AIM:To quantitatively assess the changes in mean vascular tortuosity(mVT)and mean vascular width(mVW)around the optic disc and their correlation with gestational age(GA)and birth weight(BW)in premature infants without...AIM:To quantitatively assess the changes in mean vascular tortuosity(mVT)and mean vascular width(mVW)around the optic disc and their correlation with gestational age(GA)and birth weight(BW)in premature infants without retinopathy of prematurity(ROP).METHODS:A single-center retrospective study included a total of 133(133 eyes)premature infants[mean corrected gestational age(CGA)43.6wk]without ROP as the premature group and 130(130 eyes)CGA-matched fullterm infants as the control group.The peripapillary mVT and mVW were quantitatively measured using computerassisted techniques.RESULTS:Premature infants had significantly higher mVT(P=0.0032)and lower mVW(P=0.0086)by 2.68(10^(4) cm^(-3))and 1.85μm,respectively.Subgroup analysis with GA showed significant differences(P=0.0244)in mVT between the early preterm and middle to late preterm groups,but the differences between mVW were not significant(P=0.6652).The results of the multiple linear regression model showed a significant negative correlation between GA and BW with mVT after adjusting sex and CGA(P=0.0211 and P=0.0006,respectively).For each day increase in GA at birth,mVT decreased by 0.1281(10^(4) cm^(-3))and for each 1 g increase in BW,mVT decreased by 0.006(10^(4) cm^(-3)).However,GA(P=0.9402)and BW(P=0.7275)were not significantly correlated with mVW.CONCLUSION:Preterm birth significantly affects the peripapillary vascular parameters that indicate higher mVT and narrower mVW in premature infants without ROP.Alterations in these parameters may provide new insights into the pathogenesis of ocular vascular disease.展开更多
BACKGROUND Being too light at birth can increase the risk of various diseases during infancy.AIM To explore the effect of perinatal factors on term low-birth-weight(LBW)infants and build a predictive model.This model ...BACKGROUND Being too light at birth can increase the risk of various diseases during infancy.AIM To explore the effect of perinatal factors on term low-birth-weight(LBW)infants and build a predictive model.This model aims to guide the clinical management of pregnant women’s healthcare during pregnancy and support the healthy growth of newborns.METHODS A retrospective analysis was conducted on data from 1794 single full-term pregnant women who gave birth.Newborns were grouped based on birth weight:Those with birth weight<2.5 kg were classified as the low-weight group,and those with birth weight between 2.5 kg and 4 kg were included in the normal group.Multiple logistic regression analysis was used to identify the factors influencing the occurrence of full-term LBW.A risk prediction model was established based on the analysis results.The effectiveness of the model was analyzed using the Hosmer–Leme show test and receiver operating characteristic(ROC)curve to verify the accuracy of the predictions.RESULTS Among the 1794 pregnant women,there were 62 cases of neonatal weight<2.5 kg,resulting in an LBW incidence rate of 3.46%.The factors influencing full-term LBW included low maternal education level[odds ratio(OR)=1.416],fewer prenatal examinations(OR=2.907),insufficient weight gain during pregnancy(OR=3.695),irregular calcium supplementation during pregnancy(OR=1.756),and pregnancy hypertension syndrome(OR=2.192).The prediction model equation was obtained as follows:Logit(P)=0.348×maternal education level+1.067×number of prenatal examinations+1.307×insufficient weight gain during pregnancy+0.563×irregular calcium supplementation during pregnancy+0.785×pregnancy hypertension syndrome−29.164.The area under the ROC curve for this model was 0.853,with a sensitivity of 0.852 and a specificity of 0.821.The Hosmer–Leme show test yieldedχ^(2)=2.185,P=0.449,indicating a good fit.The overall accuracy of the clinical validation model was 81.67%.CONCLUSION The occurrence of full-term LBW is related to maternal education,the number of prenatal examinations,weight gain during pregnancy,calcium supplementation during pregnancy,and pregnancy-induced hypertension.The constructed predictive model can effectively predict the risk of full-term LBW.展开更多
BACKGROUND In endemic areas,vertical transmission of hepatitis B virus(HBV)remains a major source of the global reservoir of infected people.Eliminating mother-to-child transmission(MTCT)of HBV is at the heart of Worl...BACKGROUND In endemic areas,vertical transmission of hepatitis B virus(HBV)remains a major source of the global reservoir of infected people.Eliminating mother-to-child transmission(MTCT)of HBV is at the heart of World Health Organization’s goal of reducing the incidence of HBV in children to less than 0.1%by 2030.Universal screening for hepatitis B during pregnancy and neonatal vaccination are the main preventive measures.AIM To evaluate the efficacy of HBV vaccination combined with one dose of immunoglobulin in children born to hepatitis B surface antigen(HBsAg)-positive mothers in Djibouti city.METHODS We conducted a study in a prospective cohort of HBsAg-positive pregnant women and their infants.The study ran from January 2021 to May 2022,and infants were followed up to 7 mo of age.HBV serological markers and viral load in pregnant women were measured using aVidas microparticle enzyme-linked immunosorbent assay(Biomérieux,Paris,France)and the automated Amplix platform(Biosynex,Strasbourg,France).All infants received hepatitis B immunoglobulin and were vaccinated against HBV at birth.These infants were closely monitored to assess their seroprotective response and for failure of immunoprophylaxis.Simple logistic regression was also used to identify risk factors associated with immunoprophylaxis failure and poor vaccine response.All statistical analyses were performed with version 4.0.1 of the R software.RESULTS Of the 50 pregnant women recruited,the median age was 31 years,ranging from 18 years to 41 years.The MTCT rate in this cohort was 4%(2/50)in HBsAg-positive women and 67%(2/3)in hepatitis B e antigen-positive women with a viral load>200000 IU/mL.Of the 48 infants who did not fail immunoprophylaxis,8(16%)became poor responders(anti-HB<100 mIU/mL)after HBV vaccination and hepatitis B immunoglobulin,while 40(84%)infants achieved a good level of seroprotection(anti-HB>100 mIU/mL).Factors associated with this failure of immunoprophylaxis were maternal HBV DNA levels(>200000 IU/mL)and hepatitis B e antigen-positive status(odds ratio=158,95%confidence interval:5.05-4958,P<0.01).Birth weight<2500 g was associated with a poor immune response to vaccination(odds ratio=34,95%confidence interval:3.01-383.86,P<0.01).CONCLUSION Despite a failure rate of immunoprophylaxis higher than the World Health Organization target,this study showed that the combination of immunoglobulin and HBV vaccine was effective in preventing MTCT of HBV.Therefore,further studies are needed to better understand the challenges associated with immunoprophylaxis failure in infants in Djibouti city.展开更多
Appropriate feeding practices are important during infancy for good health, growth and development of infants and children. WHO revised its earlier recommendation of Exclusive Breastfeeding (EBF) of infants from 4 to ...Appropriate feeding practices are important during infancy for good health, growth and development of infants and children. WHO revised its earlier recommendation of Exclusive Breastfeeding (EBF) of infants from 4 to 6 months of age to EBF until about 6 months of age, with the addition of complementary foods thereafter. This recommendation confirms that breast milk alone is sufficient to meet infants’ nutritional requirements for the first 6 months of life. The main objective of this study was to investigate the effect of various feeding practices on the Nutritional status of infants 0 - 12-month-old in the Kumba 1 Sub-Division. A descriptive cross-sectional study was conducted from December 2019 to August 2020. A total of 341 nursing mothers and their infants 0 - 12 months of age were recruited. Socio-demographic factors and the different feeding habits of the children were assessed using a semi-structured questionnaire. Nutritional status was assessed using anthropometric measurements. The overall proportion of infants who exclusively breastfed for 6 months was 69.2% and those who were mix-fed were 30.8% in the study area. The overall prevalence of malnutrition in the population was 61.0%. Among the malnourished children, 53.1% were underweight, 19.6% were wasted and 10.0% were stunted. Though not significant, the prevalence of wasting (21.0%) and underweight (58.3%) was higher among Mix-Fed (MF) children when compared to their EBF counterparts. Feeding practices affected the nutritional status of the infants. Underweight and wasting were observed among infants on Complementary Feeding (CF), although some exclusively breast-fed infants were stunted. Hence, nursing mothers should try as much as possible to practice EBF as recommended by WHO and can practice CF when the child is above six months.展开更多
