2751
|
The neonatal preventable harm index: a high reliability tool. J Perinatol 2016; 36:676-80. [PMID: 27054841 DOI: 10.1038/jp.2016.50] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 02/02/2016] [Accepted: 02/02/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The aim of this study is to identify, quantify and disseminate a novel set of safety indicators for monitoring the occurrence of preventable harm in the neonatal intensive care unit (NICU). STUDY DESIGN Literature review and experiences in an academic, level IV NICU identified prevalent, preventable safety events: hospital-acquired infections (catheter-associated bloodstream infection, ventilator-associated pneumonia), unscheduled extubations, intravenous infiltrates requiring intervention, first week readmissions, serious adverse drug events and miscellaneous events (unanticipated harm or serious near misses). Negative binominal regression evaluated the event incidence trends. RESULTS Of 226 preventable harm events occurring between March 2013 and January 2015, the most common were unscheduled extubations (98; 2/100 ventilator days) and intravenous infiltrates (62; 2.7/100 admissions). No trends were detected (rate ratio: 0.99; confidence limits: 0.96 to 1.01; P=0.38). CONCLUSION The Neonatal Preventable Harm Index represents a novel and transparent means to monitor serious safety events and direct harm prevention strategies in the NICU.
Collapse
|
2752
|
Wrotek S, Jędrzejewski T, Nowakowska A, Kozak W. LPS alters pattern of sickness behavior but does not affect glutathione level in aged male rats. Biogerontology 2016; 17:715-23. [PMID: 26829940 PMCID: PMC4933742 DOI: 10.1007/s10522-016-9636-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 01/25/2016] [Indexed: 01/09/2023]
Abstract
Behavioral symptoms of sickness, such as fever and motor activity are a coordinated set of changes that develop during infection. The aim of study was to compare the sickness behaviour (SB) in healthy old and young rats treated with pyrogenic dose of endotoxin and to check their glutathione level. Before experimentation male Wistar rats were selected according to standard body mass, motor activity, and white blood cells count. Intraperitoneal injection of lipopolysaccharide (LPS) from E. coli was used to provoke SB. The level of liver glutathione, interleukin (IL) -6, deep body temperature (Tb) and motor activity were measured. Glutathione level in old and young rats did not differ significantly. In both young and old rats LPS administration provoked fever (the mean value of Tb was 38.06 ± 0.01 °C in old rats, and 38.19 ± 0.06 °C in young rats). LPS injection affected night-time activity in both groups (12 h averages were 1.56 ± 0.40 counts in old LPS-treated rats vs 2.74 ± 0.53 counts in not-treated old rats and 3.44 ± 0.60 counts for young LPS-treated vs 4.28 ± 0.57 counts for young not-treated rats). The injection of LPS provoked an elevation of plasma IL-6 concentration (from values below the lowest detectable standard in not-treated groups of animals to 6322.82 ± 537.00 pg/mL in old LPS-treated rats and 7415.62 ± 451.88 pg/mL in young LPS-treated rats). Based on these data, we conclude that good health of aged rats prevents decrease in the glutathione level. Old rats are still able to develop SB in response to pyrogenic dose of LPS, although its components have changed pattern compared to young animals.
Collapse
Affiliation(s)
- Sylwia Wrotek
- />Department of Immunology, Nicolaus Copernicus University, Lwowska 1, 87-100 Torun, Poland
| | - Tomasz Jędrzejewski
- />Department of Immunology, Nicolaus Copernicus University, Lwowska 1, 87-100 Torun, Poland
| | - Anna Nowakowska
- />Department of Animal Physiology, Nicolaus Copernicus University, Lwowska 1, 87-100 Torun, Poland
| | - Wiesław Kozak
- />Department of Immunology, Nicolaus Copernicus University, Lwowska 1, 87-100 Torun, Poland
| |
Collapse
|
2753
|
Landgraf-Rauf K, Anselm B, Schaub B. The puzzle of immune phenotypes of childhood asthma. Mol Cell Pediatr 2016; 3:27. [PMID: 27468754 PMCID: PMC4965363 DOI: 10.1186/s40348-016-0057-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 07/19/2016] [Indexed: 02/07/2023] Open
Abstract
Asthma represents the most common chronic childhood disease worldwide. Whereas preschool children present with wheezing triggered by different factors (multitrigger and viral wheeze), clinical asthma manifestation in school children has previously been classified as allergic and non-allergic asthma. For both, the underlying immunological mechanisms are not yet understood in depth in children. Treatment is still prescribed regardless of underlying mechanisms, and children are not always treated successfully. This review summarizes recent key findings on the complex mechanisms of the development and manifestation of childhood asthma. Whereas traditional classification of childhood asthma is primarily based on clinical symptoms like wheezing and atopy, novel approaches to specify asthma phenotypes are under way and face challenges such as including the stability of phenotypes over time and transition into adulthood. Epidemiological studies enclose more information on the patient’s disease history and environmental influences. Latest studies define endotypes based on molecular and cellular mechanisms, for example defining risk and protective single nucleotide polymorphisms (SNPs) and new immune phenotypes, showing promising results. Also, regulatory T cells and recently discovered T helper cell subtypes such as Th9 and Th17 cells were shown to be important for the development of asthma. Innate lymphoid cells (ILC) could play a critical role in asthma patients as they produce different cytokines associated with asthma. Epigenetic findings showed different acetylation and methylation patterns for children with allergic and non-allergic asthma. On a posttranscriptional level, miRNAs are regulating factors identified to differ between asthma patients and healthy controls and also indicate differences within asthma phenotypes. Metabolomics is another exciting chapter important for endotyping asthmatic children. Despite the development of new biomarkers and the discovery of new immunological molecules, the complex puzzle of childhood asthma is still far from being completed. Addressing the current challenges of distinct clinical asthma and wheeze phenotypes, including their stability and underlying endotypes, involves addressing the interplay of innate and adaptive immune regulatory mechanisms in large, interdisciplinary cohorts.
Collapse
Affiliation(s)
- Katja Landgraf-Rauf
- Department of Pulmonary and Allergy, Dr. von Hauner Children's Hospital, LMU, Lindwurmstraße 4, 80337, Munich, Germany.,Member of German Lung Centre (DZL), CPC, Munich, Germany
| | - Bettina Anselm
- Department of Pulmonary and Allergy, Dr. von Hauner Children's Hospital, LMU, Lindwurmstraße 4, 80337, Munich, Germany
| | - Bianca Schaub
- Department of Pulmonary and Allergy, Dr. von Hauner Children's Hospital, LMU, Lindwurmstraße 4, 80337, Munich, Germany. .,Member of German Lung Centre (DZL), CPC, Munich, Germany.
| |
Collapse
|
2754
|
Robinson JL, Le Saux N. Management of urinary tract infections in children in an era of increasing antimicrobial resistance. Expert Rev Anti Infect Ther 2016; 14:809-16. [DOI: 10.1080/14787210.2016.1206816] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
2755
|
Salvatore S, Barberi S, Borrelli O, Castellazzi A, Di Mauro D, Di Mauro G, Doria M, Francavilla R, Landi M, Martelli A, Miniello VL, Simeone G, Verduci E, Verga C, Zanetti MA, Staiano A. Pharmacological interventions on early functional gastrointestinal disorders. Ital J Pediatr 2016; 42:68. [PMID: 27423188 PMCID: PMC4947301 DOI: 10.1186/s13052-016-0272-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 06/17/2016] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Functional gastrointestinal disorders (FGIDs) are chronic or recurrent gastrointestinal symptoms without structural or biochemical abnormalities. FGIDs are multifactorial conditions with different pathophysiologic mechanisms including altered motility, visceral hyperalgesia, brain-gut disturbance, genetic, environmental and psychological factors. Although in most cases gastrointestinal symptoms are transient and with spontaneous resolution in infancy multiple dietary changes and pharmacological therapy are often started despite a lack of evidence-based data. Our aim was to update and critically review the current literature to assess the effects and the clinical appropriateness of drug treatment in early (occurring in infants and toddlers) FGIDs. METHODS We systematically searched the Medline and GIMBE (Italian Group on Medicine Based on Evidence) databases, according to the methodology of the Critically Appraised Topics (CATs). We included reviews, clinical studies, and evidence-based guidelines reporting on pharmacological treatments. Systematic reviews and randomized controlled trials (RCTs) concerning pharmacologic therapies in children with early FGIDs were included, and data were extracted on participants, interventions, and outcomes. RESULTS We found no evidence-based guidelines or systematic reviews about the utility of pharmacological therapy in functional regurgitation, infant colic and functional diarrhea. In case of regurgitation associated with marked distress, some evidences support a short trial with alginate when other non pharmacological approach failed (stepped-care approach). In constipated infants younger than 6 months of age Lactulose is recommended, whilst in older ages Polyethylene glycol (PEG) represents the first-line therapy both for fecal disimpaction and maintenance therapy of constipation. Conversely, no evidence supports the use of laxatives for dyschezia. Furthermore, we found no RCTs regarding the pharmacological treatment of cyclic vomiting syndrome, but retrospective studies showed a high percentage of clinical response using cyproheptadine, propanolol and pizotifen. CONCLUSION There is some evidence that a pharmacological intervention is necessary for rectal disimpaction in childhood constipation and that PEG is the first line therapy. In contrast, for the other early FGIDs there is a lack of well-designed high-quality RCTs and no evidence on the use of pharmacological therapy was found.
Collapse
Affiliation(s)
- Silvia Salvatore
- Department of Experimental and Clinical Medicine, Pediatrics, University of Insubria, Varese, Italy
| | | | - Osvaldo Borrelli
- Division of Neurogastroenterology and Motility, Department of Pediatric Gastroenterology, UCL Institute of Child Health and Great Ormond Street Hospital, London, UK
| | - Annamaria Castellazzi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Dora Di Mauro
- Department of Clinical and Experimental Medicine, Pediatric Unit, University of Parma, Parma, Italy
| | - Giuseppe Di Mauro
- President Italian Society of Preventive and Social Pediatrics (SIPPS), Primary Care Pediatrician, Caserta, Italy
| | | | - Ruggiero Francavilla
- Interdisciplinary Department of Medicine-Pediatric Section, University of Bari, Bari, Italy.,Department of Pediatrics, San Paolo Hospital, Bari, Italy
| | - Massimo Landi
- National Pediatric Healthcare System, Turin, Italy.,Unit Research of Pediatric Pulmonology and Allergy Institute of Biomedicine and Molecular Immunology (IBIM), National Research Council, Palermo, Italy
| | - Alberto Martelli
- Pediatric Department, Garbagnate Santa Corona Hospital, Milan, Italy
| | - Vito Leonardo Miniello
- Department of Pediatrics, Aldo Moro University of Bari, Giovanni XXIII Hospital, Bari, Italy
| | | | - Elvira Verduci
- Department of Pediatrics, San Paolo Hospital, Department of Health Science, University of Milan, Milan, Italy
| | - Carmen Verga
- Primary Care Pediatrics, ASL Salerno, Vietri sul Mare, Italy
| | | | - Annamaria Staiano
- Department of Translational Medical Sciences, Section of Pediatrics, Federico II University, Naples, Italy.
| | | |
Collapse
|
2756
|
Badawy SM. Fetal hemoglobin level and nutritional status in patients with sickle cell disease. Nutr J 2016; 15:63. [PMID: 27390841 PMCID: PMC4939000 DOI: 10.1186/s12937-016-0181-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 06/22/2016] [Indexed: 12/30/2022] Open
Abstract
Hydroxyurea is the only medication approved by the U.S. Food and Drug Administration for sickle cell disease, and there is strong evidence to support the efficacy and the cost effectiveness of using hydroxyurea is patients with sickle cell disease by increasing fetal hemoglobin levels. It is important to clarify the relationship between patients' nutritional status/intake and fetal hemoglobin levels. In particular, hydroxyurea has been recommended for patients with poor growth, and the recent guidelines from the National Institute of Health suggested offering hydroxyurea to patients as young as nine month old of age.
