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Sun G, Zhang L, Qiu Y, Jia Y, Wang Y, Xu H, Zhang A, Hao L, Zhu W, Ye C. Changes of influenza vaccination rate and associated influencing factors after the COVID-19 pandemic in Shanghai, China. Hum Vaccin Immunother 2024; 20:2287294. [PMID: 38299510 PMCID: PMC10841022 DOI: 10.1080/21645515.2023.2287294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/21/2023] [Indexed: 02/02/2024] Open
Abstract
The vaccination rate for seasonal influenza remains low in most regions of China. It is essential to understand the factors that associated with the low influenza vaccination rate in various populations after the COVID-19 pandemic. A cross-sectional survey was conducted with residents in Pudong New Area, Shanghai, China. Respondents' vaccination condition during the 2021-2022 flu season and the reasons for receiving or not receiving influenza vaccine were investigated. Binary logistic regression was conducted to explore potential factors influencing vaccination uptake. 2,476 of 14,001 respondents received an influenza vaccine, with a total coverage of 17.68% (95% CI: 17.05%, 18.32%). Children had the highest vaccination coverage (35.68%; 95% CI: 34.02, 37.33), followed by adults (12.75%; 95% CI: 11.91%, 13.58%) and elderly individuals (11.70%, 95% CI: 10.78%, 12.62%). For children, lower household income was an significant promoting factor. For adults, factors significantly associated with vaccination were household income, sex, and education level. For elderly, factors significantly associated with vaccination were household income, education level, living state, and having underlying diseases. (P < .05)The main reason for vaccine hesitancy among children was worried about side effects (21.49%), for adults and elderly was self-rated good health (adults: 37.14%, elderly people: 30.66%). The overall influenza vaccination coverage rate in Shanghai, especially among elderly individuals, is lower than many developed countries. Appropriate strategies and programs targeting different populations need to be implemented to enhance influenza vaccine coverage.
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Affiliation(s)
- Geyang Sun
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Li Zhang
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Ye Qiu
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Yilin Jia
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Yuanping Wang
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Hongmei Xu
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Anran Zhang
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Lipeng Hao
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Weiping Zhu
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Chuchu Ye
- Acute infectious disease control and prevention Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
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Anandarajah A, Shato T, Humble S, Barnette AR, Brandt HM, Klesges LM, Sanders Thompson VL, Silver MI. The association of caregiver attitudes, information sources, and trust with HPV vaccine initiation among adolescents. Hum Vaccin Immunother 2024; 20:2300879. [PMID: 38174998 PMCID: PMC10773709 DOI: 10.1080/21645515.2023.2300879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/28/2023] [Indexed: 01/05/2024] Open
Abstract
This study described caregiver attitudes and the information sources they access about HPV vaccination for adolescents and determined their influence on human papillomavirus (HPV) vaccination initiation. An online survey was administered to 1,016 adults in July 2021. Participants were eligible if they were the caregiver of a child aged 9-17 residing in Mississippi, Arkansas, Tennessee, Missouri, and select counties in Southern Illinois. Multivariate logistic regression was used to estimate the association of caregiver attitudes and information sources with HPV vaccination. Information from doctors or healthcare providers (87.4%) and internet sources other than social media (31.0%) were the most used sources for HPV vaccine information. The highest proportion of caregivers trusted their doctor or healthcare providers (92.4%) and family or friends (68.5%) as sources of information. The HPV vaccine series was more likely to be initiated in children whose caregivers agreed that the vaccine is beneficial (AOR = 4.39, 95% CI = 2.05, 9.39), but less likely with caregivers who were concerned about side effects (AOR = 0.61, 95% CI = 0.42, 0.88) and who received HPV vaccination information from family or friends (AOR = 0.57, 95% CI = 0.35, 0.93). This study found that caregivers' attitudes, information sources, and trust in those sources were associated with their adolescent's HPV vaccination status. These findings highlight the need to address attitudes and information sources and suggest that tailored interventions considering these factors could increase HPV vaccination rates.
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Affiliation(s)
- Akila Anandarajah
- Department of Surgery (Division of Public Health Sciences), Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Thembekile Shato
- Department of Surgery (Division of Public Health Sciences), Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
- Implementation Science Center for Cancer Control and Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - Sarah Humble
- Department of Surgery (Division of Public Health Sciences), Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Alan R. Barnette
- Department of Neonatology, Saint Francis Medical Center, Cape Girardeau, MO, USA
| | - Heather M. Brandt
- HPV Cancer Prevention Program, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Lisa M. Klesges
- Department of Surgery (Division of Public Health Sciences), Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Michelle I. Silver
- Department of Surgery (Division of Public Health Sciences), Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
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Ahorsu DK, Potenza MN, Lin CY, Pakpour AH. Parental intention on getting children COVID-19 vaccinations: Invariance evaluation across parenting roles and COVID-19-like symptoms experiences among Iranians during the pandemic period. Hum Vaccin Immunother 2024; 20:2325230. [PMID: 38445561 PMCID: PMC10936610 DOI: 10.1080/21645515.2024.2325230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 02/27/2024] [Indexed: 03/07/2024] Open
Abstract
Countries worldwide are facing challenges with increasing the COVID-19 vaccination rates for children. This study examined associations between perceived knowledge, coping appraisal, threat appraisal, adaptive response, maladaptive response, and intention, and possible variance across parents (mother or father) and COVID-19-like symptoms experiences regarding parental intentions to vaccinate their children. A total of 836 Iranian parents with children between the ages of 6 and 12 y completed measures assessing perceived knowledge, coping appraisals, threat appraisals, intentions, adaptive responses, and maladaptive responses. Multigroup structural equation modeling revealed that perceived knowledge was positively associated with both coping and threat appraisals, coping appraisals positively associated with adaptive responses, maladaptive responses, and intentions to vaccinate, threat appraisals positively associated with adaptive and maladaptive responses, and adaptive responses positively associated with intentions to vaccinate. The invariance evaluation revealed no differences across parents or COVID-19-like symptoms experiences in parental intentions to get their children vaccinated. The findings suggest that cogent information regarding childhood COVID-19 vaccination may boost parents' knowledge influencing their appraisals, adaptive responses and intentions to vaccinate their children. Specifically, coping appraisals and adaptive responses appeared to be important mediators between knowledge and intentions to vaccinate. Furthermore, intentions to vaccinate children may not be strongly influenced by parental roles or COVID-19-like symptoms experiences. These findings may help multiple stakeholders promote COVID-19 vaccination rates among children, and countries should further examine ways of increasing rates based on their specific needs.
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Affiliation(s)
- Daniel Kwasi Ahorsu
- Department of Special Education and Counselling, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Marc N. Potenza
- Departments of Psychiatry and Neuroscience and the Child Study Center and Wu Tsai Institute, Yale School of Medicine / Yale University, New Haven, CT, USA
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Amir H. Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Mpinganjira SL, Chimkonda J, Kishombe W, Gonzalez-Martinez C. Hospital admission and its common causes in children on antiretroviral therapy (ART) in Lilongwe Malawi between 2001 and 2016: a retrospective cross-sectional study. HIV Res Clin Pract 2024; 25:2331898. [PMID: 38520119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024]
Abstract
BACKGROUND Paediatric HIV data shows a variable and sometimes catastrophic response in the initial stage of ART regimen administration. The burden of disease that affects children in their first year of treatment is not comprehensively available. OBJECTIVE Objective of our study was to describe patterns of admission in children; before ART initiation, within the first six months, and post-six months of ART between 2001 and 2016. METHODS Principal caregivers of 260 children (45.7% females 54.2% males, all <15 years) on ART for at least six months were interviewed about admissions of their children. Diagnoses were verified from the health passport books. Data on age, sex, date of ART initiation was obtained from the database of Baylor College of Medicine in Lilongwe. Data were analysed using Excel for descriptive analysis. Chi Square Test was used to test for significance. RESULTS There were more admissions before starting ART 74% (95%CI 68.67-79.33%) vs. 42% (95%CI 36.00-48.00%), after starting ART (p = <0.001 at 5% significance level); after six months of ART 34% (95%CI 28.24-39.76) vs. 20% (95% CI 15.51-24.86%) (p = <0.001 at 5% significance level). The commonest causes of admission were pneumonia, malaria, tuberculosis, anaemia; no difference in causes of admission within the first and after six months of ART initiation. CONCLUSION ART significantly reduces admission in children living with HIV. The common causes of admission are HIV non-specific conditions. No difference between causes of admission within and after six months of ART.
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Affiliation(s)
- Samuel L Mpinganjira
- Department of Epidemiology and Statistics, School of Public and Global Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Jonathan Chimkonda
- Department of Epidemiology and Statistics, School of Public and Global Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Wonder Kishombe
- Department of Epidemiology and Statistics, School of Public and Global Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Carmen Gonzalez-Martinez
- Consultant Peadiatrician, Honorary Lecturer, Department of Peadiatrics and Child Health, Kamuzu University of Health Sciences, Lilongwe, Malawi
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Zhen Y, Ai D, Huang K, Li G, Chen Z, Wu R. The influence of dead space in blood sampling needle on FVIII level and pharmacokinetic profiles in children with hemophilia. Hematology 2024; 29:2314871. [PMID: 38346146 DOI: 10.1080/16078454.2024.2314871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 12/01/2023] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE To investigate the influence of the dead space in disposable blood sampling needle on activated partial thromboplastin time (APTT), FVIII level and pharmacokinetic (PK) profiles in children with hemophilia. METHODS Children (<18 years) with severe hemophilia A were enrolled. After three days' washout-period, blood samples were collected at pre-dose, 1 h, 3 h, 9 h, 24 h and 48 h post-infusion. At each timepoint, two 2 mL vacuum tubes with 3.2% trisodium citrate were used. The first tube was signed as 'non-standard' (NS) and the second tube was signed as 'standard' (S). FVIII activities were evaluated by one-stage assay. WAPPS-Hemo was used to generate PK profiles like half-life time (t1/2), clearance (CL), trough level and time to 1, 2 and 5IU/dL after a dose of 50 ± 10IU/dL. The FVIII activities at 9 h and 24 h post-infusion were put into WAPPS and thus brought four combinations by true or biased FVIII level that used. RESULT Compared with standard-collected blood samples, prolonged APTT results (P-values < 0.01) and decreased FVIII activity (P-values < 0.05) were revealed in those non-standard blood samples. The corresponding bias was in positive relation to both APTT-S (r = 0.44, P < 0.0001) and FVIII-S level(r = 0.68, P < 0.001). The FVIII bias percentage got larger as FVIII-S level reduced (r = -0.24, P < 0.01). During the four combinations of FVIII activity at 9 h and 24 h, statistically longer t1/2, lower CL and longer time to 1, 2 or 5IU/dL were observed in 9H-S&24H-S group and 9H-NS&24H-S group. CONCLUSION While using vacuum tubes for clotting indicators and PK profiles, the dead space of blood sampling needle should be eliminated in advance.
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Affiliation(s)
- Yingzi Zhen
- Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China
| | - Di Ai
- Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China
| | - Kun Huang
- Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China
| | - Gang Li
- Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China
| | - Zhenping Chen
- Hematologic Disease Laboratory, Hematology Center, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China
| | - Runhui Wu
- Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China
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Yu N, Ouyang X, Li J, Gao J, Zeng S, Zhuang H, Jiang M, Pei Y, Jiang X. Risk factors and renal outcomes of AKI in children with secondary steroid-resistant nephrotic syndrome. Ren Fail 2024; 46:2314637. [PMID: 38383285 PMCID: PMC10885744 DOI: 10.1080/0886022x.2024.2314637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/31/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Acute kidney injury (AKI) is increasingly prevalent in children with nephrotic syndrome (NS). It is associated with adverse outcomes in NS, especially steroid-resistant nephrotic syndrome (SRNS). The incidence, risk factors and outcomes of AKI in secondary SRNS remain undefined. The main objectives of this study were to determine the risk factors and prognosis of AKI in hospitalized children with secondary SRNS. MATERIAL AND METHODS This retrospective study was conducted from January 2014 to December 2019, involving 172 hospitalizations with secondary SRNS admitted to the First Affiliated Hospital of Sun Yat-sen University. AKI was defined and classified in accordance with the 2012 Kidney Disease Improving Global Outcomes (KDIGO) guidelines. RESULTS AKI was found in 67 (39.0%) of 172 hospitalizations with secondary SRNS. Average age of onset in our group is 4.4 (3.1, 6.7) years with AKI and 3.7 (1.8, 5.6) years without AKI. Urea nitrogen level is 5.9 (4.1, 10.0) mmol/L with AKI and 5.1 (3.7, 7.0) mmol/L. Uric acid level is 446.0 (340.0, 567.0) umol/L with AKI and 401.0 (303.0, 496.0) umol/L. 24-h urinary protein level is 4.14 (2.9, 6.5) g with AKI and 2.5 (1.3, 5.3) without AKI. Multivariate logistic regression revealed that infection (OR = 5.287; 95% confidence interval, 2.349 to 11.899; p < 0.001), age at onset (OR = 1.180; 95% confidence interval, 1.032 to 1.349; p = 0.015) and uric acid level (OR = 1.003; 95% confidence interval, 1.000 to 1.006; p = 0.031) were significantly associated with the development of AKI in children with secondary SRNS. Among 72 children with secondary SRNS, six went to end-stage kidney disease (ESKD). Children in the AKI group were more likely to progress to ESKD compared with children in the non-AKI group (p = 0.017) with a median follow-up of 48.5months. CONCLUSION AKI occurred in 39.0% of total hospitalizations associated with secondary SRNS. Risk factors including infection, age of onset, and uric acid level are associated with AKI in children with secondary SRNS. Furthermore, AKI was identified as a risk factor for the progression of secondary SRNS to ESKD.
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Affiliation(s)
- Nannan Yu
- Department of Pediatric Nephrology and Rheumatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China
| | - XiaoJun Ouyang
- Department of Pediatric Nephrology and Rheumatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China
| | - Jie Li
- Department of Pediatric Nephrology and Rheumatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China
| | - Jie Gao
- Department of Pediatric Nephrology and Rheumatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China
| | - Shuhan Zeng
- Department of Pediatric Nephrology and Rheumatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China
| | - Hongjie Zhuang
- Department of Pediatric Nephrology and Rheumatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China
| | - Mengjie Jiang
- Department of Pediatric Nephrology and Rheumatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China
| | - Yuxin Pei
- Department of Pediatric Nephrology and Rheumatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China
| | - Xiaoyun Jiang
- Department of Pediatric Nephrology and Rheumatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China
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Li C, Gui S, Zhang Y. Compare the safety and efficacy of endoscopic third ventriculostomy and ventriculoperitoneal shunt placement in infants and children with hydrocephalus: a systematic review and meta-analysis. Int J Neurosci 2024; 134:1-10. [PMID: 28697664 DOI: 10.1080/00207454.2017.1348352] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 06/24/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunt placement are two surgical options used for treatment of non-communicating hydrocephalus. The purpose of this study was to compare the efficiency and safety of these techniques in pediatric patients. MATERIALS AND METHODS An extensive literature review regarding the clinical outcome, safety and efficiency of ETV and shunting in treatment of hydrocephalus was conducted in Medline, PubMed, Cochrane and Google Scholar databases up to 27 November 2015. Patient demographics, ETV and shunting success and failure rates were extracted. RESULTS A total of seven two-arm studies were included for quantitative analysis and 25 single-arm studies were included for systematic review. The two-arm studies recruited a total of 6995 patients: 1046 in the ETV group and 5949 in the shunt group. The pooled results showed that the 1 year success rate of ETV and shunt-placement procedure were similar (pooled RR = 0.870, 95% CI = 0.680-1.112, P = 0.266). The failure rate in the ETV treatment group was 0.9 times higher than in the shunt group; however, the results did not reach statistical significance (pooled RR = 0.893, 95% CI = 0.576-1.383, P = 0.611). CONCLUSIONS Both ETV and shunts are associated with similar 1 year success and failure rates. Therefore, there are no current indications to recommend one mode of treatment over the other. Future studies designed to assess the effectiveness of ETV and shunt procedures depending on patient's age and etiology are warranted.
