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Retinopathy of prematurity (ROP): From the perspective of the neonatologist 早产儿视网膜病变(ROP):新生儿科医生的视角
Pub Date : 2024-02-05 DOI: 10.1016/j.gpeds.2024.100159
Esin Koc , Ahmet Yagmur Bas

Retinopathy of prematurity (ROP) is a serious morbidity of prematurity. It is a pathophysiological condition that occurs due to abnormal proliferation of the retinal vessels. The incidence and severity of ROP increase with decreasing gestational age (GA) and birth weight (BW).

The enhanced chance of survival of premature babies in parallel with the developments in neonatal care increased the incidence of ROP. Early diagnosis and timely and appropriate treatment of ROP increases the quality of life by preventing vision loss.

Many risk factors were reported besides prematurity and inappropriate oxygen treatment for preterm infants. Pediatricians and neonatologists play important role in prevention, detection and management of ROP. It should be kept in mind that ROP may also lead to medicolegal problems.

早产儿视网膜病变(ROP)是早产儿的一种严重疾病。它是由于视网膜血管异常增殖而导致的一种病理生理状况。早产儿视网膜病变的发病率和严重程度随着胎龄(GA)和出生体重(BW)的降低而增加。随着新生儿护理的发展,早产儿的存活率也随之提高,从而增加了早产儿视网膜病变的发病率。除了早产和早产儿不适当的氧疗外,还有许多风险因素。儿科医生和新生儿科医生在早产儿视网膜病变的预防、检测和管理方面发挥着重要作用。值得注意的是,早产儿视网膜病变也可能导致医疗法律问题。
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引用次数: 0
Factors contributing to non-reporting of medication errors 导致不报告用药错误的因素
Pub Date : 2024-02-03 DOI: 10.1016/j.gpeds.2024.100144
Branislava Brestovački Svitlica, Georgios Konstantinidis

Introduction

Medication errors are the most common adverse drug events in hospitals, which are easily preventable. Therefore, reporting on their occurrence is one of the critical issues of the entire healthcare system. The objective of this study is to determine the factors that contribute to the non-reporting of medication errors.

Methods

Cross-sectional study in five healthcare institutions in Vojvodina.

Results

The most common reason for not reporting medication errors is that managers emphasize the individual without looking for a possible cause in the system (n = 583, 61%). As a reason for not reporting errors, slightly less than half of the respondents state the following: if they make a mistake, patients will develop a negative attitude towards nurses, that the mistake is not clearly defined, and the obligation to fill in the reporting forms is not presented to all employees.

Conclusion

In healthcare institutions, the readiness of the management to implement a reporting system with clearly defined adverse events and professional errors is necessary. Healthcare workers should report without fear of punishment and condemnation of others. Reporting only makes sense if a thorough professional analysis is conducted at the level of the management, based on which feedback can be given, and proposals for improving patient safety can be defined.

导言用药错误是医院中最常见的药物不良事件,很容易预防。因此,报告其发生情况是整个医疗系统的关键问题之一。本研究的目的是确定导致不报告用药错误的因素。方法在伏伊伏丁那省的五家医疗机构进行横断面研究。结果不报告用药错误最常见的原因是管理人员只强调个人,而没有从系统中寻找可能的原因(n = 583,61%)。略低于半数的受访者表示,不报告错误的原因包括:如果他们犯了错误,病人会对护士产生负面态度;错误没有明确界定;没有向所有员工介绍填写报告表的义务。医护人员应在不担心他人惩罚和谴责的情况下进行报告。只有在管理层层面进行了全面的专业分析,并在此基础上提供反馈意见和改进患者安全的建议后,报告才有意义。
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引用次数: 0
Management of cow's-milk protein allergy in infants and children. What's new in 2023? 婴幼儿牛奶蛋白过敏的管理。2023 年有哪些新变化?
Pub Date : 2024-02-03 DOI: 10.1016/j.gpeds.2024.100153
Patrick Tounian

The World Allergy Organization Diagnosis and Rationale for Action against Cow's Milk Allergy in 2022 and the European Society of Paediatric Gastroenterology, Hepatology and Nutrition in 2023 updated their guidelines for cow's-milk protein allergy (CMPA) management in infants and children. The objective of this paper is to underline the main points of these new guidelines and debate about some of them.

