Pub Date : 2024-09-28DOI: 10.1186/s12887-024-05047-9
Xu Sun, Lingqi Xu, Shurong Ma, Jun Du, Huajian Gu, Jian Wang
Background: Colony stimulating factor 1 (CSF1) is generally expressed by immune cells in response to pro-inflammatory stimuli. The CSF1 receptor (CSFR) is activated by CSF1, and plays a key role in macrophage homeostasis. Furthermore, the CSF1R+ macrophages maintain homeostasis in the intestinal epithelium. The aim of this study was to explore the functions of CSF1-expressing and CSF1R+ macrophages in necrotizing enterocolitis (NEC), which commonly affects the ileum of neonates.
Methods: In-situ CSF1 expression in the intestines of neonates with NEC or intestinal atresia (n = 4 each) was detected by immunofluorescence staining. The CSF1 levels in the intestinal crypt-derived organoid cultures were measured by ELISA. Peripheral blood monocyte-derived Mφ macrophages were co-cultured with the organoids and stimulated with lipopolysaccharide (LPS) to mimic the inflamed state of the ileum in NEC patients.
Results: CSF1 was expressed in the intestinal epithelial cells of the fetal and neonatal samples, but suppressed in the NEC samples. Furthermore, CSF1 expression was downregulated in the intestinal crypt-derived organoids by LPS. CSF1R+ macrophages were detected near the intestinal crypts in the non-inflamed intestines but were absent in tissues obtained from pediatric NEC patients. Peripheral blood monocyte-derived macrophages promoted intestinal organoid proliferation in vitro following CSF1 stimulation. Finally, low concentrations of LPS slightly enhanced the proliferation of organoids co-cultured with the macrophages, whereas higher doses had a significant inhibitory effect.
Conclusions: Intestinal epithelial cells express CSF1 to regulate the resident macrophages, maintain epithelial homeostasis, and resist infection. The abundant CSF1R+ macrophages in the fetal intestine may overexpress TNF-α upon activation of the TLR4/NF-κB pathway, resulting in epithelial damage and NEC induction.
{"title":"CSF1 is expressed by the intestinal epithelial cells to regulate Mφ macrophages and maintain epithelial homeostasis and is downregulated in neonates with necrotizing enterocolitis.","authors":"Xu Sun, Lingqi Xu, Shurong Ma, Jun Du, Huajian Gu, Jian Wang","doi":"10.1186/s12887-024-05047-9","DOIUrl":"https://doi.org/10.1186/s12887-024-05047-9","url":null,"abstract":"<p><strong>Background: </strong>Colony stimulating factor 1 (CSF1) is generally expressed by immune cells in response to pro-inflammatory stimuli. The CSF1 receptor (CSFR) is activated by CSF1, and plays a key role in macrophage homeostasis. Furthermore, the CSF1R<sup>+</sup> macrophages maintain homeostasis in the intestinal epithelium. The aim of this study was to explore the functions of CSF1-expressing and CSF1R<sup>+</sup> macrophages in necrotizing enterocolitis (NEC), which commonly affects the ileum of neonates.</p><p><strong>Methods: </strong>In-situ CSF1 expression in the intestines of neonates with NEC or intestinal atresia (n = 4 each) was detected by immunofluorescence staining. The CSF1 levels in the intestinal crypt-derived organoid cultures were measured by ELISA. Peripheral blood monocyte-derived Mφ macrophages were co-cultured with the organoids and stimulated with lipopolysaccharide (LPS) to mimic the inflamed state of the ileum in NEC patients.</p><p><strong>Results: </strong>CSF1 was expressed in the intestinal epithelial cells of the fetal and neonatal samples, but suppressed in the NEC samples. Furthermore, CSF1 expression was downregulated in the intestinal crypt-derived organoids by LPS. CSF1R<sup>+</sup> macrophages were detected near the intestinal crypts in the non-inflamed intestines but were absent in tissues obtained from pediatric NEC patients. Peripheral blood monocyte-derived macrophages promoted intestinal organoid proliferation in vitro following CSF1 stimulation. Finally, low concentrations of LPS slightly enhanced the proliferation of organoids co-cultured with the macrophages, whereas higher doses had a significant inhibitory effect.</p><p><strong>Conclusions: </strong>Intestinal epithelial cells express CSF1 to regulate the resident macrophages, maintain epithelial homeostasis, and resist infection. The abundant CSF1R<sup>+</sup> macrophages in the fetal intestine may overexpress TNF-α upon activation of the TLR4/NF-κB pathway, resulting in epithelial damage and NEC induction.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142341577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: As a rare mitochondrial disorder, the pyruvate dehydrogenase complex (PDC) deficiency is a rare inborn disease characterized with glucose metabolism defects, which leads to neurological dysfunction, serum lactic acid buildup and a resultant trend of metabolic acidosis. Although the ketogenic diet (KD) is the first-line treatment for PDC deficiency, there is currently no widely accepted consensus on specific implementation of KD for this condition. Due to the combined effect of pre-existing hyperlactacidemia and KD-induced ketoacidosis that can further exacerbate metabolic disturbances, maintaining metabolic homeostasis should be prioritized during the implementation of KD.
Case presentation: Herein, the authors present a 6-year-old boy with lactic acidosis, ataxia, hypotonia and neuromotor development retardation. The KD was started after the patient was diagnosed with PDC deficiency based on genetic testing. The initiation with classic KD resulted in severe non-diabetic ketoacidosis with elevated anion gap, which was promptly alleviated by dextrose supplementation and dietary modification to a less-restrictive KD. Long-term supervision demonstrated the efficacy of a modified KD in improving both clinical course and metabolic acidosis of the patient.
