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S U Zifan - One of the best experts on this subject based on the ideXlab platform.

  • value of low pressure pulse Air Enema to treat pediatric intussusceptions
    Hainan Medical Journal, 2011
    Co-Authors: S U Zifan
    Abstract:

    Objective To investigate the clinical value of low pressure pulse Air Enema to treat pediatric intus-susception with different pressure in different age,and to improve the safety and success ratio in intussusception reduc-tion.Methods 103 cases with pediatric intussusceptions were treated by compute remote control device Enema(JS-818) and divided into the control group and the observation group,and the observation group were further divided into A group and B group.The A group had 26 cases with the age below 6 months and the B group had 51 cases with the age more than 7 months,while the control group had 26 cases with the age above 8 months.And the data in differ-ent groups were analyzed to observe untoward effect,treatment effect and correlative factors.Results 74 cases suc-ceed,3 cases failed,with the reduction rate of 96.10% in the observation group,while 21 cases succeed and 5 cases failed,with the reduction rate of 80.76% in the control group.There is no statistically significant difference of the re-duction rate in different groups,but the discrepancy had statistically significant difference(P0.05) in untoward effect.There is no intestinal perforation and death in the operation.Conclusion Low pressure pulse Air Enema had signifi-cant reduction effectiveness on pediatric intussusceptions in different groups,with the safety.

Hongying Jia - One of the best experts on this subject based on the ideXlab platform.

  • no prophylactic antibiotic use for young children s intussusception with low risk infection after successful Air Enema reduction
    Scientific Reports, 2018
    Co-Authors: Yuan Zhang, Wen Zou, Yinghui Zhang, Qian Liu, Huandi Liu, Lemeng Ren, Zhaohui Sun, Hongying Jia
    Abstract:

    The Chinese government has issued the policy of promulgating the clinical use of antibacterial drugs since 2011. Prophylactic antibiotic use is a challenging problem among young children with intussusception after successful Air Enema reduction. There were limited data regarding the clinical value of prophylactic antibiotics for intussusception with low-risk infections. A retrospective non-randomized comparative study was conducted among 188 young children with intussusception after successful Air Enema reduction between January 1, 2011 and December 30, 2013. Among these children, 51 received prophylactic antibiotics and 137 did not receive antibiotics. Our results showed that there were no significant differences in age, gender, weight, admission period, reduction interval, axillary temperature, leukocytes, neutrophils, lymphocytes, monocytes, mesenteric lymph nodes and complications between groups (P > 0.05). The national policy had significantly improved clinical use of antibiotic for young children with low-risk intussusception (OR < 0.001, P < 0.001). Inpatients days were longer for children used antibiotics than those who did not (median, 27.0 hours vs 21.0 hours, P = 0.003). Prophylactic antibiotics appeared to be of little value after the successful Air Enema reduction of intussusception in young children with low-risk infection. Policy intervention is effective for antibiotic use in China.

  • No Prophylactic Antibiotic Use for Young Children’s Intussusception with Low-risk Infection after Successful Air Enema Reduction
    Nature Publishing Group, 2018
    Co-Authors: Yuan Zhang, Wen Zou, Yinghui Zhang, Qian Liu, Huandi Liu, Lemeng Ren, Zhaohui Sun, Hongying Jia
    Abstract:

    Abstract The Chinese government has issued the policy of promulgating the clinical use of antibacterial drugs since 2011. Prophylactic antibiotic use is a challenging problem among young children with intussusception after successful Air Enema reduction. There were limited data regarding the clinical value of prophylactic antibiotics for intussusception with low-risk infections. A retrospective non-randomized comparative study was conducted among 188 young children with intussusception after successful Air Enema reduction between January 1, 2011 and December 30, 2013. Among these children, 51 received prophylactic antibiotics and 137 did not receive antibiotics. Our results showed that there were no significant differences in age, gender, weight, admission period, reduction interval, axillary temperature, leukocytes, neutrophils, lymphocytes, monocytes, mesenteric lymph nodes and complications between groups (P > 0.05). The national policy had significantly improved clinical use of antibiotic for young children with low-risk intussusception (OR 

