European journal of pediatrics
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Comparative Study Clinical Trial
Ultrasound-guided peripheral intravenous access placement for children in the emergency department.
The usefulness of ultrasound guidance in peripheral intravenous access placement has yet to be established in children. In this prospective comparative study, we investigated success rates of intravenous access placement with ultrasound guidance in a pediatric emergency department. After a failed first attempt with the conventional technique, the second and third attempts were conducted using either the ultrasound guidance (a real-time, dual operator method) or the conventional technique. ⋯ From a total of 712 participants, those with a failed first attempt were allocated to the ultrasound guidance (n = 99) and conventional technique (n = 100) groups. The success rate was significantly lower for the ultrasound guidance (65%) than for the conventional technique (84%) group (p = 0.002, chi-square test). This remained significant after adjusting for confounders with multiple logistic regression analysis (odds ratio 2.60, 95% confidence interval 1.26-5.37, p = 0.001).
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Review Meta Analysis
Neutrophil gelatinase-associated lipocalin as predictor of acute kidney injury in neonates with perinatal asphyxia: a systematic review and meta-analysis.
There is growing evidence that neutrophil gelatinase-associated lipocalin (NGAL) is a promising biomarker of acute kidney injury. The objective of this meta-analysis is to determine the accuracy of serum and urinary NGAL in the detection of acute kidney injury in neonates with perinatal asphyxia. ⋯ The summary sensitivity of serum NGAL was 0.818 (95% CI [0.668, 0.909]), the specificity 0.870 (95% CI [0.754, 0.936]), and the area under the curve 0.912. Regarding urinary NGAL, pooled sensitivity was calculated at 0.897 (95% CI [0.829, 0.940]), specificity at 0.729 (95% CI [0.561, 0.850]), and area under the curve at 0.899.
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We tested the mediating effect of leptin on the association between physical fitness (PF) components and academic performance indicators in healthy adolescents. A total of 263 adolescents (13.9 ± 0.3 years, 47.5% girls, 12.5% overweight) from the DADOS (Deporte, ADOlescencia y Salud) Study were included in the analysis. PF components were assessed by the handgrip test for upper-limb muscular strength, standing long jump test for lower-limb muscular strength, 4 × 10-m shuttle run test for speed-agility, and 20-m shuttle run test for cardiorespiratory fitness. ⋯ Body composition was assessed by body mass index and skinfold thicknesses. Boot-strapped mediation procedures were performed and indirect effects with confidence intervals not including zero were interpreted as statistically significant. Our findings suggest that the positive associations observed between cardiorespiratory fitness and lower-limb muscular strength with academic performance indicators were mediated by leptin concentration after adjusting for sex, pubertal stage, socioeconomic status, and adiposity (percentage of mediation ranging from 54.61 to 82.02%).