Conclusions: This rare case adds to the limited evidence of KD application in PDC deficiency, and provides valuable insights into the importance of reasonably lowering the ketogenic ratio of KD at the start of treatment to reduce the risk of metabolic acidosis.
{"title":"Classic ketogenic diet-induced ketoacidosis in the treatment of pyruvate dehydrogenase deficiency: a case report and literature review.","authors":"Rongrong Li, Mingsheng Ma, Wei Chen, Zhengqing Qiu","doi":"10.1186/s12887-024-05054-w","DOIUrl":"https://doi.org/10.1186/s12887-024-05054-w","url":null,"abstract":"<p><strong>Background: </strong>As a rare mitochondrial disorder, the pyruvate dehydrogenase complex (PDC) deficiency is a rare inborn disease characterized with glucose metabolism defects, which leads to neurological dysfunction, serum lactic acid buildup and a resultant trend of metabolic acidosis. Although the ketogenic diet (KD) is the first-line treatment for PDC deficiency, there is currently no widely accepted consensus on specific implementation of KD for this condition. Due to the combined effect of pre-existing hyperlactacidemia and KD-induced ketoacidosis that can further exacerbate metabolic disturbances, maintaining metabolic homeostasis should be prioritized during the implementation of KD.</p><p><strong>Case presentation: </strong>Herein, the authors present a 6-year-old boy with lactic acidosis, ataxia, hypotonia and neuromotor development retardation. The KD was started after the patient was diagnosed with PDC deficiency based on genetic testing. The initiation with classic KD resulted in severe non-diabetic ketoacidosis with elevated anion gap, which was promptly alleviated by dextrose supplementation and dietary modification to a less-restrictive KD. Long-term supervision demonstrated the efficacy of a modified KD in improving both clinical course and metabolic acidosis of the patient.</p><p><strong>Conclusions: </strong>This rare case adds to the limited evidence of KD application in PDC deficiency, and provides valuable insights into the importance of reasonably lowering the ketogenic ratio of KD at the start of treatment to reduce the risk of metabolic acidosis.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142341573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: With the release of the coronavirus disease 2019 (COVID-19) pandemic in late 2022 in China, the number of people infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) roared, including neonatal cases. However, there were few studies on neonatal COVID-19, especially multi-center case reports. This study aimed to explore clinical characteristics and short-term outcomes of neonatal COVID-19 in China.
Methods: We reviewed 187 cases of neonatal COVID-19 between December 11, 2022, and January 12, 2023. The diagnosis was assessed by symptoms, laboratory tests, X-ray manifestations, and diagnosis code. Clinical characteristics and outcomes were evaluated.
Results: In 187 neonatal cases with COVID-19, 84 (44.9%) had severe SARS-CoV-2 infection. Most patients had confirmed exposure to SARS-CoV-2. Fever and respiratory symptoms were common (75.4% and 71.7%, respectively). Severe patients were more likely to have high alanine transaminase (ALT) (> 40U/L) (11.9% vs. 3.9%) and high N-terminal pro-brain natriuretic peptide (NT-proBNP) (> 2000pg/mL) (38.0% vs. 19.6%), compared with nonsevere ones (P < 0.05). None of the patients received COVID-19-specific medical interventions. A few severe patients received corticosteroids (1.1%), and immunoglobulin (0.5%), respectively. All patients were discharged home after the medical care with a median length of stay (LOS) of four days and none of them met the criteria of multisystem inflammatory syndrome in neonates (MIS-N).
Conclusions: After the release of the epidemic situation of COVID-19 in late 2022 in China, more neonatal cases with severe COVID-19 had high ALT and NT-proBNP level. Few specific medical interventions were given, and the outcome was satisfying.
{"title":"Clinical characteristics and outcomes of neonatal SARS-CoV-2 infection after the release of the epidemic situation of COVID-19.","authors":"Siyi Xia, Fei Bei, Cheng Cai, Liqing Xu, Xiaohui Gong, Jingjing Wang, Yongjun Zhang, Huafei Huang, Hongping Xia","doi":"10.1186/s12887-024-05096-0","DOIUrl":"https://doi.org/10.1186/s12887-024-05096-0","url":null,"abstract":"<p><strong>Background: </strong>With the release of the coronavirus disease 2019 (COVID-19) pandemic in late 2022 in China, the number of people infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) roared, including neonatal cases. However, there were few studies on neonatal COVID-19, especially multi-center case reports. This study aimed to explore clinical characteristics and short-term outcomes of neonatal COVID-19 in China.</p><p><strong>Methods: </strong>We reviewed 187 cases of neonatal COVID-19 between December 11, 2022, and January 12, 2023. The diagnosis was assessed by symptoms, laboratory tests, X-ray manifestations, and diagnosis code. Clinical characteristics and outcomes were evaluated.</p><p><strong>Results: </strong>In 187 neonatal cases with COVID-19, 84 (44.9%) had severe SARS-CoV-2 infection. Most patients had confirmed exposure to SARS-CoV-2. Fever and respiratory symptoms were common (75.4% and 71.7%, respectively). Severe patients were more likely to have high alanine transaminase (ALT) (> 40U/L) (11.9% vs. 3.9%) and high N-terminal pro-brain natriuretic peptide (NT-proBNP) (> 2000pg/mL) (38.0% vs. 19.6%), compared with nonsevere ones (P < 0.05). None of the patients received COVID-19-specific medical interventions. A few severe patients received corticosteroids (1.1%), and immunoglobulin (0.5%), respectively. All patients were discharged home after the medical care with a median length of stay (LOS) of four days and none of them met the criteria of multisystem inflammatory syndrome in neonates (MIS-N).</p><p><strong>Conclusions: </strong>After the release of the epidemic situation of COVID-19 in late 2022 in China, more neonatal cases with severe COVID-19 had high ALT and NT-proBNP level. Few specific medical interventions were given, and the outcome was satisfying.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142341575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-21DOI: 10.1186/s12887-024-05046-w
Toril Fjørtoft, Merethe Brandal, Lars Adde, Siril Osland, Hilde Rygh, Tordis Ustad, Kari Anne I Evensen
Background: Exposure to alcohol and/or other addictive drugs in pregnancy is a documented risk factor for neurological impairment. We aimed to assess neurodevelopmental outcome at two years of age in infants exposed to prenatal alcohol and/or other addictive drugs and to examine the predictive value of early motor assessment.
