雷竞技rebat在儿科领域|新和最近的文章 https://www.雷竞技rebatfrontier雷竞技电竞体育竞猜平台sin.org/journals/pediatrics RSS提要的前沿儿科|新和雷竞技rebat最近的文章 en - us 雷竞技rebat前沿Feed生成器,版本:1 2023 - 02 - 27 - t17:05:31.3748901 + 0 60 https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2022.1070858https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2022.1070858预测值的临床资料、分子生物标志物和超声心动图测量在早产儿支气管肺的发育不良 2023 - 02年- 27 - t00:00:00z 华为王 东崖燕 吴主任朱之鑫 海丰耿 交给朱 小李朱 <秒> <标题> < /名称> < p >目标我们旨在利用分子生物标志物和入学期间收集的临床资料和超声心动图来预测支气管肺的发育不良(桶)在早产儿孕龄≤32周。< / p > < /秒>Methods

Eighty-two patients (40 with BPD, BPD group and 42 healthy as controls, non-BPD group) admitted to the Department of Neonatology of the Children's Hospital of Soochow University between October 1, 2018, and February 29, 2020, were enrolled in this study at the tertiary hospital. Basic clinical data on the perinatal period, echocardiographic measurements, and molecular biomarkers (N-terminal-pro-B-brain natriuretic peptide, NT-proBNP) were collected. We used multiple logistic regression analysis to establish an early predictive model for detecting BPD development in preterm infants of gestational age ≤32 weeks. We also used a receiver operating characteristic curve to assess the sensitivity and specificity of the model.

Results

No significant differences were found between the BPD and non-BPD groups in terms of sex, birth weight, gestational age, incidence of asphyxia, maternal age, gravidity, parity, mode of delivery, premature rupture of membranes >18 h, use of prenatal hormones, placental abruption, gestational diabetes mellitus, amniotic fluid contamination, prenatal infections, and maternal diseases. The use of caffeine, albumin, gamma globulin; ventilation; days of FiO2 ≥ 40%; oxygen inhalation time; red blood cell suspension infusion volume (ml/kg); and proportion of infants who received total enteral nutrition (120 kcal/kg.d) ≥24 d after birth were higher in the BPD group than in the non-BPD group. The levels of hemoglobin, hematocrit, and albumin in the BPD group were significantly lower than those in the non-BPD group. The total calorie intake was significantly lower in the BPD group on the 3rd, 7th, and 14th day after birth than in the non-BPD group (P < 0.05). The incidence rates of patent ductus arteriosus (PDA), pulmonary hypertension, and tricuspid regurgitation were significantly higher in the BPD group than in the non-BPD group (P < 0.05). The serum level of NT-proBNP 24 h after birth was significantly higher in the BPD group than in the non-BPD group (P < 0.05). Serum NT-proBNP levels were significantly higher in infants with severe BPD than in those with mild or moderate BPD (P < 0.05).

Conclusion

As there were various risk factors for BPD, a combining clinical data, molecular biomarkers, and echocardiogram measurements can be valuable in predicting the BPD. The tricuspid regurgitation flow rate (m/s), NT-proBNP (pg/ml), ventilator-associated pneumonia, days of FiO2 ≥ 40% (d), red blood cell suspension infusion volume (ml/kg), and proportion of infants who received total enteral nutrition (120 kcal/kg.d) ≥24 d after birth were the most practical factors considered for designing an appropriate model for predicting the risk of BPD.

https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2022.1051534https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2022.1051534临床、放射学和遗传特性的SLC13A5变体在沙特家庭:基因型表型相关性和简短的文献回顾 2023 - 02年- 27 - t00:00:00z 哈难AlQudairy Hesham AlDhalaan 莎拉AlRuways Nouf AlMutairi 摩诃AlNakiyah 瑞玛·AlGhofaili Albandary AlBakheet Adeeb Alomrani 奥马尔·a·Alharbi Ehab淘气小熊 他叫AlSayed 哈马德AlZaidan 摩诃m . AlRasheed 阿里AlOdaib Namik岩石 <秒> <标题>背景< /名称> < p > <斜体> SLC13A5 < /斜体>(溶质载体家庭13,成员5)编码/柠檬酸钠转运蛋白,主要定位在额叶皮层细胞等离子体膜,视网膜和肝脏。致病性变异的基因导致常染色体隐性综合征称为“发展与釉质发生癫痫脑病25天空”。" < / p > < /秒> <秒> <标题> < /名称> < p >,结果我们已经调查了来自三个不同的血缘的沙特家庭的六名病人。受影响的个体提供新生儿癫痫,发育迟缓,牙齿发育的重要缺陷。有些病人显示其他临床特征,如肌肉无力,运动困难,智力残疾,头小畸型,除了额外的异常显示和语音问题脑电图(脑电图)和磁共振成像(MRI)。其中一个核磁共振的发现在额叶皮层增厚有关。诊断和研究病人的遗传缺陷,全外显子组测序(韦斯)加上确认Sanger测序是利用。迭代筛选确定了两种变体的<斜体> SLC13A5 < /斜体>,其中一个是小说,在家庭。家庭1和2有相同的插入(之前报道的突变),导致转移和过早停止密码子。第三个家庭小说剪切位点变异。确认Sanger测序证实韦斯变异的结果,表示完全隔离在相应的家庭。 The patients’ conditions were poorly controlled by multiple antiepileptics as they needed constant care.

