BMC Pediatrics最新文献

{"title":"Distinct phenotype and risk factor analysis of persistent airflow limitation among asthmatic children: a case-control study.","authors":"Shiqiu Xiong, Xinyu Jia, Wei Chen, Chuanhe Liu","doi":"10.1186/s12887-024-05201-3","DOIUrl":"10.1186/s12887-024-05201-3","url":null,"abstract":"<p><strong>Background: </strong>Persistent airflow limitation (PAL) in childhood asthma is associated with a poor prognosis. The aim of this study was to categorize asthmatic children with PAL into distinct phenotypes and investigate the risk factors associated with each phenotype.</p><p><strong>Methods: </strong>We conducted a case-control study with a total of 119 PAL patients and 120 non-PAL (NPAL) individuals. To classify the patients into appropriate clusters, unsupervised cluster analysis using K-means clustering was employed. The clusters were then compared to explore different PAL phenotypes. Univariate and multivariate logistic regression analyses were performed to identify risk factors for PAL and calculate odds ratios (ORs) with 95% confidence intervals (95%CIs).</p><p><strong>Results: </strong>K-means clustering divided patients into three clusters: Cluster 0 included 120 NPAL patients, Cluster 1 characterized by elevated blood neutrophils included 66 PAL patients, and Cluster 2 exhibited elevated blood eosinophils and FeNO levels, containing 53 PAL patients. Independent risk factors for PAL included older age in both Cluster 1 (9 <math><mo>∼</mo></math> 11y: OR 12.67, 95%CI 3.30-55.74; <math><mo>≥</mo></math> 11y: OR 5.42, 95%CI 1.26-25.69) and Cluster 2 (9 <math><mo>∼</mo></math> 11y: OR 7.25, 95%CI 1.70-33.35; <math><mo>≥</mo></math> 11y: OR 11.28, 95%CI 2.79-51.89), as well as pneumonia history, with an OR of 6.41(95%CI 1.34-33.41) in Cluster 1 and an OR of 7.92(95%CI 1.83-37.44) in Cluster 2. Furthermore, specific factors associated with Cluster 1 included BMI above 22 kg/ <math><msup><mi>m</mi> <mn>2</mn></msup> </math> (OR 12.28, 95%CI 2.68-70.45), asthma duration exceeding three years (OR 4.77, 95%CI 1.60-15.94), and a blood neutrophil percentage between 0.4 and 0.5 (OR 4.13, 95%CI 1.17-16.6). In Cluster 2, independent risk factors included a blood eosinophil percentage greater than 0.07 (OR 4.36, 95%CI 1.16-19.73) and a high FeNO level (OR 3.94, 95%CI 1.35-11.97).</p><p><strong>Conclusion: </strong>Our study identified two phenotypes of PAL in asthmatic children: non-eosinophilic and eosinophilic inflammation. Older age and a history of pneumonia were independent risk factors for both phenotypes. For non-eosinophilic inflammation PAL, specific contributing factors included higher BMI, long duration of asthma, and a blood neutrophil percentage between 0.4 and 0.5. Elevated FeNO levels and blood eosinophilic percentage were independently associated with eosinophilic inflammation PAL.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of home nurturing environment on early childhood neurodevelopment: a community-based survey in Shanghai, China.","authors":"Chunhua Jiang, Xingying Li, Bing-Cheng Du, Jun Huang, Yun Li, Ying Zhang, Muxin Wei, Xiaoxi Xu, Yulin Yang, Hong Jiang","doi":"10.1186/s12887-024-05190-3","DOIUrl":"10.1186/s12887-024-05190-3","url":null,"abstract":"<p><strong>Background: </strong>Ages of 0-3 years are critical stages for children's neurodevelopment. However, the impact of the home nurturing environment on early childhood neurodevelopment remains unclear.</p><p><strong>Objective: </strong>To explore the role of the home nurturing environment on early childhood neurodevelopment and to provide evidence of an association between fostering quality home nurturing and achieving optimal neurodevelopment.</p><p><strong>Participants and setting: </strong>An online cross-sectional survey using the stratified sampling method was conducted from 16 June, 2021 to 18, February, 2022 in all 13 communities of Minhang District, Shanghai. A total of 2,402 children aged 0-3 years with balanced sex distribution were included.</p><p><strong>Methods: </strong>The quality of home nurturing environments was measured using validated Child Home Nurture Environment Scales. Neurodevelopment was measured using the Ages and Stages Questionnaire - Third edition (ASQ-3). Generalized Linear Mixed Modeling was used to analyze the association between the quality of home nurturing environments and neurodevelopment.