Methods: This was a follow-up at two years of age in the prospective cohort study Children Exposed to Alcohol and/or Drugs in Intrauterine Life (CEADIL). The exposed group comprised 73 infants recruited from primary health care and included in a hospital follow-up programme at St. Olavs Hospital, Trondheim University Hospital, Norway. The control group comprised 93 healthy, unexposed infants recruited from the maternity ward at the same hospital. All children had been assessed by physiotherapists using the General Movement Assessment (GMA) at three months of age. Presence of fidgety movements, movement character and the Motor Optimality Score - Revised (MOS-R) were used. At two years of age, the children were assessed by trained examiners using the Bayley Scales of Infant and Toddler Development - Third Edition (BSID-III), Ages & Stages Questionnaires: Social-Emotional (ASQ:SE) and the Hollingshead Two-Factor Index of Social Position (SES).
Results: The cognitive, language and motor composite scores of BSID-III were considerably lower in the exposed group than in the control group. Mean differences adjusted for age and parental SES ranged from - 13.3 (95% confidence interval, CI: -18.6 to -8.0) to -17.7 (95% CI: -23.3 to -12.2). Suboptimal fidgety movements and monotonous movement character had high sensitivity (0.94 to 0.74), but low specificity (0.10 to 0.32), while sensitivity and specificity of the MOS-R was around 50 and 60%, respectively.
Conclusions: Neurodevelopmental outcome at two years of age was poorer in a group of children exposed to alcohol and/or drugs in pregnancy compared with a control group of healthy, unexposed children. Sensitivity of suboptimal fidgety movements and monotonous movement character at three months of age for later neurodevelopmental outcome was high to acceptable, but the MOS-R had limited sensitivity.
{"title":"Neurodevelopmental outcome at two years of age and predictive value of General Movement Assessment in infants exposed to alcohol and/or drugs during pregnancy: a prospective cohort study.","authors":"Toril Fjørtoft, Merethe Brandal, Lars Adde, Siril Osland, Hilde Rygh, Tordis Ustad, Kari Anne I Evensen","doi":"10.1186/s12887-024-05046-w","DOIUrl":"https://doi.org/10.1186/s12887-024-05046-w","url":null,"abstract":"<p><strong>Background: </strong>Exposure to alcohol and/or other addictive drugs in pregnancy is a documented risk factor for neurological impairment. We aimed to assess neurodevelopmental outcome at two years of age in infants exposed to prenatal alcohol and/or other addictive drugs and to examine the predictive value of early motor assessment.</p><p><strong>Methods: </strong>This was a follow-up at two years of age in the prospective cohort study Children Exposed to Alcohol and/or Drugs in Intrauterine Life (CEADIL). The exposed group comprised 73 infants recruited from primary health care and included in a hospital follow-up programme at St. Olavs Hospital, Trondheim University Hospital, Norway. The control group comprised 93 healthy, unexposed infants recruited from the maternity ward at the same hospital. All children had been assessed by physiotherapists using the General Movement Assessment (GMA) at three months of age. Presence of fidgety movements, movement character and the Motor Optimality Score - Revised (MOS-R) were used. At two years of age, the children were assessed by trained examiners using the Bayley Scales of Infant and Toddler Development - Third Edition (BSID-III), Ages & Stages Questionnaires: Social-Emotional (ASQ:SE) and the Hollingshead Two-Factor Index of Social Position (SES).</p><p><strong>Results: </strong>The cognitive, language and motor composite scores of BSID-III were considerably lower in the exposed group than in the control group. Mean differences adjusted for age and parental SES ranged from - 13.3 (95% confidence interval, CI: -18.6 to -8.0) to -17.7 (95% CI: -23.3 to -12.2). Suboptimal fidgety movements and monotonous movement character had high sensitivity (0.94 to 0.74), but low specificity (0.10 to 0.32), while sensitivity and specificity of the MOS-R was around 50 and 60%, respectively.</p><p><strong>Conclusions: </strong>Neurodevelopmental outcome at two years of age was poorer in a group of children exposed to alcohol and/or drugs in pregnancy compared with a control group of healthy, unexposed children. Sensitivity of suboptimal fidgety movements and monotonous movement character at three months of age for later neurodevelopmental outcome was high to acceptable, but the MOS-R had limited sensitivity.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-21DOI: 10.1186/s12887-024-05070-w
Gizachew Tadele Tiruneh, George Odwe, Kezia K'Oduol, Hellen Gwaro, Nebreed Fesseha, Zipporah Moraa, Alexandra Haake Kamberos, Mohamed Mosaad Hasan, Hema Magge, Yasir B Nisar, Lisa R Hirschhorn
<p><strong>Background: </strong>Sepsis is a leading cause of neonatal mortality, despite the availability of effective treatment of possible serious bacterial illness (PSBI), including when referral to a hospital is not feasible. Gaps in access and delivery worsened during COVID-19. We conducted embedded implementation research in Ethiopia and Kenya aimed at mitigating the impact of COVID-19 and addressing various implementation challenges to improve PSBI management.</p><p><strong>Methods: </strong>The implementation research projects were implemented at the subnational level in Ethiopia and Kenya between November 2020-June 2022 (Ethiopia) and December 2020-August 2022 (Kenya). Guided by the implementation research frameworks, both projects conducted mixed formative quantitative and exploratory research from April to May 2021, followed by summative evaluations conducted between June and July 2022. Frameworks encompassed Consolidated Framework for Implementation Research (CFIR), Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM), as well as health systems framework that incorporates cascades of care and World Health Organization Health Systems Building Blocks. Results were synthesized across the projects through document review and sharing cross-project measures and strategies through a project community of practice.