Jornal de pediatria最新文献

{"title":"Identifying adolescents with increased cardiometabolic risk—Simple, but challenging","authors":"Eero A. Haapala","doi":"10.1016/j.jped.2024.10.001","DOIUrl":"10.1016/j.jped.2024.10.001","url":null,"abstract":"","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 1","pages":"Pages 1-3"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WhatsApp and atopic dermatitis: a clinical trial","authors":"Thaís Braga Cerqueira ,&nbsp;Renata Robl Imoto ,&nbsp;Mariana Muzzolon ,&nbsp;Vânia Oliveira de Carvalho","doi":"10.1016/j.jped.2024.07.003","DOIUrl":"10.1016/j.jped.2024.07.003","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of text messages with information about atopic dermatitis (AD) on the quality of life (QoL) of children and their caregivers and on the severity of the disease.</div></div><div><h3>Methods</h3><div>Researcher-blinded randomized controlled clinical trial. The experimental group (EG) received messages about AD and the control group (CG) about general health. A total of 56 children under 15 years of age and their caregivers, allocated to the CG and EG, were assessed on admission, after one month, and after four months. Improvement in QoL was measured by the Children's Dermatology Life Quality Index (CDLQI), the Infants’ Dermatitis Quality of Life Index (IDQOL), and the Dermatitis Family Impact Questionnaire (DFIQ), and improvement in the severity of AD by the Scoring of Atopic Dermatitis (SCORAD) and the Eczema Area and Severity Index (EASI).</div></div><div><h3>Results</h3><div>Median age was of nine years, 33 (58.9 %) were girls. The CG and EG had similar results, except for the higher frequency of mild AD in the CG and moderate/severe AD in the EG—these severity categories were kept grouped together. Regarding mild and moderate/severe AD in the EG, the SCORAD score decreased (<em>p</em> = 0.03 and <em>p</em> &lt; 0.001). The EASI in both groups showed a significant reduction (mild AD: CG: <em>p</em> = 0.01, EG: <em>p</em> = 0.04; moderate/severe AD: CG: <em>p</em> = 0.05, EG: <em>p</em> = 0.02). The QoL of children and caregivers improved only in the EG (<em>p</em> = 0.01). Intergroup analysis showed no differences.</div></div><div><h3>Conclusion</h3><div>The improvement in the severity of AD in both groups suggests the positive effects of educational interventions in general, not only those specific to the disease.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 1","pages":"Pages 67-73"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of video-based interventions on emergence delirium in pediatric patients: a systematic review and meta-analysis of randomized controlled trials","authors":"Yue Wang,&nbsp;Lifang Wang,&nbsp;Nan Liang,&nbsp;Kan Wang","doi":"10.1016/j.jped.2024.06.016","DOIUrl":"10.1016/j.jped.2024.06.016","url":null,"abstract":"<div><h3>Objective</h3><div>Emergence delirium is frequently observed in pediatric patients. With advancements in video-based interventions, such as cartoons, video games, and virtual reality, these modalities may contribute to a reduced incidence of emergency delirium among children. However, robust evidence supporting their efficacy remains necessary.</div></div><div><h3>Methods</h3><div>The authors conducted a systematic search across multiple databases, including Embase, MEDLINE, and Cochrane Library, to identify all randomized controlled trials comparing video-based interventions with control treatments in pediatric emergence delirium. Data were aggregated and analyzed using Review Manager 5.4 to evaluate the effectiveness of video-based interventions.</div></div><div><h3>Results</h3><div>The analysis included eight randomized controlled trials comprising 872 children. The intervention group showed a trend toward lower Pediatric Anesthesia Emergence Delirium scores (<em>p</em> = 0.10) and fewer emergence delirium events (<em>p</em> = 0.52). Seven studies demonstrated that video-based interventions significantly reduced preoperative anxiety, as indicated by decreased scores on the modified Yale Pre-operative Anxiety Scale (<em>p</em> &lt; 0.00001). Anesthesia duration did not significantly differ between the intervention and control groups (<em>p</em> = 0.16). Notably, subgroup analyses revealed a significant reduction in Pediatric Anesthesia Emergence Delirium scores among children under seven years of age (<em>p</em> = 0.001).