</p><p><strong>Results: </strong>Among children aged 0-1, neglect or restriction was reported as the most prevalent problem (8.02%) among home nurturing environment dimensions, and was associated with an increased risk of suspected fine motor development delay (OR = 2.82, 95% CI: 1.18-6.69, P = 0.019). Among children aged 1-3, inadequate parental warmth, as the foremost (16.10%) problem, was associated with an increased risk of suspected gross motor development delay (OR = 4.12, 95% CI: 1.35-12.53, P = 0.013) and suspected personal-social development delay (OR = 12.50, 95%CI: 1.48-105.36, P = 0.020).</p><p><strong>Conclusions: </strong>Poor home nurturing environments were associated with an increased risk of suspected early childhood neurodevelopment delay. There exists a need for services to guide for establishing a quality home nurturing environment.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of axillary and rectal temperatures across different gestational ages in newborns admitted to the neonatal intensive care unit: a cross-sectional study.","authors":"Shaimaa Halabi, Rana Almuqati, Amenah Al Essa, Manal Althubaiti, Musab Alshareef, Abdulaziz Homedi, Ahmed Alwatban, Mohanned Alrahili, Saif Alsaif, Kamal Ali","doi":"10.1186/s12887-024-05224-w","DOIUrl":"10.1186/s12887-024-05224-w","url":null,"abstract":"<p><strong>Objective: </strong>Maintaining normothermia is crucial for neonatal survival, especially in preterm infants prone to temperature instability. This study evaluates the correlation and variability between axillary and rectal temperatures at Neonatal Intensive Care (NICU) admission across gestational age ranges of 23-28, 29-32, 33-36, and ≥ 37 weeks, aiming to inform improved neonatal thermal management strategies.</p><p><strong>Methods: </strong>This cross-sectional study was conducted at King Abdulaziz Medical City, Riyadh, from October 2023 to April 2024, involving 160 infants. Admission temperatures were measured using digital thermometers. Data analysis included ANOVA/Kruskal-Wallis for continuous variables, Chi-square tests for categorical data, Bland-Altman method for agreement assessment, and Pearson correlation coefficients to evaluate temperature correlations.</p><p><strong>Results: </strong>Mean axillary temperature increased from 36.4 °C in the 23-28 weeks gestational group, to 36.5 °C in the 29-32 weeks group, and to 36.7 °C in the 33-36 weeks and ≥ 37 weeks groups, (p = 0.033). Rectal temperature increased from 36.5 °C in the 23-28 weeks group, to 36.6 °C in the 29-32 weeks group, and reached 36.8 °C in both the 33-36 weeks and ≥ 37 weeks groups (p = 0.006). Notable differences between measurement methods were observed in the 33-36 and ≥ 37 weeks groups (p < 0.001), with less pronounced differences in the 23-28 and 29-32 weeks groups. While temperature differences between rectal and axillary measurements remained consistent across all groups at 0.1 °C (p = 0.779), neonatal outcomes varied significantly across gestational age groups, with younger infants exhibiting lower survival rates (p < 0.001), higher incidences of hypoglycemia (p < 0.001) and sepsis (p < 0.001), and extended durations of ventilation (p < 0.001) and hospital stay (p < 0.001). Strong correlations between rectal and axillary temperature were found across all age ranges (Pearson coefficients: 0.953 for 23-28 weeks, 0.762 for 29-32 weeks, 0.910 for 33-36 weeks, and 0.761 for ≥ 37 weeks; all p < 0.001). Bland-Altman analysis indicated higher variability in agreement for younger preterm groups, showing limits of agreement ranging from - 0.5 to 0.65 °C for 23-28 weeks and - 0.5 to 0.69 °C for 29-32 weeks, improving in older groups with - 0.2 to 0.4 °C for 33-36 weeks and similarly narrow ranges for ≥ 37 weeks.</p><p><strong>Conclusion: </strong>Both rectal and axillary temperatures showed variation across different age groups, exhibiting a substantial overall correlation. Notable differences between the two methods were observed in the 33-36 weeks and ≥ 37 weeks groups. Younger preterm infants demonstrated greater variability, with enhanced agreement observed in older infants.