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1.
Chemosphere ; 286(Pt 2): 131821, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34388869

RESUMO

Acute exposure to trace metals (TMs) in water is hazardous to human health. The average concentrations (Cavg.) and carcinogenic (CAR) and non-carcinogenic (non-CAR) risks of eight TMs to World Health Organization's (WHO) guidelines and national standard limits (NSLs)were determined. The Cavg. and (the range) of As, Hg, Cd, Pb, Co, Cr, Ni, and Zn were measured as 4.29 ± 0.57 µg L-1 (1.12-10.27 µg L-1), 0.22 ± 0.10 µg L-1 (ND-1.05 µg L-1), 0.31 ± 0.18 µg L-1 (ND-1.80 µg L-1), 4.66 ± 0.32 µg L-1 (0.10-14.22 µg L-1), 24.61 ± 4.65 µg L-1 (3.11-67.25 µg L-1), 16.86 ± 5.54 µg L-1 (5.12-34.61 µg L-1), 14.07 ± 4.37 µg L-1 (3.79-31.39 µg L-1), and 268.42 ± 75.82 (87.29-561.22 µg L-1), respectively. The Cavg. of Co and Hg exceeded the WHO and NSLs. The non-CAR risk assessment was used to order the TMs according to the total target hazard quotient (TTHQ) As > Pb > Cr > Co > Zn > Hg > Ni > Cd. None of the investigated age groups are at risk As there is a low Cavg of all trace metals (i.e., the THQ is > 1). The age groups were ranked based on THQ and incremental lifetime cancer risk (ILCR) As < 1 year, >1-10 years, > 11-19 years, and > + 20 years. The ILCR of As for all the age groups was >10-4, whereas for Pb it was <10-6. Cumulative carcinogenic risk (CCR) for As and Pb was at a safe threshold risk (>10-4) for all the age groups.


Assuntos
Água Potável , Mercúrio , Metais Pesados , Oligoelementos , Monitoramento Ambiental , Intoxicação por Metais Pesados , Humanos , Lactente , Metais Pesados/análise , Metais Pesados/toxicidade , Medição de Risco , Oligoelementos/análise , Oligoelementos/toxicidade
2.
J Med Virol ; 94(1): 380-383, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34403142

RESUMO

The durability of infection-induced severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunity has crucial implications for reinfection and vaccine effectiveness. However, the relationship between coronavirus disease 2019 (COVID-19) severity and long-term anti-SARS-CoV-2 immunoglobulin G (IgG) antibody level is poorly understood. Here, we measured the longevity of SARS-CoV-2-specific IgG antibodies in survivors who had recovered from COVID-19 1 year previously. In a cohort of 473 survivors with varying disease severity (asymptomatic, mild, moderate, or severe), we observed a positive correlation between virus-specific IgG antibody titers and COVID-19 severity. In particular, the highest virus-specific IgG antibody titers were observed in patients with severe COVID-19. By contrast, 74.4% of recovered asymptomatic carriers had negative anti-SARS-CoV-2 IgG test results, while many others had very low virus-specific IgG antibody titers. Our results demonstrate that SARS-CoV-2-specific IgG persistence and titer depend on COVID-19 severity.


Assuntos
Anticorpos Antivirais/sangue , COVID-19/patologia , Imunoglobulina G/sangue , SARS-CoV-2/imunologia , Índice de Gravidade de Doença , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Assintomáticas , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Adulto Jovem
3.
J Med Virol ; 94(1): 366-371, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34546584

