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1.
Artigo em Alemão | MEDLINE | ID: mdl-31529181

RESUMO

Trends of frequent chronic diseases and health problems, e.g. allergic diseases, have already been published based on the KiGGS Wave 2 study as part of the health monitoring of children and adolescents in Germany. The present work complements these findings with results on less frequent noncommunicable diseases and the trend of communicable, vaccine-preventable diseases.Information from parents about diagnoses and diseases of their 0­ to 17-year-old children from the representative cross-sectional survey KiGGS Wave 2 (2014-2017) are compared with those from the KiGGS baseline survey (2003-2006) and KiGGS Wave 1 (2009-2012).The current KiGGS results show almost unchanged prevalences for the noncommunicable diseases epilepsy, migraine, and heart disease. However, the data from KiGGS Wave 2 are supportive of an increased prevalence of diabetes mellitus, which nevertheless continues to be relatively rare and predominantly type 1 diabetes in children and adolescents.The decline in measles, chicken pox, and whooping cough diseases related to changes in vaccination recommendations shows that preventive measures can effectively benefit children and adolescents.However, the data on vaccine-preventable diseases indicate regionally varying immunity gaps in certain age groups, so the prevention potential of the vaccination recommendations of the Standing Vaccination Commission (STIKO) at the Robert Koch Institute does not seem to have been sufficiently exploited.


Assuntos
Saúde do Adolescente/estatística & dados numéricos , Doença Crônica/epidemiologia , Viroses/epidemiologia , Adolescente , Varicela/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Epilepsia/epidemiologia , Alemanha/epidemiologia , Inquéritos Epidemiológicos , Cardiopatias/epidemiologia , Humanos , Lactente , Recém-Nascido , Sarampo/epidemiologia , Transtornos de Enxaqueca/epidemiologia , Convulsões Febris/epidemiologia , Coqueluche/epidemiologia
2.
Sci Total Environ ; 692: 589-594, 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31539966

RESUMO

BACKGROUND: Several studies have reported an association between seizure and the lunar cycle; however, results are conflicting. Thus, we investigated whether emergency department (ED) visits due to febrile seizure (FS) or FS plus were affected by lunar cycle. METHODS: We reviewed the medical records of patients who were admitted to the ED with a main diagnosis of FS or FS plus from January 1, 2005 to August 31, 2018 (13 years 8 months), a period of 4991 days with 169 lunar cycles. During that period, we collected weather data such as mean temperature, average atmospheric pressure (AP), and humidity according to lunar phase (new moon, first quarter, full moon, and third or last quarter). RESULTS: A total of 1979 patients were identified. We found male predominant with a mean age of 2.62 ±â€¯2.09 years. Acute pharyngotonsillitis was the most common cause of fever, generalized tonic-clonic seizure was the most common type of seizure, and the mean peak body temperature was 38.77 ±â€¯0.81 °C. The lunar cycle did not affect the onset or frequency of FS after adjustment; however, several factors, including season, O3 and NO2 concentrations, and holidays, were associated with FS. CONCLUSION: We did not find an association between lunar cycle and FS or FS plus. However, several factors, including season, O3, NO2, and holidays were associated with FS or FS plus.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Lua , Convulsões Febris/epidemiologia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Convulsões Febris/etiologia , Fatores de Tempo
3.
Pediatrics ; 143(5)2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31004046

RESUMO

BACKGROUND: Febrile seizures (FSs) are a common pediatric condition caused by a sudden rise in temperature, affecting 3% to 5% of children aged ≤6 years. Although vaccination can cause FSs, little is known on whether FSs occurring in the time soon after vaccination (vaccine-proximate febrile seizures [VP-FSs] differ clinically from non-vaccine-proximate febrile seizures [NVP-FSs]). We compared the clinical profile and outcomes of VP-FS to NVP-FS. METHODS: Prospective cohort study of children aged ≤6 years presenting with their first FS at 1 of 5 Australian pediatric hospitals between May 2013 and June 2014. Clinical features, management, and outcomes were compared between VP-FS and NVP-FS. RESULTS: Of 1022 first FS cases (median age 19.8 months; interquartile range 13.6-27.6), 67 (6%) were VP-FSs. When comparing VP-FS to NVP-FS, there was no increased risk of prolonged (>1 day) hospitalization (odds ratio [OR] 1.61; 95% confidence interval [95% CI] 0.84-3.10), ICU admission (OR 0.72; 95% CI 0.10-5.48), seizure duration >15 minutes (OR 1.47; 95% CI 0.73-2.98), repeat FS within 24 hours (OR 0.80; 95% CI 0.34-1.89), or requirement for antiepileptic treatment on discharge (OR 1.81; 95% CI 0.41-8.02). VP-FS patients with a laboratory-confirmed infection (12%) were more likely to have a prolonged admission compared with those without. CONCLUSIONS: VP-FS accounted for a small proportion of all FS hospital presentations. There was no difference in outcomes of VP-FS compared with NVP-FS. This is reassuring data for clinicians and parents of children who experience FS after vaccination and can help guide decisions on revaccination.


