Journal of mother and child最新文献

Background: Telehealth was an alternative in many countries during the COVID-19 pandemic for infants at risk of developmental delays. However, some barriers still challenge the adoption of telehealth as a care option, particularly once face-to-face interventions recommenced. This study aimed to identify the barriers and facilitators of a telehealth program to support infants at risk for developmental delays.

Materials and methods: A prospective longitudinal study was conducted with 30 infants born at risk of developmental delay (preterm or term, with mean age of 3.1 months). Infants were enrolled between 2-12 months of corrected age. The program consisted of weekly telehealth sessions with a physical therapist focusing on supporting children's cognitive, motor, speech, and language development. After 6 months, the caregivers answered a questionnaire on perceived barriers and facilitators of the telehealth program.

Results: A mean of 9.5 (range 2-12) sessions were carried out. Most caregivers (80%) felt comfortable and satisfied with the program, found the application for video calls easy to use, got help with their questions, and perceived improvements in the development of their infants. The main barrier was most caregivers rated the concern regarding their child as low (53.3%).

Conclusion: Caregivers considered the telehealth program satisfactory and viable for complementary care and monitoring of infants' development.

Background: This study investigates genetic markers, such as polymorphisms in the vitamin D receptor (VDR) and receptor activator of nuclear factor-kappa B ligand (RANKL) genes, to determine if they can serve as prognostic indicators for the development of bone-tissue pathologies in childhood.

Material and methods: The study included 104 healthy children aged from birth to 12 months. Genetic testing was conducted to identify polymorphisms in the VDR and RANKL genes.

Results: 78% of the 104 children from the Kazakh population showed a decrease in the level of vitamin D, with particularly promising results in infants seven to 12 months old. Indicators of total calcium and phosphorus in children were uninformative for bone-metabolism analysis. The homozygous C/C type according to RANKL rs9594759 was detected in 17% of children; the homozygous T/T variant according to RANKL rs9594738 was detected in 28%; the homozygous T/T according to VDR rs2228570 was detected in 17%; and the homozygous A/A according to VDR rs2228570 was detected in 4%. These variant polymorphisms are associated with reduced bone density. RANKL rs9594738 and RANKL rs9594759 have shown a moderate connection with vitamin D serum concentration.

Conclusion: A relatively strong relationship was found between the T/T and C/T genotypes of the VDR gene and the concentration of vitamin D falling below the norm, and there is a direct relationship between vitamin D levels and bone pathology risk in children.

Background: Prenatal care in the US is often mediated through managed care organisations. Other community-based health organisations also implement nurse-led care programs to help pregnant women navigate prenatal care services. The aim of this study is to assess the impact of such organisational services.

Material and methods: This was a retrospective cohort analysis of data generated from providing community-based care management services to pregnant women in Houston, Texas. Clients' characteristics and outcomes were analysed and described.

Results: About 60 pregnant women received care management services between 2022 and 2023. Out of these, 24 (40%) were teenagers (13-19 years of age), 28 (47%) were young adults (20-26 years), 5 (8%) were 27-30 years, and 3 (5%) were older than 35 years. The youngest patient was 15 years old and the oldest was 39 years. 50% (n = 30) were African-American, 38% (n = 23) were Hispanic, and 12% (n = 7) were white. 48% (n = 29) were in their second trimester, 30% (n = 18) were in their first trimester and 22% (n = 13) were in their third trimester. The earliest gestational age was four weeks, the oldest gestational age was 38 weeks, and the average was 20 weeks. The most common medical risk factors were anxiety, depression, and epilepsy. Others included anaemia, diabetes, alcoholism, smoking, PCOS, thalassemia, renal disease, COVID-19 infection, Lupus erythematosus, multiple gestation, and previous miscarriage. Half of the women, n = 27 (46%), had incorrect Medicaid health insurance that did not cover pregnancy care, and the other half, n=32 (54%), had no health insurance at all.

Conclusion: While it took an average of 53 days for the women in this study to get enrolled in a managed care organisation, it only took an average of 22 days for them to attend their first doctor's appointment when care was directly coordinated by a nurse led community-based health organization. This speaks to the efficacy of nurse-led, community-based care management in improving early access to prenatal care.

