ABSTRACT
Resumo Enquadramento: A hospitalização e a cirurgia são consideradas pela criança como eventos ameaçadores e com repercussões no seu comportamento, nomeadamente ansiedade e medo. Objetivo: Avaliar a efetividade de um filme preparatório para procedimentos a realizar antes de uma cirurgia de ambulatório visando a redução da ansiedade e medo. Metodologia: Estudo randomizado, controlado, envolvendo 60 crianças (6-14 anos), submetidas a cirurgia de ambulatório. O grupo de intervenção visualizou um filme no período pré-operatório e o grupo de controlo recebeu os cuidados habituais. A efetividade do filme foi medida através da escala de ansiedade Children's Anxiety Meter-State e o medo pela escala Children's Fear Scale. Resultados: Não se observaram diferenças significativas (p > 0,05) entre o grupo de intervenção que visualizou o filme e o grupo de controlo que seguiu os cuidados pré-operatórios habituais. Conclusão: Importa avaliar de forma precisa se os custos envolvidos nesta intervenção compensam os benefícios. Sugere-se mais investigação nesta área, ajustando outros programas que se revelem mais efetivos neste contexto.
Abstract Background: Children often perceive hospitalization and surgery as threatening events that can lead to feelings of anxiety and fear. These feelings may affect their behaviors. Objective: To evaluate the effectiveness of an educational video in reducing anxiety and fear before outpatient surgery. Methodology: A randomized controlled study was conducted with 60 children (6 - 14 years old) undergoing outpatient surgery. The intervention group watched an educational video during the preoperative period, while the control group received standard preoperative care. The effectiveness of the video was measured using the Children's Anxiety Meter-State scale, and fear was measured using the Children's Fear Scale. Results: No significant differences (p > 0.05) were found between the intervention group that watched the video and the control group that received standard preoperative care. Conclusion: An accurate assessment of whether the costs of this intervention outweigh the benefits is essential. Further research is recommended, particularly in adapting other programs that have proven more effective in this context.
Resumen Marco contextual: La hospitalización y la intervención quirúrgica son percibidas por el niño como acontecimientos amenazantes que repercuten en su comportamiento, concretamente en la ansiedad y el miedo. Objetivo: Evaluar la eficacia de una película preparatoria para los procedimientos que deben realizarse antes de la cirugía ambulatoria con el fin de reducir la ansiedad y el miedo. Metodología: Estudio aleatorizado y controlado en el que participaron 60 niños (de 6 a 14 años) sometidos a cirugía ambulatoria. El grupo de intervención vio una película en el periodo preoperatorio y el grupo de control recibió los cuidados habituales. La eficacia de la película se midió con la escala Children's Anxiety Meter-State y el miedo con la Children's Fear Scale. Resultados: No hubo diferencias significativas (p > 0,05) entre el grupo de intervención que vio la película y el grupo de control que siguió los cuidados preoperatorios habituales. Conclusión: Es importante evaluar con precisión si los costes de esta intervención compensan los beneficios. Se sugiere seguir investigando en este ámbito, ajustando otros programas que resulten más eficaces en este contexto.
ABSTRACT
Objetivo: analisar os fatores intervenientes na gerência do cuidado de enfermagem à criança hospitalizada com cardiopatia reumática. Método: estudo descritivo-exploratório com abordagem qualitativa, que utilizou a Teoria Fundamentada em Dados e o Interacionismo Simbólico, respectivamente, como referencial metodológico e teórico. A coleta de dados foi realizada em uma instituição especializada em atendimento cardiológico, no munícipio do Rio de Janeiro. Foram entrevistados 19 profissionais de enfermagem através de um roteiro semiestruturado. Resultado: emergiram os seguintes fatores intervenientes na prática da gerência do cuidado: condição socioeconômica da família, comportamento da criança, condições de trabalho, comunicação ineficaz, educação permanente, trabalho em equipe e experiência profissional. Conclusão: os resultados apontam para a necessidade de proposição de estratégias de ação e interação que facilitem a prática gerencial de cuidado à criança com cardiopatia reumática e sua família face aos fatores intervenientes identificados.
Objective: to analyze the factors involved in the management of nursing care for children hospitalized with rheumatic heart disease. Method: this is a descriptive-exploratory study with a qualitative approach, which used Data-Based Theory and Symbolic Interactionism, respectively, as methodological, and theoretical references. Data was collected in an institution specializing in cardiac care in the city of Rio de Janeiro. Nineteen nursing professionals were interviewed using a semi-structured script. Result: the following intervening factors in the practice of care management emerged: the family's socioeconomic status, the child's behavior, working conditions, ineffective communication, continuing education, teamwork, and professional experience. Conclusion: the results point to the need to propose strategies for action and interaction that facilitate management practice in caring for children with rheumatic heart disease and their families, given the intervening factors identified.