Assuntos
Convulsões Febris/diagnóstico , Convulsões Febris/epidemiologia , Índice de Gravidade de Doença , Vacinação/efeitos adversos , Austrália/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Prospectivos , Resultado do Tratamento , Vacinação/tendências
4.
J Neurosurg Anesthesiol ; 31(1): 144-150, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30767940

RESUMO

BACKGROUND: Simple febrile seizure (SFS) affects 2% to 4% of children under 6 years of age. The purpose of this study is to examine the epidemiologic patterns and resource utilization of SFS-associated hospitalizations in children aged younger than 6 years of age in the United States. MATERIALS AND METHODS: This study is a serial, retrospective analysis of the Healthcare Cost and Utilization Project Kids' Inpatient Databases for the years 2003, 2006, 2009, and 2012. SFS-associated hospitalizations were identified based on International Classification of Diseases, Ninth Revision, Clinical Modification, diagnosis code 780.31. We calculated the proportion of hospitalizations in pediatric patients under 6 years of age due to SFS and all other nonbirth causes, the rate of SFS-associated hospitalizations per 100,000 population, the mean length of stay and inflation-adjusted hospital costs of SFS-associated hospitalizations, as well as patient demographics and hospital characteristics. RESULTS: From 2003 to 2012, the weighted proportion of hospitalizations due to SFS declined from 0.83% to 0.41% (P<0.01) and the annual rate of SFS-associated hospitalizations per 100,000 population decreased from 48.0 to 18.7 (P<0.01). However, use of computed tomography, electroencephalogram, and lumbar puncture in SFS-associated hospitalizations decreased significantly (all P<0.001), but the utilization rate of magnetic resonance imaging remained stable (P=0.53). The mean length of stay for SFS-associated hospitalizations decreased from 2.03 days in 2003 to 1.74 days in 2012, and the mean hospital costs (exclusive of professional payment) decreased from $3830 in 2003 to $3223 in 2012 (both P<0.001). CONCLUSIONS: SFS-associated hospitalizations and resource utilization in children under 6 years of age have decreased markedly in the United States, probably due to improved clinical adherence to the practice parameters set forth by the American Academy of Pediatrics for managing patients with SFS.


Assuntos
Hospitalização/estatística & dados numéricos , Convulsões Febris/epidemiologia , Convulsões Febris/terapia , Fatores Etários , Pré-Escolar , Estudos Transversais , Feminino , Recursos em Saúde , Custos Hospitalares , Hospitalização/economia , Humanos , Lactente , Recém-Nascido , Tempo de Internação , Imagem por Ressonância Magnética/estatística & dados numéricos , Masculino , Estudos Retrospectivos , Convulsões Febris/economia , Fatores Socioeconômicos , Estados Unidos/epidemiologia
5.
Epilepsy Behav ; 90: 252-259, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30527252

RESUMO

PURPOSE: Differentiating between Dravet syndrome and non-Dravet SCN1A-related phenotypes is important for prognosis regarding epilepsy severity, cognitive development, and comorbidities. When a child is diagnosed with genetic epilepsy with febrile seizures plus (GEFS+) or febrile seizures (FS), accurate prognostic information is essential as well, but detailed information on seizure course, seizure freedom, medication use, and comorbidities is lacking for this milder patient group. In this cross-sectional study, we explore disease characteristics in milder SCN1A-related phenotypes and the nature, occurrence, and relationships of SCN1A-related comorbidities in both patients with Dravet and non-Dravet syndromes. METHODS: A cohort of 164 Dutch participants with SCN1A-related seizures was evaluated, consisting of 116 patients with Dravet syndrome and 48 patients with either GEFS+, febrile seizures plus (FS+), or FS. Clinical data were collected from medical records, semi-structured telephone interviews, and three questionnaires: the Functional Mobility Scale (FMS), the Pediatric Quality of Life Inventory (PedsQL) Measurement Model, and the Child or Adult Behavior Checklists (CBCL/ABCL). RESULTS: Walking disabilities and severe behavioral problems affect 71% and 43% of patients with Dravet syndrome respectively and are almost never present in patients with non-Dravet syndromes. These comorbidities are strongly correlated to lower quality-of-life (QoL) scores. Less severe comorbidities occur in patients with non-Dravet syndromes: learning problems and psychological/behavioral problems are reported for 27% and 38% respectively. The average QoL score of the non-Dravet group was comparable with that of the general population. The majority of patients with non-Dravet syndromes becomes seizure-free after 10 years of age (85%). CONCLUSIONS: Severe behavioral problems and walking disabilities are common in patients with Dravet syndrome and should receive specific attention during clinical management. Although the epilepsy course of patients with non-Dravet syndromes is much more favorable, milder comorbidities frequently occur in this group as well. Our results may be of great value for clinical care and informing newly diagnosed patients and their parents about prognosis.


