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A Text Message Intervention for Weight Management in Childhood Obesity at the Pediatric Office 儿童办公室短信干预体重管理儿童肥胖
Pub Date : 2022-03-09 DOI: 10.23937/2469-5769/1510090
Elayyan Ala
Childhood overweight and obesity is a major public health problem affecting one-third of children and adolescents in the United States, it has been linked to significant health risks and comorbid conditions in children and adults as it has direct associations with chronic health problems in children and adults not limited to diabetes, dyslipidemia, heart disease, non-alcoholic fatty liver disease, and many others. Childhood obesity is usually diagnosed and managed at the primary care office but having secondary prevention policy will have a bigger impact as obesity has been shown to be significantly correlated with observable behaviors, and having behavior change interventions will be easiest way to improve the health outcome. Sending a text message encouraging certain behavior changes to the parents of children ranging from 2 to 18 years of age with BMIs of more than the 95 percentiles for their age during their pediatric primary care visits. Sending a text messages weekly for 6 months encouraging certain behavior changes to the parents as SMS text can serve as cue to action according to the Health Belief Model (HBM) which triggers the decisionmaking process to accept a recommended health action. RESEARCH ARtiClE
儿童超重和肥胖是影响美国三分之一儿童和青少年的一个主要公共卫生问题,它与儿童和成人的重大健康风险和共病状况有关,因为它与儿童或成人的慢性健康问题直接相关,不仅限于糖尿病、血脂异常、心脏病、非酒精性脂肪肝,以及许多其他方面。儿童肥胖通常在初级保健办公室进行诊断和管理,但二级预防政策将产生更大的影响,因为肥胖已被证明与可观察的行为显著相关,而行为改变干预将是改善健康结果的最简单方法。在儿科初级保健就诊期间,向2至18岁儿童的父母发送短信,鼓励他们改变某些行为,这些儿童的BMI超过了其年龄的95%。根据健康信念模型(HBM),在6个月内每周发送一条短信,鼓励父母改变某些行为,作为短信可以作为行动的提示,该模型触发决策过程以接受推荐的健康行动。ARtiClE研究
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引用次数: 0
Perinatal Risk Factors and Early Onset of Neonatal Sepsis 围产期危险因素与新生儿败血症的早期发病
Pub Date : 2022-02-21 DOI: 10.23937/2469-5769/1510088
Noah Fedaa Noah, Doya Leen Jamel, Jouni Oday
Background: Neonatal sepsis contributes significantly to neonatal morbidity and mortality and is an ongoing major global public health challenge particularly in developing countries. Objective: The study aims to determine the prevalence of early neonatal infections and risk factors associated with neonatal intensive care. Methods: In a cross-sectional study that included all newborns admitted to the neonatal intensive care of Tishreen University Hospital from October 2019 for one year and who fulfilled clinical and laboratory criteria for early neonatal sepsis, blood samples were drawn for laboratory analysis (CBC, CRP) with a blood culture. Results: 197 neonates (28.14%) had early neonatal sepsis. The majority of patients (80.71%) had negative blood cultures. The most common pathogen of the early neonatal infection was Staphylococcus albicans, Streptococci, and E. coli. The current study found that the most prevalent risk factor for early neonatal infection was a cesarean section, followed by maternal infections, male newborn sex, low birth weight, prematurity, maternal age greater than 30 years and less than 20 years, early rupture of membranes, need for resuscitation, and Meconium amino fluid. Conclusion: The current study confirmed an important prevalence of early neonatal sepsis in Tishreen University Hospital with its association with many risk factors; the most prevalent factors were cesarean section, the gender of the male newborn, low birth weight, and prematurity.
