Search

Objective: To describe real-world outcomes for youth using the Tandem t:slim X2 insulin pump with Control-IQ technology (“Control-IQ”) for 6 months at a large pediatric clinic. Methods: Youth with type 1 diabetes, who started Control-IQ for routine care, were prospectively followed. Data on system use and glycemic control were collected before Control-IQ start, and at 1, 3, and 6 months after start. Mixed models assessed change across time; interactions with baseline hemoglobin A1c (HbA1c) and age were tested. Results: In 191 youth (median age 14, 47% female, and median HbA1c 7.6%), percent time with glucose levels 70–180 mg/dL (time-in-range [TIR]) improved from 57% at baseline to 66% at 6 months (P 70%) doubled from 23.5% at baseline to 47.8% at 3 months, sustaining at 46.7% at 6 months (P

Objective: The study was conducted to determine the relationship between health-promoting lifestyle behaviors and sleep quality of nurses working in the pediatrics clinics. Methods: The study was conducted among nurses working in the pediatrics clinic of a training and research hospital located in Istanbul. Nurse Information Form, Health-Promoting Lifestyle Profile-II (HPLP-II), and Pittsburg Sleep Quality Index (PSQI) were applied to the nurses. Ethics committee and institutional permission, permission from the scale authors via e-mail, and written consent from the nurses were obtained in the study.Besides the descriptive statistics, Mann Whitney U test, Kruskal Wallis test, and Spearman's Rho Correlation analysis were used for the analysis of the study. Results: Among the 200 nurses that were surveyed, 121 (60.5%) responded.81% of the nurses (n=98) were female, and 80.2% had a bachelor's degree. Age average of the nurses was 25.74 +/- 3.86 years and the average weekly working hours was 49.40 +/- 7.70 hours. It was determined that total mean score of HPLP-II was 125.26 +/- 16.40 and PSQI total mean score was 12.13 +/- 2.29. The lowest mean HPLP-II subscale score was 16.19 +/- 4.64 for exercise and 17.71 +/- 3.74 for stress management. A statistically significant correlation was found between the HPLP-II total scores and PSQI total scores (r= - 0.19; p< 0.05). Conclusion: It was determined that the health-promoting lifestyle behaviors of the nurses were above the moderate level, their sleep quality was poor, and there was a significant correlation between the health-promoting lifestyle behaviors and the sleep quality of the nurses. It can be suggested by nursing to conduct the studies determining the practices that will improve the health-promoting lifestyle behaviors of the nurses and enhance their sleep quality.

A cross-sectional study was conducted to (1) examine breastfeeding initiation and continuation rates, and; (2) investigate association between food insecurity and breastfeeding status, among low-income mothers. Mothers of infants two-months or younger were recruited from a local pediatric clinic serving primarily low-income families. Upon giving consent, mothers were interviewed in-person or over the phone in either English or Spanish. Of the total 92 mothers interviewed, 90% initiated breastfeeding, but only 24% were doing exclusive breastfeeding at 2 months of infant's age. After controlling for socio-demographics, it was found that food-insecure mothers were less likely to continue with breastfeeding (β = -1.51, p = .024). Future research is warranted to understand pathways through which food insecurity affects breastfeeding and how this disparity can be prevented to ensure a safe and secure start for infants worldwide.

Congenital heart disease (CHD) is the most prevalent congenital defect that causes several problems for patients and their families and medical specialists. It is important to investigate CHD risk factors due to their significantly destructive load on society. This study aims to determine the association between maternal lead exposure and conceiving a child with CHD. This case–control study was performed on a total of 246 mothers in the pediatric clinic of Vali-e-Asr Hospital in Birjand, Iran. One hundred forty-six mothers with CHD children were defined as the case group, and 100 age-matched mothers with healthy children were considered the control group. All the mothers were between 20 and 40 years old, and their children were under the age of 6 months. Demographic data was collected from mothers using a well-designed questionnaire. In addition, all mothers were referred to the laboratory for measuring blood lead concentrations. The mean blood lead concentration (BLC) of mothers in the group of children with heart problems was 4.11 ± 10.02 with a median of 2.50 μg/dL and in the control group was 2.66 ± 2.06 with a median of 2.30 μg/dL. The Mann–Whitney test results showed that mothers’ lead concentration in the group of children with heart problems was significantly higher than the control group (z = 2.13, p = 0.03). The chi-square test results showed that lead concentrations in the two groups were significantly different from each other (χ2 = 9.11, p = 0.01). The results of our study showed that mothers of children with CHD had higher blood concentrations than mothers of healthy children.

Aims: To assess the prevalence and sex disparities for caries in the first permanent molars (FPMs) in Benghazi city, Libya. Methods: A cross-sectional study was conducted of 375 children (206 girls and 169 boys) of age 6-12 at pediatric clinic of Faculty of Dentistry. Data were analyzed using SPSS version 16, Chi square tests.Results: Caries prevalence in FPMs amongst all of the age groups 6-12 year-old was 675 teeth (45%). Contrary to national and international trends, there was no significant difference in caries prevalence of FPMs between boys and girls, in the upper right and left quadrant (P> 0.05). However, in the lower right quadrant significant differences (P

Introduction Celiac disease (CD) is an enteropathy that requires a gluten-free diet (GFD), a restriction often generating nutritional imbalances Objective. to assess the nutritional status of a pediatric CD population. Population and methods. Among 84 CD patients recruited, 64 were retained (37 F/27M) and aged 1

With the increasing incidence of pediatric inflammatory bowel disease (IBD) in children and its impact throughout life, transition care has become an important issue. In Korea, no guidelines have been proposed to support the transition from the pediatric clinic to the adult IBD clinic. This paper reviews the current issues related to IBD patient care during the transition from pediatrics to adults to identify the barriers and critical elements for a successful transition. Thus far, a multi-disciplinary pediatric/adult clinic or alternate visits between pediatric and adult health care providers is the best model for pediatric to adult IBD clinics. Self-reliance and independence of patients with pediatric IBD are also essential for a successful transition. In addition, the timing of the transition from a pediatric clinic to an adult IBD clinic should not be determined because the issue is not the chronological age but rather the individual maturity.