Assuntos
Epilepsias Mioclônicas/epidemiologia , Epilepsias Mioclônicas/genética , Epilepsia/epidemiologia , Epilepsia/genética , Canal de Sódio Disparado por Voltagem NAV1.1/genética , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos de Coortes , Comorbidade , Estudos Transversais , Epilepsias Mioclônicas/diagnóstico , Epilepsia/diagnóstico , Síndromes Epilépticas/diagnóstico , Síndromes Epilépticas/epidemiologia , Síndromes Epilépticas/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Estudos Retrospectivos , Convulsões Febris/diagnóstico , Convulsões Febris/epidemiologia , Convulsões Febris/genética , Espasmos Infantis/diagnóstico , Espasmos Infantis/epidemiologia , Espasmos Infantis/genética , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
6.
Seizure ; 64: 77-83, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30594055

RESUMO

PURPOSE: We performed a large, population-based study to analyze the risk factors of the febrile seizures and the subsequent afebrile epileptic seizures. METHODS: Relevant data from children born between 2002-2007 were retrieved from the Korean National Health Insurance Service-National Sample Cohort 2002-2013. Children who did not survive the first five years were excluded from the analysis. The risk factors for febrile seizures were assessed separately in per-person and per-febrile case analyses, and factors contributing to an increased risk of subsequent afebrile epileptic seizures were identified. RESULTS: A total of 54,233 children were included and the five-year prevalence rate of febrile seizure was 11.19%. In the per-person analysis, male sex, preterm birth and brain injury at birth increased the risk of febrile seizure with odds ratios of 1.17, 1.40 and 1.97 (all p < 0.001), respectively. A high household income level was associated with reduced odds of febrile seizure. In the per-febrile illness analysis, male sex, brain injury at birth, presumed bacterial infection, gastrointestinal or genitourinary infection and unspecified sepsis were independent risk factors of a febrile seizure during febrile illness. The cumulative number of febrile seizure episodes, especially more than the third episodes, was associated with a new diagnosis of an afebrile epileptic seizure within one year. CONCLUSION: Sex, preterm birth, brain injury at birth, presumed bacterial infection, genitourinary and gastrointestinal infections and unspecified sepsis were identified as likely risk factors for febrile seizures. A greater number of febrile seizure episodes was associated with a higher probability of subsequent afebrile epileptic seizures.


Assuntos
Epilepsia/epidemiologia , Convulsões Febris/epidemiologia , Pré-Escolar , Epilepsia/etiologia , Feminino , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Prevalência , República da Coreia/epidemiologia , Fatores de Risco , Convulsões Febris/etiologia , Fatores Sexuais
8.
Biom J ; 60(6): 1110-1120, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30284323

RESUMO

The self-controlled case series method assumes that adverse outcomes arise according to a non-homogeneous Poisson process. This implies that it is applicable to independent recurrent outcomes. However, the self-controlled case series method may also be applied to unique, non-recurrent outcomes or first outcomes only, in the limit where these become rare. We investigate this rare outcome assumption when the self-controlled case series method is applied to non-recurrent outcomes. We study this requirement analytically and by simulation, and quantify what is meant by 'rare' in this context. In simulations we also apply the self-controlled risk interval design, a special case of the self-controlled case series design. To illustrate, we extract data on the incidence rate of some recurrent and non-recurrent outcomes within a defined study population to check whether outcomes are sufficiently rare for the rare outcome assumption to hold when applying the self-controlled case series method to first or unique outcomes. The main findings are that the relative bias should be no more than 5% when the cumulative incidence over total time observed is less than 0.1 per individual. Inclusion of age (or calendar time) effects will further reduce bias. Designs that begin observation with exposure maximise bias, whereas little or no bias will be apparent when there is no time trend in the distribution of exposures, or when exposure is central within time observed.


