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Background There is a co-occurrence of adolescents' substance use and sexual practices, with an important impact on their health and health behaviours; however, limited research is conducted with adolescents. The aim of this study was to estimate the prevalence of substance use (alcohol and/or other substances) in sexual contexts and to identify its associated factors among adolescents, comparing boys and girls. Methods Cross-sectional study with data from 6352 adolescents aged 14----18years from the DESKcohort project. Prevalence of alcohol and/or other substance use in sexual contexts (OSUSC) stratified by sex were calculated, according to axes of inequality, psychosocial factors, and sexual health and health variables. Poisson regression models with robust variance were calculated to analyse potential associations with independent variables. Results Girls (51.4% of the sample) reported a higher prevalence of alcohol use in sexual contexts than boys (43.9% vs 33.9%, P Conclusions These findings suggest that substance use in sexual contexts reflects a broader pattern of co-occurring risky behaviours rather than intentional sexualised substance use. Some vulnerable groups include girls, adolescents with a minority sexual orientation, and students with disadvantaged SEPs. These findings underscore the need for holistic interventions targeting adolescents' health, addressing substance use and sexual risk behaviours simultaneously to reduce potential consequences such as unplanned pregnancies and sexually transmitted infections.
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Conducta del Adolescente , Conducta Sexual , Trastornos Relacionados con Sustancias , Humanos , Adolescente , Masculino , Femenino , Trastornos Relacionados con Sustancias/epidemiología , Estudios Transversales , Conducta Sexual/estadística & datos numéricos , Prevalencia , Conducta del Adolescente/psicología , Consumo de Bebidas Alcohólicas/epidemiología , Factores Sexuales , Asunción de RiesgosRESUMEN
BACKGROUND: There is increasing interest in screening for adverse childhood experiences in pediatric primary care, but no evidence of the actual consequences on behavioral/mental health services. This study tested the association between initiation of ACEs screening in pediatric primary care and changes in the rate of referrals to social work and visits to social work and behavioral health. METHODS: Data came from the electronic health records of children and adolescents between 2 and 18 years old who were members of a large integrated healthcare system serving Southern California (N = 513,812). Poisson regression was used to compare the rate of referrals and visits to social work and behavioral health visits for clinics doing standardized ACEs screening (i.e., intervention clinics; n = 28) versus clinics not screening (i.e., control clinics; n = 64) during June 1-December 31 2022 as well as for these same months in 2020 and 2021. RESULTS: Intervention clinics had an average screening rate of 57% (range 26.8 to 91.9%) and an average positive screen rate of 11% (range 1.6-25.1%). The difference in the adjusted rate from 2021 to 2022 was significantly different between intervention and control clinics for referrals to social work (RR 1.48, 95% CI 1.25, 1.74), but was not statistically different for visits to social work or behavioral health. CONCLUSIONS: The findings suggest that ACEs screening does not significantly increase the rates of social work and behavioral health visits, although it did increase referrals to social work. We acknowledge that this may vary based on geographic areas and populations served by different healthcare systems.
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Experiencias Adversas de la Infancia , Tamizaje Masivo , Atención Primaria de Salud , Derivación y Consulta , Servicio Social , Humanos , Niño , Adolescente , Preescolar , Masculino , Femenino , Derivación y Consulta/estadística & datos numéricos , Experiencias Adversas de la Infancia/estadística & datos numéricos , California , Servicios de Salud Mental/estadística & datos numéricosRESUMEN
Congenital heart disease (CHD) is the most common birth defect and is associated with significant morbidity and mortality. With advances in medical management and surgical techniques, most individuals with CHD now live into adulthood. Many children and adults with CHD face ongoing medical, developmental, psychological, and psychosocial challenges. Recognizing and mitigating neurodevelopmental abnormalities is an important component of the holistic care of children and adults with CHD. This article outlines the scope of neurodevelopmental abnormalities seen in children and young adults with CHD, individual risk stratification, screening and evaluation recommendations, and emerging strategies to improve neurodevelopmental outcomes. Pediatricians play a central role in identifying high-risk patients and referring for neurodevelopmental evaluation, screening low-risk patients, supporting neuroprotective practices in hospitalized patients, coordinating developmental services, and supporting children and families as they navigate the sequalae of CHD. [Pediatr Ann. 2025;54(2):e52-e56.].
