AIM:To assess the safety and utility of capsule endoscopy(CE)for children who are unable to swallow the capsule endoscope.METHODS:The medical records of all of the children who underwent CE between 2010 and 2012 were ...AIM:To assess the safety and utility of capsule endoscopy(CE)for children who are unable to swallow the capsule endoscope.METHODS:The medical records of all of the children who underwent CE between 2010 and 2012 were retrospectively reviewed.The patients were divided into 2groups:group A included patients who were unable to swallow the capsule endoscope,and group B included patients who were able to swallow it.For the patients who were unable to swallow the capsule endoscope,it was placed in the duodenum endoscopically.The small bowel transit time,endoscopic diagnosis and complications of the 2 groups were compared.RESULTS:During the study period,28 CE procedures were performed in 26 patients.Group A included 11patients with a median age of 2 years(range 10 mo-9years),and group B included 15 patients with a median age of 12 years(range 8 years-16 years).The lightest child in the study weighed 7.9 kg.The detection rates did not differ between the 2 groups.The median small bowel transit time was 401 min(range 264-734 min)in group A and 227 min(range 56-512 min)in group B(P=0.0078).No serious complications,including capsule retention,occurred.No significant mucosal trauma occurred in the pharynx,esophagus,stomach or duodenum when the capsule was introduced using an endoscope.CONCLUSION:CE is a safe and useful procedure for infants and young children who are unable to swallow the capsule endoscope.展开更多
Objective: To retrospectively study the early compli- cations of excision with hepaticoenterostomy for in- fants and children with choledochal cysts. Methods: We analyzed 16 patients with early posto- perative complic...Objective: To retrospectively study the early compli- cations of excision with hepaticoenterostomy for in- fants and children with choledochal cysts. Methods: We analyzed 16 patients with early posto- perative complications out of 173 patients with con- genital choledochal cysts aged 27 days to 14 years (mean 2.4 years) who had undergone excisional pro- cedures and biliary tract reconstruction. Results: The early complications included bile leak- age (10 patients), abdominal wall dehiscence (3), and hepatic failure, pancreatic juice leakage and postoperative intussusception (each in 1) respective- ly. Three patients died from bile leakage and 1 from postoperative hepatic failure. No statistical differen- ces were observed between the procedures of biliary tract reconstruction with jejunal segment interposi- tion hepaticoduodenostomy and Roux-en-Y hepatico- jejunostomy (P>0.75). The morbidity was signifi- cantly higher in infants below 1 year than in children (P<0.005). Prevention and treatment of the com- plications were discussed. Conclusion: Bile leakage and abdominal wall dehis- cence are major early postoperative complications. The morbidity of cholechal cysts is higher in infants than in children. Exploratory laparotomy should not be delayed when biliary leakage with diffuse peritoni- tis appears. The 'tension suture in the fascial space of the abdominal wall' is useful to prevent and treat wound dehiscence.展开更多
Objective 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 a...Objective 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-mouth 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.展开更多
Postoperative intussusception is an uncommon but serious condition in infants and children. Here, we report seven cases of postoperative intussusception in infants and children who were seen at our institution over th...Postoperative intussusception is an uncommon but serious condition in infants and children. Here, we report seven cases of postoperative intussusception in infants and children who were seen at our institution over the last 13 y. The patients showed increased nasogastfic drainage, vomiting, lack of stool, and/or growing abdominal dis- tension 2 to 9 d following abdominal surgery. Manual reduction was successful in five cases. In two cases, necro- sis was found and intestinal resection and anastomosis were carded out, No recurrence was observed at six months of follow-up. Postoperative intussusception should be suspected in pediatric surgical patients who showed signs of intestinal obstruction in the early postoperative period.展开更多
Background: Iron deficiency anemia (IDA) in children and infants is a common nutritional problem all over the world. Infants and young children have a high risk for developing iron deficiency (ID) because they have hi...Background: Iron deficiency anemia (IDA) in children and infants is a common nutritional problem all over the world. Infants and young children have a high risk for developing iron deficiency (ID) because they have high demand for iron during the period of rapid growth. This is aggravated by the insufficiency of iron in their diet. Iron supplementation programs using pediatric tablets or drops have not been successful in the control of anemia amongst infants and children in some countries. “Sprinkles” is an innovative multi-micronutrient home fortification strategy to control iron deficiency and anemia to be more useful. Objective: The objective was to estimate the prevalence ID and IDA in infants and children in Ibb City, Yemen Republic;evaluate the use of a new form of iron and determine the hematologic response to different doses and forms of iron in Sprinkles and iron drops. Design: Using a prospective, randomized, controlled design, we studied 337 randomly children aged 24 - 48 months and infants aged 6 - 24 months in Ibb City (hemoglobin: 70 - 99 g/L). One group received a daily sachet of microencapsulated ferrous fumarate (80 mg elemental Fe) in powder form plus ascorbic acid to be sprinkled onto any complementary food eaten (sprinkles group);a control group received ferrous sulfate drops 3 times/d for 2 months (total dose: 40 mg elemental Fe). Hemoglobin and serum ferritin concentrations were measured at baseline and at the end of treatment. Results: Successful treatment of anemia (hemoglobin > 100 g/L) occurred in 58% of the sprinkles group and in 56% of the drops group, with minimal side effects in both groups. Geometric mean ferritin concentrations increased significantly in each group from baseline to the end of treatment (P Conclusion: Use of ferrous sulfate drops or a single daily dose of microencapsulated ferrous fumarate sprinkles plus ascorbicacid resulted in a similar rate of successful treatment of anemia without side effects. To our knowledge, this is the first demonstration of the use of microencapsulated iron sprinkles to treat anemia in this area. Improved ease of use may favor the use of sprinkles to deliver iron.展开更多