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Affiliation(s)
- Chuzhong Li
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Beijing Institute for Brain Disorders Brain Tumor Center, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Songbai Gui
- Department of Neurosurgery, Beijing Tiantan Hospital affiliated to Capital Medical University, Beijing, China
| | - Yazhuo Zhang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Beijing Institute for Brain Disorders Brain Tumor Center, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
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Tajerian A, Sofian M, Zarinfar N, Ramezani A. Manifestations, complications, and treatment of neurobrucellosis: a systematic review and meta-analysis. Int J Neurosci 2024; 134:256-266. [PMID: 35930502 DOI: 10.1080/00207454.2022.2100776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/30/2022] [Indexed: 01/18/2023]
Abstract
PURPOSE Central nervous system involvement by Brucella species is the most morbid form of brucellosis disease. Studies on neurobrucellosis are scarce and limited to case reports and series. Brucella is unable to infect or harm neurons without the assistance of monocytes. This raises the question of whether ceftriaxone-based regimens are effective. METHODS The primary aim of this study was to identify, evaluate, and summarize the findings of all relevant individual studies in the past 30 years to help better understand the disease. To achieve this, a broad systematic search was undertaken to identify all relevant records. Epidemiological and clinical features of the disease were assessed by the pooled analysis of descriptive studies. Through a meta-analysis, the treatment period duration was compared between the ceftriaxone-based and oral regimens using Standardized mean differences to measure effect size. RESULTS 448 patients were included in the Meta-analyses from 5 studies. A moderate positive effect was found for ceftriaxone-based regimens over oral treatments, and there was a significant difference between these two groups (SMD 0.428, 95% CI -0.63 to -0.22, I 2 = 37.64). Neurobrucellosis has a different clinical picture in pediatric patients. The disease is less chronic in children. Fever, nausea and vomiting, fatigue, and abdominal pain were significantly more prevalent symptoms in children, and Convulsions, ascites, sensorineural hearing loss, and papilledema were significantly more prevalent signs in children than adults. CONCLUSION It is recommended to initiate the treatment of neurobrucellosis with IV ceftriaxone therapy in combination with oral therapy.
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Affiliation(s)
- Amin Tajerian
- Infectious Diseases Research Center (IDRC), Arak University of medical sciences, Arak, Iran
| | - Masoomeh Sofian
- Infectious Diseases Research Center (IDRC), Arak University of medical sciences, Arak, Iran
| | - Nader Zarinfar
- Infectious Diseases Research Center (IDRC), Arak University of medical sciences, Arak, Iran
| | - Amitis Ramezani
- Infectious Diseases Research Center (IDRC), Arak University of medical sciences, Arak, Iran
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Meloni A, Pistoia L, Putti MC, Longo F, Corigliano E, Ricchi P, Rossi V, Casini T, Righi R, Renne S, Peritore G, Barbuto L, Positano V, Cademartiri F. Pancreatic iron in pediatric transfusion-dependent beta-thalassemia patients: A longitudinal MRI study. Pediatr Blood Cancer 2024; 71:e30923. [PMID: 38385860 DOI: 10.1002/pbc.30923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/02/2024] [Accepted: 02/08/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND In pediatric transfusion-dependent thalassemia (TDT) patients, we evaluated the prevalence, pattern, and clinical associations of pancreatic siderosis and the changes in pancreatic iron levels and their association with baseline and changes in total body iron balance. PROCEDURE We considered 86 pediatric TDT patients consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassemia Network. Iron overload (IO) was quantified by R2* magnetic resonance imaging (MRI). RESULTS Sixty-three (73%) patients had pancreatic IO (R2* > 38 Hz). Global pancreas R2* values were significantly correlated with mean serum ferritin levels, MRI liver iron concentration (LIC) values, and global heart R2* values. Global pancreas R2* values were significantly higher in patients with altered versus normal glucose metabolism. Thirty-one patients also performed the follow-up MRI at 18 ± 3 months. Higher pancreatic R2* values were detected at the follow-up, but the difference versus the baseline MRI was not significant. The 20% of patients with baseline pancreatic IO showed no pancreatic IO at the follow-up. The 46% of patients without baseline pancreatic IO developed pancreatic siderosis. The changes in global pancreas R2* between the two MRIs were not correlated with baseline serum ferritin levels, baseline, final, and changes in MRI LIC values, or baseline pancreatic iron levels. CONCLUSIONS In children with TDT, pancreatic siderosis is a frequent finding associated with hepatic siderosis and represents a risk factor for myocardial siderosis and alterations of glucose metabolism. Iron removal from the pancreas is exceptionally challenging and independent from hepatic iron status.
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Affiliation(s)
- Antonella Meloni
- Bioengineering Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
- Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
| | - Laura Pistoia
- Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
- U.O.C. Ricerca Clinica, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
| | - Maria Caterina Putti
- Dipartimento della Salute della Donna e del Bambino, Clinica di Emato-Oncologia Pediatrica, Azienda Ospedaliero-Università di Padova, Padua, Italy
| | - Filomena Longo
- Unità Operativa Day Hospital della Talassemia e delle Emoglobinopatie, Azienda Ospedaliero-Universitaria "S. Anna,", Cona, Ferrara, Italy
| | | | - Paolo Ricchi
- U.O.S.D. Malattie Rare del Globulo Rosso, Azienda Ospedaliera di Rilievo Nazionale "A. Cardarelli", Naples, Italy
| | | | - Tommaso Casini
- SOC Oncologia, Ematologia e Trapianto di Cellule Staminali Emopoietiche, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Riccardo Righi
- Diagnostica per Immagini e Radiologia Interventistica, Ospedale del Delta, Lagosanto, Ferrara, Italy
| | - Stefania Renne
- Struttura Complessa di Cardioradiologia-UTIC, Presidio Ospedaliero "Giovanni Paolo II,", Lamezia Terme, Italy
| | - Giuseppe Peritore
- Unità Operativa Complessa di Radiologia, "ARNAS" Civico, Di Cristina Benfratelli, Palermo, Italy
| | - Luigi Barbuto
- U.O.C. Radiologia Generale e di Pronto Soccorso, Azienda Ospedaliera di Rilievo Nazionale "A. Cardarelli", Naples, Italy
| | - Vincenzo Positano
- Bioengineering Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
- Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
| | - Filippo Cademartiri
- Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
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Samadder RK, Ray G, Dutta S, Hazra A, Sadhukhan P, Chowdhury A, Ray R, Ahammed SM. The Efficacy and Safety of Sofosbuvir and Daclatasvir Treatment in Children and Adolescents With Thalassemia and Hepatitis C Virus Infection. J Clin Exp Hepatol 2024; 14:101310. [PMID: 38264577 PMCID: PMC10801307 DOI: 10.1016/j.jceh.2023.101310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 11/27/2023] [Indexed: 01/25/2024] Open
Abstract
Background/Aim Thalassemia patients are susceptible to hepatitis C virus (HCV) infection due to blood transfusions. Currently, data on treating HCV in thalassemic children with direct-acting antivirals is lacking. This study was performed to determine the efficacy and safety of sofosbuvir-daclatasvir combination therapy in thalassemic children and adolescents. Methods A nonrandomized, open-label, interventional study was carried out in a tertiary care hospital. Consecutive noncirrhotic treatment-naïve thalassemic patients with HCV infection with viremia, within the age group of 6-18 years, were treated with the combination of sofosbuvir-daclatasvir: 200 mg + 30 mg for age 6-11 years (Group A) and 400 mg + 60 mg for age 12-18 years (Group B). The primary endpoint was sustained virological response at 12 weeks (SVR12). Results A total of 70 patients (Group A 45, 64% male; Group B 25, 40% male) were recruited. The mean age was 8.5 years and 13.9 years in the two groups. Mean HCV Ribonucleic acid (RNA) levels in Groups A and B were 446906.1 IU/ml and 256187.8 IU/ml, respectively. SVR12 was achieved in 43 of 45 (95.5%) patients on an intention-to-treat basis and 43 of 44 (97.7%) patients on a perprotocol basis in Group A, and all patients in Group B (100%). In both groups, there was a significant improvement in biochemical parameters. Among the two patients who did not achieve SVR12 in Group A, one required termination of therapy due to urticaria. Conclusion Sofosbuvir-daclatasvir based treatment in noncirrhotic, treatment-naive thalassemic children and adolescents infected with HCV is effective and safe.
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Affiliation(s)
- Riten K. Samadder
- Department of Hepatology, School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Gautam Ray
- Divisions of Pediatric Gastroenterology, School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Supradip Dutta
- Division of Virus Laboratory, ICMR-National Institute of Cholera and Enteric Diseases (NICED), Kolkata, India
| | - Avijit Hazra
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Provash Sadhukhan
- Division of Virus Laboratory, ICMR-National Institute of Cholera and Enteric Diseases (NICED), Kolkata, India
| | - Abhijit Chowdhury
- Department of Hepatology, School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Raja Ray
- Department of Microbiology, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Sk. Mahiuddin Ahammed
- Department of Hepatology, School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, India
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11
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Gautam V, Kumar V, Agarwal S, Gupta S. ABO Incompatible Living Donor Liver Transplantation in Children: A Single Centre Experience from India. J Clin Exp Hepatol 2024; 14:101340. [PMID: 38283705 PMCID: PMC10809086 DOI: 10.1016/j.jceh.2023.101340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/21/2023] [Indexed: 01/30/2024] Open
Abstract
Background In recent years, paediatric ABO incompatible (ABOi) living donor liver transplant (LT) has shown promising outcomes and can potentially eliminate organ shortage. This study aims to report paediatric ABOi LT experience, including short- and long-term outcomes. Methods It is a single-centre retrospective study. Out of 108 LTs, 20 were done in children. We compared the outcomes between ABOi (n = 20) and non-ABOi (n = 220) paediatric living donor liver transplantation (LDLT) performed during the study period. All the children received pre-LT desensitization therapy comprising rituximab and plasmapheresis targeting pre-LT isohemagglutinin (IHA) titres of ≤1:16. Results Out of 239 paediatric LDLTs from 2017 to 2022, 19 children (11 females) underwent 20 ABOi LTs (including one retransplant with an ABOi domino allograft) at a median age of 12 (12, 51) months, with the majority being biliary atresia (60%). The median change in CD19 cell%, CD20 cell%, and IHA titres after rituximab from day -14 to day -1 (before LT) was satisfactory. In the first 3 months following LT, acute cellular rejection, culture-proven sepsis, and biliary and vascular complications were seen in 10%, 20%, 20%, and 15%, respectively. None of the ABOi LT recipients developed antibody-mediated rejection. ABOi LT recipients, as compared to non-ABOi LT recipients, had a higher incidence of bile leaks and prolonged hospital stay, with the rest of the complications, including biliary strictures and long-term outcomes, being comparable. At a median follow-up of 21 (14, 33) months, 4 children expired (21%). Conclusion ABOi LT in children shows excellent outcomes and can be performed safely with prior desensitization when a compatible liver is unavailable.
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Affiliation(s)
- Vipul Gautam
- Department of Pediatric Hepatology, Centre for Liver and Biliary Sciences, Max Super Speciality Hospital, Saket, New Delhi, India
| | - Vikram Kumar
- Department of Pediatric Hepatology, Centre for Liver and Biliary Sciences, Max Super Speciality Hospital, Saket, New Delhi, India
| | - Shaleen Agarwal
- Department of Liver Transplant Surgery, Centre for Liver and Biliary Sciences, Max Super Speciality Hospital, Saket, New Delhi, India
| | - Subhash Gupta
- Department of Liver Transplant Surgery, Centre for Liver and Biliary Sciences, Max Super Speciality Hospital, Saket, New Delhi, India
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12
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Stridsman C, Martinsen Ø, Selberg S, Ödling M, Konradsen JR. Uncontrolled asthma in school-aged children-a nationwide specialist care study. J Allergy Clin Immunol Glob 2024; 3:100227. [PMID: 38439947 PMCID: PMC10910119 DOI: 10.1016/j.jacig.2024.100227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 11/09/2023] [Accepted: 12/28/2023] [Indexed: 03/06/2024]
Abstract
Background Uncontrolled asthma (UCA) is different from severe asthma and can be identified in children across all ranges of prescribed treatment. Objective Our aim was to characterize uncontrolled childhood asthma in pediatric specialist care. Methods We performed a nationwide cross-sectional study of 5497 children (aged 6-17 years) with asthma who were treated by pediatricians at outpatient clinics during 2019 and registered in the Swedish National Airway Register. UCA was defined as an Asthma Control Test score of 19 or lower and/or 2 or more exacerbations in the past year and/or an FEV1 value less than 80% predicted. Treatment was categorized from step 1 to step 5 according to the Global Initiative for Asthma. Results UCA was identified in 1690 children (31%), of whom 64% had an Asthma Control Test score of 19 or lower, 20% had recurrent exacerbations, and 31% had an FEV1 value less than 80% predicted. UCA was associated with female sex (odds ratio [OR] = 1.29 [95% CI = 1.15-1.45]), older age (OR = 1.02 [95% CI = 1.00-1.04]), obesity (OR = 1.43 [95% CI = 1.12-1.83]), and more treatment using steps 1 and 2 as a reference (step 3, OR = 1.28 [95% CI = 1.12-1.46]); steps 4-5, OR = 1.32 [95% CI = 1.10-1.57]). UCA in children prescribed treatment steps 1 and 2 (group UCA1-2) occurred in 28% of all children at this treatment step (n = 887). Children in group UCA1-2 had exacerbations more frequently than did those children with UCA who were prescribed steps 4 and 5 treatment (24% vs 15% [P = .001]). Conclusion UCA was common and associated with female sex, increasing age, obesity, and higher Global Initiative for Asthma treatment step. Surprisingly, UCA was also common in children prescribed less than the maximum treatment, and those children could be considered undertreated patients.
