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1.
J Biol Regul Homeost Agents ; 34(4 Suppl. 2): 1-1, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33000592

RESUMO

This special issue provides a rich blend of news, reviews and clinical studies on many aspects of the understanding, management and prevention of cardiovascular disease in childhood. Primary care in pediatric cardiology, principally, must concern with prevention of heart disease and early detection of existing illness. In addition, pediatricians must be able to maintain the vigilance of "healthy" children in order to prevent cardiovascular risk in adulthood. With these goals, the themes presented in this "mosaic" of topics include - Cardiovascular involvement in genetic syndromes, SIDS and infectious, endocrine, kidney, storage or autoimmune diseases. - Pulmonary hypertension and patent ductus arteriosus in premature infants. - Cardiovascular risk in obese or hypertensive children. - Bicupid aortic valve and aortic dysfunction - Covid 19 and heart disease in childhood I thank the Researchers and Professors of Catanzaro, Palermo, Pavia, Brescia, Taormina and Messina University for their interesting and up-to-date scientific contributions, and I hope the information gathered in this issue will be useful to the reader.


Assuntos
Cardiologia , Pediatria , Betacoronavirus , Criança , Infecções por Coronavirus , Humanos , Lactente , Pandemias , Pneumonia Viral
2.
Sleep Med Clin ; 15(3S): e1-e7, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33008491

RESUMO

Prior to the COVID-19 pandemic, few pediatric sleep medicine clinicians routinely engaged in telemedicine visits because thorough examinations were difficult to perform; there was lack of consistent reimbursement; and many clinicians were busy with their in-office practices. This article reviews how telemedicine has been explored in pediatric sleep medicine prior to the pandemic, current applications of telemedicine, challenges, and reimagining pediatric sleep within the realm of telemedicine.


Assuntos
Pediatria , Medicina do Sono , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/terapia , Telemedicina/métodos , Betacoronavirus , Criança , Pressão Positiva Contínua nas Vias Aéreas , Infecções por Coronavirus , Humanos , Otolaringologia , Pandemias , Pneumonia Viral , Polissonografia , Encaminhamento e Consulta , Síndrome das Pernas Inquietas/diagnóstico , Síndrome das Pernas Inquietas/terapia , Sono , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/terapia , Transtornos do Sono do Ritmo Circadiano/diagnóstico , Transtornos do Sono do Ritmo Circadiano/terapia , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/terapia
3.
Ital J Pediatr ; 46(1): 142, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008445

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) is currently rare in children and they seem to have a milder disease course and better prognosis than adults. However, SARS-Cov-2 pandemic has indirectly caused problems in pediatric medical assistance. In view of this we wanted to draw a picture of what happened during health emergency and analyze future prospects for restarting. METHODS: We involved the Italian pediatric scientific societies institutionally collected in the Italian Federation of Associations and Scientific Societies of the Pediatric Area (FIARPED); We sent a questionnaire to all scientific societies about the pediatric care activity during the COVID-19 emergency and future perspectives for the phase of post-containment. RESULTS: The analysis of the questionnaires showed significant decrease of:admission, outpatient visits and specialist consultancy activities during the COVID-19 emergency, primarily linked to the fear of infection. Instead it was increased the serious degree of diseases admitted. Most of scientific societies maintained the relationship with chronic patients through some form of telemedicine, reporting a strong positive opinion about this modality. Finally showed the need to give life a new approach for hospitalizations and outpatient visits through a greater use of telemedicine, educational programs on families and a more decisive role of family pediatricians. CONCLUSIONS: Our study highlighted many aspects that can be improved in pediatric care. We think that It will be necessary a new shared strategy to improve the management and continuity of care for pediatric patients, primarily developing a network of collaboration between families, family pediatrician and hospitals and by enhancing the use of new methods of telecommunications.


