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1.
Jonathan S. Karpelowsky Alastair J. W. Millar Nelleke van der Graaf Guido van Bogerijen Heather J. Zar 《Pediatric surgery international》2012,28(10):1007-1014
Purpose
Increasingly HIV-infected children can be expected to require surgery. The aim of this study was to compare the outcome of HIV-infected and HIV-unexposed children undergoing surgery.Patients and methods
A prospective study of children less than or equal to 60?months admitted to a tertiary pediatric surgical service from July 2004 to July 2008. Children underwent age-definitive HIV testing and were followed up postoperatively for complications, length of stay and mortality.Results
Three hundred and twenty-seven children were enrolled: 82 (23?%) HIV-infected and 245 (67?%) were HIV-unexposed. Eighty-four (26?%) children were malnourished, which was higher in the HIV-infected group [41 (50.0?%) vs. 43 (17.5?%), relative risk (RR) 2.9; 95?% confidence interval (CI) 2.0–4.1; p?<?0.0001]. Three hundred and twenty-eight surgical procedures were performed. A similar number of major [28 (34.2?%) vs. 64 (26.1?%); p?=?0.2] and emergency procedures [37 (45.1?%) vs. 95 (38.8?%); p?=?0.34] were performed in each group. HIV-infected children had a higher rate of contamination at surgery [40 (48.7?%) vs. 49 (20?%); RR 2.43 (CI 1.7–3.4); p?<?0.0001]. There were more complications in the HIV-infected group [34 (41.5?%) vs. 14 (5.7?%); RR 7.3 (CI 4.1–12.8); p?<?0.0001]. The most common complications were surgical site complications 30 (55?%), followed by postoperative infections, 19 (34?%). Infections with drug-resistant organisms occurred more commonly in HIV-infected children [11/19 (58?%) vs. 2/13 (15?%); RR 3.8 (CI 1.3–14.2); p?=?0.02]. The median length of hospital stay was longer in the HIV-infected group [4 (IQR 2–14) vs. 2 (IQR 1–4) days; p?=?0.0001]. There was a higher mortality amongst the HIV-infected group [6 (7.3?%) vs. 0 (0?%); p?<?0.0001].Conclusion
HIV-infected children have a higher rate of postoperative complications and mortality compared with HIV-unexposed children. 相似文献2.
Iman Mandour Dina El Gayar Maha Amin Tarek Mohamed Farid Aliaa Adel Ali 《Indian journal of pediatrics》2013,80(9):736-744
Objective
To investigate the longitudinal changes in amino acid (AA) and acylcarnitine (AC) profiles of preterm neonates over the first 2 wk of life, and to detect any significant deviation from full term values that requires change of cut-off values used for detection of metabolic disorders in preterm neonates.Methods
This observational analytical longitudinal study was conducted on 131 premature neonates (gestational age ranged from 27 to 36 wk) and 143 healthy full-term neonates. Dried blood spots were taken on the 5th and 14th postnatal day from the premature neonates and on day 5 from full term neonates for neonatal screening. Samples were analyzed for AA and AC using tandem mass spectrometer.Results
Most AA significantly decreased on day 14 compared to day 5 among preterm neonates (p?<?0.05). The combined values of total carnitine (TC), total acylcarnitine (tAC) and short-chain acylcarnitines on day 5 among preterm neonates were statistically significantly higher compared to the day 14 sample (p 0.0001), whereas no statistically significant difference was found regarding the values of medium-, long-chain acylcarnitines, tAC/FC, and FC/TC (p?>?0.05). The levels of AA of preterm neonates were statistically significantly higher than that of the controls (p?<?0.05). The values of TC, tAC, short-, medium- and long-chain acylcarnitines, were significantly higher than those of the controls (p?<?0.05). The reference ranges for preterm neonates were determined using the 1st and 99.9th percentiles.Conclusions
AA and AC showed an age-related distribution of their concentrations. This underlines the importance of using appropriate reference values when working with a prematurely born population. 相似文献3.