Assuntos
Biometria/métodos , Estudos Epidemiológicos , Viés , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Funções Verossimilhança , Distribuição de Poisson , Recidiva , Convulsões Febris/epidemiologia
9.
BMC Pediatr ; 18(1): 297, 2018 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-30193581

RESUMO

BACKGROUND: Suboptimal intake of magnesium become prevalent due to the modern diet of processed food low in magnesium. Magnesium may modulate seizure activity by antagonizing excitatory calcium influx through the N-methyl-D-aspartate receptor. Although hyponatremia has been reported to be common in febrile seizures, the most common form of seizure, little is known about the status of serum ionized magnesium. We therefore investigated the status of serum ionized magnesium (iMg2+) in children with febrile seizures and compared with controls. METHODS: We included all patients from 1 to 6 years old who had presented with febrile seizure to the pediatric emergency department at the Korea University Guro Hospital from July 2016 to February 2017. The control group comprised patients admitted to the hospital with febrile respiratory tract infections, but with no history of febrile seizure. Clinical data, blood tests, and electroencephalogram (EEG) results were reviewed using the patients' medical records. RESULTS: A total of 133 patients with febrile seizure and 141 control patients were analyzed in the present study. As a result, hypomagnesemia (< 0.50 mmol/L) was more common in patients with febrile seizure than in controls (42.9% vs. 6.9%, p < 0.001) and it was an independent risk factor for febrile seizure (OR, odds ratio = 22.12, 95% CI = 9.23-53.02, P < 0.001). A receiver operating curve analysis revealed that serum iMg2+ levels < 0.51 mmol/L predicted the presence of febrile seizures with a sensitivity of 45.1% and a specificity of 92.6% (AUC, area under the curve = 0.731, 95% confidence interval = 0.671-0.791). When the patients with febrile seizure were divided in terms of a serum iMg2+ concentration of 0.51 mmol/L, there was no difference in clinical features. CONCLUSIONS: Hypomagnesemia was more common and serum iMg2+ level was lower in patients with febrile seizures than in controls. However, further evidence is needed for the causal relationship between low magnesium and febrile convulsions.


Assuntos
Magnésio/sangue , Convulsões Febris/epidemiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Serviço Hospitalar de Emergência , Feminino , Humanos , Hiponatremia/epidemiologia , Lactente , Masculino , República da Coreia/epidemiologia , Fatores de Risco , Sensibilidade e Especificidade
10.
Medicina (B Aires) ; 78 Suppl 2: 6-11, 2018.
Artigo em Espanhol | MEDLINE | ID: mdl-30199358

RESUMO

Paroxysmal episodes are one of the most common neurological disorders in children. It is important to distinguish between paroxysmal non-epileptic events, symptomatic seizures, febrile seizures, and unprovoked seizures. Patient's history is the key to proper diagnosis in most of the cases. A single unprovoked seizure is a frequent phenomenon in the pediatric population. Studies of recurrence after a first unprovoked seizure show percentages between 23% and 96% over a median follow-up of two years. The aim of this study is to define how to evaluate the first unprovoked epileptic seizure in a child and to review the weight of the different recurrence risk factors. Several factors enable us to predict the recurrence risk after a first unprovoked seizure including family history of epilepsy, prior history of febrile seizures, age at onset, type of seizure, prolonged seizures at onset, multiple seizures in a single day, sleep state, neurological abnormalities, etiology, and abnormalities in the electroencephalogram. The most important of these risk factors are the etiology of the seizures and the evidence of epileptiform abnormalities in the electroencephalogram.