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Cardiopatías Congénitas , Trastornos del Neurodesarrollo , Humanos , Cardiopatías Congénitas/complicaciones , Cardiopatías Congénitas/diagnóstico , Niño , Trastornos del Neurodesarrollo/etiología , Trastornos del Neurodesarrollo/diagnóstico , Adolescente , Medición de Riesgo/métodosRESUMEN
This randomized clinical trial aimed to evaluate the effect of selective caries removal in deep Class I cavities in posterior teeth followed or not by photobiomodulation (PBM) therapy at two different wavelengths on postoperative sensitivity. Baseline spontaneous and stimulated sensitivity scores of 33 vital permanent molars were determined by the participants using a numeric rating scale. The teeth had their affected dentine preserved and were randomly allocated into three groups (n = 11): selective removal of infected dentine (control), selective removal of infected dentine followed by infrared (IR; 810 nm) or red (R; 660 nm) laser irradiation. The teeth were restored with a two-step self-etch adhesive and nanoparticle composite layers, and followed by laser irradiation only for IR and R groups. Both spontaneous and stimulated sensitivity were recorded after 12 h, 7 days, and 14 days. Data were statistically analyzed by Kruskal-Wallis, Friedman, and Wilcoxon tests (p < 0.05). The pulp of all teeth positively responded to cold a stimulus. The control group presented a significant increase in spontaneous sensitivity at 12 h (p < 0.05), which decreased to the preoperative level after 14 days. In both IR and R groups, the sensitivity levels remained stable over time (p > 0.05). At both 7- and 14-day follow-ups, the spontaneous sensitivity for the IR group was significantly lower than the other groups (p < 0.05). In addition to preserving tooth sensitivity, selective deep caries removal can be associated with R or IR to respectively attenuate or completely resolve postoperative sensitivity within one week.
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Caries Dental , Sensibilidad de la Dentina , Terapia por Luz de Baja Intensidad , Humanos , Terapia por Luz de Baja Intensidad/métodos , Caries Dental/terapia , Sensibilidad de la Dentina/radioterapia , Femenino , Masculino , Adulto , Adulto Joven , Diente Molar/efectos de la radiación , AdolescenteRESUMEN
BACKGROUND: Chronic fatigue syndrome (CFS) is a chronic disease characterized by fatigue, complex symptoms and long duration. It incurs significant economic costs every year. Qigong Tuina therapy (QTT), a traditional Chinese therapy, is skilled in the treatment of fatigue. The objective of this study is to observe the effectiveness of QTT in treating patients with CFS. METHODS: A randomized controlled trial will recruit 128 patients with CFS. The patients will be allocated randomly in a 1:1 ratio to either the QTT group or the cognitive behavioral therapy (CBT) group. The interventions for both groups will be carried out once per week for 8 weeks. Then a 4 weeks follow-up will be conducted for all patients after the intervention. The primary outcome will be the changes in the Multidimensional Fatigue Inventory (MFI-20). Secondary outcomes will be measured by the 36-Item Short Form Health Survey (SF-36), Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), and functional magnetic resonance imaging (fMRI). The data will be analyzed at the baseline, 4 weeks into the intervention, at the end of the intervention, and 4 weeks after the intervention. The safety of interventions will be assessed after each treatment session. DISCUSSION: The trial aims to establish whether QTT is not inferior to CBT for CFS patients. This study provides vital information for an alternative and complementary therapy aimed at patients afflicted with CFS. ETHICS AND DISSEMINATION: Ethical approval was granted by Ethics Committee of Shanghai Municipal Hospital of Traditional Chinese Medicine (2023SHL-KY-100-02). The findings will be disseminated through publications, conferences, and briefs to professional organizations. TRIAL REGISTRATION: ChiCTR2400081828, Chinese Clinical Trial Registry. Registered on March 13, 2024.
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Síndrome de Fatiga Crónica , Qigong , Humanos , Síndrome de Fatiga Crónica/terapia , Qigong/métodos , Adulto , Femenino , Masculino , Persona de Mediana Edad , Adulto Joven , Terapia Cognitivo-Conductual/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto , AdolescenteRESUMEN
BACKGROUND: Asthma is a chronic disease characterized by airway inflammation and obstruction. Treatment aims to control symptoms with minimal medication, using disease-controlling and symptom-relieving drugs. Inhaled steroids and beta2 agonists are common treatments; however, their long-term use can cause side effects. Leukotriene receptor antagonists (LTRAs) are used in combination with inhaled steroids to manage asthma because of their anti-inflammatory and bronchodilatory effects. Combining LTRAs with Chungsangboha-tang (CSBHT), a Korean medicine, may enhance their efficacy. This study aimed to evaluate the potential of CSBHT as an adjunctive therapy for asthma management in a randomized, placebo-controlled, double-blind, multicenter clinical trial. METHODS: This randomized, placebo-controlled, double-blind, parallel-group, multicenter study aims to evaluate the efficacy and safety of CSBHT as an additional treatment for patients with asthma, particularly for those with LTRAs. Overall, 198 participants will be randomly divided into intervention and control groups, with the former receiving CSBHT thrice daily and the latter receiving a placebo. Follow-ups at weeks 0, 4, and 8 will include outcome measurements, medication dispensation, and adverse reaction monitoring. The primary outcome is the mean change in forced expiratory volume in one-second scores, with secondary outcomes including changes in peak expiratory flow, forced vital capacity, forced expiratory flow 25-75%, fractional exhaled nitric oxide, Asthma Control Test, Asthma Quality of Life Questionnaire, serum IgE, eosinophil count, C-reactive protein, rescue medication usage, and a descriptive analysis of the questionnaire on asthma symptoms in Korean medicine. Safety assessments will be conducted using laboratory tests, vital signs, and monitoring of adverse events. Economic evaluations will be conducted using either cost-minimization analysis or cost-utility analysis. DISCUSSION: This trial will evaluate the efficacy, safety, and cost-effectiveness of CSBHT as an add-on therapy to LTRAs to establish its potential as an adjuvant therapy in asthma management. TRIAL REGISTRATION: This study was registered in the Clinical Research Information Service of Korea (KCT0006005), on March 16, 2021.