Hereditary and congenital pathologies make up a significant proportion in the structure of the general morbidity and mortality of the child population. In this regard, the problem of personalized medical care in multidisciplinary clinical centers seems very urgent. In the Scientific-Practical Center of specialized medical care for children the medical genetic service successfully functions since 1995. In 2017–2019, patients were consulted by geneticists, which accounted for 10,6% of all discharged patients; karyotype studies were performed in 463 (20,4%) consulted patients, chromosomal pathology was revealed in 28 (6,04%) of all karyotyped patients. DNA research was performed in 188 patients: exome sequencing – in 112; sequencing of exons of the SCN1A gene – in 39; search for mutations in the PHOX2B gene – in 17; search for frequent mutations in the FGFR1,2,3 genes – in 15 (the technique was introduced since September 2018); sequencing of SLC2A1 gene – in 5 patients. The high demand for medical genetic counseling and laboratory genetic diagnosis of hereditary and congenital diseases confirms the need for independent medical genetic units in multidisciplinary clinical hospitals, that should interact with medical genetic services at regional and federal levels.

Objetivo: Avaliar a qualidade de vida da criança e do adolescente e o impacto físico/psicossocial nesses sujeitos com câncer em tratamento. Métodos: Estudo quantitativo e descritivo com 35 crianças e adolescentes entre 1,7 e 18 anos de idade, na Clínica Pediátrica do Hospital Estadual Mário Covas e no Ambulatório de Oncologia da Faculdade de Medicina do ABC, em Santo André, São Paulo. A coleta consistiu em aplicação de questionário para pais e filhos, com o instrumento Pediatric Quality of Life Inventory (PedsQL™) — Módulo Câncer Versão 3.0 e questionário pediátrico sobre qualidade de vida 4.0 Brasil. Os dados foram analisados e processados pelo software Epi Info, versão 5.3.1. Resultados: Entre 35 crianças, 60% eram do sexo masculino, com idade média de 8,1 anos, tendo em média os diagnósticos recentes 12,3 meses; e, conforme o diagnóstico, 54,3% eram portadores de leucemias. A dor foi frequente em mais de 50% dos casos, e os aspectos de qualidade de vida afetados ultrapassaram 40% de acordo com os pacientes e seus pais/cuidadores. Conclusões: A qualidade de vida está alterada pelas implicações que a doença desencadeou ao desenvolvimento físico e psicossocial dos indivíduos. A percepção dessas alterações, por parte da maioria dos pais/cuidadores, é similar à de seus filhos.

Systematic data are lacking on pediatric long COVID. This study prospectively assessed 90 children with persistent symptoms who presented to a designated multidisciplinary clinic for long COVID. In nearly 60%, symptoms were associated with functional impairment at 1-7 months after the onset of infection. A comprehensive structured evaluation revealed mild abnormal findings in approximately half the patients, mainly in the respiratory aspect.

Amaç: Çocuk COVID-19 olgularının akciğer tomografi, laboratuar ve klinik özelliklerini karşılaştırarak, akciğer BT’sinin tanı ve tedavideki önemini araştırmayı amaçladık. Materyal ve Metot: Mart 2020- Nisan 2020 tarihleri arasında çocuk kliniğimizde COVID-19 şüphesi ile izlenen 45 çocuk hastanın klinik ve radyolojik bulguları , hastanemizin elektronik kayıt sisteminden elde edilerek değerlendirildi. Bulgular: Olguların 24’ü kız, 21’i erkek ve ortanca yaş 177 aydı. Otuz iki hastanın RT-PCRsonucu pozitif, 13 hastanın negatifti. En sık görülen semptom öksürük (%87) idi. Hastaların 33’ünde temas öyküsü vardı. Olguların 30’unda COVID-19 u düşündüren göğüs BT bulguları vardı. RT-PCR sonuçları ile akciğer BT bulguları arasında anlamlı ilişki yoktu. Akciğer BT derecelendirmesi ile CRP arasında arasında anlamlı ilişki bulundu (p< 0.01).Sonuç: Çalışmamızda çocuk olgularda göğüs BT’sinin, tanı koymada ve tedavi planlanmasında herhangi bir üstünlüğü olmadığı görülmüştür. Bu nedenle çocuklardan göğüs BT isterken radyasyonun olası hasarları düşünülerek klinik gereklilik göz önünde bulundurulmalıdır., Objective: We aimed to investigate the importance of chest CT in diagnosis and treatment of pediatric patients with COVID-19 by comparing chest CT, laboratory, and clinical features. Materials and Methods: The clinical and image findings of 45 children with suspected COVID-19 , addmited to our pediatric clinic between March and April ,2020 were obtained from hospital electronic records. Results: The median age of children was 177 months, while 24 of the patients were female and 21 were male. RT-PCR results of 32 children were positive and of 13 were negative. The most common symptom was cough (87%). Thirty-three of the patients had a history of contact with an infected person. Chest CT images of the 30 cases suggested COVID-19. There was no significant relationship between RT-PCR results and chest CT findings. A significant correlation was found between chest CT severity and CRP (p

Objetivo: Compreender a importância da brinquedoteca na perspectiva dos cuidadores de crianças internadas na clínica pediátrica. Método: Estudo descritivo e qualitativo executado em unidade pediátrica de hospital público do Distrito Federal. Realizada observação participante e entrevistados 13 acompanhantes, sendo feita análise de conteúdo. Resultado: A brinquedoteca é vista como um local de atividades e distração à criança e seu acompanhante, porém, falha no fornecimento de atividades pedagógicas. Considerações finais: A percepção da brinquedoteca apresentada neste estudo potencializa as estratégias que a equipe de enfermagem pode usar para promoção da saúde mesmo em âmbito hospitalar.

