Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase bra...Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase brain-derived neurotrophic factor levels in children and adolescents, the effects of specific types of exercise on brain-derived neurotrophic factor levels are still controversial. To address this issue, we used meta-analytic methods to quantitatively evaluate, analyze, and integrate relevant studies. Our goals were to formulate general conclusions regarding the use of exercise interventions, explore the physiological mechanisms by which exercise improves brain health and cognitive ability in children and adolescents, and provide a reliable foundation for follow-up research. We used the Pub Med, Web of Science, Science Direct, Springer, Wiley Online Library, Weipu, Wanfang, and China National Knowledge Infrastructure databases to search for randomized controlled trials examining the influences of exercise interventions on brain-derived neurotrophic factor levels in children and adolescents. The extracted data were analyzed using Review Manager 5.3. According to the inclusion criteria, we assessed randomized controlled trials in which the samples were mainly children and adolescents, and the outcome indicators were measured before and after the intervention. We excluded animal experiments, studies that lacked a control group, and those that did not report quantitative results. The mean difference(MD;before versus after intervention) was used to evaluate the effect of exercise on brain-derived neurotrophic factor levels in children and adolescents. Overall, 531 participants(60 children and 471 adolescents, 10.9–16.1 years) were included from 13 randomized controlled trials. Heterogeneity was evaluated using the Q statistic and I^(2) test provided by Review Manager software. The meta-analysis showed that there was no heterogeneity among the studies(P = 0.67, I^(2) = 0.00%). The combined effect of the interventions was significant(MD = 2.88, 95% CI: 1.53–4.22, P < 0.0001), indicating that the brain-derived neurotrophic factor levels of the children and adolescents in the exercise group were significantly higher than those in the control group. In conclusion, different types of exercise interventions significantly increased brain-derived neurotrophic factor levels in children and adolescents. However, because of the small sample size of this meta-analysis, more high-quality research is needed to verify our conclusions. This metaanalysis was registered at PROSPERO(registration ID: CRD42023439408).展开更多
This paper examines the nutrition impacts of using non-solid cooking fuel on under-five children in developing countries.We draw on data from more than 1.12 million children in 62 developing countries from the Demogra...This paper examines the nutrition impacts of using non-solid cooking fuel on under-five children in developing countries.We draw on data from more than 1.12 million children in 62 developing countries from the Demographic and Health Surveys(DHS).Results from both fixed effects(FE)and instrumental variable(IV)estimates show that using non-solid cooking fuel significantly improves the nutrition outcomes of under-five children.Compared with their peers from households mainly using solid fuel,children from households mainly using non-solid fuel exhibit a lower probability of experiencing stunting(by 5.9 percentage points)and being underweight(by 1.2 percentage points).Our further investigation provides evidence for several underlying mechanisms,such as improved indoor air quality,induced reduction in children’s respiratory symptoms,benefits on maternal health,and reduction in maternal time spent on fuel collection or cooking.Heterogenous analyses suggest that the nutrition benefits of using non-solid cooking fuel are more prominent among boys,children above three years old,and those from households of lower socioeconomic status,rural areas,and Southeast Asia.展开更多
AIM:To evaluate the effect of lens surgery on health-related quality of life(HRQoL)of preschool children with congenital ectopia lentis(CEL).METHODS:A prospective self-controlled study was conducted in Zhongshan Ophth...AIM:To evaluate the effect of lens surgery on health-related quality of life(HRQoL)of preschool children with congenital ectopia lentis(CEL).METHODS:A prospective self-controlled study was conducted in Zhongshan Ophthalmic Center.Children aged from 5 to 7y whom were diagnosed with CEL and underwent phacoemulsification with scleral-fixated posterior chamber intraocular lens implantation and their parents were enrolled in this study.All of them completed the child and proxy(parental)PedsQL™4.0 before and after the surgery.Their preoperative scores were compared to their postoperative ones.Subgroup analyses were performed based on gender and preoperative bilateral presenting visual acuity of the children.RESULTS:Thirty-two children with CEL successfully underwent surgery without any complications,among whom 8 had monocular surgery and 24 had binocular surgery.Preoperative and postoperative questionnaires were completed by 32 child-parent pairs.Surgical intervention could significantly improve the vision of affected children(P<0.001).The medians of physical,psychosocial and total health scores self-reported by the children were 68.75(62.50,81.25),65.00(60.00,80.00)and 67.39(60.87,78.26)preoperatively and were 93.75(87.50,100.00),90.00(83.33,96.67)and 89.13(85.32,95.65)postoperatively.The preoperative scores of the affected children were significantly lower in all scales than age-matched healthy children(P<0.001).All the postoperative scores were significantly higher than the preoperative scores in affected children and their parents(P<0.001).In the physical functioning evaluation,the preoperative score reported by parents of girls was higher than parents of boys(P=0.041),and the postoperative score of girls was higher than that of boys(P=0.036).CONCLUSION:CEL is associated with significantly worse quality of life in preschool children.Surgical intervention can significantly improve the HRQoL in affected children from both personal and family perspective.展开更多
BACKGROUND Preschoolers become anxious when they are about to undergo anesthesia and surgery,warranting the development of more appropriate and effective interventions.AIM To explore the effect of static cartoons comb...BACKGROUND Preschoolers become anxious when they are about to undergo anesthesia and surgery,warranting the development of more appropriate and effective interventions.AIM To explore the effect of static cartoons combined with dynamic virtual environments on preoperative anxiety and anesthesia induction compliance in preschool-aged children undergoing surgery.METHODS One hundred and sixteen preschool-aged children were selected and assigned to the drug(n=37),intervention(n=40),and control(n=39)groups.All the children received routine preoperative checkups and nursing before being transferred to the preoperative preparation room on the day of the operation.The drug group received 0.5 mg/kg midazolam and the intervention group treatment consisting of static cartoons combined with dynamic virtual environments.The control group received no intervention.The modified Yale Preoperative Anxiety Scale was used to evaluate the children’s anxiety level on the day before surgery(T0),before leaving the preoperative preparation room(T1),when entering the operating room(T2),and at anesthesia induction(T3).Compliance during anesthesia induction(T3)was evaluated using