Pediatrics
-
Review Meta Analysis Comparative Study
Systematic review and meta-analysis of therapeutic management of upper-limb dysfunction in children with congenital hemiplegia.
Rehabilitation for children with congenital hemiplegia to improve function in the impaired upper limb and enhance participation may be time-consuming and costly. ⋯ No one treatment approach seems to be superior; however, injections of botulinum toxin A provide a supplementary benefit to a variety of upper-limb-training approaches. Additional research is needed to justify more-intensive approaches such as constraint-induced movement therapy and hand-arm bimanual intensive training.
-
Randomized Controlled Trial
Does nebulized lidocaine reduce the pain and distress of nasogastric tube insertion in young children? A randomized, double-blind, placebo-controlled trial.
Nasogastric tube insertion is a common procedure in children that is very painful and distressing. Although nebulized lidocaine has been shown to be effective in reducing the pain and discomfort of nasogastric tube insertion in adults, there have been no similar studies in children. We set out to investigate the role of nebulized lidocaine in reducing pain and distress of nasogastric tube insertion in young children. ⋯ Nasogastric tube insertion results in very high FLACC scores irrespective of lidocaine use. Nebulized lidocaine cannot be recommended as pain relief for nasogastric tube insertion in children. The delay and distress of nebulization likely outweigh a possible benefit in the postinsertion period.
-
Comparative Study
Behavioral problems and cognitive performance at 5 years of age after very preterm birth: the EPIPAGE Study.
We compared the frequency of behavioral problems in very preterm and term children at 5 years of age. We hypothesized that behavioral problems would be associated with cognitive impairment and environmental factors and that differences between the 2 groups would be reduced but persist after adjusting for cognitive performance and environmental factors. ⋯ Behavioral problems were strongly related to cognitive impairment, but very preterm children were still at higher risk even after adjusting for cognitive performance. Early screening for behavioral problems should be encouraged for all very preterm children, and maternal well-being should also be the focus of special attention.
-
Multicenter Study
Diagnostic value of immature neutrophils (bands) in the cerebrospinal fluid of children with cerebrospinal fluid pleocytosis.
We evaluated the diagnostic utility of the presence and number of cerebrospinal fluid (CSF) bands in distinguishing bacterial from aseptic meningitis among children with CSF pleocytosis. ⋯ In this multicenter study, neither the presence nor quantity of CSF bands independently predicted bacterial meningitis among children with CSF pleocytosis.
-
Comparative Study
Consistently inconsistent: a snapshot of across- and within-state disparities in the prevalence of childhood overweight and obesity.
The epidemic of childhood overweight and obesity is characterized by known disparities. Less is known about how these disparities vary across and within the state in which a child lives. ⋯ Disparities in the prevalence of childhood overweight and obesity vary significantly both within and across states. Patterns of variation are inconsistent within states, highlighting the need for states to undertake state- and population-specific analyses and interventions to address the epidemic.