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International Journal of Environmental... Nov 2021Fever is a common symptom in children that nurses and pediatricians treat. Although it is a common sign in clinical practice, fever instills irrational fears in parents... (Meta-Analysis)
Meta-Analysis Review
CONTEXT
Fever is a common symptom in children that nurses and pediatricians treat. Although it is a common sign in clinical practice, fever instills irrational fears in parents that health professionals share.
OBJECTIVE
To investigate whether doctors' and nurses' knowledge, perceptions, and attitudes toward fever influence how this sign is managed. Furthermore, it intends to evaluate whether educational programs increase knowledge and change attitudes and/or perceptions of nurses about children's fever.
DATA SOURCES
A systematic review with meta-analysis was conducted with PRISMA international standards and the Cochrane recommendations.
STUDY SELECTION
Articles examining health professionals' (doctors and/or nurses) knowledge, perceptions, and/or attitudes toward fever in children and the use of antipyretics were selected for the study.
DATA EXTRACTION
The qualitative analysis was carried out by classifying the articles according to the applied educational programs for nurses related to fever care for children that evaluated different outcomes to determine their efficacies.
RESULTS
For the qualitative synthesis, 41 articles were included, and 5 of these were taken in meta-analysis, which measured the effectiveness of educational programs for fever management in nurses.
LIMITATIONS
All of the included studies generally had a high risk of bias.
CONCLUSION
According to the evidence reviewed, nurses' and physicians' perceptions and attitudes regarding fever management in children indicate an overtreatment of this sign. We can give a recommendation grade of D on the use of educational programs to modify attitudes, perceptions, and knowledge about fever in children and improve clinical practice in nurses.
Topics: Attitude of Health Personnel; Child; Clinical Competence; Fever; Health Knowledge, Attitudes, Practice; Humans; Overtreatment; Physicians
PubMed: 34886174
DOI: 10.3390/ijerph182312444 -
Medical Hypothesis, Discovery &... 2022The coronavirus disease 2019 (COVID-19) pandemic has been the most challenging health problem in the last 2 years. Post-COVID-19 multisystem inflammatory syndrome of... (Review)
Review
BACKGROUND
The coronavirus disease 2019 (COVID-19) pandemic has been the most challenging health problem in the last 2 years. Post-COVID-19 multisystem inflammatory syndrome of children (MIS-C) is a severe post-COVID-19 complication in pediatric patients. Ocular manifestations may be the first presentation of MIS-C, wherein prompt treatment may improve outcomes. In this systematic review, we aimed to summarize the acute and sub-acute ocular manifestations in pediatric patients with laboratory-confirmed COVID-19.
METHODS
We included all online primary studies, with no language restriction and published between January 1, 2019 and November 18, 2020, reporting any acute or sub-acute ocular manifestations in children with laboratory-confirmed COVID-19. PubMed/MEDLINE was searched using the following MeSH and Emtree terms: "eye," "ophthalmologic," "ocular," "vision," "conjunctivitis," "severe acute respiratory syndrome coronavirus 2," "SARS-CoV-2," "corona," "2019-nCoV," "COVID19," and "COVID." The eligibility and quality of the selected records were assessed by two independent reviewers as per the Cochrane Handbook for Systematic Review.
RESULTS
A total of 1,192 records were identified electronically. Seven papers were extracted from the reference lists of the eligible records. Thirty-six papers met the inclusion criteria and were categorized into two subgroups according to acute or sub-acute presentation of ocular manifestations. Among 463 pediatric patients with COVID-19, 72 (15.5%) had acute ocular manifestations. There was one patient with central retinal vein occlusion and another with photophobia and diplopia associated with meningoencephalitis. Among 895 pediatric patients with post-COVID-19 MIS-C, 469 (52.4%) had ocular manifestations, which only included non-purulent conjunctivitis.
CONCLUSIONS
Ocular manifestations have been reported in less than one-fifth of pediatric patients with acute COVID-19. Furthermore, conjunctivitis was the only ocular manifestation reported in half of the patients with MIS-C, and it may be missed easily due to its non-purulent nature. During the COVID-19 pandemic, pediatricians and health workers must remain vigilant for early detection of signs of this potentially fatal post-COVID-19 inflammatory syndrome.
