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1.
Siglo cero (Madr.) ; 54(4): 29-48, oct.-dic. 2024.
Artículo en Español | IBECS | ID: ibc-EMG-557

RESUMEN

Esta investigación busca profundizar en la segregación escolar del alumnado con necesidades educativas especiales del segundo ciclo de Educación Infantil estimando su magnitud, determinando la incidencia de la titularidad del centro y de su adscripción al Programa Bilingüe y describiendo su evolución. Para ello, se realiza un estudio ex post facto con datos de los 10.182 estudiantes del segundo ciclo de Educación Infantil matriculados en alguno de los 77 centros ordinarios públicos y privados-concertados situados en dos ciudades de tamaño medio-grande de la Comunidad de Madrid. Los resultados indican que la magnitud de la segregación escolar está en torno al 0.20 (ISG); que la incidencia de la titularidad es baja (4.6 %), pero es alta la del Programa Bilingüe (17.2 % de promedio); y que la segregación ha descendido ligeramente en los últimos años, pero las diferencias entre centros atendiendo a su titularidad y adscripción al Programa Bilingüe han crecido. Con ello, se concluye que hay que prestar atención a la segregación en Educación Infantil y tomar medidas para combatirla. También se destaca la necesidad de replantear el Programa Bilingüe por su incidencia en la segregación escolar. (AU)


This research aims to explore the school segregation of students with special educational needs in the second cycle of Early Childhood Education by estimating its magnitude, determining the incidence of school ownership and affiliation to the Bilingual Program, and describing its evolution. To achieve this, we conduct an ex post facto study with data from the 10,182 students enrolled in one of the 77 public and private-subsidised schools in the Community of Madrid. The results indicate that the magnitude of school segregation is around 0.20 (ISG); that the incidence of school ownership is low (4.6 %), while the incidence of the Bilingual Program is high (17.2 % on average); and that segregation has slightly decreased in recent years, however the differences between schools based on ownership and affiliation to the Bilingual Program have increased. Therefore, we conclude that it is necessary to address segregation in Early Childhood Education and that measures need to be taken to combat it. We also highlight the importance of reconsidering the Bilingual Program due to its impact on school segregation. (AU)


Asunto(s)
Humanos , Preescolar , Niño , Discapacidades para el Aprendizaje , Educación/estadística & datos numéricos
2.
Am J Trop Med Hyg ; 110(6): 1261-1262, 2024 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-38574555

RESUMEN

A 2-year-old boy presented to Kapsowar Mission Hospital in Kenya with a history of general tiredness associated with mild, unilateral epistaxis and one episode of hematemesis. On admission, he had a hemoglobin value of 3.5 g/dL, with a white cell count of 20.6 × 109/L. The child was examined by the physician on call, with no source of bleeding found. Later that day, after a local physician noted that the presentation could be due to an unrecognized leech infestation, a deep examination of the oropharynx was performed with a laryngoscope and revealed a leech attached deep in the oropharynx. The anesthetist visualized the leech with a laryngoscope and removed it with Magill forceps. After the procedure and blood transfusion, the child's hemoglobin level improved to 10.4 g/dL, and on the following day, the child was much improved in energy and was playing outside. He was discharged home on iron supplements and made a full recovery.


Asunto(s)
Anemia , Sanguijuelas , Orofaringe , Masculino , Humanos , Animales , Preescolar , Orofaringe/parasitología , Anemia/etiología , Anemia/parasitología , Transfusión Sanguínea
3.
Compr Psychiatry ; 132: 152483, 2024 07.
Artículo en Inglés | MEDLINE | ID: mdl-38631272

RESUMEN

BACKGROUND: Given the protective effect of nurturing caregivers and families for child and adolescent mental health, there is a need to review and synthesize research evidence regarding the effectiveness of parenting and family interventions in low and middle-income countries, including humanitarian settings. To advance practice, further understanding of the active ingredients of such interventions and implementation factors that lead to effectiveness are essential. METHOD: This systematic review, an update from a previous review, included studies on any parenting or family intervention for children and adolescents aged 0-24, living in a low- or middle-income country, that quantitatively measured child or adolescent mental health outcomes. We searched Global Health, PubMed, PsychINFO, PILOTS and the Cochrane Library databases on the 9th July 2020, and updated on the 12th August 2022. Risk of bias was assessed using an adapted version of the NIH Quality Assessment Tool. We extracted data on: effectiveness outcomes, practice elements included in effective interventions, and implementation challenges and successes. MAIN FINDINGS: We found a total of 80 studies (n = 18,193 participants) representing 64 different family or parenting interventions, 43 of which had evidence of effect for a child or adolescent mental health outcome. Only 3 studies found no effect on child, adolescent or caregiver outcomes. The most common practice elements delivered in effective interventions included caregiver psychoeducation, communication skills, and differential reinforcement. Key implementation strategies and lessons learned included non-specialist delivery, the engagement of fathers, and integrated or multi-sector care to holistically address family needs. PRELIMINARY CONCLUSIONS: Despite a high level of heterogeneity, preliminary findings from the review are promising and support the use of parenting and family interventions to address the wider social ecology of children in low resource and humanitarian contexts. There are remaining gaps in understanding mechanisms of change and the empirical testing of different implementation models. Our findings have implications for better informing task sharing from specialist to non-specialist delivery, and from individual-focused to wider systemic interventions.