the Induction Compliance Checklist(ICC).Changes in mean arterial pressure(MAP),heart rate(HR),and respiratory rate(RR)were also recorded at each time point.RESULTS The anxiety scores of the three groups increased variously at T1 and T2.At T3,both the drug and intervention groups had similar anxiety scores,both of which were lower than those in the control group.At T1 and T2,MAP,HR,and RR of the three groups increased.The drug and control groups had significantly higher MAP and RR than the intervention group at T2.At T3,the MAP,HR,and RR of the drug group decreased and were significantly lower than those in the control group but were comparable to those in the intervention group.Both the drug and intervention groups had similar ICC scores and duration of anesthesia induction(T3),both of which were higher than those of the control group.CONCLUSION Combining static cartoons with dynamic virtual environments as effective as medication,specifically midazolam,in reducing preoperative anxiety and fear in preschool-aged children.This approach also improve their compliance during anesthesia induction and helped maintain their stable vital signs.展开更多
Introduction: In Côte d’Ivoire, there is a scarcity of data on children’s purulent pleurisies. Objective: This study aims to elucidate the epidemiological, diagnostic, therapeutic, and evolutionary facets of no...Introduction: In Côte d’Ivoire, there is a scarcity of data on children’s purulent pleurisies. Objective: This study aims to elucidate the epidemiological, diagnostic, therapeutic, and evolutionary facets of non-tuberculous purulent pleurisies in pediatric patients. Methods: A retrospective analysis was conducted using the medical records of children aged one month to fifteen years with purulent pleurisies at Bouaké University Hospital Center from January 2017 to December 2021. Results: The study identified 124 cases of purulent pleurisies, constituting 18% of lower respiratory tract infections and 0.8% of all hospitalizations. The majority of these cases (69%) were in children between 1 and 24 months of age. Prominent symptoms included dyspnea (85.5%), O2 saturation below 95% in room air (76.6%), respiratory distress (68.5%), cutaneous-mucosal pallor (63.7%), and fever (43.5%). Radiological findings predominantly showed right-sided pleurisy (62.1%). The pleurisy was often extensive (78.2%), accompanied by pneumothorax (37.1%), alveolo-interstitial opacities (8.1% of cases), and abscess formations (1.6%). Pleural fluid cultures were positive in 46.9% of cases, with Staphylococcus aureus (75%, methi-S) identified among 32 bacteria. Initial antibiotic treatment was empirical, favoring oxacillin (53.2%) or amoxicillin-clavulanic acid (53.2%) in dual (42%) or triple therapy (33%) with gentamicin (64.1%) and/or metronidazole (21.8%). Treatments also included pleural drainage (68.5%) or repeated evacuation punctures (33.1%), and blood transfusion (39%). The mortality rate was 18.8%. Conclusion: Non-tuberculous purulent pleurisy remains a significant concern in pediatric hospitalizations at the CHU of Bouaké, marked by high mortality rates.展开更多
Background: This study aimed to evaluate the diagnostic value of interferon-γ release assay (IGRA), a sensitive microbiological diagnostic method, in children and adolescents with suspected tuberculosis in a country ...Background: This study aimed to evaluate the diagnostic value of interferon-γ release assay (IGRA), a sensitive microbiological diagnostic method, in children and adolescents with suspected tuberculosis in a country with a high burden of tuberculosis. Method: This study included 581 children and adolescents aged 4 - 19 years who were suspected of having tuberculosis, were latently infected with Mycobacterium tuberculosis, and had received at least one dose of BCG vaccine between April 17, 2019, and February 24, 2021. The study evaluated the TST results of 106 patients who had a positive Quantiferon test and were suspected of having tuberculosis. Results: The study included 581 patients aged between 4 and 19 years. Of these, 106 patients tested positive for the Quantiferon test, while 19 were indeterminate and 456 were negative. The Quantiferon test positivity rate was 18.24%. Among the 106 QFT-Plus-positive cases, 23 patients also tested positive for TST. The difference in distribution was found to be statistically significant. Conclusion: The QFT-Plus test is considered an alternative to TST and other microbiological diagnostic methods for early tuberculosis diagnosis, particularly in children and adolescents.展开更多
Introduction and Objectives: Soil-Transmitted-Helminthiasis (STH) is a public health problem in Cameroon. The control strategies currently in place, particularly chemoprevention, has shortcomings linked to the target ...Introduction and Objectives: Soil-Transmitted-Helminthiasis (STH) is a public health problem in Cameroon. The control strategies currently in place, particularly chemoprevention, has shortcomings linked to the target population, which are school-age children. The objective was to determine the prevalence and the risk factors associated with geo-helminthiasis in children aged 0 to 3 years in a rural health district. Method: From December 2020 to May 2021, a descriptive and analytical cross-sectional study of 376 children between 6 and 36 months was carried out in the Akonolinga health district. This was a cluster sampling in 4 health areas. Stool samples were collected and analysed using the mini-FLOTAC method. The results expressed as the number of eggs per gram of stool. A questionnaire on socio-demographic and lifestyle data was administered to the parents. The Chi-squared test was used to measure the association between geo-helminth infection and the data collected. A multivariate analysis using logistic regression was performed (p 0.05). Results: The prevalence of STH was 19.4% (Ascaris lumbricoides: 16% and Trichuris trichiura: 8%). Risk factors were: consumption of contaminated water (AOR = 1.93 [1.03 - 3.6];p = 0.040), early contact of the child with the ground (before age of 4 months) (AOR = 4.9 [2.1 - 11.37];p .001), habit of walking barefoot (AOR = 2.91 [1.1 - 7.97];p = 0.038), and living in a habitat with unpaved ground (AOR = 7.4 [1.55 - 35.7];p = 0.012). Conclusion: The prevalence of STHs in infants was high. Preventive chemotherapy should be extended to this age-group, and other measures intensified.展开更多
Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with H...Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with HIV infection followed up in the pediatric department of the Regional Teaching Hospital of Borgou/Alibori (CHUDB/A) the from 2005 to 2020. Patients and Method: This was a retrospective and descriptive study conducted in the pediatric department of CHUD/B-A in Parakou. All children with HIV infection who died from January 1, 2005 to August 31, 2020 were included. Data collection was carried out in three stages: a phase of medical records processing, a phase of community survey and a phase of death audits. The variables studied were sociodemographic, clinical, biological, therapeutic and evolutionary. Results: Over the study period, the data of 464 infected children were recorded, including 92 deaths, representing a case fatality rate of 19.83%. Severe acute malnutrition (69.23%), gastro-intestinal tract infections (43.58%) and serious opportunistic pulmonary infections (24.36% pulmonary tuberculosis and 19.23% pneumocystis) were the main causes of death. The main dysfunctions found were: the delayed diagnosis of HIV infection (79.35%), the absence or delay in consultation when the child’s clinical condition deteriorates (32.61% and 47.83%), delayed initiation of antiretroviral treatment (42.39%) and non-adherence to treatment (38.04%). Non-adherence to treatment was predominant in adolescents (90.49%). Conclusion: Specific interventions for early detection, adequate nutritional care, psychosocial support for adolescents and mothers of children are necessary to reduce mortality due to HIV among children and adolescents.展开更多
