Role of Plain Abdominal X-Ray in the Differential Diagnosis of Common Acute Abdominal Conditions in Children at Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria

Background: The plain abdominal x-ray is one of the commonly requested investigations in the children emergency room, paediatric surgical ward and neonatal wards. The short interval required to carry out this investigative procedure and obtain results makes it the first imaging modality used to unravel the different causes of acute abdominal conditions in children. The safety of abdominal x-ray in children makes it attractive for use in paediatric surgical practice as part of routine work-up for undifferentiated acute abdominal conditions and also to diagnose specific causes of acute abdomen in children. Setting: Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State. Objectives: Evaluation of the role of plain abdominal x-ray in diagnosing common acute abdominal conditions in children. Materials and method: Patients admitted to the children emergency room, paediatric surgical wards, children’s ward and neonatal ward who had plain abdominal x-ray as part of their diagnostic work-up were included in the study. They were studied prospectively between March 2011 and April 2021. Results: Three Hundred and Ninety-nine patients who had plain abdominal x-rays as part of their diagnostic work-up were studied. Males were 240 while females were 159, a male to female ratio of 1.5:1. The patients were aged between 1 day to 16 years. Differential diagnoses made with plain abdominal x-ray were intestinal obstruction in 298, perforated viscus 69 patients, intra-abdominal masses 13 patients and location of intra-abdominal foreign body 14. Intestinal obstruction cases in which plain abdominal x-ray played a role in their diagnosis and management included the following: intussusception 66, neonatal sepsis 60, malrotation 48, intestinal atresia 42, anorectal malformation 32, hirschsprung’s disease in 30 cases, pyloric stenosis 24, obstructed hernia 22, post-operative adhesions 16 and intestinal helminthiasis 12. Perforated viscus accounted for 69 indications. Out of these indications, perforated gut in intussusception 19, perforated typhoid ileitis was responsible in 13 cases, gut perforation in blunt abdominal trauma 8, perforation in strangulated hernia 11 cases, perforated gut in malrotation 7, ceacal perforation in hirschsprugs disease 6 and colonic perforation in necrotizing enterocolitis 5 cases. Conclusion: Plain abdominal x-ray remains a role to play in the differential diagnosis and management of common paediatric acute abdominal conditions.

Diagnostic Value of the Thoracic Ultrasonography Compared to Conventional Chest X-Rays in Pneumonia for Children between 0 to 15 Years: Case Study in Two Hospitals in Yaoundé

Introduction: The diagnosis of pneumonia is usually made based on clinical manifestations and chest X-ray. The use of ultrasound in detecting pulmonary diseases in general, and especially consolidation syndrome has been demonstrated. The objective of this study was to determine the accuracy of thoracic ultrasound compared to chest X-ray in the diagnosis of infectious pneumonia in children. Methods: Children between 0 to 15 years were included in our study. The lung ultrasound results obtained were compared with those of the chest X-ray used as the reference. Our data were introduced into the EpiInfo 3.5.4 software and analyzed with the EpiInfo 3.5.4 and IBMSPSS Statistics version 20.0 softwares. Microsoft Office Excel 2016 was used to produce Charts. Continuous quantitative variables were presented. Cohen’s Kappa concordance test was applied with confidence interval of 95%. Results: 52 children were enrolled in the study. In imaging, the dominant sign was consolidation syndrome (75.0%) of cases by chest radiography, and in 78.8% of cases by lung ultrasound (p Conclusion: Our study demonstrated that lung echography is a non-ionizing and reliable tool in the diagnosis of childhood’s pneumonia.

Pertinence of Children’s Chest X-Ray Request Form and Practice at the Regional Hospital of Ngaoundere Cameroon