The development of components of VEP was studied in 150 infants and children between 2 weeks and 9 years of age participated as subjects. Ten adult subjects, 25 ito 35 years of age were also studied. The results indic...The development of components of VEP was studied in 150 infants and children between 2 weeks and 9 years of age participated as subjects. Ten adult subjects, 25 ito 35 years of age were also studied. The results indicated that the VEP had a simple wave form, consisting of only a slowly rising positive wave to 140', 70' and 35' checks from infants of 2 to 8 weeks following birth. P_1 wave appeared in response to 17.5' check stimulus at 10 weeks following birth. The latencies of P_1 components shortened d...展开更多
Congenital choledochal cyst is frequently seen ininfants and children in China. The extra-hepatic ductalchanges have been well described, but the changes in theintra-hepatic ducts in choledochal cyst are less well kno...Congenital choledochal cyst is frequently seen ininfants and children in China. The extra-hepatic ductalchanges have been well described, but the changes in theintra-hepatic ducts in choledochal cyst are less well known.This report is composed of 2 groups of patients: thirty-four cases who were operated upon between 1971 and1982 were followed post-operatively by plain abdominalfilm and barium meal examination and a group of 26cases receiving PTC between 1982 and 1984. In this lattergroup, both extra-and intra-hepatic ducts were shownsatisfactorily by PTC. In 23 cases (88.5%) besides thedilatation of the extra-hepatic duct, there were differentdegree and different forms of dilatation of the intra-hepatic ducts. In 10 cases(38.5%)the branches peripheralto the dilated main intra-hepatic ducts were found to benormal, in the other 10 cases (38.5%) the more peripheralbranches abruptly narrowed or were obliterated. In one case(3.8%) the entire intra-hepatic ductal system were dilatedwith a bead-like appearance. In only 3 cases were theintra-hepatic ducts normal (11.5%). Moreover the dilata-tion of the intra-hepatic ducts were found to persist longafter the obstruction was relieved in 28 cases (82.3%) ofthe 34 post-operative cases. Due to the frequent associationof intra-hepatic ductal dilatation with choledochal cyst,the various forms of dilatation and persistance of dilata-tion after relief of the obstruction, the term congenital biliary dilatation is suggested for this disease.展开更多
BACKGROUND Although breast milk is ideal for newborns,in some cases,it is replaced with cow’s milk,which contains proteins that increase the risk of cow’s milk protein allergy(CMPA).AIM To evaluate CMPA prevalence i...BACKGROUND Although breast milk is ideal for newborns,in some cases,it is replaced with cow’s milk,which contains proteins that increase the risk of cow’s milk protein allergy(CMPA).AIM To evaluate CMPA prevalence in Bahrain and compare clinical characteristics of children with immunoglobulin E(IgE)-and non-IgE-mediated CMPA.METHODS This retrospective cohort study examined children with CMPA diagnosed at the pediatric gastroenterology outpatient clinic of the Salmaniya Medical Complex,Bahrain,between 2014 and 2022,and assessed CMPA prevalence.Clinical presentations,laboratory findings,dietary modifications,and outcomes were compared between children with IgE-mediated and non-IgE-mediated CMPA.Categorical variables were compared using Fisher’s exact test or Pearson’sχ2 test,whereas continuous variables were compared using Student’s t-test or the Mann-Whitney U test.RESULTS Of 8332 patients,6022(72.3%)adhered to their appointment.Of them,618(10.3%)were suggested of having CMPA and 595(96.3%)were included;CMPA prevalence was 2%.Most patients were Bahraini(93.8%)and males(55.3%).Non-IgE-mediated type accounted for 77.3%cases and IgE-mediated type,22.7%.IgE-mediated CMPA presented more in boys(P=0.030),and later in life(5.1 months±4.5 months vs 4.2 months±4.2 months,P=0.016,95%CI:0.08-1.73),had more associated diseases(P<0.001);and presented with more cutaneous(P=0.024)and respiratory(P=0.003)manifestations,severe symptoms[rash/dry skin(P=0.031),facial swelling/angioedema(P=0.003),failure to thrive(P=0.013),apparent life-threatening event(P<0.001)],and positive physical findings(P=0.002)than non-IgE-mediated CMPA.Most patients were exclusively fed cow milk formula(50.3%).The amino acid-based formula(AAF)was most prescribed(60.5%)with no difference between the two types(P=0.173).Although breastfeeding was recommended to 49.6%,only 8.2%were exclusively breastfed.IgE-mediated CMPA was associated with a longer follow-up duration than non-IgE-mediated CMPA(17.3 months±14.0 months vs 13.5 months±13.4 months,P=0.005,95%CI:1.1-6.3).CONCLUSION This study revealed a high CMPA prevalence with clinical differences between both types that can influence treatment.AAF was most prescribed,while breastfeeding with dietary modification is rarely applied.展开更多