背景:新生儿败血症是导致新生儿发病率和死亡率的重要因素,是一项持续存在的重大全球公共卫生挑战,特别是在发展中国家。目的:本研究旨在确定新生儿早期感染的患病率和与新生儿重症监护相关的危险因素。方法:在一项横断面研究中,纳入了2019年10月起在tisshreen大学医院新生儿重症监护室住院一年的所有新生儿,并符合早期新生儿败血症的临床和实验室标准,抽取血样进行实验室分析(CBC, CRP)并进行血培养。结果:新生儿早期脓毒症197例(28.14%)。多数患者(80.71%)血培养阴性。新生儿早期感染最常见的病原菌为白色葡萄球菌、链球菌和大肠杆菌。目前的研究发现,早期新生儿感染最常见的危险因素是剖宫产,其次是产妇感染、男婴性别、低出生体重、早产、产妇年龄大于30岁和小于20岁、胎膜早期破裂、需要复苏和胎粪氨基液。结论:目前的研究证实了天津大学附属医院新生儿早期脓毒症的重要患病率,其与许多危险因素有关;最常见的因素是剖宫产、男婴性别、低出生体重和早产。
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引用次数: 10
Newborn Resuscitation Scale Up and Retention Program Associated with Improved Neonatal Outcomes in Western Nepal 尼泊尔西部新生儿复苏规模扩大和保留计划与新生儿预后改善相关
Pub Date : 2022-02-07 DOI: 10.23937/2469-5769/1510087
KC Naresh Pratap, Dhungana Ranjan, Gamboa Emily, Davis Siena F, Visick Michael K, Clark Robert B
Background: The adoption of the Helping Babies Breath (HBB) tool has improved the outcomes of neonatal resuscitation following intrapartum events. Perinatal asphyxia however remains a leading cause of neonatal morbidity and mortality in Nepal. HBB training has proven effective, but a major challenge is maintaining resuscitation skills over time. Safa Sanaulo Nepal (SSN) designed an evidence-based strategy for scaling up training and sustaining long-term retention. This paper describes the implementation of SSN’s model, and changes in newborn outcomes that occurred during the program. Methods and findings: The skills retention strategy relied on facility-based trainers to scale up and maintain resuscitation skills in 18 facilities in the area of Nepalgunj, Nepal. A single external mentor coached and assisted the facility-based trainers, provided general support, and monitored progress. Prospective outcome monitoring tracked changes in health metrics for a period of 24 months (March 2018 to March 2020). During this time, 46 facility-based trainers taught resuscitation skills to 1,785 midwives, nurses, and physicians, and supported skill retention with limited data gathered on neonatal health outcomes of 49,809 vaginal deliveries and 12,823 Caesarean sections. To analyze changes over the time SSN’s program was implemented, a comparison of beginning (first three months of assessment) and follow-up (last three months) rates of neonatal mortality, morbidity, and stillbirths was conducted. The total number of births assessed in this comparison was 15,947. Results indicate mortality dropped 60% (p = 0.01), morbidity dropped 77% (p = 0.01), and intrapartum stillbirths dropped 73% (p = 0.001) from beginning to follow-up. Conclusions: SSN’s model provides a valuable example of how an evidence-based program focusing on facility-based trainers, who are mentored and supported to scale-up and sustain resuscitation skills over time, may have a substantial influence on critical neonatal outcomes. This program demonstrated that capacity building required minimal external support and expense, with a single mentor mentoring, supporting, and monitoring 18 facilities. Future programs working to reduce neonatal mortality, morbidity, and intrapartum stillbirths may incorporate program elements to further improve neonatal outcomes.
