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1.
Food Chem ; 367: 130628, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34343807

RESUMO

A spectrophotometric method based on diazo-coupling reaction for nitrite analysis was established and validated, including inter-laboratory validation, linearity, accuracy, precision, the limit of detection (LOD) and limit of quantification (LOQ). The time-saving and high-recovery method was established by examining the filtration step, colorimetric process and concentration range of the calibration curve. This method showed good linearity (r2 > 0.999) in the range of 0.025-1.0 µg/mL. The three-level recoveries were between 86.7% and 108.6%, with the coefficient of variation (CV) below 5.8%. Mean nitrite concentration ranges in processed foods were ND-33.47 mg/kg. The mean nitrite intake was 0.8% of the Acceptable Daily Intake (ADI, 0.07 mg/kg bw/day) for all children and adolescents and 2.8% for the consumer group. The major contributors for all subjects and consumers were ham, sausage and bacon. These results indicated that the improved method was suitable for analyzing nitrite in processed foods and the nitrite exposure levels were safe.


Assuntos
Produtos da Carne , Nitritos , Adolescente , Criança , Dieta , Exposição Dietética , Humanos , Produtos da Carne/análise , Nitritos/análise , República da Coreia
2.
Infectio ; 25(4): 276-283, oct.-dic. 2021. tab, graf
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1286722

RESUMO

Resumen Objetivo: Describir la supervivencia a siete años y los principales factores asociados a esta, en las personas con VIH que fueron atendidas en el sistema de salud colombiano entre 2011 a 2018. Métodos: Análisis de supervivencia de una cohorte de 64 039 personas diagnosticadas con VIH en Colombia. Se aplicó el método de Kaplan-Meier para estimar la probabilidad de supervivencia a partir de la fecha del diagnóstico. Se ajustó un modelo de supervivencia paramétrico flexible de Royston Parmar. Resultados: La estimación de la supervivencia global a 7 años fue de 94,8% (IC 95%: 94,5-95,2). El mayor riesgo de muerte se presentó en los hombres (HR: 1,2; IC 95%: 1,1-1,4; p: 0,010); en personas ≥50 años de edad (HR: 3,1; IC 95%: 1,6-6,3; p: 0,002); en el régimen subsidiado (HR: 2,2; IC 95%: 1,9-2,5; p: <0,001); en la etapa sida (HR: 2,8; IC 95%: 2,1-3,7; p: <0,001); en quienes presentaron la última carga viral detectable (HR: 7,1; IC 95%: 6,0-8,3; p: <0,001); y en quienes mostraron conteo de linfocitos T CD4+ <350 células/μL (HR: 1,9; IC 95%: 1,4-2,4; p: <0,001). Conclusión: La probabilidad de la supervivencia de las personas que viven con VIH aumenta al ser diagnosticados en edades jóvenes, en quienes presenten un recuento de linfocitos T CD4+ ≥350 células/μL, una carga viral indetectable (< 50 copias/mL) y no se encuentren en etapa sida.


Summary Objective: to describe the seven-year survival and predictors of mortality among people with HIV who were treated in the Colombian health system between 2011 and 2018. Methods: 64 039 people diagnosed with HIV in Colombia were included. Kaplan-Meier analysis estimated the probability of survival from the date of diagnosis. A Royston Parmar flexible parametric survival model was fitted. Results: The overall survival at 7 years was 94.8% (95% CI: 94.5-95.2). Survival was related to sex (men, HR: 1.2; 95% CI: 1.1-1.4; p: 0.010); people ≥50 years of age (HR: 3.1; 95% CI: 1.6-6.3; p: 0.002); subsidized regime (HR: 2.2; 95% CI: 1.9-2.5; p: <0.001); AIDS stage (HR: 2.8; 95% CI: 2.1-3.7; p: <0.001); a detectable viral load (HR: 7.1; 95% CI: 6.0-8.3; p: <0.001); and a CD4+ Lymphocyte count <350 cells/μL (HR: 1.9; 95% CI: 1.4-2.4; p: <0.001). Conclusion: The probability of survival of people living with HIV increases when they are diagnosed at a young age, in those with a CD4+ T Lymphocyte count ≥350 cells/μL, an undetectable viral load (<50 copies/mL) and are not in the AIDS stage.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Análise de Sobrevida , Síndrome de Imunodeficiência Adquirida , Sexo , Linfócitos T , Probabilidade , HIV , Colômbia , Contagem de Linfócitos , Carga Viral , Sobrevivência
3.
Infectio ; 25(4): 256-261, oct.-dic. 2021. tab, graf
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1286719

