Mental state verbs(MSVs)are believed to be closely related with the development of Theory of Mind(ToM).Studies on MSVs have yielded fruitful results abroad over the past three decades,especially in ToM,while it still ...Mental state verbs(MSVs)are believed to be closely related with the development of Theory of Mind(ToM).Studies on MSVs have yielded fruitful results abroad over the past three decades,especially in ToM,while it still has a long way to go for the Mandarin-speaking children.The present study focuses on mental state verbs in Mandarin-speaking children and explores the universality of ToM,as well as the development features.An analysis of their spontaneous speech from the CHILDES archives reveals,first,that Mandarin-speaking children use desire terms much earlier than other terms,suggesting a pattern of theory-of-mind development similar to that in English;second,the developmental trend of the MSVs is relatively steady while the number of different categories varies a lot.This study suggests a consistency in the overall sequence,but variation in the timing of beginning and end points,which is helpful to further related investigation.展开更多
Fate is always an eternal subject that many scholars, artists, critics and writers utilizing this vast and specific subject in their compositions. Therefore, in this text, people's views of fate will be analyzed f...Fate is always an eternal subject that many scholars, artists, critics and writers utilizing this vast and specific subject in their compositions. Therefore, in this text, people's views of fate will be analyzed from two typical characters:Achilles and Childe Harold, who are heroes in their times. Through their life tracks, this text will explore the ideal model of one's destiny in the specif-ic era, and from the economic development, social condition and cultural background, the reason or cause of these views will be traced and offer some enlightenment for what people should compose today.展开更多
The airflow mechanics in adult nasal airways,whether healthy or abnormal,are extensively studied and investigated,but the flow mechanics in child nasal airways remain underexplored.This study investigates the airflow ...The airflow mechanics in adult nasal airways,whether healthy or abnormal,are extensively studied and investigated,but the flow mechanics in child nasal airways remain underexplored.This study investigates the airflow mechanics in the child’s nasal upper airway with adenoid hypertrophy,with an adenoid nasopharyngeal ratio(AN of 0.9),under cyclic inhalation and exhalation.An inlet respiratory cycle with three different flow rates(3.2 L/min calm breathing,8.6 L/min normal breathing,and 19.3 L/min intensive breathing)was simulated by using the computational fluid dynamics approach.To better capture the interaction between airflow and the flexible airway tissue,fluid-structure interaction analysis was performed at the normal breathing rate.Comparing the airflow dynamics during inhalation and exhalation,the pressure drops,nasal resistance,and wall shear stress show significant differences in the nasopharyngeal region for all different flow rates.This observation suggests that the inertial effect associated with the transient flow is important during exhalation and inhalation.Furthermore,the considerable temporal variation in flow rate distribution across a specific cross-section of the nasal airway highlights the critical role of transient data in virtual surgery planning and data for clinical decisions.展开更多
Antidepressants are the main drugs used to treat depression,but they have not been shown to be effective in the treatment of child and adolescent depression.However,many adolescent depression treatment guidelines stil...Antidepressants are the main drugs used to treat depression,but they have not been shown to be effective in the treatment of child and adolescent depression.However,many adolescent depression treatment guidelines still recommend the use of antidepressants,especially specific serotonin re-uptake inhibitors.Previous studies have suggested that antidepressants have little therapeutic effect but many side effects,such as switching to mania,suicide,and non-suicidal self injury(NSSI),in the treatment of child and adolescent depression.In the process of developing guidelines,drug recommendations should not only focus on impro-ving symptoms,but they should also consider potential side effects.This review discusses the serious side effects of antidepressants,including switching to mania,suicide,and NSSI.展开更多
