{"title":"Characteristics of pediatric hand and foot tendon injuries in a Japanese pediatric emergency department.","authors":"Takaaki Mori, Osamu Nomura, Shun Kishibe","doi":"10.1111/ped.15862","DOIUrl":"https://doi.org/10.1111/ped.15862","url":null,"abstract":"<p><strong>Background: </strong>Pediatric tendon injuries are rare but are associated with serious complications, such as permanent limb dysfunction, if not diagnosed and treated properly. However, there is a lack of data on their epidemiology and management in the emergency department (ED). The present study describes the characteristics and management of pediatric hand- and foot-tendon injuries in a Japanese pediatric ED.</p><p><strong>Methods: </strong>The present, retrospective, observational study, conducted from March, 2010 to March, 2023, enrolled children younger than 16 years who received a diagnosis of a tendon injury to the hands or feet at a pediatric ED in Tokyo Metropolitan Children's Medical Center. Visits to the ED for follow-up examinations were excluded. The patients' sex, age, arrival time, mechanism of injury, signs and symptoms, examinations, diagnoses, outcomes, and complications were extracted from their medical records.</p><p><strong>Results: </strong>Forty-two tendon injuries in 26 patients were included. Fifteen patients (58%) were male, and the median age was 9.5 years. Injuries occurred most frequently at home (58%) and most often involved a sharp object (42%). The median wound size was 2 cm. Tendon exposure occurred in 38% of patients and limited range of motion occurred in 83%. Tests performed in the ED included plain radiograph (100%) and ultrasonography (12%). Fracture complications occurred in three patients and nerve injury occurred in five. Orthopedic complications occurred in 15 patients (58%).</p><p><strong>Conclusions: </strong>Pediatric hand and foot-tendon injuries had a high risk of orthopedic complications and characteristic features included large wound size, tendon exposure, and limited range of motion.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e15862"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449269","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}
{"title":"Clinical features, diagnostic approach, and outcome of imperforate hymen: A single institution case series.","authors":"Masashi Kadohisa, Masaki Horiike, Hisanori Fujino, Takafumi Nonogaki, Narito Takada","doi":"10.1111/ped.70011","DOIUrl":"https://doi.org/10.1111/ped.70011","url":null,"abstract":"<p><strong>Background: </strong>Imperforate hymen is uncommon but it is one of the most common obstructive lesions of the female genital tract. Hydro/hematometrocolpos, derived from retained uterine and vaginal secretions and menstrual blood, causes various nonspecific symptoms. This study aimed to examine the clinical features, diagnostic approach, and outcomes of imperforate hymen at a single institution in Japan.</p><p><strong>Methods: </strong>We retrospectively reviewed all patients with imperforate hymen at Osaka Red Cross Hospital between January 2012 and November 2023.</p><p><strong>Results: </strong>Six patients were identified. Five patients were diagnosed at puberty (range: 10-13 years) and one was diagnosed in the neonatal period. A neonatal case was diagnosed incidentally during the follow-up of labial fusion. In the adolescent cases, various initial symptoms (e.g., lower abdominal pain, lower back pain, urinary retention, constipation, and abdominal distension) caused the first visit to various clinical departments, such as Internal Medicine, Emergency, Pediatrics, Obstetrics and Gynecology, Orthopedics, and Surgery. In all cases, a large cystic lesion in the lower abdomen, suggestive of hematometrocolpos, was easily detected by abdominal ultrasonography, which resulted in consultation with the appropriate clinical department or performance of additional imaging tests, such as magnetic resonance imaging, in some cases. All patients were treated with a hymenectomy or hymenotomy and circumferential suture at the vaginal introitus. Postoperative stenosis or reclosure during follow-up was not observed.</p><p><strong>Conclusions: </strong>Physicians should consider imperforate hymen as a possible diagnosis when examining adolescent girls who have not yet had menarche and present with refractory lower abdomen-related symptoms, and abdominal ultrasonography should be performed.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70011"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710792","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}
{"title":"Lich-Gregoir vs. Cohen ureteral re-implantation surgery for bilateral vesicoureteral reflux: A propensity score analysis.","authors":"Takayuki Fujii, Hiroyuki Satoh, Atsuko Sato, Yoshiaki Ishizuka, Mizuki Izawa, Yuki Morimoto, Ryuichi Shimono","doi":"10.1111/ped.70010","DOIUrl":"https://doi.org/10.1111/ped.70010","url":null,"abstract":"<p><strong>Background: </strong>The Lich-Gregoir procedure for bilateral vesicoureteral reflux (VUR) is limited by the risk of urinary retention. Here, we investigated the efficacy of the Lich-Gregoir procedure compared to that of the Cohen procedure for bilateral VUR in children.</p><p><strong>Methods: </strong>We retrospectively evaluated children who underwent open ureteral re-implantation for bilateral VUR between 2010 and 2022. The patients' clinical characteristics and perioperative outcomes were compared after 1:1 propensity score matching (PSM).