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Revista Gaucha de Enfermagem 2021To identify in the scientific literature the clinical overview of the pediatric population that tested positive for SARS-CoV-2 and care recommendations and... (Review)
Review
OBJECTIVE
To identify in the scientific literature the clinical overview of the pediatric population that tested positive for SARS-CoV-2 and care recommendations and recommendations among children who tested positive for SARS-CoV-2 in the scientific literature.
METHOD
Rapid review based on the guidelines of the Joana Briggs Institute: elaboration of the research question, structured search of the literature in April 2020, in nine databases, selection and critical analysis of the eighteen primary studies (using two instruments to assess methodological quality), elaboration of the synthesis, incorporation of suggestions and dissemination.
RESULT
The most frequent clinical overview was respiratory, gastrointestinal symptoms and fever. The images showed irregular frosted glass opacification. It is recommended to screen the pediatric population and family members who show signs and symptoms and to adopt isolation for more than fourteen days.
CONCLUSION
The clinical overview in pediatric population is varied, not exclusively with respiratory symptoms, and a significant number of asymptomatic patients. The importance of new investigations is highlighted, such as randomized clinical trial or cohort studies, identifying their participation in the transmission of COVID-19.
Topics: COVID-19; Child; Fever; Humans; Pediatrics; Respiratory Tract Diseases; SARS-CoV-2; Symptom Assessment
PubMed: 34524352
DOI: 10.1590/1983-1447.2021.20200162 -
Canadian Family Physician Medecin de... Aug 2020If a child presents to my office with several days of fever and a few features of Kawasaki disease (KD) but does not meet the diagnostic criteria, could they still have...
If a child presents to my office with several days of fever and a few features of Kawasaki disease (KD) but does not meet the diagnostic criteria, could they still have KD and is treatment needed? Presentations of KD have a range of clinical signs and symptoms. With the lack of a criterion standard test, the diagnosis of KD relies on syndrome recognition and a high index of suspicion in cases where KD does not present classically. It is still possible to have KD even if not all of the criteria are met, and these children are referred to as having incomplete forms of KD. The diagnosis of incomplete KD is usually made in a child or infant who presents with a history of prolonged fever, a few clinical criteria for KD, and other supportive features such as positive laboratory or echocardiographic findings. It is important to recognize children with incomplete forms of KD to avoid poor outcomes such as coronary artery aneurysms.
Topics: Child; Coronary Aneurysm; Echocardiography; Fever; Humans; Infant; Mucocutaneous Lymph Node Syndrome
PubMed: 32817030
DOI: No ID Found -
Medicine and Science in Sports and... Oct 2022Childhood obesity is a global health concern, with >340 million youth considered overweight or obese. In addition to contributing greatly to health care costs, excess...
PURPOSE
Childhood obesity is a global health concern, with >340 million youth considered overweight or obese. In addition to contributing greatly to health care costs, excess adiposity associated with obesity is considered a major risk factor for premature mortality from cardiovascular and metabolic diseases and is also negatively associated with cognitive and brain health. A complementary line of research highlights the importance of cardiorespiratory fitness, a by-product of engaging in physical activity, on an abundance of health factors, including cognitive and brain health.
METHODS
This study investigated the relationship among excess adiposity (visceral adipose tissue [VAT], subcutaneous abdominal adipose tissue), total abdominal adipose tissue, whole-body percent fat [WB%FAT], body mass index (BMI), and fat-free cardiorespiratory fitness (FF-V̇O 2max ) on resting-state functional connectivity (RSFC) in 121 ( f = 68) children (7-11 yr) using a data-driven whole-brain multivoxel pattern analysis.
RESULTS
Multivoxel pattern analysis revealed brain regions that were significantly associated with VAT, BMI, WB%FAT, and FF-V̇O 2 measures. Yeo's (2011) RSFC-based seven-network cerebral cortical parcellation was used for labeling the results . Post hoc seed-to-voxel analyses found robust negative correlations of VAT and BMI with areas involved in the visual, somatosensory, dorsal attention, ventral attention, limbic, frontoparietal, and default mode networks. Further, positive correlations of FF-V̇O 2 were observed with areas involved in the ventral attention and frontoparietal networks. These novel findings indicate that negative health factors in childhood may be selectively and negatively associated with the 7 Yeo-defined functional networks, yet positive health factors (FF-V̇O 2 ) may be positively associated with these networks.
CONCLUSIONS
These novel results extend the current literature to suggest that BMI and adiposity are negatively associated with, and cardiorespiratory fitness (corrected for fat-free mass) is positively associated with, RSFC networks in children.