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors of seizure and complex seizure in febrile children: a clinical study.","authors":"Farhad Heydarian, Elham Bakhtiari, Mina Bay","doi":"10.1186/s12887-024-05215-x","DOIUrl":"10.1186/s12887-024-05215-x","url":null,"abstract":"<p><strong>Purpose: </strong>There is some evidence that trace element and mineral deficiencies may promote the occurrence of febrile seizures. However, the role of these elements in the occurrence of complex seizures in children with FS has not been comprehensively investigated. The present study was conducted to evaluate this issue.</p><p><strong>Methods: </strong>In a cross-sectional study, 220 patients including 110 febrile and 110 FS children aged 6-60 months were studied. Blood samples were taken and serum zinc, potassium, sodium, magnesium and calcium levels were measured. Demographic and clinical characteristics were also recorded.</p><p><strong>Results: </strong>The patients were similar in age and sex. Higher serum zinc levels decreased the risk of seizure (RR = 0.95, p-value = 0.0001) and complex seizure (OR = 0.96, p-value = 0.03). Higher serum sodium levels decreased the risk of complex seizures (OR = 0.85, p-value = 0.023). Higher serum potassium levels were associated with a lower risk of seizure (OR = 0.55, p-value = 0.035). Serum calcium and magnesium levels were not associated with the risk of seizure and complex seizure. A BMI at the upper end of the normal range decreased the risk of complex seizures (OR = 0.83, p-value = 0.05). Male sex increased the risk of complex seizure (OR = 4.14, p-value = 0.016).</p><p><strong>Conclusions: </strong>Low serum levels of zinc, potassium and sodium are risk factors for seizure and complex seizure in febrile children. Male sex is also a risk factor for complex seizures. The time from fever to seizure was shorter in younger children. Children with a BMI at the upper end of the normal range have a lower risk of having a complex seizure.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain abscess caused by Streptococcus pyogenes with atypical symptoms: a case report and literature review.","authors":"Chun-Zhen Hua, Zhi-Peng Shen, Ming-Ming Zhou, Can Lai, Guan-Nan Bai, Wei-Zhong Gu, Yong-Ping Xie, Jin-Si Zhou, Wei-Lin Hu, Qiang Shu","doi":"10.1186/s12887-024-05208-w","DOIUrl":"10.1186/s12887-024-05208-w","url":null,"abstract":"<p><strong>Background: </strong>Streptococcus pyogenes is a common gram-positive bacterium, belonging to group A Streptococcus (GAS), and is responsible for causing a range of clinical conditions. Brain abscess caused by GAS is uncommon in pediatric infectious diseases, and GAS brain abscess without acute infectious symptoms has been rarely reported.</p><p><strong>Case presentation: </strong>We present a case of one GAS brain abscess in a previously healthy child with unusual clinical manifestations of decreased muscle strength in the left limbs. The right frontal lobe mass lesion was resected using a microscope-based neuronavigation system. A sole defectively beta-hemolytic Streptococcus pyogenes was isolated from the lesion. The patient's peripheral blood whole-exome and the pathogen's whole-genome sequencing were performed respectively, revealing a heterozygous mutation in the interferon regulatory factor-8 (IRF8) gene in the patient and lack of hyaluronic acid capsules in Streptococcus pyogenes (genotype emm22). The patient eventually recovered after prompt surgical drainage of the abscess and appropriate antibiotic treatment.</p><p><strong>Conclusions: </strong>It is important to pay attention to Streptococcus pyogenes brain abscesses with mild clinical manifestations. Upon reviewing all the cases of pediatric GAS brain abscess reported in the published literature, we discovered that early diagnosis and treatment are crucial factors that impact the prognosis of GAS brain abscess.