-
PloS One 2023Pacifier use can interfere with nurturing care practices such as breastfeeding, soothing, and sleeping. Due to contradicting beliefs, recommendations, and the high...
BACKGROUND
Pacifier use can interfere with nurturing care practices such as breastfeeding, soothing, and sleeping. Due to contradicting beliefs, recommendations, and the high frequency of pacifier use, understanding its associations may support shaping equitable public health recommendations. This study explored the socio-demographic, maternal, and infant characteristics associated with pacifier use among six-months old infants in Clark County, Nevada.
METHOD
Cross-sectional survey was conducted in 2021 with a sample of mothers (n = 276) of infants under six months old in Clark County, Nevada. Participants were recruited through advertisements in birth, lactation, pediatric care centers, and social media. We used binomial and multinomial logistic models to assess the association between pacifier use and the age of pacifier introduction, respectively, with household, maternal, infant, healthcare characteristics, and feeding and sleeping practices.
RESULTS
More than half of the participants offered pacifiers (60.5%). Pacifier use was higher among low-income households (OR (95% CI) 2.06 (0.99-4.27)), mothers who identified as non-Hispanic (OR (95% CI) 2.09 (1.22-3.59)), non-first-time mothers (OR (95% CI) 2.09 (1.11-3.05)), and bottle-feeding infants (OR (95% CI) 2.76 (1.35-5.65)). Compared to those who did not introduce a pacifier, non-Hispanic mothers (RRR (95% CI) 2.34 (1.30-4.21)) and bottle-fed infants (RRR (95% CI) 2.71 (1.29-5.69)) had a higher risk of introducing pacifier within two weeks. Likewise, infants living in food insecure households (RRR (95% CI) 2.53 (0.97-6.58)) and mothers who have more than one child (RRR (95% CI) 2.44 (1.11-5.34)) had a higher risk of introducing a pacifier after two weeks.
CONCLUSION
Pacifier use is independently associated with maternal income, ethnicity, parity, and bottle feeding among six-month-old infants living in Clark County, Nevada. Household food insecurity increased the relative risk of introducing a pacifier after two weeks. Qualitative research on pacifier use among families with diverse ethnic/racial backgrounds is needed to improve equitable interventions.
Topics: Female; Pregnancy; Child; Humans; Infant; Pacifiers; Nevada; Cross-Sectional Studies; Breast Feeding; Mothers; Demography
PubMed: 37104304
DOI: 10.1371/journal.pone.0285097 -
Journal of Bronchology & Interventional... Jan 2024The Galaxy System (Noah Medical) is a novel robotic endoluminal platform using electromagnetic navigation combined with integrated tomosynthesis technology and augmented...
BACKGROUND
The Galaxy System (Noah Medical) is a novel robotic endoluminal platform using electromagnetic navigation combined with integrated tomosynthesis technology and augmented fluoroscopy. It provides intraprocedural imaging to correct computerized tomography (CT) to body divergence and novel confirmation of tool-in-lesion (TIL). The primary aim of this study was to assess the TIL accuracy of the robotic bronchoscope with integrated digital tomosynthesis and augmented fluoroscopy.
METHODS
Four operators conducted the experiment using 4 pigs. Each physician performed between 4 and 6 nodule biopsies for 20 simulated lung nodules with purple dye and a radio pacifier. Using Galaxy's "Tool-in-Lesion Tomography (TOMO+)" with augmented fluoroscopy, the physician navigated to the lung nodules, and a tool (needle) was placed into the lesion. TIL was defined by the needle in the lesion determined by cone-beam CT.
RESULTS
The lung nodule's average size was 16.3 ± 0.97 mm and was predominantly in the lower lobes (65%). All 4 operators successfully navigated to all (100%) of the lesions in an average of 3 minutes and 39 seconds. The median number of tomosynthesis sweeps was 3 and augmented fluoroscopy was utilized in most cases (17/20 or 85%). TIL after the final TOMO sweep was 95% (19/20) and tool-touch-lesion was 5% (1/20). Biopsy yielding purple pigmentation was also 100% (20/20).
