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Braz. j. biol ; 84: e257402, 2024. tab, graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1355856


Abstract Visceral leishmaniasis (VL) is an infectious disease predominant in countries located in the tropics. The prediction of occurrence of infectious diseases through epidemiologic modeling has revealed to be an important tool in the understanding of its occurrence dynamic. The objective of this study was to develop a forecasting model for the incidence of VL in Maranhão using the Seasonal Autoregressive Integrated Moving Average model (SARIMA). We collected monthly data regarding VL cases from the National Disease Notification System (SINAN) corresponding to the period between 2001 and 2018. The Box-Jenkins method was applied in order to adjust a SARIMA prediction model for VL general incidence and by sex (male or female) for the period between January 2019 and December 2013. For 216 months of this time series, 10,431 cases of VL were notified in Maranhão, with an average of 579 cases per year. With regard to age range, there was a higher incidence among the pediatric public (0 to 14 years of age). There was a predominance in male cases, 6437 (61.71%). The Box-Pierce test figures for overall, male and female genders supported by the results of the Ljung-Box test suggest that the autocorrelations of residual values act as white noise. Regarding monthly occurrences in general and by gender, the SARIMA models (2,0,0) (2,0,0), (0,1,1) (0,1,1) and (0,1,1) (2, 0, 0) were the ones that mostly adjusted to the data respectively. The model SARIMA has proven to be an adequate tool for predicting and analyzing the trends in VL incidence in Maranhão. The time variation determination and its prediction are decisive in providing guidance in health measure intervention.

Resumo A leishmaniose visceral (LV) é uma doença de natureza infecciosa, predominante em países de zonas tropicais. A predição de ocorrência de doenças infecciosas através da modelagem epidemiológica tem se revelado uma importante ferramenta no entendimento de sua dinâmica de ocorrência. O objetivo deste estudo foi desenvolver um modelo de previsão da incidência da LV no Maranhão usando o modelo de Média Móvel Integrada Autocorrelacionada Sazonal (SARIMA). Foram coletados os dados mensais de casos de LV através do Sistema de Informação de Agravos de Notificação (SINAN) correspondentes ao período de 2001 a 2018. O método de Box-Jenkins foi aplicado para ajustar um modelo de predição SARIMA para incidência geral e por sexo (masculino e feminino) de LV para o período de janeiro de 2019 a dezembro de 2023. Durante o período de 216 meses dessa série temporal, foram registrados 10.431 casos de LV no Maranhão, com uma média de 579 casos por ano. Em relação à faixa etária, houve maior registro no público pediátrico (0 a 14 anos). Houve predominância do sexo masculino, com 6437 casos (61,71%). Os valores do teste de Box-Pierce para incidência geral, sexo masculino e feminino reforçados pelos resultados do teste Ljung-Box sugerem que as autocorrelações de resíduos apresentam um comportamento de ruído branco. Para incidência mensal geral e por sexo masculino e feminino, os modelos SARIMA (2,0,0) (2,0,0), (0,1,1) (0,1,1) e (0,1,1) (2, 0, 0) foram os que mais se ajustaram aos dados, respectivamente. O modelo SARIMA se mostrou uma ferramenta adequada de previsão e análise da tendência de incidência da LV no Maranhão. A determinação da variação temporal e sua predição são determinantes no norteamento de medidas de intervenção em saúde.

Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/epidemiologia , Estações do Ano , Brasil/epidemiologia , Incidência , Modelos Estatísticos
Int. j. clin. health psychol. (Internet) ; 23(2): 1-5, abr.-jun. 2023. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-213890


Background/Objectives: Several studies have shown that personality traits are a benchmark in research field of bullying prevention, while others have highlighted that the socio-emotional skills are important to prevent a wide range of maladjusted behaviors, suggesting that the investment in their developing may mediate the effects of personality dispositions. The present study aims to clarify if socio-emotional attitudes can mediate the relationships between personality traits and bullying. Methods: Five sequential mediation models are tested using the Big Five personality traits as focal predictors, bullying as the outcome, and trait emotional intelligence and empathy as causally chained mediators, involving 199 primary school children (8-10 years) through the Bullying Prevalence Questionnaire, the Big Five Questionnaire for children, the Emotional Intelligence Index and the Empathy-Teen Conflict Survey. Results: Data showed that openness, conscientiousness, and agreeableness were inversely related to bullying, and that the causal chain of TEI-empathy negatively and completely mediated the relationship between emotional instability and bullying and negatively and partially mediated the relationship between openness and bullying. Conclusions: These results suggest that TEI and empathy mediate the relationship between personality traits and bullying, reducing the risk of being involved in bullying perpetration. (AU)

Humanos , Masculino , Feminino , Criança , Personalidade , Bullying , Inteligência Emocional , Empatia , Inquéritos e Questionários , Desenvolvimento Infantil
J Nutr Sci ; 12: e8, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36721722


