Jornal de pediatria最新文献_第3页

Factors associated with signs of congenital syphilis in newborns. 新生儿先天性梅毒症状的相关因素。

IF 2.8 4区医学

Jornal de pediatria Pub Date : 2024-07-29 DOI: 10.1016/j.jped.2024.06.008

Ana Fátima Braga Rocha, Maria Alix Leite Araújo, Aisha Khizar Yousafzai, Rebeca Gomes de Oliveira, Ana Patrícia Alves da Silva

{"title":"Factors associated with signs of congenital syphilis in newborns.","authors":"Ana Fátima Braga Rocha, Maria Alix Leite Araújo, Aisha Khizar Yousafzai, Rebeca Gomes de Oliveira, Ana Patrícia Alves da Silva","doi":"10.1016/j.jped.2024.06.008","DOIUrl":"10.1016/j.jped.2024.06.008","url":null,"abstract":"Objective: To analyze risk factors (maternal, obstetric and demographic) associated with congenital syphilis and the clinical characteristics of the newborns.Method: A cross-sectional study carried out in ten public maternity hospitals in Fortaleza, Ceará, Brazil that included cases of live births reported with congenital syphilis in 2015.Results: 469 cases were analyzed; 199 (42.4 %) showed some sign or symptom suggestive of congenital syphilis; of these, 65 (32.7 %) were preterm, 87 (43.7 %) had low birth weight, 116 (58.3 %) had jaundice that required phototherapy, 13 (6.5 %) had hepatomegaly, 10 (5 %) had skin lesions, eight (4.0 %) had splenomegaly and one (0.5 %) had limb pseudoparalysis. Records of other clinical changes were identified in 36 (7.7 %) children. Children whose mothers were not treated or who received a drug other than penicillin and those whose mothers had a VDRL titer ≥ 1:16 at birth were 3.7 and 3.2 times more likely to be born with signs of congenital syphilis (p < 0.001- 95 % CI 2.41-5.58; p < 0.001 - 95 % CI 2.41-5.58) respectively.Conclusions: The findings of this study draw attention to the importance of improving the quality of prenatal care and the development of studies aimed at finding alternative drugs for the treatment of syphilis in pregnant women and the prevention of congenital syphilis.","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Access to genetic evaluation of 1463 individuals with orofacial cleft in Brazil. 对巴西 1463 名口面裂患者进行基因评估。

IF 2.8 4区医学

Jornal de pediatria Pub Date : 2024-07-22 DOI: 10.1016/j.jped.2024.07.002

Isabela Mayá Wayhs Silva, Milena Atique Tacla, Erlane Marques Ribeiro, Elaine Lustosa-Mendes, Agnes Cristina Fett-Conte, Têmis Maria Félix, Ana Carolina Xavier, Isabella Lopes Monlleó, Vera Lúcia Gil-da-Silva-Lopes

{"title":"Access to genetic evaluation of 1463 individuals with orofacial cleft in Brazil.","authors":"Isabela Mayá Wayhs Silva, Milena Atique Tacla, Erlane Marques Ribeiro, Elaine Lustosa-Mendes, Agnes Cristina Fett-Conte, Têmis Maria Félix, Ana Carolina Xavier, Isabella Lopes Monlleó, Vera Lúcia Gil-da-Silva-Lopes","doi":"10.1016/j.jped.2024.07.002","DOIUrl":"10.1016/j.jped.2024.07.002","url":null,"abstract":"Objective: The current study delves into the accessibility of genetic evaluations for individuals with orofacial clefts (OC), comparing data between genetics and treatment centers across Brazil.Methods: This cross-sectional retrospective study analyzed primary data from 1463 OC individuals registered in the Brazilian Database of Craniofacial Anomalies (BDCA) between 2008 and 2018 without age or sex selection. Diagnostic exam results stemming from research projects until 2023 were considered.Results: Of the 1463 individuals with typical OC, 987 were non-syndromic, 462 were syndromic (SOC), 10 presented atypical forms, and three were not specified OC cases. The average age for accessing laboratory diagnosis was 8.5 years among SOC individuals. Notably, more SOC cases were registered in genetics centers than treatment and rehabilitation centers (37.1 % vs. 29 %, p = 0.0015). Those originating from genetics centers accessed diagnosis at an average age of 7.3 years, while those from treatment and rehabilitation centers experienced delays with an average age of 10.7 years (p = 0.0581).Conclusions: Irrespective of the center of origin, the data highlight delayed diagnosis and challenges in accessing genetic tests for the syndromic group. Given the widespread reliance on the public health system by most of the Brazilian population, disseminating this data can significantly contribute to shaping an informed perspective on healthcare access. These insights can improve public policies tailored to the unique needs of individuals with OC.","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Different immunological patterns of Down syndrome patients with and without recurrent infections. 唐氏综合征患者反复感染和未反复感染的不同免疫模式。