Objetivo: analizar los factores que intervienen en la gestión del cuidado de enfermería al niño hospitalizado con cardiopatía reumática. Método: estudio descriptivo-exploratorio con enfoque cualitativo, cuyos marcos metodológico y teórico fueron la Teoría Fundamentada y el Interaccionismo Simbólico, respectivamente. La recolección de datos se realizó en una institución especializada en atención cardiológica, en la ciudad de Río de Janeiro. Fueron entrevistados 19 profesionales de enfermería mediante un cuestionario semiestructurado. Resultado: surgieron los siguientes factores intervinientes en la práctica de la gestión del cuidado: condición socioeconómica de la familia, comportamiento del niño, condiciones de trabajo, comunicación ineficaz, educación continua, trabajo en equipo y experiencia profesional. Conclusión: los resultados indican que es necesario proponer estrategias de acción e interacción que faciliten la práctica de la gestión del cuidado al niño con cardiopatía reumática y a sus familiares, con respecto a los factores intervinientes identificados.
ABSTRACT
Over recent decades, anthropogenic forest fires have significantly altered vegetation dynamics in the Amazon region. While human activities primarily initiate these fires, their escalation is intricately linked to climatic conditions, particularly droughts induced by the warm El Niño phase. This study investigates the impact of meteorological and hydrological drought on forest fires in the Amazon, focusing on the role of groundwater and El Niño events. Utilizing comprehensive drought indicators at various soil depths and standardized precipitation indexes, the research spans from 2004 to 2016, revealing a consistent decrease in humidity conditions across surface soil moisture, root zone soil moisture, and groundwater storage levels. With its slower response to precipitation changes, groundwater emerges as a crucial factor influencing hydrological drought patterns in the Amazon. The spatial distribution of drought conditions is explored, highlighting areas with lower humidity concentrations in the northeast and a correlation between forest fires and positive rates of change in burned area fraction during El Niño events. Notably, the study underscores the substantial increase in burned area during the 2015-2016, characterized by a very strong El Niño. This nuanced understanding of groundwater dynamics and its interplay with El Niño events provides critical insights for developing a tailored fire risk index in the ecologically significant and vulnerable Amazon basin, subsidizing strategies for mitigating fire risk and enhancing preparedness.
ABSTRACT
OBJECTIVE: To assess, compare and relate the toddler's pain and anxiety during venipuncture by using either the Koala Attachment Distraction method or the physical restraint method and to evaluate the level of anxiety perceived by the companions in both groups. METHOD: Randomised, single-blind, controlled clinical trial in two arms (control and intervention group) conducted in the paediatric emergency department of a tertiary university hospital. The study variables were pain and stress of the child and anxiety perceived by the accompanying persons in both groups at the time before and during the technique. The pain rating scale Face, Leg, Activity, Cry, Consolability; the Groningen stress scale and the STAI questionnaire were used. RESULTS: A total of 113 participants aged 3 to 4 years participated in the trial (n = 113). 50 % (55) were girls, mean total age 3.83 ± 0.59 years and accompanying persons 37.17 ± 6.96. During the technique the mean pain in control and intervention groups was 5.64 ± 3.30 and 3.87 ± 3.01; stress, 3.25 ± 1.22 and 2.67 ± 1.24, respectively. No statistically significant differences were found in the assessment of anxiety between the groups. CONCLUSIONS: Patients who underwent the Koala Attachment Distraction method venipuncture show a lower level of pain and anxiety than those who received physical restraint, and the anxiety perceived by the companion is similar in both groups.
ABSTRACT
El estridor es un síntoma de obstrucción de la vía aérea superior y puede ser resultado de causas congénitas o adquiridas. El diagnóstico suele ser clínico. Si es necesaria una investigación adicional para el diagnóstico diferencial, la endoscopia es el método de elección en la mayoría de los casos. Los estudios por imágenes son complementarios a la endoscopia. Permiten evaluar la patología laríngea y traqueobronquial, las compresiones extrínsecas de la vía aérea por tumores o malformaciones vasculares y definir la localización, extensión y características de una lesión. Son útiles en casos de duda diagnóstica y cuando la endoscopia no está disponible. Es fundamental comprender la anatomía y fisiopatología del tracto respiratorio, y ser conscientes de las indicaciones y limitaciones de los exámenes complementarios para el diagnóstico adecuado. Se describen las diferentes modalidades de imágenes disponibles para evaluar el estridor en pediatría y se discuten sus ventajas.
Stridor is a symptom of upper airway obstruction and may result from congenital or acquired causes. The diagnosis is usually clinical. If further investigation is necessary for differential diagnosis, endoscopy is the method of choice in most cases. Imaging studies are complementary to endoscopy. They allow evaluation of laryngeal and tracheobronchial pathology and extrinsic airway compressions due to tumors or vascular malformations and define a lesion's location, extent, and characteristics. They are helpful in cases of diagnostic doubt and when endoscopy is unavailable. It is essential to understand the anatomy and pathophysiology of the respiratory tract and to be aware of the indications and limitations of complementary examinations for proper diagnosis. The different imaging modalities available to evaluate stridor in pediatrics are described, and their advantages are discussed.