RESUMO

Resumen Objetivo: Determinar los factores de riesgo en adultos con COVID-19 en población rural andina durante 2020. Métodos: En este estudio de cohorte retrospectivo multicéntrico, incluimos a 184 pacientes adultos (≥18 años) con pruebas serológicas y moleculares para CO VID-19 de tres hospitales de la sierra peruana (Ancash y Apurímac) incluidos con sospecha clínica entre abril y junio. Se utilizó análisis descriptivos y regresión logística univariable para explorar los factores de riesgo asociados a los pacientes con COVID-19. Resultados: Del total de pacientes, 14 (7.6%) tuvieron SARS-CoV-2. En los pacientes infectados 12 (85.7%) fueron varones con promedio de edad de 47.3±21 años. Las comorbilidades estuvieron presentes en cerca de la tercera parte de pacientes, siendo la hipertensión y diabetes las más frecuentes (ambas 14.3%), y la sinto matología más frecuentes fueron fiebre y cefalea (57.2%). La regresión univariable mostró mayores probabilidades de infección con SARS-CoV-2 en la población rural andina asociada con la edad avanzada (OR: 1.1 IC95% 0.7-1.8; p=0,019), comorbilidades previas (OR: 1.7, IC95% 0.32-9.39; p=0,006), y sintomatología previa (OR: 49.8, IC95% 5.6-436.9; p=0,0011). Conclusiones: Los posibles factores de riesgo como la edad avanzada, las comorbilidades y sintomatología previas están relacionados con el desarrollo de CO VID-19 en población rural andina de Perú.


Abstract Objective: To determine the risk factors in adults with COVID-19 in the rural Andean population during 2020. Methods: This multicenter retrospective cohort study included 184 adult patients (≥18 years) with COVID-19's serological and molecular tests from three Hospitals in the Peruvian mountains (Ancash and Apurímac) included with clinical suspicion between April and June. Descriptive analysis and univariate logistic regression were used to explore the risk factors associated with patients with COVID-19. Results: Of total of patients, 14 (7.6%) had a SARS-CoV-2. In infected patients 12 (85.7%) were men with an average age of 47.3±21 years. Comorbidities were present in about a third of patients, with hypertension and diabetes being the most frequent (both 14.3%), and the most frequent symptoms were fever and hea dache (57.2%). Univariate regression showed higher probabilities of infection with SARS-CoV-2 in the rural Andean population associated with advanced age (OR: 1.1 95% CI 0.7 - 1.8; p = 0.019), previous comorbidities (OR: 1.7, 95%CI 0.32 - 9.39; p = 0.006), and previous symptoms (OR: 49.8, 95%CI 5.6 - 436.9; p = 0.0011). Conclusions: Possible risk factors such as advanced age, comorbidities and previous symptoms are related to the development of COVID-19 in the rural Andean population of Peru.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , COVID-19 , Peru , População Rural , Fatores de Risco , Estudos de Coortes , SARS-CoV-2 , Cefaleia , Hospitais , Hipertensão , Infecções
4.
Braz. j. oral sci ; 20: e211883, jan.-dez. 2021. tab
Artigo em Inglês | LILACS, BBO - odontologia (Brasil) | ID: biblio-1253946

RESUMO

Aim: The aim of the study was to investigate perceived family cohesion and adaptability and its association with trauma, malocclusion and anthropometry in school adolescents. Methods: Cross-sectional study with a representative sample of 921 adolescents from 13 to 19 years old of both sexes, enrolled in state public schools of a northeastern Brazilian municipality. A questionnaire with sociodemographic questions, the FACES III scale was applied and a clinical oral examination (dental trauma and malocclusion) and anthropometric (BMI by age) were performed. For statistical analysis, was evaluated by the Chi-square test. The variables that presented significance in the bivariate analysis of up to 25% were taken to the multivariate analysis (multinomial logistic regression), variables that presented significance in bivariate analysis of up to 25% were taken to multivariate analysis and all conclusions were drawn considering the significance level of 5%. Results: As a result, it was identified that displaced families were associated with low maternal education, agglutinated families associated with the absence of caries. Rigid families were associated with marked overjet and caries. The prevalence of dental trauma (37.5%) was considered high. Conclusion: It was concluded that family cohesion and adaptability were associated with oral health and socioeconomic factors


Assuntos
Humanos , Masculino , Feminino , Adolescente , Antropometria , Saúde Bucal , Adolescente , Traumatismos Dentários/epidemiologia , Saúde Holística , Má Oclusão/epidemiologia
5.
Rev. enferm. UERJ ; 29: e53845, jan.-dez. 2021.
Artigo em Inglês, Português | LILACS | ID: biblio-1224571

RESUMO

Objetivo: avaliar o impacto de um programa psicoeducacional nos níveis de autoeficácia, autoestima e sintomas ansiosos e depressivos em estudantes no início da graduação em enfermagem. Método: pesquisa multicêntrica, quase experimental, do tipo tempo-série, desenvolvida em duas instituições de ensino superior públicas, com 82 estudantes, no período de setembro de 2018 a maio de 2019. O programa psicoeducacional foi elaborado com base no construto da autoeficácia, baseando-se nas atividades de enfermagem da intervenção "Fortalecimento da autoestima", proposta pela Nursing Interventions Classification. Os desfechos avaliados foram: autoeficácia, mensurada pela Escala de Autoeficácia Geral e Percebida; autoestima, mensurada pela Escala de Autoestima de Rosenberg; sintomas ansiosos e depressivos, avaliados pela Escala Hospitalar de Ansiedade e Depressão. Resultados: a intervenção psicoeducacional teve efeito positivo na percepção de autoeficácia geral dos estudantes. A autoestima e os sintomas ansiosos e depressivos não foram influenciados. Conclusão: os níveis de autoeficácia foram positivamente impactados pelo programa implementado.