Background: Chest X-ray is frequently performed for evaluation of chest disease in both adults and children. Children are more exposed to the adverse effects of radiation as compared to adults. During our daily practice, we noticed that most of children’s chest X-ray results were normal. Purpose: This study aimed to evaluate the indications, the technic, the irradiation and the result of chest X-rays in children in order to know if the practice of these X-rays was relevant. Method: Cross-sectional and descriptive study conducted at the Imaging Regional Center of Ngaoundere from April to August 2017. A total number of 145 radiographs and 140 X-ray requests of 140 children were considered in this work. The conformity of the request were verified according to the recommendations of the National Agency for Accreditation and Health Evaluation in France (NAAHE), technical condition of realization and results were appreciated and the entrance surface dose (ESD) of the patients was estimated using a mathematical algorithm. Results: Children under 5 years (63.5%) were more represented in our study. The main indications were: cough (22.1%), suspicion of pneumonia (16.4%) and bronchitis (15.7%). No indication was mentioned on 69.3% of the request forms. After confrontation to the “Guide for proper use of medical imaging examinations” (GPU), we only had 24% conformity of indications. 82.7% of the examinations required immobilization assistance by the parents. Most of the children were imaged in a standing-up position (82.9%) and the anterior-posterior view (77.9%) was more practiced. After the analysis of the pictures, 62% of them presented an optimal contrast, while 42.1% of X-ray were performed without beam collimation. 25 X-rays were repeated: 12 (48%) because of patient’s motion and 13 (52%) of mispositionning. After interpretation, 87 (62.14%) chest X-ray were normal. Main lesion observed were pneumonia (17.14%) followed by bronchopeumopathy (5.71%) and bronchitis (5%). The obtained ESD values were 0.11, 0.15 and 0.17 mGy respectively for the 0 - 1 year, 1 - 5 year and 5 - 10 year age groups;0.2 and 0.57 respectively for postero-anterior (PA) and lateral (LAT) view for the age group 10 - 15 years, which were slightly greater than the values in internationally published studies. Conclusion: The request for children chest X-ray is not relevant in terms of indication, technical conditions of realization and irradiation.

Association between body mass index and body fat measured by dual-energy X-ray absorptiometry (DXA) in China: a systematic review and meta-analysis

Objective:We examined the association between body mass index(BMI)and body fat percentage(BF%)measured by dual-energy X-ray absorptiometry(DXA)among adults and children in China.Methods:We searched four databases-PubMed,China National Knowledge Infrastructure,Wanfang,and Vip for studies published in the past 22 years.Meta-analysis was conducted using random-or fixed-effect models.Results:In total of 21 studies met inclusion criteria and were included in review,and 17 ot them in meta-analysis.They were conducted across China.Their sample size ranged from 62 to 5726,and participants'age ranged from 6-80 years.Meta-analysis revealed strong associations between BMI and BF% measured by DXA in adults(pooled r=0.71,95% CI:0.66 to 0.74)and children(pooled r=0.60,95% CI:0.52 to 0.68).The association was stronger in Northern China than in East China in children(β=-0.40,95%CI:-0.65 to-0.14)and in Central China in adults(β=-0.25;95% CI:-0.51 to-0.01).Urban children's BMI was strongly associated with BF%than rural(β=0.19;95%CI:0.04 to 0.35),whereas it was stronger in adults living in rural than in urban(β=-0.35;95% CI:-0.66 to-0.05).Conclusions:BMI was strongly associated with BF%measured by DXA,and the association in children and adults in China varied by residence and region.

儿童成长家庭客厅家具产品创新设计研究与实践

通过若干设计实践案例,探讨亲子家庭客厅家具创新设计的方法。定位儿童成长家庭,通过开展市场调研,合理构建QDF质量屋;以“形式追随生活”的理念开展概念设计;严格执行《儿童家具通用技术条件》,深化产品设计。通过一系列儿童成长家庭客厅家具的创新设计尝试,提出若干儿童成长家庭客厅的创新家具产品设计解决方案。探析出儿童成长家庭的客厅家具可以从儿童的学习和运动能力的需求方面寻找设计创新点。在产品创新设计过程中需要注意:结合家庭消费观念,选择适合的解决方案;注重功能的可识别性与安全可靠;遵循尽可能简约的设计原则;选择色彩应用时,应综合考虑家庭成员的需求;产品设计风格要与全屋定制趋势相匹配。

儿童医院手术室护士组织氛围感知对职业偏差行为的影响

目的:调查某儿童医院手术室护士组织氛围感知、职业偏差行为现状,并分析两者之间的相关性。方法:采用便利抽样法选取2023年1月—4月某儿童医院141名手术室护士作为调查对象,采用手术室护士一般资料调查表、组织氛围量表与护理人员职业偏差行为量表对其进行调查,采用Pearson相关分析对组织氛围与职业偏差行为进行分析。结果:手术室护士组织氛围量表总分为(86.31±9.52)分,条目均分为(3.59±0.47)分,护理人员职业偏差行为量表总分为(27.56±7.34)分,条目均分为(1.31±0.41)分,相关性分析结果显示组织氛围量表条目均分与护理人员职业偏差行为量表条目均分呈负相关(r=-0.812,P<0.05)。结论:某儿童医院手术室护士组织氛围感处于中等水平,职业偏差行为良好,均有待进一步提高,护理管理者应当通过个体化的干预手段提升手术室护士的组织氛围感知水平,并提供职业发展相关培训以及发挥护士作用的平台,促进手术室护士的职业偏差行为改善。