BACKGROUND China has recently encountered severe challenges associated with population aging.Parents of first-generation only children face significant challenges regarding elderly care needs and the associated negati...BACKGROUND China has recently encountered severe challenges associated with population aging.Parents of first-generation only children face significant challenges regarding elderly care needs and the associated negative emotions.AIM To analyze the elderly care needs of first-generation only child parents in China and identify factors that influence negative emotions.METHODS This study used a cross-sectional design.Convenience sampling was used to select 1580 elderly individuals who met the inclusion criteria in a Chinese city between June and September 2022.A questionnaire was administered to collect general information about participants.Depression and anxiety were assessed using the patient health questionnaire-9 and generalized anxiety disorder-7 scale,respectively.A logistic regression analysis was performed to evaluate the relevant correlations.RESULTS Among 1580 first-generation only child parents,1120(70.89%)preferred family based care,324(20.51%)opted for community care,and 136(8.61%)chose institutional care,with 460(29.11%)reporting negative emotions.Significant differences in the distribution of negative emotions among only child parents were observed based on age,marital status,living conditions,disability,type of chronic disease,frailty status,and family support(P<0.05).The regression analysis indicated that disability,type of chronic disease,living environment,frailty status,and level of family support were independent risk factors for negative emotions among parents with only children(P<0.05).CONCLUSION Elderly care for parents of only children is primarily family-based.Independent risk factors for negative emotions in this group include disability,chronic disease type,and living environment.展开更多
BACKGROUND To prevent mother to child transmission(MTCT)of human immunodeficiency virus(HIV),sustained maternal viral load suppression(VLS)and early HIV testing among HIV exposed infants(HEI)is critical.AIM To investi...BACKGROUND To prevent mother to child transmission(MTCT)of human immunodeficiency virus(HIV),sustained maternal viral load suppression(VLS)and early HIV testing among HIV exposed infants(HEI)is critical.AIM To investigate maternal viral load results and infant HIV testing uptake at 6-weeks,and 9-months and 18-months in Rwanda.METHODS Between 2015 and 2022,VLS(<200 copies/mL)was measured among pregnant women living with HIV(WLHIV)from 38-healthcare facilities.Viral loads(VL)were measured at 6-months,12-months and 24-months,respectively.For maternal VL,the unit of analysis was visit-pair,and the pairs were created to define those with VL<200 copies/mL at two consecutive visits as having sustained VLS,persistent viremia(VL≥200 copies/mL at two consecutive visits),viral rebound(VL<200 copies/mL at prior visit only)and newly suppressed(VL<200 copies/mL at subsequent visit only).HEI were considered to have persistent HIV testing if they had all three HIV tests.Poisson regression models with generalized estimating equations were used to estimate the adjusted incidence rate ratio(aIRR)and 95%CI for factors associated with sustained VLS and persistent HIV testing.RESULTS A total of 1145 mother-infant pairs were analyzed.Infant HIV testing uptake at 6-weeks,9-months and 18-months was 1145(100.0%),1089(95.1%),1006(87.9%)respectively.Nine hundred ninety-nine HEI(87.3%)tested for HIV persistently.At 18-months,the incidence of HIV among HEI was 8(0.7%).Of 1145 mothers,1076(94.0%)had≥2 VL results making a total of 2010 visit-pairs(142-single;934-double visit-pairs).The incidence rate of sustained VLS,persistent viremia,viral rebound and new suppression were 91.0%,1.3%,3.6%and 4.0%respectively.Maternal disclosure of HIV status(aIRR=1.08,95%CI:1.02-1.14)was associated with increased likelihood of sustained VLS.Having peer support(aIRR=1.0595%CI:1.01-1.10)was associated with persistent HIV testing among HEI.CONCLUSION Sustained VLS is high among pregnant WLHIV in Rwanda.The low incidence of HIV among HEI may be attributed to high VLS levels.Targeted interventions,including enhanced HIV disclosure and peer support,are crucial for improving sustained VLS and increasing infant HIV testing uptake to reduce MTCT.展开更多