世界过敏组织(World Allergy Organization)于 2022 年、欧洲儿科胃肠病学、肝病学和营养学会(European Society of Paediatric Gastroenterology, Hepatology and Nutrition)于 2023 年分别更新了婴幼儿牛奶蛋白过敏(CMPA)管理指南。本文旨在强调这些新指南的要点,并就其中一些要点展开讨论。
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引用次数: 0
Bariatric surgery for young people with obesity and results of laparoscopic bariatric surgery in Serbia 塞尔维亚青少年肥胖症患者的减肥手术和腹腔镜减肥手术的结果
Pub Date : 2024-02-02 DOI: 10.1016/j.gpeds.2024.100151
Radoica Jokic

Bariatrics is the branch of medicine that deals with the causes, prevention and treatment of obesity. Bariatric surgery is a surgical weight loss procedure used to treat extreme obesity. Minimal invasive surgery became standard procedure for the treatment of obesity as well. Gastric banding (GB) usually takes 45–60 min, but in USA it is not approved for use in teenagers. Laparoscopic Roux-en Y Gastric Bypass (LRYGB) is operation where proximal pouch of stomach is anastomosied with short intestinal Roux limb. Laparoscopic gastric sleeve (LGS) procedure is laparoscopic operation during which surgeon removes about ¾ of the patients stomach along the greater curvature and create a new stomach in the shape of tube. When compared to other weight-loss surgeries, sleeve gastrectomy is technically easier with relatively less morbidity. Gastric sleeve procedure has been performed in our hospital on three patients aged 15 to 17 years. One male and two female patients, all with BMI more than 39 kg/m2. Postoperative follow up was without any complications. This small study demonstrated that children aged ≤ 18 years could successfully undergo LGS with a significant reduction in weight and BMI. Although there were no short- or long-term complications in our study, the small sample size necessitates larger studies. Results of future research will create future clinical decisions to solve the epidemic of obesity.

减肥医学是研究肥胖症的原因、预防和治疗的医学分支。减肥手术是一种用于治疗极度肥胖症的外科减肥手术。微创手术也已成为治疗肥胖症的标准程序。胃束带术(GB)通常需要 45-60 分钟,但在美国,青少年还不能使用这种手术。腹腔镜Roux-en-Y胃旁路术(LRYGB)是将胃的近端袋与短肠Roux肢体吻合的手术。腹腔镜胃袖状手术(LGS)是一种腹腔镜手术,在手术过程中,外科医生会沿着胃大弯切除患者约 3/4 的胃,然后在患者的胃部创建一个管状的新胃。与其他减肥手术相比,袖状胃切除术在技术上更简单,发病率也相对较低。本院曾为三名 15 至 17 岁的患者实施过袖状胃切除术。其中一名男性患者和两名女性患者的体重指数均超过 39 kg/m2。术后随访无任何并发症。这项小型研究表明,18 岁以下的儿童可以成功接受 LGS 手术,体重和体重指数都会显著下降。虽然我们的研究没有发现短期或长期并发症,但由于样本量较小,有必要进行更大规模的研究。未来的研究结果将为解决肥胖症的临床决策提供依据。
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引用次数: 0
Cutoff points of mid-upper arm circumference (MUAC) for diagnosis of adolescent obesity: A systematic review with metanalysis and MOSTA tape proposal 诊断青少年肥胖症的中上臂围(MUAC)临界点:带元分析的系统综述和 MOSTA 磁带提案
Pub Date : 2024-02-02 DOI: 10.1016/j.gpeds.2024.100135
Carlos Alberto Nogueira-de-Almeida , Patrícia Ruffo , Edson Zangiacomi Martinez , Fábio da Veiga Ued

Adolescents are particularly vulnerable to obesity. The initial step to implement preventive and therapeutic measures is the detection of patients affected. In some circumstances, it may be important that the diagnosis is made more quickly, and the mid-upper arm circumference (MUAC) has been used for this. The present study is a systematic review with meta-analysis seeking aiming to suggest cutoff points and propose a simple tool for screening or rapid diagnosis of adolescent obesity. Studies published between January 1990 and December 2022 on MUAC and obesity in adolescents from 10 to 18 years were researched. PRISMA statement and checklist were followed. Optimal cutoff values and the corresponding sensitivity and specificity were estimated using a meta-analysis of diagnostic accuracy studies, by maximizing the Youden index using the new “diagmeta” package of the R software. PROSPERO Submission number: 387,301. From 92 initially screened, a total of six papers fully met the inclusion criteria and were included in the meta-analysis, involving 39,149 adolescents from five countries. Using the proposed methodology, simplified cutoff points of MUAC (cm) were obtained for screening adolescents at risk for obesity: 23 for girls and 23.5 for boys (10–14 years); 28.14 for girls and 27.14 for boys (15–20 years). In conclusion, the present study proposes, through a systematic review with meta-analysis, simplified cutoff points of MUAC aiming for obesity screening for adolescents and the creation of a tool called MUAC Obesity Screening Tool for Adolescents (MOSTA tape) aimed at simple use and rapid diagnosis.