Objective:To study the effective value of introducing the concept of early oral exercise in the process of nursing intervention for preterm infants in the neonatal intensive care unit(NICU).Methods:96 cases of preterm...Objective:To study the effective value of introducing the concept of early oral exercise in the process of nursing intervention for preterm infants in the neonatal intensive care unit(NICU).Methods:96 cases of preterm infants diagnosed from January 2022 to August 2022 were selected and randomly divided into two groups:the general practice group(general nursing intervention),and the early practice group(early oral exercise intervention),and the effect of intervention on preterm infants in the two groups was observed.Results:After nursing care,the mean value of the non-nutritive sucking ability assessment(76.54±5.82),the mean value of the intellectual development degree assessment(104.57±8.45),the mean value of the psychomotor development degree assessment(102.33±6.74),and the mean value of behavioral neural reflexes ability assessment(38.71±2.40)in the early practice group were better than that as compared to the general practice group(P<0.05);the mean value of oral feeding start time of preterm infants in the early practice group(35.42±7.63)weeks,the mean value of all oral feeding time(34.12±5.28)weeks,and the mean time of hospital intervention(15.33±4.25)days were lesser than compared to those of the general practice group at 37.4±5.82 weeks,37.46±3.55 weeks,and 20.46±2.91 days,respectively(P<0.05);the rate of adverse reactions in preterm infants in the early practice group significantly lower than that of the general practice group(P<0.05).Conclusion:The introduction of the concept of early oral exercise intervention among NICU nurses improved the feeding effect,sucking ability of preterm infants,and intellectual development.Hence,early oral motor care should be popularized.展开更多
BACKGROUND Preterm birth is the leading cause of mortality in newborns,with very-low-birthweight infants usually experiencing several complications.Breast milk is considered the gold standard of nutrition,especially f...BACKGROUND Preterm birth is the leading cause of mortality in newborns,with very-low-birthweight infants usually experiencing several complications.Breast milk is considered the gold standard of nutrition,especially for preterm infants with delayed gut colonization,because it contains beneficial microorganisms,such as Lactobacilli and Bifidobacteria.AIM To analyze the gut microbiota of breastfed preterm infants with a birth weight of 1500 g or less.METHODS An observational study was performed on preterm infants with up to 36.6 wk of gestation and a birth weight of 1500 g or less,born at the University Hospital Dr.JoséEleuterio González at Monterrey,Mexico.A total of 40 preterm neonates were classified into breast milk feeding(BM)and mixed feeding(MF)groups(21 in the BM group and 19 in the MF group),from October 2017 to June 2019.Fecal samples were collected before they were introduced to any feeding type.After full enteral feeding was achieved,the composition of the gut microbiota was analyzed using 16S rRNA gene sequencing.Numerical variables were compared using Student’s t-test or using the Mann–Whitney U test for nonparametric variables.Dominance,evenness,equitability,Margalef’s index,Fisher’s alpha,Chao-1 index,and Shannon’s diversity index were also calculated.RESULTS No significant differences were observed at the genus level between the groups.Class comparison indicated higher counts of Alphaproteobacteria and Betaproteobacteria in the initial compared to the final sample of the BM group(P<0.011).In addition,higher counts of Gammaproteobacteria were detected in the final than in the initial sample(P=0.040).According to the Margalef index,Fisher’s alpha,and Chao-1 index,a decrease in species richness from the initial to the final sample,regardless of the feeding type,was observed(P<0.050).The four predominant phyla were Bacteroidetes,Actinobacteria,Firmicutes,and Proteobacteria,with Proteobacteria being the most abundant.However,no significant differences were observed between the initial and final samples at the phylum level.CONCLUSION Breastfeeding is associated with a decrease in Alphaproteobacteria and Betaproteobacteria and an increase of Gammaproteobacteria,contributing to the literature of the gut microbiota structure of very low-birth-weight,preterm.展开更多
Button cell ingestion is a common household accident among infants, often leading to serious complications that require immediate diagnosis and urgent removal. We report five cases of button cell ingestion involving i...Button cell ingestion is a common household accident among infants, often leading to serious complications that require immediate diagnosis and urgent removal. We report five cases of button cell ingestion involving infants aged between 9 and 32 months, including four boys and one girl. The ingestion was accidentally discovered in two infants, while in the other three, it was suspected during play. In three cases, mothers attempted to induce vomiting by giving fluids, but the batteries remained in the digestive tract for 38 hours to 5 days. After confirming the diagnosis, the batteries were removed within 4 to 36 hours. The locations of the cells were the esophagus in two cases, the cardia in one, the stomach in one, and the bowel in one. One case involved a large cell in the esophagus, while the others involved smaller cells. Complications occurred in four cases, including esotracheal fistula, esophageal ulceration, and perforation of the jejunum and caecum. In one case, the digestive mucosa appeared normal upon endoscopy. One patient died.展开更多
Introduction: Acute intestinal intussusception (AII) has been known for a long time but its diagnosis sometimes remains difficult and its etiologies, particularly the idiopathic forms, poorly elucidated. The objective...Introduction: Acute intestinal intussusception (AII) has been known for a long time but its diagnosis sometimes remains difficult and its etiologies, particularly the idiopathic forms, poorly elucidated. The objective of this study was to describe the clinical and therapeutic aspects of acute intestinal intussusception in order to contribute to the improvement of the management of this condition in the pediatric surgery department of the Donka National Hospital. Materials and Methods: This is a retrospective descriptive study of patients taken in charge of acute idiopathic intestinal intussusception over a period of 7 years (January 2017 to December 31, 2023). Results: We collected 72 patients operated on for IIA, i.e. a hospital frequency of 1.1% and an incidence of 10.3 cases per year. The mean age was 16.58 months with extremes of 3 months and 28 months. The sex ratio was 12.5 in favor of the boy. The triad of ombredanne dominated the clinical picture and paroxysmal abdominal pain with period of calm represented the main reason for consultation (72 cases) i.e. 100%, followed by vomiting (62 cases) and rectal bleeding (50 cases). Ultrasound was performed in 56 patients visualizing the intussusception sausage in 54 patients or 75%. The most common anatomoclinical variety of intussusception was the ileo-caeco-colic form with 35 cases (or 38%) followed by the ileocolic form 24 cases (33%). The surgical procedure performed was a manual reduction in 54 patients or 75% and an anastomosis resection in 18 patients;the appendectomy of principle was done in 62.25%. The postoperative course was simple in 64 patients or 88.88%. The mortality rate was 6.94 %. Conclusion: AII is a common abdominal surgical emergency in infants. Recognition of the Ombredanne triad especially abdominal pain with a period of calm in children and infants in particular is an important element for vital prognosis. Early diagnosis and close interdisciplinary cooperation between pediatric, radiology and pediatric surgery teams could improve the management of IIA and allow this condition to remain benign in children.展开更多