BACKGROUND Epidemiological surveys indicate an increasing incidence of type 2 diabetes mellitus(T2DM)among children and adolescents worldwide.Due to rapid disease progression,severe long-term cardiorenal complications...BACKGROUND Epidemiological surveys indicate an increasing incidence of type 2 diabetes mellitus(T2DM)among children and adolescents worldwide.Due to rapid disease progression,severe long-term cardiorenal complications,a lack of effective treatment strategies,and substantial socioeconomic burdens,it has become an urgent public health issue that requires management and resolution.Adolescent T2DM differs from adult T2DM.Despite a significant increase in our understanding of youth-onset T2DM over the past two decades,the related review and evidence-based content remain limited.AIM To visualize the hotspots and trends in pediatric and adolescent T2DM research and to forecast their future research themes.METHODS This study utilized the terms“children”,“adolescents”,and“type 2 diabetes”,retrieving relevant articles published between 1983 and 2023 from three citation databases within the Web of Science Core Collection(SCI,SSCI,ESCI).Utilizing CiteSpace and VoSviewer software,we analyze and visually represent the annual output of literature,countries involved,and participating institutions.This allows us to predict trends in this research field.Our analysis encompasses co-cited authors,journal overlays,citation overlays,time-zone views,keyword analysis,and reference analysis,etc.RESULTS A total of 9210 articles were included,and the annual publication volume in this field showed a steady growth trend.The United States had the highest number of publications and the highest H-index.The United States also had the most research institutions and the strongest research capacity.The global hot journals were primarily diabetes professional journals but also included journals related to nutrition,endocrinology,and metabolism.Keyword analysis showed that research related to endothelial dysfunction,exposure risk,cardiac metabolic risk,changes in gut microbiota,the impact on comorbidities and outcomes,etc.,were emerging keywords.They have maintained their popularity in this field,suggesting that these areas have garnered significant research interest in recent years.CONCLUSION Pediatric and adolescent T2DM is increasingly drawing global attention,with genes,behaviors,environmental factors,and multisystemic interventions potentially emerging as future research hot spots.展开更多
Pediatric pancreatic tumors,though rare,pose significant diagnostic and manage-ment challenges.The recent,22-year nationwide survey on pediatric pancreatic tumors in Japan by Makita et al offers valuable insights into...Pediatric pancreatic tumors,though rare,pose significant diagnostic and manage-ment challenges.The recent,22-year nationwide survey on pediatric pancreatic tumors in Japan by Makita et al offers valuable insights into this uncommon enti-ty,revealing striking geographical variations and questioning current treatment paradigms.This editorial commentary analyzes the study's key findings,inclu-ding the predominance of solid pseudopapillary neoplasms and their younger age of onset,which contrast sharply with Western data.It explores the implications for clinical practice and research,emphasizing the need for population-specific approaches to diagnosis and treatment.The revealed limited institutional expe-rience and surgical management patterns prompt a reevaluation of optimal care delivery for these complex cases,suggesting benefits of centralizing healthcare services.Furthermore,the commentary advocates for international collaborative studies to elucidate the genetic,environmental,and lifestyle factors influencing the development and progression of pediatric pancreatic tumors across diverse populations.It also outlines future directions,calling for advancements in precision medicine and innovative care delivery models to improve global patient outcomes.Unraveling Makita et al's findings within the broader landscape of pediatric oncology can stimulate further research and clinical advancements in managing pancreatic and other rare tumors in children.展开更多
BACKGROUND Food protein-induced enterocolitis syndrome(FPIES)is the most serious type of non-immunoglobulin E(IgE)-mediated food allergic reaction manifesting as sepsis-like symptom,which can lead to shock.Saccharomyc...BACKGROUND Food protein-induced enterocolitis syndrome(FPIES)is the most serious type of non-immunoglobulin E(IgE)-mediated food allergic reaction manifesting as sepsis-like symptom,which can lead to shock.Saccharomyces boulardii(S.boulardii),a probiotic prescribed frequently in clinical settings,has been reported to trigger FPIES in an infant with soy-triggered FPIES.In this report,we describe a new clinical FPIES in which S.boulardii was the sole triggering factor of acute FPIES adverse reaction in seven healthy infants.CASE SUMMARY Seven FPIES cases triggered by only S.boulardii were gathered from 2011 to the present.None of the patients had previously experienced any allergic reaction to cow’s milk,soy,or complementary food.The age of the patients was 4-10-months old,and the symptoms of FPIES developed after ingestion of S.boulardii,which is mostly prescribed for the treatment of gastroenteritis or antibiotic-associated diarrhea.All patients experienced severe repetitive vomiting 1-3 hours after S.boulardii ingestion.Extreme lethargy,marked pallor,and cyanosis were also observed.No IgE-mediated hypersensitivity developed in any patient.Diarrhea was followed by initial intense vomiting in approximately 5-10 hours after S.boulardii ingestion,and only one case showed bloody,purulent,and foul-smelling diarrhea.The patients stabilized quickly,mostly within 6 hours.Symptoms got all improved within 24 hours after discontinuation of S.boulardii.CONCLUSION S.boulardii can be the sole trigger of acute FPIES and be prescribed cautiously even in healthy children without FPIES.展开更多
