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1.
Esc. Anna Nery Rev. Enferm ; 26(spe): e20210179, 2022. ilus
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1292850

RESUMO

Objetivo: O estudo objetivou compreender as repercussões da pandemia da Covid-19 no cuidado de lactentes prematuros, na perspectiva de mães e profissionais de saúde. Método: Foram realizadas entrevistas semiestruturadas nos meses de junho e julho de 2020, por meio de ligação telefônica, com 14 mães e quatro profissionais de saúde do serviço de follow-up de uma maternidade pública da Paraíba, Brasil. Resultados: A partir da análise temática indutiva, os impactos da pandemia no cuidado ao lactente nascido prematuro, foram: sobrecarga e afastamento dos profissionais dos serviços de saúde, desativação temporária da unidade mãe canguru, descontinuidade da assistência ao prematuro, medo materno de expor a criança à Covid-19 e baixa condição socioeconômica. Foram elencadas estratégias de enfrentamento para o cuidado dos lactentes durante a pandemia, como: maior espaçamento das consultas, acompanhamento por meio telefônico e cumprimento das medidas de biossegurança. Conclusão e implicações para a prática: A pandemia exigi adaptações na assistência, tornando necessárias novas formas de cuidado a essas crianças, como exemplo, as consultas de acompanhamento remotas, a fim de garantir o seu direito à vida e saúde


Objective: The study aimed at understanding the repercussions of the Covid-19 pandemic in the care of premature infants, from the perspective of mothers and health professionals. Method: Semi-structured interviews were conducted in the months of June and July 2020, over the telephone, with 14 mothers and four health professionals from the follow-up service of a public maternity hospital in Paraíba, Brazil. Results: From the inductive thematic analysis, the impacts of the pandemic on the care of premature infants were as follows: overload and distancing of health service professionals, temporary deactivation of the Kangaroo mother unit, discontinuity of care for the premature infant, maternal fear of exposing the child to Covid-19 and low socioeconomic status. Coping strategies for the care of infants during the pandemic were listed, such as: greater spacing between consultations, phone follow-up and compliance with biosafety measures. Conclusion and implications for the practice: The pandemic required adaptations in care, which make new forms of care necessary for these children, such as remote follow-up consultations, in order to guarantee their right to life and health


Objetivo: El estudio tuvo como objetivo comprender las repercusiones de la pandemia de Covid-19 en la atención de bebés prematuros, desde la perspectiva de las madres y los profesionales de la salud. Método: Se realizaron entrevistas semiestructuradas en los meses de junio y julio de 2020, por medio de llamadas telefónicas, a 14 madres y cuatro profesionales de la salud del servicio de seguimiento de una maternidad pública en Paraíba, Brasil. Resultados: A partir del análisis temático inductivo, los efectos de la pandemia en la atención de bebés prematuros fueron los siguientes: sobrecarga y distanciamiento de profesionales de los servicios de salud, inhabilitación temporal de la unidad Madre Canguro, discontinuidad de la atención al bebé prematuro, miedo materno a exponer al niño al Covid-19 y nivel socioeconómico bajo. Se enumeraron estrategias de afrontamiento para la atención infantil durante la pandemia, tales como: mayor intervalo entre consultas, seguimiento telefónico y cumplimiento de medidas de bioseguridad. Conclusión e implicaciones para la práctica: La pandemia requirió adaptaciones en la atención, que hacen necesarias nuevas formas de atención para estos niños, como las consultas de monitoreo remoto, para garantizar su derecho a la vida y a la salud


Assuntos
Humanos , Feminino , Lactente , Adulto , Pessoa de Meia-Idade , Recém-Nascido Prematuro/crescimento & desenvolvimento , Pessoal de Saúde , Serviços de Saúde Materno-Infantil , COVID-19 , Cuidado do Lactente , Mães , Carga de Trabalho/psicologia , Consulta Remota , Pesquisa Qualitativa , Cobertura Vacinal , Medo , Método Canguru , Higiene das Mãos , Distanciamento Físico , COVID-19/prevenção & controle
2.
Food Chem ; 369: 130998, 2022 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-34507088

