Global pediatrics最新文献

{"title":"Pediatric RSV infection and respiratory coinfections: Is a link related to clinical severity? Single center retrospective study","authors":"Raffaele Falsaperla ,&nbsp;Francesco Gambilonghi ,&nbsp;Daria La Cognata ,&nbsp;Lucia Giovanna Tardino ,&nbsp;Silvia Marino ,&nbsp;Patrizia Grassi ,&nbsp;Grete Francesca Privitera ,&nbsp;Vincenzo Sortino ,&nbsp;Martino Ruggieri","doi":"10.1016/j.gpeds.2024.100233","DOIUrl":"10.1016/j.gpeds.2024.100233","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of the study was to assess whether there was a difference in terms of severity in paediatric patients assessed for respiratory symptoms in paediatric emergency departments between those who tested positive for RSV and those who presented with viral co-infections in addition to RSV. It was also assessed whether there was a difference between the two groups in terms of need for hospitalisation and ventilation.</div></div><div><h3>Methods</h3><div>This is a single center study from October 2022 to February 2023, compared two groups of patients: those infected with RSV and those coinfected with RSV and other viruses. Parameters examined included the severity of illness, as measured by the Clinical Respiratory Score (CRS), the need for and duration of hospitalization, and the need for ventilation via high flow nasal cannula (HFNC).</div></div><div><h3>Results</h3><div>The correlation with disease severity assessed by CRS in the two groups with RSV only and coinfection was not statistically significant (<em>p</em>-value 0.281). The correlation in the two groups between the need for hospitalization (<em>p-value</em> 1) and the need for ventilation (<em>p-value</em> 0.302) was also not significant. No significant correlation was found between the age of patients and CRS (<em>R</em> = −0.26, <em>p</em> = 0.119) and the age of patients and days of hospitalization (<em>R =</em> −0.013, <em>p =</em> 0.938).</div></div><div><h3>Conclusion</h3><div>These findings highlight the importance of careful management of RSV infections in children. Despite the limitations, the lack of significant differences in disease severity indicates the need to explore additional preventive strategies, such as RSV vaccination, to improve the clinical approach.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"10 ","pages":"Article 100233"},"PeriodicalIF":0.0,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652620","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":"Children in jeopardy: Lessons learned from the Middle East Conflict!","authors":"Joseph Haddad","doi":"10.1016/j.gpeds.2024.100234","DOIUrl":"10.1016/j.gpeds.2024.100234","url":null,"abstract":"","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"10 ","pages":"Article 100234"},"PeriodicalIF":0.0,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704350","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":"Creation of a unique centrally monitored and operated neonatal transport network in a lower and middle-income country: A first of its kind initiative","authors":"Ranganatha A Devaranavadagi ,&nbsp;Kavya M G ,&nbsp;Netra S Kannur ,&nbsp;Karthik Nagesh N","doi":"10.1016/j.gpeds.2024.100232","DOIUrl":"10.1016/j.gpeds.2024.100232","url":null,"abstract":"<div><h3>Background</h3><div>With the current growth of many neonatal units in the country, good initial stabilization of sick neonates is possible at peripheral centers. However, poor neonatal transport and retrieval facilities are unfortunately leading to higher preventable mortality and morbidity in neonates arriving at a tertiary care center in poor condition.</div></div><div><h3>Objective</h3><div>To bridge the gap between referring hospital and tertiary care, this quality improvement initiative aimed to create a well-organized ‘network transport system’ for the round-the-clock provision of a city-wide retrieval system.</div></div><div><h3>Methods and intervention</h3><div>Various causes linked to adverse events in the transport and retrieval of sick infants were initially assessed through a ‘fishbone analysis’. A step-wise-driven PDSA cycle was performed. It was realized that a well-organized, centrally controlled network of fully equipped neonatal ambulances with trained personnel for delivering neonatal intensive care on wheels was necessary even in a tier-one city like Bengaluru, India. A network transport and retrieval system for the city of Bengaluru was systematically created, involving 10 partner hospitals in the Manipal group. Training of all personnel involved in transport, creating a good infrastructure of state-of-the-art ambulances, transport incubators with ventilators, remote monitoring systems, and the creation of a centralized helpline with 24/7 response. The facility was named Neonatal Care on Wheels (NOW) and was propagated as a NICU on Wheels.</div></div><div><h3>Results</h3><div>This initiative significantly improved the quality of neonatal transport as well as the stabilization of the neonate before transport.