Objective To investigate the growth parameters of children with phenylketonuria and assess the impact of a phenylalanine-restricted diet on their physical development.Methods The study involved 39 children diagnosed w...Objective To investigate the growth parameters of children with phenylketonuria and assess the impact of a phenylalanine-restricted diet on their physical development.Methods The study involved 39 children diagnosed with phenylketonuria through newborn screening at the Central Child Teaching Hospital,Baghdad,Iraq.Data were collected during scheduled monthly check-ups,including phenylalanine levels,diet compliance,and anthropometric measurements.The children were divided into two groups based on their phenylalanine levels during the 3-year follow up period:well-controlled group(average phenylalanine level of less than 360μmol/L,with no single reading exceeding 600μmol/L;n=14)and poorly-controlled group(one or more phenylalanine readings above 600μmol/L during the follow-up period;n=25).Results The mean height readings for all time points(at birth and 3,6,9,12,15,18,21,24 and 36 months of age)were higher in the well-controlled group than the poorly-controlled group,however,only at 3 months of age the difference was statistically significant.Height Z-scores revealed a clearer pattern:although the poorly controlled group had higher height Z-scores at birth(P=0.001),the well-controlled group showed significantly higher height Z-scores at 3,6,12,15,18,24,and 36 months(P<0.05).The well-controlled group exhibited significantly higher mean weight measurements compared to the poorly-controlled group at 3,6,9,15,18 months and 21 months(P<0.05).From 6 to 36 months,the well-controlled group consistently had significantly higher weight Z-scores than the poorly controlled group(P<0.05).The well-controlled group showed more favorable height and weight Z-score distributions at 36 months of age compared to the poorly-controlled group,but the differences were not statistically significant(P>0.05).Both groups had height and weight Z-scores within the normal range at 36 months of age.Conclusions The children with phenylketonuria who receive good dietary control show better improvements in growth parameters compared to those with poor dietary control,however,both groups maintain height and weight Z-scores within the normal range,indicating generally adequate physical development across the cohort.展开更多
基金sponsored by Hunan Provincial Graduate Scientific Research and Innovation Project(Number:CX20210140)Independent Exploration and Innovation Program of Central South University(Number:2021zzts0450)。
文摘Mental state verbs(MSVs)are believed to be closely related with the development of Theory of Mind(ToM).Studies on MSVs have yielded fruitful results abroad over the past three decades,especially in ToM,while it still has a long way to go for the Mandarin-speaking children.The present study focuses on mental state verbs in Mandarin-speaking children and explores the universality of ToM,as well as the development features.An analysis of their spontaneous speech from the CHILDES archives reveals,first,that Mandarin-speaking children use desire terms much earlier than other terms,suggesting a pattern of theory-of-mind development similar to that in English;second,the developmental trend of the MSVs is relatively steady while the number of different categories varies a lot.This study suggests a consistency in the overall sequence,but variation in the timing of beginning and end points,which is helpful to further related investigation.
文摘Fate is always an eternal subject that many scholars, artists, critics and writers utilizing this vast and specific subject in their compositions. Therefore, in this text, people's views of fate will be analyzed from two typical characters:Achilles and Childe Harold, who are heroes in their times. Through their life tracks, this text will explore the ideal model of one's destiny in the specif-ic era, and from the economic development, social condition and cultural background, the reason or cause of these views will be traced and offer some enlightenment for what people should compose today.