Topics: Adiposity; Adolescent; Body Mass Index; Child; Exercise; Humans; Intra-Abdominal Fat; Overweight; Pediatric Obesity
PubMed: 35763600
DOI: 10.1249/MSS.0000000000002964 -
Journal of the American Board of Family... 2017(BP) is a common cause of prolonged cough. Our objective was to perform an updated systematic review of the clinical diagnosis of BP without restriction by patient age. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
(BP) is a common cause of prolonged cough. Our objective was to perform an updated systematic review of the clinical diagnosis of BP without restriction by patient age.
METHODS
We identified prospective cohort studies of patients with cough or suspected pertussis and assessed study quality using QUADAS-2. We performed bivariate meta-analysis to calculate summary estimates of accuracy and created summary receiver operating characteristic curves to explore heterogeneity by vaccination status and age.
RESULTS
Of 381 studies initially identified, 22 met our inclusion criteria, of which 14 had a low risk of bias. The overall clinical impression was the most accurate predictor of BP (positive likelihood ratio [LR+], 3.3; negative likelihood ratio [LR-], 0.63). The presence of whooping cough (LR+, 2.1) and posttussive vomiting (LR+, 1.7) somewhat increased the likelihood of BP, whereas the absence of paroxysmal cough (LR-, 0.58) and the absence of sputum (LR-, 0.63) decreased it. Whooping cough and posttussive vomiting have lower sensitivity in adults. Clinical criteria defined by the Centers for Disease Control and Prevention were sensitive (0.90) but nonspecific. Typical signs and symptoms of BP may be more sensitive but less specific in vaccinated patients.
CONCLUSIONS
The clinician's overall impression was the most accurate way to determine the likelihood of BP infection when a patient initially presented. Clinical decision rules that combine signs, symptoms, and point-of-care tests have not yet been developed or validated.
Topics: Age Factors; Clinical Decision-Making; Cough; Humans; Sensitivity and Specificity; Vomiting; Whooping Cough
PubMed: 28484063
DOI: 10.3122/jabfm.2017.03.160330 -
Minerva Anestesiologica May 2004The International Association for the Study of Pain (IASP) defines neuropathic pain as being caused by a lesion or dysfunction of the nervous system. Characteristics... (Review)
Review
The International Association for the Study of Pain (IASP) defines neuropathic pain as being caused by a lesion or dysfunction of the nervous system. Characteristics that would define neuropathic pain and differentiate it from other types of pain include: pain and sensory symptoms that persist beyond the healing period; presence, in variable degree, of neurological sensory signs manifesting as negative and positive sensory phenomena; presence, in variable degree, of other neurological signs, including motor, manifesting as negative and positive motor phenomena or autonomic signs. Many of the conditions causing neuropathic pain in adults are rare in children, but some forms of neuropathic pain do affect children and adolescents as complex regional pain syndrome or phantom limb pain. Treatment strategies that have demonstrated to be efficacious in adults have been extrapolated to be used in children, including medications, nerve blocks, physical therapy, and behavioral medicine. A multidisciplinary program that combines all of these approaches provides the best chance of relief.
Topics: Child; Humans; Nervous System Diseases; Pain; Pain Management
PubMed: 15181421
DOI: No ID Found -
Seizure Oct 2012Tongue biting (TB) may occur both in epileptic seizures and in syncope. A comprehensive search of the literature to determine the accuracy of this physical finding and... (Review)
Review
BACKGROUND
Tongue biting (TB) may occur both in epileptic seizures and in syncope. A comprehensive search of the literature to determine the accuracy of this physical finding and its prevalence in epileptic seizures and syncope is still lacking.
AIMS
To undertake a systematic review and a meta-analysis of studies evaluating the prevalence of TB in patients with epileptic seizures and syncope, and to determine sensitivity, specificity and likelihood ratios (LR) of this physical finding.
METHOD
Studies comparing the prevalence of TB in epileptic seizures and syncope were systematically searched. Prevalence of TB was analyzed calculating odds ratio (OR) with 95% confidence intervals (CIs). Sensitivity, specificity, positive and negative likelihood ratio (pLR, nLR) of TB were determined for each study and for the pooled results.
RESULTS
Two studies (75 epilepsy patients and 98 subjects with syncope) were included. There was a significantly higher prevalence of TB in patients with epileptic seizures (OR 12.26; 95% CI 3.99-37.69). Pooled accuracy measures of TB for the diagnosis of epileptic seizures were: sensitivity 33%, specificity 96%, pLR 8.167 (95% CI 2.969-22.461) and nLR 0.695 (95% CI 0.589-0.82).