RESUMO

High Temperature-Short Time (HTST) pasteurization was proposed as an alternative to Holder pasteurization (HOP) to increase the retention of specific human milk (HM) bioactive proteins. The present study explored whether HTST and HOP differently affect peptide release during simulated preterm infant gastrointestinal digestion. Raw (RHM), HOP- and HTST- pasteurized HM were digested using an in vitro dynamic system, and the identified peptides were analyzed by mass spectrometry and multivariate statistics. Before digestion, 158 peptides were identified in either RHM, HTST- or HOP- HM, mostly (84.4%) originating from ß-casein (CASB). During gastric digestion, HOP-HM presented a greater number and more abundant specific CASB peptides. A delayed release of peptides was observed in RHM during the intestinal phase, with respect to both pasteurized HM. Although limited to gastric digestion, the HM peptidomic profile differed according to the pasteurization type, and the pattern of the HTST peptides showed a greater similarity with RHM.


Assuntos
Leite Humano , Pasteurização , Animais , Digestão , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Leite , Peptídeos , Temperatura
3.
J Exp Child Psychol ; 213: 105260, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34390926

RESUMO

From infancy, neural processes for perceiving others' actions and producing one's own actions overlap (neural mirroring). Adults and children show enhanced mirroring in social interactions. Yet, whether social context affects mirroring in infancy, a time when processing others' actions is crucial for action learning, remains unclear. We examined whether turn-taking, an early form of social interaction, enhanced 9-month-olds' neural mirroring. We recorded electroencephalography while 9-month-olds were grasping (execution) and observing live grasps (observation). In this design, half of the infants observed and acted in alternation (turn-taking condition), whereas the other half observed several times in a row before acting (blocked condition). Replicating previous findings, infants showed significant 6- to 9-Hz mu suppression (indicating motor activation) during execution and observation (n = 24). In addition, a condition (turn-taking or blocked) by time (action start or end) interaction indicated that infants engaged in turn-taking (n = 9), but not in the blocked context (n = 15), showed more mirroring when observing the action start compared with the action end. Exploratory analyses further suggest that (a) there is higher visual-motor functional connectivity in turn-taking toward the action's end, (b) mirroring relates to later visual-motor connectivity, and (c) visual attention as indexed by occipital alpha is enhanced in turn-taking compared with the blocked context. Together, this suggests that the neural processing of others' actions is modulated by the social context in infancy and that turn-taking may be particularly effective in engaging infants' action perception system.


Assuntos
Eletroencefalografia , Comportamento do Lactente , Adulto , Criança , Força da Mão , Humanos , Lactente , Meio Social
4.
Esc. Anna Nery Rev. Enferm ; 26: e20210088, 2022. tab
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1339881

RESUMO

Resumo Objetivo: compreender, por meio do brinquedo terapêutico dramático, o significado, para o irmão, de visitar a criança hospitalizada em terapia intensiva. Método: pesquisa qualitativa, modalidade fenomenológica, que utilizou o brinquedo terapêutico dramático para acessar às experiências dos irmãos. Foi realizada em Unidade de Terapia Intensiva Pediátrica do interior do estado de São Paulo, Brasil. Participaram das sessões de brinquedo terapêutico 11 irmãos menores de 10 anos, as quais foram analisadas à luz da Teoria do Amadurecimento. Resultados: os irmãos, tendo um lugar para brincar, dramatizaram situações, anteriormente, vividas, de seu cotidiano e da visita à criança hospitalizada. Ao viver, criativamente, revelaram que brincar é fazer a integração das experiências do "eu", favorecendo o continuar a ser diante da situação vivida. Conclusões e implicações para a prática: o Brinquedo Terapêutico Dramático compreendido à luz de um referencial teórico possibilitou que o irmão significasse a visita como uma experiência de integração do "eu", revelando emoções, desejos e preferências do cotidiano. Nesse sentido, o cuidado ao irmão da criança hospitalizada define-se pela oferta do brincar livre, para que ele demonstre o sentimento de continuar a ser em suas interações com o mundo, no qual o contexto hospitalar tornou parte da realidade.


