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1.
BMJ Case Rep ; 14(6)2021 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-34117000

RESUMO

A 3-year-old boy presented with acute onset of prolonged right sided focal seizures with secondary generalisation. The investigation findings were suggestive of a neoplastic process more than an inflammatory process. Decision to perform brain biopsy from the lesion to establish the precise nature of lesion was undertaken.


Assuntos
Epilepsias Parciais , Estado Epiléptico , Pré-Escolar , Eletroencefalografia , Epilepsias Parciais/diagnóstico por imagem , Epilepsias Parciais/etiologia , Humanos , Masculino , Neuroimagem , Convulsões/etiologia
2.
Niger J Clin Pract ; 24(6): 802-807, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34121725

RESUMO

Background: Cerebral palsy (CP) is a commonly occurring disorder of movement and posture that starts in early childhood. It is accompanied by other disturbances including hearing loss which has been shown to worsen the quality of life of the patients due to problems associated with speech and language acquisition. Several factors are responsible for developing hearing loss in CP. Aims: To determine the factors that can help in early diagnosis and treatment of hearing loss in children with cerebral palsy. Methodology: This was a hospital based cross-sectional study conducted among 165 randomly selected children with CP. An interviewer-administered questionnaire was used to obtain relevant sociodemographic and clinical information. The data collected was analyzed using Statistical Product and Services Solution (SPSS) version 21. Results: The age range of the participants was 1-12 years, with a mean age and standard deviation (SD) of 4.49 ± 2.85. The male to female ratio was 2:1. The commonest type of CP encountered was of spastic variety seen in 47.3%, while the least encountered variety was of the ataxic type, seen in only 4.2%;46.7% of the children were reported to have hearing impairment by their guardian. Other comorbidities reported included epilepsy (33.9%), speech impairment (27.3%), mental retardation (17.0%) and visual impairment (8.5%). A statistically significant association was found between the presence of comorbidities (P = 0.05) and hearing loss among children with CP. Conclusion: Hearing impairment is common among children with CP. Several factors are associated with the development of hearing loss among children with CP. However, only presence of comorbidities was found to be a significant determinant of hearing loss among children with CP.


Assuntos
Paralisia Cerebral , Perda Auditiva , Paralisia Cerebral/complicações , Paralisia Cerebral/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Perda Auditiva/diagnóstico , Perda Auditiva/epidemiologia , Perda Auditiva/etiologia , Humanos , Lactente , Masculino , Nigéria/epidemiologia , Qualidade de Vida
3.
Niger J Clin Pract ; 24(6): 821-827, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34121728

RESUMO

Background: Adiponectin is an excellent insulin sensitizer. It also possesses anti-inflammatory and anti-atherogenic properties that play a crucial role in the pathogenesis of cardio-metabolic disorders. Evaluating adiponectin distribution in children and factors that modulate its blood level is critical for advancing knowledge in its future role in managing associated non-communicable diseases. Aim: To investigate the adiponectin profile in apparently healthy pre-pubertal Nigerian school children. Methods: This is a cross-sectional study comprising 125 randomly recruited pupils from eight primary schools in Nnewi located in Anambra State, Nigeria. Anthropometric values were taken and venous blood samples assayed for adiponectin using Enzyme-linked immunosorbent assay (ELISA) kits. Analysis of data was done with SPSS software version 22 and R programming software. The level of significance set at P < 0.05. Results: We enrolled a total number of 125 children, which comprised of 68 (54.4%) males and 57 (45.6%) females with a male to female ratio of 1.2:1. The mean age of all the subjects was 7.7 ± 2.0 years. The mean serum adiponectin level of all the participants was 4.67 ± 2.2 ng/mL with a range of 1.9 ng/mL to 10.0 ng/mL. Adiponectin was slightly higher in females than males (4.93 ± 2.4 ng/mL vs 4.45 ± 2.0 ng/mL, respectively; P = 0.223). In males, an inverse relationship was observed between adiponectin and increasing age, whereas in females, a positive correlation was noted (P = 0.637 vs P = 0.639, respectively). The body mass index (BMI) correlated negatively with adiponectin in all the subjects and across both the genders, but these were not statistically significant. Conclusion: Adiponectin varies with sex, age and BMI in pre-pubertal Nigerian children with normal BMI. Further local studies are needed to elucidate its role in the management of associated disease states.


