International Journal of Pediatrics最新文献_第4页

Does Therapeutic Zinc Level of Supplementation for Diminutions of Acute Diarrheal Morbidity Varied in Public and Private Health Institutions in Ethiopia, Data from EDHS 2016? EDHS 2016的数据显示，埃塞俄比亚公立和私立卫生机构在治疗性补充锌水平以降低急性腹泻发病率方面存在差异吗?

IF 2.1 Q3 PEDIATRICS

International Journal of Pediatrics

Pub Date : 2022-08-05 eCollection Date: 2022-01-01 DOI: 10.1155/2022/9975917

Fassikaw Kebede, Merkineh Markos

Background: Supplementation of zinc is a therapeutic medication for under-five children diminution incidence, severity, duration, and intensity of acute diarrhea morbidity. Nevertheless, levels of therapeutic zinc supplementation varied across public and private health institutions in Ethiopia. Thus, this study was aimed at estimating the levels of therapeutic zinc supplementation and factors associated for intent to be utilized among caregivers with their dyads, data from Ethiopia Demographic and Health Survey (EDHS 2016).

Methods: The data used were from a secondary analysis of the Ethiopia Demographic and Health Survey in 2016 (EDHS). Overall, 1090 under-five children with acute diarrheal cases of two weeks before the EDHS 2016 were included. After cleaning, editing, and coding variables, the result was presented with frequency, tables, and graphs. Bivariable and multivariable logistic regression was conducted to identify and determine factors associated after zinc is prescribed for utilizations by caregivers.

Result: The mean (±SD) age of participant children was found to be 36.4(±7.07) month. The overall levels of therapeutic zinc supplementation were 38.7% (95% CI: 35.8, 41.6) in public (29.08%) and private 138 (12.66%), respectively. The prescribed therapeutic zinc was influenced for utilization through maternal educational status (AOR = 2.55; 95% CI: 1.95, 3.47; P = 0.001), availability of health insurance (AOR = 10.7; 95% CI: 7.2, 16; P = 0.001), media exposure status (AOR = 2.1; 95% CI: 1.7, 3.6; P = 0.001).

Conclusion: More than twofold time therapeutic zinc was prescribed in public than in private health institutions. Health care workers should be encouraged both in public and private health institutions for zinc prescription.

背景:补充锌是一种治疗药物，可降低5岁以下儿童急性腹泻发病率、严重程度、持续时间和强度。然而，埃塞俄比亚公立和私立卫生机构的治疗性补锌水平各不相同。因此，本研究的目的是估计治疗性锌补充剂的水平，以及与护理人员和他们的夫妇使用意图相关的因素，数据来自埃塞俄比亚人口与健康调查(EDHS 2016)。方法:使用的数据来自2016年埃塞俄比亚人口与健康调查(EDHS)的二次分析。总体而言，纳入了2016年EDHS前两周发生急性腹泻病例的1090名五岁以下儿童。在清理、编辑和编码变量之后，结果显示为频率、表格和图形。进行了双变量和多变量逻辑回归，以确定护理人员服用锌后的相关因素。结果:患儿平均(±SD)年龄为36.4(±7.07)个月。公共(29.08%)和私人(12.66%)的治疗性锌补充总体水平分别为38.7% (95% CI: 35.8, 41.6)。母亲受教育程度影响锌的使用(AOR = 2.55;95% ci: 1.95, 3.47;P = 0.001)，健康保险的可获得性(AOR = 10.7;95% ci: 7.2, 16;P = 0.001)、媒介暴露状况(AOR = 2.1;95% ci: 1.7, 3.6;P = 0.001)。结论:公立卫生机构的治疗性锌处方是私立卫生机构的两倍以上。应鼓励卫生保健工作者在公立和私立卫生机构开具锌处方。

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引用次数: 1

Is Early Preventive Caffeine Safe and Effective in Premature Neonates? A Clinical Trial 早期预防性咖啡因对早产新生儿安全有效吗？临床试验

