Advances in pediatric research最新文献_第4页

Climate change associated to an increase in congenital heart defects 气候变化与先天性心脏缺陷增加有关

Advances in pediatric research

Pub Date : 2019-01-01 DOI: 10.35248/2385-4529.18.6.25

Patricio Fern, ez Martorell

Climate change causes a rise in global average temperatures and increases the number of extremely hot days every year in different regions of the world. The National Aeronautics and Space Administration Agency (NASA) defines climate change as: “a broad range of global phenomena created by burning fossil fuels, which add heat-trapping gases to Earth’s atmosphere. These phenomena include the increased temperature trends described as global warming”.

气候变化导致全球平均气温上升，并增加了世界不同地区每年极端炎热的天数。美国国家航空航天局(NASA)将气候变化定义为:“燃烧化石燃料导致的一系列全球现象，这些现象向地球大气中增加了吸热气体。”这些现象包括被称为“全球变暖”的气温上升趋势。

引用次数: 0

“An innovative new technique of paediatric vaccination: Take both hands and hold the needle to avoid damage of nociceptors and capillaries” “一种创新的儿科疫苗接种新技术:双手握针，避免伤害感受器和毛细血管”

Advances in pediatric research

Pub Date : 2019-01-01 DOI: 10.35248/2385-4529.19.6.26

S. Bittmann, E. Luchter

Pediatric vaccination is an important field in the daily pediatric care practice of pediatricians in Germany. According to the STIKO recommendations, children were vaccinated up to 20 times till the age of 17. A new technique of vaccination will be presented vaccinate a child taking both hands, one makes the injections, the other one holds the needle in the skin due to relieve pain and not to damage nociceptors. The importance of this technique is to avoid movement of the needle inside the skin after injection to avoid damage of nociceptors in the skin.

儿童疫苗接种是德国儿科医生日常儿科护理实践中的一个重要领域。根据STIKO的建议，儿童在17岁之前接种了多达20次疫苗。一种新的疫苗接种技术将被提出，接种疫苗的孩子用两只手，一只手进行注射，另一只手将针放在皮肤上，以减轻疼痛，而不损害伤害感受器。这项技术的重要性在于注射后避免针头在皮肤内运动，以避免损伤皮肤中的伤害感受器。

引用次数: 1

Dose dependence of pediatric thyroid cancer prevalence in the 6 years after the Fukushima nuclear power plant accident 福岛核电站事故后6年儿童甲状腺癌发病率的剂量依赖性

Advances in pediatric research

Pub Date : 2019-01-01 DOI: 10.35248/2385-4529.19.6.28

T. Katō

Background: After the Fukushima nuclear accident in March 2011, Fukushima Prefecture initiated thyroid ultrasound screening as part of the Fukushima Health Management Survey (FHMS). Regional differences in external radiation dose were often reported not associated with thyroid cancer prevalence in the firstround screening E-I (2011-2013). The association between childhood thyroid cancer and radiation exposure in the 6 years after the accident is studied by analyzing the results of the first and second-round examinations E-I+II (2011-2015). Methods: Dose dependence of thyroid cancer proportion in E-I and E-II for all residents aged ≤18 years at the accident was analyzed for FHMS external dose and UNSCEAR effective dose by regression analysis using Microsoft Excel. Two divisions of Fukushima prefecture, O-model in the order of decreasing external dose and S-model according to the initial screening schedule, were adopted. Results: In O-model, thyroid cancer proportion per 100,000 in E-II and in E-I+II were found to increase linearly to FHMS external dose in 0.2–1.4 mSv range and UNSCEAR effective dose in 1.6–5 mSv range. Thyroid cancer proportion in E-II and E-I+II was observed to increase linearly to effective dose in Smodel. Conclusion: The observed linear prevalence–dose relation after 6 years from the accident and incidencedose relation during 4-6 years after exposure suggest a possible association between pediatric thyroid cancer and radiation exposure. Regional differences were not obvious in E-I presumably because of the short interval from exposure to screening in high-dose areas. High prevalence of thyroid cancer cannot be attributed only to mass screening effect that does not depend on radiation dose and elapsed time from exposure.

