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Walsh ME, Retzler R, Huang J, Daglish A, Tweedie D, Pepper C. A prospective cohort study exploring the impact of tonsillectomy on feeding difficulties in children. Clin Otolaryngol 2024; 49:314-319. [PMID: 38415339 DOI: 10.1111/coa.14148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/06/2023] [Accepted: 02/11/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVES Paediatric feeding difficulties are common, affecting up to 25% of otherwise healthy children, symptoms include food refusal, gagging, choking, and excessive mealtime duration. These symptoms are commonly described in pre-operative discussions about tonsillectomy. This prospective study explores the impact of tonsillectomy on paediatric feeding difficulties. DESIGN This prospective cohort study invited caregivers of children undergoing tonsillectomy to complete a PediEAT questionnaire about their children's feeding behaviours, pre and post-operatively. The study was completed in two phases with 9 questions administered in phase 1 and three additional questions added for phase 2. A free text comments box was also provided. Responses were graded from 0 to 5, where 0 is 'never a problem' and 5 is 'always a problem' with eating behaviours. SETTING The study was conducted at our institution, a tertiary paediatric ENT unit. PARTICIPANTS Children aged between 6 months - 7 years undergoing tonsillectomy for any indication were invited to participate. MAIN OUTCOME MEASURES Changes to the Pedi-EAT scores pre and post operatively were the main outcome measure. RESULTS 102 participants were recruited between January 2020 and January 2022. The mean age of participants was 4.1 years, 87% had a concurrent adenoidectomy. The mean time to completion of post-operative questionnaire was 23 weeks after surgery. 9 of the 12 questions showed a statistically significant improvement in post-operative scores using a paired student t-test (p < 0.05). The most significant improvements related to 'gets tired from eating and is not able to finish' (1.49 pre-op, 0.91 post op, p < 0.01) and 'eats food that needs to be chewed' (1.4 pre-op, 0.72 post-op, p < 0.01). 13% of participants only underwent tonsillectomy and this group also showed a statistically significant improvement in fatigue during eating (p < 0.05). CONCLUSION Symptoms of fatigue during eating and avoidance of food requiring mastication are most likely to improve following tonsillectomy in children.
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Affiliation(s)
- M E Walsh
- Evelina London Childrens' Hospital, London, UK
| | - R Retzler
- Evelina London Childrens' Hospital, London, UK
| | - J Huang
- Evelina London Childrens' Hospital, London, UK
| | - A Daglish
- Evelina London Childrens' Hospital, London, UK
| | - D Tweedie
- Evelina London Childrens' Hospital, London, UK
| | - C Pepper
- Evelina London Childrens' Hospital, London, UK
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Almaatani D, Cory E, Gardner J, Alexanian-Farr M, Hulst JM, Bandsma RHJ, Van Den Heuvel M. Child and Maternal Factors Associated with Feeding Practices in Children with Poor Growth. Nutrients 2023; 15:4850. [PMID: 38004244 PMCID: PMC10675486 DOI: 10.3390/nu15224850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/10/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023] Open
Abstract
The development of adequate growth and healthy eating behaviors depends on nutritious food and responsive feeding practices. Our study examined (1) the relationship between maternal concern about child weight or perceived feeding difficulties and their feeding practices, and (2) the moderating role of child temperament and maternal mental health on their feeding practices. A cross-sessional study included mother-child dyads (n = 98) from a tertiary growth and feeding clinic. Children had a mean age of 12.7 ± 5.0 months and a mean weight-for-age z-score of -2.0 ± 1.3. Responsive and controlling feeding practices were measured with the Infant Feeding Styles Questionnaire. Spearman correlation and moderation analysis were performed. Maternal concern about child weight and perceived feeding difficulties were negatively correlated with responsive feeding (r = -0.40, -0.48, p < 0.001). A greater concern about child weight or perceived feeding difficulties was associated with greater use of pressure feeding practices when effortful control was low (B = 0.49, t = 2.47, p = 0.01; B = -0.27, p = 0.008). Maternal anxiety had a significant moderation effect on the relationship between feeding difficulty and pressure feeding (B = -0.04, p = 0.009). Higher maternal concern about child weight and perceived feeding difficulties were associated with less responsive satiety feeding beliefs and behaviors. Both child effortful control and maternal anxiety influenced the relationship between weight and feeding concerns and the use of pressure feeding practices.
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Affiliation(s)
- Dina Almaatani
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (D.A.)
| | - Emma Cory
- Department of Paediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Julie Gardner
- Department of Paediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada
| | | | - Jessie M. Hulst
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (D.A.)
- Department of Paediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada
- Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Robert H. J. Bandsma
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (D.A.)
- Department of Paediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada
- Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Meta Van Den Heuvel
- Department of Paediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada
- Division of Paediatrics, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
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Bredun S, Kotowski M, Mezydlo J, Szydlowski J. Characteristics of Patients with Laryngomalacia: A Tertiary Referral Center Experience of 106 Cases. Diagnostics (Basel) 2023; 13:3180. [PMID: 37892001 PMCID: PMC10605856 DOI: 10.3390/diagnostics13203180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/10/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023] Open
Abstract
Laryngomalacia (LM) is the most common airway congenital anomaly and the main cause of stridor in infants. Some patients with severe airway symptoms or with feeding difficulties require surgical intervention. Synchronous airway lesions (SALs) may influence the severity and course of the disease. This study aimed to determine the prevalence of various types of LM and SALs and their influence on surgical intervention decisions and feeding difficulties. Moreover, the study focused on the interrelations between SALs and the type of LM or the presence of feeding difficulties. A retrospective analysis of 106 pediatric patients revealed a significant relationship between type 2 LM and the necessity of surgical treatment. We also found a significant effect of LM type 2 on feeding difficulty. Type 1 LM is significantly more characteristic in premature children. Among different comorbidities, SALs are suspected of modification of the course and severity of LM. This study did not find a significant effect of SALs on the incidence of supraglottoplasty or feeding difficulty.
