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Wiley

  0803-5253

  1651-2227

 

Cơ quản chủ quản:  WILEY , Wiley-Blackwell

Lĩnh vực:
Medicine (miscellaneous)Pediatrics, Perinatology and Child Health

Các bài báo tiêu biểu

Tiêu chuẩn tăng trưởng trẻ em của WHO dựa trên chiều dài/chiều cao, cân nặng và tuổi Dịch bởi AI
Tập 95 Số S450 - Trang 76-85 - 2006
Mercedes de Onís
Tóm tắt

Mục tiêu: Mô tả các phương pháp được sử dụng để xây dựng Tiêu chuẩn Tăng trưởng Trẻ em của WHO dựa trên chiều dài/chiều cao, cân nặng và tuổi, và trình bày các biểu đồ tăng trưởng kết quả.Phương pháp: Tiêu chuẩn Tăng trưởng Trẻ em của WHO được xây dựng từ một mẫu quốc tế bao gồm trẻ sơ sinh và trẻ nhỏ khỏe mạnh được nuôi bằng sữa mẹ trong môi trường không cản trở sự phát triển. Các phương pháp thu thập dữ liệu nghiêm ngặt và quy trình chuẩn hóa giữa các địa điểm nghiên cứu đã tạo ra dữ liệu chất lượng rất cao. Việc tạo ra các tiêu chuẩn đã tuân theo các phương pháp thống kê hiện đại và có tính hệ thống. Phương pháp Box-Cox lũy thừa (BCPE), với việc làm mượt đường cong bằng spline bậc ba, được sử dụng để xây dựng các đường cong. BCPE có khả năng xử lý nhiều loại phân phối, từ phân phối chuẩn đến phân phối lệch hoặc kurtotic, khi cần. Một bộ công cụ chẩn đoán đã được sử dụng để phát hiện các thiên lệch có thể có trong các phần trăm hay đường cong z-score ước lượng.Kết quả: Có sự biến động lớn trong các bậc tự do cần thiết cho các spline bậc ba để đạt được mô hình tốt nhất. Ngoại trừ chiều dài/chiều cao theo tuổi, theo phân phối chuẩn, tất cả các tiêu chuẩn khác cần mô hình hóa độ lệch mà không cần mô hình hóa tính tụ. Các tiêu chuẩn chiều dài theo tuổi và chiều cao theo tuổi được xây dựng bằng cách điều chỉnh một mô hình độc nhất phản ánh sự khác biệt trung bình 0,7 cm giữa hai phép đo này. Sự tương đồng giữa các đường cong phần trăm đã được làm mượt và các phần trăm thực nghiệm là tuyệt vời và không có thiên lệch. Các phần trăm và đường cong z-score cho trẻ em trai và gái từ 0-60 tháng tuổi đã được tạo ra cho cân nặng theo tuổi, chiều dài/chiều cao theo tuổi, cân nặng theo chiều dài/chiều cao (45 đến 110 cm và 65 đến 120 cm, tương ứng) và chỉ số khối cơ thể theo tuổi.

Kết luận: Tiêu chuẩn Tăng trưởng Trẻ em của WHO mô tả sự phát triển bình thường trong các điều kiện môi trường tối ưu và có thể được sử dụng để đánh giá trẻ em ở mọi nơi, bất kể nguồn gốc dân tộc, tình trạng kinh tế xã hội và loại hình nuôi dưỡng.

Systematic review of COVID‐19 in children shows milder cases and a better prognosis than adults
Tập 109 Số 6 - Trang 1088-1095 - 2020
Jonas F. Ludvigsson
AbstractAim

The coronavirus disease 2019 (COVID‐19) pandemic has affected hundreds of thousands of people. Data on symptoms and prognosis in children are rare.

Methods

A systematic literature review was carried out to identify papers on COVID‐19, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), using the MEDLINE and Embase databases between January 1 and March 18, 2020.

Results

The search identified 45 relevant scientific papers and letters. The review showed that children have so far accounted for 1%‐5% of diagnosed COVID‐19 cases, they often have milder disease than adults and deaths have been extremely rare. Diagnostic findings have been similar to adults, with fever and respiratory symptoms being prevalent, but fewer children seem to have developed severe pneumonia. Elevated inflammatory markers were less common in children, and lymphocytopenia seemed rare. Newborn infants have developed symptomatic COVID‐19, but evidence of vertical intrauterine transmission was scarce. Suggested treatment included providing oxygen, inhalations, nutritional support and maintaining fluids and electrolyte balances.