Subject(s)
Humans , Child , Respiratory Sounds/etiology , Diagnostic Imaging/methods , Airway Obstruction/diagnosis , Airway Obstruction/etiology , Airway Obstruction/diagnostic imagingABSTRACT
Se estima que entre el 25 % y el 40 % de los niños sanos presentan algún síntoma de dificultad alimentaria (DA) durante su crecimiento y desarrollo, y muchas veces no son adecuadamente diagnosticadas. El propósito de este trabajo consistió en realizar una revisión narrativa que reuniera la información disponible sobre las dificultades alimentarias. Se desarrollaron algoritmos de evaluación y abordaje a partir de la evidencia en la literatura. La mayoría de los problemas de alimentación en los niños pequeños (selectividad alimentaria, falta de apetito, miedo a la alimentación) a menudo coexisten y es necesario evaluar el riesgo clínico para planificar una intervención individualizada. Contar con definiciones estandarizadas y terminología común para abordar estas dificultades de manera adecuada y multidisciplinaria es uno de los caminos para optimizar su tratamiento. Involucrar a los diferentes profesionales de la salud y a los padres es fundamental para abordar las dificultades alimentarias.
It has been estimated that between 25% and 40% of healthy children show symptoms of feeding difficulties (FDs) during their growth and development; many times, these are not adequately diagnosed. The objective of this study was to conduct a narrative review that collected the available information on fee ding difficulties. Assessment and management algorithms were developed based on the bibliographic evidence. Most feeding problems in young children (feeding selectivity, loss of appetite, fear of feeding) are often con current, and a clinical risk assessment is necessary to plan an individualized intervention. Having standardized definitions and common terms to address these difficulties in an appropriate and multidisciplinary manner is one of the ways to optimize their treatment. The involvement of different health care providers and parents is critical to address feeding difficulties.
Subject(s)
Humans , Child, Preschool , Child , Feeding and Eating Disorders of Childhood/diagnosis , Feeding and Eating Disorders of Childhood/etiology , Feeding and Eating Disorders of Childhood/therapy , Algorithms , Risk AssessmentABSTRACT
Introducción. La urticaria crónica es una afección inflamatoria de la piel caracterizada por presencia de habones evanescentes y/o angioedema, que ocurren durante un período ≥ 6 semanas. Objetivo. Determinar la prevalencia de esta enfermedad y describir características clínicas en niños y adolescentes menores de 19 años de un hospital general. Población y métodos. Estudio corte transversal, realizado entre el 2015 y el 2020, en una población de niños y adolescentes de un sistema de salud privado. Resultados. Se revisaron 1567 historias clínicas de pacientes con urticaria atendidos durante el período de estudio. Se identificaron 36 pacientes con urticaria crónica; se estableció una prevalencia del 0,16 % (IC95% 0,11-0,22). Conclusión. La prevalencia de urticaria crónica en niños y adolescentes fue del 0,16 %. Se observó mayor frecuencia en el sexo femenino y adolescentes.
Introduction. Chronic urticaria is an inflammatory skin condition characterized by the presence of evanescent wheals or angioedema that last for ≥ 6 weeks. Objective. To determine the prevalence of urticaria and describe its clinical characteristics in children and adolescents under 19 years of age in a general hospital. Population and methods. This was a cross-sectional study carried out between 2015 and 2020 in a population of children and adolescents seen at a private healthcare facility. Results. A total of 1567 medical records of patients with urticaria seen during the study period were reviewed. Thirty-six patients with chronic urticaria were identified; the prevalence was 0.16% (95% CI: 0.110.22). Conclusion. The prevalence of chronic urticaria in children and adolescents was 0.16%. A higher frequency was observed among girls and adolescents.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Young Adult , Chronic Urticaria/epidemiology , Hospitals, General , Urticaria/epidemiology , Prevalence , Cross-Sectional Studies , Retrospective StudiesABSTRACT
Introducción. La calidad de la alimentación implica tanto la cantidad y calidad de los alimentos que se ofrecen como la forma en que se ofrecen, el entorno y las respuestas de quien los ofrece. El objetivo de este trabajo fue identificar patrones de comportamiento relacionados a la alimentación perceptiva en niños entre 6 y 23 meses de áreas urbanas de la Argentina en 2018-19. Población y métodos. Análisis secundario de datos de la 2da Encuesta Nacional de Nutrición y Salud 2018-19, de una muestra probabilística polietápica de localidades urbanas de 5000 habitantes y más de Argentina. Se realizó análisis descriptivo y análisis de componentes principales para identificar los patrones de alimentación perceptiva en 4379 niños y niñas de 6 a 23 meses. Resultados. Se identificaron cinco patrones de alimentación perceptiva, las dos primeras dimensiones explicaron el 71,1 % de la inercia (p = 0,013). El patrón donde prevalecía la posibilidad de experimentación, la autonomía, la interacción y la ausencia de pantallas, premios y distracciones se asoció a niños/as mayores de 12 meses, de las regiones del centro y sur (Cuyo, Pampeana, Gran Buenos Aires y Patagonia), mientras que el patrón relacionado con menor autonomía, experimentación y autorregulación correspondió a las regiones Noroeste y Noreste, y a niños/as entre 6 y 11 meses. Conclusión. Se evidencian prácticas de alimentación perceptiva que se corresponden con patrones diferenciados entre sí, asociados a diferentes etapas y a la región donde viven los niños/as.