The present study aimed to (1) examine the changes in sleep habits and dietary intake among school-aged children after the school re-opening from a 3-month closure (without school lunch) due to the COVID-19 pandemic, and (2) examine whether the changes differ between those with different temporal patterns of sleep and eating during school closure, namely, 'Very early', 'Early', 'Late' and 'Very late'. The latter patterns were characterised by later timings of wake up, breakfast and lunch. Questionnaires were answered twice by 4084 children (aged 8-15 years), themselves and/or their parents: first in June 2020 (for assessing lifestyle during school closure) and second, from July 2020 to February 2021 (for assessing lifestyle after school opening). After school re-opening, the participants' wake-up time became an hour earlier (95 % CI 1⋅0, 1⋅1) and sleep duration got 0⋅94 h shorter (95 % CI 0⋅91, 0⋅97) than during school closure. An increase in dietary intake was observed for thiamine, vitamin B6, potassium, fruits and dairy products, and a decrease was observed for sugars (as foods) and confectioneries and sweetened beverages, despite small effect sizes (Cohen's d: 0⋅20-0⋅30). Significant changes in wake-up time, sleep duration and sweetened beverage intake were observed among children with the latter temporal patterns. Thus, children wake up earlier and sleep for shorter durations after school re-opening than during school closure; however, changes in dietary intake were generally insignificant. Dietary intake among school-aged children in Japan during school closure (without school lunch) might not be worse than that during school days with universal school lunch.

COVID-19 , Humanos , Criança , Pandemias , Sono , Desjejum , Ingestão de Alimentos
J Nutr Sci ; 12: e3, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36721719


The aim of the present study was to develop the ASKFV-SE tool to measure self-efficacy (SE) towards requesting fruits and vegetables (FV) in the home and school environment with school-age children (grades 4-5) from urban, ethnically diverse, low-income households. Cognitive interviews reduced the tool from eleven items to seven. The 7-item questionnaire was tested with 444 children. The items loaded on two factors: home SE (four items) and school SE (two items) with one item was excluded (<0⋅40). The reduced 6-item, 2-factor structure was the best fit for the data (χ 2 = 45⋅09; df = 9; CFI = 0⋅835; RMSEA = 0⋅147). Confirmatory factory analysis revealed that the 4-item home SE had high reliability (α = 0⋅73) and marginally acceptable reliability for the 2-item school SE (α = 0⋅53). The pre-COVID intra-class correlation coefficient (ICC) was 0⋅584 (P < 0⋅001; fair; n = 57) compared to 0⋅736 during-COVID (P < 0⋅001; good; n 50). The ASKFV-SE tool measures children's SE for asking for FVs with strong psychometric properties and low participant burden.

COVID-19 , Verduras , Humanos , Criança , Frutas , Reprodutibilidade dos Testes , Autoeficácia
Fisioterapia (Madr., Ed. impr.) ; 45(1): 38-49, ene.-feb. 2023. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-214693


Antecedentes Las enfermedades neuromusculares y las lesiones medulares comprometen los músculos respiratorios y función pulmonar ocasionando complicaciones respiratorias. La insuficiencia respiratoria aguda y el compromiso respiratorio crónico ocasionan alto riesgo de morbilidad y mortalidad. Se ha descrito el uso de la respiración glosofaríngea para mejorar variables de función pulmonar y muscular respiratoria que promueven la tos más efectiva y aumento del tiempo libre de ventilación mecánica. Objetivo Describir y presentar la evidencia actual de la efectividad de la respiración glosofaríngea en mejorar la función pulmonar y muscular respiratoria en pacientes adultos y pediátricos con enfermedades neuromusculares o lesión medular con o sin ventilación mecánica. Diseño Revisión exploratoria con la metodología PRISMA-ScR. Se realizó una búsqueda en las bases de datos PEDro, Web of Science, Scopus, PubMed, ScienceDirect, Springer, Medline, Cochrane, SciELO, Lilacs, Google Académico, se usaron palabras claves y términos MeSH en idiomas español, inglés y portugués, entre los años 2000-2020. Los resultados se presentan de forma descriptiva. Resultados Se identificaron 491 estudios y fueron incluidos 12. El 58,3% fueron realizados en países europeos. El 41,6% de los estudios fueron valorados y ninguno cumplió totalmente los criterios de calidad. La efectividad de la respiración glosofaríngea en la función pulmonar y muscular respiratoria estuvo relacionada con mejoría de capacidad vital en 66,6% y pico flujo de tos en 33,3% de los estudios. Se reportó mejoría en expansión torácica en 66,6% de los estudios y complicaciones como síncope, mareo en 33,3%. Conclusión La efectividad de respiración glosofaríngea en pacientes con enfermedades neuromusculares y lesión medular está relacionada con aumento de capacidad vital y pico flujo de tos. Se recomienda la realización de estudios con más rigurosidad científica para soportar la validez de estos resultados (AU)

