Bmc Pediatr
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Randomized Controlled Trial Multicenter Study
Early high flow nasal cannula therapy in bronchiolitis, a prospective randomised control trial (protocol): A Paediatric Acute Respiratory Intervention Study (PARIS).
Bronchiolitis imposes the largest health care burden on non-elective paediatric hospital admissions worldwide, with up to 15 % of cases requiring admission to intensive care. A number of previous studies have failed to show benefit of pharmaceutical treatment in respect to length of stay, reduction in PICU admission rates or intubation frequency. The early use of non-invasive respiratory support devices in less intensive scenarios to facilitate earlier respiratory support may have an impact on outcome by avoiding progression of the disease process. High Flow Nasal Cannula (HFNC) therapy has emerged as a new method to provide humidified air flow to deliver a non-invasive form of positive pressure support with titratable oxygen fraction. There is a lack of high-grade evidence on use of HFNC therapy in bronchiolitis. ⋯ This large multicenter randomised trial will allow the definitive assessment of the efficacy of HFNC therapy as compared to standard subnasal oxygen in the treatment of bronchiolitis.
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Randomized Controlled Trial
Baby-Led Introduction to SolidS (BLISS) study: a randomised controlled trial of a baby-led approach to complementary feeding.
In 2002, the World Health Organization recommended that the age for starting complementary feeding should be changed from 4 to 6 months of age to 6 months. Although this change in age has generated substantial debate, surprisingly little attention has been paid to whether advice on how to introduce complementary foods should also be changed. It has been proposed that by 6 months of age most infants will have developed sufficient motor skills to be able to feed themselves rather than needing to be spoon-fed by an adult. This has the potential to predispose infants to better growth by fostering better energy self-regulation, however no randomised controlled trials have been conducted to determine the benefits and risks of such a "baby-led" approach to complementary feeding. This is of particular interest given the widespread use of "Baby-Led Weaning" by parents internationally. ⋯ This study is expected to provide insight into the feasibility of a baby-led approach to complementary feeding and the extent to which this method of feeding affects infant body weight, diet quality and iron and zinc status. Results of this study will provide important information for health care professionals, parents and health policy makers.
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Paediatric research analysing the relationship between the easy-to-use anthropometric measures for adiposity and cardiometabolic risk factors remains highly controversial in youth. Several studies suggest that only body mass index (BMI), a measure of relative weight, constitutes an accurate predictor, whereas others highlight the potential role of waist-to-hip ratio (WHR), waist circumference (Waist C), and waist-to-height ratio (WHtR). In this study, we examined the effectiveness of adding anthropometric measures of body fat distribution (Waist C Z Score, WHR Z Score and/or WHtR) to BMI Z Score to predict cardiometabolic risk factors in overweight and obese youth. We also examined the consistency of these associations with the "total fat mass + trunk/legs fat mass" and/or the "total fat mass + trunk fat mass" combinations, as assessed by dual energy X-ray absorptiometry (DXA), the gold standard measurement of body composition. ⋯ Adding anthropometric measures of regional adiposity to BMI Z Score improves the prediction of cardiometabolic, inflammatory and adipokines profiles in youth.
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Comparative Study
Fever phobia: a comparison survey between caregivers in the inpatient ward and caregivers at the outpatient department in a children's hospital in China.
Fever in children is one of the most common clinical symptoms and a chief complaint and a main reason that caregivers took the children to the outpatient service or admitted to hospital. Studies have found that the majority of parents surveyed at a hospital pediatric clinic held unrealistic and unwarranted concerns about fevers, first termed as 'fever phobia' by Schmitt in 1980. In the present study, we explore whether 'fever phobia' exists in Chinese caregivers and investigate whether such phobia is alleviated when admitted to hospital after propaganda of fever related knowledge by doctors and nurses. ⋯ 'Fever phobia' also exists in Chinese caregivers. Fever related knowledge propaganda after admitted to hospital did not work effectively to improve the caregivers' understanding and management of fever and an effective way to alleviate 'Fever phobia'.
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Although sub-Saharan Africa (SSA) is particularly affected by sickle cell disease (SCD), there is dearth of research on this topic in the region, specifically targeting the magnitude of SCD-related complications. We therefore conducted this study to determine the burden of acute chest syndrome (ACS) and describe its clinical and therapeutic aspects among SCD children in Cameroon, a SSA country. ⋯ ACS is frequent among SCD children in our milieu. Its etiologies seem to be multifactorial. Patients' parents should be educated to recognize early signs and symptoms of the disease, and consult rapidly. Additionally, clinicians must be trained to diagnose ACS, and manage it promptly and efficiently to avoid its related catastrophic consequences.