BACKGROUND Bronchiolitis is a common lower respiratory tract infection in infants and young children.Severe cases may be accompanied by obvious dyspnea and oxygen saturation decline.AIM To summarize the clinical featu...BACKGROUND Bronchiolitis is a common lower respiratory tract infection in infants and young children.Severe cases may be accompanied by obvious dyspnea and oxygen saturation decline.AIM To summarize the clinical features,standard diagnosis,and treatment of bronchi-olitis.METHODS This is a retrospective analysis of 114 pediatric patients(74 males,40 females)who were first diagnosed as having bronchioles at the Department of Pediatrics of Tongling Maternal and Child Health Hospital from January 2019 to December 2019.The clinical features,imaging features,treatment,and other clinical data were recorded and analyzed.RESULTS The age of onset of the disease was mainly from 1 mo to 6 mo(75.4%),and the time to hospital visit was mostly from the 2nd day to the 4th day of the course of the disease(75.4%).Lung imaging examination showed increase in lung texture,fuzzy(93.8%).The main treatment was atomization therapy:Budesonide combined with terbutaline(45.6%)and budesonide combined with salbutamol(38.5%).The average hospitalization time was 7.1±2.4 d,and the overall cure rate was 94.7%.In patients without bacterial infection,the use of antibiotics significantly prolonged the length of hospital stay(7.8±2.5 d vs 5.7±1.8 d)and improved the cure rate(98.3%vs 87.9%,P<0.05).CONCLUSION Infants with bronchiolitis are mainly male and tend to have a good prognosis.However,the unneeded use of antibiotics may prolong the length of hospital stay significantly,which imposes the burden both on the patients and hospital system.CONCLUSION Bronchiolitis is a common acute respiratory infectious disease in infants and young children.It mainly affects male children and the age onset is between 1 to 6 mo.The standard use of antibiotics should be emphasized in view of the prolonged average length of hospital stay between the antibiotic treatment group and the non-antibiotic treatment group.When the course of disease is more than 7 d or the treatment effect is poor,active anti-infective treatment is needed to improve the long-term prognosis.Very few children have recurrent cough and wheezing symptoms within 1 year,which may be related to the risk of later asthma attack.FOOTNOTES Author contributions:Shi C and Wu MH contributed to study conception and design,and provision of study materials or patients;Shi C contributed to administrative support;Zuo A,Yang MM,and Jiang RR contributed to data collection and assembly;Shi C contributed to data analysis and interpretation,and manuscript writing;all authors contributed to the final approval of the manuscript.Institutional review board statement:The study was conducted in accordance with the Declaration of Helsinki(as revised in 2013).The study was approved by Institutional Review Board of Tongling Maternal and Child Health Hospital.展开更多
BACKGROUND Breast milk is the best and principal nutritional source for neonates and infants.It may protect infants against many metabolic diseases,predominantly obesity and type 2 diabetes.Diabetes mellitus(DM)is a c...BACKGROUND Breast milk is the best and principal nutritional source for neonates and infants.It may protect infants against many metabolic diseases,predominantly obesity and type 2 diabetes.Diabetes mellitus(DM)is a chronic metabolic and microvascular disease that affects all the body systems and all ages from intrauterine life to late adulthood.Breastfeeding protects against infant mortality and diseases,such as necrotizing enterocolitis,diarrhoea,respiratory infections,viral and bacterial infection,eczema,allergic rhinitis,asthma,food allergies,malocclusion,dental caries,Crohn's disease,and ulcerative colitis.It also protects against obesity and insulin resistance and increases intelligence and mental development.Gestational diabetes has short and long-term impacts on infants of diabetic mothers(IDM).Breast milk composition changes in mothers with gestational diabetes.AIM To investigate the beneficial or detrimental effects of breastfeeding on the cardiometabolic health of IDM and their mothers.METHODS We performed a database search on different engines and a thorough literature review and included 121 research published in English between January 2000 and December 15,2022,in this review.RESULTS Most of the literature agreed on the beneficial effects of breast milk for both the mother and the infant in the short and long terms.Breastfeeding protects mothers with gestational diabetes against obesity and type 2 DM.Despite some evidence of the protective effects of breastfeeding on IDM in the short and long term,the evidence is not strong enough due to the presence of many confounding factors and a lack of sufficient studies.CONCLUSION We need more comprehensive research to prove these effects.Despite many obstacles that may enface mothers with gestational diabetes to start and maintain breastfeeding,every effort should be made to encourage them to breastfeed.展开更多
BACKGROUND Salmonella derby(S.derby)is a Gram-negative diplococcus that is common in the digestive tract.Infected patients generally experience symptoms such as fever and diarrhea.Mild cases are mostly self-healing ga...BACKGROUND Salmonella derby(S.derby)is a Gram-negative diplococcus that is common in the digestive tract.Infected patients generally experience symptoms such as fever and diarrhea.Mild cases are mostly self-healing gastroenteritis,and severe cases can cause fatal typhoid fever.Clinical cases are more common in children.The most common form of S.derby infection is self-healing gastroenteritis,in which,fever lasts for about 2 d and diarrhea for<7 d.S.derby can often cause bacterial conjunctivitis,pneumonia,endocarditis,peritonitis and urethritis.However,intracranial infections in infants caused by S.derby are rare in clinical practice and have not been reported before in China.CASE SUMMARY A 4-mo-old female infant had recurrent fever for 2 wk,with a maximum body temperature of around 39.4°C.Treatment for infectious fever in a local hospital was ineffective,and she was admitted to our hospital.Before admission,there was one sudden convulsion,characterized by unclear consciousness,limb twitching,gaze in both eyes,and slight cyanosis on the face.Cerebrospinal fluid(CSF)culture was positive for Gram-negative bacilli,which conformed to S.derby.After treatment with meropenem and ceftriaxone antibiotics,the patient was discharged home in a clinically stable state after 4 wk of treatment.CONCLUSION We reported a rare case of S.derby cultured in CSF.S.derby enters the CSF through the blood–brain barrier,causing purulent meningitis.If not treated timeously,it can lead to serious,life-threatening infection.展开更多
Infant intestinal microbiome is closely linked with health and risk of disease. Bifidobacterium are important components of the infant gut and are known to confer various health effects on the host. However, few studi...Infant intestinal microbiome is closely linked with health and risk of disease. Bifidobacterium are important components of the infant gut and are known to confer various health effects on the host. However, few studies have described the precise composition and dynamics of early infant gut bifidobacterial communities. Thus, this was a pilot study aiming to describe the developmental trajectories and temporal dynamics of bifidobacterial communities in infants before 6 months of age. A total of 28 fecal samples from 4 infants(GF, ZZ, QM, TN, respectively)were collected and analyzed after 5, 15, 30, 60, 90, 120, 150, and 180 days of birth by a bifidobacteria-target method(based on single-molecule real-time sequencing of partial bifidobacterial rpsK genes)in conjunction with droplet digital polymerase chain reaction(ddPCR). The infant fecal microbiota comprised a total of 11 bifidobacterial species, including 4 major species, i.e., B. dentium(37.35%), B. catenulatum(32.04%), B. breve(22.24%), and B. animalis(8.02%). The infant microbiota showed highly individualized developmental trajectories. The leading species for GF was B. catenulatum, with a relatively stable developmental trajectory. In ZZ, B. breve was enriched, and the developmental trajectory was rather fluctuating. The most abundant species for QM and TN was B. dentium. The developmental trajectory of B. dentium in QM showed a trend of gradual decrease, whereas an opposite trend was seen in samples of TN. The results of ddPCR confirmed large variations in quantities of bifidobacteria between infants and suggested discordances in temporal dynamics of bifidobacterial communities during the first half year of infancy. In conclusion, our results suggested that the early infant gut bifidobacterial microbiota was highly complex and temporal dynamics, with individualized developmental trajectories, which should be considered in future research of infant gut microbiota.展开更多
Background:Persistent patent ductus arteriosus(pPDA)is a common condition in preterm infants.This metaanalysis aimed to assess the safety and efficacy of transcatheter closure(TC)when compared to surgical ligation(SL)...Background:Persistent patent ductus arteriosus(pPDA)is a common condition in preterm infants.This metaanalysis aimed to assess the safety and efficacy of transcatheter closure(TC)when compared to surgical ligation(SL)in preterm infants with pPDA.Methods:A literature search of Ovid Cochrane Library,Medline,Embase,Epub,Scopus,PMC Preprints,and ClinicalTrials.Gov was conducted from inception to May 06,2022.Eligible studies reported infants diagnosed with pPDA born at≤2000 g birth weight or at≤37 weeks’who underwent TC or SL as treatment.This review was registered in PROSPERO(CRD42022325944).Results:From 97 studies screened,8 studies met the eligibility criteria,with a total of 756 preterm infants undergoing either TC(n=366)or SL(n=390).Compared to TC,SL had higher mortality rates(OR=0.32,95%CI:0.16,0.66,I^(2)=0%).No difference was seen in post-procedural complication rate(OR=0.90,95%CI:0.18,4.44,I^(2)=79%),mean duration of post-procedural mechanical ventilation(MD=−2.21 days,95%CI:−4.88,0.47,I^(2)=60%),hospital stay length(MD=−8.30 days,95%CI:−17.03,0.44,I^(2)=0%)or neonatal intensive care unit stay length(MD=−3.50 days,95%CI:−10.27,3.27,I^(2)=0%).Conclusion:Our meta-analysis demonstrated TC as a viable alternative option in managing preterm infants with pPDA in the context of SL.Despite the promising trends demonstrated in this meta-analysis,further studies with larger sample size and controlled baseline characteristics are needed to evaluate the safety and efficacy of TC and SL for preterm infants with pPDA.展开更多
