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1.
Objective
To evaluate the changes in the LV systolic and diastolic function in children with beta-thalassemia major (β-TM) using pulsed wave tissue doppler (TD) echocardiography.Methods
Clinical, conventional echo doppler and pulsed wave tissue doppler imaging parameters were compared in 40 beta-thalassemia major patients (mean age, 6.52?±?3.5 y) and 25 age and sex matched normal subjects (mean age, 6.5?±?2.7 y).Results
There were no significant statistical differences between mean fractional shortening (FS) and ejection fraction (EF) of left ventricle (LV) of the patients and control group. Children with beta-thalassemia had significantly lower E′ wave velocities measured at the left ventricular septal annulus (8.1?±?3.3 vs. 13?±?2.5, P?<?0.001), lateral margin of the mitral annulus (9.1?±?5.4 vs. 13.3?±?2.5, P?<?0.001) and lateral margin of the tricuspid annulus (9.3?±?3.9 vs. 13.3?±?2.5, P?<?0.001) when compared to the control group. Furthermore children with beta-thalassemia had significantly lower E′/A′ wave ratio at the left ventricular septal annulus (0.76?±?0.34 vs. 1.36?±?0.23), lateral margin of the mitral annulus (0.83?±?0.17 vs. 1.28?±?0.22), and lateral margin of the tricuspid annulus ((0.90?±?0.27 vs. 1.26?±?0.23, (P?<?0.05) when compared to the control group.Conclusions
This study showed that patients with beta-thalassemia major and normal conventional echo doppler parameters had statistically significant changes detected by pulsed wave tissue doppler imaging. 相似文献2.
Aditi Sinha Pankaj Hari Piyush Kumar Sharma Ashima Gulati Mani Kalaivani Mukta Mantan Amit Kumar Dinda Rajendra N. Srivastava Arvind Bagga 《Indian pediatrics》2012,49(11):881-887
Objective
To review the disease course in patients with steroid sensitive nephrotic syndrome (SSNS) and the factors that determine outcomeDesign
Retrospective, analyticalSetting
Pediatric Nephrology Clinic at referral center in North IndiaParticipants/patients
All patients with SSNS evaluated between 1990 and 2005Intervention
NoneMain outcome measures
Disease course, in patients with at least 1-yr follow up, was categorized as none or infrequent relapses (IFR), frequent relapses or steroid dependence (FR), and late resistance. Details on complications and therapy with alternative agents were recorded.Results
Records of 2603 patients (74.8% boys) were reviewed. The mean age at onset of illness and at evaluation was 49.7±34.6 and 67.5±37.9 months respectively. The disease course at 1-yr (n=1071) was categorized as IFR in 37.4%, FR in 56.8% and late resistance in 5.9%. During follow up, 224 patients had 249 episodes of serious infections. Alternative medications for frequent relapses (n=501; 46.8%) were chiefly cyclophosphamide and levamisole. Compared to IFR, patients with FR were younger (54.9±36.0 vs. 43.3±31.4 months), fewer had received adequate (??8 weeks) initial treatment (86.8% vs. 81.7%) and had shorter initial remission (7.5±8.6 vs. 3.1±4.8 months) (all P<0.001). At follow up of 56.0±42.6 months, 77.3% patients were in remission or had IFR, and 17.3% had FR.Conclusions
A high proportion of patients with SSNS show frequent relapses, risk factors for which were an early age at onset, inadequate initial therapy and an early relapse. 相似文献3.
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4.
