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1.
Medicine (Baltimore) ; 99(2): e18504, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914021

RESUMEN

We aimed to evaluate the clinical significance of bacterial coexistence and the coinfection dynamics between bacteria and respiratory viruses among young children. We retrospectively analyzed clinical data from children aged < 5 years hospitalized with a community-acquired single respiratory viral infection of influenza, adenovirus, or RSV during 2 recent consecutive influenza seasons. Remnant respiratory specimens were used for bacterial PCR targeting Moraxella catarrhalis, Haemophilus influenzae, Streptococcus pneumoniae, and Staphylococcus aureus.A total of 102 children were included; median age was 0.8 years and 44.1% had underlying comorbidities. Overall, 6.8% (7/102) of cases were classified as severe diseases requiring intensive care unit admission and/or mechanical ventilation and ranged from 8.8% for a patient with RSV and 7.6% for those with adenovirus to 0% for those with influenza viruses. The overall viral-bacterial codetection rate was 59.8% (61/102); M catarrhalis was the most frequent (33.3%), followed by H influenzae (31.4%). Influenza cases showed higher bacterial codetection rates (80.0%; 8/10) compared with those with adenoviruses (69.2%; 9/13) and RSV (55.7%; 44/79). S pneumoniae and H influenzae codetections were associated with reduced severity (aOR, 0.24; 95% CI, 0.07-0.89), and reduced risk of wheezing (aOR, 0.36; 95% CI, 0.13-0.98), respectively.We observed the interactions between respiratory viruses and bacteria and the clinical significance of viral-bacterial coexistence in upper airway on disease severity. Future study will be necessary to elucidate the active interactions between different viruses and bacteria and give clues to risk stratified strategy in the management of respiratory infections among young children.


Asunto(s)
Adenoviridae/aislamiento & purificación , Haemophilus influenzae/aislamiento & purificación , Infecciones del Sistema Respiratorio/microbiología , Infecciones del Sistema Respiratorio/virología , Infecciones por Adenoviridae/diagnóstico , Infecciones por Adenoviridae/virología , Bacterias/genética , Preescolar , Coinfección/microbiología , Coinfección/virología , Infecciones Comunitarias Adquiridas/diagnóstico , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/virología , Femenino , Hospitalización , Humanos , Lactante , Recién Nacido , Gripe Humana/diagnóstico , Gripe Humana/virología , Masculino , Prevalencia , Ruidos Respiratorios/diagnóstico , Ruidos Respiratorios/etiología , Infecciones por Virus Sincitial Respiratorio/diagnóstico , Infecciones por Virus Sincitial Respiratorio/virología , Virus Sincitiales Respiratorios/genética , Infecciones del Sistema Respiratorio/diagnóstico , Infecciones del Sistema Respiratorio/epidemiología , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Staphylococcus aureus/aislamiento & purificación , Streptococcus pneumoniae/aislamiento & purificación , Virus/genética
2.
Isr Med Assoc J ; 22(1): 43-47, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31927805

RESUMEN

BACKGROUND: Temporary abdominal closure (TAC) surgical technique relates to a procedure in which the post-surgical abdominal wall remains open in certain indications. The Bogota bag (BB) technique is a tension-free TAC method that covers the abdominal contents with a sterilized fluid bag. There are very few reports of pediatric patients treated with this technique. OBJECTIVES: To describe our institution's 15 years of experience using the BB technique on pediatric patients. METHODS: A retrospective cohort study describing our experience treating patients with BB was conducted. The medical files of 17 pediatric patients aged 0-18 years were reviewed. RESULTS: Between January 2000 and December 2014, 17 patients were treated with BB at our medical center (6 females, median age 12 years). Indications for BB were a need for a surgical site re-exploration, mechanical inability for primary abdominal closure, and high risk for ACS development. Median BB duration was 5 days and median bag replacement was 2 days. Median ICU length of stay (LOS) was 10 days and hospital LOS was 27 days. The ICU admission and BB procedure was tolerated well by 6 patients who were discharged home without complications. Of the remaining 11 patients, 6 patients died during the admission (35%) and the others presented with major complications not related to the BB but to the patient's primary disease. CONCLUSIONS: This report represents the largest series of children treated with BB. The technique is simple to perform, inexpensive, and has very few complications.