Asunto(s)
Países en Desarrollo , Responsabilidad Parental , Humanos , Responsabilidad Parental/psicología , Adolescente , Niño , Salud Mental , Terapia Familiar/métodos , Trastornos Mentales/terapia , Trastornos Mentales/psicología , Preescolar , Adulto Joven
4.
Nutrients ; 16(7)2024 Mar 27.
Artículo en Inglés | MEDLINE | ID: mdl-38613005

RESUMEN

BACKGROUND: The identification of vitamin D (VitD) deficiency in pediatric populations is essential for preventive healthcare. We refined and tested the Evaluation of Deficiency Questionnaire (EVIDENCe-Q) for its utility in detecting VitD insufficiency among children. PATIENTS AND METHODS: We enrolled 201 pediatric patients (aged between 3 and 18 years). Clinical evaluation and serum vitamin D levels were assessed in all subjects. The EVIDENCe-Q was updated to incorporate factors influencing VitD biosynthesis, intake, assimilation, and metabolism, with scores spanning from 0 (optimal) to 36 (poor). RESULTS: We established scores for severe deficiency (<10 mg/dL) at 20, deficiency (<20 mg/dL) at 22, and insufficiency (<30 mg/dL) at 28. A score of 20 or greater was determined as the optimal cut-off for distinguishing VitD deficient from sufficient statuses, as evidenced by ROC curve analysis AUC = 0.7066; SE = 0.0841; sensitivity 100%, 95% CI 0.561-1. The most accurate alignment was seen with VitD insufficiency, defined as 25-OH-D3 < 20 ng/mL. CONCLUSIONS: This study confirms that the EVIDENCe-Q is a valid instrument for assessing the risk of vitamin D deficiency and insufficiency in children. It offers a practical approach for determining the need for clinical intervention and dietary supplementation of VitD in the pediatric population.


Asunto(s)
Deficiencia de Vitamina D , Humanos , Niño , Preescolar , Adolescente , Deficiencia de Vitamina D/diagnóstico , Deficiencia de Vitamina D/epidemiología , Vitamina D , Vitaminas , Ergocalciferoles , Calcifediol
5.
BMC Public Health ; 24(1): 960, 2024 Apr 04.
Artículo en Inglés | MEDLINE | ID: mdl-38575928

RESUMEN

BACKGROUND: Childhood malnutrition in all forms is a major public health issue worldwide. This review systematically examined the prevalence and determinants and identify the potential interventions and current gap in addressing malnutrition including undernutrition, overnutrition and micronutrient deficiencies (MNDs) in Vietnamese children aged 0-18 years old. METHODS: Embase, Scopus, PubMed, and Web of Science were systematically searched through June 2022 to identify relevant articles published within the past 25 years. Study selection and data extraction were performed by one reviewer and checked for accuracy by the other two reviewers in accordance with PRISMA guideline. Risk of publication bias was assessed using American Dietetic Association Quality Criteria Checklist. RESULTS: Seventy-two studies that met the inclusion criteria were included. Undernutrition has decreased over time but still 22.4%, 5.2% and 12.2% of children under 5 were stunted, wasted and underweight, respectively. Anaemia, iron, zinc, and vitamin D deficiencies were the more common forms of MNDs, the prevalence varied by age, region, and socioeconomic group. Population-based surveys reported that 11% and 48% of children aged 0-11 years old were iron and vitamin D deficient, respectively. Zinc deficiency affected almost one-quarter of the children and adolescents. Retinol deficiency was of less concern (< 20%). However, more evidence on MNDs prevalence is needed. Overweight and obesity is now on the rise, affecting one-third of school-aged children. The key determinants of undernutrition included living in rural areas, children with low birth weight, and poor socio-economic status, whereas living in urban and affluent areas, having an inactive lifestyle and being a boy were associated with increased risk of overweight and obesity. Nutrition specific intervention studies including supplementation and food fortification consistently showed improvements in anthropometric indices and micronutrient biomarkers. National nutrition-sensitive programmes also provided nutritional benefits for children's growth and eating behaviours, but there is a lack of data on childhood obesity. CONCLUSION: This finding highlights the need for effective double duty actions to simultaneously address different forms of childhood malnutrition in Vietnam. However, evidence on the potential intervention strategies, especially on MNDs and overnutrition are still limited to inform policy decision, thus future research is warranted.