Ashok Kumar Narendra Kumar Bagri Sriparna Basu Ravi Kumar Asthana 《Indian pediatrics》2014,51(5):375-378
Objectives
To determine the efficacy of oral zinc for treatment of idiopathic neonatal hyperbilirubinemia in near-term and term (35–41 weeks) neonates.Design
Randomized placebo-controlled trial.Setting
Tertiary-care teaching hospitalParticipants
Eighty newborns with idiopathic neonatal hyperbilirubinemia.Intervention
Neonates were randomized to receive either oral zinc sulfate (10 mg/d) or placebo for 7 days.Main outcome measures
Primary: total serum bilirubin levels at 48 (±12) h, 96 (±12) h and 144 (±12) h after intervention. Secondary: duration of phototherapy, and serum zinc and copper levels.Results
Baseline mean (SD) total serum bilirubin levels were 14.8 (3.8) and 14.4 (3.5) mg/dL in zinc and placebo groups, respectively. No significant differences were observed in total bilirubin levels between the two groups after the intervention. Mean (SD) total serum bilirubin levels in zinc and placebo groups were 13.9 (2.5) vs. 13.4 (1.9) mg/dL (mean difference 0.566; 95% CI ?0.535, 1.668, P=0.038) at 48 h, 13.1 (2.7) vs. 12.8 (2.3) mg/dL (mean difference 0.234; 95% CI ?1.011, 1.479, P =0.708) at 96 h and 8.0 (2.0) vs. 8.6 (1.2) mg/dL (mean difference ?0.569, 95% CI ?1.382, 0.242, P=0.166) at 144 h. Although the mean duration of phototherapy in the zinc group was less by 21.3 h (95% CI 11.6, 30.9, P=0.052), the difference was not significant. Postintervention, serum zinc levels were significantly higher in the zinc-supplemented group while serum copper levels were comparable between the two groups.Conclusions
Oral zinc sulfate, in a dose of 10 mg/day, is not effective in the management of idiopathic neonatal hyperbilirubinemia. 相似文献5.
Renata A. Alveno Caroline V. Miranda Caroline G. Passone Aurora R. Waetge Elza S. Hojo Sylvia C.L. Farhat Vicente Odone-Filho Uenis Tannuri Werther B. Carvalho Magda Carneiro-Sampaio Clovis A. Silva 《Jornal de pediatria》2018,94(5):539-545
Objective
To describe the characteristics of children and adolescentes with chronic diseases of outpatient clinics at a tertiary university hospital.Methods
A cross-sectional study was performed with 16,237 patients with chronic diseases followed-up in one year. The data were collected through the electronic system, according to the number of physician appointments in 23 pediatric specialties. Patients were divided in two groups: children (0–9 years) and adolescents (10–19 years). Early (10–14 years) and late (15–19 years) adolescent groups were also analyzed.Results
Of the total sample, 56% were children and 46% were adolescents. The frequencies of following pediatric specialties were significantly higher in adolescents when compared with children: cardiology, endocrinology, hematology, nephrology/renal transplantation, neurology, nutrology, oncology, palliative and pain care, psychiatry, and rheumatology (p < 0.05). The frequencies of emergency service visits (30% vs. 17%, p < 0.001), hospitalizations (23% vs. 11%, p < 0.001), intensive care unit admissions (6% vs. 2%, p < 0.001), and deaths (1% vs. 0.6%, p = 0.002) were significantly lower in adolescents than in children. However, the number of physician appointments (≥13) per patient was also higher in the adolescent group (5% vs. 6%, p = 0.018). Further analysis comparison between early and late adolescents revealed that the first group had significantly more physician appointments (35% vs. 32%, p = 0.025), and required more than two pediatric specialties (22% vs. 21%, p = 0.047). Likewise, the frequencies of emergency service visits (19% vs. 14%, p < 0.001) and hospitalizations (12% vs. 10%, p = 0.035) were higher in early adolescents.Conclusions
This study evaluated a large population in a Latin American hospital and suggested that early adolescents with chronic diseases required many appointments, multiple specialties and hospital admissions. 相似文献6.
Rotjanee Wongnoi Nawaporn Penvieng Panthong Singboottra Doungnapa Kingkeow Peninnah Oberdorfer Pannee Sirivatanapa Sakorn Pornprasert 《Indian pediatrics》2013,50(6):567-572
Objectives
To investigate the effects of antiretroviral (ARV) drugs on hematological parameters and thymic function in HIVuninfected newborns of HIV-infected mothers.Study design
Cross sectional study.Setting
Chiang-Mai University Hospital, Chiang-Mai, Thailand.Participants/Patients
49 HIV-uninfected and 26 HIV-infected pregnancies.Methods
Cord blood samples of newborns from HIV-uninfected and HIV-infected mothers were collected. Hematological parameters were measured using automatic blood cell count. T-cell receptor excision circles (TRECs) levels in cord blood mononuclear cells (CBMCs), CD4+ and CD8+ T-cells were quantified using real-time PCR.Main Outcome Measures
Hemotological parameters and thymic function.Results
Newborn of HIV-infected mother tended to have lower mean levels of hemoglobin than those of HIV-uninfected mother (137 ± 22 vs 146 ± 17 g/L, P = 0.05). Furthermore, mean of red blood cell (RBC) counts and hematocrit and median of TRECs in CD4+ T-cells in the newborns of the former were significantly lower than those of the latter [3.6 ± 0.7 vs 4.8 ± 0.6 × 1012 cells/L, P <0.001; 0.40 ± 0.07 vs 0.46 ± 0.05 L/L, P <0.001 and 0.53 (IQR: 0.03–5.76) vs 13.20 (IQR: 2.77–27.51) × 10?3 pg/μL, P = 0.02, respectively].Conclusion
ARV drugs altered hematological parameters and thymic function (TRECs CD4+ T-cells) in HIV-uninfected newborns of HIV-infected mothers. 相似文献7.