Collapse
Affiliation(s)
- Sherif M Badawy
- Department of Pediatrics, Division of Hematology, Oncology and Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine at Northwestern University, 225 E Chicago Ave., Box # 30, Chicago, IL, 60611, USA. .,Department of Pediatrics, Division of Hematology/Oncology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| |
Collapse
|
2757
|
Kandasamy Y, Hartley L, Rudd D, Smith R. The association between systemic vascular endothelial growth factor and retinopathy of prematurity in premature infants: a systematic review. Br J Ophthalmol 2016; 101:21-24. [PMID: 27388246 DOI: 10.1136/bjophthalmol-2016-308828] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 06/05/2016] [Accepted: 06/19/2016] [Indexed: 01/28/2023]
Abstract
Retinopathy of prematurity (ROP), a vasoproliferative disorder exclusive to premature infants is an important cause of childhood blindness. The number of premature infants surviving with this condition is expected to increase globally. Animal models of oxygen-induced retinopathy studies have shown vascular endothelial growth factor (VEGF) to be a key player in the pathogenesis of ROP. This has led to increased use of VEGF antagonist as an alternative treatment for ROP. The purpose of this systematic review is to determine the association between VEGF and ROP in human newborn. The literature review identified 12 studies to date which fulfilled the search criteria. Investigators used cord blood, serum, plasma and tissue samples to investigate the association between ROP and VEGF. Studies that measured VEGF in cord blood found mixed results, with low VEGF (at birth) associated with ROP in one study and no difference noted in two others. Mixed results were also seen in studies determining VEGF in postnatal venous samples. Four studies showed no difference in VEGF level between premature infants with and without ROP, one study showed an increased VEGF level in premature infants with ROP and another study found serum VEGF to be low in premature infants with ROP. The most recent study demonstrated an initial increase in serum VEGF followed by a decline at the time of treatment. These contradictory results indicate that we are yet to fully understand the role of VEGF in human premature infants and question the rationale of treating ROP with anti-VEGF. Anti-VEGF therapy results in systemic effect on serum VEGF levels for up to 2 months and this could have an effect on neurodevelopmental outcome. The effect of this on other developing organs is currently unknown. More studies are required to determine the mechanistic relationships between systemic VEGF and ROP in premature infants.
Collapse
Affiliation(s)
- Yogavijayan Kandasamy
- Department of Neonatology, The Townsville Hospital, Douglas, Queensland, Australia.,Mothers and Babies Research Centre, Hunter Medical Research Institute, John Hunter Hospital, The University of Newcastle, Callaghan, New South Wales, Australia.,College of Public Health, Medical and Veterinary Sciences, The James Cook University, Townsville, Queensland, Australia
| | - Leo Hartley
- Department of Optometry and Vision Science, The University of Melbourne, Melbourne, Victoria, Australia
| | - Donna Rudd
- College of Public Health, Medical and Veterinary Sciences, The James Cook University, Townsville, Queensland, Australia
| | - Roger Smith
- Mothers and Babies Research Centre, Hunter Medical Research Institute, John Hunter Hospital, The University of Newcastle, Callaghan, New South Wales, Australia
| |
Collapse
|
2758
|
Danzer E, Gerdes M, D'Agostino JA, Bernbaum J, Hoffman C, Herkert LM, Rintoul NE, Peranteau WH, Flake AW, Adzick NS, Hedrick HL. Younger gestational age is associated with increased risk of adverse neurodevelopmental outcome during infancy in congenital diaphragmatic hernia. J Pediatr Surg 2016; 51:1084-90. [PMID: 26831532 DOI: 10.1016/j.jpedsurg.2015.12.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 12/21/2015] [Accepted: 12/24/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND The purpose of the study was to investigate the impact of gestational age (GA) on short-term neurodevelopmental (ND) outcomes in congenital diaphragmatic hernia survivors. MATERIALS Between 6/2004 and 2/2013, 135 consecutive CDH patients underwent ND assessment using the Bayley Scales of Infant Development-III at a median follow-up age of 13months (range, 5-36). ND delay was defined by a score of ≤85 in any of the composite scales. Severe impairment was defined as a score of ≤69 in at least one domain. The effect of GA was evaluated as continuous and categorical variables. GA at delivery was grouped into full term (39-41weeks), near term (37-38), late preterm (34-36), and preterm (24-33). RESULTS Median GA at delivery was 38weeks (range, 24-41). Fifty (37%) patients were delivered full term, 59 (44%) near term, 16 (12%) late preterm, and 10 (7%) preterm. CDH children born before 39weeks' gestation were more likely to score below average (P=0.005) with corrected age for at least one composite score compared to full term peers. Cognitive (P=0.06) and language (P=0.08) scores tended to be lower in the near-term and late-preterm group compared to full-term CDH infants. Patients born near term and late preterm had significantly lower motor composite and fine motor scores compared to full-term children (P=0.009 and P<0.01, respectively). Preterm children scored the lowest in all composite scales (P<0.05). CONCLUSIONS Compared to term infants, not only preterm but also late preterm and near-term CDH children carry an increased risk of ND delays. Motor performance appears most susceptible to earlier delivery.
Collapse
Affiliation(s)
- Enrico Danzer
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
| | - Marsha Gerdes
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Jo Ann D'Agostino
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Judy Bernbaum
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Casey Hoffman
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Lisa M Herkert
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Natalie E Rintoul
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - William H Peranteau
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Alan W Flake
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - N Scott Adzick
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Holly L Hedrick
- The Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| |
Collapse
|
2759
|
van Riet-Nales DA, Schobben AFAM, Vromans H, Egberts TCG, Rademaker CMA. Safe and effective pharmacotherapy in infants and preschool children: importance of formulation aspects. Arch Dis Child 2016; 101:662-9. [PMID: 26979250 PMCID: PMC4941170 DOI: 10.1136/archdischild-2015-308227] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 01/23/2016] [Indexed: 12/25/2022]
Abstract
Safe and effective paediatric pharmacotherapy requires careful evaluation of the type of drug substance, the necessary dose and the age-appropriateness of the formulation. Generally, the younger the child, the more the attention that is required. For decades, there has been a general lack of (authorised) formulations that children are able to and willing to take. Moreover, little was known on the impact of pharmaceutical aspects on the age-appropriateness of a paediatric medicine. As a result of legislative incentives, such knowledge is increasingly becoming available. It has become evident that rapidly dissolving tablets with a diameter of 2 mm (mini-tablets) can be used in preterm neonates and non-rapidly dissolving 2 mm mini-tablets in infants from 6 months of age. In addition, uncoated 4 mm mini-tablets can be used in infants from the age of 1 year. Also, there is some evidence that children prefer mini-tablets over a powder, suspension or syrup. Other novel types of age-appropriate oral formulations such as orodispersible films may further add to the treatment possibilities. This review provides an overview of the current knowledge on oral formulations for infants and preschool children, the advantages and disadvantages of the different types of dosage forms and the age groups by which these can likely be used.
Collapse
Affiliation(s)
- Diana A van Riet-Nales
- Chemical Pharmaceutical Assessment (CFB), Medicines Evaluation Board in the Netherlands, Utrecht, The Netherlands,Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht, The Netherlands
| | - Alfred F A M Schobben
- Chemical Pharmaceutical Assessment (CFB), Medicines Evaluation Board in the Netherlands, Utrecht, The Netherlands,Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht, The Netherlands
| | - Herman Vromans
- Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht, The Netherlands,Department of Clinical Pharmacy, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Toine C G Egberts
- Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht, The Netherlands,Department of Clinical Pharmacy, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Carin M A Rademaker
- Department of Clinical Pharmacy, University Medical Centre Utrecht, Utrecht, The Netherlands
| |
Collapse
|
2760
|
Verstraete EH, Mahieu L, De Coen K, Vogelaers D, Blot S. Impact of healthcare-associated sepsis on mortality in critically ill infants. Eur J Pediatr 2016; 175:943-52. [PMID: 27118596 DOI: 10.1007/s00431-016-2726-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 03/30/2016] [Accepted: 04/18/2016] [Indexed: 12/15/2022]
Abstract
UNLABELLED Healthcare-associated sepsis (HAS) is a life-threatening complication in neonatal intensive care. Research into the impact of HAS on mortality adjusted for comorbidities is however limited. We conducted a historical cohort study to evaluate impact of HAS on mortality stratified by birth weight and risk factors for mortality in the HAS cohort. HAS was defined according to the National Institute of Child Health and Human Development criteria. Logistic regression was used to calculate adjusted odds of mortality. Of 5134 admissions, 342 infants developed HAS (6.7 %). Mortality in the total and HAS cohort was 5.6 and 10.5 %, respectively. The majority of HAS was caused by commensals (HAS-COM, 59.4 %) and 40.6 % by recognized pathogens (HAS-REC). Adjusted for comorbidities, "HAS-REC" is only a risk factor for mortality in newborns >1500 g (adjusted odds ratio [aOR] 2.3, confidence interval [CI] 1.1-4.9). Post-hoc analysis identified HAS-REC as an independent risk factor for mortality in infants with gastrointestinal disease (aOR 4.8, CI 2.1-10.8). "Renal insufficiency," "focal intestinal perforation," and "necrotizing enterocolitis" are independent risk factors for mortality in the HAS cohort (aOR 13.5, CI 4.9-36.6; aOR 7.7, CI 1.5-39.2; aOR 2.1, CI 1.0-4.7, respectively). CONCLUSION For very low birth weight infants (≤1500 g), several comorbidities overrule the impact of HAS on mortality. After adjustment for comorbidities, HAS-REC independently predicts in-hospital mortality in heavier infants and in those with gastrointestinal disease. WHAT IS KNOWN • The relationship between healthcare-associated sepsis and mortality is influenced by the causative pathogen and is confounded by comorbidities. • Research on impact of healthcare-associated sepsis on mortality adjusted for comorbidities is limited as well as research on independent risk factors for mortality in neonates with sepsis. What is New: • We included a large list of comorbidities and stratified risk by birth weight in order to assess the true effect of healthcare-associated sepsis on mortality. • Risk for mortality was calculated for commensal flora and for recognized pathogens as causative micro-organisms.