Background: Celiac disease is an immune-mediated disorder characterized by variable clinical manifestations, specific antibodies, HLA-DQ2/DQ8 haplotypes, and enteropathy. Objectives: The aim of this study was to present the clinical spectrum and patterns of celiac disease in Kosovar Albanian children. Methods: A cross-sectional retrospective study was performed with Albanian children aged 0-18 years, treated for celiac disease in the Pediatric Clinic, University Clinical Center of Kosovo from 2005 to 2016. Results: During the study period, 63 children were treated for celiac disease. The mean age at diagnosis was 5.5 years (SD ± 3.31). The mean age at celiac disease onset was 3.3 years (SD ± 2.02), while the mean delay from the first symptoms indicative of celiac disease to diagnosis was 2.2 years (SD ± 2.09). More than 70% of the patients were diagnosed in the first 7 years of life, mainly presented with gastrointestinal symptoms, while primary school children and adolescents mostly showed atypical symptoms (p Conclusions: Kosovo, as the majority of developing countries, is still facing the classical form of celiac disease as the dominant mode of presentation; as a result, most children with other forms of the celiac disease remain undiagnosed. : Physicians should be aware of the wide range of clinical presentations and utilize low testing thresholds in order to prevent potential long-term problems associated with untreated celiac disease.

OBJECTIVES The aims of this study were to determine and improve accuracy of the Broselow Tape (BT) in estimating children's weight by adding body habitus parameters. METHODS This cross-sectional study was conducted in an urban hospital pediatric clinic. Children up to 8 years old coming in for well-child visit were included. Children with acute illness or presence of any chronic condition potentially resulting in growth disturbance and out of BT height range were excluded. The following body habitus parameters were measured using the Centers for Disease Control and Prevention guidelines: actual weight, predicted weight using BT (BTW), mid-thigh circumference (MTC), body mass index, mid-arm circumference, and waist-to-hip ratio. RESULTS A total of 301 children were enrolled. Of these, 151 were male (50%). Hispanics constituted 160 (53.2%). There was a positive linear association between BTW and actual weight in the overall cohort (adjusted R = 0.9164, P < 0.001). However, there was a difference in this association among children younger than 2 years and children older than 2 years (adjusted R = 0.89 vs 0.4841). Incorporating MTC and/or waist circumference along with BTW in the model increased the accuracy, providing a better estimate of actual weight (adjusted R = 0.94, P < 0.001). CONCLUSIONS We conclude that there might be inaccuracies in the weight predicted by BT in our patient population, especially those weighing more than 15 kg and older than 2 years. Our study also demonstrates that MTC correlates closely with the actual weight and could be used in addition to BT for more accurate weight estimation.

Aim: The aim of this study is to determine the distribution of microorganisms isolated in blood culture and their antibiotic susceptibility retrospectively.Materials and Methods: This study was conducted at the Mogadishu Somalia Türkiye Recep Tayyip Erdogan Training and Research Hospital. A total of 76 patients who were hospitalized to the fpediatric clinic between the years of 2016 and 2018, who had significant reproduction in their culture tests and whose samples was performed antibiogram test were included. Demographic datas, microorganism strains and antibiogram results of these patients were recorded.Results: The subjects of this study were 37 females (48.7%) and 39 males (51.3%). The mean age of the subjects was 4.68 ± 4.74 (1 month-18 years) years. 57 (75%) of the reproduced microorganisms were Gram-positive bacteria, and 19 (25%) were Gram-negative bacteria. The most commonly isolated bacteria was coagulase-negative staphylococci (CoNS) by 36.8%. It was followed by Staphylococcus aureus (S. aureus) by 19.7%. The most commonly isolated Gram-negative bacteria was Escherichia coli (E. coli) by 6.6%. The antibiotic resistance of CoNS was highest against penicillin G by 85.7%, ampicillin-sulbactam (SAM) by 78.6% and trimethoprim sulfamethoxazole (TMP-SMX) by 75%. The antibiotic resistance of S. aureus was also highest against penicillin G (86.7%), SAM (80%) and TMP-SMX (73.3%).Conclusion: İt is necessary that conducting studies on this subject as periodic. In this way, it was concluded that morbidity and mortality may be reduced and development of antibiotic resistance may be prevented.

Purpose This article explores the challenges of risk feeding from an Australian Paediatric Palliative Care perspective. There is currently limited evidence to guide risk feeding in pediatric clinical practice. Therefore, this article uses evidence from the adult palliative and end-of-life care context (extrapolating to pediatric application), in addition to the authors' clinical experience in supporting children and their families with risk feeding. Recommendations for the clinical management of pediatric risk feeding are discussed, including the suggested focus for families and the interprofessional team along the different phases of the palliative care continuum. Conclusion There is currently limited information to guide decision making regarding risk feeding in pediatrics. Overall, in the absence of evidence-based practice guidelines, it is the authors' recommendation that a risk feeding plan is developed in consultation and collaboration with the family, treating physician, and interprofessional team. Further research is required to support guidance for clinicians working in this area.

Periodontal hastalıklar ve diş çürükleri oral kavitede karşılaştığımız iki ana hastalıktır. Bu hastalıklar her yaştan bireylerde görülebildiği gibi diş kayıplarının da temel iki nedeni olarak kabul edilir. Pedodonti kliniğine dişetleri ile ilgili akut şikayetlerle gelen pek çok hastayla karşılaşılmaktadır. Karşılaşılan bu akut problemlerle ilgili bilgi sahibi olmak, klinik durumu tanımlayabilmek ve hastaya doğru medikal veya cerrahi tedaviyi uygulamak büyük önem taşımaktadır. Bu makale çocuk ve genç hastalarda sıklıkla karşılaşılan akut periodontal hastalıkların teşhis ve tedavilerini içeren klinik yaklaşımlara dikkat çekmektedir.

Objective The aim of this study was to investigate the effect of gift-giving on the patient's behavior. We hypothesized that it is possible to improve the relationship between a doctor and a patient by giving the visiting patient gifts as such gesture may boost her confidence in the doctor, help built personable relationship, and thereby facilitate examination. Materials and Methods For this study, we selected pediatric patients aged 3 to 12 years, who visited pediatric clinic of Dr. Sheikh Hospital of Mashhad. Patients were divided into two groups. One group received a gift (stickers) after examination and prescription. The criterion for evaluating patients' behavior was parental opinion, and the questionnaire was completed in two stages. The Chi-square test was used to compare the behavior of the patients, and data were analyzed by SPSS software. Results In total, 194 people participated that included 74 boys and 120 girls. There was a significant difference at the 99% level between the control and intervention groups in the variables of stress, the desire to go to the doctor, fear reduction between visits, regular use of the drug, cooperation with the doctor, the desire for re-referral, and insistence on referring to the same physician after receiving the gift. There was also a significant difference at the 95% level between two groups in terms of the expression of physical problems by kids. However, there was no significant difference in the level of stress before the receipt of the gift, the desire and willingness to refer to the doctor before receiving the gift, and the waiting time tolerance to enter the doctor's room. Conclusion We found that gifts motivate more appropriate behaviors in kids when referring to a doctor.