青少年尤其容易肥胖。实施预防和治疗措施的第一步是发现受影响的患者。在某些情况下,更快地做出诊断可能非常重要,而中上臂围(MUAC)已被用于此目的。本研究是一项系统性综述和荟萃分析,旨在为青少年肥胖症的筛查或快速诊断提出临界点和简单工具。研究对象为 1990 年 1 月至 2022 年 12 月间发表的有关 10 至 18 岁青少年的 MUAC 和肥胖的研究。研究遵循 PRISMA 声明和核对表。使用 R 软件的新 "diagmeta "软件包,通过最大化尤登指数(Youden index),对诊断准确性研究进行荟萃分析,从而估算出最佳临界值以及相应的灵敏度和特异性。PROSPERO 提交编号:387,301。在初步筛选出的92篇论文中,共有6篇完全符合纳入标准并被纳入荟萃分析,涉及5个国家的39149名青少年。采用所建议的方法,得出了用于筛查肥胖风险青少年的 MUAC(厘米)简化临界点:女孩为 23,男孩为 23.5(10-14 岁);女孩为 28.14,男孩为 27.14(15-20 岁)。总之,本研究通过系统综述和荟萃分析,提出了旨在筛查青少年肥胖症的简化 MUAC 切点,并创建了一种名为 "青少年 MUAC 肥胖症筛查工具"(MOSTA 磁带)的工具,旨在实现简单使用和快速诊断。
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引用次数: 0
Obesity a triple pandemic, the trillion dollar disease: Prevention is imperative 肥胖症是一种三重流行病,是价值万亿美元的疾病:预防是当务之急
Pub Date : 2024-02-01 DOI: 10.1016/j.gpeds.2024.100141
Hilary Hoey , Edna Roche

Obesity is a major global preventable condition. The prevalence in children and adolescents is high and increasing globally.

It is associated with serious complications and very expensive morbidity. These include the metabolic syndrome, type 2 diabetes which is more aggressive in children than in adults and an increased prevalence of cancer. In addition, obstetric complications occur along with the development of a cycle of obesity associated with trans generational epigenetic changes associated with obese infants leading to obesity in childhood and later life.

The management and treatment of obesity is difficult including changes in established life style. Medications for children are limited and surgery is invasive, generally irreversible and requires lifelong nutritional support. There is a paucity of long-term outcome data relating to both medications and surgery.

Prevention at all ages is imperative particularly during the first 1000 days of life, during adolescence and in those who have predisposing factors relating to type 2 diabetes. It requires national governments, communities and health services to promote diet, exercise, early childhood care, school health and expert weight management services.

肥胖症是全球主要的可预防疾病。肥胖症与严重的并发症和昂贵的发病率有关。这些并发症包括代谢综合征、2 型糖尿病(儿童比成人更易患上)以及癌症发病率的上升。此外,随着产科并发症的出现,与肥胖婴儿相关的跨代表观遗传变化也会导致肥胖的循环发展,从而导致儿童期和以后的生活中出现肥胖。针对儿童的药物有限,而手术是侵入性的,通常是不可逆的,并且需要终身营养支持。各年龄段的预防工作都很重要,尤其是在生命的头 1000 天、青春期和有 2 型糖尿病易感因素的人群。这需要国家政府、社区和医疗服务机构推广饮食、运动、幼儿护理、学校卫生和专家体重管理服务。
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引用次数: 0
The Importance of scientific writing training courses in enhancing the dissemination of research findings 科学写作培训课程对加强研究成果传播的重要性
Pub Date : 2024-02-01 DOI: 10.1016/j.gpeds.2024.100152
Massimo Pettoello-Mantovani , Maria Pastore , Ida Giardino , Giuseppe Buonocore

This brief article emphasizes the vital significance of mastering the intricate skill of crafting scientific articles effectively, especially in the context of pediatric research. A well-crafted scientific article not only showcases the depth of research conducted, but also serves as a conduit for sharing valuable insights and discoveries with the wider scientific community. The article highlights that scientific publications are not mere compilations of data; they are instruments of knowledge transfer, enabling medical professionals, researchers, and policymakers to stay abreast of the latest developments in pediatric healthcare. By adhering to the highest standards of scientific writing, researchers can effectively bridge the gap between complex research outcomes and their practical implications. Medical practitioners and healthcare providers rely on these publications to inform their decision-making processes, ensuring that the treatments and interventions provided to young patients are rooted in the latest scientific research. Moreover, policymakers and funding agencies use these articles to make informed decisions about resource allocation, ultimately influencing the trajectory of pediatric healthcare at a societal level.

In conclusion, this article emphasizes why the mastery of scientific writing in the context of medical research is not just an academic pursuit, but it is also a powerful catalyst for progress and innovation in the field of medicine. By honing their skills in crafting meticulously written scientific articles, researchers contribute significantly to the advancement of pediatric healthcare, ultimately improving the lives of people around the world.