Asunto(s)
Desnutrición , Hipernutrición , Adolescente , Niño , Preescolar , Humanos , Lactante , Recién Nacido , Hierro , Desnutrición/epidemiología , Desnutrición/complicaciones , Micronutrientes , Estado Nutricional , Hipernutrición/complicaciones , Hipernutrición/epidemiología , Sobrepeso/epidemiología , Obesidad Infantil/epidemiología , Prevalencia , Vietnam/epidemiología , Zinc
6.
Cereb Cortex ; 34(4)2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38602741

RESUMEN

Studies of the development and asymmetry of the corpus striatum and thalamus in early childhood are rare. Studies investigating these structures across the lifespan have not presented their changes during childhood and adolescence in detail. For these reasons, this study investigated the effect of age and sex factors on the development and asymmetry of the corpus striatum and thalamus in the 1-18 age group. In this retrospective study, we included 652 individuals [362 (56%) males] aged 1-18 years with normal brain MRI between 2012 and 2021. Absolute and relative volumes of the corpus striatum and thalamus were obtained by segmentation of three-dimensional T1-weighted MRIs with volBrain1.0. We created age-specific volume data and month-based development models with the help of SPSS (ver.28). The corpus striatum and thalamus had cubic absolute volumetric developmental models. The relative volume of the caudate and thalamus (only males) is consistent with the decreasing "growth" model, the others with the decreasing cubic model. The absolute volumes of the males' bilateral corpus striatum and thalamus and the relative volumes of the caudate and thalamus of the females were significantly larger (P < 0.05). The caudate showed right > left lateralization; putamen, globus pallidus, and thalamus showed left > right lateralization.


Asunto(s)
Cuerpo Estriado , Tálamo , Preescolar , Adolescente , Femenino , Masculino , Humanos , Lactante , Niño , Estudios Retrospectivos , Cuerpo Estriado/diagnóstico por imagen , Tálamo/diagnóstico por imagen , Putamen , Imagen por Resonancia Magnética
7.
Eur J Psychotraumatol ; 15(1): 2339702, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38629412

RESUMEN

Background: Imagery rescripting (ImRs) has shown to be an effective treatment for posttraumatic stress disorders (PTSD) resulting from childhood-related trauma. The current theory is that the change of meaning of the trauma memory is central to the treatment. Several authors have suggested that the expression of needs, feelings and actions may act as potential healing factors, but little specific research aimed at (in)validating this hypothesis has been done so far.Objective: In this study we investigated to what extent the expression of inhibited action tendencies and the fulfilling of needs lead to the reduction of PTSD symptoms in clients with early childhood trauma.Method: Recordings of 249 therapy sessions of 24 ImRs treatments were rated with an observation instrument developed for this purpose, after which the scores were related to pre and posttreatment symptoms, assessed with the Impact of Events Scale-Revised (IES-R).Results: Scores on the IES-R decreased from pretreatment to posttreatment. The two subscales of the NATS (At-scale and N-scale)significantly predicted the posttreatment scores on the IES-R after controlling for the influence of pretreatment IES-R scores: the better the expression of inhibited action tendencies and the better the fulfilling of needs, the lower the symptoms after treatment.Conclusions: This pilot study on the underlying mechanisms of ImRs in PTSD treatment has shown that the expression of action tendencies and fulfilling basic needs during ImRs are associated with a decrease in PTSD symptoms after treatment, and that actions and basic needs cannot be viewed separately. Follow-up research could focus on which of the six domains of the Needs and Action tendencies Scale (NATS) has the greatest effect on the reduction of PTSD symptoms. With this information we can further improve the ImRs protocol.


The pilot study of working mechanisms of imaginary rescripting shows that the NATS is a reliable research tool for observing expressed action tendencies and fulfilled needs.The better the action tendencies are expressed during treatment and the better the needs are fulfilled, the lower posttreatment symptoms.It seems useful if practitioners are specifically trained during the ImRs training in performing actions that lead to the fulfilment of basic needs.


Asunto(s)
Trastornos por Estrés Postraumático , Adulto , Humanos , Preescolar , Trastornos por Estrés Postraumático/terapia , Proyectos Piloto , Emociones , Imágenes en Psicoterapia/métodos , Resultado del Tratamiento
8.
PLoS One ; 19(4): e0300845, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38635826

RESUMEN

Cucurbita moschata (Butternut squash) seeds are a rich source of nutrition containing nutrients including iron, zinc, copper, calcium, potassium, and phosphorus. The aim of this study was to determine if Cucurbita Moschata squash seed paste improves zinc and iron status, anthropometric status, and dietary intake in preschool children. A pretest-posttest control group trial using cluster randomisation was conducted over 6 months. Four preschools were randomly assigned to receive 100 g of intervention or 100 g of a placebo as the control to enhance iron and zinc status. A total of 276 preschool children were recruited from eight government registered Early Childhood Development centres in Limpopo province, South Africa. The control group consumed Cucurbita moschata flesh twice-weekly, while the intervention group consumed Cucurbita moschata seed paste twice-weekly during a six-month period. Iron (serum iron, transferrin, transferrin saturation, ferritin) and zinc (serum zinc) status and anthropometric indices such as weight, height and mid upper arm circumference for children were evaluated at baseline and the endpoint. Iron and zinc-rich food consumption was measured using a 24-hour dietary recall and food record during the study, and dietary intake was estimated using a food frequency questionnaire which was conducted at the beginning and endpoint. The intervention group significantly improved in the mean serum iron 0.23 µg/dL (95% CI: 0.11;0.33); ferritin 0.21µg/dL (95% CI: 0.13;0.39), transferrin saturation 0.33% (0.23;0.74) and zinc 0.16 µmol/dl (95% CI: 0.13;0.25) at the end of the study. In addition, the intervention group exhibited greater mean weight for age of 0.13 z-score (95% CI: 0.28; 0.34) and weight for height of 0.04 z-score (95% CI: 0.12,0.05), as well as the consumption of iron (p < 0,001), zinc (p < 0,001), and vitamin C (p < 0.001). At the end of the trial, fiber (p < 0.001), riboflavin (p = 0.001), vitamin B6 (p < 0.001), and vitamin B12 (p < 0.001) were significantly higher in the control group. Thus, the inclusion of intervention in the diet of children in an impoverished area of South Africa improved the iron and zinc status of these children. This supplement could be a cost effective and sustainable approach to improve nutrient status in rural South Africa. Trial registration: Pan African Clinical Trial Registry (PACTR202308740458863).