Collapse
Affiliation(s)
| | - Ludo Mahieu
- Department of Neonatal Medicine, Antwerp University Hospital, Antwerp, Belgium.,Department of Pediatrics, University of Antwerp, Antwerp, Belgium
| | - Kris De Coen
- Department of Neonatal Medicine, Ghent University Hospital, Ghent, Belgium
| | - Dirk Vogelaers
- Department of Internal Medicine, Ghent University, Ghent, Belgium.,Department of General Internal Medicine, Infectious Diseases and Psychosomatic Disorders, Ghent University Hospital, Ghent, Belgium
| | - Stijn Blot
- Department of Internal Medicine, Ghent University, Ghent, Belgium.,Burns, Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Australia
| |
Collapse
|
2761
|
Jalalypour F, Farajnia S, Somi MH, Hojabri Z, Yousefzadeh R, Saeedi N. Comparative Evaluation of RUT, PCR and ELISA Tests for Detection of Infection with Cytotoxigenic H. pylori. Adv Pharm Bull 2016; 6:261-6. [PMID: 27478790 DOI: 10.15171/apb.2016.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 04/19/2016] [Accepted: 04/24/2016] [Indexed: 12/28/2022] Open
Abstract
PURPOSE Helicobacter pylori is one of the most prevalent infectious agents in the world which causes a variety of gastrointestinal diseases including gastritis, peptic ulcer and gastric carcinoma. The objective of this study was to comparatively evaluate invasive (rapid urease test and polymerase chain reaction) and non-invasive (enzyme-linked immunosorbent assay) tests in diagnosis of infection with cytotoxigenic H. pylori. METHODS Biopsy specimens and sera were collected from 105 patients with gastric disorders. The presence of H. pylori infection in gastric biopsies was evaluated by RUT and PCR methods using chemotaxis signal transduction protein gene (CSTP), Urea C and HP-16srRNA primers. Serum samples were used for the ELISA test. Detection of infection with cag A-positive strains was performed by PCR and cag A-IgG ELISA kit. RESULTS Patients with at least two out of three positive results were regarded as infected. The sensitivity, specificity, predictive value and accuracy of the three different methods were evaluated. Of the 105 gastric biopsies, H. pylori were positive in 51 patients (48.57%). The best sensitivity (92.16%) belonged to RUT. The sensitivities of other tests including PCR and ELISA test were 88.24% and 90.20%, respectively. PCR showed the best specificity (94.44%), and the specificities of the other tests including RUT and ELISA test, were 90.74 % and 61.11%, respectively. Furthermore, results of PCR and cag A-IgG ELISA showed high prevalence of cag A-positive strain in the study population. CONCLUSION Based on our findings, serum ELISA is a rapid noninvasive test for screening of H. pylori infection in the absence of endoscopy indication. In addition, considering the high prevalence of cytotoxigenic H. pylori strains, cag A is suggested as a promising target for PCR and non- invasive ELISA tests for detection of infection with toxigenic strains.
Collapse
Affiliation(s)
- Farzaneh Jalalypour
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Safar Farajnia
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hossein Somi
- Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zoya Hojabri
- Infectious and tropical Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rana Yousefzadeh
- Infectious and tropical Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nazli Saeedi
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
2762
|
Roberto AJ, Lorenzo A, Li KJ, Young J, Mohan A, Pinnaka S, Lapidus KAB. First-Episode of Synthetic Cannabinoid-Induced Psychosis in a Young Adult, Successfully Managed with Hospitalization and Risperidone. Case Rep Psychiatry 2016; 2016:7257489. [PMID: 27429822 PMCID: PMC4939204 DOI: 10.1155/2016/7257489] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 05/15/2016] [Accepted: 05/18/2016] [Indexed: 11/23/2022] Open
Abstract
Synthetic cannabinoids- (SCs-) induced psychosis is a growing public health concern. It leads to significant impairment, including emotional distress, difficulty communicating, and other debilitating symptoms. In this case report, we discuss a patient with no previous history of psychotic symptoms, presenting with first-episode psychosis in the context of progressive, acutely worsening, disorganized, psychotic thoughts and behaviors following prolonged use of SCs. We also discuss relevant literature on SCs-induced psychosis, highlighting its prevalence, presentation, diagnosis, and recommended management. It is important to diagnose and treat SCs-induced psychosis as early and efficiently as possible, in order to alleviate symptoms while limiting functional impairment and emotional distress to the patient.
Collapse
Affiliation(s)
- Aaron J. Roberto
- Child and Adolescent Psychiatry, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Fegan 8, Boston, MA 02115, USA
| | - Aileen Lorenzo
- Adult Psychiatry, New York Medical College, Valhalla, NY, USA
| | - Kevin J. Li
- Adult Psychiatry, Harvard South Shore Psychiatry, Brockton, MA, USA
| | | | | | - Subhash Pinnaka
- Adult Psychiatry, New York Medical College, Valhalla, NY, USA
| | | |
Collapse
|
2763
|
Ge YX, Tian XZ, Lin YY, Liu XY. Chronic treatment with levetiracetam reverses deficits in hippocampal LTP in vivo in experimental temporal lobe epilepsy rats. Neurosci Lett 2016; 628:194-200. [PMID: 27345386 DOI: 10.1016/j.neulet.2016.06.043] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Revised: 06/10/2016] [Accepted: 06/21/2016] [Indexed: 12/21/2022]
Abstract
Temporal lobe epilepsy (TLE), the common form of epilepsy in adults, often displays complex partial seizures and cognitive deficits. The underlying mechanisms of such deficits are not yet well understood. Many contributing factors, such as initial epileptogenic lesion, seizure type, age of onset, and treatment side effects have been proposed. Levetiracetam (LEV) is a novel anti-epileptic drug (AED) used to treat partial seizures and idiopathic generalized epilepsy. It has been suggested that LEV exerts antiepileptic properties by modulation of synaptic release of neurotransmitters. However, its neuroprotective effects on learning and memory are not yet well demonstrated. Here we showed the impairment of spatial memory in the pilocarpine-induced experimental TLE rats, which can be improved by LEV. Furthermore, we found chronic LEV treatment partially reversed the SE-induced synaptic dysfunction in hippocampal LTP induction in vivo. In addition, LEV treatment can alleviate the SE-induced abnormal GluR1 phosphorylation at Ser(831) site, which may contribute to the rescue of synaptic transmission. These results indicate the neuroprotective role for LEV while it exhibits an antiseizure effect on experimental epileptic models.
Collapse
Affiliation(s)
- Yu-Xing Ge
- Department of Neurology, Tongji University Affiliated Tenth People's Hospital, 200072 Shanghai, PR China
| | - Xiang-Zhu Tian
- Department of Neurology, Tongji University Affiliated Tenth People's Hospital, 200072 Shanghai, PR China
| | - Ying-Ying Lin
- Department of Neurology, Tongji University Affiliated Tenth People's Hospital, 200072 Shanghai, PR China
| | - Xue-Yuan Liu
- Department of Neurology, Tongji University Affiliated Tenth People's Hospital, 200072 Shanghai, PR China.
| |
Collapse
|
2764
|
Determination of ibuprofen enantiomers in human plasma by HPLC–MS/MS: validation and application in neonates. Bioanalysis 2016; 8:1237-50. [PMID: 27225837 DOI: 10.4155/bio-2016-0013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim: An adaptive method to determine ibuprofen enantiomers with limited volume of plasma required is necessary for investigating PK of ibuprofen in neonates. Results: Enantiomer separation was achieved on a Lux cellulose 3 column with mobile phase consisting of methanol water (85:15, v/v) and formic acid (0.0075%) at isocratic rate of 0.2 ml/min. Calibration curve is linear for each enantiomer at the range of 0.1–60 μg/ml. Validation was conducted and results met requirements regarding to intra- and inter-run precision, accuracy and recovery. No matrix effect or interference was observed from neonatal plasma or comedications. Only 20 μl of plasma was requested in this study. Conclusion: This assay was specific and reliable to quantify ibuprofen enantiomers in neonate plasma.
Collapse
|
2765
|
Burgos A, Rábago L, Triana P. Western view of the management of gastroesophageal foreign bodies. World J Gastrointest Endosc 2016; 8:378-384. [PMID: 27170838 PMCID: PMC4861854 DOI: 10.4253/wjge.v8.i9.378] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Revised: 02/18/2016] [Accepted: 03/18/2016] [Indexed: 02/06/2023] Open
Abstract
The best modality for foreign body removal has been the subject of much controversy over the years. We have read with great interest the recent article by Souza Aguiar Municipal Hospital, Rio de Janeiro, Brazil, describing their experience with the management of esophageal foreign bodies in children. Non-endoscopic methods of removing foreign bodies (such as a Foley catheter guided or not by fluoroscopy) have been successfully used at this center. These methods could be an attractive option because of the following advantages: Shorter hospitalization time; easy to perform; no need for anesthesia; avoids esophagoscopy; and lower costs. However, the complications of these procedures can be severe and potentially fatal if not performed correctly, such as bronchoaspiration, perforation, and acute airway obstruction. In addition, it has some disadvantages, such as the inability to directly view the esophagus and the inability to always retrieve foreign bodies. Therefore, in Western countries clinical practice usually recommends endoscopic removal of foreign bodies under direct vision and with airway protection whenever possible.
Collapse
|
2766
|
Kim Y, Jung K, Ryu YJ, Moon SB. Pediatric appendectomy: the outcome differences between pediatric surgeons and general surgeons. Surg Today 2016; 46:1181-6. [PMID: 27142973 DOI: 10.1007/s00595-016-1343-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/19/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of this study was to review our experience of pediatric appendectomy performed by either a general surgeon (GS) or a pediatric surgeon (PS) to determine any differences in outcomes. METHODS We reviewed the medical records of pediatric appendicitis patients, 4 years before (GS group, 2007-2010) and after (PS group, 2011-2014) the introduction of a pediatric surgical practice. The records were reviewed for the following variables: operation time, length of hospital stay, complications, readmission in ≤30 days, type of operation, negative for appendicitis, drainage, open conversion, and reoperation in ≤30 days. RESULTS Over 8 years, 400 patients were operated on for acute appendicitis, with the PS group comprising 61 % (N = 244) of patients. The operation time (55.1 vs 43.2 min, p = 0.0001) and postoperative length of hospital stay (3.5 vs 2.7 days, p = 0.001) were shorter, more patients were treated by laparoscopy (61.3 vs 91.2 %, p = 0.0001), and a fewer patients required peritoneal drainage (29.5 vs 63.2 %, p = 0.023) in the PS group than in the GS group. The negative appendectomy rate was slightly lower in the PS group, but not to a statistically significant degree. CONCLUSION The patients in the PS group enjoyed a reduced operation time and length of hospital stay, greater likelihood of laparoscopic operation, and less peritoneal drainage than the patients in the GS group.
Collapse
Affiliation(s)
- Younglim Kim
- Department of Surgery, Kangwon National University School of Medicine, Chuncheon, 200-722, South Korea
| | - Kyuwhan Jung
- Department of Surgery, Seoul National University Bundang Hospital, Songnam, South Korea
| | - Young-Joon Ryu
- Department of Pathology, Kangwon National University School of Medicine, Chuncheon, South Korea
| | - Suk-Bae Moon
- Department of Surgery, Kangwon National University School of Medicine, Chuncheon, 200-722, South Korea.
| |
Collapse
|
2767
|
Oriá RB, Murray-Kolb LE, Scharf RJ, Pendergast LL, Lang DR, Kolling GL, Guerrant RL. Early-life enteric infections: relation between chronic systemic inflammation and poor cognition in children. Nutr Rev 2016; 74:374-86. [PMID: 27142301 DOI: 10.1093/nutrit/nuw008] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The intestinal microbiota undergoes active remodeling in the first 6 to 18 months of life, during which time the characteristics of the adult microbiota are developed. This process is strongly influenced by the early diet and enteric pathogens. Enteric infections and malnutrition early in life may favor microbiota dysbiosis and small intestinal bacterial overgrowth, resulting in intestinal barrier dysfunction and translocation of intestinal bacterial products, ultimately leading to low-grade, chronic, subclinical systemic inflammation. The leaky gut-derived low-grade systemic inflammation may have profound consequences on the gut-liver-brain axis, compromising normal growth, metabolism, and cognitive development. This review examines recent data suggesting that early-life enteric infections that lead to intestinal barrier disruption may shift the intestinal microbiota toward chronic systemic inflammation and subsequent impaired cognitive development.