基于缓解儿童就医恐惧感的急诊空间趣味情感化设计

随着医疗技术的不断进步,医疗空间的人性化设计越来越受到关注。而考虑趣味性和情感化设计的儿童医院可以有效地缓解孩子们身处医院的恐惧和焦虑。调研通过线下问卷形式进行,旨在了解家长带孩子在儿童医院就诊时的体验和感受、候诊时家长与孩子的情绪反应、对就诊环境的看法与期望等。通过情感化层次理论总结出儿童急诊空间设计策略。基于缓解儿童就医恐惧感的急诊空间趣味情感化设计有利于促进患儿积极地配合医生,有利于优化患儿及其陪护家属的就医体验,有利于促进医护人员的人文关怀理念,有利于加强医院的人文服务。

手术室护理联合舒适护理在儿童桡骨颈骨折中的应用效果

目的 探讨手术室护理联合舒适护理在儿童桡骨颈骨折中的应用效果。方法 选取2022年6月至2023年9月山东省临沂市兰陵县人民医院收治的48例桡骨颈骨折患儿作为研究对象,按照随机数字表法分为对照组(24例)与研究组(24例)。对照组采用常规护理,研究组在对照组基础上采用手术室护理联合舒适护理,比较两组恐惧心理及治疗依从性。结果 研究组Wong-Baker面部表情疼痛量表评分高于对照组,差异有统计学意义(P <0.05)。研究组治疗依从性评分高于对照组,差异有统计学意义(P <0.05)。结论 手术室护理联合舒适护理在儿童桡骨颈骨折中的应用效果较好,可改善患儿的恐惧心理,提高治疗依从性,值得推广。

Body composition of healthy Spanish children

This paper shows the distribution of the body compartments, and the age and gender related changes in Spanish children. Subjects and Methods: A total of 231 healthy children from Madrid (Spain) were recruited and divided into 3 groups according to age (birth-5, 6-10, 11-15y). Body compartments (fat mass, lean mass and bone mass) measures were obtained from dual energy X-ray absorptiometry (DXA) scans. Total and regional body compositions were evaluated. Results: There were gender differences for TBFM (total body fat mass) in 11 - 15 year age group and for TLBM (total lean body mass) in all age groups except for the 6 - 10 year age group. TBMC (total bone mineral content) shows significant gender differences form birth. Conclusions: Contrary to boys, girls showed from early infancy a smaller proportion of muscle mass and a higher proportion of body fat (from the age of 10), with fat deposits being mostly peripheral. Bone mass and muscle mass values were higher in boys.

Structural, Optical and Room Temperature Magnetic Study of Mn₂O₃Nanoparticles

In this work, Mn2O3 nanoparticles (NPs) are prepared by co-precipitation technique. The synthesized sample is characterized by X-ray powder diffraction (XRD). The XRD spectrum reveals the cubic structure of Mn2O3 NPs and the lattice parameter is calculated to be 9.4232 ?. Crystallite size (D) is estimated using Debye-Scherer’s formula and is found to be 17.3 nm. A micrograph for the NPs is obtained using Transmission Electron Microscopy (TEM). The Mn2O3 nanoparticles are viewed at 7500× magnification and their shape is spherical. D is also measured using TEM and it is 19.1 nm, which is very close to the one obtained from XRD. The elemental contents of the prepared samples are determined using particle induced X-ray emission (PIXE). In addition, the oxygencontent of the sample is obtained using non Rutherford backscattering spectroscopy (RBS) at 3 MeV proton beam. The sample shows high purity and the RBS technique is more accurate in determining the O-content. The presence of functional groups and the chemical bonding is confirmed by FTIR spectrum. The energy band gap (Eg) is calculated for the NPs using the UV-visible optical spectroscopy between 350 nm and 800 nm and found to be 1.24 eV. The sample shows high absorption in the visible range. The magnetization (VSM) is conducted to the sample and the saturation magnetization (Ms) is calculated as 2.642 emu/g. The hysteresis loop shows antiferromagnetic behavior. The EPR analysis is performed at room temperature for the NPs. The g-factor is calculated from the spectrum and found to be 1.985, and the magnetic field shift occurs at Bo = 350.5 mT. The intensity appeared to be high, which confirms the existence of Mn2+ ions on the surface.