Objective: to evaluate the impact of a psychoeducational program on the levels of self-efficacy, self-esteem, and anxious and depressive symptoms in students starting their undergraduate nursing program. Method: this quasi-experimental, multicenter, time-series type study was conducted with 82 students at two public institutions of higher education, from September 2018 to May 2019. Based on the self-efficacy construct, the psychoeducational program contemplated nursing activities of the "Strengthening self-esteem" intervention proposed by the Nursing Interventions Classification. The outcomes evaluated were self-efficacy, on the General and Perceived Self-Efficacy Scale; self-esteem, on the Rosenberg Self-Esteem Scale; and anxious and depressive symptoms, on the Hospital Anxiety and Depression Scale. Results: the psychoeducational intervention had a positive effect on the students' perception of general self-efficacy. Self-esteem and anxious and depressive symptoms were not influenced. Conclusion: the program impacted levels of self-efficacy positively.


Objetivo: evaluar el impacto de un programa psicoeducativo en los niveles de autoeficacia, autoestima y síntomas ansiosos y depresivos en estudiantes al inicio de sus estudios universitarios en enfermería. Método: investigación multicéntrica, cuasi-experimental, tipo serie temporal, desarrollada en dos instituciones públicas de educación superior, con 82 estudiantes, de septiembre de 2018 a mayo de 2019. El programa psicoeducativo se desarrolló con base en el constructo de autoeficacia y las actividades de enfermería de la intervención "Fortalecimiento de la autoestima", propuesta por la Nursing Interventions Classification. Los resultados evaluados fueron: autoeficacia, medida por la Escala de Autoeficacia General y Percibida; autoestima, medida por la Escala de Autoestima de Rosenberg; síntomas de ansiedad y depresión, evaluados por la Escala Hospitalaria de Ansiedad y Depresión. Resultados: la intervención psicoeducativa tuvo un efecto positivo sobre la percepción de autoeficacia general de los estudiantes. La autoestima y los síntomas de ansiedad y depresión no se vieron afectados. Conclusión: los niveles de autoeficacia fueron impactados positivamente por el programa implementado.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Percepção , Estudantes de Enfermagem/psicologia , Autoeficácia , Educação em Enfermagem/métodos , Ansiedade , Autoimagem , Saúde Mental , Depressão , Promoção da Saúde
6.
Porto Alegre; CEVS/RS; out. 2021. 1-15 p. ilus., graf., tab., mapas.
Não convencional em Português | Coleciona SUS (Brasil), CONASS, SES-RS | ID: biblio-1292931

RESUMO

Neste boletim são apresentados: situação mundial, ocorrência de hospitalizações confirmadas para sars-cov-2, perfil das pessoas, distribuição espacial, Síndrome Inflamatória Multissistêmica Pediátrica (SIM-P), povos indígenas, descrição de surtos, trabalhadores da saúde, Vigilância sentinela de síndrome gripal e tabelas de descrição do surto. (AU)


Assuntos
Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Perfil de Saúde , Mortalidade Hospitalar/etnologia , Grupos Populacionais/estatística & dados numéricos , COVID-19/epidemiologia , Surtos de Doenças/estatística & dados numéricos , COVID-19/complicações , COVID-19/mortalidade
7.
BMC Musculoskelet Disord ; 22(1): 853, 2021 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-34615493

RESUMO

BACKGROUND: There is a need for a validated simple Dutch paediatric activity scale. The purpose was to translate and transculturally validate the Dutch Hospital for Special Surgery Paediatric Functional Activity Brief Scale (HSS Pedi-FABS) questionnaire in healthy children and adolescents. METHODS: The original HSS Pedi-FABS was translated forward and backward and was transculturally adapted after performing a pilot study among children and professionals. The final version of the Dutch HSS Pedi-FABS was validated in healthy children and adolescents aged 10 to 18 years old. Children who had any condition or injury limiting their normal physical activity were excluded. The interval between the first questionnaire T0 (HSS Pedi-FABS, Physical Activity Questionnaire for children or adolescents (PAQ-C/A) and Tegner activity scale) and the second questionnaire T1 (HSS Pedi-FABS) was 2 weeks. Construct validity, interpretability and reliability were evaluated. Content validity was evaluated through cognitive interviews among a smaller group of children and through a questionnaire among professionals. RESULTS: To evaluate content validity, 9 children and adolescents were interviewed, and 30 professionals were consulted. Content validity among professionals showed a relevance of less than 85% for most items on construct. However, content validity among children was good with a 92% score for item relevance. Readability was scored at a reading level of 11- to 12-year-olds. The validation group consisted of 110 healthy children and adolescents (mean age of 13.9 years ±2.6). Construct validity was considered good as 8 out of 10 hypotheses were confirmed. The Dutch HSS Pedi-FABS showed no floor or ceiling effect. Analysis of the internal consistency in the validation group resulted in a Cronbach's alpha of 0.82. Test-retest reliability was evaluated among 69 children and adolescents and revealed an Intraclass Correlation Coefficient (ICC) of 0.76. CONCLUSION: The Dutch HSS Pedi-FABS showed good psychometric properties in a healthy Dutch paediatric and adolescent population. Limitations of the current Dutch HSS Pedi-FABS are content validity on construct of items reported by professionals.