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Affiliation(s)
| | - Michal Kotowski
- Department of Pediatric Otolaryngology, Poznan University of Medical Sciences, 27/33 Szpitalna Street, 60-572 Poznan, Poland
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Wei EX, Meister KD, Balakrishnan K, Cheng AG, Qian ZJ. Ankyloglossia: Clinical and Sociodemographic Predictors of Diagnosis and Management in the United States, 2004 to 2019. Otolaryngol Head Neck Surg 2023; 169:1020-1027. [PMID: 36994937 DOI: 10.1002/ohn.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 02/22/2023] [Accepted: 03/03/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVE The past 2 decades have seen a rapid increase in the diagnosis of ankyloglossia. Patients are often managed by lingual frenotomy. The objective is to define the clinical and socioeconomic factors that determine which patients receive frenotomy. STUDY DESIGN A retrospective analysis of commercially insured children. SETTING Optum Data Mart database. METHODS Trends in frenotomy including provider and setting were described. Multiple logistic regression was used to determine predictors of frenotomy. RESULTS Diagnosis of ankyloglossia increased from 2004 to 2019 (from 3377 in 2004 to 13,200 in 2019), while lingual frenotomy similarly increased from 1483 in 2004 to 6213 in 2019. The proportion of inpatient frenotomy procedures increased from 6.2% to 16.6% from 2004 to 2019, with pediatricians having the highest odds of performing inpatient frenotomies (odds ratio: 4.32, 95% confidence interval: 4.08, 4.57). Additionally, during the study period, the proportion of frenotomies performed by pediatricians increased from 13.01% in 2004 to 28.38% in 2019. In multivariate regression analyses, frenotomy was significantly associated with the male sex, white non-Hispanic ethnicity, higher parental income and education, and a greater number of siblings. CONCLUSION Ankyloglossia has been increasingly diagnosed in the past 2 decades, and among patients with ankyloglossia, frenotomy is increasingly performed. This trend was driven at least in part due to increasing rates of pediatricians as proceduralists. After accounting for maternal and patient-level clinical factors, socioeconomic differences in the management of ankyloglossia were observed.
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Affiliation(s)
- Eric X Wei
- Department of Otolaryngology-Head and Neck Surgery, Stanford Health Care, Palo Alto, California, USA
| | - Kara D Meister
- Department of Otolaryngology-Head and Neck Surgery, Stanford Health Care, Palo Alto, California, USA
| | - Karthik Balakrishnan
- Department of Otolaryngology-Head and Neck Surgery, Stanford Health Care, Palo Alto, California, USA
| | - Alan G Cheng
- Department of Otolaryngology-Head and Neck Surgery, Stanford Health Care, Palo Alto, California, USA
| | - Z Jason Qian
- Department of Otolaryngology-Head and Neck Surgery, Stanford Health Care, Palo Alto, California, USA
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Sundararajan S, Abi Habib P, Tadbiri H, Aycan F, Mangione M, Chaves AH, Seger L, Turan O, Turan S. Factors that Influence Placement of Gastrostomy Tube in Infants with Complex Congenital Heart Disease: A Single Center Study. J Neonatal Perinatal Med 2023:NPM230012. [PMID: 37270816 DOI: 10.3233/npm-230012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Factors that determine the need for Gastrostomy tube (G-tube) placement in infants with complex congenital heart defects (CHD) are variable. We aim to identify factors that improve counseling of expectant parents regarding postnatal outcomes and management. METHODS We performed a retrospective review of medical record of infants with prenatal diagnoses of complex CHD between 2015-2019 in a single tertiary care center and assessed risk factors for G-tube placement with linear regression. RESULTS Of the 105 eligible infants with complex CHD, 44 infants required G-tube (42% ). No significant association was observed between G-tube placement and chromosomal abnormalities, cardiopulmonary bypass time or type of CHD. Median days on noninvasive ventilation (4 [IQR 2-12] vs. 3 [IQR 1-8], p = 0.035), time at which gavage-tube feeds were started postoperatively (3 [IQR 2-8] vs. 2 [IQR 0-4], p = 0.0013), time to reach full-volume gavage-tube feeds (6 [IQR 3-14] vs. 5 [IQR 0-8], p = 0.038) and intensive care unit (ICU) length of stay (LOS) (41 [IQR: 21 - 90] vs. 18 [IQR: 7 - 23], p < 0.01) were associated with G-tube placement. Infants with ICU LOS duration longer than median had almost 7 times the odds of requiring a G-tube (OR: 7.23, 95% CI: 2.71-19.32; by regression). CONCLUSIONS Delay in initiation and in reaching full-volume gavage-tube feeds after cardiac surgery, increased number of days spent on non-invasive ventilation and in the ICU were found to be significant predictors for G-tube placement. The type of CHD and the need for cardiac surgery were not significant predictors for G-tube placement.
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Affiliation(s)
- S Sundararajan
- Division of Neonatology, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - P Abi Habib
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Science, University of Maryland School of Medicine, Baltimore, MD, USA
| | - H Tadbiri
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Science, University of Maryland School of Medicine, Baltimore, MD, USA
| | - F Aycan
- Division of Neonatology, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - M Mangione
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Science, University of Maryland School of Medicine, Baltimore, MD, USA
| | - A H Chaves
- Division of Pediatric Cardiology, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - L Seger
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Science, University of Maryland School of Medicine, Baltimore, MD, USA
| | - O Turan
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Science, University of Maryland School of Medicine, Baltimore, MD, USA
| | - S Turan
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Science, University of Maryland School of Medicine, Baltimore, MD, USA
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Tsuda T, Kakavand B. Feeding Difficulty and Poor Somatic Growth After Reparative Cardiac Surgery in Infants with Complex Congenital Heart Disease: Are We Missing Something Important? J Pediatr 2022; 250:13-15. [PMID: 35944714 DOI: 10.1016/j.jpeds.2022.07.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 10/15/2022]
Affiliation(s)
- Takeshi Tsuda
- Nemours Cardiac Center, Nemours Children's Health Delaware, Wilmington, Delaware.