School difficulties are common in children cancer survivors and may be prognostic for the success of the patient social reintegration after the disease.Here,we carry out a narrative review of the literature from 2001 ...School difficulties are common in children cancer survivors and may be prognostic for the success of the patient social reintegration after the disease.Here,we carry out a narrative review of the literature from 2001 to 2022 to assess the school difficulties of these patients,the predictive factors of these difficulties,and the possible long-term consequences.We punctuate this review the practical point-of-view of a teacher dedicated to our hospital,who works with children with chronic diseases such as cancer.Therefore,we expose possible barriers and solutions to improve the scholar reintegration and limit the impact of cancer on the academic achievement.展开更多
AIM:To describe the distribution of refractive errors by age and sex among schoolchildren in Soacha,Colombia.METHODS:This was an observational cross-sectional study conducted in five urban public schools in the munici...AIM:To describe the distribution of refractive errors by age and sex among schoolchildren in Soacha,Colombia.METHODS:This was an observational cross-sectional study conducted in five urban public schools in the municipality of Soacha.A total of 1161 school-aged and pre-adolescent children,aged 5-12y were examined during the school year 2021-2022.Examinations included visual acuity and static refraction.Spherical equivalent(SE)was analysed as follows:myopia SE≤-0.50 D and uncorrected visual acuity of 20/25 or worse;high myopia SE≤-6.00 D;hyperopia SE≥+1.00 D(≥7y)or SE≥+2.00 D(5-6y);significant hyperopia SE≥+3.00 D.Astigmatism was defined as a cylinder in at least one eye≥1.00 D(≥7y)or≥1.75 D(5-6y).If at least one eye was ametropic,children were classified according to the refractive error found.RESULTS:Of the 1139 schoolchildren included,50.6%were male,58.8%were aged between 5 and 9y,and 12.1%were already using optical correction.The most common refractive error was astigmatism(31.1%),followed by myopia(20.8%)and hyperopia(13.1%).There was no significant relationship between refractive error and sex.There was a significant increase in astigmatism(P<0.001)and myopia(P<0.0001)with age.CONCLUSION:Astigmatism is the most common refractive error in children in an urban area of Colombia.Emmetropia decreased and myopia increased with age.展开更多
Introduction: Acute respiratory infections remain one of the main causes of mortality in children aged 0 to 5. This work aimed to study the associated factors with the occurrence of acute respiratory infections in chi...Introduction: Acute respiratory infections remain one of the main causes of mortality in children aged 0 to 5. This work aimed to study the associated factors with the occurrence of acute respiratory infections in children 0 to 5 years old in Yénawa, Cotonou in 2023. Subjects and Method: It was an analytical cross-sectional study of children aged 0 - 5 years and their mothers in Yénawa, selected by four-degree random sampling. The sampling size, calculated using the Schwartz formula, was 126 children and 126 mothers. The dependent variable was the occurrence of acute respiratory infections. The independent variables were classified into four groups: socio-demographic and economic characteristics, behavioral factors, child-related factors, and environmental factors. Data collected by observation and questionnaire survey were analyzed using STATA version 15 software. Associated factors were investigated by bivariate analysis and multiple logistic regression, at the 5% significance level. Results: A total of 126 children aged 0 - 5 years and 126 mothers were surveyed, aged 23.5 (11 - 36) months and 30 (18 - 48) years respectively. The prevalence of acute respiratory infections was 74.60% (CI95% = 66.89 to 82.30). The associated factors were the mother’s age between 18 and 28 (OR = 10.77;CI95% = 1.89 to 61.27;p = 0.007), the use of charcoal/wood for cooking (OR = 7.36;IC = 1.99 to 27.10;p = 0.003)), children's poor personal hygiene (OR = 8.87;IC = 2.92 to 26.97;p 0.001)), and cohabitation with domestic animals (OR = 7.27;IC = 1.67 to 31.71;p = 0.015). Conclusion: Communicating with mothers about the factors identified will help reduce the prevalence of acute respiratory infections in children aged 0 to 5.展开更多
AIM:To assess the efficacy of artificial natural light in preventing incident myopia in primary school-age children.METHODS:This is a prospective,randomized control,intervention study.A total of 1840 students from 39 ...AIM:To assess the efficacy of artificial natural light in preventing incident myopia in primary school-age children.METHODS:This is a prospective,randomized control,intervention study.A total of 1840 students from 39 classes in 4 primary schools in Foshan participated in this study.The whole randomization method was adopted to include classes as a group according to 1:1 randomized control.Classrooms in the control group were illuminated by usual light,and classrooms in the intervention group were illuminated by artificial natural light.All students received uncorrected visual acuity and best-corrected visual acuity measurement,non-cycloplegic autorefraction,ocular biometric examination,slit lamp and strabismus examination.Three-year follow-up,the students underwent same procedures.Myopia was defined as spherical equivalent refraction≤-0.50 D and uncorrected visual acuity<20/20.RESULTS:There were 894 students in the control group and 946 students in the intervention group with a mean±SD age of 7.50±0.53y.The three-year cumulative incidence rate of myopia was 26.4%(207 incident cases among 784 eligible participants at baseline)in the control group and 21.2%(164 incident cases among 774 eligible participants at baseline)in the intervention group[difference of 5.2%(95%CI,3.7%to 10.1%);P=0.035].There was also a significant difference in the three-year change in spherical equivalent refraction for the control group(-0.81 D)compared with the intervention group[-0.63 D;difference of 0.18 D(95%CI,0.08 to 0.28 D);P<0.001].Elongation of axial length was significantly different between in the control group(0.77 mm)and the intervention group[0.72 mm;difference of 0.05 mm(95%CI,0.01 to 0.09 mm);P=0.003].CONCLUSION:Artificial natural light in the classroom of primary schools can result in reducing incidence rate of myopia during a period of three years.展开更多
