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  • 文章类型: Systematic Review
    背景:暴露于地震会对幸存者的心理健康造成不利影响,包括创伤后应激障碍的风险增加。目的:本系统评价旨在分析先前的次要研究,以确定从儿童到老年地震幸存者的PTSD危险因素。此外,它旨在考虑个体共同影响的复杂性,关系,和上下文风险因素,也检测到最危险的家庭。方法:在通过PubMed进行文献检索和筛选研究后,WebofScience,Scopus,和EBSCO在PRISMA指南的指导下,确定了10项符合条件的次要研究,这些研究检查了受全球地震影响的个体(从儿童到老年人)的PTSD危险因素。结果:对纳入研究的分析允许识别一系列社会人口统计学,创伤前,周围创伤,以及儿童创伤后创伤后应激障碍的危险因素,青少年,青春,成年人,老年幸存者。结果代表了这些风险因素对个体的联合影响的复杂性,关系,和上下文级别。结论:对PTSD危险因素的考虑突出了个体特征以及经历类型和暴露在之前时期的重要性,during,在地震之后。这些知识可以帮助早期识别不同年龄和家庭的高危个人,并实施干预方案。
    这是首次使用二级研究确定从儿童到老年地震幸存者的PTSD危险因素的系统评价。考虑到个体联合效应的复杂性,关系,和上下文级别,几个社会人口,创伤前,周围创伤,并在所考虑的年龄组中确定了创伤后创伤后应激障碍的危险因素.此外,这些因素的考虑有助于确定高危家庭.确定整个生命周期中PTSD的危险因素可以为预防和干预计划提供有用的知识。
    Background: Exposure to earthquakes can cause adverse effects on the mental health of survivors, including an increased risk of PTSD.Objective: This systematic review aims to analyse the previous secondary studies to identify the risk factors for PTSD from children to elderly earthquake survivors. In addition, it aims to consider the complexity of the joint effects of the individual, relational, and contextual risk factors, to also detect the most at-risk families.Method: After reviewing and screening studies from the literature search through PubMed, Web of Science, Scopus, and EBSCO under the guidance of PRISMA guidelines, ten eligible secondary studies were identified that examine the risk factors for PTSD in individuals (from children to elderly) affected by worldwide earthquakes.Results: The analysis of the included studies allowed the identification of a series of socio-demographic, pre-traumatic, peri-traumatic, and post-traumatic PTSD risk factors in children, adolescents, youth, adults, and elderly survivors. The results represent the complexity of the joint effects of these risk factors at individual, relational, and contextual levels.Conclusions: The consideration of the PTSD risk factors highlights the importance of individual characteristics and the type of experiences and exposure in the period before, during, and after the earthquake. This knowledge could allow the early identification of at-risk individuals of different ages and families and the implementation of intervention programmes.
    This is the first systematic review to identify PTSD risk factors from children to elderly earthquake survivors using secondary studies.Considering the complexity of the joint effects at individual, relational, and contextual levels, several socio-demographic, pre-traumatic, peri-traumatic, and post-traumatic risk factors for PTSD were identified in the age groups considered. Moreover, the consideration of these factors could help the identification of at-risk families.The identification of risk factors for PTSD across the lifespan could provide helpful knowledge for prevention and intervention programmes.