| | - Bahram Kakavand
- Division of Cardiology, Nemours Children's Health Florida, Orlando, Florida
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Uyar F, Özmen D, Watson R. The Edinburgh feeding evaluation in dementia (EdFED) scale: A Turkish validity and reliability study. Int J Older People Nurs 2022; 17:e12470. [PMID: 35524365 DOI: 10.1111/opn.12470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/09/2022] [Accepted: 04/02/2022] [Indexed: 11/28/2022]
Abstract
AIM The present study aimed to adapt the Edinburgh Feeding Evaluation in Dementia (EdFED) Scale to Turkish. METHOD This methodological study was reported using STARD (The STAndards for Reporting of Diagnostic Accuracy). The sample included 200 people with dementia. The data were obtained using the Personal Information Form, the Edinburgh Feeding Evaluation in Dementia Scale, and the Mini Nutritional Assessment Test. For the Turkish adaptation of the scale, construct validity (confirmatory factor analysis), criterion validity (concurrent scale validity) and reliability analysis (Cronbach's α coefficient, item-total score correlation) were performed, respectively. RESULTS The three-factor model in the original scale was verified. The content validity index was 0.95. The Cronbach's α coefficient factors were as follows: 'Indicators of Patient Difficulty' α = 0.81, 'Patient's Need for Assistance' α = 0.79 and 'Indicators of Feeding Difficulty' α = 0.64, respectively. When the CFA fit indexes were examined, the model fit values were good. The three-factor structure was verified, compared with the original model and was compatible. No modification was needed in the model. CONCLUSIONS The Edinburgh Feeding Evaluation in Dementia Scale Turkish version provides reliable and valid measures of feeding difficulties in people with dementia. It has satisfactory psychometric properties and is suitable to use in clinical practice. IMPLICATIONS FOR PRACTICE Feeding is one of the most neglected subjects in caring for people with dementia. Screening is recommended to evaluate feeding and malnutrition, but, to our knowledge, there is no tool/scale to evaluate the feeding of the dementia patient in Turkish. The EdFED scale can serve healthcare professionals and caregivers as a practical tool for feeding difficulties in people with dementia.
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Affiliation(s)
- Fatma Uyar
- Department of Nursing, Faculty of Health Sciences, Manisa Celal Bayar University, Manisa, Turkey
| | - Dilek Özmen
- Department of Nursing, Faculty of Health Sciences, Manisa Celal Bayar University, Manisa, Turkey
| | - Roger Watson
- Nursing Faculty of Health and Social Care, University of Hull, Hull, UK
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Chaware SH, Dubey SG, Kakatkar V, Jankar A, Pustake S, Darekar A. The Systematic Review and Meta-analysis of Oral Sensory Challenges in Children and Adolescents with Autism Spectrum Disorder. J Int Soc Prev Community Dent 2021; 11:469-480. [PMID: 34760790 PMCID: PMC8533039 DOI: 10.4103/jispcd.jispcd_135_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 04/28/2021] [Accepted: 05/01/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES The purpose of the systematic review was to provide a summary and evaluation of oral sensory challenges in children and adolescents with autism spectrum disorder (ASD). MATERIALS AND METHODS The review evaluated 19 studies that met the inclusion and search criteria. The review is registered in Prospero Database (CRD42020179852). The 14 studies (8 case-control, 4 cohort, 1 observational, and 1 randomized clinical trial) were related to speech disorders and five studies (case-control studies) were associated with feeding and eating behavior in ASD. The meta-analysis of speech and feeding behavior was analyzed by using risk ratios (RRs) and standardized mean difference (SMD), with 95% confidence interval (CI). RESULTS The meta-analysis found a statistically significant difference of speech disorder between children and adolescents of ASD when compared with typically developed or other neurotypical children of similar age [0.4891 (95% CI = -2.4580; 1.4799), fixed effect; -0.1726 (95% CI = -14.2925; 7.5697), random effect]. Feeding and eating behavior reported a statistically significant difference between ASD children and adolescents with similar age group of typically developed controls [0.0433 (95% CI = -0.3531; 0.4398), fixed-effect; 0.3711 (95% CI = -3.0751; 3.8172), random effect]. CONCLUSION The speech errors and feeding behavior were more consistent in ASD than in typically developed controls. The oral sensory challenges such as speech disorder and feeding behavior were more prevalent in ASD children and adolescents than in typically developed children and adolescents of the same age group. There was a significant lack in oral sensory-motor synchronization, incomplete motor planning, and poor oral neuromuscular coordination.
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Affiliation(s)
- Sachin Haribhau Chaware
- Department of Prosthodontics and Crown and Bridge, Sharad Pawar Dental College, DMIMS, Swangi (M), Wardha, Maharashtra, India
| | - Surekha Godbole Dubey
- Department of Prosthodontics and Crown and Bridge, Sharad Pawar Dental College, DMIMS, Swangi (M), Wardha, Maharashtra, India
| | - Vinay Kakatkar
- Department of Prosthodontics and Crown and Bridge, SMBT IDSR Dental College Dhamangaon, Nashik, Maharashtra, India
| | - Ajit Jankar
- Department of Prosthodontics and Crown and Bridge, MIDSR Dental College and Hospital, Latur, Maharashtra, India
| | - Swati Pustake
- Department of Prosthodontics and Crown and Bridge, MGV KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Abhishek Darekar
- Department of Prosthodontics and Crown and Bridge, MIDSR Dental College and Hospital, Latur, Maharashtra, India
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陈 兰, 赫 纹, 刘 玲. [Autosomal dominant intellectual disability type 21 in a neonate]. Zhongguo Dang Dai Er Ke Za Zhi 2021; 23:306-309. [PMID: 33691927 PMCID: PMC7969196 DOI: 10.7499/j.issn.1008-8830.2010095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/03/2021] [Indexed: 06/12/2023]
Abstract
This is a case report on a 1-day-old male neonate admitted due to a weak cry for 1 day and recurrent circumoral cyanosis for 2 hours. He had unusual facial features at birth, with a single transverse palmar crease on both hands, flat feet, weak cry, feeding difficulties, congenital heart disease, and abnormality on cerebral MRI. Whole exome sequencing showed a de novo mutation, c.778_781delAAAG(p.Lys260ValfsTer2), in exon 3 of the CTCF gene, which was considered a pathogenic mutation by protein function prediction and might damage the function of CTCF protein. He was diagnosed with autosomal dominant intellectual disability type 21 based on the clinical manifestations and genetic analysis results. This case suggests that genetic analysis should be performed as early as possible for neonates with feeding difficulties which cannot be explained by infection or hypoxia, so as to help with early diagnosis and genetic counselling.