背景:采用助婴呼吸(HBB)工具改善了分娩事件后新生儿复苏的结果。然而,围产期窒息仍然是尼泊尔新生儿发病和死亡的主要原因。HBB训练已被证明是有效的,但主要的挑战是随着时间的推移保持复苏技能。Safa Sanaulo Nepal (SSN)设计了一项以证据为基础的战略,以扩大培训并保持长期保留。本文描述了SSN模型的实施,以及该计划期间新生儿结果的变化。方法和发现:技能保留策略依赖于以设施为基础的培训师,在尼泊尔尼泊尔gunj地区的18个设施中扩大和保持复苏技能。一个单独的外部导师指导和协助以设施为基础的培训师,提供一般支持,并监测进度。前瞻性结果监测对健康指标的变化进行了为期24个月(2018年3月至2020年3月)的跟踪。在此期间,46名设施培训师向1785名助产士、护士和医生教授复苏技能,并利用收集到的49,809例阴道分娩和12,823例剖腹产新生儿健康结果的有限数据支持技能保留。为了分析SSN计划实施期间的变化,对开始(评估的前三个月)和随访(最后三个月)的新生儿死亡率、发病率和死产率进行了比较。这项比较评估的出生总数为15 947人。结果:从随访开始至随访结束,死亡率下降60% (p = 0.01),发病率下降77% (p = 0.01),产时死产下降73% (p = 0.001)。结论:SSN的模型提供了一个有价值的例子,说明一个以证据为基础的项目如何关注基于设施的培训师,这些培训师在一段时间内得到指导和支持,以扩大和维持复苏技能,可能对关键的新生儿结局产生重大影响。该项目表明,能力建设需要最少的外部支持和费用,只需一个导师指导、支持和监督设施。未来旨在降低新生儿死亡率、发病率和产时死产的项目可能会纳入项目要素,以进一步改善新生儿预后。
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引用次数: 3
Decision Making Surrounding Mode of Initial Enteral Feeding in Critically Ill Pediatric Patients 危重儿科患者初始肠内喂养模式的决策
Pub Date : 2022-01-21 DOI: 10.23937/2469-5769/1510086
Maya Arianne M, Ehresmann Kathleen R, Mustafa Moiz M, Taylor Janice A, Larson Shawn D, Islam Saleem, Petroze Robin T
Background: Wide practice variation and weak guidelines exist when considering enteral feeding options and the decision to proceed with gastric or postpyloric enteral feeding in critically ill infants and children. The purpose of this pilot study is to explore provider decision making in early feeding of critically ill pediatric patients, review the indications for choice of enteral feeding access, and qualitatively explore the role of institutional culture in medical decision making. Methods: In-person structured interviews of multi-level providers were conducted over a two-week period in PICU, NICU, and pediatric cardiac intensive care unit at our facility. A survey was developed to evaluate practitioner demographics as well as decision-making for feeding access in mock scenarios. Descriptive analysis was used for demographics and quantitative responses. Interview transcripts were analyzed using qualitative content analysis to identify common themes and variance in decision making. Results: Providers selected gastric feeding for most of the mock scenarios, a median of 7.4 times for 10 scenarios [IQR 6-9]. At least 1/3 of respondents selected postpyloric feeding for patients with neurologic impairment, hypotonia, aspiration pneumonia, and severe burns. 85% (n = 22) felt institutional culture plays a role in their decision making. 52% (n = 14) felt that postpyloric tubes result in more complications. Conclusion: Initial feeding tube decisions vary among providers, and many feel institutional culture and personal experience play a role in these decisions. Stronger feeding guidelines may help to decrease variability in enteral access choice.
背景:在考虑肠内喂养选择和决定对危重婴儿和儿童进行胃或幽门后肠内喂养时,存在广泛的实践差异和薄弱的指南。本研究旨在探讨危重儿科患者早期喂养的提供者决策,回顾肠内喂养途径选择的指征,并定性地探讨制度文化在医疗决策中的作用。方法:对我院PICU、NICU和小儿心脏重症监护病房的多层次提供者进行为期两周的面对面结构化访谈。开展了一项调查,以评估从业者人口统计数据以及模拟情景中喂养途径的决策。描述性分析用于人口统计和定量反应。访谈记录分析使用定性内容分析,以确定共同的主题和差异的决策。结果:在大多数模拟情景中,提供者选择胃喂养,10种情景中位数为7.4次[IQR 6-9]。至少1/3的应答者选择幽门后喂养用于神经功能障碍、张力低下、吸入性肺炎和严重烧伤的患者。85% (n = 22)的受访者认为制度文化在他们的决策中发挥了作用。52% (n = 14)的患者认为幽门后管并发症较多。结论:初始饲管决策因提供者而异,许多人认为制度文化和个人经验在这些决策中发挥了作用。更严格的喂养指南可能有助于减少肠内通路选择的可变性。
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引用次数: 0
High Prevalence of Neonatal Respiratory Distress and its Possible Etiologies in NICU in Syria 叙利亚新生儿重症监护病房新生儿呼吸窘迫高发及其可能的病因
Pub Date : 2022-01-01 DOI: 10.23937/2469-5769/1510099