Background: Surveys of pediatric endotracheal tube (ETT) management previously reported that specialists in pediatric anesthesia and intensive care medicine preferred to use uncuffed ETTs for children younger than 8 t...Background: Surveys of pediatric endotracheal tube (ETT) management previously reported that specialists in pediatric anesthesia and intensive care medicine preferred to use uncuffed ETTs for children younger than 8 to 10 years of age. The aim of this study was to reveal the most recent attitudes and clinical practices of pediatric ETT management in Japan. Methods: The attitudes and clinical practices of pediatric ETT management were investigated using the data sheets of each institution and each patient. The data sheets contained information on patient characteristics and type of hospital, surgical procedures, devices used for intubation, and ETT information including types, size, depth, intracuff pressure (ICP), interval of ICP measurement, laryngeal packing, ETT exchange, airway complications, and reintubations. Results: The response rate of this survey was 66.7%. More than half of children older than 2 years of age were intubated with cuffed ETTs;83.5% of cuffed ETTs were used with the cuffs inflated, and ICP was measured in 80.7% of cuffed ETTs. More than half of ICP measurements were only taken at the time of intubation. Post-extubation stridor was rarely observed in cuffed (0.4%) or uncuffed ETTs (1.2%). The pediatric ETT management questionnaire revealed age-based size selection, differences in pressure of air leakage between cuffed (15 - 20 cmH2O) and uncuffed ETTs (20 - 30 cmH2O) of different sizes, the depthmarking method of insertion length. Continuous measurement of ICP was not common. Conclusion: This study revealed widespread use of cuffed ETTs in children older than 2 years of age, rarely occurrence of post-extubation stridor, inflation of cuffs, and practice of ICP measurement.展开更多
BACKGROUND Anemia in infants and young children can have long-term effects on cognitive and physical development.In Ma'anshan City,China,there has been growing concern about the prevalence of anemia among children...BACKGROUND Anemia in infants and young children can have long-term effects on cognitive and physical development.In Ma'anshan City,China,there has been growing concern about the prevalence of anemia among children aged 6 to 36 mo.Understanding the factors influencing this condition is crucial for targeted interventions and improving overall child health in the region.AIM To analyze the anemia status and influencing factors of infants and young children aged 6 to 36 mo in Ma'anshan City,China.Providing scientific evidence for reducing the incidence of anemia and improving the health level of children in this age group.METHODS The study encompassed 37698 infants and young children,aged from 6 to 36 mo,who underwent health examinations at the Ma'anshan Maternal and Child Health Hospital from January 2018 to October 2022 were included in the study.Basic information,physical examination,and hemoglobin detection data were collected.Descriptive analysis was used to analyze the prevalence of anemia in children in the region,and univariate analysis was used to analyze the influencing factors of anemia.RESULTS The mean hemoglobin level of infants and young children aged 9 to 36 mo increased with age,and the anemia detection rate decreased with age.The anemia detection rate in rural infants aged 6,9,and 12 mo was higher than that in urban infants.Although the anemia detection rate was higher in 6-mo-old boys than girls,it was higher in 24-mo-old girls than boys.There were statistically significant differences in the anemia detection rates among 9-mo-old and 12-mo-old infants with different nutritional statuses(emaciation,overweight,obese,and normal).Moreover,there were no statistically significant differences in anemia detection rates among infants and young children with different nutritional statuses at other ages.Besides,the anemia detection rates in obese infants aged 9 and 12 mo were higher than those in normal and overweight infants,with statistically significant differences.Finally,there were no statistically significant differences in the anemia detection rates between emaciation infants and those with other nutritional statuses.CONCLUSION The anemia situation among infants and young children aged 6 to 36 mo in Ma'anshan City,China,is relatively prominent and influenced by various factors.Our result shown that attention should be paid to the anemic infant and young child population,with strengthened education and targeted prevention and dietary guidance to help them establish good living habits,improve nutritional status,and reduce the occurrence of anemia to improve children's health levels.展开更多
Background: Condylomataacuminata is an infection caused by Human Papilloma Virus, rarely reported in infants and children. Podophylline as a treatment for this condition has been used cautiously in this age group. Obj...Background: Condylomataacuminata is an infection caused by Human Papilloma Virus, rarely reported in infants and children. Podophylline as a treatment for this condition has been used cautiously in this age group. Objective: To report the cases of anogenital warts including condy lomataacuminata in infants and children and to evaluate the effectiveness and side effects of 15% podophyllin in treatment of genital warts. Patient and Methods: Thirty infants and young children were seen in Department of Dermatology and Venereology—Baghdad Teaching Hospital in this case descriptive and therapeutic trial, in the period from January 2011 to August 2012. Their ages ranged from 8 - 72 (30.43 ± 15.85) months, 20 females and 10 males with a female:male ratio of 2:1. The duration of the disease ranged from 1 - 12 (5.26 ± 4.00) months. All demographics data were recorded in this study. History and examination were carried out to all patients. Family members including mothers were assessed about the presence of any type of viral warts in other location of body. Podophyllin (15%) in tincture benzoin was applied once weekly to all viral warts and the parents advised to wash out after 2 hours of application. The number of applications was repeated until full recovery. Follow-up after recovery was carried out for 6 months to watch for any relapse and to record local or systemic side effects. Results: The clinical pictures were mostly acondylomata acuminata in a form of cauliflower like warts in 20 (73.33%) patients, while in 10 (26.77%) patients there were ordinary verruca vulgaris like warts. The location of warts was perianal in 23 (76.66%) patients, genital only in 2 (6.66%) patients, and mixed in 5 (16.66%) patients. Topical applications of podophyllin 15% gave a full recovery in 27 (90%) patients, while in 3 (10%) patients there was partial response. The number of applications ranged from 1 - 4 (2.7 ± 1.42) applications. Follow up for 6 months after recovery showed relapse in only one patient, and no side effects were reported in any patients. Conclusion: There is upsurge of cases of anogenital warts among infants and children. Podophyllin (15%) in tincture benzoin is an effective therapy and no local or systemic side effects were recorded in any case.展开更多