Background Neuromuscular diseases and spinal cord injuries compromise respiratory muscles and lung function, causing respiratory complications. Acute respiratory failure and chronic respiratory compromise cause high risk of morbidity and mortality. The use of glossopharyngeal respiration has been described to improve pulmonary and respiratory muscle function variables that promote more effective coughing and increased time off mechanical ventilation. Objective Describe and present the current evidence of the effectiveness of glossopharyngeal respiration in improving lung and respiratory muscle function in adult and pediatric patients with neuromuscular diseases or spinal cord injury with or without mechanical ventilation. Design Exploratory review with the PRISMA-ScR methodology. A search was carried out in the PEDro, Web of Science, Scopus, PubMed, ScienceDirect, Springer, Medline, Cochrane, SciELO, Lilacs, Google Academic databases, keywords and MeSH terms were used in Spanish, English and Portuguese languages, among the years 2000–2020. The results are presented in a descriptive way. Results 491 studies were identified and 12 were included. 58.3% were conducted in European countries. 41.6% of the studies were critically appraised and none fully met the quality criteria. The effectiveness of glossopharyngeal breathing in lung and respiratory muscle function was related to an improvement in vital capacity in 66.6% and peak cough flow in 33.3% of the studies. Improvement in thoracic expansion was reported in 66.6% of the studies and complications such as syncope, dizziness in 33.3%. Conclusion The effectiveness of glossopharyngeal respiration in patients with neuromuscular diseases and spinal cord injury is related to increased vital capacity and peak flow of cough. Studies with more scientific rigor are recommended to support the validity of these results (AU)

Humanos , Criança , Adulto , Doenças Neuromusculares/reabilitação , Traumatismos da Medula Espinal/reabilitação , Músculos Respiratórios , Exercícios Respiratórios/métodos , Resultado do Tratamento , Efetividade
Med. intensiva (Madr., Ed. impr.) ; 47(2): 65-72, feb. 2023.
Artigo em Espanhol | IBECS | ID: ibc-215027


Objetivo En adultos el fracaso de la ventilación no invasiva (VNI) se ha asociado a peores resultados clínicos debido al retraso en la intubación y en el inicio de la ventilación invasiva (VMI). Existe falta de evidencia de esta asociación en pediatría. Nuestro objetivo fue determinar la asociación entre la duración de la VMI y la estancia, con la duración de la VNI previo a la intubación/VMI en pacientes pediátricos. Diseño Estudio de cohorte prospectivo desde enero de 2015 a octubre de 2019. Ámbito Unidad de cuidados intensivos pediátricos (UCIP). Pacientes Niños/as menores de 15años con insuficiencia respiratoria aguda (IRA) que fracasaron a la VNI. Intervenciones Ninguna. Variables de interés principales Se registraron variables demográficas y clínicas, índice de mortalidad pediátrica (PIM2), diagnóstico de síndrome de distrés respiratorio agudo pediátrico (SDRAP), duración de la VMI y la VNI, estancia en UCIP y mortalidad intrahospitalaria. Resultados Se incluyeron un total de 109 pacientes con una mediana de edad de 7 (3-14) meses. El diagnóstico principal fue neumonía (89,9%). El 37,6% de la muestra presentó SDRAP. No se encontró asociación entre duración de la VNI y duración de la VMI mediante el análisis de Kaplan-Meier (logrank test p=0,479). No se encontraron diferencias significativas entre la estancia en UCIP (p=0,253) y hospitalaria (p=0,669) al categorizar por duración de la VNI. El SDRAP se asoció a mayor duración de la VMI (HR: 0,64 [IC95%: 0,42-0,99]). Conclusión No se encontró asociación entre la duración de la VNI previo a la intubación y la duración de la VMI, ni en la estancia en pacientes pediátricos con IRA (AU)

Objective Noninvasive ventilation (NIV) failure it has been associated to worst clinical outcomes due to a delay in intubation and initiation of invasive mechanical ventilation (IMV). There is a lack of evidence in pediatric patients regarding this topic. The objective was to determine the association between duration of IMV and length of stay, with duration of NIV prior to intubation/IMV in pediatric patients. Design A prospective cohort study since January 2015 to October 2019. Setting A pediatric intensive care unit. Patients Children under 15years with acute respiratory failure who failed to noninvasive ventilation. Interventions None. Main variables of interest Demographic variables, pediatric index of mortality (PIM2), pediatric acute respiratory distress syndrome (PARDS) diagnosis, IMV and NIV duration, PICU LOS were registered and intrahospital mortality. Results A total of 109 patients with a median (IQR) age of 7 (3-14) months were included. The main diagnosis was pneumonia (89.9%). PARDS was diagnosed in 37.6% of the sample. No association was found between NIV duration and duration of IMV after Kaplan-Meier analysis (Log rank P=.479). There was no significant difference between PICU LOS (P=.253) or hospital LOS (P=0.669), when categorized by NIV duration before intubation. PARDS diagnosis was associated to an increased length of invasive ventilation (HR: 0.64 [95%IC: 0.42-0.99]). Conclusions No association was found between NIV duration prior to intubation and duration of invasive ventilation in critical pediatric patients with acute respiratory failure (AU)

Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Respiração Artificial/métodos , Insuficiência Respiratória/terapia , Intubação Intratraqueal , Resultado do Tratamento , Estudos Prospectivos , Estudos de Coortes , Fatores de Tempo , Doença Aguda
Arch. Soc. Esp. Oftalmol ; 98(2): 83-97, feb. 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-ADZ-657


