Clinical Medicine Insights-Pediatrics最新文献

{"title":"Echocardiographic Evaluation of Postoperative Coaptation Geometry of Left AV Valve in Complete Atrioventricular Septal Defect.","authors":"Hiroo Kinami,&nbsp;Kiyozo Morita,&nbsp;Gen Shinohara,&nbsp;Yoshimasa Uno","doi":"10.1177/11795565221139118","DOIUrl":"https://doi.org/10.1177/11795565221139118","url":null,"abstract":"<p><strong>Background: </strong>We sought to determine the difference in geometric parameters in the left atrioventricular valve (LAVV) postoperative complete atrioventricular septal defect (CAVSD) compared to the normal heart, and the correlation between geometric and functional parameters for detecting the mechanism of LAVV regurgitation (LAVVR) in CAVSD.</p><p><strong>Methods: </strong>LAVV geometric parameters based on complete and acceptable quality echocardiograms of 18 patients with repaired CAVSD compared with 17 normal controls. LAVVR severity was also quantified by indexed vena contracta (I-VC) (mm) and % jet area/left atrium area (% Jet/LA), and the correlation with LAVV parameters in the CAVSD group was investigated.</p><p><strong>Results: </strong>In the CAVSD group, the posterior closing angle (Pc) was nearly the same as the anterior closing angle (Ac), yet in the normal heart, the Pc angle was double the Ac angle. The anterior opening angle (Ao) and posterior-to-anterior leaflet diameter ratio (a/p) in the CAVSD group was also significantly smaller. The CAVSD group also had a shorter indexed coaptation length (I-CL) and indexed tenting height (I-TH). Displacement length (ΔD) differed completely between the CAVSD and Normal groups, and also showed a strong positive correlation to the functional parameters of LAVVR (% Jet/LA: <i>r</i> = .70, <i>P</i> = .02; I-VC: <i>r</i> = .60, <i>P</i> = .02).</p><p><strong>Conclusions: </strong>The parameters in this study were applicable to CAVSD AV valve coaptation characteristics. We introduced 2 novel measures that may provide important insights into the differences in geometry and performance of the LAVV in repaired CAVSD as compared to normal hearts.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"16 ","pages":"11795565221139118"},"PeriodicalIF":1.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/dc/76/10.1177_11795565221139118.PMC9742689.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10731072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midgut Atresia: Diagnostic and Management Challenges From Northern Tanzania.","authors":"Jay Lodhia,&nbsp;Hilary Chipongo,&nbsp;Beatrice Mathew,&nbsp;David Msuya,&nbsp;Samwel Chugulu,&nbsp;Rune Philemon","doi":"10.1177/11795565221142810","DOIUrl":"https://doi.org/10.1177/11795565221142810","url":null,"abstract":"<p><p>Intestinal obstruction is one of the most common surgical emergencies in the neonatal period. Early diagnosis is vital for proper management and good outcome. Intestinal obstruction can be divided into high, for example, duodenal atresia and jejunal atresia, or low, for example, ileal atresia, colonic atresia, and Meckel's diverticulum. The most common cause of intestinal obstruction in neonates is midgut atresia. Surgical correction is needed and is a challenge in the developing countries where there is lack of pediatric surgeons, anesthesiologists, and intensive care. More research and data is also needed across countries to show the uneven distribution of the available resources.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"16 ","pages":"11795565221142810"},"PeriodicalIF":1.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/92/c2/10.1177_11795565221142810.PMC9761201.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10418925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal Sepsis and Associated Factors Among Neonates Admitted to Neonatal Intensive Care Unit in General Hospitals, Eastern Ethiopia 2020","authors":"Abdurahman Kedir Roble, Liyew Mekonen Ayehubizu, Hafsa Mohamed Olad","doi":"10.1177/11795565221098346","DOIUrl":"https://doi.org/10.1177/11795565221098346","url":null,"abstract":"Introduction: Globally, the major cause of neonatal mortality and morbidity is neonatal sepsis, which is defined as a clinical course marked by systemic inflammation in the presence of infection in a newborn. There are limited data concerning neonatal sepsis in eastern Ethiopia. As a result, this study aimed to determine the prevalence of neonatal sepsis and associated factors among neonates admitted to intensive care units at general hospitals in Eastern Ethiopia. Methods: A hospital-based cross-sectional study with retrospective document review was conducted among newborns hospitalized in neonatal intensive care units. Using simple random sampling, the charts of 356 newborns who were hospitalized between January and December 2019 were included, and data were collected using a pretested checklist. Data were entered into Epi data version 3.1 and analyzed with SPSS version 22. Results: The overall prevalence of neonatal sepsis was 45.8% (95% CI 40.7, 51.4). Prolonged rupture of the membrane (AOR = 2.38, 95% CI: [1.27-4.45]), vaginal delivery (AOR = 1.78, 95%, CI: [1.09, 2.96]) APGAR score <7 (AOR = 4.55, 95% CI: [2.49-8.29]), prelacteal feeding (AOR = 3.54, 95% CI: [1.68-8.23]), and mechanical ventilation (AOR = 4.97,95%CI: [2.78-8.89]) were predictors associated with neonatal sepsis. Conclusion: In this study, the prevalence of neonatal sepsis was high, and factors associated with neonatal sepsis included prolonged rupture of membrane, mode of delivery, low APGAR score, prelacteal feeding and mechanical ventilation. As a result, maternal and neonatal care should be enhanced to lower the risk of neonatal sepsis.","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"71 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85755268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Jejunoileal Atresia in a Newborn: Our Experience From Northern Tanzania and Literature Review","authors":"Gregory Goodluck, Marianne Gnanamuttupulle, A. Sadiq, D. Msuya, Samwel Chugulu, J. Lodhia","doi":"10.1177/11795565221075313","DOIUrl":"https://doi.org/10.1177/11795565221075313","url":null,"abstract":"Jenunoileal atresia is a congenital defect that causes small bowel obstruction in newborns. They are classified into 5 types and simple abdominal x-ray can aid in the diagnosis and with prompt resuscitation and surgery provides positive outcome. We present a 5-day-old newborn male baby was presented with features of intestinal obstruction since birth. Diagnosis of atresia of the small bowel was made through plain abdominal x-ray and was successfully operated. During the recovery, the baby developed surgical site infection which was managed promptly.","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"18 3 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90409523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anthropometric Criteria for Identifying Infants Under 6 Months of Age at Risk of Morbidity and Mortality: A Systematic Review.","authors":"Christoph Hoehn,&nbsp;Natasha Lelijveld,&nbsp;Martha Mwangome,&nbsp;James A Berkley,&nbsp;Marie McGrath,&nbsp;Marko Kerac","doi":"10.1177/11795565211049904","DOIUrl":"10.1177/11795565211049904","url":null,"abstract":"<p><strong>Background: </strong>There is increasing global focus on small and nutritionally at-risk infants aged <6 months (<6 m). Current WHO guidelines recommend weight-for-length <i>z</i>-score (WLZ) for enrolment to malnutrition treatment programmes but acknowledge a weak evidence-base. This review aims to inform future guidelines by examining which anthropometric criteria best identify infants <6 m at high risk of mortality/morbidity.</p><p><strong>Methods: </strong>We searched Medline, EMBASE, CINAHL, Global Health, Cochrane Library and POPLINE for studies conducted in low- and middle-income countries and published between 1990 and October 2020. We included studies reporting anthropometric assessment of nutritional status in infants <6 m and assessed the association with subsequent morbidity or mortality.</p><p><strong>Results: </strong>A total of 19 studies were included in the final review, covering 20 countries, predominantly in sub-Saharan Africa. WLZ had poor reliability and poor prognostic ability to identify infants at risk of death. Mid-upper arm circumference (MUAC) and weight-for-age <i>z</i>-score (WAZ) were better at identifying infants at risk of mortality/morbidity. MUAC-for-age <i>z</i>-score did not perform better than using a single MUAC cut-off. Suggested MUAC cut-offs for this age group varied by context, ranging from 10.5 to 11.5 cm. The assessment for reliability showed that length was difficult to measure, making WLZ the least reliable indicator overall.</p><p><strong>Conclusion: </strong>Evidence from our review suggests that a change in current practice is necessary. To better identify small and nutritionally at-risk infants <6 m WAZ and/or MUAC rather than WLZ should be used. Future research should explore possible benefits for programme coverage, impact and cost-effectiveness. Research should also examine if context-specific MUAC thresholds are needed.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":"15 ","pages":"11795565211049904"},"PeriodicalIF":1.5,"publicationDate":"2021-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8543668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10664948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and Practice of Infants Exposure to Sunlight Among Lactating Mothers Attending at Yirgalem Hospital, Sidama Regional State.","authors":"Addisu Seneshaw Bezabih,&nbsp;Daniel Eshetu,&nbsp;Nigussie Yohanis,&nbsp;Agete Tadewos Hirigo","doi":"10.1177/11795565211041348","DOIUrl":"https://doi.org/10.1177/11795565211041348","url":null,"abstract":"<p><strong>Background: </strong>Exposure to sunlight is vital for the synthesis of vitamin-D and vitamin D plays an important role in growth and bones strength. Therefore, this study aimed to assess the knowledge and practice of infants exposure to sunlight among lactating women.