Zinc deficiency is a public health concern and is the most prevalent micronutrient deficiencies in developing countries. The main objective of this study was to assess the prevalence and risk factors of zinc deficienc...Zinc deficiency is a public health concern and is the most prevalent micronutrient deficiencies in developing countries. The main objective of this study was to assess the prevalence and risk factors of zinc deficiency among infants and preschool children. Based on a community, the cross-sectional study was conducted in East Gojjam between October 2011 and April 2012. Two hundred and forty infants and preschool children were randomly selected in the study. Data on potential determinants of zinc deficiency were collected using a structured questionnaire. Serum zinc concentration was measured using atomic absorption spectrometer. Statistical analysis was done using ANOVA, independent sample student's t-test and linear regression model. The mean serum zinc concentration of infants and preschool children was 62.98 (±13.03) μg/dL in 95% confidence interval (CI) between 61.32 and 64.63 (i.e., 95% CI: 61.32, 64.63). About 57,1% of the subjects were zinc deficient. The main determinants of low serum zinc status of infants and preschool children were age and number of family members living on the same land. Zinc status of older children was 3.67 μg/dL (95% CI: -5.58, -1.77) lower than children who were aged 6-10 months. Serum zinc status of infants and preschool children is decreased by 0.83 p.g/dL (95% CI: -1.36, -0.30) with each additional family member. Food insecurity, dietary diversity, sex, child health, anthropometric indices, maternal education and wealth index were not associated with serum zinc status. Zinc deficiency among infants and preschool children is highly prevalent. Such potential deficiencies require urgent attention, including complementary food preparation education, traditional phytate reduction method and family planning implementation recommended in the study area.展开更多
Diabetes mellitus(DM)is a systemic chronic metabolic disorder characterized by increased insulin resistance and/orβ-cell defects.It affects all ages from the foetal life,neonates,childhood to late adulthood.Gestation...Diabetes mellitus(DM)is a systemic chronic metabolic disorder characterized by increased insulin resistance and/orβ-cell defects.It affects all ages from the foetal life,neonates,childhood to late adulthood.Gestational diabetes is a critical risk factor for congenital heart diseases(CHDs).Moreover,the risk increases with low maternal education,high body mass index at conception,undiagnosed pregestational diabetes,inadequate antenatal care,improper diabetes control,and maternal smoking during pregnancy.Maternal DM significantly affects the foetal heart and foetal-placental circulation in both structure and function.Cardiac defects,myocardial hypertrophy are three times more prevalent in infants of diabetic mothers(IDMs).Antenatal evaluation of the cardiac function and structures can be performed with foetal electrocardiography and echocardiography.Postnatal cardiac evaluation can be performed with natal and postnatal electrocardiography and echocardiography,detection of early atherosclerotic changes by measuring aortic intima-media thickness,and retinal vascular changes by retinal photography.Ameliorating the effects of diabetes during pregnancy on the offspring depends mainly on pregestational and gestational diabetes prevention.However,other measures to reduce the risk,such as using medications,nutritional supplements,or probiotics,still need more research.This review discusses the mechanism of foetal sequels and the risk factors that increase the prevalence of CHDs in gestational DM,the various cardiac outcomes of gestational DM on the foetus and offspring,cardiac evaluation of foetuses and IDMs,and how to alleviate the consequences of gestational DM on the offspring.展开更多
Purpose: During a large outbreak of Salmonella typhimurium (S. typhimurium) inDenmarkin 2008, a remarkable high incidence was observed among children below the age of 1 year. Therefore we performed this retrospective ...Purpose: During a large outbreak of Salmonella typhimurium (S. typhimurium) inDenmarkin 2008, a remarkable high incidence was observed among children below the age of 1 year. Therefore we performed this retrospective study to describe the epidemiology, severity and outcome among a subset of children in this age-group. Methods: Cases were identified for the years 2000-2009 through a register at the Department of Clinical Microbiology atHvidovreHospital, in theCopenhagenarea,Denmark. For hospitalized patients below 1 year with S. typhimurium, the medical record was reviewed. Results: The highest incidence for S. typhimurium was observed in 2008 with 315 cases per 100,000 among children below 1 year. In 2008 significantly more children age During the S. typhimurium outbreak in 2008, the incidence was especially high among infants age under 1 year. The infants in 2008 might have been slightly more affected than other years 2000-2009.展开更多