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential diagnosis of visceral leishmaniasis in children: a five-year retrospective study at a pediatric referral hospital.","authors":"Anaisa Gomes Ramos Soares, Juliana de Sales Landim, Natiécia Gomes França, Edilson Beserra de Alencar Filho, Rodrigo Feliciano do Carmo","doi":"10.1186/s12887-024-05160-9","DOIUrl":"10.1186/s12887-024-05160-9","url":null,"abstract":"<p><strong>Background: </strong>Visceral leishmaniasis (VL) is a zoonotic disease caused by protozoa of the genus Leishmania and is transmitted by sandflies of the genus Lutzomyia. Children under 15 years are disproportionately affected. In pediatric patients, the clinical and laboratory features of VL often overlap with those of other infectious and hematology-oncology diseases, making differential diagnosis challenging. Rapid and accurate identification of VL is critical for effective treatment. This study aimed to evaluate the epidemiological, clinical, and laboratory characteristics of pediatric patients initially suspected of having VL and to compare their final diagnoses upon discharge from a referral hospital.</p><p><strong>Methods: </strong>We retrospectively analyzed medical records of children with suspected VL, admitted between July 2014 and June 2019.</p><p><strong>Results: </strong>Infectious diseases were confirmed in 61% of cases (86 patients), with VL confirmed in 55 cases. Hematology-oncology diseases were the second most common diagnosis, affecting 22.7% of patients (32 cases). Comparisons between the VL-confirmed group and those with other diagnoses revealed no significant age difference (p = 0.690). However, female sex, spleen size, and leukopenia were identified as significant predictors of VL.</p><p><strong>Conclusions: </strong>Female sex, spleen size, and leukopenia were key predictors for differentiating VL from other pediatric diseases in a referral center in the Northeast Region of Brazil.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motor outcomes in individuals born small for gestational age at term: a systematic review.","authors":"Hoda Taiar, Silje Dahl Benum, Kristina Anna Djupvik Aakvik, Kari Anne I Evensen","doi":"10.1186/s12887-024-05187-y","DOIUrl":"10.1186/s12887-024-05187-y","url":null,"abstract":"<p><strong>Background: </strong>Being born small for gestational age (SGA) is a risk factor for motor difficulties. Previous reviews exploring this topic are mostly focused on children born preterm. We aimed to review the literature to determine the association between being born SGA at term and motor outcomes.</p><p><strong>Methods: </strong>PubMed and Embase were searched for relevant articles without any restrictions on publication year or participants' age. Inclusion criteria were SGA exposure at term (≥ 37 weeks of gestation), cohort studies or randomized controlled trials with motor outcome assessed by standardized motor tests with results reported as continuous scores (mean/median) compared with a control group. Exclusion criteria were abstracts, editorials and commentaries, articles in non-English language or no full text available. Reviews were screened for relevant articles. Quality of included studies was assessed by the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>In total, 674 records were identified by the literature search and screened by two independent authors. Thirteen original articles were eligible and included in a qualitative synthesis, and five (38%) of these were included in a meta-analysis. Nine (69%) studies were from high-income countries. Most studies were carried out in early childhood, and only one study in adulthood. Seven (54%) articles reported that individuals born SGA at term had poorer scores on standardized motor tests compared with controls, while no differences were reported in five (38%) articles. One article did not report p-values, although the differences were comparable to the other studies. Group differences were of small to moderate effect size (0.19 to 0.65 standard deviation units). The pooled effect size was -0.43 (95% confidence interval: -0.60 to -0.25). Adjustment for covariates were reported in seven (54%) articles and did not change the results. Proportions of motor difficulties, reported in five (38%) articles, ranged from 8.9 to 50% in individuals born SGA from infancy to adolescence.</p><p><strong>Conclusions: </strong>This systematic review shows that being born SGA, also at term, may be a risk factor for poorer motor outcomes throughout childhood, confirmed by a meta-analysis in early childhood. Further research is needed to establish the risk of adult motor difficulties in individuals born SGA at term.