BACKGROUND Neonatal hypertension is a rare but potentially serious condition that requires careful monitoring and treatment.Pharmacogenomics can help guide individualized drug therapy and improve outcomes.CASE SUMMARY...BACKGROUND Neonatal hypertension is a rare but potentially serious condition that requires careful monitoring and treatment.Pharmacogenomics can help guide individualized drug therapy and improve outcomes.CASE SUMMARY We report a case of a preterm infant with multiple complications,including bronchopulmonary dysplasia(BPD),sepsis,intracranial hemorrhage,and hypertension.The infant was treated with various drugs,including dexamethasone and amlodipine.The infant was diagnosed with neonatal hypertension based on blood pressure measurements exceeding the 95th percentile for his age and sex.The possible causes of hypertension included dexamethasone,hydrochlorothiazide,spironolactone,and BPD.The infant was treated with oral amlodipine to lower his blood pressure.A pharmacogenomic test was performed to evaluate the genetic polymorphisms of ABCB1 and CYP3A5,which are involved in the metabolism and transport of dexamethasone and amlodipine.The infant’s blood pressure was well controlled after the dose of amlodipine was reduced according to the pharmacogenomic results.The infant had a stable general condition and was discharged on the 100th d after birth.CONCLUSION This case illustrates the importance of regular blood pressure monitoring and etiological investigation in preterm infants with hypertension.Pharmacogenomics can provide useful information for individualized drug therapy and safety in this population.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
The provision of breast milk and breastfeeding is recommended for preterm infants.Multidisciplinary cooperation is required to promote breastfeeding.Nurses play impor tant roles in breastfeeding preterm infants.First,...The provision of breast milk and breastfeeding is recommended for preterm infants.Multidisciplinary cooperation is required to promote breastfeeding.Nurses play impor tant roles in breastfeeding preterm infants.First,nurses are strong advocates to help families be aware of the significance of breastfeeding.Second,nurses are educators providing technical and emotional support to pregnant and lying-in women.Third,nurses are coordinators in a multidisciplinary team.Nurses’unawareness of the impor tance of breastfeeding,knowledge deficit,and unsupportive lactation policy are barriers to breastfeeding promotion for preterm infants.It is therefore suggested that hospital administrators provide appropriate breastfeeding policies,set up posts,and ensure nurses’responsibilities in breastfeeding.Additionally,tailored training should be strengthened to improve nurses’knowledge and skills and thereby enable them to fully exer t their roles in the breastfeeding promotion of preterm infants.展开更多
Identify the epidemiological characteristics, etiologies and evolutionary aspects of dyspnea in infants. This was a retrospective study of infants hospitalized for dyspnea from January 1 to December 31, 2020. The para...Identify the epidemiological characteristics, etiologies and evolutionary aspects of dyspnea in infants. This was a retrospective study of infants hospitalized for dyspnea from January 1 to December 31, 2020. The parameters studied were sex, age, origin, vaccination status, existence of underlying pathology. Underlying, the diagnosis and the evolutionary modalities. Data analysis and processing were possible using Word, Excel and EPI info version 7 software. We retained 152 infants. The sex ratio was 1.34 and the median age was 4 months. Vaccines according to expanded immunization program (EPI) were up to date in 76.32%. The main antecedents with risk identified were malnutrition, hypotrophy at birth, interventricular communication. The pathologies observed were low acute respiratory diseases in 90.79%, ENT diseases in 04.60% and cardiac diseases in 03.95%. The median length of hospitalization was 4 days. Infants who died accounted for 15.13%. The median age of infants who died was 4 months. The median time to onset of death was 1.63 days. The risk factors for death were age < 6 months (p = 0.003;CI [1.27;9.33]), outdated vaccines (p = 0.012;CI [1.18;5.17]), history with risk (p = 0.031;CI [1.02;4.54]). Dyspnea in infants remains a concern in our service. Reducing mortality involves developing procedures for the management of lower respiratory ailments, continuous staff training and strengthening the technical platform.展开更多
Introduction: Transitioning to more efficacious Antiretrovirals for HIV infected pregnant women and infant prophylaxis has reduced Mother to child transmission of HIV significantly. This study aimed to determine HIV i...Introduction: Transitioning to more efficacious Antiretrovirals for HIV infected pregnant women and infant prophylaxis has reduced Mother to child transmission of HIV significantly. This study aimed to determine HIV infection status in HIVexposed infants who had their first DNA polymerase chain reaction test in our molecular Laboratory. Subjects, Materials and Methods: Dried Blood Spots for HIV DNA results from 5 states between 2009 and 2020 were analyzed in the PCR laboratory of the Federal Teaching Hospital, Gombe. Results: Nine thousand eight hundred and twenty-three Human Immunodeficiency Virus Deoxyribonucleic acid polymerase Chain Reaction results were analysed;4937 (50.2%) were males. During the study period, there was an overall declining trend in the mother-to-child transmission rate from 3.8% in 2009 to 1.0% in 2020. 6120 (62.3%) of HIV + mothers received Highly active antiretroviral therapy HAART before pregnancy. 7845 (76.2%) of the infants received Nevirapine prophylaxis. Dried blood spot samples were collected from 4077 (41.5%) at 6 - 8 weeks. 8438 (85.9%) received cotrimoxazole. 9469 (96.4%) were ever breastfed. Of the 9823 HIV DNA PCR results, 255 (2.6%) were positive while 69/4077 (1.7%) and 109/2662 (4.1%) were positive for HIV DNA at 6 - 8 weeks and > 12 weeks respectively. (p = 0.001). 86/747 (11.5%) of infants whose HIV-positive mothers received no ARVS were HIV DNA positive. (p = 0.001). 106/884 (12.0%) of infants who had no Antiretroviral prophylaxis had positive HIV DNA results;7/413 (1.7%) with Zidovudine/Nevirapine prophylaxis had positive results. (p = 0.001). 246/9469 (2.6%) of infants that were ever breastfed were positive for HIV DNA;11/354 (3.0%) that never breastfed had positive HIV DNA. Conclusion: Lack of maternal/infant ARVs and prolonged breastfeeding increased the risk of infant HIV infection.展开更多
Introduction: A higher risk of death is associated with wasting in children if it is not treated properly. The objective of this study was to investigate the ionic disorders observed in infants suffering from severe w...Introduction: A higher risk of death is associated with wasting in children if it is not treated properly. The objective of this study was to investigate the ionic disorders observed in infants suffering from severe wasting at Yalgado Ouedraogo Teaching Hospital (YO-TH) and at Charles de Gaulle Pediatric Teaching Hospital (CDG-PTH) in Ouagadougou (Burkina Faso). Methods: This was a retrospective study with a descriptive and analytical aim over the period from January 1, 2016 to December 31, 2020. Results: It concerned infants aged 6 to 24 months hospitalized at YO-TH and at CDG-PTH from Ouagadougou. We included 271 infants. The mean age of the infants was 14.48 ± 5.44 months with 42.07% which was in the age range of [12 - 18] months. On admission to the hospital, the children had an average weight, height and BMI of 6.22 ± 1.32 kg, 0.73 ± 0.07 m and 11.67 ± 1.53 kg/m<sup>2</sup>. In urban areas 56.46% of children and the main reasons for consultation were fever (88.19%), vomiting (52.80%) and diarrhea (50.20%). Electrolyte disturbances in emaciated infants affected all 8 parameters of the blood ionogram. However, the major disorders were 65.68% hyponatremia, 55.35% hypobicarbonatemia, 41.33% hypoprotidemia and 32.47% hypokalemia in infants aged 6 to 24 months. We found an association between diarrhea and residence with hypokalemia (p = 0.0000) and hypochloremia (p = 0.010), respectively. Conclusion: Severe acute wasting in infants 6 to 24 months of age remains a concern in the hospital setting. The frequency of biochemical disturbances is also high.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
基金Supported by the Fundamental Research Funds for the Central Universities (No.WK2100000045)the National Natural Science Foundation of China (No.U19B2044)+1 种基金Hefei Health Care Commission 2022 Applied Medical Research Project (No.Hwk2022yb028)Zhejiang Lab Open Research Project (No.K2022QA0AB04).