</p><p><strong>Methods: </strong>A cross-sectional study was conducted from May 01 to 30, 2019 among 327 infant coupled lactating mothers attended at Yirgalem General Hospital. An interviewer-administered questionnaire was used to collect relevant data through a convenient sampling technique.</p><p><strong>Results: </strong>A total of 84.7% of respondents exposed infants to sunlight. More than 94% knew the benefit of exposing infants to sunlight. About 20.9%, 25.6%, and 19.9% of mothers exposed infants to sunlight within 15, 16 to 30, and 31 to 45 days of birth, respectively. In addition, 59.9% of respondents exposed infants to sunshine daily and 72.2% exposed without clothing the infants' body. Moreover, 63.5% of mothers have applied lubricants and overall 54.5% of mothers exposed infants to sunlight in good practice. Unemployed women were 4.7 times more likely (aOR; 95%CI: 4.7; 2.0-11.4) to expose infants to sunlight when compared to those employed, while women whose husbands have at least secondary education level were 5.1 times more likely (aOR; 95%CI: 5.1; 1.6-16.1) to expose infants to sunlight when compared to those unable to read and write.</p><p><strong>Conclusion: </strong>More than 45% and more than one-third of lactating mothers had poor practice and exposed infants to sunlight for inadequate time, respectively. Therefore, the finding indicates a need for awareness creation to increase women's knowledge and practice toward the exposure of infants to sunlight.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":" ","pages":"11795565211041348"},"PeriodicalIF":1.5,"publicationDate":"2021-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/81/dc/10.1177_11795565211041348.PMC8450552.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39442594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease Burden Due to Respiratory Syncytial Virus in Indian Pediatric Population: A Literature Review.","authors":"Canna Ghia,&nbsp;Gautam Rambhad","doi":"10.1177/11795565211029250","DOIUrl":"https://doi.org/10.1177/11795565211029250","url":null,"abstract":"<p><p>Respiratory syncytial virus (RSV) is one of the leading causes of lower respiratory tract infections in young children. Globally, there is huge disease burden, high treatment cost, and health impact beyond acute episodes due to RSV which necessitate development and implementation of preventive strategies for the control of RSV infection. The disease burden due to RSV in pediatric population across India is still not clearly understood so this literature review was therefore conducted to gather data on disease burden due to RSV in Indian pediatric population. Systematic literature search was performed using PubMed and Google search with different medical subject headings from 2007 to 2020. Studies performed in Indian pediatric population were selected for review. Literature review revealed that in India, epidemiology of RSV infection is well documented in young children (0-5 years) as compared to children from other age groups. The rates of RSV detection in various studies conducted in younger children (0-5 years) vary from 2.1% to 62.4% in India which is higher as compared to children from other age groups. In India, RSV mainly peaks around rainy to early winter season, that is, during months of June through October while smaller peak was noted during December, January, and February. In 2020, higher RSV-associated disease burden was reported among children (<5 years) in low-income and lower-middle-income countries. Considering significant disease burden due to RSV in young Indian children, availability of RSV vaccine would be crucial to prevent RSV infections in children and its spread in the community.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":" ","pages":"11795565211029250"},"PeriodicalIF":1.5,"publicationDate":"2021-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/11795565211029250","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39203185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Masses of the Sternoclavicular Area: Case Series and Review of the Literature.","authors":"Parisa Oviedo,&nbsp;Morgan Bliss","doi":"10.1177/11795565211021600","DOIUrl":"https://doi.org/10.1177/11795565211021600","url":null,"abstract":"<p><strong>Objective: </strong>Masses of the sternoclavicular area are rare, and are not well described in the literature. We aim to present a series of patients with masses in this location and to review all reported English language cases of sternoclavicular masses in pediatric patients.</p><p><strong>Methods: </strong>This is a case series of pediatric patients with masses of the sternoclavicular area presenting to a tertiary care pediatric hospital from 2010 through 2017. Data was collected by using ICD-9 and ICD-10 codes to query the electronic medical record. Chart review included age at presentation, mass characteristics, medical and surgical interventions, and pathology results. A review of the literature was then performed.