Collapse
Affiliation(s)
- Reinaldo B Oriá
- R.B. Oriá is with the Laboratory of Tissue Healing, Ontogeny and Nutrition, Institute of Biomedicine and Department of Morphology, Faculty of Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil. L.E. Murray-Kolb is with The Pennsylvania State University, University Park, Pennsylvania, USA. R.J. Scharf, G. Kolling, and R.L. Guerrant are with the Center for Global Health, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA. L.L. Pendergast is with the School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA. D.R. Lang is with the Foundation for the National Institutes of Health, Bethesda, Maryland, USA.
| | - Laura E Murray-Kolb
- R.B. Oriá is with the Laboratory of Tissue Healing, Ontogeny and Nutrition, Institute of Biomedicine and Department of Morphology, Faculty of Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil. L.E. Murray-Kolb is with The Pennsylvania State University, University Park, Pennsylvania, USA. R.J. Scharf, G. Kolling, and R.L. Guerrant are with the Center for Global Health, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA. L.L. Pendergast is with the School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA. D.R. Lang is with the Foundation for the National Institutes of Health, Bethesda, Maryland, USA
| | - Rebecca J Scharf
- R.B. Oriá is with the Laboratory of Tissue Healing, Ontogeny and Nutrition, Institute of Biomedicine and Department of Morphology, Faculty of Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil. L.E. Murray-Kolb is with The Pennsylvania State University, University Park, Pennsylvania, USA. R.J. Scharf, G. Kolling, and R.L. Guerrant are with the Center for Global Health, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA. L.L. Pendergast is with the School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA. D.R. Lang is with the Foundation for the National Institutes of Health, Bethesda, Maryland, USA
| | - Laura L Pendergast
- R.B. Oriá is with the Laboratory of Tissue Healing, Ontogeny and Nutrition, Institute of Biomedicine and Department of Morphology, Faculty of Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil. L.E. Murray-Kolb is with The Pennsylvania State University, University Park, Pennsylvania, USA. R.J. Scharf, G. Kolling, and R.L. Guerrant are with the Center for Global Health, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA. L.L. Pendergast is with the School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA. D.R. Lang is with the Foundation for the National Institutes of Health, Bethesda, Maryland, USA
| | - Dennis R Lang
- R.B. Oriá is with the Laboratory of Tissue Healing, Ontogeny and Nutrition, Institute of Biomedicine and Department of Morphology, Faculty of Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil. L.E. Murray-Kolb is with The Pennsylvania State University, University Park, Pennsylvania, USA. R.J. Scharf, G. Kolling, and R.L. Guerrant are with the Center for Global Health, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA. L.L. Pendergast is with the School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA. D.R. Lang is with the Foundation for the National Institutes of Health, Bethesda, Maryland, USA
| | - Glynis L Kolling
- R.B. Oriá is with the Laboratory of Tissue Healing, Ontogeny and Nutrition, Institute of Biomedicine and Department of Morphology, Faculty of Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil. L.E. Murray-Kolb is with The Pennsylvania State University, University Park, Pennsylvania, USA. R.J. Scharf, G. Kolling, and R.L. Guerrant are with the Center for Global Health, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA. L.L. Pendergast is with the School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA. D.R. Lang is with the Foundation for the National Institutes of Health, Bethesda, Maryland, USA
| | - Richard L Guerrant
- R.B. Oriá is with the Laboratory of Tissue Healing, Ontogeny and Nutrition, Institute of Biomedicine and Department of Morphology, Faculty of Medicine, Federal University of Ceará, Ceará, Fortaleza, Brazil. L.E. Murray-Kolb is with The Pennsylvania State University, University Park, Pennsylvania, USA. R.J. Scharf, G. Kolling, and R.L. Guerrant are with the Center for Global Health, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA. L.L. Pendergast is with the School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA. D.R. Lang is with the Foundation for the National Institutes of Health, Bethesda, Maryland, USA
| |
Collapse
|
2768
|
Palermo CI, Costanzo CM, Franchina C, Castiglione G, Giuliano L, Russo R, Conti A, Sofia V, Scalia G. Focal epilepsy as a long term sequela of Parvovirus B19 encephalitis. J Clin Virol 2016; 80:20-3. [PMID: 27130981 DOI: 10.1016/j.jcv.2016.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/08/2016] [Accepted: 04/11/2016] [Indexed: 11/19/2022]
Abstract
Human Parvovirus B19 (PVB19), the etiological agent of the fifth disease, is associated with a large spectrum of pathologies, among which is encephalitis. Since it has been detected from the central nervous system in children or in immunocompromised patients, its causative role in serious neurological manifestations is still unclear. Here we report the case of an 18-year-old healthy boy who developed encephalitis complicated by prolonged status epilepticus. The detection of PVB19 DNA in his serum and, subsequently, in his cerebrospinal fluid supports the hypothesis that this virus could potentially play a role in the pathogenesis of neurological complications. In addition, the detection of viral DNA and the presence of specific IgM and IgG antibodies in serum, together with clinical findings such as skin rash, support the presence of a disseminated viral infection. In the presence of neurological disorders, especially when there are no specific signs, but seizures and rash are present, it is important to search for PVB19 both in immunocompromised and immunocompetent patients. Moreover, the introduction of the PVB19 DNA test into diagnostic protocols of neuropathies, especially those undiagnosed, could clarify the etiological agent that otherwise could remain unrecognized.
Collapse
Affiliation(s)
- Concetta Ilenia Palermo
- Department of Biomedical and Biotechnological Sciences, University of Catania, Italy; O.U. Central Laboratory, Clinical Virology Unit, A.O.U Policlinico-Vittorio Emanuele, O.P "Gaspare Rodolico", Catania, Italy.
| | - Carmela Maria Costanzo
- Department of Biomedical and Biotechnological Sciences, University of Catania, Italy; O.U. Central Laboratory, Clinical Virology Unit, A.O.U Policlinico-Vittorio Emanuele, O.P "Gaspare Rodolico", Catania, Italy
| | - Concetta Franchina
- Department of Biomedical and Biotechnological Sciences, University of Catania, Italy; O.U. Central Laboratory, Clinical Virology Unit, A.O.U Policlinico-Vittorio Emanuele, O.P "Gaspare Rodolico", Catania, Italy
| | - Giacomo Castiglione
- O.U. Intensive Care, A.O.U Policlinico-Vittorio Emanuele, O.P "Vittorio Emanuele II", Catania, Italy
| | - Loretta Giuliano
- Department "G. F. Ingrassia", Section of Neurosciences, University of Catania, Italy
| | - Raffaela Russo
- Department of Biomedical and Biotechnological Sciences, University of Catania, Italy; O.U. Central Laboratory, Clinical Virology Unit, A.O.U Policlinico-Vittorio Emanuele, O.P "Gaspare Rodolico", Catania, Italy
| | - Alessandro Conti
- O.U. Intensive Care, A.O.U Policlinico-Vittorio Emanuele, O.P "Vittorio Emanuele II", Catania, Italy
| | - Vito Sofia
- Department "G. F. Ingrassia", Section of Neurosciences, University of Catania, Italy
| | - Guido Scalia
- Department of Biomedical and Biotechnological Sciences, University of Catania, Italy; O.U. Central Laboratory, Clinical Virology Unit, A.O.U Policlinico-Vittorio Emanuele, O.P "Gaspare Rodolico", Catania, Italy
| |
Collapse
|
2769
|
Self-assessed physical health among children with congenital diaphragmatic hernia. Pediatr Surg Int 2016; 32:493-503. [PMID: 26909750 DOI: 10.1007/s00383-016-3879-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2016] [Indexed: 01/23/2023]
Abstract
PURPOSE The aim of this long-term follow-up study was to investigate the current self assessed physical health in a CDH birth cohort at a single center. METHODS Between 1990 and 2009, 195 children born with CDH were treated at Astrid Lindgren Children's Hospital. The primary survival rate was 85 %, and in 2010, 78 % were still alive. Data from medical records were supplemented by a questionnaire consisting of questions about perceived physical function. Patients were divided into groups according to time for intubation and need for extracorporeal membrane oxygenation. RESULTS Children born with CDH reported themselves to be having greater problems with asthma, developmental delay, seizure disorder, poor vision, and scoliosis in comparison with normal Swedish children. They also described a sense of having less strength and becoming breathless more often than healthy friends. Symptoms of gastroesophageal reflux and abdominal pain were also reported. CONCLUSIONS The majority of the children perceived their physical health as being overall good, but there was an increase of reported symptoms correlating with the severity of the malformation.
Collapse
|
2770
|
King SK, Alfaraj M, Gaiteiro R, O'Brien K, Moraes T, Humpl T, Marcon M, Chiang M, Reyes J, Haliburton B, Ryan G, Cox P, Chiu PPL. Congenital diaphragmatic hernia: Observed/expected lung-to-head ratio as a predictor of long-term morbidity. J Pediatr Surg 2016; 51:699-702. [PMID: 26932249 DOI: 10.1016/j.jpedsurg.2016.02.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 02/07/2016] [Indexed: 02/06/2023]
Abstract
AIM The aim of this study was to investigate the association of observed/expected (O/E) lung-to-head ratio (LHR) with long-term morbidity for isolated fetal congenital diaphragmatic hernia (CDH) patients in a single institution. METHODS We performed a retrospective study of prenatally diagnosed CDH from 18 to 38weeks of gestation (01/2002-04/2010). Two cohorts of O/E LHR were defined (22.6-45%, 45.1-78.3%) based upon previous studies. Survivors with at least 1-year follow-up of prospectively collected long-term morbidity assessments were included. RESULTS O/E LHR was available in 43 survivors (median 40%, range 22.8-78.3%). Follow-up data were available in 41 survivors (M:F=24:17, left CDH=39/41). Median follow-up was 6.5years (1-11years). Height/weight trajectories were similar between the two cohorts, with the majority below the 50th centile. There were no differences between the two cohorts by age 3years for Bayley scales (developmental domains) and/or REEL-3 (language development). In addition, V/Q scans in the two cohorts demonstrated similar degrees of mismatch (mean delta V/Q=35.4 versus 31.3). CONCLUSIONS In fetuses with isolated CDH, a reduction in O/E LHR does not predict a worse outcome in long-term follow-up. There is no association between a lower O/E LHR and a reduction in REEL-3 or Bayley score nor V/Q mismatch.
Collapse
Affiliation(s)
- Sebastian K King
- Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Malikah Alfaraj
- Fetal Medicine Unit, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Rose Gaiteiro
- Division of Critical Care Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Karel O'Brien
- Division of Neonatology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Theo Moraes
- Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Tilman Humpl
- Division of Cardiology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Margaret Marcon
- Division of Gastroenterology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Monping Chiang
- Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Janette Reyes
- Division of Cardiology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Beth Haliburton
- Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Greg Ryan
- Fetal Medicine Unit, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Peter Cox
- Division of Critical Care Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Priscilla P L Chiu
- Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.
| |
Collapse
|
2771
|
A decision-making tool for exchange transfusions in infants with severe hyperbilirubinemia in resource-limited settings. J Perinatol 2016; 36:338-41. [PMID: 26938921 DOI: 10.1038/jp.2016.25] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 01/18/2016] [Accepted: 01/26/2016] [Indexed: 11/08/2022]
Abstract
Late presentation and ineffective phototherapy account for excessive rates of avoidable exchange transfusions (ETs) in many low- and middle-income countries. Several system-based constraints sometimes limit the ability to provide timely ETs for all infants at risk of kernicterus, thus necessitating a treatment triage to optimize available resources. This article proposes a practical priority-setting model for term and near-term infants requiring ET after the first 48 h of life. The proposed model combines plasma/serum bilirubin estimation, clinical signs of acute bilirubin encephalopathy and neurotoxicity risk factors for predicting the risk of kernicterus based on available evidence in the literature.