RESUMO

Co-epidemics happening simultaneously can generate a burden on healthcare systems. The co-occurrence of SARS-CoV-2 with vector-borne diseases (VBD), such as malaria and dengue in resource-limited settings represents an additional challenge to the healthcare systems. Herein, we assessed the coinfection rate between SARS-CoV-2 and VBD to highlight the need to carry out an accurate diagnosis and promote timely measures for these infections in Luanda, the capital city of Angola. This was a cross-sectional study conducted with 105 subjects tested for the SARS-CoV-2 and VBD with a rapid detection test in April 2021. The participants tested positive for SARS-CoV-2 (3.80%), malaria (13.3%), and dengue (27.6%). Low odds related to testing positivity to SARS-CoV-2 or VBD were observed in participants above or equal to 40 years (odds ratio [OR]: 0.60, p = 0.536), while higher odds were observed in male (OR: 1.44, p = 0.392) and urbanized areas (OR: 3.78, p = 0.223). The overall co-infection rate between SARS-CoV-2 and VBD was 11.4%. Our findings showed a coinfection between SARS-CoV-2 with malaria and dengue, which could indicate the need to integrate the screening for VBD in the SARS-CoV-2 testing algorithm and the adjustment of treatment protocols. Further studies are warranted to better elucidate the relationship between COVID-19 and VBD in Angola.


Assuntos
COVID-19/epidemiologia , Coinfecção/epidemiologia , Dengue/epidemiologia , Malária/epidemiologia , Doenças Transmitidas por Vetores/epidemiologia , Adolescente , Adulto , Fatores Etários , Angola/epidemiologia , Anticorpos Antiprotozoários/sangue , Anticorpos Antivirais/sangue , Teste para COVID-19 , Febre de Chikungunya/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , RNA Viral/sangue , SARS-CoV-2/isolamento & purificação , Fatores Sexuais , Adulto Jovem , Infecção por Zika virus/epidemiologia
4.
Handb Exp Pharmacol ; 268: 437-448, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34196812

RESUMO

Since allergic diseases are of great public health relevance, effective primary prevention strategies are urgently needed. This chapter gives an overview of existing primary prevention programs on environmental exposures and dietary strategies based on epidemiological studies which have defined risk- and protective factors for the development of allergic diseases.The allergy protective effect mediated by growing up on a traditional farm environment is well studied. But the exact underlying mechanisms have still not been fully clarified and have not yet led to concrete prevention strategies. The beneficial effect of avoiding cigarette smoke exposure, indoor moisture and molds in pregnancy and childhood on the development of asthma is well documented. Whereas the avoidance of house dust mite exposure is not recommended to prevent eczema or allergy. Dietary supplementation with vitamins, pre- and probiotics in pregnant woman and their offspring is not harmful but evidence for the prevention of allergic diseases is still lacking. Fish oil consumption was shown to be asthma protective. The early introduction of peanuts and egg protein to prevent peanut and egg allergy in children with atopic dermatitis is promising. Further studies are needed to increase the overall evidence in allergy prevention. Most studies lack methodological standards such as randomization and blinding. More evidence is in demand on the potential beneficial impact of multifaceted interventional studies. The future of allergy prevention strategies might be based on individual risk assessment. Therefore, research in the immunological and molecular basis of allergic diseases needs to be promoted.


Assuntos
Asma , Dermatite Atópica , Eczema , Hipersensibilidade , Criança , Dieta , Feminino , Humanos , Hipersensibilidade/prevenção & controle , Lactente , Gravidez
5.
Sci Total Environ ; 806(Pt 1): 150437, 2022 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-34583069