PubMed: 37641695
DOI: 10.51329/mehdiophthal1440 -
Children (Basel, Switzerland) Feb 2023The objective of this review is to assess and synthesize the role of the maternal and child health (MCH) handbook on improving healthcare service utilization, behavior... (Review)
Review
The objective of this review is to assess and synthesize the role of the maternal and child health (MCH) handbook on improving healthcare service utilization, behavior change, and health outcomes for women and children. A systematic search of all relevant existing reports was conducted on 14 January 2021, using the following online bibliographic databases: PubMed, EMBASE, MEDLINE, The Cochrane Library, Academic Search Premier, Emcare, APA PsycINFO, and Web of Science. Two reviewers independently performed study selection, data extraction, and quality assessment. We included 7 trials from 1430 articles, and a total of 2643 women. As overall risk of bias assessment, most domains of the Cochrane risk-of-bias assessment tool showed a high or unclear risk of bias. The risk of ≥6 antenatal care (ANC) visits was 19% higher (RR 1.19, 95% CI 1.09 to 1.30, I2 = 47%, 2 studies, 955 women, moderate certainty of evidence) and skilled birth attendants during delivery was 13% higher (RR 1.13, 95% CI 1.04 to 1.24, I2 = 0%, 2 studies, 1094 women, low certainty of the evidence) in the intervention group than in the control group. The MCH handbook can increase maternal health service utilization and early breastfeeding practice. It also leads to a sense of autonomy during ANC, better communication with healthcare providers, and support from family members.
PubMed: 36979993
DOI: 10.3390/children10030435 -
Nutricion Hospitalaria 2013Obesity and overweight (O/OW) in children have reached epidemic character and both are a risk factor for chronic serious health problems. This study was perfomed in... (Review)
Review
INTRODUCTION
Obesity and overweight (O/OW) in children have reached epidemic character and both are a risk factor for chronic serious health problems. This study was perfomed in order to research the relationship between O/OW and dental caries.
MATERIAL AND METHODS
[corrected] A SR was conducted between 2007-2011 in tertiary information sources (Trip, Cochrane and NGC), secondary (PubMed, IME, MEDES IBECS) and primary (reference checks).
INCLUSION CRITERIA
Patients (children 0-18 years), risk factor (O/OW) and outcomes (primary: caries, secondary: other oral pathology).
DATA COLLECTED
Author, year, country, type of study, patient age, cases (with O/OW) and controls (body mass index-BMI-normal or low), comorbidities, socioeconomic status, prevalence of caries and other results in oral health.
RESULTS
Forty-seven documents were located, 37 of them met the criteria of the RS, temporarily distributed in 2007 (6 articles), 2008 (6), 2009 (5), 2010 (11) and 2011 (9). They presented a very wide degree of heterogeneity (in patients, intervention, primary outcome and type of design), which does not allow to apply quantitative synthesis of data (meta-analysis). Studies are conflicting regarding the relationship between BMI and frequency of dental caries (DMFT, dmft).
CONCLUSIONS
Systematic review allows dentists and pediatricians to know the relationship between O/OW and dental caries.
Topics: Adolescent; Child; Dental Caries; Humans; Obesity; Overweight
PubMed: 24160190
DOI: 10.3305/nh.2013.28.5.6674 -
Neurosurgery Nov 2016Positional plagiocephaly is a common problem seen by pediatricians, pediatric neurologists, and pediatric neurosurgeons. (Review)
Review
BACKGROUND
Positional plagiocephaly is a common problem seen by pediatricians, pediatric neurologists, and pediatric neurosurgeons.
OBJECTIVE
To create evidence-based guidelines for the treatment of pediatric positional plagiocephaly.
METHODS
This guideline was prepared by the Plagiocephaly Guideline Task Force, a multidisciplinary team made up of physician volunteers (clinical experts), medical librarians, and clinical guidelines specialists. The task force conducted a series of systematic literature searches of PubMed and the Cochrane Library, according to standard protocols for each topic addressed in subsequent chapters of this guideline.
RESULTS
The systematic literature searches returned 396 abstracts relative to the 4 main topics addressed in this guideline. The results were analyzed and are described in detail in each subsequent chapter included in this guideline.
CONCLUSION
Evidence-based guidelines for the management of infants with positional plagiocephaly will help practitioners manage this common disorder. The full guidelines documents can be located at https://www.cns.org/guidelines/guidelines-management-patients-positional-plagiocephaly.
Topics: Humans; Infant; Neurosurgery; Plagiocephaly, Nonsynostotic
PubMed: 27759671
DOI: 10.1227/NEU.0000000000001426 -
JAMA Dec 2021A 2014 review for the US Preventive Services Task Force (USPSTF) found that oral fluoride supplementation and topical fluoride use were associated with reduced caries... (Meta-Analysis)
Meta-Analysis
Screening and Interventions to Prevent Dental Caries in Children Younger Than 5 Years: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.
IMPORTANCE
A 2014 review for the US Preventive Services Task Force (USPSTF) found that oral fluoride supplementation and topical fluoride use were associated with reduced caries incidence in children younger than 5 years.
OBJECTIVE
To update the 2014 review on dental caries screening and preventive interventions to inform the USPSTF.
DATA SOURCES
Ovid MEDLINE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews (to September 2020); surveillance through July 23, 2021.