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Affiliation(s)
- 兰 陈
- />贵阳市妇幼保健院新生儿科, 贵州贵阳 550003Guiyang Maternity and Child Health Care Hospital, Guiyang 550003, China
| | - 纹 赫
- />贵阳市妇幼保健院新生儿科, 贵州贵阳 550003Guiyang Maternity and Child Health Care Hospital, Guiyang 550003, China
| | - 玲 刘
- />贵阳市妇幼保健院新生儿科, 贵州贵阳 550003Guiyang Maternity and Child Health Care Hospital, Guiyang 550003, China
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Destro F, Maestri L, Meroni M, Rebosio F, Del Re G, Mantegazza C, Calcaterra V, Pelizzo G. Usefulness of Gastrojejunostomy Prior to Fundoplication in Severe Gastro-Esophageal Reflux Complicating Long-Gap Esophageal Atresia Repair: A Preliminary Study. Children (Basel) 2021; 8:55. [PMID: 33477368 DOI: 10.3390/children8010055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/11/2021] [Accepted: 01/14/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Gastro-esophageal reflux disease (GERD), requiring surgical correction, and nutritional problems are reported after long-gap esophageal atresia (LGEA) repair and might jeopardize the postoperative course in some babies. We report an exploratory evaluation of the role of transgastric jejunostomy (TGJ) as a temporary nutritional tool before surgery for GERD in LGEA. METHODS Seven infant patients operated on for LGEA with intra-thoracic gastro-esophageal junction (GEJ) and growth failure, requiring improvement in their nutritional profile in anticipation of surgery, were retrospectively evaluated. Post-surgical follow-up, including growth evolution, complications, and parental quality of life (QoL), were considered. RESULTS The TGJ was placed at a mean age of 8.6 ± 5.6 months. The procedure was uneventful and well-tolerated in all seven cases. At 6.6 ± 2.0 months after TGJ placement, significant weight gain (weight z-score -2.68 ± 0.8 vs -0.9 ± 0.2, p < 0.001) was recorded, allowing the GERD surgery to proceed. A significant difference in hospital admissions between 3 months before and post-TGJ insertion was noted (4.8 ± 0.75 vs. 1.6 ± 0.52, p < 0.01). A significant amelioration of QoL after TGJ placement was also recorded; in particular, the biggest improvements were related to parents' perceptions of the general health and emotional state of their babies (p < 0.001). CONCLUSIONS The placement of TGJ as a temporary nutritional tool in selected cases of LGEA could improve nutritional conditions and parental QoL before fundoplication, allowing successful surgical treatment of GERD to be carried out.
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Ren Z, Lan H, Szeto IMY, Yang C, Zhang J, Li P, Li J, Wang P, Zhang Y, Zhao A. Feeding Difficulty Among Chinese Toddlers Aged 1-3 Years and Its Association With Health and Development. Front Pediatr 2021; 9:758176. [PMID: 34888269 PMCID: PMC8650057 DOI: 10.3389/fped.2021.758176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/01/2021] [Indexed: 11/24/2022] Open
Abstract
Feeding problems are biopsychosocial in nature and have a great influence on children's growth. The aim of this study was to profile the status and possible influencing factors of feeding difficulty among normal Chinese toddlers, and to investigate its association with health and development. This study is a part of the Young Investigation (YI study) conducted in 10 cities in China. Data from 924 children aged 1-3 years were analyzed. Data on socio-demographic factors, feeding behaviors, self-reported diseases, and anthropometry parameters were collected. Blood samples were drawn to determine hemoglobin levels. Feeding difficulty was evaluated by the Montreal Children's Hospital Feeding Scale (MCH-FS). Ages and Stages Questionnaires, Third Edition (ASQ-3) were used to assess developmental progress. Multivariable analyses were performed to explore the potential associations. The mean total score of the MCH-FS was 35.21 ± 12.90 and the highest scored item was "acting up/making a big fuss during mealtimes." Feeding difficulty occurred more often among children with picky eating behavior or whose caregivers once used the strategy of pre-mastication. Children with feeding difficulty had lower intakes of cereals, vegetables, and fruits, and were more likely to suffer from diarrhea (OR, 2.04; 95%CI: 1.32, 3.11) or constipation (OR, 2.04; 95%CI: 1.27, 3.24), but not anemia. Feeding difficulty was also negatively associated with weight, height, head circumference and mid-upper-arm circumference-related Z-scores (P all < 0.05). In addition, it was related to poorer fine motor skills, personal and social skills, and total scores of ASQ-3 (β, -9.00; 95%CI: -15.11, -2.89). Feeding difficulty assessed by MCH-FS showed a negative association with children's health and development, supporting the need for early identification.
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Affiliation(s)
- Zhongxia Ren
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Hanglian Lan
- Yili Maternal and Infant Nutrition Institute, Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot, China
| | - Ignatius Man-Yau Szeto
- Yili Maternal and Infant Nutrition Institute, Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot, China
| | - Chenlu Yang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jian Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Pin Li
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jingwen Li
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Peiyu Wang
- Department of Social Science and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yumei Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Ai Zhao
- Vanke School of Public Health, Tsinghua University, Beijing, China
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Pan YQ, Fu JH. Case Report: Clinical Description of a Patient Carrying a 12.48 Mb Microdeletion Involving the 10p13-15.3 Region. Front Pediatr 2021; 9:603666. [PMID: 33732667 PMCID: PMC7959834 DOI: 10.3389/fped.2021.603666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/13/2021] [Indexed: 11/13/2022] Open
Abstract
Partial deletion of 10p chromosome is a rare chromosomal aberration. Submicroscopic deletion of 10p15.3 is mainly related to cognitive deficits, speech disorders, motor delay, and hypotonia with the deleted region ranging from 0.15 to 4 Mb. The clinical phenotype is mainly determined by the ZMYND11 and DIP2C genes. Here, we report a rare case of feeding difficulties, hypocalcemia, and psychomotor retardation. Our patient has a 12.48 Mb deletion in 10p15.3-10p13, which is the second case of large 10p deletion among reported cases thus far.
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Affiliation(s)
- Yu-Qing Pan
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jian-Hua Fu
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
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Spencer JC, Damanik R, Ho MH, Montayre J, Traynor V, Chang CC, Chang HCR. Review of Food Intake Difficulty Assessment Tools for People with Dementia. West J Nurs Res 2020; 43:1132-1145. [PMID: 33371826 DOI: 10.1177/0193945920979668] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This review aimed to summarise the validity and reliability of feeding difficulties assessment tools for Individual with dementia. PubMed, PsycINFO, MEDLINE, CINAHL and Scopus were searched for feeding difficulty measurements studies published between 1990 and 2019. Sixteen publications were included and identified three tools: Edinburgh Feeding Evaluation in Dementia (EdFED), Feeding Behaviour Inventory (FBI), and Feeding Difficulty Index (FDI). Results showed the EdFED was translated and tested in various languages. The EdFED and FDI demonstrated high content and construct validity. The FBI was not validated. The EdFED had high inter-rater reliability, with Cronbach's alpha ranging from 0.75 to 0.90. The FDI and FBI showed moderate inter-rater reliability. Although the EdFED has been tested and widely used, unlike FDI, which addresses multi-aspects of feeding difficulty. The FDI have higher clinical utility but future research needs to test the psychometric properties of FDI to determine its effectiveness in assessing feeding difficulties.