Asunto(s)
Cucurbita , Hierro , Humanos , Preescolar , Zinc , Sudáfrica , Ferritinas , Semillas , Transferrina
9.
Ann Saudi Med ; 44(2): 111-115, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38615181

RESUMEN

BACKGROUND: Functional constipation (FC) is a common condition in children, and information on the clinical characteristics of FC in Saudi children is scarce. OBJECTIVE: Describe the clinical profile of FC in Saudi children. DESIGN: Retrospective. SETTING: Hospital that provides primary, intermediate and tertiary care. PATIENTS AND METHODS: All children diagnosed with FC according to the Rome IV criteria were included and had at least one follow-up clinic visit. Demographic and clinical data collected from medical records included the age at onset, duration of constipation, clinical features, treatment modalities, and factors associated with clinical response. Descriptive statistics and Pearson's chi-squared test were used in the statistical analysis to see how categorical study variables were linked to clinical response. A P value of ≤.05 was used to report statistical significance. MAIN OUTCOME MEASURE: Compliance and clinical response to polyethylene glycol (PEG) compared with lactulose. SAMPLE SIZE: 370 children from 0.1 to 13 years of age. RESULTS: The median (IQR) age of onset was 4 (5) years and less than one year in 14%. The median (IQR) duration of constipation was 4 months (11) and less than two months in 93/370 (25%). Abdominal pain was the most commonly associated feature (44%). Screening for celiac disease and hypothyroidism was negative. A Fleet enema was the most common disimpaction method (54%) and PEG was the most common maintenance medication (63.4%). PEG was significantly better tolerated (P=.0008) and more effective than lactulose (P<.0001). Compliance was the only variable significantly associated with clinical response. CONCLUSIONS: PEG was better tolerated and more effective than lactulose in our study, a finding in agreement with the literature. Therefore, PEG should be the drug of choice in the initial management of FC in Saudi children. Prospective studies on the causes of noncompliance are needed to improve the response to treatment. LIMITATIONS: The limitations of retrospective design are missing data, recall bias, and hospital-based limitation, such as missing milder cases treated at the outpatient level. However, the sample size of 370 may have minimized these limitations.


Asunto(s)
Estreñimiento , Lactulosa , Niño , Humanos , Preescolar , Lactulosa/uso terapéutico , Estudios Prospectivos , Estudios Retrospectivos , Arabia Saudita , Estreñimiento/diagnóstico , Estreñimiento/terapia , Polietilenglicoles/uso terapéutico
10.
Pol Merkur Lekarski ; 52(2): 161-170, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38642351

RESUMEN

OBJECTIVE: Aim: The purpose of the article is to form the parameters of vitamin D status in young children in the ethnic group of Kazakh nationality with the factor of highlighting the necessary recommendations for the prevention of hypovitaminosis D. PATIENTS AND METHODS: Materials and Methods: Methods for the study of the highlighted problem are the diagnosis of young children in the parameter of clinical and anamnestic research, which includes the collection of anamnestic data of children of Kazakh nationality within the framework of the identified data based on a questionnaire of parents, an evaluation component in the child's health factor at the level of his initial state, and laboratory analysis to determine 25(OH)D to identify the content of vitamin D using the method of electrochemiluminescent immunoassay. RESULTS: Results: Analysis of vitamin D levels revealed significant differences among age groups. In the 0-28-day group, average vitamin D was 13.35 ng/ml, with 92.8% deficient. In the 1-6-month group, it was 21.47 ng/ml, with 84% deficient. In the over 6-month group, it was 33.58 ng/ml, with 40% sufficient. Formula-fed children had the lowest levels (average 15.21 ng/ml), while breastfed children had insufficiency (average 23.91 ng/ml). Children with vitamin D supplementation averaged 25.9 ng/ml, compared to 19.01 ng/ml without supplementation. CONCLUSION: Conclusions: The results point to a widespread deficiency of vitamin D and offer practical recommendations for its prevention, such as creating a unified system of timely diagnosis, implementing preventive measures in pregnant women and young children, including a balanced diet enriched with vitamin D, staying outdoors in the bright hours of the day.