Introduction. Dietary quality involves both the quantity and quality of food offered, the way and the setting in which it is offered, and the responses of the person offering it. The objective of this study was to identify behavioral patterns related to responsive feeding in children aged 6 to 23 months in urban areas from Argentina in 20182019. Population and methods. Secondary analysis based on data from the second National Survey on Nutrition and Health of 20182019 conducted in a multistage probability sample from urban areas of 5000 inhabitants or more in Argentina. A descriptive analysis and a principal component analysis were performed to identify responsive feeding patterns in 4379 children aged 6 to 23 months. Results. Five responsive feeding patterns were identified; the first 2 dimensions explained 71.1% of inertia (p = 0.013). The pattern with a prevailing possibility of experimentation, autonomy, interaction, and the absence of screens, rewards and distractions was associated with children older than 12 months from the central and south regions (Cuyo, Pampa, Greater Buenos Aires, and Patagonia), whereas the pattern related to a lower autonomy, experimentation, and self-regulation corresponded to children aged 6 to 11 months from the Northwest and Northeast regions. Conclusion. There is evidence of responsive feeding practices that correspond to distinguishable patterns, associated with different stages of life and with the region where the children live
Subject(s)
Humans , Male , Female , Infant , Feeding Behavior , Argentina , Urban PopulationABSTRACT
Introducción. El trastorno del espectro autista (TEA) se caracteriza por dificultades de comunicación social y comportamientos repetitivos y estereotipados. Además de la categoría diagnóstica, las actividades que los niños, niñas y adolescentes (NNyA) pueden realizar y la participación social son los aspectos principales por considerar desde el marco de la Clasificación Internacional del Funcionamiento, la Discapacidad y la Salud (CIF), propuesta por la Organización Mundial de la Salud, para describir los estados de salud. En una investigación previa, elaboramos la primera versión de una herramienta pediátrica basada en la CIF llamada TEA-CIFunciona para evaluación funcional de NNyA con diagnóstico de TEA, que permitió captar características funcionales adaptadas a nuestro contexto cultural. Se propuso como objetivo posterior aplicar TEA-CIFunciona en formato multicéntrico para evaluar NNyA de diferentes regiones, revisar y actualizar la herramienta, e identificar barreras y facilitadores. Población y métodos. Se administró TEA-CIFunciona versión 1.0 a NNyA con diagnóstico confirmado de TEA (según criterios del DSM-5), menores de 16 años, en seguimiento en cinco centros de atención pediátrica del país. Resultados. Se obtuvo la versión 2.0 de TEA-CIFunciona con 34 categorías (10 funciones corporales, 15 actividades y participación, y 9 factores ambientales). Se elaboró el perfil funcional de la muestra completa (n = 308). Conclusiones. La versión actualizada de TEA-CIFunciona contribuye a estandarizar y a sistematizar la obtención de información necesaria para adecuar el seguimiento de los NNyA con TEA a nivel nacional. Además, permite identificar barreras por superar y facilitadores para generalizar
Introduction. Autism spectrum disorder (ASD) is characterized by difficulties in social communication and repetitive and stereotyped behaviors. In addition to the diagnostic category, the activities performed by children and adolescents and their social involvement are the main aspects to be considered according to the International Classification of Functioning, Disability, and Health (ICF) proposed by the World Health Organization to describe health status. In a previous study, we developed the first version of a pediatric tool based on the ICF called ICF-ASD for the functional assessment of children and adolescents with ASD to capture functional characteristics adapted to our cultural setting. Our subsequent objective was to apply the ICF-ASD in a multicenter format to assess children and adolescents from different regions, review, and update it, and identify barriers and facilitators. Population and methods. The ICF-ASD version 1.0 was administered to children and adolescents younger than 16 years with a confirmed diagnosis of ASD (as per DSM-5 criteria), who were receiving follow-up at 5 children's health centers across Argentina. Results. Version 2.0 of the ICF-ASD was obtained, which included 34 categories (10 under body function, 15 under activities and participation, and 9 under environmental factors). A functional profile was developed for the whole sample (n = 308). Conclusions. The updated version of the ICF-ASD helps to standardize and systematize the collection of necessary data for an adequate follow-up of children and adolescents with ASD at a national level. It also allows to identify barriers to overcome and facilitators to be generalized
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Autism Spectrum Disorder/classification , Autism Spectrum Disorder/diagnosis , Argentina , International Classification of Functioning, Disability and Health , Cross-Sectional Studies , Disability EvaluationABSTRACT
INTRODUCTION: Septic shock is a potentially life-threatening condition. The aim of this study was to identify clinical and epidemiological factors associated with mortality in pediatric patients admitted to a pediatric intensive care unit (PICU) with septic shock. MATERIALS AND METHODS: A retrospective comparative case series study was conducted with children aged 1 month to 14 years with septic shock from 2018 to 2020 in a PICU in Lima, Peru. Patients were divided into deceased and survivor groups based on their condition at discharge from the PICU. The influence of each variable on mortality was assessed using a logistic regression model. RESULTS: A total of 174 patients were included in the study, with 51 (29.3%) fatalities. Deceased patients, compared to survivors, were older, had a higher incidence of oncological disease (31.4% vs. 14.6%; p = 0.011), more frequently presented with hemoglobin ≤ 9 g/dL (44% vs. 28%; p = 0.043), lactate > 2 mmol/L (70% vs. 44%; p = 0.002), platelets ≤ 150 (×103)/µL (77% vs. 42%; p < 0.001), and pH ≤ 7.1 (31% vs. 6%; p < 0.001). In the logistic regression model, factors related to mortality were having a pH ≤ 7.1 (odds ratio [OR] = 8.95; 95% confidence interval [CI]: 2.52-31.75) and platelets ≤ 150 (×103)/µL (OR = 3.89; 95% CI: 1.40-10.84). CONCLUSIONS: Factors associated with mortality in pediatric patients with septic shock were a pH ≤ 7.1 and platelets ≤ 150 (×103)/µL in the assessments conducted upon admission to the PICU.