CONCLUSION
The Galaxy System demonstrated successful digital TOMO confirmed TIL success in 95% (19/20) of lesions and tool-touch-lesion in 5% (1/20) as confirmed by cone-beam CT. Successful diagnostic yield was achieved in 100% (20/20) of lesions as confirmed by intralesional pigment acquisition.
Topics: Humans; Animals; Swine; Lung Neoplasms; Bronchoscopy; Robotic Surgical Procedures; Lung; Electromagnetic Phenomena
PubMed: 37072895
DOI: 10.1097/LBR.0000000000000923 -
Journal of Clinical Medicine Mar 2023Sleep bruxism (SB) is a masticatory muscle activity during sleep, and its clinical manifestation in young children is still unclear. The aim of the present study was to...
Sleep bruxism (SB) is a masticatory muscle activity during sleep, and its clinical manifestation in young children is still unclear. The aim of the present study was to evaluate the role of anamnestic information in predicting possible SB in children aged 4-12 years. In a cross-sectional retrospective exploratory study, the dental files of 521 children were examined with regard to the following anamnestic information: gender, age, medical conditions associated with ear, nose, and throat (ENT), respiratory disorders, use of methylphenidate (Ritalin), oral habits, and bruxing during sleep. A child was defined as presenting possible SB when a positive report was received from parents regarding such behavior (SB positive, No. = 84). There were no age- and/or gender-wise differences between SB-positive children and children whose parents did not report SB behavior (SB negative). SB-positive children suffered more from ENT and respiratory disorders than children without SB. Additionally, the use of pacifiers/finger sucking, as well as snoring, were more common among SB-positive children as compared to their SB-negative counterparts (Chi-square). The variables which were found to significantly increase the odds of possible SB in children were mouth breathing, ENT problems, and use of a pacifier or finger sucking (forward stepwise logistic regression). Clinicians should look for clinical signs of possible SB in children whose anamnesis reveals one or more of these anamnestic signals.
PubMed: 37048648
DOI: 10.3390/jcm12072564 -
International Journal of Clinical... 2023To determine the presence of and and their association with extrinsic and intrinsic variables in 6-18-month-old infants.
AIM
To determine the presence of and and their association with extrinsic and intrinsic variables in 6-18-month-old infants.
METHODS
This was an analytical, cross-sectional study of 65 6-18-month-old infants who visited the Centers for Early Childhood in Buenos Aires City. Three groups were established according to the presence of teeth-group I (GI)-edentulous infants, group II (GII)-infants with 1-8 teeth, and group III (GIII)-infants with 9-16 teeth. Data on the variables, diet, use of artificial teats, and oral hygiene were gathered using a self-administered questionnaire. An oral examination was performed according to the International Caries Detection and Assessment System (ICDAS II) criterion. A saliva sample was taken by aspiration with a sterile plastic syringe. Cariogenic (CS) were counted using the adherence test in modified gold broth (AT-MGB). Molecular detection and quantification were performed by quantitative polymerase chain reaction (qPCR) (gtfB, gtfT, and tuf).
RESULTS
A total of 12% of infants received oral hygiene, 38% used bottles, 30% used pacifiers, and 55% had sugar intake. and were detected in 57.1 and 28.6% of the children with caries, respectively. Groups I, II, and III had CS counts of log 2, 3.4, and 3.7, respectively. was detected in 26.7% of GI, 52.9% of GII, and 85.7% of GIII, while was detected in 13.3%, 35.3%, and 57.7%, respectively.
CONCLUSION
The prevalence of was higher than in all groups. The presence of CS was significantly associated with sugar intake. No association was found between and and the presence of caries, hygiene habits, or use of artificial teats.
CLINICAL SIGNIFICANCE
This study supports the role of diet in developing a cariogenic biofilm in children under 2 years of age.
HOW TO CITE THIS ARTICLE
Cornejo CF, Soken LJ, Salgado PA, Detection of and and Their Association with Oral Microbiome Stressors in 6-18-month-old Infants. Int J Clin Pediatr Dent 2023;16(1):68-73.