Background: Wnt signalling inhibitors (Dickkopf-1 and Sclerostin) signalling play a role in vascular development and may contribute to calcification. Aim: To investigate the association between Dickkopf-1 and sclerost...Background: Wnt signalling inhibitors (Dickkopf-1 and Sclerostin) signalling play a role in vascular development and may contribute to calcification. Aim: To investigate the association between Dickkopf-1 and sclerostin serum concentrations in children undergoing maintenance hemodialysis with intimal medial thickness and peak systolic velocity of the main arteries. Patients and Methods: A study was conducted on 40 children undergoing maintenance hemodialysis and controls of the same age and sex. The study measured the initial medial thickness (IMT) and peak systolic velocity (PSV) of the main vessels (carotid, ulnar, and femoral). Dickkopf-1 and sclerostin serum levels in both groups were assessed, and a routine investigation was performed. Results: The findings indicate that the levels of serum Dickkopf-1 and Sclerostin were significantly higher in the hemodialysis group 2540.65 (2215.4 - 2909.2 pg/ml) and 1.17 (0.85 - 2.03 ng/ml)respectively (P = 0.001), compared to their control group it was 1110.45 (885.45 - 1527.65 pg/ml) and 0.28 (0.25 - 0.32 ng/ml)) respectively P = 0.001. Additionally, there was a significant increase in intima-media thickness (IMT) with a decrease in peak systolic velocity (PSV) in the main blood vessels, including the carotid, ulnar, and femoral arteries. A significant correlation was also observed between Dickkopf-1 and sclerostin levels and IMT of the carotid, ulnar, and femoral arteries. Conclusion: Wnt signalling inhibitors (Dickkopf-1 and Sclerostin) exert effects beyond the bone and significantly contribute to early vascular calcification in pediatric patients undergoing maintenance hemodialysis.展开更多
Background:High blood pressure(BP)is a major contributor to mortality and cardiovascular diseases.Despite the known benefits of exercise for reducing BP,it is crucial to identify the most effective physical activity(P...Background:High blood pressure(BP)is a major contributor to mortality and cardiovascular diseases.Despite the known benefits of exercise for reducing BP,it is crucial to identify the most effective physical activity(PA)intervention.This systematic review and network meta-analysis(NMA)aimed to evaluate the available evidence on the effectiveness of various PA interventions for reducing BP and to determine their hierarchy based on their impact on BP.Methods:A search of PubMed,SPORTDiscus,PsycINFO,Web of Science,CINAHL,Cochrane,and Eric databases was conducted up to December 2022 for this systematic review and NMA.Randomized controlled trials and quasi-experimental studies targeting healthy children and adolescents aged 6-12 years old were included in this study.Only studies that compared controlled and intervention groups using PA or exercise as the major influence were included.We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines.Three independent investigators performed the literature screening,data extraction,and risk of bias assessment.We used Bayesian arm-based NMA to synthesize the data.The primary outcomes were systolic BP and diastolic BP.We calculated the mean differences(MDs)in systolic BP and diastolic BP before and after treatment.Mean treatment differences were estimated using NMA and random-effect models.Results:We synthesized 27 studies involving 15,220 children and adolescents.PA combined with nutrition and behavior change was the most effective intervention for reducing both systolic BP and diastolic BP(MD=-8.64,95%credible interval(95%CI):-11.44 to-5.84;MD=-6.75,95%CI:-10.44 to-3.11),followed by interventions with multiple components(MD=-1.39,95%CI:-1.94 to-0.84;MD=-2.54,95%CI:-4.89 to-0.29).Conclusion:Our findings suggest that PA interventions incorporating nutrition and behavior change,followed by interventions with multiple components,are most effective for reducing both systolic BP and diastolic BP in children and adolescents.展开更多
Background: Renal osteodystrophy (ROD) is a bone disorder resulting from chronic kidney disease (CKD) and related metabolic diseases. Dickkopf-related protein-1 (DKK-1) is critical in regulating bone biology. This stu...Background: Renal osteodystrophy (ROD) is a bone disorder resulting from chronic kidney disease (CKD) and related metabolic diseases. Dickkopf-related protein-1 (DKK-1) is critical in regulating bone biology. This study aimed to evaluate the serum DKK-1 level as a bone marker in children with CKD who undergo regular hemodialysis (HD). Subjects and Methods: This case-control study involved 40 children with CKD on HD and 40 healthy children as controls. The study measured serum DKK-1 levels and performed a dual-energy X-ray absorptiometry scan (DEXA) in line with routine laboratory investigations. Results: There was a significant increase in the serum level of DKK-1 in the patient group compared to the control group. The DKK-1 levels were 2540.65 (2215.4 - 2909.2) pg/ml and 1110.45 (885.45 - 1527.65) pg/ml, respectively, with a p-value of less than 0.001. In the hemodialysis group, 25 patients (62.5%) had low bone mineral density (BMD) with a Z-score of under -2.0. Eighteen of these patients had low BMD in both the neck of the femur and lumbar spines. Additionally, there was a significant increase in serum DKK-1 level in patients with low BMD (2567.35 (2303.8 - 3108.1) pg/ml) compared to patients with normal BMD (2454 (1859 - 2820) pg/ml) (p = 0.041). There was also a significant positive correlation between DKK1 level and phosphorus, alkaline phosphatase, and Parathormone serum levels. In conclusion, the study indicates a clear correlation between DKK-1 and BMD in children undergoing maintenance hemodialysis. DKK1 is a promising biomarker for CKD-MBD.展开更多
AIM:To evaluate the visual outcomes of standard amblyopic treatment add-on training via perceptual learning in refractive amblyopic children and to identify the risk factors for treatment failure.METHODS:Retrospective...AIM:To evaluate the visual outcomes of standard amblyopic treatment add-on training via perceptual learning in refractive amblyopic children and to identify the risk factors for treatment failure.METHODS:Retrospective charts were reviewed in children with refractive amblyopia who received standard treatment and add-on Cambridge Visual Stimulator(CAM)training.The add-on CAM group that was enrolled had worn full-corrected glasses for at least 2mo before training.A control group received only the standard treatment.Treatment success was defined as best-corrected visual acuity(BCVA)≥20/25.The age,sex,initial BCVA,refractive errors,sessions and duration of training,and final BCVA were recorded.RESULTS:A total of 209 children(129 children in add-on CAM group and 80 children in control group)were enrolled.Seventy-six percent of unilateral and 87%of bilateral amblyopic children achieved treatment success.In children with unilateral or bilateral moderate amblyopia,the duration to reach BCVA≥20/25 was significantly shorter in add-on CAM group than in control group.Poor initial BCVA(P<0.001)and high astigmatism(P=0.007)were risk factors for treatment failure after add-on CAM training.Age,sex,and types of refractive error were not associated with treatment success.CONCLUSION:Add-on CAM training is an effective strategy for visual improvement and can shorten the treatment course when the effect of standard treatment is limited in amblyopic children.展开更多