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Asma , Medicamentos Herbarios Chinos , Antagonistas de Leucotrieno , Humanos , Asma/tratamiento farmacológico , Antagonistas de Leucotrieno/uso terapéutico , Antagonistas de Leucotrieno/farmacología , Método Doble Ciego , Adulto , Medicamentos Herbarios Chinos/uso terapéutico , Medicamentos Herbarios Chinos/farmacología , Quimioterapia Combinada , Masculino , Persona de Mediana Edad , Femenino , Adulto Joven , Anciano , Adolescente , República de CoreaRESUMEN
Antidromic atrioventricular re-entrant tachycardia (AVRT) is a rare clinically wide-QRS tachycardia that can often be misdiagnosed as ventricular tachycardia (VT). If the accessory pathway (AP) is slower than the normal atrioventricular (AV) junction, evidence of preexcitation will not appear on the surface electrocardiogram (ECG), which increases the difficulty of diagnosis. This report describes a 13-year-old male patient who was diagnosed with VT at a local hospital at the time of onset of palpitation. ECG revealed wide-QRS-complex tachycardia, and the ECG after the termination of palpitations was within the normal range of sinus rhythm. The patient was confirmed to have an AV accessory pathway on the left anterior free wall with Mahaim fiber features by intracardiac electrophysiological study at our hospital. Wide-QRS-complex tachycardia was confirmed to be antidromic AVRT. We treated the patient with catheter radiofrequency ablation, which eliminated tachycardia. By comparing the ECGs before and after the operation, we observed the hidden manifestation of the ventricular preexcitation wave. There was no recurrence after half a year of follow-up.
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Fascículo Atrioventricular Accesorio , Potenciales de Acción , Ablación por Catéter , Electrocardiografía , Técnicas Electrofisiológicas Cardíacas , Frecuencia Cardíaca , Preexcitación Tipo Mahaim , Taquicardia por Reentrada en el Nodo Atrioventricular , Humanos , Masculino , Adolescente , Fascículo Atrioventricular Accesorio/fisiopatología , Preexcitación Tipo Mahaim/diagnóstico , Preexcitación Tipo Mahaim/fisiopatología , Preexcitación Tipo Mahaim/cirugía , Taquicardia por Reentrada en el Nodo Atrioventricular/fisiopatología , Taquicardia por Reentrada en el Nodo Atrioventricular/diagnóstico , Taquicardia por Reentrada en el Nodo Atrioventricular/cirugía , Resultado del Tratamiento , Valor Predictivo de las Pruebas , Taquicardia Ventricular/diagnóstico , Taquicardia Ventricular/fisiopatologíaRESUMEN
BACKGROUND: Multimodal rehabilitation has shown good results in adults with temporomandibular disorder (TMD), but there is still doubt regarding the protocol's ideal format (face-to-face or online), and its effectiveness among adolescents. The purpose of this study is to describe a randomized clinical trial protocol of face-to-face and online multimodal rehabilitation, in adolescents with TMD, and to determine its effects on pain, peripheral oxygenation of the masseter muscle, and mandibular range of motion, kinesiophobia and parafunction. METHODS: A randomized, controlled clinical trial, blinded to statistical analyses, will be carried out, involving 26 adolescents, diagnosed with TMD. After randomization, the participants will be allocated into two groups: (1) telerehabilitation and (2) face-to-face treatment groups. Each group will undergo an initial assessment, followed by three treatment sessions, reassessment, and follow-up. Appointments and reassessments will be face-to-face, with instruments validated and adapted for adolescent age groups. The intervention protocol also aims at practicality, ease of execution, and strategies for the patient to easily self-manage and perform independently, adapted for face-to-face or online formats. The Diagnostic Criteria for Temporomandibular Disorders, physical and psychosocial aspects, algometry, near-infrared spectroscopy, and the Tampa scale for kinesiophobia will be used to assess the outcomes. DISCUSSION: It is expected that this study will contribute to online and face-to-face assessments and demonstrate the differences in the practice of rehabilitation of adolescents with TMD. Data will be published after the study is completed, and if the benefits are proven, care modalities may be implemented. TRIAL REGISTRATION: REBEC-RBR-5scd5tm, UTN code: U1111-1288-4495 . Registered on 19 May 2023.