Background: Helicobacter pylori (H. pylori) is one of the human pathogens proven to be present in the oral cavity due to microaerophilic nature of the dental biofilm. The present study aimed to investigate the presence of H. pylori in cavitated carious lesions of children by polymerase chain reaction (PCR). Study design: Forty-eight children aged between 4 to 7-years attending outpatient Pediatric clinic were enrolled in the study. Caries status and caries severity were assessed using the dmft and ICDAS caries index. Dentine samples were collected for DNA isolation for the detection of H. pylori by PCR. Results: H. pylori was detected among 30% of children with severe caries lesions detected by PCR. Overall, the mean ± SD of the dmft score for H. pylori positive children was higher compared to the negative control. Amongst the H. pylori-positive group, the decayed (mean-dt) number of teeth were significantly higher (p

In this Report from the Field, we reflect on the first six months of the 2018 implementation of a screener aimed at identifying and addressing social determinants of health (SDH) at Pediatric Associates, an outpatient clinic in East Harlem, New York City. We share descriptive statistics and reflect on lessons learned.

The purpose of this study was to examine the effect of a pediatric clinic simulation with standardized patients on anxiety, self-efficacy, and performance in family nurse practitioner students. A pediatric clinic simulation was developed in which family nurse practitioner students encountered standardized patients presenting for a well-child visit or exhibiting a common chief complaint. Anxiety and self-efficacy were assessed pre/post the simulation intervention, along with faculty-observed student performance. The clinic simulation resulted in increased self-efficacy, lower anxiety, and improved performance (p < .01). High-fidelity simulation of a pediatric clinic was found to foster development of clinical competency, lower student anxiety, and improve self-efficacy.

In recent years new technologies have been developed to track user's motions, as the Leap Motion Controller for hands and wrist tracking. We propose a framework for children's hand, wrist and forearm rehabilitation at home and at hospital designed and developed in collaboration with the therapists of the De Marchi Pediatric Clinic in Milan. The framework contains an application with four serious games supporting hands and wrists rehabilitation, an application specific for the therapist to manage children's progresses remotely and a server to store data about the exercises' performed by children. We developed the framework with an iterative process, prototyping, testing and updating it basing on the children and therapists feedback. We performed five testing sessions with three children in the De Marchi Clinic, at the presence of a therapist and the child's parents, each session involved one child per time.

Limited access to fresh foods is a barrier to adequate consumption of fruits and vegetables among youth, particularly in low-income communities. The current study sought to examine preliminary effectiveness of a fruit and vegetable prescription program (FVPP), which provided one USD 15 prescription to pediatric patients during office visits. The central hypothesis was that exposure to this FVPP is associated with improvements in dietary patterns and food security. This non-controlled longitudinal intervention trial included a sample of caregiver–child dyads at one urban pediatric clinic who were exposed to the FVPP for 1 year. Patients received one USD 15 prescription for fresh produce during appointments. A consecutive sample of caregivers whose children were 8–18 years of age were invited to participate in the study. Dyads separately completed surveys that evaluated food security and dietary behaviors prior to receipt of their first prescription and again at 12 months. A total of 122 dyads completed surveys at baseline and 12-month follow-up. Approximately half of youth were female (52%), and most were African American (63%). Mean caregiver-reported household food security improved from baseline to 12 months (p &lt, 0.001), as did mean child-reported food security (p = 0.01). Additionally, child-reported intake of vegetables (p = 0.001), whole grains (p = 0.001), fiber (p = 0.008), and dairy (p &lt, 0.001) improved after 12 months of exposure to the FVPP. This study provides evidence that pediatric FVPPs may positively influence food security and the dietary patterns of children.

Providers at an urban pediatric clinic lacked a standardized protocol for counseling parents and children when addressing the problem of obesity. Providers were trained to implement the 5-4-3-2-1 Go! evidence-based intervention. The electronic medical record was revised for documentation of counseling. Adherence to the protocol was monitored through observation and chart reviews. Providers found the protocol to standardize care and enhance the patient’s ability to set goals and develop plans for change. The rate with which providers recommended follow-up visits for this purpose increased significantly. 5-4-3-2-1 Go! was successfully used to standardize obesity-related follow-up visits.

Проведен анализ эффективности оказания медицинской помощи детям с редкими наследственными заболеваниями в специализированной генетической клинике. Установлено, что около половины госпитализированных больных (и их родственники) нуждалась в осуществлении генетических исследований для установления или подтверждения диагноза, уточнения формы заболевания, медико-генетического консультирования. При этом 20% обследованных детей нуждались в проведении дополнительного генетического тестирования или повторной биоинформатической интерпретации полученных данных. The effectiveness of medical care for children with rare hereditary diseases in a specialized genetic clinic was analyzed. About half of the hospitalized patients (and their relatives) needed genetic research to establish or confirm the diagnosis, clarify the form of the disease, and provide medical and genetic counseling. About 20% of the examined children required additional genetic testing or repeated bioinformatic interpretation of the data.