Collapse
|
2772
|
González Plaza JJ, Hulak N, Zhumadilov Z, Akilzhanova A. Fever as an important resource for infectious diseases research. Intractable Rare Dis Res 2016; 5:97-102. [PMID: 27195192 PMCID: PMC4869589 DOI: 10.5582/irdr.2016.01009] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 03/26/2016] [Accepted: 04/04/2016] [Indexed: 02/07/2023] Open
Abstract
Fever or pyrexia is a process where normal body temperature is raised over homeostasis conditions. Although many effects of fever over the immune system have been known for a long time, it has not been until recent studies when these effects have been evaluated in several infection processes. Results have been promising, as they have reported new ways of regulation, especially in RNA molecules. In light of these new studies, it seems important to start to evaluate the effects of pyrexia in current research efforts in host-pathogen interactions. Viruses and bacteria are responsible for different types of infectious diseases, and while it is of paramount importance to understand the mechanisms of infection, potential effects of fever on this process may have been overlooked. This is especially relevant because during the course of many infectious diseases the organism develops fever. Due to the lack of specific treatments for many of those afflictions, experimental evaluation in fever-like conditions can potentially bring new insights into the infection process and can ultimately help to develop treatments. The aim of this review is to present evidence that the temperature increase during fever affects the way the infection takes place, for both the pathogen and the host.
Collapse
Affiliation(s)
- Juan José González Plaza
- Division for Marine and Environmental Research, Ruđer Bošković Institute, Zagreb, Croatia
- Research Department, University Hospital for Infectious Diseases “Dr. Fran Mihaljević”, Zagreb, Croatia
| | - Nataša Hulak
- Department of Microbiology, Faculty of Agriculture, University of Zagreb, Zagreb, Croatia
| | - Zhaxybay Zhumadilov
- Laboratory of Genomic and Personalized Medicine, Center for Life Sciences, PI “National Laboratory Astana”, AOE “Nazarbayev University”, Astana, Kazakhstan
| | - Ainur Akilzhanova
- Laboratory of Genomic and Personalized Medicine, Center for Life Sciences, PI “National Laboratory Astana”, AOE “Nazarbayev University”, Astana, Kazakhstan
| |
Collapse
|
2773
|
Seifert G, Budach V, Keilholz U, Wust P, Eggert A, Ghadjar P. Regional hyperthermia combined with chemotherapy in paediatric, adolescent and young adult patients: current and future perspectives. Radiat Oncol 2016; 11:65. [PMID: 27138749 PMCID: PMC4852447 DOI: 10.1186/s13014-016-0639-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 04/21/2016] [Indexed: 12/16/2022] Open
Abstract
Here we evaluate the current status of clinical research on regional hyperthermia (RHT) in combination with chemotherapy or radiation therapy in paediatric oncology.Data were identified in searches of MEDLINE, Current Contents, PubMed, and references from relevant articles using medical subject headings including hyperthermia, cancer, paediatric oncology, children, radiation therapy and chemotherapy. Currently, only two RHT centres exist in Europe which treat children. Clinical RHT research in paediatric oncology has as yet been limited to children with sarcomas and germ cell tumours that respond poorly to or recur after chemotherapy. RHT is a safe and effective treatment delivering local thermic effects, which may also stimulate immunological processes via heat-shock protein reactions. RHT is used chiefly in children and adolescents with sarcomas or germ cell tumours located in the abdomino-pelvic region, chest wall or extremities to improve operability or render the tumour operable. It could potentially be combined with radiation therapy in a post-operative R1 setting where more radical surgery is not possible or combined with chemotherapy instead of radiation therapy in cases where the necessary radiation dose is impossible to achieve or would have mutilating consequences. RHT might also be an option for chemotherapy intensification in the neoadjuvant first-line treatment setting for children and adolescents, as was recently reflected in the promising long-term outcome data in adults with high-risk soft tissue sarcomas (EORTC 62961/ESHO trial).The limited data available indicate that combining RHT with chemotherapy is a promising option to treat germ cell tumours and, potentially, sarcomas. RHT may also be beneficial in first-line therapy in children, adolescents and young adults. The research should focus on optimising necessary technical demands and then initiate several clinical trials incorporating RHT into interdisciplinary treatment of children, adolescents and young adults that include translational research components exploring potential immunological mechanisms of action.
Collapse
Affiliation(s)
- Georg Seifert
- Department of Paediatric Oncology and Haematology, Otto-Heubner Centrum für Kinder- und Jugendmedizin, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Volker Budach
- Department of Radiation Oncology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Ulrich Keilholz
- Comprehensive Cancer Center, Charité - Universitätsmedizin Berlin, Virchowweg 23, 10115, Berlin, Germany
| | - Peter Wust
- Department of Radiation Oncology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Angelika Eggert
- Department of Paediatric Oncology and Haematology, Otto-Heubner Centrum für Kinder- und Jugendmedizin, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Pirus Ghadjar
- Department of Radiation Oncology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| |
Collapse
|
2774
|
|
2775
|
de Carvalho INSR, de Freitas RM, Vargas FR. Translating microRNAs into biomarkers: What is new for pediatric cancer? Med Oncol 2016; 33:49. [DOI: 10.1007/s12032-016-0766-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 04/11/2016] [Indexed: 02/06/2023]
|
2776
|
Ngwenya LB, Prevedello LM, Youssef PP. Concomitant epidural and subdural spinal abscess: a case report. Spine J 2016; 16:e275-82. [PMID: 26686603 DOI: 10.1016/j.spinee.2015.11.060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 10/27/2015] [Accepted: 11/30/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Spinal subdural abscess (SSA) is a rare occurrence for which the management typically involves open surgical removal and washout. PURPOSE This case report aims to review the literature and discuss the management of patients with SSA. STUDY DESIGN We present a case of a 33-year-old female who presented with a spinal epidural abscess and concurrent SSA. She presented in the context of intravenous (IV) drug use, back pain, and generalized lower extremity weakness. METHODS The literature was reviewed with a focus on modern treatment options for SSA. Our patient was managed with IV antibiotics, and separate laminectomies and washouts for both lesions. RESULTS The patient recovered well with return of neurologic function and normalization of infection markers. The review of the literature resulted in a management flowchart that will help direct treatment of SSA. CONCLUSIONS The literature suggests that in a patient with a definitive diagnosis of SSA, limited surgical management and IV antibiotics are the mainstay of treatment in a patient with a decline in neurologic function. There may be a role for expectant management in the absence of diagnostic imaging or the neurologically stable patient.
Collapse
Affiliation(s)
- Laura B Ngwenya
- Department of Neurological Surgery, The Ohio State University Wexner Medical Center, N1014 Doan Hall, 410 W 10th Ave, Columbus, OH 43210, USA
| | - Luciano M Prevedello
- Department of Radiology, The Ohio State University Wexner Medical Center, Room 460, 395 W 12th Ave, Columbus, OH 43210, USA
| | - Patrick P Youssef
- Department of Neurological Surgery, The Ohio State University Wexner Medical Center, N1014 Doan Hall, 410 W 10th Ave, Columbus, OH 43210, USA.
| |
Collapse
|
2777
|
|
2778
|
Hu WC. Microarray analysis of PBMC after Plasmodium falciparum infection: Molecular insights into disease pathogenesis. ASIAN PAC J TROP MED 2016; 9:313-323. [DOI: 10.1016/j.apjtm.2016.03.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 02/20/2016] [Accepted: 03/01/2016] [Indexed: 11/26/2022] Open
|
2779
|
Zhao W, Hao M, Wang Y, Feng N, Wang Z, Wang W, Wang J, Ding L. Association between folate status and cervical intraepithelial neoplasia. Eur J Clin Nutr 2016; 70:837-42. [PMID: 27026426 PMCID: PMC4940925 DOI: 10.1038/ejcn.2016.35] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 02/15/2016] [Accepted: 02/17/2016] [Indexed: 12/03/2022]
Abstract
Background/Objectives: To investigate the effect of folate status on cervical intraepithelial neoplasia (CIN) progression and its relationship with high-risk human papillomavirus (hrHPV). Subjects/Methods: We evaluated 20 000 sexually active women aged <65 years in Yangqu County by using a questionnaire; the subjects were also screened using the ThinPrep cytologic test (TCT). Patients with abnormal TCT results (other than glandular cell abnormalities) who were willing to provide informed consent were further diagnosed using colposcopy and histopathological examination. We investigated 247 cases of low-grade cervical squamous intraepithelial lesions (LSIL), 125 cases of high-grade cervical squamous intraepithelial lesions (HSIL) and 877 controls. A 24-item food frequency questionnaire was filled out by the investigator to estimate the consumption of dietary folate. Positivity for hrHPV from residual exfoliated cervical cells was tested; serum folate was also measured. Results: The hrHPV infection rate in HSIL patients (77.6%) was higher than that in LSIL (33.2%) and control (32.0%) patients. Dietary folate intakes in controls, LSIL and HSIL were 306.9±176.6, 321.8±168.0 and 314.7±193.8 μg/kcal, respectively. The levels of serum folate in controls, LSIL and HSIL were 18.2±7.9, 15.9±7.1 and 14.3±7.5 nmol/l, respectively. Increased CIN correlated with higher rates of hrHPV infection and lower levels of serum folate. Conclusions: Low levels of serum folate may increase the risk of CIN progression. Furthermore, potential synergy may exist between low serum folate levels and hrHPV infection to promote CIN development.
Collapse
Affiliation(s)
- W Zhao
- Department of Obstetrics and Gynecology, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - M Hao
- Department of Obstetrics and Gynecology, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Y Wang
- Department of Obstetrics and Gynecology, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - N Feng
- Department of Obstetrics and Gynecology, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Z Wang
- Department of Obstetrics and Gynecology, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - W Wang
- Department of Obstetrics and Gynecology, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - J Wang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - L Ding
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| |
Collapse
|
2780
|
Emokpae AA, Mabogunje CA, Imam ZO, Olusanya BO. Heliotherapy for Neonatal Hyperbilirubinemia in Southwest, Nigeria: A Baseline Pre-Intervention Study. PLoS One 2016; 11:e0151375. [PMID: 27003893 PMCID: PMC4803330 DOI: 10.1371/journal.pone.0151375] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 02/26/2016] [Indexed: 12/03/2022] Open
Abstract
Background A novel filtered-sunlight phototherapy (FSPT) device has been demonstrated to be safe and efficacious for treating infants with neonatal jaundice in resource-constrained tropical settings. We set out to provide baseline data for evaluating the clinical impact of this device in a referral pediatric hospital. Methods We reviewed the medical records of infants admitted for neonatal hyperbilirubinemia in an inner-city Children’s Hospital in Lagos, between January 2012 and December 2014 to determine the pattern, treatment and outcomes during the pre-intervention period. Factors associated with adverse outcomes were identified through multivariable logistic regression. Results Of the 5,229 neonatal admissions over the period, a total of 1,153 (22.1%) were admitted for neonatal hyperbilirubinemia. Complete records for 1,118 infants were available for analysis. The incidence of acute bilirubin encephalopathy (ABE) and exchange transfusion (ET) were 17.0% (95% CI: 14.9%–19.3%) and 31.5% (95% CI: 28.8%–34.3%) respectively. A total of 61 (5.5%, 95% CI: 4.3%–6.9%) of the jaundiced infants died. Weight on admission, peak total serum bilirubin (TSB), sepsis and exposure to hemolytic products were predictive of ABE, while age on admission, peak TSB, ABO incompatibility and ABE were predictive of ET. Rhesus incompatibility, asphyxia, exposure to hemolytic substances and ABE were associated with elevated mortality risk, while ET was a protective factor. Lack of routine irradiance monitoring and steady energy supply were frequent challenges for conventional blue-light phototherapy. Conclusions Severe hyperbilirubinemia is associated with high rates of ABE and ET in this setting, and remains a significant contributor to neonatal admissions and mortality. To be impactful, FSPT, complemented with improved diagnostic facilities, should effectively curtail jaundice-related adverse outcomes in this and comparable settings.