儿童血液净化室梅雨季发生丝状真菌污染的原因分析及应对策略

目的探讨长江中下游地区梅雨季时潮湿环境下血液净化室发生丝状真菌污染的原因及处置对策。方法分析苏州大学附属儿童医院血液净化室2021年6月在每月常规微生物的培养时发现细菌菌落并有丝状真菌,期间血液净化治疗患儿有无感染情况及对策。结果血液净化室每月常规微生物培养监测,于2021年6月在水处理间透析用水(起始端)检测到细菌菌落76cfu/ml,其中有丝状真菌;透析1号机透析液细菌菌落6cfu/ml,其中有丝状真菌;透析2号机透析液细菌菌落4cfu/ml,其中有丝状真菌。血液净化室立即启动应急预案,优先安置患儿,评估感染指针,分析丝状真菌污染原因,制定梅雨季血液净化室内相关消毒流程。结论通过在梅雨季增加针对透析室和水处理间物体表面、地面、环境及各类出风口的消毒频次,严格把控消毒质量,可明显抑制真菌的生长繁殖。

基于思维导图的手术室多元文化护理对烫伤植皮患儿围手术期治疗效果的影响

目的:探讨基于思维导图的手术室多元文化护理对烫伤患儿围手术期治疗效果的影响。方法:纳入2020年9月-2022年8月笔者医院烧伤整形科收治的107例烫伤患儿为研究对象,采用随机数字表法分为对照组(n=53)和观察组(n=54),对照组采用常规手术室护理,观察组采用基于思维导图下的手术室多元文化护理,治疗结束后比较两组患儿术中出血量、术后苏醒时间、术后寒战、水疱、溃疡发生情况、术后10 d创面愈合率、焦虑抑郁情绪、护理满意度。结果:观察组患儿术中出血量少于对照组,术后苏醒时间短于对照组,创面愈合率高于对照组,并发症(寒战、水疱、溃疡)发生率低于对照组,焦虑、抑郁程度评分低于对照组,护理总满意率高于对照组,差异均有统计学意义(P<0.05)。结论:基于思维导图的手术室多元文化护理能够提高烫伤患儿围手术期的治疗效果,改善焦虑抑郁情绪,提高护理满意度。

FAHP视角下幼儿园室内生活用房设计量化研究

基于模糊层次分析法(FAHP)构建幼儿园室内生活用房设计要素的量化体系,利用图表化语言表达符合幼儿需求的设计要素,为实现合理、趣味与高效的空间组织安排提供理论数据支撑。首先,使用马赛克法、文献法与调查法确定设计要素,构建指标框架;其次,建立设计要素量化体系,利用yaahp软件建立判断模型并确定各层次指标权重;最后,使用模糊综合评价法对湖南湘东地区某幼儿园实施评估,探寻建筑设计与幼儿需求新的耦合效应。得出了12条符合幼儿需求的室内生活用房设计要素,与其对应的量化权重数值;建立了一套适用于既成幼儿园室内生活用房的量化评价体系,根据量化数据探寻建筑旧瑕疵与优化芯方向。

信息化追溯系统在儿童输液室安全用药管理中的应用研究

目的分析信息化追溯管理系统在儿童输液室用药安全管理中的应用。方法选择2020年6月—2022年5月我院静脉输液患儿248例作为研究对象,其中2020年6月—2021年5月实施常规管理(对照组124例),2021年6月—2022年5月应用信息化追溯管理系统(观察组124例)。比较用药管理质量、工作效率及不良反应。结果应用信息化追溯管理系统后,儿童输液室用药管理质量评分高于应用前(p<0.05);护士给药、输液穿刺及输液等待时间短于应用前(p<0.05);护士专业素养、操作技能及感染防控等评分均高于应用前(p<0.05);静脉输液不良事件发生率1.62%(2/124)低于应用前9.68%(12/124)(p<0.05)。结论信息化追溯管理系统的应用可提升儿童输液室安全用药质量,降低不良事件风险。

培智类学校康复与教学用房设计研究:空间构成、模式及特殊要求

我国大陆地区培智类学校的康复与教学用房大都不满足使用主体的特殊需求,严重影响培智学生的康复与教学成效及师生家长的校园生活品质。通过借鉴教育发达国家特殊教育建筑的营建智慧,基于培智学生的特征分析,探讨其对空间的特殊需求,研究提出培智学校康复与教学用房的空间构成、模式及特殊要求。

