Background:
Studies of preterm and term-born infants have shown absent fidgety movements and an abnormal movement character to be related to brain lesions and unfavourable neurological outcomes.
...Aims:
The present study examines what effect a parent-administered early intervention program applied to preterm infants in a randomised control trial (RCT) between 34 and 36 weeks gestational age has on their fidgety movements and overall movement character at three months of age.
Study design:
The study was part of the RCT in an early intervention programme including preterm infants born between 2010 and 2014 at three Norwegian university hospitals.
Subjects:
130 preterm infants participated in the study, with 59 of them in the control group and 71 in the intervention group.
Outcome measures:
Fidgety movements and overall movement character at three months corrected age.
Results:
No difference was found between the intervention group and the control group in terms of fidgety movements or movement character. Approximately half of the infants in both groups showed an abnormal movement character.
Conclusion:
No evidence was found in this RCT to suggest that an intervention at 34 to 37 weeks gestational age has a significant effect on the fidgety movements or overall movement character of preterm infants. This is in line with the assumption that absent fidgety movements and an abnormal movement character are due to permanent brain injury and are therefore good predictors for later neurological impairments.
Hospital social workers often engage in health literacy activities to support patients' and families' functioning and adjustment to illness, but social work literature has seldom used health literacy ...terminology. This paper reports on a qualitative study of paediatric hospital social workers' understanding of the needs of parents with acutely ill children and how their contributions may accommodate these needs to strengthen parental health literacy. Utilising systematic text condensation, the study reveals four themes: (1) understanding of medical information, (2) counselling and service coordination, (3) emotional needs, and (4) timing of information. The findings suggest that hospital social workers make valuable additions to health literacy.
Human immunodeficiency virus (HIV)-related chronic lung disease (CLD) among children is associated with substantial morbidity, despite antiretroviral therapy. This may be a consequence of repeated ...respiratory tract infections and/or dysregulated immune activation that accompanies HIV infection. Macrolides have anti-inflammatory and antimicrobial properties, and we hypothesised that azithromycin would reduce decline in lung function and morbidity through preventing respiratory tract infections and controlling systemic inflammation.
We are conducting a multicentre (Malawi and Zimbabwe), double-blind, randomised controlled trial of a 12-month course of weekly azithromycin versus placebo. The primary outcome is the mean change in forced expiratory volume in 1 second (FEV
) z-score at 12 months. Participants are followed up to 18 months to explore the durability of effect. Secondary outcomes are FEV
z-score at 18 months, time to death, time to first acute respiratory exacerbation, number of exacerbations, number of hospitalisations, weight for age z-score at 12 and 18 months, number of adverse events, number of malaria episodes, number of bloodstream Salmonella typhi infections and number of gastroenteritis episodes. Participants will be followed up 3-monthly, and lung function will be assessed every 6 months. Laboratory substudies will be done to investigate the impact of azithromycin on systemic inflammation and on development of antimicrobial resistance as well as impact on the nasopharyngeal, lung and gut microbiome.
The results of this trial will be of clinical relevance because there are no established guidelines on the treatment and management of HIV-associated CLD in children in sub-Saharan Africa, where 80% of the world's HIV-infected children live and where HIV-associated CLD is highly prevalent.
ClinicalTrials.gov, NCT02426112 . Registered on 21 April 2015.
Purpose: We here aimed to examine the epidemiologic features and treatment outcomes of pediatric pulmonary tuberculosis cases who were registered to the Adana Tuberculosis Dispensaries.
Materials and ...Methods: Fifty-six pediatric patients aged 0-18 years with the diagnosis of pulmonary tuberculosis were examined retrospectively in terms of demographic data, clinical characteristics and drug susceptibility test results, as well as treatment outcomes. Data were collected through medical record review.
Results: The mean age of the patients was 12.84 ± 5.62 years and 46.4% were female. Nine patients (16%) were aged 0-5 years, 4 (7.1%) were aged 5-10 years, 17 (30.3%) were aged 10-15 years and 26 patients (46.4%) were aged 15-18 years. Fourty-eight children was only pulmonary tuberculosis whereas eight possessed characteristics of both pulmonary and extrapulmonary tuberculosis. The most frequent symptoms were prolonged cough (80.3%) and weight loss (73.2%). Drug susceptibility test was performed only 22 patients. Multidrug resistance was determined in one patient. Among the 56 children for whom treatment outcome was documented, 39 (69.6%) were completed treatment, 16 (28.5%) were cured and 1 (1.7%) had treatment failure.
Conclusion: It was observed that the signs and symptoms of our patients were compatible with the literature. The epidemiological characterization of pediatric patients with pulmonary tuberculosis helps to provide a better diagnostic approach in this population.
Amaç: Pediatrik tüberküloz dünya çapında tüberküloz yükünün önemli bir kısmını oluşturmaktadır. Pediatrik tüberküloz toplumda tüberküloz yükünün devam ettiğini göstermesi bakımından da önemlidir. Çalışmamızda Adana ili Tüberküloz Dispanserlerine kayıtlı olan pediatrik pulmoner tüberküloz olgularının epidemiyolojik özelliklerini ve tedavi sonuçlarını incelemeyi amaçladık.