This study assesses the nutritional composition as well as the availability and affordability of infant flour found on the market and in the households of Benin. To do that assessment, a two-step cross-sectional surve...This study assesses the nutritional composition as well as the availability and affordability of infant flour found on the market and in the households of Benin. To do that assessment, a two-step cross-sectional survey based on food ethnography methods was used. A total of 61 marketplaces were visited in seven towns and rural districts as part of the availability and affordability survey, while 400 children (aged 6 to 59 months) were surveyed to track the uses of infant flours at the household level. The results obtained reveal that pre-manufactured infant flour is sold more in urban areas (Cotonou, Porto-Novo and Parakou) than in rural ones. The average infant flours price did not vary (p = 0.985) in any given year (regardless of abundance or lean periods) nor does it vary (p = 0.133) from one point of sale to another (drugstore or supermarkets). However, the average price is found to be expensive considering the purchasing power of the households surveyed. On the other hand, the amount of ingredients used in the production of the flour types found on the market complies with the recommendations of the Codex Alimentarius, unlike the homemade ones. Pre-manufactured infant flour is found to be outside of the economic reach of most households (92%) who rely heavily on the homemade ones to feed their children. In light of the above, public authorities should help improve geographic access and pricing affordability to quality infant flour for low-income households in urban and remote areas. Moreover, awareness should be raised among mothers relative to the importance of complementary feeding through education on good nutrition practices.展开更多
In order to allow the guardians to monitor the physiological parameters of the infant more intuitively and to be able to respond to sudden irregularities in the pulse rate,abnormal blood oxygen,high or low body temper...In order to allow the guardians to monitor the physiological parameters of the infant more intuitively and to be able to respond to sudden irregularities in the pulse rate,abnormal blood oxygen,high or low body temperature and other conditions,and to facilitate communication with the medical staff or to request assistance in treatment,an STM32 microcontroller-based infant health monitoring system is designed.The digital signal acquisition module for pulse,blood oxygen and body temperature acquire the raw data,and the microcontroller performs algorithmic processing to display the physiological parameters such as pulse,blood oxygen and body temperature of the infant,and configures the threshold alarms for the physiological parameters by means of a keypad module.Finally,the test results are compared and tested against the standard physiological parameters of infants and children to verify that the system meets the requirements of medical precision and accuracy.展开更多
文摘AIM:To assess the safety and utility of capsule endoscopy(CE)for children who are unable to swallow the capsule endoscope.METHODS:The medical records of all of the children who underwent CE between 2010 and 2012 were retrospectively reviewed.The patients were divided into 2groups:group A included patients who were unable to swallow the capsule endoscope,and group B included patients who were able to swallow it.For the patients who were unable to swallow the capsule endoscope,it was placed in the duodenum endoscopically.The small bowel transit time,endoscopic diagnosis and complications of the 2 groups were compared.RESULTS:During the study period,28 CE procedures were performed in 26 patients.Group A included 11patients with a median age of 2 years(range 10 mo-9years),and group B included 15 patients with a median age of 12 years(range 8 years-16 years).The lightest child in the study weighed 7.9 kg.The detection rates did not differ between the 2 groups.The median small bowel transit time was 401 min(range 264-734 min)in group A and 227 min(range 56-512 min)in group B(P=0.0078).No serious complications,including capsule retention,occurred.No significant mucosal trauma occurred in the pharynx,esophagus,stomach or duodenum when the capsule was introduced using an endoscope.CONCLUSION:CE is a safe and useful procedure for infants and young children who are unable to swallow the capsule endoscope.
文摘Objective: To retrospectively study the early compli- cations of excision with hepaticoenterostomy for in- fants and children with choledochal cysts. Methods: We analyzed 16 patients with early posto- perative complications out of 173 patients with con- genital choledochal cysts aged 27 days to 14 years (mean 2.4 years) who had undergone excisional pro- cedures and biliary tract reconstruction. Results: The early complications included bile leak- age (10 patients), abdominal wall dehiscence (3), and hepatic failure, pancreatic juice leakage and postoperative intussusception (each in 1) respective- ly. Three patients died from bile leakage and 1 from postoperative hepatic failure. No statistical differen- ces were observed between the procedures of biliary tract reconstruction with jejunal segment interposi- tion hepaticoduodenostomy and Roux-en-Y hepatico- jejunostomy (P>0.75). The morbidity was signifi- cantly higher in infants below 1 year than in children (P<0.005). Prevention and treatment of the com- plications were discussed. Conclusion: Bile leakage and abdominal wall dehis- cence are major early postoperative complications. The morbidity of cholechal cysts is higher in infants than in children. Exploratory laparotomy should not be delayed when biliary leakage with diffuse peritoni- tis appears. The 'tension suture in the fascial space of the abdominal wall' is useful to prevent and treat wound dehiscence.
文摘Objective 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-mouth 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.
基金supported by a grant from Nanjing Health Department of China (No.ZKM06041)
文摘Postoperative intussusception is an uncommon but serious condition in infants and children. Here, we report seven cases of postoperative intussusception in infants and children who were seen at our institution over the last 13 y. The patients showed increased nasogastfic drainage, vomiting, lack of stool, and/or growing abdominal dis- tension 2 to 9 d following abdominal surgery. Manual reduction was successful in five cases. In two cases, necro- sis was found and intestinal resection and anastomosis were carded out, No recurrence was observed at six months of follow-up. Postoperative intussusception should be suspected in pediatric surgical patients who showed signs of intestinal obstruction in the early postoperative period.