INTRODUCCIÓN: El shock séptico es una condición potencialmente mortal. El objetivo del estudio fue identificar factores clínicos y epidemiológicos relacionados con la mortalidad en pacientes que ingresaron por shock séptico a una Unidad de Cuidados Intensivos Pediátricos (UCIP). MÉTODOS: Estudio retrospectivo tipo serie de casos comparativos con niños de 1 mes a 14 años hospitalizados por shock séptico del 2018 al 2020 en una UCIP de Lima en Perú. Los pacientes fueron divididos en fallecidos y vivos según su condición al alta de la Unidad. La influencia de cada variable sobre la mortalidad fue evaluada mediante un modelo de regresión logística. RESULTADOS: Ingresaron 174 pacientes al estudio, fallecieron 51 (29.3%). Los fallecidos en comparación con los vivos fueron de mayor edad, tuvieron más casos oncológicos (31.4% vs. 14.6%; p = 0.011), presentaron con mayor frecuencia hemoglobina ≤ 9 g/dL (44% vs. 28%; p = 0.043), lactato > 2 mmol/L (70% vs. 44%; p = 0.002), plaquetas ≤ 150 (×103)/µL (77% vs. 42%; p < 0.001) y pH ≤ 7,1 (31% vs. 6%; p < 0.001). En la regresión logística ajustada los factores que se relacionaron con la mortalidad fueron tener un pH ≤ 7,1 (OR = 8.95; IC 95%: 2.52 a 31.75) y plaquetas ≤ 150 (×103)/µL (OR = 3.89; IC 95%: 1.40 a 10.84). CONCLUSIONES: Los factores relacionados con la mortalidad en pacientes hospitalizados por shock séptico fueron tener un pH ≤ 7.1 y plaquetas ≤ 150 (×103)/µL en los controles realizados al ingreso de la UCIP.
Subject(s)
Intensive Care Units, Pediatric , Shock, Septic , Humans , Intensive Care Units, Pediatric/statistics & numerical data , Shock, Septic/mortality , Child, Preschool , Child , Male , Retrospective Studies , Infant , Female , Adolescent , Peru/epidemiology , Logistic Models , Hospital Mortality , Risk Factors , Age Factors , Neoplasms/mortalityABSTRACT
The Indian summer monsoon (ISM) rainfall interannual variability is known to be strongly linked to the El-Niño-Southern Oscillation (ENSO). This linear relationship is the primary factor in controlling the interannual variation in ISM precipitation. However, there are many outlier cases, and such deviations pose significant challenges in seasonal prediction over this region. Here we show that such challenges can be attributed to anomalous atmospheric pressure patterns in the Western North Pacific (WNP) region. The anticyclonic circulation anomaly over WNP region causes the easterly wind toward the Indian subcontinent, leading to positive precipitation anomalies with stronger low-level moist convergence, while the cyclonic circulation decreases ISM precipitation. The linear baroclinic model simulation results further support that the WNP circulation pattern can serve as an independent factor for forecasting precipitation over India. The WNP circulation anomaly play the crucial role generating ISM precipitation particularly for July and September. Our study suggests that the role of the WNP circulation anomaly should be carefully considered as the secondary prevailing mechanism on the subseasonal timescale during the boreal summer in addition to the ENSO signal.