STUDY SELECTION
Randomized clinical trials (RCTs) on screening, preventive interventions, referral to dental care; cohort studies on screening and referral; studies on diagnostic accuracy of primary care oral examination or risk assessment; and a systematic review on risk of fluorosis included in prior USPSTF reviews.
DATA EXTRACTION AND SYNTHESIS
One investigator abstracted data; a second checked accuracy. Two investigators independently rated study quality.
RESULTS
Thirty-two studies (19 trials, 9 observational studies, and 4 nonrandomized clinical intervention studies [total 106 694 participants] and 1 systematic review [19 studies]) were included. No study evaluated effects of primary care screening on clinical outcomes. One study (n = 258) found primary care pediatrician examination associated with a sensitivity of 0.76 (95% CI, 0.55 to 0.91) and specificity of 0.95 (95% CI, 0.92 to 0.98) for identifying a child with cavities, and 1 study found a risk assessment tool associated with sensitivity of 0.53 and specificity of 0.77 (n = 697, CIs not reported) for a child with future caries. No new trials of dietary fluoride supplementation were identified. For prevention, topical fluoride compared with placebo or no topical fluoride was associated with decreased caries burden (13 trials, n = 5733; mean caries increment [difference in decayed, missing, and filled teeth or surfaces], -0.94 [95% CI, -1.74 to -0.34]) and likelihood of incident caries (12 trials, n = 8177; RR, 0.80 [95% CI, 0.66 to 0.95]; absolute risk difference, -7%) in higher-risk populations or settings, with no increased fluorosis risk. Evidence on other preventive interventions was limited (education, xylitol) or unavailable (silver diamine fluoride), and no study directly evaluated primary care dentistry referral vs no referral.
CONCLUSIONS AND RELEVANCE
There was no direct evidence on benefits and harms of primary care oral health screening or referral to dentist. Dietary fluoride supplementation and fluoride varnish were associated with improved caries outcomes in higher-risk children and settings.
Topics: Advisory Committees; Cariostatic Agents; Child, Preschool; Cohort Studies; Dental Caries; Diagnosis, Oral; Fluorides; Fluorides, Topical; Humans; Non-Randomized Controlled Trials as Topic; Observational Studies as Topic; Preventive Health Services; Randomized Controlled Trials as Topic; Referral and Consultation; Sensitivity and Specificity; Xylitol
PubMed: 34874413
DOI: 10.1001/jama.2021.15658 -
Journal of Gynecology Obstetrics and... Jan 2022A twin pregnancy with a complete hydatidiform mole and co-existing viable fetus (CHMCF) is an exceedingly rare obstetric complication with few data related to perinatal... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
A twin pregnancy with a complete hydatidiform mole and co-existing viable fetus (CHMCF) is an exceedingly rare obstetric complication with few data related to perinatal treatment. This study determined the optimal timing of pregnancy termination and mode of delivery in women with CHMCF and a viable fetus.
METHODS
The articles published involving CHMCF and a viable fetus from 1967 to 31 December 2020 in the PubMed and EMBASE databases were systematically reviewed. Observational cohort studies with three or more cases identified and data on delivery management were selected. The articles were analyzed independently for full text and the data were integrated. The timing of pregnancy termination and mode of delivery were calculated using Review Manager 5.4.1.
RESULTS
There were 192 reports involving CHMCF; 209 cases had a viable fetus. According to the inclusion criteria, there were 6 case series, including 72 cases that were eligible for the analysis. The average rate of live births was 34.4%. The average duration of pregnancy was 34 weeks, ranging from 25 to 41 weeks. From 2000-2017 the live birth rate was increased year-after-year. Specifically, the live birth rate was16.7% in 2000, 33.3% in 2012, and 50% in 2017. Fifty-two cases (72.2%) had cesarean sections and 20 cases (27.8%) had vaginal deliveries. The incidence of gestational trophoblastic neoplasia was not significantly different between the two modes of delivery.
CONCLUSIONS
Ideally, a twin pregnancy with a complete hydatidiform mole co-existing with a viable fetus is managed by an obstetrician, pediatrician, and oncologist. Appropriate timing of pregnancy termination and mode of delivery are related to the pregnancy outcome.
Topics: Adult; Female; Humans; Pregnancy; Delivery, Obstetric; Fetal Viability; Hydatidiform Mole; Pregnancy Outcome; Observational Studies as Topic
PubMed: 34767996
DOI: 10.1016/j.jogoh.2021.102269 -
The British Journal of Dermatology May 2013Juvenile spring eruption of the helices of the ears is a distinctive sun-induced condition appearing on the light-exposed skin of the ears, typically in boys and young... (Review)
Review
BACKGROUND
Juvenile spring eruption of the helices of the ears is a distinctive sun-induced condition appearing on the light-exposed skin of the ears, typically in boys and young men in early spring.
OBJECTIVES
To determine clinical features and outcome of juvenile spring eruption of the ears.