Conclusion

Considering that recessive mutations are common in the Arab population, SLC13A5 screening should be prioritized in future patients harboring similar symptoms including defects in molar development.

https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1016197https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1016197对比在非常早产儿氧气补充:血氧饱和度的变化特性和他们的应用程序基于血氧过低的事件风险分层 2023 - 02年- 27 - t00:00:00z Pravitha Ramanand Premananda印度语的 投资银行部p·特拉弗斯 Namasivayam Ambalavanan <秒> <标题> < /名称> < p >背景补充通常用于维持氧饱和度(热点2 <子> < /订阅>)水平在早产儿指标范围内减少间歇性血氧过低的(IH)事件,这是与短期和长期的发病率有关。没有很多信息关于氧化模式的差异等婴儿接受建立和他们关系观察IH事件。本研究旨在描述氧化特征在两种类型的补充研究热点;2 <子> < /订阅>信号特性和评估他们的表现在NICU监测血氧不足风险筛查。< / p > < /秒>Subjects and methods

SpO2 data from 25 infants with gestational age <32 weeks and birthweight <2,000 g who underwent a cross over trial of low-flow nasal cannula (NC) and digitally-set servo-controlled oxygen environment (OE) supplementations was considered in this secondary analysis. Features pertaining to signal distribution, variability and complexity were estimated and analyzed for differences between the supplementations. Univariate and regularized multivariate logistic regression was applied to identify relevant features and develop screening models for infants likely to experience a critically high number of IH per day of observation. Their performance was assessed using area under receiver operating curves (AUROC), accuracy, sensitivity, specificity and F1 scores.

Results

While most SpO2 measures remained comparable during both supplementations, signal irregularity and complexity were elevated while on OE, pointing to more volatility in oxygen saturation during this supplementation mode. In addition, SpO2 variability measures exhibited early prognostic value in discriminating infants at higher risk of critically many IH events. Poincare plot variability at lag 1 had AUROC of 0.82, 0.86, 0.89 compared to 0.63, 0.75, 0.81 for the IH number, a clinical parameter at observation times of 30 min, 1 and 2 h, respectively. Multivariate models with two features exhibited validation AUROC > 0.80, F1 score > 0.60 and specificity >0.85 at observation times ≥ 1 h. Finally, we proposed a framework for risk stratification of infants using a cumulative risk score for continuous monitoring.

Conclusion

Analysis of oxygen saturation signal routinely collected in the NICU, may have extensive applications in inferring subtle changes to cardiorespiratory dynamics under various conditions as well as in informing clinical decisions about infant care.

https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1051026https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1051026病例报告:血管再生失败NF1-related selumetinib后性烟雾综合征:一个可能的病理生理相关吗? 2023 - 02年- 27 - t00:00:00z 克里斯蒂娜Chelleri 马塞洛Scala Patrizia德马科 莫妮卡Traverso Marzia Ognibene 艾琳布鲁诺 Pasquale Striano Mariasavina塞韦里诺 费德里科•扎拉 玛丽亚克里斯蒂娜戴安娜 马可Pavanello < p > 1型神经纤维瘤病(NF1)是一种神经皮肤综合征致病变种引起的<斜体> NF1 < /斜体>基因,编码的多畴的抑制剂Ras活性。因此,NF1被认为是RASopathy和药物针对RAS /增殖蛋白激酶(MAPK)通路,比如MAP激酶(MEK) 1/2抑制剂Selumetinib,有前途的治疗方案治疗NF1-associated肿瘤,特别是丛状纤维瘤和视神经胶质瘤。然而,手术治疗往往需要NF1-related脑血管表现,如性烟雾综合征(MMS)。我们报告一个8岁的病人接受Selumetinib 25 mg / m2的剂量口服一天2次治疗许多丛状纤维瘤。他遭受两个亲密中风和脑MRI显示严重大脑血管病变与MMS一致,与颈内动脉的狭窄。组成的两步外科血管再生过程进行了直接与encephalo-mio-synangiosis旁路(EMS)其次是encephalo-duro-arterio-synangiosis (eda)。令人惊讶的是,尽管手术技术成功,随访MRI显示缺乏预期的血管再生。Selumetinib是一个强大的治疗选择的治疗严重NF1-related肿瘤。然而,我们的研究表明,这种药物可能会干扰大脑新血管形成MMS患者需要外科血管再生。这是支持的关键作用的血管内皮生长因子(VEGF),其涉及MAPK信号通路,促进新血管形成。 Our observations suggest to adopt an imaging surveillance strategy to prevent unfavorable surgical outcome in patients with NF1-associated MMS receiving Selumetinib, and that priority should be given to surgical revascularization.

