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Brief review: Psychological health and life quality of cerebral palsy 浅谈脑瘫患者的心理健康与生活质量
Pub Date : 2022-04-20 DOI: 10.25082/tcpp.2022.01.001
N. Bhatt, Jesse Canella, J. P. Gentile
Cerebral palsy is the most common cause of disability that develops in infancy. This complex disorder affects adult life in a powerful way. Challenges include performing motor skills and achieving physical capabilities. The majority of individuals also report lifelong psychosocial stressors. Furthermore, mental health issues occur more commonly in this patient subset, as do struggles with employment and education. Often the severity of challenges correlates to the severity of the cerebral palsy. The prognosis of individuals with cerebral palsy has improved over the last three decades, although it continues to be a lifelong condition. In order to promote healthy aging across their lifespan, intervention programs should be considered to improve physical well-being, and care should be taken to maintain mental health.
脑瘫是婴儿期最常见的致残原因。这种复杂的疾病严重影响着成年人的生活。挑战包括执行运动技能和实现身体能力。大多数人还报告了终身的社会心理压力源。此外,心理健康问题在这一患者群体中更为常见,就业和教育方面的困难也是如此。挑战的严重程度通常与脑瘫的严重程度相关。脑瘫患者的预后在过去三十年中有所改善,尽管它仍然是一种终身疾病。为了在他们的一生中促进健康的老龄化,应该考虑干预方案来改善身体健康,并注意保持心理健康。
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引用次数: 0
Impact of feeding practices on nutritional status of infants aged 12 to 23 months in Lubumbashi, DRC: A community based cross-sectional study 喂养方式对刚果民主共和国卢本巴希12至23个月婴儿营养状况的影响:一项基于社区的横断面研究
Pub Date : 2022-01-01 DOI: 10.25082/tcpp.2022.01.002
Carrel Zalula Mavuta, A. Mutombo, T. Lubala, O. Mukuku, A. Nyenga, M. Shongo, M. S. Kabuya, Assumani N’Simbo, Aimée Mudekereza, O. Luboya, S. Wembonyama
Purpose: In the Democratic Republic of the Congo (DRC), malnutrition remains a public health problem despite interventions to improve the nutritional status of children. The objective of this study is to determine the degree of association between dietary practices and malnutrition among infants aged 12 to 23 months in Lubumbashi (DRC). Methods: We conducted a community-based cross-sectional study of 574 infants between 12 and 23 months of age from urban and semi-urban areas. Door to door survey was done to collect data. Nutritional status was assessed and compared with feeding practices. A multivariate analysis was conducted to evaluate the association between dietary practices and malnutrition in these children. Results: Bottle feeding before 6 months (adjusted odds ratio [aOR] = 1.8 [1.2-2.8]; p = 0.006), introduction of solid, semi-solid or soft foods before 6 months (aOR = 2.1 [1.0-4.3]; p = 0.042), and insufficient minimum dietary diversity (aOR=2.3 [1.6-3.5]; p < 0.0001) were independently associated with stunting. Late breastfeeding initiation (aOR = 2.4 [1.1-5.0]; p = 0.023) increases the risk of wasting. Conclusion: Infant malnutrition is sometimes a reflection of inappropriate eating practices from the early stages of a child’s life. Adherence to sufficient nutritional recommendations at birth can reduce this burden in developing countries.