Assuntos
Epilepsia/diagnóstico , Convulsões Febris/diagnóstico , Criança , Pré-Escolar , Eletroencefalografia , Epilepsia/epidemiologia , Humanos , Incidência , Imagem por Ressonância Magnética , Masculino , Valor Preditivo dos Testes , Recidiva , Fatores de Risco , Convulsões Febris/epidemiologia
11.
Seizure ; 61: 164-169, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30172997

RESUMO

PURPOSE: Trends of epilepsy in children were correlated with febrile seizure (FS) in a previous retrospective study. In the present study, the authors obtained relevant data from a nationwide cohort database to investigate trends in subsequent epilepsy in children with a history of recurrent FS. METHODS: A total of 10,210 children with FS comprised the cohort. The diagnosis date was used as the index date. A comparison cohort was randomly matched with each case based on age, sex, urbanization level, parents' occupation, and index date. Cox proportional hazard regression was performed to estimate the hazard ratio and confidence interval of FS-associated epilepsy. RESULTS: This retrospective cohort study included 7729 children with FS and a comparison cohort of 30,916 children. The incidence of epilepsy was 11.4-fold higher in the FS cohort than in the comparison cohort (5.67 vs. 0.49 per 1000 person-years, respectively). Compared with the comparison cohort, the epilepsy incidence rate ratio increased in children with admissions for FS, from 8.62 at 1 admission to 26.2 at ≥2 admissions (95% CI 6.80-10.9, and 19.78-34.8, respectively; p for trend < 0.0001). CONCLUSION: FS may increase the risk for subsequent epilepsy in children. Recurrent FS increased the cumulative incidence of epilepsy.


Assuntos
Convulsões Febris/epidemiologia , Convulsões Febris/fisiopatologia , Distribuição por Idade , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Masculino , Transtornos Mentais/epidemiologia , Programas Nacionais de Saúde/estatística & dados numéricos , Transtornos do Neurodesenvolvimento/epidemiologia , Recidiva , Estudos Retrospectivos , Fatores Sexuais , Estatísticas não Paramétricas , Taiwan
12.
Seizure ; 61: 45-49, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30081300

RESUMO

PURPOSE: Despite the fact that socioeconomic and environmental factors of a population are changing over time, there are few studies focusing on the effects of sociodemographic factors on the prevalence of febrile seizures (FS). This study was designed to find out the prevalence of FS and to investigate the effect of socio-cultural and economic factors on this prevalence among the Turkish school children. METHODS: A school-based, cross-sectional study was conducted in first and second-class children. Data were collected through a questionnaire from the parents who agreed to be involved in the study. The survey had questions about some socioeconomic and demographic features of the children and febrile seizure episodes. RESULTS: 3806 children and parent pairs accepted to participate in the survey. Febrile seizure prevalence was 4.8%. It was found that the prevalence of FS was significantly associated with the chronic illnesses of a child that requires continuous medication, developmental delay of a child, NICU history, gestational hypertension history of a mother, and lower educational level of a mother. Recurrence of FS was observed in 32.9% of children. Children whose first FS was seen below the 39 °C had 1.9 times more recurrence risk. CONCLUSION: FS prevalence rate has declined from 9.7% to 4.3% in our study population within ten years. It was thought that advancing healthcare systems in our country might be decreased the prevalence. Our study enabled us to find out sociodemographic risk factors of FS, but further studies are needed in order to confirm the effect of sociodemographic factors on FS prevalence.


Assuntos
Instituições Acadêmicas , Convulsões Febris/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Hipertensão Induzida pela Gravidez/epidemiologia , Hipertensão Induzida pela Gravidez/fisiopatologia , Masculino , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Turquia/epidemiologia
13.
Vaccine ; 36(39): 5803-5806, 2018 09 18.
Artigo em Inglês | MEDLINE | ID: mdl-30131195

RESUMO

This post-hoc analysis of data from a matched cohort study investigated the risk of febrile convulsions (FC) 5-12 days post-first dose of measles-mumps-rubella-varicella vaccine (MMRV) in a low-risk population, compared to measles-mumps-rubella (MMR) and varicella (V) vaccines administered separately. The low-risk population excluded children with personal history of FC (Scenario 1) and children with personal or/and family history (≥1 parent/sibling) of FC (Scenario 2). Incidence of FC post-MMRV in Scenario 2 (excluding at risk children) (36.3-49.5/100,000) and post-MMR+V in the whole cohort including children with personal/family history of FC (43.6/100,000) were similar. The risk difference of FC increased by 0.2 case/100,000 in Scenario 1 and decreased by 5.3-8.6 cases/100,000 of vaccinated children in Scenario 2, compared to the whole cohort. The overall risk of FC post-first dose MMRV vaccination could be lowered by administering MMRV only to children with no personal or family history of FC.