文摘AIM:To quantitatively assess the changes in mean vascular tortuosity(mVT)and mean vascular width(mVW)around the optic disc and their correlation with gestational age(GA)and birth weight(BW)in premature infants without retinopathy of prematurity(ROP).METHODS:A single-center retrospective study included a total of 133(133 eyes)premature infants[mean corrected gestational age(CGA)43.6wk]without ROP as the premature group and 130(130 eyes)CGA-matched fullterm infants as the control group.The peripapillary mVT and mVW were quantitatively measured using computerassisted techniques.RESULTS:Premature infants had significantly higher mVT(P=0.0032)and lower mVW(P=0.0086)by 2.68(10^(4) cm^(-3))and 1.85μm,respectively.Subgroup analysis with GA showed significant differences(P=0.0244)in mVT between the early preterm and middle to late preterm groups,but the differences between mVW were not significant(P=0.6652).The results of the multiple linear regression model showed a significant negative correlation between GA and BW with mVT after adjusting sex and CGA(P=0.0211 and P=0.0006,respectively).For each day increase in GA at birth,mVT decreased by 0.1281(10^(4) cm^(-3))and for each 1 g increase in BW,mVT decreased by 0.006(10^(4) cm^(-3)).However,GA(P=0.9402)and BW(P=0.7275)were not significantly correlated with mVW.CONCLUSION:Preterm birth significantly affects the peripapillary vascular parameters that indicate higher mVT and narrower mVW in premature infants without ROP.Alterations in these parameters may provide new insights into the pathogenesis of ocular vascular disease.
文摘BACKGROUND Being too light at birth can increase the risk of various diseases during infancy.AIM To explore the effect of perinatal factors on term low-birth-weight(LBW)infants and build a predictive model.This model aims to guide the clinical management of pregnant women’s healthcare during pregnancy and support the healthy growth of newborns.METHODS A retrospective analysis was conducted on data from 1794 single full-term pregnant women who gave birth.Newborns were grouped based on birth weight:Those with birth weight<2.5 kg were classified as the low-weight group,and those with birth weight between 2.5 kg and 4 kg were included in the normal group.Multiple logistic regression analysis was used to identify the factors influencing the occurrence of full-term LBW.A risk prediction model was established based on the analysis results.The effectiveness of the model was analyzed using the Hosmer–Leme show test and receiver operating characteristic(ROC)curve to verify the accuracy of the predictions.RESULTS Among the 1794 pregnant women,there were 62 cases of neonatal weight<2.5 kg,resulting in an LBW incidence rate of 3.46%.The factors influencing full-term LBW included low maternal education level[odds ratio(OR)=1.416],fewer prenatal examinations(OR=2.907),insufficient weight gain during pregnancy(OR=3.695),irregular calcium supplementation during pregnancy(OR=1.756),and pregnancy hypertension syndrome(OR=2.192).The prediction model equation was obtained as follows:Logit(P)=0.348×maternal education level+1.067×number of prenatal examinations+1.307×insufficient weight gain during pregnancy+0.563×irregular calcium supplementation during pregnancy+0.785×pregnancy hypertension syndrome−29.164.The area under the ROC curve for this model was 0.853,with a sensitivity of 0.852 and a specificity of 0.821.The Hosmer–Leme show test yieldedχ^(2)=2.185,P=0.449,indicating a good fit.The overall accuracy of the clinical validation model was 81.67%.CONCLUSION The occurrence of full-term LBW is related to maternal education,the number of prenatal examinations,weight gain during pregnancy,calcium supplementation during pregnancy,and pregnancy-induced hypertension.The constructed predictive model can effectively predict the risk of full-term LBW.
基金Supported by the Attestation de Financement de These de Doctorat,Dakar le 28/10/2019.
文摘BACKGROUND In endemic areas,vertical transmission of hepatitis B virus(HBV)remains a major source of the global reservoir of infected people.Eliminating mother-to-child transmission(MTCT)of HBV is at the heart of World Health Organization’s goal of reducing the incidence of HBV in children to less than 0.1%by 2030.Universal screening for hepatitis B during pregnancy and neonatal vaccination are the main preventive measures.AIM To evaluate the efficacy of HBV vaccination combined with one dose of immunoglobulin in children born to hepatitis B surface antigen(HBsAg)-positive mothers in Djibouti city.METHODS We conducted a study in a prospective cohort of HBsAg-positive pregnant women and their infants.The study ran from January 2021 to May 2022,and infants were followed up to 7 mo of age.HBV serological markers and viral load in pregnant women were measured using aVidas microparticle enzyme-linked immunosorbent assay(Biomérieux,Paris,France)and the automated Amplix platform(Biosynex,Strasbourg,France).All infants received hepatitis B immunoglobulin and were vaccinated against HBV at birth.These infants were closely monitored to assess their seroprotective response and for failure of immunoprophylaxis.Simple logistic regression was also used to identify risk factors associated with immunoprophylaxis failure and poor vaccine response.All statistical analyses were performed with version 4.0.1 of the R software.RESULTS Of the 50 pregnant women recruited,the median age was 31 years,ranging from 18 years to 41 years.The MTCT rate in this cohort was 4%(2/50)in HBsAg-positive women and 67%(2/3)in hepatitis B e antigen-positive women with a viral load>200000 IU/mL.Of the 48 infants who did not fail immunoprophylaxis,8(16%)became poor responders(anti-HB<100 mIU/mL)after HBV vaccination and hepatitis B immunoglobulin,while 40(84%)infants achieved a good level of seroprotection(anti-HB>100 mIU/mL).Factors associated with this failure of immunoprophylaxis were maternal HBV DNA levels(>200000 IU/mL)and hepatitis B e antigen-positive status(odds ratio=158,95%confidence interval:5.05-4958,P<0.01).Birth weight<2500 g was associated with a poor immune response to vaccination(odds ratio=34,95%confidence interval:3.01-383.86,P<0.01).CONCLUSION Despite a failure rate of immunoprophylaxis higher than the World Health Organization target,this study showed that the combination of immunoglobulin and HBV vaccine was effective in preventing MTCT of HBV.Therefore,further studies are needed to better understand the challenges associated with immunoprophylaxis failure in infants in Djibouti city.
