Performance and correlation of QuantiFERON-TB Gold, T-SPOT.TB and tuberculin skin test in young children with or exposed to tuberculosis

Objective:To evaluate the performance of interferon gamma release assays and tuberculin skin test in Bacillus Calmette-Guerin vaccinated young children.Methods:A cross-sectional study was conducted in healthy children younger than 5 years who were recently diagnosed with tuberculosis or had recent exposure to active tuberculosis.QuantiFERON-TB Gold,T-SPOT.TB and tuberculin skin test were performed in each patient.Results:Of the 60 children,median age 3.3 years,17 had tuberculosis and 43 had recent tuberculosis exposure.Overall,15(25.0%)children had tuberculin skin test reaction≥10 mm;8(13.3%)were positive by QuantiFERON-TB Gold In-Tube test,and 12(20.0%)by T-SPOT.TB.Nineteen(31.7%)children had at least one positive test.There was a moderate agreement between interferon gamma release assays and tuberculin skin test.Conclusions:The positive rates of interferon gamma release assays and tuberculin skin test were low in young children who were infected with tuberculosis,supporting the management strategy of not testing children younger than 5 years.

Young children with multidrug-resistant epilepsy and vagus nerve stimulation responding to perampanel: A case report

BACKGROUND Perampanel(PER),a third-generation antiepileptic drug,is a selective and noncompetitiveα-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor antagonist,and has been approved for the treatment of adults and adolescents with focal epilepsy.However,there are only a few studies about the efficacy and tolerability of PER in young children with multidrug-resistant epilepsy.In this case,we aimed to share our clinical experience in this group.CASE SUMMARY A 4-year-old boy without perinatal asphyxia and familial history of epilepsy began to have ictal seizures from age 14 mo,with jerky movement of four limbs and head nodding.Abnormal multifocal discharge and background activity were recorded through electroencephalography,and no pathogenic mutation was found in the whole exome sequencing for the patient and his parents.He had received valproate,levetiracetam,topiramate,oxcarbazepine,clonazepam and lacosamide sequentially at different times,but he still had frequent seizures even after vagus nerve stimulation(VNS)implantation.He was diagnosed with idiopathic multidrug-resistant epilepsy.However,his seizure frequency was significantly reduced after PER administration in a dose-dependent manner,and better cognitive behavior was observed.In addition,the adverse reactions of anger and aggression also appeared.CONCLUSION PER is effective as add-on therapy for young children with multidrug-resistant epilepsy who have previously undergone VNS implantation.

Population Education for young Children

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Effects of Nutrient Fortified Complementary Food Supplements on Anemia of Infants and Young Children in Poor Rural of Gansu

To assess the effectiveness of complementary food supplements with protein and multi-micronutrients on hemoglobin and anemia in infants and young children.Methods In 5 poor counties of Gansu,984 children aged 6-12 months were enrolled and divided into two groups.In addition to the usual home-made complementary food,all the children were fed one sachet of either Formula I or Formula II supplements each day.Protein and micronutrients were provided in Formula I,while the same energy intake was secured in Formula II as in Formula I.A massive dose of vitamin A was supplemented to all the children every 6 months.Hemoglobin test was done at the same time.Results Prevalence of anemia was about 35% in both Formula I and Formula II group at baseline,and there were no differences in hemoglobin concentration between the two groups.During the 6-month and 12-month supplementation,hemoglobin of children in Formula I group was higher than that in Formula II group(P<0.05),and hemoglobin increase in Formula I group was significantly higher than that in Formula II group(P<0.001).After 6-and 12-month supplementation,the prevalence of anemia in Formula I group dropped to 19.1% and 8.2% respectively,and it was 28.0% and 12.4% in Formula 2 group.The prevalence of anemia in Formula I group was significantly lower than that in Formula II group(P<0.05).After adjusting age and hemoglobin level at baseline,the hemoglobin increase at age of 24 months in formula 1 group was higher(10.7 g/L vs 7.9 g/L,P<0.0001).Conclusion Micronutrient fortified complementary food supplements,with large-dose vitamin A,is effective for children aged 6-12 months in terms of iron deficiency prevention.