Assuntos
Infecções por Coronavirus/prevenção & controle , Controle de Infecções/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena/organização & administração , Inquéritos e Questionários , Telemedicina/estatística & dados numéricos , Adulto , Assistência Ambulatorial/estatística & dados numéricos , Criança , Infecções por Coronavirus/epidemiologia , Assistência à Saúde/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Itália , Masculino , Avaliação de Resultados em Cuidados de Saúde , Pandemias/estatística & dados numéricos , Planejamento de Assistência ao Paciente/organização & administração , Pediatria/métodos , Pneumonia Viral/epidemiologia , Sociedades Médicas
5.
World J Gastroenterol ; 26(36): 5387-5394, 2020 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-33024391

RESUMO

The current coronavirus pandemic is imposing unpreceded challenges to the practice of pediatric gastroenterology. These are highlighted in their impact on performing aerosol-generating endoscopy procedures and the need to accommodate longer room turnaround time for disinfection, ensuring appropriate and consistent safety measures for patients, staff and providers, and emphasizing the importance for screening patients for active coronavirus disease (COVID) infection before endoscopy when possible. Pediatric patients are less likely to exhibit severe COVID-related symptoms so survey-based screening would not be a sensitive measure to identify patients with active infections. To address the restrictions of patients coming for face to face clinic encounters, there has been rapid expansion of telehealth services in a very short time period with several difficulties encountered. To survive these challenges, pediatric gastroenterology practices need to adapt and accept flexibility in clinical operations with ongoing commitment to safety for patients and healthcare workers.


Assuntos
Infecções por Coronavirus , Gastroenterologia/métodos , Controle de Infecções/métodos , Pandemias , Segurança do Paciente , Pediatria/métodos , Pneumonia Viral , Betacoronavirus , Humanos , Telemedicina/tendências
6.
Pediatr Rheumatol Online J ; 18(1): 78, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-33059714

RESUMO

Telehealth is an extraordinary advancement of modern medicine. It has increased access to care for underserved populations and, in the case of pediatric rheumatology, has expanded the reach of a limited work force. During the Coronavirus Disease 2019 (COVID-19) pandemic, telehealth has radically changed the way healthcare workers have been able to deliver care while maintaining social distance. In addition to the infectious havoc of COVID-19, the pandemic has further altered the psychosocial milleu of our society which directly impacts the wellness and safety of our pediatric rheumatology patients. These psychosocial factors may be difficult to assess and triage solely using telehealth. The objective of this short review is to educate practitioners on the psychosocial concerns exacerbated by the COVID-19 pandemic and to discuss the possible hurdles in utilization of telehealth to care for our vulnerable patient population.


Assuntos
Infecções por Coronavirus , Pandemias , Pediatria , Pneumonia Viral , Reumatologia , Telemedicina , Betacoronavirus , Criança , Maus-Tratos Infantis , Depressão , Humanos , Saúde Mental , Assistência Centrada no Paciente , Medição de Risco , Meio Social , Transtornos Relacionados ao Uso de Substâncias
7.
Ital J Pediatr ; 46(1): 146, 2020 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-33023616

RESUMO

BACKGROUND: There is ample evidence that COVID-19 is significantly less severe in children than in adults and asthma and allergy, the most common chronic disorders in children, are not included in the top 10 comorbidities related to COVID-19 fatalities. Nevertheless, concerns about asthma and allergy are still high.. In order to evaluate the impact of paediatric COVID-19 among Italian paediatricians, we sent a 20-questions anonymous internet-based survey to 250 Italian paediatricians with particular address to allergic symptoms and those affecting the upper airways. METHODS: The questionnaire was conceived and pretested in April 2020, by a working group of experts of the Italian Paediatric Society for Allergy and Immunology (SIAIP), and structured into different sections of 20 categorized and multiple choice questions. The first part included questions about epidemiological data follows by a second part assessing the way to manage a suspected COVID-19 infection and personal experiences about that. The third part concerned questions about patients' clinical characteristics and clinical manifestations. The survey was emailed once between April and mid-May 2020. RESULTS: A total 99 participants had participated in our survey and provided responses to our electronic questionnaire. The distribution of patients reported per month varies significantly according to the geographical area (P = 0.02). Data confirmed that in the North part of Italy the rate of patients referred is higher than in the rest of Italy. Almost all respondents (98%) reported caring for up to a maximum of 10 infected children and the last 2% more than twenty. Among these patients, according to the 75% of responders, a maximum rate of 20% were affected by allergic rhino-conjunctivitis and in particular in the North of Italy while in the Centre and in the South there was a higher incidence (P = 0.09). Almost the same applies for asthma, 83% of responders declared that up to a maximum of 20% of affected children were asthmatic, from 20 to 40% for the 13,5% of responders and from 40 to 60% for the last 3,5%. As for the allergic conjunctivitis also for asthma, we found a higher incidence in the Centre and in South than in the North (P = 0.03). CONCLUSIONS: This study is the first to provide a comprehensive review of COVID-19 knowledge and impact among paediatricians in Italy about allergic asthma and upper airway involvement. From our point of view, it provides important information clearly useful for improving a good practice.