https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1044352https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1044352分析SARS-CoV-2感染的影响在流感大流行期间住院儿科人口大巴黎大学医院 2023 - 02年- 27 - t00:00:00z 米凯拉Semeraro 皮埃尔mike vanderboegh 玛歌已经展开 Mourad Dellagi Mehdi Oualha 拿但业Beeker 海琳Chappuy <秒> <标题> < /名称> < p >背景的临床特点、疾病进展和结果影响儿童严重急性呼吸系统综合症冠状病毒2 (SARS-CoV-2)感染出现明显比老年人更温和。然而,住院治疗和临床特点的趋势似乎在儿科人口随时间不同在不同流行波。< / p > < /秒>Objective

Our aim was to understand the impact of the different COVID-19 variants in the pediatric population hospitalized in the Pediatric Departments of the Public Hospital in the Greater Paris area by the analysis performed with the Assistance Publique-Hopitaux de Paris (AP-HP) Health Data Warehouse.

Methods

This is a retrospective cohort study including 9,163 patients under 18 years of age, hospitalized from 1 March 2020 to 22 March 2022, in the Paris area, with confirmed infection by SARS-CoV-2. Three mutually exclusive groups with decreasing severity (Pediatric Inflammatory Multisystem Syndrome (PIMS), symptomatic infection, mild or asymptomatic infection) were defined and described regarding demography, medical history, complication of the SARS-CoV-2 infection, and treatment during admission. Temporal evolution was described by defining three successive waves (March–September 2020, October 2020–October 2021, and November 2021–March 2022) corresponding to the emergence of the successive variants.

Results

In the study period, 9,163 pediatric patients with SARS-CoV-2 infection were hospitalized in 21 AP-HP hospitals. The number of patients with SARS-CoV-2 infection increased over time for each wave of the pandemic (the mean number of patients per month during the first wave was 332, 322 during the 2nd, and 595 during the third wave). In the medical history, the most associated concomitant disease was chronic respiratory disease. Patients hospitalized during the third wave presented a higher incidence of pulmonary involvement (10.2% compared to 7% and 6.5% during the first and second waves, respectively). The highest incidence of PIMS was observed during the first and second waves (4.2% in the first and second waves compared to 2.3% in the 3rd wave).

Discussion

This analysis highlighted the high incidence of hospitalized children in the Greater Paris Area during the third wave of SARS-CoV-2 pandemic corresponding to the Omicron Covid-19 variant, which is probably an expression of a concomitant SARS-CoV-2, while a decreased incidence of PIMS complication was observed during the same period.

https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1067183https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1067183袋鼠妈妈护理的疗效的临床结果激光焊和早产儿的28天:随机临床试验的荟萃分析 2023 - 02年- 27 - t00:00:00z 甄朱 Xinchen王 Wenzeng陈 不要说裴 Qingmin王 Hailian关 光朱 <秒> <标题> < /名称> < p >目的本研究的目的是系统地确定袋鼠妈妈照顾的好处(KMC)的临床结果低出生体重(激光焊)和早产儿。< / p > < /秒> <秒> <标题> < /名称> < p >方法在这项研究中,以下数据库检索到的文章发表,直到2021年11月:PubMed、网络科学、EBSCO, Cochrane图书馆。主要临床结果是死亡登记和28天之间。辅助临床结果平均住院时间,体温过低,败血症,纯母乳喂养的新生儿期,并在放电纯母乳喂养。< / p > < /秒> <秒> <标题> < /名称> < p >结果我们进行了一项荟萃分析,其中包括17个相关,涉及17668名参与者。这项荟萃分析的结果表明,KMC可以降低死亡率的主要临床结果之间的登记和28天(RR: 0.80, 95% Cl: 0.71 - -0.91, p <斜体> < /斜体> & lt; 0.01)。辅助临床结果,KMC有不同程度的福利平均住院时间(SMD:−0.96, 95% Cl: 1.02−-0.90 p <斜体> < /斜体> & lt; 0.001),低体温(RR: 0.45, 95% Cl: 0.27 - -0.75, p <斜体> < /斜体> & lt; 0.01),和败血症(RR: 0.79, 95% Cl: 0.70 - -0.89, p <斜体> < /斜体> & lt; 0.001)。纯母乳喂养的新生儿期的结束,在放电的KMC纯母乳喂养的好处,虽然并没有统计学上不同(OR: 2.16, 95% Cl: 0.55 - -8.41, p <斜体> < /斜体> = 0.27;OR: 1.16, 95% Cl: 0.82 - -1.64, p <斜体> < /斜体> = 0.39,分别)。< / p > < /秒>Conclusions