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Affiliation(s)
- Caroline Stridsman
- Department of Public Health and Clinical Medicine, Division of Medicine/OLIN Unit, Umeå University, Umeå, Sweden
| | - Øyvind Martinsen
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren’s Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Stina Selberg
- Department of Public Health and Clinical Medicine, Division of Medicine/OLIN Unit, Umeå University, Umeå, Sweden
| | - Maria Ödling
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Jon R. Konradsen
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren’s Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
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13
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O'Halloran CP, Tannous P, Arva NC, Thrush PT, Monge M, Joong A, Magnetta DA. Histopathology, mRNA expression profile, and donor-derived cell-free DNA for assessment of rejection in pediatric heart transplantation. Pediatr Transplant 2024; 28:e14705. [PMID: 38528753 DOI: 10.1111/petr.14705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 01/10/2024] [Accepted: 01/23/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND The relationship between histopathologic and molecular ("MMDx"®) assessments of endomyocardial biopsy (EMB) and serum donor-derived cell-free DNA (ddcfDNA) in acute rejection (AR) assessment following pediatric heart transplantation (HT) is unknown. METHODS EMB sent for MMDx and histopathology from November 2021 to September 2022 were reviewed. MMDx and histopathology results were compared. DdcfDNA obtained ≤1 week prior to EMB were compared with histopathology and MMDx results. The discrimination of ddcfDNA for AR was assessed using receiver-operating curves. FINDINGS In this study, 177 EMBs were obtained for histopathology and MMDx, 101 had time-matched ddcfDNA values. MMDx and Histopathology displayed moderate agreement for T-cell-mediated rejection (TCMR, Kappa = 0.52, p < .001) and antibody-mediated rejection (ABMR, Kappa = 0.41, p < .001). Discordant results occurred in 24% of cases, most often with ABMR. Compared with no AR, ddcfDNA values were elevated in cases of AR diagnosed by both histopathology and MMDx (p < .01 for all). Additionally, ddcfDNA values were elevated in injury patterns on MMDx, even when AR was not present (p = .01). DdcfDNA displayed excellent discrimination (AUC 0.83) for AR by MMDx and/or histopathology. Using a threshold of ≥0.135%, ddcfDNA had a sensitivity of 90%, specificity of 63%, PPV of 52%, and NPV of 94%. CONCLUSIONS Histopathology and MMDx displayed moderate agreement in diagnosing AR following pediatric HT, with most discrepancies noted in the presence of ABMR. DdcfDNA is elevated with AR, with excellent discrimination and high NPV particularly when utilizing MMDx. A combination of all three tests may be necessary in some cases.
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Affiliation(s)
- Conor P O'Halloran
- Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Paul Tannous
- Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Nicoleta C Arva
- Department of Pathology, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Philip T Thrush
- Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Michael Monge
- Division of Cardiovascular Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Anna Joong
- Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Defne A Magnetta
- Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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14
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Baiden P, Graaf G, Okine L, LaBrenz C. Association between Adverse Childhood Experiences and Unmet Health Care Needs among Children in the United States. Soc Work Public Health 2024; 39:261-275. [PMID: 38459692 DOI: 10.1080/19371918.2024.2323137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
Although studies have investigated and found an association between adverse childhood experiences and poor health and mental health outcomes, there is a dearth of studies investigating the association between adverse childhood experiences and unmet health care needs among children. The objective of this study is to examine the association between adverse childhood experiences and unmet health care needs after adjusting for predisposing, enabling, and need factors of health care service utilization. Data for this study came from the 2016-2017 National Survey of Children's Health. An analytic sample of 46,081 children (51.3% males; average age 11.5 years) was analyzed using negative binomial regression. Based on parent reports, about 3.5% of children had unmet health care needs, and half (50%) of the sample had experienced at least one childhood adversity. Controlling for other factors, children who experienced three or more childhood adversities had 4.51 times higher odds of having unmet health care needs (AOR = 4.51, p < .001, 95% CI = 3.15-6.45) when compared to their counterparts with no childhood adversity. Children with parents who have someone to turn to for everyday emotional support were 31% less likely to have unmet health care needs (AOR = .69, p < .01, 95% CI = .54-.89). Adverse childhood experiences have a detrimental effect on unmet health care needs. The findings of this study offer an important opportunity for further research on how best to prevent adverse childhood experiences and mitigate their impact on families.
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Affiliation(s)
- Philip Baiden
- School of Social Work, The University of Texas at Arlington, Arlington, Texas
| | - Genevieve Graaf
- School of Social Work, The University of Texas at Arlington, Arlington, Texas
| | - Lucinda Okine
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
| | - Catherine LaBrenz
- School of Social Work, The University of Texas at Arlington, Arlington, Texas
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15
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Matricardi S, Scorrano G, Prezioso G, Burchiani B, Di Cara G, Striano P, Chiarelli F, Verrotti A. The latest advances in the pharmacological management of focal epilepsies in children: a narrative review. Expert Rev Neurother 2024; 24:371-381. [PMID: 38433525 DOI: 10.1080/14737175.2024.2326606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 02/29/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Focal epilepsy constitutes the most common epilepsy in children, and medical treatment represents the first-line therapy in this condition. The main goal of medical treatment for children and adolescents with epilepsy is the achievement of seizure freedom or, in drug-resistant epilepsies, a significant seizure reduction, both minimizing antiseizure medications (ASM)-related adverse events, thus improving the patient's quality of life. However, up to 20-40% of pediatric epilepsies are refractory to drug treatments. New ASMs came to light in the pediatric landscape, improving the drug profile compared to that of the preexisting ones. Clinicians should consider several factors during the drug choice process, including patient and medication-specific characteristics. AREAS COVERED This narrative review aims to summarize the latest evidence on the effectiveness and tolerability of the newest ASMs administered as monotherapy or adjunctive therapy in pediatric epilepsies with focal onset seizures, providing a practical appraisal based on the existing evidence. EXPERT OPINION The latest ASMs have the potential to be effective in the pharmacological management of focal onset seizures in children, and treatment choice should consider several drug- and epilepsy-related factors. Future treatments should be increasingly personalized and targeted on patient-specific pathways. Future research should focus on discovering new chemical compounds and repurposing medications used for other indications.
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Affiliation(s)
- Sara Matricardi
- Department of Paediatrics, University of Chieti, Chieti, Italy
| | | | | | | | - Giuseppe Di Cara
- Department of Paediatrics, University of Perugia, Perugia, Italy
| | - Pasquale Striano
- Paediatric Neurology and Muscular Disease Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | | | - Alberto Verrotti
- Department of Paediatrics, University of Perugia, Perugia, Italy
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16
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Fuentes C, Ouldbey Y, Orbach D, Sudour-Bonnange H, Verité C, Rome A, Dumesnil C, Thebaud E, Hameury F, Dijoud F, Chabaud S, Cote MD, Fresneau B, Faure-Conter C. Oncological and endocrinological outcomes for children and adolescents with testicular and ovarian sex cord-stromal tumors. Results of the TGM13 National Registry. Pediatr Blood Cancer 2024; 71:e30864. [PMID: 38259036 DOI: 10.1002/pbc.30864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/23/2023] [Accepted: 12/29/2023] [Indexed: 01/24/2024]
Abstract
RATIONALE Sex cord-stromal tumors (SCST) are hormonally active and rare. The aim was to describe their endocrinological presentation and outcomes. METHOD Patients (< 19 years) registered in the TGM13 registry between 2014 and 2021 for SCST were selected. RESULTS Sixty-three ovarian SCST (juvenile granulosa tumor (JGT) n = 34, Sertoli-Leydig cell tumor (SLCT) n = 17, other SCST n = 12) were included. Median age was 13.1 years (0.4-17.4). Germline DICER1 pathogenic variant was present in 9/17 SLCT. Sixty-one were FIGO stage I (IC n = 14). Adjuvant chemotherapy was administered for 15. Seven had recurrence (FIGO IA n = 3, IX n = 2, III n = 2), leading to one death. With a median follow-up of 42 months (2.5-92), the 3-year progression-free survival (PFS) was 89% (95% CI 76%-95%). Median age was 6.4 years (0.1-12.9) among the 15 testicular SCST (Leydig cell tumor n = 6, JGT n = 5, Sertoli cell tumor n = 3, mixed SCST n = 1). Tumor-nodes-metastases (TNM) stage was pSI in 14. Eight underwent a tumorectomy, 7 an orchiectomy. None experienced recurrence. Endocrinological data were reviewed for 41 patients (18 prepubescent). Endocrine symptoms were present at diagnosis in 29/34 females and 2/7 males (gynecomastia). After a median follow-up of 11 months, 15 patients had persistent endocrine abnormalities: gynecomastia/breast growth (2 males, 1 prepubescent female), precocious/advanced puberty (4 prepubescent females), and hirsutism/menstruation disorders/voice hoarseness/hot flashes (8 pubescent females). The mean height at the last follow-up was within normal ranges (+0.3 standard deviation). CONCLUSIONS SCSTs have a favorable prognosis. Tumorectomy appears safe with testicular primary. Endocrinological disorders, common at diagnosis, may persist warranting endocrinological follow-up.
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Affiliation(s)
- Clemence Fuentes
- Department of Pediatric Oncology, Institut d'Hemato-oncologie Pediatrique, Lyon, France
| | - Yaelle Ouldbey
- Statistical Unit, Clinical Research Department, Centre Léon Bérard, Lyon, France
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer) Institut Curie, PSL University, Paris, France
| | - Helene Sudour-Bonnange
- Anti-Cancer Center Oscar Lambret, Pediatric and Adolescents Oncology Unit, Lille, France
| | - Cecile Verité
- Pediatric Hematology-Oncology Unit, Pellegrin Hospital, CHU Bordeaux, Bordeaux, France
| | - Angelique Rome
- Department of Pediatric Oncology of Timone Children's Hospital, Marseille, France
| | - Cecile Dumesnil
- Department of Pediatric Oncology, University Hospital Center of Rouen, Rouen, France
| | - Estelle Thebaud
- Department of Pediatric Oncology, University Hospital Center of Nantes, Nantes, France
| | - Frederic Hameury
- Department of Pediatric Surgery, Hôpital Femme Mère Enfant, Lyon, France
| | | | - Sylvie Chabaud
- Statistical Unit, Clinical Research Department, Centre Léon Bérard, Lyon, France
| | - M Daval Cote
- Département of Endocrinology and Pediatric Diabetology, Hospices civils de Lyon, Lyon, France
| | - Brice Fresneau
- Gustave Roussy, Université Paris-Saclay, Department of Children and Adolescent Oncology, Paris-Saclay University, Paris-Sud University, CESP, INSERM, Villejuif, France
| | - Cecile Faure-Conter
- Department of Pediatric Oncology, Institut d'Hemato-oncologie Pediatrique, Lyon, France
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Farag RS, Spicer AC, Iyer G, Stevens JP, King A, Bain PA, McAlvin JB. Incidence of emergence agitation in children undergoing sevoflurane anesthesia compared to isoflurane anesthesia: An updated systematic review and meta-analysis. Paediatr Anaesth 2024; 34:304-317. [PMID: 38093624 DOI: 10.1111/pan.14819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 11/23/2023] [Accepted: 11/25/2023] [Indexed: 03/04/2024]
Abstract
BACKGROUND Emergence agitation is a complex syndrome of altered consciousness after emergence from anesthesia. It can result in injury to patients and staff and is associated with other postoperative complications. Sevoflurane has been associated with emergence agitation, potentially due to low tissue solubility and therefore speed of emergence. Prior meta-analyses comparing emergence agitation incidence between sevoflurane and isoflurane anesthetics did not demonstrate a statistically significant difference. Given the publication of additional relevant studies not included in prior meta-analyses as well as improved diagnosis of emergence agitation, we aim to perform an updated, comprehensive meta-analysis comparing emergence agitation incidence between sevoflurane and isoflurane anesthetics in children. METHODS We conducted an updated systematic review and meta-analysis of clinical trials comparing sevoflurane to isoflurane in children <18 years of age, reporting emergence agitation as an outcome, published before July 2023 using databases and registers. Our primary outcome was the incidence of emergence agitation. Secondary outcomes were time to extubation, awakening time, and length of stay in the postanesthetic care unit. We assessed the risk of bias using the Cochrane Risk of Bias tool version 2. We pooled the effect size for the outcomes using the fixed effects model if we had low heterogeneity, otherwise, we used a random-effects model. RESULTS Eight randomized controlled trials (523 children) were included in the final analysis. The incidence of emergence agitation after isoflurane was significantly lower compared to sevoflurane (risk ratio: 0.62 (95% CI: [0.46-0.83]; I2 = 40.01%, p < .001)). Time to extubation, awakening times, and postanesthetic care unit duration were not significantly different. The protective effect of isoflurane compared to sevoflurane remained significant in subgroups of patients who received premedication or intraoperative systemic analgesics (risk ratios: (0.48 [0.28-0.82]; I2 = 60.78%, p = .01), (0.52 [0.37-0.75]; I2 = 0.00%, p < .001), respectively). CONCLUSION The risk of emergence agitation in children after maintenance anesthesia with sevoflurane is significantly greater than with isoflurane; we did not find evidence of prolonged emergence or postanesthetic length of stay. When possible, isoflurane should be considered for maintenance anesthesia over sevoflurane in patients at high risk of emergence agitation.
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Affiliation(s)
- Rasha S Farag
- Division of Medical Critical Care, Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Clinical Research, Damietta Directorate for Health Affairs, Egyptian Ministry of Health and Population, Damietta, Egypt
| | - Aaron C Spicer
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Geetha Iyer
- Postdoctoral Fellow, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Jennifer P Stevens
- Harvard Medical School, Boston, Massachusetts, USA
- Center for Healthcare Delivery Science, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Andrew King
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Paul A Bain
- Countway Library of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - J Brian McAlvin
- Division of Medical Critical Care, Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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18
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Zhang G, Sun N, Ni X, Su Y, He L, Liu Z, Zhang J, Li Y, Zhang X, Liu Q, Liu Z, Li X, Mei L, Liu Y, Ji T, Wang S. Treatment of nasolabial fold rhabdomyosarcoma in children: A single-institution experience. Head Neck 2024; 46:905-914. [PMID: 38214480 DOI: 10.1002/hed.27637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 12/21/2023] [Accepted: 01/02/2024] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVES To summarize the clinical characteristics and prognosis of children with nasolabial fold rhabdomyosarcoma (RMS). METHODS Retrospective review of children treated for nasolabial fold RMS from January 2014 to September 2019. RESULTS Of 21 patients with nasolabial fold RMS, 90.48% were alveolar subtype, in which PAX3/7-FOXO1 fusion positive accounted for 87.5%. Ten patients (47.62%) had nodals invasion. Almost all patients received comprehensive treatment (chemotherapy [100%], radiation therapy [100%], and surgery [95.24%]). The median follow-up time was 34.3 months. The 3-year overall survival (OS) and event-free survival (EFS) was 67.7% ± 14.1% and 42.1% ± 13.5%, respectively. Four patients had regional lymph node relapse (NR), all in the ipsilateral submandibular lymph node region. CONCLUSION Majority of the patients with RMS in the nasolabial fold area were alveolar subtype and had positive PAX3/7-FOXO1 gene fusion. In addition, the nasolabial fold RMS had a high probability of regional lymph node metastasis in the submandibular area. To maintain the facial aesthetics and functions, the surgical area for nasolabial fold RMS is often very conservative and restricted. This could be one of the contributors for the poor prognosis of nasolabial fold RMS beside its worse pathological subtype and gene fusion.
