scholarly journals Ultrasound-guided hydrostatic reduction versus fluoroscopy-guided air reduction for pediatric intussusception: a multi-center, prospective, cohort study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Shu Ting Liu ◽  
Xiao Bing Tang ◽  
Huan Li ◽  
Dong Chen ◽  
Jun Lei ◽  
...  
Keyword(s):  
Cohort Study ◽  
Subgroup Analysis ◽  
Prospective Cohort ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Perforation Rate ◽  
Recurrence Rates ◽  
Hydrostatic Reduction ◽  
Stratified Analysis ◽  
Enema Reduction

Abstract Background Intussusception is the most common abdominal emergency in children. The first line treatment of uncomplicated pediatric intussusception is enema reduction. Until now, there have been no multi-center studies comparing the effectiveness and safety of UGHR and FGAR in the treatment of pediatric intussusception. The aim of this study was to compare the effectiveness and safety of the two most commonly used enema methods of pediatric intussusception: ultrasound-guided hydrostatic reduction (UGHR) and fluoroscopy-guided air reduction (FGAR). Methods From November 1, 2017 to October 31, 2018, we conducted a multi-center, prospective, cohort study. Children diagnosed with intussusception in four large Children’s Medical Centers in China were divided into UGHR and FGAR groups. Stratified analysis and subgroup analysis were used for further comparison. The success and recurrence rates were used to evaluate the effectiveness of enema reduction. The perforation rate was used to evaluate the safety of enema reduction. Results A total of 2124 cases met the inclusion criteria (UGHR group: 1119 cases; FGAR group: 1005 cases). The success and recurrence rates in the UGHR group were higher than in the FGAR group (95.80%, 9.28% vs. 93.13%, 10.65%) (P < 0.05, P > 0.05), respectively. The perforation rate in the UGHR group was 0.36% compared with 0.30% in the FGAR group (P > 0.05). Subgroup analysis showed the success rates in the UGHR group were higher than in the FGAR group of patients with onset time between 12 and 24 h (95.56% vs. 90.57%) (P < 0.05). Of patients aged 4 to 24 months, the success rates in the UGHR group were also higher than in the FGAR group (95.77% vs. 91.60%) (P < 0.05). Stratified analysis showed the success rates in the UGHR group were higher than in the FGAR group in patients with the symptom of bloody stool (91.91% vs 85.38%) (P < 0.05). Conclusions UGHR and FGAR are safe, nonsurgical treatment methods for acute pediatric intussusception. UGHR is superior to FGAR, no radiation risk, its success rate is higher, without a difference in perforation rate, especially for patients aged 4–24 months. Level of evidence Level II.

scholarly journals Ultrasound-Guided Hydrostatic Reduction Versus Fluoroscopy-Guided Air Reduction for Pediatric Intussusception: A Multi-Center, Prospective, Cohort Study

2020 ◽  
Author(s):  
Shu Ting Liu ◽  
Xiao Bing Tang ◽  
Huan Li ◽  
Dong Chen ◽  
Jun Lei ◽  
...  
Keyword(s):  
Cohort Study ◽  
Subgroup Analysis ◽  
Prospective Cohort ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Perforation Rate ◽  
Recurrence Rates ◽  
Hydrostatic Reduction ◽  
Stratified Analysis ◽  
Enema Reduction

Abstract Background：Intussusception is the most common abdominal emergency in children. The first line treatment of uncomplicated pediatric intussusception is enema reduction. Until now, there have been no multi-center studies comparing the effectiveness and safety of UGHR and FGAR in the treatment of pediatric intussusception. The aim of this study was to compare the effectiveness and safety of the two most commonly used enema methods of pediatric intussusception: Ultrasound-guided hydrostatic reduction (UGHR) and Fluoroscopy-guided air reduction (FGAR).Methods: From November 1, 2017 to October 31, 2018, we conducted a multi-center, prospective, cohort study. Children diagnosed with intussusception in four large Children’s Medical Centers in China were divided into UGHR and FGAR groups. Stratified analysis and subgroup analysis were used for further comparison. The success and recurrence rates were used to evaluate the effectiveness of enema reduction. The perforation rate was used to evaluate the safety of enema reduction.Results: A total of 2,124 cases met the inclusion criteria (UGHR group: 1119 cases; FGAR group: 1005 cases). The success and recurrence rates in the UGHR group were higher than in the FGAR group (95.80%, 9.28% vs. 93.13%, 10.65%) (P<0.05, P>0.05), respectively. The perforation rate in the UGHR group was 0.36% compared with 0.30% in the FGAR group (P>0.05). Subgroup analysis showed the success rates in the UGHR group were higher than in the FGAR group of patients with onset time between 12h and 24h (95.56% vs 90.57%) (P<0.05). Of patients aged 4 to 24 months, the success rates in the UGHR group were also higher than in the FGAR group (95.77% vs 91.60%) (P<0.05). Stratified analysis showed the success rates in the UGHR group were higher than in the FGAR group in patients with the symptom of bloody stool (91.91% vs 85.38%) (P<0.05).Conclusions: UGHR and FGAR are safe, nonsurgical treatment methods for acute pediatric intussusception. UGHR is superior to FGAR, no radiation risk, its success rate is higher, without a difference in perforation rate, especially for patients aged 4–24 months.Level of evidence: Level II.