Resumen Objeto: Comprender por medio del juego terapéutico dramático el significado, para el hermano, de la visita al niño hospitalizado en Terapia Intensiva Pediátrica. Método: Investigación cualitativa, modalidad fenomenológica, que utilizó el juego terapéutico dramático para comprender la experiencia del hermano. Se realizó en Unidad de Terapia Intensiva Pediátrica del interior del Estado de São Paulo, Brasil. Participaron de las sesiones de juego terapéutico 11 hermanos con menos de 10 años, quienes fueron analizados a la luz de la Teoría de la Maduración. Resultados: Los hermanos, al tener un lugar para jugar, dramatizaron situaciones anteriormente vividas, de su cotidiano y de la visita al niño hospitalizado. Al vivir de forma creativa, revelaron que jugar es permitir la integración de las experiencias del "yo", lo que favorece el concepto de seguir siendo, ante la situación vivida. Conclusiones e implicaciones para la práctica: El Juego Terapéutico Dramático comprendido a la luz de un referencial teórico hizo posible que el hermano entendiera la visita como una experiencia de integración del "yo", revelando emociones, deseos y preferencias cotidianas. En este sentido, el cuidado del hermano del niño hospitalizado se define por la oferta de juego libre, para que pueda demostrar su sentimiento de seguir siendo en sus interacciones con el mundo, en el que el contexto hospitalario se ha convertido en parte de la realidad.


Abstract Objective: to understand, by means of dramatic therapeutic play, the meaning, for the sibling, of visiting the child hospitalized in intensive care. Method: a qualitative research, phenomenological modality, which used the dramatic therapeutic play to access the siblings' experiences. It was carried out in a Pediatric Intensive Care Unit in the countryside of the State of São Paulo, Brazil. Eleven siblings under ten years of age participated in the therapeutic play sessions, which were analyzed in the light of the Theory of Maturation. Results: the siblings, having a place to play, dramatized previously lived situations, from their daily life and from the visit to the hospitalized child. By living creatively, they revealed that playing is to integrate the experiences of the "I", favoring the continuity of being in the face of the situation lived. Conclusions and implications for practice: the Dramatic Therapeutic Play understood in the light of a theoretical framework allowed the sibling to mean the visit as an experience of integration of the "I", revealing emotions, desires and preferences of daily life. In this sense, the care for the brother of the hospitalized child is defined by the offer of free play, so that he demonstrates the feeling of continuing to be in his interactions with the world, in which the hospital context has become part of reality.


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Jogos e Brinquedos/psicologia , Visitas a Pacientes/psicologia , Unidades de Terapia Intensiva Pediátrica , Criança Hospitalizada , Irmãos/psicologia , Relações entre Irmãos , Saúde da Criança , Criatividade , Pesquisa Qualitativa
5.
Biol Trace Elem Res ; 200(1): 1-12, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33625659

RESUMO

Trace elements are essential nutrients for the optimal growth, development, and health of infants, and the reference intervals (RIs) from these trace elements in the blood are very important for an accurate assessment of the status of the elements. In this study, blood samples from a total of 13,446 infants (7206 boys and 6240 girls) were used, and the copper (Cu), zinc (Zn), calcium (Ca), magnesium (Mg), and iron (Fe) in their blood were determined using atomic absorption spectrometry. After clearing the data and removing any outliers, the gender- and age-specific RIs obtained from the Cu, Zn, Ca, Mg, and Fe in the infants' blood were established according to the principles of the Clinical and Laboratory Standards Institute (CLSI) C28-A3. In the multivariable analysis, after making the relevant adjustments for the confounding factors, the age of the infants showed a significant positive correlation with the concentrations of Zn, Ca, Mg, and Fe found in the blood (p<0.01). Furthermore, there were obvious differences in the Cu, Zn, and Ca levels in the blood according to the gender of the infants (p<0.01). As infants are in the critical period of their growth and development, the gender- and age-specific RIs may provide helpful guidance for the nutritional status of the Cu, Zn, Ca, Mg, and Fe elements in the infants' blood.


Assuntos
Magnésio , Oligoelementos , Cálcio , Cobre , Feminino , Humanos , Lactente , Ferro , Masculino , Zinco
6.
Appl Ergon ; 98: 103553, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34428619

RESUMO

This study assessed the influence of different types of flooring on infants' crawling motion patterns and performance. Each participating infant (range: 8.7-12.4 months) was encouraged to crawl on a tatami mat made of woven straw as well as other flooring types such as hardwood, carpet, and joint mat. Material tests were conducted to quantify the friction and shock absorption of the flooring. A three-dimensional motion capture system was used to measure spatiotemporal and kinematic variables during hands-and-knees crawling. An increased crawling rate was associated with a faster cadence of cyclic arm movements, but not with crawling stride length. Hardwood flooring had a significantly lower crawling rate and longer duration of hand-floor contact than tatami, while the crawling stride length and range of motion of joint movements were hardly affected by flooring type. The results of this study suggest a drawback of hardwood flooring in terms of infants' effective quadrupedal locomotion.