</p><p><strong>Results: </strong>Despite differences in settings across the projects, cross-cutting facilitators included community health worker program and support, and existence of guidelines for PSBI management at primary care levels. Barriers included community attitudes towards seeking care for sick newborns, COVID-19 risks and fear, and lack of health care worker competence. Country-specific contextual barriers included supply chain issues, civil conflict (Ethiopia), and labor strikes (Kenya). Strategies chosen to mitigate barriers and support implementation and sustainability in both settings included leveraging community health workers to address resistance to care-seeking, health workers' training, COVID-19 infection prevention measures, stakeholder engagement, and advocacy to integrate PSBI management into existing programs, policies, and training. Other strategies addressing emerging project-specific barriers, included improving follow-up through a community health desk and PSBI mobile app (Kenya) and supply chain strengthening (Ethiopia). Both projects improved PSBI management coverage, increased adoption and uptake, and informed national policy changes supporting potential for sustainability.</p><p><strong>Conclusions: </strong>Pragmatic embedded implementation research effectively supports the identification of barriers and mapping to strategies designed to increase effective coverage of PSBI management when referral is not feasible during the COVID-19 pandemic. Despite differences in context, cross-cutting strategies identified could inform broader scale-up in the region, including during future he
{"title":"Improving possible serious bacterial infection (PSBI) management in young infants when referral is not feasible: lessons from embedded implementation research in Ethiopia and Kenya.","authors":"Gizachew Tadele Tiruneh, George Odwe, Kezia K'Oduol, Hellen Gwaro, Nebreed Fesseha, Zipporah Moraa, Alexandra Haake Kamberos, Mohamed Mosaad Hasan, Hema Magge, Yasir B Nisar, Lisa R Hirschhorn","doi":"10.1186/s12887-024-05070-w","DOIUrl":"https://doi.org/10.1186/s12887-024-05070-w","url":null,"abstract":"<p><strong>Background: </strong>Sepsis is a leading cause of neonatal mortality, despite the availability of effective treatment of possible serious bacterial illness (PSBI), including when referral to a hospital is not feasible. Gaps in access and delivery worsened during COVID-19. We conducted embedded implementation research in Ethiopia and Kenya aimed at mitigating the impact of COVID-19 and addressing various implementation challenges to improve PSBI management.</p><p><strong>Methods: </strong>The implementation research projects were implemented at the subnational level in Ethiopia and Kenya between November 2020-June 2022 (Ethiopia) and December 2020-August 2022 (Kenya). Guided by the implementation research frameworks, both projects conducted mixed formative quantitative and exploratory research from April to May 2021, followed by summative evaluations conducted between June and July 2022. Frameworks encompassed Consolidated Framework for Implementation Research (CFIR), Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM), as well as health systems framework that incorporates cascades of care and World Health Organization Health Systems Building Blocks. Results were synthesized across the projects through document review and sharing cross-project measures and strategies through a project community of practice.</p><p><strong>Results: </strong>Despite differences in settings across the projects, cross-cutting facilitators included community health worker program and support, and existence of guidelines for PSBI management at primary care levels. Barriers included community attitudes towards seeking care for sick newborns, COVID-19 risks and fear, and lack of health care worker competence. Country-specific contextual barriers included supply chain issues, civil conflict (Ethiopia), and labor strikes (Kenya). Strategies chosen to mitigate barriers and support implementation and sustainability in both settings included leveraging community health workers to address resistance to care-seeking, health workers' training, COVID-19 infection prevention measures, stakeholder engagement, and advocacy to integrate PSBI management into existing programs, policies, and training. Other strategies addressing emerging project-specific barriers, included improving follow-up through a community health desk and PSBI mobile app (Kenya) and supply chain strengthening (Ethiopia). Both projects improved PSBI management coverage, increased adoption and uptake, and informed national policy changes supporting potential for sustainability.</p><p><strong>Conclusions: </strong>Pragmatic embedded implementation research effectively supports the identification of barriers and mapping to strategies designed to increase effective coverage of PSBI management when referral is not feasible during the COVID-19 pandemic. Despite differences in context, cross-cutting strategies identified could inform broader scale-up in the region, including during future he","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11415999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-21DOI: 10.1186/s12887-024-05082-6
Yuchen Liu, Zhenjiang Bai, Tianquan Yang, Bin Yuan, Yong Han, Yongjun Xiang, Ruxuan Zhou, Jingxuan Sun, Min Chen, Chuangli Hao, Hangzhou Wang
Background: An increased incidence of brain abscesses was observed post-COVID-19 pandemic. However, it remains unclear how the COVID-19 pandemic influenced the epidemiology of brain abscesses. This study aimed to investigate changes in the epidemiology of brain abscesses pre- and post-COVID-19 pandemic.
Methods: A retrospective study of demographic, clinical, radiological, and laboratory characteristics of patients with brain abscesses in Children's Hospital of Soochow University from 2015-2023 was performed.
Results: A total of 34 patients were admitted to the hospital during the study. The post-COVID-19 cohort had an average of 5.5 cases/year, which is a 129.2% increase compared to the pre-COVID-19 cohort's average of 2.4 cases/year. Additionally, the rates of fever upon admission (86.36% vs 50%, p = 0.04) and experiencing high-grade fever within 6 weeks before admission (40.91% vs 8.33%, p = 0.044) were significantly increased. A potential rise in the rate of intensive care unit admission was observed (36.36% vs 8.33%, p = 0.113). The average value of globulin in the post-COVID cohort was significantly higher compared to the pre-COVID cohort (31.60 ± 5.97 vs 25.50 ± 5.08, p = 0.009). Streptococcal infections were the predominant cause of brain abscesses in both cohorts (40% vs 43.75%, p = 0.57).