这篇简短的文章强调了掌握有效撰写科学文章这一复杂技巧的重要意义,尤其是在儿科研究方面。一篇精心撰写的科学文章不仅能展示研究的深度,还能成为与广大科学界分享宝贵见解和发现的渠道。文章强调,科学出版物不仅仅是数据的汇编,更是知识传播的工具,让医疗专业人员、研究人员和政策制定者能够了解儿科医疗保健领域的最新发展。通过坚持科学写作的最高标准,研究人员可以有效地弥合复杂的研究成果与其实际意义之间的差距。医疗从业人员和医疗服务提供者依靠这些出版物为他们的决策过程提供信息,确保为年轻患者提供的治疗和干预措施植根于最新的科学研究。总之,本文强调了为什么在医学研究中掌握科学写作不仅是一种学术追求,而且还是医学领域进步和创新的强大催化剂。通过磨练他们精心撰写科学文章的技能,研究人员为儿科医疗保健的进步做出了巨大贡献,最终改善了全世界人民的生活。
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引用次数: 0
Long COVID in non-hospitalised children and young people: A national matched cohort study. (The CLoCk study) 非住院儿童和青少年的长期 COVID:全国匹配队列研究。(CLoCk 研究)
Pub Date : 2024-01-30 DOI: 10.1016/j.gpeds.2024.100133
Terence Stephenson, Roz Shafran

The commonest persisting symptoms after COVID in children and young people (CYP) are fatigue, headache, shortness of breath and persisting loss of smell. Early in the pandemic, many symptoms of long COVID were reported almost as commonly in negative controls giving rise to a debate whether these were the consequence of the SARS-CoV-2 virus per se or of the health and social restrictions of a ‘long pandemic’. Latterly, there are virtually no ‘negative controls’ to allow further exploration of this. Mental health outcomes also showed little difference from controls. Predictors of long COVID in CYP are older age, female sex, minority ethnicity and impaired pre-COVID-19 health and wellbeing. Vaccines prevent acute Covid-19 and hence long COVID arising from post-vaccination contact but there is little evidence in CYP that vaccination mitigates existing long COVID.

儿童和青少年(CYP)在感染后最常见的持续症状是疲劳、头痛、呼吸急促和持续嗅觉减退。在大流行早期,阴性对照组几乎同样普遍报告了许多长期 COVID 的症状,这引起了一场争论,即这些症状是 SARS-CoV-2 病毒本身的后果,还是 "长期大流行 "的健康和社会限制的后果。后来,几乎没有 "阴性对照 "来进一步探讨这个问题。心理健康结果与对照组的差异也很小。儿童青少年长期COVID的预测因素包括年龄偏大、性别为女性、少数族裔以及COVID-19前的健康和福利受损。疫苗可预防急性 Covid-19 以及接种后接触引起的长期 COVID,但在 CYP 中几乎没有证据表明接种疫苗可减轻现有的长期 COVID。
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引用次数: 0
Early life nutrition, microbiome development: Effect on health and disease 生命早期的营养、微生物组的发育:对健康和疾病的影响
Pub Date : 2024-01-30 DOI: 10.1016/j.gpeds.2024.100148
Erika Isolauri
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引用次数: 0
Management of pediatric emergencies during natural disasters: The 2023 earthquake in Turkey 自然灾害期间的儿科紧急情况管理:2023 年土耳其地震
Pub Date : 2024-01-30 DOI: 10.1016/j.gpeds.2024.100143
Esra Şevketoğlu

The earthquake that occurred in the southeastern region of Türkiye on February 6, 2023 resulted in extensive destruction, affecting 11 provinces and causing a death toll of almost 50,000 individuals. This review emphasizes the unique vulnerabilities that children face in the aftermath of earthquakes and stresses the significance of having preparedness plans specifically tailored to their needs. It is crucial to provide immediate emotional support to children and help them restore their normal routines in order to ensure their well-being. Additionally, emergency nutrition care and mental health services play a vital role in maintaining their long-term health. The disruption of healthcare services also increases the risk of infectious diseases, underscoring the urgency of vaccination efforts. It is crucial that healthcare providers should undergo training and collaborate with each other to adopt a comprehensive approach to pediatric disaster care.

2023 年 2 月 6 日发生在土耳其东南部地区的地震造成了广泛的破坏,波及 11 个省,死亡人数近 50,000 人。这次审查强调了儿童在地震后所面临的独特脆弱性,并强调了制定专门针对儿童需求的备灾计划的重要性。至关重要的是,应立即为儿童提供情感支持,帮助他们恢复正常生活习惯,以确保他们的福祉。此外,紧急营养护理和心理健康服务对于维护他们的长期健康也起着至关重要的作用。医疗保健服务的中断也会增加传染病的风险,这也凸显了疫苗接种工作的紧迫性。至关重要的是,医疗服务提供者应接受培训并相互协作,采取全面的儿科灾难护理方法。
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引用次数: 0
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Global pediatrics
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