Objective
To compare the efficacy of ferrous ascorbate and colloidal iron in the treatment of iron deficiency anemia in children.Methods
Eighty one children, aged 6 mo to 12 y, were screened for iron deficiency anemia (IDA) and those diagnosed with IDA were randomized to receive ferrous ascorbate or colloidal iron for a period of 12 wk, such that each child received elemental iron 3 mg/kg body weight/d. Increase in hemoglobin (Hb) level was the primary outcome measure. Assessment was performed at baseline, wk 4, wk 8 and wk 12.Results
Of 81 children screened, 73 were included in the study. The mean rise in Hb at the end of the 12 wk was significantly higher in ferrous ascorbate group than the colloidal iron group [3.59?±?1.67 g/dl vs. 2.43?±?1.73 g/dl; P?<?0.01]. Significantly higher proportion of children receiving ferrous ascorbate (64.86 % vs. 31.03 %; P?<?0.01) became non-anemic in comparison to colloidal iron.Conclusions
Ferrous ascorbate provides a significantly higher rise in hemoglobin levels in comparison to colloidal iron. The study supports the use of ferrous ascorbate in the pediatric age group, providing evidence for its role as an efficient oral iron supplement in the treatment of iron deficiency anemia. 相似文献8.
Objective
To compare parameters of insulin resistance, with special reference to McAuley index, in urban Indian adolescents, and to establish their cut-off values for defining metabolic syndrome.Design
Cross-sectional study.Setting
Schools located in four different geographical zones of Delhi, India.Participants
695 apparently healthy adolescents grouped as normal weight (298), overweight (205) and obese (192).Outcome measures
Cut-off point for indices of insulin resistance was assessed by fasting insulin, insulin glucose ratio, and other methods (HOMA model, QUICKI, McAuley index) to define metabolic syndrome.Results
The McAuley index increased progressively from normal weight to obese adolescents in both sexes. McAuley index was significantly lower in adolescents with metabolic syndrome (5.36 ± 1.28 vs. 7.05 ± 1.88; P<0.001). McAuley index had the highest area under curve of receiver operator characteristics [0.82 (0.02)] as compared to other indices of insulin resistance. McAuley index of 6.23 had the highest specificity (88%) with sensitivity of 63.3% for diagnosing metabolic syndrome, whereas insulin glucose ratio had the highest sensitivity (79.7%) but low (55.5%) specificity. McAuley index was negatively correlated with height (r= ?0.257, P=<0.001), weight (r= ?0.537, P=<0.001), body mass index (r= ?0.579, P<0.001), waist circumference (r= ?0.542, p<0.001), and waist hip ratio (r= ?0.268, P<0.001).Conclusions
Among various parameters of insulin resistance, McAuley index had the highest specificity, and insulin glucose ratio had the highest sensitivity in diagnosing metabolic syndrome in urban Indian adolescents. 相似文献9.