Conclusions: There was a significant increase in the number of brain abscess patients after the COVID-19 pandemic. This underscores the importance of children receiving the streptococcal vaccine.
背景:COVID-19 大流行后,脑脓肿的发病率有所上升。然而,COVID-19 大流行对脑脓肿流行病学有何影响仍不清楚。本研究旨在调查 COVID-19 大流行前后脑脓肿流行病学的变化:方法:对2015-2023年苏州大学附属儿童医院脑脓肿患者的人口学、临床、放射学和实验室特征进行回顾性研究:研究期间共有34名患者入院治疗。与COVID-19前的平均每年2.4例相比,COVID-19后的患者平均每年5.5例,增加了129.2%。此外,入院时发热(86.36% vs 50%,p = 0.04)和入院前 6 周内发高烧(40.91% vs 8.33%,p = 0.044)的比例也显著增加。入住重症监护室的比例也有可能上升(36.36% vs 8.33%,p = 0.113)。COVID后组群的球蛋白平均值明显高于COVID前组群(31.60 ± 5.97 vs 25.50 ± 5.08,p = 0.009)。在两个队列中,链球菌感染是脑脓肿的主要病因(40% vs 43.75%,p = 0.57):结论:COVID-19 大流行后,脑脓肿患者人数明显增加。结论:COVID-19 大流行后,脑脓肿患者人数明显增加,这突出表明了儿童接种链球菌疫苗的重要性。
{"title":"Changes in the epidemiology of pediatric brain abscesses pre- and post-COVID-19 pandemic: a single-center study.","authors":"Yuchen Liu, Zhenjiang Bai, Tianquan Yang, Bin Yuan, Yong Han, Yongjun Xiang, Ruxuan Zhou, Jingxuan Sun, Min Chen, Chuangli Hao, Hangzhou Wang","doi":"10.1186/s12887-024-05082-6","DOIUrl":"10.1186/s12887-024-05082-6","url":null,"abstract":"<p><strong>Background: </strong>An increased incidence of brain abscesses was observed post-COVID-19 pandemic. However, it remains unclear how the COVID-19 pandemic influenced the epidemiology of brain abscesses. This study aimed to investigate changes in the epidemiology of brain abscesses pre- and post-COVID-19 pandemic.</p><p><strong>Methods: </strong>A retrospective study of demographic, clinical, radiological, and laboratory characteristics of patients with brain abscesses in Children's Hospital of Soochow University from 2015-2023 was performed.</p><p><strong>Results: </strong>A total of 34 patients were admitted to the hospital during the study. The post-COVID-19 cohort had an average of 5.5 cases/year, which is a 129.2% increase compared to the pre-COVID-19 cohort's average of 2.4 cases/year. Additionally, the rates of fever upon admission (86.36% vs 50%, p = 0.04) and experiencing high-grade fever within 6 weeks before admission (40.91% vs 8.33%, p = 0.044) were significantly increased. A potential rise in the rate of intensive care unit admission was observed (36.36% vs 8.33%, p = 0.113). The average value of globulin in the post-COVID cohort was significantly higher compared to the pre-COVID cohort (31.60 ± 5.97 vs 25.50 ± 5.08, p = 0.009). Streptococcal infections were the predominant cause of brain abscesses in both cohorts (40% vs 43.75%, p = 0.57).</p><p><strong>Conclusions: </strong>There was a significant increase in the number of brain abscess patients after the COVID-19 pandemic. This underscores the importance of children receiving the streptococcal vaccine.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The principal route of HIV infection in children is vertical transmission. Thus, this study aimed to assess the incidence of mother-to-child transmission of HIV and predictors of positivity among HIV-exposed infants.
Method: Institutions-based retrospective follow-up study was conducted in South Gondar Public hospitals, Northwest Ethiopia from December 2019 to November 2021. The data were taken from PMTCT logbooks and patient medical records, with death being the competing event. Data were entered in to Epi info version 7 and exported to STATA version 14 for final analysis. Both bivariable and multiple variable proportional subdistribution hazard analysis were conducted to identify predictors. P-value < 0.05 was level of significance.
Result: A total of 469 exposed infant mother pairs records were included. The cumulative incidence rate at the end of the study period was 5.2 per 1000 person months (5.2; 95% CI: 3.4-8.0).Infants' absence of ARV prophylaxis at birth (aSHR = 3.7; 95% CI: 1.33-10.48), Mothers with no PMTCT intervention (aSHR = 5.1; 95% CI: 1.83-14.03), home delivery (aSHR = 4.1; 95%CI: 1.46-11.63) and maternal disclosure of HIV status to partner/families (aSHR = 2.9; 95% CI: 1.06-7.78) were predictors of HIV positivity.
Conclusion: The study found that Infants' absence of ARV prophylaxis at birth, mothers without PMTCT intervention, home delivery and mothers who were not disclosing their HIV status to families were predictors of HIV positivity.
