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Prospective memory and glycemic control in children with type 1 diabetes mellitus: a cross-sectional study  [cached]
Osipoff Jennifer N,Dixon Denise,Wilson Thomas A,Preston Thomas
International Journal of Pediatric Endocrinology , 2012, DOI: 10.1186/1687-9856-2012-29
Abstract: Background Prospective memory is that memory which is required to carry out intended actions and is therefore essential in carrying out the daily activities required in the self-management of type 1 diabetes mellitus (T1DM). This study aimed to identify the relationships between prospective memory and diabetic control in children with T1DM. Method 94 children aged 6–18 years with T1DM completed an innovative prospective memory screen, PROMS, and a series of cognitive tests. Parents answered questionnaires about their children's diabetic histories and cognitive skills. Results No association between total PROMS score and glycemic control was found. Lower HbA1C was associated with higher (better) scores on the 20 minute event-based task on the PROMS. Parental concerns about working memory and metacognition in their children were mirrored by higher HbA1C. Conclusions This study suggests that there may be an association between glycemic control and prospective memory for event based tasks. Additional studies need to be done to determine reproducibility, causality, and if prospective memory based interventions can improve diabetic control.
Day case inguinal hernia surgery in Nigerian children: Prospective study  [cached]
Usang U,Sowande O,Adejuyigbe O,Bakare TIB
African Journal of Paediatric Surgery , 2008,
Abstract: Background: There has been an increase in day case surgery for children worldwide, but there have been few reports of the practice (most of them being retrospective) by many of the surgical sub-specialties in the sub-region. The aim of this study was to document our experience with day case inguinal hernia surgery in a developing economy. Materials and Methods: This was a prospective study of uncomplicated inguinal hernias treated as day case at OAUTHC between April 2004 and December 2004. Data were collected and analysed. Results: Eighty-eight patients were recruited into the study and none defaulted. There were 88 patients, (M:F = 16.6:1). A majority (n = 54) of the hernias occurred on the right side, while just a few (n = 18) occurred on the left. There were 5 cases of wound infections giving an infection rate of 4.8%. In all, the morbidity following day case inguinal hernia surgery was slight and no patient required readmission into the hospital. Conclusion: Day case inguinal hernia surgery in children is safe and well accepted by patients and parents alike. Health institutions in which children with inguinal hernias still queue for long periods for space on the operation list need to adopt day case surgery for inguinal hernia in order to forestall the risk of their obstruction.
Electroretinographic assessment and diagnostic reappraisal of children with visual dysfunction: A prospective study  [cached]
Vedantham Vasumathy,Jethani Jithendra,Vijayalakshmi Perumalsamy
Indian Journal of Ophthalmology , 2007,
Abstract: Purpose: To assess the presence or absence of a retinal cause of visual impairment using electroretinography (ERG) in children with no obvious discernable cause on ocular examination. Design: Prospective observational case series. Materials and Methods: A prospective study was carried out involving 120 children with the mean age 4.4±3.2 years with visual dysfunction. All children underwent ERG under general anesthesia using a special handheld mini-Ganzfeld (Kurbisfeld) dome. Results: Fifty-two (43.3%) children were male and 68 (56.7%) were female. The clinical diagnosis was as follows: Leber′s congenital amaurosis (LCA) (n=47), achromatopsia (n=25), congenital stationary night blindness (CSNB) (n=9) and others (unclassifiable, n=39). The visual acuity ranged from perception of light (PL) to PL with projection in children with LCA. In the rest (n=73), some sort of visually guided behavior was discernable. Following ERG, a diagnostic reappraisal resulted as follows: LCA (n=49), achromatopsia (n=28), CSNB (n=4), cone-rod dystrophy (n=22), rod-cone degeneration (n=7), normal (n=8) and others (unclassifiable, n=2). Except for the two unclassifiable cases, ERG was successful in the diagnosis or exclusion of retinal dysfunction in the rest. By Pearson Chi-square test, there was a statistically significant association between the clinical and ERG diagnosis ( P < 0.001). Conclusion: LCA was the commonest cause of visual dysfunction in our series. A statistically significant correlation between clinical and electrophysiological diagnosis was seen. ERG helped in firmly establishing the presence or absence of global retinal dysfunction in the majority (118/120) of pediatric patients with visual dysfunction.