Asunto(s)
Deficiencia de Vitamina D , Vitaminas , Niño , Humanos , Femenino , Embarazo , Preescolar , Vitaminas/uso terapéutico , Vitamina D/uso terapéutico , Lactancia Materna , Encuestas y Cuestionarios
11.
Dev Psychobiol ; 66(2)2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38646069

RESUMEN

Choline and folate are critical nutrients for fetal brain development, but the timing of their influence during gestation has not been previously characterized. At different periods during gestation, choline stimulation of α7-nicotinic receptors facilitates conversion of γ-aminobutyric acid (GABA) receptors from excitatory to inhibitory and recruitment of GluR1-R2 receptors for faster excitatory responses to glutamate. The outcome of the fetal development of inhibition and excitation was assessed in 159 newborns by P50 cerebral auditory-evoked responses. Paired stimuli, S1, S2, were presented 500 msec apart. Higher P50 amplitude in response to S1 (P50S1microV) assesses excitation, and lower P50S2microV assesses inhibition in this paired-stimulus paradigm. Development of inhibition was related solely to maternal choline plasma concentration and folate supplementation at 16 weeks' gestation. Development of excitation was related only to maternal choline at 28 weeks. Higher maternal choline concentrations later in gestation did not compensate for earlier lower concentrations. At 4 years of age, increased behavior problems on the Child Behavior Checklist 1½-5yrs were related to both newborn inhibition and excitation. Incomplete development of inhibition and excitation associated with lower choline and folate during relatively brief periods of gestation thus has enduring effects on child development.


Asunto(s)
Colina , Potenciales Evocados Auditivos , Ácido Fólico , Humanos , Colina/farmacología , Colina/metabolismo , Femenino , Ácido Fólico/farmacología , Masculino , Recién Nacido , Embarazo , Potenciales Evocados Auditivos/fisiología , Potenciales Evocados Auditivos/efectos de los fármacos , Preescolar , Desarrollo Fetal/fisiología , Desarrollo Fetal/efectos de los fármacos , Transmisión Sináptica/fisiología , Transmisión Sináptica/efectos de los fármacos , Adulto , Edad Gestacional , Desarrollo Infantil/fisiología , Desarrollo Infantil/efectos de los fármacos
12.
BMC Ophthalmol ; 24(1): 191, 2024 Apr 25.
Artículo en Inglés | MEDLINE | ID: mdl-38664659

RESUMEN

BACKGROUND: To assess the age and timeline distribution of ocular axial length shortening among myopic children treated with photobiomodulation therapy in the real world situations. METHODS: Retrospective study of photobiomodulation therapy in Chinese children aged 4 to 13 years old where axial length measurements were recorded and assessed to determine effectiveness at two age groups (4 ∼ 8 years old group and 9 ∼ 13 years old group). Data was collected from myopic children who received photobiomodulation therapy for 6 ∼ 12 months. Effectiveness of myopia control was defined as any follow-up axial length ≤ baseline axial length, confirming a reduction in axial length. Independent t-test was used to compare the effectiveness of the younger group and the older group with SPSS 22.0. RESULTS: 342 myopic children were included with mean age 8.64 ± 2.20 years and baseline mean axial length of 24.41 ± 1.17 mm. There were 85.40%, 46.30%, 71.20% and 58.30% children with axial length shortening recorded at follow-up for 1 month, 3 months, 6 months and 12 months, respectively. With respect to the axial length shortened eyes, the mean axial length difference (standard deviation) was - 0.039 (0.11) mm, -0.032 (0.11) mm, -0.037 (0.12) mm, -0.028 (0.57) mm at 1, 3, 6, and 12-month follow-up, respectively. Greater AL shortening was observed among the older group who had longer baseline axial lengths than the younger group (P < 0.001). CONCLUSIONS: Overall myopia control effectiveness using photobiomodulation therapy was shown to be age and time related, with the maximum absolute reduction in axial elongation being cumulative.


Asunto(s)
Longitud Axial del Ojo , Terapia por Luz de Baja Intensidad , Miopía , Humanos , Estudios Retrospectivos , Niño , Femenino , Masculino , Miopía/fisiopatología , Miopía/radioterapia , Adolescente , Preescolar , Terapia por Luz de Baja Intensidad/métodos , Refracción Ocular/fisiología , Estudios de Seguimiento
13.
BMC Urol ; 24(1): 97, 2024 Apr 25.
Artículo en Inglés | MEDLINE | ID: mdl-38664686