IF 2.1 Q3 PEDIATRICS

International Journal of Pediatrics

Pub Date : 2022-06-02 DOI: 10.1155/2022/8701598

N. Sajjadian, P. Taheri, Mahboobeh Jabbari

Background Advantages of caffeine for the treatment of apnea of prematurity (AOP) have prompted clinicians to use it as a preventive drug even before the occurrence of apnea. Objective To compare the effect of early preventive caffeine therapy with routine late preventive caffeine on the occurrence rate of apnea of prematurity, bronchopulmonary dysplasia (BPD) and related radiographic changes, necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), and patent ductus arteriosus (PDA), the need for mechanical ventilation, the length of mechanical ventilation, and the length of hospitalization. Materials and Methods In this open randomized clinical trial study, 90 preterm neonates with the gestational age of 25-35 weeks were divided into 2 groups: group A received caffeine during the first two days of life (early preventive caffeine), while group B received caffeine during the third to the tenth day of life (late preventive caffeine). The occurrence rate of AOP and other outcomes were the primary outcomes. The adverse effects of caffeine in each group were the secondary outcomes. Results The total occurrence rate of AOP was significantly higher (32.6%) in the late group versus (6.8%) in the early group (p = 0.002). The total occurrence rate of BPD was also significantly higher (37%) in the late group versus (18.2%) in the early group (p = 0.047). On the other hand, we found a lower need for mechanical ventilation, shorter length of mechanical ventilation, shorter length of hospitalization, and a lower occurrence rate of PDA, NEC, and IVH in the early group that was not significant. No adverse effect of caffeine was observed in each group. Conclusions Early preventive caffeine administration was associated with a significantly lower occurrence rate of AOP, BPD, and BPD radiologic changes. As other outcomes occurred lesser in the early group that were not significant, future studies with more participants are recommended. This study has been registered at the Iranian Registry of Clinical Trials (IRCT20160827029535N8).

咖啡因治疗早产儿呼吸暂停(AOP)的优势促使临床医生甚至在呼吸暂停发生之前就将其作为预防药物使用。目的比较早期预防性咖啡因治疗与常规晚期预防性咖啡因治疗对早产儿呼吸暂停、支气管肺发育不良(BPD)及相关影像学改变、坏死性小肠结肠炎(NEC)、脑室内出血(IVH)、动脉导管未闭(PDA)发生率、机械通气需求、机械通气时间及住院时间的影响。材料与方法90例胎龄在25 ~ 35周的早产儿随机临床试验，将其分为两组:A组在出生后2天摄入咖啡因(早期预防性咖啡因)，B组在出生后3 ~ 10天摄入咖啡因(晚期预防性咖啡因)。AOP的发生率及其他指标为主要观察指标。咖啡因对各组的不良影响是次要结果。结果晚期组AOP总发生率(32.6%)明显高于早期组(6.8%)(p = 0.002)。晚期组BPD总发生率(37%)明显高于早期组(18.2%)(p = 0.047)。另一方面，我们发现早期组机械通气需求较低，机械通气时间较短，住院时间较短，PDA、NEC、IVH发生率较低，但差异不显著。在各组中均未观察到咖啡因的不良反应。结论早期预防性服用咖啡因可显著降低AOP、BPD和BPD影像学改变的发生率。由于其他结果在早期组中较少发生，但不显著，因此建议未来研究更多的参与者。本研究已在伊朗临床试验登记处注册(IRCT20160827029535N8)。

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引用次数: 1

C-Reactive Protein Levels in Children with Acute Bronchiolitis 急性毛细支气管炎患儿的c反应蛋白水平

IF 2.1 Q3 PEDIATRICS

International Journal of Pediatrics

Pub Date : 2022-05-23 DOI: 10.1155/2022/1311936

H. Isa, Abdulrahman D. Mohroofi, Fatema N Alkhan, Asma Z Hasan, M. Alkubisi, Sana S Alhewaizem, Sara I Khalifa, Noora G. Alromaihi