Bijow Fareeda Wasfy, Jouni Oday, Dayoub Adnan
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引用次数: 0
Etiological Classification of Short Stature in Children over 5 Years Old 5岁以上儿童身材矮小的病因分类
Pub Date : 2022-01-01 DOI: 10.23937/2469-5769/1510098
Abdullah Suhad, Chreitah Ahmed, Zreik Youssef
Background: Short stature is a common problem in childhood, which may be a normal variant of growth or the result of pathologic conditions. Determination of the etiological factors would lead to more appropriate assessment and clinical approach for patients. Objective: The aim of this study is to describe the etiologies of short stature among children. Materials and Methods: An Observational Cross-Sectional study was conducted in 92 children older than 5 years with short stature. They are selected from Pediatric Endocrinology Clinic, Tishreen University Hospital between September 2020 and September 2021. Weight and height were measured and target height was calculated. Samples of blood, urine, stool were taken and appropriate investigations were performed. Results: A total of 92 children, 42 males (45.7%) and 50 females (54.3%) with mean age 8.8 ± 2.7 years were included in the study. Out of the 92 children, 57(62%) were normal variants including familial short stature (44.6%) and constitutional growth delay (17.4%). Endocrine causes were founded in 14 cases (15.2%) which included hypothyroidism (8.7%), growth hormone deficiency GHD (4.3%) and vitamin D-resistant rickets (2.2%). Other causes of short stature were as follows: infection with Helicobacter pylori (9.8%), Celiac disease (6.5%), and malnutrition (4.3%).
背景:身材矮小是儿童时期常见的问题,可能是生长的正常变异,也可能是病理条件的结果。病因的确定将为患者提供更合适的评估和临床方法。目的:本研究的目的是描述儿童矮小的病因。材料与方法:对92例5岁以上矮小儿童进行观察性横断面研究。他们是在2020年9月至2021年9月期间从tisshreen大学医院儿科内分泌科诊所挑选的。测量体重和身高,计算目标身高。采集血液、尿液和粪便样本并进行适当的调查。结果:共纳入儿童92例,其中男性42例(45.7%),女性50例(54.3%),平均年龄8.8±2.7岁。在92名儿童中,57名(62%)为正常变异,包括家族性身材矮小(44.6%)和体质发育迟缓(17.4%)。内分泌病因14例(15.2%),其中甲状腺功能减退症(8.7%)、生长激素缺乏症(4.3%)和维生素d抗性佝偻病(2.2%)。其他矮小的原因有:幽门螺杆菌感染(9.8%)、乳糜泻(6.5%)和营养不良(4.3%)。
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引用次数: 1
Tension Pneumothorax in 5-Months Old Infant - An Atypical Presentation of CPAM Type I 5个月大婴儿的紧张性气胸- CPAM I型的不典型表现
Pub Date : 2022-01-01 DOI: 10.23937/2469-5769/1510100
Keretić Dorotea, Gliha Andro, Višnjić Stjepan, Car Andrija, Petračić Ivan, Pejić Josip, Batoš Ana Tripalo, Ulamec Monika, Romčević Leon, Gojenović Antonija
Congenital pulmonary airway malformation or CPAM is a rare anomaly which affects specifically one and usually lower lung lobe. In most cases it is detected during prenatal life with foetal ultrasound, but it`s not uncommon to find CPAM in background of frequent respiratory infections in childhood, rarely even in adulthood. In this paper, our aim is to present an atypical presentation of CPAM type I which we had difficulties to diagnose. Our case shows CPAM as a substrate for development of tension pneumothorax in 5-months old infant facilitated by acute bronchitis. After initial thoracic drainage and regression of pneumothorax a recurrent pneumothorax was developed and consequently CPAM was suspected. Following CT scans showed CPAM lesion in lower right lung lobe with mediastinal shift and consolidation of adjacent lung tissue. Parenchyma sparring lung resection was done and histological analysis verified CPAM type I lesion. No postoperative complications occurred and infant`s further development was normal during regular follow-up.