Objetivo Identificar las enfermedades oculares que se reportan como causas de la baja visión en los niños. Material y métodos La búsqueda sistemática se realizó en Medline (PubMed), Embase y Lilacs. Se seleccionaron estudios observacionales con poblaciones entre 0-18 años de edad, que reportaran datos de agudeza visual entre 20/60-20/400, y que informaran sobre la frecuencia de enfermedades oculares. Se excluyeron los estudios en los que el diagnóstico de la condición no hubiera sido verificado por un profesional, o que abarcaran únicamente casos de ceguera, defectos refractivos no corregidos o ambliopía. La calidad metodológica de los artículos se evaluó mediante el instrumento del Instituto Joanna Briggs para estudios de prevalencia. Resultados Fueron incluidos 27 estudios realizados en Asia (13 publicaciones), África (6 estudios), Oceanía (4 estudios) y Europa y Sudamérica (2 estudios cada uno). Las causas de la baja visión más reportadas fueron: la catarata, con prevalencias comprendidas entre el 0,8 y el 27,2%; el albinismo desde el 1,1 al 47%; el nistagmo, con prevalencias entre el 1,3 y el 22%; las distrofias de retina entre el 3,5 y el 50%; la retinopatía del prematuro (ROP) con prevalencias entre el 1,1 y el 65,8%; la atrofia óptica entre el 0,2 y el 17,6% y el glaucoma entre el 2,4 y el 18,1%. Conclusiones La catarata, el albinismo y el nistagmo son las enfermedades oculares más mencionadas por los estudios como causas de la baja visión en los niños, también enfermedades de la retina tales como la ROP y del nervio óptico como la atrofia. Sin embargo, son numerosas las condiciones oculares que pueden causar la baja visión en la población pediátrica. (AU)

Objective To identify the ocular pathologies that are reported as causes of low vision in children. Material and methods The systematic search was carried out in Medline (PubMed), Embase and Lilacs. Observational studies with populations between 0-18 years of age, reporting visual acuity data between 20/60-20/400 and reporting the frequency of ocular pathologies were selected. Studies in which the diagnosis of the condition had not been verified by a professional, or which covered only cases of blindness, uncorrected refractive errors, or amblyopia, were excluded. The methodological quality of the articles was evaluated using the Joanna Briggs Institute instrument for prevalence studies. Results27 studies conducted in Asia (13 publications), Africa (6 studies), Oceania (4 studies), Europe and South America (2 studies each) were included. The most reported causes of low vision were: cataract, with prevalence between 0.8% and 27.2%; albinism with from 1.1% to 47%; nystagmus, with prevalence between 1.3% and 22%; retinal dystrophies between 3.5% and 50%; retinopathy of prematurity (ROP) with prevalence between 1.1% and 65.8%, optic atrophy between 0.2% and 17.6%, and glaucoma from 2.4% to 18.1%. Conclusions Cataract, albinism and nystagmus are the ocular pathologies most mentioned by studies as a cause of low vision in children, as well as retinal diseases such as ROP and optic nerve diseases such as atrophy. However, there are numerous eye conditions that can result in low vision in the pediatric population. (AU)

Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Oftalmopatias/complicações , Baixa Visão/etiologia , Prevalência
Arch. Soc. Esp. Oftalmol ; 98(2): 116-120, feb. 2023. ilus
Artigo em Espanhol | IBECS | ID: ibc-ADZ-661


La encefalomielitis diseminada aguda es una enfermedad inflamatoria-desmielinizante inmunomediada que suele manifestarse tras una infección o vacunación en niños en edad escolar. Típicamente presenta una fase prodrómica con un cuadro pseudogripal seguida de una fase con clínica muy variada, pudiendo aparecer alteraciones neurooftalmológicas como oftalmoplejía o neuritis óptica.La etiología es variada, incluyendo enfermedades tumorales, vasculares, infecciosas, inflamatorias y desmielinizantes. El diagnóstico se basa en la historia clínica y en las características de la resonancia magnética cerebral, prueba de imagen de elección. El estudio del líquido cefalorraquídeo puede servir de ayuda en la orientación del cuadro clínico.El pronóstico es favorable, con excelente respuesta a los corticoides e inmunoglobulinas y con mínimas secuelas a largo plazo en la mayoría de los casos.Presentamos el caso de un varón de 8años con enfermedad desmielinizante aguda por adenovirus cuya manifestación fue un síndrome del ocho y medio. (AU)

Acute disseminated encephalomyelitis is an immune mediated inflammatory-demyelinizing disease that usually manifests after infection or vaccination in school-age children. It typically presents a prodromal phase with flu-like symptoms, followed by a phase with varied clinical symptoms, neuro-ophthalmological alterations such as ophthalmoplegia or optic neuritis may occur.The differential diagnosis includes tumor, vascular, infectious, inflammatory and demyelinating diseases. Diagnosis is based on the clinical history and the characteristics of brain magnetic resonance imaging, the gold standard test. The study of the cerebrospinal fluid can help to guide the clinical picture.The prognosis is favorable, with an excellent response to corticosteroids and immunoglobulins, with minimal long-term sequelae in most cases.We report the case of an 8-year-old male with acute demyelinating disease due to adenovirus whose manifestation was an eight-and-a-half syndrome. (AU)