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  • 文章类型: Journal Article
    目的:小儿肱骨髁上骨折很少进行切开复位。然而,缺乏明确的证据表明,采用最佳的开放方法可以取得令人满意的结果。前路手术提供了骨折的直接可视化和对神经血管结构的良好暴露,虽然它的使用不太常见。这项研究的目的是回顾适应症,结果,以及与前路切开复位这些骨折相关的并发症。
    方法:我们的方案在PROSPERO:CRD42023446923注册。MEDLINE/PubMed,Embase,WebofScience,Clinicaltrials.gov,和Cochrane图书馆从数据库开始到搜索日期(2023年12月)进行搜索,并一式两份筛选相关研究。收集了有关患者人口统计学的数据,切开复位的迹象,弗林的功能和外观结果,和并发症。使用非随机研究标准的方法学指数评估研究质量。
    结果:共纳入19项研究,涉及483例患者。一项研究被列为二级证据,十为3级,八为4级。平均MINORS评分为13.05±3.47。开放还原的主要指征是封闭还原失败,在46%的患者中观察到。97.7%和98.6%的患者取得了Flynn的功能和美容效果满意,分别。术后神经血管损伤率为1.4%。一名患者需要再次干预。
    结论:前路手术治疗需要切开复位的小儿肱骨髁上骨折是安全有效的。
    方法:2-4级证据研究的系统评价。
    OBJECTIVE: Open reduction is rarely performed in pediatric supracondylar humerus fractures. However, clear evidence is lacking regarding the optimal open approach to achieve satisfactory results. The anterior approach provides direct visualization of the fracture and excellent exposure to neurovascular structures, although its utilization is less common. The objective of this study was to review the indications, outcomes, and complications associated with the anterior approach for open reduction of these fractures.
    METHODS: Our protocol was registered at PROSPERO: CRD42023446923. MEDLINE/PubMed, Embase, Web of Science, Clinicaltrials.gov, and Cochrane Library were searched from database inception to search date (December 2023) and screened in duplicate for relevant studies. Data were collected regarding patient demographics, indications for open reduction, Flynn\'s functional and cosmetic outcomes, and complications. Study quality was assessed using the Methodological Index for Non-Randomized Studies Criteria.
    RESULTS: A total of 19 studies involving 483 patients were included. One study was classified as Level 2 evidence, ten as Level 3, and eight as Level 4. The mean MINORS score was 13.05±3.47. The primary indication for open reduction was failed closed reduction, observed in 46% of patients. 97.7% and 98.6% of patients achieved Flynn\'s functional and cosmetic satisfactory results, respectively. The postsurgical neurovascular injury rate was 1.4%. One patient required reintervention.
    CONCLUSIONS: The anterior approach is safe and effective for managing pediatric supracondylar humerus fractures requiring open reduction.
    METHODS: Systematic review of Level 2-4 evidence studies.
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  • 文章类型: Meta-Analysis
    目的:这是一项关于抗磷脂综合征(APS)儿童和青少年血栓栓塞事件发生率的系统评价和荟萃分析。
    方法:我们搜索了PubMed,EMBASE和WebofScience选择2000年1月1日至2022年2月27日发表的相关文章。我们使用随机效应荟萃分析来估计最小样本量为30的研究中血栓栓塞事件的汇总点患病率。
    结果:我们纳入了五项研究,报告了336名患有原发性APS和继发性APS(SAPS)的儿童和青少年的数据。初始一般血栓形成的汇总点患病率,动脉血栓形成,APS阳性患者的静脉血栓形成和卒中发生率为98.2%(95%置信区间[CI]87.5-100),27.6%(95%CI21.4-34.2),51.1%(95%CI38.2-63.9)和13.4%95%CI(6.3-22.7),分别。SAPS儿童和青少年初始动脉和静脉血栓形成的汇总点患病率分别为45.7%(95%CI21.1-71.6)和29.2%(95%CI14.8-46),分别。
    结论:动静脉血栓栓塞在患有SAPS的儿童和青少年中非常常见。有必要进行更多使用血栓性和非血栓性APS分类标准的研究,以更好地评估受不同类型APS影响的年龄和血统不同的儿科人群中血栓栓塞的频率和预测因素。
    OBJECTIVE: This was a systematic review and meta-analysis of the prevalence of thromboembolic events in children and adolescents with antiphospholipid syndrome (APS).
    METHODS: We searched PubMed, EMBASE and Web of Science to select relevant articles published between 1 January 2000 and 27 February 2022. We used the random-effects meta-analysis to estimate pooled point prevalence rates of thromboembolic events in studies with a minimum sample size of 30.