Lígia Bruni Queiroz Benito Lourenço Luiz Eduardo Vargas Silva Daniela Mencaroni Rodrigues Lourenço Clovis Artur Silva 《Jornal de pediatria》2018,94(6):673-679
Objective
To evaluate television and simultaneous electronic devices use in adolescents with musculoskeletal pain and musculoskeletal pain syndromes.Methods
A cross-sectional study was performed in 299 healthy adolescents of a private school. All students completed a self-administered questionnaire, including: demographic data, physical activities, musculoskeletal pain symptoms, and use of simultaneous television/electronic devices (computer, internet, electronic games, and cell phones). Seven musculoskeletal pain syndromes were also evaluated: juvenile fibromyalgia, benign joint hypermobility syndrome, myofascial syndrome, tendinitis, bursitis, epicondylitis, and complex regional pain syndrome.Results
Inter-rater agreement between pretest and retest was 0.83. Musculoskeletal pain and musculoskeletal pain syndrome were found in 183/299 (61%) and 60/183 (33%), respectively. The median age (15 [10–18] vs. 14 [10–18] years, p = 0.032) and years of education (10 [5–12] vs. 9 [5–12] years, p = 0.011) were significantly higher in adolescents with musculoskeletal pain when compared with those without this condition. The frequencies of female gender (59% vs. 47%, p = 0.019), cell phone use (93% vs. 81%, p = 0.003), and simultaneous use of at least two electronic devices (80% vs. 67%, p = 0.011) were significantly higher in the former group. Further comparisons between adolescents with and without musculoskeletal pain syndromes revealed that the frequency of female gender was significantly higher in the former group (75% vs. 25%, p = 0.002), and with a significantly reduced median of weekends/holidays electronic games use (1.5 [0–10] vs. 3 [0–17] h/day, p = 0.006).Conclusions
A high prevalence of musculoskeletal pain/syndromes was observed in female adolescents. Musculoskeletal pain was mostly reported at a median age of 15 years, and students used at least two electronic devices. Reduced use of electronic games was associated with musculoskeletal pain syndromes. 相似文献10.
Lin Zhang Ran Chen Rong Li Meng-Ying Chen Rong Huang Xiao-Nan Li 《World journal of pediatrics : WJP》2018,14(2):160-167
Background
To study the predictive factors of resting energy expenditure (REE) and evaluate the accuracy of predicted equations with indirect calorimeter (IC) in Chinese school-age children, particularly for the obese population.Methods
Recruited children were from the department of child healthcare in Nanjing children’s hospital during July 2014–September 2015. Anthropometric parameters and body composition were measured by bioelectrical impedance. Measured REE was assessed by IC. Predicted REE was estimated using ten published equations.Results
248 children aged 7–13 years were recruited, including 148 obese [body mass index standard deviation score (BMISDS) = 2.48 ± 0.91] and 100 non-obese (BMISDS = ? 0.96 ± 1.08). The unit mass of REE (REE/kg) in obese group (29.06 ± 5.74) was lower than that in non-obese group (37.51 ± 6.56). The stepwise regression showed that age, BMISDS and fat-free mass (FFM) had a major impact on REE/kg as the regression equation: Y = 54.41 ? 1.36 × X1 ? 2.25 × X2 ? 0.16 × X3 (Y REE/kg, X1 age, X2 BMISDS, X3 FFM; R = 0.633, R2 = 0.401, P < 0.01). The accuracy of predicted REE in obese subjects was 62.16% by the new predictive equations.Conclusions
The REE/kg in obese children was lower and closely correlated with age, BMISDS and FFM. It is necessary to validate the new predictive equation in a larger sample to estimate energy requirements, particularly for children with obesity.11.
K. Mehta N. K. Bhatta S. Majhi M. K. Shrivastava Rupa Rajbhandari Singh 《Indian pediatrics》2013,50(4):390-393
Objective
To study the role of Zinc in the treatment of neonatal sepsis.Design
Double blind, randomized, placebo controlled trial.Setting
Tertiary Care Hospital.Participants
614 neonates with probable neonatal sepsis.Intervention
The drug group (n=307) received 1mg/kg/day of elemental zinc, and placebo group (n=307) received the placebo, in addition to antibiotic therapy and supportive care, till the final outcome (discharge/death).Outcome Measures
Decrease in mortality rates (primary outcome), duration of hospital stay and need of higher lines of antibiotic therapy (secondary outcomes) were tested.Results
Baseline characteristics of the two groups were similar. No statistically significant differences between drug and placebo group were found in mortality rate (9.77% vs 7.81 %; P=0.393), mean duration of hospital stay (142.85±69.41 hrs, vs. 147.99±73.13 hrs; P=0.841), and requirement of higher lines of antibiotic therapy (13.35% vs 12.05%, P=0.628) after supplementation.Conclusions
This study does not report decrease in mortality rates, duration of hospital stay and requirement of higher lines of antibiotic therapy following zinc supplementation in neonatal sepsis. 相似文献12.