文摘Appropriate feeding practices are important during infancy for good health, growth and development of infants and children. WHO revised its earlier recommendation of Exclusive Breastfeeding (EBF) of infants from 4 to 6 months of age to EBF until about 6 months of age, with the addition of complementary foods thereafter. This recommendation confirms that breast milk alone is sufficient to meet infants’ nutritional requirements for the first 6 months of life. The main objective of this study was to investigate the effect of various feeding practices on the Nutritional status of infants 0 - 12-month-old in the Kumba 1 Sub-Division. A descriptive cross-sectional study was conducted from December 2019 to August 2020. A total of 341 nursing mothers and their infants 0 - 12 months of age were recruited. Socio-demographic factors and the different feeding habits of the children were assessed using a semi-structured questionnaire. Nutritional status was assessed using anthropometric measurements. The overall proportion of infants who exclusively breastfed for 6 months was 69.2% and those who were mix-fed were 30.8% in the study area. The overall prevalence of malnutrition in the population was 61.0%. Among the malnourished children, 53.1% were underweight, 19.6% were wasted and 10.0% were stunted. Though not significant, the prevalence of wasting (21.0%) and underweight (58.3%) was higher among Mix-Fed (MF) children when compared to their EBF counterparts. Feeding practices affected the nutritional status of the infants. Underweight and wasting were observed among infants on Complementary Feeding (CF), although some exclusively breast-fed infants were stunted. Hence, nursing mothers should try as much as possible to practice EBF as recommended by WHO and can practice CF when the child is above six months.
文摘Objective:To study the effective value of introducing the concept of early oral exercise in the process of nursing intervention for preterm infants in the neonatal intensive care unit(NICU).Methods:96 cases of preterm infants diagnosed from January 2022 to August 2022 were selected and randomly divided into two groups:the general practice group(general nursing intervention),and the early practice group(early oral exercise intervention),and the effect of intervention on preterm infants in the two groups was observed.Results:After nursing care,the mean value of the non-nutritive sucking ability assessment(76.54±5.82),the mean value of the intellectual development degree assessment(104.57±8.45),the mean value of the psychomotor development degree assessment(102.33±6.74),and the mean value of behavioral neural reflexes ability assessment(38.71±2.40)in the early practice group were better than that as compared to the general practice group(P<0.05);the mean value of oral feeding start time of preterm infants in the early practice group(35.42±7.63)weeks,the mean value of all oral feeding time(34.12±5.28)weeks,and the mean time of hospital intervention(15.33±4.25)days were lesser than compared to those of the general practice group at 37.4±5.82 weeks,37.46±3.55 weeks,and 20.46±2.91 days,respectively(P<0.05);the rate of adverse reactions in preterm infants in the early practice group significantly lower than that of the general practice group(P<0.05).Conclusion:The introduction of the concept of early oral exercise intervention among NICU nurses improved the feeding effect,sucking ability of preterm infants,and intellectual development.Hence,early oral motor care should be popularized.
文摘BACKGROUND Preterm birth is the leading cause of mortality in newborns,with very-low-birthweight infants usually experiencing several complications.Breast milk is considered the gold standard of nutrition,especially for preterm infants with delayed gut colonization,because it contains beneficial microorganisms,such as Lactobacilli and Bifidobacteria.AIM To analyze the gut microbiota of breastfed preterm infants with a birth weight of 1500 g or less.METHODS An observational study was performed on preterm infants with up to 36.6 wk of gestation and a birth weight of 1500 g or less,born at the University Hospital Dr.JoséEleuterio González at Monterrey,Mexico.A total of 40 preterm neonates were classified into breast milk feeding(BM)and mixed feeding(MF)groups(21 in the BM group and 19 in the MF group),from October 2017 to June 2019.Fecal samples were collected before they were introduced to any feeding type.After full enteral feeding was achieved,the composition of the gut microbiota was analyzed using 16S rRNA gene sequencing.Numerical variables were compared using Student’s t-test or using the Mann–Whitney U test for nonparametric variables.Dominance,evenness,equitability,Margalef’s index,Fisher’s alpha,Chao-1 index,and Shannon’s diversity index were also calculated.RESULTS No significant differences were observed at the genus level between the groups.Class comparison indicated higher counts of Alphaproteobacteria and Betaproteobacteria in the initial compared to the final sample of the BM group(P<0.011).In addition,higher counts of Gammaproteobacteria were detected in the final than in the initial sample(P=0.040).According to the Margalef index,Fisher’s alpha,and Chao-1 index,a decrease in species richness from the initial to the final sample,regardless of the feeding type,was observed(P<0.050).The four predominant phyla were Bacteroidetes,Actinobacteria,Firmicutes,and Proteobacteria,with Proteobacteria being the most abundant.However,no significant differences were observed between the initial and final samples at the phylum level.CONCLUSION Breastfeeding is associated with a decrease in Alphaproteobacteria and Betaproteobacteria and an increase of Gammaproteobacteria,contributing to the literature of the gut microbiota structure of very low-birth-weight,preterm.
文摘Button cell ingestion is a common household accident among infants, often leading to serious complications that require immediate diagnosis and urgent removal. We report five cases of button cell ingestion involving infants aged between 9 and 32 months, including four boys and one girl. The ingestion was accidentally discovered in two infants, while in the other three, it was suspected during play. In three cases, mothers attempted to induce vomiting by giving fluids, but the batteries remained in the digestive tract for 38 hours to 5 days. After confirming the diagnosis, the batteries were removed within 4 to 36 hours. The locations of the cells were the esophagus in two cases, the cardia in one, the stomach in one, and the bowel in one. One case involved a large cell in the esophagus, while the others involved smaller cells. Complications occurred in four cases, including esotracheal fistula, esophageal ulceration, and perforation of the jejunum and caecum. In one case, the digestive mucosa appeared normal upon endoscopy. One patient died.
文摘Introduction: Acute intestinal intussusception (AII) has been known for a long time but its diagnosis sometimes remains difficult and its etiologies, particularly the idiopathic forms, poorly elucidated. The objective of this study was to describe the clinical and therapeutic aspects of acute intestinal intussusception in order to contribute to the improvement of the management of this condition in the pediatric surgery department of the Donka National Hospital. Materials and Methods: This is a retrospective descriptive study of patients taken in charge of acute idiopathic intestinal intussusception over a period of 7 years (January 2017 to December 31, 2023). Results: We collected 72 patients operated on for IIA, i.e. a hospital frequency of 1.1% and an incidence of 10.3 cases per year. The mean age was 16.58 months with extremes of 3 months and 28 months. The sex ratio was 12.5 in favor of the boy. The triad of ombredanne dominated the clinical picture and paroxysmal abdominal pain with period of calm represented the main reason for consultation (72 cases) i.e. 100%, followed by vomiting (62 cases) and rectal bleeding (50 cases). Ultrasound was performed in 56 patients visualizing the intussusception sausage in 54 patients or 75%. The most common anatomoclinical variety of intussusception was the ileo-caeco-colic form with 35 cases (or 38%) followed by the ileocolic form 24 cases (33%). The surgical procedure performed was a manual reduction in 54 patients or 75% and an anastomosis resection in 18 patients;the appendectomy of principle was done in 62.25%. The postoperative course was simple in 64 patients or 88.88%. The mortality rate was 6.94 %. Conclusion: AII is a common abdominal surgical emergency in infants. Recognition of the Ombredanne triad especially abdominal pain with a period of calm in children and infants in particular is an important element for vital prognosis. Early diagnosis and close interdisciplinary cooperation between pediatric, radiology and pediatric surgery teams could improve the management of IIA and allow this condition to remain benign in children.