A Prospective Study of the Causes of Febrile Illness Requiring Hospitalization in Children in Cambodia  [PDF]
Kheng Chheng, Michael J. Carter, Kate Emary, Ngoun Chanpheaktra, Catrin E. Moore, Nicole Stoesser, Hor Putchhat, Soeng Sona, Sin Reaksmey, Paul Kitsutani, Borann Sar, H. Rogier van Doorn, Nguyen Hanh Uyen, Le Van Tan, Daniel Paris, Stuart D. Blacksell, Premjit Amornchai, Vanaporn Wuthiekanun, Christopher M. Parry, Nicholas P. J. Day, Varun Kumar
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0060634
Abstract: Background Febrile illnesses are pre-eminent contributors to morbidity and mortality among children in South-East Asia but the causes are poorly understood. We determined the causes of fever in children hospitalised in Siem Reap province, Cambodia. Methods and Findings A one-year prospective study of febrile children admitted to Angkor Hospital for Children, Siem Reap. Demographic, clinical, laboratory and outcome data were comprehensively analysed. Between October 12th 2009 and October 12th 2010 there were 1225 episodes of febrile illness in 1180 children. Median (IQR) age was 2.0 (0.8–6.4) years, with 850 (69%) episodes in children <5 years. Common microbiological diagnoses were dengue virus (16.2%), scrub typhus (7.8%), and Japanese encephalitis virus (5.8%). 76 (6.3%) episodes had culture-proven bloodstream infection, including Salmonella enterica serovar Typhi (22 isolates, 1.8%), Streptococcus pneumoniae (13, 1.1%), Escherichia coli (8, 0.7%), Haemophilus influenzae (7, 0.6%), Staphylococcus aureus (6, 0.5%) and Burkholderia pseudomallei (6, 0.5%). There were 69 deaths (5.6%), including those due to clinically diagnosed pneumonia (19), dengue virus (5), and melioidosis (4). 10 of 69 (14.5%) deaths were associated with culture-proven bloodstream infection in logistic regression analyses (odds ratio for mortality 3.4, 95% CI 1.6–6.9). Antimicrobial resistance was prevalent, particularly in S. enterica Typhi, (where 90% of isolates were resistant to ciprofloxacin, and 86% were multi-drug resistant). Comorbid undernutrition was present in 44% of episodes and a major risk factor for acute mortality (OR 2.1, 95% CI 1.1–4.2), as were HIV infection and cardiac disease. Conclusion We identified a microbiological cause of fever in almost 50% of episodes in this large study of community-acquired febrile illness in hospitalized children in Cambodia. The range of pathogens, antimicrobial susceptibility, and co-morbidities associated with mortality described will be of use in the development of rational guidelines for infectious disease treatment and control in Cambodia and South-East Asia.
Adverse reactions to oxacillin in hospitalized children: a prospective study
Souza, Mariana de Oliveira Brizeno de;Araújo, Maria da Concei??o Castro de;Santiago, Raquel Araújo de;Coelho, Helena Lutéscia Luna;Fonteles, Marta Maria de Fran?a;
Revista Brasileira de Saúde Materno Infantil , 2007, DOI: 10.1590/S1519-38292007000100007
Abstract: objectives: follow-up of children exposed to oxacillin during hospitalization focusing on adverse reactions. methods: patients were selected from the pediatric wards of two hospitals in fortaleza (hospital universitário walter cantídio-huwc and hospital infantil albert sabin-hias) from the first oxacillin prescription with a prospective cohort study between october, 2000 and july, 2001 (huwc) and july/2001 and march, 2002 (hias). patients' follow-up was performed by daily visits to the wards and medical charts and prescription analysis. suspected oxacillininduced adverse reactions (oxar cases) were notified and classified according to causality and severity. related statistic tests were completed. results: of the 130 patients exposed to oxacillin, 27 had oxar (20.8%). fever was the most frequent reaction (50%) followed by rash (35.7%). the majority of reactions were considered probable, for oxacillin was the only medication involved and 92.6% of the cases had moderate severity with the need of therapeutic interventions caused by oxar. a significant relation between oxacillin exposure time and oxar was determined as well as hospitalization time and the appearance of adverse reactions. exposure time over 14 days to oxacillin was established as a risk factor for oxar (relative risk = 5.49). conclusions: careful administration of oxacillin in children is recommended with established treatment duration. empiric and prolonged use must be avoided.