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Terapia por Ejercicio , Manipulaciones Musculoesqueléticas , Ensayos Clínicos Controlados Aleatorios como Asunto , Trastornos de la Articulación Temporomandibular , Humanos , Trastornos de la Articulación Temporomandibular/rehabilitación , Trastornos de la Articulación Temporomandibular/terapia , Adolescente , Terapia por Ejercicio/métodos , Manipulaciones Musculoesqueléticas/métodos , Resultado del Tratamiento , Rango del Movimiento Articular , Telerrehabilitación , Educación del Paciente como Asunto/métodos , Femenino , Terapia Combinada , Masculino , Músculo Masetero/fisiopatología , Dolor Facial/rehabilitación , Dolor Facial/diagnóstico , Dolor Facial/terapiaRESUMEN
OBJECTIVE: This paper reviews the literature evaluating psychological treatments to improve sleep quality in young adult university students. METHOD: Participants (N = 6179) were young adult (aged 18-30 years) university students. Databases (PubMed, PsychInfo, EMBASE and Medline) were searched for randomized controlled trials evaluating psychological treatments for sleep disturbance in university students. The search date was 20 September 2024. RESULTS: 22 original trials met inclusion criteria. Meta-analysis showed that psychological interventions outperformed control groups (n = 14) on improving sleep quality (g = 0.50, 95%CI:0.26-0.73). There were significantly different effect sizes found between studies that evaluated cognitive behaviour therapy for insomnia (CBT-I; n = 6, g = 0.72, CI: 0.43-1.02) versus studies that evaluated mindfulness interventions (n = 5, g = 0.16, 95% CI: -0.18-0.51). CONCLUSIONS: Psychological treatments improve sleep quality for young adult university students. While CBT-I showed larger effect sizes than interventions focused on mindfulness, further research is needed to verify if this reflects a true difference in the efficacy of the interventions.
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Terapia Cognitivo-Conductual , Calidad del Sueño , Estudiantes , Humanos , Estudiantes/psicología , Universidades , Terapia Cognitivo-Conductual/métodos , Adulto Joven , Adolescente , Trastornos del Inicio y del Mantenimiento del Sueño/terapia , Trastornos del Inicio y del Mantenimiento del Sueño/psicología , Adulto , Atención Plena/métodos , MasculinoRESUMEN
BACKGROUND: This research investigates the worldwide influence of cardiovascular diseases (CVD) associated with low intake of seafood omega-3 fatty acids, based on data from the 2021 Global Burden of Disease Study. METHOD: The study evaluated the effects of insufficient seafood omega-3 fatty acid consumption on CVD at international, regional, and country levels. It analyzed variations across different demographics, including age and gender, and explored the relationship between disease burden and the Socio-Demographic Index (SDI). Additionally, it utilized an ARIMA model to predict the incidence of CVD connected to this dietary deficiency until 2050. RESULT: In 2021, diets deficient in seafood omega-3 fatty acids contributed to roughly 737.88 thousand deaths and 17.87 million disability-adjusted life years (DALYs) from CVD, with a noted decrease in this health impact over the period studied. The most substantial effects were seen in the elderly, particularly those aged 75 and above, with males experiencing a higher disease impact. Future forecasts suggest probable declines in disease rates across all SDI areas. However, nations in North Africa and the Middle East are projected to encounter growing difficulties related to CVD stemming from low seafood omega-3 intake by 2030 and 2050. CONCLUSION: These results highlight the critical need for preventive strategies against CVD and stress the significance of dietary management.
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Enfermedades Cardiovasculares , Ácidos Grasos Omega-3 , Alimentos Marinos , Humanos , Ácidos Grasos Omega-3/administración & dosificación , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control , Masculino , Femenino , Anciano , Persona de Mediana Edad , Adulto , Carga Global de Enfermedades/tendencias , Dieta , Predicción , Adulto Joven , Adolescente , Salud Global , Anciano de 80 o más Años , Años de Vida Ajustados por Discapacidad/tendencias , IncidenciaRESUMEN
PURPOSE: Research has shown that mind-body practices like meditation and yoga can improve quality of life among female cancer survivors. Yet, correlates of the likelihood to use these practices are unknown in the USA. The goal of this study was to use recent data from the 2022 National Health Interview Survey (NHIS) to establish the prevalence and correlates of meditation and yoga practices among female cancer survivors in the USA, as well as among survivors who report high or frequent anxiety. METHODS: Using data from the NHIS, we identified eligible female respondents who had reported being diagnosed with cancer (N = 1,945). We identified factors associated with meditation and yoga practice use through self-reported surveys. RESULTS: Our sample (N = 1945) was primarily White (82.9%), 65 years or older (55.2%), heterosexual (97.2%), lived in medium/small metro areas (35.3%) in the South (36.6%), did not report frequent or high anxiety (63.9%), 21.5% used meditation, and 16.8% used yoga. Our results showed that among female survivors with high or frequent anxiety, there were higher odds of using yoga among those living in large central metro areas or who reported other cancers. CONCLUSION: Use of meditation and yoga practices after cancer diagnosis remains uncommon. To best reach diverse survivors who may benefit from evidence-based mind-body practices, tailoring may be needed.