Asunto(s)
Técnicas de Cierre de Herida Abdominal , Abdomen/cirugía , Pared Abdominal/cirugía , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Estudios Retrospectivos
3.
MMWR Morb Mortal Wkly Rep ; 69(2): 40-43, 2020 Jan 17.
Artículo en Inglés | MEDLINE | ID: mdl-31945035

RESUMEN

Multiple genetically distinct influenza B/Victoria lineage viruses have cocirculated in the United States recently, circulating sporadically during the 2018-19 season and more frequently early during the 2019-20 season (1). The beginning of the 2019-20 influenza season in Louisiana was unusually early and intense, with infections primarily caused by influenza B/Victoria lineage viruses. One large pediatric health care facility in New Orleans (facility A) reported 1,268 laboratory-confirmed influenza B virus infections, including 23 hospitalizations from July 31 to November 21, 2019, a time when influenza activity is typically low. During this period, Louisiana also reported one pediatric death associated with influenza B virus infection. An investigation of the influenza B virus infections in Louisiana, including medical and vaccine record abstraction on 198 patients, primarily from facility A, with sporadic cases from other facilities in the state, found that none of the patients had received 2019-20 seasonal influenza vaccine, in part because influenza activity began before influenza vaccination typically occurs. Among 83 influenza B viruses sequenced from 198 patients in Louisiana, 81 (98%) belonged to the recently emerged B/Victoria V1A.3 genetic subclade. Nationally, to date, B/Victoria viruses are the most commonly reported influenza viruses among persons aged <25 years (2). Of the 198 patients in the investigation, 95% were aged <18 years. Although most illnesses were uncomplicated, the number of hospitalizations, clinical complications, and the reported pediatric death in Louisiana serve as a reminder that, even though influenza B viruses are less common than influenza A viruses in most seasons, influenza B virus infection can be severe in children. All persons aged ≥6 months should receive an annual influenza vaccination if they have not already received it (3). Antiviral treatment of influenza is recommended as soon as possible for all hospitalized patients and for outpatients at high risk for influenza complications (including children aged <2 years and persons with underlying medical conditions) (4).


Asunto(s)
Virus de la Influenza B/aislamiento & purificación , Gripe Humana/epidemiología , Gripe Humana/virología , Adolescente , Adulto , Niño , Preescolar , Humanos , Lactante , Vacunas contra la Influenza/administración & dosificación , Gripe Humana/prevención & control , Louisiana/epidemiología , Estaciones del Año , Adulto Joven
4.
MMWR Morb Mortal Wkly Rep ; 68(53): 1201-1205, 2020 Jan 17.
Artículo en Inglés | MEDLINE | ID: mdl-31945036

RESUMEN

Control of communicable diseases in children, including respiratory and diarrheal illnesses that affect U.S. school-aged children, might require public health preventive efforts both in the home and at school, a primary setting for transmission. National Health Interview Survey (NHIS) data on school absenteeism and gastrointestinal and respiratory illnesses in the United States during 2010-2016 were analyzed to examine their associations with income. Prevalence of gastrointestinal and respiratory illnesses (queried for the 2 weeks preceding the survey) increased as income decreased. The likelihood of missing any school days during the past year decreased with reduced income. However, among children who missed school, those from low-income households missed more days of school than did children from higher income households. Although the reason for absenteeism cannot be ascertained from this analysis, these data underscore the importance of preventive measures (e.g. hand hygiene promotion and education) and the opportunity for both homes and schools to serve as important points for implementation of public health preventive measures, including improved hand hygiene practices.


Asunto(s)
Absentismo , Enfermedades Gastrointestinales/epidemiología , Renta/estadística & datos numéricos , Infecciones del Sistema Respiratorio/epidemiología , Instituciones Académicas , Adolescente , Niño , Preescolar , Femenino , Humanos , Masculino , Estados Unidos/epidemiología
5.
N C Med J ; 81(1): 5-13, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31908325

RESUMEN

BACKGROUND In 2016, the North Carolina Division of Public Health (DPH) launched the Improving Community Outcomes for Maternal and Child Health (ICO4MCH) program to provide 5 local health departments (LHDs) with financial resources and technical assistance to address 3 aims: improve birth outcomes, reduce infant mortality, and improve health for children from birth to 5 years.METHOD: State legislation established an academic-practice partnership between NCDPH and the University of North Carolina at Chapel Hill (UNC) to provide program evaluation and implementation coaching to LHDs. ICO4MCH used a collective impact framework, principles of implementation science, and a health equity approach to implement evidence-based strategies to address the program's aims.RESULTS: A shared measurement system was developed by an evaluation stakeholders group led by the NCDPH and UNC in which LHDs reported data on a quarterly basis and the evaluators returned reports to drive improvements. Structured assessments and technical assistance provided by implementation coaches helped grantees address barriers to implementation including cultivating and sustaining a diverse community action team, addressing staff turnover, and using data to drive improvements.LIMITATIONS: It was challenging for grantees to balance community needs and build partnerships in the first year while integrating data from multiple assessments into action plans to meet the performance measures. It was necessary to streamline assessments and reduce indicators to make data more actionable.CONCLUSION: An academic-practice partnership was integral to successful implementation of the ICO4MCH program and may serve as a model for moving evidence-based maternal child health programs to practice in LHDs.