Assuntos
Vacina contra Varicela/efeitos adversos , Esquemas de Imunização , Vacina contra Sarampo-Caxumba-Rubéola/efeitos adversos , Anamnese , Convulsões Febris/epidemiologia , Anticorpos Antivirais/sangue , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Alemanha/epidemiologia , Humanos , Incidência , Lactente , Masculino , Risco , Medição de Risco , Convulsões Febris/etiologia , Vacinação/efeitos adversos , Vacinas Combinadas/efeitos adversos
14.
Seizure ; 61: 149-152, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30153626

RESUMO

PURPOSE: Several studies reported recent trends in febrile seizure (FS) in terms of prevalence, incidence, and hospitalization rates at a national level in the USA. However, no studies have revealed risk factors for repeated admissions due to FS. METHOD: We extracted discharge records of patients with FS aged < 6 years for the years 2010-14 using the Nationwide Readmission. Data were weighted to estimate the readmission rates and ascertain the factors associated with readmission due to FS, using multivariable negative binomial regression and Cox proportional hazard models. RESULTS: The readmission rate of FS is approximately 3.45 cases per 1000 person-months after hospital discharge. Children aged 1-3 years had elevated rate of FS readmission with a peak age of 2 (adjusted IRR, 5.09; 95%CI, 2.25-11.5). Boys had 1.75 times higher rates of FS readmission than girls (95%CI, 1.13-2.70). Children with very-low income levels were more likely to be readmitted, compared to those with very-high income levels (adjusted IRR, 2.57; 95%CI, 1.39-4.76). CONCLUSIONS: We provided novel insights into the current epidemiology of children with FS and risk factors associated with FS readmissions.


Assuntos
Readmissão do Paciente/estatística & dados numéricos , Convulsões Febris/epidemiologia , Criança , Pré-Escolar , Feminino , Inquéritos Epidemiológicos , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Prevalência , Análise de Regressão , Estudos Retrospectivos , Fatores de Risco , Convulsões Febris/diagnóstico , Estados Unidos
15.
J Med Virol ; 90(11): 1757-1764, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30011348

RESUMO

BACKGROUND: Human herpesvirus 6B (HHV-6B) is the causative agent of Roseola infantum, and has also been suggested to play a role in the pathogenesis of febrile seizures in young children, a percentage of whom go on to develop febrile status epilepticus (FSE), but the existing data is conflicting and inconclusive. HHV-6A is a distinct species, rarely detected in most parts of the world, but prior studies suggest a higher prevalence in febrile African children. We describe a case-control study comparing the frequency of HHV-6A and/or HHV-6B infections in children with febrile seizures (including FSE) and a control group of febrile children without seizures. METHODS: We recruited children aged 6 to 60 months admitted with a febrile illness with (cases) or without (controls) seizures presenting within 48 hours of commencement of fever. Three milliliters of whole blood was centrifuged and plasma stored at -80°C for pooled screening for HHV-6B and HHV-6A by Taqman real-time polymerase chain reaction. RESULTS: 102 cases and 95 controls were recruited. The prevalence of HHV-6B DNA detection did not differ significantly between cases (5.8% (6/102)) and controls (10.5% (10/95)) but HHV-6B infection was associated with FSE (OR, 15; 95% CI, [1.99-120]; P= 0.009). HHV-6A was not detected. CONCLUSION: Prevalence of HHV-6B was similar among cases and controls. Within the FS group, HHV-6B infection was associated with FSE, suggesting HHV-6B infections could play a role in the pathogenesis of FSE.


Assuntos
Exantema Súbito/complicações , Exantema Súbito/patologia , Herpesvirus Humano 6/isolamento & purificação , Convulsões Febris/epidemiologia , Estado Epiléptico/epidemiologia , Estudos de Casos e Controles , Pré-Escolar , Exantema Súbito/virologia , Feminino , Herpesvirus Humano 6/genética , Hospitais , Humanos , Lactente , Masculino , Prevalência , Reação em Cadeia da Polimerase em Tempo Real , Zâmbia/epidemiologia
16.
Ital J Pediatr ; 44(1): 70, 2018 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-29907116