基金supported by the National Key Research and Development Program of China(Grant No.2022YFF0707601).
文摘The airflow mechanics in adult nasal airways,whether healthy or abnormal,are extensively studied and investigated,but the flow mechanics in child nasal airways remain underexplored.This study investigates the airflow mechanics in the child’s nasal upper airway with adenoid hypertrophy,with an adenoid nasopharyngeal ratio(AN of 0.9),under cyclic inhalation and exhalation.An inlet respiratory cycle with three different flow rates(3.2 L/min calm breathing,8.6 L/min normal breathing,and 19.3 L/min intensive breathing)was simulated by using the computational fluid dynamics approach.To better capture the interaction between airflow and the flexible airway tissue,fluid-structure interaction analysis was performed at the normal breathing rate.Comparing the airflow dynamics during inhalation and exhalation,the pressure drops,nasal resistance,and wall shear stress show significant differences in the nasopharyngeal region for all different flow rates.This observation suggests that the inertial effect associated with the transient flow is important during exhalation and inhalation.Furthermore,the considerable temporal variation in flow rate distribution across a specific cross-section of the nasal airway highlights the critical role of transient data in virtual surgery planning and data for clinical decisions.
文摘Antidepressants are the main drugs used to treat depression,but they have not been shown to be effective in the treatment of child and adolescent depression.However,many adolescent depression treatment guidelines still recommend the use of antidepressants,especially specific serotonin re-uptake inhibitors.Previous studies have suggested that antidepressants have little therapeutic effect but many side effects,such as switching to mania,suicide,and non-suicidal self injury(NSSI),in the treatment of child and adolescent depression.In the process of developing guidelines,drug recommendations should not only focus on impro-ving symptoms,but they should also consider potential side effects.This review discusses the serious side effects of antidepressants,including switching to mania,suicide,and NSSI.
基金Supported by General Projects of Henan Province Universities Humanities and Social Sciences Research in 2023,No.2023-ZDJH-533.
文摘BACKGROUND China has recently encountered severe challenges associated with population aging.Parents of first-generation only children face significant challenges regarding elderly care needs and the associated negative emotions.AIM To analyze the elderly care needs of first-generation only child parents in China and identify factors that influence negative emotions.METHODS This study used a cross-sectional design.Convenience sampling was used to select 1580 elderly individuals who met the inclusion criteria in a Chinese city between June and September 2022.A questionnaire was administered to collect general information about participants.Depression and anxiety were assessed using the patient health questionnaire-9 and generalized anxiety disorder-7 scale,respectively.A logistic regression analysis was performed to evaluate the relevant correlations.RESULTS Among 1580 first-generation only child parents,1120(70.89%)preferred family based care,324(20.51%)opted for community care,and 136(8.61%)chose institutional care,with 460(29.11%)reporting negative emotions.Significant differences in the distribution of negative emotions among only child parents were observed based on age,marital status,living conditions,disability,type of chronic disease,frailty status,and family support(P<0.05).The regression analysis indicated that disability,type of chronic disease,living environment,frailty status,and level of family support were independent risk factors for negative emotions among parents with only children(P<0.05).CONCLUSION Elderly care for parents of only children is primarily family-based.Independent risk factors for negative emotions in this group include disability,chronic disease type,and living environment.