Assuntos
Exercício Físico , Nível de Saúde , Adolescente , Criança , Hospitais , Humanos , Projetos Piloto , Reprodutibilidade dos Testes
8.
BMC Psychol ; 9(1): 150, 2021 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-34615559

RESUMO

BACKGROUND: Psychological interventions such as behavioral activation (BA) that focus on overt behaviors rather than complex cognitive skills may be developmentally well-suited to address youth mental health problems. The current systematic review synthesized evidence on the characteristics, effectiveness and acceptability of behavioral activation (BA) to examine its role as a potential 'active ingredient' for alleviating depression and anxiety among young people aged 14 to 24 years. METHODS: Evidence across the following sources were synthesized: (i) randomized control trials (RCT) evaluating interventions where BA has been used as a standalone intervention or as part of a multicomponent intervention, (ii) qualitative studies examining the acceptability of BA as an intervention or as a coping strategy among young people with lived experiences. Consultations with a youth advisory group (YAG) from India were used to draw inferences from existing evidence and identify future research priorities. RESULTS: As part of the review, 23 RCTs were identified; three studies examined BA as a standalone intervention, and the remaining studies examined multicomponent intervention where BA was a constituent element. The intervention protocols varied in composition, with the number of intervention elements ranging between 5 to 18. There was promising but limited evidence in standalone interventions for thse effectiveness of BA for depression. The impact of BA in multicomponent interventions was difficult to evaluate in the absence of focal assessment of activation outcomes. Evidence from 37 additional qualitative studies of youth lived experience literature, corroborated by the YAG inputs, indicated that young people preferred using behavioral strategies similar to BA to cope with depression in their own life. Themes indicated that the activities that are important to an individual and their socio-contextual factors need to be considered in the planning and implementing BA intervention. Evidence for the use of BA in anxiety was limited across data sources. CONCLUSIONS: Overall, there was preliminary empirical evidence for the effectiveness and acceptability of BA for youth depression. Further research is needed to examine the components and mechanisms that contribute to its effectiveness as an active intervention ingredient for depression and anxiety.


Assuntos
Ansiedade , Depressão , Adolescente , Ansiedade/terapia , Depressão/terapia , Humanos , Índia , Pesquisa Qualitativa
9.
Tidsskr Nor Laegeforen ; 1412021 09 28.
Artigo em Inglês, Norueguês | MEDLINE | ID: mdl-34596989

RESUMO

BACKGROUND: We have obtained knowledge of how the COVID-19 pandemic affected the lives of adolescents immediately after the pandemic arrived in Norway. However, we know little about adolescents' experiences from the pandemic over time, and whether sociodemographic factors and infection rates at the municipality level play a role. MATERIAL AND METHOD: We used questionnaire data from 106 448 lower and upper secondary school pupils who took part in the Ungdata survey in 167 municipalities in the spring of 2021 (response rate 76 %). The adolescents' responses regarding their experiences during the pandemic were collated with statistics on infection rates at the municipality level. We performed a Chi-square test and multilevel analyses to investigate predictors of adolescents' experiences. RESULTS: A total of 49 % responded that the COVID-19 pandemic affected their lives in a partly or very negative direction. Many reported negative changes in peer relationships, family relationships and mental health, but some also reported positive changes. Girls, older adolescents, those with a low socioeconomic background and those living in municipalities with a higher prevalence of infection reported more negative consequences. INTERPRETATION: Most adolescents reported that the pandemic has had more negative than positive consequences. Girls, older adolescents, those with a low socioeconomic background and those living in municipalities with a higher rate of infection may be especially affected by the negative effects of the pandemic.


Assuntos
COVID-19 , Pandemias , Adolescente , Feminino , Humanos , Saúde Mental , SARS-CoV-2 , Inquéritos e Questionários
10.
BMJ Open ; 11(10): e051707, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34598988

RESUMO

OBJECTIVES: To identify factors associated with COVID-19 test positivity and assess viral and antibody test concordance. DESIGN: Observational retrospective cohort study. SETTING: Optum de-identified electronic health records including over 700 hospitals and 7000 clinics in the USA. PARTICIPANTS: There were 891 754 patients who had a COVID-19 test identified in their electronic health record between 20 February 2020 and 10 July 2020. PRIMARY AND SECONDARY OUTCOME MEASURES: Per cent of viral and antibody tests positive for COVID-19 ('positivity rate'); adjusted ORs for factors associated with COVID-19 viral and antibody test positivity; and per cent concordance between positive viral and subsequent antibody test results. RESULTS: Overall positivity rate was 9% (70 472 of 771 278) and 12% (11 094 of 91 741) for viral and antibody tests, respectively. Positivity rate was inversely associated with the number of individuals tested and decreased over time across regions and race/ethnicities. Antibody test concordance among patients with an initial positive viral test was 91% (71%-95% depending on time between tests). Among tests separated by at least 2 weeks, discordant results occurred in 7% of patients and 9% of immunocompromised patients. Factors associated with increased odds of viral and antibody positivity in multivariable models included: male sex, Hispanic or non-Hispanic black or Asian race/ethnicity, uninsured or Medicaid insurance and Northeast residence. We identified a negative dose effect between the number of comorbidities and viral and antibody test positivity. Paediatric patients had reduced odds (OR=0.60, 95% CI 0.57 to 0.64) of a positive viral test but increased odds (OR=1.90, 95% CI 1.62 to 2.23) of a positive antibody test compared with those aged 18-34 years old. CONCLUSIONS: This study identified sociodemographic and clinical factors associated with COVID-19 test positivity and provided real-world evidence demonstrating high antibody test concordance among viral-positive patients.