</p><p><strong>Results: </strong>Ten patients with masses overlying the sternoclavicular area were identified. Four patients presented with abscess and were treated with incision and drainage. Three of these patients were then treated with staged excision once infection cleared. Two additional patients were treated with primary excision. Four patients were treated with observation. The most common histopathologic finding was epidermoid. One patient was found to have a dermoid cyst, and 1 had a congenital cartilaginous rest.</p><p><strong>Conclusion: </strong>Epidermoids and dermoids are the most common masses overlying the sternoclavicular area. Controversy remains regarding the embryologic origin of sternoclavicular masses. The differential for masses in this area also includes branchial remnants, bronchogenic cysts, ganglion cysts, or septic arthritis.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":" ","pages":"11795565211021600"},"PeriodicalIF":1.5,"publicationDate":"2021-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/11795565211021600","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39099098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Huge Non-parasitic Mesothelial Splenic Cyst in a Child: A Case Report and Literature Review.","authors":"Imed Krichen,&nbsp;Kais Maazoun,&nbsp;Murad Kitar,&nbsp;Naglaa M Kamal,&nbsp;Ubaidullah Khan,&nbsp;Mostafa Yl Khalif,&nbsp;Rasha A,&nbsp;Haifa Assiri,&nbsp;Kawthar Abdulrhim Bokari","doi":"10.1177/11795565211021597","DOIUrl":"https://doi.org/10.1177/11795565211021597","url":null,"abstract":"<p><strong>Background: </strong>Splenic cysts are one of the relatively rare conditions in pediatric surgery practice. Primary non-parasitic splenic cysts are even more scarce.</p><p><strong>Case presentation: </strong>A 13-years-old female patient presented with chronic left hypochondrial pain of 2 months duration. Abdominal ultrasonography and computed tomography revealed huge 18 cm × 14 cm × 10 cm splenic cyst. Deroofing of the cyst was done which was complicated by secondary infection. Subsequently, the patient was re-operated on and partial splenectomy done with good outcome at 6 months follow up.</p><p><strong>Conclusion: </strong>Partial splenectomy is the best management strategy for huge non-parasitic splenic cysts in children. There is also less recurrence rate of splenic cysts with preservation of splenic functions.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":" ","pages":"11795565211021597"},"PeriodicalIF":1.5,"publicationDate":"2021-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/11795565211021597","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39097037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Burden of Preventable Adverse Drug Events on Hospital Stay and Healthcare Costs in Japanese Pediatric Inpatients: The JADE Study.","authors":"Hitoshi Iwasaki,&nbsp;Mio Sakuma,&nbsp;Hiroyuki Ida,&nbsp;Takeshi Morimoto","doi":"10.1177/1179556521995833","DOIUrl":"https://doi.org/10.1177/1179556521995833","url":null,"abstract":"<p><strong>Background: </strong>Adverse drug events (ADEs) are a burden to the healthcare system. Preventable ADEs, which was ADEs due to medication errors, could be reduced if medication errors can be prevent or ameliorate.</p><p><strong>Objective: </strong>We investigated the burden of preventable ADEs on the length of hospital stay (LOS) and costs, and estimated the national burden of preventable ADEs in pediatric inpatients in Japan.</p><p><strong>Methods: </strong>We analyzed data from the Japan Adverse Drug Events (JADE) study on pediatric patients and estimated the incidence of preventable ADEs and associated extended LOS. Costs attributable to extended LOS by preventable ADEs were calculated using a national statistics database and we calculated the effect of preventable ADEs on national cost excess.</p><p><strong>Results: </strong>We included 907 patients with 7377 patient-days. Among them, 31 patients (3.4%) experienced preventable ADEs during hospitalization. Preventable ADEs significantly increased the LOS by 14.1 days, adjusting for gender, age, ward, resident physician, surgery during hospitalization, cancer, and severe malformation at birth. The individual cost due to the extended LOS of 14.1 days was estimated as USD 8258. We calculated the annual extra expense for preventable ADEs in Japan as USD 329 676 760. Sensitivity analyses, considering the incidence of preventable ADEs and the length of hospital stay, showed that the expected range of annual extra expense for preventable ADEs in Japan is between USD 141 468 968 and 588 450 708.</p><p><strong>Conclusion: </strong>Preventable ADEs caused longer hospitalization and considerable extra healthcare costs in pediatric inpatients. Our results would encourage further efforts to prevent and ameliorate preventable ADEs.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":" ","pages":"1179556521995833"},"PeriodicalIF":1.5,"publicationDate":"2021-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179556521995833","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25500522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}