Introduction: The setting up of camps for internally displaced persons in Burkina Faso as a result of terrorism creates favorable conditions for the emergence of digestive parasitosis in these displaced populations. T...Introduction: The setting up of camps for internally displaced persons in Burkina Faso as a result of terrorism creates favorable conditions for the emergence of digestive parasitosis in these displaced populations. The objective of this study was to evaluate the prevalence of digestive parasitosis in children of this population in the Hauts-Bassins region. Material and methods: This was a prospective cross-sectional study from November to December 2020, in which stool samples were collected from internally displaced children from the Sinfra reception site in Banzon and from Poya in Karangasso Vigué. The stool samples were stored at room temperature, protected from dust and insects, in a cooler and then sent to the laboratory of the CHUSS in Bobo-Dioulasso where the parasitological analyses were performed. Results: The mean age was 5.8 ± 2.4 years. The most represented age group was 5 to 10 years (75.31%). The sex ratio is 1.61. The overall prevalence of intestinal parasite infection was 53.09%. The prevalence was statistically higher among those who consumed well water than those consuming tap water (p = 0.01). Monoparasitism by protozoa and helminths represented 74.42% and 6.68% respectively. The polyparasitism rate was 9.31%. The species identified in monoparasite patients were protozoa with Entamoeba coli (37.21%), Giardia lamblia (25.58%), Endolimax nanus (6.98%) and Entamoeba histolytica/dispar (4.65%). Biparasitism was identified with combinations, such as E. coli + E. histolytica/dispar (11.63%). Conclusion: There is a high prevalence of digestive parasitosis among IDPs in the Sinfra and Poya reception site. Educational sessions on hand washing before meals, use of drinking water, etc. should emphasize preventive measures in these IDP camps.展开更多
基金supported by the STI 2030-Major Projects,No. 2021ZD0200500 (to XS)。
文摘Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase brain-derived neurotrophic factor levels in children and adolescents, the effects of specific types of exercise on brain-derived neurotrophic factor levels are still controversial. To address this issue, we used meta-analytic methods to quantitatively evaluate, analyze, and integrate relevant studies. Our goals were to formulate general conclusions regarding the use of exercise interventions, explore the physiological mechanisms by which exercise improves brain health and cognitive ability in children and adolescents, and provide a reliable foundation for follow-up research. We used the Pub Med, Web of Science, Science Direct, Springer, Wiley Online Library, Weipu, Wanfang, and China National Knowledge Infrastructure databases to search for randomized controlled trials examining the influences of exercise interventions on brain-derived neurotrophic factor levels in children and adolescents. The extracted data were analyzed using Review Manager 5.3. According to the inclusion criteria, we assessed randomized controlled trials in which the samples were mainly children and adolescents, and the outcome indicators were measured before and after the intervention. We excluded animal experiments, studies that lacked a control group, and those that did not report quantitative results. The mean difference(MD;before versus after intervention) was used to evaluate the effect of exercise on brain-derived neurotrophic factor levels in children and adolescents. Overall, 531 participants(60 children and 471 adolescents, 10.9–16.1 years) were included from 13 randomized controlled trials. Heterogeneity was evaluated using the Q statistic and I^(2) test provided by Review Manager software. The meta-analysis showed that there was no heterogeneity among the studies(P = 0.67, I^(2) = 0.00%). The combined effect of the interventions was significant(MD = 2.88, 95% CI: 1.53–4.22, P < 0.0001), indicating that the brain-derived neurotrophic factor levels of the children and adolescents in the exercise group were significantly higher than those in the control group. In conclusion, different types of exercise interventions significantly increased brain-derived neurotrophic factor levels in children and adolescents. However, because of the small sample size of this meta-analysis, more high-quality research is needed to verify our conclusions. This metaanalysis was registered at PROSPERO(registration ID: CRD42023439408).
基金This work was supported by the National Natural Science Foundation of China(71861147003 and 71925009).
文摘This paper examines the nutrition impacts of using non-solid cooking fuel on under-five children in developing countries.We draw on data from more than 1.12 million children in 62 developing countries from the Demographic and Health Surveys(DHS).Results from both fixed effects(FE)and instrumental variable(IV)estimates show that using non-solid cooking fuel significantly improves the nutrition outcomes of under-five children.Compared with their peers from households mainly using solid fuel,children from households mainly using non-solid fuel exhibit a lower probability of experiencing stunting(by 5.9 percentage points)and being underweight(by 1.2 percentage points).Our further investigation provides evidence for several underlying mechanisms,such as improved indoor air quality,induced reduction in children’s respiratory symptoms,benefits on maternal health,and reduction in maternal time spent on fuel collection or cooking.Heterogenous analyses suggest that the nutrition benefits of using non-solid cooking fuel are more prominent among boys,children above three years old,and those from households of lower socioeconomic status,rural areas,and Southeast Asia.
基金Supported by the National Natural Science Foundation of China(No.81873673)the Basic and Applied Basic Research Foundation of Guangdong Province(No.2021A1515011673).
文摘AIM:To evaluate the effect of lens surgery on health-related quality of life(HRQoL)of preschool children with congenital ectopia lentis(CEL).METHODS:A prospective self-controlled study was conducted in Zhongshan Ophthalmic Center.Children aged from 5 to 7y whom were diagnosed with CEL and underwent phacoemulsification with scleral-fixated posterior chamber intraocular lens implantation and their parents were enrolled in this study.All of them completed the child and proxy(parental)PedsQL™4.0 before and after the surgery.Their preoperative scores were compared to their postoperative ones.Subgroup analyses were performed based on gender and preoperative bilateral presenting visual acuity of the children.RESULTS:Thirty-two children with CEL successfully underwent surgery without any complications,among whom 8 had monocular surgery and 24 had binocular surgery.Preoperative and postoperative questionnaires were completed by 32 child-parent pairs.Surgical intervention could significantly improve the vision of affected children(P<0.001).The medians of physical,psychosocial and total health scores self-reported by the children were 68.75(62.50,81.25),65.00(60.00,80.00)and 67.39(60.87,78.26)preoperatively and were 93.75(87.50,100.00),90.00(83.33,96.67)and 89.13(85.32,95.65)postoperatively.The preoperative scores of the affected children were significantly lower in all scales than age-matched healthy children(P<0.001).All the postoperative scores were significantly higher than the preoperative scores in affected children and their parents(P<0.001).In the physical functioning evaluation,the preoperative score reported by parents of girls was higher than parents of boys(P=0.041),and the postoperative score of girls was higher than that of boys(P=0.036).CONCLUSION:CEL is associated with significantly worse quality of life in preschool children.Surgical intervention can significantly improve the HRQoL in affected children from both personal and family perspective.