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Ansiedad , Supervivientes de Cáncer , Meditación , Neoplasias , Yoga , Humanos , Femenino , Meditación/métodos , Persona de Mediana Edad , Anciano , Estados Unidos , Ansiedad/epidemiología , Neoplasias/psicología , Neoplasias/terapia , Supervivientes de Cáncer/psicología , Prevalencia , Adulto , Calidad de Vida , Adulto Joven , Encuestas Epidemiológicas , AdolescenteRESUMEN
BACKGROUND: Iron-folate supplementation is a vital and economical approach to preventing iron deficiency anemia in pregnant women. The World Health Organization targets 70% compliance, while Ethiopia's 2030 National Nutrition Program-II aims for 50% of pregnant women receiving iron-folate for 90 days by 2023. Despite various initiatives, compliance in Ethiopia continues to be low. This study examined compliance with iron-folate supplementation and its influencing factors among pregnant women in Southern Ethiopia. METHODS: A multi-center cross-sectional study was conducted among 604 systematically selected pregnant women from April 1 to 30, 2022, using structured interviewer-administered questionnaires. Data were collected via the open data kit application and analyzed in the SPSS version 25 software. Bivariable and multivariable analyses were used to identify factors associated with compliance. An odds ratio with a 95% confidence interval was used to assess the direction and strength of the association. RESULTS: Iron-folate supplementation compliance was 47.7% [95% CI 43.71%, 51.68%]. Being an urban dweller [AOR: 2.8, 95% CI 1.70, 4.86], attending primary education [AOR: 2.0, 95% CI 1.13, 3.75], having secondary education or more [AOR: 5.3, 95% CI 2.83, 10.22], being multiparous [AOR: 1.9, 95% CI 1.05, 3.52], receiving home visits [AOR: 2.0, 95% CI 1.08, 3.83], receiving counseling on iron-folate [AOR: 2.5, 95% CI 1.30, 4.78], possessing good knowledge of iron-folate [AOR: 3.1, 95% CI 2.04, 4.72], and having a good understanding of anemia [AOR: 3.2, 95% CI 2.12, 4.88] were significantly associated with compliance. CONCLUSION: Iron-folate supplementation compliance among pregnant women in Southern Ethiopia is progressing towards the 2030 national nutrition program target, although it remains below World Health Organization recommendations. Therefore, it is crucial to strengthen home visits and counseling to enhance knowledge of Iron-folate and anemia, as well as ensure consistent intake of iron-folate.
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Anemia Ferropénica , Suplementos Dietéticos , Ácido Fólico , Humanos , Femenino , Embarazo , Estudios Transversales , Etiopía , Adulto , Ácido Fólico/administración & dosificación , Adulto Joven , Anemia Ferropénica/prevención & control , Hierro/administración & dosificación , Atención Prenatal , Cooperación del Paciente/estadística & datos numéricos , Adolescente , Mujeres EmbarazadasRESUMEN
BACKGROUND: The treatment of severe bleeding, stopping pregnancies, and other gynecologic conditions have all been addressed by women using traditional medicines and methods. Even though research has been done to explore these concerns more, evidence is limited in developing countries, particularly in Ethiopia Hence, this study sought to investigate the traditional treatments and remedies employed by women in pastoralist communities living in southwestern Ethiopia. OBJECTIVE: To explore and determine traditional medicines used for bleeding control and termination of pregnancy among Suri People, South West Ethiopia, 2022. METHOD: A mixed-method exploratory sequential study design was conducted at selected kebeles of Suri District, South West, Ethiopia, from February 1 to August 30, 2022. Convenience and purposive sampling techniques were implemented for quantitative and qualitative studies, respectively. SPSS version 26 and Atlas.ti version 22 software were used for data analysis for the quantitative and qualitative parts, respectively. RESULT: 60 People participated in the qualitative study and 350 women participated in the quantitative study, making a 100% response rate. Qualitatively Blood tree, Shawly tree, and Sitch lady were utilized for bleeding control, and, the root of banana, the root of maize, Quartum, Teteracycle with alcohol, boiled alcohol, soot grass leave olive and salty soil were used for pregnancy termination. Quantitatively the proportion of women who used traditional medicines for abortion, and bleeding control were 38%, and 36% respectively. Blood tree (28%),Shawly tree(38%), and Sitch lady(34%) were the most commonly reported traditional medicines or methods used for bleeding control. Similarly, the root of banana (15%), the root of maize (19%), Teteracycle with alcohol (14%), Quartum (17%), boiled alcohol (15%), and soot grass (20%). CONCLUSION: Suri women use various plants, alcohol, and drugs to interrupt pregnancy as well as blood and shawily trees to manage bleeding during (heavy menstrual, abortion, and postpartum periods). To help people use safe methods and avoid those that have a negative impact on mothers, it is imperative to investigate more about the value of these traditional methods. Further botanical study is recommended to scientifically evaluate the traditional medicine obtained from different plants.