Evaluation Children with Global Developmental Delay: A Prospective Study at Sultan Qaboos University Hospital, Oman  [cached]
Roshan Koul,Mohammed Al-Yahmedy,Amna Al-Futaisi
Oman Medical Journal , 2012,
Abstract: Objective: A prospective study was designed to analyze risk factors and clinical features in children with global developmental delay (GDD) at our hospital. No previous data is available on GDD from Oman.Methods: This study was conducted at Sultan Qaboos University Hospital from January 2008 until June 2009. All the children aged 5 years or less, referred with suspected GDD were included in the study. Data was analyzed to determine the underlying etiology. The children with neurodegenerative disease and muscular dystrophy were excluded from the study.Results: One hundred and ten children, 59 males (53.6%) and 51 females (46.4%) were included in the study. The mean age at initial evaluation was 13.29 months. An underlying etiology was determined in 79 (71.8%) children. Perinatal history was associated with significant difference in detection of etiology (p=0.039). Abnormal neurological examination was a significant factor in detection of the underlying etiology. Magnetic resonance imaging (MRI) in 105 children and metabolic screening in 93 children were the most frequently ordered investigations. Abnormal imaging, MRI (p=0.001), CT scan (p=0.036) and metabolic screening (p=0.034) were significantly associated with detection of etiology.Conclusion: Etiology was detected in 71.8% of the children. MRI was the most significant investigation to detect the abnormality.
Prediction and treatment of asthma in preschool children at risk: study design and baseline data of a prospective cohort study in general practice (ARCADE)
Karina E van Wonderen, Lonneke Mark, Jacob Mohrs, Ronald B Geskus, Willem Wal, Wim MC van Aalderen, Patrick JE Bindels, Gerben ter Riet
BMC Pulmonary Medicine , 2009, DOI: 10.1186/1471-2466-9-13
Abstract: In this prospective cohort study one to five year old children at risk of developing asthma were selected from general practices. At risk was defined as 'visited the general practitioner with recurrent coughing (≥ 2 visits), wheezing (≥ 1) or shortness of breath (≥ 1) in the previous 12 months'. All children in this prospective cohort study will be followed until the age of six. For our prediction rule, demographic data, data with respect to clinical history and additional tests (specific immunoglobulin E (IgE), fractional exhaled nitric oxide (FENO), peak expiratory flow (PEF)) are collected. History of airway specific medication use, symptom severity and health-related quality of life (QoL) are collected to estimate the effect of different treatment intensities (as expressed in GINA levels) using recently developed statistical techniques. In total, 1,938 children at risk of asthma were selected from general practice and 771 children (40%) were enrolled. At the time of writing, follow-up for all 5-year olds and the majority of the 4-year olds is complete. The total and specific IgE measurements at baseline were carried out by 87% of the children. Response rates to the repeated questionnaires varied from 93% at baseline to 73% after 18 months follow-up; 89% and 87% performed PEF and FENO measurements, respectively.In this study a prediction rule for asthma in young children, to be used in (general) practice, will be cross-validated. Our study will also provide more insight in the effect of treatment of asthma in preschool children.Asthma is the most prevalent chronic illness in children. It is an inflammatory disorder of the airways and is strongly associated with airway hyperresponsiveness and symptoms like wheezing, shortness of breath, and coughing [1,2]. Potential predictors for asthma in childhood or later in life have been studied widely. Predictors that have already been identified include environmental factors; i.e. exposure to allergens [3-6], tobacco smoke
Prospective study of hearing loss in schools for deaf children in Assir region, Saudi Arabia
Nasser A Fageeh
West African Journal of Medicine , 2003,
Abstract: In this prospective study, various types and etiology of hearing loss among children attending public schools for the deaf were examined. One hundred students from two schools below the age of 15 years were enrolled in the study. Questionnaire was sent to all parents. Multiple modalities of investigations of hearing impairment in the children were performed. Out of the 100 students 78 (78%) had sensorineural hearing loss (SNHL) which was congenital in origin while in (22%) SNHL was acquired as a result of infancy or childhood infection. Forty one cases (41%) were born as a result of consanguineous marriages. Thirty two cases (32%) had a family history of deafness. Ninety (90%) of the students were found to have moderate to severe SNHL. The majority of these children were found to have no hearing aids and some of them were using non-functional hearing aids. Preventive methods through education of the public remain mandatory to minimize the incidence of SNHL. We recommend continuous monitoring and evaluation in association with appropriate care and rehabilitation for these children in order to achieve an acceptable level of speech and literacy.