基金Supported by Hangzhou Medical and Health Technology Project,No.OO20191141。
文摘BACKGROUND Preschoolers become anxious when they are about to undergo anesthesia and surgery,warranting the development of more appropriate and effective interventions.AIM To explore the effect of static cartoons combined with dynamic virtual environments on preoperative anxiety and anesthesia induction compliance in preschool-aged children undergoing surgery.METHODS One hundred and sixteen preschool-aged children were selected and assigned to the drug(n=37),intervention(n=40),and control(n=39)groups.All the children received routine preoperative checkups and nursing before being transferred to the preoperative preparation room on the day of the operation.The drug group received 0.5 mg/kg midazolam and the intervention group treatment consisting of static cartoons combined with dynamic virtual environments.The control group received no intervention.The modified Yale Preoperative Anxiety Scale was used to evaluate the children’s anxiety level on the day before surgery(T0),before leaving the preoperative preparation room(T1),when entering the operating room(T2),and at anesthesia induction(T3).Compliance during anesthesia induction(T3)was evaluated using the Induction Compliance Checklist(ICC).Changes in mean arterial pressure(MAP),heart rate(HR),and respiratory rate(RR)were also recorded at each time point.RESULTS The anxiety scores of the three groups increased variously at T1 and T2.At T3,both the drug and intervention groups had similar anxiety scores,both of which were lower than those in the control group.At T1 and T2,MAP,HR,and RR of the three groups increased.The drug and control groups had significantly higher MAP and RR than the intervention group at T2.At T3,the MAP,HR,and RR of the drug group decreased and were significantly lower than those in the control group but were comparable to those in the intervention group.Both the drug and intervention groups had similar ICC scores and duration of anesthesia induction(T3),both of which were higher than those of the control group.CONCLUSION Combining static cartoons with dynamic virtual environments as effective as medication,specifically midazolam,in reducing preoperative anxiety and fear in preschool-aged children.This approach also improve their compliance during anesthesia induction and helped maintain their stable vital signs.
文摘Introduction: In Côte d’Ivoire, there is a scarcity of data on children’s purulent pleurisies. Objective: This study aims to elucidate the epidemiological, diagnostic, therapeutic, and evolutionary facets of non-tuberculous purulent pleurisies in pediatric patients. Methods: A retrospective analysis was conducted using the medical records of children aged one month to fifteen years with purulent pleurisies at Bouaké University Hospital Center from January 2017 to December 2021. Results: The study identified 124 cases of purulent pleurisies, constituting 18% of lower respiratory tract infections and 0.8% of all hospitalizations. The majority of these cases (69%) were in children between 1 and 24 months of age. Prominent symptoms included dyspnea (85.5%), O2 saturation below 95% in room air (76.6%), respiratory distress (68.5%), cutaneous-mucosal pallor (63.7%), and fever (43.5%). Radiological findings predominantly showed right-sided pleurisy (62.1%). The pleurisy was often extensive (78.2%), accompanied by pneumothorax (37.1%), alveolo-interstitial opacities (8.1% of cases), and abscess formations (1.6%). Pleural fluid cultures were positive in 46.9% of cases, with Staphylococcus aureus (75%, methi-S) identified among 32 bacteria. Initial antibiotic treatment was empirical, favoring oxacillin (53.2%) or amoxicillin-clavulanic acid (53.2%) in dual (42%) or triple therapy (33%) with gentamicin (64.1%) and/or metronidazole (21.8%). Treatments also included pleural drainage (68.5%) or repeated evacuation punctures (33.1%), and blood transfusion (39%). The mortality rate was 18.8%. Conclusion: Non-tuberculous purulent pleurisy remains a significant concern in pediatric hospitalizations at the CHU of Bouaké, marked by high mortality rates.
文摘Background: This study aimed to evaluate the diagnostic value of interferon-γ release assay (IGRA), a sensitive microbiological diagnostic method, in children and adolescents with suspected tuberculosis in a country with a high burden of tuberculosis. Method: This study included 581 children and adolescents aged 4 - 19 years who were suspected of having tuberculosis, were latently infected with Mycobacterium tuberculosis, and had received at least one dose of BCG vaccine between April 17, 2019, and February 24, 2021. The study evaluated the TST results of 106 patients who had a positive Quantiferon test and were suspected of having tuberculosis. Results: The study included 581 patients aged between 4 and 19 years. Of these, 106 patients tested positive for the Quantiferon test, while 19 were indeterminate and 456 were negative. The Quantiferon test positivity rate was 18.24%. Among the 106 QFT-Plus-positive cases, 23 patients also tested positive for TST. The difference in distribution was found to be statistically significant. Conclusion: The QFT-Plus test is considered an alternative to TST and other microbiological diagnostic methods for early tuberculosis diagnosis, particularly in children and adolescents.
文摘Introduction and Objectives: Soil-Transmitted-Helminthiasis (STH) is a public health problem in Cameroon. The control strategies currently in place, particularly chemoprevention, has shortcomings linked to the target population, which are school-age children. The objective was to determine the prevalence and the risk factors associated with geo-helminthiasis in children aged 0 to 3 years in a rural health district. Method: From December 2020 to May 2021, a descriptive and analytical cross-sectional study of 376 children between 6 and 36 months was carried out in the Akonolinga health district. This was a cluster sampling in 4 health areas. Stool samples were collected and analysed using the mini-FLOTAC method. The results expressed as the number of eggs per gram of stool. A questionnaire on socio-demographic and lifestyle data was administered to the parents. The Chi-squared test was used to measure the association between geo-helminth infection and the data collected. A multivariate analysis using logistic regression was performed (p 0.05). Results: The prevalence of STH was 19.4% (Ascaris lumbricoides: 16% and Trichuris trichiura: 8%). Risk factors were: consumption of contaminated water (AOR = 1.93 [1.03 - 3.6];p = 0.040), early contact of the child with the ground (before age of 4 months) (AOR = 4.9 [2.1 - 11.37];p .001), habit of walking barefoot (AOR = 2.91 [1.1 - 7.97];p = 0.038), and living in a habitat with unpaved ground (AOR = 7.4 [1.55 - 35.7];p = 0.012). Conclusion: The prevalence of STHs in infants was high. Preventive chemotherapy should be extended to this age-group, and other measures intensified.
文摘Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with HIV infection followed up in the pediatric department of the Regional Teaching Hospital of Borgou/Alibori (CHUDB/A) the from 2005 to 2020. Patients and Method: This was a retrospective and descriptive study conducted in the pediatric department of CHUD/B-A in Parakou. All children with HIV infection who died from January 1, 2005 to August 31, 2020 were included. Data collection was carried out in three stages: a phase of medical records processing, a phase of community survey and a phase of death audits. The variables studied were sociodemographic, clinical, biological, therapeutic and evolutionary. Results: Over the study period, the data of 464 infected children were recorded, including 92 deaths, representing a case fatality rate of 19.83%. Severe acute malnutrition (69.23%), gastro-intestinal tract infections (43.58%) and serious opportunistic pulmonary infections (24.36% pulmonary tuberculosis and 19.23% pneumocystis) were the main causes of death. The main dysfunctions found were: the delayed diagnosis of HIV infection (79.35%), the absence or delay in consultation when the child’s clinical condition deteriorates (32.61% and 47.83%), delayed initiation of antiretroviral treatment (42.39%) and non-adherence to treatment (38.04%). Non-adherence to treatment was predominant in adolescents (90.49%). Conclusion: Specific interventions for early detection, adequate nutritional care, psychosocial support for adolescents and mothers of children are necessary to reduce mortality due to HIV among children and adolescents.