背景:儿童感染艾滋病病毒的主要途径是垂直传播。因此,本研究旨在评估母婴传播艾滋病的发生率以及艾滋病病毒感染婴儿的阳性预测因素:方法:2019 年 12 月至 2021 年 11 月,在埃塞俄比亚西北部的南贡达尔公立医院开展了基于机构的回顾性随访研究。数据来自预防母婴传播日志和患者病历,死亡为竞争事件。数据输入 Epi info 第 7 版,并导出到 STATA 第 14 版进行最终分析。为确定预测因素,进行了双变量和多变量比例子分布危险分析。P 值结果:共纳入 469 对暴露的婴儿母亲记录。婴儿出生时未接受抗逆转录病毒预防治疗(aSHR = 3.7;95% CI:1.33-10.48)、母亲未接受预防母婴传播干预(aSHR = 5.1;95%CI:1.83-14.03)、在家分娩(aSHR = 4.1;95%CI:1.46-11.63)和产妇向伴侣/家人透露 HIV 感染状况(aSHR = 2.9;95%CI:1.06-7.78)是 HIV 阳性的预测因素:研究发现,婴儿出生时未接受抗逆转录病毒预防治疗、母亲未接受预防母婴传播干预措施、在家分娩以及母亲未向家人公开其艾滋病毒感染状况是预测艾滋病毒阳性的因素。
{"title":"Incidence of mother-to-child transmission of HIV and predictors of positivity among HIV exposed infants in South Gondar public hospitals, Northwest Ethiopia: competing risk regression model.","authors":"Birara Ayichew Tilaye, Habtamu Shimels Hailemeskel, Fikadie Dagnew Baye, Melese Kebede Hailu, Gebrehiwot Berie Mekonnen, Getachew Arage, Binyam Minuye Birhane, Nigusie Selomon Tibebu, Natnael Moges","doi":"10.1186/s12887-024-05061-x","DOIUrl":"https://doi.org/10.1186/s12887-024-05061-x","url":null,"abstract":"<p><strong>Background: </strong>The principal route of HIV infection in children is vertical transmission. Thus, this study aimed to assess the incidence of mother-to-child transmission of HIV and predictors of positivity among HIV-exposed infants.</p><p><strong>Method: </strong>Institutions-based retrospective follow-up study was conducted in South Gondar Public hospitals, Northwest Ethiopia from December 2019 to November 2021. The data were taken from PMTCT logbooks and patient medical records, with death being the competing event. Data were entered in to Epi info version 7 and exported to STATA version 14 for final analysis. Both bivariable and multiple variable proportional subdistribution hazard analysis were conducted to identify predictors. P-value < 0.05 was level of significance.</p><p><strong>Result: </strong>A total of 469 exposed infant mother pairs records were included. The cumulative incidence rate at the end of the study period was 5.2 per 1000 person months (5.2; 95% CI: 3.4-8.0).Infants' absence of ARV prophylaxis at birth (aSHR = 3.7; 95% CI: 1.33-10.48), Mothers with no PMTCT intervention (aSHR = 5.1; 95% CI: 1.83-14.03), home delivery (aSHR = 4.1; 95%CI: 1.46-11.63) and maternal disclosure of HIV status to partner/families (aSHR = 2.9; 95% CI: 1.06-7.78) were predictors of HIV positivity.</p><p><strong>Conclusion: </strong>The study found that Infants' absence of ARV prophylaxis at birth, mothers without PMTCT intervention, home delivery and mothers who were not disclosing their HIV status to families were predictors of HIV positivity.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11414292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-19DOI: 10.1186/s12887-024-05058-6
Ana Carolina Etrusco Zaroni Santos, Carolina Marques Caiado, Alessandra Geisler Daud Lopes, Gabriela Cunha de França, Ana Karolina Antunes Eisen, Danielle Bruna Leal Oliveira, Orlei Ribeiro de Araujo, Werther Brunow de Carvalho
The objective of this study was to compare HFNC therapy to noninvasive ventilation (NIV/BiPAP) in children with bronchiolitis who developed respiratory failure. We hypothesized that HFNC therapy would not be inferior to NIV. This was a noninferiority open-label randomized single-center clinical trial conducted at a tertiary Brazilian hospital. Children under 2 years of age with no chronic conditions admitted for bronchiolitis that progressed to mild to moderate respiratory distress (Wood-Downes-Férres score < 8) were randomized to either the HFNC group or NIV (BiPAP) group through sealed envelopes. Vital signs, FiO2, Wood-Downes-Férres score and HFNC/NIV parameters were recorded up to 96 h after therapy initiation. Children who developed respiratory failure despite receiving initial therapy were intubated. Crossover was not allowed. The primary outcome analyzed was invasive mechanical ventilation requirement. The secondary outcomes were sedation usage, invasive mechanical ventilation duration, the PICU LOS, the hospital LOS, and mortality rate. A total of 126 patients were allocated to the NIV group (132 randomized and 6 excluded), and 126 were allocated to the HFNC group (136 randomized and 10 excluded). The median age was 2.5 (1–6) months in the NIV group and 3 (2–7) months in the HFNC group (p = 0,07). RSV was the most common virus isolated in both groups (72% vs. 71.4%, NIV and HFNC, respectively). Thirty-seven patients were intubated in the NIV group and 29 were intubated in the HFNC group (29% vs. 23%, p = 0.25). According to the Farrington-Manning test, with a noninferiority margin of 15%, the difference was 6.3% in favor of HFNC therapy (95% confidence interval: -4.5 to 17.1%, p < 0.0001). There was no significant difference in the PICU LOS or sedation duration. Sedation requirement, hospital LOS and invasive mechanical ventilation duration were lower in the HFNC group. HFNC therapy is noninferior to NIV in infants admitted with mild to moderate respiratory distress caused by bronchiolitis that progresses to respiratory failure. U1111-1262-1740; RBR-104z966s. Registered 03/01/2023 (retrospectively registered). ReBEC: https://ensaiosclinicos.gov.br/rg/RBR-104z966s .