背景:2011年3月福岛核事故发生后，福岛县启动了甲状腺超声筛查，作为福岛健康管理调查(FHMS)的一部分。在第一轮筛查E-I(2011-2013)中，经常报道外照射剂量的区域差异与甲状腺癌患病率无关。通过分析2011-2015年第一轮和第二轮E-I+II检查结果，研究事故发生后6年儿童甲状腺癌与辐射暴露的关系。方法:采用Microsoft Excel软件进行回归分析，分析事故发生时所有≤18岁居民E-I和E-II中甲状腺癌比例的剂量依赖性，分别为FHMS外剂量和UNSCEAR有效剂量。福岛县采用外照射剂量递减顺序的o型模型和初始筛选计划的s型模型。结果:在o型模型中，随着FHMS外剂量在0.2 ~ 1.4 mSv范围内和UNSCEAR有效剂量在1.6 ~ 5 mSv范围内，E-II组和E-I+II组每10万人中甲状腺癌比例呈线性增加。在s模型中，E-II和E-I+II的甲状腺癌比例随有效剂量线性增加。结论:从事故发生6年后的线性流行-剂量关系和暴露后4-6年的发病率-剂量关系来看，儿童甲状腺癌可能与辐射暴露有关。E-I的区域差异不明显，可能是因为在高剂量地区从暴露到筛查的时间间隔很短。甲状腺癌的高患病率不能仅仅归因于与辐射剂量和照射时间无关的大规模筛查效应。

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引用次数: 2

Novel mutation of SCN9A gene in a family with Paroxysmal Extreme Pain Disorder (PEPD): Considerations of paediatric interest 阵发性极度疼痛障碍(PEPD)家族中SCN9A基因的新突变:对儿科兴趣的考虑

Advances in pediatric research

Pub Date : 2019-01-01 DOI: 10.35248/2385-4529.19.6.32

Jerez Calero Antonio, Y. Yáñez, Munoz Gallego Maria Angeles, Augustin Morales Maria Carmen, Contreras Chova Francisco, Molina Carballo Antonio, Munoz Hoyos Antonio

Introduction: Paroxysmal Extreme Pain Disorder (PEPD) is a rare autosomal dominant disease, caused by mutations in the SCN9A gene, which encodes the NaV1.7 voltage-gated sodium channel alpha subunit. Symptoms generally begin in early infancy with episodes of excruciating, burning and spreading pain in the lower part of the body, typically in the anorectal area, which can last from seconds to hours. Case description: We describe the case of a 5-year-old male with PEPD and a novel heterozygous mutation c.5825c>T (p. Thr1942ile) in the SCN9A gene. This is a novel mutation that has not previously been reported. Discussion: According to the available information, the clinical significance of the variant c.5825c>T (p. Thr1942ile) is unknown. However, its presence in the patient and in others affected family members, reinforces its possible pathogenicity and is suggestive of mutation segregation with the disease in this family. Conclusion: We consider that it is a family case of interest to the pediatrician, for allowing: 1) To be able to intuit it by the clinic early and 2) To be able to confirm it by means of the corresponding genetic study.

简介:阵发性极度疼痛障碍(PEPD)是一种罕见的常染色体显性疾病，由编码NaV1.7电压门控钠通道α亚基的SCN9A基因突变引起。症状通常始于婴儿期早期，身体下部(通常在肛门直肠区域)出现剧烈、灼烧和蔓延的疼痛，持续数秒至数小时。病例描述:我们描述了一例5岁男性PEPD和SCN9A基因c.5825c>T (p. Thr1942ile)的新型杂合突变。这是一种新的突变，以前没有报道过。讨论:根据现有信息，c.5825c >t (p. Thr1942ile)变异的临床意义尚不清楚。然而，它在患者和其他受影响的家庭成员中的存在，加强了其可能的致病性，并提示该家庭中疾病的突变分离。结论:我们认为这是一个儿科医生感兴趣的家庭病例，因为它允许:1)能够通过临床早期直觉，2)能够通过相应的遗传研究证实它。