Aggression and Conduct Disorder in Young Children. A Case Report

Childhood Onset Conduct Disorder [CD] is a condition characterized by at least one symptom of conduct disorder (based on Diagnostic and Statistical Manual of Mental Disorders criteria—Fifth Edition) prior to 10 years of age. Children affected exhibit disruptive behaviors, usually negative, hostile, and defiant behavior similar to Oppositional Defiant Disorder [ODD]. As the child gets older they begin to display more characteristic of Conduct Disorder (lying, fighting, and stealing, vindictive behavior). These children are also likely to have comorbidities including Attention Deficit Hyperactivity Disorder (ADHD), learning disabilities, poor academic achievement, and substance abuse. Distinguishing early between symptoms of Conduct Disorder versus other differential diagnoses is essential in effective treatment. Early intervention with these children leads to a better prognosis and likelihood of functioning in society. This case illustrates the difficulty of diagnosing a young child with Childhood Onset Conduct Disorder.

Development of Child-Friendly Fish Dishes to Increase Young Children’s Acceptance and Consumption of Fish

Background: The Dietary Guidelines for Americans 2010 recommend that Americans age two years and older consume seafood, especially fish high in omega-3 polyunsaturated fatty acids, at least twice a week. Although fish is of particular importance during childhood to support proper brain and eye development, it is under-consumed in the US pediatric population. This study examined if substituting salmon for chicken would increase preschooler’s fish consumption. Methods: Two-to-five years old children (n = 45) were served eight lunches (four pairs of comparable chicken versus salmon dishes) twice, totaling sixteen lunches over a period of three months to test the hypothesis that children will consume fish at least once a week, thus increasing docosahexaenoic acid (DHA) intake. The plate waste method was used to collect intake data and consumption of total energy and DHA intake in the chicken and the fish dishes were compared using contrasts within a mixed effect ANOVA (significance at P Results: Dietary intake estimates showed that there were no significant differences in energy intake when the chicken and fish dishes looked similar (macaroni-and-cheese and wraps), but when the fish dishes looked new (nuggets and dumplings), energy intake on fish days was lower than on the chicken day. DHA intake increased significantly on all days the fish was served. Conclusions: This pilot study indicates that fish intake can meet recommendations if salmon is incorporated into familiar dishes such as salad wraps or macaroni-and-cheese, in the childcare setting. Although fish is more expensive, childcare centers may serve this highly nutritious protein once a week without experiencing undue amounts of food wastes if incorporated into well-accepted main dishes. Further studies in larger and more diverse samples of children, different experimental dishes, and longer exposure periods may elucidate additional venues to increase children’s diet quality by increasing consumption of fatty fish.

Overview of Intervention Programs for Parents of Young Children (0 - 6)

In most of the world’s societies and cultures, the biological mother and father bear primary responsibility to?care for their child’s needs and to guide him or her through the process of entry into society [1]. The parent serves, for the most part, as the significant figure with the greatest amount of influence over the child’s life. Through his parent, the child learns the skills necessary to experience the world and function in it, whether the skills are in relation to survival needs such as eating, washing and mobility or developmental and social needs such as forming social relationships and developing the capacity to think and learn through play and supervision [2]. Thus the parent plays a critical but complex role in the development of his or her child, a role that requires development of a wide range of new behavioral, communicational, cognitive and emotional skills and capabilities in order to understand and cope with the challenges of child-rearing. Similarly, parenting styles and characteristics are influenced by a number of variables: The parent, the child, the interaction between them, and environmental variables such as culture, socio-economic status, and the existing family unit [2]. When children who suffer from behavioral difficulties do not receive the parental care they need, there is reasonable cause for concern that difficulties will develop in adulthood in a range of life areas that will have an impact on their lives and well-being and on their ability to adapt to society and contribute to it [3]. Accordingly, over the past 50 years parent-training programs have been developed to strengthen parents through learning and providing tools of experience and developmental knowledge, for the purpose of promoting the child’s sense of wellbeing and quality of life [2] [4]. Objective: The purpose of this review is to provide an overview of evidence-based interventions for parents of young children (0 - 6), programs that are currently active in Israel and in the world, and to explicate the significant characteristics common to them that contribute to their effectiveness and success.