RESUMO

BACKGROUND: Breast milk is the main source of nutrition for infants but may be responsible for their exposure to environmental chemicals, including endocrine-disrupting chemicals. AIM: To review available evidence on the presence and concentrations of bisphenols, parabens (PBs), and benzophenones (BPs) in human milk and to explore factors related to exposure levels. METHODS: A systematic review was carried out using Medline, Web of Science, and Scopus databases, conducting a comprehensive search of peer-reviewed original articles published during the period 2000-2020, including epidemiological and methodological studies. Inclusion criteria were met by 50 studies, which were compiled by calculating weighted detection frequencies and arithmetic mean concentrations of the chemicals. Their risk of bias was assessed using the ROBINS-I checklist. RESULTS: Among the 50 reviewed studies, concentrations of bisphenols were assessed by 37 (74.0%), PBs by 21 (42.0%), and BPs by 10 (20.0%). Weighted detection frequencies were 63.6% for bisphenol-A (BPA), 27.9-63.4% for PBs, and 39.5% for benzophenone-3 (BP-3). Weighted mean concentrations were 1.4 ng/mL for BPA, 0.2-14.2 ng/mL for PBs, and 24.4 ng/mL for BP-3. Mean concentrations ranged among studies from 0.1 to 3.9 ng/mL for BPA, 0.1 to 1063.6 ng/mL for PBs, and 0.5 to 72.4 ng/mL for BP-3. The highest concentrations of BPA and PBs were reported in samples from Asia (versus America and Europe). Higher BPA and lower methyl-paraben concentrations were observed in samples collected after 2010. Elevated concentrations of these chemicals were associated with socio-demographic and lifestyle factors in eight studies (16.0%). Two epidemiological studies showed moderate/serious risk of bias. CONCLUSIONS: This systematic review contributes the first overview of the widespread presence and concentrations of bisphenols, PBs, and BPs in human breast milk, revealing geographical and temporal variations. The methodological heterogeneity of published studies underscores the need for well-conducted studies to assess the magnitude of exposure to these chemicals from human milk.


Assuntos
Disruptores Endócrinos , Parabenos , Ásia , Compostos Benzidrílicos/análise , Benzofenonas , Feminino , Humanos , Lactente , Leite Humano/química
6.
Chemosphere ; 287(Pt 4): 132375, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34597632

RESUMO

Evidence of associations of pre- and postnatal exposure to polychlorinated biphenyls (PCBs) with cognitive development beyond early childhood is inconsistent. A previous report from this cohort observed adverse associations between early life PCB exposures and infant Bayley scores at age 16 months. The present study examines pre- and postnatal PCB exposures in relation to both behavior and cognitive development at age 45 months. Participants were 472 mother-child pairs residing in an area of eastern Slovakia characterized by environmental contamination with PCBs, which resulted in elevated blood serum concentrations. PCB-153 and PCB-118 concentrations were measured in maternal and in infant 6-, 16-, and 45-month serum samples. At age 45 months, children were administered five subtests of the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III), and mothers completed the Child Behavior Checklist (CBCL). Negative binomial and multiple linear regressions were used to estimate PCB-CBCL and PCB-WPPSI-III subtest score associations, respectively. Pre- and postnatal levels of PCB-153 and PCB-118 were not associated with cognitive performance on the WPPSI-III in this cohort. There was some suggestion that higher postnatal PCB concentrations were associated with more sleep problems and feelings of depression and anxiousness.


Assuntos
Poluentes Ambientais , Bifenilos Policlorados , Efeitos Tardios da Exposição Pré-Natal , Pré-Escolar , Cognição , Estudos de Coortes , Exposição Ambiental , Feminino , Humanos , Lactente , Gravidez , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Eslováquia
7.
Ann Anat ; 239: 151838, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34637900

