Rheumatic Fever and Rheumatic Heart Disease in Children

Indian Journal of Pediatrics - Acute rheumatic fever (ARF) and its sequelae, Rheumatic heart disease (RHD), contribute significantly to the cardiovascular morbidity and mortality in developing...     

Clinical profile and long term outcomes of eyes with choroidal detachment following trabeculectomy

Purpose:To assess the long-term outcomes of choroidal detachments (CDs) in eyes following trabeculectomy.Methods:Retrospective comparative case series. Data of patients with CDs following trabeculectomy (5-year period) with or without cataract surgery with a minimum of 3 months of follow-up were included.Results:In total, 45 patients with CDs following trabeculectomy were included. The mean age was 63.27 ± 8.68 years, (M:F = 2:1); 29 of 45 eyes (64.4%) had a baseline IOP of >24 mm Hg. Patients had a median follow-up of 22.2 (IQR: 16.2–30.5) months. Further, 10 of 45 eyes (22.2%) had CDs following suture lysis. The median onset of choroidal detachment from the time of surgery was 16.0 (IQR: 11–36) days. The mean BCVA improved from 0.62 ± 0.28 to 0.24 ± 0.27 (P < 0.001) and mean IOP increased from 4.07 ± 2.66 to 11.20 ± 5.31 (P < 0.001) at last visit. The cumulative success rates were 76.4% (95% CI: 48.4–90.5) in POAG eyes and 79.3% (95% CI: 62.8–89.1) in PACG eyes (P = 0.547). Medical management was the mainstay in all patients. Four of 45 (8.88%) patients underwent subsequent choroidal drainage.Conclusion:Choroidal detachment following modern-day trabeculectomy has favorable long-term visual acuity and IOP outcomes. There was no difference in the long-term surgical success of trabeculectomy with choroidal detachments in primary angle-closure and open-angle glaucoma eyes. Long-term follow-up is essential to prevent chronic hypotony and trabeculectomy failure.     

火棉胶样新生儿的护理

对5例火棉胶样新生儿采取保护性隔离,每天用1:5000高锰酸钾溶液洗浴全身后,用无茵凡士林油纱布包裹软化、保护皮肤,口服维生素E,加强眼部、口腔护理等.结果 5例患儿安全渡过易感期,无感染等并发症发生.提出保护性隔离和精心的皮肤护理是火棉胶样新生儿的护理关键.     

A time–motion study of digital radiography at implementation

With increasing budgetary restraints on the health system, it is apparent that the main contribution that radiology departments can make to significant cost reduction in hospitals is to decrease the length of time between requesting an X-ray examination and receiving the report (and images). Digital radiography (DR) was introduced into the Radiology Department at the Royal Adelaide Hospital as a pilot project to research the cost–benefits and efficiency of the system, and to determine future directions for planning a digital department. The business plan developed prior to implementation of this pilot project predicted a saving of one bed-day per inpatient when a fully digital department with a picture archiving and communication system (PACS) is installed. This initial study comparing DR and conventional radiography (convR) provides baseline data and shows encouraging results for more rapid transmission of reports to clinicians.     

天津地区1670例皮肤病患儿过敏原流行特征分析

目的 分析天津地区湿疹、荨麻疹患儿过敏原特异性免疫球蛋白E(sIgE)定量检测结果,为临床诊疗提供参考.方法 采用酶联免疫捕获法对2019年8月至2020年3月就诊于天津市儿童医院的1023例湿疹、647例荨麻疹患儿进行吸入及食物过敏原sIgE检测,并对检测结果进行统计分析.结果 1670例患儿检出过敏原sIgE阳性1254例,检出率为75.09％;检出食物过敏原sIgE阳性1185例(70.96％),检出吸入过敏原sIgE阳性739例(44.25％).食物过敏原sIgE检出前3位由高到低依次为鸡蛋白/蛋黄(943例,56.47％)、牛奶(533例,31.92％)、小麦面粉(336例,20.12％),吸入过敏原sIgE检出前3位由高到低依次为屋尘(561例,33.59％)、交链孢霉(182例,10.90％)、粉尘螨(127例,7.60％).不同性别患儿过敏原sIgE检出率比较,差异无统计学意义(P>0.05);1～<4岁患儿鸡蛋白/蛋黄、屋尘、牛奶、小麦面粉sIgE检出率最高,4～6岁患儿交链孢霉sIgE检出率最高,>6岁患儿粉尘螨sIgE检出率最高.荨麻疹患儿屋尘sIgE检出率高于湿疹患儿,其余几种过敏原sIgE检出率与湿疹患儿比较,差异均无统计学意义(P>0.05).结论 该研究结果在一定程度上反映了湿疹、荨麻疹患儿过敏原sIgE的流行特征,有助于疾病的诊断和防治.     