Background: This study aimed to calculate a pharmacoeconomic indicator, specifically the cost-effectiveness coefficient, for treating paediatric bronchial asthma with combined regimens of bronchodilators and inhaled corticosteroids.

Material and methods: This study involves 54 children aged 6 to 12 years, who were divided into 6 groups depending on the age and severity of bronchial asthma. Treatment effectiveness is calculated by subtracting the percentage difference between exacerbation frequency and the number of patients. The calculation of pharmacoeconomic data was conducted using the cost-effectiveness ratio (CER).

Results: For the treatment of mild bronchial asthma, the drug Berodual is used for inhalation through a nebuliser, moderate therapy is conducted using a combination of Flixotide and Salbutamol, and severe is stopped by a combination of Symbicort and Salbutamol. From the results obtained, notably, the CER for mild severity was 0.077 for children aged 6-8 years and 0.171 for the age group 9-12 years; for moderate severity, the CER values were 0.27 for the group 6-8 years and 0.35 for the category 9-12 years; severe asthma had the following indicators: 0.506 and 0.798 for groups aged 6-8 and 9-12, respectively.

Conclusion: This study's results indicate that the most cost-effective treatment regimen is in the age groups of 6-8 years. However, the calculation of drug dosages directly depends on the patient's age and the severity of the disease. Further actions in scientific works should be directed to conducting empirical, statistical studies in the field of pharmacoeconomics of bronchial asthma among children from the standpoint of the state.

Background: The incidence of endometrial cancer is increasing globally. Cancer stem cells are now considered the driving force for tumour recurrence and metastasis. We studied whether the proportion of cancer stem cell population and stemness gene expression differ in type I and type II endometrial cancer.

Materials and methods: Type I and type II endometrial tumour tissues were obtained from patients who underwent hysterectomy. The tumour tissue was digested using collagenase, and we established a primary culture. In the primary cultures established from these two types of cancer, we used flow cytometry to measure the proportion of the cancer stem cell population expressing CD 133 and CXCR4 on its surface. We also looked for the expression of genes related to stemness, regulators of stemness, and markers of metastasis in both these cancer types.

Results: We found that the proportion of cancer stem cell population that expresses CD133 and CXCR4 was higher in type II endometrial cancer than in type I endometrial cancer. Also, genes (Nanog, ALDH, EZH2) related to stemness and aberrant transcriptome were found to be upregulated in type II endometrial cancer.

Conclusion: Our study demonstrates that the proportion of stem cells in type 2 endometrial cancer is higher than in type I endometrial cancer. The findings of this study should lead us to investigate with a larger sample size and see if the increase in the stem cell population in type II endometrial cancer may be the reason for its poor prognosis.

Preterm birth (PTB) remains a significant challenge in modern obstetric practice, posing considerable risks to maternal and neonatal health. Despite advancements in medical technology, the incidence of PTB remains high, and its prediction continues to be complex. Traditional methods for predicting PTB, including medical history evaluation, cervical length measurement, and biochemical markers, have shown limited precision in preventing this serious complication. However, recent technological advancements-such as machine learning algorithms, biomarker profiling, and genetic analyses-offer new possibilities for improving prediction accuracy. This review critically examines current and emerging approaches for PTB prediction, highlighting their potential to transform early risk detection. It also addresses the ethical and societal implications of these technologies. This narrative review aims to comprehensively analyse contemporary methods for predicting preterm birth, evaluating established and emerging approaches. It will assess the efficacy of current predictive tools, examine the limitations they face, and explore the potential for integrating advanced technologies to improve outcomes. By highlighting recent developments in the field and addressing critical knowledge gaps, this review seeks to contribute to the ongoing effort to enhance PTB prediction, aiming to improve maternal and neonatal health outcomes. The study's novelty lies in its comprehensive analysis of cutting-edge innovations in PTB prediction and its focus on identifying critical gaps in current practices.

Background: Leptin physiology in children is crucial for diagnosing and managing pediatric endocrine and metabolic disorders. The aim of this study was to assess the values of leptin, leptin receptor (sOB-R), and free leptin index (FLI) depending on age and sex in healthy Polish children and adolescents.

