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Pediatric hip dysplasia and evaluation with ultrasound 儿童髋关节发育不良及超声评估
Pub Date : 2009-10-13 DOI: 10.2217/PHE.09.45
P. Castañeda
Developmental dysplasia of the hip is a frequent condition in newborns. Certain risk factors have been associated with this condition, including female sex, a family history, a breech presentation and certain ethnicities; however, most cases of dysplasia occur in girls without any other risk factors. Clinical examination using the Barlow/Ortolani tests in newborns or by the finding of limited abduction in slightly older children may reveal the diagnosis, but childen with an inconclusive examination or with a risk factor should be referred for further screening. Ultrasonography can detect dysplasia that may not be evident on physical exam or plain radiographs. When dysplasia is identified, treatment should be instituted, and in young children dynamic splinting with the Pavlik harness is safe and effective. Early detection and treatment provides the best long-term results.
髋关节发育不良是新生儿的常见病。某些风险因素与此病有关,包括女性、家族史、臀位和某些种族;然而,大多数不典型增生病例发生在没有任何其他危险因素的女孩身上。在新生儿中使用Barlow/Ortolani试验进行临床检查,或在稍大的儿童中发现有限的外展,可能会发现诊断,但检查结果不确定或有风险因素的儿童应转诊进行进一步筛查。超声检查可以发现在体格检查或x线平片上不明显的发育不良。当发现发育不良时,应进行治疗,在幼儿中使用帕夫利克绑带进行动态夹板固定是安全有效的。早期发现和治疗可提供最佳的长期效果。
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引用次数: 6
Late preterm infants: not so near to term 晚期早产儿:不太接近足月
Pub Date : 2009-10-13 DOI: 10.2217/PHE.09.40
T. Inder, S. Liao
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引用次数: 0
Treatment options for clubfoot: an update 内翻足的治疗方案:最新进展
Pub Date : 2009-10-13 DOI: 10.2217/PHE.09.39
N. Cassis, A. torres-Gómez
Clubfoot is one of the most common yet treatable malformations of the musculoskeletal system. It is a composite of hindfoot equinus and varus, and forefoot adductus and cavus. At present, the standard treatment is the Ponseti method, which consists of manipulation and serial casting, tenotomy of the Achilles tendon and bracing; treatment should start as early as possible, ideally within the first weeks of life. Success of this method exceeds 94%. Relapses are treated with recasting or repetition of the Achilles tenotomy. Failures are treated with more complex surgical procedures, such as posteromedial release, tendon transfers and bony procedures in stiff and resistant feet.
内翻足是最常见但可治疗的肌肉骨骼系统畸形之一。它是后脚马蹄形和内翻形以及前脚内收形和凹形的复合肌。目前,标准的治疗方法是Ponseti法,由手法和连续铸造、跟腱切断术和支具组成;治疗应尽早开始,最好是在出生后的几周内。该方法的成功率超过94%。复发的治疗是重铸或重复跟腱切断术。失败的治疗采用更复杂的外科手术,如后内侧松解、肌腱转移和僵硬和阻力足的骨手术。
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引用次数: 3
Lucinactant (Surfaxin ™ ) for prevention and treatment of respiratory distress syndrome in newborns Lucinactant (Surfaxin™)预防和治疗新生儿呼吸窘迫综合征
Pub Date : 2009-10-13 DOI: 10.2217/PHE.09.49
M. Lal, S. Sinha
Respiratory distress syndrome, resulting from the deficiency of endogenous surfactant, remains a leading cause of mortality and morbidity in preterm infants. Exogenous surfactant replacement therapy is one of the most widely researched areas in neonatal medicine and is now accepted as the standard of care for preventing and treating respiratory distress syndrome in these newborns. Exogenous surfactant replacement therapy has evolved in the past three decades, but controversies still exist as to the choice of preparation (i.e., is one better than the others?), dosing and volume of individual preparations, and cost. At present, animal-derived surfactants that contain proteins appear to be the choice of most clinicians; however, they may have the limitation of being derived from animal sources. This has prompted the development of newer synthetic surfactants such as lucinactant (Surfaxin™, Discovery Laboratories, PA, USA), which contains the protein B mimic synthetic peptide, sinapultide. Although it is not ...