Kondisi tidak menentu yang dialami anak dengan Acute Limpoblastik Leukemia (ALL) setelah kemoterapi sering membuat orang tua cemas, bahkan sampai panik saat kondisi anak semakin menurun akibat efek obat kemoterapi. Kecemasan orangtua yang berlebihan, akan membuat anak ikut cemas. Peran perawat dalam mengendalikan kondisi psikologis orangtua, supaya anak tidak ikut cemas sangat diperlukan. Salah satu upaya tersebut adalah dukungan sosial yang diberikan oleh perawat. Tujuan penelitian ini untuk mengetahui apakah ada hubungan antara dukungan perawat dengan tingkat kecemasan orang tua pasien Acute Limpoblastik Leukimia di Ruang Anak RSUP Dr. Kariadi Semarang. Jenis penelitian yang digunakan discriptive correlation, dengan menggunakan pendekatan cross sectional. Sampel penelitian ini 44 orang tua pasien dengan anak ALL. Hasil penelitian menunjukkan bahwa mayoritas dukungan perawat kurang baik sebanyak 52,3% dan mayoritas tingkat kecemasan orang tua pasien adalah kategori cemas ringan sebanyak 40,9%. Hasil Uji bivariate menunjukkan ada hubungan antara dukungan perawat dengan tingkat kecemasan orang tua pasien anak dengan Acute Limpoblastik Leukimia (ALL) di Ruang Anak RSUP Dr. Kariadi Semarang dengan nilai p-value = 0,007 dan r = -0,401. Kata kunci : dukungan perawat, tingkat kecemasan, kemoterapi THE EFFECT OF THE APPLICATION OF ENERGY CONSERVATION TECHNIQUES WITH SELF-EMPOWERMENT TO THE QUALITY OF LIFE OF PATIENTS WITH CHRONIC RENAL FAILURE ABSTRACT The unstable condition in children with acute lymphoblastic leukemia (ALL) after the chemotherapy often leads the parents into anxiety, and even panicking when the children condition drops as the effect of the chemotherapy medication. However, the hyper anxiety may affect the children. In this case, the role of nurse to manage parents’ psychological state is significantly needed. One of the efforts to maintain parents’ psychological state is by nurses’ social support. This research was aimed to find out if there was correlation between nurses’ support with the anxiety level among parents of acute lymphoblastic leukemia (ALL) patients at pediatric clinic of RSUP Dr. Kariadi Semarang. It was a descriptive correlative research with cross sectional approach. The study sample was elderly patient with ALL. The research result showed that nurses’ support was mostly inadequate which was at 52.3% and parents’ anxiety level was considered to be mild anxiety with 40.9%. The bivariate test result show there was correlation between nurses’ support with anxiety level of parents of acute lymphoblastic leukemia (ALL) patients at pediatric clinic of RSUP Dr. Kariadi Semarang with p-value = 0.007 and r = -0.401. Keywords: nurses’ support, anxiety level, chemotherapy

Backgoudn: asthma is one of the most prevalent chronic diseases of childhood, data from the American national health interview survey revealed the prevalence in children 14 years of age and younger to be 9.0%. Objictive: the aim of this work is to assess the effect of adenoidectomy on bronchial asthma. The conclusions of this study may aid in counseling patients and their families regarding the impact of surgical intervention on the modulation of asthma symptoms. Patients and Methods: this was a prospective case series study. Patients were selected from those attending asthma pediatric clinic at Al-Azhar University Hospitals (Sayed Galal and Al-Hussain hospitals). After exclusion and inclusion criteria were applied, 50 children with diagnosis of chronic adenotonsillitis associated with bronchial asthma were enrolled in the study. Results: there was a significant improvement of asthma control test and SN-5 questionnaire results in both urban and rural inhabitants comparing preoperative and postoperative state. There was a non-significant difference between urban and rural residence regarding improvement of bronchial asthma after. There was a significant improvement in both sexes regarding asthma control test and SN-5 questionnaire results comparing preoperative and postoperative state. On the other hand, there was a non-significant difference between male and female gender regarding such improvement after AT. Conclusion: adenotonsillectomy in asthmatic patients with chronic adenotonsillitis may lead to significant improvement in asthma symptoms control and most of the patients are able to eliminate their medications and improve quality of their life style.

Background Cosmetic contact lenses (CCL) are popular among adolescents, but incorrect use can harm the eye. Methods This study assessed CCL hygiene behaviors among adolescents attending a Texas pediatric clinic. Anonymous surveys about CCL hygiene practices were administered to adolescents 13-18 years old. Results We found that 14% (53/392) of respondents had worn CCL, of which 83% were females. Over 70% reported first use at 8 hours/day. Moreover, 15% of CCL users reported borrowing someone else's CCL. Complications resulting from wearing CCL were common. Conclusion This study highlights poor CCL hygiene among adolescents. These data demonstrate the need to develop interventions to educate adolescents on proper care and risks associated with CCLs.

Human respiratory syncytial virus (RSV) is the leading cause of acute bronchiolitis in infants and young children. Children under the age of 2 years, hospitalized for bronchiolitis in the pediatric clinic of a tertiary hospital in northern Greece, were tested for RSV infection during two RSV seasons (2016–2017 and 2017–2018). RSV was detected in 37 of 71 (52.1%) patients, most of them younger than 6 months. Both RSV subtypes were detected – RSV-A (54.1%) and RSV-B (45.9%) – with predominance of RSV-A during the 2016–2017 and RSV-B during the 2017–2018 season. RSV-A and RSV-B sequences clustered within the ON1 and BA genotypes, respectively. Compared to the prototype strains, several amino acid substitutions were observed in the duplication region of the G gene. The study provides a first insight into the molecular epidemiology of RSV in Greece.

La hematuria es un signo frecuente en pediatría y un reto diagnóstico en muchos casos. El objetivo del estudio fue caracterizar la hematuria en pacientes ingresados en el Hospital Provincial Pediátrico Docente ¨General Milanés ¨ durante el año 2020. Se realizó un estudio, descriptivo, en niños ingresados con Hematuria en el Hospital Provincial Pediátrico Docente ¨General Milanés¨, desde enero – diciembre de 2020. El universo estuvo constituido por 86 pacientes, ingresados con hematuria macroscópica en el servicio de clínicas pediátricas. Se estudiaron las siguientes variables: edad, sexo, tipos de hematuria, síntomas y signos acompañantes, antecedentes familiares y personales y el diagnóstico definitivo al egreso. Los principales resultados destacan que el grupo de edad entre 5 y 9 años (46.02%) y el sexo masculino con (79.06 %). La disuria predomino en 45 pacientes (52.32%) y los antecedentes patológicos personales, predominaron los niños sin antecedentes para un 59.30%. En los antecedentes patológicos familiares, la hipertensión arterial predominó en el 54.55% de los niños y el 47.68% presentaron Hematuria no glomerular inespecífica, 41 pacientes. Se concluye que la hematuria predominó en el grupo etario de 5 a 9 años y el sexo masculino. La disuria fue el síntoma más frecuente así como los niños sin antecedentes patológicos personales, la hipertensión arterial constituyó el antecedente patológico familiar que predominó en la serie y el diagnóstico definitivo al egreso que más se presentó fue la hematuria no glomerular.