Assuntos
COVID-19 , Registros Eletrônicos de Saúde , Adolescente , Adulto , Criança , Feminino , Hispano-Americanos , Humanos , Masculino , Estudos Retrospectivos , SARS-CoV-2 , Estados Unidos , Adulto Jovem
11.
Orphanet J Rare Dis ; 16(1): 409, 2021 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-34600583

RESUMO

BACKGROUND: Specialized clinical care for cystic fibrosis (CF) in Cyprus, a small island country, has been implemented since the 1990s. However, only recently, a national CF patient registry has been established for the systematic recording of patients' data. In this study, we aim to present data on the epidemiological, genotypic and phenotypic features of CF patients in the country from the most recent data collection in 2019, with particular emphasis on notable rare or unique cases. RESULTS: Overall, data from 52 patients are presented, 5 of whom have deceased and 13 have been lost to follow-up in previous years. The mean age at diagnosis was 7.2 ± 12.3 years, and the mean age of 34 alive patients by the end of 2019 was 22.6 ± 13.2 years. Patients most commonly presented at diagnosis with acute or persistent respiratory symptoms (46.2%), failure to thrive or malnutrition (40.4%), and dehydration or electrolyte imbalance (32.7%). Sweat chloride levels were diagnostic (above 60 mmol/L) in 81.8% of examined patients. The most common identified mutation was p.Phe508del (F508del) (45.2%), followed by p.Leu346Pro (L346P) (6.7%), a mutation detected solely in individuals of Cypriot descent. The mean BMI and FEV1 z-scores were 0.2 ± 1.3 and - 2.1 ± 1.7 across all age groups, respectively, whereas chronic Pseudomonas aeruginosa colonization was noted in 26.9% of patients. The majority of patients (74.5%) were eligible to receive at least one of the available CFTR modulator therapies. In 25% of patients we recovered rare or unique genotypic profiles, including the endemic p.Leu346Pro (L346P), the rare CFTR-dup2, the co-segregated c.4200_4201delTG/c.489 + 3A > G, and the polymorphism p.Ser877Ala. CONCLUSIONS: CF patient registries are particularly important in small or isolated populations, such as in Cyprus, with rare or unique disease cases. Their operation is necessary for the optimization of clinical care provided to CF patients, enabling their majority to benefit from evolving advances in precision medicine.


Assuntos
Regulador de Condutância Transmembrana em Fibrose Cística , Fibrose Cística , Adolescente , Adulto , Criança , Fibrose Cística/genética , Regulador de Condutância Transmembrana em Fibrose Cística/genética , Demografia , Humanos , Laboratórios , Mutação/genética , Sistema de Registros , Adulto Jovem
12.
J Nepal Health Res Counc ; 19(2): 343-348, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34601528

RESUMO

BACKGROUND: Road traffic accidents are the leading cause of deaths worldwide among children and young adults aged between 5 to 29 years. The risk of road traffic accident-related death is higher in low-income countries. Thus, we aim to evaluate the epidemiology of road traffic accidents in Nepal during the fiscal years from 2009/10 to 2019/20. METHODS: This study is a secondary data analysis of the published police records publicly available on the official webpage of Nepal Police. A study was carried out after written permission from Nepal Police. The data obtained were analysed using Microsoft Excel-13. RESULTS: Analysing available data about reported road traffic accidents events showed an increasing trend in road traffic accidents from the fiscal years 2011/12 till 2019/20, with a steeper increase in the number of road traffic accidents in fiscal years 2017/18 and 2019/20. In fiscal years 2009/10, 11,747 vehicles collided; which rose to 25,788 in the fiscal years 2019/20. More cases of road traffic accidents were reported to occur from 12 noon-6 pm in a day. Among reported road traffic accidents commonest predispositions behind road traffic accidents was the negligence of driver followed by over speed. Among those individuals who died due to road traffic accidents, most of them were male. CONCLUSIONS: We found an increasing trend of road traffic accidents, vehicle collisions, and injuries in Nepal over the past ten years especially among two-wheelers and four-wheelers like the car, bus, and autorickshaw.