文摘Background: Iron deficiency anemia (IDA) in children and infants is a common nutritional problem all over the world. Infants and young children have a high risk for developing iron deficiency (ID) because they have high demand for iron during the period of rapid growth. This is aggravated by the insufficiency of iron in their diet. Iron supplementation programs using pediatric tablets or drops have not been successful in the control of anemia amongst infants and children in some countries. “Sprinkles” is an innovative multi-micronutrient home fortification strategy to control iron deficiency and anemia to be more useful. Objective: The objective was to estimate the prevalence ID and IDA in infants and children in Ibb City, Yemen Republic;evaluate the use of a new form of iron and determine the hematologic response to different doses and forms of iron in Sprinkles and iron drops. Design: Using a prospective, randomized, controlled design, we studied 337 randomly children aged 24 - 48 months and infants aged 6 - 24 months in Ibb City (hemoglobin: 70 - 99 g/L). One group received a daily sachet of microencapsulated ferrous fumarate (80 mg elemental Fe) in powder form plus ascorbic acid to be sprinkled onto any complementary food eaten (sprinkles group);a control group received ferrous sulfate drops 3 times/d for 2 months (total dose: 40 mg elemental Fe). Hemoglobin and serum ferritin concentrations were measured at baseline and at the end of treatment. Results: Successful treatment of anemia (hemoglobin > 100 g/L) occurred in 58% of the sprinkles group and in 56% of the drops group, with minimal side effects in both groups. Geometric mean ferritin concentrations increased significantly in each group from baseline to the end of treatment (P Conclusion: Use of ferrous sulfate drops or a single daily dose of microencapsulated ferrous fumarate sprinkles plus ascorbicacid resulted in a similar rate of successful treatment of anemia without side effects. To our knowledge, this is the first demonstration of the use of microencapsulated iron sprinkles to treat anemia in this area. Improved ease of use may favor the use of sprinkles to deliver iron.
文摘The development of components of VEP was studied in 150 infants and children between 2 weeks and 9 years of age participated as subjects. Ten adult subjects, 25 ito 35 years of age were also studied. The results indicated that the VEP had a simple wave form, consisting of only a slowly rising positive wave to 140', 70' and 35' checks from infants of 2 to 8 weeks following birth. P_1 wave appeared in response to 17.5' check stimulus at 10 weeks following birth. The latencies of P_1 components shortened d...
文摘Congenital choledochal cyst is frequently seen ininfants and children in China. The extra-hepatic ductalchanges have been well described, but the changes in theintra-hepatic ducts in choledochal cyst are less well known.This report is composed of 2 groups of patients: thirty-four cases who were operated upon between 1971 and1982 were followed post-operatively by plain abdominalfilm and barium meal examination and a group of 26cases receiving PTC between 1982 and 1984. In this lattergroup, both extra-and intra-hepatic ducts were shownsatisfactorily by PTC. In 23 cases (88.5%) besides thedilatation of the extra-hepatic duct, there were differentdegree and different forms of dilatation of the intra-hepatic ducts. In 10 cases(38.5%)the branches peripheralto the dilated main intra-hepatic ducts were found to benormal, in the other 10 cases (38.5%) the more peripheralbranches abruptly narrowed or were obliterated. In one case(3.8%) the entire intra-hepatic ductal system were dilatedwith a bead-like appearance. In only 3 cases were theintra-hepatic ducts normal (11.5%). Moreover the dilata-tion of the intra-hepatic ducts were found to persist longafter the obstruction was relieved in 28 cases (82.3%) ofthe 34 post-operative cases. Due to the frequent associationof intra-hepatic ductal dilatation with choledochal cyst,the various forms of dilatation and persistance of dilata-tion after relief of the obstruction, the term congenital biliary dilatation is suggested for this disease.
文摘BACKGROUND Although breast milk is ideal for newborns,in some cases,it is replaced with cow’s milk,which contains proteins that increase the risk of cow’s milk protein allergy(CMPA).AIM To evaluate CMPA prevalence in Bahrain and compare clinical characteristics of children with immunoglobulin E(IgE)-and non-IgE-mediated CMPA.METHODS This retrospective cohort study examined children with CMPA diagnosed at the pediatric gastroenterology outpatient clinic of the Salmaniya Medical Complex,Bahrain,between 2014 and 2022,and assessed CMPA prevalence.Clinical presentations,laboratory findings,dietary modifications,and outcomes were compared between children with IgE-mediated and non-IgE-mediated CMPA.Categorical variables were compared using Fisher’s exact test or Pearson’sχ2 test,whereas continuous variables were compared using Student’s t-test or the Mann-Whitney U test.RESULTS Of 8332 patients,6022(72.3%)adhered to their appointment.Of them,618(10.3%)were suggested of having CMPA and 595(96.3%)were included;CMPA prevalence was 2%.Most patients were Bahraini(93.8%)and males(55.3%).Non-IgE-mediated type accounted for 77.3%cases and IgE-mediated type,22.7%.IgE-mediated CMPA presented more in boys(P=0.030),and later in life(5.1 months±4.5 months vs 4.2 months±4.2 months,P=0.016,95%CI:0.08-1.73),had more associated diseases(P<0.001);and presented with more cutaneous(P=0.024)and respiratory(P=0.003)manifestations,severe symptoms[rash/dry skin(P=0.031),facial swelling/angioedema(P=0.003),failure to thrive(P=0.013),apparent life-threatening event(P<0.001)],and positive physical findings(P=0.002)than non-IgE-mediated CMPA.Most patients were exclusively fed cow milk formula(50.3%).The amino acid-based formula(AAF)was most prescribed(60.5%)with no difference between the two types(P=0.173).Although breastfeeding was recommended to 49.6%,only 8.2%were exclusively breastfed.IgE-mediated CMPA was associated with a longer follow-up duration than non-IgE-mediated CMPA(17.3 months±14.0 months vs 13.5 months±13.4 months,P=0.005,95%CI:1.1-6.3).CONCLUSION This study revealed a high CMPA prevalence with clinical differences between both types that can influence treatment.AAF was most prescribed,while breastfeeding with dietary modification is rarely applied.