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引用次数: 0

The impact of fluorescent and led lighting on students attitudes and behavior in the classroom 荧光灯和led照明对学生课堂态度和行为的影响

Advances in pediatric research

Pub Date : 2018-07-21 DOI: 10.24105/APR.2018.5.15

Brenda L. Morrow, S. Kanakri

Introduction: This study examined empirical research on the effects of high correlated color temperature light-emitting diodes (LED) and fluorescent lighting on students in the classroom. LED is becoming the most recent lighting option for optimal energy efficiency over fluorescent technology. Background: A review of the literature indicates correlated color temperature (CCT) of lighting has non-visual effects on students, with higher CCT positively impacting attitudes and behavior. The review also revealed current studies regarding dynamic or tunable lighting that adjusts CCT based on desired activity and mood. Data from an original survey analyzed teacher insights and perceptions regarding student attitudes and behaviors associated with existing classroom lighting and the impact of higher color temperature LED. Methods: Participants were pre-K through high school qualified teachers from three schools and/or personal contacts of the principal investigator. Seventy-five teachers responded to the online questionnaire. The survey data suggests teachers perceive higher color temperature lighting positively impacts student alertness, attitude, and energy level; and adjusting light levels throughout a school day positively impacts student engagement. Results and conclusion: Results supported the perception of higher correlated color temperature lighting positively impacting alertness, attitude, and energy level. Findings also supported the ability to change light levels throughout the school day to positively impact student engagement and mood. There were mixed results regarding higher correlated color temperature impacting attention and on-task/off- task behaviors. Results regarding the impact of sound and flickering from fluorescent lights were not significant.

前言:本研究考察了高相关色温发光二极管(LED)和荧光灯对课堂学生的影响。相对于荧光灯技术，LED正成为最优能源效率的最新照明选择。背景:文献综述表明，照明相关色温对学生有非视觉影响，较高的相关色温对学生的态度和行为有正向影响。该综述还揭示了目前关于动态或可调照明的研究，该研究可以根据期望的活动和情绪来调整CCT。一项原始调查的数据分析了教师对现有教室照明和高色温LED的影响有关的学生态度和行为的见解和看法。方法:参与者是来自三所学校的学前班到高中的合格教师和/或主要研究者的个人联系人。75名教师回答了在线问卷。调查数据显示，教师认为高色温照明对学生的警觉性、态度和能量水平有积极影响;在学校一天中调整光线水平对学生的参与度有积极影响。结果与结论:结果支持高相关色温照明对警觉性、态度和能量水平的积极影响。研究结果还支持在学校改变光照水平对学生的参与和情绪产生积极影响的能力。高相关色温对注意力和任务内/任务外行为的影响有不同的结果。荧光灯的声音和闪烁对小鼠的影响不显著。

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引用次数: 13

Overweight and Obesity in Early Childhood A Systematic Review of Individual, Family, and Peer Risk Factors 儿童早期超重和肥胖:个人、家庭和同伴风险因素的系统回顾

Advances in pediatric research

Pub Date : 2018-07-01 DOI: 10.12715/APR.2018.5.5

Nadja Frate, B. Jenull, H. Foran

Purpose: The prevalence of children who are overweight or obese has been increasing worldwide. While a variety of biological as well as sociodemographic correlates have been identified and reviewed, a systematic review of psychosocial factors, particularly among preschool aged children, is lacking. This systematic review synthesizes the research on individual, family and peer risk factors for overweight and obesity in preschool aged children. Method: A systematic review of the recent literature on psychosocial factors and overweight or rather obesity in the early stages of childhood was conducted. Results: A total of 27 studies from 2011-2016 were identified that examined individual, family and social risk factors for obesity in children. Results indicate the importance of eating regulation as well as family factors in understanding early childhood risk for obesity. There was mixed support for associations between behavioral and emotional symptoms and obesity among this age group. For other risk factors examined, too few studies exist to be able to make strong conclusions about their relevance for understanding preschool obesity risk. Conclusions: Psychosocial factors are associated with overweight and obesity among preschool aged children. However, this review also highlights the dearth of research on several potentially important risk factors for childhood obesity in this age group (such as family violence, parental and peer relationships). Longitudinal studies, which examine multiple risk factors simultaneously over this important developmental period, are sorely needed.

