Purpose This study aimed to provide an overview of the prevalence of the complications of a gastrostomy or a gastrojejunostomy with a low-profile gastric tube in children. The study also examined the effect of presence of the gastrostomy tube on the prevalence of complications. Methods In this cross-sectional study, parents were invited to complete an online questionnaire. Children aged 0–16 years with a low-profile gastrostomy or gastrojejunostomy tube were included in the study. Results A total of 67 complete surveys were conducted. The mean age of the included children was seven years. The most common complications during the past week, were skin irritation (35.8%), abdominal pain (34.3%), and the formation of granulation tissue (29.9%). The most common complications during the past six months were skin irritation (47.8%), vomiting (43.4%), and abdominal pain (38.8%). Most complications occurred within the first year after gastrojejunostomy placement and gradually decreased as the duration since the placement of the gastrojejunostomy tube increased. The prevalence of severe complications was rare. Parental confidence in caring for the gastrostomy positively correlated with increases in the duration of the gastrostomy tube. Even so, parental confidence in the care of the gastrostomy tube was reduced in some parents more than a year after its placement. Conclusion The prevalence of gastrojejunostomy complications in children is relatively high. The incidences of severe complications after the placement of a gastrojejunostomy tube were rare in this study. A lack of confidence in the care of the gastrostomy tube was noted in some parents more than a year after its placement.
Antibiotics are frequently administered during pregnancy. Although necessary to address acute infections, their use facilitates antibiotic resistance. Other associations have also been found with the use of antibiotics, such as perturbations of gut bacteria, delays in microbial maturation, and increased risks of allergic and inflammatory diseases. Little is known about how the prenatal and perinatal administration of antibiotics to mothers affects the clinical outcomes of their offspring. A literature search was conducted of the Cochrane, Embase, and PubMed engines. The retrieved articles were reviewed by two authors and verified for relevance. The primary outcome was the effect of pre- and perinatal maternal antibiotic use on clinical outcomes. Thirty-one relevant studies were included in the meta-analysis. Various aspects are discussed, including infections, allergies, obesity, and psychosocial factors. In animal studies, antibiotic intake during pregnancy has been suggested to cause long-term alterations in immune regulation. In humans, associations have been found between antibiotic intake during pregnancy and different types of infections and an increased risk of pediatric infection–related hospitalization. A dose-dependent positive association between pre- and perinatal antibiotic use and asthma severity has been reported in animal and human studies, while positive associations with atopic dermatitis and eczema were reported by human studies. Multiple associations were identified between antibiotic intake and psychological problems in animal studies; however, relevant data from human studies are limited. However, one study reported a positive association with autism spectrum disorders. Multiple animal and human studies reported a positive association between pre- and perinatal antibiotic use by mothers and diseases in their offspring. Our findings have potentially significant clinical relevance, particularly considering the implications for health during infancy and later in life as well as the related economic burden.
Background and objectives: The COVID-19 pandemic has put strain on the activities and well-being of health care workers. We aimed to measure the direct and indirect impact on a personal and professional level for paediatric trainees in Flanders, Belgium.Study design: Junior representatives of the Flemish Society for Paediatrics (Jong VVK) conducted a longitudinal study among their fellow paediatric trainees. The impact of COVID-19 on daily tasks, education and emotional well-being for the first (March-April 2020) and second wave (October-November 2020) of the pandemic were studied.Results: One hundred and nineteen surveys were completed in the first wave, representing data of 51% (119/233) of the total number of paediatric trainees in Flanders. Eighty surveys were completed in the second wave. Educational program changes occurred in 25% (30/119) of trainees and more than half (61%; 72/119) described the pandemic as an impediment for their educational progress. The perception of impaired education persisted for 30% of the responders (24/80) during the second wave. One out of three (30%; 35/119) felt their job was more exhausting than usual and 38% (45/119) perceived more stress at work. These numbers were comparable at both time points. Increases in stress paralleled with increased irritability in daily life and poorer sleep quality. Conclusions: COVID-19 had an important impact on the daily tasks, education and emotional well-being of the paediatric trainees. Medical training centres should be aware that there is a perception of impediment on the educational program of the paediatric trainee.
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