Lamya A. Atweh Robert C. Orth R. Paul Guillerman Wei Zhang J. Herman Kan 《Pediatric radiology》2013,43(11):1502-1506
Background
The added value of routine contrast-enhanced MR imaging in children with classic findings of osteonecrosis on unenhanced MR images has not been determined.Objective
Our purpose was to determine the added value of routine contrast-enhanced MR sequences for identifying complications of osteonecrosis.Material and methods
Sixty-four patients who underwent 139 contrast-enhanced MR examinations were retrospectively identified. Unenhanced images and subsequently both unenhanced and enhanced images were reviewed in consensus. The location of osteonecrosis and the presence of complicating features (epiphyseal collapse, marrow edema, joint effusion, soft tissue edema) were recorded. Cohen’s kappa coefficients (κ) were calculated to assess agreement.Results
A diagnosis of classic osteonecrosis was made in 22.3% of unenhanced examinations and 28.1% of enhanced examinations (κ?=?0.734, P?<?0.001). Among patients with complicated osteonecrosis, unenhanced images interpreted without and with contrast-enhanced images showed epiphyseal collapse in 51.2% and 42.5% (κ?=?0.796, P?<?0.001), marrow edema in 50.4% and 46.8% (κ?=?0.727, P?<?0.001), joint effusion in 44.9% and 51.2% (κ?=?0.686, P?<?0.001), and soft tissue edema in 12.2% and 10.1% (κ?=?0.674, P?<?0.001).Conclusion
The high observed agreement between the unenhanced MR images interpreted without and with contrast-enhanced images shows little marginal benefit from the use of routine contrast-enhanced imaging in children and young adults with classic findings of osteonecrosis on unenhanced MR images. 相似文献4.
M. Katabuka M. E. Mafuta A. M. Ngoma P. Mutombo Beya S. Yuma L. Aketi K. P. Kayembe J. R. Gini 《Indian journal of pediatrics》2013,80(8):659-662
Objective
To determine seroprevalence of hepatitis C virus (HCV), human immunodeficiency virus (HIV), and hepatitis B virus (HBV) and associated factors among transfused children.Methods
A multicenter cross-sectional study of transfused children aged between 18 mo and 13 y old was conducted in 4 hospitals in Kinshasa. Blood samples were collected for the detection of Hepatitis B surface antigen (HBsAg) and antibodies to HCV, HIV 1and 2.Results
A total of 177 (47.7 %) boys and 194 (52.3 %) girls participated in the study. The median age was 59.5 mo (Interquartile range IQR?=?60.6). The prevalence rates of HCV, HBV, and HIV infection were 13.5 %, 1.6 %, and 1.3 %, respectively. Frequency of transfusion events were significantly associated with HCV (p?<?0.001) and HIV (p?<?0.05) infections.Conclusions
HCV infection was by far more frequently identified than HBV and HIV infections among Congolese transfused children. Frequency of transfusion events was the only significant risk factor associated with HCV and HIV infections but not for HBV. 相似文献5.
Background
Gastroschisis is the most common congenital abdominal wall defect. Due to the exposure of midgut to amniotic fluid, the recovery of bowel function is often delayed. This study aimed to identify the factors associated with the successful early enteral feeding in gastroschisis and to develop further guidelines of treatment.Methods
A retrospective cohort study of gastroschisis babies from January 2006 to December 2015 was done. Exclusion criteria were incomplete data and death. Successful early enteral feeding was defined when full feeding was achieved within 21 days of life.Results
One hundred and five gastroschisis patients were divided into a successful early-feeding group (n?=?56, 53%) and a non-successful early-feeding group (n?=?49, 46%). In multivariable analysis, significant factors for successful feeding clustered by primary treatment were female (RR?=?1.38, P value <?0.001), gestational age >?36 weeks (RR?=?1.23, P value <?0.001), age at surgery less than 10 h (RR?=?1.15, P value <?0.001), postoperative extubation time <?4 days (RR?=?1.39, P value <?0.001), and age when feeding started less than 10 days (RR?=?35.69, P value?<?0.001).Conclusion
Several factors were found to be associated with successful early enteral feeding. The modifiable factors found in this study were surgery within 10 h, early postoperative extubation within 4 days, and feeding started before 10 days of life. These will guide the management of gastroschisis to achieve successful early enteral feeding.6.
