Objective: To determine the effectiveness of ultrasound screening for developm ental dysplasia of the hip (DDH) after the neonatal period. Design: Prospective cohort study. Setting: Child health care centres. Particip...Objective: To determine the effectiveness of ultrasound screening for developm ental dysplasia of the hip (DDH) after the neonatal period. Design: Prospective cohort study. Setting: Child health care centres. Participants: Infants attendin g the child health care centres. Interventions: The intervention group (n = 5170 ) was screened by ultrasound at 1, 2, and 3 months of age. The control group (n = 2066) was screened by routine physical examination as part of the programme fo r child health surveillance at the child health care centres (CHC screening). Fo r evaluation of the screening, the children in both the intervention and control group received an ultrasound examination after 6 months of age to detect any ab normality that might have been missed by the screening. Results: The sensitivity of the ultrasound screening was 88.5%, and the referral rate 7.6%. As a res ult of the ultrasound screening, 4.6%of the children were treated. The sensiti vity of the CHC screening was 76.4%, with a referral rate of 19.2%. The trea tment rate was 2.7%. Of the treated children in the ultrasound screening group , 67%were referred before the age of 13 weeks, whereas in the CHC screening gro up only 29%were referred before this age. Conclusions: This study shows that ul trasound screening detects more children with DDH than CHC screening and that mo re of them are detected at an earlier age. To accomplish this, even fewer childr en have to be referred. However, even general ultrasound screening seems not to eradicate late cases of DDH. The higher treatment rate in the population screened by ultrasound may be a result of overtreatment.展开更多
Aim: To evaluate children born post-term (gestational age ≥ 42 weeks) with respect to developmental data obtained at the ages of 4 and 5.5 y. Methods: The study population included all children (n = 354) born in 1991...Aim: To evaluate children born post-term (gestational age ≥ 42 weeks) with respect to developmental data obtained at the ages of 4 and 5.5 y. Methods: The study population included all children (n = 354) born in 1991 at Huddinge University Hospital with a gestational age of ≥ 42 wk. The births were identified and perinatal data were collected through the Swedish National Birth Registry. Developmental assessments from the child health centres were analysed. Children born at term, but before a gestational age of 42 wk, served as controls. Logistic regression analysis was used to analyse the data. Results: Children born post-term had more developmental deviations than the controls (estimated odds ratio 2.20; 95% CI: 1.29-3.85) . Boys had more deviations than girls (estimated odds ratio 1.92; 95% CI: 1.11-3.45). Conclusion: Our results indicate that there might be an association between post-term birth and developmental deviations.展开更多
Purpose: Video-assisted thoracoscopic surgical (VATS) technique for resection of cystic lung disease (CLD) may offer some advantages when compared with thoracotomy in children. From September 1999 to August 2004, 6 pe...Purpose: Video-assisted thoracoscopic surgical (VATS) technique for resection of cystic lung disease (CLD) may offer some advantages when compared with thoracotomy in children. From September 1999 to August 2004, 6 pediatric patients underwent VATS for CLD. Patients were chosen for VATS based upon surgeon’s choice. Data are expressed as mean ±SD. The Children’s Healthcare of Atlanta institutional review board approved this study. Results: The types of lesions included congenital cystic adenomatoid malformations (n = 1), extrapulmonary sequestrations (n = 3), congenital lobar emphysema (n = 1), and bronchogenic cyst (n = 1). The extent of resection included lobectomy (n = 2) and excision (n = 4). Age and weight were 11.8 ±18 months (range 6 days to 4 years) and 7.5 ±3.6 (range 4.0-14.0) kg, respectively. Operating time was 103 ±70 (range 38-223) minutes. Chest tube duration was 1.2 ±0.8 (range 0-2) days. Morphine use on the first postoperative day was 0.2±0.3(range 0.05-0.20)mg/kg. Length of stay was 2.5±1.9 (range 1-6) days. There were no conversions to thoracotomy and no complications. Conclusion: VATS technique appears to be a safe and effective technique in managing CLD in children of all ages. More patients, however, need to be studied.展开更多
文摘Objective: To determine the effectiveness of ultrasound screening for developm ental dysplasia of the hip (DDH) after the neonatal period. Design: Prospective cohort study. Setting: Child health care centres. Participants: Infants attendin g the child health care centres. Interventions: The intervention group (n = 5170 ) was screened by ultrasound at 1, 2, and 3 months of age. The control group (n = 2066) was screened by routine physical examination as part of the programme fo r child health surveillance at the child health care centres (CHC screening). Fo r evaluation of the screening, the children in both the intervention and control group received an ultrasound examination after 6 months of age to detect any ab normality that might have been missed by the screening. Results: The sensitivity of the ultrasound screening was 88.5%, and the referral rate 7.6%. As a res ult of the ultrasound screening, 4.6%of the children were treated. The sensiti vity of the CHC screening was 76.4%, with a referral rate of 19.2%. The trea tment rate was 2.7%. Of the treated children in the ultrasound screening group , 67%were referred before the age of 13 weeks, whereas in the CHC screening gro up only 29%were referred before this age. Conclusions: This study shows that ul trasound screening detects more children with DDH than CHC screening and that mo re of them are detected at an earlier age. To accomplish this, even fewer childr en have to be referred. However, even general ultrasound screening seems not to eradicate late cases of DDH. The higher treatment rate in the population screened by ultrasound may be a result of overtreatment.
文摘Aim: To evaluate children born post-term (gestational age ≥ 42 weeks) with respect to developmental data obtained at the ages of 4 and 5.5 y. Methods: The study population included all children (n = 354) born in 1991 at Huddinge University Hospital with a gestational age of ≥ 42 wk. The births were identified and perinatal data were collected through the Swedish National Birth Registry. Developmental assessments from the child health centres were analysed. Children born at term, but before a gestational age of 42 wk, served as controls. Logistic regression analysis was used to analyse the data. Results: Children born post-term had more developmental deviations than the controls (estimated odds ratio 2.20; 95% CI: 1.29-3.85) . Boys had more deviations than girls (estimated odds ratio 1.92; 95% CI: 1.11-3.45). Conclusion: Our results indicate that there might be an association between post-term birth and developmental deviations.
文摘Purpose: Video-assisted thoracoscopic surgical (VATS) technique for resection of cystic lung disease (CLD) may offer some advantages when compared with thoracotomy in children. From September 1999 to August 2004, 6 pediatric patients underwent VATS for CLD. Patients were chosen for VATS based upon surgeon’s choice. Data are expressed as mean ±SD. The Children’s Healthcare of Atlanta institutional review board approved this study. Results: The types of lesions included congenital cystic adenomatoid malformations (n = 1), extrapulmonary sequestrations (n = 3), congenital lobar emphysema (n = 1), and bronchogenic cyst (n = 1). The extent of resection included lobectomy (n = 2) and excision (n = 4). Age and weight were 11.8 ±18 months (range 6 days to 4 years) and 7.5 ±3.6 (range 4.0-14.0) kg, respectively. Operating time was 103 ±70 (range 38-223) minutes. Chest tube duration was 1.2 ±0.8 (range 0-2) days. Morphine use on the first postoperative day was 0.2±0.3(range 0.05-0.20)mg/kg. Length of stay was 2.5±1.9 (range 1-6) days. There were no conversions to thoracotomy and no complications. Conclusion: VATS technique appears to be a safe and effective technique in managing CLD in children of all ages. More patients, however, need to be studied.