Assuntos
Adiponectina , Resistência à Insulina , Índice de Massa Corporal , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Nigéria , Obesidade , Instituições Acadêmicas
4.
Niger J Clin Pract ; 24(6): 841-846, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34121731

RESUMO

Background: Obesity is an important cosmopolitan cause of morbidity in children and adolescence age groups. Information on obesity in this age group in Nigeria is scant. Aim: To determine the prevalence of obesity and the associated morbidities seen at the Paediatric Endocrinology clinic of Ekiti State University Teaching Hospital, South West, Nigeria. Methods: A retrospective review of all obese children attending the Paediatric Endocrinology clinic. Sociodemographic and other information related to paediatric obesity and associated morbidities were extracted from the case notes. Data obtained was analyzed using Statistical Package for Social Sciences (SPSS) version 20. Results: A total of 21 obese children attended the clinic in the 10 years of study. The 21 children were made of 14 (66.7%) girls and 7 (33.3%) boys, giving a 2:1 female to male ratio. The ages of the children ranged from 1 to 16 years with a mean age of 8.79 ± 4.35 years. Obesity was secondary to a nutritional cause in 16 (76.2%) of the cases and Type 1 diabetes mellitus, Type 2 diabetes mellitus, Cushing's syndrome, Iatrogenic Cushing's syndrome and post-meningitis in the remaining 1 (4.8%) case each. Seventeen (81%) of the children were from the higher socioeconomic class, and the remaining three (19.0%) from lower socioeconomic class. Four (19.0%) of the children had hypertension with their blood pressure (BP) above the 95th percentile for age and sex. Hypertension was more common among the higher socioeconomic group, children older than 10 years and the female gender. This association was not statistically significant. A greater proportion of children with body mass index (BMI) >30 had significantly higher rates of hypertension (P < 0.001). Conclusion: Obesity is a common disease condition amongst children attending paediatric endocrine clinic. Strategies to control obesity and progression of severity of obesity may have a place in reducing the prevalence of hypertension in obese children and adolescents.


Assuntos
Diabetes Mellitus Tipo 2 , Obesidade Pediátrica , Adolescente , Índice de Massa Corporal , Criança , Pré-Escolar , Feminino , Hospitais de Ensino , Humanos , Lactente , Masculino , Nigéria/epidemiologia , Obesidade Pediátrica/epidemiologia , Prevalência , Estudos Retrospectivos , Fatores de Risco
5.
Biomed Environ Sci ; 34(5): 348-355, 2021 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-34059171

RESUMO

Objective: To examine increases in average height among Chinese children and adolescents. Methods: The data were obtained from the China Health and Nutrition Survey conducted during the period 1989-2015. A stratified multistage cluster sampling method was utilized to select participants aged 2-22 years in each province. Linear regression was used to examine the effects of age, birth cohort, and survey period on height. Results: A total of 15,227 males and 13,737 females were included in the final analysis. Age (A) showed a continuous effect on height. The average heights of the investigated groups increased continuously during the investigation period. By 2015, the average height of the overall group increased by 7.87 cm compared to the average height during the 1989 survey. Moreover, birth year (cohort, C) also had a stable effect on height. Using the height of individuals born in or before 1975 as a reference, the average height of each birth cohort increased in comparison to the previous birth cohort. Conclusions: The height of Chinese children and adolescents was affected by age, period, and cohort effects, and this effect is governed by certain rules. The age-period-cohort model can be used to analyze the trends of children's and adolescent's heights. The findings provide a scientific basis for the formulation of children's and adolescents' growth and development policies in China.


