Practice, self-confidence and understanding of pediatric obstructive sleep apnea survey among pediatricians.

BACKGROUND: Pediatricians play an important role in the screening, diagnosis and management of childhood obstructive sleep apnea (OSA). This study used a questionnaire to explore the knowledge, self-confidence and general practices of childhood OSA among Thai pediatricians. METHODS: This was a descriptive cross-sectional survey study, using a newly developed questionnaire; including: 21 knowledge items, 4 self-confidence items, questions regarding OSA screening, number of OSA cases per month and OSA management. RESULTS: A total of 307, convenient pediatricians; from different types of hospitals across all regions of Thailand, participated in this study. The median, total knowledge score was 19 (range 14‒21). Two-thirds of the respondents felt confident/extremely confident in their ability to identify and manage children with OSA. The average number of OSA cases reported by pediatricians was 5.9 cases per month. During a general medical check-up, 86.6% of the respondents did not routinely ask about OSA symptoms. Significant odds ratios (ORs) for the use of montelukast, as the first-line drug for OSA in young children, were observed in pediatric allergists and pulmonologists (adjusted OR 2.58, 95% CI 1.11-6.01 and adjusted OR 2.20, 95% CI 1.2-4.02) (P = 0.008), respectively, compared to general pediatricians and other sub-specialties. CONCLUSIONS: Pediatricians had a high level of overall OSA knowledge, and good self-confidence in identifying and managing children with OSA. However, a low recognition rate and unawareness of OSA screening were observed.

Characteristics and Findings of Childhood Urinary Tract Infection in the Last Decade.

BACKGROUND: The strong association between kidney and urinary tract anomalies and childhood urinary tract infection (UTI) often leads to imaging tests being performed. -Objective: To describe the epidemiology, characteristics, and imaging findings in Thai children with UTI and compare results between boys and girls. METHODS: We retrospectively reviewed the medical records of children with UTI aged < 15 years. Demographic characteristics and findings of investigations are presented. RESULTS: One hundred seventy-eight boys and 170 girls with 432 UTI episodes were identified. The median (interquartile range) age at presentation was 1.4 (0.6-3.4) years, 1.0 for boys and 2.1 for girls (p < 0.001). Renal ultrasound, voiding cystourethrogram and 99mTc dimercaptosuccinic acid (DMSA) renal scans were performed in 273, 223 and 113 children, respectively. Overall, 283 children (81.3%) had at least one imaging study done and anomalies of the kidney and urinary tract were detected in 158 (45.4%). Primary vesicoureteral reflux was detected in 73 (32.7%) children. The remaining abnormalities were hydronephrosis (n = 54). DMSA scans detected 54 children with dysplastic or scarred kidneys. CONCLUSIONS: First UTI in a group of Thai children occurred in approximately equal proportion in boys and girls but boys were younger at diagnosis. Kidney and urinary tract anomalies were detected in half of the children.