ABSTRACT
OBJECTIVES: To systematically review risks and summarize reported complication rates associated with the performance of endoscopic retrograde cholangiopancreatography (ERCP) in children during the past 2 decades. STUDY DESIGN: A systematic literature search of MEDLINE, Embase, and Web of Science from January 1995 to January 2016 was conducted for observational studies published in English. Studies reporting ERCP complications in patients <21 years without history of liver transplant or cholecystectomy were included. A summary estimate of the proportion of children who experienced complications following ERCP was derived via a random effects meta-analysis. RESULTS: Thirty-two studies involving 2612 children and 3566 procedures were included. Subjects' ages ranged from 3 days to 21 years. Procedures were performed for biliary (54%), pancreatic (38%), and other (8%) indications; 56% of ERCPs were interventional. The pooled complication rate was 6% (95% CI 4%- 8%). Procedural complications included post-ERCP pancreatitis (166, 4.7%), bleeding (22, 0.6%), and infections (27, 0.8%). The pooled estimate of post-ERCP pancreatitis was 3% (95% CI 0.02-0.05), and other complications were 1% (95% CI 0.02-0.05). In the subgroup with neonatal cholestasis, the pooled complication rate was 3% (95% CI 0.01-0.07). Adult and pediatric gastroenterologists and surgeons performed the ERCPs. Available data limited the ability to report differences between pediatric-trained and other endoscopists. CONCLUSIONS: Complications associated with pediatric ERCP range widely in severity and are reported inconsistently. Our review suggests 6% of pediatric ERCPs have complications. Further studies that use systematic and standardized methodologies are needed to determine the frequency and risk factors for ERCP-related complications.
Subject(s)
Cholangiopancreatography, Endoscopic Retrograde/adverse effects , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Child , HumansABSTRACT
O objetivo deste estudo foi avaliar e comparar o equilíbrio corporal estático edinâmico entre um grupo de idosos praticantes de exercícios físicos (hidroginástica) e um grupo de idosos não praticantes de exercícios físicos. Através dos resultados, utilizando ametodologia proposta, verificou-se que, ao analisar individualmente os grupos do pré- para o pós-teste, ambos não obtiveram melhoras significativas. Ao comparar, porém, o equilíbrio entre os dois grupos no pré- e pós-teste pode-se afirmar que houve melhoras significativas nogrupo de praticantes de hidroginástica, com p=0,046 (pré-teste), e p=0,038 (pós-teste).(AU)
The objective of this study was to evaluate and compare the static and dynamic body balance among a group of elderly practitioners of physical exercise (aerobics) and a non-practicing group of elderly of exercise. From the results using the proposed method, it was found that by individually analyzing the groups for the pre-post test, both not achieved significant improvement. But when comparing the balance between the two groups in the pre and post-test can be stated that there was significant improvement in the group of water gymnastics classes, with p = 0,046 (pre-test), p = 0,038 (post-test).(AU)
Subject(s)
Humans , Aged , Aged , Exercise , Postural BalanceABSTRACT
O objetivo deste estudo foi avaliar e comparar o equilíbrio corporal estático e dinâmico entre um grupo de idosos praticantes de exercícios físicos (hidroginástica) e um grupo de idosos não praticantes de exercícios físicos. Através dos resultados, utilizando a metodologia proposta, verificou-se que, ao analisar individualmente os grupos do pré- para o pós-teste, ambos não obtiveram melhoras significativas. Ao comparar, porém, o equilíbrio entre os dois grupos no pré- e pós-teste pode-se afirmar que houve melhoras significativas no grupo de praticantes de hidroginástica, com p=0,046 (pré-teste), e p=0,038 (pós-teste).
The objective of this study was to evaluate and compare the static and dynamic body balance among a group of elderly practitioners of physical exercise (aerobics) and a non-practicing group of elderly of exercise. From the results using the proposed method, it was found that by individually analyzing the groups for the pre-post test, both not achieved significant improvement. But when comparing the balance between the two groups in the pre and post-test can be stated that there was significant improvement in the group of water gymnastics classes, with p = 0,046 (pre-test), p = 0,038 (post-test).