目的:在刚果民主共和国(DRC),尽管采取了改善儿童营养状况的干预措施,但营养不良仍然是一个公共卫生问题。本研究的目的是确定卢本巴希(刚果民主共和国)12至23个月婴儿的饮食习惯与营养不良之间的关联程度。方法:我们对来自城市和半城市地区的574名12至23个月大的婴儿进行了基于社区的横断面研究。为了收集数据,我们进行了挨家挨户的调查。评估营养状况,并与饲养方法进行比较。进行了多变量分析,以评估这些儿童的饮食习惯与营养不良之间的关系。结果:6月龄前奶瓶喂养(调整优势比[aOR] = 1.8 [1.2 ~ 2.8];p = 0.006), 6个月前引入固体、半固体或软质食物(aOR = 2.1 [1.0-4.3];p = 0.042),最低膳食多样性不足(aOR=2.3 [1.6-3.5];P < 0.0001)与发育迟缓独立相关。晚开始母乳喂养(aOR = 2.4 [1.1-5.0];P = 0.023)会增加浪费的风险。结论:婴儿营养不良有时是儿童生命早期不适当饮食习惯的反映。在出生时坚持足够的营养建议可以减轻发展中国家的这一负担。
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引用次数: 0
Risk factors for neonatal sepsis in Lubumbashi, Democratic Republic of Congo: A retrospective case-control study 刚果民主共和国卢本巴希新生儿败血症的危险因素:一项回顾性病例对照研究
Pub Date : 2021-06-18 DOI: 10.26420/AUSTINPEDIATR.2021.1079
Nyenga Am, O. Mukuku, Sun Jz, Assumani An, O. Luboya, W. So
Purpose: Neonatal sepsis (NS) is a major cause of neonatal morbidity and mortality, particularly in developing countries. Delays in the identification and treatment of NS are the main contributors to the high mortality. This study aims to identify risk factors for NS in newborns in the two university hospitals in Lubumbashi, in the Democratic Republic of Congo. Methods: This hospital-based case-control study was carried out on 486 mother-newborn pairs using the systematic sampling method during November 2019 to October 2020. Data were analyzed using STATA software (version 15). Binary and multivariable logistic regression analyses were computed to identify the associated factors at 95% CI. Results: A total of 162 cases and 324 controls were included in this study. Multiple logistic regression analysis showed that the possible risk factors for NS in this study were low level of education (AOR = 9.16 [2.23-37.67]), maternal genitourinary tract infections (AOR = 42.59 [17.90-101.37]), premature rupture of membranes (AOR = 19.95 [7.27-54.76]), peripartum fever (AOR = 26.25 [2.31-297.83]), prolonged labor (AOR = 14.16 [3.88-51.71]), cesarean section (AOR = 3.57 [1.48-8.61]), obstructed vaginal delivery (AOR = 13.40 [1.32-136.19]), birth weight <1500 grams (AOR = 70.38 [8.64-572.95]), and between 1500-2500 grams (AOR = 7.90 [3.04-20.52]). Conclusion: The study found that maternal and neonatal factors were strongly associated with the risk of developing NS. The present study suggests the possibility of routine assessment of sepsis in newborns born with the above characteristics.
目的:新生儿败血症(NS)是新生儿发病率和死亡率的主要原因,尤其是在发展中国家。NS的识别和治疗延误是造成高死亡率的主要原因。本研究旨在确定刚果民主共和国卢本巴希两所大学医院新生儿NS的风险因素。方法:采用系统抽样方法,于2019年11月至2020年10月对486对母婴进行了基于医院的病例对照研究。使用STATA软件(版本15)对数据进行分析。计算二元和多变量逻辑回归分析,以确定95%置信区间的相关因素。结果:本研究共纳入162例病例和324名对照。多元逻辑回归分析显示,本研究中NS的可能危险因素为低教育水平(AOR=9.16[2.23-7.67])、母体泌尿生殖道感染(AOR=42.59[17.90-101.37])、胎膜早破(AOR=19.95[7.27-54.76])、围产期发热(AOR=26.25[2.31-297.83])、分娩时间过长(AOR=14.16[3.88-51.71]),剖宫产(AOR=3.57[1.48-8.61])、阴道分娩受阻(AOR=13.40[1.32-136.19])、出生体重<1500克(AOR=70.38[8.64-572.95])和1500-2500克(AOR=7.90[3.04-2.522])。本研究提示了对具有上述特征的新生儿进行败血症常规评估的可能性。
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引用次数: 0
Sleep as a mediator in the context of emotional problems in adolescents with IBD: A pilot study 睡眠在IBD青少年情绪问题中的中介作用:一项初步研究
Pub Date : 2021-01-01 DOI: 10.25082/tcpp.2021.01.004
Ann-Kristin Manhart, Faculty for Psychology, A. Schlarb
Background: Sleep has an impact on daily life. Particularly among adolescents with IBD, adequate sleep seems to be important, as the disease itself and the associated symptoms can cause distress and impair daytime functioning. However, often parental and youth reports differ regarding perceived sleep problems of adolescents. Besides sleep problems, depression and anxiety are often prominent in young IBD patients. To date, the interplay between sleep, anxiety/depression symptoms and IBD is not fully understood. Therefore, the aim of this study was to (1) evaluate sleep problems in adolescents suffering from IBD, (2) compare adolescents’ sleep quality and impairments according to self- and parental reports, and (3) investigate the interaction between IBD symptomatology, emotional problems and sleep disturbances. Methods: 29 adolescents (age 10 - 22; M = 14.44 , SD = 1.78 ) with IBD and their parents took part in the study. Adolescents and parents completed questionnaires concerning sleep, emotional problems, and IBD symptomatology. Results: Especially overtiredness, insomnia symptoms, and nightmares play a prominent role regarding sleep problems in youths. Self-rated sleep problems and parental ratings were inconsistent, particularly for nightmares (Z = -2.12; p = .034). However, other ratings concerning emotional problems and sleep, especially anxiety and nightmares, were significantly related(r = .426, p = .034), even though we found no mediation effect for the association between IBD, nightmares and anxiety. Discussion: The present study revealed the importance of sleep and emotional well-being for adolescents suffering from IBD. Moreover, it became clear that the role of anxiety in youths suffering from IBD and sleep problems is not sufficiently answered yet. Not only emotional behavior but also sleep should be addressed when diagnosing IBD or during treatment of IBD. In addition, these results show the need for further investigation regarding the differences between parental and self-reports concerning sleep problems in young IBD patients.