Conclusions

The coronavirus disease 2019 has occurred in children, but they seemed to have a milder disease course and better prognosis than adults. Deaths were extremely rare.

Understanding diagnostic tests 3: receiver operating characteristic curves
Tập 96 Số 5 - Trang 644-647 - 2007
Anthony K Akobeng
Abstract

The results of many clinical tests are quantitative and are provided on a continuous scale. To help decide the presence or absence of disease, a cut‐off point for ‘normal’ or ‘abnormal’ is chosen. The sensitivity and specificity of a test vary according to the level that is chosen as the cut‐off point. The receiver operating characteristic (ROC) curve, a graphical technique for describing and comparing the accuracy of diagnostic tests, is obtained by plotting the sensitivity of a test on the y axis against 1‐specificity on the x axis. Two methods commonly used to establish the optimal cut‐off point include the point on the ROC curve closest to (0, 1) and the Youden index. The area under the ROC curve provides a measure of the overall performance of a diagnostic test. In this paper, the author explains how the ROC curve can be used to select optimal cut‐off points for a test result, to assess the diagnostic accuracy of a test, and to compare the usefulness of tests.

Conclusion: The ROC curve is obtained by calculating the sensitivity and specificity of a test at every possible cut‐off point, and plotting sensitivity against 1‐specificity. The curve may be used to select optimal cut‐off values for a test result, to assess the diagnostic accuracy of a test, and to compare the usefulness of different tests.

Breastfeeding and intelligence: a systematic review and meta‐analysis
Tập 104 Số S467 - Trang 14-19 - 2015
Bernardo Lessa Horta, Christian Loret de Mola, César G. Victora
AbstractAim

This study was aimed at systematically reviewing evidence of the association between breastfeeding and performance in intelligence tests.

Methods

Two independent searches were carried out using Medline, LILACS, SCIELO and Web of Science. Studies restricted to infants and those where estimates were not adjusted for stimulation or interaction at home were excluded. Fixed‐ and random‐effects models were used to pool the effect estimates, and a random‐effects regression was used to assess potential sources of heterogeneity.

Results

We included 17 studies with 18 estimates of the relationship between breastfeeding and performance in intelligence tests. In a random‐effects model, breastfed subjects achieved a higher IQ [mean difference: 3.44 points (95% confidence interval: 2.30; 4.58)]. We found no evidence of publication bias. Studies that controlled for maternal IQ showed a smaller benefit from breastfeeding [mean difference 2.62 points (95% confidence interval: 1.25; 3.98)]. In the meta‐regression, none of the study characteristics explained the heterogeneity among the studies.

Conclusion

Breastfeeding is related to improved performance in intelligence tests. A positive effect of breastfeeding on cognition was also observed in a randomised trial. This suggests that the association is causal.

The development of the subplate and thalamocortical connections in the human foetal brain
Tập 99 Số 8 - Trang 1119-1127 - 2010
Ivica Kostović, Miloš Judáš
Abstract

The aim of this review is to present clinically relevant data on prenatal development of thalamocortical connections in the human brain. The analysis is based on extensive Zagreb Neuroembryological Collection, including more than 500 prenatal human brains stained with various classical neurohistological, as well as modern histochemical and immunohistochemical methods. The connection of thalamocortical axons during the ‘waiting’ period with transient cortical subplate zone and subsequent synaptic engagement in the cortical plate is the main connectivity event in the late foetus and preterm infant. This connectivity is the structural substrate for the endogeneous subplate and sensory‐driven circuitry generating transient electrical phenomena and may represent a transient network in the developmental history of consciousness.

Conclusion:  Findings presented in this review should be considered in the management of pain in preterm infants, in searching for the vulnerability of the subplate zone in diagnostic procedures using the in vivo MRI and in revealing the developmental origin of cognitive and mental disorders.

RELATIVE UNDERWEIGHT IN CYSTIC FIBROSIS AND ITS PROGNOSTIC VALUE
Tập 67 Số 1 - Trang 33-37 - 1978
Richard Kraemer, A Rüdeberg, B Hadorn, E. Rossi

ABSTRACT. On the basis of observations in 117 children with cystic fibrosis, seen from January 1956 to June 1976, it is demonstrated that the relative underweight (weight loss corrected for height) is most pronounced in children with predominantly pulmonary symptoms. The degree of underweight closely correlates inversely with survival. Because of its prognostic value, it is recommended that this clinical parameter be included in the checkups which are periodically carried out on children suffering from cystic fibrosis.

