Global pediatrics最新文献

This article discusses the importance and benefits of investing in child health and paediatric research in terms of: 1) Primary prevention, 2) Secondary prevention, 3) Tertiary prevention, 4) Learning from the Covid-19 pandemic, 5) Long-term follow-up studies, 6) Direct benefits to recruits participating in research, 7) Investing in the early years of development and 8) Investing in health – the economic argument

The Shaken Baby Syndrome (SBS) is the result of a severe form of physical abuse inflicted on children under the age of 2, mostly by parents or other caregivers, to quiet their inconsolable crying. The violent shaking of the child results in devastating consequences up to death or can lead to serious neurological sequelae and/or compromise of their neurodevelopment. The clinical diagnosis of SBS is not always easy and immediate, especially in cases where the picture presents with subtle signs and symptoms not directly attributable to abuse: it is therefore fundamental that the family pediatrician is aware of this nosological entity, suspects it in the presence of certain risk factors, always considers it in the differential diagnosis like any other pathology, and above all prevents it through sensitization and education of parents and other caregivers to adequately manage their child's crying. This article aims to emphasize the role of primary care pediatricians in knowing, recognizing, and preventing the shaken baby syndrome.

Background

The feeding behavior of newborns is influenced by the conditions of both the mother and newborn before and after birth.

Aims

This study aimed to investigate the factors associated with newborn feeding behavior, focusing on skin-to-skin contact (SSC) as a promoting factor and epidural analgesia as an inhibiting factor, using the Japanese version of the Infant Breastfeeding Assessment Tool (IBFAT).

Study Design

Prospective observational study conducted in Japan.

Participants

A total of 176 pairs of healthy mothers and their healthy full-term newborns.

Outcome Measures

The primary outcome was newborn feeding behaviors measured using the Japanese version of IBFAT within about one day of birth. Stepwise multiple regression analysis was performed to explore the relationship between IBFAT scores and variables that might influence newborn feeding behavior.

Results

Multiple regression analysis revealed that lower IBFAT scores were associated with a higher dose of epidural fentanyl (β = −0.40), and higher IBFAT scores were associated with a longer duration of SSC (β = 0.26), even after adjusting for gestational weeks and Apgar scores. The dose and duration of synthetic oxytocin administration were not associated with IBFAT scores in the multivariate analysis.

Conclusions

Our study showed a dose-dependent relationship between fentanyl and SSC, suggesting that consistently implementing SSC for the maximum duration possible may enhance newborn feeding behaviors, which are reduced by fentanyl administration.

Ensuring a stable routine is crucial for every child, particularly during their hospitalization. Children facing illness undergo treatments that often require strict care routines, involving invasive medical procedures, lengthy hospital stays, and separation from familiar environments like home or school. These prolonged hospitalizations disrupt their usual schedules, resulting in feelings of isolation from family and friends for extended and uncertain periods. These difficulties may impede medical treatments and could contribute to psychological distress, further impacting the well-being of both the patient and their family.

Community education distributes its educational role among all those stakeholders who collaborate to promote an equitable and inclusive learning environment. While the school typically serves as the primary educational institution, for hospitalized children, their educational experience may differ significantly from that of their peers. Therefore, the hospital school encompasses a diverse team of professionals working collaboratively to deliver a tailored educational experience. This article emphasizes the critical importance of expanding such programs within hospital environments. It highlights the necessity of developing robust educational frameworks capable of adapting to the diverse needs and evolving structures of healthcare systems. Finally, the article emphasizes the imperative of upholding high-quality education, ensuring the right to education for all, and honoring the principles of special educational needs as outlined in the 1994 UNESCO Salamanca Statement

The scourge of underage marriages and forced unions transcends borders, impacting individuals under 18 across diverse regions, cultures, and religious beliefs, albeit with varying degrees of prevalence. Currently, one in every five girls globally becomes a bride before turning 18, with a staggering one-third wed before reaching 15. These unions exact a profound toll on emotional and social development, often depriving girls of their right to education, familial connections, leisure, and thrusting them into adult roles, including involuntary motherhood. The denial of childhood, coupled with the grave physical and emotional toll of underage and coerced marriages, yields lasting ramifications on girls' health, prospects, and overall well-being, imperiling not just their lives but also those of their offspring and the collective future. Such marriages constitute a severe form of child abuse, exposing girls to diverse forms of physical violence with enduring repercussions. This commentary, aims to heighten awareness among main stakeholders entrusted with the welfare of minors, including legislators, healthcare professionals and local communities, regarding this issue and its lasting perils. Finally, it underscores the pivotal role pediatricians can play as advocates, actively engaging in programs aimed at monitoring and thwarting the adverse personal and societal repercussions engendered by these distressing phenomena among the under-18 demographic.

A global outbreak of Coronavirus Disease 2019 (COVID-19) which is caused by a new virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has just occurred. An instance of an infectious virus that has been transmitted to humans and had a substantial effect on worldwide health and the economy is SARS-CoV-2. In the human population, besides SARS-CoV-2, numerous additional viruses have lately emerged or re-emerged. To accurately predict the hazards of emerging and re-emerging viral infections, close cooperation between the public health system and the scientific community is essential. Some of the reasons that may be related to the emergence and re-emergence of novel viruses include urbanization, alterations in the natural environment, globalization, and insufficient public health infrastructure.

Vaccines will aid in efficiently controlling the intense outbreaks caused by these emerging viruses. Nevertheless, the creation of novel vaccines encounters various obstacles, including tight deadlines for development and the ongoing evolution of viral variants. Notwithstanding, the difficulties encountered in vaccine development, recent progress in the vaccine development process has yielded a significant breakthrough in combating disease outbreaks. Recent advancements in immunology, genetics, and biotechnology have enabled the creation of several vaccines, including those for dengue, RSV, chikungunya, malaria, and most notably, COVID-19. These novel vaccinations protect a broad spectrum of viruses and other pathogenic microorganisms, including those that are challenging to control or have just emerged.

Bedwetting, or enuresis, represents a socially stigmatizing and distressing condition that significantly impacts the quality of life for both children and their parents. This article seeks to assess and consolidate the current understanding of traditional and innovative treatments, both pharmacological and non-pharmacological, for children with enuresis. The article discusses the various treatment modalities which have been developed and validated to alleviate symptoms of enuresis, enhance quality of life, and address the social and emotional challenges faced by affected children. Finally the article emphasizes the important primary role of general pediatricians that is to tailor therapy protocols to each individual child, considering their unique needs and circumstances, and working closely with their families to identify the most effective approach.

Asthma is the most frequent chronic disease of childhood, affecting up to 20 % of children worldwide. The authors present the current literature focusing on primary and secondary prevention of both early and late childhood asthma and the recent advances in management. The therapeutic tools for pediatric asthma have expanded significantly for both the non-severe and severe forms. The use of anti-inflammatory treatment, even for the mildest cases, and the withdrawal of symptomatic bronchodilation as monotherapy have been included in the most recent guidelines. The different biological therapies have revolutionized the therapeutical approach for severe uncontrolled asthma in children and adolescents.

The main guidelines on asthma maintenance therapy in pediatrics suggest different approaches and describe different stages of asthma to determine the most appropriate treatment.