Objective
To evaluate the role of echocardiography in reducing shock reversal time in pediatric septic shock.Methods
A prospective study conducted in the pediatric intensive care unit of a tertiary care teaching hospital from September 2013 to May 2016. Ninety septic shock patients were randomized in a 1:1 ratio for comparing the serial echocardiography-guided therapy in the study group with the standard therapy in the control group regarding clinical course, timely treatment, and outcomes.Results
Shock reversal was significantly higher in the study group (89% vs. 67%), with significantly reduced shock reversal time (3.3 vs. 4.5 days). Pediatric intensive care unit stay in the study group was significantly shorter (8 ± 3 vs. 14 ± 10 days). Mortality due to unresolved shock was significantly lower in the study group. Fluid overload was significantly lower in the study group (11% vs. 44%). In the study group, inotropes were used more frequently (89% vs. 67%) and initiated earlier (12[0.5–24] vs. 24[6–72] h) with lower maximum vasopressor inotrope score (120[30–325] vs. 170[80–395]), revealing predominant use of milrinone (62% vs. 22%).Conclusion
Serial echocardiography provided crucial data for early recognition of septic myocardial dysfunction and hypovolemia that was not apparent on clinical assessment, allowing a timely management and resulting in shock reversal time reduction among children with septic shock. 相似文献13.
Caterina Grano S. Bucci D. Aminoff F. Lucidi C. Violani 《Pediatric surgery international》2013,29(9):925-930
Purpose
Quality of life (QOL) is an important endpoint in health outcomes research, especially in pediatric chronic conditions. While some studies suggest that patients with ARM report a lower level of physical and psychosocial QOL, as compared to healthy peers, not all research shows this consistently. The aim of this study was to compare the QOL of Italian children and adolescents with ARM to the QOL of a large control sample of healthy peers.Methods
Parents of 109 children with ARM and 336 schoolchildren, completed the Pediatric Quality of Life Inventory. Analysis of variances were used to compare the groups.Results
Compared to healthy peers, children with ARM showed lower emotional functioning (F = 8,41; p = .004), social functioning (F = 4,9; p = .027) and school functioning (F = 14,7; p = .000). In the adolescent group, females had a worse QOL in the physical functioning domain (F = 5,01; p = .03) than males, independent of group membership.Conclusions
While children with ARM show a more impaired QOL compared to their peers, this difference does not emerge in the adolescent group. Our results are consistent with previous findings which hypothesize that while patients with ARM face more difficulties during childhood, by adolescence they may have learned to overcome these difficulties. 相似文献14.
C. V. S. Lakshmi G. Pramod K. Geeta S. Subramaniam Marepalli B. Rao Suhas G. Kallapur Srinivas Murki 《Indian pediatrics》2013,50(9):847-852
Background
Fetal growth restriction and abnormal Doppler flow studies are commonly associated. Neonatal outcomes are not well known particularly in developing countries, where the burden of the disease is the highest.Objective
To determine outcomes of preterm infants with history of absent/reversed end-diastolic umbilical artery Doppler flow (AREDF) vs. infants with forward end-diastolic flow (FEDF).Design
Cohort study.Setting
Tertiary care perinatal center in India.Participants
103 AREDF very low birth weight (<1500 gm) (VLBW) infants and 117 FEDF VLBW infants were prospectively enrolled.Results
At 40 weeks adjusted post-menstrual age, AREDF vs. FEDF group had a higher risk for death in the NICU (12% vs. 1%), respiratory distress syndrome (33% vs. 19%), and cystic periventricular leukomalacia (12% vs. 1%). At 12–18 months corrected age, AREDF vs. FEDF group had a trend towards increased risk for cerebral palsy (7% vs. 1%, P=0.06). After logistic regression analysis, adjusting for confounders, AREDF was independently associated only with mortality in the NICU.Conclusion
AREDF is an independent predictor of adverse outcomes in preterm infants in a developing country setting. 相似文献15.