Assuntos
Pisos e Cobertura de Pisos , Mãos , Fenômenos Biomecânicos , Humanos , Lactente , Joelho , Locomoção , Movimento
7.
Chemosphere ; 287(Pt 2): 132115, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34826892

RESUMO

Despite being restricted by many authorities, di (2-ethylhexyl) phthalate (DEHP) is still widely detected in the environment and biospecimens. To indentify populations of high risk and evaluate the effects of DEHP restrictions, we elucidated the geographic distribution of DEHP exposure levels among pregnant women and different age groups, and compared the time trend of exposure levels with the time course of productions/restrictions. The estimated daily intake (EDI) was calculated based on biomonitoring data in published epidemiological studies, and then the group EDI (EDIG) was calculated for one particular population, region, or period by weighting EDIs by sample sizes. Overall, 144,965 samples from 45 nations were included, with the sampling time ranging from 1982 to 2017. Children had the highest exposure level (5.50 µg/kg bw/day) worldwide, while infants and pregnant women had low levels (2.13 and 1.89 µg/kg bw/day, respectively). The EDIGs varied considerably between countries, and the majority of corresponding hazard quotients were less than 1; however, the risk behind can not be ignored. In the general population, the DEHP exposure level showed a downtrend from 4.40 µg/kg bw/day before 2000 to 2.23 µg/kg bw/day in 2015-2017. In the European Union, the annual trend of DEHP EDIGs of children and adults fitted the production and consumption volume, and the EDIGs decreased more sharply in children. The EDIGs of children decreased with a delay along with the regulations on the use of DEHP. Cutting productions/consumptions and restrictions are effective to reduce DEHP exposure, but current efforts are far from enough on a worldwide scale.


Assuntos
Dietilexilftalato , Ácidos Ftálicos , Adulto , Monitoramento Biológico , Criança , Exposição Ambiental/análise , União Europeia , Feminino , Humanos , Lactente , Gravidez
8.
Chemosphere ; 287(Pt 2): 132226, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34826919

RESUMO

Exposure to food and environmental contaminants is a global environmental health issue. In this study, innovative LC-MS/MS approaches were applied to investigate mycotoxin co-exposure in mother-infant pairs (n = 23) by analyzing matched plate-ready food, breast milk and urine samples of mothers and their exclusively breastfed infants. The study revealed frequent co-occurrence of two to five mycotoxins. Regulated (e.g. aflatoxins, deoxynivalenol and ochratoxin A) and emerging mycotoxins (e.g. alternariol monomethyl ether and beauvericin) were frequently detected (3 %-89 % and 45 %-100 %), in at least one specimen. In addition, a moderate association of ochratoxin A in milk to urine of mothers (r = 0.47; p = 0.003) and infants (r = 0.52; p = 0.019) but no other significant correlations were found. Average concentration levels in food mostly did not exceed European maximum residue limits, and intake estimates demonstrated exposure below tolerable daily intake values. Infants were exposed to significantly lower toxin levels compared to their mothers, indicating the protective effect of breastfeeding. However, the transfer into milk and urine and the resulting chronic low-dose exposure warrant further monitoring. In the future, occurrence of mycotoxin-mixtures, and their combined toxicological effects need to be comprehensively considered and implemented in risk management strategies. These should aim to minimize early-life exposure in critical developmental stages.


Assuntos
Mães , Micotoxinas , Cromatografia Líquida , Feminino , Contaminação de Alimentos/análise , Humanos , Lactente , Micotoxinas/análise , Nigéria , Espectrometria de Massas em Tandem
9.
Sci Total Environ ; 806(Pt 1): 150437, 2022 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-34583069