背景:睡眠对日常生活有影响。特别是在患有IBD的青少年中,充足的睡眠似乎很重要,因为这种疾病本身及其相关症状会导致痛苦并损害白天的功能。然而,父母和青少年对青少年睡眠问题的看法往往不同。除了睡眠问题,抑郁和焦虑在年轻IBD患者中也很突出。迄今为止,睡眠、焦虑/抑郁症状和IBD之间的相互作用尚未完全了解。因此,本研究的目的是(1)评估IBD青少年的睡眠问题,(2)根据自我报告和父母报告比较青少年的睡眠质量和损害情况,(3)调查IBD症状、情绪问题和睡眠障碍之间的相互作用。方法:29名青少年(10 ~ 22岁;M = 14.44, SD = 1.78)的IBD患者及其父母参与了研究。青少年和父母完成了关于睡眠、情绪问题和IBD症状的问卷调查。结果:过度疲劳、失眠、噩梦是青少年睡眠问题的主要原因。自我评定的睡眠问题和父母评定的睡眠问题不一致,尤其是在噩梦方面(Z = -2.12;P = .034)。然而,其他关于情绪问题和睡眠的评分,特别是焦虑和噩梦,显著相关(r = .426, p = .034),尽管我们没有发现IBD、噩梦和焦虑之间的关联有中介作用。讨论:目前的研究揭示了睡眠和情绪健康对患有IBD的青少年的重要性。此外,很明显,焦虑在患有IBD和睡眠问题的年轻人中的作用还没有得到充分的回答。在诊断IBD或治疗IBD时,不仅要注意情绪行为,还要注意睡眠。此外,这些结果表明,需要进一步调查父母和自我报告的关于年轻IBD患者睡眠问题的差异。
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引用次数: 0
Management of septic arthritis of the pediatric hip 小儿髋关节脓毒性关节炎的处理
Pub Date : 2020-01-01 DOI: 10.25082/tcpp.2021.01.001
J. Hughes, V. Upasani, A. Pennock, J. Bomar, E. Edmonds
Abstract: Purpose The purpose of this study was to compare outcomes and reoperation rate between open and arthroscopic treatment of a suspected isolated septic hip in the pediatric population. Methods Retrospective review was performed on two cohorts of pediatric patients who underwent surgical intervention for suspected isolated septic hip arthritis at a single institution. Patients were subdivided into two cohorts based on whether they underwent an open versus arthroscopic approach. Patients were excluded if they received an initial surgery from an outside institution, did not have an acute, active infection at presentation, defined as a hip aspiration leukocyte count <50,000 cells with <75% neutrophils, had extracaspular pathology or osteomyelitis, or had septic arthritis of a joint other than the hip. Results Fifty-six hips were included [Open group (n = 36); Arthroscopic group (n = 20)]. Six percent (2/36) of hips in the open group and 26% (5/19) of hips in the arthroscopy group had a positive tissue culture (p = 0.041). Eleven hips (31%) underwent postoperative immobilization in the open group compared to one hip (5%) in the arthroscopic group (p = 0.039). Conclusions In the setting of isolated arthritis, arthroscopy is a reasonable treatment modality with no observed additional risk compared to open arthrotomy. However, with concomitant osteomyelitis or soft tissue abscess, open arthrotomy should remain the mainstay approach to address all elements of the infection.Level of Evidence: Level III
摘要:目的本研究的目的是比较开放性和关节镜治疗小儿疑似孤立性脓毒性髋关节的结果和再手术率。方法回顾性分析两组在同一医院因疑似孤立性脓毒性髋关节关节炎接受手术治疗的儿童患者。根据患者是否接受开放或关节镜入路,将患者细分为两组。如果患者接受过外部机构的初始手术,就诊时没有急性活动性感染,定义为髋关节吸入性白细胞计数<50,000细胞,中性粒细胞<75%,有骨外病变或骨髓炎,或髋关节以外的关节脓毒性关节炎,则排除患者。结果共纳入56髋[开放组(n = 36);关节镜组(n = 20)。开放组6%(2/36)髋关节和关节镜组26%(5/19)髋关节组织培养阳性(p = 0.041)。与关节镜组1髋(5%)相比,开放组11髋(31%)进行了术后固定(p = 0.039)。结论:在孤立性关节炎的情况下,关节镜是一种合理的治疗方式,与开放关节切开术相比,没有观察到额外的风险。然而,当伴有骨髓炎或软组织脓肿时,开放性关节切开术仍然是解决所有感染因素的主要方法。证据等级:三级
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引用次数: 0
Maternal knowledge and practices regarding childhood acute respiratory infections in Lubumbashi, DRC 刚果民主共和国卢本巴希孕产妇关于儿童急性呼吸道感染的知识和做法
Pub Date : 2020-01-01 DOI: 10.25082/tcpp.2020.01.005
Aubin Ndjadi Wembonyama Kasongo, O. Mukuku, G. Kanteng, M. Shongo, A. Mutombo, Albert Mwembo Tambwe, D. Ngwej, S. Wembonyama, O. Luboya