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Affiliation(s)
- Ge Zhang
- Department of Otolaryngology - Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Nian Sun
- Department of Otolaryngology - Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xin Ni
- Department of Otolaryngology - Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- Department of Beijing Key Laboratory for Pediatric Diseases of Otolaryngology - Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yan Su
- Department of Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Lejian He
- Department of Pathology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zhikai Liu
- Department of Radiotherapy, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jie Zhang
- Department of Otolaryngology - Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yanzhen Li
- Department of Otolaryngology - Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xuexi Zhang
- Department of Otolaryngology - Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Qiaoyin Liu
- Department of Otolaryngology - Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zhiyong Liu
- Department of Otolaryngology - Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xiaodan Li
- Department of Otolaryngology - Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Lin Mei
- Department of Otolaryngology - Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yuwei Liu
- Department of Otolaryngology - Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Tingting Ji
- Department of Otolaryngology - Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Shengcai Wang
- Department of Otolaryngology - Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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Park HJ, Winant AJ, Lee EY, Kim WG, Shashi K, Stamoulis C, Paltiel HJ. Contrast-Enhanced Ultrasound of the Chest in Children and Adolescents: A Pilot Study for Assessment of Added Diagnostic Value. J Ultrasound Med 2024; 43:697-711. [PMID: 38189176 DOI: 10.1002/jum.16395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/30/2023] [Accepted: 11/28/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVES To determine the added diagnostic value of contrast-enhanced ultrasound (CEUS) in pediatric chest abnormalities by comparing interpretation of CEUS studies and confidence level to conventional US studies. METHODS CEUS studies in patients with a variety of clinically suspected chest abnormalities performed between 2016 and 2020 were reviewed and compared to same-day conventional US studies. Examinations were independently interpreted by 4 radiologists blinded to clinical and other imaging data. Rater confidence was classified as low, moderate, or high. Diagnostic accuracy was determined by comparing image interpretation to patient outcome as the ground truth. Interobserver agreement was also assessed. RESULTS Sixteen patients (10 male) with 18 CEUS studies were included. Median rater agreement with ground truth was significantly higher for CEUS (100%) than conventional US (50%; P = .004). Median rater confidence was high (3.0) for CEUS, and low-moderate (1.5) for conventional US (P < .001). CEUS sensitivity (54.6-81.8%) and specificity (63.4-100.0%) were greater than conventional US (45.5-72.7% and 12.5-63.5%, respectively). CEUS false positives (0-4) and false negatives (2-5) were fewer than conventional US (4-7 and 3-6, respectively). Except for one rater pair where agreement was substantial (κ = .78, P < .01), inter-rater agreement for CEUS for all other rater pairs was nonsignificant (κ = .25-0.51, P ≥ .07). Agreement for conventional US was moderate and statistically significant for 3 rater pairs (κ = .55-0.78) and nonsignificant for the remaining 3 rater pairs (P ≥ .06). CONCLUSIONS CEUS adds diagnostic value to the assessment of a variety of chest abnormalities. The data support further evaluation of the role of CEUS as a non-invasive, problem-solving technique in children.
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Affiliation(s)
- Halley J Park
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Abbey J Winant
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Edward Y Lee
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Wendy G Kim
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Kumar Shashi
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Catherine Stamoulis
- Department of Pediatrics, Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Harriet J Paltiel
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
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20
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Robinette LM, Hatsu IE, Johnstone JM, Bruton AM, Leung BM, Arnold LE. Treatment response to supplemental nutrients for ADHD is independent of diet quality: the MADDY Study RCT. Nutr Neurosci 2024; 27:319-328. [PMID: 36989335 PMCID: PMC10539486 DOI: 10.1080/1028415x.2023.2191415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
OBJECTIVES The 8-week Micronutrients for ADHD in Youth (MADDY) randomized controlled trial (N = 126, age 6-12) of broad-spectrum multinutrients for ADHD with emotional dysregulation found 3 times as many responders with multinutrients (54%) compared to placebo (18%) by Clinical Global Impression-Improvement (CGI-I). Our primary aim for this analysis tests the hypothesis that those with poor overall diet quality at baseline benefit more. The second aim is to explore whether specific components of diet quality moderate treatment response. METHODS 124 children (69 multinutrients, 55 placebo) had diet quality assessed using the Healthy Eating Index-2015 (HEI-2015). For each potential moderator, the outcome CGI-I at week 8 (RCT-end), was modeled two ways: (1) as a dichotomous variable: responder/non-responder, with responders defined by a rating of 1 or 2 'very much' or 'much improved,' all else equals non-responder using logistic regression, and (2) as a dimensional improvement outcome from 1 = very much improved to 7 = very much worse, using linear regression. RESULTS HEI-2015 total score did not moderate treatment response [odds ratio = 1.00 (95% CI: 0.90,1.10), p = 0.984] or improvement [β = -0.01 (95% CI: -0.06,0.04), p = 0.648]. However, total vegetable intake moderated level of improvement in exploratory analysis [β = -0.48 (95% CI: -0.82, -0.13), p = 0.007]: those with higher baseline vegetable intake showed greater benefit from multinutrients compared to placebo. CONCLUSIONS Multinutrients may benefit children with ADHD and irritability regardless of overall diet quality. The finding that higher baseline vegetable intake may improve response to multinutrients deserves further exploration, including dietary effect on gut microbiota and absorption of multinutrients and parental factors.
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Affiliation(s)
- Lisa M. Robinette
- Department of Human Sciences, The Ohio State University (OSU), Columbus, OH, USA
| | - Irene E. Hatsu
- Department of Human Sciences, The Ohio State University (OSU), Columbus, OH, USA
- OSU Extension, The Ohio State University, Columbus, OH, USA
| | - Jeanette M. Johnstone
- Department of Child & Adolescent Psychiatry, Oregon Health & Science University, Portland, OR, USA
- Helfgott Research Institute, National University of Natural Medicine
| | - Alisha M. Bruton
- Department of Child & Adolescent Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Brenda M.Y. Leung
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, CA
| | - L. Eugene Arnold
- Department of Psychiatry & Behavioral Health, The Ohio State University, Columbus, OH; Nisonger Center, The Ohio State University
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21
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Mason AE, Benson L, Hale V, Oslund M, Robinson A. Exploring Food Allergy Management and Food-Related Social Occupations in Elementary School-Aged Children. OTJR (Thorofare N J) 2024; 44:287-295. [PMID: 37377178 DOI: 10.1177/15394492231181091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
RATIONALE Elementary school-aged children with food allergies face barriers to navigating safe food practices in concert with socializing while eating. Little research examines children's role in managing their health (i.e., a food allergy). OBJECTIVES This qualitative descriptive study explores the experiences of preadolescent children with food allergies relating to food allergy management and socialization in various foodscapes in the United States. METHOD Data gathering strategies included interviews, diaries, and photo elicitation. The analysis involved coding, discussion, and thematic development. FINDINGS Participants shared food allergy management with caregivers depending on the environment. They learned to educate others, respond to emergencies, and prepare daily relating to food allergies. They faced conflict with managing food allergies with peers but overall perceived food allergy management as a low burden. CONCLUSION When provided with positive social and environmental supports, school-aged children with food allergies can learn to safely manage social food environments without direct parental involvement.
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22
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Mercolini F, Abram N, Cesaro S. Managing acute COVID-19 in immunocompromised pediatric patients. Expert Rev Clin Immunol 2024; 20:349-357. [PMID: 38099388 DOI: 10.1080/1744666x.2023.2295982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 12/13/2023] [Indexed: 03/16/2024]
Abstract
INTRODUCTION SARS-CoV-2 infection is a potentially life-threatening infection in immunocompromised pediatric patients, and its management has rapidly evolved during the pandemic. To control SARS-CoV-2 infection over time, the scenario changed for the better with the introduction of specific treatments such as antiviral drugs, vaccines, and monoclonal antibodies, together with drugs blocking the inflammatory cytokine cascade and improvements in supportive care. AREAS COVERED This paper discusses the therapeutic strategies to apply for patients affected by COVID-19 in the pediatric population, with a focus on the immunocompromised patients. EXPERT OPINION Treatment in pediatric patients retraces the therapies investigated and approved in adults and must be calibrated on the basis of the severity of the infection (anti-spike monoclonal antibody, antivirals, anti-inflammatory drugs, and immunomodulators). Transmission prevention policies and vaccination reduce the risk of infection, while early intervention in the immunocompromised patients at high-risk of progression to severe-critical COVID-19 may reduce the period of viral shedding and the need for hospitalization, intensive care admission, and death. In hemato-oncological patients, the delayed treatment of SARS-CoV-2 infection or COVID-19 disease represents a frequent complication and its impact on the patient outcome remains a matter of research for the next few years.
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Affiliation(s)
- Federico Mercolini
- Pediatric Oncology and Hematology "Lalla Seràgnoli", IRCCS, Azienda Ospedaliero-Universitaria di Bologna institution, Bologna, Italy
| | - Nicoletta Abram
- Pediatric Oncology and Hematology "Lalla Seràgnoli", IRCCS, Azienda Ospedaliero-Universitaria di Bologna institution, Bologna, Italy
| | - Simone Cesaro
- Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
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23
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Cao I, Italiano EG, Bertelli F, Motta R, Castaldi B, Pergola V, Guariento A, Scattolin F, Di Salvo G, Vida V, Padalino MA. Intracorporeal LVAD implantation in pediatric patients: A single-center 10 years' experience. Artif Organs 2024; 48:408-417. [PMID: 38380771 DOI: 10.1111/aor.14716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/28/2023] [Accepted: 01/08/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Mechanical cardiac support is currently an effective strategy to reduce morbidity and mortality in pediatric patients. However, solid evidence regarding the feasibility of intracorporeal devices in children still needs to be provided. We report our 10-year experience with intracorporeal left ventricular assist devices (LVAD) in children. MATERIALS AND METHODS We included all patients undergoing intracorporeal, continuous-flow LVAD implantation between 2012 and 2022. Baseline and postoperative data were collected from the institutional database. RESULTS Seven HeartWare and 4 HeartMate3 were implanted in 11 patients (median age 13.9 years, median body surface area - BSA - 1.42 m2, IQR 1.06-1.68). The most frequent indication to LVAD implant was dilated cardiomyopathy (72.7%). All candidates underwent a thorough preoperative advanced imaging. Three-dimensional reconstructions and implant fit simulation were performed when BSA was <1.2 m2, weight <30 kg, or internal transverse thoracic diameter <20 cm. There was no operative death. The most common postoperative complication was surgical re-exploration due to bleeding (27.3%). One patient died of severe neurological complications after about 3 months of hospitalization. No late deaths or unplanned re-hospitalizations occurred in the remaining 10, 6 of whom were discharged home. There were no major complications at the follow-up. All survivors underwent successful heart transplantation. CONCLUSIONS Intracorporeal LVAD implantation proved to be a potentially feasible and safe option in young teenagers and children whose BSA was >1.0 m2. In borderline cases, the 3D reconstruction with implant fit simulation can effectively help to identify those patients who can safely undergo intrathoracic LVAD implantation.
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Affiliation(s)
- Irene Cao
- Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Enrico G Italiano
- Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Francesco Bertelli
- Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Raffaella Motta
- Advanced and translational Imaging Unit, Department of Internal Medicine, University of Padua, Padua, Italy
| | - Biagio Castaldi
- Pediatric Cardiology Unit, Department of Woman and Child's Health, University of Padua, Padua, Italy
| | - Valeria Pergola
- Cardiology Clinic, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Alvise Guariento
- Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Fabio Scattolin
- Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Giovanni Di Salvo
- Pediatric Cardiology Unit, Department of Woman and Child's Health, University of Padua, Padua, Italy
| | - Vladimiro Vida
- Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Massimo A Padalino
- Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
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Arnot G, Pitt H, McCarthy S, Warner E, Thomas S. 'You can't really separate these risks, our environment, our animals and us': Australian children's perceptions of the risks of the climate crisis. Health Promot Int 2024; 39:daae023. [PMID: 38452241 PMCID: PMC10919885 DOI: 10.1093/heapro/daae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
Perceptions of the risks associated with the climate crisis are shaped by a range of social and political contexts and information sources. While some have expressed concerns about the impact of the spread of climate misinformation through social media platforms on young people, others have shown that the youth climate movement has played a key role in countering misinformation. Despite this, there has been very limited research with children about how they conceptualize the risks associated with the climate crisis, how they receive climate information, and how they understand and apply this to their own and others' lives. The following qualitative study used photo-elicitation techniques and in-depth interviews with Australian children to address this gap. A total of n = 28 children (12-16 years) participated, with four themes constructed from the data using a reflexive approach to thematic analysis. Children were concerned about how the climate crisis would continue to harm their futures and the health of planet and people. They recognized that some groups and countries would experience more risks associated with the climate crisis as compared to others. While they received information from a range of different sources (school, family, social media), they mostly used social media to seek out climate information. They recognized that social media sites could be a source of climate misinformation, and argued that a range of strategies were needed to identify and counter false information about the climate crisis. Children's perspectives must be harnessed to improve information about climate risks and action.
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Affiliation(s)
- Grace Arnot
- Faculty of Health, Institute for Health Transformation, Deakin University, 1 Geringhap Street, Geelong, VIC 3220, Australia
| | - Hannah Pitt
- Faculty of Health, Institute for Health Transformation, Deakin University, 1 Geringhap Street, Geelong, VIC 3220, Australia
| | - Simone McCarthy
- Faculty of Health, Institute for Health Transformation, Deakin University, 1 Geringhap Street, Geelong, VIC 3220, Australia
| | - Elyse Warner
- Faculty of Health, Institute for Health Transformation, Deakin University, 1 Geringhap Street, Geelong, VIC 3220, Australia
| | - Samantha Thomas
- Faculty of Health, Institute for Health Transformation, Deakin University, 1 Geringhap Street, Geelong, VIC 3220, Australia
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA 6102, Australia
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25
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Wang Y, Chen X, Wang A, Jordan LP, Lu S. Research Review: Grandparental care and child mental health - a systematic review and meta-analysis. J Child Psychol Psychiatry 2024; 65:568-586. [PMID: 38171720 DOI: 10.1111/jcpp.13943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND The number of children residing in grandfamilies is growing worldwide, leading to more research attention on grandparental care over the past decades. Grandparental care can influence child well-being in various forms and the effects vary across contexts. In this systematic review and meta-analysis, we synthesize the evidence on the relation between grandparental care and children's mental health status. METHODS We identified 5,745 records from seven databases, among which 38 articles were included for review. Random effects meta-analyses were used to synthesize evidence from eligible studies. We also examined the variability across study and participant characteristics, including study design, recruitment method, child age, child gender, study region, family type, comparison group, and outcome rater. RESULTS The meta-analysis consisted of 344,860 children from the included studies, whose average age was 10.29, and of which 51.39% were female. Compared with their counterparts, children being cared for by their grandparents had worse mental health status, including more internalizing problems (d = -0.20, 95% CI [-0.31, -0.09], p = .001), externalizing problems (d = -0.11, 95% CI [-0.21, -0.01], p = .03), overall mental problems (d = -0.37, 95% CI [-0.70, -0.04], p = .03), and poorer socioemotional well-being (d = -0.26, 95% CI [-0.49, -0.03], p = .03). The effects varied by study design and child gender. CONCLUSIONS The findings highlight that grandparental care is negatively associated with child mental health outcomes with trivial-to-small effect sizes. More supportive programs and interventions should be delivered to grandfamilies, especially in disadvantaged communities.