RESUMO

BACKGROUND: Breast milk is the main source of nutrition for infants but may be responsible for their exposure to environmental chemicals, including endocrine-disrupting chemicals. AIM: To review available evidence on the presence and concentrations of bisphenols, parabens (PBs), and benzophenones (BPs) in human milk and to explore factors related to exposure levels. METHODS: A systematic review was carried out using Medline, Web of Science, and Scopus databases, conducting a comprehensive search of peer-reviewed original articles published during the period 2000-2020, including epidemiological and methodological studies. Inclusion criteria were met by 50 studies, which were compiled by calculating weighted detection frequencies and arithmetic mean concentrations of the chemicals. Their risk of bias was assessed using the ROBINS-I checklist. RESULTS: Among the 50 reviewed studies, concentrations of bisphenols were assessed by 37 (74.0%), PBs by 21 (42.0%), and BPs by 10 (20.0%). Weighted detection frequencies were 63.6% for bisphenol-A (BPA), 27.9-63.4% for PBs, and 39.5% for benzophenone-3 (BP-3). Weighted mean concentrations were 1.4 ng/mL for BPA, 0.2-14.2 ng/mL for PBs, and 24.4 ng/mL for BP-3. Mean concentrations ranged among studies from 0.1 to 3.9 ng/mL for BPA, 0.1 to 1063.6 ng/mL for PBs, and 0.5 to 72.4 ng/mL for BP-3. The highest concentrations of BPA and PBs were reported in samples from Asia (versus America and Europe). Higher BPA and lower methyl-paraben concentrations were observed in samples collected after 2010. Elevated concentrations of these chemicals were associated with socio-demographic and lifestyle factors in eight studies (16.0%). Two epidemiological studies showed moderate/serious risk of bias. CONCLUSIONS: This systematic review contributes the first overview of the widespread presence and concentrations of bisphenols, PBs, and BPs in human breast milk, revealing geographical and temporal variations. The methodological heterogeneity of published studies underscores the need for well-conducted studies to assess the magnitude of exposure to these chemicals from human milk.


Assuntos
Disruptores Endócrinos , Parabenos , Ásia , Compostos Benzidrílicos/análise , Benzofenonas , Feminino , Humanos , Lactente , Leite Humano/química
10.
Chemosphere ; 287(Pt 4): 132375, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34597632

RESUMO

Evidence of associations of pre- and postnatal exposure to polychlorinated biphenyls (PCBs) with cognitive development beyond early childhood is inconsistent. A previous report from this cohort observed adverse associations between early life PCB exposures and infant Bayley scores at age 16 months. The present study examines pre- and postnatal PCB exposures in relation to both behavior and cognitive development at age 45 months. Participants were 472 mother-child pairs residing in an area of eastern Slovakia characterized by environmental contamination with PCBs, which resulted in elevated blood serum concentrations. PCB-153 and PCB-118 concentrations were measured in maternal and in infant 6-, 16-, and 45-month serum samples. At age 45 months, children were administered five subtests of the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III), and mothers completed the Child Behavior Checklist (CBCL). Negative binomial and multiple linear regressions were used to estimate PCB-CBCL and PCB-WPPSI-III subtest score associations, respectively. Pre- and postnatal levels of PCB-153 and PCB-118 were not associated with cognitive performance on the WPPSI-III in this cohort. There was some suggestion that higher postnatal PCB concentrations were associated with more sleep problems and feelings of depression and anxiousness.


Assuntos
Poluentes Ambientais , Bifenilos Policlorados , Efeitos Tardios da Exposição Pré-Natal , Pré-Escolar , Cognição , Estudos de Coortes , Exposição Ambiental , Feminino , Humanos , Lactente , Gravidez , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Eslováquia
11.
Ann Anat ; 239: 151838, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34637900