{"title":"“Comparison between high-flow nasal cannula (HFNC) therapy and noninvasive ventilation (NIV) in children with acute respiratory failure by bronchiolitis: a randomized controlled trial”","authors":"Ana Carolina Etrusco Zaroni Santos, Carolina Marques Caiado, Alessandra Geisler Daud Lopes, Gabriela Cunha de França, Ana Karolina Antunes Eisen, Danielle Bruna Leal Oliveira, Orlei Ribeiro de Araujo, Werther Brunow de Carvalho","doi":"10.1186/s12887-024-05058-6","DOIUrl":"https://doi.org/10.1186/s12887-024-05058-6","url":null,"abstract":"The objective of this study was to compare HFNC therapy to noninvasive ventilation (NIV/BiPAP) in children with bronchiolitis who developed respiratory failure. We hypothesized that HFNC therapy would not be inferior to NIV. This was a noninferiority open-label randomized single-center clinical trial conducted at a tertiary Brazilian hospital. Children under 2 years of age with no chronic conditions admitted for bronchiolitis that progressed to mild to moderate respiratory distress (Wood-Downes-Férres score < 8) were randomized to either the HFNC group or NIV (BiPAP) group through sealed envelopes. Vital signs, FiO2, Wood-Downes-Férres score and HFNC/NIV parameters were recorded up to 96 h after therapy initiation. Children who developed respiratory failure despite receiving initial therapy were intubated. Crossover was not allowed. The primary outcome analyzed was invasive mechanical ventilation requirement. The secondary outcomes were sedation usage, invasive mechanical ventilation duration, the PICU LOS, the hospital LOS, and mortality rate. A total of 126 patients were allocated to the NIV group (132 randomized and 6 excluded), and 126 were allocated to the HFNC group (136 randomized and 10 excluded). The median age was 2.5 (1–6) months in the NIV group and 3 (2–7) months in the HFNC group (p = 0,07). RSV was the most common virus isolated in both groups (72% vs. 71.4%, NIV and HFNC, respectively). Thirty-seven patients were intubated in the NIV group and 29 were intubated in the HFNC group (29% vs. 23%, p = 0.25). According to the Farrington-Manning test, with a noninferiority margin of 15%, the difference was 6.3% in favor of HFNC therapy (95% confidence interval: -4.5 to 17.1%, p < 0.0001). There was no significant difference in the PICU LOS or sedation duration. Sedation requirement, hospital LOS and invasive mechanical ventilation duration were lower in the HFNC group. HFNC therapy is noninferior to NIV in infants admitted with mild to moderate respiratory distress caused by bronchiolitis that progresses to respiratory failure. U1111-1262-1740; RBR-104z966s. Registered 03/01/2023 (retrospectively registered). ReBEC: https://ensaiosclinicos.gov.br/rg/RBR-104z966s .","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142257118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-19DOI: 10.1186/s12887-024-05079-1
Eduardo Rossato de Victo, Gerson Ferrari, Clemens Drenowatz, Dirceu Solé
The prevalence of tobacco and alcohol use among adolescents is alarming, and these substances are among the leading risk factors for current and future health among adolescents. Physical activity has the potential to help prevent substance use among adolescents. The objective of this study was to evaluate the association between physical activity, modes of transportation to or from school, and sitting time with tobacco and alcohol use among 222,495 adolescents. This cross-sectional study used data from national surveys conducted in 66 countries, obtained through the Global School-based Student Health Survey, and included adolescents aged 11 to 17 years. Information on physical activity, transportation to or from school, sitting time, and tobacco and alcohol use was collected through self-report questionnaires. Generalized linear models were employed to estimate the associations between these variables. The analysis, adjusted for sex, age, and region, revealed that being physically active was associated with lower odds of smoking (OR: 0.86, 95%CI: 0.83–0.89), alcohol use (OR: 0.74, 95%CI: 0.72–0.76), binge drinking (OR: 0.66, 95%CI: 0.62–0.69), and drunkenness (OR: 0.85, 95%CI: 0.83–0.88) compared to inactivity. Insufficiently active participants also had lower odds of tobacco use (OR: 0.83, 95%CI: 0.80–0.85), alcohol use (OR: 0.77, 95%CI: 0.75–0.79), binge drinking (OR: 0.91, 95%CI: 0.87–0.96), and drunkenness (OR: 0.88, 95%CI: 0.85–0.90) compared to inactive participants. Additionally, active transportation to or from school was associated with lower odds of tobacco use (OR: 0.97, 95%CI: 0.95–0.99), alcohol use (OR: 0.94, 95%CI: 0.92–0.96), and binge drinking (OR: 0.78, 95%CI: 0.75–0.81) compared to those using passive transportation. Participants with acceptable sitting time, however, were more likely to use tobacco (OR: 1.48, 95%CI: 1.45–1.52), use alcohol (OR: 1.68, 95%CI: 1.64–1.72), binge drink (OR: 1.68, 95%CI: 1.62–1.75), and experience drunkenness (OR: 1.66, 95%CI: 1.62–1.69) compared to those with excessive sitting time. Being physically active, even at insufficient levels, may have beneficial effects on tobacco and alcohol use in adolescents. Acceptable sedentary time, on the other hand, was positively associated with tobacco and alcohol use.