Introduction Acute respiratory infections (ARIs) are a public health problem in the Democratic Republic of Congo (DRC) and cover a range of infections, from the common cold to pneumonia. ARIs are the leading cause of death in children under-5, with the majority of deaths occurring in developing countries. Objective To assess the knowledge and home-based practices used by mothers of children under-fives during episodes of ARI. Methods A cross-sectional study was carried out among mothers of children under-five who were selected in Lubumbashi (DRC). A pre-tested questionnaire administered by researchers was used for data collection. Results Of the 582 mothers interviewed, the majority had a good knowledge of the symptoms (87.46%), danger signs of severe ARIs (95.02%) and a good knowledge of the modes of transmission of ARIs (68.73%). Knowledge level was significantly associated with age and education level regarding modes of transmission. Three hundred and sixty-eight (63.23%) mothers indicated that they use traditional remedies: 252 (43.30%) apply palm oil to their children’s noses and as many mothers (n = 252; 43.30%) apply mentholatum ointment to the nose. Almost all of the mothers (n = 579; 99.48%) indicated that they dress the child with several layers of clothes. Oral self-medication was used by 575 mothers (98.80%). Conclusion The mothers’ knowledge of modes of transmission, symptoms and danger signs of ARIs was good in the community studied in Lubumbashi. Knowledge level was associated with age and level of education regarding modes of transmission.
急性呼吸道感染(ARIs)是刚果民主共和国(DRC)的一个公共卫生问题,涵盖从普通感冒到肺炎等一系列感染。急性呼吸道感染是5岁以下儿童死亡的主要原因,其中大多数死亡发生在发展中国家。目的评估5岁以下儿童母亲在急性呼吸道感染期间的知识和家庭实践情况。方法对卢本巴希(刚果民主共和国)5岁以下儿童的母亲进行横断面研究。研究人员使用预先测试的问卷进行数据收集。结果在582名受访母亲中,大多数对急性呼吸道感染的症状(87.46%)、严重急性呼吸道感染的危险体征(95.02%)和传播方式(68.73%)有很好的了解。有关传播方式的知识水平与年龄和受教育程度显著相关。368名(63.23%)母亲表示她们使用传统疗法:252名(43.30%)母亲将棕榈油涂在孩子的鼻子上,同样多的母亲(n = 252;43.30%)在鼻子上涂薄荷油。几乎所有的母亲(n = 579;99.48%)表示他们会给孩子穿好几层衣服。575名母亲(98.80%)使用口服自我药疗。结论卢本巴希社区母亲对急性呼吸道感染的传播方式、症状和危险体征的了解程度较好。有关传播方式的知识水平与年龄和受教育程度有关。
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引用次数: 0
Melioidosis and sickle cell disease: Description of a rare association 类鼻疽和镰状细胞病:一种罕见关联的描述
Pub Date : 2020-01-01 DOI: 10.25082/tcpp.2021.01.002
M. Shongo, Mimi Mujing Yav, O. Mukuku, Gaston Kankolongo, Kumel Kasongo Kumelundu, Aubin Ndjadi Wembonyama Kasongo, A. Mutombo, A. Mutombo, P. Bunga, L. Tshilolo, O. Luboya, S. Wembonyama
Melioidosis and its germ are increasingly reported on the African continent and particularly in Central Africa, probably due to the increased awareness of clinicians and microbiologists and the growing recognition of the organism. It is called "Great Mimicker" because it produces a wide range of clinical characteristics such as would be found in patients living with sickle cell disease (SCD) in particular. However, to date, no publication presents this association between melioidosis and SCD. The authors describe here 3 clinical cases presenting this very rare association between melioidosis and SCD. These are 3 children with SCD (homozygous SS) residing in Lubumbashi in Haut-Katanga province in the Democratic Republic of Congo. One patient presented with sepsis as a clinical form of the disease. All 3 had presented a pulmonary form. Only one patient was treated specifically after the diagnosis of melioidosis; for the other two, this diagnosis was confirmed after their death. Thus the death rate is 66.67%. This article describes, through these 3 clinical cases, a very rare first association between melioidosis and SCD. This association requires research to establish whether, like Thalassemia, SCD can be considered a risk factor for melioidosis. A screening of cases of melioidosis in the general population should allow us to focus on this.