</div></div><div><h3>Conclusions</h3><div>Video-based interventions were linked to lower Pediatric Anesthesia Emergence Delirium scores and a decreased incidence of emergence delirium events. However, these results did not reach statistical significance across the broader sample. Notably, in children under seven, these interventions significantly reduced the scores.</div></div><div><h3>Level of evidence</h3><div>III</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 1","pages":"Pages 21-29"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal diagnosis of critical congenital heart disease associated with lower postpartum depressive symptoms: a case-control study","authors":"Daniela R. Vieira ,&nbsp;Patrícia P. Ruschel ,&nbsp;Márcia M. Schmidt ,&nbsp;Paulo Zielinsky","doi":"10.1016/j.jped.2024.06.011","DOIUrl":"10.1016/j.jped.2024.06.011","url":null,"abstract":"<div><h3>Objective</h3><div>When the expectant mother is faced with an unforeseen event during pregnancy, she may experience emotional fragility and depression. This study was carried out to test the association between the time of diagnosis of critical congenital heart disease (CCHD) and depressive symptoms in puerperal women.</div></div><div><h3>Method</h3><div>A case-control study. All mothers answered a semi-structured questionnaire and the Edinburgh Postnatal Depression Scale (EPDS). Pearson's correlation and multiple linear regression analysis were used to determine factors associated with depression.</div></div><div><h3>Results</h3><div>50 puerperal women, 23 cases and 27 controls. The proportion of puerperal depressive symptoms was 26.1 % among mothers of infants prenatally diagnosed with CCHD and 77.8 % among mothers of infants postnatally diagnosed (<em>p</em> = 0.001 [OR] 9.917; 95 % CI 2.703–36.379). Multiple linear regression analysis showed that the use of psychotropic drugs and time of diagnosis were significantly associated with puerperal depressive symptoms.</div></div><div><h3>Conclusion</h3><div>Prenatal diagnosis of CCHD was associated with significantly lower levels of depressive symptoms.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 1","pages":"Pages 54-60"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicogenetic characterization and response to disease-modifying therapies in spinal muscular atrophy: real-world experience from a reference center in Southern Brazil","authors":"Ana Letícia Amorim de Albuquerque ,&nbsp;Júlia Kersting Chadanowicz ,&nbsp;Isabela Possebon Bevilacqua ,&nbsp;Ana Lucia Portella Staub ,&nbsp;Pablo Brea Winckler ,&nbsp;Patricia Zambone da Silva ,&nbsp;Simone Chaves Fagondes ,&nbsp;Renata Salatti Ferrari ,&nbsp;Claudia Denise de Oliveira Trojahn ,&nbsp;Viviane Zechlinski Sacharuk ,&nbsp;Thayne Woycinck Kowalski ,&nbsp;Karina Carvalho Donis ,&nbsp;Michele Michelin Becker ,&nbsp;Jonas Alex Morales Saute","doi":"10.1016/j.jped.2024.07.011","DOIUrl":"10.1016/j.jped.2024.07.011","url":null,"abstract":"<div><h3>Objective</h3><div>Spinal Muscular Atrophy linked to chromosome 5q (SMA) is an autosomal recessive neurodegenerative disease characterized by progressive proximal muscle atrophy and weakness. This study addresses the scarcity of research on novel disease-modifying therapies for SMA in Latin America by reporting a real-world experience in Southern Brazil.</div></div><div><h3>Methodology</h3><div>This is a single-center historical cohort that included all patients diagnosed with spinal muscular atrophy at a Regional Reference Service for rare diseases.</div></div><div><h3>Results</h3><div>Eighty-one patients were included, of whom 7 died during follow-up. Of the remaining 74 patients, 5.4 % were classified as pre-symptomatic, 24.3 % with SMA type 1, 28.4 % with type 2, 36.5 % with type 3, and 5.4 % with type 4. The mean follow-up time ranged from 1.8 years for pre-symptomatic cases to 8.7 years for SMA types 2 and 3. Approximately 42 % of these patients received specific disease-modifying therapy, of these, 96.8 % received Nusinersen, with 19.4 % transitioning to gene therapy using Onasemnogene Abeparvovec, and 6.4 % starting Risdiplam. Most patients with SMA type 1 were on disease-modifying treatment, whereas only slightly over a third of patients with type 2 and about 10 % of type 3 were receiving such treatments. Among treated patients, 80 % demonstrated improvement in motor performance during the follow-up, with a lesser therapeutic response being associated with late initiation of treatment and low motor function scores at baseline.