先天性肺气道畸形(CPAM)是一种罕见的异常,只影响一个肺,通常是下肺叶。在大多数情况下,它是在产前通过胎儿超声检测到的,但在儿童时期频繁呼吸道感染的背景下发现CPAM并不罕见,甚至在成年期也很少。在本文中,我们的目的是提出一个非典型的CPAM I型,我们有困难的诊断。我们的病例显示CPAM是5个月大婴儿急性支气管炎诱发的紧张性气胸发展的基质。在最初胸腔引流和气胸消退后,出现复发性气胸,因此怀疑为CPAM。CT示右下肺叶CPAM病变伴纵隔移位及邻近肺组织实变。行肺实质分离切除,组织学分析证实为CPAM I型病变。术后随访无并发症发生,患儿进一步发育正常。
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引用次数: 0
Magnitudes of Immunization Dropout Rate and Predictors for 12-23 Months Aged Children in Abobo District Southwest Ethiopia 埃塞俄比亚西南部Abobo区12-23个月大儿童的免疫接种率下降幅度和预测因素
Pub Date : 2021-12-31 DOI: 10.23937/2469-5769/1510079
Kassaw Ayalew, Mariam Abebe Gebere, Kebede Alemi, Kebede Fassikaw
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引用次数: 0
Lead Poisoning in Pediatric Groups: A Global Burden of Disease 儿童铅中毒:全球疾病负担
Pub Date : 2021-12-31 DOI: 10.23937/2469-5769/1510083
Adeyiga Ab
Background: Lead poisoning is a major public health issues that affect pediatric age group with different multi-organ damage. In children for instance, it has been discovered that there is no small level or appreciable quantity of lead exposure that is safe for children because of developmental growth and cognitive development at this very crucial stage of life. Children are at very high risk because of their handto-mouth explorative behaviors at this developmental age thereby leading to unintentional ingestion of lead. Persistent exposure to lead has been attributed to difficulty in learning, low intelligence quotient (LIQ), attention deficit and behavioral problems. Even at low levels of lead poisoning, accumulating lines of evidence show an irreversible, deleterious effect on a child’s development that result in learning and behavioral disorders with diminished attention span. In addition, the affected patient present with clinical symptoms ranging from abdominal pain, loss of appetite, renal function impairment, and anemia due to inhibition of synthesis of oxygen carrying protein called hemoglobin. Moreover, childhood disease of lead poisoning could develop into neurodegenerative diseases such as Parkinson`s disease and Alzheimer`s disease due to epigenetic modification in future. Methods: Literature search strategy was used through electronic data bases, by using PubMed, Google Scholar, and Medline between years 1960 to year 2019. The search strategy that was used is “lead poisoning in children” or “blood toxicity of lead in childhood”. The literature quality was assessed by selecting articles that were relevant to the topic of my discussion based on the standard of Agency for Healthcare Research and Quality (AHRQ). In the search 2778 articles were got. Out of the research results obtained, only relevant articles were selected for the purpose of topic being studied. Results: In the view of the evidences above, lead poisoning and toxicity among pediatric group are a global burden of disease because of the emergent industrial activities in the world today. Conclusion: The aim of this review study is to determine the effect of lead toxicity among pediatric age group and its social burden on affected children with possible policy and education awareness to mitigate this menace.
背景:铅中毒是影响不同多器官损伤的儿童年龄组的一个主要公共卫生问题。例如,在儿童身上,人们发现,由于发育生长和认知发展处于生命的这个非常关键的阶段,对儿童来说,不存在小水平或可观数量的铅暴露是安全的。儿童处于非常高的风险,因为他们在这个发育年龄的手对嘴探索行为,从而导致无意中摄入铅。持续接触铅被归因于学习困难、低智商、注意力缺陷和行为问题。即使在铅中毒程度较低的情况下,越来越多的证据表明,铅对儿童的发育也会产生不可逆转的有害影响,导致学习和行为障碍,注意力持续时间缩短。此外,受影响的患者表现出腹痛、食欲不振、肾功能受损和贫血等临床症状,这些症状是由于被称为血红蛋白的携氧蛋白的合成受到抑制。此外,由于表观遗传学修饰,儿童铅中毒疾病可能在未来发展为神经退行性疾病,如帕金森病和阿尔茨海默病。方法:在1960年至2019年期间,使用PubMed、Google Scholar和Medline,通过电子数据库使用文献搜索策略。使用的搜索策略是“儿童铅中毒”或“儿童铅的血液毒性”。根据美国医疗保健研究与质量机构(AHRQ)的标准,通过选择与我讨论的主题相关的文章来评估文献质量。在搜索中得到了2778篇文章。在获得的研究结果中,只有相关的文章是为了研究主题而选择的。结果:鉴于上述证据,由于当今世界新兴的工业活动,儿童群体的铅中毒和毒性是全球疾病负担。结论:本综述研究的目的是通过可能的政策和教育意识来确定儿童年龄组铅中毒的影响及其对受影响儿童的社会负担,以减轻这一威胁。