Results Of 287 patients, 229 (79.2%) were included. 132 (57.6%) were males. Median presentation age was 3.7 (interquartile range (IQR), 1.27-12.33) months. Median CRP level was 10.4 (IQR, 2.8-35.1) mg/L. CRP was high in 167 (72.9%) patients. 17.6% (33/187 patients) had confirmed bacterial coinfection. Respiratory syncytial virus (RSV) was detected in 84 (36.7%) patients. Mean CRP level was higher in RSV-negative compared to RSV-positive patients, 31.3 ± 44.3 versus 21.5 ± 27.7 mg/L, respectively (P = 0.042). Respiratory viral serology profile was positive in 34.7% (17/49 patients). 66.9% (107/160 patients) had positive chest X-ray. Antibiotics were used in 78.1% (179/227 patients). Thirteen (5.7%) patients required intensive care, five (2.2%) had surgical intervention, four (1.8%) required endotracheal intubation, and four (1.8%) died. Patients with high CRP were older at presentation (P < 0.0001) and had more fever (P < 0.0001) and cough (P = 0.002), but lower hemoglobin level (P < 0.0001) compared to those with normal CRP. Fever (P = 0.016) and hemoglobin level (P = 0.002) were independent factors. Conclusion Most children with acute bronchiolitis had high rate of elevated CRP values that did not correlate with the rate of bacterial coinfection. High CRP levels were found in older children, those presented with more fever and cough, and had a lower hemoglobin level despite that those factors were previously reported to be associated with disease severity and bacterial coinfection. This study also showed a high overall rate of antibiotic prescriptions in mostly viral disease.

结果287例患者中，229例（79.2%）被纳入。男性132例（57.6%）。中位呈现年龄为3.7个月（四分位间距（IQR），1.27-12.33）。中位CRP水平为10.4（IQR，2.8-35.1）mg/L。167例（72.9%）患者CRP升高。17.6%（33/187名患者）已证实细菌合并感染。在84例（36.7%）患者中检测到呼吸道合胞病毒（RSV）。RSV阴性患者的平均CRP水平高于RSV阳性患者，分别为31.3±44.3和21.5±27.7 呼吸道病毒血清学阳性率为34.7%（17/49例）。66.9%（107/160例）胸部X线片阳性。78.1%（179/227名患者）使用了抗生素。13名（5.7%）患者需要重症监护，5名（2.2%）患者进行了手术干预，4名（1.8%）患者需要气管插管，4名患者（1.8%）死亡。与CRP正常的患者相比，CRP高的患者年龄较大（P＜0.0001），发烧（P＜0.001）和咳嗽（P＝0.002）较多，但血红蛋白水平较低（P＜0.01）。发热（P=0.016）和血红蛋白水平（P=0.002）是独立因素。结论大多数急性毛细支气管炎患儿的CRP值升高率较高，与细菌合并感染率无关。在年龄较大的儿童中发现了高CRP水平，这些儿童发烧和咳嗽较多，血红蛋白水平较低，尽管这些因素以前被报道与疾病严重程度和细菌合并感染有关。这项研究还表明，在大多数病毒性疾病中，抗生素处方的总体使用率很高。

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引用次数: 5

Role of Adenotonsillectomy and Tonsillectomy in Children with Down Syndrome Who Develop Obstructive Sleep Apnea by Obesity as a Risk Factor 腺扁桃体切除术和扁桃体切除术在唐氏综合症儿童因肥胖而发展为阻塞性睡眠呼吸暂停的危险因素中的作用