CONCLUSIONS
A pooled analysis of data from the literature shows that TB has great value in the differential diagnosis between epileptic seizures and syncope. Given a certain pre-test probability of seizures, the presence of TB greatly increases the chance that the patient had an epileptic seizure. Systematic reviews with pooled analyses (meta-analyses) of data from the literature allow an increase in statistical power and an improvement in precision, representing a useful tool to determine the accuracy of a certain physical finding in the differential diagnosis between seizures and other paroxysmal events.
Topics: Diagnosis, Differential; Epilepsy; Humans; Syncope; Tongue
PubMed: 22770819
DOI: 10.1016/j.seizure.2012.06.005 -
The Israel Medical Association Journal... Nov 2020While the routine performance of terminal ileum (TI) intubation during colonoscopy procedures is perceived to have a low yield, its utility during colonoscopies...
BACKGROUND
While the routine performance of terminal ileum (TI) intubation during colonoscopy procedures is perceived to have a low yield, its utility during colonoscopies performed for specific indications have not been well studied.
OBJECTIVES
To assess the diagnostic yield of an indication-based ileoscopy in real-life practice.
METHODS
The authors reviewed endoscopic reports of patients who underwent colonoscopies over an 8-year period (2011-2018) and had routine ileoscopy during these procedures. Demographic data, indications for colonoscopy, and endoscopic findings were documented. Diagnostic yield and odds ratio for TI findings were calculated.
RESULTS
Over 30,000 colonoscopy reports performed during the study period were reviewed. Ilesocopy was performed in 1800 patients, 216 patients had findings in the TI (ileitis or ulcers). TI findings were more prevalent in younger ages (38.3 ± 17.6 vs. 43.6 ± 20, P < 0.05). The greatest yield of ileoscopy was evident when performed for the evaluation of chronic abdominal pain and diarrhea (14.4% vs. 9.3%, odds ratio [OR] 1.62, P < 0.05). Positive fecal occult blood test (FOBT) (OR 0.1, 95% confidence interval [95%CI] 0.02-0.5, P = 0.005) and constipation (OR 0.44, 95%CI 0.2-0.9, P = 0.04) were negatively associated with TI findings.
CONCLUSIONS
Ileoscopy may have the greatest utility in evaluating suspected inflammatory bowel disease (IBD) patients, but may not add value to the evaluation of constipation and positive FOBT.
Topics: Abdominal Pain; Adult; Colonoscopy; Constipation; Diarrhea; Endoscopy, Gastrointestinal; Female; Humans; Ileal Diseases; Ileum; Inflammatory Bowel Diseases; Male; Middle Aged; Occult Blood; Retrospective Studies; Young Adult
PubMed: 33249788
DOI: No ID Found -
Hospital Pediatrics Sep 2020To determine the time to positivity for bacterial pathogens and contaminants in blood and cerebrospinal fluid (CSF) cultures in a cohort of febrile infants ≤60 days of... (Observational Study)
Observational Study
OBJECTIVES
To determine the time to positivity for bacterial pathogens and contaminants in blood and cerebrospinal fluid (CSF) cultures in a cohort of febrile infants ≤60 days of age.
METHODS
This was a secondary analysis of prospective observational multicenter study of noncritically ill infants ≤60 days of age with temperatures ≥38°C and blood cultures (December 2008 to May 2013). The main outcome was time to positivity for bacterial pathogens and contaminants.
RESULTS
A total of 256 of 303 (84.49%) patients with positive blood cultures, and 73 of 88 (82.95%) with positive CSF cultures met inclusion criteria. Median time (interquartile range [IQR]) to positivity for blood cultures was 16.6 hours (IQR 12.6-21.9) for bacterial pathogens ( = 74) and 25.1 hours (IQR 19.8-33.0) for contaminants ( = 182); < .001. Time to bacterial pathogen positivity was similar in infants 0 to 28 days of age (15.8 hours [IQR 12.6-21.0]) and 29 to 60 days of age (17.2 [IQR 12.9-24.3]; = .328). Median time to positivity for CSF was 14.0 hours (IQR 1.5-21.0) for bacterial pathogens ( = 22) and 40.5 hours (IQR 21.2-62.6) for contaminants ( = 51); < .001. A total of 82.4% (95% confidence interval, 71.8-90.3) and 81.8% (95% confidence interval, 59.7%-94.8%) of blood and CSF cultures showed bacterial pathogen positivity within 24 hours.