</p><p><strong>Results: </strong>A total of 137 patients were enrolled in this study, with 122 undergoing the Cohen procedure and 15 undergoing the Lich-Gregoir procedure. After PSM, there were 14 patients in each group. The operative time was shorter in the Lich-Gregoir group (121.0 vs. 157.0 min; p = 0.018), while the urethral Foley stay was longer in the Cohen group (6.0 vs. 4.0 days; p < 0.001). Only the Cohen group required ureteral catheter insertion (4.5 days) and had a higher rate of bladder spasms (85.7% vs. 0%; p < 0.001). The Cohen group experienced two postoperative complications, while the Lich-Gregoir group had one patient with temporary urinary retention. The hospitalization period was longer in the Cohen group (8.0 vs. 7.0 days; p < 0.001). There were no significant differences in postoperative hydronephrosis, postoperative urinary tract infection, and persistent VUR between the two groups.</p><p><strong>Conclusions: </strong>The Lich-Gregoir procedure for bilateral VUR was safely and effectively performed in patients who met several criteria (e.g., toilet-trained patients, mild-to-moderate reflux, and normal bladder volume and function).</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70010"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764618","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}
Hyo Ju Yang, Seul Gi Park, Soo Yeon Lim, Seh Hyun Kim, Seung Han Shin, Ee-Kyung Kim, Han-Suk Kim
{"title":"Preoperative predictors of worsened respiratory status after patent ductus arteriosus ligation in preterm infants.","authors":"Hyo Ju Yang, Seul Gi Park, Soo Yeon Lim, Seh Hyun Kim, Seung Han Shin, Ee-Kyung Kim, Han-Suk Kim","doi":"10.1111/ped.70030","DOIUrl":"https://doi.org/10.1111/ped.70030","url":null,"abstract":"<p><strong>Background: </strong>Preterm infants with hemodynamically significant patent ductus arteriosus (PDA) may require surgical ligation. Following the surgery, some infants may encounter a deterioration in respiratory status. This study aimed to evaluate the risk factors that can predict worsened respiratory outcomes after PDA surgical ligation.</p><p><strong>Methods: </strong>A retrospective cohort study was performed on 57 preterm infants born at less than 32 weeks of gestational age and in whom the PDA was surgically ligated between January 2014 and December 2018 at Seoul National University Children's Hospital. Participants were divided into two groups: infants with worsened respiratory outcomes 14 days after ligation and control. Worsened respiratory outcome was defined as an increase in respiratory severity score (RSS) by 30% or more at 14 days after ligation compared to RSS before ligation, or death at 14 days after ligation.</p><p><strong>Results: </strong>Among the 57 PDA-ligated infants, 12 had worsened respiratory outcomes and 45 did not. The worsened respiratory outcomes were associated with oligohydramnios (adjusted OR 1.38, 95% CI 1.1-1.73, p < 0.01) and lower weight at surgery (adjusted OR 0.99, 95% CI 0.99-0.99, p = 0.02), compared to the control.</p><p><strong>Conclusion: </strong>Worsened respiratory outcomes after PDA ligation appeared to be associated with oligohydramnios, and lower weight on the day of surgery.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70030"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764622","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}
Yu Par Khin, Nobutoshi Nawa, Yui Yamaoka, Floret Maame Owusu, Aya Abe, Takeo Fujiwara
{"title":"Association between elementary and middle school children with mixed/foreign parents and influenza vaccination in Japan.","authors":"Yu Par Khin, Nobutoshi Nawa, Yui Yamaoka, Floret Maame Owusu, Aya Abe, Takeo Fujiwara","doi":"10.1111/ped.15851","DOIUrl":"https://doi.org/10.1111/ped.15851","url":null,"abstract":"<p><strong>Background: </strong>The number of children with foreign parents is increasing in Japan; however, the percentage of these children receiving the recommended annual influenza vaccination, which must be paid for voluntarily, may be quite low. Socioeconomic status may influence voluntary vaccination decisions. This study explored the association between elementary and middle school children with mixed (either of the parents was non-Japanese) /foreign parents (both parents were non-Japanese) and influenza vaccination in Japan, stratified by household income and maternal education.</p><p><strong>Methods: </strong>We used combined data from eight cities in the Greater Tokyo area for the period from 2016 to 2019, which included 16,368 elementary and middle school students and their caregivers. Caregivers responded to questions about whether their children received influenza vaccination in the previous year and their foreign-born status. Multilevel Poisson regression was applied and further stratified by income status and maternal education.</p><p><strong>Results: </strong>Three hundred ninety-one children (2.4%) had mixed parents, and 91 (0.6%) had foreign parents. When compared with Japanese children, children with mixed (incidence risk ratio, IRR: 0.80, confidence Interval, CI: 0.71, 0.90) and foreign parents (IRR: 0.70, CI: 0.56, 0.88) were less likely to receive influenza vaccination. After stratification, children with mixed/foreign parents were less likely to receive influenza vaccination than Japanese children only in households with high income and maternal education.</p><p><strong>Conclusions: </strong>Children with mixed and foreign parents, especially in households with high socioeconomic status, had lower influenza vaccine coverage than Japanese children.</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e15851"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910130","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}