KMC was decreased mortality in LBW and premature infants between enrollment and 28 days. In addition, KMC also had a favorable effectiveness on the secondary clinical outcomes, such as mean duration of hospital stay, hypothermia, sepsis. Moreover, KMC also had a slight effectiveness on exclusive breastfeeding at the end of the neonatal period and exclusive breastfeeding at discharge.

https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1124647https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1124647意义的寻找ganglia终端直肠瘘的复杂的肛门直肠畸形:与排便功能 2023 - 02年- 27 - t00:00:00z 魏冯 华旗μ 敏敏陈 金朱 Chenzhu香 林晓风扇 习近平侯 萧红死 易王 <秒> <标题> < /名称> < p >背景需要寻找ganglia复杂终端/直肠瘘的肛门直肠畸形(武器)仍然是有争议的。本研究旨在评估神经节之间的关系没有在终端直肠/ anoplasty后瘘和排便功能。< / p > < /秒>Methods

A retrospective review of patients who received anoplasty for treating male imperforate anus with rectobulbar (RB)/rectoprostatic (RP) fistulas at a tertiary pediatric hospital was conducted with registered demographic data, imaging study results, and information on the terminal rectum/fistula specimen (excision extension and pathological findings). According to the pathological findings, patients were divided into Groups 1 (ganglia absence) and 2 (ganglia presence). Furthermore, the postoperative defecation function was evaluated using various rating scale questionnaires. Statistical analysis was performed using SPSS 22.0.

Results

Of the 62 patients, 18 (29.0%) showed ganglia absence in the terminal rectum/fistula. By analyzing the imaging data, spinal anomalies and spinal cord anomalies were found in 30.6% (19/62) and 56.5% (35/62) of patients, respectively. Baseline information was comparable between Groups 1 and 2 (P > 0.05). For defecation function, there were no significant differences in Kelly scores between the two groups (4.0 ± 0.8 vs. 4.4 ± 1.1, P = 0.177), while Krickenbeck (3.7 ± 1.8 vs. 5.2 ± 1.4) and Rintala (13.7 ± 3.6 vs. 16.0 ± 2.7) scores in Group 1 were significantly lower than those in Group 2 (both P < 0.05). The overall incidence of constipation was 50% (31/62), being higher for Group 1 than Group 2 (77.5% vs. 38.6%, P = 0.002). The area under the curve of ganglia absence for predicting constipation was 0.696, with 77.8% sensitivity and 61.4% specificity.

Conclusion

Ganglia absence in the terminal rectum/fistula of male imperforate anus with RB/RP fistulas is associated with constipation after anoplasty, but it has limited predictive value for postoperative constipation. It is necessary to search for ganglia in the terminal rectum/fistula, both intraoperatively and postoperatively.

https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1027045https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1027045内耳前庭神经异常和障碍患儿畸形:叙述审查 2023 - 02年- 27 - t00:00:00z 大卫。Brotto Marzia Ariano 摩斯Sozzi 罗伯塔Cenedese 伊娃Muraro 弗Sorrentino Patrizia Trevisi < p > 20%的儿童先天性听力损失的内耳畸形。在过去的几年里已经有很多了解的形态和功能前迷宫的一部分,因为听力损失可能产生巨大影响一个孩子的全面发展。如今,对于大多数人,听力康复的机会,使听力损失可以救治的。异常范围从整个内耳的缺乏发展到特定的隔离结构的异常。尽管经常伴随的介入后迷宫的一部分,这部分的内耳经常被忽视,同时讨论其形态和功能障碍。即使前庭平衡功能/功能障碍可能产生重大影响的全球发展的孩子,完全不知道这些特定疾病患者的内耳畸形。本综述的目的是总结现有文献关于前庭异常和障碍与内耳畸形儿童,讨论主题是目前知道什么。< / p > https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1039415https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1039415临床结果的关闭,流离失所的指骨的颈部骨折患儿不同类型的柯式钢丝固定:回顾性观察研究 2023 - 02年- 27 - t00:00:00z Chunxing吴 小君的歌 博宁 Yueqiang莫 Dahui王 <秒> <标题> < /名称> < p >目标不恰当的治疗封闭流离失所的指骨的颈部骨折(CDPNF)儿童通常会导致糟糕的结果。本研究旨在评估临床结果关闭/切开复位,年龄、不同类型的骨折和柯式钢丝固定治疗CDPNF(钢丝)。< / p > < /秒> <秒> <标题>材料和方法< /名称> < p >参与者:60例(男,46岁,女,14;右撇子,35和左撇子,25;平均年龄7.9岁(范围1.0 - -14.5年))曾CDPNF包括在内。术前x射线显示骨折流离失所,表现出明显的畸形。<大胆>干预大胆< / >:首先,减少(4例切开复位,56例闭合复位),其次是经皮钢丝固定(执行交叉固定,24例;纵向倾斜固定,17例;同侧的固定,4例;15例,单一的纵向固定)和固定化。x光检查后切除K-wires显示骨折愈合; the criteria for fracture healing were callus formation and the absence of fracture lines. Clinical outcome and radiographs between groups were compared.