Assuntos
Desenvolvimento do Adolescente , Estatura , Desenvolvimento Infantil , Indicadores Básicos de Saúde , Adolescente , Saúde do Adolescente , Fatores Etários , Criança , Saúde da Criança , Pré-Escolar , China , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Lineares , Masculino , Fatores Sexuais , Adulto Jovem
6.
Biomed Environ Sci ; 34(5): 395-399, 2021 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-34059177

RESUMO

Climate change has been referred to as one of the greatest threats to human health, with reports citing likely increases in extreme meteorological events. In this study, we estimated the relationships between temperature and outpatients at a major hospital in Qingdao, China, during 2015-2017, and assessed the morbidity burden. The results showed that both low and high temperatures were associated with an increased risk of outpatient visits. High temperatures were responsible for more morbidity than low temperatures, with an attributed fraction (AF) of 16.86%. Most temperature-related burdens were attributed to moderate cold and hot temperatures, with AFs of 5.99% and 14.44%, respectively, with the young (0-17) and male showing greater susceptibility. The results suggest that governments should implement intervention measures to reduce the adverse effects of non-optimal temperatures on public health-especially in vulnerable groups.


Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Doenças Cardiovasculares/etiologia , Temperatura Baixa/efeitos adversos , Doenças do Sistema Digestório/etiologia , Utilização de Instalações e Serviços/estatística & dados numéricos , Temperatura Alta/efeitos adversos , Doenças Respiratórias/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/terapia , Criança , Pré-Escolar , China/epidemiologia , Efeitos Psicossociais da Doença , Doenças do Sistema Digestório/epidemiologia , Doenças do Sistema Digestório/terapia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Distribuição de Poisson , Doenças Respiratórias/epidemiologia , Doenças Respiratórias/terapia , Fatores de Risco , Adulto Jovem
7.
NPJ Prim Care Respir Med ; 31(1): 33, 2021 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-34083541

RESUMO

Accurate prediction of the risk of progression of coronavirus disease (COVID-19) is needed at the time of hospitalization. Logistic regression analyses are used to interrogate clinical and laboratory co-variates from every hospital admission from an area of 2 million people with sporadic cases. From a total of 98 subjects, 3 were severe COVID-19 on admission. From the remaining subjects, 24 developed severe/critical symptoms. The predictive model includes four co-variates: age (>60 years; odds ratio [OR] = 12 [2.3, 62]); blood oxygen saturation (<97%; OR = 10.4 [2.04, 53]); C-reactive protein (>5.75 mg/L; OR = 9.3 [1.5, 58]); and prothrombin time (>12.3 s; OR = 6.7 [1.1, 41]). Cutoff value is two factors, and the sensitivity and specificity are 96% and 78% respectively. The area under the receiver-operator characteristic curve is 0.937. This model is suitable in predicting which unselected newly hospitalized persons are at-risk to develop severe/critical COVID-19.


Assuntos
COVID-19/diagnóstico , Hospitalização/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Proteína C-Reativa/análise , COVID-19/patologia , Criança , Pré-Escolar , Progressão da Doença , Feminino , Humanos , Lactente , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Oxigênio/sangue , Prognóstico , Tempo de Protrombina , Curva ROC , Medição de Risco , Sensibilidade e Especificidade , Adulto Jovem
8.
Medicine (Baltimore) ; 100(22): e25919, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34087834

RESUMO

ABSTRACT: Most of the reports about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children reported mild-to-moderate disease manifestations. However, recent reports explored a rare pediatric multisystem syndrome possibly associated with SARS-CoV-2 infection termed multisystem inflammatory syndrome in children (MIS-C).The study prospectively enrolled 5 patients with clinical and laboratory evidence of MIS-C associated with SARS-CoV-2 infection. They were admitted to the pediatric intensive care unit (PICU). Their clinical presentation, laboratory, and outcome were described.All patients shared similar clinical presentations such as persistent documented fever for more than 3 days, respiratory symptoms, gastrointestinal involvement, and increased inflammatory markers (CRP, ESR, and ferritin). Three patients had concurrent positive coronavirus disease 2019 (COVID-19) infection, and the other 2 patients had contact with suspected COVID-19 positive patients. They were all managed in the PICU and received intravenous immunoglobulin, systemic steroid, and hydroxychloroquine. The hospital stays ranged between 3 and 21 days. One patient died due to severe multiorgan failures and shock, and the other 4 patients were discharged with good conditions.Pediatric patients with SARS-CoV-2 are at risk for MIS-C. MIS-C has a spectrum of clinical and laboratory presentations, and the clinicians need to have a high index of suspicion for the diagnosis and should initiate its early treatment to avoid unfavorable outcomes. Long-term follow-up studies will be required to explore any sequelae of MIS-C, precisely the cardiovascular complications.