文摘BACKGROUND Bronchiolitis is a common lower respiratory tract infection in infants and young children.Severe cases may be accompanied by obvious dyspnea and oxygen saturation decline.AIM To summarize the clinical features,standard diagnosis,and treatment of bronchi-olitis.METHODS This is a retrospective analysis of 114 pediatric patients(74 males,40 females)who were first diagnosed as having bronchioles at the Department of Pediatrics of Tongling Maternal and Child Health Hospital from January 2019 to December 2019.The clinical features,imaging features,treatment,and other clinical data were recorded and analyzed.RESULTS The age of onset of the disease was mainly from 1 mo to 6 mo(75.4%),and the time to hospital visit was mostly from the 2nd day to the 4th day of the course of the disease(75.4%).Lung imaging examination showed increase in lung texture,fuzzy(93.8%).The main treatment was atomization therapy:Budesonide combined with terbutaline(45.6%)and budesonide combined with salbutamol(38.5%).The average hospitalization time was 7.1±2.4 d,and the overall cure rate was 94.7%.In patients without bacterial infection,the use of antibiotics significantly prolonged the length of hospital stay(7.8±2.5 d vs 5.7±1.8 d)and improved the cure rate(98.3%vs 87.9%,P<0.05).CONCLUSION Infants with bronchiolitis are mainly male and tend to have a good prognosis.However,the unneeded use of antibiotics may prolong the length of hospital stay significantly,which imposes the burden both on the patients and hospital system.CONCLUSION Bronchiolitis is a common acute respiratory infectious disease in infants and young children.It mainly affects male children and the age onset is between 1 to 6 mo.The standard use of antibiotics should be emphasized in view of the prolonged average length of hospital stay between the antibiotic treatment group and the non-antibiotic treatment group.When the course of disease is more than 7 d or the treatment effect is poor,active anti-infective treatment is needed to improve the long-term prognosis.Very few children have recurrent cough and wheezing symptoms within 1 year,which may be related to the risk of later asthma attack.FOOTNOTES Author contributions:Shi C and Wu MH contributed to study conception and design,and provision of study materials or patients;Shi C contributed to administrative support;Zuo A,Yang MM,and Jiang RR contributed to data collection and assembly;Shi C contributed to data analysis and interpretation,and manuscript writing;all authors contributed to the final approval of the manuscript.Institutional review board statement:The study was conducted in accordance with the Declaration of Helsinki(as revised in 2013).The study was approved by Institutional Review Board of Tongling Maternal and Child Health Hospital.
文摘BACKGROUND Breast milk is the best and principal nutritional source for neonates and infants.It may protect infants against many metabolic diseases,predominantly obesity and type 2 diabetes.Diabetes mellitus(DM)is a chronic metabolic and microvascular disease that affects all the body systems and all ages from intrauterine life to late adulthood.Breastfeeding protects against infant mortality and diseases,such as necrotizing enterocolitis,diarrhoea,respiratory infections,viral and bacterial infection,eczema,allergic rhinitis,asthma,food allergies,malocclusion,dental caries,Crohn's disease,and ulcerative colitis.It also protects against obesity and insulin resistance and increases intelligence and mental development.Gestational diabetes has short and long-term impacts on infants of diabetic mothers(IDM).Breast milk composition changes in mothers with gestational diabetes.AIM To investigate the beneficial or detrimental effects of breastfeeding on the cardiometabolic health of IDM and their mothers.METHODS We performed a database search on different engines and a thorough literature review and included 121 research published in English between January 2000 and December 15,2022,in this review.RESULTS Most of the literature agreed on the beneficial effects of breast milk for both the mother and the infant in the short and long terms.Breastfeeding protects mothers with gestational diabetes against obesity and type 2 DM.Despite some evidence of the protective effects of breastfeeding on IDM in the short and long term,the evidence is not strong enough due to the presence of many confounding factors and a lack of sufficient studies.CONCLUSION We need more comprehensive research to prove these effects.Despite many obstacles that may enface mothers with gestational diabetes to start and maintain breastfeeding,every effort should be made to encourage them to breastfeed.
文摘BACKGROUND Salmonella derby(S.derby)is a Gram-negative diplococcus that is common in the digestive tract.Infected patients generally experience symptoms such as fever and diarrhea.Mild cases are mostly self-healing gastroenteritis,and severe cases can cause fatal typhoid fever.Clinical cases are more common in children.The most common form of S.derby infection is self-healing gastroenteritis,in which,fever lasts for about 2 d and diarrhea for<7 d.S.derby can often cause bacterial conjunctivitis,pneumonia,endocarditis,peritonitis and urethritis.However,intracranial infections in infants caused by S.derby are rare in clinical practice and have not been reported before in China.CASE SUMMARY A 4-mo-old female infant had recurrent fever for 2 wk,with a maximum body temperature of around 39.4°C.Treatment for infectious fever in a local hospital was ineffective,and she was admitted to our hospital.Before admission,there was one sudden convulsion,characterized by unclear consciousness,limb twitching,gaze in both eyes,and slight cyanosis on the face.Cerebrospinal fluid(CSF)culture was positive for Gram-negative bacilli,which conformed to S.derby.After treatment with meropenem and ceftriaxone antibiotics,the patient was discharged home in a clinically stable state after 4 wk of treatment.CONCLUSION We reported a rare case of S.derby cultured in CSF.S.derby enters the CSF through the blood–brain barrier,causing purulent meningitis.If not treated timeously,it can lead to serious,life-threatening infection.
基金supported by the National Natural Science Foundation of China (31972083)the Natural Science Foundation of Inner Mongolia Autonomous Region (2020ZD12)+2 种基金the Inner Mongolia Science and Technology Major Projects (2021ZD0014)the Inner Mongolia Science & Technology Planning Project (2022YFSJ0017)China Agriculture Research System of MOF and MARA。
文摘Infant intestinal microbiome is closely linked with health and risk of disease. Bifidobacterium are important components of the infant gut and are known to confer various health effects on the host. However, few studies have described the precise composition and dynamics of early infant gut bifidobacterial communities. Thus, this was a pilot study aiming to describe the developmental trajectories and temporal dynamics of bifidobacterial communities in infants before 6 months of age. A total of 28 fecal samples from 4 infants(GF, ZZ, QM, TN, respectively)were collected and analyzed after 5, 15, 30, 60, 90, 120, 150, and 180 days of birth by a bifidobacteria-target method(based on single-molecule real-time sequencing of partial bifidobacterial rpsK genes)in conjunction with droplet digital polymerase chain reaction(ddPCR). The infant fecal microbiota comprised a total of 11 bifidobacterial species, including 4 major species, i.e., B. dentium(37.35%), B. catenulatum(32.04%), B. breve(22.24%), and B. animalis(8.02%). The infant microbiota showed highly individualized developmental trajectories. The leading species for GF was B. catenulatum, with a relatively stable developmental trajectory. In ZZ, B. breve was enriched, and the developmental trajectory was rather fluctuating. The most abundant species for QM and TN was B. dentium. The developmental trajectory of B. dentium in QM showed a trend of gradual decrease, whereas an opposite trend was seen in samples of TN. The results of ddPCR confirmed large variations in quantities of bifidobacteria between infants and suggested discordances in temporal dynamics of bifidobacterial communities during the first half year of infancy. In conclusion, our results suggested that the early infant gut bifidobacterial microbiota was highly complex and temporal dynamics, with individualized developmental trajectories, which should be considered in future research of infant gut microbiota.
