Disease Profile Of Children Research Articles

ORAL AND ENTERAL NUTRITION THERAPY IN INFLAMMATORY BOWEL DISEASES AMONG THE PEDIATRIC POPULATION: A LITERATURE REVIEW.

ABSTRACTObjectives: To review the literature on oral and enteral nutrition therapy and investigate the evidence of its efficacy as a treatment, as well as in preventing relapses and reducing symptoms of inflammatory bowel diseases in the pediatric population.Data source: We performed a bibliographic search in the PubMed, Web of Science, and Latin American and Caribbean Health Sciences Literature (Literatura Latino-Americana e do Caribe em Ciências da Saúde - Lilacs) databases, using the keywords “inflammatory bowel disease,” “diet,” and “diet therapy” in English and Portuguese, with filters for pediatric studies published in the previous five years.Data summary: We selected 16 articles for this study, nine on exclusive and/or partial enteral nutrition and seven on modified oral diets, such as the specific carbohydrate diet (SCD) and the Crohn’s Disease exclusion diet (CDED). The studies found evaluated the anthropometric profile of patients and the inflammatory profile of diseases in children before and after the introduction of each specific nutrition therapy. All interventions presented positive changes in these parameters; however, the results were inconclusive regarding the efficacy of SCD and CDED in the treatment and prevention of relapses.Conclusions: Exclusive enteral nutrition has proven to be effective in inducing remission of Crohn’s Disease, and the use of partial enteral nutrition for maintenance treatment has shown promising results. Other modified oral diets are inconclusive concerning their effectiveness, requiring further randomized controlled clinical trials.

Burden of respiratory diseasw among paediatric patients infected with HIV

The effects of paediatric HIV on the respiratory system are seen daily in paediatric wards. The nature of respiratory disease and the needs of HIV-positive patients have changed subsequent to the introduction of anti-retrovirals to South Africa in 2004. One hundred and twenty-five children admitted to the paediatric wards under the age of seven years were recruited for this study. The purpose of this study was to understand the disease profile of children with HIV/AIDS, their health status, presenting respiratory conditions, and need for chest physiotherapy. The most common respiratory conditions included bacterial pneumonia (66.4%), tuberculosis (48%) and pneumocystis jirovecii pneumonia (23.2%) (n=125). Two thirds of the children (68.8%) presented with a high burden of disease. Forty percent (40.8%) of the children were taking anti-retrovirals with an average length of use of 9.81 months (±SD=11.61). Analysis of immune status revealed a mean CD4 percentage of 17.33% (±SD=10.96), CD4 absolute 631.36 cell/mm3 (±SD=610.36) and viral load 2.6 million copies /ml (±SD=9.08 million copies/ml). This study highlights the characteristics and prevalence of respiratory disease burden among children with HIV in a South African setting in a post highly active antiretroviral era.

The intensive care unit in paediatric oncology: 10 years experience

We report the results of a retrospective study of the intensive care outcome of 196 children admitted with malignancy at a tertiary referral institution over a period of 10 years from 1988 to 1997. A total of 165 children required 196 admissions for a median of 3 days. Their mean age was 5.82 years and there were 100 boys (51%) and 96 girls (49%). Their admission median Apache II score was 18. A total of 150 children (76.5%) survived intensive care. Nonsurvivors had a higher Apache II score than survivors (23 vs 15 respectively, P < 0.001). Patients were divided into those needing postoperative care (n = 55), patients with respiratory infection (n = 39), systemic infection (n = 30), neurological complications (n = 20), respiratory failure with no evidence of infection (n = 17), metabolic effect (n = 13), tumour mass effect (n = 9), GI bleed (n = 5), cardiac failure (n = 4), post cardiac arrest (n = 3). The overall survival, defined as those who survived 1 week after discharge from PICU, was 73.4%. Invasive monitoring including arterial and central venous pressure line were inserted in 143 (72.9%), mechanical ventilation was required for 133 (67.8%), ionotropic support for 66 (33%), pulmonary artery floatation catheter insertion and monitoring in 23 (11.7%) and renal replacement therapy for 13 (6.6%) children. The profile of diseases in children admitted in PICU appears to be changing since last report from this unit in 1992 [1]. The most common reason for admission was need for postoperative care (28%) and survival in this group was 100%. There also is a significant improvement in survival rate of patients with systemic infections (63%) needing ventilatory support and children with respiratory (with or without infection) failure (67%) [2].

Admission patterns and outcomes in a paediatric intensive care unit in South Africa over a 25-year period (1971-1995).

To describe admission and outcome patterns of diseases managed at a paediatric intensive care unit (PICU) in a developing country between 1971 and 1995, in order to provide data which will assist in improving the management of diseases and the rational allocation of health resources. This study is based on data collated from annual audits conducted by the head of the PICU, King Edward VIII Hospital, Durban, South Africa. This unit serves a childhood population of about 3-4 million aged from 0-12 years. The proportion of children admitted to the ICU as a percentage of the general paediatric admission has increased from 1.5% in 1971 to 7% in 1995. During this period, 7580 children were admitted to the unit, an average of 303 cases per annum. The overall mortality rate was 35.44% (range 29.9 to 45.4%); over 90% of the children admitted were intubated and 80% required intermittent positive pressure ventilation. Common childhood vaccine preventable infections have declined substantially and have been replaced by HIV related syndromes, lower respiratory tract infections, metabolic disorders, septicaemia and hyaline membrane disease. The mean duration of ICU stay per survivor over the study period 1991-1995 was 13.891 days. Tetanus, septicaemia and HIV related diseases required the longest ICU stay per survivor (>20 days), while accidental injuries, neonatal apnoea and asthma required the shortest duration of ICU stay per survivor (<6 days); 23.9% of all deaths occurred in the first 24 h. The profile of diseases in children admitted to this PICU has changed considerably over 25 years. Some of these changes can be attributed to the shift in emphasis to primary health care, especially higher vaccination coverage rates. Profitable utilisation of limited ICU facilities would probably be enhanced by the use of outcome measures such as mortality and mean number of ICU days of stay per survivor.