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Vol 18, No 12
Vol 18, No 12 December 2022 ISSN 1708-8569
Review articles
Original articles
Research letters
Review articles:
Pediatric palliative care for children with cancer: a concept analysis using Rodgers* evolutionary approach
  Parvaneh Vasli, Maryam Karami, Hanieh AsadiParvar-Masouleh
Background: Providing access to pediatric palliative care (PPC) for children living with a serious illness, such as cancer, is of critical importance, although this specialized intervention, as a novel concept, still seems vague and complicated. The present study analyzed the concept of PPC for children with cancer.
Methods: Rodgers' evolutionary method was employed for the concept analysis. Articles on PPC, particularly those for children suffering from cancer, published between 2010 and 2021 were searched in valid academic research databases. The inclusion criteria for the full-text articles were based on the characteristics, antecedents, and consequences of PPC for children with cancer.
Results: In total, 19 relevant articles were selected and then reviewed and analyzed after applying the inclusion criteria and the final sampling. The analysis of the concept of PPC for children affected with cancer revealed four characteristics, including "PPC as holistic and integrated care", "PPC as patient- and family-centered care", "PPC as early-start continuous care", and "PPC as interdisciplinary and team-based care". Some effective factors could also act as antecedents for this concept, i.e., health care providers' training and expertise as well as human resources and financing. Moreover, improved quality of life, symptom reduction, and coordination between patient care and family support were among the PPC consequences for such children.
Conclusions: The study results demonstrated that delivering PPC to children with cancer demanded a comprehensive view of its various dimensions. Furthermore, numerous factors need to be delineated for its accurate and complete implementation.
  [Abstract] [Full Text] [PDF]  
Prevalence of developmental dyslexia in primary school children: a protocol for systematic review and meta-analysis
  Li-Ping Yang, Chun-Bo Li, Xiu-Mei Li, Man-Man Zhai, Jing Zhao, Xu-Chu Weng
Background: Developmental dyslexia (DD) is a specific impairment during the acquisition of reading skills and may have a lifelong negative impact on individuals. Reliable estimates of the prevalence of DD serve as the basis for evidence-based health resource allocation and policy making. However, the prevalence of DD in primary school children varies largely across studies. Moreover, it is unclear whether there are differences in prevalence in different genders and writing systems. Hence, the present study aims to conduct a systematic review and meta-analysis to assess the global prevalence of DD and to explore related factors.
Methods: We will undertake a comprehensive literature search in 14 databases, including EMBASE, PubMed, Web of Science, China National Knowledge Infrastructure and Cochrane, from their inception to June 2021. Cross-sectional and longitudinal studies that describe the prevalence of DD will be eligible. The quality of the included observational studies will be assessed using the Strengthening the Reporting of Observational Studies in Epidemiology statement. The risk of bias will be determined by sensitivity analysis to identify publication bias.
Results: One meta-analysis will be conducted to estimate the prevalence of DD in primary school children. Heterogeneity will be assessed in terms of the properties of subjects (e.g., gender, grade and writing system) and method of diagnosis in the included primary studies. Subgroup analyses will also be performed for population and secondary outcomes.
Conclusion: The results will synthesize the prevalence of DD and provide information for policy-makers and public health specialists.
  [Abstract] [Full Text] [PDF]  
Original articles:
Discriminatory capacity of serum interleukin-6 between complicated and uncomplicated acute appendicitis in children: a prospective validation study
  Javier Arredondo Montero, Giuseppa Antona, Adriana Rivero Marcotegui, Carlos Bardaj赤 Pascual, M車nica Bronte Anaut, Raquel Ros Briones, Amaya Fern芍ndez-Celis, Natalia L車pez-Andr谷s, Nerea Mart赤n-Calvo
Background: Serum interleukin-6 (IL-6) has a moderate diagnostic performance in pediatric acute appendicitis (PAA). The evidence regarding its capacity to discern between complicated and uncomplicated PAA is scarce.
Methods: We designed a prospective observational study to validate serum IL-6 as a marker for diagnostic classification between complicated and uncomplicated PAA. This study included 205 patients divided into three groups: (1) patients who underwent major outpatient surgery (n = 57); (2) patients with non-surgical abdominal pain (NSAP) in whom the diagnosis of PAA was excluded (n = 53), and (3) patients with a confirmed diagnosis of PAA (n = 95). The PAA patients were further classified as uncomplicated or complicated PAA. IL-6 concentration was determined in all patients at diagnosis. Comparative statistical analysis was performed using the Mann-Whitney U test, the Fisher exact test and the Kruskall Wallis test. The area under the receiver operating characteristic curves (AUC) were calculated.
