Developmental dysplasia of the hip(DDH) describes the spectrum of structural abnormalities that involve the growing hip. Early diagnosis and treatment is critical to provide the best possible functional outcome. Persi...Developmental dysplasia of the hip(DDH) describes the spectrum of structural abnormalities that involve the growing hip. Early diagnosis and treatment is critical to provide the best possible functional outcome. Persistence of hip dysplasia into adolescence and adulthood may result in abnormal gait, decreased strength and increased rate of degenerative hip and knee joint disease. Despite efforts to recognize and treat all cases of DDH soon after birth, diagnosis is delayed in some children, and outcomes deteriorate with increasing delay of presentation. Different screening programs for DDH were implicated. The suspicion is raised based on a physical examination soon after birth. Radiography and ultrasonography are used to confirm the diagnosis. The role of other imaging modalities, such as magnetic resonance imaging, is still undetermined; however, extensive research is underway on this subject. Treatment depends on the age of the patient and the reducibility of the hip joint. At an early age and up to 6 mo, the main treatment is an abduction brace like the Pavlik harness. If this fails, closed reduction and spica casting is usually done. After the age of 18 mo, treatment usually consists of open reduction and hip reconstruction surgery. Various treatment protocols have been proposed. We summarize the current practice for detection and treatment of DDH, emphasizing updates in screening and treatment during the last two decades.展开更多
We aim to provide an up-to-date summary of infantile hepatic hemangioma(IHH) and its misnomers and to dialectically present the differential diagnosis of these rare entities of the liver.Eligible peer-reviewed article...We aim to provide an up-to-date summary of infantile hepatic hemangioma(IHH) and its misnomers and to dialectically present the differential diagnosis of these rare entities of the liver.Eligible peer-reviewed articles on hepatic infantile hemangiomas,published between 2000 and 2015,were reviewed for this study.IHH is the most common hepatic vascular tumor in children.Once a liver mass is identified in an infant,the differential diagnosis ranges from vascular malformations to benign and malignant tumors including mesenchymal hamartoma,hepatoblastoma,metastatic neuroblastoma,so careful physical examination,imaging studies,and,if indicated,tumor markers and biopsy,are of pivotal importance to ascertain the correct diagnosis.Despite the benign nature of IHHs,some of these lesions may demand medical and/or surgical intervention,especially for multiple and diffuse IHH.Complications can include hepatomegaly,hypothyroidism and cardiac failure.Therefore,a close follow-up is required until complete involution of the lesions.We propose an algorithm to guide the physicians towards the proper management of hepatic lesions.展开更多
Objective To describe the impact of the global economic crisis on the nutritional status of children in China during and after the crisis.Methods Data from 1990 to 2010 were sourced from the National Food and Nutritio...Objective To describe the impact of the global economic crisis on the nutritional status of children in China during and after the crisis.Methods Data from 1990 to 2010 were sourced from the National Food and Nutrition Surveillance System.Approximately 16 000 children under 5 years old were selected using a stratified random cluster method from 40 surveillance sites.Anthropometric and hemoglobin measurements for children under 5 were conducted.Nutritional status was determined according to WHO child growth standards.Results Prevalence of underweight and stunting in children under 5 had a downward trend.Underweight prevalence was close to normal （less than 5%）,with prevalence of stunting 12.6% in 2009 and 12.1% in 2010 in rural areas.Prevalence of stunting in infants under 6 months and 6‐12 months old in poorer rural areas increased from 5.7%‐9.1% and 6.7%‐12.5%,respectively,in 2008‐2009.This trend also continued post‐crisis in 2010.Prevalence of stunting in children left behind by mothers was 20%‐30% higher than in children the same age in general and poorer rural areas.Prevalence of anemia in children did not change in rural areas,but prevalence of anemia in all age groups increased in poorer rural areas,especially in children under 24 months old.Level reached 30%‐40% in 2009,and fluctuated in 2010.Conclusion The nutritional status of children under 5 was comparatively stable during and after the global economic crisis,attributable to the Chinese government＇s policy response.The nutritional status in poorer rural areas fluctuated in response to the economic crisis and,thus,relevant action and intervention must be taken immediately to help the most vulnerable population in poorer rural areas.A proper national nutritional strategy for children under 2 years old,including nutrition supplementation for pregnant women and in‐home fortification for complementary feeding,should be initiated.展开更多
Respiratory syncytial virus(RSV) is the most frequent and important cause of lower respiratory tract infection in infants and children. It is a seasonal virus, with peak rates of infection occurring annually in the co...Respiratory syncytial virus(RSV) is the most frequent and important cause of lower respiratory tract infection in infants and children. It is a seasonal virus, with peak rates of infection occurring annually in the cold season in temperate climates, and in the rainy season, as temperatures fall, in tropical climates. High risk groups for severe RSV disease include infants below six mo of age, premature infants with or without chronic lung disease, infants with hemodynamically significant congenital heart disease, infants with immunodeficiency or cystic fibrosis, and infants with neuromuscular diseases. Mortality rates associated with RSV infection are generally low in previous healthy infants(below 1%), but increase significantly in children with underlying chronic conditions and comorbidities. Following early RSV lower respiratory tract infection, some patients experience recurrent episodes of wheezing mimicking early childhood asthma with persistence of lung function abnormalities until adolescence. There is currently no RSV vaccine available, but promising candidate vaccines are in development. Palivizumab, a monoclonal RSV antibody that is the only tool for immunoprophylaxis in high-riskinfants, lowers the burden of RSV infection in certain carefully selected patient groups.展开更多
文摘Developmental dysplasia of the hip(DDH) describes the spectrum of structural abnormalities that involve the growing hip. Early diagnosis and treatment is critical to provide the best possible functional outcome. Persistence of hip dysplasia into adolescence and adulthood may result in abnormal gait, decreased strength and increased rate of degenerative hip and knee joint disease. Despite efforts to recognize and treat all cases of DDH soon after birth, diagnosis is delayed in some children, and outcomes deteriorate with increasing delay of presentation. Different screening programs for DDH were implicated. The suspicion is raised based on a physical examination soon after birth. Radiography and ultrasonography are used to confirm the diagnosis. The role of other imaging modalities, such as magnetic resonance imaging, is still undetermined; however, extensive research is underway on this subject. Treatment depends on the age of the patient and the reducibility of the hip joint. At an early age and up to 6 mo, the main treatment is an abduction brace like the Pavlik harness. If this fails, closed reduction and spica casting is usually done. After the age of 18 mo, treatment usually consists of open reduction and hip reconstruction surgery. Various treatment protocols have been proposed. We summarize the current practice for detection and treatment of DDH, emphasizing updates in screening and treatment during the last two decades.