{"title":"Association of physical activity and sitting time with tobacco and alcohol use in 222,495 adolescents from 66 countries","authors":"Eduardo Rossato de Victo, Gerson Ferrari, Clemens Drenowatz, Dirceu Solé","doi":"10.1186/s12887-024-05079-1","DOIUrl":"https://doi.org/10.1186/s12887-024-05079-1","url":null,"abstract":"The prevalence of tobacco and alcohol use among adolescents is alarming, and these substances are among the leading risk factors for current and future health among adolescents. Physical activity has the potential to help prevent substance use among adolescents. The objective of this study was to evaluate the association between physical activity, modes of transportation to or from school, and sitting time with tobacco and alcohol use among 222,495 adolescents. This cross-sectional study used data from national surveys conducted in 66 countries, obtained through the Global School-based Student Health Survey, and included adolescents aged 11 to 17 years. Information on physical activity, transportation to or from school, sitting time, and tobacco and alcohol use was collected through self-report questionnaires. Generalized linear models were employed to estimate the associations between these variables. The analysis, adjusted for sex, age, and region, revealed that being physically active was associated with lower odds of smoking (OR: 0.86, 95%CI: 0.83–0.89), alcohol use (OR: 0.74, 95%CI: 0.72–0.76), binge drinking (OR: 0.66, 95%CI: 0.62–0.69), and drunkenness (OR: 0.85, 95%CI: 0.83–0.88) compared to inactivity. Insufficiently active participants also had lower odds of tobacco use (OR: 0.83, 95%CI: 0.80–0.85), alcohol use (OR: 0.77, 95%CI: 0.75–0.79), binge drinking (OR: 0.91, 95%CI: 0.87–0.96), and drunkenness (OR: 0.88, 95%CI: 0.85–0.90) compared to inactive participants. Additionally, active transportation to or from school was associated with lower odds of tobacco use (OR: 0.97, 95%CI: 0.95–0.99), alcohol use (OR: 0.94, 95%CI: 0.92–0.96), and binge drinking (OR: 0.78, 95%CI: 0.75–0.81) compared to those using passive transportation. Participants with acceptable sitting time, however, were more likely to use tobacco (OR: 1.48, 95%CI: 1.45–1.52), use alcohol (OR: 1.68, 95%CI: 1.64–1.72), binge drink (OR: 1.68, 95%CI: 1.62–1.75), and experience drunkenness (OR: 1.66, 95%CI: 1.62–1.69) compared to those with excessive sitting time. Being physically active, even at insufficient levels, may have beneficial effects on tobacco and alcohol use in adolescents. Acceptable sedentary time, on the other hand, was positively associated with tobacco and alcohol use.","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142257117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-18DOI: 10.1186/s12887-024-05076-4
Zhixiang Xiao, Lijing Wu, Jun Li, Shaohua He, Jingyi Chen, Lizhi Li, Di Xu, Yingquan Kang
To investigate the clinical efficacy of transumbilical single-incision laparoscopic surgery in the treatment of complicated appendicitis in overweight/obese adolescents. A retrospective analysis was conducted on the clinical data of 226 adolescent patients with complicated appendicitis who were admitted to our hospital from January 2014 to June 2022. Among them, 102 cases underwent transumbilical single-incision laparoscopic appendectomy as the observation group, and another 124 cases underwent conventional three-port laparoscopic appendectomy as the control group. The surgical time, intraoperative blood loss, duration of incisional pain, postoperative flatus time, length of hospital stay, surgical site infection (SSI), satisfaction with cosmetic result, and occurrence of postoperative complications were compared between the two groups. Both groups completed the surgery smoothly, and there were no statistically significant differences in gender, age, BMI, duration of illness, white blood cell count, and preoperative CRP value between the two groups (P > 0.05). There were no statistically significant differences in surgical time and intraoperative blood loss between the two groups (P > 0.05). However, the observation group had shorter hospital stays, shorter duration of incisional pain, shorter postoperative time to flatus, and lower overall postoperative complication rates compared to the control group, with statistically significant differences (P < 0.05). The observation group had higher satisfaction with cosmetic result compared to the control group, with statistically significant differences (P < 0.05). Both groups were followed up for one year postoperatively, and there were no occurrences of residual appendicitis or severe adhesive intestinal obstruction. When proficiently mastered, the application of transumbilical single-incision laparoscopy in the treatment of complicated appendicitis in overweight/obese adolescents offers advantages such as minimal trauma, rapid recovery, fewer complications, and improved aesthetic outcomes.
{"title":"Application of transumbilical single-incision laparoscopy in the treatment of complicated appendicitis in overweight/obese adolescents","authors":"Zhixiang Xiao, Lijing Wu, Jun Li, Shaohua He, Jingyi Chen, Lizhi Li, Di Xu, Yingquan Kang","doi":"10.1186/s12887-024-05076-4","DOIUrl":"https://doi.org/10.1186/s12887-024-05076-4","url":null,"abstract":"To investigate the clinical efficacy of transumbilical single-incision laparoscopic surgery in the treatment of complicated appendicitis in overweight/obese adolescents. A retrospective analysis was conducted on the clinical data of 226 adolescent patients with complicated appendicitis who were admitted to our hospital from January 2014 to June 2022. Among them, 102 cases underwent transumbilical single-incision laparoscopic appendectomy as the observation group, and another 124 cases underwent conventional three-port laparoscopic appendectomy as the control group. The surgical time, intraoperative blood loss, duration of incisional pain, postoperative flatus time, length of hospital stay, surgical site infection (SSI), satisfaction with cosmetic result, and occurrence of postoperative complications were compared between the two groups. Both groups completed the surgery smoothly, and there were no statistically significant differences in gender, age, BMI, duration of illness, white blood cell count, and preoperative CRP value between the two groups (P > 0.05). There were no statistically significant differences in surgical time and intraoperative blood loss between the two groups (P > 0.05). However, the observation group had shorter hospital stays, shorter duration of incisional pain, shorter postoperative time to flatus, and lower overall postoperative complication rates compared to the control group, with statistically significant differences (P < 0.05). The observation group had higher satisfaction with cosmetic result compared to the control group, with statistically significant differences (P < 0.05). Both groups were followed up for one year postoperatively, and there were no occurrences of residual appendicitis or severe adhesive intestinal obstruction. When proficiently mastered, the application of transumbilical single-incision laparoscopy in the treatment of complicated appendicitis in overweight/obese adolescents offers advantages such as minimal trauma, rapid recovery, fewer complications, and improved aesthetic outcomes.","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142257164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}