    RESULTS: We included five studies reporting data of 336 children and adolescents with primary APS and secondary APS (SAPS). Pooled point prevalence rates of initial general thrombosis, arterial thrombosis, venous thrombosis and stroke in individuals with seropositive APS were 98.2% (95% confidence interval [CI] 87.5-100), 27.6% (95% CI 21.4-34.2), 51.1% (95% CI 38.2-63.9) and 13.4% 95% CI (6.3-22.7), respectively. Pooled point prevalence rates of initial arterial and venous thromboses in children and adolescents with SAPS were 45.7% (95% CI 21.1-71.6) and 29.2% (95% CI 14.8-46), respectively.
    CONCLUSIONS: Arterio-venous thromboembolism is highly frequent in children and adolescents with SAPS. More studies using thrombotic and non-thrombotic APS classification criteria are warranted to better assess the frequency and predictors of thromboembolism in age- and ancestry-diverse pediatric populations affected by different types of APS.
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  • 文章类型: Systematic Review
    在COVID-19患者中观察到毛霉菌病的发生。然而,关于流行病学因素的信息有限,介绍,诊断确定性,以及儿童感染的结果。PubMed,MEDLINE,Scopus,Embase,WebofScience,LitCovid,从2019年12月至2023年3月,系统检索了已鉴定手稿的反向引用.我们在COVID-19患者中发现了14例小儿毛霉菌病。患者的中位年龄为10.7岁。在这些案例中,10例与活跃的COVID-19相关。在7个案例中,患者既往有糖尿病和糖尿病酮症酸中毒.其中7名患者接受了皮质类固醇治疗COVID-19。该疾病最常见的临床表现是鼻-眶脑毛霉菌病。7例患者死亡(50%)。鉴于死亡率高,临床医师应高度怀疑COVID-19患儿的毛霉菌病.
    The occurrence of mucormycosis has been observed in individuals with COVID-19. However, there is limited information on the epidemiological factors, presentation, diagnostic certainty, and outcome of this infection in children. PubMed, MEDLINE, Scopus, Embase, Web of Science, LitCovid, and back-references of the identified manuscripts were systematically searched from December 2019 to March 2023. We have identified 14 cases of pediatric mucormycosis in patients with COVID-19. The median age of patients was 10.7 years. Among these cases, 10 were associated with active COVID-19. In 7 cases, the patients had pre-existing diabetes mellitus and concomitant diabetic ketoacidosis. Corticosteroids were administered to treat COVID-19 in 7 of the patients. The most common clinical presentation of the disease was rhino-orbital cerebral mucormycosis. Seven patients died (50%). Given the high mortality rate, clinicians should maintain a high level of clinical suspicion of mucormycosis in pediatric patients with COVID-19.
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  • 文章类型: Systematic Review
    背景:沟通和语言技能是自闭症谱系障碍(ASD)患者受影响最严重的领域之一。当被诊断患有ASD的孩子生活在双语环境中时,父母经常担心他们的孩子是否应该同时学习两种语言,向专家寻求建议。尽管缺乏任何负面影响的证据,一些专业人士在这个问题上意见不一。在这篇系统综述中,我们研究了双语是否会影响ASD儿童的语言发展。
    方法:我们回顾了在4个不同数据库中发表的文献。应用一系列选择标准后,我们选择了12篇科学文章,包括328名被诊断患有ASD的儿童(169名双语和159名单语),年龄从3到12岁不等。使用涵盖多个领域的不同接受和表达性语言评估工具对这些患者进行了评估。评估是直接对孩子们进行的,尽管在一些研究中也对父母进行了间接评估.