文摘Background:Persistent patent ductus arteriosus(pPDA)is a common condition in preterm infants.This metaanalysis aimed to assess the safety and efficacy of transcatheter closure(TC)when compared to surgical ligation(SL)in preterm infants with pPDA.Methods:A literature search of Ovid Cochrane Library,Medline,Embase,Epub,Scopus,PMC Preprints,and ClinicalTrials.Gov was conducted from inception to May 06,2022.Eligible studies reported infants diagnosed with pPDA born at≤2000 g birth weight or at≤37 weeks’who underwent TC or SL as treatment.This review was registered in PROSPERO(CRD42022325944).Results:From 97 studies screened,8 studies met the eligibility criteria,with a total of 756 preterm infants undergoing either TC(n=366)or SL(n=390).Compared to TC,SL had higher mortality rates(OR=0.32,95%CI:0.16,0.66,I^(2)=0%).No difference was seen in post-procedural complication rate(OR=0.90,95%CI:0.18,4.44,I^(2)=79%),mean duration of post-procedural mechanical ventilation(MD=−2.21 days,95%CI:−4.88,0.47,I^(2)=60%),hospital stay length(MD=−8.30 days,95%CI:−17.03,0.44,I^(2)=0%)or neonatal intensive care unit stay length(MD=−3.50 days,95%CI:−10.27,3.27,I^(2)=0%).Conclusion:Our meta-analysis demonstrated TC as a viable alternative option in managing preterm infants with pPDA in the context of SL.Despite the promising trends demonstrated in this meta-analysis,further studies with larger sample size and controlled baseline characteristics are needed to evaluate the safety and efficacy of TC and SL for preterm infants with pPDA.
文摘BACKGROUND Neonatal hypertension is a rare but potentially serious condition that requires careful monitoring and treatment.Pharmacogenomics can help guide individualized drug therapy and improve outcomes.CASE SUMMARY We report a case of a preterm infant with multiple complications,including bronchopulmonary dysplasia(BPD),sepsis,intracranial hemorrhage,and hypertension.The infant was treated with various drugs,including dexamethasone and amlodipine.The infant was diagnosed with neonatal hypertension based on blood pressure measurements exceeding the 95th percentile for his age and sex.The possible causes of hypertension included dexamethasone,hydrochlorothiazide,spironolactone,and BPD.The infant was treated with oral amlodipine to lower his blood pressure.A pharmacogenomic test was performed to evaluate the genetic polymorphisms of ABCB1 and CYP3A5,which are involved in the metabolism and transport of dexamethasone and amlodipine.The infant’s blood pressure was well controlled after the dose of amlodipine was reduced according to the pharmacogenomic results.The infant had a stable general condition and was discharged on the 100th d after birth.CONCLUSION This case illustrates the importance of regular blood pressure monitoring and etiological investigation in preterm infants with hypertension.Pharmacogenomics can provide useful information for individualized drug therapy and safety in this population.
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.
基金supported by Peking University Longtai Nursing Grant(No.LTHL19ZD01)。
文摘The provision of breast milk and breastfeeding is recommended for preterm infants.Multidisciplinary cooperation is required to promote breastfeeding.Nurses play impor tant roles in breastfeeding preterm infants.First,nurses are strong advocates to help families be aware of the significance of breastfeeding.Second,nurses are educators providing technical and emotional support to pregnant and lying-in women.Third,nurses are coordinators in a multidisciplinary team.Nurses’unawareness of the impor tance of breastfeeding,knowledge deficit,and unsupportive lactation policy are barriers to breastfeeding promotion for preterm infants.It is therefore suggested that hospital administrators provide appropriate breastfeeding policies,set up posts,and ensure nurses’responsibilities in breastfeeding.Additionally,tailored training should be strengthened to improve nurses’knowledge and skills and thereby enable them to fully exer t their roles in the breastfeeding promotion of preterm infants.
文摘Identify the epidemiological characteristics, etiologies and evolutionary aspects of dyspnea in infants. This was a retrospective study of infants hospitalized for dyspnea from January 1 to December 31, 2020. The parameters studied were sex, age, origin, vaccination status, existence of underlying pathology. Underlying, the diagnosis and the evolutionary modalities. Data analysis and processing were possible using Word, Excel and EPI info version 7 software. We retained 152 infants. The sex ratio was 1.34 and the median age was 4 months. Vaccines according to expanded immunization program (EPI) were up to date in 76.32%. The main antecedents with risk identified were malnutrition, hypotrophy at birth, interventricular communication. The pathologies observed were low acute respiratory diseases in 90.79%, ENT diseases in 04.60% and cardiac diseases in 03.95%. The median length of hospitalization was 4 days. Infants who died accounted for 15.13%. The median age of infants who died was 4 months. The median time to onset of death was 1.63 days. The risk factors for death were age < 6 months (p = 0.003;CI [1.27;9.33]), outdated vaccines (p = 0.012;CI [1.18;5.17]), history with risk (p = 0.031;CI [1.02;4.54]). Dyspnea in infants remains a concern in our service. Reducing mortality involves developing procedures for the management of lower respiratory ailments, continuous staff training and strengthening the technical platform.
文摘Introduction: Transitioning to more efficacious Antiretrovirals for HIV infected pregnant women and infant prophylaxis has reduced Mother to child transmission of HIV significantly. This study aimed to determine HIV infection status in HIVexposed infants who had their first DNA polymerase chain reaction test in our molecular Laboratory. Subjects, Materials and Methods: Dried Blood Spots for HIV DNA results from 5 states between 2009 and 2020 were analyzed in the PCR laboratory of the Federal Teaching Hospital, Gombe. Results: Nine thousand eight hundred and twenty-three Human Immunodeficiency Virus Deoxyribonucleic acid polymerase Chain Reaction results were analysed;4937 (50.2%) were males. During the study period, there was an overall declining trend in the mother-to-child transmission rate from 3.8% in 2009 to 1.0% in 2020. 6120 (62.3%) of HIV + mothers received Highly active antiretroviral therapy HAART before pregnancy. 7845 (76.2%) of the infants received Nevirapine prophylaxis. Dried blood spot samples were collected from 4077 (41.5%) at 6 - 8 weeks. 8438 (85.9%) received cotrimoxazole. 9469 (96.4%) were ever breastfed. Of the 9823 HIV DNA PCR results, 255 (2.6%) were positive while 69/4077 (1.7%) and 109/2662 (4.1%) were positive for HIV DNA at 6 - 8 weeks and > 12 weeks respectively. (p = 0.001). 86/747 (11.5%) of infants whose HIV-positive mothers received no ARVS were HIV DNA positive. (p = 0.001). 106/884 (12.0%) of infants who had no Antiretroviral prophylaxis had positive HIV DNA results;7/413 (1.7%) with Zidovudine/Nevirapine prophylaxis had positive results. (p = 0.001). 246/9469 (2.6%) of infants that were ever breastfed were positive for HIV DNA;11/354 (3.0%) that never breastfed had positive HIV DNA. Conclusion: Lack of maternal/infant ARVs and prolonged breastfeeding increased the risk of infant HIV infection.
文摘Introduction: A higher risk of death is associated with wasting in children if it is not treated properly. The objective of this study was to investigate the ionic disorders observed in infants suffering from severe wasting at Yalgado Ouedraogo Teaching Hospital (YO-TH) and at Charles de Gaulle Pediatric Teaching Hospital (CDG-PTH) in Ouagadougou (Burkina Faso). Methods: This was a retrospective study with a descriptive and analytical aim over the period from January 1, 2016 to December 31, 2020. Results: It concerned infants aged 6 to 24 months hospitalized at YO-TH and at CDG-PTH from Ouagadougou. We included 271 infants. The mean age of the infants was 14.48 ± 5.44 months with 42.07% which was in the age range of [12 - 18] months. On admission to the hospital, the children had an average weight, height and BMI of 6.22 ± 1.32 kg, 0.73 ± 0.07 m and 11.67 ± 1.53 kg/m<sup>2</sup>. In urban areas 56.46% of children and the main reasons for consultation were fever (88.19%), vomiting (52.80%) and diarrhea (50.20%). Electrolyte disturbances in emaciated infants affected all 8 parameters of the blood ionogram. However, the major disorders were 65.68% hyponatremia, 55.35% hypobicarbonatemia, 41.33% hypoprotidemia and 32.47% hypokalemia in infants aged 6 to 24 months. We found an association between diarrhea and residence with hypokalemia (p = 0.0000) and hypochloremia (p = 0.010), respectively. Conclusion: Severe acute wasting in infants 6 to 24 months of age remains a concern in the hospital setting. The frequency of biochemical disturbances is also high.
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.