</div></div><div><h3>Conclusion</h3><div>This real-world study reinforces the effectiveness of disease-modifying therapies for SMA in Brazil within the context of low- and middle-income countries, which is greater the earlier and the better the patient's functional status.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 1","pages":"Pages 38-45"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinal muscular atrophy in Brazil: from individual treatment to global management","authors":"Laurent Servais ,&nbsp;Cristiane Araujo Martins Moreno","doi":"10.1016/j.jped.2024.11.001","DOIUrl":"10.1016/j.jped.2024.11.001","url":null,"abstract":"","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 1","pages":"Pages 4-6"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BCG vaccination in children with severe combined immunodeficiency in a tertiary center: evaluation of complications and risks","authors":"Matheus Henrique Botaro,&nbsp;Jorgete Maria e Silva,&nbsp;Soraya Regina Abu Jamra,&nbsp;Stephanie Zago Geraldino,&nbsp;Persio Roxo-Junior","doi":"10.1016/j.jped.2024.09.008","DOIUrl":"10.1016/j.jped.2024.09.008","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the complications and risks associated with BCG (Bacillus Calmette-Guérin) vaccination in patients diagnosed with SCID (Severe Combined Immunodeficiency).</div></div><div><h3>Methods</h3><div>This is a descriptive case series study. Medical charts were retrospectively reviewed for demographics, clinical manifestation, laboratory findings at diagnosis, outcome, and diagnosis of BCG vaccine-associated complications.</div></div><div><h3>Results</h3><div>Eleven patients diagnosed with SCID were enrolled. Ten were male. Seven (64 %) were considered probable SCID, while four (36 %) were considered definite SCID (genetically confirmed). The median age at the onset of symptoms was one month; the median age at SCID diagnosis was four months. Respiratory symptoms were the most frequent. Eight patients were vaccinated within seven days of life. Seven (87 %) of these patients experienced BCG vaccine-associated complications (86 % disseminated reactions; 14 % localized reactions). BCG vaccine-associated complications were the first clinical manifestation in 75 % of the vaccinated patients. Less than half of the patients (36 %) underwent hematopoietic stem cell transplantation. The overall death rate was elevated (73 %); the death rate related to BCG vaccination was 25 %.</div></div><div><h3>Conclusions</h3><div>Patients with SCID can present a high rate of BCG vaccine-associated complications, which negatively impact the clinical outcome and mortality. Pediatricians must be aware that BCG vaccine-associated complications can be the first presentation and a warning sign of SCID. Implementing newborn screening for SCID in Brazil may represent a worthy opportunity to impact the health outcomes of affected infants significantly.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 2","pages":"Pages 224-230"},"PeriodicalIF":2.8,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142836501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why study the T1D remission phase in the pediatric population?","authors":"Jesper Johannesen","doi":"10.1016/j.jped.2024.12.001","DOIUrl":"10.1016/j.jped.2024.12.001","url":null,"abstract":"","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 2","pages":"Pages 117-118"},"PeriodicalIF":2.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cloth versus disposable diapers: an exploratory study on family habits","authors":"Marjorie Uber,&nbsp;Renata R. Imoto,&nbsp;Vânia O. Carvalho","doi":"10.1016/j.jped.2024.10.008","DOIUrl":"10.1016/j.jped.2024.10.008","url":null,"abstract":"<div><h3>Objective</h3><div>To describe features and habits of diaper area care and compare the frequency of diaper dermatitis in infants using cloth diapers with those using disposable diapers.