Assuntos
COVID-19/epidemiologia , COVID-19/fisiopatologia , Síndrome de Resposta Inflamatória Sistêmica/epidemiologia , Síndrome de Resposta Inflamatória Sistêmica/fisiopatologia , Corticosteroides/uso terapêutico , Anti-Inflamatórios/uso terapêutico , COVID-19/tratamento farmacológico , Criança , Pré-Escolar , Feminino , Humanos , Hidroxicloroquina/uso terapêutico , Imunoglobulinas/uso terapêutico , Mediadores da Inflamação/metabolismo , Unidades de Terapia Intensiva Pediátrica , Tempo de Internação , Masculino , Estudos Prospectivos , SARS-CoV-2 , Arábia Saudita/epidemiologia , Índice de Gravidade de Doença , Síndrome de Resposta Inflamatória Sistêmica/tratamento farmacológico
9.
Medicine (Baltimore) ; 100(22): e25990, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34087842

RESUMO

BACKGROUND: Childhood nephrotic syndrome is widespread in pediatric nephrology. In most cases, it needs hospitalization for patient management. An increasing number of studies report that proper nursing care could promote the rate of treatment and improve post-treatment prognosis. Clinical nursing pathways refer to innovative nursing modes with high-quality, excellent efficacy, and low costing treatment. There are reports on how nursing methods that utilize data combine with clinical nursing pathway to enhance nephrotic syndrome care in kids. However, the results remain controversial. Therefore, it is necessary to conduct this study to systematically explore how evidence-based nursing combined with clinical nursing pathway plays a role in nephrotic syndrome care among children. METHODS: This study protocol will conduct a comprehensive search on MEDLINE, Cochrane Library, CINAHL, EMBASE, Scopus, Chinese National Knowledge Infrastructure, WanFang, and Web of Science electronic databases to identify relevant research articles from inception to April 25, 2021. Studies in both English and Chinese languages are used for this study. This study protocol will analyze randomized controlled trials that investigated the role of evidence-based nursing combined with clinical nursing pathway to care for nephrotic syndrome in children. Two authors will independently screen the search results, select suitable studies for inclusion, extract the characteristics and outcome data of the selected studies, and evaluate the risk of bias based on standard Cochrane methodology. Any discrepancies will be resolved by consensus. RESULTS: The present study will summarize high-quality evidence to systematically explore how a nursing model based on evidence combined with clinical nursing pathway influences the caring of children with nephrotic syndrome. CONCLUSION: The present study will summarize the direct and indirect evidence to judge whether evidence-based nursing combined with clinical nursing pathway can improve the treatment and post-treatment prognosis in children with nephrotic syndrome. ETHICS AND DISSEMINATION: This study does not require an ethical approval. REGISTRATION NUMBER: April 25, 2021.osf.io/bcrdk/ (https://osf.io/bcrdk/).


Assuntos
Síndrome Nefrótica/enfermagem , Adolescente , Criança , Pré-Escolar , Pesquisa em Enfermagem Clínica , Feminino , Humanos , Lactente , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa
10.
Medicine (Baltimore) ; 100(22): e26136, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34087865