Humanos , Masculino , Criança , Encefalomielite Aguda Disseminada/diagnóstico , Encefalomielite Aguda Disseminada/virologia , Oftalmoplegia/virologia , Infecções por Adenoviridae/complicações , Tomografia Computadorizada por Raios X , Imageamento por Ressonância Magnética , Síndrome
Neurocirugía (Soc. Luso-Esp. Neurocir.) ; 34(1): 44-l47, ene.-feb. 2023. ilus
Artigo em Inglês | IBECS | ID: ibc-214413


A 10-year-old boy presented to neurosurgery department after a gunshot wound to the upper thoracic spine. The bullet entered through the right deltoid muscle and lodged inside the spinal canal at T1 level. The patient arrived conscious and obeying commands; however, he experienced a loss of sensation below T3 level, loss of reflexes below the injured T1 level, loss of anal sphincter tone and paraplegia in the lower limbs (American Spinal Injury Association grade-A). Imaging studies revealed an intra-canalicular metallic bullet at the T1 level. The patient underwent urgent operation using a tubular retractor system and the microscope. Subsequently, the bullet was successfully retrieved. Postoperatively, the patient made a significant recovery and by the end of the 6th month, he was able to walk independently despite some gait instability. A minimally invasive approach for intra-canalicular bullet removal in the thoracic region is a safe and effective technique in pediatric patients. (AU)

Un niño de 10 años se presentó al departamento de neurocirugía después de una herida de bala en la columna torácica superior. La bala entró por el músculo deltoides derecho y se alojó dentro del canal espinal a nivel T1. El paciente llegó consciente y obedeciendo órdenes; sin embargo, experimentó una pérdida de sensibilidad por debajo del nivel T3, pérdida de reflejos por debajo del nivel T1 lesionado, pérdida del tono del esfínter anal y paraplejía en las extremidades inferiores (American Spinal Injury Association grado-A). Los estudios de imagen revelaron una bala metálica intracanalicular a nivel T1. El paciente fue intervenido de urgencia mediante un sistema retractor tubular y el microscopio. Posteriormente, la bala se recuperó con éxito. En el postoperatorio, el paciente se recuperó significativamente y, al final del sexto mes, podía caminar de forma independiente a pesar de cierta inestabilidad en la marcha. Un enfoque mínimamente invasivo para la extracción de balas intracanaliculares en la región torácica es una técnica segura y eficaz en pacientes pediátricos. (AU)

Humanos , Masculino , Criança , Procedimentos Cirúrgicos Minimamente Invasivos , Procedimentos Neurocirúrgicos/métodos , Ferimentos por Arma de Fogo/diagnóstico por imagem , Ferimentos por Arma de Fogo/cirurgia , Traumatismos da Medula Espinal/etiologia , Traumatismos da Medula Espinal/cirurgia , Resultado do Tratamento
Actas urol. esp ; 47(1): 22-26, jan.- feb. 2023. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-214418


Objetivo Este estudio investiga el impacto del uso de la cobertura de dartos para aumentar la neouretra en los resultados funcionales y cosméticos. Evaluar una técnica novedosa que demuestra cómo fijar la cobertura de dartos como cobertura de barrera de la neouretra en la corrección de hipospadias. Pacientes y métodos Este estudio se realizó en 204 pacientes varones, todos con diferentes grados de hipospadias (HPD: 132, hipospadias coronal: 46 y HPM: 26). Sus edades oscilaban entre 1-23 años (edad media: 2 años). Había incurvación ventral (chorda) en (HPD: 45, hipospadias coronal: 33 y HPM: 26). Todos los pacientes tenían un chorro urinario anormal dirigido hacia abajo. La corrección del hipospadias se realizó mediante la técnica TIP clásica, además de nuestra novedosa modificación con cobertura de dartos. El seguimiento se realizó durante 5 años mediante evaluaciones clínicas de los parámetros funcionales y cosméticos. Resultados Se registraron tasas de éxito en 200 pacientes, 3 pacientes tuvieron complicaciones con una fístula uretrocutánea subcoronal y un paciente presentó la pérdida completa de la reparación. Conclusión La fijación triple de dartos es una técnica sencilla con la que todos los hipospadiólogos pueden reducir la fístula uretrocutánea como complicación común de la corrección de hipospadias con unos buenos resultados funcionales y cosméticos (AU)

Objective This study investigates the impact of the use of dartos covering to augment the neourethra on functional and cosmetic results. To evaluate a novel technique demonstrating how to fix dartos flap to cover the neourethra as a barrier in hypospadias repair. Patients and methods This study comprised 204 male patients with different degree of hypospadias (DPH: 132, coronal hypospadias: 46, MPH: 26). Their ages ranged from 1-23 ys (mean age: 2ys). Penile chordee was in (DPH: 45, coronal hypospadias: 33, MPH: 26). All patients had abnormal downward directed urinary stream. Hypospadias repair was performed by the classic TIP technique in addition to our novel modification of dartos covering. Patients were submitted to 5 years of follow-up including clinical examination of the functional and cosmetic parameters. Results Success rates were reported in 200 patients, 3 patients had complications with subcoronal urethrocutaneous fistula and one patient with complete repair disruption. Conclusion Triple dartos fixation is a simple technique for all hypospadiologists to minimize urethrocutaneous fistula as common complication of hypospadias repair with good functional and cosmetic results (AU)