ABSTRACT
El objetivo de la ruta es establecer las pautas formales, respecto a la atención integral en salud en las niñas, niños y adolescentes, ayudando a optimizar las acciones, disminuir costos, incrementar la satisfacción de los usuarios, así como mejorar la productividad y competitividad del personal de salud. En razón de lo anterior presentamos la ruta de trabajo, para la adecuación de la normativa técnica, producto del trabajo de las diferentes dependencias vinculadas directa e indirectamente a la atención en salud a niñas, niños y adolescentes
The objective of the route is to establish formal guidelines regarding comprehensive health care in the girls, boys and adolescents, helping to optimize actions, reduce costs, increase user satisfaction, as well as improving the productivity and competitiveness of health personnel. Due to the above, we present the work route, for the adaptation of the technical regulations, product of the work of the different agencies linked directly and indirectly to care in health for girls, boys and adolescents
Subject(s)
Reference Standards , Jurisprudence , El SalvadorABSTRACT
The Yangtze River Estuary (YRE) is one of the areas in China most severely affected by harmful algal blooms (HABs). This study explored the distributive patterns of HABs in the YRE and how they are influenced by the El Niño-Southern Oscillation (ENSO) and other environmental factors. Quantitative real-time PCR (qPCR) was employed to detect and quantify the four predominant HAB species in the YRE, Karenia mikimotoi, Margalefidinium polykrikoides, Prorocentrum donghaiense, and Heterosigma akashiwo. Additionally, the study analyzed how turbidity, pH, salinity, and temperature influence these algae. Distribution of the four HAB species in the YRE area shows clear geographical variations: K. mikimotoi is predominantly found in the northwest and central sea areas, M. polykrikoides (East Asian Ribotype, EAR) is mainly distributed in the southeastern part, P. donghaiense is abundant in the northern regions, and H. akashiwo is especially prevalent at stations S26 and S27 in the northeastern part of the study area. HABs dominated by H. akashiwo and P. donghaiense were observed in the northeastern sea area of the YRE on July 22, 2020. Our study reveals that K. mikimotoi, M. polykrikoides (EAR), and P. donghaiense are mainly affected by turbidity, pH, and salinity, while temperature predominantly influences the blooms of H. akashiwo. Moreover, runoff in the YRE has a certain correlation with ENSO events, which may also impact the nutrient content of the region. The findings of this study illustrate the distributive patterns of the four HAB species under various ecological conditions in the YRE and emphasize the importance of establishing practical cases for future warning systems. To better understand how climate change affects HABs, exploring the link between ENSO and HABs is essential.
Subject(s)
Climate Change , Environmental Monitoring , Estuaries , Harmful Algal Bloom , China , Rivers , Dinoflagellida , SalinityABSTRACT
OBJECTIVES: The aim of this study is to examine how gene mutation diversity and disease severity affect physical capacity and quality of life in children/adolescents with Familial Mediterranean Fever (FMF). METHODS: Eighty children/adolescents (42 female, 38 male) diagnosed with FMF according to Tell-Hashomer diagnostic criteria were included in this study. Disease severity score (PRAS), running speed and agility and strength subtests of Bruininks-Oseretsky Test of Motor Proficiency Second Edition Short Form (BOT-2 SF), Physical Activity Questionnaire, Pediatric Quality of Life Inventory 3.0 Arthritis Module (PedsQL) was used for evaluation. Participants were divided into 2 groups as M694V and other mutations according to MEFV gene mutation and were divided into 3 groups as mild, moderate and severe according to PRAS. RESULTS: When the data were compared between groups; in terms of gene mutation, a significant difference was observed in treatment subtest of PedsQL-parent form in favor of the M694V gene mutation group (p<0.05). In terms of PRAS, significant difference was seen in the pain, treatment subtests and total score of the PedsQL-child form, and in the pain, treatment, worry subtests and total score of the PedsQL-parent form in favor of the mild group (p<0.05). CONCLUSIONS: MEFV gene mutations in children and adolescents with FMF did not differ on physical capacity and quality of life. PRAS was not effective on physical parameters, but quality of life decreased as the severity score increased. Encouraging children/adolescents with FMF to participate in physical activity and to support them psychosocially can be important to improve their quality of life.
Subject(s)
Familial Mediterranean Fever , Mutation , Pyrin , Quality of Life , Severity of Illness Index , Humans , Familial Mediterranean Fever/genetics , Male , Female , Child , Adolescent , Pyrin/genetics , Cross-Sectional StudiesABSTRACT
BACKGROUND: Dengue fever is an arboviral disease caused by the dengue virus (DENV). Its geographical distribution and health burden have been steadily increasing through tropical and subtropical climates in recent decades. METHODS: We developed a temperature- and precipitation-dependent mechanistic model for the global risk of dengue fever outbreaks using the basic reproduction number (R0) as the metric of disease transmission risk. We used our model to evaluate the global risk of dengue outbreaks from 1950 to 2020 and to investigate the impact of annual seasons and El Niño events. RESULTS: We showed that the global annual risk of dengue outbreaks has steadily increased during the last four decades. Highest R0 values were observed in South America, Southeast Asia, and the Equatorial region of Africa year-round with large seasonal variations occurring in other regions. El Niño was shown to be positively correlated with the global risk of dengue outbreaks with a correlation of 0.52. However, the impact of El Niño on dengue R0 was shown to vary across geographical regions and between El Niño events. CONCLUSIONS: Strong El Niño events may increase the risk of dengue outbreaks across the globe. The onset of these events may trigger a surge of control efforts to minimize risk of dengue outbreaks.