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Affiliation(s)
- Jia Ci Spencer
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, NSW, Australia
| | - Riris Damanik
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Mu-Hsing Ho
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, NSW, Australia.,Department of Nursing, Taipei Medical University Hospital, Taipei
| | - Jed Montayre
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Victoria Traynor
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, NSW, Australia
| | - Chia-Chi Chang
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei
| | - Hui-Chen Rita Chang
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute (IHMRI), Wollongong, NSW, Australia
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14
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Pelizzo G, Destro F, Selvaggio GGO, Maestri L, Roveri M, Bosetti A, Borsani B, Pendezza E, Meroni M, Pansini A, La Pergola E, Riccipetitoni G, De Silvestri A, Cena H, Calcaterra V. Esophageal Atresia: Nutritional Status and Energy Metabolism to Maximize Growth Outcome. Children (Basel) 2020; 7:children7110228. [PMID: 33202530 PMCID: PMC7696161 DOI: 10.3390/children7110228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/03/2020] [Accepted: 11/10/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Long-term negative sequelae of esophageal atresia (EA) may induce poor growth and impaired nutritional status in childhood. We describe the nutritional profile and energy metabolism of children with repaired EA to identify malnutrition risk factors and optimize growth management. METHODS Twenty-one children (>4 years) were included, and anthropometric measurements, nutritional assessment, and energy metabolism were considered. The subjects were defined as undernourished if they met BMI < -2 standard deviation (SD). To grade undernutrition, we defined the prevalence of underweight, stunting, and wasting (cut-off level of <-2 SD). Medical records were reviewed for the type of EA and surgery and perinatal data. RESULTS Malnutrition was detected in 28.6% of children. Underweight was detected in 23.8% of patients (all with undernutrition p < 0.01). Wasting was noted in 28.6% of patients, of these 5 children were undernourished (p < 0.001) and stunting was noticed in only one patient with malnutrition (p = 0.5). Resting expenditure energy (REE) was lower in undernourished subjects compared to subjects with adequate nutritional status (p < 0.001). Malnutrition was associated to: type of EA (p = 0.003, particularly type A and C); intervention including deferred anastomosis due to long-gap repair (p = 0.04) with/or without jejunostomy (p = 0.02), gastric pull-up (p = 0.04), primary anastomosis (p = 0.04), pyloromyotomy in long-gap (p < 0.01); small for gestational age condition (p = 0.001). CONCLUSIONS undernutrition risk factors, beyond the type of malformation, surgery, and perinatal factors, must be early considered to personalize nutritional programming. Energy metabolism is important to monitor the nutritional requirements. The management of nutritional issues is surely a contributory factor able to counteract the poor growth of children with EA.
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Affiliation(s)
- Gloria Pelizzo
- Pediatric Surgery Department, “V. Buzzi” Children’s Hospital, 20157 Milano, Italy; (F.D.); (G.G.O.S.); (L.M.); (M.R.); (M.M.); (A.P.); (E.L.P.)
- Department of Biomedical and Clinical Science “L. Sacco”, University of Milano, 20157 Milano, Italy
- Correspondence:
| | - Francesca Destro
- Pediatric Surgery Department, “V. Buzzi” Children’s Hospital, 20157 Milano, Italy; (F.D.); (G.G.O.S.); (L.M.); (M.R.); (M.M.); (A.P.); (E.L.P.)
| | - Giorgio Giuseppe Orlando Selvaggio
- Pediatric Surgery Department, “V. Buzzi” Children’s Hospital, 20157 Milano, Italy; (F.D.); (G.G.O.S.); (L.M.); (M.R.); (M.M.); (A.P.); (E.L.P.)
| | - Luciano Maestri
- Pediatric Surgery Department, “V. Buzzi” Children’s Hospital, 20157 Milano, Italy; (F.D.); (G.G.O.S.); (L.M.); (M.R.); (M.M.); (A.P.); (E.L.P.)
| | - Margherita Roveri
- Pediatric Surgery Department, “V. Buzzi” Children’s Hospital, 20157 Milano, Italy; (F.D.); (G.G.O.S.); (L.M.); (M.R.); (M.M.); (A.P.); (E.L.P.)
| | - Alessandra Bosetti
- Pediatric Department, “V. Buzzi” Children’s Hospital, 20157 Milano, Italy; (A.B.); (B.B.); (E.P.); (V.C.)
| | - Barbara Borsani
- Pediatric Department, “V. Buzzi” Children’s Hospital, 20157 Milano, Italy; (A.B.); (B.B.); (E.P.); (V.C.)
| | - Erica Pendezza
- Pediatric Department, “V. Buzzi” Children’s Hospital, 20157 Milano, Italy; (A.B.); (B.B.); (E.P.); (V.C.)
| | - Milena Meroni
- Pediatric Surgery Department, “V. Buzzi” Children’s Hospital, 20157 Milano, Italy; (F.D.); (G.G.O.S.); (L.M.); (M.R.); (M.M.); (A.P.); (E.L.P.)
| | - Andrea Pansini
- Pediatric Surgery Department, “V. Buzzi” Children’s Hospital, 20157 Milano, Italy; (F.D.); (G.G.O.S.); (L.M.); (M.R.); (M.M.); (A.P.); (E.L.P.)
| | - Enrico La Pergola
- Pediatric Surgery Department, “V. Buzzi” Children’s Hospital, 20157 Milano, Italy; (F.D.); (G.G.O.S.); (L.M.); (M.R.); (M.M.); (A.P.); (E.L.P.)
| | | | - Annalisa De Silvestri
- Clinical Epidemiology & Biometry, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy;
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, 27100 Pavia, Italy
| | - Valeria Calcaterra
- Pediatric Department, “V. Buzzi” Children’s Hospital, 20157 Milano, Italy; (A.B.); (B.B.); (E.P.); (V.C.)