PubMed: 37020757
DOI: 10.5005/jp-journals-10005-2489 -
European Journal of Pharmaceutics and... Jun 2023Administration devices play a very crucial role in achieving a drug's therapeutic effect. Children are often dosed with oral liquids, but dosing devices don't have the...
INTRODUCTION
Administration devices play a very crucial role in achieving a drug's therapeutic effect. Children are often dosed with oral liquids, but dosing devices don't have the accuracy needed, putting them at risk of inaccurate and suboptimal dosing. The availability and use of administration devices may vary throughout the world. Multiple surveys in UK, Europe and Japan have shown diverging practices by parents/caregivers. The aim of the present investigation was to conduct a larger Pan-India study through a series of workshops to understand the use and challenges of traditional devices and assess the need of innovative administration devices for liquid orals in India.
METHODS
The methodology used for the workshop was contextual inquiry and survey questionnaire were used to record the responses. Parents for the workshop were recruited by advertising the survey on various social media platforms. Informed consent was taken from the parents or caregivers for their participation in the survey. Workshops were conducted pan India and both middle class and urban worker families in the occupational category were included in the study. During the workshop, the parents were briefed about the background and purpose of the study. Certain global innovative devices such as oral syringes, syringes with pacifiers were shown to the parents. Their views and opinions were taken through survey questionnaire and via interactive sessions. The questions were themed for the interactive session on 1) challenges faced, 2) willingness to use innovative devices and 3) the factors influencing their decision on the use of innovative devices.
RESULTS
Across the four regions (4 metro cities) involved in the study, 271 caregivers agreed to participate in the workshops. 17.7 % administered solid dosage forms, 81.2 % administered liquid dosage form and the remaining 1.1 % opted for others.
TRADITIONAL DEVICES
Caregivers reported the use of measuring cups (41.4 %) followed by household spoons (25.8 %), droppers (15.3 %), measuring spoons (2.6 %), and other dosing devices (5.5 %) for measuring oral liquids. 8.0 % did not use any of the dosing devices as they were administrating tablets and/or capsules. The ease-of-use score was the highest for the dropper (2.67 ± 0.68) and the lowest for the measuring spoon (2.00 ± 1.00). The reported challenges were categorised into five categories which also influences the preference of using administration devices. This includes device design, user experience and usability, sociocultural factors, such as beliefs, knowledge and education, regulatory, and market/distribution.
INNOVATIVE DEVICES
The majority of the caregivers (86.7 %) were not aware of any of the innovative devices shown to them. 58.7 % were willing to use it if was recommended by the doctor, 1.5 % of caregivers would use it on pharmacists' recommendation and 37.6 % parents would use it if came along with the medicine. The criteria considered by the parents for use of the innovative devices in the descending order were Doctor's recommendation > Quality > Cost > Packed in medicine > Ease of use > Availability/accessibility. There were no differences observed among the low and high socioeconomic status of caregviers regarding the use of traditional devices, challenges faced and awareness about innovative devices. Overall, the study revealed heterogeneity in the SES for the use of administration devices in the four zones. The association of SES and opinion on the use of administration devices was demonstrated with no statistically significant interaction between caregiver SES and the use of administration devices.
CONCLUSION
The workshop revealed the prevalence of traditional dosing devices like measuring cups, household spoons among the caregivers. It highlighted key issues with the use of appropriate administration devices for correct and accurate dosing in children that remain unresolved and prevalent in India. This study reflects on the needs of the target community; thus hope will help facilitate the development of locally sustainable solutions to improve the administration of medicines in children in India.
Topics: Humans; Child; Caregivers; Pharmaceutical Preparations; Syringes; Surveys and Questionnaires; Parents; Administration, Oral
PubMed: 36965592
DOI: 10.1016/j.ejpb.2023.03.009 -
Acta Medica Portuguesa Jun 2023Exclusive breastfeeding (EBF) is currently recommended until six months of age. The Baby-friendly Hospital (BFH) initiative an international program to promote... (Observational Study)
Observational Study
INTRODUCTION
Exclusive breastfeeding (EBF) is currently recommended until six months of age. The Baby-friendly Hospital (BFH) initiative an international program to promote breastfeeding, was launched in Portugal in 1994. The aim of this study was to identify the prevalence and factors influencing breastfeeding in the first six months of life and to compare the results with a study carried out in 1999 including population from the same geographic area.