Gereç ve Yöntemler: Pulmoner tüberküloz tanısı konan 0-18 yaş arası 56 çocuk demografik veriler, klinik özellikler, ilaç duyarlılık testi ve tedavi sonuçları açısından geriye dönük olarak incelenmiştir. Veriler tıbbi kayıtlardan elde edilmiştir.
Bulgular: Yaş ortalaması 12,84 ± 5,62 olan olguların %46,4’ü kız idi. Sıfır-5 yaş arası 9 olgu (%16), 5-10 yaş arası 4 olgu (%7,1), 10-15 yaş arası 17 olgu (%30,3), 15-18 yaş arası 26 olgu (%46,4) vardı. Kırk sekiz çocukta sadece akciğer, sekizinde hem akciğer hem de akciğer dışı tutulum vardı. En sık görülen semptomlar uzun süren öksürük (%80,3) ve kilo kaybı (%73,2) idi. Sadece 22 hastaya ilaç duyarlılık testi uygulandı. Bir hastada çoklu ilaç direnci belirlendi. Tedavi sonuçları incelenen 56 çocuktan 39'u (%69,6) tedavisini tamamladı, 16'sında (%28,5) kür ve 1'inde (%1,7) tedavi başarısızlığı olduğu kaydedildi.
Sonuç: Hastalarımızın belirti ve bulgularının literatür ile uyumlu olduğu gözlendi. Pediatrik pulmoner tüberküloz olgularının epidemiyolojik karakterizasyonu, bu populasyonda daha iyi bir tanı yaklaşımının elde edilmesine yardımcı olacaktır.
Selection and usage of rational drugs determine the success of expected therapeutic effect, especially for pediatrics. Acute bronchitis in pediatrics is one of the highest incidents of Acute ...Respiratory Infection (ARI) in Army Hospital Kartika Husada Kubu Raya. This study aimed to evaluate rationality of drug doses conformity in outpatient pediatric acute bronchitis in Army Hospital Kartika Husada Kubu Raya on 2015. This research was a descriptive observational research with cross-sectional design. The sample was taken with purpossive sampling amounted to 36 prescriptions. Then the evaluation of drug doses conformity was counted based the literature. The results showed that drugs which were used for acute bronchitis were mucolitics and expectorants, antibiotics, bronchodilators, multivitamins, decongestans, analgesics, and antihistamins. The result of drug dosage conformity evaluation showed that the under-dose drug item (R/) was 51%, over-dose was 15% and appropriate dose was 34%.
Cedera otak traumatik merupakan penyebab terbanyak kecacatan dan kematian pada anak dan orang dewasa. Di Amerika Serikat, terjadi lebih dari 510.000 kasus cedera otak traumatik per tahun pada ...anak-anak usia 0-14 tahun;1 dengan 2.000–3.000 di antaranya meninggal setiap tahunnya. Tujuan dari penanganan cedera otak traumatik selain menangani cedera primernya, juga untuk mencegah terjadinya cedera sekunder. Seorang anak laki-laki usia 12 tahun mengalami kecelakaan lalu lintas dan didiagnosis dengan cedera otak traumatik sedang, fraktur impresi regio temporo parietal kanan dan edema serebri dengan komorbiditas anemia, rencana akan dilakukan pembedahan darurat untuk debridement, eksplorasi duramater dan rekonstruksi tulang. Pembedahan dilakukan dengan anestesi umum intubasi endotrakeal dan berjalan selama tujuh jam. Kondisi pasien selama pembedahan relatif stabil dan setelahnya dirawat di Ruang Observasi Intensif dengan bantuan ventilator. Setelah memastikan kondisi ekstrakranial normal, pasien kemudian disapih dari ventilator dan diekstubasi keesokan harinya. Pasien dipulangkan pada hari kedelapan setelah kejadian. Anesthesia Management in Pediatric Patient with Moderate Traumatic Brain Injury, Impression Fracture and Cerebral Oedema Traumatic brain injury is the leading cause of morbidity and mortality in pediatric and adult patients. In United States, 510,000 cases of traumatic brain injury occur each year in children aged 0-14 years;1 with 2.000-3.000 pass away each year. Cure the primary insult and prevent secondary injury are the important thing in traumatic brain injury. A 12-year-old boy had a motor vehicle accident and was diagnosed with moderate traumatic brain injury, impression fracture at the right temporo parietal region and cerebral edema, with anemia, planned for emergency surgery of debridement, duramater exploration and bone reconstruction. Surgery was done under general anesthesia using endotracheal intubation and lasted for seven hours. Patient’s condition remained relatively stable during surgery and was observed with ventilator supported in Intensive Observation Ward afterward. Once extracranial factors considered normal, patient was weaned and extubated the next day. Patient was sent home on the eight day after incident. Cedera otak traumatik merupakan penyebab terbanyak kecacatan dan kematian pada anak dan orang dewasa. Di Amerika Serikat, terjadi lebih dari 510.000 kasus cedera otak traumatik per tahun pada anak-anak usia 0-14 tahun;1 dengan 2.000–3.000 di antaranya meninggal setiap tahunnya. Tujuan dari penanganan cedera otak traumatik selain menangani cedera primernya, juga untuk mencegah terjadinya cedera sekunder. Seorang anak laki-laki usia 12 tahun mengalami kecelakaan lalu lintas dan didiagnosis dengan cedera otak traumatik sedang, fraktur impresi regio temporo parietal kanan dan edema serebri dengan komorbiditas anemia, rencana akan dilakukan pembedahan darurat untuk debridement, eksplorasi duramater dan rekonstruksi tulang. Pembedahan dilakukan dengan anestesi umum intubasi endotrakeal dan berjalan selama tujuh jam. Kondisi pasien selama pembedahan relatif stabil dan setelahnya dirawat di Ruang Observasi Intensif dengan bantuan ventilator. Setelah memastikan kondisi ekstrakranial normal, pasien kemudian disapih dari ventilator dan diekstubasi keesokan harinya. Pasien dipulangkan pada hari kedelapan setelah kejadian.