IF 2.8 4区医学

Jornal de pediatria Pub Date : 2024-07-22 DOI: 10.1016/j.jped.2024.06.007

Kamila Rosa Martins, Flavia Araujo Alves, Luiz Roberto da Silva, Lauren Olivia Alves da Silva, Gesmar Rodrigues Silva Segundo

{"title":"Different immunological patterns of Down syndrome patients with and without recurrent infections.","authors":"Kamila Rosa Martins, Flavia Araujo Alves, Luiz Roberto da Silva, Lauren Olivia Alves da Silva, Gesmar Rodrigues Silva Segundo","doi":"10.1016/j.jped.2024.06.007","DOIUrl":"10.1016/j.jped.2024.06.007","url":null,"abstract":"Objective: Individuals with Down Syndrome (DS) exhibit a higher susceptibility to infections, suggesting potential immunological alterations within this population. Consequently, this study aims to assess the immune response profile in children with DS to identify potential immune dysfunctions associated with recurrent infections.Methods: The authors conducted a retrospective analysis involving 49 DS patients, examining various epidemiological, clinical, cytogenetic, and laboratory variables. The study's sample comprised patients aged 2-20 years, with a predominance of males. These patients were categorized into two groups based on the presence or absence of recurrent infections, as indicated by the Jeffrey Modell Foundation alert signs.Results: Immunoglobulin (Ig) A, G, and M levels were deemed normal, although individuals with DS experiencing recurrent infections exhibited significantly lower IgA levels. Additionally, CD3, CD4, CD8, and CD19 lymphocyte counts were found to be within normal ranges, with no significant differences between the two groups. While overall data indicated normal seroconversion levels of pneumococcal polysaccharide antibodies, a notable impairment in seroconversion was observed among DS patients with recurrent infections compared to those without such infections.Conclusion: The deficiency of anti-polysaccharide antibodies in individuals with DS may constitute an important immunological comorbidity. Therefore, it warrants further investigation, particularly among individuals with recurrent infections.","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Estimation of standing height in spina bifida: model development and validation. 脊柱裂患者站立高度的估算：模型开发与验证。

IF 2.8 4区医学

Jornal de pediatria Pub Date : 2024-07-16 DOI: 10.1016/j.jped.2024.06.005

Fabio Bertapelli, Marisa Maia Leonardi-Figueiredo, Emanuela Juvenal Martins, Cyntia Rogean de Jesus Alves de Baptista, Ana Claudia Mattiello-Sverzut

{"title":"Estimation of standing height in spina bifida: model development and validation.","authors":"Fabio Bertapelli, Marisa Maia Leonardi-Figueiredo, Emanuela Juvenal Martins, Cyntia Rogean de Jesus Alves de Baptista, Ana Claudia Mattiello-Sverzut","doi":"10.1016/j.jped.2024.06.005","DOIUrl":"https://doi.org/10.1016/j.jped.2024.06.005","url":null,"abstract":"Objective: Childhood standing height has been estimated from arm span-related (heightAS) models. The authors aimed to develop and cross-validate a heightAS model in individuals with spina bifida (SB) and examine the accuracy of existing heightAS models.Methods: Participants were individuals with sacral and low-lumbar SB (n = 14) and non-SB (n = 83), 7-16 years old. Arm span, age, sex, and group (SB vs. non-SB) were candidate height predictors. Sequential regression and leave-one-out cross-validation approaches were used for the model development (M1) and cross-validation (M1-M5). Existing models were: an SB-specific model from Polfuss et al. (M2) and non-SB specific models from Gauld et al. (M3), Mulu et al. (M4), and Zverev et al. (M5) studies.Results: Arm span and group explained 95 % of the variance in height (R2 = 0.95; p < 0.001; SEE = 3.666 cm) and were included in the M1. Mean differences between actual and estimated height were 0.0 cm (M1), 0.4 cm (M2), and 0.5 cm (M5), all not significant (p > 0.05). However, Bland-Altman analysis revealed some variability in the predictability of the models across participants with limits of agreement ranging from 7.4 to 10.9 cm. Considerable errors were observed with M3 (mean diff: -5.58 cm, 95 % CI: -1.6, -20.2 cm), and M4 (mean diff: 10.5 cm, 95 % CI: -13.8, -27.3 cm).Conclusions: Models (M1, M2 and M5) may accurately estimate standing height in groups of children with SB. However, due to the wide limits of agreement, caution is recommended when applying these models for individual height estimations.","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Head growth trajectories as a window into neurodevelopment in preterm infants 作为早产儿神经发育窗口的头部生长轨迹。