MATERIAL AND METHODS
A prospective, longitudinal and observational study was carried out in two hospitals in the Lisbon metropolitan area, one BFH and another non-BFH. It consisted of different questionnaires answered by mothers at three distinct moments (zero, three and six months). The first questionnaire was applied between February and June 2019.
RESULTS
A total of 423 infants were included, 324 from the BFH and 99 from the non-BFH. The breastfeeding rate was 94.3% at discharge, 78.2% at three months and 64.4% at six months, whereas EBF rate was 74.2%, 51.8% and 25.6% respectively. All women on EBF at six months, except one, were breastfeeding on demand. The discontinuation of EBF was associated with delayed skin-to-skin contact, Neonatal Intensive Care Unit admission, pacifier and artificial teats use, mother's return to work earlier and lower education levels. Conversely, factors that promote EBF were older gestational age, adequate birthweight, breastfeeding initiation in the first hour of life, rooming-in practice, shorter hospital stay and absence of infant's illnesses. Compared with 1999, although there was a significant improvement of breastfeeding rates at three and six months, the EBF rate was similar at six months (23%). Both studies identified the mother's lower education level and mother's return to work as contributing factors to breastfeeding discontinuation.
CONCLUSION
Our results are in agreement with previously reported causes of breastfeeding discontinuation and emphasize the importance of sociocultural factors. Compared with 1999, the breastfeeding rates in this Portuguese population increased significantly at three and six months. However, it is still necessary to improve in order to achieve the World Health Organization global target.
Topics: Infant; Infant, Newborn; Female; Humans; Breast Feeding; Prevalence; Prospective Studies; Mothers; Health Promotion
PubMed: 36947662
DOI: 10.20344/amp.18692 -
Frontiers in Cardiovascular Medicine 2023Atrial fibrillation (AF) is one of the most investigated arrhythmias since it is associated with a five-fold increase in the risk of strokes. Left atrium dilation and...
Atrial fibrillation (AF) is one of the most investigated arrhythmias since it is associated with a five-fold increase in the risk of strokes. Left atrium dilation and unbalanced and irregular contraction caused by AF favour blood stasis and, consequently, stroke risk. The left atrial appendage (LAA) is the site of the highest clots formation, increasing the incidence of stroke in AF population. For many years oral anticoagulation therapy has been the most used AF treatment option available to decrease stroke risk. Unfortunately, several contraindications including bleeding risk increase, interference with other drugs and with multiorgan functioning, might outweigh its remarkable benefits on thromboembolic events. For these reasons, in recent years, other approaches have been designed, including LAA percutaneous closure. Unfortunately, nowadays, LAA occlusion (LAAO) is restricted to small subgroups of patients and require a certain level of expertise and training to successfully complete the procedure without complications. The most critical clinical problems associated with LAAO are represented by peri-device leaks and device related thrombus (DRT). The anatomical variability of the LAA plays a key role in the choice of the correct LAA occlusion device and in its correct positioning with respect to the LAA ostium during the implant. In this scenario, computational fluid dynamics (CFD) simulations could have a crucial role in improving LAAO intervention. The aim of this study was to simulate the fluid dynamics effects of LAAO in AF patients to predict hemodynamic changes due to the occlusion. LAAO was simulated by applying two different types of closure devices based on the plug and the pacifier principles on 3D LA anatomical models derived from real clinical data in five AF patients. CFD simulations were performed on the left atrium model before and after the LAAO intervention with each device. Blood velocity, particle washout and endothelial damage were computed to quantify flow pattern changes after the occlusion in relation to the thrombogenic risk. Our preliminary results confirmed an improved blood washout after the simulated implants and the capability of foreseeing thrombogenic risk based on endothelial damage and maximum blood velocities in different scenarios. This tool may help to identify effective device configurations in limiting stroke risk for patient-specific LA morphologies.