Results

According to the visual analogue scale, the pain scores were excellent. According to the Al-Qattan Grade system(AGS),all the patients presented with closed, type II phalangeal neck fractures,the results were excellent in 36 cases (36/60, 60%), good in 15 cases (15/60, 25%), fair in 5 cases (5/60, 8.3%) and poor in 4 cases (4/60, 6.7%). There were significant differences in different fracture type groups (P= 0.013*), operation age groups (P= 0.025*) and open/closed reduction groups (P= 0.042*). There was no significant difference in K-wire fixation type groups (P> 0.05).

Conclusions

Patients with open reduction, the more serious fracture type, the older at the operation, were more likely to have poor AGS result. Different K-wire fixation types for CDPNF in children had the same satisfactory results.

https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.961075https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.961075治疗触摸和联合治疗儿科护理和新生儿学:一个活跃的推理框架 2023 - 02年- 27 - t00:00:00z 佐伊McParlin 弗朗西斯科·Cerritelli 安德里亚Manzotti 卡尔·J Friston 豪尔赫·E斯特维斯 < p >治疗情感接触被认为是必不可少的生存,培育支持人际互动,加速recovery-including减少住院治疗上,促进整体健康和构建健壮的治疗联盟。通过活动推理的镜头,我们提供了一个综合模型,结合治疗触摸和通信,实现biobehavioural同步。这个模型说明大脑如何生成模型所需的复苏发展,开发成功的治疗联盟,和调节拮抗平衡在儿科手册即疗法。我们应用积极推断解释神经生理学和行为机制,导致了通过触摸同步关系的开发和维护。摘要前景治疗触摸的至关重要的作用在发展中一个坚实的联合治疗,儿科护理的临床疗效,以及三者之间的同步卫生保健从业者,护理,婴儿在各种临床情况。我们开始通过提供简要概述的意义和临床作用的接触社会互动发展的婴儿;促进积极的联合治疗和恢复体内平衡通过接触允许更有效的非稳态过程的监管。此外,我们解释CT触觉传入的角色在实现积极的临床结果和更新之前的信仰。然后我们讨论如何实现触摸治疗促进合作在诊所和促进心理理论的交互。这个承保biobehavioural同步,认知信任、同理心,和不确定性的决议。 The ensuing framework is underpinned by a critical application of the active inference framework to the fields of pediatrics and neonatology.