RESUMO

INTRODUCTION: The morphological variability of the fibularis longus tendon (FLT) in adults is well understood. However, no comprehensive classification exists in human fetuses. The goal of this study was to prepare the first comprehensive classification of the fibularis longus tendon based on its insertion in human fetuses. MATERIAL AND METHODS: Forty-seven spontaneously-aborted human fetuses were examined: 38 male, 56 female, a total of 94 lower limbs (Central European population). Age ranged from18-38 weeks of gestation at death. RESULTS: The classification comprised three types of FLT. The most common type was Type I (49%), characterized by the single distal attachment. This type was divided into two subtypes (A-B): A - the tendon inserts to the lateral tubercle of the base of the 1st metatarsal bone, B - the tendon inserts to the head of the 1st metatarsal bone. The second most type was Type II, characterized by a bifurcated distal attachment (24.5%). This type was divided into three subtypes (A-C): A - the main tendon inserts to the lateral tubercle of the base of the 1st metatarsal bone and the accessory band inserts to the medial cuneiform bone; B - the strong, main tendon inserts to both the base of the 1st metatarsal bone and medial cuneiform bone, including the first metatarsal-cuneiform joint, and the accessory bands inserts to the fourth interosseus dorsalis muscle; C - the main tendon inserts to the lateral tubercle of the base of the 1st metatarsal bone and the accessory band inserts to the first interosseus dorsalis muscle. The rarest type was Type III, characterized by a trifurcated distal attachment: the main tendon inserts to the lateral tubercle of the base of the 1st metatarsal bone and the first accessory band inserts to the medial cuneiform bone and the second accessory bands inserts to the first interosseus dorsalis muscle. The anterior frenular ligament was observed in 16% of all cases, and posterior frenular ligament in 6.4%. CONCLUSION: The FLT displays high morphological variability. The proposed classification consists of three main types, with Type I and Type II divided into sub-types; it also provides additional data regarding its accessory tendon bands.


Assuntos
Músculo Esquelético , Tendões , Adulto , Cadáver , Feminino , Feto , Humanos , Lactente , Ligamentos , Masculino
12.
J Med Virol ; 94(1): 240-245, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34460115

RESUMO

Many countries in the world are experiencing a recent surge in COVID-19 cases. This is mainly attributed to the emergence of new SARS-CoV-2 variants. Genome sequencing is the only means to detect the evolving virus mutants and emerging variants. Cycle threshold values have an inverse relationship with viral load and lower Ct values are also found to be associated with increased infectivity. In this study, we propose to use Ct values as an early indicator for upcoming COVID-19 waves. A retrospective cross-sectional study was carried out to analyze the Ct values of positive samples reported during the first wave and second wave (April 2020-May 2021). Median Ct values of confirmatory genes were taken into consideration for comparison. Ct values below 25, >25-30, and >30 were categorized as high, moderate, and low viral load respectively. Our study found a significantly higher proportion of positive samples with a low Ct value (<25) across age groups and gender during the second wave of the COVID-19 pandemic. A higher proportion of positive samples with a low Ct value (high viral load) may act as an early indicator of an upcoming surge.


Assuntos
Teste de Ácido Nucleico para COVID-19 , COVID-19/diagnóstico , COVID-19/epidemiologia , Adolescente , Adulto , Infecções Assintomáticas/epidemiologia , COVID-19/virologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , SARS-CoV-2/fisiologia , Carga Viral , Adulto Jovem
13.
Libyan J Med ; 17(1): 2007603, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34813403

RESUMO

INTRODUCTION: Atrial septal defect (ASD) is a common congenital heart disease in children that uncommonly presents with pulmonary hypertension. Much is not known about the exact predictor of PAH in children with ASD. OBJECTIVES: This study aimed to determine the predictors of pulmonary hypertension in children with ASD. PATIENTS AND METHODS: This was a descriptive analysis of children with ASD carried out in three different institutions over a five-year period. Data entry and analysis were done using IBM Statistical Package for Social Sciences (SPSS) statistical software, version 25. RESULTS: The majority of the participants, 52.2%, had pulmonary hypertension and 62.5% of them occurred as mild pulmonary hypertension. There was a very weak positive correlation between pulmonary hypertension and the size of atrial septal defect, increases in size of atrial septal defect correlate with increases in pulmonary hypertension and this was found not to be statistically significant (n = 67, r = 0.193, p = 0.118). There was a positive correlation between the size of atrial septal defect and the age of participants in months, increases in age correlate with increases in size of atrial septal defect and this was found to be statistically significant (n = 67, r = 0.357, p = 0.003).The highest proportion of respondents who had pulmonary hypertension, 64.7%, was seen among children less than 1 year old while the least proportion, 27.3%, was within 1-5 years, and the difference in proportions was found to be statistically significant (χ2 = 8.187, p = 0.017). CONCLUSION: Pulmonary hypertension in children with ASD occur usually in the mild form. Age is the only strong predictor of PAH in children with isolated ASD.