- Pediatric and Adolescent Unit. Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
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15
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Menzies J, Hughes J. Parental feeding concerns of infants and young children with oesophageal atresia. J Paediatr Child Health 2020; 56:1791-1794. [PMID: 32463154 DOI: 10.1111/jpc.14840] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/12/2020] [Accepted: 02/16/2020] [Indexed: 11/29/2022]
Abstract
AIM Feeding problems have been described in young children with oesophageal atresia (OA). The primary aim of this study was to determine the specific concerns of parents and carers of infants and young children with OA regarding introducing solids and moving up to family foods. METHODS A questionnaire was developed for parents and carers of infants and children with OA, aged 12 months to 6 years. Questionnaires were completed by 20 parents attending a multidisciplinary OA clinic between June 2016 and June 2017. Demographics and parental concern regarding feeding milestones were collected. The Montreal Children's Hospital Feeding Scale was completed. RESULTS The majority of children (95%) had type C OA. Eleven (55%) parents agreed/strongly agreed that they were concerned about their child's feeding prior to the introduction of solids and about moving to more textured solids. The most common concern was choking and food impaction for both time points. Twelve (60%) parents agreed/strongly agreed that the majority of mealtimes in their child's first 1-2 years of life were stressful. Thirteen (65%) parents reported avoiding particular foods due to their child's OA. The majority of children (n = 17) had no feeding difficulty according to an objective scale, and the rest had minor difficulty. CONCLUSIONS Parental concern around feeding still exists in infants and children without a severe feeding difficulty. Multidisciplinary involvement, including a dietitian and speech pathologist, from an early age is important for infants and children with OA.
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Affiliation(s)
- Jessica Menzies
- Department of Nutrition and Dietetics, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Jennifer Hughes
- Department of Nutrition and Dietetics, Sydney Children's Hospital, Sydney, New South Wales, Australia
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16
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Wei EX, Tunkel D, Boss E, Walsh J. Ankyloglossia: Update on Trends in Diagnosis and Management in the United States, 2012-2016. Otolaryngol Head Neck Surg 2020; 163:1029-1031. [PMID: 32427523 DOI: 10.1177/0194599820925415] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Ankyloglossia, or "tongue-tie," refers to limited tongue mobility caused by a restrictive lingual frenulum. Previous studies have demonstrated rapid increases in diagnosis and treatment of ankyloglossia in the United States up to 2012. We performed an updated retrospective review of data from the National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality (AHRQ) to evaluate trends in diagnosis of ankyloglossia and use of lingual frenotomy in the hospital setting. From 2012 to 2016, there was an 110.4% increase in reported diagnosis of ankyloglossia in the inpatient setting with similar increases in lingual frenotomy procedures. As seen previously, sex, type of insurance, median income ZIP code, and geographic region were associated with diagnosis of ankyloglossia. The observed trends from prior to 2012 have continued to increase, while unanswered questions about diagnostic criteria and about which infants should undergo frenotomy remain.
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Affiliation(s)
- Eric X Wei
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David Tunkel
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Emily Boss
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jonathan Walsh
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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17
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Warren MG, Do B, Das A, Smith PB, Adams-Chapman I, Jadcherla S, Jensen EA, Goldstein RF, Goldberg RN, Cotten CM, Bell EF, Malcolm WF. Gastrostomy Tube Feeding in Extremely Low Birthweight Infants: Frequency, Associated Comorbidities, and Long-term Outcomes. J Pediatr 2019; 214:41-46.e5. [PMID: 31427096 PMCID: PMC6815700 DOI: 10.1016/j.jpeds.2019.06.066] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 06/07/2019] [Accepted: 06/25/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To assess the frequency of gastrostomy tube (GT) placement in extremely low birth weight (ELBW) infants, associated comorbidities, and long-term outcomes. STUDY DESIGN Analysis of ELBW infants from 25 centers enrolled in the National Institute of Child Health and Human Development Neonatal Research Network's Generic Database and Follow-up Registry from 2006 to 2012. Frequency of GT placement before 18-22 months, demographic and medical factors associated with GT placement, and associated long-term outcomes at 18-22 months of corrected age were described. Associations between GT placement and neonatal morbidities and long-term outcomes were assessed with logistic regression after adjustment for center and common co-variables. RESULTS Of the 4549 ELBW infants included in these analyses, 333 (7.3%) underwent GT placement; 76% had the GT placed postdischarge. Of infants with GTs, 11% had birth weights small for gestational age, 77% had bronchopulmonary dysplasia, and 29% severe intraventricular hemorrhage or periventricular leukomalacia. At follow-up, 56% of infants with a GT had weight <10th percentile, 61% had neurodevelopmental impairment (NDI), and 55% had chronic breathing problems. After adjustment, small for gestational age, bronchopulmonary dysplasia, intraventricular hemorrhage/periventricular leukomalacia, poor growth, and NDI were associated with GT placement. Thirty-two percent of infants with GTs placed were taking full oral feeds at follow-up. CONCLUSIONS GT placement is common in ELBW infants, particularly among those with severe neonatal morbidities. GT placement in this population was associated with poor growth, NDI, and chronic respiratory and feeding problems at follow-up. The frequency of GT placement postneonatal discharge indicates the need for close nutritional follow-up of ELBW infants. TRIAL REGISTRATION ClinicalTrials.gov: NCT00063063.
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Affiliation(s)
| | - Barbara Do
- Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD
| | - Abhik Das
- Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD
| | - P Brian Smith
- Department of Pediatrics, Duke University, Durham, NC
| | - Ira Adams-Chapman
- Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta, GA
| | | | - Erik A Jensen
- Department of Pediatrics, The Children's Hospital of Philadelphia and The University of Pennsylvania, Philadelphia, PA
| | | | | | | | - Edward F Bell
- Department of Pediatrics, University of Iowa, Iowa City, IA
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18
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Kim JY, Lee YW, Kim HS, Lee EH. The mediating and moderating effects of meaning in life on the relationship between depression and quality of life in patients with dysphagia. J Clin Nurs 2019; 28:2782-2789. [PMID: 31067340 DOI: 10.1111/jocn.14907] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 02/06/2019] [Accepted: 04/16/2019] [Indexed: 12/13/2022]
Abstract
AIMS AND OBJECTIVES To identify whether meaning in life has moderating and mediating effects on the relationship between depression and quality of life in patients with dysphagia. BACKGROUND Dysphagic patients typically have multidimensional problems, such as depression, which can negatively influence their quality of life. Meaning in life, therefore, can be used as a psychological resource that may enhance quality of life for these patients. DESIGN A descriptive cross-sectional research design was used. METHODS Ninety patients with dysphagia were recruited for a survey from eight general and rehabilitation hospitals in Korea. The questionnaires, which included the Korean version of the Swallowing Quality of Life scale developed by Cha, the Center for Epidemiological Studies-Depression Scale developed by Radloff, and the Purpose in Life test developed by Crumbaugh and Maholick, were used for data collection. Descriptive statistics, Hayes' PROCESS macro and Cronbach's alpha were used for data analyses. RESULTS Meaning in life was found to mediate the relationship between depression and quality of life in patients with dysphagia. However, the index of moderation was not statistically significant, which mean that meaning in life did not moderate the relationship between the patients' depression and quality of life. CONCLUSIONS Meaning in life had a mediating effect on the relationship between depression and quality of life in patients with dysphagia. Thus, to improve the quality of life of patients with dysphagia, nurses should apply interventions to help them find meaning in life. RELEVANCE TO CLINICAL PRACTICE Meaning in life can be used as a nursing intervention strategy to improve the quality of life for patients living with dysphagia and depression.