https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1128642https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1128642的最大挑战和解决方案来改善孩子们的健康和福祉全球未来十年及以后:使用和实现复杂系统科学方法 2023 - 02年- 27 - t00:00:00z Zephanie泰克 < p >孩子的健康和幸福是最重要的社会的健康和幸福,健康和幸福的基础。介绍了角度,一个复杂的系统方法,嵌入实现科学应对不断上涨的挑战需要孩子的健康和幸福在这个十年(2020 - 2030)。反思主持人的成功项目视为承诺解决孩子的健康和幸福在过去十年(2010 - 2020),推进项目解决儿童的健康和福祉。优先需要解决的问题是开发、测试和使用儿童和家庭的健康和幸福理论(以及相关的举措),可用于建立在现有的成功取得进展。理解上下文包括进一步阐明儿童健康和福祉的司机在多个水平的相关制度(如卫生、教育、社区)在整个生命过程,并考虑影响照顾者还需要更多的考虑。方法应对未来挑战的孩子健康和幸福包括合作设计的举措,支持儿童健康和福祉与儿童和家庭本身而不是使用预先设计计划,深思熟虑的选择,结果和报告实现未来的挑战项目,促进学习。的方法、重点和方法提出了可用于设计或完善干预,模型或护理或社区计划和提供儿童健康咨询领域新方向。< / p > https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1057903https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1057903反思状态1小儿心脏移植的标准:一个案例的优先级单心室患者解剖由心室辅助装置 2023 - 02 - 24 t00:00:00z 安娜·e·贝瑞 大卫·w·Bearl < p >过去2年在小儿心脏移植的技术和技术进步有成倍增加。然而,即使小儿供心的数量增加,对该有限资源的需求远远超过了供给。因此,救生的形式支持心室辅助装置(VAD)已成为越来越多地用于桥接儿科患者心脏移植。清单标准,在当前小儿心脏移植器官共享联合网络采用(凯泽本人)在2016年,所有的儿科患者1 VAD授予地位和分配的首要移植不管他们的潜在的病理。然而,这应该是这样吗?我们建议和监督的存在仅为1状态清单可能是不够的。在这一过程中,我们特别强调提高灵敏度,资源利用率,风险,减少结果单心室患者生理支持和监督相比结构正常心脏患者1状态下都被列出。有鉴于此,从分配正义的角度来看,我们进一步表明缺乏粒度在当前小儿心脏移植清单类别可能会无意中导致一个捐献器官分配不均和医院资源特别是因为它属于单心室解剖和监督的支持。我们建议重新审视当前清单优先级的改进技术,技术和最近的数据来缓解这一现象。通过这样做,单心室患者儿科疾病可能会更公平分层在等待心脏移植。< / p > https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1058567https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1058567目前的诊断和治疗策略的管理在左心房发育不良综合症患者淋巴不足 2023 - 02 - 24 t00:00:00z 克里斯托弗·鲍尔 Yoav多丽 马里奥Scala Andreas Tulzer 杰拉尔德Tulzer < p >左心房发育不良综合症患儿分享独特的血流动力学特性,改变淋巴完整性在缓和的所有阶段。淋巴阻塞在这个病人组中几乎是通用的。它可能导致淋巴流动的逆转,淋巴管异常的发展和最终减压和损失的蛋白质丰富的淋巴流体倾向个人额外的淋巴隔间。一些最具破坏性的并发症与单心室相关生理、特别是塑料支气管炎和蛋白质失去肠病,现在已经被证明是淋巴。基于新的病理生理的概念目前已经开发出了新的诊断和治疗策略。动态对比磁共振淋巴管造影术现在主要在淋巴不足的诊断,并允许一个彻底的评估的解剖和功能主要通过intranodal淋巴隔间,肝内和intramesenteric淋巴成像。对比增强超声可以评估胸导管通畅和常规荧光镜的淋巴管造影术精炼已有评估患者的磁共振成像不能执行。小说淋巴介入技术,如胸导管栓塞,选择性淋巴导管栓塞和肝淋巴栓塞允许密封异常淋巴网络微创和显示解决症状。无名静脉疯狂下行过程、是否手术或介入设计有效地减少淋巴后负荷和增加系统的预加载失败Fontan循环。流出障碍现在可以通过新创建lympho-venous显微外科技术吻合。 Short term results for all of these new approaches are overall promising but evidence is sparse and long-term outcome still has to be defined. This review article aims to summarize current concepts of lymphatic flow disorders in single ventricle patients, discuss new emerging diagnostic and therapeutic strategies and point out lacks in evidence and needs for further research on this rapidly growing topic.

https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1111771https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1111771病例报告:扩张的表型和基因型数据TENM3-related综合症:报告的两种情况 2023 - 02 - 24 t00:00:00z 陆分 鑫徐 Bixia郑 Chunli王 魏周 剑唐 小可赵 < p > Biallelic <斜体> TENM3 < /斜体>最近报告了变异导致non-syndromic小眼与coloboma-9 (MCOPCB9)和小眼和/或缺损与发育迟缓(MCOPS15)。迄今为止,只有八个综合征和non-syndromic小眼例隐性<斜体> TENM3 < /斜体>变体已报告。在此,我们报告两个无关的新病例在<斜体> TENM3 biallelic变异< /斜体>,扩大分子和临床表现。关于病人1,韦斯揭示复合杂合变异体的<斜体> TENM3 < /斜体>基因:c.3847_3855del;p。Leu1283_Ser1285del c.3698_3699insA;p。Thr1233Thrfs * 20指数的病人,出现两国小眼,先天性白内障,头小畸型,和全球发展迟缓。关于病人2、复合错义杂合变异体的<斜体> TENM3 < /斜体>基因被确定:c.941C祝辞T;p。Ala314Val and c.6464T > C; p.Leu2155Pro in the 3-year-old boy, who presented with congenital esotropia, speech delay, and motor developmental delay. The clinical features of these two cases revealed high concordance with the previously reported cases, including microphthalmia and developmental delay. The presence of microcephaly in our patient potentially expands the neurologic phenotype associated with loss of function variants in TENM3, as microcephaly has not previously been described. Furthermore, we present evidence that missense variants in TENM3 are associated with similar, but milder, ocular features.

https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1073090https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1073090经导管动脉栓塞在新生儿病例报告:颈迅速五保供养先天性血管瘤和Kasabach-Merritt现象 2023 - 02 - 24 t00:00:00z Ying-Hsuan彭 Ming-Chih林 魏利刘 圣菱简 < p >先天性血管瘤(CHs)是一种罕见的血管肿瘤,不表现出进步产后增长。发生率小于3%的伤害。大多数CHs有良好的预后;然而,Kasabach-Merritt现象(公里)是一种罕见的但在CHs危及生命的并发症,需要积极的治疗。医学治疗糖皮质激素和干扰素已经建议。手术切除可以被认为是治疗复杂CHs病变在医学上的抵抗力。血管栓塞可能是另一种方法如果手术不认为是可行的。在此,我们报告一名9天大的新生儿接受动脉栓塞的CH公里,西罗莫司治疗相结合,结果是有利的。血管瘤完全退化迅速由3个月和五保供养先天性血管瘤(富裕)被诊断。我们与治疗的成功经验丰富与公里透露,有钱可以有潜在的严重并发症虽然他们没有治疗通常在出生后迅速解决。 Surgical resection is considered to be the standard method for the treatment of medically resistant vascular tumors, but it is difficult to perform during the active phase of KMP due to acute bleeding and severe coagulopathy. Arterial embolization is feasible and can be used as an alternative to surgical resection, even in small babies.