RESUMO

RATIONALE: Periventricular nodular heterotopia-7 (PVNH7) is a neurodevelopmental disorder associated with improper neuronal migration during neurogenesis in cortex development caused by pathogenic variants in the NEDD4L gene. PATIENT CONCERNS: We report the case of a polystigmatized 2-year-old boy having significant symptomatologic overlap with PVNH7, such as delayed psychomotor and mental development, seizures and infantile spasms, periventricular nodular heterotopia, polymicrogyria, cleft palate, 2 to 3 toe syndactyly, hypotonia, microretrognathia, strabismus, and absent speech and walking. The patient showed also distinct symptoms falling outside PVNH7 symptomatology, also present in the proband's older brother, such as blue sclerae, hydronephrosis, transversal palmar crease (found also in their father), and bilateral talipes equinovarus. In addition, the patient suffered from many other symptoms. DIAGNOSES: The boy, his brother and their parents were subjected to whole-exome sequencing. Because of uncertainties in symptomatology and inheritance pattern, the top-down approach was hard to apply. Using the bottom-up approach, we identified a known pathogenic variant, NM_001144967.2(NEDD4L):c.2677G>A:p.Glu893Lys, in the proband's genome that absented in any other analyzed family member, suggesting its de novo origin. INTERVENTIONS AND OUTCOMES: The patient was treated with Convulex 300 mg/mL for the successful seizure control and Euthyrox 25mg for the treatment of thyroid malfunction. He also took various supplements for the metabolism support and digestion regulation. Moreover, the patient underwent the corrective surgeries of cleft palate and talipes equinovarus. LESSONS: We successfully identified the causative mutation NM_001144967.2(NEDD4L):c.2677G>A:p.Glu893Lys explaining symptoms overlapping those reported for PVNH7. Symptoms shared with the brother were not explained by this variant, since he was not a carrier of the pathogenic NEDD4L variant. These are most likely not extended phenotypes of PVNH7, rather an independent clinical entity caused by a yet unidentified genetic factor in the family, highlighting thus the importance of thorough evaluation of symptomatology and genomic findings in affected and unaffected family members, when such data are available.


Assuntos
Ubiquitina-Proteína Ligases Nedd4/genética , Heterotopia Nodular Periventricular/genética , Heterotopia Nodular Periventricular/fisiopatologia , Anticonvulsivantes/uso terapêutico , Pré-Escolar , Suplementos Nutricionais , Humanos , Masculino , Heterotopia Nodular Periventricular/terapia , Tiroxina/uso terapêutico
11.
Pediatr Infect Dis J ; 40(7): e259-e262, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34097663

RESUMO

Multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 infection is an infrequent and poorly understood illness. It can present as severe multiorgan failure in children, potentially lethal. Immunomodulation is the empiric treatment because a dysregulated immune response is the primary pathophysiologic mechanism. We present an infant with severe MIS-C, refractory to usual treatment, successfully treated with plasmapheresis.


Assuntos
COVID-19/terapia , Imunomodulação , Insuficiência de Múltiplos Órgãos/imunologia , Insuficiência de Múltiplos Órgãos/terapia , Troca Plasmática , Síndrome de Resposta Inflamatória Sistêmica/terapia , Pré-Escolar , Feminino , Humanos , Resultado do Tratamento
12.
Pediatr Infect Dis J ; 40(7): e272-e274, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34097664

RESUMO

The estimated severe acute respiratory syndrome coronavirus 2 seroprevalence in children was found to be 9.46% for the Washington Metropolitan area. Hispanic/Latinx individuals were found to have higher odds of seropositivity. While chronic medical conditions were not associated with having antibodies, previous fever and body aches were predictive symptoms.


Assuntos
Anticorpos Antivirais/sangue , Teste Sorológico para COVID-19 , COVID-19/epidemiologia , Adolescente , COVID-19/etnologia , Criança , Pré-Escolar , Doença Crônica/epidemiologia , District of Columbia/epidemiologia , Feminino , Voluntários Saudáveis , Hispano-Americanos , Humanos , Imunoglobulina G/sangue , Lactente , Recém-Nascido , Masculino , Maryland/epidemiologia , Estudos Soroepidemiológicos , Virginia/epidemiologia , West Virginia/epidemiologia , Adulto Jovem
13.
Pan Afr Med J ; 38: 250, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34104298