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Affiliation(s)
- Ju-Yeun Kim
- Department of Nursing, Dongyang University, Yeongju, Korea
| | | | - Hwa-Soon Kim
- Department of Nursing, Inha University, Incheon, Korea
| | - Eun-Hyun Lee
- Graduate School of Public Health, Ajou University, Suwon, Korea
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19
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Yi YG, Oh BM, Shin SH, Shin JY, Kim EK, Shin HI. Stress Signals During Sucking Activity Are Associated With Longer Transition Time to Full Oral Feeding in Premature Infants. Front Pediatr 2018; 6:54. [PMID: 29594085 PMCID: PMC5857543 DOI: 10.3389/fped.2018.00054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 02/26/2018] [Indexed: 11/13/2022] Open
Abstract
Several treatments have been proposed to shorten the time to the attainment of full oral feeding (FOF) for premature infants, but there are only a few evaluation methods useful in estimating predictors of this period. We investigated whether specific items within the disorganized sucking patterns described by the Neonatal Oral-Motor Assessment Scale (NOMAS) could estimate the time to FOF in preterm infants with feeding difficulty. Preterm infants diagnosed with a disorganized sucking pattern in the NOMAS evaluation before 50 weeks of postmenstrual age were included. Video recordings of at least 2 min of oral feeding were further analyzed retrospectively by two assessors and the premature infants who exhibited disorganized sucking patterns (n = 109) were divided into three clusters (clusters 2-4). The observational items compatible with disorganization in the original NOMAS were divided into three groups: cluster 2 (disorganized: arrhythmical), cluster 3 (disorganized: arrhythmical + unable to sustain), and cluster 4 (disorganized: arrhythmical + incoordination ± unable to sustain) and further divided into incoordination-positive (cluster 4) and incoordination-negative groups (clusters 2 and 3). Premature infants in the incoordination-positive group (cluster 4, which means stress signals) showed a median transition time of 22 days (range: 4-121 days) which was longer than that in the incoordination-negative group (median 6 days; range: 1-25 days). Univariate linear regression analysis revealed that the presence of incoordination among disorganized sucking patterns (NOMAS cluster 4 vs. clusters 2 and 3), birth weight, total parenteral nutrition (TPN) duration, non-invasive positive pressure ventilation duration, the presence of moderate to severe bronchopulmonary dysplasia, pulmonary hypertension, sepsis, small for gestational age (SGA), and necrotizing enterocolitis are associated with the transition time to FOF. In a multivariate linear regression analysis, the variables revealed to be associated with the transition time were TPN duration, SGA, and the presence of stress signals (incoordination-positive group) among disorganized sucking patterns. When selecting premature infants to be treated with swallowing therapy, it is reasonable to pay more attention to the incoordination-positive group described in the NOMAS, that is, premature infants with stress signals to shorten the time to attain FOF.
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Affiliation(s)
- You Gyoung Yi
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Byung-Mo Oh
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Seung Han Shin
- Division of Neonatology, Department of Pediatrics, Seoul National University Children's Hospital, Seoul, South Korea
| | - Jin Yong Shin
- Department of Pediatric Occupational Therapy, Seoul National University Children's Hospital, Seoul, South Korea
| | - Ee-Kyung Kim
- Division of Neonatology, Department of Pediatrics, Seoul National University Children's Hospital, Seoul, South Korea
| | - Hyung-Ik Shin
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
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20
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Walsh J, Links A, Boss E, Tunkel D. Ankyloglossia and Lingual Frenotomy: National Trends in Inpatient Diagnosis and Management in the United States, 1997-2012. Otolaryngol Head Neck Surg 2017; 156:735-740. [PMID: 28168891 PMCID: PMC6475619 DOI: 10.1177/0194599817690135] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 01/03/2017] [Indexed: 11/17/2022]
Abstract
Objectives (1) Describe trends in the diagnosis of ankyloglossia and the use of lingual frenotomy and (2) analyze patient- and hospital-level factors as compared with the total pediatric discharge population. Study Design National database analysis. Methods We reviewed available data from 1997 to 2012 using the Kids' Inpatient Database, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality. All weighted pediatric discharges with ankyloglossia, newborn feeding difficulty, or lingual frenotomy were analyzed for variables of sex, payer, zip code median income, hospital ownership, location/teaching status, bed size, region, and children's hospital status. Chi-square analysis with 95% CIs and odds ratio were used to identify differences between the study group and the total database discharge population. Results Diagnosis of ankyloglossia increased each year of publication (every third year)-with 3934, 5430, 7785, 11,397, 19,459, and 32,837 children, respectively, from 1997 to 2012-with the largest increase in the last 6 years. Similarly, frenotomy increased with 1279, 1633, 2538, 3988, 6900, and 12,406 procedures. Compared with the total discharge population, children with ankyloglossia or frenotomy were more often male (63.6% ankyloglossia, 65.3% frenotomy vs 51.2%), privately insured (60.1%, 62.1% vs 43.6%), from a higher median-income zip code (78.1%, 78.2% vs 68.6%), and in Midwest region (29.3%, 32.3% vs 21.7%). Conclusion These pilot data show increases in diagnoses of ankyloglossia and use of frenotomy. There is a preponderance of children who are male, privately insured, or Midwest residents being diagnosed and treated for ankyloglossia. This broad variation may reflect local practice patterns or imply cultural and socioeconomic bias.