Asunto(s)
Salud del Niño , Promoción de la Salud/organización & administración , Relaciones Interinstitucionales , Salud Materna , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , North Carolina , Embarazo , Evaluación de Programas y Proyectos de Salud
6.
Klin Padiatr ; 232(1): 29-32, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914462

RESUMEN

Pseudohypoaldosteronism type I is a rare genetic disease of mineralocorticoid resistance that typically manifests in neonatal age. The patients are diagnosed with failure to thrive, dehydration, polyuria, vomiting, hyperkalemia, hyponatremia as well as potential metabolic acidosis accompanied by elevated values for serum aldosterone and renin. The disease is subdivided into a systemic and a renal type. Considering the renal type symptoms disappear in the toddler age group. The systemic type can -apart from the kidneys - affect colon, lungs, salivary and sweat glands. In that case symptoms persist until adulthood.


Asunto(s)
Insuficiencia de Crecimiento , Hiperpotasemia , Hiponatremia , Seudohipoaldosteronismo/diagnóstico , Seudohipoaldosteronismo/genética , Adulto , Aldosterona , Preescolar , Diagnóstico Diferencial , Humanos , Poliuria , Enfermedades Raras
7.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 37(1): 52-56, 2020 Jan 10.
Artículo en Chino | MEDLINE | ID: mdl-31922597

RESUMEN

OBJECTIVE: To delineate the clinical features,inheritance pattern, and genotype-phenotype correlation of a Chinese patient with a 17q25.3 duplication. METHODS: Whole exome sequencing(WES), chromosomal microarray analysis (CMA), chromosomal karyotyping and fluorescence in situ hybridization (FISH) were employed for the analysis of the proband and his family members. RESULTS: A 5.7 Mb duplication at 17q25.3→qter was identified by WES and CMA in the 4-year-old boy with multiple congenital anomalies, which was classified as a clinically pathogenic variant. This duplication was confirmed by FISH, and was inherited from his unaffected mother who carried a balanced translocation. Further study revealed that his grandmother also carried the balanced translocation but had gestated three healthy children and had no abortion history. His uncle also carried the balanced translocation, while his aunt was normal. CONCLUSION: Above results have enriched the clinical phenotypes of 17q25.3 duplication. Genetic counseling was provided for the family. P4HB, ACTG1, BAIAP2 and TBCD genes may underlie the clinical features for the 17q25.3 duplication.


Asunto(s)
Anomalías Múltiples , Duplicación Cromosómica , Cromosomas Humanos Par 17 , Discapacidades del Desarrollo , Anomalías Múltiples/genética , Adulto , Preescolar , China , Cromosomas Humanos Par 17/genética , Discapacidades del Desarrollo/genética , Humanos , Hibridación Fluorescente in Situ , Cariotipificación , Masculino , Proteínas Asociadas a Microtúbulos , Translocación Genética
8.
Zhonghua Er Ke Za Zhi ; 58(1): 13-18, 2020 Jan 02.
Artículo en Chino | MEDLINE | ID: mdl-31905470

RESUMEN

Objective: To evaluate the endothelial function in obstructive sleep apnea syndrome(OSAS) children and to identify related factors of endothelial dysfunction. Methods: This was a cross-sectional study. Children with habitual snoring (snoring ≥3 nights per week) admitted to the ward of otolaryngology, head and neck surgery, Beijing Children's Hospital were recruited to this study between 1(st) June 2015 and 1(st) March 2016. All children aged 3 to 11 years and of them 245 were boys and 110 were girls. All subjects underwent an overnight polysomnography (PSG), as well as endothelial function testing. All subjects were grouped into primary snoring (PS) and OSAS group according to the obstructive apnea hypopnea index (OAHI). T test or Wilcoxon test were used to compare the differences in PSG results between the two groups, and univariate and multivariate correlation analyses were used to explore the relevant factors affecting the endothelial function. Results: A total of 355 subjects were enrolled and 248 had OSAS, and 107 had PS. There were no significant differences in age, gender and body mass index (BMI) Z-score between the two groups (all P>0.05). OSAS group had higher OAHI, oxgen desaturation index and respiratory related arousal index (5.2 (2.2, 13.2) vs. 0.4 (0.1, 0.7), 4.1 (2.0, 13.1) vs. 0.5 (0.1, 1.0), 2.5 (1.0, 4.8) vs. 0.4 (0.1, 0.9), Z=-14.957, -11.790, -10.378, all P<0.01), and lower minimum oxygen saturation and reactive hyperemia index (RHI) than those of PS (0.89 (0.85, 0.92) vs. 0.94 (0.91, 0.95), 1.2±0.2 vs. 1.1±0.1, Z=-9.337, t=5.354, P<0.01). Univariate regression analysis showed that RHI was linearly correlated with age (parameter estimate=0.017, P<0.01), gender (parameter estimate=0.065, P<0.01), OAHI (parameter estimate=-0.023, P<0.01), oxygen desaturation index (parameter estimate=-0.019, P<0.01), respiratory related arousal index (parameter estimate=-0.031, P<0.01), and oxygen saturation nadir (parameter estimate=0.067, P=0.045). The relationship between BMI Z-score and RHI was quadratic. Multivariate regression analysis showed that age (parameter estimate=0.015, P<0.01), BMI Z-score (parameter estimate=0.040, P<0.01), BMI Z-score quadratic form (parameter estimate=-0.010, P<0.01), respiratory related arousal index (parameter estimate=-0.020, P<0.01) were independently correlated with RHI. Conclusions: Children with OSAS have significant endothelial dysfunction compared with PS. Frequent arousals due to obstructive respiratory events during sleep may be a candidate risk factor for endothelial dysfunction in children with OSAS.