Collapse
Affiliation(s)
| | | | | | - Bolajoko O. Olusanya
- Centre for Healthy Start Initiative, 286A Corporation Drive, Dolphin Estate, Ikoyi, Lagos, Nigeria
- * E-mail:
| |
Collapse
|
2781
|
Papandreou D, Makedou K, Zormpa A, Karampola M, Ioannou A, Hitoglou-Makedou A. Are Dietary Intakes Related to Obesity in Children? Open Access Maced J Med Sci 2016; 4:194-9. [PMID: 27335587 PMCID: PMC4908732 DOI: 10.3889/oamjms.2016.045] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 03/08/2016] [Accepted: 03/09/2016] [Indexed: 11/07/2022] Open
Abstract
AIM: The purpose of this study was to report obesity status and identify any dietary substances that may be related to obesity in healthy school children from Northern Greece. METHODS: Four hundred and twenty-five (n = 425) children were randomly selected to participate in the study. A 24-h recall of three days (two weekdays and one weekend day) was used to analyze the dietary data of the subjects. RESULTS: Out of 425 subjects, 146 (34.3%) of them were found to be overweight and obese. Energy, protein, carbohydrate and thiamin intake was statistically positively correlated with obesity while dietary iron intake was statistically negatively correlated with obesity. Multivariate logistic regression analysis showed that the children with dietary iron deficiency were 1.128 (95% CI: 0.002, 0.161 P < 0.031) times more likely of being obese compared to the normal group after adjustment for energy intake. CONCLUSIONS: Although most of the dietary intakes of our subjects were adequate, special consideration should be given to energy, carbohydrate, protein, and sugar and iron intake especially and its relation to obesity. Furthermore, additional studies are required to investigate any possible relation of low dietary iron consumption and obesity.
Collapse
Affiliation(s)
- Dimitrios Papandreou
- Department of Natural Science and Public Health, Zayed University, Abu Dhabi, United Arab Emirates
| | - Kali Makedou
- Laboratory of Biological Chemistry, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Areti Zormpa
- Laboratory of Lipids and Cardiovascular Disease Prevention from Childhood, 2nd Pediatric Department, AHEPA University Hospital, Thessaloniki, Greece
| | - Maria Karampola
- Laboratory of Lipids and Cardiovascular Disease Prevention from Childhood, 2nd Pediatric Department, AHEPA University Hospital, Thessaloniki, Greece
| | - Anastasia Ioannou
- Laboratory of Lipids and Cardiovascular Disease Prevention from Childhood, 2nd Pediatric Department, AHEPA University Hospital, Thessaloniki, Greece
| | - Areti Hitoglou-Makedou
- Laboratory of Lipids and Cardiovascular Disease Prevention from Childhood, 2nd Pediatric Department, AHEPA University Hospital, Thessaloniki, Greece
| |
Collapse
|
2782
|
Açıkel B, Yar A, Hergüner S. Functional Vomiting Treated Successfully with Aripiprazole in a Child with Autism Spectrum Disorder. J Child Adolesc Psychopharmacol 2016; 26:177-8. [PMID: 26938577 DOI: 10.1089/cap.2015.0202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Burak Açıkel
- 1 Department of Child and Adolescent Psychiatry, Meram Faculty of Medicine, Necmettin Erbakan University , Konya, Turkey
| | - Ahmet Yar
- 2 Child and Adolescent Psychiatry Clinic, Konya Training and Research Hospital , Konya, Turkey
| | - Sabri Hergüner
- 1 Department of Child and Adolescent Psychiatry, Meram Faculty of Medicine, Necmettin Erbakan University , Konya, Turkey
| |
Collapse
|
2783
|
Early onset epileptic encephalopathy or genetically determined encephalopathy with early onset epilepsy? Lessons learned from TSC. Eur J Paediatr Neurol 2016; 20:203-211. [PMID: 26758984 DOI: 10.1016/j.ejpn.2015.12.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 12/01/2015] [Accepted: 12/13/2015] [Indexed: 01/12/2023]
Abstract
BACKGROUND In tuberous sclerosis complex (TSC) a relationship has been shown between early and refractory seizures and intellectual disability. However, it is uncertain whether epilepsy in TSC is simply a marker in infants who are destined to develop an encephalopathic process or if seizures play a causal role in developing an encephalopathy. METHODS This paper summarizes the key points discussed during a European TSC workshop held in Rome, and reviews the experimental and clinical evidence in support of the two theories. RESULTS/CONCLUSION There are many factors that influence the appearance of both early seizure onset and the encephalopathy resulting in neurodevelopmental deficits. Experimental studies show that as a consequence of the TSC genes mutation, mammalian target of Rapamycin (mTOR) overactivation determines an alteration in cellular morphology with cytomegalic neurons, altered synaptogenesis and an imbalance between excitation/inhibition, thus providing a likely neuroanatomical substrate for the early appearance of refractory seizures and for the encephalopathic process. At the clinical level, early signs of altered developmental trajectories are often unrecognized before 12 months of age. Evidence from experimental research shows that encephalopathy in TSC might have a genetic cause, and mTOR activation caused by TSC gene mutation can be directly responsible for the early appearance of seizures and encephalopathy.
Collapse
|
2784
|
Tatler AL, Barnes J, Habgood A, Goodwin A, McAnulty RJ, Jenkins G. Caffeine inhibits TGFβ activation in epithelial cells, interrupts fibroblast responses to TGFβ, and reduces established fibrosis in ex vivo precision-cut lung slices. Thorax 2016; 71:565-7. [PMID: 26911575 PMCID: PMC4893128 DOI: 10.1136/thoraxjnl-2015-208215] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 02/01/2016] [Indexed: 01/12/2023]
Abstract
Caffeine is a commonly used food additive found naturally in many products. In addition to potently stimulating the central nervous system caffeine is able to affect various systems within the body including the cardiovascular and respiratory systems. Importantly, caffeine is used clinically to treat apnoea and bronchopulmonary dysplasia in premature babies. Recently, caffeine has been shown to exhibit antifibrotic effects in the liver in part through reducing collagen expression and deposition, and reducing expression of the profibrotic cytokine TGFβ. The potential antifibrotic effects of caffeine in the lung have not previously been investigated. Using a combined in vitro and ex vivo approach we have demonstrated that caffeine can act as an antifibrotic agent in the lung by acting on two distinct cell types, namely epithelial cells and fibroblasts. Caffeine inhibited TGFβ activation by lung epithelial cells in a concentration-dependent manner but had no effect on TGFβ activation in fibroblasts. Importantly, however, caffeine abrogated profibrotic responses to TGFβ in lung fibroblasts. It inhibited basal expression of the α-smooth muscle actin gene and reduced TGFβ-induced increases in profibrotic genes. Finally, caffeine reduced established bleomycin-induced fibrosis after 5 days treatment in an ex vivo precision-cut lung slice model. Together, these findings suggest that there is merit in further investigating the potential use of caffeine, or its analogues, as antifibrotic agents in the lung.
Collapse
Affiliation(s)
- Amanda L Tatler
- Division of Respiratory Medicine, Nottingham City Hospital, University of Nottingham, Nottingham, UK
| | - Josephine Barnes
- UCL Respiratory Centre for Inflammation and Tissue Repair, University College London, London, UK
| | - Anthony Habgood
- Division of Respiratory Medicine, Nottingham City Hospital, University of Nottingham, Nottingham, UK
| | - Amanda Goodwin
- Division of Respiratory Medicine, Nottingham City Hospital, University of Nottingham, Nottingham, UK
| | - Robin J McAnulty
- UCL Respiratory Centre for Inflammation and Tissue Repair, University College London, London, UK
| | - Gisli Jenkins
- Division of Respiratory Medicine, Nottingham City Hospital, University of Nottingham, Nottingham, UK
| |
Collapse
|
2785
|
Liu J, Zhang L, Li Z, Jin L, Zhang Y, Ye R, Liu J, Ren A. Prevalence and trend of neural tube defects in five counties in Shanxi province of Northern China, 2000 to 2014. ACTA ACUST UNITED AC 2016; 106:267-74. [PMID: 26879384 DOI: 10.1002/bdra.23486] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The prevalence of neural tube defects (NTDs) in northern China is among the highest in the world. A massive folic acid supplementation program as a specific countermeasure was introduced in 2009. Examining trends in NTD prevalence may provide evidence for future intervention. METHODS Data for 2000 to 2014 in five counties in northern China were obtained through a population-based birth defects surveillance system. All live births, stillbirths of over 20 gestational weeks, and pregnancy terminations because of NTDs at any gestational age were recorded. The prevalence of NTDs by gestational weeks (< 28 vs. ≥ 28), by calendar year, and by subtype was presented. RESULTS From 2000 to 2014, a total of 234,225 births and 2027 cases of NTDs were recorded. The prevalence of total NTDs was extremely high during 2000 to 2004, but it began to decrease continuously thereafter, from a peak of 120.0/10,000 in 2004 to a low of 31.5/10,000 in 2014. A significant decrease (60%) was observed from 78.8/10,000 in 2009 to 31.5/10,000 in 2014, 5 years after the folic acid supplementation program was introduced. All three major subtypes, namely anencephaly, spina bifida, and encephalocele, showed a decline over this period. Although the perinatal (≥ 28 gestational weeks) prevalence of NTDs decreased progressively, the pre-perinatal (< 28 gestational weeks) prevalence of NTDs remained high until 2011 and then decreased. CONCLUSION The prevalence of NTDs remains high despite a substantial and continuous decrease over the past 15 years. To further reduce NTD risk in the population, fortification staples with folic acid should be considered.
Collapse
Affiliation(s)
- Jufen Liu
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Le Zhang
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Zhiwen Li
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Lei Jin
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yali Zhang
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Rongwei Ye
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jianmeng Liu
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Aiguo Ren
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| |
Collapse
|
2786
|
|
2787
|
Bibalo C, Apicella A, Guastalla V, Marzuillo P, Zennaro F, Tringali C, Taddio A, Germani C, Barbi E. Acute lobar nephritis in children: Not so easy to recognize and manage. World J Clin Pediatr 2016; 5:136-142. [PMID: 26862513 PMCID: PMC4737688 DOI: 10.5409/wjcp.v5.i1.136] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 10/27/2015] [Accepted: 12/18/2015] [Indexed: 02/06/2023] Open
Abstract
Acute lobar nephritis (ALN) is a localized non-liquefactive inflammatory renal bacterial infection, which typically involves one or more lobes. ALN is considered to be a midpoint in the spectrum of upper urinary tract infection, a spectrum ranging from uncomplicated pyelonephritis to intrarenal abscess. This condition may be difficult to recognize due to the lack of specific symptoms and laboratory findings. Therefore the disease is probably underdiagnosed. Computed tomography scanning represents the diagnostic gold standard for ALN, but magnetic resonance imagine could be considered in order to limit irradiation. The diagnosis is relevant since initial intravenous antibiotic therapy and overall length of treatment should not be shorter than 3 wk. We review the literature and analyze the ALN clinical presentation starting from four cases with the aim to give to the clinicians the elements to suspect and recognize the ALN in children.
Collapse
|
2788
|
Cassir N, Simeoni U, La Scola B. Gut microbiota and the pathogenesis of necrotizing enterocolitis in preterm neonates. Future Microbiol 2016; 11:273-92. [PMID: 26855351 DOI: 10.2217/fmb.15.136] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Necrotizing enterocolitis (NEC) remains a devastating intestinal disease in preterm neonates. In this population, disruption of the gut microbiota development, mainly due to organ immaturity, antibiotic use and hospital microbial environment, plays a key role in the pathogenesis of NEC. This gut dysbiosis has been associated with opportunistic pathogens overgrowth, expression of virulence factors, altered metabolic functions and inflammatory dysregulated responses. In this review, we provide an updated summary of the host and gut microbiota interactions during the formative early life. We also explore the key determinants of gut dysbiosis in preterm neonates with NEC. Finally, we discuss the promising role of bacteriotherapy in the management of NEC, the aim being to shape or restore the beneficial gut bacterial communities.