ABSTRACT
El síndrome de Wells o celulitis eosinofílica es una enfermedad inflamatoria de origen desconocido, de aparición infrecuente en la edad pediátrica. Suele manifestarse clínicamente como placas eritematoedematosas, nódulos, pápulas, ampollas, entre otros. Se presenta una paciente en edad pediátrica con nódulos subcutáneos asintomáticos generalizados asociados a eosinofilia grave. El estudio histopatológico de las lesiones fue compatible con celulitis de Wells. Se realizó una evaluación interdisciplinaria en busca de la causa y trastornos eosinofílicos asociados, sin resultados positivos. Se indicó tratamiento sistémico con corticoides y presentó buena respuesta, pero, ante la recidiva de las lesiones tras su suspensión, se indicó dapsona como tratamiento de segunda línea, con mejoría posterior de las lesiones y de la eosinofilia. El objetivo del reporte es presentar una paciente con una manifestación atípica de síndrome de Wells y su desafío terapéutico.
Wells' syndrome, or eosinophilic cellulitis, is an inflammatory disease of unknown origin, uncommon in the pediatric age. It usually appears clinically as erythematous and edematous plaques, nodules, papules, blisters, among other symptoms. Here we describe the case of a female pediatric patient with generalized, asymptomatic subcutaneous nodules associated with severe eosinophilia. The histopathological examination of the lesions was compatible with Wells' syndrome. An interdisciplinary evaluation was performed to establish the cause and look for associated eosinophilic disorders; the results were negative. Systemic corticosteroids were indicated and the patient had a good response; however, in view of the recurrence of the lesions after treatment discontinuation, dapsone was indicated as a second-line treatment, with subsequent improvement of the lesions and eosinophilia. The aim of this report was to describe the case of a female patient with an atypical manifestation of Wells' syndrome and the resulting therapeutic challenge.
Subject(s)
Humans , Female , Child, Preschool , Cellulitis/diagnosis , Eosinophilia/diagnosisABSTRACT
Entre las causas de dolor torácico, la costilla deslizante presenta baja prevalencia, antecedentes traumáticos y manejo controvertido. Este síndrome merece ser incluido en el diagnóstico diferencial de causas de dolor torácico en niños. Al no asociarse a traumatismos previos y la deformidad de cartílagos, nos induce a pensar en una alteración en el desarrollo costal, al margen de la etiología traumática típica en adultos. Se presenta una serie de pacientes pediátricos intervenidos por costilla deslizante en un centro de referencia entre 2001 y 2022. Se incluyeron nueve pacientes, con un rango de edades de 11 a 16 años. Solo dos casos describen traumatismo previo. Todos presentan un inicio súbito de dolor toracoabdominal intenso. Los pacientes fueron intervenidos mediante resección abierta de cartílagos costales afectos, con resolución del dolor.
Among the causes of chest pain, slipping rib has a low prevalence, usually with a history of trauma, and its management is controversial. Slipping rib syndrome should be included in the differential diagnosis of causes of chest pain in children. When not associated with previous trauma and cartilage deformity, it is necessary to consider an alteration in rib development, regardless of the typical traumatic etiology in adults. Here we describe a series of pediatric patients with slipping rib seen at a referral hospital between 2001 and 2022. Nine patients aged 11 to 16 years were included. Only 2 had a history of trauma. All patients described a sudden onset of severe thoracic abdominal pain. The patients underwent open resection of the affected costal cartilages, with resolution of pain.
Subject(s)
Humans , Male , Female , Child , Adolescent , Chest Pain/diagnosis , Chest Pain/etiology , Ribs/abnormalities , SyndromeABSTRACT
Introducción. La rinitis alérgica (RA) es una de las enfermedades crónicas más frecuentes en la población pediátrica, afecta la calidad de vida del niño y la familia, tiene impacto económico y es frecuentemente subdiagnosticada y subtratada. Dada la escasez de datos locales, se describe su prevalencia y las características clínicas de la población en estudio. Población y métodos. Estudio observacional de corte transversal de pacientes menores de 19 años. Resultados. Se incluyeron 250 pacientes al azar, con una media de edad de 9 años (DE 5) Presentaron diagnóstico de RA 14 de ellos; se observó una prevalencia de RA del 6 %. Conclusiones. La prevalencia de RA en nuestro medio es del 6 %. Debemos darle la relevancia que amerita para brindar un diagnóstico y tratamiento adecuado.