目的：世界范围内超重或肥胖儿童的患病率一直在上升。虽然已经确定并审查了各种生物学和社会人口统计学的相关性，但缺乏对心理社会因素，特别是学龄前儿童的心理社会因素的系统审查。这篇系统综述综合了对学龄前儿童超重和肥胖的个人、家庭和同伴危险因素的研究。方法：对儿童早期的心理社会因素与超重或肥胖的最新文献进行系统综述。结果：2011-2016年共有27项研究确定了儿童肥胖的个人、家庭和社会风险因素。研究结果表明，饮食调节以及家庭因素在了解儿童早期肥胖风险方面的重要性。在这个年龄组中，人们对行为和情绪症状与肥胖之间的关系有着不同的支持。对于所检查的其他风险因素，很少有研究能够就其与了解学龄前肥胖风险的相关性得出强有力的结论。结论：心理社会因素与学龄前儿童超重和肥胖有关。然而，这篇综述也强调了缺乏对该年龄段儿童肥胖的几个潜在重要风险因素的研究（如家庭暴力、父母和同伴关系）。迫切需要进行纵向研究，在这一重要的发展时期同时检查多种风险因素。

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引用次数: 2

Real-time PCR for the diagnosis of invasive Haemophilus influenzaebacteraemia and meningitis in children: A diagnostic accuracy study ofover 2,000 samples 实时PCR诊断儿童侵袭性流感嗜血杆菌血症和脑膜炎:一项超过2000个样本的诊断准确性研究

Advances in pediatric research

Pub Date : 2018-01-01 DOI: 10.12715/APR.2018.5.2

H. O. Brien, M. Nielsen, K. Meyler, N. Sullivan, R. Cunney, R. Drew

results in a paediatric patient cohort and to review discordant results. Methods: A retrospective audit of all blood and CSF samples from a tertiary referral paediatric hospital sent to the Irish Meningitis and Sepsis Reference Laboratory over a four-year period. All PCR tests performed for H. influenzae which had a contemporaneous culture performed were included in the analysis. Results: For the blood PCR test, there were 10 positive samples out of 1,367 samples tested. The sensitivity was shown to be 60% (95% CI 14.6–94.73%) and the specificity was 99% (95% CI 98–99.7%). For the CSF assay, the sensitivity was 100% (95% CI 15.8–100%) with a specificity of 99% (95% CI 99.2–99.9%) and there were 5 positive samples by PCR out of the 1,224 samples tested. Ten patients had positive PCR results, with a negative corresponding culture (blood=7, CSF=3). Three of the 10 cases were deemed to be primary H. influenzae infections, while seven were deemed to be likely co-infection (respiratory syncytial virus=2, Influenza=2, measles=1, rotavirus=1, Staphylococcus aureus pneumonia=1). Conclusions: The incidence of invasive H. influenzae disease was low in this population. The sensitivity and specificity of the assay in CSF was excellent, but the sensitivity of the assay in blood was lower at 60%. Most patients with discordant PCR/culture results had viral co-infections. A more rational approach to requesting PCR is required in paediatric patients.

结果在一个儿科患者队列和审查不一致的结果。方法:回顾性审计所有血液和脑脊液样本从三级转诊儿科医院发送到爱尔兰脑膜炎和败血症参考实验室四年期间。同时进行培养的流感嗜血杆菌的所有PCR检测均纳入分析。结果:在血液PCR检测中，1367个样本中有10个呈阳性。灵敏度为60% (95% CI 14.6-94.73%)，特异性为99% (95% CI 98-99.7%)。脑脊液检测的敏感性为100% (95% CI 15.8-100%)，特异性为99% (95% CI 99.2-99.9%)，在1224份检测样本中有5份PCR阳性样本。PCR阳性10例，相应培养阴性(血7例，脑脊液3例)。10例中有3例被认为是原发性流感嗜血杆菌感染，7例被认为可能是合并感染(呼吸道合胞病毒=2，流感=2，麻疹=1，轮状病毒=1，金黄色葡萄球菌肺炎=1)。结论:该人群侵袭性流感嗜血杆菌发病率较低。该方法在脑脊液中的敏感性和特异性都很好，但在血液中的敏感性较低，为60%。PCR/培养结果不一致的患者多为病毒共感染。在儿科患者中，需要采取更合理的方法来请求聚合酶链反应。