在非洲大陆,特别是中非,类鼻疽病及其细菌的报道越来越多,这可能是由于临床医生和微生物学家的认识提高以及对这种有机体的认识不断提高。它被称为“伟大的模仿者”,因为它产生了广泛的临床特征,特别是在患有镰状细胞病(SCD)的患者中发现。然而,到目前为止,没有出版物提出类鼻疽病和SCD之间的这种联系。作者在这里描述了3例临床病例,这些病例在类鼻疽病和SCD之间表现出非常罕见的联系。这是居住在刚果民主共和国上加丹加省卢本巴希的3名患有SCD(纯合子SS)的儿童。1例患者表现为败血症的临床表现。3例患者均有肺部病变。诊断为类鼻疽后,仅有1例患者接受特异性治疗;对于另外两人,这种诊断在他们死后得到证实。因此死亡率为66.67%。本文通过这3例临床病例,描述了一个非常罕见的类鼻疽病与SCD之间的首次联系。这种关联需要研究来确定SCD是否可以像地中海贫血一样被认为是类鼻瘤病的危险因素。在一般人群中筛选类鼻疽病例应该使我们能够关注这一点。
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引用次数: 1
Neonatal sepsis: A review of the literature 新生儿败血症:文献综述
Pub Date : 1900-01-01 DOI: 10.25082/tcpp.2021.01.006
A. Nyenga, O. Mukuku, S. Wembonyama
Neonatal sepsis contributes significantly to neonatal morbidity and mortality and is a major public health challenge around the world. Depending on the mode of occurrence, a distinction is made between maternal-transmitted infection and that acquired in the postnatal period. Although the etiologies maternally transmitted diseases are well understood, those of postnatal acquired infections are variable depending on the epidemiology of each hospital environment. On the one hand, risk factors for maternal-transmitted infections are maternal sepsis, prolonged premature rupture of membranes, chorioamnionitis, and bacteriuria in the mother during pregnancy. On the other hand, risk factors for postnatal acquired infections are prematurity, low birth weight, lack of hygiene, and invasive therapeutic interventions. The diagnosis is based on a series of anamnestic, clinical and biological features. Although the positive diagnosis is based on the isolation of the germ by culture on a body sample (blood, cerebrospinal fluid, urine, etc.); its low sensitivity leads to the use of markers of the acute phase of inflammation such as C-reactive protein, procalcitonin and interleukins. New molecular biology techniques are promising and offer precise diagnosis with rapid results. Empirical management is a function of microbial ecology while definitive treatment is guided by the results of microbial culture. This article presents the essential elements for understanding neonatal sepsis and discusses new diagnosis and therapeutic management. It offers a thorough reading based on the issue of infections in newborns.
新生儿败血症是导致新生儿发病率和死亡率的重要因素,是世界各地面临的一项重大公共卫生挑战。根据发生方式,将产妇传播感染与产后感染加以区分。虽然母体传播疾病的病因已被很好地理解,但产后获得性感染的病因因每个医院环境的流行病学而异。一方面,母体传播感染的危险因素是母体败血症、胎膜长期早破、绒毛膜羊膜炎和妊娠期母体细菌尿。另一方面,产后获得性感染的危险因素是早产、低出生体重、缺乏卫生和侵入性治疗干预。诊断是基于一系列的记忆,临床和生物学特征。虽然阳性诊断是基于在身体样本(血液、脑脊液、尿液等)上培养分离细菌;它的低敏感性导致使用炎症急性期的标志物,如c反应蛋白、降钙素原和白细胞介素。新的分子生物学技术很有前景,可以提供精确的诊断和快速的结果。经验性管理是微生物生态学的功能,而定性处理是由微生物培养结果指导的。本文介绍了了解新生儿败血症的基本要素,并讨论了新的诊断和治疗管理。它提供了一个基于新生儿感染问题的全面阅读。
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引用次数: 4
期刊
儿科理论与临床(英文)
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