  • reducing antibiotic use for young children with intussusception following successful Air Enema reduction
    PLOS ONE, 2015
    Co-Authors: Yuan Zhang, Wen Zou, Yinghui Zhang, Xingdong Chen, Qian Liu, Huandi Liu, Hongying Jia
    Abstract:

    China introduced a new policy regarding the management of antibiotic use. We evaluated the reasonableness of antibiotic use among children suffering from intussusception before and after policy. A retrospective study was conducted involving 234 young children with intussusception who were treated between January 1, 2011 and December 30, 2013. Demographics and detailed antibiotics regimens were collected. χ2 test was used to evaluate differences between the phase I (preintervention, n = 68) and phase II (postintervention, n = 166). We determined that the overall antibiotic use rate following successful Air Enema reduction was 41% (97/234), which decreased from 99% (67/68) in phase I to 18% (30/166) in phase II. In phase I, prophylactic antibiotic usage reached up to 84% (56/67). The quantity of aztreonam for injection accounted for 63% (45/71), and cefamandole nafate for injection accounted for 25% (18/71). In phases II, prophylactic antibiotic usage were reduced to 13% (4/30). The quantity of aztreonam for injection was decreased to 12% (4/33) and cefamandole nafate for injection was 3% (1/33). Antibiotics' options were more diverse. In conclusion, policy intervention was effective in addressing some aspects of antibacterial drug usage among young children with intussusception. However, excessive drug use remains a public health problem. The guidelines for the antibiotic management of intussusception for children must be established in China.

  • Antibiotic comparisons in children with intussusception after Air Enema reduction in two phases (n,%).
    2015
    Co-Authors: Yuan Zhang, Wen Zou, Yinghui Zhang, Xingdong Chen, Qian Liu, Huandi Liu, Hongying Jia
    Abstract:

    Phase I: preintervention; Phase II: postinterventionAntibiotic comparisons in children with intussusception after Air Enema reduction in two phases (n,%).

Omer Globus - One of the best experts on this subject based on the ideXlab platform.

  • outbreak of life threatening thiamine deficiency in infants in israel caused by a defective soy based formula
    Pediatrics, 2005
    Co-Authors: Aviva Fattalvalevski, Anat Kesler, Benami Sela, Dorit Nitzankaluski, Michael Rotstein, Ronit Mesterman, Hagit Toledanoalhadef, Chaim Stolovitch, Chen Hoffmann, Omer Globus
    Abstract:

    Objective. Between October and No- vember 2003, several infants with encephalopathy were hospitalized in pediatric intensive care units in Israel. Two died of cardiomyopathy. Analysis of the accumu- lated data showed that all had been fed the same brand of soy-based formula (Remedia Super Soya 1), specifi- cally manufactured for the Israeli market. The source was identified on November 6, 2003, when a 5.5-month-old infant was admitted to Sourasky Medical Center with upbeat nystagmus, ophthalmoplegia, and vomiting. Wer- nicke's encephalopathy was suspected, and treatment with supplementary thiamine was started. His condition improved within hours. Detailed history revealed that the infant was being fed the same formula, raising sus- picions that it was deficient in thiamine. The formula was tested by the Israeli public health authorities, and the thiamine level was found to be undetectable ( 25% indicates severe deficiency. Blood lactate levels (normal: 0.5-2 mmol/L) were measured in 6 infants, cerebrospinal fluid lactate in 2 (normal: 0.5-2 mmol/L), and blood pyruvate in 4 (nor- mal: 0.03-0.08 mmol/L). The diagnostic criteria for thia- mine deficiency were abnormal transketolase activity and/or unexplained lactic acidosis. Treatment consisted of intramuscular thiamine 50 mg/day for 14 days com- bined with a switch to another infant formula. Results. Early symptoms were nonspecific and in- cluded mainly vomiting (n 8), lethargy (n 7), irrita- bility (n 5), abdominal distension (n 4), diarrhea (n 4), respiratory symptoms (n 4), developmental delay (n 3), and failure to thrive (n 2). Infection was found in all cases. Six infants were admitted with fever. One pa- tient had clinical dysentery and group C Salmonella sep- sis; the others had mild infection: acute gastroenteritis (n 2); upper respiratory infection (n 2); and broncho- pneumonia, acute bronchitis, and viral infection (n 1 each). Two infants were treated with antibiotics. Three infants had neurologic symptoms of ophthalmoplegia with bilateral abduction deficit with or without upbeat nystagmus. All 3 had blood lactic acidosis, and 2 had high cerebrospinal fluid lactate levels. Patient 1, our in- dex case, was hospitalized for upbeat nystagmus and ophthalmoplegia, in addition to daily vomiting episodes since 4 months of age and weight loss of 0.5 kg. Findings on brain computed tomography were normal. Blood lac- tate levels were high, and TPPE was 37.8%. Brain mag- netic resonance imaging (MRI) revealed no abnormali- ties. Patient 2, who presented at 5 months with lethargy, vomiting, grunting, and abdominal tenderness, was found to have intussusception on abdominal ultrasound and underwent 2 attempts at reduction with Air Enema several hours apart. However, the lethargy failed to re- solve and ophthalmoplegia appeared the next day, lead- ing to suspicions of Wernicke's encephalopathy. Labora- tory tests showed severe thiamine deficiency (TPPE 31.2%). In patients 1 and 2, treatment led to complete resolution of symptoms. The third infant, a 5-month-old girl, was admitted on October 10, 2003, well before the outbreak was recognized, with vomiting, fever, and oph- thalmoplegia. Her condition deteriorated to seizures, ap- nea, and coma. Brain MRI showed a bilateral symmetri- cal hyperintense signal in the basal ganglia, mamillary bodies, and periaqueductal gray matter. Suspecting a metabolic disease, vitamins were added to the intrave- nous solution, including thiamine 250 mg twice a day. Clinical improvement was noted 1 day later. TPPE assay performed after treatment with thiamine was started was still abnormal (17.6%). Her formula was substituted after 4 weeks, after the announcement about the thiamine deficiency. Although the MRI findings improved 5 weeks later, the infant had sequelae of ophthalmoplegia

Magnus Strom - One of the best experts on this subject based on the ideXlab platform.

  • use of Air Enema radiography to assess depth of ulceration during acute attacks of ulcerative colitis
    The Lancet, 1996
    Co-Authors: Sven Almer, Goran Bodemar, Eva Lindstrom, Magnus Strom, Po Nystrom, Lennart Franzen
    Abstract:

    Abstract Summary Background Acute colitis is usually assessed by means of plain abdominal radiographs, the diagnostic utility of which can be enhanced by barium Enema. Colonoscopy can also be useful. The latter methods may be laborious and carry risk. We describe a radiographic technique using Air as the contrast medium to show mucosal or deeper ulceration. Methods Of 60 patients undergoing colectomy for acute ulcerative colitis, 35 had Air Enema radiography and 14 had plain films with sufficient amount of spontaneously occurring gas to allow visualisation of the mucosa, during the 10 days before surgery. The degree of inflammation on Air Enema films and the extent of histopathological ulceration in colectomy specimens were independently graded and compared with each other. Depth of ulceration was compared with clinical data including a preoperative risk stratification, the APACHE II score. Findings The degree of inflammation on Air Enema radiography correlated significantly with depth of ulceration at histopathological examination (rs 0·61, p Interpretation Air Enema radiography reliably assesses the presence of colonic ulceration in patients with an acute attack of ulcerative colitis. It is a first-line investigation to assess the presence of deeper ulceration in acute colitis.