IF 2.1 Q3 PEDIATRICS

International Journal of Pediatrics

Pub Date : 2022-05-06 DOI: 10.1155/2022/8074094

Imran Ali Khan

Down syndrome (DS) or trisomy 21 is caused due to the presence of additional chromosome 21 in humans. DS can exist either as free trisomy 21 (nondisjunction), Robertsonian translocated DS, or as mosaic DS. Obstructive sleep apnea (OSA) is a complex condition with serious health implications for pediatric individuals with DS. OSA is common in DS, and when it is present, it appears to be extreme. Obesity and snoring are some of the OSA risk factors for children associated with DS and OSA. Adenotonsillectomy is one of the surgical protocols applied in children, which is useful in lowering the OSA in which obesity is commonly connected within normal and DS children. Tonsillectomy is the alternative procedure of surgery connected with postoperative respiratory complications, and adenotonsillectomy was found to be a safe surgical method in children and improves the quality of life. The main aim of this review is to bridge the gap between the role of OSA in normal children (46, XX/XY) and DS children (47, XX/XY+21) characterized by the presence of chromosomes and exactly what is the involvement with adenotonsillectomy and tonsillectomy when obesity is a risk factor. The treatment for OSA and obesity is rehabilitative and reversible; however, DS can be managed but not resolved because the disorder occurs from the existence of an extra chromosome during the failure of homologous chromosomal pairing separation during maternal meiosis I. This review concludes that there is a treatment for OSA and obesity and that DS children can be prevented from being obese or experiencing OSA but cannot be turned to normal chromosomes due to an extra trisomy 21. According to this review, children with DS and OSA/OSAS, as well as concomitant complications, can be treated.

唐氏综合症(DS)或21三体是由于人类存在额外的21号染色体而引起的。它可以以游离21三体(非分离型)、罗伯逊易位型或镶嵌型三体存在。阻塞性睡眠呼吸暂停(OSA)是一种复杂的疾病，严重影响儿童DS患者的健康。阻塞性睡眠呼吸暂停在退行性痴呆中很常见，当它出现时，它似乎是极端的。肥胖和打鼾是与DS和OSA相关的儿童的一些OSA危险因素。腺扁桃体切除术是一种适用于儿童的手术方案，它有助于降低OSA，其中肥胖通常与正常和DS儿童有关。扁桃体切除术是与术后呼吸系统并发症相关的另一种手术方式，腺扁桃体切除术是一种安全的儿童手术方法，可提高生活质量。本综述的主要目的是弥合OSA在正常儿童(46,XX/XY)和以染色体存在为特征的DS儿童(47,XX/XY+21)中的作用之间的差距，以及当肥胖是一个危险因素时，腺扁桃体切除术和扁桃体切除术究竟涉及什么。阻塞性睡眠呼吸暂停和肥胖的治疗是康复和可逆的;然而，由于在母体减数分裂过程中同源染色体配对分离失败时存在一条额外的染色体，DS可以得到控制，但无法解决。本综述认为，存在一种治疗OSA和肥胖的方法，DS儿童可以防止肥胖或经历OSA，但由于额外的21三体而不能转向正常染色体。根据这篇综述，患有DS和OSA/OSAS的儿童以及伴随的并发症是可以治疗的。

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引用次数: 4

Comparison of Airway Pressure Release Ventilation to High-Frequency Oscillatory Ventilation in Neonates with Refractory Respiratory Failure 难治性呼吸衰竭新生儿气道压力释放通气与高频振荡通气的比较

IF 2.1 Q3 PEDIATRICS

International Journal of Pediatrics

Pub Date : 2022-05-02 DOI: 10.1155/2022/7864280

Shreyas Arya, Melissa L. Kingma, Stacey Dornette, A. Weber, Cathy Bardua, Sarah Mierke, P. Kingma

Background Airway pressure release ventilation (APRV) is a relatively new mode of ventilation in neonates. We hypothesize that APRV is an effective rescue mode in infants failing conventional ventilation and it is comparable in survival rates to rescue with high-frequency oscillatory ventilation (HFOV). Methods This is a 6-year retrospective cohort study of infants that failed synchronized intermittent mandatory ventilation (SIMV) and were rescued with either APRV or HFOV. For comparison, we divided infants into two groups (28-37 and >37 weeks) based on their corrected gestational age (CGA) at failure of SIMV. Results Ninety infants were included in the study. Infants rescued with APRV (n = 46) had similar survival rates to those rescued with HFOV (n = 44)—28-37 weeks CGA (APRV 78% vs. HFOV 84%, p = 0.68) and >37 weeks CGA (APRV 76% vs. HFOV 72%, p = 0.74). Use of APRV was not associated with an increase in pneumothorax (APRV 0% and HFOV 10%, p = 0.31, in 28-37 weeks CGA, and APRV 0% and HFOV 4%, p = 0.22, in >37 weeks CGA). Conclusion APRV can be effectively used to rescue infants with refractory respiratory failure on SIMV. When compared to HFOV, rescue with APRV is not associated with an increase in mortality or pneumothorax.