Results: Median (interquartile range, IQR) serum IL-6 values were 2 pg/mL (2.0每3.4) in group 1, 3.9 pg/mL (2.4每11.9) in group 2, and 23.9 pg/mL (11.1每61.0) in group 3 (P < 0.001). Among the participants in group 3, those with uncomplicated PAA had median (IQR) serum IL-6 values of 17.2 pg/mL (8.5每36.8), and those with complicated PAA had 60.25 pg/mL (27.1每169) serum IL-6 (P < 0.001). At the cut-off point of 19.55 pg/mL, the AUC for the discrimination between patients in group 2 vs. 3 was 0.83 [95% confidence interval (CI) 0.76每0.90], with a sensitivity of 61.3% and a specificity of 86.8. The AUC for the discrimination between patients with uncomplicated and complicated PAA was 0.77 (95% CI 0.68每0.86) and the cut-off point was 25.90 pg/mL, with a sensitivity and specificity of 84.6% and 65.6%, respectively.
Conclusions: Serum IL-6 has a good performance in discerning between complicated and uncomplicated PAA. A score including clinical and radiological variables may increase the diagnostic performance of this molecule.
  [Abstract] [Full Text] [PDF]  
Performance of the PRISM I, PIM2, PELOD-2 and PRISM IV scoring systems in western China: a multicenter prospective study
  Xue-Peng Zhang, Yun-Xia Feng, Yang Li, Guo-Yan Lu, Xin-Yue Zhou, Can-Zheng Wei, Xi-Ying Gui, Kai-Ying Yang, Tong Qiu, Jiang-Yuan Zhou, Hua Yao, Geng Zhang, Wen-Qi Zhang, Yu-Hang Hu, Hong Wu, Si-Yuan Chen, Yi Ji
Background: The aim of this study was to evaluate the performance of the four scoring tools in predicting mortality in pediatric intensive care units (PICUs) in western China.
Methods: This was a multicenter, prospective, cohort study conducted in six PICUs in western China. The performances of the scoring systems were evaluated based on both discrimination and calibration. Discrimination was assessed by calculating the area under the receiver operating characteristic curve (AUC) for each model. Calibration was measured across defined groups based on mortality risk using the Hosmer-Lemeshow goodness-of-fi t test.
Results: A total of 2034 patients were included in this study, of whom 127 (6.2%) died. For the entire cohort, AUCs for Pediatric Risk of Mortality Score (PRISM) I, Pediatric Index of Mortality 2 (PIM2), Pediatric Logistic Organ Dysfunction Score-2 (PELOD-2) and PRISM IV were 0.88 [95% confidence interval (CI) 0.85每0.92], 0.84 (95% CI 0.80每0.88), 0.80 (95% CI 0.75每0.85), and 0.91 (95% CI 0.88每0.94), respectively. The Hosmer-Lemeshow goodness-of-fi t Chi-square value was 12.71 (P = 0.12) for PRISM I, 4.70 (P = 0.79) for PIM2, 205.98 (P < 0.001) for PELOD-2, and 7.50 (P = 0.48) for PRISM IV [degree of freedom (df) = 8]. The standardized mortality ratios obtained with the PRISM I, PIM2, PELOD-2, and PRISM IV models were 0.87 (95% CI, 0.75每1.01), 0.97 (95% CI, 0.85每1.12), 1.74 (95% CI, 1.58每1.92), and 1.05 (95% CI, 0.92每1.21), respectively.
Conclusions: PRISM IV performed best and can be used as a prediction tool in PICUs in Western China. However, PRISM IV needs to be further validated in NICUs.
  [Abstract] [Full Text] [PDF]  
A three-pronged analysis confirms the association of the serotoninergic system with attention deficit hyperactivity disorder
  Mahasweta Chatterjee, Sharmistha Saha, Swagata Sinha, Kanchan Mukhopadhyay
Background: The serotonin transporter (SERT), encoded by the solute carrier family 6 number 4 (SLC6A4) gene, controls serotonin (5-HT) availability and is essential for the regulation of behavioral traits. Two SLC6A4 genetic variants, 5-HTTLPR and STin2, were widely investigated in patients with various neurobehavioral disorders, including attention deficit hyperactivity disorder (ADHD).
Methods: We analyzed the association of the 5-HTTLPR (L/S) and STin2 (10/12) variants, plasma 5-HT, and 5-hydroxyindole acetic acid (5-HIAA), as well as SERT messenger RNA (mRNA) with ADHD in the eastern Indian subjects. Nuclear families with ADHD probands (n = 274) and ethnically matched controls (n = 367) were recruited following the Diagnostic and Statistical Manual of Mental Disorders. Behavioral traits, executive function, and intelligence quotient (IQ) of the probands were assessed using the Conner's Parent Rating Scale每Revised, Parental Account of Children*s Symptoms (PACS), Barkley Deficit in Executive Functioning〞Child and Adolescent Scale, and Wechsler Intelligence Scale for Children-III, respectively. After obtaining informed written consent, peripheral blood was collected to analyze genetic variants, plasma 5-HT, 5-HIAA, and SERT mRNA expression.