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Affiliation(s)
- Yihang Wang
- Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Xintai Chen
- Department of Social Work, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Anzhuo Wang
- Department of Sociology, University of Macau, Taipa, Macau
| | - Lucy Porter Jordan
- Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Shuang Lu
- School of Social Work, University of Central Florida, Orlando, Florida, USA
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26
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Medrano Nava E, Flores-Lázaro JC, Nicolini Sánchez H, Juárez García F. Effects of comorbidity on executive functions among children with ADHD, finding trends. Appl Neuropsychol Child 2024; 13:100-112. [PMID: 36395527 DOI: 10.1080/21622965.2022.2135440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
There is still no basic overview about the effect of various types of comorbidity in executive functions due to two main reasons: (1) the type and number of comorbidities in ADHD is significantly varied, (2) EFs are very diverse and have different neuropsychological properties. Our objective was to determine the effect of comorbid disorders (number and type) on the performance in a wide range (seven) of executive functions in a sample of children with ADHD. Fifty-five male children aged seven to nine years with ADHD were divided into six groups: G1 = ADHD only (ADHD-O), G1 = Oppositional defiant disorder (ODD), G3 = (anxiety/depressive disorder (ADD), G4 = ODD + ADD, G5 = ODD + learning disorder (LD), G6 = ODD + LD + conduct disorder (CD). The six groups exhibited different number of deficits in EFs; G1 showed only 1 deficit in contrast, G6 presented 11. Statistical analysis (ANOVA and logistic regression) identified three most affected EFs: Working memory, generation/classification of semantic categories, and inhibitory control. Alterations in EFs increased mainly in relation to the increase of the specific number and type of comorbidity. To date, no studies have addressed comorbidity from this perspective. A wide range approach of EF confirms the need to further study comorbidity in ADHD from a wide range/variety perspective and determine all possible combinations (number/type) to clarify its contribution to the complex neuropsychology functioning in ADHD.
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Affiliation(s)
- Eliana Medrano Nava
- Child Psychiatry Hospital, SAP-DJNN, Ministry of Health, Mexico City, Mexico
- Postgraduate program in Health Sciences, Faculty of Medicine, UNAM, Mexico City, Mexico
| | - Julio C Flores-Lázaro
- Child Psychiatry Hospital, SAP-DJNN, Ministry of Health, Mexico City, Mexico
- Psychology Faculty, UNAM, Mexico City, Mexico
| | - Humberto Nicolini Sánchez
- Genomics of Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico
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Ma J, Cui C, Tang Y, Hu Y, Dong S, Zhang J, Xie X, Meng J, Wang Z, Zhang W, Chen Z, Wu R. Machine learning models developed and internally validated for predicting chronicity in pediatric immune thrombocytopenia. J Thromb Haemost 2024; 22:1167-1178. [PMID: 38103736 DOI: 10.1016/j.jtha.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/01/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Primary immune thrombocytopenia (ITP) in children is typically self-limiting; however, 20% to 30% of patients may experience prolonged thrombocytopenia lasting over a year. The challenge is predicting chronicity to ensure personalized treatment approaches. OBJECTIVES To address this issue, we developed and internally validated 4 machine learning (ML) models using demographic and immunologic characteristics to predict the likelihood of chronicity. METHODS The present study was conducted at Beijing Children's Hospital from June 2018 to December 2021, aiming to develop predictive models for determining the chronicity of pediatric ITP. Four ML models, based on a logistic regression classifier, random forest classifier, eXtreme Gradient Boosting (XGBoost), and support vector machine, were employed. These models used a set of 16 variables, including 14 immunologic and 2 demographic predictors. The performance evaluation criteria included prediction accuracy, precision, recall, F1 score, and area under the receiver operating characteristic curve (AUROC). RESULTS Data were collected from 662 patients who were randomly assigned to either a training dataset or a testing dataset using a random number generator. Among them, 26.5% had chronic disease. All models performed well, with AUROC values ranging from 0.81 to 0.84, and XGBoost was selected for its highest AUROC score and interpretability in constructing the predictive model. Age, T helper 17, T helper 17-to-regulatory T cell ratio, T helper 1, and double-negative T cells were identified as significant predictors by the XGBoost algorithm. CONCLUSION We developed a precise predictive model for chronicity in pediatric ITP using ML during the initial phase. The XGBoost model achieved high predictive accuracy by using individual patient clinical parameters and demonstrated commendable interpretability.
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Affiliation(s)
- Jingyao Ma
- Hematology Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Chang Cui
- The State Key Laboratory of Multimodal Artificial Intelligence Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Yongqiang Tang
- The State Key Laboratory of Multimodal Artificial Intelligence Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China.
| | - Yu Hu
- Hematology Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Shuyue Dong
- Hematology Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Jialu Zhang
- Hematology Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xingjuan Xie
- Hematology Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Jinxi Meng
- Hematology Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zhifa Wang
- Hematology Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Wensheng Zhang
- The State Key Laboratory of Multimodal Artificial Intelligence Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Zhenping Chen
- Hematologic Disease Laboratory, Hematology Center, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
| | - Runhui Wu
- Hematology Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
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Mori T, Osumi T, Kada A, Ohki K, Koga Y, Fukano R, Fujita N, Mitsui T, Mori T, Saito AM, Nakazawa A, Kobayashi R, Sekimizu M. Rituximab with standard LMB chemotherapy in pediatric high-risk mature B-cell non-Hodgkin lymphoma: A report from the JPLSG B-NHL14 trial. Eur J Haematol 2024; 112:585-593. [PMID: 38112205 DOI: 10.1111/ejh.14148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND The benefit of adding rituximab to standard lymphomes malins B (LMB) chemotherapy for children with high-risk mature B-cell non-Hodgkin lymphoma (B-NHL) has previously been demonstrated in an international randomized phase III trial, to which the Japanese Pediatric Leukemia/Lymphoma Study Group could not participate. METHODS To evaluate the efficacy and safety of rituximab in combination with LMB chemotherapy in Japanese patients, we conducted a single-arm multicenter trial. RESULTS In this study, 45 patients were enrolled between April 2016 and September 2018. A total of 33 (73.3%), 5 (11.1%), and 6 (13.3%) patients had Burkitt lymphoma/leukemia, diffuse large B-cell lymphoma, and aggressive mature B-NHL, not otherwise specified, respectively. Ten (22.2%) and 21 (46.7%) patients had central nervous system disease and leukemic disease, respectively. The median follow-up period was 47.5 months. Three-year event-free survival and overall survival were 97.7% (95% confidence interval, 84.9-99.7) and 100%, respectively. The only event was relapse, which occurred in a patient with diffuse large B-cell lymphoma. Seven patients (15.6%) developed Grade 4 or higher non-hematologic adverse events. Febrile neutropenia was the most frequent Grade 3 or higher adverse event after the pre-phase treatment, with a frequency of 54.5%. CONCLUSION The efficacy and safety of rituximab in combination with LMB chemotherapy in children with high-risk mature B-NHL was observed in Japan.
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Affiliation(s)
- Tetsuya Mori
- Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Tomoo Osumi
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Akiko Kada
- Clinical Research Center, NHO Nagoya Medical Center, Aichi, Japan
| | - Kentaro Ohki
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Yuhki Koga
- Department of Pediatrics, Graduate School of Medical Sciences Kyushu University, Fukuoka, Japan
| | - Reiji Fukano
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Naoto Fujita
- Department of Pediatrics, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Tetsuo Mitsui
- Department of Pediatrics, Yamagata University, Yamagata, Japan
| | - Takeshi Mori
- Department of Hematology and Oncology, Children's Cancer Center, Hyogo Prefectural Kobe Children's Hospital, Hyogo, Japan
| | - Akiko M Saito
- Clinical Research Center, NHO Nagoya Medical Center, Aichi, Japan
| | - Atsuko Nakazawa
- Department of Clinical Research, Saitama Children's Medical Center, Saitama, Japan
| | - Ryoji Kobayashi
- Department of Hematology/Oncology for Children and Adolescents, Sapporo Hokuyu Hospital, Hokkaido, Japan
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Barbour A, Penman D, Kubba H. Prevalence of thyroid gland tissue in midline neck dermoid cysts in children and a proposed new 'thyroglossal entrainment' hypothesis for their formation. J Laryngol Otol 2024; 138:448-450. [PMID: 37795741 DOI: 10.1017/s0022215123001792] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
BACKGROUND Thyroglossal duct cysts and dermoid cysts both commonly present as midline neck lumps in children. They are treated as separate entities with different embryological origins. There are isolated reports of thyroid gland tissue in a dermoid cyst, concurrent thyroglossal and dermoid cysts, and cysts with mixed histology. It is not known if these are rare or common. METHODS All children undergoing excision of a congenital midline neck cyst between January 2017 and December 2022 were identified. Histopathology slides were reviewed in detail. RESULTS In 53 children, there were 26 thyroglossal duct cysts, 24 dermoids, 1 lymph node and 2 with no diagnostic material identified. Five dermoids (28 per cent) had associated thyroid gland tissue, and 1 (4 per cent) had hybrid histology with keratinising and respiratory epithelium. Infection occurred in 17 per cent of dermoids prior to excision and 8 per cent of dermoids recurred after excision. CONCLUSION Hybrid histology, infection and recurrence are all common in midline neck dermoids. A new theory for their embryological origin is proposed, with the suggestion that some may need more extensive surgery.
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Affiliation(s)
- Amy Barbour
- Department of Paediatric Otolaryngology, Royal Hospital for Children, Glasgow, Scotland, UK
| | - Dawn Penman
- Department of Pathology, Royal Hospital for Children, Glasgow, Scotland, UK
| | - Haytham Kubba
- Department of Paediatric Otolaryngology, Royal Hospital for Children, Glasgow, Scotland, UK
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Zheng S, Chen S, Hu Y, Wang M, Liao W. Alveolar nitric oxide concentration plays an important role in identifying cough variant asthma and assessing asthma control in children. J Asthma 2024; 61:328-337. [PMID: 37855443 DOI: 10.1080/02770903.2023.2272806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/15/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVE To study the value of alveolar nitric oxide concentration (CaNO) in the identification and disease control of cough variant asthma. METHODS A retrospective study was conducted on cough variant asthma (CVA-Group), nonasthmatic cough (NAC-Group) and healthy control children (C-Group) aged 5-12 years. The exhaled nitric oxide and spirometry test results of the three groups were collected and compared. RESULTS A total of 410 children were included in this study, including 190 in the CVA-Group, 183 in the NAC-Group, and 37 in the C-Group. The CaNO values of the CVA-Group [11.40 ppb (8.48-14.25)] were significantly higher than those of the NAC-Group and C-Group (all p values <.05). The MMEF %pred values of the CVA-Group [63.65 (56.28-73.58)] were significantly lower than those of the NAC-Group and C-Group (all p values <.05). FeNO50, JawNO and other spirometry indices (FVC %pred, FEV1%pred, FEV1/FVC %pred) showed no significant difference among the three groups. ROC curve analysis showed that the optimal cutoff point value of CaNO was 9.45 ppb, corresponding to 0.816 sensitivity and 0.736 specificity. Spearman correlation analysis showed a significant negative correlation between the CaNO measurement and CVA control score. CONCLUSIONS CaNO can not only help identify CVA early in children aged 5-12 years with chronic cough but is also significantly negatively correlated with the CVA control score.
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Affiliation(s)
- Shouyan Zheng
- Department of Pediatrics, The First Hospital Affiliated to Army Medical University, Chongqing, China
| | - Sheng Chen
- Department of Pediatrics, The First Hospital Affiliated to Army Medical University, Chongqing, China
| | - Ying Hu
- Department of Pediatrics, The First Hospital Affiliated to Army Medical University, Chongqing, China
| | - Mei Wang
- Department of Pediatrics, The First Hospital Affiliated to Army Medical University, Chongqing, China
| | - Wei Liao
- Department of Pediatrics, The First Hospital Affiliated to Army Medical University, Chongqing, China
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Casini F, Valentino MS, Lorenzo MG, Caiazzo R, Coppola C, David D, Di Tonno R, Giacomet V. Use of transcriptomics for diagnosis of infections and sepsis in children: A narrative review. Acta Paediatr 2024; 113:670-676. [PMID: 38243675 DOI: 10.1111/apa.17119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 01/21/2024]
Abstract
AIM The aim of this review was to summarise the most recent evidence about the use of omics-based techniques as an instrument for a more rapid and accurate characterisation of respiratory tract infections, neurological infections and sepsis in paediatrics. METHODS We performed a narrative review using PubMed and a set of inclusion criteria: English language articles, clinical trials, meta-analysis and reviews including only paediatric population inherited to this topic in the last 15 years. RESULTS The examined studies suggest that host gene expression signatures are an effective method to characterise the different types of infections, to distinguish infection from colonisation and, in some cases, to assess the severity of the disease in children. CONCLUSIONS 'Omics-based techniques' may help to define the aetiology of infections in paediatrics, representing a useful tool to choose the most appropriate therapies and limit antibiotic resistance.
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Affiliation(s)
- Francesca Casini
- Pediatric Department, "Vittore Buzzi" Children's Hospital, Milan, Italy
| | - Maria Sole Valentino
- Pediatric Infectious Disease Unit, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Marc Garcia Lorenzo
- Pediatric Infectious Disease Unit, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Roberta Caiazzo
- Pediatric Infectious Disease Unit, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Crescenzo Coppola
- Pediatric Infectious Disease Unit, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Daniela David
- Pediatric Infectious Disease Unit, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Raffaella Di Tonno
- Pediatric Infectious Disease Unit, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Vania Giacomet
- Pediatric Infectious Disease Unit, Luigi Sacco Hospital, University of Milan, Milan, Italy
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Parsons CLB, Mountain RV, Jacobsson K, Bidlack FB, Lehmann LS, Dunn EC. Cultural diversity of traditions for the disposal of exfoliated teeth: Implications for researchers. Community Dent Oral Epidemiol 2024; 52:139-149. [PMID: 38217075 DOI: 10.1111/cdoe.12928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 10/25/2023] [Accepted: 11/06/2023] [Indexed: 01/14/2024]
Abstract
OBJECTIVES For decades, researchers in anthropology and archaeology have used teeth, including exfoliated primary teeth, as fossil records of people's physical life experiences. Recently, researchers in psychiatry, epidemiology, environmental health and other fields have recognized the potential for teeth to serve as biomarkers of other early-life experiences, including trauma exposure and other types of psychosocial stress, which are potent determinants of later mental and physical health problems. Despite the emerging appreciation and value of teeth as biospecimens, little is understood about cultural beliefs and practices surrounding exfoliated teeth. If known, such insights could inform culturally appropriate practices for paediatric dental care and improve protocols for the ethical acquisition of teeth as biospecimens in research studies. To address this gap, a qualitative systematic review was performed to summarize the variety of traditions performed worldwide for disposing of primary exfoliated teeth. METHODS PubMed, Google Scholar, AnthroSource, Anthropological Literature, EHRAF World Cultures and Anthropology Plus were searched with a systematic search strategy to identify articles published from inception through December 2, 2021. Citations of relevant papers were also forward and backward searched. RESULTS There were 3289 articles that met the initial inclusion criteria, of which 37 were included after individual screening and applying exclusion criteria. Thematic analysis was used to identify 74 distinct traditions related to the disposal of exfoliated teeth, which were organized into seven general themes: (1) giving teeth to a tooth fairy, (2) giving teeth to mouse figures, (3) throwing teeth, (4) hiding/keeping teeth, (5) burying teeth, (6) giving teeth to animals and (7) eating the tooth. CONCLUSIONS The results of this study elucidate the diversity within-yet universality of-exfoliated tooth disposal traditions and underscore the importance of tooth exfoliation as a major milestone during child development. Special attention must be paid to these traditions and related ethical concerns when designing research protocols related to their collection. With a greater understanding of beliefs and practices related to exfoliated teeth, researchers will be better equipped to engage children and families in studies that include analyses of exfoliated teeth, collect teeth as biospecimens, and broaden the use of teeth in research.