RESUMO

BACKGROUND: In previous study, we have found intermittent oral levetiracetam (LEV) can effectively prevent recurrence of febrile seizure (FS). This study aimed to analyze the effects of the preventive on the patients with frequent FS accompanied with epileptiform discharge. METHODS: Patients with frequent FS were assigned to undergo Electroencephalogram (EEG). At the onset of fever, the patients who presented epileptiform discharge were orally administered with LEV with a dose of 15-30 mg/kg per day twice daily for 1 week, thereafter, the dosage was gradually reduced until totally discontinued in the second week. The seizure frequency associated with febrile events and FS recurrence rate during a 48-week follow-up were analyzed. RESULTS: among the 19 patients presented epileptiform discharge on EEG, 31.58% (6 of 19) had complex FS, 68.42% (13 of 19) had simple FS. Up to 57.89% (11 of 19) had a family history of seizure disorder and 36.84% (7 of 19) had a family history of FS in first-degree relatives. 42.11% (8 of 19) happened the first FS episode at the age < 18 months. 36.84% (7/19) presented generalized spikes, 63.16% (12/19) showed focal spikes. During the 48-week follow-up period, the patients experienced 26 febrile episodes, none of them presented seizure recurrence. CONCLUSION: Intermittent oral LEV can prevent the seizure recurrence of FS accompanied with epileptiform discharge in 48-week. However, further randomized controlled trials should be conducted. TRIAL REGISTRATION: ChiCTR-IPR-15007241 ; Registered 1 January 2014 - Retrospectively registered.


Assuntos
Eletroencefalografia/métodos , Epilepsia/tratamento farmacológico , Epilepsia/epidemiologia , Piracetam/análogos & derivados , Convulsões Febris/tratamento farmacológico , Convulsões Febris/epidemiologia , Administração Oral , Assistência Ambulatorial , Anticonvulsivantes/administração & dosagem , Pré-Escolar , Estudos de Coortes , Comorbidade , Relação Dose-Resposta a Droga , Esquema de Medicação , Epilepsia/diagnóstico por imagem , Feminino , Humanos , Lactente , Levetiracetam , Masculino , Projetos Piloto , Piracetam/administração & dosagem , Prognóstico , Recidiva , Estudos Retrospectivos , Convulsões Febris/diagnóstico por imagem , Índice de Gravidade de Doença , Resultado do Tratamento
17.
Brain Dev ; 40(9): 775-780, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29801922

RESUMO

PURPOSE: Epilepsy is an important neurological condition that frequently associated with neurobehavioral disorders in childhood. Our aim was to identify the risk of developing epilepsy subsequent to febrile seizure and the association between epilepsy risk factors and neurobehavioral disorders. SUBJECTS AND METHODS: This longitudinal population-based cohort data included 952 patients with a febrile seizure diagnosis and 3808 age- and sex-matched controls. Participants were recruited for the study from 1996 to 2011, and all patients were followed up for maximum 12.34 years. RESULTS: The association of epilepsy was significantly higher (18.76-fold) in individuals that experienced febrile seizure compared to controls. Further, of those individuals who experienced febrile seizure, the frequency of subsequent development of epilepsy was 2.15-fold greater in females, 4.846-fold greater in patients with recurrent febrile seizure, and 11.26-fold greater patients with comorbid autism. CONCLUSIONS: Our study showed that being female, comorbid autism with febrile seizure and recurrent febrile seizure had an increased association with development of epilepsy. Increased recognition the association for epilepsy might be warranted in those febrile seizure children with certain characteristics.


Assuntos
Epilepsia/epidemiologia , Epilepsia/etiologia , Convulsões Febris/complicações , Convulsões Febris/epidemiologia , Fatores Etários , Transtorno Autístico/complicações , Transtorno Autístico/epidemiologia , Transtorno Autístico/fisiopatologia , Pré-Escolar , Comorbidade , Progressão da Doença , Epilepsia/fisiopatologia , Feminino , Seguimentos , Humanos , Lactente , Estimativa de Kaplan-Meier , Estudos Longitudinais , Masculino , Fatores de Risco , Convulsões Febris/fisiopatologia , Fatores Sexuais
18.
Acad Emerg Med ; 25(11): 1242-1250, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29701893

RESUMO

OBJECTIVES: The objective was to determine the national lumbar puncture (LP) practice patterns relative to the incidence of central nervous system (CNS) infections among children presenting to the emergency department (ED) with complex febrile seizures (CFS). METHODS: This was a retrospective study of ED visits for CFS from 2007 to 2014 in patients aged 0 to 5 years using a national sample. Primary outcomes include the frequency of LP, incidence of CNS infections, and ED disposition. RESULTS: Of 28,810 ED visits for CFS (44.4% female; mean age = 1.39 years), LP was performed in 7,445 (25.8%, 95% confidence interval [CI] 23.5%-28.2%). There was no significant difference in the proportion due to hospital teaching status or geographical region. The proportion decreased from 31.4% to 17.8% over the study period (Rao-Scott statistic = 5.85, p < 0.001). CNS infection was diagnosed in 80 (0.3%) encounters (95% CI = 41-112). The most commonly associated infections were otitis media (16.8%), upper respiratory infections (15.8%), and other viral infections (14.6%). A total of 14,696 encounters (51.0%, 95% CI = 47.9%-54.1%) resulted in a hospital admission. CONCLUSIONS: Although rates have been declining, LP was performed in one-fourth of ED encounters for CFS over the 8-year study period. The incidence of CNS infections was very low, however, suggesting that this procedure could be avoided in many patients.