    结论:关于双语不会给3岁以下ASD儿童的语言发展带来任何额外困难的说法,似乎已经达成共识。
    BACKGROUND: Communication and language skills are among the most severely affected domains in individuals with autistic spectrum disorder (ASD). When a child diagnosed with ASD lives in a bilingual environment, the parents often express concerns about whether their child should learn both languages simultaneously, turning to specialists for advice. Despite the lack of evidence of any negative effect, some professionals disagree on this subject. In this systematic review we study whether bilingualism affects language development in children with ASD.
    METHODS: We reviewed the literature published in 4 different databases. After applying a series of selection criteria, we selected 12 scientific articles, including a total of 328 children diagnosed with ASD (169 bilingual and 159 monolingual), with ages ranging from 3 to 12 years. These patients were evaluated with different receptive and expressive language assessment instruments covering several areas. The assessments were performed directly on the children, although indirect assessment of parents was also performed in some studies.
    CONCLUSIONS: There seems to be consensus regarding the assertion that bilingualism does not entail any additional difficulty for language development in children with ASD from the age of 3.
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  • 文章类型: Systematic Review
    自闭症谱系障碍(ASD)具有不同的特征,对社会产生影响,交流和感觉运动(SM)水平。SM特征是姿势控制(PC)问题。有各种运动干预策略(MIS),但相对于LC的好处是没有被广泛分析的。目的是在ASD儿童和青少年的PC上描述MIS及其结果。搜索PubMed,Scopus,进行了WebofScience和Cochrane。共有8篇文章符合资格标准。所有MIS对PC的改进均显示出有益的结果。管理信息系统性质各异(舞蹈练习,个性化的身体活动,视频游戏,太极拳,跆拳道和虚拟现实)。有必要改进设计并考虑偏差的风险,因为它们限制了结果的范围。
    Autism spectrum disorder (ASD) has varied characteristics with an impact at the social, communicative and sensorimotor (SM) level. An SM feature is postural control (PC) problems. There are various motor intervention strategies (MIS), but the benefit over LC is something that has been analyzed less extensively. The objective was to describe the MIS and its results on the PC of children and adolescents with ASD. A search of PubMed, Scopus, Web of Science and Cochrane was performed. A total of eight articles met the eligibility criteria. All MIS showed beneficial results on the improvement of PC. The MIS were of a varied nature (dance practice, personalized physical activity, video games, Tai Chi Chuan, Taekwondo and virtual reality). It is necessary to improve the designs and consider the risks of bias, since they limit the scope of the results.
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  • 文章类型: Journal Article
    流感在健康儿童和青少年中很常见,并且在该组中住院率很高。尤其是那些<5年。尽管自2012年以来,世卫组织已建议在5岁以下儿童中接种疫苗,但如今却很少在国家实施。本文的目的是通过对2010年至2020年之间进行的非系统研究,回顾有关流感疫苗接种对18岁以下健康儿童的功效/有效性的现有证据。尽管由于设计的差异,结果的可变性很高,41项选定研究中包括的疫苗类型和季节,具有统计学意义的研究表明,流感疫苗的效力值在25.6%至74.2%之间,有效率从26%提高到78.8%。尽管有必要进行系统的审查以证实证据,这篇综述表明,儿科疫苗接种通常是根据国际生物建议预防健康儿童流感的有效措施。
    Influenza is common in healthy children and adolescents and is associated with a high rate of hospitalization in this group, especially for those <5 years. Although the WHO has recommended vaccination in children under 5 years of age since 2012, it is really implemented in few countries today. The aim of this paper was to review the available evidence on the efficacy/effectiveness of influenza vaccination in healthy children <18 years of age through a non-systematic search of studies conducted between 2010 and 2020. Despite the high variability in results due to differences in design, vaccine type and season included in the 41 selected studies, statistically significant studies show efficacy values for the influenza vaccine of between 25.6% and 74.2%, and effectiveness from 26% to 78.8%. Although a systematic review would be necessary to corroborate the evidence, this review suggests that paediatric vaccination is generally an effective measure for preventing influenza in healthy children in line with international organisms\' recommendations.