RESUMEN

BACKGROUND: Overactive bladder is a common chronic urological disorder in children, liable to impact normal social activities, disrupt sleep and even impair self-esteem. We aimed to evaluate the efficacy and safety of solifenacin combined with biofeedback for paediatric overactive bladder. METHOD: Forty-five children with overactive bladder were enrolled and divided into three groups: 15 patients in Group A were treated with solifenacin, 15 cases in Group B with biofeedback, and the other 15 patients in Group C with the combination of solifenacin plus biofeedback. Each group was subdivided into the non-urge incontinence (non-UI) and urge incontinence (UI) groups. The remission rates were compared among the three groups at 2, 4, 8 and 12 weeks from the beginning of treatment. The side effects of solifenacin were recorded and followed up. RESULT: After 2 weeks since initial treatment, the complete response rates were 33.3% (5/15), 20.0% (3/15), and 53.3% (8/15) in the three groups. At 4 weeks, the complete remission rates were 46.7% (7/15), 33.3% (5/15), and 60.0% (9/15) respectively. Moreover, the complete remission rates of the UI groups were higher than the non-UI groups (p < 0.05). At 8 weeks, the complete response rates were 53.3% (8/15), 40.0% (6/15), and 67.7% (10/15). At 12 weeks, the complete response rates were 67.8% (10/15), 60.0% (9/15), and 86.7% (13/15). The complete response rates were higher and urodynamic parameters were improved obviously in group C than the other two groups (p < 0.05) during the follow-ups. The median voiding frequency decreased and median functional bladder capacity increased obviously in Group C after 4 weeks (p < 0.05). Dry mouth was observed in 2 patients (4.4%). 2 patients experienced constipation (4.4%), and neither case was severe. The symptoms of these four patients had relieved by reducing the dose of solifenacin. CONCLUSION: Solifenacin combined with biofeedback had good efficacy and compliance for children experiencing overactive bladder. It took only 2 weeks to achieve the complete response rate over 50%, especially for the improvement of UI symptoms.


Asunto(s)
Biorretroalimentación Psicológica , Succinato de Solifenacina , Vejiga Urinaria Hiperactiva , Humanos , Succinato de Solifenacina/uso terapéutico , Vejiga Urinaria Hiperactiva/tratamiento farmacológico , Vejiga Urinaria Hiperactiva/terapia , Niño , Femenino , Masculino , Resultado del Tratamiento , Terapia Combinada , Antagonistas Muscarínicos/uso terapéutico , Adolescente , Preescolar
14.
Emerg Infect Dis ; 30(5): 968-973, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38666613

RESUMEN

We conducted a large surveillance study among members of an integrated healthcare delivery system in Pacific Northwest of the United States to estimate medical costs attributable to medically attended acute gastroenteritis (MAAGE) on the day care was sought and during 30-day follow-up. We used multivariable regression to compare costs of MAAGE and non-MAAGE cases matched on age, gender, and index time. Differences accounted for confounders, including race, ethnicity, and history of chronic underlying conditions. Analyses included 73,140 MAAGE episodes from adults and 18,617 from children who were Kaiser Permanente Northwest members during 2014-2016. Total costs were higher for MAAGE cases relative to non-MAAGE comparators as were costs on the day care was sought and costs during follow-up. Costs of MAAGE are substantial relative to the cost of usual-care medical services, and much of the burden accrues during short-term follow-up.


Asunto(s)
Costo de Enfermedad , Prestación Integrada de Atención de Salud , Gastroenteritis , Costos de la Atención en Salud , Humanos , Gastroenteritis/epidemiología , Gastroenteritis/economía , Prestación Integrada de Atención de Salud/economía , Masculino , Femenino , Adulto , Niño , Preescolar , Estados Unidos/epidemiología , Adolescente , Persona de Mediana Edad , Costos de la Atención en Salud/estadística & datos numéricos , Adulto Joven , Lactante , Anciano , Enfermedad Aguda/epidemiología , Historia del Siglo XXI
15.
Sci Rep ; 14(1): 7744, 2024 04 02.
Artículo en Inglés | MEDLINE | ID: mdl-38565633

RESUMEN

This study aimed to determine the effects of resistance training combined with a probiotic supplement enriched with vitamin D and leucine on sestrin2, oxidative stress, antioxidant defense, and mitophagy markers in aged Wistar rats. Thirty-five male rats were randomly assigned to two age groups (old with 18-24 months of age and young with 8-12 weeks of age) and then divided into five groups, including (1) old control (OC: n = 5 + 2 for reserve in all groups), (2) young control (YC: n = 5), (3) old resistance training (OR: n = 5), (4) old resistance training plus supplement (ORS: n = 5), and old supplement group (OS: n = 5). Training groups performed ladder climbing resistance training 3 times per week for 8 weeks. Training intensity was inserted progressively, with values equal to 65, 75, and 85, determining rats' maximal carrying load capacity. Each animal made 5 to 8 climbs in each training session, and the time of each climb was between 12 and 15 s, although the time was not the subject of the evaluation, and the climbing pattern was different in the animals. Old resistance plus supplement and old supplement groups received 1 ml of supplement 5 times per week by oral gavage in addition to standard feeding, 1 to 2 h post training sessions. Forty-eight hours after the end of the training program, 3 ml of blood samples were taken, and all rats were then sacrificed to achieve muscle samples. After 8 weeks of training, total antioxidant capacity and superoxide dismutase activity levels increased in both interventions. A synergistic effect of supplement with resistance training was observed for total antioxidant capacity, superoxide dismutase, and PTEN-induced kinase 1. Sestrin 2 decreased in intervention groups. These results suggest that resistance training plus supplement can boost antioxidant defense and mitophagy while potentially decreasing muscle strength loss.