  • Air Enema radiology compared with leukocyte scintigraphy for imaging inflammation in active ulcerative colitis
    European Journal of Gastroenterology & Hepatology, 1995
    Co-Authors: Sven Almer, Goran Bodemar, Eva Lindstrom, A M Peters, Magnus Strom
    Abstract:

    Objective : To compare Air Enema radiology with a leukocyte scintigraphy technique using technetium-99m-hexamethyl propylene amine oxime-labelled leukocytes for imaging colonic inflammation in ulcerative colitis. Design : Prospective study in a University hospital. One radiologist and one nuclear physician independently graded the degree of inflammation in six colon segments per patient using radiographs and leukocyte scans. Patients : Twenty consecutive patients with symptoms of active ulcerative colitis requiring corticosteroids, inflammation on rigid sigmoidoscopy and a positive leukocyte scan above the rectum. Results : Using Air Enema radiology, inflammation above the rectum was observed in 17 of the 20 patients. Eleven patients had the same extent of disease with both imaging techniques (total n = 5 ; extensive n = 3 ; distal n = 3). Seven patients had more widespread colitis using leukocyte scintigraphy. In the remaining two patients with extensive inflammation at scintigraphy, Air Enema films showed total colitis. When the colon was subdivided into six different segments, prediction of the presence of inflammation in individual segments was 0.88 for Air Enema radiology compared with leukocyte scintigraphy and 0.60 for the prediction of absence of inflammation. All segments with an irregular mucosal contour or ulceration on Air Enema films had intense inflammation at scintigraphy. Conclusions : In patients with active ulcerative colitis, Air Enema radiology underestimates the extent of inflammation because this investigation shows secondary patho-anatomical changes, while leukocyte scintigraphy visualizes the acute cellular infiltrate. In patients with more severe inflammation, there is excellent agreement between the two methods.

  • plain x ray films and Air Enema films reflect severe mucosal inflammation in acute ulcerative colitis
    Digestion, 1995
    Co-Authors: Sven Almer, Goran Bodemar, Eva Lindstrom, Lennart Franzen, Bengt Noren, Magnus Strom
    Abstract:

    In a prospective study of 34 patients with active ulcerative colitis, the findings of inflammation on plain abdominal films and Air Enema films were compared to those at colonoscopy including biopsy w

Yuan Zhang - One of the best experts on this subject based on the ideXlab platform.

  • ultrasound findings to predict risk of recurrence in pediatric intussusception after Air Enema reduction
    Journal of Ultrasound in Medicine, 2021
    Co-Authors: Yuan Zhang, Chunchun Shao, Xiuliang Wei, Hui Guan, Chen Zhao, Feixue Zhang
    Abstract:

    Objectives Intussusception is one of the most common abdominal emergencies in early children. Intussusception recurs in 8-20% of children after successful nonoperative reduction. The aim of this study was to explore the ultrasound findings to predict risk of recurrence in pediatric intussusception after Air Enema reduction. Methods A total of 336 intussusception children were followed up for 1 year after received successful Air Enema reduction. They were divided into the recurrent group and the non-recurrent group. The differences of clinical characteristics, ultrasonic features, and laboratory tests were analyzed by univariate analyses and the Cox proportional hazard model. Results Sixty-five children with recurrent intussusception were identified. There were statistically significances in the diameter of the mass, in the presence or absence of enlarged lymph nodes out of the sleeve, and in the sleeve between recurrent and non-recurrent groups (P .05). Multivariate Cox proportional hazard model showed that the diameter of the mass and abdominal lymph nodes may be the risk factors of intussusception recurrence (HR = 1.395, 95% CI: 1.045~1.863 and HR = 2.078, 95% CI: 1.118~3.865, P Conclusions Intussusception recurrence was prone with greater mass diameter (>2.55 cm) and enlarged abdominal lymph nodes. Although these ultrasound findings for recurrence do not necessarily reduce the rate of recurrence, it can predict the recurrent possibility, and help the emergency physicians to be more vigilant in these children and better counsel parents upon discharge.