RESUMO

INTRODUCTION: The morphological variability of the fibularis longus tendon (FLT) in adults is well understood. However, no comprehensive classification exists in human fetuses. The goal of this study was to prepare the first comprehensive classification of the fibularis longus tendon based on its insertion in human fetuses. MATERIAL AND METHODS: Forty-seven spontaneously-aborted human fetuses were examined: 38 male, 56 female, a total of 94 lower limbs (Central European population). Age ranged from18-38 weeks of gestation at death. RESULTS: The classification comprised three types of FLT. The most common type was Type I (49%), characterized by the single distal attachment. This type was divided into two subtypes (A-B): A - the tendon inserts to the lateral tubercle of the base of the 1st metatarsal bone, B - the tendon inserts to the head of the 1st metatarsal bone. The second most type was Type II, characterized by a bifurcated distal attachment (24.5%). This type was divided into three subtypes (A-C): A - the main tendon inserts to the lateral tubercle of the base of the 1st metatarsal bone and the accessory band inserts to the medial cuneiform bone; B - the strong, main tendon inserts to both the base of the 1st metatarsal bone and medial cuneiform bone, including the first metatarsal-cuneiform joint, and the accessory bands inserts to the fourth interosseus dorsalis muscle; C - the main tendon inserts to the lateral tubercle of the base of the 1st metatarsal bone and the accessory band inserts to the first interosseus dorsalis muscle. The rarest type was Type III, characterized by a trifurcated distal attachment: the main tendon inserts to the lateral tubercle of the base of the 1st metatarsal bone and the first accessory band inserts to the medial cuneiform bone and the second accessory bands inserts to the first interosseus dorsalis muscle. The anterior frenular ligament was observed in 16% of all cases, and posterior frenular ligament in 6.4%. CONCLUSION: The FLT displays high morphological variability. The proposed classification consists of three main types, with Type I and Type II divided into sub-types; it also provides additional data regarding its accessory tendon bands.


Assuntos
Músculo Esquelético , Tendões , Adulto , Cadáver , Feminino , Feto , Humanos , Lactente , Ligamentos , Masculino
8.
Chemosphere ; 287(Pt 2): 132115, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34826892

RESUMO

Despite being restricted by many authorities, di (2-ethylhexyl) phthalate (DEHP) is still widely detected in the environment and biospecimens. To indentify populations of high risk and evaluate the effects of DEHP restrictions, we elucidated the geographic distribution of DEHP exposure levels among pregnant women and different age groups, and compared the time trend of exposure levels with the time course of productions/restrictions. The estimated daily intake (EDI) was calculated based on biomonitoring data in published epidemiological studies, and then the group EDI (EDIG) was calculated for one particular population, region, or period by weighting EDIs by sample sizes. Overall, 144,965 samples from 45 nations were included, with the sampling time ranging from 1982 to 2017. Children had the highest exposure level (5.50 µg/kg bw/day) worldwide, while infants and pregnant women had low levels (2.13 and 1.89 µg/kg bw/day, respectively). The EDIGs varied considerably between countries, and the majority of corresponding hazard quotients were less than 1; however, the risk behind can not be ignored. In the general population, the DEHP exposure level showed a downtrend from 4.40 µg/kg bw/day before 2000 to 2.23 µg/kg bw/day in 2015-2017. In the European Union, the annual trend of DEHP EDIGs of children and adults fitted the production and consumption volume, and the EDIGs decreased more sharply in children. The EDIGs of children decreased with a delay along with the regulations on the use of DEHP. Cutting productions/consumptions and restrictions are effective to reduce DEHP exposure, but current efforts are far from enough on a worldwide scale.


Assuntos
Dietilexilftalato , Ácidos Ftálicos , Adulto , Monitoramento Biológico , Criança , Exposição Ambiental/análise , União Europeia , Feminino , Humanos , Lactente , Gravidez
9.
Chemosphere ; 287(Pt 2): 132226, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34826919

RESUMO

Exposure to food and environmental contaminants is a global environmental health issue. In this study, innovative LC-MS/MS approaches were applied to investigate mycotoxin co-exposure in mother-infant pairs (n = 23) by analyzing matched plate-ready food, breast milk and urine samples of mothers and their exclusively breastfed infants. The study revealed frequent co-occurrence of two to five mycotoxins. Regulated (e.g. aflatoxins, deoxynivalenol and ochratoxin A) and emerging mycotoxins (e.g. alternariol monomethyl ether and beauvericin) were frequently detected (3 %-89 % and 45 %-100 %), in at least one specimen. In addition, a moderate association of ochratoxin A in milk to urine of mothers (r = 0.47; p = 0.003) and infants (r = 0.52; p = 0.019) but no other significant correlations were found. Average concentration levels in food mostly did not exceed European maximum residue limits, and intake estimates demonstrated exposure below tolerable daily intake values. Infants were exposed to significantly lower toxin levels compared to their mothers, indicating the protective effect of breastfeeding. However, the transfer into milk and urine and the resulting chronic low-dose exposure warrant further monitoring. In the future, occurrence of mycotoxin-mixtures, and their combined toxicological effects need to be comprehensively considered and implemented in risk management strategies. These should aim to minimize early-life exposure in critical developmental stages.