IF 2.8 4区医学

Jornal de pediatria Pub Date : 2024-07-09 DOI: 10.1016/j.jped.2024.07.001

引用次数: 0

Evaluation of the level of information of pediatricians about the diagnosis and management of cryptorchidism. 评估儿科医生对隐睾症诊断和治疗的了解程度。

IF 2.8 4区医学

Jornal de pediatria Pub Date : 2024-07-09 DOI: 10.1016/j.jped.2024.06.002

Larissa de Lima Monte, Rodrigo Campos Ocáriz, Joaquim Murray Bustorff-Silva, Patricia Traballi de Carvalho Pegolo, Gil Guerra-Junior, Márcio Lopes Miranda

{"title":"Evaluation of the level of information of pediatricians about the diagnosis and management of cryptorchidism.","authors":"Larissa de Lima Monte, Rodrigo Campos Ocáriz, Joaquim Murray Bustorff-Silva, Patricia Traballi de Carvalho Pegolo, Gil Guerra-Junior, Márcio Lopes Miranda","doi":"10.1016/j.jped.2024.06.002","DOIUrl":"10.1016/j.jped.2024.06.002","url":null,"abstract":"Objective: Evaluate the level of information of pediatricians about the diagnosis and management of cryptorchidism.Method: A cross-sectional observational study was conducted using a form via the \"Google Forms\" platform. The study population included pediatricians and pediatric residents associated with the Brazilian Society of Pediatrics. Seven hundred twenty-eight responses were recorded and analyzed using IBM SPSS v21.Results: 728 valid responses were obtained. Of these answers, only 20.5 % answered that the physical examination was sufficient for the diagnosis, and 79.4 % responded that they requested ultrasound as the best test to aid in diagnosing cryptorchidism. When questioned about the ideal age for referring a patient with cryptorchidism, the survey recorded 56.3 % of the responses defending the correct age as six months old, 30.2 % shortly after birth, and 13.2 % at two years old. Other topics were addressed in the form, such as the frequency of evaluation of testicular position and investigation for DDS, among others. Still, the answers to these questions were compatible with current manuals and guidelines on cryptorchidism.Conclusion: It is evident that the understanding of the professionals consulted about the diagnosis and management of cryptorchidism needs to be updated with the current practices adopted and that pediatricians, in general, must maintain periodic programs on this subject. Therefore, this topic should be part of a continuing education program with pediatric surgery.","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141599830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparing the clinical characteristics and outcomes of septic shock children with and without malignancies: a retrospective cohort study. 比较患有和未患有恶性肿瘤的脓毒性休克患儿的临床特征和预后：一项回顾性队列研究。

IF 2.8 4区医学

Jornal de pediatria Pub Date : 2024-07-03 DOI: 10.1016/j.jped.2024.06.003

Haixin Huang, Ruichen Zhang, Jian Chen, Hongxing Dang, Chengjun Liu, Siwei Lu, Yue-Qiang Fu

{"title":"Comparing the clinical characteristics and outcomes of septic shock children with and without malignancies: a retrospective cohort study.","authors":"Haixin Huang, Ruichen Zhang, Jian Chen, Hongxing Dang, Chengjun Liu, Siwei Lu, Yue-Qiang Fu","doi":"10.1016/j.jped.2024.06.003","DOIUrl":"10.1016/j.jped.2024.06.003","url":null,"abstract":"Objective: There is an amelioration in mortality rates of septic shock patients with malignancies over time, but it remains uncertain in children. Therefore, the authors endeavored to compare the clinical characteristics, treatment needs, and outcomes of septic shock children with or without malignancies.Methods: The authors retrospectively analyzed the data of children admitted to the PICU due to septic shock from January 2015 to December 2022 in a tertiary pediatric hospital. The main outcome was in-hospital mortality.Results: A total of 508 patients were enrolled. The proportion of Gram-negative bacteria and fungal infections in children with malignancies was significantly higher than those without malignancies. Septic shock children with malignancies had a longer length of stay (LOS) in the hospital (21 vs. 11 days, p<0.001). However, there were no statistically significant differences in the LOS of PICU (5 vs. 5 days, p = 0.591), in-hospital mortality (43.0 % vs. 49.4 %, p = 0.276), and 28-day mortality (49.2 % vs. 44.7 %, p = 0.452). The 28-day survival analysis (p = 0.314) also showed no significant differences.Conclusion: Although there are significant differences in the bacterial spectrum of infections, the septic shock children with or without malignancies showed a similar mortality rate. The septic shock children with malignancies had longer LOS of the hospital.","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141537860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Inference of stature using segmental measures in comparison with directly measured height in children and adolescents: an analytical cross-sectional study. 使用分段测量法推断儿童和青少年的身高与直接测量身高的比较：一项横断面分析研究。