Akshay Kapoor A. K. Patwari Praveen Kumar Anju Jain Shashi Narayan 《Indian journal of pediatrics》2013,80(2):108-113
Objectives
To evaluate the markers of lymphocyte activation (sIL-2R, IL-6 and TNF α) in the peripheral blood of newly diagnosed patients with celiac disease (CD) and patients with CD on Gluten free diet (GFD) for at least 2 y. The markers were correlated with conventional serological tests Anti-tissue transglutaminase (Anti-TTG) used for diagnosis and follow up of the disease; wherever possible.Methods
Thirty newly diagnosed cases of CD (on the basis of histopathology and serology) not on GFD were enrolled as Group 1 of the study. Thirty age and sex matched controls from the Pediatric Surgery OPD formed Group 2. Thirty cases of CD on GFD for at least 2 y (Group 3) were also enrolled in the study. Upper G.I. endoscopy was performed in all Group 1 patients and cytokine levels assayed by ELISA on serum obtained from all patients in Groups 1, 2, 3.Results
Mean sIL-2R level in Group 1(1498.1+/?1234.31 pg/ml) and Group 3 (488.78+/?396.18 pg/ml) were significantly higher than the controls (336.27+/?218.67 pg/ml p?<?0.05). Among the patients with CD, mean serum levels in Group 1 were higher than in Group 3 (p?<?0.05). sIL-2R levels showed good correlation with tTg levels in Group 1 patients (p?<?0.000, r?=?0.69). Mean IL-6 levels in Group 1 were significantly higher (28.43+/?28.32 pg/ml) than Group 2(15.03+/?7.72 pg/ml p?<?0.05) and Group 3(11.26+/?5.13 pg/ml p?<?0.05). IL-6 levels were comparable between Groups 2 and 3 (p?>?0.05).IL-6 levels showed good correlation with tTg levels in Group 1(p?<?0.008, r?=?0.471). Mean TNFα levels in Group 1(179.66+/?102.93 pg/ml), Group 2 (153.16+/?27.02 pg/ml) and Group 3 (166.67+/?28.95 pg/ml) were comparable (p?>?0.05). TNFα levels showed poor correlation with tTg levels in Group 1 patients (p?>?0.604, r?=??0.099).Conclusions
sIL-2R and IL-6 levels have a good correlation with CD activity and can be used as reliable markers for detecting minimal transgression from GFD. 相似文献7.
Background
A small fraction of hand–foot–mouth disease (HFMD) progression from the onset of severity to fatality may be remarkably rapid. Early recognition of children at risk of severity is critical to increase treatment effectiveness and reduce acute mortality.Methods
A frequency-matched case–control study was conducted between January 2010 and June 2011 in Ningbo to identify risk factors associated with the occurrence of severity in children with HFMD. Data including demographic characteristics, clinical features, and laboratory test results were collected by trained interviewers through retrospective medical record review and/or face-to-face interviews with children’s parents using a standardized questionnaire.Results
Eighty-nine cases with severe HFMD and 267 controls with mild HFMD were recruited in this study. Palm rashes (OR?=?0.004, 95%CI?=?0.000–0.039, p?0.001), oral ulcers or herpes (OR?=?0.001, 95%CI?=?0.000–0.009, p?0.001) were significantly associated with protection against severity, and an increased risk of severity was significantly associated with the presence of, e.g., a high fever of over 39°C for more than 3?days (OR?=?2.217, 95%CI?=?1.082–4.541, p?=?0.030), leg trembling (OR?=?29.008, 95%CI?=?1.535–548.178, p?=?0.025), papule rash (OR?=?4.622, 95%CI?=?1.110–19.252, p?=?0.035), a raised WBC count?>?10.8?×?109/L (OR?=?4.495, 95%CI?=?1.311–15.415, p?=?0.017), and human enterovirus 71 infection (OR?=?39.172, 95%CI?=?9.803–156.522, p?0.001).Conclusion
Clinicians should pay increased attention to children diagnosed as HFMD with the independent risk factors above. 相似文献8.
