J Pediatr (Rio J)
Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brazil. Electronic address:
Published: May 2022
Objectives: To describe the management, to compare treatment at initial referral vs. during specialized follow-up, and to describe outcomes of children with functional constipation (FC) referred to a Brazilian tertiary care center.
Methods: Retrospective study, including children (4-18 years) with FC followed at a single center from 2006 to 2019. Demographics, treatments, time of follow-up, and outcomes were analyzed. The management of FC followed an institutional protocol.
Results: 104 patients were identified, 79 were eligible and included in the analysis: 59% male, mean age at referral was 6.4 years, and mean duration of symptoms was 4.4 years. There were significant changes in the therapy(ies) used at the time of referral compared to during follow-up, with a noticeable increase in the frequency of the use of polyethylene glycol, enemas, magnesium hydroxide, and bisacodyl; 5.1% received trans-anal irrigation, and 3.8% underwent surgery. Outcomes were favorable in more than half of the cases: 31% improved; 19.5% had complete resolution and 2.5% were transferred back to primary care. Symptoms remained unchanged in 30.4%, and no patients experienced worsening of symptoms. The mean duration of follow-up was 2.8 years. When comparing patients with favorable vs. unfavorable outcomes, the authors did not identify significant differences in gender, age, therapies used, duration of symptoms, or length of follow-up.
Conclusions: Children with FC are often referred to specialized care not receiving optimal therapy. Many patients whose FC was labeled "refractory" may be treated successfully with a well-established plan of care, and do not truly present intractable constipation.
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http://dx.doi.org/10.1016/j.jped.2021.06.006 | DOI Listing |
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Department of Psychology, Sapienza University of Rome, Rome, Italy; Body and Action Lab, IRCCS Fondazione Santa Lucia, Rome, Italy. Electronic address:
Introduction: Brain and sleep development in childhood shapes emotional and cognitive growth, including the ability to recall dreams. In line with the continuity hypothesis of dreaming, several findings suggest a link between clinical symptoms and nightmare frequency. Sleep disorders and anxiety are among the most frequently co-occurring conditions in children and adolescents with autism spectrum disorder (ASD).
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Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Clalit Health Services, Dan Petah Tikva District, Petah Tikva, Israel. Electronic address:
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Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia, PA 19104, USA; Penn-Children's Hospital of Philadelphia Lung Biology Institute, University of Pennsylvania, Philadelphia, PA 19104, USA; Penn Cardiovascular Institute, University of Pennsylvania, Philadelphia, PA 19104, USA. Electronic address:
Functional regeneration of the lung's gas exchange surface following injury requires the coordination of a complex series of cell behaviors within the alveolar niche. Using single-cell transcriptomics combined with lineage tracing of proliferating progenitors, we examined mouse lung regeneration after influenza injury, demonstrating an asynchronously phased response across different cellular compartments. This longitudinal atlas of injury responses has produced a catalog of transient and persistent transcriptional alterations in cells as they transit across axes of differentiation.
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VIVE - The Danish Center for Social Science Research, Denmark. Electronic address:
Introduction: Research on the long-term effects of treatment for attention deficit hyperactivity disorder (ADHD) on educational and social outcomes is limited. This study aims to evaluate long-term social functioning outcomes in patients with ADHD and the potential effects of pharmacological treatment for ADHD.
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