Assuntos
Mães , Micotoxinas , Cromatografia Líquida , Feminino , Contaminação de Alimentos/análise , Humanos , Lactente , Micotoxinas/análise , Nigéria , Espectrometria de Massas em Tandem
10.
Clin Podiatr Med Surg ; 39(1): 1-14, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34809788

RESUMO

Clubfoot or talipes equinovarus deformity is one of the most common anomalies affecting the lower extremities. This review provides an update on the outcomes of various treatment options used to correct clubfoot. The ultimate goal in the treatment of clubfoot is to obtain a fully functional and pain-free foot and maintain a long-term correction. The Ponseti method is now considered the gold standard of treatment for primary clubfoot. Relapse is common after primary treatment with the Ponseti method, and other interventions are discussed that are used to provide for long-term successful outcomes.


Assuntos
Pé Torto Equinovaro , Moldes Cirúrgicos , Pé Torto Equinovaro/terapia , , Humanos , Lactente , Recidiva , Resultado do Tratamento
11.
Biol Trace Elem Res ; 200(1): 1-12, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33625659

RESUMO

Trace elements are essential nutrients for the optimal growth, development, and health of infants, and the reference intervals (RIs) from these trace elements in the blood are very important for an accurate assessment of the status of the elements. In this study, blood samples from a total of 13,446 infants (7206 boys and 6240 girls) were used, and the copper (Cu), zinc (Zn), calcium (Ca), magnesium (Mg), and iron (Fe) in their blood were determined using atomic absorption spectrometry. After clearing the data and removing any outliers, the gender- and age-specific RIs obtained from the Cu, Zn, Ca, Mg, and Fe in the infants' blood were established according to the principles of the Clinical and Laboratory Standards Institute (CLSI) C28-A3. In the multivariable analysis, after making the relevant adjustments for the confounding factors, the age of the infants showed a significant positive correlation with the concentrations of Zn, Ca, Mg, and Fe found in the blood (p<0.01). Furthermore, there were obvious differences in the Cu, Zn, and Ca levels in the blood according to the gender of the infants (p<0.01). As infants are in the critical period of their growth and development, the gender- and age-specific RIs may provide helpful guidance for the nutritional status of the Cu, Zn, Ca, Mg, and Fe elements in the infants' blood.


Assuntos
Magnésio , Oligoelementos , Cálcio , Cobre , Feminino , Humanos , Lactente , Ferro , Masculino , Zinco
12.
Chemosphere ; 287(Pt 2): 132065, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34496338