RESUMO

Introduction: diabetic complications have been identified as the major causes of morbidity and mortality in persons with type 1 diabetes mellitus (T1DM). Lack of appropriate glycaemic control is a significant risk factor for the onset and progression of long term complications of diabetes. Identifying the determinants of good glycaemic control is therefore imperative. Methods: this was a cross-sectional, hospital-based study of children aged 3-18 years with T1DM. Subjects were consecutively enrolled after obtaining consent from their parents and assent from children aged ≥7 years. A questionnaire was completed recording their clinical history and sociodemographic variables. Their HbA1c was estimated and values ≤7.5% was defined as the cut-off for optimal glycaemic control. Results: seventy-one children with T1DM were enrolled for the study. Thirty-eight (53.5%) of them were males. Mean age (years) was 13.7±4. Mean age at onset of diabetes was 11.6 years (range: 3-16 years), mean duration of diabetes was 24.4 months (range: 4-84 months), mean HbA1c value was 10.5% (range: 6.4%-14%); a multivariate logistic regression analysis was performed to identify determinants of optimal glycaemic control. Only caregivers' involvement in diabetes management P<0.016, odd ratio 13.03 (95% CI: 1.60-105.95) was identified as determinant of good glycaemic control. Conclusion: our data suggest that of all the sociodemographic factors studied, caregivers' involvement in diabetes management was the only strong determinant for optimal glycaemic control.


Assuntos
Glicemia/análise , Cuidadores/estatística & dados numéricos , Diabetes Mellitus Tipo 1/terapia , Controle Glicêmico , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Diabetes Mellitus Tipo 1/complicações , Feminino , Hemoglobina A Glicada/análise , Humanos , Masculino , Nigéria , Fatores de Risco , Inquéritos e Questionários
14.
Pan Afr Med J ; 38: 259, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34104307

RESUMO

Introduction: acute diarrhea in children under five years is a public health problem in developing countries and particularly in malaria-endemic areas where both diseases co-exist. The present study examined the etiology of childhood diarrhea and its comorbidity with malaria in a rural area of Burkina Faso. Methods: conventional culture techniques, direct stools examination, and viruses´ detection by rapid tests were performed on the fresh stools and microscopy was used to diagnose malaria. Some risk factors were also assessed. Results: on a total of 191 samples collected, at least one pathogen was identified in 89 cases (46.6%). The proportions of pathogens found on the 89 positive stool samples were parasites 51.69% (46 cases), viruses 39.33% (35 cases), and bacteria 14.61% (13 cases), respectively. The relationship between malaria and infectious diarrhea was significant in viral and parasites causes (p=0.005 and 0.043 respectively). Fever, vomiting and abdominal pain were the major symptoms associated with diarrhea, with 71.51%, 31.72% and 23.66% respectively. The highest viral diarrhea prevalence was reported during the dry season (OR=5.29, 95% CI: 1.74 - 16.07, p=0.001) while parasite diarrhea was more encountered during the rainy season (OR=0.41, 95% CI: 0.33 - 0.87, p=0.011). Conclusion: Giardia spp and rotavirus were the leading cause of acute diarrhea in Nanoro, Burkina Faso with a predominance of rotavirus in children less than 2 years. Parasite and viral diarrhea were the most pathogens associated with malaria. However, the high rate of negative stool samples suggests the need to determine other enteric microorganisms.


Assuntos
Diarreia/epidemiologia , Malária/epidemiologia , População Rural , Dor Abdominal/epidemiologia , Doença Aguda , Burkina Faso/epidemiologia , Pré-Escolar , Comorbidade , Diarreia/microbiologia , Feminino , Febre/epidemiologia , Giardíase/epidemiologia , Humanos , Lactente , Masculino , Prevalência , Fatores de Risco , Infecções por Rotavirus/epidemiologia , Estações do Ano , Vômito/epidemiologia
15.
PLoS One ; 16(6): e0252238, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34097694