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Affiliation(s)
- Clara L B Parsons
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Rebecca V Mountain
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School and the Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kristina Jacobsson
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Felicitas B Bidlack
- Forsyth Institute, Cambridge, Massachusetts, USA
- Department of Developmental Biology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Lisa Soleymani Lehmann
- Brigham and Women's Division of General Internal Medicine and Primary Care, Department of Medicine, Boston, Massachusetts, USA
| | - Erin C Dunn
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School and the Massachusetts General Hospital, Boston, Massachusetts, USA
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, Massachusetts, USA
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Yimer BL, Tilwani SA. The association between caregiver child relationships and mental health of Ethiopian orphans. Clin Child Psychol Psychiatry 2024; 29:737-745. [PMID: 37842789 DOI: 10.1177/13591045231205968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
OBJECTIVE The relationship between caregivers and children has importance for the development of children's mental health and wellbeing. This study examines the association between orphaned children's mental health and their relationship with their current caregivers. METHOD It used a correlational research design, appropriate to answer the research questions. The participants were 172 Ethiopian orphans aged 12-18 years, living in institutional care settings, who were selected by stratified sampling techniques, based on a proportionate number of orphans of both sexes. RESULTS The findings of multivariate analysis revealed that the level of trusting relationships between children and caregivers was strongly associated, and significantly contributed to mental health measures, such as depression, social anxiety, and self-esteem. CONCLUSIONS Trusting relationships with caregivers showed a significant contribution to mental health measures (depression, social anxiety, and self-esteem).
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Affiliation(s)
- Beneyam Lake Yimer
- Psychology Department, College of Education and Behavioural Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Shouket Ahmad Tilwani
- College of Science and Humanities, Al-Kharj, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
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İriz E, Tak S, Yiğiter EN, Leventoğlu E, Demirtaş H, Akkuzu E, Uysal Yazıcı M, Fidan K, Dalgıç A. A rare cause and an even rarer treatment of hypertension in a 5-year-old boy: Mid-aortic syndrome. Nephrology (Carlton) 2024; 29:230-234. [PMID: 38109884 DOI: 10.1111/nep.14262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/10/2023] [Accepted: 12/01/2023] [Indexed: 12/20/2023]
Abstract
Renal artery stenosis is one of the common vascular diseases that cause hypertension in children. However, renal artery aneurysms and abdominal aortic aneurysms, which may be components of mid-aortic syndrome, are rarely associated with renal artery stenosis. Despite its rarity, early diagnosis and treatment are critical to prevent fatal complications. Currently, non-surgical invasive techniques are considered the first choice for treatment, but in some cases, surgery is inevitable. Here, we present a 5-year-old boy with a mid-aortic syndrome. The patient presented with a history of severe headache and epistaxis 5-6 times a day and was diagnosed with hypertension. A 9 × 9 mm saccular aneurysm on the anterior surface of the abdominal aorta at the level of the left renal artery ostium, and a 12 mm aneurysm in the left renal artery after a stenotic segment at the hilum level was detected in the doppler USG and contrast-enhanced imaging techniques. The patient was operated on electively. We used a PTFE patch to repair the abdominal aorta and, saphenous vein which was taken from his father to repair the renal artery. The patient recovered well and was discharged on the 18th day.
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Affiliation(s)
- Erkan İriz
- Faculty of Medicine, Department of Cardiovascular Surgery, Gazi University, Ankara, Turkey
| | - Sercan Tak
- Faculty of Medicine, Department of Cardiovascular Surgery, Gazi University, Ankara, Turkey
| | - Eda Nur Yiğiter
- Faculty of Medicine, Department of Cardiovascular Surgery, Gazi University, Ankara, Turkey
| | - Emre Leventoğlu
- Faculty of Medicine, Department of Pediatric Nephrology, Gazi University, Ankara, Turkey
| | - Hüseyin Demirtaş
- Faculty of Medicine, Department of Cardiovascular Surgery, Gazi University, Ankara, Turkey
| | - Emine Akkuzu
- Faculty of Medicine, Department of Pediatric Intensive Care, Gazi University, Ankara, Turkey
| | - Mutlu Uysal Yazıcı
- Faculty of Medicine, Department of Pediatric Intensive Care, Gazi University, Ankara, Turkey
| | - Kibriya Fidan
- Faculty of Medicine, Department of Pediatric Nephrology, Gazi University, Ankara, Turkey
| | - Aydın Dalgıç
- Faculty of Medicine, Department of General Surgery, Gazi University, Ankara, Turkey
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Cervin M, Martí Valls C, Möller S, Frick A, Björkstrand J, Watson D. A Psychometric Evaluation of the Expanded Version of the Inventory of Depression and Anxiety Symptoms (IDAS-II) in Children and Adolescents. Assessment 2024; 31:588-601. [PMID: 37177831 PMCID: PMC10903129 DOI: 10.1177/10731911231170841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The expanded version of the Inventory of Depression and Anxiety Symptoms (IDAS-II) is a self-report measure of 18 empirically derived internalizing symptom dimensions. The measure has shown good psychometric properties in adults but has never been evaluated in children and adolescents. A Swedish version of the IDAS-II was administered to 633 children and adolescents (Mage =16.6 [SD = 2.0]) and 203 adults (Mage = 35.4 [SD = 12.1]). The model/data fit of the 18-factor structure was excellent in both samples and measurement invariance across age groups was supported. All scales showed good to excellent internal consistency and psychometric properties replicated in the younger youth sample (< 16 years). Among youth, good convergent validity was established for all scales and divergent validity for most scales. The IDAS-II was better at identifying youth with current mental health problems than an internationally recommended scale of internalizing symptoms. In conclusion, the IDAS-II shows promise as a measure of internalizing symptoms in youth.
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Booth AT, Guest ZC, Vuong A, Von Doussa H, Ralfs C, McIntosh JE. Child-Reported Family Violence: A Systematic Review of Available Instruments. Trauma Violence Abuse 2024; 25:1661-1679. [PMID: 37646364 PMCID: PMC10913336 DOI: 10.1177/15248380231194062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
The impact of family violence (FV) on children is a significant global public policy issue. Earliest identification of FV among children is critical for preventing escalating sequelae. While practitioners routinely ask adults about FV, there are relatively few measures that enable children to reliably self-report on their own safety. This review sought to systematically identify and appraise all available child self-report measures for screening and assessment of FV in both clinical and research settings. Database searching was conducted in January 2022. Articles were eligible for review if they included a validated child (5-18 years) self-report measure of FV (including victimization, perpetration, and/or exposure to inter-parental violence). Screening of an initial 4,714 records identified a total of 85 articles, representing 32 unique validated instruments. Results provide an up-to-date catalog of child self-report measures of FV, intended to benefit practitioners, services and researchers in selecting appropriate tools, and in understanding their suitability and limitations for different cohorts and practice goals. While just under half of the measures captured both exposure to inter-parental violence and direct victimization, none captured all three domains of exposure, victimization and perpetration together. Instruments with provision for input from multiple respondents (e.g., both child and parent report) and with assessment of contextual risk factors were few. Findings point to the need for developmentally appropriate, whole-of-family screening and assessment frameworks to support children in the early identification of family safety concerns.
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Affiliation(s)
| | | | - An Vuong
- La Trobe University, Bundoora, VIC, Australia
| | | | - Claire Ralfs
- Relationships Australia South Australia, Hindmarsh, SA, Australia
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Kannikeswaran N, Spencer P, Carcone A, Huth M, Mehmood Y, Ellis D. Utilization of electronic portal referrals to a community agency for children presenting with an asthma exacerbation to a pediatric emergency department. J Asthma 2024; 61:307-312. [PMID: 37847783 PMCID: PMC10939958 DOI: 10.1080/02770903.2023.2272796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/15/2023] [Indexed: 10/19/2023]
Abstract
PURPOSE To evaluate referral rates and factors associated with referrals to a community agency for children evaluated for an asthma exacerbation at a pediatric emergency department (PED) and compare PED visits for asthma the following year between those referred and not referred. METHODS We reviewed electronic health records of children 2-18 years evaluated in our PED from 01/01/2019 to 12/31/2019 with an ICD-10 diagnostic code for asthma (J45x) following the introduction of a portal where clinicians could refer children to a community agency focused on improving health outcomes for asthma. We abstracted data on demographics, PED visits, and hospitalizations and used multivariate logistic regression to evaluate factors associated with referrals. RESULTS Of the 2262 charts analyzed, the majority of patients were male (61%), Black (76%), and held public insurance (71%). Only a minority of patients (n = 140, 6%) were referred. Age [6-12 years (AOR: 1.93, 95% CI: 1.21-3.08, p = .006), 13-18 years (AOR: 10.61, 95% CI: 6.53-17.24, p = .001)] and lifetime number of PED asthma visits [≥3 visits (AOR: 1.91, 95% CI, 1.01-3.62, p = .05)] were associated with referral. There was no significant difference in the mean number of PED visits in one year [referred: 0.59 (SD1.2) vs. not referred: 0.79 (SD1.3), t = 1.70, p = .09] between the two groups. CONCLUSION The referral rate to community agency from PED for asthma is low. There was no difference in short-term PED utilization for asthma between those referred and not referred.
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Affiliation(s)
- Nirupama Kannikeswaran
- Division of Emergency Medicine, Department of Pediatrics and Emergency Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit, MI, USA
| | - Priya Spencer
- Division of Emergency Medicine, Children's Hospital of Michigan, Detroit, MI, USA
| | - April Carcone
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Marissa Huth
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Yasir Mehmood
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Deborah Ellis
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, USA
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Jiménez-Fernández S, Gurpegui M, Correll CU, de Leon J, Schoretsanitis G. A Systematic Review of Clozapine Concentration-Dose Ratio from Therapeutic Drug Monitoring Studies in Children and Adolescents Treated with Clozapine for Mental Disorders. Ther Drug Monit 2024; 46:170-180. [PMID: 38018845 PMCID: PMC10930379 DOI: 10.1097/ftd.0000000000001154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/14/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Therapeutic drug monitoring of clozapine in children and adolescents has received insufficient attention. Calculation of concentration-to-dose (C/D) ratios from trough steady-state concentrations estimate drug clearance. METHODS A systematic electronic literature search was conducted in 3 article databases from inception until January 10, 2023, and articles reporting clozapine concentrations in children and adolescents were retrieved. The pharmacokinetic quality of the studies was assessed, and clozapine C/D ratios were calculated using the sample mean clozapine dose and concentration. RESULTS Of the 37 articles of potential interest, only 7 reported clozapine trough and steady-state concentrations. After excluding case reports and a study confounded by fluvoxamine, 4 studies on psychosis from Europe and the United States were included. The clozapine C/D ratios were similar to published adult values and ranged from 0.82 to 1.24 with a weighted mean of 1.08 ng/mL per mg/d. The weighted means were 334 mg/d for the dose and 380 ng/mL for the concentration. The stratified analysis of the weighted mean clozapine C/D ratios from 2 studies showed lower values in 52 male (1.05 ng/mL per mg/d) than in 46 female (1.46 ng/mL per mg/d) children and adolescents, with values similar to those reported for European adult nonsmokers. Two female adolescents had high clozapine C/D ratios (2.54 ng/mL per mg/d), an Asian American patient with borderline obesity and a patient with intellectual disability with low dosage (mean = 102 mg/d) and concentration (mean = 55 ng/mL). CONCLUSIONS Reports on clozapine therapeutic drug monitoring in children and adolescents are limited in number and quality. Future studies should focus on basic pharmacokinetic issues, such as stratification by sex, smoking, and relevant comedications with inductive or inhibitory properties.
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Affiliation(s)
- Sara Jiménez-Fernández
- Child and Adolescent Mental Health Unit, Virgen de Las Nieves University Hospital, Granada, Spain
- CTS-549 Research Group (Psychiatry and Neurosciences), Junta de Andalucía, Spain
| | - Manuel Gurpegui
- CTS-549 Research Group (Psychiatry and Neurosciences), Junta de Andalucía, Spain
- Granada Center for Psychiatric Studies, Granada, Spain
| | - Christoph U. Correll
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
- The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, New York
- Department of Psychiatry, Zucker School of Medicine at Northwell/Hofstra, Hempstead, New York
| | - Jose de Leon
- Mental Health Research Center, Eastern State Hospital, Lexington, Kentucky
- Biomedical Research Centre in Mental Health Net (CIBERSAM), Santiago Apóstol Hospital, University of the Basque Country, Vitoria, Spain; and
| | - Georgios Schoretsanitis
- The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, New York
- Department of Psychiatry, Zucker School of Medicine at Northwell/Hofstra, Hempstead, New York
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Zürich, Switzerland
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Balderas-Arteaga N, Mendez K, Gonzalez-Rocha A, Pacheco-Miranda S, Bonvecchio A, Denova-Gutiérrez E. Healthy lifestyle interventions within the curriculum in school-age children: systematic review and meta-analysis. Health Promot Int 2024; 39:daae020. [PMID: 38470184 DOI: 10.1093/heapro/daae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
Childhood obesity is a major public health challenge. Previous research has identified the impact of school-based interventions for preventing and treating obesity; we hypothesized that when curricular changes are integrated, results could be exponentiated. This study aimed to systematically review and conduct a meta-analysis of the published literature analyzing information about school-based interventions inserted in the curriculum. The Cochrane Handbook methodology was followed. An electronic search was conducted in five databases, with a specific design strategy per database. Randomized controlled trials or quasi-experimental studies of children with nutrition and physical activity (PA) interventions inserted into the school curricula were included. The risk of bias was assessed with the Risk of Bias tool. The mean differences were pooled using a fixed-effects model for the meta-analysis. The certainty of the evidence was evaluated according to the guidelines of the Grading of the Recommendations, Assessment, Development, and Evaluations working group (Protocol ID: CRD42021270557). After the screening and selection process, 12 studies were included. The interventions identified, based on the school curricula, include classroom activities and homework, among others. A meta-analysis with five intervention groups presented an overall mean difference of -0.14 body mass index (BMI) Z-score (95% CI: -0.25, -0.03) after this intervention with high certainty of the evidence. This systematic review and meta-analysis suggest that nutrition and PA lessons inserted into the curricula and supported with additional activities (i.e. homework, workshops, etc.) could increase nutrition knowledge and improve attitudes toward fruit, vegetables, and water consumption, and BMI Z-score reduction.