Asunto(s)
Endotelio Vascular/fisiopatología , Apnea Obstructiva del Sueño/fisiopatología , Ronquido/fisiopatología , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Masculino , Polisomnografía , Sueño
9.
Zhonghua Er Ke Za Zhi ; 58(1): 19-24, 2020 Jan 02.
Artículo en Chino | MEDLINE | ID: mdl-31905471

RESUMEN

Objective: To summarize the diagnosis, clinical manifestations, treatment and prognosis of congenital cystic lung lesions. Methods: A retrospective study described the clinical course of 96 patients (46 female and 50 male) diagnosed with congenital cystic lung lesions treated at the Tianjin Children's Hospital from January 2010 to March 2019. The clinical findings, imaging examinations, pathological findings, treatment and follow-up were analyzed. Results: Totally 96 patients (aged from 4 days to 13 years) with congenital cystic lung lesions were included in this study. Eighty-six patients (90%) were diagnosed when they had cough and fever symptoms. Forty (42%) patients exhibited congenital cystic adenomatoid malformation, 30 underwent surgical excision, two were at emergency operations and one dead. There were 12 (13%) patients with pulmonary sequestration and four were surgical treated. Twelve (13%) patients with bronchogenic cyst were included and 4 were surgically treated. There were 3 (3%) patients with congenital lobar emphysema and one was surgically treated. Another patient with pneumothorax was operated in other hospital 2 months after discharge. Twenty-nine (30%) patients with unclassified congenital cystic lung lesions could not be definitively diagnosed by CT. Some of them were difficult to be distinguished from necrotizing pneumonia. Finally, 2 patients were diagnosed as necrotizing pneumonia after 6, 10 months follow-up. After operation 37 out of 39 patients recovered well. Conclusions: The diagnosis of congenital pulmonary cystic disease depend on imaging and pathological examination. Most patients are diagnosed when they have respiratory tract infection. The main clinical manifestations are cough and fever. The prognosis of operative management is good.


Asunto(s)
Quiste Broncogénico/diagnóstico , Quiste Broncogénico/cirugía , Malformación Adenomatoide Quística Congénita del Pulmón/diagnóstico , Enfisema Pulmonar/patología , Adolescente , Quiste Broncogénico/congénito , Secuestro Broncopulmonar/diagnóstico , Secuestro Broncopulmonar/cirugía , Niño , Preescolar , Malformación Adenomatoide Quística Congénita del Pulmón/cirugía , Femenino , Humanos , Lactante , Masculino , Neumonectomía , Enfisema Pulmonar/cirugía , Estudios Retrospectivos , Resultado del Tratamiento
10.
Zhonghua Er Ke Za Zhi ; 58(1): 35-40, 2020 Jan 02.
Artículo en Chino | MEDLINE | ID: mdl-31905474

RESUMEN

Objective: To investigate the genotype and phenotype of children with KCNA2 gene related developmental and epileptic encephalopathy (DEE). Methods: Clinical data including the manifestations and electroencephalogram of 8 children with KCNA2 variants treated in the Department of Pediatrics, Peking University First Hospital from March 2017 to June 2019 were collected and analyzed retrospectively. Results: Among the 8 epileptic patients with KCNA2 variants, 5 were males and 3 were females. The age of onset was from 1 day to 11 months. The age at last follow-up ranged from 4 months to 86 months. Two variants including c.1214C>T (loss-of-function) and c.1120A>G (gain-and loss-of-function) were identified. The variant of c.1214C>T was found in six patients (case 1-6). For these patients, the age of onset was from 5 to 11 months and they were characterized by multiple seizure types. All had focal seizures and had normal development before seizure onset with developmental regression after seizure onset. The first electroencephalogram showed epileptic discharges in Rolandic region in two, epileptic discharges in Rolandic region combined with generalized discharge in one, generalized discharge with posterior predominance in two (combined with or transferred to Rolandic region during the course) and epileptic discharges in posterior region combined with generalized discharge in one. And in 5 of them the Rolandic discharges developed into epileptic electrical status (ESES) during sleep. All the six patients were still treated with a combination of multiple antiepileptic drugs. Two of them had seizure controlled at 80 months and 68 months, respectively. The variant of c.1120A>G were identified in two of eight patients (case 7 and 8) and they had seizure onset on the 1st day after birth. Their epileptic seizures were frequent and difficult to control. They had remarkably developmental delay and microcephaly since birth. One case (case 8) had a wide forehead. They had frequent seizures up to the last follow-up. In case 7, the early electroencephalogram showed epileptic discharges in temporal region, and interictal electroencephalogram at 3 months of age showed multifocal discharge with posterior and temporal region predominance. In case 8, the early electroencephalogram was normal and electroencephalogram showed burst suppression at 2 months of age, and it developed epileptiform discharge in posterior region at 1 year of age. Conclusions: KCNA2 gene variants can lead to DEE with multiple seizures types. Among them, loss-of-function c.1214C>T is the most common, and these patients have seizure onset at infancy with Rolandic discharges tended to develop into to ESES pattern. The variant of c.1120A>G is a gain-of- and loss-of-function variant, patients with c.1120A>G have seizure onset in neonatal period, the phenotype overlaps with the former but is more severe.