Complications of continuous renal replacement therapy in critically ill children: a prospective observational evaluation study
Maria J Santiago, Jesús López-Herce, Javier Urbano, María Solana, Jimena del Castillo, Yolanda Ballestero, Marta Botrán, Jose Bellón
Critical Care , 2009, DOI: 10.1186/cc8172
Abstract: A prospective, single-centre, observational study was performed in all critically ill children treated using CRRT in order to determine the incidence of complications related to the technique (problems of catheterization, hypotension at the time of connection to the CRRT, hemorrhage, electrolyte disturbances) and their relationship with patient characteristics, clinical severity, need for vasoactive drugs and mechanical ventilation, and the characteristics of the filtration techniques.Of 174 children treated with CRRT, 13 (7.4%) presented problems of venous catheterization; this complication was significantly more common in children under 12 months of age and in those weighing less than 10 kg. Hypotension on connection to CRRT was detected in 53 patients (30.4%). Hypotension was not associated with any patient or CRRT characteristics. Clinically significant hemorrhage occurred in 18 patients (10.3%); this complication was not related to any of the variables studied. The sodium, chloride, and phosphate levels fell during the first 72 hours of CRRT; the changes in electrolyte levels during the course of treatment were not found to be related to any of the variables analyzed, nor were they associated with mortality.CRRT-related complications are common in children and some are potentially serious. The most common are hypotension at the time of connection and electrolyte disturbances. Strict control and continuous monitoring of the technique are therefore necessary in children on CRRT.Continuous renal replacement therapy (CRRT) is currently the most widely used technique for extrarenal filtration in critically ill children, because it allows continuous and programmed fluid removal [1-5].Although a number of studies have demonstrated that these techniques are useful and safe in critically ill children of any age [4-7], complications do occur [8]. Children are at a higher risk than adults for developing complications associated with CRRT due to the difficulty of venous ca
A prospective, longitudinal study of growth, nutrition and sedentary behaviour in young children with cerebral palsy
Kristie L Bell, Roslyn N Boyd, Sean M Tweedy, Kelly A Weir, Richard D Stevenson, Peter SW Davies
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-179
Abstract: This prospective, longitudinal, population-based study aims to recruit a total of 240 young children with cerebral palsy born in Queensland, Australia between 1st September 2006 and 31st December 2009 (80 from each birth year). Data collection will occur at three time points for each child: 17 - 25 months corrected age, 36 ± 1 months and 60 ± 1 months. Outcomes to be assessed include linear growth, body weight, body composition, dietary intake, oral motor function and feeding ability, time spent sedentary, participation, medical resource use and quality of life.This protocol describes a study that will provide the first longitudinal description of the relationship between functional attainment and modifiable lifestyle factors (dietary intake and habitual time spent sedentary) and their impact on the growth, body composition and nutritional status of young children with cerebral palsy across all levels of functional ability.Cerebral palsy (CP) is the most common cause of physical disability in childhood occurring in 1 in 500 children [1]. It is a group of permanent disorders of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing foetal or infant brain [2]. Damage to the structure of the brain is static and permanent; however, the consequent symptoms are variable and may change over time [2]. In addition to disordered movement or posture, children may have a range of associated disabilities, including intellectual disability, hearing and visual deficits, nutrition, feeding and swallowing problems, respiratory infections and epilepsy [1]. Cerebral palsy has substantial life long effects on daily function and quality of life (QOL) for children and their families with an estimated economic cost of over AUD $115,000 per person per annum [3].Poor growth and nutritional status are commonly reported in children with CP [4,5]. Conversely, there is evidence to suggest that certain children with
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