背景气道压力释放通气（APRV）是新生儿一种相对较新的通气方式。我们假设APRV是常规通气失败婴儿的有效抢救模式，其存活率与高频振荡通气（HFOV）的抢救率相当。方法这是一项6年的回顾性队列研究，研究了同步间歇强制通气（SIMV）失败并用APRV或HFOV抢救的婴儿。为了进行比较，我们根据SIMV失败时的校正胎龄（CGA）将婴儿分为两组（28-37周和>37周）。结果90名婴儿被纳入研究。使用APRV抢救的婴儿（n=46）的存活率与使用HFOV抢救的婴儿相似（n=44）——28-37周CGA（APRV 78%对HFOV 84%，p=0.68）和>37周CGA）（APRV 76%对HFOV72%，p=0.74）。使用APRV与肺气肿的增加无关（在28-37周的CGA中，APRV 0%和HFOV 10%，p=0.31，在>37周的CGA。结论APRV可有效抢救SIMV上的难治性呼吸衰竭患儿。与HFOV相比，APRV抢救与死亡率或肺气肿的增加无关。

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引用次数: 0

Indications and Yield of Pediatric Endoscopy in Bahrain: A Tertiary Center Experience 巴林儿童内窥镜的适应症和疗效：三级中心的经验

IF 2.1 Q3 PEDIATRICS

International Journal of Pediatrics

Pub Date : 2022-03-26 DOI: 10.1155/2022/6836842

H. Isa, Fatema N Alfayez

Results Of 1,111 patients, 1,101 (99.1%) were included in the study. 589 (53.6%) patients were males. Median age at the time of endoscopy was 8 (interquartile range 3, 11) years. 1534 endoscopies were performed (1193 upper GI endoscopies (UGIE) and 341 colonoscopies) in 1296 sessions. The mean number of endoscopies per year was 59 ± 30.9 procedures with 81.4% reduction noted after coronavirus pandemic (P < 0.0001). Ratio between UGIE to colonoscopy was 3.5 : 1. Median number of endoscopies per patient was one, ranging from one to eight procedures. 1153 (89%) sessions were diagnostic, and 143 (11.0%) were therapeutic. Main endoscopic indication was chronic abdominal pain (451 (40.9%) patients) followed by upper GI bleeding (302 (27.4%) patients). Overall positive yield was 68.1% (716/1052 procedures). Endoscopic yield varies according to the type of procedure (P = 0.003). Colonoscopy alone gave a higher yield (82.6%, 38/46 procedures) compared to combined procedures (75.4%, 141/187) and UGIE alone (65.6%, 537/819). Conclusions This study emphasizes a careful selection of the type of endoscopic procedures, based on the expected endoscopic yield, to diagnose and treat pediatric GI diseases. In patients with chronic abdominal pain, endoscopy should be reserved as a second-line tool to avoid unnecessary use of invasive procedures.

结果1111例患者中，1101例（99.1%）纳入本研究。589例（53.6%）患者为男性。内窥镜检查时的中位年龄为8岁（四分位间距3/11）。在1296个疗程中进行了1534次内镜检查（1193次上消化道内镜检查（UGIE）和341次结肠镜检查）。每年的平均内镜检查次数为59±30.9次，在冠状病毒大流行后减少了81.4%（P<0.0001）。UGIE与结肠镜检查的比率为3.5 : 1.每位患者的内镜检查中位数为1次，从1次到8次不等。1153个疗程（89%）为诊断性疗程，143个疗程（11.0%）为治疗性疗程。主要内镜指征是慢性腹痛（451名（40.9%）患者），其次是上消化道出血（302名（27.4%）患者）。总阳性率为68.1%（716/1052次手术）。内窥镜检查的产率因手术类型而异（P=0.003）。与联合手术（75.4%，141/187）和单独的UGIE（65.6%，537/819）相比，单独的结肠镜检查的产量更高（82.6%，38/46）。结论本研究强调根据预期的内镜效果，仔细选择内镜手术类型，以诊断和治疗儿童胃肠道疾病。对于慢性腹痛患者，应保留内镜作为二线工具，以避免不必要地使用侵入性手术。