Assuntos
Conjuntivite Alérgica/epidemiologia , Infecções por Coronavirus/epidemiologia , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Rinite Alérgica/epidemiologia , Inquéritos e Questionários , Adolescente , Distribuição por Idade , Causalidade , Criança , Conjuntivite Alérgica/diagnóstico , Infecções por Coronavirus/prevenção & controle , Estudos Transversais , Feminino , Humanos , Incidência , Itália/epidemiologia , Masculino , Pandemias/prevenção & controle , Pediatras/estatística & dados numéricos , Pediatria/normas , Pneumonia Viral/prevenção & controle , Rinite Alérgica/diagnóstico , Medição de Risco , Distribuição por Sexo , Sociedades Médicas
8.
Ital J Pediatr ; 46(1): 149, 2020 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-33032650

RESUMO

The rapid spread of the COVID-19 outbreak in Italy has dramatically impacted the National Healthcare System, causing the sudden congestion of hospitals, especially in Northern Italy, thus imposing drastic restriction of almost all routine medical care. This exceptional adaptation of the Italian National Healthcare System has also been felt by non-frontline settings such as Pediatric Orthopaedic Units, where the limitation or temporary suspension of most routine care activities met with a need to maintain continuity of care and avoid secondary issues due to the delay or suspension of the routine clinical practice. The Italian Society of Pediatric Orthopaedics and Traumatology formulated general and specific recommendations to face the COVID-19 outbreak, aiming to provide essential care for children needing orthopaedic treatments during the pandemic and early post-peak period, ensure safety of children, caregivers and healthcare providers and limit the spread of contagion.


Assuntos
Infecção Hospitalar/prevenção & controle , Assistência à Saúde/organização & administração , Procedimentos Ortopédicos/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde , Guias de Prática Clínica como Assunto/normas , Criança , Pré-Escolar , Tomada de Decisão Clínica , Feminino , Humanos , Itália , Masculino , Saúde do Trabalhador/estatística & dados numéricos , Procedimentos Ortopédicos/métodos , Ortopedia/normas , Segurança do Paciente , Pediatria/normas , Sociedades Médicas/normas , Traumatologia/normas
9.
Pediatr Ann ; 49(10): e407-e412, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33034653

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) appeared in December 2019 in Wuhan, Hubei province, China. Soon after, it was discovered to be a novel human virus and it subsequently spread throughout the world, leading to a global pandemic. From the experience we have so far with this virus, it appears that compared to most other respiratory viral illnesses to which they are typically highly susceptible, children are affected less by SARS-CoV-2 than adults. It will continue to be important to collect data and study different populations to learn more about how children are affected by the disease, particularly as we head back to school in different forms this fall. We also must pay close attention to whether or not children are significant transmitters of the disease, as this is largely unknown and will have an affect on those who are providing care for children at school, daycare, and at home. [Pediatr Ann. 2020;49(10):e407-e412.].


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Pediatria/métodos , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Criança , Infecções por Coronavirus/fisiopatologia , Humanos , Pandemias , Pneumonia Viral/fisiopatologia
10.
BMJ Open ; 10(10): e043763, 2020 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-33020109

RESUMO

OBJECTIVES: We evaluated whether implementation of lockdown orders in South Africa affected ambulatory clinic visitation in rural Kwa-Zulu Natal (KZN). DESIGN: Observational cohort SETTING: Data were analysed from 11 primary healthcare clinics in northern KZN. PARTICIPANTS: A total of 46 523 individuals made 89 476 clinic visits during the observation period. EXPOSURE OF INTEREST: We conducted an interrupted time series analysis to estimate changes in clinic visitation with a focus on transitions from the prelockdown to the level 5, 4 and 3 lockdown periods. OUTCOME MEASURES: Daily clinic visitation at ambulatory clinics. In stratified analyses, we assessed visitation for the following subcategories: child health, perinatal care and family planning, HIV services, non-communicable diseases and by age and sex strata. RESULTS: We found no change in total clinic visits/clinic/day at the time of implementation of the level 5 lockdown (change from 90.3 to 84.6 mean visits/clinic/day, 95% CI -16.5 to 3.1), or at the transitions to less stringent level 4 and 3 lockdown levels. We did detect a >50% reduction in child healthcare visits at the start of the level 5 lockdown from 11.9 to 4.7 visits/day (-7.1 visits/clinic/day, 95% CI -8.9 to 5.3), both for children aged <1 year and 1-5 years, with a gradual return to prelockdown within 3 months after the first lockdown measure. In contrast, we found no drop in clinic visitation in adults at the start of the level 5 lockdown, or related to HIV care (from 37.5 to 45.6, 8.0 visits/clinic/day, 95% CI 2.1 to 13.8). CONCLUSIONS: In rural KZN, we identified a significant, although temporary, reduction in child healthcare visitation but general resilience of adult ambulatory care provision during the first 4 months of the lockdown. Future work should explore the impacts of the circulating epidemic on primary care provision and long-term impacts of reduced child visitation on outcomes in the region.


Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Acesso aos Serviços de Saúde/estatística & dados numéricos , Acesso aos Serviços de Saúde/tendências , Pneumonia Viral/epidemiologia , Atenção Primária à Saúde , Saúde Pública , Adulto , Fatores Etários , Betacoronavirus , Serviços de Planejamento Familiar/estatística & dados numéricos , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Pandemias , Pediatria/estatística & dados numéricos , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/estatística & dados numéricos , Saúde Pública/métodos , Saúde Pública/estatística & dados numéricos , População Rural
12.
Recurso na Internet em Espanhol | LIS - Localizador de Informação em Saúde | ID: lis-47881

RESUMO

Organización civil, científica y cultural, creada el 20 de enero de 1939, integrada no sólo por Médicos Puericultores y Pediatras, sino por profesionales universitarios que tienen como norte una inquebrantable misión: “Velar por el sagrado derecho del bienestar integral del niño y del adolescente, orientando a la sociedad y a los poderes públicos para ayudar a encontrar respuestas efectivas a los problemas sanitarios que les afectan”. Casa Editora de la Revista Anales Venezolanos de Puericultura y Pediatría


Assuntos
Revistas Eletrônicas , Pediatria , Cuidado da Criança
13.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47829

RESUMO

Divulgação do podcast da revista Residência Pediátrica (RP). Nesta edição, o dr. Roberto Issler, do Departamento de Aleitamento Materno da SBP, é o convidado do último programa da série “RP Convida - especial Agosto Dourado" o especialista apresenta o tema “Você é um pediatra amigo da amamentação?”, ressaltando a importância do engajamento contínuo dos pediatras para o sucesso da amamentação no Brasil.


Assuntos
Aleitamento Materno , Promoção da Saúde , Pediatria
14.
J Bras Nefrol ; 42(2 suppl 1): 32-35, 2020 Aug 26.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32877496

RESUMO

INTRODUCTION: The impact of the new coronavirus (SARS-COV-2) and its worldwide clinical manifestations (COVID-19) imposed specific regional recommendations for populations in need of specialized care, such as children and adolescents with kidney diseases, particularly in renal replacement therapies (RRT). We present the recommendations of the Brazilian Society of Nephrology regarding the treatment of pediatric patients with kidney diseases during the COVID-19 pandemic. METHODS: Articles and documents from medical societies and government agencies on specific recommendations for children on RRT in relation to COVID-19 as well as those focused on epidemiological aspects of this condition in Brazil Were evaluated and analyzed. RESULTS: We present recommendations on outpatient care, transportation to dialysis centers, peritoneal dialysis, hemodialysis, and kidney transplantation in children and adolescents during the COVID-19 pandemic in Brazil. DISCUSSION: Despite initial observations of higher mortality rates in specific age groups (the elderly) and with comorbidities (obese, diabetics, and those with cardiovascular diseases), patients with chronic kidney disease (CKD) on RRT are particularly prone to develop COVID-19. Specific measures must be taken to reduce the risk of contracting SARS-CoV-2 and developing COVID-19, especially during transport to dialysis facilities, as well as on arrival and in contact with other patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Nefropatias/terapia , Pneumonia Viral/epidemiologia , Terapia de Substituição Renal/normas , Adolescente , Assistência Ambulatorial , Brasil/epidemiologia , Criança , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Humanos , Higiene/normas , Transplante de Rim , Máscaras , Nefrologia/normas , Doenças Profissionais/prevenção & controle , Pandemias/prevenção & controle , Isolamento de Pacientes , Pediatria , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Terapia de Substituição Renal/métodos , Sociedades Médicas , Avaliação de Sintomas , Transporte de Pacientes
15.
Pediatr Ann ; 49(9): e403-e404, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32929516

RESUMO

Two pediatricians share perspectives on patient experience and delivery, future health care encounters, and social implications during the coronavirus 2019 pandemic. Collateral effects may comprise the most significant impacts on children, from limitations on hospital visitors, to closures of child-friendly hospital playrooms during this pandemic, to an alarming decrease in vaccination rates. Educational disparities will also likely widen, especially among those with limited access to technology at home. [Pediatr Ann. 2020;49(9):e403-e404.].