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Affiliation(s)
- Nydia Balderas-Arteaga
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Kenia Mendez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Alejandra Gonzalez-Rocha
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Selene Pacheco-Miranda
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Anabelle Bonvecchio
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Edgar Denova-Gutiérrez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
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Steinberg R, Marty V, Korten I, Aebi C, Latzin P, Agyeman PKA. Epidemiology and Clinical Characteristics of Human Metapneumovirus Infections in Hospitalized Children in Two Consecutive Postpandemic Years. Pediatr Infect Dis J 2024; 43:e141-e144. [PMID: 38241663 PMCID: PMC10919270 DOI: 10.1097/inf.0000000000004221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/21/2024]
Abstract
We assessed human metapneumovirus infections in children hospitalized between 2011 and 2023 and compared the strongest pre- and postpandemic seasons. After the COVID-19 pandemic, we observed offseason cases and loss of the alternating pattern of the human metapneumovirus season magnitude. Incidence rate ratio of 0- to 11-month-old versus 12- to 23-month-old children was 2.1 (95% CI: 1.0-4.8) before and 1.3 (95% CI: 0.6-2.9) after the pandemic.
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Affiliation(s)
- Ruth Steinberg
- From the Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Véronique Marty
- From the Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital
| | - Insa Korten
- From the Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital
| | - Christoph Aebi
- Division of Paediatric Infectious Diseases, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- From the Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital
| | - Philipp KA Agyeman
- Division of Paediatric Infectious Diseases, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Sethi V, Bassi S, Bahl D, Kumar A, Choedon T, Bhatia N, de Wagt A, Joe W, Arora M. Prevalence of overweight and obesity and associated demographic and health factors in India: Findings from Comprehensive National Nutrition Survey (CNNS). Pediatr Obes 2024; 19:e13092. [PMID: 38326947 DOI: 10.1111/ijpo.13092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 08/11/2023] [Accepted: 11/08/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND Childhood obesity (5-9 years) in India is likely to contribute 11% to the global burden by 2030. METHODS Data from India's Comprehensive National Nutrition Survey (CNNS, 2016-2018) was used to assess the prevalence and key associated factors of overweight and obesity. Multivariable logistic regression models were applied to identify potential determinants associated with being overweight and obese. RESULTS Overweight prevalence (including obesity) varied from 1.6% (0-4 years) to 4.8% (10-19 years). The majority of states reported a higher proportion of adolescents overweight and obese, than younger age group 5-9 years. A significantly higher prevalence of children and adolescents with obesity was reported in higher wealth quintiles and residents of urban areas. The prevalence of overweight and obesity and associated demographic and health factors in India included: the presence of NCD risk factor (adolescents: 1.68, 95% CI [1.31-2.14]), micronutrient deficiency (5-9 years children: 1.72, 95% CI [1.30-2.28]), mother's education (5-9 years children: 4.84, 95% CI [2.92-8.03]; adolescents: 2.17, 95% CI [1.42-3.32]), wealth (adolescents: 1.92, 95% CI [1.16-3.19]), place of residence (5-9 years children: 1.68, 95% CI [1.39-2.03]; adolescents: 1.39, 95% CI [1.16-1.66]), child age (5-9 years children: 1.64, 95% CI [1.40-1.93], and screen-time (adolescents: 1.63, 95% CI [1.22-2.19]. CONCLUSION The findings set out policy and research recommendations to pave the path for curtailing the increasing prevalence of overweight and obesity and achieving the World Health Assembly's Global Nutrition target of 'no increase in childhood overweight (Target 4) by 2025'.
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Affiliation(s)
- Vani Sethi
- UNICEF-Regional Office for South Asia, Kathmandu, Nepal
| | - Shalini Bassi
- Health Promotion Division, Public Health Foundation of India (PHFI), New Delhi, India
| | - Deepika Bahl
- Health Promotion Division, Public Health Foundation of India (PHFI), New Delhi, India
| | | | | | - Neena Bhatia
- Department of Food & Nutrition, Lady Irwin College, University of Delhi, New Delhi, India
| | | | - William Joe
- Institute of Economic Growth, New Delhi, India
| | - Monika Arora
- Health Promotion Division, Public Health Foundation of India (PHFI), New Delhi, India
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Gürtler N, Honegger F. Eustachian Tube Balloon Dilation in Children: Short- and Long-Term Outcome. Ann Otol Rhinol Laryngol 2024; 133:369-374. [PMID: 38197378 PMCID: PMC10898197 DOI: 10.1177/00034894231221888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
OBJECTIVE Eustachian Tube Balloon Dilation (ETBD) represents an innovative therapeutic approach for chronic Eustachian tube dysfunction (CETD), a common disease in children. Some evidence of a benefit of ETBD in the adults exist in contrast to sparse reports in children. The objective was to analyze short- and long-term outcome of ETBD in children with CETD. METHODS A retrospective chart-review was performed in a cohort of 19 children (mean age 13 years, 7-17) who underwent ETBD. The following parameters were analyzed: tubomanometry (R-value), tympanogram, hearing (CPT-AMA, Air-bone gap [ABG]), Eustachian Tube Score (ETS and ETS-7), and Eustachian Tube Disease questionnaire (ETDQ). RESULTS Twenty-four ears were dilated (in 5 patients subsequently after successful first intervention) and grouped as A (17) without and B (7) with additional T-tube insertion. Most children suffered from either chronic otitis media with effusion or chronic perforation (12, 63%), the remainder comprising recurrent otitis media, adhesive otitis media and CETD with barotrauma. Mean duration of symptoms were 7/8.2 years and mean follow-up 13.7/11.1 months. Eighty percent of patients reported a subjective benefit. Accordingly, the R-value, ETS, and ETS-7 were significantly (P < .05) improved. Tympanometry, CPT-AMA and ABG showed a positive trend, but the result was not significant. Tympanic retraction remained largely the same; a spontaneous closure of a chronic tympanic perforation was seen in 1 of 3 cases. CONCLUSIONS The high subjective benefit and some significant objective improvement warrants further analysis of ETBD as part of the therapeutic management in pediatric CETD.
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Affiliation(s)
- Nicolas Gürtler
- Hals-Nasen-Ohren-Universitätsklinik, University Hospital Basel, University of Basel, Basel, Switzerland
- Hals-Nasen-Ohren-Klinik, University Children’s Hospital Basel, Basel, Switzerland
| | - Flurin Honegger
- Hals-Nasen-Ohren-Universitätsklinik, University Hospital Basel, University of Basel, Basel, Switzerland
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Wolf LJ, Costin V, Iosifyan M, Thorne SR, Nolan A, Foad C, Webb E, Karremans J, Haddock G, Maio GR. Attitudes toward children: Distinguishing affection and stress. J Pers 2024; 92:601-619. [PMID: 37269146 DOI: 10.1111/jopy.12854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/31/2023] [Accepted: 05/21/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Adults' views and behaviors toward children can vary from being supportive to shockingly abusive, and there are significant unanswered questions about the psychological factors underpinning this variability. OBJECTIVE The present research examined the content of adults' attitudes toward children to address these questions. METHOD Ten studies (N = 4702) identified the factor structure of adults' descriptions of babies, toddlers, and school-age children and examined how the resulting factors related to a range of external variables. RESULTS Two factors emerged-affection toward children and stress elicited by them-and this factor structure was invariant across the United Kingdom, the United States, and South Africa. Affection uniquely captures emotional approach tendencies, concern for others, and broad positivity in evaluations, experiences, motivations, and donation behavior. Stress relates to emotional instability, emotional avoidance, and concern about disruptions to a self-oriented, structured life. The factors also predict distinct experiences in a challenging situation-home-parenting during COVID-19 lockdown-with affection explaining greater enjoyment and stress explaining greater perceived difficulty. Affection further predicts mentally visualizing children as pleasant and confident, whereas stress predicts mentally visualizing children as less innocent. CONCLUSIONS These findings offer fundamental new insights about social cognitive processes in adults that impact adult-child relationships and children's well-being.
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Affiliation(s)
- Lukas J Wolf
- Department of Psychology, University of Bath, Bath, UK
| | - Vlad Costin
- School of Psychology, Cardiff University, Cardiff, UK
- School of Psychology, University of Sussex, Falmer, UK
| | - Marina Iosifyan
- Department of Psychology, University of Bath, Bath, UK
- School of Psychology, University of St Andrews, St Andrews, UK
| | | | | | - Colin Foad
- School of Psychology, Cardiff University, Cardiff, UK
| | - Elspeth Webb
- School of Psychology, Cardiff University, Cardiff, UK
| | - Johan Karremans
- Department of Psychology, Radboud University, Nijmegen, Netherlands
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Spivack OK, Dellenmark-Blom M, Dingemann J, ten Kate CA, Wallace V, Bramer WM, Quitmann JH, Rietman A. A Narrative Review of Patient-Reported Outcome Measures and Their Application in Recent Pediatric Surgical Research: Advancing Knowledge and Offering New Perspectives to the Field. Eur J Pediatr Surg 2024; 34:143-161. [PMID: 38272041 PMCID: PMC10920019 DOI: 10.1055/s-0043-1778108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 01/27/2024]
Abstract
INTRODUCTION Patient-reported outcome measures (PROMs) can be employed in both research and clinical care to enhance our understanding of outcomes that matter to patients. This narrative review aims to describe PROM use in recent pediatric surgical research, identify and describe psychometrically robust PROMs, providing an overview of those derived from pediatric patient input, and make recommendations for future research. MATERIALS AND METHODS A search was conducted to identify articles published from 2021 to August 2023 describing the availability and/or use of at least one valid or reliable PROM in children with conditions including anorectal malformations, biliary atresia, congenital diaphragmatic hernia, duodenal atresia, esophageal atresia, abdominal wall defects, Hirschsprung's disease, sacrococcygeal teratoma, and short bowel syndrome. Articles were categorized based on their objectives in applying PROMs. Psychometrically robust PROMs were identified and described. RESULTS Out of the 345 articles identified, 49 met the inclusion criteria. Seventeen focused on esophageal atresia and 14 on Hirschsprung's disease. Twenty-nine PROMs were identified, with 12 deemed psychometrically robust. Seven psychometrically robust PROMs were developed using patient input in the primary item generation. Most PROMs were applied to advance understanding of conditions and/or treatment and fewer were developed or psychometrically evaluated. No PROMs were assessed for their impact or incorporated into an implementation study. CONCLUSIONS This review reveals gaps in the application of PROMs in recent pediatric surgical research. Emphasis should be placed on the development and utilization of psychometrically robust PROMs, broadening the scope of covered diseases, conducting impact assessments, and evaluating implementation strategies.
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Affiliation(s)
- Olivia K.C. Spivack
- Department of Pediatric Surgery, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
- Quality of Life working group, European Reference Network for rare Inherited Congenital Anomalies (ERNICA)
| | - Michaela Dellenmark-Blom
- Quality of Life working group, European Reference Network for rare Inherited Congenital Anomalies (ERNICA)
- Department of Pediatrics, University of Gothenburg Institute of Clinical Sciences, Gothenburg, Sweden
- Department of Pediatric Surgery, Sahlgrenska University Hospital Queen Silvia Children's Hospital, Gothenburg, Sweden
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Jens Dingemann
- Quality of Life working group, European Reference Network for rare Inherited Congenital Anomalies (ERNICA)
- Department of Pediatric Surgery, Hannover Medical School, Hannover, Niedersachsen, Germany
| | - Chantal A. ten Kate
- Department of Pediatric Surgery, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Vuokko Wallace
- Quality of Life working group, European Reference Network for rare Inherited Congenital Anomalies (ERNICA)
- EAT (Esophageal Atresia Global Support Groups), Stuttgart, Germany
- Department of Psychology, University of Bath, Bath, United Kingdom
| | - Wichor M. Bramer
- Medical Library, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Julia H. Quitmann
- Quality of Life working group, European Reference Network for rare Inherited Congenital Anomalies (ERNICA)
- Faculty of Business and Social Sciences, Hamburg University of Applied Sciences (HAW Hamburg), Hamburg, Germany
| | - Andre Rietman
- Department of Pediatric Surgery, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
- Quality of Life working group, European Reference Network for rare Inherited Congenital Anomalies (ERNICA)
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
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Stefanachi F, Affinita MC, Fichera G, Tagarelli A, De Corti F, Rea F, Bisogno G. Mediastinal Germ-cell Tumors Relapse in a Male With Klinefelter Syndrome. Is Longer Surveillance Needed? J Pediatr Hematol Oncol 2024; 46:e248-e250. [PMID: 38446472 PMCID: PMC10956653 DOI: 10.1097/mph.0000000000002837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/19/2024] [Indexed: 03/07/2024]
Abstract
Germ cell tumors (GCTs) are a heterogeneous group of pediatric cancers. In up to one-third of male patients, a primary mediastinal location is associated with the presence of Klinefelter syndrome (KS). We describe a case of mediastinal GCT in a patient, with unacknowledged KS, that presented a relapse 7 years from diagnosis, that is, 2 years after the end of the follow-up program usually recommended for patients with GCT. There are no recommendations for screening for KS in patients with mediastinal GCT and there are no specific guidelines for surveillance of GCT in KS patients. Our experience suggests that KS should be suspected in patients with mediastinal GCT, and a longer follow-up plan should be implemented when GCT occurs in patients with KS.
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Affiliation(s)
| | | | | | - Arianna Tagarelli
- Department of Woman’s and Children’s Health, Hematology and Oncology Unit
| | - Federica De Corti
- Department for the Health of Woman and Child, Pediatric Surgery Division
| | - Federico Rea
- Thoracic Surgery Unit, Department of Cardiologic, Thoracic and Vascular Sciences, University Hospital of Padova, Padova, Italy
| | - Gianni Bisogno
- Department of Woman’s and Children’s Health, Hematology and Oncology Unit
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Uban KA, Jonker D, Donald KA, Bodison SC, Brooks SJ, Kan E, Steigelmann B, Roos A, Marshall A, Adise S, Butler-Kruger L, Melly B, Narr KL, Joshi SH, Odendaal HJ, Sowell ER, Stein DJ. Associations between community-level patterns of prenatal alcohol and tobacco exposure on brain structure in a non-clinical sample of 6-year-old children: a South African pilot study. Acta Neuropsychiatr 2024; 36:87-96. [PMID: 36700449 PMCID: PMC10368794 DOI: 10.1017/neu.2022.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The current small study utilised prospective data collection of patterns of prenatal alcohol and tobacco exposure (PAE and PTE) to examine associations with structural brain outcomes in 6-year-olds and served as a pilot to determine the value of prospective data describing community-level patterns of PAE and PTE in a non-clinical sample of children. Participants from the Safe Passage Study in pregnancy were approached when their child was ∼6 years old and completed structural brain magnetic resonance imaging to examine with archived PAE and PTE data (n = 51 children-mother dyads). Linear regression was used to conduct whole-brain structural analyses, with false-discovery rate (FDR) correction, to examine: (a) main effects of PAE, PTE and their interaction; and (b) predictive potential of data that reflect patterns of PAE and PTE (e.g. quantity, frequency and timing (QFT)). Associations between PAE, PTE and their interaction with brain structural measures demonstrated unique profiles of cortical and subcortical alterations that were distinct between PAE only, PTE only and their interactive effects. Analyses examining associations between patterns of PAE and PTE (e.g. QFT) were able to significantly detect brain alterations (that survived FDR correction) in this small non-clinical sample of children. These findings support the hypothesis that considering QFT and co-exposures is important for identifying brain alterations following PAE and/or PTE in a small group of young children. Current results demonstrate that teratogenic outcomes on brain structure differ as a function PAE, PTE or their co-exposures, as well as the pattern (QFT) or exposure.