PubMed: 36891242
DOI: 10.3389/fcvm.2023.1067964 -
Frontiers in Pediatrics 2022Breastfeeding is a protective factor against respiratory and intestinal infections in developing countries. In developed countries, proof of this protection is more...
Breastfeeding and respiratory, ear and gastro-intestinal infections, in children, under the age of one year, admitted through the paediatric emergency departments of five hospitals.
BACKGROUND
Breastfeeding is a protective factor against respiratory and intestinal infections in developing countries. In developed countries, proof of this protection is more difficult to show. The objective of the study is to compare the proportion of children breastfed during their first year in groups of children with infectious pathologies supposedly prevented by breastfeeding and children free of these infectious pathologies.
METHOD
Questionnaires about diet, socio-demographic data and the motive for consultation were given to the parents upon arrival in the paediatric emergency departments of 5 hospitals located in Pays de Loire (France) in 2018 and 2019. Children with lower respiratory tract infections, acute gastroenteritis and acute otitis media were included in the case group (A), children admitted for other reasons were included in the same control group (B). Breastfeeding was classified as exclusive or partial.
RESULTS
During the study period, 741 infants were included, of which 266 (35.9%) in group A. In this group, children were significantly less likely to have been breastfed at the time of admission than children in group B: for example, for children under 6 months, 23.3% were currently breastfed in group A, vs. 36.6% (weaned BF or formula diet) in group B [OR = 0.53 (0.34-0.82); = 0.004]. Similar results were found at 9 and 12 months. After taking into account the age of the patients, the same results were confirmed with an aOR = 0.60 (0.38-0.94) ( = 0.02) at 6 months, but with when considering six variables six variables, aOR was not significative aOR = 0.65 (0.40-1.05); = 0.08), meaning that factors such as the childcare out of home, socio-professional categories, and the pacifier decrease the protective effect of breastfeeding. Sensitivity analyses (age-matching, analysis by type of infection) showed the same protection effect provided by breastfeeding when it was pursued for at least 6 months and also that the protective effect of breastfeeding is especially true against gastro-enteritis.
CONCLUSION
Breastfeeding is a protective factor against respiratory, gastrointestinal and ear infections when pursued at least 6 months after birth. Other factors such as collective childcare, pacifiers and low parental professional status can reduce the protective effect of breastfeeding.
PubMed: 36874253
DOI: 10.3389/fped.2022.1053473 -
European Journal of Paediatric Dentistry Feb 2023It is widely recognised by the scientific dental community that the correct development of the deciduous and mixed dentitions is paramount to the oral health of...
It is widely recognised by the scientific dental community that the correct development of the deciduous and mixed dentitions is paramount to the oral health of paediatric patients. In this respect, interceptive orthodontics plays a fundamental role in the process. Specifically, the paediatric dentist monitors the condition of the mouth from early childhood, distinguishing three age brackets for intervention, each defined by their own characteristics. It would also be desirable for other professionals who treat young patients and their mothers to various extents, such as paediatricians, gynaecologists, obstetricians and speech therapists to share valuable information with us. What follows is a brief summary of important conditions and key information regarding interceptive orthodontics. Age range 0-3 years: breastfeeding during the first months of life has been shown to have a positive effect on the development of the jaws. Later on, the transition to solid food, promoted by the eruption of the deciduous teeth, further stimulates their growth. During this phase, it is recommended to monitor and intercept any muscular hypotonia and low tongue postures. Additionally, it is essential to instruct parents on the proper dietary and lifestyle behaviours needed to ensure the physiological growth of the child, while protecting the health of their oral cavity. Age range 4-6 years: attention should be paid to the deciduous dentition and the development of the upper and lower maxillary bones, along with prompt interception and correction of bad habits such as the continued use of the pacifier, finger sucking, oral breathing and atypical swallowing. Age >6 years: within this phase, the careful monitoring of the space available in the arch, the natural exfoliation of milk teeth, the eruption of the permanent teeth and their occlusal relationship, as well as the maxillomandibular relationship are all important. If necessary, in addition to removing any risk factor, fixed or mobile orthodontic appliances can also be used during the above stages, especially stage 2 and 3, depending on the occlusal and skeletal status of the patient. Early diagnosis of malocclusion is crucial, as well as the sharing of information with other clinicians that deal with children and their parents, who need to be informed about the various therapies that their child may need. The paediatric dentist could, in fact, directly reach out to families to make them understand that malocclusion and other manifestations linked to conditions affecting oral functions such as breathing, sleeping, chewing and feeding often show the first signs as early as pre-school age, long before eruption of the first milk tooth, which is the time when the first dental visit is usually booked! We trust that awareness is the first form of prevention, and this is the message that must be conveyed to all of those involved in paediatric dentistry, patients and professionals alike: awareness and prevention is the first cure.