METHODS
We report a new outbreak in 14 Swiss-Italian children. A systematic search of the literature was also performed.
RESULTS
Five outbreaks in children involved a total of 203 cases (boys, 72%), and three outbreaks in young adults involved 223 male subjects. A further 54 sporadic cases were found: 41 among children (boys, 97%) and 13 among young adult males. The typical presentation included itching and diffuse erythema of both ears starting in the evening after exposure to bright sunlight during cold weather, followed within 24-48 h by papules or blisters. No other organ system was involved. The subjects recovered spontaneously without sequelae within 1-2 weeks. In New Zealand, among 162 school-aged boys, 20 developed the condition.
CONCLUSIONS
A limitation is that the analysis was based upon the scanty available literature. Juvenile spring eruption is a self-limiting and generally easy recognizable variant of polymorphic light eruption. Outbreaks tend to appear on sunny and cold spring days. Paediatricians and general practitioners might rapidly develop the skills necessary to clinically appreciate this condition.
Topics: Adolescent; Age Factors; Child; Diagnosis, Differential; Disease Outbreaks; Ear, External; Erythema; Female; Humans; Male; Photosensitivity Disorders; Seasons; Sex Factors; Skin Diseases, Vesiculobullous; Sunlight; Young Adult
PubMed: 23374016
DOI: 10.1111/bjd.12197 -
Clinical Diabetes and Endocrinology Mar 2022Hyperinsulinemic hypoglycemia is the most common cause of severe and persistent hypoglycemia in neonates and children. It is a heterogeneous condition with dysregulated...
BACKGROUND
Hyperinsulinemic hypoglycemia is the most common cause of severe and persistent hypoglycemia in neonates and children. It is a heterogeneous condition with dysregulated insulin secretion, which persists in the presence of low blood glucose levels.
CASE PRESENTATION
We report a case of a 15 year-old male with hyperinsulinemic hypoglycemia, who underwent a subtotal pancreatectomy after inadequate response to medical therapy. Pathological examination was positive for nesidioblastosis (diffuse β-cell hyperplasia by H-E and immunohistochemical techniques). The patient's blood glucose levels normalized after surgery and he remains asymptomatic after 1 year of follow-up. The systematic review allowed us to identify 41 adolescents from a total of 205 cases reported in 22 manuscripts, from a total of 454 found in the original search done in PubMed and Lilacs.
CONCLUSIONS
Although very well reported in children, hyperinsulinemic hypoglycemia can occur in adolescents or young adults, as it happens in our reported case. These patients can be seen, treated and reported by pediatricians or adult teams either way due to the wide age range used to define adolescence. Most of them do not respond to medical treatment, and subtotal distal pancreatectomy has become the elected procedure with excellent long-term response in the vast majority.
PubMed: 35296370
DOI: 10.1186/s40842-022-00138-x -
Journal of Eating Disorders Aug 2023Estimate the prevalence, and associated risk factors, of high school students who are considered at risk for an eating disorder based on screening measures. (Review)
Review
OBJECTIVE
Estimate the prevalence, and associated risk factors, of high school students who are considered at risk for an eating disorder based on screening measures.
METHODS
An electronic search of nine databases was completed from their inception until 1st September 2022. A random-effects meta-analysis was conducted, and confounder (moderator) analyses and meta-regressions examined whether the overall prevalence estimate for of screen-based disordered eating (SBDE) was moderated by student age, BMI, or gender, as well as culture and type of SBDE assessment.
RESULTS
The mean estimate of the prevalence of SBDE among high school students (K = 42 (66 datapoints), N = 56282] in the sample of 25 countries was 13% ([95% CI] = 10.0-16.8%, I = 99.0%, Cochran's Q p = 0.001). This effect was not moderated by features of the samples such as gender, BMI, or age. Among cultures, non-Western countries had a higher prevalence of SBDE prevalence than Western countries, but the difference was not significant. There was considerable variability in the prevalence estimates as a function of the assessment measure, but no meaningful pattern emerged.
CONCLUSION
The estimated figure of 1 in 8 high school students with SBDE-unmoderated by gender and BMI-stands out as a problem in need of attention from public health officials, psychologists, psychiatrists, pediatricians, parents, and educators. There is a great need for innovative, integrated policy and program development all along the spectrum of health promotion and universal, selective, and indicated prevention. Further research is also needed to validate and refine this estimate by (a) conducting basic research on the accuracy of eating disorder screening measurements in samples ages 14 through 17; (b) examining representative samples in more countries in general and Latin American countries in particular; (c) clarifying the relationships between SBDE and age throughout the different phases of late childhood, adolescence, and emerging adulthood; and (d) investigating whether there are meaningful forms of disordered eating and whether these are associated with variables such as gender, ethnicity, and BMI.
PubMed: 37537604
DOI: 10.1186/s40337-023-00849-1