</div></div><div><h3>Methods</h3><div>Questionnaires were administered to families with infants who had not started potty training, to assess the frequency of diaper rash in two groups: babies who use exclusively cloth diapers (CD), and others with exclusively disposable diapers (DD). The hygiene methods of the perineal region and the skin lesions frequency were evaluated. The study was approved by the Ethics Committee.</div></div><div><h3>Results</h3><div>1389 participants were included, 53 % male, with a median age of 16 (7–24) months, 1269 (91.4 %) in DD and 120 (8.6 %) in CD. Mild diaper rash occurred a few times a year in 47.0 % and 47.5 % in the DD and CD groups, respectively (<em>p</em> = 0.47). Severe diaper rash occurred a few times a year in 13 % and 10.7 % in the DD and CD groups, respectively (<em>p</em> = 0.66). In the DD, the most used hygiene method was wet wipes (61.5 %), whereas in the CD it was cotton/cloth with water (62.2 %; <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Disposable diapers continue to be more used; hygiene habits differ between the groups and the use of cloth diapers did not increase the frequency of diaper dermatitis when compared to the use of disposable diapers.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 2","pages":"Pages 276-281"},"PeriodicalIF":2.8,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of fatty pancreas and its relation with anthropometric values on the Growth and Obesity Cohort Study","authors":"Gigliola Alberti ,&nbsp;Thelma Cantillo ,&nbsp;Ana Pereira ,&nbsp;Florencia De Barbieri ,&nbsp;Cristian García ,&nbsp;Luis Villarroel ,&nbsp;Juan Cristóbal Gana","doi":"10.1016/j.jped.2024.09.007","DOIUrl":"10.1016/j.jped.2024.09.007","url":null,"abstract":"<div><h3>Objective</h3><div>Nonalcoholic Fatty Pancreas Disease (NAFPD) is characterized by excessive lipid accumulation within the pancreas in the absence of alcohol intake, potentially leading to pancreatic dysfunction and metabolic complications, including type 2 diabetes mellitus, acute and chronic pancreatitis, and pancreatic carcinoma. The authors aim to estimate the prevalence of NAFPD and its association with anthropometric parameters in a cohort of Chilean adolescents.</div></div><div><h3>Method</h3><div>The authors conducted a cross-sectional analysis of the \"Growth and Obesity Chilean Cohort Study\" (GOCS), a longitudinal study involving nearly 1000 children, followed yearly since 2006. All participants underwent anthropometric measurements and abdominal ultrasonography.</div></div><div><h3>Results</h3><div>A total of 741 adolescents were included; 30 exhibited ultrasonography findings compatible with fatty pancreas (4 %). Adolescents with NAFPD had higher BMI z-score (2.33 (1.52–2.69) vs 0.67 (-0.2–1.4), <em>p</em> &lt; 0.001), waist circumference (WC) (90.9 (81.53–98.58) vs 72.2 (67.55–79.83), <em>p</em> &lt; 0.001), waist-to-height ratio (0.55 (0.48–0.6) vs 0.44 (0.41–0.49), <em>p</em> &lt; 0.001), triponderal index (17.35 (15.14–19.25) vs 13.62 (12.07–15.54), <em>p</em> &lt; 0.001), subcutaneous fat (32.4 (21.77–44.95) vs 16.2 (9.3 - 25.3), <em>p</em> &lt; 0.001), visceral fat (45.15 (36.92–62.08) vs 35.5 (28.55–44.25), <em>p</em> &lt; 0.001), systolic blood pressure (<em>p</em> = 0.009), and diastolic blood pressure but only in boys (<em>p</em> = 0.004) compared with controls. The prevalence of liver steatosis was significantly higher in the NAFPD group (63.3% vs 5.2 %, <em>p</em> &lt; 0.001). After adjusting for sex and BMI, only the association with waist circumference and liver steatosis remains statistically significant.</div></div><div><h3>Conclusion</h3><div>In adolescents, NAFPD has a prevalence of 4 % and is associated with a higher BMI z-score, WC, superficial fat, and blood pressure levels. Liver steatosis exhibited a strong association with NAFPD.</div></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":"101 3","pages":"Pages 362-369"},"PeriodicalIF":2.8,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806613","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}