RESUMO

BACKGROUND: To investigate the excess of deaths by specific causes, in the first half of 2020 in the city of São Paulo-Brazil, during the COVID-19 pandemic. METHODS: Ecological study conducted from 01/01 to 06/30 of 2019 and 2020. Population and mortality data were obtained from DATASUS. The standardized mortality ratio (SMR) by age was calculated by comparing the standardized mortality rate in 2020 to that of 2019, for overall and specific mortality. The ratio between the standardized mortality rate due to COVID-19 in men as compared to women was calculated for 2020. Crude mortality rates were standardized using the direct method. RESULTS: COVID-19 was responsible for 94.4% of the excess deaths in São Paulo. In 2020 there was an increase in overall mortality observed among both men (SMR 1.3, 95% CI 1.17-1.42) and women (SMR 1.2, 95% CI 1.06-1.36) as well as a towards reduced mortality for all cancers. Mortality due to COVID-19 was twice as high for men as for women (SMR 2.1, 95% CI 1.67-2.59). There was an excess of deaths observed in men above 45 years of age, and in women from the age group of 60 to 79 years. CONCLUSION: There was an increase in overall mortality during the first six months of 2020 in São Paulo, which seems to be related to the COVID-19 pandemic. Chronic health conditions, such as cancer and other non-communicable diseases, should not be disregarded.


Assuntos
COVID-19/mortalidade , Mortalidade , Pandemias , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Causalidade , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Adulto Jovem
16.
J Pak Med Assoc ; 71(6): 1551-1555, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34111070

RESUMO

Objective: To determine the effect of maternal tolerance on behavioural problems in children with enuresis. METHODS: The cross-sectional descriptive study was conducted from January to November 2018 at the outpatient departments of three hospitals in Lahore and Sialkot district of the Punjab province in Pakistan. The sample comprised of mothers aged 23-50 years having children with enuresis visiting one public-sector tertiary-care hospital and two private-sector secondary-care hospitals. Data was collected using the Tolerance Scale and the Children Behavioural Questionnaire and was analysed using SPSS 21. RESULTS: There were 80 mothers with a mean age of 34.53±4.89 years and as many children with a mean age of 8.16±2.36 years. Maternal intolerance was positively and significantly correlated with rule-breaking (p=0.02) and aggressive behaviour (p=0.01) in children with enuresis. Maternal intolerance was a significant and positive predictor of rule-breaking behaviour (p=0.02), aggressive behaviour (p=0.001) and attention problems (p=0.01) in the affected children. Conclusion: Maternal intolerance and hostile attitudes towards children with enuresis was seen to be leading to secondary behavioural and emotional difficulties.


Assuntos
Enurese , Comportamento Problema , Incontinência Urinária , Adulto , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Paquistão/epidemiologia
17.
J Pak Med Assoc ; 71(6): 1662-1665, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34111092

RESUMO

This study was conducted on children between 2 and 10 years age to determine the frequency of hearing impairment in middle ear infection. It was a cross-sectional survey, done at Riphah International University from August 2018 to January 2019. Data was collected from the ENT Department of Children's Hospital Lahore through convenience sampling technique and included 52 patients with middle ear infection. Measurements for the level of hearing impairment were taken, and data was analysed using statistical package for social sciences, SPSS 20.0. Of the total 52 patients, 15 (28.8%) had ear infection once a month and 37 (71.2%) had it off and on. Mild hearing loss was determined in 35 (67.3%) patients,13 (25%) had moderate, 2 (3.8%) severe and 2 (3.8%) had normal hearing. It was concluded that most of the children with middle ear infections developed hearing loss.


Assuntos
Perda Auditiva , Otite Média , Criança , Pré-Escolar , Estudos Transversais , Perda Auditiva/epidemiologia , Humanos , Otite Média/complicações , Otite Média/epidemiologia
18.
MMWR Morb Mortal Wkly Rep ; 70(23): 833-839, 2021 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-34111057