RESUMO

Human beings are extensively and concurrently exposed to multiple volatile organic compounds (VOCs, including some Class I human carcinogens), which may induce oxidative stress in human body. Data on urinary metabolites of VOCs (mVOCs) among young children are limited. No studies have examined their inter-day variability of mVOCs and their associations with oxidative stress biomarkers (OSBs) using repeated urine samples from children. In this study, we measured twenty one mVOCs and three OSBs [8-hydroxy-2'-deoxyguanosine (8-OHdG; for DNA), 8-hydroxyguanosine (8-OHG; for RNA], and 4-hydroxy nonenal mercapturic acid (HNEMA; for lipid)] in 390 urine samples of 130 children (three samples on three consecutive days provided by each participant) aged 0-7 years from September 2018 to January 2019 in Shenzhen, south China, and Wuhan, central China. HPMMA (3-hydroxypropyl-1-methyl mercapturic acid/N-Acetyl-S-(3-hydroxypropyl-1-methyl)-l-cysteine), 3HPMA (3-hydroxypropyl mercapturic acid/N-Acetyl-S-(3-hydroxypropyl)-l-cysteine), and ATCA (2-aminothiazoline-4-carboxylic acid) had higher specific gravity-adjusted median concentrations (1 383, 286, and 273 µg/L, respectively) than the others. Intraclass correlation coefficients of mVOCs ranged from 0.29 to 0.71. After false-discovery rate (FDR, defined as FDR q-value < 0.05) adjustment, linear mixed-effects models revealed that 14 mVOCs were positively associated with 8-OHdG (ß range: 0.09-0.37), 11 mVOCs were positively associated with 8-OHG (ß range: 0.08-0.30), and 11 mVOCs were positively associated with HNEMA (ß range: 0.21-0.70) in urine. Considering the weight of the mVOC index accounted for the associations, based on the weighted quantile sum regression model, parent compounds of DHBMA (3,4-dihydroxybutyl mercapturic acid/N-Acetyl-S-(3,4-dihydroxybutyl)-l-cysteine) and t,t-MA (trans,trans-muconic acid) should be listed as priority VOCs for management to mitigate health risks. For the first time, this study characterized the inter-day variability of urinary mVOCs and their associations with selected OSBs (8-OHdG, 8-OHG, and NHEMA) in young, healthy Chinese children.


Assuntos
Compostos Orgânicos Voláteis , 8-Hidroxi-2'-Desoxiguanosina , Biomarcadores , Criança , Pré-Escolar , China , Humanos , Lactente , Recém-Nascido , Estresse Oxidativo
13.
J Med Virol ; 94(1): 240-245, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34460115

RESUMO

Many countries in the world are experiencing a recent surge in COVID-19 cases. This is mainly attributed to the emergence of new SARS-CoV-2 variants. Genome sequencing is the only means to detect the evolving virus mutants and emerging variants. Cycle threshold values have an inverse relationship with viral load and lower Ct values are also found to be associated with increased infectivity. In this study, we propose to use Ct values as an early indicator for upcoming COVID-19 waves. A retrospective cross-sectional study was carried out to analyze the Ct values of positive samples reported during the first wave and second wave (April 2020-May 2021). Median Ct values of confirmatory genes were taken into consideration for comparison. Ct values below 25, >25-30, and >30 were categorized as high, moderate, and low viral load respectively. Our study found a significantly higher proportion of positive samples with a low Ct value (<25) across age groups and gender during the second wave of the COVID-19 pandemic. A higher proportion of positive samples with a low Ct value (high viral load) may act as an early indicator of an upcoming surge.


Assuntos
Teste de Ácido Nucleico para COVID-19 , COVID-19/diagnóstico , COVID-19/epidemiologia , Adolescente , Adulto , Infecções Assintomáticas/epidemiologia , COVID-19/virologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , SARS-CoV-2/fisiologia , Carga Viral , Adulto Jovem
14.
J Med Virol ; 94(1): 161-172, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34415583

RESUMO

Detailed information on intrahost viral evolution in SARS-CoV-2 with and without treatment is limited. Sequential viral loads and deep sequencing of SARS-CoV-2 from the upper respiratory tract of nine hospitalized children, three of whom were treated with remdesivir, revealed that remdesivir treatment suppressed viral load in one patient but not in a second infected with an identical strain without any evidence of drug resistance found. Reduced levels of subgenomic RNA during treatment of the second patient, suggest an additional effect of remdesivir on viral replication. Haplotype reconstruction uncovered persistent SARS-CoV-2 variant genotypes in four patients. These likely arose from within-host evolution, although superinfection cannot be excluded in one case. Although our dataset is small, observed sample-to-sample heterogeneity in variant frequencies across four of nine patients suggests the presence of discrete viral populations in the lung with incomplete population sampling in diagnostic swabs. Such compartmentalization could compromise the penetration of remdesivir into the lung, limiting the drugs in vivo efficacy, as has been observed in other lung infections.