Shuchismita Behera Sujata Dixit Gandham Bulliyya Shantanu Kumar Kar 《Indian journal of pediatrics》2014,81(3):270-274
Objective
To assess the antioxidant vitamins A (retinol) and E (α-tocopherol) levels, iron status and growth retardation in children with β-thalassemia major in Odisha, an eastern state of India.Methods
Forty three children aged 1–15 y diagnosed with β-thalassemia major (28 males and 15 females) and 42 age-matched healthy controls (22 males and 20 females) were studied. β-thalassemia was detected by using Bio-rad variant assay. Measurement of blood hemoglobin (Hb), hematocrit, serum vitamins (A and E) and ferritin was carried out by standard methods.Results
Mean hemoglobin (6.60?±?1.84 vs. 11.8?±?2.29 g/dL, p?<?0.01), serum retinol (28.0?±?17.67 vs. 54.4?±?36.56 μg/dL, p?<?0.001) and α-tocopherol (0.2?±?0.34 vs. 1.1?±?0.82 mg/dL, p?<?0.001) were significantly lower in children with thalassemia compared with control group, however, serum ferritin (storage iron) was elevated in thalassemia patients (553.7?±?176.80 vs. 57.3?±?40.73 ng/mL, p?<?0.001). Vitamin E had significantly correlated with hemoglobin and hematocrit values in the patients. Growth retardation in terms of stunting (79 % vs. 24 %, p?<?0.0001) and thinness (32.6 % vs. 9.5 %, p?<?0.05) was significantly higher in thalassemic children compared with normal children.Conclusions
This study shows that children with β-thalas-semia major are in a state of oxidative stress of hyperfer-ritinemia with deprived antioxidant vitamins (A and E) and poor growth status suggesting a possible need for reduction in iron overload and additional antioxidant supplementation. 相似文献9.
Hassan Boskabadi Abbas Navaee Boroujeni Hesam Mostafavi-Toroghi Golkoo Hosseini Majid Ghayour-Mobarhan Dariush Hamidi Alamdari Mahtab Biranvandi Hamidreza Saber Gordon A. Ferns 《Indian journal of pediatrics》2014,81(3):248-253
Objective
To determine the prooxidant-antioxidant balance (PAB) in neonatal asphyxia and compare it with values for PAB in healthy neonates.Methods
In a prospective observational study, serum PAB of umbilical cord blood of 30 neonates with asphyxia [pH <?7.2, low Apgar score, signs of respiratory distress syndrome (RDS)] as the case group and 35 healthy neonates (without an abnormal clinical event at birth and after the first week) as the control group were compared.Results
Among the 35 neonates in the control group, the average level of serum PAB was 20.00 HK units, which was significantly lower than for the 30 neonates within the case group (40.46 HK units; p?=?0.019). The blood pH in the case group was significantly lower than for control group (P?<?0.001). In controls, HCO3 - and pCO2 were 18.6 mmol/L and 38.5 mmHg respectively, whilst in the case group these values were 15.5 mmol/L and 45.7 mmHg respectively (p?<?0.05).Conclusions
Determination of PAB may be useful in the early diagnosis of perinatal asphyxia and is consistent with HCO3 -, pCO2 and Apgar score. 相似文献10.
Alan D. White Diaa Othman Michael J. Dawrant Soroush Sohrabi Alastair L. Young Roly Squire 《Pediatric surgery international》2012,28(12):1195-1199
Purpose
The aim of this study was to determine if there is a difference between complications for totally implantable central venous catheters (ports) and tunnelled external central venous catheters (external CVCs) that result in early removal of the central venous catheter (CVC) in children and adolescents with acute lymphoblastic leukaemia (ALL).Methods
All children hospitalised between November 1996 and December 2007 with ALL who had a CVC were included retrospectively. We analysed data regarding the patient??s first CVC.Results
We included 322 patients. 254 received a port and 68 received an external CVC. There were 102 CVC complications that required removal of the CVC prior to the completion of chemotherapy (65 in patients with ports, 37 in patients with external CVCs). Overall complications requiring CVC removal were significantly less likely to occur in the patient??s with ports (p?<?0.001). Ports were significantly less likely to require removal prior to the end of treatment overall (p?<?0.001) and for specific complications such as infection (p?<?0.001) and dislodgement (p?=?0.001). However, when adjusted for disease severity there is no difference in premature CVC removal rates.Conclusion
When patients are risk-stratified for disease severity there is no difference in rates of CVC removal prior to completion of treatment. 相似文献11.