TRANSEPIDERMAL WATER LOSS IN NEWBORN INFANTS
Tập 68 Số 6 - Trang 795-801
Karen Hammarlund, Gunnar Sedin
Neonatal respiratory morbidity risk and mode of delivery at term: influence of timing of elective caesarean delivery
Tập 93 Số 5 - Trang 643-647 - 2004
Vincenzo Zanardo, AK Simbi, Malida Franzoi, Giuseppe Soldà, Alessandro Salvadori, Daniele Trevisanuto

Aim: To establish whether the timing of delivery between 37 + 0 and 41 + 6wk gestation influences neonatal respiratory outcome in elective caesarean delivery, following uncomplicated pregnancy, thus providing information that can be used to aid planning of elective delivery at term. Methods: All pregnant women who were delivered by elective caesarean delivery at term during a 3‐y period were identified from a perinatal database and compared retrospectively with pregnant women matched for week of gestation, who were vaginally delivered. Maternal characteristics, neonatal outcome, incidence of respiratory distress syndrome (RDS) and transient tachypnea of the newborn (TTN) were analysed. During this time, 1284 elective caesarean section deliveries occurred at or after 37 + 0 wk of gestation. Results: Neonatal respiratory morbidity risk (odds ratio, OR), including RDS and TTN, was significantly higher in the infant group delivered by elective caesarean delivery compared with vaginal delivery (OR 2.6; 95% CI: 1.35–5.9; p < 0.01). While TTN risk in caesarean delivery was not increased (OR 1.19; 95% CI: 0.58–2.4; p > 0.05), the RDS risk was significantly increased (OR 5.85; 95% CI: 2.27–32.4; p < 0.01). This RDS risk is greatly increased in weeks 37 + 0 to 38 + 6 (OR 12.9; 95% CI: 3.57–35.53; p < 0.01). After 39 + 0 wk, there was no significant difference in RDS risk.

Conclusions: Infants born by elective caesarean delivery at term are at increased risk for developing respiratory disorders compared with those born by vaginal delivery. A significant reduction in neonatal RDS would be obtained if elective caesarean delivery were performed after 39 + 0 gestational weeks of pregnancy.

The Influence of Phenylalanine Intake on the Chemistry and Behaviour of a Phenylketonuria Child
Tập 43 Số 1 - Trang 64-77 - 1954
Horst Bickel, J. W. Gerrard, E. M. Hickmans

Summary

Phenylketonuria is a not uncommon cause of mental deficiency (there are probably 1600 cases in Great Britain alone). On the supposition that the high level of phenylalanine or its breakdown products in the blood and cerebrospinal fluid might be responsible for the mental retardation in this disorder we have treated a two year‐old child with a diet low in phenylalanine. The introduction of this diet was associated with an appreciable improvement in the patient's mental status and a fall in the level of phenylalanine in the blood and urine. When phenylalanine was again given in fairly large amounts there was an immediate and dramatic deterioration in the child's mental and biochemical condition. A similar phenylalanine intake produced no clinical reaction in a control child.

The main source of aminoacids in the diet was an acid casein hydrolysate which was specially treated to remove phenylalanine. The aim of the phenylalanine‐poor diet was to keep the phenylalanine blood level as near the normal range as possible. The preparation of such a diet presents little difficulty if a phenylalanine‐free casein hydrolysate is available. Its value in the treatment of other children is at present being investigated; it seems reasonable to assume that patients in the first two years of life will benefit most.

INTERMITTENT MUSCULAR WEAKNESS, EXTRASYSTOLES, AND MULTIPLE DEVELOPMENTAL ANOMALIES
Tập 60 Số 5 - Trang 559-564 - 1971
E Andersen, Peter A. Krasilnikoff, HANS OVERVAD
Summary

A description is given of an eight‐year‐old boy with extrasystoles, seizures of muscular weakness, and multiple developmental anomalies (dwarfism, scaphocephalic skull, hypertelorism, bilateral ptosis, low‐set ears, broad nose, mandibular hypoplasia, aplasia of a number of teeth, defect of both the soft and osseous palate, inward bending of the fifth fingers, single transverse palmar crease of both hands, and cryptorchidism). These findings suggest a specific syndrome, but no similar description was found in the literature. The investigations disclosed no signs of either a chromosomal, a neuromuscular, or an endocrine disease.