  • no prophylactic antibiotic use for young children s intussusception with low risk infection after successful Air Enema reduction
    Scientific Reports, 2018
    Co-Authors: Yuan Zhang, Wen Zou, Yinghui Zhang, Qian Liu, Huandi Liu, Lemeng Ren, Zhaohui Sun, Hongying Jia
    Abstract:

    The Chinese government has issued the policy of promulgating the clinical use of antibacterial drugs since 2011. Prophylactic antibiotic use is a challenging problem among young children with intussusception after successful Air Enema reduction. There were limited data regarding the clinical value of prophylactic antibiotics for intussusception with low-risk infections. A retrospective non-randomized comparative study was conducted among 188 young children with intussusception after successful Air Enema reduction between January 1, 2011 and December 30, 2013. Among these children, 51 received prophylactic antibiotics and 137 did not receive antibiotics. Our results showed that there were no significant differences in age, gender, weight, admission period, reduction interval, axillary temperature, leukocytes, neutrophils, lymphocytes, monocytes, mesenteric lymph nodes and complications between groups (P > 0.05). The national policy had significantly improved clinical use of antibiotic for young children with low-risk intussusception (OR < 0.001, P < 0.001). Inpatients days were longer for children used antibiotics than those who did not (median, 27.0 hours vs 21.0 hours, P = 0.003). Prophylactic antibiotics appeared to be of little value after the successful Air Enema reduction of intussusception in young children with low-risk infection. Policy intervention is effective for antibiotic use in China.

  • No Prophylactic Antibiotic Use for Young Children’s Intussusception with Low-risk Infection after Successful Air Enema Reduction
    Nature Publishing Group, 2018
    Co-Authors: Yuan Zhang, Wen Zou, Yinghui Zhang, Qian Liu, Huandi Liu, Lemeng Ren, Zhaohui Sun, Hongying Jia
    Abstract:

    Abstract The Chinese government has issued the policy of promulgating the clinical use of antibacterial drugs since 2011. Prophylactic antibiotic use is a challenging problem among young children with intussusception after successful Air Enema reduction. There were limited data regarding the clinical value of prophylactic antibiotics for intussusception with low-risk infections. A retrospective non-randomized comparative study was conducted among 188 young children with intussusception after successful Air Enema reduction between January 1, 2011 and December 30, 2013. Among these children, 51 received prophylactic antibiotics and 137 did not receive antibiotics. Our results showed that there were no significant differences in age, gender, weight, admission period, reduction interval, axillary temperature, leukocytes, neutrophils, lymphocytes, monocytes, mesenteric lymph nodes and complications between groups (P > 0.05). The national policy had significantly improved clinical use of antibiotic for young children with low-risk intussusception (OR 

  • reducing antibiotic use for young children with intussusception following successful Air Enema reduction
    PLOS ONE, 2015
    Co-Authors: Yuan Zhang, Wen Zou, Yinghui Zhang, Xingdong Chen, Qian Liu, Huandi Liu, Hongying Jia
    Abstract:

    China introduced a new policy regarding the management of antibiotic use. We evaluated the reasonableness of antibiotic use among children suffering from intussusception before and after policy. A retrospective study was conducted involving 234 young children with intussusception who were treated between January 1, 2011 and December 30, 2013. Demographics and detailed antibiotics regimens were collected. χ2 test was used to evaluate differences between the phase I (preintervention, n = 68) and phase II (postintervention, n = 166). We determined that the overall antibiotic use rate following successful Air Enema reduction was 41% (97/234), which decreased from 99% (67/68) in phase I to 18% (30/166) in phase II. In phase I, prophylactic antibiotic usage reached up to 84% (56/67). The quantity of aztreonam for injection accounted for 63% (45/71), and cefamandole nafate for injection accounted for 25% (18/71). In phases II, prophylactic antibiotic usage were reduced to 13% (4/30). The quantity of aztreonam for injection was decreased to 12% (4/33) and cefamandole nafate for injection was 3% (1/33). Antibiotics' options were more diverse. In conclusion, policy intervention was effective in addressing some aspects of antibacterial drug usage among young children with intussusception. However, excessive drug use remains a public health problem. The guidelines for the antibiotic management of intussusception for children must be established in China.

  • Antibiotic comparisons in children with intussusception after Air Enema reduction in two phases (n,%).
    2015
    Co-Authors: Yuan Zhang, Wen Zou, Yinghui Zhang, Xingdong Chen, Qian Liu, Huandi Liu, Hongying Jia
    Abstract:

    Phase I: preintervention; Phase II: postinterventionAntibiotic comparisons in children with intussusception after Air Enema reduction in two phases (n,%).