BACKGROUND A woman’s health in the interconception period has an impact on birth outcomes. Pediatric visits offer a unique opportunity to provide interconception care (ICC). Our aim was to screen and provide interconception and safe sleep screening, counseling, and interventions for 50% of caregivers of children METHODS Two pediatric clinics implemented the March of Dimes’ Interventions to Minimize Preterm and Low Birth Weight Infants Through Continuous Improvement Techniques (IMPLICIT) toolkit, in addition to standardized safe sleep assessments. A quality improvement learning collaborative was formed with a local “infant mortality champion” leading quality improvement efforts. Monthly webinars with the clinic teams reviewed project successes and challenges. Framework for Reporting Adaptations and Modifications was used to document adaptations. RESULTS For each individual IMPLICIT domain, clinics screened and provided needed interventions for ICC and safe sleep in >50% of eligible encounters. Over the course of the quality improvement learning collaborative, the number of caregivers screened for at least 4 of the 5 IMPLICIT domains increased from 0% to 95%. CONCLUSIONS To successfully implement the IMPLICIT toolkit in pediatrics, adaptations were made to the existing model, which had previously been used in family medicine clinics. Pediatricians should consider providing ICC as an innovative way to impact infant mortality rates in their community. Framework for Reporting Adaptations and Modifications can be used to systematically describe the adaptations needed to improve the fit of IMPLICIT in the pediatric clinic, understand the process of change and potential application to local context.

BACKGROUND AND OBJECTIVES Rates of chlamydia and gonorrhea among adolescents continue to rise. We aimed to evaluate if a universal testing program for chlamydia and gonorrhea improved testing rates in an urban general pediatric clinic and an urban family medicine clinic within a system of federally qualified health care centers and evaluated the feasibility, cost, and logistic challenges of expanding implementation across 28 primary care clinics within a federally qualified health care centers system. METHODS A universal testing quality improvement program for male and female patient 14 to 18 years old was implemented in a general pediatrics and family medicine clinic in Denver, Colorado. The intervention was evaluated by using a controlled pre-post quasi-experimental design. The difference in testing rates due to the intervention was assessed by using a difference-in-differences regression model weighted with the inverse probability of treatment. RESULTS In total, 15 541 pediatric encounters and 5420 family medicine encounters were included in the analyses. In pediatrics, the unadjusted testing rates increased from 32.0% to 66.7% in the intervention group and from 20.9% to 28.9% in the comparison group. For family medicine, the rates increased from 38.5% to 49.9% in the intervention group and decreased from 26.3% to 24.8% in the comparison group. The intervention resulted in an adjusted increase in screening rates of 25.2% (P < .01) in pediatrics and 11.8% (P < .01) in family medicine. The intervention was well received and cost neutral to the clinic. CONCLUSIONS Universal testing for chlamydia and gonorrhea in primary care pediatrics and family medicine is a feasible approach to improving testing rates .

Objective Examine whether differences were present by Supplemental Nutrition Assistance Program (SNAP) participation in dietary patterns, achievement of dietary recommendations, and food security for children (aged 7–18 years) receiving free/reduced-price school meals. Methods Cross-sectional study. Caregiver–child dyads at a pediatric clinic completed validated surveys. Food security, dietary patterns, and achievement of dietary recommendations were compared between child SNAP participants/nonparticipants. Results Among 205 caregivers, 128 (62.4%) reported SNAP participation. Percentages of child SNAP participants/nonparticipants meeting recommendations were largely nonsignificantly different and overwhelmingly low. Supplemental Nutrition Assistance Program participants reported higher mean daily servings of vegetables (P = 0.01) and fruits (P = 0.01) than nonparticipants. Caregiver-reported household food security was not significantly different between SNAP participants and nonparticipants (P = 0.44). Conclusions and Implications In this study, child-reported fruit/vegetable intakes were significantly higher among SNAP participants than nonparticipants, suggesting child SNAP participants may experience small but noteworthy benefits related to fruit/vegetable consumption. Additional supports are needed to achieve dietary recommendations.

Background Non-Epileptic Paroxysmal Events (NEPE) are common clinical manifestations in pediatric age presenting with dysfunction of motor and behavioral activity mimicking features of epileptic seizures. Objective To present and analyze number and clinical characteristic of a group of children/adolescents presenting with various types of NEPE; to compare clinical data of this group of NEPE affected children/adolescents with a group of children/adolescents affected by Epileptic Seizures (ES). Methods The retrospective study was conducted at the Pediatric Clinic of University of Catania, Catania, Italy, in a period ranging from January 2005 and January 2018. Two groups of children/adolescents, aged from 1 month to 15 years, were selected: 312 affected by NEPE and 192 by ES. Number and percentage of the single type of NEPE were reported. Then, demographic characteristics, clinical manifestations, duration of the events, time of diagnosis, and age of onset of each type of NEPE and ES affected children/adolescents were analyzed and compared. Results of statistical analysis of the data were carried out between ES and some type of NEPEs including Sandifer syndrome, breath-holding spells, paroxysmal tremors, vertigo, and syncope. Results Among the group of NEPE, vertigo, type of paroxysmal event clinically not classifiable, syncope, and Sandifer syndrome were the most common events; In the comparative analyzed samples, variability between NEPE and ES was found in the duration of the paroxysmal events, in number of episodes, in lag-time between the onset of symptoms and the diagnosis, and in age of onset. Analyzing clinical data of ES with some type of NEPE, statistical significant results were obtained in vertigo as regards the duration and average duration event, in paroxysmal tremors as number of events, in Sandifer syndrome as lag-time of diagnosis, and finally in all the types of NEPE as regards the age of onset, and loss of consciousness. Conclusions Analyzing the clinical features of each type of NEPE differences with ES are found. However, globally considered diagnostic differences between NEPE and ES remain difficult, questionable, and unrealizable without the support of correct parental report, direct clinical observations, and video-EEG monitoring.