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引用次数: 2

Effects of Phototherapy on the Serum Magnesium Level in Neonates with Indirect Hyperbilirubinemia: A Prospective Cohort Study 光疗对间接高胆红素血症新生儿血清镁水平的影响:一项前瞻性队列研究

IF 2.1 Q3 PEDIATRICS

International Journal of Pediatrics

Pub Date : 2022-03-22 DOI: 10.1155/2022/5439630

F. Eghbalian, S. Shabani, J. Faradmal, E. Jenabi

Objectives Neonatal jaundice or hyperbilirubinemia is one of the common findings in neonatal medicine. Severe disease can cause neurological damage and even Kernicterus. Magnesium ion is the most important N-methyl-D-aspartate receptor antagonist. The most commonly used treatment for jaundice is phototherapy, but the effect of phototherapy on serum magnesium is less investigated. In this study, we aim to investigate the effects of phototherapy on total serum magnesium levels in icteric neonates. Methods This prospective cohort study was carried out on 160 neonates with jaundice referring to the Besat Hospital of Hamadan. Based on the bilirubin level, newborns were divided into three subgroups of mild, moderate, and severe disease which were subjected to single, double, and intensive phototherapy, respectively. Serum bilirubin and magnesium levels were measured before and after phototherapy and compared using parametric tests. Results Subjects have a mean intrauterine age of 38.8 weeks and a jaundice onset age of 3.8 days. In all groups, serum magnesium levels were within the normal range before phototherapy. After phototherapy, on the other hand, the most reduction of total serum magnesium was in the double phototherapy group, which was −0.13 ± 0.42 mg/dl (P = 0.018). The change in serum magnesium level was not significant in the single phototherapy (−0.02 ± 0.25) and intensive phototherapy (−13.55 ± 2.73) groups (P > 0.05). Conclusion In the present study, serum magnesium did not increase significantly before the treatment in three groups. After treatment, a significant reduction was seen in the double phototherapy group.

目的新生儿黄疸或高胆红素血症是新生儿医学的常见表现之一。严重的疾病会导致神经损伤甚至是核黄疸。镁离子是最重要的n -甲基- d -天冬氨酸受体拮抗剂。黄疸最常用的治疗方法是光疗，但光疗对血清镁的影响研究较少。在本研究中，我们旨在探讨光疗对黄疸新生儿血清总镁水平的影响。方法对在哈马丹市Besat医院就诊的160例黄疸新生儿进行前瞻性队列研究。根据胆红素水平将新生儿分为轻、中、重度三个亚组，分别进行单次、双次和强化光疗。测定光疗前后血清胆红素和镁水平，并用参数检验进行比较。结果受试者的平均宫内年龄为38.8周，黄疸发病年龄为3.8天。光疗前各组血清镁水平均在正常范围内。光疗后，双光疗组血清总镁降低幅度最大，为- 0.13±0.42 mg/dl (P = 0.018)。单光疗组(- 0.02±0.25)和强化光疗组(- 13.55±2.73)血清镁水平变化无统计学意义(P < 0.05)。结论三组患者治疗前血清镁含量均无明显升高。治疗后，双光治疗组明显减少。

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引用次数: 0

Effect of Massage Therapy for the Treatment of Neonatal Jaundice: A Systematic Review and Dose-Response Meta-analysis 推拿治疗新生儿黄疸疗效的系统评价及剂量反应Meta分析