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Affiliation(s)
- Jonathan Walsh
- 1 Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - Anne Links
- 1 Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - Emily Boss
- 1 Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - David Tunkel
- 1 Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
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21
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Kim K, Lee J, Paik HY, Yoon J, Ryu B, Shim JE. Effects of multiple herb formula SEC-22 supplementation on dietary intake, picky eating behaviors, and growth indices in thin preschool children. Nutr Res Pract 2015; 9:393-9. [PMID: 26244078 PMCID: PMC4523483 DOI: 10.4162/nrp.2015.9.4.393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 02/05/2015] [Accepted: 04/05/2015] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND/OBJECTIVES Thin children may have insufficient intake of energy and nutrients, resulting in reduced immune function and growth. This study aimed to identify the effects of multiple herb formula SEC-22 supplementation on growth, dietary changes, and picky eating behaviors in thin children. SUBJECTS/METHODS A double-blind, randomized clinical trial was conducted on 79 children aged 2-5 years with poor appetites, BMI percentile < 25, and without any illness. Subjects were given either SEC-22 (n = 35) or placebo (n = 44) for 2 months and followed for an additional 2 months. Three-day dietary records, questionnaires on picky eating behaviors, and anthropometric measures were collected. RESULTS Energy, carbohydrate intake, and feeding difficulty improved in both groups during the intervention period. However, changes were maintained only in the SEC-22 group after 2 months of follow-up post-supplementation. 'Frequency of trying to feed' was improved in the SEC-22 group compared to the placebo group after the first month of follow-up (P < 0.05). Intakes of potassium and thiamine were improved in the SEC-22 group compared to the placebo group after the first month of intervention (P < 0.05). 'Frequency of food reward', eating amount, and intakes of carbohydrate, potassium, and vitamin C showed significant improvement compared to the placebo group after the second month of follow-up (P < 0.05). CONCLUSIONS These results suggest that SEC-22 supplementation can improve parental feeding difficulty resulting from insufficient eating amount or picky eating as well as increase nutrient intake in thin children. Although these improvements were observable at least 2 months after supplementation, effects beyond this time frame need to be confirmed.
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Affiliation(s)
- Kijoon Kim
- Department of Food and Nutrition, Seoul National University, Seoul 151-742, Korea
- BOM Research Institute, Seoul National University, Seoul 151-742, Korea
| | - Joonsuk Lee
- BOM Research Institute, Seoul National University, Seoul 151-742, Korea
| | - Hee Young Paik
- Department of Food and Nutrition, Seoul National University, Seoul 151-742, Korea
| | - Jihyun Yoon
- Department of Food and Nutrition, Seoul National University, Seoul 151-742, Korea
| | - Bongha Ryu
- 3rd department of Internal Medicine, College of Oriental Medicine, Kyung-Hee University, Seoul 130-701, Korea
| | - Jae Eun Shim
- Department of Food and Nutrition, Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon 300-716, Korea
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22
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Abstract
While many long-term complications of esophageal atresia (EA) have been well investigated, little is known about feeding difficulties in children after surgical correction of EA and its impact on caregivers. This study investigates the feeding behaviors of children with EA through a validated feeding questionnaire. The Montreal Children's Hospital Feeding Scale (MCH-FS) was filled out by the primary caregiver during patient follow-up visits in the multidisciplinary EA clinic. Demographic information, EA subtype, associated anomalies and outcomes were recorded. Results were compared between groups and to a normative sample. Thirty caregivers have completed the MCH-FS; 26 patients had type C atresia (86.7%). In comparison to controls, 17.5% of EA cases are one standard deviation above the mean feeding difficulty score, while 6.7% (n = 2) cases are greater than two standard deviations above normative values. Typical EA patients (type C who were not born <30 weeks) had mean MCH-FS scores in the subclinical range, whereas one extremely premature child and the patients with non-type C EA (n = 4) all had scores in the severe range. Feeding difficulties of patients with typical EA appear mild. Likely explanations include the use of early protocolized care and intensive multidisciplinary care in follow up. Nonetheless, patients with complicated EA (non-type C) and their caregivers tend to experience significant feeding difficulties. Early targeted care may be required for this patient subset, and additional cases will be investigated to confirm these preliminary findings and explore further risk factors of feeding problem in this cohort.
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Affiliation(s)
- R Baird
- Department of Pediatric General and Thoracic Surgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
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Fucile S, McFarland DH, Gisel EG, Lau C. Oral and nonoral sensorimotor interventions facilitate suck-swallow-respiration functions and their coordination in preterm infants. Early Hum Dev 2012; 88:345-50. [PMID: 21962771 PMCID: PMC3262089 DOI: 10.1016/j.earlhumdev.2011.09.007] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 08/30/2011] [Accepted: 09/06/2011] [Indexed: 11/24/2022]
Abstract
BACKGROUND Preterm infants are at high risk of encountering oral feeding difficulties. Early sensorimotor interventions may improve oral feeding skills in preterm infants. AIM To further explore the effects of an oral (O), tactile/kinesthetic (T/K), and combined (O+T/K) sensorimotor intervention on preterm infants' nutritive sucking, swallowing and their coordination with respiration. STUDY DESIGN Seventy-five infants (29 [0.3, standard error of mean, SEM] weeks gestation, 49 males/26 females) were randomly assigned to an O group involving sensorimotor input to the oral structures; a T/K group involving sensorimotor input to the trunk and limbs; a combined (O+T/K) group; and a control group. OUTCOME MEASURES Stage of sucking, suction and expression amplitudes (mmHg), suck-swallow ratio, stability of suck-swallow interval, and swallow-respiration patterns. RESULTS The O group had significantly more advanced sucking stages, and greater suction and expression amplitudes than controls [p≤0.035, effect size (ES) >0.6]. The suck-swallow ratio and stability of suck-swallow intervals did not significantly differ among groups (p≥0.181, ES≤0.3). The three interventions led to fewer swallows bracketed by prolonged respiratory pauses compared to controls (pause-swallow-pause, p≤0.044, ES≥0.7). The T/K and combined (O+T/K) groups had greater occurrence of swallows bracketed by expiration than the control and O groups (expiration-swallow-expiration, p≤0.039, ES≥0.3). CONCLUSION The O intervention enhanced specific components of nutritive sucking. All three interventions resulted in improved swallow-respiration coordination. Sensorimotor interventions have distributed beneficial effects that go beyond the specific target of input.
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Affiliation(s)
- Sandra Fucile
- School of Physical & Occupational Therapy, McGill University, Montreal, QC, Canada.
| | - David H McFarland
- École d’orthophonie et d’audiologie, Université de Montréal, Montréal, QC, Canada
| | - Erika G Gisel
- School of Physical & Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Chantal Lau
- Department of Pediatrics/Neonatology, Baylor College of Medicine, Houston, TX, USA
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