Collapse
Affiliation(s)
- Nadim Cassir
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, INSERM U1095, Facultés de Médecine et de Pharmacie, Aix-Marseille Université, Marseille, France
| | - Umberto Simeoni
- Service de Pédiatrie, Centre Hospitalier Universitaire Vaudois, Lausanne, Suisse, Switzerland
| | - Bernard La Scola
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, INSERM U1095, Facultés de Médecine et de Pharmacie, Aix-Marseille Université, Marseille, France
| |
Collapse
|
2789
|
Lebron D, Vasconcellos E. The Episodic Syndromes That Maybe Associated with Migraines. Semin Pediatr Neurol 2016; 23:6-10. [PMID: 27017014 DOI: 10.1016/j.spen.2016.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The "childhood periodic syndromes" have been renamed "the episodic syndromes that maybe associated with migraines". These syndromes were initially considered precursors of migraines that only occurred in childhood; however recent literature suggests that the episodic syndromes can occur in adults with known migraine and does not necessarily present as a precursor. This review article discusses the recent literature regarding the episodic syndromes and potential treatments. These disorders are seen by multiple subspecialists, therefore it is important to recognize and use the same definitions, criteria and nomenclature. A collaborative and multidisciplinary approach is critical to characterize, manage and potentially improve outcomes.
Collapse
Affiliation(s)
- Diana Lebron
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN.
| | | |
Collapse
|
2790
|
Cerebral Toxoplasmosis in an HIV-Negative Patient: A Case Report. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2016. [DOI: 10.5812/archcid.30759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
2791
|
Öngöz Dede F, Bozkurt Doğan Ş, Balli U, Avci B, Durmuşlar MC, Baratzade T. Glutathione levels in plasma, saliva and gingival crevicular fluid after periodontal therapy in obese and normal weight individuals. J Periodontal Res 2016; 51:726-734. [PMID: 26740476 DOI: 10.1111/jre.12349] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2015] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND OBJECTIVE The purpose of this study was to investigate the effects of obesity on reduced and oxidized glutathione (GSH and GSSG) levels in the gingival crevicular fluid, plasma and saliva of patients with chronic periodontitis and to evaluate the changes after nonsurgical periodontal therapy. MATERIAL AND METHODS The study included 60 patients: 30 patients with chronic periodontitis (15 obese patients and 15 normal weight patients) and 30 healthy control subjects (15 obese patients and 15 normal weight patients). Gingival crevicular fluid, plasma and saliva samples were collected, and clinical periodontal measurements were recorded at baseline and at the first month after periodontal therapy from patients with chronic periodontitis. GSH and GSSG levels were analyzed with spectrophotometry. RESULTS The GSH levels in the plasma, saliva and gingival crevicular fluid in obese individuals with chronic periodontitis were lower than in normal weight individuals at baseline (p < 0.01). There was a significant difference in the GSH/GSSG ratio in plasma and gingival crevicular fluid between the obese and normal weight groups at baseline (p < 0.01). The GSH levels in plasma, gingival crevicular fluid and saliva were significantly increased in both chronic periodontitis groups after nonsurgical periodontal therapy (p < 0.01). A significant positive correlation was found between GSH levels in saliva, plasma and gingival crevicular fluid in all groups (p < 0.001). CONCLUSIONS The study revealed that obesity in patients with chronic periodontitis is associated with decreased GSH levels and the GSH/GSSG ratio. Moreover, nonsurgical periodontal therapy may be helpful for improvement in glutathione values in obese and normal weight individuals with chronic periodontitis.
Collapse
Affiliation(s)
- F Öngöz Dede
- Department of Periodontology, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey
| | - Ş Bozkurt Doğan
- Department of Periodontology, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey
| | - U Balli
- Department of Periodontology, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey
| | - B Avci
- Department of Biochemistry, Faculty of Medicine, Ondokuzmayis University, Samsun, Turkey
| | - M C Durmuşlar
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey
| | - T Baratzade
- Department of Biochemistry, Faculty of Medicine, Ondokuzmayis University, Samsun, Turkey
| |
Collapse
|
2792
|
Musova Z, Hancarova M, Havlovicova M, Pourova R, Hrdlicka M, Kraus J, Trkova M, Stejskal D, Sedlacek Z. Expanded DMPK repeats in dizygotic twins referred for diagnosis of autism versus absence of expanded DMPK repeats at screening of 330 children with autism. Neuropsychiatr Dis Treat 2016; 12:2367-2372. [PMID: 27695335 PMCID: PMC5034902 DOI: 10.2147/ndt.s113917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Myotonic dystrophy type 1 (DM1) belongs to the broad spectrum of genetic disorders associated with autism spectrum disorders (ASD). ASD were reported predominantly in congenital and early childhood forms of DM1. We describe dizygotic twin boys with ASD who were referred for routine laboratory genetic testing and in whom karyotyping, FMR1 gene testing, and single nucleotide polymorphism array analysis yielded negative results. The father of the boys was later diagnosed with suspected DM1, and testing revealed characteristic DMPK gene expansions in his genome as well as in the genomes of both twins and their elder brother, who also suffered from ASD. In accord with previous reports on childhood forms of DM1, our patients showed prominent neuropsychiatric phenotypes characterized especially by hypotonia, developmental and language delay, emotional and affective lability, lowered adaptability, and social withdrawal. The experience with this family and multiple literature reports of ASD in DM1 on the one side but the lack of literature data on the frequency of DMPK gene expansions in ASD patients on the other side prompted us to screen the DMPK gene in a sample of 330 patients with ASD who were first seen by a geneticist before they were 10 years of age, before the muscular weakness, which may signal DM1, usually becomes obvious. The absence of any DMPK gene expansions in this cohort indicates that targeted DMPK gene testing can be recommended only in ASD patients with specific symptoms or family history suggestive of DM1.
Collapse
Affiliation(s)
| | | | | | | | | | - Josef Kraus
- Department of Child Neurology, Charles University 2nd Faculty of Medicine and University Hospital Motol
| | - Marie Trkova
- Gennet, Centre for Fetal Medicine, Prague, Czech Republic
| | - David Stejskal
- Gennet, Centre for Fetal Medicine, Prague, Czech Republic
| | | |
Collapse
|
2793
|
Guerrero-Romero F, Rodríguez-Morán M, Hernández-Ronquillo G, Gómez-Díaz R, Pizano-Zarate ML, Wacher NH, Mondragón-González R, Simental-Mendia LE. Low Serum Magnesium Levels and Its Association with High Blood Pressure in Children. J Pediatr 2016; 168:93-98.e1. [PMID: 26490130 DOI: 10.1016/j.jpeds.2015.09.050] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 07/29/2015] [Accepted: 09/15/2015] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To evaluate the association of hypomagnesemia with prehypertension (preHTN) and hypertension in children. STUDY DESIGN A total of 3954 apparently healthy Mexican children were enrolled in a cross-sectional study. Exclusion criteria were type 2 diabetes; hepatic, renal, or endocrine disease; impaired fasting glucose; chronic diarrhea; and intake of vitamins or magnesium supplements in the previous 6 months. preHTN was defined by systolic and/or diastolic blood pressure ≥90th to <95th percentile and hypertension by systolic and/or diastolic blood pressure ≥95th percentile, according to age, sex, and height percentile. Hypomagnesemia was defined by serum magnesium concentration <1.8 mg/dL (<0.74 mmol/L). To control for potential sources of bias related to age, participants were allocated into 2 groups, aged 6-10 years and 11-15 years. RESULTS The prevalence of preHTN and hypertension was 12.2% and 6.4%, respectively, in children aged 6-10 years and 13.9% and 10.6% in those aged 11-15 years. Hypomagnesemia was identified in 59 children with preHTN (27.3%) and 52 (45.6%) with hypertension in the 6-10 year age group, and in 115 children with preHTN (36.0%) and 109 (49.6%) with hypertension in the 11-15 year age group. Adjusted multiple logistic regression analysis showed that in children in both age groups, hypomagnesemia was associated with both preHTN (6-10 years: OR, 2.18, P < .0005; 11-15 years: OR, 1.38, P = .018) and hypertension (6-10 years: OR, 4.87, P < .0005; 11-15 years: OR, 1.83, P = .0002). CONCLUSION Our results indicate that serum magnesium level <1.8 mg/dL is significantly associated with preHTN and hypertension in apparently healthy children.
Collapse
Affiliation(s)
- Fernando Guerrero-Romero
- Biomedical Research Unit of the Mexican Social Security Institute at Durango, Mexico; Research Group on Diabetes and Chronic Illnesses at Durango, Mexico
| | | | | | - Rita Gómez-Díaz
- National Institute of Perinatology from Mexico, Mexico; High Specialty Medical Unit, Specialty Hospital, National Medical Center Century XXI, Mexican Social Security Institute, Mexico
| | - María L Pizano-Zarate
- National Institute of Perinatology from Mexico, Mexico; Family Medicine Unit 4, Mexican Social Security Institute, Mexico
| | - Niels H Wacher
- Research Unit in Clinic Epidemiology, High Specialty Medical Unit, Specialty Hospital, National Medical Center Century XXI, Mexico
| | - Rafael Mondragón-González
- Research Unit in Clinic Epidemiology, High Specialty Medical Unit, Specialty Hospital, National Medical Center Century XXI, Mexico
| | - Luis E Simental-Mendia
- Biomedical Research Unit of the Mexican Social Security Institute at Durango, Mexico; Research Group on Diabetes and Chronic Illnesses at Durango, Mexico
| |
Collapse
|
2794
|
Gupta SN, Gupta VS, Borad N. Spectrum of migraine variants and beyond: The individual syndromes in children. Brain Dev 2016; 38:10-26. [PMID: 26081103 DOI: 10.1016/j.braindev.2015.05.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Revised: 05/07/2015] [Accepted: 05/10/2015] [Indexed: 01/03/2023]
Abstract
"Migraine-related conditions" are probably the second most common condition after seizure encountered in pediatric neurology requiring frequent Emergency Department visits. Among migraines, migraine-related condition presents with an acute onset sign or symptom other than headache or visual aura of unknown etiology. A delay in diagnosis is a common occurrence. Previously, the authors proposed a common clinical profile and suggested that the future review should seek the applicability of the common profile in aid to clinical diagnosis of migraine-related individual syndromes. Authors describe the clinical characteristics and differential diagnosis of the spectrum of migraine variants and beyond in children.
Collapse
Affiliation(s)
- Surya N Gupta
- Section of Child Neurology, Women's and Children's Hospital, Charleston Area Medical Center, Charleston, WV, USA.
| | - Vikash S Gupta
- MS-IV, Texila American University, Woolford Ave, Georgetown, Guyana.
| | - Nirali Borad
- Department of Physiology, P.D.U. Government Medical College, Rajkot, Gujarat, India.
| |
Collapse
|
2795
|
|
2796
|
Peñagarikano O. New Therapeutic Options for Autism Spectrum Disorder: Experimental Evidences. Exp Neurobiol 2015; 24:301-11. [PMID: 26713078 PMCID: PMC4688330 DOI: 10.5607/en.2015.24.4.301] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 11/25/2015] [Accepted: 11/25/2015] [Indexed: 02/07/2023] Open
Abstract
Autism spectrum disorder (ASD) is characterized by impairment in two behavioral domains: social interaction/communication together with the presence of stereotyped behaviors and restricted interests. The heterogeneity in the phenotype among patients and the complex etiology of the disorder have long impeded the advancement of the development of successful pharmacotherapies. However, in the recent years, the integration of findings of multiple levels of research, from human genetics to mouse models, have made considerable progress towards the understanding of ASD pathophysiology, allowing the development of more effective targeted drug therapies. The present review discusses the current state of pharmacological research in ASD based on the emerging common pathophysiology signature.