Materials and methods: A total of 236 children and adolescents aged 1-18 years were recruited. Leptin and leptin receptor concentrations were determined by immunoenzymatic methods. FLI values were calculated as leptin divided by sOB-R concentrations. In 114 children between the ages of 5 and 10 years, a measurement of fat mass was assessed by dual-energy X-ray absorptiometry.

Results: The studied groups of girls and boys were of similar age and did not differ in terms of weight, height, body mass index (BMI), BMI Z-score values, or leptin receptor concentrations. Leptin concentrations and FLI were higher by about 50% (p=0.006; p=0.051, respectively) in girls than boys. Positive correlations were found between leptin and age, BMI, and BMI Z-score values (r=0.562, r=0.563, p=0.397; p<0.001, respectively), and even stronger between FLI and age, BMI, and BMI Z-score values (r=0.670, r=0.632, p=0.409; p<0.001, respectively).

Conclusions: The results concerning leptin and leptin receptor concentrations and FLI values in healthy individuals may be useful in clinical practice in early identification of children and adolescents with an unfavorable adipokine profile resulting in a predisposition to the development of obesity and obesity-related complications. These markers may also be helpful in monitoring therapy effectiveness in patients with obesity, diabetes, and metabolic syndrome.

Introduction: The triad of symptoms: renal defects, congenital inferior vena cava agenesis (IVCA) and deep vein thrombosis of the lower limbs make up the KILT syndrome (kidney and IVC abnormalities with leg thrombosis).

Case report: A 17-year-old boy complained of periodic abdominal pain. Abdominal ultrasonography revealed a multilocular cyst in the right kidney. Physical examination showed no abnormalities, and his blood pressure was 120/80mmHg. Abdominal ultrasonography showed a cyst measuring 36×30×25mm in the right kidney hilum. Computed tomography did not show the hepatic and suprarenal sections of the inferior vena cava. Numerous varicose-dilated collateral vessels, including renal venous vessels, were found in the right kidney hilum. The collateral vessels in the tomography matched the described in the ultrasound renal cyst. MRI confirmed IVCA with no other additional vascular abnormalities. Due to the risk of deep vein thrombosis of the lower limbs, non-pharmacological antithrombotic prophylaxis was recommended.

Conclusions: Early detection of inferior vena cava agenesis allows for the reduction of the risk of dangerous thrombotic complications.

Background: Routine haemoglobin assay is a common postoperative (PO) practice after caesarean sections (CSs). There is no consensus regarding the acceptable haemoglobin's (Hb's) drop after uncomplicated CSs. Objective: To detect the acceptable Hb's drop after uncomplicated caesarean sections (CSs).

Material and methods: Seventy-five (75) participants delivered by uncomplicated elective CSs (ECSs) were recruited for the current study. Participants' pre-operative Hb was compared to PO-Hbs using t-test to detect the acceptable Hb's drop after uncomplicated ECSs. Correlations between the 48-hrs. PO-Hb's drop or 1-week PO-Hb's drop and estimated blood loss (EBL) during uncomplicated ECSs was detected using Pearson's correlation.

Results: Mean duration of uncomplicated ECS was 43.3 ± 1.7 min. and mean EBL during uncomplicated ECSs was 654.4 ± 54.49 ml. No significant difference was detected in this study when 48-hrs. PO-Hb (10.89 ± 0.43 gms%) or 1-week PO-Hb (10.86 ± 0.46 gms%) were compared to the participants' pre-operative Hb (12.2 ± 0.46 gms%), (p=0.3 and 0.5, respectively). Mean 48-hrs. and 1-week PO-Hb's drop after uncomplicated ECSs were 1.28 ± 0.09 and 1.3 ± 0.07 gms%, respectively. The correlation between 48-hrs. PO-Hb's drop and EBL during uncomplicated ECSs was not significant (r=-0.14; p=0.23). The correlation between 1-week PO-Hb's drop and EBL during uncomplicated ECSs was also not significant (r=0.017; p=0.89).

Conclusions: Mean 48-hrs. and 1-week PO-Hb's drop after uncomplicated ECSs were 1.28 ± 0.09 and 1.3 ± 0.07 gms%, respectively. Correlations between either the 48-hrs. PO-Hb's drop or 1-week PO-Hb's drop and EBL during uncomplicated ECSs were not significant.