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Medicinas Tradicionales Africanas , Humanos , Femenino , Etiopía , Embarazo , Adulto , Adulto Joven , Medicinas Tradicionales Africanas/métodos , Aborto Inducido , Persona de Mediana Edad , Investigación Cualitativa , Hemorragia Uterina/tratamiento farmacológico , AdolescenteRESUMEN
INTRODUCTION: Iron deficiency anaemia (IDA) accounts for nearly two-thirds of all anaemia cases globally. Despite the widespread use of iron supplementation, the optimal dose and duration for treating IDA remain unclear. In this study, we aimed to determine the most effective dose and duration of iron supplementation for improving haemoglobin (Hb) levels in children and adolescents (≤19 years) with IDA. METHODS: A systematic review and meta-analysis were conducted. We searched MEDLINE, Embase, CINAHL, and the Cochrane Library for peer-reviewed studies published between 2013 and 2024. The interventions included iron supplementation with a defined dose and duration of at least 30 days. Comparators were placebo, no treatment, or alternative regimens. The outcome was the change in Hb levels. Eligible studies included IDA cases diagnosed through ferritin level measurements in healthy individuals. Studies involving pregnant women or children with underlying conditions were excluded. A meta-analysis was performed using standardized mean differences to pool effect sizes for Hb improvement with 95% confidence intervals (CIs). Subgroup analyses were performed for different treatment durations (<3 months, 3-6 months, >6 months) and dosage categories (<5 mg/kg/day, 5-10 mg/kg/day, >10 mg/kg/day). A random-effects meta-regression model was used to determine the optimal dose and duration, accounting for known covariates affecting Hb improvement. RESULTS: A total of 28 studies with 8,829 participants from 16 countries were included. The pooled effect size for Hb improvement was 2.01 gm/dL (95% CI: 1.48-2.54, p < 0.001). Iron supplementation for less than 3 months showed the highest significant effect size (2.39 gm/dL, 95% CI: 0.72-4.07), followed by treatments exceeding 6 months (1.93 gm/dL, 95% CI: 0.09-3.77). The lowest effect size was observed in treatments lasting 3-6 months (1.58 gm/dL, 95% CI: 0.93-2.23). Low-dose iron supplementation (<5 mg/kg/day) demonstrated favourable trends in Hb improvement, particularly in individuals with lower baseline Hb levels. Oral ferrous sulphate had a significant effect (2.03 gm/dL, 95% CI: 1.24-2.82), while parenteral ferric Carboxymaltose showed consistent efficacy. CONCLUSION: Low-dose iron supplementation (<5 mg/kg/day) combined with treatment durations of either less than 3 months or more than 6 months, is optimal for improving Hb levels in children and adolescents with IDA. Tailoring treatment based on baseline Hb levels and anaemia severity is essential. These findings provide evidence to support updated guidelines on iron supplementation in paediatric and adolescent populations and inform national anaemia management programmes. TRIAL REGISTRATION: Prospero registration number: This study was registered with PROSPERO (CRD42024541773).
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Anemia Ferropénica , Suplementos Dietéticos , Hierro , Humanos , Anemia Ferropénica/tratamiento farmacológico , Anemia Ferropénica/sangre , Adolescente , Niño , Hierro/administración & dosificación , Hemoglobinas/análisis , Hemoglobinas/metabolismo , Femenino , Preescolar , Relación Dosis-Respuesta a Droga , Masculino , Resultado del TratamientoRESUMEN
To find and assess the effectiveness and safety of short-term Photobiomodulation (PBM) treatment in children with low-to-moderate myopia. Children with low-to-moderate myopia were recruited and divided into PBM or control groups based on whether they received PBM treatment. The PBM group underwent a three-month treatment with a 650 nm low-energy semiconductor laser, while the control group did not receive any therapeutic intervention. At the end of the trial, the changes in spherical equivalent refractive (SER) and axial length (AL) before and after treatment were compared between the PBM group and the control group to evaluate the effectiveness of PBM in preventing myopia. The best corrected visual acuity (BCVA), nerve fiber layer thickness (RNFLT), ganglion cell layer thickness (GCLT), central point retinal thickness (CPRT), 3-mm subfield central retinal thickness (3 mm-CRT), superficial retinal vascular density (SCP), and central choroid thickness (CCT) were self-compared to assess the safety of PBM. A total of 57 subjects were prospectively followed from October 2020 to September 2021, comprising 28 participants (56 eyes) in the PBM group and 29 participants (58 eyes) in the control group. After three months of treatment, the AL decreased by 0.07 ± 0.11 mm, and the SER decreased by -0.12 ± 0.39 D in the PBM group. However, both SER and AL increased in the control group. Furthermore, there were statistically significant differences between the PBM and control groups (p < 0.01). The BCVA, RNFLT, GCLT, CPRT, and 3 mm-CRT remained almost unchanged in the PBM group; The SCP decreased from 0.37 ± 0.03 to 0.35 ± 0.02 in the PBM group with a statistically significant difference before and after treatment (p = 0.045). The CCT increased from 255 ± 41 µm to 274 ± 29 µm in the PBM group without any significant difference before and after treatment. The administration of PBM significantly suppresses the elevation of AL and SER following a three-month duration. No significant adverse effects were observed on visual function and retinal morphology.Trial Registration: This study is registered at https://clinicaltrials.gov/ (registration number: NCT04604405).