文摘Background: Surveys of pediatric endotracheal tube (ETT) management previously reported that specialists in pediatric anesthesia and intensive care medicine preferred to use uncuffed ETTs for children younger than 8 to 10 years of age. The aim of this study was to reveal the most recent attitudes and clinical practices of pediatric ETT management in Japan. Methods: The attitudes and clinical practices of pediatric ETT management were investigated using the data sheets of each institution and each patient. The data sheets contained information on patient characteristics and type of hospital, surgical procedures, devices used for intubation, and ETT information including types, size, depth, intracuff pressure (ICP), interval of ICP measurement, laryngeal packing, ETT exchange, airway complications, and reintubations. Results: The response rate of this survey was 66.7%. More than half of children older than 2 years of age were intubated with cuffed ETTs;83.5% of cuffed ETTs were used with the cuffs inflated, and ICP was measured in 80.7% of cuffed ETTs. More than half of ICP measurements were only taken at the time of intubation. Post-extubation stridor was rarely observed in cuffed (0.4%) or uncuffed ETTs (1.2%). The pediatric ETT management questionnaire revealed age-based size selection, differences in pressure of air leakage between cuffed (15 - 20 cmH2O) and uncuffed ETTs (20 - 30 cmH2O) of different sizes, the depthmarking method of insertion length. Continuous measurement of ICP was not common. Conclusion: This study revealed widespread use of cuffed ETTs in children older than 2 years of age, rarely occurrence of post-extubation stridor, inflation of cuffs, and practice of ICP measurement.
文摘BACKGROUND Anemia in infants and young children can have long-term effects on cognitive and physical development.In Ma'anshan City,China,there has been growing concern about the prevalence of anemia among children aged 6 to 36 mo.Understanding the factors influencing this condition is crucial for targeted interventions and improving overall child health in the region.AIM To analyze the anemia status and influencing factors of infants and young children aged 6 to 36 mo in Ma'anshan City,China.Providing scientific evidence for reducing the incidence of anemia and improving the health level of children in this age group.METHODS The study encompassed 37698 infants and young children,aged from 6 to 36 mo,who underwent health examinations at the Ma'anshan Maternal and Child Health Hospital from January 2018 to October 2022 were included in the study.Basic information,physical examination,and hemoglobin detection data were collected.Descriptive analysis was used to analyze the prevalence of anemia in children in the region,and univariate analysis was used to analyze the influencing factors of anemia.RESULTS The mean hemoglobin level of infants and young children aged 9 to 36 mo increased with age,and the anemia detection rate decreased with age.The anemia detection rate in rural infants aged 6,9,and 12 mo was higher than that in urban infants.Although the anemia detection rate was higher in 6-mo-old boys than girls,it was higher in 24-mo-old girls than boys.There were statistically significant differences in the anemia detection rates among 9-mo-old and 12-mo-old infants with different nutritional statuses(emaciation,overweight,obese,and normal).Moreover,there were no statistically significant differences in anemia detection rates among infants and young children with different nutritional statuses at other ages.Besides,the anemia detection rates in obese infants aged 9 and 12 mo were higher than those in normal and overweight infants,with statistically significant differences.Finally,there were no statistically significant differences in the anemia detection rates between emaciation infants and those with other nutritional statuses.CONCLUSION The anemia situation among infants and young children aged 6 to 36 mo in Ma'anshan City,China,is relatively prominent and influenced by various factors.Our result shown that attention should be paid to the anemic infant and young child population,with strengthened education and targeted prevention and dietary guidance to help them establish good living habits,improve nutritional status,and reduce the occurrence of anemia to improve children's health levels.
文摘Background: Condylomataacuminata is an infection caused by Human Papilloma Virus, rarely reported in infants and children. Podophylline as a treatment for this condition has been used cautiously in this age group. Objective: To report the cases of anogenital warts including condy lomataacuminata in infants and children and to evaluate the effectiveness and side effects of 15% podophyllin in treatment of genital warts. Patient and Methods: Thirty infants and young children were seen in Department of Dermatology and Venereology—Baghdad Teaching Hospital in this case descriptive and therapeutic trial, in the period from January 2011 to August 2012. Their ages ranged from 8 - 72 (30.43 ± 15.85) months, 20 females and 10 males with a female:male ratio of 2:1. The duration of the disease ranged from 1 - 12 (5.26 ± 4.00) months. All demographics data were recorded in this study. History and examination were carried out to all patients. Family members including mothers were assessed about the presence of any type of viral warts in other location of body. Podophyllin (15%) in tincture benzoin was applied once weekly to all viral warts and the parents advised to wash out after 2 hours of application. The number of applications was repeated until full recovery. Follow-up after recovery was carried out for 6 months to watch for any relapse and to record local or systemic side effects. Results: The clinical pictures were mostly acondylomata acuminata in a form of cauliflower like warts in 20 (73.33%) patients, while in 10 (26.77%) patients there were ordinary verruca vulgaris like warts. The location of warts was perianal in 23 (76.66%) patients, genital only in 2 (6.66%) patients, and mixed in 5 (16.66%) patients. Topical applications of podophyllin 15% gave a full recovery in 27 (90%) patients, while in 3 (10%) patients there was partial response. The number of applications ranged from 1 - 4 (2.7 ± 1.42) applications. Follow up for 6 months after recovery showed relapse in only one patient, and no side effects were reported in any patients. Conclusion: There is upsurge of cases of anogenital warts among infants and children. Podophyllin (15%) in tincture benzoin is an effective therapy and no local or systemic side effects were recorded in any case.