CONCLUSIONS
Among febrile infants ≤60 days of age, time to blood and CSF positivity was significantly shorter for bacterial pathogens than contaminants. Most blood and CSF cultures for bacterial pathogens were positive within 24 hours. With our findings, there is potential to reduce duration of hospitalization and avoid unnecessary antibiotics.
Topics: Anti-Bacterial Agents; Blood Culture; Cohort Studies; Fever; Humans; Infant; Retrospective Studies
PubMed: 32868377
DOI: 10.1542/hpeds.2020-0045 -
Scottish Medical Journal Nov 2020The first case of a novel coronavirus (COVID-19) infection was detected in Wuhan, fever and respiratory symptoms have been frequently reported in patients infected with...
BACKGROUND
The first case of a novel coronavirus (COVID-19) infection was detected in Wuhan, fever and respiratory symptoms have been frequently reported in patients infected with this virus.
AIM
It was aimed to compare the symptoms of patients with COVID-19 positivity and patients without COVID-19 positivity hospitalized with suspicion of COVID-19.
METHODS
Patients presenting to the Sakarya University Training and Research Hospital with suspicion of COVID-19 were included in the study. Samples were obtained from the patients and PCR tests were performed; the patients were grouped as COVID-19 positive and COVID-19 negative; these two groups were questioned for 15 symptoms and the results were compared.
RESULTS
A total of 297 patients with suspicion of COVID-19 were included in the study. COVID-19 was positive in 143 patients and negative in 154 patients. The most common symptoms in the COVID-19 positive group were: cough (56.6%), weakness (56.6%), taste disorder (35.7%), myalgia (34.3%), and fever (33.6%); and in the COVID-19 negative group: cough (63%), weakness (45.5%), dyspnea (29.9%), headache (27.3%) and fever (24.7%). When these two groups were compared, taste disorder, smell disorder and diarrhea were significantly higher in the COVID-19 positive group (p = <0,00001, p = 0,00001 and p = 0,02).
CONCLUSION
Our study showed that taste and smell disorders and diarrhea were important markers in COVID-19 infection.
Topics: Aged; Aged, 80 and over; Betacoronavirus; COVID-19; Coronavirus Infections; Cough; Diarrhea; Female; Fever; Hospitalization; Humans; Male; Middle Aged; Muscle Weakness; Myalgia; Olfaction Disorders; Pandemics; Pneumonia, Viral; Retrospective Studies; SARS-CoV-2; Symptom Assessment; Taste Disorders; Turkey
PubMed: 32807018
DOI: 10.1177/0036933020949253 -
World Journal of Gastroenterology Mar 2017() is a spore-forming, toxin-producing, gram-positive anaerobic bacterium that is the principal etiologic agent of antibiotic-associated diarrhea. Infection with (CDI)... (Review)
Review
() is a spore-forming, toxin-producing, gram-positive anaerobic bacterium that is the principal etiologic agent of antibiotic-associated diarrhea. Infection with (CDI) is characterized by diarrhea in clinical syndromes that vary from self-limited to mild or severe. Since its initial recognition as the causative agent of pseudomembranous colitis, has spread around the world. CDI is one of the most common healthcare-associated infections and a significant cause of morbidity and mortality among older adult hospitalized patients. Due to extensive antibiotic usage, the number of CDIs has increased. Diagnosis of CDI is often difficult and has a substantial impact on the management of patients with the disease, mainly with regards to antibiotic management. The diagnosis of CDI is primarily based on the clinical signs and symptoms and is only confirmed by laboratory testing. Despite the high burden of CDI and the increasing interest in the disease, episodes of CDI are often misdiagnosed. The reasons for misdiagnosis are the lack of clinical suspicion or the use of inappropriate tests. The proper diagnosis of CDI reduces transmission, prevents inadequate or unnecessary treatments, and assures best antibiotic treatment. We review the options for the laboratory diagnosis of CDI within the settings of the most accepted guidelines for CDI diagnosis, treatment, and prevention of CDI.
Topics: Algorithms; Anti-Bacterial Agents; Biomarkers; Clinical Laboratory Techniques; Clostridioides difficile; Clostridium Infections; Cross Infection; Diarrhea; Enterocolitis, Pseudomembranous; Glutamate Dehydrogenase; Hospitalization; Humans; Immunoenzyme Techniques; Practice Guidelines as Topic; Risk Factors
PubMed: 28321156
DOI: 10.3748/wjg.v23.i9.1552