文摘BACKGROUND To prevent mother to child transmission(MTCT)of human immunodeficiency virus(HIV),sustained maternal viral load suppression(VLS)and early HIV testing among HIV exposed infants(HEI)is critical.AIM To investigate maternal viral load results and infant HIV testing uptake at 6-weeks,and 9-months and 18-months in Rwanda.METHODS Between 2015 and 2022,VLS(<200 copies/mL)was measured among pregnant women living with HIV(WLHIV)from 38-healthcare facilities.Viral loads(VL)were measured at 6-months,12-months and 24-months,respectively.For maternal VL,the unit of analysis was visit-pair,and the pairs were created to define those with VL<200 copies/mL at two consecutive visits as having sustained VLS,persistent viremia(VL≥200 copies/mL at two consecutive visits),viral rebound(VL<200 copies/mL at prior visit only)and newly suppressed(VL<200 copies/mL at subsequent visit only).HEI were considered to have persistent HIV testing if they had all three HIV tests.Poisson regression models with generalized estimating equations were used to estimate the adjusted incidence rate ratio(aIRR)and 95%CI for factors associated with sustained VLS and persistent HIV testing.RESULTS A total of 1145 mother-infant pairs were analyzed.Infant HIV testing uptake at 6-weeks,9-months and 18-months was 1145(100.0%),1089(95.1%),1006(87.9%)respectively.Nine hundred ninety-nine HEI(87.3%)tested for HIV persistently.At 18-months,the incidence of HIV among HEI was 8(0.7%).Of 1145 mothers,1076(94.0%)had≥2 VL results making a total of 2010 visit-pairs(142-single;934-double visit-pairs).The incidence rate of sustained VLS,persistent viremia,viral rebound and new suppression were 91.0%,1.3%,3.6%and 4.0%respectively.Maternal disclosure of HIV status(aIRR=1.08,95%CI:1.02-1.14)was associated with increased likelihood of sustained VLS.Having peer support(aIRR=1.0595%CI:1.01-1.10)was associated with persistent HIV testing among HEI.CONCLUSION Sustained VLS is high among pregnant WLHIV in Rwanda.The low incidence of HIV among HEI may be attributed to high VLS levels.Targeted interventions,including enhanced HIV disclosure and peer support,are crucial for improving sustained VLS and increasing infant HIV testing uptake to reduce MTCT.
基金Supported by the National Natural Science Foundation of China,No.82105018 and No.81903950.
文摘BACKGROUND Epidemiological surveys indicate an increasing incidence of type 2 diabetes mellitus(T2DM)among children and adolescents worldwide.Due to rapid disease progression,severe long-term cardiorenal complications,a lack of effective treatment strategies,and substantial socioeconomic burdens,it has become an urgent public health issue that requires management and resolution.Adolescent T2DM differs from adult T2DM.Despite a significant increase in our understanding of youth-onset T2DM over the past two decades,the related review and evidence-based content remain limited.AIM To visualize the hotspots and trends in pediatric and adolescent T2DM research and to forecast their future research themes.METHODS This study utilized the terms“children”,“adolescents”,and“type 2 diabetes”,retrieving relevant articles published between 1983 and 2023 from three citation databases within the Web of Science Core Collection(SCI,SSCI,ESCI).Utilizing CiteSpace and VoSviewer software,we analyze and visually represent the annual output of literature,countries involved,and participating institutions.This allows us to predict trends in this research field.Our analysis encompasses co-cited authors,journal overlays,citation overlays,time-zone views,keyword analysis,and reference analysis,etc.RESULTS A total of 9210 articles were included,and the annual publication volume in this field showed a steady growth trend.The United States had the highest number of publications and the highest H-index.The United States also had the most research institutions and the strongest research capacity.The global hot journals were primarily diabetes professional journals but also included journals related to nutrition,endocrinology,and metabolism.Keyword analysis showed that research related to endothelial dysfunction,exposure risk,cardiac metabolic risk,changes in gut microbiota,the impact on comorbidities and outcomes,etc.,were emerging keywords.They have maintained their popularity in this field,suggesting that these areas have garnered significant research interest in recent years.CONCLUSION Pediatric and adolescent T2DM is increasingly drawing global attention,with genes,behaviors,environmental factors,and multisystemic interventions potentially emerging as future research hot spots.