IF 2.1 Q3 PEDIATRICS

International Journal of Pediatrics

Pub Date : 2022-03-20 DOI: 10.1155/2022/9161074

Marjan Shahbazi, S. Khazaei, Samad Moslehi, F. Shahbazi

Background The effectiveness of massage therapy in the treatment of neonatal jaundice has been established in previous literature, but how much the level of massage can reduce the mean of bilirubin in neonates with jaundice is a question that has been addressed in this review. Methods Four electronic databases, including Cochrane, PubMed, Scopus, and Web of Science, were searched for relevant literature. For the dose-response association between massage therapy and treatment of neonatal icterus, we conducted a meta-analysis using the random-effects model. For any level of intervention, we calculated the overall mean difference (MD) with 95% confidence intervals (CI). Results Twenty studies were included in our meta-analysis. There was a positive and significant increasing dose-response trend between massage therapy and the mean reduction of bilirubin in neonates with hyperbilirubinemia as follows: <50 minutes massage during the experiment -0.36 (95% CI: -0.67, -0.06; I2 = 66%), 50-60 minutes massage during the experiment -0.41 (95% CI: -0.95, 0.13; I2 = 84%), and ≥101 minutes massage during the experiment -1.20 (95% CI: -1.63, -0.78; I2 = 83%). The heterogeneity across studies was mild to moderate. Conclusions The presence of a dose-response relationship favors the causal relationship between massage therapy and reduction of neonatal jaundice.

背景推拿疗法治疗新生儿黄疸的有效性已在以往文献中得到证实，但推拿水平能在多大程度上降低新生儿黄疸胆红素的平均值是本综述探讨的问题。方法检索Cochrane、PubMed、Scopus、Web of Science 4个电子数据库的相关文献。对于按摩疗法与新生儿黄疸治疗之间的剂量-反应相关性，我们使用随机效应模型进行了荟萃分析。对于任何水平的干预，我们以95%置信区间(CI)计算总平均差(MD)。结果20项研究被纳入meta分析。按摩治疗与高胆红素血症新生儿平均胆红素降低呈显著正相关增加趋势:实验期间按摩<50分钟-0.36 (95% CI: -0.67， -0.06;I2 = 66%)，实验期间按摩50-60分钟-0.41 (95% CI: -0.95, 0.13;I2 = 84%)，实验期间按摩≥101分钟-1.20 (95% CI: -1.63， -0.78;I2 = 83%)。各研究的异质性为轻度至中度。结论推拿治疗与新生儿黄疸的减少存在一定的量效关系。

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引用次数: 3

Analysis of Fluid Balance as Predictor of Length of Assisted Mechanical Ventilation in Children Admitted to Pediatric Intensive Care Unit (PICU) 小儿重症监护病房(PICU)患儿液体平衡预测辅助机械通气时间的分析

IF 2.1 Q3 PEDIATRICS

International Journal of Pediatrics

Pub Date : 2022-03-20 DOI: 10.1155/2022/2090323

Praveen Unki, S. Save

Background Ventilator-associated lung injury (VALI) is a devastating complication of assisted mechanical ventilation (AMV) and is one of the root causes of prolonged AMV. Many strategies were made to decrease the effect of the same. This study is conducted to determine the association of prolonged AMV with fluid balance and pediatric index of mortality 2 (PIM2) score. Methods This prospective observational study was carried out in a PICU of a tertiary care centre over a period of 12 months. Patient's fluid balance was calculated by tabulating fluid input-output over initial 48 hours of AMV. The PIM2 score on admission was documented. The association between qualitative variables was assessed by a chi-square test. Comparison of quantitative data measured between cases with duration of AMV ≥ 7 days and <7 days was done using the Mann–Whitney U test. Correlation between quantitative data was done by using the Pearson product moment correlation. Results Out of 40 patients, 27 patients who had ≥15% positive fluid balance required prolonged mechanical ventilation. Similarly, 27 patients with PIM2 score ≥ 5 required prolonged AMV. On applying the Pearson chi-square test, we found a significant association between positive fluid balance and prolonged mechanical ventilation (P value = 2.25 × 10−7 (<0.05)). Likewise, a statistically significant association was found between PIM2 score and prolonged ventilation (P value = 1.19 × 10−5 (<0.05)). Conclusion There is a significant association of prolonged AMV with positive fluid balance (>15%) and PIM2 score (>5). By strict maintenance of fluid balance with appropriate intervention, the length of AMV and PICU stay can be decreased.