Impact of Seven Valent Pneumococcal Conjugate Vaccine on Nasopharyngeal Carriage in Young Children in Okinawa, Japan

In Japan, the heptavalent pneumococcal conjugate vaccine (PCV7) became available in February 2010 and was subsidized by the national funding system from May 2011 in Okinawa, after which it was incorporated into the national immunization practice (NIP) in April 2013 using a 3 + 1 schedule for all infants. We conducted an annual survey in 2012 to determine the effect of PCV7 on nasopharyngeal colonization by pneumococcal serotypes and to analyze the risk factors for colonization in infants. Nasopharyngeal swabs for pneumococcal isolation and serotyping were obtained from infant 2 to 22 months of age before and after PCV7 immunization among 4 clinics in Okinawa, Japan. Between January 2012 and December 2012, nasopharyngeal swabs for bacterial cultures were obtained among 782 infants aged 2 to 22 months old and demographic data was obtained among 725 participant infants. Among the 725 evaluable infants, 193 pneumococcal strains were detected in 180 infants for an overall nasopharyngeal carriage of 24.8%. The main capsular serotypes isolated were 6C (16.1%), 19A (12.4%) and 15B (9.8%). Carriage of PCV7 serotypes accounted for 21.8% (42/193). The result of multivariate data analysis showed the pneumococcal carriage rate of non-PCV7 serotypes was significantly (P < 0.001) high in infant with siblings and daycare attendance. On the other hand, the result of multivariate data analysis showed that carriage rate of PCV7 serotype had only significantly high risk in infant with siblings and did not have a significant risk dependent on age and daycare attendance. Carriage PCV7 serotypes increased in the presence of other siblings, while PCV7 vaccination was shown to eliminate daycare attendance as a risk. The results of this study demonstrates that PCV7 vaccination decrease the overall nasopharyngeal carriage of PCV7 serotypes in vaccinated children including children at risk such as children attending day-care centers.

Consensus on pediatric epilepsy Che up surgery for young children:an investigation by the China Association Against Epilepsy task force on epilepsy surgery

Researchers have widely acknowledged the therapeutic value of epilepsy surgery for drug-resistant epilepsy.None-theless,there is a substantial gap in the surgical treatment for appropriate candidates owing to several factors,particularly in the population of young children.To standardize the protocols of preoperative evaluation and sur-gery of young children for epilepsy surgery,the China Association Against Epilepsy has appointed an expert task force to standardize the protocols of preoperative evaluation and surgery in pediatric epilepsy patients.It adopted the modifed Delphi method and performed two rounds of surveys through an anonymous inquiry among 75 experts from four subgroups including pediatric neurologists,epileptologists,pediatric epilepsy surgeons,and functional neurosurgeons.The survey contents contained:(1)the participants,comprising children aged≤6 years;(2)adopted DRE definition proposed by the International League Against Epilepsy in 2010;and(3)investigated epilepsy surgery,principally referring to curative epilepsy surgeries.The neuromodulation therapies were excluded because of the differences in treatment mechanisms from the above-mentioned surgeries.According to the Delphi process,a con-sensus was achieved for most aspects by incorporating two rounds of surveys including preoperative assessment,sur-gical strategies and techniques,and perioperative and long-term postoperative management,despite controversial opinions on certain items.We hope the results of this consensus will improve the level of surgical treatment and man-agement of intractable epilepsy in young children.

Update on the safety of anesthesia in young children presenting for adenotonsillectomy

Tonsillectomy with and without adenoidectomy is a frequently performed surgical procedure in children.Although a common procedure,it is not without significant risk.It is critical for anesthesiologists to consider preoperative,intraoperative,and postoperative patient factors and events to optimize safety,especially in young children.In the majority of cases,the indication for adenotonsillectomy in young children is obstructive breathing.Preoperative evaluation for patient comorbidities,especially obstructive sleep apnea,risk factors for a difficult airway,and history of recent illness are crucial to prepare the patient for surgery and develop an anesthetic plan.Communication and collaboration with the otolaryngologist is key to prevent and treat intraoperative events such as airway fires or hemorrhage.Postoperative analgesia planning is critical for safe pain control especially for those patients with a history of obstructive sleep apnea and opioid sensitivity.In young children,it is important to also consider the impact of anesthetic medications on the developing brain.This is an area of continuing research but needs to be weighed when planning for surgical treatment and when discussing risks and benefits with patients’families.