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  • 文章类型: Journal Article
    背景:肱骨外髁骨折是儿童肘部最常见的第二骨折。然而,肘关节脱位是一个罕见的实体。因此,关于这种罕见组合的年轻患者的文献很少。我们旨在对与肘关节脱位相关的小儿肱骨外髁骨折的文献进行系统回顾。
    方法:在1960年至2020年之间对PubMed和Embase数据库进行了系统回顾,以获取同行评审的文献。两名审阅者过滤了结果,寻找英语和西班牙语的文章,报道了肱骨外髁骨折与肘关节脱位相关的骨骼未成熟患者。结果包括患者和受伤特征,治疗策略,并发症,和最终结果,包括运动范围。
    结果:最初的搜索共产生了851项研究。经过初步筛选,包括16项研究,67名患者可供复查。受伤时报告的年龄为2至12岁。病变更常见于男性(60%)患有MilchII,和Jakob3型骨折.在大多数情况下,脱位的方向是后内侧。通过侧向入路和克氏针放置切开复位是最有效的治疗方法。报告的随访时间为3至156个月。14项研究报告了1/3患者的并发症,包括:活动范围有限,肘内翻,不稳定性,硬件突出,延迟工会,骨不连,malunion,异位骨化,神经损伤,硬件故障。13项研究报告了临床结果,在10例患者中,有2例被评为一般或较差。
    结论:目前的证据是IV级,表明在肘关节脱位相关的情况下,外侧髁骨折手术治疗后的并发症发生率很高。次优结果的百分比升高。本系列中最常见的并发症是肘部僵硬和肘内翻。
    BACKGROUND: Lateral humeral condyle fractures are the second most common fracture around the elbow in children. However, the association of an elbow dislocation is a rare entity. Therefore, literature on young patients with this uncommon combination is sparse. We aimed to perform a systematic review of the literature searching for paediatric lateral condyle humerus fractures associated to elbow dislocation.
    METHODS: A systematic review of the PubMed and Embase databases was conducted for peer-reviewed literature between 1960 and 2020. Two reviewers filtered the results, looking for articles in English and Spanish that reported fractures of the lateral condyle of the humerus associated to elbow dislocation in skeletally immature patients. Outcomes included patient and injury characteristics, treatment strategies, complications, and final outcomes including range of motion.
    RESULTS: The initial search yielded a total of 851 studies. After initial screening, 16 studies were included, with 67 patients available for review. Age reported at the time of injury ranged from 2 to 12 years. The lesion occurred more commonly in males (60%) with Milch II, and Jakob type 3 fractures. The direction of the dislocation was posteromedial in most cases. Open reduction by lateral approach and Kirschner pin placement was the most performed treatment. The reported follow-up ranged from 3 to 156 months. Fourteen studies reported complications in 1/3 of the patients including: limited range of motion, cubitus varus, instability, hardware prominence, delayed union, nonunion, malunion, heterotopic ossification, neurological injury, and hardware failure. Thirteen studies reported clinical outcomes, which were rated as fair or poor in 2 out of 10 patients.
    CONCLUSIONS: Current evidence is level IV and suggests that the complication rate after surgical management of lateral condyle fractures is substantial in the context of an associated elbow dislocation, with an elevated percentage of suboptimal results. The most frequent complications in this series were elbow stiffness and cubitus varus.