Antonio Alberto Zuppa P. Catenazzi C. Orchi F. Cota V. Calabrese M. Cavani C. Romagnoli 《Indian journal of pediatrics》2013,80(6):455-459
Objective
To compare the characteristics of jaundice and hyperbilirubinemia in the newborn population of both immigrant and Italian mothers.Methods
The authors studied a group of 1,680 infants born at “A. Gemelli” hospital during 1 y. All were with appropriate weight for gestational age, weighting more than 2,500 g, born to low-risk pregnancy. Maternal ethnicity, clinically evident jaundice (that is total serum bilirubin (TSB)?>?7 mg/dL), hyperbilirubinemia (TSB?>?12 mg/dL), the duration of hospital stay and their need of phototherapy were evaluated.Results
In infants born to Asian mothers, hyperbilirubinemia was significantly more frequent (48.8 % vs. 26.5 %, p?=?0.003) and they reached mean TSB peak significantly later (86.5?±?38.5 vs. 74.5?±?20.6 h, P?=?0.0001) compared with Italian infants. The average length of hospitalization of infants of Asian and Latin American mothers is significantly longer compared to Italian newborns (4.5?±?1.9 vs. 3.6?±?1.1, p <0.0001 and 4.2?±?1.6 vs. 3.6?±?1.1, p?=?0.0004). With regard to the use of phototherapy, and to its duration, there are no significant differences between the populations studied.Conclusions
Having studied all infants at low risk, the greater length of hospitalization is due to later peak and the higher frequency of jaundice in newborns of immigrant mother, especially in Asia. Therefore, as it happens to the Italian newborns, it would be desirable to build forecasting nomograms in these populations, to reduce the length of hospitalization and facilitate protected discharge. 相似文献12.
Mooneera Peerboccus Nasroolla Damry Sanjiva Pather Arnaud Devriendt Freddy Avni 《Pediatric radiology》2013,43(12):1557-1565
Background
Kidney ultrasonography is frequently performed in children; to date there are no specific guidelines regarding hydration before the examination.Objective
Because certain renal measurements can be indicative of pathology, we used sequential US images to investigate the effect of standardised hydration in children relative to renal size, echogenicity and pelvic expansion.Materials and methods
Thirty-one children (7 years to 14 years old) underwent US examinations before hydration (T0) and at 30 min (T30) and 60 min (T60) after ingesting water. We measured bladder volume, inter-polar kidney size, renal volume and anterior-posterior diameter of the pelvis. Cortical echogenicity was compared to that of the liver and spleen.Results
On the right side the increase in average inter-polar renal size was 2.5% at T30 and 2.6% at T60 (P?<?0.05) compared to T0. On the left the increase was 3.8% at T30 and 4.3% at T60 (P?<?0.05). Volume expansion for the right kidney was 16.8% at T30 and 14.0% at T60 (P?<?0.05). On the left it was 12.9% at T30 and 10.2% at T60 (P?<?0.05). Cortical echogenicity progressed from hypoechogenicity to isoechogenicity (P?<?0.05). The percentage of expanded pelves increased with hydration (T0: 3.2%, T30: 9.7%, T60: 22.6%).Conclusion
Oral hydration influences renal length, volume and echogenicity in children. Hydration results in expansion of the pelvis. We recommend standardisation of hydration before US examination. 相似文献13.
