ABSTRACT
OBJECTIVE@#To explore the feasibility of remote monitoring of neonatal jaundice in newborns with ABO hemolytic disease.@*METHODS@#Forty six neonates of gestational age >35 weeks with ABO hemolytic disease admitted to Women's Hospital, Zhejiang University School of Medicine from January 20th, 2020 to February 29th, 2020 were enrolled in the study (study group). The newborns were followed up at home after discharge, the transcutaneous bilirubin (TCB) levels were measured by parents using the provided device and the results were sent to the doctor by smart phone using the installed APP. Fifty six newborns with ABO hemolytic disease admitted in 2018 who received conventional outpatient follow-up after discharge served as the control group. The demographic characteristics, total serum bilirubin (TSB) level during hospitalization, number of outpatient visit and rate of re-admission due to rebound hyperbilirubinemia were compared between the two groups.@*RESULTS@#There were no significant differences between the two groups in gestational age, birth weight, delivery mode, gender, length of the first hospitalization, TSB level before phototherapy and before discharge, and the managements during the first hospitalization (all @*CONCLUSIONS@#The remote follow-up for neonatal jaundice at home can effectively reduce the number of outpatient visits without increasing the risk of readmission and severe neonatal hyperbilirubinemia for newborns with ABO hemolytic disease.
Subject(s)
Female , Humans , Infant, Newborn , Bilirubin , Erythroblastosis, Fetal/diagnosis , Hyperbilirubinemia, Neonatal/diagnosis , Jaundice, Neonatal/diagnosis , Monitoring, Physiologic/methods , PhototherapyABSTRACT
Infancy is the peak stage of weight gain,and overweight or obesity during this period may be closely linked to wheezing in infancy and the development of asthma in the future.Obesity has been proven to be a risk factor for asthma in adults and children,and numerous studies have shown the rationality of the mechanism.However,the relationship between weight and wheezing in infancy has rarely been reported.This review summarizes the latest research progresses of the relationship between them.
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Objective To investigate the distribution and drug resistance to pathogenic bacterial pathogen in children with community acquired pneumonia (CAP),so as to provide recommendations for clinical rational use of anti-biotics. Methods A retrospective analysis was made on the distribution and drug resistance to bacteria in CAP chil-dren admitted to Department of Respiration,Shanghai Children′s Medical Center from January 2014 to December 2015. Results There were 463 patients with positive sputum culture,and a total of 496 strains of pathogens were found. There were 273 Galanz negative bacteria,195 Galanz positive bacteria and 28 other rare bacteria,accounted for 55. 04％,39. 31％ and 5. 65％ of the total bacteria,respectively. The main pathogens were Streptococcus pneumoniae, Staphylococcus aureus,Haemophilus influenzae,Klebsiella pneumoniae and Escherichia coli. The highest detection rate of bacteria in 1-12 months children with CAP was Staphylococcus aureus,Klebsiella pneumoniae and Escherichia coli;in > 12 months children with CAP,the highest detection rate of bacteria was Streptococcus pneumoniae,Haemophilus influenzae and Staphylococcus aureus. Both of Streptococcus pneumoniae and Staphylococcus aureus had a high resis-tance to Erythromycin,Clindamycin and Oxacillin. There were 11. 00％ Streptococcus pneumoniae and 94. 74％ taphy-lococcus aureus resistant to Penicillin,while they were not resistant to Vancomycin. Escherichia coli and Klebsiella pneumoniae both showed a high resistance to ampicillin,the second and third generation cephalosporins. Haemophilus influenzae were highly resistant to Compound sulfamethoxazole and Ampicillin. Galanz negative bacteria had the lowest resistance to Piperacillin/ Tazobactam and Amikacin. Conclusions The main pathogens of CAP in children were G -bacteria. There were some differences among the isolates at different ages of CAP. Their resistance to very common anti-biotics was very high in children.
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Objective To assess the efficacy of oral treatment and parenteral treatment in community acquired pneumonia( CAP) children by meta-analysis method. Methods Searches were made in MEDLINE、EMBASE and Cochrane Central Register of Controlled Trials ( CENTRAL ) from the establishment of the data base till September 2016. All randomized controlled trials about oral and parenteral treatment in community ac-quired pneumonia children were eligible. Review Manager 5. 3 was used to analyze the studies enroued in this meta-analysis. Results 4582 literatures were reviewed. Seven(n=5030)eligible trials were used for meta-a-nalysis. The treatment failure between community acquired pneumonia children treated with oral treatment and parenteral treatment was found no significant difference(OR =0. 82, 95% CI =0. 63-1. 08,P <0. 05). The treatment failure of oral treatment group was found to be significantly higher than parenteral treatment group in CAP children under 1 year of age(OR=2. 25,95%CI=1. 61-3. 14,P<0. 01). The treatment failure of children who had used antibiotics before included in the study was found to be significantly higher than those who had not used(OR=1. 94,95%CI=1. 50-2. 50,P<0. 01). The death rate of oral treatment group was found to be signif-icantly lower than the parenteral treatment group(OR=0. 31,95%CI=0. 11-0. 85,P=0. 02). There was no sig-nificant difference of relapse rate (OR=1. 28,95%CI=0. 34-4. 82) and loss to follow-up rate(OR=1. 08,95%CI=0. 77-1. 51) between the two group. Conclusion Oral treatment is as effective as parenteral treatment in CAP children. The death rate of oral treatment group is significantly lower than the parenteral treatment group.
ABSTRACT
Objective To assess the efficacy of oral treatment and parenteral treatment in community acquired pneumonia( CAP) children by meta-analysis method. Methods Searches were made in MEDLINE、EMBASE and Cochrane Central Register of Controlled Trials ( CENTRAL ) from the establishment of the data base till September 2016. All randomized controlled trials about oral and parenteral treatment in community ac-quired pneumonia children were eligible. Review Manager 5. 3 was used to analyze the studies enroued in this meta-analysis. Results 4582 literatures were reviewed. Seven(n=5030)eligible trials were used for meta-a-nalysis. The treatment failure between community acquired pneumonia children treated with oral treatment and parenteral treatment was found no significant difference(OR =0. 82, 95% CI =0. 63-1. 08,P <0. 05). The treatment failure of oral treatment group was found to be significantly higher than parenteral treatment group in CAP children under 1 year of age(OR=2. 25,95%CI=1. 61-3. 14,P<0. 01). The treatment failure of children who had used antibiotics before included in the study was found to be significantly higher than those who had not used(OR=1. 94,95%CI=1. 50-2. 50,P<0. 01). The death rate of oral treatment group was found to be signif-icantly lower than the parenteral treatment group(OR=0. 31,95%CI=0. 11-0. 85,P=0. 02). There was no sig-nificant difference of relapse rate (OR=1. 28,95%CI=0. 34-4. 82) and loss to follow-up rate(OR=1. 08,95%CI=0. 77-1. 51) between the two group. Conclusion Oral treatment is as effective as parenteral treatment in CAP children. The death rate of oral treatment group is significantly lower than the parenteral treatment group.