Asunto(s)
Encefalopatías/genética , Epilepsia/diagnóstico , Canal de Potasio Kv.1.2/genética , Convulsiones , Edad de Inicio , Encéfalo/fisiopatología , Encefalopatías/fisiopatología , Niño , Preescolar , Discapacidades del Desarrollo/fisiopatología , Epilepsia/complicaciones , Epilepsia/genética , Femenino , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Lactante , Recién Nacido , Masculino , Fenotipo , Estudios Retrospectivos
11.
Zhonghua Bing Li Xue Za Zhi ; 49(1): 52-56, 2020 Jan 08.
Artículo en Chino | MEDLINE | ID: mdl-31914535

RESUMEN

Objective: To investigate the immunohistochemical staining of anaplastic lymphoma kinase (ALK; clone 1A4) in pediatric medulloblastoma (MB). Methods: Molecular subtyping was performed based on the NanoString and sequencing techniques for 44 pediatric MB cases at Children's Hospital, Zhejiang University School of Medicine from 2014 to 2017. ALK expression was detected with EnVision immunhistochemistry using ALK clone 1A4 on whole section. Statistical analyses were performed to evaluate the correlation of protein expression with molecular subgroups. Results: The age ranged from 0.5 to 13.0 years with an average age of 5.8 years. There were 28 males and 16 females, and 31 classic, 5 desmoplastic nodular, 3 extensive nodular and 5 large cell/anaplastic MBs. Except three cases was unable classified, 41 MBs were classified into the four molecular groups: 5 in WNT group, 12 in SHH group, 9 in Group 3 and 15 in Group 4. Thirteen of 44 MB cases were positive staining for ALK, and the positive rate was 29.5%. Six cases were strong reaction, and 7 cases were weak. The expression of ALK at the protein level was associated with the WNT group (P<0.01). The characteristic perinuclear dot-like staining was only showed in WNT group. Conclusions: The ALK immunhistochemistry using antibody clone 1A4 is a useful marker for the molecular subgroup detection of MB. The strong staining and perinuclear dot-like staining indicate as WNT group.


Asunto(s)
Neoplasias Cerebelosas , Meduloblastoma , Adolescente , Quinasa de Linfoma Anaplásico , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Proteínas Tirosina Quinasas Receptoras
12.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(1): 21-36, 2020 Jan 06.
Artículo en Chino | MEDLINE | ID: mdl-31914565

RESUMEN

Influenza virus infection is a respiratory infectious disease. The World Health Organization (WHO) estimated that seasonal influenza epidemics have caused an annual 3 to 5 million severe cases, and 290 000 to 650 000 deaths globally. Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and complications from infection. Currently, China has licensed trivalent inactivated influenza vaccine (IIV3) and quadrivalent inactivated influenza vaccine (IIV4). In 2018, the Chinese Center for Disease Control and Prevention issued the "Technical Guidelines for Seasonal Influenza Vaccination in China (2018-2019)" ( "Guide 2018" for short). To strengthen the technical guidance for prevention and control of influenza and operational research on influenza vaccination in China, the National Immunization Advisory Committee (NIAC) Influenza Vaccination Technical Working Group (TWG), updated the 2018 technical guidelines and compiled the "Technical guidelines for seasonal influenza vaccination in China (2019-2020)" . The main updates in this version include the following: First, new research evidences especially studies of China, including disease burden, effectiveness, Vaccine-avoidable disease burden, vaccine safety monitoring, and cost-effectiveness and cost-benefit. Second, policies and measures for influenza prevention and control issued by National Health Commission (PRC) in the past year. Thirdly, new type seasonal influenza vaccine licensed and issued in 2019-2020 in China. Fourth, northern hemisphere influenza vaccination composition for the 2019-2020 season which included trivalent and quadrivalent influenza vaccine. The recommendations described in this report include the following: Points of Vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications. No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one licensed, recommended, and appropriate product is available. To decrease the risk of severe infections and complications due to influenza virus infection among high risk groups, the recommendations prioritize seasonal influenza vaccination for children aged 6-59 months, adults ≥60 years of age, persons with specific chronic diseases, healthcare workers, the family members and caregivers of infants <6 months of age, and pregnant women or women who plan to become pregnant during the influenza season. Children aged 6 months through 8 years require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection. If they were vaccinated in 2018-2019 influenza season or a prior season, 1 dose is recommended. People more than 8 years old require 1 dose of influenza vaccine. It is recommended that people receive their influenza vaccination by the end of October. Influenza vaccination should be offered as soon as the vaccination is available. For the people unable to be vaccinated before the end of October, influenza vaccination will continue to be offered for the whole season. Influenza vaccine is also recommended for use in pregnant women during any trimester. These guidelines are intended for use by staff members of the Centers for Disease Control and Prevention at all levels who work on influenza control and prevention, PoVs staff members, healthcare workers from the departments of pediatrics, internal medicine, and infectious diseases, and staff members of maternity and child care institutions at all levels. These guidelines will be updated periodically as new evidence becomes available.