Humanos , Masculino , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Hipospadia/cirurgia , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Resultado do Tratamento , Seguimentos , Estudos Prospectivos , Uretra/cirurgia
BMC Pediatr ; 23(1): 50, 2023 01 31.
Artigo em Inglês | MEDLINE | ID: mdl-36721123


OBJECTIVES: (1) To translate to Arabic a validated pediatric sleep questionnaire, (2) To assess the validity and reliability of the translated questionnaire, and (3) To assess the prevalence of sleep-disordered breathing (SDB) among a group of pre-school children in Jeddah, Saudi Arabia. METHODS: Using forward and back-translation, a set of 6 hierarchically arranged questions that comprise the Gozal sleep questionnaire was translated into Arabic. Validity was assessed using face validity and content validity for consistency and clarity, using both item-level and scale-level content validity indices (I-CVI, S-CVI). Consent forms were sent to 1783 mothers recruited from 8 different pre-schools in Jeddah between October 2017 and April 2018, and 209 signed and returned the consent forms. Out of this sample, 34 mothers were contacted to assess internal consistency using Cronbach's alpha, and test-retest reliability using Interclass correlation coefficient (ICC). Finally, all 209 mothers were contacted to answer the questionnaire to obtain the prevalence of SDB. RESULTS: Using face validity and content validity, the translated questionnaire proved to be valid with perfect I-CVI and S-CVI. Internal consistency (Cronbach's Alpha 0.64-0.89) and test-retest reliability (ICC=0.87, p<0.001) showed the translated questionnaire to have good to favorable reliability. Depending on the severity of SDB, the prevalence of SDB was 7.7%, 5.7%, and 3.8% for mild, moderate and severe cut-off values respectively. CONCLUSION: A validated pediatric sleep questionnaire to assess SDB was translated into Arabic and the translation proved to be valid and reliable. The prevalence of SDB was found to be very comparable to other areas in the world.

Síndromes da Apneia do Sono , Pré-Escolar , Criança , Humanos , Prevalência , Reprodutibilidade dos Testes , Arábia Saudita/epidemiologia , Síndromes da Apneia do Sono/diagnóstico , Síndromes da Apneia do Sono/epidemiologia , Sono
J Int Assoc Provid AIDS Care ; 22: 23259582231151844, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36721359


Introduction: Intimate partner violence (IPV) is the most common form of violence against women. Pregnant women are also not exempted from the menace of IPV which has dire consequences for both the mother and child. There is an established link between HIV and IPV and both have a synergistic effect. This study is aimed at comparing the prevalence, pattern, and determinants of IPV among pregnant women living with HIV and HIV-negative pregnant women attending antenatal clinics in Oyo state. Methodology: This is a descriptive cross-sectional study carried out among women attending antenatal clinics in Oyo state using a multistage sampling technique. The study spanned through March and September 2019. The data collection was conducted using a semi-structured questionnaire and the analysis was done using Statistical Package for Social Sciences version 22. The pattern and prevalence of IPV were measured using the Composite Abuse Scale, a 30-item validated interviewer-administered research instrument. It measured 4 dimensions of abuse: physical, emotional, severe, combined, and sexual harassment. A preliminary cut-off score of 7 was used to divide respondents into the presence or absence of IPV. A Chi-square test was used to test for an association between IPV and socio-demographic characteristics and a logistic regression was used at the multivariate level to identify the determinants of IPV. The P-value was set at <.05. Results: Out of the 240 booked pregnant women, 44.2% of HIV-negative respondents and 47.5% of women living with HIV reported being abused in the index pregnancy. Severe combined abuse was the most common type of abuse, 110 (75.1%), followed by emotional abuse, 70 (40.2%), physical abuse, 68 (39.3%), and sexual harassment, 67 (38.1%). Respondents living with HIV reported suffering more physical abuse than their HIV-negative counterparts. Occupation of respondents and duration of marriage determinants of IPV among HIV-positive participants are statistically significant while the duration of marriage was not statistically significant for IPV among HIV-negative respondents. Conclusion: This study recorded a high prevalence of IPV among pregnant women living with HIV and HIV-negative pregnant women with a slight increase in the group living with HIV. It is therefore recommended that IPV screening programs and intervention strategies should be developed for every pregnant woman, irrespective of their HIV status.

Infecções por HIV , Violência por Parceiro Íntimo , Gravidez , Feminino , Humanos , Criança , Gestantes , Nigéria/epidemiologia , Estudos Transversais , Infecções por HIV/epidemiologia
Inquiry ; 60: 469580231152323, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36721916


To examine macronutrient intake among under-five children, which is cost-effective, reliable, and validated by regional food choice and availability, we developed a new Semi Quantitative-Food Frequency Questionnaire (SQ-FFQ). We validated the Sleman Under Five Children SQ-FFQ (SUFS) compared to the 3-time 24-hour recalls (24HR) and conducted reliability tests between the first and second SUFS interviews. This study included 102 under-five children. All tests were conducted for the "12-35 months" and "36-59 months" groups. Compared to 24HR using Pearson's Correlation Coefficient, Spearman's Correlation Coefficient, Bland Altman plots, Cross Classification and Limits of Agreement (LOA), the SUFS was valid but significantly overestimated the macro-nutrient consumption. The reliability test results using the Interclass Correlation Coefficient and Cronbach's alpha showed moderate to good reliability (ICC and α ranged from .6 to .9), and a high correlation using Spearman's Correlation Coefficient (rho:.42-.89). The SUFS is valid compared to the 24HR and reliable for assessing macronutrient consumption for children under five.