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Image-based deep learning in diagnosing mycoplasma pneumonia on pediatric chest X-rays.","authors":"Xing-Hao Lan, Yun-Xu Zhang, Wei-Hua Yuan, Fei Shi, Wan-Liang Guo","doi":"10.1186/s12887-024-05204-0","DOIUrl":"10.1186/s12887-024-05204-0","url":null,"abstract":"<p><strong>Background: </strong>Correctly diagnosing and accurately distinguishing mycoplasma pneumonia in children has consistently posed a challenge in clinical practice, as it can directly impact the prognosis of affected children. To address this issue, we analyzed chest X-rays (CXR) using various deep learning models to diagnose pediatric mycoplasma pneumonia.</p><p><strong>Methods: </strong>We collected 578 cases of children with mycoplasma infection and 191 cases of children with virus infection, with available CXR sets. Three deep convolutional neural networks (ResNet50, DenseNet121, and EfficientNetv2-S) were used to distinguish mycoplasma pneumonia from viral pneumonia based on CXR. Accuracy, area under the curve (AUC), sensitivity, and specificity were used to evaluate the performance of the model. Visualization was also achieved through the use of Class Activation Mapping (CAM), providing more transparent and interpretable classification results.</p><p><strong>Results: </strong>Of the three models evaluated, ResNet50 outperformed the others. Pretrained with the ZhangLabData dataset, the ResNet50 model achieved 80.00% accuracy in the validation set. The model also showed robustness in two test sets, with accuracy of 82.65 and 83.27%, and AUC values of 0.822 and 0.758. In the test results using ImageNet pre-training weights, the accuracy of the ResNet50 model in the validation set was 80.00%; the accuracy in the two test sets was 81.63 and 62.91%; and the corresponding AUC values were 0.851 and 0.776. The sensitivity values were 0.884 and 0.595, and the specificity values were 0.655 and 0.814.</p><p><strong>Conclusions: </strong>This study demonstrates that deep convolutional networks utilizing transfer learning are effective in detecting mycoplasma pneumonia based on chest X-rays (CXR). This suggests that, in the near future, such computer-aided detection approaches can be employed for the early screening of pneumonia pathogens. This has significant clinical implications for the rapid diagnosis and appropriate medical intervention of pneumonia, potentially enhancing the prognosis for affected children.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of acute kidney injury and its predictors among neonates admitted at neonatal intensive care unit of, Northwest Ethiopia comprehensive specialized hospitals, 2023.","authors":"Gezahagn Demsu Gedefaw, Abere Gebru Abuhay, Asnake Tadesse Abate, Wubet Tazeb Wondie, Zenebe Abebe Gebreegzabiher, Rahel Asres Shimelash, Astewil Moges Bazezew, Gebrehiwot Berie Mekonnen, Tewodros Getaneh Alemu, Tsehayu Melak Siyoum, Yaregal Semanew Endeshaw, Menyichil Tamir Tizazu, Almaz Tefera Gonete, Fekadeselassie Belege Getaneh, Habtamu Sewunet Mekonnen, Dawit Tesfaye Daka, Bruck Tesfaye Legesse","doi":"10.1186/s12887-024-05147-6","DOIUrl":"10.1186/s12887-024-05147-6","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury is an acute and reversible increment in serum creatinine (SCr) levels with a reduction in urine output oliguria, or anuria. Acute kidney injury is a major cause of neonatal morbidity and mortality worldwide; it is a serious problem in low and middle-income countries, particularly in sub-Saharan Africa such as Ethiopia. Moreover, there are few studies in developing countries. This study aimed to investigate the incidence and predictors of acute kidney injury in neonates admitted to the neonatal intensive care unit of some specialized hospitals in the Amhara region of northwestern Ethiopia.</p><p><strong>Methods: </strong>A facility-based retrospective follow-up study was conducted in the Northwest Amhara Region's comprehensive specialized hospitals with 634 neonates from January 2020 to December 2022. Data were collected by reviewing patient charts using simple random sampling with a pretested checklist, entered using Epi-data 4.6, and analyzed using STATA 14. Median survival time, Kaplan-Meier survival curve, and log-rank test were calculated. Bivariable and multivariable Cox hazard models were used to determine the determinants of acute kidney injury. A hazard ratio with a 95% confidence interval was calculated. Variables with p-values less than 0.05 were considered statistically significant.