Asunto(s)
Vacunas contra la Influenza/administración & dosificación , Gripe Humana/prevención & control , Vacunación/normas , Adolescente , Adulto , Niño , Preescolar , China , Femenino , Humanos , Esquemas de Inmunización , Lactante , Persona de Mediana Edad , Embarazo , Estaciones del Año , Adulto Joven
13.
Prax Kinderpsychol Kinderpsychiatr ; 69(1): 22-39, 2020 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-31918644

RESUMEN

The Emotional Competence of Mothers and the Clinical Quality of Mother-Child Relationship in a Preschool Psychiatric Population The quality of mother-child interaction and relationship is an essential risk factor for the development of mental disorders at preschool age. We examine maternal emotional competence and maternal level of psychopathology as predictors for the quality of mother-child relationship. At the beginning of their treatment a clinical sample of mother-child-dyads at the Child Psychiatric Family Day Hospital in Münster was assessed concerning the emotional competence of mothers (EKF), the maternal psychopathology (SCL) and the mother-child relationship quality, the latter with three different instruments reflecting the mother's, the child's and the therapist's perspective (PIR-GAS, SKEI, M-PCR). The mothers showed decreased results in the EKF scales emotional regulation, recognition of emotions and in the EKF-overall-score and presented a higher level of maternal psychopathology compared to the normal population. There is a direct relation between emotional regulation and the M-PCR scales affective bond and functional-conflict. Besides the direct influence of the maternal psychopathology, the expected moderator effect of emotional expressiveness and the M-PCR scale functional-conflict, reported by mothers, was apparent. Certain aspects of the emotional competence of mothers and their psychopathology show an influence on mother-child relationship quality. The method and the perspective of assessment are crucial to the results.


Asunto(s)
Emociones , Trastornos Mentales , Relaciones Madre-Hijo , Madres , Preescolar , Femenino , Humanos , Madres/psicología , Psicopatología
14.
Prax Kinderpsychol Kinderpsychiatr ; 69(1): 3-21, 2020 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-31918650

RESUMEN

Parents' and Childcare Teachers' Agreement on Mental Health Problems, Psychosocial Ressources and Need for Action Young Children with mental health problems rarely receive professional help. Recognising a problem is one key factor for mental health care utilisation in kindergarten age. In this study psychosocial problems and ressources of 255 children (age 3,0-6,6 years) were assessed by parents and childcare teachers with the instrument "Verhaltensskalen für das Kindergartenalter" (VSK, Koglin u. Petermann, 2016). Subjective need for action was also measured. Teachers announced a need for action in 19.8 % of the children, while parents did so for 17.3 % of the children, but they agreed only for 18.9 % of these children. So agreement on need for action was low (κ = .16). Agreement was also low for psychosocial problems (Median ICC = .32), and very low with respect to the borderline/clinical range (κ = .13). No agreement was found for psychosocial ressources. Results underline the importance for Early Education and Care professionals to cooperate with institutions like social-pediatric centers to avoid blind spots in the identification of mental health problems in preschool age.


Asunto(s)
Trastornos de la Conducta Infantil , Salud Mental , Maestros , Niño , Trastornos de la Conducta Infantil/diagnóstico , Trastornos de la Conducta Infantil/terapia , Preescolar , Humanos , Padres
15.
Orv Hetil ; 161(4): 151-160, 2020 Jan.
Artículo en Húngaro | MEDLINE | ID: mdl-31955583