Plasma gelsolin level predicts acute kidney injury after cardiopulmonary bypass in infants and young children

Background Acute kidney injury(AKI)after cardiopulmonary bypass(CPB)is a common complication especially in pedi-atric population.Plasma gelsolin(pGSN)is an anti-inflammatory factor through binding with actin and pro-inflammatory cytokines in circulation.Decrease in pGSN has been reported in some pathologic conditions.The purpose of the study was to determine the alterations of pGSN level in infants and young children after CPB and the role of pGSN as a predictor for the morbidity and severity of post-CPB AKI.Methods Sixty-seven infants and young children at age≤3 years old undergoing CPB were prospectively enrolled.PGSN levels were measured during peri-operative period with enzyme-linked immuno-sorbent assay and normalized with plasma total protein concentration.Other clinical characteristics of the patients were also recorded.Results In patients developing AKI,the normalized pGSN(pGSN_(N))levels significantly decreased at 6 h post-operation and remained low for 24 h post-operation as compared to the patients with non-AKI.PGSNN at 6 h post-operation combining with CPB time presents an excellent predictive value for AKI.Conclusions Decreased pGSN_(N)identifies post-CPB AKI in the patients≤3 years old,and is associated with adverse clini-cal outcomes.The findings suggest that circulating GSN in post-CPB patients may have beneficial effects on diminishing inflammatory responses.

Influences of teachers’attitudes and oral guidance on the persistence of young children aged 3-6 years old

坚持性是学前儿童自我控制发展的重要内容。本研究基于中国幼儿园存在教师对幼儿的高度控制,教师在组织幼儿园教学活动过程中的一言一行都将对幼儿产生重要影响的情况,设计了四种实验情境,探索教师态度及言语指导对学前儿童坚持性发展所产生的影响。结果表明,教师态度及言语指导方式对幼儿坚持性的发展会产生不同的影响。

《生长减缓婴幼儿的追赶生长:指导临床医师的专家建议》解读

生长减缓是帮助早期识别营养问题的重要临床表现,尽早识别和干预婴幼儿生长减缓对改善其近远期健康结局意义重大。之前发表的相关指南和专家共识对生长减缓缺乏统一的定义,影响临床识别、评估与规范管理。2023年3月,Journal of Pediatric Gastroenterology and Nutrition杂志发表了《生长减缓婴幼儿的追赶生长:指导临床医师的专家建议》,不仅阐述了追赶生长的重要性,还针对如何适当地定义、评估和管理生长减缓制定了切实可行的共识建议,对临床医生具有现实的指导价值。本文结合我国临床现状,对该“建议”进行解读,以期为我国临床医师管理生长减缓婴幼儿提供指导和参考。

婴幼儿头皮医用粘胶相关性皮肤损伤防护方案的构建与应用

目的降低视频脑电图监测婴幼儿头皮医用粘胶相关性皮肤损伤。方法采用历史对照设计,将2018年1月至2019年12月入住癫痫监测单元行头皮视频脑电图监测的患儿856例纳入对照组,实施常规皮肤护理;将2021年1月至2022年12月入住癫痫监测单元行头皮视频脑电图监测的患儿851例纳入观察组,构建和实施医用粘胶相关性皮肤损伤防护方案。比较两组头皮医用粘胶相关性皮肤损伤发生率。结果观察组头皮医用粘胶相关性皮肤损伤发生率显著低于对照组(P<0.05)。结论婴幼儿头皮医用粘胶相关性皮肤损伤防护方案的应用,可有效降低婴幼儿头皮医用粘胶相关性皮肤损伤发生率。