https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1133258https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1133258儿童肠道微生物群组成变更分析和功能分类与生长激素缺乏症 2023 - 02 - 24 t00:00:00z Congfu黄 东明孟 Yinhu李 石羊路 杨魏 吴本 Shufen陈 (杨 海鹰刘 <秒> <标题>目的< /名称> < p >研究肠道微生物群的组成和功能的变化(GM)患儿生长激素缺乏症(GHD)使用高通量测序。< / p > < /秒>Methods

Thirty-three children with GHD diagnosed in Longgang District Maternity and Child Health Hospital were included in the disease group and 24 healthy children of the same age comprised the control group. Total DNA was extracted and amplified from stool samples obtained from all subjects. High-throughput sequencing was used to analyze the GM composition and functions.

Results

The GM from the two groups of children showed significant differences in α-diversity (P < 0.05). In comparison with the control group, the abundance of the phylum Bacteroidetes was significantly higher (45.96% vs. 65.71%) while the Firmicutes count was significantly lower (47.09% vs. 25.20%). At the genus level, the abundance of Prevotella in the disease group was significantly higher (3.16% vs. 20.67%) and that of Lachnospiracea incertae sedis, Clostridium XlVa, and Megamonas was lower (6.576% vs. 1.75%; 4.51% vs. 0.80%; 5.08% vs. 2.02%, respectively). GM functions, including those involved in membrane_transport, energy_metabolism, poorly_characterized, metabolism_of_cofactors_and_vitamins, glycan_biosynthesis_and_metabolism, transcription, folding,_sorting,_and_degradation, were significantly altered in the disease group. The abundance of various GM components was correlated with endocrine hormone levels.

Conclusion

Significant alterations in the GM are seen in children with growth hormone deficiency, which may affect both energy metabolism and the levels of endocrine hormones, potentially leading to growth restriction.

https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1033793https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1033793氯胺酮和芬太尼(KetaFent)超声引导下的安全插入中心静脉导管在婴儿 2023 - 02 - 24 t00:00:00z 维托D 'Andrea Giorgia Prontera 乔凡尼的问题 乔凡尼Vento < p >集中插入中央导管(软构件的超声引导穿刺放置或brachio-cephalic颈内静脉。是至关重要的实现良好的镇静和镇痛以保持婴儿仍然从而减少程序失败的风险。本研究的目的是评估的有效性结合氯胺酮和芬太尼在中金放置过程。我们回顾性收集数据从72年婴儿接受中金插入与KetaFent镇静后协议。主要结果是评估过程的成功定义为中金公司的位置。次要结果插管过程中自冷婴儿(非侵入式通风或自然呼吸),需要重复剂量的完成过程,研究药物的时间来完成这个过程,镇痛评估使用的重要参数。在100%的情况下完成了程序。没有例低血压和结束时的过程。没有自冷婴儿进行插管。氯胺酮和芬太尼的镇静和镇痛婴儿需要插入的中金公司是100%成功。 It is associated with a low risk of side effect like apnea and intubation. Insertion of a central venous catheter is a painful procedure for infants. Adequate sedation is mandatory to keep the baby still thus reducing the risk of procedural failure.

https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2022.1022110https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2022.1022110预后因素和模型预测小儿脓毒症的死亡率:一个范围 2023 - 02年- 23 - t00:00:00z 艾琳Yuniar 削减Nurul Hafifah Sharfina Fulki Adilla Arifah努尔Shadrina 安东尼基督教Darmawan Kholisah取得 Respati w . Ranakusuma 类滇Safitri <秒> <标题> < /名称> < p >介绍几种评分系统可用来评估在儿科患者脓毒症的严重程度不同的设置。本研究调查的质量和适用性为确定小儿脓毒症的死亡率预测模型,特别是在急性护理和资源有限的设置。< / p > < /秒>Data sources

Mortality prediction factors and models were searched in four databases using the following criteria: developed for pediatric health care, especially in acute settings, and with mortality as an outcome.

Study selection

Two or more reviewers performed the study selection to ensure no bias occurred. Any disagreements were solved by consensus or by the decision of a third reviewer.

Data extraction

The authors extracted the results and mapped the selected studies qualitatively to describe the prognostic properties of the risk factors and models proposed in the study.