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引用次数: 1

Advances in pediatric research 儿科研究进展

Advances in pediatric research

Pub Date : 2018-01-01 DOI: 10.24105/APR.2018.5.9

S. Bittmann

Pediatric research is a very important field to improve the therapy of children, not only to accept old strategies. Pediatric research is based on different subgroups, molecular-based research up to clinical research, which became also very important in the last years. Other fields of interest became more prominent like complementary therapies in childhood. Good medical care in children includes not only concentrating on school medicine but include additional innovative complementary therapies like homeopathic or anthroposophical therapies. All these therapies should bare in mind in modern pediatric treatment.

儿科研究是一个非常重要的领域，以提高儿童的治疗，而不是只接受旧的策略。儿科研究基于不同的亚组，从分子研究到临床研究，这在过去几年也变得非常重要。其他感兴趣的领域也变得更加突出，比如儿童的补充疗法。良好的儿童医疗保健不仅包括集中于学校医学，还包括其他创新的补充疗法，如顺势疗法或人智疗法。所有这些治疗方法在现代儿科治疗中都应牢记在心。

引用次数: 0

Twin study confirms virtually identical prenatal alcohol exposures can lead to markedly different fetal alcohol spectrum disorder outcomes-fetal genetics influences fetal vulnerability. 双胞胎研究证实，几乎相同的产前酒精暴露可导致明显不同的胎儿酒精谱系障碍结果--胎儿遗传影响胎儿的易感性。

Advances in pediatric research

Pub Date : 2018-01-01 Epub Date: 2019-01-12 DOI: 10.24105/apr.2019.5.23

Susan J Astley Hemingway, Julia M Bledsoe, Allison Brooks, Julian K Davies, Tracy Jirikowic, Erin M Olson, John C Thorne

Background: Risk of fetal alcohol spectrum disorder (FASD) is not based solely on the timing and level of prenatal alcohol exposure (PAE). The effects of teratogens can be modified by genetic differences in fetal susceptibility and resistance. This is best illustrated in twins.

Objective: To compare the prevalence and magnitude of pairwise discordance in FASD diagnoses across monozygotic twins, dizygotic twins, full-siblings, and half-siblings sharing a common birth mother.

Methods: Data from the Fetal Alcohol Syndrome Diagnostic & Prevention Network clinical database was used. Sibling pairs were matched on age and PAE, raised together, and diagnosed by the same University of Washington interdisciplinary team using the FASD 4-Digit Code. This design sought to assess and isolate the role of genetics on fetal vulnerability/resistance to the teratogenic effects of PAE by eliminating or minimizing pairwise discordance in PAE and other prenatal/postnatal risk factors.

Results: As genetic relatedness between siblings decreased from 100% to 50% to 50% to 25% across the four groups (9 monozygotic, 39 dizygotic, 27 full-sibling and 9 half-sibling pairs, respectively), the prevalence of pairwise discordance in FASD diagnoses increased from 0% to 44% to 59% to 78%. Despite virtually identical PAE, 4 pairs of dizygotic twins had FASD diagnoses at opposite ends of the fetal alcohol spectrum-Partial Fetal Alcohol Syndrome versus Neurobehavioral Disorder/Alcohol-Exposed.

Conclusion: Despite virtually identical PAE, fetuses can experience vastly different FASD outcomes. Thus, to protect all fetuses, especially the most genetically vulnerable, the only safe amount to drink is none at all.