Faezeh Ghalichi Jamal Ghaemmaghami Ayyoub Malek Alireza Ostadrahimi 《World journal of pediatrics : WJP》2016,12(4):436-442
Background
Genetic and environmental factors are both responsible for the etiology of autism spectrum disorders (ASD). Although epidemiological studies have been conducted to clarify the association between restriction diets and ASD, the conclusion remains unclear. This study was undertaken to investigate the effect of gluten free diet (GFD) on gastrointestinal symptoms and behavioral indices in children with ASD.Methods
In this randomized clinical trial, 80 children diagnosed with ASD by the Autism Diagnostic Interview-Revised (ADI-R) were assigned into GFD (n=40) and regular diet (RD) (n=40) groups for 6 weeks. At the beginning and end of the intervention, the ROME Ш questionnaire for evaluating gastrointestinal symptoms and Gilliam Autism Rating Scale 2 questionnaire (GARS-2) for assessing psychometric properties were completed.Results
Of the 80 children, 53.9% had gastrointestinal abnormalities. In the GFD group, the prevalence of gastrointestinal symptoms decreased significantly (P<0.05) after intake of GFD (40.57% vs. 17.10%) but increased insignificantly in the RD group (42.45% vs. 44.05%). GFD intervention resulted in a significant decrease in behavioral disorders (80.03±14.07 vs. 75.82±15.37, P<0.05) but an insignificant increase in the RD group (79.92±15.49 vs. 80.92±16.24).Conclusion
This study suggested that GFD may be effective in controlling gastrointestinal symptoms and ASD behaviors.16.
Objective
The objective of this study is to evaluate the hypothesis that use of heliox would result in improvement of gas exchange when used with high flow nasal cannula in infants with RSV acute bronchiolitis.Methods
All patients that met the inclusion criteria were randomized to either heliox (70:30) or air–oxygen mixture 30% via high flow nasal cannula at 8 L/min for a continuous 24 h. Measurements were taken at baseline, after 2 h, and at the end of the 24 h.Results
This prospective study included 48 patients. After 2 h of treatment with heliox, the oxygen saturation and PaO2 significantly improved when compared with the air–oxygen group, 98.3% vs. 92.9%, 62.0 mmHg vs. 43.6 mmHg (p = 0.04 and 0.01), respectively. Furthermore, PaO2/FiO2 ratio was significantly higher in the heliox group when compared with the air–oxygen group, 206.7 vs. 145.3. Nevertheless, CO2 showed better elimination when heliox was used, without significance. MWCA score dropped significantly in the heliox group, 2.2 points vs. 4.0 points in air–oxygen (p = 0.04), 2 h after starting the therapy.Conclusion
Transient improvement of oxygenation in infants with RSV acute bronchiolitis during the initial phase of the therapy is associated with heliox when provided with HFNC, may provide a precious time for other therapeutic agents to work or for the disease to resolve naturally, avoiding other aggressive interventions. 相似文献17.
Sasivimon Soonsawad Buranee Swatesutipun Anchalee Limrungsikul Pracha Nuntnarumit 《Indian journal of pediatrics》2017,84(4):262-266
Objectives
To compare extubation failure rate between the heated humidified high-flow nasal cannula (HHHFNC) and continuous positive airway pressure (CPAP) groups.Methods
Intubated infants with gestational age (GA) <32 wk, who were ready to extubate, were randomized to receive respiratory support with either CPAP or HHHFNC after extubation. In CPAP group, nasal mask CPAP with preset pressure and fraction of inspired oxygen (FiO2) equal to positive end-expiratory pressure (PEEP) and FiO2 of ventilator before extubation was applied. In the HHHFNC group, predefined flow rate according to the protocol was applied. Primary outcome was extubation failure within 72 h after endotracheal tube removal.Results
Forty-nine infants were enrolled; 24 in the HHHFNC and 25 in the CPAP group. Baseline demographic and respiratory conditions before extubation were similar. There was no difference in infants who met failed extubation criteria between the two groups [8 (33%) in HHHFNC vs. 6 (24%) in CPAP group (p = 0.47)]. However, 6 infants (75%) in HHHFNC and 4 infants (66%) in CPAP group who met failed extubation criteria could be rescued by bilevel CPAP. Therefore, the reintubation rate was comparable [2 infants (8.3%) in HHHFNC vs. 2 infants (8%) in CPAP group]. Morbidities or related complications were not different but infants in the HHHFNC group had significantly less nasal trauma (16.7% vs. 44%; p = 0.03).Conclusions
In the index study, the extubation failure rate was not statistically different between infants who were on HHHFNC or CPAP support.18.