RESUMO

In 2005, the Regional Committee of the World Health Organization (WHO) European Region (EUR) passed a resolution calling for the regional elimination of measles, rubella, and congenital rubella syndrome (CRS) (1). In 2010, all 53 countries in EUR* reaffirmed their commitment to eliminating measles, rubella, and CRS (2); this goal was included in the European Vaccine Action Plan 2015-2020 (3,4). Rubella, which typically manifests as a mild febrile rash illness, is the leading vaccine-preventable cause of birth defects. Rubella infection during pregnancy can result in miscarriage, fetal death, or a constellation of malformations known as CRS, which usually includes one or more visual, auditory, or cardiac defects (5). The WHO-recommended measles and rubella elimination strategies in EUR include 1) achieving and maintaining ≥95% coverage with 2 doses of measles- and rubella-containing vaccine (MRCV) through routine immunization services; 2) providing measles and rubella vaccination opportunities, including supplementary immunization activities (SIAs), to populations susceptible to measles or rubella; 3) strengthening surveillance by conducting case investigations and confirming suspected cases and outbreaks with laboratory results; and 4) improving the availability and use of evidence to clearly communicate the benefits and risks of preventing these diseases through vaccination to health professionals and the public (6). This report updates a previous report and describes progress toward rubella and CRS elimination in EUR during 2005-2019 (7). In 2000, estimated coverage with the first dose of a rubella-containing vaccine (RCV1) in EUR was 60%, and 621,039 rubella cases were reported (incidence = 716.9 per 1 million population). During 2005-2019, estimated regional coverage with RCV1 was 93%-95%, and in 2019, 31 (58%) countries achieved ≥95% coverage with the RCV1. During 2005-2019, approximately 38 million persons received an RCV during SIAs in 20 (37%) countries. Rubella incidence declined by >99%, from 234.9 cases per 1 million population (206,359 cases) in 2005 to 0.67 cases per 1 million population (620 cases) by 2019. CRS cases declined by 50%, from 16 cases in 2005 to eight cases in 2019. For rubella and CRS elimination in EUR to be achieved and maintained, measures are needed to strengthen immunization programs by ensuring high coverage with an RCV in every district of each country, offering supplementary rubella vaccination to susceptible adults, maintaining high-quality surveillance for rapid case detection and confirmation, and ensuring effective outbreak preparedness and response.


Assuntos
Erradicação de Doenças , Vigilância da População , Rubéola (Sarampo Alemão)/epidemiologia , Rubéola (Sarampo Alemão)/prevenção & controle , Adolescente , Criança , Pré-Escolar , Europa (Continente)/epidemiologia , Genótipo , Humanos , Incidência , Lactente , Vacina contra Rubéola/administração & dosagem , Vírus da Rubéola/genética , Vírus da Rubéola/isolamento & purificação , Cobertura Vacinal/estatística & dados numéricos , Organização Mundial da Saúde
19.
Infez Med ; 29(2): 216-223, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34061786

RESUMO

Studies concerning Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in paediatrics are limited to children mainly selected from hospitals, where patients with complications and co-morbidities are managed. We aimed to describe the course of the Coronavirus Disease 2019 (COVID-19) in a population of children enrolled by place of residence, from diagnosis to recovery, with a long-term clinical and serological follow-up. We identified patients aged <14 years old living in the Turin Health District 3 who had SARS-CoV-2 detected in at least one nasopharyngeal swab from 1st March to 1st June 2020. Epidemiological and clinical features of SARS-CoV-2 infection were collected by way of a telephone inquiry. Enrolled patients were tested for SARS-CoV-2 serology in order to provide evidence of seroconversion and persistence of specific antibodies some time after the infection. A total of 46 patients with SARS-CoV-2 infection/COVID-19 were identified. The main pattern of viral transmission was intra-family. Eleven children were totally asymptomatic. If symptoms appeared, the disease had a mild course. A single case of COVID-19-related respiratory insufficiency was registered. Among children who underwent serological evaluation, 84% had seroconversion. No significant differences in antibody development were found according to the age and the burden of the disease. Children tested farther from the primary infection had lower antibody index titre values than the others. In conclusion, COVID-19 has a good prognosis in paediatric age. Children are able to develop a valid immune response, although their index titres seem to decrease a long time after the disease.


Assuntos
COVID-19/diagnóstico , SARS-CoV-2/imunologia , Soroconversão , Adolescente , COVID-19/imunologia , COVID-19/transmissão , Teste Sorológico para COVID-19 , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Itália , Masculino , Características de Residência , SARS-CoV-2/isolamento & purificação , Irmãos , Avaliação de Sintomas
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