无缝隙手术室护理模式在小儿双侧扁桃体等离子消融术中的应用

目的探讨无缝隙手术室护理模式在小儿双侧扁桃体等离子消融术中的应用。方法选取2020年2月至2022年11月临沂市中医医院收治的66例行双侧扁桃体等离子消融术的扁桃体炎患儿,按照随机数字表法分为研究组(33例)和对照组(33例)。研究组予以无缝隙手术室护理模式,对照组予以手术室常规护理。比较两组心理状态、疼痛程度、住院时间及并发症发生情况。结果护理后,研究组焦虑自评量表及抑郁自评量表评分均低于对照组(P<0.05)。研究组视觉模拟评分法评分及住院时间均优于对照组(P<0.05)。研究组并发症总发生率低于对照组(P<0.05)。结论无缝隙手术室护理模式在小儿双侧扁桃体等离子消融术中的应用可有效改善患儿心理状态和疼痛程度,减少并发症发生风险,缩短住院时间。

手术室儿童手术护理中安全隐患干预的应用效果

目的研究分析安全隐患干预在手术室儿童手术护理中的应用效果。方法选取我院2022年1月至2022年10月收治的70例手术患儿,均采取安全隐患干预,作为观察组(n=70);从手术室数据库中配对选取2021年3月至2021年12月收治的70例手术患儿,均采取常规护理,作为对照组(n=70)。对比两组的干预效果。结果从两组的护理质量、护理不良事件发生情况和满意度方面进行对比分析,两组在干预后,观察组的消毒感染管理、专科技术管理、环境管理和人文关怀维度评分均要明显高于对照组(P<0.05);两组在干预过程中均出现了护理不良事件,观察组总发生率(2.86%)明显低于对照组的11.43%(P<0.05);两组的满意度比较,观察组的总满意度(97.14%)显著高于对照组的85.71%(P<0.05)。结论在手术室儿童手术护理中,采取安全隐患护理干预,能够大幅度降低护理不良事件的发生风险,提升护理质量,并且患儿及家属对护理服务的满意度更高,有利于手术的顺利推进。

手术室护理联合人性化护理在斜视患儿手术中的应用效果研究

目的:探讨手术室护理联合人性化护理在斜视患儿手术中的应用。方法:选取2017年10月-2021年10月在笔者医院就诊并行手术治疗的120例斜视患儿为研究对象,按照数字随机法将所有患儿分为对照组及观察组,每组60例。对照组采用常规护理和人性化护理,观察组采用手术室联合人性化护理。比较两组患儿围手术期负性情绪水平;比较两组干预前后斜视改善情况、围术期并发症发生情况、两组患儿麻醉诱导时平均动脉压及心率、手术前及术后3个月的视力及眼压情况。结果:与干预前比较,干预后两组DSRSC及SCARED评分均显著降低,且观察组DSRSC及SCARED评分均低于对照组,差异有统计学意义(P<0.05)。与术前比较,两组出院前斜视均有明显改善,并且观察组患儿看近斜视度和看远斜视度均低于对照组,差异有统计学意义(P<0.05)。麻醉诱导前观察组平均动脉压及心率均低于对照组,差异有统计学意义(P<0.05)。围手术期观察组患儿并发症总发生率低于对照组,差异有统计学意义(P<0.05)。与术前比较,两组术后3个月视力及眼压情况均优于术前,且术后3个月观察组视力及眼压情况显著优于对照组,差异均有统计学意义(P<0.05)。结论:手术室护理联合人性化护理可有效减轻斜视患儿围手术期焦虑水平,减少并发症发生,有效促进患儿康复。

人性化角度下的医疗建筑病区细部设计

介绍了医疗建筑人性化设计的相关理论基础,分析了医院建筑的部分设计需求;结合具体医院建设项目,从疗愈性景观设计、内部空间设计、老年病区设计、儿童病区设计等方面阐述了人性化设计的具体做法。

整体护理在小儿手术室护理中的应用及对患儿预后的影响

目的探讨整体护理在小儿手术室护理中的应用及对患儿预后的影响。方法选取2021年7月至2022年7月滨州市中心医院手术室患儿74例,按随机数字表法分为对照组与观察组,每组各37例。对照组采用常规护理,观察组采用整体护理。比较两组家属满意度、并发症总发生率、护理质量、抗生素使用时间及住院时间。结果观察组各项家属满意度评分均高于对照组(P<0.05)。观察组并发症总发生率低于对照组(P<0.05)。观察组各项护理质量评分均高于对照组(P<0.05)。观察组抗生素使用时间及住院时间均短于对照组(P<0.05)。结论整体护理应用于小儿手术室护理中有利于家属满意度的提升,可减少并发症发生风险,有效提高护理质量,加速术后康复速度,具有推广价值。