RESUMEN

Introduction: The prevalence of overweight and obesity is increasing worldwide, which affects not only adults, but children and adolescents as well. Moreover, this condition may lead to several comorbidities, such as elevated or even high blood pressure. Aim: Aim of this study was to assess the prevalence of overweight- and obesity-related elevated and high blood pressure in a population aged 3-18 years in Hungary. Method: Between 2005 and 2018, altogether 8624 (boys = 4719) individuals were enrolled to this study. Normal weight, overweight and obese groups were created on the basis of body mass index. The diagnosis of elevated (systolic and/or diastolic blood pressure is between 90th and 95th percentile) and high blood pressure (systolic and/or diastolic blood pressure is over 95th percentile) was based on detailed examination (laboratory tests, abdominal ultrasonography, paediatric cardiology and 24-hours ambulatory blood pressure monitoring). Results: In this study, the prevalence of overweight and obesity was 23.5% overall, 26.4% in boys and 20% in girls. The prevalence of elevated blood pressure was 9.8% in overweight patients, while it was 4.6% in the obese group. The prevalence of high blood pressure was 8.3% (odds ratio: 1.1%, 95% CI) among overweight subjects, while it was 26.7% (odds ratio: 3.6, 95% CI) in the obese group. Conclusion: To the best of our knowledge, this is the first Hungarian population-based study on the prevalence of overweight- and obesity-related elevated and high blood pressure assessed in a large contemporary cohort of children and adolescents. The cardiovascular risk is increased in this patient group. Hence, it is essential to set up a proper primary prevention strategy. Orv Hetil. 2020; 161(4): 151-160.


Asunto(s)
Hipertensión/epidemiología , Obesidad Pediátrica/epidemiología , Adolescente , Niño , Preescolar , Femenino , Humanos , Hungría/epidemiología , Masculino , Prevalencia
16.
FP Essent ; 488: 21-24, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31894952

RESUMEN

Toilet training is a developmental task that typically can be accomplished without medical intervention. Parent counseling about it can begin approximately at the 18- to 24-month well child visit. Guidelines from the American Academy of Pediatrics recommend beginning toilet training when the child shows signs of readiness, but typically not before age 2 years; praising success using positive terms; avoiding punishment, shaming, or force; and making training positive, nonthreatening, and natural. Nocturnal enuresis is defined as urinary incontinence that occurs at night during sleep in children 5 years or older for 3 consecutive months. It is common, affecting 5%-10% of 7-year-old children in the United States. Nonpharmacologic management includes behavioral interventions (eg, limiting fluid intake before bedtime, waking the child at night to attempt to urinate, lifting the sleeping child onto the toilet and then waking him or her to urinate, bladder training to increase bladder capacity, or instituting a reward system). Bed alarms are the first-line intervention but typically are not reimbursed by health insurance. Pharmacotherapy includes desmopressin, tricyclic antidepressants, and anticholinergics. The combination of a bed alarm with pharmacotherapy can be considered as initial management or after an unsuccessful initial intervention.


Asunto(s)
Enuresis Nocturna , Control de Esfínteres , Antidepresivos Tricíclicos , Terapia Conductista , Niño , Preescolar , Desamino Arginina Vasopresina , Femenino , Humanos , Lactante , Masculino , Enuresis Nocturna/terapia
17.
FP Essent ; 488: 25-34, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31894953

RESUMEN

Acute urinary tract infection (UTI) is among the most common bacterial infections in infants and children. Diagnosis requires evidence of infection and the presence of at least 50,000 colony-forming units (CFU)/mL of a pathogen cultured from an appropriately collected urine specimen. Febrile UTIs (ie, temperature 38°C [100.4°F] or greater) are most common during the first two years of life. Risk factors for UTI in febrile female infants are white race, age younger than 12 months, temperature 39°C (102.2°F) or greater, fever lasting 2 days or more, and absence of another source of infection. For febrile male infants, risk factors include being uncircumcised. If circumcised, risk factors include nonblack race, temperature 39°C (102.2°F) or greater, fever for more than 24 hours, and absence of another source of infection. Antibiotic treatment should be continued for 7 to 14 days. Renal and bladder ultrasonography is indicated for infants ages 2 to 24 months with a febrile UTI. If ultrasonography results are abnormal, a voiding cystourethrogram (VCUG) is indicated. VCUG also is indicated for children with recurrence of febrile UTI to identify vesicoureteral reflux and/or other anatomic findings associated with recurrent UTI. Recent studies have shown a statistically significant benefit of continuous antibiotic prophylaxis for prevention of recurrent UTI.


Asunto(s)
Infecciones Urinarias , Reflujo Vesicoureteral , Profilaxis Antibiótica , Niño , Preescolar , Femenino , Fiebre , Humanos , Lactante , Masculino , Factores de Riesgo
18.
Am J Clin Hypn ; 62(1-2): 60-73, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31265372

RESUMEN

This article examines the spatial and social nature of human relationships with children and adolescents in clinical hypnosis. Beginning with the unique way in which the phenomenon of rapport is intrinsic to the therapeutic uses of hypnosis and is distinct among other therapies, the stage is set for the importance of relational hypnosis. Through the use of case vignettes that illustrate developmental imperatives, relationship factors influencing the clinical interaction are demonstrated in practice. These include transference and countertransference, safety, embodiment, novelty, creativity, respect, trust, equality, being with, loving responses, synchronicity, and empathy. Hypnotic relating exists in a framework through which absorption in play and imagination evokes the child's resources and suggestions are made. In this receptive stance the personalized suggestions lead to an environment for positive change.


