test-retest reliability were evaluated using Cronbach alpha coefficient and intraclass correlation coefficient (ICC), respectively. Validity was evaluated using athletic competence (AC), self-efficacy (SE), body mass index (BMI), body fat percentage (%BF), cardiovascular fitness (CVF), and World Health Organization Health Behavior in School-aged Children (WHO HBSC) physical activity questionnaire.</p><p><strong>Results: </strong>Internal consistency was acceptable (alpha = 0.80) and test-retest reliability showed excellent agreement (ICC = 0.83). The PAQ-C score was significantly correlated with AC (<i>r</i> = 0.41), SE (<i>r</i> = 0.65), %BF (<i>r</i> = 0.19), and CVF (<i>r</i> = -0.32). The PAQ-C score of the active group classified by the WHO HBSC physical activity questionnaire (mean score ± standard deviation [SD] = 3.03 ± 0.57) was significantly higher than that of the inactive group (mean score ± SD = 2.27 ± 0.63, <i>P</i> < .01).</p><p><strong>Conclusions: </strong>The PAQ-C had acceptable reliability and validity. The PAQ-C is a useful instrument to evaluate physical activity for Japanese children aged 9 to 12 years.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2019-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179556519835833","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37265792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Goal: This work aims to describe and explore the circumstances of appearance of Klebsiella pneumoniae producing OXA-48 carbapenemase, which has occurred in a neonatal intensive care service at the Mohammed VI University Hospital of Marrakech.
Results: During February 2015, the alert was triggered by the isolation of 6 isolates of K pneumoniae with the same antibiotic susceptibility profile in the neonatal intensive care service, suggesting a possible outbreak. Blood cultures represented the main site of isolation of these isolates. The phenotypic study of the isolates made it possible to identify a strain of K pneumoniae susceptible to third-generation cephalosporins, ciprofloxacin, and aminoglycosides, and resistant to ertapenem, β-lactamases inhibitors (ticarcillin-clavulanate, piperacillin-tazobactam; amoxicillin-clavulanic acid), and cotrimoxazole. The genotypic study of the epidemic isolate revealed the presence of the blaOXA-48 gene. The action to be taken was the establishment of corrective measures to stop this epidemic to a multi-resistant germ transmitted by hand transmission. The reinforcement of hygiene measures and the awareness of the staff made it possible to put an end to the epidemic at March 30, 2015, without closing the service. The outcome of 6 infected newborns was fatal due to the fragile terrain and the inappropriate probabilistic antibiotic therapy.
Conclusion: The production of carbapenemase in K pneumoniae is an emerging resistance mechanism that must be suspected and identified to offer targeted therapy and to limit its spread. The implementation of a local policy to control multidrug-resistant germs is essential to limit their dissemination in hospitals.
{"title":"Emergence of OXA-48 Carbapenemase Producing <i>Klebsiella pneumoniae</i> in a Neonatal Intensive Care Unit in Marrakech, Morocco.","authors":"Lahoucine Taoufik, Asma Amrani Hanchi, Bennaoui Fatiha, Slitine Nissrine, Maouainine Fadl Mrabih Rabou, Soraa Nabila","doi":"10.1177/1179556519834524","DOIUrl":"https://doi.org/10.1177/1179556519834524","url":null,"abstract":"<p><strong>Goal: </strong>This work aims to describe and explore the circumstances of appearance of <i>Klebsiella pneumoniae</i> producing OXA-48 carbapenemase, which has occurred in a neonatal intensive care service at the Mohammed VI University Hospital of Marrakech.</p><p><strong>Results: </strong>During February 2015, the alert was triggered by the isolation of 6 isolates of <i>K pneumoniae</i> with the same antibiotic susceptibility profile in the neonatal intensive care service, suggesting a possible outbreak. Blood cultures represented the main site of isolation of these isolates. The phenotypic study of the isolates made it possible to identify a strain of <i>K pneumoniae</i> susceptible to third-generation cephalosporins, ciprofloxacin, and aminoglycosides, and resistant to ertapenem, β-lactamases inhibitors (ticarcillin-clavulanate, piperacillin-tazobactam; amoxicillin-clavulanic acid), and cotrimoxazole. The genotypic study of the epidemic isolate revealed the presence of the <i>bla<sub>OXA-48</sub></i> gene. The action to be taken was the establishment of corrective measures to stop this epidemic to a multi-resistant germ transmitted by hand transmission. The reinforcement of hygiene measures and the awareness of the staff made it possible to put an end to the epidemic at March 30, 2015, without closing the service. The outcome of 6 infected newborns was fatal due to the fragile terrain and the inappropriate probabilistic antibiotic therapy.</p><p><strong>Conclusion: </strong>The production of carbapenemase in <i>K pneumoniae</i> is an emerging resistance mechanism that must be suspected and identified to offer targeted therapy and to limit its spread. The implementation of a local policy to control multidrug-resistant germs is essential to limit their dissemination in hospitals.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2019-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179556519834524","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37241657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-03eCollection Date: 2019-01-01DOI: 10.1177/1179556518824375
Mostafa A Mostafa, Naglaa M Kamal, Sherif Eltaher, Yahia Hamed, Hany Abdelaziz, Walid Abdelghany, Efat Aser, Eman Fawzy, Laila M Sherief
Background and objectives: To evaluate the knowledge of the primary health care physicians (PHCP) in Kalubia governorate, Egypt, about the causes, diagnosis, complications, and treatment of neonatal hyperbilirubinemia (NHB).