Assuntos
Acidentes de Trânsito , Adolescente , Adulto , Criança , Pré-Escolar , Análise por Conglomerados , Humanos , Masculino , Nepal/epidemiologia , Pobreza , Adulto Jovem
13.
BMC Med Imaging ; 21(1): 143, 2021 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-34602051

RESUMO

BACKGROUND: This study aimed to compare the performance and interobservers agreement of cases with findings on chest CT based on the British Society of Thoracic Imaging (BSTI) guideline statement of COVID-19 and the Radiological Society of North America (RSNA) expert consensus statement. METHODS: In this study, 903 patients who had admitted to the emergency department with a pre-diagnosis of COVID-19 between 1 and 18 July 2020 and had chest CT. Two radiologists classified the chest CT findings according to the RSNA and BSTI consensus statements. The performance, sensitivity and specificity values of the two classification systems were calculated and the agreement between the observers was compared by using kappa analysis. RESULTS: Considering RT-PCR test result as a gold standard, the sensitivity, specificity and positive predictive values were significantly higher for the two observers according to the BSTI guidance statement and the RSNA expert consensus statement (83.3%, 89.7%, 89.0%; % 81.2,% 89.7,% 88.7, respectively). There was a good agreement in the PCR positive group (κ: 0.707; p < 0.001 for BSTI and κ: 0.716; p < 0.001 for RSNA), a good agreement in the PCR negative group (κ: 0.645; p < 0.001 for BSTI and κ: 0.743; p < 0.001 for RSNA) according to the BSTI and RSNA classification between the two radiologists. CONCLUSION: As a result, RSNA and BSTI statement provided reasonable performance and interobservers agreement in reporting CT findings of COVID-19. However, the number of patients defined as false negative and indeterminate in both classification systems is at a level that cannot be neglected.


Assuntos
COVID-19/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Consenso , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/virologia , Valor Preditivo dos Testes , Estudos Retrospectivos , SARS-CoV-2 , Sensibilidade e Especificidade , Sociedades Médicas , Turquia
14.
Trials ; 22(1): 676, 2021 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-34602065

RESUMO

BACKGROUND: High-quality evidence supports the integration of exercise to mitigate treatment-related side effects in a wide range of paediatric and adult cancer cohorts. However, the implementation of exercise in adolescent and young adult (AYA) cancer patients is yet to be explored in depth. FiGHTINGF!T is a randomised controlled cross over trial designed to determine if a supervised, structured, and progressive exercise programme can reduce the decline in physical fitness (V02peak) associated with cancer treatment in AYAs from diagnosis. METHODS/DESIGN: A total of 40 AYAs recently diagnosed and due to commence systemic treatment (± 2 weeks) for a primary haematological malignancy or solid tumour will be recruited and randomised to either an immediate exercise intervention or usual care (delayed exercise) for 10 weeks. This randomised controlled crossover trial will see both groups engage in a supervised exercise intervention from either diagnosis (baseline assessment) for 10 weeks (0-10 weeks) or following an interim assessment to 20 weeks (10-20 weeks). The bi-weekly tailored exercise programme will combine aerobic and resistance exercises and be supervised by an Accredited Exercise Physiologist. Participants will complete a range of assessments at 0, 10, and 20 weeks including cardiopulmonary exercise tests, 1 repetition maximum strength measures, physical functioning, and self-reported quality of life measurements. Patient-reported treatment-related toxicities will be recorded on a weekly basis. DISCUSSION: The FiGHTINGF!T trial will provide insight into the potential benefits of a supervised exercise programme in AYAs undergoing cancer treatment. This trial will contribute to the evidence supporting the necessary integration of exercise during cancer treatment, specifically in the under-reported AYA cohort. TRIAL REGISTRATION: This trial was registered retrospectively with the Australia New Zealand Clinical Trial registry ( ACTRN12620000663954 ). Registered on 10 June 2020.


Assuntos
Neoplasias , Qualidade de Vida , Adolescente , Criança , Exercício Físico , Terapia por Exercício , Humanos , Neoplasias/terapia , Aptidão Física , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Retrospectivos , Adulto Jovem
15.
BMC Musculoskelet Disord ; 22(1): 837, 2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34592975

RESUMO

INTRODUCTION: Ataluren is a relatively new treatment for male patients with Duchenne muscular dystrophy (DMD) due to a premature stop codon. Long-term longitudinal data as well as efficacy data on non-ambulant patients are still lacking. Here we present the results from a long-term follow-up study of all DMD patients treated with ataluren and followed at the Queen Silvia Children's Hospital in Gothenburg, Sweden, with focus on the evolution of patients' upper motor and respiratory function over time. METHODS: This is a retrospective longitudinal case-series study of all male DMD patients treated with ataluren and followed at the Queen Silvia Children's Hospital in Gothenburg, Sweden, since 2008. RESULTS: Our eleven patients had a median exposure to ataluren of 2312 days which is almost a fourfold higher than previous studies. Loss of ambulation occurred at a median age of 13.2 years. Patients who lost ambulation prior to 13.2 years of age had received ataluren for 5 years, whereas patients who continued to be ambulatory after 13.2 years of age had received ataluren for 6.5 years until loss of ambulation or last follow-up if still ambulatory. Four of six non ambulatory patients had Performance of the Upper Limb scores above the expected mean values over time. All but one patient maintained a pulmonary decline above the expected over time. All ambulatory patients increased in their predicted forced vital capacity (FVC) with 2.8 to 8.2% annually. Following loss of ambulation, 5 of 6 patients declined in predicted FVC (%), with annual rate of decline varying from 1.8 to 21.1%. The treatment was safe and well tolerated throughout the follow-up period. CONCLUSIONS: This is the first study to present long-term cumulative treatment outcomes over a median period of 6.3 years on ataluren treatment. Our results indicate a delay in loss of ambulation, as well as a slower decline in FVC and upper limb motor function even after loss of ambulation. We suggest that treatment with ataluren should be initiated as soon as the diagnosis is confirmed, closely monitored and, in case of sustainable benefit, continued even after loss of ambulation.