文摘Pediatric pancreatic tumors,though rare,pose significant diagnostic and manage-ment challenges.The recent,22-year nationwide survey on pediatric pancreatic tumors in Japan by Makita et al offers valuable insights into this uncommon enti-ty,revealing striking geographical variations and questioning current treatment paradigms.This editorial commentary analyzes the study's key findings,inclu-ding the predominance of solid pseudopapillary neoplasms and their younger age of onset,which contrast sharply with Western data.It explores the implications for clinical practice and research,emphasizing the need for population-specific approaches to diagnosis and treatment.The revealed limited institutional expe-rience and surgical management patterns prompt a reevaluation of optimal care delivery for these complex cases,suggesting benefits of centralizing healthcare services.Furthermore,the commentary advocates for international collaborative studies to elucidate the genetic,environmental,and lifestyle factors influencing the development and progression of pediatric pancreatic tumors across diverse populations.It also outlines future directions,calling for advancements in precision medicine and innovative care delivery models to improve global patient outcomes.Unraveling Makita et al's findings within the broader landscape of pediatric oncology can stimulate further research and clinical advancements in managing pancreatic and other rare tumors in children.
基金Supported by The Keimyung University Dongsan Medical Center in 2006.
文摘BACKGROUND Food protein-induced enterocolitis syndrome(FPIES)is the most serious type of non-immunoglobulin E(IgE)-mediated food allergic reaction manifesting as sepsis-like symptom,which can lead to shock.Saccharomyces boulardii(S.boulardii),a probiotic prescribed frequently in clinical settings,has been reported to trigger FPIES in an infant with soy-triggered FPIES.In this report,we describe a new clinical FPIES in which S.boulardii was the sole triggering factor of acute FPIES adverse reaction in seven healthy infants.CASE SUMMARY Seven FPIES cases triggered by only S.boulardii were gathered from 2011 to the present.None of the patients had previously experienced any allergic reaction to cow’s milk,soy,or complementary food.The age of the patients was 4-10-months old,and the symptoms of FPIES developed after ingestion of S.boulardii,which is mostly prescribed for the treatment of gastroenteritis or antibiotic-associated diarrhea.All patients experienced severe repetitive vomiting 1-3 hours after S.boulardii ingestion.Extreme lethargy,marked pallor,and cyanosis were also observed.No IgE-mediated hypersensitivity developed in any patient.Diarrhea was followed by initial intense vomiting in approximately 5-10 hours after S.boulardii ingestion,and only one case showed bloody,purulent,and foul-smelling diarrhea.The patients stabilized quickly,mostly within 6 hours.Symptoms got all improved within 24 hours after discontinuation of S.boulardii.CONCLUSION S.boulardii can be the sole trigger of acute FPIES and be prescribed cautiously even in healthy children without FPIES.
文摘Objective To investigate the growth parameters of children with phenylketonuria and assess the impact of a phenylalanine-restricted diet on their physical development.Methods The study involved 39 children diagnosed with phenylketonuria through newborn screening at the Central Child Teaching Hospital,Baghdad,Iraq.Data were collected during scheduled monthly check-ups,including phenylalanine levels,diet compliance,and anthropometric measurements.The children were divided into two groups based on their phenylalanine levels during the 3-year follow up period:well-controlled group(average phenylalanine level of less than 360μmol/L,with no single reading exceeding 600μmol/L;n=14)and poorly-controlled group(one or more phenylalanine readings above 600μmol/L during the follow-up period;n=25).Results The mean height readings for all time points(at birth and 3,6,9,12,15,18,21,24 and 36 months of age)were higher in the well-controlled group than the poorly-controlled group,however,only at 3 months of age the difference was statistically significant.Height Z-scores revealed a clearer pattern:although the poorly controlled group had higher height Z-scores at birth(P=0.001),the well-controlled group showed significantly higher height Z-scores at 3,6,12,15,18,24,and 36 months(P<0.05).The well-controlled group exhibited significantly higher mean weight measurements compared to the poorly-controlled group at 3,6,9,15,18 months and 21 months(P<0.05).From 6 to 36 months,the well-controlled group consistently had significantly higher weight Z-scores than the poorly controlled group(P<0.05).The well-controlled group showed more favorable height and weight Z-score distributions at 36 months of age compared to the poorly-controlled group,but the differences were not statistically significant(P>0.05).Both groups had height and weight Z-scores within the normal range at 36 months of age.Conclusions The children with phenylketonuria who receive good dietary control show better improvements in growth parameters compared to those with poor dietary control,however,both groups maintain height and weight Z-scores within the normal range,indicating generally adequate physical development across the cohort.