背景呼吸机相关性肺损伤（VALI）是辅助机械通气（AMV）的一种破坏性并发症，也是AMV延长的根本原因之一。采取了许多策略来减少同样的影响。本研究旨在确定AMV延长与液体平衡和儿童死亡率指数2（PIM2）评分的关系。方法这项前瞻性观察性研究在一家三级护理中心的PICU进行，为期12个月。患者的液体平衡是通过将AMV最初48小时内的液体输入输出制表来计算的。记录入院时的PIM2评分。定性变量之间的相关性通过卡方检验进行评估。AMV持续时间≥7的病例之间测量的定量数据的比较天和15%）和PIM2评分（＞5）。通过严格保持液体平衡并进行适当干预，可以缩短AMV和PICU的停留时间。

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引用次数: 0

The Effectiveness of Synbiotic on the Improvement of Clinical Symptoms in Children with Eosinophilic Esophagitis 合生菌改善儿童嗜酸性食管炎临床症状的疗效观察

IF 2.1 Q3 PEDIATRICS

International Journal of Pediatrics

Pub Date : 2022-03-07 DOI: 10.1155/2022/4211626

N. Amini, M. Khademian, Tooba Momen, H. Saneian, Peiman Nasri, F. Famouri, Giti Ebrahimi

Background Eosinophilic esophagitis (EoE) is an allergic inflammatory disorder of the esophagus. Today, probiotics are included as adjuvant therapy in the treatment of allergic diseases. The aim of this study was to assess the effect of synbiotic on clinical symptom improvement in EoE patients. Methods This study is designed by a double-blind, placebo-controlled clinical trial with two parallel groups, which was performed on 30 children with eosinophilic esophagitis. All participants were children aged 6 months to 15 years. Both groups received the same treatment (elimination diet, topical steroid, and proton pump inhibitor). A synbiotic (KidiLact) was added to the medication regimen of 15 patients (case), while the next 15 patients received a placebo (control). Severity and frequency of symptoms were assessed with a checklist derived from a validated scoring tool in both groups before and after 8 weeks of treatment. Results There was a significant reduction in the severity score of chest pain and poor appetite (P value < 0.05) in the case group taking probiotics, while nausea and poor appetite were the only symptoms with a significant reduction in the frequency score after intervention in this group. Conclusion Probiotics can be used as adjuvant treatment for patients with EoE. Improvement in the severity of chest pain and poor appetite and reduction in the frequency of nausea and poor appetite in these patients can be seen.

背景嗜酸性食管炎(EoE)是一种食道的过敏性炎症性疾病。如今，益生菌已被纳入过敏性疾病的辅助治疗。本研究的目的是评估合生菌对EoE患者临床症状改善的影响。方法本研究采用双盲、安慰剂对照的临床试验，分为两个平行组，对30例嗜酸性粒细胞性食管炎患儿进行研究。所有参与者都是6个月至15岁的儿童。两组接受相同的治疗(消除饮食，局部类固醇和质子泵抑制剂)。15名患者(病例)在药物治疗方案中加入了一种合成药物(KidiLact)，而接下来的15名患者接受安慰剂(对照组)。在治疗前和治疗8周后，用一种经过验证的评分工具生成的检查表对两组患者的症状严重程度和频率进行评估。结果服用益生菌的病例组胸痛和食欲不良严重程度评分显著降低(P值< 0.05)，而恶心和食欲不良是本组干预后唯一频率评分显著降低的症状。结论益生菌可作为EoE患者的辅助治疗。这些患者胸痛和食欲差的严重程度有所改善，恶心和食欲差的频率有所减少。

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引用次数: 1