文摘Zinc deficiency is a public health concern and is the most prevalent micronutrient deficiencies in developing countries. The main objective of this study was to assess the prevalence and risk factors of zinc deficiency among infants and preschool children. Based on a community, the cross-sectional study was conducted in East Gojjam between October 2011 and April 2012. Two hundred and forty infants and preschool children were randomly selected in the study. Data on potential determinants of zinc deficiency were collected using a structured questionnaire. Serum zinc concentration was measured using atomic absorption spectrometer. Statistical analysis was done using ANOVA, independent sample student's t-test and linear regression model. The mean serum zinc concentration of infants and preschool children was 62.98 (±13.03) μg/dL in 95% confidence interval (CI) between 61.32 and 64.63 (i.e., 95% CI: 61.32, 64.63). About 57,1% of the subjects were zinc deficient. The main determinants of low serum zinc status of infants and preschool children were age and number of family members living on the same land. Zinc status of older children was 3.67 μg/dL (95% CI: -5.58, -1.77) lower than children who were aged 6-10 months. Serum zinc status of infants and preschool children is decreased by 0.83 p.g/dL (95% CI: -1.36, -0.30) with each additional family member. Food insecurity, dietary diversity, sex, child health, anthropometric indices, maternal education and wealth index were not associated with serum zinc status. Zinc deficiency among infants and preschool children is highly prevalent. Such potential deficiencies require urgent attention, including complementary food preparation education, traditional phytate reduction method and family planning implementation recommended in the study area.
文摘Diabetes mellitus(DM)is a systemic chronic metabolic disorder characterized by increased insulin resistance and/orβ-cell defects.It affects all ages from the foetal life,neonates,childhood to late adulthood.Gestational diabetes is a critical risk factor for congenital heart diseases(CHDs).Moreover,the risk increases with low maternal education,high body mass index at conception,undiagnosed pregestational diabetes,inadequate antenatal care,improper diabetes control,and maternal smoking during pregnancy.Maternal DM significantly affects the foetal heart and foetal-placental circulation in both structure and function.Cardiac defects,myocardial hypertrophy are three times more prevalent in infants of diabetic mothers(IDMs).Antenatal evaluation of the cardiac function and structures can be performed with foetal electrocardiography and echocardiography.Postnatal cardiac evaluation can be performed with natal and postnatal electrocardiography and echocardiography,detection of early atherosclerotic changes by measuring aortic intima-media thickness,and retinal vascular changes by retinal photography.Ameliorating the effects of diabetes during pregnancy on the offspring depends mainly on pregestational and gestational diabetes prevention.However,other measures to reduce the risk,such as using medications,nutritional supplements,or probiotics,still need more research.This review discusses the mechanism of foetal sequels and the risk factors that increase the prevalence of CHDs in gestational DM,the various cardiac outcomes of gestational DM on the foetus and offspring,cardiac evaluation of foetuses and IDMs,and how to alleviate the consequences of gestational DM on the offspring.
文摘Purpose: During a large outbreak of Salmonella typhimurium (S. typhimurium) inDenmarkin 2008, a remarkable high incidence was observed among children below the age of 1 year. Therefore we performed this retrospective study to describe the epidemiology, severity and outcome among a subset of children in this age-group. Methods: Cases were identified for the years 2000-2009 through a register at the Department of Clinical Microbiology atHvidovreHospital, in theCopenhagenarea,Denmark. For hospitalized patients below 1 year with S. typhimurium, the medical record was reviewed. Results: The highest incidence for S. typhimurium was observed in 2008 with 315 cases per 100,000 among children below 1 year. In 2008 significantly more children age During the S. typhimurium outbreak in 2008, the incidence was especially high among infants age under 1 year. The infants in 2008 might have been slightly more affected than other years 2000-2009.
文摘This study assesses the nutritional composition as well as the availability and affordability of infant flour found on the market and in the households of Benin. To do that assessment, a two-step cross-sectional survey based on food ethnography methods was used. A total of 61 marketplaces were visited in seven towns and rural districts as part of the availability and affordability survey, while 400 children (aged 6 to 59 months) were surveyed to track the uses of infant flours at the household level. The results obtained reveal that pre-manufactured infant flour is sold more in urban areas (Cotonou, Porto-Novo and Parakou) than in rural ones. The average infant flours price did not vary (p = 0.985) in any given year (regardless of abundance or lean periods) nor does it vary (p = 0.133) from one point of sale to another (drugstore or supermarkets). However, the average price is found to be expensive considering the purchasing power of the households surveyed. On the other hand, the amount of ingredients used in the production of the flour types found on the market complies with the recommendations of the Codex Alimentarius, unlike the homemade ones. Pre-manufactured infant flour is found to be outside of the economic reach of most households (92%) who rely heavily on the homemade ones to feed their children. In light of the above, public authorities should help improve geographic access and pricing affordability to quality infant flour for low-income households in urban and remote areas. Moreover, awareness should be raised among mothers relative to the importance of complementary feeding through education on good nutrition practices.
文摘In order to allow the guardians to monitor the physiological parameters of the infant more intuitively and to be able to respond to sudden irregularities in the pulse rate,abnormal blood oxygen,high or low body temperature and other conditions,and to facilitate communication with the medical staff or to request assistance in treatment,an STM32 microcontroller-based infant health monitoring system is designed.The digital signal acquisition module for pulse,blood oxygen and body temperature acquire the raw data,and the microcontroller performs algorithmic processing to display the physiological parameters such as pulse,blood oxygen and body temperature of the infant,and configures the threshold alarms for the physiological parameters by means of a keypad module.Finally,the test results are compared and tested against the standard physiological parameters of infants and children to verify that the system meets the requirements of medical precision and accuracy.