Assuntos
Infecções do Sistema Nervoso Central/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Convulsões Febris/epidemiologia , Punção Espinal/estatística & dados numéricos , Infecções do Sistema Nervoso Central/líquido cefalorraquidiano , Infecções do Sistema Nervoso Central/diagnóstico , Criança , Pré-Escolar , Feminino , Hospitalização , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos
19.
Scand J Work Environ Health ; 44(5): 539-546, 2018 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-29574476

RESUMO

Objectives Exposure to traffic noise and air pollution is suspected to increase susceptibility to viral infections - the main triggering factor for febrile seizures. No studies have examined these two exposures in relation to febrile seizures. We aimed to investigate whether exposure to road traffic noise and air pollution are associated with risk of febrile seizures in childhood. Methods From our study base of 51 465 singletons from a national birth cohort, we identified 2175 cases with febrile seizures using a nationwide registry. Residential address history from conception to six years of age were found in national registers, and road traffic noise (L den) and air pollution (NO 2) were modeled for all addresses. Analyses were done using Cox proportional hazard model with adjustment for potential confounders, including mutual exposure adjustment. Results An interquartile range (IQR) increase in childhood exposure to road traffic noise and air pollution was associated with an 11% [incidence rate ratio (IRR) 1.11, 95% confidence interval (CI) 1.04-1.19) and 5% (IRR 1.05, 95% CI 1.02-1.07) higher risk for febrile seizures, respectively, after adjustment for potential confounders. Weaker tendencies were seen for pregnancy exposure. In models with mutual exposure adjustment, the estimates were slightly lower, with IRR of 1.08 (95% CI 1.00-1.16) and 1.03 (95% CI 0.99-1.06) per IQR increase in childhood exposure to road traffic noise and air pollution, respectively. Conclusions This study suggests that residential exposure to road traffic noise and air pollution is associated with higher risk for febrile seizures.


Assuntos
Poluição do Ar/efeitos adversos , Ruído dos Transportes/efeitos adversos , Convulsões Febris/epidemiologia , Emissões de Veículos/toxicidade , Criança , Pré-Escolar , Estudos de Coortes , Dinamarca/epidemiologia , Feminino , Humanos , Lactente , Masculino , Convulsões Febris/etiologia
20.
Epilepsy Behav ; 80: 280-284, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29422395

RESUMO

Several studies describing the diurnal occurrence of febrile seizures have reported greater seizure frequency early or late in the evening relative to midnight or early morning. However, no articles have reported on the diurnal occurrence of complex febrile seizure. Moreover, no studies have addressed the relationship between seizure severity and diurnal occurrence. We retrospectively evaluated complex febrile seizures in 462 children needing hospitalization, and investigated the relationship between severity and diurnal occurrence according to four categorized time periods (morning, afternoon, evening, and night). Our study showed that complex febrile seizures occurred most often in the evening, peaking around 18:00 (18:00-18:59), and least often at night (02:00-02:59). In addition, the frequency with which patients developed status epilepticus or needed anticonvulsant treatments was also lower during the night. However, the seizure duration and the proportion of the patients who needed anticonvulsant treatment were the same among the four time periods. Furthermore, we compared three subclasses (repeated episodes of convulsions, focal seizures, and prolonged seizures (≧15min)), two of the complex features (focal seizures and prolonged seizures), and all complex features among the four time periods. However, they were the same among the four time periods. Taken together, our data indicate that although the severity of seizures was stable over a 24-hour period, the occurrence of seizures in our cohort of pediatric patients with complex febrile seizures requiring hospitalization was highest in the evening and lowest at night.


Assuntos
Ritmo Circadiano , Fotoperíodo , Convulsões Febris/fisiopatologia , Estado Epiléptico/fisiopatologia , Criança , Estudos de Coortes , Feminino , Hospitalização , Humanos , Lactente , Japão/epidemiologia , Masculino , Estudos Retrospectivos , Convulsões Febris/epidemiologia , Estado Epiléptico/epidemiologia
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