Global pediatrics最新文献

Pediatric inflammatory bowel diseases (PIBD) are autoinflammatory, multifactorial diseases that can affect children at any age. There are three types of PIBD: Crohn's disease, ulcerative colitis and unclassified colitis Both genetic and environmental factors are involved in the onset of PIBD. It is suspected that diet composition significantly contributes to IBD risk. On the other hand, in clinical presentation, malnutrition and growth retardation are one of the key signs and they are caused by anorexia and increased metabolism rate. We can say that diet is an important hallmark of PIBD in pathogenesis as well as in the therapy. Exclusive enteral nutrition (EEN) is the most widely used dietary intervention for the treatment of Crohn's disease, but is affected by a low tolerability, especially in pediatric patients. Promising alternative regimens are represented by Crohn's Disease Exclusion Diet (CDED), and other elimination diets, whose use is gradually spreading. The aim of the review is to provide an overview on the latest evidence about the role of nutrition and diet in pediatric IBD.

High quality early childhood education programs can positively impact children's development. A growing body of research has used technology to measure aspects of quality in childcare environments, including sensors to measure the indoor built environment (temperature, light, and noise), physical activity in children and caregivers, and language environments. However, while sensors may generate significant research insights into childcare quality, little work has explored the acceptability of sensors for wide scale use in childcare quality improvement efforts. This study explored childcare staff's experiences with and perceptions of different sensors that could be used to measure parameters of quality indicators in early childcare programs. Research questions were addressed by applying a mixed methods approach using the Unified Theory of Acceptance and Use of Technology framework. Data was collected through online surveys and interviews. Results indicate that childcare staff have little experience with sensors, but most would be comfortable with sensor use in their programs and about half were interested in using them to measure various aspects of quality of childcare environments. Privacy and security issues such as data storage and use were raised as critical to address prior to implementation, along with clear communication with parents and childcare professionals on reasons for using sensors and the documentation of the value of sensor data in predicting child development. The findings highlight the need to include childcare staff and parents in the design of sensor systems and to consider how information will be shared and used.

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.

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.

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.

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.

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.

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.

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.

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.