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Volume 8

2022, June

Volume 8, Issue 1

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Volume 7

2020-2021, December

Volume 7, Issue 1

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Volume 6

December, 2019

Volume 6, Issue 1

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Volume 5

December, 2018

Volume 5, Issue 1

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Volume 4

April, 2017

Volume 4, Issue 1

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Volume 3

July, 2016

Volume 3, Issue 1

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Volume 2

October, 2015

Volume 2, Issue 2

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April, 2015

Volume 2, Issue 1

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April, 2016

Volume 2, Issue 3

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Volume 1

December, 2014

Volume 1, Issue 1

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Special Edition

Volume 8

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Issue 2

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Article in press

  • 2022, July

    systematic review

    Parenteral Diarrhea and Pediatric Urinary Tract Infections: A Systematic ReviewOpen Access

    Larry B. Mellick*, Sarathi Kalra and Edward Panacek
    DOI: https://dx.doi.org/10.17140/PNNOJ-8-137
    Provisional PDF405.13 KB 405.13 KB
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    Abstract [+]

    Background
    Parenteral diarrhea is non-infectious diarrhea associated with extraintestinal infections such as urinary tract infection (UTI), but evidence supporting this association is limited. We performed a systematic literature review to determine the reported frequency of UTI in pediatric patients who had diarrhea.
    Methods
    We searched electronic databases (PubMed, Scopus, Google Scholar, and CINAHL) to identify articles about diarrhea and UTI. We included English-language articles about studies of children (age, ≤5-years) who presented with diarrhea in which the frequency of culture positive UTI was reported. We excluded studies that examined particular diets or specific pediatric patient populations presenting with diarrhea. Patient and study characteristics were extracted manually.
    Results
    The database search identified 32 articles. After excluding 25 articles and adding 3 articles identified during manual review of article references, there were 10 articles in the final review including 8 cohort and 2 case control studies. In all 10 studies combined, UTIs were observed in 172 of 1086 children who presented with diarrhea (15.8%), but the frequency of UTI varied between studies (range, 5 to 32%). Escherichia coli was the most common bacterial isolate from urine in all 9 studies that reported microbiology results. The stool and urine culture results (E. coli) were similar in 4 of the 6 studies that reported stool culture results.
    Conclusion
    In infants and children up to age 5-years, diarrhea may be associated with an UTI. In patients who have diarrhea of unknown cause, it may be prudent to consider an evaluation for a coexisting UTI.

    Keywords
    Gastroenterology; Genitourinary system; Diarrhea; Bacteriuria; Urinary tract infection (UTI).


NOTE: The DOIs of the In-Press Articles will only function after the final publication of the articles and once they are uploaded to the Current Issues.
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Current Issue

  • 2022, January

    review

    Healthcare Issues in Children with Developmental Disabilities (Autism)Open Access

    Enow V. A. Eta*
    DOI: https://dx.doi.org/10.17140/PNNOJ-8-134
    PDF455.22 KB 455.22 KB
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    Abstract [+]

    Developmental disabilities (DDs) refer to a group of conditions that influence the early development of children and cause changes in their normal developmental pattern affecting their physical, language and mental abilities or behavior. Children with DDs just like normally developing children have health issues that need to be addressed. This special group of children especially those having autism frequently suffer from associated conditions such as gastrointestinal disorders, eating and feeding challenges, seizures, sleep disturbances, attention deficit and hyperactivity disorder, and anxiety among others. These health problems affect the health of these children in different ways and extent. Thus, children with DDs need to access healthcare services and receive quality medical care just like their normally developing peers. However, the health needs of children with DDs particularly autism are not being met as required even though this special population are more likely to seek medical care due to their disabilities and associated conditions. Children with autism and other DDs experience disparities in health and healthcare service utilization. Autism is linked to many health conditions such as epilepsy, gastrointestinal problems and other mental disorders. These health problems affect each individual with autism in a unique way negatively affecting his/her existing social interaction and communication impairments. Again, health facilities and medical equipment are not disability-friendly making it difficult for this special group to effectively have access to quality care. In addition, most healthcare providers do not possess adequate knowledge and skills required to make critical decisions regarding this very special group of persons. Furthermore, due to cultural differences certain diagnosis and treatment regarding autism and other developmental disabilities may not be welcomed. The public health sector of all nations has the duty to promote health and prevent diseases for all including persons with disabilities.
    Keywords
    Developmental disabilities; Children with autism; Health conditions; Disparities in health;
    Disparities in healthcare service utilization.