背景：胎儿酒精谱系障碍（FASD）的风险并不仅仅取决于产前酒精暴露（PAE）的时间和程度。胎儿易感性和抵抗力的遗传差异可改变致畸剂的影响。这一点在双胞胎身上体现得淋漓尽致：目的：比较单卵双胞胎、双卵双胞胎、全兄妹和同母异父兄妹的 FASD 诊断不一致的发生率和程度：方法：使用胎儿酒精综合症诊断和预防网络临床数据库中的数据。这对兄妹的年龄和PAE相匹配，一起长大，并由华盛顿大学的同一个跨学科团队使用FASD 4位数代码进行诊断。这一设计旨在通过消除或尽量减少 PAE 和其他产前/产后风险因素的配对不一致性，评估和分离遗传对胎儿易受 PAE 致畸影响/抵抗力的作用：随着四组（分别为 9 对单卵双生、39 对双卵双生、27 对全卵双生和 9 对半卵双生）同胞之间的遗传亲缘关系从 100% 到 50% 再到 50% 到 25%，FASD 诊断中的配对不一致率从 0% 到 44% 再到 59% 到 78%。尽管 PAE 几乎完全相同，但 4 对异卵双胞胎的 FASD 诊断结果却在胎儿酒精谱系的两端--部分胎儿酒精综合征与神经行为障碍/酒精暴露：结论：尽管 PAE 几乎相同，但胎儿的 FASD 结果却可能大相径庭。因此，为了保护所有胎儿，尤其是基因最脆弱的胎儿，唯一安全的饮酒量就是完全不喝。

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引用次数: 0

Focus group or individual interviews for exploring children's health behaviour: the example of physical activity 探讨儿童健康行为的焦点小组或个人访谈:以身体活动为例

Advances in pediatric research

Pub Date : 2018-01-01 DOI: 10.24105/apr.2018.5.11

K. Woolley, K. Edwards, C. Glazebrook

Background: Children's health behaviours affect their current and future health. An appreciation of children’s perceptions regarding these behaviours can inform health promotion initiatives. Focus groups and individual interviews have increasingly been used to explore health-related issues with children although the rationale for choosing any one method is not often explained and despite considerable debate about their benefits and drawbacks these methods have rarely been compared directly. This study aimed to explore the relative merits of the two approaches when collecting information from children about their perceptions of physical activity. Methods: Twelve children from Year 6 classes at one UK primary school were randomly allocated to an 'interview group' or a 'focus group' and asked questions about facilitators and barriers relating to their physical activity at school. Focus group interactions and interviews were recorded and transcribed verbatim. Qualitative data were analysed using exploratory thematic analysis and subsequently content analysis was undertaken to quantify differences between the groups. Results: Although both methods were suitable for collecting information from children about physical activity, children who were interviewed spoke on more occasions and offered more information about facilitators for physical activity. They also spoke more frequently about potentially important aspects of the school outdoor environment with regard to physical activity promotion. The focus group was more time efficient in this setting. Conclusion: Qualitative methods for exploring health behaviours may not be equivalent and need to be chosen carefully depending on the specific research problem and practical constraints within a project.

背景:儿童的健康行为影响其当前和未来的健康。了解儿童对这些行为的看法可以为促进健康的举措提供信息。焦点小组和个人访谈越来越多地用于探讨与儿童有关的健康问题，尽管通常不解释选择任何一种方法的理由，尽管对这些方法的利弊进行了大量辩论，但很少对这些方法进行直接比较。本研究旨在探讨两种方法在收集儿童对体育活动的看法时的相对优点。方法:来自英国一所小学六年级的12名儿童被随机分配到“访谈组”或“焦点组”，并被问及有关他们在学校体育活动的促进因素和障碍的问题。焦点小组的互动和访谈被逐字记录和转录。使用探索性专题分析对定性数据进行分析，随后进行内容分析以量化各组之间的差异。结果:虽然两种方法都适用于儿童体育活动信息的收集，但被调查儿童在更多场合发言，提供更多关于体育活动促进者的信息。他们还更频繁地谈到学校户外环境在促进体育活动方面的潜在重要方面。在这种情况下，焦点小组的时间效率更高。结论:探索健康行为的定性方法可能并不等同，需要根据具体的研究问题和项目中的实际限制因素仔细选择。

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引用次数: 6