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Terapia por Luz de Baja Intensidad , Miopía , Agudeza Visual , Humanos , Miopía/radioterapia , Miopía/fisiopatología , Terapia por Luz de Baja Intensidad/métodos , Masculino , Femenino , Niño , Agudeza Visual/efectos de la radiación , Estudios Prospectivos , Resultado del Tratamiento , Adolescente , Refracción Ocular/efectos de la radiación , Refracción Ocular/fisiología , Tomografía de Coherencia Óptica , Láseres de Semiconductores/uso terapéuticoRESUMEN
Previous research has documented that family-related supportive factors (e.g., family resilience) can protect adolescents from risky behaviors. However, the data regarding the potential psychological mechanism linking family resilience and non-suicidal self-injury (NSSI) remain scarce. This study aimed to explore the possible serial mediational roles of mindfulness and individual resilience in the relationship between family resilience and NSSI. A sample including 548 Chinese adolescents (Mage = 16.10, SD = 1.61; 50.9 % male) with a six-month interval and two waves (Time 1, T1 - September 25, 2023 - October 13, 2023; Time 2, T2 - March 9, 2024 - March 22, 2024) of follow-up was used in the present study. Results showed that, within the examined model, mindfulness at T2 mediated the relation between family resilience at T1 and NSSI at T2; individual resilience at T2 mediated the association between family resilience at T1 and NSSI at T2; and the relationship between family resilience at T1 and NSSI at T2 was fully serially mediated by mindfulness and individual resilience at T2. The findings suggest that family resilience may reduce the likelihood of NSSI by enhancing adolescents' mindfulness and individual resilience. Future interventions aimed at reducing NSSI may benefit from incorporating strategies to strengthen family resilience, promote mindfulness practices, and enhance individual resilience in adolescents.
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Familia , Atención Plena , Resiliencia Psicológica , Conducta Autodestructiva , Humanos , Adolescente , Masculino , Femenino , Conducta Autodestructiva/psicología , China , Familia/psicología , Encuestas y Cuestionarios , Conducta del Adolescente/psicología , Pueblos del Este de AsiaRESUMEN
Given the widespread occurrence of procrastination and its adverse association with well-being, investigating the individual variables that influence procrastination is a crucial matter. Previous research has identified dispositional mindfulness to be negatively associated with procrastination, but the underlying mechanisms driving this relationship remain unclear. In this study, the aim was to investigate whether the inverse relationship between dispositional mindfulness and procrastination could be explained by the mediating roles of trait anxiety and maladaptive perfectionism. In a cross-sectional survey, 126 participants (aged 18-33) completed the 15-Item Five-Facet Mindfulness Questionnaire, the State-Trait Anxiety Inventory-Trait Form, the Almost Perfect Scale-Revised, and the Pure Procrastination Scale. A parallel mediation model was tested to investigate the mediating role of self-reported maladaptive perfectionism and trait anxiety to explain the relationship between dispositional mindfulness and procrastination with a bootstrapped multivariate technique. The results revealed that maladaptive perfectionism significantly mediated the relationship between mindfulness and procrastination -indicating that dispositional mindfulness has a significant indirect effect on procrastination via decreased levels of maladaptive perfectionism. It was determined that 15% of the variance in procrastination was significantly explained by this model (R2 = .15, ß = -.39, B = -.83, 95% CI = [-1.18, -.48], p < .001]. As the study highlights the importance of maladaptive perfectionism to explain the link between mindfulness and procrastination, we suggest that future research could investigate the influence of mindfulness on procrastination via mindfulness-based interventions, and include measurements of both trait anxiety and maladaptive perfectionism across longitudinal or experimental designs to unpack causality with respect to our pattern of observed findings.