Methods: Cross-sectional survey distributed by interview to 500 physicians working in the primary health care (PHC) sector in Kalubia.
Results: Out of 500 distributed surveys, 419 (84%) PHCP completed the questionnaire. They represent 174 (90%) out of 193 PHC units and centers. About 18% were males and 82% females with mean age of 28.5 ± 5.2 years, and mean duration of work was 3.3 ± 4.4 years. All of the respondents have patients with NHB in their daily practice. The knowledge of the PHCP was good in some aspects about NHB; however, it was poor and may be even hazardous in other aspects.
Conclusions: Many areas of defects are detected in PHCP knowledge about NHB. Pre-service and continuous training of the PHCP about the diagnosis and management of NHB are essential.
{"title":"Knowledge of Neonatal Hyperbilirubinemia Among Primary Health Care Physicians: A Single-Center Experience.","authors":"Mostafa A Mostafa, Naglaa M Kamal, Sherif Eltaher, Yahia Hamed, Hany Abdelaziz, Walid Abdelghany, Efat Aser, Eman Fawzy, Laila M Sherief","doi":"10.1177/1179556518824375","DOIUrl":"https://doi.org/10.1177/1179556518824375","url":null,"abstract":"<p><strong>Background and objectives: </strong>To evaluate the knowledge of the primary health care physicians (PHCP) in Kalubia governorate, Egypt, about the causes, diagnosis, complications, and treatment of neonatal hyperbilirubinemia (NHB).</p><p><strong>Methods: </strong>Cross-sectional survey distributed by interview to 500 physicians working in the primary health care (PHC) sector in Kalubia.</p><p><strong>Results: </strong>Out of 500 distributed surveys, 419 (84%) PHCP completed the questionnaire. They represent 174 (90%) out of 193 PHC units and centers. About 18% were males and 82% females with mean age of 28.5 ± 5.2 years, and mean duration of work was 3.3 ± 4.4 years. All of the respondents have patients with NHB in their daily practice. The knowledge of the PHCP was good in some aspects about NHB; however, it was poor and may be even hazardous in other aspects.</p><p><strong>Conclusions: </strong>Many areas of defects are detected in PHCP knowledge about NHB. Pre-service and continuous training of the PHCP about the diagnosis and management of NHB are essential.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2019-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179556518824375","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37041023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-20eCollection Date: 2019-01-01DOI: 10.1177/1179556518824362
Jill Landsbaugh Kaar, Katherine A Sauder, Allison Lb Shapiro, Anne P Starling, Brandy M Ringham, Susan L Johnson, Dana Dabelea
Background: To describe infant feeding practices among a diverse group of mother-offspring pairs and identify factors associated with adherence to the American Academy of Pediatrics (AAP) recommendations.
Methods: Data were analyzed from 835 mother-offspring dyads in The Healthy Start Study, an ongoing longitudinal prebirth cohort in Denver, Colorado. Maternal report of infant feeding practices was obtained at 4 to 6 months and 18 to 24 months postnatally. Practices were classified according to the following AAP recommendations: exclusive breastfeeding for first 6 months, continued breastfeeding through 12 months, and introduction of solid foods around 6 months of age. Participants who met all 3 recommendations were categorized as "adherent." All others were categorized as "not adherent."
Results: About 77% of dyads did not adhere fully to the AAP recommendations. Women who worked ⩾35 hours/week or had a higher prepregnancy body mass index were more likely to be nonadherent. Women who were older, college educated, or had offspring with greater weight for gestational age at birth were less likely to be nonadherent.
Conclusions: Most of the women in a large contemporary cohort are not adhering to AAP infant feeding recommendations. Our results highlight the specific subgroups of women who may need additional support to optimize infant feeding practices.
{"title":"Infant Feeding Practices In a Diverse Group of Women: The Healthy Start Study.","authors":"Jill Landsbaugh Kaar, Katherine A Sauder, Allison Lb Shapiro, Anne P Starling, Brandy M Ringham, Susan L Johnson, Dana Dabelea","doi":"10.1177/1179556518824362","DOIUrl":"https://doi.org/10.1177/1179556518824362","url":null,"abstract":"<p><strong>Background: </strong>To describe infant feeding practices among a diverse group of mother-offspring pairs and identify factors associated with adherence to the American Academy of Pediatrics (AAP) recommendations.</p><p><strong>Methods: </strong>Data were analyzed from 835 mother-offspring dyads in The Healthy Start Study, an ongoing longitudinal prebirth cohort in Denver, Colorado. Maternal report of infant feeding practices was obtained at 4 to 6 months and 18 to 24 months postnatally. Practices were classified according to the following AAP recommendations: exclusive breastfeeding for first 6 months, continued breastfeeding through 12 months, and introduction of solid foods around 6 months of age. Participants who met all 3 recommendations were categorized as \"adherent.\" All others were categorized as \"not adherent.\"</p><p><strong>Results: </strong>About 77% of dyads did not adhere fully to the AAP recommendations. Women who worked ⩾35 hours/week or had a higher prepregnancy body mass index were more likely to be nonadherent. Women who were older, college educated, or had offspring with greater weight for gestational age at birth were less likely to be nonadherent.</p><p><strong>Conclusions: </strong>Most of the women in a large contemporary cohort are not adhering to AAP infant feeding recommendations. Our results highlight the specific subgroups of women who may need additional support to optimize infant feeding practices.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2019-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179556518824362","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36918130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}