文摘School difficulties are common in children cancer survivors and may be prognostic for the success of the patient social reintegration after the disease.Here,we carry out a narrative review of the literature from 2001 to 2022 to assess the school difficulties of these patients,the predictive factors of these difficulties,and the possible long-term consequences.We punctuate this review the practical point-of-view of a teacher dedicated to our hospital,who works with children with chronic diseases such as cancer.Therefore,we expose possible barriers and solutions to improve the scholar reintegration and limit the impact of cancer on the academic achievement.
基金Supported by the OneSight EssilorLuxottica Foundation.
文摘AIM:To describe the distribution of refractive errors by age and sex among schoolchildren in Soacha,Colombia.METHODS:This was an observational cross-sectional study conducted in five urban public schools in the municipality of Soacha.A total of 1161 school-aged and pre-adolescent children,aged 5-12y were examined during the school year 2021-2022.Examinations included visual acuity and static refraction.Spherical equivalent(SE)was analysed as follows:myopia SE≤-0.50 D and uncorrected visual acuity of 20/25 or worse;high myopia SE≤-6.00 D;hyperopia SE≥+1.00 D(≥7y)or SE≥+2.00 D(5-6y);significant hyperopia SE≥+3.00 D.Astigmatism was defined as a cylinder in at least one eye≥1.00 D(≥7y)or≥1.75 D(5-6y).If at least one eye was ametropic,children were classified according to the refractive error found.RESULTS:Of the 1139 schoolchildren included,50.6%were male,58.8%were aged between 5 and 9y,and 12.1%were already using optical correction.The most common refractive error was astigmatism(31.1%),followed by myopia(20.8%)and hyperopia(13.1%).There was no significant relationship between refractive error and sex.There was a significant increase in astigmatism(P<0.001)and myopia(P<0.0001)with age.CONCLUSION:Astigmatism is the most common refractive error in children in an urban area of Colombia.Emmetropia decreased and myopia increased with age.
文摘Introduction: Acute respiratory infections remain one of the main causes of mortality in children aged 0 to 5. This work aimed to study the associated factors with the occurrence of acute respiratory infections in children 0 to 5 years old in Yénawa, Cotonou in 2023. Subjects and Method: It was an analytical cross-sectional study of children aged 0 - 5 years and their mothers in Yénawa, selected by four-degree random sampling. The sampling size, calculated using the Schwartz formula, was 126 children and 126 mothers. The dependent variable was the occurrence of acute respiratory infections. The independent variables were classified into four groups: socio-demographic and economic characteristics, behavioral factors, child-related factors, and environmental factors. Data collected by observation and questionnaire survey were analyzed using STATA version 15 software. Associated factors were investigated by bivariate analysis and multiple logistic regression, at the 5% significance level. Results: A total of 126 children aged 0 - 5 years and 126 mothers were surveyed, aged 23.5 (11 - 36) months and 30 (18 - 48) years respectively. The prevalence of acute respiratory infections was 74.60% (CI95% = 66.89 to 82.30). The associated factors were the mother’s age between 18 and 28 (OR = 10.77;CI95% = 1.89 to 61.27;p = 0.007), the use of charcoal/wood for cooking (OR = 7.36;IC = 1.99 to 27.10;p = 0.003)), children's poor personal hygiene (OR = 8.87;IC = 2.92 to 26.97;p 0.001)), and cohabitation with domestic animals (OR = 7.27;IC = 1.67 to 31.71;p = 0.015). Conclusion: Communicating with mothers about the factors identified will help reduce the prevalence of acute respiratory infections in children aged 0 to 5.
基金Guangdong Basic and Applied Basic Research Foundation(No.2019B1515120011)Medical Research,Foshan Health and Wellness Department(No.20220374).
文摘AIM:To assess the efficacy of artificial natural light in preventing incident myopia in primary school-age children.METHODS:This is a prospective,randomized control,intervention study.A total of 1840 students from 39 classes in 4 primary schools in Foshan participated in this study.The whole randomization method was adopted to include classes as a group according to 1:1 randomized control.Classrooms in the control group were illuminated by usual light,and classrooms in the intervention group were illuminated by artificial natural light.All students received uncorrected visual acuity and best-corrected visual acuity measurement,non-cycloplegic autorefraction,ocular biometric examination,slit lamp and strabismus examination.Three-year follow-up,the students underwent same procedures.Myopia was defined as spherical equivalent refraction≤-0.50 D and uncorrected visual acuity<20/20.RESULTS:There were 894 students in the control group and 946 students in the intervention group with a mean±SD age of 7.50±0.53y.The three-year cumulative incidence rate of myopia was 26.4%(207 incident cases among 784 eligible participants at baseline)in the control group and 21.2%(164 incident cases among 774 eligible participants at baseline)in the intervention group[difference of 5.2%(95%CI,3.7%to 10.1%);P=0.035].There was also a significant difference in the three-year change in spherical equivalent refraction for the control group(-0.81 D)compared with the intervention group[-0.63 D;difference of 0.18 D(95%CI,0.08 to 0.28 D);P<0.001].Elongation of axial length was significantly different between in the control group(0.77 mm)and the intervention group[0.72 mm;difference of 0.05 mm(95%CI,0.01 to 0.09 mm);P=0.003].CONCLUSION:Artificial natural light in the classroom of primary schools can result in reducing incidence rate of myopia during a period of three years.
文摘Background: Wnt signalling inhibitors (Dickkopf-1 and Sclerostin) signalling play a role in vascular development and may contribute to calcification. Aim: To investigate the association between Dickkopf-1 and sclerostin serum concentrations in children undergoing maintenance hemodialysis with intimal medial thickness and peak systolic velocity of the main arteries. Patients and Methods: A study was conducted on 40 children undergoing maintenance hemodialysis and controls of the same age and sex. The study measured the initial medial thickness (IMT) and peak systolic velocity (PSV) of the main vessels (carotid, ulnar, and femoral). Dickkopf-1 and sclerostin serum levels in both groups were assessed, and a routine investigation was performed. Results: The findings indicate that the levels of serum Dickkopf-1 and Sclerostin were significantly higher in the hemodialysis group 2540.65 (2215.4 - 2909.2 pg/ml) and 1.17 (0.85 - 2.03 ng/ml)respectively (P = 0.001), compared to their control group it was 1110.45 (885.45 - 1527.65 pg/ml) and 0.28 (0.25 - 0.32 ng/ml)) respectively P = 0.001. Additionally, there was a significant increase in intima-media thickness (IMT) with a decrease in peak systolic velocity (PSV) in the main blood vessels, including the carotid, ulnar, and femoral arteries. A significant correlation was also observed between Dickkopf-1 and sclerostin levels and IMT of the carotid, ulnar, and femoral arteries. Conclusion: Wnt signalling inhibitors (Dickkopf-1 and Sclerostin) exert effects beyond the bone and significantly contribute to early vascular calcification in pediatric patients undergoing maintenance hemodialysis.