虚拟模拟器在输尿管镜培训中应用的初步探讨

目的 评估虚拟模拟器UroMentorTM在输尿管镜培训中的应用价值. 方法 30名泌尿外科医师按单独完成输尿管镜例数＜ 20例和≥20例分成2组,分别为18名及12名.应用左输尿管下段取石模拟操作进行初评,包括:总操作时间、输尿管插管时间、损伤致出血点的数目、尝试插管次数以及综合总体评分(GRS),连续训练48 h后复评并与初评比较. 结果 经过模拟器训练后所有受试者总操作时间明显缩短[( 333±32)s及(228±18)s,P=0.001],GRS评分明显改善(24.4±2.1及28.1±1.2,P=0.010).少(无)经验组和有经验组初评总操作时间[(405±40)s及(262±22)s,P=0.014]、复评总操作时间[(276±12)s及(179±9)s,P=0.000]及初评GRS评分(19.6±2.5及29.2±1.3,P＝0.009)、复评GRS评分(25.0±1.1及31.2±0.7,P=0.002)差异均有统计学意义.独立完成的输尿管镜例数与GRS评分相关(初评r=0.705,复评r=0.756). 结论虚拟模拟器URO MentorTM可以成为输尿管镜技能培训及评估的有效工具.     

Energy expenditure, energy balance, and composition of weight gain in low birth weight infants fed diets of different protein and energy content

The effect of energy and protein intakes on energy expenditure, energy balance, and amount and relative rate of both protein and fat deposition in new tissue was investigated in 19 low birth weight infants whose mean protein and energy intakes, respectively, were 2.24 g/kg/d and 113 kcal/kg/d (formula A, n = 8), 3.6 g/kg/d and 115 kcal/kg/d (formula B, n = 5), and 3.5 g/kg/d and 149 kcal/kg/d (formula C, n = 6). The higher energy intake (formula C) but not the higher protein intake (formula B) resulted in greater energy expenditure. Both the higher protein (formula B vs formula A) and higher energy intakes (formula C vs formula B) resulted in greater weight gain secondary, in group B, to a greater absolute rate of protein deposition and, in group C, to a greater absolute rate of fat deposition. The relative composition of the new tissue deposited reflected the proportional intakes of protein and energy. The numerical value of the protein/fat ratio (g/g) of the new tissue deposited by infants fed formulas A and C, the protein contents of which were low relative to energy contents, were similar and significantly lower than the numerical value of the protein/fat ratio of the new tissue deposited by infants fed formula B, which had a higher protein content relative to energy content. These findings suggest that the composition of weight gain is related to both the absolute amounts and the proportions of dietary protein and energy; thus, both must be considered in formulation of nutritional regimens for LBW infants.     

NCP防控期间以家庭为中心的护理模式在PICU患儿家长转科应激中的应用

目的 探讨新型冠状病毒肺炎(NCP)防控期间,小儿重症监护病房(PICU)采用以家庭为中心的护理模式对危重患儿家长转科应激压力的影响.方法 应用方便抽样方法,选择该院PICU 2019年12月至2020年1月转科患儿家长为对照组,实施常规优质护理模式;选择2020年2-3月转科患儿家长为观察组,开展以家庭为中心的护理模...