</p><p><strong>Results: </strong>The incidence of Acute Kidney Injury among Neonates admitted to Neonatal Intensive Care Unit was 14.9 per 1000 (95% CI: 12.5-17.7) with the proportion of acute kidney injury (20.19%) (95% CI: 17.23-23.50) neonates with sepsis (AHR: 2.59; 95%CI: 1.21-5.56), neonates with perinatal asphyxia [(AHR: 2.70; 95%CI: 1.29-5.65) were taking gentamicin drugs [(AHR = 1.74; 95%CI: 1.03-2.94], neonates were preterm [(AHR; 1.77: 95%CI: 1.05 -2.98], and neonatal-hyponatremia [(AHR: 2.14; 95%CI: (1.00 -4.9)] and hyperkalemia [(AHR: 2.64; 95 CI: (1.11- 6.2)] were statistically found to be significant predictors of acute kidney injury.</p><p><strong>Conclusions: </strong>The incidence of acute kidney injury in neonates was high. Premature infants, neonates with sepsis, who suffered perinatal asphyxia, who received gentamicin drugs, whose sodium levels decreased and potassium levels increased were at higher risk of developing acute kidney injury. All concerned agencies should work to prevent acute kidney injury and pay special attention to multifactorial causes. Therefore, strategies need to be developed and/or strengthened to prevent the occurrence of acute kidney injury in infants with sepsis, neonates who suffered perinatal asphyxia, and preterm infants whose sodium levels decreased and potassium levels increased.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functioning profile and related impairments of children and adolescents with cerebral palsy - PartiCipa Brazil preliminary results.","authors":"Paula S C Chagas, Alana G Lemos, Kênnea M A Ayupe, Aline M Toledo, Ana Cristina R Camargos, Egmar Longo, Rosane L S Morais, Hércules R Leite, Robert J Palisano, Peter Rosenbaum, Angélica C S F Romeros, Amanda L O Lima, Déborah E Fontes, Elton D D Magalhães, Jaíza M M Silva, Maria Luíza F Alves, Rayane F L Monteiro, Ana Carolina de Campos, Rafaela S Moreira","doi":"10.1186/s12887-024-05210-2","DOIUrl":"10.1186/s12887-024-05210-2","url":null,"abstract":"<p><strong>Background: </strong>Limited information is available about functioning and related impairments of children and adolescents with Cerebral Palsy (CP) in low- and middle-income countries (LMIC) like Brazil. The aim of this study is to describe the characteristics, functioning, and impairments of Brazilian children and adolescents with CP.</p><p><strong>Methods: </strong>Cross-sectional preliminary study as part of the PartiCipa Brazil multicentered cohort study. Families of children and adolescents with CP from Brazil, 4 months to 15 years, were enrolled. They responded to an online survey with questions about their child's health condition, impairments, contextual factors, and functioning according to the Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS). Data were described as frequencies, percentages, means, and standard deviations, according to age bands.</p><p><strong>Results: </strong>Of the 404 participants (6.5±3.6 years) enrolled in this preliminary analysis, 54.7% are male, 90.4% under 12 years of age, 77.7% have bilateral CP, 49% in GMFCS levels IV and V, and 50.7% in MACS levels II and V. Most participants are from Southeast (63.4%) and Centre-west (19.5%) of Brazil. Regarding the impairments and functioning limitations: 1 in 2 did not talk; 1 in 2 has epilepsy; 2 of 5 reports pain, 1 of 4 has visual impairments, 3 out of 5 did not feed themselves, 1 out of 20 has a hearing impairment and 1 of 4 did not go to school.</p><p><strong>Conclusion: </strong>This first preliminar Brazilian study shows a high prevalence of children at MACS levels II and V and GMFCS levels IV and V, representing almost half of the group, indicating more impairments and limitations than children/adolescents from high-income countries. This study provides a preliminary deeper understanding of the key impairments and limitations in activities among children and adolescents with CP from various Brazilian regions.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}