Laurence-Moon-Bardet-Biedl syndrome (LMBBS) is a rare ciliopathic genetic multisystem disorder. It has several primary and secondary clinical features, which include central obesity, retinitis pigmentosa, mental subnormalities, polydactyly, and renal dysfunction. The majority of children may not show all clinical features at birth, and clinical features can develop progressively over the years. The authors report two children who were followed up for obesity at the pediatric clinic in the local hospital and the ophthalmology clinic at the tertiary care center, respectively, without a diagnosis, and were referred for specialist pediatric evaluation of hypertension detected on their routine checkup and for further management. Both children were investigated and found to have satisfied criteria for LMBBS in association with primary hypertension. Both children were diagnosed late as LMBBS at 12 years and four years of their age although both of them had enough features to have a suspicion of this syndrome.

Background: We aimed to analyze the neutrophil/lymphocyte ratio (NLR) and lymphocyte/monocyte ratio (LMR) to investigate their value in supporting the diagnosis of influenza in cases with influenza-like symptoms. Methods: A total of 5,693 pediatric patients who applied to the Pediatric Clinic between January 2015 and Decem-ber 2018 were included in the study. Complete blood count and influenza rapid antigen tests were evaluated at the time of admission. Results: The mean LMR was significantly lower in patients with influenza A than non-influenza A patients (p < 0.001). LMR was also significantly lower in those with influenza A or B compared to those in the influenza-nega-tive group (p < 0.001). There was no significant difference (p = 0.83) in terms of the mean LMR between influenza B positive and negative patients. The mean NLR was significantly higher in influenza A positive patients in com-parison with influenza A negative patients (p < 0.001), and it was significantly lower in influenza B positive pa-tients than in influenza B negative patients (p < 0.001). Conclusions: We concluded that LMR and NLR, which had been rarely examined in the literature, had important value in the diagnosis of influenza. However, these values alone were far from being sufficient for the definitive di-agnosis of influenza.

El presente documento apunta al despliegue y desarrollo de una propuesta arquitectónica basada en un problema, redirigiendo el cuestionamiento a un ámbito multidimensional en el sector salud en Colombia y particularmente en zonas aledañas a las capitales departamentales; en este caso el municipio de San Gil Santander con influencia provincial. Con esto se identifica las múltiples influencias que afectan el sector salud, situaciones que en gran parte de los casos carecen de efectividad, por ello el planteamiento del equipamiento en la zona de la provincia Guanentina responde a la pesquisa, supliendo el déficit de áreas destinadas a la atención de un grupo especial y amplía la capacidad de respuesta en la red existente; estableciendo un modelo de arquitectura amigable con el usuario y con la ciudadanía siendo ésta detectable y de fácil acceso para la población en el radio de acción, el desenlace de este proyecto sintetiza y potencia el afianzamiento de la red de atención y pretende referenciar el sector salud de manera positiva en la zona santandereana por medio de un acertado y fluido diseño arquitectónico. This document aims at the deployment and development of an architectural proposal based on a problem question, redirecting the questioning to a multidimensional field in the health sector in Colombia and particularly in areas surrounding departmental capitals; in this case the municipality of San Gil Santander with provincial influence. This identifies the multiple influences that affect the health sector, situations that in many cases lack effectiveness, so the approach of the equipment in the Guanentina province area responds to the survey by supplying the deficit of areas destined to the attention of a special group and expands the response capacity in the existing network; establishing a model of friendly architecture with the user and with the public being this detectable and easily accessible for the population in the radius of action, the outcome of this project synthesizes and strengthens the strengthening of the care network and aims to reference the health sector in a positive way in the santandereana area through a successful and fluid architectural design. Arquitecto http://www.ustabuca.edu.co/ustabmanga/presentacion Pregrado

Pediatric missed appointments impact patient outcomes and the financial well-being of clinics. Our purpose was to implement the Six Sigma methodology at a pediatric clinic to (1) identify significant predictor factors of missed appointments and develop a prediction model and (2) implement interventions to reduce the missed appointment rate. Binary logistic regression identified historical no-show rate, high-risk visit types, lack of insurance, the number of provider visits, and appointment lead time as significant predictor factors. Interventions led to a significant drop in the missed appointment rate and the no-show rate.

Background: Pyelonephritis as a life-threatening infection often leads to renal scarring, which presumably controls by minerals. Objectives: The aim of this study was pyelonephritis treatment by vitamin A in children. Methods: In the current study,106 cases from Imam Reza pediatric clinic and Amir-Kabir Hospital, considered a study group. Children divided into groups with or without urinary incontinence. Demographic data, clinical manifestations, and urinary biomarkers were evaluated and then statistically analyzed. Results: Our data showed that there is a statistical difference between study groups in terms of dysuria (P = 0.001), abdominal pain (P = 0.001), frequency (P = 0.003), incontinency (P = 0.001), urgency (P = 0.002), intermittency (P = 0.004) and fever (P = 0.002). Conclusions: It has been assumed that vitamin A as a therapeutic agent could be used in children with vesicoureteral reflux induced by Pyelonephritis and congenital anomalies.

Background Children who enter school developmentally ready for kindergarten are more likely to succeed academically, be healthy and lead productive lives. However, low-income and minority children often enter kindergarten behind their more affluent peers. Pediatric clinics, as trusted family partners, are well positioned to provide school readiness (SR) support. Objective To explore Latinx parent perceptions of a clinic-based SR coaching intervention using qualitative methods. Intervention was a 1-hour visit with an SR coach (bilingual community health worker trained to assess child SR, role model SR skills and provide educational tools and community resources). Methods Qualitative theme analysis of Latinx parent semistructured interviews completed 6 to 9 months after SR coaching intervention (June 2016–February 2017). Parent-child pairs received the SR coaching intervention (N = 74), postintervention interviews (N = 50) were completed, audio recorded, and transcribed. Iterative team-based coding and inductive thematic analysis of interviews were conducted. Results Three domains emerged and included the SR coaching model, community SR resources, and parent SR knowledge. Subthemes included 1) Parents valued the one-to-one SR coaching intervention, were receptive to coach recommendations and believed other parents would benefit from SR coaching; 2) Parents tried new early literacy activities with their child; 3) Despite positive intervention effects, parents lacked a comprehensive understanding of SR. Conclusion A brief clinic-based SR coaching intervention with a bilingual SR coach was well received by low-income Latinx parents and increased parent SR behaviors. Expanded implementation and further quantitative evaluation using school entry child-specific data are needed to quantify effects.