Latar belakang. Sejak tahun 2000 hingga kuartal I tahun 2005 angka kunjunganpasien rawat jalan mengalami penurunan secara gradual di Unit Rawat Jalan DepartemenIlmu Kesehatan Anak Rumah Sakit Umum ...Pusat Dr. Cipto Mangunkusumo (URJDepartemen IKA RSUP CM) Jakarta. Kecenderungan penurunan angka kunjunganpasien merupakan indikator bagi pengelola untuk meninjau kembali strategi pelayanandi Pediatri Rawat Jalan.Tujuan Penelitian. Meneliti tingkat kepuasan orangtua pasien yang membawa anaknyaberobat jalan di URJ Departemen IKA RSCM.Metoda penelitian. Studi survai deskriptif dengan metode potong lintang (crosssectional) dilakukan di URJ Departemen IKA RSCM dalam kurun waktu Agustus –Nopember 2005. Pengumpulan data primer menggunakan kuesioner yang terstrukturberisi 30 pertanyaan.Hasil penelitian. Dari 144 orang tua pasien, enam puluh dua persen orangtua pasienmerasa puas terhadap kualitas pelayanan, skor kepuasan total terhadap dimensi kualitaspelayanan 3,55 (puas). Bukti fisik (tangibility) memberi skor kepuasan tertinggisedangkan kehandalan pelayanan (reliability) memberi skor kepuasan terendah bagiorangtua pasien.Kesimpulan. Kualitas pelayanan di URJ Departemen IKA RSCM memuaskan (skor3,55) dan persentase orangtua pasien yang puas 62%.
The aim of our study was to assess associations between smoking behavior before and during pregnancy and selected adverse birth outcomes. This study is based on the Murmansk County Birth Registry ...(MCBR). Our study includes women who delivered a singleton pregnancy after 37 weeks of gestation (N = 44,486). Smoking information was self-reported and assessed at the first antenatal visit during pregnancy. We adjusted for potential confounders using logistic regression. The highest proportion of infants with low values of birth weight, birth length, head circumference, ponderal index and of the Apgar score at 5 min was observed for women who smoked both before and during pregnancy. We observed a dose-response relationship between the number of cigarettes smoked per day during pregnancy and the odds of the aforementioned adverse birth outcomes; neither were there significant differences in their occurrences among non-smokers and those who smoked before but not during pregnancy. Moreover, smoking reduction during pregnancy relative to its pre-gestation level did not influence the odds of the adverse birth outcomes. Our findings emphasize a continued need for action against tobacco smoking during pregnancy.
Aim: Plate fixation and titanium elastic nailing are conventional surgical treatment modalities for both-bone forearm fractures in children. The purpose of this study is to assess the functional and ...radiographic results of these techniques and compare with literature. Patient and Methods: We evaluated data of 36 children retrospectively. Twelve of the patients (group 1; 1 girls, 11 boys, age range 9-15 years) were treated by open reduction plate fixation and 24 of the children (group 2; 3 girls, 21 boys, age range 9-14 years) were treated by closed reduction intramedullary nailing. Mean total time from fracture until the surgery was 4.3 and 6.1 days in group 1 and 2, respectively. We compared the groups according to union duration, the number and the severity of the complications and clinical outcomes according to Price criteria. Results: Mean follow-up duration was 22.0 months in group 1 and 19.7 months in group 2. Mean age was 13.0±1.2 years and 11.7±1.6 years in group 1 and 2, respectively. According to Price criteria, we obtained no poor outcomes in both groups. The rate of excellent outcome was 75% and 87.5 % in group 1 and 2, respectively. Union was obtained in 7.6 weeks and 6.7 weeks in group 1 and 2, respectively; this difference was statistically significant (p<0.001). The rate of major complication was 8.3% in group 1. There were none in group 2. Conclusion: According to our results, a favorable technique for pediatric both-bone forearm fractures requiring surgical treatment may be titanium elastic nailing because of better clinical outcomes and fewer and less severe complications.
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