Topics: Humans; Child; Child, Preschool; Female; Infant, Newborn; Infant; Orthodontics, Interceptive; Malocclusion; Breast Feeding; Dentists; Dentition, Mixed
PubMed: 36853207
DOI: 10.23804/ejpd.2023.24.01.01 -
Nutrients Feb 2023(1) Background: The current evidence on management of infants under six months (u6m) with growth faltering is limited and of low quality. This review aimed at updating... (Review)
Review
(1) Background: The current evidence on management of infants under six months (u6m) with growth faltering is limited and of low quality. This review aimed at updating an existing review to inform the WHO guideline update on prevention and management of growth faltering in infants u6m. The objective is to synthesise evidence on interventions to manage breastfeeding difficulties in mothers or caregivers of infants u6m with growth faltering to improve breastfeeding practices and breastmilk intake. (2) Methods: We searched PubMed, CINAHL, and Cochrane Library from December 2018 to December 2021 for experimental studies. Using RoB 2.0 and ROBINS-I tools, we assessed study quality and results were synthesised narratively. Using the GRADE approach, we assessed the quality of evidence for four outcome domains-breastfeeding (critical), anthropometric (important), mortality (important), and morbidity (important). (3) Results: We identified seven studies, conducted among neonates (mainly preterm, n = 14 to 607), and assessed the following interventions: (a) non-nutritive sucking (NNS) on breast (n = 2) and (b) alternative supplemental feeding techniques (n = 5, cup feeding, spoon feeding, supplemental feeding tube device, and syringe feeding), and reported breastfeeding and anthropometric outcomes. None of the studies reported mortality and morbidity outcomes. The reported breastfeeding outcomes included LATCH (Latch, Audible swallowing, Type of nipple, Comfort, Hold) total score, PIBBS (Preterm Infants Breastfeeding Behaviour Scale) total score, EBF (exclusive breastfeeding) at various time points and time to transition to full breastfeeding, and reported anthropometric outcomes included weight gain and weight at different time points. Studies had 'serious' indirectness and 'serious' to 'very serious' risks of bias. From the limited studies we found, NNS on breast compared to NNS on finger may have some benefits on PIBBS total score; NNS on breast compared to NNS on pacifier may have some benefits on EBF at discharge; and cup feeding compared to bottle feeding may have some benefits on EBF at discharge, at three months and at six months. (4) Conclusions: Evidence on the effectiveness of interventions to manage breastfeeding difficulties in mothers or caregivers of infants u6m with growth faltering to improve breastfeeding practices and increase breastmilk intake is 'limited' and of 'low' to 'very low' quality. As the majority of the infants in the included studies were neonates, no new recommendations can be made for infants from one to six months due to lack of evidence in this population. We need more studies targeting infants from one to six months of age. The review was registered with PROSPERO (CRD42022309001).
Topics: Female; Infant, Newborn; Infant; Humans; Breast Feeding; Infant, Premature; Bottle Feeding; Infant Nutritional Physiological Phenomena; Mothers
PubMed: 36839345
DOI: 10.3390/nu15040988