</div></div><div><h3>Conclusion</h3><div>This robust network transport has proven to show improvements in the quality of retrieval and survival similar to that seen in Western countries.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"10 ","pages":"Article 100232"},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704971","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":"Training in primary care paediatrics: The role of entrustable professional activities","authors":"C. Villaizán Pérez ,&nbsp;M. Aparicio Rodrigo ,&nbsp;F. Fehr","doi":"10.1016/j.gpeds.2024.100230","DOIUrl":"10.1016/j.gpeds.2024.100230","url":null,"abstract":"<div><div>Primary care paediatrics is practiced throughout the countries of Europe with different structures of health care systems and identities of care providers. The best way to guarantee that paediatricians are competently trained and provide high quality care to children and adolescents in primary care is a flexible and comprehensive training program based on practice and demonstration of acquired competencies. Entrustable professional activities represent a significant step toward improving the training and assessment of future healthcare professionals. It may constitute a model that unifies the training standards in primary care and community paediatrics.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"10 ","pages":"Article 100230"},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142416005","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, confidence and clinical reasoning of dental students for diagnosing pediatric periodontal diseases","authors":"Disha Nagpal ,&nbsp;Hollis Lai ,&nbsp;Monica Prasad Gibson ,&nbsp;Mehdi Salehi Zeinabadi ,&nbsp;Ida M Kornerup","doi":"10.1016/j.gpeds.2024.100229","DOIUrl":"10.1016/j.gpeds.2024.100229","url":null,"abstract":"<div><h3>Objective</h3><p>Given the importance of diagnosing periodontal diseases in pediatric patients, the objective of this study was to examine knowledge, confidence, and clinical reasoning of third- and fourth-year dental students regarding periodontal diagnosis and treatment planning in pediatric patients.</p></div><div><h3>Methods</h3><p>An explanatory sequential mixed-method study was conducted in two phases. In the first phase, the survey questions were administered online to the third-and fourth-year dental students. Surveys tested for knowledge, confidence and clinical decision-making using questions and case-studies. Answers from periodontists and the pediatric dentists were used as the gold standard. For the next phase, individual interviews were recorded, transcribed, and coded followed by verbal analysis to assess their clinical reasoning for the specific diagnosis and treatment planning.</p></div><div><h3>Results</h3><p>While there was no overall difference in the knowledge and the confidence level between the students, they differed from the experts for some questions in confidence levels. As measured using the Script Concordance Test (SCT), no significant differences were observed between the participants in their clinical reasoning. The verbal analysis of the interview data showed that the students used three different patterns for searching through the problem space. Most of the students used the forward pattern of search and reported low confidence in diagnosing and treating pediatric periodontal diseases.</p></div><div><h3>Conclusion</h3><p>Due to low self-reported confidence in diagnosing periodontal disease in pediatric patients. Providing education solutions will improve the confidence of undergraduate dental students in diagnosing and treating periodontal disease.</p></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"9 ","pages":"Article 100229"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667009724000976/pdfft?md5=188cc0e8d5a2870808121f8bfe3ea01d&pid=1-s2.0-S2667009724000976-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142098172","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":"Time to recovery from severe pneumonia and its predictors among pediatric patients admitted in South West Region governmental hospitals, South West Ethiopia: Prospective follow-up study","authors":"Yalemtsehay Dagnaw Genie ,&nbsp;Alemayehu Sayih ,&nbsp;Nigatu Dessalegn ,&nbsp;Emebet Adugnaw ,&nbsp;Aynalem Yetwale Hiwot ,&nbsp;Tsegaw Biyazin Tesfa ,&nbsp;Kassa Kindie ,&nbsp;Lidiya Gutema ,&nbsp;Ermias Ayalew ,&nbsp;Belete Fenta Kebede","doi":"10.1016/j.gpeds.2024.100227","DOIUrl":"10.1016/j.gpeds.2024.100227","url":null,"abstract":"<div><h3>Background</h3><p>The Ethiopian Federal Ministry of Health has been working by introducing vaccines, and integrating the management of newborn and child illnesses to prevent pneumonia, pneumonia-related hospitalization, and mortality. Despite these attempts, the prevalence of pneumonia and the proportion of hospitalizations have increased. Little is known about recovery time from severe pneumonia and its predictors in pediatric patients in the study area. Therefore, this study aimed to determine the time to recovery from severe pneumonia and its predictors in pediatric patients admitted to government hospitals in the southwest Region.