Introduction. Allergic rhinitis (AR) is one of the most frequent chronic diseases in the pediatric population; it affects the quality of life of children and their families, has economic impact, and is frequently underdiagnosed and undertreated. Given the scarcity of local data, here we describe the prevalence of AR and the clinical characteristics of the study population. Population and methods. Observational, cross-sectional study in patients younger than 19 years. Results. A total of 250 patients were randomly included; their mean age was 9 years (SD: 5). AR was diagnosed in 14 of them. The prevalence of AR was 6%. Conclusions. The prevalence of AR in our setting was 6%. AR should be given the relevance it deserves so as to provide an adequate diagnosis and treatment.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Rhinitis, Allergic/diagnosis , Rhinitis, Allergic/epidemiology , Hospitals, General , Pediatrics , Prevalence , Cross-Sectional Studies , Hospital Departments/statistics & numerical dataABSTRACT
The extreme dry and hot 2015/16 El Niño episode caused large losses in tropical live aboveground carbon (AGC) stocks. Followed by climatic conditions conducive to high vegetation productivity since 2016, tropical AGC are expected to recover from large losses during the El Niño episode; however, the recovery rate and its spatial distribution remain unknown. Here, we used low-frequency microwave satellite data to track AGC changes, and showed that tropical AGC stocks returned to pre-El Niño levels by the end of 2020, resulting in an AGC sink of 0.18 0.14 0.26 $$ {0.18}_{0.14}^{0.26} $$ Pg C year-1 during 2014-2020. This sink was dominated by strong AGC increases ( 0.61 0.49 0.84 $$ {0.61}_{0.49}^{0.84} $$ Pg C year-1) in non-forest woody vegetation during 2016-2020, compensating the forest AGC losses attributed to the El Niño event, forest loss, and degradation. Our findings highlight that non-forest woody vegetation is an increasingly important contributor to interannual to decadal variability in the global carbon cycle.
Subject(s)
Carbon , El Nino-Southern Oscillation , Tropical Climate , Carbon/metabolism , Carbon/analysis , Carbon Cycle , Forests , Carbon Sequestration , Climate ChangeABSTRACT
Introduction: Background: childhood obesity is one of the major health problem worldwide. Obesity is associated with low-level chronic inflammation resulting from inflammatory cytokine release in white adipose tissue. We aim to specify inflammatory markers tumor necrosis factor-alpha (TNF-alpha) and interleukin-10 (IL-10) in children and adolescents to determine their relationship with obesity. Materials and methods: forty obese patients and 46 controls were included in the study from the pediatric clinic. Blood samples from the study group were centrifuged, and the sera were stored at -80 °C after separation. Serum levels of TNF-alpha and IL-10 were determined using Human ELISA kits for TNF-alpha and IL-10. Results: serum samples from 86 children, including 45 girls (52.3 %) in the study group, were analyzed for TNF-alpha and IL-10 levels. TNF-alpha levels in the obese and control groups were 1.04 ± 0.79 and 0.60 ± 0.72 pg/ml, respectively (p = 0.010). Also, IL-10 levels in the obese and control groups were 0.76 ± 0.62 and 1.54 ± 0.71 pg/ml, respectively (p < 0.001). Gender was not identified as a factor for serum TNF-alpha and IL-10 levels (p = 0.281 and p = 0.477, respectively). Moreover, white blood cell (WBC) and serum C-reactive protein (CRP) levels were higher in the obese patient group than in the control group (p = 0.002 and p = 0.010, respectively). Conclusion: TNF-alpha levels were higher than control in obese patients and it was important in terms of showing that obesity triggers inflammation in the body. IL-10 levels, which inhibit inflammation, were lower in obese patients than controls.
Introducción: Antecedentes: la obesidad infantil es uno de los principales problemas de salud a nivel mundial. La obesidad está asociada con una inflamación crónica de bajo nivel, resultado de la liberación de citocinas inflamatorias en el tejido adiposo blanco. Nuestro objetivo es especificar los marcadores inflamatorios factor de necrosis tumoral-alfa (TNF-alfa) e interleucina-10 (IL-10) en niños y adolescentes para determinar su relación con la obesidad. Materiales y métodos: cuarenta pacientes obesos y 46 controles fueron incluidos en el estudio desde la clínica pediátrica. Las muestras de sangre del grupo de estudio se centrifugaron, y los sueros se almacenaron a -80 °C después de la separación. Los niveles séricos de TNF-alfa e IL-10 se determinaron utilizando kits ELISA humanos para TNF-alfa e IL-10. Resultados: se analizaron muestras de suero de 86 niños, incluidas 45 niñas (52,3 %) en el grupo de estudio, para los niveles de TNF-alfa e IL-10. Los niveles de TNF-alfa en los grupos de obesos y control fueron de 1,04 ± 0,79 y 0,60 ± 0,72 pg/ml, respectivamente (p = 0,010). Además, los niveles de IL-10 en los grupos de obesos y control fueron de 0,76 ± 0,62 y 1,54 ± 0,71 pg/ml, respectivamente (p < 0,001). El género no se identificó como un factor para los niveles séricos de TNF-alfa e IL-10 (p = 0,281 y p = 0,477, respectivamente). Además, los niveles de glóbulos blancos (WBC) y proteína C-reactiva (PCR) en suero fueron más altos en el grupo de pacientes obesos que en el grupo de control (p = 0,002 y p = 0,010, respectivamente). Conclusión: los niveles de TNF-alfa fueron más altos en el grupo de pacientes obesos que en el grupo control, lo que es importante para mostrar que la obesidad desencadena inflamación en el organismo. Los niveles de IL-10, que inhiben la inflamación, fueron más bajos en pacientes obesos que en controles.