  • 2022, April

    original research

    Can Automated Text Messaging Successfully Monitor Antibiotic Adherence for Urban Adolescents and Young Women Managed for Pelvic Inflammatory Disease in the Outpatient SettingOpen Access

    Bria Rice, Jamie Perin, Steven Huettner, Arlene Butz, Hasiya E. Yusuf and Maria Trent
    DOI: https://dx.doi.org/10.17140/PNNOJ-8-135
    PDF606.00 KB 606.00 KB
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    Abstract [+]

    Objective
    This study evaluates patient responsiveness to an automated text messaging system for pelvic inflammatory disease (PID) self-care support, and measures the reliability of text-reported adherence.
    Design
    Patients aged 13-25-years with mild to moderate PID were recruited from urban, academic outpatient settings. Enrolled patients received antibiotics and were randomized into a standard of care or intervention group. During a 14-day treatment period, participants in the intervention arm received a community-based nursing visit and daily text message medication reminders with evening prompts to report the number of doses taken.
    Result
    Of the 97 participants randomized into the intervention arm, 91 (94%) were eligible for analysis. Most were African American and low income, with a mean age of 18.3 (SD=2.2) years. Participants responded to ~53% (SD=34%) of all dosage inquiry messages. Responsiveness attenuated at approximately 2.2% per day over the treatment period. Ninety-three percent (n=85) of the analyzed intervention arm returned for the two-week follow-up. Despite overall adherence and general responsiveness, text-reported and self-reported medication adherence were not well correlated (r=0.37, p<0.001). Conclusion Our findings show that text messaging is a feasible strategy for reaching urban adolescents being managed for complicated sexually transmitted infections in outpatient settings. However, patient responsiveness to self-care text messages do vary, limiting the adherence monitoring capacity of this technology. Given the number of unanswered text messages and incomplete text-reported adherence data, additional measures to assess adolescents’ adherence to PID medications are needed in clinical trials. Keywords Pelvic inflammatory disease; Sexually transmitted infections; Adolescents; Outpatient; Text messaging; Community health nursing.


  • 2022, April

    review

    Early Identification, Assessment and Interventions in Children with Developmental Disabilities: A Review on AutismOpen Access

    Enow V. A. Eta*
    DOI: https://dx.doi.org/10.17140/PNNOJ-8-136
    PDF474.87 KB 474.87 KB
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    Abstract [+]

    Developmental disabilities are a set of disorders which occur during the child’s developmental stages affecting his or her language, physical and mental abilities or behavior. These include autism and other related disorders which all negatively influence the way the child achieves normal developmental milestones. Nurses are expected to work in collaboration with parents and other health care professionals to monitor each child’s growth and development during each well-child visit or Infant Welfare Clinics (IWC) as well as during illness episodes. Generally, parents’ concerns regarding developmental delays are discussed and the child is followed-up accordingly through developmental screening. A brief test is conducted on the child while the parent/caregiver completes a questionnaire or checklist regarding the child’s developmental history. The American Academy of Pediatrics (AAP) recommends that developmental and behavioral screening be conducted for all children during regular IWC or well-child visits at nine, 18 and 30-months. Early diagnosis together with early treatment can make a major difference in a child’s life and also decrease the possibility for costly interventions in future. Several programs have been designed to deal with the variety of social and behavioral difficulties associated with autism, focusing on reducing problem behaviors in children with autism. Once an individual is given a confirmed autism diagnosis by a qualified professional, the parents need to seek further information immediately on how to support their child. Early intervention treatment services have been shown to greatly improve a child’s development. Thus, diagnosing autism early and instituting treatment and support promptly is mandatory for better prognosis.
    Keywords
    Developmental disabilities; Children with autism; Early assessment, Diagnosis and interventions.


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Previous Issue

  • 2020, November

    original research

    Seventy Cases of Partial Gastric Pull-Up According to the Schärli Technique for Esophageal Replacement in PediatricsOpen Access

    Martín Rubio, Mariano Boglione*, Carlos Fraire, Silvia Takeda, Cristian Weyersberg, Fermín Prieto and Marcelo Barrenechea
    DOI: https://dx.doi.org/10.17140/PNNOJ-7-131
    PDF336.82 KB 336.82 KB
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    Abstract [+]

    Introduction
    Esophageal replacement (ER) is indicated in patients with long gap esophageal atresia (LGEA) or failure of the primary anastomosis. Also, severe caustic or peptic strictures, resistant to conservative treatment with medication and dilations, may require an ER. Numerous techniques with different organs and routes have been described, all with satisfactory results.
    Objective
    Our objective is to describe the experience obtained with partial gastric pull-up according to the Schärli principles (SGPA).
    Materials and Methods
    Medical records of patients who required a SGPA between October 1995 to June 2018 were reviewed. The analysis was observational, longitudinal, retro-prospective and descriptive. Epidemiological data, surgical aspects and postoperative complications of the patients were considered.
    Results
    Seventy ER were performed with SGPA. The indication was esophageal atresia (EA) in 58 cases (44 long gap and 14 failure of the anastomosis), 10 caustic strictures, one peptic stricture resistant to conservative treatment and the other due to a retained foreign body. The age of the ER was on average 2-years and 9-months. The route was: posterior mediastinal (35), retrosternal (29) and transpleural (6); without a thoracic approach in 59 patients. The duration of the procedure was 4.7-hours on average. There were 13 cases of intraoperative complications, 8 cases of pneumothorax, 5 bleeding injuries (3 in the spleen, 1 liver and 1 cervical), and one injury to the cervical trachea. Anastomotic dehiscence was observed in 37 patients (52%), which closed spontaneously after an average of 17.8-days in all except one patient. Thirty-one patients (44%) developed anastomotic stenosis, requiring redo anastomosis in 6 cases; 37% developed dumping and 23% gastroesophageal reflux disease. There were 3 deaths (4.2%): all in EA patients with associated malformations, following a morbid postoperative period with infectious complications in intensive care at 10-days, 7 and 8-months after ER. Follow-up was an average of 8-years. All 67 living patients are currently tolerating oral feeding.
    Conclusion
    In our experience with ER using SGPA, we observed a high incidence of complications, generating a longer post-operative evolution and with greater morbidity than that described in other techniques. Given these results, we changed our strategy to complete gastric transposition, in order to reduce morbidity and improve the evolution of this complex group of patients.
    Keywords
    Esophageal replacement; Partial gastric pull-up; Esophageal atresia; Caustic stricture.


