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关键词： 抗癫痫药   母乳喂养   拉莫三嗪   丙戊酸钠   儿科学   苯妥英钠   美国医学会杂志   语言能力   认知功能   观察性  

摘要： 英美学者的联合研究显示,对于因接受母乳喂养而暴露于抗癫痫药物（AED）的儿童,在其6岁时,未观察到曾经的AED暴露的不良影响。这与另一项以3岁儿童为研究对象的类似研究的结论一致。在本研究中,接受母乳喂养的儿童有较高的智商和较强的语言能力。论文6月16日在线发表于《美国医学会杂志·儿科学》（JAMAPediatr）。该前瞻性、观察性、多中心研究,纳入因癫痫接受卡马西平、拉莫三嗪、苯妥英钠或丙戊酸钠单药治疗的妊娠女性。在其子女6岁时,共计有181名儿童因接受了母乳喂养并接受过智商评估,而被纳入因母乳喂养所致AED暴露对其认知功能影响。

关键词： PNEUMONIA in children   CHILDREN -- Hospital care   PNEUMOCOCCAL vaccine  

摘要： The author comments on a study which examined pneumonia admissions among children below five years of age in Karachi, Pakistan. Topics discussed include prevalence of pneumonia in South Asia, history of pneumococcal vaccines and the role of urinary antigen test in the diagnosis of pneumococcal pneumonia.

关键词： NEUROMUSCULAR diseases   DISEASE prevalence   LIFE expectancy   MEDICAL databases   JUVENILE diseases   ETHNICITY  

摘要： More severe, early onset neuromuscular disorders (NMD) disorders are associated with a shortened life expectancy and thus prevalence data calculated from the population as a whole may underestimate the prevalence of the more severe NMC seen in childhood. It is not known how prevalence varies with ethnicity. Retrospective case note review of patients under 16 years with a diagnosis of a NMD in 2010, under the care of the tertiary regional service. Cases were ascertained using existing databases and data was analysed using chi-squared tests. Prevalence was calculated according to the formula prevalence = number of cases/population at risk ×100,000. Data was collected from 261 patients. The overall prevalence of NMD in Yorkshire was 35.2 per 100,000 with dystrophin related muscle disease being the most common condition with a prevalence of 16.9 per 100,000 males. There was a statistically significant difference between ethnic groups with a total NMD prevalence of 90.2/100,000 in the South Asian population compared to a prevalence of 29.0/100,000 in the White population ( p < 0.001). The increase in prevalence of non-dystrophin related NMC was more marked: 82.2/100,000 South Asian compared to 19.6/100,000 White. Autosomal recessive conditions were twice as common in the South Asian community ( p < 0.001). The proportion of children with consanguineous parents in the group with autosomal recessive conditions was higher than those with a non-autosomal recessive inheritance pattern ( p < 0.001). The prevalence of neuromuscular conditions in Yorkshire children was comparable to previously published data. The three fold increase in prevalence of all neuromuscular conditions, particularly recessive disorders, in the South Asian population has not been previously reported. This community has a greater need for subspecialist services and resources. [ABSTRACT FROM AUTHOR]

关键词： CLINICAL trials   NEUROMUSCULAR diseases   PATIENTS   MEDICINE -- Specialties & specialists   MYOTONIA atrophica   JUVENILE diseases   MEROSIN  

摘要： An estimated 85–90% of all paediatric neuromuscular patients in the Republic of Ireland are followed at one neuromuscular centre, located at the Central Remedial Clinic, Dublin, resulting in centralised and coordinated care for the vast majority of Irish paediatric neuromuscular patients. The neuromuscular cohort followed by two neuromuscular specialists at this main centre totals 183 patients (ages 4 months–25 years), and the most common molecularly confirmed diagnoses are: Duchenne muscular dystrophy ( n = 61), myotonic dystrophy ( n = 16), spinal muscular atrophy ( n = 14), merosin deficient congenital muscular dystrophy ( n = 8), RYR1 -related myopathy ( n = 4) and collagen VI-related myopathy ( n = 3). Future clinical trials for Duchenne muscular dystrophy, spinal muscular atrophy, merosin deficient congenital muscular dystrophy and collagen VI-related myopathies are presently in planning stages. Given the molecular characterization of these Irish patient cohorts, their close pulmonary and cardiology surveillance and their six monthly neuromuscular clinic assessments, these neuromuscular patient subgroups are clinical trial ready. Furthermore, the Central Remedial Clinic, Dublin, Ireland provides an ideal setting for future clinical trials, with its highly-trained and large-sized physiotherapy and occupational therapy teams, adequate space and facilities for motor function testing and the availability of support and nursing staff. Presently for neuromuscular patients in Ireland, participation in clinical trials would require that they travel to the United Kingdom, which is costly as well as burdensome for neuromuscular patients and their families. Given the availability of neuromuscular clinical expertise, an excellent facility for coordinated neuromuscular care and motor assessments and the commitment of patients and their families to participate in upcoming clinical trials, establishing a neuromuscular clinical trial site in Dublin is an achievable and import