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Ansiedad , Atención Plena , Perfeccionismo , Procrastinación , Humanos , Masculino , Femenino , Adulto , Adolescente , Adulto Joven , Estudios Transversales , Ansiedad/psicología , Encuestas y Cuestionarios , AutoinformeRESUMEN
This study analyzed breast cancer patients treated with trastuzumab in Brazil's unified health system (SUS) from 2008 to 2015. A non-concurrent cohort study using SUS data applied propensity score matching to reduce bias between trastuzumab and non-trastuzumab groups. Survival probabilities were estimated via Kaplan-Meier, with subgroup analysis using the log-rank test. Hazard ratios (HR) were calculated using Cox proportional hazards models. Among 20,852 patients, the overall survival rate was 92%, with 94% in the trastuzumab group and 90% in the non-trastuzumab group. Younger, black patients and those in the North region had poorer survival. Advanced disease stages and palliative treatments were linked to higher mortality, while adjuvant therapy and radiotherapy were protective. During follow-up, 8.1% of patients died, with better outcomes observed in the trastuzumab group (p < 0.0001). Late initiation of trastuzumab (after 16 months) improved survival, especially in early stages (I and II). Invasive tumors and stage IV disease were associated with worse prognoses. The study demonstrates trastuzumab's effectiveness in SUS, underscores survival disparities related to sociodemographic factors, and emphasizes the need for early detection, equitable access, and optimized treatment timelines to improve outcomes in public healthcare.
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Antineoplásicos Inmunológicos , Neoplasias de la Mama , Trastuzumab , Estimación de Kaplan-Meier , Estudios de Cohortes , Brasil/epidemiología , Trastuzumab/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/mortalidad , Neoplasias de la Mama/radioterapia , Factores Sociodemográficos , Humanos , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Programas Nacionales de Salud/estadística & datos numéricos , Factores de Tiempo , Antineoplásicos Inmunológicos/uso terapéutico , Quimioterapia Adyuvante/estadística & datos numéricosRESUMEN
OBJECTIVE: To explore the efficacy and safety of acupuncture combined with atlantoaxial joint bone-setting therapy for the treatment of Tourette syndrome. METHODS: We randomly divided 600 patients at a ratio of 1â¶1â¶1 into three groups: group A (acupuncture combined with atlantoaxial joint bone setting therapy group), group B (acupuncture group), and group C (tiapride group). After two months of treatment, the Yale global tic severity scale (YGTSS) score reduction, improvement in social function impairment, clinical efficacy, and long-term efficacy in the three groups were compared. RESULTS: After treatment, in the analysis of YGTSS score reduction, social function impairment improvement, the clinical control rate, and long-term efficacy, the results were all Group A > Group B > Group C, with a statistically significant difference (P < 0.05). However, the total clinical efficacy of treatment in group A (94.9%) was not significantly different from that in group B (91.8%). Adverse reactions did not occur in groups A and B, and several adverse reactions occurred in 29% (n = 58) of the group C patients. CONCLUSION: Compared with traditional drug therapy, acupuncture combined with atlantoaxial joint bone setting therapy has better clinical and long-term efficacy. This treatment strategy can improve the social function of children and prevent adverse reactions to drugs.
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Terapia por Acupuntura , Síndrome de Tourette , Humanos , Síndrome de Tourette/terapia , Masculino , Femenino , Niño , Adolescente , Resultado del Tratamiento , Terapia Combinada , Puntos de Acupuntura , Adulto , Preescolar , Adulto JovenRESUMEN
Micronutrients have demonstrated promise in managing inattention and emotional dysregulation in children with attention-deficit/hyperactivity disorder (ADHD). One plausible pathway by which micronutrients improve symptoms is the gut microbiome. This study examines changes in fecal microbial composition and diversity after micronutrient supplementation in children with ADHD (N = 44) and highlights potential mechanisms responsible for the behavioral improvement, as determined by blinded clinician-rated global improvement response to micronutrients. Participants represent a sub-group of the Micronutrients for ADHD in Youth (MADDY) study, a double blind randomized controlled trial in which participants received micronutrients or placebo for 8 weeks, followed by an 8-week open extension. Stool samples collected at baseline, week 8, and week 16 were analyzed using 16S rRNA amplicon sequencing targeting the V4 hypervariable region. Pairwise compositional analyses investigated changes in fecal microbial composition between micronutrients versus placebo and responders versus non-responders. A significant change in microbial evenness, as measured by alpha diversity, and beta-diversity, as measured by Bray-Curtis, was observed following micronutrients supplementation. The phylum Actinobacteriota decreased in the micronutrients group compared to placebo. Two butyrate-producing bacterial families: Rikenellaceae and Oscillospiraceae, exhibited a significant increase in change following micronutrients between responders versus non-responders. These findings suggest that micronutrients modulated the composition of the fecal microbiota and identified specific bacterial changes associated with micronutrient responders.