文摘Background:High blood pressure(BP)is a major contributor to mortality and cardiovascular diseases.Despite the known benefits of exercise for reducing BP,it is crucial to identify the most effective physical activity(PA)intervention.This systematic review and network meta-analysis(NMA)aimed to evaluate the available evidence on the effectiveness of various PA interventions for reducing BP and to determine their hierarchy based on their impact on BP.Methods:A search of PubMed,SPORTDiscus,PsycINFO,Web of Science,CINAHL,Cochrane,and Eric databases was conducted up to December 2022 for this systematic review and NMA.Randomized controlled trials and quasi-experimental studies targeting healthy children and adolescents aged 6-12 years old were included in this study.Only studies that compared controlled and intervention groups using PA or exercise as the major influence were included.We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines.Three independent investigators performed the literature screening,data extraction,and risk of bias assessment.We used Bayesian arm-based NMA to synthesize the data.The primary outcomes were systolic BP and diastolic BP.We calculated the mean differences(MDs)in systolic BP and diastolic BP before and after treatment.Mean treatment differences were estimated using NMA and random-effect models.Results:We synthesized 27 studies involving 15,220 children and adolescents.PA combined with nutrition and behavior change was the most effective intervention for reducing both systolic BP and diastolic BP(MD=-8.64,95%credible interval(95%CI):-11.44 to-5.84;MD=-6.75,95%CI:-10.44 to-3.11),followed by interventions with multiple components(MD=-1.39,95%CI:-1.94 to-0.84;MD=-2.54,95%CI:-4.89 to-0.29).Conclusion:Our findings suggest that PA interventions incorporating nutrition and behavior change,followed by interventions with multiple components,are most effective for reducing both systolic BP and diastolic BP in children and adolescents.
文摘Background: Renal osteodystrophy (ROD) is a bone disorder resulting from chronic kidney disease (CKD) and related metabolic diseases. Dickkopf-related protein-1 (DKK-1) is critical in regulating bone biology. This study aimed to evaluate the serum DKK-1 level as a bone marker in children with CKD who undergo regular hemodialysis (HD). Subjects and Methods: This case-control study involved 40 children with CKD on HD and 40 healthy children as controls. The study measured serum DKK-1 levels and performed a dual-energy X-ray absorptiometry scan (DEXA) in line with routine laboratory investigations. Results: There was a significant increase in the serum level of DKK-1 in the patient group compared to the control group. The DKK-1 levels were 2540.65 (2215.4 - 2909.2) pg/ml and 1110.45 (885.45 - 1527.65) pg/ml, respectively, with a p-value of less than 0.001. In the hemodialysis group, 25 patients (62.5%) had low bone mineral density (BMD) with a Z-score of under -2.0. Eighteen of these patients had low BMD in both the neck of the femur and lumbar spines. Additionally, there was a significant increase in serum DKK-1 level in patients with low BMD (2567.35 (2303.8 - 3108.1) pg/ml) compared to patients with normal BMD (2454 (1859 - 2820) pg/ml) (p = 0.041). There was also a significant positive correlation between DKK1 level and phosphorus, alkaline phosphatase, and Parathormone serum levels. In conclusion, the study indicates a clear correlation between DKK-1 and BMD in children undergoing maintenance hemodialysis. DKK1 is a promising biomarker for CKD-MBD.
基金Supported by the Kaohsiung Chang Gung Memorial Hospital and University College of Medicine(No.CMRPG8L1231,No.CMRPG8L1232,Kaohsiung,Taiwan).
文摘AIM:To evaluate the visual outcomes of standard amblyopic treatment add-on training via perceptual learning in refractive amblyopic children and to identify the risk factors for treatment failure.METHODS:Retrospective charts were reviewed in children with refractive amblyopia who received standard treatment and add-on Cambridge Visual Stimulator(CAM)training.The add-on CAM group that was enrolled had worn full-corrected glasses for at least 2mo before training.A control group received only the standard treatment.Treatment success was defined as best-corrected visual acuity(BCVA)≥20/25.The age,sex,initial BCVA,refractive errors,sessions and duration of training,and final BCVA were recorded.RESULTS:A total of 209 children(129 children in add-on CAM group and 80 children in control group)were enrolled.Seventy-six percent of unilateral and 87%of bilateral amblyopic children achieved treatment success.In children with unilateral or bilateral moderate amblyopia,the duration to reach BCVA≥20/25 was significantly shorter in add-on CAM group than in control group.Poor initial BCVA(P<0.001)and high astigmatism(P=0.007)were risk factors for treatment failure after add-on CAM training.Age,sex,and types of refractive error were not associated with treatment success.CONCLUSION:Add-on CAM training is an effective strategy for visual improvement and can shorten the treatment course when the effect of standard treatment is limited in amblyopic children.
文摘Introduction: The setting up of camps for internally displaced persons in Burkina Faso as a result of terrorism creates favorable conditions for the emergence of digestive parasitosis in these displaced populations. The objective of this study was to evaluate the prevalence of digestive parasitosis in children of this population in the Hauts-Bassins region. Material and methods: This was a prospective cross-sectional study from November to December 2020, in which stool samples were collected from internally displaced children from the Sinfra reception site in Banzon and from Poya in Karangasso Vigué. The stool samples were stored at room temperature, protected from dust and insects, in a cooler and then sent to the laboratory of the CHUSS in Bobo-Dioulasso where the parasitological analyses were performed. Results: The mean age was 5.8 ± 2.4 years. The most represented age group was 5 to 10 years (75.31%). The sex ratio is 1.61. The overall prevalence of intestinal parasite infection was 53.09%. The prevalence was statistically higher among those who consumed well water than those consuming tap water (p = 0.01). Monoparasitism by protozoa and helminths represented 74.42% and 6.68% respectively. The polyparasitism rate was 9.31%. The species identified in monoparasite patients were protozoa with Entamoeba coli (37.21%), Giardia lamblia (25.58%), Endolimax nanus (6.98%) and Entamoeba histolytica/dispar (4.65%). Biparasitism was identified with combinations, such as E. coli + E. histolytica/dispar (11.63%). Conclusion: There is a high prevalence of digestive parasitosis among IDPs in the Sinfra and Poya reception site. Educational sessions on hand washing before meals, use of drinking water, etc. should emphasize preventive measures in these IDP camps.