Asunto(s)
Hipnosis , Imaginación , Adolescente , Niño , Desarrollo Infantil , Preescolar , Femenino , Humanos , Masculino , Relaciones Profesional-Paciente , Alianza Terapéutica
19.
Br J Radiol ; 93(1105): 20180677, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31674803

RESUMEN

OBJECTIVES: Our aim was to compare cancer incidence in a cohort exposed in childhood (1950-63) to a therapeutic dose of radiation in the North of Portugal and followed-up until the end of 2012, with the incidence rates for the same age and sex in the general population. METHODS: A population-based North Region cancer registry (RORENO) was used to assess which members of the cohort developed cancer. The association between radiation exposure and overall and specific cancer sites was evaluated using standardised incidence ratios (SIR). RESULTS: Over the full follow-up period, 3357 individuals of the 5356 original tinea capitis (TC) cohort (63%) were retrieved in the RORENO, and 399 new cancer cases were identified, representing an increased risk of 49% when compared with the general population (SIR = 1.49; 95% CI: 1.35-1.64). The risk was slightly higher in males than in females (SIR = 1.65; 95% CI: 1.43-1.89 vs SIR = 1.35; CI = 1.17-1.55). The risk was slightly higher in the individuals exposed to a higher radiation dose (SIR = 1.78; 95% CI: 1.22-2.51 for ≥630 R vs SIR = 1.46; 95% CI: 1.31-1.62 for 325-475 R). In females, there was an excess cancer risk in all cancers with the higher radiation dose (SIR = 2.00; 95% CI: 1.21-3.13 for ≥630 R vs SIR = 1.30; 95% CI: 1.11-1.51 for 325-475 R) which was not observed in males, and for combined dose categories significantly raised SIRs for thyroid and head and neck cancer, suggesting a possible higher radiosensitivity of females. An increased risk was also observed for some cancers located far from the irradiated area. CONCLUSIONS: The results suggest an association between radiation exposure and later increased cancer risk for cancers located near the radiation exposed area, mainly thyroid, and head and neck cancers. Further studies are necessary to disentangle possible non-radiation causes for distant cancers increased risk. ADVANCES IN KNOWLEDGE: This paper shows a possible association between childhood X-ray epilation and increased risk of cancer which was not previously investigated in the Portuguese TC cohort.


Asunto(s)
Neoplasias Inducidas por Radiación/epidemiología , Tiña del Cuero Cabelludo/radioterapia , Niño , Preescolar , Femenino , Humanos , Incidencia , Lactante , Masculino , Portugal/epidemiología , Sistema de Registros , Factores de Riesgo
20.
J Sci Food Agric ; 100(2): 634-647, 2020 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-31591722

RESUMEN

BACKGROUND: Vitamin A deficiency (VAD) is widespread in sub-Saharan Africa (SSA). Unlike in developed countries, where the main source of vitamin A comes from meat, the diet of poor populations in SSA is largely plant based. It is thus important to identify local / popular plants with higher vitamin A content for combating VAD. Banana (including plantains) is an important staple food crop in this region. The identification and promotion of vitamin A-rich banana cultivars could contribute significantly to the alleviation of VAD in areas heavily dependent on the crop. We assessed pro-vitamin A carotenoid (pVACs) content in the fruit pulp of 48 local plantains from eastern Democratic Republic of Congo, to identify cultivars that could help reduce VAD, especially among young children and women of reproductive age. RESULTS: Mean pVACs content varied from 175-1756 µg/100 gfw in ripe fruits. Significant increases (P < 0.001) in total pVACs content occurred after ripening in all cultivars except 'UCG II'. Retinol activity equivalents (RAE) in ripe fruits ranged from 12-113 µg/100 gfw. Fifteen plantain cultivars, including 'Adili II', 'Nzirabahima', 'Mayayi', 'Buembe', and 'Sanza Tatu' (associated with RAE values of 44 µg/100 gfw and above) can be considered as good sources of pVACs. Modest consumption (250 or 500 gfw) of the fruit pulp of the five best plantain cultivars at ripening stage 5 meets between 39-71% and 44-81% of vitamin A dietary reference intake (DRI) respectively, for children below 5 years old and women of reproductive age. CONCLUSION: The 15 best plantain cultivars (especially the top 5) could potentially be introduced / promoted as alternative sources of pro-vitamin A in banana-dependent communities, and help to reduce cases of VAD substantially. © 2019 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.


Asunto(s)
Carotenoides/análisis , Musa/química , Vitamina A/análisis , Adolescente , Adulto , Carotenoides/metabolismo , Preescolar , República Democrática del Congo , Femenino , Frutas/química , Frutas/metabolismo , Humanos , Lactante , Masculino , Persona de Mediana Edad , Musa/clasificación , Musa/metabolismo , Provitaminas/análisis , Vitamina A/metabolismo , Deficiencia de Vitamina A/dietoterapia , Deficiencia de Vitamina A/metabolismo , Adulto Joven
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