Asunto(s)
Condicionamiento Físico Animal , Probióticos , Entrenamiento de Fuerza , Humanos , Anciano , Ratas , Masculino , Animales , Lactante , Preescolar , Ratas Wistar , Antioxidantes/metabolismo , Entrenamiento de Fuerza/métodos , Mitofagia , Condicionamiento Físico Animal/fisiología , Estrés Oxidativo , Superóxido Dismutasa/metabolismo , Músculo Esquelético/metabolismo
16.
Pediatr Blood Cancer ; 71(6): e30966, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38556719

RESUMEN

BACKGROUND: Oral mucositis (OM) is a painful and common complication of hematopoietic stem cell transplant (HSCT). The Children's Oncology Group recently published guidelines recommending photobiomodulation (PBM) for preventing and treating OM in pediatric HSCT patients. However, this is a rarely used intervention in pediatric hospitals. PROCEDURE: Patients undergoing allogeneic HSCT, or autologous HSCT for a neuroblastoma diagnosis, had PBM administered from the first day of conditioning to transplant Day +20. We successfully developed a standardized treatment protocol and workflow to ensure consistent and uniform delivery of PBM. In addition, clinical patient data were compared before and after PBM implementation. RESULTS: The administration of PBM at our center was feasible, but required dedicated staff. A registered nurse (RN) was determined to be the best fit to deliver PBM. Sixty-two patients received PBM from October 2022 to September 2023; patients from 2021 before PBM implementation were used for comparison. Patients receiving PBM were more likely (p = .03) to engage in teeth brushing (56/62 = 90%) compared to baseline (61/81 = 75%). Mean days of OM decreased from 11.3 to 9 days; patients who received PBM were less likely (p < .001) to be discharged on total parental nutrition (TPN) (11/62 = 18%) compared to baseline (50/82 = 61%). OM-related supportive care costs (TPN and patient-controlled anesthesia [PCA]) were lower (p = .02) for those who received PBM (median cost = $31,229.87 vs. $37,370.66). CONCLUSION: PBM, as the standard of care in the pediatric HSCT population, is safe, feasible, and well-tolerated. At our center, a dedicated RN was critical to providing standardized treatment and ensuring sustainability.


Asunto(s)
Trasplante de Células Madre Hematopoyéticas , Terapia por Luz de Baja Intensidad , Estomatitis , Humanos , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Estomatitis/etiología , Estomatitis/prevención & control , Estomatitis/terapia , Niño , Masculino , Femenino , Terapia por Luz de Baja Intensidad/métodos , Preescolar , Adolescente , Acondicionamiento Pretrasplante/efectos adversos , Acondicionamiento Pretrasplante/métodos , Lactante , Estudios de Seguimiento , Pronóstico
17.
Obesity (Silver Spring) ; 32(6): 1179-1186, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38572577

RESUMEN

OBJECTIVE: This study aimed to examine associations of maternal folic acid supplementation (FAS) during pregnancy with childhood overweight or obesity (OWO) or adiposity. METHODS: In a population-based cohort of 1479 children, maternal FAS during pregnancy was assessed retrospectively by questionnaires. BMI and body fat percentages were measured at a mean age of 6.4 years. Pertinent factors were accounted for in data analyses. RESULTS: Maternal FAS during pregnancy was negatively associated with OWO (adjusted odds ratio: 0.70; 95% CI: 0.50 to 0.99). There were inverse associations of maternal FAS during pregnancy with BMI z score (ß: -0.22; 95% CI: -0.39 to -0.05), whole body fat percentage (ß: -1.28; 95% CI: -2.27 to -0.30), trunk fat percentage (ß: -1.41; 95% CI: -2.78 to -0.04), and limb fat percentage (ß: -1.31; 95% CI: -2.32 to -0.30). Stratified analyses found inverse associations of FAS during pregnancy with OWO, BMI z score, and body fat percentages predominantly among children without breastfeeding and whose parents had a below-tertiary educational level. CONCLUSIONS: This study provides novel evidence that maternal FAS during pregnancy was significantly associated with a decreased risk of childhood OWO and adiposity, particularly among children with no breastfeeding and lower parental educational level.


Asunto(s)
Índice de Masa Corporal , Suplementos Dietéticos , Ácido Fólico , Obesidad Infantil , Humanos , Femenino , Embarazo , Ácido Fólico/administración & dosificación , Niño , Estudios Retrospectivos , Masculino , Adiposidad , Sobrepeso , Adulto , Efectos Tardíos de la Exposición Prenatal , Preescolar , Fenómenos Fisiologicos Nutricionales Maternos , Lactancia Materna
18.
Appetite ; 198: 107356, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38636668

RESUMEN

Caregiver feeding practices during the complementary feeding period (6 months-2 years) may be particularly important for infants with Down syndrome (DS) as they are at higher risk for later health conditions (e.g., obesity, diabetes) that can be influenced by early feeding practices. However, how well caregivers of infants with DS are meeting infant feeding evidence-based practices is relatively unknown. Caregivers of infants with DS (N = 75) and caregivers of typically developing (TD) infants (N = 66) aged 0-2 years completed an online survey about their infant feeding practices and information sources. Caregiver practices and information sources were statistically compared between groups. Results indicated that there are significant differences in the feeding practices of caregivers of infants with DS when compared to caregivers of TD infants. Caregivers of infants with DS were less likely to meet infant feeding evidence-based practices than caregivers of TD infants. Caregivers of infants with DS were also more concerned about their infant's food intake and later weight status. Some individual feeding practices also significantly differed between groups, with caregivers of infants with DS more likely to meet evidence-based practices of purchasing iron rich foods and avoiding added salt, but less likely to use responsive feeding practices than caregivers of TD infants. Caregivers of infants with DS were also less likely to receive information about how to navigate the complementary feeding period than caregivers of TD infants. Coupled with existing research, the results of the present study suggest that infant feeding evidence-based practices should be reviewed for their appropriateness for this population and additional support for caregivers of infants with DS should be implemented to help them navigate this important period.