S. R. Ravikiran B. Shantharam Baliga Animesh Jain M. Shashidhar Kotian 《Indian journal of pediatrics》2014,81(2):114-119
Objectives
To study the effect of socio-demographic factors, parental regulations and maternal television usage on the television viewing practices of Indian schoolchildren.Methods
Mothers of 6–12 y old children were interviewed using a pre-tested questionnaire at the pediatric outpatient. The television viewing practices of 405 schoolchildren with maternal television viewing and parental television rules were analyzed. Specific television viewing practices considered harmful in the present study were- viewing television >2 h, viewing television just prior to sleep (at bedtime), predominantly viewing general adult channels and using television as an aid to sleep.Results
35.8 % (n?=?145) of the children viewed television for >2 h on schooldays. 20 % (n?=?81) used television as sleep-aid. 28.1 % (n?=?114) children had televisions in the room they slept. The frequency of parental television rules were with respect to: duration of viewing- 77.5 % (n?=?314), timing of viewing- 63.7 % (n?=?258), content- 35.6 % (n?=?144). The children of families with the rule needing of parental permission to switch on the television [present in 34.8 % (n?=?141) children] had lower harmful television viewing practices: duration of television viewing on schooldays >2 h (23.4 %, n?=?33, P?<?0.001); television viewed just before sleep (39 %, n?=?55, P?<?0.001); use of television as sleep-aid (12.1 %, n?=?17, P?=?0.003). 26.7 % (n?=?108) of the mothers viewed television for >2 h. Linear regression analysis showed association between average television duration of children and average maternal television duration on schooldays (Beta?=?0.246, t?=?5.09, P?<?0.001). Binary logistic regression analysis showed that harmful television viewing practices were significantly more in children with television in bedroom [OR?=?7.49(4.19–13.38), P?<?0.001]. It was reduced significantly by the parental rules on content viewed [OR?=?0.41(0.23–0.72), P?=?0.002]; need of permission to switch on television [OR?=?0.31(0.18–0.53), P?<?0.001] and a higher maternal education [OR?=?0.29 (0.14–0.59), P?=?0.001].Conclusions
Lower maternal education, increased maternal television usage, presence of television in bedroom resulted in harmful television viewing practices among Indian children. The parental rules that were effective in countering these were the rule on content viewed and needing parental permission to switch on television. 相似文献14.
Abdullah Barış Akcan Fırat Kardelen Seyhan Erişir Oygucu Abdullah Kocabaş Deniz Özel Halide Akbaş Nihal Oygür 《Indian journal of pediatrics》2013,80(11):896-902
Objectives
To evaluate if cardiac dysfunctions are important in assessing the outcome in newborns with Bronchopulmonary Dysplasia (BPD), by evaluating cardiac functions with N-terminal prohormone of brain natriüretic peptide (NT-proBNP) levels, M-mode and tissue doppler echocardiography at 6–12 mo of age.Methods
Twenty eight patients were retrospectively classified as mild, moderate and severe according to the diagnostic criterias for BPD. All cases were assessed with standard M-mode, tissue doppler echocardiography and NT-proBNP levels. Control group consisted of 28 healthy infants, having similar postnatal ages as patients and were assessed with standard M-mode and tissue doppler echocardiography.Results
The age of patients with BPD was 9.8?±?2.3 mo and control group was 9.5?±?2.6 mo. There was no significant difference between the postnatal ages of two groups (p?>?0.05). Neither pulmonary hypertension nor pulmonary/tricuspid regurgitation was detected. The M-mode echocardiography measurements did not differ between patients and control group (p?>?0.05). Tissue doppler echocardiography, tricuspid valve medial segment early diastolic myocardial relaxation velocity (TME’) measurements of patients were found significantly lower, peak transtricuspid filling velocity in the early diastole (TE)/TME’ ratios and isovolumetric relaxation time (IVRT) measurements were found significantly higher than control group (p?<?0.05). Tricuspid E, TE/TLE’ (Tricuspid valve lateral segment early diastolic myocardial relaxation velocity), TE/RVLE’(Right ventricular lateral segment early diastolic myocardial relaxation velocity), TE/TME’ levels were also found as significantly abnormal in patients with severe BPD. A significant correlation was found between right ventricular diastolic disfunctions and severity of BPD (p?<?0.05). No statistically significant difference was found between NT-proBNP levels, BPD stages and tissue doppler echocardiography measurements (p?>?0.05).Conclusions
This is the first study evaluating cardiac findings in patients with BPD by tissue doppler echocardiography and NT-proBNP at the same time. On the basis of cardiac evaluations, tissue doppler echocardiography measurements were found as significant and specific for the early assessment of right ventricular diastolic disfunctions. 相似文献15.