Assuntos
Distrofia Muscular de Duchenne , Oxidiazóis , Adolescente , Criança , Pré-Escolar , Seguimentos , Humanos , Masculino , Distrofia Muscular de Duchenne/diagnóstico , Distrofia Muscular de Duchenne/epidemiologia , Distrofia Muscular de Duchenne/terapia , Estudos Retrospectivos , Suécia/epidemiologia
16.
Trials ; 22(1): 669, 2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34593015

RESUMO

BACKGROUND: Treatment guidelines recommend behaviour therapy (BT) for patients with Tourette syndrome (TS) and chronic tic disorder (CTD). However, BT is rarely accessible due to limited availability of trained therapists and long travel distances to specialist clinics. Internet-delivered BT has the potential of overcoming these barriers through remote delivery of treatment with minimal therapist support. In the current protocol, we outline the design and methods of a randomised controlled trial (RCT) evaluating an internet-delivered BT programme referred to as BIP TIC. The trial's primary objective is to determine the clinical efficacy of BIP TIC for reducing tic severity in young people with TS/CTD, compared with an active control intervention. Secondary objectives are to investigate the 12-month durability of the treatment effects and to perform a health economic evaluation of the intervention. METHODS: In this single-blind superiority RCT, 220 participants (9-17 years) with TS/CTD throughout Sweden will be randomised to 10-12 weeks of either therapist-supported internet-delivered BT based on exposure with response prevention (BIP TIC) or therapist-supported internet-delivered education. Data will be collected at baseline, 3 and 5 weeks into the treatment, at post-treatment, and 3, 6, and 12 months post-treatment. The primary endpoint is the 3-month follow-up. The primary outcome is tic severity as measured by the Yale Global Tic Severity Scale - Total Tic Severity Score. Treatment response is operationalised as scores of "Very much improved" or "Much improved" on the Clinical Global Impression - Improvement scale, administered at the primary endpoint. Outcome assessors will be blind to treatment condition at all assessment points. A health economic evaluation of BIP TIC will be performed, both in the short term (primary endpoint) and the long term (12-month follow-up). There are no planned interim analyses. DISCUSSION: Participant recruitment started on 26 April 2019 and finished on 9 April 2021. The total number of included participants was 221. The final participant is expected to reach the primary endpoint in September 2021 and the 12-month follow-up in June 2022. Data analysis for the primary objective will commence after the last participant reaches the primary endpoint. TRIAL REGISTRATION: ClinicalTrials.gov NCT03916055 . Registered on 16 April 2019.


Assuntos
Síndrome de Tourette , Adolescente , Terapia Comportamental , Criança , Análise Custo-Benefício , Humanos , Internet , Ensaios Clínicos Controlados Aleatórios como Assunto , Método Simples-Cego , Síndrome de Tourette/diagnóstico , Síndrome de Tourette/terapia , Resultado do Tratamento
17.
BMJ Case Rep ; 14(9)2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34593545

RESUMO

We present the case of a fifteen-year-old achondroplastic (ACH) woman who requested to have her femurs lengthened by intramedullary nails. She had undergone bilateral tibial lengthening at the age of eleven and presented with a varus deformity of the right lower limb, lateral thrust of the right knee and valgus deformity of the left lower limb. We performed deformity analyses based on mechanical axis measurements, and we came with a staged surgical plan. In ACH adolescences, correction of bony deformity needs to encounter continuous fibula growth dynamics. Lateral knee thrust was corrected by gradual distal translation of the fibula head via an Ilizarov frame and the amount of translation we decided clinically. Tibial lengthening and valgus osteotomy of the distal femur accentuate lateral collateral ligament (LCL) complex laxity. In patients with ACH, tibial lengthening and valgus osteotomy of the distal femur-if needed-should precede LCL complex tightening, and femoral lengthening should follow.