  • 2021, June

    case report

    A Case Report of Congenital Oesophageal Atresia with Tracheo-Oesophageal Fistula and Review of the LiteratureOpen Access

    Amelia Mosada*, Mohamed L. El-Dawy and Abdelhadi A. Abdelhadi
    DOI: https://dx.doi.org/10.17140/PNNOJ-7-132
    PDF434.76 KB 434.76 KB
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    Abstract [+]

    Introduction
    Congenital oesophageal atresia (COA) refers to a congenitally interrupted oesophagus. It is commonly referred to in the literature as oesophageal atresia (OA) with or without tracheo oesophageal fistula (TOF) but acquired TOF is a different entity.
    Case Report
    We present a case of OA with TOF which was not suspected antenatally despite the presence of polyhydramnios. The baby presented with respiratory distress and excessive oral secretions at the age of 3-hours following initiation of breastfeeding. Thorascopic repair was performed on the second day of life. The pre-, intra- and post-operative course was smooth with no major challenges. There was no associated anomalies in our case following thorough systemic evaluation including brain ultrasound, abdominal ultrasound, skeletal survey, ophthalmic assessment and echocardiography.
    Conclusion
    This case demonstrates the importance of maintaining a high index of suspicion for OA when faced with a combination of respiratory distress and persistent frothy oral secretions in a newborn. The antenatal and postnatal diagnostic approaches are discussed with highlights of associated anomalies and pre-operative assessment and management
    Keywords
    Congenital oesophageal atresia (COA); Tracheo oesophageal fistula (TOF); Oesophageal atresia (OA); Vertebral defects, anal atresia, cardiac defects, renal anomalies and limb abnormalities (VACTERL); Choanal atresia, retardation of growth, genital abnormalities,
    and ear abnormalities (CHARGE).


  • 2021, December

    original research

    Knowledge, Attitudes and Practices of Parents Regarding Convulsion in Children Under Five Years in Muea Community, CameroonOpen Access

    Enow V. A. Eta* and Aymle N. N. Gaelle
    DOI: https://dx.doi.org/10.17140/PNNOJ-7-133
    PDF384.21 KB 384.21 KB
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    Abstract [+]

    Background
    Convulsion is an event that can emotionally traumatise most parents. Inadequate knowledge regarding convulsion can cause parental anxiety.
    Aim
    This research sought to investigate the knowledge, attitudes, concerns and practices of parents regarding convulsion in children under five-years.
    Methods
    The study employed a community based cross-sectional survey design. Purposive, convenient and snowball samplings were used to select the study site and enroll participants to the study. The study was conducted in Muea Community, Buea Health District in Fako Division, South West Region of Cameroon. The study participants were made up of parents of children under 5-years of age and who had witnessed convulsion in a child. Respondents who met the inclusion criteria and gave their consent to participate in the study were selected. Data was collected using a semi-structured questionnaire made up of both open and closed-ended questions. Data was collected on the knowledge, attitudes, concerns and practices of parents regarding convulsions in children. Data collected was entered using a pre-designed EpiData version 3.1 and data from open-ended questions were analysed using systematic process of thematic analysis.
    Results
    A total of 100 respondents participated in the study. The study revealed that more than half of the respondents 53.7% had good knowledge on convulsion, 61.9% of the respondents had positive attitudes towards convulsion and 51.4% of parents had good practices regarding convulsion. This study also revealed that knowledge of convulsion had an association (p=0.05) with gender and marital status but was not dependent (p>0.05) on age and level of school attained.
    Conclusion
    The study concluded that even though more than half of the respondents were knowledgeable on convulsion, there is still need for proper parental education as inappropriate attitudes and practices like putting the child’s head in the toilet pit, which can lead to complications are still being practiced.
    Keywords
    Knowledge; Convulsion; Attitudes; Concerns practices; Children under five; Parents.


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    Editor-in-Chief

    John E. Nathan, DDS, MDS


    Associate Professor of Clinical Otolaryngology
    Department of Otolaryngology/Dentistry
    Northwestern University Feinberg School of Medicine
    Adjunct Professor
    Departments of Pediatric Dentistry, University of Alabama
    Birmingham and Case Western
    Reserve University, Cleveland, USA

    Associate Editors

    William J. Keenan, MD


    Professor
    Department of Pediatrics & OB/GYN
    Saint Louis University School of Medicine
    St. Louis, MO, USA

    Our editorial team


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