Humanos , Criança , Reprodutibilidade dos Testes , Inquéritos e Questionários
Bone Joint J ; 105-B(2): 209-214, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36722054


AIMS: A national screening programme has existed in the UK for the diagnosis of developmental dysplasia of the hip (DDH) since 1969. However, every aspect of screening and treatment remains controversial. Screening programmes throughout the world vary enormously, and in the UK there is significant variation in screening practice and treatment pathways. We report the results of an attempt by the British Society for Children's Orthopaedic Surgery (BSCOS) to identify a nationwide consensus for the management of DDH in order to unify treatment and suggest an approach for screening. METHODS: A Delphi consensus study was performed among the membership of BSCOS. Statements were generated by a steering group regarding aspects of the management of DDH in children aged under three months, namely screening and surveillance (15 questions), the technique of ultrasound scanning (eight questions), the initiation of treatment (19 questions), care during treatment with a splint (ten questions), and on quality, governance, and research (eight questions). A two-round Delphi process was used and a consensus document was produced at the final meeting of the steering group. RESULTS: A total of 60 statements were graded by 128 clinicians in the first round and 132 in the second round. Consensus was reached on 30 out of 60 statements in the first round and an additional 12 in the seond. This was summarized in a consensus statement and distilled into a flowchart to guide clinical practice. CONCLUSION: We identified agreement in an area of medicine that has a long history of controversy and varied practice. None of the areas of consensus are based on high-quality evidence. This document is thus a framework to guide clinical practice and on which high-quality clinical trials can be developed.Cite this article: Bone Joint J 2023;105-B(2):209-214.

Displasia do Desenvolvimento do Quadril , Procedimentos Ortopédicos , Ortopedia , Criança , Humanos , Cognição , Consenso
J R Soc Interface ; 20(199): 20220698, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36722072


New Zealand experienced a wave of the Omicron variant of SARS-CoV-2 in early 2022, which occurred against a backdrop of high two-dose vaccination rates, ongoing roll-out of boosters and paediatric doses, and negligible levels of prior infection. New Omicron subvariants have subsequently emerged with a significant growth advantage over the previously dominant BA.2. We investigated a mathematical model that included waning of vaccine-derived and infection-derived immunity, as well as the impact of the BA.5 subvariant which began spreading in New Zealand in May 2022. The model was used to provide scenarios to the New Zealand Government with differing levels of BA.5 growth advantage, helping to inform policy response and healthcare system preparedness during the winter period. In all scenarios investigated, the projected peak in new infections during the BA.5 wave was smaller than in the first Omicron wave in March 2022. However, results indicated that the peak hospital occupancy was likely to be higher than in March 2022, primarily due to a shift in the age distribution of infections to older groups. We compare model results with subsequent epidemiological data and show that the model provided a good projection of cases, hospitalizations and deaths during the BA.5 wave.

COVID-19 , Humanos , Criança , COVID-19/epidemiologia , COVID-19/prevenção & controle , Nova Zelândia/epidemiologia , SARS-CoV-2 , Hospitalização
J Genet ; 1022023.
Artigo em Inglês | MEDLINE | ID: mdl-36722210


Congenital myasthenic syndromes (CMSs) are a diverse group of diseases that have an underlying defect in transmission of signals from nerve cells to muscles that lead to muscular weakness. A 13-year-old male child born of consanguineous parents with profound motor developmental delay and normal cognition was referred to us. The younger male sibling aged 9 months was similarly affected. Electromyography (EMG) and nerve conduction studies revealed CMS. Clinical exome sequencing revealed a novel large deletion including the exons 2 to 9 of SYT2 gene which confirmed the diagnosis of presynaptic CMS type 7 in the siblings. The deletion was confirmed on a chromosomal exon microarray. The parents were confirmed carriers of the same mutation and were normal on clinical and EMG studies. This is the second case of CMS type 7 described with a large deletion of SYT2 gene, a first case with SYT2 gene mutation from India and overall 10th recessive case in the world.

Sinaptotagmina II , Adolescente , Criança , Humanos , Masculino , Consanguinidade , Eletromiografia , Éxons/genética
Am J Psychiatry ; 180(2): 127-138, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36722118