scholarly journals Effects of dental general anaesthesia treatment on early childhood caries: a prospective cohort study in China

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e028931 ◽  
Author(s):  
Haofeng Jiang ◽  
Lu Shen ◽  
Dan Qin ◽  
Songlin He ◽  
Jinhua Wang
Keyword(s):  
Early Childhood ◽  
Cohort Study ◽  
Oral Health ◽  
Prospective Cohort ◽  
Early Childhood Caries ◽  
Success Rates ◽  
Recurrence Rates ◽  
Dental Procedures ◽  
Dental General Anaesthesia ◽  
Over Time

ObjectivesTo evaluate the success rates of dental procedures, the recurrence rates of caries and changes in oral health-related quality of life (OHRQoL) in children following treatment for early childhood caries (ECC) under dental general anaesthesia (DGA) in Chongqing, China.DesignA single-centre prospective cohort study conducted from December 2016 to June 2017.SettingA tertiary stomatological hospital in Chongqing, China.ParticipantsA total of 159 children aged 2–5 years who received treatment for ECC under DGA were included.Main outcome measuresThe primary outcomes were the success rates of dental procedures (the number of successful procedures divided by the total number of procedures) and the recurrence rates of caries. The success and recurrence rates were evaluated by a specialised examiner. The secondary outcome was the change in children’s OHRQoL after DGA treatment, which was measured with the Early Childhood Oral Health Impact Scale (ECOHIS).ResultsOverall, 117 children (73.6%) and 101 children (63.5%) participated in 6-month and 12-month clinical examinations, respectively, and 151 children (95.0%) completed OHRQoL surveys pretreatment and at 1, 3, 6 and 12 months post-treatment. The resin composite, stainless steel crown, indirect pulp capping, pulpectomy, space maintenance and dental sealant success rates were 89.6%, 96.3%, 96.0%, 94.4%, 76.9% and 92.9%, respectively, at 6 months and 78.8%, 95.1%, 92.2%, 88.9%, 63.6% and 89.3%, respectively, at 12 months. 10 (8.5%) and 19 children (18.8%) developed recurrent caries within 6 and 12 months, respectively. Within 1 year of treatment, the total ECOHIS scores at each post-treatment time point were still significantly lower than those at pretreatment, although they had increased slowly over time.ConclusionsOverall, high success rates were obtained for the dental procedures, and the children’s OHRQoL significantly improved after treatment. However, there was a tendency towards caries relapse, and the children’s OHRQoL deteriorated over time.

Ultrasound guided catheter tip location in neonates: a prospective cohort study

2021 ◽  
Author(s):  
Fiorentino Grasso ◽  
Antonella Capasso ◽  
Daniela Pacella ◽  
Francesco Borgia ◽  
Serena Salomè ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Ultrasound Guided ◽  
Catheter Tip

scholarly journals Candida Infective Endocarditis: an Observational Cohort Study with a Focus on Therapy

2015 ◽  
Vol 59 (4) ◽  
pp. 2365-2373 ◽  
Author(s):  
Christopher J. Arnold ◽  
Melissa Johnson ◽  
Arnold S. Bayer ◽  
Suzanne Bradley ◽  
Efthymia Giannitsioti ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Infective Endocarditis ◽  
Mortality Rate ◽  
Amphotericin B ◽  
Prospective Cohort Study ◽  
Antifungal Therapy ◽  
Subgroup Analysis ◽  
Prospective Cohort ◽  
Content Type

ABSTRACTCandidainfective endocarditis is a rare disease with a high mortality rate. Our understanding of this infection is derived from case series, case reports, and small prospective cohorts. The purpose of this study was to evaluate the clinical features and use of different antifungal treatment regimens forCandidainfective endocarditis. This prospective cohort study was based on 70 cases ofCandidainfective endocarditis from the International Collaboration on Endocarditis (ICE)-Prospective Cohort Study and ICE-Plus databases collected between 2000 and 2010. The majority of infections were acquired nosocomially (67%). Congestive heart failure (24%), prosthetic heart valve (46%), and previous infective endocarditis (26%) were common comorbidities. Overall mortality was high, with 36% mortality in the hospital and 59% at 1 year. On univariate analysis, older age, heart failure at baseline, persistent candidemia, nosocomial acquisition, heart failure as a complication, and intracardiac abscess were associated with higher mortality. Mortality was not affected by use of surgical therapy or choice of antifungal agent. A subgroup analysis was performed on 33 patients for whom specific antifungal therapy information was available. In this subgroup, 11 patients received amphotericin B-based therapy and 14 received echinocandin-based therapy. Despite a higher percentage of older patients and nosocomial infection in the echinocandin group, mortality rates were similar between the two groups. In conclusion,Candidainfective endocarditis is associated with a high mortality rate that was not impacted by choice of antifungal therapy or by adjunctive surgical intervention. Additionally, echinocandin therapy was as effective as amphotericin B-based therapy in the small subgroup analysis.

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