Assuntos
Cardiopatias Congênitas , Comunicação Interatrial , Hipertensão Pulmonar , Criança , Comunicação Interatrial/complicações , Comunicação Interatrial/epidemiologia , Humanos , Hipertensão Pulmonar/epidemiologia , Hipertensão Pulmonar/etiologia , Lactente
14.
Neurosurg Clin N Am ; 33(1): 105-112, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34801135

RESUMO

Craniosynostosis involves the premature fusion of 1 or more cranial sutures and commonly presents as an isolated, nonsyndromic diagnosis. A subset of patients have syndromic craniosynostosis. Several unique considerations must be taken into account when managing patients with syndromic craniosynostosis. A multidisciplinary craniofacial team with a central coordinator is particularly useful for coordinating care among various specialists, and close monitoring is mandatory owing to the increased risk of intracranial hypertension. Surgical management varies among centers, but core options include fronto-orbital advancement with cranial vault remodeling, posterior vault expansion, endoscopic-assisted suturectomy with postoperative orthotic therapy, and midface advancement.


Assuntos
Craniossinostoses , Hipertensão Intracraniana , Craniossinostoses/diagnóstico por imagem , Craniossinostoses/cirurgia , Humanos , Lactente , Crânio , Síndrome
15.
Neurosurg Clin N Am ; 33(1): 17-23, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34801138

RESUMO

Achondroplasia is the most common of skeletal dysplasias and is caused by a defect in endochondral bone formation. In addition to skeletal deformities, patients with achondroplasia possess significant abnormalities of the axial skeleton, including small skull base with a narrowed foramen magnum and small vertebral bodies with shortened pedicles. Consequently, patients with achondroplasia are at risk of several severe neurologic conditions, such as cervicomedullary compression, spinal stenosis, and hydrocephalus, which frequently require the attention of a neurosurgeon. This article provides an updated review on the neurosurgical evaluation and care of children with Achondroplasia.


Assuntos
Acondroplasia , Hidrocefalia , Estenose Espinal , Acondroplasia/cirurgia , Criança , Constrição Patológica , Forame Magno , Humanos , Hidrocefalia/cirurgia , Lactente
16.
Neurosurg Clin N Am ; 33(1): 25-35, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34801139

RESUMO

Much of the current medical discussion for within centers for skeletal dysplasia and specifically patients with achondroplasia focuses on infancy and early childhood. Most neurosurgical concerns arise due to a defect in the endochondral ossification, resulting on early fusion of the synchondrosis. As patients age, the neurosurgical focus shifts from primarily cranial to spinal concerns. Often pediatric neurosurgeons may continue to follow their patients with skeletal dysplasia. However, general adult neurosurgeons and orthopedic surgeons may see these graduated adults in their practice. This article provides a review of the common neurosurgical concerns for patients with achondroplasia.


Assuntos
Acondroplasia , Forame Magno , Acondroplasia/cirurgia , Adulto , Criança , Pré-Escolar , Constrição Patológica , Humanos , Lactente
17.
J Med Virol ; 94(1): 161-172, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34415583

RESUMO

Detailed information on intrahost viral evolution in SARS-CoV-2 with and without treatment is limited. Sequential viral loads and deep sequencing of SARS-CoV-2 from the upper respiratory tract of nine hospitalized children, three of whom were treated with remdesivir, revealed that remdesivir treatment suppressed viral load in one patient but not in a second infected with an identical strain without any evidence of drug resistance found. Reduced levels of subgenomic RNA during treatment of the second patient, suggest an additional effect of remdesivir on viral replication. Haplotype reconstruction uncovered persistent SARS-CoV-2 variant genotypes in four patients. These likely arose from within-host evolution, although superinfection cannot be excluded in one case. Although our dataset is small, observed sample-to-sample heterogeneity in variant frequencies across four of nine patients suggests the presence of discrete viral populations in the lung with incomplete population sampling in diagnostic swabs. Such compartmentalization could compromise the penetration of remdesivir into the lung, limiting the drugs in vivo efficacy, as has been observed in other lung infections.