OBJECTIVE: Black Americans in the United States are disproportionately exposed to childhood adversity compared with White Americans. Such disparities may contribute to race-related differences in brain structures involved in regulating the emotional response to stress, such as the amygdala, hippocampus, and prefrontal cortex (PFC). The authors investigated neuroanatomical consequences of racial disparities in adversity. METHODS: The sample included 7,350 White American and 1,786 Black American children (ages 9-10) from the Adolescent Brain Cognitive Development Study (public data release 2.0). Structural MRI data, parent and child self-reports of adversity-related measures, and U.S. Census neighborhood data were used to investigate the relationship between racial disparities in adversity exposure and race-related differences in brain structure. RESULTS: Black children experienced more traumatic events, family conflict, and material hardship on average compared with White children, and their parents or caregivers had lower educational attainment, lower income, and more unemployment compared with those of White children. Black children showed lower amygdala, hippocampus, and PFC gray matter volumes compared with White children. The volumes of the PFC and amygdala, but not the hippocampus, also varied with metrics of childhood adversity, with income being the most common predictor of brain volume differences. Accounting for differences in childhood adversity attenuated the magnitude of some race-related differences in gray matter volume. CONCLUSIONS: The results suggest that disparities in childhood adversity contribute to race-related differences in gray matter volume in key brain regions associated with threat-related processes. Structural alterations of these regions are linked to cognitive-affective dysfunction observed in disorders such as posttraumatic stress disorder. More granular assessments of structural inequities across racial/ethnic identities are needed for a thorough understanding of their impact on the brain. Together, the present findings may provide insight into potential systemic contributors to disparate rates of psychiatric disease among Black and White individuals in the United States.

Encéfalo , Substância Cinzenta , Adolescente , Criança , Humanos , Encéfalo/diagnóstico por imagem , Substância Cinzenta/diagnóstico por imagem , Córtex Pré-Frontal , Córtex Cerebral , Emoções
J Genet ; 1022023.
Artigo em Inglês | MEDLINE | ID: mdl-36722215


Wilms' tumour (WT) is the most typical type of renal tumour in children, which has a poor prognosis and high recurrence rate. This study explored whether lncRNA EMX2 opposite strand / antisense RNA (EMX2OS) modulated the stemness, epithelial-mesenchymal transition (EMT) and metastasis of WTcells through the interaction with insulin-like growth factor 2 mRNA-binding protein 1 (IGF2BP1). The expression levels of EMX2OS, IGF2BP1 and stem cell markers OCT4, Nanog, Sox2 and CD133 were detected by real time quantitative polymerase chain reaction (RT-qPCR). The stemness, migration and invasion of WTcells were determined by sphere formation assay, scratch and transwell assay, respectively. The levels of EMT-related proteins were detected by Western blotting. RNA pull down and RIP assays were utilized to validate the interaction between EMX2OS and IGF2BP1. The tumourigenicity of WTcells in vivo was analysed using a xenograft tumour assay. EMX2OS was downregulated in WT patients, while IGF2BP1 was upregulated. EMX2OS overexpression or IGF2BP1 knockdown suppressed WT cell sphere formation, migration and invasion. Moreover, EMX2OS could directly interact with RNA-binding protein IGF2BP1, and IGF2BP1 overexpression counteracted the inhibitory effect of EMX2OS on WT cell stemness, migration, invasion and EMT. The in vivo tumour growth, stemness and EMT were repressed by EMX2OS through the interaction with IGF2BP1. In conclusion, EMX2OS acted as a tumour suppressor for WT by interacting with IGF2BP1, which might be a novel target for WT diagnosis and therapy.

Neoplasias Renais , RNA Longo não Codificante , Proteínas de Ligação a RNA , Fatores de Transcrição , Tumor de Wilms , Criança , Humanos , Transição Epitelial-Mesenquimal/genética , Neoplasias Renais/genética , Reação em Cadeia da Polimerase em Tempo Real , Tumor de Wilms/genética , Fatores de Transcrição/genética , Proteínas de Ligação a RNA/genética
Singapore Med J ; 64(1): 7-16, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36722512


There are more than 7,000 paediatric genetic diseases (PGDs) but less than 5% have treatment options. Treatment strategies targeting different levels of the biological process of the disease have led to optimal health outcomes in a subset of patients with PGDs, where treatment is available. In the past 3 decades, there has been rapid advancement in the development of novel therapies, including gene therapy, for many PGDs. The therapeutic success of treatment relies heavily on knowledge of the genetic basis and the disease mechanism. Specifically, gene therapy has been shown to be effective in various clinical trials, and indeed, these trials have led to regulatory approvals, paving the way for gene therapies for other types of PGDs. In this review, we provide an overview of the treatment strategies and focus on some of the recent advancements in therapeutics for PGDs.

Doenças Genéticas Inatas , Criança , Humanos , Doenças Genéticas Inatas/terapia , Terapia Genética
Rev Bras Enferm ; 76(1): e20220201, 2023.
Artigo em Inglês, Português | MEDLINE | ID: mdl-36722648


OBJECTIVES: to map and summarize the existing scientific evidence on parents' transition experience to exercise the caregiver role of a child with 1DM, identifying gaps in knowledge of this experience. METHODS: a scoping review was carried out based on JBI methodology, in two databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. RESULTS: we included 31 articles. From the studies, constitutive elements of parents' transition experience to caregiver role of a child with 1DM were found, which focused on the nature of the experience, the feelings and emotions experienced, the hindering conditions, the facilitating conditions, the strategies used by parents and the results or effects obtained. FINAL CONSIDERATIONS: the transition process' characterizing elements were identified, but not a theoretical explanation of it. Additional research should be carried out in order to allow a deeper understanding of this process.

Diabetes Mellitus Tipo 1 , Criança , Humanos , Cuidadores , Lista de Checagem , Bases de Dados Factuais , Pais