Assuntos
Monofosfato de Adenosina/análogos & derivados , Alanina/análogos & derivados , Antivirais/uso terapêutico , COVID-19/tratamento farmacológico , COVID-19/virologia , Evolução Molecular , SARS-CoV-2/genética , Monofosfato de Adenosina/uso terapêutico , Adolescente , Alanina/uso terapêutico , Criança , Pré-Escolar , Farmacorresistência Viral , Feminino , Haplótipos , Humanos , Lactente , Pulmão/virologia , Masculino , Filogenia , RNA Viral/análise , RNA Viral/genética , SARS-CoV-2/isolamento & purificação , SARS-CoV-2/fisiologia , Carga Viral , Replicação Viral/efeitos dos fármacos
15.
Libyan J Med ; 17(1): 2007603, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34813403

RESUMO

INTRODUCTION: Atrial septal defect (ASD) is a common congenital heart disease in children that uncommonly presents with pulmonary hypertension. Much is not known about the exact predictor of PAH in children with ASD. OBJECTIVES: This study aimed to determine the predictors of pulmonary hypertension in children with ASD. PATIENTS AND METHODS: This was a descriptive analysis of children with ASD carried out in three different institutions over a five-year period. Data entry and analysis were done using IBM Statistical Package for Social Sciences (SPSS) statistical software, version 25. RESULTS: The majority of the participants, 52.2%, had pulmonary hypertension and 62.5% of them occurred as mild pulmonary hypertension. There was a very weak positive correlation between pulmonary hypertension and the size of atrial septal defect, increases in size of atrial septal defect correlate with increases in pulmonary hypertension and this was found not to be statistically significant (n = 67, r = 0.193, p = 0.118). There was a positive correlation between the size of atrial septal defect and the age of participants in months, increases in age correlate with increases in size of atrial septal defect and this was found to be statistically significant (n = 67, r = 0.357, p = 0.003).The highest proportion of respondents who had pulmonary hypertension, 64.7%, was seen among children less than 1 year old while the least proportion, 27.3%, was within 1-5 years, and the difference in proportions was found to be statistically significant (χ2 = 8.187, p = 0.017). CONCLUSION: Pulmonary hypertension in children with ASD occur usually in the mild form. Age is the only strong predictor of PAH in children with isolated ASD.


Assuntos
Cardiopatias Congênitas , Comunicação Interatrial , Hipertensão Pulmonar , Criança , Comunicação Interatrial/complicações , Comunicação Interatrial/epidemiologia , Humanos , Hipertensão Pulmonar/epidemiologia , Hipertensão Pulmonar/etiologia , Lactente
16.
Neurosurg Clin N Am ; 33(1): 105-112, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34801135

RESUMO

Craniosynostosis involves the premature fusion of 1 or more cranial sutures and commonly presents as an isolated, nonsyndromic diagnosis. A subset of patients have syndromic craniosynostosis. Several unique considerations must be taken into account when managing patients with syndromic craniosynostosis. A multidisciplinary craniofacial team with a central coordinator is particularly useful for coordinating care among various specialists, and close monitoring is mandatory owing to the increased risk of intracranial hypertension. Surgical management varies among centers, but core options include fronto-orbital advancement with cranial vault remodeling, posterior vault expansion, endoscopic-assisted suturectomy with postoperative orthotic therapy, and midface advancement.


Assuntos
Craniossinostoses , Hipertensão Intracraniana , Craniossinostoses/diagnóstico por imagem , Craniossinostoses/cirurgia , Humanos , Lactente , Crânio , Síndrome
17.
Neurosurg Clin N Am ; 33(1): 17-23, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34801138

RESUMO

Achondroplasia is the most common of skeletal dysplasias and is caused by a defect in endochondral bone formation. In addition to skeletal deformities, patients with achondroplasia possess significant abnormalities of the axial skeleton, including small skull base with a narrowed foramen magnum and small vertebral bodies with shortened pedicles. Consequently, patients with achondroplasia are at risk of several severe neurologic conditions, such as cervicomedullary compression, spinal stenosis, and hydrocephalus, which frequently require the attention of a neurosurgeon. This article provides an updated review on the neurosurgical evaluation and care of children with Achondroplasia.