</p></div><div><h3>Methods and Materials</h3><p>A hospital-based prospective follow-up study was conducted among 791 pediatric patients admitted with severe pneumonia at a governmental hospital in the South West Region, of Ethiopia. A systematic sampling technique was used to recruit participants. Data were entered into Epi-data 4.4.2.1 and exported to STATA 14 for analysis. The assumptions of Cox proportional hazard models and goodness of fit were assessed using the Shoenfield residual and Cox-Snell, respectively. Bivariate and multivariable Cox regression models were used to identify the predictors of time to recovery. Variables with a p-value of &lt;0.05 at a 95 % confidence level in multivariable Cox regression model analysis were declared statistically significant predictors of time to recovery.</p></div><div><h3>Results</h3><p>This study revealed that 641 (81.04 %) participants recovered with an incidence rate of 12.48 per 100 person-day observations. The median time to recovery was 5 days. Rural residence [AHR=0.82; 95 % CI 0.69–0.97], hypoxemia [AHR=1.25; 95 % CI 1.01- 1.55], danger sign, [AHR=1.77; 95 % CI 1.28- 2.45], comorbidity [AHR=0.60; 95 % CI 0.50- 0.7] and history of previous respiratory infections [AHR=0.76; 95 % CI 0.64- 0.90] were found significant predictors of time to recovery from severe pneumonia.</p></div><div><h3>Conclusion</h3><p>In this study, the recovery rate from severe pneumonia among pediatric patients was low and the time to recovery was slightly prolonged with a median time to recovery of five days. Rural residence, hypoxemia, danger signs, comorbidity, and history of previous respiratory infections were independent predictors of time to recovery among pediatric patients. Therefore, the Ethiopian Federal Ministry of Health, family, community leaders, healthcare providers, and other stakeholders should provide timely initiation of advanced diagnosis, appropriate therapeutic interventions, and proper follow-up for pediatric patients with severe pneumonia to reduce mortality.</p></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"9 ","pages":"Article 100227"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667009724000952/pdfft?md5=5fd3670aa98bf9f7047717941b4e0225&pid=1-s2.0-S2667009724000952-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142098171","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":"Shortage of essential pediatric medications puts children's health at risk. Results from a European Confederation of Primary Care Paediatricians (ECPCP) Survey 2023","authors":"Christine Magendie ,&nbsp;Gottfried Huss ,&nbsp;Laura Reali ,&nbsp;Stephen Reingold","doi":"10.1016/j.gpeds.2024.100224","DOIUrl":"10.1016/j.gpeds.2024.100224","url":null,"abstract":"<div><p>Unparalleled drug shortages during the winter of 2022/2023 had a profound impact on paediatric primary care across Europe. A survey conducted by the European Confederation of Primary Care Paediatricians (ECPCP) evaluated the availability of essential pediatric drugs and the resulting challenges. The survey was conducted between January and March 2023 and included responses from 640 paediatricians from 18 countries. The results of the survey indicated that there were substantial shortages, particularly of child friendly formulations of commonly prescribed medicines. Paediatricians in the survey feared that the use of less appropriate alternatives could potentially compromise the efficacy and safety of treatment. The survey findings highlight the urgent need for coordinated actions at multiple levels to ensure the availability of essential pediatric medications and safeguard children's health in future crises.</p></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"9 ","pages":"Article 100224"},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667009724000927/pdfft?md5=8515c00c6812cd573b51e769f625473d&pid=1-s2.0-S2667009724000927-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044621","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":"Beyond conjoined: A tale of successful separation of pyopagus twins","authors":"Mudassar Fiaz Gondal,&nbsp;Noor Ul Sabah Butt,&nbsp;Usama Iftkhar,&nbsp;Hamna Atique,&nbsp;Jawad Abbasi,&nbsp;Muhammad Omer Fraz,&nbsp;Hafsa Atique,&nbsp;Saad Ahmed","doi":"10.1016/j.gpeds.2024.100226","DOIUrl":"10.1016/j.gpeds.2024.100226","url":null,"abstract":"<div><p>Conjoined twins, a rare anomaly in which same-sex fetuses are partially or completely joined, present unique challenges in diagnosis and management. This article reports the first successful operative separation of pyopagus conjoint twins in Pakistan, an achievement in a low-resource setting. The female twins, diagnosed prenatally, underwent a planned cesarean section at 37 weeks. The initial physical examination revealed an 18 cm conjoined area with a shared anal opening. Postnatal monitoring in the neonatal intensive care unit detected abdominal distension, leading to pelvicdivided colostomies. A multidisciplinary team, including gynaecologists, anesthesiologists, pediatric medicine specialists, neurosurgeons, and pediatric surgeons, collaborated on the operative procedure of the six-month-olds. The process involved bone removal, dural incision, and anorectoplasty. Postoperatively, one twin experienced cerebrospinal fluid leakage, which was managed conservatively. The twins were discharged after a week with a one-month follow-up.