Asunto(s)
Cuidadores , Síndrome de Down , Conducta Alimentaria , Fenómenos Fisiológicos Nutricionales del Lactante , Humanos , Lactante , Cuidadores/psicología , Masculino , Femenino , Conducta Alimentaria/psicología , Adulto , Preescolar , Encuestas y Cuestionarios , Desarrollo Infantil , Recién Nacido , Alimentos Infantiles
19.
J Behav Ther Exp Psychiatry ; 84: 101957, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38574561

RESUMEN

BACKGROUND AND OBJECTIVES: ImRs, a technique targeting distressing mental images, has shown promise in adult psychiatric treatment. Initial research indicates positive outcomes in children, with potential for reducing mental health care burden. This pilot study examined the use of Imagery Rescripting (ImRs) as an intervention for children who have experienced negative life events. We aimed to assess short-term emotional changes, participant satisfaction, and the feasibility of a larger-scale ImRs intervention for children. METHODS: We employed a pre-posttest within-group design, and included 35 children (ages 5-18) who experienced negative life events, as well as 12 coaches. ImRs targeted distressing images related to negative events. Measurement tools included Visual Analogue Scales for distress and emotions, along with satisfaction surveys for both children and coaches. The feasibility of a larger-scale study was also explored through a coach questionnaire. RESULTS: We found significant short-term improvements for all emotional states, with large effects for anxiety, sadness, and happiness, and a moderate effect for anger. Children reported fair levels of satisfaction with the intervention's acceptability and complexity. Coaches expressed high levels of satisfaction with the intervention as a whole and with its characteristics. Coaches were also strongly motivation for future, more in-depth research. An important limitation of this pilot study was the lack of a control group. In light of the promising results, more extensive studies with diagnostic information, multiple measures, and follow-up assessments are warranted. CONCLUSION: Altogether, imagery rescripting based interventions seem a promising venue for children who experienced negative events.


Asunto(s)
Estudios de Factibilidad , Imágenes en Psicoterapia , Humanos , Proyectos Piloto , Femenino , Masculino , Adolescente , Niño , Imágenes en Psicoterapia/métodos , Preescolar , Satisfacción Personal , Satisfacción del Paciente , Acontecimientos que Cambian la Vida , Emociones/fisiología
20.
Eur J Endocrinol ; 190(5): 347-353, 2024 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-38652803

RESUMEN

BACKGROUND AND OBJECTIVE: Apparent mineralocorticoid excess (AME) syndrome is an ultra-rare autosomal-recessive tubulopathy, caused by mutations in HSD11B2, leading to excessive activation of the kidney mineralocorticoid receptor, and characterized by early-onset low-renin hypertension, hypokalemia, and risk of chronic kidney disease (CKD). To date, most reports included few patients, and none described patients from Israel. We aimed to describe AME patients from Israel and to review the relevant literature. DESIGN: Retrospective cohort study. METHODS: Clinical, laboratory, and molecular data from patients' records were collected. RESULTS: Five patients presented at early childhood with normal estimated glomerular filtration rate (eGFR), while 2 patients presented during late childhood with CKD. Molecular analysis revealed 2 novel homozygous mutations in HSD11B2. All patients presented with severe hypertension and hypokalemia. While all patients developed nephrocalcinosis, only 1 showed hypercalciuria. All individuals were managed with potassium supplements, mineralocorticoid receptor antagonists, and various antihypertensive medications. One patient survived cardiac arrest secondary to severe hyperkalemia. At last follow-up, those 5 patients who presented early exhibited normal eGFR and near-normal blood pressure, but 2 have hypertension complications. The 2 patients who presented with CKD progressed to end-stage kidney disease (ESKD) necessitating dialysis and kidney transplantation. CONCLUSIONS: In this 11-year follow-up report of 2 Israeli families with AME, patients who presented early maintained long-term normal kidney function, while those who presented late progressed to ESKD. Nevertheless, despite early diagnosis and management, AME is commonly associated with serious complications of the disease or its treatment.


Asunto(s)
Síndrome de Exceso Aparente de Mineralocorticoides , Humanos , Israel/epidemiología , Masculino , Femenino , Síndrome de Exceso Aparente de Mineralocorticoides/genética , Síndrome de Exceso Aparente de Mineralocorticoides/diagnóstico , Estudios Retrospectivos , Niño , Preescolar , 11-beta-Hidroxiesteroide Deshidrogenasa de Tipo 2/genética , Adolescente , Insuficiencia Renal Crónica/epidemiología , Insuficiencia Renal Crónica/terapia , Mutación , Hipertensión/epidemiología , Hipopotasemia , Adulto
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