Assuntos
Betacoronavirus , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/terapia , Assistência à Saúde/métodos , Pediatria/métodos , Pneumonia Viral/psicologia , Pneumonia Viral/terapia , Quarentena/psicologia , Isolamento Social/psicologia , Criança , Assistência à Saúde/tendências , Humanos , Pandemias , Pediatria/tendências
18.
PLoS One ; 15(9): e0236484, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32877419

RESUMO

BACKGROUND: Objective Structured Clinical Examinations (OSCEs) have been used to assess the clinical competence of medical students for decades. Limited data are available on the factors that predict students' performance on the OSCEs. The aim of our study was to evaluate the factors predicting performance on the pediatrics final OSCE, including the timing of students' clerkship and their performance on the in-training OSCE and written examinations. METHODS: Grades in pediatrics for 3 consecutive academic years (2013-2016) were included. The average scores of the in-training OSCEs, written and final OSCEs and written exams were compared among the three years using the analysis of variance (ANOVA) test. The correlations between performance on the final OSCEs and the in-training OSCEs, in-training written exams and final written exams were studied using Spearman's Rho correlation test. The effect of the timing of the clerkship on the final OSCE performance was evaluated. RESULTS: A total of 286 students' records were included. There were 115 male students and 171 female students (M:F 1:1.5). There were strong positive correlations between students' performance on the in-training examinations (OSCE and written) and the final OSCE (correlation coefficients of 0.508 and 0.473, respectively). The final written exam scores were positively correlated with the final OSCEs (r = 0.448). There was no significant effect of the timing of the clerkship. CONCLUSIONS: Students' performance on in-training examinations might predict their final OSCE scores. Thus, it is important to provide students with the necessary intervention at an early stage to reduce failure rates. The final OSCE performance does not seem to be affected by the timing of the clerkship.


Assuntos
Sucesso Acadêmico , Pediatria/educação , Estágio Clínico , Avaliação Educacional , Feminino , Humanos , Masculino , Estudantes de Medicina
20.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32943534

RESUMO

The National Institutes of Health's Environmental Influences on Child Health Outcomes (ECHO) program aims to study high-priority and high-impact pediatric conditions. This broad-based health initiative is unique in the National Institutes of Health research portfolio and involves 2 research components: (1) a large group of established centers with pediatric cohorts combining data to support longitudinal studies (ECHO cohorts) and (2) pediatric trials program for institutions within Institutional Development Awards states, known as the ECHO Institutional Development Awards States Pediatric Clinical Trials Network (ISPCTN). In the current presentation, we provide a broad overview of the ISPCTN and, particularly, its importance in enhancing clinical trials capabilities of pediatrician scientists through the support of research infrastructure, while at the same time implementing clinical trials that inform future health care for children. The ISPCTN research mission is aligned with the health priority conditions emphasized in the ECHO program, with a commitment to bringing state-of-the-science trials to children residing in underserved and rural communities. ISPCTN site infrastructure is critical to successful trial implementation and includes research training for pediatric faculty and coordinators. Network sites exist in settings that have historically had limited National Institutes of Health funding success and lacked pediatric research infrastructure, with the initial funding directed to considerable efforts in professional development, implementation of regulatory procedures, and engagement of communities and families. The Network has made considerable headway with these objectives, opening two large research studies during its initial 18 months as well as producing findings that serve as markers of success that will optimize sustainability.


Assuntos
Ensaios Clínicos como Assunto/organização & administração , Área Carente de Assistência Médica , Pediatria , Apoio à Pesquisa como Assunto/organização & administração , População Rural , Fortalecimento Institucional , Saúde da Criança , Ensaios Clínicos como Assunto/economia , Educação Continuada , Humanos , Apoio à Pesquisa como Assunto/economia , Estados Unidos
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