由内源性表面活性剂缺乏引起的呼吸窘迫综合征仍然是早产儿死亡和发病的主要原因。外源性表面活性剂替代疗法是新生儿医学中研究最广泛的领域之一,现已被公认为预防和治疗新生儿呼吸窘迫综合征的标准护理方法。外源性表面活性剂替代疗法在过去三十年中不断发展,但在制剂的选择(即一种制剂比其他制剂好吗?)、单个制剂的剂量和体积以及成本等方面仍然存在争议。目前,含有蛋白质的动物源性表面活性剂似乎是大多数临床医生的选择;然而,它们可能有来自动物来源的限制。这促使了新的合成表面活性剂的发展,如lucinactant (Surfaxin™,Discovery Laboratories, PA, USA),它含有蛋白质B模拟合成肽,sinapultide。虽然不是……
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引用次数: 3
Childhood constipation and diet 儿童期便秘与饮食
Pub Date : 2009-08-18 DOI: 10.2217/PHE.09.38
M. Inan
Constipation is a common problem in children. However, there is much controversy surrounding the etiology, diagnosis and treatment of functional constipation observed in childhood. Despite the high frequency of this problem documented in the literature, there is little research that assesses the direct relationship between the food consumed and the eventual stool consistency. Breastfeeding is an excellent way to prevent constipation in infants and toddlers, as is fruit and vegetable consumption in older children. The aim of this review is to investigate available tools in the literature concerning constipation in children and to discuss the relationship between constipation and diet in childhood.
便秘是儿童常见的问题。然而,关于儿童期功能性便秘的病因、诊断和治疗仍存在诸多争议。尽管这个问题在文献中记录的频率很高,但很少有研究评估所摄入的食物和最终大便一致性之间的直接关系。母乳喂养是防止婴幼儿便秘的好方法,大一点的孩子吃水果和蔬菜也是如此。本综述的目的是调查文献中关于儿童便秘的可用工具,并讨论儿童便秘与饮食之间的关系。
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引用次数: 1
Screening for severe neonatal hyperbilirubinemia 新生儿重症高胆红素血症的筛查
Pub Date : 2009-08-18 DOI: 10.2217/PHE.09.36
V. Bhutani
Screening for severe neonatal hyperbilirubinemia is integral to newborn care. Predischarge risk assessment relies on documentation of visual jaundice: age at onset and progression; identification of clinical risk such as late prematurity and bruising; with determination of total bilirubin (blood or transcutaneous assay) adjusted for age in hours. Along with promotion of breastfeeding, coordination between birthing hospital and medically supervised outpatient follow-up, a systems approach allows for a safer and effective means to prevent adverse effects of extreme hyperbilirubinemia.
筛查新生儿严重高胆红素血症是新生儿护理不可或缺的一部分。出院前风险评估依赖于视觉黄疸的记录:发病年龄和进展情况;确定晚期早产和瘀伤等临床风险;测定总胆红素(血或经皮测定)调整年龄小时。随着母乳喂养的推广,分娩医院和医疗监督门诊随访之间的协调,一个系统的方法允许一个更安全有效的手段来防止极端高胆红素血症的不良影响。
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引用次数: 4
Insights into the nutritional management of short-bowel syndrome 短肠综合征的营养管理见解
Pub Date : 2009-08-18 DOI: 10.2217/PHE.09.33
B. Carter, Kristi L King
Short-bowel syndrome is a malabsorptive state that occurs after resection of the intestine or, alternatively, secondary to the functional incapacity of the bowel to absorb a sufficient amount of nutrients. The clinical presentation of this syndrome is quite diverse and its severity is primarily dependent on both the length of functional remnant bowel remaining after surgical resection and the intestinal adaptive capabilities of the host. Management of patients with short-bowel syndrome requires attention to detail, individualized care and a multidisciplinary approach. Herein, we describe the clinical spectrum of short-bowel syndrome and highlight particular nutritional strategies that may help facilitate intestinal adaptation while meeting growth and nutritional needs.