文摘We aim to provide an up-to-date summary of infantile hepatic hemangioma(IHH) and its misnomers and to dialectically present the differential diagnosis of these rare entities of the liver.Eligible peer-reviewed articles on hepatic infantile hemangiomas,published between 2000 and 2015,were reviewed for this study.IHH is the most common hepatic vascular tumor in children.Once a liver mass is identified in an infant,the differential diagnosis ranges from vascular malformations to benign and malignant tumors including mesenchymal hamartoma,hepatoblastoma,metastatic neuroblastoma,so careful physical examination,imaging studies,and,if indicated,tumor markers and biopsy,are of pivotal importance to ascertain the correct diagnosis.Despite the benign nature of IHHs,some of these lesions may demand medical and/or surgical intervention,especially for multiple and diffuse IHH.Complications can include hepatomegaly,hypothyroidism and cardiac failure.Therefore,a close follow-up is required until complete involution of the lesions.We propose an algorithm to guide the physicians towards the proper management of hepatic lesions.
文摘Objective To describe the impact of the global economic crisis on the nutritional status of children in China during and after the crisis.Methods Data from 1990 to 2010 were sourced from the National Food and Nutrition Surveillance System.Approximately 16 000 children under 5 years old were selected using a stratified random cluster method from 40 surveillance sites.Anthropometric and hemoglobin measurements for children under 5 were conducted.Nutritional status was determined according to WHO child growth standards.Results Prevalence of underweight and stunting in children under 5 had a downward trend.Underweight prevalence was close to normal （less than 5%）,with prevalence of stunting 12.6% in 2009 and 12.1% in 2010 in rural areas.Prevalence of stunting in infants under 6 months and 6‐12 months old in poorer rural areas increased from 5.7%‐9.1% and 6.7%‐12.5%,respectively,in 2008‐2009.This trend also continued post‐crisis in 2010.Prevalence of stunting in children left behind by mothers was 20%‐30% higher than in children the same age in general and poorer rural areas.Prevalence of anemia in children did not change in rural areas,but prevalence of anemia in all age groups increased in poorer rural areas,especially in children under 24 months old.Level reached 30%‐40% in 2009,and fluctuated in 2010.Conclusion The nutritional status of children under 5 was comparatively stable during and after the global economic crisis,attributable to the Chinese government＇s policy response.The nutritional status in poorer rural areas fluctuated in response to the economic crisis and,thus,relevant action and intervention must be taken immediately to help the most vulnerable population in poorer rural areas.A proper national nutritional strategy for children under 2 years old,including nutrition supplementation for pregnant women and in‐home fortification for complementary feeding,should be initiated.
文摘Respiratory syncytial virus(RSV) is the most frequent and important cause of lower respiratory tract infection in infants and children. It is a seasonal virus, with peak rates of infection occurring annually in the cold season in temperate climates, and in the rainy season, as temperatures fall, in tropical climates. High risk groups for severe RSV disease include infants below six mo of age, premature infants with or without chronic lung disease, infants with hemodynamically significant congenital heart disease, infants with immunodeficiency or cystic fibrosis, and infants with neuromuscular diseases. Mortality rates associated with RSV infection are generally low in previous healthy infants(below 1%), but increase significantly in children with underlying chronic conditions and comorbidities. Following early RSV lower respiratory tract infection, some patients experience recurrent episodes of wheezing mimicking early childhood asthma with persistence of lung function abnormalities until adolescence. There is currently no RSV vaccine available, but promising candidate vaccines are in development. Palivizumab, a monoclonal RSV antibody that is the only tool for immunoprophylaxis in high-riskinfants, lowers the burden of RSV infection in certain carefully selected patient groups.