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  • 文章类型: Journal Article
    背景:肱骨外髁骨折是儿童肘部最常见的第二骨折。然而,肘关节脱位是一个罕见的实体。因此,关于这种罕见组合的年轻患者的文献很少。我们旨在对与肘关节脱位相关的小儿肱骨外髁骨折的文献进行系统回顾。
    方法:在1960年至2020年之间对PubMed和Embase数据库进行了系统回顾,以获取同行评审的文献。两名审阅者过滤了结果,寻找英语和西班牙语的文章,报道了肱骨外髁骨折与肘关节脱位相关的骨骼未成熟患者。结果包括患者和受伤特征,治疗策略,并发症,和最终结果,包括运动范围。
    结果:最初的搜索共产生了851项研究。经过初步筛选,包括16项研究,67名患者可供复查。受伤时报告的年龄为2至12岁。病变更常见于男性(60%)患有MilchII,和Jakob3型骨折.在大多数情况下,脱位的方向是后内侧。通过侧向入路和克氏针放置切开复位是最有效的治疗方法。报告的随访时间为3至156个月。14项研究报告了1/3患者的并发症,包括:活动范围有限,肘内翻,不稳定性,硬件突出,延迟工会,骨不连,malunion,异位骨化,神经损伤,硬件故障。13项研究报告了临床结果,10名患者中有2名被评为一般或较差。
    结论:目前的证据是IV级,表明在肘关节脱位相关的情况下,外侧髁骨折手术治疗后的并发症发生率很高。次优结果的百分比升高。本系列中最常见的并发症是肘部僵硬和肘内翻。
    BACKGROUND: Lateral humeral condyle fractures are the second most common fracture around the elbow in children. However, the association of an elbow dislocation is a rare entity. Therefore, literature on young patients with this uncommon combination is sparse. We aimed to perform a systematic review of the literature searching for pediatric lateral condyle humerus fractures associated to elbow dislocation.
    METHODS: A systematic review of the PubMed and Embase databases was conducted for peer-reviewed literature between 1960 and 2020. Two reviewers filtered the results, looking for articles in English and Spanish that reported fractures of the lateral condyle of the humerus associated to elbow dislocation in skeletally immature patients. Outcomes included patient and injury characteristics, treatment strategies, complications, and final outcomes including range of motion.
    RESULTS: The initial search yielded a total of 851 studies. After initial screening, 16 studies were included, with 67 patients available for review. Age reported at the time of injury ranged from 2 to 12 years. The lesion occurred more commonly in males (60%) with Milch II, and Jakob type 3 fractures. The direction of the dislocation was posteromedial in most cases. Open reduction by lateral approach and Kirschner pin placement was the most performed treatment. The reported follow-up ranged from 3 to 156 months. Fourteen studies reported complications in 1/3 of the patients including: limited range of motion, cubitus varus, instability, hardware prominence, delayed union, nonunion, malunion, heterotopic ossification, neurological injury, and hardware failure. Thirteen studies reported clinical outcomes, which were rated as fair or poor in 2out of 10patients.
    CONCLUSIONS: Current evidence is level IV and suggests that the complication rate after surgical management of lateral condyle fractures is substantial in the context of an associated elbow dislocation, with an elevated percentage of suboptimal results. The most frequent complications in this series were elbow stiffness and cubitus varus.
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  • 文章类型: Journal Article
    由于生长引起的神经解剖学成熟,童年的步态模式不断变化,为此,我们建议从已发表的研究和动作捕捉方法中确定,获得儿童步态生物力学模式的基本特征。在Scopus进行了科学论文的搜索,SciELO,PudMed和PEDro在18岁以下的受试者中评估步态,基于运动捕捉方法和生物力学参数。结果表明,从7到9岁的孩子获得确定的步态模式,最常用的运动捕捉方法是Vicon,随着视频的使用,力平台和肌电图和使用的参数是空间,temporal,时空,运动学,动力学和肌电图。
    The gait patter in childhood is constantly changing as a result of the neuro-anatomical maturation due to growth, for this reason we propose to identify from published studies and the motion capture method, the essential features for obtaining the biomechanical pattern of gait in children. A search for scientific articles was carried out in Scopus, SciELO, PudMed and PEDro where gait is evaluated in subjects under 18 years old, based on motion capture methods and biomechanical parameters. The results showed that from 7 to 9 years old the child acquires the definitive gait pattern, the most used motion capture method was Vicon, with the use of video, force platform and electromyography and the parameters used were the spatial, temporal, spatial-temporal, kinematic, kinetic and electromyographic.
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