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引用次数: 0
Complementary and Alternative Medicine among Inpatient Pediatric Under One Year of Age in Baghdad City-Iraq 伊拉克巴格达1岁以下住院儿童的补充和替代医学
Pub Date : 2021-12-31 DOI: 10.23937/2469-5769/1510082
A. Suadad J
Background: Complementary & alternative medicine popular in Iraq, its use from many age group but shortage of data is available about uses of traditional medicine in pediatric. Material and methods: The aim of this study to measure the prevalence of complementary and alternative medicine CAM (one type of CAM called saqua) use in acutely sick children (complaining from gastro intestinal symptom) and factors associated with it. This is a cross-sectional study, hospital-based study in a tertiary center of Baghdad CityIraq from the first January 2018 to January 2019. Children were assessed using a specially designed questionnaire, interview with one of child’s family almost the mother or grandmother, face to face interview. Data were analyzed using SPSS (statistical software version 20), Chi-square test for association between using CAM and not using. P-value of 0.05 was considered significant. Results: Among the total 415 admitted children one year’s olds or less complaining from gastro intestinal symptom, 36 (8.6%) were using complementary and alternate medicine. The age distribution of the children using CAM less than first year, children were using CAM, age group less than one month 11 (30.6%), 1 to 6 months 22 (61.1%) and from 6 months to 1 year 3 (8.3%), male 22 (61.1%), female 14 (38.9), about region urban 23 (63.9%) and rural 13 (36.1%), parent with low education state. During period of hospitalization, observation and follow up was done, complication more in the children who use CAM (saqua), 9 (25%) out of 36 using saqua complaining from complication compare with non-using 12(3. 2%). Deaths increasing in the children which using saqua 21 (58.3%) compare with non-using 8 (2.11%). Conclusion: The usage of CAM concerning on value and believes, in this study was founded Complication more in children using CAM camper not using CAM (saqua), also number of death more in pediatric using CAM (saqua), so need awareness about it and more study about (saqua) one type of CAM.
背景:补充和替代医学在伊拉克很流行,它的使用来自许多年龄组,但缺乏关于传统医学在儿科使用的数据。材料和方法:本研究的目的是测量补充和替代医学CAM(一种称为saqua的CAM)在急病儿童(从胃肠道症状主诉)中的使用情况及其相关因素。这是一项横断面研究,基于医院的研究,于2018年1月1日至2019年1月在伊拉克巴格达市的一个三级中心进行。对儿童的评估采用特别设计的问卷,与儿童家庭中的一位几乎是母亲或祖母进行面谈,面对面面谈。采用SPSS(统计软件版本20)对数据进行分析,使用与未使用CAM的相关性采用卡方检验。p值0.05被认为是显著的。结果:415例1岁及以下以胃肠道症状为主诉的患儿中,36例(8.6%)使用了补充和替代药物。使用CAM的儿童年龄分布:1岁以下、正在使用CAM的儿童、1个月以下儿童11人(30.6%)、1 ~ 6个月儿童22人(61.1%)、6个月~ 1岁儿童3人(8.3%)、男性22人(61.1%)、女性14人(38.9)、约地区城市23人(63.9%)、农村13人(36.1%)、父母受教育程度低。住院期间观察随访发现,使用CAM (saqua)的患儿并发症较多,36例使用saqua的患儿中有9例(25%)出现并发症,而未使用saqua的患儿中有12例(3%)出现并发症。2%)。使用saqua 21的儿童死亡率(58.3%)高于未使用8的儿童死亡率(2.11%)。结论:CAM的使用具有一定的价值,本研究发现使用CAM的儿童并发症多于不使用CAM (saqua)的儿童,使用CAM (saqua)的儿童死亡人数也多于使用CAM (saqua)的儿童,因此需要提高对CAM (saqua)的认识,并对CAM的一种类型进行更多的研究。
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引用次数: 0
期刊
International journal of pediatric research
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