Objectives Childhood brucellosis is a common public health problem in developing countries. The diagnosis of brucellosis based on nonspecific symptoms is an ongoing problem for physicians, especially in endemic areas. In this study, it is aimed to discuss the efficacy of frequently used test methods in the differential diagnosis of brucellosis. Methods The records of 332 patients admitted to pediatric clinic on suspicion of brucellosis were retrospectively analyzed. Patients with brucellosis were included in the positive group (n = 262) and those without brucellosis were included in the negative group (n = 70). Results As a result of biochemical analysis of the cases, median alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), erythrocyte sedimentation rate (ESR), and C reactive protein (CRP) values were significantly higher in the positive group than that in the negative group (p0.05). Receiver operating curves were plotted to compare predictive values of CRP (area under curve (AUC): 0.635, p= 0.001), ESR(AUC:0.701, p

Despite the well known effectiveness of two licensed live attenuated oral rotavirus (RV)-vaccines, Rotarix and RotaTeq, constant monitoring of vaccine effectiveness (VE) is essential considering the evolving power and reassortment capability of RVs. In this study, we detected RV, norovirus (NV) and adenovirus (AV) infections using immunochromatography (IC)-based kits in children with acute gastroenteritis (AGE) who attended a pediatric clinic in Kiryu city, Gunma, Japan during June, 2014–September, 2018. VEs were determined using a test-negative study design. Among 1658 AGE-children, RV, NV and AV were detected in 96 (5.8 %), 146 (8.8 %) and 46 (2.8 %) children, respectively. Interestingly, the distributions of infections were found to be associated with age and sex. Namely, RV infections were significantly higher in female (P=0.02) and in the 19–30 month age group children, while NV and AV infections predominated in the 13–24 month and 7–18 month age groups, respectively. The disease severity for RV and NV infections remained similar and significantly higher than that of AV infections. The VE of RV-vaccines was 49.8 % (95 % CI: 22.7 to 67.3 %) against all RV infections, which was increased up to 67.2 % (95 % CI: 35.3 to 83.4 %) against severe RV infections. RV-vaccinated children experienced less severe symptoms in RV-infections while non-RV AGE remained less serious for both RV-vaccinated and unvaccinated children. Finally, the prevalence of RV infection remained minimized (≤5.4 %) in this population since 2015. Thus, this study provided important information on distribution of major AGEs in young children and exhibited the effective role of RV vaccines in post-vaccine era.

Airborne transmission is an important mechanism of spread for both viruses and bacteria in hospitals, with nosocomial infections putting a great burden on public health. In this study, we designed and manufactured a bed for pediatric clinic consultation rooms providing air isolation to protect patients and medical personnel from pathogen transmission. The pediatric isolation bed has several primary efficiency filters and a high-efficiency particulate air filter in the bedside unit. The air circulation between inlet and outlet forms negative pressure to remove the patient’s exhaled air timeously and effectively. A computational fluid dynamics model was used to calculate the speed of the airflow and the angle of sampler. Following this, we conducted purification experiments using cigarette smoke, Staphylococcus albus (S. albus) and human adenovirus type 5 (HAdV-5) to demonstrate the isolation efficacy. The results showed that the patient’s head should be placed as close to the air inlet hood as possible, and an air intake wind speed of 0.86 m/s was effective. The isolation efficacy of the pediatric isolation bed was demonstrated by computational fluid dynamics technology. The isolation efficiency against cigarette smoke exceeded 91.8%, and against S. albus was greater than 99.8%, while the isolation efficiency against HAdV-5 was 100%. The pediatric isolation bed could be used where isolation wards are unavailable, such as in intensive care units and primary clinical settings, to control hospital acquired infections.

Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus strain (SARS-CoV-2). COVID-19 is an acute respiratory infection that occurs with a wide range of symptoms. The best way to prevent and slow down infection is based on the assumption that we know the characteristics of the SARS-CoV-2 virus, the disease it causes, and the way it spreads. This review has been prepared by the Pediatric Infectious Diseases Unit of the Behçet Uz Children’s Education and Research Hospital in order to share the preparations and strategies to combat the SARS-CoV-2 virus together with other hospitals. What has been prepared in the clinic (physical arrangements, disinfection, regulations for the protection of employees from occupational infections, regulations for patients and companions) is explained under subheadings. The COVID-19 epidemic, which has affected the entire world and caused many people to die, requires the establishment of many new regulations in health services, including new ones to existing patient safety and infection control measures. The treatment and care for children and their families continued without interruption, with various arrangements made in the clinic in cooperation with the team, based on the guidelines updated frequently by the Ministry of Health, international literature, and experiences. Nurses who managed to communicate with children by wearing clothes that looked “like robots” (in the words of the children) used their existing knowledge and equipment in this process and gained new knowledge. It is thought that this review will be useful in guiding future developments of new information emerging during the COVID-19 outbreak.

PURPOSE: To describe the development and implementation of the Children’s of Alabama (COA) Spina Bifida (SB) Lifetime-Care-Model, including standardized care protocols and transition plan. METHODS: In 2010, members of the pediatric team at COA began to evaluate limitations in access to care for patients with SB at various stages of life. Through clinic surveys, observations, and caregiver report, a Lifetime-Care-Model was developed and implemented. Partnerships were made with adult medicine colleagues to create an interdisciplinary model at each stage. Since developing this program, it has evolved to include standardized care protocols. RESULTS: Since 2011, there have been 42 prenatal clinics; 114 families received counseling and prenatal care. Of these, 106 have delivered at our center and established care in our pediatric clinic. There are currently 474 patients in the pediatric and 218 in the adult clinics. CONCLUSIONS: Our institutional experience suggests that patients with SB benefit from continuity of care throughout their lifetime. This article describes early failures which led to an evolution in approach and implementation of a Lifetime-Care-Model which results in a smooth transition between all phases of life. We hope that other institutions may adapt and build upon it to create programs unique to their specific patient needs.