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Affiliation(s)
- Kristina A Uban
- Public Health, University of California, Irvine, CA, USA
- Center for Neurobiology of Learning and Memory
| | - Deborah Jonker
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Kirsten A Donald
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Stefanie C Bodison
- Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | | | - Eric Kan
- Department of Pediatrics, Keck School of Medicine, Children's Hospital Los Angeles, University of Southern California, Los Angeles, CA, USA
| | | | - Annerine Roos
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Andrew Marshall
- Department of Pediatrics, Keck School of Medicine, Children's Hospital Los Angeles, University of Southern California, Los Angeles, CA, USA
| | - Shana Adise
- Department of Pediatrics, Keck School of Medicine, Children's Hospital Los Angeles, University of Southern California, Los Angeles, CA, USA
| | - Letitia Butler-Kruger
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Brigitte Melly
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Katherine L Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Shantanu H Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Bioengineering, University of California, Los Angeles, CA, USA
| | - Hein J Odendaal
- Department of Obstetrics and Gynaecology, Stellenbosch University, Cape Town, South Africa
| | - Elizabeth R Sowell
- Department of Pediatrics, Keck School of Medicine, Children's Hospital Los Angeles, University of Southern California, Los Angeles, CA, USA
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council (SAMRC), Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa
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Kalinina II, Antonova KS, Avdonin PV, Klebanova EE, Kotskaya NN, Kurnikova EE, Shutova AD, Matveev VE, Maschan AA. Successful Treatment of Acquired Thrombotic Thrombocytopenic Purpura With Caplacizumab Combined With Plasma Exchanges and Immune Suppression in 3 Children. J Pediatr Hematol Oncol 2024; 46:e220-e222. [PMID: 38447071 PMCID: PMC10956674 DOI: 10.1097/mph.0000000000002843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/29/2024] [Indexed: 03/08/2024]
Abstract
Acquired thrombotic thrombocytopenic (aTTP) purpura is a life-threatening condition that can lead to devastating thromboembolic events. Recently, caplacizumab has been shown to rapidly restore platelet numbers and reduce the risk of severe end-organ damage when added to plasma exchanges (PEXs) and immunosuppression (IST). Here, we report the outcomes in 3 children with aTTP who were treated with caplacizumab in combination with PEXs and IST. In all 3 patients, platelet count increased to >15,000/mm 3 in 24 h and normalized on day 4, whereas normalization of ADAMTS13 activity >50% and elimination of the inhibitor was achieved after 18 to 89 days. Epistaxis was observed in 2 patients and was the only side effect related to caplacizumab. Caplacizumab is a promising agent for first-line treatment of children with aTTP.
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Affiliation(s)
- Irina I. Kalinina
- Department of General Hematology, Dmitri Rogachev National Research Center for Pediatric Hematology, Oncology and Immunology
| | - Khristina S. Antonova
- Department of General Hematology, Dmitri Rogachev National Research Center for Pediatric Hematology, Oncology and Immunology
| | - Pavel V. Avdonin
- Laboratory of the Physiology of Receptors and Signal Pathways, N.K. Koltsov Institute of Developmental Biology
| | - Elizaveta E. Klebanova
- Express-Laboratory of ICU, National Research Center for Hematology, Moscow, Russian Federation
| | - Natalia N. Kotskaya
- Department of General Hematology, Dmitri Rogachev National Research Center for Pediatric Hematology, Oncology and Immunology
| | - Elena E. Kurnikova
- Department of Blood Transfusion, Dmitri Rogachev National Research Center for Pediatric Hematology, Oncology and Immunology
| | - Alexandra D. Shutova
- Department of General Hematology, Dmitri Rogachev National Research Center for Pediatric Hematology, Oncology and Immunology
| | - Victor E. Matveev
- Department of General Hematology, Dmitri Rogachev National Research Center for Pediatric Hematology, Oncology and Immunology
| | - Alexey A. Maschan
- Department of General Hematology, Dmitri Rogachev National Research Center for Pediatric Hematology, Oncology and Immunology
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Coventry A, Sikorskii A, Zalwango SK, Familiar-Lopez I, Cardino VN, Giordani B, Ezeamama AE. In utero/peripartum antiretroviral therapy exposure and mental health outcomes at 8-18 years old: A longitudinal comparative study of children with perinatally acquired HIV, children perinatally HIV exposed but uninfected, and children unexposed uninfected from Uganda. Res Nurs Health 2024; 47:195-207. [PMID: 38031814 DOI: 10.1002/nur.22359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/28/2023] [Accepted: 11/19/2023] [Indexed: 12/01/2023]
Abstract
In utero/peripartum antiretroviral therapy (IPA) exposure type was examined in relationship to mental health symptoms among 577 children with perinatally acquired HIV (CPHIV), children perinatally HIV exposed but uninfected (CHEU), and children HIV unexposed uninfected (CHUU). IPA exposure was categorized for CPHIV and CHEU as none, single-dose nevirapine with or without zidovudine (sdNVP±AZT), sdNVP+AZT+lamivudine (3TC), or combination antiretroviral therapy (cART). Anxiety and depressive symptoms were reported at baseline, 6-, and 12-month follow-up per behavioral assessment system for children. Multivariable linear mixed models were used to estimate differences (b) with 95% confidence intervals (95% CI) for IPA exposure types versus CHEU without IPA exposure. Depressive and anxiety symptoms were lower in CHUU relative to CHEU and CPHIV but did not differ between CPHIV and CHEU. CHEU with sdNVP±AZT exposure had greater anxiety (b = 0.51, 95% CI: [0.06, 0.96]) and depressive symptoms (b = 0.48, 95% CI: [0.07, 0.89]) than CHEU without IPA exposure. CHEU with sdNVP+AZT+3TC exposure had higher anxiety (b = 0.0.45, 95% CI: [0.03, 0.86]) and depressive symptoms (b = 0.72, 95% CI: [0.27, 1.17]) versus CHEU without IPA exposure. Depressive and anxiety symptoms were not different for CHEU and CPHIV exposed to cART (b = 0.12-0.60, 95% CI: [-0.41, 1.30]) and CHEU and CHUU (b = -0.04 to 0.08, 95% CI: [-0.24, 0.29]) without IPA exposure. Among CHEU, peripartum sdNVP±AZT and sdNVP+AZT+3TC but not cART compared to no IPA exposure was associated with clinically important elevations in anxiety and depressive symptoms. Monitoring of mental health trajectory of HIV-affected children considering IPA is needed to inform mental health interventions. Patient Contribution: Caregivers and their dependents provided consent for participation and collaborated with study team to identify mutually convenient times for protocol implementation.
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Affiliation(s)
- Audrey Coventry
- Department of Psychiatry, University of Washington, Seattle, Washington, USA
| | - Alla Sikorskii
- Department of Psychiatry, Michigan State University, East Lansing, Michigan, USA
| | - Sarah K Zalwango
- Public Health and Environment, Kampala Capital City Authority, Kampala, Uganda
| | | | - Vanessa N Cardino
- Department of Psychiatry, Michigan State University, East Lansing, Michigan, USA
| | - Bruno Giordani
- Departments of Psychiatry, Neurology, Psychology, and School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Amara E Ezeamama
- Department of Psychiatry, Michigan State University, East Lansing, Michigan, USA
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49
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Dahlawi N, Milnes L, Swallow V. Children's behavioural and emotional reactions towards living with congenital heart disease in Saudi Arabia: A grounded theory study. Health Expect 2024; 27:e13959. [PMID: 38411365 PMCID: PMC10897868 DOI: 10.1111/hex.13959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 12/16/2023] [Accepted: 12/18/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND A high incidence of children with congenital heart disease (CHD) was found in Saudi Arabia (SA). International literature reports that children with CHD exhibit behavioural and emotional issues due to experiencing hospitalisation and clinical treatments combined with a dearth of qualitative understanding of the experiences of younger children with CHD. Therefore, the aim was to explore the behaviour and emotions of 4-10-year-olds with CHD in SA through children's accounts of their own experiences and parental proxy reports of children's behaviour and emotions. METHODS Charmaz's constructivist grounded theory (GT) approach was used. Twenty single semi-structured interviews of 10 child/parent dyads were undertaken at a hospital clinic in SA. Children's interviews were combined with an arts-based approach using drawings, pictures and faces of emotions (emojis). Constant comparison analysis was undertaken. Consolidated Criteria for Reporting Qualitative Research guidelines was followed in reporting this study. FINDINGS A substantive GT: children's behavioural and emotional reactions towards stressors related to living with CHD was developed and provides new insights into children's and parents' perceptions of the children's behavioural and emotional reactions to living with CHD in SA. The theory proposes that children's reactions to living with CHD relate to medical treatment stressors, sociocultural stressors and physical change stressors. Several further factors influenced children's responses to these stressors. CONCLUSION Children and parents in SA contributed to a new understanding of the relationship between CHD and children's behavioural and emotional reactions. In addition, findings support the need for early assessment of behaviour and emotions among children with CHD and the application of preventative and supportive measures for the children and their families in SA. PATIENT OR PUBLIC CONTRIBUTION Before the research commenced, the developmental appropriateness of the proposed arts-based data collection tools was tested with three healthy children aged 6-9 years old; the tools were then revised accordingly before the interviews were undertaken.
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Affiliation(s)
- Nada Dahlawi
- Nursing Faculty, King Abdulaziz University, Jeddah, Saudi Arabia
- School of Healthcare, University of Leeds, Leeds, UK
| | - Linda Milnes
- School of Healthcare, University of Leeds, Leeds, UK
| | - Veronica Swallow
- Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield, UK
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Bakkaloğlu SA, Büyükkaragöz B, Pınarbaşı AS, Leventoğlu E, Saygılı S, Çomak E, Yıldırım ZY, Akıncı N, Dursun İ, Karabay Bayazıt A, Kavaz Tufan A, Akman S, Yılmaz A, Noyan A, Ağbaş A, Serdaroğlu E, Delibaş A, Elmacı AM, Taşdemir M, Ezgü FS, Sever L. Comprehensive evaluation of patients with primary hyperoxaluria type 1: A nationwide study. Nephrology (Carlton) 2024; 29:201-213. [PMID: 38290500 DOI: 10.1111/nep.14273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/10/2024] [Accepted: 01/14/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Primary hyperoxaluria type 1 (PH1) is characterized by increased endogenous oxalate production and deposition as calcium oxalate crystals. The main manifestations are nephrocalcinosis/nephrolithiasis, causing impaired kidney function. We aimed to evaluate the clinical characteristics and overall outcomes of paediatric PH1 patients in Turkey. METHODS This is a nationwide, multicentre, retrospective study evaluating all available paediatric PH1 patients from 15 different paediatric nephrology centres in Turkey. Detailed patient data was collected which included demographic, clinical and laboratory features. Patients were classified according to their age and characteristics at presentation: patients presenting in the first year of life with nephrocalcinosis/nephrolithiasis (infantile oxalosis, Group 1), cases with recurrent nephrolithiasis diagnosed during childhood (childhood-onset PH1, Group 2), and asymptomatic children diagnosed with family screening (Group 3). RESULTS Forty-eight patients had a mutation consistent with PH1. The most common mutation was c.971_972delTG (25%). Infantile oxalosis patients had more advanced chronic kidney disease (CKD) or kidney failure necessitating dialysis (76.9% vs. 45.5%). These patients had much worse clinical course and mortality rates seemed to be higher (23.1% vs. 13.6%). Patients with fatal outcomes were the ones with significant comorbidities, especially with cardiovascular involvement. Patients in Group 3 were followed with better outcomes, with no kidney failure or mortality. CONCLUSION PH1 is not an isolated kidney disease but a systemic disease. Family screening helps to preserve kidney function and prevent systemic complications. Despite all efforts made with traditional treatment methods including transplantation, our results show devastating outcomes or mortality.
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Affiliation(s)
| | | | - Ayşe Seda Pınarbaşı
- Diyarbakır Children's Hospital, Pediatric Nephrology Unit, Diyarbakır, Turkey
| | - Emre Leventoğlu
- Department of Pediatric Nephrology, Gazi University, Ankara, Turkey
| | - Seha Saygılı
- Cerrahpaşa Faculty of Medicine, Department of Pediatric Nephrology, İstanbul University, İstanbul, Turkey
| | - Elif Çomak
- Department of Pediatric Nephrology, Akdeniz University, Antalya, Turkey
| | - Zeynep Y Yıldırım
- İstanbul Faculty of Medicine, Department of Pediatric Nephrology, Istanbul University, İstanbul, Turkey
| | - Nurver Akıncı
- Department of Pediatric Nephrology, Şişli Etfal Research and Training Hospital, İstanbul, Turkey
| | - İsmail Dursun
- Department of Pediatric Nephrology, Erciyes University, Kayseri, Turkey
| | | | - Aslı Kavaz Tufan
- Department of Pediatric Nephrology, Osmangazi University, Eskişehir, Turkey
| | - Sema Akman
- Department of Pediatric Nephrology, Akdeniz University, Antalya, Turkey
| | - Alev Yılmaz
- İstanbul Faculty of Medicine, Department of Pediatric Nephrology, Istanbul University, İstanbul, Turkey
| | - Aytül Noyan
- Adana Hospital, Department of Pediatric Nephrology, Başkent University, Adana, Turkey
| | - Ayşe Ağbaş
- Department of Pediatric Nephrology, Haseki Research and Training Hospital, İstanbul, Turkey
| | - Erkin Serdaroğlu
- Department of Pediatric Nephrology, Dr. Behçet Uz Children Hospital, İzmir, Turkey
| | - Ali Delibaş
- Department of Pediatric Nephrology, Mersin University, Mersin, Turkey
| | - Ahmet Midhat Elmacı
- Pediatric Nephrology Unit, Konya Maternal and Children Hospital, Konya, Turkey
| | - Mehmet Taşdemir
- Department of Pediatric Nephrology, İstinye University, İstanbul, Turkey
| | - Fatih S Ezgü
- Department of Pediatric Inborn Metabolic Disorders, Gazi University, Ankara, Turkey
- Department of Pediatric Genetic Disorders, Gazi University, Ankara, Turkey
| | - Lale Sever
- Cerrahpaşa Faculty of Medicine, Department of Pediatric Nephrology, İstanbul University, İstanbul, Turkey
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