Assuntos
Alongamento Ósseo , Adolescente , Feminino , Fêmur/diagnóstico por imagem , Fêmur/cirurgia , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Osteotomia , Tíbia/diagnóstico por imagem , Tíbia/cirurgia
18.
Dev Psychol ; 57(4): 548-556, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34594056

RESUMO

The role of early child care experiences on the development of the mother-child attachment relationship has been studied extensively. However, no prospective studies of early child care have addressed how these experiences might be reflected in the content of attachment representations during adolescence and beyond. The goal of this study was to estimate relatively precise associations between child care quality, child care quantity, and type of care in the first 54 months of life and the content of adolescents' attachment representations around age 18 years (N = 857; 51% female; 78% White, non-Hispanic; M income-to-needs ratio = 4.13), leveraging data from the longitudinal NICHD Study of Early Child Care and Youth Development (SECCYD). We identified a small positive association between the observed quality of early child care (but not quantity or type of care) and secure attachment states of mind as measured by the Adult Attachment Interview (but not the Attachment Script Assessment) at age 18 years that was robust to demographic covariates and observations of maternal and paternal sensitivity during childhood. We observed no significant interactions among child care variables. Associations between early child care experiences and indicators of adolescent attachment were likewise not moderated by maternal sensitivity from infancy to mid-adolescence or by maternal reports of child temperament in early childhood.


Assuntos
Cuidado da Criança , National Institute of Child Health and Human Development (U.S.) , Adolescente , Adulto , Criança , Desenvolvimento Infantil , Pré-Escolar , Feminino , Humanos , Masculino , Relações Mãe-Filho , Apego ao Objeto , Estados Unidos
19.
J Med Microbiol ; 70(10)2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34596013

RESUMO

Introduction. Pseudomonas aeruginosa produces quorum sensing signalling molecules including 2-alkyl-4-quinolones (AQs), which regulate virulence factor production in the cystic fibrosis (CF) airways.Hypothesis/Gap statement. Culture can lead to condition-dependent artefacts which may limit the potential insights and applications of AQs as minimally-invasive biomarkers of bacterial load.Aim. We aimed to use culture-independent methods to explore the correlations between AQ levels and live P. aeruginosa load in adults with CF.Methodology. Seventy-five sputum samples at clinical stability and 48 paired sputum samples obtained at the beginning and end of IV antibiotics for a pulmonary exacerbation in adults with CF were processed using a viable cell separation technique followed by quantitative P. aeruginosa polymerase chain reaction (qPCR). Live P. aeruginosa qPCR load was compared with the concentrations of three AQs (HHQ, NHQ and HQNO) detected in sputum, plasma and urine.Results. At clinical stability and the beginning of IV antibiotics for pulmonary exacerbation, HHQ, NHQ and HQNO measured in sputum, plasma and urine were consistently positively correlated with live P. aeruginosa qPCR load in sputum, compared to culture. Following systemic antibiotics live P. aeruginosa qPCR load decreased significantly (P<0.001) and was correlated with a reduction in plasma NHQ (plasma: r=0.463, P=0.003).Conclusion. In adults with CF, AQ concentrations correlated more strongly with live P. aeruginosa bacterial load measured by qPCR compared to traditional culture. Prospective studies are required to assess the potential of systemic AQs as biomarkers of P. aeruginosa bacterial burden.


Assuntos
4-Quinolonas/isolamento & purificação , Fibrose Cística/complicações , Infecções por Pseudomonas/complicações , Pseudomonas aeruginosa/isolamento & purificação , Percepção de Quorum , 4-Quinolonas/sangue , 4-Quinolonas/urina , Adolescente , Adulto , Carga Bacteriana , Biomarcadores , Fibrose Cística/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Pseudomonas/microbiologia , Reação em Cadeia da Polimerase em Tempo Real , Escarro/química , Adulto Jovem
20.
Euro Surveill ; 26(39)2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34596019

RESUMO

BackgroundAcross the World Health Organization European Region, there are few estimates of the proportion of people seeking medical care for influenza-like illness or acute respiratory infections and who have laboratory-confirmed seasonal influenza infection.MethodsWe conducted a meta-analysis of data extracted from studies published between 2004 and 2017 and from sentinel data from the European surveillance system (TESSy) between 2004 and 2018. We pooled within-season estimates by influenza type/subtype, setting (outpatient (OP)/inpatient (IP)) and age group to estimate the proportion of people tested who have laboratory-confirmed and medically-attended seasonal influenza in Europe.ResultsIn the literature review, the pooled proportion for all influenza types was 33% (95% confidence interval (CI): 30-36), higher among OP 36% (95% CI: 33-40) than IP 24% (95% CI: 20-29). Pooled estimates for all influenza types by age group were: 0-17 years, 26% (22-31); 18-64 years, 41% (32-50); ≥ 65 years, 33% (27-40). From TESSy data, 33% (31-34) of OP and 24% (21-27) of IP were positive. The highest proportion of influenza A was in people aged 18-64 years (22%, 16-29). By subtype, A(H1N1)pdm09 was highest in 18-64 year-olds (16%, 11-21%) whereas A(H3N2) was highest in those ≥ 65 years (10%, 2-22). For influenza B, the highest proportion of infections was in those aged 18-64 years (15%, 9-24).ConclusionsLaboratory-confirmed influenza accounted for approximately one third of all acute respiratory infections for which medical care was sought during the influenza season.


Assuntos
Vírus da Influenza A Subtipo H1N1 , Vacinas contra Influenza , Influenza Humana , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Vírus da Influenza A Subtipo H3N2 , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , Laboratórios , Estações do Ano , Vigilância de Evento Sentinela , Organização Mundial da Saúde
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