Background
We aimed to analyze the effect of oral zinc supplementation on serum insulin-like growth factor-1 (IGF-1) levels and catch-up growth in infants with non-organic failure to thrive (NOFTT) who were born preterm as compared to those born at term.Methods
Totally, 105 NOFTT infants aged 2 years or less were enrolled and divided into two groups according to gestational age at birth. Oral zinc sulfate was administered for 6 months to 49/66 children born at term, and 21/39 children born preterm. Serum zinc, IGF-1, weight, and height were measured at baseline and at 6 months.Results
There were no differences in baseline serum zinc levels between the two groups. In preterm NOFTT infants, zinc supplementation significantly increased serum zinc levels compared to those in the non-supplementation group (Δ zinc 0–6 month 10.3 ± 26.4 μg/dL vs. ?8.8 ± 23.7 μg/dL, p = 0.018), but it did not significantly change serum IGF-1 levels or weight- and height for age Z-scores. In NOFTT infants born at term who received zinc supplementation, serum zinc levels, IGF-1, weight for age Z-score, and height for age Z-score increased at 6 months (p = 0.001, p = 0.014, p = 0.049, and p = 0.029, respectively), but this increase was not significantly greater than in the non-supplementation group. Only the increase in serum zinc levels was significant after 6 months (Δ zinc 0–6 month 16.8 ± 32.0 μg/dL vs. ?10.0 ± 22.6 μg/dL, p = 0.002).Conclusion
Zinc supplementation in NOFTT infants improves serum zinc status, regardless of gestational age at birth. Zinc supplementation in NOFTT infants born at term may improve serum IGF-1 levels and growth, but it does not in NOFTT infants born preterm. Overall nutritional support rather than supplementation of a single nutrient may be more effective for catch-up growth in NOFTT infants born preterm. 相似文献19.
Polyana Romano Oliosa Divanei Zaniqueli Rafael de Oliveira Alvim Miriam Carmo Rodrigues Barbosa José Geraldo Mill 《Jornal de pediatria》2019,95(1):112-118
Objective
To assess whether the indicators of weight status body mass index and waist-to-height ratio are similar to body fat percentage to identify obese children and adolescents with unfavorable lipid profile.Methods
This was a cross-sectional study involving 840 children and adolescents (6–18 years). The same individuals were classified as non-obese (<P95) or obese (≥P95) according to body fat percentage and indicators of weight status, body mass index, and waist-to-height ratio. Body fat percentage was obtained by multi-frequency bioelectrical impedance. Linear association between obesity and increased lipid fractions was tested by ANCOVA. Normal distribution curves of non-HDL cholesterol were designed for obese and non-obese. To provide the proportion of obese individuals with elevated non-HDL-c across all indicators, Z-score was calculated.Results
Obese boys presented higher non-HDL cholesterol when compared with those non-obese, classified by body mass index (107 ± 28 vs. 94 ± 25 mg/dL, p = 0.001), waist-to-height ratio (115 ± 29 vs. 94 ± 25 mg/dL, p < 0.001) and body fat percentage (119 ± 33 vs. 94 ± 24 mg/dL, p < 0.001). Differently, obese girls presented with higher non-HDL cholesterol when compared with those non-obese only according to the body fat percentage classification (118 ± 24 vs. 96 ± 26 mg/dL, p = 0.001). A large shift to the right in the distribution curve of non-HDL cholesterol among obese girls compared with non-obese was observed only when body fat percentage was used to discriminate between obese and non-obese.Conclusion
Body fat percentage was better than the indicators of weight status to identify children and adolescents with unfavorable lipid profile, mainly among girls. 相似文献20.
Takaaki Tanaka Tadaharu Okazaki Yumi Fukatsu Manabu Okawada Hiroyuki Koga Go Miyano Yuki Ogasawara Geoffrey J. Lane Atsuyuki Yamataka 《Pediatric surgery international》2013,29(11):1183-1186