Assuntos
Monofosfato de Adenosina/análogos & derivados , Alanina/análogos & derivados , Antivirais/uso terapêutico , COVID-19/tratamento farmacológico , COVID-19/virologia , Evolução Molecular , SARS-CoV-2/genética , Monofosfato de Adenosina/uso terapêutico , Adolescente , Alanina/uso terapêutico , Criança , Pré-Escolar , Farmacorresistência Viral , Feminino , Haplótipos , Humanos , Lactente , Pulmão/virologia , Masculino , Filogenia , RNA Viral/análise , RNA Viral/genética , SARS-CoV-2/isolamento & purificação , SARS-CoV-2/fisiologia , Carga Viral , Replicação Viral/efeitos dos fármacos
18.
Addict Behav ; 124: 107120, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34560423

RESUMO

BACKGROUND: Pre-gaming, or drinking before going out, is common among young adults and associated with heavier drinking and negative consequences. However, findings have been mixed as to whether a unique, day-level association between pre-gaming and negative consequences exists independent of alcohol intake. It is also unknown whether young adults experience more positive consequences of alcohol use on days they engage in pre-gaming. This study tested day-level associations between pre-gaming and positive and negative consequences, controlling for same-day alcohol intake, as well as whether these associations were moderated by person- and day-level variables. METHODS: Participants were 148 young adult heavy drinkers (Mage = 20.30, SDage = 1.45, 57.4% female) who reported past-month simultaneous alcohol and marijuana use. For up to 14 consecutive days, participants completed electronic surveys asking about their drinking behaviors and consequences the previous day. RESULTS: Prior to adjusting for alcohol intake, Poisson multilevel models showed that participants reported more negative and positive consequences on days they pre-gamed and those who reported pre-gaming more often throughout the study also experienced more negative and positive consequences overall. After controlling for alcohol intake, a positive, day-level association between pre-gaming and positive consequences remained. There was no evidence of moderation of study associations by person- or day-level variables. CONCLUSION: The unique association between pre-gaming and positive consequences may help explain why pre-gaming is linked with heavy drinking and other risky behaviors as positive consequences have been shown to reinforce such behaviors. Findings suggest pre-gaming may be a useful intervention point for alcohol reduction programs.


Assuntos
Intoxicação Alcoólica , Fumar Maconha , Uso da Maconha , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Etanol , Feminino , Humanos , Lactente , Masculino , Uso da Maconha/epidemiologia , Adulto Jovem
19.
J Exp Child Psychol ; 213: 105270, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34487976

RESUMO

Developmental studies have shown that infants exploit ordinal information to extract and generalize repetition-based rules from a sequence of items. Within the visual modality, this ability is constrained by the spatial layout within which items are delivered given that a left-to-right orientation boosts infants' rule learning, whereas a right-to-left orientation hinders this ability. Infants' rule learning operates across different domains and can also be transferred across modalities when learning is triggered by speech. However, no studies have investigated whether the transfer of rule learning occurs across different domains when language is not involved. Using a visual habituation procedure, we tested 7-month-old infants' ability to extract rule-like patterns from numerical sequences and generalize them to non-numerical sequences of visual shapes and whether this ability is affected by the spatial orientation. Infants were first habituated to left-to-right or right-to-left oriented numerical sequences instantiating an ABB rule and were then tested with the familiar rule instantiated across sequences of single geometrical shapes and a novel (ABA) rule. Results showed a transfer of learning from number to visual shapes for left-to-right oriented sequences but not for right-to-left oriented ones (Experiment 1) even when the direction of the numerical change (increasing vs. decreasing) within the habituation sequences violated a small-left/large-right number-space association (Experiment 2). These results provide the first demonstration that visual rule learning mechanisms in infancy operate at a high level of abstraction and confirm earlier findings that left-to-right oriented directional cues facilitate infants' representation of order.


Assuntos
Desenvolvimento Infantil , Fala , Humanos , Lactente , Idioma , Percepção Espacial
20.
Clin Podiatr Med Surg ; 39(1): 1-14, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34809788

RESUMO

Clubfoot or talipes equinovarus deformity is one of the most common anomalies affecting the lower extremities. This review provides an update on the outcomes of various treatment options used to correct clubfoot. The ultimate goal in the treatment of clubfoot is to obtain a fully functional and pain-free foot and maintain a long-term correction. The Ponseti method is now considered the gold standard of treatment for primary clubfoot. Relapse is common after primary treatment with the Ponseti method, and other interventions are discussed that are used to provide for long-term successful outcomes.


Assuntos
Pé Torto Equinovaro , Moldes Cirúrgicos , Pé Torto Equinovaro/terapia , , Humanos , Lactente , Recidiva , Resultado do Tratamento
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