关键词： MUSCLES -- Diseases -- Diagnosis   DISEASE prevalence   MITOCHONDRIAL proteins   SKELETAL muscle   BIOPSY   BIOCHEMICAL markers   MUSCLES -- Diseases   PATIENTS   JUVENILE diseases  

摘要： Background Paediatric mitochondrial disease (mtD) is clinico-genetically heterogenous. Muscle biopsies often lack classical disease markers like ragged red (RRF) and COX negative fibres. Instead, subsarcolemmal mitochondrial aggregates (SSMA) are considered more prominent and various % SSMA cut-offs (>2%, ⩽4%) have been proposed as markers of mitochondrial biochemical defects. Aims and Methods Our main objectives were to assess the prevalence of % SSMA in muscle biopsies of patients with mtD and age-matched controls (CTRL) from 0 to 16 years, examine their relationship to the biopsy age, mtDNA copy number and biopsy group (mtD versus CTRL) by conventional light microscopy (CLM), and develop a novel image analysis (IA) tool for precise quantitation. We retrospectively audited 54 diagnostic muscle biopsies (mtD = 25, CTRL = 29) performed at our institution. The mtD group included cases defined genetically, biochemically, and/or pathologically (RRF and/or COX-negative fibres). CTRL group included histologically normal/minimal change biopsies in whom mitochondrial disease was excluded. Biopsies were assessed by CLM and a new IA tool (Definiens). mtDNA copy number was obtained by real-time PCR in 41 biopsies. Stata was used for data analysis. Results The mtD and CTRL groups did not differ significantly in terms of biopsy age, gender, slow predominance, prominent internal mitochondria and tube-feeding. Significant differences were observed for % SSMA; mtD 4.6 versus CTRL 15.5 ( p = 0.01), mtDNA copy number; mtD 27.5 versus CTRL 95.5 ( p = 0.001) and lipid content; mtD 60% versus CTRL 13.8% ( p < 0.0001). Linear regression showed significant association of biopsy group, biopsy age and mtDNA copy number with % SSMA in the unadjusted analysis. With multivariable analysis increasing biopsy age was the only variable significantly associated with increasing % SSMA ( p < 0,0001). Applying the previously suggested 4 % SSMA cut-off to our cohort yielded 50 % sensitivity and 82.7%

关键词： 儿科学   儿童   脊柱弯曲异常   医疗检查   PAEDIATRICS   CHILDREN   MEDICAL INSPECTION  

标准号: GB/T 16133-2014

摘要： 本标准规定了儿童青少年脊柱弯曲异常筛查的原则、检查方法和结果统计。 本标准适用于6岁-18岁儿童青少年健康筛查和健康监测对脊柱弯曲异常的筛查。学龄前儿童和青年的脊柱健康检查可参照使用。

关键词： 儿科学   川崎病   说课  

摘要： 说课是教师口头表述具体课题的教学设想及其理论依据,也是授课教师在备课的基础上,面对同行或教研人员,讲述自己的教学设计,然后由听着评说,达到互相交流、共同提高的目的的一种教学研究和师资培训的活动。更全面地说,说课既可以是针对具体问题或具体课题的,也可以是针对一个观点或一个问题的。简单地说,说课其实就是教师说说你是怎么教的,你为什么要这样教。为了更好地对儿科学的教学进行完善和改进,本文选取"川崎病"的说课设计方案,从六个方面进行探讨。

关键词： 医学模拟教学   儿科学  

摘要： 在儿科学临床教学中应用模拟教学,使医学生在接触病人前就得到充分的实践培训,为理论学习与在病人身上的实践操作之间做了一个过渡的铺垫,可以促进医学生成长,减少医疗事故和纠纷在临床实践中的发生。

关键词： 病毒性疾病   中药疗法   腹泻   儿科学   中医疗法   综述  

摘要： 小儿腹泻或称腹泻病，是一组由多病原、多因素引起的以大便次数增多和大便性状改变为特点、我国婴幼儿最常见的消化道综合征，是造成小儿营养不良、生长发育障碍和死亡的主要原因之一。病毒性腹泻指由病毒感染引起的腹泻，主要为轮状病毒，目前现代医学对本病尚无特殊治疗方法，主要是抗病毒治疗，而中医药治疗,小儿病毒性腹泻历史悠久，疗效显著。兹将小儿病毒性腹泻的中医药治疗进展。

关键词： 儿科学   范德堡大学   儿童病   林恩   克尔   腹痛不适   郁症  

摘要： 肚子疼是常见儿童病。美国《儿科学》杂志刊登的一项新研究发现,儿时经常肚子痛的孩子成年发生焦虑和抑郁的危险更大。新研究中,美国范德堡大学儿科学教授林恩·沃克尔及其同事比较了332名儿时经常腹痛20岁左右的年轻人和儿时肚子不经常痛的147名同龄参试者。研究发现,10年之后,参试者不再发生腹痛,大使其焦虑症发病率贝Ⅱ更高。儿时经常腹痛的参试者日后罹患焦虑症的几率为51%,目前发生焦虑的几率为30%。