Results: ADHD probands showed a higher frequency of the 5-HTTLPR ※L§ allele and ※L/L§ genotype (P < 0.05), lower 5-HIAA level, and higher SERT mRNA expression. Scores for behavioral problems and hyperactivity were higher in the presence of the ※S§ allele and ※S/S§ genotype, while executive deficit was higher in the presence of the ※L§ allele. IQ score was lower in the presence of the STin2 ※12§ allele and L-12 haplotype.
Conclusion: Data obtained indicate a significant association of the serotoninergic system with ADHD, warranting further in-depth investigation.
  [Abstract] [Full Text] [PDF]  
Variation in SARS-CoV-2 seroprevalence in children in the region of Asturias, Northern Spain
  Elisa Garc赤a-Garc赤a, Mercedes Rodr赤guez-P谷rez, David P谷rez-Sol赤s, Carlos P谷rez-M谷ndez, Cristina Molinos-Norniella, Ángeles Cobo-Ruis芍nchez, Eva Mar赤a Fern芍ndez Fern芍ndez, Noelia Garc赤a Gonz芍lez, Laura Calle-Miguel
Background: Updated seroprevalence estimates are important to describe the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) landscape and to guide public health decisions. The aims are to describe longitudinal changes in seroprevalence in children in a region in Northern Spain and to analyze factors associated with SARS-CoV-2 seropositivity.
Methods: Prospective multicenter longitudinal study with subjects recruited from July to September 2020. Children (up to 14 years old) were included and followed up until September 2021. Venous blood samples were collected every six months during three testing rounds and were analyzed for SARS-CoV-2 antibodies. The data regarding epidemiological features, contact tracing, symptoms, and virological tests were collected. The evolution of SARS-CoV-2 seroprevalence during the study and the differences between children with positive and negative SARS-CoV-2 antibody tests were analyzed.
Results: Two hundred children were recruited (50.5% girls, median age 9.7 years). The overall seroprevalence increased from round 1 [1.5%, 95% confidence interval (CI) 0.3%每4.3%] to round 2 (9.1%, 95% CI 4.6%每12.7%) and round 3 (16.6%, 95% CI 9.5%每19.6%) (P < 0.001). Main changes occurred in children aged zero to four years (P = 0.001) who lived in urban areas (P < 0.001). None of the children who were previously positive became seronegative. Following multivariable analysis, three variables independently associated with SARS-CoV-2 seropositivity were identified: close contact with coronavirus disease 2019 (COVID-19) confirmed or suspected cases [odds ratio (OR) = 3.9, 95% CI 1.2每12.5], previous positive virological test (OR = 17.1, 95% CI 3.7每78.3) and fatigue (OR = 18.1, 95% CI 1.7每193.4).
Conclusions: SARS-CoV-2 seroprevalence in children has remarkably increased during the time of our study. Fatigue was the only COVID-19-compatible symptom that was more frequent in seropositive than in seronegative children.
  [Abstract] [Full Text] [PDF]  
Research letters:
Electroencephalogram response in premature infants to different odors: a feasibility study
  Janine Gellrich, Sandy Schlage, Veronika Messer, Valentin A. Schriever
  [Abstract] [Full Text] [PDF]  
Implementation experience of a 12-month intervention to introduce intermittent kangaroo mother care to eight Chinese neonatal intensive care units
  Xin Liu, Xiao-Hui Chen, Zhan-Kui Li, Bei Cao, Shao-Jie Yue, Qiong-Yu Liu, Chuan-Zhong Yang, Chang-Yi Yang, Ying-Xi Zhao, Geng-Li Zhao, Qi Feng
  [Abstract] [Full Text] [PDF]  
Management of foreign bodies ingestion in children
  Qing-Jiang Chen, Lin-Yan Wang, Yi Chen, Jia-Jin Xue, Yue-Bin Zhang, Li-Feng Zhang, Yun-Zhong Qian, Qi-Xing Xiong, Zhi-Gang Gao
  [Abstract] [Full Text] [PDF]  
A novel SPINT2 missense mutation causes syndromic congenital sodium diarrhea
  Xian-Xu Zhang, Xi Chen, Wei Zhou, Vasilis Caesar Mavratsas, Yang-Yang Xiao, Xin-Rui Tan, Song-Jia Zheng, Xing-Xing Zhang
  [Abstract] [Full Text] [PDF]  
World Journal of Pediatric Surgery
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