短肠综合征是肠切除术后发生的一种吸收不良状态,或者是继发于肠功能丧失吸收足够营养物质的能力。该综合征的临床表现多种多样,其严重程度主要取决于手术切除后功能性残肠的长度和宿主的肠道适应能力。短肠综合征患者的管理需要注意细节,个性化护理和多学科方法。在这里,我们描述了短肠综合征的临床谱,并强调了特定的营养策略,可能有助于促进肠道适应,同时满足生长和营养需求。
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引用次数: 0
Desmopressin for the treatment of primary nocturnal enuresis 去氨加压素治疗原发性夜间遗尿
Pub Date : 2009-08-18 DOI: 10.2217/PHE.09.20
P. Kerrebroeck, J. Nørgaard
Primary nocturnal enuresis (PNE) affects a large proportion of children aged 5 years and over, and can persist into adolescence if left untreated. To patients and families, the condition is extremely distressing and embarrassing, as well as inconvenient owing to the increased washing of bedclothes required, and the difficulties surrounding socializing, such as planning sleepovers or holidays. PNE is caused by a mismatch between the capacity of the bladder to store urine and the volume of urine produced at night, which is frequently excessive in children with PNE. Excessive urine production at night can be caused by an impairment of the circadian rhythm of antidiuretic hormone secretion. Treatment for PNE is primarily by means of behavioral conditioning or pharmacological therapy. Desmopressin is a synthetic analogue of naturally occurring antidiuretic hormone, and is the only pharmacological therapy with a Grade A, level 1 recommendation from the International Consultation on Incontinence as a first-line ...
原发性夜间遗尿症(PNE)影响很大一部分5岁及以上的儿童,如果不及时治疗,可持续到青春期。对于患者和家属来说,这种情况是非常痛苦和尴尬的,而且由于需要洗涤更多的被褥,以及在社交方面的困难,例如计划过夜或度假,也带来了不便。PNE是由膀胱储存尿液的能力与夜间产生的尿液量不匹配引起的,这在PNE患儿中经常过量。夜间尿量过多可由抗利尿激素分泌的昼夜节律受损引起。PNE的治疗主要是通过行为调节或药物治疗。去氨加压素是一种天然存在的抗利尿激素的合成类似物,是国际尿失禁咨询协会唯一推荐的a级1级药物治疗,作为一线治疗…
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引用次数: 8
Long-term survival and reproduction in preterm infants 早产儿的长期生存和繁殖
Pub Date : 2009-08-18 DOI: 10.2217/PHE.09.29
J. Chin, G. Swamy
The rate of preterm birth is increasing in developed countries. Improvements in neonatal intensive care have decreased the rate of infant mortality after preterm birth, particularly for those born at the earliest gestational ages. However, the result is an increasing absolute number of preterm birth survivors who suffer from disabilities such as neurosensory, respiratory and cognitive impairments. Evidence is also accumulating demonstrating that these survivors may be at increased risk for mortality, even into later childhood, and that they may face challenges transitioning into adulthood, such as a decreased likelihood of reproduction.
在发达国家,早产率正在上升。新生儿重症监护的改善降低了早产后婴儿死亡率,特别是那些在最早胎龄出生的婴儿死亡率。然而,结果是患有神经感觉、呼吸和认知障碍等残疾的早产幸存者的绝对数量不断增加。越来越多的证据表明,这些幸存者的死亡风险可能会增加,甚至在童年后期也是如此,并且他们可能面临过渡到成年的挑战,例如生殖可能性降低。
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引用次数: 3
Neurally adjusted ventilatory assist for infants in critical condition 危重婴儿的神经调节通气辅助
Pub Date : 2009-08-18 DOI: 10.2217/PHE.09.30
C. Sinder, J. Beck
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引用次数: 2
期刊
Pediatric health
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