Assuntos
Acondroplasia , Hidrocefalia , Estenose Espinal , Acondroplasia/cirurgia , Criança , Constrição Patológica , Forame Magno , Humanos , Hidrocefalia/cirurgia , Lactente
18.
Neurosurg Clin N Am ; 33(1): 25-35, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34801139

RESUMO

Much of the current medical discussion for within centers for skeletal dysplasia and specifically patients with achondroplasia focuses on infancy and early childhood. Most neurosurgical concerns arise due to a defect in the endochondral ossification, resulting on early fusion of the synchondrosis. As patients age, the neurosurgical focus shifts from primarily cranial to spinal concerns. Often pediatric neurosurgeons may continue to follow their patients with skeletal dysplasia. However, general adult neurosurgeons and orthopedic surgeons may see these graduated adults in their practice. This article provides a review of the common neurosurgical concerns for patients with achondroplasia.


Assuntos
Acondroplasia , Forame Magno , Acondroplasia/cirurgia , Adulto , Criança , Pré-Escolar , Constrição Patológica , Humanos , Lactente
19.
Curr Probl Cardiol ; 47(1): 100905, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34172316

RESUMO

Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-COV2) infection is a rapid evolving pandemic with multiple peaks of outbreak and substantial mortality worldwide. It has been proposed that infants are more vulnerable to SARS-COV-2 infection. On the other hand, children with COVID-19 have generally milder disease compared to infected adults and more often presented with gastrointestinal symptoms compared to respiratory ones. Multisystem inflammatory syndrome in children (MIS-c) is an ominous demonstration of COVID-19 with cardiac involvement and mortality rate <2%. From cardiovascular point of view, wide spectrum of manifestations including subclinical myocardial injury, myocarditis, stress cardiomyopathies, cardiac arrhythmias, pulmonary thromboembolism and thrombus formation in cardiac chambers and vascular bed has been reported in COVID-19 disease. Congenital heart disease (CHD), assumed as the most prevalent form of congenital disease. Advances in medical and surgical treatments for CHD have led to more alive patients with underlying heart disease secondary to congenital defects. These group of pediatric patients are prone to heart failure, arrhythmia and embolic events. In this narrative review, we intended to evaluate the cardiovascular and pediatric presentations of COVID-19 as well as the manifestation and outcomes of SARS-CoV-2 infection on pediatric patients with CHD.


Assuntos
COVID-19 , Cardiopatias Congênitas , Adulto , COVID-19/complicações , Criança , Cardiopatias Congênitas/complicações , Cardiopatias Congênitas/epidemiologia , Humanos , Lactente , Pandemias , SARS-CoV-2 , Síndrome de Resposta Inflamatória Sistêmica
20.
Appl Ergon ; 98: 103553, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34428619

RESUMO

This study assessed the influence of different types of flooring on infants' crawling motion patterns and performance. Each participating infant (range: 8.7-12.4 months) was encouraged to crawl on a tatami mat made of woven straw as well as other flooring types such as hardwood, carpet, and joint mat. Material tests were conducted to quantify the friction and shock absorption of the flooring. A three-dimensional motion capture system was used to measure spatiotemporal and kinematic variables during hands-and-knees crawling. An increased crawling rate was associated with a faster cadence of cyclic arm movements, but not with crawling stride length. Hardwood flooring had a significantly lower crawling rate and longer duration of hand-floor contact than tatami, while the crawling stride length and range of motion of joint movements were hardly affected by flooring type. The results of this study suggest a drawback of hardwood flooring in terms of infants' effective quadrupedal locomotion.


Assuntos
Pisos e Cobertura de Pisos , Mãos , Fenômenos Biomecânicos , Humanos , Lactente , Joelho , Locomoção , Movimento
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