Jagdish Kumar Amit Upadhyay Ajeet Kumar Dwivedi Sunil Gothwal Vijay Jaiswal Sunny Aggarwal 《Indian journal of pediatrics》2013,80(6):465-469
Objective
To study the effect of oil massage on growth in preterm babies less than 1800 g.Methods
This randomised controlled trial was conducted in Neonatal intensive care unit of a level II hospital. Neonates with birth weight?<?1800 g, gestation?<?35 wk and?<?48 h of age at enrolment were included in the studies. Eligible neonates were randomized to one of the two groups (a) Oil massage along with standard care of low birth weight (b) Standard care of low birth weight without massage. Weight, length and head circumference was measured in the two groups at 7 d intervals. Serum triglyceride levels were measured at enrolment and at completion of study. Primary outcome variable was weight gain at 28 d after enrolment.Results
A total of forty-eight neonates were randomisd to either oil massage group (n?=?25) or standard care of low birth weight without massage group (n?=?23). Mean (SD) weight of babies in the two groups was 1466.4?±?226.8 g in oil massage group and 1416.6?±?229.9 g in the control group. At 28 d, weight gain in the oil massage group (476.76?±?47.9 g) was higher compared to the control group (334.96?±?46.4 g) (p?<?0.05). At 7 d, less weight loss (7.80?±?9.8 g) was observed in babies in oil massage group compared to control group (21.52?±?19.4 g) (p?=?0.003). However, there was no significant difference in serum triglycerides and other anthropometric parameters.Conclusions
Oil application has a potential to improve weight gain and cause less weight loss in first 7 d in low birth weight neonates 相似文献16.
Yik YI Clarke MC Catto-Smith AG Robertson VJ Sutcliffe JR Chase JW Gibb S Cain TM Cook DJ Tudball CF Hutson JM Southwell BR 《Pediatric surgery international》2011,27(7):705-711
Purpose
Transcutaneous electrical stimulation (TES) speeds up colonic transit in children with slow-transit constipation (STC). This study examined if concurrent upper gastrointestinal dysmotility (UGD) affected response to TES.Methods
Radio-nuclear transit studies (NTS) were performed before and after TES treatment of STC as part of a larger randomised controlled trial. UGD was defined as delayed gastric emptying and/or slow small bowel transit. Improvement was defined as increase of ??1 Geometric Centre (median radiotracer position at each time [small bowel?=?1, toilet?=?6]).Results
Forty-six subjects completed the trial, 34 had NTS after stimulation (21?M, 8?C17?years, mean 11.3?years; symptoms >9?years). Active stimulation increased transit in >50% versus only 25% with sham (p?=?0.04). Seventeen children also had UGD. In children with STC and either normal upper GI motility (NUGM) and UGD, NTS improved slightly after 1?month (57 vs. 60%; p?=?0.9) and more after 2?months (88 vs. 40%; p?=?0.07). However, mean transit rate significantly increased with NUGM, but not UGD (5.0?±?0.2: 3.6?±?0.6, p?<?0.01).Conclusion
Transcutaneous electrical stimulation was beneficial for STC, with response weakly associated with UGD. As measured by NTS, STC children with NUGM responded slightly more, but with significantly greater increased transit compared to those with UGD. Higher numbers are needed to determine if the difference is important. 相似文献17.
Sayed Nour Gang Dai Daniel Carbognani Minze Feng Daya Yang Nermine Lila Juan Carlos Chachques Guifu Wu 《Pediatric cardiology》2012,33(8):1332-1342
Objective
Pulmonary arterial hypertension (PAH) is a dysfunctional endothelium disease with increased pulmonary vascular resistance (PVR) and poor prognosis. Current therapies are still insufficient. Here we propose a new pulsatile device as a more effective tool for PAH management compared with traditional treatments.Materials and Methods
Twelve piglets (10.3?±?3.8?kg) were given either intrapulmonary pulsatile [P (n?=?6)] or nonpulsatile [NP (n?=?6)] tadalafil treatment. After median sternotomy and heparin injection (250?IU/kg), both groups underwent aorto-pulmonary surgical shunt for 1?h. During a second 1?h period in group P, a catheter prototype, driven by a small ventilator, was introduced into the pulmonary trunk and pulsated intermittently at 110?bpm irrespective of heart rate (90.6?±?10.74 bpm). In group NP, tadalafil was given orally (1?mg/kg).Results
Hemodynamics and cardiac output (CO) were significantly (p?<?0.05) improved in group P compared with group NP: CO was 0.56?±?0.0.26 versus 0.54?±?0.11 (L/min), respectively. Mean pulmonary artery pressure (PAP) was decreased in group P compared with group NP: PAP was 9.6?±?2.97 versus 32.2?±?5.07, respectively. Vascular resistances (dynes.s.cm?5/kg) were significantly lower in group P versus group NP: pulmonary resistance was 85?±?42.12 versus 478?±?192.91 and systemic resistance was 298.8?±?172.85 versus 1301?±?615.79, respectively. Using Western blot analysis, endogenous NO synthase expression in PA segments was nonsignificantly (p?>?0.05) greater in group P (0.81?±?0.78) versus (0.62?±?0.35) group NP.Conclusion
Induced with an appropriate device, intrapulmonary shear stress?Cmediated endothelial function enhancement provides a more effective nearly physiological therapy for PAH. 相似文献18.