IF 2.8 4区医学

Jornal de pediatria Pub Date : 2024-07-02 DOI: 10.1016/j.jped.2024.05.004

Isabela Lima Negrão, Márcia Reimol de Andrade, José Carlos R Rodrigues, Yasmim de França S Serapião, Laila Cristina M Damázio, Joel Alves Lamounier, Jacqueline Domingues Tibúrcio

{"title":"Inference of stature using segmental measures in comparison with directly measured height in children and adolescents: an analytical cross-sectional study.","authors":"Isabela Lima Negrão, Márcia Reimol de Andrade, José Carlos R Rodrigues, Yasmim de França S Serapião, Laila Cristina M Damázio, Joel Alves Lamounier, Jacqueline Domingues Tibúrcio","doi":"10.1016/j.jped.2024.05.004","DOIUrl":"10.1016/j.jped.2024.05.004","url":null,"abstract":"Objectives: In the clinical routine of pediatricians, height is the most reliable indicator for assessing growth. However, there are situations where it is not possible to measure this parameter directly, making the estimation of height or length a useful alternative. The main goal of this study is to identify which segmental measure, including upper arm length (UAL), tibial length (TL), and knee-heel length (KHL), provides the stature estimate that most closely approximates directly measured height in the study participants.Methods: Analytical cross-sectional study of the anthropometric and segmental measures of 248 participants, aged 0 to 14 years old, using Stevenson's and Kihara's equations to estimate indirectly measured height.Results: The segmental measure that provided a measurement that deviated the least from the actual height was the KHL, followed by TL, both calculated using Stevenson's equations.Conclusion: The use of segmental measures to infer a child's stature is valuable in clinical practice, particularly in bedridden and incapacitated patients. Based on the present findings, the KHL and TL segments yielded more accurate results than the UAL.","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141537862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Corrigendum to 对......的更正

IF 2.8 4区医学

Jornal de pediatria Pub Date : 2024-07-02 DOI: 10.1016/j.jped.2024.06.004

引用次数: 0

Validation of entrustable professional activities for use in neonatal care residency programs. 验证新生儿护理住院医师培训计划中使用的可委托专业活动。

IF 2.8 4区医学

Jornal de pediatria Pub Date : 2024-06-29 DOI: 10.1016/j.jped.2024.05.003

Marcia L Costa, Maria Albertina Santiago Rego, Flavia Cardoso Rodrigues, Sandy S Pinheiro, Marcela O Deus, Alexandre S Moura

{"title":"Validation of entrustable professional activities for use in neonatal care residency programs.","authors":"Marcia L Costa, Maria Albertina Santiago Rego, Flavia Cardoso Rodrigues, Sandy S Pinheiro, Marcela O Deus, Alexandre S Moura","doi":"10.1016/j.jped.2024.05.003","DOIUrl":"10.1016/j.jped.2024.05.003","url":null,"abstract":"Objective: Define and develop a set of entrustable professional activities (EPAs) to link clinical training and assessment of the hospital components of neonatal care in neonatology medical residency programs.Methods: An exploratory study was conducted in two phases using a modified Delphi approach. In the first phase, a committee of five neonatology residency program coordinators drafted an initial set of EPAs based on the national matrix of competencies and on EPAs defined by international organizations. In the second phase, a group of neonatal care physicians and medical residents rated the indispensability and clarity of the EPAs and provided comments and suggestions.Results: Seven EPAs were drafted by the coordinators´ committee (n = 5) and used in the content validation process with a group (n = 37) of neonatal care physicians and medical residents. In the first Delphi round, all EPAs reached a content validity index (CVI) above 0.8. The coordinators´ committee analyzed comments and suggestions and revised the EPAs. A second Delphi round with the revised EPAs was conducted to validate and all items maintained a CVI above 0.8 for indispensability and clarity.Conclusion: Seven entrustable professional activities were developed to assess residents in the hospital components of neonatal care medicine. These EPAs might contribute to implementing competency-based neonatology medical residency programs grounded in core professional activities.","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141492084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0