Data synthesis

The final analysis included 28 mortality prediction models. Their characteristics, analysis, and performance measures were summarized. Performance was described in terms of calibration and discrimination, including assessing for risk of bias and applicability. A modified version of the PRISM-III score based on physiologic criteria (PRISM-III-APS) increased its predictive value to 0.85–0.95. The vasoactive-inotropic score at 12 h had a strong independent association with death. Albumin had an excellent predictive value when combined with other variables. Lactate, a biomarker widely measured in patients with sepsis, was highly associated with mortality. The bioimpedance phase angle was not considered applicable in our setting. Measurement using more straightforward methods, such as mid-upper arm circumference, was feasible in numerous health care facilities.

Conclusion

Leveraging prognostic models to predict mortality among pediatric patients with sepsis remains an important and well-recognized area of study. While much validation and development work remains to be done, available prognostic models could aid clinicians at the bedside of children with sepsis. Furthermore, mortality prediction models are essential and valuable tools for assessing the quality of care provided to critically ill pediatric patients.

https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.891633https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.891633运动学习在高危婴儿脑瘫:一项研究协议 2023 - 02年- 23 - t00:00:00z 劳拉·a·普罗塞 朱莉Skorup 塞缪尔·r·皮尔斯 阿巴斯f . Jawad 安德鲁·h·Fagg Thubi h·a·Kolobe 贝思史密斯 <秒> <标题> < /名称> < p >背景在患有脑瘫肢体残疾(CP)创建终身流动性的挑战和医疗成本。尽管如此,很少有人了解如何对CP高危婴儿学会移动和获得早期的运动技能,终身流动奠定了基础。这个项目的目的是描述运动的进化学习在生命的头18个月为CP高危婴儿。描述运动技能是如何学习的,我们将使用机器人和传感器技术提供干预和纵向研究婴儿运动在人类运动控制的发展的三个阶段:早期自发运动,运动(爬行)倾向,直立运动(散步)。< / p > < /秒> <秒> <标题>研究设计< /名称> < p >这纵向观察/干预队列研究(ClinicalTrials.gov标识符:NCT04561232)将招收六十参与者是CP由于脑损伤的风险,一个月过期的年龄。研究参与将在18个月内完成。早期自发的腿部运动将测量每月从1到4个月大的时候使用惯性传感器戴在脚踝每月两天。高危婴儿仍在4个月大的时候,CP确定临床评估的运动机能和运动质量,将继续通过两个运动训练阶段。倾向于运动训练将从5到9个月大的时候使用一个机器人爬行训练设备,实时响应婴儿的行为。直立运动训练将从9到18个月的年龄使用动态重量支持系统允许参与者实践技能超出了他们目前的功能。重复评估运动技能,训练特征(如运动误差、可变性、运动时间和姿势控制),和变量可能调解运动期间将收集每两个月学习培训和每三个月在直立。< / p > < /秒> <秒> <标题> < /名称> < p >讨论本研究将开发预测模型随着时间的推移运动技能的习得。我们假设经历错误和纠正运动技能习得的关键在婴儿的风险CP和运动学习是由神经行为因素以外的培训。< / p > < p > <大胆> < /大胆> 1 r01hd098364-01a1项目号码。< / p > < p > <大胆> ClinicalTrials.gov标识符:< /大胆> NCT04561232 < / p > < /秒> https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1015610https://www.雷竞技rebatfrontiersin.org/articles/10.3389/fped.2023.1015610未满足的社会需求和健康的生活方式育儿行为之间的联系 2023 - 02年- 23 - t00:00:00z 凯尔西·a·伊根 人罗 梅根·珀金斯 伊内斯卡斯特罗 梅根桑德尔 卡罗琳·j·Kistin 埃尔希m . Taveras 劳伦Fiechtner <秒> <标题> < /名称> < p >客观检查横断面食品和住房协会安全风险和健康的生活方式育儿行为相关的营养和身体活动与超重/肥胖在有孩子的家庭。< / p > < /秒> <秒> <标题> < /名称> < p >的方法,我们调查了407名6 - 12岁儿童的父母与超重/肥胖。曝光是食品和住房不安全风险的措施。结果健康生活方式教育行为相关的营养和身体活动。逻辑回归模型为每个exposure-outcome关系调整的父母受教育程度、父母同居状态、家庭规模、家庭收入。< / p > < /秒>Results

In multivariable-adjusted models, food insecurity was associated with significantly lower odds of parent modeling exercise {aOR 0.60 [95% confidence interval (CI): 0.37, 0.96]} and parent modeling eating healthy foods [aOR 0.42 (95% CI: 0.24, 0.73)]. Housing insecurity was associated with significantly lower odds of parent modeling exercise [aOR 0.57 (95% CI: 0.35, 0.95)].

Conclusions

Food insecurity and housing insecurity may be barriers to parents adopting and modeling healthy lifestyle parenting behaviors related to physical activity and nutrition.