Objectives
To evaluate arylesterase and lactonase activity of paraoxonase (PON)1 in cord blood of neonates in relation to their birth weight. The authors hypothesized that cord blood PON1 arylesterase and lactonase activities will be compromised in neonates having low birth weight.Methods
Eighty neonates born in authors’ hospital, irrespective of mode of delivery were included. Forty children with low birth weight were included in case group and 40 with normal birth weight were included as controls. PON1 arylesterase and lactonase activities were measured.Results
Serum arylesterase activity decreased significantly in low birth weight babies (p?<?0.05). Linear regression analysis (R?=?0.728) indicated significant correlation between arylesterase and birth weight. Serum lactonase activity was also reduced in low birth weight babies. Its linear regression analysis (R?=?0.727) indicated significant correlation between lactonase and birth weight.Conclusions
PON 1 activity is significantly reduced among low birth weight babies in comparison to normal weight babies. 相似文献19.
We investigated the potential role of pentraxin 3 (PTX3) in Henoch-Schönlein purpura (HSP), a common multisystemic vasculitis affecting children, as a predictor of Henoch-Schönlein purpura nephritis (HSPN). A total of 108 cases consisting of 34 children with HSP, 37 children with HSPN, and 37 healthy control children were enrolled in this prospective study from March 2010 to February 2013. Blood and urine samples were collected to measure plasma PTX3, C-reactive protein (CRP), serum creatinine, blood urea nitrogen (BUN), urine microalbumin (MALB), and β2-microglobulin (β2-MG). Median plasma PTX3 concentrations were significantly higher in children with HSPN and HSP than in control subjects before treatment (6.99, 4.18–9.78 ng/ml; 3.19, 1.13–4.27 ng/ml; 1.24, 0.87–2.08 ng/ml, respectively; all p?<?0.05). Median plasma PTX3 concentrations were also significantly higher in children with HSPN than in children with HSP before treatment (6.99, 4.18–9.78 vs. 3.19, 1.13–4.27 ng/ml; p?<?0.05). After treatment, median plasma PTX3 concentrations significantly decreased in children with HSP (from 3.19, 1.13–4.27 to 1.08, 0.65–2.19 ng/ml; p?<?0.05) and HSPN (from 6.99, 4.18–9.78 to 1.29, 1.01–2.26 ng/ml; p?<?0.05). Plasma PTX3 concentration was positively correlated with CRP (rho?=?0.532, p?=?0.001), MALB (rho?=?0.606, p?<?0.001), β2-MG (rho?=?0.490, p?=?0.002), and 24-h urinary protein quantity (rho?=?0.650, p?<?0.001) in children with HSPN. Considering vasculitis, we found that PTX3 could be used as a more efficient potential predictor of HSPN than CRP as indicated by the area under the receiver operating characteristic (ROC) curve (AUCROC) of PTX3 (AUCROC?=?0.837; p?<?0.001) and CRP (AUCROC?=?0.514; p?=?0.845). The threshold PTX3 concentration with optimal sensitivity and specificity was 4.30 ng/ml (sensitivity73.0 %, specificity79.6 %). Conclusion: PTX3 seems to have an important role in multisystemic vasculitis of HSP, may be involved in the development of HSPN, and used as an early biomarker to predict HSPN. 相似文献
20.
Bhawna Arya Stéphanie M. Levasseur Kristal Woldu Julie S. Glickstein Howard F. Andrews Ismée A. Williams 《Pediatric cardiology》2014,35(5):810-816