</p></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"9 ","pages":"Article 100226"},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667009724000940/pdfft?md5=5f26999914e73a3c5bfae8aaf00b9e33&pid=1-s2.0-S2667009724000940-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142021145","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 utility of the child development review in Suriname: Validating a neurodevelopmental screener for use in a low- to middle- income Country","authors":"Maria Kinsey ,&nbsp;Arti Shankar ,&nbsp;Waylon J. Hastings ,&nbsp;Maureen Lichtveld ,&nbsp;Noelle Martin ,&nbsp;Brooke Maglia Batista ,&nbsp;Anisma Gokoel ,&nbsp;Shellice Sairras ,&nbsp;Lauren W.Y. McLester-Davis ,&nbsp;Stacy Drury ,&nbsp;Wilco Zijlmans","doi":"10.1016/j.gpeds.2024.100225","DOIUrl":"10.1016/j.gpeds.2024.100225","url":null,"abstract":"<div><h3>Background</h3><p>Access to efficient, culturally relevant, and validated measures of neurodevelopment in Low- and Middle-Income Countries (LMICs) remains a critical need. This study describes the validation and reliability of the Child Development Review (CDR), a parent report neurodevelopmental screening tool, for use in a cohort of Surinamese children aged 2–4 years.</p></div><div><h3>Subjects</h3><p>Complete data from 355 Surinamese children through the Caribbean Consortium for Research in Environmental and Occupational Health were utilized for validation. Convergent validity was assessed using a subset of 31 children with concurrently administered CDRs and Bayley Scales of Infant and Child Development Third Edition (BSID-III).</p></div><div><h3>Methods</h3><p>Cronbach's alpha was used to assess subscale reliability. Cluster analyses were used to assess internal factor structure. Measures of convergent validity used Cohen's Kappa statistic and partial correlations between comparative CDR and BSID-III subscales.</p></div><div><h3>Results</h3><p>Cronbach's Alpha values were acceptable for all CDR subscales (range 0.63 - 0.79). CDR subscale responses clustered into two distinct groups, representing milestones that were or were not achieved. Patterns of change indicate increased milestone achievement with increased age. Partial correlations indicated that the social, fine motor, and language subscales of the CDR and BSID-III subscales were significantly correlated. However, Cohen's Kappa was only significant for the gross motor CDR and BSID-III subscales.</p></div><div><h3>Conclusions</h3><p>The CDR has acceptable reliability, internal validity, and convergent validity. Use of the CDR should be considered as a screening tool for neurodevelopment in Suriname and may provide an efficient initial assessment of developmental delay in LMIC.</p></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"9 ","pages":"Article 100225"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667009724000939/pdfft?md5=2c5c80dbb738066eb7b2644f6c49417b&pid=1-s2.0-S2667009724000939-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141953844","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":"Neuroprotective treatment options for neonatal hypoxic-ischemic encephalopathy: Therapeutic hypothermia and beyond","authors":"Merih Cetinkaya","doi":"10.1016/j.gpeds.2024.100223","DOIUrl":"10.1016/j.gpeds.2024.100223","url":null,"abstract":"<div><p>Hypoxic-ischemic encephalopathy (HIE) is the most common form of neonatal encephalopathy that develops due to perinatal asphyxia or ischemia in term and late-preterm infants. It is an important cause of significant neurological impairment and also mortality in newborns worldwide. The pathophysiology of HIE is multifactorial and involves complex cascades of cellular and biochemical events in the brain including excitotoxicity, oxidative stress, inflammation, and cell death, respectively. Therapeutic hypothermia (TH), is the only standard neuroprotective therapy for HIE and is associated with reduced composite outcome of death or major neurodevelopmental disability. However, although TH is beneficial, neonates with HIE still experience unacceptably high rate of devistating morbidities. Therefore, research for adjunctive therapies continue to further improve outcomes in infants with HIE. In this review, both TH and other promising adjunctive neuroprotective therapies are discussed for developing future treatment strategies.</p></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"9 ","pages":"Article 100223"},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667009724000915/pdfft?md5=cdf0a71b1ff18024db042aa41d5e0a9e&pid=1-s2.0-S2667009724000915-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839228","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}