“三孩”政策背景下婴幼儿家庭养育压力的影响因素探究

为了解“三孩”政策背景下0~6岁婴幼儿家庭养育压力的现状及其影响因素,采用基本信息问卷、简式养育压力量表(PSI-SF)对我国东、中、西部六省3982个婴幼儿家庭所面临的养育压力展开调查,并从个体家庭因素、经济因素和社会区域因素三个方面分析0~6岁婴幼儿家庭养育压力产生的原因。结果显示,在0~6岁婴幼儿家庭中,近五成家庭养育压力超出正常范围,且从养育压力的各个维度来看,育儿愁苦得分高于困难儿童得分高于亲子互动失调得分;家庭结构、社会经济地位以及城乡地区对0~6岁婴幼儿家庭的养育压力有显著影响。基于此,建议关注父亲的养育压力,政府社区家庭合作共育;明确家庭压力来源,缓解家庭养育压力;加大政府投入,降低家庭养育成本;完善社会服务支持,提高家庭养育知识与技能。

Clinical Value of Echocardiographic Screening and Dynamic Observations for Ductus Arteriosus Closure in Newborns

Objective:To explore and analyze the clinical value of echocardiography screening and dynamic observation for ductus arteriosus closure in newborns.Methods:The study was conducted from August 2022 to December 2023.500 newborns who were admitted to our hospital were selected as research subjects for this study(Kunming Tongren Hospital).All subjects underwent echocardiography to determine the severity of patent ductus arteriosus(PDA).The inner diameter of the pulmonary artery was measured,and the pulmonary artery pressure was estimated through tricuspid regurgitation.If the patient had high pulmonary artery pressure,elective closure surgery was performed.Results:Among the 500 subjects,448 cases of ductus arteriosus closure and 52 cases of PDA were detected by echocardiography,including 23 cases of simple PDA,15 cases with patent foramen ovale,11 cases with atrial septal defect,1 case with muscular ventricular septal defect,1 case with tricuspid valve prolapse,and 1 case with tricuspid valve chordae tendineae rupture.After symptomatic treatment and intervention,their echocardiogram results were reviewed and no abnormalities were found.All measurement results of children with PDA combined with pulmonary hypertension were better than before treatment(P<0.05).Conclusion:Echocardiography is a fast,accurate,and reliable non-invasive imaging examination technology.It can significantly improve congenital heart disease detection rate in infants and young children.Early intervention based on the examination results can dramatically improve the quality of life of infants and young children with PDA.

幼童脑干形态学与增龄发育的数字化特征

背景:既往对脑干研究多集中于成人和胎儿,而对国人幼童脑干的增龄发育特征研究甚少。目的:观测健康幼童脑干发育特征,探究其增龄差异及其与性别间的相关性。方法:2019年1月至2022年4月对内蒙古医科大学附属医院174例2-6岁幼童颅颈部3.0T MRI图像行回顾性研究,测量脑干(含中脑、脑桥、延髓)正中矢状面径线、面积和角度。结果与结论:中脑、脑桥、延髓前后径在2-5岁组,中脑、脑桥、延髓纵径和面积在2-6岁组总体随增龄呈递增趋势,除延髓纵径外均呈正相关(r>0,P<0.05),在2-3岁组、4-5岁组期间处于快速生长发育阶段,这2个年龄组可作为幼童发育重点观测指标;脑桥前后径、纵径、面积和脑干总面积与年龄相关性较强,可作为其脑干发育重点观测指标。

“永葆童心”——鲍勃·迪伦歌曲绘本儿童伦理教育价值探析

媒介融合背景下,适当选用歌曲和绘本有益于儿童初步塑造道德品质、探索伦理身份。诺贝尔文学奖得主鲍勃·迪伦的歌曲Forever Young表达了关于儿童养成友善、平等和诚挚道德品质的期望。该歌曲配套绘本将音乐、绘画、歌词有机融合,不仅能使儿童在接受绘画艺术熏陶时同步感受歌曲传递的伦理价值观念,还能凸显儿童伦理身份重要性。绘本主要展现儿童伦理身份的构建过程,引导儿童思考何为社会伦理身份,并帮助儿童调整伦理身份定位。“因时、因地制宜”运用该歌曲绘本,有助于儿童对各类伦理品质的理解由语音层面提升至语义层面,再逐渐内化到观念层面,从而引导他们永葆纯洁善良的“童心”,为其成年后步入社会奠定良好基础。