Collapse
Affiliation(s)
- Olga Peñagarikano
- Department of Pharmacology, School of Medicine, University of the Basque Country, Sarriena s/n, Leioa 48940, Spain
| |
Collapse
|
2797
|
Bergon-Sendin E, Perez-Grande C, Lora-Pablos D, Moral-Pumarega MT, Melgar-Bonis A, Peña-Peloche C, Diezma-Rodino M, García-San Jose L, Cabañes-Alonso E, Pallas-Alonso CR. Smart pumps and random safety audits in a Neonatal Intensive Care Unit: a new challenge for patient safety. BMC Pediatr 2015; 15:206. [PMID: 26654316 PMCID: PMC4676130 DOI: 10.1186/s12887-015-0521-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 12/03/2015] [Indexed: 11/30/2022] Open
Abstract
Background Random safety audits (RSA) are a safety tool enabling prevention of adverse events, but they have not been widely used in hospitals. The aim of this study was to use RSAs to assess and compare the frequency of appropriate use of infusion pump safety systems in a Neonatal Intensive Care Unit (NICU) before and after quality improvement interventions and to analyse the intravenous medication programming data. Methods Prospective, observational study comparing the frequency of appropriate use of Alaris® CC smart pumps through RSAs over two periods, from 1 January to 31 December 2012 and from 1 November 2014 to 31 January 2015. Appropriate use was defined as all evaluated variables being correctly programmed into the same device. Between the two periods they were established interventions to improve the use of pumps. The information recorded at the pumps with the new security system, also extracted for one year. Results Fifty-two measurements were collected during the first period and 160 measurements during the second period. The frequency of appropriate use was 73.13 % (117/160) in the second period versus 0 % (0/52) in the first period (p < 0.0001). Information was recorded on 44,924 infusions; in 46.03 % (20,680/44,924) of cases the drug name was recorded. In 2.5 % (532/20,680) of cases there was an attempt to exceed the absolute limit. Conclusions Random Safety Audits were a very useful tool for detecting inappropriate use of pumps in the NICU. The improvement strategies were effective for improving appropriate use and programming of the intravenous medication infusion pumps in our NICU.
Collapse
Affiliation(s)
- Elena Bergon-Sendin
- Department of Neonatology, Biomedical Research Institute i + 12, 12 de Octubre University Hospital, Avenida de Córdoba s/n, Madrid, 28041, Spain.
| | - Carmen Perez-Grande
- Department of Neonatology, Biomedical Research Institute i + 12, 12 de Octubre University Hospital, Avenida de Córdoba s/n, Madrid, 28041, Spain.
| | - David Lora-Pablos
- Department of Neonatology, Biomedical Research Institute i + 12, 12 de Octubre University Hospital, Avenida de Córdoba s/n, Madrid, 28041, Spain.
| | - María Teresa Moral-Pumarega
- Department of Neonatology, Biomedical Research Institute i + 12, 12 de Octubre University Hospital, Avenida de Córdoba s/n, Madrid, 28041, Spain.
| | - Ana Melgar-Bonis
- Department of Neonatology, Biomedical Research Institute i + 12, 12 de Octubre University Hospital, Avenida de Córdoba s/n, Madrid, 28041, Spain.
| | - Carmen Peña-Peloche
- Department of Neonatology, Biomedical Research Institute i + 12, 12 de Octubre University Hospital, Avenida de Córdoba s/n, Madrid, 28041, Spain.
| | - Mercedes Diezma-Rodino
- Department of Neonatology, Biomedical Research Institute i + 12, 12 de Octubre University Hospital, Avenida de Córdoba s/n, Madrid, 28041, Spain.
| | - Lidia García-San Jose
- Department of Neonatology, Biomedical Research Institute i + 12, 12 de Octubre University Hospital, Avenida de Córdoba s/n, Madrid, 28041, Spain.
| | - Esther Cabañes-Alonso
- Department of Neonatology, Biomedical Research Institute i + 12, 12 de Octubre University Hospital, Avenida de Córdoba s/n, Madrid, 28041, Spain.
| | - Carmen Rosa Pallas-Alonso
- Department of Neonatology, Biomedical Research Institute i + 12, 12 de Octubre University Hospital, Avenida de Córdoba s/n, Madrid, 28041, Spain.
| |
Collapse
|
2798
|
Liu X, Lin R, Zhao B, Guan R, Li T, Jin R. Correlation between oxidative stress and the NF-κB signaling pathway in the pulmonary tissues of obese asthmatic mice. Mol Med Rep 2015; 13:1127-34. [PMID: 26677140 PMCID: PMC4732835 DOI: 10.3892/mmr.2015.4663] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 11/17/2015] [Indexed: 02/06/2023] Open
Abstract
The obesity-asthma phenotype is characterized by increased asthma severity and decreased glucocorticoid responsiveness. To date, the mechanism underlying the association between obesity and asthma remain to be fully elucidated. The present study investigated the correlation between oxidative stress and the nuclear factor (NF)-κB pathway in obese asthmatic mice. The animals were divided into the following groups: Control (n=8), comprising C57BL/6J mice without exposure to a high-fat diet; non-obese asthma group (n=8), comprising mice of a normal weight subjected to the induction of asthma; obese control group (n=8), comprising C57BL/6J mice subjected to a high-fat diet; and obese asthmatic group (n=8), comprising obese mice subject to the induction of asthma. The levels of the malondialdehyde (MDA) oxidant and glutathione (GSH) antioxidant in the lungs and bronchoalveolar lavage fluid (BALF) were measured using ELISA. The expression levels of inhibitory κB kinase-β (IKK-β) and the inhibitor of κBα (IκB-α) in the pulmonary tissues was determined using western blot analysis. An electrophoretic mobility shift assay was performed to determine the transcription activity of NF-κB. The levels of MDA in the BALF and lung tissues increased significantly in the two asthmatic groups, compared with the control groups (P<0.01). The asthmatic mice showed significantly lower concentrations of GSH in the BALF and lung tissues, compared with the control groups (P<0.01). In the asthmatic animals, the expression of IκB kinase (IKK)-β and activation of NF-κB were upregulated in the pulmonary tissues, compared with those in the control groups (P<0.01). The expression of IKK-β and transcriptional activity of NF-κB were significantly higher the in obese asthmatic mice, compared with the non-obese asthmatic mice (P<0.01). On examining the expression levels of IκB-α in the pulmonary tissues, a significant reduction was found in the asthmatic animals, compared with the controls (P<0.01). In addition, the level of IκB-α was significantly lower in the obese asthmatics, compared with the non-obese asthmatics (P<0.01). MDA was positively correlated with NF-κB in the obese asthmatic group (R=0.83; P<0.05) and non-obese asthmatic group (R=0.82; P<0.05). Oxidative stress was upregulated in the pulmonary tissues of the asthmatic mice. This upregulation was more marked in the obese asthmatic mice, and was positively correlated with activation of the NF-κB signaling pathway in the pulmonary tissues. The results in the present study indicated that higher oxidative stress and activation of the NF-κB signaling pathway were observed in the lung tissues of the obese asthmatics. Furthermore, a positive correlation was identified between oxidative stress and NF-κB.
Collapse
Affiliation(s)
- Xiaomei Liu
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Rongjun Lin
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Baochun Zhao
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Renzheng Guan
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Tang Li
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Rong Jin
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| |
Collapse
|
2799
|
Abstract
Linked administrative population data were used to estimate the burden of childhood respiratory syncytial virus (RSV) hospitalization in an Australian cohort aged <5 years. RSV-coded hospitalizations data were extracted for all children aged <5 years born in New South Wales (NSW), Australia between 2001 and 2010. Incidence was calculated as the total number of new episodes of RSV hospitalization divided by the child-years at risk. Mean cost per episode of RSV hospitalization was estimated using public hospital cost weights. The cohort comprised of 870 314 children. The population-based incidence/1000 child-years of RSV hospitalization for children aged <5 years was 4·9 with a rate of 25·6 in children aged <3 months. The incidence of RSV hospitalization (per 1000 child-years) was 11·0 for Indigenous children, 81·5 for children with bronchopulmonary dysplasia (BPD), 10·2 for preterm children with gestational age (GA) 32-36 weeks, 27·0 for children with GA 28-31 weeks, 39·0 for children with GA <28 weeks and 6·7 for term children with low birthweight. RSV hospitalization was associated with an average annual cost of more than AUD 9 million in NSW. RSV was associated with a substantial burden of childhood hospitalization specifically in children aged <3 months and in Indigenous children and children born preterm or with BPD.
Collapse
|
2800
|
Vignoli A, La Briola F, Peron A, Turner K, Vannicola C, Saccani M, Magnaghi E, Scornavacca GF, Canevini MP. Autism spectrum disorder in tuberous sclerosis complex: searching for risk markers. Orphanet J Rare Dis 2015; 10:154. [PMID: 26631248 PMCID: PMC4668631 DOI: 10.1186/s13023-015-0371-1] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 11/24/2015] [Indexed: 12/04/2022] Open
Abstract
Background Neuropsychiatric disorders are present in up to 90 % of patients with Tuberous Sclerosis Complex (TSC), and represent an important issue for families. Autism Spectrum Disorder (ASD) is the most common neurobehavioral disease, affecting up to 61 % of patients. The aims of this study were: 1) to assess the prevalence of ASD in a TSC population; 2) to describe the severity of ASD; 3) to identify potential risk factors associated with the development of ASD in TSC patients. Methods We selected 42 individuals over age 4 years with a definite diagnosis of TSC and followed at a TSC clinic in Northern Italy. We collected and reported clinical and genetic data, as well as cognitive level, for each of them. We administered the Social Communication Questionnaire (SCQ) as a reliable screening tool for ASD, and performed comparisons between the average scores and each clinical and genetic feature. Results Seventeen out of 42 patients (40.5 %) had a score at the SCQ suggestive of ASD (≥15 points). When calculated for each cognitive level category, the average SCQ score tended to be progressively higher in patients with a worse cognitive level, and the number of pathological SCQ scores increased with worsening of intellectual disability. With respect to ASD severity, the scores were equally distributed, indicating that the degree of ASD in TSC patients may have a large variability. By comparing the average SCQ scores with the clinical features, we found statistically significant correlations with epilepsy, seizure onset before age one year, spasms, mutations in TSC2, cognitive level, sleep disorders, and other psychiatric problems, but not with seizure frequency, tubers localization and gender. Conclusions Our study showed a prevalence of ASD of 40.5 %, confirming the higher risk for this disorder in patients with TSC. However, the severity seems to have a notable variability in TSC patients. Risk factors for ASD are epilepsy, infantile spams, and mutations in TSC2.
Collapse
Affiliation(s)
- Aglaia Vignoli
- Child Neuropsychiatry Unit - Epilepsy Center, AO San Paolo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
| | - Francesca La Briola
- Child Neuropsychiatry Unit - Epilepsy Center, AO San Paolo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
| | - Angela Peron
- Child Neuropsychiatry Unit - Epilepsy Center, AO San Paolo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
| | - Katherine Turner
- Child Neuropsychiatry Unit - Epilepsy Center, AO San Paolo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
| | - Chiara Vannicola
- Child Neuropsychiatry Unit - Epilepsy Center, AO San Paolo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
| | | | | | - Giulia Federica Scornavacca
- Child Neuropsychiatry Unit - Epilepsy Center, AO San Paolo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
| | - Maria Paola Canevini
- Child Neuropsychiatry Unit - Epilepsy Center, AO San Paolo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
| |
Collapse
|